-
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
THE WILLIAM AND ELAINE KAPLAN FAMILY
PRIVATE FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)
CO PKFOD LLP 32 FOSTERTOWN RD
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
NEWBURGH
,
NY
125501279
A Employer identification number
22-2470361
B
Telephone number (see instructions)
(845) 565-5400
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)
$
60,397,758
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
14,842
14,842
4
Dividends and interest from securities
...
1,038,474
1,083,583
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
1,633,602
b
Gross sales price for all assets on line 6a
14,005,893
7
Capital gain net income (from Part IV, line 2)
...
2,626,096
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)
.......
2,499
327
12
Total.
Add lines 1 through 11
........
2,689,417
3,724,848
13
Compensation of officers, directors, trustees, etc.
60,000
0
60,000
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
48,266
0
48,266
b
Accounting fees (attach schedule)
.......
36,000
0
36,000
c
Other professional fees (attach schedule)
....
166,810
129,810
37,000
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
159,526
0
0
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
50,800
0
50,800
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
18,337
22,557
18,127
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
539,739
152,367
250,193
25
Contributions, gifts, grants paid
.......
2,481,022
2,481,022
26
Total expenses and disbursements.
Add lines 24 and 25
3,020,761
152,367
2,731,215
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-331,344
b
Net investment income
(if negative, enter -0-)
3,572,481
c
Adjusted net income
(if negative, enter -0-)
...
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2019)
Form 990-PF (2019)
Page
2
Part II
Balance Sheets
Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year
End of year
(a)
Book Value
(b)
Book Value
(c)
Fair Market Value
1
Cash—non-interest-bearing
.............
60,374
71,657
71,657
2
Savings and temporary cash investments
.........
583,227
858,441
858,441
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)
2,696,701
0
0
b
Investments—corporate stock (attach schedule)
.......
458,448
882,630
1,002,499
c
Investments—corporate bonds (attach schedule)
.......
5,926,490
8,637,650
8,812,426
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
41,641,783
40,585,301
49,652,735
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)
51,367,023
51,035,679
60,397,758
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
...........
51,367,023
51,035,679
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)
.....
51,367,023
51,035,679
30
Total liabilities and net assets/fund balances
(see instructions)
.
51,367,023
51,035,679
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
51,367,023
2
Enter amount from Part I, line 27a
.....................
2
-331,344
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
51,035,679
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
51,035,679
Form
990-PF
(2019)
Form 990-PF (2019)
Page
3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a)
List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)
(b)
How acquired
P—Purchase
D—Donation
(c)
Date acquired
(mo., day, yr.)
(d)
Date sold
(mo., day, yr.)
1 a
PUBLICLY TRADED SECURITIES
b
GOLDENTREEE OFFSHORE LTD.
P
c
LOCUST WOOD CAPITAL OFFSHORE, LTD.
P
d
AESSF III PRIVATE INVESTORS OFFSHORE, L.P.
P
e
AIF VIII PRIVATE INVESTORS OFFSHORE, L.P.
P
BCP VI PRIVATE INVESTORS OFFSHORE, LP
P
BLACKSTONE GSO PRIVATE INVESTORS, L.P. (OFFSHORE)
P
BSREP II (BROOKFIELD) PRIVATE INVESTORS OFFSHORE, L.P.
P
CCMP III PRIVATE INVESTORS OFFSHORE, L.P.
P
CERBERUS VI PRIVATE INVESTORS OFFSHORE, L.P.
P
COATUE EARLY STAGE FUND PRIVATE INVESTORS (CAYMAN), L.P.
P
GIF V PRIVATE INVESTORS OFFSHORE LP
P
GSO PRIVATE INVESTORS OFFSHORE III
P
HIGHBRIDGE MEZZANINE PARTNERS, L.P. (OFFSHORE)
P
HPS MEZZANINE PRIVATE INVESTORS OFFSHORE II L.P.
P
HPS MEZZANINE PRIVATE INVESTORS OFFSHORE 2019 L.P.
P
KKR ASIAN FUND PRIVATE INVESTORS OFFSHORE L.P.
P
KKR ASIAN FUND II PRIVATE INVESTORS OFFSHORE, L.P.
P
LC ASIA 3 PRIVATE INVESTORS OFFSHORE
P
LION CAPITAL II PRIVATE INVESTORS OFFSHORE, L.P.
P
PEG DIGITAL GROWTH FUND OFFSHORE SPECIAL II LP
P
PEG DIGITAL GROWTH FUND OFFSHORE LP
P
PROVIDENCE VIII PRIVATE INVESTORS OFFSHORE, L.P.
P
PROVIDENCE VII PRIVATE INVESTORS, LP (OFFSHORE)
P
RIVERSTONE GLOBAL ENERGY AND POWER OFFSHORE IV, LP
P
RIVERSTONE GLOBAL ENERGY AND POWER PRIVATE INVESTORS V, LP (OFFSHORE)
P
SLA PRIVATE INVESTORS OFFSHORE
P
STARWOOD SOF XI PRIVATE INVESTORS OFFSHORE 2, L.P.
P
THRU SCHEDULE K-1'S
P
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
11,908,570
10,191,782
1,716,788
b
979,768
437,275
542,493
c
1,092,544
950,000
142,544
d
-1,257
e
-2,641
-11,439
1,319
-2,983
-723
-1,924
-17,046
175,740
-2,464
24,722
44,052
-16,714
14,119
-8,919
4,520
-806
-13,072
1,046
-17,892
-682
1,308
-22,496
376
-1,850
54,966
25,011
25,011
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
1,716,788
b
542,493
c
142,544
d
-1,257
e
-2,641
-11,439
1,319
-2,983
-723
-1,924
-17,046
175,740
-2,464
24,722
44,052
-16,714
14,119
-8,919
4,520
-806
-13,072
1,046
-17,892
-682
1,308
-22,496
376
-1,850
54,966
25,011
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
2,626,096
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
2,939,449
59,870,956
0.049096
2017
3,966,349
59,130,718
0.067078
2016
4,199,913
55,079,115
0.076252
2015
2,994,876
34,500,782
0.086806
2014
4,309,757
61,287,117
0.070321
2
Total
of line 1, column (d)
.....................
2
0.349553
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
0.069911
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
59,089,298
5
Multiply line 4 by line 3
......................
5
4,130,992
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
35,725
7
Add lines 5 and 6
........................
7
4,166,717
8
Enter qualifying distributions from Part XII, line 4
,.............
8
2,731,215
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
71,450
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
71,450
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
71,450
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
75,000
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
60,000
d
Backup withholding erroneously withheld
...........
6d
0
7
Total credits and payments. Add lines 6a through 6d
..............
7
135,000
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
1,273
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
62,277
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
62,277
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)
NY
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 MARKS TREASURER
Telephone no.
(845) 565-5400
Located at
C/O PKFOD LLP 32 FOSTERTOWN RD
NEWBURGH
NY
ZIP+4
125501279
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
WILLIAM KAPLAN
DIRECTOR, CHAIRMAN
1.00
0
0
0
C/O PKFOD LLP 32 FOSTERTOWN RD
NEWBURGH
,
NY
125501279
JOAN P KAPLAN
DIRECTOR, PRESIDENT
8.00
60,000
0
0
C/O PKFOD LLP 32 FOSTERTOWN RD
NEWBURGH
,
NY
125501279
AMY KAPLAN
DIRECTOR, VICE PRESIDENT
1.00
0
0
0
C/O PKFOD LLP 32 FOSTERTOWN RD
NEWBURGH
,
NY
125501279
DAVID MARKS
DIRECTOR, TREASURER
1.00
0
0
0
C/O PKFOD LLP 32 FOSTERTOWN RD
NEWBURGH
,
NY
125501279
RICHARD J DRAKE ESQ
DIRECTOR, SECRETARY
1.00
0
0
0
C/O PKFOD LLP 32 FOSTERTOWN RD
NEWBURGH
,
NY
125501279
DR HAROLD KAPLAN
DIRECTOR
1.00
0
0
0
C/O PKFOD LLP 32 FOSTERTOWN RD
NEWBURGH
,
NY
125501279
A VINCENT MAZZIE
DIRECTOR
1.00
0
0
0
C/O PKFOD LLP 32 FOSTERTOWN RD
NEWBURGH
,
NY
125501279
JAMES O'DONNELL
DIRECTOR
1.00
0
0
0
C/O PKFOD LLP 32 FOSTERTOWN RD
NEWBURGH
,
NY
125501279
SISTER ANN SAKAC
DIRECTOR
1.00
0
0
0
C/O PKFOD LLP 32 FOSTERTOWN RD
NEWBURGH
,
NY
125501279
GLEN L HELLER ESQ
ASSISTANT SECRETARY
1.00
0
0
0
C/O PKFOD LLP 32 FOSTERTOWN RD
NEWBURGH
,
NY
125501279
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
JPMORGAN CHASE
INVESTMENT ADVISORY
129,810
1111 POLARIS PARKWAY
COLUMBUS
,
OH
43240
Total
number of others receiving over $50,000 for professional services
.............
0
Part IX-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
2
3
4
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
8
Part X
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations, see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities
...................
1a
59,183,252
b
Average of monthly cash balances
.......................
1b
805,883
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
59,989,135
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
59,989,135
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
899,837
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
59,089,298
6
Minimum investment return.
Enter 5% of line 5
..................
6
2,954,465
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
2,954,465
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
71,450
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
71,450
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
2,883,015
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
2,883,015
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
2,883,015
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
2,731,215
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
2,731,215
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
2,731,215
Note:
The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
the section 4940(e) reduction of tax in those years.
Form
990-PF
(2019)
Form 990-PF (2019)
Page
9
Part XIII
Undistributed Income
(see instructions)
(a)
Corpus
(b)
Years prior to 2018
(c)
2018
(d)
2019
1
Distributable amount for 2019 from Part XI, line 7
2,883,015
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
0
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
1,459,246
b
From 2015
......
c
From 2016
......
1,476,497
d
From 2017
......
1,056,258
e
From 2018
......
63,018
f
Total
of lines 3a through e
........
4,055,019
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
2,731,215
a
Applied to 2018, but not more than line 2a
0
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
0
c
Treated as distributions out of corpus (Election
required—see instructions)
........
0
d
Applied to 2019 distributable amount
.....
2,731,215
e
Remaining amount distributed out of corpus
0
5
Excess distributions carryover applied to 2019.
151,800
151,800
(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
3,903,219
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
0
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
0
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
0
e
Undistributed income for 2018. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
0
f
Undistributed income for 2019. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2020
..........
0
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)
...
1,307,446
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
2,595,773
10
Analysis of line 9:
a
Excess from 2015
....
b
Excess from 2016
....
1,476,497
c
Excess from 2017
....
1,056,258
d
Excess from 2018
....
63,018
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
ACCESS SUPPORTS FOR LIVING FOUNDATION
15 FORTUNE ROAD WEST
MIDDLETOWN
,
NY
10941
N/A
PC
OPERATING SUPPORT
11,000
BEST BAPTIST TEMPLE CHURCH
7 WILLIAM STREET
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
650
BETHEL WOODS CENTER FOR THE ARTS
200 HURD ROAD
BETHEL
,
NY
12720
N/A
PC
OPERATING SUPPORT
7,010
BOYS AND GIRLS CLUB NEWBURGH
285 LIBERTY STREET
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
200
CARE DIMENSIONS
75 SYLVAN STREET SUITE B-102
DANVERS
,
MA
01923
N/A
PC
OPERATING SUPPORT
50,000
CATHOLIC CHARITIES COMMUNITY SERVICES
280 BROADWAY
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
220
CENTER FOR PREVENTION CHILD ABUSE
35 VAN WAGNER ROAD
POUGHKEEPSIE
,
NY
12603
N/A
PC
OPERATING SUPPORT
2,500
COLUMBIA UNIVERSITY
213 LOW LIBRARY 535 WEST 116TH
STREET
NEW YORK
,
NY
10027
N/A
PC
OPERATING SUPPORT
5,000
COMMUNITY FOUNDATION OF ORANGE & SULLIVAN
30 SCOTTS CORNERS DRIVE SUITE 203
MONTGOMERY
,
NY
12549
N/A
PC
OPERATING SUPPORT
21,000
CONGREGATION AGUDAS ISRAEL
290 NORTH STREET
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
75,000
CORNERSTONE FAMILY HEALTHCARE
147 LAKE STREET
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
110,000
EDUCATION FOUNDATION OF OCCC
115 SOUTH STREET
MIDDLETOWN
,
NY
10940
N/A
PC
OPERATING SUPPORT
500,000
FIRST REFORMED CHURCH OF FISHKILL
1153 MAIN STREET
FISHKILL
,
NY
12524
N/A
PC
OPERATING SUPPORT
550
FOOD BANK OF THE HUDSON VALLEY
195 HUDSON STREET
CORNWALLONHUDSON
,
NY
12520
N/A
PC
OPERATING SUPPORT
6,500
FOR BETTER LIVES WORLDWIDE INC
PO BOX 9
WASHINGTONVILLE
,
NY
10992
N/A
PC
OPERATING SUPPORT
1,000
FOUNDATION FOR NEUROLOGIC DISEASES
10 STATE STREET
NEWBURYPORT
,
MA
01950
N/A
PC
OPERATING SUPPORT
200,000
GARRISON ART CENTER
23 GARRISONS LANDING
GARRISON
,
NY
10524
N/A
PC
OPERATING SUPPORT
550
GREATER NEWBURGH SYMPHONY ORCHESTRA
211 DUPONT AVENUE
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
14,500
GUIDING EYES FOR THE BLIND
611 GRANITE SPRINGS ROAD
YORKTOWN HEIGHTS
,
NY
10598
N/A
PC
OPERATING SUPPORT
3,500
HOSPICE OF ORANGE & SULLIVAN COUNTIES
800 STONY BROOK COURT
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
74,435
HUDSON HIGHLANDS NATURE MUSEUM
120 MUSER DRIVE
CORNWALL
,
NY
12518
N/A
PC
OPERATING SUPPORT
1,000
INSPIRE FOUNDATION
2 FLETCHER STREET
GOSHEN
,
NY
10924
N/A
PC
OPERATING SUPPORT
2,850
JEWISH FAMILY SERVICE OF ORANGE COUNTY
720 ROUTE 17M
MIDDLETOWN
,
NY
10940
N/A
PC
OPERATING SUPPORT
500
JUVENILE DIABETES RESEARCH FOUNDATION
200 VESEY STREET 28TH FLOOR
NEW YORK
,
NY
10281
N/A
PC
OPERATING SUPPORT
10,300
KOL YISRAEL
429 MIDDLE NECK ROAD
GREAT NECK
,
NY
11023
N/A
PC
OPERATING SUPPORT
369,000
LATINOS UNIDOS OF THE HUDSON VALLEY INC
PO BOX 3281
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
400
LIBERTY SCIENCE CENTER
222 JERSEY CITY BOULEVARD
JERSEY CITY
,
NJ
07305
N/A
PC
OPERATING SUPPORT
2,500
MEALS ON WHEELS OF GREATER NEWBURGH
35 CERONE PLACE
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
1,500
METROPOLITAN MUSEUM OF ART
1000 5TH AVENUE
NEW YORK
,
NY
10028
N/A
PC
OPERATING SUPPORT
600
MOUNT SAINT MARY COLLEGE
330 POWELL AVENUE
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
561,600
NATIONAL PURPLE HEART HALL OF HONOR
374 TEMPLE HILL ROAD
NEW WINDSOR
,
NY
12553
N/A
PC
OPERATING SUPPORT
500
NEW MILFORD HIGH SCHOOL ATHLETICS
388 DANBURY ROAD
NEW MILFORD
,
CT
06776
N/A
PC
OPERATING SUPPORT
1,000
NEWBURGH ARMORY UNITY CENTER
321 SOUTH WILLIAM STREET
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
221,000
NEWBURGH FIREFIGHTER BENEVOLENT ASSOCIATION
PO BOX 1513
NEWBURGH
,
NY
12551
N/A
PC
OPERATING SUPPORT
2,500
NEWBURGH JEWISH COMMUNITY CENTER
290 NORTH STREET
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
3,550
NEWBURGH URBAN FARM & FOOD INC
PO BOX 541
NEWBURGH
,
NY
12551
N/A
PC
OPERATING SUPPORT
500
NEWBURGH ZION LIONS
180 SOUTH STREET
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
7,500
ORANGE COUNTY ARTS COUNCIL
23 WHITE OAK DRIVE
CHESTER
,
NY
10918
N/A
PC
OPERATING SUPPORT
42,500
ORANGE COUNTY CITIZENS FOUNDATION INC
23 WHITE OAK DRIVE
CHESTER
,
NY
10918
N/A
PC
OPERATING SUPPORT
19,500
ORANGE COUNTY COMMUNITY COLLEGE
ONE WASHINGTON CENTER
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
9,059
SACRED HEART-SAINT FRANCIS
301 ANN STREET
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
2,000
SAFE HARBORS OF THE HUDSON
111 BROADWAY
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
5,000
SCENIC HUDSON
ONE CIVIC CENTER PLAZA SUITE 200
POUGHKEEPSIE
,
NY
12601
N/A
PC
OPERATING SUPPORT
5,000
ST JUDE'S CHILDREN'S RESEARCH HOSPITAL
501 ST JUDE PLACE
MEMPHIS
,
TN
38105
N/A
PC
OPERATING SUPPORT
10,000
ST LUKE'S CORNWALL HOSPITAL
70 DUBOIS STREET
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
25,500
ST NICHOLAS GREEK ORTHODOX CHURCH
19 FULLERTON AVENUE
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
2,800
ST PATRICK'S MID-HUDSON PARADE COMMITTEE INC
PO BOX 45
CHESTER
,
NY
10918
N/A
PC
OPERATING SUPPORT
1,000
STORM KING ART CENTER
1 MUSEUM ROAD
NEW WINDSOR
,
NY
12553
N/A
PC
OPERATING SUPPORT
7,500
STORM KING SCHOOL
314 MOUNTAIN ROAD
CORNWALLONHUDSON
,
NY
12520
N/A
PC
OPERATING SUPPORT
10,000
SUNY ORANGE FOUNDATION
ONE WASHINGTON CENTER
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
30,400
TEMPLE BETH JACOB
290 NORTH STREET
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
800
THE ARC OF SULLIVAN-ORANGE COUNTIES
249 BROADWAY
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
250
THE JIMMY FUND
PO BOX 3595
BOSTON
,
MA
02241
N/A
PC
OPERATING SUPPORT
18,000
TOWN OF NEWBURGH EMS
97 SOUTH PLANK ROAD
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
1,000
TROUT UNLIMITED
99 MERCER STREET SUITE 1
JERSEY CITY
,
NJ
07302
N/A
PC
OPERATING SUPPORT
1,000
TUSKEGEE AIRMEN INC MAJOR GENERAL IRIENE TROWELL-HARRIS CHAPTER
1032 FIRST STREET BUILDING 112
SUITE 118
NEW WINDSOR
,
NY
12553
N/A
PC
OPERATING SUPPORT
1,300
UNITED WAY OF THE DUTCHESS-ORANGE REGION
75 MARKET STREET
POUGHKEEPSIE
,
NY
12601
N/A
PC
OPERATING SUPPORT
270
WALKWAY OVER THE HUDSON
87 HAVILAND ROAD
HIGHLAND
,
NY
12528
N/A
PC
OPERATING SUPPORT
2,500
WENDY WALK FJC
11400 WEST OLYMPIC BOULEVARD SUITE
600
LOS ANGELES
,
CA
90064
N/A
PC
OPERATING SUPPORT
10,000
WOODSTOCK FARM SANCTURY
2 RESCUE ROAD
HIGH FALLS
,
NY
12440
N/A
PC
OPERATING SUPPORT
5,228
Total
.................................
3a
2,481,022
b
Approved for future payment
ACCESS SUPPORTS FOR LIVING FOUNDATION
15 FORTUNE ROAD WEST
MIDDLETOWN
,
NY
10941
N/A
PC
OPERATING SUPPORT
800,000
CARE DIMENSIONS
75 SYLVAN STREET SUITE B-102
DANVERS
,
MA
01923
N/A
PC
OPERATING SUPPORT
250,000
CORNERSTONE FAMILY HEALTHCARE
147 LAKE STREET
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
100,000
FOUNDATION FOR NEUROLOGICAL DISEASES
10 STATE STREET
NEWBURYPORT
,
MA
01950
N/A
PC
OPERATING SUPPORT
1,800,000
KOL YISRAEL
429 MIDDLE NECK ROAD
GREAT NECK
,
NY
11023
N/A
PC
OPERATING SUPPORT
2,050,000
MSMC - DOMINICAN CENTER
330 POWELL AVENUE
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
2,500,000
MSMC MATH SCI & TECH CTR
330 POWELL AVENUE
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
2,700,000
NATIONAL PURPLE HEART HALL OF HONOR
374 TEMPLE HILL ROAD
NEW WINDSOR
,
NY
12553
N/A
PC
OPERATING SUPPORT
150,000
NEWBURGH ARMORY UNITY CENTER
321 SOUTH WILLIAM STREET
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
75,000
ORANGE COUNTY COMMUNITY COLLEGE - NEWBURGH CAMPUS
ONE WASHINGTON CENTER
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
4,500,000
SUNY ORANGE FOUNDATION
ONE WASHINGTON CENTER
NEWBURGH
,
NY
12550
N/A
PC
OPERATING SUPPORT
30,000
Total
.................................
3b
14,955,000
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
14,842
4
Dividends and interest from securities
....
14
1,038,474
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not debt-financed property
.....
6
Net rental income or (loss) from personal property
7
Other investment income
.....
8
Gain or (loss) from sales of assets other than
inventory
............
18
1,633,602
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
MISCELLANEOUS INCOME
01
2,499
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
0
2,689,417
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
2,689,417
(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