-
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
08-01-2019
, and ending
07-31-2020
Name of foundation
DEWINE FAMILY FOUNDATION INC
Number and street (or P.O. box number if mail is not delivered to street address)
3030 GRIEST AVE
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CINCINNATI
,
OH
45208
A Employer identification number
31-1483132
B
Telephone number (see instructions)
(513) 533-3561
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)
$
15,860,937
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
...
429,692
429,692
429,692
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
-561,120
b
Gross sales price for all assets on line 6a
4,256,642
7
Capital gain net income (from Part IV, line 2)
...
8
Net short-term capital gain
.........
9
Income modifications
...........
10a
Gross sales less returns and allowances
b
Less: Cost of goods sold
....
c
Gross profit or (loss) (attach schedule)
.....
11
Other income (attach schedule)
.......
4,692
4,692
12
Total.
Add lines 1 through 11
........
-126,736
429,692
434,384
13
Compensation of officers, directors, trustees, etc.
37,000
37,000
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
3,202
3,202
16a
Legal fees (attach schedule)
.........
200
200
b
Accounting fees (attach schedule)
.......
14,547
14,547
c
Other professional fees (attach schedule)
....
18,370
18,370
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
14,574
14,574
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
2,449
2,449
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
90,342
18,370
71,972
25
Contributions, gifts, grants paid
.......
925,048
925,048
26
Total expenses and disbursements.
Add lines 24 and 25
1,015,390
18,370
997,020
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-1,142,126
b
Net investment income
(if negative, enter -0-)
411,322
c
Adjusted net income
(if negative, enter -0-)
...
434,384
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
.............
305,359
135,766
135,766
2
Savings and temporary cash investments
.........
3
Accounts receivable
Less: allowance for doubtful accounts
4
Pledges receivable
Less: allowance for doubtful accounts
5
Grants receivable
.................
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)
.....
7
Other notes and loans receivable (attach schedule)
1,069,993
Less: allowance for doubtful accounts
1,220,364
1,069,993
1,069,993
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)
.......
11,508,793
10,700,593
14,639,513
c
Investments—corporate bonds (attach schedule)
.......
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
13,040
15,665
15,665
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
13,047,556
11,922,017
15,860,937
17
Accounts payable and accrued expenses
..........
3,319
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)
.........
3,319
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
........
27
Paid-in or capital surplus, or land, bldg., and equipment fund
28
Retained earnings, accumulated income, endowment, or other funds
13,047,556
11,918,698
29
Total net assets or fund balances
(see instructions)
.....
13,047,556
11,918,698
30
Total liabilities and net assets/fund balances
(see instructions)
.
13,047,556
11,922,017
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
13,047,556
2
Enter amount from Part I, line 27a
.....................
2
-1,142,126
3
Other increases not included in line 2 (itemize)
3
13,808
4
Add lines 1, 2, and 3
..........................
4
11,919,238
5
Decreases not included in line 2 (itemize)
5
540
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
11,918,698
Form
990-PF
(2019)
Form 990-PF (2019)
Page
3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a)
List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)
(b)
How acquired
P—Purchase
D—Donation
(c)
Date acquired
(mo., day, yr.)
(d)
Date sold
(mo., day, yr.)
1a
b
c
d
e
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-)
or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
Excess of col. (i)
over col. (j), if any
a
b
c
d
e
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
3
Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8
...................
3
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)
If section 4940(d)(2) applies, leave this part blank.
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period?
Yes
No
If "Yes," the foundation does not qualify under section 4940(e). Do not complete this part.
1
Enter the appropriate amount in each column for each year; see instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in)
(b)
Adjusted qualifying distributions
(c)
Net value of noncharitable-use assets
(d)
Distribution ratio
(col. (b) divided by col. (c))
2018
2017
2016
2015
2014
2
Total
of line 1, column (d)
.....................
2
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
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
5
Multiply line 4 by line 3
......................
5
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
7
Add lines 5 and 6
........................
7
8
Enter qualifying distributions from Part XII, line 4
,.............
8
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
8,226
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
3
Add lines 1 and 2
...........................
3
8,226
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
4
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
8,226
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
15,665
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
15,665
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
11
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
7,428
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
7,428
Refunded
11
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)
OH
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
KAREN DEWINE
Telephone no.
(513) 533-3561
Located at
3030 GRIEST AVE
CINCINNATI
OH
ZIP+4
45208
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
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
R MICHAEL DEWINE
PRESIDENT
000.00
0
0
0
2587 CONLEY ROAD
CEDARVILLE
,
OH
45314
JILL E DEWINE DARLING
TRUSTEE
000.00
0
0
0
6796 BOWERMAN STREET EAST
WORTHINGTON
,
OH
43085
KAREN DEWINE
SEC/TREAS
000.00
37,000
0
0
3030 GRIEST AVE
CINCINNATI
,
OH
45208
FRANCES DEWINE
VICE PRES
000.00
0
0
0
2587 CONLEY ROAD
CEDARVILLE
,
OH
45314
JOHN DEWINE
TRUSTEE
000.00
0
0
0
100 FAIRFIELD-YELLOW SPRINGS ROAD
YELLOW SPRINGS
,
OH
45387
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
...................
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
.............
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
N/A
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
15,056,487
b
Average of monthly cash balances
.......................
1b
133,090
c
Fair market value of all other assets (see instructions)
................
1c
1,069,994
d
Total
(add lines 1a, b, and c)
.........................
1d
16,259,571
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation)
.............
1e
2
Acquisition indebtedness applicable to line 1 assets
..................
2
3
Subtract line 2 from line 1d
.........................
3
16,259,571
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
243,894
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
16,015,677
6
Minimum investment return.
Enter 5% of line 5
..................
6
800,784
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
800,784
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
8,226
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
8,226
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
792,558
4
Recoveries of amounts treated as qualifying distributions
................
4
5
Add lines 3 and 4
............................
5
792,558
6
Deduction from distributable amount (see instructions)
.................
6
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1
...
7
792,558
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
997,020
b
Program-related investments—total from Part IX-B
..................
1b
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
b
Cash distribution test (attach the required schedule)
.................
3b
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
997,020
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
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
997,020
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
792,558
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
b
Total for prior years:
20
,
20
,
20
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
26,357
b
From 2015
......
c
From 2016
......
d
From 2017
......
59,573
e
From 2018
......
34,572
f
Total
of lines 3a through e
........
120,502
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
997,020
a
Applied to 2018, but not more than line 2a
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
c
Treated as distributions out of corpus (Election
required—see instructions)
........
d
Applied to 2019 distributable amount
.....
792,558
e
Remaining amount distributed out of corpus
204,462
5
Excess distributions carryover applied to 2019.
(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
324,964
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
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
......
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
e
Undistributed income for 2018. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
f
Undistributed income for 2019. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2020
..........
0
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions)
.......
8
Excess distributions carryover from 2014 not
applied on line 5 or line 7 (see instructions)
...
26,357
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
298,607
10
Analysis of line 9:
a
Excess from 2015
....
b
Excess from 2016
....
c
Excess from 2017
....
59,573
d
Excess from 2018
....
34,572
e
Excess from 2019
....
204,462
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
AKRON CHILDREN'S HOSPITAL
6505 MARKET STREET
BOARDMAN
,
OH
44512
N/A
PUBLIC
GENERAL FUNDING CHILDRES'S HOSP
1,000
ALZHEIMER'S ASSOCIATION
225 N MICHIGAN AVE FLR 1
CHICAGO
,
IL
60601
N / A
PUBLIC
RESEARCH AND CARE FUNDING
100
AMERICAN HEART ASSOCIATION
300 SOUNT RIVERSIDE PLAZA
STE 1200
CHICAGO
,
IL
60606
N/A
PUBLIC
FUNDING RESEARCH AND CARE
500
AMERICAN LINE BLDR JOINT APPRENTICE
P O BOX 370
MEDWAY
,
OH
45341
N / A
PUBLIC
SCHOLARSHIP FUNDING
476
ANDY NOWACKI ENDOWMENT
PO BOX 1869
MENTOR
,
OH
44061
N/A
PUBLIC
SCHOLARSHIP FUNDING
1,000
AWAKENING ANGELS
18605 DETROIT AVE
LAKEWOOD
,
OH
44107
N / A
PUBLIC
DOWN SYNDROME RESEARCH FUNDING
1,000
BARTON COLLEGE
PO BOX 5000
WILSON
,
NC
27893
N/A
PUBLIC
SCHOLARSHIP FUNDING
10,000
BEREA COLLEGE
CPO 2172
BEREA
,
KY
40404
N / A
PUBIC
BECKY DEWINE SCHOLARSHIP
731
BLOCK 43 COURTYARD
3610 CLIFTON ROAD
GREENSBORO
,
NC
27407
N/A
PUBLIC
SCHOLARSHIP FUNDING
8,475
CAHTOLIC CHARITIES OF CLEVELAND
1404 EAST 9TH STREET
CVLEVELAND
,
OH
44114
N/A
PUBLIC
FUNDING CATHOLIC CHARTIES
200
CEDARVILLE UNITED PRESBYTERIAN CHUR
30 WEST CHILLICOTHER ST
CEDARVILLE
,
OH
45314
N/A
PUBLIC
GENERAL FUNDING
200
CEDARVILLE UNIVERSITY
251 N MAIN ST
CEDARVILLE
,
OH
45314
N / A
PUBLIC
BECKY DEWINE SCHOLARSHIPS
35,000
CEENDETRIA TRANCHANT
280 HAZEL MILL ROAD
ASHEVILLE
,
NC
28806
N/A
PUBLIC
SCHOLARSHIP FUNDING
783
CISE
100 E EIGHT ST
CINCINNATI
,
OH
45202
N / A
PUBLIC
CATHOLIC EDUCATION FUNDING FOR YOUTH
12,000
CHERRY FORK PRESBYTERIAN CHRUCH
PO BOX 107
CHERRY FORK
,
OH
45618
N/A
PUBLIC
CHURCH FUNDING
150
COLUMBUS STATE COMMUNITY COLLEGE
550 EAST SPRING STREET
COLUMBUS
,
OH
43216
N / A
PUBLIC
BECKY DEWINE SCHOLARSHIP
1,976
COMBINED CHARITABLE CAMPAIGN
STATEOFOHIOCCC
UWCENTRALOHIOORG
COLUMBUS
,
OH
43222
N/A
PUBLIC
COMBINED CHARITABLE GIVING
2,000
CYSTIC FIBROSIS FOUNDATION
4420 CARVER WOODS DR
BLUE ASH
,
OH
45242
N/A
PUBLIC
RESEARCH AND CARE
250
DOWN SYNDROME ASSOC GRTR CINCINNATI
4623 WESLEY AVE STE A
CINCINNATI
,
OH
45212
N / A
PUBLIC
RESEARCH, EDUCATION & PROGRAMS
200
ELIZABETH NEW LIFE CENTER
359 FOREST AVE STE 203
DAYTON
,
OH
45405
N / A
PUBLIC
GENERAL RESEARCH FUNDING
5,000
FABRETTO CHILDRENS
3124 NORTH 10TH ST
2ND FLOOR
ARLINGTON
,
VA
22201
N/A
PUBLIC
UNDERSERVED CHILDRE NICARAGUA
9,996
FAITH AND FRIENDS RADIO
PO BOX 24855
DAYTON
,
OH
45424
N/A
PUBLIC
GENERAL OPERATIONS FUNDING
200
FATHER FREDERICK SCHOLARSHIP FUND
1478 EAGLE WAY
MARIN
,
OH
43302
N/A
PUBLIC
SCHOLARSHIP FUNDING
1,000
FIRST PRESBYTERIAN CHURCH
1130 HIGHVIEW DR
FAIRBORN
,
OH
45324
N/A
PUBLIC
GENERAL CHURCH FUNDING
150
FRANKLIN FAITH TABERNACLE CHURCH
7769 SHARTS ROAD
SPRINGBORO
,
OH
45066
N/A
PUBLIC
GENERAL CHURCH FUNDING
100
FOR THE LOVE OF CHILDREN
128 WEST 1ST ST
DAYTON
,
OH
45402
N/A
PUBLIC
TUTORING UNDERSERVED STUDENTS
100
GIRL SCOUTS OF WESTERN OHIO
450 SHOUP MILL ROAD
DAYTON
,
OH
45415
N / A
PUBLIC
FEMALE LEADERSHIP ORGANIZATION
10,000
GIRL SCOUNTS OF NORTH EAST OHIO
ONE GIR SCOUT WAY
MACEDONIA
,
OH
44056
N/A
PUBLIC
GENERAL FUNDING
200
GLEN HELEN ASSOCIATION
405 CORRY STREET
YELLOW SPRINGS
,
OH
45387
N / A
PUBLIC
FUND NATURE PRESERVE AND EDUCATION
5,500
GREEN GIVING
941 WEST 2ND ST
XENIA
,
OH
45385
N/A
PUBLIC
FUNDING COMMUNITY PARKS & PLAYGROUND
1,000
GRACE COLLEGE AND SEMINARY
200 SEMINARY DRIVE
WEST LAKE
,
IN
46590
N / A
PUBLIC
BECKY DEWINE SCHOLARSHIP
5,000
GREAT OAKS EDUCATION FOUNDATION
110 GREAT OAKS DR
CINCINNATI
,
OH
45241
N/A
PUBLIC
EDUCATION & EMPLOYMENT COUNSELING
250
HANDS TOGETHER
P O BOX 80985
SPRINGFIELD
,
MA
01138
N / A
PUBLIC
FUNDING FOR SCHOOL IN HAITI
400,000
HAWKEN SCHOOL
12465 COUNTY LINE ROAD
GATES MILL
,
OH
44040
N / A
PUBLIC
SCHOLARSHIP FUNDING
1,934
HEALTHNETWORK FOUNDATION
33 RIVER ST 3
CHARGRIN FALLS
,
OH
44022
N/A
PUBLIC
GENERAL FUNDING
1,000
HIRAM COLLEGE
P O BOX 1808
HIRAM
,
OH
44234
N / A
PUBLIC
BECKY DEWINE SCHOLARSHIP
3,000
HOCKING COLLEGE
3301 HOCKING PKWY
NELSONVILLE
,
OH
45764
N / A
PUBLIC
BECKY DEWINE SCHOLARSHP
13,836
HOLLINS UNIVERSITY
P O BOX 9658
ROANOKE
,
VA
24020
N / A
PUBLIC
BECKY DEWINE SCHOLARSHIP
4,809
HONDROS COLLEGE OF NURSING
1810 SUCCESSFUL DRIVE
FAIRBORN
,
OH
45324
N / A
PUBLIC
BECKY DEWINE SCHOLARSHIP
10,769
IVY TECHNICAL COMMUNITY COLLEGE
2357 CHESTER BOULEVARD
RICHMOND
,
IN
47374
N/A
PUBLIC
SCHOLARSHIP FUNDING
1,928
KAIA L GRANT MEMORIAL SCHOLARSHIP F
73 CHESTNUT AVE
CINCINNATI
,
OH
45215
N/A
PUBLIC
SCHOLARSHIP FUNDING
150
KETTTERING MEDICAL CENTER CANCER
3700 SOUTHERN BOULEVARD
KETTERING
,
OH
45429
N/A
PUBLIC
CANCER RESEARCH
100
KURT TUNNELL SERVANT LEADERSHIIP FD
100 SOUTH 3RD ST
COLUMBUS
,
OH
43215
N/A
PUBLIC
FUNDING LEADERSHIP SKILLS PROGRAM
500
LAKEWOOD MONTESSORI SCHOOL
1447 ORCHARD GROVE AVE
LAKEWOOD
,
OH
44107
N/A
PUBLIC
GENERAL FUNDING
1,000
LAUREL SCHOOL
1 LYMAN CIRCLE
SHAKER HEIGHTS
,
OH
44122
N / A
PUBLIC
SCHOLARSHIP FUNDING
500
LIFELINE OF OHIO
770 KINNEAR ROAD 200
COLUMBUS
,
OH
43212
N/A
PUBLIC
FUNDIONG ORGAN DONATION
100
LICKING COUNTY HUMANE SOCIETY
825 THORNWOOD DR SW
HEATH
,
OH
43056
N/A
PUBLIC
ANIMAL PROTECTION
100
LITTLE ART THEATRE
247 XENIA AVENUE
YELLOW SPRINGS
,
OH
45387
N / A
PUBLIC
FUNDS FOR COMMUNITY THEATRE
1,000
LOURDES UNIVERSITY
6832 COVENT BOULEVARD
SYLVANIA
,
OH
43560
N/A
PUBLIC
GENERAL FUNDING
2,000
MADISON PLAINS SCHOLARSHIP FOUNDATI
12460 FRALICK ROAD
SOUTH SOLON
,
OH
43153
N/A
PUBLIC
SCHOLARSHIP FUNDING
200
MALAWI TALENT FUND
5207 NORWICH
HILLIARD
,
OH
43026
N/A
PUBLIC
FUNDING JOB CREATION
1,000
MARCH OF DIMES
6 ROBERTS ROAD STE 102
ASHEVILLE
,
NC
28803
N / A
PUBLIC
IMPROVING HEALTH OF BABIES FUNDING
1,500
MARION SHELTER HOUSE
326 WEST FAIRGROUND ST
MARION
,
OH
43302
N/A
PUBLIC
SERVICES FOR THE HOMELESS
100
MIAMI UNIVERSITY
301 SOUTH CAMPUS AVE
OXFORD
,
OH
45056
N / A
PUBLIC
BECKY DEWINE SCHOLARSHIP
10,000
MIAMI VALLEY WOMEN'S CENTER
2345 WEST STROOP ROAD
DAYTON
,
OH
45439
N/A
PUBLIC
FUNDING WOMENS HEALTH
2,500
MARIAN K SHAUGHNESSY NURSING LEADER
10900 EUCLID AVE
CLEVELAND
,
OH
44106
N/A
PUBLIC
FUNDING NURSING SCHOLARSHIP
200
NATIONAL BASEBALL HALL OF FAME
25 MAIN STREET
COOPERSTOWN
,
NY
13326
N / A
PUBLIC
OPERATIONS FUNDING
5,000
NATIONWIDE CHILDRENS HOSP FOUNDA
700 CHILDRES DR
COLUMBUS
,
OH
43205
N/A
PUBLIC
GENERAL FUNDING
2,700
WESTERN CAROLINA UNIVERSITY
118 KILLIAN ANNEX
CELLOSHEE
,
NC
28723
N/A
PUBLIC
SCHOLARSHIP FUNDING
1,479
ODNR DIVISION OF NATURAL AREAS
2045 MORSE RD BLDG C-3
COLUMBUS
,
OH
43229
N/A
PUBLIC
FUNDING TO PROTECT NATURAL AREAS
500
OHIO RESTAURANT ASSOC PRO START
100 EAST CAMPUS VIEW
BOULVARD STE 150
COLUMBUS
,
OH
43235
N/A
PUBLIC
SCHOLARSHIP FUNDING
10,673
OHIO UNIVERSITY
CHUBB HALL 010
ATHENS
,
OH
45701
N / A
PUBLIC
BECKY DEWINE SCHOLARSHIPS
7,500
OHIO FARM BUREAU
PO BOX 182383
COLUMBUS
,
OH
43218
N/A
PUBLIC
SUPPORT OHIO AGRICULTURE
200
OUR LADY OF GUADALUPE CENTER
409 INDUSTRY DR
COLUMBUS
,
OH
43204
N/A
PUBLIC
CATHOLIC SOCIAL SERVICES
100
PAMELA SMITHERMAN SCHOLARSHIP FUND
100 LENOX PLACE
CINCINNATI
,
OH
45229
N/A
PUBLIC
SCHOLARSHIP FUNDING
1,000
RAINBOW COMMUNITY SCHOOL
574 HAYWOOD DRIVE
ASHEVILLE
,
NC
28806
N / A
PUBLIC
GENERAL SCHOOL FUNDING
1,500
REDS HALL OF FAME
100 JOE NUXALL WAY
CINCINNATI
,
OH
45202
N / A
PUBLIC
MUSEUM AND PROGRAM FUNDING
1,000
ROYLENE A MOORE LIVING LEGACY
804 SUMMIT ST
SPENCER
,
WV
25276
N/A
PUBLIC
SCHOLARSHIP FUNDING
200
SAM'S FANS
94355 SHELBOURNE LANE
COLUMBUS
,
OH
43220
N / A
PUBLIC
MUSIC ART THERAPY HOSPITAL PATIENTS
1,000
SAVE THE ANIMAL FOUNDATION
4011 RED BANK ROAD
CINCINNATI
,
OH
45227
N/A
PUBLIC
ANIMAL PROTECTION & ADOPTING
100
SCHNEIDER HOUSE OF HOPE
124 DETROIT ST
XENIA
,
OH
45385
N/A
PUBLIC
UNITING RELIGIOUS & BUSINESS COMM
500
SINCLAIR COMMUNITY COLLEGE
444 W THIRD STREET
DAYTON
,
OH
45402
N / A
PUBLIC
BECKY DEWINE SCHOLARSHIPS
6,408
SPRING HILL COLLEGE
4000 DAUPHIN STREET
MOBILE
,
AL
36608
N / A
PUBLIC
SCHOLARSHIPS FUNDING
236,050
ST IGNATIUS
1911 WEST 30TH ST
CLEVELAND
,
OH
44113
N/A
PUBLIC
SCHOLARSHIP FUNDING
2,250
STRATFORD ECOLOGICAL CENTER
3083 LIBERTY ROAD
DELAWARE
,
OH
43015
N/A
PUBLIC
ORGANIC FARM & NATURE PRESERVE
500
SUMMIT COUNTRY DAY ANNUAL FUND
2161 GRANDIN ROAD
CINCINNATI
,
OH
45208
N / A
PUBLIC
GENERAL CHURCH FUNDING
1,000
TECUMSEH COUNCIL BSA
326 THOMPSON AVE
SPRINGFIELD
,
OH
45506
N / A
PUBLIC
PROGRAMS & FACILITIES FOR BOY SCOUTS
1,000
TECUMSEH LAND TRUST
P O BOX 417
YELLOW SPRINGS
,
OH
45387
N / A
PUBLIC
FUNDING LAND PRESERVATION
1,000
THE OHIO STATE UNIVERSITY
2036 NEIL AVE
COLUMBUS
,
OH
43210
N / A
PUBLIC
SCHOLARSHIP FUNDING
2,500
THE WEST PARK CLEVELAND POLICE
1300 WEST 58TH STREET
CLEVELAND
,
OH
44102
N / A
PUBLIC
POLICE & FIREFIGHTER'S MEMORIAL FUND
1,000
TRINITY WASHINGTON UNIVERSITY
125 MICHIGAN AVENUE NE
WASHINGTON
,
DC
20017
N / A
PUBLIC
BECKY DEWINE SCHOLARSHIP
3,000
UNIVERSITY CASHIER
450 RIDGE ROAD CB1400
CHAPEL HILL
,
NC
27599
N / A
PUBLIC
BECKY DEWINE SCHOLARSHIP
4,207
UNIVERSITY NORTH CAROLINA ASHEVILLE
ONE UNIVERSITY HEIGHTS
ASHEVILLE
,
NC
28808
N / A
PUBLIC
BECKY DEWINE SCHOLARSHIP
5,000
UNIVERSITY OF CINCINNATI
51 GOODMAN DRIVE
CINCINNATI
,
OH
45219
N / A
PUBLIC
BECKY DEWINE SCHOLARSHIP
6,500
UNIVERSITY DISTRICT PROPERTIES
605 NORTH HIGH ST
COLUMBUS
,
OH
43215
N/A
PUBLIC
SCHOLARSHIP FUNDING
4,840
UNIVERSITY OF FINDLAY
100 NARTH MAIN ST
FINDLAY
,
OH
45840
N/A
PUBLIC
SCHOLARSHIP FUNDING
7,500
USA MITCHELL CANCER INSTITUTE
30 ALUMNI CIRCLE
MOBILE
,
AL
36688
N / A
PUBLIC
RESEARCH FUNDING
1,000
WESTERN CAROLINA UNIVERSITY
118 KILLIAN ANNEX
CULLOSHEE
,
NC
28723
N / A
PUBLIC
BECKY DEWINE SCHOLARSHIPS
2,014
WESTERN RESERVE ACADEMY
115 COLLEGE ST
HUDSON
,
OH
44236
N/A
PUBLIC
SCHOLARSHIP FUNDING
250
WESTERVILLE PUBLIC LIBRARY OUTREACH
126 SOUTH STATE ST
WESTERVILLE
,
OH
43081
N/A
PUBLIC
GENERAL FUNDING
500
WILMINGTON COLLEGE
1870 QUAKER WAY
WILMINGTON
,
OH
45177
NJ / A
PUBLIC
BECKY DEWINE SCHOLARSHIP
12,500
WINSTON-SALEM STATE UNIVERSITY
601 S MARTIN LUTHER KING
WINSTONSALEM
,
NC
27110
N / A
PUBLIC
BECKY DEWINE SCHOLARSHIP
3,459
WOMEN'S CARE CENTER
935 EAST BROAD SST
COLUMBUS
,
OH
43205
N/A
PUBLIC
WOMENS HEALTH
500
WRIGHT STATE UNIVERSITY
3640 COLONEL GLENN HWY
DAYTON
,
OH
45435
N / A
PUBLIC
BECKY DEWINE SCHOLARSHIPS
2,881
XAVIER UNIVERSITY
3800 VICTORY PARKWAY
CINCINNATI
,
OH
45207
N / A
PUBLIC
BECKY DEWINE SCHOLARSHIP
1,500
YOUTH LEADERSHIP ASSOCIATION
400 MAIN ST 2ND FLOOR
POINT PLEASANT
,
WV
25550
N/A
PUBLIC
YOUTH BUSINESS LEADERSHIP
1,000
CASEY STURGILL
120 EAST FRAHN AVENUE
FAIRBORN
,
OH
45324
N / A
INDIVIDUAL
BECKY DEWINE SCHOLARSHIP
783
DELCINA ROBERTSON
3440 CLOVERIDGE COURT
FAIRBORN
,
OH
45324
N/A
INDIVIDUAL
SCHOLARSHIP FUNDING
233
ELIZABETH KASONGO
2558 MISSISSIPPI ST
BATON ROUGE
,
LA
70808
N/A
INDIVIDUAL
SCHOLARSHIP FUNDING
1,480
EMMA B RICE
14014 SHAKER BLVD 202
SHAKER HEIGHTS
,
OH
44120
N / A
INDIVIDUAL
BECKY DEWINE SCHOLARSHIP
6,750
KAILEY ROGERS
1600 FAIRGROUND ROAD
XENIA
,
OH
45385
N/A
INDIVIDUAL
SCHOLARSHIP FUNDING
219
LOXLEY CHASE
3736 KINGS ROW
WINSTONSALEM
,
NC
27106
N/A
INDIVIDUAL
SCHOLARSHIP FUNDING
450
PATRICK J UNGARO
655 WICK AVE
YOUNGSTOWN
,
OH
44502
N/A
INDIVIDUAL
SCHOLARSHIP FUNDING
500
REANNA HORSELY
97 W ANKENEY MILL ROAD
XENIA
,
OH
45385
N / A
INDIVIDUAL
SCHOLARSHIP FUNDING
59
Total
.................................
3a
925,048
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
429,692
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
............
-561,120
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
GIFTS RECEIVED
14
200
b
PARTNERSHIP ORDINARY GAINS
14
4,492
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
434,384
-561,120
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
-126,736
(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