Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletInformation about Form 990-PF and its instructions is at www.irs.gov/form990pf.
OMB No. 1545-0052
2014
Open to Public Inspection
For calendar year 2014, or tax year beginning 2014, and ending , 20
Name of foundation
HOWARD & ROBERTA GOSS CHARITABLE FOUNDATION INC
 

Number and street (or P.O. box number if mail is not delivered to street address)620 ORCHARD LANE   Room/suite
City or town, state or province, country, and ZIP or foreign postal code
GLENCOE, IL60022
A Employer identification number

36-3370191
B Telephone number (see instructions)

(312) 427-2818
C bullet
G Check all that apply:

D 1. bullet
2. bullet
E bullet
H Check type of organization:
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$753,900J Accounting method:
 
(Part I, column (d) must be on cash basis.)
F bullet
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach
schedule).............. 48,531
2 Check bullet
Sch. B ...............
3 Interest on savings and temporary cash investments 25 25  
4 Dividends and interest from securities...... 11,550 11,550  
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 41,684
b Gross sales price for all assets on line 6a 174,897
7 Capital gain net income (from Part IV, line 2)... 54,225
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 101,790 65,800  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0 0   0
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 3,086 1,543   0
c Other professional fees (attach schedule)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 834 304   0
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 2,393 2,368   0
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 6,313 4,215   0
25 Contributions, gifts, grants paid........ 114,196 114,196
26 Total expenses and disbursements. Add lines 24 and 25 120,509 4,215   114,196
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -18,719
b Net investment income (if negative, enter -0-) 61,585
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2014)
Form 990-PF (2014)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)		 Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing...............      
2 Savings and temporary cash investments.......... 32,355 75,125 75,125
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use...............      
9 Prepaid expenses and deferred charges...........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)........      
c Investments—corporate bonds (attach schedule)........      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans..............      
13 Investments—other (attach schedule)........... 607,419 Click to see attachment545,930 678,775
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 639,774 621,055 753,900
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable..................    
19 Deferred revenue..................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22).......... 0 0
Net Assets or Fund Balances bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted...................    
25 Temporarily restricted................    
26 Permanently restricted................    
bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds......... 0 0
28 Paid-in or capital surplus, or land, bldg., and equipment fund 0 0
29 Retained earnings, accumulated income, endowment, or other funds 639,774 621,055
30 Total net assets or fund balances (see instructions)...... 639,774 621,055
31 Total liabilities and net assets/fund balances (see instructions).. 639,774 621,055
Part III Analysis of Changes in Net Assets or Fund Balances
1 Total net assets or fund balances at beginning of year—Part II, column (a), line 30 (must agree
with end-of-year figure reported on prior year’s return)............... 1 639,774
2 Enter amount from Part I, line 27a..................... 2 -18,719
3 Other increases not included in line 2 (itemize) bullet 3 0
4 Add lines 1, 2, and 3.......................... 4 621,055
5 Decreases not included in line 2 (itemize) bullet 5 0
6 Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30. 6 621,055
Form 990-PF (2014)
Form 990-PF (2014)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.) 		(b) How acquired
P—Purchase
D—Donation 		(c) Date acquired
(mo., day, yr.) 		(d) Date sold
(mo., day, yr.)
1 a 3,333.333 SH CMG ULTRA SHORT TERM FUND P 2014-04-24 2014-07-21
b 1,111.111 SH CMG ULTRA SHORT TERM FUND P 2014-04-24 2014-09-22
c 2,753.475 SH CMG ULTRA SHORT TERM FUND P 2014-04-24 2014-12-16
d 1,095.257 SH PRUDENTIAL JENNISON MID-CAP GROWTH FUND INC CL Z D 2014-12-03 2015-01-29
e 381.679 SH ARBITRAGE FUND CL I P 2012-01-10 2014-09-22
295.779 SH ARBITRAGE FUND CL I P 2012-04-04 2014-09-22
106.18 SH PERMANENT PORTFOLIO MUTUAL FUND AGENT P 2012-01-10 2014-09-22
124.922 SH PERMANENT PORTFOLIO MUTUAL FUND AGENT P 2012-04-04 2014-09-22
LITIGATION SETTLEMENT PROCEEDS - MEDTRONIC INC. P 2008-04-17 2015-04-22
CAPITAL GAINS DIVIDENDS P    
(e) Gross sales price (f) Depreciation allowed
(or allowable) 		(g) Cost or other basis
plus expense of sale 		(h) Gain or (loss)
(e) plus (f) minus (g)
a 30,000   30,000 0
b 10,000   10,000 0
c 24,754   24,781 -27
d 43,274   35,990 7,284
e 4,950   5,000 -50
3,836   3,901 -65
4,638   5,000 -362
5,457   6,000 -543
108     108
47,880     47,880
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l) Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i) F.M.V. as of 12/31/69 (j) Adjusted basis
as of 12/31/69 		(k) Excess of col. (i)
over col. (j), if any
a       0
b       0
c       -27
d       7,284
e       -50
      -65
      -362
      -543
      108
      47,880
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 54,225
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 . . . . . . . . . . . . . . . . 		Bracket 3  
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)

If section 4940(d)(2) applies, leave this part blank.
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period?
If "Yes," the foundation does not qualify under section 4940(e). Do not complete this part.
1 Enter the appropriate amount in each column for each year; see instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in) 		(b)
Adjusted qualifying distributions 		(c)
Net value of noncharitable-use assets 		(d)
Distribution ratio
(col. (b) divided by col. (c))
2013 108,275 742,314 0.145861
2012 97,403 658,221 0.147979
2011 108,615 663,191 0.163776
2010 113,371 686,983 0.165027
2009 113,106 658,898 0.171659
2 Total of line 1, column (d) ...................... 2 0.794302
3 Average distribution ratio for the 5-year base period—divide the total on line 2 by 5, or by
the number of years the foundation has been in existence if less than 5 years. . . 		3 0.158860
4 Enter the net value of noncharitable-use assets for 2014 from Part X, line 5..... 4 745,975
5 Multiply line 4 by line 3....................... 5 118,506
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 616
7 Add lines 5 and 6......................... 7 119,122
8 Enter qualifying distributions from Part XII, line 4.............. 8 114,196
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See
the Part VI instructions.
Form 990-PF (2014)
Form 990-PF (2014)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see page 18 of the instructions)
1a Bulletand enter “N/A" on line 1. Bracket
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b 1 1,232
hereBulletand enter 1% of Part I, line 27b...................
c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 1,232
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 1,232
6 Credits/Payments:
a 2014 estimated tax payments and 2013 overpayment credited to 2014 6a 1,200
b Exempt foreign organizations—tax withheld at source....... 6b
c Tax paid with application for extension of time to file (Form 8868)... 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 1,200
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 32
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2015 estimated taxBullet   RefundedBullet 11  
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see Instructions
for definition)?.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletIL
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2014 or the taxable year beginning in 2014 (see instructions for Part XIV)?
    If "Yes," complete Part XIV.............................
    9
     
    No
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 5
    Part VII-A
    Statements Regarding Activities (continued)
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. (see instructions) .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement (see instructions).................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletN/A
    14
    The books are in care ofbulletMORRISON MORRISON LTD Telephone no.bullet (312) 346-2141
    Located atbullet19 S LASALLE ST SUITE 1100CHICAGOIL ZIP+4bullet60603
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041.........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ......bullet
    15  
    16 At any time during calendar year 2014, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country?
    16   No
    See instructions for exceptions and filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR). If "Yes", enter the name of the foreign country bullet  
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 6
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?........................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?.................
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).........
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance (see instructions)? ........
    1b
     
     
    .........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2014?.............
    1c
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2014, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2014?...............
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?........................
    b
    If "Yes," did it have excess business holdings in 2014 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2014.)....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2014?
    4b
     
    No
    5a
    During the year did the foundation pay or incur any amount to:
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?...............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? (see instructions)..................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?........
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance (see instructions)? ......
    5b
     
     
    .........bullet
    c
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?............
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?.......................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 7
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation (see instructions).
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to
    employee benefit plans
    and deferred compensation     		(e) Expense account,
    other allowances
    HOWARD GOSS PRESIDENT/DIRECTOR
    1.00     		0 0 0
    620 ORCHARD LANE
    GLENCOE,IL60022
    ROBERTA GOSS DIRECTOR
    1.00     		0 0 0
    620 ORCHARD LANE
    GLENCOE,IL60022
    DAVID GOSS SEC/TREAS/DIRECTOR
    1.00     		0 0 0
    2226 N RACINE UNIT 3
    CHICAGO,IL60614
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet 0
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1 NONE 0
    2  
    3  
    4  
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 8
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1 N/A 0
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet0
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,
    see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    700,997
    b
    Average of monthly cash balances.......................
    1b
    56,338
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    757,335
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    757,335
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    11,360
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    745,975
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    37,299
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    37,299
    2a
    Tax on investment income for 2014 from Part VI, line 5......
    2a
    1,232
    b
    Income tax for 2014. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    1,232
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    36,067
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    36,067
    6
    Deduction from distributable amount (see instructions).................
    6
    0
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
    36,067
    Part XII
    Qualifying Distributions (see instructions)
    1
    Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
    a
    Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........
    1a
    114,196
    b
    Program-related investments—total from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    114,196
    5
    Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
    income. Enter 1% of Part I, line 27b (see instructions).................
    5
    0
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    114,196
    Note: The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
    the section 4940(e) reduction of tax in those years.
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2013     		(c)
    2013     		(d)
    2014
    1 Distributable amount for 2014 from Part XI, line 7 36,067
    2 Undistributed income, if any, as of the end of 2014:
    a Enter amount for 2013 only....... 0
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2014:
    a From 2009....... 80,383
    b From 2010....... 80,144
    c From 2011....... 77,003
    d From 2012....... 65,362
    e From 2013....... 72,957
    fTotal of lines 3a through e......... 375,849
    4Qualifying distributions for 2014 from Part
    XII, line 4: bullet$ 114,196
    a Applied to 2013, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		0
    c Treated as distributions out of corpus (Election
    required—see instructions).........     		0
    d Applied to 2014 distributable amount..... 36,067
    e Remaining amount distributed out of corpus 78,129
    5 Excess distributions carryover applied to 2014. 0 0
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 453,978
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ...........     		0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		0
    e Undistributed income for 2013. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2014. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2015 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8Excess distributions carryover from 2009 not
    applied on line 5 or line 7 (see instructions) ...     		80,383
    9Excess distributions carryover to 2015.
    Subtract lines 7 and 8 from line 6a ......     		373,595
    10 Analysis of line 9:
    a Excess from 2010.... 80,144
    b Excess from 2011.... 77,003
    c Excess from 2012.... 65,362
    d Excess from 2013.... 72,957
    e Excess from 2014.... 78,129
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 10
    Part XIV
    Private Operating Foundations (see instructions and Part VII-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2014, enter the date of the ruling.......bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2014 (b) 2013 (c) 2012 (d) 2011
             
    b 85% of line 2a .........          
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used
    directly for active conduct of exempt activities ...........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part X, line 6 for each year listed...     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XV
    Supplementary Information (Complete this part only if the organization had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    HOWARD GOSS
    ROBERTA GOSS
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 11
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    ADLER PLANETARIUM
    1300 S LAKE SHORE DRIVE
    CHICAGO,IL60605     		NONE PUBLIC CHARITABLE 3,000
    ADOPT A PLATOON
    PO BOX 234
    LOZANO,TX78568     		NONE PUBLIC CHARITABLE 56
    ALS ASSOCIATION
    220 WEST HURON STREET SUITE 4003
    CHICAGO,IL60654     		NONE PUBLIC CHARITABLE 100
    ALZHEIMER ASSOCATION
    225 N MICHIGAN AVENUE 17TH FL
    CHICAGO,IL60601     		NONE PUBLIC CHARITABLE 1,100
    AMERICAN COMMITTEE FOR THE WEIZMANN INSTITUTE OF SCIENCE
    633 THIRD AVENUE
    NEW YORK,NY10017     		NONE PUBLIC MEDICAL 200
    AMERICAN HEART ASSOCIATION
    7272 GREENVILLE AVE
    DALLAS,TX75231     		NONE PUBLIC MEDICAL 72
    AMERICAN RED MAGEN DAVID FOR ISRAEL
    1620 NW 87TH TER
    PLANTATION,FL33322     		NONE PUBLIC CHARITABLE 100
    AMERICAN SOCIETY FOR YAD VASHEM
    500 FIFTH AVENUE
    NEW YORK,NY10110     		NONE PUBLIC RELIGIOUS 250
    AN OLIVE BRANCH
    124 WILLOW RIDGE ROAD
    SEWICKLEY,PA15143     		NONE PUBLIC CHARITABLE 50
    ART INSTITUTE OF CHICAGO
    111 S MICHIGAN AVENUE
    CHICAGO,IL60603     		NONE PUBLIC CHARITABLE 185
    B'NAI B'RITH YOUTH ORGANIZATION
    12500 NW MILITARY HIGHWAY
    SAN ANTONIO,TX78231     		NONE PUBLIC CHARITABLE 50
    B'NAI JEHOSHUA BETH ELOHIM SYNAGOGUE
    901 MILWAUKEE AVENUE
    GLENVIEW,IL60025     		NONE PUBLIC RELIGIOUS 5,737
    BBYO INTERNATIONAL
    800 EIGHTH STREET NW
    WASHINGTON,DC20001     		NONE PUBLIC CHARITABLE 72
    BIRTHRIGHT ISRAEL FOUNDATION
    SHLOMO HALEVI 5
    HAR HOTZVIM JERUSALEM    
    IS     		NONE PUBLIC CHARITABLE 200
    CANCER WELLNESS CENTER
    215 REVERE DRIVE
    NORTHBROOK,IL60062     		NONE PUBLIC MEDICAL 850
    CHICAGO BOTANIC GARDEN
    1000 LAKE COOK ROAD
    GLENCOE,IL60022     		NONE PUBLIC CHARITABLE 250
    CHICAGO JEWISH HISTORICAL SOCIETY
    610 S MICHIGAN AVENUE
    CHICAGO,IL60605     		NONE PUBLIC CHARITABLE 100
    CITY OF HOPE
    20 N WACKER DRIVE SUITE 750
    CHICAGO,IL60606     		NONE PUBLIC CHARITABLE 50
    COALITION TO SALUTE AMERICAN HEROES
    12 GODFREY PLACE
    WILTON,CT06897     		NONE PUBLIC CHARITABLE 150
    COUNCIL FOR JEWISH ELDERLY
    3002 W TOUHY AVENUE
    CHICAGO,IL60645     		NONE PUBLIC CHARITABLE 36
    DEPAUL UNIVERSITY
    1 E JACKSON STREET
    CHICAGO,IL60604     		NONE PUBLIC EDUCATIONAL 10,000
    FAMILY SERVICE OF GLENCOE
    675 VILLAGE COURT
    GLENCOE,IL60022     		NONE PUBLIC CHARITABLE 50
    FOOD ALLERGY RESEARCH & EDUCATION INC
    7925 JONES BRANCH DR SUITE 1100
    MCLEAN,VA22102     		NONE PUBLIC CHARITABLE 200
    FOOD FOR THE POOR INC
    6401 LYONS ROAD
    COCONUT CREEK,FL33073     		NONE PUBLIC CHARITABLE 50
    FREE WHEELCHAIR MISSION
    608 E HAWLEY STREET
    MUNDELEIN,IL60060     		NONE PUBLIC CHARITABLE 1,000
    FRIENDS OF THE GLENCOE PUBLIC LIBRARY
    320 PARK AVENUE
    GLENCOE,IL60022     		NONE PUBLIC CHARITABLE 25
    FRIENDS OF THE ISRAEL DEFENSE FORCES
    350 FIFTH AVENUE
    NEW YORK,NY10118     		NONE PUBLIC PUBLIC SAFETY 1,175
    GENERAL ISRAEL ORPHAN HOME FOR GIRLS
    132 NASSAU STREET SUITE 725
    NEW YORK,NY10038     		NONE PUBLIC CHARITABLE 36
    GLENCOE PARK DISTRICT
    999 GREEN BAY ROAD
    GLENCOE,IL60022     		NONE PUBLIC CHARITABLE 25
    GREATER CHICAGO FOOD DEPOSITORY
    4100 W ANN LURIE PL
    CHICAGO,IL60632     		NONE PUBLIC CHARITABLE 86
    GUN VIOLENCE SURVIVORS FOUNDATION
    45 E CITY AVENUE SUITE 286
    BALA CYNWYD,PA19004     		NONE PUBLIC MEDICAL 50
    HADASSAH
    50 WEST 58TH STREET
    NEW YORK,NY10019     		NONE PUBLIC CHARITABLE 500
    HOLY NAME SOCIETY OF SACRED HEART PARISH
    11652 S CHURCH STREET
    CHICAGO,IL60643     		NONE PUBLIC CHARITABLE 25
    ILLINOIS HOLOCAUST MUSEUM & EDUCATION CENTER
    9603 WOODS DRIVE
    SKOKIE,IL60077     		NONE PUBLIC CHARITABLE 500
    JEWISH CHILD & FAMILY SERVICES - NORTH SHORE AUXILIARY
    216 W JACKSON 8TH FLOOR
    CHICAGO,IL60606     		NONE PUBLIC CHARITABLE 475
    JEWISH COMMUNITY CENTERS
    30 S WELLS STREET
    CHICAGO,IL60606     		NONE PUBLIC CHARITABLE 100
    JEWISH NATIONAL FUND
    42 EAST 69TH STREET
    NEW YORK,NY10021     		NONE PUBLIC CHARITABLE 316
    JEWISH UNITED FUND
    30 S WELLS STREET
    CHICAGO,IL60606     		NONE PUBLIC CHARITABLE 51,996
    JEWISH WAR VETERANS
    1811 R STREET
    WASHINGTON,DC20009     		NONE PUBLIC CHARITABLE 36
    JOSEPH WOHLNER MEMORIAL FUND
    2160 S 1ST AVE
    MAYWOOD,IL60153     		NONE PUBLIC CHARITABLE 25
    KELLOGG SCHOOL OF MANAGEMENT
    2169 CAMPUS DRIVE
    EVANSTON,IL60208     		NONE PUBLIC EDUCATIONAL 500
    KESHET
    600 ACADEMY DRIVE SUITE 130
    NORTHBROOK,IL60062     		NONE PUBLIC CHARITABLE 50
    LEUKEMIA RESEARCH FOUNDATION
    3520 LAKE AVENUE SUITE 202
    WILMETTE,IL60091     		NONE PUBLIC MEDICAL 125
    LISA KLITZKY FOUNDATION
    PO BOX 5048
    BUFFALO GROVE,IL60089     		NONE PUBLIC MEDICAL 250
    LUNGEVITY FOUNDATION
    228 S WABASH AVE SUITE 700
    CHICAGO,IL60604     		NONE PUBLIC MEDICAL 25
    LURIE CHILDREN'S FOUNDATION
    225 E CHICAGO AVE
    CHICAGO,IL60611     		NONE PUBLIC MEDICAL 50
    MAOT CHITIM OF GREATER CHICAGO
    7366 N LINCOLN AVE SUITE 301
    LINCOLNWOOD,IL60712     		NONE PUBLIC CHARITABLE 36
    MARINE TOYS FOR TOTS FOUNDATION
    3034 W FOSTER AVENUE
    CHICAGO,IL60625     		NONE PUBLIC CHARITABLE 50
    MAYO CLINIC
    200 FIRST STREET SW
    ROCHESTER,MN55905     		NONE PUBLIC MEDICAL 50
    MEALS ON WHEELS FOUNDATION OF NORTHERN ILLINOIS
    208 S LASALLE STREET
    CHICAGO,IL60604     		NONE PUBLIC CHARITABLE 36
    MERCY HOME FOR BOYS AND GIRLS
    1140 W JACKSON BLVD
    CHICAGO,IL60607     		NONE PUBLIC CHARITABLE 100
    MIKEY CZECH FOUNDATION
    PO BOX 1717
    NEW CANAAN,CT06840     		NONE PUBLIC MEDICAL 25
    NATIONAL FRAGILE X FOUNDATION
    2100 M STREET NW SUITE 170 BOX 302
    WASHINGTON,DC20037     		NONE PUBLIC CHARITABLE 500
    NATIONAL PARK FOUNDATION
    1201 EYE STREET NW SUITE 550B
    WASHINGTON,DC20005     		NONE PUBLIC CHARITABLE 25
    NORTH SHORE CONGREGATION ISRAEL
    1185 SHERIDAN ROAD
    GLENCOE,IL60022     		NONE PUBLIC RELIGIOUS 7,050
    ORT AMERICA
    3701 COMMERCIAL AVENUE
    NORTHBROOK,IL60062     		NONE PUBLIC CHARITABLE 432
    PEF ISRAEL ENDOWMENT FUNDS INC
    630 THIRD AVENUE SUITE 1501
    NEW YORK,NY10017     		NONE PUBLIC MEDICAL 2,000
    PEDIATRIC SUN PROTECTION FOUNDATION INC
    PO BOX 8181
    NORTHFIELD,IL60093     		NONE PUBLIC CHARITABLE 300
    RAVINIA FESTIVAL ASSOCIATION
    418 SHERIDAN ROAD
    HIGHLAND PARK,IL60035     		NONE PUBLIC CHARITABLE 6,000
    REHABILITATION INSTITUTE OF CHICAGO
    345 E SUPERIOR STREET
    CHICAGO,IL60611     		NONE PUBLIC MEDICAL 2,500
    RONALD MCDONALD HOUSE CHARITIES
    26345 NETWORK PLACE
    CHICAGO,IL60673     		NONE PUBLIC CHARITABLE 50
    RUSH UNIVERSITY MEDICAL CENTER
    1653 W CONGRESS PARKWAY
    CHICAGO,IL60612     		NONE PUBLIC CHARITABLE 25
    SALVATION ARMY
    5040 N PULASKI ROAD
    CHICAGO,IL60630     		NONE PUBLIC CHARITABLE 50
    SCOPE MIDWEST
    275 PARKWAY DRIVE
    LINCOLNSHIRE,IL60069     		NONE PUBLIC CHARITABLE 300
    SHALVA
    PO BOX 46375
    CHICAGO,IL60646     		NONE PUBLIC CHARITABLE 500
    SIMON WIESENTHAL CENTER
    1399 S ROXBURY DRIVE
    LOS ANGELES,CA90035     		NONE PUBLIC CHARITABLE 1,050
    SOLOMON SCHECTER DAY SCHOOL
    3210 W DUNDEE ROAD
    NORTHBROOK,IL60062     		NONE PUBLIC EDUCATIONAL 50
    SPECIAL OLYMPICS
    1133 19TH STREET
    WASHINGTON,DC20036     		NONE PUBLIC CHARITABLE 72
    ST JUDE CHILDREN'S RESEARCH HOSPITAL
    262 DANNY THOMAS PLACE
    MEMPHIS,TN38105     		NONE PUBLIC MEDICAL 100
    TELSHE YESHIVA
    3535 W FOSTER AVENUE
    CHICAGO,IL60625     		NONE PUBLIC CHARITABLE 36
    THE ARK
    6450 N CALIFORNIA AVENUE
    CHICAGO,IL60645     		NONE PUBLIC CHARITABLE 144
    THE FOUNDATION FOR TOMORROW
    PO BOX 470836
    CHARLOTTE,NC28247     		NONE PUBLIC CHARITABLE 150
    THE ISRAEL PROJECT
    2020 K STREET NW
    WASHINGTON,DC20006     		NONE PUBLIC CHARITABLE 430
    THE NATIONAL WORLD WAR II MUSEUM
    945 MAGAZINE ST
    NEW ORLEANS,LA70130     		NONE PUBLIC CHARITABLE 36
    UNITED STATES HOLOCAUST MEMORIAL MUSEUM
    595 ELM STREET
    HIGHLAND PARK,IL60035     		NONE PUBLIC CHARITABLE 10,345
    UNIVERSITY OF WISCONSIN - HILLEL FOUNDATION
    611 LANGDON STREET
    MADISON,WI53703     		NONE PUBLIC EDUCATION 200
    US OLYMPIC COMMITTEE
    27 SOUTH TEJON
    COLORADO SPRINGS,CO80903     		NONE PUBLIC CHARITABLE 100
    USO
    PO BOX 96322
    WASHINGTON,DC20090     		NONE PUBLIC CHARITABLE 100
    VAIL VALLEY MEDICAL CENTER FOUNDATION
    PO BOX 309
    VAIL,CO81658     		NONE PUBLIC MEDICAL 100
    VIETNAM VETERANS MEMORIAL FUND
    2600 VIRGINIA AVENUE NW SUITE 104
    WASHINGTON,DC20037     		NONE PUBLIC CHARITABLE 36
    VOLUNTEERS OF AMERICA OF ILLINOISOPERATION BACKPACK
    47 W POLK STREET SUITE 250
    CHICAGO,IL60605     		NONE PUBLIC CHARITABLE 500
    WORLD JEWISH CONGRESS
    501 MADISON AVENUE
    NEW YORK,NY10022     		NONE PUBLIC PUBLIC SAFETY 200
    WOUNDED WARRIOR PROJECT
    7020 A C SKINNER PARKWAY
    JACKSONVILLE,FL32256     		NONE PUBLIC CHARITABLE 200
    WTTW CHANNEL 11
    5400 N ST LOUIS
    CHICAGO,IL60625     		NONE PUBLIC CHARITABLE 40
    Total .................................bullet 3a 114,196
    bApproved for future payment
    Total .................................bullet 3b 0
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3
    Interest on savings and temporary cash investments ............     		    14 25  
    4 Dividends and interest from securities....     14 11,550  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6
    Net rental income or (loss) from personal property .............     		         
    7 Other investment income.....          
    8
    Gain or (loss) from sales of assets other than inventory .............     		    18 41,684  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory..          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e).. 0 53,259 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    1353,259
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 13
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political
    Yes
    No
    organizations?
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527?...........
    b
    If "Yes," complete the following schedule.
    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    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 taxpayer) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below
    (see instr.)?
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's namebullet



    Firm's addressbullet







         		Firm's EINbullet
    Phone no.
    Form 990-PF (2014)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description
    Schedule B
    (Form 990, 990-EZ,
    or 990-PF)
    Department of the Treasury
    Internal Revenue Service
    Schedule of Contributors
    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
    OMB No. 1545-0047
    2014
    Name of the organization
    HOWARD & ROBERTA GOSS CHARITABLE FOUNDATION INC
     
    Employer identification number

    36-3370191
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ





    Form 990-PF




    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
    Special Rules
    ......... Arrow Bullet $  
    Caution. An organization that is not covered by the General Rule and/or the Special Rules does not 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 990PF, Part I, line 2, to certify that it does not 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.
    Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2014)

    Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
    Page 2
    Name of organization
    HOWARD & ROBERTA GOSS CHARITABLE FOUNDATION INC
          		Employer identification number

    36-3370191
    Part I
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    1
     
     

    HOWARD GOSS  
    620 ORCHARD LANE
     
    GLENCOE, IL60022

    		$48,531


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     

       
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     

       
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     

       
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     

       
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     

       
     
     

    		$  


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

    Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
    Page 3
    Name of organization
    HOWARD & ROBERTA GOSS CHARITABLE FOUNDATION INC
          		Employer identification number

    36-3370191
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
    1
    		 1,095.257 SH PRUDENTIAL JENNSON MID-CAP GROWTH FUND CLASS Z $ 48,531 2014-12-03
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

    Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
    Page 4
    Name of organization
    HOWARD & ROBERTA GOSS CHARITABLE FOUNDATION INC
          		Employer identification number

    36-3370191
    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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a) No.
    from
    Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a) No.
    from
    Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a) No.
    from
    Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a) No.
    from
    Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

    Additional Data


    Software ID:  
    Software Version:  

    TY 2014 AccountingFeesSchedule
    Name:
    HOWARD & ROBERTA GOSS CHARITABLE FOUNDATION INC
    EIN: 36-3370191
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING AND TAX RETURN PREPARATION 3,086 1,543   0

    TY 2014 InvestmentsOtherSchedule2
    Name:
    HOWARD & ROBERTA GOSS CHARITABLE FOUNDATION INC
    EIN: 36-3370191
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    1,000.000 SH ISHARES MSCI EAFE INDEX FUND AT COST 63,046 66,640
    1,164.415 SH ALLIANCEBERNSTEIN SMALL MID CAP AT COST 25,000 24,907
    1,220.504 SH SCHRODER EMERGING MKT EQUITY FUND AT COST 15,000 16,111
    1,249.844 SH COLUMBIA MID CAP GROWTH FUND AT COST 35,053 39,458
    1,459.762 SH JOHN HANCOCK FDS III AT COST 18,656 30,874
    6,690.970 SH CMG ULTRA SHORT TERM FUND AT COST 60,219 60,219
    165.022 SH HARBOR INTERNATIONAL FUND AT COST 6,919 11,862
    231.102 SH PERMANENT PORTFOLIO MUTUAL FUND AGENT AT COST 0 0
    260.071 SH JANUS ENTERPRISE FUND AT COST 20,379 24,363
    261.028 SH VICTORY SMALL CO OPPTY FUND AT COST 10,000 10,496
    367.107 SH LEGG MASON CLEARBRIDGE SMALL CAP GROWTH FUND CL 1 AT COST 10,000 10,940
    4,883.901 SH COLUMBIA SELECT LARGE CAP GROWTH FUND AT COST 50,006 93,868
    416.840 SH ARTISAN INTERNATIONAL FUND AT COST 10,000 13,364
    489.258 SH KALMAR GROWTH-WITH-VALUE SMALL CAP FUND AT COST 10,000 9,986
    588.100 SH EAGLE SMALL CAP GROWTH FUND CLASS 1 AT COST 30,501 34,527
    646.412 SH ROYCE OPPORTUNITY FUND AT COST 10,000 8,882
    677.458 SH ARBITRAGE FUND CL I AT COST 0 0
    7,509.885 SH COLUMBIA DIVIDEND INCOME FUND AT COST 97,271 143,364
    778.674 SH COLUMBIA ACORN INTERNATIONAL FUND AT COST 32,687 35,025
    953.895 SH CAMBIAR SMALL CAP FUND INV AT COST 18,000 19,850
    831.255 SH COHEN & STEERS INTL REALTY FUND AT COST 10,000 9,800
    150.000 SH ISHARES COHEN & STEERS REIT EFT AT COST 13,193 14,239
    7,197.919 SH CMG ULTRA SHORT TERM FUND AT COST 0 0

    TY 2014 OtherExpensesSchedule
    Name:
    HOWARD & ROBERTA GOSS CHARITABLE FOUNDATION INC
    EIN: 36-3370191
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    IL ANNUAL FEES 15 0   0
    MANAGEMENT FEES 2,368 2,368   0
    SECRETARY OF STATE 10 0   0


    TY 2014 TaxesSchedule
    Name:
    HOWARD & ROBERTA GOSS CHARITABLE FOUNDATION INC
    EIN: 36-3370191
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES PAID 304 304   0
    FEDERAL TAXES 530 0   0