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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
08-01-2019
, and ending
07-31-2020
Name of foundation
LATANE FELICITE B ENDOWMENT FD
Number and street (or P.O. box number if mail is not delivered to street address)
PO BOX 1908
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
ORLANDO
,
FL
328021908
A Employer identification number
56-6544480
B
Telephone number (see instructions)
(919) 918-2442
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)
$
516,562
J
Accounting method:
Cash
Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)
Part I
Analysis of Revenue and Expenses
(The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).)
(a)
Revenue and
expenses per
books
(b)
Net investment
income
(c)
Adjusted net
income
(d)
Disbursements
for charitable
purposes
(cash basis only)
1
Contributions, gifts, grants, etc., received (attach schedule)
2
Check
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
9,640
9,630
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
-1,300
b
Gross sales price for all assets on line 6a
306,266
7
Capital gain net income (from Part IV, line 2)
...
0
8
Net short-term capital gain
.........
0
9
Income modifications
...........
10a
Gross sales less returns and allowances
b
Less: Cost of goods sold
....
c
Gross profit or (loss) (attach schedule)
.....
11
Other income (attach schedule)
.......
12
Total.
Add lines 1 through 11
........
8,340
9,630
13
Compensation of officers, directors, trustees, etc.
8,638
4,319
4,319
14
Other employee salaries and wages
......
0
0
0
15
Pension plans, employee benefits
.......
0
0
16a
Legal fees (attach schedule)
.........
0
b
Accounting fees (attach schedule)
.......
2,500
0
0
2,500
c
Other professional fees (attach schedule)
....
0
17
Interest
...............
0
18
Taxes (attach schedule) (see instructions)
...
177
177
0
19
Depreciation (attach schedule) and depletion
...
0
0
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
0
0
22
Printing and publications
..........
0
0
23
Other expenses (attach schedule)
.......
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
11,315
4,496
0
6,819
25
Contributions, gifts, grants paid
.......
31,009
31,009
26
Total expenses and disbursements.
Add lines 24 and 25
42,324
4,496
0
37,828
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-33,984
b
Net investment income
(if negative, enter -0-)
5,134
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
.............
2
Savings and temporary cash investments
.........
26,460
31,241
31,241
3
Accounts receivable
Less: allowance for doubtful accounts
0
0
4
Pledges receivable
Less: allowance for doubtful accounts
5
Grants receivable
.................
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)
.....
7
Other notes and loans receivable (attach schedule)
Less: allowance for doubtful accounts
0
8
Inventories for sale or use
..............
9
Prepaid expenses and deferred charges
..........
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
.......
92,963
131,775
232,977
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)
..........
291,518
214,017
252,344
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)
410,941
377,033
516,562
17
Accounts payable and accrued expenses
..........
18
Grants payable
.................
19
Deferred revenue
.................
20
Loans from officers, directors, trustees, and other disqualified persons
21
Mortgages and other notes payable (attach schedule)
......
22
Other liabilities (describe
)
23
Total liabilities
(add lines 17 through 22)
.........
0
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
25
Net assets with donor restrictions
............
Foundations that do not follow FASB ASC 958, check here
and complete lines 26 through 30.
26
Capital stock, trust principal, or current funds
........
410,941
377,033
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)
.....
410,941
377,033
30
Total liabilities and net assets/fund balances
(see instructions)
.
410,941
377,033
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
410,941
2
Enter amount from Part I, line 27a
.....................
2
-33,984
3
Other increases not included in line 2 (itemize)
3
348
4
Add lines 1, 2, and 3
..........................
4
377,305
5
Decreases not included in line 2 (itemize)
5
272
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
377,033
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
53.84 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2018-08-28
2019-08-05
b
322.73 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2017-12-04
2019-08-08
c
322.74 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2018-08-28
2019-08-08
d
7.259 CAMBIAR INTL EQUITY FUND-INS
2016-07-20
2019-08-19
e
1. ALPHABET INC CL A
2009-02-23
2019-08-19
119.537 DOUBLELINE TOTL RET BND-I
2012-08-06
2019-08-19
4. HOME DEPOT INC
2009-02-23
2019-08-19
128. ISHARES US TREASURY BOND ETF
2015-02-23
2019-08-19
202. ISHARES MSCI JAPAN ETF
2018-02-05
2019-08-19
18.514 NEUBERGER BERMAN HIGH INCM BD-INS
2019-03-13
2019-08-19
233.395 PIMCO INVESTMENT GRD CORP-IN
2015-02-23
2019-08-19
213.736 VAN ECK EMERGING MARKETS-I
2015-06-15
2019-08-19
14.366 VANGUARD M/B SEC INDEX-ADM
2014-10-27
2019-08-19
39. FLOWSERVE CORP
2011-02-22
2019-09-05
53.37 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2017-12-06
2019-09-05
53.37 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2018-08-28
2019-09-05
82. PFIZER INC
2011-08-30
2019-09-05
13. SNAP-ON INC
2017-09-22
2019-09-05
248.81 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2017-12-07
2019-09-10
320.25 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2018-08-28
2019-09-10
1112.67 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2018-08-28
2019-09-11
64. INTEL CORP
2012-12-20
2019-09-13
8. VISA INC CL A
2011-02-23
2019-09-13
53.63 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2017-12-20
2019-10-03
53.63 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2018-12-06
2019-10-03
321.8 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2017-12-20
2019-10-08
321.8 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2018-12-06
2019-10-08
51.115 INVESCO DEVELOPING MARKETS FUND
2018-02-05
2019-10-17
1. ADOBE INC
2019-06-24
2019-10-17
57.165 CAMBIAR INTL EQUITY FUND-INS
2016-07-20
2019-10-17
74.974 JOHCM INTERNATIONAL SEL-I
2015-06-15
2019-10-17
4.461 JOHCM INTERNATIONAL SEL-I
2019-08-19
2019-10-17
2. ALLSTATE CORP
2019-08-19
2019-10-17
1. ALPHABET INC CL C
2009-02-23
2019-10-17
1. AMAZON.COM INC
2017-10-09
2019-10-17
1. AMGEN INC
2011-07-18
2019-10-17
1. APPLE INC
2019-08-19
2019-10-17
2. APPLIED MATERIALS INC
2019-09-13
2019-10-17
16. BANK OF AMERICA CORP
2019-08-19
2019-10-17
5. BANK OF AMERICA CORP
2013-06-05
2019-10-17
1. BERKSHIRE HATHAWAY INC-CL B
2018-11-06
2019-10-17
92.251 BLACKSTONE ALT MULTI-STRAT-I
2017-10-16
2019-10-17
1. BOEING CO
2019-04-04
2019-10-17
5. BOSTON SCIENTIFIC CORP
2019-08-19
2019-10-17
3. CAPITAL ONE FINANCIAL CORP
2018-03-20
2019-10-17
2. CARLISLE COS INC
2019-09-05
2019-10-17
4. CHEVRON CORP
2019-04-15
2019-10-17
15. CISCO SYSTEMS INC
2019-08-19
2019-10-17
7. CITIZENS FINANCIAL GROUP INC
2019-08-19
2019-10-17
1. CITIZENS FINANCIAL GROUP INC
2015-08-19
2019-10-17
3. COMCAST CORP-CL A
2019-08-19
2019-10-17
6. CORTEVA INC
2016-12-05
2019-10-17
2. COSTCO WHOLESALE CORP
2019-08-19
2019-10-17
1. CROWN CASTLE INTL CORP REIT
2019-08-19
2019-10-17
1. DIGITAL REALTY TRUST INC REIT
2016-06-17
2019-10-17
3. DISNEY WALT CO NEW
2019-08-19
2019-10-17
74.557 DOUBLELINE TOTL RET BND-I
2012-08-06
2019-10-17
3. DOW INC
2016-12-05
2019-10-17
2. DUPONT DE NEMOURS INC
2016-12-05
2019-10-17
33.393 EATON VANCE-ATLANTA SMID-R6
2019-10-17
1. ECOLAB INC
2012-03-06
2019-10-17
1. ELECTRONIC ARTS INC
2018-08-23
2019-10-17
1. FIDELITY NATL INFORMATION SVCS INC
2019-04-12
2019-10-17
2. HOME DEPOT INC
2009-02-23
2019-10-17
1. HONEYWELL INTERNATIONAL INC
2019-08-19
2019-10-17
1. INCYTE CORPORATION
2019-09-05
2019-10-17
1. INTUITIVE SURGICAL INC
2018-03-20
2019-10-17
32. ISHARES US TREASURY BOND ETF
2015-02-23
2019-10-17
2. JOHNSON & JOHNSON
2019-05-02
2019-10-17
1. MASTERCARD INC CL A
2019-09-13
2019-10-17
1. MCDONALDS CORP
2019-08-19
2019-10-17
2. MERCK & CO INC
2019-08-19
2019-10-17
6. MICROSOFT CORP
2019-08-19
2019-10-17
70.175 NEUBERGER BERMAN HIGH INCM BD-INS
2019-03-13
2019-10-17
1. NEXTERA ENERGY INC
2019-08-19
2019-10-17
3. NIKE INC-CLASS B
2019-08-19
2019-10-17
1. NOVARTIS AG SPONS ADR
2019-09-05
2019-10-17
1. NVIDIA CORP
2018-02-07
2019-10-17
26.327 NUVEEN SMALL CAP VALUE-I
2017-10-16
2019-10-17
3. PNC FINL SVCS GROUP INC
2019-08-19
2019-10-17
82.797 PIMCO INVESTMENT GRD CORP-IN
2015-02-23
2019-10-17
1. PROCTER & GAMBLE CO
2019-08-19
2019-10-17
1. RAYTHEON COMPANY
2019-08-19
2019-10-17
1. RAYTHEON COMPANY
2016-05-16
2019-10-17
1. SALESFORCE COM INC
2019-08-19
2019-10-17
3. SCHLUMBERGER LTD
2019-08-19
2019-10-17
7.766 T ROWE PR QM US S/C GR EQ-I
2019-08-19
2019-10-17
1. THERMO FISHER SCIENTIFIC INC
2019-08-19
2019-10-17
3. TRACTOR SUPPLY CO
2019-08-19
2019-10-17
2. UNION PAC CORP
2019-08-19
2019-10-17
1. UNITEDHEALTH GROUP INC
2019-08-19
2019-10-17
1. UNITEDHEALTH GROUP INC
2016-06-01
2019-10-17
44.053 VAN ECK EMERGING MARKETS-I
2015-06-15
2019-10-17
18.832 VANGUARD M/B SEC INDEX-ADM
2014-10-27
2019-10-17
2. VERIZON COMMUNICATIONS INC
2019-08-19
2019-10-17
1. VISA INC CL A
2011-02-23
2019-10-17
2. WALMART INC
2019-08-19
2019-10-17
1. XILINX INC
2019-05-02
2019-10-17
1. INGERSOLL-RAND PLC
2016-06-29
2019-10-17
1. INGERSOLL-RAND PLC
2019-08-19
2019-10-17
1. NOMAD FOODS LTD
2019-03-08
2019-10-17
27624.07 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2018-12-17
2019-10-18
3. COSTCO WHOLESALE CORP
2016-07-07
2019-10-29
7. DISNEY WALT CO NEW
2019-04-15
2019-10-29
4. ELECTRONIC ARTS INC
2019-03-29
2019-10-29
7. ELECTRONIC ARTS INC
2018-08-23
2019-10-29
51.02 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2019-10-21
2019-11-05
302.81 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2017-12-21
2019-11-08
306.12 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2019-10-21
2019-11-08
51.99 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2019-10-21
2019-12-04
311.95 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2017-12-21
2019-12-09
311.95 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2019-10-21
2019-12-09
23.8 INVESCO DEVELOPING MARKETS FUND
2018-02-05
2019-12-16
11.438 CAMBIAR INTL EQUITY FUND-INS
2016-07-20
2019-12-16
261.573 JOHCM INTERNATIONAL SEL-I
2015-06-15
2019-12-16
1. APPLE INC
2009-02-23
2019-12-16
3. APPLIED MATERIALS INC
2019-09-13
2019-12-16
2. BOSTON SCIENTIFIC CORP
2019-08-19
2019-12-16
2. BOSTON SCIENTIFIC CORP
2018-01-31
2019-12-16
1. CAPITAL ONE FINANCIAL CORP
2018-03-20
2019-12-16
3. CISCO SYSTEMS INC
2016-07-27
2019-12-16
386.504 DOUBLELINE TOTL RET BND-I
2012-08-06
2019-12-16
23.405 EATON VANCE-ATLANTA SMID-R6
2019-03-13
2019-12-16
56. ISHARES US TREASURY BOND ETF
2015-02-23
2019-12-16
2. MICROSOFT CORP
2012-01-30
2019-12-16
259.328 NEUBERGER BERMAN HIGH INCM BD-INS
2019-03-13
2019-12-16
1. PNC FINL SVCS GROUP INC
2011-07-18
2019-12-16
178.774 PIMCO INVESTMENT GRD CORP-IN
2015-02-23
2019-12-16
1. PIONEER NATURAL RESOURCES CO
2018-11-20
2019-12-16
2. SCHLUMBERGER LTD
2002-08-13
2019-12-16
1. SCHLUMBERGER LTD
2019-08-19
2019-12-16
10.983 VAN ECK EMERGING MARKETS-I
2015-06-15
2019-12-16
1. VISA INC CL A
2011-02-23
2019-12-16
8. NOMAD FOODS LTD
2019-03-08
2019-12-16
18231.92 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2019-10-21
2019-12-18
53.01 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2017-12-29
2020-01-06
53.01 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2019-12-17
2020-01-06
318.06 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2017-12-29
2020-01-09
318.06 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2019-12-17
2020-01-09
19. CISCO SYSTEMS INC
2016-07-27
2020-01-14
14.42 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2019-12-17
2020-01-16
4. BOEING CO
2020-01-28
6. BOEING CO
2018-12-04
2020-01-28
25.19 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2018-01-02
2020-02-05
52.79 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2019-12-17
2020-02-05
316.74 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2018-01-02
2020-02-10
316.74 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2019-12-17
2020-02-10
18.676 BLACKSTONE ALT MULTI-STRAT-I
2019-12-16
2020-03-02
17.058 BLACKSTONE ALT MULTI-STRAT-I
2017-10-16
2020-03-02
149.129 DOUBLELINE TOTL RET BND-I
2012-08-06
2020-03-02
135. ISHARES US TREASURY BOND ETF
2015-02-23
2020-03-02
1. MERCK & CO INC
2019-08-19
2020-03-02
2. MERCK & CO INC
2009-02-23
2020-03-02
23.641 NEUBERGER BERMAN HIGH INCM BD-INS
2019-03-13
2020-03-02
194.186 PIMCO INVESTMENT GRD CORP-IN
2020-03-02
10.913 VANGUARD M/B SEC INDEX-ADM
2019-12-16
2020-03-02
14.621 VANGUARD M/B SEC INDEX-ADM
2014-10-27
2020-03-02
3. VERIZON COMMUNICATIONS INC
2018-11-06
2020-03-02
1. WALMART INC
2019-08-19
2020-03-02
6. NOMAD FOODS LTD
2019-03-08
2020-03-02
388. FEDERATED HERMES GOVT OBLIG-I #5 FFS
2019-12-17
2020-03-03
50.21 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2018-01-03
2020-03-04
914.19 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2019-12-17
2020-03-04
16. EOG RESOURCES INC
2014-02-26
2020-03-09
301.27 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2018-01-03
2020-03-09
301.27 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2019-12-17
2020-03-09
5. SCHLUMBERGER LTD
2020-03-02
2020-03-09
28. SCHLUMBERGER LTD
2002-08-13
2020-03-09
382.75 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2019-12-17
2020-03-11
.648 INGERSOLL-RAND INC
2016-06-29
2020-03-16
16. MICRON TECHNOLOGY INC
2020-01-14
2020-03-19
7. PIONEER NATURAL RESOURCES CO
2018-11-20
2020-03-31
1. PIONEER NATURAL RESOURCES CO
2020-03-02
2020-03-31
45.27 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2018-01-03
2020-04-03
45.27 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2019-12-17
2020-04-03
108.246 INVESCO DEVELOPING MARKETS FUND
2020-04-06
24.45 INVESCO DEVELOPING MARKETS FUND
2020-03-02
2020-04-06
535.001 CAMBIAR INTL EQUITY FUND-INS
2016-07-20
2020-04-06
50.333 CAMBIAR INTL EQUITY FUND-INS
2020-03-02
2020-04-06
383.561 JOHCM INTERNATIONAL SEL-I
2015-06-15
2020-04-06
39.709 JOHCM INTERNATIONAL SEL-I
2020-03-02
2020-04-06
2318.344 BLACKSTONE ALT MULTI-STRAT-I
2020-04-06
293.358 BLACKSTONE ALT MULTI-STRAT-I
2019-08-19
2020-04-06
613.11 DOUBLELINE TOTL RET BND-I
2020-04-06
296. ISHARES MSCI EAFE SMALL CAP ETF
2020-04-06
10. ISHARES US TREASURY BOND ETF
2015-02-23
2020-04-06
241.716 PIMCO INVESTMENT GRD CORP-IN
2020-04-06
10.552 T ROWE PR QM US S/C GR EQ-I
2020-04-06
8.696 T ROWE PR QM US S/C GR EQ-I
2019-03-13
2020-04-06
271.6 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2018-01-03
2020-04-08
42498.06 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2019-12-17
2020-04-08
.3524 RAYTHEON TECHNOLOGIES CORP
2016-05-16
2020-04-23
6.51 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2018-01-24
2020-05-05
49.06 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2020-04-07
2020-05-05
289.54 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2018-01-24
2020-05-08
294.34 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2020-04-07
2020-05-08
41.77 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2018-02-02
2020-06-03
50.89 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2020-04-07
2020-06-03
19.906 INVESCO DEVELOPING MARKETS FUND
2019-03-13
2020-06-08
1. ADOBE INC
2020-04-06
2020-06-08
70.954 JOHCM INTERNATIONAL SEL-I
2015-06-15
2020-06-08
3. ALLSTATE CORP
2020-06-08
1. ALPHABET INC CL C
2019-12-16
2020-06-08
3. APPLE INC
2020-06-08
5. APPLIED MATERIALS INC
2020-06-08
8.139 ARTISAN INTL VALUE FUND-ADV
2020-04-06
2020-06-08
2. ASSURANT INC
2020-04-06
2020-06-08
20. BANK OF AMERICA CORP
2020-06-08
1. BERKSHIRE HATHAWAY INC-CL B
2018-11-06
2020-06-08
6. CAPITAL ONE FINANCIAL CORP
2020-06-08
4. CAPITAL ONE FINANCIAL CORP
2018-03-20
2020-06-08
2. CARDINAL HEALTH INC
2020-03-09
2020-06-08
2. CARLISLE COS INC
2019-09-05
2020-06-08
3. CISCO SYSTEMS INC
2020-04-06
2020-06-08
11. CITIZENS FINANCIAL GROUP INC
2015-08-19
2020-06-08
4. CITIZENS FINANCIAL GROUP INC
2020-03-02
2020-06-08
3. COMCAST CORP-CL A
2019-03-29
2020-06-08
4. CORTEVA INC
2016-12-05
2020-06-08
1. CROWN CASTLE INTL CORP REIT
2020-04-06
2020-06-08
1. DIGITAL REALTY TRUST INC REIT
2020-04-06
2020-06-08
3. DISNEY WALT CO NEW
2020-06-08
76.537 EATON VANCE-ATLANTA SMID-R6
2020-06-08
35.745 EATON VANCE-ATLANTA SMID-R6
2020-03-02
2020-06-08
1. ECOLAB INC
2019-12-16
2020-06-08
1. FACEBOOK INC-A
2019-10-29
2020-06-08
3. FIDELITY NATL INFORMATION SVCS INC
2020-04-06
2020-06-08
3. HOME DEPOT INC
2020-04-06
2020-06-08
1. HONEYWELL INTERNATIONAL INC
2020-04-06
2020-06-08
1. MASTERCARD INC CL A
2020-03-02
2020-06-08
1. MCDONALDS CORP
2020-04-06
2020-06-08
5. MICROSOFT CORP
2020-04-06
2020-06-08
276.54 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2018-02-02
2020-06-08
305.34 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2020-04-07
2020-06-08
2. NEXTERA ENERGY INC
2020-04-06
2020-06-08
4. NIKE INC-CLASS B
2020-04-06
2020-06-08
2. NVIDIA CORP
2020-04-06
2020-06-08
55.136 NUVEEN SMALL CAP VALUE-I
2017-10-16
2020-06-08
6. PNC FINL SVCS GROUP INC
2020-06-08
3. SALESFORCE COM INC
2020-04-06
2020-06-08
22.816 T ROWE PR QM US S/C GR EQ-I
2019-03-13
2020-06-08
2. TRACTOR SUPPLY CO
2018-09-18
2020-06-08
2. UNITEDHEALTH GROUP INC
2020-03-02
2020-06-08
11.194 VAN ECK EMERGING MARKETS-I
2015-06-15
2020-06-08
2. VISA INC CL A
2020-06-08
2. TRANE TECHNOLOGIES PLC
2020-04-06
2020-06-08
53. FEDERATED HERMES GOVT OBLIG-I #5 FFS
2020-04-07
2020-06-09
51.96 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2020-04-07
2020-07-06
236.97 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2020-07-08
311.74 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2020-04-07
2020-07-08
1250. FEDERATED HERMES GOVT OBLIG-I #5 FFS
2020-07-14
1250. FEDERATED HERMES GOVT OBLIG-I #5 FFS
2020-04-07
2020-07-14
2. MCDONALDS CORP
2020-04-06
2020-07-21
11. MCDONALDS CORP
2018-03-16
2020-07-21
116.93 FEDERATED HERMES GOVT OBLIG-I #5 FFS
2020-04-07
2020-07-23
CAPITAL GAIN DIVIDENDS
P
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
54
54
b
323
323
c
323
323
d
179
173
6
e
1,192
169
1,023
1,291
1,347
-56
829
452
377
3,378
3,288
90
10,807
12,354
-1,547
157
156
1
2,537
2,496
41
3,719
3,326
393
305
305
1,713
1,579
134
53
53
53
53
2,979
1,656
1,323
1,978
2,010
-32
249
249
320
320
1,113
1,113
3,360
1,425
1,935
1,419
471
948
54
54
54
54
322
322
322
322
2,200
2,248
-48
273
301
-28
1,500
1,362
138
1,699
1,554
145
101
101
216
209
7
1,251
169
1,082
1,798
993
805
202
55
147
235
211
24
105
104
1
484
442
42
151
66
85
209
218
-9
1,000
1,016
-16
372
395
-23
192
215
-23
272
298
-26
283
289
-6
462
481
-19
706
719
-13
248
232
16
35
27
8
137
131
6
162
213
-51
598
553
45
135
143
-8
131
101
30
398
411
-13
800
840
-40
142
165
-23
133
157
-24
1,300
1,197
103
196
59
137
97
127
-30
132
113
19
473
38
435
166
167
-1
78
79
-1
535
431
104
836
811
25
272
281
-9
279
277
2
208
220
-12
169
171
-2
846
827
19
600
591
9
229
217
12
287
246
41
88
89
-1
196
229
-33
600
685
-85
428
387
41
900
885
15
117
120
-3
204
179
25
204
131
73
148
146
2
96
101
-5
300
299
1
282
279
3
282
305
-23
323
338
-15
239
247
-8
239
134
105
800
685
115
400
400
120
114
6
179
18
161
239
228
11
96
119
-23
117
62
55
117
120
-3
19
21
-2
27,624
27,624
890
488
402
909
924
-15
379
408
-29
664
889
-225
51
51
303
303
306
306
52
52
312
312
312
312
1,071
1,046
25
315
273
42
6,317
5,422
895
277
13
264
183
155
28
91
86
5
91
56
35
105
99
6
137
92
45
4,124
4,356
-232
877
807
70
1,456
1,419
37
310
59
251
2,238
2,184
54
160
56
104
1,954
1,912
42
141
153
-12
78
41
37
39
34
5
209
171
38
186
18
168
166
171
-5
18,232
18,232
53
53
53
53
318
318
318
318
911
585
326
14
14
1,267
1,514
-247
1,900
2,126
-226
25
25
53
53
317
317
317
317
200
206
-6
182
188
-6
1,627
1,681
-54
3,678
3,421
257
77
86
-9
154
56
98
200
199
1
2,171
2,074
97
235
232
3
315
310
5
165
171
-6
108
114
-6
110
128
-18
388
388
50
50
914
914
605
1,496
-891
301
301
301
301
79
137
-58
443
578
-135
383
383
14
10
4
587
925
-338
488
1,069
-581
70
124
-54
45
45
45
45
3,847
4,745
-898
869
1,033
-164
10,320
12,749
-2,429
971
1,211
-240
7,813
7,951
-138
809
901
-92
20,958
25,265
-4,307
2,652
3,180
-528
6,407
6,881
-474
12,949
18,163
-5,214
281
253
28
2,451
2,532
-81
323
400
-77
266
316
-50
272
272
42,498
42,498
22
20
2
7
7
49
49
290
290
294
294
42
42
51
51
846
831
15
391
307
84
1,771
1,471
300
317
286
31
1,422
1,355
67
990
785
205
300
273
27
272
220
52
232
207
25
572
524
48
202
218
-16
487
484
3
325
397
-72
114
97
17
276
289
-13
142
122
20
337
291
46
122
127
-5
126
120
6
119
142
-23
168
148
20
141
141
375
313
62
2,804
2,607
197
1,310
1,240
70
228
186
42
229
190
39
427
365
62
757
564
193
161
134
27
311
300
11
196
169
27
928
803
125
277
277
305
305
506
461
45
412
328
84
710
511
199
1,052
1,434
-382
784
651
133
521
417
104
901
828
73
241
177
64
617
515
102
196
174
22
399
346
53
202
168
34
53
53
52
52
237
237
312
312
1,250
1,250
1,250
1,250
387
338
49
2,131
1,788
343
117
117
2,443
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-)
or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
Excess of col. (i)
over col. (j), if any
a
b
c
d
6
e
1,023
-56
377
90
-1,547
1
41
393
134
1,323
-32
1,935
948
-48
-28
138
145
7
1,082
805
147
24
1
42
85
-9
-16
-23
-23
-26
-6
-19
-13
16
8
6
-51
45
-8
30
-13
-40
-23
-24
103
137
-30
19
435
-1
-1
104
25
-9
2
-12
-2
19
9
12
41
-1
-33
-85
41
15
-3
25
73
2
-5
1
3
-23
-15
-8
105
115
6
161
11
-23
55
-3
-2
402
-15
-29
-225
25
42
895
264
28
5
35
6
45
-232
70
37
251
54
104
42
-12
37
5
38
168
-5
326
-247
-226
-6
-6
-54
257
-9
98
1
97
3
5
-6
-6
-18
-891
-58
-135
4
-338
-581
-54
-898
-164
-2,429
-240
-138
-92
-4,307
-528
-474
-5,214
28
-81
-77
-50
2
15
84
300
31
67
205
27
52
25
48
-16
3
-72
17
-13
20
46
-5
6
-23
20
62
197
70
42
39
62
193
27
11
27
125
45
84
199
-382
133
104
73
64
102
22
53
34
49
343
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
-1,300
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
39,179
491,877
0.079652
2017
39,441
525,208
0.075096
2016
38,866
510,199
0.076178
2015
64,774
528,103
0.122654
2014
79,766
637,083
0.125205
2
Total
of line 1, column (d)
.....................
2
0.478785
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
0.095757
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
486,212
5
Multiply line 4 by line 3
......................
5
46,558
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
51
7
Add lines 5 and 6
........................
7
46,609
8
Enter qualifying distributions from Part XII, line 4
,.............
8
37,828
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
103
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
103
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
103
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
339
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
0
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
339
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
236
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
104
Refunded
11
132
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition)
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
(2)
On foundation managers.
$
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
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)
NC
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
SUNTRUST BANK
Telephone no.
(919) 918-2442
Located at
PO BOX 1908
ORLANDO
FL
ZIP+4
328021908
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
SUNTRUST BANK
TRUSTEE
1
8,638
PO BOX 1908
ORLANDO
,
FL
328021908
2
Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a)
Name and address of each employee paid more than $50,000
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
NONE
Total
number of other employees paid over $50,000
...................
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
7
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
(continued)
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
NONE
Total
number of others receiving over $50,000 for professional services
.............
0
Part IX-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
2
3
4
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
Form
990-PF
(2019)
Form 990-PF (2019)
Page
8
Part X
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations, see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities
...................
1a
461,516
b
Average of monthly cash balances
.......................
1b
32,100
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
493,616
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
493,616
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
7,404
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
486,212
6
Minimum investment return.
Enter 5% of line 5
..................
6
24,311
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
24,311
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
103
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
103
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
24,208
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
24,208
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
24,208
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
37,828
b
Program-related investments—total from Part IX-B
..................
1b
0
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
0
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
0
b
Cash distribution test (attach the required schedule)
.................
3b
0
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
37,828
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
37,828
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
24,208
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
......
48,904
b
From 2015
......
38,509
c
From 2016
......
13,828
d
From 2017
......
13,793
e
From 2018
......
14,858
f
Total
of lines 3a through e
........
129,892
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
37,828
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
.....
24,208
e
Remaining amount distributed out of corpus
13,620
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
143,512
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)
...
48,904
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
94,608
10
Analysis of line 9:
a
Excess from 2015
....
38,509
b
Excess from 2016
....
13,828
c
Excess from 2017
....
13,793
d
Excess from 2018
....
14,858
e
Excess from 2019
....
13,620
Form
990-PF
(2019)
Form 990-PF (2019)
Page
10
Part XIV
Private Operating Foundations
(see instructions and Part VII-A, question 9)
1a
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2019, enter the date of the ruling
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2019
(b)
2018
(c)
2017
(d)
2016
b
85% of line 2a
.........
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed
...
c
“Support" alternative test—enter:
(1)
Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
....
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
(3)
Largest amount of support
from an exempt organization
(4)
Gross investment income
Part XV
Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
NONE
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
NONE
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or email address of the person to whom applications should be addressed:
b
The form in which applications should be submitted and information and materials they should include:
c
Any submission deadlines:
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Form
990-PF
(2019)
Form 990-PF (2019)
Page
11
Part XV
Supplementary Information
(continued)
3
Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
PAWS 4EVER
6311- A NICKS RD
MEBANE
,
NC
27302
NONE
PC
GENERAL OPERATING
31,009
Total
.................................
3a
31,009
b
Approved for future payment
Total
.................................
3b
Form
990-PF
(2019)
Form 990-PF (2019)
Page
12
Part XVI-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
Unrelated business income
Excluded by section 512, 513, or 514
(e)
Related or exempt
function income
(See instructions.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
4
Dividends and interest from securities
....
14
9,640
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
-1,300
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)
..
8,340
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
8,340
(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