-
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
H & Z ORCHARD CHARIT TR DTD 31887
Number and street (or P.O. box number if mail is not delivered to street address)
2751 CENTERVILLE RD STE 400
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
WILMINGTON
,
DE
19808
A Employer identification number
65-6294862
B
Telephone number (see instructions)
(302) 246-5400
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)
$
1,984,650
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
...
32,385
32,385
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
95,212
b
Gross sales price for all assets on line 6a
350,766
7
Capital gain net income (from Part IV, line 2)
...
95,212
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)
.......
3,016
12
Total.
Add lines 1 through 11
........
130,613
127,597
13
Compensation of officers, directors, trustees, etc.
6,563
4,922
1,641
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)
.......
500
0
0
500
c
Other professional fees (attach schedule)
....
14,242
14,242
0
17
Interest
...............
0
18
Taxes (attach schedule) (see instructions)
...
5,128
1,109
10
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)
.......
52
52
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
26,485
20,325
0
2,151
25
Contributions, gifts, grants paid
.......
84,687
84,687
26
Total expenses and disbursements.
Add lines 24 and 25
111,172
20,325
0
86,838
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
19,441
b
Net investment income
(if negative, enter -0-)
107,272
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
.............
117
100
100
2
Savings and temporary cash investments
.........
55,862
79,038
79,038
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)
.......
c
Investments—corporate bonds (attach schedule)
.......
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
1,012,368
1,008,826
1,905,512
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)
1,068,347
1,087,964
1,984,650
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
........
1,068,347
1,087,964
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)
.....
1,068,347
1,087,964
30
Total liabilities and net assets/fund balances
(see instructions)
.
1,068,347
1,087,964
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
1,068,347
2
Enter amount from Part I, line 27a
.....................
2
19,441
3
Other increases not included in line 2 (itemize)
3
176
4
Add lines 1, 2, and 3
..........................
4
1,087,964
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
1,087,964
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
4. MCCORMICK & CO INC/MD
2017-10-04
2019-01-02
b
14. MCCORMICK & CO INC/MD
2017-10-04
2019-01-02
c
9. CELGENE CORP
2017-10-27
2019-01-03
d
127. CITIGROUP INC
2014-10-14
2019-01-03
e
21. ERSTE GROUP BANK AG
2018-08-01
2019-01-03
32. MCCORMICK & CO INC/MD
2017-08-09
2019-01-03
12. UMICORE SA
2018-04-27
2019-01-03
5. MCCORMICK & CO INC/MD
2017-08-09
2019-01-07
25. CELGENE CORP
2017-10-27
2019-01-08
8. CELGENE CORP
2009-05-28
2019-01-10
4. MCCORMICK & CO INC/MD
2017-08-09
2019-01-10
11. ORIX CORP
2010-08-19
2019-01-10
2. ORIX CORP
2010-08-19
2019-01-11
2. ORIX CORP
2010-08-19
2019-01-11
15. ORIX CORP
2010-08-19
2019-01-15
12. ORIX CORP
2010-08-19
2019-01-16
12. ORIX CORP
2010-08-19
2019-01-16
3. CELGENE CORP
2009-05-28
2019-01-17
18. HOYA CORP
2013-11-07
2019-01-17
3. MCCORMICK & CO INC/MD
2017-08-09
2019-01-17
11. ORIX CORP
2010-08-19
2019-01-17
7. HOYA CORP
2013-11-07
2019-01-22
11. ORIX CORP
2010-08-19
2019-01-22
4. RED HAT INC
2013-12-04
2019-01-22
1. REGENERON PHARMACEUTICALS INC
2014-07-18
2019-01-22
21. HOYA CORP
2013-11-07
2019-01-23
3. MCCORMICK & CO INC/MD
2017-08-09
2019-01-23
17. ORIX CORP
2010-08-19
2019-01-23
14. HOYA CORP
2013-11-07
2019-01-24
13. MARTIN MARIETTA MATERIALS INC
2017-08-01
2019-01-25
12. CELGENE CORP
2009-05-28
2019-01-30
3. RED HAT INC
2013-12-04
2019-01-30
11. CELGENE CORP
2009-05-28
2019-01-31
9. CELGENE CORP
2009-05-28
2019-02-04
11. CELGENE CORP
2009-05-28
2019-02-05
43. MARSH & MCLENNAN COS INC
2017-02-13
2019-02-06
3. REGENERON PHARMACEUTICALS INC
2014-07-18
2019-02-06
4. RED HAT INC
2013-12-04
2019-02-07
18. CELGENE CORP
2009-05-28
2019-02-08
31. YUM CHINA HOLDINGS INC
2017-07-07
2019-02-08
65. RENTOKIL INITIAL PLC
2018-10-18
2019-02-11
11. RENTOKIL INITIAL PLC
2017-06-26
2019-02-11
49. AFLAC INC
2017-08-01
2019-02-22
4. METTLER-TOLEDO INTL INC
2018-07-26
2019-02-22
11. ECOLAB INC
2016-01-06
2019-03-01
32. RENTOKIL INITIAL PLC
2017-06-26
2019-03-06
237. VALE SA
2016-11-10
2019-03-06
105. HALLIBURTON CO
2016-10-17
2019-03-07
7. REGENERON PHARMACEUTICALS INC
2014-07-17
2019-03-07
17. ERSTE GROUP BANK AG
2017-09-07
2019-03-11
46. ERSTE GROUP BANK AG
2018-09-21
2019-03-11
53. ERSTE GROUP BANK AG
2017-11-03
2019-03-12
8. YUM CHINA HOLDINGS INC
2016-11-09
2019-03-18
2. BLACKROCK INC
2009-03-30
2019-03-19
95.54 TWENTY FIRST CENTY FOX INC CL B
2016-10-17
2019-03-19
38. AFLAC INC
2017-06-09
2019-03-22
5. CANADIAN PACIFIC RAILWAY LTD
2017-05-11
2019-03-22
13. YUM CHINA HOLDINGS INC
2016-11-10
2019-03-25
11. ANTHEM INC
2014-01-29
2019-03-27
8. HONEYWELL INTERNATIONAL INC COM
2019-02-04
2019-03-27
13. HONEYWELL INTERNATIONAL INC COM
2017-09-15
2019-03-27
7. BAIDU.COM
2018-01-16
2019-03-28
11. YUM CHINA HOLDINGS INC
2016-11-10
2019-03-28
11. BAIDU.COM
2018-02-15
2019-03-29
7. BAIDU.COM
2018-04-30
2019-03-29
267.46 TWENTY FIRST CENTY FOX INC CL B
2012-06-01
2019-03-29
10. YUM CHINA HOLDINGS INC
2016-11-10
2019-04-01
.12 WALT DISNEY CO
2019-01-22
2019-04-02
2. WALT DISNEY CO
2019-01-22
2019-04-02
4. RED HAT INC
2013-11-13
2019-04-02
6. BIOGEN IDEC INC
2018-05-02
2019-04-03
9. YUM CHINA HOLDINGS INC
2016-11-10
2019-04-03
1. FOX CORP B COM
2019-03-19
2019-04-04
9. YUM CHINA HOLDINGS INC
2016-11-10
2019-04-04
3. BIOGEN IDEC INC
2018-05-02
2019-04-05
21. MOTOROLA SOLUTIONS INC
2017-03-27
2019-04-05
3. BIOGEN IDEC INC
2015-09-22
2019-04-09
2. BIOGEN IDEC INC
2018-05-02
2019-04-09
7. YUM CHINA HOLDINGS INC
2013-06-21
2019-04-09
16. QUALCOMM INC
2018-08-15
2019-04-10
5. BIOGEN IDEC INC
2015-09-22
2019-04-11
21. ALCON INC ORD SHS
2019-03-27
2019-04-11
3.8 ALCON INC ORD SHS
2018-08-09
2019-04-11
16.2 ALCON INC ORD SHS
2017-02-13
2019-04-11
8. APPLE COMPUTER INC
2018-09-26
2019-04-12
15. AMGEN INC
2014-04-24
2019-04-15
8. BIOGEN IDEC INC
2003-03-10
2019-04-16
49. BANK OF NEW YORK MELLON CORP/THE
2017-02-13
2019-04-23
10. SHOPIFY INC CL A
2018-08-27
2019-04-23
9. YUM CHINA HOLDINGS INC
2013-06-21
2019-04-23
9. YUM CHINA HOLDINGS INC
2013-03-13
2019-04-24
13. AFLAC INC
2017-06-09
2019-04-26
.4 ALCON INC ORD SHS
2010-08-19
2019-04-29
43. AFLAC INC
2017-06-09
2019-04-30
21. YUM CHINA HOLDINGS INC
2013-10-09
2019-04-30
11. YUM CHINA HOLDINGS INC
2012-12-21
2019-05-02
11. YUM CHINA HOLDINGS INC
2012-12-21
2019-05-02
40. AFLAC INC
2017-06-09
2019-05-03
44. SCHLUMBERGER LTD
2015-08-27
2019-05-08
11. CANADIAN PACIFIC RAILWAY LTD
2017-02-13
2019-05-09
7. SHOPIFY INC CL A
2018-08-01
2019-05-09
55. SCHLUMBERGER LTD
2015-12-07
2019-05-10
2200. WEATHERFORD INTL PLC ORD SHS
2017-02-13
2019-05-15
18. YUM CHINA HOLDINGS INC
2012-12-21
2019-05-17
19. PAYPAL HOLDINGS INCORPORATION
2010-02-05
2019-05-23
7. PAYPAL HOLDINGS INCORPORATION
2010-02-05
2019-05-24
8. SPLUNK INC
2017-05-26
2019-05-24
7. PAYPAL HOLDINGS INCORPORATION
2010-02-05
2019-05-29
5. CANADIAN PACIFIC RAILWAY LTD
2016-03-17
2019-05-30
5. RED HAT INC
2013-11-13
2019-05-31
3. TEMENOS AG
2019-02-22
2019-05-31
6. TEMENOS AG
2019-02-22
2019-06-03
7. HONEYWELL INTERNATIONAL INC COM
2017-03-16
2019-06-04
7. PAYPAL HOLDINGS INCORPORATION
2010-02-05
2019-06-04
64. HALLIBURTON CO
2018-09-07
2019-06-05
169. HALLIBURTON CO
2014-12-11
2019-06-05
227. LONDON STOCK EXCHANGE GROUP PLC
2015-11-09
2019-06-05
10. PAYPAL HOLDINGS INCORPORATION
2010-02-05
2019-06-05
28. STATE STR CORP COM
2012-06-01
2019-06-05
61. AFLAC INC
2017-06-02
2019-06-06
31. STATE STR CORP COM
2012-06-01
2019-06-06
30. STATE STR CORP COM
2012-06-01
2019-06-07
8. PAYPAL HOLDINGS INCORPORATION
2010-02-05
2019-06-10
4. RED HAT INC
2013-11-13
2019-06-10
8. PAYPAL HOLDINGS INCORPORATION
2010-02-05
2019-06-11
5. RED HAT INC
2013-11-13
2019-06-12
9. RED HAT INC
2013-11-13
2019-06-21
34. AUTODESK INC
2003-03-24
2019-06-24
111. COMCAST CORP
2019-04-02
2019-06-24
33. L3 TECHNOLOGIES INC
2003-03-10
2019-06-24
10. TE CONNECTIVITY LTD
2018-12-26
2019-06-24
5. TE CONNECTIVITY LTD
2007-07-18
2019-06-24
40. COMCAST CORP
2019-04-02
2019-06-26
28. ILLINOIS TOOL WKS INC
2017-02-13
2019-07-11
24. MOTOROLA SOLUTIONS INC
2017-03-27
2019-07-11
96. UMICORE SA
2018-04-27
2019-07-11
1. METTLER-TOLEDO INTL INC
2018-07-25
2019-07-15
9. METTLER-TOLEDO INTL INC
2018-06-07
2019-07-15
.7 L3HARRIS TECHNOLOGIES INC
2003-03-10
2019-07-16
15. PAYPAL HOLDINGS INCORPORATION
2010-02-05
2019-07-16
15. PAYPAL HOLDINGS INCORPORATION
2010-02-05
2019-07-22
20. COCA COLA CO
2003-04-21
2019-07-25
78. RENTOKIL INITIAL PLC
2017-06-26
2019-07-25
97. CAPITAL ONE FINANCIAL CORP COM
2017-02-13
2019-07-30
16. RENTOKIL INITIAL PLC
2017-02-13
2019-07-30
38. COCA COLA CO
2003-04-21
2019-07-31
37. COCA COLA CO
2003-04-21
2019-08-02
76. LONDON STOCK EXCHANGE GROUP PLC
2015-11-09
2019-08-05
33. RENTOKIL INITIAL PLC
2017-02-13
2019-08-05
241. ANADARKO PETE CORP
2017-02-13
2019-08-09
13. AKAMAI TECHNOLOGIES INC
2009-07-30
2019-08-13
169. WELLS FARGO & CO
2017-02-13
2019-08-13
3. EQUINIX INC
2018-02-13
2019-08-14
.71 OCCIDENTAL PETROLEUM CORP
2019-08-09
2019-08-14
1. EQUINIX INC
2018-02-13
2019-08-16
120. METLIFE INC COM
2017-02-13
2019-08-19
4. COSTCO WHOLESALE CORP
2019-01-04
2019-08-21
35. LONDON STOCK EXCHANGE GROUP PLC
2015-11-09
2019-08-22
17. RENTOKIL INITIAL PLC
2016-08-03
2019-08-22
10. CANADIAN PACIFIC RAILWAY LTD
2016-03-04
2019-08-26
13. CATERPILLAR INC
2018-03-13
2019-08-26
138.01 SCHLUMBERGER LTD
2015-12-07
2019-08-27
9. CATERPILLAR INC
2018-02-06
2019-08-28
10. CATERPILLAR INC
2018-03-01
2019-09-04
9. CATERPILLAR INC
2018-04-26
2019-09-06
17. CANADIAN PACIFIC RAILWAY LTD
2016-03-04
2019-09-09
93. LONDON STOCK EXCHANGE GROUP PLC
2015-11-09
2019-09-09
33. RENTOKIL INITIAL PLC
2016-08-03
2019-09-09
38. HONG KONG EXCHANGES & CLEARING LTD
2018-03-13
2019-09-10
19. NESTLE SA
2018-10-17
2019-09-10
14. NESTLE SA
2017-02-13
2019-09-10
4. ECOLAB INC
2016-01-06
2019-09-11
63. HONG KONG EXCHANGES & CLEARING LTD
2018-01-04
2019-09-12
61. HONG KONG EXCHANGES & CLEARING LTD
2015-04-10
2019-09-13
67. HONG KONG EXCHANGES & CLEARING LTD
2017-12-11
2019-09-16
6. CHIPOTLE MEXICAN GRILL INC CLASS A
2016-12-09
2019-10-02
13. TEXAS INSTRUMENTS INC
2003-03-10
2019-10-02
8. ANTHEM INC
2012-06-01
2019-10-03
3. CHIPOTLE MEXICAN GRILL INC CLASS A
2017-08-03
2019-10-03
9. UNITEDHEALTH GROUP INC
2019-04-12
2019-10-03
2. UNITEDHEALTH GROUP INC
2009-04-01
2019-10-03
.5 CERENCE INC COM
2014-05-13
2019-10-09
20. US BANCORP
2019-01-03
2019-10-11
43. GRUBHUB INC
2019-03-19
2019-10-29
28. CHECK POINT SOFTWARE TECH LT
2017-02-13
2019-10-29
30. CHECK POINT SOFTWARE TECH LT
2013-06-24
2019-10-30
19. GRUBHUB INC
2019-04-05
2019-11-01
133. XEROX HOLDINGS CORP
2017-02-13
2019-11-07
14. QUALCOMM INC
2019-08-01
2019-11-18
6. QUALCOMM INC
2018-05-23
2019-11-18
14. SHISEIDO LTD ADR
2015-08-28
2019-11-26
41. ROGERS COMMUNICATIONS INC
2018-11-28
2019-12-02
27. SUNCOR ENERGY INC
2017-02-23
2019-12-02
23. SUNCOR ENERGY INC
2019-02-07
2019-12-02
12. ICON PLC
2010-08-19
2019-12-02
14. SHISEIDO LTD ADR
2015-08-28
2019-12-05
3. BLACKROCK INC
2009-03-30
2019-12-09
1. BLACKROCK INC
2009-03-30
2019-12-13
9. NESTLE SA
2017-02-13
2019-12-13
29. RENTOKIL INITIAL PLC
2016-08-03
2019-12-13
29. SUNCOR ENERGY INC
2017-02-23
2019-12-13
40. SUNCOR ENERGY INC
2017-02-13
2019-12-17
40. SUNCOR ENERGY INC
2017-02-13
2019-12-18
48. SUNCOR ENERGY INC
2010-08-19
2019-12-19
47. SUNCOR ENERGY INC
2010-08-19
2019-12-20
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
543
398
145
b
1,901
1,361
540
c
740
876
-136
d
6,694
6,331
363
e
353
456
-103
4,374
3,071
1,303
114
168
-54
692
480
212
2,182
750
1,432
695
166
529
559
384
175
851
430
421
154
78
76
154
78
76
1,155
587
568
923
470
453
923
470
453
261
62
199
1,071
469
602
418
288
130
852
430
422
402
182
220
855
430
425
701
185
516
408
300
108
1,193
547
646
415
288
127
1,300
665
635
790
365
425
2,281
2,951
-670
1,053
250
803
529
139
390
968
229
739
789
187
602
966
229
737
3,901
2,472
1,429
1,238
898
340
716
184
532
1,572
375
1,197
1,256
1,099
157
1,480
1,285
195
250
202
48
2,390
1,968
422
2,706
2,444
262
1,869
1,204
665
750
588
162
2,939
1,889
1,050
2,938
4,583
-1,645
2,888
1,996
892
296
359
-63
800
996
-196
922
1,118
-196
345
210
135
878
252
626
4,867
1,723
3,144
1,888
1,458
430
1,006
767
239
561
341
220
3,126
949
2,177
1,258
1,164
94
2,045
1,662
383
1,146
1,825
-679
478
288
190
1,807
2,796
-989
1,150
1,745
-595
13,552
3,181
10,371
454
262
192
13
13
222
221
1
733
184
549
1,392
1,637
-245
410
235
175
36
40
-4
401
229
172
722
819
-97
2,952
1,764
1,188
712
812
-100
475
546
-71
306
139
167
912
1,037
-125
1,176
1,105
71
1,167
1,108
59
211
192
19
900
556
344
1,587
1,800
-213
2,860
1,709
1,151
1,842
210
1,632
2,372
2,032
340
2,241
1,418
823
399
177
222
399
177
222
642
499
143
22
12
10
2,156
1,650
506
980
398
582
521
199
322
521
199
322
2,019
1,521
498
1,769
3,206
-1,437
2,416
1,467
949
1,806
957
849
2,161
4,006
-1,845
110
18,297
-18,187
744
325
419
2,087
299
1,788
771
94
677
960
502
458
771
94
677
1,105
635
470
924
230
694
517
426
91
1,044
827
217
1,176
851
325
755
94
661
1,351
2,332
-981
3,568
5,310
-1,742
3,832
2,244
1,588
1,103
134
969
1,567
1,129
438
3,278
2,317
961
1,727
1,250
477
1,697
1,210
487
930
107
823
741
184
557
915
107
808
925
230
695
1,691
414
1,277
5,767
261
5,506
4,820
4,454
366
8,450
1,159
7,291
949
707
242
474
189
285
1,690
1,525
165
4,092
2,955
1,137
4,088
2,011
2,077
680
1,090
-410
822
607
215
7,394
1,504
5,890
136
19
117
1,804
201
1,603
1,780
201
1,579
1,062
406
656
1,991
1,186
805
8,730
5,578
3,152
401
240
161
2,011
771
1,240
1,936
750
1,186
1,518
751
767
865
485
380
17,493
12,686
4,807
1,151
215
936
7,798
6,318
1,480
1,626
1,305
321
32
33
-1
550
435
115
5,501
4,509
992
1,102
822
280
736
346
390
468
249
219
2,342
1,262
1,080
1,487
2,029
-542
4,341
9,177
-4,836
1,026
1,377
-351
1,185
1,518
-333
1,109
1,317
-208
4,036
2,145
1,891
2,044
919
1,125
911
484
427
1,188
1,393
-205
2,086
1,517
569
1,537
1,062
475
785
431
354
1,909
2,012
-103
1,858
1,933
-75
2,013
1,930
83
4,866
2,211
2,655
1,649
210
1,439
1,902
536
1,366
2,440
1,070
1,370
1,934
2,071
-137
430
41
389
7
9
-2
1,076
921
155
1,473
3,381
-1,908
3,134
1,953
1,181
3,354
1,474
1,880
638
1,386
-748
4,997
2,798
2,199
1,269
997
272
544
349
195
1,018
308
710
1,957
2,180
-223
840
880
-40
715
754
-39
1,963
271
1,692
971
308
663
1,486
378
1,108
499
126
373
941
661
280
823
425
398
928
921
7
1,292
1,269
23
1,290
1,269
21
1,556
1,523
33
1,520
1,491
29
43
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
145
b
540
c
-136
d
363
e
-103
1,303
-54
212
1,432
529
175
421
76
76
568
453
453
199
602
130
422
220
425
516
108
646
127
635
425
-670
803
390
739
602
737
1,429
340
532
1,197
157
195
48
422
262
665
162
1,050
-1,645
892
-63
-196
-196
135
626
3,144
430
239
220
2,177
94
383
-679
190
-989
-595
10,371
192
1
549
-245
175
-4
172
-97
1,188
-100
-71
167
-125
71
59
19
344
-213
1,151
1,632
340
823
222
222
143
10
506
582
322
322
498
-1,437
949
849
-1,845
-18,187
419
1,788
677
458
677
470
694
91
217
325
661
-981
-1,742
1,588
969
438
961
477
487
823
557
808
695
1,277
5,506
366
7,291
242
285
165
1,137
2,077
-410
215
5,890
117
1,603
1,579
656
805
3,152
161
1,240
1,186
767
380
4,807
936
1,480
321
-1
115
992
280
390
219
1,080
-542
-4,836
-351
-333
-208
1,891
1,125
427
-205
569
475
354
-103
-75
83
2,655
1,439
1,366
1,370
-137
389
-2
155
-1,908
1,181
1,880
-748
2,199
272
195
710
-223
-40
-39
1,692
663
1,108
373
280
398
7
23
21
33
29
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
95,212
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
89,758
1,847,943
0.048572
2017
80,786
1,732,675
0.046625
2016
73,436
1,706,320
0.043038
2015
74,046
1,607,168
0.046072
2014
65,133
1,565,444
0.041607
2
Total
of line 1, column (d)
.....................
2
0.225914
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
0.045183
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
1,811,057
5
Multiply line 4 by line 3
......................
5
81,829
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
1,073
7
Add lines 5 and 6
........................
7
82,902
8
Enter qualifying distributions from Part XII, line 4
,.............
8
86,838
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See the Part VI instructions.
Form
990-PF
(2019)
Form 990-PF (2019)
Page
4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a
Exempt operating foundations described in section 4940(d)(2), check here
and enter “N/A" on line 1.
Date of ruling or determination letter:
(attach copy of letter if necessary–see instructions)
b
Domestic foundations that meet the section 4940(e) requirements in Part V, check
1
1,073
here
and enter 1% of Part I, line 27b
...................
c
All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
2
0
3
Add lines 1 and 2
...........................
3
1,073
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
4
6,060
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
0
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
1,264
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
7
Total credits and payments. Add lines 6a through 6d
..............
7
1,264
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
1,264
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
0
Refunded
11
1,264
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)
CA
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
ARDEN TRUST COMPANY
Telephone no.
(302) 246-5400
Located at
2751 CENTERVILLE RD STE 400
WILMINGTON
DE
ZIP+4
19808
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1)
Engage in the sale or exchange, or leasing of property with a disqualified person?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(5)
Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)?
...............
Yes
No
(6)
Agree to pay money or property to a government official? (
Exception.
Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.)
.......
Yes
No
b
If any answer is "Yes" to 1a(1)–(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions
........
1b
No
Organizations relying on a current notice regarding disaster assistance check here
........
c
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2019?
.............
1c
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2019, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2019?
.............
Yes
No
If "Yes," list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer "No" and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
......................
Yes
No
b
If "Yes," did it have excess business holdings in 2019 as a result of
(1)
any purchase by the foundation
or disqualified persons after May 26, 1969;
(2)
the lapse of the 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or
(3)
the lapse of the 10-, 15-, or 20-year first phase holding period?
(Use Schedule C, Form 4720, to determine
if the foundation had excess business holdings in 2019.)
..................
3b
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2019?
4b
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
6
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
(continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
No
b
If any answer is "Yes" to 5a(1)–(5), did
any
of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions
......
5b
Organizations relying on a current notice regarding disaster assistance check here
.........
c
If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant?
..........
Yes
No
If "Yes," attach the statement required by Regulations section 53.4945–5(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract?
.....................
Yes
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
....
6b
No
If "Yes" to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
Yes
No
b
If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction?
....
7b
8
Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment during the year?
.................
Yes
No
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1
List all officers, directors, trustees, foundation managers and their compensation. See instructions
(a)
Name and address
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(If not paid, enter
-0-)
(d)
Contributions to employee benefit plans and deferred compensation
(e)
Expense account,
other allowances
ARDEN TRUST COMPANY
TRUSTEE
1
6,563
2751 CENTERVILLE RD STE 400
WILMINGTON
,
DE
19808
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
1,754,244
b
Average of monthly cash balances
.......................
1b
84,393
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
1,838,637
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
1,838,637
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
27,580
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
1,811,057
6
Minimum investment return.
Enter 5% of line 5
..................
6
90,553
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
90,553
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
6,060
c
Add lines 2a and 2b
............................
2c
6,060
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
84,493
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
84,493
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
84,493
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
86,838
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
86,838
5
Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
income. Enter 1% of Part I, line 27b. See instructions
.................
5
1,073
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
85,765
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
84,493
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
62,782
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:
$
86,838
a
Applied to 2018, but not more than line 2a
62,782
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
.....
24,056
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
..........
60,437
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).)
NONE
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.
NONE
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
AMERICAN BIBLE SOCIETY
ATTN LEA VELIS DIR LEGAL AFFAI
NEW YORK
,
NY
10023
NONE
PC
GENERAL OPERATING
5,589
GOD'S BIBLE SCHOOL COLLEGE
ATTN HAROLD FOURMAN
ATTN HAROLD FOURMAN 1810 YOUNG
CINCINNATI
,
OH
45202
NONE
PC
GENERAL OPERATING
8,469
FREE METHODIST CHURCH MISSIONS
ATTN JO LAMMEY CONTROLLER
DENVER
,
CO
80207
NONE
PC
GENERAL OPERATING
16,937
SPRING ARBOR COLLEGE
106 E MAIN ST ATTN JANET TJEP
SPRING ARBOR
,
MI
49283
NONE
PC
GENERAL OPERATING
5,674
CHILDREN INTERNATIONAL
2000 EAST RED BRIDGE ROAD ATTN
KANSAS CITY
,
MO
64131
NONE
PC
GENERAL OPERATING
5,674
HOBE SOUND BIBLE COLLEGE
P O BOX 1065 SE GOMEZ AVE ATTN
HOBE SOUND
,
FL
33475
NONE
PC
GENERAL OPERATING
8,469
ASBURY THEOLOGICAL SEMINARY
204 N LEXINGTON AVE ATTN JIM B
WILMORE
,
KY
40390
NONE
PC
GENERAL OPERATING
5,674
PRISON FELLOWSHIP MINISTRIES 5
PO BOX 1550
MERRIFIELD
,
VA
221161550
NONE
PC
GENERAL OPERATING
5,674
WESLEY BIBLICAL SEMINARY
ATTN PEGGY PRICE PO BOX 600
RIDGELAND
,
MS
39158
NONE
PC
GENERAL OPERATING
5,589
OMS INTERNATIONAL INC
941 FRY ROA - ATTN WAYNE A KIN
GREENWOOD
,
IN
46142
NONE
PC
GENERAL OPERATING
8,469
WORLD VISION INC
ATTN MELISSA STUBBLEFIELD P O
FEDERAL WAY
,
WA
980639716
NONE
PC
GENERAL OPERATING
8,469
Total
.................................
3a
84,687
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
32,385
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
95,212
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
FEDERAL TAX REFUND
1
3,016
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
130,613
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
130,613
(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