-
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
MATTINA R PROCTOR FOUNDATION
C/O BROUDE & HOCHBERG LLP
Number and street (or P.O. box number if mail is not delivered to street address)
75 FEDERAL ST NO 1300
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
BOSTON
,
MA
021101921
A Employer identification number
11-1067014
B
Telephone number (see instructions)
(617) 748-5100
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)
$
16,122,390
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
1,646
1,656
4
Dividends and interest from securities
...
463,957
467,958
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
1,504,129
b
Gross sales price for all assets on line 6a
3,293,393
7
Capital gain net income (from Part IV, line 2)
...
2,007,178
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)
.......
85,270
85,270
12
Total.
Add lines 1 through 11
........
2,055,002
2,562,062
13
Compensation of officers, directors, trustees, etc.
105,232
52,616
52,616
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
1,715
0
0
b
Accounting fees (attach schedule)
.......
6,879
0
0
c
Other professional fees (attach schedule)
....
98,647
26,531
72,116
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
22,000
0
0
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
2,686
0
2,686
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
33,325
27,943
3,000
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
270,484
107,090
130,418
25
Contributions, gifts, grants paid
.......
497,000
497,000
26
Total expenses and disbursements.
Add lines 24 and 25
767,484
107,090
627,418
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
1,287,518
b
Net investment income
(if negative, enter -0-)
2,454,972
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
.............
2
Savings and temporary cash investments
.........
159,761
252,654
252,654
3
Accounts receivable
Less: allowance for doubtful accounts
2,800
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)
.......
7,375,856
8,573,281
15,869,736
c
Investments—corporate bonds (attach schedule)
.......
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
7,538,417
8,825,935
16,122,390
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
........
7,538,417
8,825,935
27
Paid-in or capital surplus, or land, bldg., and equipment fund
0
0
28
Retained earnings, accumulated income, endowment, or other funds
0
0
29
Total net assets or fund balances
(see instructions)
.....
7,538,417
8,825,935
30
Total liabilities and net assets/fund balances
(see instructions)
.
7,538,417
8,825,935
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
7,538,417
2
Enter amount from Part I, line 27a
.....................
2
1,287,518
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
8,825,935
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
8,825,935
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
DUPONT DE NEMOURS INC - CASH IN LIEU
P
2019-06-03
2019-06-03
b
500.000 SHS CHEVRON CORP
P
2005-02-20
2019-10-22
c
200.000 SHS CHEVRON CORP
P
2005-02-20
2019-10-22
d
300.000 SHS CHEVRON CORP
P
2005-02-20
2019-10-22
e
2,000.000 SHS COCA-COLA CO
P
1990-02-28
2019-10-22
480.000 SHS COCA-COLA CO
P
1990-02-28
2019-10-22
1,520.000 SHS COCA-COLA CO
P
1990-02-28
2019-10-22
7,000.000 SHS COCA-COLA CO
P
2005-02-20
2019-10-22
0.05107 SHS CORTEVA INC
P
1946-09-07
2019-06-03
0.02554 SHS CORTEVA INC
P
1992-05-21
2019-06-03
0.17875 SHS CORTEVA INC
P
2005-02-20
2019-06-03
0.08964 SHS CORTEVA INC
P
2005-02-20
2019-06-03
854.61732 SHS CORTEVA INC
P
1946-09-07
2019-10-22
427.30866 SHS CORTEVA INC
P
1992-05-21
2019-10-22
2,991.16063 SHS CORTEVA INC
P
2005-02-20
2019-10-22
1,499.91339 SHS CORTEVA INC
P
2005-02-20
2019-10-22
0.05107 SHS DOW INC
P
1946-09-07
2019-04-02
0.02554 SHS DOW INC
P
1992-05-21
2019-04-02
0.08964 SHS DOW INC
P
2005-02-20
2019-04-02
0.17875 SHS DOW INC
P
2005-02-20
2019-04-02
854.61732 SHS DUPONT DE NEMOURS INC
P
1946-09-07
2019-10-22
427.30866 SHS DUPONT DE NEMOURS INC
P
1992-05-21
2019-10-22
1,449.91340 SHS DUPONT DE NEMOURS INC
P
2005-02-20
2019-10-22
2,991.16062 SHS DUPONT DE NEMOURS INC
P
2005-02-20
2019-10-22
2,000.000 SHS EXXON MOBIL CORP
P
1983-07-14
2019-10-22
3,360.000 SHS EXXON MOBIL CORP
P
1983-07-14
2019-10-22
100.000 SHS EXXON MOBIL CORP
P
1986-07-17
2019-10-22
200.000 SHS EXXON MOBIL CORP
P
1986-07-17
2019-10-22
272.000 SHS EXXON MOBIL CORP
P
1986-07-17
2019-10-22
3,040.000 SHS EXXON MOBIL CORP
P
1986-07-17
2019-10-22
528.000 SHS EXXON MOBIL CORP
P
1986-07-17
2019-10-22
4,800.000 SHS GENERAL ELECTRIC CO
P
1985-05-10
2019-01-18
1,200.000 SHS GENERAL ELECTRIC CO
P
1986-06-25
2019-01-18
2,936.000 SHS GENERAL ELECTRIC CO
P
1989-06-22
2019-01-18
9,064.000 SHS GENERAL ELECTRIC CO
P
1989-06-22
2019-01-18
510.000 SHS GENERAL ELECTRIC CO
P
2005-02-20
2019-01-18
8,300.000 SHS GENERAL ELECTRIC CO
P
2005-02-20
2019-01-18
2,000.000 SHS GENERAL MILLS INC
P
1992-05-21
2019-10-22
2,000.000 SHS GENERAL MILLS INC
P
1996-04-24
2019-10-22
3,000.000 SHS GENERAL MILLS INC
P
2005-02-20
2019-10-22
1,200.000 SHS PROCTER & GAMBLE CO
P
1994-08-25
2019-10-22
1,200.000 SHS PROCTER & GAMBLE CO
P
1995-02-23
2019-10-22
3,600.000 SHS PROCTER & GAMBLE CO
P
1995-12-15
2019-10-22
100.000 SHS PROCTER & GAMBLE CO
P
2005-02-20
2019-10-22
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
24
24
b
59,031
29,895
29,136
c
23,612
11,958
11,654
d
35,416
17,937
17,479
e
108,248
8,930
99,318
25,979
2,143
23,836
82,268
6,785
75,483
378,867
150,010
228,857
1
1
1
1
4
4
0
2
2
0
22,044
2,854
19,190
11,022
4,401
6,621
77,153
60,629
16,524
38,688
41,311
-2,623
3
3
1
1
0
5
5
0
10
7
3
56,016
8,181
47,835
28,008
12,612
15,396
98,311
118,396
-20,085
196,055
173,760
22,295
139,139
607
138,532
233,754
1,020
232,734
6,957
32
6,925
13,914
64
13,850
18,923
30
18,893
211,491
965
210,526
36,733
103
36,630
43,647
11,691
31,956
10,912
4,098
6,814
26,698
13,079
13,619
95,351
40,379
54,972
5,365
18,233
-12,868
87,314
296,725
-209,411
102,804
25,524
77,280
102,804
27,093
75,711
154,206
77,325
76,881
148,345
17,352
130,993
148,345
19,959
128,386
445,034
76,950
368,084
12,362
5,165
7,197
8,526
8,526
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
24
b
29,136
c
11,654
d
17,479
e
99,318
23,836
75,483
228,857
1
1
0
0
19,190
6,621
16,524
-2,623
3
0
0
3
47,835
15,396
-20,085
22,295
138,532
232,734
6,925
13,850
18,893
210,526
36,630
31,956
6,814
13,619
54,972
-12,868
-209,411
77,280
75,711
76,881
130,993
128,386
368,084
7,197
8,526
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
2,007,178
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
636,317
14,624,394
0.043511
2017
642,819
14,918,298
0.043089
2016
689,653
13,983,021
0.049321
2015
830,431
14,057,360
0.059074
2014
837,021
15,121,394
0.055353
2
Total
of line 1, column (d)
.....................
2
0.250348
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
0.050070
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
14,511,117
5
Multiply line 4 by line 3
......................
5
726,572
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
24,550
7
Add lines 5 and 6
........................
7
751,122
8
Enter qualifying distributions from Part XII, line 4
,.............
8
627,418
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
49,099
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
49,099
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
49,099
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
22,000
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
50,000
d
Backup withholding erroneously withheld
...........
6d
0
7
Total credits and payments. Add lines 6a through 6d
..............
7
72,000
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
22,901
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
22,901
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)
MA
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
WWW.MRPF.ORG
14
The books are in care of
JEFFREY D HUTCHINS TRUSTEE
Telephone no.
(617) 748-5100
Located at
75 FEDERAL ST SUITE 1300
BOSTON
MA
ZIP+4
021101921
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1)
Engage in the sale or exchange, or leasing of property with a disqualified person?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(5)
Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)?
...............
Yes
No
(6)
Agree to pay money or property to a government official? (
Exception.
Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.)
.......
Yes
No
b
If any answer is "Yes" to 1a(1)–(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions
........
1b
No
Organizations relying on a current notice regarding disaster assistance check here
........
c
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2019?
.............
1c
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2019, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2019?
.............
Yes
No
If "Yes," list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer "No" and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
......................
Yes
No
b
If "Yes," did it have excess business holdings in 2019 as a result of
(1)
any purchase by the foundation
or disqualified persons after May 26, 1969;
(2)
the lapse of the 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or
(3)
the lapse of the 10-, 15-, or 20-year first phase holding period?
(Use Schedule C, Form 4720, to determine
if the foundation had excess business holdings in 2019.)
..................
3b
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2019?
4b
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
6
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
(continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
No
b
If any answer is "Yes" to 5a(1)–(5), did
any
of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions
......
5b
No
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
JEFFREY D HUTCHINS
TRUSTEE
10.00
52,616
0
0
75 FEDERAL STREET SUITE 1300
BOSTON
,
MA
02110
WILLIAM I HOCHBERG
TRUSTEE
10.00
52,616
0
0
1900 AVENUE OF THE STARS 21ST FLOOR
LOS ANGELES
,
CA
90067
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
BROUDE & HOCHBERG LLP
GRANT ADMINISTRATION
72,116
75 FEDERAL ST STE 1300
BOSTON
,
MA
02110
BROUDE & HOCHBERG LLP
TRUST ADMINISTRATION
26,308
75 FEDERAL ST STE 1300
BOSTON
,
MA
02110
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
14,533,694
b
Average of monthly cash balances
.......................
1b
198,404
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
14,732,098
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
14,732,098
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
220,981
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
14,511,117
6
Minimum investment return.
Enter 5% of line 5
..................
6
725,556
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
725,556
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
49,099
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
49,099
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
676,457
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
676,457
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
676,457
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
627,418
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
627,418
5
Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
income. Enter 1% of Part I, line 27b. See instructions
.................
5
0
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
627,418
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
676,457
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
307,220
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:
$
627,418
a
Applied to 2018, but not more than line 2a
307,220
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
.....
320,198
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
..........
356,259
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).)
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:
JEFFREY D HUTCHINS TRUSTEE CO BROUD
75 FEDERAL STREET SUITE 1300
BOSTON
,
MA
02110
(617) 748-5100
b
The form in which applications should be submitted and information and materials they should include:
APPLICATIONS ACCEPTED FROM PUBLIC CHARITIES. APPLICATIONS SHOULD BE BY LETTER, AND CONTAIN A DESCRIPTION OF THE APPLICANT ORGANIZATION, PURPOSE AND BUDGET OF GRANT SOLICITED, AND PROOF OF TAX EXEMPT STATUS.
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:
PREFERENCE IS GIVEN TO ORGANIZATIONS LOCATED IN THE NORTHEASTERN UNITED STATES.
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
ALBANY MUSIC FOUNDATION
915 BROADWAY
ALBANY
,
NY
12207
N/A
PUBLIC CHARITY
RECORDING OF "SKY LEGENDS" CD BY COMPOSER DAVID OWENS; PROMOTION FOR "SKY LEGENDS AND "RAKING THE SNOW" CDS
6,000
APPALACHIAN MOUNTAIN CLUB
10 CITY SQUARE
BOSTON
,
MA
02129
N/A
PUBLIC CHARITY
SUPPORT FOR AMC'S PROJECT, "RESTORING NATIVE TROUT AND SALMON HABITAT IN MAINE'S 100 MILE WILDERNESS"
2,500
APPRENTICESHOP
643 MAIN STREET
ROCKLAND
,
ME
04841
N/A
PUBLIC CHARITY
SUPPORT FOR SHIPBUILDING AND SEAMANSHIP PROGRAMS, COMMUNITY SAILING AND OTHER GENERAL NEEDS
6,000
ARTS LEARNING
12 COVEY ROAD
WALPOLE
,
MA
02081
N/A
PUBLIC CHARITY
GENERAL OPERATIONS AND THE SCHOOL ARTS LEADERS (SAL) PROGRAM
5,000
BERKLEE COLLEGE OF MUSIC
1140 BOYLSTON STREET
BOSTON
,
MA
02115
N/A
PUBLIC CHARITY
TOWARD BERKLEE INSTITUTE FOR ARTS EDUCATION AND SPECIAL NEEDS PROGRAM
9,000
BOSTON BAROQUE
10 GUEST STREET SUITE 290
BOSTON
,
MA
02135
N/A
PUBLIC CHARITY
SUPPORT FOR THE PRODUCTION OF HANDEL'S "JEPHTHA" TO BE PRESENTED AT JORDAN HALL
2,500
BOSTON LYRIC OPERA
11 AVENUE DE LAFAYETTE
BOSTON
,
MA
02111
N/A
PUBLIC CHARITY
SUPPORT FOR THE 2018-2019 CONCERT SEASON AND GENERAL OPERATING SUPPORT
50,000
BOSTON LYRIC OPERA
11 AVENUE DE LAFAYETTE
BOSTON
,
MA
02111
N/A
PUBLIC CHARITY
SUPPORT FOR FULL WORKSHOP OF JOSEPH SUMMER'S OPERA "HAMLET"
50,000
BOSTON YOUTH SYMPHONY ORCHESTRA
855 COMMONWEALTH AVENUE
BOSTON
,
MA
02215
N/A
PUBLIC CHARITY
IN SUPPORT OF THE BYSO PRODUCTION OF GIACOMO PUCCINI'S OPERA, "LABOHEME"
15,000
BRANDEIS UNIVERSITY
415 SOUTH STREET
WALTHAM
,
MA
02453
N/A
PUBLIC CHARITY
FOR 2019 CONCERTS AND MUSIC PROGRAMS
6,000
COASTAL MOUNTAINS LAND TRUST
101 MT BATTIE STREET
CAMDEN
,
ME
04843
N/A
PUBLIC CHARITY
TWO-YEAR PLEDGE IN SUPPORT FOR THE "ROUND THE MOUNTAIN COLLABORATION; INSTALLMENT #2 OF 2
12,500
CREATIVE COMMUNITY FOR PEACE
PO BOX 34122
LOS ANGELES
,
CA
90034
N/A
PUBLIC CHARITY
IN SUPPORT OF PROGRAMS TO ENCOURAGE MUSIC ARTISTS FROM AROUND THE WORLD TO PERFORM IN ISRAEL
3,000
EMMANUEL MUSIC
PO BOX 171184
BOSTON
,
MA
02117
N/A
PUBLIC CHARITY
IN SUPPORT OF THE SECOND CONCERT OF THE 2019 SEASON FEATURING WORKS BY BACH AND HARBISON
5,000
FARNSWORTH ART MUSEUM
16 MUSEUM STREET
ROCKLAND
,
ME
04841
N/A
PUBLIC CHARITY
EDUCATIONAL PROGRAMS FOR CHILDREN
30,000
FOUNDATION FOR MODERN OPERA
15 BREWSTER ROAD
WORCESTER
,
MA
01602
N/A
PRIVATE FOUNDATION
SUPPORT FOR THE SHAKESPEARE CONCERTS 2019 PERFORMANCES AND RELATED RECORDINGS
33,500
FOUNDATION FOR MODERN OPERA
15 BREWSTER ROAD
WORCESTER
,
MA
01602
N/A
PRIVATE FOUNDATION
FOR ADDITIONAL RECORDING SESSIONS
16,000
FRIENDS OF MERRYMEETING BAY
PO BOX 233
RICHMOND
,
ME
04357
N/A
PUBLIC CHARITY
IN SUPPORT OF EFFORTS TO MONITOR AND ASSESS AQUATIC VEGETATION AND UPLAND HABITAT CHANGES IN AND AROUND MERRYMEETING BAY
3,000
GRAMMY MUSEUM
888 SOUTH FIGUEROA STREET SUITE 600
LOS ANGELES
,
CA
90017
N/A
PUBLIC CHARITY
IN SUPPORT OF GRAMMY SIGNATURE SCHOOLS PROGRAM IN THE BOSTON OR ROCKLAND, ME, REGIONS AND/OR OTHER PROJECT OR CAPITAL NEEDS
6,000
GUITARS IN THE CLASSROOM
1761 HOTEL CIRCLE S SUITE 210
SAN DIEGO
,
CA
92108
N/A
PUBLIC CHARITY
GENERAL ACTIVITIES
1,800
HANDEL HAYDN SOCIETY
9 HARCOURT STREET
BOSTON
,
MA
02116
N/A
PUBLIC CHARITY
IN SUPPORT OF THE PRODUCTION OF PURCELL'S "DIDO AND AENEAS" AT BOSTON'S JORDAN HALL
2,500
JAZZ BAKERY
1836 BENEDICT CANYON DRIVE
BEVERLY HILLS
,
CA
90210
N/A
PUBLIC CHARITY
FUNDING DIRECTED TOWARD THE QUINCY JONES URBAN JAZZ CAMP FOR UNDER-PRIVILEGED YOUTH
6,000
JEWISH FAMILY & CHILDREN'S SERVICE
1430 MAIN STREET
WALTHAM
,
MA
02451
N/A
PUBLIC CHARITY
SUPPORT FOR ADOPTION RESOURCES PROGRAM
5,000
KNITTING CONNECTION THE
PO BOX 560065
MEDFORD
,
MA
02156
N/A
PUBLIC CHARITY
GENERAL SUPPORT FOR CHARITABLE MISSION TO PROVIDE KNITTED ITEMS TO THOSE IN NEED
1,000
MAINE MEDIA WORKSHOPS & COLLEGE
PO BOX 200
ROCKPORT
,
ME
04856
N/A
PUBLIC CHARITY
IN SUPPORT OF MASTER FACILITIES PLAN
6,000
MARITIME GLOUCESTER
21 HARBOR LOOP
GLOUCESTER
,
MA
01930
N/A
PUBLIC CHARITY
IN SUPPORT OF THE AQUARIUM AT THE CENTER
4,000
MERCY HEALTHCARE FOUNDATION
MERCY HOSPITAL 144 STATE STREET
PORTLAND
,
ME
04101
N/A
PUBLIC CHARITY
FIVE-YEAR PLEDGE TO THE MATTINA R. PROCTOR DIABETES & ENDOCRINOLOGY CENTER FOR OUTREACH AND FOR RELOCATION TO FORE RIVER CAMPUS, INSTALLMENT #5 OF 5
75,000
MID-COAST RECOVERY COALITION
411 MAIN STREET SUITE 205
ROCKLAND
,
ME
04841
N/A
PUBLIC CHARITY
TOWARD THE PURCHASE OF 63 WASHINGTON STREET, CAMDEN, MAINE
10,000
NEW ENGLAND AQUARIUM
CENTRAL WHARF
BOSTON
,
MA
02110
N/A
PUBLIC CHARITY
FOR THE ANDERSON CABOT CENTER'S WORK AT THE INTERSECTION OF NORTH ATLANTIC RIGHT WHALE CONSERVATION AND FISHERIES RESILIENCE
11,500
NEW ENGLAND CONSERVATORY
290 HUNTINGTON AVENUE
BOSTON
,
MA
02115
N/A
PUBLIC CHARITY
GENERAL
30,000
NORTHEASTERN UNIVERSITY SCHOOL OF LAW
416 HUNTINGTON AVENUE CAMPUS 202
KNOWLES
BOSTON
,
MA
02115
N/A
PUBLIC CHARITY
SUPPORT FOR THE CENTER FOR LAW, INNOVATION AND CREATIVITY
20,000
PERKINS SCHOOL FOR THE BLIND
175 N BEACON STREET
WATERTOWN
,
MA
02472
N/A
PUBLIC CHARITY
IN SUPPORT OF PERKINS RADIO, WITH A FOCUS ON STAFF EXPANSION AND IMPROVEMENT OF THE STATION'S TECHNOLOGY
12,000
PINE STREET INN
444 HARRISON AVENUE
BOSTON
,
MA
02118
N/A
PUBLIC CHARITY
GENERAL
2,000
PINE TREE LEGAL ASSISTANCE
PO BOX 547
PORTLAND
,
ME
04112
N/A
PUBLIC CHARITY
GENERAL FUNDING FOR MISSION OF PROVIDING LEGAL ASSISTANCE TO MAINE'S UNDERSERVED AND VULNERABLE POPULATIONS
1,200
POINTS NORTH INSTITUTE
PO BOX 836
CAMDEN
,
ME
04843
N/A
PUBLIC CHARITY
IN SUPPORT OF THE CAMDEN INTERNATIONAL FILM FESTIVAL
10,000
PRICE CENTER THE
27 CHRISTINA STREET SUITE 201
NEWTON
,
MA
02461
N/A
PUBLIC CHARITY
GENERAL OPERATIONS
2,500
RONALD MCDONALD HOUSE BOSTON HARBOR
250 FIRST AVENUE 318
BOSTON
,
MA
02129
N/A
PUBLIC CHARITY
TO ASSIST IN FUNDING AN APARTMENT PROVIDING HOUSING TO AN MGH PATIENT AND HIS OR HER FAMILY DURING TREATMENT IN THE PEDIATRIC HEMATOLOGY-ONCOLOGY PROGRAM AT MASSACHUSETTS GENERAL HOSPITAL FOR CHILDREN
15,000
THE FIELD
75 MAIDEN LANE SUITE 906
NEW YORK
,
NY
10038
N/A
PUBLIC CHARITY
IN SUPPORT OF THE LISA KIRCHNER/BERG-BEETHOVEN SPONSORED PROJECT (CD RECORDING OF PETER SERKIN WITH LEON KIRCHNER AND THE HARVARD CHAMBER ORCHESTRA)
8,000
WALKER SCHOOL
PO BOX 83
PORTLAND
,
ME
04112
N/A
PUBLIC CHARITY
IN SUPPORT OF STEM CURRICULA AT THE SCHOOL
2,500
CENTER FOR FURNITURE CRAFTSMANSHIP
25 MILL STREET
ROCKPORT
,
ME
04856
N/A
PUBLIC CHARITY
TWO-YEAR PLEDGE IN SUPPORT OF THE "TEACHING THE TEACHERS" SCHOLARSHIP PROGRAM; INSTALLMENT #1 OF 2
10,000
Total
.................................
3a
497,000
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
1,646
4
Dividends and interest from securities
....
14
463,957
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
.....
15
85,270
8
Gain or (loss) from sales of assets other than
inventory
............
18
1,504,129
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
0
2,055,002
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
2,055,002
(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