Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0052
2018
Open to Public Inspection
For calendar year 2018, or tax year beginning 11-01-2018 , and ending 10-31-2019
Name of foundation
HARRY & THELMA SURRENA MEMORIAL
 
Number and street (or P.O. box number if mail is not delivered to street address)P O BOX 603
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SHERIDAN, WY82801
A Employer identification number

23-7435554
B Telephone number (see instructions)

(307) 672-6494
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$5,823,583J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet.............
3 Interest on savings and temporary cash investments 7,727 7,727  
4 Dividends and interest from securities... 130,696 130,696  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 734,853
b Gross sales price for all assets on line 6a 3,658,311
7 Capital gain net income (from Part IV, line 2)... 734,853
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 873,276 873,276  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 38,982 19,491   19,491
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 2,200 1,650   550
c Other professional fees (attach schedule).... Click to see attachment 32,700 32,700    
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 19,463 1,491   1,491
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule).......        
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 93,345 55,332   21,532
25 Contributions, gifts, grants paid....... 241,000 241,000
26 Total expenses and disbursements. Add lines 24 and 25 334,345 55,332   262,532
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 538,931
b Net investment income (if negative, enter -0-) 817,944
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2018)
Form 990-PF (2018)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing.............      
2 Savings and temporary cash investments......... 92,201 207,546 207,980
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule) 400,000 Click to see attachment346,368 347,744
b Investments—corporate stock (attach schedule)....... 3,336,122 Click to see attachment3,509,033 3,909,850
c Investments—corporate bonds (attach schedule)....... 1,033,499 Click to see attachment1,341,289 1,335,027
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet) Click to see attachment22,982 Click to see attachment22,982 Click to see attachment22,982
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 4,884,804 5,427,218 5,823,583
Liabilities 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 bullet) Click to see attachment4,998 Click to see attachment8,481
23 Total liabilities (add lines 17 through 22)......... 4,998 8,481
Net Assets or Fund Balances Foundations that follow SFAS 117, check here bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted..................    
25 Temporarily restricted...............    
26 Permanently restricted...............    
Foundations that do not follow SFAS 117, check here bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds........ 2,443,594 2,443,594
28 Paid-in or capital surplus, or land, bldg., and equipment fund    
29 Retained earnings, accumulated income, endowment, or other funds 2,436,212 2,975,143
30 Total net assets or fund balances (see instructions)..... 4,879,806 5,418,737
31 Total liabilities and net assets/fund balances (see instructions). 4,884,804 5,427,218
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 30 (must agree with end-of-year figure reported on prior year’s return) ...............
1
4,879,806
2
Enter amount from Part I, line 27a .....................
2
538,931
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
5,418,737
5
Decreases not included in line 2 (itemize) bullet
5
 
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30 .
6
5,418,737
Form 990-PF (2018)
Form 990-PF (2018)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1 a 471-EXELON CORP P 2015-03-31 2018-12-03
b 257-AMERICAN EXPRESS CO P 2013-08-29 2019-04-05
c 150-EXXON MOBIL CORP P 2011-03-03 2019-04-05
d 367-NIKE INC P 2016-10-12 2019-04-05
e 424-TECHNOLOGY SELECT SECTOR SPDR FU P 2018-03-16 2019-04-05
4369.117-VANGUARD HIGH-YIELD CORPORA P 2009-09-17 2019-04-05
349-QUALCOMM INC P 2017-02-02 2019-05-13
221-MONDELEZ INTERNATIONAL INC P 2011-10-25 2019-07-10
12-CHEVRON CORP P 2003-06-16 2019-09-24
14-PEPSICO INC P 1997-03-21 2019-09-24
3395.311-DFA GLOBAL REAL ESTATE SECU P 2017-04-10 2019-09-24
1960-TENNESSEE VALLEY AUTHORITY VARI P 2005-06-23 2019-01-28
104-AMERICAN EXPRESS CO P 2016-03-11 2019-04-05
109-EXXON MOBIL CORP P 2015-12-10 2019-04-05
230-PEPSICO INC P 1997-03-21 2019-04-05
295-TECHNOLOGY SELECT SECTOR SPDR FU P 2018-05-16 2019-04-05
4329.004-VANGUARD INTERMEDIATE-TERM P 2015-04-01 2019-04-05
137-STARBUCKS CORP P 2016-04-18 2019-05-15
6-MONDELEZ INTERNATIONAL INC P 2012-11-02 2019-07-10
28-CISCO SYSTEMS INC P 2011-10-25 2019-09-24
32-MATERIALS SELECT SECTOR SPDR FUND P 2019-02-08 2019-09-24
187.324-FIDELITY INTERNATIONAL INDEX P 2018-01-17 2019-09-24
4472.272-EATON VANCE FLOATING-RATE A P 2014-03-03 2019-01-29
211-APPLE INC P 2014-03-28 2019-04-05
14-FACEBOOK INC P 2016-11-18 2019-04-05
97-QUALCOMM INC P 2016-03-11 2019-04-05
115-TECHNOLOGY SELECT SECTOR SPDR FU P 2018-08-10 2019-04-05
4336.513-VANGUARD INTERMEDIATE-TERM P 2016-05-26 2019-04-05
16-STARBUCKS CORP P 2017-06-29 2019-05-15
136-MONDELEZ INTERNATIONAL INC P 2012-11-02 2019-07-10
17-WALT DISNEY CO/THE P 2012-05-09 2019-09-24
43-HEALTH CARE SELECT SECTOR SPDR FU P 2018-08-10 2019-09-24
759.277-GOLDMAN SACHS INTERNATIONAL P 2013-08-27 2019-09-24
4484.305-EATON VANCE FLOATING-RATE A P 2013-08-27 2019-01-29
122-BERKSHIRE HATHAWAY INC P 2010-02-17 2019-04-05
72-FACEBOOK INC P 2018-03-27 2019-04-05
243-QUALCOMM INC P 2017-02-02 2019-04-05
703-COMMUNICATION SERVICES SELECT SE P 2018-08-10 2019-04-05
5611.169-VANGUARD INTERMEDIATE-TERM P 2017-11-03 2019-04-05
92-WALT DISNEY CO/THE P 2010-03-12 2019-05-30
13-SCHLUMBERGER LTD P 2011-12-27 2019-08-12
30-EMERSON ELECTRIC CO P 2004-02-25 2019-09-24
23-CONSUMER STAPLES SELECT SECTOR SP P 2018-05-16 2019-09-24
54.089-VANGUARD 500 INDEX FUND P 2016-01-27 2019-09-24
424.286-EATON VANCE FLOATING-RATE AD P 2018-05-24 2019-01-29
150-BOEING CO/THE P 1997-03-21 2019-04-05
98-FEDEX CORP P 2015-12-14 2019-04-05
260-SCHLUMBERGER LTD P 2011-11-23 2019-04-05
692-REAL ESTATE SELECT SECTOR SPDR F P 2019-03-28 2019-04-05
1654.204-VANGUARD SHORT-TERM INVESTM P 2014-11-19 2019-04-05
19-WALT DISNEY CO/THE P 2010-03-12 2019-05-30
470-SCHLUMBERGER LTD P 2018-11-30 2019-08-12
21-EXELON CORP P 2015-03-31 2019-09-24
9-CONSUMER DISCRETIONARY SELECT SECT P 2019-05-14 2019-09-24
228.643-VANGUARD 500 INDEX FUND P 2016-01-27 2019-10-09
96.15-DOWDUPONT INC P 2011-03-03 2019-02-11
150-BOEING CO/THE P 2011-11-04 2019-04-05
450-GILEAD SCIENCES INC P 2012-05-04 2019-04-05
212-SCHLUMBERGER LTD P 2011-12-27 2019-04-05
274-SKYWORKS SOLUTIONS INC P 2013-08-23 2019-04-05
655.179-VANGUARD MID-CAP INDEX FUND P 2016-05-26 2019-04-05
73-WALT DISNEY CO/THE P 2012-05-09 2019-05-30
7561.437-VANGUARD SHORT-TERM INVESTM P 2014-11-19 2019-09-04
15-EXXON MOBIL CORP P 2015-12-10 2019-09-24
77-FINANCIAL SELECT SECTOR SPDR FUND P 2018-10-31 2019-09-24
826.535-VANGUARD 500 INDEX FUND P 2019-04-05 2019-10-09
288.45-DOWDUPONT INC P 2011-10-25 2019-02-11
402-BRISTOL-MYERS SQUIBB CO P 2013-02-05 2019-04-05
126-GOLDMAN SACHS GROUP INC/THE P 2018-10-31 2019-04-05
327-MATERIALS SELECT SECTOR SPDR FUN P 2018-06-18 2019-04-05
448-STARBUCKS CORP P 2016-04-18 2019-04-05
148.801-VANGUARD MID-CAP INDEX FUND P 2017-02-02 2019-04-05
1111.865-AMERICAN FUNDS EUROPACIFIC P 2004-11-12 2019-06-26
13666.352-VANGUARD SHORT-TERM FEDERA P 2019-04-08 2019-09-04
10-FACEBOOK INC P 2018-03-27 2019-09-24
60-TECHNOLOGY SELECT SECTOR SPDR FUN P 2018-08-10 2019-09-24
51-APPLE INC P 2016-04-28 2019-10-16
280.4-DOWDUPONT INC P 2010-10-26 2019-02-11
154-CHEVRON CORP P 2003-06-16 2019-04-05
248-JPMORGAN CHASE & CO P 2012-05-25 2019-04-05
139-MATERIALS SELECT SECTOR SPDR FUN P 2019-02-08 2019-04-05
174-UNION PACIFIC CORP P 2013-11-20 2019-04-05
135.561-VANGUARD MID-CAP INDEX FUND P 2017-11-03 2019-04-05
693.782-AMERICAN FUNDS EUROPACIFIC G P 2005-06-24 2019-06-26
10314.118-VANGUARD SHORT-TERM FEDERA P 2019-06-27 2019-09-04
12-FEDEX CORP P 2015-12-14 2019-09-24
62-COMMUNICATION SERVICES SELECT SEC P 2018-08-10 2019-09-24
LITIGATION PROCEEDS P 2018-01-01 2019-01-07
173-FACEBOOK INC P 2016-11-18 2019-02-12
74-CISCO SYSTEMS INC P 2004-02-25 2019-04-05
344-LOWE'S COS INC P 2016-10-19 2019-04-05
594-HEALTH CARE SELECT SECTOR SPDR F P 2018-04-04 2019-04-05
89-UNITEDHEALTH GROUP INC P 2012-09-27 2019-04-05
4578.754-EATON VANCE FLOATING-RATE A P 2015-04-01 2019-04-08
264.794-AMERICAN FUNDS EUROPACIFIC G P 2012-07-27 2019-06-26
2-ALPHABET INC P 2017-07-26 2019-09-24
22-GILEAD SCIENCES INC P 2012-05-04 2019-09-24
49-REAL ESTATE SELECT SECTOR SPDR FU P 2019-03-28 2019-09-24
429-CONSUMER DISCRETIONARY SELECT SE P 2018-03-16 2019-02-19
500-CISCO SYSTEMS INC P 2010-06-02 2019-04-05
157-MCKESSON CORP P 2012-09-13 2019-04-05
74-HEALTH CARE SELECT SECTOR SPDR FU P 2018-08-10 2019-04-05
252-WALMART INC P 2016-01-25 2019-04-05
3216.96-EATON VANCE FLOATING-RATE AD P 2017-11-03 2019-04-08
121.85-AMERICAN FUNDS EUROPACIFIC GR P 2015-04-01 2019-06-26
1-AMAZON.COM INC P 2019-02-15 2019-09-24
9-GOLDMAN SACHS GROUP INC/THE P 2018-10-31 2019-09-24
13-SKYWORKS SOLUTIONS INC P 2013-08-23 2019-09-24
2021.836-VANGUARD SHORT-TERM INFLATI P 2013-08-27 2019-03-04
21-CISCO SYSTEMS INC P 2011-10-25 2019-04-05
73-MCKESSON CORP P 2016-04-18 2019-04-05
206-CONSUMER STAPLES SELECT SECTOR S P 2018-05-16 2019-04-05
8650.519-DFA INFLATION PROTECTED SEC P 2018-05-24 2019-04-05
9633.912-DFA COMMODITY STRATEGY PORT P 2016-01-27 2019-04-10
1800.798-DFA US SMALL CAP PORTFOLIO P 2016-01-27 2019-06-26
22-AMERICAN EXPRESS CO P 2016-03-11 2019-09-24
14-JPMORGAN CHASE & CO P 2012-05-25 2019-09-24
26-STARBUCKS CORP P 2017-06-29 2019-09-24
510-JPMORGAN CHASE & CO P 2012-05-25 2019-03-29
451-WALT DISNEY CO/THE P 2010-03-12 2019-04-05
307-MICROSOFT CORP P 2013-08-15 2019-04-05
96-ENERGY SELECT SECTOR SPDR FUND P 2018-10-31 2019-04-05
4344.049-DFA INFLATION PROTECTED SEC P 2019-03-04 2019-04-05
11087.588-DFA COMMODITY STRATEGY POR P 2017-02-02 2019-04-10
742.942-DFA US SMALL CAP PORTFOLIO P 2017-02-02 2019-06-26
13-APPLE INC P 2014-03-28 2019-09-24
19-LOWE'S COS INC P 2016-10-19 2019-09-24
10-UNION PACIFIC CORP P 2013-11-20 2019-09-24
21-ALPHABET INC P 2016-11-18 2019-04-05
356-EMERSON ELECTRIC CO P 2004-02-25 2019-04-05
174-MICROCHIP TECHNOLOGY INC P 2018-10-31 2019-04-05
927-FINANCIAL SELECT SECTOR SPDR FUN P 2018-03-27 2019-04-05
36.655-OPPENHEIMER INTERNATIONAL BON P 2014-03-03 2019-04-05
1548.467-DFA US SMALL CAP PORTFOLIO P 2015-04-01 2019-05-10
690.799-DFA US SMALL CAP PORTFOLIO P 2017-11-03 2019-06-26
10-BERKSHIRE HATHAWAY INC P 2010-02-17 2019-09-24
20-MICROSOFT CORP P 2013-08-15 2019-09-24
5-UNITEDHEALTH GROUP INC P 2012-09-27 2019-09-24
2-ALPHABET INC P 2017-07-26 2019-04-05
371-EXELON CORP P 2015-03-31 2019-04-05
304-MONDELEZ INTERNATIONAL INC P 2010-08-06 2019-04-05
280-FINANCIAL SELECT SECTOR SPDR FUN P 2018-10-31 2019-04-05
4065.206-OPPENHEIMER INTERNATIONAL B P 2014-05-13 2019-04-05
150.041-DFA US SMALL CAP PORTFOLIO P 2016-01-27 2019-05-10
115.907-DFA US SMALL CAP PORTFOLIO P 2018-05-24 2019-06-26
4-BOEING CO/THE P 2019-07-10 2019-09-24
21-MICROCHIP TECHNOLOGY INC P 2018-10-31 2019-09-24
18-WALMART INC P 2016-01-25 2019-09-24
13-AMAZON.COM INC P 2019-02-15 2019-04-05
128-EXXON MOBIL CORP P 1983-06-24 2019-04-05
229-MONDELEZ INTERNATIONAL INC P 2011-10-25 2019-04-05
418-INDUSTRIAL SELECT SECTOR SPDR FU P 2018-02-02 2019-04-05
8250.964-OPPENHEIMER INTERNATIONAL B P 2014-09-12 2019-04-05
4.938-VANGUARD 500 INDEX FUND P 2016-01-27 2019-05-10
94-MCKESSON CORP P 2016-04-18 2019-07-10
40-BRISTOL-MYERS SQUIBB CO P 2013-02-05 2019-09-24
23-NIKE INC P 2016-10-12 2019-09-24
79.372-AMERICAN FUNDS EUROPACIFIC GR P 2015-04-01 2019-09-24
(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 21,599   15,738 5,861
b 28,492   18,626 9,866
c 12,326   12,824 -498
d 31,430   19,309 12,121
e 32,182   29,572 2,610
25,341   23,025 2,316
29,524   17,760 11,764
12,210   4,940 7,270
1,496   451 1,045
1,907   430 1,477
42,034   36,466 5,568
49,039   49,980 -941
11,530   6,195 5,335
8,957   8,302 655
27,957   7,072 20,885
22,391   20,468 1,923
47,792   50,000 -2,208
10,569   8,361 2,208
332   157 175
1,397   495 902
1,866   1,678 188
7,703   8,493 -790
47,674   50,000 -2,326
41,487   16,173 25,314
2,458   1,640 818
5,619   4,895 724
8,729   8,422 307
47,875   50,000 -2,125
1,234   938 296
7,519   3,566 3,953
2,276   768 1,508
3,949   3,861 88
8,618   7,160 1,458
47,803   50,000 -2,197
25,026   9,298 15,728
12,639   10,899 1,740
14,077   12,366 1,711
33,927   34,683 -756
61,947   62,621 -674
12,107   3,101 9,006
446   901 -455
1,949   948 1,001
1,398   1,142 256
14,873   9,401 5,472
4,523   4,642 -119
59,151   7,943 51,208
18,487   13,930 4,557
11,596   17,339 -5,743
25,203   24,947 256
17,501   17,717 -216
2,504   640 1,864
16,128   21,330 -5,202
1,019   702 317
1,093   1,030 63
61,635   39,741 21,894
4,935   3,901 1,034
59,151   9,873 49,278
30,349   11,415 18,934
9,455   14,696 -5,241
23,604   6,891 16,713
133,604   100,000 33,604
9,621   3,298 6,323
81,588   80,983 605
1,077   1,142 -65
2,171   2,034 137
222,809   220,701 2,108
14,806   9,748 5,058
18,822   14,857 3,965
25,704   28,538 -2,834
18,972   19,464 -492
33,582   27,341 6,241
30,344   25,000 5,344
58,295   38,447 19,848
147,597   145,000 2,597
1,880   1,514 366
4,861   4,394 467
11,933   4,890 7,043
14,393   9,785 4,608
19,362   5,787 13,575
26,139   8,340 17,799
8,065   7,290 775
29,460   13,827 15,633
27,644   25,000 2,644
36,375   25,000 11,375
111,392   110,464 928
1,749   1,706 43
3,141   3,059 82
1,218     1,218
28,517   20,263 8,254
4,105   1,734 2,371
39,342   23,907 15,435
54,636   47,791 6,845
21,864   5,016 16,848
49,313   50,000 -687
13,883   10,000 3,883
2,480   1,930 550
1,451   558 893
1,928   1,766 162
47,155   45,340 1,815
27,735   11,565 16,170
18,354   13,805 4,549
6,807   6,645 162
24,938   16,054 8,884
34,647   35,065 -418
6,389   6,121 268
1,791   1,611 180
1,926   2,038 -112
1,041   327 714
48,969   50,000 -1,031
1,165   371 794
8,534   12,730 -4,196
11,429   10,229 1,200
101,298   100,000 1,298
54,624   50,000 4,624
59,372   46,154 13,218
2,615   1,310 1,305
1,663   471 1,192
2,381   1,523 858
51,110   17,151 33,959
51,685   15,202 36,483
36,880   9,752 27,128
6,431   6,513 -82
50,869   50,000 869
62,867   67,413 -4,546
24,495   25,000 -505
2,874   996 1,878
2,118   1,320 798
1,671   795 876
25,573   16,361 9,212
25,288   11,145 14,143
16,030   11,402 4,628
24,641   25,084 -443
202   217 -15
53,112   50,000 3,112
22,776   25,000 -2,224
2,080   762 1,318
2,800   635 2,165
1,147   282 865
2,435   1,930 505
18,443   12,397 6,046
15,097   5,855 9,242
7,443   7,396 47
22,359   24,440 -2,081
5,146   3,846 1,300
3,821   4,341 -520
1,518   1,410 108
1,937   1,376 561
2,128   1,147 981
23,841   20,946 2,895
10,518   553 9,965
11,372   5,119 6,253
32,207   33,090 -883
45,380   48,862 -3,482
1,316   858 458
13,129   16,392 -3,263
2,023   1,478 545
2,034   1,210 824
4,149   3,987 162
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       5,861
b       9,866
c       -498
d       12,121
e       2,610
      2,316
      11,764
      7,270
      1,045
      1,477
      5,568
      -941
      5,335
      655
      20,885
      1,923
      -2,208
      2,208
      175
      902
      188
      -790
      -2,326
      25,314
      818
      724
      307
      -2,125
      296
      3,953
      1,508
      88
      1,458
      -2,197
      15,728
      1,740
      1,711
      -756
      -674
      9,006
      -455
      1,001
      256
      5,472
      -119
      51,208
      4,557
      -5,743
      256
      -216
      1,864
      -5,202
      317
      63
      21,894
      1,034
      49,278
      18,934
      -5,241
      16,713
      33,604
      6,323
      605
      -65
      137
      2,108
      5,058
      3,965
      -2,834
      -492
      6,241
      5,344
      19,848
      2,597
      366
      467
      7,043
      4,608
      13,575
      17,799
      775
      15,633
      2,644
      11,375
      928
      43
      82
      1,218
      8,254
      2,371
      15,435
      6,845
      16,848
      -687
      3,883
      550
      893
      162
      1,815
      16,170
      4,549
      162
      8,884
      -418
      268
      180
      -112
      714
      -1,031
      794
      -4,196
      1,200
      1,298
      4,624
      13,218
      1,305
      1,192
      858
      33,959
      36,483
      27,128
      -82
      869
      -4,546
      -505
      1,878
      798
      876
      9,212
      14,143
      4,628
      -443
      -15
      3,112
      -2,224
      1,318
      2,165
      865
      505
      6,046
      9,242
      47
      -2,081
      1,300
      -520
      108
      561
      981
      2,895
      9,965
      6,253
      -883
      -3,482
      458
      -3,263
      545
      824
      162
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 734,853
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3 13,610
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)

If section 4940(d)(2) applies, leave this part blank.
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period?
If "Yes," the foundation does not qualify under section 4940(e). Do not complete this part.
1 Enter the appropriate amount in each column for each year; see instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in) 		(b)
Adjusted qualifying distributions 		(c)
Net value of noncharitable-use assets 		(d)
Distribution ratio
(col. (b) divided by col. (c))
2017 285,532 5,920,934 0.048224
2016 285,507 5,836,340 0.048919
2015 295,282 5,544,325 0.053258
2014 308,616 5,532,056 0.055787
2013 303,292 5,560,400 0.054545
2
Total of line 1, column (d) .....................
2
0.260733
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
0.052147
4
Enter the net value of noncharitable-use assets for 2018 from Part X, line 5......
4
5,683,452
5
Multiply line 4 by line 3......................
5
296,375
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
8,179
7
Add lines 5 and 6........................
7
304,554
8
Enter qualifying distributions from Part XII, line 4,.............
8
262,532
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See the Part VI instructions.
Form 990-PF (2018)
Form 990-PF (2018)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket includes lines 1a and 1b
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b Domestic foundations that meet the section 4940(e) requirements in Part V, check 1 16,359
hereBulletand enter 1% of Part I, line 27b...................
c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2  
3 Add lines 1 and 2........................... 3 16,359
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 16,359
6 Credits/Payments:
a 2018 estimated tax payments and 2017 overpayment credited to 2018 6a 8,000
b Exempt foreign organizations—tax withheld at source...... 6b
c Tax paid with application for extension of time to file (Form 8868)... 6c 10,100
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 18,100
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. Click to see attachment 8 122
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 1,619
11 Enter the amount of line 10 to be: Credited to 2019 estimated taxBullet1,619 RefundedBullet 11  
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition).................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletWY
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2018 or the taxable year beginning in 2018? See the instructions for Part XIV.
    If "Yes," complete Part XIV .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 5
    Part VII-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletN/A
    14
    The books are in care ofbulletMOHATT JOHNSON & GODWIN LLP Telephone no.bullet (307) 672-6494

    Located atbulletPO BOX 603SHERIDANWY ZIP+4bullet82801
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2018, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet  
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?......................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?...............
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).......
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ........
    1b
     
    No
    ........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2018?.............
    1c
     
     
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2018, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2018?.............
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?......................
    b
    If "Yes," did it have excess business holdings in 2018 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2018.)..................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2018?
    4b
     
    No
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 6
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?.............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?.....
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ......
    5b
     
     
    .........bullet
    c
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?..........
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?.....................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .................
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    JOHN PRADERE TRUSTEE
    6.00     		19,491 0 0
    PO BOX 603
    SHERIDAN,WY82801
    ROBERT WYATT TRUSTEE
    6.00     		19,491 0 0
    PO BOX 603
    SHERIDAN,WY82081
    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...................bullet  
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 7
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1 N/A  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 8
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    5,555,536
    b
    Average of monthly cash balances.......................
    1b
    191,484
    c
    Fair market value of all other assets (see instructions)................
    1c
    22,982
    d
    Total (add lines 1a, b, and c).........................
    1d
    5,770,002
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
     
    3
    Subtract line 2 from line 1d.........................
    3
    5,770,002
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    86,550
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    5,683,452
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    284,173
    Part XI
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    284,173
    2a
    Tax on investment income for 2018 from Part VI, line 5......
    2a
    16,359
    b
    Income tax for 2018. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    16,359
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    267,814
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    267,814
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
    267,814
    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
    262,532
    b
    Program-related investments—total from Part IX-B..................
    1b
     
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    262,532
    5
    Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
    income. Enter 1% of Part I, line 27b. See instructions.................
    5
     
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    262,532
    Note: The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
    the section 4940(e) reduction of tax in those years.
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2017     		(c)
    2017     		(d)
    2018
    1 Distributable amount for 2018 from Part XI, line 7 267,814
    2 Undistributed income, if any, as of the end of 2018:
    a Enter amount for 2017 only.......  
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2018:
    a From 2013......  
    b From 2014...... 17,903
    c From 2015...... 20,740
    d From 2016...... 1,533
    e From 2017...... 2,333
    fTotal of lines 3a through e........ 42,509
    4Qualifying distributions for 2018 from Part
    XII, line 4: bullet$ 262,532
    a Applied to 2017, but not more than line 2a  
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		 
    d Applied to 2018 distributable amount..... 262,532
    e Remaining amount distributed out of corpus  
    5 Excess distributions carryover applied to 2018. 5,282 5,282
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 37,227
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		 
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		 
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		 
    e Undistributed income for 2017. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    f Undistributed income for 2018. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2019 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		 
    8 Excess distributions carryover from 2013 not
    applied on line 5 or line 7 (see instructions) ...     		 
    9Excess distributions carryover to 2019.
    Subtract lines 7 and 8 from line 6a ......     		37,227
    10 Analysis of line 9:
    a Excess from 2014.... 12,621
    b Excess from 2015.... 20,740
    c Excess from 2016.... 1,533
    d Excess from 2017.... 2,333
    e Excess from 2018....  
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 10
    Part XIV
    Private Operating Foundations (see instructions and Part VII-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2018, enter the date of the ruling....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2018 (b) 2017 (c) 2016 (d) 2015
             
    b 85% of line 2a .........          
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part X, line 6 for each year listed...     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    SURRENA MEMORIAL FUND
    PO BOX 603
    SHERIDAN,WY82801
    (307) 752-6855
    bThe form in which applications should be submitted and information and materials they should include:
    WRITTEN APPLICATION
    cAny submission deadlines:
    NONE
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    CHARITABLE, RELIGIOUS, SCIENTIFIC, & EDUCATIONAL PURPOSES IN THE U.S.
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 11
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    BREAD OF LIFE
    PO BOX 909
    BUFFALO,WY82834     		NONE EXEMPT ORG. GENERAL OPERATIONS 7,500
    BUFFALO SENIOR CENTER
    PO BOX 941
    BUFFALO,WY82834     		NONE EXEMPT ORG. GENERAL OPERATIONS 6,000
    CHILDREN'S CENTER
    863 HIGHLAND AVE
    SHERIDAN,WY82801     		NONE EXEMPT ORG. GENERAL OPERATIONS 25,000
    CHILDREN'S CENTER - BUFFALO
    151 KLONDIKE
    BUFFALO,WY82834     		NONE EXEMPT ORG. GENERAL OPERATIONS 45,000
    CLEARMONT COMMUNITY LIBRARY
    PO BOX 26
    CLEARMONT,WY82835     		NONE EXEMPT ORG. GENERAL OPERATIONS 5,000
    GENESIS FOUNDATION
    444 CRESCENT DR
    SHERIDAN,WY82801     		NONE EXEMPT ORG. GENERAL OPERATIONS 20,000
    JOHNSON COUNTY LIBRARY
    FOUNDATION
    171 N ADAMS
    BUFFALO,WY82834     		NONE EXEMPT ORG. GENERAL OPERATIONS 5,000
    HABITAT FOR HUMANITY
    OF THE EASTERN BIGHORNS
    PO BOX 6196
    SHERIDAN,WY82801     		NONE EXEMPT ORG. GENERAL OPERATIONS 6,000
    JOHNSON COUNTY YMCA
    101 SOUTH KLONDIKE
    BUFFALO,WY82834     		NONE EXEMPT ORG. GENERAL OPERATIONS 17,500
    LUNCH TOGETHER SOUP KITCHEN
    102 S CONNER ST
    SHERIDAN,WY82801     		NONE EXEMPT ORG. GENERAL OPERATIONS 7,500
    METHODIST CHURCH
    OF BUFFALO WYOMING
    132 N ADAMS AVE
    BUFFALO,WY82834     		NONE EXEMPT ORG. GENERAL OPERATIONS 2,500
    METHODIST CHURCH
    OF SHERIDAN WYOMING
    215 W WORKS
    SHERIDAN,WY82801     		NONE EXEMPT ORG. GENERAL OPERATIONS 5,000
    SENIOR CITIZENS COUNCIL
    211 SMITH STREET
    SHERIDAN,WY82801     		NONE EXEMPT ORG. GENERAL OPERATIONS 6,000
    SHERIDAN COLLEGE
    FOUNDATION
    3059 COFFEEN AVE
    SHERIDAN,WY82801     		NONE EXEMPT ORG. SCHOLARSHIPS 10,000
    SHERIDAN COUNTY LIBRARY
    FOUNDATION INC
    335 W ALGER
    SHERIDAN,WY82801     		NONE EXEMPT ORG. GENERAL OPERATIONS 5,000
    SHERIDAN COUNTY YMCA
    417 NORTH JEFFERSON
    SHERIDAN,WY82801     		NONE EXEMPT ORG. GENERAL OPERATIONS 17,500
    STORY BRANCH LIBRARY
    PO BOX 188
    STORY,WY82842     		NONE EXEMPT ORG. GENERAL OPERATIONS 5,000
    STORY COMMUNITY CHURCH
    PO BOX 415
    STORY,WY82842     		NONE EXEMPT ORG. GENERAL OPERATIONS 5,000
    THE FOOD GROUP
    51 COFFEEN AVE-SUITE 101
    SHERIDAN,WY82801     		NONE EXEMPT ORG. GENERAL OPERATIONS 5,000
    TONGUE RIVER BRANCH
    LIBRARY
    PO BOX 909
    RANCHESTER,WY82839     		NONE EXEMPT ORG. GENERAL OPERATIONS 5,000
    TONGUE RIVER CHILD'S
    PLACE
    PO BOX 232
    RANCHESTER,WY82839     		NONE EXEMPT ORG. GENERAL OPERATIONS 15,000
    VOLUNTEERS OF AMERICA OF
    WYOMING AND MONTANA
    1876 S SHERIDAN AVE
    SHERIDAN,WY82801     		NONE EXEMPT ORG. HOMELESS SHELTER 4,000
    COMPASS-CENTER FOR FAMILIES
    PO BOX 6022
    SHERIDAN,WY82801     		NONE EXEMPT ORG. CASA PROGRAM 5,000
    MOUNTAIN PLAINS HERITAGE PARK
    PO BOX 1034
    BUFFALO,WY82834     		NONE EXEMPT ORG. GENERAL OPERATIONS 2,500
    CHILDHOOD LANGUAGE CLINIC
    NORTHERN WYOMING SCOTTISH RITE
    109 S GOULD STREET
    SHERIDAN,WY82801     		NONE EXPEMPT ORG. GENERAL OPERATIONS 4,000
    Total .................................bullet 3a 241,000
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3 Interest on savings and temporary cash
    investments ...........     		    14 7,727  
    4 Dividends and interest from securities....     14 130,696  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income.....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		    18 734,853  
    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)..   873,276  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    873,276
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 13
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.

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

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


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


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2018 AccountingFeesSchedule
    Name:
    HARRY & THELMA SURRENA MEMORIAL
    EIN:
    23-7435554
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING FEES 2,200 1,650   550

    TY 2018 InvestmentsCorpBondsSchedule
    Name:
    HARRY & THELMA SURRENA MEMORIAL
    EIN:
    23-7435554
    Name of Bond End of Year Book Value End of Year Fair Market Value
    BLACKROCK INC 50,000 51,134
    EATON VANCE FLOATING RATE FUND 60,293 58,447
    GENERAL ELECTRIC CAP 5.1%    
    MORGAN STANLEY 2.8% 50,908 50,769
    OPPENHEIMER INTERNATIONAL BOND FUND    
    TEMPLETON GLOBAL BOND FUND 220,431 190,064
    TENNESSEE VALLEY AUTHORITY    
    VANGUARD HIGH YIELD CORPORATE FUND 168,881 175,293
    VANGUARD INTERMEDIATE-TERM INVEST 740,065 758,782
    VANGUARD SHORT-TERM INVESTMENT GRADE    
    WELLS FARGO & CO 2.5% 50,711 50,538

    TY 2018 InvestmentsCorpStockSchedule
    Name:
    HARRY & THELMA SURRENA MEMORIAL
    EIN:
    23-7435554
    Name of Stock End of Year Book Value End of Year Fair Market Value
    ALPHABET INC CAP STK CL A 22,198 28,952
    AMAZON.COM INC 24,169 26,650
    AMERICAN EUROPACIFIC GROWTH FUND 143,564 146,404
    AMERICAN EXPRESS 20,728 40,963
    APPLE COMPUTER INC 14,767 38,309
    BERKSHIRE HATHAWAY INC - CL B 9,539 24,872
    BOEING CO 11,636 11,217
    BRISTOL MYERS SQUIBB 14,487 22,650
    CHEVRON CORP 10,823 17,421
    CISCO SYSTEMS 11,513 30,929
    COMMUNICATION SERVICES SEL SPDR 43,231 44,697
    CONSUMER DISCRETIONARY SEL SPDR 10,759 11,360
    CONSUMER STAPLES SEL SECTOR SPDR 10,725 13,211
    DFA COMMODITY STRATEGY PORTFOLIO 188,370 169,709
    DFA EMERGING MARKETS SMALL CAP 271,000 250,230
    DFA GLOBAL REAL ESTATE SECURITIES 358,490 409,649
    DFA US SMALL CAP PORTFOLIO 288,659 282,717
    DOWDUPONT INC    
    EMERSON ELECTRIC CO 11,739 26,306
    ENERGY SELECT SECTOR SPDR 10,357 9,100
    EXELON CORPORATION 10,559 14,375
    EXXON MOBIL CORP 28,768 26,014
    FACEBOOK INC 11,807 14,949
    FEDEX CORP 13,504 14,503
    FIDELITY INTERNATIONAL INDEX FUND 262,906 261,565
    FINANCIAL SELECT SECTOR SPDR 34,656 37,654
    GILEAD SCIENCES INC. 29,061 28,797
    GOLDMAN SACHS GROUP INC 28,311 26,673
    GOLDMAN SACHS INTERNATIONAL SMALL CA 142,840 143,853
    HEALTH CARE SELEC SECTOR SPDR 60,889 64,525
    INDUSTRICAL SELECT SECTOR SPDR 44,134 44,044
    J.P. MORGAN CHASE & CO 8,340 30,980
    LOWE'S COS INC 25,618 38,359
    MATERIALS SELECT SECTOR SPDR 24,964 27,698
    MCKESSON CORPORATION 19,539 18,753
    MICROCHIP TECHNOLOGY INC 14,350 20,650
    MICROSOFT CORPORATION 9,943 44,875
    MONDELEZ INTERNATIONAL INC 5,402 10,805
    NIKE INC 19,046 32,417
    INV OPPENHEIMER DEVELOPING MKTS 295,798 323,082
    PEPSICO 6,857 30,589
    QUALCOMM INC    
    REAL ESTATE SELECT SECTOR SPDR 24,550 26,784
    SCHLUMBERGER LIMITED    
    SKYWORKS SOLUTIONS INC 6,614 23,949
    STARBUCKS CORP 16,758 24,184
    TECHNOLOGY SELECT SECTOR SPDR 101,221 117,556
    UBER TECHNOLOGIES INC 27,528 24,728
    UNION PACIFIC 14,065 29,286
    UNITEDHEALTH GROUP INC 4,960 22,238
    VANGUARD 500 INDEX FUND 389,299 408,921
    VANGUARD MID-CAP INDEX FUND    
    VANUGARD EMERGING MARKETS STOCK INDE 310,000 306,833
    WAL-MART STORES INC 19,804 30,957
    WALT DISNEY 20,188 33,908

    TY 2018 InvestmentsGovtObligationsSch
    Name:
    HARRY & THELMA SURRENA MEMORIAL
    EIN:
    23-7435554
    US Government Securities - End of Year Book Value:

    346,368
    US Government Securities - End of Year Fair Market Value:

    347,744
    State & Local Government Securities - End of Year Book Value:


     
    State & Local Government Securities - End of Year Fair Market Value:


     


    TY 2018 OtherAssetsSchedule
    Name:
    HARRY & THELMA SURRENA MEMORIAL
    EIN:
    23-7435554
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    MINERAL RIGHTS 22,982 22,982 22,982


    TY 2018 OtherLiabilitiesSchedule
    Name:
    HARRY & THELMA SURRENA MEMORIAL
    EIN:
    23-7435554
    Description Beginning of Year - Book Value End of Year - Book Value
    FEDERAL TAXES PAYABLE 4,998 8,481


    TY 2018 OtherProfessionalFeesSchedule
    Name:
    HARRY & THELMA SURRENA MEMORIAL
    EIN:
    23-7435554
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT MANAGEMENT FEES 32,700 32,700    


    TY 2018 TaxesSchedule
    Name:
    HARRY & THELMA SURRENA MEMORIAL
    EIN:
    23-7435554
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    EXCISE TAXES 16,359      
    PAYROLL TAXES 2,982 1,491   1,491
    PENALTY 122