-
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
07-01-2019
, and ending
06-30-2020
Name of foundation
HOOVER FAMILY FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)
860 E 86TH STREET RM/STE 5
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
INDIANAPOLIS
,
IN
46240
A Employer identification number
35-1873953
B
Telephone number (see instructions)
(317) 815-9553
C
If exemption application is pending, check here
G
Check all that apply:
Initial return
Initial return of a former public charity
Final return
Amended return
Address change
Name change
D 1.
Foreign organizations, check here.............
2
. Foreign organizations meeting the 85%
test, check here and attach computation ...
E
If private foundation status was terminated
under section 507(b)(1)(A), check here .......
H
Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here .......
I
Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)
$
12,748,261
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
380
380
4
Dividends and interest from securities
...
299,774
299,774
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
454,263
b
Gross sales price for all assets on line 6a
3,482,196
7
Capital gain net income (from Part IV, line 2)
...
454,263
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)
.......
12
Total.
Add lines 1 through 11
........
754,417
754,417
13
Compensation of officers, directors, trustees, etc.
196,564
3,931
192,632
14
Other employee salaries and wages
......
9,000
9,000
15
Pension plans, employee benefits
.......
111,127
2,223
108,904
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
7,029
35
6,993
c
Other professional fees (attach schedule)
....
53,881
53,881
17
Interest
...............
16
16
18
Taxes (attach schedule) (see instructions)
...
11,869
11,869
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
12,974
12,974
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
26,118
8,823
17,295
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
428,578
26,881
401,695
25
Contributions, gifts, grants paid
.......
562,630
562,630
26
Total expenses and disbursements.
Add lines 24 and 25
991,208
26,881
964,325
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-236,791
b
Net investment income
(if negative, enter -0-)
727,536
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
.............
173,828
195,379
195,379
2
Savings and temporary cash investments
.........
963,402
880,134
218,097
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)
.......
7,904,456
7,337,226
9,366,318
c
Investments—corporate bonds (attach schedule)
.......
2,400,371
2,792,855
2,960,079
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
14
Land, buildings, and equipment: basis
7,194
Less: accumulated depreciation (attach schedule)
7,194
15
Other assets (describe
)
8,716
8,388
8,388
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
11,450,773
11,213,982
12,748,261
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
...........
11,450,773
11,213,982
25
Net assets with donor restrictions
............
Foundations that do not follow FASB ASC 958, check here
and complete lines 26 through 30.
26
Capital stock, trust principal, or current funds
........
27
Paid-in or capital surplus, or land, bldg., and equipment fund
28
Retained earnings, accumulated income, endowment, or other funds
29
Total net assets or fund balances
(see instructions)
.....
11,450,773
11,213,982
30
Total liabilities and net assets/fund balances
(see instructions)
.
11,450,773
11,213,982
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return)
...............
1
11,450,773
2
Enter amount from Part I, line 27a
.....................
2
-236,791
3
Other increases not included in line 2 (itemize)
3
4
Add lines 1, 2, and 3
..........................
4
11,213,982
5
Decreases not included in line 2 (itemize)
5
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
11,213,982
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
JP MORGAN - LONG TERM
P
b
JP MORGAN - SHORT TERM
P
c
d
e
(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
2,333,463
1,932,705
400,758
b
1,054,250
1,095,228
-40,978
c
d
e
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
400,758
b
-40,978
c
d
e
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
454,263
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
952,012
11,121,803
0.085599
2017
910,623
11,081,517
0.082175
2016
872,636
11,236,352
0.077662
2015
898,017
11,569,999
0.077616
2014
1,124,326
12,056,409
0.093255
2
Total
of line 1, column (d)
.....................
2
0.416307
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
0.083261
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
11,153,968
5
Multiply line 4 by line 3
......................
5
928,691
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
7,275
7
Add lines 5 and 6
........................
7
935,966
8
Enter qualifying distributions from Part XII, line 4
,.............
8
964,325
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
7,275
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
3
Add lines 1 and 2
...........................
3
7,275
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
4
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
7,275
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
6,400
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
6,400
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
50
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
925
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
Refunded
11
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
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
WWW.HOOVERFF.ORG
14
The books are in care of
DAVID C HOOVER
Telephone no.
(317) 815-9553
Located at
860 E 86TH STREET SUITE 5
INDIANAPOLIS
IN
ZIP+4
46240
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
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
DAVID C HOOVER
PRESIDENT
40.00
105,612
40,959
0
860 E 86TH STREET SUITE 5
INDIANAPOLIS
,
IN
46240
CYNTHIA K HOOVER
VICE PRESIDE
000.00
0
3,000
0
860 E 86TH STREET SUITE 5
INDIANAPOLIS
,
IN
46240
GLEN H FRIEDMAN
EXECUTIVE DI
000.00
90,952
57,835
0
19250 NIXON AVE
WEST LINN
,
OR
97068
ANNE HOOVER
DIRECTOR
000.00
0
3,000
0
860 E 86TH STREET RM 5
INDIANAPOLIS
,
IN
46240
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
...................
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
.............
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
N/A
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
7,620,841
b
Average of monthly cash balances
.......................
1b
1,106,371
c
Fair market value of all other assets (see instructions)
................
1c
2,596,613
d
Total
(add lines 1a, b, and c)
.........................
1d
11,323,825
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation)
.............
1e
2
Acquisition indebtedness applicable to line 1 assets
..................
2
3
Subtract line 2 from line 1d
.........................
3
11,323,825
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
169,857
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
11,153,968
6
Minimum investment return.
Enter 5% of line 5
..................
6
557,698
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
557,698
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
7,275
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
7,275
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
550,423
4
Recoveries of amounts treated as qualifying distributions
................
4
5
Add lines 3 and 4
............................
5
550,423
6
Deduction from distributable amount (see instructions)
.................
6
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1
...
7
550,423
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
964,325
b
Program-related investments—total from Part IX-B
..................
1b
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
964,325
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
7,275
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
957,050
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
550,423
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
b
Total for prior years:
20
,
20
,
20
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
528,277
b
From 2015
......
325,817
c
From 2016
......
326,516
d
From 2017
......
370,715
e
From 2018
......
421,258
f
Total
of lines 3a through e
........
1,972,583
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
964,325
a
Applied to 2018, but not more than line 2a
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
c
Treated as distributions out of corpus (Election
required—see instructions)
........
d
Applied to 2019 distributable amount
.....
550,423
e
Remaining amount distributed out of corpus
413,902
5
Excess distributions carryover applied to 2019.
(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
2,386,485
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
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
......
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
e
Undistributed income for 2018. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
f
Undistributed income for 2019. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2020
..........
0
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)
.......
8
Excess distributions carryover from 2014 not
applied on line 5 or line 7 (see instructions)
...
528,277
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
1,858,208
10
Analysis of line 9:
a
Excess from 2015
....
325,817
b
Excess from 2016
....
326,516
c
Excess from 2017
....
370,715
d
Excess from 2018
....
421,258
e
Excess from 2019
....
413,902
Form
990-PF
(2019)
Form 990-PF (2019)
Page
10
Part XIV
Private Operating Foundations
(see instructions and Part VII-A, question 9)
1a
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2019, enter the date of the ruling
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2019
(b)
2018
(c)
2017
(d)
2016
b
85% of line 2a
.........
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed
...
c
“Support" alternative test—enter:
(1)
Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
....
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
(3)
Largest amount of support
from an exempt organization
(4)
Gross investment income
Part XV
Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
HOOVER FAMILY FOUNDATION
860 E 86TH STREET SUITE 5
INDIANAPOLIS
,
IN
462401806
(317) 815-9553
b
The form in which applications should be submitted and information and materials they should include:
APPLICATION AND INFORMATION ARE AVAILABLE ON THE HOOVER FAMILY FOUNDATION WEBSITE HTTP://WWW.HOOVERFF.ORG. A COPY OF THE GUIDELINES AND HOW TO APPLY INFORMATION ARE AVAILABLE ON THE WEBSITE.
c
Any submission deadlines:
PERIODIC APPLICATION DEADLINES ARE MARCH 1ST, JULY 1ST AND NOVEMBER 1ST.
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
SEE THE HOOVER FAMILY FOUNDATION WEBSITE FOR RESTRICTIONS AND LIMITATIONS ON AWARDS. HTTP://WWW.HOOVERFF.ORG
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
ARC OF INDIANA
143 W MARKET ST STE 200
INDIANAPOLIS
,
IN
46204
NONE
CHARITY
FACE MASKS FOR DISABLED CLIENTS
1,000
BEAVERTON EDUCATION FOUNDATION
3800 SW CEDAR HILLS BLVD
PORTLAND
,
OR
97005
NONE
CHARITY
EDUCATIONAL ENRICHMENT LOW INC CHILD
5,000
BEYOND ALL BARRIERS
55 S STATE AVE 3107
INDIANAPOLIS
,
IN
46206
NONE
CHARITY
HSE TEST FOR LOW INC YTH/ADULTS
1,000
BIRCH COMMUNITY SERVICES
17780 NE SAN RAFAEL ST
PORTLAND
,
OR
97230
NONE
CHARITY
SUSTAINABLE FAMILIES PROGRAM
6,000
BLACK PARENT INITIATIVE
2915 NE MLK JR BLVD
PORTLAND
,
OR
97212
NONE
CHARITY
EMPLOYMENT SERVICES PROGRAM
5,000
BOSMA VISIONARY OPPORTUNITIES FOUND
6720 CORPORATE DRIVE
INDIANAPOLIS
,
IN
46278
NONE
CHARITY
EMPLOYMENT SERVICES FOR BLIND/VIS IM
10,000
BRADLEY ANGLE
5432 ALBINA AVE
PORTLAND
,
OR
97217
NONE
CHARITY
PROG FOR SURVIVORS OF DOM VIOLENCE
5,000
BROOKSIDE COMMUNITY DEVELOPMENT COR
1035 N OLNEY
INDIANAPOLIS
,
IN
46201
NONE
CHARITY
FAMILY ENGAGEMENT COORDINATOR
10,000
CANBY CENTER
681 SW 2ND AVENUE
PORTLAND
,
OR
97013
NONE
CHARITY
READING MENTORS PROGRAM
7,000
CASA FOR CHILDREN OF MULTNOMAH WA
1401 NE 68TH AVENUE
PORTLAND
,
OR
97213
NONE
CHARITY
EDUCATIONAL ADVANCEMENT PROJECT
8,000
CASA OF CLACKAMAS COUNTY
421 HIGH STREET
OREGON CITY
,
OR
97045
NONE
CHARITY
EXPAND PROGRAMS FOR FOSTER CHILDREN
8,000
CASA OF OREGON
20508 SW ROY ROGERS RD
SHERWOOD
,
OR
97140
NONE
CHARITY
YOUTH FIN INDEPENDENCE TODAY PROG
5,500
CASCADE AIDS PROJECT
520 NW DAVIS ST 215
PORTLAND
,
OR
97209
NONE
CHARITY
MENTAL HLTH SERV FOR HIV & HOMELESS
7,500
CENTER FOR LEADERSHIP DEVELOPMENT
2425 DR MLK JR STREET
INDIANAPOLIS
,
IN
46208
NONE
CHARITY
COLLEGE PREP INST FOR AFR AMER YOUTH
8,000
CHILDREN'S CENTER
1713 PENN LANE
OREGON CITY
,
OR
97045
NONE
CHARITY
MEDICAL ASSESSMEENT PROGRAM
8,000
CHILDREN'S THERAPLAY FOUNDATION
9919 TOWNE ROAD
CARMEL
,
IN
46032
NONE
CHARITY
AUTISM SPECIALIST POSITION OT & PT
10,000
CICOA AGING & IN-HOME SOLUTIONS
8440 WOODFIELD CROSSING B
INDIANAPOLIS
,
IN
46240
NONE
CHARITY
HOME ACCESS & SAFETY MODS FOR SENIOR
10,000
CLACKAMAS WOMEN'S SERVICES
256 WARNER MILNE RD
OREGON CITY
,
OR
97045
NONE
CHARITY
LEGAL SERV FOR SURV OF ABUSE & VIOL
8,000
COBURN PLACE SAFE HAVEN II
604 E 38TH STREET
INDIANAPOLIS
,
IN
46205
NONE
CHARITY
SURVIVORS OF INTERPERSONAL VIOLENCE
10,000
COLLEGE POSSIBLE
532 SE GRAND AVENUE
PORTLAND
,
OR
97214
NONE
CHARITY
CURRICULUM FOR UNDERSERVED STUDENTS
5,000
COMMUNITY TRANSITIONAL SCHOOL
6601 NE KILLINGSWORTH ST
PORTLAND
,
OR
97218
NONE
CHARITY
TRANSPORT PROG FOR HOMELESS STUDENTS
5,000
COMPUTERS FOR REUSE
PO BOX 601
INDIANAPOLIS
,
IN
46206
NONE
CHARITY
UPGRADING COMPUTERS
1,000
CROSSROADS OF AMERICA COUNCIL BOY
7125 FALL CREEK RD NORTH
INDIANAPOLIS
,
IN
46256
NONE
CHARITY
LATINO INITIATIVES PROGRAM
10,000
DAVID'S HARP
11261 NE KNOTT STREET
PORTLAND
,
OR
97220
NONE
CHARITY
COMMUNITY INTEGRATION PROGRAM
5,000
DYSLEXIA INSTITUTE OF INDIANA
8395 WOODFIELD CROSSING
INDIANAPOLIS
,
IN
46240
NONE
CHARITY
TEACHER TRAINING STRATEGIES
12,375
EDUCATE BEYOND ALL BARRIERS
PO BOX 601
INDIANAPOLIS
,
IN
46206
NONE
CHARITY
ONLINE INSTRUCTION
1,000
EXODUS REFUGEE IMMIGRATION
2427 E WASHINGTON ST A
INDIANAPOLIS
,
IN
46201
NONE
CHARITY
REFUGEE MENTAL WELLNESS PROGRAM
10,000
FAIRBANKS HOSPITAL
7330 SHADELAND STAT 150
INDIANAPOLIS
,
IN
46256
NONE
CHARITY
SUPPORTIVE LIVING PROGRAM
10,000
FAMILY PROMISE OF BEAVERTON
PO BOX 1932
PORTLAND
,
OR
97075
NONE
CHARITY
SERV FOR FAMILY INTO STABLE HOUSING
6,000
FLETCHER PLACE COMMUNITY CENTER
PO BOX 825
INDIANAPOLIS
,
IN
46206
NONE
CHARITY
HIRE FAM ENGAGEMENT SPECIALIST
10,000
GIRLS INC OF GREATER INDIANAPOLIS
3935 N MERIDIAN ST
INDIANAPOLIS
,
IN
46208
NONE
CHARITY
YOUNG WOMEN IN LEADERSHIP PROGRAM
5,000
GLEANERS FOOD BANK OF INDIANA
3737 WALDEMERE AVE
INDIANAPOLIS
,
IN
46241
NONE
CHARITY
PERSONNEL COSTS FOR CARE PROGRAM
5,000
GLEANERS OF CLACKAMAS COUNTY
PO BOX 1660
OREGON CITY
,
OR
97045
NONE
CHARITY
FOOD DISTRIBUTION SERVICES
5,000
GLOBAL ILLUMINATION91 PLACE
6041 DEWEY AVE
INDIANAPOLIS
,
IN
46219
NONE
CHARITY
HOMELESS YOUTH IN TRANSITIONAL HOME
5,000
IMPACT NW
1785 NE SANDY BLVD 200
PORTLAND
,
OR
97232
NONE
CHARITY
HOMELESSNESS PREVENTION SERVICES
8,000
INDIANA CHAPTER AMER ACADEMY PEDIA
350 MASSACHUSETTS AVE 300
INDIANAPOLIS
,
IN
46204
NONE
CHARITY
REACH OUT & READ PROGRAM
11,000
INDIANA YOUTH GROUP
3733 N MERIDIAN STREET
INDIANAPOLIS
,
IN
46208
NONE
CHARITY
BASIC NEEDS PROGRAM FOR LGBTQ+ YOUTH
10,000
JOY'S HOUSE
2028 E BROAD RIPPLE AVE
INDIANAPOLIS
,
IN
46220
NONE
CHARITY
SENIOR GUEST RELATIONS ASSISTANT
10,000
KIDS' VOICE OF INDIANA
127 E MICHIGAN ST 500
INDIANAPOLIS
,
IN
46204
NONE
CHARITY
SAFE CHILD PARENTING TIME PROGRAM
3,000
LITERARY ARTS
925 SW WASHINGTON STREET
PORTLAND
,
OR
97205
NONE
CHARITY
WRITERS IN THE SCHOOLS RESIDENCIES
5,000
LIVING YOGA
5100 SW MACADAM AVE 360
PORTLAND
,
OR
97239
NONE
CHARITY
TRAUMA-INFORMED RECOVERY PROJECT
8,000
MY VOICE MUSIC
PO BOX 28043
PORTLAND
,
OR
97228
NONE
CHARITY
MUSIC INSTRUCTION/MENTORSHIP PROGRAM
7,500
NEW LIFE JR JESSEE RECOVERY HOUSE
5729 E BONNA AVENUE
INDIANAPOLIS
,
IN
46219
NONE
CHARITY
LIFE SKILLS TRAINING PROGRAM FOR MEN
7,680
NORTHWEST CATHOLIC COUNSELING CTR
8383 NE SANDY BLVD 205
PORTLAND
,
OR
97220
NONE
CHARITY
PROVIDE COUNSELING TO LOW INCOME
8,000
NORTHWEST HOUSING ALTERNATIVES
2316 SE WILLARD STREET
PORTLAND
,
OR
97222
NONE
CHARITY
SUPPORTING OREGON'S KIDS PROGRAM
8,000
OREGON BALLET THEATRE
0720 SW BANCROFT STREET
PORTLAND
,
OR
97239
NONE
CHARITY
L.A.B. ARTS RESIDENCY FOR LOW INC.
5,000
OREGON CHILDREN'S THEATRE
1939 NE SANDY BLVD
PORTLAND
,
OR
97232
NONE
CHARITY
LOUD & CLEAR SPEAKING SKILLS
7,600
OREGON FOOD BANK
7900 NE 33RD DRIVE
PORTLAND
,
OR
97211
NONE
CHARITY
SCHOOL PANTRIES PROGRAM
8,000
OREGON TRADESWOMEN
3934 NE MLK JR BLVD
PORTLAND
,
OR
97212
NONE
CHARITY
PROGRAM SERVING LOW INCOME WOMEN
8,000
OUTREACH INC
PO BOX 11416
INDIANAPOLIS
,
IN
46201
NONE
CHARITY
CASE MANAGER POSITION FOR ARCH PROG
10,000
OUTSIDE IN
1132 SW 13TH AVE
PORTLAND
,
OR
97205
NONE
CHARITY
EMPLOYMENT & ED RESOURCE CENTER
7,000
OUTWARD BOUND PORTLAND
1411 SW MORRISON ST 250
PORTLAND
,
OR
97205
NONE
CHARITY
PUB SCHOOL PROG YOUTH DEVELOPMENT
6,000
PACIFIC YOUTH CHOIR
620 SW MAIN ST STE 203
PORTLAND
,
OR
97205
NONE
CHARITY
NEIGHBORHOOD CHOIR PROGRAM
5,000
PARROTT CREEK CHILD & FAMILY SERV
1001 MOLALLA AVE 209
OREGON CITY
,
OR
97045
NONE
CHARITY
FAMILY ENGAGEMENT PROGRAM
8,000
PATHFINDERS OF OREGON
2501 SW FIRST AVE 300
PORTLAND
,
OR
97201
NONE
CHARITY
JUSTICE SYSTEM IMPACT CHILDS PROGRAM
6,500
PIANO SANTA
PO BOX 80214
PORTLAND
,
OR
97280
NONE
CHARITY
MUSIC ED OPPORTUNITIES FOR LOW INCOM
2,000
PORTLAND AFTERSCHOOL TENNIS & EDUC
7519 N BURLINGTON AVE
PORTLAND
,
OR
97203
NONE
CHARITY
BRIDGE PROGRAM
5,000
PORTLAND HOMELESS FAMILY SOLUTIONS
6220 SE 92ND AVENUE
PORTLAND
,
OR
97266
NONE
CHARITY
HIRE HOUSING SPECIALIST
8,000
PORTLAND STATE UNIVERSITY FOUNDATIO
1930 SW 4TH AVE STE 104
PORTLAND
,
OR
97201
NONE
CHARITY
AFTER SCHOOL STEM EDUCATION
8,000
PRO100TEENWORKS
2820 N MERIDIAN STREET
INDIANAPOLIS
,
IN
46208
NONE
CHARITY
TO SUPPORT PROGRAM MANAGER
10,000
PROGRESS HOUSE
201 SHELBY STREET
INDIANAPOLIS
,
IN
46202
NONE
CHARITY
CAREER/JOB TRAINING & PLACEMENT
10,000
PROJECT ACCESS NOW
PO BOX 10953
PORTLAND
,
OR
97296
NONE
CHARITY
TRANSITION PATIENTS TO HEALTH INSUR
7,000
RAPHAEL HOUSE OF PORTLAND
4110 SE HAWTHORNE BLVD
PORTLAND
,
OR
97214
NONE
CHARITY
SHELTER TO STABILITY PROGRAM
7,500
READING RESULTS
3115 NE SANDY BLVD 229
PORTLAND
,
OR
97232
NONE
CHARITY
READING PROGRAM FOR LOW INCOME
7,500
REBUILDING TOGETHER
12550 SW 3RD STREET
BEAVERTON
,
OR
97005
NONE
CHARITY
CRITICAL REPAIR PROGRAM LOW INCOME
5,000
SATURDAY ACADEMY
5000 N WILLAMETTE BLVD
PORTLAND
,
OR
97203
NONE
CHARITY
SA2U PROGRAM TO BRING STEM CLASSES
8,000
SCHOOL ON WHEELS
2605 E 62ND ST STE 2005
INDIANAPOLIS
,
IN
46220
NONE
CHARITY
SUPPORT EDUC SUPPORT COORDINATOR
10,000
SOAR INITIATIVE CORP
3901 ROCKWOOD AVE
INDIANAPOLIS
,
IN
46208
NONE
CHARITY
PURCHASE CRM DATABASE
5,000
ST ANDREW NATIVITY SCHOOL
4925 NE 9TH AVE
PORTLAND
,
OR
97211
NONE
CHARITY
EMERGENCY SERVICES PROGRAM
5,000
STARFISH INITIATIVE
6958 HILLSDALE COURT
INDIANAPOLIS
,
IN
46250
NONE
CHARITY
ALUMNI ENGAGEMENT INITIATIVE
10,000
STREET ROOTS
211 NW DAVID STREET
PORTLAND
,
OR
97209
NONE
CHARITY
LIFT UP EVERY VENDOR PROGRAM
5,500
THERAPYWORKS NW
7927 SE ORIENT DRIVE
PORTLAND
,
OR
97080
NONE
CHARITY
THERAPY FOR UNDERPRIVILEGED W DISABI
5,000
TUCKER MAXON SCHOOL
2860 SE HOLGATE BLVD
PORTLAND
,
OR
97202
NONE
CHARITY
TUTORING FOR DEAF STUDENTS
8,000
VISUALLY IMPAIRED PRESCHOOL SERVICE
1100 W 42ND ST STE 228
INDIANAPOLIS
,
IN
46208
NONE
CHARITY
EARLY CHILDHOOD INTERVENTION PROGRAM
9,975
WILLIAM TEMPLE HOUSE
2023 NW HOYT STREET
PORTLAND
,
OR
97209
NONE
CHARITY
HEALTHY MODEL FOOD PANTRY
7,500
YOUNG AUDIENCES OF INDIANA
546 E 17TH ST STE 200
INDIANAPOLIS
,
IN
46227
NONE
CHARITY
ARTS INTEGRATION RESIDENCIES
10,000
YOUTH PROGRESS ASSOCIATION
12141 NE HALSEY
PORTLAND
,
OR
97220
NONE
CHARITY
PROGRAMMING FOR YOUTH IN FOSTER CARE
7,500
YOUTH RIGHTS & JUSTICE
1785 NE SANDY BLVD 300
PORTLAND
,
OR
97232
NONE
CHARITY
LEGAL ASSISTANCE FOR FOSTER CARE
8,000
YOUTH VILLAGES OREGON
2507 CHRISTIE DRIVE
LAKE OSWEGO
,
OR
97034
NONE
CHARITY
TRANSITION SUPPORT FOSTER CARE YOUTH
7,500
Total
.................................
3a
562,630
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
...........
14
380
4
Dividends and interest from securities
....
14
299,774
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
............
454,263
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)
..
300,154
454,263
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
754,417
(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