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 12-01-2017 , and ending 11-30-2018
Name of foundation
THE SAM S BLOOM FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)P O BOX 2413
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
LITTLETON, CO801612413
A Employer identification number

84-0929690
B Telephone number (see instructions)

(303) 771-2266
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$10,103,056J 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 97 97  
4 Dividends and interest from securities... 185,412 185,412  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 509,261
b Gross sales price for all assets on line 6a 1,274,312
7 Capital gain net income (from Part IV, line 2)... 509,261
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........ 694,770 694,770  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 58,729 29,365   29,365
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 2,580 2,580    
c Other professional fees (attach schedule).... Click to see attachment 47,612 47,612    
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 18,978 5   5
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings....... 1,193 596   597
22 Printing and publications.......... 499 250   249
23 Other expenses (attach schedule)....... Click to see attachment 6,948 3,474   3,474
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 136,539 83,882   33,690
25 Contributions, gifts, grants paid....... 462,500 462,500
26 Total expenses and disbursements. Add lines 24 and 25 599,039 83,882   496,190
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 95,731
b Net investment income (if negative, enter -0-) 610,888
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............. 14,149 9,208 9,208
2 Savings and temporary cash investments.........      
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)....... 7,805,546 Click to see attachment7,906,218 10,093,848
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 7,819,695 7,915,426 10,103,056
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 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........ 48,379 48,379
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds 7,771,316 7,867,047
29 Total net assets or fund balances (see instructions)..... 7,819,695 7,915,426
30 Total liabilities and net assets/fund balances (see instructions). 7,819,695 7,915,426
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
7,819,695
2
Enter amount from Part I, line 27a .....................
2
95,731
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
7,915,426
5
Decreases not included in line 2 (itemize) bullet
5
 
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
7,915,426
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 VANGUARD 500 INDEX P 2015-01-15 2018-01-04
b HARDING LOEVNER EMERGING MKT P 2015-01-15 2018-04-03
c VANGUARD 500 INDEX P 2015-01-15 2018-05-10
d NEW PERSPECTIVE FUND P 2015-01-15 2018-05-10
e VANGUARD 500 INDEX P 2015-01-15 2018-07-02
VANGUARD 500 INDEX P 2015-01-15 2018-10-02
VANGUARD 500 INDEX P 2015-01-15 2018-11-06
LOOMIS SAYLES INTERM DURATION FUND P 2015-01-15 2018-11-06
NEW PERSPECTIVE FUND P 2015-01-15 2018-11-06
SEIX FLOATING RATE HIGH INCOME FND P 2015-01-15 2018-11-06
VANGUARD EXTENDED MARKET FUND P 2015-01-15 2018-11-06
BLACKSTONE ALTERNATIVE MULT-STRATEGY P 2015-01-15 2018-11-06
(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 28,000   13,928 14,072
b 47,000   33,355 13,645
c 155,000   77,327 77,673
d 400,000   259,286 140,714
e 28,000   14,037 13,963
28,000   13,157 14,843
160,000   79,662 80,338
10,000   10,484 -484
63,000   42,764 20,236
160,000   164,353 -4,353
40,000   27,554 12,446
30,000   29,144 856
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       14,072
b       13,645
c       77,673
d       140,714
e       13,963
      14,843
      80,338
      -484
      20,236
      -4,353
      12,446
      856
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 2 509,261
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 463,484 10,172,929 0.045561
2017 486,384 9,354,388 0.051995
2016 492,787 9,949,565 0.049528
2015 444,072 10,022,075 0.044309
2014 409,282 9,102,131 0.044966
2
Total of line 1, column (d) .....................
2
0.236359
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
0.047272
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5......
4
10,711,844
5
Multiply line 4 by line 3......................
5
506,370
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
6,109
7
Add lines 5 and 6........................
7
512,479
8
Enter qualifying distributions from Part XII, line 4,.............
8
496,190
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 12,218
hereBulletand enter 1% of Part I, line 27b...................
c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2  
3 Add lines 1 and 2........................... 3 12,218
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 12,218
6 Credits/Payments:
a 2019 estimated tax payments and 2018 overpayment credited to 2019 6a 9,500
b Exempt foreign organizations—tax withheld at source...... 6b
c Tax paid with application for extension of time to file (Form 8868)... 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 9,500
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 2,718
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 2020 estimated taxBullet   RefundedBullet 11  
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)
    bulletCO
    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 .............
    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 addressbulletHTTP://WWW.GUIDESTAR.ORG
    14
    The books are in care ofbulletC CROWLEY Telephone no.bullet (303) 771-2266

    Located atbulletPO BOX 2413LITTLETONCO ZIP+4bullet801612413
    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
    DONALD R JACOBS PRESIDENT
    1.00     		0 0 0
    PO BOX 2413
    LITTLETON,CO80161
    JON LUDWIGSON VICE PRES
    1.00     		0 0 0
    PO BOX 2413
    LITTLETON,CO80161
    NEIL KESSELMAN SECRETARY
    1.00     		0 0 0
    PO BOX 2413
    LITTLETON,CO80161
    A MARVIN STRAIT TREASURER
    1.00     		0 0 0
    PO BOX 2413
    LITTLETON,CO80161
    CHERYL CALDWELL DIRECTOR
    1.00     		0 0 0
    PO BOX 2413
    LITTLETON,CO80161
    MARY T CARRAHER DIRECTOR
    1.00     		0 0 0
    PO BOX 2413
    LITTLETON,CO80161
    TONIE L GATCH DIRECTOR
    1.00     		0 0 0
    PO BOX 2413
    LITTLETON,CO80161
    DEBBIE STRAIT GONZALES DIRECTOR
    1.00     		0 0 0
    PO BOX 2413
    LITTLETON,CO80161
    RODGER A HARA DIRECTOR
    1.00     		0 0 0
    PO BOX 2413
    LITTLETON,CO80161
    SASHA JACOBS-LOWRY DIRECTOR
    1.00     		0 0 0
    PO BOX 2413
    LITTLETON,CO80161
    JOANN RADETSKY DIRECTOR
    1.00     		0 0 0
    PO BOX 2413
    LITTLETON,CO80161
    NANCY J SALTZMAN DIRECTOR
    1.00     		0 0 0
    PO BOX 2413
    LITTLETON,CO80161
    C CROWLEY FDN MGR
    27.00     		58,729 0 893
    PO BOX 2413
    LITTLETON,CO80161
    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  
    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.............bullet  
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1 N/A  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    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
    10,863,288
    b
    Average of monthly cash balances.......................
    1b
    11,681
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    10,874,969
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
     
    3
    Subtract line 2 from line 1d.........................
    3
    10,874,969
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    163,125
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    10,711,844
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    535,592
    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
    535,592
    2a
    Tax on investment income for 2019 from Part VI, line 5......
    2a
    12,218
    b
    Income tax for 2019. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    12,218
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    523,374
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    523,374
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
    523,374
    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
    496,190
    b
    Program-related investments—total from Part IX-B..................
    1b
     
    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
    496,190
    5
    Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
    income. Enter 1% of Part I, line 27b. See instructions.................
    5
     
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    496,190
    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 7 523,374
    2 Undistributed income, if any, as of the end of 2019:
    a Enter amount for 2018 only....... 462,493
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2019:
    a From 2014......  
    b From 2015......  
    c From 2016......  
    d From 2017......  
    e From 2018......  
    fTotal of lines 3a through e........  
    4Qualifying distributions for 2019 from Part
    XII, line 4: bullet$ 496,190
    a Applied to 2018, but not more than line 2a 462,493
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		 
    d Applied to 2019 distributable amount..... 33,697
    e Remaining amount distributed out of corpus  
    5 Excess distributions carryover applied to 2019.    
    (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  
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		 
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		 
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		 
    e Undistributed income for 2018. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    f Undistributed income for 2019. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2020 ..........     		489,677
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		 
    8 Excess distributions carryover from 2014 not
    applied on line 5 or line 7 (see instructions) ...     		 
    9Excess distributions carryover to 2020.
    Subtract lines 7 and 8 from line 6a ......     		 
    10 Analysis of line 9:
    a Excess from 2015....  
    b Excess from 2016....  
    c Excess from 2017....  
    d Excess from 2018....  
    e Excess from 2019....  
    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 e-mail address of the person to whom applications should be addressed:
    C CROWLEY
    PO BOX 2413
    LITTLETON,CO801612413
    (303) 771-2266
    bThe form in which applications should be submitted and information and materials they should include:
    SEE ATTACHED GUIDELINES AND APPLICATIONS PROCEDURES.
    cAny submission deadlines:
    SEE ATTACHED GUIDELINES AND APPLICATIONS PROCEDURES
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    SEE ATTACHED GUIDELINES AND APPLICATIONS PROCEDURES.
    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
    ABILITY CONNECTION COLORADO
    801 YOSEMITE STREET
    DENVER,CO80230     		    EARLY CHILDHOOD EDUCATION 3,500
    BAL SWAN CHILDREN'S CENTER
    1145 EAST 13TH AVENUE
    BROOMFIELD,CO80020     		    SERVICES TO HELP AT-RISK SPECIAL NEE 3,500
    BOULDER COMMUNITY HOUSING CORPORATI
    PO BOX 471
    BOULDER,CO80306     		    EDUCATION AND JOB SKILLS TRAINING PR 2,500
    BOULDER HOUSING PARTNERS
    4800 N BROADWAY
    BOULDER,CO80304     		    EDUCATION AND SUPPORT PROGRAM 3,000
    BRIGHT BY THREE
    3605 MARTIN LUTHER KING B
    DENVER,CO80205     		    PARENTING EDUCATION PROGRAM FOR LOW- 10,000
    BRIGHT FUTURES FOR EARLY CHILDHOOD
    P O BOX 4216
    TELLURIDE,CO81435     		    PARENTING EDUCATION PROGRAM FOR LOW- 4,500
    BRISTLECONE MONTESSORI SCHOOL
    P O BOX 236
    ALMA,CO80420     		    PRESCHOOL SCHOLARSHIP/FINANCIAL AID 4,000
    CATHOLIC CHARITIES AND COMMUNITY SE
    6240 SMITH ROAD
    DENVER,CO802164632     		    EARLY CHILDHOOD EDUCATION AND CHILD 5,500
    CATHOLIC CHARITIES OF THE DIOCESE
    429 W 10TH STREET
    PUEBLO,CO81003     		    PARENTING EDUCATION PROGRAM 5,000
    COLORADO COALITION FOR THE HOMELESS
    2111 CHAMPA STREET
    DENVER,CO80205     		    EARLY CHILDHOOD EDUCATION PROGRAM AT 3,000
    COLORADO HOMELESS FAMILIES
    P O BOX 740130
    ARVADA,CO80006     		    TRANSITIONAL HOUSING AND SUPPORTIVE 30,000
    COLORADO STATEWIDE PARENT COALITION
    7150 HOOKER SUITE B
    WESTMINSTER,CO80030     		    PARENTING EDUCATION PROGRAM 2,500
    COMMUNITY PARTNERSHIP FAMILY RESOUR
    P O BOX 396
    DIVIDE,CO80814     		    EARLY CHILDHOOD AND PARENTING EDUCAT 5,000
    COMMUNITY PARTNERSHIP FOR CHILD DEV
    2330 ROBINSON STREET
    COLORADO SPRINGS,CO80904     		    COLORADO PRESCHOOL PROGRAM SERVING A 6,500
    CONGREGATION RODEF SHALOM
    450 SOUTH KEARNEY STREET
    DENVER,CO80224     		    YOUTH SCHOLARSHIP FUNDING 3,500
    CREEDE EARLY LEARNING CENTER
    P O BOX 191
    CREEDE,CO81130     		    EARLY CHILDHOOD EDUCATION 4,000
    DENVER PUBLIC LIBRARY FRIENDS FOUND
    10 WEST 14TH AVENUE PARKW
    DENVER,CO80204     		    READ ALOUD PROGRAM SERVING LOW-INCOM 4,500
    DENVER ZOO
    2300 STEELE STREET
    DENVER,CO80205     		    NATURE EDUCATION PROGRAM FOR YOUNG C 3,000
    DIAKONIA
    2630 ROSSMERE STREET
    COLORADO SPRINGS,CO80919     		    PRESCHOOL PROGRAM FOR LOW-INCOME CHI 5,000
    DRESS FOR SUCCESS
    2425 S COLORADO BLVD
    DENVER,CO80222     		    SUPPORT SERVICES, EMPLOYMENT AND JOB 5,000
    EARLY CONNECTIONS LEARNING CENTERS
    104 E RIO GRANDE
    COLORADO SPRINGS,CO80903     		    EARLY CARE AND EDUCATION PROGRAM FOR 8,000
    EARLY EXCELLENCE PROGRAM OF DENVER
    3580 FRANKLIN STREET
    DENVER,CO80205     		    EARLY CHILDHOOD EDUCATION FOR AT-RIS 8,000
    EMERGENCY FAMILY ASSISTANCE ASSOCIA
    1575 YARMOUTH AVENUE
    BOULDER,CO80304     		    JOB READINESS TRAINING PROGRAM AND S 4,000
    EMILY GRIFFITH FOUNDATION INC
    1860 LINCOLN STREET SUIT
    DENVER,CO80203     		    STIPENDS FOR ADULT STUDENTS 5,500
    FAMILIES FIRST
    2163 SOUTH YOSEMITE STREE
    DENVER,CO80231     		    PARENTING EDUCATION PROGRAM 4,500
    FAMILY STAR INC
    2246 FEDERAL BOULEVARD
    DENVER,CO80211     		    EARLY CHILDHOOD EDUCATION 4,000
    FAMILY VISITOR PROGRAMS
    PO BOX 1845
    GLENWOOD SPRINGS,CO81602     		    PARENTING EDUCATION PROGRAMS 6,000
    FLORENCE CRITTENTON SERVICES OF COL
    96 SOUTH ZUNI STREET
    DENVER,CO80223     		    HIGH SCHOOL AND FAMILY SUPPORT PROGR 30,000
    FOCUS POINTS FAMILY RESOURCE CENTER
    2501 E 48TH AVENUE
    DENVER,CO80216     		    EARLY CHILDHOOD EDUCATION AND PARENT 6,000
    GOODWILL INDUSTRIES OF DENVER
    6850 FEDERAL BOULEVARD
    DENVER,CO80221     		    BANKWORK ADULT CAREER DEVELOPMENT P 4,000
    GRECCIO HOUSING
    1015 E PIKES PEAK SUITE
    COLORADO SPRINGS,CO80903     		    LIFE SKILLS AND JOB READINESS TRAINI 3,000
    GREELEY TRANSITIONAL HOUSE
    1206 10TH STREET
    GREELEY,CO80631     		    CASE MANAGEMENT SERVICES FOR HOMELES 3,500
    GROWING HOME
    3489 W 72ND AVENUE SUIT
    WESTMINSTER,CO80030     		    EARLY CHILDHOOD AND PARENTING EDUCAT 7,500
    HILLTOP COMMUNITY RESOURCES INC
    1331 HERMOSA AVENUE
    GRAND JUNCTION,CO81506     		    PARENTING EDUCATION PROGRAM 6,000
    HOPE COMMUNITIES INC
    2543 CALIFORNIA STREET
    DENVER,CO80205     		    CASE MANAGEMENT AND SUPPORTIVE SERVI 4,500
    HOUSE OF NEIGHBORLY SERVICE
    1511 E 11TH STREET SUIT
    LOVELAND,CO80537     		    CASE MANAGEMENT AND SUPPORTIVE SERVI 3,000
    INN BETWEEN OF LONGMONT INC
    515 KIMBARK STREET SUITE
    LONGMONT,CO80501     		    SUPPORTIVE SERVICES FOR HOMELESS WOR 3,000
    INTERCAMBIO UNITING COMMUNITIES
    4735 WALNUT STREET SUITE
    BOULDER,CO80301     		    ENGLISH LANGUAGE CLASSES AND LIFE SK 2,500
    LA PLATA FAMILY CENTERS COALITION
    150 TECH CENTER DRIVE SU
    DURANGO,CO81301     		    PARENTING EDUCATION PROGRAMS 3,500
    LA PUENTE HOME INC
    P O BOX 1235
    ALAMOSA,CO81101     		    TRANSITIONAL LIVING PROGRAM FOR HOME 30,000
    METROPOLITAN STATE UNIVERSITY OF DE
    P O BOX 173362/CAMPUS B
    DENVER,CO802173362     		    PARENTING EDUCATION PROGRAMS 3,500
    MI CASA RESOURCE CENTER
    345 S GROVE STREET
    DENVER,CO80219     		    CAREER DEVELOPMENT PROGRAM 5,000
    MILE HIGH MINISTRIES
    913 WYANDOT STREET
    DENVER,CO80204     		    ADULT EDUCATION, JOB SERVICES AND LI 3,500
    MOUNTAIN RESOURCE CENTER INC
    P O BOX 425
    CONIFER,CO80433     		    PARENTING EDUCATION PROGRAM 4,000
    NER TAMID SYNAGOGUE
    15318 POMERADO ROAD
    POWAY,CA92064     		    RELIGIOUS EDUCATION 10,000
    PARTNERS IN HOUSING
    455 GOLD PASS HEIGHTS
    COLORADO SPRINGS,CO80906     		    TRANSITIONAL HOUSING AND SUPPORTIVE 6,000
    PEAK VISTA COMMUNITY HEALTH CENTERS
    3205 N ACADEMY BLVD SU
    COLORADO SPRINGS,CO80917     		    PARENTING EDUCATION 5,000
    PHILLIPS COUNTY FAMILY EDUCATION SE
    P O BOX 365
    HOLYOKE,CO80734     		    ADULT EDUCATION 1,500
    PRAIRIE FAMILY CENTER
    309 14TH STREET
    BURLINGTON,CO80807     		    EARLY CHILDHOOD EDUCATION 3,500
    PROJECT SELF-SUFFICIENCY OF LOVELAN
    375 WEST 37TH STREET SUI
    LOVELAND,CO80538     		    LIFE SKILLS TRAINING AND JOB READINE 30,000
    REACH OUT AND READ COLORADO
    1660 S ALBION STREET SU
    DENVER,CO80222     		    READING PROGRAM FOR CHILDREN FROM LO 8,000
    READ TO ME
    P O BOX 1654
    CASTLE ROCK,CO80104     		    EARLY READING EDUCATIONAL MATERIALS 3,000
    ROCKY MOUNTAIN MICROFINANCE INSTITU
    P O BOX 48138
    DENVER,CO80204     		    BUSINESS DEVELOPMENT PROGRAM TO SUPP 11,000
    SAFEHOUSE DENVER
    1649 DOWNING STREET
    DENVER,CO80218     		    SELF-SUFFICIENCY AND PARENTING SUPPO 4,500
    SEWALL CHILD DEVELOPMENT CENTER
    940 FILLMORE STREET
    DENVER,CO80206     		    EARLY CHILDHOOD EDUCATION 6,000
    SPRING INSTITUTE FOR INTERCULTURAL
    1373 GRANT STREET
    DENVER,CO80203     		    EARLY CHILDHOOD EDUCATION AND PARENT 5,000
    TEACHING TREE EARLY CHILDHOOD LEARN
    424 PINE STREET SUITE 10
    FORT COLLINS,CO80524     		    TUITION ASSISTANCE PROGRAM FOR CHILD 7,000
    THE GATHERING PLACE A REFUGE FOR R
    1535 HIGH STREET
    DENVER,CO80218     		    EDUCATION AND JOB READINESS PROGRAM 3,500
    THE MATTHEWS HOUSE
    415 MASON COURT 1
    FORT COLLINS,CO80524     		    EARLY CHILDHOOD PROGRAM AND PARENTIN 5,000
    THE PINON PROJECT FAMILY RESOURCE C
    P O BOX 1510
    CORTEZ,CO81321     		    SUPPORTIVE SERVICES FOR FAMILIES WOR 30,000
    THOMPSON VALLEY PRESCHOOL INC
    803 EAST 16TH STREET
    LOVELAND,CO80538     		    TUITION SUBSIDIES FOR CHILDREN FROM 3,000
    TLC LEARNING CENTER
    611 KORTE PARKWAY
    LONGMONT,CO80501     		    SCHOLARSHIPS AND SERVICES FOR CHILDR 5,000
    TRI-COUNTY FAMILY CARE CENTER INC
    512 1/2 N MAIN STREET
    ROCKY FORD,CO81067     		    CASE MANAGEMENT AND SUPPORTIVE SERVI 4,000
    TRI-LAKES CARES
    P O BOX 1301
    MONUMENT,CO80132     		    GETTING AHEAD SELF-SUFFICIENCY PROGR 2,500
    VOLUNTEERS OF AMERICA COLORADO BRAN
    2660 LARIMER STREET
    DENVER,CO80205     		    EARLY CHILDHOOD EDUCATION 2,500
    WARREN VILLAGE
    1323 GILPIN STREET
    DENVER,CO80218     		    TRANSITIONAL HOUSING AND SUPPORT SER 9,000
    WOMEN'S BEAN PROJECT
    3201 CURTIS STREET
    DENVER,CO80205     		    JOB READINESS AND LIFE SKILLS EMPLOY 5,000
    WOMEN'S RESOURCE CENTER IN DURANGO
    679 EAST SECOND AVENUE U
    DURANGO,CO81301     		    RESOURCE AND REFERRAL PROGRAM 2,500
    WORK OPTIONS FOR WOMEN
    1200 FEDERAL BOULEVARD
    DENVER,CO80204     		    JOB READINESS AND LIFE SKILLS CAREER 6,000
    YOUTHPOWER 365
    P O BOX 6550
    AVON,CO81620     		    EARLY CHILDHOOD EDUCATION AND PARENT 5,000
    YWCA OF BOULDER COUNTY
    2222 14TH STREET
    BOULDER,CO80302     		    EARLY CHILDHOOD AND PARENTING EDUC 3,000
    Total .................................bullet 3a 462,500
    bApproved for future payment
    Total .................................bullet 3b  
    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 97  
    4 Dividends and interest from securities....     14 185,412  
    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 ............     		    18 509,261  
    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)..   694,770  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    694,770
    (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

    TY 2017 AccountingFeesSchedule
    Name:
    THE SAM S BLOOM FOUNDATION
    EIN:
    84-0929690
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INDIRECT ACCOUNTING FEES 2,580 2,580    

    TY 2017 InvestmentsCorpStockSchedule
    Name:
    THE SAM S BLOOM FOUNDATION
    EIN:
    84-0929690
    Name of Stock End of Year Book Value End of Year Fair Market Value
    BLACKSTONE ALTERNATIVE MULTI-STRATEG 494,317 508,361
    DODGE & COX INTL STOCK FUND 1,359,449 1,384,728
    HARDING LOEVNER EMERGING MKT 480,575 549,288
    LOOMIS SAYLES INTERM DURATION FND 1,595,794 1,523,775
    NEW PERSPECTIVE FUND 1,396,977 2,041,936
    SEIX FLOATING RATE HIGH INCOME FUND 725,887 697,802
    VANGUARD 500 INDEX FUND 1,244,103 2,508,558
    VANGUARD EXTENDED MKT INDEX FND 609,116 879,400

    TY 2017 OtherExpensesSchedule
    Name:
    THE SAM S BLOOM FOUNDATION
    EIN:
    84-0929690
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    EXPENSES        
    ARCHIVAL 2,442 1,221   1,221
    BANK CHARGES 95 48   47
    DUES 1,455 728   727
    INSURANCE 739 370   369
    OFFICE EXPENSE 553 276   277
    POSTAGE & DELIVERY 803 401   402
    TELEPHONE 861 430   431


    TY 2017 OtherProfessionalFeesSchedule
    Name:
    THE SAM S BLOOM FOUNDATION
    EIN:
    84-0929690
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT ADVISORY FEES 42,282 42,282    
    INVESTMENT CUSTODIAL FEES 5,330 5,330    


    TY 2017 TaxesSchedule
    Name:
    THE SAM S BLOOM FOUNDATION
    EIN:
    84-0929690
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ANNUAL LICENSE 10 5   5
    EXCISE TAX 18,968