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TIN:
Form
990-PF
Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
Do not enter social security numbers on this form as it may be made public.
Go to
www.irs.gov/Form990PF
for instructions and the latest information.
OMB No. 1545-0052
20
19
Open to Public Inspection
For calendar year 2019, or tax year beginning
01-01-2019
, and ending
12-31-2019
Name of foundation
CAROL B PHELON FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)
12681 CREEKSIDE LANE
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
FORT MYERS
,
FL
33919
A Employer identification number
81-3637307
B
Telephone number (see instructions)
(239) 461-5900
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)
$
21,454,128
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
...
532,527
530,927
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
1,686,401
b
Gross sales price for all assets on line 6a
12,879,297
7
Capital gain net income (from Part IV, line 2)
...
1,686,401
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
........
2,218,928
2,217,328
13
Compensation of officers, directors, trustees, etc.
115,676
86,757
28,919
14
Other employee salaries and wages
......
0
0
0
15
Pension plans, employee benefits
.......
0
0
16a
Legal fees (attach schedule)
.........
0
b
Accounting fees (attach schedule)
.......
1,300
975
0
325
c
Other professional fees (attach schedule)
....
6,465
4,849
1,616
17
Interest
...............
0
18
Taxes (attach schedule) (see instructions)
...
12,443
10,653
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)
.......
247
185
62
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
136,131
103,419
0
30,922
25
Contributions, gifts, grants paid
.......
217,795
217,795
26
Total expenses and disbursements.
Add lines 24 and 25
353,926
103,419
0
248,717
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
1,865,002
b
Net investment income
(if negative, enter -0-)
2,113,909
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
.............
2
Savings and temporary cash investments
.........
664,963
1,280,262
1,280,262
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)
.......
11,577,509
13,265,667
16,604,287
c
Investments—corporate bonds (attach schedule)
.......
3,906,117
3,469,119
3,561,150
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
)
10,373
8,429
8,429
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
16,158,962
18,023,477
21,454,128
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
........
16,158,962
18,023,477
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)
.....
16,158,962
18,023,477
30
Total liabilities and net assets/fund balances
(see instructions)
.
16,158,962
18,023,477
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
16,158,962
2
Enter amount from Part I, line 27a
.....................
2
1,865,002
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
18,023,964
5
Decreases not included in line 2 (itemize)
5
487
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
18,023,477
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
50000. OKLAHOMA CNTY OKLA INDPT SCH D GO COMB PURP BDS 3.00% DTD 01/01
2015-08-10
2019-01-01
b
106. BP PLC SPON ADR
2018-08-03
2019-01-04
c
61. ROYAL DUTCH SHELL PLC SPONSORED ADR REPSTG A SHS
2018-03-29
2019-01-07
d
56. NOVO NORDISK A S ADR
2018-10-30
2019-01-09
e
303. CREDIT SUISSE GROUP SPONSORED ADR
2018-10-15
2019-01-11
210. DISNEY WALT CO COM
2015-12-16
2019-01-15
208. GARRETT MOTION INC COM
2015-12-16
2019-01-15
3200. KRAFT HEINZ CO COM
2016-04-20
2019-01-15
50000. LANCASTER CNTY NEB SCH DIST NO GO SCH BDS 5.00% DTD 02/11/2009
2015-08-10
2019-01-15
382. VANGUARD FTSE EMERGING MARKETS ETF
2015-08-10
2019-01-15
41572.473 BLACKSTONE ALTERNATIVE MULTI STRATEGY FUND CLASS I #9520
2017-10-31
2019-01-16
2450. CME GROUP INC COM
2015-12-16
2019-01-16
6628.197 CATALYST/MILLBURN HEDGE STRATEGY FUND CLASS I #562
2018-09-07
2019-01-16
57128.818 ABBEY CAPITAL FUTURES STRATEGY FUND CLASS I #7003
2017-10-31
2019-01-16
8700. VANGUARD WHITEHALL FDS HIGH DIVIDEND YIELD ETF SHS
2016-12-21
2019-01-16
70. NESTLE S A SPONSORED ADR REPSTG REG SH
2019-01-23
2019-01-28
1684. AT&T INC COM
2015-12-16
2019-01-30
819. BOEING CO COM
2015-12-16
2019-01-30
2915. BRISTOL MYERS SQUIBB CO COM
2016-08-18
2019-01-30
2002. J P MORGAN CHASE & CO COM
2015-12-16
2019-01-30
2127. PROCTER & GAMBLE CO COM
2015-08-10
2019-01-30
3000. SPDR TR UNIT SER 1
2016-12-21
2019-01-30
4299. WELLS FARGO CO COM
2015-12-16
2019-01-30
287. MEDTRONIC PLC SHS
2015-12-18
2019-01-30
200000. ABBOTT LABS NT 2.95% DTD 03/10/2015 DUE 03/15/2025
2016-05-06
2019-02-01
200000. AMERISOURCEBERGEN CORP SR GLBL 3.40% DTD 05/22/2014 DUE 05/15/
2016-02-24
2019-02-01
130000. APPLE INC GLBL NT 2.40% DTD 05/03/2013 DUE 05/03/2023
2016-02-24
2019-02-01
200000. DISNEY WALT CO MTNS FR 3.15% DTD 09/17/2015 DUE 09/17/2025
2017-08-24
2019-02-01
200000. EXXON MOBIL CORP SR GLBL NT 2.222% DTD 03/03/2016 DUE 03/01/20
2016-03-04
2019-02-01
200000. GENERAL DYNAMICS CORP SR GLBL NT 3.375% DTD 05/11/2018 DUE 05/
2018-05-22
2019-02-01
200000. HONEYWELL INTL INC SR NT 3.35% DTD 11/21/2013 DUE 12/01/2023
2018-05-22
2019-02-01
200000. JPMORGAN CHASE & CO SR NT 3.25% DTD 09/24/2012 DUE 09/23/2022
2016-01-05
2019-02-01
200000. UNITEDHEALTH GROUP INC SR GLBL NT 3.35% DTD 07/23/2015 DUE 07/
2018-05-22
2019-02-01
100000. EGG HARBOR WIS GO BDS 3.50% DTD 01/28/2010 DUE 10/01/2019
2015-08-10
2019-02-04
50000. FRANKFORT KY ELEC & WTR PLT BR REV BDS 2.50% DTD 09/12/2013 DUE
2015-08-10
2019-02-04
100000. HARRISON TWP N J GO IMPT BDS 3.00% DTD 08/31/2010 DUE 08/01/20
2015-08-10
2019-02-04
88. METHANEX CORP COM
2018-12-18
2019-02-04
44. METHANEX CORP COM
2018-01-23
2019-02-04
110000. WEST FARGO N D PK DIST BLDG AU LSE REV BDS 3.00% DTD 09/05/201
2015-08-10
2019-02-04
56. LYONDELLBASELL INDUSTRIES N V SHS A
2018-09-06
2019-02-06
54. MELLANOX TECHNOLOGIES LTD SHS
2019-01-24
2019-02-22
457. SWISS RE LTD SPONSORED ADR
2019-01-23
2019-02-25
49268.553 GOLDMAN SACHS HIGH YIELD MUNICIPAL FUND CLASS I #1258
2015-12-17
2019-02-26
43498.168 VANGUARD LIMITED-TERM TAX-EXEMPT FUND #531
2017-12-07
2019-02-26
100. ALLIANZ SE SP ADR SH
2018-01-23
2019-03-04
189. ALLIANZ SE SP ADR SH
2019-01-17
2019-03-04
105000. FEDERAL NATL MTG ASSN 1.875% DTD 04/10/2017 DUE 04/05/2022
2019-02-14
2019-03-12
1691.08 FEDERAL HOME LN MTG CORP PARTN GOLD GROUP #G18294 5.500% DTD 0
2019-02-06
2019-03-15
19. MULTICHOICE GROUP LIMITED SPONSORED ADS
2018-10-01
2019-03-18
.8 MULTICHOICE GROUP LIMITED SPONSORED ADS
2018-10-01
2019-03-20
3901.18 FEDERAL NATL MTG ASSN GTD PASSTHRU CTF POOL #AE0178 6.000% DTD
2019-02-04
2019-03-25
795. CELGENE CORP COM
2019-02-04
2019-03-29
102. MELLANOX TECHNOLOGIES LTD SHS
2019-01-24
2019-04-05
195. ALCON INC ORD SHS
2019-02-04
2019-04-10
278. ALCON INC ORD SHS
2019-02-01
2019-04-10
1385. ROYAL DUTCH SHELL PLC SPONSORED ADR REPSTG A SHS
2016-08-01
2019-04-11
924. VALERO ENERGY CORP NEW COM
2017-03-03
2019-04-11
2455.04 FEDERAL HOME LN MTG CORP PARTN GOLD GROUP #G18294 5.500% DTD 0
2019-02-06
2019-04-15
15.6 ALCON INC ORD SHS
2018-03-29
2019-04-17
8.4 ALCON INC ORD SHS
2019-03-20
2019-04-17
95. BROADCOM INC COM
2019-02-04
2019-04-18
388. CDW CORP COM
2019-02-04
2019-04-18
1882. DOWDUPONT INC COM
2016-07-11
2019-04-18
1905. ANADARKO PETE CORP COM
2019-02-04
2019-04-24
4035.15 FEDERAL NATL MTG ASSN GTD PASSTHRU CTF POOL #AE0178 6.000% DTD
2019-02-04
2019-04-25
.334 DOW INC COM
2016-07-11
2019-04-30
.334 DOW INC COM
2016-07-11
2019-04-30
.2 ALCON INC ORD SHS
2019-02-04
2019-04-30
.6 ALCON INC ORD SHS
2019-02-01
2019-04-30
116. ADIDAS AG ADR
2019-01-17
2019-05-07
1252. DOWDUPONT INC COM
2016-07-11
2019-05-09
2026.46 FEDERAL HOME LN MTG CORP PARTN GOLD GROUP #G18294 5.500% DTD 0
2019-02-06
2019-05-15
44. EVEREST RE GROUP LTD COM
2019-01-17
2019-05-22
3148.07 FEDERAL NATL MTG ASSN GTD PASSTHRU CTF POOL #AE0178 6.000% DTD
2019-02-04
2019-05-28
379. CANADIAN NAT RES LTD COM
2019-03-13
2019-06-07
78. NOVARTIS AG SPONSORED ADR
2018-03-29
2019-06-10
7. NOVARTIS AG SPONSORED ADR
2019-03-20
2019-06-10
95. SANOFI SPONSORED ADR
2018-03-29
2019-06-10
126. OPEN TEXT CORP COM
2018-05-23
2019-06-12
187. OPEN TEXT CORP COM
2019-02-01
2019-06-12
72. ORTHOFIX MED INC COM
2018-03-29
2019-06-12
201. ORTHOFIX MED INC COM
2019-01-17
2019-06-12
2784.06 FEDERAL HOME LN MTG CORP PARTN GOLD GROUP #G18294 5.500% DTD 0
2019-02-06
2019-06-15
1026. J P MORGAN EXCHANGE-TRADED FD TR ULTRA-SHORT INCOME ETF
2019-06-13
2019-06-21
4605.86 FEDERAL NATL MTG ASSN GTD PASSTHRU CTF POOL #AE0178 6.000% DTD
2019-02-04
2019-06-25
95000. GOLDMAN SACHS GRP INC MTN FR 6.00% DTD 06/03/2010 DUE 06/15/202
2019-02-04
2019-06-25
622. CORTEVA INC COM
2016-07-11
2019-06-26
264. GLAXOSMITHKLINE PLC SPONSORED ADR
2019-02-25
2019-07-05
2178.95 FEDERAL HOME LN MTG CORP PARTN GOLD GROUP #G18294 5.500% DTD 0
2019-02-06
2019-07-15
105000. ONTARIO PROV CDA SR GLBL BD 2.25% DTD 05/18/2017 DUE 05/18/202
2019-02-04
2019-07-15
460. CRITEO S A SPONS ADS
2019-04-24
2019-07-19
205. HERBALIFE LTD COM USD SHS
2019-04-17
2019-07-19
2767.13 FEDERAL NATL MTG ASSN GTD PASSTHRU CTF POOL #AE0178 6.000% DTD
2019-02-04
2019-07-25
67. KONINKLIJKE PHILIPS N V NY REG SH NEW
2019-01-17
2019-07-26
225. KONINKLIJKE PHILIPS N V NY REG SH NEW
2019-01-17
2019-08-02
1734.88 FEDERAL HOME LN MTG CORP PARTN GOLD GROUP #G18294 5.500% DTD 0
2019-02-06
2019-08-15
570. TERNIUM SA SPONSORED ADS
2019-04-04
2019-08-16
105. SUN LIFE FINL INC COM
2018-08-15
2019-08-20
159. SUN LIFE FINL INC COM
2019-01-23
2019-08-20
59. SONY CORP ADR NEW
2019-01-17
2019-08-22
101. SONY CORP ADR NEW
2018-03-29
2019-08-22
4733.89 FEDERAL NATL MTG ASSN GTD PASSTHRU CTF POOL #AE0178 6.000% DTD
2019-02-04
2019-08-26
100000. SAN FRANCISCO CALIF CITY & CNT BDS 2019B TAXABLE 2.632% DTD 02
2019-02-08
2019-09-01
337. MICROSOFT CORP COM
2015-08-10
2019-09-04
135. DOLLAR GEN CORP NEW COM
2019-02-04
2019-09-10
127. MASTERCARD INC CL A
2019-02-04
2019-09-10
86. ORIX CORP SPONSORED ADR
2019-01-17
2019-09-12
66. SIEMENS A G SPONSORED ADR
2018-09-10
2019-09-12
185. SIEMENS A G SPONSORED ADR
2019-03-20
2019-09-12
2020.03 FEDERAL HOME LN MTG CORP PARTN GOLD GROUP #G18294 5.500% DTD 0
2019-02-06
2019-09-15
2373.86 FEDERAL NATL MTG ASSN GTD PASSTHRU CTF POOL #AE0178 6.000% DTD
2019-02-04
2019-09-25
100. CHINA MOBILE LIMITED SPONSORED ADR
2019-04-05
2019-09-26
885. MITSUBISHI UFJ FINL GROUP INC SPONSORED ADR
2019-01-22
2019-09-26
216. APPLE COMPUTER INC COM
2015-08-10
2019-10-01
252. CHINA MOBILE LIMITED SPONSORED ADR
2019-06-19
2019-10-01
336. MICROSOFT CORP COM
2015-08-10
2019-10-01
368. WALMART INC.
2019-02-01
2019-10-01
208. NETFLIX INC COM
2019-07-25
2019-10-07
1258. BARCLAYS PLC ADR
2019-03-28
2019-10-14
2216.05 FEDERAL HOME LN MTG CORP PARTN GOLD GROUP #G18294 5.500% DTD 0
2019-02-06
2019-10-15
132. NASPERS LTD SPONSORED ADR
2019-03-20
2019-10-17
99. NASPERS LTD SPONSORED ADR
2018-10-01
2019-10-17
414. COTT CORP QUE COM
2018-09-06
2019-10-18
612. COTT CORP QUE COM
2019-01-23
2019-10-18
4755. BT GROUP ORD
2019-09-20
2019-10-24
4075.89 FEDERAL NATL MTG ASSN GTD PASSTHRU CTF POOL #AE0178 6.000% DTD
2019-02-04
2019-10-25
563. ABB LTD SPONSORED ADR
2019-07-12
2019-10-28
1170. CAPITAL ONE FINL CORP COM
2015-12-16
2019-11-01
133. ORIX CORP SPONSORED ADR
2019-04-16
2019-11-01
1780. CAPITAL ONE FINL CORP COM
2015-12-16
2019-11-07
488. APPLE COMPUTER INC COM
2015-08-10
2019-11-08
252. BLACKROCK INC COM
2015-12-16
2019-11-08
2918. CISCO SYS INC COM
2015-12-16
2019-11-08
1684. DUKE ENERGY CORP NEW COM
2015-12-28
2019-11-08
1354. EXXON MOBIL CORP COM
2015-08-10
2019-11-08
1033. HOME DEPOT INC COM
2015-08-10
2019-11-08
1000. HONEYWELL INTERNATIONAL INC COM
2015-12-16
2019-11-08
523. LOCKHEED MARTIN CORP COM
2015-12-16
2019-11-08
951. MERCK & CO INC NEW COM
2015-08-10
2019-11-08
1554. MICROSOFT CORP COM
2015-08-10
2019-11-08
1950. NIKE INC CL B
2015-12-16
2019-11-08
1086. PEPSICO INC COM
2015-08-10
2019-11-08
586. RAYTHEON COM NEW
2015-08-10
2019-11-08
1413. UNITED PARCEL SVC INC CL B
2015-12-17
2019-11-08
1758. UNITED TECHNOLOGIES CORP COM
2015-12-16
2019-11-08
1551. VERIZON COMMUNICATIONS COM
2015-12-16
2019-11-08
3764.56 FEDERAL HOME LN MTG CORP PARTN GOLD GROUP #G18294 5.500% DTD 0
2019-02-06
2019-11-15
2492.59 FEDERAL NATL MTG ASSN GTD PASSTHRU CTF POOL #AE0178 6.000% DTD
2019-02-04
2019-11-25
1257. KT CORP SPONSORED ADR
2019-04-04
2019-12-02
922. DOLLAR GEN CORP NEW COM
2019-11-12
2019-12-05
32. EXXON MOBIL CORP COM
2019-11-12
2019-12-10
1846. EXXON MOBIL CORP COM
2015-08-10
2019-12-10
7122. HP INC COM
2019-11-12
2019-12-10
1261. PRUDENTIAL FINL INC COM
2019-11-12
2019-12-10
120. SANOFI SPONSORED ADR
2019-07-15
2019-12-12
41. SANOFI SPONSORED ADR
2018-03-28
2019-12-12
231. PROSUS N V SPONSORED ADR
2019-09-19
2019-12-13
3012.82 FEDERAL HOME LN MTG CORP PARTN GOLD GROUP #G18294 5.500% DTD 0
2019-02-06
2019-12-15
72. CHINA PETE & CHEM CORP SPON ADR H SHS
2018-10-12
2019-12-16
107. CHINA PETE & CHEM CORP SPON ADR H SHS
2019-01-17
2019-12-16
58. WILLIS TOWERS WATSON PUB LTD CO SHS
2019-05-07
2019-12-16
14. ALIBABA GROUP HLDG LTD SPONSORED ADS
2019-10-01
2019-12-17
248. SMITH & NEPHEW PLC SPDN ADR NEW
2019-11-05
2019-12-20
2202.37 FEDERAL NATL MTG ASSN GTD PASSTHRU CTF POOL #AE0178 6.000% DTD
2019-02-04
2019-12-26
116. ALLIANZ SE SP ADR SH
2018-12-10
2019-12-30
349. ALLIANZ SE SP ADR SH
2019-01-17
2019-12-30
(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
50,000
50,000
b
4,191
4,613
-422
c
3,689
4,024
-335
d
2,733
2,359
374
e
3,562
4,118
-556
23,463
23,417
46
2,775
2,339
436
149,636
246,804
-97,168
50,000
50,000
15,154
14,514
640
437,342
450,000
-12,658
447,790
234,417
213,373
198,978
212,500
-13,522
610,707
650,000
-39,293
700,950
670,874
30,076
5,932
5,944
-12
49,543
58,035
-8,492
318,947
121,067
197,880
143,316
172,976
-29,660
210,407
136,265
74,142
201,170
161,971
39,199
805,244
678,381
126,863
216,323
246,294
-29,971
25,236
22,154
3,082
196,770
197,780
-1,010
195,758
200,998
-5,240
127,878
127,934
-56
200,720
206,128
-5,408
198,176
200,690
-2,514
203,446
200,278
3,168
203,232
201,330
1,902
201,368
201,361
7
203,850
200,968
2,882
101,087
101,571
-484
50,066
50,371
-305
100,650
100,680
-30
4,883
5,062
-179
2,442
2,623
-181
111,374
111,762
-388
4,848
6,146
-1,298
5,580
4,496
1,084
11,217
10,880
337
478,890
453,764
25,126
475,870
475,000
870
2,235
2,532
-297
4,225
4,060
165
103,166
103,040
126
1,691
1,691
159
120
39
7
5
2
3,901
3,901
74,166
70,469
3,697
12,102
8,465
3,637
11,114
10,518
596
15,844
14,841
1,003
90,038
69,305
20,733
81,699
61,175
20,524
2,455
2,455
886
770
116
477
478
-1
30,288
25,413
4,875
40,801
32,588
8,213
72,880
62,707
10,173
135,671
91,383
44,288
4,035
4,035
19
17
2
19
17
2
12
12
35
35
16,354
12,810
3,544
39,037
41,716
-2,679
2,026
2,026
10,986
9,620
1,366
3,148
3,148
10,142
10,607
-465
6,861
5,536
1,325
616
572
44
4,151
3,823
328
5,188
4,321
867
7,700
7,012
688
3,661
4,029
-368
10,220
10,374
-154
2,784
2,784
51,756
51,746
10
4,606
4,606
98,283
97,625
658
18,124
16,083
2,041
10,775
10,378
397
2,179
2,179
105,708
103,303
2,405
8,165
10,346
-2,181
8,620
10,446
-1,826
2,767
2,767
3,149
2,380
769
10,437
7,747
2,690
1,735
1,735
9,661
15,926
-6,265
4,152
4,149
3
6,287
5,691
596
3,221
2,998
223
5,515
5,002
513
4,734
4,734
100,000
100,000
46,243
15,895
30,348
21,195
15,552
5,643
34,733
27,224
7,509
6,794
6,639
155
3,534
4,154
-620
9,906
10,480
-574
2,020
2,020
2,374
2,374
4,100
5,086
-986
4,612
4,698
-86
48,924
25,544
23,380
10,422
11,913
-1,491
46,584
15,847
30,737
43,615
35,192
8,423
57,210
67,336
-10,126
9,970
10,146
-176
2,216
2,216
4,161
5,924
-1,763
3,121
4,164
-1,043
5,156
6,509
-1,353
7,622
9,250
-1,628
12,291
10,618
1,673
4,076
4,076
11,886
10,616
1,270
110,942
90,611
20,331
10,587
9,785
802
175,398
137,852
37,546
126,238
57,711
68,527
123,437
83,590
39,847
141,257
81,095
60,162
154,218
121,080
33,138
96,917
105,504
-8,587
240,467
121,739
118,728
179,646
100,614
79,032
197,475
113,915
83,560
78,646
55,569
23,077
223,818
73,294
150,524
176,023
117,302
58,721
144,739
107,834
36,905
125,853
64,460
61,393
174,516
143,969
30,547
259,229
172,384
86,845
93,043
72,028
21,015
3,765
3,765
2,493
2,493
13,907
16,441
-2,534
142,529
116,158
26,371
2,222
2,226
-4
128,175
143,840
-15,665
143,962
152,505
-8,543
116,655
117,549
-894
5,918
5,022
896
2,022
1,648
374
3,184
3,540
-356
3,013
3,013
4,164
6,118
-1,954
6,189
8,511
-2,322
11,690
10,229
1,461
2,911
2,333
578
11,900
10,615
1,285
2,202
2,202
2,823
2,309
514
8,493
7,156
1,337
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-)
or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
Excess of col. (i)
over col. (j), if any
a
b
-422
c
-335
d
374
e
-556
46
436
-97,168
640
-12,658
213,373
-13,522
-39,293
30,076
-12
-8,492
197,880
-29,660
74,142
39,199
126,863
-29,971
3,082
-1,010
-5,240
-56
-5,408
-2,514
3,168
1,902
7
2,882
-484
-305
-30
-179
-181
-388
-1,298
1,084
337
25,126
870
-297
165
126
39
2
3,697
3,637
596
1,003
20,733
20,524
116
-1
4,875
8,213
10,173
44,288
2
2
12
35
3,544
-2,679
1,366
-465
1,325
44
328
867
688
-368
-154
10
658
2,041
397
2,405
-2,181
-1,826
769
2,690
-6,265
3
596
223
513
30,348
5,643
7,509
155
-620
-574
-986
-86
23,380
-1,491
30,737
8,423
-10,126
-176
-1,763
-1,043
-1,353
-1,628
1,673
1,270
20,331
802
37,546
68,527
39,847
60,162
33,138
-8,587
118,728
79,032
83,560
23,077
150,524
58,721
36,905
61,393
30,547
86,845
21,015
-2,534
26,371
-4
-15,665
-8,543
-894
896
374
-356
-1,954
-2,322
1,461
578
1,285
514
1,337
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
1,686,401
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
82,041
4,521,606
0.018144
2017
8,928
1,600,074
0.00558
2016
850
487,884
0.001742
2015
2014
2
Total
of line 1, column (d)
.....................
2
0.025466
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
0.008489
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
19,800,322
5
Multiply line 4 by line 3
......................
5
168,085
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
21,139
7
Add lines 5 and 6
........................
7
189,224
8
Enter qualifying distributions from Part XII, line 4
,.............
8
248,717
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
21,139
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
21,139
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
21,139
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
1,096
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
1,096
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
20,043
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)
FL
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
FINEMARK NATIONAL BANK & TRUST
Telephone no.
(239) 461-5900
Located at
12681 CREEKSIDE LANE
FORT MYERS
FL
ZIP+4
33919
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1)
Engage in the sale or exchange, or leasing of property with a disqualified person?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(5)
Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)?
...............
Yes
No
(6)
Agree to pay money or property to a government official? (
Exception.
Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.)
.......
Yes
No
b
If any answer is "Yes" to 1a(1)–(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions
........
1b
Organizations relying on a current notice regarding disaster assistance check here
........
c
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2019?
.............
1c
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2019, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2019?
.............
Yes
No
If "Yes," list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer "No" and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
......................
Yes
No
b
If "Yes," did it have excess business holdings in 2019 as a result of
(1)
any purchase by the foundation
or disqualified persons after May 26, 1969;
(2)
the lapse of the 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or
(3)
the lapse of the 10-, 15-, or 20-year first phase holding period?
(Use Schedule C, Form 4720, to determine
if the foundation had excess business holdings in 2019.)
..................
3b
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2019?
4b
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
6
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
(continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
No
b
If any answer is "Yes" to 5a(1)–(5), did
any
of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions
......
5b
Organizations relying on a current notice regarding disaster assistance check here
.........
c
If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant?
..........
Yes
No
If "Yes," attach the statement required by Regulations section 53.4945–5(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract?
.....................
Yes
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
....
6b
No
If "Yes" to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
Yes
No
b
If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction?
....
7b
8
Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment during the year?
.................
Yes
No
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1
List all officers, directors, trustees, foundation managers and their compensation. See instructions
(a)
Name and address
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(If not paid, enter
-0-)
(d)
Contributions to employee benefit plans and deferred compensation
(e)
Expense account,
other allowances
FINEMARK NATIONAL BANK & TRUST
TRUSTEE
2
57,302
12681 CREEKSIDE LAND
FORT MYERS
,
FL
33919
WALTER G BURKERT
TRUSTEE
2
58,374
2419 WESTMINISTER DR
CONCORD
,
NC
28027
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
18,787,775
b
Average of monthly cash balances
.......................
1b
1,314,075
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
20,101,850
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
20,101,850
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
301,528
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
19,800,322
6
Minimum investment return.
Enter 5% of line 5
..................
6
990,016
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
990,016
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
21,139
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
21,139
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
968,877
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
968,877
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
968,877
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
248,717
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
248,717
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
21,139
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
227,578
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
968,877
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
217,795
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:
$
248,717
a
Applied to 2018, but not more than line 2a
217,795
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
.....
30,922
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
..........
937,955
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions)
.......
0
8
Excess distributions carryover from 2014 not
applied on line 5 or line 7 (see instructions)
...
0
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
0
10
Analysis of line 9:
a
Excess from 2015
....
0
b
Excess from 2016
....
0
c
Excess from 2017
....
0
d
Excess from 2018
....
0
e
Excess from 2019
....
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
10
Part XIV
Private Operating Foundations
(see instructions and Part VII-A, question 9)
1a
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2019, enter the date of the ruling
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2019
(b)
2018
(c)
2017
(d)
2016
b
85% of line 2a
.........
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed
...
c
“Support" alternative test—enter:
(1)
Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
....
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
(3)
Largest amount of support
from an exempt organization
(4)
Gross investment income
Part XV
Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or email address of the person to whom applications should be addressed:
b
The form in which applications should be submitted and information and materials they should include:
c
Any submission deadlines:
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Form
990-PF
(2019)
Form 990-PF (2019)
Page
11
Part XV
Supplementary Information
(continued)
3
Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
NEW HORIZONS OF SOUTHWEST FLORIDA
PO BOX 111833
NAPLES
,
FL
34108
NONE
PC
GENERAL OPERATIONS
8,000
ABLE ACADEMY
5860 GOLDEN GATE PKWY
Naples
,
FL
34116
NONE
PC
GENERAL OPERATIONS
6,000
CANCER ALLIANCE OF NAPLES
3384 WOODS EDGE CIRCLE SUITE 102
BONITA SPRINGS
,
FL
34109
NONE
PC
GENERAL OPERATIONS
4,000
MEALS OF HOPE
2221 CORPORATION BLVD
Naples
,
FL
34109
NONE
PC
GENERAL OPERATIONS
6,000
LIGHTHOUSE OF COLLIER
2685 HORSESHOE DRIVE SOUTH SUITE 21
Naples
,
AL
34104
NONE
PC
GENERAL OPERATIONS
6,000
RUSTY'S LEGACY
139 LYTLE MOUNTAIN RD
Marion
,
NC
28752
NONE
PC
GENERAL OPERATIONS
2,000
VALERIE'S HOUSE
PO BOX 1955
Fort Myers
,
FL
33902
NONE
PC
GENERAL OPERATIONS
6,000
GULF COAST HUMANE SOCIETY
2010 ARCADIA ST
Fort Myers
,
FL
33916
NONE
PC
GENERAL OPERATIONS
7,000
HUMANE SOCIETY OF COLLIER COUNTY
370 AIRPORT-PULLING ROAD N
NAPLES
,
FL
34104
NONE
PC
GENERAL OPERATIONS
15,000
CONSERVANCY OF SOUTHWEST FLORIDA
1495 SMITH PRESERVE WAY
Naples
,
FL
34102
NONE
PC
GENERAL OPERATIONS
6,000
HABITAT FOR HUMANITY OF COLLIER COUNTY
11145 TAMIAMI TRAIL E
NAPLES
,
FL
34113
NONE
PC
GENERAL OPERATIONS
15,000
VOLUNTEER SERVICES FOR ANIMALS
6017 PINE RIDGE ROAD 330
Naples
,
FL
34119
NONE
PC
GENERAL OPERATIONS
5,000
AVOW HOSPICE
1095 WHIPPOORWILL LANE
NAPLES
,
FL
34105
NONE
PC
GENERAL OPERATIONS
7,000
DAVID LAWRENCE MENTAL HEALTH CENTER
6075 BATHEY LANE
Naples
,
FL
34116
NONE
PC
GENERAL OPERATIONS
6,000
DING DARLING WILDLIFE SOCIETY
1 WILDLIFE DR
Sanibel
,
FL
33957
NONE
PC
GENERAL OPERATIONS
2,000
HARRY CHAPLIN FOOD BANK OF SW FL
3760 FOWLER STREET
FORT MYERS
,
FL
33901
NONE
PC
GENERAL OPERATIONS
12,000
STARABILITY FOUNDATION
5125 CASTELLO DRIVE
Naples
,
FL
34103
NONE
PC
GENERAL OPERATIONS
5,000
GUADALUPE CENTER
509 HOPE CIRCLE
Immokalee
,
FL
34142
NONE
PC
GENERAL OPERATIONS
8,000
THE SHELTER FOR ABUSED WOMEN & CHLDREN
PO BOX 10102
NAPLES
,
FL
34101
NONE
PC
GENERAL OPERATIONS
8,000
NEIGHBORHOOD HEALTH CLINIC
121 GOODLETTE ROAD NORTH
NAPLES
,
FL
34102
NONE
PC
GENERAL OPERATIONS
6,000
FRIENDS OF FOSTER CHILDREN FOREVER
2675 HORSESHOE DRIVE SOUTH 402
Naples
,
FL
34104
NONE
PC
GENERAL OPERATIONS
8,000
SHY WOLF SANCTUARY
POB 3032
NAPLES
,
FL
34106
NONE
PC
GENERAL OPERATIONS
5,000
GOODWILL INDUSTRIES OF SW FL
5100 TICE STREET
FORT MYERS
,
FL
33905
NONE
PC
GENERAL OPERATIONS
12,000
CHILDREN'S ADVOCACY CENTER
3830 EVANS AVENUE
Fort Myers
,
FL
33901
NONE
PC
GENERAL OPERATIONS
5,000
ANIMAL REFUGE CENTER
PO BOX 62605
FORT MYERS
,
FL
33906
NONE
PC
GENERAL OPERATIONS
8,000
THE EDUCATION FOUNDATION
3606 ENTERPRISE AVE STE 150
NAPLES
,
FL
34104
NONE
PC
GENERAL OPERATIONS
4,795
BOYS & GIRLS CLUB OF COLLIER COUNTY
7500 DAVIS BOULEVARD
NAPLES
,
FL
34104
NONE
PC
GENERAL OPERATIONS
8,000
THE IMMOKALEE FOUNDATION
2375 TAMIAMI TRAIL N SUITE 308
Naples
,
FL
34103
NONE
PC
GENERAL OPERATIONS
8,000
ST MATTHEW'S HOUSE
2001 AIRPORT ROAD S
Naples
,
FL
34112
NONE
PC
GENERAL OPERATIONS
7,000
GRACE PLACE FOR CHILDREN & FAMILIES
PO BOX 990531
NAPLES
,
FL
34116
NONE
PC
GENERAL OPERATIONS
10,000
HEARTS AND HANDS FOR ANIMALS
PO BOX 8202
Morganton
,
NC
28680
NONE
PC
GENERAL OPERATIONS
2,000
Total
.................................
3a
217,795
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
532,527
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
1,686,401
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)
..
2,218,928
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
2,218,928
(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