TY 2015 Form 990PF

- TIN:

Form990-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.
bullet

Information about Form 990-PF and its instructions is at www.irs.gov/form990pf.

OMB No. 1545-0052

2015

Open to Public Inspection

For calendar year 2015, or tax year beginning 01-01-2015 , and ending 12-31-2015

Name of foundation
The Arlindo and Evelyn Jorge Family
Foundation and Trust

Number and street (or P.O. box number if mail is not delivered to street address)25 Sydney Road
Room/suite

City or town, state or province, country, and ZIP or foreign postal code
Halesite, NY117431231

A Employer identification number

20-6710947

B Telephone number (see instructions)

(516) 294-6638

C If exemption application is pending, check here bullet

G Check all that apply: Initial returnInitial return of a former public charity
Final returnAmended return
Address changeName change

D 1. Foreign organizations, check here ............. bullet

2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet

E If private foundation status was terminated
under section 507(b)(1)(A), check here ....... bullet

H Check type of organization: Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trustOther taxable private foundation

F If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here ....... bullet

I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16) bullet

$7,053,255J Accounting method: Cash Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)

	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	(d) Disbursements for charitable purposes (cash basis only)


1	Contributions, gifts, grants, etc., received (attach schedule)
2	Check Sch. B .............
3	Interest on savings and temporary cash investments	7,257		7,257
4	Dividends and interest from securities...	185,848		178,521
5a	Gross rents............
b	Net rental income or (loss)
6a	Net gain or (loss) from sale of assets not on line 10		174,060
b	Gross sales price for all assets on line 6a 1,136,207
7	Capital gain net income (from Part IV, line 2)...			174,060
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........	367,165		359,838
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).......		3,276	1,638	0
c	Other professional fees (attach schedule)....		4,263	4,263	0
17	Interest...............
18	Taxes (attach schedule) (see instructions)...		2,369	333	0
19	Depreciation (attach schedule) and depletion...
20	Occupancy..............
21	Travel, conferences, and meetings.......
22	Printing and publications..........
23	Other expenses (attach schedule).......		250	0	250
24	Total operating and administrative expenses.
	Add lines 13 through 23..........	10,158		6,234	250
25	Contributions, gifts, grants paid.......	256,500			256,500
26	Total expenses and disbursements. Add lines 24 and 25	266,658		6,234	256,750
27	Subtract line 26 from line 12:
a	Excess of revenue over expenses and disbursements	100,507
b	Net investment income (if negative, enter -0-)			353,604
c	Adjusted net income (if negative, enter -0-)...

For Paperwork Reduction Act Notice, see instructions.

Cat. No. 11289X Form 990-PF (2015)

Form 990-PF (2015)

Page 2

Part II		Balance Sheets	Beginning of year	End of year
Part II		Balance Sheets	(a) Book Value	(b) Book Value	(c) Fair Market Value
	1	Cash—non-interest-bearing.............
	2	Savings and temporary cash investments.........	912,362	769,993	769,993
	3	Accounts receivable 3,664
		Less: allowance for doubtful accounts		3,664	3,664
	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)	124,356	115,142	114,697
	b	Investments—corporate stock (attach schedule).......	2,979,015	3,533,783	5,259,643
	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)..........	726,025	699,560	905,258
	14	Land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	15	Other assets (describe )	947,352	667,475	0
	16	Total assets (to be completed by all filers—see the
		instructions. Also, see page 1, item I)	5,689,110	5,789,617	7,053,255
	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	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........	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	5,689,110	5,789,617
	30	Total net assets or fund balances (see instructions).....	5,689,110	5,789,617
	31	Total liabilities and net assets/fund balances (see instructions).	5,689,110	5,789,617

Part III

Analysis of Changes in Net Assets or Fund Balances

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) ...............

5,689,110

Enter amount from Part I, line 27a .....................

100,507

Other increases not included in line 2 (itemize) bullet

Add lines 1, 2, and 3 ..........................

5,789,617

Decreases not included in line 2 (itemize) bullet

Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30 .

5,789,617

Form 990-PF (2015)

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	283 Shares Kraft Group	P	2011-09-14	2015-07-06
b	1445 Shares Pall Corp.	P	2011-09-14	2015-08-31
c	333 Shares Kraft Group	P	2010-01-15	2015-07-06
d	1000 Shares Pall Corp.	P	2010-12-22	2015-08-31
e	The Chemours Corp. Cash in Lieu	P	2015-07-08	2015-07-08
	420 Shares Pall corp.	P	2006-07-13	2015-08-31
	WMI Corp. Cash in Lieu	P	2015-08-20	2015-08-20
	See Schedule I ML 40199	P	2015-01-01	2015-12-31
	See Schedule II ML 40200	P	2015-01-01	2015-12-31
	See Schedule III ML 40201	P	2015-01-01	2015-12-31
	Capital Gains Dividends	P

(e) Gross sales price		(g) Cost or other basis plus expense of sale	(h) Gain or (loss) (e) plus (f) minus (g)
a	4,670	16,018	-11,348
b	183,804	62,265	121,539
c	5,495	5,235	260
d	127,200	50,380	76,820
e	8		8
	53,424	21,160	32,264
	1		1
	255,541	260,382	-3,496
	222,792	254,431	-31,639
	268,673	293,994	-24,948
	14,599		14,599

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			-11,348
b			121,539
c			260
d			76,820
e			8
			32,264
			1
			-3,496
			-31,639
			-24,948
			14,599

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	174,060
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))
2014	160,427	5,328,027	0.030110
2013	125,121	2,977,987	0.042015
2012	80,132	2,483,192	0.032270
2011	62,382	1,577,210	0.039552
2010	49,711	1,274,790	0.038995

Total of line 1, column (d) .....................

20.182942

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 . . .

0.036588

Enter the net value of noncharitable-use assets for 2015 from Part X, line 5.....

6,818,700

Multiply line 4 by line 3......................

249,483

Enter 1% of net investment income (1% of Part I, line 27b)...........

3,536

Add lines 5 and 6........................

253,019

Enter qualifying distributions from Part XII, line 4.............

256,750

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 (2015)

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	3,536
	hereand 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	3,536
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	3,536
6	Credits/Payments:

a	2015 estimated tax payments and 2014 overpayment credited to 2015	6a	3,200
b	Exempt foreign organizations—tax withheld at source......	6b
c	Tax paid with application for extension of time to file (Form 8868)...	6c	1,238
d	Backup withholding erroneously withheld ...........	6d

7	Total credits and payments. Add lines 6a through 6d..............		7	4,438
8	Enter any penalty for underpayment of estimated tax. Check hereif Form 2220 is attached.		8	2
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	900
11	Enter the amount of line 10 to be: Credited to 2015 estimated tax900	Refunded	11	0

Part VII-A

Statements Regarding Activities

During the tax year, did the foundation attempt to influence any national, state, or local legislation or did

Yes

it participate or intervene in any political campaign? ....................

Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see Instructions

for definition)?.................................

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.

Did the foundation file Form 1120-POL for this year?.....................

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

Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed

on foundation managers. bullet

$ 0

Has the foundation engaged in any activities that have not previously been reported to the IRS?.......

If "Yes," attach a detailed description of the activities.

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....

Did the foundation have unrelated business gross income of $1,000 or more during the year?........

If "Yes," has it filed a tax return on Form 990-T for this year?...................

Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........

If "Yes," attach the statement required by General Instruction T.

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?................

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..................................

Yes

Enter the states to which the foundation reports or with which it is registered (see instructions)

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 .

Yes

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 2015 or the taxable year beginning in 2015 (see instructions for Part XIV)?

If "Yes," complete Part XIV.............................

Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names

and addresses. ...............................

Form 990-PF (2015)

Page 5

Part VII-A

Statements Regarding Activities (continued)

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) .............

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).................

Did the foundation comply with the public inspection requirements for its annual returns and exemption application?

Yes

Website address bullet

N/A

The books are in care of bullet

DAVID A BLACK CPA Telephone no. bullet

(516) 294-6638

Located at bullet

31 ROBBINS DRIVEEAST WILLISTONNY ZIP+4 bullet

11596

Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —Check here....... bullet

and enter the amount of tax-exempt interest received or accrued during the year ...... bullet

16 At any time during calendar year 2015, 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

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

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? YesNo

(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)

a disqualified person?......................YesNo

(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? YesNo

(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? YesNo

(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)?...............YesNo

(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.).......YesNo

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)? ........

Organizations relying on a current notice regarding disaster assistance check here........ bullet

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 2015?.............

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)):

At the end of tax year 2015, did the foundation have any undistributed income (lines 6d

and 6e, Part XIII) for tax year(s) beginning before 2015?.............YesNo

If "Yes," list the years bullet

20, 20, 20, 20

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.) ..............

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

Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at

any time during the year?......................YesNo

If "Yes," did it have excess business holdings in 2015 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 2015.)..................

Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?

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 2015?

Form 990-PF (2015)

Page 6

Part VII-B

Statements Regarding Activities for Which Form 4720 May Be Required (Continued)

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))? YesNo

(2) Influence the outcome of any specific public election (see section 4955); or to carry

on, directly or indirectly, any voter registration drive?.............YesNo

(3) Provide a grant to an individual for travel, study, or other similar purposes? YesNo

(4) Provide a grant to an organization other than a charitable, etc., organization described

in section 4945(d)(4)(A)? (see instructions)................YesNo

(5) Provide for any purpose other than religious, charitable, scientific, literary, or

educational purposes, or for the prevention of cruelty to children or animals?.....YesNo

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)? ......

Organizations relying on a current notice regarding disaster assistance check here......... bullet

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?..........YesNo

If "Yes," attach the statement required by Regulations section 53.4945–5(d).

Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on

a personal benefit contract?.....................YesNo

Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?....

If "Yes" to 6b, file Form 8870.

At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction? YesNo

If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....

Form 990-PF (2015)

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
Arlin A Jorge	Chairman 2.00	0	0	0
166 Huntington Bay Road Huntington,NY11743	Chairman 2.00	0	0	0
Judy A Kay	Secretary/Treasurer 2.00	0	0	0
25 Sydney Road Halesite,NY11743	Secretary/Treasurer 2.00	0	0	0

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...................				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............. bullet

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

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......................... bullet

Form 990-PF (2015)

Page 8

Part X

Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,see instructions.)

Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,

purposes:

Average monthly fair market value of securities...................

6,211,846

Average of monthly cash balances.......................

710,692

Fair market value of all other assets (see instructions)................

Total (add lines 1a, b, and c).........................

6,922,538

Reduction claimed for blockage or other factors reported on lines 1a and

1c (attach detailed explanation) .............

Acquisition indebtedness applicable to line 1 assets..................

Subtract line 2 from line 1d.........................

6,922,538

Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see

instructions) .............................

103,838

Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4

6,818,700

Minimum investment return. Enter 5% of line 5..................

340,935

Part XI

Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here bullet

and do not complete this part.)

Minimum investment return from Part X, line 6....................

340,935

Tax on investment income for 2015 from Part VI, line 5......

3,536

Income tax for 2015. (This does not include the tax from Part VI.)...

Add lines 2a and 2b............................

3,536

Distributable amount before adjustments. Subtract line 2c from line 1............

337,399

Recoveries of amounts treated as qualifying distributions................

Add lines 3 and 4............................

337,399

Deduction from distributable amount (see instructions).................

Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...

337,399

Part XII

Qualifying Distributions (see instructions)

Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:

Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........

256,750

Program-related investments—total from Part IX-B..................

Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,

purposes...............................

Amounts set aside for specific charitable projects that satisfy the:

Suitability test (prior IRS approval required)....................

Cash distribution test (attach the required schedule) .................

Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4

256,750

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).................

3,536

Adjusted qualifying distributions. Subtract line 5 from line 4..............

253,214

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 (2015)

Page 9

Part XIII

Undistributed Income (see instructions)

	(a) Corpus	(b) Years prior to 2014	(c) 2014	(d) 2015
1 Distributable amount for 2015 from Part XI, line 7				337,399
2 Undistributed income, if any, as of the end of 2015:
a Enter amount for 2014 only.......			245,208
b Total for prior years:20, 20, 20		0
3 Excess distributions carryover, if any, to 2015:
a From 2010......
b From 2011......
c From 2012......
d From 2013......
e From 2014......
fTotal of lines 3a through e........	0
4Qualifying distributions for 2015 from Part
XII, line 4: $ 256,750
a Applied to 2014, but not more than line 2a			245,208
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 2015 distributable amount.....				11,542
e Remaining amount distributed out of corpus	0
5 Excess distributions carryover applied to 2015.	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	0
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 2014. Subtract line 4a from line 2a. Taxable amount—see instructions .............			0
f Undistributed income for 2016. Subtract lines 4d and 5 from line 1. This amount must be distributed in 2015 ..........				325,857
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 2010 not applied on line 5 or line 7 (see instructions) ...	0
9Excess distributions carryover to 2016. Subtract lines 7 and 8 from line 6a ......	0
10 Analysis of line 9:
a Excess from 2011....
b Excess from 2012....
c Excess from 2013....
d Excess from 2014....
e Excess from 2015....

Form 990-PF (2015)

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 2015, enter the date of the ruling....... bullet

b Check box to indicate whether the organization is a private operating foundation described in section4942(j)(3) or4942(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) 2015	(b) 2014	(c) 2013	(d) 2012	(e) Total

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).)

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

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.

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 (2015)

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)		Foundation status of recipient	Purpose of grant or contribution	Amount
aPaid during the year
Huntington Hospital 270 Park Avenue Huntington,NY11743	None	Public	General	50,000
Huntington YMCA 60 Main Street Huntington,NY11743	None	Public	GENERAL	200,000
Lustgarten Foundation 1111 Stewart Avenue Bethpage,NY11714	None	Public	GeneralGeneral	2,000
The Pogil Project PO Box 3003 Lancaster,PA176043003	None	Public Charity	General	2,500
SOS Healthcare Inc PO Box 7136 Myrtle Beach,SC29572	None	Public Charity	General Fund	2,000
Total ................................. 3a				256,500

bApproved for future payment

Total ................................. 3b				0

Form 990-PF (2015)

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	(e) Related or exempt function income (See instructions.)
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 ...........					7,257
4 Dividends and interest from securities....			14	185,848
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	174,060
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		359,908	7,257

13Total. Add line 12, columns (b), (d), and (e)..................

13367,165

(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.)
3	Earnings on investments will be used to fund future distributions to Charity
4	Earnings on investments will be used to fund future distributions to Charity

Form 990-PF (2015)

Page 13

Part XVII

Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations

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 organizations?

Yes

Transfers from the reporting foundation to a noncharitable exempt organization of:

(1) Cash...................................

1a(1)

(2) Other assets.................................

1a(2)

Other transactions:

(1) Sales of assets to a noncharitable exempt organization....................

1b(1)

(2) Purchases of assets from a noncharitable exempt organization..................

1b(2)

(3) Rental of facilities, equipment, or other assets.......................

1b(3)

(4) Reimbursement arrangements...........................

1b(4)

(5) Loans or loan guarantees.............................

1b(5)

(6) Performance of services or membership or fundraising solicitations................

1b(6)

Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............

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

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?...........YesNo

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 EIN
	Firm's address				Phone no.

Form 990-PF (2015)

Additional Data

Software ID:
Software Version:

Form 990PF - Special Condition Description:

Special Condition Description

- TIN:

TY 2015 AccountingFeesSchedule

Name:

The Arlindo and Evelyn Jorge Family

Foundation and Trust

EIN:

20-6710947

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
Accounting	3,276	1,638		0

- TIN:

TY 2015 InvestmentsCorpStockSchedule

Name:

The Arlindo and Evelyn Jorge Family

Foundation and Trust

EIN:

20-6710947

Name of Stock	End of Year Book Value	End of Year Fair Market Value
500 Shares Altria Group	8,383	29,105
1000 Shares AT&T	28,005	34,410
700 Shares Bank of America Corp.	33,166	11,781
1000 Shares Bristol Myers Squibb	25,685	68,790
500 Shares Caterpillar	35,753	33,980
100 Shares CitiGroup	48,451	5,175
1000 Shares Conagra Foods	22,415	42,160
1000 Shares Consolidated Edison	43,878	64,270
800 Dow Chemical	30,281	41,184
500 DuPont	20,305	33,300
333 Duke Energy	16,769	23,773
1000 Shares General Electric	33,767	31,150
500 Shares Well Tower	15,380	34,015
1000 Shares Home Depot	36,475	132,250
500 Shares Johnson & Johnson	30,820	51,360
1000 Shares JP Morgan Chase	40,692	66,030
1000 Shares Merck	35,041	52,820
2000 Shares Microsoft	45,443	110,960
2000 Shares Monmouth RE Invs Corp.	16,045	20,920
1000 Shares Pfizer	22,995	32,280
700 Shares Proctor & Gamble	39,018	55,587
1000 Shares Verizon	29,371	46,220
333 Shares Kraft Foods	9,778	24,229
500 Shares Spectra Energy	15,750	11,970
500 Shares Philip Morris Intl	19,102	43,955
162 Shares Ares Capital	14,830	2,309
1000 Shares Altria	20,495	58,210
116 Shares AT&T	3,372	3,992
500 Home Depot	14,319	66,125
500 Johnson and Johnson	32,215	51,360
654 Mondelez International	12,522	29,325
1000 Pall Corp	0	0
300 Proctor and Gamble	18,354	23,823
500 Shares Caterpillar	30,245	33,980
1000 Shares Duke Energy	16,818	23,773
1000 Shares General Electric	16,615	31,150
1000 Shares Well Tower	40,888	68,030
100 Shares Health Care REIT	4,307	6,803
240 Shares Frontier	1,745	1,120
2000 Monmouth RE Invs Corp A	14,301	20,920
2000 Monmouth RE Invs Corp A	14,301	20,920
500 UMH Properties Inc.	4,102	5,060
1000 Health Care Reit Series D	51,460	68,030
363 Comcast Corp New CL. A	6,102	20,484
1000 Shares AT&T	30,630	34,410
2000 Bristol Myers Squibb	65,280	137,580
75 Shares Citigroup	2,560	3,881
100 Shares Citigroup	3,413	5,175
333 Shares Duke Energy	20,969	23,773
400 Shares Duke Energy	25,180	28,556
334 Shares Duke Energy	2,132	23,844
1000 Shares Exxon Mobil Corp	86,830	77,950
1000 Shares General Electric	19,120	31,150
2000 Shares General Electric	38,240	62,300
1000 Shares General Electric	19,120	31,150
346 Mondelez International	5,585	15,515
4000 Monmouth RE Invs Corp. A	32,707	41,840
100 Shares Panacos Pharmaceuticals	1	1
500 Shares Spectra Energy	15,750	11,970
600 Spectra Energy Corp.	18,900	14,364
4000 Shares UMH Properties	37,300	40,480
23 Shares WMI Holdings	30,747	60
1000 Shares Comcast New CL A	17,104	56,430
846 Shares Alcatel Lucent	2,502	3,240
300 Proctor and Gamble	95,771	117,235
1702 Shares Bank of America	11,957	28,645
446 Shares Banco Santander	3,879	1,735
426 Shares Boeing	26,776	61,595
202 Shares Comcast	4,434	11,399
955 Shares Capital One	41,141	68,932
850 Shares Caterpillar	72,033	57,766
336 Shares Citigroup	9,144	17,388
1192 Shares Cisco	19,650	32,369
1272 Shares Conagra	30,057	53,628
1419 Shares Duke Energy	81,104	101,302
846 Shares Dow Chemical	22,529	43,552
848 Shares Dupont	38,396	56,477
519 Shares Exxon Mobil	37,607	40,456
5676 Shares General Electric	92,159	176,808
1070 Shares HOme Depot	36,772	141,508
2558 Shares JP MOrgan Chase	83,199	168,905
852 Shares Johnson and Johnson	54,294	87,517
283 Shares Kraft Food	10,248	20,591
854 Shares Merck	27,623	45,108
850 Shares Mondelez	18,980	38,114
5104 Shares Microsoft	134,465	283,170
100 Shares NCR	178	2,446
842 Shares Nabors Industries	15,004	7,165
1865 Shares Pall Corp.	0	0
1100 Shares Paychex	28,952	58,179
1830 Shares Panacos Pharm	8	1
424 Shares Philip Morris Intl	28,586	37,274
848 Shares Pfizer	15,527	27,373
1702 Proctor and Gamble	105,932	135,156
2208 Spectra Energy	43,315	40,890
636 Shares Sysco	17,280	26,076
100 Shares Teradata	5,030	2,642
426 Shares 3M	33,505	64,173
2268 Magellan Midsreatm	67,626	154,043
848 XCEL Energy	20,918	30,452
1509 Federated Govt Securities	0	0
700 Shares Apple	58,281	73,682
Merrill Lynch	647,594	665,134

- TIN:

TY 2015 InvestmentsGovtObligationsSch

Name:

The Arlindo and Evelyn Jorge Family

Foundation and Trust

EIN:

20-6710947

US Government Securities - End of Year Book Value:

115,142

US Government Securities - End of Year Fair Market Value:

114,697

State & Local Government Securities - End of Year Book Value:

State & Local Government Securities - End of Year Fair Market Value:

- TIN:

TY 2015 InvestmentsOtherSchedule2

Name:

The Arlindo and Evelyn Jorge Family

Foundation and Trust

EIN:

20-6710947

Category/ Item	Listed at Cost or FMV	Book Value	End of Year Fair Market Value
6000 Aberdeen Asia PAC Inc.	AT COST	37,340	27,420
4000 Blackrock Income Trust	AT COST	24,325	25,520
2000 Shares Blackrock Gl	AT COST	37,361	25,000
4000 Calamos Conv & High Inc.	AT COST	60,507	42,040
3000 Shares Flaherty & Crumrine	AT COST	54,380	60,150
3000 Pimco Corporate Income	AT COST	44,230	40,200
2000 Magellan MIdstream	AT COST	43,277	135,840
550 Energy Transfer Partners	AT COST	25,960	18,551
900 Health Care REIT Inc.	AT COST	43,081	61,227
1000 Health Care REit Inc.	AT COST	54,960	68,030
2000 Magellan Midstream Partners	AT COST	73,370	135,840
1000 Energy Transfer Partners	AT COST	45,343	33,730
3406 Shares Health Care REIT	AT COST	155,426	231,710

- TIN:

TY 2015 OtherAssetsSchedule

Name:

The Arlindo and Evelyn Jorge Family

Foundation and Trust

EIN:

20-6710947

Description	Beginning of Year - Book Value	End of Year - Book Value	End of Year - Fair Market Value
Unrealized gains/losses	947,352	667,475

- TIN:

TY 2015 OtherExpensesSchedule

Name:

The Arlindo and Evelyn Jorge Family

Foundation and Trust

EIN:

20-6710947

Description	Revenue and Expenses per Books	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
Filing fees	250	0		250

- TIN:

TY 2015 OtherProfessionalFeesSchedule

Name:

The Arlindo and Evelyn Jorge Family

Foundation and Trust

EIN:

20-6710947

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
Investment Management	4,263	4,263		0

- TIN:

TY 2015 TaxesSchedule

Name:

The Arlindo and Evelyn Jorge Family

Foundation and Trust

EIN:

20-6710947

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
Federal Excise Tax	2,036	0		0
Foreign Withholding Taxes	333	333		0