-
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 SCHEUMANN FOUNDATION INC
C/O JOHN B SCHEUMANN
Number and street (or P.O. box number if mail is not delivered to street address)
PO BOX 811
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
LAFAYETTE
,
IN
479020811
A Employer identification number
30-0129316
B
Telephone number (see instructions)
(765) 742-0300
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)
$
11,537,222
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
108,826
94,326
4
Dividends and interest from securities
...
251,199
251,199
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
1,171,174
b
Gross sales price for all assets on line 6a
6,371,883
7
Capital gain net income (from Part IV, line 2)
...
1,171,174
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)
.......
14,266
12
Total.
Add lines 1 through 11
........
1,545,465
1,516,699
13
Compensation of officers, directors, trustees, etc.
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
15,015
c
Other professional fees (attach schedule)
....
74,388
74,388
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
39,199
39,199
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
18,097
18,097
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
146,699
131,684
0
25
Contributions, gifts, grants paid
.......
470,854
470,854
26
Total expenses and disbursements.
Add lines 24 and 25
617,553
131,684
470,854
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
927,912
b
Net investment income
(if negative, enter -0-)
1,385,015
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
.............
20,440
39,182
39,182
2
Savings and temporary cash investments
.........
3
Accounts receivable
Less: allowance for doubtful accounts
4
Pledges receivable
Less: allowance for doubtful accounts
5
Grants receivable
.................
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)
.....
7
Other notes and loans receivable (attach schedule)
Less: allowance for doubtful accounts
8
Inventories for sale or use
..............
9
Prepaid expenses and deferred charges
..........
49,126
21,452
21,452
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
.......
10,371,297
11,476,588
11,476,588
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)
..........
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)
10,440,863
11,537,222
11,537,222
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
)
30,000
23
Total liabilities
(add lines 17 through 22)
.........
30,000
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
........
27
Paid-in or capital surplus, or land, bldg., and equipment fund
28
Retained earnings, accumulated income, endowment, or other funds
10,410,863
11,537,222
29
Total net assets or fund balances
(see instructions)
.....
10,410,863
11,537,222
30
Total liabilities and net assets/fund balances
(see instructions)
.
10,440,863
11,537,222
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
10,410,863
2
Enter amount from Part I, line 27a
.....................
2
927,912
3
Other increases not included in line 2 (itemize)
3
198,447
4
Add lines 1, 2, and 3
..........................
4
11,537,222
5
Decreases not included in line 2 (itemize)
5
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
11,537,222
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
ALCON INC
P
2018-08-16
2019-06-19
b
ELI LILLY & CO
P
2009-07-23
2019-12-24
c
TENET HEALTHCARE
P
2019-01-25
2019-09-11
d
CLEAR CHANNEL WORLDWIDE
P
2017-11-09
2019-09-04
e
PRECISION DRILLING
P
2017-11-14
2019-01-11
CALL ADM 7/19/19
P
2019-07-19
2019-07-19
CALL CVX 10/18/19
P
2019-10-18
2019-10-18
CALL GLW 11/15/19
P
2019-11-15
2019-11-15
CALL JNJ 10/18/19
P
2019-10-18
2019-10-18
CALL PFE 1/18/19
P
2019-01-18
2019-01-18
CALL WELL 4/18/19
P
2019-04-18
2019-04-18
CORNING INC
P
2019-10-31
2019-12-20
PFIZER INC
P
2018-09-25
2019-06-21
CHUBB LTD
P
2019-03-18
2019-05-17
SUNTRUST BKS
P
2019-07-23
2019-09-20
PROSIEBENSAT 1 MEDIA AG
P
2018-04-23
2019-03-01
SMITH GROUP PLC
P
2018-04-23
2019-09-04
ISHARES MSCI ACWI
P
2019-06-14
2019-07-15
TENCENT MUSIC ENTMT GROUP
P
2019-02-26
2019-05-20
KIMCO REALTY
P
2018-03-14
2019-04-16
HORIZON BANCORP INC
P
2016-12-19
2019-02-26
HORIZON BANCORP INC
P
2019-07-31
BANCO SANTANDER SA
P
2018-10-24
2019-12-30
RYANAIR HLDGS PLC
P
2019-07-15
2019-07-24
CORTEVA INC
P
2018-11-14
2019-07-09
HSBC HOLDINGS PLC
P
2009-06-01
2019-08-16
THE CHEMOURS COMPANY
P
2019-05-03
2019-05-20
CONSOL ENEGY INC
P
2017-10-30
2019-05-16
RANGE RESOURCES
P
2017-11-03
2019-01-17
CALL ADM 10/18/19
P
2019-10-18
2019-10-18
CALL DD 6/21/19
P
2019-06-21
2019-06-21
CALL GPC 4/18/19
P
2019-04-18
2019-04-18
CALL JPM 1/18/19
P
2019-01-18
2019-01-18
CALL PFE 3/15/19
P
2019-03-15
2019-03-15
CALL WELL 9/20/19
P
2019-09-20
2019-09-20
CORTEVA INC
P
2019-05-10
2019-06-17
PHILIP MORRIS INTL INC
P
2019-10-31
2019-11-15
CORNING INC
P
2019-10-21
2019-12-20
TRUIST FINL CORP
P
2019-07-23
2019-12-09
SSE PLC
P
2018-04-23
2019-02-06
SSE PLC
P
2017-11-28
2019-02-06
LOGITECH INTL SA
P
2018-08-14
2019-07-03
VANGUARD FTSE EUROPE
P
2019-04-23
2019-11-14
KITE REALTY GROUP
P
2018-02-12
2019-10-07
HORIZON BANCORP INC
P
2016-12-19
2019-02-26
HORIZON BANCORP INC
P
2019-07-31
CIGNA CORP
P
2017-08-21
2019-06-14
TAL EDUC GROUP
P
2017-05-30
2019-06-06
DUPONT DE NEMOURS INC
P
2018-11-14
2019-10-24
MICROSOFT CORP
P
2010-09-07
2019-07-05
UNITED RENTALS
P
2019-01-03
2019-11-20
DAVITA INC
P
2017-11-08
2019-09-13
ROWAN COMPANIES
P
2017-11-13
2019-07-01
CALL ADB 11/15/19
P
2019-11-15
2019-11-15
CALL DD 7/19/19
P
2019-07-19
2019-07-19
CALL GPC 7/19/19
P
2019-07-19
2019-07-19
CALL JPM 5/17/19
P
2019-05-17
2019-05-17
CALL PFE 4/18/19
P
2019-04-18
2019-04-18
CALL WELL 10/18/19
P
2019-10-18
2019-10-18
DOW INC
P
2019-06-17
2019-11-15
RAYTHEON CO
P
2019-03-11
2019-08-19
CORTEVA INC
P
2019-04-22
2019-06-17
DUKE ENERGY CORPORATION
P
2018-07-23
2019-09-20
TELEFONICA BRASIL SA
P
2018-04-23
2019-03-11
TELEFONICA BRASIL SA
P
2018-01-23
2019-05-28
MONSTER BEVERAGE CORP
P
2018-09-07
2019-09-06
WELLTOWER INC
P
2019-07-17
2019-12-27
KROGER CO
P
2017-10-09
2019-01-07
HORIZON BANCORP INC
P
2017-10-20
2019-10-22
HORIZON BANCORP INC
P
2019-09-16
CONSTELLATION BRANDS INC
P
2018-02-09
2019-06-14
UBS GROUP AG
P
2018-10-29
2019-04-23
ALCON INC
P
2017-04-04
2019-06-19
NEXTERA ENERGY INC
P
2009-07-23
2019-09-23
WELLCARE PLANS
P
2019-01-11
2019-11-01
DIAMONDBACK ENERGY 4750
P
2018-02-07
2019-06-19
SESI LLC
P
2017-11-08
2019-01-04
CALL CAH 3/15/19
P
2019-03-05
2019-03-08
CALL DD 8/16/17
P
2019-08-16
2019-08-16
CALL GPC 11/15/19
P
2019-11-15
2019-11-15
CALL JPM 8/16/19
P
2019-08-16
2019-08-16
CALL PFE 7/19/19
P
2019-07-19
2019-07-19
CALL WFC 3/15/19
P
2019-03-15
2019-03-15
DOWDUPONT INC
P
2018-11-14
2019-04-18
SIEMENS AKTIENGESELLSCHAFT
P
2018-11-21
2019-06-17
DOW INC
P
2019-04-22
2019-11-15
HCP INCORPORATED
P
2017-11-02
2019-09-20
UBS GROUP AG
P
2018-04-23
2019-03-11
VERMILION ENERGY INC
P
2018-04-23
2019-10-07
NETEASE.COM INC1/13/19
P
2019-11-25
2019-11-25
BANK OF AMERICA
P
2018-05-29
2019-01-15
VENTAS INC
P
2018-02-12
2019-10-02
HORIZON BANCORP INC
P
2018-01-19
2019-10-22
HORIZON BANCORP INC
P
2019-09-16
CVS HEALTH CORP
P
2019-03-28
2019-04-03
VMWARE INC
P
2017-05-08
2019-09-24
CORNING INC
P
2014-02-03
2019-12-17
TRAVELERS COMPANIES INC
P
2009-07-23
2019-11-05
AMERICAN AXLE
P
2017-10-27
2019-04-23
DIAMONDBACK ENERGY 5375
P
2017-12-01
2019-08-07
SOUTHWESTERN ENERGY
P
2017-12-14
2019-03-18
CALL COP 3/15/19
P
2019-03-15
2019-03-15
CALL DOW 8/16/19
P
2019-08-16
2019-08-16
CALL HSBC 1/18/19
P
2019-01-18
2019-01-18
CALL KMB 5/17/19
P
2019-05-17
2019-05-17
CALL PM 9/20/19
P
2019-09-17
2019-09-18
CALL WFC 4/18/19
P
2019-04-18
2019-04-18
DUKE ENERGY CORPORATION
P
2018-12-26
2019-09-20
SUNTRUST BKS
P
2019-07-23
2019-09-20
DOWDUPONT INC
P
2019-01-23
2019-04-18
HONEYWELL INTERNATIONAL INC
P
2017-11-02
2019-01-14
VODAPHONE GROUP
P
2018-11-26
2019-05-15
VODAPHONE GROUP PLC
P
2018-04-23
2019-05-15
NORTHEN TRUS CORP
P
2018-11-19
2019-06-06
BNP PARIBAS SP
P
2018-06-25
2019-01-07
WALGREENS BOOTS ALLIANCE
P
2017-10-20
2019-04-03
HORIZON BANCORP INC
P
2018-04-20
2019-10-22
HORIZON BANCORP INC
P
2019-09-19
EMERSON ELECTRIC CO
P
2016-01-27
2019-08-02
APPLE INC
P
2012-11-30
2019-10-29
CORTEVA INC
P
2018-06-22
2019-07-09
WELLTOWER INC
P
2008-05-13
2019-09-23
ANTERO RESOURCES 5375
P
2017-11-13
2019-03-12
DISH DBS CORP
P
2018-03-08
2019-05-03
T-MOBILE USA INC
P
2017-11-07
2019-07-23
CALL COP 4/15/19
P
2019-04-18
2019-04-18
CALL DUK 1/18/19
P
2019-01-18
2019-01-18
CALL HSBC 2/15/19
P
2019-02-15
2019-02-15
CALL KMB 6/21/19
P
2019-06-21
2019-06-21
CALL PPL 5/17/19
P
2019-05-17
2019-05-17
CALL WFC 6/21/19
P
2019-06-21
2019-06-21
DUPONT DE NEMOURS INC
P
2019-04-22
2019-09-20
TARGET CORPORATION
P
2019-02-11
2019-07-10
DUPONT DE NEMOURS INC
P
2019-04-22
2019-09-20
HSBC HOLDINGS PLC
P
2018-04-24
2019-06-27
ALCON INC
P
2017-11-28
2019-04-16
AMGEN
P
2018-11-28
2019-03-04
PALO ALO NETWORKS INC.
P
2019-07-15
2019-10-01
E.I. DUPONT
P
2019-02-22
2019-04-22
WELLS FARGO & CO
P
2016-11-08
2019-09-16
HORIZON BANCORP INC
P
2018-07-20
2019-10-22
HORIZON BANCORP INC
P
2019-09-19
ILL TOOL WORKS INC
P
2016-04-29
2019-03-13
BRITISH AMER TOB
P
2012-11-30
2019-04-04
DUPONT DE NEOURS INC
P
2018-06-22
2019-10-24
AMERICAN AXLE
P
2018-06-21
2019-05-21
ANTERO RESOURCES 5625
P
2017-12-27
2019-03-12
ENSCO PLC
P
2017-10-30
2019-04-04
THE CHEMOURS COMPANY
P
2017-11-29
2019-04-24
CALL COP 6/21/19
P
2019-06-21
2019-06-21
CALL DUK 10/18/19
P
2019-10-18
2019-10-18
CALL INTC 1/18/19
P
2019-01-18
2019-01-18
CALL KMB 7/19/19
P
2019-07-19
2019-07-19
CALL PPL 8/16/19
P
2019-08-16
2019-08-16
CALL WFC 7/19/19
P
2019-07-19
2019-07-19
EATON CORP PLC
P
2019-06-24
2019-12-20
TRAVELERS COMPANIES INC
P
2018-08-21
2019-08-19
EATON CORP PLC
P
2019-06-24
2019-12-20
INTEL CORP
P
2018-03-19
2019-04-18
ASTRAZENECA PLC
P
2018-04-23
2019-09-18
BANCO SANTANDER S.A.
P
2019-07-15
2019-12-30
PAYPAL HLDGS INC
P
2019-04-29
2019-11-18
FIRST ENERGY CORP
P
2018-02-28
2019-01-07
HORIZON BANCORP INC
P
2011-12-13
2019-02-19
HORIZON BANCORP INC
P
2018-10-19
2019-10-22
HORIZON BANCORP INC
P
2019-09-20
JPMORGANCHASE & CO
P
2017-01-26
2019-03-18
RYANAIR HLDGS PLC
P
2012-11-30
2019-11-14
MERCK & CO INC
P
2011-09-29
2019-11-05
ANTERO RESOURCES
P
2019-08-01
2019-11-06
ARAMARK SERVICES
P
2017-11-30
2019-10-08
GOODYEAR TIRE & RUBBER
P
2017-11-21
2019-03-28
TRANSOCEAN INC
P
2017-11-21
2019-01-03
CALL COP 11/15/19
P
2019-11-15
2019-11-15
CALL DWDP 2/15/19
P
2019-02-05
2019-02-06
CALL INTC 10/18/19
P
2019-10-18
2019-10-18
CALLL KMB 10/18/19
P
2019-10-18
2019-10-18
CALL STI 5/17/19
P
2019-05-17
2019-05-17
CALL WFC 10/18/19
P
2019-10-18
2019-10-18
GENUINE PARTS CO
P
2019-06-25
2019-09-20
UNILEVER NV NY
P
2019-08-19
2019-10-18
GENUINE PARTS CO
P
2019-02-20
2019-09-20
PPL CORPORATION
P
2017-11-02
2019-02-11
BRITISH AMER TOB
P
2018-04-23
2019-10-07
CIGNA CORP
P
2018-09-11
2019-04-10
PROGRSSIVE CORP OHIO
P
2019-07-24
2019-11-18
GOLDMAN SACHS
P
2018-05-29
2019-02-15
HORIZON BANCORP INC
P
2011-12-13
2019-02-19
HORIZON BANCORP INC
P
2019-02-26
HORIZON BANCORP INC
P
2019-09-20
LOGITECH INTL SA
P
2017-05-01
2019-07-03
MICROSOFT CORP
P
2011-07-26
2019-07-05
EDISON INTERNATIONAL
P
2019-07-17
2019-11-14
BOYD GAMING CORP
P
2007-11-10
2019-12-03
HCA INC
P
2018-06-19
2019-07-05
TRBUNE MEDIA COMPANY
P
2017-10-30
2019-09-19
CALL COP 12/20/19
P
2019-12-20
2019-12-20
CALL ETN 8/16/19
P
2019-08-16
2019-08-16
CALL INTC 11/15/19
P
2019-11-15
2019-11-15
CALL MO 4/18/19
P
2019-04-18
2019-04-18
CALL T 2/15/19
P
2019-02-15
2019-02-15
CALL WFC 12/20/19
P
2019-12-20
2019-12-20
HSBC HOLDINGS PLC
P
2018-09-11
2019-06-27
VERIZON COMMUNICATIONS
P
2019-03-18
2019-09-20
JOHNSON & JOHNSON
P
2019-06-24
2019-12-20
ROYAL DUTCH SHELL PLC
P
2018-04-24
2019-10-10
DAIMLER AG
P
2018-04-23
2019-10-08
COMPANHIA ENERGY
P
2019-02-11
2019-12-03
ROYAL DUTCH SHELL
P
2018-12-10
2019-10-10
HORMEL FOODS CORPORATION
P
2018-02-12
2019-01-07
HORIZON BANCORP INC
P
2011-12-13
2019-02-20
HORIZON BANCORP INC
P
2019-02-27
HORIZON BANCORP INC
P
2019-09-25
MASTERCARD INC
P
2018-06-27
2019-09-06
ROYAL DUTCH SHELL
P
2011-03-28
2019-12-18
ENCOMPAS HEALTH
P
2019-08-01
2019-11-06
CCO HOLDINGS LLC 5750
P
2017-11-07
2019-10-23
ICAHN ENTERPRISES
P
2017-10-30
2019-08-01
EQ1 BC8A6 TND
P
2019-11-18
CALL CSCO 5/17/19
P
2019-05-17
2019-05-17
CALL ETN 9/20/19
P
2019-09-20
2019-09-20
CALL INTC 12/20/19
P
2019-12-20
2019-12-20
CALL MO 5/17/19
P
2019-05-17
2019-05-17
CALL TRV 8/16/19
P
2019-08-16
2019-08-16
CARDINAL HEALTH
P
2019-02-19
2019-03-05
INTEL CORP
P
2019-07-22
2019-09-20
WELLS FARGO
P
2018-10-01
2019-09-20
JOHNSON CNTLS INTL PLC
P
2018-09-07
2019-05-14
TRAVELERS COMPANIES INC
P
2018-08-21
2019-08-19
HONDA MOTOR COMPANY
P
2018-08-09
2019-10-08
CONSTELLATION BRANDS INC
P
2018-11-12
2019-06-14
RYNAIR HLDGS PLC
P
2019-07-15
2019-11-14
JPMORGAN CHASE
P
2019-03-01
2019-12-23
HORIZON BANCORP INC
P
2011-12-13
2019-02-20
HORIZON BANCORP INC
P
2019-03-01
HORIZON BANCORP INC
P
2019-09-25
MC DONALDS CORP
P
2017-10-10
2019-01-07
TRUIST FINL GROUP
P
2017-12-20
2019-12-09
ENERGY TRANSFER
P
2019-02-13
2019-03-05
CCO HOLDINGS LLC 5125
P
2018-02-15
2019-07-15
ISTAR FINANCIAL
P
2017-11-24
2019-03-07
LTD BRANDS
P
2019-06-20
CALL CSCO 8/16/19
P
2019-08-16
2019-08-16
CALL ETN 11/15/19
P
2019-11-15
2019-11-15
CALLJCI 4/18/19
P
2019-04-18
2019-04-18
CALL MO 8/16/19
P
2019-08-16
2019-08-16
CALL VZ 2/15/19
P
2019-02-15
2019-02-15
CHEVRON CORP
P
2019-06-24
2019-09-20
JPHNSON AND JOHNSON
P
2019-07-18
2019-12-20
WELLTOWER INC
P
2018-12-26
2019-06-21
JPMORGAN CHASE & CO
P
2019-09-23
2019-12-20
UNILEVER NV
P
2018-06-12
2019-10-18
HSBC HOLDINGS PLC
P
2018-04-23
2019-08-16
COPA HOLDINGS S.A.
P
2019-01-22
2019-05-17
SMITH & NEPHEW PLC
P
2019-10-16
2019-12-04
KIMCO REALTY CORP
P
2018-12-04
2019-04-16
HORIZON BANCORP INC
P
2011-12-13
2019-02-21
HORIZON BANCORP INC
P
2019-03-04
HORIZON BANCORP INC
P
2019-10-22
NATIONAL OIL WELL VARCO INC
P
2016-02-12
2019-04-12
ALTRIA GROUP INC
P
2008-05-13
2019-06-04
ENSCO PLC
P
2019-04-14
2019-06-06
CENTURYLINK INC
P
2017-11-01
2019-07-19
ISTAR INC
P
2017-11-22
2019-10-16
ALCAN INC
P
2018-08-22
2019-05-29
CALL CSCO 9/20/19
P
2019-09-20
2019-09-20
CALL GLW 3/15/19
P
2019-03-15
2019-03-15
CALL JCI 7/19/19
P
2019-07-19
2019-07-19
CALL MRK 1/18/19
P
2019-01-18
2019-01-18
CALL VZ 5/17/19
P
2019-05-03
2019-05-06
CHUBB LTD
P
2019-03-18
2019-05-17
JOHNSON CNTLS INTL PLC
P
2018-10-01
2019-05-17
ALCON INC
P
2018-08-22
2019-05-29
KIMBELY CLARK CORP
P
2019-08-19
2019-10-21
WELLS FARGO & CO
P
2018-01-23
2019-09-20
PROSIEBENSAT 1 MEDIA AG
P
2018-05-24
2019-03-01
DANAHER CORPORATION
P
2018-04-17
2019-03-19
SOFTBANK CORP
P
2019-07-15
2019-12-03
KITE RELTY GROUP
P
2019-01-07
2019-10-07
HORIZON BANCORP INC
P
2011-12-13
2019-02-22
HORIZON BANCORP INC
P
2019-03-05
ABB LTD
P
2016-12-22
2019-03-01
NIPPON TELEGRAPH&TELEPHONE
P
2016-12-02
2019-05-17
CORTEVA INC
P
2009-12-31
2019-07-09
OLIN CORP
P
2018-07-31
2019-07-02
CF INDUSTRIES
P
2017-11-03
2019-07-17
LEVEL 3 COMMUNICATIONS
P
2017-11-02
2019-12-02
ALTRIA GROUP INC
P
2018-11-29
2019-11-15
CALL CSCO 10/18/19
P
2019-10-18
2019-10-18
CALL GLW 4/18/19
P
2019-04-18
2019-04-18
CALL JCI 10/18/19
P
2019-10-18
2019-10-18
CALL MRK 10/18/19
P
2019-10-18
2019-10-18
CALL WBA 4/18/19
P
2019-04-18
2019-04-18
CYSCO SYS INC
P
2019-04-22
2019-06-21
JP MORGAN CHASE & CO
P
2019-11-18
2019-12-20
ALTRIA GROUP INC
P
2019-03-18
2019-11-15
NOVARTIS AG
P
2018-08-22
2019-06-21
ALCON INC
P
2018-04-23
2019-04-16
ROCHE HOLDINGS
P
2017-11-28
2019-09-18
DIAMONBACK ENERGY INC
P
2019-07-15
2019-12-03
SVB FNCL GRP
P
2019-03-18
2019-06-14
PALL CORPORATION
P
2019-03-05
2019-10-24
HORIZON BANCORP INC
P
2011-12-13
2019-02-25
HORIZON BANCORP INC
P
2019-03-05
AERCAP HOLDINGS NV
P
2016-12-02
2019-03-20
NORTHERN TRUST CORP
P
2018-04-03
2019-06-14
DOW INC
P
2009-12-31
2019-04-02
SERVICE CORP INTERNATIONAL
P
2019-06-26
2019-10-11
CHESAPEAKE ENERGY
P
2018-05-25
2019-07-24
MGM RESORTS INTERNATIONAL
P
2017-12-04
2019-01-30
AT&T INC
P
2019-09-23
2019-11-15
CALL CSCO 11/15/19
P
2019-11-15
2019-11-15
CALL GLW 8/16/19
P
2019-08-16
2019-08-16
CALL JNJ 4/18/19
P
2019-04-18
2019-04-18
CALL MRK 11/15/19
P
2019-11-15
2019-11-15
CALL WBA 7/19/19
P
2019-07-19
2019-07-19
CONAGRA BANDS INC
P
2019-10-22
2019-12-20
KIMBERLY CLARK CORP
P
2019-08-19
2019-10-21
AT&T INC
P
2018-08-22
2019-11-15
PFIZER INC
P
2018-07-23
2019-06-21
DAIMLER AG
P
2018-11-19
2019-01-08
SANOFI
P
2017-11-28
2019-03-11
EXTRA SPACE STORAGE INC
P
2019-03-06
2019-11-05
TAL EDUC GROUP
P
2019-01-07
2019-05-23
CVS HEALTH CORP
P
2018-01-10
2019-04-03
HORIZON BANCORP INC
P
2016-12-19
2019-02-25
HORIZON BANCORP INC
P
2019-03-06
ALPHABET INC
P
2016-02-17
2019-02-07
NORTHROP GRUMMAN CP
P
2013-09-23
2019-04-18
DUPONT DE NEMOURS INC
P
2009-12-31
2019-10-24
SPRINT CORP
P
2018-08-07
2019-05-28
CHESAPEAKE ENERGY
P
2018-05-18
2019-07-23
NRG YIELD OPERATING
P
2017-11-06
2019-01-29
BANK OF AMERICA CORP
P
2019-06-27
2019-11-15
CALL CVX 7/19/19
P
2019-07-19
2019-07-19
CALL GLW 9/20/19
P
2019-09-20
2019-09-20
CALL JNJ 5/17/19
P
2019-05-17
2019-05-17
CALL PEAK 12/20/19
P
2019-12-20
2019-12-20
CALL WBA 10/18/19
P
2019-10-18
2019-10-18
CONOCO PHILLIPS
P
2019-06-17
2019-09-20
MERC & CO INC
P
2018-11-19
2019-08-16
CHEVRON CORP
P
2019-06-24
2019-09-20
PHILIP MORRIS INTL INC
P
2019-10-21
2019-11-15
NOVARTIS AG
P
2019-04-16
2019-09-18
SIEMENS AKTIENGESELLSCHAFT
P
2017-11-28
2019-08-16
HOME DEPOT INC
P
2019-11-18
2019-12-27
TENCENT HLDGS LTD
P
2019-01-04
2019-08-29
HORMEL FOODS CORPORATION
P
2017-10-20
2019-01-07
HORIZON BANCORP INC
P
2016-12-19
2019-02-25
HORIZON BANCORP INC
P
2019-07-30
APPLE INC
P
2016-12-02
2019-02-19
ROYAL DUTCH SHELL
P
2018-02-26
2019-08-01
(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
764
653
111
b
7,205
1,876
5,329
c
5,195
5,095
100
d
5,108
5,114
-6
e
4,275
4,688
-413
141
141
120
120
180
180
77
77
80
80
60
60
15,611
16,297
-686
12,015
11,120
895
36,706
41,371
-4,665
7,780
9,640
-1,860
3,149
6,184
-3,035
2,901
3,210
-309
169,122
164,573
4,549
5,157
6,938
-1,781
151,225
123,020
28,205
87,447
62,382
25,065
2,753
1,495
1,258
2,174
2,404
-230
20,562
23,435
-2,873
1,464
1,604
-140
2,887
3,644
-757
5,118
5,261
-143
4,890
5,092
-202
4,511
4,888
-377
128
128
70
70
126
126
70
70
54
54
125
125
1,751
1,906
-155
16,352
16,551
-199
30,093
36,507
-6,414
25
28
-3
2,031
2,451
-420
2,527
2,999
-472
354
741
-387
11,032
10,886
146
112,823
116,674
-3,851
9,724
6,941
2,783
85,290
46,305
38,985
26,564
28,494
-1,930
9,052
3,910
5,142
3,499
4,597
-1,098
2,056
360
1,696
5,116
4,925
191
5,048
5,106
-58
8,870
9,563
-693
72
72
52
52
100
100
126
126
84
84
83
83
7,915
8,143
-228
12,640
11,364
1,276
1,489
2,076
-587
1,868
1,602
266
3,451
4,098
-647
2,649
3,535
-886
6,839
7,136
-297
6,852
7,184
-332
84,449
61,710
22,739
2,242
2,445
-203
85,677
46,305
39,372
19,179
22,943
-3,764
10,245
12,471
-2,226
4,056
3,072
984
5,647
1,369
4,278
5,225
5,013
212
3,075
3,014
61
4,263
5,111
-848
60
60
75
75
46
46
95
95
99
99
123
123
11,570
13,614
-2,044
10,450
10,359
91
6,110
8,477
-2,367
14,589
11,509
3,080
3,634
5,188
-1,554
4,496
9,520
-5,024
25,717
23,332
2,385
100,000
100,000
130,013
106,997
23,016
2,323
2,456
-133
91,209
49,295
41,914
9,077
11,549
-2,472
9,663
5,408
4,255
9,947
5,954
3,993
4,598
1,438
3,160
2,046
2,057
-11
5,220
5,171
49
5,108
5,322
-214
77
77
130
130
65
65
85
85
89
89
189
189
7,471
6,619
852
29,717
32,667
-2,950
8,115
9,838
-1,723
6,860
6,949
-89
3,338
4,427
-1,089
3,327
6,121
-2,794
30,597
35,691
-5,094
46,799
62,166
-15,367
55,200
67,244
-12,044
2,541
2,847
-306
50,154
27,185
22,969
34,375
25,016
9,359
9,067
3,419
5,648
2,262
2,388
-126
5,374
2,526
2,848
5,040
5,097
-57
2,933
2,903
30
5,350
5,357
-7
43
43
110
110
46
46
70
70
60
60
120
120
2,866
3,411
-545
6,028
4,897
1,131
4,323
6,277
-1,954
7,870
10,736
-2,866
1,179
1,106
73
6,241
6,500
-259
51,393
57,063
-5,670
154,795
153,268
1,527
46,000
48,442
-2,442
2,458
2,861
-403
90,943
49,295
41,648
32,056
23,677
8,379
4,556
5,356
-800
5,406
6,845
-1,439
3,890
3,985
-95
5,015
5,207
-192
3,915
4,118
-203
3,105
3,144
-39
62
62
76
76
112
112
135
135
84
84
99
99
38,091
38,114
-23
1,471
1,319
152
12,508
11,497
1,011
10,793
9,423
1,370
5,333
4,617
716
82,439
89,671
-7,232
4,025
4,381
-356
74,943
62,878
12,065
330
106
224
2,819
2,873
-54
50,019
27,185
22,834
27,263
22,241
5,022
5,100
2,118
2,982
7,089
2,762
4,327
4,935
5,636
-701
5,150
5,205
-55
4,609
5,068
-459
1,360
1,588
-228
193
193
130
130
56
56
150
150
204
204
135
135
13,953
14,252
-299
1,819
1,816
3
16,019
17,787
-1,768
4,842
5,882
-1,040
4,002
7,564
-3,562
17,067
18,090
-1,023
22,503
25,641
-3,138
100,000
100,000
86,176
27,668
58,508
77,663
42,418
35,245
125,878
68,415
57,463
12,079
9,754
2,325
13,024
2,334
10,690
5,389
5,524
-135
5,172
5,235
-63
2,191
2,074
117
5,073
5,133
-60
151
151
120
120
57
57
106
106
126
126
260
260
2,071
2,141
-70
24,578
23,561
1,017
33,375
36,852
-3,477
9,120
10,434
-1,314
6,601
11,243
-4,642
14,948
17,375
-2,427
51,220
57,543
-6,323
42,392
32,955
9,437
87,822
27,773
60,049
87,805
47,800
40,005
49,900
27,815
22,085
6,709
4,505
2,204
5,641
6,871
-1,230
2,019
2,019
5,106
5,151
-45
5,000
5,074
-74
5,165
5,165
104
104
100
100
162
162
54
54
255
255
15,193
16,794
-1,601
30,905
31,986
-1,081
970
1,051
-81
10,957
12,996
-2,039
16,185
14,858
1,327
8,833
11,694
-2,861
21,320
25,703
-4,383
15,075
12,223
2,852
100,000
99,480
520
87,410
27,773
59,637
88,043
47,800
40,243
125,578
68,415
57,163
6,327
5,636
691
29
27
2
5,063
5,055
8
3,049
3,013
36
3,000
3,011
-11
5,300
5,300
144
144
90
90
168
168
88
88
94
94
18,228
18,837
-609
11,089
11,335
-246
15,635
13,414
2,221
31,220
31,726
-506
10,306
9,619
687
3,498
4,846
-1,348
19,927
19,157
770
14,410
15,421
-1,011
45,228
42,865
2,363
87,496
27,773
59,723
88,526
47,800
40,726
168,868
91,082
77,786
4,193
5,074
-881
4,033
1,739
2,294
4,470
5,170
-700
5,525
5,213
312
5,081
5,125
-44
117
103
14
66
66
78
78
110
110
64
64
198
198
4,078
4,073
5
3,808
3,705
103
1,985
1,806
179
37,648
39,011
-1,363
13,576
17,207
-3,631
2,001
3,707
-1,706
8,033
6,304
1,729
13,009
16,655
-3,646
128,748
119,170
9,578
88,418
27,773
60,645
9,759
5,319
4,440
6,502
6,915
-413
20,286
20,247
39
3,282
1,548
1,734
5,135
4,913
222
5,056
4,985
71
5,000
5,107
-107
4,312
5,055
-743
74
74
84
84
89
89
156
156
82
82
45,883
44,845
1,038
41,545
39,487
2,058
17,252
23,041
-5,789
8,820
7,629
1,191
1,179
1,009
170
1,729
1,553
176
31,883
40,250
-8,367
30,372
34,907
-4,535
203,888
202,495
1,393
56,634
17,849
38,785
77,948
42,418
35,530
3,082
3,093
-11
10,642
12,699
-2,057
19
8
11
5,344
5,281
63
4,194
5,041
-847
3,124
3,175
-51
11,119
10,297
822
161
161
93
93
128
128
190
190
214
214
12,528
11,018
1,510
25,690
25,743
-53
17,154
15,462
1,692
858
748
110
462
563
-101
4,274
4,559
-285
10,997
9,967
1,030
7,828
6,264
1,564
36,866
54,137
-17,271
31,489
22,291
9,198
6,989
3,824
3,165
34,145
21,729
12,416
40,755
19,052
21,703
7,849
4,436
3,413
5,155
5,148
7
3,925
5,030
-1,105
4,708
5,204
-496
9,426
8,466
960
118
118
75
75
108
108
60
60
148
148
38,582
42,656
-4,074
16,351
15,249
1,102
18,350
20,525
-2,175
24,394
32,499
-8,105
949
887
62
902
1,293
-391
14,110
15,221
-1,111
7,434
7,366
68
127,176
93,203
33,973
88,040
62,382
25,658
87,387
47,800
39,587
10,928
7,544
3,384
11,596
12,393
-797
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
111
b
5,329
c
100
d
-6
e
-413
141
120
180
77
80
60
-686
895
-4,665
-1,860
-3,035
-309
4,549
-1,781
28,205
25,065
1,258
-230
-2,873
-140
-757
-143
-202
-377
128
70
126
70
54
125
-155
-199
-6,414
-3
-420
-472
-387
146
-3,851
2,783
38,985
-1,930
5,142
-1,098
1,696
191
-58
-693
72
52
100
126
84
83
-228
1,276
-587
266
-647
-886
-297
-332
22,739
-203
39,372
-3,764
-2,226
984
4,278
212
61
-848
60
75
46
95
99
123
-2,044
91
-2,367
3,080
-1,554
-5,024
2,385
23,016
-133
41,914
-2,472
4,255
3,993
3,160
-11
49
-214
77
130
65
85
89
189
852
-2,950
-1,723
-89
-1,089
-2,794
-5,094
-15,367
-12,044
-306
22,969
9,359
5,648
-126
2,848
-57
30
-7
43
110
46
70
60
120
-545
1,131
-1,954
-2,866
73
-259
-5,670
1,527
-2,442
-403
41,648
8,379
-800
-1,439
-95
-192
-203
-39
62
76
112
135
84
99
-23
152
1,011
1,370
716
-7,232
-356
12,065
224
-54
22,834
5,022
2,982
4,327
-701
-55
-459
-228
193
130
56
150
204
135
-299
3
-1,768
-1,040
-3,562
-1,023
-3,138
58,508
35,245
57,463
2,325
10,690
-135
-63
117
-60
151
120
57
106
126
260
-70
1,017
-3,477
-1,314
-4,642
-2,427
-6,323
9,437
60,049
40,005
22,085
2,204
-1,230
-45
-74
104
100
162
54
255
-1,601
-1,081
-81
-2,039
1,327
-2,861
-4,383
2,852
520
59,637
40,243
57,163
691
2
8
36
-11
144
90
168
88
94
-609
-246
2,221
-506
687
-1,348
770
-1,011
2,363
59,723
40,726
77,786
-881
2,294
-700
312
-44
14
66
78
110
64
198
5
103
179
-1,363
-3,631
-1,706
1,729
-3,646
9,578
60,645
4,440
-413
39
1,734
222
71
-107
-743
74
84
89
156
82
1,038
2,058
-5,789
1,191
170
176
-8,367
-4,535
1,393
38,785
35,530
-11
-2,057
11
63
-847
-51
822
161
93
128
190
214
1,510
-53
1,692
110
-101
-285
1,030
1,564
-17,271
9,198
3,165
12,416
21,703
3,413
7
-1,105
-496
960
118
75
108
60
148
-4,074
1,102
-2,175
-8,105
62
-391
-1,111
68
33,973
25,658
39,587
3,384
-797
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
1,171,174
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
-71,025
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
436,100
7,941,967
0.054911
2017
5,228,184
6,897,189
0.758017
2016
331,984
5,711,163
0.058129
2015
253,250
5,662,688
0.044723
2014
66,000
5,630,024
0.011723
2
Total
of line 1, column (d)
.....................
2
0.927503
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
0.185501
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
10,372,691
5
Multiply line 4 by line 3
......................
5
1,924,145
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
13,850
7
Add lines 5 and 6
........................
7
1,937,995
8
Enter qualifying distributions from Part XII, line 4
,.............
8
470,854
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
27,700
here
and enter 1% of Part I, line 27b
...................
c
All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
2
3
Add lines 1 and 2
...........................
3
27,700
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
4
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
27,700
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
49,152
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
49,152
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
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
21,452
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
21,452
Refunded
11
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition)
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
(2)
On foundation managers.
$
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
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)
IN
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
JOHN B SCHEUMANN
Telephone no.
(765) 742-0300
Located at
PO BOX 811
LAFAYETTE
IN
ZIP+4
47902
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
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
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
JOHN B SCHEUMANN
PRES/TREAS
1.00
0
0
0
34 THISE COURT
LALAYETTE
,
IN
47905
JOHN B SCHEUMANN JR
SECY
1.00
0
0
0
653 APPALOOSA TRAIL
WEST LAFAYETTE
,
IN
47906
JUNE M SCHEUMANN
ASST SECY
1.00
0
0
0
34 THISE COURT
LAFAYETTE
,
IN
47905
2
Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a)
Name and address of each employee paid more than $50,000
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
NONE
Total
number of other employees paid over $50,000
...................
Form
990-PF
(2019)
Form 990-PF (2019)
Page
7
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
(continued)
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
NONE
Total
number of others receiving over $50,000 for professional services
.............
Part IX-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
2
3
4
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
N/A
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
9,790,993
b
Average of monthly cash balances
.......................
1b
739,658
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
10,530,651
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation)
.............
1e
2
Acquisition indebtedness applicable to line 1 assets
..................
2
3
Subtract line 2 from line 1d
.........................
3
10,530,651
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
157,960
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
10,372,691
6
Minimum investment return.
Enter 5% of line 5
..................
6
518,635
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
518,635
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
27,700
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
27,700
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
490,935
4
Recoveries of amounts treated as qualifying distributions
................
4
5
Add lines 3 and 4
............................
5
490,935
6
Deduction from distributable amount (see instructions)
.................
6
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1
...
7
490,935
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
470,854
b
Program-related investments—total from Part IX-B
..................
1b
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
b
Cash distribution test (attach the required schedule)
.................
3b
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
470,854
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
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
470,854
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
490,935
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
b
Total for prior years:
20
,
20
,
20
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
b
From 2015
......
c
From 2016
......
48,458
d
From 2017
......
4,953,705
e
From 2018
......
58,298
f
Total
of lines 3a through e
........
5,060,461
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
470,854
a
Applied to 2018, but not more than line 2a
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
c
Treated as distributions out of corpus (Election
required—see instructions)
........
d
Applied to 2019 distributable amount
.....
470,854
e
Remaining amount distributed out of corpus
5
Excess distributions carryover applied to 2019.
20,081
20,081
(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
5,040,380
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
e
Undistributed income for 2018. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
f
Undistributed income for 2019. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2020
..........
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)
.......
8
Excess distributions carryover from 2014 not
applied on line 5 or line 7 (see instructions)
...
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
5,040,380
10
Analysis of line 9:
a
Excess from 2015
....
b
Excess from 2016
....
28,377
c
Excess from 2017
....
4,953,705
d
Excess from 2018
....
58,298
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).)
JOHN B SCHEUMANN
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
JOHN SCHEUMANN
PO BOX 811
LAFAYETTE
,
IN
479020811
(765) 742-0300
b
The form in which applications should be submitted and information and materials they should include:
1. NAME/ADDRESS/TELEPHONE NUMBER 2. EXEMPT STATUS 3. NATURE OF REQUEST 4. FINANCIAL DATA
c
Any submission deadlines:
NONE
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
RESTRICTIONS AND LIMITATIONS WHICH WOULD JEOPARDIZE THE EXEMPT FOUNDATION STATUS.
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
LAFAYETTE PARKS FOUNDATION
1915 SCOTT STREET
LAFAYETTE
,
IN
47904
GENERAL FUND
100,000
SALVATION ARMY
1110 UNION STREET
LAFAYETTE
,
IN
479041934
GENERAL FUND
5,100
LAFAYETTE URBAN MINISTRY
420 N 4TH STREET
LAFAYETTE
,
IN
479012213
GENERAL FUND
3,500
LAFAYETTE YMCA
1950 SOUTH 18TH STREET
LAFAYETTE
,
IN
479052099
GENERAL FUND
25,000
BALL STATE UNIVERSITY FOUNDATION
2800 WEST BETHEL AVE
MUNCIE
,
IN
47304
GENERAL FUND
30,000
HEIFER INTERNATIONAL
1 WORLD AVENUE
LITTLE ROCK
,
AR
72202
GENERAL FUND
10,000
GROUP HOMES FOR CHILDREN
3307 LONGLOIS DRIVE
LAFAYETTE
,
IN
47904
GENERAL FUND
1,000
PURDUE FOUNDATION INC
1281 WIN HENTSCHEL BLVD
WEST LAFAYETTE
,
IN
47906
GENERAL FUND
25,000
HABITAT FOR HUMANITY
420 SOUTH 1ST ST
LAFAYETTEE
,
IN
47905
GENERAL FUND
180,754
THE ARC OF TIPPECANOE COUNTY
PO BOX 1222
LAFAYETTE
,
IN
479021222
GENERAL FUND
1,000
YOUNG LIFE GREATER LAFAYETTE
PO BOX 2630
LAFAYETTE
,
IN
479962630
GENERAL FUND
1,000
WABASH CENTER
2000 GREENBUSH ST
LAFAYETTE
,
IN
47904
GENERAL FUND
1,000
MENTAL HEALTH ASSOCIATION
914 SOUTH STREET
LAFAYETTE
,
IN
47901
GENERAL FUND
1,000
CAREGIVER COMPANION
612 WABASH AVE
LAFAYETTE
,
IN
47905
GENERAL FUND
5,000
GREATER LAFAYETTE COMMERCE
337 COLUMBIA STREET
LAFAYETTE
,
IN
47901
GENERAL FUND
50,000
DICESE OF LAFAYETTE
610 LINGLE AVENUE
LAFAYETTE
,
IN
47901
GENERAL FUND
8,000
SHELTERING WINGS
PO BOX 92
DANVILLE
,
IN
46122
GENERAL FUND
2,500
OUTRUN THE SUN
8435 KEYSTONE CROSSING ST
INDIANAPOLIS
,
IN
46240
GENERAL FUND
10,000
WILLOWSTONE FAMILY SERVICES
615 N 18TH ST STE 101
INDIANAPOLIS
,
IN
47904
GENERAL FUND
1,000
RILEY CHILDREN'S FOUNDATION
30 S MERIDAN ST STE 200
INDIANAPOLIS
,
IN
46204
GENERAL FUND
10,000
Total
.................................
3a
470,854
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
...........
14
108,826
4
Dividends and interest from securities
....
14
251,199
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
24,150
1,147,024
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
NONDIVIDEND - DISTRIBUTIONS
14
14,202
b
MISCELLANEOUS INCOME
14
62
c
ROUNDING
14
2
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
398,441
1,147,024
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
1,545,465
(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.)
3
INCOME FROM THE PRUDENT INVESTMENT OF PRIVATE DONATIONS
4
INCOME FROM THE PRUDENT INVESTMENT OF PRIVATE DONATIONS
8
DIVERSIFICATION OF INVESTMENTS; REBALANCING OF INVESTMENTS
8
X
8
X
8
X
8
X
8
X
8
X
8
X
8
X
8
X
8
X
8
X
8
X
8
X
8
X
8
X
8
X
8
X
8
X
8
X
8
X
8
X
8
X
8
X
8
X
8
X
8
X
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