-
TIN:
Form
990-PF
Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
Do not enter social security numbers on this form as it may be made public.
Go to
www.irs.gov/Form990PF
for instructions and the latest information.
OMB No. 1545-0052
20
19
Open to Public Inspection
For calendar year 2019, or tax year beginning
08-01-2017
, and ending
07-31-2018
Name of foundation
Follett Educational Foundation
Number and street (or P.O. box number if mail is not delivered to street address)
1340 Ridgeview Drive
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
McHenry
,
IL
60050
A Employer identification number
36-6104348
B
Telephone number (see instructions)
(708) 884-3047
C
If exemption application is pending, check here
G
Check all that apply:
Initial return
Initial return of a former public charity
Final return
Amended return
Address change
Name change
D 1.
Foreign organizations, check here.............
2
. Foreign organizations meeting the 85%
test, check here and attach computation ...
E
If private foundation status was terminated
under section 507(b)(1)(A), check here .......
H
Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here .......
I
Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)
$
5,055,168
J
Accounting method:
Cash
Accrual
Other (specify)
(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)
1
Contributions, gifts, grants, etc., received (attach schedule)
120,560
2
Check
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
268,939
268,939
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
9,631
b
Gross sales price for all assets on line 6a
40,060
7
Capital gain net income (from Part IV, line 2)
...
9,631
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)
.......
146,060
12
Total.
Add lines 1 through 11
........
545,190
278,570
13
Compensation of officers, directors, trustees, etc.
14
Other employee salaries and wages
......
26,148
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
8,500
b
Accounting fees (attach schedule)
.......
c
Other professional fees (attach schedule)
....
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
6,376
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
55,799
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
96,823
0
0
25
Contributions, gifts, grants paid
.......
288,520
288,520
26
Total expenses and disbursements.
Add lines 24 and 25
385,343
0
288,520
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
159,847
b
Net investment income
(if negative, enter -0-)
278,570
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
1
Cash—non-interest-bearing
.............
228,139
207,122
207,122
2
Savings and temporary cash investments
.........
3
Accounts receivable
Less: allowance for doubtful accounts
4
Pledges receivable
Less: allowance for doubtful accounts
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)
Less: allowance for doubtful accounts
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)
.......
58,694
28,265
34,554
c
Investments—corporate bonds (attach schedule)
.......
350,000
350,000
284,338
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
3,642,619
3,853,780
4,529,154
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
4,279,452
4,439,167
5,055,168
17
Accounts payable and accrued expenses
..........
298
166
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
)
23
Total liabilities
(add lines 17 through 22)
.........
298
166
Foundations that follow FASB ASC 958, check here
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
and complete lines 26 through 30.
26
Capital stock, trust principal, or current funds
........
27
Paid-in or capital surplus, or land, bldg., and equipment fund
28
Retained earnings, accumulated income, endowment, or other funds
29
Total net assets or fund balances
(see instructions)
.....
4,279,154
4,439,001
30
Total liabilities and net assets/fund balances
(see instructions)
.
4,279,452
4,439,167
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
4,279,154
2
Enter amount from Part I, line 27a
.....................
2
159,847
3
Other increases not included in line 2 (itemize)
3
4
Add lines 1, 2, and 3
..........................
4
4,439,001
5
Decreases not included in line 2 (itemize)
5
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
4,439,001
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 Total Stock Market ETF
P
2003-11-05
2017-10-17
b
Citigroup Inc
P
2005-11-29
2017-10-17
c
CNO Conseco Fin
P
1999-05-13
2017-10-17
d
McGraw-Hill
P
2005-07-25
2017-10-17
e
(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
339
0
318
21
b
89
0
1,027
-938
c
33,228
0
28,065
5,163
d
6,404
0
1,019
5,385
e
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
0
0
0
21
b
0
0
0
-938
c
0
0
0
5,163
d
0
0
0
5,385
e
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
9,631
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
...................
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?
Yes
No
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
258,141
4,264,028
0.060539
2017
265,770
4,144,003
0.064134
2016
302,526
4,040,193
0.074879
2015
273,092
3,719,762
0.073417
2014
235,038
3,321,382
0.070765
2
Total
of line 1, column (d)
.....................
2
0.343734
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
0.068747
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
4,709,507
5
Multiply line 4 by line 3
......................
5
323,764
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
2,786
7
Add lines 5 and 6
........................
7
326,550
8
Enter qualifying distributions from Part XII, line 4
,.............
8
288,520
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
and enter “N/A" on line 1.
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
5,571
here
and enter 1% of Part I, line 27b
...................
c
All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
2
0
3
Add lines 1 and 2
...........................
3
5,571
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
5,571
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
3,400
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
3,400
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
.......
9
2,171
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
0
Refunded
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.
$
(2)
On foundation managers.
$
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
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)
IL
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 address
www.folletteducationalfoundation.org
14
The books are in care of
BRITTEN FOLLETT
Telephone no.
(708) 884-3508
Located at
1340 Ridgeview Dr
McHenry
IL
ZIP+4
60050
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over
Yes
No
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
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?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(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)?
...............
Yes
No
(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.)
.......
Yes
No
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
Organizations relying on a current notice regarding disaster assistance check here
........
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?
.............
Yes
No
If "Yes," list the years
20
,
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.
20
,
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?
......................
Yes
No
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))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
No
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
Organizations relying on a current notice regarding disaster assistance check here
.........
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?
..........
Yes
No
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?
.....................
Yes
No
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?
Yes
No
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?
.................
Yes
No
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
BRITTEN FOLLETT
Pres/Trustee
2.00
0
0
0
1340 Ridgeview Dr
McHenry
,
IL
60050
KEITH O'HARA
Vice President
1.00
0
0
0
1340 Ridgeview Dr
McHenry
,
IL
60050
CHRISTOPHER TRAUT
Trustee
1.00
0
0
0
1340 Ridgeview Dr
McHenry
,
IL
60050
ROBERT B FERRIS
Treasurer
8.00
0
0
0
1340 Ridgeview Dr
McHenry
,
IL
60050
MATTHEW FOLLETT
Trustee
1.00
0
0
0
1340 Ridgeview Dr
McHenry
,
IL
60050
FRANK GENTILE
Trustee
1.00
0
0
0
1340 Ridgeview Dr
McHenry
,
IL
60050
IRIS WAICHLER
Secretary
1.00
0
0
0
1340 Ridgeview Dr
McHenry
,
IL
60050
BRENDAN THORNTON
Trustee
1.00
0
0
0
1340 Ridgeview Dr
McHenry
,
IL
60050
RAMONA BURNS
Trustee
1.00
0
0
0
1340 Ridgeview Dr
McHenry
,
IL
60050
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
...................
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
7
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
(continued)
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
NONE
Total
number of others receiving over $50,000 for professional services
.............
0
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
.........................
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
4,649,929
b
Average of monthly cash balances
.......................
1b
131,296
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
4,781,225
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
4,781,225
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
71,718
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
4,709,507
6
Minimum investment return.
Enter 5% of line 5
..................
6
235,475
Part XI
Distributable Amount
(see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here
and do not complete this part.)
1
Minimum investment return from Part X, line 6
....................
1
235,475
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
5,571
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
5,571
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
229,904
4
Recoveries of amounts treated as qualifying distributions
................
4
5
Add lines 3 and 4
............................
5
229,904
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
229,904
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
288,520
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
288,520
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
288,520
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
229,904
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
b
Total for prior years:
20
,
20
,
20
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
71,190
b
From 2015
......
90,949
c
From 2016
......
107,416
d
From 2017
......
63,733
e
From 2018
......
48,333
f
Total
of lines 3a through e
........
381,621
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
288,520
a
Applied to 2018, 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)
........
d
Applied to 2019 distributable amount
.....
229,904
e
Remaining amount distributed out of corpus
58,616
5
Excess distributions carryover applied to 2019.
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
440,237
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
..........
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 2014 not
applied on line 5 or line 7 (see instructions)
...
71,190
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
369,047
10
Analysis of line 9:
a
Excess from 2015
....
90,949
b
Excess from 2016
....
107,416
c
Excess from 2017
....
63,733
d
Excess from 2018
....
48,333
e
Excess from 2019
....
58,616
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
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
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.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
NONE
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
NONE
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
FOLLETT CORPORATION - HUMAN RESOURC
3 Westbrook Corp Center Suite 200
Westchester
,
IL
60154
(708) 437-2402
b
The form in which applications should be submitted and information and materials they should include:
APPLICATION FORMS AVAILABLE UPON REQUEST
c
Any submission deadlines:
MAY 1ST
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
GRANTEES ARE CHILDREN OF FOLLETT EMPLOYEES WITH AT LEAST 1 YEAR OF SERVICE.
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)
a
Paid during the year
S ACAR
Northwestern Univ 1801 Hinman Ave
Evanston
,
IL
60208
none
Education Grant
2,250
K ALBERT
College of Lake Cty 19351 W Washing
Grayslake
,
IL
60030
none
Education Grant
2,070
A ATKINSON
Univ of VA 400 Emmet St
Charlottesville
,
VA
60030
none
Education Grant
1,071
B AUGUSTINE
Worchester State Univ 486 Chandler
Worchester
,
MA
016022597
none
Education Grant
2,250
J AVERCH
Morningside College 1501 Morningsid
Sioux City
,
IA
51106
none
Education Grant
1,500
M BANKS
Univ of IL 910 South Third Street
Champaign
,
IL
61820
none
Education Grant
2,500
E BENNETT
Univ of Maine 5703 Alumni Hall Rm 1
Orono
,
ME
04469
none
Education Grant
1,750
K BERANDT
Univ of WI- Oshkosh 800 A
Oshkosh
,
WI
54901
none
Education Grant
1,250
A BLACK
Tallahassee Community College 444 A
Tallahassee
,
FL
32304
none
Education Grant
1,250
G BOGO
Ball St Univ
Muncie
,
IN
47306
none
Education Grant
2,500
D BONNETT
Univ of So MS 101118 College Dr
Hattisburg
,
MS
39406
none
Education Grant
2,500
B BOSOWSKI
Univ of WI 800 W Main St Hyer Hall
Whitewater
,
WI
53190
none
Education Grant
2,500
R BOSOWSKI
Univ of WI 800 W Main St Hyer Hall
Whitewater
,
WI
53190
none
Education Grant
1,750
T BRETZ
NIU 1425 W Lincoln Hgwy
DeKalb
,
IL
60115
none
Education Grant
3,000
I BRILEY
Metropolitan State Univ of Denver P
Denver
,
CO
80217
none
Education Grant
2,250
G BRINN
Univ of Central FL PO Box 160115
Orlando
,
FL
32816
none
Education Grant
2,250
D BRYANT
Penn State 109 Shields Building
University Park
,
PA
16802
none
Education Grant
3,000
J CHATMAN
Indiana State Univ Bursar Operation
Terre Haute
,
IN
47809
none
Education Grant
1,500
A CHENEY
Snow College 150 E College
Ephraim
,
UT
84627
none
Education Grant
1,750
K CIRUELAS
Univ of IL 1200 W Harrison Rm 1800
Chicago
,
IL
60607
none
Education Grant
3,500
M COCHARA
Columbia College 1001 Rogers St
Columbia
,
MO
65216
none
Education Grant
3,250
C CONLISS
IL State Univ Box 1210
Normal
,
IL
61790
none
Education Grant
3,250
M COTE
Univ of Mass 215 Whitmore Adm Bldg
Amherst
,
MA
01003
none
Education Grant
1,000
E CRANDALL
Univ of Iowa PO Box 14409
DesMoines
,
IA
50306
none
Education Grant
2,250
B CUEVAS
Miami Dade College 11011 SW 104th S
Miami
,
FL
33176
none
Education Grant
1,250
D DACASIN
Chamberlain University
Downers Grove
,
IL
60515
none
Education Grant
3,000
M DASS
Univ of MD Lee Bldg
College Park
,
MD
20742
none
Education Grant
1,250
TY DENNIS
Minn State Univ 120 Wrigley Adm Ctr
Mankato
,
MN
56001
none
Education Grant
2,750
D DICKEY
Ball St Univ Office of Bursar
Muncie
,
IN
473060725
none
Education Grant
2,000
C DIGGINS
Marquette Univ PO Box 1881
Milwaukee
,
WI
53201
none
Education Grant
1,250
C DILLION
College of Western Idaho 5725 E Fra
Nampa
,
ID
83687
none
Education Grant
1,500
C DRURY
Western Tech College400 Seventh St
LaCrosse
,
WI
09085
none
Education Grant
2,000
A EASLEY
NIU 1425 W Lincoln Highway
DeKalb
,
IL
60115
none
Education Grant
3,250
K EASLEY
McHenry College 8900 US Hwy 14
Crystal Lake
,
IL
60012
none
Education Grant
1,528
B FLORES
Univ of Texas
San Antonio
,
TX
78249
none
Education Grant
1,500
D FRANKLIN
Clemson Univ 08 Sikes Hall Box 3453
Clemson
,
SC
29634
none
Education Grant
1,750
J FRANKLIN
Clemson Univ 08 Sikes Hall Box 3453
Clemson
,
SC
29634
none
Education Grant
2,000
B GIBLEY
Aquinas College 1700 Fulton St East
Grand Rapids
,
MI
78249
none
Education Grant
2,250
P GLENN
1501 Lakeside Dr
Lynchburg
,
VA
24501
none
Education Grant
2,250
C HAGGERTY
PO Box 320455
Fairfield
,
CT
06824
none
Education Grant
2,750
R HAMEL
Bethel College 300 E 27t St
North Newton
,
KS
67114
none
Education Grant
885
J HAYDEL
Office of Scholarships - Room 261
Natchitoches
,
LA
71497
none
Education Grant
2,000
R HAYMAKER
Office of Bursar 113 Student Union
Stillwater
,
OK
74078
none
Education Grant
2,000
R HAYMAKER
Office of Bursar 113 Student Union
Stillwater
,
OK
74078
none
Education Grant
3,000
J HRUBES
Northern Essex Comm College 100 Ell
Haverhill
,
MA
01830
none
Education Grant
2,250
K HULTBERG
Oregon State University 100 Kerr
Corvallis
,
OR
97331
none
Education Grant
2,000
J IBARRA
Northern AZ Univ 601 S Knoles
Flagstaff
,
AZ
86001
none
Education Grant
1,750
L IBARRA
Northern AZ Univ 601 S Knoles
Flagstaff
,
AZ
86001
none
Education Grant
2,750
A JACKSON
OK State Univ 113 Student Union
Stillwater
,
OK
74078
none
Education Grant
2,750
A JUAREZ
Univ of IL at Urbana 3081 Universit
Macomb
,
IL
61455
none
Education Grant
3,000
A JUAREZ
620 East John Street
Champaign
,
IL
61820
none
Education Grant
3,500
R JUREK
Univ of IL 1200 West Harrison Stree
Chicago
,
IL
60607
none
Education Grant
2,500
H KANIEWSKI
Ball St Univ Office of the Bursar L
Muncie
,
IN
47306
none
Education Grant
2,250
A KAMRAT
Bromley Hall 910 S Third
Champaign
,
IL
61821
none
Education Grant
2,500
J KNIGHT
Acadia Univ 915 Univ
Wolfville Nova Scotia
,
CA
99999
none
Education Grant
1,250
J KOLWICZ
Columbus St Univ 4225 University Av
Columbus
,
GA
31907
none
Education Grant
2,500
M KONLEY
St Xavier Univ 3700 W 103rd St
Chicago
,
IL
60655
none
Education Grant
2,500
A LAM
Univ of IL
Urbana
,
IL
61820
none
Education Grant
1,750
J LE
Univ of IL- Chgo1200 West Harrison
Chicago
,
IL
60607
none
Education Grant
2,000
K LE
Triton College 2000 Fifth Ave
River Grove
,
IL
60171
none
Education Grant
2,472
J LEON
McHenry College 8900 US Hwy 14
Crystal Lake
,
IL
60012
none
Education Grant
2,000
L LEON
Central College 812 University
Pella
,
IA
50219
none
Education Grant
2,500
K LETO
1500 University Center
Tallahassee
,
FL
32306
none
Education Grant
2,500
T LEWIS
Iowa State Univ0210 Beardshear Hall
Ames
,
IA
50011
none
Education Grant
1,750
J LIVENGOOD
Texas Womens Univ 304 Administratio
Denton
,
TX
76204
none
Education Grant
1,250
M LONG
Texas Luthern Univ 1000 W Court St
Sequin
,
TX
78155
none
Education Grant
1,000
C LOPEZ
Store No 1168 MA 10723146 Solutions
Chicago
,
IL
60677
none
Education Grant
1,051
M LOSURDO
COD 425 Fawell
Glen Ellyn
,
IL
60137
none
Education Grant
2,000
S MAJEWSKI
Univ of IL Chgo9000 West College Pa
Palos Hills
,
IL
60465
none
Education Grant
2,750
J MCGRAW
St Bona Venture Univ PO Box 2448 St
Bonaventure
,
NY
14778
none
Education Grant
3,000
K MCGRAW
St Bona Venture Univ PO Box 2448 St
Bonaventure
,
NY
14778
none
Education Grant
2,750
K MCKENZIE
Delaware St Univ 1200 N DuPont Hwy
Dover
,
DE
19901
none
Education Grant
2,000
M MCQUEENY
Carthage College 2001 Alford Park D
Kenosha
,
WI
53140
none
Education Grant
2,000
K MCRAITH
Univ of MO-Columbia15 Jesse Hall
Columbia
,
MO
65211
none
Education Grant
2,500
C MEHR
Spring Hill College 4000 Dauphin St
Mobile
,
AL
36608
none
Education Grant
1,750
B MELTON
Lee University 1120 N Ocoee St
Cleveland
,
TN
37311
none
Education Grant
2,250
B MOORE
Univ of AL PO Box 870120
Tuscaloosa
,
AL
35487
none
Education Grant
1,500
J MOORE
Univ of AK at Little Rock 2801 S Un
Little Rock
,
AR
72204
none
Education Grant
1,681
C MORRIS
Loyola Univ
Chicago
,
IL
60660
none
Education Grant
2,500
A NOVY
McHenry County College8900 US Highw
Crystal Lake
,
IL
60012
none
Education Grant
1,750
J OCHSNER
1420 W 24 St Ste A
Kearney
,
NE
68845
none
Education Grant
1,732
H OLIVER
Wofford College 429 N Church St
Spartanburg
,
SC
29303
none
Education Grant
2,500
M OLIVER
20 Tillman Hall
Rock Hill
,
SC
29733
none
Education Grant
3,000
A OSWALT
McHenry Cty1 Hairpin Drive
Edwardsville
,
IL
62026
none
Education Grant
1,658
S OSWALT
McHenry College 1 University Circle
Macomb
,
IL
61455
none
Education Grant
2,250
C PAIGE
Mississippi St Univ PO Drawer 5316
Mississippi
,
MS
39762
none
Education Grant
2,000
M PENNINGTON
Central Methodist Univ 411 Central
Fayette
,
MO
65248
none
Education Grant
1,500
W PENNINGTON
Coconino Comm College2800 South Lon
Flagstaff
,
AZ
86005
none
Education Grant
1,450
D PERRY
Student A/CsPO Box 2701
Savannah
,
GA
314022701
none
Education Grant
2,750
E PLATT
Monmouth College 700 E Broadway
Monmouth
,
IL
61462
none
Education Grant
3,000
J POLLARD
Eastern Connecticut St Univ 83 Wind
Willimantic
,
CT
06226
none
Education Grant
2,250
K PRINCE
McHenry CtyPO BOX 2640
State University
,
AR
724672640
none
Education Grant
1,750
A RAJEEV
620 E John Street - MC-303
Champaign
,
IL
61820
none
Education Grant
1,000
C RAY
Rose-Hulman Institute of Tech5500 W
Terre Haute
,
IN
47803
none
Education Grant
1,750
S REED
Grand Valley St Univ 1049 JHZ1 Camp
Allendale
,
MI
49401
none
Education Grant
1,750
M REINDERS
Univ of Nebraska 984245 Nebraska Me
Omaha
,
NE
68198
none
Education Grant
3,750
A REYES
University of IL
Urbana
,
IL
61820
none
Education Grant
2,000
P RIGODON
NIU 1425 West Lincoln Highway
DeKalb
,
IL
60115
none
Education Grant
2,250
K ROUSH
Ohio Univ 0201 Ohio University
Athens
,
OH
45701
none
Education Grant
2,750
R RUIZ
University of Vermont 85 S Prospect
Burlington
,
VT
05401
none
Education Grant
2,750
A SALASEK
Franciscan University 1235 Universi
Steubenville
,
OH
439521763
none
Education Grant
1,500
A SANCHEZ
Kellam Building Ste 240601 Universi
San Marcos
,
TX
78666
none
Education Grant
3,250
K SCHMITTENDORF
Niagara Univ PO Box 2004
Niagara University
,
NY
141092004
none
Education Grant
2,250
S SCHMITTENDORF
Case Western Reserve 10900 Euclid A
Cleveland
,
OH
44106
none
Education Grant
3,250
J SEXTON
1215 Houbolt Rd
Joliet
,
IL
604318938
none
Education Grant
1,349
L SEXTON
Aurora University 347 S Gladstone A
Aurora
,
IL
60506
none
Education Grant
3,000
M SMITH
Cal St Long Beach 1551250 Bellflowe
Long Beach
,
CA
908400103
none
Education Grant
2,750
D SNARSKI
McHenry Cty College
Crystal Lake
,
IL
600122761
none
Education Grant
1,750
J SNARSKI
NIU 1425 W Lincoln Hgwy
DeKalb
,
IL
60015
none
Education Grant
3,250
R SPANIER
Univ of MN 200 Fraser Hall 106 Plea
Minnesota
,
MN
55455
none
Education Grant
1,250
A SPIKES
425 Fawell Blvd
Glen Ellyn
,
IL
60137
none
Education Grant
2,250
D STANLEY
Georgia St Univ PO Box 4029
Atlanta
,
GA
303024029
none
Education Grant
3,500
D STRAUBE
Univ of WI 800 W Main St
Whitewater
,
WI
53190
none
Education Grant
1,250
M STUMP
Lourdes Univ 6832 Convent Blvd
Sylvania
,
OH
43560
none
Education Grant
1,250
C SUWANSKI
Olivet Nazarene Univ One University
Bourbonnais
,
IL
609142345
none
Education Grant
2,000
M THOMAS
4225 University Avenue
Columbus
,
GA
31907
none
Education Grant
2,250
L TUD
Triton College2000 5th Avenue
River Grove
,
IL
60171
none
Education Grant
1,624
Y TUD
Triton College2000 5th Avenue
River Grove
,
IL
60171
none
Education Grant
1,698
C UHL
Univ of Wisc Whitewater 800 W Main
Whitewater
,
WI
53190
none
Education Grant
2,000
R UHL
Univ of Wisc Whitewater 800 W Main
Whitewater
,
WI
53190
none
Education Grant
2,500
K VANDIKE
Eastern IL Univ 600 Lincoln Ave
Charleston
,
IL
61920
none
Education Grant
2,500
A VARBLE
UofI-SpringfieldUniversity Hall 101
Springfield
,
IL
62703
none
Education Grant
2,000
R VARNEY
Boyden Hall Room 107
Bridgewater
,
MA
02325
none
Education Grant
2,750
N VOLCHKO
Elgin Comm College 1700 Spartan Dri
Elgin
,
IL
601237189
none
Education Grant
1,751
J VONCKX
Univ of WI 1 University Plaza
Platteville
,
WI
53818
none
Education Grant
2,750
S WALLECK
Bethany College3301 North Mulford R
Rockford
,
IL
61114
none
Education Grant
3,000
N WALTON
Niagara Univ PO Box 2004
Niagara University
,
NY
141092004
none
Education
1,250
B WARD
Univ of New Hampshire11 Garrison Av
Durham
,
NH
03824
none
Education Grant
2,000
J WARD
Auburn Univ 203 Mary Martin Hall
Auburn University
,
AL
368495119
none
Education Grant
2,750
A WEDIG
Univ of WI 1 University Plaza
Platteville
,
WI
53818
none
Education Grant
3,000
L WHITED
Purdue Univ 610 Purdue Mall
Lafayette
,
IN
479072040
none
Education Grant
1,000
L WHITESIDE
PO Box 500
Milwaukee
,
WI
53201
none
Education Grant
2,750
S WHITESIDE
Univ of WI 800 Algoma Blvd
Oshkosh
,
WI
54901
none
Education Grant
2,750
Total
.................................
3a
288,520
b
Approved for future payment
Total
.................................
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.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
4
Dividends and interest from securities
....
14
268,939
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not 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
9,631
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)
..
278,570
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
278,570
(See worksheet in line 13 instructions to verify calculations.)
Part XVI-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
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?
...........
Yes
No
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.
May the IRS discuss this return
with the preparer shown below
(see instr.)
Yes
No
Signature of officer or trustee
Date
Title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's Signature
Date
Check if self-
employed
PTIN
Firm's name
Firm's EIN
Firm's address
Phone no.
Form
990-PF
(2019)
Additional Data
Software ID:
Software Version:
Part VI Line 7 - Tax Paid with the Original Return:
3,400
Form 990PF - Special Condition Description:
Special Condition Description