-
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
NANCY D CARMICHAEL TRUST XXXXX3006
Number and street (or P.O. box number if mail is not delivered to street address)
10 S DEARBORN IL1-0111
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CHICAGO
,
IL
60603
A Employer identification number
74-6088829
B
Telephone number (see instructions)
(800) 496-2583
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)
$
5,416,597
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
...
181,597
181,378
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
162,337
b
Gross sales price for all assets on line 6a
1,575,801
7
Capital gain net income (from Part IV, line 2)
...
162,337
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)
.......
8,345
7,972
12
Total.
Add lines 1 through 11
........
352,279
351,687
13
Compensation of officers, directors, trustees, etc.
46,540
28,553
17,987
14
Other employee salaries and wages
......
0
0
0
15
Pension plans, employee benefits
.......
0
0
16a
Legal fees (attach schedule)
.........
0
b
Accounting fees (attach schedule)
.......
c
Other professional fees (attach schedule)
....
308
308
0
17
Interest
...............
0
18
Taxes (attach schedule) (see instructions)
...
9,055
2,283
0
19
Depreciation (attach schedule) and depletion
...
0
0
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
0
0
22
Printing and publications
..........
0
0
23
Other expenses (attach schedule)
.......
261
261
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
56,164
31,405
0
17,987
25
Contributions, gifts, grants paid
.......
241,691
241,691
26
Total expenses and disbursements.
Add lines 24 and 25
297,855
31,405
0
259,678
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
54,424
b
Net investment income
(if negative, enter -0-)
320,282
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
.............
34,025
49,531
49,531
2
Savings and temporary cash investments
.........
66,761
26,660
26,660
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)
.......
2,191,814
2,057,946
3,063,201
c
Investments—corporate bonds (attach schedule)
.......
1,666,599
1,880,873
1,924,983
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
245,160
244,584
244,785
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
8,875
8,875
107,437
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
4,213,234
4,268,469
5,416,597
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
........
4,213,234
4,268,469
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)
.....
4,213,234
4,268,469
30
Total liabilities and net assets/fund balances
(see instructions)
.
4,213,234
4,268,469
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
4,213,234
2
Enter amount from Part I, line 27a
.....................
2
54,424
3
Other increases not included in line 2 (itemize)
3
4,285
4
Add lines 1, 2, and 3
..........................
4
4,271,943
5
Decreases not included in line 2 (itemize)
5
3,474
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
4,268,469
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
300. VANGUARD BD INDEX FD INC
2018-12-17
2019-01-02
b
1. GILEAD SCIENCES INC
2018-01-08
2019-01-23
c
9. GILEAD SCIENCES INC
2018-01-08
2019-01-23
d
2. GILEAD SCIENCES INC
2018-01-08
2019-01-23
e
3. GILEAD SCIENCES INC
2018-01-08
2019-01-23
4. MASTERCARD INC - CLASS A
2012-10-15
2019-01-23
12. WORLDPAY INC CL A
2018-10-08
2019-01-23
1. WORLDPAY INC CL A
2018-10-08
2019-01-23
15. GILEAD SCIENCES INC
2018-01-08
2019-01-24
3. MASTERCARD INC - CLASS A
2012-10-15
2019-01-24
10. MASTERCARD INC - CLASS A
2012-10-15
2019-01-24
16. WORLDPAY INC CL A
2018-10-08
2019-01-24
4. WORLDPAY INC CL A
2017-09-22
2019-01-24
2. GILEAD SCIENCES INC
2018-01-08
2019-01-25
5. GILEAD SCIENCES INC
2018-01-08
2019-01-25
1. GILEAD SCIENCES INC
2018-01-08
2019-01-25
13. MASTERCARD INC - CLASS A
2012-10-15
2019-01-25
25. WORLDPAY INC CL A
2017-09-22
2019-01-25
2. GILEAD SCIENCES INC
2018-01-08
2019-01-28
4. GILEAD SCIENCES INC
2018-01-08
2019-01-28
14. WORLDPAY INC CL A
2017-09-22
2019-01-28
3. GILEAD SCIENCES INC
2018-01-08
2019-01-29
3. WORLDPAY INC CL A
2017-09-22
2019-01-29
2. GILEAD SCIENCES INC
2018-01-08
2019-01-30
17. WORLDPAY INC CL A
2017-09-22
2019-01-30
1. GILEAD SCIENCES INC
2018-01-08
2019-01-31
2. GILEAD SCIENCES INC
2018-01-08
2019-01-31
4. GILEAD SCIENCES INC
2018-01-08
2019-02-01
4869.546 JPM MULTI SECTOR INC FD - R6
2019-02-11
5778.738 PIMCO INV GRD CRD BND-INST
2019-02-11
3608.614 PIMCO INV GRD CRD BND-INST
2018-01-30
2019-02-11
6872.596 PGIM TOTAL RETURN BOND-R6
2013-08-14
2019-02-11
1515. VANGUARD BD INDEX FD INC
2019-02-11
1231.393 DODGE & INTERNATIONAL STOCK FUND
2013-01-22
2019-02-14
3429.226 MFS EMERG MRKTS DEBT-R5
2016-07-13
2019-02-14
15. ANALOG DEVICES INC
2018-09-13
2019-02-19
6. ANALOG DEVICES INC
2018-09-13
2019-02-19
18. ANALOG DEVICES INC
2019-02-19
14. ANALOG DEVICES INC
2018-09-13
2019-02-19
34. ANALOG DEVICES INC
2019-02-19
6. ANALOG DEVICES INC
2019-02-19
24. ANALOG DEVICES INC
2019-02-20
5000. US TREAS 1.375% 02/28/19
2016-05-16
2019-02-28
1. ADOBE SYS INC
2012-08-03
2019-03-06
1. ALPHABET INC-CL A
2016-07-11
2019-03-06
1. AMAZON COM INC
2015-04-08
2019-03-06
1. AMERICAN EXPRESS CO
2018-07-18
2019-03-06
5. APPLE COMPUTER INC
2008-01-08
2019-03-06
1. AUTOMATIC DATA PROCESSING INC
2018-12-03
2019-03-06
18. BANK OF AMERICA CORPORATION
2018-02-06
2019-03-06
2. BERKSHIRE HATHAWAY INC DEL CL B
2018-09-11
2019-03-06
2. BIOGEN IDEC INC
2018-10-08
2019-03-06
9. BOSTON SCIENTIFIC CORP
2016-09-15
2019-03-06
4. BRISTOL MYERS SQUIBB CO
2017-02-23
2019-03-06
1. BROADCOM INC
2013-04-25
2019-03-06
1. CELGENE CORP.
2016-10-28
2019-03-06
1. CHARTER COMMUNICATIONS INC-A
2018-04-13
2019-03-06
6. CITIGROUP INC NEW
2017-05-15
2019-03-06
4. COCA-COLA CO
2018-04-16
2019-03-06
7. COMCAST CORP NEW CL A
2019-01-29
2019-03-06
2. DELTA AIR LINES INC DEL NEW
2018-01-08
2019-03-06
2. DIAMONDBACK ENERGY INC
2019-01-08
2019-03-06
4. DISNEY WALT CO
2018-01-08
2019-03-06
1970.293 DODGE & INTERNATIONAL STOCK FUND
2013-01-22
2019-03-06
2. DOLLAR TREE INC
2017-10-27
2019-03-06
8. DOWDUPONT INC
2019-03-06
3. EOG RESOURCES INC
2016-08-05
2019-03-06
2. ELECTRONIC ARTS
2018-09-20
2019-03-06
2. FACEBOOK INC-A
2014-07-25
2019-03-06
2. FIDELITY NATL INFORMATION SVCS INC
2015-04-10
2019-03-06
3. FISERV INC
2019-01-25
2019-03-06
1. GENERAL DYNAMICS CORP
2017-02-10
2019-03-06
2. HOME DEPOT INC
2011-09-29
2019-03-06
4. HONEYWELL INTL INC
2012-06-15
2019-03-06
2. INTERCONTINENTALEXCHANGE GROUP, INC
2017-02-01
2019-03-06
640. JPMORGAN BETABUILDERS JAPAN ETF
2019-03-06
1000. JPMORGAN BETABUILDERS JAPAN ETF
2019-03-06
12. KEYCORP NEW
2018-10-08
2019-03-06
2. LOWES COS INC
2011-09-28
2019-03-06
4. MARATHON PETROLEUM CORPORATION
2018-09-20
2019-03-06
2. MASTERCARD INC - CLASS A
2012-10-15
2019-03-06
3. MERCK & CO INC
2018-01-08
2019-03-06
11. MICROSOFT CORP
2015-02-13
2019-03-06
6. MONDELEZ INTERNATIONAL-W/I
2019-03-06
10. MORGAN STANLEY DEAN WITTER & CO NEW
2015-12-02
2019-03-06
1. NEXTERA ENERGY INC
2018-07-18
2019-03-06
6. NISOURCE INC
2015-12-03
2019-03-06
2. NORFOLK SOUTHN CORP
2019-03-06
1. NVIDIA CORP
2018-10-08
2019-03-06
1. O'REILLY AUTOMOTIVE INC
2017-05-05
2019-03-06
6. OCCIDENTAL PETE CORP
2019-03-06
1. PARKER HANNIFIN CORP
2018-01-11
2019-03-06
4. PAYPAL HOLDINGS INC
2019-01-23
2019-03-06
4. PEPSICO INC
2018-05-22
2019-03-06
12. PFIZER INC
2018-10-30
2019-03-06
4. PHILIP MORRIS INTERNATIONAL
2017-04-24
2019-03-06
1. PIONEER NAT RES CO
2015-12-10
2019-03-06
1. PRUDENTIAL FINL INC
2018-12-21
2019-03-06
2. ROSS STORES INC
2018-12-11
2019-03-06
1. SVB FINANCIAL GROUP
2015-08-12
2019-03-06
3. SALESFORCE.COM INC
2018-10-08
2019-03-06
3. SCHWAB CHARLES CORP NEW
2019-03-06
2. STANLEY BLACK & DECKER,INC.
2015-11-09
2019-03-06
4. TEXAS INSTRS INC
2019-02-19
2019-03-06
2. UNION PAC CORP
2018-02-22
2019-03-06
1. UNITED TECHNOLOGIES CORP
2018-01-08
2019-03-06
3. UNITEDHEALTH GROUP INC
2019-03-06
2. VISA INC CLASS A SHARES
2015-10-19
2019-03-06
2. WASTE CONNECTIONS INC
2016-08-10
2019-03-06
7. WELLS FARGO & CO NEW
2007-12-17
2019-03-06
1. WEX INC
2016-05-02
2019-03-06
1. YUM BRANDS INC
2018-11-29
2019-03-06
3. ZIMMER HLDGS INC
2018-04-26
2019-03-06
2. ALLEGION PLC
2019-03-06
1. ACCENTURE PLC
2016-02-09
2019-03-06
1. LINDE PLC
2018-12-11
2019-03-06
2. MEDTRONIC PLC
2018-07-18
2019-03-06
2. APTIV PLC
2018-04-26
2019-03-06
2. CHUBB LTD
2012-01-09
2019-03-06
2. NXP SEMICONDUCTORS NV
2019-02-20
2019-03-06
6621.182 BLCKRCK HI YLD BND PORT-K
2016-02-22
2019-03-07
11. BIOGEN IDEC INC
2010-06-18
2019-03-14
6. BIOGEN IDEC INC
2018-10-08
2019-03-14
185. BRISTOL MYERS SQUIBB CO
2019-03-14
41. DISNEY WALT CO
2019-03-14
. BANK OF AMERICA CORPORATION
2019-03-20
15000. FHLMC 3.750% 03/27/2019 DTD 03/27/2009
2009-10-28
2019-03-27
. PFIZER INC
2019-04-03
35. DOW INC
2019-04-08
5. DOW INC
2019-04-08
2. DOW INC
2017-02-22
2019-04-08
44. DOW INC
2019-04-08
23. DOW INC
2019-04-08
5. DOW INC
2015-07-15
2019-04-09
7. ADOBE SYS INC
2012-08-03
2019-04-11
6. ALEXION PHARMACEUTICALS INC
2019-03-14
2019-04-11
4. ALPHABET INC-CL C
2019-04-11
1. ALPHABET INC-CL C
2018-05-07
2019-04-11
1. ALPHABET INC-CL A
2016-07-11
2019-04-11
3. AMAZON COM INC
2015-04-08
2019-04-11
7. AMERICAN EXPRESS CO
2018-07-18
2019-04-11
28. APPLE COMPUTER INC
2008-01-08
2019-04-11
8. AUTOMATIC DATA PROCESSING INC
2018-12-03
2019-04-11
108. BANK OF AMERICA CORPORATION
2019-04-11
13. BERKSHIRE HATHAWAY INC DEL CL B
2018-09-11
2019-04-11
53. BOSTON SCIENTIFIC CORP
2019-04-11
11. BROADCOM INC
2013-04-25
2019-04-11
14. CELGENE CORP.
2019-04-11
6. CHARTER COMMUNICATIONS INC-A
2018-04-13
2019-04-11
38. CITIGROUP INC NEW
2019-04-11
26. COCA-COLA CO
2019-04-11
62. COMCAST CORP NEW CL A
2019-03-14
2019-04-11
16. DELTA AIR LINES INC DEL NEW
2018-01-08
2019-04-11
10. DIAMONDBACK ENERGY INC
2019-04-11
20. DISNEY WALT CO
2016-12-08
2019-04-11
13. DOLLAR TREE INC
2017-10-27
2019-04-11
56. DOWDUPONT INC
2019-04-11
23. EOG RESOURCES INC
2016-08-05
2019-04-11
18. ELECTRONIC ARTS
2018-09-20
2019-04-11
9. FACEBOOK INC-A
2014-07-25
2019-04-11
14. FIDELITY NATL INFORMATION SVCS INC
2019-04-11
13. FISERV INC
2019-04-11
5. GENERAL DYNAMICS CORP
2018-12-13
2019-04-11
4. GENERAL DYNAMICS CORP
2017-02-10
2019-04-11
13. HOME DEPOT INC
2011-09-29
2019-04-11
21. HONEYWELL INTL INC
2019-04-11
8. INTERCONTINENTALEXCHANGE GROUP, INC
2019-04-11
75. KEYCORP NEW
2019-04-11
20. LILLY ELI & CO
2019-04-11
15. LOWES COS INC
2011-09-28
2019-04-11
934.143 MFS INTL INTRINSIC VALUE-R6
2019-04-11
27. MARATHON PETROLEUM CORPORATION
2019-04-11
15. MASTERCARD INC - CLASS A
2009-05-05
2019-04-11
30. MERCK & CO INC
2019-03-14
2019-04-11
67. MICROSOFT CORP
2019-04-11
36. MONDELEZ INTERNATIONAL-W/I
2019-04-11
61. MORGAN STANLEY DEAN WITTER & CO NEW
2019-04-11
3. NETFLIX.COM INC
2018-09-13
2019-04-11
8. NEXTERA ENERGY INC
2019-04-11
33. NISOURCE INC
2019-04-11
13. NORFOLK SOUTHN CORP
2019-04-11
6. NORTHROP GRUMMAN CORP
2019-04-11
9. NVIDIA CORP
2018-10-08
2019-04-11
2. O'REILLY AUTOMOTIVE INC
2017-05-05
2019-04-11
29. OCCIDENTAL PETE CORP
2018-01-08
2019-04-11
8. OCCIDENTAL PETE CORP
2018-08-09
2019-04-11
4. PARKER HANNIFIN CORP
2018-01-11
2019-04-11
20. PAYPAL HOLDINGS INC
2019-01-23
2019-04-11
20. PEPSICO INC
2018-05-22
2019-04-11
50. PFIZER INC
2018-10-30
2019-04-11
23. PFIZER INC
2015-04-08
2019-04-11
18. PHILIP MORRIS INTERNATIONAL
2019-04-11
11. PIONEER NAT RES CO
2019-04-11
10. PRUDENTIAL FINL INC
2019-04-11
2. REGENERON PHARMACEUTICALS INC
2019-04-11
14. ROSS STORES INC
2018-12-11
2019-04-11
4. SVB FINANCIAL GROUP
2019-04-11
11. SALESFORCE.COM INC
2018-10-08
2019-04-11
20. SCHWAB CHARLES CORP NEW
2019-04-11
11. STANLEY BLACK & DECKER,INC.
2019-04-11
23. TEXAS INSTRS INC
2019-02-19
2019-04-11
16. UNION PAC CORP
2019-04-11
7. UNITED TECHNOLOGIES CORP
2018-01-08
2019-04-11
19. UNITEDHEALTH GROUP INC
2019-04-11
6. VERTEX PHARMACEUTICALS INC
2011-12-15
2019-04-11
10. VISA INC CLASS A SHARES
2015-10-19
2019-04-11
13. WASTE CONNECTIONS INC
2019-04-11
44. WELLS FARGO & CO NEW
2019-04-11
6. WEX INC
2016-05-02
2019-04-11
8. YUM BRANDS INC
2019-04-11
19. ZIMMER HLDGS INC
2019-04-11
11. ALLEGION PLC
2019-04-11
11. ACCENTURE PLC
2019-04-11
12. LINDE PLC
2019-04-08
2019-04-11
17. MEDTRONIC PLC
2018-07-18
2019-04-11
13. APTIV PLC
2018-04-26
2019-04-11
14. CHUBB LTD
2012-01-09
2019-04-11
11. NXP SEMICONDUCTORS NV
2019-04-11
. DOW INC
2019-04-23
69. OCCIDENTAL PETE CORP
2018-01-08
2019-04-25
68. OCCIDENTAL PETE CORP
2018-01-08
2019-04-25
15. OCCIDENTAL PETE CORP
2019-05-01
3. OCCIDENTAL PETE CORP
2019-05-01
9. REGENERON PHARMACEUTICALS INC
2019-05-01
2. REGENERON PHARMACEUTICALS INC
2019-05-01
44. OCCIDENTAL PETE CORP
2019-05-02
3. OCCIDENTAL PETE CORP
2019-05-02
2. OCCIDENTAL PETE CORP
2019-05-02
9. OCCIDENTAL PETE CORP
2019-05-02
4. OCCIDENTAL PETE CORP
2017-02-14
2019-05-02
5. OCCIDENTAL PETE CORP
2019-05-03
16. OCCIDENTAL PETE CORP
2008-10-15
2019-05-03
2. PRUDENTIAL FINL INC
2018-12-21
2019-05-14
34. PRUDENTIAL FINL INC
2018-12-21
2019-05-14
16. PRUDENTIAL FINL INC
2018-12-21
2019-05-14
5. PRUDENTIAL FINL INC
2018-12-21
2019-05-14
7. PRUDENTIAL FINL INC
2018-12-21
2019-05-14
49. SCHWAB CHARLES CORP NEW
2019-05-15
43. SCHWAB CHARLES CORP NEW
2019-05-16
11. SCHWAB CHARLES CORP NEW
2019-05-16
28. SCHWAB CHARLES CORP NEW
2019-05-16
25. MEDTRONIC PLC
2019-05-16
13. MEDTRONIC PLC
2019-05-16
33. MEDTRONIC PLC
2019-05-16
13. MEDTRONIC PLC
2019-05-17
23. MEDTRONIC PLC
2019-05-17
11. PARKER HANNIFIN CORP
2018-01-11
2019-05-20
12. PARKER HANNIFIN CORP
2018-01-11
2019-05-20
5. PARKER HANNIFIN CORP
2018-01-11
2019-05-20
44. DELTA AIR LINES INC DEL NEW
2018-01-08
2019-06-05
16. DELTA AIR LINES INC DEL NEW
2018-01-08
2019-06-05
48. PHILIP MORRIS INTERNATIONAL
2018-01-08
2019-06-05
7. PHILIP MORRIS INTERNATIONAL
2018-10-24
2019-06-05
1. DELTA AIR LINES INC DEL NEW
2018-01-08
2019-06-06
14. DELTA AIR LINES INC DEL NEW
2018-01-08
2019-06-06
16. DELTA AIR LINES INC DEL NEW
2018-01-08
2019-06-06
3. DELTA AIR LINES INC DEL NEW
2018-01-08
2019-06-06
2. DELTA AIR LINES INC DEL NEW
2018-01-08
2019-06-07
1. DELTA AIR LINES INC DEL NEW
2018-01-08
2019-06-07
2. DELTA AIR LINES INC DEL NEW
2018-01-08
2019-06-07
3. DELTA AIR LINES INC DEL NEW
2018-01-08
2019-06-07
1. DELTA AIR LINES INC DEL NEW
2018-01-08
2019-06-07
133. BANK OF AMERICA CORPORATION
2019-06-10
29. DOLLAR TREE INC
2019-06-10
105. WELLS FARGO & CO NEW
2019-06-10
29. DOLLAR TREE INC
2019-06-11
13. DOLLAR TREE INC
2018-12-17
2019-06-11
10. DOLLAR TREE INC
2018-12-17
2019-06-11
. CORTEVA INC
2019-06-13
. DUPONT DE NEMOURS INC-WI
2019-06-13
25000. FHLB 4.125% 03/13/20
2011-04-14
2019-06-13
5000. US TREAS 2% 02/28/21
2015-08-17
2019-06-13
5000. U S A TREAS NOTES
2019-04-26
2019-06-13
5000. US TREAS 2% 11/30/22
2018-11-15
2019-06-13
5000. US TREAS 2.625% 11/15/20
2010-12-23
2019-06-13
5000. US TREAS 2% 11/15/21
2015-05-15
2019-06-13
5000. US TREAS 2% 02/15/22
2015-08-17
2019-06-13
5000. US TREAS 1.625% 08/15/22
2012-10-15
2019-06-13
5000. US TREAS 2% 02/15/23
2016-05-16
2019-06-13
5000. US TREAS 1.75% 05/15/23
2014-08-08
2019-06-13
5000. US TREAS 2.75% 11/15/23
2016-08-01
2019-06-13
1647.037 DIAMOND HILL LONG/SHORT-Y
2018-11-16
2019-06-18
10. ADOBE SYS INC
2012-08-03
2019-06-27
. AMGEN INC
2019-07-17
10000. USA TREAS NOTES
2015-05-15
2019-07-31
9. SVB FINANCIAL GROUP
2019-08-14
7. SVB FINANCIAL GROUP
2015-02-05
2019-08-14
15. APTIV PLC
2018-04-26
2019-08-14
8. APTIV PLC
2019-08-14
22. APTIV PLC
2019-08-14
12. SVB FINANCIAL GROUP
2015-02-05
2019-08-15
41. APTIV PLC
2019-08-15
. GENERAL MOTORS CO
2019-09-05
930. ISHARES TR BARCLAYS MBS BD FD
2019-02-11
2019-09-19
1250. VANGUARD BD INDEX FD INC
2019-09-19
52. DISNEY WALT CO
2019-10-25
13. ACCENTURE PLC
2014-01-15
2019-10-25
16. ACCENTURE PLC
2019-10-28
34. NISOURCE INC
2019-11-11
43. NISOURCE INC
2019-11-11
35. NISOURCE INC
2019-11-12
87. NISOURCE INC
2019-11-12
8. NISOURCE INC
2013-02-26
2019-11-12
8. NISOURCE INC
2013-02-26
2019-11-13
10000. U S A NOTES
2019-11-15
154. CELGENE CORP.
2019-11-21
49. CELGENE CORP.
2019-11-21
78. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-25
8. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-25
3. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-25
412.126 FIDELITY 500 INDEX-INST PRM
2018-02-07
2019-11-25
581. ISHARES CORE MSCI EAFE ETF
2019-11-25
98. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-26
16. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-27
2617.323 EQUINOX IMP SYSTEM MACRO-I
2015-12-23
2019-12-09
1491.146 JPM GL RES ENH IDX FD - USD - R6 ISIN US48129C2070
2019-12-12
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
23,588
23,505
83
b
69
74
-5
c
615
668
-53
d
137
149
-12
e
204
223
-19
793
190
603
988
1,164
-176
83
97
-14
1,017
1,114
-97
599
142
457
1,989
475
1,514
1,316
1,552
-236
329
288
41
136
149
-13
345
371
-26
69
74
-5
2,634
617
2,017
2,073
1,801
272
136
149
-13
271
297
-26
1,165
1,009
156
207
223
-16
246
216
30
139
149
-10
1,420
1,225
195
70
74
-4
140
149
-9
279
297
-18
47,040
47,539
-499
58,481
59,151
-670
36,519
37,583
-1,064
96,972
95,799
1,173
119,456
118,494
962
48,874
44,232
4,642
48,695
51,507
-2,812
1,570
1,382
188
626
553
73
1,889
1,658
231
1,461
1,288
173
3,548
2,171
1,377
630
382
248
2,542
1,519
1,023
5,000
5,064
-64
256
32
224
1,168
727
441
1,680
381
1,299
109
103
6
874
130
744
153
147
6
522
547
-25
403
428
-25
638
685
-47
359
210
149
211
223
-12
273
39
234
86
104
-18
341
306
35
377
369
8
182
179
3
270
253
17
99
109
-10
201
210
-9
460
441
19
80,486
70,773
9,713
201
185
16
436
511
-75
278
271
7
190
228
-38
345
151
194
214
128
86
256
255
1
167
184
-17
369
68
301
617
213
404
150
117
33
14,371
15,120
-749
22,442
23,610
-1,168
205
246
-41
205
40
165
239
326
-87
451
95
356
242
170
72
1,230
478
752
282
238
44
418
349
69
188
170
18
163
115
48
359
301
58
154
268
-114
375
252
123
397
464
-67
173
208
-35
387
362
25
466
399
67
501
511
-10
349
449
-100
139
149
-10
96
80
16
190
161
29
246
138
108
472
454
18
137
87
50
269
213
56
424
430
-6
334
267
67
126
134
-8
716
342
374
296
154
142
169
106
63
351
212
139
175
94
81
97
92
5
370
344
26
180
133
47
163
93
70
170
161
9
185
176
9
166
174
-8
267
140
127
185
189
-4
49,593
45,752
3,841
3,522
506
3,016
1,921
2,054
-133
9,102
7,644
1,458
4,688
4,323
365
12
12
15,000
14,991
9
262
262
2,000
2,246
-246
286
318
-32
115
127
-12
2,518
2,593
-75
1,317
1,228
89
284
264
20
1,898
224
1,674
846
808
38
4,809
2,103
2,706
1,202
1,052
150
1,206
727
479
5,543
1,142
4,401
772
721
51
5,605
727
4,878
1,288
1,177
111
3,151
2,823
328
2,659
2,782
-123
2,037
1,237
800
3,394
427
2,967
1,323
1,458
-135
2,127
1,836
291
2,505
2,329
176
1,212
1,161
51
2,547
2,470
77
931
875
56
1,026
1,050
-24
2,347
2,069
278
1,348
1,205
143
2,152
2,374
-222
2,257
2,076
181
1,815
2,050
-235
1,599
678
921
1,573
893
680
1,128
1,098
30
842
859
-17
674
736
-62
2,599
439
2,160
3,359
1,035
2,324
615
468
147
1,232
1,489
-257
2,543
1,716
827
1,701
302
1,399
40,000
22,106
17,894
1,715
2,177
-462
3,550
274
3,276
2,421
2,443
-22
8,078
2,499
5,579
1,791
1,419
372
2,727
1,851
876
1,087
1,112
-25
1,511
1,356
155
918
629
289
2,506
1,952
554
1,634
1,759
-125
1,728
2,414
-686
815
504
311
1,937
2,177
-240
534
615
-81
732
833
-101
2,138
1,808
330
2,448
1,997
451
2,137
2,129
8
983
797
186
1,543
1,940
-397
1,644
1,606
38
994
800
194
815
853
-38
1,381
1,129
252
954
506
448
1,751
1,665
86
886
582
304
1,569
1,166
403
2,634
2,475
159
2,664
2,136
528
923
936
-13
4,684
1,089
3,595
1,142
188
954
1,585
771
814
1,122
685
437
2,109
1,191
918
1,191
565
626
798
735
63
2,445
2,179
266
1,025
731
294
1,955
931
1,024
2,171
2,218
-47
1,506
1,497
9
1,146
1,132
14
1,925
980
945
1,079
1,035
44
19
19
4,286
5,180
-894
4,222
5,105
-883
864
1,060
-196
174
208
-34
3,069
3,731
-662
680
798
-118
2,523
3,015
-492
172
202
-30
115
135
-20
517
602
-85
230
264
-34
290
243
47
930
708
222
196
159
37
3,346
2,708
638
1,581
1,274
307
488
398
90
693
558
135
2,096
1,411
685
1,874
1,211
663
478
297
181
1,215
750
465
2,204
2,201
3
1,146
1,031
115
2,915
2,612
303
1,143
1,024
119
2,031
1,785
246
1,794
2,290
-496
1,959
2,499
-540
815
1,041
-226
2,417
2,405
12
879
875
4
3,707
5,000
-1,293
541
624
-83
55
55
768
765
3
873
875
-2
164
164
110
109
1
56
55
1
111
109
2
167
164
3
55
55
3,751
1,643
2,108
3,011
2,670
341
4,872
2,663
2,209
3,093
2,654
439
1,386
1,123
263
1,066
864
202
17
17
50
50
25,335
25,855
-520
5,010
5,079
-69
4,970
4,956
14
5,031
4,850
181
5,048
4,954
94
5,025
5,059
-34
5,027
5,047
-20
4,973
4,985
-12
5,033
5,153
-120
4,988
4,898
90
5,195
5,494
-299
43,778
43,500
278
2,937
319
2,618
17
17
10,000
10,000
1,718
1,126
592
1,331
842
489
1,193
1,306
-113
643
695
-52
1,756
1,589
167
2,241
1,443
798
3,251
2,903
348
27
27
100,406
97,777
2,629
100,664
98,799
1,865
6,829
5,110
1,719
2,381
1,081
1,300
2,940
1,286
1,654
892
526
366
1,123
654
469
912
378
534
2,265
845
1,420
208
77
131
210
77
133
10,000
10,823
-823
16,637
14,363
2,274
5,293
1,379
3,914
163
179
-16
17
18
-1
6
7
-1
45,000
38,682
6,318
37,379
35,599
1,780
208
225
-17
34
37
-3
25,414
25,990
-576
32,000
26,729
5,271
23,312
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
83
b
-5
c
-53
d
-12
e
-19
603
-176
-14
-97
457
1,514
-236
41
-13
-26
-5
2,017
272
-13
-26
156
-16
30
-10
195
-4
-9
-18
-499
-670
-1,064
1,173
962
4,642
-2,812
188
73
231
173
1,377
248
1,023
-64
224
441
1,299
6
744
6
-25
-25
-47
149
-12
234
-18
35
8
3
17
-10
-9
19
9,713
16
-75
7
-38
194
86
1
-17
301
404
33
-749
-1,168
-41
165
-87
356
72
752
44
69
18
48
58
-114
123
-67
-35
25
67
-10
-100
-10
16
29
108
18
50
56
-6
67
-8
374
142
63
139
81
5
26
47
70
9
9
-8
127
-4
3,841
3,016
-133
1,458
365
12
9
262
-246
-32
-12
-75
89
20
1,674
38
2,706
150
479
4,401
51
4,878
111
328
-123
800
2,967
-135
291
176
51
77
56
-24
278
143
-222
181
-235
921
680
30
-17
-62
2,160
2,324
147
-257
827
1,399
17,894
-462
3,276
-22
5,579
372
876
-25
155
289
554
-125
-686
311
-240
-81
-101
330
451
8
186
-397
38
194
-38
252
448
86
304
403
159
528
-13
3,595
954
814
437
918
626
63
266
294
1,024
-47
9
14
945
44
19
-894
-883
-196
-34
-662
-118
-492
-30
-20
-85
-34
47
222
37
638
307
90
135
685
663
181
465
3
115
303
119
246
-496
-540
-226
12
4
-1,293
-83
3
-2
1
1
2
3
2,108
341
2,209
439
263
202
17
50
-520
-69
14
181
94
-34
-20
-12
-120
90
-299
278
2,618
17
592
489
-113
-52
167
798
348
27
2,629
1,865
1,719
1,300
1,654
366
469
534
1,420
131
133
-823
2,274
3,914
-16
-1
-1
6,318
1,780
-17
-3
-576
5,271
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
162,337
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
248,966
5,240,101
0.047512
2017
248,412
5,103,659
0.048673
2016
268,693
5,080,205
0.05289
2015
266,326
5,457,149
0.048803
2014
108,167
5,400,715
0.020028
2
Total
of line 1, column (d)
.....................
2
0.217906
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
0.043581
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
5,184,366
5
Multiply line 4 by line 3
......................
5
225,940
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
3,203
7
Add lines 5 and 6
........................
7
229,143
8
Enter qualifying distributions from Part XII, line 4
,.............
8
259,678
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
3,203
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
3,203
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
3,203
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
6,836
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
6,836
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
3,633
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
3,204
Refunded
11
429
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)
TX
b
If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G?
If "No," attach explanation
.
8b
Yes
9
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
or 4942(j)(5) for calendar year 2019 or the taxable year beginning in 2019? See the instructions for Part XIV.
If "Yes," complete Part XIV
.............................
9
No
10
Did any persons become substantial contributors during the tax year?
If "Yes," attach a schedule listing their names
and addresses.
...............................
10
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
5
Part VII-A
Statements Regarding Activities
(continued)
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions
.............
11
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement. See instructions
.................
12
No
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
14
The books are in care of
JP MORGAN CHASE BANK NA
Telephone no.
(800) 496-2583
Located at
10 S DEARBORN ST MC IL 1-0111
CHICAGO
IL
ZIP+4
60603
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1)
Engage in the sale or exchange, or leasing of property with a disqualified person?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(5)
Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)?
...............
Yes
No
(6)
Agree to pay money or property to a government official? (
Exception.
Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.)
.......
Yes
No
b
If any answer is "Yes" to 1a(1)–(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions
........
1b
No
Organizations relying on a current notice regarding disaster assistance check here
........
c
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2019?
.............
1c
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2019, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2019?
.............
Yes
No
If "Yes," list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer "No" and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
......................
Yes
No
b
If "Yes," did it have excess business holdings in 2019 as a result of
(1)
any purchase by the foundation
or disqualified persons after May 26, 1969;
(2)
the lapse of the 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or
(3)
the lapse of the 10-, 15-, or 20-year first phase holding period?
(Use Schedule C, Form 4720, to determine
if the foundation had excess business holdings in 2019.)
..................
3b
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2019?
4b
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
6
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
(continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
No
b
If any answer is "Yes" to 5a(1)–(5), did
any
of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions
......
5b
Organizations relying on a current notice regarding disaster assistance check here
.........
c
If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant?
..........
Yes
No
If "Yes," attach the statement required by Regulations section 53.4945–5(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract?
.....................
Yes
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
....
6b
No
If "Yes" to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
Yes
No
b
If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction?
....
7b
8
Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment during the year?
.................
Yes
No
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1
List all officers, directors, trustees, foundation managers and their compensation. See instructions
(a)
Name and address
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(If not paid, enter
-0-)
(d)
Contributions to employee benefit plans and deferred compensation
(e)
Expense account,
other allowances
JP MORGAN CHASE
TRUSTEE
2
46,540
10 S DEARBORN ST MC IL 1-0111
CHICAGO
,
IL
60603
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
5,028,670
b
Average of monthly cash balances
.......................
1b
127,047
c
Fair market value of all other assets (see instructions)
................
1c
107,599
d
Total
(add lines 1a, b, and c)
.........................
1d
5,263,316
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
5,263,316
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
78,950
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
5,184,366
6
Minimum investment return.
Enter 5% of line 5
..................
6
259,218
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
259,218
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
3,203
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
3,203
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
256,015
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
256,015
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
256,015
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
259,678
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
259,678
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
3,203
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
256,475
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
256,015
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
241,690
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:
$
259,678
a
Applied to 2018, but not more than line 2a
241,690
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
0
c
Treated as distributions out of corpus (Election
required—see instructions)
........
0
d
Applied to 2019 distributable amount
.....
17,988
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
..........
238,027
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions)
.......
0
8
Excess distributions carryover from 2014 not
applied on line 5 or line 7 (see instructions)
...
0
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
0
10
Analysis of line 9:
a
Excess from 2015
....
0
b
Excess from 2016
....
0
c
Excess from 2017
....
0
d
Excess from 2018
....
0
e
Excess from 2019
....
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
10
Part XIV
Private Operating Foundations
(see instructions and Part VII-A, question 9)
1a
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2019, enter the date of the ruling
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2019
(b)
2018
(c)
2017
(d)
2016
b
85% of line 2a
.........
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed
...
c
“Support" alternative test—enter:
(1)
Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
....
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
(3)
Largest amount of support
from an exempt organization
(4)
Gross investment income
Part XV
Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or email address of the person to whom applications should be addressed:
b
The form in which applications should be submitted and information and materials they should include:
c
Any submission deadlines:
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Form
990-PF
(2019)
Form 990-PF (2019)
Page
11
Part XV
Supplementary Information
(continued)
3
Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
AMERICAN HEART ASSOCIATION
ATTN SARAH WIILIAMSON BEQUEST ADMI
ST PETERSBURG
,
FL
337422035
NONE
PC
GENERAL
120,845
BAYLOR COLLEGE OF MEDICINE
ATTN KRISTI S COOPER
ATTN ANNE KATHRYN HUNTER
HOUSTON
,
TX
770303411
NONE
PC
GENERAL
60,423
UNIVERSITY OF TEXAS
110 INNER CAMPUS DR
AUSTIN
,
TX
78712
NONE
PC
GENERAL
60,423
Total
.................................
3a
241,691
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
181,597
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
162,337
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
FEDERAL REFUND
1
373
b
ROYALTY INCOME
16
7,972
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
352,279
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
352,279
(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