Form990-PF
Click to see attachment

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
CHAMBERS TOM & GERT IRREV S4
 
Number and street (or P.O. box number if mail is not delivered to street address)6325 S RAINBOW BLVD STE 300
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
LAS VEGAS, NV89118
A Employer identification number

38-6729601
B Telephone number (see instructions)

(888) 730-4933
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$865,420
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)  
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 23,356 23,078  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 60,840
b Gross sales price for all assets on line 6a 344,890
7 Capital gain net income (from Part IV, line 2)... 60,840
8 Net short-term capital gain......... 0
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........ 84,196 83,918  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 14,641 13,177   1,464
14 Other employee salaries and wages......   0 0 0
15 Pension plans, employee benefits.......   0 0  
16a Legal fees (attach schedule).........       0
b Accounting fees (attach schedule)....... 1,158 0 0 1,158
c Other professional fees (attach schedule)....       0
17 Interest...............       0
18 Taxes (attach schedule) (see instructions)... 2,078 884   0
19 Depreciation (attach schedule) and depletion... 0 0  
20 Occupancy..............        
21 Travel, conferences, and meetings.......   0 0  
22 Printing and publications..........   0 0  
23 Other expenses (attach schedule)....... 17 17    
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 17,894 14,078 0 2,622
25 Contributions, gifts, grants paid....... 38,004 38,004
26 Total expenses and disbursements. Add lines 24 and 25 55,898 14,078 0 40,626
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 28,298
b Net investment income (if negative, enter -0-) 69,840
c Adjusted net income (if negative, enter -0-)... 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.............      
2 Savings and temporary cash investments......... 36,441 36,986 36,986
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet     0 0
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 bullet0      
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 755,450 Click to see attachment782,713 828,434
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) 791,891 819,699 865,420
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
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........ 791,891 819,699
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)..... 791,891 819,699
31 Total liabilities and net assets/fund balances (see instructions). 791,891 819,699
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
791,891
2
Enter amount from Part I, line 27a .....................
2
28,298
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
820,189
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
490
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30 .
6
819,699
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 58. AQR MANAGED FUTURES STR-I   2015-03-02 2018-02-02
b 1. ALPHABET INC/CA   2016-02-17 2018-02-02
c 42. AMERIPRISE FINL INC     2018-02-02
d 7. APPLE INC   2014-10-31 2018-02-02
e 1. BLACKROCK INC   2015-02-27 2018-02-02
7. BOEING CO   2016-04-01 2018-02-02
28. CME GROUP INC     2018-02-02
46. CISCO SYSTEMS INC   2015-02-27 2018-02-02
8. CITIGROUP INC     2018-02-02
13. COGNIZANT TECH SOLUTIONS CRP COM   2016-08-24 2018-02-02
5. DIAGEO PLC - ADR   2015-02-27 2018-02-02
6. WALT DISNEY CO   2009-02-10 2018-02-02
6. HOME DEPOT INC   2017-04-03 2018-02-02
9. ISHARES S&P MID-CAP 400 GROWTH   2015-02-26 2018-02-02
386. ISHARES CORE S&P SMALL-CAP E     2018-02-02
12. JPMORGAN CHASE & CO   2016-03-08 2018-02-02
13. LAS VEGAS SANDS CORP   2015-02-27 2018-02-02
36. MANULIFE FINANCIAL CORP   2017-10-03 2018-02-02
11. MERCK & CO INC NEW   2016-04-25 2018-02-02
12. MICROSOFT CORP   2016-04-25 2018-02-02
11. ASG GLOBAL ALTERNATIVES-Y 1993   2013-07-19 2018-02-02
14. NEUBERGER BERMAN LONG SH-INS #1830   2017-10-26 2018-02-02
16. SPDR DJ WILSHIRE INTERNATIONAL REAL   2017-10-23 2018-02-02
17. TARGET CORP   2016-04-01 2018-02-02
21. TOTAL S.A. - ADR     2018-02-02
4. UNION PACIFIC CORP   2016-11-08 2018-02-02
184. VANGUARD INTERMEDIATE TERM B     2018-02-02
178. VANGUARD BD INDEX FD INC   2008-11-04 2018-02-02
16. VANGUARD BD INDEX FD INC   2017-10-23 2018-02-02
29. VANGUARD EUROPE PACIFIC ETF   2014-10-23 2018-02-02
9.421 VANGUARD INFLAT-PROT SECS-ADM 5119   2017-10-26 2018-02-02
245.251 VANGUARD INFLAT-PROT SECS-ADM 5119     2018-02-02
55. VANGUARD FTSE EMERGING MARKETS ETF   2013-07-17 2018-02-02
13. TE CONNECTIVITY LTD     2018-02-02
4. APPLE INC     2018-02-13
3. BERSHIRE HATHAWAY INC.   2009-11-04 2018-02-13
1. BLACKROCK INC   2015-02-27 2018-02-13
5. CELANESE CORP   2015-02-27 2018-02-13
14. CISCO SYSTEMS INC   2015-02-27 2018-02-13
15. MANULIFE FINANCIAL CORP   2017-10-03 2018-02-13
7. MANULIFE FINANCIAL CORP   2016-03-08 2018-02-13
3. MCKESSON CORP   2012-11-07 2018-02-13
5. MICROSOFT CORP   2016-04-25 2018-02-13
3. PNC FINANCIAL SERVICES GROUP   2016-10-04 2018-02-13
19. ROCHE HOLDINGS LTD - ADR   2015-06-22 2018-02-13
2. UNITEDHEALTH GROUP INC   2018-02-02 2018-02-13
12. AFFILIATED MANAGERS GROUP, INC COM     2018-04-10
139. AQR MANAGED FUTURES STR-I   2015-03-02 2018-05-16
63.108 BLACKROCK GL L/S CREDIT-K #1940   2017-10-26 2018-05-16
293.892 BLACKROCK GL L/S CREDIT-K #1940   2015-10-27 2018-05-16
6. CVS HEALTH CORPORATION   2014-10-31 2018-05-16
10. CVS HEALTH CORPORATION   2017-05-22 2018-05-16
10. CISCO SYSTEMS INC   2015-02-27 2018-05-16
278. EATON VANCE GLOB MACRO ADV-I 208   2017-10-26 2018-05-16
258.978 FID ADV EMER MKTS INC- CL I 607   2016-08-24 2018-05-16
90.022 FID ADV EMER MKTS INC- CL I 607     2018-05-16
13. ISHARES S&P MID-CAP 400 GROWTH   2015-02-26 2018-05-16
35. ISHARES RUSSELL 2000 ETF   2018-02-02 2018-05-16
11. ISHARES S&P MID-CAP 400 VALUE   2014-05-01 2018-05-16
218. JOHN HANCOCK II-CURR STR-I 3643   2017-10-26 2018-05-16
16.12 JPMORGAN HIGH YIELD FUND SS 3580   2016-04-27 2018-05-16
139.88 JPMORGAN HIGH YIELD FUND SS 3580     2018-05-16
106. ASG GLOBAL ALTERNATIVES-Y 1993   2013-07-19 2018-05-16
248. NEUBERGER BERMAN LONG SH-INS #1830   2017-10-26 2018-05-16
63. T ROWE PRICE INST FLOAT RATE 170     2018-05-16
138.021 T ROWE PR REAL ESTATE-I #432   2017-01-26 2018-05-16
23.979 T ROWE PR REAL ESTATE-I #432   2017-07-28 2018-05-16
5. SPDR DJ WILSHIRE INTERNATIONAL REAL   2017-10-23 2018-05-16
55. SPDR DJ WILSHIRE INTERNATIONAL REAL   2017-01-20 2018-05-16
11. SUNCOR ENERGY INC NEW F   2016-04-25 2018-05-16
10. TARGET CORP   2016-04-01 2018-05-16
8. TOTAL S.A. - ADR     2018-05-16
3. UNION PACIFIC CORP   2016-11-08 2018-05-16
1. UNITEDHEALTH GROUP INC   2018-02-02 2018-05-16
5. UNITEDHEALTH GROUP INC     2018-05-16
100. VANGUARD INTERMEDIATE TERM B   2016-04-22 2018-05-16
84. VANGUARD EUROPE PACIFIC ETF     2018-05-16
63. VANGUARD FTSE EMERGING MARKETS ETF   2013-07-17 2018-05-16
6. VANGUARD REIT VIPER   2017-10-23 2018-05-16
7. VANGUARD REIT VIPER   2017-01-20 2018-05-16
11.5 BAYER AG ADR- RIGHTS DEEMED 7/15/18   2016-12-09 2018-07-02
17.5 BAYER AG ADR- RIGHTS DEEMED 7/15/18   2018-02-02 2018-07-02
11.292 T ROWE PR REAL ESTATE-I #432   2017-10-26 2018-07-13
20.3509 T ROWE PR REAL ESTATE-I #432   2017-01-26 2018-07-13
1024.3571 T ROWE PR REAL ESTATE-I #432     2018-07-13
68. SPDR DJ WILSHIRE INTERNATIONAL REAL   2017-01-20 2018-07-13
157. VANGUARD REIT VIPER     2018-07-13
23. VANGUARD REIT VIPER   2018-02-02 2018-07-13
2. BOEING CO   2016-04-01 2018-07-18
33. COMCAST CORP CLASS A     2018-07-18
7. JPMORGAN CHASE & CO   2016-03-08 2018-07-18
6. MCKESSON CORP   2012-11-07 2018-07-18
2. THERMO FISHER SCIENTIFIC INC   2009-07-09 2018-07-18
10. APPLE INC     2018-08-03
46. BAYER AG - ADR   2016-12-09 2018-08-03
70. BAYER AG - ADR   2018-02-02 2018-08-03
24. ISHARES RUSSELL 2000 ETF   2018-02-02 2018-08-03
7. ISHARES S&P MID-CAP 400 VALUE   2014-05-01 2018-08-03
10. ELI LILLY & CO COM   2016-10-04 2018-08-03
15. MICROSOFT CORP   2016-04-25 2018-08-03
32. TCW EMRG MKTS INCM-I 4721   2018-07-18 2018-08-03
60. AQR MANAGED FUTURES STR-I   2015-03-02 2018-10-02
470. BLACKROCK GL L/S CREDIT-K #1940   2015-10-27 2018-10-02
5. ISHARES S&P MID-CAP 400 GROWTH   2015-02-26 2018-10-02
5. ISHARES S&P MID-CAP 400 VALUE   2014-05-01 2018-10-02
14. JOHN HANCOCK II-CURR STR-I 3643   2017-10-26 2018-10-02
1061.309 NEUBERGER BERMAN LONG SH-INS #1830   2017-07-28 2018-10-02
846.691 NEUBERGER BERMAN LONG SH-INS #1830     2018-10-02
6. T ROWE PR REAL ESTATE-I #432   2017-02-21 2018-10-02
150. VANGUARD INTERMEDIATE TERM B     2018-10-02
33. VANGUARD INTERMEDIATE TERM B   2017-10-23 2018-10-02
12. VANGUARD BD INDEX FD INC   2018-08-03 2018-10-02
33. VANGUARD BD INDEX FD INC   2008-11-04 2018-10-02
2. BOEING CO   2011-03-18 2018-10-03
4. CVS HEALTH CORPORATION   2018-02-02 2018-10-03
2. CVS HEALTH CORPORATION   2017-05-22 2018-10-03
36. CISCO SYSTEMS INC     2018-10-03
18. CITIGROUP INC   2014-03-27 2018-10-03
34. COMCAST CORP CLASS A     2018-10-03
4. DIAGEO PLC - ADR   2015-02-27 2018-10-03
85. MANULIFE FINANCIAL CORP   2016-03-08 2018-10-03
10. MERCK & CO INC NEW   2016-04-25 2018-10-03
4. MICROSOFT CORP   2016-04-25 2018-10-03
22. ROCHE HOLDINGS LTD - ADR   2015-06-22 2018-10-03
33. SUNCOR ENERGY INC NEW F   2016-04-25 2018-10-03
8. TOTAL S.A. - ADR   2015-10-28 2018-10-03
4. UNITED PARCEL SERVICE-CL B   2017-10-03 2018-10-03
6. EATON CORP PLC     2018-10-03
28. UBS GROUP AG   2018-02-02 2018-10-03
510. T ROWE PR REAL ESTATE-I #432     2018-11-16
12. SPDR DJ WILSHIRE INTERNATIONAL REAL   2018-10-02 2018-11-16
354. SPDR DJ WILSHIRE INTERNATIONAL REAL     2018-11-16
33. CVS HEALTH CORPORATION     2018-11-28
7. CITIGROUP INC   2018-11-19 2018-11-28
14. CITIGROUP INC     2018-11-28
2. DIAGEO PLC - ADR   2015-02-27 2018-11-28
5. DIAGEO PLC - ADR   2018-11-19 2018-11-28
3. JPMORGAN CHASE & CO   2016-03-08 2018-11-28
9. JPMORGAN CHASE & CO   2018-11-19 2018-11-28
14. MICROSOFT CORP   2018-11-19 2018-11-28
12. SCHLUMBERGER LTD   2018-11-19 2018-11-28
59. SCHLUMBERGER LTD     2018-11-28
CAPITAL GAIN DIVIDENDS P    
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a 552   644 -92
b 1,114   708 406
c 7,026   4,060 2,966
d 1,131   756 375
e 547   373 174
2,445   888 1,557
4,466   1,855 2,611
1,894   1,357 537
616   387 229
986   748 238
708   595 113
651   113 538
1,164   879 285
2,019   1,517 502
30,063   8,423 21,640
1,371   710 661
979   739 240
731   728 3
646   619 27
1,105   624 481
125   127 -2
207   198 9
653   614 39
1,240   1,409 -169
1,202   1,128 74
517   363 154
15,049   15,958 -909
13,968   13,450 518
1,256   1,275 -19
1,345   1,115 230
238   241 -3
6,183   6,365 -182
2,677   2,207 470
1,327   849 478
656   432 224
594   203 391
521   373 148
505   286 219
576   413 163
294   303 -9
137   96 41
438   278 160
448   260 188
459   271 188
556   695 -139
453   466 -13
2,126   1,325 801
1,250   1,543 -293
659   662 -3
3,068   3,062 6
397   521 -124
662   763 -101
451   295 156
2,827   2,969 -142
3,408   3,633 -225
1,185   1,269 -84
2,925   2,192 733
5,639   5,411 228
1,778   1,322 456
1,942   2,128 -186
117   114 3
1,014   1,030 -16
1,185   1,229 -44
3,646   3,514 132
631   634 -3
3,670   3,940 -270
638   687 -49
201   192 9
2,207   2,003 204
451   311 140
753   829 -76
505   414 91
426   272 154
241   233 8
1,207   161 1,046
7,995   8,605 -610
3,806   3,222 584
2,896   2,528 368
457   498 -41
533   571 -38
19     19
29     29
321   319 2
579   581 -2
29,122   29,210 -88
2,675   2,477 198
12,933   3,771 9,162
1,895   1,768 127
722   254 468
1,123   292 831
778   414 364
804   557 247
423   76 347
2,078   505 1,573
1,264   1,137 127
1,923   2,218 -295
3,993   3,710 283
1,162   841 321
1,002   811 191
1,613   780 833
257   257  
539   666 -127
4,897   4,897  
1,153   843 310
831   601 230
126   137 -11
16,100   14,975 1,125
12,844   12,037 807
167   171 -4
12,038   12,654 -616
2,648   2,790 -142
934   937 -3
2,569   2,494 75
785   139 646
321   304 17
160   153 7
1,773   977 796
1,299   852 447
1,212   250 962
575   476 99
1,510   1,163 347
721   562 159
463   208 255
676   804 -128
1,310   934 376
519   388 131
473   480 -7
529   349 180
430   566 -136
14,224   13,324 900
445   454 -9
13,138   12,716 422
2,652   2,542 110
455   456 -1
910   655 255
290   238 52
726   717 9
333   178 155
998   998  
1,541   1,470 71
551   582 -31
2,710   4,336 -1,626
      1,445
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       -92
b       406
c       2,966
d       375
e       174
      1,557
      2,611
      537
      229
      238
      113
      538
      285
      502
      21,640
      661
      240
      3
      27
      481
      -2
      9
      39
      -169
      74
      154
      -909
      518
      -19
      230
      -3
      -182
      470
      478
      224
      391
      148
      219
      163
      -9
      41
      160
      188
      188
      -139
      -13
      801
      -293
      -3
      6
      -124
      -101
      156
      -142
      -225
      -84
      733
      228
      456
      -186
      3
      -16
      -44
      132
      -3
      -270
      -49
      9
      204
      140
      -76
      91
      154
      8
      1,046
      -610
      584
      368
      -41
      -38
      19
      29
      2
      -2
      -88
      198
      9,162
      127
      468
      831
      364
      247
      347
      1,573
      127
      -295
      283
      321
      191
      833
       
      -127
       
      310
      230
      -11
      1,125
      807
      -4
      -616
      -142
      -3
      75
      646
      17
      7
      796
      447
      962
      99
      347
      159
      255
      -128
      376
      131
      -7
      180
      -136
      900
      -9
      422
      110
      -1
      255
      52
      9
      155
       
      71
      -31
      -1,626
       
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 60,840
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  
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 36,621 927,536 0.039482
2016 36,347 861,710 0.04218
2015 52,591 935,726 0.056203
2014 52,496 993,097 0.052861
2013 36,333 981,828 0.037005
2
Total of line 1, column (d) .....................
2
0.227731
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
0.045546
4
Enter the net value of noncharitable-use assets for 2018 from Part X, line 5......
4
937,330
5
Multiply line 4 by line 3......................
5
42,692
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
698
7
Add lines 5 and 6........................
7
43,390
8
Enter qualifying distributions from Part XII, line 4,.............
8
40,626
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 1,397
hereBulletand enter 1% of Part I, line 27b...................
c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 1,397
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 1,397
6 Credits/Payments:
a 2018 estimated tax payments and 2017 overpayment credited to 2018 6a 733
b Exempt foreign organizations—tax withheld at source...... 6b
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 733
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 664
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2019 estimated taxBullet0 RefundedBullet 11 0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition).................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (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)
    bulletMI
    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. ...............................
    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 ofbulletWELLS FARGO BANK NA Telephone no.bullet (888) 730-4933

    Located atbullet100 N MAIN ST MAC D4001-117WINSTON SALEMNC ZIP+4bullet27101
    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
     
    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 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
     
     
    .........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
     
     
    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
    Wells Fargo Bank NA TRUSTEE
    1
    14,641    
    100 N ST MAC D4001-117
    WINSTON SALEM,NC27101
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation
    (e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet 0
    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
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................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
    913,069
    b
    Average of monthly cash balances.......................
    1b
    38,535
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    951,604
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    951,604
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    14,274
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    937,330
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    46,867
    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
    46,867
    2a
    Tax on investment income for 2018 from Part VI, line 5......
    2a
    1,397
    b
    Income tax for 2018. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    1,397
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    45,470
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    45,470
    6
    Deduction from distributable amount (see instructions).................
    6
    0
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
    45,470
    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
    40,626
    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
    40,626
    5
    Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
    income. Enter 1% of Part I, line 27b. See instructions.................
    5
    0
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    40,626
    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 45,470
    2 Undistributed income, if any, as of the end of 2018:
    a Enter amount for 2017 only....... 37,485
    b Total for prior years:2016, 2015, 20 0
    3 Excess distributions carryover, if any, to 2018:
    a From 2013...... 0
    b From 2014...... 0
    c From 2015...... 0
    d From 2016...... 0
    e From 2017...... 0
    fTotal of lines 3a through e........ 0
    4Qualifying distributions for 2018 from Part
    XII, line 4: bullet$ 40,626
    a Applied to 2017, but not more than line 2a 37,485
    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 2018 distributable amount..... 3,141
    e Remaining amount distributed out of corpus 0
    5 Excess distributions carryover applied to 2018. 0 0
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 0
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........
    0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......
    0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........
    0
    e Undistributed income for 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 ..........
    42,329
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......
    0
    8 Excess distributions carryover from 2013 not
    applied on line 5 or line 7 (see instructions) ...
    0
    9Excess distributions carryover to 2019.
    Subtract lines 7 and 8 from line 6a ......
    0
    10 Analysis of line 9:
    a Excess from 2014.... 0
    b Excess from 2015.... 0
    c Excess from 2016.... 0
    d Excess from 2017.... 0
    e Excess from 2018.... 0
    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).)
    NONE
    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.
    NONE
    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
    PICKFORD PUBLIC SCHOOLS
    333 PLEASANT ST
    PICKFORD,MI49774
    NONE PC GENERAL OPERATING 12,668
    MENOMINEE AREA PUBLIC SCHOOLS
    1230 13TH ST
    MENOMINEE,MI49858
    NONE PC GENERAL OPERATING 12,668
    APPLETON CITY R2 SCHOOL DISTRICT
    408 W 4TH ST
    APPLETON CITY,MO64724
    NONE PC GENERAL OPERATING 12,668
    Total .................................bullet 3a 38,004
    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 23,356  
    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 60,840  
    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)..   84,196  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    84,196
    (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

    TY 2018 AccountingFeesSchedule
    Name:
    CHAMBERS TOM & GERT IRREV S4
    EIN:
    38-6729601
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAX PREPARATION FEE (NON-ALLOC 1,158     1,158

    TY 2018 GeneralExplanationAttachment
    Name:
    CHAMBERS TOM & GERT IRREV S4
    EIN:
    38-6729601
    Identifier Return Reference Explanation
    The compensation reported in column (c) is calculated based on periodic market values and/or the applicable fee agreement. It is not determined on an hourly basis and the reference to one hour per week is an estimate only. Corporate trustee services include, but are not limited to, administrative services such as fiduciary accounting, custody of assets, complying with tax filing requirements, complying with distribution provisions, and complying with federal and state laws applicable to private foundations, plus asset management services such as creating asset allocation strategies, investments reporting and reallocating and rebalancing of portfolios as necessary.

    TY 2018 InvestmentsOtherSchedule2
    Name:
    CHAMBERS TOM & GERT IRREV S4
    EIN:
    38-6729601
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    02079K107 ALPHABET INC/CA AT COST 2,690 5,178
    03076C106 AMERIPRISE FINL INC AT COST 1,771 1,670
    277923264 EATON VANCE GLOB MAC AT COST 30,915 27,725
    98978V103 ZOETIS INC AT COST 934 1,454
    09247X101 BLACKROCK INC AT COST 5,079 5,892
    87234N765 TCW EMRG MKTS INCM-I AT COST 48,642 46,542
    20030N101 COMCAST CORP CLASS A AT COST 177 885
    63872T885 ASG GLOBAL ALTERNATI AT COST 18,840 17,669
    517834107 LAS VEGAS SANDS CORP AT COST 6,873 6,558
    46434G103 ISHARES CORE MSCI EM AT COST 27,472 26,263
    921937827 VANGUARD BD INDEX FD AT COST 14,810 15,400
    921937819 VANGUARD INTERMEDIAT AT COST 50,539 52,107
    126650100 CVS/CAREMARK CORPORA AT COST 4,707 5,766
    771195104 ROCHE HOLDINGS LTD - AT COST 7,894 7,055
    31641Q763 FIDELITY NEW MRKTS I AT COST 60,620 55,921
    084670702 BERSHIRE HATHAWAY IN AT COST 923 1,429
    00206R102 AT & T INC AT COST 9,277 7,620
    47803M168 JOHN HANCOCK II-CURR AT COST 20,541 19,439
    609207105 MONDELEZ INTERNATION AT COST 5,674 5,204
    921943858 VANGUARD EUROPE PACI AT COST 57,400 57,134
    Y2573F102 FLEXTRONICS INTL LTD AT COST 1,067 495
    56501R106 MANULIFE FINANCIAL C AT COST 4,635 4,654
    405217100 HAIN CELESTIAL GROUP AT COST 1,835 999
    26875P101 EOG RESOURCES, INC AT COST 1,108 785
    911312106 UNITED PARCEL SERVIC AT COST 6,869 6,730
    464287705 ISHARES S&P MIDCAP 4 AT COST 19,694 35,138
    192446102 COGNIZANT TECH SOLUT AT COST 3,060 3,428
    77958B402 T ROWE PRICE INST FL AT COST 5,796 5,594
    848574109 SPIRIT AEROSYTSEMS H AT COST 908 1,081
    78463X863 SPDR DJ WILSHIRE INT AT COST 7,092 8,729
    64128R608 NEUBERGER BERMAN LON AT COST 16,570 16,178
    097023105 BOEING COMPANY AT COST 1,875 5,160
    17275R102 CISCO SYSTEMS INC AT COST 5,175 9,489
    25243Q205 DIAGEO PLC - ADR AT COST 3,508 5,672
    375558103 GILEAD SCIENCES INC AT COST 5,483 5,004
    654106103 NIKE INC CL B AT COST 2,750 3,188
    693475105 PNC FINANCIAL SERVIC AT COST 2,288 3,040
    872540109 TJX COS INC NEW AT COST 1,742 2,461
    87612E106 TARGET CORP AT COST 4,822 4,825
    464287655 ISHARES RUSSELL 2000 AT COST 69,705 60,121
    46625H100 JPMORGAN CHASE & CO AT COST 2,112 6,052
    46090F100 INVESCO OPTIMUM YIEL AT COST 20,002 15,733
    922042858 VANGUARD EMERGING MA AT COST 47,721 52,807
    172967424 CITIGROUP INC AT COST 1,002 1,197
    254687106 WALT DISNEY CO AT COST 1,199 2,193
    532457108 ELI LILLY & CO COM AT COST 6,235 8,448
    883556102 THERMO FISHER SCIENT AT COST 342 2,014
    89151E109 TOTAL FINA ELF S.A. AT COST 8,363 8,505
    H42097107 UBS GROUP AG AT COST 6,279 4,024
    09260C703 BLACKROCK GL L/S CRE AT COST 28,126 26,352
    00203H859 AQR MANAGED FUTURES AT COST 32,041 26,783
    H84989104 TE CONNECTIVITY LTD AT COST 3,775 3,857
    4812C0803 JPMORGAN HIGH YIELD AT COST 12,892 12,346
    037833100 APPLE COMPUTER INC C AT COST 2,773 8,676
    437076102 HOME DEPOT INC AT COST 2,197 2,577
    594918104 MICROSOFT CORP AT COST 5,591 13,814
    91324P102 UNITEDHEALTH GROUP I AT COST 1,288 4,982
    58933Y105 MERCK & CO INC NEW AT COST 5,852 8,252
    779919307 T ROWE PR REAL ESTAT AT COST 8,666 8,306
    G29183103 EATON CORP PLC AT COST 5,410 6,454
    907818108 UNION PACIFIC CORP AT COST 1,528 4,838
    867224107 SUNCOR ENERGY INC NE AT COST 8,775 8,307
    464287606 ISHARES S&P MIDCAP 4 AT COST 22,485 34,995
    150870103 CELANESE CORP AT COST 1,638 2,519
    12572Q105 CME GROUP INC AT COST 378 1,317
    512807108 LAM RESEARCH CORP CO AT COST 4,283 3,404

    TY 2018 OtherDecreasesSchedule
    Name:
    CHAMBERS TOM & GERT IRREV S4
    EIN:
    38-6729601
    Description Amount
    MUTUAL FUND TIMING DIFFERENCE 67
    PY RETURN OF CAPITAL ADJUSTMENT 343
    COST BASIS ADJUSTMENT 80


    TY 2018 OtherExpensesSchedule
    Name:
    CHAMBERS TOM & GERT IRREV S4
    EIN:
    38-6729601
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT EXPENSES-DIVIDEND I 17 17   0


    TY 2018 TaxesSchedule
    Name:
    CHAMBERS TOM & GERT IRREV S4
    EIN:
    38-6729601
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 438 438   0
    FEDERAL TAX PAYMENT - PRIOR YE 461 0   0
    FEDERAL ESTIMATES - PRINCIPAL 733 0   0
    FOREIGN TAXES ON QUALIFIED FOR 188 188   0
    FOREIGN TAXES ON NONQUALIFIED 258 258   0