-
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
CAMILLE BECKMAN FOUNDATION INC
Number and street (or P.O. box number if mail is not delivered to street address)
175 S ROSEBUD LANE
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
EAGLE
,
ID
83616
A Employer identification number
82-0484130
B
Telephone number (see instructions)
(208) 344-7150
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)
$
6,452,043
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
129
129
4
Dividends and interest from securities
...
50,786
49,701
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
463,398
b
Gross sales price for all assets on line 6a
1,326,098
7
Capital gain net income (from Part IV, line 2)
...
463,398
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)
.......
5,898
5,898
12
Total.
Add lines 1 through 11
........
520,211
519,126
13
Compensation of officers, directors, trustees, etc.
0
0
0
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
7,920
7,541
379
c
Other professional fees (attach schedule)
....
39,919
39,919
0
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
16,763
211
0
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
10,481
2,447
8,024
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
75,083
50,118
8,403
25
Contributions, gifts, grants paid
.......
298,650
298,650
26
Total expenses and disbursements.
Add lines 24 and 25
373,733
50,118
307,053
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
146,478
b
Net investment income
(if negative, enter -0-)
469,008
c
Adjusted net income
(if negative, enter -0-)
...
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2019)
Form 990-PF (2019)
Page
2
Part II
Balance Sheets
Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year
End of year
(a)
Book Value
(b)
Book Value
(c)
Fair Market Value
1
Cash—non-interest-bearing
.............
1,191,117
689,721
689,721
2
Savings and temporary cash investments
.........
3
Accounts receivable
Less: allowance for doubtful accounts
4
Pledges receivable
Less: allowance for doubtful accounts
5
Grants receivable
.................
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)
.....
7
Other notes and loans receivable (attach schedule)
136,317
Less: allowance for doubtful accounts
0
136,317
136,317
1
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)
.......
2,901,899
3,408,176
5,258,195
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)
..........
345,975
487,572
504,126
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)
4,575,308
4,721,786
6,452,043
17
Accounts payable and accrued expenses
..........
18
Grants payable
.................
19
Deferred revenue
.................
20
Loans from officers, directors, trustees, and other disqualified persons
21
Mortgages and other notes payable (attach schedule)
......
22
Other liabilities (describe
)
23
Total liabilities
(add lines 17 through 22)
.........
0
0
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
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
........
0
0
27
Paid-in or capital surplus, or land, bldg., and equipment fund
0
0
28
Retained earnings, accumulated income, endowment, or other funds
4,575,308
4,721,786
29
Total net assets or fund balances
(see instructions)
.....
4,575,308
4,721,786
30
Total liabilities and net assets/fund balances
(see instructions)
.
4,575,308
4,721,786
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
4,575,308
2
Enter amount from Part I, line 27a
.....................
2
146,478
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
4,721,786
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
4,721,786
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
BUCKEYE LONG TERM
b
OAK TREE CAPITAL GROUP LONG TERM
c
HIGHWAY II LONG TERM
d
OAK TREE CAPITAL GROUP SHORT TERM
e
BAUSCH HEALTH COS INC
2019-06-05
2019-01-10
BLACKBERRY LTD
2019-06-05
2019-05-20
CANOPY GROWTH CORP
2019-08-14
EXXON MOBIL CORP
2019-03-21
2019-05-22
FORTINET INC
2019-04-10
2019-05-07
GOLDCORP INC
2019-03-12
2019-04-26
VANGUARD EXTENDED
2019-04-12
2019-07-31
VERTEX PHARMACEUTICA
2018-08-28
2019-04-17
NEWMONT CORP
2019-04-26
2019-04-29
ABBVIE INC
2017-04-27
2014-03-21
BAUSCH HEALTH COS INC
2017-12-11
2019-03-02
BLACKBERRY LTD
2019-05-20
SQUARE INC
2018-03-05
2019-04-22
APPTIO INC CL A
2018-07-13
2019-01-11
ISHARES S&P ASIA
2018-07-06
2019-03-27
BOEING COMPANY
2013-07-12
2019-05-08
BOEING COMPANY
2013-07-12
2019-12-13
BOEING COMPANY
2013-07-12
2019-12-13
LOGMEIN INC
2016-02-08
2019-10-31
ARCHER DANIELS MIDLD
2010-11-02
2019-03-07
JOHNSON AND JOHNSON COM
1997-05-28
2019-07-12
OAKTREE CAP GROUP LLC
2013-03-12
2019-09-06
BUCKEYE PARTNERS LP
2004-10-04
2019-05-10
CDK GLOGAL, INC
2018-07-27
2019-01-30
CDK GLOGAL, INC
2018-07-27
2019-02-19
CDK GLOGAL, INC
2018-08-02
2019-02-19
KAR AUCTION SERVICES INC SHS
2019-07-27
2019-03-28
KAR AUCTION SERVICES INC SHS
2018-08-02
2019-03-28
METTLER-TOLEDO INTL INC
2018-05-14
2019-02-19
AIR PRODUCT & CHEM
2016-09-29
2019-05-28
AIR PRODUCT & CHEM
2016-10-13
2019-05-28
AIR PRODUCT & CHEM
2016-10-13
2019-06-26
AIR PRODUCT & CHEM
2016-10-13
2019-08-13
AIR PRODUCT & CHEM
2016-11-09
2019-03-13
AIR PRODUCT & CHEM
2016-11-09
2019-11-06
AIR PRODUCT & CHEM
2017-07-27
2019-11-06
ANSYS INC COM
2018-07-10
2019-10-10
AON PLC
2015-10-14
2019-01-16
AON PLC
2015-10-14
2019-03-28
AUTODESK INC DEL
2015-09-14
2019-01-16
BROOKFIELD ASSET MGMT INC
2014-01-24
2019-04-25
BROOKFIELD ASSET MGMT INC
2014-02-13
2019-04-25
COPART INC COM
2013-04-01
2019-07-25
COPART INC COM
2013-04-01
2019-08-28
CARMAX INC
2014-04-28
2019-04-25
CARMAX INC
2014-07-28
2019-04-25
CDK GLOBAL INC SHS
2015-11-19
2019-01-30
CDK GLOBAL INC SHS
2016-11-29
2019-01-30
CDK GLOBAL INC SHS
2016-12-08
2019-01-30
DOLLAR GENERAL CORP
2013-04-19
2019-07-25
DOLLAR GENERAL CORP
2013-10-28
2019-07-25
DOLLAR GENERAL CORP
2013-10-28
2019-10-10
DOLLAR GENERAL CORP
2015-01-30
2019-10-10
DOLLAR GENERAL CORP
2015-01-30
2019-11-27
DOLLAR GENERAL CORP
2017-06-08
2019-11-27
ECHOSTAR CORPORATION
2013-03-11
2019-08-13
ECHOSTAR CORPORATION
2013-03-11
2019-08-14
ECHOSTAR CORPORATION
2015-01-30
2019-08-14
EXPEDIA GROUP INC
2016-01-27
2019-08-02
EXPEDIA GROUP INC
2016-05-12
2019-08-02
EXPEDIA GROUP INC
2016-05-12
2019-08-02
EQUINIX INC
2015-11-03
2019-06-26
EQUINIX INC
2015-11-19
2019-06-26
EQUINIX INC
2015-11-19
2019-07-11
EQUINIX INC
2015-11-19
2019-10-10
GARTNER INC
2017-11-27
2019-04-25
GARTNER INC
2017-11-27
2019-08-13
HD SUPPLY HLDGS INC
2017-05-25
2019-02-19
HD SUPPLY HLDGS INC
2017-05-25
2019-03-04
IHS MARKIT LTD SHS
2016-11-09
2019-09-18
IHS MARKIT LTD SHS
2016-12-08
2019-09-18
IHS MARKIT LTD SHS
2016-12-08
2019-11-27
KAR AUCTION SERVICES INC SHS
2014-04-14
2019-03-28
KAR AUCTION SERVICES INC SHS
2014-07-28
2019-03-28
KAR AUCTION SERVICES INC SHS
2015-01-30
2019-03-28
LIBERTY EXPEDIA HOLDINGS INC REG
2014-09-10
2019-05-28
LIBERTY EXPEDIA HOLDINGS INC REG
2014-09-23
2019-05-28
LIBERTY EXPEDIA HOLDINGS INC REG
2014-10-18
2019-05-28
LIBERTY EXPEDIA HOLDINGS INC REG
2014-11-12
2019-05-28
LIBERTY EXPEDIA HOLDINGS INC REG
2015-03-30
2019-05-28
MARTIN MARIETTA MATLS
2016-09-29
2019-04-09
MARTIN MARIETTA MATLS
2016-10-13
2019-04-09
MARTIN MARIETTA MATLS
2017-03-01
2019-04-09
MARTIN MARIETTA MATLS
2017-03-01
2019-04-25
MARTIN MARIETTA MATLS
2017-03-01
2019-10-15
MARTIN MARIETTA MATLS
2017-03-01
2019-11-06
MARTIN MARIETTA MATLS
2017-08-10
2019-11-06
MARTIN MARIETTA MATLS
2017-08-10
2019-11-27
MARTIN MARIETTA MATLS
2017-11-15
2019-11-27
MOODY'S CORP
2015-08-12
2019-01-30
MOODY'S CORP
2015-09-28
2019-01-30
MOODY'S CORP
2015-09-28
2019-11-06
METTLER-TOLEDO INTL INC
2018-05-14
2019-06-13
METTLER-TOLEDO INTL INC
2018-05-14
2019-10-10
SSP GLOBAL WC
2016-01-26
2019-01-16
SSP GLOBAL WC
2016-01-27
2019-07-25
SSP GLOBAL WC
2016-01-27
2019-09-18
SSP GLOBAL WC
2016-01-27
2019-10-10
SSP GLOBAL WC
2016-01-27
2019-11-06
MOHAWK INDUSTRIES INC
2013-03-11
2019-07-25
MOHAWK INDUSTRIES INC
2013-03-11
2019-06-13
MOHAWK INDUSTRIES INC
2014-03-10
2019-08-13
MOHAWK INDUSTRIES INC
2014-07-28
2019-08-13
MOHAWK INDUSTRIES INC
2015-01-30
2019-08-13
MOHAWK INDUSTRIES INC
2016-02-25
2019-08-13
O'REILLY AUTOMOTICE INC
2013-03-11
2019-01-16
O'REILLY AUTOMOTICE INC
2013-03-11
2019-01-30
O'REILLY AUTOMOTICE INC
2013-03-11
2019-03-04
O'REILLY AUTOMOTICE INC
2013-03-11
2019-07-11
PROGRESSIVE CRP OHIO
2014-03-26
2019-07-11
PROGRESSIVE CRP OHIO
2015-01-30
2019-07-11
RESTAURANT BRANDS WTL SMC SHS
2013-03-11
2019-08-13
RESTAURANT BRANDS WTL SMC SHS
2013-03-11
2019-08-28
RESTAURANT BRANDS WTL SMC SHS
2013-03-11
2019-08-28
ROPER TECHNOLOGIES INC
2015-03-10
2019-01-30
SBA COMMUNICATIONS CORP NEW
2015-05-14
2019-03-04
SBA COMMUNICATIONS CORP NEW
2015-05-27
2019-03-04
SBA COMMUNICATIONS CORP NEW
2015-05-27
2019-04-09
SBA COMMUNICATIONS CORP NEW
2015-06-10
2019-04-09
SBA COMMUNICATIONS CORP NEW
2015-06-10
2019-04-25
SBA COMMUNICATIONS CORP NEW
2015-06-25
2019-09-24
SBA COMMUNICATIONS CORP NEW
2015-09-28
2019-09-24
TRANSUNION
2017-11-15
2019-08-28
TRANSUNION
2017-11-15
2019-11-27
TRANSDIGM GROUP INC
2015-08-12
2019-03-04
TRANSDIGM GROUP INC
2015-08-12
2019-04-09
TRANSDIGM GROUP INC
2015-08-12
2019-04-25
TRANSDIGM GROUP INC
2015-08-12
2019-06-26
TRANSDIGM GROUP INC
2015-08-27
2019-07-25
TRANSDIGM GROUP INC
2015-10-14
2019-08-28
VERISIGN INC
2013-03-11
2019-06-26
VERISIGN INC
2013-03-11
2019-07-11
VERISIGN INC
2013-03-11
2019-07-25
VERISIGN INC
2013-03-11
2019-10-10
VERISK ANALYTICS INC
2014-06-26
2019-04-09
VERISK ANALYTICS INC
2014-06-26
2019-05-26
VERISK ANALYTICS INC
2014-07-28
2019-06-26
VERISK ANALYTICS INC
2014-07-28
2019-07-11
VERISK ANALYTICS INC
2014-07-28
2019-10-10
VERISK ANALYTICS INC
2014-11-12
2019-10-10
EXPEDIA GROUP SMC
2019-08-07
2019-08-07
COVETRUS INC REG SHS
2018-11-05
2019-11-04
CHURCH&SWIGHT CO INC
2018-10-29
2019-07-12
ANSYS INC COM
2014-04-08
2019-03-21
ANSYS INC COM
2014-04-11
2019-03-21
ANSYS INC COM
2014-04-11
2019-07-19
ANSYS INC COM
2014-04-14
2019-07-19
ANSYS INC COM
2014-04-14
2019-09-05
ANSYS INC COM
2014-09-08
2019-09-05
ANSYS INC COM
2014-09-09
2019-09-05
ANSYS INC COM
2014-09-09
2019-10-23
ANSYS INC COM
2015-05-19
2019-10-23
ANSYS INC COM
2015-05-20
2019-10-23
ANSYS INC COM
2015-05-20
2019-12-10
ANSYS INC COM
2016-05-25
2019-12-10
ARAMARK SHS
2016-02-04
2019-04-17
ARAMARK SHS
2016-02-04
2019-03-28
WR BERKLEY CORP
2016-05-03
2019-08-28
COVETRUS INC REG SHS
2015-09-30
2019-11-04
COVETRUS INC REG SHS
2018-10-25
2019-11-04
COPART INC COM
2013-10-18
2019-11-25
CDW CORP
2015-02-09
2019-11-25
CDW CORP
2015-02-10
2019-08-28
CDW CORP
2015-02-10
2019-09-05
CDW CORP
2015-02-10
2019-09-06
CDW CORP
2015-02-10
2019-09-18
CDW CORP
2015-07-29
2019-09-18
CHURCH&SWIGHT CO INC
2011-03-01
2019-05-01
CHURCH&SWIGHT CO INC
2011-03-01
2019-07-12
MANHATTAN ASSOCS INC
2014-11-03
2019-11-05
MANHATTAN ASSOCS INC
2014-11-04
2019-11-05
MANHATTAN ASSOCS INC
2014-11-04
2019-11-06
MANHATTAN ASSOCS INC
2016-01-28
2019-11-06
MANHATTAN ASSOCS INC
2016-01-28
2019-11-07
MANHATTAN ASSOCS INC
2016-10-21
2019-11-07
SERVICEMASTER GLOBAL HLDGS INC
2015-08-05
2019-05-30
TELEFLEX INC
2014-06-11
2019-03-27
TELEFLEX INC
2014-06-12
2019-03-27
TELEFLEX INC
2014-06-12
2019-11-26
TELEFLEX INC
2014-07-24
2019-11-26
TELEFLEX INC
2014-09-11
2019-11-26
COVETRUS INC REG SHS
2008-12-18
2019-11-04
COVETRUS INC REG SHS
2009-12-15
2019-11-04
COPART INC COM
2007-04-19
2019-05-30
COPART INC COM
2008-11-24
2019-05-30
COPART INC COM
2008-11-24
2019-07-24
COPART INC COM
2008-11-24
2019-09-06
COPART INC COM
2008-12-10
2019-09-06
COPART INC COM
2008-12-10
2019-10-23
COPART INC COM
2008-12-30
2019-10-23
COPART INC COM
2008-12-30
2019-11-25
CHURCH&SWIGHT CO INC
2009-03-12
2019-02-01
CHURCH&SWIGHT CO INC
2009-06-11
2019-02-01
CHURCH&SWIGHT CO INC
2009-06-11
2019-04-03
CHURCH&SWIGHT CO INC
2009-06-11
2019-05-01
DENTSPLY SIRONA
2007-04-19
2019-01-29
DENTSPLY SIRONA
2008-04-10
2019-01-29
DENTSPLY SIRONA
2009-03-05
2019-01-29
DENTSPLY SIRONA
2010-06-18
2019-01-29
FAIR ISAAC CORPORATION
2008-04-02
2019-03-27
FAIR ISAAC CORPORATION
2008-04-03
2019-03-27
FAIR ISAAC CORPORATION
2008-04-03
2019-10-16
FAIR ISAAC CORPORATION
2008-06-20
2019-10-16
HUNT JB TRANS SVCS INC
2010-12-13
2019-09-26
SENDGRID INC
2018-07-16
2019-01-18
CHIPOTLE MEXICAN GRL
2013-01-18
2019-01-17
TWILIO INC
2019-02-04
2019-02-04
CARTER VALIDUS MISSION CRITIAL REIT MERGER
2019-10-07
CARTER VALIDUS MISSION CRITIAL REIT MERGER
2019-10-07
CAPITAL GAINS DIVIDENDS
P
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
433
-433
b
98
98
c
6,783
-6,783
d
17
17
e
7,316
7,456
-140
8,221
12,275
-4,054
27,404
43,117
-15,713
40,994
44,144
-3,150
32,921
36,286
-3,365
36,029
36,111
-82
115,923
105,161
10,762
39,929
42,901
-2,972
7
8
-1
47,545
40,877
6,668
58,057
52,348
5,709
35,491
53,676
-18,185
80,104
55,336
24,768
26,220
24,564
1,656
37,857
39,027
-1,170
13,242
3,716
9,526
18,866
5,524
13,342
19,895
5,825
14,070
3,251
3,594
-343
20,850
15,360
5,490
13,338
2,972
10,366
15,993
14,657
1,336
5,852
4,824
1,028
396
508
-112
292
318
-26
759
804
-45
693
821
-128
1,089
1,295
-206
670
569
101
613
414
199
613
395
218
1,112
658
454
231
132
99
461
274
187
1,527
960
567
436
286
150
663
519
144
451
271
180
505
271
234
1,628
555
1,073
383
200
183
335
181
154
1,190
254
936
743
170
573
153
86
67
997
650
347
248
243
5
842
1,001
-159
495
590
-95
138
52
86
826
357
469
480
179
301
160
67
93
634
268
366
317
148
169
614
575
39
40
38
2
119
157
-38
131
128
3
131
128
3
131
128
3
489
300
189
978
572
406
526
286
240
1,140
572
568
946
711
235
1,028
947
81
529
498
31
389
374
15
475
249
226
475
247
228
582
283
299
297
176
121
495
304
191
247
170
77
167
141
26
208
163
45
292
207
85
125
96
29
333
300
33
617
550
67
617
513
104
617
669
-52
426
446
-20
797
669
128
255
223
32
2,296
1,868
428
545
415
130
545
418
127
929
651
278
619
393
226
644
295
349
693
569
124
670
569
101
735
340
395
967
339
628
761
254
507
998
339
659
505
170
335
934
675
259
693
675
18
115
144
-29
345
380
-35
115
165
-50
230
339
-109
1,025
313
712
1,025
313
712
1,476
418
1,058
781
208
573
415
120
295
166
52
114
752
363
389
310
145
165
465
218
247
283
166
117
363
232
131
727
452
275
802
452
350
1,003
583
420
994
583
411
1,542
718
824
514
210
304
334
217
117
783
489
294
1,304
630
674
457
210
247
953
420
533
479
210
269
999
426
573
1,561
552
1,009
1,243
281
962
657
140
517
214
47
167
366
94
272
675
296
379
574
237
337
430
187
243
601
250
351
157
62
95
314
126
188
121
121
508
2,229
-1,721
9,772
7,630
2,142
4,362
1,777
2,585
4,180
1,702
2,478
4,376
1,554
2,822
1,042
371
671
218
74
144
8,509
3,167
5,342
218
81
137
1,938
726
1,212
1,077
451
626
861
361
500
1,773
631
1,142
17,222
5,958
11,264
4,325
4,325
0
8,363
6,897
1,466
8,536
4,454
4,082
42
125
-83
1,227
5,173
-3,946
7,735
1,371
6,364
7,150
2,304
4,846
1,229
402
827
3,434
1,061
2,373
6,258
1,938
4,320
3,617
1,097
2,520
5,546
1,609
3,937
3,412
860
2,552
5,562
1,383
4,179
3,833
2,000
1,833
920
483
437
909
483
426
3,258
2,387
871
3,857
2,831
1,026
1,210
832
378
13,125
5,885
7,240
1,802
639
1,163
6,608
2,338
4,270
1,048
319
729
6,987
2,130
4,857
1,048
331
717
317
290
27
317
420
-103
4,343
438
3,905
4,983
465
4,518
4,658
392
4,266
2,515
206
2,309
1,947
154
1,793
2,982
231
2,751
1,574
124
1,450
5,618
399
5,219
3,111
573
2,538
6,157
1,217
4,940
4,174
743
3,431
519
90
429
2,663
2,132
531
1,639
1,495
144
2,459
1,360
1,099
983
759
224
1,844
162
1,682
5,795
530
5,265
8,570
675
7,895
4,591
341
4,250
8,870
3,113
5,757
190,193
5,654
184,539
103,994
59,505
44,489
57
57
68
68
0
2,243
86
2,157
3,897
3,897
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
-433
b
98
c
-6,783
d
17
e
-140
-4,054
-15,713
-3,150
-3,365
-82
10,762
-2,972
-1
6,668
5,709
-18,185
24,768
1,656
-1,170
9,526
13,342
14,070
-343
5,490
10,366
1,336
1,028
-112
-26
-45
-128
-206
101
199
218
454
99
187
567
150
144
180
234
1,073
183
154
936
573
67
347
5
-159
-95
86
469
301
93
366
169
39
2
-38
3
3
3
189
406
240
568
235
81
31
15
226
228
299
121
191
77
26
45
85
29
33
67
104
-52
-20
128
32
428
130
127
278
226
349
124
101
395
628
507
659
335
259
18
-29
-35
-50
-109
712
712
1,058
573
295
114
389
165
247
117
131
275
350
420
411
824
304
117
294
674
247
533
269
573
1,009
962
517
167
272
379
337
243
351
95
188
121
-1,721
2,142
2,585
2,478
2,822
671
144
5,342
137
1,212
626
500
1,142
11,264
0
1,466
4,082
-83
-3,946
6,364
4,846
827
2,373
4,320
2,520
3,937
2,552
4,179
1,833
437
426
871
1,026
378
7,240
1,163
4,270
729
4,857
717
27
-103
3,905
4,518
4,266
2,309
1,793
2,751
1,450
5,219
2,538
4,940
3,431
429
531
144
1,099
224
1,682
5,265
7,895
4,250
5,757
184,539
44,489
57
0
2,157
3,897
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
463,398
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
127,907
6,276,696
0.020378
2017
426,780
5,760,339
0.074089
2016
244,976
5,084,151
0.048184
2015
125,795
5,330,500
0.023599
2014
261,899
5,282,503
0.049579
2
Total
of line 1, column (d)
.....................
2
0.215829
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
0.043166
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
6,337,633
5
Multiply line 4 by line 3
......................
5
273,570
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
4,690
7
Add lines 5 and 6
........................
7
278,260
8
Enter qualifying distributions from Part XII, line 4
,.............
8
307,053
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
4,690
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
4,690
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
4,690
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
12,640
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
12,640
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
7,950
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
7,950
Refunded
11
0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition)
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
0
(2)
On foundation managers.
$
0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
Yes
7
Did the foundation have at least $5,000 in assets at any time during the year?
If "Yes," complete Part II, col. (c),
and Part XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
ID
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
Yes
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
EIDE BAILLY LLP
Telephone no.
(208) 344-7150
Located at
877 WEST MAIN STREET STE 800
BOISE
ID
ZIP+4
83702
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
SUSAN CAMILLE ROGHANI
PRESIDENT
2.00
0
0
0
175 S ROSEBUD LANE
EAGLE
,
ID
83616
FOAD ROGHANI
VICE PRESIDENT
2.00
0
0
0
175 S ROSEBUD LANE
EAGLE
,
ID
83616
MICHAEL R LINDSTROM
TREASURER
2.00
0
0
0
175 S ROSEBUD LANE
EAGLE
,
ID
83616
ALBERT P BARKER
SECRETARY
1.00
0
0
0
175 S ROSEBUD LANE
EAGLE
,
ID
83616
ROSHAN ROGHANI
DIRECTOR
1.00
0
0
0
175 S ROSEBUD LANE
EAGLE
,
ID
83616
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
5,237,272
b
Average of monthly cash balances
.......................
1b
1,196,873
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
6,434,145
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
6,434,145
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
96,512
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
6,337,633
6
Minimum investment return.
Enter 5% of line 5
..................
6
316,882
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
316,882
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
4,690
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
4,690
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
312,192
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
312,192
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
312,192
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
307,053
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
307,053
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
4,690
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
302,363
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
312,192
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
300,340
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:
$
307,053
a
Applied to 2018, but not more than line 2a
300,340
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
.....
6,713
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
..........
305,479
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).)
SUSAN CAMILLE ROGHANI
FOAD ROGHANI
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
CAMILLE BECKMAN FOUNDATION INC
175 S ROSEBUD LANE
EAGLE
,
ID
83616
(208) 344-7150
b
The form in which applications should be submitted and information and materials they should include:
WRITTEN REQUESTS CONTAINING ORGANIZATIONS BUDGET AND DESCRIPTION OF PROGRAM SERVICES
c
Any submission deadlines:
NONE
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
NONE
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
ASSISTANCE LEAGUE
5825 N GLENWOOD ST 1343
BOISE
,
ID
83714
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
2,000
JESSE TREE
1121 W MILLER ST
BOISE
,
ID
83702
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
5,000
BOYS&GIRLS CLUB ADA C
610 E 42ND STREET
GARDEN CITY
,
ID
83714
NONE
PC
COMMUNITY IMPOVEMENT
10,000
CAPUCHIN SOUP KITCHEN
1820 MOUNT ELLIOTT STREET
DETROIT
,
MI
48207
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
4,000
GENESIS WORLD MISSION
215 W 35TH ST
BOISE
,
ID
83714
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
5,000
HOPE HOUSE
7696 OLD BRUNEAU HWY
MARSING
,
ID
83639
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
5,000
IDAHO STATE FAA FOUNDATION
650 WEST STATE STREET
BOISE
,
ID
83720
NONE
PC
YOUTH SERVICES
5,000
INTERFAITH SANCTUARY
1620 W RIVER ST
BOISE
,
ID
83702
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
10,000
LINH THUU TU TEMPLE
8813 W ARDENE ST
BOISE
,
ID
83709
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
10,000
MERIDIAN LIONS CLUB
6054 W CHERRY LN
MERIDIAN
,
ID
83642
NONE
PC
COMMUNITY IMPOVEMENT
5,000
NW CHILDERN'S HOME
602 13TH ST
LEWISTON
,
ID
83501
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
5,000
ORE-IDA BOY SCOUTS
8901 FRANKLIN RD
BOISE
,
ID
83709
NONE
PC
YOUTH SERVICES
10,000
PANCREATIC CANCER SOCIETY
1500 ROSECRANS AVE SUITE 200
MANHATTAN BEACH
,
CA
90266
NONE
PC
PUBLIC HEALTH
2,000
SALVATION ARMY
9492 W EMERALD ST
BOISE
,
ID
83704
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
10,000
UNCONDITIONAL LIFE (TIPPS)
512 W IDAHO ST 200
BOISE
,
ID
83702
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
10,000
FRIENDS OF FANA
11654 PLAZA AMERICA DR
RESTON
,
VA
201904700
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
5,000
TERRY REILLY HEALTH CENTER
211 16TH AVENUE NORTH
NAMPA
,
ID
83687
NONE
PC
PUBLIC HEALTH
15,000
TERRY REILLY HEALTH CENTER
211 16TH AVENUE NORTH
NAMPA
,
ID
83687
NONE
PC
PUBLIC HEALTH
5,000
EAGLE FOOD BANK
149 W STATE ST
EAGLE
,
ID
83616
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
400
JESSE TREE
1121 W MILLER ST
BOISE
,
ID
83702
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
20,000
BOYS&GIRLS CLUB ADA COUNTY
610 E 42ND STREET
GARDEN CITY
,
ID
83714
NONE
PC
COMMUNITY IMPOVEMENT
10,000
IDAHO FOOD BANK
3630 E COMMERCIAL ST
MERIDIAN
,
ID
83642
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
40,000
INTERFAITH SANCTUARY
1620 W RIVER ST
BOISE
,
ID
83702
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
10,000
INTER CHILDREN SURG FOUND
PO BOX 4594
BOISE
,
ID
837114594
NONE
PC
PUBLIC HEALTH
40,000
ADVOCATE AGAINST FAMILY VIOLENCE
PO BOX 1496
CALDWEL
,
ID
83605
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
5,000
IDAHO DIAPER BANK
621 E KING ST
MERIDIAN
,
ID
83642
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
2,000
HANDS OF HOPE NW
1201 S POWERLINE RD
NAMPA
,
ID
83686
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
5,000
SALVATION ARMY
9492 W EMERALD ST
BOISE
,
ID
83704
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
10,000
TERRY REILLY
211 16TH AVENUE NORTH
NAMPA
,
ID
83687
NONE
PC
PUBLIC HEALTH
15,000
LINH THUU TU TEMPLE
8813 W ARDENE ST
BOISE
,
ID
83709
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
10,000
ASSISTANCE LEAGUE
5825 N GLENWOOD ST 1343
BOISE
,
ID
83714
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
2,000
GENESIS WORLD MISSION
215 W 35TH ST
BOISE
,
ID
83714
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
5,000
IDAHO FOOD BANK
3630 E COMMERCIAL ST
MERIDIAN
,
ID
83642
NONE
PC
ASSISTANCE TO DISADVANTAGED INDIVIDUALS
1,250
Total
.................................
3a
298,650
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
129
4
Dividends and interest from securities
....
14
50,786
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not debt-financed property
.....
6
Net rental income or (loss) from personal property
7
Other investment income
.....
8
Gain or (loss) from sales of assets other than
inventory
............
18
463,398
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
PARTNERSHIP INCOME(LOSS)
523000
01
5,898
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
0
520,211
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
520,211
(See worksheet in line 13 instructions to verify calculations.)
Part XVI-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
instructions.)
Form
990-PF
(2019)
Form 990-PF (2019)
Page
13
Part XVII
Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
1
Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
Yes
No
a
Transfers from the reporting foundation to a noncharitable exempt organization of:
(1)
Cash
...................................
1a(1)
No
(2)
Other assets
.................................
1a(2)
No
b
Other transactions:
(1)
Sales of assets to a noncharitable exempt organization
....................
1b(1)
No
(2)
Purchases of assets from a noncharitable exempt organization
..................
1b(2)
No
(3)
Rental of facilities, equipment, or other assets
.......................
1b(3)
No
(4)
Reimbursement arrangements
...........................
1b(4)
No
(5)
Loans or loan guarantees
.............................
1b(5)
No
(6)
Performance of services or membership or fundraising solicitations
................
1b(6)
No
c
Sharing of facilities, equipment, mailing lists, other assets, or paid employees
..............
1c
No
d
If the answer to any of the above is "Yes," complete the following schedule. Column
(b)
should always show the fair market value
of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
in any transaction or sharing arrangement, show in column
(d)
the value of the goods, other assets, or services received.
(a)
Line No.
(b)
Amount involved
(c)
Name of noncharitable exempt organization
(d)
Description of transfers, transactions, and sharing arrangements
2a
Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
described in section 501(c) (other than section 501(c)(3)) or in section 527?
...........
Yes
No
b
If "Yes," complete the following schedule.
(a)
Name of organization
(b)
Type of organization
(c)
Description of relationship
Sign Here
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
May the IRS discuss this return
with the preparer shown below
(see instr.)
Yes
No
Signature of officer or trustee
Date
Title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's Signature
Date
Check if self-
employed
PTIN
Firm's name
Firm's EIN
Firm's address
Phone no.
Form
990-PF
(2019)
Additional Data
Software ID:
Software Version:
Form 990PF - Special Condition Description:
Special Condition Description