-
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
01-01-2019
, and ending
12-31-2019
Name of foundation
D RICHARD MEAD CHARITABLE FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)
PO BOX 803878
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CHICAGO
,
IL
60680
A Employer identification number
65-6106335
B
Telephone number (see instructions)
(312) 630-6000
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)
$
2,886,026
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
...
107,135
80,480
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
33,611
b
Gross sales price for all assets on line 6a
1,365,782
7
Capital gain net income (from Part IV, line 2)
...
33,611
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
........
140,746
114,091
13
Compensation of officers, directors, trustees, etc.
10,308
3,960
6,348
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)
.......
2,500
1,250
0
1,250
c
Other professional fees (attach schedule)
....
0
17
Interest
...............
0
18
Taxes (attach schedule) (see instructions)
...
1,540
1,540
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)
.......
65
50
15
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
14,413
6,800
0
7,613
25
Contributions, gifts, grants paid
.......
132,250
132,250
26
Total expenses and disbursements.
Add lines 24 and 25
146,663
6,800
0
139,863
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-5,917
b
Net investment income
(if negative, enter -0-)
107,291
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
.........
-4,876
148,911
148,911
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)
.......
1,789,599
1,632,540
1,959,502
c
Investments—corporate bonds (attach schedule)
.......
672,541
668,360
668,757
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
84,236
84,236
108,856
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)
2,541,500
2,534,047
2,886,026
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
........
2,541,500
2,534,047
27
Paid-in or capital surplus, or land, bldg., and equipment fund
28
Retained earnings, accumulated income, endowment, or other funds
29
Total net assets or fund balances
(see instructions)
.....
2,541,500
2,534,047
30
Total liabilities and net assets/fund balances
(see instructions)
.
2,541,500
2,534,047
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
2,541,500
2
Enter amount from Part I, line 27a
.....................
2
-5,917
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
2,535,583
5
Decreases not included in line 2 (itemize)
5
1,536
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
2,534,047
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
26. AFLAC INC
2017-09-25
2019-01-11
b
212. AFLAC INC
2017-09-25
2019-03-20
c
9. AMC NETWORKS INC CL A
2017-08-01
2019-01-11
d
26. AMC NETWORKS INC CL A
2017-08-01
2019-09-03
e
106. AMC NETWORKS INC CL A
2017-08-01
2019-12-10
28. AT&T INC
2017-08-01
2019-09-03
18. ALLISON TRANSMISSION HOLDING
2018-10-02
2019-01-11
18. ALLISON TRANSMISSION HOLDING
2018-10-02
2019-09-03
3. ALPHABET INC CAPITAL STOCK USD0.001 CL A
2017-08-01
2019-01-11
3. ALPHABET INC CAPITAL STOCK USD0.001 CL A
2012-01-13
2019-09-03
198. ALTRIA GROUP INC
2018-05-25
2019-03-20
1. AMAZON COM INC
2017-08-01
2019-01-11
2. AMAZON COM INC
2018-05-25
2019-09-03
11. AMERISOURCE BERGEN CORP
2019-03-20
2019-08-20
15. AMERISOURCE BERGEN CORP
2019-03-20
2019-09-03
7. AMGEN INC
2018-01-04
2019-01-11
15. AMGEN INC
2017-08-01
2019-09-03
2. AMGEN INC
2017-08-01
2019-12-10
18. APPLE COMPUTER INC
2017-09-25
2019-01-11
29. APPLE COMPUTER INC
2009-07-07
2019-09-03
6. APPLE COMPUTER INC
2009-07-07
2019-12-10
28. APPLIED MATERIALS INC
2017-08-01
2019-01-11
185. APPLIED MATERIALS INC
2017-08-01
2019-03-20
78. APPLIED MATERIALS INC
2018-10-02
2019-03-20
73. ARCHER DANIELS MIDLAND CO
2018-10-02
2019-08-20
1. AUTOZONE INC
2019-08-20
2019-09-03
50. #REORG/ AXA NAME CHANGE WITH CUSIP CHANGE EQUITABLE HLDGS 2B15AY3
2019-03-21
2019-09-03
30. #REORG/ AXA NAME CHANGE WITH CUSIP CHANGE EQUITABLE HLDGS 2B15AY3
2019-03-21
2019-12-10
23. BAXTER INTL INC
2013-12-11
2019-01-11
22. BAXTER INTL INC
2013-12-11
2019-08-20
16. BAXTER INTL INC
2013-12-11
2019-09-03
4. BERKSHIRE HATHAWAY INC-CL B
2017-09-25
2019-01-11
12. BERKSHIRE HATHAWAY INC-CL B
2017-09-25
2019-09-03
12. BEST BUY INC
2017-08-01
2019-01-11
9. BEST BUY INC
2017-08-01
2019-09-03
14. BEST BUY INC
2017-08-01
2019-12-10
6. BIOGEN INC COMMON STOCK
2019-03-20
2019-09-03
27. H & R BLOCK INC
2017-08-01
2019-08-20
45. H & R BLOCK INC
2017-08-01
2019-09-03
4. BOEING CO
2017-08-01
2019-01-11
44. BOEING CO
2017-08-01
2019-08-20
35. BOOZ ALLEN HAMILTON HLDG CORP CL A COM STK
2019-03-20
2019-08-20
17. BOOZ ALLEN HAMILTON HLDG CORP CL A COM STK
2019-03-20
2019-09-03
96. BOOZ ALLEN HAMILTON HLDG CORP CL A COM STK
2019-03-20
2019-12-10
26. BRIGHTHOUSE FINL INC COM
2019-03-20
2019-09-03
141. BRIGHTHOUSE FINL INC COM
2019-03-20
2019-12-10
228. BRISTOL MYERS SQUIBB CO
2019-03-20
2019-08-20
25. CBRE GROUP INC CL A CL A
2019-08-20
2019-09-03
5. CBRE GROUP INC CL A CL A
2019-08-20
2019-12-10
98. C H ROBINSON WORLDWIDE INC COM NEW COM NEW
2019-03-20
2019-08-20
7. CIGNA CORP NEW COM
2012-01-24
2019-01-11
.18 CIGNA CORP NEW COM
2017-04-26
2019-01-17
77. CIGNA CORP NEW COM
2017-08-01
2019-03-20
36. CIT GROUP INC NEW COM NEW COM NEW
2018-05-25
2019-09-03
11. CAPITAL ONE FINL CORP
2018-01-04
2019-01-11
19. CAPITAL ONE FINL CORP
2018-01-04
2019-09-03
7. CAPITAL ONE FINL CORP
2018-01-04
2019-12-10
5. CELGENE CORP
2019-03-20
2019-09-03
22. CELGENE CORP
2019-03-20
2019-11-21
9. CHEVRONTEXACO CORP
2018-01-04
2019-01-11
22. CHEVRONTEXACO CORP
2018-01-04
2019-09-03
37. CISCO SYS INC
2017-08-01
2019-01-11
31. CISCO SYS INC
2017-08-01
2019-03-20
49. CISCO SYS INC
2017-08-01
2019-09-03
19. CITIGROUP INC COM NEW COM NEW
2013-10-25
2019-01-11
40. CITIGROUP INC COM NEW COM NEW
2014-07-17
2019-09-03
10. CITIGROUP INC COM NEW COM NEW
2014-07-17
2019-12-10
23. CITIZENS FINL GROUP INC COM
2018-05-25
2019-01-11
33. CITIZENS FINL GROUP INC COM
2018-05-25
2019-09-03
9. CITRIX SYS INC
2017-08-01
2019-01-11
82. CITRIX SYS INC
2017-09-25
2019-08-20
16. CONOCOPHILLIPS
2017-08-01
2019-01-11
30. CONOCOPHILLIPS
2017-08-01
2019-09-03
4. CUMMINS ENGINE INC
2017-09-25
2019-01-11
7. CUMMINS ENGINE INC
2017-09-25
2019-03-20
7. CUMMINS ENGINE INC
2017-09-25
2019-09-03
5. CUMMINS ENGINE INC
2017-09-25
2019-12-10
2127.66 MFO DFA INVT DIMENSIONS GROUP INC U S CORE EQUITY 1 PORT
2017-12-14
2019-09-03
83.81 MFO DFA INVT DIMENSIONS GROUP INC TAX-MANAGED US 6-10 SMALL CO P
2018-12-18
2019-09-03
2682.63 MFO DFA INVT DIMENSIONS GROUP INC TAX-MANAGED US 6-10 SMALL CO
2017-12-15
2019-09-03
4. DARDEN RESTAURANTS INC
2017-08-01
2019-01-11
18. DARDEN RESTAURANTS INC
2017-08-01
2019-09-03
28. DARDEN RESTAURANTS INC
2017-08-01
2019-12-10
33. DARDEN RESTAURANTS INC
2019-03-20
2019-12-10
26. DICK'S SPORTING GOODS INC
2018-10-02
2019-01-11
246. DICK'S SPORTING GOODS INC
2018-10-02
2019-08-20
14. WALT DISNEY CO
2018-10-02
2019-01-11
42. WALT DISNEY CO
2018-10-02
2019-08-20
84. WALT DISNEY CO
2018-10-02
2019-08-20
14. DOMTAR CORP COM NEW COM NEW
2018-01-04
2019-01-11
166. DOMTAR CORP COM NEW COM NEW
2018-01-04
2019-08-20
34. EBAY INC
2019-08-20
2019-09-03
10. ENTERGY CORP NEW
2017-08-01
2019-01-11
13. ENTERGY CORP NEW
2017-08-01
2019-03-20
16. ENTERGY CORP NEW
2018-05-25
2019-08-20
12. ENTERGY CORP NEW
2017-08-01
2019-09-03
29. EQUITY COMMONWEALTH USD0.01( BNF INT) INT
2018-10-02
2019-01-11
271. EQUITY COMMONWEALTH USD0.01( BNF INT) INT
2018-10-02
2019-03-20
36. EQUITY COMMONWEALTH USD0.01( BNF INT) INT
2019-08-20
2019-09-03
32. EXELON CORP
2019-03-20
2019-09-03
22. EXXON MOBIL CORP
2016-06-28
2019-01-11
41. EXXON MOBIL CORP
2009-07-07
2019-09-03
123. EXXON MOBIL CORP
2009-07-07
2019-12-10
72. EXXON MOBIL CORP
2019-03-20
2019-12-10
5. FACEBOOK INC COM USD0.000006 CL 'A'
2018-01-04
2019-01-11
11. FACEBOOK INC COM USD0.000006 CL 'A'
2017-08-01
2019-09-03
36. FIFTH THIRD BANCORP
2017-08-01
2019-01-11
45. FIFTH THIRD BANCORP
2018-10-02
2019-08-20
289. FIFTH THIRD BANCORP
2017-08-01
2019-08-20
19. FOOT LOCKER INC
2018-10-02
2019-01-11
36. FOOT LOCKER INC
2018-10-02
2019-03-20
139. FOOT LOCKER INC
2018-10-02
2019-08-20
42. FRANKLIN RESOURCES INC
2019-08-20
2019-09-03
232. FRANKLIN RESOURCES INC
2019-08-20
2019-12-10
25. GENERAL MILLS INC
2019-08-20
2019-09-03
47. GENTEX CORP
2019-08-20
2019-09-03
17. GILEAD SCIENCES INC
2016-06-07
2019-01-11
160. GILEAD SCIENCES INC
2018-01-04
2019-03-20
.99 GLOBAL PMTS INC
2017-08-01
2019-09-18
46. GLOBAL PMTS INC
2017-08-01
2019-12-10
7. GOLDMAN SACHS GROUP INC
2017-08-01
2019-09-03
288. HCP, INC
2019-03-20
2019-08-20
26. HD SUPPLY HLDGS INC. COM
2018-01-04
2019-01-11
209. HD SUPPLY HLDGS INC. COM
2018-01-04
2019-08-20
42. HP INC COM
2018-05-25
2019-01-11
398. HP INC COM
2018-05-25
2019-08-20
70. HP INC COM
2019-03-20
2019-08-20
11. HILL-ROM HLDGS INC COM STK
2019-03-20
2019-09-03
66. HILL-ROM HLDGS INC COM STK
2019-03-20
2019-12-10
127. HOLLYFRONTIER CORP COM
2017-09-25
2019-08-20
11. HOME DEPOT INC
2012-01-23
2019-01-11
29. HOME DEPOT INC
2012-01-23
2019-03-20
54. HOST MARRIOTT CORP NEW REIT
2017-08-01
2019-01-11
52. HOST MARRIOTT CORP NEW REIT
2017-08-01
2019-09-03
10. HUBBELL INC COM
2019-08-20
2019-09-03
6. HUNTINGTON INGALLS INDS INC COM
2017-08-01
2019-01-11
35. HUNTINGTON INGALLS INDS INC COM
2017-08-01
2019-08-20
34. HUNTSMAN CORP COM STK
2017-08-01
2019-01-11
142. HUNTSMAN CORP COM STK
2019-03-20
2019-08-20
234. HUNTSMAN CORP COM STK
2017-08-01
2019-08-20
4. IDEXX LABS INC
2018-05-25
2019-01-11
38. IDEXX LABS INC
2018-05-25
2019-03-20
4. INTEL CORP
2018-05-25
2019-01-11
35. INTEL CORP
2018-01-04
2019-01-11
39. INTEL CORP
2018-05-25
2019-03-20
42.00027 INTEL CORP
2018-05-25
2019-09-03
8.99973 INTEL CORP
2018-05-25
2019-09-03
15. INTEL CORP
2018-05-25
2019-12-10
16. INTL BUSINESS MACHINES CORP
2017-09-25
2019-09-03
15. J P MORGAN CHASE & CO
2018-01-04
2019-01-11
11. J P MORGAN CHASE & CO
2018-01-04
2019-09-03
66. JEFFERIES FINL GROUP INC COM
2019-08-20
2019-09-03
14. JEFFERIES FINL GROUP INC COM
2019-08-20
2019-12-10
16. JOHNSON & JOHNSON
2017-08-01
2019-01-11
32. JOHNSON & JOHNSON
2017-08-01
2019-09-03
68. JOHNSON & JOHNSON
2017-08-01
2019-12-10
5. JONES LANG LASALLE INC
2018-05-25
2019-01-11
50. JONES LANG LASALLE INC
2018-05-25
2019-08-20
10. KLA-TENCOR CORP
2017-09-25
2019-01-11
17. KLA-TENCOR CORP
2017-08-01
2019-03-20
10. KLA-TENCOR CORP
2017-08-01
2019-08-20
10. KLA-TENCOR CORP
2017-08-01
2019-09-03
4. KLA-TENCOR CORP
2018-10-02
2019-12-10
13. KIMBERLY CLARK CORP
2018-05-25
2019-01-11
20. KIMBERLY CLARK CORP
2018-05-25
2019-08-20
11. KIMBERLY CLARK CORP
2018-05-25
2019-09-03
67. KIMCO REALTY CORP
2019-08-20
2019-09-03
370. KIMCO REALTY CORP
2019-08-20
2019-12-10
13. KOHLS CORP
2018-10-02
2019-01-11
119. KOHLS CORP
2018-10-02
2019-08-20
35. KROGER CO
2018-10-02
2019-01-11
329. KROGER CO
2018-10-02
2019-08-20
14. LAM RESEARCH CORP
2019-03-20
2019-09-03
5. LAM RESEARCH CORP
2019-03-20
2019-12-10
17. LAMAR ADVERTISING CO NEW CL A CL A
2019-03-20
2019-09-03
91. LAMAR ADVERTISING CO NEW CL A CL A
2019-03-20
2019-12-10
10. LANDSTAR SYSTEM INC
2018-05-25
2019-01-11
9. LANDSTAR SYSTEM INC
2018-05-25
2019-09-03
61. LEAR CORP COM NEW COM NEW
2019-03-20
2019-08-20
12. ELI LILLY & CO
2018-10-02
2019-01-11
117. ELI LILLY & CO
2018-10-02
2019-03-20
16. ELI LILLY & CO
2019-08-20
2019-09-03
5. LOCKHEED MARTIN CORP
2019-08-20
2019-09-03
15. MANHATTAN ASSOCS INC COM
2019-08-20
2019-09-03
33. MASCO CORP
2019-08-20
2019-09-03
16. MASCO CORP
2019-08-20
2019-12-10
14. MATCH GROUP INC COM
2019-08-20
2019-09-03
81. MATCH GROUP INC COM
2019-08-20
2019-12-10
13. MCKESSON HBOC INC
2019-03-20
2019-08-20
9. MCKESSON HBOC INC
2019-03-20
2019-09-03
28. MERCK & CO INC
2019-08-20
2019-09-03
10. METLIFE INC
2019-03-20
2019-08-20
31. METLIFE INC
2019-03-20
2019-09-03
39. MICROSOFT CORP COM
2017-08-01
2019-01-11
38. MICROSOFT CORP COM
2017-08-01
2019-03-20
46. MICROSOFT CORP COM
2017-08-01
2019-09-03
24. MORGAN STANLEY DEAN WITTER & CO NEW
2017-08-01
2019-01-11
36. MORGAN STANLEY DEAN WITTER & CO NEW
2017-08-01
2019-09-03
12. MORGAN STANLEY DEAN WITTER & CO NEW
2017-08-01
2019-12-10
83. NAVIENT CORP COM
2017-08-01
2019-08-20
93. NAVIENT CORP COM
2017-08-01
2019-09-03
9. NETAPP INC COM STK
2018-05-25
2019-01-11
82. NETAPP INC COM STK
2018-05-25
2019-03-20
3. NETFLIX INC COM STK
2019-03-20
2019-09-03
8912.66 MFB NORTHN INTL EQTY INDEX FD
2014-11-17
2019-01-10
4233.7 MFB NORTHN INTL EQTY INDEX FD
2014-11-17
2019-08-30
6582.41 MFB NORTHN FDS SHORT BD FD
2013-07-03
2019-01-03
7.2 MFB NORTHN FDS SHORT BD FD
2019-01-03
2019-01-03
1353.79 MFB NORTHN FUNDS EMERGING MKTS EQTY EQTY INDEX FD
2009-12-23
2019-01-10
2719.86 MFB NORTHN FUNDS EMERGING MKTS EQTY EQTY INDEX FD
2009-12-23
2019-08-30
4770.99 MFB NORTHERN FDS FIXED INCOME FD
2013-12-19
2019-08-30
22. OMNICOM GROUP
2017-08-01
2019-03-20
23. OMNICOM GROUP
2017-08-01
2019-09-03
28. ORACLE CORPORATION
2018-10-02
2019-01-11
31. ORACLE CORPORATION
2018-10-02
2019-03-20
12. ORACLE CORPORATION
2018-10-02
2019-08-20
36. ORACLE CORPORATION
2018-10-02
2019-09-03
13. OSHKOSH TRUCK CORP CL B
2019-03-20
2019-09-03
16. OSHKOSH TRUCK CORP CL B
2019-03-20
2019-12-10
29. PBF ENERGY INC CL A CL A
2018-05-25
2019-01-11
174. PBF ENERGY INC CL A CL A
2018-05-25
2019-03-20
47. PARK HOTELS & RESORTS INC COM
2017-09-25
2019-01-11
271. PARK HOTELS & RESORTS INC COM
2017-09-25
2019-08-20
7. PEPSICO INC
2017-08-01
2019-01-11
10. PEPSICO INC
2017-08-01
2019-09-03
45. PFIZER INC
2018-01-04
2019-01-11
93. PFIZER INC
2018-01-04
2019-03-20
326. PFIZER INC
2017-08-01
2019-08-20
20. PHILIP MORRIS INTERNATIONAL
2019-03-20
2019-09-03
109. PHILIP MORRIS INTERNATIONAL
2019-03-20
2019-12-10
8. PROCTER & GAMBLE CO
2019-08-20
2019-09-03
8. PRUDENTIAL FINL INC
2018-01-04
2019-01-11
101. PRUDENTIAL FINL INC
2018-05-25
2019-08-20
15. PUBLIC SVC ENTERPRISE GROUP INC
2017-08-01
2019-01-11
24. PUBLIC SVC ENTERPRISE GROUP INC
2017-08-01
2019-09-03
13. REGAL BELOIT CORP
2017-08-01
2019-01-11
103. REGAL BELOIT CORP
2018-01-04
2019-03-20
44. REGIONS FINL CORP NEW COM
2017-08-01
2019-01-11
87. REGIONS FINL CORP NEW COM
2017-08-01
2019-09-03
14. REGIONS FINL CORP NEW COM
2017-08-01
2019-12-10
13. RELIANCE STEEL & ALUMINUM COM
2019-08-20
2019-09-03
8. RELIANCE STEEL & ALUMINUM COM
2019-08-20
2019-12-10
19. ROBERT HALF INTL INC
2018-05-25
2019-01-11
21. ROBERT HALF INTL INC
2018-05-25
2019-09-03
11. SCOTTS CO CL A
2019-08-20
2019-09-03
27. SINCLAIR BROADCAST GROUP INC CL A
2019-08-20
2019-09-03
152. SINCLAIR BROADCAST GROUP INC CL A
2019-08-20
2019-12-10
19. SOUTHWEST AIRLINES CO
2019-08-20
2019-09-03
.22 SPECTRUM BRANDS HLDGS INC COM USD0.01
2019-10-11
2019-10-11
9. SPECTRUM BRANDS HLDGS INC COM USD0.01
2019-10-11
2019-12-10
12. SPIRIT AEROSYSTEMS HLDGS INC CL A
2019-08-20
2019-09-03
31. STEEL DYNAMICS INC COM
2019-03-20
2019-08-20
207. STEEL DYNAMICS INC COM
2017-09-25
2019-08-20
15. SUNTRUST BANKS INC
2018-10-02
2019-01-11
148. SUNTRUST BANKS INC
2018-10-02
2019-03-20
20. SYSCO CORP
2019-08-20
2019-09-03
4. SYSCO CORP
2019-08-20
2019-12-10
4. 3M CO
2017-08-01
2019-01-11
30. 3M CO
2017-08-01
2019-03-20
19. TOTAL SYSTEMS SERVICE
2017-08-01
2019-01-11
26. TOTAL SYSTEMS SERVICE
2017-08-01
2019-08-20
10. TOTAL SYSTEMS SERVICE
2017-08-01
2019-09-03
15. UGI CORP NEW COM
2017-08-01
2019-01-11
23. UGI CORP NEW COM
2017-08-01
2019-09-03
123. UGI CORP NEW COM
2017-08-01
2019-12-10
12. UNITED AIRLINES HOLDINGS INC COM USD0.01
2018-10-02
2019-01-11
107. UNITED AIRLINES HOLDINGS INC COM USD0.01
2018-10-02
2019-08-20
4. UNITEDHEALTH GROUP INC
2018-01-04
2019-01-11
10. UNITEDHEALTH GROUP INC
2018-05-25
2019-09-03
45. UNITEDHEALTH GROUP INC
2018-10-02
2019-12-10
7. UNITEDHEALTH GROUP INC
2019-08-20
2019-12-10
9. VALERO ENERGY CORP NEW
2017-08-01
2019-01-11
84. VALERO ENERGY CORP NEW
2017-08-01
2019-03-20
15. VARIAN MED SYS INC
2017-08-01
2019-01-11
9. VARIAN MED SYS INC
2017-08-01
2019-03-20
63. VARIAN MED SYS INC
2017-08-01
2019-08-20
46. VERIZON COMMUNICATIONS
2018-01-04
2019-01-11
18. VERIZON COMMUNICATIONS
2018-01-04
2019-03-20
55. VERIZON COMMUNICATIONS
2018-01-04
2019-09-03
30. VIACOM INC
2018-10-02
2019-01-11
.76 VIACOMCBS INC NPV
2018-10-02
2019-12-05
165. VIACOMCBS INC NPV
2018-10-02
2019-12-10
11. VISA INC CLASS A SHARES
2018-05-25
2019-09-03
14. VISA INC CLASS A SHARES
2019-08-20
2019-12-10
16. WALGREENS BOOTS ALLIANCE INC COM
2018-10-02
2019-01-11
16. WALGREENS BOOTS ALLIANCE INC COM
2018-05-25
2019-09-03
4. WATERS CORP
2017-09-25
2019-01-11
9. WATERS CORP
2017-09-25
2019-03-20
3. #REORG/WELLCARE HEALTH CASH AND STOCK MERGER CENTENE CORP 2113732 0
2018-05-25
2019-01-11
29. #REORG/WELLCARE HEALTH CASH AND STOCK MERGER CENTENE CORP 2113732
2018-05-25
2019-03-20
28. WELLS FARGO & CO NEW
2009-07-07
2019-08-20
27. WESTERN UNION CO
2017-08-01
2019-01-11
464. WESTERN UNION CO
2018-01-04
2019-03-20
279. WEYERHAEUSER CO
2018-05-25
2019-03-20
22. WYNDHAM DESTINATIONS INC COM STK
2018-10-02
2019-01-11
41. WYNDHAM DESTINATIONS INC COM STK
2018-10-02
2019-09-03
17. WYNDHAM DESTINATIONS INC COM STK
2018-10-02
2019-12-10
9. ZEBRA TECHNOLOGIES CORP CL A
2018-05-25
2019-01-11
12. ZEBRA TECHNOLOGIES CORP CL A
2018-05-25
2019-03-20
6. ZEBRA TECHNOLOGIES CORP CL A
2018-05-25
2019-09-03
11. AMDOCS LTD ORD
2019-08-20
2019-09-03
22. ASSURED GUARANTY LTD COMMON STK
2018-05-25
2019-01-11
55. ASSURED GUARANTY LTD COMMON STK
2018-05-25
2019-09-03
3. ASSURED GUARANTY LTD COMMON STK
2018-05-25
2019-12-10
11. ACCENTURE PLC SHS CL A NEW
2018-01-04
2019-01-11
10. ACCENTURE PLC SHS CL A NEW
2018-01-04
2019-08-20
10. ACCENTURE PLC SHS CL A NEW
2018-01-04
2019-09-03
16. CAPRI HOLDINGS LTD COM NPV
2017-09-25
2019-01-11
131. CAPRI HOLDINGS LTD COM NPV
2017-09-25
2019-03-20
13. HERBALIFE NUTRITION LTD COM STK
2018-05-25
2019-01-11
161. HERBALIFE NUTRITION LTD COM STK
2018-05-25
2019-08-20
10. INGERSOLL-RAND PLC COM STK
2017-08-01
2019-01-11
93. INGERSOLL-RAND PLC COM STK
2017-08-01
2019-03-20
15. MEDTRONIC PLC COMMON STOCK STOCK
2019-08-20
2019-09-03
10. LYONDELLBASELL IND N V COM USD0.01 CL 'A'
2017-08-01
2019-01-11
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
1,188
1,095
93
b
10,500
8,928
1,572
c
555
575
-20
d
1,224
1,661
-437
e
3,904
6,774
-2,870
986
1,094
-108
852
948
-96
780
948
-168
3,190
2,853
337
3,545
939
2,606
10,984
11,056
-72
1,646
1,000
646
3,590
3,220
370
966
876
90
1,247
1,195
52
1,398
1,240
158
3,087
2,624
463
469
350
119
2,739
2,442
297
5,942
564
5,378
1,613
117
1,496
971
1,235
-264
7,320
8,160
-840
3,086
3,051
35
2,744
3,686
-942
1,103
1,105
-2
1,004
1,043
-39
734
626
108
1,534
855
679
1,935
818
1,117
1,405
595
810
783
728
55
2,410
2,118
292
686
708
-22
571
531
40
1,163
826
337
1,307
1,932
-625
741
830
-89
1,100
1,383
-283
1,408
963
445
14,592
10,593
3,999
2,578
1,990
588
1,286
966
320
6,833
5,457
1,376
884
997
-113
5,555
5,407
148
10,811
11,250
-439
1,283
1,313
-30
291
263
28
8,240
8,519
-279
1,352
1,275
77
33
33
12,923
13,578
-655
1,486
1,879
-393
884
1,120
-236
1,609
1,934
-325
715
712
3
482
444
38
2,377
1,952
425
1,012
1,150
-138
2,537
2,657
-120
1,601
1,167
434
1,654
978
676
2,275
1,546
729
1,085
951
134
2,514
2,002
512
759
497
262
750
954
-204
1,076
1,369
-293
953
713
240
7,575
6,457
1,118
1,061
717
344
1,543
1,344
199
557
673
-116
1,106
1,177
-71
1,015
1,177
-162
900
841
59
50,000
38,516
11,484
3,291
3,140
151
105,347
99,014
6,333
431
339
92
2,150
1,524
626
3,320
2,371
949
3,913
3,591
322
871
905
-34
8,009
8,558
-549
1,577
1,639
-62
5,694
4,917
777
11,383
9,835
1,548
604
706
-102
5,577
8,369
-2,792
1,348
1,370
-22
859
771
88
1,215
991
224
1,761
1,224
537
1,378
893
485
883
941
-58
8,850
8,791
59
1,219
1,221
-2
1,519
1,573
-54
1,575
1,614
-39
2,797
2,745
52
8,473
8,236
237
4,960
5,878
-918
719
910
-191
2,019
1,868
151
898
966
-68
1,151
1,252
-101
7,394
7,753
-359
1,079
922
157
2,140
1,748
392
5,462
6,747
-1,285
1,086
1,140
-54
6,034
6,296
-262
1,344
1,365
-21
1,237
1,247
-10
1,156
1,490
-334
10,356
11,849
-1,493
162
78
84
8,031
3,639
4,392
1,383
1,595
-212
9,901
8,795
1,106
983
1,028
-45
7,845
8,265
-420
876
921
-45
7,561
8,726
-1,165
1,330
1,402
-72
1,168
1,149
19
7,035
6,892
143
5,810
4,461
1,349
1,969
489
1,480
5,387
1,290
4,097
950
1,010
-60
828
973
-145
1,274
1,282
-8
1,143
1,236
-93
7,251
7,208
43
729
904
-175
2,764
3,593
-829
4,555
6,221
-1,666
763
815
-52
8,332
7,740
592
196
222
-26
1,711
1,550
161
2,104
2,160
-56
1,964
2,326
-362
421
498
-77
850
831
19
2,147
2,325
-178
1,497
1,644
-147
1,186
1,206
-20
1,198
1,241
-43
294
263
31
2,060
2,126
-66
4,108
4,251
-143
9,520
9,034
486
673
852
-179
6,777
8,520
-1,743
936
968
-32
2,039
1,567
472
1,411
922
489
1,495
922
573
655
409
246
1,517
1,373
144
2,829
2,112
717
1,555
1,162
393
1,249
1,261
-12
7,806
6,956
850
880
967
-87
5,525
8,849
-3,324
996
1,015
-19
7,539
9,544
-2,005
2,971
2,476
495
1,353
884
469
1,292
1,325
-33
7,919
7,090
829
1,004
1,131
-127
990
1,018
-28
6,679
8,269
-1,590
1,385
1,294
91
15,021
12,617
2,404
1,813
1,795
18
1,910
1,916
-6
1,230
1,275
-45
1,321
1,300
21
735
630
105
1,193
1,166
27
5,518
6,744
-1,226
1,914
1,574
340
1,239
1,090
149
2,418
2,420
-2
458
435
23
1,346
1,349
-3
3,981
2,840
1,141
4,475
2,767
1,708
6,272
3,350
2,922
999
1,135
-136
1,462
1,702
-240
597
567
30
1,089
1,239
-150
1,153
1,388
-235
551
606
-55
5,526
5,518
8
876
1,124
-248
100,000
108,455
-8,455
50,000
50,508
-508
121,511
125,000
-3,489
133
133
15,000
14,648
352
30,000
29,429
571
50,000
50,653
-653
1,633
1,742
-109
1,741
1,822
-81
1,350
1,420
-70
1,630
1,573
57
644
609
35
1,864
1,826
38
885
966
-81
1,473
1,189
284
1,008
1,292
-284
5,763
7,752
-1,989
1,336
1,316
20
6,486
7,590
-1,104
755
817
-62
1,371
1,167
204
1,908
1,658
250
3,927
3,155
772
11,391
10,815
576
1,441
1,814
-373
9,138
9,889
-751
969
962
7
700
937
-237
8,242
11,627
-3,385
779
679
100
1,459
1,087
372
928
1,075
-147
8,492
8,443
49
651
647
4
1,229
1,279
-50
239
206
33
1,242
1,289
-47
965
793
172
1,102
1,215
-113
1,099
1,342
-243
1,158
1,228
-70
1,146
1,218
-72
4,856
6,858
-2,002
974
951
23
11
11
562
440
122
943
885
58
871
1,088
-217
5,816
7,218
-1,402
838
987
-149
9,091
9,736
-645
1,486
1,473
13
333
295
38
767
812
-45
6,257
6,088
169
1,583
1,218
365
3,353
1,666
1,687
1,355
641
714
813
765
48
1,107
1,174
-67
5,315
6,277
-962
961
1,046
-85
8,990
9,326
-336
983
901
82
2,294
2,442
-148
12,495
10,997
1,498
1,944
1,694
250
705
623
82
7,260
5,818
1,442
1,865
1,473
392
1,226
884
342
6,856
6,188
668
2,673
2,424
249
1,036
949
87
3,183
2,814
369
884
976
-92
30
41
-11
6,281
9,002
-2,721
1,980
1,446
534
2,557
2,520
37
1,139
1,177
-38
801
1,015
-214
792
721
71
2,208
1,622
586
741
663
78
7,091
6,406
685
1,255
649
606
470
534
-64
8,350
9,147
-797
7,065
10,310
-3,245
841
909
-68
1,762
1,693
69
829
702
127
1,460
1,391
69
2,580
1,855
725
1,192
927
265
711
712
-1
856
799
57
2,343
1,997
346
149
109
40
1,617
1,719
-102
1,950
1,563
387
1,972
1,563
409
644
734
-90
5,944
6,013
-69
740
646
94
5,715
7,996
-2,281
948
864
84
9,744
8,039
1,705
1,610
1,637
-27
861
890
-29
6,247
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
93
b
1,572
c
-20
d
-437
e
-2,870
-108
-96
-168
337
2,606
-72
646
370
90
52
158
463
119
297
5,378
1,496
-264
-840
35
-942
-2
-39
108
679
1,117
810
55
292
-22
40
337
-625
-89
-283
445
3,999
588
320
1,376
-113
148
-439
-30
28
-279
77
-655
-393
-236
-325
3
38
425
-138
-120
434
676
729
134
512
262
-204
-293
240
1,118
344
199
-116
-71
-162
59
11,484
151
6,333
92
626
949
322
-34
-549
-62
777
1,548
-102
-2,792
-22
88
224
537
485
-58
59
-2
-54
-39
52
237
-918
-191
151
-68
-101
-359
157
392
-1,285
-54
-262
-21
-10
-334
-1,493
84
4,392
-212
1,106
-45
-420
-45
-1,165
-72
19
143
1,349
1,480
4,097
-60
-145
-8
-93
43
-175
-829
-1,666
-52
592
-26
161
-56
-362
-77
19
-178
-147
-20
-43
31
-66
-143
486
-179
-1,743
-32
472
489
573
246
144
717
393
-12
850
-87
-3,324
-19
-2,005
495
469
-33
829
-127
-28
-1,590
91
2,404
18
-6
-45
21
105
27
-1,226
340
149
-2
23
-3
1,141
1,708
2,922
-136
-240
30
-150
-235
-55
8
-248
-8,455
-508
-3,489
352
571
-653
-109
-81
-70
57
35
38
-81
284
-284
-1,989
20
-1,104
-62
204
250
772
576
-373
-751
7
-237
-3,385
100
372
-147
49
4
-50
33
-47
172
-113
-243
-70
-72
-2,002
23
122
58
-217
-1,402
-149
-645
13
38
-45
169
365
1,687
714
48
-67
-962
-85
-336
82
-148
1,498
250
82
1,442
392
342
668
249
87
369
-92
-11
-2,721
534
37
-38
-214
71
586
78
685
606
-64
-797
-3,245
-68
69
127
69
725
265
-1
57
346
40
-102
387
409
-90
-69
94
-2,281
84
1,705
-27
-29
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
33,611
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
129,713
2,792,616
0.046449
2017
120,643
2,710,314
0.044513
2016
131,670
2,512,276
0.052411
2015
146,848
2,664,713
0.055108
2014
121,276
2,755,235
0.044017
2
Total
of line 1, column (d)
.....................
2
0.242498
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
0.0485
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
2,765,781
5
Multiply line 4 by line 3
......................
5
134,140
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
1,073
7
Add lines 5 and 6
........................
7
135,213
8
Enter qualifying distributions from Part XII, line 4
,.............
8
139,863
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
1,073
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
1,073
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
1,073
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
2,201
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
2,201
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
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
1,128
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
1,128
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)
FL
,
IL
b
If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G?
If "No," attach explanation
.
8b
Yes
9
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
or 4942(j)(5) for calendar year 2019 or the taxable year beginning in 2019? See the instructions for Part XIV.
If "Yes," complete Part XIV
.............................
9
No
10
Did any persons become substantial contributors during the tax year?
If "Yes," attach a schedule listing their names
and addresses.
...............................
10
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
5
Part VII-A
Statements Regarding Activities
(continued)
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions
.............
11
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement. See instructions
.................
12
No
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
14
The books are in care of
THE NORTHERN TRUST COMPANY
Telephone no.
(312) 630-6000
Located at
PO BOX 803878
CHICAGO
IL
ZIP+4
60680
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
THE NORTHERN TRUST COMPANY
CO-TRUSTEE
40
10,308
PO BOX 80378
CHICAGO
,
IL
60680
D RICHARD MEAD JR
CO-TRUSTEE
1
0
4990 SW 72ND AVE 105
MIAMI
,
FL
33155
MARY CATHERINE HAMIL
CO-TRUSTEE
1
0
1259 S DORA BLVD
TAVARES
,
FL
32778
STANLEY BUDGE MEAD
CO-TRUSTEE
1
0
1835 YAUPOR AVE
BOULDER
,
CO
80304
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
2,807,900
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
2,807,900
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
2,807,900
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
42,119
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
2,765,781
6
Minimum investment return.
Enter 5% of line 5
..................
6
138,289
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
138,289
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
1,073
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
1,073
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
137,216
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
137,216
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
137,216
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
139,863
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
139,863
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
1,073
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
138,790
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
137,216
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
135,859
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:
$
139,863
a
Applied to 2018, but not more than line 2a
135,859
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
.....
4,004
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
..........
133,212
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
VARIOUS-SEE ATTACHED
SEE ATTACHED
SEE ATTACHED
,
IL
60680
N/A
PUBLIC
GENERAL
132,250
Total
.................................
3a
132,250
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
107,135
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
33,611
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)
..
140,746
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
140,746
(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