-
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
BULOVA GALE FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)
C/O ORENSTEIN - 150 PITTSFIELD ROAD
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
LENOX
,
MA
01240
A Employer identification number
13-3866091
B
Telephone number (see instructions)
(413) 447-1900
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)
$
2,860,933
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
...
84,395
84,395
84,395
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
-1,206
b
Gross sales price for all assets on line 6a
1,765,069
7
Capital gain net income (from Part IV, line 2)
...
8
Net short-term capital gain
.........
3,106
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
........
83,189
84,395
87,501
13
Compensation of officers, directors, trustees, etc.
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
6,142
4,095
2,047
c
Other professional fees (attach schedule)
....
21,134
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
1,722
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
250
250
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
29,248
4,095
2,297
25
Contributions, gifts, grants paid
.......
130,000
130,000
26
Total expenses and disbursements.
Add lines 24 and 25
159,248
4,095
132,297
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-76,059
b
Net investment income
(if negative, enter -0-)
80,300
c
Adjusted net income
(if negative, enter -0-)
...
87,501
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
.............
10,229
19,219
19,219
2
Savings and temporary cash investments
.........
3
Accounts receivable
Less: allowance for doubtful accounts
4
Pledges receivable
Less: allowance for doubtful accounts
5
Grants receivable
.................
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)
.....
7
Other notes and loans receivable (attach schedule)
Less: allowance for doubtful accounts
8
Inventories for sale or use
..............
9
Prepaid expenses and deferred charges
..........
10a
Investments—U.S. and state government obligations (attach schedule)
8,405
8,376
10,030
b
Investments—corporate stock (attach schedule)
.......
297,547
272,003
445,442
c
Investments—corporate bonds (attach schedule)
.......
13,510
13,469
16,583
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
2,087,761
2,028,326
2,369,659
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)
2,417,452
2,341,393
2,860,933
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
...........
2,417,452
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)
.....
2,417,452
2,341,393
30
Total liabilities and net assets/fund balances
(see instructions)
.
2,417,452
2,341,393
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
2,417,452
2
Enter amount from Part I, line 27a
.....................
2
-76,059
3
Other increases not included in line 2 (itemize)
3
4
Add lines 1, 2, and 3
..........................
4
2,341,393
5
Decreases not included in line 2 (itemize)
5
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
2,341,393
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
P
b
668 Air Lease CorporationCl ASymbol: Al
P
2017-05-25
2019-06-11
c
303 Analog Devices IncSymbol: Adi
P
2017-05-25
2019-04-02
d
788 Brookfield RenewablePartners L PSymbol: Bep
P
2017-06-06
2019-02-01
e
1055 Carlyle Group L PCom Unit Ltd Partnership IntCusip: 14309l102
P
2017-10-24
2019-03-13
335 Citigroup IncComSymbol: C
P
2017-10-24
2019-04-02
663.782 Financial Invs TrEmerald Bkg & Fin Fd Instl ClSymbol: Hssix
P
2016-12-09
2019-04-02
408.688 Financial Invs TrEmerald Bkg & Fin Fd Instl ClSymbol: Hssix
P
2017-03-10
2019-04-02
28.73 Financial Invs TrEmerald Bkg & Fin Fd Instl ClSymbol: Hssix
P
2017-12-20
2019-04-02
884.976 Fundamental Invs IncCl F2 ShsSymbol: Finfx
P
2017-02-15
2019-09-24
2.76 Fundamental Invs IncCl F2 ShsSymbol: Finfx
P
2017-03-16
2019-09-24
2.623 Fundamental Invs IncCl F2 ShsSymbol: Finfx
P
2017-06-15
2019-09-24
9.629 Fundamental Invs IncCl F2 ShsSymbol: Finfx
P
2017-06-15
2019-09-24
2.792 Fundamental Invs IncCl F2 ShsSymbol: Finfx
P
2017-09-18
2019-09-24
6.923 Fundamental Invs IncCl F2 ShsSymbol: Finfx
P
2017-12-21
2019-09-24
47.434 Fundamental Invs IncCl F2 ShsSymbol: Finfx
P
2017-12-21
2019-09-24
2.842 Fundamental Invs IncCl F2 ShsSymbol: Finfx
P
2018-03-19
2019-09-24
2.831 Fundamental Invs IncCl F2 ShsSymbol: Finfx
P
2018-06-18
2019-09-24
8.022 Fundamental Invs IncCl F2 ShsSymbol: Finfx
P
2018-06-18
2019-09-24
2.931 Fundamental Invs IncCl F2 ShsSymbol: Finfx
P
2018-09-17
2019-09-24
599.3531 Ishares Core High Dividend EtfSymbol: Hdv
P
2016-06-10
2019-12-24
15.6469 Ishares Core High Dividend EtfSymbol: Hdv
P
2016-09-30
2019-12-24
0.162 Ishares Core High Dividend EtfSymbol: Hdv
P
2016-09-30
2019-12-24
1358 Ishares Global Energy EtfSymbol: Ixc
P
2018-01-08
2019-06-11
2904.325 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2017-04-12
2019-04-02
1261.364 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2017-04-13
2019-04-02
13.825 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2017-05-01
2019-04-02
24.407 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2017-06-01
2019-04-02
25.275 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2017-07-03
2019-04-02
22.918 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2017-08-01
2019-04-02
24.379 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2017-09-01
2019-04-02
24.483 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2017-10-02
2019-04-02
20.756 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2017-11-01
2019-04-02
11.23 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2017-12-01
2019-04-02
18.149 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2017-12-28
2019-04-02
12.08 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2018-01-02
2019-04-02
11.461 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2018-02-01
2019-04-02
10.604 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2018-03-01
2019-04-02
2572.016 Putnam Focused Equity FundCl YSymbol: Pgilx
P
2016-12-09
2019-09-24
62.381 Putnam Focused Equity FundCl YSymbol: Pgilx
P
2016-12-27
2019-09-24
7.397 Putnam Focused Equity FundCl YSymbol: Pgilx
P
2016-12-27
2019-09-24
17.444 Putnam Focused Equity FundCl YSymbol: Pgilx
P
2016-12-27
2019-09-24
18.672 Putnam Focused Equity FundCl YSymbol: Pgilx
P
2017-12-26
2019-09-24
63.151 Putnam Focused Equity FundCl YSymbol: Pgilx
P
2017-12-26
2019-09-24
35.322 Putnam Focused Equity FundCl YSymbol: Pgilx
P
2017-12-26
2019-09-24
920.146 Putnam Ultra Short DurationIncome Fd Cl YSymbol: Psdyx
P
2018-10-23
2019-08-12
23.348 Putnam Ultra Short DurationIncome Fd Cl YSymbol: Psdyx
P
2019-03-01
2019-08-12
12.268 Putnam Ultra Short DurationIncome Fd Cl YSymbol: Psdyx
P
2019-04-01
2019-08-12
375.296 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2014-09-08
2019-12-24
15.173 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2014-10-31
2019-12-24
1987.281 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2015-01-07
2019-12-24
42.104 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2015-01-30
2019-12-24
38.702 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2015-04-30
2019-12-24
45.746 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2015-07-31
2019-12-24
2685.285 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2015-10-26
2019-12-24
104.317 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2015-10-30
2019-12-24
163.747 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2016-01-29
2019-12-24
917.874 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2016-04-05
2019-12-24
155.499 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2016-04-29
2019-12-24
147.568 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2016-07-29
2019-12-24
111.073 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2016-10-28
2019-12-24
91.613 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2017-02-17
2019-12-24
98.531 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2017-05-17
2019-12-24
110.819 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2017-08-17
2019-12-24
117.232 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2017-11-17
2019-12-24
115.474 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2018-02-20
2019-12-24
92.026 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2018-05-17
2019-12-24
88.611 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2018-08-17
2019-12-24
85.031 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2018-11-19
2019-12-24
1029 Select Sector Spdr TrustThe Financial Select SectorSymbol: Xlf
P
2017-02-15
2019-04-02
705 Select Sector Spdr TrustThe Financial Select SectorSymbol: Xlf
P
2017-03-10
2019-04-02
0 Uit Ft Imagine 2025 PortfolioSer Semi Annual Fee ReinvestCusip: 30309v437
P
2018-09-12
2019-11-25
0 Uit Ft Imagine 2025 PortfolioSer Semi Annual Fee ReinvestCusip: 30309v437
P
2018-10-25
2019-11-25
0 Uit Ft Imagine 2025 PortfolioSer Semi Annual Fee ReinvestCusip: 30309v437
P
2018-09-12
2019-12-25
0 Uit Ft Imagine 2025 PortfolioSer Semi Annual Fee ReinvestCusip: 30309v437
P
2018-10-25
2019-12-25
363 W P Carey IncComSymbol: Wpc
P
2017-10-24
2019-12-30
863.7748 Wisdomtree TrustWisdomtree U S SmallcapSymbol: Des
P
2015-10-26
2019-06-11
6.2073 Wisdomtree TrustWisdomtree U S SmallcapSymbol: Des
P
2015-11-30
2019-06-11
15.6984 Wisdomtree TrustWisdomtree U S SmallcapSymbol: Des
P
2015-12-28
2019-06-11
1.9293 Wisdomtree TrustWisdomtree U S SmallcapSymbol: Des
P
2016-01-05
2019-06-11
6.0264 Wisdomtree TrustWisdomtree U S SmallcapSymbol: Des
P
2016-01-29
2019-06-11
4.7244 Wisdomtree TrustWisdomtree U S SmallcapSymbol: Des
P
2016-02-26
2019-06-11
5.6988 Wisdomtree TrustWisdomtree U S SmallcapSymbol: Des
P
2016-03-28
2019-06-11
11.2038 Wisdomtree TrustWisdomtree U S SmallcapSymbol: Des
P
2016-04-29
2019-06-11
8.4171 Wisdomtree TrustWisdomtree U S SmallcapSymbol: Des
P
2016-05-27
2019-06-11
10.8927 Wisdomtree TrustWisdomtree U S SmallcapSymbol: Des
P
2016-09-30
2019-06-11
11.3883 Wisdomtree TrustWisdomtree U S SmallcapSymbol: Des
P
2016-10-28
2019-06-11
6.6513 Wisdomtree TrustWisdomtree U S SmallcapSymbol: Des
P
2016-11-28
2019-06-11
713.3874 Wisdomtree TrustWisdomtree U S SmallcapSymbol: Des
P
2016-12-09
2019-06-11
0.6126 Wisdomtree TrustWisdomtree U S SmallcapSymbol: Des
P
2016-12-09
2019-06-11
495 Wisdomtree TrustIntl Midcap Dividend Fd EtfSymbol: Dim
P
2018-01-08
2019-06-11
445 Wisdomtree TrustIntl Smallcap Dividend Fd EtfSymbol: Dls
P
2018-01-08
2019-06-11
703.4094 Wisdomtree TrustWisdomtree U S Midcap DividendSymbol: Don
P
2015-10-26
2019-06-11
5.6919 Wisdomtree TrustWisdomtree U S Midcap DividendSymbol: Don
P
2015-11-30
2019-06-11
22.1499 Wisdomtree TrustWisdomtree U S Midcap DividendSymbol: Don
P
2015-12-28
2019-06-11
3.6687 Wisdomtree TrustWisdomtree U S Midcap DividendSymbol: Don
P
2016-01-29
2019-06-11
3.3057 Wisdomtree TrustWisdomtree U S Midcap DividendSymbol: Don
P
2016-02-26
2019-06-11
3.6027 Wisdomtree TrustWisdomtree U S Midcap DividendSymbol: Don
P
2016-03-28
2019-06-11
6.6576 Wisdomtree TrustWisdomtree U S Midcap DividendSymbol: Don
P
2016-04-29
2019-06-11
6.2094 Wisdomtree TrustWisdomtree U S Midcap DividendSymbol: Don
P
2016-05-27
2019-06-11
9.1995 Wisdomtree TrustWisdomtree U S Midcap DividendSymbol: Don
P
2016-09-30
2019-06-11
5.2278 Wisdomtree TrustWisdomtree U S Midcap DividendSymbol: Don
P
2016-10-28
2019-06-11
5.6727 Wisdomtree TrustWisdomtree U S Midcap DividendSymbol: Don
P
2016-11-28
2019-06-11
620.2047 Wisdomtree TrustWisdomtree U S Midcap DividendSymbol: Don
P
2016-12-09
2019-06-11
0.7953 Wisdomtree TrustWisdomtree U S Midcap DividendSymbol: Don
P
2016-12-09
2019-06-11
274.934 Financial Invs TrEmerald Bkg & Fin Fd Instl ClSymbol: Hssix
P
2018-12-19
2019-04-02
10.325 Fundamental Invs IncCl F2 ShsSymbol: Finfx
P
2018-12-24
2019-09-24
81.475 Fundamental Invs IncCl F2 ShsSymbol: Finfx
P
2018-12-24
2019-09-24
3.493 Fundamental Invs IncCl F2 ShsSymbol: Finfx
P
2019-03-18
2019-09-24
3.588 Fundamental Invs IncCl F2 ShsSymbol: Finfx
P
2019-06-17
2019-09-24
10.413 Fundamental Invs IncCl F2 ShsSymbol: Finfx
P
2019-06-17
2019-09-24
3.688 Fundamental Invs IncCl F2 ShsSymbol: Finfx
P
2019-09-16
2019-09-24
517 Ishares Select Dividend EtfSymbol: Dvy
P
2018-10-22
2019-09-24
89 Ishares TrIshares Msci Usa MomentumSymbol: Mtum
P
2018-10-22
2019-04-02
118 Ishares U S HealthcareProviders EtfSymbol: Ihf
P
2018-10-22
2019-03-13
2985 Legg Mason Etf Investment TrstLegg Mason Low VolatilitySymbol: Lvhd
P
2019-09-24
2019-12-24
11141 Lord Abbett Short DurationIncome Fund Cl FSymbol: Ldlfx
P
2018-06-25
2019-02-01
11141 Lord Abbett Short DurationIncome Fund Cl FSymbol: Ldlfx
P
2018-06-25
2019-02-01
11244.019 Lord Abbett Short DurationIncome Fund Cl FSymbol: Ldlfx
P
2018-06-25
2019-04-02
10134.268 Lord Abbett Short DurationIncome Fund Cl FSymbol: Ldlfx
P
2018-06-25
2019-06-11
23.916 Lord Abbett Short DurationIncome Fund Cl FSymbol: Ldlfx
P
2018-07-02
2019-06-11
140.408 Lord Abbett Short DurationIncome Fund Cl FSymbol: Ldlfx
P
2018-08-01
2019-06-11
150.381 Lord Abbett Short DurationIncome Fund Cl FSymbol: Ldlfx
P
2018-09-04
2019-06-11
149.964 Lord Abbett Short DurationIncome Fund Cl FSymbol: Ldlfx
P
2018-10-01
2019-06-11
144.297 Lord Abbett Short DurationIncome Fund Cl FSymbol: Ldlfx
P
2018-11-01
2019-06-11
148.234 Lord Abbett Short DurationIncome Fund Cl FSymbol: Ldlfx
P
2018-12-03
2019-06-11
147.307 Lord Abbett Short DurationIncome Fund Cl FSymbol: Ldlfx
P
2019-01-02
2019-06-11
143.553 Lord Abbett Short DurationIncome Fund Cl FSymbol: Ldlfx
P
2019-02-01
2019-06-11
81.048 Lord Abbett Short DurationIncome Fund Cl FSymbol: Ldlfx
P
2019-03-01
2019-06-11
73.308 Lord Abbett Short DurationIncome Fund Cl FSymbol: Ldlfx
P
2019-04-01
2019-06-11
39.449 Lord Abbett Short DurationIncome Fund Cl FSymbol: Ldlfx
P
2019-05-01
2019-06-11
36.417 Lord Abbett Short DurationIncome Fund Cl FSymbol: Ldlfx
P
2019-06-03
2019-06-11
10162.602 Natixis Fds Loomis SaylesSr Fltg Rate & Fxd Inc Fd Cl YSymbol: Lsfyx
P
2018-06-25
2019-02-01
52.106 Natixis Fds Loomis SaylesSr Fltg Rate & Fxd Inc Fd Cl YSymbol: Lsfyx
P
2018-07-30
2019-02-01
48.523 Natixis Fds Loomis SaylesSr Fltg Rate & Fxd Inc Fd Cl YSymbol: Lsfyx
P
2018-08-28
2019-02-01
48.334 Natixis Fds Loomis SaylesSr Fltg Rate & Fxd Inc Fd Cl YSymbol: Lsfyx
P
2018-09-27
2019-02-01
55.832 Natixis Fds Loomis SaylesSr Fltg Rate & Fxd Inc Fd Cl YSymbol: Lsfyx
P
2018-10-30
2019-02-01
53.721 Natixis Fds Loomis SaylesSr Fltg Rate & Fxd Inc Fd Cl YSymbol: Lsfyx
P
2018-11-29
2019-02-01
58.902 Natixis Fds Loomis SaylesSr Fltg Rate & Fxd Inc Fd Cl YSymbol: Lsfyx
P
2018-12-19
2019-02-01
54.832 Natixis Fds Loomis SaylesSr Fltg Rate & Fxd Inc Fd Cl YSymbol: Lsfyx
P
2019-01-30
2019-02-01
6291.946 Pimco FdsIncome Fd Cl I 2Symbol: Ponpx
P
2019-02-01
2019-09-24
25.628 Pimco FdsIncome Fd Cl I 2Symbol: Ponpx
P
2019-03-01
2019-09-24
28.697 Pimco FdsIncome Fd Cl I 2Symbol: Ponpx
P
2019-04-01
2019-09-24
4142.39 Pimco FdsIncome Fd Cl I 2Symbol: Ponpx
P
2019-04-02
2019-09-24
3247.294 Pimco FdsIncome Fd Cl I 2Symbol: Ponpx
P
2019-04-02
2019-09-24
59.892 Pimco FdsIncome Fd Cl I 2Symbol: Ponpx
P
2019-05-01
2019-09-24
62.39 Pimco FdsIncome Fd Cl I 2Symbol: Ponpx
P
2019-06-03
2019-09-24
1983.94 Pimco FdsIncome Fd Cl I 2Symbol: Ponpx
P
2019-06-11
2019-09-24
68.372 Pimco FdsIncome Fd Cl I 2Symbol: Ponpx
P
2019-07-01
2019-09-24
71.654 Pimco FdsIncome Fd Cl I 2Symbol: Ponpx
P
2019-08-01
2019-09-24
73.121 Pimco FdsIncome Fd Cl I 2Symbol: Ponpx
P
2019-09-03
2019-09-24
8792.497 Pimco Low Duration IncomeFund Class I 2Symbol: Pftpx
P
2018-10-22
2019-02-01
5861.665 Pimco Low Duration IncomeFund Class I 2Symbol: Pftpx
P
2018-10-22
2019-02-01
4545.455 Pimco Low Duration IncomeFund Class I 2Symbol: Pftpx
P
2018-10-22
2019-04-02
4357.66 Pimco Low Duration IncomeFund Class I 2Symbol: Pftpx
P
2018-10-22
2019-06-11
18.434 Pimco Low Duration IncomeFund Class I 2Symbol: Pftpx
P
2018-11-01
2019-06-11
71.121 Pimco Low Duration IncomeFund Class I 2Symbol: Pftpx
P
2018-12-03
2019-06-11
61.187 Pimco Low Duration IncomeFund Class I 2Symbol: Pftpx
P
2019-01-02
2019-06-11
67.714 Pimco Low Duration IncomeFund Class I 2Symbol: Pftpx
P
2019-02-01
2019-06-11
32.283 Pimco Low Duration IncomeFund Class I 2Symbol: Pftpx
P
2019-03-01
2019-06-11
30.852 Pimco Low Duration IncomeFund Class I 2Symbol: Pftpx
P
2019-04-01
2019-06-11
16.053 Pimco Low Duration IncomeFund Class I 2Symbol: Pftpx
P
2019-05-01
2019-06-11
16.509 Pimco Low Duration IncomeFund Class I 2Symbol: Pftpx
P
2019-06-03
2019-06-11
12.109 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2018-04-02
2019-04-02
11.044 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2018-05-01
2019-04-02
11.766 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2018-06-01
2019-04-02
11.819 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2018-07-02
2019-04-02
11.475 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2018-08-01
2019-04-02
13.025 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2018-09-04
2019-04-02
10.39 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2018-10-01
2019-04-02
11.979 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2018-11-01
2019-04-02
12.409 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2018-12-03
2019-04-02
46.597 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2018-12-27
2019-04-02
11.874 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2019-01-02
2019-04-02
11.962 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2019-02-01
2019-04-02
11.193 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2019-03-01
2019-04-02
12.365 Pimco Mortgage OpportunitiesAnd Bond Fund I 2Symbol: Pmzpx
P
2019-04-01
2019-04-02
239.786 Putnam Focused Equity FundCl YSymbol: Pgilx
P
2018-12-26
2019-09-24
7803.181 Putnam Ultra Short DurationIncome Fd Cl YSymbol: Psdyx
P
2018-06-25
2019-03-13
5.254 Putnam Ultra Short DurationIncome Fd Cl YSymbol: Psdyx
P
2018-07-02
2019-03-13
26.193 Putnam Ultra Short DurationIncome Fd Cl YSymbol: Psdyx
P
2018-08-01
2019-03-13
29.829 Putnam Ultra Short DurationIncome Fd Cl YSymbol: Psdyx
P
2018-09-04
2019-03-13
23.831 Putnam Ultra Short DurationIncome Fd Cl YSymbol: Psdyx
P
2018-10-01
2019-03-13
2061.961 Putnam Ultra Short DurationIncome Fd Cl YSymbol: Psdyx
P
2018-10-23
2019-03-13
17.343 Putnam Ultra Short DurationIncome Fd Cl YSymbol: Psdyx
P
2018-11-01
2019-08-12
23.346 Putnam Ultra Short DurationIncome Fd Cl YSymbol: Psdyx
P
2018-12-03
2019-08-12
0.87 Putnam Ultra Short DurationIncome Fd Cl YSymbol: Psdyx
P
2018-12-31
2019-08-12
0.87 Putnam Ultra Short DurationIncome Fd Cl YSymbol: Psdyx
P
2018-12-31
2019-08-12
22.623 Putnam Ultra Short DurationIncome Fd Cl YSymbol: Psdyx
P
2019-01-02
2019-08-12
25.529 Putnam Ultra Short DurationIncome Fd Cl YSymbol: Psdyx
P
2019-02-01
2019-08-12
2.342 Putnam Ultra Short DurationIncome Fd Cl YSymbol: Psdyx
P
2019-05-01
2019-08-12
2.556 Putnam Ultra Short DurationIncome Fd Cl YSymbol: Psdyx
P
2019-06-03
2019-08-12
2.136 Putnam Ultra Short DurationIncome Fd Cl YSymbol: Psdyx
P
2019-07-01
2019-08-12
2.329 Putnam Ultra Short DurationIncome Fd Cl YSymbol: Psdyx
P
2019-08-01
2019-08-12
81.166 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2019-02-20
2019-12-24
3382.95 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2019-03-13
2019-12-24
119.332 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2019-05-17
2019-12-24
130.864 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2019-08-20
2019-12-24
137.219 Salient Mlp & EnergyInfrastructure Fund Class ISymbol: Smlpx
P
2019-11-19
2019-12-24
0 Uit Ft Imagine 2025 PortfolioSer Semi Annual Fee ReinvestCusip: 30309v437
P
2018-09-12
2019-03-25
0 Uit Ft Imagine 2025 PortfolioSer Semi Annual Fee ReinvestCusip: 30309v437
P
2018-10-25
2019-03-25
0 Uit Ft Imagine 2025 PortfolioSer Semi Annual Fee ReinvestCusip: 30309v437
P
2018-12-26
2019-03-25
0 Uit Ft Imagine 2025 PortfolioSer Semi Annual Fee ReinvestCusip: 30309v437
P
2018-12-26
2019-11-25
0 Uit Ft Imagine 2025 PortfolioSer Semi Annual Fee ReinvestCusip: 30309v437
P
2019-03-25
2019-11-25
0 Uit Ft Imagine 2025 PortfolioSer Semi Annual Fee ReinvestCusip: 30309v437
P
2019-06-25
2019-11-25
0 Uit Ft Imagine 2025 PortfolioSer Semi Annual Fee ReinvestCusip: 30309v437
P
2018-12-26
2019-12-25
0 Uit Ft Imagine 2025 PortfolioSer Semi Annual Fee ReinvestCusip: 30309v437
P
2019-03-25
2019-12-25
0 Uit Ft Imagine 2025 PortfolioSer Semi Annual Fee ReinvestCusip: 30309v437
P
2019-06-25
2019-12-25
0 Uit Ft Imagine 2025 PortfolioSer Semi Annual Fee ReinvestCusip: 30309v437
P
2019-11-25
2019-12-25
275 Vanguard Specialized FundsVanguard Real Estate EtfSymbol: Vnq
P
2019-02-01
2019-12-24
(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
26,689
25,021
1,668
c
32,630
25,000
7,630
d
22,825
24,898
-2,073
e
19,373
24,586
-5,213
21,661
25,017
-3,356
21,234
27,733
-6,499
13,074
17,500
-4,426
919
1,379
-460
52,258
50,833
1,425
163
160
3
155
156
-1
569
572
-3
165
171
-6
409
429
-20
2,801
2,939
-138
168
181
-13
167
180
-13
474
511
-37
173
190
-17
58,882
48,652
10,230
1,537
1,273
264
16
13
3
43,895
50,000
-6,105
31,512
31,919
-407
13,686
13,875
-189
150
152
-2
265
271
-6
274
280
-6
249
255
-6
265
273
-8
266
273
-7
225
232
-7
122
125
-3
197
201
-4
131
134
-3
124
126
-2
115
117
-2
56,199
50,000
6,199
1,363
1,150
213
162
136
26
381
322
59
408
418
-10
1,380
1,412
-32
772
790
-18
9,257
9,257
235
235
123
123
2,646
5,300
-2,654
107
195
-88
14,010
21,578
-7,568
297
456
-159
273
476
-203
323
479
-156
18,931
21,207
-2,276
735
832
-97
1,154
787
367
6,471
4,594
1,877
1,096
979
117
1,040
1,027
13
783
862
-79
646
1,311
-665
695
785
-90
781
802
-21
826
825
1
814
852
-38
649
670
-21
625
686
-61
599
588
11
27,115
25,045
2,070
18,577
17,491
1,086
105
105
2
2
410
410
7
7
28,617
24,690
3,927
23,081
19,369
3,712
166
142
24
419
345
74
52
41
11
161
121
40
126
99
27
152
127
25
299
263
36
225
194
31
291
272
19
304
273
31
178
179
-1
19,063
19,961
-898
16
17
-1
30,831
35,048
-4,217
29,443
35,046
-5,603
25,098
19,348
5,750
203
158
45
790
596
194
131
94
37
118
88
30
129
101
28
238
192
46
222
181
41
328
278
50
187
154
33
202
177
25
22,129
19,953
2,176
28
26
2
8,795
8,495
300
610
520
90
4,811
4,106
705
206
204
2
212
207
5
615
601
14
218
221
-3
52,312
50,059
2,253
9,995
9,739
256
20,407
22,603
-2,196
101,692
99,818
1,874
46,347
46,562
-215
46,347
46,569
-222
47,000
47,000
42,564
42,361
203
100
100
590
586
4
632
627
5
630
624
6
606
597
9
623
614
9
619
613
6
603
600
3
340
340
308
307
1
166
165
1
153
153
96,341
100,000
-3,659
494
512
-18
460
476
-16
458
474
-16
529
545
-16
509
517
-8
558
555
3
520
520
75,126
75,000
126
306
306
343
344
-1
49,460
49,750
-290
38,773
39,000
-227
715
722
-7
745
752
-7
23,688
23,966
-278
816
829
-13
856
867
-11
873
871
2
75,000
74,648
352
50,000
49,766
234
39,000
38,591
409
37,563
36,997
566
159
156
3
613
600
13
527
516
11
584
578
6
278
276
2
266
265
1
138
138
142
142
131
133
-2
120
121
-1
128
130
-2
128
130
-2
125
126
-1
141
143
-2
113
114
-1
130
131
-1
135
136
-1
506
502
4
129
128
1
130
129
1
121
121
134
134
5,239
4,151
1,088
78,422
78,500
-78
53
53
263
264
-1
300
300
240
240
20,723
20,743
-20
174
174
235
235
9
9
9
9
228
227
1
257
256
1
24
24
26
26
21
21
23
23
572
598
-26
23,850
24,640
-790
841
876
-35
923
889
34
967
904
63
63
63
1
1
1
1
1
1
1
1
3
3
1
1
25,045
22,440
2,605
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
1,668
c
7,630
d
-2,073
e
-5,213
-3,356
-6,499
-4,426
-460
1,425
3
-1
-3
-6
-20
-138
-13
-13
-37
-17
10,230
264
3
-6,105
-407
-189
-2
-6
-6
-6
-8
-7
-7
-3
-4
-3
-2
-2
6,199
213
26
59
-10
-32
-18
-2,654
-88
-7,568
-159
-203
-156
-2,276
-97
367
1,877
117
13
-79
-665
-90
-21
1
-38
-21
-61
11
2,070
1,086
3,927
3,712
24
74
11
40
27
25
36
31
19
31
-1
-898
-1
-4,217
-5,603
5,750
45
194
37
30
28
46
41
50
33
25
2,176
2
300
90
705
2
5
14
-3
2,253
256
-2,196
1,874
-215
-222
203
4
5
6
9
9
6
3
1
1
-3,659
-18
-16
-16
-16
-8
3
126
-1
-290
-227
-7
-7
-278
-13
-11
2
352
234
409
566
3
13
11
6
2
1
-2
-1
-2
-2
-1
-2
-1
-1
-1
4
1
1
1,088
-78
-1
-20
1
1
-26
-790
-35
34
63
2,605
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
-1,206
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
3,106
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
127,099
2,674,776
0.04752
2017
116,269
2,589,827
0.04490
2016
115,640
2,384,134
0.04850
2015
135,234
2,676,187
0.05053
2014
142,263
2,789,776
0.05099
2
Total
of line 1, column (d)
.....................
2
0.242443
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
0.048489
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
2,674,584
5
Multiply line 4 by line 3
......................
5
129,688
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
803
7
Add lines 5 and 6
........................
7
130,491
8
Enter qualifying distributions from Part XII, line 4
,.............
8
132,297
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
803
here
and enter 1% of Part I, line 27b
...................
c
All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
2
3
Add lines 1 and 2
...........................
3
803
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
4
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
803
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
30
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
833
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
Refunded
11
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition)
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
(2)
On foundation managers.
$
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
No
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)
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
DAVID L ORENSTEIN
Telephone no.
(413) 447-1900
Located at
150 PITTSFIELD ROAD
LENOX
MA
ZIP+4
01240
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
PETER GALE
Vice President
0.50
0
214 DAWSON ROAD
HILLSDALE
,
NY
12529
LYNN GALE
President
0.50
0
8167 NICE WAY
SARASOTA
,
FL
34238
BARBARA MAISEL
SECY/TREAS
0.50
0
4894 bradshaw COURT
SAN DIEGO
,
CA
92140
DAVID L ORENSTEIN
CPA
0.00
0
75 NORTH STREET
PITTSFIELD
,
MA
01201
2
Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a)
Name and address of each employee paid more than $50,000
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
NONE
Total
number of other employees paid over $50,000
...................
Form
990-PF
(2019)
Form 990-PF (2019)
Page
7
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
(continued)
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
DAVID L ORENSTEIN CPA
ACCOUNTING
6,142
150 PITTSFIELD ROAD
LENOX
,
MA
01240
RBC WEALTH MANAGEMENT
INVESTMENT MANAGEMENT
21,134
200 PARK AVENUS2ND FL
FLORHAM PARK
,
NJ
07932
Total
number of others receiving over $50,000 for professional services
.............
Part IX-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
2
3
4
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
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
2,680,395
b
Average of monthly cash balances
.......................
1b
34,919
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
2,715,314
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
3
Subtract line 2 from line 1d
.........................
3
2,715,314
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
40,730
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
2,674,584
6
Minimum investment return.
Enter 5% of line 5
..................
6
133,729
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
133,729
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
803
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
803
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
132,926
4
Recoveries of amounts treated as qualifying distributions
................
4
5
Add lines 3 and 4
............................
5
132,926
6
Deduction from distributable amount (see instructions)
.................
6
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1
...
7
132,926
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
132,297
b
Program-related investments—total from Part IX-B
..................
1b
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
b
Cash distribution test (attach the required schedule)
.................
3b
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
132,297
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
803
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
131,494
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
132,926
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
129,659
b
Total for prior years:
20
,
20
,
20
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
b
From 2015
......
c
From 2016
......
d
From 2017
......
e
From 2018
......
f
Total
of lines 3a through e
........
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
132,297
a
Applied to 2018, but not more than line 2a
129,659
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
c
Treated as distributions out of corpus (Election
required—see instructions)
........
0
d
Applied to 2019 distributable amount
.....
2,638
e
Remaining amount distributed out of corpus
5
Excess distributions carryover applied to 2019.
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
e
Undistributed income for 2018. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
f
Undistributed income for 2019. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2020
..........
130,288
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions)
.......
8
Excess distributions carryover from 2014 not
applied on line 5 or line 7 (see instructions)
...
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
10
Analysis of line 9:
a
Excess from 2015
....
b
Excess from 2016
....
c
Excess from 2017
....
d
Excess from 2018
....
e
Excess from 2019
....
Form
990-PF
(2019)
Form 990-PF (2019)
Page
10
Part XIV
Private Operating Foundations
(see instructions and Part VII-A, question 9)
1a
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2019, enter the date of the ruling
.......
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
HAWTHORNE VALLEY ASSOCIATION
327 ROUTE 21C
GHENT
,
NY
12075
NONE
exempt
SCHOLARSHIP FUND, TUITION & FACULTY ASSISTANCE
8,000
BERKSHIRE PULSE
420 PARK STREET BOX 37
HOUSATONIC
,
MA
01236
NONE
exempt
CULTURAL ACTIVITIES
1,200
HEVREH OF SOUTHERN BERKSHIRE
PO BOX 912
GREAT BARRINGTON
,
MA
01230
NONE
exempt
RELIGIOUS ACTIVITES
10,400
JEWISH FEDERATION OF THE BERKSHIRES
196 SOUTH STREET
PITTSFIELD
,
MA
01201
NONE
exempt
RELIGIOUS ACTIVITIES
11,500
THE ARC OF SAN DIEGO
9575 AERO DRIVE
SAN DIEGO
,
CA
92123
NONE
exempt
SERVICES FOR MENTALLY DISABLED
1,500
TRUSTEES OF GRINNELL COLLEGE
733 BROAD STREET
GRINELL
,
IA
50112
NONE
exempt
EDUCATION
20,000
HELEN WOODWARD ANIMAL CENTER
PO BOX 64
RANCHO SANTA FE
,
CA
92067
NONE
exempt
ANIMAL SERVICES
2,000
MAMA'S KITCHEN
1875 SECOND AVENUE
SAN DIEGO
,
CA
92101
NONE
exempt
FOOD SERVICE
4,250
ACLU FOUNDATION INC
125 BROAD STREET - 18TH FLOOR
NEW YORK
,
NY
10004
NONE
exempt
PROTECT CIVIL LIBERTIES
4,250
MARCH OF DIMES
515 MADISON AVENUE 20TH FLOOR
NEW YORK
,
NY
10022
NONE
exempt
HEALTH SERVICES
2,000
MINIATURE SCHNAUZER FRIENDS RESCUE
1540 STEINHART AVENUE
REDONDO BEACH
,
CA
90278
NONE
exempt
ANIMAL RESCUE
5,000
WILDLIFE CENTER OF VENICE INC
3252 BORDER ROAD
VENICE
,
FL
34292
NONE
exempt
ANIMAL RESCUE & REHAB
3,334
NEURO CHALLENGE FOUNDATION
5602 MARQUESAS CIRCLE - STE 211
SARASOTA
,
FL
34233
NONE
exempt
MEDICAL SERVICES FOR PARKINSONS DISEASE
10,000
UNIVERSITY OF SOUTH FLORIDA FOUNDAT
4001 E FLETCHER AVENUE 6TH FL
TAMPA
,
FL
33613
NONE
EXEMPT
FURTHERANCE OF EDUCATION
10,000
SAN DIEGO LGBT COMMUNITY CENTER
3909 CENTRE STREET
SAN DIEGO
,
CA
92103
NONE
EXEMPT
SUPPORT HEALTH & WELL BEING OF LOCAL LGBT COMMUNITY
2,000
CHILDREN FIRST INC
1648 S 16TH ST
PHOENIX
,
AZ
85034
NONE
EXEMPT
Help underprivileged and homeless children access a quality education
5,000
CHILDREN FIRST INC
1723 N ORANGE AVENUE
SARASOTA
,
FL
34234
NONE
PC
PROMOTE EARLY CHILDHOOD EDUCATION AND DEVELOPMENT
5,000
DOUG VARONE DANCERS
260 W BROADWAY
NEW YORK
,
NY
10013
NONE
PC
TRAIN DANCERS AND CHOREOGRAPHERS AND PROMOTE THE ART OF DANCE.
1,000
MEMORIAL SLOANE KETTERING
1275 YORK AVENUE
NEW YORK
,
NY
10065
NONE
PC
SUPPORT RESEARCH AND FURTHER DEVELOP NEW TREAMENTS FOR CANCER
5,000
BACKYARD BOUNTY OF THE BERKSHIRES
353 MAIN STREET
GREAT BARRINGTON
,
MA
01230
NONE
PC
collect bumper crops of fruit that ARE distributed to the hungry IN BERKSHIRE COUNTY, MA.
1,433
THE TREVOR PROJECT
8704 SANTA MONICA BOULEVARD
WEST HOLLYWOOD
,
CA
90069
NONE
PC
SEEK to PREVENT AND end suicide among gay, lesbian, bisexual, transgender, queer & questioning young people.
1,000
SARASOTA SHARKS INC
8587 POTTER PARK DRIVE
SARASOTA
,
FL
34238
NONE
PC
PROMOTE SWIMMING & COMPETITIVE ABILITY AMONGST YOUNG STUDENTS
3,000
THOMAS JEFFERSON UNIVERSITY
1020 WALNUT STREET
PHIALDELPHIA
,
PA
19107
NONE
PC
PROMOTE EDUCATION IN MEDICAL AND HEALTH SCIENCES FIELDS
3,333
A PRECIOUS CHILD
7051 W 118THS AVENUE
BROOMFIELD
,
CO
80020
NONE
PC
PROVIDE CHILDREN IN NEED WITH OPPORTUNITIES AND RESOURCES TO SUCCEED.
1,000
RIP MEDICAL DEBT RELIEF
80 THEODROE FREMD AVE
RYE
,
NY
10580
NONE
PC
PROVIDE FINANCIAL RELIEF TO NEEDY INDIVIDUALS & FAMILIES SADDLED WITH SIGNIFCIANT MEDICAL DEBTS.
1,800
BERKSHIRE BABY BOX
PO BOX 587
SOUTH EGREMONT
,
MA
01258
NONE
PC
PROVIDE EXPECTANT MOTHERS IN THE BERSHIRES WITH FINNISH STYLE BABY BOX AND ASSIST WITH PROGRAMS & RESOURCES TO ALLEVIATE FEELINGS OF ISOLATION IN NEW MOTHERS
1,000
JAZZ CLASSICS FOR CHANGE
56 FERN HILL ROAD
GHENT
,
NY
12075
NONE
PC
PROMOTE MUSICAL CONCERTS TO CONNECT TO ARTS IN WAYS THAT ARE HOPEFUL AND HEALING.
1,000
NATIONAL NETWORK OF ABORTION FUNDS
PO BOX 170280
BOSTON
,
MA
02117
NONE
PC
REMOVE FINANCIAL AND LOGISTICAL BARRIERS TO ACCESS TO ABORTION AT THE INTERSECTION OF RACIAL, ECONOMIC AND REPRODUCTIVE JUSTICE
1,000
THE ORANGUTAN PROJECT
2641 SANTA MONICA BOULEVARD
SANTA MONICA
,
CA
90404
NONE
PC
To ensure the survival of all orangutan species in their natural habitat and promote the welfare of all orangutans.
1,000
THE WILMA THEATRE
265 SOUTH BROAD STREET
PHILADELPHIA
,
PA
19107
NONE
PC
PROMOTE APPRECIATION OF LIVE THEATER ARTS
3,000
Total
.................................
3a
130,000
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
84,395
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
............
-1,206
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)
..
84,395
-1,206
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
83,189
(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:
19009920
Software Version:
2019v5.0
Form 990PF - Special Condition Description:
Special Condition Description