-
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
BRENDEN MANN FOUNDATION CO DORSEY & WHITNEY
Number and street (or P.O. box number if mail is not delivered to street address)
401 E 8TH ST STE 319
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SIOUX FALLS
,
SD
571037031
A Employer identification number
11-3789260
B
Telephone number (see instructions)
(605) 336-6832
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)
$
20,990,144
J
Accounting method:
Cash
Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)
Part I
Analysis of Revenue and Expenses
(The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).)
(a)
Revenue and
expenses per
books
(b)
Net investment
income
(c)
Adjusted net
income
(d)
Disbursements
for charitable
purposes
(cash basis only)
1
Contributions, gifts, grants, etc., received (attach schedule)
2
Check
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
589,849
579,983
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
133,252
b
Gross sales price for all assets on line 6a
6,000,415
7
Capital gain net income (from Part IV, line 2)
...
133,252
8
Net short-term capital gain
.........
0
9
Income modifications
...........
10a
Gross sales less returns and allowances
b
Less: Cost of goods sold
....
c
Gross profit or (loss) (attach schedule)
.....
11
Other income (attach schedule)
.......
79,343
79,343
12
Total.
Add lines 1 through 11
........
802,444
792,578
13
Compensation of officers, directors, trustees, etc.
215,000
50,000
165,000
14
Other employee salaries and wages
......
0
0
0
15
Pension plans, employee benefits
.......
0
0
16a
Legal fees (attach schedule)
.........
0
b
Accounting fees (attach schedule)
.......
c
Other professional fees (attach schedule)
....
126,586
82,083
44,503
17
Interest
...............
0
18
Taxes (attach schedule) (see instructions)
...
28,123
21,238
6,885
19
Depreciation (attach schedule) and depletion
...
0
0
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
17,875
2,990
0
14,885
22
Printing and publications
..........
0
0
23
Other expenses (attach schedule)
.......
31,706
12,891
50
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
419,290
169,202
0
231,323
25
Contributions, gifts, grants paid
.......
782,200
782,200
26
Total expenses and disbursements.
Add lines 24 and 25
1,201,490
169,202
0
1,013,523
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-399,046
b
Net investment income
(if negative, enter -0-)
623,376
c
Adjusted net income
(if negative, enter -0-)
...
0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2019)
Form 990-PF (2019)
Page
2
Part II
Balance Sheets
Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year
End of year
(a)
Book Value
(b)
Book Value
(c)
Fair Market Value
1
Cash—non-interest-bearing
.............
0
2
Savings and temporary cash investments
.........
789,005
584,007
584,007
3
Accounts receivable
Less: allowance for doubtful accounts
0
0
4
Pledges receivable
Less: allowance for doubtful accounts
5
Grants receivable
.................
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)
.....
7
Other notes and loans receivable (attach schedule)
Less: allowance for doubtful accounts
0
8
Inventories for sale or use
..............
9
Prepaid expenses and deferred charges
..........
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
.......
2,681,871
2,223,021
2,925,308
c
Investments—corporate bonds (attach schedule)
.......
2,855,989
2,378,963
2,526,011
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
12,218,636
12,679,234
14,954,818
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)
18,545,501
17,865,225
20,990,144
17
Accounts payable and accrued expenses
..........
18
Grants payable
.................
19
Deferred revenue
.................
20
Loans from officers, directors, trustees, and other disqualified persons
21
Mortgages and other notes payable (attach schedule)
......
22
Other liabilities (describe
)
23
Total liabilities
(add lines 17 through 22)
.........
0
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
25
Net assets with donor restrictions
............
Foundations that do not follow FASB ASC 958, check here
and complete lines 26 through 30.
26
Capital stock, trust principal, or current funds
........
18,545,501
17,865,225
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)
.....
18,545,501
17,865,225
30
Total liabilities and net assets/fund balances
(see instructions)
.
18,545,501
17,865,225
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
18,545,501
2
Enter amount from Part I, line 27a
.....................
2
-399,046
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
18,146,455
5
Decreases not included in line 2 (itemize)
5
281,230
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
17,865,225
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
66. CELGENE CORP
2019-01-10
b
265. RYOHIN KEIKAKU CO -UNSP ADR
2019-01-11
c
51. AUTODESK INC
2015-09-03
2019-01-23
d
980. ABB LTD-SPON ADR
2019-01-30
e
99. BEACON ROOFING SUPPLY INC
2019-01-31
178. BEACON ROOFING SUPPLY INC
2019-01-31
361. KNIGHT-SWIFT TRANSPORTATION
2018-03-12
2019-01-31
94. KEYSIGHT TECHNOLOGIES IN
2017-06-26
2019-02-05
400. RED ELECTRICA COR-UNSPON ADR
2018-08-28
2019-02-20
.4 COVETRUS INC
2015-12-14
2019-02-26
58. AMN HEALTHCARE SERVICES INC
2019-02-27
21. ACUITY BRANDS INC
2019-02-27
58. ALARM.COM HOLDINGS INC
2017-06-13
2019-02-27
44. ANSYS INC
2019-02-27
33. BIO-TECHNE CORP
2012-08-21
2019-02-27
88. BLACKLINE INC
2019-02-27
22. CHEMED CORP
2012-08-21
2019-02-27
87. COGNEX CORP
2015-07-06
2019-02-27
23. COSTAR GROUP INC
2012-08-21
2019-02-27
30. ELLIE MAE INC
2016-12-01
2019-02-27
200. EVOLENT HEALTH INC CL A
2017-06-13
2019-02-27
55. EXLSERVICE HOLDINGS INC
2016-12-12
2019-02-27
125. FASTENAL CO
2012-08-21
2019-02-27
50. FIVE BELOW
2019-02-27
162. GENTEX CORP
2017-08-16
2019-02-27
69. GODADDY INC - CLASS A
2017-11-06
2019-02-27
63. GRAND CANYON EDUCATION INC
2019-02-27
26. GUIDEWIRE SOFTWARE INC
2018-10-22
2019-02-27
157. HEALTHCARE SERVICES GROUP
2019-02-27
119. HEICO CORP
2019-02-27
34. INTL FLAVORS & FRAGRANCES
2019-02-27
2650. ISHARES IBOXX HIGH YLD CORP
2019-02-27
122. LKQ CORP
2012-08-21
2019-02-27
16. LENNOX INTERNATIONAL INC
2019-02-27
29. MIDDLEBY CORP
2013-12-24
2019-02-27
128. NATIONAL INSTRUMENTS CORP
2012-08-21
2019-02-27
37. NEOGEN CORP
2012-08-21
2019-02-27
109. PRA GROUP INC
2019-02-27
33. PAYCOM SOFTWARE INC
2019-02-27
124. PLURALSIGHT INC - A
2019-02-27
161. PROS HOLDINGS INC
2017-08-16
2019-02-27
61. PROTO LABS INC
2014-12-11
2019-02-27
204. RITCHIE BROS AUCTIONEERS
2019-02-27
160. ROLLINS INC
2012-08-21
2019-02-27
30. HENRY SCHEIN INC
2015-12-14
2019-02-27
52. SMITH (A.O.) CORP
2018-03-12
2019-02-27
22. SNAP-ON INC
2017-02-01
2019-02-27
68. TELADOC HEALTH INC
2018-12-19
2019-02-27
98. 2U INC
2019-02-27
24. TYLER TECHNOLOGIES INC
2017-07-18
2019-02-27
29. ULTIMATE SOFTWARE GROUP INC
2012-08-21
2019-02-27
90. VEEVA SYSTEMS INC-CLASS A
2019-02-27
68. VERISK ANALYTICS INC
2019-02-27
24. WABCO HOLDINGS INC
2016-10-18
2019-02-27
70. WAGEWORKS INC
2017-04-28
2019-02-27
19. WATSCO INC
2017-07-18
2019-02-27
55. WEST PHARMACEUTICAL SERVICES
2017-04-28
2019-02-27
103. IHS MARKIT LTD
2016-07-13
2019-02-27
68. GLOBANT SA
2017-07-18
2019-02-27
62. COVETRUS INC
2019-02-28
350. BHP GROUP LTD-SPON ADR
2018-03-26
2019-03-01
400. ROGERS COMMUNICATIONS INC-B
2019-03-01
625. RED ELECTRICA COR-UNSPON ADR
2019-03-04
100. YANDEX NV CL A
2018-03-26
2019-03-08
75. ASHTEAD GROUP PLC-UNSPON ADR
2016-11-21
2019-03-11
65. YANDEX NV CL A
2018-03-26
2019-03-11
47. FACEBOOK INC-CLASS A
2018-08-07
2019-03-15
180. CIA SANEAMENTO BASICO DE-ADR
2018-03-26
2019-03-26
330. FERGUSON PLC SPONS ADR
2018-03-26
2019-03-26
126. ELLIE MAE INC
2016-12-01
2019-03-28
3. ALPHABET INC-CL A
2015-04-10
2019-04-05
10. ANTHEM INC
2017-04-07
2019-04-05
120. ULTIMATE SOFTWARE GROUP INC
2012-08-21
2019-04-12
1000. CIELO SA SPONS ADR
2019-04-15
2000. CIELO SA SPONS ADR
2019-04-16
543. CIELO SA SPONS ADR
2019-04-17
1040. CIELO SA SPONS ADR
2018-06-27
2019-04-17
.2 ALCON INC
2015-04-21
2019-04-23
39. KEYSIGHT TECHNOLOGIES IN
2017-06-26
2019-05-02
143. ANADARKO PETE CORP
2018-03-19
2019-05-06
107. ANADARKO PETE CORP
2019-02-22
2019-05-06
28. ACCENTURE PLC-CL A
2018-03-26
2019-05-08
705. COMPASS GROUP PLC-SPON ADR
2019-05-09
7. ACCENTURE PLC-CL A
2018-03-26
2019-05-09
70. WOLTERS KLUWER NV-SPONS ADR
2018-01-16
2019-05-10
97. WABCO HOLDINGS INC
2019-05-24
400. UBISOFT ENTERTAIN-UNSPON ADR
2018-04-04
2019-05-28
160. SONOVA HOLDING-UNSPON ADR
2018-09-07
2019-06-04
735. TENCENT HOLDINGS LTD-UNS ADR
2019-06-04
92. VEEVA SYSTEMS INC-CLASS A
2015-12-15
2019-06-04
350. TENCENT HOLDINGS LTD-UNS ADR
2019-06-06
120. BHP GROUP LTD-SPON ADR
2018-03-26
2019-06-07
40. CANADIAN NATL RAILWAY CO
2017-03-30
2019-06-10
995. FERGUSON PLC-ADR
2018-03-26
2019-06-10
130. HEICO CORP
2019-06-10
440. ABN AMRO GROUP NV UNSPONS ADR
2018-03-26
2019-06-27
125. ANHEUSER-BUSCH INBEV-SPN ADR
2018-01-12
2019-06-27
995. ASSA ABLOY AB - UNSP ADR
2019-06-27
155. ATOS ORIGIN SA-UNSP ADR
2019-06-27
635. BB SEGURIDADE PARTI-SPON ADR
2018-03-26
2019-06-27
110. BHP GROUP LTD-SPON ADR
2018-03-26
2019-06-27
55. CANADIAN NATL RAILWAY CO
2019-06-27
325. CARLSBERG AS-B-SPON ADR
2018-03-26
2019-06-27
635. CIE FINANCIERE RICH-UNSP ADR
2019-06-27
330. CIA SANEAMENTO BASICO DE-ADR
2018-03-26
2019-06-27
260. COMPASS GROUP PLC-SPON ADR
2019-06-27
100. DBS GROUP HOLDINGS-SPON ADR
2018-03-26
2019-06-27
245. DAIWA HOUSE INDUS-UNSP ADR
2018-03-26
2019-06-27
615. ENGIE-SPON ADR
2019-06-27
265. EQUINOR ASA-SPON ADR
2018-03-26
2019-06-27
590. FERGUSON PLC-ADR
2018-03-26
2019-06-27
65. 58.COM INC-ADR
2018-03-26
2019-06-27
160. GENMAB A/S -SP ADR
2018-03-26
2019-06-27
160. GRUPO FIN BANORTE-SPON ADR
2019-06-27
900. ICICI BANK LTD-SPON ADR
2019-06-27
320. KAO CORP
2017-05-18
2019-06-27
140. KASIKORNBANK PCL-UNSPON ADR
2019-06-27
280. KOMATSU LTD -SPONS ADR
2018-08-28
2019-06-27
190. LONZA GROUP AG-UNSPON ADR
2019-06-27
185. MAKITA CORP-SPONS ADR
2018-03-26
2019-06-27
240. MICHELIN (CGDE)-UNSPON ADR
2018-03-26
2019-06-27
215. MR PRICE GROUP LTD SPONS ADR
2018-03-26
2019-06-27
160. NASPERS LTD-N SHS SPON ADR
2019-06-04
2019-06-27
705. NORDEA BANK ABP - SPON ADR
2017-08-14
2019-06-27
165. NOVARTIS AG-SPONSORED ADR
2019-06-27
145. TELEKOMUNIK INDONESIA-SP ADR
2018-03-26
2019-06-27
525. PING AN INSURANCE-ADR
2018-03-26
2019-06-27
300. PRUDENTIAL PLC-ADR
2018-03-26
2019-06-27
535. RED ELECTRICA COR-UNSPON ADR
2018-03-26
2019-06-27
435. RELX PLC - SPON ADR
2019-06-27
90. ROGERS COMMUNICATIONS INC-B
2019-06-27
170. KONINKLIJKE DSM NV-SPONS ADR
2019-06-27
250. ROYAL DUTCH SHELL-SPON ADR-A
2018-03-26
2019-06-27
75. RYANAIR HOLDINGS PLC SPONS ADR
2018-03-26
2019-06-27
130. RYOHIN KEIKAKU CO -UNSP ADR
2018-03-26
2019-06-27
370. SAFRAN SA-UNSPON ADR
2018-03-26
2019-06-27
380. SAMPO OYJ-A SHS-UNSP ADR
2019-06-27
500. SANLAM LTD-SPONSORED ADR
2019-06-27
240. SANOFI-ADR
2019-03-22
2019-06-27
120. SAP SE-SPONSORED ADR
2018-03-26
2019-06-27
85. SONOVA HOLDING-UNSPON ADR
2019-06-27
1025. SUMITOMO MITSUI-SPONS ADR
2018-03-26
2019-06-27
315. SUNCOR ENERGY INC
2018-03-26
2019-06-27
30. SUZUKI MOTOR CORP-UNS ADR
2019-01-17
2019-06-27
230. TAIWAN SEMICONDUCTOR-SP ADR
2019-06-27
435. TELENOR ASA-ADR
2018-03-26
2019-06-27
80. TENCENT HOLDINGS LTD-UNS ADR
2019-06-27
240. UBISOFT ENTERTAIN-UNSPON ADR
2019-06-27
180. UNILEVER PLC-SPONSORED ADR
2018-01-12
2019-06-27
300. VINCI S.A.-UNSPONS ADR
2019-06-27
340. VIVENDI SA-UNSPON ADR
2019-06-27
515. VOLKSWAGEN AG-UNSP ADR PREF
2018-11-02
2019-06-27
298. WAGEWORKS INC
2019-06-27
145. WOLTERS KLUWER NV-SPONS ADR
2019-06-27
70. AON PLC
2019-06-27
70. ACCENTURE PLC-CL A
2019-06-27
145. MEDTRONIC PLC
2018-03-26
2019-06-27
35. ALCON INC
2019-06-27
135. YANDEX NV CL A
2018-03-26
2019-06-27
10. ACCENTURE PLC-CL A
2019-07-01
245. SONOVA HOLDING-UNSPON ADR
2019-07-02
91324.201 VANGUARD TOT BD MKT IDX-ADM
2018-01-24
2019-07-02
55555.556 VANGUARD DEV MKT INDX-ADM
2018-01-19
2019-07-02
265. VINCI S.A.-UNSPONS ADR
2018-03-26
2019-07-02
95. WOLTERS KLUWER NV-SPONS ADR
2019-07-02
25. ACCENTURE PLC-CL A
2016-10-17
2019-07-02
430. RED ELECTRICA COR-UNSPON ADR
2018-03-26
2019-07-05
58. APTIV PLC
2017-11-06
2019-07-24
200. MICHELIN (CGDE)-UNSPON ADR
2018-03-26
2019-07-25
5. VINCI S.A.-UNSPONS ADR
2018-03-26
2019-07-25
156. SCHLUMBERGER LTD
2016-04-19
2019-07-31
310. CARLSBERG AS-B-SPON ADR
2019-08-02
790. ABN AMRO GROUP NV UNSPONS ADR
2018-03-26
2019-08-09
455. ABN AMRO GROUP NV UNSPONS ADR
2018-08-29
2019-08-09
.89 FISERV INC
2018-01-10
2019-08-12
10. IQVIA HOLDINGS INC
2015-11-05
2019-08-13
16. STARBUCKS CORP
2018-07-13
2019-08-13
11. VISA INC-CLASS A SHARES
2016-09-01
2019-08-13
475. ICICI BANK LTD-SPON ADR
2018-03-26
2019-08-22
100. CIA SANEAMENTO BASICO DE-ADR
2018-03-26
2019-08-23
110. CIA SANEAMENTO BASICO DE-ADR
2018-03-26
2019-08-27
470. MICHELIN (CGDE)-UNSPON ADR
2019-08-27
300. SANLAM LTD-SPONSORED ADR
2016-11-01
2019-09-03
70. SANLAM LTD-SPONSORED ADR
2019-09-04
12. COSTAR GROUP INC
2012-08-21
2019-09-05
275. RITCHIE BROS AUCTIONEERS
2018-03-12
2019-09-05
126. HENRY SCHEIN INC
2019-09-06
19. FISERV INC
2018-01-10
2019-09-13
17. VISA INC-CLASS A SHARES
2016-09-01
2019-09-13
177. PROS HOLDINGS INC
2019-09-17
245. ROGERS COMMUNICATIONS INC-B
2018-07-11
2019-09-18
560. ICICI BANK LTD-SPON ADR
2018-03-26
2019-09-20
220. ICICI BANK LTD-SPON ADR
2018-03-26
2019-09-20
72. AUTODESK INC
2015-09-03
2019-09-23
160. CBS CORPORATION CLASS B W/I
2019-09-24
121. ELANCO ANIMAL HEALTH INC
2019-01-14
2019-10-07
700. ASSA ABLOY AB - UNSP ADR
2018-03-26
2019-10-09
840. CONTINENTAL AG-SPONS ADR
2019-07-24
2019-10-09
455. NASPERS LTD-N SHS SPON ADR
2019-06-04
2019-10-09
455. PROSUS NV -SPON ADR
2019-06-04
2019-10-09
150. ASSA ABLOY AB - UNSP ADR
2018-03-26
2019-10-10
435. ATOS ORIGIN SA-UNSP ADR
2019-05-23
2019-10-11
100. YANDEX NV CL A
2018-03-26
2019-10-15
280. YANDEX NV CL A
2019-10-15
135. COMPASS GROUP PLC-SPON ADR
2019-10-18
100. ANHEUSER-BUSCH INBEV-SPN ADR
2018-01-12
2019-10-30
55. ANHEUSER-BUSCH INBEV-SPN ADR
2019-10-31
35. ANHEUSER-BUSCH INBEV-SPN ADR
2018-11-16
2019-10-31
20. ANHEUSER-BUSCH INBEV-SPN ADR
2018-03-26
2019-10-31
7. ALPHABET INC-CL A
2015-04-10
2019-11-05
34. ANTHEM INC
2017-04-07
2019-11-05
1772. CIE FINANCIERE RICH-UNSP ADR
2019-11-11
115. ANHEUSER-BUSCH INBEV-SPN ADR
2019-11-13
35. ANHEUSER-BUSCH INBEV-SPN ADR
2018-11-01
2019-11-13
1800. ZOZO INC UNSPONS ADR
2019-08-19
2019-11-15
510. UBISOFT ENTERTAIN-UNSPON ADR
2017-07-24
2019-11-18
165. UBISOFT ENTERTAIN-UNSPON ADR
2018-12-19
2019-11-18
735. ABN AMRO BANK UNSPONS ADR
2019-08-13
2019-11-22
418. LKQ CORP
2012-08-21
2019-12-03
91. LKQ CORP
2012-08-21
2019-12-03
148. IHS MARKIT LTD
2016-07-13
2019-12-03
281. IHS MARKIT LTD
2016-07-13
2019-12-03
17797. ISHARES CORE MSCI EMERGING
2019-12-11
6125. VANGUARD TOTAL INTL BOND ETF
2019-12-11
667. VANGUARD S&P 500 ETF
2018-01-18
2019-12-11
7137.759 VANGUARD DEV MKT INDX-ADM
2018-01-19
2019-12-12
175. UNILEVER PLC-SPONSORED ADR
2019-12-17
966738.71 ACL ALTERNATIVE FUND
2012-02-06
2019-12-23
50. AON PLC
2019-12-27
33704.804 SJC OFFSHORE CAP FINANCE FD
2011-12-29
2019-12-31
129084. MORGAN STANLEY REAL ESTATE FUND VI
2019-12-31
CAPITAL GAIN DIVIDENDS
P
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
5,723
5,978
-255
b
11,325
11,379
-54
c
7,001
2,346
4,655
d
18,625
22,423
-3,798
e
3,600
2,743
857
6,453
4,802
1,651
11,578
17,909
-6,331
7,101
3,614
3,487
4,356
4,301
55
15
17
-2
2,928
3,228
-300
2,756
4,128
-1,372
3,776
2,106
1,670
7,742
3,999
3,743
6,362
2,236
4,126
4,690
3,688
1,002
7,189
1,462
5,727
4,667
2,083
2,584
10,501
1,916
8,585
2,980
2,400
580
2,714
5,021
-2,307
3,394
2,745
649
7,890
5,448
2,442
6,005
1,856
4,149
3,282
2,830
452
5,224
3,225
1,999
7,160
2,733
4,427
2,377
2,366
11
5,993
5,130
863
10,909
3,781
7,128
4,307
3,937
370
227,172
220,621
6,551
3,323
2,368
955
3,925
3,281
644
3,656
2,377
1,279
5,957
3,412
2,545
2,274
761
1,513
3,471
4,031
-560
5,978
3,511
2,467
3,817
3,719
98
6,774
4,287
2,487
6,835
4,099
2,736
7,611
4,222
3,389
6,277
1,681
4,596
1,743
1,796
-53
2,731
3,448
-717
3,564
3,963
-399
4,627
3,355
1,272
7,281
3,531
3,750
4,924
4,216
708
9,615
2,766
6,849
10,464
2,502
7,962
8,558
5,479
3,079
3,285
2,568
717
2,430
5,163
-2,733
2,737
2,838
-101
5,710
5,021
689
5,473
3,396
2,077
4,697
2,909
1,788
2,229
2,600
-371
18,419
15,654
2,765
20,313
20,367
-54
6,606
6,341
265
3,501
4,189
-688
7,521
5,384
2,137
2,315
2,723
-408
7,804
8,674
-870
1,905
2,066
-161
2,073
2,592
-519
12,427
10,080
2,347
3,651
1,639
2,012
2,902
1,664
1,238
39,629
11,444
28,185
2,242
7,880
-5,638
4,409
15,116
-10,707
1,173
3,710
-2,537
2,246
4,347
-2,101
11
13
-2
3,373
1,499
1,874
10,805
8,307
2,498
8,085
4,716
3,369
4,883
4,177
706
15,601
14,279
1,322
1,203
1,044
159
4,794
3,650
1,144
12,612
10,061
2,551
6,354
6,584
-230
7,014
6,468
546
30,737
39,965
-9,228
14,174
2,504
11,670
14,736
9,604
5,132
6,369
5,367
1,002
3,643
2,964
679
6,274
7,814
-1,540
16,728
3,981
12,747
4,607
6,494
-1,887
10,887
14,364
-3,477
10,995
10,638
357
2,503
2,475
28
5,232
5,734
-502
6,408
4,920
1,488
5,019
3,417
1,602
8,518
7,704
814
5,334
5,794
-460
3,830
3,787
43
6,216
4,846
1,370
7,603
8,326
-723
7,026
9,037
-2,011
9,157
9,208
-51
5,287
6,301
-1,014
4,165
4,633
-468
4,155
5,454
-1,299
2,800
3,363
-563
4,645
5,235
-590
11,304
7,994
3,310
4,826
3,922
904
3,412
3,830
-418
6,622
7,962
-1,340
6,260
6,389
-129
6,244
8,805
-2,561
6,060
7,135
-1,075
2,984
5,397
-2,413
7,624
7,303
321
5,139
9,080
-3,941
15,030
12,432
2,598
4,191
3,821
370
12,542
11,372
1,170
12,954
15,479
-2,525
5,628
5,157
471
10,606
9,879
727
4,755
4,414
341
5,202
4,725
477
16,420
16,015
405
4,728
9,354
-4,626
4,533
8,853
-4,320
13,520
9,547
3,973
8,892
10,752
-1,860
5,512
6,722
-1,210
10,303
10,782
-479
16,039
12,584
3,455
3,813
3,424
389
7,167
8,696
-1,529
9,944
10,561
-617
5,550
6,308
-758
9,099
6,803
2,296
9,344
9,935
-591
3,587
1,945
1,642
3,672
3,534
138
11,071
9,795
1,276
7,602
7,426
176
9,190
8,901
289
8,626
9,221
-595
15,058
20,078
-5,020
10,506
6,606
3,900
13,313
9,358
3,955
12,558
9,582
2,976
14,185
11,193
2,992
2,089
1,814
275
5,119
5,655
-536
1,866
1,190
676
11,012
9,360
1,652
1,000,000
970,776
29,224
750,000
840,556
-90,556
6,748
6,537
211
6,967
3,849
3,118
4,700
2,939
1,761
4,349
4,145
204
4,808
4,689
119
4,786
5,946
-1,160
127
123
4
6,279
12,312
-6,033
8,424
7,244
1,180
8,234
11,660
-3,426
4,742
6,320
-1,578
93
52
41
1,571
719
852
1,542
818
724
1,965
896
1,069
5,074
4,192
882
1,277
1,148
129
1,333
1,262
71
9,597
12,785
-3,188
2,800
2,877
-77
675
659
16
7,328
999
6,329
10,795
9,158
1,637
7,749
7,536
213
1,948
1,106
842
3,010
1,384
1,626
10,832
4,096
6,736
12,367
11,966
401
6,265
4,942
1,323
2,560
1,942
618
10,979
3,311
7,668
6,528
8,491
-1,963
3,212
3,838
-626
7,499
7,406
93
10,255
12,304
-2,049
13,355
14,172
-817
6,404
6,596
-192
1,607
1,587
20
6,391
6,947
-556
3,083
4,189
-1,106
8,594
9,940
-1,346
3,362
2,478
884
8,103
11,491
-3,388
4,444
6,034
-1,590
2,828
2,759
69
1,616
2,155
-539
9,058
3,825
5,233
9,304
5,659
3,645
12,935
12,580
355
9,148
8,837
311
2,784
2,686
98
7,879
6,853
1,026
5,625
6,370
-745
1,820
2,679
-859
13,013
13,317
-304
14,342
8,114
6,228
3,120
1,766
1,354
10,657
4,879
5,778
20,242
9,264
10,978
928,206
952,561
-24,355
355,425
330,527
24,898
192,212
171,422
20,790
100,000
107,994
-7,994
9,917
9,126
791
912,197
937,287
-25,090
10,358
6,648
3,710
865
865
8,324
8,324
3,398
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
-255
b
-54
c
4,655
d
-3,798
e
857
1,651
-6,331
3,487
55
-2
-300
-1,372
1,670
3,743
4,126
1,002
5,727
2,584
8,585
580
-2,307
649
2,442
4,149
452
1,999
4,427
11
863
7,128
370
6,551
955
644
1,279
2,545
1,513
-560
2,467
98
2,487
2,736
3,389
4,596
-53
-717
-399
1,272
3,750
708
6,849
7,962
3,079
717
-2,733
-101
689
2,077
1,788
-371
2,765
-54
265
-688
2,137
-408
-870
-161
-519
2,347
2,012
1,238
28,185
-5,638
-10,707
-2,537
-2,101
-2
1,874
2,498
3,369
706
1,322
159
1,144
2,551
-230
546
-9,228
11,670
5,132
1,002
679
-1,540
12,747
-1,887
-3,477
357
28
-502
1,488
1,602
814
-460
43
1,370
-723
-2,011
-51
-1,014
-468
-1,299
-563
-590
3,310
904
-418
-1,340
-129
-2,561
-1,075
-2,413
321
-3,941
2,598
370
1,170
-2,525
471
727
341
477
405
-4,626
-4,320
3,973
-1,860
-1,210
-479
3,455
389
-1,529
-617
-758
2,296
-591
1,642
138
1,276
176
289
-595
-5,020
3,900
3,955
2,976
2,992
275
-536
676
1,652
29,224
-90,556
211
3,118
1,761
204
119
-1,160
4
-6,033
1,180
-3,426
-1,578
41
852
724
1,069
882
129
71
-3,188
-77
16
6,329
1,637
213
842
1,626
6,736
401
1,323
618
7,668
-1,963
-626
93
-2,049
-817
-192
20
-556
-1,106
-1,346
884
-3,388
-1,590
69
-539
5,233
3,645
355
311
98
1,026
-745
-859
-304
6,228
1,354
5,778
10,978
-24,355
24,898
20,790
-7,994
791
-25,090
3,710
865
8,324
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
133,252
3
Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8
...................
3
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)
If section 4940(d)(2) applies, leave this part blank.
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period?
Yes
No
If "Yes," the foundation does not qualify under section 4940(e). Do not complete this part.
1
Enter the appropriate amount in each column for each year; see instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in)
(b)
Adjusted qualifying distributions
(c)
Net value of noncharitable-use assets
(d)
Distribution ratio
(col. (b) divided by col. (c))
2018
1,085,624
19,890,805
0.054579
2017
1,141,474
19,713,831
0.057902
2016
1,104,206
19,476,138
0.056695
2015
949,523
22,303,896
0.042572
2014
907,333
21,173,479
0.042852
2
Total
of line 1, column (d)
.....................
2
0.2546
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
0.05092
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
19,699,096
5
Multiply line 4 by line 3
......................
5
1,003,078
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
6,234
7
Add lines 5 and 6
........................
7
1,009,312
8
Enter qualifying distributions from Part XII, line 4
,.............
8
1,013,523
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
6,234
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
6,234
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
6,234
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
8,373
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
4,800
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
13,173
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
6,939
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
6,939
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.
$
(2)
On foundation managers.
$
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
Yes
7
Did the foundation have at least $5,000 in assets at any time during the year?
If "Yes," complete Part II, col. (c),
and Part XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
NV
b
If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G?
If "No," attach explanation
.
8b
Yes
9
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
or 4942(j)(5) for calendar year 2019 or the taxable year beginning in 2019? See the instructions for Part XIV.
If "Yes," complete Part XIV
.............................
9
No
10
Did any persons become substantial contributors during the tax year?
If "Yes," attach a schedule listing their names
and addresses.
...............................
10
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
5
Part VII-A
Statements Regarding Activities
(continued)
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions
.............
11
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement. See instructions
.................
12
No
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
14
The books are in care of
DORSEY & WHITNEY TRUST COMPANY LLC
Telephone no.
(605) 336-6832
Located at
401 E 8TH ST STE 319
SIOUX FALLS
SD
ZIP+4
571037031
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
JOHNNY BRENDEN
CHAIR, SEC, TREASURER
10
120,000
4321 WEST FLAMINGO RD
LAS VEGAS
,
NV
89103
KATHRYN JENSEN
EXECUTIVE DIRECTOR
2
75,000
4321 WEST FLAMINGO RD
LAS VEGAS
,
NV
89103
MICHAEL SULLIVAN
DIRECTOR
1
20,000
4321 WEST FLAMINGO RD
LAS VEGAS
,
NV
89103
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
KATHRYN JENSEN
EXECUTIVE DIRECTOR
75,000
PO BOX 227
BAYFIELD
,
WI
54814
Total
number of others receiving over $50,000 for professional services
.............
0
Part IX-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
2
3
4
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
Form
990-PF
(2019)
Form 990-PF (2019)
Page
8
Part X
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations, see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities
...................
1a
19,400,105
b
Average of monthly cash balances
.......................
1b
598,977
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
19,999,082
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
19,999,082
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
299,986
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
19,699,096
6
Minimum investment return.
Enter 5% of line 5
..................
6
984,955
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
984,955
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
6,234
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
6,234
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
978,721
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
978,721
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
978,721
Part XII
Qualifying Distributions
(see instructions)
1
Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
a
Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26
..........
1a
1,013,523
b
Program-related investments—total from Part IX-B
..................
1b
0
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
0
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
0
b
Cash distribution test (attach the required schedule)
.................
3b
0
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
1,013,523
5
Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
income. Enter 1% of Part I, line 27b. See instructions
.................
5
6,234
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
1,007,289
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
978,721
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
495,700
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
0
b
From 2015
......
0
c
From 2016
......
0
d
From 2017
......
0
e
From 2018
......
0
f
Total
of lines 3a through e
........
0
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
1,013,523
a
Applied to 2018, but not more than line 2a
495,700
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
.....
517,823
e
Remaining amount distributed out of corpus
0
5
Excess distributions carryover applied to 2019.
0
0
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
0
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
0
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
0
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
0
e
Undistributed income for 2018. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
0
f
Undistributed income for 2019. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2020
..........
460,898
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions)
.......
0
8
Excess distributions carryover from 2014 not
applied on line 5 or line 7 (see instructions)
...
0
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
0
10
Analysis of line 9:
a
Excess from 2015
....
0
b
Excess from 2016
....
0
c
Excess from 2017
....
0
d
Excess from 2018
....
0
e
Excess from 2019
....
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
10
Part XIV
Private Operating Foundations
(see instructions and Part VII-A, question 9)
1a
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2019, enter the date of the ruling
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2019
(b)
2018
(c)
2017
(d)
2016
b
85% of line 2a
.........
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed
...
c
“Support" alternative test—enter:
(1)
Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
....
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
(3)
Largest amount of support
from an exempt organization
(4)
Gross investment income
Part XV
Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or email address of the person to whom applications should be addressed:
b
The form in which applications should be submitted and information and materials they should include:
c
Any submission deadlines:
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Form
990-PF
(2019)
Form 990-PF (2019)
Page
11
Part XV
Supplementary Information
(continued)
3
Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
East Bay Golf Foundation
2290 DIAMOND BLVD SUITE 203
Concord
,
CA
94520
N/A
PC
ANNUAL MAYOR'S CUP GOLF
1,000
Landmark School Inc
429 HALE ST PO BOX 227
Prides Crossing
,
MA
01965
N/A
PC
MIDDLE SCHOOL SCIENCE LAB &
41,000
Will Rogers Motion Picture Pioneers
Foundation
6767 FOREST LAWN DRIVE STE 303
Los Angeles
,
CA
90068
N/A
PC
PIONEER OF THE YEAR EVENT
21,000
Sapphire Foundation for Prostate Cancer
3025 SAMMY DAVIS JR DR
Las Vegas
,
NV
89109
N/A
PC
POKER TOURNAMENT
2,600
Jewish Resource Center Chabad of Aspen
435 WEST MAIN SREET
Aspen
,
CO
81611
N/A
PC
YOUTH PROGRAMMING
5,000
Israeli-American Council
5900 CANOGA AVE STE 390
Woodland Hills
,
CA
91367
N/A
PC
ANNUAL GALA
5,000
Variety - the Children's Charity of the
United States Inc
4601 WILSHIRE BOULEVARD SUITE 260
Los Angeles
,
CA
90010
N/A
PC
VARIETY NORTH AMERICAN
10,000
One Drop Foundation Inc
980 KELLY JOHNSON DR STE 200
Las Vegas
,
NV
89119
N/A
PC
ONE NIGHT FOR ONE DROP
5,550
Camping & Education Foundation
3515 MICHIGAN AVE
Cincinnati
,
OH
45208
N/A
PC
ANNUAL FUND
2,000
Second Harvest Food Bank of Orange
County Inc
8014 MARINE WAY
Irvine
,
CA
92618
N/A
PC
CHRISTMAS FOOD DRIVE
5,000
Islamic Educational Center
3194 AIRPORT LOOP DR STE B
Costa Mesa
,
CA
92626
N/A
PC
MEMORIAL DONATION
1,000
Developments In Literacy Inc
17320 RED HILL AVENUE SUITE 120
Irvine
,
CA
92614
N/A
PC
LAS VEGAS ANNUAL GALA
2,500
Cleveland Clinic Foundation
PO BOX 931517
Cleveland
,
OH
44193
N/A
PC
POWER OF LOVE EVENT & ART
16,500
Augsburg University
2211 RIVERSIDE AVE
Minneapolis
,
MN
55454
N/A
PC
STEPUP GALA
10,000
Mount Olivet Rolling Acres Inc
18986 LAKE DRIVE EAST
CHANHASSEN
,
MN
55317
N/A
PC
GENERAL OPERATING SUPPORT
6,000
Mayo Clinic
200 FIRST ST SW
Rochester
,
MN
55905
N/A
PC
INTERCEPT PROJECT FOR
15,000
Conquer Paralysis Now
PO BOX 3661
Princeton
,
NJ
08543
N/A
PC
FUNDRAISING AND AWARENESS
2,000
Options for Life Foundation
5481 COLLINGWOOD CIR
Calabasas
,
CA
91302
N/A
PC
ANNUAL OPTIONS FOR LIFE
5,000
Aspen Valley Hospital Foundation
401 CASTLE CREEK RD
Aspen
,
CO
81611
N/A
PC
FAXITRON MACHINE FOR THE
10,000
Raiders Foundation
1220 HARBOR BAY PKWY
Alameda
,
CA
94502
N/A
PC
RAIDERS FOUNDATION CHARITY
1,000
Huntington Beach Police and Community
Foundation
8840 WARNER AVE STE 204
Fountain Vly
,
CA
92708
N/A
PC
ANNUAL AWARDS LUNCHEON &
6,000
Contra Costa Family Justice Alliance
256 24TH ST
Richmond
,
CA
94804
N/A
PC
BUILDING SAFETY THROUGH
5,000
Todos Santos Business Association Arts
Foundation Inc
PO BOX 921
Concord
,
CA
94522
N/A
PC
CONCORD'S 4TH OF JULY
2,500
Contra Costa Midrasha
25 HILLCROFT WAY
Walnut Creek
,
CA
94597
N/A
PC
BRENDEN MANN SCHOLARSHIP
5,000
Contra Costa County Sheriffs Search
and Rescue
50 GLACIER DR
MARTINEZ
,
CA
94553
N/A
PC
ADULT & INFANT CPR MANIKINS
3,500
Sheriffs Charities Inc
PO BOX 1088
Danville
,
CA
94526
N/A
PC
GOLF TOURNAMENT
2,500
Aspenfilm
110 E HALLAM ST STE 103
Aspen
,
CO
81611
N/A
PC
40TH ANNIVERSARY FILM
10,000
Poetry Promise Inc
5771 EMPRESS GARDEN CT
Las Vegas
,
NV
89148
N/A
PC
LAS VEGAS JEWISH FILM
1,000
Vegas Golden Knights Foundation Inc
1701 VILLAGE CENTER CIRCLE
Las Vegas
,
NV
89134
N/A
PC
GOLDEN KNIGHTS GALA
15,000
Aspen Art Museum
637 EAST HYMAN AVE
Aspen
,
CO
81611
N/A
PC
ARTCRUSH EVENT
6,000
City of Aspen
130 SOUTH GALENA STREET
Aspen
,
CO
81611
N/A
GOV
ASPEN POLICE DEPARTMENT
2,000
City of Rifle
202 RAILROAD AVE
Rifle
,
CO
81650
N/A
GOV
RIFLE POLICE DEPARTMENT
6,000
Aspen Fire Protection District
420 E HOPKINS AVE
Aspen
,
CO
81611
N/A
GOV
PURCHASE OF A ROVIR THERMAL
8,000
Variety-the Childrens Charity of
Southern Nevada
PO BOX 26701
Las Vegas
,
NV
89126
N/A
PC
SENSORY ROOM AT DISCOVERY
25,000
Boys & Girls Clubs of Southern Nevada
2850 LINDELL ROAD
Las Vegas
,
NV
89146
N/A
PC
TECHNOLOGY ENHANCEMENTS FOR
4,750
Jewish Federation of Las Vegas
2317 RENAISSANCE DR
Las Vegas
,
NV
89119
N/A
PC
WOMEN'S PHILANTHROPY UNITED
5,000
The Animal Foundation
655 N MOJAVE RD
Las Vegas
,
NV
89101
N/A
PC
CPR PROGRAM
2,100
The Shade Tree Incorporated
1 W OWENS AVE
N Las Vegas
,
NV
89030
N/A
PC
SPECIAL EVENTS FOR WOMEN
5,000
Opportunity Village Foundation
6300 W OAKEY BLVD
Las Vegas
,
NV
89146
N/A
PC
SANTA RUN
5,000
The Smith Center for the Performing Arts
361 SYMPHONY PARK
Las Vegas
,
NV
89106
N/A
PC
HEART OF EDUCATION AWARDS
5,000
Friends for Las Vegas Metropolitan
Police Department
PO BOX 271468
Las Vegas
,
NV
89106
N/A
PC
HIDDEN HEROES BLACK AND
5,000
The Branson School
39 FERNHILL AVE
Ross
,
CA
94957
N/A
PC
STUDENT FINANCIAL AID
2,500
Variety - the Children's Charity of
Northern California
582 MARKET ST SUITE 101
San Francisco
,
CA
94104
N/A
PC
ANNUAL GOLD HEART CLASSIC
5,000
Nevada Ballet Theatre
1651 INNER CIR
Las Vegas
,
NV
89134
N/A
PC
FUTURE DANCE SPRING CONCERT
10,000
Candlelighters for Childhood Cancer
8990 SPANISH RIDGE AVENUE SUITE 10
Las Vegas
,
NV
89148
N/A
PC
COUNSELING SERVICES &
21,500
Childrens Crisis Center of Stanislaus
County
PO BOX 1062
MODESTO
,
CA
95353
N/A
PC
PREMIER EVENT FUNDRAISER
5,000
Dr Miriam & Sheldon G Adelson
Educational Institute
9700 HILLPOINTE RD
Las Vegas
,
NV
89134
N/A
PC
GALA & CAMPERSHIPS TO CAMP
27,500
University of Nevada Las Vegas
Foundation
4505 S MARYLAND PKWY BOX 451006
LAS VEGAS
,
NV
89154
N/A
PC
FILM DEPARTMENT PROJECTS &
78,700
City of Concord Police Department
1350 GALINDO STREET
Concord
,
CA
94520
N/A
GOV
WEEKEND OFFICER PROGRAM &
13,300
Variety the Children's Charity of
Southern California Tent 25
4601 WILSHIRE BLVD SUITE 260
Los Angeles
,
CA
90010
N/A
PC
CASINO NIGHT/GOLF
31,000
Pepperdine University
24255 PACIFIC COAST HIGHWAY
Malibu
,
CA
90263
N/A
PC
SCHOLARS PROGRAM & ISRAEL
226,000
First Christian Church of H B
1207 MAIN ST
Huntington Beach
,
CA
92648
N/A
PC
YOUTH RETREATS, MISSION
22,200
Variety Boys and Girls Club
2530 CINCINNATI ST
Los Angeles
,
CA
90033
N/A
PC
ANNUAL GOLF TOURNAMENT AND
10,000
University of California Irvine
Foundation
100 THEORY SUITE 250
Irvine
,
CA
92617
N/A
PC
BREAST CANCER PATIENT
10,000
Los Angeles LGBT Center
1118 N MCCADDEN PLACE
Los Angeles
,
CA
90038
N/A
PC
SUPPORT FOR AIDS/LIFECYCLE
2,000
Rhonda Fleming Foundation
1723 CLOVERFIELD BLVD
Santa Monica
,
CA
90404
N/A
PF
GENERAL OPERATING SUPPORT
12,500
Learning With A Difference Inc
5461 LOUISE AVE
Encino
,
CA
91316
N/A
PC
WESTMARK PARENTS
2,500
Malibu Foundation for Youth and Families
11766 WILSHIRE BLVD STE 500
Los Angeles
,
CA
90025
N/A
PC
GENERAL OPERATING SUPPORT
1,000
CHP 11-99 Foundation
2244 N STATE COLLEGE BLVD
Fullerton
,
CA
92831
N/A
PC
GENERAL OPERATING SUPPORT
5,000
Total
.................................
3a
782,200
b
Approved for future payment
Total
.................................
3b
Form
990-PF
(2019)
Form 990-PF (2019)
Page
12
Part XVI-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
Unrelated business income
Excluded by section 512, 513, or 514
(e)
Related or exempt
function income
(See instructions.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
4
Dividends and interest from securities
....
14
589,849
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
79,343
8
Gain or (loss) from sales of assets other than
inventory
............
18
133,252
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)
..
802,444
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
802,444
(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