-
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
THE ROS FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)
4811 S 76TH STREET NO 211
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
GREENFIELD
,
WI
53220
A Employer identification number
39-1948463
B
Telephone number (see instructions)
(414) 281-6000
C
If exemption application is pending, check here
G
Check all that apply:
Initial return
Initial return of a former public charity
Final return
Amended return
Address change
Name change
D 1.
Foreign organizations, check here.............
2
. Foreign organizations meeting the 85%
test, check here and attach computation ...
E
If private foundation status was terminated
under section 507(b)(1)(A), check here .......
H
Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here .......
I
Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)
$
33,901,563
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
15,322
15,322
4
Dividends and interest from securities
...
1,007,328
1,007,328
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
73,193
b
Gross sales price for all assets on line 6a
1,434,107
7
Capital gain net income (from Part IV, line 2)
...
73,193
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)
.......
7,230
7,230
12
Total.
Add lines 1 through 11
........
1,103,073
1,103,073
13
Compensation of officers, directors, trustees, etc.
0
0
0
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
4,700
3,525
1,175
c
Other professional fees (attach schedule)
....
155,606
101,558
54,048
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
12,399
5,237
0
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
5,252
4,824
428
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
177,957
115,144
55,651
25
Contributions, gifts, grants paid
.......
2,000,000
2,000,000
26
Total expenses and disbursements.
Add lines 24 and 25
2,177,957
115,144
2,055,651
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-1,074,884
b
Net investment income
(if negative, enter -0-)
987,929
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
.............
0
0
2
Savings and temporary cash investments
.........
4,929,027
4,245,634
4,245,634
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)
.......
1,772,036
6,386,286
12,125,202
c
Investments—corporate bonds (attach schedule)
.......
0
4,335,928
4,529,534
11
Investments—land, buildings, and equipment: basis
75,000
Less: accumulated depreciation (attach schedule)
75,000
75,000
75,000
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
9,046,905
0
0
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
13,213,930
12,926,193
12,926,193
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
29,036,898
27,969,041
33,901,563
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
)
1,402
0
23
Total liabilities
(add lines 17 through 22)
.........
1,402
0
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
29,035,496
27,969,041
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
........
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)
.....
29,035,496
27,969,041
30
Total liabilities and net assets/fund balances
(see instructions)
.
29,036,898
27,969,041
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
29,035,496
2
Enter amount from Part I, line 27a
.....................
2
-1,074,884
3
Other increases not included in line 2 (itemize)
3
8,429
4
Add lines 1, 2, and 3
..........................
4
27,969,041
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
27,969,041
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
PUBLICLY TRADED SECURITIES
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
1,434,107
1,360,914
73,193
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
73,193
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
73,193
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
2,194,240
35,234,571
0.062275
2017
1,952,798
35,804,742
0.054540
2016
705,500
17,327,124
0.040717
2015
545,402
14,999,244
0.036362
2014
442,441
10,767,379
0.041091
2
Total
of line 1, column (d)
.....................
2
0.234985
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
0.046997
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
33,745,305
5
Multiply line 4 by line 3
......................
5
1,585,928
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
9,879
7
Add lines 5 and 6
........................
7
1,595,807
8
Enter qualifying distributions from Part XII, line 4
,.............
8
2,055,651
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
9,879
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
9,879
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
9,879
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
5,760
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
4,240
d
Backup withholding erroneously withheld
...........
6d
0
7
Total credits and payments. Add lines 6a through 6d
..............
7
10,000
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
7
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
114
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
114
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)
WI
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
LYNNE MILLER
Telephone no.
(414) 281-6000
Located at
4811 S 76TH STREET 211
GREENFIELD
WI
ZIP+4
53220
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
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
BRIAN RIORDAN
TRUSTEE
0.10
0
0
0
8691 PURSLANE DRIVE
NAPLES
,
FL
34109
SUSAN L RIORDAN
TRUSTEE
0.10
0
0
0
8691 PURSLANE DRIVE
NAPLES
,
FL
34109
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
REALTY MANAGEMENT CONSULTANTS INC
ADMINISTRATIVE MGT
108,095
4811 S 76TH STREET
GREENFIELD
,
WI
53221
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
.........................
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
15,765,621
b
Average of monthly cash balances
.......................
1b
5,446,537
c
Fair market value of all other assets (see instructions)
................
1c
13,047,035
d
Total
(add lines 1a, b, and c)
.........................
1d
34,259,193
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
34,259,193
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
513,888
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
33,745,305
6
Minimum investment return.
Enter 5% of line 5
..................
6
1,687,265
Part XI
Distributable Amount
(see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here
and do not complete this part.)
1
Minimum investment return from Part X, line 6
....................
1
1,687,265
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
9,879
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
9,879
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
1,677,386
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
1,677,386
6
Deduction from distributable amount (see instructions)
.................
6
0
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1
...
7
1,677,386
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
2,055,651
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
2,055,651
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
9,879
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
2,045,772
Note:
The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
the section 4940(e) reduction of tax in those years.
Form
990-PF
(2019)
Form 990-PF (2019)
Page
9
Part XIII
Undistributed Income
(see instructions)
(a)
Corpus
(b)
Years prior to 2018
(c)
2018
(d)
2019
1
Distributable amount for 2019 from Part XI, line 7
1,677,386
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
240,357
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
b
From 2015
......
c
From 2016
......
d
From 2017
......
e
From 2018
......
f
Total
of lines 3a through e
........
0
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
2,055,651
a
Applied to 2018, but not more than line 2a
240,357
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
.....
1,677,386
e
Remaining amount distributed out of corpus
137,908
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
137,908
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)
...
0
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
137,908
10
Analysis of line 9:
a
Excess from 2015
....
b
Excess from 2016
....
c
Excess from 2017
....
d
Excess from 2018
....
e
Excess from 2019
....
137,908
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:
THE ROS FOUNDATION
4811 S 76TH STREET STE 211
GREENFIELD
,
WI
53220
(414) 281-6000
b
The form in which applications should be submitted and information and materials they should include:
NO SPECIFIC FORM REQUIRED. BROCHURES AND LETTERS STATING CHARITABLE PURPOSE PREFERRED. INCLUDE COPY OF IRS DETERMINATION LETTER.
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:
NONE
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
ABUSE COUNSELING AND TREATMENT INC
PO BOX 60401
FORT MYERS
,
FL
33906
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
50,000
ALL KIDS CAN LEARN INTERNATIONAL INC
224 N WASHINGTON ST
HAVRE DE GRACE
,
MD
21078
NONE
PUBLIC CHARITY
ORPHANAGE
25,000
ALVERNO COLLEGE
3400 SOUTH 43RD STREET
MILWAUKEE
,
WI
53219
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
ANIMAL LEGAL DEFENSE FUND
525 EAST COTATI AVENUE
COTATI
,
CA
94931
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
20,000
ARTS AT LARGE INC
1100 S 5TH STREET
MILWAUKEE
,
WI
53204
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
BAY VIEW COMMUNITY CENTER OF MILWAUKEE INC
1320 E OKLAHOMA AVE
MILWAUKEE
,
WI
532072457
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
BIG BROTHERS & BIG SISTERS OF METRO MILWAUKEE INC
788 NORTH JEFFERSON STREET SUITE
600
MILWAUKEE
,
WI
532023739
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
20,000
BOYS & GIRLS CLUB OF COLLIER COUNTY
7500 DAVIS BOULEVARD
NAPLES
,
FL
34104
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
5,000
BOYS & GIRLS CLUBS OF GREATER MILWAUKEE
1558 N 6TH STREET
MILWAUKEE
,
WI
532123845
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
20,000
CAMP FOR KIDS CO GREATER MILWAUKEE FOUNDATION
101 W PLEASANT ST SUITE 210
MILWAUKEE
,
WI
532023157
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
20,000
CENTER FOR GREAT APES
P O BOX 488
WAUCHULA
,
FL
33873
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
CENTER FOR VETERANS ISSUES
312 W COURT STREET
MILWAUKEE
,
WI
53212
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
20,000
CENTER FOR WORKING FAMILIES INC
12605 W NORTH AVE 130
BROOKFIELD
,
WI
530054629
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
CHILDRENS HOSPITAL OF WISCONSIN
8915 W CONNELL CT
MILWAUKEE
,
WI
53226
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
50,000
COLUMBIA ST MARY'S FOUNDATION
2320 NORTH LAKE DRIVE
MILWAUKEE
,
WI
53211
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
50,000
CORNELL LAB OF ORNITHOLOGY
159 SAPSUCKER WOODS ROAD
ITHACA
,
NY
14850
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
DISCOVERY WORLD
500 N HARBOR DRIVE
MILWAUKEE
,
WI
53202
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
EISENHOWER CENTER
4425 W WOOLWORTH AVE
MILWAUKEE
,
WI
53218
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
FARM SANCTUARY
3100 AIKENS ROAD / PO BOX 150
WATKINS GLEN
,
NY
14891
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
25,000
FEEDING AMERICA EASTERN WI
1700 W FOND DU LAC AVENUE
MILWAUKEE
,
WI
53205
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
50,000
FLORENTINE OPERA CO INC
930 E BURLEIGH ST
MILWAUKEE
,
WI
53212
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
FOREST HOME HISTORIC CEMETERY PRESERVATION ASSOCIATION
2405 W FOREST HOME AVE
MILWAUKEE
,
WI
53215
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
5,000
FRIENDS OF FOSTER CHILDREN FOREVER INC
2675 HORSESHOE DRIVE SOUTH 402
NAPLES
,
FL
34104
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
5,000
GENERATIONS AGAINST BULLYING INC
6550 W FOREST HOME AVENUE
MILWAUKEE
,
WI
53220
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
5,000
GREENFIELD PUBLIC LIBRARY FOUNDATION INC
5310 W LAYTON AVENUE
GREENFIELD
,
WI
53220
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
HARRY CHAPIN FOOD BANK
3760 FOWLER STREET
FORT MYERS
,
FL
33901
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
15,000
HUMANE SOCIETY OF NAPLES
370 AIRPORT-PULLING RD N
NAPLES
,
FL
34104
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
5,000
HUNGER TASK FORCE OF MILWAUKEE
201 S HAWLEY CT
MILWAUKEE
,
WI
532141966
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
50,000
IMPACT ALCOHOL & OTHER DRUG ABUSE SERVICES INC
6737 W WASHINGTON AV SUITE 2225
MILWAUKEE
,
WI
53214
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
100,000
INDIAN COMMUNITY SCHOOL OF MILWAUKEE INC
10405 WEST ST MARTINS ROAD
FRANKLIN
,
WI
53132
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
20,000
JANE GOODALL INSTITUTE FOR WILDLIFE RESEARCH EDUCATION AND CONSERVATION
1595 SPRING HILL ROAD SUITE 550
VIENNA
,
VA
22182
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
20,000
JOURNEY HOUSE
2110 W SCOTT ST
MILWAUKEE
,
WI
53204
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
LA CAUSA CRISIS NURSERY PROGRAM
PO BOX 04188
MILWAUKEE
,
WI
532040188
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
40,000
LAD LAKE INC
PO BOX 158
DOUSMAN
,
WI
53118
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
MACC FUND
10000 W INNOVATION DRIVE 135
MILWAUKEE
,
WI
53226
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
25,000
MAKE-A-WISH FOUNDATION OF WISCONSIN
11020 WEST PLANK COURT 200
WAUWATOSA
,
WI
53226
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
5,000
MILWAUKEE ART MUSEUM
700 N ART MUSEUM DRIVE
MILWAUKEE
,
WI
53202
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
15,000
MILWAUKEE BALLET COMPANY
504 W NATIONAL AVENUE
MILWAUKEE
,
WI
53204
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
MILWAUKEE HOMELESS VETERANS INITIATIVE
PO BOX 14575
WEST ALLIS
,
WI
53214
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
30,000
MILWAUKEE RESCUE MISSION
830 19TH STREET
MILWAUKEE
,
WI
532331616
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
50,000
MILWAUKEE SYMPHONY ORCHESTRA
1101 NORTH MARKET ST SUITE 100
MILWAUKEE
,
WI
53202
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
15,000
NATIONAL ANTI-VIVISECTION SOCIETY
53 WEST JACKSON BOULEVARD NO 1552
CHICAGO
,
IL
60604
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
50,000
NATIONAL WILDLIFE FEDERATION
P O BOX 1583
MERRIFIELD
,
VA
221161583
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
NEIGHBORHOOD HOUSE OF MILWAUKEE
2819 W RICHARDSON PLACE
MILWAUKEE
,
WI
53208
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
OUR MOTHER'S HOME OF SOUTHWEST FLORIDA INC
18011 S TAMIAMI TRAIL 16-106
FORT MEYERS
,
FL
33908
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
PACE CENTER FOR GIRLS INC
ONE WEST ADAMS STREET SUITE 301
JACKSONVILLE
,
FL
32202
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
PATHFINDERS MILWAUKEE INC
4200 N HOLTON AVENUE 400
MILWAUKEE
,
WI
53212
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
100,000
PETA
501 FRONT STREET
NORFOLK
,
VA
23510
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
25,000
PETER STATHAS DANCE INC
P O BOX 11410
SHOREWOOD
,
WI
53211
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
50,000
PHYSICIANS COMMITTEE FOR RESPONSIBLE MEDICINE
5100 WISCONSIN AVENUE NW 400
WASHINGTON
,
DC
20016
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
PINE VIEW WILDLIFE REHABILITATION AND EDUCATION CENTER
W4953 HIGHWAY H
FREDONIA
,
WI
530219725
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
15,000
PITT BULL SLAM CHARTER SCHOOL
542 NW 12TH AVENUE
MIAMI
,
FL
33136
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
PLANNED PARENTHOOD FEDERATION OF AMERICA INC
123 WILLIAMS STREET
NEW YORK
,
NY
10038
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
50,000
PRIMATES INC
P O BOX 7384
MADISON
,
WI
53707
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
15,000
PROJECT CHIMPS
P O BOX 2140
BLUE RIDGE
,
GA
30513
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
20,000
PROVIDENCE HOUSE
P O BOX 128
NAPLES
,
FL
34106
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
5,000
REVITALIZE MILWAUKEE INC
700 W VIRGINIA STREET SUITE 306
MILWAUKEE
,
WI
53204
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
50,000
RONALD MCDONALD HOUSE CHARITIES
8948 WATERTOWN PLANK ROAD
MILWAUKEE
,
WI
53226
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
20,000
RUNNING REBELS COMMUNITY ORGANIZATION
1300 A W FOND DU LAC AVE
MILWAUKEE
,
WI
53205
NONE
PUBLIC CHARITY
GENERAL OPERATING PUPOSES
10,000
SAINTA
3333 N MAYFAIR ROAD STE 110
MILWAUKEE
,
WI
53222
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
100,000
SALVATION ARMY OF WI & UP MI
11315 W WATERTOWN PLANK RD
WAUWATOSA
,
WI
532260019
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
75,000
SOJOURNER FAMILY PEACE CENTER
PO BOX 080319
MILWAUKEE
,
WI
53208
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
SOUTHWEST FLORIDA REGIONAL HUMAN TRAFFICKING COALITION
6900-29 DANIELS PKWY 358
FORT MYERS
,
FL
33912
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
50,000
ST ANN'S INTERGENERATIONAL CARE CENTER
2801 E MORGAN AVE
MILWAUKEE
,
WI
532073771
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
THE AMERICAN RED CROSS - WISCONSIN CHAPTER
2600 W WISCONSIN AVE
MILWAUKEE
,
WI
53233
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
100,000
THE BENEDICT CENTER
1849 W DR MARTIN LUTHER KING DR
SUITE 101
MILWAUKEE
,
WI
53212
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
COLUMBUS ZOO
4850 POWELL ROAD
POWELL
,
OH
43065
NONE
PUBLIC CHARITY
JACK & SUZI HANNA FUND
10,000
THE CONSERVANCY OF SOUTHWEST FLORIDA
1495 SMITH PRESERVE WAY
NAPLES
,
FL
34102
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
THE ELEPHANT SANCTUARY IN TENNESSEE
PO BOX 393
HOHENWALD
,
TN
38462
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
30,000
THE FIRST TEE OF SE WISCONSIN
11350 W THEO TRECKER WAY
WEST ALLIS
,
WI
53214
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
5,000
THE SHELTER FOR ABUSED WOMEN
P O BOX 10102
NAPLES
,
FL
34101
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
50,000
URBAN ECOLOGY CENTER INC
1500 E PARK PLACE
MILWAUKEE
,
WI
53211
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
UWM OFFICE OF DEVELOPMENT
3271 N LAKE DRIVE
MILWAUKEE
,
WI
53211
NONE
PUBLIC CHARITY
HEFTER CONFERENCE CENTER
20,000
VICTIMS OF VIOLENCE BURIAL FUND
11414 W PARK PLACE STE 202
MILWAUKEE
,
WI
53223
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
VISION FORWARD
912 NORTH HAWLEY ROAD
MILWAUKEE
,
WI
53213
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
100,000
WALKER'S POINT YOUTH AND FAMILY CENTER
1123 N WATER ST SUITE 400
MILWAUKEE
,
WI
53202
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
WILDLIFE IN NEED CENTER LTD
W349 S1480 WATERVILLE RD SUITE B
OCONOMOWOC
,
WI
53066
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
20,000
WISCONSIN HUMANE SOCIETY
4500 W WISCONSIN AVENUE
MILWAUKEE
,
WI
532083156
NONE
PUBLIC CHARITY
GENERAL OPERATING PURPOSES
10,000
Total
.................................
3a
2,000,000
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
15,322
4
Dividends and interest from securities
....
14
1,007,328
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
7,230
8
Gain or (loss) from sales of assets other than
inventory
............
18
73,193
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
1,103,073
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
1,103,073
(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