-
TIN:
Form
990-PF
Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
Do not enter social security numbers on this form as it may be made public.
Go to
www.irs.gov/Form990PF
for instructions and the latest information.
OMB No. 1545-0052
20
19
Open to Public Inspection
For calendar year 2019, or tax year beginning
01-01-2019
, and ending
12-31-2019
Name of foundation
THE SHOFF FOUNDATION INC
Number and street (or P.O. box number if mail is not delivered to street address)
6602 DARTMOOR DRIVE
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
FLOWERY BRANCH
,
GA
30542
A Employer identification number
45-2717854
B
Telephone number (see instructions)
(770) 497-1122
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)
$
5,018,103
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
29,321
29,321
4
Dividends and interest from securities
...
56,401
56,401
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
69,897
b
Gross sales price for all assets on line 6a
1,041,526
7
Capital gain net income (from Part IV, line 2)
...
69,897
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
........
155,619
155,619
13
Compensation of officers, directors, trustees, etc.
81,600
27,198
54,402
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
10,554
10,554
0
c
Other professional fees (attach schedule)
....
5,600
2,800
2,800
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
57,906
53,745
4,161
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
155,660
94,297
61,363
25
Contributions, gifts, grants paid
.......
230,600
230,600
26
Total expenses and disbursements.
Add lines 24 and 25
386,260
94,297
291,963
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-230,641
b
Net investment income
(if negative, enter -0-)
61,322
c
Adjusted net income
(if negative, enter -0-)
...
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2019)
Form 990-PF (2019)
Page
2
Part II
Balance Sheets
Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year
End of year
(a)
Book Value
(b)
Book Value
(c)
Fair Market Value
1
Cash—non-interest-bearing
.............
238,854
222,343
222,343
2
Savings and temporary cash investments
.........
3
Accounts receivable
Less: allowance for doubtful accounts
4
Pledges receivable
Less: allowance for doubtful accounts
5
Grants receivable
.................
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)
.....
7
Other notes and loans receivable (attach schedule)
51,897
Less: allowance for doubtful accounts
0
67,859
51,897
51,897
8
Inventories for sale or use
..............
9
Prepaid expenses and deferred charges
..........
10a
Investments—U.S. and state government obligations (attach schedule)
0
89,680
89,737
b
Investments—corporate stock (attach schedule)
.......
2,113,281
1,921,123
3,863,972
c
Investments—corporate bonds (attach schedule)
.......
876,207
780,517
790,154
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
3,296,201
3,065,560
5,018,103
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
0
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
3,296,201
3,065,560
25
Net assets with donor restrictions
............
Foundations that do not follow FASB ASC 958, check here
and complete lines 26 through 30.
26
Capital stock, trust principal, or current funds
........
27
Paid-in or capital surplus, or land, bldg., and equipment fund
28
Retained earnings, accumulated income, endowment, or other funds
29
Total net assets or fund balances
(see instructions)
.....
3,296,201
3,065,560
30
Total liabilities and net assets/fund balances
(see instructions)
.
3,296,201
3,065,560
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
3,296,201
2
Enter amount from Part I, line 27a
.....................
2
-230,641
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
3,065,560
5
Decreases not included in line 2 (itemize)
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
3,065,560
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
COMCAST CORP
P
2018-12-19
2019-11-13
b
CELGENE CORP
P
2016-07-19
2019-04-30
c
CONSTELLATION INC
P
2017-04-27
2019-08-28
d
DAVITA HEALTHCARE
P
2016-07-19
2019-01-09
e
HCA HOLDINGS INC
P
2016-07-19
2019-07-05
LEAR CORP
P
2016-07-19
2019-05-29
LIMITED BRANDS
P
2016-07-19
2019-06-04
ALTRIA GROUP INC
P
2018-08-23
2019-01-17
AMERICAN TOWER REIT COM
P
2018-08-06
2019-01-17
AMERICAN TOWER REIT COM
P
2018-08-06
2019-07-12
APPLE INC
P
2019-01-10
2019-07-12
APPLE INC
P
2019-01-10
2019-12-17
AT&T INC
P
2018-08-23
2019-01-17
AT&T INC
P
2018-08-23
2019-07-12
AT&T INC
P
2019-07-31
2019-12-17
BRISTOL MYERS SQUIBB CO
P
2019-01-07
2019-01-17
BRISTOL MYERS SQUIBB CO
P
2019-02-22
2019-07-12
BRISTOL MYERS SQUIBB CO
P
2019-02-22
2019-12-17
COMCAST CORP
P
2018-05-10
2019-01-17
COMCAST CORP
P
2018-11-09
2019-07-12
COMCAST CORP
P
2019-11-25
2019-12-17
DELTA AIR LINES INC
P
2018-11-27
2019-07-12
DELTA AIR LINES INC
P
2018-11-27
2019-10-10
GILEAD SCIENCE
P
2019-01-07
2019-07-12
GILEAD SCIENCE
P
2019-01-07
2019-10-07
GILEAD SCIENCE
P
2019-05-13
2019-10-07
INTEL CORP
P
2018-03-05
2019-01-17
JOHNSON & JOHNSON
P
2019-11-15
2019-12-17
KONTOOR BRANDS INC
P
2018-07-13
2019-05-28
KONTOOR BRANDS INC
P
2018-11-01
2019-05-28
KONTOOR BRANDS INC
P
2018-11-27
2019-05-28
MEDTRONIC PLC SHS
P
2018-08-23
2019-07-12
PFIZER INC
P
2018-09-20
2019-07-12
RESTAURANT BRANDS INTL INC
P
2019-05-28
2019-07-12
RESTAURANT BRANDS INTL INC
P
2019-05-28
2019-12-17
STARBUCKS CORP
P
2018-05-10
2019-01-17
T ROWE PRICE GROUP INC
P
2019-04-22
2019-07-12
T ROWE PRICE GROUP INC
P
2019-11-11
2019-12-17
TIFFANY & COMPANY
P
2018-12-27
2019-01-17
TIFFANY & COMPANY
P
2019-05-28
2019-07-12
TIFFANY & COMPANY
P
2019-05-28
2019-12-17
UNITED TECHNOLOGIES CORP
P
2018-09-20
2019-07-12
VF CORP
P
2019-06-17
2019-07-12
VF CORP
P
2019-06-17
2019-12-17
WALGREENS BOOTS ALLIANCE INC
P
2018-04-23
2019-01-17
WALMART INC
P
2019-06-17
2019-07-12
WALMART INC
P
2019-05-28
2019-12-17
WALMART INC
P
2019-06-17
2019-12-17
AFLAC INCORPORATED
P
2016-07-18
2019-01-17
AFLAC INCORPORATED
P
2016-07-18
2019-07-12
AFLAC INCORPORATED
P
2016-07-18
2019-12-17
ALTRIA GROUP INC
P
2018-08-23
2019-12-17
AMERICAN TOWER REIT COM
P
2018-08-06
2019-12-17
APPLE INC
P
2017-04-11
2019-12-17
BB&T CORP
P
2016-07-18
2019-01-17
BB&T CORP
P
2016-07-18
2019-07-12
CHEVRON CORP
P
2016-11-02
2019-07-12
CHEVRON CORP
P
2016-11-02
2019-12-17
COCA COLA CO
P
2016-07-18
2019-01-17
COCA COLA CO
P
2016-07-18
2019-07-12
COCA COLA CO
P
2016-07-18
2019-12-17
DELTA AIR LINES INC
P
2017-10-11
2019-01-17
DELTA AIR LINES INC
P
2017-10-11
2019-10-10
DELTA AIR LINES INC
P
2018-05-11
2019-10-10
INTEL CORP
P
2018-03-05
2019-05-14
JOHNSON & JOHNSON
P
2017-04-11
2019-07-12
JPMORGAN CHASE & CO
P
2017-03-02
2019-01-17
JPMORGAN CHASE & CO
P
2017-03-02
2019-07-12
JPMORGAN CHASE & CO
P
2017-03-02
2019-12-17
KONTOOR BRANDS INC
P
2017-06-23
2019-05-23
KONTOOR BRANDS INC
P
2017-06-23
2019-05-28
KONTOOR BRANDS INC
P
2017-07-05
2019-05-28
KONTOOR BRANDS INC
P
2017-07-24
2019-05-28
MARSH & MCCLENNAN COS
P
2016-07-18
2019-01-17
MARSH & MCCLENNAN COS
P
2017-04-11
2019-07-12
MARSH & MCCLENNAN COS
P
2016-12-09
2019-12-17
MARSH & MCCLENNAN COS
P
2017-04-11
2019-12-17
MEDTRONIC PLC SHS
P
2016-07-18
2019-01-17
MEDTRONIC PLC SHS
P
2016-07-18
2019-12-17
MEDTRONIC PLC SHS
P
2018-08-23
2019-12-17
MICROSOFT CORP
P
2016-07-18
2019-01-17
MICROSOFT CORP
P
2017-04-11
2019-07-12
MICROSOFT CORP
P
2016-07-18
2019-12-17
MICROSOFT CORP
P
2017-04-11
2019-12-17
NESTLE SPON ADR REP REG
P
2016-07-18
2019-01-17
NESTLE SPON ADR REP REG
P
2016-07-18
2019-07-12
NESTLE SPON ADR REP REG
P
2016-07-18
2019-12-17
PEPSICO INC
P
2016-07-18
2019-01-17
PEPSICO INC
P
2017-04-11
2019-07-12
PEPSICO INC
P
2016-07-18
2019-12-17
PEPSICO INC
P
2017-04-11
2019-12-17
PFIZER INC
P
2016-07-18
2019-01-17
PFIZER INC
P
2018-09-20
2019-12-17
PHILIP MORRIS INTL INC
P
2016-07-18
2019-01-17
PHILIP MORRIS INTL INC
P
2016-07-18
2019-07-12
PHILIP MORRIS INTL INC
P
2017-04-11
2019-07-12
PHILIP MORRIS INTL INC
P
2016-07-18
2019-12-17
ROYAL DUTCH SHELL PLC
P
2016-07-18
2019-01-17
ROYAL DUTCH SHELL PLC
P
2017-12-04
2019-07-12
ROYAL DUTCH SHELL PLC
P
2016-07-18
2019-12-17
ROYAL DUTCH SHELL PLC
P
2017-12-04
2019-12-17
STARBUCKS CORP
P
2018-05-10
2019-07-12
STARBUCKS CORP
P
2018-05-10
2019-12-17
TROWE PRICE GROUP INC
P
2019-03-29
2019-01-17
TRUIST FINL CORP
P
2016-07-18
2019-12-17
UNITED TECHNOLOGIES CORP
P
2016-07-18
2019-01-17
UNITED TECHNOLOGIES CORP
P
2017-04-11
2019-12-17
UNITED TECHNOLOGIES CORP
P
2018-09-20
2019-12-17
VF CORP
P
2017-04-27
2019-01-17
VF CORP
P
2018-07-13
2019-12-17
VERIZON COMMUNICATIONS
P
2016-07-18
2019-01-17
VERIZON COMMUNICATIONS
P
2016-07-18
2019-07-12
VERIZON COMMUNICATIONS
P
2016-07-18
2019-12-17
WALGREENS BOOTS ALLIANCE INC
P
2018-04-23
2019-07-12
WALGREENS BOOTS ALLIANCE INC
P
2018-04-23
2019-11-15
WALGREENS BOOTS ALLIANCE INC
P
2018-04-23
2019-12-17
WALMART INC
P
2016-07-18
2019-01-17
WEYERHAEUSER CO
P
2016-07-18
2019-01-17
WEYERHAEUSER CO
P
2016-07-18
2019-07-12
WEYERHAEUSER CO
P
2016-07-18
2019-12-17
APPLE INC
P
2015-08-27
2019-01-17
CHEVRON CORP
P
2010-06-29
2019-01-17
CHEVRON CORP
P
2010-06-29
2019-12-17
JOHNSON & JOHNSON
P
2010-08-19
2019-01-17
ALIBABA GROUP HLDG LTD
P
2019-02-01
2019-07-12
ALIBABA GROUP HLDG LTD
P
2019-11-11
2019-12-17
ALPHABET INC
P
2019-05-28
2019-07-12
ALPHABET INC
P
2019-05-28
2019-12-17
ANADARKO PETE
P
2018-12-07
2019-01-17
ANADARKO PETE
P
2018-12-07
2019-04-26
ANADARKO PETE
P
2019-02-22
2019-04-26
APPLE INC
P
2019-01-10
2019-07-12
BAIDU INC
P
2019-03-05
2019-05-21
BAIDU INC
P
2019-03-05
2019-07-12
BAIDU INC
P
2018-12-26
2019-10-07
BAIDU INC
P
2019-03-05
2019-10-07
BERKSHIRE HATHAWAY
P
2018-01-30
2019-01-17
BIOGEN INC
P
2019-01-31
2019-05-13
COMCAST CORP
P
2019-05-28
2019-07-12
COMCAST CORP
P
2019-05-28
2019-12-17
DANAHER CORPORATION
P
2018-09-19
2019-07-12
DELTA AIR LINES INC
P
2018-11-27
2019-01-03
DELTA AIR LINES INC
P
2018-11-27
2019-03-01
DELTA AIR LINES INC
P
2018-12-26
2019-03-01
DELTA AIR LINES INC
P
2018-11-27
2019-07-12
FACEBOOK INC
P
2019-06-17
2019-07-12
FACEBOOK INC
P
2019-06-17
2019-12-17
ILLUMINA INC
P
2019-11-20
2019-12-17
L OREAL CO
P
2018-11-27
2019-01-03
L OREAL CO
P
2019-02-22
2019-07-12
L OREAL CO
P
2019-11-20
2019-12-17
LVMH MOET HENNESSY JOUIS VUITT
P
2019-02-22
2019-07-12
LVMH MOET HENNESSY JOUIS VUITT
P
2019-11-26
2019-12-17
NATIONAL OILWELL VARCO INC
P
2018-10-01
2019-05-21
NIKE INC
P
2019-12-11
2019-12-17
SALESFORCE.COM INC
P
2019-11-20
2019-12-17
TIFFANY & COMPANY
P
2018-12-26
2019-07-12
TIFFANY & COMPANY
P
2018-12-26
2019-12-17
ULTA BEAUTY INC
P
2019-06-17
2019-07-12
ULTA BEAUTY INC
P
2019-06-17
2019-12-17
ALIBABA GROUP HLDG LTD
P
2016-07-18
2019-01-17
ALPHABET INC
P
2016-07-18
2019-01-17
ALPHABET INC
P
2016-07-18
2019-07-12
ALPHABET INC
P
2016-07-18
2019-01-17
AMAZON COM INC
P
2016-07-18
2019-01-17
AMAZON COM INC
P
2016-07-18
2019-07-12
AMAZON COM INC
P
2016-07-18
2019-12-17
BAIDU INC
P
2016-07-18
2019-01-17
BAIDU INC
P
2016-12-09
2019-05-21
BAIDU INC
P
2017-02-01
2019-05-21
BAIDU INC
P
2017-02-02
2019-05-21
BAIDU INC
P
2016-07-18
2019-10-07
BAIDU INC
P
2016-07-19
2019-10-07
BERKSHIRE HATHAWAY
P
2018-01-30
2019-07-12
BERKSHIRE HATHAWAY
P
2018-11-27
2019-07-12
BERKSHIRE HATHAWAY
P
2018-01-30
2019-12-17
BIOGEN INC
P
2016-07-18
2019-01-17
BIOGEN INC
P
2016-07-18
2019-05-13
BIOGEN INC
P
2017-08-16
2019-05-13
BOOKING HOLDINGS INC
P
2016-07-18
2019-01-17
BOOKING HOLDINGS INC
P
2017-10-06
2019-07-12
BOOKING HOLDINGS INC
P
2017-10-06
2019-12-17
COMCAST CORP
P
2016-07-18
2019-01-17
DANAHER CORPORATION
P
2016-07-18
2019-01-17
DANAHER CORPORATION
P
2018-09-19
2019-12-17
DAVITA INC
P
2016-07-18
2019-01-03
DAVITA INC
P
2016-07-18
2019-01-17
DAVITA INC
P
2016-07-18
2019-07-12
DAVITA INC
P
2016-07-18
2019-12-17
DELTA AIR LINES INC
P
2016-12-27
2019-01-17
DELTA AIR LINES INC
P
2018-05-11
2019-07-12
DELTA AIR LINES INC
P
2016-12-27
2019-10-10
DELTA AIR LINES INC
P
2017-01-05
2019-10-10
DELTA AIR LINES INC
P
2017-04-11
2019-10-10
DELTA AIR LINES INC
P
2017-05-17
2019-10-10
DELTA AIR LINES INC
P
2018-05-11
2019-10-10
DELTA AIR LINES INC
P
2018-12-26
2019-10-10
ECOLAB INC
P
2016-07-18
2019-01-17
ECOLAB INC
P
2016-07-18
2019-07-12
ECOLAB INC
P
2016-12-09
2019-08-15
ECOLAB INC
P
2016-07-18
2019-12-17
FACEBOOK INC
P
2016-07-18
2019-01-17
ILLUMINA INC
P
2016-07-18
2019-01-17
ILLUMINA INC
P
2016-07-18
2019-07-12
INTUIT INC
P
2016-07-18
2019-01-17
INTUIT INC
P
2017-04-11
2019-07-12
INTUIT INC
P
2016-07-18
2019-12-17
INTUIT INC
P
2017-04-11
2019-12-17
L OREAL CO
P
2017-11-03
2019-01-03
MASTERCARD INC
P
2016-07-18
2019-01-17
MASTERCARD INC
P
2016-07-18
2019-07-12
MASTERCARD INC
P
2016-07-18
2019-12-17
NATIONAL OILWELL VARCO INC
P
2016-07-18
2019-01-17
NATIONAL OILWELL VARCO INC
P
2017-04-11
2019-05-21
NATIONAL OILWELL VARCO INC
P
2018-02-07
2019-05-21
NATIONAL OILWELL VARCO INC
P
2018-02-07
2019-12-17
NIKE INC
P
2016-12-27
2019-01-17
NIKE INC
P
2017-11-20
2019-07-12
NIKE INC
P
2017-11-02
2019-12-17
NIKE INC
P
2017-11-20
2019-12-17
PAYPAL HLDGS INC
P
2017-01-30
2019-01-17
PAYPAL HLDGS INC
P
2017-04-18
2019-07-12
PAYPAL HLDGS INC
P
2017-04-18
2019-12-17
REGENERON PHARM
P
2016-07-18
2019-01-17
REGENERON PHARM
P
2016-07-18
2019-05-13
REGENERON PHARM
P
2018-05-11
2019-05-13
REGENERON PHARM
P
2018-12-26
2019-05-13
REGENERON PHARM
P
2018-12-26
2019-05-13
REGENERON PHARM
P
2018-12-26
2019-05-13
RESMED INC
P
2016-07-18
2019-01-17
RESMED INC
P
2016-07-18
2019-07-12
RESMED INC
P
2016-07-18
2019-12-17
STARBUCKS CORP
P
2016-07-18
2019-01-17
STARBUCKS CORP
P
2016-07-20
2019-07-12
STARBUCKS CORP
P
2016-07-20
2019-12-17
TIFFANY & COMPANY
P
2016-07-18
2019-01-17
VISA INC
P
2016-07-18
2019-01-17
VISA INC
P
2017-04-11
2019-07-12
VISA INC
P
2016-07-18
2019-12-17
VISA INC
P
2017-04-11
2019-12-17
APPLE INC
P
2015-08-27
2019-01-17
APPLE INC
P
2015-08-27
2019-07-12
APPLE INC
P
2015-08-27
2019-12-17
ADOBE INC
P
2018-03-09
2019-01-17
ADOBE INC
P
2018-12-03
2019-07-12
ANADARKO PETE
P
2018-12-07
2019-04-26
BAIDU INC
P
2019-03-05
2019-05-21
BAIDU INC
P
2019-04-24
2019-05-21
BAIDU INC
P
2019-03-05
2019-10-07
BIOGEN INC
P
2019-01-31
2019-10-07
CANADA GOOSE HOLDINGS INC
P
2019-08-14
2019-12-17
DAVITA INC
P
2019-06-07
2019-12-17
FACEBOOK INC
P
2019-04-22
2019-07-12
FACEBOOK INC
P
2019-10-11
2019-12-17
FLEETCOR TECHNOLOGIES
P
2018-11-07
2019-01-03
INSULET CORP
P
2019-05-13
2019-07-12
INSULET CORP
P
2019-05-13
2019-12-17
JB HUNT TRANS SERV
P
2019-07-18
2019-12-17
LEAR CORP
P
2018-12-26
2019-07-12
LEAR CORP
P
2018-12-26
2019-08-15
LKQ CORPORATION
P
2018-09-11
2019-07-12
LULULEMON ATHLETIC INC
P
2019-04-24
2019-07-12
LULULEMON ATHLETIC INC
P
2019-08-21
2019-12-17
MONSTER BEVERAGE CORP
P
2018-07-19
2019-07-12
MONSTER BEVERAGE CORP
P
2019-02-22
2019-12-17
SALESFORCE.COM INC
P
2019-05-28
2019-07-12
SALESFORCE.COM INC
P
2019-07-18
2019-12-17
SHOPIFY INC
P
2019-10-11
2019-12-17
SNAP-ON INC
P
2019-01-14
2019-07-12
SNAP-ON INC
P
2019-01-14
2019-12-17
SPOTIFY TECHNOLOGY
P
2018-05-25
2019-01-17
SPOTIFY TECHNOLOGY
P
2018-05-25
2019-04-17
SPOTIFY TECHNOLOGY
P
2018-06-04
2019-04-17
SPOTIFY TECHNOLOGY
P
2018-06-08
2019-04-17
SPOTIFY TECHNOLOGY
P
2018-09-11
2019-04-17
TENCENT HLDGS LTD
P
2019-01-11
2019-08-15
TENCENT HLDGS LTD
P
2019-03-05
2019-08-15
TIFFANY & COMPANY
P
2018-12-26
2019-07-12
TIFFANY & COMPANY
P
2019-08-21
2019-12-17
TRACTOR SUPPLY CO
P
2018-04-19
2019-01-17
TRACTOR SUPPLY CO
P
2018-07-23
2019-07-12
TRACTOR SUPPLY CO
P
2019-10-07
2019-12-17
ULTA BEAUTY INC
P
2019-08-30
2019-12-17
VEEVA SYS INC
P
2018-12-03
2019-07-12
XPO LOGISTICS INC
P
2018-02-23
2019-01-17
XPO LOGISTICS INC
P
2018-02-23
2019-02-15
XPO LOGISTICS INC
P
2018-08-06
2019-02-15
XPO LOGISTICS INC
P
2018-12-26
2019-02-15
ADOBE INC
P
2018-04-23
2019-12-17
ADOBE INC
P
2018-12-03
2019-12-17
ALIBABA GROUP HLDG LTD
P
2017-05-16
2019-01-17
ALIBABA GROUP HLDG LTD
P
2018-03-09
2019-07-12
ALIBABA GROUP HLDG LTD
P
2018-06-04
2019-07-12
ALIBABA GROUP HLDG LTD
P
2018-03-09
2019-12-17
AMERICAN TOWER REIT COM
P
2016-07-18
2019-01-17
AMERICAN TOWER REIT COM
P
2016-07-18
2019-07-12
AMERICAN TOWER REIT COM
P
2016-07-18
2019-12-17
AUTONATION INC
P
2017-10-25
2019-11-14
AUTONATION INC
P
2018-01-24
2019-11-14
AUTONATION INC
P
2017-02-28
2019-12-17
AUTONATION INC
P
2017-10-25
2019-12-17
BIOGEN INC
P
2016-07-18
2019-01-17
BIOGEN INC
P
2016-07-18
2019-10-07
CARMAX INC
P
2017-06-26
2019-01-17
CARMAX INC
P
2018-01-24
2019-07-12
CARMAX INC
P
2018-01-24
2019-12-17
DEXCOM INC
P
2016-07-18
2019-01-03
DEXCOM INC
P
2017-12-04
2019-01-03
DEXCOM INC
P
2016-07-18
2019-01-17
DEXCOM INC
P
2016-07-18
2019-07-12
DEXCOM INC
P
2016-07-18
2019-12-17
FACEBOOK INC
P
2016-07-18
2019-01-17
FACTSET RESEARCH SYSTEMS INC
P
2016-07-18
2019-01-17
FACTSET RESEARCH SYSTEMS INC
P
2016-12-09
2019-07-12
FACTSET RESEARCH SYSTEMS INC
P
2016-12-09
2019-12-17
FLEETCOR TECHNOLOGIES
P
2017-07-31
2019-01-03
FLEETCOR TECHNOLOGIES
P
2017-10-30
2019-01-03
FLEETCOR TECHNOLOGIES
P
2017-11-30
2019-01-03
FLEETCOR TECHNOLOGIES
P
2017-05-15
2019-01-17
FLEETCOR TECHNOLOGIES
P
2017-07-31
2019-07-12
FLEETCOR TECHNOLOGIES
P
2017-05-15
2019-07-16
FLEETCOR TECHNOLOGIES
P
2017-07-31
2019-07-16
FLEETCOR TECHNOLOGIES
P
2017-08-18
2019-07-16
FLEETCOR TECHNOLOGIES
P
2017-05-15
2019-12-17
ILLUMINA INC
P
2016-07-18
2019-01-17
ILLUMINA INC
P
2016-07-18
2019-07-12
ILLUMINA INC
P
2016-07-18
2019-12-17
IQVIA HOLDINGS INC
P
2016-07-18
2019-01-17
IQVIA HOLDINGS INC
P
2016-07-18
2019-07-12
IQVIA HOLDINGS INC
P
2016-07-18
2019-11-14
IQVIA HOLDINGS INC
P
2016-07-18
2019-12-17
JB HUNT TRANS SERV
P
2016-07-18
2019-07-12
LEAR CORP
P
2016-07-18
2019-01-17
LEAR CORP
P
2016-07-18
2019-08-15
LEAR CORP
P
2016-07-18
2019-08-15
LEAR CORP
P
2016-08-01
2019-08-15
LKQ CORPORATION
P
2017-07-10
2019-01-17
LKQ CORPORATION
P
2018-09-11
2019-12-17
MONSTER BEVERAGE CORP
P
2016-07-18
2019-01-17
MONSTER BEVERAGE CORP
P
2018-07-19
2019-12-17
NATIONAL OILWELL VARCO INC
P
2016-07-18
2019-01-17
NATIONAL OILWELL VARCO INC
P
2016-07-18
2019-05-21
NATIONAL OILWELL VARCO INC
P
2016-07-18
2019-12-17
PAYPAL HLDGS INC
P
2017-04-20
2019-01-17
PAYPAL HLDGS INC
P
2018-04-18
2019-07-12
PAYPAL HLDGS INC
P
2018-04-18
2019-12-17
PAYPAL HLDGS INC
P
2018-05-07
2019-12-17
RESMED INC
P
2016-07-18
2019-01-17
RESMED INC
P
2016-07-18
2019-07-12
RESMED INC
P
2016-07-18
2019-12-17
RESTAURANT BRANDS INTL INC
P
2016-07-18
2019-01-03
RESTAURANT BRANDS INTL INC
P
2016-07-18
2019-01-17
RESTAURANT BRANDS INTL INC
P
2016-07-18
2019-07-12
RESTAURANT BRANDS INTL INC
P
2016-07-18
2019-12-17
SALESFORCE.COM INC
P
2017-10-18
2019-01-17
SALESFORCE.COM INC
P
2018-02-26
2019-07-12
SNAP-ON INC
P
2017-08-03
2019-01-17
TESLA INC
P
2016-07-18
2019-01-17
TESLA INC
P
2017-12-26
2019-07-12
TESLA INC
P
2017-12-26
2019-12-17
TIFFANY & COMPANY
P
2016-07-18
2019-01-17
ULTA BEAUTY INC
P
2017-08-25
2019-01-17
ULTA BEAUTY INC
P
2017-11-30
2019-07-12
VEEVA SYS INC
P
2017-08-17
2019-01-17
VEEVA SYS INC
P
2017-08-17
2019-07-12
VEEVA SYS INC
P
2017-08-17
2019-07-12
VEEVA SYS INC
P
2017-07-18
2019-12-17
XPO LOGISTICS INC
P
2018-12-26
2019-02-15
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
30,406
30,049
357
b
60,899
62,431
-1,532
c
30,093
30,116
-23
d
29,250
31,144
-1,894
e
61,404
61,255
149
61,613
62,921
-1,308
30,825
31,712
-887
424
538
-114
819
754
65
836
603
233
406
306
100
561
306
255
673
717
-44
637
619
18
1,771
1,585
186
594
566
28
796
917
-121
2,065
1,630
435
1,259
1,091
168
1,329
1,147
182
2,688
2,688
0
1,054
991
63
1,616
1,808
-192
731
745
-14
9,339
10,022
-683
5,111
5,177
-66
826
842
-16
3,308
3,088
220
132
130
2
280
275
5
111
102
9
1,781
1,728
53
973
999
-26
730
684
46
1,111
1,163
-52
1,027
917
110
881
851
30
2,342
2,279
63
511
463
48
948
928
20
2,942
2,042
900
800
848
-48
1,601
1,576
25
1,711
1,576
135
864
774
90
1,488
1,417
71
727
621
106
1,940
1,744
196
992
771
221
1,024
661
363
1,861
1,284
577
1,425
1,673
-248
1,267
904
363
4,204
2,126
2,078
819
624
195
705
514
191
755
631
124
238
210
28
2,257
2,187
70
729
638
91
1,034
866
168
917
1,007
-90
12,456
12,666
-210
4,847
4,908
-61
14,980
16,500
-1,520
1,472
1,366
106
927
830
97
919
737
182
1,940
1,291
649
20
14
6
328
213
115
434
289
145
640
436
204
905
731
174
1,024
732
292
895
556
339
1,007
659
348
1,841
1,849
-8
2,748
2,113
635
916
768
148
2,861
1,463
1,398
2,914
1,373
1,541
1,700
596
1,104
5,409
2,289
3,120
1,521
1,429
92
1,646
1,270
376
3,161
2,382
779
764
762
2
799
669
130
136
109
27
1,089
892
197
1,148
989
159
2,296
2,563
-267
869
1,235
-366
163
206
-43
653
908
-255
1,460
1,750
-290
901
834
67
1,170
1,158
12
469
445
24
879
965
-86
1,255
802
453
2,106
1,375
731
665
476
189
1,411
918
493
789
740
49
1,184
903
281
148
141
7
1,387
1,100
287
1,236
1,033
203
1,641
1,618
23
1,944
1,898
46
2,709
2,456
253
335
387
-52
6,101
6,324
-223
573
645
-72
1,066
814
252
688
899
-211
615
770
-155
1,272
1,381
-109
1,719
1,248
471
783
483
300
952
552
400
1,550
715
835
2,545
2,523
22
6,635
5,824
811
2,289
2,289
0
5,435
4,579
856
48
53
-5
36,132
26,241
9,891
8,327
5,050
3,277
203
153
50
1,564
2,165
-601
115
167
-52
5,498
8,591
-3,093
1,425
2,332
-907
1,587
1,725
-138
11,171
16,536
-5,365
2,173
2,092
81
3,989
3,927
62
1,820
1,402
418
2,080
2,624
-544
4,362
5,249
-887
2,181
2,741
-560
807
758
49
2,832
2,618
214
5,355
5,049
306
4,200
4,063
137
3,099
3,237
-138
283
256
27
1,601
1,613
-12
865
683
182
1,879
1,898
-19
8,180
15,020
-6,840
398
388
10
1,297
1,320
-23
1,423
1,144
279
5,349
3,050
2,299
1,070
1,054
16
3,570
4,916
-1,346
2,508
1,317
1,191
1,093
752
341
1,145
752
393
3,250
2,200
1,050
6,761
2,949
3,812
4,020
1,475
2,545
5,349
2,212
3,137
1,009
983
26
722
1,018
-296
4,932
7,126
-2,194
361
524
-163
5,803
9,336
-3,533
3,054
4,877
-1,823
213
216
-3
1,281
1,319
-38
2,498
2,372
126
1,349
965
384
12,065
13,027
-962
11,618
15,303
-3,685
3,461
2,687
774
1,882
1,918
-36
2,006
1,918
88
1,799
1,674
125
1,581
1,209
372
3,489
2,480
1,009
6,255
9,435
-3,180
284
387
-103
57
77
-20
2,952
3,171
-219
1,302
1,360
-58
372
317
55
6,046
5,841
205
15,114
14,421
693
365
315
50
9,590
8,831
759
6,932
7,020
-88
261
255
6
1,674
1,324
350
1,991
1,204
787
8,123
4,789
3,334
2,802
1,806
996
2,061
1,657
404
4,046
1,941
2,105
1,832
896
936
2,107
1,150
957
1,123
474
649
1,303
575
728
261
119
142
2,201
2,192
9
7,778
3,561
4,217
4,737
1,552
3,185
9,749
3,013
6,736
1,368
1,524
-156
313
502
-189
818
1,197
-379
3,007
4,436
-1,429
2,927
1,911
1,016
1,516
1,005
511
1,093
606
487
1,590
946
644
2,524
1,122
1,402
2,277
819
1,458
4,870
1,939
2,931
1,254
1,138
116
14,217
17,830
-3,613
7,260
7,202
58
605
719
-114
1,815
2,507
-692
1,815
2,319
-504
1,288
718
570
1,119
588
531
2,504
1,045
1,459
2,886
2,575
311
2,690
1,719
971
6,321
4,125
2,196
1,533
1,112
421
1,922
1,097
825
2,695
1,330
1,365
4,632
1,958
2,674
185
89
96
2,340
1,702
638
2,439
1,362
1,077
6,446
2,610
3,836
486
438
48
618
510
108
8,617
6,258
2,359
241
333
-92
1,564
2,225
-661
3,767
6,163
-2,396
2,262
3,307
-1,045
599
632
-33
720
478
242
809
723
86
1,389
1,297
92
731
814
-83
362
300
62
875
499
376
574
493
81
408
354
54
423
472
-49
321
401
-80
378
356
22
670
550
120
716
676
40
941
880
61
474
471
3
1,135
1,100
35
387
333
54
642
645
-3
859
806
53
266
315
-49
2,752
3,146
-394
3,027
3,518
-491
1,101
1,360
-259
1,376
1,827
-451
4,157
4,214
-57
1,704
1,888
-184
379
305
74
936
591
345
440
300
140
453
323
130
748
746
2
1,274
1,199
75
2,957
1,668
1,289
310
481
-171
4,044
7,891
-3,847
1,184
2,458
-1,274
1,036
1,122
-86
323
227
96
323
255
68
938
739
199
170
190
-20
509
622
-113
1,660
1,520
140
656
465
191
627
349
278
1,056
581
475
1,526
1,349
177
526
607
-81
360
324
36
154
140
14
337
241
96
6,108
6,506
-398
386
377
9
445
355
90
791
568
223
2,161
1,476
685
796
555
241
899
466
433
893
466
427
2,380
855
1,525
590
473
117
421
332
89
591
333
258
269
166
103
1,278
1,064
214
1,096
986
110
1,096
1,091
5
384
279
105
292
152
140
877
418
459
877
456
421
877
427
450
909
418
491
933
448
485
612
298
314
1,612
746
866
743
431
312
787
360
427
1,888
935
953
1,180
575
605
466
410
56
452
338
114
317
338
-21
4,971
5,303
-332
1,904
2,041
-137
324
379
-55
794
734
60
597
566
31
251
246
5
505
563
-58
1,660
2,286
-626
501
696
-195
903
438
465
1,079
717
362
973
717
256
757
522
235
352
196
156
498
261
237
626
261
365
2,220
1,857
363
342
259
83
365
216
149
523
346
177
598
386
212
158
116
42
663
612
51
695
452
243
488
639
-151
1,139
959
180
425
309
116
843
639
204
713
449
264
516
321
195
1,392
513
879
699
256
443
867
385
482
247
438
-191
736
736
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
357
b
-1,532
c
-23
d
-1,894
e
149
-1,308
-887
-114
65
233
100
255
-44
18
186
28
-121
435
168
182
0
63
-192
-14
-683
-66
-16
220
2
5
9
53
-26
46
-52
110
30
63
48
20
900
-48
25
135
90
71
106
196
221
363
577
-248
363
2,078
195
191
124
28
70
91
168
-90
-210
-61
-1,520
106
97
182
649
6
115
145
204
174
292
339
348
-8
635
148
1,398
1,541
1,104
3,120
92
376
779
2
130
27
197
159
-267
-366
-43
-255
-290
67
12
24
-86
453
731
189
493
49
281
7
287
203
23
46
253
-52
-223
-72
252
-211
-155
-109
471
300
400
835
22
811
0
856
-5
9,891
3,277
50
-601
-52
-3,093
-907
-138
-5,365
81
62
418
-544
-887
-560
49
214
306
137
-138
27
-12
182
-19
-6,840
10
-23
279
2,299
16
-1,346
1,191
341
393
1,050
3,812
2,545
3,137
26
-296
-2,194
-163
-3,533
-1,823
-3
-38
126
384
-962
-3,685
774
-36
88
125
372
1,009
-3,180
-103
-20
-219
-58
55
205
693
50
759
-88
6
350
787
3,334
996
404
2,105
936
957
649
728
142
9
4,217
3,185
6,736
-156
-189
-379
-1,429
1,016
511
487
644
1,402
1,458
2,931
116
-3,613
58
-114
-692
-504
570
531
1,459
311
971
2,196
421
825
1,365
2,674
96
638
1,077
3,836
48
108
2,359
-92
-661
-2,396
-1,045
-33
242
86
92
-83
62
376
81
54
-49
-80
22
120
40
61
3
35
54
-3
53
-49
-394
-491
-259
-451
-57
-184
74
345
140
130
2
75
1,289
-171
-3,847
-1,274
-86
96
68
199
-20
-113
140
191
278
475
177
-81
36
14
96
-398
9
90
223
685
241
433
427
1,525
117
89
258
103
214
110
5
105
140
459
421
450
491
485
314
866
312
427
953
605
56
114
-21
-332
-137
-55
60
31
5
-58
-626
-195
465
362
256
235
156
237
365
363
83
149
177
212
42
51
243
-151
180
116
204
264
195
879
443
482
-191
736
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
69,897
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
275,769
4,464,062
0.061775
2017
265,195
4,352,586
0.060928
2016
230,625
4,072,344
0.056632
2015
229,792
4,337,360
0.052980
2014
304,396
4,833,768
0.062973
2
Total
of line 1, column (d)
.....................
2
0.295288
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
0.059058
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
4,618,709
5
Multiply line 4 by line 3
......................
5
272,772
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
613
7
Add lines 5 and 6
........................
7
273,385
8
Enter qualifying distributions from Part XII, line 4
,.............
8
291,963
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
613
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
613
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
613
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
7,780
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
7,780
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
0
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
7,167
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
7,167
Refunded
11
0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition)
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
0
(2)
On foundation managers.
$
0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
No
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)
GA
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
WWW.SHOFFFOUNDATION.ORG
14
The books are in care of
GERALD R STINNETT CPA PC
Telephone no.
(770) 497-1122
Located at
454 SATELLITE BLVD NW SUITE 302
SUWANEE
GA
ZIP+4
30024
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
RICHARD L MASON
CEO
20.00
42,000
0
0
1953 SW 15TH ST 80
DEERFIELD BEACH
,
FL
33442
CHRISTINE M KERR
SECRETARY
20.00
39,600
0
0
1725 LAUREL CREEK DRIVE
LAWRENCEVILLE
,
GA
30043
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
GERALD R STINNETT CPA PC
ACCOUNTING/TAX RELATED
10,554
454 SATELLITE BLVD STE 302
SUWANEE
,
GA
30024
Total
number of others receiving over $50,000 for professional services
.............
0
Part IX-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
2
3
4
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
8
Part X
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations, see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities
...................
1a
4,398,568
b
Average of monthly cash balances
.......................
1b
230,599
c
Fair market value of all other assets (see instructions)
................
1c
59,878
d
Total
(add lines 1a, b, and c)
.........................
1d
4,689,045
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
4,689,045
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
70,336
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
4,618,709
6
Minimum investment return.
Enter 5% of line 5
..................
6
230,935
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
230,935
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
613
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
613
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
230,322
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
230,322
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
230,322
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
291,963
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
291,963
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
613
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
291,350
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
230,322
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
......
66,598
b
From 2015
......
15,974
c
From 2016
......
28,278
d
From 2017
......
47,596
e
From 2018
......
54,756
f
Total
of lines 3a through e
........
213,202
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
291,963
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
.....
230,322
e
Remaining amount distributed out of corpus
61,641
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
274,843
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)
...
66,598
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
208,245
10
Analysis of line 9:
a
Excess from 2015
....
15,974
b
Excess from 2016
....
28,278
c
Excess from 2017
....
47,596
d
Excess from 2018
....
54,756
e
Excess from 2019
....
61,641
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
ATLANTA MISSION
2353 BOLTON RD NW
ATLANTA
,
GA
30318
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
2,600
CARVER FOUNDATION OF NORWALK INC
7 ACADEMY STREET
NORWALK
,
CT
06850
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
5,000
CHILDREN'S HEALTHCARE OF ATLANTA FOUNDATION
3395 NE EXPRESSWAY STE 100
BOWLING GREEN
,
OH
43403
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATIONCHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
2,000
COMMUNITY COUNCIL ON AGING
430 PRIOR ST SE
GAINESVILLE
,
GA
30501
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
1,000
CORNELL UNIVERSITY LAW SCHOOL
410 THURSTON AE
ITHACA
,
NY
14850
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
20,000
EAGLE RANCH INC
5500 UNION CHURCH RD
FLOWERY BRANCH
,
GA
30542
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
15,000
FAITH METHODIST CHURCH
4500 DUE WEST RD NW
KENNESAW
,
GA
30152
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATIONCHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
3,000
FLORIDA GULF COAST UNIVERSITY FOUNDATION INC
10501 FGCU BOULEVARD SOUTH
FT MYERS
,
FL
33695
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
15,000
FORT TICONDEROGA MUSEUM
102 FORT TI ROAD
TICONDEROGA
,
NY
12883
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
3,000
GEORGIA MOUNTAIN FOOD BANK
1642 CALVARY INDUSTRIAL DR SW
GAINESVILLE
,
GA
30507
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
4,000
HUMAN SERVICES COUNCIL
ONE PARK STREET
NORWALK
,
CT
06851
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
3,000
LAKE GEORGE LAND CONSERVANCY
PO BOX 1250
BOLTON LANDING
,
NY
12814
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
5,000
PEACE PLACE INC
PO BOX 948
WINDER
,
GA
30680
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATIONCHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
3,000
PRINCE AVENUE CHRISTIAN SCHOOL
2201 RUTH JACKSON RD
BOGART
,
GA
30622
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
45,000
RONALD MCDONALD HOUSE CHARITIES
795 GATEWOOD ROAD NE
ATLANTA
,
GA
30329
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATIONCHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
9,500
SALVATION ARMY
400 LUCKIE ST NW
ATLANTA
,
GA
30313
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
4,000
ST JUDE'S CHILDREN RESEARCH HOSPITAL
692 DANNY THOMAS PLACE
MEMPHIS
,
TN
28105
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
3,000
TOYS FOR TOTS FOUNDATION
3072 BILTMORE WOODS DR
BUFORD
,
GA
30519
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
1,000
UYC MARITIME FOUNDATION INC
6649 YACHT CLUB ROAD
FLOWERY BRANCH
,
GA
30542
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
20,500
WILTON AMBULANCE CORPS
224 DANBURY ROAD
WILTON
,
CT
06897
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
5,000
WILTON CANDLELIGHT CONCERTS INC
PO BOX 3 WILTON LIBRARY
WILTON
,
CT
06897
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
5,000
WILTON LIBRARY ASSOCIATION
137 OLD RIDGEFIELD RD
WILTON
,
CT
06897
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
5,000
LAO ASIAN COMMUNITY SERVICES OF GEORGIA
PO BOX 491583
LAWRENCEVILLE
,
GA
30049
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATIONCHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
500
LANIER TECHNICAL COLLEGE FOUNDATION
2535 LANIER TECH DRIVE
GAINESVILLE
,
GA
30507
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
1,000
HAPPY FEAT FOUINDATION INC
320 TOWN CENTER AVE STE 311
SUWANEE
,
GA
30024
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
1,000
THE BULLOCK CHAPEL INC
UNIVERSITY YACHT CLUB
FLOWERY BRANCH
,
GA
30542
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
1,000
LAWRENCEVILLE POLICE BENEVOLENCE
PO BOX 2200
LAWRENCEVILLE
,
GA
30046
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
5,000
GEORGE WALTON ACADEMY
ONE BULLDOG DRIVE
MONROE
,
GA
30655
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
25,000
WILTON HISTORICAL SOCIETY
224 DANBURY ROAD
WILTON
,
CT
06897
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
2,500
ROBERTS ELEMENTARY PTO
251 BUFORD HWY
SUWANEE
,
GA
30024
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
2,000
FRIENDS OF AMBLER FARMS
PO BOX 7442
WILTON
,
CT
06897
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
2,500
SEGS4VETS
500 FOX RIDGE RD
SAINT LOUIS
,
MO
63131
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
5,000
PI KAPPA DELTA FOUNDATION
8347 WEST RANGE COVE
MEMPHIS
,
TN
38125
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
1,000
FRIENDS OF HALL COUNTY LIBRARY SYSTEM
100 BRENAU AVE
GAINESVILLE
,
GA
30501
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
1,500
BOWLING GREEN STATE UNIVERSITY FOUNDATION INC
BOWLING GREEN STATE UNIV
BOWLING GREEN
,
OH
43403
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
1,000
MAKE A WISH
1775 THE EXCHANGE SE STE 200
ATLANTA
,
GA
30339
NONE
N/A
CHARITABLE CONTRIBUTION TO PUBLICLY SUPPORTED 501(C)(3) ORGANIZATION
2,000
Total
.................................
3a
230,600
b
Approved for future payment
Total
.................................
3b
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
12
Part XVI-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
Unrelated business income
Excluded by section 512, 513, or 514
(e)
Related or exempt
function income
(See instructions.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
29,321
4
Dividends and interest from securities
....
56,401
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
............
69,897
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
0
155,619
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
155,619
(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.)
3
INVESTMENT INCOME-INTEREST(AVAILABLE FOR CHARITABLE DONATIONS)
4
INVESTMENT INCOME-DIVIDENDS(AVAILABLE FOR CHARITABLE DONATIONS)
8
INVESTMENT INCOME-CAPITAL GAINS(AVAILABLE FOR CHARITABLE DONATIONS)
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