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 10-01-2015 , and ending 09-30-2016
Name of foundation
Washington Square Health Foundation
 
Number and street (or P.O. box number if mail is not delivered to street address)875 North Michigan Ave 3516
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Chicago, IL60611
A Employer identification number

36-1210140
B Telephone number (see instructions)

(312) 664-6488
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$18,802,589J 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) 6,269
2 Check bullet Sch. B .............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 446,172 446,172  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 -170,840
b Gross sales price for all assets on line 6a 370,785
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 0
b Less: Cost of goods sold.... 0
c Gross profit or (loss) (attach schedule)..... 0  
11 Other income (attach schedule)....... 0 0 0
12 Total. Add lines 1 through 11........ 281,601 446,172 0
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 379,454 37,945   341,509
14 Other employee salaries and wages...... 9,494 949   8,544
15 Pension plans, employee benefits....... 72,534 7,253   65,281
16a Legal fees (attach schedule)......... Click to see attachment 1,517 152 0 1,365
b Accounting fees (attach schedule)....... Click to see attachment 37,991 3,799 0 34,192
c Other professional fees (attach schedule).... Click to see attachment 5,826 583 0 5,243
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 29,242 2,004 0 18,038
19 Depreciation (attach schedule) and depletion... Click to see attachment 5,956 596 0
20 Occupancy.............. 53,970 5,397   48,573
21 Travel, conferences, and meetings....... 7,254 725   6,529
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 121,119 12,111 0 109,008
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 724,357 71,514 0 638,282
25 Contributions, gifts, grants paid....... 488,215 488,215
26 Total expenses and disbursements. Add lines 24 and 25 1,212,572 71,514 0 1,126,497
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -930,971
b Net investment income (if negative, enter -0-) 374,658
c Adjusted net income (if negative, enter -0-)... 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............. 1,054,999 589,358 589,358
2 Savings and temporary cash investments.........   816,643 816,643
3 Accounts receivable bullet2,707
Less: allowance for doubtful accounts bullet   3,248 2,707 2,707
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet     0 0
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)..... 0 0 0
7 Other notes and loans receivable (attach schedule) bullet0
Less: allowance for doubtful accounts bullet0 0 0 0
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges.......... 28,235 101,338 101,338
10a Investments—U.S. and state government obligations (attach schedule) 0 0 0
b Investments—corporate stock (attach schedule)....... 16,182,805 Click to see attachment16,647,110 16,647,110
c Investments—corporate bonds (attach schedule)....... 0 Click to see attachment0 0
11 Investments—land, buildings, and equipment: basis bullet0
Less: accumulated depreciation (attach schedule) bullet0 0 Click to see attachment0 0
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 12,599 Click to see attachment14,463 14,463
14 Land, buildings, and equipment: basis bullet47,552
Less: accumulated depreciation (attach schedule) bullet23,849 20,154 Click to see attachment23,703 23,703
15 Other assets (describe bullet) Click to see attachment754,469 Click to see attachment607,267 Click to see attachment607,267
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 18,056,509 18,802,589 18,802,589
Liabilities 17 Accounts payable and accrued expenses.......... 40,867 36,185
18 Grants payable..................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons 0 0
21 Mortgages and other notes payable (attach schedule)...... 0 0
22 Other liabilities (describe bullet) Click to see attachment268,571 Click to see attachment325,867
23 Total liabilities (add lines 17 through 22)......... 309,438 362,052
Net Assets or Fund Balances bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted.................. 17,747,071 18,440,537
25 Temporarily restricted...............    
26 Permanently restricted...............    
bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds........    
28 Paid-in or capital surplus, or land, bldg., and equipment fund    
29 Retained earnings, accumulated income, endowment, or other funds    
30 Total net assets or fund balances (see instructions)..... 17,747,071 18,440,537
31 Total liabilities and net assets/fund balances (see instructions). 18,056,509 18,802,589
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
17,747,071
2
Enter amount from Part I, line 27a .....................
2
-930,971
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
1,624,437
4
Add lines 1, 2, and 3 ..........................
4
18,440,537
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
18,440,537
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 Securities      
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 370,785   541,625 -170,840
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     0 -170,840
b
c
d
e
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 -170,840
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 0
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 1,180,159 19,648,925 0.060062
2013 1,228,244 20,739,957 0.059221
2012 1,437,298 18,914,653 0.075989
2011 1,451,619 19,066,141 0.076136
2010 1,320,953 20,403,914 0.064740
2
Total of line 1, column (d) .....................
20.336148
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
0.067230
4
Enter the net value of noncharitable-use assets for 2015 from Part X, line 5.....
4
17,510,913
5
Multiply line 4 by line 3......................
5
1,177,259
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
3,747
7
Add lines 5 and 6........................
7
1,181,006
8
Enter qualifying distributions from Part XII, line 4.............
8
1,165,437
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 7,493
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  
3 Add lines 1 and 2........................... 3 7,493
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 7,493
6 Credits/Payments:
a 2015 estimated tax payments and 2014 overpayment credited to 2015 6a 85,200
b Exempt foreign organizations—tax withheld at source...... 6b
c Tax paid with application for extension of time to file (Form 8868)... 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 85,200
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 77,707
11 Enter the amount of line 10 to be: Credited to 2015 estimated taxBullet23,000 RefundedBullet 11 54,707
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
 
 
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletIL
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .Click to see attachment
    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 addressbulletWWW.WSHF.ORG
    14
    The books are in care ofbulletHOWARD NOCHUMSON Telephone no.bullet (312) 664-6488

    Located atbullet875 NORTH MICHIGAN AVE STE 3516CHICAGOIL ZIP+4bullet60611
    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
     
    No
    ........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
     
    No
    .........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
    William N Werner MD MPH Board Chair/Director
    2.000     		19,500 0 0
    875 North Michigan Ave
    Chicago,IL60611
    William B Friedeman Secretary/Director
    2.000     		8,250 0 0
    875 North Michigan Ave
    Chicago,IL60611
    James M Snyder Treasurer/Director
    2.000     		8,250 0 0
    875 North Michigan Ave
    Chicago,IL60611
    Barbara Berendt Director
    2.000     		5,000 0 0
    875 North Michigan Ave
    Chicago,IL60611
    Howard Nochumson Executive Director & President
    40.000     		208,172 83,650 0
    875 North Michigan Ave
    Chicago,IL60611
    Catherine M Creticos MD Director
    2.000     		6,000 0 0
    875 North Michigan Ave
    Chicago,IL60611
    Sandy Goldberg PhD Director
    2.000     		6,750 0 0
    875 North Michigan Ave
    Chicago,IL60611
    Catherine Kapella MPH Associate Director & Vice President
    40.000     		117,532 42,307 0
    875 North Michigan Ave
    Chicago,IL60611
    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
     
    Total number of other employees paid over $50,000...................bullet  
    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
     
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1
     
    2  
    3  
    4  
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1 Clearbrook: PRI: Mechanical Lifts; an investment in safety and wellness 38,940
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet38,940
    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
    16,635,679
    b
    Average of monthly cash balances.......................
    1b
    1,091,807
    c
    Fair market value of all other assets (see instructions)................
    1c
    50,091
    d
    Total (add lines 1a, b, and c).........................
    1d
    17,777,577
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
     
    3
    Subtract line 2 from line 1d.........................
    3
    17,777,577
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    266,664
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    17,510,913
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    875,546
    Part XI
    Distributable Amount bullet
    1
    Minimum investment return from Part X, line 6....................
    1
    875,546
    2a
    Tax on investment income for 2015 from Part VI, line 5......
    2a
    7,493
    b
    Income tax for 2015. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    7,493
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    868,053
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    195,952
    5
    Add lines 3 and 4............................
    5
    1,064,005
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
    1,064,005
    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 Click to see attachment..........
    1a
    1,126,497
    b
    Program-related investments—total from Part IX-B..................
    1b
    38,940
    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
    0
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    1,165,437
    5
    Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
    income. Enter 1% of Part I, line 27b (see instructions).................
    5
     
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    1,165,437
    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 1,064,005
    2 Undistributed income, if any, as of the end of 2015:
    a Enter amount for 2014 only.......  
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2015:
    a From 2010...... 131,153
    b From 2011...... 423,306
    c From 2012...... 502,552
    d From 2013...... 39,421
    e From 2014...... 87,150
    fTotal of lines 3a through e........ 1,183,582
    4Qualifying distributions for 2015 from Part
    XII, line 4: bullet$ 1,165,437
    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..... 1,064,005
    e Remaining amount distributed out of corpus 101,432
    5 Excess distributions carryover applied to 2015.   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 1,285,014
    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......     		 
    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) ...     		131,153
    9Excess distributions carryover to 2016.
    Subtract lines 7 and 8 from line 6a ......     		1,153,861
    10 Analysis of line 9:
    a Excess from 2011.... 423,306
    b Excess from 2012.... 502,552
    c Excess from 2013.... 39,421
    d Excess from 2014.... 87,150
    e Excess from 2015.... 101,432
    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
    0       0
    b 85% of line 2a ......... 0       0
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....     		0       0
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		        0
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		0       0
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part X, line 6 for each year listed...     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XV
    Supplementary Information (Complete this part only if the organization had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    HOWARD NOCHUMSON
    875 NORTH MICHIGAN AVE
    SUITE 3516
    CHICAGO,IL60611
    (312) 664-6488
    bThe form in which applications should be submitted and information and materials they should include:
    Visit the website for the organization's grant guidelines & application: http://wshf.org/general-guidelines/
    cAny submission deadlines:
    GRANT SUBMISSIONS WERE ACCEPTED ON A CONTINUOUS ROLLING BASIS FOR EITHER THE 12/1 OR 6/1 DEADLINES.
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    none
    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
    A Silver Lining Foundation
    134 N LA SALLE ST
    Ste 1218
    Chicago,IL60602     		  PC A Silver Lining Foundation's Metastatic Event 7,500
    A Silver Lining Foundation
    134 N LA SALLE ST
    Ste 1218
    Chicago,IL60602     		  PC Dr. Sandy Goldberg's Board of Director Grant to A Silver Lining Foundation in Loving Memory of Gregg Helfer 5,000
    A Silver Lining Foundation
    134 N LA SALLE ST
    Ste 1218
    Chicago,IL60602     		  PC Barbara Berendt's Board of Director Grant to A Silver Lining Foundation 1,000
    A Silver Lining Foundation
    134 N LA SALLE ST
    Ste 1218
    Chicago,IL60602     		  PC Executive Committee Grant to A Silver Lining Foundation 3,500
    Access Community Health Network
    222 North Canal Street
    Chicago,IL60606     		  PC Discharge Planning for Behavioral Health Patients 7,500
    Advocate Charitable Foundation
    205 W Touhy Ave
    Ste 225
    Park Ridge,IL60068     		  PC Howard Nochumson's Board of Director Grant to the Eye Center 500
    Advocate Charitable Foundation
    205 W Touhy Ave
    Ste 225
    Park Ridge,IL60068     		  PC Dr. Catherine M. Creticos' Board of Director Grant to the Angelo P. Creticos Lectureship Fund at Advocate Illinois Masonic Medical Center 1,000
    Advocate Charitable Foundation
    205 W Touhy Ave
    Ste 225
    Park Ridge,IL60068     		  PC Dr. Catherine M. Creticos' Board of Director Grant to the Anastasia and Angelo P. Creticos, MD Medical Innovation Endowment at Advocate Illinois Masonic Medical Center 1,000
    Advocate Charitable Foundation
    205 W Touhy Ave
    Ste 225
    Park Ridge,IL60068     		  PC Dr. Catherine M. Creticos' Board of Director Grant to the Anastasia Creticos Music Fund at Advocate Illinois Masonic Medical Center 500
    Advocate Charitable Foundation
    205 W Touhy Ave
    Ste 225
    Park Ridge,IL60068     		  PC Dr. Catherine M. Creticos' Board of Director Grant to the Creticos Cancer Center 500
    Ann AND Robert H Lurie Children's Hospital of Chicago
    225 E CHICAGO AVE PR DPT
    Chicago,IL60611     		  PC Heroes for Life: Campaign for Ann & Robert H. Lurie Children's Hospital of Chicago 25,000
    Ann AND Robert H Lurie Children's Hospital of Chicago
    225 E CHICAGO AVE PR DPT
    Chicago,IL60611     		  PC Hematology, Oncology and Stem Cell Transplant Research Fellowship program 60,000
    Breakthrough Urban Ministries
    PO Box 47200
    Chicago,IL60647     		  PC Behavioral Health for Homeless Adults Program -- Behavioral Health Assistant 10,000
    Catholic Charities Of The Archdiocese Of Chicago
    721 N LaSalle
    Chicago,IL60654     		  PC Comprehensive Continuum of HIV/AIDS Care Program 25,000
    Chicago Chesed Fund
    7045 N Ridgeway Ave
    Lincolnwood,IL60712     		  PC Bright Futures Mental Health Referral Network 12,500
    Chicago Chesed Fund
    7045 N Ridgeway Ave
    Lincolnwood,IL60712     		  PC Howard Nochumson's Board Director Grant to Chicago Chesed Fund 2,000
    Chicago Chesed Fund
    7045 N Ridgeway Ave
    Lincolnwood,IL60712     		  PC Barbara Berendt's Board of Director Grant to the Chicago Chesed Fund 1,000
    Chicago Hearing Society
    2001 N Clybourn Ave
    2nd Fl
    Chicago,IL60614     		  PC Expanding Chicago Hearing Society's Services through New Technology 13,046
    Chicago Women's Health Center
    1025 W Sunnyside Ave
    Ste 201
    Chicago,IL60640     		  PC Clinical Services Program 7,500
    Council on Foundations
    2121 Crystal Drive
    Ste 700
    Arlington,VA22202     		  PC Foundation Designated Grant 3,100
    Donors Forum of Chicago
    208 SOUTH LASALLE
    1540
    Chicago,IL60604     		  PC Foundation Designated Grant 369
    Exponent Philanthropy
    1720 N Street NW
    Washington,DC20036     		  PC Special Designated Grant for Exponent Philanthropy's 20th Anniversary Foundation Connections Mixer and Annual Membership 7,500
    Gilda's Club Chicago
    537 N Wells St
    Chicago,IL60654     		  PC Hospital Satellite Initiative at Lurie Children's Hospital 6,250
    Goldie's Place
    5705 North Lincoln Avenue
    Chicago,IL60659     		  PC Healthy Smiles 10,500
    Goldie's Place
    5705 North Lincoln Avenue
    Chicago,IL60659     		  PC Mr. James M. Snyder's Board of Director Grant to Goldie's Place 2,500
    Grantmakers In Health
    140 S Dearborn Street
    Suite 400
    Chicago,IL60603     		  PC Special Designated Grant 3,175
    Howard Brown Health Center
    4025 N Sheridan Rd
    Chicago,IL60613     		  PC Dr. Catherine M. Creticos' Board of Director Grant to Howard Brown Health Center 1,000
    Keshet
    600 Academy Dr
    Ste 130
    Northbrook,IL60062     		  PC Healthy Lifestyles for Adults with Intellectual and Developmental Disabilities 12,500
    Keshet
    600 Academy Dr
    Ste 130
    Northbrook,IL60062     		  PC Howard Nochumson's Board of Director Grant for the David Nochumson, Charles Nochumson and Sara Wolf Torah Memorial Scholarship Fund 1,000
    La Rabida Children's Hospital
    6501 S PROMONTORY DR
    Chicago,IL60649     		  PC La Rabida Children's Hospital Outpatient Facility Expansion 25,000
    La Rabida Children's Hospital
    6501 S PROMONTORY DR
    Chicago,IL60649     		  PC Mr. James M. Snyder's Board of Director Grant to La Rabida Children's Hospital 2,500
    Little City Foundation
    1760 W Algonquin Rd
    Palatine,IL60067     		  PC Oral Health and Community Outreach Program 12,500
    Loyola University
    820 N MICHIGAN AVE
    Chicago,IL60611     		  PC Northeast Senior Health Project: Loyola University Community Nursing Center 15,000
    North Park Friendship Center
    3448 W Foster Ave
    Chicago,IL60625     		  PC Dr. William N. Werner's Board of Director Grant to the North Park Friendship Center Food Pantry Program. 2,500
    North Park Friendship Center
    3448 W Foster Ave
    Chicago,IL60625     		  PC Barbara Berendt's Board of Director Grant to the North Park Friendship Center Food Pantry 1,000
    North Park University
    3225 W Foster Ave
    Chicago,IL60625     		  PC Dr. William N. Werner's Board of Director Grant to the Second Year of the North Park University Research Experience for Summer Students (NPRESS). 2,500
    North Park University
    3225 W Foster Ave
    Chicago,IL60625     		  PC Executive Committee Meeting Grant for North Park Research Experience for Summer Students (NPRESS) 35,000
    Old Irving Park Community Clinic
    5425 W Addison St
    Chicago,IL60641     		  PC Provide evidence based care for the uninsured, undocumented patients with diabetes and hypertension 12,500
    Peninsula Open Space Trust
    222 High Street
    Palo Alto,CA94301     		  PC Mr. William B. Friedeman's Board of Director Grant to Peninsula Open Space Trust 500
    Primo Center For Women And Children
    4241 W WASHINGTON BLVD
    Chicago,IL60624     		  PC Catherine Kapella's Board Officer Grant to Primo Center 2,500
    Project Seed of Suburban Chicago Inc
    6045 N Monticello Ave
    Chicago,IL60659     		  PC Howard Nochumson's Board of Director Grant to Project Seed of Suburban Chicago for life coaching and counseling services. 1,000
    Ray Graham Association for People with Disabilities
    901 Warrenville Road
    Ste 500
    Lisle,IL60532     		  PC Dr. Catherine M. Creticos' Board of Director Grant to the Hanson Center Therapeutic Riding Program at Ray Graham Association for People with Disabilities. 1,000
    Ronald McDonald House Charities of Chicagoland and Northwest Indiana
    1301 W 22nd Street
    Ste 905
    Oak Brook,IL60523     		  PC Mr. William B. Friedeman's Board of Director Grant to Ronald McDonald House in honor of Colby and Allie Friedeman 1,250
    Rush University Medical Center
    1700 WEST VAN BUREN STREET
    Room 250
    Chicago,IL60612     		  PC A Novel Curriculum to Train Surgical Residents in Laparoscopic Skills 47,748
    Sonoma Valley Hospital Foundation
    347 Andrieux Street
    Sonoma,CA95476     		  PC William B. Friedeman's Board of Director Grant to the Sonoma Valley Hospital Foundation for the Women's Health Initiative Project to help purchase fetal warmers and carts in the OB department 1,000
    Sonoma Valley Hospital Foundation
    347 Andrieux Street
    Sonoma,CA95476     		  PC Mr. William B. Friedeman's Board of Director Grant to Sonoma Valley Foundation 1,000
    St Jude Children's Research Hospital
    501 St Jude Place
    Memphis,TN38105     		  PC Mr. William B. Friedeman's Board of Director Grant to St. Judes Children's Research Hospital in honor of Colby and Allie Friedeman 1,250
    Swedish Covenant Hospital
    5145 N California Ave
    Chicago,IL60625     		  PC A Silver Lining Foundation Buy A Mom A Mammogram Program at Swedish Covenant Hospital 15,000
    Team Spirit Institute
    7336 N KEDVALE AVE
    Lincolnwood,IL60712     		  PC Barbara Berendt's Board of Director Grant to Team Spirit Institute 1,000
    Team Spirit Institute
    7336 N KEDVALE AVE
    Lincolnwood,IL60712     		  PC Howard Nochumson's Board of Director Grant to Team Spirit Institute 500
    The Children's Clinic
    320 Lake Street
    Oak Park,IL60302     		  PC Equipment for Pediatric Dental Care 2,223
    The Children's Clinic
    320 Lake Street
    Oak Park,IL60302     		  PC Catherine Kapella's Board Officer Grant to The Children's Clinic 2,500
    The Night Ministry
    4711 N Ravenswood Ave
    Chicago,IL60640     		  PC The Street Medicine Initiative 24,150
    United Way of Will County
    54 N OTTAWA ST
    Ste 300
    Joliet,IL60432     		  PC Barbara Berendt's Board of Director Grant to United Way of Will County 1,000
    University of Illinois Foundation
    1305 WEST GREEN STREET
    Urbana,IL61801     		  PC 11th Annual Chicago Diabetes Project Conference 10,000
    Urban Institute
    2100 M St NW
    Washington,DC20037     		  PC Project Test Case 43,965
    Total .................................bullet 3a 498,026
    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....     14 446,172  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6
    Net rental income or (loss) from personal property     		         
    7 Other investment income.....          
    8
    Gain or (loss) from sales of assets other than inventory ............     		    18 -170,840  
    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).. 0 275,332 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13275,332
    (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: 15000238
    Software Version: 2015v3.0


    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
    Washington Square Health Foundation
     
    Employer identification number

    36-1210140
    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
    Washington Square Health Foundation
          		Employer identification number
    36-1210140
    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
    G H ZENDT CHARITABLE TRUST
     

       
    C/O BOA
    231 S LASALLE ST
    CHICAGO, IL60697

    		$ 5,269


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

       
     
     

    		$  


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

       
     
     

    		$  


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

       
     
     

    		$  


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

       
     
     

    		$  


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

       
     
     

    		$  


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

    36-1210140
    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
    Washington Square Health Foundation
          		Employer identification number

    36-1210140
    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: 15000238
    Software Version: 2015v3.0

    TY 2015 AccountingFeesSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    15000238
    Software Version:
    2015v3.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Accounting Fees 37,991 3,799   34,192

    Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

    TY 2015 DepreciationSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    15000238
    Software Version:
    2015v3.0
    Description of Property Date Acquired Cost or Other Basis Prior Years' Depreciation Computation Method Rate /
    Life (# of years)    		 Current Year's Depreciation Expense Net Investment Income Adjusted Net Income Cost of Goods Sold Not Included
    Equipment           5,956 596    

    TY 2015 InvestmentsCorpStockSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    15000238
    Software Version:
    2015v3.0
    Name of Stock End of Year Book Value End of Year Fair Market Value
    DOM. SMALL CAP MUTUAL FUNDS 1,888,054 1,888,054
    DOM. LARGE CAP MUTUAL FUNDS 5,967,176 5,967,176
    DOMESTIC EQUITY FUNDS 125,609 125,609
    FIXED INCOME 2,521,439 2,521,439
    DOM. CONV. SECURITIES FUNDS 0 0
    INTERNATIONAL EQUITY FUNDS 4,124,281 4,124,281
    DOM. MIDDLE CAP MUTUAL FUNDS 1,933,335 1,933,335
    COMMINGLED EQUITY FUNDS 87,216 87,216

    TY 2015 InvestmentsLandSchedule2
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    15000238
    Software Version:
    2015v3.0
    Category/ Item Cost/Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
    Land        
    Building     0  
    LeasholdImprovement     0  
    Equipment     0  
    Other     0  

    TY 2015 InvestmentsOtherSchedule2
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    15000238
    Software Version:
    2015v3.0
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    LONG-TERM GROWTH EQUITY FUND FMV 12,599 14,463

    TY 2015 LandEtcSchedule2
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    15000238
    Software Version:
    2015v3.0
    Category / Item Cost / Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
    Land        
    Building     0  
    LeasholdImprovement     0  
    Equipment 47,552 23,849 23,703 23,703
    Other     0  


    TY 2015 LegalFeesSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    15000238
    Software Version:
    2015v3.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    LEGAL FEES 1,517 152   1,365


    TY 2015 OtherAssetsSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    15000238
    Software Version:
    2015v3.0
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    RENT SECURITY DEPOSIT 6,971 6,971 6,971
    PROGRAM RELATED INVESTMENTS 747,498 600,296 600,296


    TY 2015 OtherExpensesSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    15000238
    Software Version:
    2015v3.0
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INSURANCE 54,361 5,436   48,925
    OFFICE SUPPLIES 16,371 1,637   14,734
    BOARD EXPENSES 26,319 2,632   23,687
    SITE VISIT 121 12   109
    DUES & SUBSCRIPTIONS 16,059 1,606   14,453
    SERVICE CONTRACTS 4,811 481   4,330
    DELIVERY EXPENSE 54 5   49
    BANK CHARGES 661 66   595
    DIABETES PROGRAM MEETING 143 14   129
    MISCELLANEOUS 2,219 222   1,997


    TY 2015 OtherIncreasesSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    15000238
    Software Version:
    2015v3.0
    Description Amount
    Unrealized Gain 1,624,437


    TY 2015 OtherLiabilitiesSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    15000238
    Software Version:
    2015v3.0
    Description Beginning of Year - Book Value End of Year - Book Value
    EMPLOYEE BENEFIT PLAN 268,571 325,867


    TY 2015 OtherProfessionalFeesSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    15000238
    Software Version:
    2015v3.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    CONSULTING FEES 5,826 583   5,243


    TY 2015 TaxesSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    15000238
    Software Version:
    2015v3.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FEDERAL EXCISE TAX 9,200      
    Payroll Tax 20,042 2,004   18,038