-
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
RUCKER FAMILY CHARITABLE TRUST
Number and street (or P.O. box number if mail is not delivered to street address)
1003 W CENTENNIAL DRIVE
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
PEORIA
,
IL
616142828
A Employer identification number
37-1457914
B
Telephone number (see instructions)
(309) 692-0621
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)
$
2,890,656
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)
163,079
2
Check
.............
3
Interest on savings and temporary cash investments
488
488
4
Dividends and interest from securities
...
68,035
59,291
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
-182,157
b
Gross sales price for all assets on line 6a
4,146,060
7
Capital gain net income (from Part IV, line 2)
...
0
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)
.......
30
30
12
Total.
Add lines 1 through 11
........
49,475
59,809
13
Compensation of officers, directors, trustees, etc.
0
0
0
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
7,865
5,506
2,359
c
Other professional fees (attach schedule)
....
27,157
27,157
0
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
7,460
1,460
0
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
116
116
0
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
42,598
34,239
2,359
25
Contributions, gifts, grants paid
.......
132,066
132,066
26
Total expenses and disbursements.
Add lines 24 and 25
174,664
34,239
134,425
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-125,189
b
Net investment income
(if negative, enter -0-)
25,570
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
.........
25,493
33,192
33,192
3
Accounts receivable
Less: allowance for doubtful accounts
4
Pledges receivable
Less: allowance for doubtful accounts
5
Grants receivable
.................
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)
.....
7
Other notes and loans receivable (attach schedule)
Less: allowance for doubtful accounts
8
Inventories for sale or use
..............
9
Prepaid expenses and deferred charges
..........
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
.......
2,738,429
2,662,066
2,856,959
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)
..........
10,030
505
505
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)
2,773,952
2,695,763
2,890,656
17
Accounts payable and accrued expenses
..........
18
Grants payable
.................
19
Deferred revenue
.................
20
Loans from officers, directors, trustees, and other disqualified persons
2,000
21
Mortgages and other notes payable (attach schedule)
......
22
Other liabilities (describe
)
0
45,000
23
Total liabilities
(add lines 17 through 22)
.........
0
47,000
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
25
Net assets with donor restrictions
............
Foundations that do not follow FASB ASC 958, check here
and complete lines 26 through 30.
26
Capital stock, trust principal, or current funds
........
0
0
27
Paid-in or capital surplus, or land, bldg., and equipment fund
0
0
28
Retained earnings, accumulated income, endowment, or other funds
2,773,952
2,648,763
29
Total net assets or fund balances
(see instructions)
.....
2,773,952
2,648,763
30
Total liabilities and net assets/fund balances
(see instructions)
.
2,773,952
2,695,763
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
2,773,952
2
Enter amount from Part I, line 27a
.....................
2
-125,189
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
2,648,763
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
2,648,763
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
500 SH ABBVIE INC
2018-04-17
2019-04-01
b
500 SH ADVANCE ENERGY INDUSTRIES
2018-05-07
2019-04-01
c
50 SH AGEX THERAPEUTICS INC
2018-11-29
2019-04-01
d
500 SH AIRCASTLE LTD (BERMUDA)
2018-02-20
2019-04-01
e
55 SH ALCOA INCORPORATED- NEW
2015-04-15
2019-04-01
9 SH ALPHABET INC A (FORMERLY GOOGLE INC. CL A)
2006-02-07
2019-04-01
9 SH ALPHABET INC C (GOOGLE INC. CL C)
2006-02-07
2019-04-01
100 SH AMAZON COM INC
2018-07-05
2019-04-01
500 SH AMERICAN HOMES 4 RENT
2018-06-18
2019-04-01
20 SH AMERICAN SUPERCONDUCTOR
2011-02-07
2019-04-01
500 SH APPLE INC
2017-03-14
2019-04-01
200 SH APPLIED OPTOELECTRONICS INC
2018-06-05
2019-04-01
300 SH APPLIED OPTOELECTRONICS INC
2017-08-28
2019-04-01
500 SH ARCBEST CORP
2018-09-05
2019-04-01
166 SH ARCONIC INCORPORATED
2015-04-15
2019-04-01
500 SH AT&T
2019-03-04
2019-04-01
500 SH AT&T
2016-10-26
2019-04-01
500 SH AUTONATION INCORPORATED
2016-04-14
2019-04-01
200 SH BAKER HUGHES INC
2009-05-18
2019-04-01
500 SH BANK OF THE OZARKS INC.
2016-09-20
2019-04-01
500 SH BAXTER INTERNATIONAL INC.
2018-01-03
2019-02-26
500 SH BED BATH AND BEYOND
2015-01-09
2019-04-01
500 SH BERRY GLOBAL GRP INCORP
2018-01-22
2019-04-01
500 SH BIG LOTS INC
2017-01-06
2019-04-01
1000 SH BLOOMIN BRANDS INC
2018-10-30
2019-04-01
500 SH BIOTIME INC
2012-02-24
2019-04-01
100 SH BOEING CO
2008-12-09
2019-02-26
1000 SH BOSTON SCIENTIFIC CORP
2018-10-01
2019-04-01
500 SH CADENCE BANCORPORATION CLASS A
2018-08-21
2019-04-01
200 SH CATERPILLAR INC
2018-11-07
2019-04-01
500 SH CHEASPEAKE ENERGY CORP
2011-11-30
2019-04-01
700 SH CIRRUS LOGIC INC
2017-01-06
2019-04-01
300 SH CISCO SYSTEMS INC
2018-12-11
2019-04-01
300 SH CSX CORP
2018-07-19
2019-04-01
300 SH CNX RESOURCES CORP
2017-11-06
2019-04-01
500 SH COGNIZANT TECHNOLOGY SOLUTIONS
2018-09-10
2019-04-01
500 SH COGNIZANT TECHNOLOGY SOLUTIONS
2017-11-06
2019-04-01
37 SH CONSOL ENERGY INC.
2010-12-02
2019-04-01
300 SH CORPORATE OFFICE PPTYS TR SH REIT
2007-10-19
2019-04-01
500 SH CVS HEALTH CORPORATION
2016-11-08
2019-04-01
500 SH D R HORTON INC.
2018-08-27
2019-04-01
20 SH E-TRADE FINANCIAL CORP.
2006-03-15
2019-04-01
1000 SH ENCANA CORPORATION CA
2018-05-01
2019-04-01
300 SH ENERPLUS CORP
2008-09-11
2019-04-01
400 SH EXXON MOBIL
2015-09-23
2019-04-01
1000 SH FITBIT INC
2017-09-19
2019-04-01
500 SH FLEX LIMITED ORD
2018-01-09
2019-04-01
500 SH FLIR SYSTEM
2018-05-21
2019-04-01
300 SH FREEPORT-MCMORAN COPPER & GOLD
2011-03-21
2019-04-01
133 SH FRONTIER COMMUNICATIONS - NEW
2016-01-04
2019-04-01
24 SH FTD COMPANIES INCORPORATED
2013-11-01
2019-04-01
500 SH GENERAL ELECTRIC
2006-11-03
2019-04-01
500 SH GENERAL MILLS INC
2017-09-26
2019-04-01
300 SH GENESSEE & WYO INC CLASS A
2018-07-11
2019-04-01
500 SH GENTEX CORP
2018-10-08
2019-04-01
500 SH GILEAD SCIENCES INC.
2016-01-12
2019-04-01
300 SH INCYTE CORP
2018-12-04
2019-04-01
500 SH INTERNATIONAL PAPER CO
2018-10-08
2019-04-01
500 SH ITRON INC
2018-08-07
2019-04-01
500 SH KENNAMETAL INCORPORATED
2019-02-25
2019-04-01
1000 SH KIMCO REALTY CORP REIT
2017-06-27
2019-04-01
500 SH KITE REALTY GROUP NEW REIT
2017-02-22
2019-04-01
500 SH KNOLL INC
2017-12-26
2019-04-01
1000 SH KROGER COMPANY
2015-04-14
2019-04-01
300 SH LAS VEGAS SANDS CORP
2017-07-27
2019-04-01
300 SH LEIDOS HLDGS INC
2018-04-24
2019-04-01
500 SH LUMENTUM HLDGS INC
2018-08-21
2019-04-01
500 SH MALLINCKRODT PUB LTD CO
2017-03-23
2019-04-01
43 SH MGM RESORTS INTERNATIONAL
2007-10-19
2019-04-01
500 SH MANNING & NAPIER
2014-03-26
2019-04-01
500 SH MARATHON OIL CORP
2018-07-31
2019-04-01
500 SH MARATHON PETE CORPORATION
2019-02-07
2019-04-01
500 SH MICROSOFT CORP
2018-11-14
2019-04-01
1000 SH MYLAN
2015-02-27
2019-04-01
200 SH NOBLE CORPORATION
2014-10-21
2019-04-01
500 SH NOKIA CORP ADR
2008-11-07
2019-04-01
1000 SH NUANCE COMMUNICATIONS
2012-03-14
2019-04-01
120 SH NUTRIEN LIMITED CA
2011-08-16
2019-04-01
500 SH OCCIDENTAL PETROLEUM CORP
2018-11-06
2019-04-01
25 SH ONCOCYTE
2016-01-04
2019-04-01
300 SH OWENS ILL INC.
2015-05-13
2019-04-01
110 SH PARK HOTELS INC
2015-02-26
2019-04-01
7 SH PJT PARTNERS INC
2015-10-01
2019-04-01
1000 SH PPL CORP
2018-09-24
2019-04-01
500 SH PACCAR INC
2018-03-20
2019-04-01
500 SH PITNEY BOWES INC
2016-03-09
2019-04-01
500 SH PROLOGIS INC
2018-03-05
2019-02-07
300 SH PRUDENTIAL FINL INCORP
2018-07-05
2019-04-01
500 SH QUANTA SVCS INCORPORATED
2018-05-14
2019-04-01
100 SH SCHLUMBERGER LIMITED
2016-01-25
2019-04-01
1 SH SEADRILL LIMITED
2018-07-02
2019-04-01
200 SH SPROUTS FMRS
2014-07-16
2019-04-01
500 SH SYNCHRONOS TECHNOLOGIES INC
2017-07-07
2019-04-01
500 SH TECK RESOURCES LIMITED CLASS B
2018-12-18
2019-04-01
1000 SH TECK RESOURCES LIMITED CLASS B
2017-10-30
2019-04-01
42 SH TERADATA CORP.
2007-10-19
2019-04-01
300 SH TEREX CORP
2008-01-22
2019-04-01
21 SH THOMSON REUTERS CORP
2007-10-19
2019-04-01
200 SH TRANSOCEAN LTD
2014-10-21
2019-04-01
500 SH 3-D SYSTEMS CORP
2014-10-15
2019-04-01
200 SH TWITTER
2014-07-07
2019-04-01
41 SH UNITED COMM. BANKS
2006-04-19
2019-04-01
100 SH UNITI GROUP INC
2013-09-24
2019-04-01
51 SH UPS INC CL B
2007-10-19
2019-04-01
500 SH UNITED STATES STEEL CORP
2018-08-13
2019-04-01
500 SH VIKING THERAPEUTICS INC
2018-10-08
2019-04-01
500 SH VOLKSWAGEN AG SPONSORED
2016-01-19
2019-03-26
0.69 SH WABTEC CORPORATION
2019-02-26
2019-03-01
2 SH WABTEC CORPORATION
2019-02-26
2019-04-01
16 SH WINDSTREAM HOLDINGS CORP
2007-06-05
2019-04-01
48 SH ZIMMER HOLDINGS INC.
2007-10-19
2019-04-01
544.665 SH CAPITAL INCOME BUILDER
2008-11-12
2019-04-01
20.189 SH CAPITAL INCOME BUILDER
2019-01-01
2019-04-01
75.835 SH COLUMBIA SELIGMAN COMM
2018-12-10
2019-04-01
633.133 SH COLUMBIA SELIGMAN COMM
2010-10-12
2019-04-01
195.734 SH DAVIS NEW YORK VENTURE
2018-12-13
2019-04-01
905.862 SH DAVIS NEW YORK VENTURE
2009-05-21
2019-04-01
31.234 SH EUROPACIFIC GROWTH FUND
2018-12-21
2019-04-01
541.833 SH EUROPACIFIC GROWTH FUND
2009-05-21
2019-04-01
57.486 SH FIRST EAGLE GLOBAL FUND
2018-12-13
2019-04-01
930.232 SH FIRST EAGLE GLOBAL FUND
2003-12-17
2019-04-01
10.327 SH FIRST EAGLE OVERSEAS FUND
2018-12-13
2019-04-01
341.951 SH FIRST EAGLE OVERSEAS FUND
2008-02-11
2019-04-01
522.76 SH FIRST EAGLE GOLD FUND CL A
2007-11-21
2019-04-01
2042.221 SH FRANKLIN INCOME FUND CL A
2018-04-03
2019-04-01
37767.068 SH FRANKLIN INCOME FUND CL A
2011-08-10
2019-04-01
9700 SH GOLDMAN SACHS ACCES TREASURY 0-1 YEAR ETF
2019-04-01
2019-04-12
9 SH GOLDMAN SACHS ACCES TREASURY 0-1 YEAR ETF
2019-04-01
2019-04-18
6 SH GOLDMAN SACHS ACCES TREASURY 0-1 YEAR ETF
2019-04-01
2019-05-28
1055 SH GOLDMAN SACHS ACCES TREASURY 0-1 YEAR ETF
2019-04-01
2019-11-13
138.154 SH GROWTH FUND OF AMERICA A
2018-12-24
2019-04-01
1103.879 SH GROWTH FUND OF AMERICA A
2008-11-12
2019-04-01
406.303 SH HARTFORD MIDCAP A
2018-12-18
2019-04-01
2946.339 SH HARTFORD MIDCAP A
2008-11-12
2019-04-01
110 SH ISHARES TR CORE MSCI EAFE
2019-04-12
2019-04-18
110 SH ISHARES TR CORE MSCI EAFE
2019-04-12
2019-05-28
2030 SH ISHARES TR CORE MSCI EAFE
2019-04-12
2019-08-14
10 SH ISHARES INCORPORATED CORE MSCI EMKT
2019-04-12
2019-04-18
22 SH ISHARES INCORPORATED CORE MSCI EMKT
2019-04-12
2019-05-28
405 SH ISHARES INCORPORATED CORE MSCI EMKT
2019-04-12
2019-06-04
400 SH ISHARES INCORPORATED CORE MSCI EMKT
2019-04-12
2019-08-14
5 SH ISHARES TR CORE S&P SCP ETF
2019-04-12
2019-04-18
9 SH ISHARES TR CORE S&P SCP ETF
2019-04-12
2019-05-28
70 SH ISHARES TR MIN VOL USA ETF
2019-04-12
2019-04-18
147 SH ISHARES TR MIN VOL USA ETF
2019-04-12
2019-05-28
173.306 SH IVY ASSET STRATEGY FUND
2018-06-15
2019-04-01
886.784 SH IVY ASSET STRATEGY FUND
2010-10-25
2019-04-01
716.83 SH IVY NATURAL RESOURCES FUND
2008-09-12
2019-04-01
80.475 SH KEELEY SMALL CAP VALUE FUND
2018-11-29
2019-04-01
829.421 SH KEELEY SMALL CAP VALUE FUND
2009-05-26
2019-04-01
24.435 SH NEW PERSPECTIVE FUND CL A
2018-12-24
2019-04-01
310.359 SH NEW PERSPECTIVE FUND CL A
2015-10-07
2019-04-01
25.359 SH PIMCO REAL RETURN FUND
2018-05-01
2019-04-01
1101.196 SH PIMCO REAL RETURN FUND
2009-11-07
2019-04-01
631.203 SH QUAKER IMPACT GROWTH FUND
2010-10-25
2019-04-01
1152.506 SH TOUCHSTONE SMALL COMPANY FUND
2018-12-13
2019-04-01
8439.746 SH TOUCHSTONE SMALL COMPANY FUND
2011-05-27
2019-04-01
300 SH SECTOR SPDR TR SBI INT-ENERGY
2015-01-22
2019-04-01
1200 SH VANGUARD INDEX FUNDS S&P 500 ETF
2019-04-03
2019-04-12
22 SH VANGUARD INDEX FUNDS S&P 500 ETF
2019-04-03
2019-04-18
16 SH VANGUARD INDEX FUNDS S&P 500 ETF
2019-04-03
2019-05-28
60 SH VANGUARD TAX-EXEMPT BOND ETF
2019-04-12
2019-04-18
120 SH VANGUARD TAX-EXEMPT BOND ETF
2019-04-12
2019-05-28
100 SH VANGUARD TOTAL STOCK ETF
2018-04-03
2019-04-01
70.043 SH DIAMOND HILL LONG-SHORT FUND CL A
2007-04-09
2019-04-01
1451.12 SH DIAMOND HILL LONG-SHORT FUND CL A
2018-12-14
2019-04-01
300 SH BLACKSTONE GROUP LP
2015-09-15
2019-04-01
800 SH BAKER HUGHES INC
2014-09-03
2019-04-01
200 SH TEREX CORP
2008-09-11
2019-04-01
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
40,204
44,585
-4,381
b
25,310
32,486
-7,176
c
197
135
62
d
10,315
10,521
-206
e
1,620
2,272
-652
10,765
2,874
7,891
10,733
2,878
7,855
181,219
174,466
6,753
11,330
10,784
546
256
5,663
-5,407
95,114
74,413
20,701
2,528
9,622
-7,094
3,793
18,654
-14,861
16,411
24,376
-7,965
3,229
4,571
-1,342
15,912
15,198
714
15,912
18,504
-2,592
17,960
23,639
-5,679
5,610
7,440
-1,830
14,925
19,862
-4,937
36,787
34,707
2,080
8,370
32,212
-23,842
27,195
29,349
-2,154
19,210
25,119
-5,909
20,440
20,670
-230
655
2,684
-2,029
41,720
4,174
37,546
38,551
39,532
-981
9,520
14,603
-5,083
27,890
27,091
799
1,582
11,916
-10,334
28,119
39,971
-11,852
16,416
14,388
2,028
22,884
20,744
2,140
3,216
11,262
-8,046
36,825
38,640
-1,815
36,825
37,990
-1,165
1,281
2,153
-872
8,161
11,756
-3,595
26,960
36,323
-9,363
20,736
23,016
-2,280
959
5,191
-4,232
7,420
12,935
-5,515
2,574
10,802
-8,228
32,624
29,229
3,395
5,830
6,410
-580
5,155
9,570
-4,415
24,338
27,801
-3,463
3,945
12,452
-8,507
274
8,227
-7,953
12
2,624
-2,612
5,000
15,402
-10,402
25,415
26,452
-1,037
26,639
25,475
1,164
10,585
10,403
182
32,846
43,911
-11,065
25,782
20,645
5,137
23,580
23,995
-415
23,695
31,584
-7,889
18,751
20,162
-1,411
18,060
18,776
-716
7,990
11,334
-3,344
9,535
11,761
-2,226
24,811
38,269
-13,458
18,839
18,969
-130
19,380
19,970
-590
28,857
32,675
-3,818
11,442
22,024
-10,582
1,142
4,072
-2,930
1,053
8,311
-7,258
8,660
10,661
-2,001
30,575
32,284
-1,709
59,440
53,972
5,468
28,521
50,227
-21,706
601
4,171
-3,570
2,875
7,355
-4,480
17,041
26,196
-9,155
6,383
16,856
-10,473
33,570
37,019
-3,449
101
106
-5
5,802
8,009
-2,207
3,462
3,316
146
295
156
139
31,600
29,724
1,876
34,405
33,695
710
3,505
9,984
-6,479
34,656
31,073
3,583
28,531
28,648
-117
19,161
18,641
520
4,476
6,482
-2,006
9
20
-11
4,362
6,369
-2,007
3,043
8,358
-5,315
11,820
11,215
605
23,640
21,055
2,585
1,837
1,210
627
9,805
12,778
-2,973
1,238
702
536
1,840
6,121
-4,281
5,445
19,794
-14,349
6,679
8,200
-1,521
1,051
5,813
-4,762
1,130
3,274
-2,144
5,806
3,877
1,929
10,065
15,412
-5,347
4,970
7,670
-2,700
17,450
13,611
3,839
51
54
-3
148
156
-8
4
1,027
-1,023
6,123
3,964
2,159
33,083
24,607
8,476
1,226
1,181
45
5,522
4,551
971
46,098
33,026
13,072
5,553
5,588
-35
25,699
26,919
-1,220
1,613
1,568
45
27,980
18,082
9,898
3,242
3,007
235
52,456
39,335
13,121
241
224
17
7,985
7,573
412
7,873
14,906
-7,033
4,738
4,643
95
87,620
78,924
8,696
971,345
970,873
472
902
901
1
601
601
0
105,846
105,718
128
6,803
5,657
1,146
54,355
31,010
23,345
12,027
10,019
2,008
87,212
51,078
36,134
6,874
6,813
61
6,588
6,813
-225
118,920
125,738
-6,818
535
537
-2
1,058
1,181
-123
19,861
21,740
-1,879
18,961
21,472
-2,511
399
397
2
675
714
-39
4,143
4,121
22
8,783
8,654
129
3,605
3,477
128
18,445
21,212
-2,767
9,778
16,215
-6,437
2,244
2,141
103
23,124
16,705
6,419
1,062
887
175
13,488
11,681
1,807
276
274
2
11,970
12,575
-605
21,095
9,582
11,513
5,601
5,255
346
41,017
52,343
-11,326
20,110
22,920
-2,810
317,266
314,359
2,907
5,864
5,763
101
4,131
4,191
-60
3,119
3,116
3
6,326
6,233
93
14,599
13,625
974
1,759
1,637
122
36,438
28,011
8,427
10,608
9,698
910
22,440
50,873
-28,433
6,536
7,344
-808
4,947
4,947
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
-4,381
b
-7,176
c
62
d
-206
e
-652
7,891
7,855
6,753
546
-5,407
20,701
-7,094
-14,861
-7,965
-1,342
714
-2,592
-5,679
-1,830
-4,937
2,080
-23,842
-2,154
-5,909
-230
-2,029
37,546
-981
-5,083
799
-10,334
-11,852
2,028
2,140
-8,046
-1,815
-1,165
-872
-3,595
-9,363
-2,280
-4,232
-5,515
-8,228
3,395
-580
-4,415
-3,463
-8,507
-7,953
-2,612
-10,402
-1,037
1,164
182
-11,065
5,137
-415
-7,889
-1,411
-716
-3,344
-2,226
-13,458
-130
-590
-3,818
-10,582
-2,930
-7,258
-2,001
-1,709
5,468
-21,706
-3,570
-4,480
-9,155
-10,473
-3,449
-5
-2,207
146
139
1,876
710
-6,479
3,583
-117
520
-2,006
-11
-2,007
-5,315
605
2,585
627
-2,973
536
-4,281
-14,349
-1,521
-4,762
-2,144
1,929
-5,347
-2,700
3,839
-3
-8
-1,023
2,159
8,476
45
971
13,072
-35
-1,220
45
9,898
235
13,121
17
412
-7,033
95
8,696
472
1
0
128
1,146
23,345
2,008
36,134
61
-225
-6,818
-2
-123
-1,879
-2,511
2
-39
22
129
128
-2,767
-6,437
103
6,419
175
1,807
2
-605
11,513
346
-11,326
-2,810
2,907
101
-60
3
93
974
122
8,427
910
-28,433
-808
4,947
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
-182,157
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
112,586
2,552,899
0.044101
2017
92,315
2,265,561
0.040747
2016
89,391
1,960,508
0.045596
2015
85,888
1,855,566
0.046287
2014
74,015
1,791,752
0.041309
2
Total
of line 1, column (d)
.....................
2
0.218040
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
0.043608
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
2,674,300
5
Multiply line 4 by line 3
......................
5
116,621
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
256
7
Add lines 5 and 6
........................
7
116,877
8
Enter qualifying distributions from Part XII, line 4
,.............
8
134,425
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
256
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
256
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
256
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
7,109
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
0
d
Backup withholding erroneously withheld
...........
6d
0
7
Total credits and payments. Add lines 6a through 6d
..............
7
7,109
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
6,853
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
6,853
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)
VA
b
If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G?
If "No," attach explanation
.
8b
Yes
9
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
or 4942(j)(5) for calendar year 2019 or the taxable year beginning in 2019? See the instructions for Part XIV.
If "Yes," complete Part XIV
.............................
9
No
10
Did any persons become substantial contributors during the tax year?
If "Yes," attach a schedule listing their names
and addresses.
...............................
10
Yes
Form
990-PF
(2019)
Form 990-PF (2019)
Page
5
Part VII-A
Statements Regarding Activities
(continued)
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions
.............
11
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement. See instructions
.................
12
No
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
N/A
14
The books are in care of
THE FOUNDATION
Telephone no.
(309) 692-0621
Located at
1003 W CENTENNIAL DRIVE
PEORIA
IL
ZIP+4
61614
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1)
Engage in the sale or exchange, or leasing of property with a disqualified person?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(5)
Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)?
...............
Yes
No
(6)
Agree to pay money or property to a government official? (
Exception.
Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.)
.......
Yes
No
b
If any answer is "Yes" to 1a(1)–(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions
........
1b
Organizations relying on a current notice regarding disaster assistance check here
........
c
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2019?
.............
1c
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2019, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2019?
.............
Yes
No
If "Yes," list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer "No" and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
......................
Yes
No
b
If "Yes," did it have excess business holdings in 2019 as a result of
(1)
any purchase by the foundation
or disqualified persons after May 26, 1969;
(2)
the lapse of the 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or
(3)
the lapse of the 10-, 15-, or 20-year first phase holding period?
(Use Schedule C, Form 4720, to determine
if the foundation had excess business holdings in 2019.)
..................
3b
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2019?
4b
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
6
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
(continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
No
b
If any answer is "Yes" to 5a(1)–(5), did
any
of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions
......
5b
Organizations relying on a current notice regarding disaster assistance check here
.........
c
If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant?
..........
Yes
No
If "Yes," attach the statement required by Regulations section 53.4945–5(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract?
.....................
Yes
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
....
6b
No
If "Yes" to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
Yes
No
b
If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction?
....
7b
8
Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment during the year?
.................
Yes
No
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1
List all officers, directors, trustees, foundation managers and their compensation. See instructions
(a)
Name and address
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(If not paid, enter
-0-)
(d)
Contributions to employee benefit plans and deferred compensation
(e)
Expense account,
other allowances
MICHAEL P RUCKER
TRUSTEE
2.00
0
0
0
1003 W CENTENNIAL DRIVE
PEORIA
,
IL
616142828
DEREK P RUCKER
TRUSTEE
1.00
0
0
0
15994 HYLAND POINTE COURT
APPLE VALLEY
,
MN
55124
2
Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a)
Name and address of each employee paid more than $50,000
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
NONE
Total
number of other employees paid over $50,000
...................
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
7
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
(continued)
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
NONE
Total
number of others receiving over $50,000 for professional services
.............
0
Part IX-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
2
3
4
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
8
Part X
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations, see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities
...................
1a
2,628,453
b
Average of monthly cash balances
.......................
1b
86,572
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
2,715,025
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
2,715,025
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
40,725
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
2,674,300
6
Minimum investment return.
Enter 5% of line 5
..................
6
133,715
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
133,715
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
256
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
256
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
133,459
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
133,459
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
133,459
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
134,425
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
134,425
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
256
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
134,169
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
133,459
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
123,064
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:
$
134,425
a
Applied to 2018, but not more than line 2a
123,064
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
.....
11,361
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
..........
122,098
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 email address of the person to whom applications should be addressed:
b
The form in which applications should be submitted and information and materials they should include:
c
Any submission deadlines:
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Form
990-PF
(2019)
Form 990-PF (2019)
Page
11
Part XV
Supplementary Information
(continued)
3
Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
ACT FOR ALEXANDRIA
201 KING STREET SUITE 200
ALEXANDRIA
,
VA
22314
NONE
CHARITABLE
GENERAL
2,000
AMHERST COUNTY MUSEUM & HISTORICAL SOCIETY
154 SOUTH MAIN STREET
AMHERST
,
VA
24521
NONE
CHARITABLE
GENERAL
1,000
APPALACHIAN TRAIL CONSERVANCY
799 WASHINGTON STREET
HARPERS FERRY
,
WV
25425
NONE
CHARITABLE
CONSERVATION
500
BRADLEY UNIVERSITY
1501 WEST BRADLEY AVENUE
PEORIA
,
IL
61625
NONE
CHARITABLE
EDUCATION
2,000
CENTRAL ILLINOIS LANDMARKS FOUNDATION
PO BOX 495
PEORIAL
,
IL
56151
NONE
CHARITABLE
PRESERVATION
2,000
CLASSICAL ACTORS ENSEMBLE
3125 OAKLAND AVENUE SOUTH
MINNEAPOLIS
,
MN
55407
NONE
CHARITABLE
GENERAL
10,000
COMMUNITY FOUNDATION OF CENTRAL ILLINOIS
23625 NORTH SHERIDAN ROAD
PEORIA
,
IL
61604
NONE
GENERAL
GENERAL
10,000
EAST PEORIA FESTIVAL OF LIGHTS
401 W WASHINGTON STREET
EAST PEORIA
,
IL
61611
NONE
CHARITABLE
GENERAL
500
FRIENDS OF ROCKY GLEN
15215 N IVY LAKE RD
CHILLICOTHE
,
IL
61523
NONE
CHARITABLE
CONSERVATION
1,500
FRIENDS OF WILDLIFE PRAIRIE PARK
3826 N TAYLOR RD
HANNA CITY
,
IL
61536
NONE
CHARITABLE
CONSERVATION
1,945
GALAPAGOS CONSERVANCY
11150 FAIRFAX BLVD STE 408
FAIRFAX
,
VA
22030
NONE
CHARITABLE
CONSERVATION
500
GREAT PLAINS INSTITUTE
2801 21ST AVE S STE 220
MINNEAPOLIS
,
MN
55407
NONE
CHARITABLE
CONSERVATION
5,000
KEEP PEORIA BEAUTIFUL
416 MAIN STREET STE 730
PEORIA
,
IL
61602
NONE
CHARITABLE
GENERAL
2,000
LOOK IT'S MY BOOK
310 E HIGH POINT LANE
PEORIA
,
IL
61614
NONE
CHARITABLE
GENERAL
2,000
MARION BRADLEY VIA MEMORIAL FOUNDATION
4415 ELECTRIC ROAD
ROANOKE
,
VA
24018
NONE
CHARITABLE
GENERAL PURPOSE
1,000
MASS INST OF TECHNOLOGY SLOAN SCHOOL
600 MEMORIAL DRIVE THIRD FL
CAMBRIDGE
,
MA
02139
NONE
CHARITABLE
GENERAL
2,500
PEORIA COUNTY JUVENILE DETENTION CENTER
223 N MAXWELL ROAD
PEORIA
,
IL
61602
NONE
GENERAL
GENERAL
1,000
PEORIA HISTORICAL SOCIETY
611 SW WASHINGTON ST
PEORIA
,
IL
61602
NONE
GENERAL
GENERAL
2,000
PEORIA PARK DISTRICT
1125 W LAKE AVENUE
PEORIA
,
IL
61614
NONE
CHARITABLE
GENERAL
3,000
PEORIA RIVERFRONT MUSEUM
222 SW WASHINGTON ST
PEORIA
,
IL
61602
NONE
CHARITABLE
GENERAL
25,000
RAILS TO TRAILS
2121 WARD COURT NW 5TH FLOOR
WASHINGTON
,
DC
20037
NONE
CHARITABLE
GENERAL
500
SPRINGDALE HISTORIC PRESERVATION FOUNDATION
PO BOX 5511
PEORIA
,
IL
60601
NONE
CHARITABLE
CONSERVATION
10,000
ST PAUL ACADEMY
1712 RANDOLPH AVEENUE
ST PAUL
,
MN
55105
NONE
CHARITABLE
GENERAL
10,000
SUN FOUNDATION
1276 SUN ROAD
WASHBURN
,
IL
61570
NONE
CHARITABLE
CONSERVATION
2,000
THE WORKS MUSEUM
9740 GRAND AVENUE S
BLOOMINGTON
,
MN
55420
NONE
CHARITABLE
GENERAL PURPOSE
20,000
TOWERSIDE INNOVATION DISTRICT
2642 UNIVERSITY AVE W
ST PAUL
,
MN
55114
NONE
GENERAL
GENERAL
10,000
VIRGINIA TECH UNIVERSITY
902 PRICES FORD RD
BLACKSBURG
,
VA
24060
NONE
CHARITABLE
GENERAL
2,121
WHEELS O'TIME MUSEUM
1710 W WOODSIDE DR
DUNLAP
,
IL
61525
NONE
CHARITABLE
GENERAL
2,000
Total
.................................
3a
132,066
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
488
4
Dividends and interest from securities
....
14
68,035
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not debt-financed property
.....
6
Net rental income or (loss) from personal property
7
Other investment income
.....
14
30
8
Gain or (loss) from sales of assets other than
inventory
............
18
-182,157
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
-113,604
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
-113,604
(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