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					MAIL TO:,                                                              ANNUAL
~legistry of Charitable’Trusts                  REGISTRATION RENEWAL FEE REPORT
P.O. Box 903447                                TO ATTORNEY GENERAL OF CALIFORNIA
Sacramento, CA 94203-4470
Telephone: (916) 445-2021                        Sections 12586 and 12587, California Government Code
                                                     11 Cal. Code Regs. sections 301-307,311 and 312
WEB SITE ADDRESS:                 Failure to submit this report annually no later than four months and fileen days after the
http://ag.ca.~ov/charities/       end of the organization’s accounting period may result in the loss of tax exemption and
                                 the assessment of a minimum tax of $800, plus interest, and/or fines or filing penalties
                                  as defined in Government Code section 12586.1. IRS extensions will be honored. ~
                                                                                            Check if:
 State Charity Registration Number: CT 0 4 1 3 1 6
                                                                                             J---1 Change of address


 TENDERLOIN HOUSING CLINIC, INC.                                                                [~ Amended report
 Name of Organization

  126 HYDE STREET                                                                              Corporate or Organization No.        0 9 8 4 615
 Address (Numb~ and Street)

 SAN FRANCISCO, CA                              94102                                          Federal Employer I.D. No.        9 4- 2 6 817 0 (5
 City or Town, State and ZIP Coda

                        ANNUAL REGISTRATION RENEWAL FEE SCHEDULE (11 Cal. Code Regs sections 301-307, 311 and 312)
                                    Make Check Payable to Attorney General’s Registry of Charitable Trusts
 Gross Annual Revenue                         Fee         Gross Annual Revenue                   Fee            Gross Annual Revenue                     Fee


 Less than $25,000                              0         Between $100,001 and $250,000 $50                     Between $1,000,001 and $10 million
 Between $25,000 and $100,000                 $25         Between $250,001 and $1 million $75                   Between $10,000,001 and $50 million
                                                                                                                Greater than $50 million
  PART A - ACTIVITIES
           For your most recent full accounting period (beginning 0 7 / 01 / 2 0 0 7 ending 0 6 / 3 0 / 2 0 0 8 ) list:
           Gross annual revenue $               2 3,7 3 6,6 61. Total assets $                 10,101,745¯

  PART B - STATEMENTS REGARDING ORGANIZATION DURING THE PERIOD OF THIS REPORT
  Note: If you answer "yes" to any of the questions below, you must attach a separate sheet providing an explanation
        and details for each "yes" response. Please review RRF-1 instructions for information required.
                                                                                                                                                       Yes     No
 1.        During this reporting period, were there any contracts, loans, leases or other financial transactions between the organization
           and any officer, director or trustee thereof either directly or with an entity in which any such officer, director or trustee had
           any financial interest?                                                                                                                             X
 2.        During this reporting period, was there any theft, embezzlement, diversion or misuse of the organization’s charitable property
           or funds?                                                                                                                                           X
 3.        During this reporting period, did non-program expenditures exceed 50% of gross revenues?

 4.        During this reporting period, were any organization funds used to pay any penalty, fine or judgment? If you filed a Form 4720
           with the Internal Revenue Service, attach a copy.                                                                                                   X
 5.        During this reporting period, were the services of a commercial fundraiser or fundraising counsel for charitable purposes used?
           If "yes," provide an attachment listing the name, address, and telephone number of the service provider.                                            X
 6.        During this reporting period, did the organization receive any governmental funding? If so, provide an attachment listing the
           name of the agency, mailing address, contact person, and telephone number.                              S~,,~ ST~r~..~.Nr~ 1 0               X
 7.        During this reporting period, did the organization hold a raffle for charitable purposes? If "yes," provide an attachment indicating
           the number of raffles and the date(s) they occurred.                                                                                                X
 8.        Does the organization conduct a vehicle donation program? If "yes," provide an attachment indicating whether the program is
           operated by the charity or whether the organization contracts with a commercial fundraiser for charitable purposes.                                 X
 9.        Did your organization have prepared an audited financial statement in accordance with generally accepted accounting
           principles for this reporting period?
  Organization’s area code and telephone number 4 1 5 - 8 8 5 - 3 2 8 6

  Organization’s e-mail address
  I declare under penalty of perjury that I have examined this report, including accompanying docEs, and to the best of my knowledge an~d belief, it is true,



                                                    Printed N                                           Title
                                                                                                  ~
  Signaturelo(aut~d officer

720291
o~-2~-o~                                                                                                                                              RRF-1 (3-05)
  TENDeRlOiN HOUSING CLINIC, INC.                              94-2681706



FORM RRF- 1      INFORMATION REGARDING GOVERNMENT FUNDING   STATEMENT i0
                            PART B, LINE 6


 HUMAN SERVICE AGENCY
 OF THE CITY AND COUNTY OF SAN FRANCISCO
 CONTACT PERSON: KIM FERGISON
 415-557-5585
 PO BOX 7988
 SAN FRANCISCO, CA 94120-7988

 DEPT OF PUBLIC HEALTH
 OF THE CITY AND COUNTY OF SAN FRANCISCO
 CONTACT PERSON: ANDREW WILLIAMS
 415-554-2503
 i01 GROVE ST.
 SAN FRANCISCO, CA 94102-4505

 DEPT OF BUILDING INSPECTION
 OF THE CITY AND COUNTY OF SAN FRANCISCO
 CODE ENFOREMENT PROGRAM
 CONTACT PERSON: SARAH LUU
 415-558-6324
 1650 MISSION STREET
 SAN FRANCISCO, CA 94103-2414

 MAYOR’S OFFICE OF HOUSING
 COMMUNITY BLOCK GRANT
 CONTACT PERSON: MARK WON
 415-701-5549
 1 SOUTH VAN NESS AVE. 5TH FLOOR
 SAN FRANCISCO, CA 94103-2414

 RESIDENTIAL RENT STABLIZATION & ARBITRATION BOARD
 OUTREACH PROGRAM
 OF THE CITY AND COUNTY OF SAN FRANCISCO
 CONTACT PERSON: TIM LEE
 E-MAIL: TIMOTHY.LEE@SFGOV.ORG
 25 VAN NESS AVE. #320
 SAN FRANCISCO, CA 94103-2414

  TRANSPORTATION AUTHORITY
  CONTACT PERSON: AMBER CRABBE
  415-522-4801
  I00 VAN NESS AVE. 26TH FLOOR
  SAN FRANCISCO, CA 94103-2414

  THE SAN FRANCISCO CITY AND COUNTY
  SHELTER PLUS CARE PROGRAM
  FUNDED BY GRANT FROM THE UNITED STATES
  DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
  CONTACT PERSON: SHANE BALANON
  415-558-1980
  PO BOX 7988




                                                            STATEMENT(S) I0
 TENDERLOI~ HOUSING CLINIC,   INC.                 94-2681706



FORM RRF-I                                      STATEMENT   10




 SAN FRANCISCO,   CA 94120-7988

 DEPARTMENT OF CHILDREN, YOUTH AIqD FAMILIES
 OF THE CITY AND COUNTY OF SAN FRANCISCO
 CONTACT PERSON: LINA MORALES
 415-554-8430
 1390 MARKET STREET SUITE 900
 SAN FRANCISCO, CA 94102

 CITY AND COUNTY OF SAN FRANCISCO
 MAYOR’S OFFICE OF ECONOMIC AND
 WORKFORCE DEVELOPMENT
 CONTACT PERSON: RICH HILLIS
 415-558-1980
 CITY HALL, ROOM 448
 SAN FRANCISCO, CA 94102




                                               STATEMENT(S) I0

				
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