-
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
15
Open to Public Inspection
For calendar year 2015, or tax year beginning
01-01-2015
, and ending
12-31-2015
Name of foundation
JAMES B LUKE FAMILY CHARITABLE
FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)
50 ROUTE 46 SUITE 100
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
PARSIPPANY
,
NJ
07054
A Employer identification number
26-6244583
B
Telephone number (see instructions)
(973) 227-1366
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
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here .......
I
Fair market value of all assets at end
of year
(from Part II, col. (c),
line 16)
$
11,294
J
Accounting method:
Cash
Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)
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)
148,000
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)
...
0
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
........
148,000
0
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)
.......
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)
.......
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
0
0
0
25
Contributions, gifts, grants paid
.......
140,390
140,390
26
Total expenses and disbursements.
Add lines 24 and 25
140,390
0
140,390
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
7,610
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
(2015)
Form 990-PF (2015)
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
.............
2
Savings and temporary cash investments
.........
3,684
11,294
11,294
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)
3,684
11,294
11,294
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
3,684
11,294
30
Total net assets or fund balances
(see instructions)
.....
3,684
11,294
31
Total liabilities and net assets/fund balances
(see instructions)
.
3,684
11,294
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
3,684
2
Enter amount from Part I, line 27a
.....................
2
7,610
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
11,294
5
Decreases not included in line 2 (itemize)
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30
.
6
11,294
Form
990-PF
(2015)
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.)
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))
2014
119,650
13,228
9.045207
2013
112,070
15,528
7.217285
2012
78,000
11,701
6.666097
2011
120,025
16,783
7.151582
2010
65,950
7,555
8.729318
2
Total
of line 1, column (d)
.....................
2
38.809489
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
7.761898
4
Enter the net value of noncharitable-use assets for 2015 from Part X, line 5
.....
4
11,400
5
Multiply line 4 by line 3
......................
5
88,486
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
0
7
Add lines 5 and 6
........................
7
88,486
8
Enter qualifying distributions from Part XII, line 4
.............
8
140,390
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)
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
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
0
3
Add lines 1 and 2
...........................
3
0
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
0
6
Credits/Payments:
a
2015 estimated tax payments and 2014 overpayment credited to 2015
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
0
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
0
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.
$
0
(2)
On foundation managers.
$
0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
Yes
7
Did the foundation have at least $5,000 in assets at any time during the year?
If "Yes," complete Part II, col. (c),
and Part XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
NJ
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
No
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 2015 or the taxable year beginning in 2015 (see instructions for Part XIV)?
If "Yes," complete Part XIV
.............................
9
No
10
Did any persons become substantial contributors during the tax year?
If "Yes," attach a schedule listing their names
and addresses.
...............................
10
Yes
Form
990-PF
(2015)
Form 990-PF (2015)
Page
5
Part VII-A
Statements Regarding Activities (continued)
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
FOUNDATION
Telephone no.
(973) 227-1366
Located at
50 ROUTE 46 SUITE 100
PARSIPPANY
NJ
ZIP+4
07054
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 2015, 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
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
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 2015?
.............
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 2015, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2015?
.............
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
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 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.)
..................
3b
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2015?
4b
No
Form
990-PF
(2015)
Form 990-PF (2015)
Page
6
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
(Continued)
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
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
Form
990-PF
(2015)
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
KENNETH EBERLE
TRUSTEE
0.50
0
0
0
50 ROUTE 46 SUITE 100
PARSIPPANY
,
NJ
07054
TIMOTHY MATTHEWS
TRUSTEE
0.50
0
0
0
1439 COURSE VIEW DRIVE
ORANGE PARK
,
FL
32003
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
.............
0
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
.........................
0
Form
990-PF
(2015)
Form 990-PF (2015)
Page
8
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
11,574
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
11,574
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation)
.............
1e
0
2
Acquisition indebtedness applicable to line 1 assets
..................
2
0
3
Subtract line 2 from line 1d
.........................
3
11,574
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
174
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
11,400
6
Minimum investment return.
Enter 5% of line 5
..................
6
570
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
570
2a
Tax on investment income for 2015 from Part VI, line 5
......
2a
b
Income tax for 2015. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
0
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
570
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
570
6
Deduction from distributable amount (see instructions)
.................
6
0
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1
...
7
570
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
140,390
b
Program-related investments—total from Part IX-B
..................
1b
0
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
b
Cash distribution test (attach the required schedule)
.................
3b
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
140,390
5
Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
income. Enter 1% of Part I, line 27b (see instructions)
.................
5
0
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
140,390
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)
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
570
2
Undistributed income, if any, as of the end of 2015:
a
Enter amount for 2014 only
.......
0
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2015:
a
From 2010
......
65,572
b
From 2011
......
119,186
c
From 2012
......
77,415
d
From 2013
......
111,294
e
From 2014
......
118,989
f
Total
of lines 3a through e
........
492,456
4
Qualifying distributions for 2015 from Part
XII, line 4:
$
140,390
a
Applied to 2014, but not more than line 2a
0
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
0
c
Treated as distributions out of corpus (Election
required—see instructions)
........
0
d
Applied to 2015 distributable amount
.....
570
e
Remaining amount distributed out of corpus
139,820
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).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
632,276
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
..........
0
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions)
.......
0
8
Excess distributions carryover from 2010 not
applied on line 5 or line 7 (see instructions)
...
65,572
9
Excess distributions carryover to 2016.
Subtract lines 7 and 8 from line 6a
......
566,704
10
Analysis of line 9:
a
Excess from 2011
....
119,186
b
Excess from 2012
....
77,415
c
Excess from 2013
....
111,294
d
Excess from 2014
....
118,989
e
Excess from 2015
....
139,820
Form
990-PF
(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
.......
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)
2015
(b)
2014
(c)
2013
(d)
2012
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
(2015)
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)
a
Paid during the year
AARP FOUNDATION
P O BOX 93207
LONG BEACH
,
CA
90809
NONE
PUBLIC CHARITY
HELP SERVE VULNERABLE PEOPLE 50+ BY CREATING AND ADVANCING EFFECTIVE SOLUTIONS THAT HELP THEM SECURE THE ESSENTIALS.
1,000
ALZHEIMER'S ASSOCIATION NJ CHAPTER
400 MORRIS AVENUE SSTE 251
DENVILLE
,
NJ
078341365
NONE
PUBLIC CHARITY
TO HELP ELIMINATE ALZHEIMER'S DISEASE THROUGH THE ADVANCEMENT OF RESEARCH.
4,000
AMERICAN CANCER SOCIETY HOPE LODGE NYC
132 WEST 32ND STREET
NEW YORK
,
NY
10001
NONE
PUBLIC CHARITY
TO CREATE A PLACE WHERE CANCER PATIENTS AND THEIR CAREGIVERS CAN FIND HELP AND HOPE WHEN HOME IS FAR AWAY.
1,500
AMERICAN HUMANE ASSOCIATION
214 BRAZILIAN AVENUE SUITE 280
PALM BEACH
,
FL
33480
NONE
PUBLIC CHARITY
TO PROTECT CHILDREN AND ANIMALS FROM CRUELTY, ABUSE, NEGLECT AND EXPLOITATION.
2,000
ASPCA
424 E 92ND STREET
NEW YORK
,
NY
10128
NONE
PUBLIC CHARITY
TO PROVIDE EFFECTIVE MEANS FOR THE PREVENTION OF CRUELTY TO ANIMALS THROUGHOUT THE UNITED STATES.
1,000
AUTISM SPEAKS
1060 STATE ROAD 2ND FL
PRINCETON
,
NJ
085401446
NONE
PUBLIC CHARITY
FUND THE GOAL IS TO CHANGE THE FUTURE FOR ALL WHO STRUGGLE WITH AN AUTISM SPECTRUM DISORDER.
4,000
BALLENISLES CHARITIES FOUNDATION INC
100 BALLENISLES CIRCLE
PALM BEACH GARDENS
,
FL
33418
NONE
PUBLIC CHARITY
TO RENDER FINANCIAL AND IN-KIND SUPPORT TO CIVIC AND NOT-FOR-PROFIT ORGANIZATIONS WHOSE PURPOSES ARE TO PROVIDE CIVIC AND CULTURAL PROGRAMS.
4,000
BIG DOG RANCH RESCUE
10948 ACME ROAD
WELLINGTON
,
FL
33414
NONE
PUBLIC CHARITY
TO BE A LEADER IN THE NATIONAL ANIMAL WELFARE MOVEMENT, THROUGH COMPASSION.
2,000
BOY SCOUTS OF AMERICA-NORTHERN NJ COUNCIL
25 RAMAPO VALLEY ROAD
OAKLAND
,
NJ
07436
NONE
PUBLIC CHARITY
TO PREPARE YOUNG PEOPLE TO MAKE ETHICAL AND MORAL CHOICES OVER THEIR LIFETIMES.
250
BRADY CENTER TO PREVENT GUN VIOLENCE
1225 EYE STREET NW STE 1000
WASHINGTON
,
DC
20005
NONE
PUBLIC CHARITY
TO CREATE A SAFER AMERICA FOR ALL OF US THAT WILL LEAD TO A DRAMATIC REDUCTION IN GUN DEATHS AND INJURIES.
1,500
BRATTLEBORO AREA HOSPICE
191 CANAL ST
BRATTLEBORO
,
VT
05301
NONE
PUBLIC CHARITY
PROVIDE NON-MEDICAL ASSISTANCE TO THE TERMINALLY ILL AND THEIR LOVED ONES, BEREAVEMENT SERVICES TO HOSPICE FAMILIES AS WELL AS THE GENERAL PUBLIC.
500
BUSCH WILDLIFE SANCTUARY
2500 JUPITER PARK DRIVE
JUPITER
,
FL
33458
NONE
PUBLIC CHARITY
TO FUND WILDLIFE REHABILITATION AND ENVIRONMENTAL EDUCATION.
2,000
CARE GIFT CENTER
P O BOX 1870
MERRIFIELD
,
VA
22116
NONE
PUBLIC CHARITY
TO HELP SERVE INDIVIDUALS AND FAMILIES IN THE POOREST COMMUNITIES IN THE WORLD.
2,000
CHAPEL OF THE SNOWS
C/O OUR LADY OF MERCY P O BOX 1870
MANCHESTER CENTER
,
VT
05255
NONE
PUBLIC CHARITY
TO JOYFULLY SHARE FAITH, AND TO HUMBLY SERVE THE NEEDS OF OTHERS.
500
CHILTON MEMORIAL HOSPITAL FOUNDATION
97 WEST PARKWAY
POMPTON PLAINS
,
NJ
07444
NONE
PUBLIC CHARITY
TO SUPPORT THE CAPITAL NEEDS OF CHILTON MEDICAL CENTER AND ITS FAMILY OF AFFILIATES.
4,000
DEIRDRE'S HOUSE
8 COURT STREET
MORRISTOWN
,
NJ
07960
NONE
PUBLIC CHARITY
RELIGIOUS, MEDICAL, EDUCATIONAL OR OTHER CHARITABLE
1,000
EVA'S VILLAGE
393 MAIN ST
PATERSON
,
NJ
07501
NONE
PUBLIC CHARITY
TO FEED THE HUNGRY, SHELTER THE HOMELESS, AND TREAT THE ADDICTED.
4,000
FEEDING AMERICA
35 E WACKER DRIVE SUITE 2000
CHICAGO
,
IL
60601
NONE
PUBLIC CHARITY
HELPING THE FIGHT AGAINST HUNGER NATIONWIDE.
1,000
FRIENDS OF WAYNE ANIMALS
P O BOX 3701
WAYNE
,
NJ
07470
NONE
PUBLIC CHARITY
TO HELP RECRUIT AND TRAIN VOLUNTEERS WHO WILL SAVE LIVES BY INCREASING PET ADOPTIONS.
2,000
GOODWILL RESCUE MISSION
P O BOX 7026 ROSEVILLE STATION
NEWARK
,
NJ
07107
NONE
PUBLIC CHARITY
ENABLE THE POOR, HOMELESS, AND ADDICTED OF NEWARK TO ENCOUNTER CHRIST THROUGH COMPASSIONATE CARE.
1,000
GRACE COTTAGE FOUNDATION
P O BOX 1
TOWNSHEND
,
VT
05353
NONE
PUBLIC CHARITY
TO HELP SERVE THE HEALTH CARE NEEDS OF THE COMMUNITY.
750
HABITAT FOR HUMANITY
121 HABITAT STREET
AMERICUS
,
GA
31707
NONE
PUBLIC CHARITY
TO HELP BRING PEOPLE TOGETHER TO BUILD HOMES, COMMUNITIES AND HOPE.
1,750
LAKE BOMOSEEN PRESERVATION TRUST
25 WASHINGTON STREET
RUTLAND
,
VT
05701
NONE
PUBLIC CHARITY
SEEK TO PRESERVE THE HISTORIC AND NATURAL BEAUTY OF LAKE BOMOSEEN.
4,000
LEADERS IN FURTHERING EDUCATION
1720 S OCEAN BLVD
MANALAPAN
,
FL
33462
NONE
PUBLIC CHARITY
EDUCATING THE DISADVANTAGED, MARGINALIZED, OR FORGOTTEN BECAUSE OF DISABILITIES.
3,000
MARKET STREET MISSION
9 MARKET STREET
MORRISTOWN
,
NJ
07960
NONE
PUBLIC CHARITY
TO MINISTER TO THE HOMELESS, HELPLESS, AND HOPELESS IN NORTHERN NJ.
4,000
MATT TALBOT RETREAT GROUP NO 8 OF MAHWAH
32 WATKINS DRIVE
SANDY HOOK
,
CT
06482
NONE
PUBLIC CHARITY
TO HELP FUND THE TREATMENT SUBSTANCE ABUSE.
890
MAYO PERFORMING ARTS
1000 SOUTH STREET
MORRISTOWN
,
NJ
07960
NONE
PUBLIC CHARITY
TO HELP SUPPORT AND CULTIVATE THE PERFORMING ARTS
1,000
MIDDLEBURY COLLEGE
14 OLD CHAPEL ROAD
MIDDLEBURY
,
VT
05753
NONE
PUBLIC CHARITY
TO OFFER AN INSPIRATIONAL SETTING FOR LEARNING AND REFLECTION, REINFORCING COMMITMENT TO INTEGRATING ENVIRONMENTAL STEWARDSHIP INTO BOTH CURRICULUM AND PRACTICE.
25,000
MONTVILLE PET PARENTS
P O BOX 231
PINE BROOK
,
NJ
07058
NONE
PUBLIC CHARITY
TO HELP BUILD A KINDER WORLD FOR HOMLESS PETS.
2,000
NATIONAL HEADACHE FOUNDATION
820 N ORLEANS SUITE 217
CHICAGO
,
IL
60610
NONE
PUBLIC CHARITY
FUNDING ADVANCEMENTS IN HEADACHE MEDICINE.
1,000
NATIONAL MUSEUMS OF SCOTLAND
275 MADISON AVENUE STE 401
NEW YORK
,
NY
10016
NONE
PUBLIC CHARITY
TO HELP PRESERVE, INTERPRET AND MAKE ACCESSIBLE FOR ALL, THE PAST AND PRESENT OF SCOTLAND.
500
NB4T
28 DWIGHT PLACE
FAIRFIELD
,
NJ
07004
NONE
PUBLIC CHARITY
TO ESTABLISH A COLLABORATIVE ENVIRONMENT IN WHICH PROFESSIONALS COME TOGETHER TO SUPPORT INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES.
3,250
PALM BEACH GARDENS FIRE RESCUE
10500 N MILITARY TRAIL
PALM BEACH GARDENS
,
FL
33410
NONE
PUBLIC CHARITY
SUPPORT ADVANCED LIFE SUPPORT, RESCUE SERVICE, FIRE SUPPRESSION, FIRE SAFETY AND INSPECTION.
4,000
PASSAIC VALLEY HOSPICE
783 RIVERVIEW DR
TOTOWA
,
NJ
07511
NONE
PUBLIC CHARITY
HELP PROVIDE CARING, PROFESSIONAL AND COMPREHENSIVE SERVICES TO PATIENTS IN THE FINAL PHASE OF TERMINAL ILLNESS.
2,000
PEGGY ADAMS ANIMAL RESCUE LEAGUE
3200 N MILITARY TRAIL
WEST PALM BEACH
,
FL
33405
NONE
PUBLIC CHARITY
TO HELP PROVIDE SHELTER TO LOST, HOMELESS AND UNWANTED ANIMALS.
2,000
PLANNED PARENTHOOD
153 WASHINGTON STREET
NEWARK
,
NJ
07102
NONE
PUBLIC CHARITY
TO PROMOTE THE ABILITY OF ALL INDIVIDUALS TO LEAD FULFILLED LIVES, BUILD HEALTHY FAMILIES.
1,000
POMPTON FALLS VOLUNTEER FIRE DEPT #3
130 JACKSON AVENUE P O BOX 2011
WAYNE
,
NJ
07474
NONE
PUBLIC CHARITY
TO HELP VOLUNTEERS RESPOND TO ALL SERIOUS INCIDENTS INCLUDING STRUCTURE FIRES.
1,000
PREAKNESS BIBLE CHURCH
1108 PREAKNESS AVE
WAYNE
,
NJ
07470
NONE
PUBLIC CHARITY
TO PARTNER WITH OTHERS TO SHARE THE GOOD NEWS OF JESUS CHRIST AROUND THE WORLD.
6,000
SALVATION ARMY-PATERSON
541 W BROADWAY
PATERSON
,
NJ
07509
NONE
PUBLIC CHARITY
TO PREACH THE GOSPEL OF JESUS CHRIST AND TO MEET HUMAN NEEDS IN HIS NAME WITHOUT DISCRIMINATION.
4,000
SOUTHERN POVERTY LAW CENTER
400 WASHINGTON AVENUE
MONTGOMERY
,
AL
36104
NONE
PUBLIC CHARITY
TO HELP FUND THE FIGHTING OF HATE AND BIGOTRY AND SEEKING JUSTICE FOR THE MOST VULNERABLE MEMBERS OF OUR SOCIETY.
1,000
ST JOSEPH'S HOSPITAL FOUNDATION
224 HAMBURG TPKE
WAYNE
,
NJ
07470
NONE
PUBLIC CHARITY
TO EXTEND THE HEALING MINISTRY OF JESUS BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE OF PEOPLE.
4,000
ST MARY'S FOOD PANTRY
17 POMPTON AVE
POMPTON LAKES
,
NJ
07422
NONE
PUBLIC CHARITY
TO ALLEVIATE HUNGER THROUGH THE GATHERING AND DISTRIBUTION OF FOOD.
500
STRAIGHT AND NARROW
508 STRAIGHT STREET
PATERSON
,
NJ
07509
NONE
PUBLIC CHARITY
TO DEVELOP AND DELIVER EFFECTIVE PREVENTION, EDUCATION AND TREATMENT SERVICES.
4,000
STRATTON MOUNTAIN FOUNDATION
P O BOX 523
STRATTON MOUNTAIN
,
VT
05155
NONE
PUBLIC CHARITY
TO MAINTAIN, GROW, AND SUPPORT FREESTYLE SKI PROGRAMS.
1,000
THE BILLFISH FOUNDATION
2161 E COMMERCIAL BLVD 2ND FL
FORT LAUDERDALE
,
FL
33308
NONE
PUBLIC CHARITY
SUPPORT CONSERVATION THROUGH SPORTFISHING BY USING RESEARCH, EDUCATION, AND ADVOCACY.
1,000
THE CARTER CENTER
ONE COPENHILL AVE P O BOX 47339
ATLANTA
,
GA
30362
NONE
PUBLIC CHARITY
SUPPORTING THE FUNDAMENTAL COMMITMENT TO HUMAN RIGHTS AND THE ALLEVIATION OF HUMAN SUFFERING.
1,000
THE WILSON HOUSE
378 VILLAGE STREET
EAST DORSET
,
VT
05253
NONE
PUBLIC CHARITY
TO HELP SERVE THE HOMELESS ABUSER THROUGH COUNSELING AND THE 12-STEP PROGRAM .
2,000
UNICEF
P O BOX 27780
NEWARK
,
NJ
07101
NONE
PUBLIC CHARITY
TO ADVOCATE FOR THE PROTECTION OF CHILDREN'S RIGHTS AND TO EXPAND THEIR OPPORTUNITIES.
2,000
VISITING HEALTH OF NEW JERSEY
783 RIVERVIEW DR P O BOX 1007
TOTOWA
,
NJ
07511
NONE
PUBLIC CHARITY
TO HELP DELIVER HIGH QUALITY PROFESSIONAL AND ANCILLARY HEALTH CARE TO ELIGIBLE RECIPIENTS.
4,000
WAYNE INTERFAITH NETWORK
1 PIKE DRIVE
WAYNE
,
NJ
07470
NONE
PUBLIC CHARITY
TO HELP PROVIDE A CULTURAL, SPIRITUAL, AND RELIGIOUS HOME FOR A DIVERSE JEWISH POPULATION.
2,000
WAYNE TOWNSHIP FIRST AID SQUAD
P O BOX 291
WAYNE
,
NJ
07470
NONE
PUBLIC CHARITY
TO PROVIDE VOLUNTEER EMS AND RESCUE.
2,000
WAYNE TOWNSHIP PAL
1 PAL DRIVE
WAYNE
,
NJ
07470
NONE
PUBLIC CHARITY
PROVIDE FUNDING FOR A WIDE RANGE OF SPORTS FOR KIDS.
2,000
WAYNE TOWNSHIP PBA
P O BOX 3597
WAYNE
,
NJ
07470
NONE
PUBLIC CHARITY
PROVIDE FUNDING FOR A WIDE RANGE OF SPORTS FOR KIDS.
2,000
WEST RIVER HABITAT FOR HUMANITY
P O BOX 40
JACKSONVILLE
,
VT
05342
NONE
PUBLIC CHARITY
HELPING PUT GOD'S LOVE INTO ACTION, BRING PEOPLE TOGETHER TO BUILD HOMES, COMMUNITIES AND HOPE.
500
WNET - PATRON NETWORK
825 8TH AVE
NEW YORK
,
NY
10019
NONE
PUBLIC CHARITY
SUPPORT OUR HIGH-QUALITY, INSPIRING AND COMMERCIAL-FREE PROGRAMS.
1,000
WORLD WILDLIFE FUND
1250 24TH STREET NW
WASHINGTON
,
DC
20037
NONE
PUBLIC CHARITY
HELP STOP THE DEGRADATION OF THE PLANET'S NATURAL ENVIRONMENT.
1,250
WXEL
P O BOX 6607
WEST PALM BEACH
,
FL
33405
NONE
PUBLIC CHARITY
HELP SERVE THE EDUCATIONAL, CULTURAL AND ENTERTAINMENT NEEDS OF THE COMMUNITY.
750
PENN STATE DANCE MARATHON
227D HUB
UNIVERSITY PARK
,
PA
16802
NONE
PUBLIC CHARITY
TO HELP RAISE AWARENESS FOR THE FIGHT AGAINST PEDIATRIC CANCER.
2,000
Total
.................................
3a
140,390
b
Approved for future payment
Total
.................................
3b
0
Form
990-PF
(2015)
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.)
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)
..
0
0
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
0
(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
(2015)
Form 990-PF (2015)
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 organizations?
Yes
No
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 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:
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
15
Name of the organization
JAMES B LUKE FAMILY CHARITABLE
FOUNDATION
Employer identification number
26-6244583
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 other 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) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page
2
Name of organization
JAMES B LUKE FAMILY CHARITABLE
FOUNDATION
Employer identification number
26-6244583
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
LUKE FAMILY CHARITABLE LEAD ANNUITY TRUST
50 ROUTE 46 SUITE 100
PARSIPPANY
,
NJ
07054
$
148,000
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) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page
3
Name of organization
JAMES B LUKE FAMILY CHARITABLE
FOUNDATION
Employer identification number
26-6244583
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) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page
4
Name of organization
JAMES B LUKE FAMILY CHARITABLE
FOUNDATION
Employer identification number
26-6244583
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) (2015)
Additional Data
Software ID:
Software Version:
-
TIN:
TY 2015 ExplnOfNonFilingWithAGStmt
Name:
JAMES B LUKE FAMILY CHARITABLE
FOUNDATION
EIN:
26-6244583
Statement:
THE STATE OF NEW JERSEY HAS NO REGISTRATION REQUIREMENT FOR ORGANIZATIONS THAT DO NOT EXCEED $10,000 IN GROSS PUBLIC CONTRIBUTIONS FOR THE CURRENT FISCAL YEAR.
-
TIN:
TY 2015 SubstantialContributorsSch
Name:
JAMES B LUKE FAMILY CHARITABLE
FOUNDATION
EIN:
26-6244583
Name
Address
LUKE FAMILY CHARITABLE LEAD ANNUITY TRUST
50 ROUTE 46 SUITE 100
PARSIPPANY
,
NJ
07054