Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0052
2018
Open to Public Inspection
For calendar year 2018, or tax year beginning 01-01-2018 , and ending 12-31-2018
Name of foundation
CHANGE A LIFE FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)6970 S CIMARRON RD 170
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
LAS VEGAS, NV89113
A Employer identification number

33-0935713
B Telephone number (see instructions)

(702) 869-9760
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$178,069J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule) 3,500,000
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities...      
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10  
b Gross sales price for all assets on line 6a  
7 Capital gain net income (from Part IV, line 2)...  
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 3,500,000 0  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 212,221      
14 Other employee salaries and wages...... 96,006      
15 Pension plans, employee benefits....... 52,998      
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 38,425      
c Other professional fees (attach schedule).... Click to see attachment 2,027      
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 728      
19 Depreciation (attach schedule) and depletion... Click to see attachment 1,374    
20 Occupancy.............. 39,600      
21 Travel, conferences, and meetings....... 10,215      
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 33,694      
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 487,288 0   0
25 Contributions, gifts, grants paid....... 3,356,676 3,356,676
26 Total expenses and disbursements. Add lines 24 and 25 3,843,964 0   3,356,676
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -343,964
b Net investment income (if negative, enter -0-) 0
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2018)
Form 990-PF (2018)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............. 482,554 173,675 173,675
2 Savings and temporary cash investments.........      
3 Accounts receivable bullet3,200
Less: allowance for doubtful accounts bullet     3,200 3,200
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges.......... 5,434 910 910
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet39,120
Less: accumulated depreciation (attach schedule) bullet38,836 1,659 Click to see attachment284 284
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet) Click to see attachment50,508    
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 540,155 178,069 178,069
Liabilities 17 Accounts payable and accrued expenses.......... 39,302 21,180
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22)......... 39,302 21,180
Net Assets or Fund Balances Foundations that follow SFAS 117, check here bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted.................. 500,853 156,889
25 Temporarily restricted...............    
26 Permanently restricted...............    
Foundations that do not follow SFAS 117, check here bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds........    
28 Paid-in or capital surplus, or land, bldg., and equipment fund    
29 Retained earnings, accumulated income, endowment, or other funds    
30 Total net assets or fund balances (see instructions)..... 500,853 156,889
31 Total liabilities and net assets/fund balances (see instructions). 540,155 178,069
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 30 (must agree with end-of-year figure reported on prior year’s return) ...............
1
500,853
2
Enter amount from Part I, line 27a .....................
2
-343,964
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
156,889
5
Decreases not included in line 2 (itemize) bullet
5
 
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30 .
6
156,889
Form 990-PF (2018)
Form 990-PF (2018)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1a
b
c
d
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
b
c
d
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
b
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2  
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)

If section 4940(d)(2) applies, leave this part blank.
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period?
If "Yes," the foundation does not qualify under section 4940(e). Do not complete this part.
1 Enter the appropriate amount in each column for each year; see instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in) 		(b)
Adjusted qualifying distributions 		(c)
Net value of noncharitable-use assets 		(d)
Distribution ratio
(col. (b) divided by col. (c))
2017 3,356,675 254,806 13.173454
2016 1,613,164 155,991 10.341391
2015 1,653,169 196,860 8.397689
2014 1,249,156 143,559 8.701342
2013 1,433,375 108,646 13.193077
2
Total of line 1, column (d) .....................
2
53.806953
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
10.761391
4
Enter the net value of noncharitable-use assets for 2018 from Part X, line 5......
4
254,806
5
Multiply line 4 by line 3......................
5
2,742,067
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
 
7
Add lines 5 and 6........................
7
2,742,067
8
Enter qualifying distributions from Part XII, line 4,.............
8
3,356,676
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See the Part VI instructions.
Form 990-PF (2018)
Form 990-PF (2018)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket includes lines 1a and 1b
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b Domestic foundations that meet the section 4940(e) requirements in Part V, check 1 0
hereBulletand enter 1% of Part I, line 27b...................
c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2  
3 Add lines 1 and 2........................... 3  
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  
6 Credits/Payments:
a 2018 estimated tax payments and 2017 overpayment credited to 2018 6a 79
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 79
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 79
11 Enter the amount of line 10 to be: Credited to 2019 estimated taxBullet0 RefundedBullet 11 79
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition).................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletCA
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2018 or the taxable year beginning in 2018? See the instructions for Part XIV.
    If "Yes," complete Part XIV .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 5
    Part VII-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletCHANGEALIFE.ORG
    14
    The books are in care ofbulletRICHARD E TOMLIN JR Telephone no.bullet (702) 869-9760

    Located atbullet6970 S CIMARRON ROAD SUITE 170LAS VEGASNV ZIP+4bullet89113
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2018, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet  
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?......................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?...............
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).......
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ........
    1b
     
     
    ........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2018?.............
    1c
     
     
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2018, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2018?.............
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?......................
    b
    If "Yes," did it have excess business holdings in 2018 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2018.)..................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2018?
    4b
     
    No
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 6
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?.............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?.....
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ......
    5b
     
     
    .........bullet
    c
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?..........
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?.....................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .................
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    LISA FUJIMOTO EXECUTIVE DI
    40.00     		212,221 37,067 0
    1048 IRVINE AVENUE 609
    NEWPORT BEACH,CA92660
    RICHARD E TOMLIN JR PRESIDENT
    2.00     		0 0 0
    6970 S CIMARRON ROAD SUITE 170
    LAS VEGAS,NV89113
    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
    JACLYN DUARTE PROGRAM DIRE
    40.00     		96,006 2,130  
    1048 IRVINE AVENUE 609
    NEWPORT BEACH,CA92660
    Total number of other employees paid over $50,000...................bullet  
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 7
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1 DISTRIBUTED 3,356,675 TO CHARITABLE ORGANIZATIONS THAT SERVE INDIVIDUALS WHO THROUGH NO FAULT OF THEIR OWN, HAVE EXPERIENCED AN INJURY, ILLNESS, DISABILITY, OR CATASTROPHIC LIFE EVENT, AND WHO ARE SUFFERING FINANCIAL HARDSHIP BY PROVIDING SUPPORT THAT PROMOTES SELF- SUFFICIENCY AND IMPROVES QUALITY OF LIFE. 3,356,675
    2  
    3  
    4  
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1 N/A  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 8
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    4,925
    b
    Average of monthly cash balances.......................
    1b
    232,371
    c
    Fair market value of all other assets (see instructions)................
    1c
    21,390
    d
    Total (add lines 1a, b, and c).........................
    1d
    258,686
    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
    258,686
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    3,880
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    254,806
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    12,740
    Part XI
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    12,740
    2a
    Tax on investment income for 2018 from Part VI, line 5......
    2a
     
    b
    Income tax for 2018. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
     
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    12,740
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    12,740
    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
    12,740
    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
    3,356,676
    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
    3,356,676
    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
    3,356,676
    Note: The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
    the section 4940(e) reduction of tax in those years.
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2017     		(c)
    2017     		(d)
    2018
    1 Distributable amount for 2018 from Part XI, line 7 12,740
    2 Undistributed income, if any, as of the end of 2018:
    a Enter amount for 2017 only.......  
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2018:
    a From 2013...... 1,427,945
    b From 2014...... 1,241,978
    c From 2015...... 1,643,326
    d From 2016...... 1,605,364
    e From 2017...... 1,402,515
    fTotal of lines 3a through e........ 7,321,128
    4Qualifying distributions for 2018 from Part
    XII, line 4: bullet$ 3,356,676
    a Applied to 2017, but not more than line 2a  
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		 
    d Applied to 2018 distributable amount..... 12,740
    e Remaining amount distributed out of corpus 3,343,936
    5 Excess distributions carryover applied to 2018.    
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 10,665,064
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		 
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		 
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		 
    e Undistributed income for 2017. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    f Undistributed income for 2018. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2019 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		 
    8 Excess distributions carryover from 2013 not
    applied on line 5 or line 7 (see instructions) ...     		1,427,945
    9Excess distributions carryover to 2019.
    Subtract lines 7 and 8 from line 6a ......     		9,237,119
    10 Analysis of line 9:
    a Excess from 2014.... 1,241,978
    b Excess from 2015.... 1,643,326
    c Excess from 2016.... 1,605,364
    d Excess from 2017.... 1,402,515
    e Excess from 2018.... 3,343,936
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 10
    Part XIV
    Private Operating Foundations (see instructions and Part VII-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2018, enter the date of the ruling....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2018 (b) 2017 (c) 2016 (d) 2015
             
    b 85% of line 2a .........          
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part X, line 6 for each year listed...     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    JACLYN DUARTE
    1048 IRVINE AVENUE 609
    NEWPORT BEACH,CA92660
    (805) 423-1667
    JDUARTE@CHANGEALIFE.ORG
    bThe form in which applications should be submitted and information and materials they should include:
     
    cAny submission deadlines:
     
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
     
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 11
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    AGE WELL SENIOR SERVICES
    24461 RIDGE ROUTE DRIV
    LAGUNA HILLS,CA92653     		  PC ASSISTANCE 7,513
    ALISA ANN RUCH BURN FOUNDATION
    50 N HILL AVENUE SUI
    PASADENA,CA90017     		  PC ASSISTANCE 49,338
    ARTHRITIS FOUNDATION SOUTHERN CALI
    800 W 6TH STREET
    LOS ANGELES,CA90017     		  PC ASSISTANCE 8,250
    AVA'S HEART
    9461 CHARLEVILLE BLVD
    BEVERLY HILLS,CA90212     		  PC ASSISTANCE 59,700
    BROWN UNIVERSITY
    69 BROWN STREET
    PROVIDENCE,RI02912     		    ASSISTANCE 5,000
    BLIND CHILDREN'S LEARNING CENTER
    18542-B VANDERLIP AVE
    SANTA ANA,CA92705     		  PC ASSISTANCE 17,782
    BOWDOIN COLLEGE
    5420 COLLEGE STATION
    BRUNSWICK,ME04011     		  PC ASSISTANCE 1,850
    BOYS HOPE GIRLS HOPE
    1041 W 18TH STREET A101
    IRVINE,CA92067     		  PC ASSISTANCE 50,000
    BURN INSTITUTE
    8825 AERO DRIVE 200
    SAN DIEGO,CA92123     		  PC ASSISTANCE 27,267
    CALIFORNIA STATE UNIVERSITY NORTHR
    18111 NORDHOFF STREET
    NORTHRIDGE,CA91330     		  PC ASSISTANCE 5,000
    CALIFORNIA STATE UNIVERSITY LONG B
    1250 BELLFLOWER BLVD MS-
    LONG BEACH,CA90804     		  PC ASSISTANCE 13,305
    CALIFORNIA STATE UNIVERSITY SAN BE
    5500 UNIVERSITY PARKWAY
    SAN BERNANDINO,CA92407     		  PC ASSISTANCE 10,000
    CANCER CENTER OF SNATA BARBARA
    300 W PUEBLO ST
    SANTA BARBARA,CA93105     		  PC ASSISTANCE 18,037
    COMMUNITY SENIOR SERVICES
    141 S SPRING STREET
    CLAREMONT,CA91711     		  PC ASSISTANCE 36,213
    CHILDREN'S BUREAU
    1910 MAGNOLIA AVENUE
    LOS ANGELES,CA90007     		  PC ASSISTANCE 3,000
    CHILDREN'S BURN FOUNDATION
    5000 VAN NUYS BLVD
    SHERMAN OAKS,CA91403     		  PC ASSISTANCE 50,000
    CHILDREN'S HOSPITAL OF OC
    1201 W LA VETA AVE
    ORANGE,CA92868     		  PC ASSISTANCE 25,000
    CHILD ABUSE PREVENTION CENTER
    2390 E ORANGEWOOD AVE
    ANAHEIM,CA92806     		  PC ASSISTANCE 10,000
    CITY OF HOPE
    1500 E DUARTE ROAD
    DUARTE,CA91010     		  PC ASSISTANCE 92,069
    COUNCIL ON AGING
    2 EXECUTIVE CIR 175
    IRVINE,CA92697     		  PC ASSISTANCE 25,000
    COMMUNITY SENIORSERV
    1200 N KNOLLWOOD CIRC
    ANAHEIM,CA92801     		  PC ASSISTANCE 76,964
    DAVID & MARGARET HOME
    1350 THIRD STREET
    LA VERNE,CA91750     		  PC ASSISTANCE 69,776
    DARTMOUTH COLLEGE
    6024 MCNUTT HALL
    HANOVER,NH03755     		  PC ASSISTANCE 4,000
    DEAF COMMUNITY SERVICES OF SAN DIEG
    1545 HOTEL CIRCLE SOUTH
    SAN DIEGO,CA92108     		  PC ASSISTANCE 13,191
    FAMILY SUPPORT NETWORK
    1015 S PLACENTIA AVEN
    FULLERTON,CA92831     		  PC ASSISTANCE 39,035
    FAMILIES FORWARD
    8 THOMAS
    IRVINE,CA92618     		  PC ASSISTANCE 25,000
    FIVE ACRES
    760 W MOUNTAIN VIEW ST
    ALTANDENA,CA91001     		  PC ASSISTANCE 95,000
    FULFILLMENT FUND
    6100 WILSHIRE BLVD SUIT
    LOS ANGELES,CA90048     		  PC ASSISTANCE 50,000
    HABITAT FOR HUMANITY - OC
    2200 RITCHEY ST
    SANTA ANA,CA92705     		  PC ASSISTANCE 100,000
    HABITAT FOR HUMANITY EAST BAY
    2619 BROADWAY
    OAKLAND,CA94612     		  PC ASSISTANCE 31,200
    HUMAN OPTIONS
    5540 TRABUCO RD
    IRVINE,CA92620     		  PC ASSISTANCE 25,000
    HABITAT FOR HUMANITY OF GREATER LA
    8739 ARTESIA BLVD
    BELLFLOWER,CA90706     		  PC ASSISTANCE 115,600
    HARVARD UNIVERSITY
    1585 MASSACHUSETTS AVENUE
    CAMBRIDGE,MA02138     		  PC ASSISTANCE 2,000
    HOMEAID ORANGE COUNTY
    24 EXECUTIVE PARK SUI
    IRVINE,CA92614     		  PC ASSISTANCE 10,000
    ILLUMINATION FOUNDATION
    1091 N BATAVIA ST
    ORANGE,CA92867     		  PC ASSISTANCE 75,000
    JEWISH FAMILY SERVICE OF LOS ANGELE
    3580 WILSHIRE BLVD S
    LOS ANGELES,CA90010     		  PC ASSISTANCE 127,069
    JEWISH FAMILY SERVICE OF SAN DIEGO
    8804 BALBOA AVENUE
    SAN DIEGO,CA92123     		  PC ASSISTANCE 9,313
    JEWISH FAMILY AND CHILDEN'S SERVICE
    PO BOX 159004
    SAN FRANCISCO,CA94115     		  PC ASSISTANCE 54,084
    JUST IN TIME FOR FOSTER YOUTH
    PO BOX 81292
    SAN DIEGO,CA92138     		  PC ASSISTANCE 50,137
    KOINONIA HOME FOR TEENS
    PO BOX 1403
    LOOMIS,CA95650     		  PC ASSISTANCE 4,580
    KNOX UNIVERSITY
    2 EAST SOUTH ST
    GALESBURG,IL61401     		  PC ASSISTANCE 5,000
    LAURA'S HOUSE
    999 CORPORATE DRIVE S
    LADERA RANCH,CA92694     		  PC ASSISTANCE 10,000
    LIFESTEPS
    3247 RAMOS CIRCLE
    SACRAMENTO,CA95827     		  PC ASSISTANCE 32,887
    LUCILE PACKARD FND FOR CHILDREN'S H
    400 HAMILTON AVENUE S
    PALO ALTO,CA94307     		  PC ASSISTANCE 3,438
    MARIAN CANCER CENTER
    1400 E CHURCH ST
    SANTA MARIA,CA93454     		  PC ASSISTANCE 19,978
    MERCY HOUSE
    PO BOX 1905
    SANTA ANA,CA92702     		  PC ASSISTANCE 1,542
    MONTEBELLO-COMMERCE YMCA
    2000 W BEVERLY BLVD
    MONTEBELLO,CA90640     		  PC ASSISTANCE 10,000
    NATIONAL MULTIPLE SCLEROSIS SOCIETY
    192 NICKERSON ST SUI
    SEATTLE,WA98109     		  PC ASSISTANCE 4,710
    NEW BEGINNINGS COUNSELING CENTER
    324 EAST CARRILLO STRE
    SANTA BARBARA,CA93101     		  PC ASSISTANCE 72,353
    OLIVE CREST TREATMENT CENTERS
    555 TECHNOLOGY COURT
    RIVERSIDE,CA92507     		  PC ASSISTANCE 9,390
    ORANGE COUNTY FAMILY JUSTICE CENTER
    150 W VERMONT AVENUE
    ANAHEIM,CA92805     		  PC ASSISTANCE 21,147
    ORANGE COUNTY RESCUE MISSION
    ONE HOPE DRIVE
    TUSTIN,CA92782     		  PC ASSISTANCE 86,154
    OPTIMIST YOUTH HOMES
    6957 NORTH FIGUEROA ST
    LOS ANGELES,CA90041     		  PC ASSISTANCE 1,815
    PABLOVE FOUNDATION
    6607 SUNSET BLVD
    LOS ANGELES,CA90028     		  PC ASSISTANCE 70,000
    PARTNERS IN CARE FOUNDATION
    732 MOTT STREET SUITE
    SAN FERNANDO,CA91340     		  PC ASSISTANCE 49,531
    PENNY LANE CENTERS
    15305 RAYEN STREET
    NORTH HILLS,CA91343     		  PC ASSISTANCE 20,185
    PEOPLE SELF-HELP HOUSING
    26 E VICTORIA STREET
    SANTA BARBARA,CA93101     		  PC ASSISTANCE 47,127
    PRINCETON UNIVERSITY
    P O BOX 430
    PRINCETON,NJ08542     		  PC ASSISTANCE 7,000
    PROMISES2KIDS
    9440 RUFFIN COURT SUI
    SAN DIEGO,CA92123     		  PC ASSISTANCE 160,081
    PROGRAM FOR TORTURE VICTIMS
    3550 WILSHIRE BLVD S
    LOS ANGELES,CA90010     		  PC ASSISTANCE 175,960
    PROJECT HOPE ALLIANCE
    1954 PLACENTIA AVENUE
    COSTA MESA,CA92627     		  PC ASSISTANCE 15,000
    RIDLEY TREE CANCER CENTER
    601 WEST JUNIPERO STRE
    SANTA BARBARA,CA93105     		  PC ASSISTANCE 16,741
    ROGERS CENTER FOR HOLOCAUST ED
    ONE UNIVERSITY DRIVE
    ORANGE,CA92866     		  PC ASSISTANCE 15,000
    ORANGE COUNTY RONALD MCDONALD HOUSE
    383 S BATAVIA STREET
    ORANGE,CA92868     		  PC ASSISTANCE 10,000
    SCAN
    3800 KILROY AIRPORT WA
    LONG BEACH,CA90806     		  PC ASSISTANCE 18,415
    SMITH COLLEGE
    7 COLLEGE LANE
    NORTHAMPTON,MA01063     		  PC ASSISTANCE 2,000
    SAN DIEGO STATE UNIVERSITY
    5500 CAMPANILE DRIVE
    SAN DIEGO,CA92182     		  PC ASSISTANCE 10,000
    SAN FRANCISCO STATE UNIVERSITY
    1600 HOLLOWAY
    SAN FRANCISCO,CA94132     		  PC ASSISTANCE 5,000
    SAN JOSE STATE UNIVERSITY
    ONE WASHINGTON SQUARE
    SAN JOS,CA95192     		  PC ASSISTANCE 7,000
    SANTA CLARA UNIVERSITY
    500 EL CAMINO REAL
    SANTA CLARA,CA95053     		  PC ASSISTANCE 5,000
    SCRS
    800 LINDEN ST
    SCRANTON,PA18510     		  PC ASSISTANCE 10,398
    SECOND STORY ASSOCIATES
    808 LAGUNA STREET
    SANTA BARBARA,CA93101     		  PC ASSISTANCE 6,371
    ST JOSEPH HOSPITAL
    1100 WEST STEWART
    ORANGE,CA92868     		  PC ASSISTANCE 300
    ST MARYS COLLEGE OF CALIFORNIA
    PMB 4530
    MORAGA,CA94575     		  PC ASSISTANCE 5,000
    SO CA RESOURCE SERVICES FOR IND LIV
    7830 QUILL DRIVE STE
    DOWNEY,CA90242     		  PC ASSISTANCE 36,804
    SURVIVORS OF TORTURE
    PO BOX 151240
    SAN DIEGO,CA92175     		  PC ASSISTANCE 120,136
    TEXAS A&M UNIVERSITY
    PO BOX 30016
    COLLEGE STATION,TX77842     		  PC ASSISTANCE 5,000
    THE UNDERGROUND MUSEUM
    3508 W WASHINGTON BLVD
    LOS ANGELES,CA90018     		  PC ASSISTANCE 50,000
    UNIVERSITY OF CALIFORNIA SANTA CRU
    1156 HIGH ST
    SANT CRUZ,CA95064     		  PC ASSISTANCE 10,000
    UNIVERSITY OF CALIFORNIA IRVINE
    102 ALDRICH HALL
    IRVINE,CA92697     		  PC ASSISTANCE 19,538
    UNIVERSITY OF CALIFORNIA SAN DIEGO
    9500 GILMAN DRIVE DEPT 0
    LA JOLLA,CA92093     		  PC ASSISTANCE 29,000
    UNITED CEREBRAL PALSY OF SAN DIEGO
    8525 GIBBS DRIVE SUIT
    SAN DIEGO,CA92123     		  PC ASSISTANCE 20,486
    UNIVERSITY OF CALIFORNIA BERKELEY
    18 SPROUL HALL 1960
    BERKELEY,CA94720     		  PC ASSISTANCE 50,000
    CALIFORNIA STATE UNIVERSITY LOS AN
    5151 STATE UNIVERSITY DR
    LOS ANGELES,CA90032     		  PC ASSISTANCE 28,700
    UNIVERSITY OF CA SANTA BARBARA
    1210 CHEADLE HALL
    SANTA BARBARA,CA93106     		  PC ASSISTANCE 9,215
    USC FINANCIAL AID OFFICE
    700 CHILDS WAY JHH 325
    LOS ANGELES,CA90089     		  PC ASSISTANCE 9,000
    UNIVERSITY OF PENNSYLVANIA
    3451 WALNUT STREET
    PHILADELPHIA,PA19104     		  PC ASSISTANCE 5,380
    VIOLENCE INTERVENTION PROGRAM
    1721 GRIFFIN AVE
    LOS ANGELES,CA90031     		  PC ASSISTANCE 50,000
    VENICE FAMILY CLINIC
    905 VENICE BLVD
    VENICE,CA90291     		  PC ASSISTANCE 75,000
    WASHINGTON UNIVERSITY IN ST LOUIS
    ONE BROOKINGS DR
    ST LOUIS,MO63130     		  PC ASSISTANCE 5,000
    WITH HOPE THE AMBER CRAIG MEMO
    P O BOX 550
    PLACENTIA,CA92871     		  PC ASSISTANCE 10,000
    YALE UNIVERSITY
    PO BOX 208232
    NEW HAVEN,CT06520     		  PC ASSISTANCE 6,450
    FILM2FUTURE
    8111 BEVERLY BLVD
    LOS ANGELES,CA90048     		  PC ASSISTANCE 50,000
    LOS ANGELES JEWISH HOME
    7150 TAMPA AVE
    RESEDA,CA91335     		  PC ASSISTANCE 50,000
    THE METROPOLITAN MUSEUM OF ART
    1000 5TH STREET
    NEW YORK,NY10028     		  PC ASSISTANCE 25,000
    ORANGE COUNTY COMMUNITY FDTN
    4041 MACARTHUR BLVD 510
    NEWPORT BEACH,CA92660     		  PC ASSISTANCE 50,000
    PROJECT ACCESS
    2100 W ORANGEWOOD AVE
    ORANGE,CA92868     		  PC ASSISTANCE 11,649
    PRETEND CITY
    29 HUBBLE IRVINE CA
    IRVINE,CA92618     		  PC ASSISTANCE 10,000
    BEVERLY HOSPITAL
    309 W BEVERLY BLVD
    MONTEBELLO,CA90644     		  PC ASSISTANCE 14,750
    BOYS & GIRLS CLUBS
    2635 PASADENA AVE
    LOS ANGELES,CA90031     		  PC ASSISTANCE 50,000
    CALIFORNIA STATE UNIVERSITY
    1000 E VICTORIA STREET
    CARSON,CA90747     		  PC ASSISTANCE 9,000
    CHAPMAN UNIVERSITY
    ONE UNIVERSITY DRIVE
    ORANGE,CA92866     		  PC ASSISTANCE 5,000
    COLUMBIA UNIVERSITY
    1130 AMSTERDAM AVE
    NEW YORK,NY10027     		  PC ASSISTANCE 5,000
    SOUTH COUNTY OUTREACH
    7 WHATNEY SUITE B
    IRVINE,CA92618     		  PC ASSISTANCE 9,459
    TAHIIH JUSTICE CENTER
    6402 ARLINGTON BLVD
    FALLS CHURCH,VA22042     		  PC ASSISTANCE 50,000
    UNIVERSITY OF CA DAVIS
    1 SHIELDS AVE
    DAVIS,CA95616     		  PC ASSISTANCE 5,000
    CASA YOUTH SHELTER
    10911 REGAN ST
    LOS ALAMITOS,CA90720     		  PC ASSISTANCE 20,000
    CASA TERESA
    P O BOX 429
    ORANGE,CA92865     		  PC ASSISTANCE 9,600
    LIFE ROLLS ON FOUNDATION
    2901 WASHINGTON BLVD
    LOS ANGELES CA,CA90292     		  PC ASSISTANCE 5,500
    OTHER
    VARIOUS
    VARIOUS,CA92092     		  PC ASSISTANCE 11,213
    Total .................................bullet 3a 3,356,676
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3 Interest on savings and temporary cash
    investments ...........     		         
    4 Dividends and interest from securities....          
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income.....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		         
    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)..      
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
     
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 13
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.

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

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


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


    Software ID:  
    Software Version:  


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

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

    33-0935713
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ






    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......... Arrow Bullet $  
    Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
    Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2
    Name of organization
    CHANGE A LIFE FOUNDATION
          		Employer identification number
    33-0935713
    Part I
    Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    1
    SWFF
     
    6970 S CIMARRON ROAD STE 170
     
    LAS VEGAS, NV89113

    		$ 3,500,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
    Page 3
    Name of organization
    CHANGE A LIFE FOUNDATION
          		Employer identification number

    33-0935713
    Part II
    Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
    Page 4
    Name of organization
    CHANGE A LIFE FOUNDATION
          		Employer identification number

    33-0935713
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

    Additional Data


    Software ID:  
    Software Version:  

    TY 2018 AccountingFeesSchedule
    Name:
    CHANGE A LIFE FOUNDATION
    EIN:
    33-0935713
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INDIRECT ACCOUNTING FEES 38,425      

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

    TY 2018 DepreciationSchedule
    Name:
    CHANGE A LIFE FOUNDATION
    EIN:
    33-0935713
    Description of Property Date Acquired Cost or Other Basis Prior Years' Depreciation Computation Method Rate /
    Life (# of years)    		 Current Year's Depreciation Expense Net Investment Income Adjusted Net Income Cost of Goods Sold Not Included
    DEPRECIATION           1,374      

    TY 2018 InvestmentsLandSchedule2
    Name:
    CHANGE A LIFE FOUNDATION
    EIN:
    33-0935713
    Category/ Item Cost/Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
    FURNITURE & EQUIPMENT 39,120 38,836 284 284

    TY 2018 OtherAssetsSchedule
    Name:
    CHANGE A LIFE FOUNDATION
    EIN:
    33-0935713
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    DEPOSITS 3,200    
    OTHER RECEIVABLES 33,406    
    WATCHES 13,902    


    TY 2018 OtherExpensesSchedule
    Name:
    CHANGE A LIFE FOUNDATION
    EIN:
    33-0935713
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    EXPENSES        
    OFFICE EXPENSES 12,528      
    POSTAAGE & DELIVERY 4,445      
    TELEPHONE 4,375      
    WEBSITE EXPENSES 4,296      
    INSURANCE 3,853      
    SUPPLIES 2,657      
    COMPUTER EXPENSES 1,540      


    TY 2018 OtherProfessionalFeesSchedule
    Name:
    CHANGE A LIFE FOUNDATION
    EIN:
    33-0935713
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ADP CHARGES 1,477      
    OTHER 550      


    TY 2018 TaxesSchedule
    Name:
    CHANGE A LIFE FOUNDATION
    EIN:
    33-0935713
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INDIRECT TAXES/LICENSES 728