-
TIN:
Form
990-PF
Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
Do not enter social security numbers on this form as it may be made public.
Go to
www.irs.gov/Form990PF
for instructions and the latest information.
OMB No. 1545-0052
20
19
Open to Public Inspection
For calendar year 2019, or tax year beginning
01-01-2019
, and ending
12-31-2019
Name of foundation
THE RAMAK FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)
1602 RIVER ROAD
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MAUMEE
,
OH
43537
A Employer identification number
20-0510049
B
Telephone number (see instructions)
(419) 891-9825
C
If exemption application is pending, check here
G
Check all that apply:
Initial return
Initial return of a former public charity
Final return
Amended return
Address change
Name change
D 1.
Foreign organizations, check here.............
2
. Foreign organizations meeting the 85%
test, check here and attach computation ...
E
If private foundation status was terminated
under section 507(b)(1)(A), check here .......
H
Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here .......
I
Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)
$
1,817,506
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
264
264
4
Dividends and interest from securities
...
41,660
41,660
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
-30,290
b
Gross sales price for all assets on line 6a
759,892
7
Capital gain net income (from Part IV, line 2)
...
0
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)
.......
162
162
12
Total.
Add lines 1 through 11
........
11,796
42,086
13
Compensation of officers, directors, trustees, etc.
0
0
0
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
c
Other professional fees (attach schedule)
....
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
8,315
8,315
0
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
15,665
14,897
0
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
23,980
23,212
0
25
Contributions, gifts, grants paid
.......
206,475
206,475
26
Total expenses and disbursements.
Add lines 24 and 25
230,455
23,212
206,475
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-218,659
b
Net investment income
(if negative, enter -0-)
18,874
c
Adjusted net income
(if negative, enter -0-)
...
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2019)
Form 990-PF (2019)
Page
2
Part II
Balance Sheets
Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year
End of year
(a)
Book Value
(b)
Book Value
(c)
Fair Market Value
1
Cash—non-interest-bearing
.............
2
Savings and temporary cash investments
.........
105,752
47,269
47,269
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)
Less: allowance for doubtful accounts
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)
.......
691,726
484,677
589,223
c
Investments—corporate bonds (attach schedule)
.......
259,021
237,284
251,439
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
790,974
859,584
929,575
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
1,847,473
1,628,814
1,817,506
17
Accounts payable and accrued expenses
..........
18
Grants payable
.................
19
Deferred revenue
.................
20
Loans from officers, directors, trustees, and other disqualified persons
21
Mortgages and other notes payable (attach schedule)
......
22
Other liabilities (describe
)
23
Total liabilities
(add lines 17 through 22)
.........
0
0
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
25
Net assets with donor restrictions
............
Foundations that do not follow FASB ASC 958, check here
and complete lines 26 through 30.
26
Capital stock, trust principal, or current funds
........
0
0
27
Paid-in or capital surplus, or land, bldg., and equipment fund
0
0
28
Retained earnings, accumulated income, endowment, or other funds
1,847,473
1,628,814
29
Total net assets or fund balances
(see instructions)
.....
1,847,473
1,628,814
30
Total liabilities and net assets/fund balances
(see instructions)
.
1,847,473
1,628,814
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return)
...............
1
1,847,473
2
Enter amount from Part I, line 27a
.....................
2
-218,659
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
1,628,814
5
Decreases not included in line 2 (itemize)
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
1,628,814
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
AMN INTL GROUP
P
2018-09-28
2019-07-16
b
ANHEUSER-BUSCH IN
P
2018-09-28
2019-05-01
c
AT&T INC
P
2019-03-15
2019-05-01
d
ASTRAZENECA PLC
P
2018-09-28
2019-05-01
e
BHP BILLITON FIN
P
2018-09-28
2019-05-01
BP CAP MARKETS PL
P
2018-09-28
2019-05-01
HOME DEPOT INC
P
2018-09-28
2019-05-01
COCA-COLA CO
P
2018-09-28
2019-05-01
CITIGROUP INC
P
2018-09-28
2019-05-01
CVS HEALTH CORP
P
2018-09-28
2019-05-01
DISCO SYS
P
2018-09-28
2019-03-01
COMCAST CORP
P
2019-09-28
2019-05-01
DUKE ENERGY CORP
P
2018-10-01
2019-05-01
GOLDMAN SACHS GRO
P
2018-09-28
2019-05-01
GENL DYNAMICS COR
P
2018-09-28
2019-05-01
GILEAD SCIENCE
P
2018-09-28
2019-05-01
GENERAL MILLS
P
2018-09-28
2019-05-01
JPMORGAN CHASE
P
2018-09-28
2019-05-01
LOWE'S CO
P
2018-09-28
2019-05-01
LOCKHEED MARTIN
P
2018-09-28
2019-05-01
MORGAN STANLEY
P
2018-09-28
2019-05-01
METLIFE INC
P
2018-09-28
2019-05-01
ORACLE CORP
P
2018-09-28
2019-05-01
OCCIDENTAL PETROL
P
2018-09-28
2019-05-01
PFIZER INC
P
2018-09-28
2019-05-01
PROCTER & GAMBLE
P
2018-09-28
2019-05-01
STARBUCKS CORP
P
2018-09-28
2019-05-01
TIME WARNER INC
P
2018-09-28
2019-05-01
WELLPOINT INC
P
2018-09-28
2019-05-01
WELLS FARGO
P
2018-09-28
2019-05-01
MCDONALD'S CORP
P
2018-09-28
2019-05-01
WALT DISNEY CO
P
2018-09-28
2019-05-01
BANK OF NY
P
2018-09-28
2019-05-01
ABBOTT LABS
P
2019-07-29
2019-12-02
AIR PRODUCTS
P
2018-09-27
2019-07-31
ALTRIA GROUP
P
2018-09-27
2019-09-19
AMAZON COM INC
P
2018-09-27
2019-07-31
ASTRAZENECA PLC SPND
P
2018-09-27
2019-05-01
ASAHI KASEI CORP
P
2018-09-27
2019-05-01
ANHEUSER-BUSCH INBEV
P
2018-09-27
2019-05-01
ACCENTURE PLC
P
2018-09-27
2019-05-01
PROLOGIS INC
P
2018-09-27
2019-05-01
AIA GROUP LTD
P
2018-09-27
2019-05-01
AMERICAN TOWER REIT
P
2018-09-27
2019-08-06
ASML HLDG NV NY REG
P
2018-09-27
2019-05-01
ABBVIE INC
P
2018-09-27
2019-08-07
ALLERGAN PLC
P
2018-09-27
2019-07-25
ALPHABET INC
P
2018-09-27
2019-05-01
AES CORP
P
2018-09-27
2019-05-01
AMER EXP CO
P
2018-09-27
2019-05-01
ACTIVISION BLIZZARD
P
2018-11-12
2019-05-01
AMGEN INC
P
2018-09-27
2019-07-11
ANALOG DEVICES
P
2018-09-27
2019-05-01
APPLE INC
P
2018-09-27
2019-05-01
AUTOMATIC DATA PROC
P
2018-09-27
2019-09-19
BAKER HUGHES INC
P
2019-03-29
2019-12-02
BROADCOM LTD
P
2018-09-27
2019-05-01
BIOGEN INC
P
2018-09-27
2019-05-01
BB&T CORPORATION
P
2018-09-27
2019-05-01
BLACKROCK INC
P
2018-09-27
2019-06-30
BANK NY MELLON
P
2018-09-27
2019-05-01
BAXTER INTL
P
2019-06-05
2019-11-01
BRISTOL-MYERS SQUIBB
P
2018-11-09
2019-05-01
CSX CORP
P
2018-09-27
2019-05-01
COMCAST CORP
P
2018-09-27
2019-05-01
CAPITAL ONE
P
2018-09-27
2019-05-01
CARGURUS
P
2018-09-27
2019-05-01
CHENIERE ENTERGY
P
2019-07-24
2019-12-02
COSTCO WHOLESALE
P
2018-09-27
2019-08-06
CONTELLATION BRANDS INC
P
2019-07-16
2019-12-02
CHEVRON CORP
P
2019-02-04
2019-12-02
CATERPILLAR INC
P
2018-09-27
2019-05-01
CME GROUP INC
P
2018-09-27
2019-07-29
CARLSBERG
P
2018-09-27
2019-05-01
CITIGROUP INC
P
2018-09-27
2019-08-21
CROWN CASTLE REIT
P
2018-09-27
2019-07-31
CHUBB LTD
P
2018-09-27
2019-08-22
CISCO SYS COM
P
2018-09-27
2019-06-30
COCA-COLA CO
P
2019-02-04
2019-05-01
DOW INC
P
2018-09-27
2019-04-05
DOWDUPONT INC
P
2018-09-27
2019-04-23
DARDEN RESTAURANTS
P
2019-09-19
2019-12-02
DANAHER CORP
P
2018-09-27
2019-08-06
DIAGEO PLC SPSD
P
2018-09-27
2019-05-01
DANONE-SPONS
P
2018-09-27
2019-05-01
DNB ASA SP
P
2018-09-27
2019-05-01
DEERE CO
P
2018-09-27
2019-07-29
DISNEY (WALT) CO
P
2018-09-27
2019-05-01
EBAY INC
P
2018-09-27
2019-05-01
ENBRIDGE INC
P
2018-09-27
2019-05-01
EXXON MOBIL CORP
P
2018-09-27
2019-05-01
ERICSSON AMERICAN
P
2018-09-27
2019-02-08
ESSILORLUXOTTICA SA
P
2018-09-27
2019-05-01
AIRBUS SE
P
2018-09-27
2019-05-01
EVERSOURCE ENERGY COM
P
2019-04-05
2019-05-01
EQUIFAX INC
P
2018-09-27
2019-05-01
FOX CORP CL B
P
2019-07-18
2019-12-02
FIRST REP BK SAN FRANCISC
P
2018-09-27
2019-05-01
FACEBOOK INC
P
2018-09-27
2019-05-01
VANGUARD FTSE EMERGING
P
2018-09-27
2019-06-30
FIRST TRUST DOW JONES
P
2018-09-27
2019-06-30
VANGUARD FTSE DEV
P
2018-09-27
2019-06-14
REAL ESTATE SELECT
P
2018-09-27
2019-06-13
COMM SVCS SELECT
P
2018-10-18
2019-09-12
GOLDMAN SACHS GROUP
P
2018-09-27
2019-07-31
GENERAL ELECTRIC
P
2018-09-27
2019-08-16
GENMAB A/S
P
2018-12-20
2019-05-01
GODADDY INC
P
2018-09-27
2019-05-01
GILEAD SCIENCE
P
2018-09-27
2019-05-01
HONEYWELL INTL INC
P
2018-09-27
2019-05-01
HDFC BANK LTD
P
2018-09-27
2019-05-01
HP INC
P
2018-09-27
2019-05-01
HILTON WORLDWIDE
P
2018-09-27
2019-07-23
HASBRO INC
P
2018-09-27
2019-03-12
HOME DEPOT INC
P
2018-09-27
2019-07-31
HUMANA INC
P
2018-09-27
2019-06-04
ILLINOIS TOOL WORKS INC
P
2018-09-27
2019-05-01
ISHARES CORE S&P, GROWTH
P
2018-09-27
2019-05-01
ISHARES CORE S&P, VALUE ETF
P
2018-09-27
2019-07-31
INTEL CORP
P
2019-06-27
2019-06-04
FIRST TRUST CLOUD
P
2018-09-27
2019-06-13
INTERCONTINENTAL EXCHANGE
P
2018-09-27
2019-05-01
JPMORGAN CHASE
P
2018-09-27
2019-07-31
JARDINE MATHESON HD
P
2018-11-13
2019-05-01
JOHNSON AND JOHNSON COM
P
2018-09-27
2019-05-01
KEURIG DR PEPPER INC
P
2018-10-31
2019-09-30
KONINKL PHIL NV SH
P
2019-07-30
2019-12-02
KINDER MORGAN INC
P
2018-11-21
2019-05-01
LVMH MOET HENNESSY ADR
P
2018-09-27
2019-05-10
LOCKHEED MARTIN CORP
P
2018-09-27
2019-07-31
LAS VEGAS SANDS CORP
P
2018-09-27
2019-05-01
LYONDELLBASELL INDSTRIE
P
2018-09-27
2019-05-01
LIBERTY MEDIA CORP
P
2018-09-27
2019-05-01
LENNAR CORP
P
2018-09-27
2019-08-16
ELI LILLY & CO
P
2018-09-27
2019-05-01
L OREAL CO
P
2018-09-27
2019-05-01
MULTICHOICE GROUP
P
2019-03-05
2019-04-09
MOODY'S CORP
P
2018-09-27
2019-07-31
MORGAN STANLEY
P
2018-09-27
2019-05-01
MCDONALD'S CORP
P
2018-09-27
2019-07-31
MICROSOFT CORP
P
2018-09-27
2019-08-08
MICROCHIP TECH
P
2018-09-27
2019-05-01
NASPERS LTD SHS
P
2018-09-27
2019-05-01
NVIDIA
P
2019-01-31
2019-08-29
NEXTERA ENERGY INC
P
2018-09-27
2019-07-31
TWENTY-FIRST CENTURY
P
2018-09-27
2019-03-18
NUTRIEN LTD REG
P
2018-09-27
2019-05-01
NESTLE S A REP
P
2018-09-27
2019-05-01
NOVO NORDISK A
P
2018-09-27
2019-05-01
ONEOK INC
P
2019-01-29
2019-05-01
PROSUS N V
P
2019-09-17
2019-10-23
PRUDENTIAL FINANCIAL INC
P
2018-09-27
2019-02-14
PAYCHECX INC
P
2018-09-27
2019-05-01
PHILIP MORRIS INTL INC
P
2018-09-27
2019-07-29
PERNOD-RICARD SA
P
2018-09-27
1996-05-01
PHILLIPS 66 SHS
P
2018-09-27
2019-05-01
PEPSICO INC
P
2018-09-27
2019-05-01
PFIZER INC
P
2019-07-10
2019-12-02
POLARIS INDUSTRIES
P
2018-09-27
2019-08-16
REALTY INCM CRP MD
P
2018-09-27
2019-05-01
ROYAL DUTCH SHEL
P
2018-09-27
2019-05-01
RECKITT BENCKISER GROUP
P
2018-09-27
2019-05-01
RYANAIR HOLDINGS PLC
P
2019-02-08
2019-05-01
ROSS STORES INC
P
2019-07-12
2019-09-30
SAP SE SHS
P
2018-09-27
2019-05-01
STATE STREET CORP
P
2018-09-27
2019-07-29
SEMPRA ENERGY
P
2018-09-27
2019-05-01
SAPO PLC SHS
P
2018-09-27
2019-07-30
SCHLUMBERGER LTD
P
2018-10-22
2019-08-28
SIMON PROP GROUP
P
2019-01-25
2019-12-02
HEALTH CARE SELECT SPDR
P
2018-09-27
2019-09-12
CONSUMER DISCRETIONARY SPDR
P
2018-09-27
2019-08-14
SPDR US FINANCIAL SECTOR
P
2018-09-27
2019-09-12
SEATTLE GENETICS INC
P
2018-09-27
2019-05-01
SAFRAN SA-UNSPON
P
2018-09-27
2019-05-01
SHIN-ETSU CHEM-UNSPON
P
2018-12-20
2019-05-01
SOFTBANK GROUP CORP
P
2018-09-27
2019-07-30
SHERWIN WILLIAMS
P
2018-09-27
2019-08-27
SYNCHRONY FINL COM
P
2018-09-27
2019-05-01
ANTHEM INC
P
2019-07-12
2019-12-02
WEC ENERGY GROUP INC
P
2018-09-27
2019-05-01
STARBUCKS CORP
P
2018-09-27
2019-05-01
SUNTRUST BKS INC
P
2018-09-27
2019-05-01
SYSCO CORP
P
2018-09-27
2019-05-01
TOTAL S.A.
P
2019-07-16
2019-12-02
TEXAS INSTRUMENTS
P
2018-09-27
2019-05-01
TAIWAN S MANUFCTRING
P
2018-09-27
2019-05-01
3M COMPANY
P
2018-09-27
2019-06-14
THEMPUR SEALY INTL
P
2018-09-27
2019-05-01
TWITTER INC
P
2018-09-27
2019-08-29
THERMO FISHER SCIENTIFIC
P
2018-09-27
2019-07-31
UNITEDHEALTH GROUP INC
P
2018-09-27
2019-07-31
US BANCORP
P
2018-09-27
2019-05-01
UNION PACIFIC CORP
P
2018-09-27
2019-07-31
VALERO ENERGY CORP
P
2018-09-27
2019-05-01
VISA INC CL A SHRS
P
2018-09-27
2019-07-31
VTECH HOLDINGS LTD
P
2018-09-27
2019-02-19
VODAFONE GROUP PLC
P
2019-10-22
2019-12-02
ZIMMER BIOMET HOLD
P
2018-11-07
2019-05-01
ZOETIS INC
P
2019-06-03
2019-09-30
WORKDAY INC CL A
P
2018-09-27
2019-05-01
WALMART INC
P
2018-09-27
2019-07-31
WILLIAMS COMPANIES
P
2018-09-27
2019-05-01
YUM BRANDS INC
P
2018-09-27
2019-05-01
SMC CORP
P
2018-09-28
2019-05-07
WELL FARGO & CO
P
2018-09-27
2019-05-01
WABTEC
P
2018-10-01
2019-08-29
LORD ABBETT FLOATING
P
2019-09-30
2019-12-02
ISHARES CORE S&P, SMALL CAP
P
2018-09-27
2019-05-01
ISHARES NASDAQ BIOTECH
P
2018-09-27
2019-08-14
VANGUARD CONSUMER STAPLES
P
2018-09-27
2019-08-14
VANGUARD MATERIALS
P
2018-09-27
2019-05-01
VANGUARD INFORMATION
P
2018-09-27
2019-07-31
VANGUARD INDUSTRIAL ETF
P
2018-09-27
2019-08-14
MARRIOTT INTL INC
P
2018-11-21
2019-08-29
MURATA MANUFACTURING CO
P
2019-07-30
2019-12-10
MONDELEZ INTERNATIONAL
P
2019-10-03
2019-12-02
MEDTRONIC PLC SHS
P
2018-09-27
2019-07-31
MARSH & MCLENNANA COS
P
2018-09-27
2019-05-01
MAXIM INTEGRATED PRODS
P
2018-09-27
2019-05-01
MC CORMICK NON VTG
P
2018-09-27
2019-02-05
ANHEUSER PART CALLD
P
2018-09-28
2019-11-12
DEERE & CO.
P
2018-10-02
2019-10-16
ABBOTT LABS
P
2018-09-27
2019-09-30
AMAZON COM INC
P
2018-09-27
2019-12-02
ASAHI KASEI CORP
P
2018-09-27
2019-12-02
ANHESER-BUSCH INBEV
P
2018-09-27
2019-12-02
ACCENTURE PL C SHS
P
2018-09-27
2019-10-22
PROLOGIS INC
P
2018-09-27
2019-11-05
AMERICAN TOWER REIT INC
P
2018-09-27
2019-11-05
ASML HLDG NV NY REG
P
2018-09-27
2019-10-29
APPLE INC
P
2018-09-27
2019-12-09
BAKER HUGHES CO
P
2018-11-14
2019-12-02
BIOGEN INC
P
2018-09-27
2019-10-11
BLACKROCK INC
P
2018-09-27
2019-09-30
BANK NEW YORK MELLON
P
2018-09-27
2019-12-02
CSX CORP
P
2018-09-27
2019-02-02
CARGURUS
P
2018-10-04
2019-12-02
CHENIERE ENERGY
P
2018-10-25
2019-12-02
CHEVRON CORP
P
2018-09-27
2019-12-02
CATERPILLAR INC
P
2018-09-27
2019-12-02
CME GROUP INC
P
2018-09-27
2019-10-29
CHUBB LTD
P
2018-09-27
2019-11-06
CISCO SYS COM
P
2018-09-27
2019-12-02
DNB ASA SP
P
2018-09-27
2019-12-02
DISNEY (WALT) CO
P
2018-09-27
2019-09-30
EXXON MOBIL CORP
P
2018-09-27
2019-12-02
EOG RESOURCES INC
P
2018-09-27
2019-12-02
ISHARES CORE S&P, SMALL CAP
P
2018-09-27
2019-12-02
ISHARES NASDAQ BIOTECH
P
2018-09-27
2019-12-02
VANGUARD MATERIALS
P
2018-09-27
2019-12-02
VANGUARD INFORMATION
P
2018-09-27
2019-12-10
VANGUARD INDUSTRIAL ETF
P
2018-09-27
2019-10-16
FIRST TRUST DOW JONES
P
2018-09-27
2019-12-02
VANGUARD FTSE DEV
P
2018-09-27
2019-12-02
GOLDMAN SACHS GROUP
P
2018-09-27
2019-12-02
GODADDY INC
P
2018-09-27
2019-12-02
GILEAD SCIENCE
P
2018-09-27
2019-12-02
HP INC
P
2018-09-27
2019-10-18
JACK HENRY & ASSOC
P
2018-09-27
2019-12-02
HOME DEPOT INC
P
2018-09-27
2019-11-05
ISHARES CORE S&P US VALUE
P
2018-09-27
2019-09-30
JPMORGAN CHASE & CO
P
2018-09-27
2019-09-30
JPMORGAN CHASE & CO
P
2018-09-27
2019-10-29
JARDINE MATHESON HD
P
2018-11-14
2019-12-02
JOHNSON AND JOHNSON COM
P
2018-09-27
2019-12-02
LOCKHEED MARTIN CORP
P
2018-09-27
2019-11-06
LYONDELLBASELL INDUSTRIE
P
2018-09-27
2019-12-02
MOODY'S CORP
P
2018-09-27
2019-10-30
MURATA MANUFACTURING CO
P
2018-09-27
2019-12-10
MONDELEZ INTERNATIONAL
P
2018-09-27
2019-10-22
MICROSOFT CORP
P
2018-09-27
2019-11-13
NASPERS LTD SHS CL
P
2018-09-27
2019-12-02
NEXTERA ENERGY INC
P
2018-09-27
2019-10-03
NUTRIEN LTD REG
P
2018-09-27
2019-12-02
PAYCHECX INC
P
2018-09-27
2019-12-26
PFIZER INC
P
2018-09-27
2019-12-02
POLARIS INC
P
2018-09-27
2019-02-02
ROYAL DUTCH SHEL
P
2018-09-27
2019-12-02
RECKITT BENCKISER GROUP
P
2018-09-27
2019-12-02
STATE STREET CORP
P
2018-09-27
2019-12-02
SEMPRA ENERGY
P
2018-09-27
2019-09-30
SIMON PROP GROUP
P
2018-09-27
2019-12-02
HEALTH CARE SELECT SPDR
P
2018-09-27
2019-12-10
CONSUMER DISCRETIONARY SPDR
P
2018-09-27
2019-12-10
SPDR US FINANCIAL SECTOR
P
2018-09-27
2019-12-10
SOFTBANK GROUP CORP
P
2018-09-27
2019-12-02
STARBUCKS CORP
P
2018-09-27
2019-09-30
SUNTRUST BKS INC
P
2018-09-27
2019-11-06
TRUIST FINL CORP
P
2018-09-27
2019-12-17
TOTAL S.A.
P
2018-09-27
2019-12-02
TEXAS INSTRUMENTS
P
2018-09-27
2019-09-30
VALERO ENERGY CORP
P
2018-09-27
2019-12-02
WILLIAMS COMPANIES
P
2018-09-27
2019-12-02
WELLS FARGO & CO
P
2018-09-27
2019-10-04
WABTEC
P
2018-10-01
2019-12-02
LORD ABBETT FLOATING
P
2018-09-27
2019-12-02
ANHEUSER-BUSCH PRTL CALL
P
2018-09-28
2019-10-29
CAPITAL GAINS DIVIDENDS
P
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
6,000
6,000
0
b
989
971
18
c
1,033
997
36
d
1,013
971
42
e
1,015
1,003
12
1,007
981
26
1,001
981
20
1,009
1,005
4
1,037
1,007
30
1,012
978
34
6,000
6,000
0
1,002
951
51
983
936
47
1,020
997
23
1,050
1,005
45
1,019
986
33
1,045
989
56
1,027
994
33
1,008
996
12
1,030
991
39
1,025
986
39
1,014
986
28
1,005
966
39
962
956
6
6,000
6,000
0
993
978
15
1,008
965
43
1,010
964
46
1,015
1,003
12
972
934
38
1,016
984
32
1,016
976
40
1,032
1,001
31
6,547
6,552
-5
1,317
1,013
304
2,261
3,174
-913
3,832
3,832
0
187
198
-11
186
278
-92
178
177
1
183
170
13
710
600
110
410
354
56
3,916
3,101
815
209
189
20
3,477
4,335
-858
5,590
6,678
-1,088
1,178
1,212
-34
103
82
21
118
108
10
244
271
-27
3,438
3,991
-553
116
92
24
3,480
4,000
-520
6,132
5,701
431
1,029
1,320
-291
322
246
76
231
356
-125
919
887
32
1,388
1,438
-50
149
155
-6
4,430
4,489
-59
47
53
-6
158
149
9
524
424
100
371
383
-12
160
223
-63
2,687
2,969
-282
2,125
2,111
14
2,649
2,860
-211
1,785
1,808
-23
139
153
-14
1,173
1,038
135
288
265
23
3,274
3,480
-206
1,027
868
159
1,670
1,471
199
6,315
6,556
-241
147
147
0
594
660
-66
3,140
3,800
-660
1,070
1,113
-43
2,614
2,058
556
337
284
53
325
314
11
115
128
-13
1,016
910
106
655
563
92
1,846
1,800
46
221
195
26
239
258
-19
1,390
1,417
-27
183
226
-43
377
348
29
71
71
0
126
130
-4
2,498
2,629
-131
316
289
27
391
340
51
3,768
3,712
56
5,785
5,821
-36
20,655
22,845
-2,190
5,663
5,261
402
9,458
8,876
582
1,412
1,598
-186
3,661
4,849
-1,188
67
65
2
245
250
-5
326
384
-58
1,735
1,593
142
117
93
24
160
206
-46
5,966
5,155
811
779
959
-180
2,858
3,111
-253
4,596
6,027
-1,431
311
285
26
7,522
7,460
62
9,981
9,838
143
3,049
3,410
-361
3,976
3,811
165
162
151
11
2,543
2,536
7
131
123
8
566
556
10
567
515
52
1,510
1,561
-51
59
52
7
157
144
13
2,442
2,396
46
1,817
1,734
83
355
413
-58
233
222
11
2,755
2,588
167
119
107
12
220
195
25
91
66
25
623
521
102
286
288
-2
1,010
834
176
6,807
6,007
800
738
631
107
258
221
37
1,016
869
147
1,775
1,493
282
724
647
77
108
114
-6
505
416
89
247
239
8
134
126
8
636
719
-83
2,120
2,335
-215
667
589
78
953
899
54
244
230
14
188
226
-38
894
781
113
1,026
1,116
-90
2,306
2,895
-589
282
223
59
193
213
-20
160
183
-23
79
71
8
219
211
8
130
126
4
900
920
-20
635
560
75
1,010
1,255
-245
3,630
6,784
-3,154
1,695
1,979
-284
12,817
13,272
-455
5,936
5,875
61
7,029
7,053
-24
135
158
-23
365
355
10
142
117
25
1,112
1,023
89
3,545
3,184
361
750
795
-45
5,848
5,895
-47
1,085
922
163
468
345
123
718
746
-28
1,688
1,815
-127
2,585
2,807
-222
590
537
53
401
403
-2
3,402
4,216
-814
928
798
130
1,258
881
377
1,520
1,468
52
724
786
-62
267
266
1
1,733
1,640
93
363
461
-98
3,034
2,707
327
1,311
1,690
-379
805
872
-67
122
118
4
250
208
42
2,290
1,756
534
2,626
2,548
78
226
218
8
102
90
12
397
336
61
242
242
0
227
337
-110
4,165
4,239
-74
803
871
-68
3,379
3,715
-336
10,643
9,959
684
379
396
-17
9,280
8,891
389
17,909
18,797
-888
896
887
9
1,363
1,136
227
1,460
1,440
20
3,995
4,306
-311
375
335
40
241
225
16
1,456
1,536
-80
4,079
3,866
213
5,000
5,000
0
336
292
44
21,218
24,194
-2,976
1,377
1,916
-539
1,820
2,030
-210
1,098
1,023
75
1,204
933
271
613
432
181
1,576
1,136
440
1,337
1,128
209
1,766
2,308
-542
1,122
1,779
-657
448
479
-31
1,715
1,810
-95
1,772
1,858
-86
2,753
3,899
-1,146
3,153
3,595
-442
3,869
4,052
-183
1,726
1,834
-108
1,004
865
139
1,342
1,204
138
5,820
6,306
-486
1,209
1,556
-347
261
232
29
1,646
2,063
-417
788
1,397
-609
25,959
27,858
-1,899
15,699
16,241
-542
6,653
6,735
-82
1,875
1,616
259
3,057
3,108
-51
21,527
22,838
-1,311
65,207
66,830
-1,623
2,394
2,511
-117
2,357
2,996
-639
3,928
4,536
-608
975
1,519
-544
1,201
1,280
-79
463
415
48
231
226
5
236
231
5
1,012
923
89
751
860
-109
4,643
4,724
-81
1,499
1,380
119
2,142
2,372
-230
1,075
869
206
1,777
1,689
88
998
818
180
589
459
130
1,258
1,985
-727
923
664
259
1,211
1,482
-271
844
737
107
3,296
3,855
-559
2,905
3,075
-170
2,419
2,988
-569
1,205
1,387
-182
1,061
1,144
-83
295
224
71
1,640
1,936
-296
1,199
1,139
60
2,801
2,703
98
1,921
1,875
46
837
1,072
-235
265
173
92
428
407
21
56
49
7
3,548
4,445
-897
1,417
1,182
235
1,924
2,306
-382
1,600
1,884
-284
2,639
2,866
-227
941
1,269
-328
81,826
85,857
-4,031
1,020
967
53
2
2
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
0
b
18
c
36
d
42
e
12
26
20
4
30
34
0
51
47
23
45
33
56
33
12
39
39
28
39
6
0
15
43
46
12
38
32
40
31
-5
304
-913
0
-11
-92
1
13
110
56
815
20
-858
-1,088
-34
21
10
-27
-553
24
-520
431
-291
76
-125
32
-50
-6
-59
-6
9
100
-12
-63
-282
14
-211
-23
-14
135
23
-206
159
199
-241
0
-66
-660
-43
556
53
11
-13
106
92
46
26
-19
-27
-43
29
0
-4
-131
27
51
56
-36
-2,190
402
582
-186
-1,188
2
-5
-58
142
24
-46
811
-180
-253
-1,431
26
62
143
-361
165
11
7
8
10
52
-51
7
13
46
83
-58
11
167
12
25
25
102
-2
176
800
107
37
147
282
77
-6
89
8
8
-83
-215
78
54
14
-38
113
-90
-589
59
-20
-23
8
8
4
-20
75
-245
-3,154
-284
-455
61
-24
-23
10
25
89
361
-45
-47
163
123
-28
-127
-222
53
-2
-814
130
377
52
-62
1
93
-98
327
-379
-67
4
42
534
78
8
12
61
0
-110
-74
-68
-336
684
-17
389
-888
9
227
20
-311
40
16
-80
213
0
44
-2,976
-539
-210
75
271
181
440
209
-542
-657
-31
-95
-86
-1,146
-442
-183
-108
139
138
-486
-347
29
-417
-609
-1,899
-542
-82
259
-51
-1,311
-1,623
-117
-639
-608
-544
-79
48
5
5
89
-109
-81
119
-230
206
88
180
130
-727
259
-271
107
-559
-170
-569
-182
-83
71
-296
60
98
46
-235
92
21
7
-897
235
-382
-284
-227
-328
-4,031
53
2
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
-30,290
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
140,250
1,871,492
0.074940
2017
56,858
1,822,181
0.031203
2016
29,924
1,605,957
0.018633
2015
25,450
1,633,087
0.015584
2014
34,950
1,613,094
0.021666
2
Total
of line 1, column (d)
.....................
2
0.162026
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
0.032405
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
67,939
5
Multiply line 4 by line 3
......................
5
2,202
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
189
7
Add lines 5 and 6
........................
7
2,391
8
Enter qualifying distributions from Part XII, line 4
,.............
8
206,475
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
189
here
and enter 1% of Part I, line 27b
...................
c
All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
2
0
3
Add lines 1 and 2
...........................
3
189
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
189
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
2,220
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
0
d
Backup withholding erroneously withheld
...........
6d
0
7
Total credits and payments. Add lines 6a through 6d
..............
7
2,220
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
0
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
2,031
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
2,031
Refunded
11
0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition)
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
0
(2)
On foundation managers.
$
0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
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
RICHARD SHERMAN BEARSS
Telephone no.
(419) 891-9825
Located at
1602 RIVER RD
MAUMEE
OH
ZIP+4
435373508
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1)
Engage in the sale or exchange, or leasing of property with a disqualified person?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(5)
Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)?
...............
Yes
No
(6)
Agree to pay money or property to a government official? (
Exception.
Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.)
.......
Yes
No
b
If any answer is "Yes" to 1a(1)–(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions
........
1b
Organizations relying on a current notice regarding disaster assistance check here
........
c
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2019?
.............
1c
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2019, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2019?
.............
Yes
No
If "Yes," list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer "No" and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
......................
Yes
No
b
If "Yes," did it have excess business holdings in 2019 as a result of
(1)
any purchase by the foundation
or disqualified persons after May 26, 1969;
(2)
the lapse of the 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or
(3)
the lapse of the 10-, 15-, or 20-year first phase holding period?
(Use Schedule C, Form 4720, to determine
if the foundation had excess business holdings in 2019.)
..................
3b
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2019?
4b
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
6
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
(continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
No
b
If any answer is "Yes" to 5a(1)–(5), did
any
of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions
......
5b
Organizations relying on a current notice regarding disaster assistance check here
.........
c
If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant?
..........
Yes
No
If "Yes," attach the statement required by Regulations section 53.4945–5(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract?
.....................
Yes
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
....
6b
No
If "Yes" to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
Yes
No
b
If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction?
....
7b
8
Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment during the year?
.................
Yes
No
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1
List all officers, directors, trustees, foundation managers and their compensation. See instructions
(a)
Name and address
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(If not paid, enter
-0-)
(d)
Contributions to employee benefit plans and deferred compensation
(e)
Expense account,
other allowances
RICHARD SHERMAN BEARSS
PRESIDENT, TRUSTEE
2.00
0
0
0
1602 RIVER RD
MAUMEE
,
OH
43537
AMANDA AYERS
TRUSTEE
0.50
0
0
0
773 WHISPERING MARSH DR
CHARLESTON
,
SC
29412
MICHAEL BEARSS
TRUSTEE
0.50
0
0
0
4710 MIDDLE BR
MONCLOVA
,
OH
43542
2
Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a)
Name and address of each employee paid more than $50,000
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
NONE
Total
number of other employees paid over $50,000
...................
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
7
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
(continued)
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
NONE
Total
number of others receiving over $50,000 for professional services
.............
0
Part IX-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
2
3
4
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
8
Part X
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations, see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities
...................
1a
64,568
b
Average of monthly cash balances
.......................
1b
4,406
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
68,974
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
68,974
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
1,035
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
67,939
6
Minimum investment return.
Enter 5% of line 5
..................
6
3,397
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
3,397
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
189
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
189
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
3,208
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
3,208
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
3,208
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
206,475
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
206,475
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
189
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
206,286
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
3,208
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
27,314
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
b
From 2015
......
c
From 2016
......
d
From 2017
......
e
From 2018
......
f
Total
of lines 3a through e
........
0
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
206,475
a
Applied to 2018, but not more than line 2a
27,314
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
.....
3,208
e
Remaining amount distributed out of corpus
175,953
5
Excess distributions carryover applied to 2019.
0
0
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
175,953
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)
...
0
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
175,953
10
Analysis of line 9:
a
Excess from 2015
....
b
Excess from 2016
....
c
Excess from 2017
....
d
Excess from 2018
....
e
Excess from 2019
....
175,953
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).)
RICHARD SHERMAN BEARSS
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 e-mail address of the person to whom applications should be addressed:
RICHARD S BEARSS
1062 RIVER ROAD
MAUMEE
,
OH
43537
(419) 891-9825
b
The form in which applications should be submitted and information and materials they should include:
SEND EMAIL FOR DETAILS OF GRANT APPLICATION REQUIREMENTS
c
Any submission deadlines:
NO DEADLINES AT THIS TIME
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
ALL AWARDS MUST BE GIVEN TO SEC. 501(C)(3) CHARITABLE ORGANIZATIONS
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
YMCA CAMP GREENVILLE
4399 YMCA CAMP RD
CLEVELAND
,
SC
29635
NONE
PUBLIC CHARITY
UNRESTRICTED
178,175
YMCA CAMP STORER
6941 STONY LAKE RD
JACKSON
,
MI
49201
NONE
PUBLIC CHARITY
UNRESTRICTED
28,300
Total
.................................
3a
206,475
b
Approved for future payment
Total
.................................
3b
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
12
Part XVI-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
Unrelated business income
Excluded by section 512, 513, or 514
(e)
Related or exempt
function income
(See instructions.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
14
264
4
Dividends and interest from securities
....
14
41,660
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
.....
14
162
8
Gain or (loss) from sales of assets other than
inventory
............
18
-30,290
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
11,796
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
11,796
(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