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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
ADAMS MASTROVICH FAM FDN
Number and street (or P.O. box number if mail is not delivered to street address)
6325 S RAINBOW BLVD STE 300
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
LAS VEGAS
,
NV
89118
A Employer identification number
41-6014092
B
Telephone number (see instructions)
(888) 730-4933
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)
$
26,489,408
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
...
643,737
618,784
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
584,122
b
Gross sales price for all assets on line 6a
14,504,059
7
Capital gain net income (from Part IV, line 2)
...
584,122
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)
.......
8,512
1,432
12
Total.
Add lines 1 through 11
........
1,236,371
1,204,338
13
Compensation of officers, directors, trustees, etc.
170,459
143,963
26,496
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)
.......
1,972
0
0
1,972
c
Other professional fees (attach schedule)
....
31,552
5,519
26,033
17
Interest
...............
0
18
Taxes (attach schedule) (see instructions)
...
11,066
9,566
0
19
Depreciation (attach schedule) and depletion
...
0
0
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
9,828
0
0
9,828
22
Printing and publications
..........
0
0
23
Other expenses (attach schedule)
.......
1,505
1,480
25
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
226,382
160,528
0
64,354
25
Contributions, gifts, grants paid
.......
1,401,725
1,401,725
26
Total expenses and disbursements.
Add lines 24 and 25
1,628,107
160,528
0
1,466,079
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-391,736
b
Net investment income
(if negative, enter -0-)
1,043,810
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
.............
8,555
8,555
2
Savings and temporary cash investments
.........
599,723
927,054
927,054
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)
.......
c
Investments—corporate bonds (attach schedule)
.......
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
21,146,925
20,362,987
25,553,799
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)
21,746,648
21,298,596
26,489,408
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
........
21,746,648
21,298,596
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)
.....
21,746,648
21,298,596
30
Total liabilities and net assets/fund balances
(see instructions)
.
21,746,648
21,298,596
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
21,746,648
2
Enter amount from Part I, line 27a
.....................
2
-391,736
3
Other increases not included in line 2 (itemize)
3
802
4
Add lines 1, 2, and 3
..........................
4
21,355,714
5
Decreases not included in line 2 (itemize)
5
57,118
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
21,298,596
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
12. ESCO TECHNOLOGIES INC
2018-06-07
2019-01-02
b
30. PRICESMART INC
2018-06-07
2019-01-02
c
35. BANKUNITED INC
2018-06-07
2019-01-07
d
16. PRICESMART INC
2018-06-07
2019-01-07
e
216. WELBILT INC
2019-01-07
118. EVERBRIDGE INC
2018-06-07
2019-01-08
219. ALDER BIOPHARMACEUTICALS INC
2018-06-07
2019-01-09
36. ESCO TECHNOLOGIES INC
2018-06-07
2019-01-09
56. HABIT RESTAURANTS INC/THE
2018-06-07
2019-01-11
18. WASTE CONNECTIONS INC
2018-06-07
2019-01-14
59. COGENT COMMUNICATIONS GROUP INC
2018-06-07
2019-01-15
219. CONNECTONE BANCORP INC
2018-06-07
2019-01-15
57. BANKUNITED INC
2018-06-07
2019-01-24
215.74 FED HOME LN MTG CORP 3.034% 10/25/20
2014-01-08
2019-01-25
66. BLACKBAUD INC
2018-06-07
2019-01-28
39. BLACKLINE INC
2018-06-07
2019-01-31
71. BLACKLINE INC
2018-06-07
2019-02-07
4. ETSY INC
2018-11-12
2019-02-07
83. EVERBRIDGE INC
2018-06-07
2019-02-12
32. HEICO CORP
2018-06-07
2019-02-12
28. BLACKLINE INC
2018-06-07
2019-02-13
3. BALL CORP
2018-08-02
2019-02-14
1. CINTAS CORP
2018-08-02
2019-02-14
2. CITRIX SYS INC COM
2018-08-02
2019-02-14
4. COPART INC COM
2018-08-02
2019-02-14
2. HASBRO INC
2018-08-02
2019-02-14
66. LOXO ONCOLOGY INC
2019-02-14
2. T ROWE PRICE GROUP INC
2018-08-02
2019-02-14
6. STORE CAPITAL CORP
2018-08-02
2019-02-14
50. CARROLS RESTAURANT GROUP INC
2018-06-07
2019-02-15
90. COGENT COMMUNICATIONS GROUP INC
2018-06-07
2019-02-15
56. COGENT COMMUNICATIONS GROUP INC
2018-06-07
2019-02-25
216.48 FED HOME LN MTG CORP 3.034% 10/25/20
2014-01-08
2019-02-25
840.96 FNMA POOL #AL8387 4.000% 4/01/46
2018-01-09
2019-02-25
3. AMAZON COM INC COM
2009-03-09
2019-02-27
60000. BORGWARNER INC 4.625% 9/15/20
2012-04-17
2019-02-27
85. BROADCOM INC
2018-02-09
2019-02-27
1437. ISHARES TIPS BOND ETF
2019-02-27
100000. MORGAN STANLEY 7.300% 5/13/19
2019-02-27
50000. ORACLE CORP 5.000% 7/08/19
2013-11-15
2019-02-27
29. SALESFORCE COM INC
2014-04-10
2019-02-27
30. TRANSDIGM GROUP INC
2015-12-21
2019-02-27
48. WORLDPAY INC
2016-08-12
2019-02-27
347. ISHARES CORE S&P MIDCAP ETF
2019-02-28
112. CORE-MARK HOLDING CO INC
2018-06-07
2019-03-01
288. BALL CORP
2018-08-02
2019-03-07
252. PROGRESSIVE CORP OHIO
2019-03-07
32. PROGRESSIVE CORP OHIO
2019-03-07
140. ALEXANDRIA REAL ESTATE EQUITIES
2019-03-11
475. AMERICAN HOMES 4 RENT
2019-03-11
252. AMERICAN TOWER REIT
2019-03-11
23. AMERICAN TOWER REIT
2012-06-13
2019-03-11
135. CAMDEN PPTY TR SH BEN INT
2019-03-11
26.6241 CORESITE REALTY CORP
2019-03-11
3.3759 CORESITE REALTY CORP
2018-06-20
2019-03-11
65. EQUINIX INC
2019-03-11
105. EQUITY RESIDENTIAL PPTYS TR SH BEN
2019-03-11
10. ESSEX PPTY TR COM
2018-03-29
2019-03-11
355. FOUR CORNERS PROPERTY TRUST
2019-03-11
190. HOST HOTELS & RESORTS, INC.
2012-04-04
2019-03-11
950. HOST HOTELS & RESORTS, INC.
2018-03-29
2019-03-11
520. HUDSON PACIFIC PROPERTIES INC
2018-03-29
2019-03-11
445. INVITATION HOMES INC
2019-03-11
40. INVITATION HOMES INC
2017-03-01
2019-03-11
715. PHYSICIANS REALTY TRUST
2019-03-11
880. PHYSICIANS REALTY TRUST
2018-03-29
2019-03-11
278. PROLOGIS INC
2015-05-15
2019-03-11
37. PROLOGIS INC
2018-03-29
2019-03-11
890. RETAIL OPPORTUNITY INVESTMENTS CORP
2018-03-29
2019-03-11
28. SIMON PROPERTY GROUP INC
2018-03-29
2019-03-11
62. SIMON PROPERTY GROUP INC
2019-03-11
135. SUN CMNTYS INC COM
2019-03-11
95. TAUBMAN CTRS INC COM
2019-03-11
15. VENTAS INC COM
2012-04-04
2019-03-11
75000. US TREASURY NOTE 3.125% 5/15/19
2014-01-22
2019-03-19
17870.992 AQR MANAGED FUTURES STR-I
2019-03-20
14258.555 EATON VANCE GLOB MACRO ADV-I 208
2018-01-25
2019-03-20
19527.235 JOHN HANCOCK II-CURR STR-I 3643
2016-11-16
2019-03-20
12574.692 ABBEY CAP FUTURES STRAT-I #231
2016-12-07
2019-03-20
17. ACCELERON PHARMA INC
2019-03-22
82. ACCELERON PHARMA INC
2018-06-07
2019-03-22
36. ANAPTYSBIO INC
2019-03-22
56. APPFOLIO INC
2019-03-22
543. ARES MANAGEMENT CORP-A
2019-03-22
262. ARRAY BIOPHARMA INC
2019-03-22
71. BLACKBAUD INC
2019-03-22
220. BLACKLINE INC
2019-03-22
49. BLUEPRINT MEDICINES CORP
2019-02-01
2019-03-22
258. CACTUS INC
2019-03-22
652. CARROLS RESTAURANT GROUP INC
2018-06-07
2019-03-22
528. CHEGG INC
2019-03-22
522. CLARUS CORP
2018-06-07
2019-03-22
54. COGENT COMMUNICATIONS GROUP INC
2018-06-07
2019-03-22
203. COHERUS BIOSCIENCES INC
2018-06-07
2019-03-22
873. EVO PAYMENTS INC
2019-03-22
46. ENVESTNET INC
2018-06-07
2019-03-22
171. ESCO TECHNOLOGIES INC
2018-06-07
2019-03-22
301. ETSY INC
2019-03-22
112. GLOBAL BLOOD THERAPEUTICS INC
2019-03-22
289. HABIT RESTAURANTS INC/THE
2018-06-07
2019-03-22
202. HAMILTON LANE INC
2019-03-22
259. HEALTHCARE SVCS GROUP INC
2018-06-07
2019-03-22
23. HEALTHEQUITY INC
2019-01-17
2019-03-22
61. HEALTHEQUITY INC
2019-03-22
81. INTEGRA LIFESCIENCES HOLDING
2019-03-22
114. JOHN BEAN TECHNOLOGIES CORP
2018-07-10
2019-03-22
509. LINDBLAD EXPEDITIONS HOLDINGS
2018-06-07
2019-03-22
28.00011 LITTELFUSE INC COM
2019-03-22
.99989 LITTELFUSE INC COM
2018-06-07
2019-03-22
3. LITTELFUSE INC COM
2018-01-10
2019-03-22
44. MAXIMUS INC
2018-06-07
2019-03-22
130. MERCURY COMPUTER SYS INC
2018-06-07
2019-03-22
292. NATIONAL VISION HOLDINGS INC
2019-03-22
154. NATIONAL VISION HOLDINGS INC
2018-03-15
2019-03-22
764. NEOGENOMICS INC
2019-03-22
176. PAYLOCITY HOLDING CORP
2019-03-22
15. PRICESMART INC
2019-03-22
259. SITEONE LANDSCAPE SUPPLY INC
2019-03-22
355. TOPBUILD CORP
2019-03-22
352. WASTE CONNECTIONS INC
2018-06-07
2019-03-22
247. WASTE CONNECTIONS INC
2019-03-22
161. WOODWARD INC.
2019-03-22
453. WORKIVA INC
2018-10-25
2019-03-22
457. ZUORA INC
2019-03-22
845. MIMECAST LTD
2019-03-22
426. DESPEGAR.COM CORP
2019-03-22
576. HUDSON LTD-CLASS A
2019-03-22
665. MAKEMYTRIP LTD
2019-03-22
424. ACTIVISION BLIZZARD INC
2018-11-21
2019-03-25
101. AGIOS PHARMACEUTICALS INC
2019-03-25
51. ALIGN TECHNOLOGY INC
2015-08-03
2019-03-25
30. ALLEGHANY CORP DEL NEW
2018-08-02
2019-03-25
75. ARISTA NETWORKS INC
2018-10-10
2019-03-25
361. BWX TECHNOLOGIES INC
2019-03-25
145. BANKUNITED INC
2019-03-25
70. BROADRIDGE FINANCIAL SOLUTIONS
2018-06-07
2019-03-25
61. BROADCOM INC
2019-03-25
278. BROWN FORMAN CORP CL B
2018-08-02
2019-03-25
180. CALAVO GROWERS INC
2019-03-25
229. CARMAX INC
2018-08-02
2019-03-25
98. CATALENT INC
2019-03-25
11. CATALENT INC
2018-07-25
2019-03-25
156. CHOICE HOTELS INTL INC COM
2019-03-25
28. CINTAS CORP
2018-08-02
2019-03-25
162. CITRIX SYS INC COM
2018-08-02
2019-03-25
37. CONCHO RESOURCES INC
2018-09-12
2019-03-25
196. CONNECTONE BANCORP INC
2018-06-07
2019-03-25
152. COPART INC COM
2018-08-02
2019-03-25
106. CORE-MARK HOLDING CO INC
2018-06-07
2019-03-25
161. CORELOGIC INC
2018-06-07
2019-03-25
52. COUPA SOFTWARE INC
2018-06-07
2019-03-25
405. COVETRUS INC
2019-03-25
86. DECKERS OUTDOOR CORP
2019-03-25
102. DECKERS OUTDOOR CORP
2018-08-02
2019-03-25
163. DEXCOM INC
2018-09-12
2019-03-25
89. DOLLAR TREE INC
2018-08-02
2019-03-25
917. ENTEGRIS INC
2018-09-13
2019-03-25
55. FACEBOOK INC
2013-11-05
2019-03-25
258.82 FED HOME LN MTG CORP 3.034% 10/25/20
2014-01-08
2019-03-25
702.3 FNMA POOL #AL8387 4.000% 4/01/46
2018-01-09
2019-03-25
53984.576 OAKMARK INTERNATIONAL-INST #2886
2018-11-12
2019-03-25
127. HASBRO INC
2019-03-25
145. HASBRO INC
2018-08-02
2019-03-25
83. HEXCEL CORP NEW COM
2019-03-25
4125. ISHA CURR HEDGED MSCI EAFE
2015-12-02
2019-03-25
43250.50856 JPMORGAN HIGH YIELD FUND SS 3580
2016-07-15
2019-03-25
9030.118 JPMORGAN HIGH YIELD FUND SS 3580
2019-03-25
5586.58444 JPMORGAN HIGH YIELD FUND SS 3580
2016-07-15
2019-03-25
415. KNIGHT-SWIFT TRANSPORTATION
2018-06-07
2019-03-25
107. M & T BANK CORPORATION COM
2018-08-02
2019-03-25
69. MIDDLEBY CORP
2018-03-13
2019-03-25
581. MORGAN STANLEY
2017-12-26
2019-03-25
25. NETFLIX.COM INC
2018-08-21
2019-03-25
105. NEUROCRINE BIOSCIENCES INC COM
2019-03-25
25149.66 NEUBERGER BERMAN LONG SH-INS #1830
2019-03-25
93. OLD DOMINION FREIGHT LINES INC
2018-08-02
2019-03-25
259. PENSKE AUTO GROUP INC
2018-08-02
2019-03-25
55. PENSKE AUTO GROUP INC
2016-11-11
2019-03-25
158. T ROWE PRICE GROUP INC
2018-08-02
2019-03-25
172. PROSPERITY BANCSHARES INC
2019-03-25
220. SKYWORKS SOLUTIONS INC
2018-09-24
2019-03-25
151. TIFFANY & CO NEW
2018-08-02
2019-03-25
74. 2U INC
2019-03-25
5. ULTA SALON COSMETICS & FRAGRAN
2018-12-24
2019-03-25
51. ULTA SALON COSMETICS & FRAGRAN
2017-06-23
2019-03-25
8922. VANGUARD GLBL EX-US REAL EST
2018-01-25
2019-03-25
4625. VANGUARD INDEX FD ETF
2018-04-17
2019-03-25
119. VULCAN MATERIALS COMPANY
2018-08-02
2019-03-25
101. VULCAN MATERIALS COMPANY
2019-03-25
314. WEBSTER FINL CORP WATERBURY CONN
2018-06-07
2019-03-25
791. WELBILT INC
2019-03-25
66. WHIRLPOOL CORP
2018-08-02
2019-03-25
57. WHIRLPOOL CORP
2019-03-25
361. XPO LOGISTICS INC
2019-03-25
181. ALLERGAN PLC
2019-03-25
803. AXALTA COATING SYSTEMS LTD
2019-03-25
173. BIOHAVEN PHARMACEUTICAL HOLD
2019-03-25
38. JAZZ PHARMACEUTICALS PLC
2018-02-09
2019-03-25
269. MARVELL TECHNOLOGY GROUP
2018-07-09
2019-03-25
260. SENSATA TECHNOLOGIES HOLDING
2019-03-25
217. SENSATA TECHNOLOGIES HOLDING
2018-01-17
2019-03-25
23. EQUITY RESIDENTIAL PPTYS TR SH BEN
2018-03-29
2019-04-05
259. HUDSON PACIFIC PROPERTIES INC
2018-03-29
2019-04-05
232. PHYSICIANS REALTY TRUST
2018-03-29
2019-04-05
38. PROLOGIS INC
2015-05-15
2019-04-05
16. SIMON PROPERTY GROUP INC
2018-03-29
2019-04-05
55000. KERN CA CMNTY CLG DI 3.193% 11/01/21
2014-03-14
2019-04-22
33. MASIMO CORP
2019-03-22
2019-04-24
23. NEXSTAR BROADCASTING GROUP INC
2019-03-22
2019-04-24
91. ALEXION PHARMACEUTICALS INC
2019-02-27
2019-04-25
20. ARISTA NETWORKS INC
2018-10-10
2019-04-25
31. BOEING CO
2019-02-27
2019-04-25
12. BROADCOM INC
2018-04-04
2019-04-25
96. DEXCOM INC
2018-10-03
2019-04-25
.6667 DOW INC
2019-03-25
2019-04-25
9. ENERGIZER SPINCO INC
2016-08-12
2019-04-25
184. ENERGIZER SPINCO INC
2018-08-02
2019-04-25
218.13 FED HOME LN MTG CORP 3.034% 10/25/20
2014-01-08
2019-04-25
1008.47 FNMA POOL #AL8387 4.000% 4/01/46
2018-01-09
2019-04-25
54. MIDDLEBY CORP
2015-09-02
2019-04-25
10. ULTA SALON COSMETICS & FRAGRAN
2018-04-04
2019-04-25
70. VERTEX PHARMACEUTICALS INC COM
2018-09-12
2019-04-25
126. NORWEGIAN CRUISE LINE HOLDING
2015-05-28
2019-04-25
192. ULTIMATE SOFTWARE GROUP INC
2019-05-03
383. CDK GLOBAL INC
2019-03-07
2019-05-10
167. DOWDUPONT INC
2019-03-25
2019-05-10
33. HUMANA INC
2019-03-25
2019-05-10
175. ELI LILLY & CO COM
2019-03-25
2019-05-10
316. NRG ENERGY INC
2019-03-25
2019-05-10
34. REGENERON PHARMACEUTICALS INC
2019-03-25
2019-05-10
44. 3M CO
2019-03-25
2019-05-10
127. 2U INC
2019-05-10
34. ULTA SALON COSMETICS & FRAGRAN
2018-04-04
2019-05-10
330000. US TREASURY NOTE 3.125% 5/15/19
2019-05-15
4. AMN HEALTHCARE SVCS INC
2019-03-22
2019-05-17
2. AGREE RLTY CORP
2019-03-22
2019-05-17
2. AMERICAN WOODMARK CORP
2019-03-22
2019-05-17
6. ANGIODYNAMICS INC
2019-03-22
2019-05-17
2. ANIXTER INTL INC
2019-03-22
2019-05-17
3. BARNES GROUP INC
2019-03-22
2019-05-17
5. BENCHMARK ELECTRS INC COM
2019-03-22
2019-05-17
3. BIG LOTS INC
2019-03-22
2019-05-17
4. CTS CORP
2019-03-22
2019-05-17
1. CACI INTL INC FORMERLY CACI INC TO
2019-03-22
2019-05-17
9. CALAMP CORP
2019-03-22
2019-05-17
4. CAMBREX CORP COM
2019-03-22
2019-05-17
5. CAROLINA FINANCIAL CORP
2019-03-22
2019-05-17
4. CARPENTER TECHNOLOGY CORP
2019-03-22
2019-05-17
14. CARRIZO OIL & GAS INC
2019-03-22
2019-05-17
12. EASTERLY GOVERNMENT PROPERTIES
2019-03-22
2019-05-17
2. EXLSERVICE HOLDINGS INC
2019-03-22
2019-05-17
3. FORWARD AIR CORP
2019-03-22
2019-05-17
2. FRANKLIN ELEC INC COM
2019-03-22
2019-05-17
2. IDACORP INC
2019-03-22
2019-05-17
4. K.FORCE, INC.
2019-03-22
2019-05-17
4. LTC PROPERTIES INC COM
2019-03-22
2019-05-17
4. LA-Z-BOY INC
2019-03-22
2019-05-17
1. LITTELFUSE INC COM
2018-05-09
2019-05-17
4. MSG NETWORKS INC
2019-03-22
2019-05-17
4. MTS SYS CORP
2019-03-22
2019-05-17
5. MARCUS & MILLICHAP INC
2019-03-22
2019-05-17
11. MATADOR RESOURCES CO
2019-03-22
2019-05-17
3. MERCANTILE BANK CORP
2019-03-22
2019-05-17
5. METHODE ELECTRON INC COMMON
2019-03-22
2019-05-17
2. OMNICELL INC
2019-03-22
2019-05-17
4. PC CONNECTION INC COM
2019-03-22
2019-05-17
4. SELECTIVE INS GROUP INC
2019-03-22
2019-05-17
3. SENSIENT TECHNOLOGIES CORP
2019-03-22
2019-05-17
2. SOUTH STATE CORP
2019-03-22
2019-05-17
4. STANDARD MTR PRODS INC
2019-03-22
2019-05-17
3. STIFEL FINANCIAL CORP
2019-03-22
2019-05-17
2. STURM RUGER & CO INC
2019-03-22
2019-05-17
5. SYKES ENTERPRISES INC COM
2019-03-22
2019-05-17
5. UNITED BANKSHARES INC COM
2019-03-22
2019-05-17
4. VAREX IMAGING CORP
2019-03-22
2019-05-17
2. AMBARELLA INC
2019-03-22
2019-05-17
2. ARGO GROUP INTL HLDGS LTD
2019-03-22
2019-05-17
58. EMERGENT BIOSOLUTIONS INC
2019-03-22
2019-05-20
33. AMERICAN TOWER REIT
2012-06-13
2019-05-23
83. ESSEX PPTY TR COM
2018-03-29
2019-05-23
93. HOST HOTELS & RESORTS, INC.
2012-04-04
2019-05-23
275. TAUBMAN CTRS INC COM
2018-03-29
2019-05-23
232.69 FED HOME LN MTG CORP 3.034% 10/25/20
2014-01-08
2019-05-25
1113.8 FNMA POOL #AL8387 4.000% 4/01/46
2018-01-09
2019-05-25
72. LYDALL INC
2019-03-22
2019-05-31
43887.374 PARAMETRIC EMERGING MARKETS FUND
2019-06-10
36447.979 FIDELITY NEW MRKTS INC-Z #3323
2019-06-10
1015.228 T ROWE PRICE INST FLOAT RATE 170
2019-02-27
2019-06-10
16814.632 T ROWE PRICE INST FLOAT RATE 170
2019-06-10
40. ALPHABET INC/CA
2019-06-12
216. AMGEN INC
2019-03-25
2019-06-12
673. INTEL CORP
2019-03-25
2019-06-12
7613. ISHARES RUSSELL 1000 VALUE ETF
2019-06-12
2200. ISHARES RUSSELL 2000 VALUE ETF
2011-06-23
2019-06-12
132. LOWES COS INC
2019-05-10
2019-06-12
99. LYDALL INC
2019-03-22
2019-06-12
220. MICRON TECHNOLOGY INC
2019-04-25
2019-06-12
589. PHILIP MORRIS INTERNATIONAL IN
2019-03-25
2019-06-12
178. STERICYCLE INC COM
2019-03-25
2019-06-12
37. TESLA MOTORS INC
2019-04-25
2019-06-12
166. DAVE & BUSTER'S ENTERTAINMENT
2019-06-18
794. AMERICAN HOMES 4 RENT
2018-03-29
2019-06-24
520. AMERICAN HOMES 4 RENT
2018-03-29
2019-06-25
219.69 FED HOME LN MTG CORP 3.034% 10/25/20
2014-01-08
2019-06-25
1266.03 FNMA POOL #AL8387 4.000% 4/01/46
2018-01-09
2019-06-25
31. OMNICELL INC
2019-03-22
2019-06-26
2. OMNICELL INC
2019-04-17
2019-06-26
70000. US TREASURY NOTE 2.000% 9/30/20
2019-05-15
2019-07-05
51. RED HAT INC
2019-05-10
2019-07-09
234.21 FED HOME LN MTG CORP 3.034% 10/25/20
2014-01-08
2019-07-25
1171.26 FNMA POOL #AL8387 4.000% 4/01/46
2018-01-09
2019-07-25
300. WORLDPAY INC
2016-06-01
2019-07-31
88. WORLDPAY INC
2016-08-12
2019-07-31
24. ALEXION PHARMACEUTICALS INC
2016-11-16
2019-08-02
1. ALEXION PHARMACEUTICALS INC
2019-02-27
2019-08-02
260. CATALENT INC
2018-06-07
2019-08-02
106. PRA HEALTH SCIENCES INC
2019-08-02
9. ULTA SALON COSMETICS & FRAGRAN
2018-04-04
2019-08-02
217. PERRIGO CO PLC
2019-03-07
2019-08-02
144. STURM RUGER & CO INC
2019-08-08
236. CAMBREX CORP COM
2019-08-13
34. CACI INTL INC FORMERLY CACI INC TO
2019-06-12
2019-08-16
647. NAVIGANT CONSULTING CO
2019-08-20
25. AMERICAN TOWER REIT
2012-06-13
2019-08-21
245. HEALTHCARE TRUST OF AME-CL A
2019-08-21
488. PHYSICIANS REALTY TRUST
2018-03-29
2019-08-21
51. PROLOGIS INC
2015-05-15
2019-08-21
25. SBA COMMUNICATIONS CORP
2019-04-05
2019-08-21
100. SELECTIVE INS GROUP INC
2019-06-12
2019-08-21
210.138 FIDELITY NEW MRKTS INC-Z #3323
2019-03-29
2019-08-22
36652.442 FIDELITY NEW MRKTS INC-Z #3323
2019-08-22
51533.601 GOLDMAN SACHS COMM STRATEGY INSTL
2019-08-22
35536.603 OAKMARK INTL SM CAP - INST #2888
2019-03-25
2019-08-22
576.97 FHLMC POOL #ZT0000 3.000% 1/01/47
2019-07-01
2019-08-25
221.27 FED HOME LN MTG CORP 3.034% 10/25/20
2014-01-08
2019-08-25
1646.83 FNMA POOL #AL8387 4.000% 4/01/46
2018-01-09
2019-08-25
3435. ISHARES RUSSELL 2000 VALUE ETF
2019-08-26
150000. US TREASURY NOTE 2.000% 9/30/20
2019-05-15
2019-08-27
29581.397 ROBECO BP LNG/SHRT RES-INS
2013-07-24
2019-08-28
9184.423 THORNBURG GLOBAL OPPORT-I 272
2019-03-25
2019-08-28
.336 FIDELITY NATL INFORMATION SVCS INC
2016-08-12
2019-08-29
652. MSG NETWORKS INC
2019-08-30
902. PHYSICIANS REALTY TRUST
2018-03-29
2019-09-06
1577. PHYSICIANS REALTY TRUST
2018-03-29
2019-09-09
25000. AMPHENOL CORP 3.125% 9/15/21
2014-09-09
2019-09-10
313. ABBVIE INC
2019-09-13
27. ALEXION PHARMACEUTICALS INC
2016-11-16
2019-09-13
401. ALTRIA GROUP INC
2019-03-25
2019-09-13
348. CISCO SYSTEMS INC
2019-03-25
2019-09-13
189. CONCHO RESOURCES INC
2019-09-13
112. CONCHO RESOURCES INC
2019-06-12
2019-09-13
161. ERIE INDTY CO
2019-06-12
2019-09-13
541. EXELON CORPORATION
2019-09-13
341. EXXON MOBIL CORPORATION
2019-09-13
34. ILLUMINA INC
2019-06-12
2019-09-13
298. JOHNSON & JOHNSON
2019-09-13
1306. LINCOLN NATL CORP IND
2019-06-12
2019-09-13
835. PPL CORPORATION
2019-03-25
2019-09-13
525. PFIZER INC
2019-06-12
2019-09-13
640. PIONEER NAT RES CO COM
2019-03-25
2019-09-13
136. PROGRESSIVE CORP OHIO
2019-06-12
2019-09-13
103. UNITEDHEALTH GROUP INC
2019-03-25
2019-09-13
472. WILLIAMS COS INC
2019-03-25
2019-09-13
631.65 FHLMC POOL #ZT0000 3.000% 1/01/47
2019-07-01
2019-09-25
222.03 FED HOME LN MTG CORP 3.034% 10/25/20
2014-01-08
2019-09-25
1498.32 FNMA POOL #AL8387 4.000% 4/01/46
2018-01-09
2019-09-25
50000. PEMBROKE PINES FL CO 3.583% 10/01/19
2013-09-12
2019-10-01
43. CONSTELLATION BRANDS INC
2014-12-29
2019-10-22
55. DOW INC
2019-03-25
2019-10-22
145. ENERGIZER SPINCO INC
2019-10-22
100. FORTUNE BRANDS HOME & SECURITY
2013-02-05
2019-10-22
300. SALESFORCE COM INC
2019-06-12
2019-10-22
32. TRACTOR SUPPLY CO COM
2012-11-08
2019-10-22
24. TRANSDIGM GROUP INC
2015-12-21
2019-10-22
13. ULTA SALON COSMETICS & FRAGRAN
2018-12-24
2019-10-22
24. JAZZ PHARMACEUTICALS PLC
2016-11-16
2019-10-22
493.3 FHLMC POOL #ZT0000 3.000% 1/01/47
2019-07-01
2019-10-25
236.48 FED HOME LN MTG CORP 3.034% 10/25/20
2014-01-08
2019-10-25
1335.03 FNMA POOL #AL8387 4.000% 4/01/46
2018-01-09
2019-10-25
263. ANIXTER INTL INC
2019-10-30
55000. MACOMB CNTY MI 2.161% 11/01/19
2015-03-11
2019-11-01
100000. BURLINGTN NORTH SANT 3.850% 9/01/23
2013-10-09
2019-11-07
117. CELGENE CORP COM
2019-06-12
2019-11-21
594.06 FHLMC POOL #ZT0000 3.000% 1/01/47
2019-07-01
2019-11-25
223.62 FED HOME LN MTG CORP 3.034% 10/25/20
2014-01-08
2019-11-25
121685.76 FED HOME LN MTG CORP 3.034% 10/25/20
2014-01-08
2019-11-25
1814.22 FNMA POOL #AL8387 4.000% 4/01/46
2018-01-09
2019-11-25
27. AMAZON COM INC COM
2019-06-12
2019-12-03
100. CENTENE CORP DEL
2016-06-01
2019-12-03
103. INTUIT COM
2019-06-12
2019-12-03
72. CAMDEN PPTY TR SH BEN INT
2018-03-29
2019-12-13
4. HEALTHCARE TRUST OF AME-CL A
2019-04-05
2019-12-13
99. HEALTHCARE TRUST OF AME-CL A
2018-03-29
2019-12-13
179. HOST HOTELS & RESORTS, INC.
2012-04-04
2019-12-13
17. SIMON PROPERTY GROUP INC
2018-03-29
2019-12-13
27. VENTAS INC COM
2019-05-23
2019-12-13
350. VENTAS INC COM
2012-04-04
2019-12-13
11. EQUINIX INC
2019-05-23
2019-12-19
686. HEALTHCARE TRUST OF AME-CL A
2019-12-19
10. PUBLIC STORAGE INC COM
2018-03-29
2019-12-19
20. PUBLIC STORAGE INC COM
2019-04-05
2019-12-19
50000. US TREASURY NOTE 2.000% 9/30/20
2019-05-15
2019-12-19
449.2 FHLMC POOL #ZT0000 3.000% 1/01/47
2019-07-01
2019-12-25
1423.45 FNMA POOL #AL8387 4.000% 4/01/46
2018-01-09
2019-12-25
1452.44 FNMA POOL #AL8387 4.000% 4/01/46
2018-01-09
2019-12-31
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
775
705
70
b
1,761
2,621
-860
c
1,126
1,528
-402
d
987
1,398
-411
e
2,604
4,676
-2,072
6,808
5,511
1,297
2,251
3,837
-1,586
2,371
2,114
257
640
553
87
1,402
1,386
16
2,822
3,033
-211
4,222
5,983
-1,761
1,936
2,489
-553
216
220
-4
4,624
6,678
-2,054
1,852
1,668
184
3,377
3,037
340
207
206
1
5,372
3,876
1,496
2,895
2,414
481
1,356
1,198
158
164
121
43
200
207
-7
209
218
-9
212
231
-19
178
199
-21
15,510
10,893
4,617
194
234
-40
191
167
24
463
661
-198
4,369
4,627
-258
2,820
2,879
-59
216
221
-5
841
879
-38
4,891
185
4,706
61,037
64,876
-3,839
23,088
19,704
3,384
159,567
163,535
-3,968
100,863
112,101
-11,238
50,393
57,131
-6,738
4,700
1,575
3,125
12,898
6,081
6,817
4,667
2,614
2,053
66,464
33,730
32,734
4,026
2,284
1,742
15,708
11,617
4,091
18,197
8,410
9,787
2,311
1,960
351
19,502
17,416
2,086
10,535
10,097
438
46,426
36,400
10,026
4,237
1,529
2,708
13,484
11,721
1,763
2,730
2,886
-156
346
366
-20
28,378
27,304
1,074
7,786
6,871
915
2,849
2,411
438
10,100
9,511
589
3,678
3,113
565
18,392
17,764
628
17,519
16,882
637
10,437
9,971
466
938
817
121
12,913
13,583
-670
15,893
13,160
2,733
19,596
11,322
8,274
2,608
2,334
274
15,000
15,708
-708
4,902
4,341
561
10,855
10,415
440
15,784
12,505
3,279
4,878
5,835
-957
941
730
211
75,076
80,004
-4,928
148,865
169,103
-20,238
139,734
150,000
-10,266
179,260
190,000
-10,740
136,813
143,100
-6,287
783
708
75
3,779
2,890
889
2,677
2,665
12
4,343
3,245
1,098
12,728
11,727
1,001
6,105
5,912
193
5,644
6,456
-812
10,652
9,199
1,453
4,073
3,643
430
9,248
8,433
815
6,485
8,617
-2,132
20,398
13,689
6,709
6,232
3,847
2,385
2,843
2,759
84
3,049
3,323
-274
24,131
20,516
3,615
3,005
2,515
490
11,925
10,041
1,884
20,495
11,496
8,999
5,794
4,854
940
3,101
2,852
249
8,564
9,066
-502
8,316
10,173
-1,857
1,792
1,345
447
4,754
3,033
1,721
4,594
5,049
-455
10,410
10,593
-183
7,711
6,306
1,405
5,301
6,264
-963
189
223
-34
568
605
-37
3,142
2,749
393
8,312
4,858
3,454
8,564
10,687
-2,123
4,517
5,106
-589
14,967
10,410
4,557
15,734
10,407
5,327
909
1,309
-400
14,592
18,437
-3,845
23,180
27,136
-3,956
29,923
27,111
2,812
20,997
12,121
8,876
15,478
10,788
4,690
22,237
15,137
7,100
9,976
8,537
1,439
39,310
34,582
4,728
6,435
6,453
-18
7,983
11,873
-3,890
17,509
21,518
-4,009
19,864
21,654
-1,790
6,317
9,359
-3,042
13,817
3,188
10,629
18,226
19,065
-839
22,395
17,183
5,212
17,382
23,291
-5,909
4,659
6,308
-1,649
6,990
8,264
-1,274
17,758
14,079
3,679
14,517
14,701
-184
14,756
14,772
-16
14,175
16,786
-2,611
3,975
4,046
-71
446
468
-22
11,993
12,845
-852
5,470
5,789
-319
16,052
17,690
-1,638
3,877
5,240
-1,363
3,712
5,355
-1,643
9,020
8,760
260
3,873
2,161
1,712
5,811
8,683
-2,872
4,658
3,050
1,608
13,508
15,265
-1,757
12,297
4,473
7,824
14,584
11,825
2,759
20,299
23,522
-3,223
9,077
8,046
1,031
31,664
27,728
3,936
9,027
2,742
6,285
259
264
-5
702
734
-32
1,197,378
1,260,000
-62,622
10,597
10,885
-288
12,099
14,447
-2,348
5,586
5,789
-203
116,901
110,113
6,788
310,971
316,161
-5,190
64,927
65,000
-73
40,168
40,838
-670
13,050
16,251
-3,201
16,366
18,643
-2,277
8,726
9,181
-455
23,949
30,413
-6,464
9,063
8,429
634
8,952
10,149
-1,197
346,059
350,000
-3,941
13,303
13,610
-307
11,075
13,250
-2,175
2,352
2,565
-213
15,532
18,469
-2,937
11,497
12,858
-1,361
17,739
20,267
-2,528
15,594
20,524
-4,930
4,851
6,366
-1,515
1,677
1,157
520
17,101
14,543
2,558
523,327
576,106
-52,779
1,184,128
1,148,265
35,863
13,632
13,587
45
11,570
12,461
-891
15,398
21,027
-5,629
12,474
16,634
-4,160
8,548
8,686
-138
7,383
9,678
-2,295
17,989
20,862
-2,873
26,608
41,665
-15,057
20,017
24,980
-4,963
8,901
6,282
2,619
5,182
5,256
-74
5,319
5,763
-444
11,796
14,020
-2,224
9,845
11,931
-2,086
1,730
1,422
308
8,958
8,385
573
4,289
3,439
850
2,761
1,548
1,213
2,941
2,481
460
55,653
55,000
653
4,218
4,497
-279
2,671
2,466
205
12,101
12,320
-219
6,350
4,582
1,768
11,914
13,476
-1,562
3,730
2,830
900
11,403
12,131
-728
37
36
1
425
456
-31
8,692
11,273
-2,581
218
222
-4
1,008
1,054
-46
7,153
5,795
1,358
3,541
2,066
1,475
12,192
12,460
-268
7,170
6,900
270
63,648
35,755
27,893
20,057
22,055
-1,998
5,249
5,953
-704
8,057
8,974
-917
20,258
22,746
-2,488
11,733
13,670
-1,937
10,688
13,414
-2,726
7,731
8,965
-1,234
5,341
6,978
-1,637
11,639
7,024
4,615
330,000
338,311
-8,311
202
196
6
135
136
-1
179
154
25
119
134
-15
116
114
2
168
161
7
122
131
-9
97
105
-8
108
123
-15
205
183
22
119
113
6
175
154
21
186
171
15
186
177
9
185
173
12
224
217
7
122
119
3
181
188
-7
92
103
-11
207
201
6
141
142
-1
183
183
133
129
4
173
223
-50
89
88
1
225
216
9
166
194
-28
223
211
12
98
95
3
139
145
-6
161
168
-7
138
148
-10
285
251
34
213
198
15
146
131
15
186
195
-9
173
157
16
104
103
1
128
141
-13
186
175
11
114
136
-22
92
86
6
148
142
6
2,533
2,859
-326
6,699
2,194
4,505
23,924
20,012
3,912
1,753
1,524
229
13,390
15,541
-2,151
233
237
-4
1,114
1,164
-50
1,342
1,751
-409
619,690
531,500
88,190
550,000
589,173
-39,173
10,000
10,000
165,624
170,000
-4,376
42,922
47,180
-4,258
38,006
40,368
-2,362
31,277
35,474
-4,197
953,086
744,151
208,935
259,284
154,574
104,710
12,730
14,090
-1,360
1,949
2,408
-459
7,281
9,486
-2,205
45,864
52,273
-6,409
7,958
9,119
-1,161
7,866
9,182
-1,316
6,571
7,539
-968
19,694
16,004
3,690
12,850
10,481
2,369
220
224
-4
1,266
1,323
-57
2,594
2,600
-6
167
174
-7
70,038
69,773
265
9,690
9,436
254
234
239
-5
1,171
1,224
-53
19,405
16,105
3,300
5,760
4,792
968
2,687
2,939
-252
112
135
-23
14,223
10,234
3,989
10,151
9,707
444
3,035
1,859
1,176
11,295
10,119
1,176
6,301
7,444
-1,143
14,161
9,485
4,676
7,044
6,932
112
17,970
13,356
4,614
5,678
1,662
4,016
6,838
6,932
-94
8,570
7,172
1,398
4,246
2,077
2,169
6,496
4,957
1,539
8,011
7,506
505
3,131
3,184
-53
546,121
578,102
-31,981
530,281
552,800
-22,519
492,893
500,000
-7,107
577
586
-9
221
226
-5
1,647
1,720
-73
386,256
295,404
90,852
150,439
149,614
825
444,313
396,982
47,331
241,550
250,000
-8,450
46
20
26
10,611
12,438
-1,827
15,521
13,256
2,265
27,231
23,176
4,055
25,478
24,978
500
22,139
24,805
-2,666
2,914
3,306
-392
16,961
22,671
-5,710
17,443
18,312
-869
13,903
17,852
-3,949
8,239
11,014
-2,775
33,117
39,690
-6,573
25,518
27,197
-1,679
24,732
26,680
-1,948
10,306
11,384
-1,078
38,965
41,800
-2,835
80,890
82,866
-1,976
25,810
27,144
-1,334
19,294
22,478
-3,184
85,704
89,330
-3,626
9,903
11,089
-1,186
24,080
25,341
-1,261
11,665
13,418
-1,753
632
642
-10
222
226
-4
1,498
1,565
-67
50,000
50,000
8,402
4,269
4,133
2,542
2,971
-429
5,970
6,712
-742
5,809
3,237
2,572
43,214
45,525
-2,311
3,000
1,476
1,524
12,525
4,767
7,758
3,099
3,009
90
2,935
2,679
256
493
501
-8
236
241
-5
1,335
1,395
-60
21,533
15,003
6,530
55,000
55,000
106,257
100,352
5,905
12,719
11,301
1,418
594
603
-9
224
228
-4
122,142
124,115
-1,973
1,814
1,895
-81
47,531
50,093
-2,562
5,973
3,166
2,807
26,092
26,446
-354
7,551
6,060
1,491
115
113
2
2,845
2,559
286
3,184
2,933
251
2,439
2,636
-197
1,488
1,745
-257
19,295
16,824
2,471
6,338
5,450
888
20,505
17,671
2,834
2,092
2,019
73
4,184
4,355
-171
50,141
49,838
303
449
456
-7
1,423
1,487
-64
1,452
1,517
-65
191,306
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
70
b
-860
c
-402
d
-411
e
-2,072
1,297
-1,586
257
87
16
-211
-1,761
-553
-4
-2,054
184
340
1
1,496
481
158
43
-7
-9
-19
-21
4,617
-40
24
-198
-258
-59
-5
-38
4,706
-3,839
3,384
-3,968
-11,238
-6,738
3,125
6,817
2,053
32,734
1,742
4,091
9,787
351
2,086
438
10,026
2,708
1,763
-156
-20
1,074
915
438
589
565
628
637
466
121
-670
2,733
8,274
274
-708
561
440
3,279
-957
211
-4,928
-20,238
-10,266
-10,740
-6,287
75
889
12
1,098
1,001
193
-812
1,453
430
815
-2,132
6,709
2,385
84
-274
3,615
490
1,884
8,999
940
249
-502
-1,857
447
1,721
-455
-183
1,405
-963
-34
-37
393
3,454
-2,123
-589
4,557
5,327
-400
-3,845
-3,956
2,812
8,876
4,690
7,100
1,439
4,728
-18
-3,890
-4,009
-1,790
-3,042
10,629
-839
5,212
-5,909
-1,649
-1,274
3,679
-184
-16
-2,611
-71
-22
-852
-319
-1,638
-1,363
-1,643
260
1,712
-2,872
1,608
-1,757
7,824
2,759
-3,223
1,031
3,936
6,285
-5
-32
-62,622
-288
-2,348
-203
6,788
-5,190
-73
-670
-3,201
-2,277
-455
-6,464
634
-1,197
-3,941
-307
-2,175
-213
-2,937
-1,361
-2,528
-4,930
-1,515
520
2,558
-52,779
35,863
45
-891
-5,629
-4,160
-138
-2,295
-2,873
-15,057
-4,963
2,619
-74
-444
-2,224
-2,086
308
573
850
1,213
460
653
-279
205
-219
1,768
-1,562
900
-728
1
-31
-2,581
-4
-46
1,358
1,475
-268
270
27,893
-1,998
-704
-917
-2,488
-1,937
-2,726
-1,234
-1,637
4,615
-8,311
6
-1
25
-15
2
7
-9
-8
-15
22
6
21
15
9
12
7
3
-7
-11
6
-1
4
-50
1
9
-28
12
3
-6
-7
-10
34
15
15
-9
16
1
-13
11
-22
6
6
-326
4,505
3,912
229
-2,151
-4
-50
-409
88,190
-39,173
-4,376
-4,258
-2,362
-4,197
208,935
104,710
-1,360
-459
-2,205
-6,409
-1,161
-1,316
-968
3,690
2,369
-4
-57
-6
-7
265
254
-5
-53
3,300
968
-252
-23
3,989
444
1,176
1,176
-1,143
4,676
112
4,614
4,016
-94
1,398
2,169
1,539
505
-53
-31,981
-22,519
-7,107
-9
-5
-73
90,852
825
47,331
-8,450
26
-1,827
2,265
4,055
500
-2,666
-392
-5,710
-869
-3,949
-2,775
-6,573
-1,679
-1,948
-1,078
-2,835
-1,976
-1,334
-3,184
-3,626
-1,186
-1,261
-1,753
-10
-4
-67
4,133
-429
-742
2,572
-2,311
1,524
7,758
90
256
-8
-5
-60
6,530
5,905
1,418
-9
-4
-1,973
-81
-2,562
2,807
-354
1,491
2
286
251
-197
-257
2,471
888
2,834
73
-171
303
-7
-64
-65
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
584,122
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
1,288,074
26,098,583
0.049354
2017
1,266,395
25,348,046
0.04996
2016
1,242,261
23,916,460
0.051942
2015
1,243,121
25,435,787
0.048873
2014
1,165,337
26,119,685
0.044615
2
Total
of line 1, column (d)
.....................
2
0.244744
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
0.048949
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
25,764,312
5
Multiply line 4 by line 3
......................
5
1,261,137
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
10,438
7
Add lines 5 and 6
........................
7
1,271,575
8
Enter qualifying distributions from Part XII, line 4
,.............
8
1,466,079
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
10,438
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
10,438
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
10,438
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
24,960
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
24,960
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
14,522
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
10,440
Refunded
11
4,082
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)
MN
b
If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G?
If "No," attach explanation
.
8b
Yes
9
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
or 4942(j)(5) for calendar year 2019 or the taxable year beginning in 2019? See the instructions for Part XIV.
If "Yes," complete Part XIV
.............................
9
No
10
Did any persons become substantial contributors during the tax year?
If "Yes," attach a schedule listing their names
and addresses.
...............................
10
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
5
Part VII-A
Statements Regarding Activities
(continued)
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions
.............
11
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement. See instructions
.................
12
No
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
N/A
14
The books are in care of
WELLS FARGO BANK NA
Telephone no.
(888) 730-4933
Located at
100 N MAIN ST MAC D4001-117
WINSTON SALEM
NC
ZIP+4
27101
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
Yes
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
Yes
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
WELLS FARGO BANK N A
TRUSTEE
1
159,959
100 N MAIN ST MAC D4001-117
WINSTON SALEM
,
NC
27101
HALSEY H HALLS
COMMITTEE MEMBERS
0
500
11124 BLOOMINGTON FERRY ROAD
BLOOMINGTON
,
MN
55438
SANDRA ANDERSON
COMMITTEE MEMBERS
0
2,000
7112 WILLOW LANE
BROOKLYN CENTER
,
MN
55430
RON ISLAND
COMMITTEE MEMBERS
0
2,000
1711 BRANDING IRON DRIVE
SPEARFISH
,
SD
57783
ROBERT A ENGEBRETSEN
COMMITTEE MEMBERS
0
2,000
8232 NEVADA CIR
BLOOMINGTON
,
MN
55438
BARRY A KELNER
COMMITTEE MEMBERS
0
2,000
5245 DOMINICK DRIVE
MINNETONKA
,
MN
55343
THOMAS M MORIN
COMMITTEE MEMBERS
0
2,000
2525 E LAKE OF THE ISLES PKWY
MINNEAPOLIS
,
MN
55405
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
24,698,712
b
Average of monthly cash balances
.......................
1b
1,457,950
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
26,156,662
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
26,156,662
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
392,350
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
25,764,312
6
Minimum investment return.
Enter 5% of line 5
..................
6
1,288,216
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
1,288,216
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
10,438
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
10,438
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
1,277,778
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
1,277,778
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
1,277,778
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
1,466,079
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
1,466,079
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
10,438
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
1,455,641
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
1,277,778
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
832,733
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:
$
1,466,079
a
Applied to 2018, but not more than line 2a
832,733
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
.....
633,346
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
..........
644,432
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).)
NONE
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
NONE
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
WELLS FARGO BANK N A
100 N MAIN ST MAC D4001-117
WINSTON SALEM
,
NC
27101
(888) 730-4933
b
The form in which applications should be submitted and information and materials they should include:
THE APPLICATION MAY BE COMPLETED ONLINE AT WELLSFARGO.COM/PRIVATEFOUND
c
Any submission deadlines:
AUGUST 1ST ANNUALLY
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
THE RECIPIENT ORGANIZATION MUST BE LOCATED IN LOS ANGELES COUTY, CA AND SOUTH DAKOTA
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
4GIRLS Organization
PO BOX 41452
Long Beach
,
CA
90853
NONE
PC
GENERAL OPERATING
5,000
Alexandria House
426 S ALEXANDRIA AVE
Los Angeles
,
CA
90020
NONE
PC
GENERAL OPERATING
20,000
AbilityFirst
PO BOX 3367
Crestline
,
CA
92325
NONE
PC
GENERAL OPERATING
10,000
Amanecer Community Counseling Services
1200 WILSHIRE BLVD SUITE 400
Los Angeles
,
CA
90017
NONE
PC
GENERAL OPERATING
5,000
American Youth Symphony Inc
2301 ROSECRANS AVE 2160
El Segundo
,
CA
90245
NONE
PC
GENERAL OPERATING
10,000
Angelica Center for Arts & Music
1345 S BURLINGTON AVE
Los Angeles
,
CA
90006
NONE
PC
GENERAL OPERATING
8,400
Assistance League of Los Angeles
826 COLE AVE
Los Angeles
,
CA
90038
NONE
PC
GENERAL OPERATING
10,000
Cantwell-Sacred Heart of Mary High Schoo
329 N GARFIELD AVE
Montebello
,
CA
90640
NONE
PC
GENERAL OPERATING
10,000
Catholic Big Brothers Big Sisters Inc
1530 JAMES M WOOD BLVD
Los Angeles
,
CA
90015
NONE
PC
GENERAL OPERATING
10,000
Christian Outreach in Action
515 EAST THIRD STREET
Long Beach
,
CA
90802
NONE
PC
GENERAL OPERATING
5,000
The Colburn School
200 S GRAND AVE
Los Angeles
,
CA
90012
NONE
PC
GENERAL OPERATING
15,000
Conga Kids
5858 WILSHIRE BLVD STE 301
Los Angeles
,
CA
90036
NONE
PC
GENERAL OPERATING
5,000
Dignity Health
185 BERRY STREET SUITE 300
San Francisco
,
CA
94107
NONE
PC
GENERAL OPERATING
10,000
Fernando Pullum Community Art Center
3351 W 43RD ST
Los Angeles
,
CA
90008
NONE
PC
GENERAL OPERATING
5,000
Food Finders
3744 INDUSTRY AVE 401
Lakewood
,
CA
90712
NONE
PC
GENERAL OPERATING
5,000
Food On Foot
1625 SCHRADER BLVD
Los Angeles
,
CA
90028
NONE
PC
GENERAL OPERATING
5,000
Foundation for Women Warriors
11206 WEDDINGTON ST
North Hollywood
,
CA
91601
NONE
PC
GENERAL OPERATING
5,000
Good Shepherd Shelter
2561 W VENICE BLVD
Los Angeles
,
CA
90019
NONE
PC
GENERAL OPERATING
50,000
Hamburger Home Inc
7120 FRANKLIN AVE
Los Angeles
,
CA
90046
NONE
PC
GENERAL OPERATING
10,000
Heart of Los Angeles (HOLA)
2701 WILSHIRE BLVD 100
Los Angeles
,
CA
90057
NONE
PC
GENERAL OPERATING
20,000
House Of Blues Music Forward Foundation
7060 HOLLYWOOD BLVD
Los Angeles
,
CA
90028
NONE
PC
GENERAL OPERATING
10,000
LA Family Housing Corporation
7843 LANKERSHIM BLVD
North Hollywood
,
CA
91605
NONE
PC
GENERAL OPERATING
10,000
LACER Afterschool Programs
1277 WILCOX AVE 2
Los Angeles
,
CA
90038
NONE
PC
GENERAL OPERATING
10,000
Meals On Wheels West
1823-A MICHIGAN AVENUE
Santa Monica
,
CA
90404
NONE
PC
GENERAL OPERATING
5,000
The Midnight Mission
601 SAN PEDRO ST
Los Angeles
,
CA
90014
NONE
PC
GENERAL OPERATING
15,000
New Beginnings Inc
2624 LORD BALTIMORE DR L
Windsor Mill
,
MD
21244
NONE
PC
GENERAL OPERATING
10,000
Operation Save the Streets
PO BOX 904
Lancaster
,
CA
93584
NONE
PC
GENERAL OPERATING
5,000
Archdiocese of Los Angeles
3424 WILSHIRE BLVD
Los Angeles
,
CA
90010
NONE
PC
GENERAL OPERATING
15,000
Saint Andrew's Abbey
31001 N VALYERMO RD
Valyermo
,
CA
93563
NONE
PC
GENERAL OPERATING
30,000
Saint John s Health Center Foundation
2221 SANTA MONICA BLVD
Santa Monica
,
CA
90404
NONE
PC
GENERAL OPERATING
15,000
Santa Teresita
819 BUENA VISTA STREET
Duarte
,
CA
91010
NONE
PC
GENERAL OPERATING
20,000
Su Casa Ending Domestic Violence
3750 E ANAHEIM ST SUITE 100
Long Beach
,
CA
90804
NONE
PC
GENERAL OPERATING
10,000
Union Station Homeless Services
825 E ORANGE GROVE BLVD
Pasadena
,
CA
91104
NONE
PC
GENERAL OPERATING
5,000
Venice Family Clinic
604 ROSE AVENUE
Venice
,
CA
90291
NONE
PC
GENERAL OPERATING
10,000
Vista Del Mar Child and Family Services
3200 MOTOR AVE
Los Angeles
,
CA
90034
NONE
PC
GENERAL OPERATING
10,000
The Whole Child
10155 COLIMA RD
Whittier
,
CA
90603
NONE
PC
GENERAL OPERATING
10,000
Wilmington Community Clinic
1009 N AVALON BLVD
Wilmington
,
CA
90744
NONE
PC
GENERAL OPERATING
10,000
WOMEN CROWNED IN GLORY CORPORATION
PO BOX 40034
STUDIO CITY
,
CA
91614
NONE
PC
GENERAL OPERATING
10,000
Children's Home Society
PO BOX 1749
Sioux Falls
,
SD
571011749
NONE
PC
GENERAL OPERATING
10,000
The Mammoth Site
1800 US-18 BYP
Hot Springs
,
SD
57747
NONE
PC
GENERAL OPERATING
5,000
Missouri Valley Crisis Center
PO BOX 4
Chamberlain
,
SD
57325
NONE
PC
GENERAL OPERATING
15,000
Sioux Spiritual Center
20100 CENTER ROAD
Howes
,
SD
57748
NONE
PC
GENERAL OPERATING
10,000
StVincentdePaul StPatrickStAmbrose Conf
PO BOX 239
Lead
,
SD
57754
NONE
PC
GENERAL OPERATING
10,000
St Ambrose Catholic Church
760 MAIN ST
Deadwood
,
SD
57732
NONE
PC
GENERAL OPERATING
4,000
St Patrick Church
3585 30TH ST
San Diego
,
CA
92104
NONE
PC
GENERAL OPERATING
4,000
Lawrence County Teen Court
68 SHERMAN ST 213
Deadwood
,
SD
57732
NONE
PC
GENERAL OPERATING
5,000
WolakotaWaldorf Society
3 MILE CREEK RD
Kyle
,
SD
57752
NONE
PC
GENERAL OPERATING
20,000
BOYS AND GIRLS CLUB OF HOLLYWOOD
850 N CAHUENGA BLVD
LOS ANGELES
,
CA
90038
NONE
PC
GENERAL OPERATING
10,000
BROTHERS HELPERS INC
215 FOOTHILL BLVD
LA CANADA
,
CA
91011
NONE
PC
GENERAL OPERATING
5,000
LOYOLA MARYMOUNT UNIVERSITY
1 LMU DRIVE
LOS ANGELES
,
CA
90045
NONE
PC
GENERAL OPERATING
150,325
HABITAT FOR HUMANITY OF GREATER SIOUX FA
721 E AMIDON ST
SIOUX FALLS
,
SD
57104
NONE
PC
GENERAL OPERATING
10,000
CROSSROADS INC
PO BOX 15
CLAREMONT
,
CA
91711
NONE
PC
GENERAL OPERATING
10,000
DEADWOOD HISTORY INC
150 SHERMAN ST
DEADWOOD
,
SD
57732
NONE
PC
GENERAL OPERATING
250,000
RED CLOUD INDIAN SCHOOL
100 MISSION DRIVE
PINE RIDGE
,
SD
57770
NONE
PC
GENERAL OPERATING
100,000
HAVEN HILLS INC
PO BOX 260
CANOGA PARK
,
CA
91305
NONE
PC
GENERAL OPERATING
5,000
PINE RIDGE GIRLS SCHOOL INC
100 CHILDRENS LANE
PORCUPINE
,
SD
57772
NONE
PC
GENERAL OPERATING
10,000
CATHOLIC CHARITIES OF LOS ANGELES
1531 JAMES M WOOD BOULEVARD
LOS ANGELES
,
CA
90015
NONE
PC
GENERAL OPERATING
30,000
HOUSE OF RUTH INC
PO BOX 459
CLAREMONT
,
CA
91768
NONE
PC
GENERAL OPERATING
5,000
DOWNTOWN WOMENS CENTER
442 SAN PEDRO ST
LOS ANGELES
,
CA
90013
NONE
PC
GENERAL OPERATING
25,000
GIRLS INC OF GREATER LOS ANGELES
9800 S LA CIENEGA BLVD 410
INGLEWOOD
,
CA
90301
NONE
PC
GENERAL OPERATING
15,000
FOOD FORWARD INC
7412 FULTON AVE 3
HOLLYWOOD
,
CA
91605
NONE
PC
GENERAL OPERATING
10,000
FAMILY HOPE
PO BOX 94077
PASADENA
,
CA
91009
NONE
PC
GENERAL OPERATING
10,000
LOS ANGELES CHILDRENS CHORUS
585 E COLORADO BOULEVARD
PASADENA
,
CA
91101
NONE
PC
GENERAL OPERATING
5,000
MARYCREST MANOR
10664 SAINT JAMES DR
CULVER CITY
,
CA
90230
NONE
PC
GENERAL OPERATING
35,000
JOSEPH LEARNING LAB
1316 E 29TH ST
SIGNAL HILL
,
CA
90755
NONE
PC
GENERAL OPERATING
10,000
SERVANTS OF MARY MINISTERS TO THE SICK
2131 W 27TH ST
LOS ANGELES
,
CA
90018
NONE
PC
GENERAL OPERATING
15,000
DIOCESE OF RAPID CITY
2101 CITY SPRINGS RD STE 300
RAPID CITY
,
SD
57702
NONE
PC
GENERAL OPERATING
5,000
CATHOLIC SOCIAL SERVICES
529 KANSAS CITY ST SUITE 100
RAPID CITY
,
FL
57701
NONE
PC
GENERAL OPERATING
10,000
NATIVE AMERICAN COMMUNITY BOARD
PO BOX 572
LAKE ANDES
,
SD
57356
NONE
PC
GENERAL OPERATING
5,000
NEIGHBORHOOD HOUSING SERVICES
795 MAIN ST
DEADWOOD
,
SD
57732
NONE
PC
GENERAL OPERATING
15,000
HISTORIC HOMESTAKE OPERA HOUSE
PO BOX 412
LEAD
,
SD
57754
NONE
PC
GENERAL OPERATING
50,000
HISTORIC DEADWOOD LEAD ARTS COUNCIL
PO BOX 595
LEAD
,
SD
57754
NONE
PC
GENERAL OPERATING
15,000
NORTHERN HILLS ALLIANCE FOR CHILDREN
753 MAIN ST
DEADWOOD
,
SD
57732
NONE
PC
GENERAL OPERATING
50,000
YOUTH AND FAMILY SERVICES INC
7565 EAST HIGHWAY 66
EL RENO
,
OK
73036
NONE
PC
GENERAL OPERATING
5,000
ST JOSEPHS INDIAN SCHOOL
1301 N MAIN ST
CHAMBERLAIN
,
SD
57325
NONE
PC
GENERAL OPERATING
10,000
RAPID CITY CATHOLIC SCHOOL SYSTEM
242 FAIRMONT BLVD
RAPID CITY
,
SD
57701
NONE
PC
GENERAL OPERATING
5,000
NORTHERN BLACK HILLS SOCIETY FOR PRESER
PO BOX 431
DEADWOOD
,
SD
57732
NONE
PC
GENERAL OPERATING
5,000
Total
.................................
3a
1,401,725
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
643,737
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
584,122
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
PARTNERSHIP INCOME
91
b
OTHER INCOME
1,341
c
FEDERAL TAX REFUND
7,080
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
1,236,371
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
1,236,371
(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