-
TIN:
Form
990-PF
Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
Do not enter social security numbers on this form as it may be made public.
Information about Form 990-PF and its instructions is at
www.irs.gov/form990pf
.
OMB No. 1545-0052
20
14
Open to Public Inspection
For calendar year 2014, or tax year beginning
2014, and ending
, 20
Name of foundation
REPUBLIC NATIONAL DISTRIBUTING COMPANY
FOUNDATION INC
Number and street (or P.O. box number if mail is not delivered to street address)
ONE NATIONAL DRIVE
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
ATLANTA
,
GA
30336
A Employer identification number
45-3842838
B
Telephone number (see instructions)
(404) 472-2245
C
If exemption application is pending, check here
G
Check all that apply:
Initial return
Initial return of a former public charity
Final return
Amended return
Address change
Name change
D 1.
Foreign organizations, check here .............
2.
Foreign organizations meeting the 85%
test, check here and attach computation ...
E
If private foundation status was terminated
under section 507(b)(1)(A), check here .......
H
Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
I
Fair market value of all assets at end
of year
(from Part II, col. (c),
line 16)
$
25,547
J
Accounting method:
Cash
Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here .......
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)
1
Contributions, gifts, grants, etc., received (attach
schedule)
..............
600,000
2
Check
Sch. B
...............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
......
5a
Gross rents
..............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
b
Gross sales price for all assets on line 6a
7
Capital gain net income (from Part IV, line 2)
...
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
........
600,000
0
13
Compensation of officers, directors, trustees, etc.
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
c
Other professional fees (attach schedule)
....
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
566
566
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
566
0
566
25
Contributions, gifts, grants paid
........
596,793
596,793
26
Total expenses and disbursements.
Add lines 24 and 25
597,359
0
597,359
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
2,641
b
Net investment income
(if negative, enter -0-)
0
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
1
Cash—non-interest-bearing
...............
22,906
25,547
25,547
2
Savings and temporary cash investments
..........
3
Accounts receivable
Less: allowance for doubtful accounts
4
Pledges receivable
Less: allowance for doubtful accounts
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)
Less: allowance for doubtful accounts
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
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
..............
13
Investments—other (attach schedule)
...........
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
22,906
25,547
25,547
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
)
23
Total liabilities
(add lines 17 through 22)
..........
0
Foundations that follow SFAS 117, check here
and complete lines 24 through 26 and lines 30 and 31.
24
Unrestricted
...................
25
Temporarily restricted
................
26
Permanently restricted
................
Foundations that do not follow SFAS 117, check here
and complete lines 27 through 31.
27
Capital stock, trust principal, or current funds
.........
28
Paid-in or capital surplus, or land, bldg., and equipment fund
29
Retained earnings, accumulated income, endowment, or other funds
22,906
25,547
30
Total net assets or fund balances
(see instructions)
......
22,906
25,547
31
Total liabilities and net assets/fund balances
(see instructions)
..
22,906
25,547
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
22,906
2
Enter amount from Part I, line 27a
.....................
2
2,641
3
Other increases not included in line 2 (itemize)
3
4
Add lines 1, 2, and 3
..........................
4
25,547
5
Decreases not included in line 2 (itemize)
5
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30
.
6
25,547
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.)
1a
b
c
d
e
(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
b
c
d
e
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
b
c
d
e
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
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
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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?
Yes
No
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
2012
2011
2010
2009
2
Total
of line 1, column (d)
......................
2
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
4
Enter the net value of noncharitable-use assets for 2014 from Part X, line 5
.....
4
5
Multiply line 4 by line 3
.......................
5
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
7
Add lines 5 and 6
.........................
7
8
Enter qualifying distributions from Part XII, line 4
..............
8
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
Exempt operating foundations described in section 4940(d)(2), check here
and enter “N/A" on line 1.
Date of ruling or determination letter:
(attach copy of letter if necessary–see instructions)
b
Domestic foundations that meet the section 4940(e) requirements in Part V, check
1
0
here
and 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
3
Add lines 1 and 2
...........................
3
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
4
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
6
Credits/Payments:
a
2014 estimated tax payments and 2013 overpayment credited to 2014
6a
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
8
Enter any
penalty
for underpayment of estimated tax.
Check here
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
.......
9
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
11
Enter the amount of line 10 to be:
Credited to 2015 estimated tax
Refunded
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.
$
(2)
On foundation managers.
$
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
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
No
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
No
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)
GA
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
Yes
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 address
N/A
14
The books are in care of
FRANCIE PURNELL
Telephone no.
(404) 472-2294
Located at
ONE NATIONAL DRIVE
ATLANTA
GA
ZIP+4
30336
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—Check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
......
15
16
At any time during calendar year 2014, did the foundation have an interest in or a signature or other authority over
Yes
No
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
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?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
........................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(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)?
.................
Yes
No
(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.)
.........
Yes
No
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
No
Organizations relying on a current notice regarding disaster assistance check here
.........
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?
...............
Yes
No
If "Yes," list the years
20
,
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
No
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
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?
........................
Yes
No
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
No
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))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
...............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? (see instructions)
..................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
........
Yes
No
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
No
Organizations relying on a current notice regarding disaster assistance check here
.........
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?
............
Yes
No
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?
.......................
Yes
No
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?
Yes
No
b
If yes, did the foundation receive any proceeds or have any net income attributable to the transaction?
....
7b
No
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
EMILE SARTALAMACCHIA
CORP DIRCTR TAX
1.00
0
809 JEFFERSON HIGHWAY
NEW ORLEANS
,
LA
70121
GREGORY JOHNSON
VP/TREASURER
1.00
0
ONE NATIONAL DRIVE
ATLANTA
,
GA
30336
DENNIS BASHUK
Foundation Mgr.
3.00
0
ONE NATIONAL DRIVE
ATLANTA
,
GA
30336
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
...................
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
.............
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
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
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
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
0
b
Average of monthly cash balances
.......................
1b
76,098
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
76,098
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
3
Subtract line 2 from line 1d
.........................
3
76,098
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
1,141
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
74,957
6
Minimum investment return.
Enter 5% of line 5
..................
6
3,748
Part XI
Distributable Amount
(see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here
and do not complete this part.)
1
Minimum investment return from Part X, line 6
....................
1
3,748
2a
Tax on investment income for 2014 from Part VI, line 5
......
2a
b
Income tax for 2014. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
3,748
4
Recoveries of amounts treated as qualifying distributions
................
4
5
Add lines 3 and 4
............................
5
3,748
6
Deduction from distributable amount (see instructions)
.................
6
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1
...
7
3,748
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
597,359
b
Program-related investments—total from Part IX-B
..................
1b
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
597,359
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
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
597,359
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
3,748
2
Undistributed income, if any, as of the end of 2014:
a
Enter amount for 2013 only
.......
b
Total for prior years:
20
,
20
,
20
3
Excess distributions carryover, if any, to 2014:
a
From 2009
.......
b
From 2010
.......
c
From 2011
.......
d
From 2012
.......
477,453
e
From 2013
.......
426,512
f
Total
of lines 3a through e
.........
903,965
4
Qualifying distributions for 2014 from Part
XII, line 4:
$
597,359
a
Applied to 2013, but not more than line 2a
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
c
Treated as distributions out of corpus (Election
required—see instructions)
.........
0
d
Applied to 2014 distributable amount
.....
3,748
e
Remaining amount distributed out of corpus
593,611
5
Excess distributions carryover applied to 2014.
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
1,497,576
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
...........
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
......
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
e
Undistributed income for 2013. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
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)
.......
8
Excess distributions carryover from 2009 not
applied on line 5 or line 7 (see instructions)
...
9
Excess distributions carryover to 2015.
Subtract lines 7 and 8 from line 6a
......
1,497,576
10
Analysis of line 9:
a
Excess from 2010
....
b
Excess from 2011
....
c
Excess from 2012
....
477,453
d
Excess from 2013
....
426,512
e
Excess from 2014
....
593,611
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
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
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.)
1
Information Regarding Foundation Managers:
a
List 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).)
b
List 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.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. (see instructions) to individuals or organizations under
other conditions, complete items 2a, b, c, and d.
a
The name, address, and telephone number or email address of the person to whom applications should be addressed:
b
The form in which applications should be submitted and information and materials they should include:
c
Any submission deadlines:
d
Any 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)
a
Paid during the year
ACTORS THEATRE OF LOUISVILLE
316 WEST MAIN STREET
LOUISVILLE
,
KY
40202
NONE
PC
COMMUNITY SERVICE
10,000
AMERICAN DIABETES ASSOCIATION
1701 NORTH BEAUREGARD STREET
ALEXANDRIA
,
VA
22311
NONE
PC
MEDICAL RESEARCH
3,000
AMERICAN HEART ASSOC
217 E REDWOOD STREET 23RD FLOOR
BALTIMORE
,
MD
21201
NONE
PC
MEDICAL RESEARCH
2,000
AMERICAN RED CROSS
53 GORDON PLAZA SW
ATLANTA
,
GA
30310
NONE
PC
COMMUNITY SERVICE
5,000
AMERICAN RED CROSS
2025 E STREET NW
WASHINGTON
,
DC
20006
NONE
PC
COMMUNITY SERVICE
2,500
ANY BABY CAN
217 HOWARD STREET
SAN ANTONIO
,
TX
78212
NONE
PC
COMMUNITY SERVICE
600
ARAPAHOE HOUSE
8801 LIPAN STREET - THORNTON
COLORADO
,
CO
80260
NONE
PC
COMMUNITY SERVICE
3,000
AUCTION OF WASHINGTON WINES
1201 WESTERN AVENUE SUITE 450
SEATTLE
,
WA
98101
NONE
PC
EDUCATIONAL
5,000
AUTISM SPEAKS
410 Bagby St Memorial Dr
Houston
,
TX
77002
NONE
PC
MEDICAL RESEARCH
1,000
BEAM INC DISTRIBUTORS FOUNDATION
510 LAKE COOK ROAD
DEERFIELD
,
IL
60015
NONE
PC
COMMUNITY SERVICE
20,000
CHILDREN'S NATIONAL MEDICAL CENTER
111 MICHIGAN AVENUE NW
WASHINGTON
,
DC
20010
NONE
PC
MEDICAL
5,000
COLLEGE SUCCESS FOUNDATION
PO BOX 1976
WOODINVILLE
,
WA
98072
NONE
PC
COMMUNITY SERVICE
15,481
COLORADO RESTURANT ASSOC EDUCATION
439 E 7TH AVE
DENVER
,
CO
80203
NONE
PC
EDUCATIONAL
2,500
COMMUNITY UNITED METHODIST CHURCH
8680 FT SMALLWOOD ROAD
PASADENA
,
MD
21122
NONE
PC
RELIGIOUS
1,000
DALLAS CHILDREN'S ADVOCACY CENTER
PO BOX 720338
DALLAS
,
TX
75372
NONE
PC
COMMUNITY SERVICE
1,750
ESCAPE FAMILY RESOURCE CENTER
1721 PECH ROAD 300
HOUSTON
,
TX
77055
NONE
PC
COMMUNITY SERVICE
2,400
FAMILY CHILDREN'S SERVICES
1112 S MEMORIAL DRIVE
TULSA
,
OK
74112
NONE
PC
COMMUNITY SERVICE
2,500
FLORIDA RESTAURANT LODGING ASSOCIAT
PO BOX 566263
MIAMI
,
FL
33256
NONE
PC
COMMUNITY SERVICE
2,500
FOUNDATION FOR HISTORICAL LOUISIANA
502 NORTH BLVD
BATON ROUGE
,
LA
70802
NONE
PC
EDUCATIONAL
2,000
HISTIO CURE FOUNDATION
1600 RIVER OAKS BLVD
HOUSTON
,
TX
77019
NONE
PC
MEDICAL RESEARCH
1,500
HOSPICE PALLIATIVE CARE OF WESTERN
3090 B NORTH 12TH STREET
GRAND JUNCTION
,
CO
81506
NONE
PC
MEDICAL
1,500
JUVENILE DIABETES RESEARCH FOUNDATI
9400 N CENTRAL EXPY
DALLAS
,
TX
75231
NONE
PC
EDUCATIONAL
5,000
MAKE A WISH FOUNDATION
6655 DESEO
IRVING
,
TX
75039
NONE
PC
COMMUNITY SERVICE
2,500
MARCH OF DIMES- TX
104 SW 6TH AVE 301
AMARILLO
,
TX
79101
NONE
PC
MEDICAL
1,200
MARCH OF DIMES-COLORADO
1325 S COLORADO BLVD STE B-508
DENVER
,
CO
80222
NONE
PC
MEDICAL
1,600
MARILLAC CLINIC
2420 W 26TH AVE SUITE 100D
DENVER
,
CO
80211
NONE
PC
MEDICAL
1,500
MT VERNON LADIES ASSOCIATION
1250 EYE STREET NW STE 400
WASHINGTON
,
DC
20005
NONE
PC
COMMUNITY SERVICE
10,000
OKLAHOMA CITY POLICE ATHLETIC LEAGU
1925 DOWNING STREET
OKLAHOMA CITY
,
OK
73120
NONE
PC
COMMUNITY SERVICE
4,500
OSU ALUMNI ASSOCIATION-TULSA CHAPTE
700 N GREENWOOD AVE
TULSA
,
OK
74106
NONE
PC
EDUCATIONAL
500
PALM BEACH INDIA ASSOCIATION
PO BOX 31225
PALM BEACH GARDENS
,
FL
33420
NONE
PC
COMMUNITY SERVICE
3,000
PRAY FOR GRAY
PO BOX 446
FARGO
,
ND
58107
NONE
PC
RELIGIOUS
1,000
RONALD MCDONALD HOUSE
405 E 73RD STREET
NEW YORK
,
NY
10021
NONE
PC
MEDICAL
1,000
SAN ANTONIO SPORTS
100 MONTANA STREET
SAN ANTONIO
,
TX
78203
NONE
PC
EDUCATIONAL
1,000
SEMINOLE REGION CHARITY GOLF TOURNA
PO BOX 3070
BOCA RATON
,
FL
33431
NONE
PC
COMMUNITY SERVICE
10,000
SHRINERS HOSPITAL FOR CHILDREN
3100 SAMFORD AVE
SHREVEPORT
,
LA
71103
NONE
PC
MEDICAL
1,000
THE CHILDREN'S SHELTER
2939 W WOODLAWN
SAN ANTONIO
,
TX
78228
NONE
PC
COMMUNITY SERVICE
250
THE HOME FRONT CARES
1120 N CIRCLE DRIVE 7
COLORADO SPRINGS
,
CO
80909
NONE
PC
COMMUNITY SERVICE
1,500
TRANSPLANTS FOR CHILDREN
7550 IH 10 WEST SUITE 104
SAN ANTONIO
,
TX
78229
NONE
PC
MEDICAL
1,000
TUREK AUBERT MEMORIAL SCHOLARSHIP F
PO BOX 372278
DENVER
,
CO
80237
NONE
PC
EDUCATIONAL
500
UCP OF CENTRAL FLORIDA
3305 S ORANGE AVE
ORLANDO
,
FL
32806
NONE
PC
MEDICAL
27,500
UCSF MEDICAL CENTER
505 PARNASSUS AVE
SAN FRANCISCO
,
CA
94143
NONE
PC
MEDICAL
20,000
UJA-FEDERATION OF NEW YORK
130 E 59TH STREET
NEW YORK
,
NY
10022
NONE
PC
RELIGIOUS
30,000
UNITED CEREBRAL PALSY
2700 W 81 STREET
HIALEAH
,
FL
33016
NONE
PC
MEDICAL
3,300
UNIVERSITY OF THE INCARNATE WORD
4301 BROADWAY
SAN ANTONIO
,
TX
78209
NONE
PC
EDUCATIONAL
5,500
VILLAGE FAMILY SERVICES
1201 25ST STREET SOUTH
FARGO
,
ND
58103
NONE
PC
COMMUNITY SERVICE
800
YOUNG LEADERSHIP COUNCIL
PO BOX 56909
NEW ORLEANS
,
LA
70156
NONE
PC
COMMUNITY SERVICE
10,000
ARMED SERVICES - YMCA
7505 Alban Station Court Ste B215
Springfield
,
VA
22150
NONE
PC
COMMUNITY SERVICE
10,000
AUTISM SOCIETY of Boulder County
PO BOX 270300
Louisville
,
CO
80027
NONE
PC
MEDICAL RESEARCH
500
CHILDREN OF RESTAURANT EMPLOYEES LT
1196-C Buckhead Crossing
Woodstock
,
GA
30189
NONE
PC
COMMUNITY SERVICE
5,000
Designated Driver of Colorado Sprin
555 17th St Ste 3200
Denver
,
CO
80202
NONE
PC
COMMUNITY SERVICE
300
El Paso Public Television Foundatio
P O Box 26668
El Paso
,
TX
79968
NONE
PC
EDUCATIONAL
1,925
Hispanic Community and Education Fu
104 Lou Jon Circle
San Antonio
,
TX
78213
NONE
PC
EDUCATIONAL
15,000
Honor Flight DFW
10455 N Central Expwy Ste 109-195
Dallas
,
TX
75231
NONE
PC
CULTURAL
4,150
North Dakota Cowboy Hall of Fame
250 Main St
Medora
,
ND
58645
NONE
PC
CULTURAL
1,000
Oklahoma Zoological Society
2101 NE 50th St
Oklahoma City
,
OK
73111
NONE
PC
EDUCATIONAL
2,500
Snake River Community Association
140 Ida Bella Drive Suite F4
Keystone
,
CO
80435
NONE
PC
CULTURAL
2,000
The Virginia Gentlemen Foundation
2420 Atlantic Avenue Suite 201
Virginia Beach
,
VA
23451
NONE
PC
MEDICAL
9,000
Universal Orlando Foundation
1000 Universal Studios Plaza
Orlando
,
FL
32819
NONE
PC
COMMUNITY SERVICE
15,000
Wheel for Kids
180 Royal Palm Way Suite 211
Palm Beach
,
FL
33480
NONE
PC
COMMUNITY SERVICE
1,000
YWCA Cass Clay
3000 S University Dr
Fargo
,
ND
58103
NONE
PC
COMMUNITY SERVICE
700
AUTISM SOCIETY of Colorado
550 S Wadsworth Blvd Suite 100
Lakewood
,
CO
80226
NONE
PC
MEDICAL RESEARCH
1,000
CITY YEAR SAN ANTONIO
109 N SAN SABA STREET
SAN ANTONIO
,
TX
78207
NONE
PC
COMMUNITY SERVICE
1,723
PROJECT ANGLE HEART
4950 WASHINGTON ST
DENVER
,
CO
80216
NONE
PC
COMMUNITY SERVICE
3,000
ST CECILIA CATHOLIC CHURCH
434 NORTON ROAD
COLUMBUS
,
OH
43228
NONE
PC
RELIGIOUS
500
A PROM TO REMEMBER
1007 NORTH FEDERAL HWY 384
FORT LAUDERDALE
,
FL
33304
NONE
PC
COMMUNITY SERVICE
1,500
AMERICAN HEART ASSOCIATION
208 S LA SALLE STREET STE 1500
CHICAGO
,
IL
60604
NONE
PC
MEDICAL REARCH
280
UNIVERSITY OF MISSISSIPPI
PO BOX 1848
UNIVERSITY
,
MS
38677
NONE
PC
EDUCATIONAL
500
MURRAY HILL ATHLETIC
4208 KINGSBURY STREET
JACKSONVILLE
,
FL
32205
NONE
PC
COMMUNITY SERVICE
500
AMERICAN RED CROSS
1955 MONROE DRIVE NE
ATLANTA
,
GA
30324
NONE
PC
COMMUNITY SERVICE
5,000
TRI COUNTY HUMANE SOCIETY
3350 NORTH WEST SECONDAVE
BOCA RATON
,
FL
33431
NONE
PC
COMMUNITY SERVICE
2,250
ST PJS CHILDRENS HOME
919 MISSION ROAD
SAN ANTONIO
,
TX
78210
NONE
PC
COMMUNITY SERVICE
1,000
AMERICAN HEART ASSOCIATION
1586 S 21ST STREET 10
COLORADO SPRINGS
,
CO
80904
NONE
PC
MEDICAL RESEARCH
1,000
CHARLEE HOMES FOR CHILDREN
155 S MIAMI AVE 700
MIAMI
,
FL
33130
NONE
PC
COMMUNITY SERVICE
1,800
AMERICAN DIABETES ASSOCIATION
7670 WOODWAY DRIVE SUITE 230
HOUSTON
,
TX
77063
NONE
PC
MEDICAL RESEARCH
10,600
SHARE OUR STRENGTH
1824 LINCOLN STREET
DENVER
,
CO
80203
NONE
PC
COMMUNITY SERVICE
3,000
WHOLE PLANET FOUNDATION
550 BOWIE STREET
AUSTIN
,
TX
78703
NONE
PC
COMMUNITY SERVICE
384
OPTIMIST CLUB OF PUEBLO
4494 LINDELL BLVD
ST LOUIS
,
MO
63108
NONE
PC
COMMUNITY SERVICE
1,500
THE LUSTGARTEN FOUNDATION
111 STEWART AVE
BETHPAGE
,
NY
11714
NONE
PC
MEDICAL RESEARCH
5,000
YMCA OF CENTRAL FLORIDA
9055 NORTHLAKE PARKWAY
ORLANDO
,
FL
32827
NONE
PC
COMMUNITY SERVICE
1,000
WOUNDED WARRIOR PROJECTS
4899 BELFORT ROAD STE 300
JACKSONVILLE
,
FL
32256
NONE
PC
COMMUNITY SERVICE
150
CYSTIC FIBROSIS FOUNDATION
740 LAKEVIEW PLAZA BLVD
WORTHINGTON
,
OH
43085
NONE
PC
MEDICAL RESEARCH
500
ATLANTIC INDIA ASSOCIATION
PO BOX 882162
PORT ST LUCIE
,
FL
34988
NONE
PC
COMMUNITY SERVICE
250
CHESED FOUNDATION
9858 CLINT MOORE ROAD
BOCA RATON
,
FL
33496
NONE
PC
COMMUNITY SERVICE
250
A BETTER LIFE RESCUE
15757 PINES BLVD 309
PEMBROKE PINES
,
FL
33027
NONE
PC
COMMUNITY SERVICE
250
CROHNS & COLITIS FOUNDATION
21301 POWERLINE ROAD 301
BOCA RATON
,
FL
33433
NONE
PC
COMMUNITY SERVICE
2,500
TOMORROWS RAINBOW INC
4341 NW 39TH AVE
COCONUT CREEK
,
FL
33073
NONE
PC
COMMUNITY SERVICE
500
BIG BROTHER BIG SISTER KENTUCKIANA
1519 GARDINER LANE
LOUISVILLE
,
KY
40218
NONE
PC
COMMUNITY SERVICE
2,500
BIKER DOWN
6870 W 52ND AVE STE 103
ARVADA
,
CO
80002
NONE
PC
COMMUNITY SERVICE
300
PKD FOUNDATION
8330 WARD PARKWAY STE 510
KANSAS CITY
,
MO
64114
NONE
PC
MEDICAL RESEARCH
5,000
MULTIPLE MYELOMA RESEARCH
PO BOX 20067
COLUMBUS
,
OH
43220
NONE
PC
MEDICAL RESEARCH
300
HEBREW EDUCATIONAL ALLIANCE
3600 S IVANHOE STREET
DENVER
,
CO
80237
NONE
PC
EDUCATIONAL
1,000
CAPITOL HILL UNITED NEIGHBORHOODS INC
1290 WILLIAMS STREET SUITE 102
DENVER
,
CO
80218
NONE
PC
COMMUNITY SERVICE
1,500
SNACK PAK 4 KIDS
701 PARK PLACE AVE
AMARILLO
,
TX
79101
NONE
PC
COMMUNITY SERVICE
1,000
BERNIE GRACE FOUNDATION
14926 MOSS ARCH
SAN ANTONIO
,
TX
78232
NONE
PC
COMMUNITY SERVICE
500
HOUSE OF RUTH
607 EAST ST CATHERINE STREET
LOUISVILLE
,
KY
40203
NONE
PC
COMMUNITY SERVICE
2,500
BAPTIST HEALTH FOUNDATION
750 EAST MULBERRY AVE
SAN ANTONIO
,
TX
78212
NONE
PC
MEDICAL
2,000
BOYS & GIRLS CLUB OF HELENA
1420 TAINTER STREET
ST HELENA
,
CA
94574
NONE
PC
COMMUNITY SERVICE
1,000
THE VILLAGE CHURCH OF MARIEMONT
3908 PLAINVILLE ROAD
CINCINNATI
,
OH
45227
NONE
PC
RELIGIOUS
300
HEALING HOUSE OF LOUISIANA
707 LEE AVE
LAFAYETTE
,
LA
70501
NONE
PC
EDUCATIONAL
1,000
GIGIS PLAYHOUSE
3224 20TH STREET
FARGO
,
ND
58104
NONE
PC
COMMUNITY SERVICE
500
UNITED WAY
700 S ALAMO ST
SAN ANTONIO
,
TX
78205
NONE
PC
COMMUNITY SERVICE
3,000
FOUNDATION OF GLOBAL SCHOLARS
1031 33RD STREET
DENVER
,
CO
80205
NONE
PC
EDUCATIONAL
800
LEUKEMIA & LYMPHOMA SOCIETY
5845 RICHARD HWY 800
ALEXANDRIA
,
VA
22303
NONE
PC
MEDICAL RESEARCH
1,250
MAD DADS JACKSONVILLE CHAPTER
5732 NORMANDY BLVD 8
JACKSONVILLE
,
FL
32205
NONE
PC
COMMUNITY SERVICE
500
AGA KHAN FOUNDATION
1825 K STREET NW SUITE 901
WASHINGTON
,
DC
20006
NONE
PC
COMMUNITY SERVICE
1,000
MARINE TOYS FOR TOTS FOUNATION
18251 QUANTICO GATEWAY DRIVE
TRIANGLE
,
VA
22172
NONE
PC
COMMUNITY SERVICE
500
THE FOUNDATION FOR BARNES-JEWISH HOSPITA
HIGHLANDS PLAZA DRIVE SUITE 140
ST LOUIS
,
MO
63110
NONE
PC
MEDICAL
500
SOUTHERN FEDERATION FOUNDATION
3131 NW LOOP 410 SUITE 200
SAN ANTONIO
,
TX
78230
NONE
PC
COMMUNITY SERVICE
1,000
THE OUTREACH CENTER
625 N UNIVERSITY AVE
LAFAYETTE
,
LA
70506
NONE
PC
COMMUNITY SERVICE
2,500
ST PAULS LUTHERAN SCHOOL
308 OAK MANOR DRIVE
GLEN BURNIE
,
MD
21061
NONE
PC
RELIGIOUS
5,000
AMERICAN LUNG ASSOCIATION
55 W WACKER DRIVE SUITE 1150
CHICAGO
,
IL
60601
NONE
PC
MEDICAL RESEARCH
500
THE IMPACT FOUNDATION
4141 28TH AVE S
FARGO
,
ND
58104
NONE
PC
COMMUNITY SERVICE
1,000
AMERICAN HEART ASSOCIATION
4217 PARK PLACE COURT
GLEN ALLEN
,
VA
23060
NONE
PC
MEDICAL RESEARCH
250
CITY ON A HILL
1140 MORRISON DRIVE
FORT WORTH
,
TX
76120
NONE
PC
RELIGIOUS
600
TEXAS CHILDRENS HOSPITAL
6621 FANNIN STREET
HOUSTON
,
TX
77030
NONE
PC
MEDICAL
600
THE SALVATION ARMY
1357 W 86TH STREET
INDIANAPOLIS
,
IN
46260
NONE
PC
COMMUNITY SERVICE
5,000
MADELINE GORDON GIFT OF LIFE FOUNDATION
PO bOX 6945
CINCINNATI
,
OH
45206
NONE
PC
COMMUNITY SERVICE
300
JUVENILE DIABETES RESEARCH FOUNDATION
9457 BROOKLINE AVENUE
BATON ROUGE
,
LA
70809
NONE
PC
MEDICAL RESEARCH
1,000
VOLUNTEERS OF AMERICA NORTH LOUISIANA
360 JORDAN STREET
SHREVEPORT
,
LA
71101
NONE
PC
COMMUNITY SERVICE
1,000
HOLY ANGELS
10450 ELLERBE ROAD
SHREVEPORT
,
LA
71106
NONE
PC
COMMUNITY SERVICE
1,000
FIRST SERVE
3400 N PORTLAND AVE
OKLAHOMA CITY
,
OK
73112
NONE
PC
COMMUNITY SERVICE
2,500
MEALS ON WHEELS
8446 VIRGINIA ST
MERRILLVILLE
,
IN
46410
NONE
PC
COMMUNITY SERVICE
2,500
BACK ON MY FEET
964 N PENNSYLVANIA STREET
INDIANAPOLIS
,
IN
46204
NONE
PC
COMMUNITY SERVICE
2,500
INDIANAPOLIS ZOO
1200 W WASHINGTON STREET
INDIANAPOLIS
,
IN
46222
NONE
PC
COMMUNITY SERVICE
5,000
THE CHAMPION FUND INC
5000 SUNSET BLVD 4TH FLOOR
LOS ANGELES
,
CA
90027
NONE
PC
COMMUNITY SERVICE
8,000
CORNELL UNIVERSITY
130 E SENECA STREET
ITHACA
,
NY
14850
NONE
PC
EDUCATIONAL
25,000
AMERICAN CANCER SOCIETY
132 W 32ND STREET
NEW YORK
,
NY
10001
NONE
PC
MEDICAL RESEARCH
35,000
SONOMA VALLEY VINTNERS & GROWERS
783 BROADWAY
SONOMA
,
CA
95476
NONE
PC
COMMUNITY SERVICE
10,000
FORE KIDS FOUNDATION
11005 LAPALCO BLVD
AVONDALE
,
LA
70094
NONE
PC
COMMUNITY SERVICE
8,000
BOYS & GIRLS TOWN OF ITALY
250 E 63RD STREET 204
NEW YORK
,
NY
10065
NONE
PC
COMMUNITY SERVICE
7,500
MUHAMMAD ALI CENTER
144 N 6TH STREET
LOUISVILLE
,
KY
40202
NONE
PC
COMMUNITY SERVICE
10,000
THE OGDEN MUSEUM OF SOUTHERN ART
925 CAMP STREET
NEW ORLEANS
,
LA
70130
NONE
PC
CULTURAL
15,000
TISCH MSRCNY
521 W 57TH STREET
NEW YORK
,
NY
10019
NONE
PC
MEDICAL RESEARCH
25,000
EMERIL LAGASSE FOUNDATION
829 ST CHARLES AVENUE
NEW ORLEANS
,
LA
70130
NONE
PC
COMMUNITY SERVICE
20,000
ARCH-DIOCESE OF GALVESTON -HOUSTON
1700 SAN JACINTO STREET
HOUSTON
,
TX
77002
NONE
PC
RELIGIOUS
10,000
TARRANT AREA FOOD BANK
2600 CULLEN STREET
FORT WORTH
,
TX
76107
NONE
PC
COMMUNITY SERVICE
7,350
NORTH TEXAS FOOD BANK
4500S COCKRELL HILL ROAD
DALLAS
,
TX
75236
NONE
PC
COMMUNITY SERVICE
7,350
FLORENCE FULLER CHILD DEVELOPMENT C
200 NE 14TH STREET
BOCA RATON
,
FL
33432
NONE
PC
COMMUNITY SERVICE
1,000
Total
.................................
3a
596,793
b
Approved for future payment
Total
.................................
3b
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.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash investments
............
4
Dividends and interest from securities
....
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not 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
.............
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)
..
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
(See worksheet in line 13 instructions to verify calculations.)
Part XVI-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
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?
...........
Yes
No
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.
May the IRS discuss this return
with the preparer shown below
(see instr.)?
Yes
No
Signature of officer or trustee
Date
Title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's Signature
Date
Check if self-
employed
PTIN
Firm's name
Firm's address
Firm's EIN
Phone no.
Form
990-PF
(2014)
Additional Data
Software ID:
14000265
Software Version:
2014v5.0
Form 990PF - Special Condition Description:
Special Condition Description
-
TIN:
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Attach to Form 990, 990-EZ, or 990-PF.
Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at
www.irs.gov/form990
.
OMB No. 1545-0047
20
14
Name of the organization
REPUBLIC NATIONAL DISTRIBUTING COMPANY
FOUNDATION INC
Employer identification number
45-3842838
Organization type
(check one):
Filers of:
Section:
Form 990 or 990-EZ
501(c)(
) (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 33
1
/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, 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. Do not 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
.........
$
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. 30613X
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page
2
Name of organization
REPUBLIC NATIONAL DISTRIBUTING COMPANY
FOUNDATION INC
Employer identification number
45-3842838
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
REPUBLIC NATIONAL
ONE NATIONAL DRIVE
ATLANTA
,
GA
30336
$
600,000
Person
Payroll
Noncash
(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
$
Person
Payroll
Noncash
(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
$
Person
Payroll
Noncash
(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
$
Person
Payroll
Noncash
(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
$
Person
Payroll
Noncash
(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
$
Person
Payroll
Noncash
(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
REPUBLIC NATIONAL DISTRIBUTING COMPANY
FOUNDATION INC
Employer identification number
45-3842838
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
$
(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
REPUBLIC NATIONAL DISTRIBUTING COMPANY
FOUNDATION INC
Employer identification number
45-3842838
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.)
$
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:
14000265
Software Version:
2014v5.0
-
TIN:
TY 2014 OtherExpensesSchedule
Name:
REPUBLIC NATIONAL DISTRIBUTING COMPANY
FOUNDATION INC
EIN:
45-3842838
Software ID:
14000265
Software Version:
2014v5.0
Description
Revenue and Expenses per Books
Net Investment Income
Adjusted Net Income
Disbursements for Charitable Purposes
BANK CHARGES
566
566
-
TIN:
TY 2014 SubstantialContributorsSch
Name:
REPUBLIC NATIONAL DISTRIBUTING COMPANY
FOUNDATION INC
EIN:
45-3842838
Software ID:
14000265
Software Version:
2014v5.0
Name
Address
REPUBLIC NATIONAL DISTRIBUTING CO
ONE NATIONAL DRIVE
ATLANTA
,
GA
30336