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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
Graphic Arrow Attach to Form 990.
Graphic Arrow Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
PETER E HAAS JR FAMILY FUND
 
Employer identification number
14-1962681
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) 10000 DEGREES
1401 LOS GAMOS DRIVE SUITE 205
SAN RAFAEL,CA94903 		95-3667812 501(C)(3) 150,000 0     SUPPORT A SONOMA COUNTY-WIDE COORDINATOR
(2) AIM HIGH FOR HIGH SCHOOL
PO BOX 410715
SAN FRANCISCO,CA94141 		94-3296338 501(C)(3) 25,000 0     CHALLENGE GRANT FOR PILOT EXPANSION
(3) COMMUNITY PARTNERS
1000 NORTH ALAMEDA STREET SUITE 240
LOS ANGELES,CA90012 		95-4302067 501(C)(3) 50,000 0     HIRE AN EXECUTIVE DIRECTOR AND SUPPORT HEALTH ACTION
(4) HEALTHCARE FOUNDATION NORTHERN SONOMA COUNTY
PO BOX 1025
HEALDSBURG,CA95448 		68-0474109 501(C)(3) 60,000 0     SUPPORT FIVE REGIONAL COMMUNITY RESPONSE TEAMS
(5) LATINO SERVICE PROVIDERS
1015-A CENTER DRIVE
SANTA ROSA,CA95403 		46-4107589 501(C)(3) 100,000 0     SECURE AN OFFICE LOCATION IN SANTA ROSA
(6) LEGAL AID OF SONOMA COUNTY
144 SOUTH E STREET SUITE 100
SANTA ROSA,CA95404 		68-0008581 501(C)(3) 100,000 0     ONGOING EFFORTS TO SUPPORT VETERANS AND IMMIGRANTS
(7) NEW VENTURE FUND
1828 L STREET NW SUITE 300A
WASHINGTON,DC20036 		20-5806345 501(C)(3) 350,000 0     GENERAL OPERATING SUPPORT TO STRENGTHEN ACCESS TO VOTING
(8) NORTH MARIN COMMUNITY SERVICES
680 WILSON AVENUE
NOVATO,CA94947 		94-1735064 501(C)(3) 126,965 0     SUPPORT HEALTHY NOVATO: PROMOTORES AND LEADERSHIP
(9) NOVATO UNIFIED SCHOOL DISTRICT
1015 SEVENTH STREET
NOVATO,CA94945 		68-0112169 CA DEPT OF EDUCATION 225,000 0     CO-FUNDING FOR THE EARLY SCHOOL SUCCESS INITIATIVE
(10) PETALUMA RIVER PARK FOUNDATION INC
101 H STREET SUITE B
PETALUMA,CA94952 		84-2431277 501(C)(3) 550,000 0     ADMINISTRATIVE OPERATING NEEDS AND LAND PURCHASE
(11) PROTECT DEMOCRACY PROJECT
2020 PENNSYLVANIA AVENUE NW SUITE
163
WASHINGTON,DC20006 		81-4777062 501(C)(3) 500,000 0     PROVIDE GENERAL OPERATING SUPPORT
(12) SANTA ROSA JUNIOR COLLEGE FOUNDATION
1501 MENDOCINO AVENUE
SANTA ROSA,CA95401 		94-1735861 501(C)(3) 100,000 0     OUTREACH AND SUPPORT FOR LOW INCOME STUDENTS IN HEALTH SCIENCES
(13) SCOPA HAS A DREAM INC
PO BOX 1004
HEALDSBURG,CA95448 		27-3044487 501(C)(3) 200,000 0     FUNDING TO SECURE FAMILIES COLLABORATIVE
(14) STANFORD UNIVERSITY BOARD OF TRUSTEES OF THE LELAND STANFORD JUNIOR UNIVERS
PO BOX 20466
STANFORD,CA94305 		94-1156365 501(C)(3) 806,200 0     CANCER CENTER MULTI-DISCIPLINARY CUTANEOUS LYMPHOMA PROGRAM
(15) STATE VOICES
1616 P STREET NW SUITE 220
WASHINGTON,DC20036 		20-1115618 501(C)(3) 350,000 0     GENERAL OPERATING SUPPORT
(16) VOTO LATINO INC
PO BOX 35608
WASHINGTON,DC20033 		20-1350252 501(C)(3) 75,000 0     PROVIDE GENERAL OPERATING SUPPORT
(17) MARIN COMMUNITY FOUNDATION
5 HAMILTON LANDING SUITE 200
NOVATO,CA94949 		94-3007979 501(C)(3) 3,477,350 0     GENERAL OPERATING SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Graphic Arrow
17
3
Enter total number of other organizations listed in the line 1 table ........................ . Graphic Arrow
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2021
Page 2

Schedule I (Form 990) 2021
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
PART I, LINE 2: TO QUALIFY FOR A GRANT DISTRIBUTION FROM THE FOUNDATION A GRANTEE MUST BE ABLE TO SATISFY THE FOUNDATION'S DUE DILIGENCE REQUIREMENTS. THIS PROCESS INCLUDES MAKING AN INDEPENDENT INVESTIGATION OF THE PROSPECTIVE GRANTEE TO ESTABLISH THAT IT QUALIFIES TO RECEIVE THE GRANT. THE GRANTEE ORGANIZATION MUST ALSO HAVE THE CAPACITY TO FULFILL THE TERMS OF THE GRANT AND BE WILLING TO FURNISH THE FOUNDATION WITH ANY REQUIRED EVALUATIVE REPORTS. DEPENDING UPON THE SIZE AND SOURCE OF THE GRANT, A WRITTEN REPORT FROM THE GRANTEE MAY BE REQUIRED.
Schedule I (Form 990) 2021



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