TY 2019 Form 990PF

- TIN:

Form990-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.
bullet

Go to www.irs.gov/Form990PF for instructions and the latest information.

OMB No. 1545-0052

2019

Open to Public Inspection

For calendar year 2019, or tax year beginning 01-01-2019 , and ending 12-31-2019

Name of foundation
ELISHA LEAVENWORTH FOUNDATION INC

Number and street (or P.O. box number if mail is not delivered to street address)PO Box 1032
Room/suite

City or town, state or province, country, and ZIP or foreign postal code
Middlebury, CT06762

A Employer identification number

06-6035206

B Telephone number (see instructions)

(203) 758-8086

C If exemption application is pending, check here bullet

G Check all that apply: Initial returnInitial return of a former public charity
Final returnAmended return
Address change Name change

D 1. Foreign organizations, check here............. bullet

2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet

E If private foundation status was terminated
under section 507(b)(1)(A), check here ....... bullet

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 ....... bullet

I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16) bullet

$5,726,642J Accounting method: Cash Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)

	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)		48,200
2	Check .............
3	Interest on savings and temporary cash investments		14		14
4	Dividends and interest from securities...		100,645		100,645
5a	Gross rents............
b	Net rental income or (loss)
6a	Net gain or (loss) from sale of assets not on line 10			267,054
b	Gross sales price for all assets on line 6a 1,949,783
7	Capital gain net income (from Part IV, line 2)...				267,054
8	Net short-term capital gain.........
9	Income modifications...........
10a	Gross sales less returns and allowances	10,000
b	Less: Cost of goods sold....
c	Gross profit or (loss) (attach schedule).....			10,000		10,000
11	Other income (attach schedule).......
12	Total. Add lines 1 through 11........		425,913		367,713	10,000
13	Compensation of officers, directors, trustees, etc.		0		0	0	0
14	Other employee salaries and wages......
15	Pension plans, employee benefits.......
16a	Legal fees (attach schedule).........
b	Accounting fees (attach schedule).......
c	Other professional fees (attach schedule)....			38,743	38,743	0	0
17	Interest...............
18	Taxes (attach schedule) (see instructions)...			4,826	0	0	0
19	Depreciation (attach schedule) and depletion...
20	Occupancy..............
21	Travel, conferences, and meetings.......
22	Printing and publications..........
23	Other expenses (attach schedule).......			1,490	0	0	0
24	Total operating and administrative expenses.
	Add lines 13 through 23..........		45,059		38,743	0	0
25	Contributions, gifts, grants paid.......		248,990				248,990
26	Total expenses and disbursements. Add lines 24 and 25		294,049		38,743	0	248,990
27	Subtract line 26 from line 12:
a	Excess of revenue over expenses and disbursements		131,864
b	Net investment income (if negative, enter -0-)				328,970
c	Adjusted net income (if negative, enter -0-)...					10,000

For Paperwork Reduction Act Notice, see instructions.

Cat. No. 11289X Form 990-PF (2019)

Form 990-PF (2019)

Page 2

Part II		Balance Sheets	Beginning of year	End of year
Part II		Balance Sheets	(a) Book Value	(b) Book Value	(c) Fair Market Value
	1	Cash—non-interest-bearing.............	44,529	31,779	31,779
	2	Savings and temporary cash investments.........	233,878	443,874	443,874
	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).......
	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)..........	3,508,270	3,442,888	5,250,989
	14	Land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	15	Other assets (describe )
	16	Total assets (to be completed by all filers—see the
		instructions. Also, see page 1, item I)	3,786,677	3,918,541	5,726,642
	17	Accounts payable and accrued expenses..........
	18	Grants payable.................
	19	Deferred revenue.................
	20	Loans from officers, directors, trustees, and other disqualified persons
	21	Mortgages and other notes payable (attach schedule)......
	22	Other liabilities (describe )
	23	Total liabilities (add lines 17 through 22).........	0	0
		Foundations that follow FASB ASC 958, check here
		and complete lines 24, 25, 29 and 30.
	24	Net assets without donor restrictions...........	3,786,677	3,918,541
	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).....	3,786,677	3,918,541
	30	Total liabilities and net assets/fund balances (see instructions).	3,786,677	3,918,541

Part III

Analysis of Changes in Net Assets or Fund Balances

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) ...............

3,786,677

Enter amount from Part I, line 27a .....................

131,864

Other increases not included in line 2 (itemize) bullet

Add lines 1, 2, and 3 ..........................

3,918,541

Decreases not included in line 2 (itemize) bullet

Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .

3,918,541

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	USTN	P	2018-01-30	2016-02-28
b	Visa	P	2011-08-11	2016-09-04
c	Goldman Sachs	P	2018-03-01	2019-01-01
d	Goldman Sachs	P	2018-11-06	2019-01-01
e	Dominion Energy	P	2017-11-15	2019-01-15
	Ecolab	P	2015-03-25	2019-01-17
	Becton Dickinson	P	2016-12-09	2019-01-29
	Becton Dickinson	P	2017-01-10	2019-01-29
	USTN	P	2017-06-21	2019-01-31
	McDonalds	P	2015-10-26	2019-02-01
	Eaton Corp	P	2018-02-07	2019-02-06
	Eaton Corp	P	2018-04-17	2019-02-06
	Eaton Corp	P	2018-01-09	2019-02-06
	Bank of America	P	2017-09-29	2019-02-15
	Bank of America	P	2017-10-20	2019-02-15
	State Street	P	2014-05-08	2019-02-15
	State Street	P	2016-01-29	2019-02-15
	Suntrust	P	2016-11-09	2019-02-25
	Eaton Corp	P	2015-03-25	2019-02-25
	Eaton Corp	P	2013-06-13	2019-02-25
	Eaton Corp	P	2013-03-01	2019-02-25
	Ultra Beauty	P	2018-07-18	2019-03-19
	Quest Diagnostics	P	2017-11-28	2019-04-01
	USTN	P	2018-04-23	2019-04-30
	Amgen	P	2017-11-07	2019-05-10
	Ecolab	P	2015-03-25	2019-05-10
	Eaton Corp	P	2015-12-09	2019-05-10
	Eaton Corp	P	2013-03-01	2019-05-10
	Eaton Corp	P	2013-04-22	2019-05-10
	Eaton Corp	P	2013-06-12	2019-05-10
	State Street	P	2016-01-29	2019-05-21
	State Street	P	2011-02-01	2019-05-21
	State Street	P	2011-02-16	2019-05-21
	State Street	P	2011-04-01	2019-05-21
	State Street	P	2011-04-06	2019-05-21
	State Street	P	2011-08-17	2019-05-21
	State Street	P	2011-09-16	2019-05-21
	McDonalds	P	2018-01-17	2019-05-29
	VMWare	P	2016-07-20	2019-05-29
	Visa	P	2014-04-16	2019-06-25
	TD Bank Note	P	2016-09-15	2019-07-02
	USTN 10yr TIPS	P	2014-11-05	2019-07-15
	USTN 10yr TIPS	P	2014-11-07	2019-07-15
	USTN 10yr TIPS	P	2014-05-16	2019-07-15
	Alphabet CL C	P	2006-10-04	2019-07-19
	Alphabet CL C	P	2006-07-21	2019-07-19
	Visa	P	2013-08-13	2019-07-19
	Ecolab	P	2015-03-25	2019-08-01
	Visa	P	2013-08-13	2019-08-01
	Charles Schwab	P	2016-01-26	2019-08-08
	Charles Schwab	P	2016-02-25	2019-08-08
	Charles Schwab	P	2016-03-10	2019-08-08
	CVS	P	2016-03-28	2019-08-12
	American Express	P	2016-10-25	2019-08-15
	Visa	P	2013-08-13	2019-08-20
	Old Domion Freight	P	2018-12-11	2019-09-04
	Dollar General	P	2015-11-30	2019-09-04
	Dunkin Brands	P	2017-08-04	2019-09-04
	Dunkin Brands	P	2014-06-17	2019-09-04
	Kellog	P	2013-12-05	2019-09-08
	Accenture	P	2013-10-17	2019-09-25
	Thermo Fisher	P	2019-08-20	2019-09-27
	Old Dominion Freight	P	2018-10-25	2019-10-08
	Dollar General	P	2012-12-13	2019-10-08
	Oracle Note	P	2014-12-10	2019-10-08
	CSX	P	2019-05-09	2019-10-14
	Oracle	P	2016-01-29	2019-10-17
	Apple	P	2016-09-26	2019-10-30
	Old Dominion Freight	P	2018-10-25	2019-11-13
	Oracle	P	2013-05-15	2019-11-13
	USTN 3.375%	P	2018-06-26	2019-11-15
	USTN 3.375%	P	2018-08-23	2019-11-15
	ULTA	P	2019-08-20	2019-12-04
	Apple	P	2019-09-26	2019-12-04
	ULTA	P	2018-05-29	2019-12-04
	ULTA	P	2018-07-24	2019-12-04
	Nordstroms	P	2015-04-20	2019-12-06
	Apple	P	2016-09-27	2019-12-09
	USTN 1.875%	P	2019-09-04	2019-12-31
	Capital Gains Dividends	P

(e) Gross sales price		(g) Cost or other basis plus expense of sale	(h) Gain or (loss) (e) plus (f) minus (g)
a	50,000	49,913	87
b	9,054	1,040	8,014
c	49,511	78,903	-29,392
d	33,008	45,664	-12,656
e	50,000	50,000	0
	15,172	11,467	3,705
	24,212	16,636	7,576
	12,106	8,553	3,553
	50,000	49,944	56
	75,000	75,000	0
	15,400	16,316	-916
	23,099	22,797	302
	15,400	15,964	-564
	14,565	12,708	1,857
	5,826	5,398	428
	7,072	6,511	561
	7,072	5,374	1,698
	13,234	9,440	3,794
	8,130	5,297	2,833
	8,130	5,365	2,765
	4,065	2,623	1,442
	16,746	12,512	4,234
	75,000	75,000	0
	50,000	49,847	153
	50,000	50,000	0
	9,016	5,733	3,283
	16,103	8,914	7,189
	12,077	7,868	4,209
	40,257	23,548	16,709
	16,103	10,432	5,671
	6,028	5,374	654
	12,055	9,573	2,482
	12,055	9,186	2,869
	6,028	4,549	1,479
	6,028	4,616	1,412
	18,083	10,434	7,649
	12,055	6,870	5,185
	50,000	49,880	120
	19,245	5,899	13,346
	34,597	10,331	24,266
	35,000	35,000	0
	17,970	17,969	1
	11,980	11,979	1
	29,950	29,948	2
	22,626	4,047	18,579
	156	27	129
	18,065	4,491	13,574
	10,160	5,733	4,427
	9,019	2,245	6,774
	63,290	43,069	20,221
	29,783	19,076	10,707
	7,446	5,360	2,086
	40,000	40,000	0
	50,000	50,000	0
	9,000	2,245	6,755
	16,137	13,282	2,855
	15,673	6,474	9,199
	8,322	5,434	2,888
	16,091	8,948	7,143
	30,113	30,094	19
	18,945	7,199	11,746
	52,159	51,659	500
	16,377	12,751	3,626
	15,954	4,505	11,449
	40,000	40,000	0
	76,421	75,697	724
	16,554	10,827	5,727
	12,110	5,647	6,463
	19,314	12,751	6,563
	16,878	10,200	6,678
	50,000	50,000	0
	25,000	25,000	0
	23,833	24,405	-572
	13,052	5,647	7,405
	47,666	49,935	-2,269
	23,833	24,688	-855
	25,301	25,275	26
	13,392	5,643	7,749
	50,000	50,000	0
	681		681

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			87
b			8,014
c			-29,392
d			-12,656
e			0
			3,705
			7,576
			3,553
			56
			0
			-916
			302
			-564
			1,857
			428
			561
			1,698
			3,794
			2,833
			2,765
			1,442
			4,234
			0
			153
			0
			3,283
			7,189
			4,209
			16,709
			5,671
			654
			2,482
			2,869
			1,479
			1,412
			7,649
			5,185
			120
			13,346
			24,266
			0
			1
			1
			2
			18,579
			129
			13,574
			4,427
			6,774
			20,221
			10,707
			2,086
			0
			0
			6,755
			2,855
			9,199
			2,888
			7,143
			19
			11,746
			500
			3,626
			11,449
			0
			724
			5,727
			6,463
			6,563
			6,678
			0
			0
			-572
			7,405
			-2,269
			-855
			26
			7,749
			0
			681

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	267,054
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	274,270	5,232,559	0.052416
2017	214,375	5,085,121	0.042157
2016	165,679	4,717,404	0.035121
2015	163,155	4,593,930	0.035515
2014	154,048	3,693,435	0.041709

Total of line 1, column (d) .....................

0.206918

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 ......

0.041384

Enter the net value of noncharitable-use assets for 2019 from Part X, line 5......

5,475,847

Multiply line 4 by line 3......................

226,612

Enter 1% of net investment income (1% of Part I, line 27b)...........

3,290

Add lines 5 and 6........................

229,902

Enter qualifying distributions from Part XII, line 4,.............

248,990

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)

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	3,290
	hereand 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	3,290
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	3,290
6	Credits/Payments:

a	2019 estimated tax payments and 2018 overpayment credited to 2019	6a	2,500
b	Exempt foreign organizations—tax withheld at source......	6b
c	Tax paid with application for extension of time to file (Form 8868)...	6c	0
d	Backup withholding erroneously withheld ...........	6d	0

7	Total credits and payments. Add lines 6a through 6d..............		7	2,500
8	Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached.		8	32
9	Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......		9	822
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

During the tax year, did the foundation attempt to influence any national, state, or local legislation or did

Yes

it participate or intervene in any political campaign? ....................

Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions

for definition).................................

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.

Did the foundation file Form 1120-POL for this year?.....................

Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:

(1) On the foundation. bullet

$ 0(2) On foundation managers. bullet

$ 0

Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed

on foundation managers. bullet

$ 0

Has the foundation engaged in any activities that have not previously been reported to the IRS?.......

If "Yes," attach a detailed description of the activities.

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....

Did the foundation have unrelated business gross income of $1,000 or more during the year?........

If "Yes," has it filed a tax return on Form 990-T for this year?...................

Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........

If "Yes," attach the statement required by General Instruction T.

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?................

Yes

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..................................

Yes

Enter the states to which the foundation reports or with which it is registered (see instructions)

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 .

Yes

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 .............................

Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names

and addresses. ...............................

Form 990-PF (2019)

Page 5

Part VII-A

Statements Regarding Activities (continued)

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 .............

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.................

Did the foundation comply with the public inspection requirements for its annual returns and exemption application?

Yes

Website address bullet

N/A

The books are in care of bullet

Sally Kernan Telephone no. bullet

(203) 758-8086

Located at bullet

700 Breakneck Hill RoadMiddleburyCT ZIP+4 bullet

06762

Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here ......... bullet

and enter the amount of tax-exempt interest received or accrued during the year ........ bullet

16 At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over YesNo

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 bullet

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

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? YesNo

(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)

a disqualified person?......................YesNo

(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? YesNo

(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? YesNo

(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)?...............YesNo

(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.).......YesNo

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 ........

Organizations relying on a current notice regarding disaster assistance check here........ bullet

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?.............

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)):

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?.............YesNo

If "Yes," list the years bullet

20, 20, 20, 20

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.) ..............

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

Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at

any time during the year?......................YesNo

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.)..................

Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?

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?

Form 990-PF (2019)

Page 6

Part VII-B

Statements Regarding Activities for Which Form 4720 May Be Required (continued)

During the year did the foundation pay or incur any amount to:

Yes

(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? YesNo

(2) Influence the outcome of any specific public election (see section 4955); or to carry

on, directly or indirectly, any voter registration drive?.............YesNo

(3) Provide a grant to an individual for travel, study, or other similar purposes? YesNo

(4) Provide a grant to an organization other than a charitable, etc., organization described

in section 4945(d)(4)(A)? See instructions................YesNo

(5) Provide for any purpose other than religious, charitable, scientific, literary, or

educational purposes, or for the prevention of cruelty to children or animals?.....YesNo

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 ......

Organizations relying on a current notice regarding disaster assistance check here......... bullet

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?..........YesNo

If "Yes," attach the statement required by Regulations section 53.4945–5(d).

Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on

a personal benefit contract?.....................YesNo

Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....

If "Yes" to 6b, file Form 8870.

At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction? YesNo

If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? ....

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? .................YesNo

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
EMILY ANDERSON	DIRECTOR 0.00	0	0	0
531 UPPER GRASSY HILL ROAD WOODBURY,CT06798	DIRECTOR 0.00	0	0	0
SALLY CIARO	DIRECTOR 0.00	0	0	0
396 WATERTOWN ROAD MIDDLEBURY,CT06762	DIRECTOR 0.00	0	0	0
PATRICIA DUNN	DIRECTOR 0.00	0	0	0
70 MASTERS DRIVE SOUTHINGTON,CT06489	DIRECTOR 0.00	0	0	0
LYNN FRANKLIN HENRY	DIRECTOR 0.00	0	0	0
ASH SWAMP ROAD WOODBURY,CT06798	DIRECTOR 0.00	0	0	0
SALLY KERNAN	TREASURER 0.00	0	0	0
700 BREAKNECK HILL ROAD MIDDLEBURY,CT06762	TREASURER 0.00	0	0	0
MARGARET LAWLOR	PRESIDENT 0.00	0	0	0
200 SOUTHWEST RD WATERBURY,CT06708	PRESIDENT 0.00	0	0	0
CHRISTINE PAPE	DIRECTOR 0.00	0	0	0
55 SOUTH STREET MIDDLEBURY,CT06762	DIRECTOR 0.00	0	0	0
LAURIE ST JOHN	DIRECTOR 0.00	0	0	0
22 KETTLETOWN RD SOUTHBURY,CT06844	DIRECTOR 0.00	0	0	0
M CATHERINE SMITH	PRESIDENT 0.00	0	0	0
PO BOX 1436 MIDDLEBURY,CT06762	PRESIDENT 0.00	0	0	0
STEPHANIE CUMMINGS	DIRECTOR 0.00	0	0	0
66 FLEETWOOD DR WATERBURY,CT06702	DIRECTOR 0.00	0	0	0
KATHRYN LAURIA	DIRECTOR 0.00	0	0	0
53 HOLLOW ROAD WOODBURY,CT06798	DIRECTOR 0.00	0	0	0
MARCEA MONAGAN	DIRECTOR 0.00	0	0	0
206 SUGAR MAPLE WAY MIDDLEBURY,CT06762	DIRECTOR 0.00	0	0	0
ANNIE SCOTT	DIRECTOR 0.00	0	0	0
585 PARK RD WATEBURY,CT06708	DIRECTOR 0.00	0	0	0

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)

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............. bullet

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	0
2


All other program-related investments. See instructions.
3

Total. Add lines 1 through 3......................... bullet

Form 990-PF (2019)

Page 8

Part X

Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)

Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,

purposes:

Average monthly fair market value of securities...................

5,139,236

Average of monthly cash balances.......................

420,000

Fair market value of all other assets (see instructions)................

Total (add lines 1a, b, and c).........................

5,559,236

Reduction claimed for blockage or other factors reported on lines 1a and

1c (attach detailed explanation) .............

Acquisition indebtedness applicable to line 1 assets..................

Subtract line 2 from line 1d.........................

5,559,236

Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see

instructions) .............................

83,389

Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4

5,475,847

Minimum investment return. Enter 5% of line 5..................

273,792

Part XI

Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow

and do not complete this part.)

Minimum investment return from Part X, line 6....................

273,792

Tax on investment income for 2019 from Part VI, line 5......

3,290

Income tax for 2019. (This does not include the tax from Part VI.)...

Add lines 2a and 2b............................

3,290

Distributable amount before adjustments. Subtract line 2c from line 1............

270,502

Recoveries of amounts treated as qualifying distributions................

Add lines 3 and 4............................

270,502

Deduction from distributable amount (see instructions).................

Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...

270,502

Part XII

Qualifying Distributions (see instructions)

Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:

Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........

248,990

Program-related investments—total from Part IX-B..................

Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,

purposes...............................

Amounts set aside for specific charitable projects that satisfy the:

Suitability test (prior IRS approval required)....................

Cash distribution test (attach the required schedule) .................

Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4

248,990

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.................

3,290

Adjusted qualifying distributions. Subtract line 5 from line 4..............

245,700

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)

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				270,502
2 Undistributed income, if any, as of the end of 2019:
a Enter amount for 2018 only.......			235,397
b Total for prior years:20, 20, 20		0
3 Excess distributions carryover, if any, to 2019:
a From 2014......
b From 2015......
c From 2016......
d From 2017......
e From 2018......
fTotal of lines 3a through e........	0
4Qualifying distributions for 2019 from Part
XII, line 4: $ 248,990
a Applied to 2018, but not more than line 2a			235,397
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.....				13,593
e Remaining amount distributed out of corpus	0
5 Excess distributions carryover applied to 2019.	0			0
(If an amount appears in column (d), the same amount must be shown in column (a).)
6Enter the net total of each column as indicated below:
a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5	0
b Prior years’ undistributed income. Subtract line 4b from line 2b ..........		0
c Enter the amount of prior years’ undistributed income for which a notice of deficiency has been issued, or on which the section 4942(a) tax has been previously assessed......		0
d Subtract line 6c from line 6b. Taxable amount —see instructions ...........		0
e Undistributed income for 2018. Subtract line 4a from line 2a. Taxable amount—see instructions .............			0
f Undistributed income for 2019. Subtract lines 4d and 5 from line 1. This amount must be distributed in 2020 ..........				256,909
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
9Excess distributions carryover to 2020. Subtract lines 7 and 8 from line 6a ......	0
10 Analysis of line 9:
a Excess from 2015....
b Excess from 2016....
c Excess from 2017....
d Excess from 2018....
e Excess from 2019....

Form 990-PF (2019)

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....... bullet

b Check box to indicate whether the organization is a private operating foundation described in section4942(j)(3) or4942(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	(e) Total

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.)

1Information Regarding Foundation Managers:

aList 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).)

bList 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.

2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:

Check here bullet

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

aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:

ELISHA LEAVENWORTH FOUNDATION INC
PO BOX 1032
MIDDLEBURY,CT06762
(999) 999-9999

bThe form in which applications should be submitted and information and materials they should include:

Request application from the foundation. Complete application and return with proof of acceptance to a 2 or 4 year degree program.

cAny submission deadlines:

April 30

dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:

Must have been a member of Girl's Inc for Three Years

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)		Foundation status of recipient	Purpose of grant or contribution	Amount
aPaid during the year
Act 54 Ministries 1713 Thomaston Ave waterbury,CT06705			Operating Support	25,600
Brass City Charter School 212 Chestnut St Waterbury,CT06710			Operating Support	25,000
Chlldren's Community School 31 Wolcott St STE D Waterbury,CT06702			Operating Support	250
CT Community Fund 43 Field Street Waterbury,CT06702			Operating Support	500
Flanders Nature Center 596 Flanders Rd Woodbury,CT06798			Operating Support	10,290
Hopeville Church 160 Piedmont Waterbury,CT06706			Operating Support	5,500
Mattatuck Museum 63 Prospect ST waterbury,CT06702			Operating Support	25,000
Police Activity League of Waterbury 64 Division Street Waterbury,CT06704			Operating Support	20,000
Sacred Heart HS 142 S Elm Stree Waterbury,CT06706			Financial Aid	5,000
Safe Haven 29 Central Avenue Waterbury,CT06702			Operating Support	20,000
Salvation Army 74 Central Ave Waterbury,CT06702			Operating Support	10,000
Seven Angels Theater 1 Plank Rd Waterbury,CT06705			Operating Support	6,500
ST Margarets- Willow PlazaCommunity Center 60 Elmwood Avenue Waterbury,CT06702			Operating Support	8,000
St Vincent de Paul 144 Benedict Street Waterbury,CT06706			Operating Support	20,000
University of Arizona 1200 E University Blvd Tucson,AZ85721			Financial Aid	5,000
University of CT 99 E Main Street Waterbury,CT06702			Financial Aid	10,000
Waterbury Reads 267 Grand Street Waterbury,CT06702			Operating Support	14,500
Waterbury Youth Services 83 Prospect ST Waterbury,CT06702			Operating Support	12,850
YMCA 136 W Main Street Waterbury,CT06702			Operating Support	25,000
Total ................................. 3a				248,990

bApproved for future payment

Total ................................. 3b				0

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.)
1Program service revenue:	(a) Business code	(b) Amount	(c) Exclusion code	(d) Amount	(e) Related or exempt function income (See instructions.)
a
b
c
d
e
f
gFees and contracts from government agencies
2 Membership dues and assessments....
3 Interest on savings and temporary cash investments ...........			14		14
4 Dividends and interest from securities....			14		100,645
5 Net rental income or (loss) from real estate:
aDebt-financed property......
bNot debt-financed property.....
6 Net rental income or (loss) from personal property
7 Other investment income.....			14
8 Gain or (loss) from sales of assets other than inventory ............			14		267,054
9 Net income or (loss) from special events:
10 Gross profit or (loss) from sales of inventory					10,000
11 Other revenue: a
b
c
d
e
12 Subtotal. Add columns (b), (d), and (e)..		0		0	377,713

13Total. Add line 12, columns (b), (d), and (e)..................

377,713

(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.)
8	Realized Gain on Sale of Securities

Form 990-PF (2019)

Page 13

Part XVII

Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations

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

Transfers from the reporting foundation to a noncharitable exempt organization of:

(1) Cash...................................

1a(1)

(2) Other assets.................................

1a(2)

Other transactions:

(1) Sales of assets to a noncharitable exempt organization....................

1b(1)

(2) Purchases of assets from a noncharitable exempt organization..................

1b(2)

(3) Rental of facilities, equipment, or other assets.......................

1b(3)

(4) Reimbursement arrangements...........................

1b(4)

(5) Loans or loan guarantees.............................

1b(5)

(6) Performance of services or membership or fundraising solicitations................

1b(6)

Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............

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

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

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)

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