Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletInformation about Form 990-PF and its instructions is at www.irs.gov/form990pf.
OMB No. 1545-0052
2015
Open to Public Inspection
For calendar year 2015, or tax year beginning 01-01-2015 , and ending 12-31-2015
Name of foundation
CLERMONT FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)C/O GLORIA CHOONG PO BOX 429
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SUMMIT, NJ079020429
A Employer identification number

22-3177379
B Telephone number (see instructions)

(908) 273-0807
C bullet
G Check all that apply:

D 1. bullet
2. bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$6,101,416J Accounting method:
 
(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)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule) 183,438
2 Check bullet Sch. B .............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 121,608 101,030  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 333,960
b Gross sales price for all assets on line 6a 2,756,902
7 Capital gain net income (from Part IV, line 2)... 333,960
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)....... Click to see attachment 26,391 26,391  
12 Total. Add lines 1 through 11........ 665,397 461,381  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0 0   0
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 15,500 7,750   7,750
c Other professional fees (attach schedule)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 23,374 3,347   27
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 1,962 1,826   136
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 40,836 12,923   7,913
25 Contributions, gifts, grants paid....... 328,250 328,250
26 Total expenses and disbursements. Add lines 24 and 25 369,086 12,923   336,163
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 296,311
b Net investment income (if negative, enter -0-) 448,458
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
Assets 1 Cash—non-interest-bearing............. 51,787 130,200 130,200
2 Savings and temporary cash investments......... 414,325 439,438 439,438
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 3,606,953 Click to see attachment3,753,041 4,753,776
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet) Click to see attachment638,389 Click to see attachment700,586 Click to see attachment778,002
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 4,711,454 5,023,265 6,101,416
Liabilities 17 Accounts payable and accrued expenses.......... 600 16,100
18 Grants payable..................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22)......... 600 16,100
Net Assets or Fund Balances bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted..................    
25 Temporarily restricted...............    
26 Permanently restricted...............    
bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds........ 2,285,339 2,285,339
28 Paid-in or capital surplus, or land, bldg., and equipment fund 0 0
29 Retained earnings, accumulated income, endowment, or other funds 2,425,515 2,721,826
30 Total net assets or fund balances (see instructions)..... 4,710,854 5,007,165
31 Total liabilities and net assets/fund balances (see instructions). 4,711,454 5,023,265
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
4,710,854
2
Enter amount from Part I, line 27a .....................
2
296,311
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
5,007,165
5
Decreases not included in line 2 (itemize) bullet
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30 .
6
5,007,165
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.)
1 a SCHWAB 0296-PUBLICLY TRADED SECURITIES SHORT TERM P    
b SCHWAB 0296-PUBLICLY TRADED SECURITIES LONG TERM P    
c SCHWAB 3936-PUBLICLY TRADED SECURITIES SHORT TERM P    
d SCHWAB 3936-PUBLICLY TRADED SECURITIES LONG TERM P    
e SCHWAB 4262-PUBLICLY TRADED SECURITIES SHORT TERM P    
SCHWAB 4262-PUBLICLY TRADED SECURITIES LONG TERM P    
SCHWAB 8967-PUBLICLY TRADED SECURITIES SHORT TERM P    
ASIA REDUX-LONG TERM P    
ASIA REDUX-SHORT TERM GAIN P    
CAPITAL GAINS DIVIDENDS P    
(e) Gross sales price (f) Depreciation allowed
(or allowable) 		(g) Cost or other basis
plus expense of sale 		(h) Gain or (loss)
(e) plus (f) minus (g)
a 8,179   8,387 -208
b 2,840   3,133 -293
c 1,294,402   1,217,651 76,751
d 1,371,128   1,129,940 241,188
e 3,487   5,181 -1,694
3,042   2,442 600
49,853   46,212 3,641
4,158     4,158
    9,996 -9,996
19,813     19,813
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       -208
b       -293
c       76,751
d       241,188
e       -1,694
      600
      3,641
      4,158
      -9,996
      19,813
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 333,960
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)
If section 4940(d)(2) applies, leave this part blank.
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period?
If "Yes," the foundation does not qualify under section 4940(e). Do not complete this part.
1 Enter the appropriate amount in each column for each year; see instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in) 		(b)
Adjusted qualifying distributions 		(c)
Net value of noncharitable-use assets 		(d)
Distribution ratio
(col. (b) divided by col. (c))
2014 256,533 6,072,777 0.042243
2013 283,017 5,365,425 0.052748
2012 239,803 4,363,725 0.054954
2011 208,839 4,309,851 0.048456
2010 186,842 4,213,009 0.044349
2
Total of line 1, column (d) .....................
20.242750
3
Average distribution ratio for the 5-year base period—divide the total on line 2 by 5, or by
the number of years the foundation has been in existence if less than 5 years . . .
3
0.048550
4
Enter the net value of noncharitable-use assets for 2015 from Part X, line 5.....
4
6,174,380
5
Multiply line 4 by line 3......................
5
299,766
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
4,485
7
Add lines 5 and 6........................
7
304,251
8
Enter qualifying distributions from Part XII, line 4.............
8
336,163
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 Bullet and enter “N/A" on line 1. Bracket
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b 1 4,485
hereBulletand enter 1% of Part I, line 27b...................
c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 4,485
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 4,485
6 Credits/Payments:
a 2015 estimated tax payments and 2014 overpayment credited to 2015 6a 15,723
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 15,723
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. Click to see attachment 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 11,238
11 Enter the amount of line 10 to be: Credited to 2015 estimated taxBullet11,238 RefundedBullet 11 0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see Instructions
for definition)?.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletNJ
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 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
     
    No
    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 addressbulletN/A
    14
    The books are in care ofbulletMARTHA KEITH TRUSTEE Telephone no.bullet (908) 273-0807

    Located atbulletC/O GLORIA CHOONG PO BOX 429SUMMITNJ ZIP+4bullet079020429
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041.......bullet
    and enter the amount of tax-exempt interest received or accrued during the year ......bullet
    15  
    16 At any time during calendar year 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
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?......................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?...............
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).......
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance (see instructions)? ........
    1b
     
     
    ........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 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?.............
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?......................
    b
    If "Yes," did it have excess business holdings in 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))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?.............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? (see instructions)................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?.....
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance (see instructions)? ......
    5b
     
     
    .........bullet
    c
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?..........
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?.....................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    Form 990-PF (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
    MARTHA H KEITH TRUSTEE
    1.00     		0 0 0
    C/O GLORIA CHOONG PO BOX 429
    SUMMIT,NJ079020429
    GARNETT L KEITH TRUSTEE
    1.00     		0 0 0
    C/O GLORIA CHOONG PO BOX 429
    SUMMIT,NJ079020429
    GLORIA CHOONG SECRETARY
    5.00     		0 0 0
    C/O GLORIA CHOONG PO BOX 429
    SUMMIT,NJ079020429
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet 0
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1
     
    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.........................bullet0
    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
    5,677,961
    b
    Average of monthly cash balances.......................
    1b
    590,445
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    6,268,406
    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
    6,268,406
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    94,026
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    6,174,380
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    308,719
    Part XI
    Distributable Amount bullet
    1
    Minimum investment return from Part X, line 6....................
    1
    308,719
    2a
    Tax on investment income for 2015 from Part VI, line 5......
    2a
    4,485
    b
    Income tax for 2015. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    4,485
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    304,234
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    304,234
    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
    304,234
    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
    336,163
    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
    336,163
    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
    4,485
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    331,678
    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 7 304,234
    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......  
    b From 2011......  
    c From 2012......  
    d From 2013...... 18,262
    e From 2014......  
    fTotal of lines 3a through e........ 18,262
    4Qualifying distributions for 2015 from Part
    XII, line 4: bullet$ 336,163
    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..... 304,234
    e Remaining amount distributed out of corpus 31,929
    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 50,191
    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
    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 ......     		50,191
    10 Analysis of line 9:
    a Excess from 2011....  
    b Excess from 2012....  
    c Excess from 2013.... 18,262
    d Excess from 2014....  
    e Excess from 2015.... 31,929
    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.......bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 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.)
    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).)
    MARTHA H KEITH
    GARNETT L KEITH
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail 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:
    N/A
    cAny submission deadlines:
    N/A
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    N/A
    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)
    aPaid during the year
    AGNES SCOTT COLLEGE
    141 EAST COLLEGE AVE
    DECATUR,GA300303770     		NONE EXEMPT EDUCATION 20,000
    AMERICAN INDIAN INSTITUTE
    504 WEST MEDENHALL ST
    BOZEMAN,MT59715     		NONE EXEMPT HEALTH 1,000
    AMERICAN RED CROSS NEW JERSEY CROSSROADS
    695 SPRINGFIELD AVE
    SPRINGFIELD,NJ07901     		NONE EXEMPT HEALTH 2,000
    AMNESTY INTERNATIONAL USA
    5 PENN PLAZA
    NEW YORK,NY100011810     		NONE EXEMPT HEALTH 1,000
    ASPEN MUSIC FESTIVAL & SCHOOL
    2 MUSIC SCHOOL ROAD
    ASPEN,CO81611     		NONE EXEMPT ARTS 1,000
    BETA PSI FOUNDATION
    6400 POWERS FERRY RD STE 400
    ATLANTA,GA30339     		NONE EXEMPT EDUCATION 1,000
    BIG SKY YOUTH EMPOWERMENT PROJECT INC
    PO BOX 6757
    BOZEMAN,MT597717021     		NONE EXEMPT COMMUNITY 1,000
    BOSTON BALLET
    19 CLARENDON ST
    BOSTON,MA02116     		NONE EXEMPT SOCIAL SERVICE 500
    BOSTON RESCUE MISSION
    PO BOX 849100
    BOSTON,MA022849100     		NONE EXEMPT SOCIAL SERIVCE 250
    BREAD FOR THE WORLD INSTITUTE
    425 3RD ST SW STE 1200
    WASHINGTON,DC20024     		NONE EXEMPT SOCIAL SERVICE 5,000
    CAMBRIDGE INSIGHT MEDITATION CENTER
    331 BROADWAY
    CAMBRIDGE,MA02139     		NONE EXEMPT EDUCATION 5,000
    COMMUNITY FOUNDATION OF GREATER ATLANTA INC
    191 PEACHTREE ST NE STE 1000
    ATLANTA,GA30303     		NONE EXEMPT SOCIAL SERIVCE 2,500
    DIRECT RELIEF INTERNATIONAL
    27 S LA PATERA LN
    SANTA BARBARA,CA93107     		NONE EXEMPT HEALTH 5,000
    DOCTORS WITHOUT BORDERS
    333 SEVENTH AVE 2ND FL
    NEW YORK,NY10001     		NONE EXEMPT HEALTH 10,000
    DUKE UNIVERSITY (CLASS OF 1960)
    PO BOX 90581
    DURHAM,NC277080581     		NONE EXEMPT EDUCATION -5,000
    ENVIRONMENTAL DEFENSE
    257 PARK AVE S
    NEW YORK,NY10010     		NONE EXEMPT ENVIRONMENT 2,000
    GALLATIN VALLEY LAND TRUST
    PO BOX 7021
    BOZEMAN,MT597717021     		NONE EXEMPT ENVIRONMENT 5,000
    GEORGIA TECH FOUNDATION
    760 SPRING ST NW STE 400
    ATLANTA,GA30308     		NONE EXEMPT EDUCATION 25,000
    GEORGIA TEC FOUNDATION INC
    177 NORTH AVE NW
    ATLANTA,GA303320220     		NONE EXEMPT EDUCATION 25,000
    GEORGIA TECH FOUNDATION ROLL CALL
    190 NORTH AVENUE NW
    ATLANTA,GA303132550     		NONE EXEMPT EDUCATION 250
    GTF INC
    760 SPRING ST NW STE 400
    ATLANTA,GA30308     		NONE EXEMPT EDUCATION 5,000
    GIANT STEPS THERAPEUTIC EQUESTRIAN CENTER
    PO BOX 4855
    PETALUMA,CA949554855     		NONE EXEMPT HEALTH 500
    GREATER BOSTON FOOD BANK THE
    70 SOUTH BAN AVE
    BOSTON,MA02118     		NONE EXEMPT SOCIAL SERVICE 1,000
    GREATER FOUR CORNER ACTION COALITION EASTERN SERVICE WORKERS ASSN
    247 BOWDOIN ST
    DORCHESTER,MA02122     		NONE EXEMPT SOCIAL SERVICE 8,000
    HARVARD BUSINESS SCHOOL FUND
    SOLDIERS FIELD RD
    BOSTON,MA021639904     		NONE EXEMPT EDUCATION 1,000
    HEADWATERS ACADEMY
    418 WEST GARFIELD ST
    BOZEMAN,MT59715     		NONE EXEMPT SOCIAL SERVICE 2,000
    HUMAN RESOURCE DEVELOPMENT COUNCIL (HRDC)OF DISTRICT IX INC
    32 SOUTH TRACY
    BOZEMAN,MT59715     		NONE EXEMPT HEALTH 1,000
    LEAGUE OF WOMEN'S VOTERS EDUCATION FUND
    1730 M ST NW STE 1000
    WASHINGTON,DC200364508     		NONE EXEMPT EDUCATION 250
    LEXINGTON FIREFIGHTERS AIDE AND RELIEF ASSN
    45 BEDFORD ST PO BOX 186
    LEXINGTON,MA02421     		NONE EXEMPT SOCIAL SERVICE 250
    LEXINGTON HISTORICAL SOCIETY
    13 DEPOT SQ PO BOX 514
    LEXINGTON,MA02420     		NONE EXEMPT EDUCATION 250
    LEXINGTON SYMPHONY
    PO BOX 194
    LEXINGTON,MA024200002     		NONE EXEMPT ARTS 1,000
    LEXINGTON YOUTH AND FAMILY SERVICES
    7 HARRINGTON ROAD
    LEXINGTON,MA02421     		NONE EXEMPT SOCIAL SERVICE 15,000
    MCLEAN HOSPITAL
    115 MILL STREET MAIL STOP 126
    BELMONT,MA024781064     		NONE EXEMPT HEALTH 15,000
    MAYO FOUNDATION
    200 FIRST ST SW
    ROCHESTER,MN55905     		NONE EXEMPT HEALTH 10,000
    MIDDLE CREEK MONTESSORI SCHOOL
    1572 COBB HILL RD
    BOZEMAN,MT59718     		NONE EXEMPT EDUCATION 10,000
    NATIONAL OUTDOOR LEADERSHIP SCHOOL
    284 LINCOLN ST
    LANDER,WY825022848     		NONE EXEMPT EDUCATION 4,000
    NEWARK MUSEUM
    49 WASHINGTON STREET
    NEWARK,NJ07101     		NONE EXEMPT ARTS 2,000
    NORTHFIELD MOUNT HERMON GIFT RECORDING OFFICE-NORTON HOUSE
    ONE LAMPLIGHTER WAY
    MT HERMON,MA01354     		NONE EXEMPT EDUCATION 10,000
    NORTHWEST FURNITURE BANK
    117 PUYALLUP AVE
    TACOMA,WA98421     		NONE EXEMPT SOCIAL SERVICE 1,000
    NURSE-FAMILY PARTNERSHIP
    1900 GRANT ST STE 400
    DENVER,CO80230     		NONE EXEMPT HEALTH 5,000
    OVERLOOK HOSPITAL FOUNDATION
    36 UPPER OVERLOOK RD
    SUMMIT,NJ079020220     		NONE EXEMPT HEALTH 1,000
    OXFAM AMERICA
    PO BOX 55807
    BOSTON,MA022055807     		NONE EXEMPT HEALTH 5,000
    PARK LAKE PRESBYTERIAN CHURCH
    309 E COLONIAL DR
    ORLANDO,FL328011286     		NONE EXEMPT RELIGION 12,000
    PLANNED PARENTHOOLD FEDERATION OF AMERICA
    434 WEST 33RD ST
    NEW YORK,NY10001     		NONE EXEMPT HEALTH 3,000
    PROJECT RENEWAL
    200 VARICK ST
    NEW YORK,NY10014     		NONE EXEMPT SOCIAL SERVICE 2,000
    REACH OUT AND READ
    56 ROLAND ST STE 1000
    BOSTON,MA02129     		NONE EXEMPT EDUCATION 5,000
    SAN JOAQUIN RIVER PARKWAY AND CONSERVATION TRUST INC
    11605 OLD FRIANT RD
    FRESNO,CA93730     		NONE EXEMPT ENVIRONMENT 1,000
    SAVE THE CHILDREN
    501 KINGS HWY E STE 400
    FAIRFIELD,CT06825     		NONE EXEMPT HEALTH 3,000
    SHALLOWFORD PRESBYTERIAN CHURCH
    2375 SHALLOWFORD RD NE
    ATLANTA,GA30345     		NONE EXEMPT RELIGION 13,000
    SNOWMASS WILDCAT FIRE DEPARTMENT
    BOX 6436
    SNOWMASS VILLAGE,CO81615     		NONE EXEMPT HEALTH 500
    SPRINGBOARD COLLABORATIVE
    1701 WALNUT ST 7TH FL
    PHILADELPHIA,PA19103     		NONE EXEMPT COMMUNITY 5,000
    SUMMIT VOLUNTEER FIRST AID SQUAD
    PO BOX 234
    SUMMIT,NJ079020234     		NONE EXEMPT HEALTH 500
    THE BOZEMAN DHARMA CENTER
    1019 EAST MAIN ST STE 202
    BOZEMAN,MT59715     		NONE EXEMPT HEALTH 25,000
    THE FOUNDATION OF RELIGIOUS LITERACY
    100 SUMMER ST 25TH FLOOR
    BOSTON,MA02110     		NONE EXEMPT EDUCATION 1,000
    THE LOOMIS CHAFFEE SCHOOL
    4 BATCHELDER RD PO BOX 600
    WINDSOR,CT060959956     		NONE EXEMPT EDUCATION 7,000
    THE SCHOOL FOR CHILDREN WITH HIDDEN INTELLIGENCE
    812 EAST COUNTY LINE RD
    LAKEWOOD,NJ08701     		NONE EXEMPT EDUCATION 5,000
    THE WILDERNESS SOCIETY
    503 WEST MENDANHALL
    BOZEMAN,MT59715     		NONE EXEMPT ENVIRONMENT 2,000
    THICH NHAT HANH FOUNDATION
    2499 MELRU LN
    ESCONDIDO,CA92026     		NONE EXEMPT HEALTH 1,000
    TUFTS UNIVERSITY
    80 GEORGE ST STE 200-3
    MEDFORD,MA021557056     		NONE EXEMPT EDUCATION 7,000
    US FUND FOR UNICEF
    125 MAIDEN LN
    NEW YORK,NY10038     		NONE EXEMPT HEALTH 3,000
    UNIVERSITY OF IDAHO FOUNDATION CHEMICAL ENGINEERING
    875 PERIMETER DR PO BOX 443147
    MOSCOW,ID838443147     		NONE EXEMPT EDUCATION 7,000
    UNIVERSITY OF WASHINGTON FOUNDATION CHEMICAL ENGINEERING ENDOWMENT
    1200 5TH AVE STE 500
    SEATTLE,WA981011116     		NONE EXEMPT EDUCATION 7,000
    UPAYA INSTITUTE & ZEN CENTER
    1404 CERRO GORDO RD
    SANTA FE,NM87501     		NONE EXEMPT SOCIAL SERVICE 1,000
    WGBH
    ONE GUEST STREETPO BOX 55875
    BOSTON,MA022055875     		NONE EXEMPT EDUCATION 1,500
    WOUNDED WARRIOR PROJECT
    PO BOX 78540
    TOPEKA,KS666758540     		NONE EXEMPT HEALTH 10,000
    Total .................................bullet 3a 328,250
    bApproved for future payment
    Total .................................bullet 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.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3
    Interest on savings and temporary cash investments ...........     		         
    4 Dividends and interest from securities....     14 121,608  
    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.....     14 26,391  
    8
    Gain or (loss) from sales of assets other than inventory ............     		    18 333,960  
    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).. 0 481,959 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13481,959
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (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?...........
    b
    If "Yes," complete the following schedule.

    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below
    (see instr.)?
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    		 Firm's EIN SmallBullet
    Firm's address SmallBullet


    		 Phone no.
    Form 990-PF (2015)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description
    Schedule B
    (Form 990, 990-EZ,
    or 990-PF)
    Department of the Treasury
    Internal Revenue Service
    Schedule of Contributors
    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
    OMB No. 1545-0047
    2015
    Name of the organization
    CLERMONT FOUNDATION
     
    Employer identification number

    22-3177379
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ





    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......... Arrow Bullet $  
    Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
    Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2015)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2
    Name of organization
    CLERMONT FOUNDATION
          		Employer identification number
    22-3177379
    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
     
     

    GARNETT L AND MARTHA H KEITH  
    PO BOX 429
     
    SUMMIT, NJ079020429

    		$ 27,705


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    2
     
     

    GARNETT L AND MARTHA H KEITH  
    PO BOX 429
     
    SUMMIT, NJ079020429

    		$ 45,276


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    3
     
     

    GARNETT L AND MARTHA H KEITH  
    PO BOX 429
     
    SUMMIT, NJ079020429

    		$ 22,730


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

    GARNETT L AND MARTHA H KEITH  
    PO BOX 429
     
    SUMMIT, NJ079020429

    		$ 11,995


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    5
     
     

    GARNETT L AND MARTHA H KEITH  
    PO BOX 429
     
    SUMMIT, NJ079020429

    		$ 1,443


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    6
     
     

    GARNETT L AND MARTHA H KEITH  
    PO BOX 429
     
    SUMMIT, NJ079020429

    		$ 12,064


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
    Name of organization
    CLERMONT FOUNDATION
          		Employer identification number
    22-3177379
    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
    7
     
     

    GARNETT L AND MARTHA H KEITH  
    PO BOX 429
     
    SUMMIT, NJ079020429

    		$ 14,641


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    8
     
     

    GARNETT L AND MARTHA H KEITH  
    PO BOX 429
     
    SUMMIT, NJ079020429

    		$ 9,763


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    9
     
     

    GARNETT L AND MARTHA H KEITH  
    PO BOX 429
     
    SUMMIT, NJ079020429

    		$ 16,765


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    10
     
     

    GARNETT L AND MARTHA H KEITH  
    PO BOX 429
     
    SUMMIT, NJ079020429

    		$ 8,052


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    11
     
     

    GARNETT L AND MARTHA H KEITH  
    PO BOX 429
     
    SUMMIT, NJ079020429

    		$ 13,003


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

       
     
     

    		$  


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
    Page 3
    Name of organization
    CLERMONT FOUNDATION
          		Employer identification number

    22-3177379
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    (a)
    No.from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
    1
    		 170.0 SHARES OF ALLERGAN,PLC $ 50,544 2015-11-17
    (a)
    No.from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
    2
    		 700 SHARES OF APPLE, INC $ 79,583 2015-11-17
    (a)
    No.from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
    3
    		 1,260 SHARES OF BLACKSTONE GROUP, LP $ 38,896 2015-11-17
    (a)
    No.from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
    4
    		 240 SHARES OF THE WALT DISNEY CO. $ 27,871 2015-11-17
    (a)
    No.from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
    5
    		 320 UNITS OF ENERGY TRANSFER EQUITY, LP $ 6,304 2015-11-17
    (a)
    No.from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
    6
    		 3,200 UNITS OF ENERGY TRANSFER EQUITY, LP $ 63,040 2015-11-17
    Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
    Name of organization
    CLERMONT FOUNDATION
          		Employer identification number

    22-3177379
    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
    7
    		 390 SHARES OF J.P. MORGAN CHASE & CO. $ 25,791 2015-11-17
    (a)
    No.from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
    8
    		 260 SHARES OF J.P. MORGAN CHASE & CO. $ 17,194 2015-11-17
    (a)
    No.from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
    9
    		 500 SHARES OF J.P. MORGAN CHASE & CO. $ 33,065 2015-11-17
    (a)
    No.from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
    10
    		 240 SHARES OF J.P. MORGAN CHASE & CO. $ 15,871 2015-11-17
    (a)
    No.from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
    11
    		 240 SHARES OF THERMO FISHER SCIENTIFIC $ 32,506 2015-11-17
    (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
    CLERMONT FOUNDATION
          		Employer identification number

    22-3177379
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No.from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No.from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No.from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No.from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

    Additional Data


    Software ID:  
    Software Version:  

    TY 2015 AccountingFeesSchedule
    Name:
    CLERMONT FOUNDATION
    EIN:
    22-3177379
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAX PREPARATION FEES 15,500 7,750   7,750

    TY 2015 InvestmentsOtherSchedule2
    Name:
    CLERMONT FOUNDATION
    EIN:
    22-3177379
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    T. ROWE PRICE INT'L DISCOVER -T. ROWE AT COST 33,334 60,363
    HARBOR INTERNATIONAL -FIDELITY AT COST 154,957 267,477
    T. ROWE PRICE INTL GROWTH & INCOME -FIDELITY AT COST 2,084 1,748
    COSTCO WHOLESALE CORP-SCHWAB 0296 AT COST 2,740 16,150
    BALL CORP-SCHWAB 0296 AT COST 2,741 5,818
    THERMO FISHER SCIENTIFIC-SCHWAB 0296 AT COST 1,086 2,837
    HONEYWELL INTL-SCHWAB 0296 AT COST 3,306 4,143
    TIME WARNER INC-SCHWAB 0296 AT COST 3,212 3,234
    WISDOMTREE EUROPME ETF-SCHWAB 0296 AT COST 2,768 2,690
    RUSSELL SHORT DURATION BOND CL S-SCHWAB 0296 AT COST 3,000 2,927
    WESTWOOD INCOME OPPTY FD-SCHWAB 0296 AT COST 5,154 6,796
    STARWOOD PPTY TRUST-SCHWAB 0296 AT COST 2,314 3,084
    SHIRE PLC-SCHWAB 0296 AT COST 1,056 1,435
    ALPHABET INC-SCHWAB 0296 AT COST 3,236 4,668
    CVS CAREMARK-SCHWAB 0296 AT COST 3,098 3,911
    HOME DEPOT-SCHWAB 0296 AT COST 3,226 5,422
    WELLS FARGO & CO-SCHWAB 0296 AT COST 5,066 5,436
    BANK OF AMERICA-SCHWAB 0296 AT COST 4,042 4,208
    WISDOMTREE TRUST ETF EUROPE HEDGED SMALL CAP-SCHWAB 0926 AT COST 3,131 2,947
    APPLE INC-SCHWAB 0296 AT COST 3,190 2,632
    JP MORGAN CHASE & CO-SCHWAB 0296 AT COST 3,361 3,302
    LOWES COMPANIES-SCHWAB 0296 AT COST 3,050 3,422
    PROSHARES SHORT RUSSELL 2000 ETF AT COST 2,997 3,105
    PROSHARES SHORT MSCI EMERGING ETF-SCHWAB 0296 AT COST 1,608 1,473
    PRICELINE GROUP-SCHWAB 0296 AT COST 2,660 2,550
    PROSHARES SHORT MSCI EMERGING ETF-SCHWAB 0296 AT COST 4,248 4,176
    MAINGATE MLP FD-SCHWAB 0296 AT COST 8,500 5,907
    PIMCO ETF-SCHWAB 0296 AT COST 5,346 4,581
    WISDOMTREE JAPAN-SCHWAB 0296 AT COST 3,264 3,005
    THERMO FISHER SCIENTIFIC-SCHWAB 4262 AT COST 815 2,127
    BALL CORP-SCHWAB 4262 AT COST 2,741 5,818
    HONEYWELL INTL-SCHWAB 4262 AT COST 3,306 4,143
    TIME WARNER INC-SCHWAB 4262 AT COST 450 453
    DREYFUS SHORT TERM INCM FD-SCHWAB 4262 AT COST 1,219 1,164
    STARWOOD PPTY TRUST INC-SCHWAB 4262 AT COST 2,314 3,084
    WISDOMTREE EUROPE ETF-SCHWAB 4262 AT COST 2,492 2,421
    MAINGATE MLP FD-SCHWAB 4262 AT COST 4,500 3,122
    CVS CAREMARK-SCHWAB 4262 AT COST 3,098 3,911
    HOME DEPOT-SCHWAB 4262 AT COST 3,226 5,422
    WELLS FARGO & CO-SCHWAB 4262 AT COST 3,043 3,262
    BANK OF AMERICA-SCHWAB 4262 AT COST 3,104 3,029
    ALPHABET INC-SCHWAB 4262 AT COST 3,289 4,668
    APPLE INC-SCHWAB 4262 AT COST 3,190 2,632
    LOWES COMPANIES INC-SCHWAB 4262 AT COST 3,050 3,422
    AMGEN-SCHWAB 4262 AT COST 3,071 3,247
    WISDOMTREE JAPAN-SCHWAB 4262 AT COST 2,179 2,003
    AIA GROUP LTD ORD-SCHWAB 3936 AT COST 83,097 86,584
    ALLERGAN PLC-SCHWAB 3936 AT COST 27,705 53,125
    ALPHABET INC-SCHWAB 3936 AT COST 48,350 248,498
    AMGEN INC-SCHWAB 3936 AT COST 89,028 100,645
    APPLE INC-SCHWAB 3936 AT COST 50,788 112,312
    BANK OF AMERICA-SCHWAB 3936 AT COST 110,820 111,583
    BAIDU INC ADR-SCHWAB 3936 AT COST 72,926 62,383
    BLANKSTONE GROUP-SCHWAB 3936 AT COST 22,952 36,842
    CITIGROUP INC-SCHWAB 3936 AT COST 91,853 107,123
    CHARLES SCHWAB CORP-SCHWAB 3936 AT COST 67,700 65,860
    CHEUNG KONG INSFRAS ORD/F-SCHWAB 3936 AT COST 55,501 64,850
    CK HUTCHINSON HLDGS ORD F-SCHWAB 3936 AT COST 65,008 60,734
    COSTCO WHOLESALE CORP-SCHWAB 3936 AT COST 31,301 156,816
    CROWN CASTLE INTL CO-SCHWAB 3936 AT COST 65,787 66,566
    CROWN HOLDINGS INC-SCHWAB 3936 AT COST 67,811 72,501
    CVS CAREMARK-SCHWAB 3936 AT COST 30,878 75,283
    DREYFUS SHORT TERM INCM FD-SCHWAB 3936 AT COST 70,000 66,821
    EATON CORP-SCHWAB 3936 AT COST 78,620 57,244
    ENERGY TRANSFER EQUITY-SCHWAB 3936 AT COST 12,306 48,365
    FOMENTO ECO MEX SAB ADRF-SCHWAB 3936 AT COST 47,066 75,727
    HOME DEPOT-SCHWAB 3936 AT COST 58,156 81,995
    HONEYWELL INTL-SCHWAB 3936 AT COST 55,475 70,428
    JP MORGAN CHASE & CO-SCHWAB 3936 AT COST 80,873 153,190
    KAO CORP ORD-SCHWAB 3936 AT COST 63,205 62,254
    KENNEDY WILSON HOLDINGS-SCHWAB 3936 AT COST 76,453 109,805
    LENNAR CORP-SCHWAB 3936 AT COST 68,135 64,072
    LEVEL 3 COMMUNICATION NEW-SCHWAB 3936 AT COST 57,129 57,622
    LIBERTY GLOBAL PLC-SCHWAB 3936 AT COST 94,526 81,948
    LIBERTY INTERACTIVE -SCHWAB 3936 AT COST 43,668 44,258
    LOWES COMPANIES INC-SCHWAB 3936 AT COST 90,639 98,092
    MAINGATE MLP FD-SCHWAB 3936 AT COST 220,000 150,007
    MAN WAH HOLDINGS NEW-SCHWAB 3936 AT COST 18,894 43,306
    MISUMI GROUUP INC ORD F-SCHWAB 3936 AT COST 62,522 67,121
    MOHAWK INDUSTRIES INC-SCHWAB 3936 AT COST 55,067 70,074
    PIGEON CORP-SCHWAB 3936 AT COST 14,975 49,183
    POWERSHRES PREFERRED AT COST 49,007 50,083
    PRICELINE GROUP, THE-SCHWAB 3936 AT COST 72,076 80,322
    PROSHARES SHORT MSCI EMERGING ETF-SCHWAB 3639 AT COST 45,397 41,686
    PROSHARES SHORT RUSSELL-SCHWAB 3936 AT COST 81,624 85,091
    PROSHARES SHORT QQQ ETF-SCHWAB 3936 AT COST 110,812 108,054
    SHIRE PLC-SCHWAB 3936 AT COST 47,783 75,030
    STARWOOD PPTY TRUST-SCHWAB 3936 AT COST 46,030 68,876
    TERRAFORM POWER INC-SCHWAB 3936 AT COST 42,635 27,676
    THERMO FISHER SCIENTIFIC-SCHWAB 3936 AT COST 40,628 106,388
    TIME WARNER INC-SCHWAB 3936 AT COST 53,935 72,430
    WELLS FARGO & CO-SCHWAB 3936 AT COST 47,844 73,930
    WISDOMTREE EUROPE ETF-SCHWAB 3936 AT COST 153,047 139,413
    WISDOMTREE JAPAN ETF-SCHWAB 3936 AT COST 118,577 140,224
    WISDOMTREE JAPAN HEDGED FNCLS-SCHWAB 3936 AT COST 45,727 45,257
    ZOJIRUSHI CORP-SCHWAB 3936 AT COST 49,216 41,611
    ASCENT CAPITAL GROUP INC-SCHWAB 8967 AT COST 4,591 1,588
    BANK OF AMERICA-SCHWAB 8967 AT COST 15,781 15,820
    CALPINE CORP-SCHWAB 8967 AT COST 15,842 10,852
    CIMPRESS NV-SCHWAB 8967 AT COST 14,714 16,228
    COLFAX CORP-SCHWAB 8967 AT COST 11,515 5,978
    EXPRESS SCRIPTS HLDG-SCHWAB 8967 AT COST 8,266 8,566
    LEUCADIA NATIONAL CORP-SCHWAB 8967 AT COST 11,065 8,556
    LIBERTY BROADCAST CO-SCHWAB 8967 AT COST 10,648 10,847
    LIBERTY GLOBAL PLC-SCHWAB 8967 AT COST 9,652 9,030
    LIBERTY INTERACTIVE CP:LVNTV-SCHWAB 8967 AT COST 14,966 18,405
    LIBERTY INTERACTIVE CP:QVCA-SCHWAB 8967 AT COST 10,433 10,382
    LIBERTY MEDICA CORP-SCHWAB 8967 AT COST 10,180 10,815
    LIVE NATION ENTMT INC-SCHWAB 8967 AT COST 8,175 8,108
    NOW INC-SCHWAB 8967 AT COST 6,932 4,762
    POST HOLDINGS INC-SCHWAB 8967 AT COST 13,595 20,053
    WILLIS GROUP HLDGS PUBLIC-SCHWAB 8967 AT COST 10,272 11,123

    TY 2015 OtherAssetsSchedule
    Name:
    CLERMONT FOUNDATION
    EIN:
    22-3177379
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    SEABRIDGE ASIA REDUX, LLC 454,631 456,298 503,149
    JASPER RIDGE PARTNERS 183,758 244,288 274,853


    TY 2015 OtherExpensesSchedule
    Name:
    CLERMONT FOUNDATION
    EIN:
    22-3177379
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ADR & OTHER INVESTMENT FEES 1,690 1,690   0
    POSTAGE 28 14   14
    BANK CHARGES 244 122   122


    TY 2015 OtherIncomeSchedule2
    Name:
    CLERMONT FOUNDATION
    EIN:
    22-3177379
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    PARTNERSHIP NET INCOME 26,391 26,391 26,391


    TY 2015 TaxesSchedule
    Name:
    CLERMONT FOUNDATION
    EIN:
    22-3177379
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 3,319 3,319   0
    NJ DIV OF CONSUMER AFFAIRS 55 28   27
    2014 EXTENSION TAX PAYMENT 20,000 0   0