-
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
SUSAN R AND JOHN W SULLIVAN FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)
411 SE OSCEOLA STREET SUITE 201
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
STUART
,
FL
349943008
A Employer identification number
22-2612047
B
Telephone number (see instructions)
(772) 283-3838
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)
$
6,177,340
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
...
122,429
122,429
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
132,455
b
Gross sales price for all assets on line 6a
1,136,881
7
Capital gain net income (from Part IV, line 2)
...
132,455
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)
.......
29,031
4,289
12
Total.
Add lines 1 through 11
........
283,915
259,173
13
Compensation of officers, directors, trustees, etc.
80,000
40,000
40,000
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
15,795
7,898
7,897
c
Other professional fees (attach schedule)
....
17
Interest
...............
142
0
0
18
Taxes (attach schedule) (see instructions)
...
9,928
4,432
2,547
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
24,880
12,440
12,440
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
30,037
29,823
214
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
160,782
94,593
63,098
25
Contributions, gifts, grants paid
.......
451,000
451,000
26
Total expenses and disbursements.
Add lines 24 and 25
611,782
94,593
514,098
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-327,867
b
Net investment income
(if negative, enter -0-)
164,580
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
.............
76,169
93,706
93,706
2
Savings and temporary cash investments
.........
275,033
226,389
226,389
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)
Less: allowance for doubtful accounts
8
Inventories for sale or use
..............
9
Prepaid expenses and deferred charges
..........
10a
Investments—U.S. and state government obligations (attach schedule)
200,909
297,501
303,329
b
Investments—corporate stock (attach schedule)
.......
c
Investments—corporate bonds (attach schedule)
.......
271,386
183,995
191,553
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
5,102,112
4,804,362
5,362,363
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)
5,925,609
5,605,953
6,177,340
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
)
16,453
24,664
23
Total liabilities
(add lines 17 through 22)
.........
16,453
24,664
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
........
5,909,156
5,581,289
27
Paid-in or capital surplus, or land, bldg., and equipment fund
0
0
28
Retained earnings, accumulated income, endowment, or other funds
0
0
29
Total net assets or fund balances
(see instructions)
.....
5,909,156
5,581,289
30
Total liabilities and net assets/fund balances
(see instructions)
.
5,925,609
5,605,953
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
5,909,156
2
Enter amount from Part I, line 27a
.....................
2
-327,867
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
5,581,289
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
5,581,289
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
12000 SHS DUPONT DE NEMOU 4.205%23 DUE 11/15/23
2019-03-26
2019-12-17
b
5000 SHS US TREASUR NT 1%11/19 UST NOTE DUE 11/15/19
2019-03-11
2019-11-06
c
15000 SHS US TREASUR NT 1%11/19 US T NOTE DUE 11/15/19
2018-12-21
2019-11-06
d
10000 SHS UST INFL IDX 0.25%07/29 INFL INDEX DUE 07/15/29
2019-08-08
2019-10-22
e
9000 SHS GENERAL MOTORS F 3.45%22 DUE 01/14/22
2018-08-03
2019-10-22
3000 SHS GENERAL MOTORS F 3.45%22 DUE 01/14/22
2018-08-03
2019-10-18
15000 SHS EXELON GENERATION 5.2%19 DUE 10/01/19
2017-08-16
2019-10-01
13000 SHS CVS HEALTH CORP 4.1%25 DUE 03/25/25
2018-03-14
2019-09-20
15000 SHS DUKE ENERGY CORP 5.05%19 DUE 09/15/19
2017-08-21
2019-09-15
5000 SHS US TREASUR NT 1%11/19 UST NOTE DUE 11/15/19
2018-12-21
2019-08-08
17000 SHS US TREASUR NT 2%08/25 UST NOTE DUE 08/15/25
2017-08-10
2019-08-08
15000 SHS HUNTINGTON BANCS 3.15%21 DUE 03/14/21
2017-08-11
2019-05-10
3000 SHS THE GOLDMAN SACHS VAR 25 DUE 09/29/25
2017-11-03
2019-04-05
12000 SHS CAPITAL ONE FINL 3.05%22 DUE 03/09/22
2017-08-11
2019-03-26
3000 SHS CAPITAL ONE FINL 3.05%22 DUE 03/09/22
2017-08-11
2019-03-22
4000 SHS ROYAL CARIBBEAN 5.25%22F DUE 11/15/22
2017-08-25
2019-03-18
5000 SHS UST INFL IDX 0.125%07/26 INFL INDEX DUE 07/15/26
2018-02-14
2019-03-11
15000 SHS WELLTOWER INC. 4.125%19 **CALLED** @100 EFF: 03/18/2019
2017-08-11
2019-03-11
9000 SHS UST INFL IDX 0.125%07/26 INFL INDEX DUE 07/15/26
2019-01-30
2019-03-11
10000 SHS UST INFL IDX 0.125%07/26 INFL INDEX DUE 07/15/26
2017-08-10
2019-03-11
6000 SHS E*TRADE FINL COR 2.95%22 DUE 08/24/22
2017-08-16
2019-03-01
3000 SHS AT&T INC. 4.125%26 DUE 02/17/26
2017-09-22
2019-02-26
3000 SHS ROPER TECHNOLOGIE 3.8%26 DUE 12/15/26
2017-12-05
2019-02-25
3000 SHS KINDER MORGAN EN 4.25%24 DUE 09/01/24
2017-08-11
2019-02-13
10000 SHS US TREASUR NT 1%11/19 US T NOTE DUE 11/15/19
2018-08-27
2019-02-06
5000 SHS US TREASUR NT 1%11/19 UST NOTE DUE 11/15/19
2018-11-20
2019-02-06
5000 SHS US TREASUR NT 1%11/19 UST NOTE DUE 11/15/19
2018-08-27
2019-01-30
5000 SHS US TREASUR NT 2%11/26 UST NOTE DUE 11/15/26
2017-08-10
2019-01-30
12000 SHS JPMORGAN CHASE & VAR 23 DUE 04/25/23
2018-04-11
2019-01-17
12000 SHS BANK OF AMERICA C VAR 24 DUE 03/05/24
2018-04-11
2019-01-10
1174.347 SHS FPA CRESCENT FUND INST CL SHARES
2014-10-02
2019-11-19
2768.45 SHS BLACKROCK MULTI ASSET INCM PORT INST
2015-11-23
2019-11-19
133.698 SHS VANGUARD EQUITY INCOME FD ADMIRAL SHRS
2014-08-12
2019-09-04
1027.742 SHS DODGE & COX INTL STOCK FUND
2014-08-12
2019-09-03
1879.286 SHS HARDING LOEVNER INTL EQTY PORT INST
2017-11-09
2019-09-03
1665.335 SHS VANGUARD DIV GROWTH FD INVESTOR SHRS
2014-12-22
2019-07-24
416.563 SHS T ROWE PRICE BLUE CHIP GROWTH FD INV
2014-08-12
2019-07-23
860.896 SHS DIAMOND HILL LONG SHORT FUND CL I
2018-12-28
2019-05-07
9430.598 SHS DIAMOND HILL LONG SHORT FUND CL I
2014-12-22
2019-05-07
457.613 SHS VANGUARD EQUITY INCOME FD ADMIRAL SHRS
2014-08-12
2019-01-30
522.466 SHS T ROWE PRICE BLUE CHIP GROWTH FD INV
2014-08-12
2019-01-30
867.764 SHS VANGUARD TOTAL STOCK MKT INDEX FD ADMIRAL SHARE
2014-08-20
2019-01-30
14300.286 SHS VANGUARD SHORT TERM INVESTMENT GRADE FUND ADMIRAL
2014-12-17
2019-01-30
WH AEM FUND LIQUIDATING TRUST - DISTRIBUTIONS IN EXCESS OF BASIS
P
2019-08-31
CREDIT SUISSE/KATZ FAIR FUND DISTRIBUTION
P
2019-03-15
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
12,803
12,491
312
b
4,996
4,996
0
c
14,989
14,989
0
d
10,107
10,177
-70
e
9,156
8,934
222
3,048
2,978
70
15,000
15,000
0
13,815
13,012
803
15,000
15,000
0
4,974
4,974
0
17,381
16,863
518
15,089
15,233
-144
2,953
3,000
-47
12,039
12,119
-80
2,997
3,030
-33
4,238
4,326
-88
5,059
5,031
28
14,991
15,016
-25
9,106
8,961
145
10,117
10,319
-202
5,874
6,018
-144
3,002
3,076
-74
2,953
3,092
-139
3,060
3,088
-28
9,875
9,875
0
4,938
4,938
0
4,926
4,926
0
4,755
4,923
-168
11,869
12,082
-213
11,693
11,973
-280
40,000
39,575
425
30,000
29,567
433
10,000
8,633
1,367
40,000
46,824
-6,824
40,000
42,661
-2,661
50,000
38,919
11,081
50,000
27,718
22,282
22,899
20,000
2,899
250,845
230,012
20,833
32,000
29,548
2,452
55,000
34,765
20,235
58,000
43,466
14,534
150,000
152,298
-2,298
3,380
3,380
4,586
4,586
39,368
39,368
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
312
b
0
c
0
d
-70
e
222
70
0
803
0
0
518
-144
-47
-80
-33
-88
28
-25
145
-202
-144
-74
-139
-28
0
0
0
-168
-213
-280
425
433
1,367
-6,824
-2,661
11,081
22,282
2,899
20,833
2,452
20,235
14,534
-2,298
3,380
4,586
39,368
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
132,455
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
438,336
6,109,088
0.071751
2017
432,369
6,035,378
0.071639
2016
245,281
6,009,292
0.040817
2015
441,318
6,413,620
0.068810
2014
466,451
6,728,855
0.069321
2
Total
of line 1, column (d)
.....................
2
0.322338
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
0.064468
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
5,857,839
5
Multiply line 4 by line 3
......................
5
377,643
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
1,646
7
Add lines 5 and 6
........................
7
379,289
8
Enter qualifying distributions from Part XII, line 4
,.............
8
514,098
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See the Part VI instructions.
Form
990-PF
(2019)
Form 990-PF (2019)
Page
4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a
Exempt operating foundations described in section 4940(d)(2), check here
and enter “N/A" on line 1.
Date of ruling or determination letter:
(attach copy of letter if necessary–see instructions)
b
Domestic foundations that meet the section 4940(e) requirements in Part V, check
1
1,646
here
and enter 1% of Part I, line 27b
...................
c
All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
2
0
3
Add lines 1 and 2
...........................
3
1,646
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
4
0
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
1,646
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
4,362
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
4,362
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
2,716
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
2,716
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
Yes
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
Yes
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
N/A
14
The books are in care of
SUSAN R SULLIVAN
Telephone no.
(772) 283-3838
Located at
411 SE OSCEOLA STREET SUITE 201
STUART
FL
ZIP+4
349943008
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1)
Engage in the sale or exchange, or leasing of property with a disqualified person?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(5)
Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)?
...............
Yes
No
(6)
Agree to pay money or property to a government official? (
Exception.
Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.)
.......
Yes
No
b
If any answer is "Yes" to 1a(1)–(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions
........
1b
No
Organizations relying on a current notice regarding disaster assistance check here
........
c
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2019?
.............
1c
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2019, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2019?
.............
Yes
No
If "Yes," list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer "No" and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
......................
Yes
No
b
If "Yes," did it have excess business holdings in 2019 as a result of
(1)
any purchase by the foundation
or disqualified persons after May 26, 1969;
(2)
the lapse of the 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or
(3)
the lapse of the 10-, 15-, or 20-year first phase holding period?
(Use Schedule C, Form 4720, to determine
if the foundation had excess business holdings in 2019.)
..................
3b
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2019?
4b
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
6
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
(continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
No
b
If any answer is "Yes" to 5a(1)–(5), did
any
of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions
......
5b
Organizations relying on a current notice regarding disaster assistance check here
.........
c
If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant?
..........
Yes
No
If "Yes," attach the statement required by Regulations section 53.4945–5(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract?
.....................
Yes
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
....
6b
No
If "Yes" to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
Yes
No
b
If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction?
....
7b
8
Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment during the year?
.................
Yes
No
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1
List all officers, directors, trustees, foundation managers and their compensation. See instructions
(a)
Name and address
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(If not paid, enter
-0-)
(d)
Contributions to employee benefit plans and deferred compensation
(e)
Expense account,
other allowances
SUSAN R SULLIVAN
PRESIDENT/DIRECTOR
8.00
30,000
0
0
411 SE OSCEOLA STREET SUITE 201
STUART
,
FL
349943008
LISA E CHIAVETTA
SECRETARY
15.00
35,000
0
0
411 SE OSCEOLA STREET SUITE 201
STUART
,
FL
349943008
WILLIAM C FOWLER
TREASURER
2.00
0
0
0
411 SE OSCEOLA STREET SUITE 201
STUART
,
FL
349943008
JENNIFER S MCKAY
DIRECTOR
1.00
3,000
0
0
411 SE OSCEOLA STREET SUITE 201
STUART
,
FL
349943008
GIERIET S BOWEN
DIRECTOR
1.00
3,000
0
0
411 SE OSCEOLA STREET SUITE 201
STUART
,
FL
349943008
JOHN W SULLIVAN JR
DIRECTOR
1.00
3,000
0
0
411 SE OSCEOLA STREET SUITE 201
STUART
,
FL
349943008
J BOLTON SULLIVAN II
DIRECTOR
1.00
3,000
0
0
411 SE OSCEOLA STREET SUITE 201
STUART
,
FL
349943008
KATHLEEN B SULLIVAN
DIRECTOR
1.00
3,000
0
0
411 SE OSCEOLA STREET SUITE 201
STUART
,
FL
349943008
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
.........................
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
5,077,374
b
Average of monthly cash balances
.......................
1b
109,080
c
Fair market value of all other assets (see instructions)
................
1c
760,591
d
Total
(add lines 1a, b, and c)
.........................
1d
5,947,045
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
5,947,045
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
89,206
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
5,857,839
6
Minimum investment return.
Enter 5% of line 5
..................
6
292,892
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
292,892
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
1,646
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
4,831
c
Add lines 2a and 2b
............................
2c
6,477
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
286,415
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
286,415
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
286,415
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
514,098
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
514,098
5
Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
income. Enter 1% of Part I, line 27b. See instructions
.................
5
1,646
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
512,452
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
286,415
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
......
156,418
b
From 2015
......
122,629
c
From 2016
......
d
From 2017
......
197,053
e
From 2018
......
138,496
f
Total
of lines 3a through e
........
614,596
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
514,098
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
.....
286,415
e
Remaining amount distributed out of corpus
227,683
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
842,279
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)
...
156,418
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
685,861
10
Analysis of line 9:
a
Excess from 2015
....
122,629
b
Excess from 2016
....
c
Excess from 2017
....
197,053
d
Excess from 2018
....
138,496
e
Excess from 2019
....
227,683
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).)
SUSAN R SULLIVAN
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 e-mail address of the person to whom applications should be addressed:
SUSAN R SULLIVAN PRESIDENTDIRECTOR
411 SE OSCEOLA STREET SUITE 201
STUART
,
FL
349943008
(772) 283-3838
b
The form in which applications should be submitted and information and materials they should include:
SEND PRINTED MATERIALS REGARDING CHARITABLE ORGANIZATION ALONG WITH CURRENT FINANCIAL STATEMENTS.
c
Any submission deadlines:
NOVEMBER 15TH OF EACH YEAR.
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
NONE.
Form
990-PF
(2019)
Form 990-PF (2019)
Page
11
Part XV
Supplementary Information
(continued)
3
Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
AMERICAN RED CROSS
2750 SOUTH KANNER HIGHWAY
STUART
,
FL
34994
NONE.
PUBLIC CHARITY
DISASTER RELIEF
5,000
ARCHDIOCESE OF CHICAGO - TO TEACH WHO CHRIST IS
PO BOX 7256
KENSINGTON
,
CT
060377256
NONE.
PUBLIC CHARITY
RELIGIOUS SUPPORT
5,000
ARRUPE COLLEGE OF LOYOLA UNIVERSITY CHICAGO
820 NORTH MICHIGAN AVENUE
CHICAGO
,
IL
60611
NONE.
PUBLIC CHARITY
EDUCATIONAL SUPPORT
19,500
BANNER LAKE CLUB INC - BLAST PROGRAM
12212 SE LANTANA AVE
HOBE SOUND
,
FL
33455
NONE.
PUBLIC CHARITY
EDUCATIONAL SUPPORT
500
BOYS AND GIRLS CLUB OF MARTIN COUNTY
11500 SE LARES AVENUE
HOBE SOUND
,
FL
33475
NONE.
PUBLIC CHARITY
EDUCATIONAL SUPPORT
6,000
BRAIN CHEMISTRY LABS
PO BOX 3464
JACKSON
,
WY
83001
NONE.
FOUNDATION
MEDICAL RESEARCH
2,000
BYERSCHOOL FOUNDATION
1926 ARCH STREET SUITE 3F
PHILADELPHIA
,
PA
19103
NONE.
FOUNDATION
EDUCATIONAL SUPPORT
2,000
COLLEGE OF THE HOLY CROSS
1 COLLEGE STREET
WORCESTER
,
MA
01610
NONE.
PUBLIC CHARITY
EDUCATIONAL SUPPORT
12,500
COUNCIL ON AGING OF MARTIN COUNTY INC
900 SE SALERNO ROAD
STUART
,
FL
34997
NONE.
PUBLIC CHARITY
SUPPORT FOR THE AGING
6,000
CRISTO REY NETWORK
11 EAST ADAMS STREET SUITE 800
CHICAGO
,
IL
60603
NONE.
PUBLIC CHARITY
EDUCATIONAL SUPPORT
2,000
DIOCESE OF PALM BEACH - DIOCESAN SERVICES APPEAL
9995 NORTH MILITARY TRAIL
PALM BEACH GARDENS
,
FL
33410
NONE.
PUBLIC CHARITY
RELIGIOUS SUPPORT
1,000
EVERGLADES FOUNDATION
18001 OLD CUTLER ROAD SUITE 625
PALMETTO BAY
,
FL
33157
NONE.
FOUNDATION
EVNIRONMENTAL SUPPORT
5,000
FENIX FAMILY HEALTH CENTER INC
130 WASHINGTON AVENUE
HIGHWOOD
,
IL
60040
NONE.
PUBLIC CHARITY
HEALTH CARE
10,000
FLORIDA ATLANTIC UNIVERSITY LIFE LONG LEARNING
5353 PARKSIDE DRIVE PA134
JUPITER
,
FL
334589972
NONE.
PUBLIC CHARITY
EDUCATIONAL SUPPORT
1,000
FLORIDA OCEANOGRAPHIC SOCIETY
890 NE OCEAN BLVD
STUART
,
FL
34996
NONE.
PUBLIC CHARITY
ENVIRONMENTAL SUPPORT
10,000
FRED HUTCHINSON CANCER RESEARCH CENTER
1100 FAIRVIEW AVENUE N
SEATTLE
,
WA
98109
NONE.
PUBLIC CHARITY
CANCER RESEARCH
3,000
GEORGETOWN UNIVERSITY
2115 WISCONSIN AVENUE NW 500
WASHINGTON
,
DC
20007
NONE.
PUBLIC CHARITY
EDUCATIONAL SUPPORT
14,000
HABITAT FOR HUMANITY OF MARTIN COUNTY INC
2555 SE BONITA STREET
STUART
,
FL
34997
NONE.
PUBLIC CHARITY
HOUSING FOR LOW INCOME FAMILIES
3,000
HABITAT FOR HUMANITY OF PUERTO RICO
1357 AVENIDA ASHFORD PMB 135
SAN JUAN
,
PR
009071400
NONE.
PUBLIC CHARITY
HURRICANE RECOVERY
5,000
HADJI SHRINERS
800 WEST NINE MILE ROAD
PENSACOLA
,
FL
32534
NONE.
PUBLIC CHARITY
ASSIST WITH TRANSPORTATION NEEDS FOR THE SHRINERS HOSPITAL
1,000
HELPING PEOPLE SUCCEED
1601 NE BRAILLE PLACE
JENSEN BEACH
,
FL
34957
NONE.
PUBLIC CHARITY
EDUCATIONAL SUPPORT
2,000
HOBE SOUND COMMUNITY CHEST
PO BOX 511
HOBE SOUND
,
FL
33475
NONE.
PUBLIC CHARITY
SUPPORT FOR THE HOMELESS AND HUNGRY
12,500
HOBE SOUND FINE ARTS LEAGUE
8879 SE BRIDGE ROAD
HOBE SOUND
,
FL
33455
NONE.
PUBLIC CHARITY
SUPPLY ART SUPPLIES FOR PUBLIC SCHOOLS
1,000
HOBE SOUND NATURE CENTER
PO BOX 214
HOBE SOUND
,
FL
33475
NONE.
PUBLIC CHARITY
ENVIRONMENTAL SUPPORT
4,000
HOPE RURAL SCHOOL
15929 SW 150TH STREET
INDIANTOWN
,
FL
34956
NONE.
PUBLIC CHARITY
EDUCATIONAL SUPPORT
1,000
HOUSE OF HOPE
2484 SE BONITA STREET
STUART
,
FL
34997
NONE.
PUBLIC CHARITY
AID THE HOMELESS AND HUNGRY
10,000
INDIAN HILL CLUB SCHOLARSHIP FOUNDATION
1 INDIAN HILL ROAD
WINNETKA
,
IL
60093
NONE.
FOUNDATION
EDUCATIONAL SUPPORT
1,000
JESUIT REFUGEE SERVICEUSA
1627 K ST NW SUITE 1100
WASHINGTON
,
DC
20036
NONE.
PUBLIC CHARITY
AID FOR INTERNATIONAL REFUGEES
3,000
JUPITER MEDICAL CENTER FOUNDATION
1210 S OLD DIXIE HIGHWAY
JUPITER
,
FL
334589972
NONE.
FOUNDATION
HEALTH CARE SUPPORT
1,000
KELLOGG GRADUATE SCHOOL OF MGMT
2020 RIDGE AVENUE 230
EVANSTON
,
IL
60201
NONE.
PUBLIC CHARITY
EDUCATIONAL SUPPORT
5,000
LAWRENCEVILLE SCHOOL
PO BOX 6125
LAWRENCEVILLE
,
NJ
086489987
NONE.
PUBLIC CHARITY
EDUCATIONAL SUPPORT
3,000
LIGHT OF THE WORLD CHARITIES
1300 EAST 10TH STREET SUITE B
STUART
,
FL
34996
NONE.
PUBLIC CHARITY
MEDICAL SUPPORT
500
LOBLOLLY COMMUNITY FOUNDATION INC
7407 SE HILL TERRACE
HOBE SOUND
,
FL
33455
NONE.
FOUNDATION
EDUCATIONAL AND HEALTH CARE SUPPORT
12,700
MISS INC (MOTHERS AND INFANTS STRIVING FOR SUCCESS INC)
4434 SE CLECKLEY WAY
STUART
,
FL
34997
NONE.
PUBLIC CHARITY
AID TO THE HOMELESS
15,000
MALTZ JUPITER THEATRE
1001 EAST INDIANTOWN ROAD
JUPITER
,
FL
33477
NONE.
PUBLIC CHARITY
SUPPORT FOR THE ARTS
3,000
MANHATTANVILLE COLLEGE
2900 PURCHASE STREET
PURCHASE
,
NY
10577
NONE.
PUBLIC CHARITY
EDUCATIONAL SUPPORT
5,000
MARTIN HEALTH FOUNDATION
PO BOX 9010
STUART
,
FL
349952020
NONE.
FOUNDATION
HEALTH CARE SUPPORT
100,000
MAYO CLINIC
200 FIRST STREET SW
ROCHESTER
,
MN
55905
NONE.
PUBLIC CHARITY
HEALTH CARE SUPPORT
1,000
MEDICAL UNIVERSITY OF SOUTH CAROLINA HOLLINGS CANCER CENTER
86 JONATHAN LUCAS STREET MSC 955
CHARLESTON
,
SC
29425
NONE.
PUBLIC CHARITY
CANCER RESEARCH
20,000
MEPKIN ABBEY
1098 MEPKIN ABBEY ROAD
MONCKS CORNER
,
SC
29461
NONE.
PUBLIC CHARITY
RELIGIOUS SUPPORT
2,500
MERCER ISLAND SCHOOL FOUNDATION
PO BOX 1243
MERCER ISLAND
,
WA
98040
NONE.
FOUNDATION
EDUCATIONAL SUPPORT
8,000
NASAREANORG
112 S MAIN STREET 181
STOWE
,
VT
05672
NONE.
PUBLIC CHARITY
REFUGEE SUPPORT
2,500
NORTHERN VIRGINIA EMERGENCY MEDICAL SERVICES COUNCIL INC
7250 HERITAGE VILLAGE PLAZA SUITE
102
GAINESVILLE
,
VA
20155
NONE.
PUBLIC CHARITY
ASHES2ART PROGRAM FOR FIRST RESPONDERS
20,000
ONE80 PLACE
PO BOX 20038
CHARLESTON
,
SC
29413
NONE.
PUBLIC CHARITY
AID THE HOMELESS AND HUNGRY
10,000
PAN MASS CHALLENGE
77 4TH AVENUE
NEEDHAM
,
MA
02494
NONE.
PUBLIC CHARITY
CANCER RESEARCH
5,000
PART OF THE SOLUTION
2759 WEBSTER AVENUE
BRONX
,
NY
104583708
NONE.
PUBLIC CHARITY
SUPPORT FOR THE HOMELESS AND HUNGRY
250
RED DE FUNDACIONES DE PUERTO RICO INC
167 AVENIDA PONCE DE LEON ESQ
QUISQUEYA
SAN JUAN
,
PR
00917
NONE.
FOUNDATION
HURRICANE RECOVERY
5,000
REDEEMER LUTHERAN CHURCH
2450 SE OCEAN BLVD
STUART
,
FL
34996
NONE.
PUBLIC CHARITY
AID TO THE HOMELESS AND HUNGRY
5,000
RIVERS COALITION INC
PO BOX 2627
STUART
,
FL
34995
NONE.
PUBLIC CHARITY
ENVIRONMENTAL SUPPORT
1,000
SALVATION ARMY
821 SE MARTIN LUTHER KING JR BLVD
STUART
,
FL
34994
NONE.
PUBLIC CHARITY
AID TO THE HOMELESS AND HUNGRY
10,000
SHADDAI SHRINERS
1101 WEST 19TH STREET
PANAMA CITY
,
FL
32405
NONE.
PUBLIC CHARITY
ASSIST WITH TRANSPORTATION NEEDS FOR THE SHRINERS HOSPITAL
3,000
SHRINERS HOSPITALS - AMARA SHRINE CENTER
2900 ROCKY POINT DR
TAMPA
,
FL
33607
NONE.
PUBLIC CHARITY
ASSIST WITH TRANSPORTATION NEEDS FOR THE SHRINERS HOSPITAL
1,000
SPACE NEEDLE FOUNDATION
223 TAYLOR AVENUE N SUITE 100
SEATTLE
,
WA
98109
NONE.
FOUNDATION
CANCER RESEARCH
5,000
ST CHRISTOPHER CHURCH
12001 SE FEDERAL HIGHWAY
HOBE SOUND
,
FL
33455
NONE.
PUBLIC CHARITY
RELIGIOUS SUPPORT
10,000
ST VINCENT DE PAUL SOCIETY
12001 SE FEDERAL HIGHWAY
HOBE SOUND
,
FL
33455
NONE.
PUBLIC CHARITY
RELIGIOUS SUPPORT
5,000
THE BENJAMIN SCHOOL
11000 ELLISON WILSON ROAD
NORTH PALM BEACH
,
FL
33408
NONE.
PUBLIC CHARITY
EDUCATIONAL SUPPORT
5,000
THE WISTAR INSTITUTE
3601 SPRUCE STREET
PHILADELPHIA
,
PA
19104
NONE.
PUBLIC CHARITY
CANCER RESEARCH
1,000
TREASURE COAST HOSPICE FOUNDATION
1201 SE INDIAN STREET
STUART
,
FL
34997
NONE.
FOUNDATION
MEDICAL CARE AND SUPPORT
3,000
UNITED WAY OF MARTIN COUNTY
PO BOX 362
STUART
,
FL
34995
NONE.
PUBLIC CHARITY
COMMUNITY-WIDE SUPPORT FOR HOMELESS, HUNGRY & HEALTH CARE
15,000
UNIVERSITY OF THE ARTS
320 SOUTH BROAD STREET
PHILADELPHIA
,
PA
19102
NONE.
FOUNDATION
EDUCATIONAL SUPPORT
300
UNIVERSTIY OF CHICAGO MEDICAL CENTER-CPCI
130 EAST RANDOLPH STREET 1400
CHICAGO
,
IL
60601
NONE.
PUBLIC CHARITY
CANCER RESEARCH
1,000
VISITING NURSE FOUNDATION
2400 SE MONTEREY ROAD 300
STUART
,
FL
34996
NONE.
FOUNDATION
HEALTH CARE SUPPORT
2,250
VOLUNTEERS IN MEDICINE
417 SE BALBOA AVENUE
STUART
,
FL
349942327
NONE.
PUBLIC CHARITY
HEALTH CARE SUPPORT
3,500
WATER MISSION
PO BOX 71489
N CHARLESTON
,
SC
29415
NONE.
PUBLIC CHARITY
SUPPORT INTERNATIONAL HEALTH CARE
12,500
Total
.................................
3a
451,000
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
...........
4
Dividends and interest from securities
....
14
122,429
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
.....
531120
24,742
14
4,289
8
Gain or (loss) from sales of assets other than
inventory
............
18
132,455
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)
..
24,742
259,173
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
283,915
(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