-
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 Evelyn V McPherson Foundation Inc
John J Raymond Jr President
Number and street (or P.O. box number if mail is not delivered to street address)
251 Royal Palm Way Suite 215
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Palm Beach
,
FL
33480
A Employer identification number
41-2061167
B
Telephone number (see instructions)
(561) 659-8660
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)
$
7,184,617
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)
101,056
2
Check
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
240,461
240,461
5a
Gross rents
............
b
Net rental income or (loss)
-77,423
6a
Net gain or (loss) from sale of assets not on line 10
1,739
b
Gross sales price for all assets on line 6a
308,200
7
Capital gain net income (from Part IV, line 2)
...
1,739
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
........
343,256
242,200
13
Compensation of officers, directors, trustees, etc.
0
0
0
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
46,104
34,578
11,526
b
Accounting fees (attach schedule)
.......
5,000
3,750
1,250
c
Other professional fees (attach schedule)
....
31,313
31,313
0
17
Interest
...............
64,177
64,177
0
18
Taxes (attach schedule) (see instructions)
...
1,290
1,290
0
19
Depreciation (attach schedule) and depletion
...
40,000
40,000
20
Occupancy
..............
15,724
0
15,723
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
41,903
37,423
4,480
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
245,511
212,531
32,979
25
Contributions, gifts, grants paid
.......
314,881
314,881
26
Total expenses and disbursements.
Add lines 24 and 25
560,392
212,531
347,860
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-217,136
b
Net investment income
(if negative, enter -0-)
29,669
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
.............
22,793
66,028
66,028
2
Savings and temporary cash investments
.........
180,792
125,853
125,853
3
Accounts receivable
Less: allowance for doubtful accounts
4,375
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
..........
5,451
5,511
5,511
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
.......
1,586,229
1,450,799
2,290,997
c
Investments—corporate bonds (attach schedule)
.......
1,087,906
961,875
973,419
11
Investments—land, buildings, and equipment: basis
200,000
Less: accumulated depreciation (attach schedule)
160,000
80,000
40,000
40,000
12
Investments—mortgage loans
.............
3,030,069
3,160,242
3,160,242
13
Investments—other (attach schedule)
..........
507,490
522,567
522,567
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)
6,505,105
6,332,875
7,184,617
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
)
2,210,807
2,311,985
23
Total liabilities
(add lines 17 through 22)
.........
2,210,807
2,311,985
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
4,294,298
4,020,890
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)
.....
4,294,298
4,020,890
30
Total liabilities and net assets/fund balances
(see instructions)
.
6,505,105
6,332,875
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
4,294,298
2
Enter amount from Part I, line 27a
.....................
2
-217,136
3
Other increases not included in line 2 (itemize)
3
528
4
Add lines 1, 2, and 3
..........................
4
4,077,690
5
Decreases not included in line 2 (itemize)
5
56,800
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
4,020,890
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
50 shs Alaska Atr Group Inc
2000-12-31
2019-09-24
b
100000 shs Bank of America Corp Sr Nts
2012-03-08
2019-06-01
c
0.666 shs Corteva Inc
2000-12-31
2019-06-12
d
91 shs Corteva Inc
2000-12-31
2019-09-24
e
0.667 shs Dow Inc
2000-12-31
2019-06-12
91 shs Dow Inc
2000-12-31
2019-09-24
0.74 shs Fidelity National Information
2000-12-31
2019-08-08
20 shs Garrett Motion Inc
2000-12-31
2019-09-10
0.666 shs DuPont De Nemours
2000-12-31
2019-06-12
91 shs DuPont De Nemours
2000-12-31
2019-09-24
425 shs General Elec Co
2000-12-31
2019-02-14
225 shs Keurig Dr Pepper Inc
2000-12-31
2019-02-14
50000 shs Morgan Stanley Sr Unsec
2012-03-08
2019-05-13
250 shs Nike Inc Cl B
2000-12-31
2019-09-24
375 shs Principal Financial Group
2000-12-31
2019-02-14
33 shs Resideo Technologies Inc
2000-12-31
2019-09-24
275 shs Schlumberger Ltd
2000-12-31
2019-09-24
200 shs Worldpay Inc Merged
2000-12-31
2019-08-01
175 shs Wyndham Worldwide Corp
2000-12-31
2019-02-14
175 shs Wyndham Hotels & Resorts
2000-12-31
2019-02-14
150 shs Checkpoint Software Com
2000-12-31
2019-09-24
60 shs American Water Works Co Inc
2016-02-17
2019-05-07
0.011 shs Baird Intermediate Bd Fd
2017-08-28
2019-05-13
100 shs Comcast Corporation Cl A
2011-11-02
2019-05-07
20 shs Home Depot Inc
2014-11-19
2019-05-10
40 shs JPMorgan Chase & Co
2009-04-06
2019-03-15
40 shs JPMorgan Chase & Co
2009-04-06
2019-05-10
30 shs Microsoft Corp
2009-04-06
2019-05-10
351.503 shs Western Asset Intermediate Bond Fund
2017-08-28
2019-03-22
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
9,757
12,103
-2,346
b
100,000
113,576
-13,576
c
17
19
-2
d
2,631
2,569
62
e
37
34
3
4,353
4,640
-287
101
44
57
210
221
-11
49
52
-3
6,488
7,082
-594
4,263
11,398
-7,135
6,382
11,638
-5,256
50,000
53,588
-3,588
21,980
14,812
7,168
18,389
18,777
-388
472
619
-147
10,138
17,955
-7,817
2,200
2,200
8,015
5,033
2,982
8,913
6,583
2,330
16,305
12,046
4,259
6,428
3,884
2,544
0
4,276
1,150
3,126
3,864
1,932
1,932
4,221
1,142
3,079
4,469
1,142
3,327
3,756
556
3,200
3,824
3,866
-42
6,662
6,662
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
-2,346
b
-13,576
c
-2
d
62
e
3
-287
57
-11
-3
-594
-7,135
-5,256
-3,588
7,168
-388
-147
-7,817
2,200
2,982
2,330
4,259
2,544
0
3,126
1,932
3,079
3,327
3,200
-42
6,662
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
1,739
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
391,098
3,464,794
0.112878
2017
343,305
3,627,793
0.094632
2016
415,702
3,519,575
0.118111
2015
331,393
3,778,060
0.087715
2014
400,683
3,976,418
0.100765
2
Total
of line 1, column (d)
.....................
2
0.514101
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
0.102820
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
6,871,982
5
Multiply line 4 by line 3
......................
5
706,577
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
297
7
Add lines 5 and 6
........................
7
706,874
8
Enter qualifying distributions from Part XII, line 4
,.............
8
347,860
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
593
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
593
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
593
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
5,511
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
5,511
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
4,918
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
4,918
Refunded
11
0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition)
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
0
(2)
On foundation managers.
$
0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
No
7
Did the foundation have at least $5,000 in assets at any time during the year?
If "Yes," complete Part II, col. (c),
and Part XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
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
R Keith Walton CPA
Telephone no.
(561) 395-6653
Located at
2101 NW Boca Raton Blvd Ste 5
Boca Raton
FL
ZIP+4
334317498
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
John J Raymond
President
5.00
0
0
0
251 Royal Palm Way Ste 215
Palm Beach
,
FL
33480
R Keith Walton
Treasurer
1.00
0
0
0
2101 NW Boca Raton Blvd Ste 5
Boca Raton
,
FL
33431
Connie McKenzie
Secretary
1.00
0
0
0
251 Royal Palm Way Ste 215
Palm Beach
,
FL
33480
Beverlee Miller Raymond
Director
1.00
0
0
0
251 Royal Palm Way Ste 215
Palm Beach
,
FL
33480
Brenda McAdams
Director
1.00
0
0
0
251 Royal Palm Way Ste 215
Palm Beach
,
FL
33480
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
6,778,898
b
Average of monthly cash balances
.......................
1b
197,733
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
6,976,631
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
6,976,631
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
104,649
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
6,871,982
6
Minimum investment return.
Enter 5% of line 5
..................
6
343,599
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
343,599
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
593
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
593
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
343,006
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
343,006
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
343,006
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
347,860
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
347,860
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
347,860
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
343,006
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
......
214,260
b
From 2015
......
198,879
c
From 2016
......
241,173
d
From 2017
......
164,614
e
From 2018
......
217,858
f
Total
of lines 3a through e
........
1,036,784
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
347,860
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
.....
343,006
e
Remaining amount distributed out of corpus
4,854
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
1,041,638
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)
...
214,260
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
827,378
10
Analysis of line 9:
a
Excess from 2015
....
198,879
b
Excess from 2016
....
241,173
c
Excess from 2017
....
164,614
d
Excess from 2018
....
217,858
e
Excess from 2019
....
4,854
Form
990-PF
(2019)
Form 990-PF (2019)
Page
10
Part XIV
Private Operating Foundations
(see instructions and Part VII-A, question 9)
1a
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2019, enter the date of the ruling
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2019
(b)
2018
(c)
2017
(d)
2016
b
85% of line 2a
.........
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed
...
c
“Support" alternative test—enter:
(1)
Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
....
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
(3)
Largest amount of support
from an exempt organization
(4)
Gross investment income
Part XV
Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or email address of the person to whom applications should be addressed:
b
The form in which applications should be submitted and information and materials they should include:
c
Any submission deadlines:
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Form
990-PF
(2019)
Form 990-PF (2019)
Page
11
Part XV
Supplementary Information
(continued)
3
Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
Aging Life Care Association
3275 W Ina Road Suite 130
Tucson
,
AZ
85741
501(c)(3)
unrestricted donations
15,000
American Red Cross
1250 Northpoint Parkway
West Palm Beach
,
FL
33407
501(c)(3)
unrestricted donations
250
Autism Project Palm Beach County
5800 Corporate Way
West Palm Beach
,
FL
33407
501(c)(3)
unrestricted donations
280
Boys and Girl Club of Palm Beach County
800 Northpoint Parkway Suite 204
West Palm Beach
,
FL
33407
501(c)(3)
unrestricted donations
15,000
Center for Autism & Related Disorders
5301 N Federal Hwy Ste 380 Office
10
Boca Raton
,
FL
33487
501(c)(3)
unrestricted donations
1,200
Center for Creative Education
425 24th St
West Palm Beach
,
FL
33407
501(c)(3)
unrestricted donations
5,000
Chamber of Music Society of Palm Beach
125 Worth Avenue Suite 330
Palm Beach
,
FL
33480
501(c)(3)
unrestricted donations
23,000
Congress Middle School
101 S Congress Ave
Boynton Beach
,
FL
33426
501(c)(3)
unrestricted donations
5,000
Cystic Fibrosis Foundation
3443 NW 55th St 1
Fort Lauderdale
,
FL
33309
501(c)(3)
unrestricted donations
250
DePorres Place Adult Literacy Center
1016 N Dixie Hwy
West Palm Beach
,
FL
33401
501(c)(3)
unrestricted donations
5,000
Extraordrinary Charities
125 Worth Avenue Suite 330
Palm Beach
,
FL
33480
501(c)(3)
unrestricted donations
90,000
Faith Hope Love Charity Inc
3175 S Congress Ave Suite 310
Palm Springs
,
FL
33461
501(c)(3)
unrestricted donations
500
Florida Youth Challenge Academy
5629 Florida 16
Starke
,
FL
32091
501(c)(3)
unrestricted donations
1,200
Jacobson Jewish Community Foundation of South Palm Beach County
9901 Donna Klein Blvd
Boca Raton
,
FL
33428
501(c)(3)
unrestricted donations
250
Kips Bay Boys & Girls Club
1930 Randall Avenue
Bronx
,
NY
10473
501(c)(3)
unrestricted donations
125
Linville Central Rescue Squad
1940 Linville Falls Hwy
Newland
,
NC
28657
501(c)(3)
unrestricted donations
100
Norton Museum of Art
1450 S Dixie Hwy
West Palm Beach
,
FL
33401
501(c)(3)
unrestricted donations
290
Palm Beach County Bar Association
PO Box 17726
West Palm Beach
,
FL
33416
501(c)(3)
unrestricted donations
2,000
Palm Beach County Food Bank
525 Gator Drive
Lantana
,
FL
33462
501(c)(3)
unrestricted donations
75
Paralegal Association of Florida Inc
466 94th Ave North
St Petersburg
,
FL
33702
501(c)(3)
unrestricted donations
2,620
Pediatric Oncology Support Team
5325 Greenwood Ave 301
West Palm Beach
,
FL
33407
501(c)(3)
unrestricted donations
1,000
Peter Blum Family YMCA
6631 Palmetto Cir S
Boca Raton
,
FL
33433
501(c)(3)
unrestricted donations
1,200
Quilts of Valor Foundation
PO Box 191
Winterset
,
IA
50273
501(c)(3)
unrestricted donations
1,200
Southside Hospital
301 East Main Street
Bay Shore
,
NY
11706
501(c)(3)
unrestricted donations
10,000
Stand Down
3175 S Congress Ave Suite 310
Palm Springs
,
FL
33461
501(c)(3)
unrestricted donations
500
Sunrise Association
15 Neil Court
Oceanside
,
NY
11572
501(c)(3)
unrestricted donations
6,000
The Glades Project
125 Worth Avenue Suite 330
Palm Beach
,
FL
33480
501(c)(3)
unrestricted donations
99,641
The Robbins Fund
350 E Las Olas Blvd Ste 1250
Fort Lauderdale
,
FL
33301
501(c)(3)
Hurricane Dorian Relief
5,000
The Victory Center
18900 NE 25th Ave
North Miami Beach
,
FL
33180
501(c)(3)
unrestricted donations
5,000
The Volen Center
1515 West Palmetto Park Road
Boca Raton
,
FL
33486
501(c)(3)
unrestricted donations
9,000
Wounded Veterans Relief Fund
1335 Old Dixie Hwy Unit 3
Lake Park
,
FL
33403
501(c)(3)
unrestricted donations
8,000
The Robbins Fund
350 E Las Olas Blvd Ste 1250
Fort Lauderdale
,
FL
33301
501(c)(3)
unrestricted donations
1,200
Total
.................................
3a
314,881
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
240,461
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
531390
-37,423
b
Not debt-financed property
.....
6
Net rental income or (loss) from personal property
532420
-40,000
7
Other investment income
.....
8
Gain or (loss) from sales of assets other than
inventory
............
18
1,739
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)
..
-77,423
242,200
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
164,777
(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