-
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
CHRIS GERMAN MEMORIAL FUND TAI XXXXX2004
Number and street (or P.O. box number if mail is not delivered to street address)
10 S DEARBORN IL1-0111
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CHICAGO
,
IL
60603
A Employer identification number
20-1701357
B
Telephone number (see instructions)
(800) 496-2583
C
If exemption application is pending, check here
G
Check all that apply:
Initial return
Initial return of a former public charity
Final return
Amended return
Address change
Name change
D 1.
Foreign organizations, check here.............
2
. Foreign organizations meeting the 85%
test, check here and attach computation ...
E
If private foundation status was terminated
under section 507(b)(1)(A), check here .......
H
Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here .......
I
Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)
$
1,449,121
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
...
32,729
32,729
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
86,448
b
Gross sales price for all assets on line 6a
438,823
7
Capital gain net income (from Part IV, line 2)
...
86,448
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)
.......
12
Total.
Add lines 1 through 11
........
119,177
119,177
13
Compensation of officers, directors, trustees, etc.
24,805
16,100
8,705
14
Other employee salaries and wages
......
0
0
0
15
Pension plans, employee benefits
.......
0
0
16a
Legal fees (attach schedule)
.........
750
0
0
750
b
Accounting fees (attach schedule)
.......
c
Other professional fees (attach schedule)
....
0
17
Interest
...............
0
18
Taxes (attach schedule) (see instructions)
...
866
842
0
19
Depreciation (attach schedule) and depletion
...
0
0
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
0
0
22
Printing and publications
..........
0
0
23
Other expenses (attach schedule)
.......
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
26,421
16,942
0
9,455
25
Contributions, gifts, grants paid
.......
60,000
60,000
26
Total expenses and disbursements.
Add lines 24 and 25
86,421
16,942
0
69,455
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
32,756
b
Net investment income
(if negative, enter -0-)
102,235
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
.............
9,415
10,828
10,828
2
Savings and temporary cash investments
.........
13,251
41,891
41,891
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)
.......
853,410
827,122
1,104,080
c
Investments—corporate bonds (attach schedule)
.......
259,948
288,891
292,322
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
0
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)
1,136,024
1,168,732
1,449,121
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
........
1,136,024
1,168,732
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)
.....
1,136,024
1,168,732
30
Total liabilities and net assets/fund balances
(see instructions)
.
1,136,024
1,168,732
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
1,136,024
2
Enter amount from Part I, line 27a
.....................
2
32,756
3
Other increases not included in line 2 (itemize)
3
1,116
4
Add lines 1, 2, and 3
..........................
4
1,169,896
5
Decreases not included in line 2 (itemize)
5
1,164
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
1,168,732
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
3. GILEAD SCIENCES INC
2015-01-08
2019-01-23
b
1. GILEAD SCIENCES INC
2015-01-08
2019-01-23
c
1. GILEAD SCIENCES INC
2015-01-08
2019-01-23
d
1. MASTERCARD INC - CLASS A
2009-07-17
2019-01-23
e
4. WORLDPAY INC CL A
2017-09-22
2019-01-23
1. WORLDPAY INC CL A
2017-09-22
2019-01-23
5. GILEAD SCIENCES INC
2015-01-08
2019-01-24
1. MASTERCARD INC - CLASS A
2009-07-17
2019-01-24
4. MASTERCARD INC - CLASS A
2009-07-17
2019-01-24
7. WORLDPAY INC CL A
2017-09-22
2019-01-24
1. GILEAD SCIENCES INC
2016-02-10
2019-01-25
2. GILEAD SCIENCES INC
2016-02-10
2019-01-25
5. MASTERCARD INC - CLASS A
2009-07-17
2019-01-25
8. WORLDPAY INC CL A
2017-09-22
2019-01-25
1. GILEAD SCIENCES INC
2016-02-10
2019-01-28
1. GILEAD SCIENCES INC
2016-02-10
2019-01-28
5. WORLDPAY INC CL A
2018-10-08
2019-01-28
1. GILEAD SCIENCES INC
2016-02-10
2019-01-29
1. WORLDPAY INC CL A
2018-10-08
2019-01-29
1. GILEAD SCIENCES INC
2016-02-10
2019-01-30
1. GILEAD SCIENCES INC
2016-02-10
2019-01-30
6. WORLDPAY INC CL A
2018-10-08
2019-01-30
1. GILEAD SCIENCES INC
2016-02-10
2019-01-31
1. GILEAD SCIENCES INC
2016-02-10
2019-02-01
1448.63 DODGE & COX INCOME FUND
2017-11-17
2019-02-05
325. VANGUARD BD INDEX FD INC
2018-12-17
2019-02-05
321.24 DODGE & INTERNATIONAL STOCK FUND
2011-01-31
2019-02-14
5. ANALOG DEVICES INC
2016-10-31
2019-02-19
2. ANALOG DEVICES INC
2016-10-31
2019-02-19
7. ANALOG DEVICES INC
2016-10-31
2019-02-19
7. ANALOG DEVICES INC
2016-11-01
2019-02-19
10. ANALOG DEVICES INC
2018-09-13
2019-02-19
2. ANALOG DEVICES INC
2018-09-13
2019-02-19
9. ANALOG DEVICES INC
2018-09-13
2019-02-20
1. ADOBE SYS INC
2012-11-05
2019-03-06
3. APPLE COMPUTER INC
2010-08-13
2019-03-06
1. AUTOMATIC DATA PROCESSING INC
2018-10-19
2019-03-06
12. BANK OF AMERICA CORPORATION
2012-11-08
2019-03-06
1. BERKSHIRE HATHAWAY INC DEL CL B
2017-04-20
2019-03-06
6. BOSTON SCIENTIFIC CORP
2016-09-15
2019-03-06
2. BRISTOL MYERS SQUIBB CO
2013-05-13
2019-03-06
1. BROADCOM INC
2013-06-07
2019-03-06
1. CELGENE CORP.
2014-05-29
2019-03-06
3. CITIGROUP INC NEW
2012-10-23
2019-03-06
2. COCA-COLA CO
2018-04-13
2019-03-06
4. COMCAST CORP NEW CL A
2016-02-05
2019-03-06
3. DELTA AIR LINES INC DEL NEW
2017-12-13
2019-03-06
1. DIAMONDBACK ENERGY INC
2017-05-15
2019-03-06
2. DISNEY WALT CO
2016-10-07
2019-03-06
305.998 DODGE & INTERNATIONAL STOCK FUND
2011-01-31
2019-03-06
1. DOLLAR TREE INC
2017-10-27
2019-03-06
5. DOWDUPONT INC
2015-06-18
2019-03-06
2. EOG RESOURCES INC
2016-03-07
2019-03-06
2. ELECTRONIC ARTS
2018-09-20
2019-03-06
1. FACEBOOK INC-A
2015-04-27
2019-03-06
1. FIDELITY NATL INFORMATION SVCS INC
2014-12-18
2019-03-06
2. FISERV INC
2019-01-23
2019-03-06
1. GENERAL DYNAMICS CORP
2016-08-11
2019-03-06
1. HOME DEPOT INC
2012-03-20
2019-03-06
2. HONEYWELL INTL INC
2010-10-22
2019-03-06
2. INTERCONTINENTALEXCHANGE GROUP, INC
2017-01-30
2019-03-06
8. KEYCORP NEW
2016-03-01
2019-03-06
1. LOWES COS INC
2011-09-22
2019-03-06
2. MARATHON PETROLEUM CORPORATION
2018-03-09
2019-03-06
1. MASTERCARD INC - CLASS A
2009-07-17
2019-03-06
2. MERCK & CO INC
2016-08-05
2019-03-06
7. MICROSOFT CORP
2012-07-06
2019-03-06
4. MONDELEZ INTERNATIONAL-W/I
2011-09-19
2019-03-06
6. MORGAN STANLEY DEAN WITTER & CO NEW
2013-04-19
2019-03-06
1. NETFLIX.COM INC
2018-09-13
2019-03-06
1. NEXTERA ENERGY INC
2016-10-18
2019-03-06
7. NISOURCE INC
2013-10-17
2019-03-06
1. NORFOLK SOUTHN CORP
2017-01-31
2019-03-06
1. NORTHROP GRUMMAN CORP
2016-09-15
2019-03-06
1. NVIDIA CORP
2017-10-03
2019-03-06
4. OCCIDENTAL PETE CORP
2012-09-13
2019-03-06
2. PAYPAL HOLDINGS INC
2018-01-26
2019-03-06
2. PEPSICO INC
2014-10-07
2019-03-06
7. PFIZER INC
2015-04-08
2019-03-06
2. PHILIP MORRIS INTERNATIONAL
2017-04-24
2019-03-06
1. PIONEER NAT RES CO
2015-12-09
2019-03-06
1. PRUDENTIAL FINL INC
2018-12-21
2019-03-06
2. ROSS STORES INC
2018-12-11
2019-03-06
1. SVB FINANCIAL GROUP
2015-02-05
2019-03-06
2. SALESFORCE.COM INC
2018-04-13
2019-03-06
2. SCHWAB CHARLES CORP NEW
2015-10-19
2019-03-06
1. STANLEY BLACK & DECKER,INC.
2015-11-13
2019-03-06
2. TEXAS INSTRS INC
2016-02-05
2019-03-06
1. UNION PAC CORP
2015-09-29
2019-03-06
1. UNITED TECHNOLOGIES CORP
2017-12-05
2019-03-06
2. UNITEDHEALTH GROUP INC
2013-06-24
2019-03-06
1. VERTEX PHARMACEUTICALS INC
2014-09-09
2019-03-06
1. VISA INC CLASS A SHARES
2015-10-19
2019-03-06
2. WASTE CONNECTIONS INC
2016-07-25
2019-03-06
5. WELLS FARGO & CO NEW
2011-08-12
2019-03-06
1. WEX INC
2016-05-02
2019-03-06
2. ZIMMER HLDGS INC
2017-11-10
2019-03-06
2. ALLEGION PLC
2015-10-29
2019-03-06
1. ACCENTURE PLC
2014-01-15
2019-03-06
1. LINDE PLC
2018-12-11
2019-03-06
1. MEDTRONIC PLC
2018-04-06
2019-03-06
3. APTIV PLC
2017-05-18
2019-03-06
2. CHUBB LTD
2011-05-23
2019-03-06
2. NXP SEMICONDUCTORS NV
2019-02-19
2019-03-06
4. BIOGEN IDEC INC
2014-05-08
2019-03-14
2. BIOGEN IDEC INC
2018-10-08
2019-03-14
64. BRISTOL MYERS SQUIBB CO
2013-05-13
2019-03-14
14. DISNEY WALT CO
2016-10-07
2019-03-14
. BANK OF AMERICA CORPORATION
2019-03-20
. PFIZER INC
2019-04-03
12. DOW INC
2015-07-15
2019-04-08
2. DOW INC
2017-02-22
2019-04-08
1. DOW INC
2017-02-22
2019-04-08
15. DOW INC
2017-02-22
2019-04-08
1.632 DOW INC
2018-04-09
2019-04-08
5.368 DOW INC
2017-03-20
2019-04-08
2. DOW INC
2018-04-09
2019-04-09
2. ADOBE SYS INC
2012-11-05
2019-04-11
3. ALEXION PHARMACEUTICALS INC
2019-03-14
2019-04-11
2. ALPHABET INC-CL C
2013-04-04
2019-04-11
1. ALPHABET INC-CL A
2013-05-22
2019-04-11
1. AMAZON COM INC
2015-03-12
2019-04-11
3. AMERICAN EXPRESS CO
2018-07-18
2019-04-11
10. APPLE COMPUTER INC
2010-08-13
2019-04-11
3. AUTOMATIC DATA PROCESSING INC
2018-10-19
2019-04-11
38. BANK OF AMERICA CORPORATION
2012-11-08
2019-04-11
5. BERKSHIRE HATHAWAY INC DEL CL B
2017-04-20
2019-04-11
19. BOSTON SCIENTIFIC CORP
2016-09-15
2019-04-11
3. BROADCOM INC
2013-06-10
2019-04-11
5. CELGENE CORP.
2015-08-11
2019-04-11
3. CHARTER COMMUNICATIONS INC-A
2016-02-09
2019-04-11
14. CITIGROUP INC NEW
2012-10-23
2019-04-11
9. COCA-COLA CO
2018-04-13
2019-04-11
22. COMCAST CORP NEW CL A
2016-02-05
2019-04-11
6. DELTA AIR LINES INC DEL NEW
2017-12-13
2019-04-11
3. DIAMONDBACK ENERGY INC
2017-05-15
2019-04-11
8. DISNEY WALT CO
2016-10-27
2019-04-11
4. DOLLAR TREE INC
2017-10-27
2019-04-11
20. DOWDUPONT INC
2015-07-15
2019-04-11
8. EOG RESOURCES INC
2016-03-07
2019-04-11
6. ELECTRONIC ARTS
2018-09-20
2019-04-11
4. FACEBOOK INC-A
2015-04-27
2019-04-11
5. FIDELITY NATL INFORMATION SVCS INC
2014-12-18
2019-04-11
5. FISERV INC
2019-01-23
2019-04-11
3. GENERAL DYNAMICS CORP
2016-08-15
2019-04-11
5. HOME DEPOT INC
2012-03-20
2019-04-11
8. HONEYWELL INTL INC
2010-10-22
2019-04-11
2. INTERCONTINENTALEXCHANGE GROUP, INC
2017-01-30
2019-04-11
26. KEYCORP NEW
2016-03-01
2019-04-11
8. LILLY ELI & CO
2015-07-02
2019-04-11
6. LOWES COS INC
2011-09-22
2019-04-11
10. MARATHON PETROLEUM CORPORATION
2018-03-09
2019-04-11
3. MASTERCARD INC - CLASS A
2012-10-15
2019-04-11
2. MASTERCARD INC - CLASS A
2009-07-17
2019-04-11
11. MERCK & CO INC
2016-08-05
2019-04-11
24. MICROSOFT CORP
2012-07-06
2019-04-11
2. MONDELEZ INTERNATIONAL-W/I
2012-10-15
2019-04-11
11. MONDELEZ INTERNATIONAL-W/I
2011-09-19
2019-04-11
22. MORGAN STANLEY DEAN WITTER & CO NEW
2013-04-19
2019-04-11
1. NETFLIX.COM INC
2018-09-13
2019-04-11
3. NEXTERA ENERGY INC
2016-10-18
2019-04-11
11. NISOURCE INC
2013-10-17
2019-04-11
5. NORFOLK SOUTHN CORP
2017-01-31
2019-04-11
2. NORTHROP GRUMMAN CORP
2016-09-16
2019-04-11
3. NVIDIA CORP
2017-10-03
2019-04-11
1. O'REILLY AUTOMOTIVE INC
2017-05-04
2019-04-11
13. OCCIDENTAL PETE CORP
2013-06-03
2019-04-11
2. PARKER HANNIFIN CORP
2018-01-11
2019-04-11
7. PAYPAL HOLDINGS INC
2018-01-26
2019-04-11
7. PEPSICO INC
2014-10-07
2019-04-11
26. PFIZER INC
2015-04-08
2019-04-11
6. PHILIP MORRIS INTERNATIONAL
2017-04-24
2019-04-11
4. PIONEER NAT RES CO
2015-12-09
2019-04-11
3. PRUDENTIAL FINL INC
2018-12-21
2019-04-11
1. REGENERON PHARMACEUTICALS INC
2019-01-23
2019-04-11
5. ROSS STORES INC
2018-12-11
2019-04-11
1. SVB FINANCIAL GROUP
2015-02-05
2019-04-11
4. SALESFORCE.COM INC
2018-04-13
2019-04-11
7. SCHWAB CHARLES CORP NEW
2015-10-19
2019-04-11
4. STANLEY BLACK & DECKER,INC.
2015-11-18
2019-04-11
8. TEXAS INSTRS INC
2016-02-05
2019-04-11
6. UNION PAC CORP
2015-09-29
2019-04-11
2. UNITED TECHNOLOGIES CORP
2017-12-05
2019-04-11
6. UNITEDHEALTH GROUP INC
2013-06-24
2019-04-11
2. VERTEX PHARMACEUTICALS INC
2014-09-09
2019-04-11
4. VISA INC CLASS A SHARES
2015-10-19
2019-04-11
5. WASTE CONNECTIONS INC
2016-07-26
2019-04-11
9. WELLS FARGO & CO NEW
2011-08-12
2019-04-11
7. WELLS FARGO & CO NEW
2012-03-16
2019-04-11
2. WEX INC
2016-05-02
2019-04-11
3. YUM BRANDS INC
2018-11-27
2019-04-11
6. ZIMMER HLDGS INC
2017-11-10
2019-04-11
4. ALLEGION PLC
2015-11-02
2019-04-11
4. ACCENTURE PLC
2014-01-16
2019-04-11
4. LINDE PLC
2018-12-11
2019-04-11
6. MEDTRONIC PLC
2018-04-06
2019-04-11
5. APTIV PLC
2017-05-18
2019-04-11
5. CHUBB LTD
2011-05-23
2019-04-11
4. NXP SEMICONDUCTORS NV
2019-02-19
2019-04-11
264.749 DODGE & INTERNATIONAL STOCK FUND
2011-08-15
2019-04-12
253.229 DODGE & INTERNATIONAL STOCK FUND
2015-11-11
2019-04-12
4626.801 T ROWE PR OVERSEAS STOCK-I
2015-11-11
2019-04-12
. DOW INC
2019-04-23
24. OCCIDENTAL PETE CORP
2014-09-24
2019-04-25
24. OCCIDENTAL PETE CORP
2014-11-11
2019-04-25
5. OCCIDENTAL PETE CORP
2017-02-10
2019-05-01
1. OCCIDENTAL PETE CORP
2017-02-10
2019-05-01
3. REGENERON PHARMACEUTICALS INC
2019-01-23
2019-05-01
1. REGENERON PHARMACEUTICALS INC
2019-01-30
2019-05-01
15. OCCIDENTAL PETE CORP
2017-02-10
2019-05-02
1. OCCIDENTAL PETE CORP
2018-08-09
2019-05-02
1. OCCIDENTAL PETE CORP
2018-08-09
2019-05-02
3. OCCIDENTAL PETE CORP
2018-08-09
2019-05-02
1. OCCIDENTAL PETE CORP
2018-08-09
2019-05-02
2. OCCIDENTAL PETE CORP
2018-08-09
2019-05-03
5. OCCIDENTAL PETE CORP
2018-08-09
2019-05-03
1. PRUDENTIAL FINL INC
2018-12-21
2019-05-14
11. PRUDENTIAL FINL INC
2018-12-21
2019-05-14
6. PRUDENTIAL FINL INC
2018-12-21
2019-05-14
2. PRUDENTIAL FINL INC
2018-12-21
2019-05-14
2. PRUDENTIAL FINL INC
2018-12-21
2019-05-14
17. SCHWAB CHARLES CORP NEW
2015-10-19
2019-05-15
15. SCHWAB CHARLES CORP NEW
2016-06-03
2019-05-16
4. SCHWAB CHARLES CORP NEW
2016-06-03
2019-05-16
9. SCHWAB CHARLES CORP NEW
2016-06-03
2019-05-16
13. MEDTRONIC PLC
2018-04-09
2019-05-16
7. MEDTRONIC PLC
2018-07-18
2019-05-16
5. MEDTRONIC PLC
2018-04-10
2019-05-16
4. MEDTRONIC PLC
2018-07-18
2019-05-17
8. MEDTRONIC PLC
2018-07-18
2019-05-17
3. PARKER HANNIFIN CORP
2018-01-11
2019-05-20
4. PARKER HANNIFIN CORP
2018-01-11
2019-05-20
2. PARKER HANNIFIN CORP
2018-01-11
2019-05-20
15. DELTA AIR LINES INC DEL NEW
2017-12-13
2019-06-05
6. DELTA AIR LINES INC DEL NEW
2017-12-13
2019-06-05
16. PHILIP MORRIS INTERNATIONAL
2017-05-18
2019-06-05
3. PHILIP MORRIS INTERNATIONAL
2018-10-24
2019-06-05
5. DELTA AIR LINES INC DEL NEW
2017-12-13
2019-06-06
5. DELTA AIR LINES INC DEL NEW
2017-12-13
2019-06-06
1. DELTA AIR LINES INC DEL NEW
2017-12-13
2019-06-06
1. DELTA AIR LINES INC DEL NEW
2017-12-13
2019-06-07
1. DELTA AIR LINES INC DEL NEW
2017-12-13
2019-06-07
1. DELTA AIR LINES INC DEL NEW
2017-12-13
2019-06-07
46. BANK OF AMERICA CORPORATION
2013-04-18
2019-06-10
10. DOLLAR TREE INC
2017-10-27
2019-06-10
35. WELLS FARGO & CO NEW
2012-03-16
2019-06-10
3. DOLLAR TREE INC
2018-12-17
2019-06-11
11. DOLLAR TREE INC
2017-10-30
2019-06-11
4. DOLLAR TREE INC
2018-12-17
2019-06-11
. CORTEVA INC
2019-06-13
. DUPONT DE NEMOURS INC-WI
2019-06-13
4. ADOBE SYS INC
2012-11-05
2019-06-27
. AMGEN INC
2019-07-17
4. SVB FINANCIAL GROUP
2015-02-05
2019-08-14
2. SVB FINANCIAL GROUP
2015-02-06
2019-08-14
5. APTIV PLC
2017-05-18
2019-08-14
3. APTIV PLC
2017-05-18
2019-08-14
7. APTIV PLC
2017-05-18
2019-08-14
4. SVB FINANCIAL GROUP
2015-08-12
2019-08-15
14. APTIV PLC
2018-04-26
2019-08-15
125. ISHARES TR BARCLAYS MBS BD FD
2019-02-05
2019-09-24
350. VANGUARD BD INDEX FD INC
2019-03-06
2019-09-24
17. DISNEY WALT CO
2016-12-05
2019-10-25
4. ACCENTURE PLC
2014-01-17
2019-10-25
6. ACCENTURE PLC
2014-04-03
2019-10-28
691.085 CAPITAL GR NON US EQUITY
2013-08-01
2019-10-29
12. NISOURCE INC
2014-01-14
2019-11-11
15. NISOURCE INC
2014-01-16
2019-11-11
12. NISOURCE INC
2015-03-17
2019-11-12
30. NISOURCE INC
2015-03-20
2019-11-12
2. NISOURCE INC
2015-12-03
2019-11-12
3. NISOURCE INC
2015-12-03
2019-11-13
17. CELGENE CORP.
2015-08-11
2019-11-21
52. CELGENE CORP.
2019-03-14
2019-11-21
50. SPDR TR UNIT SER 1
2012-07-06
2019-11-22
27. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-25
3. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-25
1. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-25
33. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-26
5. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-27
4. ABBVIE INC
2019-09-16
2019-12-10
1. ADOBE SYS INC
2013-05-09
2019-12-10
1. ALPHABET INC-CL C
2013-05-22
2019-12-10
1. AMAZON COM INC
2015-03-12
2019-12-10
4. AMERICAN EXPRESS CO
2018-07-18
2019-12-10
5. APPLE COMPUTER INC
2010-08-13
2019-12-10
1. AUTOMATIC DATA PROCESSING INC
2018-10-19
2019-12-10
16. BANK OF AMERICA CORPORATION
2013-04-19
2019-12-10
2. BERKSHIRE HATHAWAY INC DEL CL B
2017-04-20
2019-12-10
9. BOSTON SCIENTIFIC CORP
2016-09-15
2019-12-10
5. BRISTOL MYERS SQUIBB CO
2019-11-21
2019-12-10
2. BROADCOM INC
2013-06-10
2019-12-10
336.022 AMER FNDS INTL VNTG-F3
2013-08-14
2019-12-10
1. CHARTER COMMUNICATIONS INC-A
2016-02-09
2019-12-10
6. CITIGROUP INC NEW
2013-04-16
2019-12-10
5. COCA-COLA CO
2018-04-13
2019-12-10
13. COMCAST CORP NEW CL A
2018-01-11
2019-12-10
5. CORTEVA INC
2016-08-10
2019-12-10
2. DIAMONDBACK ENERGY INC
2017-05-15
2019-12-10
2. DISNEY WALT CO
2016-12-08
2019-12-10
234.302 DOUBLELINE TTL RTRN BND-I
2016-06-20
2019-12-10
3. DUPONT DE NEMOURS INC-WI
2016-08-10
2019-12-10
4. EOG RESOURCES INC
2016-05-02
2019-12-10
3. ELECTRONIC ARTS
2018-09-20
2019-12-10
2. FACEBOOK INC-A
2015-04-27
2019-12-10
4. FIDELITY NATL INFORMATION SVCS INC
2014-12-18
2019-12-10
6. FISERV INC
2019-01-24
2019-12-10
2. GENERAL DYNAMICS CORP
2016-08-16
2019-12-10
2. HOME DEPOT INC
2012-03-20
2019-12-10
1. HONEYWELL INTL INC
2010-10-22
2019-12-10
2. HONEYWELL INTL INC
2012-06-15
2019-12-10
2. INTERCONTINENTALEXCHANGE GROUP, INC
2017-01-31
2019-12-10
1749.781 JPM GL RES ENH IDX FD - USD - R6 ISIN US48129C2070
2014-02-04
2019-12-10
1046.901 JPMORGAN CORE BOND FUND ULTRA
2016-06-20
2019-12-10
13. KEYCORP NEW
2016-03-01
2019-12-10
3. LILLY ELI & CO
2015-07-07
2019-12-10
2. LOWES COS INC
2011-09-22
2019-12-10
7. MARATHON PETROLEUM CORPORATION
2018-03-09
2019-12-10
3. MASTERCARD INC - CLASS A
2012-10-15
2019-12-10
1. MCDONALDS CORP
2019-06-10
2019-12-10
5. MERCK & CO INC
2016-08-05
2019-12-10
11. MICROSOFT CORP
2013-08-09
2019-12-10
6. MONDELEZ INTERNATIONAL-W/I
2012-10-15
2019-12-10
10. MORGAN STANLEY DEAN WITTER & CO NEW
2013-04-19
2019-12-10
1. NETFLIX.COM INC
2018-09-13
2019-12-10
1. NEXTERA ENERGY INC
2016-10-18
2019-12-10
2. NORFOLK SOUTHN CORP
2017-02-02
2019-12-10
1. NORTHROP GRUMMAN CORP
2016-09-16
2019-12-10
1. NVIDIA CORP
2017-10-03
2019-12-10
1. O'REILLY AUTOMOTIVE INC
2017-05-04
2019-12-10
3. PAYPAL HOLDINGS INC
2018-01-26
2019-12-10
4. PEPSICO INC
2014-10-13
2019-12-10
13. PFIZER INC
2015-06-04
2019-12-10
2. PHILIP MORRIS INTERNATIONAL
2018-10-24
2019-12-10
2. PIONEER NAT RES CO
2015-12-10
2019-12-10
2. PROCTER & GAMBLE CO
2019-06-05
2019-12-10
2. QUALCOMM INC
2019-05-01
2019-12-10
2. ROSS STORES INC
2018-12-11
2019-12-10
3. SALESFORCE.COM INC
2018-04-13
2019-12-10
2. STANLEY BLACK & DECKER,INC.
2015-11-30
2019-12-10
4. TEXAS INSTRS INC
2016-02-05
2019-12-10
3. UNION PAC CORP
2015-09-29
2019-12-10
2. UNITED TECHNOLOGIES CORP
2017-12-05
2019-12-10
3. UNITEDHEALTH GROUP INC
2013-09-03
2019-12-10
1. VERTEX PHARMACEUTICALS INC
2015-04-08
2019-12-10
2. VISA INC CLASS A SHARES
2015-10-19
2019-12-10
2. WASTE CONNECTIONS INC
2016-07-26
2019-12-10
5. WELLS FARGO & CO NEW
2012-06-05
2019-12-10
1. WEX INC
2016-05-02
2019-12-10
2. YUM BRANDS INC
2018-11-27
2019-12-10
4. ZIMMER HLDGS INC
2017-11-10
2019-12-10
1. ALLEGION PLC
2015-11-04
2019-12-10
1. ACCENTURE PLC
2014-04-22
2019-12-10
4. LINDE PLC
2018-12-11
2019-12-10
2. CHUBB LTD
2011-05-23
2019-12-10
2. NXP SEMICONDUCTORS NV
2019-02-19
2019-12-10
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
205
305
-100
b
68
102
-34
c
68
102
-34
d
198
18
180
e
329
288
41
83
72
11
339
471
-132
200
18
182
796
72
724
576
504
72
68
89
-21
138
178
-40
1,013
90
923
663
576
87
68
89
-21
68
89
-21
416
485
-69
69
89
-20
82
97
-15
70
89
-19
69
89
-20
501
582
-81
70
89
-19
70
89
-19
19,528
20,000
-472
25,592
25,463
129
12,750
11,529
1,221
523
321
202
209
129
80
735
448
287
730
445
285
1,043
921
122
210
184
26
953
829
124
257
34
223
523
107
416
152
143
9
347
114
233
201
165
36
240
140
100
106
82
24
275
56
219
86
77
9
188
111
77
91
89
2
155
117
38
150
160
-10
102
104
-2
229
185
44
12,500
10,391
2,109
96
92
4
272
265
7
188
145
43
192
227
-35
173
82
91
107
63
44
171
161
10
168
151
17
185
49
136
309
90
219
151
116
35
137
87
50
103
19
84
120
141
-21
226
18
208
162
128
34
784
211
573
188
88
100
251
123
128
352
371
-19
188
125
63
189
78
111
178
119
59
284
212
72
155
179
-24
268
356
-88
194
170
24
233
186
47
296
242
54
174
224
-50
141
145
-4
97
80
17
192
161
31
248
120
128
317
239
78
92
57
35
134
104
30
212
100
112
166
86
80
127
121
6
480
129
351
187
93
94
148
77
71
168
100
68
249
123
126
176
94
82
247
221
26
180
129
51
164
84
80
169
161
8
93
78
15
252
212
40
267
137
130
186
185
1
1,281
1,064
217
640
685
-45
3,149
3,380
-231
1,601
1,304
297
33
33
314
314
686
650
36
114
129
-15
57
64
-7
858
969
-111
93
106
-13
307
348
-41
114
130
-16
543
68
475
413
404
9
2,408
792
1,616
1,208
453
755
1,843
374
1,469
329
309
20
1,990
358
1,632
484
431
53
1,106
413
693
1,033
825
208
719
443
276
927
181
746
471
649
-178
1,064
542
522
921
547
374
419
401
18
902
734
168
350
321
29
302
311
-9
934
771
163
418
370
48
778
700
78
790
651
139
602
681
-79
709
330
379
566
314
252
427
406
21
514
460
54
1,005
247
758
1,287
359
928
154
116
38
427
278
149
1,001
691
310
690
114
576
632
702
-70
707
142
565
471
36
435
878
699
179
2,881
773
2,108
99
54
45
546
243
303
985
452
533
368
371
-3
570
376
194
308
124
184
967
595
372
555
423
132
573
537
36
407
249
158
873
1,176
-303
371
416
-45
744
595
149
850
660
190
1,097
896
201
514
680
-166
603
579
24
299
240
59
393
400
-7
486
403
83
238
120
118
642
477
165
310
200
110
578
429
149
916
399
517
1,000
518
482
266
241
25
1,411
409
1,002
371
217
154
630
308
322
437
250
187
430
221
209
334
238
96
400
188
212
302
267
35
772
664
108
375
263
112
712
335
377
720
643
77
527
467
60
444
354
90
689
341
348
390
370
20
11,119
8,626
2,493
10,636
10,000
636
48,443
43,494
4,949
19
19
1,491
2,112
-621
1,490
1,911
-421
288
347
-59
58
69
-11
1,023
1,222
-199
340
420
-80
860
1,016
-156
57
78
-21
57
77
-20
172
231
-59
57
78
-21
116
156
-40
291
390
-99
98
80
18
1,083
876
207
593
478
115
195
159
36
198
159
39
727
532
195
654
437
217
174
117
57
391
262
129
1,146
1,029
117
618
617
1
442
395
47
352
352
707
705
2
489
625
-136
653
833
-180
326
416
-90
824
803
21
330
321
9
1,236
1,855
-619
232
267
-35
274
268
6
273
267
6
55
53
2
55
53
2
55
53
2
56
53
3
1,297
523
774
1,038
925
113
1,624
1,160
464
320
259
61
1,173
1,007
166
426
346
80
17
17
50
50
1,175
147
1,028
18
18
763
493
270
380
253
127
398
354
44
241
212
29
559
544
15
747
554
193
1,110
1,218
-108
13,520
13,120
400
28,270
27,622
648
2,233
1,736
497
733
327
406
1,102
475
627
10,000
7,707
2,293
315
144
171
392
228
164
313
182
131
781
575
206
52
38
14
79
57
22
1,837
1,902
-65
5,618
4,851
767
15,547
6,781
8,766
57
62
-5
6
7
-1
2
2
70
76
-6
11
12
-1
347
283
64
307
44
263
1,346
452
894
1,744
374
1,370
483
412
71
1,346
179
1,167
169
144
25
536
187
349
443
330
113
397
210
187
309
282
27
630
113
517
5,000
3,753
1,247
467
181
286
453
278
175
270
223
47
557
550
7
128
140
-12
169
208
-39
292
207
85
2,500
2,554
-54
193
241
-48
298
323
-25
307
341
-34
401
165
236
546
254
292
685
493
192
363
306
57
432
99
333
174
45
129
349
106
243
185
116
69
40,000
32,250
7,750
12,500
12,479
21
256
139
117
361
264
97
234
38
196
411
493
-82
868
142
726
195
201
-6
446
312
134
1,666
360
1,306
326
162
164
498
205
293
296
371
-75
235
125
110
377
248
129
344
211
133
215
179
36
444
251
193
311
255
56
548
381
167
497
445
52
168
178
-10
268
294
-26
249
213
36
170
173
-3
230
161
69
471
358
113
316
219
97
491
210
281
515
279
236
291
241
50
831
216
615
221
123
98
365
154
211
181
100
81
268
152
116
197
94
103
198
179
19
590
443
147
124
65
59
202
80
122
819
643
176
305
137
168
240
185
55
4,892
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
-100
b
-34
c
-34
d
180
e
41
11
-132
182
724
72
-21
-40
923
87
-21
-21
-69
-20
-15
-19
-20
-81
-19
-19
-472
129
1,221
202
80
287
285
122
26
124
223
416
9
233
36
100
24
219
9
77
2
38
-10
-2
44
2,109
4
7
43
-35
91
44
10
17
136
219
35
50
84
-21
208
34
573
100
128
-19
63
111
59
72
-24
-88
24
47
54
-50
-4
17
31
128
78
35
30
112
80
6
351
94
71
68
126
82
26
51
80
8
15
40
130
1
217
-45
-231
297
33
314
36
-15
-7
-111
-13
-41
-16
475
9
1,616
755
1,469
20
1,632
53
693
208
276
746
-178
522
374
18
168
29
-9
163
48
78
139
-79
379
252
21
54
758
928
38
149
310
576
-70
565
435
179
2,108
45
303
533
-3
194
184
372
132
36
158
-303
-45
149
190
201
-166
24
59
-7
83
118
165
110
149
517
482
25
1,002
154
322
187
209
96
212
35
108
112
377
77
60
90
348
20
2,493
636
4,949
19
-621
-421
-59
-11
-199
-80
-156
-21
-20
-59
-21
-40
-99
18
207
115
36
39
195
217
57
129
117
1
47
2
-136
-180
-90
21
9
-619
-35
6
6
2
2
2
3
774
113
464
61
166
80
17
50
1,028
18
270
127
44
29
15
193
-108
400
648
497
406
627
2,293
171
164
131
206
14
22
-65
767
8,766
-5
-1
-6
-1
64
263
894
1,370
71
1,167
25
349
113
187
27
517
1,247
286
175
47
7
-12
-39
85
-54
-48
-25
-34
236
292
192
57
333
129
243
69
7,750
21
117
97
196
-82
726
-6
134
1,306
164
293
-75
110
129
133
36
193
56
167
52
-10
-26
36
-3
69
113
97
281
236
50
615
98
211
81
116
103
19
147
59
122
176
168
55
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
86,448
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
67,753
1,398,070
0.048462
2017
61,593
1,351,933
0.045559
2016
66,809
1,253,150
0.053313
2015
69,139
1,330,239
0.051975
2014
62,075
1,369,498
0.045327
2
Total
of line 1, column (d)
.....................
2
0.244636
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
0.048927
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
1,376,044
5
Multiply line 4 by line 3
......................
5
67,326
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
1,022
7
Add lines 5 and 6
........................
7
68,348
8
Enter qualifying distributions from Part XII, line 4
,.............
8
69,455
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
1,022
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
1,022
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
1,022
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
840
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
0
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
840
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
182
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
0
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)
AZ
b
If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G?
If "No," attach explanation
.
8b
Yes
9
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
or 4942(j)(5) for calendar year 2019 or the taxable year beginning in 2019? See the instructions for Part XIV.
If "Yes," complete Part XIV
.............................
9
No
10
Did any persons become substantial contributors during the tax year?
If "Yes," attach a schedule listing their names
and addresses.
...............................
10
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
5
Part VII-A
Statements Regarding Activities
(continued)
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions
.............
11
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement. See instructions
.................
12
No
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
14
The books are in care of
JP MORGAN CHASE BANK NA
Telephone no.
(800) 496-2583
Located at
10 S DEARBORN ST MC IL 1-0111
CHICAGO
IL
ZIP+4
60603
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1)
Engage in the sale or exchange, or leasing of property with a disqualified person?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(5)
Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)?
...............
Yes
No
(6)
Agree to pay money or property to a government official? (
Exception.
Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.)
.......
Yes
No
b
If any answer is "Yes" to 1a(1)–(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions
........
1b
No
Organizations relying on a current notice regarding disaster assistance check here
........
c
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2019?
.............
1c
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2019, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2019?
.............
Yes
No
If "Yes," list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer "No" and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
......................
Yes
No
b
If "Yes," did it have excess business holdings in 2019 as a result of
(1)
any purchase by the foundation
or disqualified persons after May 26, 1969;
(2)
the lapse of the 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or
(3)
the lapse of the 10-, 15-, or 20-year first phase holding period?
(Use Schedule C, Form 4720, to determine
if the foundation had excess business holdings in 2019.)
..................
3b
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2019?
4b
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
6
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
(continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
No
b
If any answer is "Yes" to 5a(1)–(5), did
any
of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions
......
5b
Organizations relying on a current notice regarding disaster assistance check here
.........
c
If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant?
..........
Yes
No
If "Yes," attach the statement required by Regulations section 53.4945–5(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract?
.....................
Yes
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
....
6b
No
If "Yes" to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
Yes
No
b
If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction?
....
7b
8
Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment during the year?
.................
Yes
No
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1
List all officers, directors, trustees, foundation managers and their compensation. See instructions
(a)
Name and address
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(If not paid, enter
-0-)
(d)
Contributions to employee benefit plans and deferred compensation
(e)
Expense account,
other allowances
JP MORGAN CHASE BANK N A
TRUSTEE
2
24,805
10 S DEARBORN ST MC IL 1-0111
CHICAGO
,
IL
60603
2
Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a)
Name and address of each employee paid more than $50,000
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
NONE
Total
number of other employees paid over $50,000
...................
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
7
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
(continued)
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
NONE
Total
number of others receiving over $50,000 for professional services
.............
0
Part IX-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
2
3
4
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
Form
990-PF
(2019)
Form 990-PF (2019)
Page
8
Part X
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations, see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities
...................
1a
1,368,001
b
Average of monthly cash balances
.......................
1b
28,998
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
1,396,999
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
1,396,999
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
20,955
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
1,376,044
6
Minimum investment return.
Enter 5% of line 5
..................
6
68,802
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
68,802
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
1,022
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
1,022
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
67,780
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
67,780
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
67,780
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
69,455
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
69,455
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
1,022
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
68,433
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
67,780
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
58,808
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:
$
69,455
a
Applied to 2018, but not more than line 2a
58,808
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
.....
10,647
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
..........
57,133
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).)
NA
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.
NA
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
SAN FRANCISCO SOCIETY FOR
PREVENTION OF CRUELTY TO ANIMALS
201 ALABAMA STREET
SAN FRANCISCO
,
CA
94103
NONE
PC
GENERAL
6,000
UNITED WAY OF THE BAY AREA
550 KEARNEY STREET SUITE 1000
SAN FRANCISCO
,
CA
94108
NONE
PC
GENERAL
6,000
HUMANE SOCIETY OF SOUTHERN ARIZONA
3450 N KELVIN BLVD
TUCSON
,
AZ
85716
NONE
PC
GENERAL
6,000
UNITED WAY OF THE DESERT
73710 FRED WARING STE 104
PALM DESERT
,
CA
85745
NONE
PC
GENERAL
6,000
UNITED WAY OF TUCSON AND SOUTHERN ARIZON
330 N COMMERCE PARK LOOP SUITE 20
TUCSON
,
AZ
85745
NONE
PC
GENERAL
6,000
HUMANE SOCIETY OF THE DESERT
DESERT RESCUE MISSION
PO BOX 580798
NORTH PALM SPRINGS
,
CA
92258
NONE
PC
GENERAL
6,000
UNIVERSITY OF ARIZONA FOUNDATION
1111 N CHERRY AVENUE
TUCSON
,
AZ
85721
NONE
PC
GENERAL
24,000
Total
.................................
3a
60,000
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
32,729
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not debt-financed property
.....
6
Net rental income or (loss) from personal property
7
Other investment income
.....
8
Gain or (loss) from sales of assets other than
inventory
............
18
86,448
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)
..
119,177
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
119,177
(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