LH 2018 990

KATHY PLOCH, CPA
P O BOX 820182
HOUSTON, TX 77282-0182
(832) 230-0967
kmploch@gmail.com
July 14, 2019
The Lazarus House A Center for Wellness

4106 Austin St.
Houston, TX 77004
Dear Danielle,
Enclosed is the 2018 U.S. Form 990, Return of Organization Exempt from Income Tax, for The
Lazarus House A Center for Wellness for the tax year ending December 31, 2018.
Your 2018 U.S. Form 990, Return of Organization Exempt from Income Tax, return will be
electronically filed.
We very much appreciate the opportunity to serve you. If you have any questions regarding this
return, please do not hesitate to call.
Sincerely,
KATHY PLOCH
990 Return of Organization Exempt From Income Tax
OMB No. 1545-0047
2018
Form
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
a Do not enter social security numbers on this form as it may be made public.
Department of the Treasury
Open to Public
Internal Revenue Service a Go to www.irs.gov/Form990 for instructions and the latest information. Inspection
A For the 2018 calendar year, or tax year beginning , 2018, and ending , 20
B Check if applicable: C Name of organization The Lazarus House A Center for Wellness D Employer identification number
Address change Doing business as 76-0693417
Name change Number and street (or P.O. box if mail is not delivered to street address) Room/suite E Telephone number
Initial return 4106 Austin St. (713)526-5071
Final return/terminated City or town, state or province, country, and ZIP or foreign postal code
Amended return Houston, TX 77004 G Gross receipts $ 334,378.

Application pending F Name and address of principal officer: H(a) Is this a group return for subordinates? Yes No
Danielle Sampey, 4106 Austin, Houston, TX 77004 H(b) Are all subordinates included? Yes No
I Tax-exempt status: 501(c)(3) 501(c) ( ) ` (insert no.) 4947(a)(1) or 527 If “No,” attach a list. (see instructions)
J Website: a www.thelazarushouse.org H(c) Group exemption number a
K Form of organization: Corporation Trust Association Other a L Year of formation: 2003 M State of legal domicile: TX
Part I Summary
1 Briefly describe the organization’s mission or most significant activities: The Lazarus House is dedicated to
Activities & Governance
decreasing & limiting the effects of disease related wasting cachexia,

through low cost services of wellness, nutrition & support in a non
2 Check this box a if the organization discontinued its operations or disposed of more than 25% of its net assets.
3 Number of voting members of the governing body (Part VI, line 1a) . . . . . . . . . 3 6
4 Number of independent voting members of the governing body (Part VI, line 1b) . . . . 4 6
5 Total number of individuals employed in calendar year 2018 (Part V, line 2a) . . . . . 5 10
6 Total number of volunteers (estimate if necessary) . . . . . . . . . . . . . . 6 50
7a Total unrelated business revenue from Part VIII, column (C), line 12 . . . . . . . . 7a 0.
b Net unrelated business taxable income from Form 990-T, line 38 . . . . . . . . . 7b 0.
Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) . . . . . . . . . . . . 91,479. 235,708.
Revenue
9 Program service revenue (Part VIII, line 2g) . . . . . . . . . . . 57,689. 52,630.

10 Investment income (Part VIII, column (A), lines 3, 4, and 7d) . . . . . . 123. 240.
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) . . . 46,477. 39,606.
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 195,768. 328,184.
13 Grants and similar amounts paid (Part IX, column (A), lines 1–3) . . . . .
14 Benefits paid to or for members (Part IX, column (A), line 4) . . . . . .
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 163,480. 173,127.
Expenses
16a Professional fundraising fees (Part IX, column (A), line 11e) . . . . . .
b Total fundraising expenses (Part IX, column (D), line 25) a 0.
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e) . . . . . 44,339. 49,632.
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) . 207,819. 222,759.
19 Revenue less expenses. Subtract line 18 from line 12 . . . . . . . . -12,051. 105,425.
Beginning of Current Year End of Year
Fund Balances
Net Assets or
20 Total assets (Part X, line 16) . . . . . . . . . . . . . . . . 383,134. 480,824.

21 Total liabilities (Part X, line 26) . . . . . . . . . . . . . . . . 166,334. 158,293.
22 Net assets or fund balances. Subtract line 21 from line 20 . . . . . . 216,800. 322,531.
Part II Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is
true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
FF
07/15/2019
Sign Signature of officer Date
Here Danielle Sampey, Executive Director
Type or print name and title
Print/Type preparer’s name Preparer's signature Date PTIN
Paid Check if
Preparer KATHY PLOCH P00158545
self-employed
Use Only Firm’s name a KATHY PLOCH, CPA Firm’s EIN 46-0830510
a
Firm’s address a P O BOX 820182, HOUSTON, TX 77282-0182 Phone no. (832)230-0967

May the IRS discuss this return with the preparer shown above? (see instructions) . . . . . . . . . . . . Yes No
For Paperwork Reduction Act Notice, see the separate instructions. BAA REV 05/20/19 PRO Form 990 (2018)
Form 990 (2018) Page 2
Part III Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III . . . . . . . . . . . . .
1 Briefly describe the organization’s mission:
The Lazarus House is dedicated to
decreasing & limiting the effects of disease related wasting cachexia,
through low cost services of wellness, nutrition & support in a non
2 Did the organization undertake any significant program services during the year which were not listed on the
prior Form 990 or 990-EZ? . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
If “Yes,” describe these new services on Schedule O.
3 Did the organization cease conducting, or make significant changes in how it conducts, any program
services? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
If “Yes,” describe these changes on Schedule O.
4 Describe the organization’s program service accomplishments for each of its three largest program services, as measured by
expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others,
the total expenses, and revenue, if any, for each program service reported.
4a (Code: ) (Expenses $ 185,327. including grants of $ 0. ) (Revenue $ 52,630. )

Wellness Program: Provided a low cost program of wellness for individuals
suffering from disease related muscle loss, or cachexia. We provided an
exercise program that utilized progressive resistance training to address &
attenuate disease related muscle loss, cardiopulmonary training to increase
endurance & address dysmorphic issues associated with some medications,
& nutritional counseling to encourage optimal muscle growth. Certified personal trainers
provided researched & disease specific exercise training session. Progress
was documenteed through a series of measurements taken before initiation,
at 6 weeks, & upon completion. Measurements demonstrated that clients, on
average, gained muscle & reflected a decrease in muscular wasting. We
See Part III, Ln 4a statement
4b (Code: ) (Expenses $ 0. including grants of $ 0. ) (Revenue $ 0. )

Provided lectures for community organizations, free of charge, offering
information about exercise and disease related wasting.
4c (Code: ) (Expenses $ including grants of $ ) (Revenue $ )
4d Other program services (Describe in Schedule O.)

(Expenses $ including grants of $ ) (Revenue $ )
4e Total program service expenses a 185,327.
REV 05/20/19 PRO Form 990 (2018)
Form 990 (2018) Page 3
Part IV Checklist of Required Schedules
Yes No
1 Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,”
complete Schedule A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? . . . 2
3 Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to
candidates for public office? If “Yes,” complete Schedule C, Part I . . . . . . . . . . . . . . 3
4 Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h)
election in effect during the tax year? If “Yes,” complete Schedule C, Part II . . . . . . . . . . . 4
5 Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues,
assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III 5
6 Did the organization maintain any donor advised funds or any similar funds or accounts for which donors
have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If
“Yes,” complete Schedule D, Part I . . . . . . . . . . . . . . . . . . . . . . . . 6
7 Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If “Yes,” complete Schedule D, Part II . . . 7
8 Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,”
complete Schedule D, Part III . . . . . . . . . . . . . . . . . . . . . . . . . . 8
9 Did the organization report an amount in Part X, line 21, for escrow or custodial account liability, serve as a
custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or
debt negotiation services? If “Yes,” complete Schedule D, Part IV . . . . . . . . . . . . . . 9
10 Did the organization, directly or through a related organization, hold assets in temporarily restricted
endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part V . . 10
11 If the organization’s answer to any of the following questions is “Yes,” then complete Schedule D, Parts VI,
VII, VIII, IX, or X as applicable.
a Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If “Yes,”
complete Schedule D, Part VI . . . . . . . . . . . . . . . . . . . . . . . . . . 11a
b Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more
of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII . . . . . . . . 11b
c Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more
of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII . . . . . . . . 11c
d Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets
reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX . . . . . . . . . . . . . . 11d
e Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X 11e
f Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses
the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X 11f
12a Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete
Schedule D, Parts XI and XII . . . . . . . . . . . . . . . . . . . . . . . . . . . 12a
b Was the organization included in consolidated, independent audited financial statements for the tax year? If
“Yes,” and if the organization answered “No” to line 12a, then completing Schedule D, Parts XI and XII is optional 12b
13 Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E . . . . 13
14a Did the organization maintain an office, employees, or agents outside of the United States? . . . . . 14a
b Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking,
fundraising, business, investment, and program service activities outside the United States, or aggregate
foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Parts I and IV . . . . . 14b
15 Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or
for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV . . . . . . . . . . . 15
16 Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other
assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV. . . . . . . . 16
17 Did the organization report a total of more than $15,000 of expenses for professional fundraising services on
Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I (see instructions) . . . . . 17
18 Did the organization report more than $15,000 total of fundraising event gross income and contributions on
Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II . . . . . . . . . . . . . . . 18
19 Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a?
If “Yes,” complete Schedule G, Part III . . . . . . . . . . . . . . . . . . . . . . . 19
20 a Did the organization operate one or more hospital facilities? If “Yes,” complete Schedule H . . . . . . 20a
b If “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this return? . 20b
21 Did the organization report more than $5,000 of grants or other assistance to any domestic organization or
domestic government on Part IX, column (A), line 1? IfREV“Yes,” complete
05/20/19 PRO Schedule I, Parts I and II . . . . 21
Form 990 (2018)
Form 990 (2018) Page 4
Part IV Checklist of Required Schedules (continued)
Yes No
22 Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on
Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III . . . . . . . . . . . . 22
23 Did the organization answer “Yes” to Part VII, Section A, line 3, 4, or 5 about compensation of the
organization’s current and former officers, directors, trustees, key employees, and highest compensated
employees? If “Yes,” complete Schedule J . . . . . . . . . . . . . . . . . . . . . . 23
24a Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than
$100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b
through 24d and complete Schedule K. If “No,” go to line 25a . . . . . . . . . . . . . . . 24a
b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception? . . 24b
c Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? . . . . . . . . . . . . . . . . . . . . . . . . 24c
d Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year? . . 24d
25a Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit
transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I . . . . . 25a
b Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior
year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ?
If “Yes,” complete Schedule L, Part I . . . . . . . . . . . . . . . . . . . . . . . . 25b
26 Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any
current or former officers, directors, trustees, key employees, highest compensated employees, or
disqualified persons? If “Yes,” complete Schedule L, Part II . . . . . . . . . . . . . . . . 26
27 Did the organization provide a grant or other assistance to an officer, director, trustee, key employee,
substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled
entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III . . . . . . . 27
28 Was the organization a party to a business transaction with one of the following parties (see Schedule L,
Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV . . 28a
b A family member of a current or former officer, director, trustee, or key employee? If “Yes,” complete
Schedule L, Part IV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28b
c An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof)
was an officer, director, trustee, or direct or indirect owner? If “Yes,” complete Schedule L, Part IV . . . 28c
29 Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M 29
30 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified
conservation contributions? If “Yes,” complete Schedule M . . . . . . . . . . . . . . . . 30
31 Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N, Part I 31
32 Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,”
complete Schedule N, Part II . . . . . . . . . . . . . . . . . . . . . . . . . . 32
33 Did the organization own 100% of an entity disregarded as separate from the organization under Regulations
sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I . . . . . . . . . . . 33
34 Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Part II, III,
or IV, and Part V, line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
35a Did the organization have a controlled entity within the meaning of section 512(b)(13)? . . . . . . . 35a
b If “Yes” to line 35a, did the organization receive any payment from or engage in any transaction with a
controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2 . . 35b
36 Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable
related organization? If “Yes,” complete Schedule R, Part V, line 2 . . . . . . . . . . . . . . 36
37 Did the organization conduct more than 5% of its activities through an entity that is not a related organization
and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VI 37
38 Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and
19? Note. All Form 990 filers are required to complete Schedule O. 38
Part V Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V . . . . . . . . . . . . .
Yes No
1a Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable . . . . 1a 0
b Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable . . . . 1b 0
c Did the organization comply with backup withholding rules for reportable payments to vendors and
reportable gaming (gambling) winnings to prize winners? . . . . . . . . . . . . . . . . . 1c
REV 05/20/19 PRO Form 990 (2018)
Form 990 (2018) Page 5
Part V Statements Regarding Other IRS Filings and Tax Compliance (continued)
Yes No
2a Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax
Statements, filed for the calendar year ending with or within the year covered by this return 2a 10
b If at least one is reported on line 2a, did the organization file all required federal employment tax returns? . 2b
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions) . .
3a Did the organization have unrelated business gross income of $1,000 or more during the year? . . . . 3a
b If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O . . 3b
4a At any time during the calendar year, did the organization have an interest in, or a signature or other authority over,
a financial account in a foreign country (such as a bank account, securities account, or other financial account)? 4a
b If “Yes,” enter the name of the foreign country: a
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? . . . 5a
b Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction? 5b
c If “Yes” to line 5a or 5b, did the organization file Form 8886-T? . . . . . . . . . . . . . . . 5c
6a Does the organization have annual gross receipts that are normally greater than $100,000, and did the
organization solicit any contributions that were not tax deductible as charitable contributions? . . . . . 6a
b If “Yes,” did the organization include with every solicitation an express statement that such contributions or
gifts were not tax deductible? . . . . . . . . . . . . . . . . . . . . . . . . . . 6b
7 Organizations that may receive deductible contributions under section 170(c).
a Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods
and services provided to the payor? . . . . . . . . . . . . . . . . . . . . . . . . 7a
b If “Yes,” did the organization notify the donor of the value of the goods or services provided? . . . . . 7b
c Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was
required to file Form 8282? . . . . . . . . . . . . . . . . . . . . . . . . . . . 7c
d If “Yes,” indicate the number of Forms 8282 filed during the year . . . . . . . . 7d
e Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? 7e
f Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? . 7f
g If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? 7g
h If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? 7h
8 Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the
sponsoring organization have excess business holdings at any time during the year? . . . . . . . . 8
9 Sponsoring organizations maintaining donor advised funds.
a Did the sponsoring organization make any taxable distributions under section 4966? . . . . . . . . 9a
b Did the sponsoring organization make a distribution to a donor, donor advisor, or related person? . . . 9b
10 Section 501(c)(7) organizations. Enter:
a Initiation fees and capital contributions included on Part VIII, line 12 . . . . . . . 10a
b Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities . 10b
11 Section 501(c)(12) organizations. Enter:
a Gross income from members or shareholders . . . . . . . . . . . . . . . 11a
b Gross income from other sources (Do not net amounts due or paid to other sources
against amounts due or received from them.) . . . . . . . . . . . . . . . 11b
12a Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041? 12a
b If “Yes,” enter the amount of tax-exempt interest received or accrued during the year . . 12b
13 Section 501(c)(29) qualified nonprofit health insurance issuers.
a Is the organization licensed to issue qualified health plans in more than one state? . . . . . . . . 13a
Note. See the instructions for additional information the organization must report on Schedule O.
b Enter the amount of reserves the organization is required to maintain by the states in which
the organization is licensed to issue qualified health plans . . . . . . . . . . 13b
c Enter the amount of reserves on hand . . . . . . . . . . . . . . . . . 13c
14a Did the organization receive any payments for indoor tanning services during the tax year? . . . . . . 14a
b If “Yes,” has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O . 14b
15 Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment(s) during the year? . . . . . . . . . . . . . . . . . . . . 15
If "Yes," see instructions and file Form 4720, Schedule N.
16 Is the organization an educational institution subject to the section 4968 excise tax on net investment income? 16
If "Yes," complete Form 4720, Schedule O.
Form 990 (2018)
REV 05/20/19 PRO

Form 990 (2018) Page 6
Part VI Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No”
response to line 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI . . . . . . . . . . . . .
Section A. Governing Body and Management
Yes No
1a Enter the number of voting members of the governing body at the end of the tax year . . 1a 6
If there are material differences in voting rights among members of the governing body, or
if the governing body delegated broad authority to an executive committee or similar
committee, explain in Schedule O.
b Enter the number of voting members included in line 1a, above, who are independent . 1b 6
2 Did any officer, director, trustee, or key employee have a family relationship or a business relationship with
any other officer, director, trustee, or key employee? . . . . . . . . . . . . . . . . . . 2
3 Did the organization delegate control over management duties customarily performed by or under the direct
supervision of officers, directors, or trustees, or key employees to a management company or other person? . 3
4 Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? 4
5 Did the organization become aware during the year of a significant diversion of the organization’s assets? . 5
6 Did the organization have members or stockholders? . . . . . . . . . . . . . . . . . . 6
7a Did the organization have members, stockholders, or other persons who had the power to elect or appoint
one or more members of the governing body? . . . . . . . . . . . . . . . . . . . . 7a
b Are any governance decisions of the organization reserved to (or subject to approval by) members,
stockholders, or persons other than the governing body? . . . . . . . . . . . . . . . . . 7b
8 Did the organization contemporaneously document the meetings held or written actions undertaken during
the year by the following:
a The governing body? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8a
b Each committee with authority to act on behalf of the governing body? . . . . . . . . . . . . 8b
9 Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at
the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O . . . . . 9
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes No
10a Did the organization have local chapters, branches, or affiliates? . . . . . . . . . . . . . . 10a
b If “Yes,” did the organization have written policies and procedures governing the activities of such chapters,
affiliates, and branches to ensure their operations are consistent with the organization’s exempt purposes? 10b
11a Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? 11a
b Describe in Schedule O the process, if any, used by the organization to review this Form 990.
12a Did the organization have a written conflict of interest policy? If “No,” go to line 13 . . . . . . . . 12a
b Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? 12b
c Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,”
describe in Schedule O how this was done . . . . . . . . . . . . . . . . . . . . . . 12c
13 Did the organization have a written whistleblower policy? . . . . . . . . . . . . . . . . . 13
14 Did the organization have a written document retention and destruction policy? . . . . . . . . . 14
15 Did the process for determining compensation of the following persons include a review and approval by
independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a The organization’s CEO, Executive Director, or top management official . . . . . . . . . . . . 15a
b Other officers or key employees of the organization . . . . . . . . . . . . . . . . . . . 15b
If “Yes” to line 15a or 15b, describe the process in Schedule O (see instructions).
16a Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement
with a taxable entity during the year? . . . . . . . . . . . . . . . . . . . . . . . . 16a
b If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its
participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the
organization’s exempt status with respect to such arrangements? . . . . . . . . . . . . . . 16b
Section C. Disclosure
17 List the states with which a copy of this Form 990 is required to be filed a
18 Section 6104 requires an organization to make its Forms 1023 (1024 or 1024-A if applicable), 990, and 990-T (Section 501(c)
(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
Own website Another’s website Upon request Other (explain in Schedule O)
19 Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and
financial statements available to the public during the tax year.
20 State the name, address, and telephone number of the person who possesses the organization’s books and records a
Danielle Sampey, 4106 Austin, Houston, TX 77004 (713)526-5071
REV 05/20/19 PRO Form 990 (2018)
Form 990 (2018) Page 7
Part VII Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and
Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII . . . . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the
organization’s tax year.
• List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount of
compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.
• List all of the organization’s current key employees, if any. See instructions for definition of “key employee.”
• List the organization’s five current highest compensated employees (other than an officer, director, trustee, or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.
• List all of the organization’s former officers, key employees, and highest compensated employees who received more than
$100,000 of reportable compensation from the organization and any related organizations.
• List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.
List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(C)
Position
(A) (B) (D) (E) (F)
(do not check more than one
Name and Title Average box, unless person is both an Reportable Reportable Estimated
hours per officer and a director/trustee) compensation compensation from amount of
week (list any from related other
or director
Individual trustee
Institutional trustee
Officer
Key employee
employee
Highest compensated
Former
hours for the organizations compensation
related organization (W-2/1099-MISC) from the
organizations (W-2/1099-MISC) organization
below dotted and related
line) organizations
(1) Stacey Batiste 3.00

Treasurer 0. 0. 0.
(2) Ralais Harper 1.00
Director 0. 0. 0.
(3) David Gooding 3.00
Vice President 0. 0. 0.
(4) Julia Macias 3.00
Secretary 0. 0. 0.
(5) Melissa Wilson 0.00
Honorary Member 0. 0. 0.
(6) Kimberly Sparrow 1.00
Director 0. 0. 0.
(7) Danielle Sampy 40.00
Executive Director 43,258. 0. 0.
(8) Danielle Mulvihill 7.00
President 0. 0. 0.
(9)
(10)
(11)
(12)
(13)
(14)
REV 05/20/19 PRO Form 990 (2018)

Form 990 (2018) Page 8
Part VII Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(C)
Position
(A) (B) (D) (E) (F)
(do not check more than one
Name and title Average box, unless person is both an Reportable Reportable Estimated
hours per officer and a director/trustee) compensation compensation from amount of
week (list any from related other
or director
Individual trustee
Institutional trustee
Officer
Key employee
employee
Highest compensated
Former
hours for the organizations compensation
related organization (W-2/1099-MISC) from the
organizations (W-2/1099-MISC) organization
below dotted and related
line) organizations
(15)
(16)
(17)
(18)
(19)
(20)
(21)
(22)
(23)
(24)
(25)
1b Sub-total . . . . . . . . . . . . . . . . . . . . . a 43,258. 0. 0.
c Total from continuation sheets to Part VII, Section A . . . . . a
d Total (add lines 1b and 1c) . . . . . . . . . . . . . . . a 43,258. 0. 0.
2 Total number of individuals (including but not limited to those listed above) who received more than $100,000 of
reportable compensation from the organization a
Yes No
3 Did the organization list any former officer, director, or trustee, key employee, or highest compensated
employee on line 1a? If “Yes,” complete Schedule J for such individual . . . . . . . . . . . . 3
4 For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the
organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such
individual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
5 Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual
for services rendered to the organization? If “Yes,” complete Schedule J for such person . . . . . . 5
Section B. Independent Contractors
1 Complete this table for your five highest compensated independent contractors that received more than $100,000 of
compensation from the organization. Report compensation for the calendar year ending with or within the organization's tax
year.
(A) (B) (C)
Name and business address Description of services Compensation
2 Total number of independent contractors (including but not limited to those listed above) who
received more than $100,000 of compensation from the organization a
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Form 990 (2018) Page 9
Part VIII Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII . . . . . . . . . . . . .
(A) (B) (C) (D)
Total revenue Related or Unrelated Revenue
exempt business excluded from tax
function revenue under sections
revenue 512–514
1a
Contributions, Gifts, Grants
and Other Similar Amounts
Federated campaigns . . . 1a
b Membership dues . . . . 1b
c Fundraising events . . . . 1c
d Related organizations . . . 1d
e Government grants (contributions) 1e
f All other contributions, gifts, grants,
and similar amounts not included above 1f 235,708.
g Noncash contributions included in lines 1a–1f: $
h Total. Add lines 1a–1f . . . . . . . . . a 235,708.
Program Service Revenue
Business Code
2a Client fee 624100 52,630. 52,630. 0. 0.
b
c
d
e
f All other program service revenue .
g Total. Add lines 2a–2f . . . . . . . . . a 52,630.
3 Investment income (including dividends, interest,
and other similar amounts) . . . . . . . a 240. 0. 0. 240.
4 Income from investment of tax-exempt bond proceeds a
5 Royalties . . . . . . . . . . . . . a
(i) Real (ii) Personal
6a Gross rents . .
b Less: rental expenses
c Rental income or (loss)
d Net rental income or (loss) . . . . . . . a
(i) Securities (ii) Other
7a Gross amount from sales of
assets other than inventory
b Less: cost or other basis
and sales expenses .
c Gain or (loss) . .
d Net gain or (loss) . . . . . . . . . . a
Other Revenue
8a Gross income from fundraising

events (not including $
of contributions reported on line 1c).
See Part IV, line 18 . . . . . a 45,800.
b Less: direct expenses . . . . b 6,194.
c Net income or (loss) from fundraising events . a 39,606. 0. 39,606.
9a Gross income from gaming activities.
See Part IV, line 19 . . . . . a
b Less: direct expenses . . . . b
c Net income or (loss) from gaming activities . . a
10a Gross sales of inventory, less
returns and allowances . . . a
b Less: cost of goods sold . . . b
c Net income or (loss) from sales of inventory . . a
Miscellaneous Revenue Business Code
11a
b
c
d All other revenue . . . . .
e Total. Add lines 11a–11d . . . . . . . . a
12 Total revenue. See instructions . . . . . a 328,184. 52,630. 0. 39,846.
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Form 990 (2018) Page 10
Part IX Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).
Check if Schedule O contains a response or note to any line in this Part IX . . . . . . . . . . . . .
Do not include amounts reported on lines 6b, 7b, (A) (B) (C) (D)
Total expenses Program service Management and Fundraising
8b, 9b, and 10b of Part VIII. expenses general expenses expenses
1 Grants and other assistance to domestic organizations
and domestic governments. See Part IV, line 21 . .
2 Grants and other assistance to domestic
individuals. See Part IV, line 22 . . . . .
3 Grants and other assistance to foreign
organizations, foreign governments, and foreign
individuals. See Part IV, lines 15 and 16 . . .
4 Benefits paid to or for members . . . .
5 Compensation of current officers, directors,
trustees, and key employees . . . . .
6 Compensation not included above, to disqualified
persons (as defined under section 4958(f)(1)) and
persons described in section 4958(c)(3)(B) . . 43,258. 30,281. 12,977. 0.
7 Other salaries and wages . . . . . . 120,437. 113,454. 6,983. 0.
8 Pension plan accruals and contributions (include
section 401(k) and 403(b) employer contributions)
9 Other employee benefits . . . . . . .
10 Payroll taxes . . . . . . . . . . . 9,432. 6,305. 3,127. 0.
11 Fees for services (non-employees):
a Management . . . . . . . . . .
b Legal . . . . . . . . . . . . .
c Accounting . . . . . . . . . . . 500. 0. 500. 0.
d Lobbying . . . . . . . . . . . .
e Professional fundraising services. See Part IV, line 17
f Investment management fees . . . . .
g Other. (If line 11g amount exceeds 10% of line 25, column
(A) amount, list line 11g expenses on Schedule O.) . .
12 Advertising and promotion . . . . . . 67. 0. 67. 0.
13 Office expenses . . . . . . . . . 12,974. 0. 12,974. 0.
14 Information technology . . . . . . . 619. 619. 0. 0.
15 Royalties . . . . . . . . . . . .
16 Occupancy . . . . . . . . . . . 20,714. 20,714. 0. 0.
17 Travel . . . . . . . . . . . . .
18 Payments of travel or entertainment expenses
for any federal, state, or local public officials
19 Conferences, conventions, and meetings .
20 Interest . . . . . . . . . . . . 7,010. 7,010. 0. 0.
21 Payments to affiliates . . . . . . . .
22 Depreciation, depletion, and amortization . 1,928. 1,928. 0. 0.
23 Insurance . . . . . . . . . . . . 5,611. 4,807. 804. 0.
24 Other expenses. Itemize expenses not covered
above (List miscellaneous expenses in line 24e. If
line 24e amount exceeds 10% of line 25, column
(A) amount, list line 24e expenses on Schedule O.)
a Membership 209. 209. 0. 0.
b
c
d
e All other expenses
25 Total functional expenses. Add lines 1 through 24e 222,759. 185,327. 37,432. 0.
26 Joint costs. Complete this line only if the
organization reported in column (B) joint costs
from a combined educational campaign and
fundraising solicitation. Check here a if
following SOP 98-2 (ASC 958-720) . . . .
REV 05/20/19 PRO Form 990 (2018)
Form 990 (2018) Page 11
Part X Balance Sheet
Check if Schedule O contains a response or note to any line in this Part X . . . . . . . . . . . . .
(A) (B)
Beginning of year End of year
1 Cash—non-interest-bearing . . . . . . . . . . . . . . 149,066. 1 220,294.
2 Savings and temporary cash investments . . . . . . . . . . 2
3 Pledges and grants receivable, net . . . . . . . . . . . . 3
4 Accounts receivable, net . . . . . . . . . . . . . . . 4
5 Loans and other receivables from current and former officers, directors,
trustees, key employees, and highest compensated employees.
Complete Part II of Schedule L . . . . . . . . . . . . . 5
6 Loans and other receivables from other disqualified persons (as defined under section
4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and
sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary
organizations (see instructions). Complete Part II of Schedule L . . . . . .
Assets
6
7 Notes and loans receivable, net . . . . . . . . . . . . . 7
8 Inventories for sale or use . . . . . . . . . . . . . . . 8
9 Prepaid expenses and deferred charges . . . . . . . . . . 9
10a Land, buildings, and equipment: cost or
other basis. Complete Part VI of Schedule D 10a 298,887.
b Less: accumulated depreciation . . . . 10b 38,357. 234,068. 10c 260,530.
11 Investments—publicly traded securities . . . . . . . . . . 11
12 Investments—other securities. See Part IV, line 11 . . . . . . . 12
13 Investments—program-related. See Part IV, line 11 . . . . . . . 13
14 Intangible assets . . . . . . . . . . . . . . . . . . 14
15 Other assets. See Part IV, line 11 . . . . . . . . . . . . . 15
16 Total assets. Add lines 1 through 15 (must equal line 34) . . . . . 383,134. 16 480,824.
17 Accounts payable and accrued expenses . . . . . . . . . . 17
18 Grants payable . . . . . . . . . . . . . . . . . . . 18
19 Deferred revenue . . . . . . . . . . . . . . . . . . 19
20 Tax-exempt bond liabilities . . . . . . . . . . . . . . . 20
21 Escrow or custodial account liability. Complete Part IV of Schedule D . 21
Liabilities
22 Loans and other payables to current and former officers, directors,

trustees, key employees, highest compensated employees, and
disqualified persons. Complete Part II of Schedule L . . . . . . 22
23 Secured mortgages and notes payable to unrelated third parties . . 166,334. 23 158,293.
24 Unsecured notes and loans payable to unrelated third parties . . . 24
25 Other liabilities (including federal income tax, payables to related third
parties, and other liabilities not included on lines 17–24). Complete Part X
of Schedule D 25
26 Total liabilities. Add lines 17 through 25 . . . . . . . . . . 166,334. 26 158,293.
Organizations that follow SFAS 117 (ASC 958), check here a and
Net Assets or Fund Balances
complete lines 27 through 29, and lines 33 and 34.

27 Unrestricted net assets . . . . . . . . . . . . . . . . 27
28 Temporarily restricted net assets . . . . . . . . . . . . . 28
29 Permanently restricted net assets . . . . . . . . . . . . . 29
Organizations that do not follow SFAS 117 (ASC 958), check here a and
complete lines 30 through 34.
30 Capital stock or trust principal, or current funds . . . . . . . . 30
31 Paid-in or capital surplus, or land, building, or equipment fund . . . 31
32 Retained earnings, endowment, accumulated income, or other funds . 216,800. 32 322,531.
33 Total net assets or fund balances . . . . . . . . . . . . . 216,800. 33 322,531.
34 Total liabilities and net assets/fund balances . . . . . . . . . 383,134. 34 480,824.
Form 990 (2018)
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Form 990 (2018) Page 12
Part XI Reconciliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI . . . . . . . . . . . . .
1 Total revenue (must equal Part VIII, column (A), line 12) . . . . . . . . . . . . . . 1 328,184.
2 Total expenses (must equal Part IX, column (A), line 25) . . . . . . . . . . . . . 2 222,759.
3 Revenue less expenses. Subtract line 2 from line 1 . . . . . . . . . . . . . . . 3 105,425.
4 Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . . . 4 216,800.
5 Net unrealized gains (losses) on investments . . . . . . . . . . . . . . . . . 5
6 Donated services and use of facilities . . . . . . . . . . . . . . . . . . . 6
7 Investment expenses . . . . . . . . . . . . . . . . . . . . . . . . . 7
8 Prior period adjustments . . . . . . . . . . . . . . . . . . . . . . . . 8 306.
9 Other changes in net assets or fund balances (explain in Schedule O) . . . . . . . . . 9
10 Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line
33, column (B)) . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 322,531.
Part XII Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII . . . . . . . . . . . . .
Yes No
1 Accounting method used to prepare the Form 990: Cash Accrual Other
If the organization changed its method of accounting from a prior year or checked “Other,” explain in
Schedule O.
2a Were the organization’s financial statements compiled or reviewed by an independent accountant? . . . 2a
If “Yes,” check a box below to indicate whether the financial statements for the year were compiled or
reviewed on a separate basis, consolidated basis, or both:
Separate basis Consolidated basis Both consolidated and separate basis
b Were the organization’s financial statements audited by an independent accountant? . . . . . . . 2b
If “Yes,” check a box below to indicate whether the financial statements for the year were audited on a
separate basis, consolidated basis, or both:
Separate basis Consolidated basis Both consolidated and separate basis
c If “Yes” to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight
of the audit, review, or compilation of its financial statements and selection of an independent accountant? 2c
If the organization changed either its oversight process or selection process during the tax year, explain in
Schedule O.
3a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in
the Single Audit Act and OMB Circular A-133? . . . . . . . . . . . . . . . . . . . . . 3a
b If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the
required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. 3b
Form 990 (2018)
REV 05/20/19 PRO

The Lazarus House A Center for Wellness 76-0693417 1
Additional information from your Form 990: Return of Organization Exempt from Income Tax
Form 990: Return of Organization Exempt from Income Tax

Form 990, Page 2, Part III, Line 4a (continued) Continuation Statement
Description
worked with an average of 51 clients, adolescent & adults, three times
weekly in 2018. Clients presented with vary etiologies & degress of cachexia.
Disease related muscle loss addressed at The Lazarus House involved
clients who suffered from HIV/AIDS, cancer & spinal trauma.
OMB No. 1545-0047
SCHEDULE A Public Charity Status and Public Support
(Form 990 or 990-EZ)
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust. 2018
a Attach to Form 990 or Form 990-EZ.
Department of the Treasury Open to Public
Name of the organization Employer identification number
The Lazarus House A Center for Wellness 76-0693417
Part I Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
1 A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).
2 A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)
3 A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).
4 A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the
hospital’s name, city, and state:
5 An organization operated for the benefit of a college or university owned or operated by a governmental unit described in
section 170(b)(1)(A)(iv). (Complete Part II.)
6 A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).
7 An organization that normally receives a substantial part of its support from a governmental unit or from the general public
described in section 170(b)(1)(A)(vi). (Complete Part II.)
8 A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)
9 An agricultural research organization described in section 170(b)(1)(A)(ix) operated in conjunction with a land-grant college
or university or a non-land-grant college of agriculture (see instructions). Enter the name, city, and state of the college or
university:
10 An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its
support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
11 An organization organized and operated exclusively to test for public safety. See section 509(a)(4).
12 An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes
of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3).
Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.
a Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving
the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the
supporting organization. You must complete Part IV, Sections A and B.
b Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having
control or management of the supporting organization vested in the same persons that control or manage the supported
organization(s). You must complete Part IV, Sections A and C.
c Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with,
its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.
d Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s)
that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness
requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.
e Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III
functionally integrated, or Type III non-functionally integrated supporting organization.
f Enter the number of supported organizations . . . . . . . . . . . . . . . . . . . . . . .
g Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (iv) Is the organization (v) Amount of monetary (vi) Amount of
(described on lines 1–10 listed in your governing support (see other support (see
above (see instructions)) document? instructions) instructions)
Yes No
(A)
(B)
(C)
(D)
(E)
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. BAA Schedule A (Form 990 or 990-EZ) 2018
REV 10/24/18 PRO
Schedule A (Form 990 or 990-EZ) 2018 Page 2
Part II Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under
Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) a (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
1 Gifts, grants, contributions, and
membership fees received. (Do not
include any “unusual grants.”) . . . 98,091. 132,207. 115,207. 143,082. 235,708. 724,295.
2 Tax revenues levied for the
organization’s benefit and either paid
to or expended on its behalf . . .
3 The value of services or facilities
furnished by a governmental unit to the
organization without charge . . . .
4 Total. Add lines 1 through 3 . . . . 98,091. 132,207. 115,207. 143,082. 235,708. 724,295.
5 The portion of total contributions by
each person (other than a
governmental unit or publicly
supported organization) included on
line 1 that exceeds 2% of the amount
shown on line 11, column (f) . . . . 181,358.
6 Public support. Subtract line 5 from line 4 542,937.
Section B. Total Support
7 Amounts from line 4 . . . . . . 98,091. 132,207. 115,207. 143,082. 235,708. 724,295.
8 Gross income from interest, dividends,
payments received on securities loans,
rents, royalties, and income from
similar sources . . . . . . . . 0. 458. 458. 162. 240. 1,318.
9 Net income from unrelated business
activities, whether or not the business
is regularly carried on . . . . .
10 Other income. Do not include gain or
loss from the sale of capital assets
(Explain in Part VI.) . . . . . . .
11 Total support. Add lines 7 through 10 725,613.
12 Gross receipts from related activities, etc. (see instructions) . . . . . . . . . . . . 12
13 First five years. If the Form 990 is for the organization’s first, second, third, fourth, or fifth tax year as a section 501(c)(3)
organization, check this box and stop here . . . . . . . . . . . . . . . . . . . . . . . . . a
Section C. Computation of Public Support Percentage
14 Public support percentage for 2018 (line 6, column (f) divided by line 11, column (f)) . . . . 14 74.82 %
15 Public support percentage from 2017 Schedule A, Part II, line 14 . . . . . . . . . . 15 82.38 %
16a 331/3% support test—2018. If the organization did not check the box on line 13, and line 14 is 331/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization . . . . . . . . . . . . a
b 331/3% support test—2017. If the organization did not check a box on line 13 or 16a, and line 15 is 331/3% or more, check
this box and stop here. The organization qualifies as a publicly supported organization . . . . . . . . . . . a
17a 10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is
10% or more, and if the organization meets the “facts-and-circumstances” test, check this box and stop here. Explain in
Part VI how the organization meets the “facts-and-circumstances” test. The organization qualifies as a publicly supported
organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a
b 10%-facts-and-circumstances test—2017. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the “facts-and-circumstances” test, check this box and stop here.
Explain in Part VI how the organization meets the “facts-and-circumstances” test. The organization qualifies as a publicly
supported organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a
18 Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a
Schedule A (Form 990 or 990-EZ) 2018
REV 10/24/18 PRO

Part III Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II.
If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
1 Gifts, grants, contributions, and membership fees
received. (Do not include any “unusual grants.”)
2 Gross receipts from admissions, merchandise
sold or services performed, or facilities
furnished in any activity that is related to the
organization’s tax-exempt purpose . . .
3 Gross receipts from activities that are not an
unrelated trade or business under section 513
4 Tax revenues levied for the
organization’s benefit and either paid to
or expended on its behalf . . . .
5 The value of services or facilities
furnished by a governmental unit to the
organization without charge . . . .
6 Total. Add lines 1 through 5 . . . .
7a Amounts included on lines 1, 2, and 3
received from disqualified persons .
b Amounts included on lines 2 and 3
received from other than disqualified
persons that exceed the greater of $5,000
or 1% of the amount on line 13 for the year
c Add lines 7a and 7b . . . . . .
8 Public support. (Subtract line 7c from
line 6.) . . . . . . . . . . .
Section B. Total Support
9 Amounts from line 6 . . . . . .
10a Gross income from interest, dividends,
payments received on securities loans, rents,
royalties, and income from similar sources .
b Unrelated business taxable income (less
section 511 taxes) from businesses
acquired after June 30, 1975 . . . .
c Add lines 10a and 10b . . . . .
11 Net income from unrelated business
activities not included in line 10b, whether
or not the business is regularly carried on
12 Other income. Do not include gain or
loss from the sale of capital assets
(Explain in Part VI.) . . . . . . .
13 Total support. (Add lines 9, 10c, 11,
and 12.) . . . . . . . . . .
14 First five years. If the Form 990 is for the organization’s first, second, third, fourth, or fifth tax year as a section 501(c)(3)
organization, check this box and stop here . . . . . . . . . . . . . . . . . . . . . . . . . a
Section C. Computation of Public Support Percentage
15 Public support percentage for 2018 (line 8, column (f), divided by line 13, column (f)) . . . . . 15 %
16 Public support percentage from 2017 Schedule A, Part III, line 15 . . . . . . . . . . . 16 %
Section D. Computation of Investment Income Percentage
17 Investment income percentage for 2018 (line 10c, column (f), divided by line 13, column (f)) . . . 17 %
18 Investment income percentage from 2017 Schedule A, Part III, line 17 . . . . . . . . . . 18 %
19a 331/3% support tests—2018. If the organization did not check the box on line 14, and line 15 is more than 331/3%, and line
17 is not more than 331/3%, check this box and stop here. The organization qualifies as a publicly supported organization . a
b 331/3% support tests—2017. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 331/3%, and
line 18 is not more than 331/3%, check this box and stop here. The organization qualifies as a publicly supported organization a
20 Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions a
REV 10/24/18 PRO Schedule A (Form 990 or 990-EZ) 2018
Part IV Supporting Organizations
(Complete only if you checked a box in line 12 on Part I. If you checked 12a of Part I, complete Sections A
and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete
Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes No
1 Are all of the organization’s supported organizations listed by name in the organization’s governing
documents? If “No,” describe in Part VI how the supported organizations are designated. If designated by
class or purpose, describe the designation. If historic and continuing relationship, explain. 1
2 Did the organization have any supported organization that does not have an IRS determination of status
under section 509(a)(1) or (2)? If “Yes,” explain in Part VI how the organization determined that the supported
organization was described in section 509(a)(1) or (2). 2
3a Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If “Yes,” answer
(b) and (c) below. 3a
b Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and
satisfied the public support tests under section 509(a)(2)? If “Yes,” describe in Part VI when and how the
organization made the determination. 3b
c Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B)
purposes? If “Yes,” explain in Part VI what controls the organization put in place to ensure such use. 3c
4a Was any supported organization not organized in the United States (“foreign supported organization”)? If
“Yes,” and if you checked 12a or 12b in Part I, answer (b) and (c) below. 4a
b Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign
supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion
despite being controlled or supervised by or in connection with its supported organizations. 4b
c Did the organization support any foreign supported organization that does not have an IRS determination
under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used
to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B)
purposes. 4c
5a Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,”
answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN
numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action;
(iii) the authority under the organization’s organizing document authorizing such action; and (iv) how the action
was accomplished (such as by amendment to the organizing document). 5a
b Type I or Type II only. Was any added or substituted supported organization part of a class already
designated in the organization’s organizing document? 5b
c Substitutions only. Was the substitution the result of an event beyond the organization’s control? 5c
6 Did the organization provide support (whether in the form of grants or the provision of services or facilities) to
anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited
by one or more of its supported organizations, or (iii) other supporting organizations that also support or
benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI. 6
7 Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor
(as defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity
with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ). 7
8 Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7?
If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ). 8
9a Was the organization controlled directly or indirectly at any time during the tax year by one or more
disqualified persons as defined in section 4946 (other than foundation managers and organizations described
in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI. 9a
b Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which
the supporting organization had an interest? If “Yes,” provide detail in Part VI. 9b
c Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit
from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI. 9c
10a Was the organization subject to the excess business holdings rules of section 4943 because of section
4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated
supporting organizations)? If “Yes,” answer 10b below. 10a
b Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to
determine whether the organization had excess business holdings.) 10b
REV 10/24/18 PRO
Part IV Supporting Organizations (continued)
Yes No
11 Has the organization accepted a gift or contribution from any of the following persons?
a A person who directly or indirectly controls, either alone or together with persons described in (b) and (c)
below, the governing body of a supported organization? 11a
b A family member of a person described in (a) above? 11b
c A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI. 11c
Section B. Type I Supporting Organizations
Yes No
1 Did the directors, trustees, or membership of one or more supported organizations have the power to
regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the
tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or
controlled the organization’s activities. If the organization had more than one supported organization,
describe how the powers to appoint and/or remove directors or trustees were allocated among the supported
organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
2 Did the organization operate for the benefit of any supported organization other than the supported
organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part
VI how providing such benefit carried out the purposes of the supported organization(s) that operated,
supervised, or controlled the supporting organization. 2
Section C. Type II Supporting Organizations
Yes No
1 Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors
or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control
or management of the supporting organization was vested in the same persons that controlled or managed
the supported organization(s). 1
Section D. All Type III Supporting Organizations
Yes No
1 Did the organization provide to each of its supported organizations, by the last day of the fifth month of the
organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax
year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the
organization’s governing documents in effect on the date of notification, to the extent not previously provided? 1
2 Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported
organization(s) or (ii) serving on the governing body of a supported organization? If “No,” explain in Part VI how
the organization maintained a close and continuous working relationship with the supported organization(s). 2
3 By reason of the relationship described in (2), did the organization’s supported organizations have a
significant voice in the organization’s investment policies and in directing the use of the organization’s
income or assets at all times during the tax year? If “Yes,” describe in Part VI the role the organization’s
supported organizations played in this regard. 3
Section E. Type III Functionally Integrated Supporting Organizations
1 Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions).
a The organization satisfied the Activities Test. Complete line 2 below.
b The organization is the parent of each of its supported organizations. Complete line 3 below.
c The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions).
2 Activities Test. Answer (a) and (b) below. Yes No
a Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of
the supported organization(s) to which the organization was responsive? If “Yes,” then in Part VI identify
those supported organizations and explain how these activities directly furthered their exempt purposes,
how the organization was responsive to those supported organizations, and how the organization determined
that these activities constituted substantially all of its activities. 2a
b Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more
of the organization’s supported organization(s) would have been engaged in? If “Yes,” explain in Part VI the
reasons for the organization’s position that its supported organization(s) would have engaged in these
activities but for the organization’s involvement. 2b
3 Parent of Supported Organizations. Answer (a) and (b) below.
a Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or
trustees of each of the supported organizations? Provide details in Part VI. 3a
b Did the organization exercise a substantial degree of direction over the policies, programs, and activities of each
of its supported organizations? If “Yes,” describe in Part VI the role played by the organization in this regard. 3b
REV 10/24/18 PRO
Part V Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1 Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See
instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.
Section A—Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1
2 Recoveries of prior-year distributions 2
3 Other gross income (see instructions) 3
4 Add lines 1 through 3. 4
5 Depreciation and depletion 5
6 Portion of operating expenses paid or incurred for production or
collection of gross income or for management, conservation, or
maintenance of property held for production of income (see instructions) 6
7 Other expenses (see instructions) 7
8 Adjusted Net Income (subtract lines 5, 6, and 7 from line 4) 8
(B) Current Year
Section B—Minimum Asset Amount (A) Prior Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see
instructions for short tax year or assets held for part of year):
a Average monthly value of securities 1a
b Average monthly cash balances 1b
c Fair market value of other non-exempt-use assets 1c
d Total (add lines 1a, 1b, and 1c) 1d
e Discount claimed for blockage or other
factors (explain in detail in Part VI):
2 Acquisition indebtedness applicable to non-exempt-use assets 2
3 Subtract line 2 from line 1d. 3
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount,
see instructions). 4
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5
6 Multiply line 5 by .035. 6
7 Recoveries of prior-year distributions 7
8 Minimum Asset Amount (add line 7 to line 6) 8
Section C—Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1
2 Enter 85% of line 1. 2
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3
4 Enter greater of line 2 or line 3. 4
5 Income tax imposed in prior year 5
6 Distributable Amount. Subtract line 5 from line 4, unless subject to
emergency temporary reduction (see instructions). 6
7 Check here if the current year is the organization’s first as a non-functionally integrated Type III supporting organization (see
instructions).
REV 10/24/18 PRO

Part V Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
Section D—Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes

2 Amounts paid to perform activity that directly furthers exempt purposes of supported
organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions.
7 Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive
(provide details in Part VI). See instructions.
9 Distributable amount for 2018 from Section C, line 6
10 Line 8 amount divided by line 9 amount
(ii) (iii)
(i)
Section E—Distribution Allocations (see instructions) Underdistributions Distributable
Excess Distributions
Pre-2018 Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018
(reasonable cause required—explain in Part VI). See
instructions.
3 Excess distributions carryover, if any, to 2018
a From 2013 . . . . .
b From 2014 . . . . .
c From 2015 . . . . .
d From 2016 . . . . .
e From 2017 . . . . .
f Total of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4 Distributions for 2018 from
Section D, line 7: $
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if
any. Subtract lines 3g and 4a from line 2. For result
greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h
and 4b from line 1. For result greater than zero, explain in
Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j
and 4c.
8 Breakdown of line 7:
a Excess from 2014 . . .
b Excess from 2015 . . .
c Excess from 2016 . . .
d Excess from 2017 . . .
e Excess from 2018 . . .
REV 10/24/18 PRO

Part VI Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part
III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section
B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b,
3a, and 3b; Part V, line 1; Part V, Section B, line 1e; Part V, Section D, lines 5, 6, and 8; and Part V, Section E,
lines 2, 5, and 6. Also complete this part for any additional information. (See instructions.)
REV 10/24/18 PRO Schedule A (Form 990 or 990-EZ) 2018

Schedule B Schedule of Contributors OMB No. 1545-0047
(Form 990, 990-EZ,
or 990-PF)
a Attach
a Go
to Form 990, Form 990-EZ, or Form 990-PF.
to www.irs.gov/Form990 for the latest information.
2018
Internal Revenue Service
Organization type (check one):
Filers of: Section:
Form 990 or 990-EZ 501(c)( 3 ) (enter number) organization
4947(a)(1) nonexempt charitable trust not treated as a private foundation
527 political organization
Form 990-PF 501(c)(3) exempt private foundation
4947(a)(1) nonexempt charitable trust treated as a private foundation
501(c)(3) taxable private foundation
Check if your organization is covered by the General Rule or a Special Rule.

Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See
instructions.
General Rule
For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000
or more (in money or property) from any one contributor. Complete Parts I and II. See instructions for determining a
contributor’s total contributions.
Special Rules
For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 331/3% support test of the
regulations under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line
13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1)
$5,000; or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h; or (ii) Form 990-EZ, line 1. Complete Parts I and II.
For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one
contributor, during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific,
literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I (entering
“N/A” in column (b) instead of the contributor name and address), II, and III.
For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one
contributor, during the year, contributions exclusively for religious, charitable, etc., purposes, but no such
contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received
during the year for an exclusively religious, charitable, etc., purpose. Don’t complete any of the parts unless the
General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions
totaling $5,000 or more during the year . . . . . . . . . . . . . . . . . . a $
Caution: An organization that isn’t covered by the General Rule and/or the Special Rules doesn’t file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on its
Form 990-PF, Part I, line 2, to certify that it doesn’t meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the instructions for Form 990, 990-EZ, or 990-PF. REV 11/12/18 PRO Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
BAA
Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2
Name of organization Employer identification number
Part I Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) (b) (c) (d)
No. Name, address, and ZIP + 4 Total contributions Type of contribution
1 St. Anne Catholic Church Person

Payroll
2018 Westheimer $ 9,000. Noncash
(Complete Part II for
Houston TX 77098 noncash contributions.)
(a) (b) (c) (d)

2 Heimbinder Family Foundation Person

Payroll
1111 Hermann Dr. $ 25,000. Noncash
(a) (b) (c) (d)

3 Bunnies on the Bayou Person

Payroll
P. O. Box 66832 $ 11,000. Noncash
(a) (b) (c) (d)

4 Hollyfield Foundation Person

Payroll
P. O. Box 6672 $ 5,000. Noncash
(a) (b) (c) (d)

5 Cameron Foundation Person

Payroll
2001 Kirby Dr. Suite 1200 $ 10,000. Noncash
(a) (b) (c) (d)

6 Gary & Diane Heavin Person

Payroll
P. O. Box 7990 $ 25,000. Noncash
Waco TX 76714 noncash contributions.)
REV 11/12/18 PRO Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

BAA
Part I Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) (b) (c) (d)
7 Nordstrom Person
Payroll
1700 7th Avenue Suite 1000 $ 9,200. Noncash
Seattle WA 98101 noncash contributions.)
(a) (b) (c) (d)

8 Dearing Family Foundation Person

Payroll
310 Timberwilde Lane $ 100,000. Noncash
(a) (b) (c) (d)

Person
Payroll
$ Noncash
noncash contributions.)
(a) (b) (c) (d)

Person
Payroll
$ Noncash
(a) (b) (c) (d)

Person
Payroll
$ Noncash
(a) (b) (c) (d)

Person
Payroll
$ Noncash

BAA
Part II Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. (c)

(b) (d)
from FMV (or estimate)
Description of noncash property given Date received
Part I (See instructions.)
(a) No. (c)

(b) (d)
(a) No. (c)

(b) (d)
(a) No. (c)

(b) (d)
(a) No. (c)

(b) (d)
(a) No. (c)

(b) (d)

BAA
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or
(10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and
the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) a $
Use duplicate copies of Part III if additional space is needed.
(a) No.
from (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
Part I
(e) Transfer of gift

Transferee’s name, address, and ZIP + 4 Relationship of transferor to transferee
(a) No.
Part I

(a) No.
Part I

(a) No.
Part I


BAA
SCHEDULE D
Supplemental Financial Statements
OMB No. 1545-0047
(Form 990)
a Complete if the organization answered “Yes” on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
2018
Department of the Treasury a Attach to Form 990. Open to Public

Part I Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts.
Complete if the organization answered “Yes” on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year . . . . . . .
2 Aggregate value of contributions to (during year)
3 Aggregate value of grants from (during year) .
4 Aggregate value at end of year . . . . . .
5 Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization’s property, subject to the organization’s exclusive legal control? . . . . . . Yes No
6 Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used
only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose
conferring impermissible private benefit? . . . . . . . . . . . . . . . . . . . . . . Yes No
Part II Conservation Easements.
1 Purpose(s) of conservation easements held by the organization (check all that apply).
Preservation of land for public use (e.g., recreation or education) Preservation of a historically important land area
Protection of natural habitat Preservation of a certified historic structure
Preservation of open space
2 Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation
easement on the last day of the tax year. Held at the End of the Tax Year
a Total number of conservation easements . . . . . . . . . . . . . . . . . 2a
b Total acreage restricted by conservation easements . . . . . . . . . . . . . . 2b
c Number of conservation easements on a certified historic structure included in (a) . . . . 2c
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a
historic structure listed in the National Register . . . . . . . . . . . . . . . 2d
3 Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year a
4 Number of states where property subject to conservation easement is located a
5 Does the organization have a written policy regarding the periodic monitoring, inspection, handling of
violations, and enforcement of the conservation easements it holds? . . . . . . . . . . . . . Yes No
6 Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
a
7 Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
a$
8 Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i)
and section 170(h)(4)(B)(ii)? . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
9 In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes the
organization’s accounting for conservation easements.
Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
1a If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet
works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of
public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet
works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of
public service, provide the following amounts relating to these items:
(i) Revenue included on Form 990, Part VIII, line 1 . . . . . . . . . . . . . . . . a $
(ii) Assets included in Form 990, Part X . . . . . . . . . . . . . . . . . . . . a $
2 If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a Revenue included on Form 990, Part VIII, line 1 . . . . . . . . . . . . . . . . . a $
b Assets included in Form 990, Part X . . . . . . . . . . . . . . . . . . . . . a $
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule D (Form 990) 2018
REV 11/12/18 PRO
BAA
Schedule D (Form 990) 2018 Page 2
Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3 Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its
collection items (check all that apply):
a Public exhibition d Loan or exchange programs
b Scholarly research e Other
c Preservation for future generations
4 Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in Part
XIII.
5 During the year, did the organization solicit or receive donations of art, historical treasures, or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection? . . Yes No
Part IV Escrow and Custodial Arrangements.
Complete if the organization answered “Yes” on Form 990, Part IV, line 9, or reported an amount on Form
990, Part X, line 21.
1a Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
b If “Yes,” explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance . . . . . . . . . . . . . . . . . . . . . . 1c
d Additions during the year . . . . . . . . . . . . . . . . . . . 1d
e Distributions during the year . . . . . . . . . . . . . . . . . . 1e
f Ending balance . . . . . . . . . . . . . . . . . . . . . . . 1f
2a Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? Yes No
b If “Yes,” explain the arrangement in Part XIII. Check here if the explanation has been provided on Part XIII . . . .
Part V Endowment Funds.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance . . .
b Contributions . . . . . . .
c Net investment earnings, gains, and
losses . . . . . . . . . .
d Grants or scholarships . . . .
e Other expenditures for facilities and
programs . . . . . . . . .
f Administrative expenses . . . .
g End of year balance . . . . .
2 Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a Board designated or quasi-endowment a %
b Permanent endowment a %
c Temporarily restricted endowment a %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a Are there endowment funds not in the possession of the organization that are held and administered for the
organization by: Yes No
(i) unrelated organizations . . . . . . . . . . . . . . . . . . . . . . . . . . . 3a(i)
(ii) related organizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3a(ii)
b If “Yes” on line 3a(ii), are the related organizations listed as required on Schedule R? . . . . . . . . 3b
4 Describe in Part XIII the intended uses of the organization’s endowment funds.
Part VI Land, Buildings, and Equipment.
Complete if the organization answered “Yes” on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (b) Cost or other basis (c) Accumulated (d) Book value
(investment) (other) depreciation
1a Land . . . . . . . . . . . 0. 153,866. 153,866.

b Buildings . . . . . . . . . . 112,596. 7,785. 104,811.
c Leasehold improvements . . . .
d Equipment . . . . . . . . . 32,425. 30,572. 1,853.
e Other . . . . . . . . . . .
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10c.) . . . . . a 260,530.
REV 11/12/18 PRO Schedule D (Form 990) 2018
BAA
Part VII Investments—Other Securities.
Complete if the organization answered “Yes” on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category (b) Book value (c) Method of valuation:
(including name of security) Cost or end-of-year market value
(1) Financial derivatives . . . . . . . . . . . . . . .

(2) Closely-held equity interests . . . . . . . . . . . . .
(3) Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.) a
Part VIII Investments—Program Related.
Complete if the organization answered “Yes” on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Part IX Other Assets.

Complete if the organization answered “Yes” on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 15.) . . . . . . . . . . . . . . a
Part X Other Liabilities.

Complete if the organization answered “Yes” on Form 990, Part IV, line 11e or 11f. See Form 990, Part X,
line 25.
1. (a) Description of liability (b) Book value
(1) Federal income taxes
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization’s financial statements that reports the
organization’s liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2018
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return.
Complete if the organization answered “Yes” on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements . . . . . . . . . 1
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments . . . . . . . . . 2a
b Donated services and use of facilities . . . . . . . . . . . 2b
c Recoveries of prior year grants . . . . . . . . . . . . . . 2c
d Other (Describe in Part XIII.) . . . . . . . . . . . . . . . 2d
e Add lines 2a through 2d . . . . . . . . . . . . . . . . . . . . . . . . . 2e
3 Subtract line 2e from line 1 . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . . 4a
b Other (Describe in Part XIII.) . . . . . . . . . . . . . . . 4b
c Add lines 4a and 4b . . . . . . . . . . . . . . . . . . . . . . . . . . 4c
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) . . . . . . . 5
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return.
Complete if the organization answered “Yes” on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements . . . . . . . . . . . . . 1
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities . . . . . . . . . . . 2a
b Prior year adjustments . . . . . . . . . . . . . . . . 2b
c Other losses . . . . . . . . . . . . . . . . . . . . 2c
d Other (Describe in Part XIII.) . . . . . . . . . . . . . . . 2d
e Add lines 2a through 2d . . . . . . . . . . . . . . . . . . . . . . . . . 2e
3 Subtract line 2e from line 1 . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . . 4a
b Other (Describe in Part XIII.) . . . . . . . . . . . . . . . 4b
c Add lines 4a and 4b . . . . . . . . . . . . . . . . . . . . . . . . . . 4c
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) . . . . . . . 5
Part XIII Supplemental Information.
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part IV, lines 1b and 2b; Part V, line 4; Part X, line
2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
REV 11/12/18 PRO Schedule D (Form 990) 2018

BAA
Part XIII Supplemental Information (continued)
Schedule D (Form 990) 2018

SCHEDULE G Supplemental Information Regarding Fundraising or Gaming Activities OMB No. 1545-0047
(Form 990 or 990-EZ)
2018
Complete if the organization answered “Yes” on Form 990, Part IV, line 17, 18, or 19, or if the
organization entered more than $15,000 on Form 990-EZ, line 6a.
a Attach to Form 990 or Form 990-EZ.
Department of the Treasury Open to Public
Internal Revenue Service a Go to www.irs.gov/Form990 for instructions and the latest information.
Inspection
Part I Fundraising Activities. Complete if the organization answered “Yes” on Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
1 Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a Mail solicitations e Solicitation of non-government grants
b Internet and email solicitations f Solicitation of government grants
c Phone solicitations g Special fundraising events
d In-person solicitations
2a Did the organization have a written or oral agreement with any individual (including officers, directors, trustees,
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services? Yes No
b If “Yes,” list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is to be
compensated at least $5,000 by the organization.
(v) Amount paid to

(iii) Did fundraiser have (vi) Amount paid to
(i) Name and address of individual (iv) Gross receipts (or retained by)
(ii) Activity custody or control of (or retained by)
or entity (fundraiser) from activity fundraiser listed in
contributions? organization
col. (i)
Yes No
1
10
Total . . . . . . . . . . . . . . . . . . . . . . a
3 List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from
registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule G (Form 990 or 990-EZ) 2018
REV 10/17/18 PRO
BAA
Schedule G (Form 990 or 990-EZ) 2018 Page 2
Part II Fundraising Events. Complete if the organization answered “Yes” on Form 990, Part IV, line 18, or reported more
than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with
gross receipts greater than $5,000.
(a) Event #1 (b) Event #2 (c) Other events
(d) Total events
AIDS Walk Fiesta 2018 1 (add col. (a) through
col. (c))
(event type) (event type) (total number)
Revenue
1 Gross receipts . . . . 21,870. 13,416. 9,260. 44,546.
2 Less: Contributions . .
3 Gross income (line 1 minus
line 2) . . . . . . . 21,870. 13,416. 9,260. 44,546.
4 Cash prizes . . . . .
5 Noncash prizes . . .
Direct Expenses
6 Rent/facility costs . . . 2,084. 2,084.
7 Food and beverages . . 74. 974. 1,272. 2,320.
8 Entertainment . . . . 300. 300.
9 Other direct expenses . 537. 954. 1,491.
10 Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . .

6,195.. . . a
11 Net income summary. Subtract line 10 from line 3, column (d) . . . . . . .
38,351.. . . a
Part III Gaming. Complete if the organization answered “Yes” on Form 990, Part IV, line 19, or reported more than
$15,000 on Form 990-EZ, line 6a.
(b) Pull tabs/instant (d) Total gaming (add
Revenue
(a) Bingo (c) Other gaming

bingo/progressive bingo col. (a) through col. (c))
1 Gross revenue . . . .
2 Cash prizes . . . . .
Direct Expenses
3 Noncash prizes . . .
4 Rent/facility costs . . .
5 Other direct expenses .

Yes % Yes % Yes %
6 Volunteer labor . . . . No No No
7 Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . a
8 Net gaming income summary. Subtract line 7 from line 1, column (d) . . . . . . . . a
9 Enter the state(s) in which the organization conducts gaming activities:

a Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . . . Yes No
b If “No,” explain:
10a Were any of the organization’s gaming licenses revoked, suspended, or terminated during the tax year? . Yes No
b If “Yes,” explain:
REV 10/17/18 PRO Schedule G (Form 990 or 990-EZ) 2018

BAA
Schedule G (Form 990 or 990-EZ) 2018 Page 3
11 Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . . . . Yes No
12 Is the organization a grantor, beneficiary or trustee of a trust, or a member of a partnership or other entity
formed to administer charitable gaming? . . . . . . . . . . . . . . . . . . . . . . Yes No
13 Indicate the percentage of gaming activity conducted in:
a The organization’s facility . . . . . . . . . . . . . . . . . . . . . . . . . 13a %
b An outside facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13b %
14 Enter the name and address of the person who prepares the organization’s gaming/special events books and
records:
Name a
Address a
15a Does the organization have a contract with a third party from whom the organization receives gaming
revenue? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
b If “Yes,” enter the amount of gaming revenue received by the organization a $ and the
amount of gaming revenue retained by the third party a $
c If “Yes,” enter name and address of the third party:
Name a
Address a
16 Gaming manager information:
Name a
Gaming manager compensation a $
Description of services provided a
Director/officer Employee Independent contractor
17 Mandatory distributions:
a Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
b Enter the amount of distributions required under state law to be distributed to other exempt organizations or
spent in the organization’s own exempt activities during the tax year a $
Part IV Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and
Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information.
See instructions.
BAA REV 10/17/18 PRO Schedule G (Form 990 or 990-EZ) 2018

SCHEDULE O Supplemental Information to Form 990 or 990-EZ OMB No. 1545-0047
2018
(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.

aAttach to Form 990 or 990-EZ. Open to Public
a Go to www.irs.gov/Form990 for the latest information.
Internal Revenue Service Inspection
Pt VI, Line 11b: Report is e-mailed to board members.
Pt VI, Line 15a: The United Way Compensation Survey is used.
Pt VI, Line 15b: The United Way Compensaion Survey is used.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Cat. No. 51056K
BAA Schedule O (Form 990 or 990-EZ) (2018)
REV 10/24/18 PRO

Form 4562 Depreciation and Amortization
(Including Information on Listed Property)
OMB No. 1545-0172
2018
a Attach
to your tax return.
Department of the Treasury Attachment
Internal Revenue Service (99)
a Go to www.irs.gov/Form4562 for instructions and the latest information. Sequence No. 179
Name(s) shown on return Business or activity to which this form relates Identifying number
The Lazarus House A Center for Wellness Form 990 / Form 990EZ 76-0693417
Part I Election To Expense Certain Property Under Section 179
Note: If you have any listed property, complete Part V before you complete Part I.
1 Maximum amount (see instructions) . . . . . . . . . . . . . . . . . . . . . . . 1
2 Total cost of section 179 property placed in service (see instructions) . . . . . . . . . . . 2
3 Threshold cost of section 179 property before reduction in limitation (see instructions) . . . . . . 3
4 Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -0- . . . . . . . . . . 4
5 Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less, enter -0-. If married filing
separately, see instructions . . . . . . . . . . . . . . . . . . . . . . . . . 5
6 (a) Description of property (b) Cost (business use only) (c) Elected cost
7 Listed property. Enter the amount from line 29 . . . . . . . . . 7

8 Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 7 . . . . . . 8
9 Tentative deduction. Enter the smaller of line 5 or line 8 . . . . . . . . . . . . . . . . 9
10 Carryover of disallowed deduction from line 13 of your 2017 Form 4562 . . . . . . . . . . . 10
11 Business income limitation. Enter the smaller of business income (not less than zero) or line 5. See instructions . 11
12 Section 179 expense deduction. Add lines 9 and 10, but don’t enter more than line 11 . . . . . . 12
13 Carryover of disallowed deduction to 2019. Add lines 9 and 10, less line 12 a 13
Note: Don’t use Part II or Part III below for listed property. Instead, use Part V.
Part II Special Depreciation Allowance and Other Depreciation (Don’t include listed property. See instructions.)
14 Special depreciation allowance for qualified property (other than listed property) placed in service
during the tax year. See instructions . . . . . . . . . . . . . . . . . . . . . . . 14
15 Property subject to section 168(f)(1) election . . . . . . . . . . . . . . . . . . . . 15
16 Other depreciation (including ACRS) . . . . . . . . . . . . . . . . . . . . . . 16
Part III MACRS Depreciation (Don’t include listed property. See instructions.)
Section A
17 MACRS deductions for assets placed in service in tax years beginning before 2018 . . . . . . . 17 1,928.
18 If you are electing to group any assets placed in service during the tax year into one or more general
asset accounts, check here . . . . . . . . . . . . . . . . . . . . . . a
Section B—Assets Placed in Service During 2018 Tax Year Using the General Depreciation System
(b) Month and year (c) Basis for depreciation
(a) Classification of property placed in (business/investment use (d) Recovery (e) Convention (f) Method (g) Depreciation deduction
service only—see instructions) period
19a 3-year property

b 5-year property
c 7-year property
d 10-year property
e 15-year property
f 20-year property
g 25-year property 25 yrs. S/L
h Residential rental 27.5 yrs. MM S/L
property 27.5 yrs. MM S/L
i Nonresidential real 39 yrs. MM S/L
property MM S/L
Section C—Assets Placed in Service During 2018 Tax Year Using the Alternative Depreciation System
20a Class life S/L
b 12-year 12 yrs. S/L
c 30-year 30 yrs. MM S/L
d 40-year 40 yrs. MM S/L
Part IV Summary (See instructions.)
21 Listed property. Enter amount from line 28 . . . . . . . . . . . . . . . . . . . . 21
22 Total. Add amounts from line 12, lines 14 through 17, lines 19 and 20 in column (g), and line 21. Enter
here and on the appropriate lines of your return. Partnerships and S corporations—see instructions . 22 1,928.
23 For assets shown above and placed in service during the current year, enter the
portion of the basis attributable to section 263A costs . . . . . . . . 23
For Paperwork Reduction Act Notice, see separate instructions. REV 01/02/19 PRO Form 4562 (2018)
BAA
Form 8868 Application for Automatic Extension of Time To File an
Exempt Organization Return
(Rev. January 2019) OMB No. 1545-1709
a File a separate application for each return.
a Go to www.irs.gov/Form8868 for the latest information.
Electronic filing (e-file). You can electronically file Form 8868 to request a 6-month automatic extension of time to file any of the
forms listed below with the exception of Form 8870, Information Return for Transfers Associated With Certain Personal Benefit
Contracts, for which an extension request must be sent to the IRS in paper format (see instructions). For more details on the electronic
filing of this form, visit www.irs.gov/e-file-providers/e-file-for-charities-and-non-profits.
Automatic 6-Month Extension of Time. Only submit original (no copies needed).
All corporations required to file an income tax return other than Form 990-T (including 1120-C filers), partnerships, REMICs, and trusts
must use Form 7004 to request an extension of time to file income tax returns.
Enter filer’s identifying number, see instructions
Type or Name of exempt organization or other filer, see instructions. Employer identification number (EIN) or
print The Lazarus House A Center for Wellness 76-0693417
Number, street, and room or suite no. If a P.O. box, see instructions. Social security number (SSN)
File by the
due date for 4106 Austin St.
filing your
City, town or post office, state, and ZIP code. For a foreign address, see instructions.
return. See
instructions. Houston TX 77004
Enter the Return Code for the return that this application is for (file a separate application for each return) . . . . . . 0 1
Application Return Application Return
Is For Code Is For Code
Form 990 or Form 990-EZ 01 Form 990-T (corporation) 07
Form 990-BL 02 Form 1041-A 08
Form 4720 (individual) 03 Form 4720 (other than individual) 09
Form 990-PF 04 Form 5227 10
Form 990-T (sec. 401(a) or 408(a) trust) 05 Form 6069 11
Form 990-T (trust other than above) 06 Form 8870 12
• The books are in the care of a Danielle Sampey
Telephone No. a (713)526-5071 Fax No. a

• If the organization does not have an office or place of business in the United States, check this box . . . . . . . . . a
• If this is for a Group Return, enter the organization’s four digit Group Exemption Number (GEN) . If this is
for the whole group, check this box . . . a . If it is for part of the group, check this box . . . . a and attach
a list with the names and EINs of all members the extension is for.
1 I request an automatic 6-month extension of time until Nov 15 , 20 19 , to file the exempt organization return for
the organization named above. The extension is for the organization’s return for:
a calendar year 20 18 or
a tax year beginning , 20 , and ending , 20 .
2 If the tax year entered in line 1 is for less than 12 months, check reason: Initial return Final return
Change in accounting period
3a If this application is for Forms 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less
any nonrefundable credits. See instructions. 3a $ 0.
b If this application is for Forms 990-PF, 990-T, 4720, or 6069, enter any refundable credits and
estimated tax payments made. Include any prior year overpayment allowed as a credit. 3b $ 0.
c Balance due. Subtract line 3b from line 3a. Include your payment with this form, if required, by
using EFTPS (Electronic Federal Tax Payment System). See instructions. 3c $ 0.
Caution: If you are going to make an electronic funds withdrawal (direct debit) with this Form 8868, see Form 8453-EO and Form 8879-EO for payment
instructions.
For Privacy Act and Paperwork Reduction Act Notice, see instructions. BAA REV 12/20/18 PRO Form 8868 (Rev. 1-2019)
Federal Depreciation Options 2018
G Keep for your records
Name as Shown on Return Employer Identification No.

MACRS Convention
Compute convention (result shown below)
When ’Compute convention’ is checked, the program determines which convention applies to MACRS
personal property assets placed in service in 2018, and checks the appropriate box below.
The program uses the ’Half-year convention’ unless the ’Mid-quarter convention’ box is checked.
1 Half-year convention 2 Mid-quarter convention
MACRS Computation
Use IRS tables for all MACRS property placed in service this year? Yes No
Treat all MACRS assets for this activity as qualified Indian reservation property? Yes No
Treat all assets acquired after Aug 27, 2005 as qualified GO Zone property? Reg Ext No
Treat all assets acquired after May 4, 2007 as
qualified Kansas Disaster Zone property? Yes No
Was this business located in a Qualified Disaster Area? Yes No
Form 990-T Section 179 Information
1 Taxable income computed without the Section 179 or contribution deduction 1

2 Contribution deduction for purposes of Section 179 limitation 2
3 Taxable income computed for the Section 179 limitation 3
4 Elect to treat Qualified Real Property as "Section 179 Property" 4 Yes No
5a Calculated "Total cost of Section 179 property placed in service" 5a
b Additions or subtractions to calculated value b
teew7901.SCR 04/13/17
8879-EO IRS e-file Signature Authorization
for an Exempt Organization
Form OMB No. 1545-1878
For calendar year 2018, or fiscal year beginning , 2018, and ending , 20
aDo not send to the IRS. Keep for your records.
a Go to www.irs.gov/Form8879EO for the latest information.
2018
Name of exempt organization Employer identification number

Name and title of officer
Danielle Sampey, Executive Director

Part I Type of Return and Return Information (Whole Dollars Only)
Check the box for the return for which you are using this Form 8879-EO and enter the applicable amount, if any, from the return. If you
check the box on line 1a, 2a, 3a, 4a, or 5a, below, and the amount on that line for the return being filed with this form was blank, then
leave line 1b, 2b, 3b, 4b, or 5b, whichever is applicable, blank (do not enter -0-). But, if you entered -0- on the return, then enter -0- on
the applicable line below. Do not complete more than one line in Part I.
1a Form 990 check here a b Total revenue, if any (Form 990, Part VIII, column (A), line 12) . . . 1b 328,184.
2a Form 990-EZ check here a b Total revenue, if any (Form 990-EZ, line 9) . . . . . . . . . 2b
3a Form 1120-POL check here a b Total tax (Form 1120-POL, line 22) . . . . . . . . . . 3b
4a Form 990-PF check here a b Tax based on investment income (Form 990-PF, Part VI, line 5) . . 4b
5a Form 8868 check here a b Balance Due (Form 8868, line 3c) . . . . . . . . . . . . . 5b
Part II Declaration and Signature Authorization of Officer

Under penalties of perjury, I declare that I am an officer of the above organization and that I have examined a copy of the
organization’s 2018 electronic return and accompanying schedules and statements and to the best of my knowledge and belief, they
are true, correct, and complete. I further declare that the amount in Part I above is the amount shown on the copy of the
organization’s electronic return. I consent to allow my intermediate service provider, transmitter, or electronic return originator (ERO)
to send the organization’s return to the IRS and to receive from the IRS (a) an acknowledgement of receipt or reason for rejection of
the transmission, (b) the reason for any delay in processing the return or refund, and (c) the date of any refund. If applicable, I
authorize the U.S. Treasury and its designated Financial Agent to initiate an electronic funds withdrawal (direct debit) entry to the
financial institution account indicated in the tax preparation software for payment of the organization’s federal taxes owed on this
return, and the financial institution to debit the entry to this account. To revoke a payment, I must contact the U.S. Treasury Financial
Agent at 1-888-353-4537 no later than 2 business days prior to the payment (settlement) date. I also authorize the financial institutions
involved in the processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and
resolve issues related to the payment. I have selected a personal identification number (PIN) as my signature for the organization’s
electronic return and, if applicable, the organization’s consent to electronic funds withdrawal.
Officer’s PIN: check one box only
I authorize KATHY PLOCH, CPA to enter my PIN 9 3 4 1 7 as my signature
ERO firm name Enter five numbers, but
do not enter all zeros
on the organization’s tax year 2018 electronically filed return. If I have indicated within this return that a copy of the return is
being filed with a state agency(ies) regulating charities as part of the IRS Fed/State program, I also authorize the aforementioned
ERO to enter my PIN on the return’s disclosure consent screen.
As an officer of the organization, I will enter my PIN as my signature on the organization’s tax year 2018 electronically filed return.
If I have indicated within this return that a copy of the return is being filed with a state agency(ies) regulating charities as part of
the IRS Fed/State program, I will enter my PIN on the return’s disclosure consent screen.
Officer’s signature a Date a 07/15/2019
Part III Certification and Authentication
ERO’s EFIN/PIN. Enter your six-digit electronic filing identification
number (EFIN) followed by your five-digit self-selected PIN. 7 9 7 8 1 1 7 7 0 7 7
Do not enter all zeros
I certify that the above numeric entry is my PIN, which is my signature on the 2018 electronically filed return for the organization
indicated above. I confirm that I am submitting this return in accordance with the requirements of Pub. 4163, Modernized e-File (MeF)
Information for Authorized IRS e-file Providers for Business Returns.
ERO’s signature a Date a
ERO Must Retain This Form — See Instructions

Do Not Submit This Form to the IRS Unless Requested To Do So
For Paperwork Reduction Act Notice, see back of form. BAA REV 11/05/18 PRO Form 8879-EO (2018)
Form 4562 Depreciation and Amortization Report 2018
Tax Year 2018
G Keep for your records Page 1 of 1
Name as Shown on Return Identifying Number

QuickZoom here to enter assets

QuickZoom here to set MACRS convention for assets acquired in 2018
Activity: Form 990 - / Form 990EZ
Date Cost Land Bus Section Special Depreciable Method/ Prior Current
Asset Description Code In Service (Net of Use % 179 Depreciation Basis Life Convention Depreciation Depreciation
* Land) Allowance
DEPRECIATION
Prior assets 01/01/04 7,900 100.00 7,9007.00 200DB/HY 7,900 0
Equipment 05/01/05 2,000 100.00 2,0007.00 200DB/HY 2,000 0
Bioelectric impedance analysis 05/01/06 1,592 100.00 1,5927.00 200DB/HY 1,592 0
AT&T phone system 03/07/07 318 100.00 3187.00 200DB/HY 318 0
Mats, Bosu, Flex-test 04/10/07 476 100.00 4767.00 200DB/HY 476 0
FreeMotion Cable 07/25/07 4,530 100.00 4,5307.00 200DB/HY 4,530 0
Landice Rehab Treadmill 09/07/07 4,020 100.00 4,0207.00 200DB/HY 4,020 0
Handicap access 10/04/07 1,860 100.00 1,8607.00 200DB/HY 1,860 0
Cybex Olympic Flat Bench 04/11/09 150 100.00 1507.00 200DB/HY 150 0
Cybex Cable Multistation 04/11/09 1,000 100.00 1,0007.00 200DB/HY 1,000 0
Cybex Squat Rack 04/11/09 350 100.00 3507.00 200DB/HY 350 0
Handicap access improvement 05/01/09 2,650 100.00 2,6507.00 200DB/HY 2,650 0
Building - 4106 Austin St. 11/08/12 49,573 153,866 100.00 49,57339.00SL/MM 6,514 1,271
Rehab treadmill 04/27/17 5,370 100.00 2,685 2,6857.00 200DB/HY 384 657
SUBTOTAL PRIOR YEAR 81,789 153,866 0 2,685 79,104 33,744 1,928
TOTALS 81,789 153,866 0 2,685 79,104 33,744 1,928
* Code: S = Sold, A = Auto, L = Listed, V = Vine with SDA in Year Planted/Grafted, C = COGS
990-EZ, 990, 990-T and 990-PF
Information Worksheet 2018
Part I ' Identifying Information
Employer Identification Number 76-0693417
Name The Lazarus House A Center for Wellness
Doing Business As
Address 4106 Austin St. Room/Suite
City Houston State TX ZIP Code 77004
Province/State Foreign Postal Code
Foreign Code Foreign Country
Telephone Number (713)526-5071 Extension

Fax E-Mail Address daniellesampey@thelazarushouse.org
Eligible for hurricane tax relief legislation benefits, check here
Part II ' Type of Return
Form 990-EZ only Form 990-EZ with Form 990-T

X Form 990 only Form 990 with Form 990-T
Form 990-PF only Form 990-PF with Form 990-T
Form 990-T only Form 990-N (gross receipts $50,000 or less) for Electronic Filing only
QuickBooks Import Users & 990 to 990-EZ Data Transfer Option: Check if you’re filing the EZ & want
990 imported data copied to the EZ OR for those not importing from QuickBooks who transferred from prior
year 990 and now qualify to file the EZ this year, check this box to transfer 990 data to the EZ.
IMPORTANT
Before transferring data from Form 990 to Form 990-EZ , refer to "How to transfer data from
filing Form 990 to 990-EZ" listed above in the Most Common Support Questions or Tax Help for this line.
Part III ' Type of Organization
X 501(c) Corporation/Association 3 (subsection number) 220(e) Trust

501(c) Trust (subsection number) 408A Trust
4947(a)(1) Trust 529(a) Corporation
408(e) Trust 529(a) Trust
401(a) Trust 530(a) Trust
Other (describe) Corporation/Association 527 Organization
Or Trust 501(c) Association
Part IV ' Tax Year and Filing Information
X Calendar year
Fiscal year ' Ending month
Short year ' Beginning date Ending date
X Check this box if the organization is enrolled in the Electronic Federal Tax Payment System (EFTPS)
The Lazarus House A Center for Wellness 76-0693417 Page 2
Part V ' 2018 Estimated Taxes Paid
Check this box if the organization is a private foundation

Form 990-T Form 990-PF
Amount of 2017 overpayment credited to 2018 estimated tax
Form 990-T Form 990-PF
Due Date Amount Date Amount

Payment Quarters Date Paid Paid Paid Paid
1st Quarter Payment 04/17/18

2nd Quarter Payment 06/15/18
3rd Quarter Payment 09/17/18
4th Quarter Payment 12/17/18
Additional Payment 1
Part VI - Taxpayer Signature Information
Officer’s Name Danielle Sampey

Officer’s Title Executive Director
Part VII ' Electronic Filing Information
IMPORTANT: Do not use the Miscellaneous Statement or Additional Information if filing Form 990 or
Form 990-EZ. These statements will not be transmitted with the return. Use Schedule O or the applicable
Supplemental Information for the appropriate Schedule.
QuickZoom to the Electronic Filing Information Worksheet

Electronic Filing:
X File the federal return electronically
File the state(s) electronically
* Select the state or states to file electronically. (Multiple states can be entered)
State(s) *
File Form 114 Report of Foreign Bank and Financial Accounts (FBAR) electronically
Practitioner PIN program:

X Sign this return electronically using the Practitioner PIN
X ERO entered PIN
Officer’s PIN (enter any 5 numbers) 93417
Date PIN entered 05/14/2019
Electronic Filing of Extensions:

X Check this box to file Form 8868 (application for extension of time to file return) electronically
The Lazarus House A Center for Wellness 76-0693417 Page 3
Electronic Filing of Amended Return:

Check this box to file amended return electronically
Check this box to file the state and/or city amended return(s) electronically
* Select the state and/or city amended return(s) to file electronically.
State(s) *
File Amended Form 114 Report of Foreign Bank and Financial Accounts (FBAR) electronically
Part VIII ' Electronic Funds Withdrawal Information (Form 990PF filers only)
Yes No
Use electronic funds withdrawal of federal balance due (EF only)?
Use electronic funds withdrawal of Form 8868 balance due (EF only)?
Use electronic funds withdrawal of amended return balance due (EF only)?
Bank Information
Check to confirm transferred account information (which appears in green) is correct
Name of Financial Institution (optional)
Check the appropriate box Checking Savings
Routing number
Account number
Payment Information
Enter the payment date to withdraw tax payment
Balance due amount from this return
Enter an amount to withdraw tax payment
If partial payment is made, the remaining balance due
Payment date for amended returns
Balance due amount for amended returns
Part IX ' Information for Client Letter
Form 990-EZ or
Form 990 Form 990-PF Form 990-T
Extended Due Date 11/15/19
Letter Salutation Danielle
Part X ' Return Preparer
Enter preparer code from Firm/Preparer Info (See Help) 1

QuickZoom to Firm/Preparer Info
QuickZoom to Form 990-EZ, Pages 1 through 4

QuickZoom to Form 990, Page 1
QuickZoom to Form 990-PF, Page 1
QuickZoom to Form 990-T, Page 1
QuickZoom to Form 990-N, e-PostCard
QuickZoom to Client Status

teew0101.SCR 09/12/18
Form 4562 Alternative Minimum Tax Depreciation Report 2018
Tax Year 2018
G Keep for your records Page 1 of 1
Name as Shown on Return Identifying Number

Activity: Form 990 - / Form 990EZ

Asset Date Cost Land Bus Section Special Depr Method/ Prior Current Adj/
Description Code In (Net of Use % 179 Depr Basis Life Convention Depr Depr Pref
* Service Land) Allowance
DEPRECIATION
Prior assets 01/01/04 7,900 100.00 7,9007.00 150DB/HY 7,900 0 0.
Equipment 05/01/05 2,000 100.00 2,0007.00 150DB/HY 2,000 0 0.
Bioelectric impedance analysis 05/01/06 1,592 100.00 1,5927.00 150DB/HY 1,592 0 0.
AT&T phone system 03/07/07 318 100.00 3187.00 150DB/HY 318 0 0.
Mats, Bosu, Flex-test 04/10/07 476 100.00 4767.00 150DB/HY 476 0 0.
FreeMotion Cable 07/25/07 4,530 100.00 4,5307.00 150DB/HY 4,530 0 0.
Landice Rehab Treadmill 09/07/07 4,020 100.00 4,0207.00 150DB/HY 4,020 0 0.
Handicap access 10/04/07 1,860 100.00 1,8607.00 150DB/HY 1,860 0 0.
Cybex Olympic Flat Bench 04/11/09 150 100.00 1507.00 150DB/HY 150 0 0.
Cybex Cable Multistation 04/11/09 1,000 100.00 1,0007.00 150DB/HY 1,000 0 0.
Cybex Squat Rack 04/11/09 350 100.00 3507.00 150DB/HY 350 0 0.
Handicap access improvement 05/01/09 2,650 100.00 2,6507.00 150DB/HY 2,650 0 0.
Building - 4106 Austin St. 11/08/12 49,573 153,866 100.00 49,57339.00SL/MM 6,514 1,271 0.
Rehab treadmill 04/27/17 5,370 100.00 2,685 2,6857.00 200DB/HY 384 657 0.
SUBTOTAL PRIOR YEAR 81,789 153,866 0 2,685 79,104 33,744 1,928 0.
TOTALS 81,789 153,866 0 2,685 79,104 33,744 1,928 0.
* Code: S = Sold, A = Auto, L = Listed, V = Vine with SDA in Year Planted/Grafted, C = COGS, P = Passive
IRS e-file Authentication Statement 2018
Name(s) Shown on Return Employer ID No.

A ' Practitioner PIN Authorization
QuickZoom to the Federal Information Worksheet to enter PIN information
Please indicate how the taxpayer(s) PIN(s) are entered into the program.
Officer entered PIN
ERO entered Officer’s PIN X
B ' Signature of Electronic Return Originator
ERO Declaration:
I declare that the information contained in this electronic tax return is the information furnished to me by the
Corporation. If the Exempt Organization furnished me a completed tax return, I declare that the information
contained in this electronic tax return is identical to that contained in the return provided by the Exempt
Organization. If the furnished return was signed by a paid preparer, I declare I have entered the
paid preparer’s identifying information in the appropriate portion of this electronic return. If I am the paid
preparer, under the penalties of perjury, I declare that I have examined this electronic return, and to the
best of my knowledge and belief, it is true, correct, and complete. This declaration is based on all
information of which I have any knowledge.
I am signing this Tax Return by entering my PIN below.
ERO’s PIN (EFIN followed by any 5 numbers) EFIN 797811 Self-Select PIN 77077
C ' Signature of Officer
Perjury Statement:
Under penalties of perjury, I declare that I am an officer of the above Exempt Organization and that I have
examined a copy of the Exempt Organization’s 2018 electronic income tax return and accompanying
schedules and statements and to the best of my knowledge and belief, it is true, correct, and complete.
Consent to Disclosure:
I consent to allow my electronic return originator (ERO), transmitter, or intermediate service provider to send
the Exempt Organization’s return to the IRS and to receive from the IRS (a) an acknowledgment of receipt or
reason for rejection of the transmission, (b) an indication of any refund offset, (c) the reason for any delay in
processing the return or refund, and (d) the date of any refund.
Electronic Funds Withdrawal Consent (if applicable):

I authorize the U.S. Treasury and its designated Financial Agent to initiate an electronic funds withdrawal
(direct debit) entry to the financial institution account indicated in the tax preparation software for payment
of the Exempt Organization’s federal taxes owed on this return, and the financial institution to debit the
entry to this account. To revoke a payment, I must contact the U.S. Treasury Financial Agent at
1-888-353-4537 no later than 2 business days prior to the payment (settlement) date. I also authorize the
financial institution involved in the processing of the electronic payment of taxes to receive confidential
information necessary to answer inquiries and resolve issues related to the payment.
I am signing this Tax Return and Electronic Funds Withdrawal Consent, if applicable, by entering my
self-selected PIN below.
Officer’s PIN 93417

Date 05/14/2019
teew2701.SCR 04/30/15
Electronic Filing Information Worksheet 2018
Name(s) shown on return Identifying number

Part I ' State Electronic Filing:
Check this box to force state only filing for all states selected to be filed electronically
Part II ' Electronic Return Originator Information
The ERO Information below will automatically calculate based on the preparer code entered on the return.
For returns that are prepared as a "Non-Paid Preparer" (XNP) or "Self-Prepared" (XSP)
enter the EFIN for the ERO that is responsible for this return 797811
For returns that are marked as a "Non-Paid Preparer" (XNP) or "Self-Prepared" (XSP)
enter a PIN for the ERO that is responsible for filing return
ERO Name ERO Electronic Filers Identification Number (EFIN)
KATHY PLOCH, CPA 797811
ERO Address ERO Employer Identification Number
P O BOX 820182 46-0830510
City State ZIP Code ERO Social Security Number or PTIN
HOUSTON TX 77282-0182
Country
Part III ' Paid Preparer Information
Firm Name Preparer Social Security Number or PTIN

KATHY PLOCH, CPA P00158545
Preparer Name Employer Identification Number
KATHY PLOCH 46-0830510
Address Phone Number Fax Number
P O BOX 820182 (832)230-0967 (832)230-0967
City State ZIP Code
HOUSTON TX 77282-0182
Country Preparer E-mail Address
kmploch@gmail.com
Part IV ' Selection of Additional Amended Returns

Amount you are paying with the amended return
Check this box to file another federal amended return electronically
File another Amended Form 114 Report of Foreign Bank and Financial Accounts (FBAR) electronically
Check this box to file another state and/or city amended return electronically
* Select the state and/or city amended return(s) to file electronically.
State/City *
California State Exempt
Part V ' Name Control
Name Control, enter here to override default LAZA

cpcv1701.SCR 10/06/10
Form 8868 Electronic Filing Information Worksheet 2018
Name Social Security Number

Prepare Form 8868 for Electronic Filing
Extension accepted (will be blanked if extension not previously transmitted) X
Signature of Officer
Officer’s Name
Officer’s Title
Signature Date 05/14/19
Electronic Funds Withdrawal - Amount paid with Form 8868
NOTE - A practitioner PIN or Form 8453 is required for Form 8868 efile if using electronic funds withdrawal
Practitioner PIN information for Form 8868
Sign Form 8868 electronically using the Practitioner PIN

NOTE - A practitioner PIN or Form 8453 is required for Form 8868 efile if using electronic funds withdrawal
Please indicate how the Officer PIN is entered into the program.
Officer entered PIN
ERO entered Officer’s PIN
ERO’s Practitioner PIN (EFIN followed by any 5 numbers) EFIN Self-Select PIN
ERO Declaration: I certify that the above numeric entry is my PIN, which is my signature to authorize
submission of the electronic application for extension and electronic funds withdrawal for the corporation
indicated above. I confirm that I am submitting application for extension in accordance with the requirements
of the Pracitioner PIN method and Publications 4163, Modernized e-File Information for Authorized IRS e-file
Providers, and 3112, IRS e-file Application and Participation.
Perjury Statement: Under penalties of perjury, I declare that I have been authorized by the above taxpayer
to make this authorization and that I have examined a copy of the taxpayer’s electronic extension (Form
7004) for the tax period indicated above and to the best of my knowledge and belief, it is true, correct, and
complete.
Consent to disclosure: I consent to allow my electronic return originator (ERO), transmitter, or intermediate
service provider to send the exempt organization’s return to the IRS and to receive from the IRS (a) an
acknowledgement of receipt or reason for rejection of the transmission, (b) an indication of any refund
offset, (c) the reason for any delay in processing the return or refund, and (d) the date of any refund.
Electronic Funds Withdrawal Consent (if applicable): I authorize the U.S. Treasury and its designated
Financial Agent to initiate an electronic funds withdrawal (direct debit) entry to the financial institution
account indicated in the tax preparation software for payment of the corporation’s Federal taxes owed on
Form 8868, and the financial institution to debit the entry to this account. To revoke a payment, I must
contact the U.S. Treasury Financial Agent at 1-888-353-4537 no later than 2 business days prior to the
payment (settlement) date. I also authorize the financial institution involved in the processing of the
electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve
issues related to the payment.
I certify that I have the authority to execute this consent on behalf of the organization. I am signing this
Disclosure Consent by entering my self-selected PIN below.
Date
Officer’s PIN (enter any 5 numbers)
Smart Worksheets from your 2018 Federal Exempt Tax Return
SMART WORKSHEET FOR: Form 990: Return of Organization Exempt from Income Tax
Line 22 - Depreciation, Depletion, and Amortization Smart Worksheet
To enter assets, QuickZoom to Asset Entry Worksheet O

To view a calculated report of all depreciation information for Form 990,
QuickZoom to the Depreciation/Amortization Report O
QuickZoom to Form 4562 for Form 990 O
The following items carry to line 22 below:

(A) (B) (C) (D)
Description Total Program Management Fundraising
services and general
A Depreciation 1,928. 1,928. 0. 0.
B Depletion
C Amortization
SMART WORKSHEET FOR: Schedule B: Contributors (Copy 2)
General Information Smart Worksheet
A Description for this copy of Schedule B, Part I Copy 2
SMART WORKSHEET FOR: Schedule B: Contributors (Copy 2)
General Information Smart Worksheet
A Description for this copy of Schedule B, Part I Copy 3
SMART WORKSHEET FOR: Form 8868: Application for Extension of Time to File an Exempt Organization Return
Filing Address Smart Worksheet
Send Form 8868 to: Department of the Treasury

Internal Revenue Service Center
Ogden, UT 84201-0045
SMART WORKSHEET FOR: Exempt Organization Information Wks
2017 Tax Cuts & Jobs Act

Apply 15-year recovery period to qualified improvement property
(asset types J2, J3, J4 and J5)
placed in service after December 31, 2017?
Yes No X
Refer to Tax Help

Language

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KATHY PLOCH, CPA

July 14, 2019

The Lazarus House A Center for Wellness

Amended return Houston, TX 77004 G Gross receipts $ 334,378.

J Website: a www.thelazarushouse.org H(c) Group exemption number a

decreasing & limiting the effects of disease related wasting cachexia,

9 Program service revenue (Part VIII, line 2g) . . . . . . . . . . . 57,689. 52,630.

20 Total assets (Part X, line 16) . . . . . . . . . . . . . . . . 383,134. 480,824.

Firm’s address a P O BOX 820182, HOUSTON, TX 77282-0182 Phone no. (832)230-0967

4a (Code: ) (Expenses $ 185,327. including grants of $ 0. ) (Revenue $ 52,630. )

4b (Code: ) (Expenses $ 0. including grants of $ 0. ) (Revenue $ 0. )

4c (Code: ) (Expenses $ including grants of $ ) (Revenue $ )

4d Other program services (Describe in Schedule O.)

REV 05/20/19 PRO

(1) Stacey Batiste 3.00

REV 05/20/19 PRO Form 990 (2018)

8a Gross income from fundraising

22 Loans and other payables to current and former officers, directors,

complete lines 27 through 29, and lines 33 and 34.

REV 05/20/19 PRO

REV 05/20/19 PRO

Form 990: Return of Organization Exempt from Income Tax

REV 10/24/18 PRO

REV 10/24/18 PRO

1 Amounts paid to supported organizations to accomplish exempt purposes

REV 10/24/18 PRO

REV 10/24/18 PRO Schedule A (Form 990 or 990-EZ) 2018

Filers of: Section:

Form 990 or 990-EZ 501(c)( 3 ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF 501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.

1 St. Anne Catholic Church Person

(a) (b) (c) (d)

2 Heimbinder Family Foundation Person

(a) (b) (c) (d)

3 Bunnies on the Bayou Person

(a) (b) (c) (d)

4 Hollyfield Foundation Person

(a) (b) (c) (d)

5 Cameron Foundation Person

(a) (b) (c) (d)

6 Gary & Diane Heavin Person

REV 11/12/18 PRO Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

(a) (b) (c) (d)

8 Dearing Family Foundation Person

(a) (b) (c) (d)

(a) (b) (c) (d)

(a) (b) (c) (d)

(a) (b) (c) (d)

REV 11/12/18 PRO Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

(a) No. (c)

(a) No. (c)

(a) No. (c)

(a) No. (c)

(a) No. (c)

(a) No. (c)

REV 11/12/18 PRO Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

(e) Transfer of gift

(e) Transfer of gift