-
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
THE RICBAC FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)
CO ERIC ISSELBACHER PO BOX 600071
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
NEWTONVILLE
,
MA
02460
A Employer identification number
04-2660137
B
Telephone number (see instructions)
(617) 726-5610
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)
$
55,804,169
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)
6,600
2
Check
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
1,337,393
1,337,393
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
1,669,993
b
Gross sales price for all assets on line 6a
1,988,448
7
Capital gain net income (from Part IV, line 2)
...
1,669,993
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)
.......
-66,762
7,744
12
Total.
Add lines 1 through 11
........
2,947,224
3,015,130
13
Compensation of officers, directors, trustees, etc.
90,000
22,500
67,500
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
54,357
27,179
27,178
b
Accounting fees (attach schedule)
.......
28,650
21,488
7,162
c
Other professional fees (attach schedule)
....
20,000
10,000
10,000
17
Interest
...............
1,669
1,669
0
18
Taxes (attach schedule) (see instructions)
...
77,345
10,655
1,490
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
223,377
217,212
6,165
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
495,398
310,703
119,495
25
Contributions, gifts, grants paid
.......
2,352,130
6,357,686
26
Total expenses and disbursements.
Add lines 24 and 25
2,847,528
310,703
6,477,181
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
99,696
b
Net investment income
(if negative, enter -0-)
2,704,427
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
.............
170,535
115,191
115,191
2
Savings and temporary cash investments
.........
1,780,331
1,666,802
1,666,802
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)
.......
49,176,451
45,671,841
51,584,154
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)
..........
2,131,378
1,932,164
2,263,118
14
Land, buildings, and equipment: basis
94,481
Less: accumulated depreciation (attach schedule)
3,551
90,930
90,930
90,930
15
Other assets (describe
)
63,842
83,974
83,974
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
53,413,467
49,560,902
55,804,169
17
Accounts payable and accrued expenses
..........
55,347
108,642
18
Grants payable
.................
6,809,004
2,803,448
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)
.........
6,864,351
2,912,090
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
........
46,549,116
46,648,812
27
Paid-in or capital surplus, or land, bldg., and equipment fund
0
0
28
Retained earnings, accumulated income, endowment, or other funds
0
0
29
Total net assets or fund balances
(see instructions)
.....
46,549,116
46,648,812
30
Total liabilities and net assets/fund balances
(see instructions)
.
53,413,467
49,560,902
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
46,549,116
2
Enter amount from Part I, line 27a
.....................
2
99,696
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
46,648,812
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
46,648,812
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
3M CO
b
ABB LTD SPON ADR
c
ABB LTD SPON ADR
d
ABBOTT LABS
e
ABBVIE INC COM
ACCENTURE PLC IRELAND
ACE INA HOLDINGS INC B/E
ACUSHNET HLDGS CORP
ADOBE INC. (DELAWARE)
AGREE REALTY CORP
AIA GROUP LTD SPON ADR
AIR PROD & CHEMICAL INC
AKBANK T.A.S. NEW ADR
ALASKA AIR GROUP INC
ALBANY INTL CORP NEW
ALBEMARLE CORP
ALBEMARLE CORP
ALCON INC CHF
ALIBABA GROUP HLDG LTD
ALIBABA GROUP HLDG LTD
ALLETE INC NEW
ALLIANT ENERGY CORP
ALLIANZ SE EXCHANGE :
ALLSTATE CORP
ALPHABET INC CL A
ALPHABET INC CL C
AMADEUS IT GROUP
AMAZON.COM INC
AMAZON.COM INC
AMBEV SA SPON ADR
AMCOR LTD NEW AU
AMCOR PLC
AMER EXPRESS CO
AMERICAN INTL GROUP INC
AMERICAN INTL GROUP INC
AMERICAN TOWER CORP REIT
AMERIPRISE FINANCIAL INC
AMGEN INC
AMN HEALTHCARE SERVICES
ANGLO AMERN PLC SPON ADR
ANHUI CONCH CEM CO LTD
ANSYS INC
ARCHER DANIELS MIDLAND
ASPEN TECHNOLOGY INC DEL
ASSOCIATED BRITISH FOODS
ASSURED GUARANTY LTD
AT&T INC
AT&T INC NTS B/E
AUTODESK INC
AUTOLIV INC
AUTOMATIC DATA PROCESSNG
AVERY DENNISON CORP
AXA ADR
B&G FOODS INC CL A
BAIDU INC ADS REPSNTG CL
BAIDU INC ADS REPSNTG CL
BALTIMORE GAS & ELEC CO
BANCO BRADESCO S.A. NEW
BANCO LATINOAMERICANO DE
BANCO LATINOAMERICANO DE
BANCO MACRO S.A SPON ADS
BANK OF AMER CORP
BANK OF CHINA ADR
BANK OF GA GROUP PLC GBP
BANK OZK
BARCLAYS PLC ADR
BB SEGURIDADE
BB&T CORP **NAME CHANGE
BERKLEY W R CORP
BERKSHIRE HATHAWAY INC
BGC PARTNERS INC CL A
BLACKROCK INC
BLACKROCK INC
BNP PARIBAS SA ADR
BNP PARIBAS SA ADR
BOK FINANCIAL CORP NEW
BP CAPITAL MARKETS PLC
BRAMBLES LTD SPON ADR
BRENNTAG AG UNSPON ADR
BROADCOM INC
BROADCOM INC
BROADRIDGE FINANCIAL
CARDINAL HEALTH INC
CARLSBERG AS SPON ADR
CATHAY GENL BANCORP
CDN NATL RAILWAY CO CAD
CDW CORP
CEMEX S.A.B. DE C.V.
CERNER CORP
CGI INC CAD
CHARLES RIVER
CHEVRON CORP
CHEVRON CORP B/E
CHINA CONSTR BK CORP ADR
CHINA MOBILE LTD SPON
CHINA PETROLEUM &
CIGNA CORP
CISCO SYSTEMS INC
CITIGROUP INC B/E
CK HUTCHISON HLDGS LTD
COCA COLA CO COM
COCA COLA CO COM
COGNIZANT TECH SOLUTIONS
COLGATE PALMOLIVE CO
COLGATE PALMOLIVE CO
COMCAST CORP NEW CL A
COMPANHIA BRASILEIRA DE
COMPANHIA DE SANEAMENTO
COMPASS GROUP PLC SPON
CONMED CORP
CONOCOPHILLIPS
CONSOLIDATED
CONSOLIDATED
COOPER COMPANIES INC NEW
COPART INC
CORTEVA INC
CORTEVA INC
COSTCO WHOLESALE CORP
CRANE CO
CREDICORP LTD
CREDIT SUISSE GROUP SPON
CRITEO S A SPON ADR
CRITEO S A SPON ADR
CROWN CASTLE INTL CORP
CSL LTD SPON ADR
CTRIP.COM INTL LTD ADS
CULLEN FROST BANKERS INC
CVS HEALTH CORP
CYRUSONE INC REIT
DANAHER CORP
DANONE SPON ADR
DEERE AND CO
DELEK US HLDGS INC NEW
DEUTSCHE BOERSE ADR
DEUTSCHE POST AG SPON
DEUTSCHE WOHNEN AG
DEUTSCHE WOHNEN AG
DIAGEO PLC NEW GB SPON
DNB ASA SPON ADR
DOCUSIGN INC
DOLLAR TREE INC
DONALDSON CO INC
DOW INC
DOW INC
EAST WEST BANCORP INC
EASTGROUP PROPERTIES INC
EBARA CORP ADR
ECOLAB INC
EDISON INTL
ELANCO ANIMAL HEALTH INC
ENEL AMERICAS SA SPON
ENERGIZER HLDGS INC
ENLINK MIDSTREAM LLC
ENLINK MIDSTREAM LLC
ENTERCOM COMMUNICATIONS
ENTERPRISE PRODUCTS OPER
EPR PROPERTIES REIT
EQUITY RESIDENTIAL SBI
ESSILORLUXOTTICA ADR
EVERGY INC
EVERSOURCE ENERGY COM
EXPEDITORS INTL WASH INC
EXXON MOBIL CORP
FACEBOOK INC CL A
FACTSET RESH SYSTEMS INC
FANUC CORP ADR
FANUC CORP ADR
FERGUSON PLC **EXCHANGE:
FERGUSON PLC SPON ADR
FHLMC PL G08669 04.0000
FHLMC PL G08669 04.0000
FHLMC PL G60440 03.5000
FHLMC PL G60440 03.5000
FIDELITY NATIONAL
FLIR SYSTEMS INC
FLIR SYSTEMS INC
FNMA - CALL BOND
FNMA PL BM1285 04.5000
FNMA PL MA3210 03.5000
FNMA PL MA3210 03.5000
FNMA PL MA3385 04.5000
FNMA PL MA3597 03.5000
FOMENTO ECONOMICO
FORTIS INC CANADA ORD
FOUR CORNERS PPTY TRUST
GALLAGHER ARTHUR J & CO
GALLAGHER ARTHUR J & CO
GALP ENERGIA SGPS SA ADR
GARMIN LTD SHS CHF
GARMIN LTD SHS CHF
GEA GROUP AG SPON ADR
GEELY AUTOMOBILE HLDGS
GENL ELEC CAP CORP NTS
GERDAU S A SPON ADR
GLAXO SMITHKLINE PLC ADR
GOLDMAN SACHS GROUP INC
GRAN TIERRA ENERGY INC
GRUPO AEROPORTURAIO DEL
GRUPO FINANCIERO BANORTE
H B FULLER CO
HALLIBURTON CO
HASBRO INC
HAWAIIAN HOLDINGS INC
HCA INC NTS B/E
HDFC BANK LTD ADR
HELLA KGAA HUECK & CO
HENRY JACK & ASSOC INC
HNI CORP
HOME DEPOT INC
HONEYWELL INTL INC
HOPE BANCORP INC COM
HOYA CORP SPON ADR
HOYA CORP SPON ADR
HP INC
HUBBELL INC
HUNTSMAN CORP
IAA INC
ICICI BANK LTD SPON ADR
IDEX CORP
ILLINOIS TOOL WORKS INC
INFINEON TECHNOLOGIES
INFORMA PLC SPON ADR
INFORMA PLC SPON ADR
INFOSYS LTD SPON ADR
ING GROEP N V NL SPON
INGREDION INC COM
INTEL CORP
INTERACTIVE BROKERS
INTERCONTINENTALEXCHANGE
INTESA SANPAOLO SPON ADR
INVINCIBLE INVT CORP
ISHARES 3-7 YEAR TREAS
ISHARES 7-10 YEAR TREAS
ISHARES CORE S&P TOTAL
ISHARES EDGE MSCI MIN
ISHARES MSCI EAFE ETF
ISHARES MSCI EAFE GROWTH
ISHARES MSCI EAFE GROWTH
ISHARES MSCI EAFE VALUE
ISHARES MSCI EAFE VALUE
ISHARES MSCI JAPAN ETF
ITAU UNIBANCO HLDG SA
J P MORGAN CHASE & CO
J2 GLOBAL INC COM
JAMES RIV GROUP HLDGS
JAPAN AIRLINES CO
JOHNSON & JOHNSON COM
JPMORGAN CHASE & CO
JPMORGAN CHASE & CO B/E
JULIUS BAER GROUP LTD
KAO CORP UNSPONSORED ADR
KAO CORP UNSPONSORED ADR
KAR AUCTION SVCS INC
KASIKORNBANK PC
KASIKORNBANK PC
KB FINL GROUP INC SPON
KOC HOLDINGS ADR
KROTON EDUCACIONAL
KULICKE & SOFFA IND
LAS VEGAS SANDS CORP
LAUDER ESTEE COS CL A
LCI INDUSTRIES
LEG IMMOBILIEN AG EUR
LEIDOS HLDGS INC
LENNOX INTL INC
LILLY ELI & CO
LINCOLN ELEC HOLDINGS
LITTELFUSE INC
LOCKHEED MARTIN CORP
LOREAL CO ADR FRANCE ADR
LOWES COMPANIES INC
LUKOIL PJSC SPON ADR
LYONDELLBASELL
M&G PRUDENTIAL PLC GBP
M&G PRUDENTIAL PLC GBP
MACROMILL INC JPY
MAN WAH HOLDINGS LTD HKD
MARATHON OIL CORP
MARSH & MCLENNAN COS INC
MAXIM INTEGRATED PRODS
MC CORMICK & CO NV
MCDONALDS CORP
MEDICAL PROPERTIES TRUST
MEDIOBANCA SPA ADR
MEDTRONIC INC B/E
MEDTRONIC PLC
MERCK & CO INC NEW COM
MICROSOFT CORP
MICROSOFT CORP
MICROSOFT CORP B/E
MITSUBISHI UFJ FINANCIAL
MITSUBISHI UFJ FINANCIAL
MKS INSTRUMENTS INC
MOBILE TELESYSTEMS PJSC
MOMO INC UNSPONSORED ADR
MONDELEZ INTL INC
MONDELEZ INTL INC
MONSTER BEVERAGE CORP
MSA SAFETY INC COM
MSCI INC
MULTICHOICE GROUP LTD
NASPERS LTD SPON ADR
NATIONAL RETAIL
NATL HEALTH INVESTORS
NEDBANK GROUP LTD SPON
NEW ORIENTAL EDUCATION &
NEWMARK GROUP INC CL A
NEXTERA ENERGY INC COM
NORDSON CORP
NOVARTIS AG SPON ADR
NOVO NORDISK ADR DENMARK
NUTRIEN LTD CAD
NUTRIEN LTD CAD
NVENT ELEC PLC
NVIDIA CORP
O REILLY AUTOMOTIVE INC
OMEGA HEALTHCARE INVS
ONEOK INC NEW
OPEN TEXT CORP CAD
ORACLE CORP
ORACLE CORP NTS B/E
P.T. TELEKOMUNIKASI
PACIFIC GAS & ELEC CO
PACKAGING CORP OF
PACWEST BANCORP
PADDY PWR PLC
PAN PAC INTL HLDGS CORP
PARKER HANNIFIN CORP
PAYCHEX INC
PEPSICO INC
PERNOD RICARD SA ADR
PETROLEO BRASILEIRO SA
PFIZER INC
PHILLIPS 66
PING AN INSURANCE
PNM RESOURCES INC
POOL CORP
PORTLAND GENL ELEC CO
POSCO SPON ADR
PRIMERICA INC
PROCTER & GAMBLE CO
PRUDENTIAL PLC ADR
PT BK MANDIRI PERSERO
PT BK RAKYAT ADR
QUALCOMM INC
QUEST DIAGNOSTICS INC
QUEST DIAGNOSTICS INC
RAYTHEON CO NEW**MERGER
RBC BEARINGS INC
REALTY INCOME CORP MD
RECKITT BENCKISER PLC
RECRUIT HLDGS CO LTD JPY
RED HAT INC **CASH
RED HAT INC **CASH
REGENERON PHARMACEUTICLS
RELX PLC SPON ADR
RESIDEO TECHNOLOGIES INC
RESIDEO TECHNOLOGIES INC
ROCHE HLDG LTD SPONS ADR
ROCHE HLDG LTD SPONS ADR
ROCKWELL AUTOMATION INC
ROYAL BANK SCOTLAND
ROYAL DUTCH SHELL PLC
RPM INTL INC (DELA)
RPT RLTY REIT
RPT RLTY REIT
SAP SE SPON ADR
SBERBANK SPON ADR
SCHLUMBERGER LTD
SCHLUMBERGER LTD
SCHNEIDER ELEC SE
SCHWAB US LARGE-CAP
SCOTTS MIRACLE-GRO CO
SEI INVESTMENTS CO
SEMPRA ENERGY
SEVEN & I HLDGS CO LTD
SHELL INTL FIN NTS B/E
SHINHAN FINANCIAL HLDG
SIGNATURE BANK NEW YORK
SIMON PPTY GROUP INC SBI
SINA CORP
SITEONE LANDSCAPE SUPPLY
SNAP ON INC
SOFTBANK GROUP CORP ADR
SONY CORP ADR NEW JAPAN
SOUTHERN COPPER CORP
SPDR DOW JONES REIT ETF
SPDR MSCI ACWI EX-US ETF
SPDR PORTFOLIO INTER
SPDR S&P 400 MID CAP
SPDR S&P400 M/C GROWTH
ST JAMES'S PLACE PLC 15P
STARBUCKS CORP
STARBUCKS CORP
STERIS PLC
STERIS PLC **EXCHANGE:
SUNCOR ENERGY INC NEW
SUNNY OPTICAL TECH
SUNTORY BEVERAGE & FOOD
SUZUKI MOTOR CORP LTD
TAIWAN SEMICONDUCTOR MFG
TAIWAN SEMICONDUCTOR MFG
TANGER FACTORY OUTLET
TARGA RESOURCES
TATA MOTORS LTD SPON ADR
TECHNIPFMC PLC
TECHNOPRO HLDGS INC
TECHTRONIC INDS SPON ADR
TELEFLEX INC
TELEFONICA BRASIL SA
TENCENT HLDGS LTD ADR
TERADYNE INC
TEXAS INSTRUMENTS
THALES SPONS ORD EUR
THERMO FISHER SCIENTIFIC
THOR INDUSTRIES INC
TJX COS INC NEW
TOPCON CORP JPY
TOTAL S.A. FRANCE SPON
TRAVELPORT WORLDWIDE LTD
TRAVELPORT WORLDWIDE LTD
TURKCELL ILETISIM
UBS GROUP AG CHF
UNILEVER NV N Y SHS NEW
UNILEVER NV N Y SHS NEW
UNITED PARCEL SERVICE
UNITED STATES TREAS BOND
UNITEDHEALTH GROUP INC
UNTD OVERSEAS BK LTD
UNTD TECHNOLOGIES CORP
UNTD TECHNOLOGIES CORP
US BANCORP DEL (NEW)
US BANCORP DEL (NEW)
US TSY NOTE 02.125 %
US TSY NOTE 02.625 %
US TSY NOTE 02.750 %
US TSY NOTE 02.750 %
VALE SA-SP SPON ADR
VALEO SPON ADR
VALERO ENERGY CORP NEW
VANGUARD RUSSELL 2000
VANGUARD SHORT-TERM
VARIAN MEDICAL SYSTEMS
VEDANTA LTD SPON ADR
VERIZON COMMUNICATIONS
VERMILION ENERGY INC CAD
VINCI S.A ADR
VISA INC CL A
VISA INC NTS B/E
VIVENDI SA ADR
VODAFONE GROUP PLC SPON
VOLKSWAGEN AG PREFERRED
WABCO HOLDINGS INC
WABCO HOLDINGS INC
WALT DISNEY CO (HOLDING
WASH TRUST BANCORP INC
WASTE MGMT INC NEW
WEC ENERGY GROUP INC COM
WELLS FARGO & CO B/E
WELLS FARGO & CO NEW
WESTERN ASSET SMASH
WH GROUP LTD SPON ADR
WH GROUP LTD SPON ADR
WILLIAMS COS INC (DEL)
WINMARK CORP
WNS HOLDINGS LTD SPON
WOLTERS KLUWER NV
YOKOGAWA ELEC ADR
P
YOKOGAWA ELEC ADR
P
YUM CHINA HLDGS INC
P
YUM CHINA HLDGS INC
P
YUM! BRANDS INC
P
YY INC UNSPONSORED
P
ZTO EXPRESS CAYMAN INC
P
ZURICH INS GROUP LTD
P
KNIGHTHEAD
P
FIR TREE
P
CENTERBRIDGE
P
TAILWATER ENERGY FUND II LP
P
ATALAYA SPECIAL OPP FUND VI LP
P
TAILWATER ENERGY FUND II LP
P
FIR TREE INTL VALUE FUND
P
ATALAYA SPECIAL OPP FUND VI LP
P
THOMPSON STREET CAPITAL PARTNERS
P
AMERICAN SECURITY PARTNERS
P
TAILWATER ENERGY FUND II LP
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
849
849
b
1,785
-1,785
c
910
-910
d
16,888
16,888
e
2,824
2,824
10,339
10,339
1,858
-1,858
45
45
13,013
13,013
201
201
1,408
1,408
4,308
4,308
5,086
-5,086
166
-166
132
132
1,207
-1,207
3,590
-3,590
766
766
28,375
28,375
9
-9
957
957
855
855
1,279
1,279
1,711
1,711
17,804
17,804
11,540
11,540
1,314
1,314
37,098
37,098
1,184
1,184
40
-40
121
-121
384
-384
12,851
12,851
726
-726
1,558
-1,558
11,123
11,123
10,728
10,728
5,124
5,124
536
-536
116
-116
125
125
2,628
2,628
140
-140
7,715
7,715
1,403
-1,403
250
250
2,336
-2,336
987
987
27,260
27,260
12
12
6,679
6,679
1,061
1,061
1,368
-1,368
12,829
-12,829
5,645
-5,645
7,842
-7,842
2,123
-2,123
1,894
1,894
400
-400
78
78
717
717
69
-69
559
-559
39
-39
433
-433
212
-212
56
-56
3,707
3,707
2,519
2,519
1,501
-1,501
4
4
5,164
5,164
823
823
3,576
-3,576
1,698
-1,698
260
260
253
-253
1,178
1,178
121
121
7,659
7,659
1,891
1,891
63
63
7,882
-7,882
1,553
1,553
0
791
791
4,642
4,642
1,609
-1,609
2,063
2,063
1,546
1,546
497
497
274
274
1,091
-1,091
32
32
16
-16
46
-46
1,568
-1,568
26,524
26,524
75
-75
3,044
-3,044
98
-98
3,891
3,891
22
22
7,457
-7,457
906
-906
1,247
1,247
55
55
758
758
1,709
1,709
9
9
5,394
5,394
5,043
-5,043
1,630
-1,630
9,146
9,146
4,519
4,519
326
-326
1,184
-1,184
2,644
2,644
157
157
948
948
165
-165
0
0
3,029
3,029
783
783
236
236
187
187
8,875
-8,875
420
-420
9,312
9,312
1,533
1,533
12,010
12,010
37
-37
263
263
3,541
-3,541
1,003
-1,003
586
-586
2,089
2,089
400
400
1,168
1,168
5,291
5,291
120
120
669
669
584
-584
126
126
192
192
1,226
-1,226
18,080
18,080
1,183
-1,183
51
-51
49
-49
67
-67
14,281
-14,281
298
-298
5,717
-5,717
379
379
3
3
3,430
3,430
20
20
5,704
5,704
2
2
11,976
11,976
367
-367
24,102
24,102
7,379
7,379
1,896
-1,896
3
-3
96
96
1,652
1,652
3,604
-3,604
67
-67
4,706
-4,706
683
683
320
320
166
166
151
-151
151
-151
1,232
-1,232
2,774
2,774
210
210
210
210
80
80
1,015
1,015
1,452
1,452
49
49
2,238
2,238
138
138
590
-590
3,928
3,928
783
783
5,681
-5,681
12
12
3,397
-3,397
45
-45
339
339
50
-50
2,535
-2,535
15
15
256
256
488
-488
3,164
-3,164
843
843
68
-68
2,063
2,063
67
67
1,141
1,141
2,978
2,978
1,638
-1,638
13,059
13,059
8,691
8,691
1,809
-1,809
415
415
1,662
1,662
3,787
-3,787
39
-39
140
140
4,340
4,340
739
739
4,192
4,192
1,014
1,014
888
-888
430
430
111
-111
161
161
1,655
-1,655
131
-131
1,544
1,544
81
81
5,962
5,962
2,819
-2,819
3,440
3,440
2,894
-2,894
4,689
-4,689
42,015
42,015
59,947
59,947
1,491
-1,491
242,006
242,006
1,186
1,186
65,903
65,903
1,126
-1,126
132
-132
49
-49
1,046
-1,046
1,028
1,028
48
48
449
449
4,661
4,661
5,041
5,041
204
204
1,172
-1,172
4,147
4,147
34
34
1,292
1,292
669
-669
648
-648
98
-98
172
172
54
54
159
-159
560
560
1,382
1,382
277
-277
353
353
2,217
2,217
2,580
2,580
344
344
119
119
379
379
3,600
3,600
1,665
1,665
8,947
8,947
407
407
1,381
-1,381
275
-275
90
-90
11,644
-11,644
3,782
-3,782
878
878
5,636
5,636
666
666
2,718
2,718
1,521
1,521
657
657
315
-315
639
639
949
949
7,705
7,705
43,829
43,829
5,050
5,050
13
-13
5,173
-5,173
1,391
-1,391
348
-348
34
34
217
217
294
294
4,454
4,454
5,480
5,480
370
370
3,239
3,239
154
154
3,726
-3,726
88
88
79
79
88
-88
4,150
4,150
124
124
9,475
9,475
3,140
3,140
3,828
3,828
4,054
4,054
293
-293
217
-217
111
-111
7,707
7,707
1,772
1,772
5,129
5,129
74
74
1,603
1,603
12,518
12,518
1,652
1,652
9
-9
2,841
-2,841
106
106
176
-176
617
-617
5,849
5,849
1,047
-1,047
5,188
5,188
1,540
1,540
1,182
1,182
108
108
4,502
4,502
530
-530
1,649
1,649
92
92
2,961
2,961
12
12
10
-10
3,419
3,419
9,272
9,272
1,161
-1,161
959
959
633
633
10,188
10,188
7,864
7,864
2,967
2,967
3,670
3,670
3,769
3,769
528
528
1,141
-1,141
1,386
1,386
37,658
37,658
11,067
11,067
3,545
-3,545
857
857
118
118
41
-41
466
466
282
282
1,581
1,581
167
167
578
-578
27
27
106
106
82
82
1,772
1,772
295
295
27,697
-27,697
3,776
-3,776
1,398
1,398
231,551
231,551
1,039
-1,039
5,343
5,343
623
623
216
-216
22
-22
57
57
2,228
-2,228
566
566
1,826
-1,826
1,166
-1,166
1,819
1,819
298
298
3,679
3,679
18
-18
13,978
13,978
173
173
7,124
-7,124
13,013
13,013
21,974
21,974
0
2,197
2,197
14,236
14,236
4,708
4,708
826
826
411
411
111
111
130
130
310
-310
2,096
2,096
351
351
2,123
-2,123
793
793
48
-48
1,175
-1,175
12,386
12,386
299
299
1,816
1,816
276
276
96
-96
10,690
10,690
8,591
8,591
150
-150
9,934
9,934
1,699
-1,699
1,845
1,845
160
-160
233
-233
1,990
1,990
440
440
0
2,668
-2,668
3,192
3,192
46
46
1,682
-1,682
758
-758
673
673
1,697
1,697
8,617
8,617
652
652
42
42
98
-98
249
-249
676
676
1,068
1,068
191
191
739
-739
186
186
557
557
127,001
127,001
6,931
-6,931
8,621
8,621
134
-134
950
950
212
-212
284
-284
51,630
51,630
3,821
3,821
288
288
6,862
-6,862
417
-417
9,533
9,533
3,010
3,010
9,782
9,782
144
144
6,832
6,832
4,695
4,695
71
-71
0
2,930
-2,930
497
-497
2,085
2,085
370
-370
1,561
1,561
58
58
8,327
8,327
329
-329
1,395
-1,395
5,255
5,255
650
650
6,653
6,653
76
76
82
82
66
66
31,289
31,289
11,368
11,368
1,716
-1,716
10,362
10,362
236
236
71,972
71,972
8,561
-8,561
1,566
-1,566
2,183
-2,183
1,042
1,042
126
126
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
849
b
-1,785
c
-910
d
16,888
e
2,824
10,339
-1,858
45
13,013
201
1,408
4,308
-5,086
-166
132
-1,207
-3,590
766
28,375
-9
957
855
1,279
1,711
17,804
11,540
1,314
37,098
1,184
-40
-121
-384
12,851
-726
-1,558
11,123
10,728
5,124
-536
-116
125
2,628
-140
7,715
-1,403
250
-2,336
987
27,260
12
6,679
1,061
-1,368
-12,829
-5,645
-7,842
-2,123
1,894
-400
78
717
-69
-559
-39
-433
-212
-56
3,707
2,519
-1,501
4
5,164
823
-3,576
-1,698
260
-253
1,178
121
7,659
1,891
63
-7,882
1,553
0
791
4,642
-1,609
2,063
1,546
497
274
-1,091
32
-16
-46
-1,568
26,524
-75
-3,044
-98
3,891
22
-7,457
-906
1,247
55
758
1,709
9
5,394
-5,043
-1,630
9,146
4,519
-326
-1,184
2,644
157
948
-165
0
0
3,029
783
236
187
-8,875
-420
9,312
1,533
12,010
-37
263
-3,541
-1,003
-586
2,089
400
1,168
5,291
120
669
-584
126
192
-1,226
18,080
-1,183
-51
-49
-67
-14,281
-298
-5,717
379
3
3,430
20
5,704
2
11,976
-367
24,102
7,379
-1,896
-3
96
1,652
-3,604
-67
-4,706
683
320
166
-151
-151
-1,232
2,774
210
210
80
1,015
1,452
49
2,238
138
-590
3,928
783
-5,681
12
-3,397
-45
339
-50
-2,535
15
256
-488
-3,164
843
-68
2,063
67
1,141
2,978
-1,638
13,059
8,691
-1,809
415
1,662
-3,787
-39
140
4,340
739
4,192
1,014
-888
430
-111
161
-1,655
-131
1,544
81
5,962
-2,819
3,440
-2,894
-4,689
42,015
59,947
-1,491
242,006
1,186
65,903
-1,126
-132
-49
-1,046
1,028
48
449
4,661
5,041
204
-1,172
4,147
34
1,292
-669
-648
-98
172
54
-159
560
1,382
-277
353
2,217
2,580
344
119
379
3,600
1,665
8,947
407
-1,381
-275
-90
-11,644
-3,782
878
5,636
666
2,718
1,521
657
-315
639
949
7,705
43,829
5,050
-13
-5,173
-1,391
-348
34
217
294
4,454
5,480
370
3,239
154
-3,726
88
79
-88
4,150
124
9,475
3,140
3,828
4,054
-293
-217
-111
7,707
1,772
5,129
74
1,603
12,518
1,652
-9
-2,841
106
-176
-617
5,849
-1,047
5,188
1,540
1,182
108
4,502
-530
1,649
92
2,961
12
-10
3,419
9,272
-1,161
959
633
10,188
7,864
2,967
3,670
3,769
528
-1,141
1,386
37,658
11,067
-3,545
857
118
-41
466
282
1,581
167
-578
27
106
82
1,772
295
-27,697
-3,776
1,398
231,551
-1,039
5,343
623
-216
-22
57
-2,228
566
-1,826
-1,166
1,819
298
3,679
-18
13,978
173
-7,124
13,013
21,974
0
2,197
14,236
4,708
826
411
111
130
-310
2,096
351
-2,123
793
-48
-1,175
12,386
299
1,816
276
-96
10,690
8,591
-150
9,934
-1,699
1,845
-160
-233
1,990
440
0
-2,668
3,192
46
-1,682
-758
673
1,697
8,617
652
42
-98
-249
676
1,068
191
-739
186
557
127,001
-6,931
8,621
-134
950
-212
-284
51,630
3,821
288
-6,862
-417
9,533
3,010
9,782
144
6,832
4,695
-71
0
-2,930
-497
2,085
-370
1,561
58
8,327
-329
-1,395
5,255
650
6,653
76
82
66
31,289
11,368
-1,716
10,362
236
71,972
-8,561
-1,566
-2,183
1,042
126
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
1,669,993
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
2,239,053
57,052,489
0.039245
2017
4,532,618
55,948,223
0.081015
2016
2,994,381
55,301,648
0.054146
2015
2,295,822
59,711,544
0.038449
2014
3,242,822
64,697,310
0.050123
2
Total
of line 1, column (d)
.....................
2
0.262978
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
0.052596
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
53,229,415
5
Multiply line 4 by line 3
......................
5
2,799,654
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
27,044
7
Add lines 5 and 6
........................
7
2,826,698
8
Enter qualifying distributions from Part XII, line 4
,.............
8
6,477,181
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
27,044
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
27,044
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
27,044
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
0
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
50,000
d
Backup withholding erroneously withheld
...........
6d
0
7
Total credits and payments. Add lines 6a through 6d
..............
7
50,000
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
1,024
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
21,932
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
21,932
Refunded
11
0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition)
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
0
(2)
On foundation managers.
$
0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
Yes
7
Did the foundation have at least $5,000 in assets at any time during the year?
If "Yes," complete Part II, col. (c),
and Part XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
MA
b
If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G?
If "No," attach explanation
.
8b
Yes
9
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
or 4942(j)(5) for calendar year 2019 or the taxable year beginning in 2019? See the instructions for Part XIV.
If "Yes," complete Part XIV
.............................
9
No
10
Did any persons become substantial contributors during the tax year?
If "Yes," attach a schedule listing their names
and addresses.
...............................
10
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
5
Part VII-A
Statements Regarding Activities
(continued)
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions
.............
11
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement. See instructions
.................
12
Yes
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
NONE
14
The books are in care of
ERIC ISSELBACHER
Telephone no.
(617) 726-5610
Located at
MGH
CHARLESTOWN
MA
ZIP+4
02129
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1)
Engage in the sale or exchange, or leasing of property with a disqualified person?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(5)
Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)?
...............
Yes
No
(6)
Agree to pay money or property to a government official? (
Exception.
Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.)
.......
Yes
No
b
If any answer is "Yes" to 1a(1)–(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions
........
1b
No
Organizations relying on a current notice regarding disaster assistance check here
........
c
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2019?
.............
1c
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2019, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2019?
.............
Yes
No
If "Yes," list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer "No" and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
......................
Yes
No
b
If "Yes," did it have excess business holdings in 2019 as a result of
(1)
any purchase by the foundation
or disqualified persons after May 26, 1969;
(2)
the lapse of the 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or
(3)
the lapse of the 10-, 15-, or 20-year first phase holding period?
(Use Schedule C, Form 4720, to determine
if the foundation had excess business holdings in 2019.)
..................
3b
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2019?
4b
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
6
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
(continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
No
b
If any answer is "Yes" to 5a(1)–(5), did
any
of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions
......
5b
Organizations relying on a current notice regarding disaster assistance check here
.........
c
If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant?
..........
Yes
No
If "Yes," attach the statement required by Regulations section 53.4945–5(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract?
.....................
Yes
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
....
6b
No
If "Yes" to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
Yes
No
b
If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction?
....
7b
8
Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment during the year?
.................
Yes
No
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1
List all officers, directors, trustees, foundation managers and their compensation. See instructions
(a)
Name and address
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(If not paid, enter
-0-)
(d)
Contributions to employee benefit plans and deferred compensation
(e)
Expense account,
other allowances
KURT J ISSELBACHER MD
TRUSTEE, TREASURER
7.00
20,000
0
0
MGH BLG 149 13TH ST
CHARLESTOWN
,
MA
02129
RAY A GOLDBERG MBA PHD
TRUSTEE
1.00
0
0
0
975 MEMORIAL DRIVE APT 701
CAMBRIDGE
,
MA
02138
WALTER SALMON
TRUSTEE
1.00
0
0
0
64 WINTER ST
LINCOLN
,
MA
01773
ERIC ISSELBACHER MD
TRUSTEE, CHAIRMAN
7.00
40,000
0
0
19 HOWARD ST
NEWTON
,
MA
02458
LEILA E DAL POS
SECRETARY
1.00
0
0
0
ONE FEDERAL ST
BOSTON
,
MA
02110
PETER HERMANN
TRUSTEE
1.00
10,000
0
0
14 OLD ORCHARD RD
CHESTNUT HILL
,
MA
02467
HUGH BARRY
TRUSTEE
1.00
10,000
0
0
112 LAKIBRIDGE DRIVE
KINGS PARK
,
NY
11754
ANNE BECKER
TRUSTEE, TREASURER
1.00
10,000
0
0
19 HOWARD ST
NEWTON
,
MA
02458
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
UBS INVESTMENTS
INVESTMENT ADVISORY
181,346
ONE POST OFFICE SQUARE 33RD FLOOR
BOSTON
,
MA
02109
MORGAN LEWIS
LEGAL FEES
54,357
ONE FEDERAL STREET
BOSTON
,
MA
02110
Total
number of others receiving over $50,000 for professional services
.............
0
Part IX-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
2
3
4
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
8
Part X
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations, see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities
...................
1a
49,423,674
b
Average of monthly cash balances
.......................
1b
2,342,275
c
Fair market value of all other assets (see instructions)
................
1c
2,274,066
d
Total
(add lines 1a, b, and c)
.........................
1d
54,040,015
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
54,040,015
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
810,600
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
53,229,415
6
Minimum investment return.
Enter 5% of line 5
..................
6
2,661,471
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
2,661,471
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
27,044
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
27,044
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
2,634,427
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
2,634,427
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
2,634,427
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
6,477,181
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
6,477,181
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
27,044
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
6,450,137
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
2,634,427
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
0
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
......
190,388
d
From 2017
......
1,779,915
e
From 2018
......
f
Total
of lines 3a through e
........
1,970,303
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
6,477,181
a
Applied to 2018, but not more than line 2a
0
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
.....
2,634,427
e
Remaining amount distributed out of corpus
3,842,754
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
5,813,057
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
..........
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)
.......
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
......
5,813,057
10
Analysis of line 9:
a
Excess from 2015
....
b
Excess from 2016
....
190,388
c
Excess from 2017
....
1,779,915
d
Excess from 2018
....
e
Excess from 2019
....
3,842,754
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
MARINE BIOLOGICAL LABORATORY
7 MBL STREET
WOODS HOLE
,
MA
02543
N/A
PUBLIC CHARITY
BIOLOGICAL ADVANCEMENT
2,000
MASS GENERAL HOSPITAL
13TH ST
CHARLESTOWN
,
MA
02129
N/A
PUBLIC CHARITY
MEDICAL CANCER RESEARCH
1,157,806
MASS GENERAL HOSPITAL - PRIOR YEAR GRANTS PAID IN CURRENT YEAR
MASS GENERAL HOSPITAL - FUTURE YEAR
GRANTS
CHARLESTOWN
,
MA
02129
N/A
PUBLIC CHARITY
MEDICAL CANCER RESEARCH
4,197,880
NEW YORK EAR & EYE- FUTURE YEAR GRANTS- PRIOR YEAR GRANTS PAID IN CURRENT Y
310 E 14TH ST
NEW YORK
,
NY
10003
N/A
PUBLIC CHARITY
BIOLOGICAL ADVANCEMENT
1,000,000
Total
.................................
3a
6,357,686
b
Approved for future payment
MASS GENERAL HOSPITAL - FUTURE YEAR GRANTS
MASS GENERAL HOSPITAL - FUTURE YEAR
GRANTS
CHARLESTOWN
,
MA
02129
N/A
PUBLIC CHARITY
MEDICAL CANCER RESEARCH
1,050,000
Total
.................................
3b
1,050,000
Form
990-PF
(2019)
Form 990-PF (2019)
Page
12
Part XVI-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
Unrelated business income
Excluded by section 512, 513, or 514
(e)
Related or exempt
function income
(See instructions.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
4
Dividends and interest from securities
....
14
1,337,393
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
7,744
8
Gain or (loss) from sales of assets other than
inventory
............
18
1,669,993
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
OTHER INCOME FROM PASSTHROUGH ACTIVITIES - UBTI
900000
-74,506
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
-74,506
3,015,130
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
2,940,624
(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