-
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
ALBEN F & CLARA G BATES FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)
159 COTTAGE HILL ROAD APT 113
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
ELMHURST
,
IL
60126
A Employer identification number
36-6081072
B
Telephone number (see instructions)
(630) 832-1070
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)
$
5,315,193
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
353
353
4
Dividends and interest from securities
...
139,354
139,354
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
151,616
b
Gross sales price for all assets on line 6a
500,026
7
Capital gain net income (from Part IV, line 2)
...
47,545
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)
.......
12
Total.
Add lines 1 through 11
........
291,323
187,252
13
Compensation of officers, directors, trustees, etc.
11,286
5,643
5,643
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
2,850
2,850
c
Other professional fees (attach schedule)
....
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
5,407
4,950
457
19
Depreciation (attach schedule) and depletion
...
118
118
20
Occupancy
..............
5,258
2,629
2,629
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
3,402
3,135
267
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
28,321
19,325
8,996
25
Contributions, gifts, grants paid
.......
474,500
474,500
26
Total expenses and disbursements.
Add lines 24 and 25
502,821
19,325
483,496
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-211,498
b
Net investment income
(if negative, enter -0-)
167,927
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
.............
32,465
53,134
53,134
2
Savings and temporary cash investments
.........
3
Accounts receivable
Less: allowance for doubtful accounts
4
Pledges receivable
Less: allowance for doubtful accounts
5
Grants receivable
.................
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)
.....
7
Other notes and loans receivable (attach schedule)
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)
.......
3,082,178
2,850,157
5,262,059
c
Investments—corporate bonds (attach schedule)
.......
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
14
Land, buildings, and equipment: basis
4,922
Less: accumulated depreciation (attach schedule)
2,388
2,652
2,534
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
3,117,295
2,905,825
5,315,193
17
Accounts payable and accrued expenses
..........
290
318
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)
.........
290
318
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
3,117,005
2,905,507
25
Net assets with donor restrictions
............
Foundations that do not follow FASB ASC 958, check here
and complete lines 26 through 30.
26
Capital stock, trust principal, or current funds
........
27
Paid-in or capital surplus, or land, bldg., and equipment fund
28
Retained earnings, accumulated income, endowment, or other funds
29
Total net assets or fund balances
(see instructions)
.....
3,117,005
2,905,507
30
Total liabilities and net assets/fund balances
(see instructions)
.
3,117,295
2,905,825
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return)
...............
1
3,117,005
2
Enter amount from Part I, line 27a
.....................
2
-211,498
3
Other increases not included in line 2 (itemize)
3
4
Add lines 1, 2, and 3
..........................
4
2,905,507
5
Decreases not included in line 2 (itemize)
5
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
2,905,507
Form
990-PF
(2019)
Form 990-PF (2019)
Page
3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a)
List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)
(b)
How acquired
P—Purchase
D—Donation
(c)
Date acquired
(mo., day, yr.)
(d)
Date sold
(mo., day, yr.)
1a
b
c
d
e
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-)
or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
Excess of col. (i)
over col. (j), if any
a
b
c
d
e
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
47,545
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
406,726
5,296,381
0.076793
2017
366,844
5,302,528
0.069183
2016
266,177
4,820,237
0.055221
2015
264,952
4,937,015
0.053666
2014
417,854
5,193,160
0.080462
2
Total
of line 1, column (d)
.....................
2
0.335325
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
0.067065
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
5,192,438
5
Multiply line 4 by line 3
......................
5
348,231
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
1,679
7
Add lines 5 and 6
........................
7
349,910
8
Enter qualifying distributions from Part XII, line 4
,.............
8
483,496
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See the Part VI instructions.
Form
990-PF
(2019)
Form 990-PF (2019)
Page
4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a
Exempt operating foundations described in section 4940(d)(2), check here
and enter “N/A" on line 1.
Date of ruling or determination letter:
(attach copy of letter if necessary–see instructions)
b
Domestic foundations that meet the section 4940(e) requirements in Part V, check
1
1,679
here
and enter 1% of Part I, line 27b
...................
c
All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
2
3
Add lines 1 and 2
...........................
3
1,679
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
4
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
1,679
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
4,005
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
4,005
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
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
2,326
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
2,326
Refunded
11
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition)
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
(2)
On foundation managers.
$
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
Yes
7
Did the foundation have at least $5,000 in assets at any time during the year?
If "Yes," complete Part II, col. (c),
and Part XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
IL
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
JOSEPHINE B PRASIL
Telephone no.
(630) 832-1070
Located at
159 COTTAGE HILL AVENUE 113
ELMHURST
IL
ZIP+4
60126
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1)
Engage in the sale or exchange, or leasing of property with a disqualified person?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(5)
Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)?
...............
Yes
No
(6)
Agree to pay money or property to a government official? (
Exception.
Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.)
.......
Yes
No
b
If any answer is "Yes" to 1a(1)–(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions
........
1b
Organizations relying on a current notice regarding disaster assistance check here
........
c
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2019?
.............
1c
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2019, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2019?
.............
Yes
No
If "Yes," list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer "No" and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
......................
Yes
No
b
If "Yes," did it have excess business holdings in 2019 as a result of
(1)
any purchase by the foundation
or disqualified persons after May 26, 1969;
(2)
the lapse of the 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or
(3)
the lapse of the 10-, 15-, or 20-year first phase holding period?
(Use Schedule C, Form 4720, to determine
if the foundation had excess business holdings in 2019.)
..................
3b
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2019?
4b
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
6
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
(continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
No
b
If any answer is "Yes" to 5a(1)–(5), did
any
of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions
......
5b
Organizations relying on a current notice regarding disaster assistance check here
.........
c
If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant?
..........
Yes
No
If "Yes," attach the statement required by Regulations section 53.4945–5(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract?
.....................
Yes
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
....
6b
No
If "Yes" to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
Yes
No
b
If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction?
....
7b
8
Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment during the year?
.................
Yes
No
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1
List all officers, directors, trustees, foundation managers and their compensation. See instructions
(a)
Name and address
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(If not paid, enter
-0-)
(d)
Contributions to employee benefit plans and deferred compensation
(e)
Expense account,
other allowances
JOSEPHINE B PRASIL
VP/SEC/TREAS
10.00
11,286
0
0
159 COTTAGE HILL AVENUE 113
ELMHURST
,
IL
60126
ROBERT H WIER
DIRECTOR
1.00
0
0
0
159 COTTAGE HILL AVENUE 113
ELMHURST
,
IL
60126
PATRICIA B PACE
PRESIDENT
1.00
0
0
0
159 COTTAGE HILL AVE 113
ELMHURST
,
IL
60126
DEBORAH D COLLINS
VP/ASST. TRE
1.00
0
0
0
159 COTTAGE HILL AVE 113
ELMHURST
,
IL
60126
2
Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a)
Name and address of each employee paid more than $50,000
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
NONE
Total
number of other employees paid over $50,000
...................
Form
990-PF
(2019)
Form 990-PF (2019)
Page
7
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
(continued)
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
NONE
Total
number of others receiving over $50,000 for professional services
.............
Part IX-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
2
3
4
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
N/A
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
Form
990-PF
(2019)
Form 990-PF (2019)
Page
8
Part X
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations, see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities
...................
1a
5,256,466
b
Average of monthly cash balances
.......................
1b
15,045
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
5,271,511
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation)
.............
1e
2
Acquisition indebtedness applicable to line 1 assets
..................
2
3
Subtract line 2 from line 1d
.........................
3
5,271,511
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
79,073
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
5,192,438
6
Minimum investment return.
Enter 5% of line 5
..................
6
259,622
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
259,622
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
1,679
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
1,679
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
257,943
4
Recoveries of amounts treated as qualifying distributions
................
4
5
Add lines 3 and 4
............................
5
257,943
6
Deduction from distributable amount (see instructions)
.................
6
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1
...
7
257,943
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
483,496
b
Program-related investments—total from Part IX-B
..................
1b
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
b
Cash distribution test (attach the required schedule)
.................
3b
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
483,496
5
Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
income. Enter 1% of Part I, line 27b. See instructions
.................
5
1,679
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
481,817
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
257,943
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
b
Total for prior years:
20
,
20
,
20
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
161,370
b
From 2015
......
20,936
c
From 2016
......
27,915
d
From 2017
......
105,352
e
From 2018
......
145,763
f
Total
of lines 3a through e
........
461,336
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
483,496
a
Applied to 2018, but not more than line 2a
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
c
Treated as distributions out of corpus (Election
required—see instructions)
........
d
Applied to 2019 distributable amount
.....
257,943
e
Remaining amount distributed out of corpus
225,553
5
Excess distributions carryover applied to 2019.
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
686,889
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
e
Undistributed income for 2018. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
f
Undistributed income for 2019. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2020
..........
0
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions)
.......
8
Excess distributions carryover from 2014 not
applied on line 5 or line 7 (see instructions)
...
161,370
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
525,519
10
Analysis of line 9:
a
Excess from 2015
....
20,936
b
Excess from 2016
....
27,915
c
Excess from 2017
....
105,352
d
Excess from 2018
....
145,763
e
Excess from 2019
....
225,553
Form
990-PF
(2019)
Form 990-PF (2019)
Page
10
Part XIV
Private Operating Foundations
(see instructions and Part VII-A, question 9)
1a
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2019, enter the date of the ruling
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2019
(b)
2018
(c)
2017
(d)
2016
b
85% of line 2a
.........
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed
...
c
“Support" alternative test—enter:
(1)
Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
....
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
(3)
Largest amount of support
from an exempt organization
(4)
Gross investment income
Part XV
Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or email address of the person to whom applications should be addressed:
b
The form in which applications should be submitted and information and materials they should include:
c
Any submission deadlines:
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Form
990-PF
(2019)
Form 990-PF (2019)
Page
11
Part XV
Supplementary Information
(continued)
3
Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
1ST CONGREGATIONAL CHURCH ELMHURST
235 S KENILWORTH
ELMHURST
,
IL
60126
NONE
UNRESTRICTED
3,000
AURORA UNIVERSITY - MUSIC ON THE LA
350 CONSTANCE BOULEVAARD
WILLIAMS BAY
,
WI
53191
NONE
UNRESTRICTED
2,500
BROOKFIELD ZOO
3300 GOLF ROAD
BROOKFIELD
,
IL
60513
NONE
UNRESTRICTED
2,000
CENTRAL IOWA SYMPHONY
PO BOX 1080
AMES
,
IA
500141080
NONE
UNRESTRICTED
1,250
CHRISTOPHER & DANA REEVE FOUNDATION
636 MORRIS TURNPIKE SUITE
SHORT HILLS
,
NJ
07078
NONE
UNRESTRICTED
1,250
CYSTIC FIBROSIS FOUNDATION
4550 MONTGOMERY AVE
BETHESDA
,
MD
20814
NONE
UNRESTRICTED
1,000
DUPAGE CHILDRENS MUSEUM
301 N WASHINGTON STREET
NAPERVILLE
,
IL
60540
NONE
UNRESTRICTED
6,500
DUPAGE COUNTY HISTORICAL SOCIETY
PO BOX 1460
WHEATON
,
IL
60189
NONE
UNRESTRICTED
1,000
ELGIN ACADEMY
350 PARK AVENUE
ELGIN
,
IL
60120
NONE
UNRESTRICTED
2,000
ELMHURST ART MUSEUM
150 COTTAGE HILL AVENUE
ELMHURST
,
IL
60126
NONE
UNRESTRICTED
3,000
ELMHURST COLLEGE
190 S PROSPECT AVENUE
ELMHURST
,
IL
60126
NONE
BATES OBSERVATORY
20,000
ELMHURST FAMILY YMCA
211 W FIRST STREET
ELMHURST
,
IL
60126
NONE
UNRESTRICTED
13,000
ELMHURST HERITAGE FOUNDATION
120 E PARK
ELMHURST
,
IL
60126
NONE
UNRESTRICTED
20,000
ELMHURST MEMORIAL HEALTHCARE
155 E BRUSH HILL ROAD
ELMHURST
,
IL
60126
NONE
UNRESTRICTED
20,000
ELMHURST SYMPHONY ASSOCIATION
PO BOX 345
ELMHURST
,
IL
60126
NONE
UNRESTRICTED
1,500
EPISCOPAL CHURCH OF OUR SAVIOR
116 E CHURCH STREET
ELMHURST
,
IL
60126
NONE
UNRESTRICTED
1,250
FIELD MUSEUM OF NATURAL HISTORY
1400 S LAKE SHORE DRIVE
CHICAGO
,
IL
606052496
NONE
UNRESTRICTED
500
FONTANA PUBLIC LIBRARY
166 2ND AVENUE
FONTANA
,
WI
53125
NONE
UNRESTRICTED
1,000
FRIENDS OF ELMHURST PUBLIC LIBRARY
125 S PROSPECT
ELMHURST
,
IL
60126
NONE
UNRESTRICTED
4,000
GENEVA LAKE ASSOCIATION
PO BOX 412
LAKE GENEVA
,
WI
53147
NONE
UNRESTRICTED
1,500
GENEVA LAKE CONSERVANCY
PO BOX 588 398 MILL ST
FONTANA
,
WI
53125
NONE
UNRESTRICTED
3,000
GENEVA LAKE ENVIRONMENTAL AGENCY
PO BOX 914
WILLIAMS BAY
,
WI
531910914
NONE
UNRESTRICTED
3,000
GENEVA LAKE LEVEL CORPORATION
PO BOX 656
LAKE GENEVA
,
WI
53147
NONE
UNRESTRICTED
1,500
GENEVA LAKE WATER SAFETY COMMITTEE
PO BOX 548
WILLIAMS BAY
,
WI
53191
NONE
NW MILITARY & NAVAL ACADEMY EXH
8,000
GIGI'S PLAYHOUSE - CHICAGO
3948 N LINCOLN AVENUE
CHICAGO
,
IL
60613
NONE
UNRESTRICTED
9,000
GRAUE MILL AND MUSEUM
3800 S YORK ROAD
OAK BROOK
,
IL
60523
NONE
UNRESTRICTED
1,000
GUIDING EYES FOR THE BLIND
611 GRANITE SPRINGS RD
YORKTOWN HEIGHTS
,
NY
10598
NONE
UNRESTRICTED
2,000
HINSDALE COMMUNITY HOUSE
415 W EIGHTH STREET
HINSDALE
,
IL
60521
NONE
UNRESTRICTED
1,000
HINSDALE HOSPITAL FOUNDATION
120 N OAK STREET
HINSDALE
,
IL
60521
NONE
UNRESTRICTED
3,000
HORTICULTURAL HALL FOUNDATION
PO BOX 71
LAKE GENEVA
,
WI
53147
NONE
UNRESTRICTED
1,500
IOWA ENVIRONMENTAL COUNCIL
521 E LOCUST ST SUITE 220
DES MOINES
,
IA
50309
NONE
UNRESTRICTED
1,000
IOWA ENVIRONMENTAL WILDLIFE CENTER
328 MAIN ST SUITE 208
AMES
,
IA
50010
NONE
UNRESTRICTED
2,500
KEYS CHILDREN FOUNDATION
24 DOCKSIDE LANE PMB 139
KEY LARGO
,
FL
330375267
NONE
UNRESTRICTED
5,000
KHOI-FM RADIO
410 DOUGLAS AVE
AMES
,
IA
50010
NONE
UNRESTRICTED
1,500
LAKE GENEVA FRESH AIR ASSOCIATION
PO BOX 10 361 N LAKE SHO
WILLIAMS BAY
,
WI
53191
NONE
UNRESTRICTED
12,000
LAKE GENEVA PUBLIC LIBRARY FTN
918 W MAIN
LAKE GENEVA
,
WI
53147
NONE
UNRESTRICTED
1,500
LEAGUE OF WOMEN VOTERS OF US
2236 STORM STREET
AMES
,
IA
50010
NONE
UNRESTRICTED
1,500
LURIE CHILDRENS HOSPITAL FOUNDATION
225 E CHICAGO AVE
CHICAGO
,
IL
60611
NONE
UNRESTRICTED
5,000
MCLEAN HOSPITAL
115 MILL STREET
BELMONT
,
MA
024789106
NONE
UNRESTRICTED
6,500
MERCY WALWORTH MEDICAL CENTER
1000 MINERAL POINT AVENUE
JANESVILLE
,
WI
535475003
NONE
UNRESTRICTED
5,000
MORTON ARBORETUM
4100 ILLINOIS ROUTE 53
LISLE
,
IL
605321293
NONE
UNRESTRICTED
2,000
ONE THOUSAND FRIENDS OF IOWA
3850 MERLE HAY ROAD 605
DES MOINES
,
IA
503101300
NONE
UNRESTRICTED
1,500
PLANNED PARENTHOOD OF THE HEARTLAND
PO BOX 4557
DES MOINES
,
IA
503054557
NONE
UNRESTRICTED
8,750
SHEDD AQUARIUM SOCIETY
1200 S LAKE SHORE DRIVE
CHICAGO
,
IL
60605
NONE
UNRESTRICTED
500
SHRINERS HOSPITALS FOR CHILDREN
2211 N OAK PARK AVE
CHICAGO
,
IL
60707
NONE
UNRESTRICTED
1,000
ST JOHNS NORTHWESTERN MILITARY ACAD
1101 GENESEE STREET
DELAFIELD
,
WI
530181498
NONE
UNRESTRICTED
4,500
THE ENVIRONMENTAL EDUCATION FDN
P O BOX 244
FONTANA
,
WI
531250244
NONE
UNRESTRICTED
2,000
UNITED CEREBRAL PALSY SEQUIN-CHGO
3100 S CENTRAL AVENUE
CICERO
,
IL
60804
NONE
UNRESTRICTED
1,500
US FUND FOR UNICEF
125 MAIDEN LANE
NEW YORK
,
NY
10038
NONE
UNRESTRICTED
2,250
VASSAR COLLEGE
BOX 725 - 124 RAYMOND AVE
POUGHKEEPSIE
,
NY
126040014
NONE
UNRESTRICTED
4,000
WELLNESS HOUSE
131 N COUNTY LINE ROAD
HINSDALE
,
IL
60521
NONE
UNRESTRICTED
1,000
WM GUY FORBECK RESEARCH FNDN
PO BOX 1033
CARBONDALE
,
CO
81623
NONE
UNRESTRICTED
4,000
NORTHWESTERN MEMORIAL DELNOR HOSP
300 S RANDALL ROAD
GENEVA
,
IL
60134
NONE
UNRESTRICTED
7,798
DOCTORS WITHOUT BORDERS USA
40 RECTOR STREET FLOOR 16
NEW YORK
,
NY
100061705
NONE
UNRESTRICTED
1,000
ACUMEN FUND INC
40 WORTH STREET STE 303
NEW YORK
,
NY
10013
NONE
UNRESTRICTED
1,500
ADOPTIVE SPORTS CENTER
PO BOX 1639
CRESTED BUTTE
,
CO
81224
NONE
UNRESTRICTED
500
AKC CANINE HEALTH FOUNDATION
PO BOX 900061
RALEIGH
,
NC
27675
NONE
UNRESTRICTED
3,000
BEST BUDDIES ILLINOIS
101 W GRAND AVE
CHICAGO
,
IL
60654
NONE
UNRESTRICTED
1,000
CASS COMMUNITY SOCIAL SERVICES
11745 ROSA PARKS BLVD
DETROIT
,
MI
48206
NONE
UNRESTRICTED
1,500
CREATIVE CAPITAL FOUNDATION
15 MAIDEN LANE 18TH FLOOR
NEW YORK
,
NY
10038
NONE
UNRESTRICTED
4,000
DOWNTOWN BOXING GYM YOUTH PRG
6445 E VERNON HWY
DETROIT
,
MI
48207
NONE
UNRESTRICTED
2,000
ENDEAVOR GLOBAL INC
900 BROADWAY STE 301
NEW YORK
,
NY
10003
NONE
UNRESTRICTED
1,500
FRIENDS OF CLAR HILLS PUB LIBRARY
7 N PROSPECT AVE
CLARENDON HILLS
,
IL
60514
NONE
UNRESTRICTED
900
GENEVA LAKE MUSEUM
255 MILL STREET
LAKE GENEVA
,
WI
53147
NONE
UNRESTRICTED
2,000
GENEVA LAKES FAMILY YMCA
203 S WELLS ST
LAKE GENEVA
,
WI
53147
NONE
UNRESTRICTED
2,000
GIRL SCOUTS OF GRTR CHGONW IN
20 S CLARK ST STE 200
CHICAGO
,
IL
60603
NONE
UNRESTRICTED
1,000
GREATER CHICAGO FOOD DEPOSITORY
4100 W ANN LURIE PLACE
CHICAGO
,
IL
60632
NONE
UNRESTRICTED
2,000
HCS FAMILY SERVICES
19 E CHICAGO AVE 2ND FLR
HINSDALE
,
IL
60521
NONE
UNRESTRICTED
5,000
HELPING ANIMALS TO SURVIVE
PO BOX 243
DENVER
,
CO
80206
NONE
UNRESTRICTED
500
HINSDALE HUMANE SOCIETY
21 SALT CREEK LANE
HINSDALE
,
IL
60521
NONE
UNRESTRICTED
2,000
HINSDALE PUBLIC LIBRARY FNDN
19 E CHICAGO AVE
HINSDALE
,
IL
60521
NONE
UNRESTRICTED
2,000
HOLY FAMILY MINISTRIES
3225 ARNOLD LANE
NORTHBROOK
,
IL
60062
NONE
UNRESTRICTED
3,500
HUDSON COMMUNITY FOUNDATION
49 E MAIN ST PO BOX 944
HUDSON
,
OH
44236
NONE
UNRESTRICTED
4,000
INFANT WELFARE SOC OF CHICAGO
3600 W FULLERTON
CHICAGO
,
IL
60647
NONE
UNRESTRICTED
2,100
JUNIOR LEAGUE OF CHICAGO
1447 N ASTOR STREET
CHICAGO
,
IL
60610
NONE
UNRESTRICTED
1,000
KAPPA KAPPA GAMMA FOUNDATION
6640 RIVERSIDE DR STE 200
DUBLIN
,
OH
43017
NONE
UNRESTRICTED
9,200
LIFEBANC
4775 RICHMOND ROAD
CLEVELAND
,
OH
44128
NONE
UNRESTRICTED
3,666
LINCOLN CHARTER SCHOOL
2243 HWY 16
NORTH DENVER
,
NC
28037
NONE
UNRESTRICTED
2,500
LIONS CLUB OF CLARENDON HILLS
PO BOX 61
CLARENDON HILLS
,
IL
60514
NONE
UNRESTRICTED
1,000
MILWAUKEE TECHNICAL COLLEGE FTN
1036 N 8TH ST
MILWAUKEE
,
WI
53233
NONE
UNRESTRICTED
500
MUSEUM OF COASTAL CAROLINA
21 E SECOND ST
OCEAN ISLE BEACH
,
NC
28469
NONE
UNRESTRICTED
1,000
MUSEUM OF SCIENCE & INDUSTRY
57TH ST AND LAKE SHORE DR
CHICAGO
,
IL
60637
NONE
UNRESTRICTED
500
NATL ALOPECIA AREATA FOUND
65 MITCHELL BLVD STE 200B
SAN RAFAEL
,
CA
94903
NONE
UNRESTRICTED
5,467
OCEAN CONSERVANCY
1900 19TH ST 8TH FL
WASHINGTON
,
DC
20036
NONE
UNRESTRICTED
1,000
OCEAN REEF CULTURAL CENTER
200 ANCHOR DRIVE
KEY LARGO
,
FL
33037
NONE
UNRESTRICTED
20,000
ORACLE SCHOOLS FOUNDATION
PO BOX 8863
CATALINA
,
AZ
85738
NONE
UNRESTRICTED
7,000
PILGRIM LUTHERAN CHURCH & SCHOOL
4300 N WINCHESTER AVE
CHICAGO
,
IL
60613
NONE
UNRESTRICTED
5,000
PIONEER WORKS ART FOUNDATION
159 PIONEER ST
BROOKLYN
,
NY
11231
NONE
UNRESTRICTED
2,500
PLANNED PARENTHOOD FED OF AMER
PO BOX 97166
WASHINGTON
,
DC
20090
NONE
UNRESTRICTED
5,600
SHELTER HOUSING CORPORATION
225 S KELLOGG
AMES
,
IA
50010
NONE
UNRESTRICTED
2,000
SPECIAL KIDS DAY
533 SPRING RD
ELMHURST
,
IL
60126
NONE
UNRESTRICTED
750
SPECIAL OLYMPICS CHICAGO
541 N FAIRBANKS CT
CHICAGO
,
IL
60611
NONE
UNRESTRICTED
1,400
SPECIAL OLYMPICS ILLINOIS
605 E WILLOW ST
NORMAL
,
IL
61761
NONE
UNRRESTRICTED
1,400
SPECIAL OLYMPICS INC
1133 19TH ST NW
WASHINGTON
,
DC
20036
NONE
UNRESTRICTED
1,000
THE EYEBEAM ATELIER INC
199 COOK ST STE 104
BROOKLYN
,
NY
11026
NONE
UNRESTRICTED
1,600
THE HUNDRED CLUB OF CHICAGO
875 N MICHIGAN AVE 1351
CHICAGO
,
IL
60611
NONE
UNRESTRICTED
5,000
TRIANGLE LAND CONSERVANCY INC
514 S DUKE ST
DURHAM
,
NC
27701
NONE
UNRESTRICTED
10,000
UNITED COMM CONCERNS ASSO
125 W CHURCH ST
ELMHURST
,
IL
60126
NONE
UNRESTRICTED
3,000
UNIVERSITY OF AZ FOUNDATION
PO BOX 210067 MLBV67
TUCSON
,
AZ
85721
NONE
UNRESTRICTED
2,000
UNIVERSITY OF WI FOUNDATION
US BANK LOCKBOX 78807
MILWAUKEE
,
WI
53278
NONE
UNRRESTRICTED
1,000
VOLUNTEERS IN ASIA
995 MARKET ST
SAN FRANCISCO
,
CA
94103
NONE
UNRESTRICTED
2,250
VOTERUNLEAD
1103 MISSOURI AVE
DULUTH
,
MN
55811
NONE
UNRESTRICTED
4,500
WBEZ-NPR
848 E GRAND AVE
CHICAGO
,
IL
60611
NONE
UNRESTRICTED
2,000
WILDLIFE CONSERVATION SOCIETY
2300 SOUTHERN BLVD
BRONX
,
NY
10460
NONE
UNRESTRICTED
1,000
YELLOWSTONEYUKON CONSERVATION
200-1350 RAILWAY AVE
CANMORE TW P
,
ALBERTA
CA
NONE
UNRESTRICTED
20,000
AMERICAN CIVIL LIBERTIES UNION
125 BROAD ST 18TH FL
NEW YORK
,
NY
10033
NONE
UNRESTRICTED
1,500
AMERICAN HEART ASSOCIATION
208 S LASALLE
CHICAGO
,
IL
60604
NONE
UNRESTRICTED
1,000
AMERICAN THEATRE WING
230 W 41 ST STE 1101
NEW YORK
,
NY
10036
NONE
UNRESTRICTED
5,050
ASPCA
424 E 92ND ST
NEW YORK
,
NY
101286804
NONE
UNRESTRICTED
1,000
AURORA LAKELAND MEDICAL CENTER
W3985 COUNTY RD NN
ELKHORN
,
WI
53121
NONE
UNRESTRICTED
3,500
BAPTIST HEALTH SOUTH FLORIDA FDN
8900 N KENDALL DR
MIAMI
,
FL
331762197
NONE
UNRESTRICTED
1,250
BICHON & LITTLE BUDDIES RESCUE
828 PERKINS DR
MUKWONAGO
,
WI
53149
NONE
UNRESTRICTED
750
BRAIN & BEHAVIOR RESEARCH FDN
747 THIRD AVE 33RD FL
NEW YORK
,
NY
10017
NONE
UNRESTRICTED
5,000
CANTIGNY FOUNDATION
1S151 WINFIELD RD
WHEATON
,
IL
60189
NONE
UNRESTRICTED
1,100
CENTER FOR THE LIVING CITY
25 CENTRAL PARK W APT 2J
NEW YORK
,
NY
10023
NONE
UNRESTRICTED
700
CHICAGO POLICE MEMORIAL FDN
1407 W WASHINGTON ST
CHICAGO
,
IL
60607
NONE
UNRESTRICTED
1,000
CHRIST CHURCH EPISCOPAL
470 MAPLE STREET
WINNETKA
,
IL
60093
NONE
UNRESTRICTED
1,500
COALITION FOR SONORAN DESERT PROTEC
738 N 5TH AVE
TUCSON
,
AZ
85705
NONE
UNRESTRICTED
1,000
COLLINGS FOUNDATION
137 BARTON RD PO BOX 248
STOW
,
MA
01175
NONE
UNRESTRICTED
2,000
COLORADO CRANE CONSERVATION
40625 COUNTY RD 69A
HAYDEN
,
CO
81639
NONE
UNRESTRICTED
1,000
EARTHJUSTICE
50 CALIFORNIA ST STE 500
SAN FRANCISCO
,
CA
94111
NONE
UNRESTRICTED
1,600
EASTERN MARKET CORPORATION
2934 RUSSELL ST
DETROIT
,
MI
48207
NONE
UNRESTRICTED
1,000
ELMHURST YORKFIELD FOOD PANTRY
1083 S YORK ST
ELMHURST
,
IL
60126
NONE
UNRESTRICTED
1,000
ENVIRONMENTAL DEFENSE FUND
900 BROADWAY STE 301
NEW YORK
,
NY
10003
NONE
UNRESTRICTED
500
EQUAL JUSTICE INITIATIVE
122 COMMERCE ST
MONTGOMERY
,
AL
36104
NONE
UNRESTRICTED
1,000
EVANS SCHOLARSHIP FOUNDATION
1 BRIAR RD
GOLF
,
IL
60029
NONE
UNRESTRICTED
500
FIGHT WITH ME
411 STONEMONT WAY
STANLEY
,
NC
28164
NONE
UNRESTRICTED
2,000
FONTANA FIRE & RESCUE DEPT
190 FONTANA BLVD BOX 200
FONTANA
,
WI
53125
NONE
UNRESTRICTED
1,000
FREEDOM HOUSE DETROIT
PO BOX 9208
DETROIT
,
MI
48209
NONE
UNRESTRICTED
1,500
FRIENDS OF FISCHER FARM FDN
16W680 GRAND AVE
BENSENVILLE
,
IL
60106
NONE
UNRESTRICTED
2,000
FRIENDS OF KISHWAUKETOE LTD
250 WILLIAMS ST BOX 580
WILLIAMS BAY
,
WI
53191
NONE
UNRESTRICTED
1,000
GIVE POWER FOUNDATION
500 SECOND ST STE 100
SAN FRANCISCO
,
CA
94107
NONE
UNRESTRICTED
5,000
GLOBAL LIVING FOUNDATION
1110 VERMONT AVE NW 550
WASHINGTON
,
DC
20005
NONE
UNRESTRICTED
1,100
HOMES FOR OUR TROOPS
6 MAIN ST
TAUNTON
,
MA
02780
NONE
UNRESTRICTED
1,500
INDEPENDENCE PARK ADVISORY
3945 S SPRINGFIELD AVE
CHICAGO
,
IL
60618
NONE
UNRESTRICTED
800
INSTITUTE FOR NONVIOLENCE CHICAGO
4926 W CHICAGO AVE
CHICAGO
,
IL
60651
NONE
UNRESTRICTED
500
LOYOLA CARDINAL BERNADINE CENTER
2160 W FIRST AVE
MAYWOOD
,
IL
60153
NONE
UNRESTRICTED
10,000
MAGNOLIA MANOR
2700 WASHINGTON AVE
CAIRO
,
IL
62914
NONE
UNRESTRICTED
1,600
MARINE TOYS FOR TOTS FDN
18251 QUANTICO GATEWAY DR
TRIANGLE
,
VA
22172
NONE
UNRESTRICTED
1,000
MIDWEST SHELTER FOR HOMELESS
433 S CARLTON AVE
WHEATON
,
IL
60187
NONE
UNRESTRICTED
1,000
NATL CHILDREN CANCER SOCIETY
500 N BROADWAY STE 1850
ST LOUIS
,
MO
63102
NONE
UNRESTRICTED
1,000
NATL NETWORK OF ABORTION FUNDS
PO BOX 22457
PHILADELPHIA
,
PA
19110
NONE
UNRESTRICTED
1,600
NATL RESOURCES DEFENSE COUNCIL
40 W 20 ST
NEW YORK
,
NY
10011
NONE
UNRESTRICTED
1,500
PAWS OF WAR
127 SMITHTOWN BLVD
NESCONSET
,
NY
11767
NONE
UNRESTRICTED
500
PILLARE COMMUNITY HEALTH
23 CALENDAR CT
LAGRANGE
,
IL
60525
NONE
UNRESTRICTED
2,250
SAFE HAVEN FOR CATS
8134-137 GARVEY DR
RALEIGH
,
NC
276163267
NONE
UNRESTRICTED
3,000
SANCTUARY FOR FAMILIES
PO BOX 1406
WALL STREET STATION
,
NY
10268
NONE
UNRESTRICTED
1,600
ST JUDE CHILDREN'S RESEARCH HOSP
501 ST JUDE PL
MEMPHIS
,
TN
38105
NONE
UNRESTRICTED
2,435
THE SMILE TRAIN
PO BOX 96231
WASHINGTON
,
DC
200906231
NONE
UNRESTRICTED
2,434
THE TREVOR PROJECT
8704 SANTA MONICA BLVD
WEST HOLLYWOOD
,
CA
900694548
NONE
UNRESTRICTED
1,000
THREE FIRES COUNCIL
415 N 2ND ST
ST CHARLES
,
IL
60174
NONE
UNRESTRICTED
1,850
WOUNDED WARRIER PROJECT
PO BOX 758516
TOPEKA
,
KS
666758516
NONE
UNRESTRICTED
3,000
Total
.................................
3a
474,500
b
Approved for future payment
Total
.................................
3b
Form
990-PF
(2019)
Form 990-PF (2019)
Page
12
Part XVI-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
Unrelated business income
Excluded by section 512, 513, or 514
(e)
Related or exempt
function income
(See instructions.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
14
353
4
Dividends and interest from securities
....
14
139,354
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not debt-financed property
.....
6
Net rental income or (loss) from personal property
7
Other investment income
.....
8
Gain or (loss) from sales of assets other than
inventory
............
14
47,545
104,071
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)
..
187,252
104,071
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
291,323
(See worksheet in line 13 instructions to verify calculations.)
Part XVI-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
instructions.)
Form
990-PF
(2019)
Form 990-PF (2019)
Page
13
Part XVII
Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
1
Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
Yes
No
a
Transfers from the reporting foundation to a noncharitable exempt organization of:
(1)
Cash
...................................
1a(1)
No
(2)
Other assets
.................................
1a(2)
No
b
Other transactions:
(1)
Sales of assets to a noncharitable exempt organization
....................
1b(1)
No
(2)
Purchases of assets from a noncharitable exempt organization
..................
1b(2)
No
(3)
Rental of facilities, equipment, or other assets
.......................
1b(3)
No
(4)
Reimbursement arrangements
...........................
1b(4)
No
(5)
Loans or loan guarantees
.............................
1b(5)
No
(6)
Performance of services or membership or fundraising solicitations
................
1b(6)
No
c
Sharing of facilities, equipment, mailing lists, other assets, or paid employees
..............
1c
No
d
If the answer to any of the above is "Yes," complete the following schedule. Column
(b)
should always show the fair market value
of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
in any transaction or sharing arrangement, show in column
(d)
the value of the goods, other assets, or services received.
(a)
Line No.
(b)
Amount involved
(c)
Name of noncharitable exempt organization
(d)
Description of transfers, transactions, and sharing arrangements
2a
Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
described in section 501(c) (other than section 501(c)(3)) or in section 527?
...........
Yes
No
b
If "Yes," complete the following schedule.
(a)
Name of organization
(b)
Type of organization
(c)
Description of relationship
Sign Here
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
May the IRS discuss this return
with the preparer shown below
(see instr.)
Yes
No
Signature of officer or trustee
Date
Title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's Signature
Date
Check if self-
employed
PTIN
Firm's name
Firm's EIN
Firm's address
Phone no.
Form
990-PF
(2019)
Additional Data
Software ID:
Software Version:
Form 990PF - Special Condition Description:
Special Condition Description