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
2019
Open to Public Inspection
For calendar year 2019, or tax year beginning 10-01-2017 , and ending 09-30-2018
Name of foundation
GODDARD HEALTH SERVICES INC
 
Number and street (or P.O. box number if mail is not delivered to street address)130 LIBERTY ST UNIT 12
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
BROCKTON, MA02301
A Employer identification number

04-2852328
B Telephone number (see instructions)

(508) 587-1114
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$8,289,260J 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) 20,000
2 Check bullet.............
3 Interest on savings and temporary cash investments 9,095 9,095  
4 Dividends and interest from securities... 215,338 215,338  
5a Gross rents............ 2,600 2,600  
b Net rental income or (loss) 2,600
6a Net gain or (loss) from sale of assets not on line 10 185,922
b Gross sales price for all assets on line 6a 2,573,314
7 Capital gain net income (from Part IV, line 2)... 185,922
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........ 432,955 412,955  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 40,597 8,119   33,687
14 Other employee salaries and wages...... 17,817 3,563   17,817
15 Pension plans, employee benefits....... 1,227 245   0
16a Legal fees (attach schedule)......... Click to see attachment 1,560 0   1,560
b Accounting fees (attach schedule)....... Click to see attachment 19,838 9,919   9,782
c Other professional fees (attach schedule).... Click to see attachment 40,064 30,146   8,263
17 Interest............... 1,548 31   2,085
18 Taxes (attach schedule) (see instructions)... Click to see attachment 12,486 0   0
19 Depreciation (attach schedule) and depletion... 11,718 2,343  
20 Occupancy.............. 25,535 19,663   5,513
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 36,428 3,595   33,830
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 208,818 77,624   112,537
25 Contributions, gifts, grants paid....... 292,000 233,500
26 Total expenses and disbursements. Add lines 24 and 25 500,818 77,624   346,037
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -67,863
b Net investment income (if negative, enter -0-) 335,331
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2019)
Form 990-PF (2019)
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......... 153,594 220,382 220,382
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.......... 4,992 5,005 5,005
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)....... 2,575,178 Click to see attachment2,692,464 2,692,464
c Investments—corporate bonds (attach schedule)....... 1,007,280 Click to see attachment2,820,465 2,820,465
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 3,855,925 Click to see attachment2,246,691 2,246,691
14 Land, buildings, and equipment: basis bullet326,046
Less: accumulated depreciation (attach schedule) bullet25,627 310,891 300,419 300,419
15 Other assets (describe bullet) Click to see attachment4,443 Click to see attachment3,834 Click to see attachment3,834
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 7,912,303 8,289,260 8,289,260
Liabilities 17 Accounts payable and accrued expenses.......... 14,384 64,001
18 Grants payable................. 20,000 40,000
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)...... 140,000  
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22)......... 174,384 104,001
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions...........    
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds    
29 Total net assets or fund balances (see instructions)..... 7,737,919 8,185,259
30 Total liabilities and net assets/fund balances (see instructions). 7,912,303 8,289,260
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 29 (must agree with end-of-year figure reported on prior year’s return) ...............
1
7,737,919
2
Enter amount from Part I, line 27a .....................
2
-67,863
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
515,203
4
Add lines 1, 2, and 3 ..........................
4
8,185,259
5
Decreases not included in line 2 (itemize) bullet
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
8,185,259
Form 990-PF (2019)
Form 990-PF (2019)
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 GENERAL ELECTRIC P 2014-11-14 2017-10-05
b CABOT CORP 2.55% JAN15 18 P 2013-09-25 2018-01-16
c RIVERNORTH DOUBLELINE P 2017-08-31 2018-01-12
d PPL CORPORATION P 2014-11-14 2018-01-12
e DOWDUPONT INC COM P 2014-11-14 2018-02-07
INTL BUSINESS MACHINES P 2016-11-10 2018-02-07
WESTERN ASSET CLAYMORE P 2017-10-05 2018-04-16
PIMCO COMM STRAT P P 2018-04-16 2018-04-19
PIMCO COMM STRAT FD 12 P 2018-05-15 2018-05-17
PIMCO COMM FUND CL 12 P 2015-01-08 2018-05-15
PACIFIC GAS & ELE 3.85% 23 P 2015-12-09 2018-06-20
ORACLE CORP 0.01 DEL P 2017-10-23 2018-06-20
ORACLE CORP 0.01 DEL P 2018-02-07 2018-06-20
AMERICAN EURO PACIFIC P 2017-01-13 2018-06-20
AMERICAN EURO PACIFIC P 2017-06-15 2018-06-20
AMERICAN EURO PACIFIC P 2017-06-15 2018-06-20
AMERICAN EURO PACIFIC P 2017-12-22 2018-06-20
AMERICAN EURO PACIFIC P 2017-12-22 2018-06-20
AMERICAN EURO PACIFIC P 2017-12-22 2018-06-20
AMERICAN EURO PACIFIC P 2018-06-14 2018-06-20
AMERICAN EURO PACIFIC P 2018-06-14 2018-06-20
AMERICAN EURO PACIFIC P 2018-06-14 2018-06-20
METRO W TTL RTRN BD CL I P 2015-01-08 2017-10-05
METRO W TTL RTRN BD CL I P 2015-01-12 2017-10-05
METRO W TTL RTRN BD CL I P 2015-01-12 2017-10-05
METRO W TTL RTRN BD CL I P 2015-01-12 2017-10-05
METRO W TTL RTRN BD CL I P 2015-01-30 2017-10-05
METRO W TTL RTRN BD CL I P 2015-01-30 2017-10-05
METRO W TTL RTRN BD CL I P 2015-02-27 2017-10-05
METRO W TTL RTRN BD CL I P 2015-03-31 2017-10-05
METRO W TTL RTRN BD CL I P 2015-03-31 2017-10-05
METRO W TTL RTRN BD CL I P 2015-04-30 2017-10-05
METRO W TTL RTRN BD CL I P 2015-05-29 2017-10-05
METRO W TTL RTRN BD CL I P 2015-05-29 2017-10-05
METRO W TTL RTRN BD CL I P 2015-06-30 2017-10-05
METRO W TTL RTRN BD CL I P 2015-07-31 2017-10-05
METRO W TTL RTRN BD CL I P 2015-08-31 2017-10-05
METRO W TTL RTRN BD CL I P 2015-09-30 2017-10-05
METRO W TTL RTRN BD CL I P 2015-09-30 2017-10-05
METRO W TTL RTRN BD CL I P 2015-10-30 2017-10-05
METRO W TTL RTRN BD CL I P 2015-11-30 2017-10-05
METRO W TTL RTRN BD CL I P 2015-11-30 2017-10-05
METRO W TTL RTRN BD CL I P 2015-12-14 2017-10-05
METRO W TTL RTRN BD CL I P 2015-12-14 2017-10-05
METRO W TTL RTRN BD CL I P 2015-12-14 2017-10-05
METRO W TTL RTRN BD CL I P 2015-12-31 2017-10-05
METRO W TTL RTRN BD CL I P 2015-12-31 2017-10-05
METRO W TTL RTRN BD CL I P 2016-01-29 2017-10-05
METRO W TTL RTRN BD CL I P 2016-02-29 2017-10-05
METRO W TTL RTRN BD CL I P 2016-02-29 2017-10-05
METRO W TTL RTRN BD CL I P 2016-03-31 2017-10-05
METRO W TTL RTRN BD CL I P 2016-03-31 2017-10-05
METRO W TTL RTRN BD CL I P 2016-04-29 2017-10-05
METRO W TTL RTRN BD CL I P 2016-05-31 2017-10-05
METRO W TTL RTRN BD CL I P 2016-06-30 2017-10-05
METRO W TTL RTRN BD CL I P 2016-06-30 2017-10-05
METRO W TTL RTRN BD CL I P 2016-07-29 2017-10-05
METRO W TTL RTRN BD CL I P 2016-07-29 2017-10-05
METRO W TTL RTRN BD CL I P 2016-08-31 2017-10-05
METRO W TTL RTRN BD CL I P 2016-08-31 2017-10-05
METRO W TTL RTRN BD CL I P 2016-09-30 2017-10-05
METRO W TTL RTRN BD CL I P 2016-10-31 2017-10-05
METRO W TTL RTRN BD CL I P 2016-10-31 2017-10-05
METRO W TTL RTRN BD CL I P 2016-11-30 2017-10-05
METRO W TTL RTRN BD CL I P 2016-12-12 2017-10-05
METRO W TTL RTRN BD CL I P 2016-12-12 2017-10-05
METRO W TTL RTRN BD CL I P 2016-12-12 2017-10-05
METRO W TTL RTRN BD CL I P 2016-12-30 2017-10-05
METRO W TTL RTRN BD CL I P 2017-01-31 2017-10-05
METRO W TTL RTRN BD CL I P 2017-01-31 2017-10-05
METRO W TTL RTRN BD CL I P 2017-02-28 2017-10-05
METRO W TTL RTRN BD CL I P 2017-03-31 2017-10-05
METRO W TTL RTRN BD CL I P 2017-04-28 2017-10-05
METRO W TTL RTRN BD CL I P 2017-04-28 2017-10-05
METRO W TTL RTRN BD CL I P 2017-05-31 2017-10-05
METRO W TTL RTRN BD CL I P 2017-06-30 2017-10-05
METRO W TTL RTRN BD CL I P 2017-06-30 2017-10-05
METRO W TTL RTRN BD CL I P 2017-07-31 2017-10-05
METRO W TTL RTRN BD CL I P 2017-08-31 2017-10-05
METRO W TTL RTRN BD CL I P 2017-08-31 2017-10-05
METRO W TTL RTRN BD CL I P 2017-09-29 2017-10-05
METRO W TTL RTRN BD CL I P 2017-09-29 2017-10-05
PIMCO INCOME FUND CLP P 2015-01-18 2017-10-06
PIMCO INCOME FUND CLP P 2017-09-29 2017-10-06
CD SYNCHRONY BK (FKA GE) P 2017-10-05 2018-01-16
CALAMOS CONV & HIGH INC P 2016-04-21 2018-02-16
WESTERN ASSET EMRGNG P 2016-04-21 2018-02-16
MFS VALUE FD CL I P 2017-01-13 2018-02-16
MFS VALUE FD CL I P 2017-12-21 2018-02-16
AMERICAN EURO PACIFIC P 2017-01-13 2018-02-16
AMERICAN EURO PACIFIC P 2017-12-22 2018-02-16
AMER FUNDS AMCAP P 2015-01-08 2018-02-16
AMER FUNDS AMCAP P 2015-01-14 2018-02-16
CD BANK OF BARODA P 2017-10-05 2018-04-13
MFS VALUE FD CL I P 2017-01-13 2018-04-12
MFS VALUE FD CL I P 2017-03-29 2018-04-12
MFS VALUE FD CL I P 2017-06-28 2018-04-12
MFS VALUE FD CL I P 2017-06-28 2018-04-12
MFS VALUE FD CL I P 2017-09-27 2018-04-12
MFS VALUE FD CL I P 2017-09-27 2018-04-12
MFS VALUE FD CL I P 2017-12-21 2018-04-12
MFS VALUE FD CL I P 2017-12-21 2018-04-12
MFS VALUE FD CL I P 2017-12-21 2018-04-12
MFS VALUE FD CL I P 2017-12-21 2018-04-12
MFS VALUE FD CL I P 2018-03-27 2018-04-12
MFS VALUE FD CL I P 2018-03-27 2018-04-12
MFS VALUE FD CL I P 2018-03-27 2018-04-12
PRIMECAP ODYSSY STK FD P 2015-01-08 2018-04-12
PRIMECAP ODYSSY STK FD P 2015-01-14 2018-04-12
PRIMECAP ODYSSY STK FD P 2017-12-18 2018-04-12
AMERICAN EURO PACIFIC P 2017-01-13 2018-04-12
AMERICAN EURO PACIFIC P 2017-01-13 2018-04-12
AMERICAN EURO PACIFIC P 2017-12-22 2018-04-12
AMER FUNDS AMCAP P 2015-01-08 2018-04-12
AMER FUNDS AMCAP P 2015-01-14 2018-04-12
AMER FUNDS AMCAP P 2017-12-19 2018-04-12
PIMCO INCOME FUND CL I2 P 2015-01-08 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-01-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-01-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-02-27 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-03-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-03-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-03-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-04-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-05-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-06-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-06-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-07-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-08-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-08-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-09-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-10-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-10-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-11-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-12-16 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-12-16 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-12-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-12-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-12-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-01-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-01-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-02-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-02-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-03-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-04-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-05-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-05-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-06-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-07-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-07-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-08-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-09-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-09-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-10-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-10-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-11-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-12-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-12-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-01-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-01-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-02-28 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-03-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-04-28 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-04-28 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-05-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-05-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-06-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-07-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-07-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-08-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-08-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-09-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-10-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-11-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-11-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-12-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2018-01-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2018-02-28 2018-05-15
PIMCO INCOME FUND CL I2 P 2018-02-28 2018-05-15
PIMCO INCOME FUND CL I2 P 2018-03-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2018-04-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2018-04-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2018-04-30 2018-05-15
AMERICAN EURO PACIFIC P 2018-06-14 2018-06-21
CD MORGAN STANLEY BK NA P 2018-04-13 2018-07-19
WESTERN ASSET EMRGNG P 2016-04-19 2018-03-05
SPROTT PHYSICAL GOLD AND P 2018-01-12 2018-03-05
FIRST EAG GLOBAL CL I P 2017-01-13 2018-03-05
FIRST EAG GLOBAL CL I P 2017-07-05 2018-03-05
FIRST EAG GLOBAL CL I P 2017-07-05 2018-03-05
FIRST EAG GLOBAL CL I P 2017-07-05 2018-03-06
MAT ASIAN FDS JAPAN FD P 2017-11-07 2018-04-12
MATTHEWS JAPAN FUND P 2017-11-07 2018-04-12
MAT ASIAN FDS JAPAN FD P 2017-11-07 2018-04-23
MAT ASIAN FDS JAPAN FD P 2017-11-07 2018-04-23
MAT ASIAN FDS JAPAN FD P 2017-12-06 2018-04-23
MAT ASIAN FDS JAPAN FD P 2017-12-06 2018-04-23
MAT ASIAN FDS JAPAN FD P 2017-12-06 2018-04-23
MAT ASIAN FDS JAPAN FD P 2017-12-06 2018-04-23
MAT ASIAN FDS JAPAN FD P 2017-12-06 2018-04-12
PARNASSUS CORE EQ INSTL P 2015-09-23 2018-04-12
PARNASSUS CORE EQ INSTL P 2018-03-29 2018-04-12
DELAWARE EM MKT INST P 2017-11-07 2018-04-12
DELAWARE EMERGING P 2017-11-07 2018-04-12
DELAWARE EM MKT INST P 2017-11-07 2018-04-23
DELAWARE EM MKT INST P 2017-11-07 2018-04-23
DELAWARE EM MKT INST P 2017-12-26 2018-04-23
DELAWARE EM MKT INST P 2017-12-26 2018-04-12
MFS VALUE FD CL I P 2017-01-13 2018-04-16
MFS VALUE FD CL I P 2017-05-25 2018-04-16
MFS VALUE FD CL I P 2017-05-25 2018-04-16
MFS VALUE FD CL I P 2017-07-05 2018-04-16
MFS VALUE FD CL I P 2017-11-07 2018-04-16
MFS VALUE FD CL I P 2018-03-27 2018-04-16
MFS VALUE FD CL I P 2018-03-27 2018-04-16
MFS VALUE FD CL I P 2018-03-27 2018-04-16
PRIMECAP ODYSSY STK FD P 2015-01-08 2018-04-12
PRIMECAP ODYSSY STOCK P 2015-01-08 2018-04-12
PRIMECAP ODYSSY STK FD P 2017-11-07 2018-04-12
PRIMECAP ODYSSY GROWTH P 2018-03-05 2018-04-12
PRIMECAP ODYSSY GROWTH P 2018-03-05 2018-04-12
PRIMECAP ODYSSY GROWTH P 2018-03-05 2018-04-12
AMERICAN EURO PACIFIC P 2017-01-13 2018-04-12
AMERICAN EURO PACIFIC P 2017-01-13 2018-04-12
AMERICAN EURO PACIFIC P 2017-01-13 2018-04-12
PIMCO INCOME FUND CL I2 P 2014-11-08 2018-05-15
PIMCO INCOME FUND CL I2 P 2014-11-08 2018-05-15
PIMCO INCOME FUND CL I2 P 2014-11-08 2018-05-15
PIMCO INCOME FUND CL I2 P 2014-11-08 2018-05-15
PIMCO INCOME FUND CL I2 P 2014-11-14 2018-05-15
PIMCO INCOME FUND CL I2 P 2014-11-14 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-01-08 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-01-08 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-01-08 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-01-14 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-01-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-01-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-02-27 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-02-27 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-03-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-03-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-04-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-05-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-05-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-06-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-07-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-07-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-08-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-09-23 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-09-23 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-09-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-09-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-10-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-11-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-11-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-12-16 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-12-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-12-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2015-12-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-01-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-02-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-05-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-05-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-06-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-09-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-09-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-10-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-11-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-11-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2016-12-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-01-13 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-01-13 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-01-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-02-28 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-02-28 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-03-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-04-28 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-05-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-06-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-06-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-07-05 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-07-05 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-07-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-08-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-08-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-09-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-09-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-10-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-11-07 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-11-30 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-12-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2017-12-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2018-01-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2018-01-31 2018-05-15
PIMCO INCOME FUND CL I2 P 2018-02-28 2018-05-15
PIMCO INCOME FUND CL I2 P 2018-03-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2018-03-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2018-03-29 2018-05-15
PIMCO INCOME FUND CL I2 P 2018-04-30 2018-05-15
SOUTHERN CO 1.50% JUN01 18 P 2017-03-20 2018-06-01
AMERICAN EURO PACIFIC P 2017-01-13 2018-06-08
AMERICAN EURO PACIFIC P 2017-01-13 2018-06-08
AMERICAN EURO PACIFIC P 2018-04-23 2018-06-08
AMERICAN EURO PACIFIC P 2018-04-23 2018-06-08
PIMCO COMM STRAT FD I2 P 2018-04-16 2018-08-21
PIMCO COMM STRAT FD I2 P 2018-05-15 2018-08-21
PIMCO COMM STRAT FD I2 P 2018-05-15 2018-08-21
PIMCO COMM STRAT FD I2 P 2018-06-14 2018-08-21
PIMCO COMM STRAT FD I2 P 2018-06-14 2018-08-21
PIMCO COMM STRAT FD I2 P 2018-06-14 2018-08-21
ABBOT LABORATORI 2.00% 18 P 2018-01-17 2018-09-17
RALPH LAUREN CORP 2.12% 18 P 2018-05-16 2018-09-26
CELGENE CORP COM P 2017-03-20 2017-10-05
BERKSHIRE HATHAWAY INC P 2017-08-04 2017-11-07
FIRST EAG GLOBAL CL I P 2017-01-13 2017-11-07
FIRST EAG GLOBAL CL I P 2017-07-05 2017-11-07
AMERICAN EURO PACIFIC P 2017-01-13 2017-11-07
AMERICAN EURO PACIFIC P 2017-01-13 2017-11-07
CELGENE CORP 2.12% AUG15 18 P 2017-03-20 2017-12-11
WELLS FARGO & CO 1.5% 18 P 2017-07-05 2017-07-16
CAPITAL GAIN DISTRIBUTION P 2018-01-01 2018-12-31
(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 15,927   17,216 -1,289
b 25,000   25,000 0
c 23,803   25,046 -1,243
d 24,994   26,391 -1,397
e 7,099   5,037 2,062
26,979   27,910 -931
25,649   25,308 341
7   6 1
3   3 0
49,837   50,838 -1,001
29,523   30,693 -1,170
8,710   9,886 -1,176
15,242   17,203 -1,961
221,914   191,392 30,522
810   778 32
5,294   5,082 212
54   53 1
2,377   2,447 -70
6,104   6,284 -180
162   167 -5
54   48 6
6,861   7,048 -187
113,358   116,439 -3,081
11   11 0
56,946   58,707 -1,761
11   11 0
11   11 0
181   189 -8
256   264 -8
11   11 0
256   264 -8
288   296 -8
11   11 0
363   372 -9
331   335 -4
341   347 -6
331   335 -4
11   11 0
277   282 -5
288   292 -4
11   11 0
299   302 -3
1,003   999 4
11   11 0
1,291   1,286 5
11   11 0
341   340 1
299   300 -1
11   11 0
256   258 -2
11   11 0
363   368 -5
320   326 -6
309   314 -5
11   11 0
277   286 -9
11   11 0
309   320 -11
11   11 0
267   276 -9
235   242 -7
11   11 0
256   262 -6
245   246 -1
267   263 4
11   11 0
2,305   2,268 37
288   284 4
11   11 0
288   285 3
288   286 2
363   359 4
11   11 0
320   319 1
331   331 0
11   11 0
309   309 0
320   320 0
11   11 0
331   333 -2
6   6 0
299   299 0
50   49 1
10   10 0
62,000   62,000 0
38,922   32,176 6,746
35,408   33,452 1,956
19,692   17,483 2,209
8   8 0
19,669   15,841 3,828
31   30 1
19,686   16,548 3,138
14     14
62,000   62,000 0
250,001   230,775 19,226
995   946 49
40   38 2
1,035   1,023 12
40   40 0
915   922 -7
1,353   1,391 -38
7,242   7,444 -202
40   41 -1
756   777 -21
40   40 0
8   8 0
915   896 19
54,968   40,690 14,278
19     19
13   13 0
47,971   39,182 8,789
12   10 2
18   17 1
49,987   42,336 7,651
10     10
4   4 0
61,601   62,839 -1,238
12   12 0
503   512 -9
647   664 -17
12   12 0
647   665 -18
53,575   55,098 -1,523
875   903 -28
887   918 -31
12   12 0
899   921 -22
899   922 -23
12   12 0
910   923 -13
934   937 -3
12   12 0
922   933 -11
934   942 -8
12   12 0
180   179 1
12   12 0
4,433   4,318 115
970   944 26
12   12 0
994   965 29
12   12 0
1,018   979 39
1,006   982 24
946   930 16
12   12 0
839   826 13
839   827 12
12   12 0
839   833 6
839   835 4
12   12 0
839   839 0
12   12 0
839   839 0
851   846 5
12   12 0
851   853 -2
12   12 0
851   858 -7
851   866 -15
851   869 -18
12   12 0
851   871 -20
12   12 0
851   876 -25
851   877 -26
12   12 0
851   878 -27
12   12 0
851   883 -32
863   896 -33
863   896 -33
12   12 0
863   895 -32
875   906 -31
887   912 -25
12   12 0
899   916 -17
899   916 -17
12   12 0
1   1 0
911   920 -9
40   41 -1
75,000   75,000 0
25,125   23,890 1,235
52,818   54,668 -1,850
58,942   55,449 3,493
59   56 3
5,020   4,956 64
17   17 0
15,382   14,938 444
7   7 0
18,520   18,279 241
18   18 0
270   258 12
25   24 1
1,006   963 43
25   23 2
11   11 0
25,980   23,542 2,438
20   20 0
12,789   13,145 -356
4   4 0
19,332   20,079 -747
16   17 -1
578   585 -7
7   7 0
87,487   80,475 7,012
40   37 3
25,875   24,987 888
10,102   9,994 108
6,948   7,045 -97
40   40 0
29   28 1
439   428 11
24,983   18,493 6,490
16   12 4
1   1 0
6   6 0
5,993   6,126 -133
1   1 0
14,944   12,207 2,737
50   41 9
5   4 1
12   13 -1
12   13 -1
407   427 -20
407   431 -24
156   164 -8
156   165 -9
12   12 0
25,266   25,774 -508
12   12 0
240   244 -4
12   12 0
347   354 -7
12   12 0
395   406 -11
12   12 0
395   407 -12
395   408 -13
12   12 0
395   410 -15
407   418 -11
12   12 0
407   418 -11
419   425 -6
12   12 0
34,982   35,188 -206
12   12 0
455   456 -1
575   582 -7
12   12 0
575   579 -4
108   107 1
12   12 0
2,767   2,696 71
611   594 17
623   605 18
635   611 24
12   12 0
419   413 6
419   413 6
12   12 0
311   312 -1
323   323 0
12   12 0
323   322 1
323   324 -1
7,008   7,051 -43
27,542   27,711 -169
407   411 -4
12   12 0
479   488 -9
479   490 -11
479   491 -12
479   494 -15
12   12 0
479   494 -15
12   12 0
8,721   8,991 -270
515   532 -17
12   12 0
515   534 -19
12   12 0
515   535 -20
527   548 -21
6,577   6,835 -258
551   572 -21
12   12 0
551   571 -20
12   12 0
563   579 -16
575   586 -11
12   12 0
551   562 -11
12   12 0
10   11 -1
25,000   25,000 0
24,962   20,406 4,556
25,987   21,245 4,742
55   54 1
2,963   2,952 11
51,635   54,994 -3,359
6   7 -1
45,965   51,197 -5,232
6   7 -1
4   5 -1
4,600   4,802 -202
25,000   25,000 0
25,000   25,000 0
27,660   25,290 2,370
4,651   3,222 1,429
27,509   25,002 2,507
23   21 2
44   36 8
32,638   26,599 6,039
25,061   25,040 21
25,000   25,000 0
70,366     70,366
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       -1,289
b       0
c       -1,243
d       -1,397
e       2,062
      -931
      341
      1
      0
      -1,001
      -1,170
      -1,176
      -1,961
      30,522
      32
      212
      1
      -70
      -180
      -5
      6
      -187
      -3,081
      0
      -1,761
      0
      0
      -8
      -8
      0
      -8
      -8
      0
      -9
      -4
      -6
      -4
      0
      -5
      -4
      0
      -3
      4
      0
      5
      0
      1
      -1
      0
      -2
      0
      -5
      -6
      -5
      0
      -9
      0
      -11
      0
      -9
      -7
      0
      -6
      -1
      4
      0
      37
      4
      0
      3
      2
      4
      0
      1
      0
      0
      0
      0
      0
      -2
      0
      0
      1
      0
      0
      6,746
      1,956
      2,209
      0
      3,828
      1
      3,138
      14
      0
      19,226
      49
      2
      12
      0
      -7
      -38
      -202
      -1
      -21
      0
      0
      19
      14,278
      19
      0
      8,789
      2
      1
      7,651
      10
      0
      -1,238
      0
      -9
      -17
      0
      -18
      -1,523
      -28
      -31
      0
      -22
      -23
      0
      -13
      -3
      0
      -11
      -8
      0
      1
      0
      115
      26
      0
      29
      0
      39
      24
      16
      0
      13
      12
      0
      6
      4
      0
      0
      0
      0
      5
      0
      -2
      0
      -7
      -15
      -18
      0
      -20
      0
      -25
      -26
      0
      -27
      0
      -32
      -33
      -33
      0
      -32
      -31
      -25
      0
      -17
      -17
      0
      0
      -9
      -1
      0
      1,235
      -1,850
      3,493
      3
      64
      0
      444
      0
      241
      0
      12
      1
      43
      2
      0
      2,438
      0
      -356
      0
      -747
      -1
      -7
      0
      7,012
      3
      888
      108
      -97
      0
      1
      11
      6,490
      4
      0
      0
      -133
      0
      2,737
      9
      1
      -1
      -1
      -20
      -24
      -8
      -9
      0
      -508
      0
      -4
      0
      -7
      0
      -11
      0
      -12
      -13
      0
      -15
      -11
      0
      -11
      -6
      0
      -206
      0
      -1
      -7
      0
      -4
      1
      0
      71
      17
      18
      24
      0
      6
      6
      0
      -1
      0
      0
      1
      -1
      -43
      -169
      -4
      0
      -9
      -11
      -12
      -15
      0
      -15
      0
      -270
      -17
      0
      -19
      0
      -20
      -21
      -258
      -21
      0
      -20
      0
      -16
      -11
      0
      -11
      0
      -1
      0
      4,556
      4,742
      1
      11
      -3,359
      -1
      -5,232
      -1
      -1
      -202
      0
      0
      2,370
      1,429
      2,507
      2
      8
      6,039
      21
      0
      70,366
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 2 185,922
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))
2018 285,849 3,537,870 0.080797
2017 197,019 2,596,546 0.075877
2016 179,153 2,565,870 0.069822
2015 199,823 2,542,926 0.078580
2014 188,603 3,080,921 0.061216
2
Total of line 1, column (d) .....................
2
0.366292
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
0.073258
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5......
4
5,156,851
5
Multiply line 4 by line 3......................
5
377,781
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
3,353
7
Add lines 5 and 6........................
7
381,134
8
Enter qualifying distributions from Part XII, line 4,.............
8
346,037
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 (2019)
Form 990-PF (2019)
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 6,707
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 6,707
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 6,707
6 Credits/Payments:
a 2019 estimated tax payments and 2018 overpayment credited to 2019 6a 2,399
b Exempt foreign organizations—tax withheld at source...... 6b
c Tax paid with application for extension of time to file (Form 8868)... 6c 9,200
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 11,599
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. Click to see attachment 8 0
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 4,892
11 Enter the amount of line 10 to be: Credited to 2020 estimated taxBullet4,892 RefundedBullet 11 0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition).................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletMA
    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 2019 or the taxable year beginning in 2019? 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 (2019)
    Form 990-PF (2019)
    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 Click to see attachment.............
    11
    Yes
     
    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 ofbulletCHARLIE COAKLEY Telephone no.bullet (508) 587-1114

    Located atbullet130 LIBERTY ST UNIT 12BROCKTONMA ZIP+4bullet02301
    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 2019, 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 2019?.............
    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 2019, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2019?.............
    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 2019 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 2019.)..................
    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 2019?
    4b
     
    No
    Form 990-PF (2019)
    Form 990-PF (2019)
    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
    ALYSSA ASACK ESQ SECRETARY
    1.00     		0 0 0
    130 LIBERTY ST UNIT 12
    BROCKTON,MA02301
    LOU BRAMBILLA CHAIRMAN
    1.00     		0 0 0
    130 LIBERTY ST UNIT 12
    BROCKTON,MA02301
    CHARLES COAKLEY TREASURER
    1.00     		0 0 0
    130 LIBERTY ST UNIT 12
    BROCKTON,MA02301
    CHRISTOPHER J SULMONTE CPA TRUSTEE
    1.00     		0 0 0
    130 LIBERTY ST UNIT 12
    BROCKTON,MA02301
    GEORGE H JOHNSON SR TRUSTEE
    1.00     		0 0 0
    130 LIBERTY ST UNIT 12
    BROCKTON,MA02301
    HOLLY FLETCHER TRUSTEE
    1.00     		0 0 0
    130 LIBERTY ST UNIT 12
    BROCKTON,MA02301
    JANE L DUEBLER TRUSTEE
    1.00     		0 0 0
    130 LIBERTY ST UNIT 12
    BROCKTON,MA02301
    WILLIAM MORSE VICE CHAIRPERSON
    1.00     		0 0 0
    130 LIBERTY ST UNIT 12
    BROCKTON,MA02301
    MARIA O'CONNELL UNDA EXECUTIVE DIRECTOR
    10.00     		40,595 810 0
    130 LIBERTY ST UNIT 12
    BROCKTON,MA02301
    MAUREEN REGAN TRUSTEE
    1.00     		0 0 0
    130 LIBERTY ST UNIT 12
    BROCKTON,MA02301
    PRISCILLA MUELLER TRUSTEE
    1.00     		0 0 0
    130 LIBERTY ST UNIT 12
    BROCKTON,MA02301
    STEPHEN MCDUFFY TRUSTEE
    1.00     		0 0 0
    130 LIBERTY ST UNIT 12
    BROCKTON,MA02301
    STEVE PRINCE TRUSTEE
    1.00     		0 0 0
    130 LIBERTY ST UNIT 12
    BROCKTON,MA02301
    HEATHER MORAN TRUSTEE
    1.00     		0 0 0
    130 LIBERTY ST UNIT 12
    BROCKTON,MA02301
    PETER FREDERICKSEN TRUSTEE
    1.00     		0 0 0
    130 LIBERTY ST UNIT 12
    BROCKTON,MA02301
    SHAUN FITZGERALD TRUSTEE
    1.00     		0 0 0
    130 LIBERTY ST UNIT 12
    BROCKTON,MA02301
    JESSICA WAINWRIGHT TRUSTEE
    1.00     		0 0 0
    130 LIBERTY ST UNIT 12
    BROCKTON,MA02301
    BRENT WARREN TRUSTEE
    1.00     		0 0 0
    130 LIBERTY ST UNIT 12
    BROCKTON,MA02301
    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 (2019)
    Form 990-PF (2019)
    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.........................bullet0
    Form 990-PF (2019)
    Form 990-PF (2019)
    Page 8
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    5,059,756
    b
    Average of monthly cash balances.......................
    1b
    175,626
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    5,235,382
    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
    5,235,382
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    78,531
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    5,156,851
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    257,843
    Part XI
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    257,843
    2a
    Tax on investment income for 2019 from Part VI, line 5......
    2a
    6,707
    b
    Income tax for 2019. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    6,707
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    251,136
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    251,136
    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
    251,136
    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
    346,037
    b
    Program-related investments—total from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    346,037
    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
    346,037
    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 (2019)
    Form 990-PF (2019)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2018     		(c)
    2018     		(d)
    2019
    1 Distributable amount for 2019 from Part XI, line 7 251,136
    2 Undistributed income, if any, as of the end of 2019:
    a Enter amount for 2018 only....... 0
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2019:
    a From 2014...... 38,211
    b From 2015...... 76,395
    c From 2016...... 55,007
    d From 2017...... 68,520
    e From 2018...... 111,175
    fTotal of lines 3a through e........ 349,308
    4Qualifying distributions for 2019 from Part
    XII, line 4: bullet$ 346,037
    a Applied to 2018, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		0
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		0
    d Applied to 2019 distributable amount..... 251,136
    e Remaining amount distributed out of corpus 94,901
    5 Excess distributions carryover applied to 2019. 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 5 444,209
    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 2018. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2019. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2020 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8 Excess distributions carryover from 2014 not
    applied on line 5 or line 7 (see instructions) ...     		38,211
    9Excess distributions carryover to 2020.
    Subtract lines 7 and 8 from line 6a ......     		405,998
    10 Analysis of line 9:
    a Excess from 2015.... 76,395
    b Excess from 2016.... 55,007
    c Excess from 2017.... 68,520
    d Excess from 2018.... 111,175
    e Excess from 2019.... 94,901
    Form 990-PF (2019)
    Form 990-PF (2019)
    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 2019, 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) 2019 (b) 2018 (c) 2017 (d) 2016
             
    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).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or 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 (2019)
    Form 990-PF (2019)
    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
    ABINGTON FOOD PANTRY
    425 PLYMOUTH ST
    ABINGTON,MA02351     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 1,000
    BAMSI
    10 CHRISTYS DRIVE
    BROCKTON,MA02301     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 20,000
    BOYS & GIRLS CLUB BROCKTON
    233 WARREN AVE
    BROCKTON,MA02301     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 20,000
    BROCKTON AFTER DARK PROGRAM CO BROCKTON PUBLIC SCHOOLS
    43 CRESCENT ST
    BROCKTON,MA02301     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 1,000
    BROCKTON AREA ARC
    1250 W CHESTNUT ST
    BROCKTON,MA02301     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 6,000
    BROCKTON DAY NURSERY
    243 CRESCENT ST
    BROCKTON,MA02302     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 25,000
    BROCKTON NEIGHBORHOOD HEALTH CENTER
    63 MAIN STREET
    BROCKTON,MA02301     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 18,000
    BROCKTON VISITING NURSE ASSOCIATION
    500 BELMONT ST 200
    BROCKTON,MA02301     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 15,000
    CATHOLIC CHARITIES SOUTH
    169 COURT STREET
    BROCKTON,MA02302     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 10,000
    DJ DREAM FUND
    670 DEPOT ST
    EASTON,MA02334     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 10,000
    EAST YOUTH CENTER
    105 DEPOT ST
    SOUTH EASTON,MA02375     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 6,000
    EAST BRIDGEWATER FOOD PANTRY
    105 PLEASANT ST
    EAST BRIDGEWATER,MA02333     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 1,000
    HEALTH IMPERATIVES
    111 TORREY ST
    BROCKTON,MA02301     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 20,000
    HOUSE OF POSSIBILITIES
    350 WASHINGTON ST
    NORTH EASTON,MA02356     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 1,000
    LIVING INDEPENDENTLY FOR EQUALITY
    54 HAVERHILL STREET
    BROCKTON,MA02301     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 10,000
    MY BROTHERS KEEPER
    PO BOX 338
    EASTON,MA02356     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 2,500
    OLD COLONY YMCA
    320 MAIN STREET
    BROCKTON,MA02301     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 37,000
    SACRED HEART FOOD PANTRY
    PO BOX 1381
    MIDDLEBORO,MA02346     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 1,000
    SUNSHINE FARM
    258 WALNUT ST
    BRIDGEWATER,MA02324     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 1,000
    SUPPORT OUR LIBRARY ASSOCIATION INC
    84 PARK STREET
    STOUGHTON,MA02072     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 5,000
    TEEN CHALLENGE OF BROCKTON
    1315 MAIN STREET
    BROCKTON,MA02301     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 6,000
    THE CHARITY GUILD INC
    501 MAIN ST
    BROCKTON,MA02301     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 1,000
    WHEELCHAIR STRONG
    37 BELMONT STREET
    BROCKTON,MA02301     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 1,000
    KELLY MONTEIRO
    58 PORTER STREET
    BROCKTON,MA02301     		NONE   JUDGE ROBERT S. PRINCE SCHOLARSHIP 5,000
    JOSHUA NICKANDROS
    220 WEST POND STREET
    EAST BRIDGEWATER,MA02333     		NONE   GODDARD HEALTH FOUNDATION SCHOLARSHIP 2,500
    MALLORY BREEN
    11 LYNDA ROAD
    EASTON,MA02375     		NONE   GODDARD HEALTH FOUNDATION SCHOLARSHIP 2,500
    SARAH GERAGHTY
    65 THREE RIVERS DRIVE
    BRIDGEWATER,MA02324     		NONE   GODDARD HEALTH FOUNDATION SCHOLARSHIP 2,500
    MICHAELA PECK
    25 MAHONEY AVE
    STOUGHTON,MA02072     		NONE   GODDARD HEALTH FOUNDATION SCHOLARSHIP 2,500
    Total .................................bullet 3a 233,500
    bApproved for future payment
    CATHOLIC CHARITIES SOUTH
    169 COURT STREET
    BROCKTON,MA02302     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 10,000
    DJ DREAM FUND
    670 DEPOT ST
    EASTON,MA02334     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 10,000
    SUPPORT OUR LIBRARY ASSOCIATION INC
    84 PARK STREET
    STOUGHTON,MA02072     		NONE PUBLIC CHARITY CHARITABLE CONTRIBUTION 20,000
    Total .................................bullet 3b 40,000
    Form 990-PF (2019)
    Form 990-PF (2019)
    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 ...........     		    14 9,095  
    4 Dividends and interest from securities....     14 215,338  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......     17 2,600  
    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 ............     		    18 185,922  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e).. 0 412,955 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    412,955
    (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 (2019)
    Form 990-PF (2019)
    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 (2019)
    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
    2019
    Name of the organization
    GODDARD HEALTH SERVICES INC
     
    Employer identification number

    04-2852328
    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) (2019)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2
    Name of organization
    GODDARD HEALTH SERVICES INC
          		Employer identification number
    04-2852328
    Part I
    Contributors
    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
    SAMUEL WARREN GODDARD
     
    2 WOOD DUCK LANE
     
    BEAUFORT, SC29907

    		$ 20,000


    (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) (2019)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
    Page 3
    Name of organization
    GODDARD HEALTH SERVICES INC
          		Employer identification number

    04-2852328
    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) (2019)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
    Page 4
    Name of organization
    GODDARD HEALTH SERVICES INC
          		Employer identification number

    04-2852328
    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) (2019)

    Additional Data


    Software ID:  
    Software Version:  

    TY 2017 AccountingFeesSchedule
    Name:
    GODDARD HEALTH SERVICES INC
    EIN:
    04-2852328
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    AUDIT 9,488 4,744   4,607
    BOOKKEEPING 10,350 5,175   5,175

    TY 2017 InvestmentsCorpBondsSchedule
    Name:
    GODDARD HEALTH SERVICES INC
    EIN:
    04-2852328
    Name of Bond End of Year Book Value End of Year Fair Market Value
    CORPORATE BONDS 2,820,465 2,820,465

    TY 2017 InvestmentsCorpStockSchedule
    Name:
    GODDARD HEALTH SERVICES INC
    EIN:
    04-2852328
    Name of Stock End of Year Book Value End of Year Fair Market Value
    SUBSIDARY - GODDARD RESTORATIVE CARE 2,692,464 2,692,464

    TY 2017 InvestmentsOtherSchedule2
    Name:
    GODDARD HEALTH SERVICES INC
    EIN:
    04-2852328
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    MUTUAL FUNDS FMV 2,246,691 2,246,691

    TY 2017 LegalFeesSchedule
    Name:
    GODDARD HEALTH SERVICES INC
    EIN:
    04-2852328
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    LEGAL 1,560 0   1,560


    TY 2017 OtherAssetsSchedule
    Name:
    GODDARD HEALTH SERVICES INC
    EIN:
    04-2852328
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    INTEREST RECEIVABLE 4,443 3,834 3,834


    TY 2017 OtherExpensesSchedule
    Name:
    GODDARD HEALTH SERVICES INC
    EIN:
    04-2852328
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INSURANCE 16,184 0   16,533
    MISCELLANEOUS EXPENSES 5,268 600   4,450
    OFFICE SUPPLIES 14,976 2,995   12,847


    TY 2017 OtherIncreasesSchedule
    Name:
    GODDARD HEALTH SERVICES INC
    EIN:
    04-2852328
    Description Amount
    UNREALIZED GAIN ON INVESTMENTS IN MARKETABLE SECURITIES 11,941
    INCOME FROM SUBSIDIARY 58,710
    INTERCOMPANY GIFT FROM GODDARD RESTORATIVE CARE, INC. 385,976
    PRIOR YEAR ADJUSTMENT 58,576


    TY 2017 OtherProfessionalFeesSchedule
    Name:
    GODDARD HEALTH SERVICES INC
    EIN:
    04-2852328
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    CONSULTING 12,509 2,591   8,263
    INVESTMENT SERVICE FEES 27,555 27,555   0


    TY 2017 TaxesSchedule
    Name:
    GODDARD HEALTH SERVICES INC
    EIN:
    04-2852328
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FEDERAL INCOME TAX 12,486 0   0


    TY 2017 TransfersToControlledEntities
    Name:
    GODDARD HEALTH SERVICES INC
    EIN:
    04-2852328
    Name US /
    Foreign Address    		 EIN Description Amount
    GODDARD RESTORATIVE CARE UNIT INC 130 LIBERTY ST UNIT 12
    BROCKTON,MA02301     		04-3081668 ON 11/27/2017 A TRANSFER OF $132,176 FROM GRC 132,176
    GODDARD RESTORATIVE CARE UNIT INC 130 LIBERTY ST UNIT 12
    BROCKTON,MA02301     		04-3081668 ON 1/2/2018 A TRANSFER OF $165,000 FROM GRC 165,000
    GODDARD RESTORATIVE CARE UNIT INC 130 LIBERTY ST UNIT 12
    BROCKTON,MA02301     		04-3081668 ON 6/12/2018 A TRANSFER OF $48,000 FROM GRC. 48,000
    GODDARD RESTORATIVE CARE UNIT INC 130 LIBERTY ST UNIT 12
    BROCKTON,MA02301     		04-3081668 12 MONTHLY PAYMENTS OF $3,400 FROM GRC 40,800
    Total     385,976