-
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
08-01-2019
, and ending
07-31-2020
Name of foundation
SITES 1969 FDN IRREV CHAR TA
Number and street (or P.O. box number if mail is not delivered to street address)
6325 S RAINBOW BLVD STE 300
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
LAS VEGAS
,
NV
89118
A Employer identification number
35-6211743
B
Telephone number (see instructions)
(888) 730-4933
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)
$
9,261,105
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
4
Dividends and interest from securities
...
227,926
227,926
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
185,039
b
Gross sales price for all assets on line 6a
6,264,639
7
Capital gain net income (from Part IV, line 2)
...
185,039
8
Net short-term capital gain
.........
0
9
Income modifications
...........
10a
Gross sales less returns and allowances
b
Less: Cost of goods sold
....
c
Gross profit or (loss) (attach schedule)
.....
11
Other income (attach schedule)
.......
12
Total.
Add lines 1 through 11
........
412,965
412,965
13
Compensation of officers, directors, trustees, etc.
96,216
86,595
9,622
14
Other employee salaries and wages
......
0
0
0
15
Pension plans, employee benefits
.......
0
0
16a
Legal fees (attach schedule)
.........
0
b
Accounting fees (attach schedule)
.......
923
0
0
923
c
Other professional fees (attach schedule)
....
0
17
Interest
...............
0
18
Taxes (attach schedule) (see instructions)
...
15,056
7,799
0
19
Depreciation (attach schedule) and depletion
...
0
0
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
0
0
22
Printing and publications
..........
0
0
23
Other expenses (attach schedule)
.......
60
60
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
112,255
94,454
0
10,545
25
Contributions, gifts, grants paid
.......
444,000
444,000
26
Total expenses and disbursements.
Add lines 24 and 25
556,255
94,454
0
454,545
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-143,290
b
Net investment income
(if negative, enter -0-)
318,511
c
Adjusted net income
(if negative, enter -0-)
...
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
.............
1,416
1,299
1,299
2
Savings and temporary cash investments
.........
264,801
322,686
322,686
3
Accounts receivable
Less: allowance for doubtful accounts
0
0
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
0
8
Inventories for sale or use
..............
9
Prepaid expenses and deferred charges
..........
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
.......
c
Investments—corporate bonds (attach schedule)
.......
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
7,639,288
7,446,593
8,937,120
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)
7,905,505
7,770,578
9,261,105
17
Accounts payable and accrued expenses
..........
18
Grants payable
.................
19
Deferred revenue
.................
20
Loans from officers, directors, trustees, and other disqualified persons
21
Mortgages and other notes payable (attach schedule)
......
22
Other liabilities (describe
)
23
Total liabilities
(add lines 17 through 22)
.........
0
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
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
........
7,905,505
7,770,578
27
Paid-in or capital surplus, or land, bldg., and equipment fund
28
Retained earnings, accumulated income, endowment, or other funds
29
Total net assets or fund balances
(see instructions)
.....
7,905,505
7,770,578
30
Total liabilities and net assets/fund balances
(see instructions)
.
7,905,505
7,770,578
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
7,905,505
2
Enter amount from Part I, line 27a
.....................
2
-143,290
3
Other increases not included in line 2 (itemize)
3
9,645
4
Add lines 1, 2, and 3
..........................
4
7,771,860
5
Decreases not included in line 2 (itemize)
5
1,282
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
7,770,578
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
10000. FED NATL MTG ASSN 2.625% 9/06/24
2015-03-26
2019-08-02
b
10000. FED NATL MTG ASSN 2.625% 9/06/24
2019-05-16
2019-08-02
c
7. INV OPP DEVELOP MRKTS-R6
2018-10-09
2019-08-08
d
30819.232 AQR MANAGED FUTURES STR-I
2013-07-08
2019-08-08
e
1578.171 AQR MANAGED FUTURES STR-I
2019-02-27
2019-08-08
27413.043 INV BALANCE RISK COMM STR-Y 8611
2018-10-09
2019-08-08
1461.444 INV BALANCE RISK COMM STR-Y 8611
2019-02-27
2019-08-08
692. AMER CENT SMALL CAP GRWTH INST 336
2018-02-01
2019-08-08
534. ARTISAN MID CAP FUND-INSTL 1333
2012-04-24
2019-08-08
27107.444 BLACKROCK GL L/S CREDIT-K #1940
2015-10-13
2019-08-08
880.675 BLACKROCK GL L/S CREDIT-K #1940
2019-02-27
2019-08-08
242.508 DODGE & COX INT'L STOCK FD #1048
2018-10-09
2019-08-08
7316.968 DODGE & COX INT'L STOCK FD #1048
2011-02-15
2019-08-08
420.607 DODGE & COX INT'L STOCK FD #1048
2019-02-27
2019-08-08
2211. EATON VANCE GLOB MACRO ADV-I 208
2018-02-01
2019-08-08
508.005 FIDELITY NEW MRKTS INC-Z #3323
2015-01-27
2019-08-08
177.995 FIDELITY NEW MRKTS INC-Z #3323
2018-10-09
2019-08-08
52. JP MORGAN MID CAP VALUE-I #758
2016-01-26
2019-08-08
1641. JOHN HANCOCK II-CURR STR-I 3643
2018-02-01
2019-08-08
16627.736 ASG GLOBAL ALTERNATIVES-Y 1993
2013-07-22
2019-08-08
261.173 ASG GLOBAL ALTERNATIVES-Y 1993
2019-02-27
2019-08-08
910.866 NEUBERGER BERMAN LONG SH-INS #1830
2019-02-27
2019-08-08
12069.391 NEUBERGER BERMAN LONG SH-INS #1830
2014-07-14
2019-08-08
29.839 T ROWE PR REAL ESTATE-I #432
2019-02-27
2019-08-08
56.161 T ROWE PR REAL ESTATE-I #432
2015-12-24
2019-08-08
41. SPDR DJ WILSHIRE INTERNATIONAL REAL
2017-01-20
2019-08-08
9. STERLING CAPITAL STRATTON SMALL CAP
2018-02-01
2019-08-08
3151. TCW EMRG MKTS INCM-I 4721
2018-07-16
2019-08-08
28. APPLE INC
2019-08-09
2019-08-14
121. COGNIZANT TECH SOLUTIONS CRP COM
2019-08-09
2019-08-14
54. DIAGEO PLC - ADR
2019-08-09
2019-08-14
15000. FED NATL MTG ASSN 2.625% 9/06/24
2019-05-16
2019-08-14
61. UNION PACIFIC CORP
2019-08-09
2019-08-14
74. UNITED PARCEL SERVICE-CL B
2019-08-09
2019-08-14
14000. CVS HEALTH CORP 3.350% 3/09/21
2019-03-06
2019-08-21
108. CELANESE CORP
2019-08-09
2019-09-10
64. NIKE INC CL B
2019-08-09
2019-09-10
20. PNC FINANCIAL SERVICES GROUP
2015-05-27
2019-09-10
108. PNC FINANCIAL SERVICES GROUP
2019-08-09
2019-09-10
1000. CVS HEALTH CORP 3.350% 3/09/21
2019-03-06
2019-09-18
15000. CVS HEALTH CORP 3.350% 3/09/21
2018-06-11
2019-09-18
25000. US TREASURY NOTE 2.125% 9/30/21
2015-06-19
2019-09-25
16000. JPMORGAN CHASE & CO 4.250% 10/15/20
2015-08-03
2019-09-26
4000. JPMORGAN CHASE & CO 4.250% 10/15/20
2019-03-06
2019-09-26
15000. JPMORGAN CHASE & CO 4.250% 10/15/20
2019-05-16
2019-09-26
11346.379 JPMORGAN HIGH YIELD FUND SS 3580
2019-08-09
2019-10-11
17737.513 JPMORGAN HIGH YIELD FUND SS 3580
2015-11-16
2019-10-11
8004.558 JPMORGAN HIGH YIELD FUND SS 3580
2019-04-10
2019-10-11
35. LAM RESEARCH CORP COM
2018-07-24
2019-10-22
2010. UBS GROUP AG
2018-01-31
2019-10-22
608. UBS GROUP AG
2018-11-19
2019-10-22
713. UBS GROUP AG
2019-08-09
2019-10-22
85. TE CONNECTIVITY LTD
2019-08-09
2019-10-22
5000. DOW CHEMICAL CO/THE 4.125% 11/15/21
2019-03-06
2019-11-12
10000. DOW CHEMICAL CO/THE 4.125% 11/15/21
2019-05-16
2019-11-12
10000. DOW CHEMICAL CO/THE 4.125% 11/15/21
2013-06-26
2019-11-12
50. LAM RESEARCH CORP COM
2018-07-24
2019-12-26
42. ZOETIS INC
2019-08-09
2020-02-03
228. ZOETIS INC
2017-04-25
2020-02-03
461. FLEXTRONICS INTL LTD
2018-03-07
2020-02-03
2455. INV OPP DEVELOP MRKTS-R6
2011-02-15
2020-02-14
3. ALPHABET INC/CA
2018-11-19
2020-02-14
7. ALPHABET INC/CA
2019-08-09
2020-02-14
343. AMER CENT SMALL CAP GRWTH INST 336
2018-02-01
2020-02-14
7. APPLE INC
2018-11-19
2020-02-14
70. APPLE INC
2019-08-09
2020-02-14
691. ARTISAN MID CAP FUND-INSTL 1333
2012-04-24
2020-02-14
19. BLACKROCK INC
2018-08-08
2020-02-14
114. CVS HEALTH CORPORATION
2017-08-09
2020-02-14
57. CELANESE CORP
2019-02-14
2020-02-14
120. CISCO SYSTEMS INC
2019-08-09
2020-02-14
75. CITIGROUP INC
2019-10-22
2020-02-14
41. CITIGROUP INC
2019-07-30
2020-02-14
90. COGNIZANT TECH SOLUTIONS CRP COM
2016-03-16
2020-02-14
36. DIAGEO PLC - ADR
2019-08-09
2020-02-14
51. WALT DISNEY CO
2019-08-09
2020-02-14
73. EOG RESOURCES, INC
2018-04-12
2020-02-14
51. ELECTRONIC ARTS INC
2019-12-24
2020-02-14
36. FIDELITY NATL INFORMATION SVCS INC
2019-08-09
2020-02-14
204. HAIN CELESTIAL GROUP INC
2015-12-18
2020-02-14
25. HOME DEPOT INC
2019-08-09
2020-02-14
5340. ISHARES CORE MSCI EMERGING
2018-10-05
2020-02-14
474. ISHARES CORE MSCI EMERGING
2019-05-14
2020-02-14
45. JPMORGAN CHASE & CO
2018-12-06
2020-02-14
8324.076 JPMORGAN MID CAP VALUE-R6 #2335
2011-02-15
2020-02-14
18287.461 JOHN HANCOCK II-CURR STR-I 3643
2018-02-01
2020-02-14
868.126 JOHN HANCOCK II-CURR STR-I 3643
2019-05-14
2020-02-14
27. LAM RESEARCH CORP COM
2018-07-24
2020-02-14
25.99862 LAS VEGAS SANDS CORP
2018-07-27
2020-02-14
72. LAS VEGAS SANDS CORP
2020-02-03
2020-02-14
4.00138 LAS VEGAS SANDS CORP
2018-07-27
2020-02-14
296. MANULIFE FINANCIAL CORP
2019-10-22
2020-02-14
67. MERCK & CO INC NEW
2019-08-09
2020-02-14
37. MICROSOFT CORP
2018-11-19
2020-02-14
71. MICROSOFT CORP
2019-08-09
2020-02-14
113. MONDELEZ INTERNATIONAL INC
2019-08-09
2020-02-14
21. NIKE INC CL B
2017-11-02
2020-02-14
72. NIKE INC CL B
2019-08-09
2020-02-14
36. PNC FINANCIAL SERVICES GROUP
2015-05-27
2020-02-14
25. RAYTHEON COMPANY
2019-10-22
2020-02-14
461.023 T ROWE PR OVERSEAS STOCK-I #521
2018-10-09
2020-02-14
2099.977 T ROWE PR OVERSEAS STOCK-I #521
2019-02-27
2020-02-14
3150.325 T ROWE PR REAL ESTATE-I #432
2016-01-26
2020-02-14
2348. SPDR DJ WILSHIRE INTERNATIONAL REAL
2017-01-20
2020-02-14
80. SPIRIT AEROSYTSEMS HOLD-CL A
2019-07-03
2020-02-14
226. SUNCOR ENERGY INC NEW F
2018-12-03
2020-02-14
87. TJX COMPANIES INC
2019-10-22
2020-02-14
47. TARGET CORP
2007-01-29
2020-02-14
17. THERMO FISHER SCIENTIFIC INC
2019-08-09
2020-02-14
106. TORONTO DOMINION BK ONT COM NEW
2019-07-30
2020-02-14
63. TOTAL S.A. - ADR
2019-02-26
2020-02-14
61. TOTAL S.A. - ADR
2018-11-19
2020-02-14
36. UNION PACIFIC CORP
2019-08-09
2020-02-14
3. UNION PACIFIC CORP
2010-12-07
2020-02-14
52. UNITED PARCEL SERVICE-CL B
2019-02-26
2020-02-14
48. UNITEDHEALTH GROUP INC
2019-08-09
2020-02-14
58. EATON CORP PLC
2018-11-19
2020-02-14
47. MEDTRONIC PLC
2019-08-09
2020-02-14
8. TE CONNECTIVITY LTD
2018-11-19
2020-02-14
50. TE CONNECTIVITY LTD
2019-08-09
2020-02-14
10000. DOWDUPONT INC 3.766% 11/15/20
2018-11-20
2020-02-20
10000. DOWDUPONT INC 3.766% 11/15/20
2019-03-06
2020-02-20
5000. US TREASURY NOTE 2.625% 6/15/21
2019-03-06
2020-02-20
20000. US TREASURY NOTE 2.625% 6/15/21
2018-07-02
2020-02-20
34000. US TREASURY NOTE 2.625% 8/15/20
2019-03-06
2020-02-20
26000. US TREASURY NOTE 2.625% 8/15/20
2011-03-04
2020-02-20
24. APPLE INC
2019-08-09
2020-03-03
12000. HALLIBURTON COMPANY 3.500% 8/01/23
2013-10-18
2020-03-03
25000. HALLIBURTON COMPANY 3.500% 8/01/23
2019-03-06
2020-03-03
167. HOME DEPOT INC
2017-03-31
2020-03-03
23. HOME DEPOT INC
2019-08-09
2020-03-03
36. MICROSOFT CORP
2019-08-09
2020-03-03
15. THERMO FISHER SCIENTIFIC INC
2019-08-09
2020-03-03
3. THERMO FISHER SCIENTIFIC INC
2011-02-11
2020-03-03
221. EATON CORP PLC
2012-12-03
2020-03-03
112. CVS HEALTH CORPORATION
2019-09-10
2020-03-16
68. JPMORGAN CHASE & CO
2018-12-06
2020-03-16
72. ELI LILLY & CO COM
2016-10-03
2020-03-16
33. UNION PACIFIC CORP
2010-12-07
2020-03-16
203. EATON CORP PLC
2012-12-06
2020-03-16
122. EATON CORP PLC
2019-08-09
2020-03-16
1526.109 INV OPP DEVELOP MRKTS-R6
2017-01-26
2020-04-03
5000. APPLE INC 2.400% 5/03/23
2019-08-13
2020-04-03
15000. BNP PARIBAS 5.000% 1/15/21
2018-03-14
2020-04-03
5000. BNP PARIBAS 5.000% 1/15/21
2019-05-16
2020-04-03
3000. BANK OF AMERICA CORP 5.625% 7/01/20
2011-02-15
2020-04-03
10000. BANK OF AMERICA CORP 3.248% 10/21/27
2020-02-20
2020-04-03
20000. WALT DISNEY COMPANY/ 2.000% 9/01/29
2020-02-20
2020-04-03
1512.069 EATON VANCE GLOB MACRO ADV-I 208
2018-02-01
2020-04-03
870.732 EATON VANCE GLOB MACRO ADV-I 208
2020-02-20
2020-04-03
35000. FED NATL MTG ASSN 2.625% 9/06/24
2015-08-03
2020-04-03
207.491 FIDELITY NEW MRKTS INC-Z #3323
2020-02-20
2020-04-03
20000. HSBC HOLDING PLC 4.000% 3/30/22
2020-02-20
2020-04-03
3000. HALLIBURTON COMPANY 3.500% 8/01/23
2013-10-18
2020-04-03
5000. HOME DEPOT INC 3.000% 4/01/26
2019-08-13
2020-04-03
570. ISHARES BARCLAYS MBS BOND FUND
2011-02-15
2020-04-03
360. ISHARES BARCLAYS MBS BOND FUND
2020-02-20
2020-04-03
600. ISHARES BARCLAYS MBS BOND FUND
2019-05-13
2020-04-03
3623. ISHARES CORE MSCI EMERGING
2019-08-08
2020-04-03
5000. NOVARTIS CAPITAL COR 3.000% 11/20/25
2019-08-13
2020-04-03
2010.077 PIMCO HIGH YIELD FD-INST #108
2019-10-11
2020-04-03
22427.713 T ROWE PR OVERSEAS STOCK-I #521
2017-04-26
2020-04-03
109.943 T ROWE PR OVERSEAS STOCK-I #521
2019-05-14
2020-04-03
20000. SUNTRUST BANKS INC 4.000% 5/01/25
2020-02-20
2020-04-03
15000. US TREASURY NOTE 2.750% 2/15/28
2019-08-13
2020-04-03
25000. US TREASURY NOTE 2.750% 2/15/28
2020-02-20
2020-04-03
35000. US TREASURY NOTE 2.625% 3/31/25
2020-02-20
2020-04-03
5000. US TREASURY NOTE 2.625% 3/31/25
2019-08-13
2020-04-03
40000. US TREASURY NOTE 3.125% 11/15/28
2020-02-20
2020-04-03
5000. US TREASURY NOTE 2.625% 1/31/26
2019-08-13
2020-04-03
35000. US TREASURY NOTE 2.625% 1/31/26
2020-02-20
2020-04-03
20000. US TREASURY NOTE 2.500% 5/15/29
2020-02-20
2020-04-03
20000. U S TREASURY NT 3.125% 5/25/21
2019-05-16
2020-04-03
15000. US TREASURY NOTE 2.500% 5/15/24
2015-04-10
2020-04-03
5000. US TREASURY NOTE 2.500% 5/15/24
2019-08-13
2020-04-03
20000. US TREASURY NOTE 2.500% 5/15/24
2020-02-20
2020-04-03
260. PNC FINANCIAL SERVICES GROUP
2015-04-29
2020-04-08
.947 RAYTHEON TECHNOLOGIES CORP
2019-10-22
2020-04-29
20000. CAPITAL ONE FINANCIA 2.500% 5/12/20
2019-05-16
2020-05-12
249.841 INV OPP DEVELOP MRKTS-R6
2017-01-26
2020-05-15
14563.194 AMER CENT SMALL CAP GRWTH INST 336
2015-07-24
2020-05-15
1999.429 AMER CENT SMALL CAP GRWTH INST 336
2020-04-09
2020-05-15
943.685 ARTISAN MID CAP FUND-INSTL 1333
2012-04-24
2020-05-15
3. BLACKROCK INC
2018-11-19
2020-05-15
15. BLACKROCK INC
2020-04-08
2020-05-15
96. CVS HEALTH CORPORATION
2017-08-09
2020-05-15
195. CVS HEALTH CORPORATION
2019-08-09
2020-05-15
117. EOG RESOURCES, INC
2020-04-08
2020-05-15
270. EOG RESOURCES, INC
2018-04-12
2020-05-15
168. EOG RESOURCES, INC
2019-06-11
2020-05-15
81.197 EATON VANCE GLOB MACRO ADV-I 208
2018-02-01
2020-05-15
30. ELECTRONIC ARTS INC
2019-12-24
2020-05-15
64. ELECTRONIC ARTS INC
2019-02-14
2020-05-15
49. GILEAD SCIENCES INC
2017-03-24
2020-05-15
36. GILEAD SCIENCES INC
2019-08-09
2020-05-15
69. GILEAD SCIENCES INC
2020-04-08
2020-05-15
84. MONDELEZ INTERNATIONAL INC
2020-04-08
2020-05-15
105. MONDELEZ INTERNATIONAL INC
2019-08-09
2020-05-15
29802.139 PIMCO HIGH YIELD FD-INST #108
2019-10-11
2020-05-15
594.885 T ROWE PR OVERSEAS STOCK-I #521
2017-04-26
2020-05-15
3552.862 STERLING CAPITAL STRATTON SMALL CAP
2014-07-14
2020-05-15
921.534 STERLING CAPITAL STRATTON SMALL CAP
2020-02-20
2020-05-15
88.235 TCW EMRG MKTS INCM-I 4721
2020-02-20
2020-05-15
7. THERMO FISHER SCIENTIFIC INC
2011-02-11
2020-05-15
22. THERMO FISHER SCIENTIFIC INC
2020-04-08
2020-05-15
238. VANGUARD MIDCAP VIPER
2020-02-14
2020-05-15
137. CITIGROUP INC
2019-06-11
2020-05-28
55. ELECTRONIC ARTS INC
2020-04-08
2020-05-28
485. HAIN CELESTIAL GROUP INC
2016-01-15
2020-05-28
488. TJX COMPANIES INC
2011-10-12
2020-05-28
3. TJX COMPANIES INC
2019-10-22
2020-05-28
130. TJX COMPANIES INC
2020-03-03
2020-05-28
12052.418 JAMES ALPHA GL REAL EST-I
2020-02-20
2020-06-25
CAPITAL GAIN 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
10,440
10,308
132
b
10,440
10,192
248
c
291
273
18
d
283,229
305,311
-22,082
e
14,503
12,941
1,562
169,138
189,150
-20,012
9,017
9,417
-400
12,767
12,657
110
23,517
21,221
2,296
272,972
277,244
-4,272
8,868
8,613
255
9,601
10,309
-708
289,679
259,117
30,562
16,652
17,117
-465
22,508
23,260
-752
7,742
7,628
114
2,713
2,595
118
1,985
1,639
346
15,048
15,212
-164
183,570
182,940
630
2,883
2,805
78
13,208
12,406
802
175,006
156,428
18,578
864
836
28
1,626
1,539
87
1,565
1,493
72
694
802
-108
26,563
25,303
1,260
5,735
5,669
66
7,303
7,571
-268
8,833
8,867
-34
15,773
15,289
484
10,072
10,296
-224
8,469
8,637
-168
14,311
14,093
218
13,302
11,823
1,479
5,556
5,281
275
2,751
1,919
832
14,858
14,322
536
1,015
1,003
12
15,231
14,986
245
25,200
25,310
-110
16,364
17,137
-773
4,091
4,079
12
15,341
15,316
25
81,694
81,467
227
127,710
126,307
1,403
57,633
57,953
-320
8,299
6,073
2,226
23,190
39,691
-16,501
7,015
8,237
-1,222
8,226
7,801
425
7,967
7,676
291
5,212
5,127
85
10,424
10,292
132
10,424
10,276
148
14,718
8,676
6,042
5,692
5,268
424
30,901
13,516
17,385
5,851
8,493
-2,642
110,720
84,187
26,533
4,551
3,108
1,443
10,619
8,360
2,259
6,860
6,273
587
2,270
1,312
958
22,701
14,174
8,527
30,128
27,460
2,668
10,715
8,659
2,056
8,096
9,046
-950
6,237
5,961
276
5,609
6,316
-707
5,897
5,411
486
3,224
2,928
296
6,116
5,301
815
5,782
5,911
-129
7,120
7,089
31
5,438
8,063
-2,625
5,585
5,547
38
5,639
4,930
709
5,439
8,236
-2,797
6,106
5,273
833
283,635
263,371
20,264
25,177
23,094
2,083
6,166
5,368
798
334,295
204,495
129,800
158,552
169,525
-10,973
7,527
7,735
-208
9,134
4,685
4,449
1,774
1,849
-75
4,912
4,805
107
273
285
-12
5,822
5,577
245
5,530
5,738
-208
6,832
3,886
2,946
13,111
9,808
3,303
6,728
6,208
520
2,168
1,161
1,007
7,433
5,941
1,492
5,527
3,455
2,072
5,661
5,165
496
5,140
4,956
184
23,415
21,439
1,976
85,374
84,700
674
92,601
85,513
7,088
5,437
6,285
-848
6,702
7,338
-636
5,502
5,254
248
5,473
3,342
2,131
5,743
4,719
1,024
6,016
6,208
-192
3,085
3,578
-493
2,987
3,469
-482
6,591
6,076
515
549
142
407
5,487
5,942
-455
14,319
12,000
2,319
5,986
4,285
1,701
5,497
4,772
725
743
604
139
4,643
4,515
128
10,137
10,037
100
10,137
10,142
-5
5,076
5,013
63
20,303
19,993
310
34,175
34,127
48
26,134
25,784
350
6,905
4,860
2,045
12,956
12,061
895
26,991
25,553
1,438
38,070
24,714
13,356
5,243
4,852
391
5,950
4,973
977
4,659
4,163
496
932
172
760
20,711
13,603
7,108
6,106
7,155
-1,049
6,104
8,111
-2,007
9,727
7,438
2,289
4,175
1,567
2,608
15,585
9,484
6,101
9,366
9,706
-340
52,132
51,537
595
5,180
5,078
102
15,317
15,742
-425
5,106
5,188
-82
3,009
3,099
-90
10,209
10,634
-425
19,464
19,837
-373
14,440
15,907
-1,467
8,315
9,282
-967
38,000
35,385
2,615
2,633
3,181
-548
20,465
20,905
-440
2,831
3,014
-183
5,251
5,251
62,772
60,319
2,453
39,646
39,203
443
66,076
64,099
1,977
142,737
175,118
-32,381
5,326
5,256
70
15,618
18,148
-2,530
180,767
224,950
-44,183
886
1,107
-221
21,254
21,921
-667
17,577
16,254
1,323
29,295
27,418
1,877
38,891
37,157
1,734
5,556
5,279
277
48,650
45,339
3,311
5,627
5,311
316
39,386
37,425
1,961
23,206
21,494
1,712
20,655
20,425
230
16,328
15,373
955
5,443
5,213
230
21,770
20,938
832
25,389
22,737
2,652
64
84
-20
20,000
20,008
-8
9,257
8,437
820
258,497
227,216
31,281
35,490
31,511
3,979
40,692
37,502
3,190
1,521
1,230
291
7,603
6,780
823
5,989
7,571
-1,582
12,165
12,536
-371
5,642
5,113
529
13,020
29,315
-16,295
8,102
13,847
-5,745
827
854
-27
3,532
3,245
287
7,535
6,755
780
3,727
3,305
422
2,738
2,350
388
5,248
5,110
138
4,194
4,361
-167
5,243
5,769
-526
243,782
265,239
-21,457
5,235
5,967
-732
195,017
289,176
-94,159
50,583
55,917
-5,334
628
766
-138
2,385
402
1,983
7,497
6,477
1,020
34,802
44,196
-9,394
6,889
9,370
-2,481
6,644
5,854
790
14,849
17,632
-2,783
26,596
7,074
19,522
164
181
-17
7,085
7,844
-759
188,741
227,045
-38,304
101,782
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
132
b
248
c
18
d
-22,082
e
1,562
-20,012
-400
110
2,296
-4,272
255
-708
30,562
-465
-752
114
118
346
-164
630
78
802
18,578
28
87
72
-108
1,260
66
-268
-34
484
-224
-168
218
1,479
275
832
536
12
245
-110
-773
12
25
227
1,403
-320
2,226
-16,501
-1,222
425
291
85
132
148
6,042
424
17,385
-2,642
26,533
1,443
2,259
587
958
8,527
2,668
2,056
-950
276
-707
486
296
815
-129
31
-2,625
38
709
-2,797
833
20,264
2,083
798
129,800
-10,973
-208
4,449
-75
107
-12
245
-208
2,946
3,303
520
1,007
1,492
2,072
496
184
1,976
674
7,088
-848
-636
248
2,131
1,024
-192
-493
-482
515
407
-455
2,319
1,701
725
139
128
100
-5
63
310
48
350
2,045
895
1,438
13,356
391
977
496
760
7,108
-1,049
-2,007
2,289
2,608
6,101
-340
595
102
-425
-82
-90
-425
-373
-1,467
-967
2,615
-548
-440
-183
2,453
443
1,977
-32,381
70
-2,530
-44,183
-221
-667
1,323
1,877
1,734
277
3,311
316
1,961
1,712
230
955
230
832
2,652
-20
-8
820
31,281
3,979
3,190
291
823
-1,582
-371
529
-16,295
-5,745
-27
287
780
422
388
138
-167
-526
-21,457
-732
-94,159
-5,334
-138
1,983
1,020
-9,394
-2,481
790
-2,783
19,522
-17
-759
-38,304
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
185,039
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
2017
2016
2015
2014
2
Total
of line 1, column (d)
.....................
2
3
Average distribution ratio for the 5-year base period—divide the total on line 2 by 5.0, or by the number of years the foundation has been in existence if less than 5 years
......
3
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
5
Multiply line 4 by line 3
......................
5
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
7
Add lines 5 and 6
........................
7
8
Enter qualifying distributions from Part XII, line 4
,.............
8
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
6,370
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
6,370
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
6,370
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
9,120
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
7
Total credits and payments. Add lines 6a through 6d
..............
7
9,120
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
2,750
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
2,750
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.
$
(2)
On foundation managers.
$
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
Yes
7
Did the foundation have at least $5,000 in assets at any time during the year?
If "Yes," complete Part II, col. (c),
and Part XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
IN
b
If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G?
If "No," attach explanation
.
8b
Yes
9
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
or 4942(j)(5) for calendar year 2019 or the taxable year beginning in 2019? See the instructions for Part XIV.
If "Yes," complete Part XIV
.............................
9
No
10
Did any persons become substantial contributors during the tax year?
If "Yes," attach a schedule listing their names
and addresses.
...............................
10
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
5
Part VII-A
Statements Regarding Activities
(continued)
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions
.............
11
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement. See instructions
.................
12
No
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
N/A
14
The books are in care of
WELLS FARGO BANK NA
Telephone no.
(888) 730-4933
Located at
100 N MAIN ST MAC D4001-117
WINSTON SALEM
NC
ZIP+4
27101
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
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
WELLS FARGO BANK N A
TRUSTEE
1
96,216
100 N MAIN ST MAC D4001-117
WINSTON SALEM
,
NC
27101
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
.........................
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
8,589,150
b
Average of monthly cash balances
.......................
1b
499,028
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
9,088,178
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
9,088,178
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
136,323
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
8,951,855
6
Minimum investment return.
Enter 5% of line 5
..................
6
447,593
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
447,593
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
6,370
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
6,370
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
441,223
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
441,223
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
441,223
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
454,545
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
0
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
0
b
Cash distribution test (attach the required schedule)
.................
3b
0
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
454,545
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
454,545
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
441,223
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
431,296
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
0
b
From 2015
......
0
c
From 2016
......
0
d
From 2017
......
0
e
From 2018
......
0
f
Total
of lines 3a through e
........
0
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
454,545
a
Applied to 2018, but not more than line 2a
431,296
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
.....
23,249
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
..........
417,974
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
....
0
b
Excess from 2016
....
0
c
Excess from 2017
....
0
d
Excess from 2018
....
0
e
Excess from 2019
....
0
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).)
NONE
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.
NONE
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:
WELLS FARGO BANK
222 EAST WAYNE ST
FORT WAYNE
,
IN
46802
(260) 461-6548
b
The form in which applications should be submitted and information and materials they should include:
LETTER
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
YWCA NATIONAL BOARD
ATTN FINANCIAL DEPARTMENT
WASHINGTON DC
,
DC
20036
NONE
PC
GENERAL SUPPORT
44,400
AMERICAN CANCER SOCIETY INC
6525 N MERIDIAN AVE NO 110
OKLAHOMA CITY
,
OK
731720366
NONE
PC
GENERAL SUPPORT
22,200
AMERICAN FRIENDS SERVICE COMMITTEE
ATTN OFFICE OF PLANNED GIVING
PHILADELPHIA
,
PA
19102
NONE
PC
GENERAL SUPPORT
128,760
WITTENBERG UNIVERSITY
ATT OFFICE OF UNIVERSITY ADVANCEMEN
SPRINGFIELD
,
OH
455010720
NONE
PC
GENERAL SUPPORT
22,200
YWCA
5920 DECATUR ROAD
FORT WAYNE
,
IN
46816
NONE
PC
GENERAL SUPPORT
22,200
TRINITY ENGLISH LUTHERAN CHURCH
450 WEST WASHINGTON BLVD
FORT WAYNE
,
IN
46802
NONE
PC
GENERAL SUPPORT
44,400
ELCA FOUNDATION
8765 WEST HIGGINS RD
CHICAGO
,
IL
60631
NONE
PC
GENERAL SUPPORT
88,800
PACIFIC LUTHERAN THEO SEMINARY
2000 CENTER ST STE 200
BERKELEY
,
CA
94704
NONE
PC
GENERAL SUPPORT
44,400
LA JOLLA LUTHERAN CHURCH
7111 LA JOLLA BLVD
LA JOLLA
,
CA
92037
NONE
PC
GENERAL SUPPORT
22,200
COMMUNITY CONG CH OF CHULA VISTA
276 F ST
CHULA VISTA
,
CA
91910
NONE
PC
GENERAL SUPPORT
4,440
Total
.................................
3a
444,000
b
Approved for future payment
Total
.................................
3b
Form
990-PF
(2019)
Form 990-PF (2019)
Page
12
Part XVI-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
Unrelated business income
Excluded by section 512, 513, or 514
(e)
Related or exempt
function income
(See instructions.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
4
Dividends and interest from securities
....
14
227,926
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
185,039
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)
..
412,965
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
412,965
(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