-
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
GAIL G ELLIS FOUNDATION INC
C/O DAVID FRIEDLANDER FGMK
Number and street (or P.O. box number if mail is not delivered to street address)
2801 LAKESIDE DRIVE - 3RD FLOOR
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
BANNOCKBURN
,
IL
60015
A Employer identification number
36-4076867
B
Telephone number (see instructions)
(847) 374-0400
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)
$
12,507,473
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
49,708
49,708
4
Dividends and interest from securities
...
99,085
99,085
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
309,168
b
Gross sales price for all assets on line 6a
7
Capital gain net income (from Part IV, line 2)
...
309,168
8
Net short-term capital gain
.........
9
Income modifications
...........
10a
Gross sales less returns and allowances
14,000
b
Less: Cost of goods sold
....
c
Gross profit or (loss) (attach schedule)
.....
14,000
14,000
11
Other income (attach schedule)
.......
174,249
174,249
0
12
Total.
Add lines 1 through 11
........
646,210
632,210
14,000
13
Compensation of officers, directors, trustees, etc.
0
0
0
0
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
c
Other professional fees (attach schedule)
....
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
5,314
5,314
0
0
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
158,689
158,689
0
0
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
164,003
164,003
0
0
25
Contributions, gifts, grants paid
.......
617,710
617,710
26
Total expenses and disbursements.
Add lines 24 and 25
781,713
164,003
0
617,710
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-135,503
b
Net investment income
(if negative, enter -0-)
468,207
c
Adjusted net income
(if negative, enter -0-)
...
14,000
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2019)
Form 990-PF (2019)
Page
2
Part II
Balance Sheets
Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year
End of year
(a)
Book Value
(b)
Book Value
(c)
Fair Market Value
1
Cash—non-interest-bearing
.............
2
Savings and temporary cash investments
.........
106,189
82,091
82,091
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)
..........
11,491,203
12,576,589
12,425,382
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)
11,597,392
12,658,680
12,507,473
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)
......
7,672
88,163
22
Other liabilities (describe
)
23
Total liabilities
(add lines 17 through 22)
.........
7,672
88,163
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
11,589,720
12,570,517
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)
.....
11,589,720
12,570,517
30
Total liabilities and net assets/fund balances
(see instructions)
.
11,597,392
12,658,680
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
11,589,720
2
Enter amount from Part I, line 27a
.....................
2
-135,503
3
Other increases not included in line 2 (itemize)
3
1,116,300
4
Add lines 1, 2, and 3
..........................
4
12,570,517
5
Decreases not included in line 2 (itemize)
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
12,570,517
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
K-1 GORE CREEK STOCK FUND S1
P
b
K-1 GORE CREEK STOCK FUND S1
P
c
K-1 GORE CREEK PRIVATE FUND S1B
P
d
K-1 GORE CREEK PRIVATE FUND S1B
P
e
K-1 GORE CREEK HEDGE FUND S1
P
K-1 GORE CREEK HEDGE FUND S1
P
K-1 GORE CREEK BOND FUND S1
P
K-1 GORE CREEK PRIVATE FUND S1
P
K-1 GORE CREEK PRIVATE FUND S1
P
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
18,321
b
204,104
c
-1,658
d
-34,014
e
12,635
69,610
-4,163
-759
45,092
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
18,321
b
204,104
c
-1,658
d
-34,014
e
12,635
69,610
-4,163
-759
45,092
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
309,168
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
527,975
11,725,824
0.045027
2017
622,452
11,764,032
0.052911
2016
580,377
11,302,182
0.051351
2015
567,592
11,762,840
0.048253
2014
530,652
11,884,582
0.044650
2
Total
of line 1, column (d)
.....................
2
0.242192
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
0.048438
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
11,909,103
5
Multiply line 4 by line 3
......................
5
576,853
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
4,682
7
Add lines 5 and 6
........................
7
581,535
8
Enter qualifying distributions from Part XII, line 4
,.............
8
617,710
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
4,682
here
and enter 1% of Part I, line 27b
...................
c
All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
2
0
3
Add lines 1 and 2
...........................
3
4,682
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
4
0
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
4,682
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
6,470
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
0
d
Backup withholding erroneously withheld
...........
6d
0
7
Total credits and payments. Add lines 6a through 6d
..............
7
6,470
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
0
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
1,788
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
1,788
Refunded
11
0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition)
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
0
(2)
On foundation managers.
$
0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
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)
IL
b
If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G?
If "No," attach explanation
.
8b
Yes
9
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
or 4942(j)(5) for calendar year 2019 or the taxable year beginning in 2019? See the instructions for Part XIV.
If "Yes," complete Part XIV
.............................
9
No
10
Did any persons become substantial contributors during the tax year?
If "Yes," attach a schedule listing their names
and addresses.
...............................
10
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
5
Part VII-A
Statements Regarding Activities
(continued)
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions
.............
11
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement. See instructions
.................
12
No
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
N/A
14
The books are in care of
DAVID FRIEDLANDER
Telephone no.
(847) 940-3240
Located at
2801 LAKESIDE 300
BANNOCKBURN
IL
ZIP+4
60015
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
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2019, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2019?
.............
Yes
No
If "Yes," list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer "No" and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
......................
Yes
No
b
If "Yes," did it have excess business holdings in 2019 as a result of
(1)
any purchase by the foundation
or disqualified persons after May 26, 1969;
(2)
the lapse of the 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or
(3)
the lapse of the 10-, 15-, or 20-year first phase holding period?
(Use Schedule C, Form 4720, to determine
if the foundation had excess business holdings in 2019.)
..................
3b
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2019?
4b
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
6
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
(continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
No
b
If any answer is "Yes" to 5a(1)–(5), did
any
of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions
......
5b
Organizations relying on a current notice regarding disaster assistance check here
.........
c
If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant?
..........
Yes
No
If "Yes," attach the statement required by Regulations section 53.4945–5(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract?
.....................
Yes
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
....
6b
No
If "Yes" to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
Yes
No
b
If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction?
....
7b
8
Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment during the year?
.................
Yes
No
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1
List all officers, directors, trustees, foundation managers and their compensation. See instructions
(a)
Name and address
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(If not paid, enter
-0-)
(d)
Contributions to employee benefit plans and deferred compensation
(e)
Expense account,
other allowances
GAIL G ELLIS
DIRECTOR
0.00
0
0
0
1435 CIRCLE DRIVE
SAN MARINO
,
CA
91108
BRIAN C SULLIVAN
DIRECTOR
0.00
0
0
0
15040 ALTATA DRIVE
PACIFIC PALISADES
,
CA
90272
CARRIE E SULLIVAN
DIRECTOR
0.00
0
0
0
1455 CIRCLE DRIVE
SAN MARINO
,
CA
91108
2
Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a)
Name and address of each employee paid more than $50,000
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
NONE
Total
number of other employees paid over $50,000
...................
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
7
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
(continued)
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
NONE
Total
number of others receiving over $50,000 for professional services
.............
0
Part IX-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
2
3
4
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
8
Part X
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations, see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities
...................
1a
0
b
Average of monthly cash balances
.......................
1b
94,140
c
Fair market value of all other assets (see instructions)
................
1c
11,996,320
d
Total
(add lines 1a, b, and c)
.........................
1d
12,090,460
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation)
.............
1e
0
2
Acquisition indebtedness applicable to line 1 assets
..................
2
0
3
Subtract line 2 from line 1d
.........................
3
12,090,460
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
181,357
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
11,909,103
6
Minimum investment return.
Enter 5% of line 5
..................
6
595,455
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
595,455
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
4,682
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
4,682
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
590,773
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
590,773
6
Deduction from distributable amount (see instructions)
.................
6
0
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1
...
7
590,773
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
617,710
b
Program-related investments—total from Part IX-B
..................
1b
0
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
b
Cash distribution test (attach the required schedule)
.................
3b
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
617,710
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
4,682
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
613,028
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
590,773
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
568,419
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
b
From 2015
......
c
From 2016
......
d
From 2017
......
e
From 2018
......
f
Total
of lines 3a through e
........
0
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
617,710
a
Applied to 2018, but not more than line 2a
568,419
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
0
c
Treated as distributions out of corpus (Election
required—see instructions)
........
0
d
Applied to 2019 distributable amount
.....
49,291
e
Remaining amount distributed out of corpus
0
5
Excess distributions carryover applied to 2019.
0
0
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
0
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
0
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
0
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
0
e
Undistributed income for 2018. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
0
f
Undistributed income for 2019. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2020
..........
541,482
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions)
.......
0
8
Excess distributions carryover from 2014 not
applied on line 5 or line 7 (see instructions)
...
0
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
0
10
Analysis of line 9:
a
Excess from 2015
....
b
Excess from 2016
....
c
Excess from 2017
....
d
Excess from 2018
....
e
Excess from 2019
....
Form
990-PF
(2019)
Form 990-PF (2019)
Page
10
Part XIV
Private Operating Foundations
(see instructions and Part VII-A, question 9)
1a
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2019, enter the date of the ruling
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2019
(b)
2018
(c)
2017
(d)
2016
b
85% of line 2a
.........
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed
...
c
“Support" alternative test—enter:
(1)
Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
....
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
(3)
Largest amount of support
from an exempt organization
(4)
Gross investment income
Part XV
Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
GAIL G ELLIS
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
ABILITYFIRST
1300 E GREEN STREET
PASADENA
,
CA
91106
PUBLIC CHARITY
4,000
ACADEMY OF ST JOAN OF ARC
9245 LAWNDALE AVE
EVANSTON
,
IL
602031308
PUBLIC CHARITY
1,000
ADOPTAPLANTOON
PO BOX 234
LOZANO
,
TX
78568
PUBLIC CHARITY
1,000
AIM FOR MENTAL HEALTH
PO BOX 4235
CARMEL BY THE SEA
,
CA
93921
PUBLIC CHARITY
1,000
ALZHEIMER'S ASSOCIATION
4709 GOLF RD
SKOKIE
,
IL
60076
PUBLIC CHARITY
1,000
AM LUNG ASSOCIATION
PO BOX 11039
LEWISTON
,
MD
04243
PUBLIC CHARITY
1,000
AMERICAN HEART ASSOCIATION
208 S LASALLE ST STE 1500
CHICAGO
,
IL
60604
PUBLIC CHARITY
1,000
AMERICAN INSTITUTE FOR CANCER RESEARCH
PO BOX 97167
WASHINGTON
,
DC
200907167
PUBLIC CHARITY
1,000
AMERICAN RED CROSS
PO BOX 37639
BOONE
,
IA
50037
PUBLIC CHARITY
5,000
ART CENTER COLLEGE OF DESIGN
1700 LIDA ST
PASADENA
,
CA
91103
PUBLIC CHARITY
1,000
ASPCA
424 E 92ND ST
NEW YORK
,
NY
10128
PUBLIC CHARITY
1,000
ASSOC OF THE SACRED HEART
PO BOX 411821
ST LOUIS
,
MO
63147
PUBLIC CHARITY
1,000
AUTISM SPEAKS
1 EAST 33RD STREET 4TH FLOOR
NEW YORK
,
NY
10016
PUBLIC CHARITY
4,000
AUTRY MUSEUM OF THE AMERICAN WEST
4700 WESTERN HERITAGE WAY
LOS ANGELES
,
CA
90027
PUBLIC CHARITY
3,000
BETTY FORD ALPINE GARDENS
530 SOUTH FRONTAGE ROAD EAST
VAIL
,
CO
81657
PUBLIC CHARITY
1,000
BOY SCOUTS OF AMERICA
1325 W WALNUT HILL LANE
IRVING
,
TX
75015
PUBLIC CHARITY
2,000
BOYS AND GIRLS CLUB OF AMERICA
1275 PEACHTREE ST NE
ATLANTA
,
GA
303093506
PUBLIC CHARITY
2,000
BOY'S TOWN
14100 CRAWFORD ST
BOYS TOWN
,
NE
68010
PUBLIC CHARITY
1,000
BRAILLE INSTITUTE OF AMERICA
741 N VERMONT AVE
LOS ANGELES
,
CA
90029
PUBLIC CHARITY
1,000
BRAVO VAIL
2271 N FRONTAGE RD W
VAIL
,
CO
81657
PUBLIC CHARITY
5,000
CAL FARLEY'S BOYS RANCH
PO BOX 98156
WASHINGTON
,
DC
20090
PUBLIC CHARITY
1,000
CALTECH
1200 E CALIFORNIA BLVD
PASADENA
,
CA
91125
PUBLIC CHARITY
2,000
CAMPING AND EDUCATION FOUNDATION
3515 MICHIGAN AVENUE
CINCINNATI
,
OH
45208
PUBLIC CHARITY
1,000
CASA OF LOS ANGELES
201 CENTRE PLAZA DR 1100
MONTEREY PARK
,
CA
91754
PUBLIC CHARITY
1,000
CATHOLIC RELIEF SERVICES
PO BOX 17145
BALTIMORE
,
MD
21298
PUBLIC CHARITY
1,000
CHILDREN'S BURN FOUNDATION
5000 VAN NUYS BOULEVARD SUITE 210
SHERMAN OAKS
,
CA
91403
PUBLIC CHARITY
1,000
CHILDREN'S HOSPITAL OF LA
4650 SUNSET BLVD
LOS ANGELES
,
CA
90027
PUBLIC CHARITY
10,000
CIRCLE OF FRIENDS
225 E CHICAGO ST
CHICAGO
,
IL
60611
PUBLIC CHARITY
1,000
CITY OF HOPE
1500 EAST DUARTE ROAD
DUARTE
,
CA
91010
PUBLIC CHARITY
5,000
CLASSICAL KUSC
PO BOX 7913
LOS ANGELES
,
CA
90007
PUBLIC CHARITY
2,000
COAST GUARD FOUNDATION
394 TAUGWONK RD
STONINGTON
,
CT
06378
PUBLIC CHARITY
1,000
DOCTORS WITHOUT BORDERS
333 7TH AVENUE 2ND FLOOR
NEW YORK
,
NY
10001
PUBLIC CHARITY
2,000
DOWNTOWN WOMEN'S CENTER
442 SAN PEDRO ST
LOS ANGELES
,
CA
90013
PUBLIC CHARITY
1,000
EARTHWATCH INSTITUTE
114 WESTERN AVE
BOSTON
,
MA
02134
PUBLIC CHARITY
1,000
EASTER SEALS
PO BOX 35908
LOS ANGELES
,
CA
900350906
PUBLIC CHARITY
500
EDUCATIONAL FOUNDATION---BARRINGTON
283 COUNTRY ROAD
BARRINGTON
,
RI
60011
PUBLIC CHARITY
1,000
EPILEPSY FOUNDATION
PO BOX 96548
WASHINGTON
,
DC
20077
PUBLIC CHARITY
500
FEED THE CHILDREN
333 N MERIDIAN
OKLAHOMA CITY
,
OK
73107
PUBLIC CHARITY
1,000
FEEDING AMERICA
PO BOX 96749
WASHINGTON
,
DC
20077
PUBLIC CHARITY
1,200
FINCA
PO BOX 98048
WASHINGTON
,
DC
200908048
PUBLIC CHARITY
500
FIVE ACRES
760 W MOUNTAIN VIEW ST
ALTADENA
,
CA
91001
PUBLIC CHARITY
5,000
FLINTRIDGE PREPARATORY SCHOOL
4543 CROWN AVE
LA CANADA FLINTRIDGE
,
CA
91011
PUBLIC CHARITY
10,000
FOOTHILL FAMILY SERVICES
2500 E FOOTHILL BLVD STE 300
PASADENA
,
CA
91107
PUBLIC CHARITY
1,000
FRESH AIR FOOD
PO BOX 4535
NEW YORK
,
NY
101644542
PUBLIC CHARITY
500
GENTLE GIANTS DRAFT HORSE RESCUE
PO BOX 5058
HAGERSTOWN
,
MD
21741
PUBLIC CHARITY
500
GEORGETOWN UNIVERSITY
3700 O ST NW
WASHINGTON
,
DC
20057
PUBLIC CHARITY
2,000
GREATER LOS ANGELES ZOO ASSOCIATION
5333 ZOO DR
LOS ANGELES
,
CA
90027
PUBLIC CHARITY
5,000
GUIDING EYES FOR THE BLIND
611 GRANITE SPRINGS RD
YORKTOWN HEIGHTS
,
NY
10598
PUBLIC CHARITY
1,000
HABITAT FOR HUMANITY INTERNATIONAL
800 N STATE ST
ELGIN
,
IL
60123
PUBLIC CHARITY
2,000
HATHAWAY-SYCAMORES
100 W WALNUT ST STE 375
PASADENA
,
CA
91124
PUBLIC CHARITY
1,000
HEARTS THERAPEUTIC EQUESTRIAN CENTER
4420 CALLE REAL
SANTA BARBARA
,
CA
93110
PUBLIC CHARITY
1,000
HEIFER INTERNATIONAL
1 WORLD AVENUE
LITTLE ROCK
,
AR
72202
PUBLIC CHARITY
1,000
HILLSIDES
940 AVENUE 64
PASADENA
,
CA
91105
PUBLIC CHARITY
1,000
HOLLYWOOD BOWL
2301 N HIGHLAND AVE
LOS ANGELES
,
CA
90068
PUBLIC CHARITY
5,010
HOLY FAMILY CATHOLIC CHURCH
600 BROOK FOREST AVE
SHOREWOOD
,
IL
60404
PUBLIC CHARITY
5,000
HUMANE SOCIETY OF THE UNITED STATES
1255 23RD STREET NW STE 450
WASHINGTON
,
DC
20037
PUBLIC CHARITY
500
HUNTINGTON HOSPITAL
270 PARK AVE
HUNTINGTON
,
NY
11743
PUBLIC CHARITY
40,000
HUNTINGTON LIBRARY SOCIETY OF FELLOWS
1151 OXFORD ROAD
SAN MARINO
,
CA
91108
PUBLIC CHARITY
5,000
INNER CITY ARTS
720 KOHLER ST
LOS ANGELES
,
CA
90021
PUBLIC CHARITY
1,000
INTERNATIONAL MEDICAL CORPS
12400 WILSHIRE BLVD STE 1500
LOS ANGELES
,
CA
90025
PUBLIC CHARITY
1,000
JUNIOR LEAGUE OF PASADENA
149 S MADISON AVE
PASADENA
,
CA
91101
PUBLIC CHARITY
2,000
K9 FOR WARRIORS
11050 LAKE UNDERHILL RD
ORLANDO
,
FL
32025
PUBLIC CHARITY
1,000
KCET
2900 WEST ALAMEDA AVE
BURBANK
,
CA
91505
PUBLIC CHARITY
5,000
KIDSPACE CHILDREN'S MUSEUM
480 N ARROYO BLVD
PASADENA
,
CA
91103
PUBLIC CHARITY
9,000
LOS ANGELES MISSION
PO BOX 60127
LOS ANGELES
,
CA
30060
PUBLIC CHARITY
1,000
LOS ANGELES OPERA FUND
135 NORTH GRAND AVENUE
LOS ANGELES
,
CA
90012
PUBLIC CHARITY
5,000
LUPUS FOUNDATION OF AM
PO BOX 96864
WASHINGTON
,
DC
20090
PUBLIC CHARITY
1,000
LYRIC OPERA-CHICAGO
20 N WACKER DR
CHICAGO
,
IL
60606
PUBLIC CHARITY
1,000
MACH 1
1530 W BROADWAY ROAD
TEMPE
,
AZ
85282
PUBLIC CHARITY
1,000
MADD
511 E JOHN CARPENTER FREEWAY
IRVING
,
TX
75062
PUBLIC CHARITY
1,000
MAGICAL STRINGS OF YOUTH
1250 RADCLIFFE ROAD
BUFFALO GROVE
,
IL
60089
PUBLIC CHARITY
20,000
MAKE-A-WISH
640 NORTH LASALLE DRIVE SUITE 280
CHICAGO
,
IL
60654
PUBLIC CHARITY
2,000
MARINE TOYS FOR TOTS
18251 QUANTICO GATEWAY DR
TRIANGLE
,
VA
22172
PUBLIC CHARITY
1,000
MD ANDERSON CANCER CENTER
1840 OLD SPANISH TRAIL
HOUSTON
,
TX
77054
PUBLIC CHARITY
1,000
MEMORIAL SLOAN KETTERING
1275 YORK AVENUE
NEW YORK
,
NY
10065
PUBLIC CHARITY
1,000
MENLO CHARITY
1298 ROYAL ROAD
ANNVILLE
,
PA
17003
PUBLIC CHARITY
13,000
MERCY HOME FOR BOYS AND GIRLS
1140 W JACKSON BLVD
CHICAGO
,
IL
60607
PUBLIC CHARITY
1,000
MERCY SHIPS
PO BOX 2020
GARDEN VALLEY
,
TX
75771
PUBLIC CHARITY
2,000
METHODIST HOSPITAL FOUNDATION
8701 W DODGE RD STE 450
OMAHA
,
NE
68114
PUBLIC CHARITY
1,000
MOBILE CARE FOUNDATION
321 N LOOMIS ST
CHICAGO
,
IL
60607
PUBLIC CHARITY
150,000
MUSCULAR DYSTROPHY FAMILY FOUNDATION
PO BOX 776
CARMEL
,
IN
46032
PUBLIC CHARITY
1,000
MY FRIENDS PLACE
5850 HOLLYWOOD BLVD
LOS ANGELES
,
CA
90028
PUBLIC CHARITY
5,000
NAMI
3803 N FAIRFAX DR SUITE 100
ARLINGTON
,
VA
22203
PUBLIC CHARITY
1,000
NATIONAL ASSOCIATION OF BLIND VETERANS
12516 HAMMOCK POINTE CIR
LAKE COUNTY
,
FL
34711
PUBLIC CHARITY
1,000
NATIONAL MULTIPLE SCLREROSIS SOCIETY
PO BOX 512098
LOS ANGELES
,
CA
900510098
PUBLIC CHARITY
2,000
NATURAL HISTORY MUSEUM
900 EXPOSITION BLVD
LOS ANGELES
,
CA
90007
PUBLIC CHARITY
3,000
NORTHWESTERN UNIVERSITY
633 CLARK ST
EVANSTON
,
IL
60208
PUBLIC CHARITY
3,000
OPERATION SMILE
3641 FACULTY BLVD
VIRGINIA BEACH
,
VA
23453
PUBLIC CHARITY
2,000
PALM BEACH SYMPHONY
400 HIBISCUS ST 100
WEST PALM BEACH
,
FL
33401
PUBLIC CHARITY
10,000
PARALYZED VETERANS OF AMERICA
801 EIGHTEENTH STREET NW
WASHINGTON
,
DC
20006
PUBLIC CHARITY
1,000
PARKINSON RESEARCH FOUNDATION
PO BOX 96318
WASHINGTON
,
DC
20090
PUBLIC CHARITY
2,000
PASADENA ART ALLIANCE
1028 N LAKE AVE 104
PASADENA
,
CA
91104
PUBLIC CHARITY
1,000
PASADENA HUMANE SOCIETY
361 S RAYMOND AVE
PASADENA
,
CA
91105
PUBLIC CHARITY
5,000
PASADENA PLAYHOUSE
39 S EL MOLINO AVE
PASADENA
,
CA
91101
PUBLIC CHARITY
2,000
PASADENA SENIORS CENTER
85 E HOLLY ST
PASADENA
,
CA
91103
PUBLIC CHARITY
1,000
PASADENA SHOWCASE HOURSE OF THE ARTS
PO BOX 93486
PASADENA
,
CA
91109
PUBLIC CHARITY
1,000
PASADENA SYMPHONY AND POPS
2 N LAKE AVE
PASADENA
,
CA
91101
PUBLIC CHARITY
1,000
PAWS FOR PURPLE HEARTS
5860 LABATH AVE
ROHNERT PARK
,
CA
94928
PUBLIC CHARITY
2,000
PBS-CO CAL
3080 BRISTOL STREET SUITE 100
COSTA MESA
,
CA
92626
PUBLIC CHARITY
1,000
PLANNED PARENTHOOD
114 UNIVERSITY AVENUE
ROCHESTER
,
NY
14605
PUBLIC CHARITY
2,000
POLYTECHNIC SCHOOL
1030 E CALIFORNIA BLVD
PASADENA
,
CA
91106
PUBLIC CHARITY
50,000
PROVIDENCE ST JOSEPH HOSPITAL
501 S BUENA VISTA ST
BURBANK
,
CA
91505
PUBLIC CHARITY
10,000
RONALD MCDONALD HOUSE
763 SOUTH PASADENA AVE
PASADENA
,
CA
91105
PUBLIC CHARITY
2,000
SAINT MATTHEWS PARISH SCHOOL
1555 GLEN ELLYN RD
GLENDALE HEIGHTS
,
IL
60139
PUBLIC CHARITY
20,000
SALVATION ARMY
615 SLATERS LANE PO BOX 269
ALEXANDRIA
,
VA
22313
PUBLIC CHARITY
5,000
SAN MARINO FIRE ASSOCIATION
2200 HUNTINGTON DR
SAN MARINO
,
CA
91108
PUBLIC CHARITY
1,000
SAN MARINO POLICE ASSOCIATION
2275 HUNTINGTON DR 411
SAN MARION
,
CA
91108
PUBLIC CHARITY
1,000
SAN MARINO SCHOOLS FOUNDATION
1665 WEST DR
SAN MARINO
,
CA
91108
PUBLIC CHARITY
5,000
SAVE THE CHILDREN
501 KINGS HIGHWAY
FAIRFIELD
,
CT
06825
PUBLIC CHARITY
1,000
SCHOOL YEAR ABROAD
120 WATER STREET SUITE 310
NORTH ANDOVER
,
MA
01845
PUBLIC CHARITY
1,000
SEMESTER AT SEA
2410 OLD IVY ROAD
CHARLOTTESVILLE
,
VA
22903
PUBLIC CHARITY
2,000
SEMPER K9
PO BOX 17619
WASHINGTON
,
DC
20041
PUBLIC CHARITY
1,000
SHRINERS HOSPITALS FOR CHILDREN
2900 N ROCKY POINT DR
TAMPA
,
FL
33607
PUBLIC CHARITY
1,000
SOCIETY OF THE SACRED HEART
4120 FOREST PARK AVENUE
ST LOUIS
,
MO
63108
PUBLIC CHARITY
1,000
SOUTH PASADENA EDUCATIONAL FOUNDATION
351 S HUDSON AVE
PASADENA
,
CA
91101
PUBLIC CHARITY
1,000
SOUTH PASADENA SAN MARINO YMCA
1605 N GARFIELD AVE
SOUTH PASADENA
,
CA
91030
PUBLIC CHARITY
1,000
SPECIAL OLYMPICS
1133 19TH STREET NW
WASHINGTON
,
DC
20036
PUBLIC CHARITY
10,000
ST JOSEPH'S INDIAN SCHOOL
1301 N MAIN ST
CHAMBERLAIN
,
SD
57325
PUBLIC CHARITY
1,000
ST JUDES CHILDREN RESEARCH HOSPITAL
501 ST JUDE PLACE
MEMPHIS
,
TN
38105
PUBLIC CHARITY
3,000
ST VINCENT MEALS ON WHEELS
2303 MIRAMAR ST
LOS ANGELES
,
CA
90057
PUBLIC CHARITY
1,000
STEADMAN PHIIPPON RESEARCH INSTITUTE
181 W MEADOW DR 1000
VAIL
,
CO
81657
PUBLIC CHARITY
2,000
SUSAN G KOMEN
213 W INSTITUTE PL SUITE 302
CHICAGO
,
IL
60610
PUBLIC CHARITY
2,000
TEAM USA PARA-OLYMPIC FOUNDATION
1 OLYMPIC PLAZA
COLORADO SPRINGS
,
CO
80909
PUBLIC CHARITY
3,000
THE ARTHRITIS FOUNDATION
1355 PEACHTREE ST NE 6TH FL
ATLANTA
,
GA
30309
PUBLIC CHARITY
1,000
THE COLBURN SCHOOL
200 S GRAND AVE
LOS ANGELES
,
CA
90012
PUBLIC CHARITY
1,000
THE SMILE TRAIN
41 MADISON AVE 28TH FLOOR
NEW YORK
,
NY
10010
PUBLIC CHARITY
1,000
THRIVE RESCUE
360 E 1ST STREET 921
TUSTIN
,
CA
92780
PUBLIC CHARITY
2,000
TROJAN ATHELTIC FUND
3501 WATT WAY HERITAGE HALL 203B
LOS ANGELES
,
CA
90089
PUBLIC CHARITY
10,000
UNION RESCUE MISSION
545 S SAN PEDRO ST
LOS ANGELES
,
CA
90013
PUBLIC CHARITY
3,000
UNION STATION FOUNDATION
825 E ORANGE GROVE BOULEVARD
PASADENA
,
CA
91104
PUBLIC CHARITY
3,000
UNITED STATES HOLOCAUST MEMORIAL
595 ELM PL
HIGHLAND PARK
,
IL
60035
PUBLIC CHARITY
1,000
UNITED STATES OLYMPIC COMMITTEE
1 OLYMPIC PLAZA
COLORADO SPRINGS
,
CO
80909
PUBLIC CHARITY
1,000
UNIVERSITY OF NOTRE DAME
400 MAIN BUILDING
NOTRE DAME
,
IN
46556
PUBLIC CHARITY
3,000
URBAN COMPASS
11100 S CENTRAL AVE
LOS ANGELES
,
CA
90059
PUBLIC CHARITY
2,000
URYADI'S VILLAGE
PO BOX 1086
SANDPOINT
,
ID
83864
PUBLIC CHARITY
500
USET FOUNDATION
PO BOX 355
GLADSTONE
,
NJ
07934
PUBLIC CHARITY
5,000
USHJA FOUNDATION
3870 CIGAR LANE
LEXINGTON
,
KY
07934
PUBLIC CHARITY
2,000
USO
PO BOX 96860
WASHINGTON
,
DC
20077
PUBLIC CHARITY
3,000
VAIL HEALTH FOUNDATION
PO BOX 1529
VAIL
,
CO
81658
PUBLIC CHARITY
5,000
VAIL VALLEY MEDICAL CENTER FOUNDATION
322 BREAD CREEK RD
EDWARDS
,
CO
81632
PUBLIC CHARITY
5,000
VIETNAM VETERANS MEMORIAL FUND
PO BOX 96764
WASHINGTON
,
DC
20090
PUBLIC CHARITY
1,000
VILLA ESPERANZA
2060 F VILLA
PASADENA
,
CA
91107
PUBLIC CHARITY
1,000
WILDLIFE WAYSTATION
14831 LITTLE TUJUNGA CANYON RD
SYLMAR
,
CA
91342
PUBLIC CHARITY
6,000
WOUNDED WARRIOR PROJECT
84899 BELFORT RD STE 300
JACKSONVILLE
,
FL
32256
PUBLIC CHARITY
2,000
YOUNG & HEALTHY
1905 LINCOLN AVE BUILDING D ROOM
416
PASADENA
,
CA
91103
PUBLIC CHARITY
6,000
SAN MARINO PUBLIC LIBRARY CAMPAIGN
1890 HUNTINGTON BLVD
SAN MARINO
,
CA
91108
PUBLIC CHARITY
1,000
Total
.................................
3a
617,710
b
Approved for future payment
Total
.................................
3b
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
12
Part XVI-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
Unrelated business income
Excluded by section 512, 513, or 514
(e)
Related or exempt
function income
(See instructions.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
14
49,708
4
Dividends and interest from securities
....
14
99,085
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
.....
14
174,249
8
Gain or (loss) from sales of assets other than
inventory
............
18
309,168
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
14,000
11
Other revenue:
a
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
0
632,210
14,000
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
646,210
(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.)
8
INVESTMENTS SOLD AT A GAIN OR LOSS DURING THE PLAN YEAR
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