-
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
EQUITRANS MIDSTREAM FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)
2200 ENERGY DRIVE
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CANONSBURG
,
PA
15317
A Employer identification number
83-2213567
B
Telephone number (see instructions)
(412) 395-2126
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)
$
15,398,406
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)
0
2
Check
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
452,407
452,407
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
b
Gross sales price for all assets on line 6a
7
Capital gain net income (from Part IV, line 2)
...
0
8
Net short-term capital gain
.........
9
Income modifications
...........
10a
Gross sales less returns and allowances
b
Less: Cost of goods sold
....
c
Gross profit or (loss) (attach schedule)
.....
11
Other income (attach schedule)
.......
12
Total.
Add lines 1 through 11
........
452,407
452,407
13
Compensation of officers, directors, trustees, etc.
0
0
0
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
13,927
0
13,927
b
Accounting fees (attach schedule)
.......
1,945
0
1,945
c
Other professional fees (attach schedule)
....
55,250
18,750
36,500
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
6,155
0
0
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
16,957
0
16,957
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
94,234
18,750
69,329
25
Contributions, gifts, grants paid
.......
493,123
468,263
26
Total expenses and disbursements.
Add lines 24 and 25
587,357
18,750
537,592
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-134,950
b
Net investment income
(if negative, enter -0-)
433,657
c
Adjusted net income
(if negative, enter -0-)
...
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2019)
Form 990-PF (2019)
Page
2
Part II
Balance Sheets
Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year
End of year
(a)
Book Value
(b)
Book Value
(c)
Fair Market Value
1
Cash—non-interest-bearing
.............
2
Savings and temporary cash investments
.........
15,021,877
5,099,917
5,099,917
3
Accounts receivable
6,515
Less: allowance for doubtful accounts
6,515
6,515
4
Pledges receivable
Less: allowance for doubtful accounts
5
Grants receivable
.................
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)
.....
7
Other notes and loans receivable (attach schedule)
Less: allowance for doubtful accounts
8
Inventories for sale or use
..............
9
Prepaid expenses and deferred charges
..........
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
.......
c
Investments—corporate bonds (attach schedule)
.......
0
5,249,737
5,249,737
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
0
5,042,237
5,042,237
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)
15,021,877
15,398,406
15,398,406
17
Accounts payable and accrued expenses
..........
18
Grants payable
.................
24,860
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
)
0
4,155
23
Total liabilities
(add lines 17 through 22)
.........
0
29,015
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
15,021,877
15,369,391
25
Net assets with donor restrictions
............
Foundations that do not follow FASB ASC 958, check here
and complete lines 26 through 30.
26
Capital stock, trust principal, or current funds
........
27
Paid-in or capital surplus, or land, bldg., and equipment fund
28
Retained earnings, accumulated income, endowment, or other funds
29
Total net assets or fund balances
(see instructions)
.....
15,021,877
15,369,391
30
Total liabilities and net assets/fund balances
(see instructions)
.
15,021,877
15,398,406
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
15,021,877
2
Enter amount from Part I, line 27a
.....................
2
-134,950
3
Other increases not included in line 2 (itemize)
3
482,464
4
Add lines 1, 2, and 3
..........................
4
15,369,391
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
15,369,391
Form
990-PF
(2019)
Form 990-PF (2019)
Page
3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a)
List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)
(b)
How acquired
P—Purchase
D—Donation
(c)
Date acquired
(mo., day, yr.)
(d)
Date sold
(mo., day, yr.)
1a
b
c
d
e
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-)
or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
Excess of col. (i)
over col. (j), if any
a
b
c
d
e
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
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
0
9,857,183
0.000000
2017
2016
2015
2014
2
Total
of line 1, column (d)
.....................
2
0.000000
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
0.000000
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
15,293,642
5
Multiply line 4 by line 3
......................
5
0
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
4,337
7
Add lines 5 and 6
........................
7
4,337
8
Enter qualifying distributions from Part XII, line 4
,.............
8
537,592
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
4,337
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
4,337
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
4,337
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
7,600
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
7,600
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
27
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
3,236
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
3,236
Refunded
11
0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition)
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
0
(2)
On foundation managers.
$
0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
Yes
7
Did the foundation have at least $5,000 in assets at any time during the year?
If "Yes," complete Part II, col. (c),
and Part XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
PA
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
LORELLE GEYER
Telephone no.
(412) 395-2126
Located at
2200 ENERGY DRIVE
CANONSBURG
PA
ZIP+4
15317
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
ANNE NAQI
PRESIDENT
1.00
0
0
0
2200 ENERGY DRIVE
CANONSBURG
,
PA
15317
JOSEPH PICCIRILLI
TREASURER
1.00
0
0
0
2200 ENERGY DRIVE
CANONSBURG
,
PA
15317
LORELLE GEYER
ASST. TREASURER
1.00
0
0
0
2200 ENERGY DRIVE
CANONSBURG
,
PA
15317
ROBIN PASCARELLA
SECRETARY
1.00
0
0
0
2200 ENERGY DRIVE
CANONSBURG
,
PA
15317
DIANA CHARLETTA
BOARD MEMBER
1.00
0
0
0
2200 ENERGY DRIVE
CANONSBURG
,
PA
15317
BOB COOPER
BOARD MEMBER
1.00
0
0
0
2200 ENERGY DRIVE
CANONSBURG
,
PA
15317
CARMINE FANTINI
BOARD MEMBER
1.00
0
0
0
2200 ENERGY DRIVE
CANONSBURG
,
PA
15317
KIRK OLIVER
BOARD MEMBER
1.00
0
0
0
2200 ENERGY DRIVE
CANONSBURG
,
PA
15317
STEVE MOORE
BOARD MEMBER
1.00
0
0
0
2200 ENERGY DRIVE
CANONSBURG
,
PA
15317
LISA LIND
BOARD MEMBER
1.00
0
0
0
2200 ENERGY DRIVE
CANONSBURG
,
PA
15317
2
Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a)
Name and address of each employee paid more than $50,000
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
NONE
Total
number of other employees paid over $50,000
...................
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
7
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
(continued)
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
NONE
Total
number of others receiving over $50,000 for professional services
.............
0
Part IX-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
2
3
4
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
8
Part X
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations, see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities
...................
1a
5,454,243
b
Average of monthly cash balances
.......................
1b
10,072,297
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
15,526,540
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
15,526,540
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
232,898
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
15,293,642
6
Minimum investment return.
Enter 5% of line 5
..................
6
764,682
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
764,682
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
4,337
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
4,337
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
760,345
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
760,345
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
760,345
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
537,592
b
Program-related investments—total from Part IX-B
..................
1b
0
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
b
Cash distribution test (attach the required schedule)
.................
3b
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
537,592
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
4,337
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
533,255
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
760,345
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
121,091
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
b
From 2015
......
c
From 2016
......
d
From 2017
......
e
From 2018
......
f
Total
of lines 3a through e
........
0
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
537,592
a
Applied to 2018, but not more than line 2a
121,091
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
.....
416,501
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
..........
343,844
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
....
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
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2019
(b)
2018
(c)
2017
(d)
2016
b
85% of line 2a
.........
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed
...
c
“Support" alternative test—enter:
(1)
Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
....
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
(3)
Largest amount of support
from an exempt organization
(4)
Gross investment income
Part XV
Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or email address of the person to whom applications should be addressed:
b
The form in which applications should be submitted and information and materials they should include:
c
Any submission deadlines:
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Form
990-PF
(2019)
Form 990-PF (2019)
Page
11
Part XV
Supplementary Information
(continued)
3
Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
ACHIEVA
711 BINGHAM STREET
PITTSBURGH
,
PA
15203
N/A
PC
MATCHING GIFT
500
ACHIEVA
711 BIGHAM STREET
PITTSBURGH
,
PA
15203
N/A
PC
MATCHING GIFT
347
ACHIEVA
711 BINGHAM STREET
PITTSBURGH
,
PA
15203
N/A
PC
MATCHING GIFT
320
ALEXS LEMONADE STAND FOUNDATION
111 PRESIDENTIAL BLVD SUITE 203
BALA CYNWOOD
,
PA
19004
N/A
PC
MATCHING GIFT
100
ALLEGHENY COUNTY PARKS FOUNDATION
675 OLD FRANKSTOWN RD
PITTSBURGH
,
PA
15239
N/A
PC
MATCHING GIFT
200
ALS ASSOCIATION TEXAS CHAPTER
1213 HERMANN DRIVE SUITE 525
HOUSTON
,
TX
77004
N/A
PC
MATCHING GIFT
100
AMERICAN ASSC OF BLACKS IN ENERGY
1625 K STREET NW 450
WASHINGTON
,
DC
20006
N/A
PC
MATCHING GIFT
1,000
AMERICAN CANCER SOCIETY
510 PELLIS ROAD SUITE 203
GREENSBURG
,
PA
15601
N/A
PC
MATCHING GIFT
125
AMERICAN CANCER SOCIETY
P O BOX 22718
OKLAHOMA CITY
,
OK
73123
N/A
PC
MATCHING GIFT
100
AMERICAN CANCER SOCIETY
250 WILLIAMS ST
ATLANTA
,
GA
30303
N/A
PC
MATCHING GIFT
100
AMERICAN DIABETES ASSOCIATION
2451 CRYSTAL DRIVE SUITE 900
ARLINGTON
,
VA
22202
N/A
PC
MATCHING GIFT
500
AMERICAN HEART ASSOCIATION
5455 N HIGH STREET
COLUMBUS
,
OH
43214
N/A
PC
MATCHING GIFT
100
AMERICAN HEART ASSOCIATION
5455 N HIGH STREET
COLUMBUS
,
OH
43212
N/A
PC
MATCHING GIFT
130
AMERICAN LUNG ASSOCIATION
810 RIVER AVENUE SUITE 140
PITTSBURGH
,
PA
15212
N/A
PC
MATCHING GIFT
200
AMERICAN MACULAR DEGENERATION FDN
P O BOX 515
NORTHAMPTON
,
MA
01061
N/A
PC
MATCHING GIFT
100
AUTISM SPEAKS
1060 STATE ROUTE RD 2ND FLOOR
PRINCETON
,
NJ
28540
N/A
PC
MATCHING GIFT
100
AUTISM SPEAKS
1060 STATE ROUTE RD 2ND FLOOR
PRINCETON
,
NJ
28540
N/A
PC
MATCHING GIFT
100
BREAKTHROUGH PITTSBURGH
315 ACADEMY AVENUE
SEWICKLEY
,
PA
15143
N/A
PC
MATCHING GIFT
1,000
BRICOLAGE PRODUCTION COMPANY
937 LIBERTY AVENUE FIRST FLOOR
PITTSBURGH
,
PA
15222
N/A
PC
MATCHING GIFT
2,200
BRIDGE BUILDERS COMMUNITY FDN
206 SENECA STREET
OIL CITY
,
PA
16301
N/A
PC
MATCHING GIFT
3,000
BROWN UNIVERSITY
BOX 1877
PROVIDENCE
,
RI
02912
N/A
PC
MATCHING GIFT
2,500
BROWN UNIVERSITY
DIVISION OF ADVANCEMENT BOX 1893
PROVIDENCE
,
RI
02912
N/A
PC
MATCHING GIFT
3,000
CARNEGIE LIBRARY OF PITTSBURGH
4400 FORBES AVENUE
PITTSBURGH
,
PA
15213
N/A
PC
MATCHING GIFT
1,000
CARNEGIE MELLON UNIVERSITY
P O BOX 371525
PITTSBURGH
,
PA
15251
N/A
PC
MATCHING GIFT
100
CARNEGIE MELLON UNIVERSITY
P O BOX 371525
PITTSBURGH
,
PA
15251
N/A
PC
MATCHING GIFT
100
CARNEGIE MELLON UNIVERSITY
5000 FORBES AVENUE
PITTSBURGH
,
PA
15213
N/A
PC
MATCHING GIFT
250
CARNEGIE MUSEUMS OF PITTSBURGH
4400 FORBES AVENUE
PITTSBURGH
,
PA
15213
N/A
PC
MATCHING GIFT
369
CATHOLIC CENTRAL HIGH SCHOOL
320 WESTVIEW AVENUE
STEUBENVILLE
,
PA
43952
N/A
PC
MATCHING GIFT
150
CATHOLIC RELIEF SERVICES
P O BOX 17090
BALTIMORE
,
MD
21297
N/A
PC
MATCHING GIFT
2,000
CENTRAL CATHOLIC HIGH SCHOOL
4720 FIFTH AVENUE
PITTSBURGH
,
PA
15213
N/A
PC
MATCHING GIFT
1,250
CHILDREN HOSPITAL PITTSBURGH FDN
1 CHILDRENS HOSPITAL DRIVE
PITTSBURGH
,
PA
15224
N/A
PC
MATCHING GIFT
1,000
CHILDRENS HEART FOUNDATION
5 REVERE DRIVE SUITE 200
NORTHBROOK
,
IL
60062
N/A
PC
MATCHING GIFT
100
CHILDRENS HOSPITAL OF PGH
1 CHILDRENS HOSPITAL DRIVE
PITTSBURGH
,
PA
15224
N/A
PC
MATCHING GIFT
100
CHILDRENS HOSPITAL OF PITTSBURGH
4401 PENN AVENUE
PITTSBURGH
,
PA
15224
N/A
PC
MATCHING GIFT
100
CHILDRENS MUSEUM OF PITTSBURGH
10 CHILDRENS WAY
PITTSBURGH
,
PA
15212
N/A
PC
MATCHING GIFT
5,000
CITY MISSION
84 WEST WHEELING STREET
WASHINGTON
,
PA
15301
N/A
PC
MATCHING GIFT
226
CMU TEPPER SCHOOL OF BUSINESS
4765 FORBES AVENUE TEP 4400
PITTSBURGH
,
PA
15213
N/A
PC
MATCHING GIFT
2,500
CONSTRUCTION JUNCTION
214 N LEXINGTON STREET
PITTSBURGH
,
PA
15208
N/A
PC
MATCHING GIFT
4,000
CORNELL LAB OF ORNITHOLOGY
159 SAPSUCKER WOODS RD
ITHACA
,
NY
14850
N/A
PC
MATCHING GIFT
100
CORNERSTONE OF HOPE
5905 BRECKSVILLE ROAD
INDEPENDENCE
,
OH
44131
N/A
PC
MATCHING GIFT
250
CUPIDS CHARITIES
1100 N GLEBE ROAD 1010
ARLINGTON
,
VA
22202
N/A
PC
MATCHING GIFT
100
DAVIDSON COLLEGE
P O BOX 7170
DAVIDSON
,
NC
28035
N/A
PC
MATCHING GIFT
25,000
ENTERTAINMENT INDUSTRY FOUNDATION
10880 WILSHIRE BLVD SUITE 1400
LOS ANGELES
,
CA
90024
N/A
PC
MATCHING GIFT
100
FAME
6031 BROAD ST SUITE 200
PITTSBURGH
,
PA
15206
N/A
PC
MATCHING GIFT
1,000
FOCUS ON RENEWAL
420 CHARTIERS AVENUE
MCKEES ROCKS
,
PA
15136
N/A
PC
MATCHING GIFT
1,000
FOOD FOR THE POOR
P O BOX 979001
COCONUT CREEK
,
FL
33073
N/A
PC
MATCHING GIFT
100
FRANCISCAN UNIVERSITY
1235 UNIVERSITY BLVD
STEUBENVILLE
,
OH
43952
N/A
PC
MATCHING GIFT
150
GFWC BRIDGEPORT JR WOMANS CLUB
P O BOX 932
BRIDGEPORT
,
WV
26330
N/A
PC
MATCHING GIFT
250
GIRL SCOUTS NATIONS CAPITAL
4301 CONNECTICUT AVE NW
WASHINGTON
,
DC
20008
N/A
PC
MATCHING GIFT
5,500
GLOBAL LINKS
700 TRUMBULL DRIVE
PITTSBURGH
,
PA
15205
N/A
PC
MATCHING GIFT
100
GOOD SAMARITAN HOSPICE
116 BROWNS HILL ROAD SUITE 100
VALENCIA
,
PA
16059
N/A
PC
MATCHING GIFT
500
GRADYS DECISION
P O BOX 9343
ERIE
,
PA
16507
N/A
PC
MATCHING GIFT
1,000
GREATER PGH COMMUNITY FOOD BANK
1 NORTH LINDEN STREET
DUQUESNE
,
PA
15110
N/A
PC
MATCHING GIFT
100
GREATER PITTSBURGH COMMUNITY FOOD BANK
1 NORTH LINDEN STREET
DUQUESNE
,
PA
15110
N/A
PC
MATCHING GIFT
500
HABITAT FOR HUMANITY
322 WEST LAMAR STREET
AMERICUS
,
GA
31709
N/A
PC
MATCHING GIFT
100
HEARTH
P O BOX 318
GLENSHAW
,
PA
15116
N/A
PC
MATCHING GIFT
300
HIAS
1300 SPRING STREET SUITE 500
SILVER SPRING
,
MD
20910
N/A
PC
MATCHING GIFT
100
HUMANE ANIMAL RESCUE
6620 HAMILTON AVENUE
PITTSBURGH
,
PA
15208
N/A
PC
MATCHING GIFT
250
HUMANE ANIMAL RESCUE
6620 HAMILTON AVENUE
PITTSBURGH
,
PA
15206
N/A
PC
MATCHING GIFT
100
JAMES CONNECTION
P O BOX 751
PITTSBURGH
,
PA
15146
N/A
PC
MATCHING GIFT
5,000
JDRF ONE WALK
501 MARTINDALE ST SUITE 670
PITTSBURGH
,
PA
15212
N/A
PC
MATCHING GIFT
100
KELLEY SCHOOL OF BUSINESS
1275 E 10TH STREET 3080
BLOOMINGTON
,
IN
47405
N/A
PC
MATCHING GIFT
5,000
KENT STATE UNIVERSITY
P O BOX 5190
KENT
,
OH
44242
N/A
PC
MATCHING GIFT
1,500
KETTERING UNIVERSITY
1700 UNIVERSITY AVENUE
FLINT
,
MI
48504
N/A
PC
MATCHING GIFT
29,740
LEMINGTON RESIDENTIAL CORP
1621 LINCOLN AVENUE
PITTSBURGH
,
PA
15206
N/A
PC
MATCHING GIFT
1,000
MADONNA HIGH SCHOOL
150 MICHAEL WAY
WEIRTON
,
WV
26062
N/A
PC
MATCHING GIFT
617
MAKE A WISH
GULF TOWER 37 FLOOR 707 GRANT
STREET
PITTSBURGH
,
PA
15219
N/A
PC
MATCHING GIFT
2,000
MANCHESTER BIDWELL CORPORATION
1815 METROPOLITAN ST
PITTSBURGH
,
PA
15233
N/A
PC
MATCHING GIFT
2,500
MONA PANTS FOUNDATION
P O BOX 7960
JUPITER
,
FL
33468
N/A
PC
MATCHING GIFT
100
MOUNTAINEER SCHOLARSHIP FUND
P O BOX 877
MORGANTOWN
,
WV
26505
N/A
PC
MATCHING GIFT
1,750
MULTIPLE MYELOMA RESEARCH FOUNDATION
383 MAIN AVENUE SUITE 5
NORWALK
,
CT
06851
N/A
PC
MATCHING GIFT
100
NASH EDUCATION CORPORATION
63 STANCEY ROAD
PITTSBURGH
,
PA
15220
N/A
PC
MATCHING GIFT
100
NAT MULTIPLE SCLEROSIS SOCIETY
8111 N STADIUM DRIVE SUITE 100
HOUSTON
,
TX
77054
N/A
PC
MATCHING GIFT
500
NATIONAL AVIARY
700 ARCH STREET
PITTSBURGH
,
PA
15212
N/A
PC
MATCHING GIFT
500
NATIONAL MS SOCIETY
1501 REEDSDALE STREET
PITTSBURGH
,
PA
15233
N/A
PC
MATCHING GIFT
150
NEW LIFE OPTIONS
308 CHESS STREET
MONONGAHELA
,
PA
15063
N/A
PC
MATCHING GIFT
100
OAKLAND CATHOLIC HIGH SCHOOL
144 NORTH CRAIG STREET
PITTSBURGH
,
PA
15213
N/A
PC
MATCHING GIFT
1,250
OHIO HEALTH FOUNDATION GIVING
3430 OHIO HEALTH PARKWAY
COLUMBUS
,
OH
43202
N/A
PC
MATCHING GIFT
250
OHIO STATE UNIVERSITY FOUNDATION
1480 WEST LANE AVENUE
COLUMBUS
,
OH
43210
N/A
PC
MATCHING GIFT
150
PARTNERS FOR QUALITY FOUNDATION
250 CLEVER ROAD
MCKEES ROCKS
,
PA
15136
N/A
PC
MATCHING GIFT
530
PENN STATE THON
2583 GATEWAY DRIVE SUITE 130
STATE COLLEGE
,
PA
16801
N/A
PC
MATCHING GIFT
100
PENN STATE UNIVERSITY
2583 GATEWAY DRIVE SUITE 130
STATE COLLEGE
,
PA
16801
N/A
PC
MATCHING GIFT
250
PENNSYLVANIA STATE UNIVERSITY
408 OLD MAIN
UNIVERSITY PARK
,
PA
16802
N/A
PC
MATCHING GIFT
600
PGH COMMUNITY BROADCASTING CORP
67 BEDFORD SQUARE
PITTSBURGH
,
PA
15203
N/A
PC
MATCHING GIFT
5,000
PINE RICHLANDS AQUATICS
POST OFFICE BOX 15
GIBSONIA
,
PA
15044
N/A
PC
MATCHING GIFT
200
PITTSBURGH CULTURAL TRUST
803 LIBERTY AVENUE
PITTSBURGH
,
PA
15222
N/A
PC
MATCHING GIFT
2,500
PITTSBURGH CULTURAL TRUST
803 LIBERTY AVENUE
PITTSBURGH
,
PA
15222
N/A
PC
MATCHING GIFT
25,000
PITTSBURGH KIDS FOUNDATION
116 FEDERAL STREET
PITTSBURGH
,
PA
15212
N/A
PC
MATCHING GIFT
500
PITTSBURGH SYMPHONY ORCHESTRA
600 PENN AVENUE HEINZ HALL
PITTSBURGH
,
PA
15222
N/A
PC
MATCHING GIFT
7,500
POPE PAUL VI INSTITUTE
6901 MERCY ROAD SUITE 200
OMAHA
,
NE
68106
N/A
PC
MATCHING GIFT
5,000
PROPEL SCHOOLS FOUNDATION
3447 EAST CARSON ST
PITTSBURGH
,
PA
15203
N/A
PC
MATCHING GIFT
2,000
PURDUE UNIV KRANNERT SCHOOL
403 WEST STATE STREET
WEST LAFAYETTE
,
IN
47906
N/A
PC
MATCHING GIFT
5,000
QUEENS UNIV OF CHARLOTTE
1900 SELWYN AVENUE
CHARLOTTE
,
NC
28274
N/A
PC
MATCHING GIFT
25,000
RAND CORPORATION
1776 MAIN STREET
SANTA MONICA
,
CA
90407
N/A
PC
MATCHING GIFT
25,000
READING IS FUNDAMENTAL PITTSBURGH
10 CHILDRENS WAY SUITE 300
PITTSBURGH
,
PA
15212
N/A
PC
MATCHING GIFT
300
REDEFINING SPINA BIFIDA
12472 LAKE UNDERHILL RD SUITE 454
ORLANDO
,
FL
32828
N/A
PC
MATCHING GIFT
100
SALTWORKS
569 NORTH NEVILLE STREET
PITTSBURGH
,
PA
15213
N/A
PC
MATCHING GIFT
700
SALTWORKS THEATRE COMPANY
569 N NEVILLE STREET
PITTSBURGH
,
PA
15213
N/A
PC
MATCHING GIFT
1,500
SEMPER FI FUND
825 COLLEGE BLVD SUITE 102
OCEANSIDE
,
CA
92055
N/A
PC
MATCHING GIFT
5,000
SETON LASALLE HIGH SCHOOL
1000 MCNEILLY ROAD
MT LEBANON
,
PA
15226
N/A
PC
MATCHING GIFT
2,500
SEWICKLEY ACADEMY
315 ACADEMY AVENUE
SEWICKLEY
,
PA
15143
N/A
PC
MATCHING GIFT
1,000
SEWICKLEY VALLEY YMCA
625 BLACKBURN ROAD
SEWICKLEY
,
PA
15143
N/A
PC
MATCHING GIFT
250
SEWICKLEY VALLEY YMCA
625 BLACKBURN ROAD
SEWICKLEY
,
PA
15143
N/A
PC
MATCHING GIFT
500
SHADY SIDE ACADEMY
423 FOX CHAPEL ROAD
PITTSBURGH
,
PA
15238
N/A
PC
MATCHING GIFT
1,000
SHEKINAH WESTERN RANCH CAMP
371 CRACKER JACK RD
MONONGAHELA
,
PA
15063
N/A
PC
MATCHING GIFT
500
SHEKINAH WESTERN RANCH CAMP
371 CRACKER JACK RD
MONONGAHELA
,
PA
15063
N/A
PC
MATCHING GIFT
100
SOUTH HARRISON SPORTS CLUB
P O BOX 231
WEST MILFORD
,
WV
26451
N/A
PC
MATCHING GIFT
710
SOUTH HILLS INTERFAITH MOVEMENT
5301 PARK AVENUE
PITTSBURGH
,
PA
15102
N/A
PC
MATCHING GIFT
500
SOUTH HILLS INTERFAITH MOVEMENT
5301 PARK AVENUE
BETHEL PARK
,
PA
15102
N/A
PC
MATCHING GIFT
500
SOUTH HILLS INTERFAITH MOVEMENT
5301 PARK AVENUE
BETHEL PARK
,
PA
15102
N/A
PC
MATCHING GIFT
750
SPINA BIFIDA ASSC OF WESTERN PA
3000 STONEWOOD DRIVE SUITE 100
WEXFORD
,
PA
15090
N/A
PC
MATCHING GIFT
250
ST JOSEPHS COLLEGIATE INSTITUTE
845 KENMORE AVENUE
BUFFALO
,
NY
14223
N/A
PC
MATCHING GIFT
125
ST JUDE CHILDRENS RESEARCH HOSP
501 ST JUDE PLACE
MEMPHIS
,
TN
38105
N/A
PC
MATCHING GIFT
100
ST JUDE CHILDRENS RESEARCH HSP
501 ST JUDE PLACE
MEMPHIS
,
TN
38105
N/A
PC
MATCHING GIFT
100
ST JUDE CHILDRENS RESEARCH HSP
501 ST JUDE PLACE
MEMPHIS
,
TN
38105
N/A
PC
MATCHING GIFT
100
ST JUDE HOSPITAL
262 DANNY THOMAS PLACE
MEMPHIS
,
TN
38104
N/A
PC
MATCHING GIFT
250
ST PAUL SCHOOL
140 WALNUT STREET
WEIRTON
,
WV
26062
N/A
PC
MATCHING GIFT
503
ST PAUL SCHOOL
140 WALNUT STREET
WEIRTON
,
WV
26062
N/A
PC
MATCHING GIFT
500
ST PAUL SCHOOL
140 WALNUT STREET
WEIRTON
,
WV
26062
N/A
PC
MATCHING GIFT
250
ST PAUL SCHOOL
140 WALNUT STREET
WEIRTON
,
WV
26062
N/A
PC
MATCHING GIFT
835
STANFORD GRAD SCHOOL OF BUSINESS
655 KNIGHT WAY
PALO ALTO
,
CA
94305
N/A
PC
MATCHING GIFT
6,250
STAR LEGACY FOUNDATION
7820 TERREY PINE CT 80
EDEN PRAIRIE
,
MN
55347
N/A
PC
MATCHING GIFT
100
THE MENTORING PARTNERSHIP OF SWPA
ONE HOPE SQUARE 1901 CENTRE AVENUE
PITTSBURGH
,
PA
15219
N/A
PC
MATCHING GIFT
5,000
THE PHI SIGMA RHO FOUNDATION
P O BOX 7021
WINCHESTER
,
IL
60154
N/A
PC
MATCHING GIFT
100
THE PIARIST SCHOOL
POST OFFICE BOX 369
HAGERHILL
,
KY
41222
N/A
PC
MATCHING GIFT
1,000
THE PITTSBURGH PROMISE
1901 CENTRE AVE SUITE 204
PITTSBURGH
,
PA
15219
N/A
PC
MATCHING GIFT
500
UNITED WAY
511 N FOURTH STREET
STEUBENVILLE
,
OH
43952
N/A
PC
MATCHING GIFT
350
UNITED WAY
511 N FOURTH STREET
STEUBENVILLE
,
OH
43952
N/A
PC
MATCHING GIFT
350
UNITED WAY OF SOUTHWESTERN PENNSYLVANIA
1250 PENN AVENUE
PITTSBURGH
,
PA
15222
N/A
PC
MATCHING GIFT
6,692
UNITED WAY OF SW PENNSYLVANIA
P O BOX 735
PITTSBURGH
,
PA
15230
N/A
PC
MATCHING GIFT
250
UNIV OF CHICAGO BOOTH BUS SCHOOL
5807 S WOODLAWN AVENUE
CHICAGO
,
IL
60637
N/A
PC
MATCHING GIFT
5,000
UNIV OF PITT BRAIN INSTITUTE
3501 FIFTH AVENUE 4074 BST 3
PITTSBURGH
,
PA
15261
N/A
PC
MATCHING GIFT
25,000
UNIVERSITY OF MICHIGAN MEDICINE
1000 OAKBROOK DRIVE SUITE 100
ANN ARBOR
,
MI
48104
N/A
PC
MATCHING GIFT
8,000
UNIVERSITY OF PITTSBURGH
107 PARK PLAZA
PITTSBURGH
,
PA
15260
N/A
PC
MATCHING GIFT
1,000
VALLEY SCHOOL OF LIGONIER
POST OFFICE BOX 616
LIGONIER
,
PA
15658
N/A
PC
MATCHING GIFT
1,400
WEIRTON MADONNA HIGH SCHOOL
150 MICHAEL WAY
WEIRTON
,
WV
26062
N/A
PC
MATCHING GIFT
250
WEIRTON MADONNA HIGH SCHOOL
150 MICHAEL WAY
WEIRTON
,
WV
26062
N/A
PC
MATCHING GIFT
831
WEST VIRGINIA WESLEYAN COLLEGE
59 COLLEGE AVENUE
BUCKHANNON
,
WV
26201
N/A
PC
MATCHING GIFT
250
WESTERN PA CONSERVANCY
800 WATERFORD DRIVE
PITTSBURGH
,
PA
15222
N/A
PC
MATCHING GIFT
1,000
WESTERN PA CONSERVANCY
800 WATERFRONT DR
PITTSBURGH
,
PA
15222
N/A
PC
MATCHING GIFT
500
WESTERN PA CONSERVANCY
800 WATERFRONT DRIVE
PITTSBURGH
,
PA
15222
N/A
PC
MATCHING GIFT
1,000
WOMENS CTR & SHELTER GREATER PGH
P O BOX 9024
PITTSBURGH
,
PA
15224
N/A
PC
MATCHING GIFT
250
WOMENS CTR & SHELTER GREATER PGH
P O BOX 9024
PITTSBURGH
,
PA
15224
N/A
PC
MATCHING GIFT
1,000
WORLD VISION
P O BOX 971
FEDERAL WAY
,
WA
98063
N/A
PC
MATCHING GIFT
120
WOUNDED WARRIOR PROJECT
4899 BELFORT ROAD SUITE 300
JACKSONVILLE
,
FL
32256
N/A
PC
MATCHING GIFT
600
WQED MULTIMEDIA
4802 FIFTH AVENUE
PITTSBURGH
,
PA
15213
N/A
PC
MATCHING GIFT
2,500
WVU FOUNDATION
P O BOX 1650
MORGANTOWN
,
WV
26507
N/A
PC
MATCHING GIFT
500
WVU FOUNDATION
P O BOX 1650
MORGANTOWN
,
WV
26507
N/A
PC
MATCHING GIFT
1,000
WVU FOUNDATION
P O BOX 1650
MORGANTOWN
,
WV
26507
N/A
PC
MATCHING GIFT
900
BIG BROTHERS BIG SISTERS OF GREATER PGH
5989 CENTRE AVENUE
PITTSBURGH
,
PA
15206
N/A
PC
EDUCATION
7,500
CORNER CUPBOARD FOOD BANK-KIDS BAGS PROGRAM
881 ROLLING MEADOWS
WAYNESBURGH
,
PA
15370
N/A
PC
COMMUNITY
30,000
DONORA HISTORICAL SOCIETY
595 MCKEAN AVENUE
DONORA
,
PA
15033
N/A
PC
COMMUNITY & ECONOMIC DEVELOPMENT/EDUCATION
2,000
INNOVATION WORKS STARTABLE GREENE COUNTY
2 ALLEGHENY CENTER SUITE 100
PITTSBURGH
,
PA
15212
N/A
PC
EDUCATION
20,893
PGH SYMPHONY INC
HEINZ HALL 600 PENN AVENUE
PITTSBURGH
,
PA
15222
N/A
PC
EDUCATION
25,000
PITTSBURGH TRUST FOR CULTURAL RESOURCES
803 LIBERTY AVENUE
PITTSBURGH
,
PA
15222
N/A
PC
EDUCATION
25,000
SALVATION ARMY
700 NORTH BELL AVENUE
CARNEGIE
,
PA
15106
N/A
PC
COMMUNITY & ECONOMIC DEVELOPMENT
30,000
WQED MULTIMEDIA
4802 FIFTH AVENUE
PITTSBURGH
,
PA
15213
N/A
PC
EDUCATION
10,000
Total
.................................
3a
468,263
b
Approved for future payment
SOUTH HILLS INTERFAITH MOVEMENT
5301 PARK AVENUE
BETHEL PARK
,
PA
15102
N/A
PC
MATCHING GIFT
515
GEORGIA TECH FOUNDATION
190 NORTH AVENUE NW
ATLANTA
,
GA
30313
N/A
PC
MATCHING GIFT
1,260
LAWRENCE TECH
2100 WEST TEN MILE RD
SOUTHFIELD
,
MI
48075
N/A
PC
MATCHING GIFT
1,050
UNIV OF CHICAGO BOOTH
5807 WOODLAWN AVENUE
CHICAGO
,
IL
60637
N/A
PC
MATCHING GIFT
5,000
TALI POISE FOUNDATION
TWO GATEWAY CTR SUITE 1700 603
STANWIX ST
PITTSBURGH
,
PA
15222
N/A
PC
MATCHING GIFT
2,000
FAME
6031 BROAD STREET SUITE 200
PITTSBURGH
,
PA
15206
N/A
PC
MATCHING GIFT
500
REGENTS UNIVERSITY OF MICHIGAN
DEPT CH 10189
PALATINE
,
IL
60055
N/A
PC
MATCHING GIFT
5,000
ALS THERAPY DEVELOPMENT
300 TECHNOLOGY SQUARE SUITE 400
CAMBRIDGE
,
MA
02139
N/A
PC
MATCHING GIFT
100
WYEP
67 BEDFOD SQUARE
PITTSBURGH
,
PA
15203
N/A
PC
MATCHING GIFT
100
GREATER PGH COMMUNITY FOOD BANK
POST OFFICE BOX 99608
PITTSBURGH
,
PA
15233
N/A
PC
MATCHING GIFT
500
PITTSBURGH PROMISE
1901 CENTRE AVENUE SUITE 204
PITTSBURGH
,
PA
15222
N/A
PC
MATCHING GIFT
500
UNIVERSITY OF NOTRE DAME
1251 NORTH EDDY STREET SUITE 300
SOUTH BEND
,
IN
46617
N/A
PC
MATCHING GIFT
500
EVANS SCHOLARS FOUNDATION
2501 PATRIOT BLVD
GLENVIEW
,
IL
60026
N/A
PC
MATCHING GIFT
5,000
CYNTHIA ROSE PHILLIPSON FDN
190 ANTHONY DRIVE
WINTERSVILLE
,
OH
43953
N/A
PC
MATCHING GIFT
565
ST ANTHONY CHARITABLE FOUNDATION
2000 CORPORATE DRIVE SUITE 580
WEXFORD
,
PA
15090
N/A
PC
MATCHING GIFT
200
PENN STATE
27 OLD MAIN
UNIVERSITY PARK
,
PA
16802
N/A
PC
MATCHING GIFT
500
CARNEGIE MUSEUMS OF PGH
4400 FORBES AVENUE
PITTSBURGH
,
PA
15213
N/A
PC
MATCHING GIFT
469
CHILDRENS HOSPITAL FOUNDATION
4401 PENN AVENUE
PITTSBURGH
,
PA
15224
N/A
PC
MATCHING GIFT
500
CORNER CUPBOARD FOOD BANK
881 ROLLING MEADOWS RD
WAYNESBURGH
,
PA
15370
N/A
PC
MATCHING GIFT
100
ARYSE
6101 PENN AVENUE SUITE 201
PITTSBURGH
,
PA
15206
N/A
PC
MATCHING GIFT
500
Total
.................................
3b
24,859
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
452,407
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
............
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
452,407
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
452,407
(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