-
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
HAWAII HEPTACHLOR RESEARCH & EDUCATION
FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)
CO RICK SCUDDER ADMINPO BOX 3
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
HONOLULU
,
HI
96812
A Employer identification number
99-0258945
B
Telephone number (see instructions)
(808) 842-3429
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)
$
817,820
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
17
17
4
Dividends and interest from securities
...
18,675
18,675
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
10,172
b
Gross sales price for all assets on line 6a
154,277
7
Capital gain net income (from Part IV, line 2)
...
10,172
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)
.......
996
996
0
12
Total.
Add lines 1 through 11
........
29,860
29,860
0
13
Compensation of officers, directors, trustees, etc.
18,094
0
0
18,094
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
7,958
796
0
7,162
c
Other professional fees (attach schedule)
....
12,396
4,958
0
7,438
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
6,450
0
0
0
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
1,948
0
0
1,948
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
3,999
0
0
3,999
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
50,845
5,754
0
38,641
25
Contributions, gifts, grants paid
.......
0
0
26
Total expenses and disbursements.
Add lines 24 and 25
50,845
5,754
0
38,641
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-20,985
b
Net investment income
(if negative, enter -0-)
24,106
c
Adjusted net income
(if negative, enter -0-)
...
0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2019)
Form 990-PF (2019)
Page
2
Part II
Balance Sheets
Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year
End of year
(a)
Book Value
(b)
Book Value
(c)
Fair Market Value
1
Cash—non-interest-bearing
.............
47
47
47
2
Savings and temporary cash investments
.........
19,055
28,879
28,879
3
Accounts receivable
Less: allowance for doubtful accounts
4
Pledges receivable
Less: allowance for doubtful accounts
5
Grants receivable
.................
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)
.....
7
Other notes and loans receivable (attach schedule)
Less: allowance for doubtful accounts
8
Inventories for sale or use
..............
9
Prepaid expenses and deferred charges
..........
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
.......
144,989
168,658
210,696
c
Investments—corporate bonds (attach schedule)
.......
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
604,047
549,569
578,198
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)
768,138
747,153
817,820
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
0
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
25
Net assets with donor restrictions
............
Foundations that do not follow FASB ASC 958, check here
and complete lines 26 through 30.
26
Capital stock, trust principal, or current funds
........
0
0
27
Paid-in or capital surplus, or land, bldg., and equipment fund
0
0
28
Retained earnings, accumulated income, endowment, or other funds
768,138
747,153
29
Total net assets or fund balances
(see instructions)
.....
768,138
747,153
30
Total liabilities and net assets/fund balances
(see instructions)
.
768,138
747,153
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
768,138
2
Enter amount from Part I, line 27a
.....................
2
-20,985
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
747,153
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
747,153
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
12SHS CITI GROUP NEW
P
2015-07-08
2019-01-03
b
1SH MARTIN MARIETTA MATERIALS
P
2015-07-08
2019-01-23
c
1SH MC CORMICK AND CO NON VOTING
P
2017-10-04
2019-01-02
d
2SHS MC CORMICK AND CO NON VOTING
P
2017-08-09
2019-01-03
e
2SHS MC CORMICK AND CO NON VOTING
P
2017-10-04
2019-01-03
1SH AMERICAN TOWER REIT COM
P
2018-08-07
2019-02-05
8SHS AMERICAN TOWER REIT COM
P
2015-07-08
2019-02-05
FOX CORP CL B
P
2019-03-19
2019-03-19
HONEYWELL INTERNATIONAL INC
P
2019-01-03
2019-03-27
1SH ANTHEM INC COM
P
2015-07-08
2019-03-27
950.973SHS TIAA CREF SOCIAL CHOICE BD ADV
P
2016-06-29
2019-03-27
19SHS TWENTY-FIRST CASH CLQ08
P
2015-07-08
2019-03-19
13SHS TWENTY-FIRST CASH CLQ08
P
2016-01-14
2019-03-19
11SHS EMERSON ELECTRIC CO
P
2019-04-04
2019-04-17
17SHS MERCK & CO INC NEW COM
P
2019-04-04
2019-04-17
18SHS MICROSOFT CORP
P
2019-04-04
2019-04-17
1.2SHS ALCON INC
P
2015-07-08
2019-04-11
0.8SH ALCON INC
P
2015-07-08
2019-04-11
1SH AMGEN INC
P
2015-08-17
2019-04-15
11SHS BANK OF NEW YORK MELLON CORP
P
2015-07-08
2019-04-23
1SH EMERSON ELECTRIC CO
P
2015-07-08
2019-04-17
1SH MERCK & CO INC NEW COM
P
2015-07-08
2019-04-17
1SH MICROSOFT CORP
P
2015-07-08
2019-04-17
2SHS MOTOROLA SOLUTIONS INC
P
2015-07-08
2019-04-05
13.99SHS TWENTY-FIRST CENTURY FOX INC B
P
2015-07-08
2019-03-21
9.579SHS TWENTY-FIRST CENTURY FOX INC B
P
2016-01-04
2019-03-21
0.111SH WALT DISNEY CO HLDG CO
P
2015-07-08
2019-03-21
0.076SH WALT DISNEY CO HLDG CO
P
2016-01-14
2019-03-21
11SHS ANADARKO PETE
P
2015-07-08
2019-05-09
4SHS ANADARKO PETE
P
2015-08-24
2019-05-09
2SHS ANADARKO PETE
P
2015-08-24
2019-05-09
20SHS ANADARKO PETE
P
2016-01-12
2019-05-09
931.524SHS CRA QUALIFIED INVESTMENT INSTL
P
2015-07-08
2019-05-29
256SHS WEATHERFORD INTERNATIONAL
P
2015-07-08
2019-05-15
66SHS WEATHERFORD INTERNATIONAL
P
2015-08-17
2019-05-15
30SHS WEATHERFORD INTERNATIONAL
P
2016-01-22
2019-05-15
98SHS WEATHERFORD INTERNATIONAL
P
2016-05-23
2019-05-15
2SHS STATE STREET CORP
P
2015-07-08
2019-06-05
4SHS STATE STREET CORP
P
2015-07-08
2019-06-06
3SHS STATE STREET CORP
P
2015-07-08
2019-06-07
1SH CAPITAL ONE FINANCIAL CORP
P
2018-08-07
2019-07-30
8SHS CAPITAL ONE FINANCIAL CORP
P
2015-07-08
2019-07-30
2SHS ILL TOOL WORKS INC
P
2015-12-16
2019-07-11
2SHS MOTOROLA SOLUTIONS INC
P
2015-07-08
2019-07-11
17SHS ANADARKO PETE
P
2019-02-08
2019-08-09
9SHS JOHNSON & JOHNSON
P
2019-04-04
2019-08-29
0.976SH OCCIDENTAL PETROLEUM CORP DE
P
2019-08-09
2019-08-09
9SHS TWITTER INC
P
2019-02-07
2019-08-29
5SHS TWITTER INC
P
2019-03-28
2019-08-29
2SHS ALLERGAN PLC SHS
P
2015-07-08
2019-08-29
1SH ALLERGAN PLC SHS
P
2015-10-21
2019-08-29
17SHS ANADARKO PETE
P
2016-01-12
2019-08-29
1SH ANTHEM INC COM
P
2015-07-08
2019-08-29
5SHS BANK OF AMERICA CORP
P
2017-09-22
2019-08-29
5SHS BANK OF AMERICA CORP
P
2018-06-07
2019-08-29
4SHS BANK OF AMERICA CORP
P
2018-08-07
2019-08-29
206.996SHS CALVERT EMERGING MARKETS EQ 1
P
2018-08-07
2019-08-29
13SHS COMCAST CORP (NEW) CLASS A
P
2015-07-08
2019-08-29
9SHS COMCAST CORP (NEW) CLASS A
P
2018-06-13
2019-08-29
4SHS COMCAST CORP (NEW) CLASS A
P
2018-06-13
2019-08-29
1,100SHS CRA QUALIFIED INVESTMENT INSTL
P
2015-07-08
2019-08-29
2SHS DANAHER CORPORATION
P
2015-07-08
2019-08-29
2SHS HONEYWELL INTERNATIONAL INC
P
2015-07-08
2019-08-29
18SHS ISHARES TRUT ISHARES ESG MS
P
2018-08-07
2019-08-29
11SHS JOHNSON CTLS INTL PLC
P
2015-07-08
2019-08-29
3SHS JPMORGAN CHASE & CO
P
2015-07-08
2019-08-29
1SH MARTIN MARIETTA MATERIALS
P
2015-07-08
2019-08-29
13SHS METLIFE INCORPORATED\
P
2015-07-08
2019-08-19
2SHS MICROSOFT CORP
P
2015-07-08
2019-08-29
41.981SHS NEUBERGER BRMN SUSTAIN EQ INSTL
P
2018-08-07
2019-08-29
2SHS PEPSICO INC NC
P
2015-07-08
2019-08-29
8SHS SCHLUMBERGER LTD
P
2015-07-08
2019-08-27
10SHS SCHLUMBERGER LTD
P
2016-04-04
2019-08-27
9SHS TE CONNECTIVITY LTD NEW
P
2015-07-08
2019-08-29
1SH TE CONNECTIVITY LTD NEW
P
2015-07-08
2019-08-29
2,488.992SHS TIAA CREF SOCIAL CHOICE BD ADV
P
2016-06-29
2019-08-29
9SHS TWITTER INC
P
2016-01-13
2019-08-29
7SHS U S BANCORP COM NEW
P
2015-07-08
2019-08-29
58.961SHS UBS INTERNATIONAL SUST EQ P
P
2018-08-07
2019-08-29
1SH ANTHEM INC COM
P
2015-07-08
2019-10-03
51.551SHS CALVERT EMERGING MARKETS EQ I
P
2018-08-07
2019-10-04
0.5SH CERENCE INC
P
2015-07-08
2019-10-02
4SHS COCA COLA CO
P
2015-07-08
2019-10-04
3SHS EATON CORP PLC SHS
P
2017-05-15
2019-10-04
1SH HOME DEPOT INC
P
2015-07-08
2019-10-04
2SHS MARSH & MCLENNAN COS INC
P
2015-07-08
2019-10-04
5SHS ORACLE CORP
P
2017-10-27
2019-10-04
8SHS SEAGATE ECHNOLOGY PLC
P
2015-07-08
2019-10-04
1SH SEAGATE ECHNOLOGY PLC
P
2015-10-20
2019-10-11
3SH U S BANKCORP COM NEW
P
2015-07-08
2019-10-04
4SHS WESTERN DIGITAL CORPORATION
P
2015-11-05
2019-10-04
1SH WESTERN DIGITAL CORPORATION
P
2015-12-03
2019-10-04
1SH AMERICAN TOWER REIT COM
P
2019-03-06
2019-11-25
1SH BROADCOM INC
P
2019-06-14
2019-11-25
31.597SHS DOMINI IMPACT INTL EQ Y
P
2019-02-08
2019-11-25
1SH UNITEDHEALTH GP INC
P
2019-01-03
2019-11-25
1SH AIR PROD & CHEM INC
P
2018-08-07
2019-11-25
2SHS ALLERGAN PLC SHS
P
2015-10-21
2019-11-25
2SHS AMERICAN EXPRESS CO
P
2015-07-08
2019-11-25
1SH AMGEN INC
P
2015-07-08
2019-11-25
7SHS AT&T INC
P
2015-07-08
2019-11-25
2SHS AUTODESK INC DELAWARE
P
2015-07-08
2019-11-25
79.953SHS CALVERT EMERGING MARKETS EQ I
P
2018-08-07
2019-11-25
272.283SHS DOMINI IMPACT INTL EQ Y
P
2016-01-22
2019-11-25
25SHS ISHARES TRUST ISHARES ESG MS
P
2018-08-07
2019-11-25
3SHS MEDTRONIC PLC SHS
P
2015-07-08
2019-11-25
3SHS MERCK & CO INC NEW COM
P
2015-07-08
2019-11-25
2SHS MOTOROLA SOLUTIONS INC
P
2015-07-08
2019-11-25
91.989SHS NEUBERGER BRMN SUSTAIN EQ INST
P
2018-08-07
2019-11-25
183.991SHS TOUCHSTONE GLOBAL ESG EQUITY Y
P
2016-06-29
2019-11-25
283.996SHS UBS INTERATIONAL SUST EQ P
P
2018-08-07
2019-11-25
2SHS UNITEDHEALTH GP INC
P
2015-07-08
2019-11-25
15SHS XEROX HOLDINGS CORP
P
2015-07-08
2019-11-07
4SHS MICROSOFT CORP
P
2015-07-08
2019-12-20
ALCON INC
P
2018-10-19
2019-04-09
3SHS ALCON INC
P
2018-10-19
2019-05-21
38SHS CHUNGHWA TELECOM LTD ADR
P
2018-10-19
2019-05-21
64SHS CNO FINL GROUP INC COM
P
2018-10-19
2019-05-21
22SHS COGNIZANT TECH SOLUTIONS CL A
P
2018-10-19
2019-05-21
18SHS CVS HEALTH CORP COM
P
2018-10-19
2019-05-21
2SHS DANAHER CORPORATION
P
2018-10-19
2019-05-21
11SHS ENEL AMERICAS S A SPONSORED AD
P
2018-10-19
2019-05-21
9SHS EXELON CORP
P
2018-10-19
2019-05-21
17SHS GREEN DOT CORP CL A
P
2018-10-19
2019-05-21
10SHS HANNON ARMSTRONG SUS INFRA CAP
P
2018-10-19
2019-05-21
6SHS HCP INCORPORATED
P
2018-10-19
2019-05-21
7SHS ISHARES INC ISHARES ESG MSC
P
2018-10-19
2019-05-21
9SHS LULULEMON ATLETICA INC
P
2018-10-19
2019-05-21
18SHS NOVARTIS AG ADR
P
2018-10-19
2019-05-21
30SHS NOVO NORDISK A/S ADR
P
2018-10-19
2019-05-21
74SHS NUANCE COMMUNICATIONS INC
P
2018-10-19
2019-05-21
3SHS PAYPAL HLDGS INC COM
P
2018-10-19
2019-05-21
115SHS PEARSON PLC SP ADR
P
2018-10-19
2019-05-21
19SHS PRUDENTIAL PLC ADR
P
2018-10-19
2019-05-21
7SHS PRUDENTIAL PLC ADR
P
2018-10-19
2019-05-21
53SHS PT TELEKOMUNIKASA INDONESIA
P
2018-10-19
2019-05-21
16SHS ROCKWELL AUTOMATION INC
P
2018-10-19
2019-05-21
38SHS SMITH & NEPHEW PLC ADR
P
2018-10-19
2019-05-21
1SHS TESLA INC
P
2018-10-19
2019-05-21
3SHS VOYA FINL INC
P
2019-05-21
2019-05-21
2SHS WELLTOWER INC
P
2019-05-21
2019-05-21
ABBOTT LOBORATORIES
P
2019-05-21
2019-07-24
ABBOTT LOBORATORIES
P
2019-05-21
2019-07-24
ENEL AMERICAS S A RTS
P
2018-10-19
2019-07-12
PATTERN ENERGY GROUP INC CL A
P
2018-10-19
2019-07-24
PAYPAL HLDGS INC COM
P
2018-10-19
2019-07-24
SYMANTEC CORP
P
2018-10-19
2019-07-24
TRANSUNION
P
2018-10-19
2019-07-24
ACUSHNET HOLDINGS CORP
P
2019-09-04
2019-11-11
ACUSHNET HOLDINGS CORP
P
2019-09-05
2019-11-11
APPLE INC
P
2019-09-04
2019-11-11
APPLE INC
P
2019-09-05
2019-11-11
DANAHER CORPORATION
P
2019-09-04
2019-11-11
DEERE & CO
P
2019-09-04
2019-11-11
ENEL AMERICAS S A SPONSORED AD
P
2019-06-27
2019-11-11
ENEL AMERICAS S A SPONSORED AD
P
2019-09-04
2019-11-11
MEDTRONIC PLC SHS
P
2019-09-04
2019-11-11
MEDTRONIC PLC SHS
P
2019-09-13
2019-11-11
PATTERN ENERGY GROUP ONC CL A
P
2019-09-04
2019-11-11
DANAHER CORPORATION
P
2018-10-19
2019-11-11
ENEL AMERICAS S A SPONSORED AD
P
2018-10-19
2019-11-11
LINCOLN NTL CORP IND
P
2018-10-19
2019-11-11
TESLA INC
P
2018-10-19
2019-11-11
PRUDENTIAL PLC ADR
P
2019-09-04
2019-11-08
PRUDENTIAL PLC ADR
P
2018-10-19
2019-11-08
CAPITAL GAINS DIVIDENDS
P
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
637
636
1
b
175
145
30
c
136
100
36
d
273
192
81
e
273
199
74
171
150
21
1,365
756
609
25
27
-2
157
132
25
287
159
128
9,795
9,995
-200
255
159
96
174
92
82
796
778
18
1,263
1,386
-123
2,182
2,138
44
67
73
-6
44
48
-4
191
169
22
532
447
85
72
54
18
74
57
17
121
44
77
281
114
167
709
709
485
485
12
12
0
8
8
0
809
833
-24
294
265
29
147
133
14
1,470
741
729
9,790
10,033
-243
13
2,879
-2,866
3
641
-638
2
197
-195
5
499
-494
112
150
-38
222
299
-77
170
224
-54
90
98
-8
720
690
30
292
185
107
341
114
227
1,234
700
534
1,153
1,218
-65
46
45
1
383
277
106
213
164
49
319
600
-281
159
256
-97
1,234
630
604
260
159
101
137
125
12
137
151
-14
110
127
-17
3,237
3,324
-87
575
401
174
398
292
106
177
130
47
11,781
11,847
-66
283
131
152
328
194
134
1,115
1,195
-80
467
435
32
329
196
133
253
145
108
595
634
-39
276
89
187
1,552
1,722
-170
272
192
80
252
664
-412
314
721
-407
828
557
271
92
62
30
26,856
26,159
697
383
169
214
367
299
68
560
614
-54
238
159
79
834
828
6
7
9
-2
217
160
57
237
213
24
228
111
117
196
113
83
275
253
22
428
370
58
53
39
14
161
128
33
233
271
-38
58
63
-5
210
181
29
319
264
55
254
237
17
283
241
42
234
161
73
370
512
-142
241
152
89
234
152
82
261
228
33
338
105
233
1,370
1,284
86
2,192
1,844
348
1,685
1,660
25
335
217
118
257
172
85
331
114
217
3,671
3,772
-101
4,140
3,536
604
2,954
2,959
-5
566
238
328
564
442
122
626
177
449
32
32
0
178
160
18
1,360
1,317
43
1,072
1,282
-210
1,339
1,636
-297
959
1,355
-396
262
203
59
87
85
2
443
393
50
819
1,295
-476
270
200
70
187
155
32
227
218
9
1,587
1,288
299
1,485
1,382
103
1,427
1,307
120
1,334
1,294
40
337
253
84
1,147
1,303
-156
803
746
57
296
275
21
1,308
1,307
1
2,580
2,655
-75
1,593
1,284
309
205
263
-58
162
142
20
160
127
33
88
76
12
88
76
12
2
2
211
159
52
241
168
73
1,480
1,301
179
164
138
26
582
491
91
31
26
5
1,046
836
210
261
212
49
1,076
1,117
-41
180
151
29
10
9
1
1,252
1,055
197
216
214
2
108
110
-2
330
323
7
1,480
1,117
363
1,512
1,217
295
722
770
-48
347
263
84
125
112
13
165
167
-2
4,586
4,586
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
1
b
30
c
36
d
81
e
74
21
609
-2
25
128
-200
96
82
18
-123
44
-6
-4
22
85
18
17
77
167
709
485
0
0
-24
29
14
729
-243
-2,866
-638
-195
-494
-38
-77
-54
-8
30
107
227
534
-65
1
106
49
-281
-97
604
101
12
-14
-17
-87
174
106
47
-66
152
134
-80
32
133
108
-39
187
-170
80
-412
-407
271
30
697
214
68
-54
79
6
-2
57
24
117
83
22
58
14
33
-38
-5
29
55
17
42
73
-142
89
82
33
233
86
348
25
118
85
217
-101
604
-5
328
122
449
0
18
43
-210
-297
-396
59
2
50
-476
70
32
9
299
103
120
40
84
-156
57
21
1
-75
309
-58
20
33
12
12
2
52
73
179
26
91
5
210
49
-41
29
1
197
2
-2
7
363
295
-48
84
13
-2
4,586
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
10,172
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
2017
2016
2015
2014
2
Total
of line 1, column (d)
.....................
2
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
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
5
Multiply line 4 by line 3
......................
5
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
7
Add lines 5 and 6
........................
7
8
Enter qualifying distributions from Part XII, line 4
,.............
8
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
482
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
482
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
482
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
1,762
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
1,762
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
0
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
1,280
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
1,280
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)
HI
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
WWW.HAWAIIHEPTACHLOR.WORDPRESS.COM
14
The books are in care of
RICK SCUDDER ADMINISTRATOR
Telephone no.
(808) 842-3429
Located at
PO BOX 3735
HONOLULU
HI
ZIP+4
96812
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
2018
,
2017
,
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
Yes
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
ART MORI PHD
PRESIDENT
2.00
0
0
0
C/O RICK SCUDDER ADMIN PO BOX 3735
HONOLULU
,
HI
96812
THALIA MAA LAPILIO
SECRETARY
0.25
0
0
0
C/O RICK SCUDDER ADMIN PO BOX 3735
HONOLULU
,
HI
96812
DAVID G WATUMULL JR
TREASURER
0.25
0
0
0
C/O RICK SCUDDER ADMIN PO BOX 3735
HONOLULU
,
HI
96812
JO ELLEN YOUNGS
DIRECTOR
0.25
0
0
0
C/O RICK SCUDDER ADMIN PO BOX 3735
HONOLULU
,
HI
96812
STEVEN L MONTGOMERY PHD
VICE PRESIDENT
0.25
0
0
0
C/O RICK SCUDDER ADMIN PO BOX 3735
HONOLULU
,
HI
96812
HELENE TAKEMOTO
DIRECTOR
0.25
0
0
0
C/O RICK SCUDDER ADMIN PO BOX 3735
HONOLULU
,
HI
96812
HAZEL CUNNINGHAM MPH
DIRECTOR
0.25
0
0
0
C/O RICK SCUDDER ADMIN PO BOX 3735
HONOLULU
,
HI
96812
RICHARD SCUDDER
ADMINISTRATOR
11.00
18,094
0
0
C/O RICK SCUDDER ADMIN PO BOX 3735
HONOLULU
,
HI
96812
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
THE YEAR 2019 FOCUSED ON MONITORING HEALTH EFFECTS INFORMATION AND SUPPORTING A NEW EDUCATIONAL GRANT. THE FOUNDATION ALSO MAINTAINS A WEBSITE AT WWW.HAWAIIHEPTACHLOR.WORDPRESS.COM. THE WEBSITE WAS UPDATED DURING 2019. THE CONTRACTED ADMINISTRATOR DOES THIS WORK.
27,050
2
THE FOUNDATION BOARD MADE NO MAJOR RESEARCH GRANTS DURING 2019. THE BOARD IS CONSIDERING WHAT FOLLOWUP STUDIES MIGHT BE SUPPORTED UTILIZING THE AVAILABLE HEALTH STATISTICS AND RELATED HEPTACHLOR RESEARCHERS. THE ADMINISTRATOR MONITORS ANY RELATED RESEARCH ON HEPTACHLOR CONTAMINATION AND POSSIBLE HEALTH EFFECTS. ONE EXAMPLE IS IF THERE IS A POSSIBLE RELATIONSHIP HEPTACHLOR EXPOSURE AND CANCER. HE MAINTAINS CONTACT WITH THE CHAIRMAN, DR. DONALD MATTISSON, AND MEMBERS OF THE SCIENTIFIC ADVISORY COUNCIL.
11,593
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
NONE
0
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
768,758
b
Average of monthly cash balances
.......................
1b
17,105
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
785,863
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
785,863
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
11,788
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
774,075
6
Minimum investment return.
Enter 5% of line 5
..................
6
38,704
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
38,704
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
482
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
482
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
38,222
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
38,222
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
38,222
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
38,641
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
38,641
5
Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
income. Enter 1% of Part I, line 27b. See instructions
.................
5
0
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
38,641
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
38,222
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
40,219
b
Total for prior years:
2017
,
20
,
20
13,165
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:
$
38,641
a
Applied to 2018, but not more than line 2a
25,476
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
13,165
c
Treated as distributions out of corpus (Election
required—see instructions)
........
0
d
Applied to 2019 distributable amount
.....
0
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
.............
14,743
f
Undistributed income for 2019. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2020
..........
38,222
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 e-mail address of the person to whom applications should be addressed:
ART MORI PHDPRESIDENT
C/O HHREF PO BOX 3735
HONOLULU
,
HI
96812
(808) 842-3429
WWW.ADMINHHREF@HAWAII.RR.COM
b
The form in which applications should be submitted and information and materials they should include:
THE HAWAII HEPTACHLOR RESEARCH & EDUCATION FOUNDATION REQUESTS LETTERS OF INTENT FROM POTENTIAL RESEARCHERS IN RESPONSE TO PUBLISHED REQUESTS FOR PROPOSALS. AFTER REVIEW OF ALL THE LETTERS OF INTENT BY THE SCIENTIFIC ADVISORY AND BOARD OF DIRECTORS, THE FOUNDATION REQUESTS FULL PROPOSALS FROM ONLY THOSE SELECTED.
c
Any submission deadlines:
DEADLINES ARE SET IN THE REQUEST FOR PROPOSALS.
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
RESEARCHERS HAVE TO COMPLY WITH THE FOUNDATION'S POLICIES ON RESEARCH AND CLINICAL INVESTIGATIONS. THE FOUNDATION MUST COMPLY WITH THE STATED INTENT OF THE COURT ORDERS REGARDING THE HEPTACHLOR CONTAMINATION LAWSUITS AND HAS A COURT REVIEW OF ITS PROGRAMS AND BUDGET.
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
Total
.................................
3a
0
b
Approved for future payment
Total
.................................
3b
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
12
Part XVI-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
Unrelated business income
Excluded by section 512, 513, or 514
(e)
Related or exempt
function income
(See instructions.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
14
17
4
Dividends and interest from securities
....
14
18,675
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
.....
01
996
8
Gain or (loss) from sales of assets other than
inventory
............
18
10,172
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
29,860
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
29,860
(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