-
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 ENSIGN-BICKFORD FOUNDATION INC
Number and street (or P.O. box number if mail is not delivered to street address)
999 17TH STREET SUITE 900
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
DENVER
,
CO
80202
A Employer identification number
06-6041097
B
Telephone number (see instructions)
(303) 583-1345
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)
$
4,257,801
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)
1,000,000
2
Check
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
64,922
64,922
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
b
Gross sales price for all assets on line 6a
7
Capital gain net income (from Part IV, line 2)
...
0
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
........
1,064,922
64,922
0
13
Compensation of officers, directors, trustees, etc.
0
0
0
0
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
c
Other professional fees (attach schedule)
....
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)
.......
60,260
0
0
0
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
60,260
0
0
0
25
Contributions, gifts, grants paid
.......
404,120
404,120
26
Total expenses and disbursements.
Add lines 24 and 25
464,380
0
0
404,120
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
600,542
b
Net investment income
(if negative, enter -0-)
64,922
c
Adjusted net income
(if negative, enter -0-)
...
0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2019)
Form 990-PF (2019)
Page
2
Part II
Balance Sheets
Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year
End of year
(a)
Book Value
(b)
Book Value
(c)
Fair Market Value
1
Cash—non-interest-bearing
.............
140,124
115,744
115,744
2
Savings and temporary cash investments
.........
683,316
454,859
454,859
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)
b
Investments—corporate stock (attach schedule)
.......
2,196,324
3,687,198
3,687,198
c
Investments—corporate bonds (attach schedule)
.......
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)
3,019,764
4,257,801
4,257,801
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
...........
3,019,764
4,257,801
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)
.....
3,019,764
4,257,801
30
Total liabilities and net assets/fund balances
(see instructions)
.
3,019,764
4,257,801
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
3,019,764
2
Enter amount from Part I, line 27a
.....................
2
600,542
3
Other increases not included in line 2 (itemize)
3
637,495
4
Add lines 1, 2, and 3
..........................
4
4,257,801
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
4,257,801
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.)
1a
b
c
d
e
(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
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-)
or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
Excess of col. (i)
over col. (j), if any
a
b
c
d
e
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
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
305,399
2,963,248
0.103062
2017
292,071
3,415,198
0.085521
2016
162,721
1,189,615
0.136785
2015
189,525
46,932
4.038289
2014
303,114
27,647
10.963721
2
Total
of line 1, column (d)
.....................
2
15.327378
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
3.065476
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
4,203,751
5
Multiply line 4 by line 3
......................
5
12,886,498
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
649
7
Add lines 5 and 6
........................
7
12,887,147
8
Enter qualifying distributions from Part XII, line 4
,.............
8
404,120
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
1,298
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
1,298
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
1,298
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
1,828
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
500
d
Backup withholding erroneously withheld
...........
6d
0
7
Total credits and payments. Add lines 6a through 6d
..............
7
2,328
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
2
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
1,028
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
1,028
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
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)
CT
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
Yes
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.E-BFOUNDATION.COM
14
The books are in care of
LISA CASTILLO
Telephone no.
(303) 583-1345
Located at
999 17TH STREET SUITE 900
DENVER
CO
ZIP+4
80202
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
JOSEPH E LOVEJOY
CHAIRMAN
0.20
0
0
0
999 17TH STREET SUITE 900
DENVER
,
CO
80202
THOMAS J PERLITZ
OFFICER
0.20
0
0
0
999 17TH STREET SUITE 900
DENVER
,
CO
80202
JARED LOZO
DIRECTOR
0.20
0
0
0
999 17TH STREET SUITE 900
DENVER
,
CO
80202
DOROTHY HAMMETT
OFFICER
0.20
0
0
0
999 17TH STREET SUITE 900
DENVER
,
CO
80202
BRENDAN M WALSH
OFFICER
0.20
0
0
0
999 17TH STREET SUITE 900
DENVER
,
CO
80202
WILLIAM M WELCH
OFFICER
0.20
0
0
0
999 17TH STREET SUITE 900
DENVER
,
CO
80202
DAVID DEMEO
OFFICER
0.20
0
0
0
999 17TH STREET SUITE 900
DENVER
,
CO
80202
KELLY FRAUENKNECHT
OFFICER
0.20
0
0
0
999 17TH STREET SUITE 900
DENVER
,
CO
80202
BRENDAN KEHOE
OFFICER
0.20
0
0
0
999 17TH STREET SUITE 900
DENVER
,
CO
80202
CAMERON MOYER
OFFICER
0.20
0
0
0
999 17TH STREET SUITE 900
DENVER
,
CO
80202
CHAD THOMPSON
OFFICER
0.20
0
0
0
999 17TH STREET SUITE 900
DENVER
,
CO
80202
KIEL DAVIS
OFFICER
0.20
0
0
0
999 17TH STREET SUITE 900
DENVER
,
CO
80202
ANDY PLINER
OFFICER
0.20
0
0
0
999 17TH STREET SUITE 900
DENVER
,
CO
80202
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
0
b
Average of monthly cash balances
.......................
1b
125,711
c
Fair market value of all other assets (see instructions)
................
1c
4,142,057
d
Total
(add lines 1a, b, and c)
.........................
1d
4,267,768
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
4,267,768
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
64,017
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
4,203,751
6
Minimum investment return.
Enter 5% of line 5
..................
6
210,188
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
210,188
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
1,298
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
1,298
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
208,890
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
208,890
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
208,890
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
404,120
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
404,120
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
0
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
404,120
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
208,890
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
......
301,732
b
From 2015
......
187,178
c
From 2016
......
103,445
d
From 2017
......
121,912
e
From 2018
......
158,456
f
Total
of lines 3a through e
........
872,723
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
404,120
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
.....
208,890
e
Remaining amount distributed out of corpus
195,230
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
1,067,953
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)
...
301,732
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
766,221
10
Analysis of line 9:
a
Excess from 2015
....
187,178
b
Excess from 2016
....
103,445
c
Excess from 2017
....
121,912
d
Excess from 2018
....
158,456
e
Excess from 2019
....
195,230
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 e-mail address of the person to whom applications should be addressed:
DI RIVERA
999 17TH STREET SUITE 900
DENVER
,
CO
80202
(303) 583-1345
b
The form in which applications should be submitted and information and materials they should include:
A LETTER STATING THE PURPOSE OF THE REQUEST, ANNUAL BUDGET, OTHER FUNDING AND GEOGRAPHIC AREA IN WHICH PROCEEDS WILL BE DISTRIBUTED.
c
Any submission deadlines:
NONE
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
ORGANIZATIONS WITHIN THE LOCAL GEOGRAPHIC AREA OF THE FOUNDATION'S CORPORATE OFFICES ARE GENERALLY SUPPORTED.
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
ALPHA KAPPA EDUCATIONAL FOUND
PO BOX 865
ROLLA
,
MO
65402
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
2,000
AMER FOUND FOR SUICIDE PREVENT
120 WALL STREET
NEW YORK
,
NY
10005
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
441
AMERICAN CANCER SOCIETY INC
825 BROOK ST-I-91 TECH CENTER
ROCKY HILL
,
CT
06067
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
500
AMERICAN CANCER SOCIETY INC
825 BROOK ST-I-91 TECH CENTER
ROCKY HILL
,
CT
06067
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
500
ASCENT SOCCER USA
1440 W ST NW
WASHINGTON
,
DC
20009
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
2,000
ASHOKA US
1700 NORTH MOORE STREET
ARLINGTON
,
VA
22209
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
500
AURORA FIRST BAPTIST CHURCH
201 S JEFFERSON
AURORA
,
MO
65605
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
5,000
AURORA MARCHING BAND
305 W PROSPECT
AURORA
,
MO
65605
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
500
AURORA MISSOURI LION'S CLUB
608 EAST KIRKWOOD DRIVE
AURORA
,
MO
65605
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
500
AURORA UNITED METHODIST
1211 S CARNATION DRIVE
AURORA
,
MO
65605
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
3,000
AVON DOLLARS FOR SCHOLARS
PO BOX 706
AVON
,
CT
06001
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
1,000
AXIA PROJECT
1719 GLEN AVE
PASADENA
,
CA
91103
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
500
BATES COLLEGE
2 ANDREWS ROAD
LEWISTON
,
ME
04240
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
125
BAYSTATE HEALTH FOUNDATION
280 CHESTNUT STREET
SPRINGFIELD
,
MA
01199
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
418
BERKELEY HIGH SCHOOL JAZZ PROGRAM
PO BOX 1027
BERKELEY
,
CA
94701
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
100
BIG CITY MOUNTAINEERS
710 10TH STREET
GOLDEN
,
CO
80401
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
933
BRYANT UNIVERSITY
1150 DOUGLAS PIKE
SMITHFIELD
,
RI
02917
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
250
CAMP MOWGLIS
PO BOX 9
HEBRON
,
NH
03241
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
1,903
CAMP MOWGLIS
PO BOX 9
HEBRON
,
NH
03241
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
2,000
CASTLEBAY LANE ELEMENTARY
19010 CASTLEBAY LANE
PORTER RANCH
,
CA
91326
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
10,000
CHRIST THE KING SCHOOL
1500 KINGSWAY DRIVE
MADISONVILLE
,
KY
42431
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
900
CLARKSON UNIVERSITY
8 CLARKSON AVENUE
POTSDAM
,
NY
13699
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
10,000
COLLGATE UNIVERSITY
13 OAK DRIVE
HAMILTON
,
NY
13346
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
2,000
CONN HUMANE SOCIETY
701 RUSSELL ROAD
NEWINGTON
,
CT
06111
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
500
CONN SCIENCE CENTER
250 COLUMBUS BLVD
HARTFORD
,
CT
06103
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
50,000
CONN WOMEN'S HALL OF FAME
320 FITCH STREET
NEW HAVEN
,
CT
06515
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
1,200
CONN WOMEN'S HALL OF FAME
320 FITCH STREET
NEW HAVEN
,
CT
06515
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
5,000
CONNECTICUT THEATRE COMPANY
23 NORDEN STREET
NEW BRITAIN
,
CT
06051
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
100
DOCTORS WITHOUT BORDERS
40 RECTOR STREET 16TH FLOOR
NEW YORK
,
NY
10006
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
500
FAMILY PROMISE NO SHORE BOSTON
PO BOX 507
BEVERLY
,
MA
01915
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
250
FARMINGTON VALLEY VNA
8 OLD MILL LANE
SIMSBURY
,
CT
06070
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
250
FIDELITY CHARITABLE GIFT FUND- ERRACE
100 CROSBY PARKWAY
COVINGTON
,
KY
41014
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
328
FIRST
200 BEDFORD STREET
MANCHESTER
,
NH
03101
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
500
FOOTHILL UNITY CENTER
790 WEST CHESTNUT AVENUE
MONROVIA
,
CA
91016
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
3,000
FOUNDATION FOR PORTLAND PUBLIC
353 CUMBERLAND AVE
PORTLAND
,
ME
04101
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
2,000
FOUNDATION FOR PORTLAND PUBLIC
353 CUMBERLAND AVE
PORTLAND
,
ME
04101
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
16,000
GIFTS OF LOVE
PO BOX 463
AVON
,
CT
06001
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
3,000
GIRLS ON THE RUN- MAINE
ONE KAREN DRIVE
WESTBROOK
,
ME
04092
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
1,000
GIRLS ON THE RUN- MAINE
ONE KAREN DRIVE
WESTBROOK
,
ME
04092
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
3,000
GOODSPEED OPERA HOUSE
PO BOX A
EAST HADDAM
,
CT
064230281
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
100
GRANBY MEMORIAL HIGH SCHOOL RO
315 SALMON BROOK ST
GRANBY
,
CT
06035
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
200
GREATER MUHLENBERG PARKS & REC
PO BOX 169
GREENVILLE
,
KY
42345
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
10,000
HALL HIGH SCHOOL PTO SAFE GRAD
975 N MAIN ST
WEST HARTFORD
,
CT
06117
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
350
HARTFORD PUBLIC LIBRARY
30 STATE HOUSE SQUARE
HARTOFRD
,
CT
06103
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
235
HARTFORD SYMPHONY ORCHESTRA
166 CAPITOL AVENUE
HARTFORD
,
CT
06106
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
1,724
HEALING MEALS FOUNDATION CORP
PO BOX 501
SIMSBURY
,
CT
06070
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
3,000
HOPKINS COUNTY BOARD OF EDUCATION
320 S SEMINARY STREET
MADISONVILLE
,
KY
42431
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
10,000
HORIZONS AT WESTMINSTER
995 HOPMEADOW STREET
SIMSBURY
,
CT
06070
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
15,000
JDRF INTERNATIONAL-MO CHAPTER
50 CRESTWOOD EXECUTIVE DRIVE
ST LOUIS
,
MO
63126
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
200
JUNIOR ACHIEVEMENT OF
70 FARMINGTON AVENUE
HARTFORD
,
CT
06105
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
5,000
JUNIOR ACHIEVEMENT OF
70 FARMINGTON AVENUE
HARTFORD
,
CT
06105
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
10,000
JUNIOR ACHIEVEMENT OF ST LOUIS INC
17339 N OUTER 40 ROAD
CHESTERFIELD
,
MO
63005
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
5,000
KEARNS COMMUNITY CENTER
239 TURKEY HILLS RD
EAST GRANBY
,
CT
06026
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
2,000
KIAWAH WOMENS' FOUNDATION
535 BUFFLEHEAD DRIVE
KIAWAH ISLAND
,
SC
29455
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
1,000
LAHEY CLINIC FOUNDATION
41 MALL ROAD
BURLINGTON
,
MA
01805
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
2,000
LIVE LIKE BECCA SCHOLARSHIP
9 GORDON STREET
MALDEN
,
MA
02148
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
300
LOAVES AND FISHES MINISTRIES
646 PROSPECT AVENUE
HARTFORD
,
CT
06105
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
200
LOAVES AND FISHES MINISTRIES
646 PROSPECT AVENUE
HARTFORD
,
CT
06105
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
500
MAIN STREET AURORA
114 WEST LOCUST
AURORA
,
MO
65605
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
9,750
MAIN STREET AURORA
114 WEST LOCUST
AURORA
,
MO
65605
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
12,500
MAINE CANCER FOUNDATION
170 US ROUTE 1
FALMOUTH
,
ME
04105
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
100
MAINE CANCER FOUNDATION
170 US ROUTE 1
FALMOUTH
,
ME
04105
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
250
MAINE ROLLER DERBY
PO BOX 8413
PORTLAND
,
ME
04104
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
500
MARTHA'S VINEYARD HOSPITAL
PO BOX 1477
OAK BLUFFS
,
MA
02557
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
150
MERCY HEALTH FOUNDATION
615 S NEW BALLAS RD
ST LOUIS
,
MO
63141
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
1,000
MERCY'S HOPE
18506 ROYAL DRIVE
WARRENTON
,
MO
63383
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
1,000
MISSOURI UNIVERSITY OF SCIENCE
1201 N STATE STREET
ROLLA
,
MO
65409
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
2,000
NATIONAL INSTITUTE OF AEROSPAC
100 EXPLORATION WAY
HAMPTON
,
VA
23666
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
5,000
NATIONAL MULTIPLE SCLEROSIS SO
733 THIRD AVENUE
NEW YORK
,
NY
10017
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
449
NCSSM FOUNDATION
PO BOX 2733
DURHAM
,
NC
277152733
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
250
NEW ENGLAND WILDLIFE CENTER
500 COLUMBIAN STREET
SOUTH WEYMOUTH
,
MA
02190
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
250
NEW ENGLAND WILDLIFE CENTER
500 COLUMBIAN STREET
SOUTH WEYMOUTH
,
MA
02190
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
250
NEW ENGLAND WILDLIFE CENTER
500 COLUMBIAN STREET
SOUTH WEYMOUTH
,
MA
02190
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
250
NEW ENGLAND WILDLIFE CENTER
500 COLUMBIAN STREET
SOUTH WEYMOUTH
,
MA
02190
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
250
NOD ROAD PRESERVATION INC
PO BOX 233
AVON
,
CT
06001
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
2,000
NORTHEAST ANIMAL SHELTER
347 HIGHLAND AVENUE
SALEM
,
MA
01970
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
125
NORTHEAST ANIMAL SHELTER
347 HIGHLAND AVENUE
SALEM
,
MA
01970
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
125
OCEAN COMMUNITY YMCA
95 HIGH STREET
WESTERLY
,
RI
02891
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
2,000
OSTERVILLE VILLAGE LIBRARY
43 WIANNO AVENUE
OSTERVILLE
,
MA
02655
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
500
OUTREACH UNITED RESOURCE CENTER INC
220 COLLYER STREET
LONGMONT
,
CO
80501
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
3,000
PAN MASS CHALLENGE
77 4TH AVENUE
NEEDHAM
,
MA
02494
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
120
PAN MASS CHALLENGE
77 4TH AVENUE
NEEDHAM
,
MA
02494
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
200
PAN MASS CHALLENGE
77 4TH AVENUE
NEEDHAM
,
MA
02494
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
890
PARADOX SPORTS
3330 ELDORADO SPRINGS
ELDORADO SPRINGS
,
CO
80025
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
263
PASADENA EDUCATIONAL
351 S HUDSON AVE RM 153
PASADENA
,
CA
91101
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
1,500
PEDIGREE FOUNDATION
2013 OVATION PARKWAY
FRANKLIN
,
TN
37067
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
2,500
PLANNED PARENTHOOD OF SO NE
345 WHITNEY AVE
NEW HAVEN
,
CT
06511
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
100
PRESIDENT AND FELLOWS OF
124 MOUNT AUBURN ST
CAMBRIDGE
,
MA
02138
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
2,000
PURDUE UNIVERSITY
403 W WOOD STREET
WEST LAFAYETTE
,
IN
479072007
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
100
PURDUE UNIVERSITY
403 W WOOD STREET
WEST LAFAYETTE
,
IN
479072007
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
225
PURDUE UNIVERSITY
403 W WOOD STREET
WEST LAFAYETTE
,
IN
479072007
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
17,500
SAINT LOUIS ZOO
1 GOVERNMENT DR
ST LOUIS
,
MO
63110
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
10,000
SAN RAFAEL HIGH SCHOOL BOOSTER
PO BOX 151203
SAN RAFAEL
,
CA
94915
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
700
SCIART EXCHANGE
4315 INDIAN SUNRISE COURT
HOUSTON
,
TX
77059
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
5,000
SIMSBURY HIGH SCHOOL
34 FARMS VILLAGE ROAD
SIMSBURY
,
CT
06070
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
10,000
SIMSBURY LAND TRUST
PO BOX 634
SIMSBURY
,
CT
060700634
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
500
SIMSBURY MEADOW PERFORMING ART
22 IRON HORSE BLVD
SIMSBURY
,
CT
06070
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
2,500
SIMSBURY VOLUNTEER AMBULANCE A
64 WEST STREET
SIMSBURY
,
CT
06070
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
100
SIMSBURY VOLUNTEER FIRE COMPANY
871 HOPMEADOW STREET
SIMSBURY
,
CT
06070
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
10,000
SINALOA MIDDLE SCHOOL PTSA
2045 VINEYARD ROAD
NOVATO
,
CA
94947
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
300
SOUTH WINDSOR HIGH SCHOOL
161 NEVERS ROAD
SOUTH WINDSOR
,
CT
06074
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
2,000
SPRINGFIELD RESCUE MISSION
10 MILL ST
SPRINGFIELD
,
MA
01102
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
100
ST LOUIS SCIENCE CENTER FOUNDATION
5050 OAKLAND AVENUE
ST LOUIS
,
MO
63110
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
10,000
ST FRANCIS FOUNDATION
95 WOODLAND STREET
HARTFORD
,
CT
061059720
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
500
ST VRAIN VALLEY EDUCATIONAL FOUNDATION
PO BOX 2598
LONGMONT
,
CO
80502
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
2,000
STEPHEN SILLER TUNNEL TO TOWER
2361 HYLAND BLVD
STATEN ISLAND
,
NY
10306
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
266
THE BUSHNELL
166 CAPITOL AVENUE
HARTFORD
,
CT
06106
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
500
THE COBB SCHOOL MONTESSORI
112 SAND HILL ROAD
SIMSBURY
,
CT
06070
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
1,000
THE MARS SOCIETY
11111 W 8TH AVE UNIT A
LAKEWOOD
,
CO
80215
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
2,500
THE SUSIE FOUNDATION
66 COOK LANE
BEACON FALLS
,
CT
06403
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
1,000
THE TELLING ROOM
225 COMMERCIAL STREET
PORTLAND
,
ME
04101
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
200
THREE BAYS PRESERVATION
PO BOX 215
OSTERVILLE
,
MA
02655
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
250
TOWN OF SIMSBURY
933 HOPMEADOW STREET
SIMSBURY
,
CT
06070
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
2,500
TOWN OF SIMSBURY
933 HOPMEADOW STREET
SIMSBURY
,
CT
06070
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
18,500
UNIVERSITY OF COLORADO FOUNDATION
1800 GRANT STREET
DENVER
,
CO
80203
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
7,000
UNIVERSITY OF CONNECTICUT
2390 ALUMNI DRIVE
STORRS
,
CT
06269
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
10,000
UNIVERSITY OF CONNECTICUT
2390 ALUMNI DRIVE
STORRS
,
CT
06269
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
10,000
UNIVERSITY OF NH FOUNDATION
9 EDGEWOOD ROAD
DURHAM
,
NH
03824
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
2,000
UNIVERSITY OF SOUTHERN
1150 S OLIVE ST
LOS ANGELS
,
CA
90015
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
3,000
WARREN COUNTY COUNCIL AGAINST
PO BOX 426
WARRENTON
,
MO
633830426
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
1,000
WEST HARTFORD EXCHANGE CLUB FOUNDATION
67 GLENBROOK ROAD
WEST HARTFORD
,
CT
06107
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
600
WHEN THE SAINTS
6614 CLAYTON ROAD
ST LOUIS
,
MO
63117
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
1,000
WOOD RANCH PTA
455 CIRCLE KNOLL DRIVE
SIMI VALLEY
,
CA
93065
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
1,500
WORCESTER POLYTECHNIC
100 INSTITUTE ROAD
WORCESTER
,
MA
01609
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
10,000
WRIGHT CITY R-II SCHOOL DISTRICT FOUND
90 BELL ROAD
WRIGHT CITY
,
MO
63390
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
10,000
YWCA OF WESTERN MASSACHUSETTS
ONE CLOUGH STREET
SPRINGFIELD
,
MA
011182213
NONE
NONPRIVATE
COMMUNITY ASSISTANCE
2,000
Total
.................................
3a
404,120
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
64,922
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
............
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
64,922
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
64,922
(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