Form990-PF
Click to see attachment

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0052
2018
Open to Public Inspection
For calendar year 2018, or tax year beginning 03-01-2018 , and ending 02-28-2019
Name of foundation
ZICHRON SIMCHA DSASSOV
 
Number and street (or P.O. box number if mail is not delivered to street address)86 ROUTE 59
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SPRING VALLEY, NY10977
A Employer identification number

45-0673679
B Telephone number (see instructions)

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$417,512J 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) 916,271
2 Check bullet.............
3 Interest on savings and temporary cash investments 102 102 102
4 Dividends and interest from securities... 1,800 1,800 1,800
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 3,157
b Gross sales price for all assets on line 6a 228,389
7 Capital gain net income (from Part IV, line 2)... 3,157
8 Net short-term capital gain......... 3,157
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........ 921,330 5,059 5,059
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc.        
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule).......        
c Other professional fees (attach schedule)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)...        
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see list of attachments 4,868      
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 4,868 0   0
25 Contributions, gifts, grants paid....... 559,955 559,955
26 Total expenses and disbursements. Add lines 24 and 25 564,823 0   559,955
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 356,507
b Net investment income (if negative, enter -0-) 5,059
c Adjusted net income (if negative, enter -0-)... 5,059
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2018)
Form 990-PF (2018)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............. 54,373 203,381 203,381
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) bullet8,231
Less: allowance for doubtful accounts bullet   2,075 8,231 8,231
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).......   201,500 205,900
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) Click to see attachment1,306 Click to see attachment1,149  
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 57,754 414,261 417,512
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22).........   0
Net Assets or Fund Balances Foundations that follow SFAS 117, check here bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted..................    
25 Temporarily restricted...............    
26 Permanently restricted...............    
Foundations that do not follow SFAS 117, check here bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds........    
28 Paid-in or capital surplus, or land, bldg., and equipment fund    
29 Retained earnings, accumulated income, endowment, or other funds 57,754 414,261
30 Total net assets or fund balances (see instructions)..... 57,754 414,261
31 Total liabilities and net assets/fund balances (see instructions). 57,754 414,261
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 30 (must agree with end-of-year figure reported on prior year’s return) ...............
1
57,754
2
Enter amount from Part I, line 27a .....................
2
356,507
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
414,261
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 30 .
6
414,261
Form 990-PF (2018)
Form 990-PF (2018)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1 a 1000 GOLDCORP P 2019-01-08 2019-02-19
b 500 GOLDCORP P 2019-01-08 2019-02-20
c 1000 GOLDCORP P 2019-01-08 2019-02-25
d 7500 PCSB P 2018-05-11 2019-01-07
e 2500 PCSB P 2018-05-11 2019-01-08
(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 10,970   9,493 1,477
b 5,699   4,746 953
c 10,989   9,493 1,496
d 150,613   151,125 -512
e 50,118   50,375 -257
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       1,477
b       953
c       1,496
d       -512
e       -257
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 3,157
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 3,157
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)

If section 4940(d)(2) applies, leave this part blank.
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period?
If "Yes," the foundation does not qualify under section 4940(e). Do not complete this part.
1 Enter the appropriate amount in each column for each year; see instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in) 		(b)
Adjusted qualifying distributions 		(c)
Net value of noncharitable-use assets 		(d)
Distribution ratio
(col. (b) divided by col. (c))
2017 482,565 25,590 18.85756
2016 245,686 21,848 11.24524
2015 162,517 3,113 52.20591
2014 186,768 7,540 24.77029
2013 165,905 10,517 15.77494
2
Total of line 1, column (d) .....................
2
122.853941
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
24.570788
4
Enter the net value of noncharitable-use assets for 2018 from Part X, line 5......
4
326,986
5
Multiply line 4 by line 3......................
5
8,034,304
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
51
7
Add lines 5 and 6........................
7
8,034,355
8
Enter qualifying distributions from Part XII, line 4,.............
8
559,955
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See the Part VI instructions.
Form 990-PF (2018)
Form 990-PF (2018)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket includes lines 1a and 1b
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b Domestic foundations that meet the section 4940(e) requirements in Part V, check 1 101
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........................... 3 101
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- ..... 5 101
6 Credits/Payments:
a 2018 estimated tax payments and 2017 overpayment credited to 2018 6a  
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  
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 9 101
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2019 estimated 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
 
No
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
     
    No
    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)
    bulletNY
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2018 or the taxable year beginning in 2018? See the instructions for Part XIV.
    If "Yes," complete Part XIV .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 5
    Part VII-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletN/A
    14
    The books are in care ofbulletSCHMUEL HOROWITZ Telephone no.bullet (845) 356-7773

    Located atbullet86 ROUTE 59SPRING VALLEYNY ZIP+4bullet10977
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2018, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet  
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?......................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?...............
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).......
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ........
    1b
     
    No
    ........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2018?.............
    1c
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2018, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2018?.............
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
    No
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?......................
    b
    If "Yes," did it have excess business holdings in 2018 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2018.)..................
    3b
     
    No
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2018?
    4b
     
    No
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 6
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?.............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?.....
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ......
    5b
     
    No
    .........bullet
    c
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?..........
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    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
     
    No
    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
    SCHMUEL HOROWITZ Trustee
    5.00     		0    
    86 ROUTE 59
    SPRING VALLEY,NY10977
    RACHEL HOROWITZ Trustee
    1.00     		0    
    86 ROUTE 59
    SPRING VALLEY,NY10977
    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 (2018)
    Form 990-PF (2018)
    Page 7
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 8
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    298,967
    b
    Average of monthly cash balances.......................
    1b
    32,998
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    331,965
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
     
    3
    Subtract line 2 from line 1d.........................
    3
    331,965
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    4,979
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    326,986
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    16,349
    Part XI
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    16,349
    2a
    Tax on investment income for 2018 from Part VI, line 5......
    2a
    101
    b
    Income tax for 2018. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    101
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    16,248
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    16,248
    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
    16,248
    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
    559,955
    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
    559,955
    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
    559,955
    Note: The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
    the section 4940(e) reduction of tax in those years.
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2017     		(c)
    2017     		(d)
    2018
    1 Distributable amount for 2018 from Part XI, line 7 16,248
    2 Undistributed income, if any, as of the end of 2018:
    a Enter amount for 2017 only.......  
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2018:
    a From 2013...... 165,379
    b From 2014...... 186,391
    c From 2015...... 162,361
    d From 2016...... 244,594
    e From 2017...... 481,285
    fTotal of lines 3a through e........ 1,240,010
    4Qualifying distributions for 2018 from Part
    XII, line 4: bullet$ 559,955
    a Applied to 2017, but not more than line 2a  
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		0
    d Applied to 2018 distributable amount..... 16,248
    e Remaining amount distributed out of corpus 543,707
    5 Excess distributions carryover applied to 2018.    
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 1,783,717
    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 2017. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    f Undistributed income for 2018. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2019 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		 
    8 Excess distributions carryover from 2013 not
    applied on line 5 or line 7 (see instructions) ...     		165,379
    9Excess distributions carryover to 2019.
    Subtract lines 7 and 8 from line 6a ......     		1,618,338
    10 Analysis of line 9:
    a Excess from 2014.... 186,391
    b Excess from 2015.... 162,361
    c Excess from 2016.... 244,594
    d Excess from 2017.... 481,285
    e Excess from 2018.... 543,707
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 10
    Part XIV
    Private Operating Foundations (see instructions and Part VII-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2018, enter the date of the ruling....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2018 (b) 2017 (c) 2016 (d) 2015
             
    b 85% of line 2a .........          
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part X, line 6 for each year listed...     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    SCHMUEL HOROWITZ
    RACHEL HOROWITZ
    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 (2018)
    Form 990-PF (2018)
    Page 11
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    AHAVAS CHESED
    4 RIBIER COURT
    MONSEY,NY10952     		None Exempt General Contribution 1,000
    AHAVAS YISROEL
    1470 EAST 19TH STREET
    BROOKLYN,NY11230     		None Exempt General Contribution 250
    CONG AHAVAS YISROEL
    4 MORRIS ROAD
    SPRING VALLEY,NY10977     		None Exempt General Contribution 1,360
    CONG SHAARI CHESED INC
    92 SADDLE RIVER ROAD
    MONSEY,NY10952     		None Exempt General Contribution 4,160
    Cong Beth Hamedrosh of Melitz Lizen
    653 BEDFORD AVENUE
    BROOKLYN,NY11211     		None Exempt General Contribution 250
    CONG NACHLACH MOSHE MAKAVA
    25 DANA ROAD
    MONSEY,NY10952     		None Exempt General Contribution 360
    CONG TORAH VACHESSED
    12 YALE DRIVE
    MONSEY,NY10952     		None Exempt General Contribution 500
    CONGREGATION ADAS YEREIM
    33 UNION ROAD
    MONSEY,NY10952     		None Exempt General Contribution 100
    CONGREGATION KEREN EZRAH INC
    11 GWEN LANE
    MONSEY,NY10952     		None Exempt General Contribution 4,250
    CONGREGATION TIFERES YISROEL
    55 WEST MAPLE AVENUE
    MONSEY,NY10952     		None Exempt General Contribution 25,936
    CONGREGATION YESHIVAS AVIR YAAKOV
    766 N MAIN STREET
    SPRING VALLEY,NY10977     		None Exempt General Contribution 360
    CONGREGATION ZICHRON SHLOMO
    33 CARLTON ROAD
    MONSEY,NY10952     		None Exempt General Contribution 1,000
    GEMACH ZICHRON MOSHE SHMIEL DVEIN
    26 CARLTON ROAD
    MONSEY,NY10952     		None Exempt General Contribution 250
    KEREN NESEIN WIZNITZ
    PO BOX 454
    MONSEY,NY10952     		None Exempt General Contribution 250
    KEREN YAD VEIZER
    51 BLAUVELT ROAD
    MONSEY,NY10952     		None Exempt General Contribution 500
    MESILA INTERNATIONAL INC
    1215 40TH STREET
    BROOKLYN,NY11218     		None Exempt General Contribution 5,000
    MESIVTA BAIS YOCHONAN SHRAGA
    22 WEST MAPLE AVENUE
    MONSEY,NY10952     		None Exempt General Contribution 1,850
    REFUA
    106 NORTH COLE AVENUE
    SPRING VALLEY,NY10977     		None Exempt General Contribution 180
    ROFEH CHOLIM CANCER SOCIETY
    762 BEDFORD AVENUE
    BROOKLYN,NY11205     		None Exempt General Contribution 1,800
    SMACH ZEVILIN OF NY INC
    18 STONEHOUSE DRIVE
    SPRING VALLEY,NY10977     		None Exempt General Contribution 750
    TOV VCHESED FOUNDATION INC
    PO BOX 855
    MONSEY,NY10952     		None Exempt General Contribution 5,340
    YESHIVA MESIVTA MEOR YITZCHOK MONSE
    65 DYKSTRAS WAY
    MONSEY,NY10952     		None Exempt General Contribution 2,750
    YESHIVA BETH DAVID
    22 WEST MAPLE AVENUE
    MONSEY,NY10952     		None Exempt General Contribution 32,500
    ZICHRON MENACHEM INC
    10 MAPLE TERRACE
    MONSEY,NY10952     		None Exempt General Contribution 19,156
    ZICHRON YONASON INC
    17 HAMMOND STREET
    MONSEY,NY10952     		None Exempt General Contribution 180
    AHAVAS CHAVEIRIM GEMILAS CHESED INC
    4 RIBIER COURT
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 500
    BETH MEDRASH OF ROCKLAND
    2 EAST FUNSTON AVE
    SPRING VALLEY,NY10977     		None Exempt GENERAL CONTRIBUTION 180
    BINYAN YERUSHALAYIM
    1274 49TH STREET
    BROOKLYN,NY11219     		None Exempt GENERAL CONTRIBUTION 180
    CONGREGATION EZER LYEHUDA
    45 YALE DRIVE
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 360
    CONGREGATION AHAVAS TZDOKAH VCHESED
    1347 42ND STREET
    BROOKLYN,NY11219     		None Exempt GENERAL CONTRIBUTION 1,000
    CONGREGATION OHR MOSHE
    1 MONSEY BLVD
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 1,000
    HACHNOSAS ORCHIM OF MONSEY
    2 DR FRANK ROAD
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 360
    YAD YEHUDA
    1451 52 ST UNIT B5
    BROOKLYN,NY11204     		None Exempt GENERAL CONTRIBUTION 500
    CONGREGATION CHASDEI BOBOV OF MONSE
    18 JILL LANE
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 180
    KOLLEL SHOMREI HACHOMOS RABBI MEIR
    18 HEYWARD STREET
    BROOKLYN,NY11249     		None Exempt GENERAL CONTRIBUTION 500
    MERKAZ HABRITH FOR RUSSIAN JEWRY
    2054 BEDFORD AVE
    BROOKLYN,NY11210     		None Exempt GENERAL CONTRIBUTION 180
    CONGREGATION OHEL TORAH
    8 JOSHUA COURT
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 180
    MOSDOS VIZNITZ
    5314 16TH AVENUE
    BROOKLYN,NY11204     		None Exempt GENERAL CONTRIBUTION 1,000
    CHASDEI YAKOV
    56 MAIN STREET
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 650
    YESHIVATH VIZNITZ DKALH TORATH CHAI
    PO BOX 446
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 250
    KOLLEL CHATZOS
    2 SCHUNNEMUNK ROAD UNIT 304
    MONROE,NY10950     		None Exempt GENERAL CONTRIBUTION 720
    CONG YETEV LEV
    PO BOX 837
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 2,500
    VARIOUS
    VARIOUS
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 5,886
    YESHIVA BETH DAVID
    22 W MAPLE AVE
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 1,000
    CONGREGATION CHAIM V-CHESED INC
    11B EDWIN LANE
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 1,800
    CONGREGATION OHEL MORDECHE DTOSH
    34 SATMAR DR STE 201
    MONROE,NY10950     		None Exempt GENERAL CONTRIBUTION 610
    BAIS YISROEL
    95 DIVISION AVE
    BROOKLYN,NY11211     		None Exempt GENERAL CONTRIBUTION 1,000
    YESHIVA INSTITUTE DIVREI SHMUEL INC
    2 PHYLLIS TERRACE
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 180
    CONGREGATION TOLDOS AVRUHOM YITZCHO
    1219 56TH STREET
    BROOKLYN,NY11219     		None Exempt GENERAL CONTRIBUTION 92,472
    CONGREGATION EZRAS YISROEL
    4415 14TH AVE
    BROOKLYN,NY11219     		None Exempt GENERAL CONTRIBUTION 5,000
    KOLEL METZEYONIM OF ROCKLAND COUNTY
    16 JEFFREY PL
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 500
    MA'AYNEI HAYESHUA TRUST
    5417 18TH AVE
    BROOKLYN,NY11204     		None Exempt GENERAL CONTRIBUTION 250
    THE JEWISH CENTER FOR SPECIAL EDUCA
    1760 53RD ST
    BROOKLYN,NY11204     		None Exempt GENERAL CONTRIBUTION 250
    CONG VYOEL MOSHE
    1 MONSEY BLVD
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 4,000
    ZICHRON AVROHOM VESTHER FUND
    PO BOX 724
    TALLMAN,NY10982     		None Exempt GENERAL CONTRIBUTION 1,800
    RAV CHESED
    1511 50TH ST
    BROOKLYN,NY11219     		None Exempt GENERAL CONTRIBUTION 10,250
    CHEVRA OSAI TZDOKOH VCHESED DSATMAR
    44 ADAR CT
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 1,110
    A TIME
    1310 48TH STREET STE 406
    BROOKLYN,NY11219     		None Exempt GENERAL CONTRIBUTION 180
    MATAN B SETER BAMBI INC
    1728 53RD STREET
    BROOKLYN,NY11204     		None Exempt GENERAL CONTRIBUTION 368
    CONG KHAL YEREIM
    52 CARLTON RD
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 1,100
    CONGREGATION CHASSIDIC VIZNITC
    POB 190
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 180
    GATESHEAD SEMINARY COMMITTE INC
    82 BLAUVELT RD
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 1,000
    CONG KEREN ECRAH INC
    11 GWEN LANE
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 500
    CONG TASHBAR NACHLAS CHAIM
    POB 657
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 3,040
    YESHIVA MIR YERUSHALAYIM
    5227 NEW UTRECHT AVE
    BROOKLYN,NY11219     		None Exempt GENERAL CONTRIBUTION 1,800
    AMERICAN FRIENDS OF RABBINICAL COLL
    818 Forest Ave
    Lakewood,NJ08701     		None Exempt General contribution 500
    YESIVA LAVREICHIM METZUYANIM INC
    4515 12Th Avenue
    Brooklyn,NY11219     		None Exempt General contribution 2,000
    CONGREGATION BAIS AHARON
    PO BOX 57
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 360
    BAIS CHAYA ESTHER
    1118 AVENUE P
    BROOKLYN,NY11229     		None Exempt GENERAL CONTRIBUTION 500
    BAYITH LEPLEITOT INC
    1428 36TH ST
    BROOKLYN,NY11218     		None Exempt GENERAL CONTRIBUTION 9,000
    CONGREGATION BETH JACOB OHEV SHOLOM
    284 RODNEY STREET
    BROOKLYN,NY11211     		None Exempt GENERAL CONTRIBUTION 1,000
    YISMACH MOSHE INSTITUTE
    1621 51ST STREET
    BROOKLYN,NY11294     		None Exempt GENERAL CONTRIBUTON 13,000
    CONG OHEL YAKOV
    1 CHALLENGER CT
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 24,060
    CONGREGATION OSHER BCHAIM INC
    POB 673
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUTION 4,666
    CONGREGATION KHAL AVREICHIM
    31 DOVER TERRACE
    MONSEY,NY10952     		None Exempt GENERAL CONTRIBUITON 18,394
    MOSDOT BOTOSHAN INC
    915 EAST 7 STREET
    BROOKLYN,NY11250     		None Exempt GENERAL CONTRIBUTION 750
    CONG MEOR EINAYIM
    123 HARDS LANE
    LAWRENCE,NY11559     		None Exempt GENERAL CONTRIBUTION 500
    IMREI BINAH
    1400 PINE STREET
    LAKEWOOD,NJ08701     		None EXEMPT GENERAL CONTRIBUTION 5,750
    CONGREGATION RACHMASTRIVKA
    1164 45TH STREET
    BROOKLYN,NY11219     		None EXEMPT GENERAL CONTRIBUTION 3,600
    THE CHESED FUND
    1340 E 13TH STREET
    BROOKLYN,NY11230     		None EXEMPT GENERAL CONTRIBUTION 540
    TAG ROCKLAND COUNTY
    19 MAIN STREET
    MONSEY,NY10952     		None EXEMPT GENERAL CONTRIBUTION 3,600
    GREATER BETH HATZLACHA INC
    1046 DAHILL RD
    BROOKLYN,NY11204     		None EXEMPT GENERAL CONTRIBUTION 4,000
    CONGREGATION KOLEL AHAVAS YERUSHALA
    1 JEFFREY PL
    MONSEY,NY10952     		None EXEMPT GENERAL CONTRIBUTION 4,710
    CONGREGATION SHAREI SHOMAYIM D MOSH
    5002 17TH AVENUE
    BROOKLYN,NY11204     		None EXEMPT GENERAL CONTRIBUTION 2,500
    CONGREGATION ZICHRON REFOEL INC
    309 DEWEY AVENUE
    LAKEWOOD,NJ08701     		None EXEMPT GENERAL CONTRIBUTION 500
    GEMACH KEREN HILLEL
    32 SATMAR DRIVE
    MONROE,NY10950     		None EXEMPT GENERAL CONTRIBUTION 500
    BELZ INSTITUTIONS IN ISRAEL
    4303 15TH AVENUE
    BROOKLYN,NY11219     		None EXEMPT GENERAL CONTRIBUTION 500
    CONGREGATION CHASODIM TOVIM INC
    7 MAPLE LEAF RD
    MONSEY,NY10952     		None EXEMPT GENERAL CONTRIBUTION 4,600
    CONGREGATION KOLEL BAIS AVROHOM YAK
    57 FRANCIS PLACE
    MONSEY,NY10952     		None EXEMPT GENERAL CONTRIBUTION 4,100
    CHAIM VCHESED DRIBNITZ
    55 OLD NYACK TPKE
    MONSEY,NY10952     		None EXEMPT GENERAL CONTRIBUTION 180
    AMERICAN FRIENDS OF AVOS UBANIM INC
    17 CARLTON RD
    MONSEY,NY10952     		None EXEMPT GENRAL CONTRIBUTION 1,000
    CONGREGATION OF FOREST PARK
    2 FOREST PARK CIR
    LAKEWOOD,NJ08701     		None EXEMPT GENERAL CONTRIBUTION 496
    CONGREGATION BNEI YAKOV
    15 EMES LANE
    MONSEY,NY10952     		None EXEMPT GENERAL CONTRIBUTION 500
    MERKAZ HAKOLILIM DSHIKUN SQUARE
    12 JEFFESON AVE
    SPRING VALLEY,NY10977     		None EXEMPT GENERAL CONTRIBUTION 500
    OIZ VEHUDAR
    8 TRUMAN AVENUE
    SPRING VALLEY,NY10977     		None EXEMPT GENERAL CONTRIBUTION 5,000
    YESHUAS YISROEL
    3054 BEDFORD AVENUE
    BROOKLYN,NY11210     		None EXEMPT GENERAL CONTRIBUTION 180
    CONGREGATION ZICHRON MOSHE
    1441 MONMOUTH AVE
    LAKEWOOD,NJ08701     		None EXEMPT GENERAL CONTRIBUTION 180
    KEHILLAS BAIS TZVI OF CEARHURST INC
    391 OAKLAND AVE
    CEDARHURST,NY11516     		None EXEMPT GENERAL CONTRIBUTION 9,320
    CONGREGATION BNEI SHOLEM OF KAHAL N
    15 KAUFMAN CT UNIT 211
    MONSEY,NY10952     		None EXEMPT GENERAL CONTRIBUTION 500
    TORAS HAMISHPACHA DBA TAHAREINU
    78 BUCHANAN LANE
    SPRING VALLEY,NY10977     		None EXEMPT GENERAL CONTRIBUTION 2,000
    CONG YESHIVA TIFERES BACHURIM
    17 CAMEO RIDGE RD
    MONSEY,NY10952     		None EXEMPT GENERAL CONTRIBUTION 500
    YESHUAS MOSHE DVIZNITZ
    9 NANCY LANE
    MONSEY,NY10952     		None EXEMPT GENERAL CONTRIBUTION 500
    ICHUD CHASIDEI LELOV
    1842 53RD ST
    BROOKLYN,NY11204     		None EXEMPT GENERAL CONTRIBUTION 500
    YESHIVA TOLDOS ISRAEL STANISLAV
    59 W MAPLE AVE
    MONSEY,NY10952     		None EXEMPT GENERAL CONTRIBUTION 117,550
    YESHIVA TIFERES YISROEL
    1271 E 35TH ST
    BROOKLYN,NY11210     		None EXEMPT GENERAL CONTRIBUTION 500
    YESHIVA OHOLEI SHEM DNITRA
    50 COMMERCE ST
    SPRING VALLEY,NY10977     		None EXEMPT GENERAL CONTRIBUTION 360
    YESHIVA GEVOHA LEV SIMCHA
    5115 OLD NEW UTRECHT RD
    BROOKLYN,NY11204     		None EXEMPT GENERAL CONTRIBUTION 750
    YESHIVA GEDOLAH OHR YISRAEL
    2899 NOSTRAND AVE
    BROOKLYN,NY11229     		None EXEMPT GENERAL CONTRIBUTION 1,360
    YESHIVA DARKEI EMUNAH MUNKATCH
    201 ROUTE 306
    MONSEY,NY10952     		None EXEMPT GENERAL CONTRIBUTION 3,080
    VAAD HAERUV OF ROCKLAND
    POB 1161
    MONSEY,NY10952     		None EXEMPT GENERAL CONTRIBUTION 101
    CONGREGATION TOMCHEI TORAH
    1750 44TH ST
    BROOKLYN,NY11204     		None EXEMPT GENERAL CONTRIBUTION 250
    TIFERES ELIEZER
    2 HAWK ST
    SPRING VALLEY,NY10977     		None EXEMPT GENERAL CONTRIBUTION 250
    TALMUD TORAH BAIS AVROHOM
    915 NEW HAPSHIRE AVE
    LAKEWOOD,NJ08701     		None EXEMPT GENERAL CONTRIBUTION 3,000
    BIRKAS ELIEZER SERET VIZNITZ
    4607 14TH AVE
    BROOKLYN,NY11219     		None EXEMPT GENERAL CONTRIBUTION 250
    REB SHAYALAS KITCHEN
    46 MAIN STREET 381
    MONSEY,NY10952     		None EXEMPT GENERAL CONTRIBUTION 500
    CONGREGATION OTZAR HACHAIM
    143 HUNGRY HOLLOW RD
    SPRING VALLEY,NY10977     		None EXEMPT GENERAL CONTRIBUTION 1,000
    OHR HACHAIM HAKADOSH
    9 BUSH LANE
    SPRING VALLEY,NY10977     		None EXEMPT GENERAL CONTRIBUTION 720
    MACHNE OHEL MOSEH
    114 LAKE HOUSE RD
    WOODRIDGE,NY12789     		None EXEMPT GENERAL CONTRIBUTION 250
    MOSDOS KEVER RACHEL IMEINU
    1305 53RD STREET
    BROOKLYN,NY11219     		None EXEMPT GENERAL CONTRIBUTION 10,000
    MEKIMI
    1463 42ND ST
    BROOKLYN,NY11219     		None EXEMPT GENERAL CONTRIBUTION 1,000
    YESHIVA KOMEMIYUS
    1305 CONEY ISLAND AVE
    BROOKLYN,NY11230     		None EXEMPT GENERAL CONTRIBUTION 3,300
    CONGREGATION EMES VEMUNA INC
    25 PHYLLIS TERR
    MONSEY,NY10952     		None EXEMPT GENERAL CONTRIBUTION 720
    CONGREGATION KHAL TORATH CHAIM
    25 PHYLLIS TERRACE
    MONSEY,NY10952     		None EXEMPT GENERAL CONTRIBUTION 800
    ELEF HAMUGEIN
    183 WILSON ST
    BROOKLYN,NY11211     		None EXEMPT GENERAL CONTRIBUTION 250
    CONG SHAARE EZRA INC
    12 PRAG BLVD 101
    MONROE,NY10950     		None EXEMPT GENERAL CONTRIBUTION 430
    YESHIVA OHR NAFTOLI
    701 BLOOMING GROVE TURNPIKE
    NEW WINDSOR,NY12553     		None EXEMPT GENERAL CONTRIBUTION 500
    MAMAR MORDECHAI FOUNDATION
    1364 53RD STREET
    BROOKLYN,NY11219     		None EXEMPT GENERAL CONTRIBUTION 1,000
    CONGREGATION HAKSHIVA
    1105 48TH STREET
    BROOKLYN,NY11219     		None EXEMPT GENERAL CONTRIBUTION 6,000
    CONG CHAIM IVRUCHU
    12 YALE DRIVE
    MONSEY,NY10952     		None EXEMPT GENERAL CONTRIBUTION 180
    CONG RAV LEHOSHIA INC
    1303 53RD ST 224
    BROOKLYN,NY11219     		None EXEMPT GENERAL CONTRIBUTION 180
    CONG OHEL YITZCHOK SVALIVA
    PO BOX 259
    MONSEY,NY10952     		None EXEMPT GENERAL CONTRIBUTION 3,000
    CONGREGATION MINCHAS YEHUDA
    1266 50TH STREET
    BROOKLYN,NY11219     		None EXEMPT GENERAL CONTRIBUTION 1,000
    CONGREGATOIN KOLLEL BAIS SHEFTAL YE
    111 FOREST AVE
    LAKEWOOD,NJ08701     		None EXEMPT GENERAL CONTRIBUTION 250
    TOVA UVRUCHA INC
    45 THROOP AVE STE A
    BROOKLYN,NY11206     		None EXEMPT GENERAL CONTRIBUTION 500
    100 RIDE INC
    360 LEXINGTON AVE
    NEW YORK,NY10017     		None EXEMPT GENERAL CONTRIBUTION 180
    NACHZIK CHAZAK INC
    931 E 5TH ST
    BROOKLYN,NY11230     		None EXEMPT GENERAL CONTRIBUTION 1,000
    EIN OID MILVADOI CHARITABLE TR
    502 NEW YORK AVE APT 6A
    BROOKLYN,NY11225     		None EXEMPT GENERAL CONTRIBUTION 180
    EZER LEYISROEL INC
    149 WILLIAMSBURG LN
    LAKEWOOD,NJ08701     		None EXEMPT GENERAL CONTRIBUTION 500
    CONGREGATION BARNEV INC
    28 HOMESTEAD LN
    MONSEY,NY10952     		None EXEMPT GENERAL CONTRIBUTION 100
    ATERES MOSHE CHASIDEI UMOSDOS LELOV
    1830 50TH STREET
    BROOKLYN,NY11204     		None EXEMPT GENERAL CONTRIBUTION 360
    CONG MESIFTA OHEL TORAH INC
    PO BOX 456
    MONSEY,NY10952     		None EXEMPT GENERAL CONTRIBUTION 120
    CONG BE'ER AVRAHAM SLONIM
    1411 48TH STREET
    BROOKLYN,NY11219     		None EXEMPT GENERAL CONTRIBUTION 250
    CONG BAIS MOSHE INC
    8220 21ST AVE
    BROOKLYN,NY11214     		None EXEMPT GENERAL CONTRIBUTION 500
    CHEDER BE'ER YESHAYA
    4 CAMPBELL AVE
    SUFFERN,NY10901     		None EXEMPT GENERAL CONTRIBUTION 250
    CHAVERIM OF ROCKLAND
    40 RED SCHOOLHOUSE RD
    SPRING VALLEY,NY10977     		None EXEMPT GENERAL CONTRIBUTION 180
    CHASUDIM TOVIM FOUNDATION
    177 N 11TH ST
    BROOKLYN,NY11211     		None EXEMPT GENERAL CONTRIBUTION 18
    CHABAD OF CLOSTER
    CLOSTER DOCK RD
    CLOSTER,NJ07624     		None EXEMPT GENERAL CONTRIBUTION 1,500
    CHABAD LUBAVITCH WORLD HEADQUARTERS
    770 EASTERN PARKWAY
    BROOKLYN,NY11213     		None EXEMPT GENERAL CONTRIBUTION 1,000
    CATSKILLS HATZALAH INC
    1070 MCDONALD AVE
    BROOKLYN,NY11230     		None EXEMPT GENERAL CONTRIBUTION 860
    CONGREGATION OHR CHAIM INC
    199 LEE AVE 182
    BROOKLYN,NY11211     		None EXEMPT GENERAL CONTRIBUTION 1,800
    AMERICAN FRIENDS OF BINYAN YISROEL
    137 GLEN AVE
    LAKEWOOD,NJ08701     		None EXEMPT GENERAL CONTRIBUTION 360
    BILLER FAMILY FOUNDATION
    601 UNION STREET SUITE 3030
    SEATTLE,WA98101     		None EXEMPT GENERAL CONTRIBUTION 250
    YESHIVA BETH ISRAEL TIFERETH MENACH
    60 PARKVILLE AVE
    BROOKLNY,NY11230     		None EXEMPT GENERAL CONTRIBUTION 1,000
    BEIN ISH
    1514 55TH STREET
    BROOKLYN,NY11219     		None EXEMPT GENERAL CONTRIBUTION 360
    CONGREGATION BEER MOSHE
    1569 E 48TH ST
    BROOKLYN,NY11234     		None EXEMPT GENERAL CONTRIBUTION 120
    ALEPH INSTITUTE
    9540 COLLINS AVE
    MIAMI BEACH,FL33154     		None EXEMPT GENERAL CONTRIBUTION 101
    KOLEL SIEBENBURGEN - KOLEL AHAVAS Z
    202 HEWES ST
    BROOKLYN,NY11211     		None EXEMPT GENERAL CONTRIBUTION 316
    KEHAL BELED
    1146 50TH STREET
    BROOKLYN,NY11219     		None EXEMPT GENERAL CONTRIBUTION 180
    OHR YECHIEL
    132 NASSAU ST 300
    NEW YORK,NY10038     		None EXEMPT GENERAL CONTRIBUTION 120
    CHASDEI ELIEZER INC
    3047 AVENUE U 2ND FL
    BROKLYN,NY11229     		None EXEMPT GENERAL CONTRIBUTION 101
    CONG OTZER HACHAIM IC
    760 CHESTNUT RIDGE RD STE 221
    SPRING VALLEY,NY10977     		None EXEMPT GENERAL CONTRIBUTION 360
    GITTER FOUNATION
    5 NORTH END ROAD
    LONDON,LONDONNW117RJ
    UK     		None EXEMPT GENERAL CONTRIBUTION 2,324
    BEER MAYIM CHAIM - BETH CHANA FOR G
    620 BEDFORD AVE
    BROOKLYN,NY11211     		None EXEMPT GENERAL CONTRIBUTION 1,000
    Total .................................bullet 3a 559,955
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3 Interest on savings and temporary cash
    investments ...........     		    14 102  
    4 Dividends and interest from securities....     14 1,800  
    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 3,157  
    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)..   5,059  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    5,059
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 13
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.

    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below
    (see instr.)?
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    		 Firm's EIN SmallBullet
    Firm's address SmallBullet


    		 Phone no.
    Form 990-PF (2018)
    Additional Data


    Software ID: 18007218
    Software Version: 2018v3.1


    Form 990PF - Special Condition Description:
    Special Condition Description
    Schedule B
    (Form 990, 990-EZ,
    or 990-PF)
    Department of the Treasury
    Internal Revenue Service
    Schedule of Contributors

    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
    OMB No. 1545-0047
    2018
    Name of the organization
    ZICHRON SIMCHA DSASSOV
     
    Employer identification number

    45-0673679
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ






    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......... Arrow Bullet $  
    Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
    Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2
    Name of organization
    ZICHRON SIMCHA DSASSOV
          		Employer identification number
    45-0673679
    Part I
    Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    1
    SCHMUEL HOROWITZ  
    86 ROUTE 59
     
    SPRING VALLEY, NY10977

    		$ 816,271


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    2
    CAPITAL REALTY GROUP S HOROWITZ SH  
    86 ROUTE 59 E
     
    SPRING VALLEY, NY10977

    		$ 100,000


    (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.)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
    Page 3
    Name of organization
    ZICHRON SIMCHA DSASSOV
          		Employer identification number

    45-0673679
    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
    1
    		 20,000 PCSB Shares $ 403,000  
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
    Page 4
    Name of organization
    ZICHRON SIMCHA DSASSOV
          		Employer identification number

    45-0673679
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

    Additional Data


    Software ID: 18007218
    Software Version: 2018v3.1

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

    TY 2018 AmortizationSchedule
    Name:
    ZICHRON SIMCHA DSASSOV
    EIN:
    45-0673679
    Software ID:
    18007218
    Software Version:
    2018v3.1
    Description of Amortized Expenses Date Acquired, Completed, or Expended Amount Amortized Deduction for Prior Years Amortization Method Current Year Amortization Net Investment Income Adjusted Net Income Total Amount of Amortization
    Set-up costs 2011-04-11 1,500 750 15.0000 100     850
    Set up costs 2013-01-15 850 294 15.0000 57     351

    TY 2018 OtherAssetsSchedule
    Name:
    ZICHRON SIMCHA DSASSOV
    EIN:
    45-0673679
    Software ID:
    18007218
    Software Version:
    2018v3.1
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    Net Intangible Assets 1,306 1,149  


    TY 2018 OtherExpensesSchedule
    Name:
    ZICHRON SIMCHA DSASSOV
    EIN:
    45-0673679
    Software ID:
    18007218
    Software Version:
    2018v3.1
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Amortization 157      
    Bank Charges 761      
    Filing Fees 50      
    Professional Fees 3,900