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.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0052
2018
Open to Public Inspection
For calendar year 2018, or tax year beginning 01-01-2018 , and ending 12-31-2018
Name of foundation
C R BARD FOUNDATION INC
 
% LINDA HREVNACK
Number and street (or P.O. box number if mail is not delivered to street address)730 CENTRAL AVENUE
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MURRAY HILL, NJ07974
A Employer identification number

22-2840708
B Telephone number (see instructions)

(551) 233-6641
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ...
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$0
J 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) 98,546
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 256,486 174,400  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 -263,895
b Gross sales price for all assets on line 6a 4,133,751
7 Capital gain net income (from Part IV, line 2)... 117,226
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 91,137 291,626  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0      
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule)......... 73,546 0 0 73,546
b Accounting fees (attach schedule)....... 47,025 0 0 47,025
c Other professional fees (attach schedule).... 41,993 36,427 0 5,566
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... 9,490 0 0 0
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule).......        
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 172,054 36,427 0 126,137
25 Contributions, gifts, grants paid....... 9,582,630 10,382,925
26 Total expenses and disbursements. Add lines 24 and 25 9,754,684 36,427 0 10,509,062
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -9,663,547
b Net investment income (if negative, enter -0-) 255,199
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2018)
Form 990-PF (2018)
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............. 194,159 0 0
2 Savings and temporary cash investments.........      
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)....... 10,263,651 Click to see attachment0 0
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)..........      
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 10,457,810 0 0
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22)......... 0 0
Net Assets or Fund Balances Foundations that follow SFAS 117, check here bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted..................    
25 Temporarily restricted...............    
26 Permanently restricted...............    
Foundations that do not follow SFAS 117, check here bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds........ 10,457,810  
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)..... 10,457,810 0
31 Total liabilities and net assets/fund balances (see instructions). 10,457,810 0
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
10,457,810
2
Enter amount from Part I, line 27a .....................
2
-9,663,547
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
51,190
4
Add lines 1, 2, and 3 ..........................
4
845,453
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
845,453
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30 .
6
 
Form 990-PF (2018)
Form 990-PF (2018)
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 UBS ACCOUNT 3F 02432      
b UBS ACCOUNT 3F 02432      
c UBS ACCOUNT 3F 02433      
d UBS ACCOUNT 3F 02433      
e UBS ACCOUNT 3F 02463      
UBS ACCOUNT 3F 02463      
(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 547,446   540,994 6,452
b 266,392   238,541 27,851
c 251,036   243,107 7,929
d 325,006   250,839 74,167
e 649,648   649,648  
2,094,223   2,093,396 827
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       6,452
b       27,851
c       7,929
d       74,167
e        
      827
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 2 117,226
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))
2017 3,454,282 12,302,179 0.280786
2016 2,863,826 14,766,750 0.193937
2015 2,459,379 17,231,475 0.142726
2014 4,984,732 27,801,331 0.179298
2013 2,442,984 1,944,290 1.256492
2
Total of line 1, column (d) .....................
2
2.053239
3
Average distribution ratio for the 5-year base period—divide the total on line 2 by 5.0, or by the number of years the foundation has been in existence if less than 5 years ......
3
0.410648
4
Enter the net value of noncharitable-use assets for 2018 from Part X, line 5......
4
7,931,773
5
Multiply line 4 by line 3......................
5
3,257,167
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
2,552
7
Add lines 5 and 6........................
7
3,259,719
8
Enter qualifying distributions from Part XII, line 4,.............
8
10,509,062
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 (2018)
Form 990-PF (2018)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket includes lines 1a and 1b
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b Domestic foundations that meet the section 4940(e) requirements in Part V, check 1 2,552
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 2,552
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 2,552
6 Credits/Payments:
a 2018 estimated tax payments and 2017 overpayment credited to 2018 6a 9,490
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 9,490
8 Enter any penalty for underpayment of estimated tax. Check here 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 6,938
11 Enter the amount of line 10 to be: Credited to 2019 estimated taxBullet0 RefundedBullet 11 6,938
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? Click to see list of attachments....................
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$   (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 changesClick to see list of attachments....
3
Yes
 
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
Yes
 
If "Yes," attach the statement required by General Instruction T.Click to see list of attachments
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 2018 or the taxable year beginning in 2018? See the 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. Click to see attachment...............................
    10
     
    No
    Form 990-PF (2018)
    Form 990-PF (2018)
    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 ofbulletLINDA HREVNACK Telephone no.bullet (551) 233-6641

    Located atbullet1 BECTON DRIVE B305EFRANKLIN LAKESNJ ZIP+4bullet07417
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2018, 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 the instructions for exceptions and filing requirements for FinCEN Form 114. 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 2018?.............
    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 2018, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2018?.............
    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 2018 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 2018.)..................
    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 2018?
    4b
     
    No
    Form 990-PF (2018)
    Form 990-PF (2018)
    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:
    Yes
    No
    (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). Click to see attachment
    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
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .................
    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
    SAMRAT S KHICHI PRESIDENT AS OF AUG, 2018
    0.01
    0 0 0
    730 CENTRAL AVENUE
    MURRAY HILL,NJ07974
    HERMAN V CUETO VP & TREASURER
    0.01
    0 0 0
    730 CENTRAL AVENUE
    MURRAY HILL,NJ07974
    BETTY D LARSON SECRETARY
    0.01
    0 0 0
    730 CENTRAL AVENUE
    MURRAY HILL,NJ07974
    JOHN GROETELAARS PRESIDENT UNTIL AUG, 2018
    0.01
    0 0 0
    730 CENTRAL AVENUE
    MURRAY HILL,NJ07974
    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  
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 7
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    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
    REED SMITH LLP LEGAL 100,337
    1901 AVENUE OF THE STARS SUITE 700
    LOS ANGELES,CA90067
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2018)
    Form 990-PF (2018)
    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
    7,389,839
    b
    Average of monthly cash balances.......................
    1b
    662,722
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    8,052,561
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    8,052,561
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    120,788
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    7,931,773
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    396,589
    Part XI
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    396,589
    2a
    Tax on investment income for 2018 from Part VI, line 5......
    2a
    2,552
    b
    Income tax for 2018. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    2,552
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    394,037
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    5,842
    5
    Add lines 3 and 4............................
    5
    399,879
    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
    399,879
    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
    10,509,062
    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
    0
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
    0
    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
    10,509,062
    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
    2,552
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    10,506,510
    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 (2018)
    Form 990-PF (2018)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus
    (b)
    Years prior to 2017
    (c)
    2017
    (d)
    2018
    1 Distributable amount for 2018 from Part XI, line 7 399,879
    2 Undistributed income, if any, as of the end of 2018:
    a Enter amount for 2017 only....... 0
    b Total for prior years:2016, 2015, 2014 0
    3 Excess distributions carryover, if any, to 2018:
    a From 2013...... 2,345,704
    b From 2014...... 3,578,246
    c From 2015...... 1,600,900
    d From 2016...... 2,129,985
    e From 2017...... 2,849,597
    fTotal of lines 3a through e........ 12,504,432
    4Qualifying distributions for 2018 from Part
    XII, line 4: bullet$ 10,509,062
    a Applied to 2017, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election required—see instructions).....
     
    c Treated as distributions out of corpus (Election
    required—see instructions)........
     
    d Applied to 2018 distributable amount..... 399,879
    e Remaining amount distributed out of corpus 10,109,183
    5 Excess distributions carryover applied to 2018.    
    (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 22,613,615
    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 2017. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............
    0
    f Undistributed income for 2018. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2019 ..........
    0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......
     
    8 Excess distributions carryover from 2013 not
    applied on line 5 or line 7 (see instructions) ...
    2,345,704
    9Excess distributions carryover to 2019.
    Subtract lines 7 and 8 from line 6a ......
    20,267,911
    10 Analysis of line 9:
    a Excess from 2014.... 3,578,246
    b Excess from 2015.... 1,600,900
    c Excess from 2016.... 2,129,985
    d Excess from 2017.... 2,849,597
    e Excess from 2018.... 10,109,183
    Form 990-PF (2018)
    Form 990-PF (2018)
    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 2018, 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) 2018 (b) 2017 (c) 2016 (d) 2015
             
    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 foundation 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).)
    NA
    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.
    NA
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2018)
    Form 990-PF (2018)
    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 Child's Voice Child Advocacy Center Inc
    216 Brookstone Place
    Social Circle,GA30025
      PC Community Development 13,000
    Action Ministries Inc
    2160 Church Street
    Covington,GA30015
      PC Community Development 7,000
    Amanda Hope Rainbow Angels
    340 East Coronado Road 100
    Phoenix,AZ85004
      PC Health 5,000
    American Cancer Society
    2310 Route 34 Suite 1D
    Manasquan,NJ08736
      PC Health 1,500
    American Cancer Society
    4550 East Bell Road Suite 126
    Phoenix,AZ85032
      PC Health 15,000
    American Cancer Society
    Calle Cabo Alverio 566 Urb La Me
    Hato Rey,PR00918
      PC Health 25,000
    American Cancer Society Inc
    3375 20th Street Suite 100
    Vero Beach,FL32960
      PC Health 13,250
    American Cancer Society Inc
    375 E 100 S
    Salt Lake City,UT84111
      PC Health 2,042
    American Diabetes Association
    5333 N 7th Street Suite B212
    Phoenix,AZ85014
      PC Health 5,000
    American Diabetes Association
    5333 N 7th Street Suite B212
    Phoenix,AZ85014
      PC Health 5,000
    American Heart Association
    465 S 400 E Suite 110
    Salt Lake City,UT84111
      PC Health 5,000
    American Heart Association
    2929 South 48th Street
    Tempe,AZ85282
      PC Health 5,000
    American Heart Association
    250 Pehle Avenue Suite 202
    Saddle Brook,NJ07663
      PC Health 15,000
    American Institute for MedBio Engineering
    1400 Eye Street NW Suite 235
    Washington,DC20005
      PC Health 10,000
    American Red Cross
    P O Box 9021067
    San Juan,PR009021067
      PC Education 2,500
    American Red Cross
    33 Everett Road
    Albany,NY12205
      PC Community Development 500
    American Red Cross
    695 Springfield Avenue
    Summit,NJ07901
      PC Community Development 10,000
    American Red Cross
    2424 A City Hall Lane
    North Charleston,SC29406
      PC Community Development 3,000
    American Red Cross
    P O Box 9021067
    San Juan,PR009021067
      PC Education 2,500
    Americares Foundation
    88 Hamilton Avenue
    Stamford,CT06902
      PC Health 10,000
    Angel Flight Soars Inc
    2000 Airport Road Suite 227
    Atlanta,GA30341
      PC Health 4,000
    Ara Parseghian Medical Research Fund at the Univer
    215 Jordan Hall of Science
    Notre Dame,IN46556
      PC Health 90,000
    Ara Parseghian Medical Research Fund at the Univer
    215 Jordan Hall of Science
    Notre Dame,IN46556
      PC Health 30,000
    Arizona Recreation Center for the Handicapped
    1550 W Colter Street
    Phoenix,AZ85015
      PC Health 2,000
    Autism Speaks Inc
    1955 West Baseline Road Suite 113-
    Mesa,AZ85202
      PC Health 5,000
    Autism Speaks Inc
    1060 State Road 2nd Floor
    Princeton,NJ08540
      PC Health 5,000
    Berkeley County Foundation of Volunteers of the SC
    PO Box 2695
    Goose Creek,SC29445
      PC Community Development 2,000
    Berkeley County Kids Who Care Inc
    P O Box 491
    Goose Creek,SC29445
      PC Education 4,000
    Black Child Development Institute-Albany New York
    PO Box 232
    Glenmont,NY12077
      PC Education 2,100
    Boy Scouts of America Inc
    1 Saddle Road
    Cedar Knolls,NJ07927
      PC Community Development 15,000
    Boys & Girls Club of Pawtucket
    One Moeller Place
    Pawtucket,RI02860
      PC Community Development 2,000
    Callen Lacey Center for Children
    5055 Lackawanna Boulevard
    North Charleston,SC29405
      PC Community Development 10,000
    Camp Patriot Corp
    P O Box 627
    Libby,MT59923
      PC Community Development 1,000
    Camp Ruggles Inc
    P O Box 353
    Chepachet,RI02814
      PC Community Development 2,000
    Can Do Canines
    9440 Science Center Drive
    Minneapolis,MN55428
      PC Community Development 2,000
    Cancer Support Community Arizona
    360 East Palm Lane
    Phoenix,AZ85004
      PC Health 2,000
    Cancer Support Community of Central New Jersey
    3 Crossroads Drive
    Bedminster,NJ07921
      PC Health 10,000
    Caritas Incorporated
    142 Bay Street
    Glens Falls,NY12801
      PC Health 1,500
    Casa de la Bondad Inc
    P O Box 8999
    Humacao,PR007928999
      PC Community Development 4,000
    Catholic Partnership Schools Camden
    808 Market Street
    Camden,NJ08102
      PC Education 5,000
    Children's Home Society
    650 10th Street
    Vero Beach,FL32960
      PC Community Development 6,625
    Children's Specialized Hospital Foundation
    150 New Providence Road
    Mountainside,NJ07092
      PC Health 30,000
    Children's Specialized Hospital Foundation
    150 New Providence Road
    Mountainside,NJ07092
      PC Health 10,000
    Circle of Life Children's Center
    274 South Orange Avenue
    Newark,NJ07103
      PC Health 20,000
    Cleveland Clinic Foundation
    9500 Euclid Avenue/UA3
    Cleveland,OH44195
      PC Health 10,000
    College of New Jersey Foundation
    P O Box 7718
    Ewing,NJ086280718
      PC Education 10,000
    Community Arts Association in Newton County
    1106 Washington Street
    Covington,GA30014
      PC Culture, Arts & Humanities 2,750
    Community Educational Outreach
    PO Box 18874
    Denver,CO80218
      PC Education 3,000
    Community Foundation of New Jersey
    P O Box 338
    Morristown,NJ079630338
      PC Employee Disaster Relief Fund 426,119
    Community Foundation of New Jersey
    P O Box 338
    Morristown,NJ079630338
      PC Employee Disaster Relief Fund 300,000
    Community Foundation of New Jersey
    P O Box 338
    Morristown,NJ079630338
      PC Employee Disaster Relief Fund 200,000
    Community Health Charities
    1199 North Fairfax Street Suite 60
    Alexandria,VA22314
      PC Health 97,000
    Cookies For Kids Cancer
    P O Box 415
    Califon,NJ07830
      PC Health 5,000
    Crossroads Rhode Island
    160 Broad Street
    Providence,RI02903
      PC Community Development 5,000
    Double H Hole in the Woods Ranch
    97 Hidden Valley Road
    Lake Luzerne,NY12846
      PC Health 10,000
    Drew University
    36 Madison Avenue
    Madison,NJ07940
      PC Education 5,000
    Elizabeth Buffum Chace Center
    P O Box 9476
    Warwick,RI02889
      PC Community Development 4,000
    Engaging Creative Minds
    7301 Rivers Avenue Suite 270
    Charleston,SC29406
      PC Education 1,000
    Fairfield University
    1073 North Benson Road
    Fairfield,CT06824
      PC Education 50,000
    Fairfield University
    1073 North Benson Road
    Fairfield,CT06824
      PC Education 25,000
    Family YMCA of the Glens Falls Area
    600 Glen Street
    Glens Falls,NY12801
      PC Community Development 3,000
    Foundation for Morristown Medical Center
    475 South Street
    Morristown,NJ07960
      PC Health 25,000
    Foundation for Service Dog Support
    5350 West Bell Road Suite C122 6
    Glendale,AZ85308
      PC Community Development 5,000
    Freedom House Inc
    2004 Route 31 North Suite 1
    Clinton,NJ08809
      PC Health 7,000
    Fundacion Dr John A Smith Memorial
    P O Box 859
    Humacao,PR00792
      PC Health 2,500
    Girls Incorporated of Greater Lowell
    220 Worthen Street
    Lowell,MA01852
      PC Education 2,000
    Glens Falls Area Habitat For Humanity Int'l Inc
    1373 US 9
    Moreau,NY12828
      PC Community Development 5,000
    Glens Falls Area Youth Center Inc
    60 Montcalm Street
    Glens Falls,NY12801
      PC Community Development 2,400
    Glens Falls Hospital Inc
    100 Park Street
    Glens Falls,NY12801
      PC Health 1,500
    Good Neighbor Center
    441 Rice Street
    St Paul,MN55103
      PC Education 3,500
    Goodwill Industries of Rhode Island
    100 Houghton Street
    Providence,RI02904
      PC Education 5,000
    Habitat For Humanity of Berkeley County
    1 Belknap Road
    Goose Creek,SC29445
      PC Community Development 1,000
    Hernia Repair for the Underserved
    12370 Rose Lane
    Omaha,NE68154
      PC Health 10,000
    Homesharing Program of Somerset County Inc
    120 Finderne Avenue
    Bridgewater,NJ08807
      PC Community Development 2,500
    Hope Hospice & Palliative Care Rhode Island
    1085 North Main Street
    Providence,RI02904
      PC Health 5,000
    HopeKids Inc
    PO Box 28471
    Scottsdale,AZ85255
      PC Community Development 5,000
    Independent College Fund of New Jersey
    797 Springfield Avenue
    Summit,NJ07901
      PC Education 25,000
    It's About Caring for Kids
    P O Box 16201
    Rochester,NY14616
      PC Community Development 2,000
    JDRF International
    132 S 600 E Suite 100
    Salt Lake City,UT84102
      PC Health 5,000
    John F Kennedy Center for the Performing Arts
    2700 F Street NW
    Washington,DC20566
      PC Culture, Arts & Humanities 33,333
    John F Kennedy Center for the Performing Arts
    2700 F Street NW
    Washington,DC20566
      PC Culture, Arts & Humanities 33,333
    Johns Hopkins Medicine
    600 N Wolfe Street CMSC 1380
    Baltimore,MD21287
      PC Health 25,000
    Johns Hopkins University
    5200 Eastern Avenue MFL Center Tow
    Baltimore,MD21224
      PC Health 10,000
    Joy Bus
    P O Box 22163
    Phoenix,AZ85028
      PC Health 1,000
    Junior Achievement of New Jersey
    360 Pear Blossom Drive
    Edison,NJ08837
      PC Education 5,000
    Liberty Science Center
    222 Jersey City Blvd Liberty Stat
    Jersey City,NJ07305
      PC Culture, Arts & Humanities 10,000
    Make-A-Wish Foundation of Greater PAVA Inc
    707 Grant Street Suite 3700
    Pittsburgh,PA15219
      PC Health 3,000
    Marklund Children's Home
    1S450 Wyatt Drive
    Geneva,IL60134
      PC Education 3,000
    Massachusetts General Hospital
    125 Nashua Street Suite 540
    Boston,MA02114
      PC Health 40,000
    Massachusetts General Hospital
    125 Nashua Street Suite 540
    Boston,MA02114
      PC Health 20,000
    Meals on Wheels of Rhode Island Inc
    70 Bath Street
    Providence,RI02908
      PC Community Development 4,000
    MedShare International
    3240 Clifton Springs Road
    Decatur,GA30034
      PC Disaster Relief 2,750
    Merrimack Valley Food Bank
    PO Box 8638
    Lowell,MA01853
      PC Community Development 2,000
    Morristown Neighborhood House Association
    12 Flagler Street
    Morristown,NJ07960
      PC Community Development 5,000
    National Coalition For Women With Heart Disease
    1100 17th Street NW Suite 500
    Washington,DC20036
      PC Education 25,000
    National Kidney Foundation
    2403 Sidney Street Suite 230
    Pittsburgh,PA15203
      PC Health 3,000
    National Kidney Foundation Inc
    360 E Coronado Road Suite 180
    Phoenix,AZ85004
      PC Health 5,000
    National Veterans Transition Services Inc
    9242 Lightwave Avenue Suite 120
    San Jose,CA92123
      PC Education 1,000
    New Jersey Performing Arts Center
    1 Center Street
    Newark,NJ07102
      PC Culture, Arts & Humanities 20,000
    New Jersey SEEDS
    494 Broad Street
    Newark,NJ07102
      PC Education 20,000
    New Providence Downtown Improvement District
    360 Elkwood Avenue
    New Providence,NJ07974
      PC Community Development 5,000
    New Providence Fire Department
    P O Box 671
    New Providence,NJ07974
      PC Community Development 5,000
    Newton County Community Food Pantry Inc
    7125 Turner Lake Circle
    Covington,GA30014
      PC Community Development 2,750
    Newton County Community Partnership Inc
    P OBox 445
    Covington,GA30015
      PC Education 5,500
    Northern Illinois Food Bank
    273 Dearborn Court
    Geneva,IL60134
      PC Community Development 1,000
    Our House Foundation Inc
    76 Floral Avenue
    New Providence,NJ07974
      PC Community Development 7,500
    Overlook Hospital Foundation
    36 Upper Overlook Road
    Summit,NJ07960
      PC Health 25,000
    Paper Mill Playhouse
    22 Brookside Drive
    Millburn,NJ07041
      PC Culture, Arts & Humanities 10,000
    Project HOPE The People-to-People Health Fdn Inc
    255 Carter Hall Lane
    Millwood,VA22646
      PC Health 155,000
    Project ReNeWal Domestic Violence Intervention Pro
    P O Box 1205
    Conyers,GA30012
      PC Community Development 7,000
    PTA New York Congress
    24 Jackson Avenue
    Glens Falls,NY12801
      PC Education 1,000
    Purdue Foundation Inc
    403 West Wood Street
    West Lafayette,IN47907
      PC Education 5,000
    Rhode Island Community Food Bank Association
    200 Niantic Avenue
    Providence,RI02907
      PC Community Development 2,000
    Ronald McDonald House Charities of Phoenix
    501 East Roanoke Avenue
    Phoenix,AZ85004
      PC Community Development 5,000
    Ronald McDonald House Charities of Capital Region
    139 South Lake Avenue
    Albany,NY12208
      PC Health 7,500
    Roper St Francis Foundation
    125 Doughty Street Suite 790
    Charleston,SC29403
      SO I Health 1,000
    Rutgers University Foundation
    7 College Avenue
    New Brunswick,NJ08901
      PC Health 10,000
    Rutgers University Fdn - Cancer Institute of NJ
    120 Albany Street Suite 305
    New Brunswick,NJ08901
      PC Health 25,000
    Rutgers University Fdn - Cancer Institute of NJ
    120 Albany Street Suite 305
    New Brunswick,NJ08901
      PC Education 50,000
    SAGE Eldercare Inc
    290 Broad Street
    Summit,NJ07901
      PC Health 15,000
    Saint Paul Neighborhood Network
    550 Vandalia Street 170
    Saint Paul,MN55114
      PC Community Development 1,000
    Salvation Army
    37 Broad Street
    Glens Falls,NY12801
      PC Community Development 5,000
    Samaritans of Rhode Island
    PO Box 9086
    Providence,RI02940
      PC Health 5,000
    Save the Bay Inc
    100 Save The Bay Drive
    Providence,RI02905
      PC Education 2,000
    Someone Cares Soup Kitchen
    720 West 19th Street
    Costa Mesa,CA92627
      PC Community Development 1,000
    Special Olympics Georgia
    6046 Financial Drive
    Norcross,GA30071
      PC Community Development 2,000
    Special Olympics Georgia
    6046 Financial Drive
    Norcross,GA30071
      PC Community Development 2,750
    Special Olympics New Jersey
    1 Eunice Kennedy Shriver Way
    Lawrenceville,NJ08648
      PC Community Development 2,500
    Spectrum 360
    1 Sunset Avenue
    Verona,NJ07044
      PC Community Development 5,000
    Steffen Thomas Museum & Archives
    4200 Bethany Road
    Buckhead,GA30625
      PC Culture, Arts & Humanities 3,500
    Summit Speech School
    705 Central Avenue
    New Providence,NJ07974
      PC Education 15,000
    SUNY Adirondack Foundation
    640 Bay Road
    Queensbury,NY12804
      PC Education 5,000
    Susan G Komen Breast Cancer Foundation
    4 Campus Drive
    Parsippany,NJ07054
      PC Health 10,000
    Tennyson Center for Children at Colorado Christian
    2950 Tennyson Street
    Denver,CO80212
      PC Health 3,000
    The Board of Trustees - Leland Stanford Junior Uni
    318 Campus Drive Room E100 James
    Stanford,CA943055428
      PC Education 100,000
    The World War II Foundation
    333 White Horn Drive Suite One
    Kingston,RI02891
      PC Culture, Arts & Humanities 2,000
    Thomas Jefferson University
    125 S 9th Street Suite 600
    Philadelphia,PA19107
      PC Health 75,000
    Thomas Jefferson University
    125 S 9th Street Suite 600
    Philadelphia,PA19107
      PC Health 75,000
    Travelers Aid Of Metropolitan Atlanta Inc
    34 Peachtree Street NW Suite 700
    Atlanta,GA30303
      PC Community Development 2,750
    Treasure Coast Food Bank
    401 Angle Road
    Fort Pierce,FL34947
      PC Community Development 6,625
    Tri-County Scholarship Fund
    4 Century Drive
    Parsippany,NJ07054
      PC Education 15,000
    Trident Literacy Association Inc
    6185-D Rivers Avenue
    North Charleston,SC29406
      PC Community Development 3,000
    Trinitas Health Foundation
    P O Box 259
    Elizabeth,NJ07207
      PC Health 10,000
    Trinitas Health Foundation
    P O Box 259
    Elizabeth,NJ07207
      PC Health 5,000
    Union County Performing Arts Center
    1601 Irving Street
    Rahway,NJ07065
      PC Culture, Arts & Humanities 5,000
    United Way of Greater Union County
    33 West Grand Street
    Elizabeth,NJ07202
      PC Community Development 248,000
    University of Utah
    WEB 1885 72 South Central Campus D
    Salt Lake City,UT84112
      PC Education 18,000
    University of Utah
    WEB 1885 72 South Central Campus D
    Salt Lake City,UT84112
      PC Education 26,875
    Val Skinner Foundation
    P O Box 213
    Bayhead,NJ08742
      PC Health 40,000
    Val Skinner Foundation
    P O Box 213
    Bayhead,NJ08742
      PC Health 20,000
    Warren Washington Counties Homeless Youth Coalitio
    PO Box 3252
    Glens Falls,NY12801
      PC Community Development 10,000
    Wasatch Homeless Health Care Inc
    409 West 400 South
    Salt Lake City,UT84101
      PC Health 583
    Willing Helpers Inc
    8111 Brown Bridge Road
    Covington,GA30014
      PC Community Development 4,000
    Willing Helpers Medical Inc
    8111 Brown Bridge Road
    Covington,GA30014
      PC Health 10,000
    WisePlace
    1411 North Broadway
    Santa Ana,CA92706
      PC Community Development 1,000
    Woburn Council of Social Concern Inc
    2 Merrimac Street
    Woburn,MA01801
      PC Community Development 1,000
    Year Up Providence
    40 Fountain Street Floor 7
    Providence,RI02903
      PC Community Development 2,000
    YMCA of Metropolitan Atlanta
    2140 Newton Drive
    Covington,GA30014
      PC Community Development 2,750
    Matching Gifts - See Attachment 16
    730 CENTRAL AVENUE
    MURRAY HILL,NJ07974
      PC MATCHING GIFTS (SEE ATTACHED) 1,072,174
    BD FOUNDATION INC
    1 BECTON DRIVE
    FRANKLIN LANES,NJ074171880
      PF The Grant and any income therefrom shall be used for BD Foundation's general operations, constituting charitable, educational or scientific purposes, within the meaning of Internal Revenue Code ("IRC") section 501(c)(3). 6,255,966
    Total .................................bullet 3a 10,382,925
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2018)
    Form 990-PF (2018)
    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....     14 256,486  
    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 -263,895  
    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)..   -7,409  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    -7,409
    (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 (2018)
    Form 990-PF (2018)
    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) (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) (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 (2018)
    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 Go to www.irs.gov/Form990 for the latest information.
    OMB No. 1545-0047
    2018
    Name of the organization
    C R BARD FOUNDATION INC
     
    Employer identification number

    22-2840708
    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 isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2018)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2
    Name of organization
    C R BARD FOUNDATION INC
     
    Employer identification number
    22-2840708
    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
    BECTON DICKINSON AND COMPANY  
    1 BECTON DRIVE
     
    FRANKLIN LANES, NJ074171880

    $ 98,546


    (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) (2018)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
    Page 3
    Name of organization
    C R BARD FOUNDATION INC
     
    Employer identification number

    22-2840708
    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) (2018)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
    Page 4
    Name of organization
    C R BARD FOUNDATION INC
     
    Employer identification number

    22-2840708
    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) (2018)

    Additional Data


    Software ID:  
    Software Version:  

    TY 2018 AccountingFeesSchedule
    Name:
    C R BARD FOUNDATION INC
    EIN:
    22-2840708
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAX COMPLIANCE FEES 22,025     22,025
    AUDIT FEES 25,000     25,000

    TY 2018 ContractorCompensationExpln
    Name:
    C R BARD FOUNDATION INC
    EIN:
    22-2840708
    Contractor Explanation
    REED SMITH LLP LEGAL FEES RELATED TO MERGER BETWEEN C.R. BARD FOUNDATION AND BD FOUNDATION.

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

    TY 2018 DepreciationSchedule
    Name:
    C R BARD FOUNDATION INC
    EIN:
    22-2840708
    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

    TY 2018 DissolutionStmt
    Name:
    C R BARD FOUNDATION INC
    EIN:
    22-2840708
    Dissolution Name Dissolution Address Explanation Dissolution Amount
    BD FOUNDATION 1 BECTON DRIVE
    FRANKLIN LANES,NJ07417
    THIS STATEMENT IS SUBMITTED IN ACCORDANCE WITH REG. 1.6043-3(A)(1) AND FORM 990-PF GENERAL INSTRUCTION T TO REPORT THE DISTRIBUTION OF CERTAIN ASSETS THAT RESULTED IN A SUBSTANTIAL CONTRACTION OF ASSETS DURING THE CURRENT TAX YEAR. DURING 2018, THE C.R. BARD FOUNDATION MADE ONE DISTRIBUTION OF ASSETS FROM SOURCES OTHER THAN CURRENT INCOME. SUCH DISTRIBUTIONS REPRESENTED 100% OF THE C.R. BARD FOUNDATION'S NET ASSETS (AS MEASURED BY FAIR MARKET VALUE) AT THE ENDING OF 2018. INFORMATION REGARDING THESE DISTRIBUTIONS IS AS FOLLOWS: 1) NAME AND ADDRESS OF DISTRIBUTEES: BD FOUNDATION, INC. 1 BECTON DRIVE, FRANKLIN LANES, NJ 07417-1880 2) ASSETS DISTRIBUTED: PORTFOLIO INVESTMENTS 3) DATE OF DISTRIBUTION: 12/31/2018 4) FAIR MARKET VALUE OF DISTRIBUTION: $6,255,966 BD FOUNDATION IS EXEMPT FROM TAXES UNDER IRC SEC. 501(C)(3) AND IS A PRIVATE NON-OPERATING FOUNDATION AS DEFINED IN IRC SEC. 509(A)(3). IT IS NOT CONTROLLED (DIRECTLY OR INDIRECTLY) BY C.R. BARD FOUNDATION OR ANY DISQUALIFIED PERSONS 6,255,966


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

    TY 2018 ExpenditureResponsibilityStmt
    Name:
    C R BARD FOUNDATION INC
    EIN:
    22-2840708
    Grantee's Name Grantee's Address Grant Date Grant Amount Grant Purpose Amount Expended By Grantee Any Diversion By Grantee? Dates of Reports By Grantee Date of Verification Results of Verification
    BD FOUNDATION INC
     
    1 BECTON DRIVE
    FRANKLIN LANES,NJ074171880
    2018-12-31 6,255,966 The Grant shall be used for BD Foundation's purposes within the meaning of IRC Section 501(c)(3). 0 NO NARR-REQUESTED; FINL-REQUESTED   THE FOUNDATION HAS EXERCISED EXPENDITURE RESPONSIBILITY WITH REGARDS TO THIS GRANT AND HAS RECEIVED OR REQUESTED AN ANNUAL REPORT FROM THE GRANTEE. THE FOUNDATION HAS NO REASON TO DOUBT THE ACCURACY OR RELIABILITY OF ANY REPORTS RECEIVED FROM THE GRANTEE SO NO INDEPENDENT VERIFICATION OF THE REPORTS WAS REQUIRED OR MADE.

    TY 2018 InvestmentsCorpStockSchedule
    Name:
    C R BARD FOUNDATION INC
    EIN:
    22-2840708
    Name of Stock End of Year Book Value End of Year Fair Market Value
    PORTFOLIO INVESTMENTS 0 0

    TY 2018 LiquidationExplanationStmt
    Name:
    C R BARD FOUNDATION INC
    EIN:
    22-2840708
    Statement:
    This statement is submitted in accordance with Reg. 1.6043-3(a)(1) and Form 990-PF General Instruction T to report the distribution of certain assets that resulted in a substantial contraction of assets during the current tax year. During 2018, the C.R. Bard Foundation made one distribution of assets from sources other than current income. Such distributions represented 100% of The C.R. Bard Foundations net assets (as measured by fair market value) at the ending of 2018. Information regarding these distributions is as follows: Name and Address of Assets Date of Fair Market Value Distributees Distributed Distribution of Distribution BD Foundation, Inc. Portfolio 12/31/2018 $6,255,966 1 Becton Drive Investments Franklin Lanes, NJ 07417-1880 BD Foundation is exempt from taxes under IRC Sec. 501(c)(3) and is a private non-operating foundation as defined in IRC Sec. 509(a)(3). It is not controlled (directly or indirectly) by C.R. Bard Foundation or any disqualified persons with respect to C.R. Bard Foundation. The distributions were made to BD Foundation as a result of merger between C.R. Bard Foundation and BD Foundation. An expenditure responsibility was also reported further to describe this transaction made during 2018. Further, BD Foundation is under no obligation to use the funds in a manner that will directly benefit C.R. Bard Foundation based on the assets transfer / grant made.


    TY 2018 LegalFeesSchedule
    Name:
    C R BARD FOUNDATION INC
    EIN:
    22-2840708
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    LEGAL FEES RELATED TO MERGER 73,546 0 0 73,546


    TY 2018 OtherDecreasesSchedule
    Name:
    C R BARD FOUNDATION INC
    EIN:
    22-2840708
    Description Amount
    GRANTS PAYABLE - BOOK TAX DIFFERENCE 794,453
    DONATED SERVICES 51,000


    TY 2018 OtherIncreasesSchedule
    Name:
    C R BARD FOUNDATION INC
    EIN:
    22-2840708
    Description Amount
    DONATED SERVICES 51,000
    MISC. ADJUSTMENTS 190


    TY 2018 OtherProfessionalFeesSchedule
    Name:
    C R BARD FOUNDATION INC
    EIN:
    22-2840708
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    MATCHING GIFT ADMIN SERVICES 5,566 0 0 5,566
    INVESTMENT MANAGEMENT FEES 36,157 36,157 0 0
    BANK FEES 270 270 0 0


    TY 2018 SubstantialContributorsSch
    Name:
    C R BARD FOUNDATION INC
    EIN:
    22-2840708
    Name Address
    BECTON DICKINSON AND COMPANY 1 BECTON DRIVE
    FRANKLIN LANES,NJ074171880


    TY 2018 TaxesSchedule
    Name:
    C R BARD FOUNDATION INC
    EIN:
    22-2840708
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ESTIMATED TAX PAYMENT 9,490 0 0 0