-
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
SECKINGER FOUNDATION CORPORATION
Number and street (or P.O. box number if mail is not delivered to street address)
5900 SW 73RD STREET
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MIAMI
,
FL
33143
A Employer identification number
82-2524117
B
Telephone number (see instructions)
(305) 667-2001
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)
$
280,418
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)
2,500
2
Check
.............
3
Interest on savings and temporary cash investments
10
10
10
4
Dividends and interest from securities
...
5,520
5,520
5,520
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
b
Gross sales price for all assets on line 6a
7
Capital gain net income (from Part IV, line 2)
...
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)
.......
12
Total.
Add lines 1 through 11
........
8,030
5,530
5,530
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)
.......
900
900
c
Other professional fees (attach schedule)
....
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
15,535
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
60
23
Other expenses (attach schedule)
.......
19,646
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
36,141
900
0
25
Contributions, gifts, grants paid
.......
4,364
4,364
26
Total expenses and disbursements.
Add lines 24 and 25
40,505
900
4,364
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-32,475
b
Net investment income
(if negative, enter -0-)
4,630
c
Adjusted net income
(if negative, enter -0-)
...
5,530
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
.............
31,503
2,265
2,265
2
Savings and temporary cash investments
.........
281,390
278,153
278,153
3
Accounts receivable
Less: allowance for doubtful accounts
4
Pledges receivable
Less: allowance for doubtful accounts
5
Grants receivable
.................
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)
.....
7
Other notes and loans receivable (attach schedule)
Less: allowance for doubtful accounts
8
Inventories for sale or use
..............
9
Prepaid expenses and deferred charges
..........
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
.......
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)
312,893
280,418
280,418
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
...........
312,893
25
Net assets with donor restrictions
............
Foundations that do not follow FASB ASC 958, check here
and complete lines 26 through 30.
26
Capital stock, trust principal, or current funds
........
27
Paid-in or capital surplus, or land, bldg., and equipment fund
28
Retained earnings, accumulated income, endowment, or other funds
29
Total net assets or fund balances
(see instructions)
.....
312,893
280,418
30
Total liabilities and net assets/fund balances
(see instructions)
.
312,893
280,418
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
312,893
2
Enter amount from Part I, line 27a
.....................
2
-32,475
3
Other increases not included in line 2 (itemize)
3
4
Add lines 1, 2, and 3
..........................
4
280,418
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
280,418
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.)
1a
b
c
d
e
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
b
c
d
e
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
e
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
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
4,364
2017
2016
2015
2014
2
Total
of line 1, column (d)
.....................
2
3
Average distribution ratio for the 5-year base period—divide the total on line 2 by 5.0, or by the number of years the foundation has been in existence if less than 5 years
......
3
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
274,954
5
Multiply line 4 by line 3
......................
5
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
46
7
Add lines 5 and 6
........................
7
46
8
Enter qualifying distributions from Part XII, line 4
,.............
8
4,364
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
46
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
46
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
46
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
46
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
Refunded
11
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition)
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
(2)
On foundation managers.
$
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
No
7
Did the foundation have at least $5,000 in assets at any time during the year?
If "Yes," complete Part II, col. (c),
and Part XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
b
If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G?
If "No," attach explanation
.
8b
Yes
9
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
or 4942(j)(5) for calendar year 2019 or the taxable year beginning in 2019? See the instructions for Part XIV.
If "Yes," complete Part XIV
.............................
9
No
10
Did any persons become substantial contributors during the tax year?
If "Yes," attach a schedule listing their names
and addresses.
...............................
10
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
5
Part VII-A
Statements Regarding Activities
(continued)
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions
.............
11
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement. See instructions
.................
12
No
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
N/A
14
The books are in care of
JAGUSZTYN & JAGUSZTYN PA
Telephone no.
(954) 491-1065
Located at
701 EAST COMMERCIAL BLVD SUITE 200
FORT LAUDERDALE
FL
ZIP+4
33334
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1)
Engage in the sale or exchange, or leasing of property with a disqualified person?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(5)
Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)?
...............
Yes
No
(6)
Agree to pay money or property to a government official? (
Exception.
Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.)
.......
Yes
No
b
If any answer is "Yes" to 1a(1)–(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions
........
1b
No
Organizations relying on a current notice regarding disaster assistance check here
........
c
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2019?
.............
1c
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2019, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2019?
.............
Yes
No
If "Yes," list the years
2018
,
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
Yes
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
......................
Yes
No
b
If "Yes," did it have excess business holdings in 2019 as a result of
(1)
any purchase by the foundation
or disqualified persons after May 26, 1969;
(2)
the lapse of the 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or
(3)
the lapse of the 10-, 15-, or 20-year first phase holding period?
(Use Schedule C, Form 4720, to determine
if the foundation had excess business holdings in 2019.)
..................
3b
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2019?
4b
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
6
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
(continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
No
b
If any answer is "Yes" to 5a(1)–(5), did
any
of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions
......
5b
Organizations relying on a current notice regarding disaster assistance check here
.........
c
If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant?
..........
Yes
No
If "Yes," attach the statement required by Regulations section 53.4945–5(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract?
.....................
Yes
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
....
6b
No
If "Yes" to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
Yes
No
b
If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction?
....
7b
8
Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment during the year?
.................
Yes
No
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1
List all officers, directors, trustees, foundation managers and their compensation. See instructions
(a)
Name and address
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(If not paid, enter
-0-)
(d)
Contributions to employee benefit plans and deferred compensation
(e)
Expense account,
other allowances
Patricia Seckinger
President
20.00
0
5215 Hammock Drive
Coral Gables
,
FL
33156
Sammy Thompson
Vice President
15.00
0
8835 NW 3rd Court
Coral Springs
,
FL
33071
Dan Brablick
Director
10.00
0
5900 SW 73rd Street STE 201
South Florida
,
FL
33143
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
ALL FUNDS DONATED IN 2019 WERE IN KEEPING WITH THE FOUNDATION'S MISSION TO PROVIDE FOR THE RESCUE AND SHELTER OF ANIMALS. THE CONTRIBUTIONS MADE WERE TO 501(c)(3) QUALIFIED ORGANIZATIONS.
0
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
275,728
b
Average of monthly cash balances
.......................
1b
3,413
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
279,141
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation)
.............
1e
0
2
Acquisition indebtedness applicable to line 1 assets
..................
2
3
Subtract line 2 from line 1d
.........................
3
279,141
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
4,187
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
274,954
6
Minimum investment return.
Enter 5% of line 5
..................
6
13,748
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
13,748
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
46
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
46
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
13,702
4
Recoveries of amounts treated as qualifying distributions
................
4
5
Add lines 3 and 4
............................
5
13,702
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
13,702
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
4,364
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
4,364
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
46
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
4,318
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
13,702
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
11,978
b
Total for prior years:
20
,
20
,
20
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
b
From 2015
......
c
From 2016
......
d
From 2017
......
e
From 2018
......
2,177
f
Total
of lines 3a through e
........
2,177
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
4,364
a
Applied to 2018, but not more than line 2a
4,364
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
c
Treated as distributions out of corpus (Election
required—see instructions)
........
0
d
Applied to 2019 distributable amount
.....
e
Remaining amount distributed out of corpus
5
Excess distributions carryover applied to 2019.
2,177
2,177
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
e
Undistributed income for 2018. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
7,614
f
Undistributed income for 2019. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2020
..........
11,525
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions)
.......
8
Excess distributions carryover from 2014 not
applied on line 5 or line 7 (see instructions)
...
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
10
Analysis of line 9:
a
Excess from 2015
....
b
Excess from 2016
....
c
Excess from 2017
....
d
Excess from 2018
....
e
Excess from 2019
....
Form
990-PF
(2019)
Form 990-PF (2019)
Page
10
Part XIV
Private Operating Foundations
(see instructions and Part VII-A, question 9)
1a
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2019, enter the date of the ruling
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2019
(b)
2018
(c)
2017
(d)
2016
b
85% of line 2a
.........
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed
...
c
“Support" alternative test—enter:
(1)
Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
....
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
(3)
Largest amount of support
from an exempt organization
(4)
Gross investment income
Part XV
Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or email address of the person to whom applications should be addressed:
b
The form in which applications should be submitted and information and materials they should include:
c
Any submission deadlines:
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Form
990-PF
(2019)
Form 990-PF (2019)
Page
11
Part XV
Supplementary Information
(continued)
3
Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
Best Friends Animal Society
5001 Angel Canyon Road
Kanab
,
UT
84741
Animal Rescue
75
ASPCA
424 E 92nd Street
New York
,
NY
10128
Animal Rescue
40
North Shore Animal League
25 Davis Ave
Port Washington
,
NY
11050
Animal Rescue
125
K9 Lifeline Rescue
PO Box 772
Genoa City
,
WI
53128
Animal Rescue
64
Ring Dog Rescue
PO Box 28632
Henrico
,
VA
23228
Animal Rescue
80
Orphan Acres
1183 Rofthfork Road
Viola
,
ID
83872
Animal Rescue
56
Smiling Dog Farms
PO Box 743
Wharton
,
TX
77448
Animal Rescue
54
National Humane Society
116101 W Dixie Hwy
North Miami Beach
,
FL
33160
Animal Rescue
40
Covenant House
4100 733 Breakers Ave
Ft Lauderdale
,
FL
33304
Helping Homeless Children
60
PETA
501 Front Street
Norfolk
,
VA
23510
Animal Rescue
60
Doris Day Animal League
8033 Sunset Ste 845
Los Angeles
,
CA
90046
Animal Rescue
38
Doctors without Borders
40 Rector St
New York
,
NY
10006
Medical Care
90
Food for the Poor
6401 Lyons Road
Coconut Creek
,
FL
33073
Provide food and housing
48
PCRM
5100 Wisconsin Ave
Washington
,
DC
20016
Health Organization
35
Reservation Animal Rescue
16415 Addison Road
Addison
,
TX
75001
Animal Rescue
50
Christian Appalachian Project
485 Ponderosa Drive
Painstville
,
KY
41240
Poverty Relief
85
Mercy for Animals
7908 Santa Monica Blvd
West Hollywood
,
CA
90046
Animal Rights
25
The Salvation Army
PO Box 269
Alexandria
,
VA
22313
Adult and Child Services
50
Miami Rescue Mission
2020 NW 1st Ave
Miami
,
FL
33127
Homeless shelters
35
Florida Sheriffs Youth Ranches
751 Rye Wilderness
Parrish
,
FL
34219
Assist at-risk children
75
Farm Sanctuary Florida
39610 Carlton Rd
Duette
,
FL
34219
Animal Rescue
50
Alley Cat Rescue
PO Box 585
Mount Rainer
,
MD
20712
Feline Rescue
25
South Florida PBS
3401 S Congress Ave
Boynton Beach
,
FL
33426
Public Broadcasting
45
Pilots to the Rescue
931 Manhattan Ave
Brooklyn
,
NY
11222
Animal Rescue
54
Wounded Paw Project
9707 Waterfront Dr
Manassas
,
VA
20111
Animal Rescue
53
Four Corners Equine Rescue
33 Rd 3334
Aztec
,
NM
87410
Animal Rescue
29
Last Chance for Animals
8033 Sunset Blvd
Los Angeles
,
CA
90046
Animal Rescue
100
Boys Town
14100 Crawford St
Boys Town
,
NE
68010
Saving Children
50
Delta Rescue
PO Box 9
Glendale
,
CA
91209
Animal Sanctuary
55
Macular Degeneration Foundation
PO Box 515
Northhampton
,
MA
01061
Research on Macular Degeneration
63
Kindness Ranch
854 WY-270
Hartville
,
WY
82215
Animal Rescue
30
Animal Recovery Mission
PO Box 403344
Miami Beach
,
FL
33140
Prevent Animal Cruelty
95
Hooves and Paws
PO Box 1469
Littlerock
,
CA
93553
Animal Rescue
85
Alzheimer's Disease Research
22512 Gatway Center Drive
Clarksburg
,
MD
20871
Alzheimer disease research
35
American Red Cross
335 SW 27th Ave
Miami
,
FL
33135
Humanitarian aid
53
Animal Legal Defense Fund
525 East Cotati Ave
Cotati
,
CA
94931
advocacy for animals
35
Animal Place
17314 McCourtney Rd
Grass Valley
,
CA
95949
Animal Rescue
75
Bidawee
410 E 38th St
New York
,
NY
10016
Animal Shelter
25
Compantion Animal Protestation Soci
759 Chief Justice Curshing Hwy
Cohasset
,
MA
02025
Animal rights
50
Dreamchaser Horse Rescue
PO Box 2269
Peoria
,
AZ
85380
Horse Rescue
58
Epilepsy Foundation
7300 N Kendall Dr Suite 760
Miami
,
FL
33156
Support for epilepsy sufferers
25
Feed the Children
PO Box 36
Oklahoma City
,
OK
73101
Help Children in Poverty
50
Feeding South Florida
2501 SW 32nd Terrace
Pembroke Park
,
FL
33023
Food Bank
25
Florida School for the Deaf and Bli
207 San Marco Ave
St Augustine
,
FL
32084
School for Deaf and Blind
35
Mercy Home for Boys and Girls
1140 W Jackson Blvd
Chicago
,
IL
60607
For homeless children
30
Friends of WLRN
172 NE 15th St
Miami
,
FL
33132
public broadcasting
35
Gentle Giants Draft Horse Rescue
PO box 5058
Hagerstown
,
MD
21741
Horse Rescue
28
Grey2k USA Worldwide
PO Box F
Arlington
,
MA
02476
Greyhound protection
25
Guardians of Rescue
34 E Main St 303
Smithtown
,
NY
11787
Animal Rescue
25
Habitat for Humanity
6060 Habitat for Horses Lane
Alvin
,
TX
77511
Homeless Shelter
35
Help our Military and Police Dogs H
PO Box 5687
Spring Hill
,
FL
34611
Support Military and Police Dogs
25
Humane Society International
1255 23rd St NW
Washington
,
DC
20037
Animal Rescue
75
Humane Society Legislative Fund
1255 23rd Street NW Suite 455
Washington
,
DC
20037
Animal Protection
48
Lifesavers Wild Horse Ranch
23809 E Ave J
Lancaster
,
CA
93535
Animal Rescue
27
Little Shelter
33 Warnter Rd
Huntington
,
NY
11743
Animal Rescue
35
Meals on Wheels America
1550 Cyrstal Drive Suite 1004
Arlington
,
VA
22202
Meals for Seniors
50
Mercy Corps
45 Ankeny St
Portland
,
OR
97204
Humanitarian aid
30
National Anti-Vivisection Society
53 W Jackson Blvd Suite 1552
Chicago
,
IL
60604
Animal welfare
25
National Police Association
8710 Bash st
Indianapolis
,
IN
46250
Support Law Enforcement
35
New England Anti Vivesection Societ
333 Washington St Suite 850
Boston
,
MA
02108
Animal Rights
25
Ocean Conservancy
600 1st Ave N 301
St Petersburg
,
FL
33701
Ocean Conservation
43
Paralyzed Veterans of America
801 18th Street NW
Washington
,
DC
20006
Build future for injured veterans
80
Paws for Purple Hearts
7404 Commerce Way
Ruther Glen
,
VA
22546
Canine therapy
25
Pets of the Homeless
PO Box 5057
Hagerstown
,
MD
21741
Pet support
54
Physicians Committee for Responsibl
5100 Wisconsin Ave NW Suite 400
Washington
,
DC
20016
Animal Advocacy
60
Project K9 Hero
PO Box 9797
Pubelo
,
CO
81008
Animal Adoption
27
Red Rover
PO box 188890
Sacramento
,
CA
95818
Animal Shelter
75
Shriners Hospital for Children
PO Box 1510
Ranson
,
WV
25438
Child Welfare
50
Southern Winds Equine Rescue
PO Box 3863
Wichita
,
KS
67201
Animal Rescue
35
Speak Up for Horses
PO Box 7081
Merrifield
,
VA
22116
Animal Rescue
58
St Labre Indian School
PO Box 216
Ashland
,
MT
59003
Education
20
Turning Pointe Donkey Rescue
PO Box 1338
Merrifield
,
VA
22116
Animal Rescue
35
White Coat Waste Project
PO Box 26029
Washington
,
DC
20001
Animal Advocacy
25
Wolf Paws
2525 Edgewater Ln
Dandridge
,
TN
37725
Animal Sanctuary
25
Wounded Warrior Project
PO Box 758516
Topeka
,
KS
66675
Health and rehabiliation
35
Friends of the Underline
Sw 1st Ave
Miami
,
FL
33130
Environmental
50
American Cancer Society
250 Williams Street NW
Atlanta
,
GA
30303
Cancer Research
50
American Heart Association
4000 Hollywood Blvd 170
Hollywood
,
FL
33021
Medical Research
25
Habitat for Horses
6060 Habirtat for Horses Lane
Alvin
,
TX
77511
Animal Shelter
25
International Fund for Animal Welfa
260 Summer Street
Yarmouth Port
,
MA
02675
Animal Welfare
25
Izzy's Love Equine Rescue
9739 Dry Bridge Rd
Emmitsburg
,
MD
21727
Animal Rescue
25
Memorial Sloan Kettering Cancer Cen
1275 York Ave
New York
,
NY
10065
Cancer research
35
Equine Voices
6 Cam Otero
Tubac
,
AZ
85646
Animal Rescue
50
UM Bascom Palmer Eye Institute
PO Box 016880
Miami
,
FL
33101
Eradicate Eye Disease
50
Human Rescue Alliance
PO Box 96312
Washington
,
DC
20090
Animal Rescue
50
Stand for America
1300 Pennsylvania Ave
Washington
,
DC
20004
Community Development
50
Mutts with a Mission
PO Box 4147
Suffolk
,
VA
23439
Disability Services
25
Eckerd Connects
100 Starcrest Drive
Clearwater
,
FL
33765
Youth Services
35
Republican Party of FL
420 E Jefferson Street
Tallahassee
,
FL
32301
Political donation
50
KEM Foundation
PO Box 18847
Cleveland Heights
,
OH
44118
Cancer Research
200
The Fellowship
30 North LaSalle Street
Chicago
,
IL
60602
Religous Advocacy
34
Total
.................................
3a
4,364
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
10
4
Dividends and interest from securities
....
14
5,520
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
............
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)
..
5,530
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
5,530
(See worksheet in line 13 instructions to verify calculations.)
Part XVI-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
instructions.)
Form
990-PF
(2019)
Form 990-PF (2019)
Page
13
Part XVII
Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
1
Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
Yes
No
a
Transfers from the reporting foundation to a noncharitable exempt organization of:
(1)
Cash
...................................
1a(1)
No
(2)
Other assets
.................................
1a(2)
No
b
Other transactions:
(1)
Sales of assets to a noncharitable exempt organization
....................
1b(1)
No
(2)
Purchases of assets from a noncharitable exempt organization
..................
1b(2)
No
(3)
Rental of facilities, equipment, or other assets
.......................
1b(3)
No
(4)
Reimbursement arrangements
...........................
1b(4)
No
(5)
Loans or loan guarantees
.............................
1b(5)
No
(6)
Performance of services or membership or fundraising solicitations
................
1b(6)
No
c
Sharing of facilities, equipment, mailing lists, other assets, or paid employees
..............
1c
No
d
If the answer to any of the above is "Yes," complete the following schedule. Column
(b)
should always show the fair market value
of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
in any transaction or sharing arrangement, show in column
(d)
the value of the goods, other assets, or services received.
(a)
Line No.
(b)
Amount involved
(c)
Name of noncharitable exempt organization
(d)
Description of transfers, transactions, and sharing arrangements
2a
Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
described in section 501(c) (other than section 501(c)(3)) or in section 527?
...........
Yes
No
b
If "Yes," complete the following schedule.
(a)
Name of organization
(b)
Type of organization
(c)
Description of relationship
Sign Here
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
May the IRS discuss this return
with the preparer shown below
(see instr.)
Yes
No
Signature of officer or trustee
Date
Title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's Signature
Date
Check if self-
employed
PTIN
Firm's name
Firm's EIN
Firm's address
Phone no.
Form
990-PF
(2019)
Additional Data
Software ID:
19009920
Software Version:
2019v5.0
Form 990PF - Special Condition Description:
Special Condition Description