-
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
VISTA HERMOSA
Number and street (or P.O. box number if mail is not delivered to street address)
3525 EAST A ST
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
PASCO
,
WA
99301
A Employer identification number
91-1491438
B
Telephone number (see instructions)
(509) 547-1711
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)
$
164,882,430
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)
25,589
2
Check
.............
3
Interest on savings and temporary cash investments
1,648
1,648
1,648
4
Dividends and interest from securities
...
2,736,432
2,872,345
2,736,432
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
1,231,628
b
Gross sales price for all assets on line 6a
5,249,737
7
Capital gain net income (from Part IV, line 2)
...
1,231,628
8
Net short-term capital gain
.........
0
9
Income modifications
...........
3,869
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)
.......
141,179
0
141,179
12
Total.
Add lines 1 through 11
........
4,136,476
4,105,621
2,883,128
13
Compensation of officers, directors, trustees, etc.
143,650
18,301
48,917
76,432
14
Other employee salaries and wages
......
715,888
0
44,429
671,458
15
Pension plans, employee benefits
.......
62,879
0
5,580
68,256
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
44,946
4,495
0
40,451
c
Other professional fees (attach schedule)
....
359,232
355,698
355,698
201
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
175,967
10,738
5,104
166,569
19
Depreciation (attach schedule) and depletion
...
40,840
0
40,840
20
Occupancy
..............
1,200
0
0
1,200
21
Travel, conferences, and meetings
.......
30,957
0
359
30,598
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
153,106
184,211
18,121
125,077
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
1,728,665
573,443
519,048
1,180,242
25
Contributions, gifts, grants paid
.......
3,955,432
3,955,432
26
Total expenses and disbursements.
Add lines 24 and 25
5,684,097
573,443
519,048
5,135,674
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-1,547,621
b
Net investment income
(if negative, enter -0-)
3,532,178
c
Adjusted net income
(if negative, enter -0-)
...
2,364,080
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
.............
292,597
111,889
111,889
2
Savings and temporary cash investments
.........
112,049,441
1,085,809
1,085,809
3
Accounts receivable
33,685
Less: allowance for doubtful accounts
53,753
33,685
33,685
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
..........
19,896
72,200
72,200
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
.......
29,783,997
151,962,337
151,962,337
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)
..........
11,485,635
11,401,563
11,401,563
14
Land, buildings, and equipment: basis
467,524
Less: accumulated depreciation (attach schedule)
252,577
230,877
214,947
214,947
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
153,916,196
164,882,430
164,882,430
17
Accounts payable and accrued expenses
..........
27,171
9,415
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)
.........
27,171
9,415
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
153,889,025
164,873,015
29
Total net assets or fund balances
(see instructions)
.....
153,889,025
164,873,015
30
Total liabilities and net assets/fund balances
(see instructions)
.
153,916,196
164,882,430
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
153,889,025
2
Enter amount from Part I, line 27a
.....................
2
-1,547,621
3
Other increases not included in line 2 (itemize)
3
12,531,611
4
Add lines 1, 2, and 3
..........................
4
164,873,015
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
164,873,015
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
PUBLICLY TRADED SECURITIES LT
b
PUBLICLY TRADED SECURITIES ST
c
DISPOSITION OF CHARITABLE ASSETS
P
d
CAPITAL GAIN DISTRIBUTIONS
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
3,809,009
3,654,040
154,969
b
317,050
364,069
-47,019
c
100
100
d
1,123,578
1,123,578
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
154,969
b
-47,019
c
100
d
1,123,578
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
1,231,628
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
-47,019
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
4,180,240
54,114,268
0.077248
2017
3,561,805
45,162,811
0.078866
2016
3,357,574
39,951,705
0.084041
2015
4,417,314
39,659,852
0.111380
2014
4,862,227
39,392,639
0.123430
2
Total
of line 1, column (d)
.....................
2
0.474965
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
0.094993
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
155,325,789
5
Multiply line 4 by line 3
......................
5
14,754,863
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
35,322
7
Add lines 5 and 6
........................
7
14,790,185
8
Enter qualifying distributions from Part XII, line 4
,.............
8
5,160,584
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
70,644
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
70,644
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
70,644
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
139,535
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
139,535
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
68,891
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
68,891
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
Yes
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
Yes
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
Yes
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)
WA
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
Yes
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
WWW.VISTA-HERMOSA.ORG
14
The books are in care of
SHELLY BROETJE
Telephone no.
(509) 547-1711
Located at
3525 EAST A ST
PASCO
WA
ZIP+4
99301
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1)
Engage in the sale or exchange, or leasing of property with a disqualified person?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(5)
Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)?
...............
Yes
No
(6)
Agree to pay money or property to a government official? (
Exception.
Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.)
.......
Yes
No
b
If any answer is "Yes" to 1a(1)–(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions
........
1b
No
Organizations relying on a current notice regarding disaster assistance check here
........
c
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2019?
.............
1c
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2019, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2019?
.............
Yes
No
If "Yes," list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer "No" and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
......................
Yes
No
b
If "Yes," did it have excess business holdings in 2019 as a result of
(1)
any purchase by the foundation
or disqualified persons after May 26, 1969;
(2)
the lapse of the 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or
(3)
the lapse of the 10-, 15-, or 20-year first phase holding period?
(Use Schedule C, Form 4720, to determine
if the foundation had excess business holdings in 2019.)
..................
3b
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2019?
4b
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
6
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
(continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
No
b
If any answer is "Yes" to 5a(1)–(5), did
any
of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions
......
5b
Yes
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
CHERYL BROETJE
PRESIDENT
2.00
0
0
0
3525 EAST A STREET
PASCO
,
WA
99301
RALPH BROETJE
VICE PRESIDENT
2.00
0
0
0
3525 EAST A STREET
PASCO
,
WA
99301
SUZANNE BROETJE
CHAIR/ EXECUTIVE DIRECTOR
32.00
113,162
5,926
0
3525 EAST A STREET
PASCO
,
WA
99301
SANDRA GAMBLE
TREASURER/ SECRETARY
2.00
0
0
0
1333 COLUMBIA PARK TRAIL 210
RICHLAND
,
WA
99352
ROGER BAIRSTOW
BOARD MEMBER
2.00
0
0
0
3525 EAST A STREET
PASCO
,
WA
99301
SHAUN BROETJE
BOARD MEMBER
2.00
0
0
0
3525 EAST A STREET
PASCO
,
WA
99301
TYLER BROETJE
BOARD MEMBER
2.00
30,488
3,369
0
3525 EAST A STREET
PASCO
,
WA
99301
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
SUSAN H DOBKINS
PROGRAMS DIRECTOR
40.00
74,971
0
0
3525 EAST A ST
PASCO
,
WA
99301
DARILYN D HACKETT
SCHOOL DIRECTOR, NEL
40.00
68,765
4,447
0
3525 EAST A ST
PASCO
,
WA
99301
Total
number of other employees paid over $50,000
...................
2
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
US BANK WEALTH MANAGEMENT
INVESTMENT ADVISORY AND MANAGEMENT AND TRUST SERVICES
258,360
1305 FOWLER STREET SUITE 107
RICHLAND
,
WA
99352
FIDELITY BROKERAGE SERVICES
INVESTMENT ADVISORY AND MANAGEMENT SERVICES
97,338
PO BOX 28019
ALBUQUERQUE
,
NM
871258019
Total
number of others receiving over $50,000 for professional services
.............
1
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
VISTA HERMOSA OPERATES NUEVA ESPERANZA LEADERSHIP ACADEMY (NELA), A PRIVATE, CHRISTIAN SCHOOL FOR GRADES K-8. NELA OFFERS A SMALL, SAFE, AND LOVING ENVIRONMENT DESIGNED FOR STUDENTS TO DISCOVER THEIR PASSION AS THEY GROW PERSONALLY AND ACADEMICALLY. BUILDING ON SERVANT LEADERSHIP PRINCIPLES, COUPLED WITH TRAUMA INFORMED PRACTICES, THE SCHOOL'S SPIRITUAL FOUNDATION FOSTERS A CULTURE IN WHICH STUDENTS ARE GIVEN MANY OPPORTUNITIES TO USE THEIR GIFTS TO HONOR AND SERVE THEIR COMMUNITY AND CONNECT WITH THE WORLD AROUND THEM.
1,033,523
2
VISTA HERMOSA PROVIDES EXTENDED CARE PROGRAMS FOR THE CHILDREN OF FAMILIES EMPLOYED IN AGRICULTURE.
87,962
3
VISTA HERMOSA OPERATES THE FIRSTFRUITS SCHOLARS PROGRAM, A STUDENT SUPPORT PROGRAM FOR FIRST GENERATION COLLEGE STUDENTS CONNECTED TO FIRSTFRUITS FARMS. ELIGIBLE STUDENTS WHO ARE AWARDED SCHOLARSHIPS FROM FIRSTFRUITS FARMS ARE ENROLLED IN THIS SUPPLEMENTAL SUPPORT PROGRAM AND RECEIVE ONGOING GUIDANCE AND MENTORING TO HELP ENSURE THEY ARE SUCCESSFUL IN IDENTIFYING THEIR GOALS AND COMPLETING THEIR PROGRAMS.
58,004
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
140,872,399
b
Average of monthly cash balances
.......................
1b
5,360,481
c
Fair market value of all other assets (see instructions)
................
1c
11,458,276
d
Total
(add lines 1a, b, and c)
.........................
1d
157,691,156
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
157,691,156
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
2,365,367
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
155,325,789
6
Minimum investment return.
Enter 5% of line 5
..................
6
7,766,289
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
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
4
Recoveries of amounts treated as qualifying distributions
................
4
5
Add lines 3 and 4
............................
5
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
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
5,135,674
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
24,910
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
5,160,584
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
0
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
5,160,584
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
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
......
b
From 2015
......
c
From 2016
......
d
From 2017
......
e
From 2018
......
f
Total
of lines 3a through e
........
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
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
.....
e
Remaining amount distributed out of corpus
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
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
..........
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)
...
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
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
....
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
.......
1995-11-08
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
2,364,080
619,064
1,175,789
990,772
5,149,705
b
85% of line 2a
.........
2,009,468
526,204
999,421
842,156
4,377,249
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
5,160,584
4,180,240
3,561,805
3,357,574
16,260,203
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
3,955,432
2,258,317
1,501,989
1,195,295
8,911,033
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
1,205,152
1,921,923
2,059,816
2,162,279
7,349,170
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
0
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
0
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed
...
5,177,526
1,803,809
1,505,427
1,331,723
9,818,485
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)
....
0
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
0
(3)
Largest amount of support
from an exempt organization
0
(4)
Gross investment income
0
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).)
CHERYL BROETJE
RALPH BROETJE
SUZANNE BROETJE
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:
SUZANNE BROETJE
3525 EAST A ST
PASCO
,
WA
99301
(509) 412-1763
b
The form in which applications should be submitted and information and materials they should include:
THE REQUEST FOR GRANTS SHOULD BE IN WRITING AND SHOULD CONTAIN ANY INFORMATION DEEMED PERTINENT BY THE APPLICANT.
c
Any submission deadlines:
THERE ARE NO DEADLINES.
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
THERE ARE NO ESTABLISHED RESTRICTIONS OR LIMITATIONS.
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
AFRICAN LEADERSHIP AND RECONC MINISTRIES (ALARM)
4140 MIDWAY RD SUITE 208
DALLAS
,
TX
75244
NONE
PC: 509(A)(1)
GENDER CURRICULUM DEVELOPMENT
36,430
AMEXTRA (ASOCIACION MEXICANA DE TRANSFORMACION RURAL Y URBANA AC)
8226 HOLLY CT UNIT A
PALOS HILLS
,
IL
60465
NONE
PC: 509(A)(1)
COMMUNITY DEVELOPMENT, GUERRERO
78,000
AMEXTRA (ASOCIACION MEXICANA DE TRANSFORMACION RURAL Y URBANA AC)
8226 HOLLY CT UNIT A
PALOS HILLS
,
ILLINOIS
60465
MX
NONE
PC: 509(A)(1)
COMMUNITY DEVELOPMENT, CHIAPAS
112,500
ARACELI BENITEZ ARBALLO
XXXX
SINALOA
MX
NONE
I: INDIVIDUAL
TUITION SCHOLARSHIPS
2,057
BEYOND BORDERS
PO BOX 2132
NORRISTOWN
,
PA
19403
NONE
PC: 509(A)(1)
MODEL COMMUNITY INITIATIVE, LAGONAV
220,000
BEYOND BORDERS
PO BOX 2132
NORRISTOWN
,
PA
19403
NONE
PC: 509(A)(1)
SUSTAINABILITY PLANNING
60,000
BLUE MOUNTAIN COMMUNITY FOUNDATION
22 E POPLAR ST STE 206
WALLA WALLA
,
WA
99362
NONE
PC: 509(A)(1)
FUNDS AND ADMINISTRATION FEES FOR FIRSTFRUITS SCHOLARS AT-LARGE
18,750
BRIGHAM YOUNG UNIVERSITY
OFF CAMPUS SCHOLARSHIP OFFICE A-41
ASB
PROVO
,
UT
84602
NONE
I: INDIVIDUAL
TUITION SCHOLARSHIPS
2,250
CAPABLE
2335 E VISTA ROYALE DRIVE
ORANGE
,
CA
92867
NONE
PC: 509(A)(1)
COMMUNITY GRAD PROGRAM - UGANDA
100,000
CARE OF CREATION
PO BOX 44582
MADISON
,
WI
53744
NONE
PC: 509(A)(1)
OPERATING SUPPORT
50,000
CATHOLIC RELIEF SERVICES
228 W LEXINGTON ST
BALTIMORE
,
MD
21201
NONE
PC: 509(A)(1)
PREVENTION OF CHILD MIGRATION, BIHAR
194,813
CENTRAL WASHINGTON UNIVERSITY
400 E UNIVERSITY WAY
ELLENSBURG
,
WA
989267495
NONE
I: INDIVIDUAL
TUITION SCHOLARSHIPS
1,500
CENTRO DE COMPARTIMIENTO (CDC)
AV ALVARO OBREGON NO 40 COLONIA
CENTRO H CD
JUCHITAN DE ZARAGOZA OAXA
70000
MX
NONE
NC
LAND PURCHASE FOR STUDENT HOUSING AND PROGRAMS
241,707
CENTRO DE COMPARTIMIENTO (CDC)
AV ALVARO OBREGON NO 40 COLONIA
CENTRO H CD
JUCHITAN DE ZARAGOZA OAXA
70000
MX
NONE
NC
OPERATING SUPPORT
32,870
COLORADO SCHOOL OF MINES
1200 16TH ST
GOLDEN
,
CO
80401
NONE
I: INDIVIDUAL
TUITION SCHOLARSHIPS
2,250
COLUMBIA BASIN COLLEGE
2600 N 20TH AVE
PASCO
,
WA
99301
NONE
I: INDIVIDUAL
TUITION SCHOLARSHIPS
1,500
EQUIP ASIA
PO BOX 1314
WHEATON
,
IL
60187
NONE
PC: 509(A)(1)
INCLUSIVE COMMUNITY TRANFORMATION
30,000
FONKOZE
1700 KALARAMA RD NW STE 102
WASHINGTON
,
DC
20009
NONE
NC
SUPPORTING COMMUNITIES TO SERVE THE ULTRA POOR
101,989
GLOBAL GRASSROOTS
1950 LAFAYETTE RD STE 200 BOX 1
PORTSMOUTH
,
NH
03801
NONE
PC: 509(A)(1)
WOMEN-LED WATER VENTURES
30,000
GRAND CANYON UNIVERSITY
3300 W CAMELBACK RD
PHOENIX
,
AZ
85017
NONE
I: INDIVIDUAL
TUITION SCHOLARSHIPS
2,250
GROUNDSWELL INTERNATIONAL
1875 CONNECTICUT AVE NW 10TH FLOOR
WASHINGTON
,
DC
20009
NONE
PC: 509(A)(1)
PDL AGROECOLOGY, HAITI
60,000
GROUNDSWELL INTERNATIONAL
1875 CONNECTICUT AVE NW 10TH FLOOR
WASHINGTON
,
DC
20009
NONE
PC: 509(A)(1)
PDL AGROECOLOGY, HAITI
125,000
HAITI PARTNERS
PO BOX 2865
VERO BEACH
,
FL
32961
NONE
PC: 509(A)(1)
CHILDREN'S ACADEMY, HAITI
50,000
IDEAS COMUNITARIAS
IGNACIO ALDAMA 108 COLONIA NACIONAL
SANTA LUCIA DEL CAMINO OA
71228
MX
NONE
NC
SCHOOL FOR THE COMMON GOOD, MIXTECA, OAXACA
43,489
INSTITUTO DE ESTUDIOS E INVESTIGACION INTERCULTURAL
CALLE FRANZ BLOM 38-A CUXTITALI SAN
CRISTOBAL DE LAS CASAS
CHIAPAS
MX
NONE
NC
LEADERSHIP DEVELOPMENT
19,500
JAQUELINE VELAZCO
XXXX
PASCO
,
WA
99301
NONE
I: INDIVIDUAL
TUITION SCHOLARSHIPS
121
KUPENDA FOR THE CHILDREN
PO BOX 473
HAMPTON
,
NH
03843
NONE
PC: 509(A)(1)
DISABILITY ADVOCACY TRAINING, KENYA
80,000
LET'S BREAKTHROUGH INC
4 W 43RD ST STE 715
NEW YORK
,
NY
10036
NONE
PC: 509(A)(1)
ADOLESCENT EMPOWERMENT PROGRAM, BIHAR
31,472
NATIONAL IMMIGRATION FORUM
50 F ST NW STE 300
WASHINGTON
,
DC
20001
NONE
PC: 509(A)(1)
IMMIGRATION ADVOCACY
250,000
OASIS MINISTRIES
222 E GLENARM ST STE B-2
PASADENA
,
CA
91106
NONE
PC: 509(A)(1)
COMMUNITY CENTER, PUNGANUR, INDIA
23,588
OPPORTUNITY INTERNATIONAL
550 W VAN BUREN ST
CHICAGO
,
IL
60607
NONE
PC: 509(A)(1)
STORY CAPTURE METHODOLOGY
250,000
PLANT WITH PURPOSE
4747 MORENA BLVD STE 100
SAN DIEGO
,
CA
92117
NONE
PC: 509(A)(1)
SUSTAINABLE COMMUNITY DEVELOPMENT
65,000
PROGRAMA NINOS DE LA CALLE
CALLE SOLEDAD SOLORZANO S/N MZ 48
LOTE 5 COYOACAN CARMEN SERDAN
CIUDAD DE MEXICO CDMX
04910
MX
NONE
NC
COYOACAN PREVENTION CENTER PROGRAMMING
25,000
SATYANA INSTITUTE
18113 80TH ST NE
GRANITE FALLS
,
WA
98252
NONE
PC: 509(A)(1)
GENDER EQUITY FACILITATOR TRAINING, KENYA
67,965
SCHOOL OF CHOICE EDUCATION ORGANIZATION
3200 OWL DRIVE
ROLLING MEADOWS
,
IL
60008
NONE
PC: 509(A)(1)
SOCIAL EMOTIONAL LEARNING, HAITI
22,011
SERGIO GOMEZ-RIVERA
XXXX
TOLUCA
MX
NONE
I: INDIVIDUAL
TUITION SCHOLARSHIPS
2,185
SOCIAL AND ENVIRONMENTAL ENTREPRENEURS
23532 CALABASAS ROAD SUITE A
CALABASAS
,
CA
91302
NONE
PC: 509(A)(1)
TIERRA NATIVE PROJECT, CHIHUAHUA
50,000
SOJOURNERS
PO BOX 70730
WASHINGTON
,
DC
200240730
NONE
PC: 509(A)(1)
IMMIGRATION ADVOCACY
250,000
THE MINISTRY OFFICE
17409 COMET CIRCLE
MINNETONKA
,
MN
55345
NONE
PC: 509(A)(1)
CARE OF CREATION, KENYA
75,000
UNIVERSITY OF WASHINGTON
PO BOX 24967
SEATTLE
,
WA
981241967
NONE
I: INDIVIDUAL
TUITION SCHOLARSHIPS
1,500
VIVA LATIN AMERICA AND CARIBBEAN
PO BOX 544-2050
SAN PEDRO
CS
NONE
PC: 509(A)(1)
MEXICO CHILD PROTECTION NETWORK
15,000
WESTERN WASHINGTON UNIVERSITY
516 HIGH ST MS 9004
BELLINGHAM
,
WA
98225
NONE
I: INDIVIDUAL
TUITION SCHOLARSHIPS
2,250
WORLD RELIEF
7 E BALTIMORE ST
BALTIMORE
,
MD
21202
NONE
PC: 509(A)(1)
CHURCH EMPOWERMENT ZONES, HAITI
107,500
WORLD VISION
PO BOX 9716
FEDERAL WAY
,
WA
98063
NONE
PC: 509(A)(1)
CHILD PROTECTION, WEST BENGAL
230,000
WORLD VISION
PO BOX 9716
FEDERAL WAY
,
WA
98063
NONE
PC: 509(A)(1)
CHILD PROTECTION, KENYA
500,000
WORLD VISION
PO BOX 9716
FEDERAL WAY
,
WA
98063
NONE
PC: 509(A)(1)
VIDARBHA FARMER LIVELIHOODS, INDIA
237,777
XILOTL ASOCIACION PARA EL DESARROLLO
AV SAN JERONIMO 157-301
MEXICO DF
5550 0804 - 5616
MX
NONE
NC
OCOSINGO: TRANSFORMATION FOR PEACE AND A FULL LIFE
52,208
Total
.................................
3a
3,955,432
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
SCHOOL PROGRAMS
33,684
b
FOOD PROGRAM
26,740
c
MISCELLANEOUS PROGRAM SUPPORT
7,162
d
SCHOLAR PROGRAM
73,593
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
14
1,648
4
Dividends and interest from securities
....
14
2,736,432
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not debt-financed property
.....
6
Net rental income or (loss) from personal property
7
Other investment income
.....
8
Gain or (loss) from sales of assets other than
inventory
............
18
1,231,628
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
3,969,708
141,179
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
4,110,887
(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.)
1A
VISTA HERMOSA OPERATES NUEVA ESPERANZA LEADERSHIP ACADEMY (NELA), A
1A
PRIVATE, CHRISTIAN SCHOOL FOR GRADES K-8. BUILDING ON SERVANT
1A
LEADERSHIP PRINCIPLES AND TRAUMA INFORMED PRACTICES, NELA GIVES
1A
STUDENTS OPPORTUNITIES TO HONOR AND SERVE THEIR COMMUNITY.
1B
WASHINGTON STATE SPI REIMBURSEMENTS
1C
MISCELLANEOUS INCOME FROM SCHOOL EVENTS
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