Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0052
2019
Open to Public Inspection
For calendar year 2019, or tax year beginning 01-01-2019 , and ending 12-31-2019
Name of foundation
OSCAR G & ELSA S MAYER FAMILY FOUNDATION
C/O SEDGWICK ADVISERS LLC
Number and street (or P.O. box number if mail is not delivered to street address)111 E BUSSE AVENUE NO 601
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MOUNT PROSPECT, IL60056
A Employer identification number

36-4035204
B Telephone number (see instructions)

(312) 332-3682
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ...
bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$16,920,842
J Accounting method:
 
(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)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet.............
3 Interest on savings and temporary cash investments 2,692    
4 Dividends and interest from securities... 308,036 308,036  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 556,064
b Gross sales price for all assets on line 6a  
7 Capital gain net income (from Part IV, line 2)... 556,064
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)....... 2,371 -10,592  
12 Total. Add lines 1 through 11........ 869,163 853,508  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 40,768 0   40,768
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... 61,500 5,500   56,000
c Other professional fees (attach schedule).... 69,539 9,769   59,770
17 Interest............... 3,587 3,587   0
18 Taxes (attach schedule) (see instructions)... 18,453 18,453   0
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings....... 65,086 0   65,086
22 Printing and publications..........        
23 Other expenses (attach schedule)....... 143,797 0   2,858
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 402,730 37,309   224,482
25 Contributions, gifts, grants paid....... 681,781 681,781
26 Total expenses and disbursements. Add lines 24 and 25 1,084,511 37,309   906,263
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -215,348
b Net investment income (if negative, enter -0-) 816,199
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2019)
Form 990-PF (2019)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing.............      
2 Savings and temporary cash investments......... 886,937 244,780 244,780
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
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) bullet  
Less: allowance for doubtful accounts bullet        
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)....... 3,602,765 Click to see attachment3,654,985 5,022,525
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 1,356,835 Click to see attachment1,356,835 1,310,073
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet) Click to see attachment7,708,806 Click to see attachment8,083,253 Click to see attachment10,343,464
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 13,555,343 13,339,853 16,920,842
Liabilities 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 bullet)    
23 Total liabilities (add lines 17 through 22)......... 0 0
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
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 bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........ 14,483,546 14,483,546
27 Paid-in or capital surplus, or land, bldg., and equipment fund 0 0
28 Retained earnings, accumulated income, endowment, or other funds -928,203 -1,143,693
29 Total net assets or fund balances (see instructions)..... 13,555,343 13,339,853
30 Total liabilities and net assets/fund balances (see instructions). 13,555,343 13,339,853
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
13,555,343
2
Enter amount from Part I, line 27a .....................
2
-215,348
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
13,339,995
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
142
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
13,339,853
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 FROM K-1 - IR&M P    
b FROM K-1 - IR&M P    
c FROM K-1 SEP-PRIVATE EQUITY FD 2008 P    
d FROM K-1 SEP-PRIVATE EQUITY FD 2013 P    
e FROM K-1 SEP-PRIVATE EQUITY FD 2016 P    
FROM K-1 - REP I P    
FROM K-1 - REP II P    
FROM K-1 - REP III P    
FROM K-1 - SEDGWICK STREET FUNDS P    
FROM K-1 - SEDGWICK STREET FUNDS P    
FROM K-1 SEP-PRIVATE EQUITY FD 2008 P    
FROM K-1 SEP-PRIVATE EQUITY FD 2013 P    
FROM K-1 SEP-PRIVATE EQUITY FD 2016 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       8,932
b       4,124
c       85,058
d       40,679
e       21,227
      -26,492
      74,697
      71,960
      -24,507
      297,635
      534
      -44
      2,261
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       8,932
b       4,124
c       85,058
d       40,679
e       21,227
      -26,492
      74,697
      71,960
      -24,507
      297,635
      534
      -44
      2,261
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
Bracket 2 556,064
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 ...................
Bracket 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?
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 890,797 16,447,978 0.054158
2017 916,594 16,356,087 0.056040
2016 795,165 15,222,285 0.052237
2015 854,122 16,257,240 0.052538
2014 875,953 16,839,220 0.052019
2
Total of line 1, column (d) .....................
2
0.266992
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
0.053398
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5......
4
16,262,197
5
Multiply line 4 by line 3......................
5
868,369
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
8,162
7
Add lines 5 and 6........................
7
876,531
8
Enter qualifying distributions from Part XII, line 4,.............
8
906,263
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 Bullet and enter “N/A" on line 1. Bracket includes lines 1a and 1b
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 8,162
hereBulletand 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 8,162
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 8,162
6 Credits/Payments:
a 2019 estimated tax payments and 2018 overpayment credited to 2019 6a 13,534
b Exempt foreign organizations—tax withheld at source...... 6b
c Tax paid with application for extension of time to file (Form 8868)... 6c 10,000
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 23,534
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. Click to see attachment 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 15,372
11 Enter the amount of line 10 to be: Credited to 2020 estimated taxBullet15,372 RefundedBullet 11 0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition).................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
  • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletIL
    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 addressbulletN/A
    14
    The books are in care ofbulletSEDGWICK ADVISERS LLC Telephone no.bullet (312) 332-3682

    Located atbullet111 E BUSSE AVENUE SUITE 601MOUNT PROSPECTIL ZIP+4bullet60056
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over YesNo
    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 bullet
    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?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?......................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (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)?...............
    (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.).......
    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
     
     
    ........bullet
    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?.............
    If "Yes," list the years bullet20, 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.
    bullet20, 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?......................
    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))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?.............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?.....
    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
     
     
    .........bullet
    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?..........
    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?.....................
    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?
    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? .................
    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
    HAROLD F MAYER DIRECTOR & VICE PRESIDENT
    10.00
    0 0 0
    6519 CROWN COLONY PLACE 201
    NAPLES,FL34108
    ALISON M SHETTER DIRECTOR & SECRETARY
    1.00
    0 0 0
    5107 SUNSHINE CANYON DRIVE
    BOULDER,CO80302
    OSCAR H MAYER DIRECTOR
    1.00
    0 0 0
    2445 NW WESTOVER ROAD 311
    PORTLAND,OR97210
    ALLAN C MAYER JR DIRECTOR
    1.00
    0 0 0
    214 MANSON VIEW DRIVE
    MANSON,WA98831
    RICHARD A MAYER DIRECTOR & TREASURER
    1.00
    0 0 0
    340 CHURCHILL STREET
    NORTHFIELD,IL60093
    WENDY MAYER BERRY DIRECTOR
    1.00
    0 0 0
    210 CHESTNUT STREET
    CLINTON,MA01510
    WILLIAM E MAYER DIRECTOR & PRESIDENT
    1.00
    0 0 0
    117 HOMAN LAKE ROAD
    IRON RIVER,MI49935
    KARLA K RITT ASST SECRETARY
    10.00
    40,768 0 0
    1288 SUMMIT AVE SUITE 107-134
    OCONOMOWOC,WI53066
    OSCAR HENRY MAYER DIRECTOR
    1.00
    0 0 0
    204 HOWARD STREET
    RIVERTON,NJ08077
    RICHARD C MAYER DIRECTOR
    1.00
    0 0 0
    1750 30TH STREET 220
    BOULDER,CO80301
    TIMOTHY N THOMPSON ASST TREASURER
    1.00
    0 0 0
    111 E BUSSE AVENUE 601
    MOUNT PROSPECT,IL60056
    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...................bullet 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.............bullet0
    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.........................bullet0
    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
    16,172,505
    b
    Average of monthly cash balances.......................
    1b
    337,340
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    16,509,845
    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
    16,509,845
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    247,648
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    16,262,197
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    813,110
    Part XI
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    813,110
    2a
    Tax on investment income for 2019 from Part VI, line 5......
    2a
    8,162
    b
    Income tax for 2019. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    8,162
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    804,948
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    804,948
    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
    804,948
    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
    906,263
    b
    Program-related investments—total from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    906,263
    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
    8,162
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    898,101
    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 7 804,948
    2 Undistributed income, if any, as of the end of 2019:
    a Enter amount for 2018 only....... 0
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2019:
    a From 2014...... 51,824
    b From 2015...... 46,136
    c From 2016...... 40,441
    d From 2017...... 116,868
    e From 2018...... 84,280
    fTotal of lines 3a through e........ 339,549
    4Qualifying distributions for 2019 from Part
    XII, line 4: bullet$ 906,263
    a Applied to 2018, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election required—see instructions).....
    0
    c Treated as distributions out of corpus (Election
    required—see instructions)........
    0
    d Applied to 2019 distributable amount..... 804,948
    e Remaining amount distributed out of corpus 101,315
    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).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 440,864
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........
    0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......
    0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........
    0
    e Undistributed income for 2018. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............
    0
    f Undistributed income for 2019. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2020 ..........
    0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......
    0
    8 Excess distributions carryover from 2014 not
    applied on line 5 or line 7 (see instructions) ...
    51,824
    9Excess distributions carryover to 2020.
    Subtract lines 7 and 8 from line 6a ......
    389,040
    10 Analysis of line 9:
    a Excess from 2015.... 46,136
    b Excess from 2016.... 40,441
    c Excess from 2017.... 116,868
    d Excess from 2018.... 84,280
    e Excess from 2019.... 101,315
    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....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    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.)
    1Information Regarding Foundation Managers:
    aList 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).)
    bList 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.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny 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)
    aPaid during the year
    5280 HIGH SCHOOL
    3631 N FILMORE STREET
    DENVER,CO80205
    NONE   GENERAL 1,000
    ACCESS OPPORTUNITY
    1871 FOLSOM STREET 110
    BOULDER,CO80302
    NONE   GENERAL 500
    ACLU MONTANA
    PO BOX 1317
    HELENA,MT59624
    NONE   GENERAL 1,000
    AEROBRIDGE
    22861 SWENSON RAVINE
    GRASS VALLEY,CA95949
    NONE   GENERAL 1,000
    AGE WELL
    76 PEARL STREET SUITE 201
    ESSEX JUNCTION,VT05452
    NONE   GENERAL 2,500
    ARIZONA HUMANE SOCIETY
    1521 WEST DOBBINS ROAD
    PHOENIX,AZ85241
    NONE   GENERAL 2,500
    ASU FOUNDATION
    300 EAST UNIVERSITY DRIVE
    TEMPE,AZ85281
    NONE   GENERAL 2,500
    ATTENTION HOMES
    1443 SPRUCE STREET
    BOULDER,CO80302
    NONE   HOMELESS AT-RISK YOUTH DEVELOPMENT PROGRAMMING 52,430
    BABIES OF HOMELESSNESS
    PO BOX 147
    BOTHELL,WA98041
    NONE   GENERAL 2,000
    BELOIT COLLEGE
    700 COLLEGE STREET
    BELOIT,WI53511
    NONE   GENERAL 10,000
    BILLINGS WEST HIGH SCHOOL
    2201 ST JOHNS AVENUE
    BILLINGS,MT59102
    NONE   FORENSICS 1,000
    CHILDREN'S INSTITUTE
    1411 SW MORRISON STREET 205
    PORTLAND,OR97205
    NONE   STRENGTHENING EARLY WORKS HEALTH AND FAMILY ENGAGEMENT SERVICES 50,000
    CHILDREN'S SPINE FOUNDATION
    PO BOX 397
    VALLEY FORGE,PA19481
    NONE   GENERAL 500
    CHRYSALIS
    2055 W NORTHERN AVENUE
    PHOENIX,AZ85021
    NONE   GENERAL 1,000
    CURE CMD
    1621 W 25TH STREET 623
    SAN PEDRO,CA90732
    NONE   GENERAL 1,000
    CURE SMA
    925 BUSSE ROAD
    ELK GROVE VILLAGE,IL60007
    NONE   CURE SMA CENTER NETWORK AND CLINICAL DATA REGISTRY 50,000
    DENVER CENTER FOR PERFORMING ARTS
    1101 13TH STREET
    DENVER,CO80204
    NONE   GENERAL 5,700
    DUKE UNIVERSITY
    PO BOX 90600
    DURHAM,NC27708
    NONE   GENERAL 4,500
    EQUAL JUSTICE INITIATIVE
    122 COMMERCE STREET
    MONTGOMERY,AL36104
    NONE   DISABILITY RIGHTS LITIGATION 50,000
    FAMILIES AGAINST MANDATORY MINIMUMS
    1100 H STREET SUITE 1000
    WASHINGTON DC,DC20005
    NONE   GENERAL 1,000
    FRIENDLY HOUSE
    2617 NW SAVIER STREET
    PORTLAND,OR97210
    NONE   GENERAL 1,500
    FROM K-1'S
    111 BUSSE AVENUE SUITE 601
    MOUNT PROSPECT,IL60056
    NONE   FROM K-1'S 51
    GRAHAM MEMORIAL PRESBYTERIAN CHURCH
    959 C AVENUE
    CORONADO,CA92118
    NONE   GENERAL 2,500
    GEORGE WASHINGTON UNIVERSITY
    2600 VIRGINIA AVENUE 3RD FLOOR
    WASHINGTON DC,DC20037
    NONE   GW HEALING CLINIC 1,000
    HUMANE SOCIETY OF BOULDER VALLEY
    2323 55TH AVENUE
    BOULDER,CO80301
    NONE   GENERAL 100
    I SING FIRST BAPTIST CHURCH OF PALO ALTO
    305 CALIFORNIA AVENUE
    PALO ALTO,CA94301
    NONE   GENERAL 1,000
    ITHACA COLLEGE
    953 DANBURY ROAD
    ITHACA,NY14850
    NONE   ITHACA NATURAL LANDS 1,000
    INVEST IN KIDS
    1775 SHERMAN STREET 1445
    DENVER,CO80203
    NONE   THE INCREDIBLE YEARS IN COLORADO 50,000
    JUVENILE DIABETES RESEARCH FOUNDATION
    26 BROADWAY 14TH FLOOR
    NEW YORK,NY10004
    NONE   GENERAL 10,000
    LAFAYETTE COLLEGE
    307 MARCKLE HALL
    EASTON,PA18042
    NONE   GENERAL 750
    LAKE CHELAN ROTARY COMMUNITY & INTERNATIONAL FUND
    PO BOX 601
    CHELAN,WA98816
    NONE   GENERAL 1,000
    MANSON VOLUNTEER FIREFIGHTER ASSOCIATION
    PO BOX D
    MANSON,WA98831
    NONE   GENERAL 2,000
    MARY LIN EDUCATION FOUNDATION
    586 CANDLER PARK NE
    ATLANTA,GA30307
    NONE   GENERAL 1,000
    MAYBELLE CENTER FOR COMMUNITY
    121 NW SIXTH AVENUE
    PORTLAND,OR97209
    NONE   GENERAL 500
    MAYO CLINIC ALIX SCHOOL OF MEDICINE
    13400 E SHEA BOULEVARD
    SCOTTSDALE,AZ85259
    NONE   SCHOLARSHIP FUND 10,000
    METROPOLITAN FAMILY SERVICE
    1808 SE BELMONT STREET
    PORTLAND,OR97214
    NONE   GENERAL 750
    MONTAGE HEALTH FOUNDATION
    40 RYAN COURT 200
    MONTEREY,CA93940
    NONE   GENERAL 10,000
    MONTESSORI SCHOOL OF ENGLEWOOD
    6936 S HERMITAGE AVENUE
    CHICAGO,IL60636
    NONE   TRAUMA-INFORMED PROGRAM OF ACADEMIC AND SOCIAL EMOTIONAL LEARNING 50,000
    NATIONAL INDIGENOUS WOMENS RESOURCE CENTER
    PO BOX 99
    LAME DEER,MT59043
    NONE   GENERAL 1,000
    NATIONAL PSORIASIS FOUNDATION
    6600 SW 92ND AVENUE 300
    PORTLAND,OR97223
    NONE   GENERAL 1,000
    NATIVITY SCHOOL
    6309 EL APAJO ROAD
    RANCHO SANTA FE,CA90267
    NONE   GENERAL 2,500
    NORTHWESTERN UNIVERSITY
    1007 CHURCH STREET
    EVANSTON,IL60201
    NONE   KELLOGG SCHOOL OF MANAGEMENT 2,000
    OREGON COMMUNITY FOUNDATION
    1221 SW YAMHILL 100
    PORTLAND,OR97205
    NONE   TECHNICAL ASSISTANCE SUPPORT BUILD INITIATIVE 40,000
    PARENT PROJECT FOR MUSCULAR DYSTROPHY
    401 HACKENSACK AVENUE 9TH FLOOR
    HACKENSACK,NJ07601
    NONE   GENERAL 500
    PEOPLE'S MUSIC SCHOOL
    931 W EASTWOOD AVENUE
    CHICAGO,IL60640
    NONE   GENERAL 1,000
    PLANNED PARENTHOOD OF ILLINOIS
    18 S MICHIGAN AVENUE 6TH FLOOR
    CHICAGO,IL60603
    NONE   GENERAL 1,000
    PORTLAND CHILDREN'S MUSEUM
    4015 SW CANYON ROAD
    PORTLAND,OR97221
    NONE   BABY GARDEN RENOVATION/GENERAL 20,500
    PROVIDENCE HEALTH & SERVICES
    6410 NE HALSEY STREET 300
    PORTLAND,OR97213
    NONE   CAMP ERIN PORTLAND 750
    PROVIDENCE ST MEL SCHOOL
    119 S CENTRAL PARK BOULEVARD
    CHICAGO,IL60624
    NONE   GENERAL 10,000
    PUGET SOUND HONOR FLIGHT
    PO BOX 434
    GRAPEVIEW,WA98546
    NONE   GENERAL 1,000
    RECOVERY FOUNDATION
    5005 UNIVERSITY AVENUE 100
    MADISON,WI53705
    NONE   GENERAL 1,000
    REEF CHECK
    13723 FIJI WAY B-2
    MARINA DEL REY,CA90292
    NONE   GENERAL 1,000
    ROOTS COMMUNITY SCHOOL
    2133 W WOODEN AVENUE
    CHELAN,WA98816
    NONE   GENERAL 2,500
    RYR-1 FOUNDATION
    PO BOX 13312
    PITTSBURGH,PA15243
    NONE   CLINICAL CARE GUIDELINES FOR RYR-1 RELATED DISEASES 50,000
    RYTHER FOUNDATION
    2400 NE 95TH STREET
    SEATTLE,WA98115
    NONE   GENERAL 1,000
    SAN DIEGO SAINTS BASEBALL
    PO BOX 1193
    SAN DIEGO,CA92111
    NONE   GENERAL 1,500
    SAVANNAH EARLY CHILDHOOD FOUNDATION
    40 MODENA ISLAND DRIVE
    SAVANNAH,GA31411
    NONE   EARLY LEARNING COLLEGE 40,000
    SEA SHEPHERD CONSERVATION SOCIETY
    PO BOX 8628
    ALEXANDRIA,VA22306
    NONE   GENERAL 1,000
    SHRINERS HOSPITAL FOR CHILDREN
    2900 N ROCKY POINT DRIVE
    TAMPA,FL33607
    NONE   GENERAL 2,500
    SEVEN ACRES FOUNDATION
    PO BOX 2505
    CHELAN,WA98816
    NONE   GENERAL 2,500
    SOCIAL VENTURE PARTNERS PORTLAND
    308 SW FIRST AVENUE 158
    PORTLAND,WA97204
    NONE   GENERAL/BUILDING FINANCIAL MANAGEMENT CAPACITY FOR EARLY LEARNING EXPANSION 55,000
    SOUND
    6400 SOUTH CENTER BOULEVARD
    TUKWILA,WA98002
    NONE   BUILDING ATTACHMENT EARLY CHILDHOOD PARENTING CLASS 50,000
    SOUND CHILD AND FAMILY SERVICES
    4238 AUBURN WAY
    AUBURN,WA98002
    NONE   RETREAT/TEAM BUILDING TRAINING 1,000
    TRANS LIFELINE
    101 BROADWAY 311
    OAKLAND,CA94607
    NONE   GENERAL 1,000
    TRANSGENDER LAW CENTER
    PO BOX 70976
    OAKLAND,CA94612
    NONE   LEGAL SERVICES PROJECT 2,500
    UNIVERSITY OF COLORADO FOUNDATION
    PO BOX 17126
    DENVER,CO80217
    NONE   CONFERENCE ON WORLD AFFAIRS 500
    VERA COURT NEIGHBORHOOD CENTER
    614 VERA COURT
    MADISON,WI53704
    NONE   GENERAL 1,000
    YELLOWSTONE BOYS & GIRLS RANCH
    2050 OVERLAND AVENUE
    BILLINGS,MT59102
    NONE   THERAPEUTIC FOSTER CARE PROGRAM 1,000
    YMCA CAMP MATOLLIONEQUAY
    1303 STOKES ROAD
    MEDFORD,NJ08055
    NONE   GENERAL 750
    YMCA CAMP OCKANICKON
    1303 STOKES ROAD
    MEDFORD,NJ08055
    NONE   FINANCIAL NEEDS OF CAMPERS 1,000
    YOUTH PROGRESS ASSOCIATION
    12141 NE HALSEY STREET
    PORTLAND,WA97220
    NONE   GENERAL 500
    Total .................................bullet 3a 681,781
    bApproved for future payment
    Total .................................bullet 3b 0
    Form 990-PF (2019)
    Form 990-PF (2019)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code
    (b)
    Amount
    (c)
    Exclusion code
    (d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3 Interest on savings and temporary cash
    investments ...........
        14 2,692  
    4 Dividends and interest from securities....     14 308,036  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income.....     14 2,371  
    8 Gain or (loss) from sales of assets other than
    inventory ............
        18 556,064  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e).. 0 869,163 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    869,163
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow
    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? ...........
    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.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below
    (see instr.)
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    Firm's EIN SmallBullet
    Firm's address SmallBullet


    Phone no.
    Form 990-PF (2019)
    Additional Data


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