Cecile Stephens Charitable Foundation — Form 990PF, tax year 2019
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-
TIN:
Form
990-PF
Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
Do not enter social security numbers on this form as it may be made public.
Go to
www.irs.gov/Form990PF
for instructions and the latest information.
OMB No. 1545-0052
20
19
Open to Public Inspection
For calendar year 2019, or tax year beginning
01-01-2019
, and ending
12-31-2019
Name of foundation
CECILE STEPHENS CHARITABLE FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)
PO BOX 903
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SEAL BEACH
,
CA
90740
A Employer identification number
20-1106340
B
Telephone number (see instructions)
(714) 422-8541
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)
$
161,780
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)
150,000
2
Check
.............
3
Interest on savings and temporary cash investments
9
9
4
Dividends and interest from securities
...
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
b
Gross sales price for all assets on line 6a
7
Capital gain net income (from Part IV, line 2)
...
0
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)
.......
3,656
3,656
12
Total.
Add lines 1 through 11
........
153,665
3,665
13
Compensation of officers, directors, trustees, etc.
60,000
0
0
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
c
Other professional fees (attach schedule)
....
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
35
0
0
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
581
0
281
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
60,616
0
281
25
Contributions, gifts, grants paid
.......
96,014
96,014
26
Total expenses and disbursements.
Add lines 24 and 25
156,630
0
96,295
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-2,965
b
Net investment income
(if negative, enter -0-)
3,665
c
Adjusted net income
(if negative, enter -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
.............
3,167
16,574
16,574
2
Savings and temporary cash investments
.........
50,045
30,052
30,052
3
Accounts receivable
Less: allowance for doubtful accounts
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
8
Inventories for sale or use
..............
9
Prepaid expenses and deferred charges
..........
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
.......
c
Investments—corporate bonds (attach schedule)
.......
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
111,686
115,342
115,154
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
164,898
161,968
161,780
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
)
0
35
23
Total liabilities
(add lines 17 through 22)
.........
0
35
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
........
164,898
161,933
27
Paid-in or capital surplus, or land, bldg., and equipment fund
0
0
28
Retained earnings, accumulated income, endowment, or other funds
0
0
29
Total net assets or fund balances
(see instructions)
.....
164,898
161,933
30
Total liabilities and net assets/fund balances
(see instructions)
.
164,898
161,968
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
164,898
2
Enter amount from Part I, line 27a
.....................
2
-2,965
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
161,933
5
Decreases not included in line 2 (itemize)
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
161,933
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.)
1a
b
c
d
e
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-)
or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
Excess of col. (i)
over col. (j), if any
a
b
c
d
e
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
3
Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8
...................
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
76,374
230,336
0.331576
2017
78,690
200,283
0.392894
2016
79,087
306,010
0.258446
2015
90,822
377,602
0.240523
2014
113,925
462,825
0.246151
2
Total
of line 1, column (d)
.....................
2
1.469590
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
0.293918
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
157,459
5
Multiply line 4 by line 3
......................
5
46,280
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
37
7
Add lines 5 and 6
........................
7
46,317
8
Enter qualifying distributions from Part XII, line 4
,.............
8
96,295
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
37
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
37
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
37
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
143
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
0
7
Total credits and payments. Add lines 6a through 6d
..............
7
143
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
106
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
106
Refunded
11
0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition)
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
0
(2)
On foundation managers.
$
0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
0
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)
CA
b
If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G?
If "No," attach explanation
.
8b
Yes
9
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
or 4942(j)(5) for calendar year 2019 or the taxable year beginning in 2019? See the instructions for Part XIV.
If "Yes," complete Part XIV
.............................
9
No
10
Did any persons become substantial contributors during the tax year?
If "Yes," attach a schedule listing their names
and addresses.
...............................
10
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
5
Part VII-A
Statements Regarding Activities
(continued)
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions
.............
11
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement. See instructions
.................
12
No
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
N/A
14
The books are in care of
KEVIN E MONSON
Telephone no.
(714) 422-8541
Located at
18430 BROOKHURST STREET STE 202N
FOUNTAIN VALLEY
CA
ZIP+4
92708
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
No
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
KEVIN E MONSON
TRUSTEE
10.00
30,000
0
0
PO BOX 903
SEAL BEACH
,
CA
90740
BRIAN MCMAHON
TRUSTEE
10.00
30,000
0
0
PO BOX 903
SEAL BEACH
,
CA
90740
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
THE FOUNDATION PRESENTED SCHOLARSHIPS TO 77 GRADUATING HIGH SCHOOL STUDENTS FOR USE IN PAYMENT OF TUITION, BOOKS, AND RELATED EDUCATIONAL EXPENSES FOR COLLEGE STUDIES.
54,480
2
THE FOUNDATION PROVIDED FINANCIAL ASSISTANCE TO SHELTERS FOR ABANDONED, ENDANGERED AND DISABLED WOMEN AND CHILDREN.
31,259
3
THE FOUNDATION PROVIDED FINANCIAL ASSISTANCE TO HIGH SCHOOL MUSIC PROGRAM.
8,275
4
THE FOUNDATION PROVIDED FINANCIAL ASSISTANCE TO AN ANIMAL SHELTER
2,000
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
.........................
0
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
0
b
Average of monthly cash balances
.......................
1b
46,531
c
Fair market value of all other assets (see instructions)
................
1c
113,326
d
Total
(add lines 1a, b, and c)
.........................
1d
159,857
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
159,857
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
2,398
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
157,459
6
Minimum investment return.
Enter 5% of line 5
..................
6
7,873
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
7,873
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
37
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
37
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
7,836
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
7,836
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
7,836
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
96,295
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
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
96,295
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
37
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
96,258
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
7,836
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
0
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
91,088
b
From 2015
......
72,166
c
From 2016
......
63,944
d
From 2017
......
68,796
e
From 2018
......
64,929
f
Total
of lines 3a through e
........
360,923
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
96,295
a
Applied to 2018, but not more than line 2a
0
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
.....
7,836
e
Remaining amount distributed out of corpus
88,459
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
449,382
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
..........
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)
.......
0
8
Excess distributions carryover from 2014 not
applied on line 5 or line 7 (see instructions)
...
91,088
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
358,294
10
Analysis of line 9:
a
Excess from 2015
....
72,166
b
Excess from 2016
....
63,944
c
Excess from 2017
....
68,796
d
Excess from 2018
....
64,929
e
Excess from 2019
....
88,459
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 e-mail address of the person to whom applications should be addressed:
KEVIN E MONSON
POST OFFICE BOX 903
SEAL BEACH
,
CA
90740
(714) 422-8541
b
The form in which applications should be submitted and information and materials they should include:
THE CHOIR SCHOLARSHIP APPLICATION NEEDS TO BE COMPLETED AND SUBMITTED ALONG WITH A ONE-PAGE ESSAY DESCRIBING FUTURE PLANS, GOALS, AND DREAMS.
c
Any submission deadlines:
MAY 1
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
GRADUATING FROM FOUNTAIN VALLEY HIGH SCHOOL, MINIMUM 2.5 UNWEIGHTED GRADE POINT AVERAGE IN HIGH SCHOOL, AND MINIMUM THREE YEARS PERFORMING WITH THE FOUNTAIN VALLEY HIGH SCHOOL CHOIR.
a
The name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
KEVIN E MONSON
POST OFFICE BOX 903
SEAL BEACH
,
CA
90740
(714) 422-8541
b
The form in which applications should be submitted and information and materials they should include:
A BRIEF ESSAY CONTAINING PLANS FOR HOW FUNDS WILL BE USED AND PLANS FOR OVERCOMING FINANCIAL DIFFICULTIES.
c
Any submission deadlines:
NONE
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
INDIGENT FAMILIES, PRIMARILY THOSE OF SINGLE OR ABANDONED WOMEN WITH MINOR CHILDREN OR TERMINALLY ILL.
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
CINDY AGUDO - PAID DIRECTLY TO LONG
734 S LOCUST CIRCLE
COMPTON
,
CA
90221
NONE
INDIVIDUAL
SCHOLARSHIP
500
KARELI AGUIRRE - PAID DIRECTLY TO U
6497 ORANGE AVENUE
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
JASMIN MATA AMARO - PAID DIRECTLY T
244 E 69TH WAY
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
ROBERTO ANDRADE-MORENO - PAID DIREC
725 E ARTESIA BLVD APT 1
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
SHOEARAH ANWAR - PAID DIRECTLY TO L
3321 E 61ST STREET
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
ANDREA AUGUSTUS - PAID DIRECTLY TO
18161 SANTA SOPHIA CIRCLE
FOUNTAIN VALLEY
,
CA
92708
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
DIANA BLANCAS - PAID DIRECTLY TO LO
129 E SCOTT STREET
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
DIAMOND BOXLEY - PAID DIRECTLY TO U
6550 LEMON AVENUE
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
AMERICA CALVARIO - PAID DIRECTLY TO
6652 GALE AVENUE
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
JENNIFER CARDENAS - PAID DIRECTLY T
6738 GARDENIA AVENUE
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
ANGELINA CARRILLO - PAID DIRECTLY T
60 W LOUISE STREET
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
ELAINE CONTRERAS - PAID DIRECTLY TO
6029 GUNDRY AVENUE
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
KEVIN CUARA - PAID DIRECTLY TO CALI
428 E NORTON STREET
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
RACHELLE DAVIS - PAID DIRECTLY TO B
9661 MADISON CIRCLE
GARDEN GROVE
,
CA
92844
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
MARIA DOMINGUEZ - PAID DIRECTLY TO
6889 LONG BEACH BLVD APT 7
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
KYLIE DORNBUSH - PAID DIRECTLY TO N
19361 BROOOKHURST STREET SPC 39
HUNTINGTON BEACH
,
CA
92646
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
JESSIE DU - PAID DIRECTLY TO CALIFO
12131 NELSON STREET
GARDEN GROVE
,
CA
92840
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
KENNY DU - PAID DIRECTLY TO CALIFOR
12131 NELSON STREET
GARDEN GROVE
,
CA
92840
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
KATIE FLORES-PRIEGO - PAID DIRECTLY
6901 LONG BEACH BLVD APT 1
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
KATHY FLORES - PAID DIRECTLY TO UNI
2926 E 65TH STREET APT 4
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
MARIA FUENTES - PAID DIRECTLY TO CA
400 E HULLETT STREET APT 3
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
SHENN GARCIA - PAID DIRECTLY TO CAL
6477 ATLANTIC AVENUE 5329
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
KELLY GODINEZ - PAID DIRECTLY TO CA
465 E 57TH STREET
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
DIANA GODOY - PAID DIRECTLY TO CALI
1345 E 63RD STREET
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
ZION GREEN - PAID DIRECTLY TO COMPT
417 WEST CRESSEY STREET
COMPTON
,
CA
90222
NONE
INDIVIDUAL
SCHOLARSHIP
500
EVELYN GUTIERREZ - PAID DIRECTLY TO
5333 PINE AVENUE APT 1
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
THANASI HALFHILL - PAID DIRECTLY TO
3801 GOLDENROD STREET
SEAL BEACH
,
CA
90740
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
DESHON HARRIS - PAID DIRECTLY TO LO
1621 WEST 19TH STREET APT 4
LONG BEACH
,
CA
90810
NONE
INDIVIDUAL
SCHOLARSHIP
500
AMANDA HAY - PAID DIRECTLY TO VANGU
17275 SAN LORENZO CIRCLE
FOUNTAIN VALLEY
,
CA
92708
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
CINDY HEREDIA - PAID DIRECTLY TO CA
16719 S CUZCO AVENUE
COMPTON
,
CA
90221
NONE
INDIVIDUAL
SCHOLARSHIP
500
PRISCILLA HERNANDEZ - PAID DIRECTLY
6475 ATLANTIC AVE NO 829
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
MARCELIN VILLALTA HERNANDEZ - PAID
47 W 52ND STREET APT A
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
JONATHAN NGUYEN - PAID DIRECTLY TO
10564 EL MANZANO AVENUE
FOUNTAIN VALLEY
,
CA
92708
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
HEAVEN HOLLOWAY - PAID DIRECTLY TO
215 S BOWEN COURT
COMPTON
,
CA
90221
NONE
INDIVIDUAL
SCHOLARSHIP
500
SHIVANI KESHAV - PAID DIRECTLY TO C
16196 PACIFIC COAST HIGHWAY
HUNTINGTON BEACH
,
CA
92649
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
JOHN KIM - PAID DIRECTLY TO PRINCET
2962 BRIMHALL DRIVE
LOS ALAMITOS
,
CA
90720
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
JOSE LOPEZ - PAID DIRECTLY TO CALIF
1751 E 68TH STREET UNIT 12
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
JUDITH XITALLI LOPEZ - PAID DIRECTL
2601 WARRING STREET BLDG 8
BERKELEY
,
CA
94720
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
EMMA MAFI - PAID DIRECTLY TO BRIGHA
197 HARVARD LANE
SEAL BEACH
,
CA
90740
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
MIRACLE MCMILLAN - PAID DIRECTLY TO
5461 N PARAMOUNT BLVD APT 201
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
GABRIEL MEJIA - PAID DIRECTLY TO CA
206 E MARKER STREET
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
IKE MENDEZ-MAZARIEGOS - PAID DIRECT
6475 ATALANTIC AVENUE SPC 147
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
JAILENE MERAZ - PAID DIRECTLY TO CA
3285 E ARTESIA BLVD APT 1
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
GILBERTO MORALES - PAID DIRECTLY TO
6255 CHERRY AVENUE
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
SUMMER MOSS - PAID DIRECTLY TO HOWA
5834 LIME AVENUE APT 1
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
DANYELLE BURKE NORTH - PAID DIRECTL
11947 VALLEY VIEW ST UNIT 6025
GARDEN GROVE
,
CA
92846
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
GUADALUPE ORTEGA - PAID DIRECTLY TO
1222 E GLENCOE STREET
COMPTON
,
CA
90221
NONE
INDIVIDUAL
SCHOLARSHIP
500
JACQUELINE PADILLA - PAID DIRECTLY
5533 LONG BEACH BLVD SPC 40
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
ERNESTO AM PELAYO - PAID DIRECTLY T
4907 LOCUST AVENUE
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
JULIEL PEREZ - PAID DIRECTLY TO CAL
3043 E 65TH STREET
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
MANUEL PUNZO-ZIRANDA - PAID DIRECTL
5379 OLIVE AVENUE
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
MARITZA QUEZADA - PAID DIRECTLY TO
12316 222ND STREET
HAWAIIAN GARDENS
,
CA
90716
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
EMERALDA QUEZADA-VALADEZ - PAID DIR
1147 E 70TH STREET
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
KATELYN RAMOS - PAID DIRECTLY TO CA
812 E COOLIDGE STREET
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
ANTHONY J REED - PAID DIRECTLY TO U
4642 PEPPERWOOD AVENUE
LONG BEACH
,
CA
90808
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
RAMIRO RENTERIA - PAID DIRECTLY TO
44 W 49TH STREET
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
DANIEL REYES - PAID DIRECTLY TO LON
49 W ZANE STREET
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
ALAN ROJAS - PAID DIRECTLY TO CALIF
1132 E 67TH STREET
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
MATILDE RUIZ - PAID DIRECTLY TO LON
4349 ELM AVENUE APT 2
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
MELISSA RUPERT - PAID DIRECTLY TO U
3281 DONNIE ANN ROAD
ROSSMOOR
,
CA
90720
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
KAREN SANDOVAL - PAID DIRECTLY TO C
151 E 67TH STREET
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
ERIN SCHWARTZ - PAID DIRECTLY TO PU
4524 ELDER AVENUE
SEAL BEACH
,
CA
90740
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
JUANPAULO SEPULVEDA - PAID DIRECTLY
293 E 69TH WAY
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
JAYLIANNE SUNGA - PAID DIRECTLY TO
5450 N PARAMOUNT BLVD SPC 131
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
MELANIE TANAKA - PAID DIRECTLY TO B
14341 BAKER STREET
WESTMINSTER
,
CA
92683
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
PEOUKINIK THAN - PAID DIRECTLY TO L
2136 E 65TH STREET
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
DAVID TORIBIO - PAID DIRECTLY TO CA
165 W FORHAN STREET
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
ANA TRUJILLO - PAID DIRECTLY TO CAL
256 E ARTESIA BLVD APT C
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
JONATHAN TSAI - PAID DIRECTLY TO UN
9373 JASMINE AVENUE
FOUNTAIN VALLEY
,
CA
92708
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
ASHLEY FLORES VAQUERANO - PAID DIRE
6018 CERRITOS AVENUE
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
VIVIAN VELAZQUEZ - PAID DIRECTLY TO
1302 E 64TH STREET
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
PAOLA VILLALOBOS - PAID DIRECTLY TO
5961 ELM AVENUE
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
JONATHAN VU - PAID DIRECTLY TO UNIV
2926 E 65TH STREET APT 7
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
TAYLOR WEBER - PAID DIRECTLY TO SAN
5612 TRINETTE AVENUE
GARDEN GROVE
,
CA
92845
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
JACQUELINE YEPEZ - PAID DIRECTLY TO
5838 LEWIS AVENUE
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
CHRISTOPHER YEPEZ - PAID DIRECTLY T
5838 LEWIS AVENUE
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
ALEXANDER ZERMENO - PAID DIRECTLY T
151 E 67TH STREET
LONG BEACH
,
CA
90805
NONE
INDIVIDUAL
SCHOLARSHIP
500
LDS CHURCH - CORDATA PARK WARD
17500 BUSHARD STREET
FOUNTAIN VALLEY
,
CA
92708
NONE
PC
SUPPORT FOR HOMELESS CONTRIBUTIONS
627
UNLIMITED HORIZONS (HORIZON SIN LIMITES)
404 E 1ST STREET STE 176
LONG BEACH CA
,
CA
90805
NONE
PC
PROVIDE SCHOOL SUPPLIES TO UNDERPRIVILEDGED CHILDREN
1,500
WOMEN WHO WELD
1300 E LAFAYETTE STREET
DETROIT
,
MI
48207
NONE
PC
SUPPORT FOR A SUMMER CAMP FOR AT-RISK YOUTH
3,000
ROBYNE'S NEST
7602 TALBERT AVENUE UNIT F
HUNTINGTON BEACH
,
CA
92648
NONE
PC
SUPPORT FOR A SHELTER FOR HOMELESS AND ENDANGERED YOUTH
2,500
GRACE OPEN DOORS CHARITABLE FOUNDATION
3061 CAROB STREET
NEWPORT BEACH
,
CA
92660
NONE
PC
SUPPORT SCHOOL AND YOUTH SHELTER IN CAMBODIA
5,000
VOCAL MUSIC PARENTS ASSOCIATION OF FOUNTAIN VALLEY HIGH SCHOOL
17816 BUSHARD STREET
FOUNTAIN VALLEY
,
CA
92708
NONE
PC
PROVIDE FINANCIAL SUPPORT FOR FOUNTAIN VALLEY HIGH SCHOOL VOCAL MUSIC PROGRAM
8,275
PRECIOUS LAMBS PRESCHOOL INC
2005 PALO VERDE AVE PMB 301
LONG BEACH
,
CA
90815
NONE
PC
SUPPORT FOR TROUBLED AND ENDANGERED YOUTH
2,000
INTERVAL HOUSE
PO BOX 3356
SEAL BEACH
,
CA
90740
NONE
PC
SUPPORT A SHELTER FOR TROUBLED AND ENDANGERED YOUTH
2,500
AMANDA GILLIS FOUNDATION - PAID THROUGH NEVADA COMMUNITY FOUNDATION
1417 N LAS VEGAS BLVD
LAS VEGAS
,
NV
89101
NONE
PC
SUPPORT A SHELTER FOR TROUBLED AND ENDANGERED YOUTH
2,500
COVENANT HOUSE
5 PENN PLAZA
NEW YORK
,
NY
10001
NONE
PC
SUPPORT A SHELTER FOR ABANDONED AND ENDANGERED WOMEN AND CHILDREN
2,000
SEAL BEACH ANIMAL SHELTER
1700 ADOLFO LOPEZ DRIVE
SEAL BEACH
,
CA
90740
NONE
PC
SUPPORT FOR ANIMAL SHELTER
2,000
BLIND CHILDREN'S LEARNING CENTER
18542 VANDERLIP AVENUE B
SANTA ANA
,
CA
92705
NONE
PC
SUPPORT A CENTER FOR THE TRAINING AND EDUCATION OF BLIND CHILDREN
2,500
CORY LOVETT
10325 BUNTING CIRCLE
FOUNTAIN VALLEY
,
CA
92708
NONE
INDIVIDUAL
ASSISTANCE TO FAMILY OF MUSCULAR DYSTROPHY PATIENT
1,100
JULIE MATTHEWS
PO BOX 903
SEAL BEACH
,
CA
90740
NONE
INDIVIDUAL
ASSISTANCE TO A MOTHER OF EIGHT CHILDREN ABANDONED BY HER HUSBAND
6,032
SCHOLARSHIP PAID TO UNIVERSITY OF C
PO BOX 903
SEAL BEACH
,
CA
90740
NONE
INDIVIDUAL
SCHOLARSHIP
1,000
RETURNED SCHOLARSHIPS
PO BOX 903
SEAL BEACH
,
CA
90740
NONE
INDIVIDUAL
SCHOLARSHIP
-520
Total
.................................
3a
96,014
b
Approved for future payment
Total
.................................
3b
0
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
...........
14
9
4
Dividends and interest from securities
....
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
.....
14
3,656
8
Gain or (loss) from sales of assets other than
inventory
............
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
0
3,665
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
3,665
(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