Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0052
2019
Open to Public Inspection
For calendar year 2019, or tax year beginning 01-01-2019 , and ending 12-31-2019
Name of foundation
BERNARD ETTINGER FOUNDATION INC
C/O BERNARD ETTINGER
Number and street (or P.O. box number if mail is not delivered to street address)68 STONE HILL DRIVE SOUTH
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MANHASSET, NY110304428
A Employer identification number

26-1557790
B Telephone number (see instructions)

(516) 627-0665
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ...
bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$894,534
J Accounting method:
 
(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)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet.............
3 Interest on savings and temporary cash investments 130 130  
4 Dividends and interest from securities... 14,338 14,338  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 22,364
b Gross sales price for all assets on line 6a 134,159
7 Capital gain net income (from Part IV, line 2)... 22,364
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 36,832 36,832  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0 0   0
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... 5,014 5,014   0
c Other professional fees (attach schedule)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... 188 188   0
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... 10,390 10,390   0
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 15,592 15,592   0
25 Contributions, gifts, grants paid....... 71,836 71,836
26 Total expenses and disbursements. Add lines 24 and 25 87,428 15,592   71,836
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -50,596
b Net investment income (if negative, enter -0-) 21,240
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2019)
Form 990-PF (2019)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing.............      
2 Savings and temporary cash investments......... 82,313 19,912 19,912
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
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) bullet  
Less: allowance for doubtful accounts bullet        
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)....... 492,283 Click to see attachment504,088 674,622
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 200,000 Click to see attachment200,000 200,000
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 774,596 724,000 894,534
Liabilities 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 bullet)    
23 Total liabilities (add lines 17 through 22)......... 0 0
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
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 bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........ 774,596 724,000
27 Paid-in or capital surplus, or land, bldg., and equipment fund 0 0
28 Retained earnings, accumulated income, endowment, or other funds 0 0
29 Total net assets or fund balances (see instructions)..... 774,596 724,000
30 Total liabilities and net assets/fund balances (see instructions). 774,596 724,000
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
774,596
2
Enter amount from Part I, line 27a .....................
2
-50,596
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
724,000
5
Decreases not included in line 2 (itemize) bullet
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
724,000
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 JPMORGAN STRATEGIC INCOME OPPORTUNITIES P   2019-07-11
b GOLDMAN SACHS MLP INCOME OPP P 2017-12-06 2019-07-11
c ISHARES MSCI EAFE ETF P 2016-05-03 2019-07-11
d ISHARES RUSSELL 1000 GROWTH ETF P 2013-07-15 2019-12-13
e JPMORGAN STRATEGIC INCOME OPPORTUNITIES P   2019-07-11
CAPITAL GAINS 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 2,242   2,238 4
b 16,065   14,336 1,729
c 19,713   17,423 2,290
d 17,223   7,615 9,608
e 70,016   70,183 -167
8,900     8,900
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       4
b       1,729
c       2,290
d       9,608
e       -167
      8,900
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
Bracket 2 22,364
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 ...................
Bracket 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?
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 59,088 919,591 0.064255
2017 59,965 950,155 0.063111
2016 72,412 950,047 0.076219
2015 63,695 1,070,992 0.059473
2014 69,876 1,147,948 0.060870
2
Total of line 1, column (d) .....................
2
0.323928
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
0.064786
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5......
4
874,501
5
Multiply line 4 by line 3......................
5
56,655
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
212
7
Add lines 5 and 6........................
7
56,867
8
Enter qualifying distributions from Part XII, line 4,.............
8
71,836
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 Bullet and enter “N/A" on line 1. Bracket includes lines 1a and 1b
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 1 212
hereBulletand 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........................... 3 212
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- ..... 5 212
6 Credits/Payments:
a 2019 estimated tax payments and 2018 overpayment credited to 2019 6a 192
b Exempt foreign organizations—tax withheld at source...... 6b
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 192
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.......Bullet 9 20
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2020 estimated taxBullet   RefundedBullet 11  
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. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
  • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletNY
    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 addressbulletN/A
    14
    The books are in care ofbulletBERNARD ETTINGER FOUNDATION INC Telephone no.bullet (516) 627-0665

    Located atbullet68 STONE HILL DRIVE SOUTHMANHASSETNY ZIP+4bullet110304428
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over YesNo
    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 bullet
    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?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?......................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (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)?...............
    (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.).......
    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
     
     
    ........bullet
    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?.............
    If "Yes," list the years bullet20, 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.
    bullet20, 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?......................
    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))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?.............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?.....
    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
     
     
    .........bullet
    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?..........
    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?.....................
    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?
    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? .................
    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
    BERNARD ETTINGER DIRECTOR
    5.00
    0 0 0
    68 STONE HILL DRIVE SOUTH
    MANHASSET,NY110304428
    LESLIE ETTINGER DIRECTOR
    5.00
    0 0 0
    68 STONE HILL DRIVE SOUTH
    MANHASSET,NY110304428
    MELVIN PARADISE DIRECTOR
    5.00
    0 0 0
    168 FALCON COURT
    MANHASSET,NY11030
    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...................bullet 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.............bullet0
    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.........................bullet0
    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
    642,485
    b
    Average of monthly cash balances.......................
    1b
    45,333
    c
    Fair market value of all other assets (see instructions)................
    1c
    200,000
    d
    Total (add lines 1a, b, and c).........................
    1d
    887,818
    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
    887,818
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    13,317
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    874,501
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    43,725
    Part XI
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    43,725
    2a
    Tax on investment income for 2019 from Part VI, line 5......
    2a
    212
    b
    Income tax for 2019. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    212
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    43,513
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    43,513
    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
    43,513
    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
    71,836
    b
    Program-related investments—total from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    71,836
    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
    212
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    71,624
    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 43,513
    2 Undistributed income, if any, as of the end of 2019:
    a Enter amount for 2018 only....... 0
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2019:
    a From 2014......  
    b From 2015......  
    c From 2016...... 10,096
    d From 2017...... 12,713
    e From 2018...... 13,290
    fTotal of lines 3a through e........ 36,099
    4Qualifying distributions for 2019 from Part
    XII, line 4: bullet$ 71,836
    a Applied to 2018, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election required—see instructions).....
    0
    c Treated as distributions out of corpus (Election
    required—see instructions)........
    0
    d Applied to 2019 distributable amount..... 43,513
    e Remaining amount distributed out of corpus 28,323
    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).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 64,422
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........
    0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......
    0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........
    0
    e Undistributed income for 2018. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............
    0
    f Undistributed income for 2019. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2020 ..........
    0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......
    0
    8 Excess distributions carryover from 2014 not
    applied on line 5 or line 7 (see instructions) ...
    0
    9Excess distributions carryover to 2020.
    Subtract lines 7 and 8 from line 6a ......
    64,422
    10 Analysis of line 9:
    a Excess from 2015....  
    b Excess from 2016.... 10,096
    c Excess from 2017.... 12,713
    d Excess from 2018.... 13,290
    e Excess from 2019.... 28,323
    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....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    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.)
    1Information Regarding Foundation Managers:
    aList 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).)
    BERNARD ETTINGER
    bList 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.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    BERNARD ETTINGER
    68 STONE HILL DRIVE SOUTH
    MANHASSET,NY110304428
    (516) 627-0665
    bThe form in which applications should be submitted and information and materials they should include:
    LETTER
    cAny submission deadlines:
    NONE
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    NONE
    Form 990-PF (2019)
    Form 990-PF (2019)
    Page 11
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    Foundation
    status of
    recipient
    Purpose of grant or
    contribution
    Amount
    Name and address (home or business)
    aPaid during the year
    ACLD
    807 SOUTH OYSTER BAY ROAD
    BETHPAGE,NY11714
      EXEMPT DONATION 200
    AMERICAN BREAST CANCER FOUNDATION
    10400 LITTLE PATUXENT PARKWAY
    COLUMBIA,MD21044
      EXEMPT DONATION 100
    APH
    189 FRANKFORT AVENUE
    LOUISVILLE,KY40206
      EXEMPT DONATION 26
    ASPCA
    424 E 92ND STREET
    NEW YORK,NY10128
      EXEMPT DONATION 40
    AUTISM SPEAKS
    1 EAST 33RD ST 4TH FLOOR
    NEW YORK,NY10016
      EXEMPT DONATION 100
    BNAI BRITH
    1120 20TH ST NW 300N
    WASHINGTON,DC20036
      EXEMPT DONATION 60
    ADL
    605 THIRD AVE
    NEW YORK,NY10158
      EXEMPT DONATION 350
    AFMDA
    888 7TH AVENUE
    NEW YORK,NY10106
      EXEMPT DONATION 500
    AFPCC
    6350 HORIZON DRIVE
    TITUSVILLE,FL32780
      EXEMPT DONATION 125
    BOCA RATON REG HOSPITAL FOUNDATION
    800 MEADOWS ROAD
    BOCA RATON,FL33486
      EXEMPT DONATION 450
    ALUMNI ASSN OF CCNY
    160 CONVENT AVE SHEPARD HALL RM 616
    NEW YORK,NY10031
      EXEMPT DONATION 80
    ALZHEIMERS ASSOCIATION
    225 N MICHIGAN AVE FL 17
    CHICAGO,IL60601
      EXEMPT DONATION 200
    AMERICAN ACTION FUND FOR BLIND
    381 PARK AVE SO STE 809
    NEW YORK,NY10016
      EXEMPT DONATIONDONATION 270
    AMERICAN CANCER SOCIETY
    250 WILLIAMS STREET NW
    ATLANTA,GA30303
      EXEMPT DONATION 1,050
    AMERICAN FOUNDATION FOR THE BLIND
    1401 S CLARK ST STE 730
    ATLINGTON,VA22202
      EXEMPT DONATION 100
    AMERICAN FRIENDS OF SHALVA
    315 5TH AVE
    NEW YORK,NY10016
      EXEMPT DONATION 100
    AMERICAN HEART ASSOC
    122 E 42ND ST
    NEW YORK,NY10168
      EXEMPT DONATION 30
    CANCER CARE
    275 SEVENTH AVENUE 22ND FL
    NEW YORK,NY10001
      EXEMPT DONATION 300
    AMERICAN SOCIETY FOR YAD VASHEM
    500 5TH AVE 42
    NEW YORK,NY10110
      EXEMPT DONATION 75
    CARDIO RES FOUNDATION
    1700 BROADWAY 9TH FLOOR
    NEW YORK,NY10019
      EXEMPT DONATION 100
    CHILDREN'S MED FUND OF NY
    300 ROBBINS LANE
    SYOSSET,NY11791
      EXEMPT DONATION 200
    BIRTHRIGHT ISRAEL
    PO BOX 5892
    HICKSVILLE,NY11802
      EXEMPT DONATION 175
    CSAH
    552 FORT EVANS ROAD SUITE 300
    LEESBURG,VA20176
      EXEMPT DONATION 40
    CYSTIC FIBROSIS FOUNDATION
    4550 MONTGOMERY AVE SUITE 1100 N
    BETHESDA,MD20814
      EXEMPT DONATION 300
    CHRF
    PO BOX 5366
    SANTA RPSA,CA95402
      EXEMPT DONATION 180
    CHRONS & COLITIS FOUNDATION
    733 3RD AVE
    NEW YORK,NY10017
      EXEMPT DONATION 500
    DOROT
    171 WEST 85TH STREET
    NEW YORK,NY10024
      EXEMPT DONATION 50
    FEEDING AMERICA
    35 EAST WACKER DRIVE SUITE 2000
    CHICAGO,IL60601
      EXEMPT DONATION 50
    FRIENDS OF THE ISRAEL DEFENSE FORCE
    PO BOX 4224
    NEW YORK,NY10163
      EXEMPT DONATION 200
    EZEV LYOLDOT
    UNIT 22A NORTHFIELD RD
    LONDON   N16 5RN
    UK
      EXEMPT DONATION 500
    HABITAT FOR HUMANITY
    285 PEACHTREE CENTER AVE NE STE
    2700
    ATLANTA,GA30303
      EXEMPT DONATION 50
    FOUNDATION FIGHTING BLINDNESS
    381 PARK AVE S STE 809
    NEW YORK,NY10016
      EXEMPT DONATION 500
    GLEN OAKS CLUB
    175 POST RD
    OLD WESTBURY,NY11568
      EXEMPT DONATION 750
    GUIDE DOG FOUNDATION
    371 JERICHO TURNPIKE
    SMOTHTOWN,NY11787
      EXEMPT DONATION 50
    GUIDING EYES FOR THE BLIND
    611 GRANITE SPRINGS RD
    YORKSTOWN HEIGHTS,NY10598
      EXEMPT DONATION 50
    GURWIN JEWISH HEALTHCARE FOUNDATION
    68 HAUPPAGUE ROAD
    COMMACK,NY11725
      EXEMPT DONATION 50
    HANDS ON TZEDAKAH
    2901 CINT MOORE RD
    BOCA RATON,FL33496
      EXEMPT DONATION 1,500
    HELEN KELLER INST
    ONE DAG HAMMARSKJOLD PLAZA
    NEW YORK,NY10017
      EXEMPT DONATION 50
    HILLEL
    800 EIGTH STREET NW
    WASHINGTON,DC20001
      EXEMPT DONATIONDONATION 50
    HOLY APOSTLES SOUP KITCHEN
    296 9TH AVENUE
    NEW YORK,NY10001
      EXEMPT DONATION 50
    JDRF
    200 VESEY STREET 28TH FLOOR
    NEW YORK,NY10281
      EXEMPT DONATION 60
    ICHUD MOSDOS
    3611 4TH AVE
    NEW YORK,NY11218
      EXEMPT DONATION 1,000
    JEWISH COMM CTR OF FORT LEE
    1405-1411 15TH ST
    FORT LEE,NJ07024
      EXEMPT DONATION 36
    JEWISH FED OF SOUTH PALM BEACH
    9901 DONNA KKLEIN BLVD
    BOCA RATON,FL33428
      EXEMPT DONATION 5,250
    KIDS WISH NETWORK
    4060 LOIUS AVE HOLIDAY
    HOLIDAY,FL34691
      EXEMPT DONATION 130
    LAKE SUCESS JEWISH CENTER
    354 LAKEVILLE RD
    GREAT NECK,NY11020
      EXEMPT DONATION 3,603
    JNF
    42 EAST 69TH STREET
    NEW YORK,NY10021
      EXEMPT DONATION 90
    LONG ISLAND ALZHEIMERS FOUNDATION
    1025 OLD COUNTRY ROAD 115
    WESTBURY,NY11590
      EXEMPT DONATION 50
    LYMPHOMA RESEARCH FOUNDATION
    88 PINE ST
    NEW YORK,NY10055
      EXEMPT DONATIONDONATION 500
    MARCH OF DIMES
    1550 CRYSTAL DR SUITE 1300
    ARLINGTON,VA22202
      EXEMPT DONATIONDONATION 50
    MARINE TOYS FOR TOTS
    18251 QUANTICO GATEWAY DR
    TRIANGLE,VA22172
      EXEMPT DONATION 100
    MD ANDERSON CANCER CENTER
    400 HADDON AVE
    CAMPDEN,NJ08103
      EXEMPT DONATION 250
    MET COUNCIL ON JEWISH POVERTY
    1275 YORK AVENUE
    NEW YORK,NY10065
      EXEMPT DONATION 200
    MERCY CORPS
    45 SW ANKENY ST
    PORTLAND,OR97204
      EXEMPT DONATION 50
    METRO OPERA
    80 LINCOLN CENTER
    NEW YORK,NY10023
      EXEMPT DONATION 7,380
    NATIONAL FRAGILE X FOUNDATION
    1861 INTERNATIONAL DR STE 200
    MCLEAN,VA22102
      EXEMPT DONATION 150
    NATIONAL MS SOCIETY
    4920 LORING DRIVE
    WEST PALM BEACH,FL33417
      EXEMPT DONATION 50
    MSSA LIFE FOUNDATION
    375 KINGS HWY
    N CHERRY HILL,NJ08034
      EXEMPT DONATION 50
    MUSCULAR DYSTROPHY ASSOSCIATION
    5 DAKOTA DR 101
    NEW HYDE PARK,NY11042
      EXEMPT DONATION 75
    NATIONAL FEDERATION FOR THE BLIND
    200 EAST WELLS STREET
    BALTIMORE,MD21230
      EXEMPT DONATION 108
    NATIONAL GLAUCOMA RESEARCH
    251 POST ST STE 600
    SAN FRANCISCO,CA94108
      EXEMPT DONATION 300
    NATIONAL JEWISH HEALTH FOUNDATION
    1400 JACKSON ST
    DENVER,CO80206
      EXEMPT DONATION 100
    NLEOMF
    901 E STREET NW
    WASHINGTON,DC20004
      EXEMPT DONATION 170
    NORTHWELL HEALTH FDN
    2000 MARCUS AVE
    NEW HYDE PARK,NY11042
      EXEMPT DONATION 6,150
    PALM BEACH COUNTY FOOD BANK
    525 GATOR DRIVE
    LANTANA,FL33462
      EXEMPT DONATION 100
    PARKINSON'S FOUNDATION
    135 PARKINSON AVENUE
    STATEN ISLAND,NY10305
      EXEMPT DONATION 75
    RE MEMBER
    PO BOX 5054
    PINE RIDGE,SD57770
      EXEMPT DONATION 250
    PARALAYZED VETERANS OF AMERICA
    801 EIGHTEENTH ST NW
    WASHINGTON,DC20006
      EXEMPT DONATION 100
    SEEDS OF PEACE
    370 LEXINGTON AVE SUITE 1201
    NEW YORK,NY10017
      EXEMPT DONATION 200
    PERKENS SCHOOL FOR THE BLIND
    175 BEACON ST
    WATERTOWN,MA02472
      EXEMPT DONATIONDONATIONDONATION 100
    PROSTATE CANCER FOUNDATION
    25-15 31ST
    QUEENS,NY11103
      EXEMPT DONATION 50
    RAYMOND KRAVIS CENTER
    701 OKEECHOBEE BLVD
    WEST PALM BEACH,FL33401
      EXEMPT DONATION 2,000
    SAVE THE CHILDREN
    501 KINGS HWY
    FAIRFIELD,CT06825
      EXEMPT DONATION 100
    SHARE OUR STRENTH
    1030 15TH ST NW
    WASHINGTON,DC20005
      EXEMPT DONATION 50
    SHRINERS HOSPITAL FOR CHILDREN
    2900 ROCKY POINT DR
    TAMPA,FL33607
      EXEMPT DONATION 375
    SMILE TRAIN
    633 THIRD AVE 9TH FLOOR
    NEW YORK,NY10017
      EXEMPT DONATION 50
    SPECIAL OLYMPICS
    1133 19TH ST NW
    WASHINGTON,DC20036
      EXEMPT DONATION 86
    ST JUDE CHILDRENS RESEARCH
    363 7TH AVENUE
    NEW YORK,NY10001
      EXEMPT DONATION 150
    SOCIETY OF THE UNITED STATES
    68 STONE HILL DR
    MANHASSET,NY11030
      EXEMPT DONATION 25
    SPECTRUM FOR LIVING
    210 RIVERDALE ROAD SUITE 3
    RIVER VALE,NJ07675
      EXEMPT DONATION 250
    THE GLAUCOMA FOUNDATION
    80 MAIDEN LANE
    NEW YORK,NY10038
      EXEMPT DONATION 60
    THE LEUKEMIA & LYMPHOMA SOCIETY
    1311 MAMARONECK AVE STE 310
    WHITE PLAINS,NY10605
      EXEMPT DONATION 350
    THE MICHAEL J FOX FOUNDATION
    PO BOX 4777
    NEW YORK,NY10163
      EXEMPT DONATION 100
    THE USO
    US ORG PO BOX 96860
    WASHINGTON,DC20077
      EXEMPT DONATION 50
    UJA FEDERATION OF NEW YORK
    130 E 59TH STREET
    NEW YORK,NY10022
      EXEMPT DONATION 31,250
    US HOLOCAUST MEMORIAL
    100 RAOUL WALLENBERG PL SW
    WASHINGTON,DC20024
      EXEMPT DONATION 50
    UNITED CHILDREN'S FOOD BANK
    244 FIFTH AVENUE SUITE 244
    NEW YORK,NY10001
      EXEMPT DONATION 36
    USCJ
    767 5TH AVE NW
    NEW YORK,NY10153
      EXEMPT DONATION 76
    USOPF
    1 OLYMPIC PLAZA
    COLORADO SPRINGS,CO80909
      EXEMPT DONATION 100
    WELFARE FUND
    57 BROADWAY 7
    NEW YORK,NY10004
      EXEMPT DONATION 50
    WORLD JEWISH CONGRESS FOUNDATION
    PO BOX 90400
    WASHINGTON,DC20090
      EXEMPT DONATION 100
    WOUNDED WARRIOR PROJECT
    PO BOX 758517
    TOPEKA,KS66675
      EXEMPT DONATION 200
    Total .................................bullet 3a 71,836
    bApproved for future payment
    Total .................................bullet 3b 0
    Form 990-PF (2019)
    Form 990-PF (2019)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code
    (b)
    Amount
    (c)
    Exclusion code
    (d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3 Interest on savings and temporary cash
    investments ...........
        14 130  
    4 Dividends and interest from securities....     14 14,338  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot 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 ............
        14 22,364  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e).. 0 36,832 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    36,832
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow
    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? ...........
    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.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below
    (see instr.)
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    Firm's EIN SmallBullet
    Firm's address SmallBullet


    Phone no.
    Form 990-PF (2019)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description