2025-10-30T18:41:06-05:00 2023-12-31 872729353 CNACPA PC 16450 MONTEREY ROAD SUITE 5 MORGAN HILL CA 95037 990 2023-01-01 770440847 SAN JOSE POA INSURANCE & BENEFIT FUND SANJ 4082981133 1151 NORTH FOURTH STREET SAN JOSE CA 95112 DAVID WOOLSEY CFO 4082981133 2025-10-28 1 1 SHELDON CHAVAN P01001593 4087762401 2025-10-27 2023 2025-03-06 01:10:19Z X DAVID WOOLSEY 1151 NORTH FOURTH STREET SAN JOSE CA 95112 1520567 0 X N/A X 1988 CA PROVIDES INSURANCE COVERAGE FOR MEMBERS 15 15 0 0 0 0 0 0 1398698 1502928 10576 17639 0 0 1409274 1520567 0 0 1530297 1593855 0 0 0 0 0 27985 7271 1558282 1601126 -149008 -80559 1002894 1046181 152387 26000 850507 1020181 PROVIDES INSURANCE COVERAGE FOR MEMBERS. 0 0 1601126 PROVIDES INSURANCE SERVICES FOR MEMBERS ELECTING TO PARTICIPATE, AND BASIC LIFE INSURANCE COVERAGE TO ALL MEMBERS 1601126 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 1 0 0 0 CA X DAVID WOOLSEY CFO 4082981133 1151 NORTH FOURTH STREET SAN JOSE CA 95112 X DAVID WOOLSEY DIRECTOR 0.00 X 0 0 0 ANTHONY KILMER DIRECTOR 0.00 X 0 0 0 TED DAVIS DIRECTOR 0.00 X 0 0 0 CAT ALVAREZ DIRECTOR 0.00 X 0 0 0 GINA BARAJAS DIRECTOR 0.00 X 0 0 0 BOB LABARBERA DIRECTOR 0.00 X 0 0 0 RYAN FERGUSON DIRECTOR 0.00 X 0 0 0 KESTON FRANKLIN DIRECTOR 0.00 X 0 0 0 AIDAN GUY DIRECTOR 0.00 X 0 0 0 JOHN MOUTZOURIDIS DIRECTOR 0.00 X 0 0 0 ASHLEY TRAVAGLIONE DIRECTOR 0.00 X 0 0 0 SEBASTIAN WISNIEWSKI DIRECTOR 0.00 X 0 0 0 DAVID WILSON CFO 0.00 X 0 0 0 STEVE SLACK VICE PRESIDENT 0.00 X 0 0 0 SEAN PRITCHARD PRESIDENT 0.00 X 0 0 0 0 0 0 0 0 0 0 0 MEMBERSHIP DUES 900099 1423225 1423225 CONTRIBUTIONS FROM SJP 900099 79703 79703 1502928 17639 17639 1520567 1502928 0 17639 1593855 1593855 7271 7271 1601126 1601126 0 0 86972 233218 77120 79560 838802 733403 1002894 1046181 152387 26000 152387 26000 X 850507 1020181 850507 1020181 1002894 1046181 -80559 123846 126387 0 X X 0 1 X 1 0 0 PUBLICLY TRADED SECURITIES 733403 F 733403 1644413 123846 123846 1520567 0 1520567 1601126 0 1601126 0 1601126 PART XI, LINE 2D - OTHER ADJUSTMENTS: UNREALIZED GAIN ON NET ASSETS 123,846. EXPLANATION OF AMENDMENTS: THIS AMENDED FORM 990 IS BEING FILED TO REFLECT CHANGES RESULTING FROM A RESTATEMENT OF THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS FOR THE TAX YEAR ENDED DECEMBER 31, 2023. THE RESTATEMENT WAS MADE BY THE ORGANIZATION'S INDEPENDENT AUDITORS TO CORRECT PREVIOUSLY REPORTED FINANCIAL INFORMATION. AS A RESULT OF THE RESTATEMENT, THE FOLLOWING SECTIONS OF THE ORIGINALLY FILED FORM 990 HAVE BEEN REVISED: PART VIII - STATEMENT OF REVENUE LINE 2B (PROGRAM SERVICE REVENUE) WAS CHANGED FROM $1,423,225 TO $1,502,928, AND LINE 12 (TOTAL REVENUE) FROM $1,440,864 TO $1,520,567. PART X - BALANCE SHEET LINE 26 (TOTAL LIABILITIES) WAS UPDATED FROM $232,090 TO $26,000, AND LINE 27 (NET ASSETS WITHOUT DONOR RESTRICTIONS) FROM $814,091 TO $1,046,181. ADDITIONALLY, SCHEDULE D HAS BEEN UPDATED TO REFLECT THE REVISED RECONCILIATION OF NET ASSETS AND OTHER FINANCIAL DISCLOSURES CONSISTENT WITH THE RESTATED AUDITED FINANCIAL STATEMENTS. NO OTHER CHANGES HAVE BEEN MADE TO THE ORIGINALLY FILED RETURN. THIS AMENDMENT IS BEING SUBMITTED SOLELY TO ENSURE CONSISTENCY BETWEEN THE IRS FILING AND THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS. FORM 990, PART VI, SECTION B, LINE 11B AN OUTSIDE SERVICE PROVIDER PREPARES AND REVIEWS THE FORM 990. COMPANY PERSONNEL REVIEW PRIOR TO SIGNING BY A TRUSTEE. FORM 990, PART VI, SECTION C, LINE 19 FORM 990 IS MADE AVAILABLE TO THE PUBLIC UPON REQUEST. PART XII, LINE 2C EXPLANATION: NO CHANGES FROM PRIOR YEAR.