-
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
10-01-2017
, and ending
09-30-2018
Name of foundation
ROMAINE GILMOUR TESTAMENTARY TRUST FOR THE
Number and street (or P.O. box number if mail is not delivered to street address)
116 ALLEGHENY CENTER MALL P8YB3502L
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
PITTSBURGH
,
PA
15212
A Employer identification number
23-7879529
B
Telephone number (see instructions)
(412) 762-3792
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)
$
1,343,512
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)
2
Check
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
27,806
27,806
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
141,191
b
Gross sales price for all assets on line 6a
650,726
7
Capital gain net income (from Part IV, line 2)
...
141,191
8
Net short-term capital gain
.........
0
9
Income modifications
...........
10a
Gross sales less returns and allowances
b
Less: Cost of goods sold
....
c
Gross profit or (loss) (attach schedule)
.....
11
Other income (attach schedule)
.......
12
Total.
Add lines 1 through 11
........
168,997
168,997
13
Compensation of officers, directors, trustees, etc.
15,605
14,825
780
14
Other employee salaries and wages
......
0
0
0
15
Pension plans, employee benefits
.......
0
0
16a
Legal fees (attach schedule)
.........
0
b
Accounting fees (attach schedule)
.......
c
Other professional fees (attach schedule)
....
0
17
Interest
...............
0
18
Taxes (attach schedule) (see instructions)
...
1,525
89
0
19
Depreciation (attach schedule) and depletion
...
0
0
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
0
0
22
Printing and publications
..........
0
0
23
Other expenses (attach schedule)
.......
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
17,130
14,914
0
780
25
Contributions, gifts, grants paid
.......
51,859
51,859
26
Total expenses and disbursements.
Add lines 24 and 25
68,989
14,914
0
52,639
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
100,008
b
Net investment income
(if negative, enter -0-)
154,083
c
Adjusted net income
(if negative, enter -0-)
...
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
.............
2
Savings and temporary cash investments
.........
12,070
11,195
11,195
3
Accounts receivable
Less: allowance for doubtful accounts
0
0
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
0
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)
.......
183,584
98,009
143,019
c
Investments—corporate bonds (attach schedule)
.......
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
914,833
1,101,278
1,189,298
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)
1,110,487
1,210,482
1,343,512
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
)
23
Total liabilities
(add lines 17 through 22)
.........
0
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
........
1,098,417
1,209,290
27
Paid-in or capital surplus, or land, bldg., and equipment fund
28
Retained earnings, accumulated income, endowment, or other funds
12,070
1,192
29
Total net assets or fund balances
(see instructions)
.....
1,110,487
1,210,482
30
Total liabilities and net assets/fund balances
(see instructions)
.
1,110,487
1,210,482
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
1,110,487
2
Enter amount from Part I, line 27a
.....................
2
100,008
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
1,210,495
5
Decreases not included in line 2 (itemize)
5
13
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
1,210,482
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
14. DR PEPPER SNAPPLE GROUP INC
2014-10-13
2017-10-02
b
9. DR PEPPER SNAPPLE GROUP INC
2014-10-14
2017-10-03
c
1. DR PEPPER SNAPPLE GROUP INC
2014-10-13
2017-10-03
d
8. DR PEPPER SNAPPLE GROUP INC
2014-10-13
2017-10-03
e
3. DR PEPPER SNAPPLE GROUP INC
2014-10-13
2017-10-03
11. DR PEPPER SNAPPLE GROUP INC
2014-10-13
2017-10-04
22. CSX CORP COM
2017-06-19
2017-10-20
22. EXXON MOBIL CORP
2002-08-07
2017-10-20
4. EXXON MOBIL CORP
2002-08-07
2017-10-20
38. CSX CORP COM
2017-06-19
2017-10-23
1. CSX CORP COM
2017-06-20
2017-10-23
1. JP MORGAN CHASE & COMPANY FAIR FUND
2001-01-01
2017-10-23
5. CSX CORP COM
2017-06-20
2017-10-24
1. CSX CORP COM
2017-06-20
2017-10-24
142. ISHARES MSCI EMERGING MKTS INDEX FUND
2017-08-31
2017-10-31
4. SECTOR SPDR TR SBI INT-TECH
2017-04-28
2017-10-31
1. VALERO ENERGY CORP NEW COM
2016-12-09
2017-11-03
15. VALERO ENERGY CORP NEW COM
2016-12-09
2017-11-03
1. VALERO ENERGY CORP NEW COM
2016-12-09
2017-11-03
16. INGERSOLL-RAND PLC SEDOL: B633030
2016-05-27
2017-11-03
1. INGERSOLL-RAND PLC SEDOL: B633030
2016-05-27
2017-11-03
18. VALERO ENERGY CORP NEW COM
2016-12-09
2017-11-06
17. INGERSOLL-RAND PLC SEDOL: B633030
2016-05-26
2017-11-06
5. AETNA INC NEW
2013-05-30
2017-11-10
4. EDWARDS LIFESCIENCES CORP
2015-02-06
2017-11-10
26. EDWARDS LIFESCIENCES CORP
2015-02-06
2017-11-10
90. ISHARES TR S&P SMLCAP 600
2017-10-31
2017-11-30
259. AMEX FINANCIAL SELECT SPDR
2017-01-31
2017-11-30
59. ABBOTT LABORATORIES INC
2016-06-24
2017-12-08
6. ABBVIE INC
2017-12-08
2017-12-11
3. AETNA INC NEW
2013-05-30
2017-12-11
10. AGILENT TECHNOLOGIES (IPO)
2017-08-18
2017-12-11
2. ALPHABET INC/CA-CL A
2013-07-01
2017-12-11
8. ALTRIA GROUP INC
2013-05-13
2017-12-11
6. AMERICAN WATER WORKS CO INC
2016-02-05
2017-12-11
5. AMGEN INC
2013-12-30
2017-12-11
8. ANALOG DEVICES INC
2017-09-01
2017-12-11
14. APPLE INC
2017-04-28
2017-12-11
10. APPLIED MATERIALS INC
2016-07-13
2017-12-11
18.059 BAIRD AGGREGATE BOND FUND FD 72
2013-04-26
2017-12-11
9. BANK NEW YORK MELLON CORP COM
2016-04-29
2017-12-11
13. BERRY GLOBAL GROUP INC
2016-08-25
2017-12-11
2. BIOGEN INC
2016-08-02
2017-12-11
3856.676 BLACKROCK CORE BOND PORTFOLIO
2007-08-01
2017-12-11
2. BOEING CO
2017-10-20
2017-12-11
15. BORG WARNER INC.
2017-09-29
2017-12-11
2. BURLINGTON STORES INC
2016-09-01
2017-12-11
4. BURLINGTON STORES INC
2017-03-13
2017-12-11
8. CBS CORP CLASS B WI
2016-08-08
2017-12-11
11. CISCO SYS INC COM
2012-01-09
2017-12-11
8. CITIGROUP INC
2017-07-28
2017-12-11
20. CITIZENS FINANCIAL GROUP
2016-11-14
2017-12-11
25. COMCAST CORPORATION CL A
2011-10-12
2017-12-11
9. CONOCOPHILLIPS
2017-11-06
2017-12-11
5. CONSTELLATION BRANDS INC CL A
2014-05-15
2017-12-11
3. CUMMINS INC
2017-02-21
2017-12-11
11. DOWDUPONT INC
2015-04-28
2017-12-11
8. FACEBOOK INC
2016-03-02
2017-12-11
3. GENERAL DYNAMICS CORP
2015-05-27
2017-12-11
11. HALLIBURTON CO
2017-01-27
2017-12-11
710.644 HARBOR FD INTL FD
2003-10-02
2017-12-11
6. HOME DEPOT INC COM
2012-01-09
2017-12-11
4. HONEYWELL INTL INC
2015-02-02
2017-12-11
4. ILLINOIS TOOL WORKS INC COM
2016-02-17
2017-12-11
11. INTEL CORP
2016-08-19
2017-12-11
109. ISHARES MSCI EAFE SMALL-CAP ETF
2017-11-30
2017-12-11
1. ISHARES EDGE MSCI USA QUALITY FACTOR ETF
2017-04-28
2017-12-11
698. ISHARES EDGE MSCI USA VALUE FACTOR ETF
2016-12-14
2017-12-11
17. J P MORGAN CHASE & CO COM
2004-10-13
2017-12-11
3. JOHNSON & JOHNSON COM
2002-08-07
2017-12-11
3. LAM RESEARCH CORP
2015-12-18
2017-12-11
7. LAUDER ESTEE COS INC CL A
2017-09-29
2017-12-11
5. MCDONALDS CORP COM
2017-07-28
2017-12-11
8. MICROSOFT CORP
2002-08-07
2017-12-11
1. MOHAWK INDS INC
2017-03-13
2017-12-11
2. MOHAWK INDS INC
2017-08-18
2017-12-11
14. MORGAN STANLEY
2016-10-21
2017-12-11
2. NORTHROP GRUMMAN CORPORATION
2015-02-19
2017-12-11
3. PARKER HANNIFIN CORP
2017-04-07
2017-12-11
7. PEPSICO INC COM
2016-06-02
2017-12-11
20. PFIZER INC COM
2017-11-10
2017-12-11
7. PRICE T ROWE GROUP INC COM
2017-08-28
2017-12-11
14. PROLOGIS INC
2017-06-02
2017-12-11
3441.939 PGIM JENNISON 20/20 FOCUS FUND 451
2005-01-26
2017-12-11
299.325 PGIM JENNISON 20/20 FOCUS FUND 451
2016-12-13
2017-12-11
3. RAYTHEON COMPANY
2016-01-29
2017-12-11
8. ROYAL DUTCH SHELL PLC ADR A
2017-10-23
2017-12-11
6. S&P GLOBAL INC
2016-05-20
2017-12-11
1. SHERWIN-WILLIAMS CO
2017-06-20
2017-12-11
3. STANLEY BLACK & DECKER INC
2017-11-07
2017-12-11
8. STATE STR CORP COM
2016-09-07
2017-12-11
3. STRYKER CORP
2017-03-15
2017-12-11
14. SUNTRUST BANKS INC COM
2016-06-24
2017-12-11
8. T-MOBILE US INC
2017-05-01
2017-12-11
10. TEXAS INSTRS INC COM
2015-11-11
2017-12-11
3. THERMO ELECTRON CORP COM
2015-08-20
2017-12-11
12. TOTAL FINA S A
2016-05-06
2017-12-11
10. TRANSCANADA CORP (HOLDING CO)
2017-06-06
2017-12-11
9. TYSON FDS INC COM
2017-09-29
2017-12-11
4. UNITED RENTALS INC COM
2017-05-25
2017-12-11
3. UNITEDHEALTH GROUP INC COM
2017-01-27
2017-12-11
6. VISA INC CLASS A SHARES
2013-02-08
2017-12-11
12. WEC ENERGY GROUP INC
2009-03-13
2017-12-11
72. WISDOMTREE U.S. QUALITY DIVI ETF
2016-12-14
2017-12-11
6. WYNDHAM WORLDWIDE CORP
2013-03-18
2017-12-11
9. TE CONNECTIVITY LTD SEDOL B62B7C3 ISIN CH0102993182
2017-06-19
2017-12-11
6. ROYAL CARRIBEAN CRUISES LTD SEDOL 2754907 ISIN LR0008862868
2017-04-10
2017-12-11
212. ISHARES EDGE MSCI USA QUALITY FACTOR ETF
2016-12-14
2017-12-12
321. POWERSHARES DYN L/C VALUE ETF
2017-12-11
2017-12-12
41. SPDR S&P INTERNATIONAL SMALL CAP
2017-12-11
2017-12-12
21. SECTOR SPDR TR SBI INT-TECH
2017-04-28
2017-12-12
2. SECTOR SPDR TR SBI INT-TECH
2017-11-30
2017-12-12
41.319 VANGUARD TOTL BD MKT IDX-ADM
2013-04-30
2017-12-12
353. WISDOMTREE U.S. QUALITY DIVI ETF
2016-12-14
2017-12-12
298.329 ALLIANCEBERNSTEIN GLOBAL BD FD INC ADV FD 456
2016-07-21
2017-12-20
407.992 TEMPLETON GLOBAL BOND FUND AD FUND
2014-12-30
2017-12-20
7.981 TEMPLETON GLOBAL BOND FUND AD FUND
2017-04-19
2017-12-20
11. AGILENT TECHNOLOGIES (IPO)
2017-04-24
2018-01-04
1. AGILENT TECHNOLOGIES (IPO)
2017-08-18
2018-01-04
3. AGILENT TECHNOLOGIES (IPO)
2017-04-21
2018-01-04
5. THERMO ELECTRON CORP COM
2015-08-20
2018-01-04
10. WYNDHAM WORLDWIDE CORP
2013-03-18
2018-01-04
21. WYNDHAM WORLDWIDE CORP
2013-03-18
2018-01-05
7. TRANSCANADA CORP (HOLDING CO)
2017-06-06
2018-01-19
9. TRANSCANADA CORP (HOLDING CO)
2017-06-05
2018-01-19
5. TRANSCANADA CORP (HOLDING CO)
2017-06-05
2018-01-22
24. TRANSCANADA CORP (HOLDING CO)
2017-06-02
2018-01-22
37. CBS CORP CLASS B WI
2016-08-08
2018-02-02
6. HOME DEPOT INC COM
2012-01-09
2018-02-02
2. MOHAWK INDS INC
2016-08-05
2018-02-02
1. MOHAWK INDS INC
2017-03-13
2018-02-02
31. PEPSICO INC COM
2016-06-02
2018-02-23
38. PROLOGIS INC
2016-10-21
2018-02-23
10. PROLOGIS INC
2017-06-02
2018-02-23
16. PROLOGIS INC
2016-10-21
2018-02-26
6. SHERWIN-WILLIAMS CO
2017-06-19
2018-03-02
14. STANLEY BLACK & DECKER INC
2017-11-03
2018-03-09
1. ABBVIE INC
2017-12-08
2018-03-16
1. AGILENT TECHNOLOGIES (IPO)
2017-04-21
2018-03-16
1. ALTRIA GROUP INC
2013-05-13
2018-03-16
1. AMERICAN WATER WORKS CO INC
2016-02-05
2018-03-16
1. AMGEN INC
2013-12-30
2018-03-16
1. ANALOG DEVICES INC
2017-09-01
2018-03-16
2. APPLE INC
2017-04-28
2018-03-16
2. APPLIED MATERIALS INC
2016-07-13
2018-03-16
1. BANK NEW YORK MELLON CORP COM
2016-04-29
2018-03-16
1. BAXTER INTERNATIONAL INC
2018-01-04
2018-03-16
2. BERRY GLOBAL GROUP INC
2016-10-14
2018-03-16
2. BORG WARNER INC.
2017-09-29
2018-03-16
1. BURLINGTON STORES INC
2016-09-01
2018-03-16
3. CBRE GROUP INC
2018-02-28
2018-03-16
2. CISCO SYS INC COM
2012-01-09
2018-03-16
1. CITIGROUP INC
2017-07-28
2018-03-16
3. CITIZENS FINANCIAL GROUP
2016-11-14
2018-03-16
4. COMCAST CORPORATION CL A
2011-10-12
2018-03-16
1. CONOCOPHILLIPS
2017-11-06
2018-03-16
1. CONSTELLATION BRANDS INC CL A
2014-05-15
2018-03-16
2. DOWDUPONT INC
2015-04-28
2018-03-16
1. EASTMAN CHEM CO
2018-03-06
2018-03-16
1. FACEBOOK INC
2016-03-02
2018-03-16
2. HALLIBURTON CO
2017-01-27
2018-03-16
1. HOME DEPOT INC COM
2012-01-09
2018-03-16
1. HONEYWELL INTL INC
2015-02-02
2018-03-16
1. ILLINOIS TOOL WORKS INC COM
2016-02-17
2018-03-16
2. INTEL CORP
2016-08-19
2018-03-16
43. ISHARES MSCI EMERGING MKTS INDEX FUND
2017-11-30
2018-03-16
46. ISHARES EDGE MSCI USA QUALITY FACTOR ETF
2016-12-14
2018-03-16
3. J P MORGAN CHASE & CO COM
2009-05-11
2018-03-16
1. JOHNSON & JOHNSON COM
2002-08-07
2018-03-16
1. LAUDER ESTEE COS INC CL A
2017-09-29
2018-03-16
1. MARRIOTT INTERNATIONAL INC CL A
2018-01-04
2018-03-16
1. MCDONALDS CORP COM
2017-07-28
2018-03-16
1. MICROSOFT CORP
2002-08-07
2018-03-16
2. MORGAN STANLEY
2016-10-21
2018-03-16
1. OCCIDENTAL PETE CORP COM
2018-01-19
2018-03-16
1. PARKER HANNIFIN CORP
2017-04-07
2018-03-16
3. PFIZER INC COM
2017-11-10
2018-03-16
1. PRICE T ROWE GROUP INC COM
2017-08-28
2018-03-16
1. ROYAL DUTCH SHELL PLC ADR A
2017-10-23
2018-03-16
1. S&P GLOBAL INC
2016-05-20
2018-03-16
3. SPDR S&P INTERNATIONAL SMALL CAP
2017-12-11
2018-03-16
9. SECTOR SPDR TR SBI INT-TECH
2017-04-28
2018-03-16
1. SMUCKER J M CO COM NEW
2018-02-27
2018-03-16
1. STATE STR CORP COM
2016-09-07
2018-03-16
1. STRYKER CORP
2017-03-15
2018-03-16
2. SUNTRUST BANKS INC COM
2016-06-24
2018-03-16
1. T-MOBILE US INC
2017-05-01
2018-03-16
1. TEXAS INSTRS INC COM
2015-11-11
2018-03-16
2. TOTAL FINA S A
2016-05-06
2018-03-16
1. TYSON FDS INC COM
2017-09-29
2018-03-16
1. UNITED RENTALS INC COM
2017-05-25
2018-03-16
1. UNITEDHEALTH GROUP INC COM
2016-10-27
2018-03-16
1. VISA INC CLASS A SHARES
2013-02-08
2018-03-16
2. WEC ENERGY GROUP INC
2009-03-13
2018-03-16
1. WASTE MANAGEMENT INC
2018-03-09
2018-03-16
57. WISDOMTREE U.S. QUALITY DIVI ETF
2016-12-14
2018-03-16
1. TE CONNECTIVITY LTD SEDOL B62B7C3 ISIN CH0102993182
2017-06-19
2018-03-16
1. ROYAL CARRIBEAN CRUISES LTD SEDOL 2754907 ISIN LR0008862868
2017-04-10
2018-03-16
10. MOHAWK INDS INC
2016-08-05
2018-04-05
4031.734 COLUMBIA FLOATING RATE FUND INSTITUTIONAL
2016-08-17
2018-04-12
75.786 COLUMBIA FLOATING RATE FUND INSTITUTIONAL
2017-04-30
2018-04-12
79.589 COLUMBIA FLOATING RATE FUND INSTITUTIONAL
2017-10-31
2018-04-12
1. JPMORGAN CHASE 46625H100
2001-01-01
2018-04-24
13. AETNA INC NEW
2013-05-30
2018-04-26
7. ILLINOIS TOOL WORKS INC COM
2016-02-17
2018-04-26
14. ILLINOIS TOOL WORKS INC COM
2016-02-16
2018-04-27
151. SPDR S&P INTERNATIONAL SMALL CAP
2017-12-11
2018-04-30
37. ALTRIA GROUP INC
2013-05-13
2018-05-04
27. COMCAST CORPORATION CL A
2011-10-12
2018-05-04
6. ROYAL CARRIBEAN CRUISES LTD SEDOL 2754907 ISIN LR0008862868
2017-04-10
2018-05-04
6. BERRY GLOBAL GROUP INC
2016-10-14
2018-05-15
30. BERRY GLOBAL GROUP INC
2016-08-24
2018-05-15
15. HONEYWELL INTL INC
2015-02-02
2018-05-15
1. HONEYWELL INTL INC
2015-02-02
2018-05-15
9. BERRY GLOBAL GROUP INC
2016-08-24
2018-05-16
9. BERRY GLOBAL GROUP INC
2016-08-24
2018-05-16
3. BERRY GLOBAL GROUP INC
2016-08-24
2018-05-16
1. BERRY GLOBAL GROUP INC
2016-08-24
2018-05-17
1. BERRY GLOBAL GROUP INC
2016-08-24
2018-05-17
38. ANALOG DEVICES INC
2017-06-14
2018-05-23
4. ISHARES MSCI EMERGING MKTS INDEX FUND
2017-12-11
2018-05-31
105. ISHARES MSCI EMERGING MKTS INDEX FUND
2017-11-30
2018-05-31
2. SECTOR SPDR TR SBI INT-TECH
2017-04-28
2018-05-31
53. HALLIBURTON CO
2017-01-27
2018-06-13
6. SMUCKER J M CO COM NEW
2018-02-27
2018-06-13
11. ABBVIE INC
2017-12-08
2018-06-14
15. AGILENT TECHNOLOGIES (IPO)
2017-04-21
2018-06-14
3. ALPHABET INC/CA-CL A
2009-01-27
2018-06-14
2. AMAZON.COM INC
2018-05-04
2018-06-14
12. AMERICAN WATER WORKS CO INC
2016-02-05
2018-06-14
10. AMGEN INC
2013-12-30
2018-06-14
27. APPLE INC
2006-08-24
2018-06-14
21. APPLIED MATERIALS INC
2016-07-13
2018-06-14
12. AUTOMATIC DATA PROCESSING INC
2018-05-24
2018-06-14
20. BANK NEW YORK MELLON CORP COM
2016-04-29
2018-06-14
15. BAXTER INTERNATIONAL INC
2018-01-04
2018-06-14
5. BIOGEN INC
2016-08-02
2018-06-14
5. BOEING CO
2017-10-20
2018-06-14
29. BORG WARNER INC.
2017-08-21
2018-06-14
12. BURLINGTON STORES INC
2016-08-31
2018-06-14
36. CBRE GROUP INC
2018-02-27
2018-06-14
10. CELANESE CORP
2018-05-16
2018-06-14
9. CENTENE CORP
2018-04-27
2018-06-14
10. CHEVRON CORPORATION
2018-06-13
2018-06-14
34. CISCO SYS INC COM
2018-04-26
2018-06-14
4. CISCO SYS INC COM
2012-01-09
2018-06-14
17. CITIGROUP INC
2017-07-28
2018-06-14
40. CITIZENS FINANCIAL GROUP
2016-11-11
2018-06-14
37. COMCAST CORPORATION CL A
2011-10-12
2018-06-14
19. CONOCOPHILLIPS
2017-11-03
2018-06-14
10. CONSTELLATION BRANDS INC CL A
2014-05-15
2018-06-14
5. CUMMINS INC
2017-02-21
2018-06-14
21. DOWDUPONT INC
2015-04-28
2018-06-14
10. EASTMAN CHEM CO
2018-03-06
2018-06-14
17. FACEBOOK INC
2016-03-02
2018-06-14
4. FEDEX CORPORATION
2018-05-15
2018-06-14
6. GENERAL DYNAMICS CORP
2015-05-27
2018-06-14
10. HOME DEPOT INC COM
2012-01-09
2018-06-14
23. INTEL CORP
2016-08-19
2018-06-14
34. J P MORGAN CHASE & CO COM
2009-04-29
2018-06-14
7. JOHNSON & JOHNSON COM
2002-08-07
2018-06-14
16. KOHLS CORP COM
2018-04-05
2018-06-14
6. LAM RESEARCH CORP
2015-12-18
2018-06-14
13. LAUDER ESTEE COS INC CL A
2017-09-01
2018-06-14
9. MARRIOTT INTERNATIONAL INC CL A
2018-01-04
2018-06-14
10. MCDONALDS CORP COM
2017-06-19
2018-06-14
16. MICROSOFT CORP
2002-08-07
2018-06-14
29. MORGAN STANLEY
2016-10-21
2018-06-14
5. NORTHROP GRUMMAN CORPORATION
2015-03-27
2018-06-14
14. OCCIDENTAL PETE CORP COM
2018-01-19
2018-06-14
7. PARKER HANNIFIN CORP
2017-04-07
2018-06-14
39. PFIZER INC COM
2017-11-10
2018-06-14
14. PRICE T ROWE GROUP INC COM
2017-08-28
2018-06-14
6. RAYTHEON COMPANY
2016-01-29
2018-06-14
16. ROYAL DUTCH SHELL PLC ADR A
2017-10-20
2018-06-14
11. S&P GLOBAL INC
2016-05-20
2018-06-14
6. SMUCKER J M CO COM NEW
2018-02-26
2018-06-14
17. STATE STR CORP COM
2016-09-07
2018-06-14
6. STRYKER CORP
2017-03-13
2018-06-14
28. SUNTRUST BANKS INC COM
2016-06-24
2018-06-14
17. T-MOBILE US INC
2017-05-01
2018-06-14
20. TEXAS INSTRS INC COM
2015-11-11
2018-06-14
5. THERMO ELECTRON CORP COM
2015-08-20
2018-06-14
25. TOTAL FINA S A
2016-05-06
2018-06-14
10. TYSON FDS INC COM
2016-03-11
2018-06-14
8. TYSON FDS INC COM
2017-09-29
2018-06-14
7. UNITED RENTALS INC COM
2017-05-25
2018-06-14
21. US FOODS HOLDING CORP
2018-06-13
2018-06-14
7. UNITEDHEALTH GROUP INC COM
2016-10-27
2018-06-14
13. VISA INC CLASS A SHARES
2013-02-08
2018-06-14
23. WEC ENERGY GROUP INC
2009-03-13
2018-06-14
21. WASTE MANAGEMENT INC
2018-03-09
2018-06-14
10. TE CONNECTIVITY LTD SEDOL B62B7C3 ISIN CH0102993182
2017-05-25
2018-06-14
9. TE CONNECTIVITY LTD SEDOL B62B7C3 ISIN CH0102993182
2017-06-19
2018-06-14
9. ROYAL CARRIBEAN CRUISES LTD SEDOL 2754907 ISIN LR0008862868
2017-04-07
2018-06-14
4. AGILENT TECHNOLOGIES (IPO)
2017-04-21
2018-06-15
15. AGILENT TECHNOLOGIES (IPO)
2017-04-21
2018-06-15
15. SMUCKER J M CO COM NEW
2018-02-23
2018-06-15
186. AMEX FINANCIAL SELECT SPDR
2018-04-30
2018-06-29
6. CONSTELLATION BRANDS INC CL A
2014-05-15
2018-07-02
5. CUMMINS INC
2017-02-17
2018-07-02
3. CUMMINS INC
2017-02-17
2018-07-03
7. CONSTELLATION BRANDS INC CL A
2014-05-15
2018-07-13
2. GENERAL DYNAMICS CORP
2015-05-27
2018-07-13
1. GENERAL DYNAMICS CORP
2015-05-27
2018-07-13
4. THERMO ELECTRON CORP COM
2015-08-20
2018-07-13
5. GENERAL DYNAMICS CORP
2015-05-27
2018-07-16
3. THERMO ELECTRON CORP COM
2015-08-20
2018-07-16
3. PARKER HANNIFIN CORP
2017-04-07
2018-07-27
1. PARKER HANNIFIN CORP
2018-07-19
2018-07-27
6. STATE STR CORP COM
2016-09-09
2018-07-27
17. STATE STR CORP COM
2016-09-09
2018-07-27
7. TYSON FDS INC COM
2016-03-11
2018-07-27
1. TYSON FDS INC COM
2016-03-11
2018-07-27
6. PARKER HANNIFIN CORP
2017-04-07
2018-07-30
7. TYSON FDS INC COM
2016-03-11
2018-07-30
8. TYSON FDS INC COM
2016-03-11
2018-07-30
69. SECTOR SPDR TR SBI INT-ENERGY
2018-05-31
2018-07-31
9. JOHNSON & JOHNSON COM
2002-08-07
2018-08-16
1. JOHNSON & JOHNSON COM
2018-07-19
2018-08-16
6. LAUDER ESTEE COS INC CL A
2017-09-01
2018-08-16
1. LAUDER ESTEE COS INC CL A
2018-07-19
2018-08-16
4. LAUDER ESTEE COS INC CL A
2017-09-01
2018-08-16
10. FACEBOOK INC
2016-03-02
2018-08-17
7. LAUDER ESTEE COS INC CL A
2017-09-01
2018-08-17
2. ROYAL DUTCH SHELL PLC ADR A
2018-07-19
2018-08-23
1. ROYAL DUTCH SHELL PLC ADR A
2017-10-20
2018-08-23
10. ROYAL DUTCH SHELL PLC ADR A
2017-10-20
2018-08-24
9. ROYAL DUTCH SHELL PLC ADR A
2017-10-20
2018-08-27
75. SECTOR SPDR TR SBI INT-TECH
2017-04-28
2018-08-31
7. LAM RESEARCH CORP
2015-12-18
2018-09-14
1. LAM RESEARCH CORP
2018-07-19
2018-09-14
5. MARRIOTT INTERNATIONAL INC CL A
2018-01-04
2018-09-14
1. MARRIOTT INTERNATIONAL INC CL A
2018-01-04
2018-09-14
9. STRYKER CORP
2017-03-13
2018-09-14
7. MARRIOTT INTERNATIONAL INC CL A
2018-01-04
2018-09-17
CAPITAL GAIN DIVIDENDS
P
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
1,229
900
329
b
798
579
219
c
88
64
24
d
698
514
184
e
262
193
69
961
707
254
1,201
1,169
32
1,825
732
1,093
331
133
198
2,065
2,011
54
55
52
3
70
25
45
272
261
11
55
52
3
6,550
6,369
181
251
218
33
81
68
13
1,214
1,017
197
81
68
13
1,381
1,062
319
86
66
20
1,465
1,221
244
1,471
1,127
344
872
308
564
415
266
149
2,701
1,722
979
6,988
6,738
250
7,141
6,034
1,107
3,214
2,253
961
578
576
2
545
185
360
669
615
54
2,103
887
1,216
572
296
276
552
382
170
884
577
307
685
674
11
2,415
2,011
404
515
259
256
196
196
490
361
129
783
583
200
656
590
66
36,986
35,854
1,132
566
529
37
800
770
30
224
164
60
448
376
72
461
416
45
417
209
208
606
540
66
824
614
210
959
296
663
464
482
-18
1,095
398
697
513
463
50
778
567
211
1,433
877
556
598
421
177
496
640
-144
50,392
32,706
17,686
1,092
259
833
612
393
219
659
380
279
478
388
90
6,893
6,954
-61
83
73
10
58,184
50,012
8,172
1,792
649
1,143
423
154
269
556
233
323
877
755
122
865
779
86
681
181
500
277
230
47
555
497
58
738
468
270
609
330
279
575
483
92
821
713
108
723
701
22
712
589
123
919
796
123
65,672
51,058
14,614
5,711
4,577
1,134
561
382
179
511
490
21
1,027
650
377
408
359
49
501
499
2
778
564
214
457
397
60
901
572
329
505
544
-39
987
579
408
567
399
168
667
589
78
487
473
14
742
635
107
655
450
205
667
489
178
674
236
438
826
227
599
2,956
2,431
525
675
375
300
854
719
135
751
589
162
17,617
14,946
2,671
12,562
12,540
22
1,473
1,479
-6
1,349
1,142
207
128
127
1
444
453
-9
14,550
11,917
2,633
2,500
2,563
-63
4,904
5,055
-151
96
99
-3
759
598
161
69
61
8
208
162
46
995
665
330
1,160
625
535
2,370
1,313
1,057
336
331
5
432
424
8
240
235
5
1,151
1,128
23
2,070
1,926
144
1,172
259
913
543
426
117
271
230
41
3,394
3,157
237
2,326
1,999
327
612
569
43
979
837
142
2,350
2,135
215
2,238
2,293
-55
114
96
18
70
53
17
63
37
26
82
64
18
189
115
74
94
84
10
357
287
70
119
52
67
55
40
15
68
68
112
89
23
102
101
1
127
82
45
142
142
90
38
52
74
68
6
135
92
43
144
47
97
55
54
1
229
80
149
137
103
34
107
105
2
184
110
74
92
116
-24
179
43
136
152
98
54
171
95
76
103
71
32
2,116
1,993
123
3,954
3,230
724
347
110
237
133
51
82
146
108
38
141
136
5
163
156
7
94
23
71
115
67
48
64
75
-11
182
161
21
110
105
5
116
84
32
62
61
1
192
108
84
107
108
-1
626
489
137
126
128
-2
107
70
37
167
132
35
143
82
61
64
68
-4
110
58
52
116
98
18
74
71
3
187
112
75
228
142
86
124
39
85
124
38
86
86
87
-1
2,393
1,924
469
104
80
24
124
98
26
2,395
2,132
263
36,810
35,893
917
692
684
8
727
725
2
26
25
1
2,327
801
1,526
1,007
665
342
1,993
1,304
689
5,383
5,446
-63
2,086
1,368
718
860
320
540
642
589
53
287
268
19
1,427
1,334
93
2,208
1,473
735
147
98
49
429
390
39
430
390
40
143
130
13
48
43
5
47
43
4
3,589
3,095
494
182
185
-3
4,789
4,866
-77
140
109
31
2,536
3,051
-515
629
769
-140
1,080
1,056
24
993
798
195
3,496
771
2,725
3,442
3,162
280
952
764
188
1,849
1,154
695
5,160
1,100
4,060
1,045
544
501
1,685
1,565
120
1,138
802
336
1,131
1,026
105
1,542
1,476
66
1,817
1,323
494
1,413
1,348
65
1,862
968
894
1,736
1,697
39
1,154
1,112
42
1,112
993
119
1,270
1,272
-2
1,522
1,503
19
179
76
103
1,130
1,149
-19
1,656
1,196
460
1,241
438
803
1,303
1,012
291
2,310
796
1,514
708
771
-63
1,438
1,082
356
1,078
1,049
29
3,348
1,863
1,485
1,054
989
65
1,179
843
336
1,997
432
1,565
1,276
811
465
3,685
1,189
2,496
856
360
496
1,174
1,064
110
1,092
465
627
2,031
1,402
629
1,252
1,226
26
1,673
1,531
142
1,627
363
1,264
1,490
969
521
1,614
802
812
1,185
1,056
129
1,205
1,128
77
1,409
1,367
42
1,734
1,177
557
1,214
764
450
1,110
981
129
2,285
1,191
1,094
624
760
-136
1,667
1,197
470
1,013
788
225
1,928
1,145
783
1,012
1,154
-142
2,296
1,142
1,154
1,078
665
413
1,538
1,226
312
708
675
33
566
564
2
1,150
787
363
784
781
3
1,784
995
789
1,756
512
1,244
1,373
435
938
1,747
1,821
-74
994
779
215
895
717
178
1,027
879
148
263
212
51
989
795
194
1,572
1,873
-301
5,003
5,170
-167
1,290
478
812
660
765
-105
396
457
-61
1,510
557
953
386
281
105
193
140
53
845
532
313
958
702
256
629
399
230
494
483
11
165
163
2
523
422
101
1,480
1,196
284
447
473
-26
64
68
-4
989
967
22
410
473
-63
474
540
-66
5,328
5,268
60
1,190
463
727
132
127
5
802
647
155
134
140
-6
535
431
104
1,732
1,096
636
947
755
192
130
138
-8
65
61
4
658
610
48
594
549
45
5,665
4,079
1,586
1,072
543
529
153
179
-26
653
681
-28
130
136
-6
1,537
1,179
358
908
954
-46
13,793
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
329
b
219
c
24
d
184
e
69
254
32
1,093
198
54
3
45
11
3
181
33
13
197
13
319
20
244
344
564
149
979
250
1,107
961
2
360
54
1,216
276
170
307
11
404
256
129
200
66
1,132
37
30
60
72
45
208
66
210
663
-18
697
50
211
556
177
-144
17,686
833
219
279
90
-61
10
8,172
1,143
269
323
122
86
500
47
58
270
279
92
108
22
123
123
14,614
1,134
179
21
377
49
2
214
60
329
-39
408
168
78
14
107
205
178
438
599
525
300
135
162
2,671
22
-6
207
1
-9
2,633
-63
-151
-3
161
8
46
330
535
1,057
5
8
5
23
144
913
117
41
237
327
43
142
215
-55
18
17
26
18
74
10
70
67
15
23
1
45
52
6
43
97
1
149
34
2
74
-24
136
54
76
32
123
724
237
82
38
5
7
71
48
-11
21
5
32
1
84
-1
137
-2
37
35
61
-4
52
18
3
75
86
85
86
-1
469
24
26
263
917
8
2
1
1,526
342
689
-63
718
540
53
19
93
735
49
39
40
13
5
4
494
-3
-77
31
-515
-140
24
195
2,725
280
188
695
4,060
501
120
336
105
66
494
65
894
39
42
119
-2
19
103
-19
460
803
291
1,514
-63
356
29
1,485
65
336
1,565
465
2,496
496
110
627
629
26
142
1,264
521
812
129
77
42
557
450
129
1,094
-136
470
225
783
-142
1,154
413
312
33
2
363
3
789
1,244
938
-74
215
178
148
51
194
-301
-167
812
-105
-61
953
105
53
313
256
230
11
2
101
284
-26
-4
22
-63
-66
60
727
5
155
-6
104
636
192
-8
4
48
45
1,586
529
-26
-28
-6
358
-46
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
141,191
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
55,924
1,239,175
0.04513
2017
56,689
1,202,061
0.04716
2016
55,333
1,269,145
0.043599
2015
52,499
1,249,378
0.04202
2014
50,477
1,163,646
0.043378
2
Total
of line 1, column (d)
.....................
2
0.221287
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
0.044257
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
1,113,037
5
Multiply line 4 by line 3
......................
5
49,260
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
1,541
7
Add lines 5 and 6
........................
7
50,801
8
Enter qualifying distributions from Part XII, line 4
,.............
8
52,639
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
1,541
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
1,541
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
4
0
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
1,541
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
1,209
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
0
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
1,209
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
0
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
332
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
0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition)
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
(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)
PA
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
N/A
14
The books are in care of
PNC BANK
Telephone no.
(412) 762-3792
Located at
116 ALLEGHENY CENTER MALL P8-YB35-
PITTSBURGH
PA
ZIP+4
152129938
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
No
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
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
PNC BANK NA
TRUSTEE
3
15,605
116 Allegheny Center Mall
PITTSBURGH
,
PA
152129938
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
1,129,987
b
Average of monthly cash balances
.......................
1b
0
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
1,129,987
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation)
.............
1e
0
2
Acquisition indebtedness applicable to line 1 assets
..................
2
0
3
Subtract line 2 from line 1d
.........................
3
1,129,987
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
16,950
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
1,113,037
6
Minimum investment return.
Enter 5% of line 5
..................
6
55,652
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
55,652
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
1,541
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
1,541
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
54,111
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
54,111
6
Deduction from distributable amount (see instructions)
.................
6
0
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1
...
7
54,111
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
52,639
b
Program-related investments—total from Part IX-B
..................
1b
0
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
0
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
0
b
Cash distribution test (attach the required schedule)
.................
3b
0
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
52,639
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
1,541
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
51,098
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
54,111
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
35,342
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
0
b
From 2015
......
0
c
From 2016
......
0
d
From 2017
......
0
e
From 2018
......
0
f
Total
of lines 3a through e
........
0
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
52,639
a
Applied to 2018, but not more than line 2a
35,342
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
0
c
Treated as distributions out of corpus (Election
required—see instructions)
........
0
d
Applied to 2019 distributable amount
.....
17,297
e
Remaining amount distributed out of corpus
0
5
Excess distributions carryover applied to 2019.
0
0
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
0
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
0
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
0
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
0
e
Undistributed income for 2018. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
0
f
Undistributed income for 2019. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2020
..........
36,814
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions)
.......
0
8
Excess distributions carryover from 2014 not
applied on line 5 or line 7 (see instructions)
...
0
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
0
10
Analysis of line 9:
a
Excess from 2015
....
0
b
Excess from 2016
....
0
c
Excess from 2017
....
0
d
Excess from 2018
....
0
e
Excess from 2019
....
0
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).)
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.
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 email address of the person to whom applications should be addressed:
b
The form in which applications should be submitted and information and materials they should include:
c
Any submission deadlines:
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Form
990-PF
(2019)
Form 990-PF (2019)
Page
11
Part XV
Supplementary Information
(continued)
3
Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
GRACE LUTHERAN CHURCH
P O BOX 336
STOYSTOWN
,
PA
15563
NONE
PC
GENERAL SUPPORT
51,859
Total
.................................
3a
51,859
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
27,806
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
141,191
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)
..
168,997
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
168,997
(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:
Form 990PF - Special Condition Description:
Special Condition Description