-
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
NELSON BENJAMIN F CHARITABLE TRUST
Number and street (or P.O. box number if mail is not delivered to street address)
6325 S RAINBOW BLVD STE 300
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
LAS VEGAS
,
NV
89118
A Employer identification number
41-6012270
B
Telephone number (see instructions)
(888) 730-4933
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)
$
7,947,876
J
Accounting method:
Cash
Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)
Part I
Analysis of Revenue and Expenses
(The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).)
(a)
Revenue and
expenses per
books
(b)
Net investment
income
(c)
Adjusted net
income
(d)
Disbursements
for charitable
purposes
(cash basis only)
1
Contributions, gifts, grants, etc., received (attach schedule)
2
Check
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
185,340
184,262
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
97,745
b
Gross sales price for all assets on line 6a
2,904,588
7
Capital gain net income (from Part IV, line 2)
...
97,745
8
Net short-term capital gain
.........
0
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)
.......
463,015
12
Total.
Add lines 1 through 11
........
746,100
282,007
13
Compensation of officers, directors, trustees, etc.
75,806
68,226
7,581
14
Other employee salaries and wages
......
0
0
0
15
Pension plans, employee benefits
.......
0
0
16a
Legal fees (attach schedule)
.........
0
b
Accounting fees (attach schedule)
.......
939
0
0
939
c
Other professional fees (attach schedule)
....
0
17
Interest
...............
0
18
Taxes (attach schedule) (see instructions)
...
11,471
4,373
0
19
Depreciation (attach schedule) and depletion
...
0
0
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
0
0
22
Printing and publications
..........
0
0
23
Other expenses (attach schedule)
.......
105
80
25
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
88,321
72,679
0
8,545
25
Contributions, gifts, grants paid
.......
325,001
325,001
26
Total expenses and disbursements.
Add lines 24 and 25
413,322
72,679
0
333,546
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
332,778
b
Net investment income
(if negative, enter -0-)
209,328
c
Adjusted net income
(if negative, enter -0-)
...
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
.............
9,680
9,680
2
Savings and temporary cash investments
.........
271,945
361,188
361,188
3
Accounts receivable
Less: allowance for doubtful accounts
0
0
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
0
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)
.......
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)
..........
5,616,540
5,856,723
7,577,008
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
5,888,485
6,227,591
7,947,876
17
Accounts payable and accrued expenses
..........
18
Grants payable
.................
19
Deferred revenue
.................
20
Loans from officers, directors, trustees, and other disqualified persons
21
Mortgages and other notes payable (attach schedule)
......
22
Other liabilities (describe
)
23
Total liabilities
(add lines 17 through 22)
.........
0
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
........
5,888,485
6,227,591
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)
.....
5,888,485
6,227,591
30
Total liabilities and net assets/fund balances
(see instructions)
.
5,888,485
6,227,591
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
5,888,485
2
Enter amount from Part I, line 27a
.....................
2
332,778
3
Other increases not included in line 2 (itemize)
3
7,077
4
Add lines 1, 2, and 3
..........................
4
6,228,340
5
Decreases not included in line 2 (itemize)
5
749
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
6,227,591
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
354. COMCAST CORP CLASS A
2008-03-03
2019-02-15
b
117. COMCAST CORP CLASS A
2007-02-22
2019-02-15
c
644. BLACKROCK GL L/S CREDIT-K #1940
2015-10-27
2019-02-27
d
103. EATON VANCE GLOB MACRO ADV-I 208
2017-10-24
2019-02-27
e
257. FIDELITY NEW MRKTS INC-I
2014-06-23
2019-02-27
136. ISHARES RUSSELL 2000 ETF
2018-01-25
2019-02-27
91. ISHARES RUSSELL 2000 ETF
2018-09-13
2019-02-27
312. JOHN HANCOCK II-CURR STR-I 3643
2017-10-24
2019-02-27
265. JPMORGAN HIGH YIELD FUND SS 3580
2016-08-26
2019-02-27
2988.64936 NEUBERGER BERMAN LONG SH-INS #1830
2014-06-23
2019-02-27
458.35064 NEUBERGER BERMAN LONG SH-INS #1830
2017-05-26
2019-02-27
430. T ROWE PRICE INST FLOAT RATE 170
2016-04-22
2019-02-27
916. T ROWE PR REAL ESTATE-I #432
2015-12-24
2019-02-27
657. SPDR DJ WILSHIRE INTERNATIONAL REAL
2011-09-27
2019-02-27
526. TCW EMRG MKTS INCM-I 4721
2018-07-12
2019-02-27
27. VANGUARD INTERMEDIATE TERM B
2017-04-21
2019-02-27
1616. FIDELITY NEW MRKTS INC-I
2016-08-26
2019-03-01
819. ISHARES RUSSELL 2000 ETF
2018-01-25
2019-03-01
113. ISHARES CORE MSCI EMERGING
2018-09-25
2019-03-01
67. SPDR DJ WILSHIRE INTERNATIONAL REAL
2011-09-27
2019-03-01
1831. TCW EMRG MKTS INCM-I 4721
2018-07-13
2019-03-01
310. VANGUARD FTSE EMERGING MARKETS ETF
2018-09-25
2019-03-01
1. AT & T INC
2018-02-13
2019-04-03
151. AT & T INC
2018-04-10
2019-04-03
1. AT & T INC
2018-02-13
2019-04-03
44. AT & T INC
2018-04-10
2019-04-03
3. ALPHABET INC/CA
2018-11-15
2019-04-03
2. ALPHABET INC/CA
2019-02-15
2019-04-03
1. APPLE INC
2010-10-26
2019-04-03
52. APPLE INC
2018-11-15
2019-04-03
14. APPLE INC
2013-01-29
2019-04-03
9. BLACKROCK INC
2018-08-13
2019-04-03
1. BLACKROCK INC
2014-10-28
2019-04-03
2. BLACKROCK INC
2018-08-13
2019-04-03
11. BOEING CO
2018-11-30
2019-04-03
4. BOEING CO
2018-11-30
2019-04-03
21. CME GROUP INC
2018-11-15
2019-04-03
6. CME GROUP INC
2019-02-27
2019-04-03
11. CVS HEALTH CORPORATION
2016-01-20
2019-04-03
54. CVS HEALTH CORPORATION
2018-11-15
2019-04-03
14. CELANESE CORP
2019-02-15
2019-04-03
118. CISCO SYSTEMS INC
2018-11-15
2019-04-03
4. CISCO SYSTEMS INC
2011-09-27
2019-04-03
3. CISCO SYSTEMS INC
2014-10-28
2019-04-03
33. CISCO SYSTEMS INC
2019-02-27
2019-04-03
15. CITIGROUP INC
2014-03-25
2019-04-03
39. CITIGROUP INC
2018-11-15
2019-04-03
16. CITIGROUP INC
2019-02-27
2019-04-03
65. COGNIZANT TECH SOLUTIONS CRP COM
2018-11-15
2019-04-03
4. COGNIZANT TECH SOLUTIONS CRP COM
2016-03-16
2019-04-03
20. COGNIZANT TECH SOLUTIONS CRP COM
2019-02-27
2019-04-03
35. DIAGEO PLC - ADR
2018-11-26
2019-04-03
12. DIAGEO PLC - ADR
2018-11-26
2019-04-03
10. WALT DISNEY CO
2019-02-27
2019-04-03
30. EOG RESOURCES, INC
2018-04-10
2019-04-03
11. EOG RESOURCES, INC
2018-04-10
2019-04-03
26. ELECTRONIC ARTS INC
2019-02-15
2019-04-03
9. ELECTRONIC ARTS INC
2019-02-15
2019-04-03
48. JPMORGAN CHASE & CO
2018-11-15
2019-04-03
16. JPMORGAN CHASE & CO
2018-12-24
2019-04-03
32. LAS VEGAS SANDS CORP
2014-10-28
2019-04-03
36. LAS VEGAS SANDS CORP
2018-10-01
2019-04-03
19. LAS VEGAS SANDS CORP
2019-02-27
2019-04-03
2. LAS VEGAS SANDS CORP
2014-10-28
2019-04-03
25. ELI LILLY & CO COM
2018-11-15
2019-04-03
7. ELI LILLY & CO COM
2016-10-05
2019-04-03
10. ELI LILLY & CO COM
2019-02-27
2019-04-03
146. MANULIFE FINANCIAL CORP
2018-11-15
2019-04-03
47. MANULIFE FINANCIAL CORP
2015-12-17
2019-04-03
64. MANULIFE FINANCIAL CORP
2015-12-17
2019-04-03
96. MICROSOFT CORP
2018-11-15
2019-04-03
5. MICROSOFT CORP
2015-08-10
2019-04-03
16. MICROSOFT CORP
2016-04-26
2019-04-03
14. MICROSOFT CORP
2019-02-27
2019-04-03
104. MONDELEZ INTERNATIONAL INC
2018-07-17
2019-04-03
29. MONDELEZ INTERNATIONAL INC
2018-09-13
2019-04-03
25. NIKE INC CL B
2018-11-15
2019-04-03
34. NIKE INC CL B
2017-11-01
2019-04-03
11. NIKE INC CL B
2019-02-27
2019-04-03
7. NIKE INC CL B
2017-11-01
2019-04-03
30. PNC FINANCIAL SERVICES GROUP
2018-11-15
2019-04-03
7. PNC FINANCIAL SERVICES GROUP
2019-02-27
2019-04-03
119. ROCHE HOLDINGS LTD - ADR
2015-02-27
2019-04-03
34. ROCHE HOLDINGS LTD - ADR
2019-02-27
2019-04-03
2894.982 T ROWE PRICE INST FLOAT RATE 170
2016-04-22
2019-04-03
1009.621 T ROWE PRICE INST FLOAT RATE 170
2016-04-22
2019-04-03
163. SUNCOR ENERGY INC NEW F
2018-11-26
2019-04-03
57. SUNCOR ENERGY INC NEW F
2018-11-26
2019-04-03
19. THERMO FISHER SCIENTIFIC INC
2018-11-15
2019-04-03
5. THERMO FISHER SCIENTIFIC INC
2019-02-27
2019-04-03
98. TOTAL S.A. - ADR
2018-11-15
2019-04-03
34. TOTAL S.A. - ADR
2018-11-26
2019-04-03
36. UNION PACIFIC CORP
2018-11-15
2019-04-03
2. UNION PACIFIC CORP
2011-09-27
2019-04-03
1. UNION PACIFIC CORP
2015-08-28
2019-04-03
10. UNION PACIFIC CORP
2019-02-27
2019-04-03
35. UNITED PARCEL SERVICE-CL B
2018-11-26
2019-04-03
13. UNITED PARCEL SERVICE-CL B
2018-11-26
2019-04-03
10. UNITEDHEALTH GROUP INC
2008-03-03
2019-04-03
14. UNITEDHEALTH GROUP INC
2018-11-15
2019-04-03
7. UNITEDHEALTH GROUP INC
2019-02-27
2019-04-03
10. ZOETIS INC
2019-02-27
2019-04-03
45. EATON CORP PLC
2018-11-26
2019-04-03
15. EATON CORP PLC
2018-11-26
2019-04-03
12. TE CONNECTIVITY LTD
2019-02-27
2019-04-03
88. BERSHIRE HATHAWAY INC.
2011-09-27
2019-04-23
26. BERSHIRE HATHAWAY INC.
2011-09-27
2019-04-23
19. WALT DISNEY CO
2018-04-10
2019-05-08
12739.997 FIDELITY NEW MRKTS INC-Z #3323
2013-10-11
2019-05-08
57.003 FIDELITY NEW MRKTS INC-Z #3323
2019-03-29
2019-05-08
14. ISHARES S&P MID-CAP 400 GROWTH
2019-03-01
2019-05-08
5403. TCW EMRG MKTS INCM-I 4721
2018-07-13
2019-05-08
643. VANGUARD BD INDEX FD INC
2014-01-22
2019-05-08
112. VANGUARD EUROPE PACIFIC ETF
2018-09-25
2019-05-08
113. VANGUARD FTSE EMERGING MARKETS ETF
2018-09-25
2019-05-08
259. FLEXTRONICS INTL LTD
2018-03-08
2019-05-08
18.619 FIDELITY NEW MRKTS INC-Z #3323
2019-03-29
2019-05-09
4215.381 FIDELITY NEW MRKTS INC-Z #3323
2013-10-11
2019-05-09
5. HOME DEPOT INC
2019-02-27
2019-05-09
5. ISHARES S&P MID-CAP 400 GROWTH
2018-09-13
2019-05-09
5. LAM RESEARCH CORP COM
2019-02-27
2019-05-09
1797. TCW EMRG MKTS INCM-I 4721
2018-07-12
2019-05-09
17. TJX COMPANIES INC
2011-09-27
2019-05-09
203. VANGUARD BD INDEX FD INC
2015-06-10
2019-05-09
25. VANGUARD EUROPE PACIFIC ETF
2018-04-19
2019-05-09
17. VANGUARD EUROPE PACIFIC ETF
2018-09-13
2019-05-09
33. VANGUARD FTSE EMERGING MARKETS ETF
2018-04-19
2019-05-09
15. VANGUARD FTSE EMERGING MARKETS ETF
2018-09-13
2019-05-09
87. FLEXTRONICS INTL LTD
2018-03-08
2019-05-09
126. ROCHE HOLDINGS LTD - ADR
2015-02-27
2019-05-10
33. ROCHE HOLDINGS LTD - ADR
2015-02-27
2019-05-10
9. ROCHE HOLDINGS LTD - ADR
2019-02-27
2019-05-10
23. THERMO FISHER SCIENTIFIC INC
2011-09-27
2019-05-10
1. THERMO FISHER SCIENTIFIC INC
2019-02-27
2019-05-10
7. THERMO FISHER SCIENTIFIC INC
2015-08-28
2019-05-10
50. ZOETIS INC
2017-04-25
2019-05-10
2. ZOETIS INC
2019-02-27
2019-05-10
8. ZOETIS INC
2017-04-25
2019-05-10
43. WALT DISNEY CO
2008-03-03
2019-06-11
15. WALT DISNEY CO
2007-02-22
2019-06-11
436. ROCHE HOLDINGS LTD - ADR
2015-10-27
2019-06-11
112. ROCHE HOLDINGS LTD - ADR
2018-11-15
2019-06-11
181. ROCHE HOLDINGS LTD - ADR
2015-10-27
2019-06-11
30. APPLE INC
2010-10-26
2019-07-03
10. APPLE INC
2013-01-29
2019-07-03
128. CISCO SYSTEMS INC
2011-09-27
2019-07-03
42. CISCO SYSTEMS INC
2011-09-27
2019-07-03
56. MICROSOFT CORP
2015-07-21
2019-07-03
19. MICROSOFT CORP
2015-08-10
2019-07-03
34. UNION PACIFIC CORP
2011-09-27
2019-07-03
11. UNION PACIFIC CORP
2015-08-28
2019-07-03
29. ELI LILLY & CO COM
2016-10-05
2019-07-19
7. ELI LILLY & CO COM
2016-10-05
2019-07-19
3. ELI LILLY & CO COM
2019-02-27
2019-07-19
70. MERCK & CO INC NEW
2016-02-05
2019-07-19
23. MERCK & CO INC NEW
2016-04-26
2019-07-19
18. THERMO FISHER SCIENTIFIC INC
2011-09-27
2019-07-19
6. THERMO FISHER SCIENTIFIC INC
2011-09-27
2019-07-19
50. ZOETIS INC
2017-04-25
2019-07-19
17. ZOETIS INC
2017-04-25
2019-07-19
27. CME GROUP INC
2018-10-01
2019-07-31
9. CME GROUP INC
2012-06-07
2019-07-31
12. CME GROUP INC
2018-10-01
2019-07-31
217.319 AQR MANAGED FUTURES STR-I
2019-02-28
2019-08-07
5641.436 AQR MANAGED FUTURES STR-I
2014-10-21
2019-08-07
137.276 BLACKROCK GL L/S CREDIT-K #1940
2019-05-10
2019-08-07
4974.112 BLACKROCK GL L/S CREDIT-K #1940
2015-10-27
2019-08-07
92. EATON VANCE GLOB MACRO ADV-I 208
2017-10-24
2019-08-07
2015. INVESCO OPTIMUM YIELD DIVERS
2019-02-27
2019-08-07
45. ISHARES S&P MID-CAP 400 GROWTH
2011-09-27
2019-08-07
25. ISHARES S&P MID-CAP 400 GROWTH
2018-09-13
2019-08-07
89. ISHARES RUSSELL 2000 ETF
2018-01-25
2019-08-07
25. ISHARES S&P MID-CAP 400 VALUE
2018-09-13
2019-08-07
64. ISHARES S&P MID-CAP 400 VALUE
2014-04-23
2019-08-07
3085.429 ASG GLOBAL ALTERNATIVES-Y 1993
2013-07-15
2019-08-07
2403.218 NEUBERGER BERMAN LONG SH-INS #1830
2014-06-23
2019-08-07
17021.61 AQR MANAGED FUTURES STR-I
2013-07-15
2019-08-16
698. AQR MANAGED FUTURES STR-I
2019-03-04
2019-08-16
632.272 BLACKROCK GL L/S CREDIT-K #1940
2019-05-09
2019-08-16
14855.527 BLACKROCK GL L/S CREDIT-K #1940
2015-10-27
2019-08-16
537. EATON VANCE GLOB MACRO ADV-I 208
2017-10-20
2019-08-16
6096. INVESCO OPTIMUM YIELD DIVERS
2018-09-25
2019-08-16
27. ISHARES S&P MID-CAP 400 GROWTH
2019-03-01
2019-08-16
199. ISHARES S&P MID-CAP 400 GROWTH
2011-09-27
2019-08-16
289. ISHARES RUSSELL 2000 ETF
2018-01-25
2019-08-16
33. ISHARES S&P MID-CAP 400 VALUE
2019-03-01
2019-08-16
257. ISHARES S&P MID-CAP 400 VALUE
2011-09-27
2019-08-16
9363.483 ASG GLOBAL ALTERNATIVES-Y 1993
2013-07-15
2019-08-16
7271.03 NEUBERGER BERMAN LONG SH-INS #1830
2014-06-23
2019-08-16
537. TCW EMRG MKTS INCM-I 4721
2018-07-13
2019-08-16
58. VANGUARD INTERMEDIATE TERM B
2016-04-20
2019-08-16
9. APPLE INC
2019-08-07
2019-09-10
19. CELANESE CORP
2014-10-28
2019-09-10
19. NIKE INC CL B
2017-11-01
2019-09-10
1. PNC FINANCIAL SERVICES GROUP
2016-10-25
2019-09-10
18. PNC FINANCIAL SERVICES GROUP
2019-08-07
2019-09-10
38. CELANESE CORP
2019-08-16
2019-09-26
20. COGNIZANT TECH SOLUTIONS CRP COM
2019-02-27
2019-09-26
31. NIKE INC CL B
2019-08-16
2019-09-26
45. PNC FINANCIAL SERVICES GROUP
2018-11-15
2019-09-26
7. UNION PACIFIC CORP
2019-08-07
2019-09-26
11. UNITED PARCEL SERVICE-CL B
2019-08-07
2019-09-26
55. VANGUARD INTERMEDIATE TERM B
2016-04-20
2019-09-26
33. VANGUARD INTERMEDIATE TERM B
2015-07-21
2019-09-26
261. VANGUARD FTSE EMERGING MARKETS ETF
2019-08-16
2019-09-26
4582. VANGUARD FTSE EMERGING MARKETS ETF
2011-09-27
2019-09-26
126. VANGUARD FTSE EMERGING MARKETS ETF
2019-08-07
2019-09-26
1511. VANGUARD FTSE EMERGING MARKETS ETF
2011-09-27
2019-09-26
9666.061 JPMORGAN HIGH YIELD FUND SS 3580
2015-11-13
2019-10-09
11792.988 JPMORGAN HIGH YIELD FUND SS 3580
2019-04-04
2019-10-09
4037.102 JPMORGAN HIGH YIELD FUND SS 3580
2019-04-04
2019-10-09
3166.638 JPMORGAN HIGH YIELD FUND SS 3580
2016-04-22
2019-10-09
3. ALPHABET INC/CA
2019-09-26
2019-10-17
18. APPLE INC
2019-08-16
2019-10-17
342. EATON VANCE GLOB MACRO ADV-I 208
2017-10-20
2019-10-17
131. ISHARES BARCLAYS AGGREGATE BOND FUND
2019-08-16
2019-10-17
17. LAM RESEARCH CORP COM
2019-08-16
2019-10-17
28. MICROSOFT CORP
2019-09-26
2019-10-17
129. VANGUARD INTERMEDIATE TERM B
2016-04-20
2019-10-17
1196. UBS GROUP AG
2018-01-25
2019-10-17
619. UBS GROUP AG
2019-08-16
2019-10-17
33. TE CONNECTIVITY LTD
2019-08-16
2019-10-17
1. ALPHABET INC/CA
2019-09-26
2019-10-18
4. APPLE INC
2019-09-26
2019-10-18
8. DIAGEO PLC - ADR
2019-08-07
2019-10-18
185. EATON VANCE GLOB MACRO ADV-I 208
2017-10-24
2019-10-18
43. ISHARES BARCLAYS AGGREGATE BOND FUND
2019-09-26
2019-10-18
6. LAM RESEARCH CORP COM
2018-09-13
2019-10-18
9. MICROSOFT CORP
2019-08-07
2019-10-18
31.072 T ROWE PR REAL ESTATE-I #432
2019-08-08
2019-10-18
4.928 T ROWE PR REAL ESTATE-I #432
2016-01-22
2019-10-18
22. SPDR DJ WILSHIRE INTERNATIONAL REAL
2019-08-07
2019-10-18
131. TCW EMRG MKTS INCM-I 4721
2018-07-12
2019-10-18
43. VANGUARD INTERMEDIATE TERM B
2015-07-21
2019-10-18
358. UBS GROUP AG
2018-01-25
2019-10-18
251. UBS GROUP AG
2019-02-27
2019-10-18
13. TE CONNECTIVITY LTD
2019-08-07
2019-10-18
10866.818 JOHN HANCOCK II-CURR STR-I 3643
2017-10-20
2019-12-05
574.355 JOHN HANCOCK II-CURR STR-I 3643
2019-05-09
2019-12-05
3526.39 JOHN HANCOCK II-CURR STR-I 3643
2017-10-24
2019-12-06
356.925 JOHN HANCOCK II-CURR STR-I 3643
2019-05-10
2019-12-06
32. LAM RESEARCH CORP COM
2018-09-25
2019-12-23
11. LAM RESEARCH CORP COM
2018-09-13
2019-12-23
CAPITAL GAIN DIVIDENDS
P
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
13,342
3,480
9,862
b
4,410
1,560
2,850
c
6,298
6,711
-413
d
1,004
1,103
-99
e
3,873
4,215
-342
21,362
21,598
-236
14,293
15,534
-1,241
2,849
3,008
-159
1,897
1,956
-59
40,705
40,770
-65
6,243
6,334
-91
4,236
4,261
-25
25,657
24,766
891
25,234
23,438
1,796
4,282
4,213
69
2,227
2,283
-56
24,224
26,255
-2,031
129,177
130,063
-886
5,807
5,851
-44
2,561
2,266
295
14,831
14,721
110
12,966
12,851
115
32
37
-5
4,791
5,332
-541
32
37
-5
1,396
1,554
-158
3,614
3,117
497
2,409
2,225
184
193
44
149
10,048
9,811
237
2,705
1,385
1,320
3,953
4,285
-332
439
328
111
878
952
-74
4,288
4,285
3
1,559
1,519
40
3,551
3,945
-394
1,015
1,067
-52
579
1,027
-448
2,840
4,271
-1,431
1,440
1,401
39
6,514
5,485
1,029
221
65
156
166
72
94
1,822
1,692
130
972
755
217
2,528
2,456
72
1,037
1,028
9
4,816
4,409
407
296
236
60
1,482
1,435
47
5,694
5,050
644
1,952
1,731
221
1,125
1,131
-6
2,874
3,216
-342
1,054
1,179
-125
2,644
2,769
-125
915
959
-44
5,060
5,144
-84
1,687
1,488
199
2,081
1,944
137
2,341
2,149
192
1,236
1,174
62
130
121
9
3,213
2,723
490
900
573
327
1,285
1,246
39
2,565
2,429
136
826
691
135
1,125
903
222
11,481
10,125
1,356
598
237
361
1,913
840
1,073
1,674
1,564
110
5,149
4,526
623
1,436
1,369
67
2,114
1,842
272
2,874
1,872
1,002
930
941
-11
592
385
207
3,828
4,040
-212
893
864
29
4,068
4,055
13
1,162
1,184
-22
28,458
28,689
-231
9,925
10,051
-126
5,368
5,286
82
1,877
1,849
28
5,270
4,398
872
1,387
1,265
122
5,520
5,490
30
1,915
1,867
48
6,130
5,333
797
341
87
254
170
87
83
1,703
1,690
13
4,022
3,874
148
1,494
1,439
55
2,466
463
2,003
3,452
3,684
-232
1,726
1,823
-97
1,021
933
88
3,734
3,345
389
1,245
1,115
130
1,031
999
32
18,567
6,426
12,141
5,486
1,899
3,587
2,538
1,921
617
190,463
201,548
-11,085
852
864
-12
3,125
3,072
53
43,980
43,440
540
51,050
51,331
-281
4,580
4,927
-347
4,747
4,684
63
2,802
4,816
-2,014
278
282
-4
62,851
65,856
-3,005
963
939
24
1,100
1,185
-85
978
889
89
14,574
14,394
180
910
248
662
16,123
16,233
-110
1,012
1,136
-124
688
725
-37
1,352
1,551
-199
615
614
1
877
1,618
-741
4,038
4,231
-193
1,058
1,116
-58
288
313
-25
6,171
1,219
4,952
268
253
15
1,878
894
984
5,104
2,757
2,347
204
187
17
817
441
376
5,810
3,387
2,423
2,027
1,184
843
14,875
13,866
1,009
3,821
3,441
380
6,175
5,691
484
6,107
1,322
4,785
2,036
655
1,381
7,139
2,090
5,049
2,342
854
1,488
7,674
2,629
5,045
2,604
907
1,697
5,826
1,478
4,348
1,885
953
932
3,115
2,373
742
752
573
179
322
374
-52
5,705
3,734
1,971
1,875
1,289
586
5,228
954
4,274
1,743
318
1,425
5,705
2,757
2,948
1,940
937
1,003
5,263
4,728
535
1,754
483
1,271
2,339
2,093
246
2,002
1,780
222
51,958
56,523
-4,565
1,381
1,362
19
50,040
50,994
-954
936
985
-49
30,781
33,693
-2,912
9,922
4,609
5,313
5,512
5,718
-206
13,153
14,134
-981
3,812
4,222
-410
9,759
8,375
1,384
33,816
34,897
-1,081
34,630
31,042
3,588
156,599
169,998
-13,399
6,422
5,724
698
6,361
6,272
89
149,447
152,352
-2,905
5,418
5,762
-344
94,060
112,715
-18,655
5,973
5,925
48
44,020
19,399
24,621
42,979
45,895
-2,916
5,011
5,344
-333
39,028
25,130
13,898
103,092
106,537
-3,445
105,503
94,367
11,136
4,468
4,317
151
5,126
5,010
116
1,932
1,758
174
2,338
1,129
1,209
1,640
1,046
594
138
94
44
2,476
2,319
157
4,610
4,193
417
1,197
1,245
-48
2,841
2,491
350
6,294
5,723
571
1,147
1,158
-11
1,303
1,253
50
4,827
4,750
77
2,896
2,778
118
10,594
10,382
212
185,987
177,787
8,200
5,114
5,002
112
61,333
58,652
2,681
69,306
68,537
769
84,556
84,919
-363
28,946
29,070
-124
22,705
22,532
173
3,753
3,735
18
4,229
3,716
513
3,509
3,670
-161
14,766
14,892
-126
4,041
3,505
536
3,950
3,900
50
11,310
11,142
168
13,475
23,734
-10,259
6,974
6,461
513
3,068
2,967
101
1,254
1,245
9
939
877
62
1,297
1,314
-17
1,898
1,981
-83
4,850
4,862
-12
1,401
923
478
1,257
1,248
9
932
900
32
148
129
19
896
835
61
1,090
1,049
41
3,774
3,605
169
4,042
7,105
-3,063
2,834
2,859
-25
1,204
1,144
60
98,600
104,430
-5,830
5,211
5,118
93
32,039
33,811
-1,772
3,243
3,206
37
9,427
4,925
4,502
3,241
1,691
1,550
9,749
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
9,862
b
2,850
c
-413
d
-99
e
-342
-236
-1,241
-159
-59
-65
-91
-25
891
1,796
69
-56
-2,031
-886
-44
295
110
115
-5
-541
-5
-158
497
184
149
237
1,320
-332
111
-74
3
40
-394
-52
-448
-1,431
39
1,029
156
94
130
217
72
9
407
60
47
644
221
-6
-342
-125
-125
-44
-84
199
137
192
62
9
490
327
39
136
135
222
1,356
361
1,073
110
623
67
272
1,002
-11
207
-212
29
13
-22
-231
-126
82
28
872
122
30
48
797
254
83
13
148
55
2,003
-232
-97
88
389
130
32
12,141
3,587
617
-11,085
-12
53
540
-281
-347
63
-2,014
-4
-3,005
24
-85
89
180
662
-110
-124
-37
-199
1
-741
-193
-58
-25
4,952
15
984
2,347
17
376
2,423
843
1,009
380
484
4,785
1,381
5,049
1,488
5,045
1,697
4,348
932
742
179
-52
1,971
586
4,274
1,425
2,948
1,003
535
1,271
246
222
-4,565
19
-954
-49
-2,912
5,313
-206
-981
-410
1,384
-1,081
3,588
-13,399
698
89
-2,905
-344
-18,655
48
24,621
-2,916
-333
13,898
-3,445
11,136
151
116
174
1,209
594
44
157
417
-48
350
571
-11
50
77
118
212
8,200
112
2,681
769
-363
-124
173
18
513
-161
-126
536
50
168
-10,259
513
101
9
62
-17
-83
-12
478
9
32
19
61
41
169
-3,063
-25
60
-5,830
93
-1,772
37
4,502
1,550
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
97,745
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
371,281
7,394,199
0.050212
2017
449,640
7,397,408
0.060783
2016
358,508
7,356,866
0.048731
2015
230,536
7,752,557
0.029737
2014
212,587
7,651,276
0.027785
2
Total
of line 1, column (d)
.....................
2
0.217248
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
0.04345
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
7,258,967
5
Multiply line 4 by line 3
......................
5
315,402
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
2,093
7
Add lines 5 and 6
........................
7
317,495
8
Enter qualifying distributions from Part XII, line 4
,.............
8
333,546
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
2,093
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
2,093
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
2,093
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
4,880
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
7
Total credits and payments. Add lines 6a through 6d
..............
7
4,880
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
0
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
2,787
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
2,096
Refunded
11
691
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
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)
MN
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
WELLS FARGO BANK NA
Telephone no.
(888) 730-4933
Located at
100 N MAIN ST MAC D4001-117
WINSTON SALEM
NC
ZIP+4
27101
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
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
WELLS FARGO BANK N A
TRUSTEE
1
75,806
100 N MAIN ST MAC D4001-117
WINSTON SALEM
,
NC
27101
2
Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a)
Name and address of each employee paid more than $50,000
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
NONE
Total
number of other employees paid over $50,000
...................
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
7
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
(continued)
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
NONE
Total
number of others receiving over $50,000 for professional services
.............
0
Part IX-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
2
3
4
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
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
6,921,952
b
Average of monthly cash balances
.......................
1b
447,558
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
7,369,510
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
7,369,510
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
110,543
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
7,258,967
6
Minimum investment return.
Enter 5% of line 5
..................
6
362,948
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
362,948
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
2,093
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
2,093
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
360,855
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
360,855
6
Deduction from distributable amount (see instructions)
.................
6
0
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1
...
7
360,855
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
333,546
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
0
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
0
b
Cash distribution test (attach the required schedule)
.................
3b
0
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
333,546
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
2,093
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
331,453
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
360,855
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
241,397
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
0
b
From 2015
......
0
c
From 2016
......
0
d
From 2017
......
0
e
From 2018
......
0
f
Total
of lines 3a through e
........
0
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
333,546
a
Applied to 2018, but not more than line 2a
241,397
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
0
c
Treated as distributions out of corpus (Election
required—see instructions)
........
0
d
Applied to 2019 distributable amount
.....
92,149
e
Remaining amount distributed out of corpus
0
5
Excess distributions carryover applied to 2019.
0
0
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
0
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
0
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
0
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
0
e
Undistributed income for 2018. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
0
f
Undistributed income for 2019. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2020
..........
268,706
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions)
.......
0
8
Excess distributions carryover from 2014 not
applied on line 5 or line 7 (see instructions)
...
0
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
0
10
Analysis of line 9:
a
Excess from 2015
....
0
b
Excess from 2016
....
0
c
Excess from 2017
....
0
d
Excess from 2018
....
0
e
Excess from 2019
....
0
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).)
NONE
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.
NONE
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
THE CHURCH OF OUR LADY OF GRACE
595 E MAIN ST
Avon Park
,
FL
33825
NONE
PC
GENERAL OPERATING
80,798
MARYKNOLL FATHERS AND BROTHERS
77 RYDER ROAD ATTN DAVID A SMITH CF
MARYKNOLL
,
NY
105459998
NONE
PC
GENERAL OPERATING
81,401
UNIVERSITY OF MINNESOTA FOUNDATION
JANE GODFREY PLANNED GIVING ESTAT
MINNEAPOLIS
,
MN
554552010
NONE
PC
GENERAL OPERATING
81,401
LITTLE SISTERS OF THE POOR
SR GEMMA ALESSI
PALATINE
,
IL
60067
NONE
PC
GENERAL OPERATING
81,401
Total
.................................
3a
325,001
b
Approved for future payment
Total
.................................
3b
Form
990-PF
(2019)
Form 990-PF (2019)
Page
12
Part XVI-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
Unrelated business income
Excluded by section 512, 513, or 514
(e)
Related or exempt
function income
(See instructions.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
4
Dividends and interest from securities
....
14
185,340
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
97,745
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
INCOME FROM PASSTH
900099
463,015
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
463,015
283,085
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
746,100
(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