SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2016
Open to Public
Inspection
Name of the organization
Lutheran Community Services Northwest
 
Employer identification number

93-0386860
Return Reference Explanation
Form 99, Part I, Line 6: Volunteers are an essential part of LCSNW, providing over 150,000 hours of service per year and helping LCSNW maintain a valuable community connection.
Form 990, Part VI, Section A, line 6 The corporation has five members with voting rights. The membership consists of the following entities or their successors in interest: (a) Northwest District of the Lutheran Church Missouri Synod; (b) Oregon Synod of the Evangelical Lutheran Church in America; (c) Northwest Washington Synod of the Evangelical Lutheran Church in America; (d) Southwestern Washington Synod of the Evangelical Lutheran Church in America; and (e) Eastern Washington-Idaho Synod of the Evangelical Lutheran Church in America.
Form 990, Part VI, Section A, line 7a The bishop or president of the five members serves as ex-officio, non-voting member of the board, and each appoints one representative to the Board of Directors. If an appointed position becomes vacant, the member who appointed the representative will appoint a new director. Also, a member may remove any director appointed by such member.
Form 990, Part VI, Section B, line 11b Management reviewed the Form 990 and provided the Board of Directors with a copy before filing the form with the IRS.
Form 990, Part VI, Section B, line 12c The Board of Directors annually signs and reaffirms the Board Code of Conduct, which includes a section on conflict of interest. All employees are also covered by the agency's Conflict of Interest Policy. If a conflict of interest is identified, the President/CEO evaluates the conflict. In the event a board member or employee is found to have a conflict of interest, the board member or employee must recuse himself/herself from discussing or voting on the issue.
Form 990, Part VI, Section B, line 15 In this fiscal year, we determined that a revision to our compensation review practices was necessary given changes in the markets in which we operate. During this fiscal year, we began a consulting effort with a third party, external, compensation expert to review our entire structure. The study will be completed and implemented in the following fiscal year. The last compensation review was performed in December 2015.
Form 990, Part VI, Section C, line 19 The agency includes summarized year-end financial information in its annual report, which is mailed to donors and is also available on the Agency's website. Governing documents and the conflict of interest policy can be made available to the public upon request.
Form 990, Part XI, line 9: Uncollectible pledges -6,000.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2016


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