-
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
WF & BLANCHE E WEST EDUCATIONAL & COFFMAN JF
Number and street (or P.O. box number if mail is not delivered to street address)
PO BOX 1608
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CHEHALIS
,
WA
98532
A Employer identification number
91-6101769
B
Telephone number (see instructions)
(253) 305-0757
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)
$
3,593,467
J
Accounting method:
Cash
Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)
Part I
Analysis of Revenue and Expenses
(The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).)
(a)
Revenue and
expenses per
books
(b)
Net investment
income
(c)
Adjusted net
income
(d)
Disbursements
for charitable
purposes
(cash basis only)
1
Contributions, gifts, grants, etc., received (attach schedule)
2
Check
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
85,502
85,453
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
167,850
b
Gross sales price for all assets on line 6a
1,296,144
7
Capital gain net income (from Part IV, line 2)
...
167,850
8
Net short-term capital gain
.........
0
9
Income modifications
...........
10a
Gross sales less returns and allowances
b
Less: Cost of goods sold
....
c
Gross profit or (loss) (attach schedule)
.....
11
Other income (attach schedule)
.......
2,971
2,971
12
Total.
Add lines 1 through 11
........
256,323
256,274
13
Compensation of officers, directors, trustees, etc.
14
Other employee salaries and wages
......
0
0
0
15
Pension plans, employee benefits
.......
0
0
16a
Legal fees (attach schedule)
.........
0
b
Accounting fees (attach schedule)
.......
700
350
0
350
c
Other professional fees (attach schedule)
....
19,647
9,824
9,824
17
Interest
...............
0
18
Taxes (attach schedule) (see instructions)
...
0
19
Depreciation (attach schedule) and depletion
...
0
0
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
0
0
22
Printing and publications
..........
0
0
23
Other expenses (attach schedule)
.......
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
20,347
10,174
0
10,174
25
Contributions, gifts, grants paid
.......
178,400
178,400
26
Total expenses and disbursements.
Add lines 24 and 25
198,747
10,174
0
188,574
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
57,576
b
Net investment income
(if negative, enter -0-)
246,100
c
Adjusted net income
(if negative, enter -0-)
...
0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2019)
Form 990-PF (2019)
Page
2
Part II
Balance Sheets
Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year
End of year
(a)
Book Value
(b)
Book Value
(c)
Fair Market Value
1
Cash—non-interest-bearing
.............
2
Savings and temporary cash investments
.........
121,259
110,888
110,888
3
Accounts receivable
Less: allowance for doubtful accounts
0
0
4
Pledges receivable
Less: allowance for doubtful accounts
5
Grants receivable
.................
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)
.....
7
Other notes and loans receivable (attach schedule)
Less: allowance for doubtful accounts
0
8
Inventories for sale or use
..............
9
Prepaid expenses and deferred charges
..........
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
.......
1,775,336
1,464,741
1,779,837
c
Investments—corporate bonds (attach schedule)
.......
1,301,184
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
1,688,001
1,702,742
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)
3,197,779
3,263,630
3,593,467
17
Accounts payable and accrued expenses
..........
18
Grants payable
.................
19
Deferred revenue
.................
20
Loans from officers, directors, trustees, and other disqualified persons
21
Mortgages and other notes payable (attach schedule)
......
22
Other liabilities (describe
)
23
Total liabilities
(add lines 17 through 22)
.........
0
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
25
Net assets with donor restrictions
............
Foundations that do not follow FASB ASC 958, check here
and complete lines 26 through 30.
26
Capital stock, trust principal, or current funds
........
3,197,779
3,263,630
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)
.....
3,197,779
3,263,630
30
Total liabilities and net assets/fund balances
(see instructions)
.
3,197,779
3,263,630
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
3,197,779
2
Enter amount from Part I, line 27a
.....................
2
57,576
3
Other increases not included in line 2 (itemize)
3
8,275
4
Add lines 1, 2, and 3
..........................
4
3,263,630
5
Decreases not included in line 2 (itemize)
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
3,263,630
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
75. LABORATORY CORP OF AMERICA
2018-07-19
2019-03-14
b
9197.452 AQR MANAGED FUTURES STRATEGY I
2017-12-07
2019-04-22
c
40. ALPHABET INC CLASS C
2014-12-04
2019-04-22
d
12. AMAZON COMMUNICATIONS INC COMMON
2014-12-04
2019-04-22
e
25. BIOGEN, INC
2018-02-07
2019-04-22
43. EDWARDS LIFESCIENCES CP COMMON
2017-01-20
2019-04-22
2390.438 GOLDMAN SACHS INTERNATIONAL EQUITY INSIG
2018-05-17
2019-04-22
2574. ISHARES FLOATING RATE BOND ETF
2018-02-07
2019-04-22
207. SCHLUMBERGER LTD COMMON
2017-12-07
2019-04-22
200. STEEL DYNAMICS INC
2017-09-29
2019-04-22
100. UNION PACIFIC CORP COMMON
2017-01-20
2019-04-22
.3333 DOW INC COM
2017-01-20
2019-04-23
.3333 CORTEVA INC
2017-01-20
2019-06-19
.3333 DUPONT DE NEMOURS INC WI
2017-01-20
2019-06-19
79. AFLAC INC
2017-01-20
2019-07-10
3559.493 AQR LONG-SHORT EQUITY I
2017-09-29
2019-07-10
10. ADOBE, INC
2018-05-17
2019-07-10
24. AIR PRODUCTS & CHEMICALS INC COMMON
2019-04-22
2019-07-10
11. AMAZON COMMUNICATIONS INC COMMON
2012-02-16
2019-07-10
55. APPLE INC COMMON
2008-12-11
2019-07-10
29. AUTODESK, INC
2018-10-10
2019-07-10
1897.222 BLACKROCK TOTAL RETURN K
2017-09-29
2019-07-10
1008.065 BLACKROCK GLOBAL LONG/SHORT CREDIT K
2019-04-23
2019-07-10
9433.251 BLACKROCK GLOBAL LONG/SHORT CREDIT K
2016-09-12
2019-07-10
8. BROADCOM INC
2019-04-22
2019-07-10
18. CATERPILLAR INC COMMON
2017-01-20
2019-07-10
70. CITIGROUP INC (NEW)
2017-01-20
2019-07-10
42. CONOCOPHILLIPS COMMON
2017-01-20
2019-07-10
33. CORTEVA INC
2017-01-20
2019-07-10
48. COSTCO WHOLESALE CORP NEW COMMON
2017-01-20
2019-07-10
30. CROWN CASTLE INTERNATIONAL CORP COMMON
2019-04-22
2019-07-10
14. CUMMINS ENGINE INC COMMON
2017-12-07
2019-07-10
33. DUPONT DE NEMOURS INC WI
2017-01-20
2019-07-10
35. EDWARDS LIFESCIENCES CP COMMON
2017-01-20
2019-07-10
70. EXPEDIA, INC.
2017-01-20
2019-07-10
3064.096 GOLDMAN SACHS INTERNATIONAL EQUITY INSIG
2018-05-17
2019-07-10
31. HCA HOLDINGS INC
2018-10-10
2019-07-10
17. ISHARES JP MORGAN USD EMERG MKTS BOND
2019-04-22
2019-07-10
1377. ISHARES FLOATING RATE BOND ETF
2017-02-16
2019-07-10
26. ISHARES SHORT MATURITY BOND ETF
2019-04-22
2019-07-10
56. JPMORGAN CHASE & CO COMMON
2017-01-20
2019-07-10
18.129 JANUS HENDERSON ENTERPRISE FUND I
2018-05-17
2019-07-10
94. JOHNSON & JOHNSON COMMON
2017-01-20
2019-07-10
42. ESTEE LAUDER COMPANIES CLA COMMON
2018-10-10
2019-07-10
27. MCDONALDS CORP
2017-09-29
2019-07-10
167. MICROSOFT CORP
2008-12-11
2019-07-10
102. NIKE INC CL B
2016-08-26
2019-07-10
35. NORFOLK SOUTHERN CORP COMMON
2017-09-29
2019-07-10
24. PNC FINANCIAL SERVICES GROUP INC.
2017-01-20
2019-07-10
32. PALO ALTO NETWORKS INC
2018-10-10
2019-07-10
17. PARKER-HANNIFIN
2017-01-20
2019-07-10
99. PEPSICO INC COMMON
2017-01-20
2019-07-10
75. PIONEER NATURAL RESOURCES
2017-01-20
2019-07-10
78.283 T ROWE PRICE INSTL EMERGING MKTS EQ
2018-05-16
2019-07-10
2076.984 T ROWE PRICE INST CONCENTRATED EQUITY FUNAME CHANGE 11/1/2014
2017-02-16
2019-07-10
61. SALESFORCE.COM
2014-06-11
2019-07-10
54. SPLUNK INC
2018-10-10
2019-07-10
68. SQUARE, INC
2018-05-17
2019-07-10
27. STRYKER CORPORATION COMMON
2017-01-20
2019-07-10
47. SUNTRUST BANKS INC
2017-01-20
2019-07-10
60. THERMO FISHER SCIENTIFIC
2017-01-20
2019-07-10
21. UNITED HEALTH GROUP INC COMMON
2018-02-07
2019-07-10
767.487 VICTORY SYCAMORE SMALL CAP OPPORTUNITY F
2018-12-21
2019-07-10
956.235 VICTORY SYCAMORE ESTABLISHED VALUE FUND
2017-11-14
2019-07-10
92. VISA INC CLASS A
2013-07-02
2019-07-10
27. EATON GLOBAL CORP COMMON
2017-01-20
2019-07-10
33. DOW INC COM
2017-01-20
2019-09-05
97. LAS VEGAS SANDS
2019-07-12
2019-09-12
1356.239 AQR LONG-SHORT EQUITY I
2017-09-29
2019-10-31
100. ALEXION PHARMACEUTICALS INC COMMON
2019-04-22
2019-10-31
250. BANK AMER CORP
2017-01-20
2019-10-31
3524.673 BLACKROCK EVENT DRIVEN EQUITY FUND
2019-07-12
2019-10-31
22. BROADCOM INC
2019-04-22
2019-10-31
75. CLOROX COMPANY
2018-10-10
2019-10-31
40. CLOROX COMPANY
2019-07-12
2019-10-31
101. CONOCOPHILLIPS COMMON
2017-01-20
2019-10-31
65. EOG RES INC COM
2017-01-20
2019-10-31
2749.411 FIDELITY REAL ESTATE INCOME
2017-02-16
2019-10-31
100. LILLY ELI & CO
2018-10-10
2019-10-31
3614.458 NUVEEN STRATEGIC INCOME I
2017-09-29
2019-10-31
64. PNC FINANCIAL SERVICES GROUP INC.
2017-01-20
2019-10-31
96. PROSPERITY BANCSHARES INC
2017-01-20
2019-10-31
82. SQUARE, INC
2018-05-17
2019-10-31
110. ROYAL CARIBBEAN CRUISES LTD SHS
2018-02-07
2019-10-31
45. EXPEDIA, INC.
2017-01-20
2019-11-08
CAPITAL GAIN 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
11,478
13,955
-2,477
b
78,638
81,174
-2,536
c
49,770
14,576
35,194
d
22,639
3,114
19,525
e
5,706
8,251
-2,545
7,631
4,100
3,531
30,000
33,490
-3,490
130,919
131,097
-178
9,509
16,679
-7,170
6,589
6,937
-348
17,894
10,799
7,095
20
19
1
9
4
5
25
38
-13
4,479
2,762
1,717
39,261
52,182
-12,921
3,072
2,366
706
5,428
4,724
704
22,247
1,970
20,277
11,192
783
10,409
5,037
3,972
1,065
22,330
22,319
11
10,091
10,000
91
94,427
96,672
-2,245
2,215
2,523
-308
2,401
1,698
703
4,989
3,935
1,054
2,562
2,126
436
876
987
-111
12,979
7,861
5,118
4,081
3,648
433
2,350
2,365
-15
2,303
2,827
-524
6,700
3,338
3,362
9,364
8,395
969
38,454
42,928
-4,474
4,244
4,309
-65
1,922
1,860
62
69,991
69,993
-2
1,305
1,306
-1
6,345
4,682
1,663
2,542
2,294
248
13,339
10,738
2,601
7,751
5,516
2,235
5,753
4,233
1,520
23,017
3,308
19,709
8,967
6,006
2,961
6,920
4,664
2,256
3,381
2,811
570
6,867
6,646
221
2,750
2,425
325
13,273
10,198
3,075
10,959
13,875
-2,916
3,124
3,214
-90
22,514
24,425
-1,911
9,527
3,242
6,285
7,163
5,418
1,745
5,334
3,813
1,521
5,657
3,289
2,368
3,010
2,568
442
17,834
8,623
9,211
5,195
4,794
401
33,693
28,397
5,296
37,599
38,192
-593
16,503
4,244
12,259
2,147
1,832
315
1,435
1,907
-472
5,834
6,132
-298
15,000
18,862
-3,862
10,504
12,841
-2,337
7,767
5,656
2,111
35,000
34,507
493
6,461
6,938
-477
11,133
11,201
-68
5,937
6,301
-364
5,507
5,113
394
4,450
6,866
-2,416
35,000
33,020
1,980
11,422
11,469
-47
39,000
38,398
602
9,332
7,497
1,835
6,696
6,878
-182
5,024
4,598
426
11,950
13,184
-1,234
4,502
5,397
-895
27,899
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
-2,477
b
-2,536
c
35,194
d
19,525
e
-2,545
3,531
-3,490
-178
-7,170
-348
7,095
1
5
-13
1,717
-12,921
706
704
20,277
10,409
1,065
11
91
-2,245
-308
703
1,054
436
-111
5,118
433
-15
-524
3,362
969
-4,474
-65
62
-2
-1
1,663
248
2,601
2,235
1,520
19,709
2,961
2,256
570
221
325
3,075
-2,916
-90
-1,911
6,285
1,745
1,521
2,368
442
9,211
401
5,296
-593
12,259
315
-472
-298
-3,862
-2,337
2,111
493
-477
-68
-364
394
-2,416
1,980
-47
602
1,835
-182
426
-1,234
-895
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
167,850
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
168,763
3,410,350
0.049486
2017
150,103
3,305,382
0.045412
2016
134,210
2,800,806
0.047918
2015
127,894
2,628,535
0.048656
2014
123,965
2,710,677
0.045732
2
Total
of line 1, column (d)
.....................
2
0.237204
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
0.047441
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
3,413,309
5
Multiply line 4 by line 3
......................
5
161,931
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
2,461
7
Add lines 5 and 6
........................
7
164,392
8
Enter qualifying distributions from Part XII, line 4
,.............
8
188,574
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
2,461
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
2,461
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
2,461
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
2,044
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
1,649
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
3,693
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
1,232
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
1,232
Refunded
11
0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition)
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
(2)
On foundation managers.
$
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
Yes
7
Did the foundation have at least $5,000 in assets at any time during the year?
If "Yes," complete Part II, col. (c),
and Part XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
WA
b
If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G?
If "No," attach explanation
.
8b
Yes
9
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
or 4942(j)(5) for calendar year 2019 or the taxable year beginning in 2019? See the instructions for Part XIV.
If "Yes," complete Part XIV
.............................
9
No
10
Did any persons become substantial contributors during the tax year?
If "Yes," attach a schedule listing their names
and addresses.
...............................
10
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
5
Part VII-A
Statements Regarding Activities
(continued)
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions
.............
11
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement. See instructions
.................
12
No
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
14
The books are in care of
COLUMBIA TRUST COMPANY
Telephone no.
(253) 305-0757
Located at
1301 A STREET STE 800
TACOMA
WA
ZIP+4
98402
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
CHEHALIS FOUNDATION
TRUSTEE
0
0
PO BOX 1608
CHEHALIS
,
WA
98532
2
Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a)
Name and address of each employee paid more than $50,000
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
NONE
Total
number of other employees paid over $50,000
...................
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
7
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
(continued)
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
NONE
Total
number of others receiving over $50,000 for professional services
.............
0
Part IX-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
2
3
4
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
Form
990-PF
(2019)
Form 990-PF (2019)
Page
8
Part X
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations, see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities
...................
1a
3,379,138
b
Average of monthly cash balances
.......................
1b
86,150
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
3,465,288
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
3,465,288
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
51,979
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
3,413,309
6
Minimum investment return.
Enter 5% of line 5
..................
6
170,665
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
170,665
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
2,461
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
2,461
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
168,204
4
Recoveries of amounts treated as qualifying distributions
................
4
5,234
5
Add lines 3 and 4
............................
5
173,438
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
173,438
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
188,574
b
Program-related investments—total from Part IX-B
..................
1b
0
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
0
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
0
b
Cash distribution test (attach the required schedule)
.................
3b
0
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
188,574
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
2,461
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
186,113
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
173,438
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
85,540
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
0
b
From 2015
......
0
c
From 2016
......
0
d
From 2017
......
0
e
From 2018
......
0
f
Total
of lines 3a through e
........
0
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
188,574
a
Applied to 2018, but not more than line 2a
85,540
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
.....
103,034
e
Remaining amount distributed out of corpus
0
5
Excess distributions carryover applied to 2019.
0
0
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
0
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
0
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
0
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
0
e
Undistributed income for 2018. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
0
f
Undistributed income for 2019. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2020
..........
70,404
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions)
.......
0
8
Excess distributions carryover from 2014 not
applied on line 5 or line 7 (see instructions)
...
0
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
0
10
Analysis of line 9:
a
Excess from 2015
....
0
b
Excess from 2016
....
0
c
Excess from 2017
....
0
d
Excess from 2018
....
0
e
Excess from 2019
....
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
10
Part XIV
Private Operating Foundations
(see instructions and Part VII-A, question 9)
1a
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2019, enter the date of the ruling
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2019
(b)
2018
(c)
2017
(d)
2016
b
85% of line 2a
.........
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed
...
c
“Support" alternative test—enter:
(1)
Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
....
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
(3)
Largest amount of support
from an exempt organization
(4)
Gross investment income
Part XV
Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or email address of the person to whom applications should be addressed:
b
The form in which applications should be submitted and information and materials they should include:
c
Any submission deadlines:
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Form
990-PF
(2019)
Form 990-PF (2019)
Page
11
Part XV
Supplementary Information
(continued)
3
Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
ARIZONA STATE UNIVERSITY
FINANCIAL AID AND SCHOLARSHIP SERVICES
PO BOX 870412
PHOENIX
,
AZ
85004
NONE
PC
SCHOLARSHIP
3,000
BIOLA UNIVERITY
13800 BIOLA AVE
LA MIRADA
,
CA
90639
NONE
PC
SCHOLARSHIP
1,000
BOISE STATE UNIVERSITY
1910 UNIVERSITY DR
BOISE
,
ID
83725
NONE
PC
SCHOLARSHIP
1,000
BRINGHAM YOUNG UNIVERSITY IDAHO
525 S CENTER ST
REXBURG
,
ID
83460
NONE
PC
SCHOLARSHIP
3,000
CENTRAL WASHINGTON UNIVERSITY
FINANCIAL AID OFFICE BOUILLION HALL 106
400 E UNIVERSITY WAY
ELLENSBURG
,
WA
98926
NONE
PC
SCHOLARSHIP
13,600
CENTRALIA COLLEGE
600 CENTRALIA COLLEGE BLVD
CENTRALIA
,
WA
98531
NONE
PC
SCHOLARSHIPS
28,800
CORNISH COLLEGE OF THE ARTS
1000 LENORA STREET
SEATTLE
,
WA
98121
NONE
PC
SCHOLARSHIP
1,000
COLUMBIA UNIVERSITY IN THE CITY OF
NEW YORK 100 HAMILTON HL MC 2802
1130 AMSTERDAM AVE
NEW YORK
,
NY
10027
NONE
PC
SCHOLARSHIP
1,000
CONCORDIA UNIVERSITY ANN ARBOR
4090 GEDDES ROAD
ANN ARBOR
,
MI
48105
NONE
PC
SCHOLARSHIP
1,000
CONCORDIA UNIVERSITY WISCONSIN
ATTN FINANCIAL AID OFFICE
12800 N LAKE SHORE DRIVE
MEQUON
,
WI
53097
NONE
PC
SCHOLARSHIP
1,000
DAVIS AND ELKINS COLLEGE
100 CAMPUS DRIVE
ELKINS
,
WV
26241
NONE
PC
SCHOLARSHIP
1,000
EASTERN WASHINGTON UNIVERSITY
ATTN FINANCIAL AID OFFICE
333 EAGLE LN 102 SUTTON HALL
CHENEY
,
WA
99004
NONE
PC
SCHOLARSHIP
7,000
FITCHBURG STATE UNIVERSITY
160 PERAL STREET
FICHBURG
,
MA
01420
NONE
PC
SCHOLARSHIP
1,000
GEORGE FOX UNIVERSITY
414 N MERIDIAN 6068
NEWBERG
,
OR
97132
NONE
PC
SCHOLARSHIP
9,000
GRAND CANYON UNIVERSITY
ATTN STUDENT ACCOUNTING
PO BOX 11097
PHOENIX
,
AZ
85017
NONE
PC
SCHOLARSHIP
2,000
GONZAGA UNVIERSITY
502 EAST BOONE AVE
SPOKANE
,
WA
99258
NONE
PC
SCHOLARSHIP
3,000
LINFIELD COLLEGE
FINANCIAL AID MELROSE HALL SUITE 030
900 SE BAKER ST
MCMINNVILLE
,
OR
97128
NONE
PC
SCHOLARSHIP
2,000
LOWER COLUMBIA COLLEGE
1600 MAPLE STREET
LONGVIEW
,
WA
98632
NONE
PC
SCHOLARSHIP
800
MIDWESTERN UNIVERSITY GLENDALE
19555 N 59TH AVE
GLENDALE
,
AZ
85308
NONE
PC
SCHOLARSHIP
1,000
MOODY BIBLE INSITUTE
820 N LASALLE BLVD
CHICAGO
,
IL
60610
NONE
PC
SCHOLARSHIP
1,000
NORTHWEST NAZARENE UNIVERSITY
FINANCIAL AID OFFICE NNU
623 S UNIVERSITY BLVD
NAMPA
,
ID
83686
NONE
PC
SCHOLARSHIP
1,000
OREGON INSTITUTE OF TECHNOLOGY
FINANCIAL AID OFF 1ST FL COLLEGE UNION
3201 CAMPUS DRIVE
KLAMATH FALLS
,
OR
97601
NONE
PC
SCHOLARSHIP
2,000
OREGON STATE UNIVERSITY
FINANCIAL AID
218 KERR ADMIN
CORVALLIS
,
OR
97331
NONE
PC
SCHOLARSHIP
2,000
PACIFIC LUTHERAN UNIVERSITY
FINANCIAL SERV HAUGE ADM BLD RM 102
12180 PARK AVE S
TACOMA
,
WA
98447
NONE
PC
SCHOLARSHIP
3,000
SEATTLE PACIFIC UNIVERSITY
3307 THIRD AVE W SUITE 114
SEATTLE
,
WA
98119
NONE
PC
SCHOLARSHIP
1,000
SOUTHERN ADVENTIST UNIVERSITY
ATTN STUDENT FINANCE
5006 UNIVERSITY DR UNIT 370
COLLEGEDALE
,
TN
37315
NONE
PC
SCHOLARSHIP
3,000
UNIVERSITY OF HAWAII AT HILO
FINANCIAL AID OFFICE
200 W KAWILI ST
HILO
,
HI
96720
NONE
PC
SCHOLARSHIP
1,000
UNIVERSITY OF SOUTH DAKOTA
OFFICE OF FINANCIAL AID BELBAS CENTER
414 E CLARK ST
VERMILLION
,
SD
57069
NONE
PC
SCHOLARSHIP
1,000
UNIVERSITY OF WASHINGTON SEATTLE
OFFICE OF STUDENT FINANCIAL AID
PO BOX 355880
SEATTLE
,
WA
98195
NONE
PC
SCHOLARSHIP
10,000
UNIVERSITY OF IDAHO
STUDENT FINANCIAL AID OFFICE
875 PERIMETER DR MS 4291
MOSCOW
,
ID
83844
NONE
PC
SCHOLARSHIP
2,000
UNIVERSITY OF WASHINGTON
OFFICE OF STUDENT FINANCIAL AID
PO BOX 355880
SEATTLE
,
WA
98195
NONE
PC
SCHOLARSHIP
4,000
UNIVERSITY OF MONTANA
EMMA B LOMMASSON CENTER
32 CAMPUS DR
MISSOULA
,
MT
59812
NONE
PC
SCHOLARSHIP
1,000
UNIVERSITY OF PORTLAND
WALDSCHMIDT HALL MSC 166
5000 N WILLAMETTE BLVD
PORTLAND
,
OR
97203
NONE
PC
SCHOLARSHIP
2,000
UNIVERSITY OF PACIFIC
3601 PACIFIC AVE
STOCKTON
,
CA
95211
NONE
PC
SCHOLARSHIP
1,000
WESTERN WASHINTON UNIVERSITY
OLD MAIN 265 MS 9006 516 HIGH STR
BELLINGHAM
,
WA
98225
NONE
PC
SCHOLARSHIPS
18,000
WASHINGTON STATE UNIVERSITY
LIGHTLY STUDENT SERVICE BLG RM 380
1815 WILSON RD PO BOX 641068
PULLMAN
,
WA
991641068
NONE
PC
SCHOLARSHIPS
23,000
WESTERN GOVERNORS UNIVERSITY
WGU FINANCIAL AID OFFICE
4001 SOUTH 700 EAST SUITE 700
SALT LAKE CITY
,
UT
84107
NONE
PC
SCHOLARSHIPS
4,000
WHITWORTH UNIVERSITY
300 W HAWTHORNE RD
SPOKANE
,
WA
99251
NONE
PC
SCHOLARSHIP
2,000
WALLA WALLA COMMUNITY COLLEGE
FINANCIAL AID OFFICE
500 TAUSICK WAY
WALLA WALLA
,
WA
99362
NONE
PC
SCHOLARSHIP
800
BELLINGHAM TECHNICAL COLLEGE
3028 LINDBERGH AVE
BELLINGHAM
,
WA
98225
NONE
PC
SCHOLARSHIP
800
BRINGHAM YOUNG UNIVERSITY - UTAH
ENROLLMENT SERVICES D155 ASB
PROVO
,
UT
84602
NONE
PC
SCHOLARSHIP
1,000
EMBRY RIDDLE UNIVERSITY
3700 WILLOW CREEK ROAD
PRESCOTT
,
AZ
86301
NONE
PC
SCHOLARSHIP
1,000
JOHN HOPKINS UNIVERSITY
3400 N CHARLES ST 146 GARLAND HALL
BALTIMORE
,
MD
21218
NONE
PC
SCHOLARSHIP
1,000
LIBERTY UNIVERSITY
FINANCIAL AID MSC BOXC 710282
1971 UNIVERSITY BLVD
LYNCHBURG
,
VA
24515
NONE
PC
SCHOLARSHIP
1,000
LINDENWOOD UNIVERSITY
209 S KINGS HIGHWAY STREET
ST CHARLES
,
MO
63301
NONE
PC
SCHOLARSHIP
1,000
MODESTO JUNIOR COLLEGE
435 COLLEGE AVE
MODESTO
,
CA
95350
NONE
PC
SCHOLARSHIP
800
PACIFIC NORTHWEST UNIV OF HEALTH SCIENCE
111 UNIVERSITY PARKWAY SUITE 202
YAKIMA
,
WA
98901
NONE
PC
SCHOLARSHIP
3,000
PAUL MITCHELL HAIR DESIGN
234 SW BROADWAY
PORTLAND
,
OR
97205
NONE
PC
SCHOLARSHIP
800
PORTLAND STATE UNIVERSITY
1914 SW PARK AVE
PORTLAND
,
OR
97201
NONE
PC
SCHOLARSHIP
1,000
SAN DIEGO STATE UNIVERSITY
OFFICE OF FINANCIAL AID
5500 CAMPANILE DR
SAN DIEGO
,
CA
92182
NONE
PC
SCHOLARSHIP
1,000
UNIVERSITY OF ARIZONA
UA OFFICE OF SCHOLARSHIP AND FIN AID
PO BOX 210066
TUCSON
,
AZ
85721
NONE
PC
SCHOLARSHIP
2,000
Total
.................................
3a
178,400
b
Approved for future payment
Total
.................................
3b
Form
990-PF
(2019)
Form 990-PF (2019)
Page
12
Part XVI-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
Unrelated business income
Excluded by section 512, 513, or 514
(e)
Related or exempt
function income
(See instructions.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
4
Dividends and interest from securities
....
14
85,502
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not debt-financed property
.....
6
Net rental income or (loss) from personal property
7
Other investment income
.....
8
Gain or (loss) from sales of assets other than
inventory
............
18
167,850
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)
..
256,323
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
256,323
(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