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Nonprofiteer
← PALI MOMI FOUNDATION

Form 990 for tax year 2023

Filed by PALI MOMI FOUNDATION.

Totals

Total revenue
$1,275,961
Total expenses
$1,963,413
Contributions and grants received
$1,241,047
Grants paid
$1,329,024
Program service revenue
$0
Investment income
$34,914
Other revenue
$0
Total assets, end of year
$1,202,821
Total liabilities, end of year
$221,048
Net assets or fund balances, end of year
$981,773
Program services expenses (Part IX)
$1,486,004
Management and general expenses
$271,013
Fundraising expenses
$206,396
Program service expenses (Part III)
$1,486,004

Program services were 75.7% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1e · Government grants (contributions)

    $81,371

  • 1f · All other contributions, gifts and grants

    $1,159,676

  • 1g · Noncash contributions included above

    $8,310

  • 2f · All other program service revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 3 · Investment income

    total $34,918 · excluded $34,918

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 7a · Gross sales of assets other than inventory

    securities $2,251

  • 7b · Less cost or other basis and sales expenses

    securities $2,255

  • 7c · Gain or loss

    securities -$4 · other assets $0

  • 7d · Net gain or loss

    total -$4 · excluded -$4

  • 11d · All other revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $0

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $1,329,024 · program services $1,329,024

  • 4 · Benefits paid to or for members

    total $0 · program services $0

  • 11c · Fees: accounting

    total $12,558 · management and general $12,558

  • 11g · Fees: other

    total $431,441 · program services $156,980 · management and general $192,200 · fundraising $82,261

  • 12 · Advertising and promotion

    total $2,942 · fundraising $2,942

  • 13 · Office expenses

    total $6,360 · management and general $3,838 · fundraising $2,522

  • 14 · Information technology

    total $24,669 · fundraising $24,669

  • 16 · Occupancy

    total $18,980 · fundraising $18,980

  • 17 · Travel

    total $12,040 · fundraising $12,040

  • 19 · Conferences, conventions and meetings

    total $901 · fundraising $901

  • 23 · Insurance

    total $9,656 · management and general $9,656

  • 24a · Other expenses: CORPORATE ALLOCATION

    total $52,761 · management and general $52,761

  • 24b · Other expenses: PRINTING & DESIGN SERVICES

    total $55,583 · fundraising $55,583

  • 24c · Other expenses: DUES

    total $1,752 · fundraising $1,752

  • 24d · Other expenses: SUBSCRIPTION

    total $4,692 · fundraising $4,692

  • 24e · All other expenses

    total $54 · program services $0 · management and general $0 · fundraising $54

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $0 · end of year $0

  • 2 · Savings and temporary cash investments

    beginning of year $1,241,699 · end of year $212,547

  • 3 · Pledges and grants receivable

    beginning of year $163,138 · end of year $312,795

  • 4 · Accounts receivable

    beginning of year $0 · end of year $0

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 7 · Other notes and loans receivable

    beginning of year $0 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $0 · end of year $0

  • 9 · Prepaid expenses and deferred charges

    beginning of year $0 · end of year $0

  • 10a · Land, buildings and equipment: cost or other basis

    $0

  • 10b · Land, buildings and equipment: accumulated depreciation

    $0

  • 10c · Land, buildings and equipment, net

    beginning of year $0 · end of year $0

  • 11 · Investments: publicly traded securities

    beginning of year $113,367 · end of year $135,677

  • 12 · Investments: other securities

    beginning of year $191,354 · end of year $229,274

  • 13 · Investments: program-related

    beginning of year $234,660 · end of year $234,660

  • 14 · Intangible assets

    beginning of year $0 · end of year $0

  • 15 · Other assets

    beginning of year $92,559 · end of year $77,868

  • 17 · Accounts payable and accrued expenses

    beginning of year $34,115 · end of year $42,730

  • 18 · Grants payable

    beginning of year $0 · end of year $0

  • 19 · Deferred revenue

    beginning of year $0 · end of year $0

  • 20 · Tax-exempt bond liabilities

    beginning of year $0 · end of year $0

  • 21 · Escrow or custodial account liability

    beginning of year $0 · end of year $0

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 23 · Secured mortgages and notes payable

    beginning of year $0 · end of year $0

  • 24 · Unsecured notes and loans payable

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $261,214 · end of year $178,318

  • 27 · Net assets without donor restrictions

    beginning of year -$3,311,726 · end of year -$3,932,334

  • 28 · Net assets with donor restrictions

    beginning of year $5,053,174 · end of year $4,914,107

  • 29 · Capital stock, trust principal or current funds

    beginning of year $0 · end of year $0

  • 30 · Paid-in or capital surplus, or land, building or equipment fund

    beginning of year $0 · end of year $0

  • 31 · Retained earnings, endowment or other funds

    beginning of year $0 · end of year $0

Mission and programs · 2023

Mission

THE MISSION OF PALI MOMI FOUNDATION IS TO CREATE A HEALTHIER HAWAI'I.

  • SEE SCHEDULE O

    Expenses $1,486,004 · Grants $1,329,024

As filed on the 2023 return.

Listed in Part VII

  • Aaron Akau

    Board of Director, Vice Chair

    Total calculated
    $0
    Hours/week
    0.1

  • Keith Horita

    Board of Director, Vice Chair (PART YEAR)

    Total calculated
    $0
    Hours/week
    0.1

  • Michele Otake

    Board of Director, Chair

    Total calculated
    $0
    Hours/week
    0.1

  • Daniel Arita

    Board of Director

    Total calculated
    $0
    Hours/week
    0.1

  • Darryl Turner

    Board of Director

    Total calculated
    $0
    Hours/week
    0.1

  • James Lai MD

    Board of Director

    Total calculated
    $0
    Hours/week
    0.1

  • Luke Yeh

    Board of Director

    Total calculated
    $0
    Hours/week
    0.1

  • Mike Lam

    Board of Director

    Total calculated
    $0
    Hours/week
    0.1

  • Raymond P Vara Jr

    Board of Director

    Total calculated
    $4,411,352
    From this org
    $0
    From related orgs
    $2,464,885
    Other
    $1,946,467
    Hours/week
    0.1 + 62 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,231,412 related
    Bonus
    $0 + $505,774 related
    Other
    $0 + $727,699 related
    Deferred
    $0 + $1,923,428 related
    Nontaxable benefits
    $0 + $23,039 related
    Filer's total
    $0 + $4,411,352 related

  • Stacy Philippou

    Board of Director

    Total calculated
    $0
    Hours/week
    0.1

  • Susan Utsugi

    Board of Director

    Total calculated
    $0
    Hours/week
    0.1

  • Wade Gesteuyala

    Board of Director

    Total calculated
    $0
    Hours/week
    0.1

  • Carrie Ann Tsutsui

    Assistant Treasurer

    Total calculated
    $386,410
    From this org
    $0
    From related orgs
    $307,290
    Other
    $79,120
    Hours/week
    0.1 + 48.3 related

    Schedule J breakdown matched by us

    Base
    $0 + $239,446 related
    Bonus
    $0 + $42,745 related
    Other
    $0 + $25,099 related
    Deferred
    $0 + $67,840 related
    Nontaxable benefits
    $0 + $11,280 related
    Filer's total
    $0 + $386,410 related

  • Charles R Ching

    Secretary

    Total calculated
    $1,125,301
    From this org
    $0
    From related orgs
    $830,806
    Other
    $294,495
    Hours/week
    0.1 + 39.9 related

    Schedule J breakdown matched by us

    Base
    $0 + $474,538 related
    Bonus
    $0 + $139,662 related
    Other
    $0 + $216,606 related
    Deferred
    $0 + $278,322 related
    Nontaxable benefits
    $0 + $16,173 related
    Filer's total
    $0 + $1,125,301 related

  • David Okabe

    Treasurer

    Total calculated
    $1,548,574
    From this org
    $0
    From related orgs
    $1,124,153
    Other
    $424,421
    Hours/week
    0.1 + 49.9 related

    Schedule J breakdown matched by us

    Base
    $0 + $601,227 related
    Bonus
    $0 + $206,576 related
    Other
    $0 + $316,350 related
    Deferred
    $0 + $408,248 related
    Nontaxable benefits
    $0 + $16,173 related
    Filer's total
    $0 + $1,548,574 related

  • Dawn Dunbar

    President

    Total calculated
    $552,162
    From this org
    $0
    From related orgs
    $432,600
    Other
    $119,562
    Hours/week
    5 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $313,399 related
    Bonus
    $0 + $74,859 related
    Other
    $0 + $44,342 related
    Deferred
    $0 + $94,230 related
    Nontaxable benefits
    $0 + $25,332 related
    Filer's total
    $0 + $552,162 related

  • Jessica Lewis

    Assistant Secretary

    Total calculated
    $229,658
    From this org
    $0
    From related orgs
    $183,999
    Other
    $45,659
    Hours/week
    0.5 + 39.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $176,275 related
    Bonus
    $0 + $5,000 related
    Other
    $0 + $2,724 related
    Deferred
    $0 + $18,051 related
    Nontaxable benefits
    $0 + $27,608 related
    Filer's total
    $0 + $229,658 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
THE ORGANIZATION'S PRESIDENT IS PAID BY ITS TAX EXEMPT PARENT, HAWAI'I PACIFIC HEALTH ('HPH'), AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, FORM 990, PART VI, LINE 15A FOR THE PROCESS USED BY HPH TO DETERMINE COMPENSATION.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THE RESTORATION PLAN WAS DESIGNED TO RESTORE BENEFITS THAT ARE LOST DUE TO LIMITS IMPOSED BY SECTIONS 401 AND 415 OF THE INTERNAL REVENUE CODE ON COMPENSATION CONSIDERED UNDER SUCH PLANS. AMOUNTS PAID OUT BY RELATED ORGANIZATIONS: RAYMOND P. VARA JR. - $307,960 DAVID OKABE - $114,710 CHARLES R. CHING - $77,492 ANNUAL INCENTIVE PLAN THE ANNUAL INCENTIVE PLANS ARE AFFORDED TO EXECUTIVES BASED ON ANNUAL SYSTEM GOALS THAT ARE NOT BASED ON A PERCENTAGE OF NET EARNINGS. AMOUNTS PAID OUT BY RELATED ORGANIZATIONS: RAYMOND P. VARA JR. - $505,774 DAVID OKABE - $176,576 CARRIE ANN TSUTSUI - $42,745 CHARLES R. CHING - $139,662 DAWN DUNBAR - $74,859 RETENTION INCENTIVE PLAN THE RETENTION INCENTIVE PLAN WAS DESIGNED TO ENCOURAGE CONTINUED INTEREST IN THE SUCCESS OF THE ORGANIZATION AND PROVIDE COMPETITIVE RETIREMENT BENEFITS. THE SOLE PLAN PARTICIPANT IS HAWAI'I PACIFIC HEALTH'S CHIEF EXECUTIVE OFFICER, RAYMOND P. VARA JR. THE PLAN DOES NOT REPLACE THE ANNUAL AND LONG-TERM INCENTIVE PLAN NOR THE SERP RESTORATION PLAN. AMOUNTS PAID OUT DURING THE YEAR BY A RELATED ORGANIZATION: RAYMOND P. VARA JR. - $500,000

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

Provenance

Return type
form_990
Tax year
2023
Filed
15 May 2025
IRS schema version
2023v6.0
Source object
202531359349308348

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