Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo 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
MIDCONTINENT FOUNDATION
 
% PATRICK MCADARAGH
Number and street (or P.O. box number if mail is not delivered to street address)3600 MINNESOTA DRIVE NO 700
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MINNEAPOLIS, MN554357979
A Employer identification number

36-3556764
B Telephone number (see instructions)

(952) 844-2600
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$22,090J Accounting method:
 
(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)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule) 240,000
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities...      
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10  
b Gross sales price for all assets on line 6a  
7 Capital gain net income (from Part IV, line 2)...  
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 240,000 0  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0      
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 5,876 0 0 1,768
c Other professional fees (attach schedule)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 80 0 0 0
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings....... 12,361     12,361
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 1,425 0 0 1,425
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 19,742 0 0 15,554
25 Contributions, gifts, grants paid....... 238,830 238,830
26 Total expenses and disbursements. Add lines 24 and 25 258,572 0 0 254,384
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -18,572
b Net investment income (if negative, enter -0-) 0
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
Assets 1 Cash—non-interest-bearing............. 30,154 22,090 22,090
2 Savings and temporary cash investments.........      
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
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) bullet  
Less: allowance for doubtful accounts bullet        
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 bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 30,154 22,090 22,090
Liabilities 17 Accounts payable and accrued expenses.......... 1,768 5,876
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 bullet)    
23 Total liabilities (add lines 17 through 22)......... 1,768 5,876
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
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 bullet
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 28,386 16,214
29 Total net assets or fund balances (see instructions)..... 28,386 16,214
30 Total liabilities and net assets/fund balances (see instructions). 30,154 22,090
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
28,386
2
Enter amount from Part I, line 27a .....................
2
-18,572
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
6,400
4
Add lines 1, 2, and 3 ..........................
4
16,214
5
Decreases not included in line 2 (itemize) bullet
5
 
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
16,214
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.)
1a
b
c
d
e
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a
b
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2  
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 ................... 		Bracket 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?
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 255,318 32,435 7.871682
2017 232,296 42,497 5.466174
2016 227,579 78,022 2.916857
2015 236,170 66,173 3.568978
2014 211,716 54,682 3.871768
2
Total of line 1, column (d) .....................
2
23.695459
3
Average distribution ratio for the 5-year base period—divide the total on line 2 by 5.0, or by the number of years the foundation has been in existence if less than 5 years ......
3
4.739092
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5......
4
37,313
5
Multiply line 4 by line 3......................
5
176,830
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
0
7
Add lines 5 and 6........................
7
176,830
8
Enter qualifying distributions from Part XII, line 4,.............
8
254,384
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 Bullet and enter “N/A" on line 1. Bracket includes lines 1a and 1b
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 0
hereBulletand enter 1% of Part I, line 27b...................
c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2  
3 Add lines 1 and 2........................... 3 0
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 0
6 Credits/Payments:
a 2019 estimated tax payments and 2018 overpayment credited to 2019 6a  
b Exempt foreign organizations—tax withheld at source...... 6b
c Tax paid with application for extension of time to file (Form 8868)... 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 0
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 0
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2020 estimated taxBullet   RefundedBullet 11  
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition).................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
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
Yes
 
If "Yes," attach the statement required by General Instruction T.Click to see attachment
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)
    bulletSD
    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 .Click to see attachment
    8b
     
    No
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2019 or the taxable year beginning in 2019? See the instructions for Part XIV.
    If "Yes," complete Part XIV .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2019)
    Form 990-PF (2019)
    Page 5
    Part VII-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
     
    No
    Website addressbulletN/A
    14
    The books are in care ofbulletPATRICK MCADARAGH Telephone no.bullet (952) 844-2600

    Located atbullet3600 MINNESOTA DRIVE SUITE 700MINNEAPOLISMN ZIP+4bullet55435
    15
    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
    15
     
    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
    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?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?......................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (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)?...............
    (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.).......
    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
    Yes
     
    ........bullet
    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
    Yes
     
    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?.............
    If "Yes," list the years bullet20, 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.
    bullet20, 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?......................
    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))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?.............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?.....
    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
     
     
    .........bullet
    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?..........
    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?.....................
    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?
    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? .................
    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
    Pat McAdaragh Director
    1.0     		0 0 0
    3600 Minnesota Drive Suite 700
    Minneapolis,MN55435
    Wynne Haakenstad Executive Director
    2.0     		0 0 0
    3600 Minnesota Drive Suite 700
    Minneapolis,MN55435
    Paige Pearson Meyer Director - as of 8/2019
    1.0     		0 0 0
    3901 North Louise Avenue
    Sioux Falls,SD57107
    Steve Schuster Director - THRU 10/2019
    1.0     		0 0 0
    3600 Minnesota Drive Suite 700
    Minneapolis,MN55435
    Debbie Schmidt Director - THRU 05/2019
    1.0     		0 0 0
    2000 W 31st Street Suite C
    Lawrence,KS66046
    Tom Heier Director - THRU 05/2019
    1.0     		0 0 0
    3901 North Louise Avenue
    Sioux Falls,SD57107
    Ann McGlennen Director
    1.0     		0 0 0
    3600 Minnesota Drive Suite 700
    Minneapolis,MN55435
    Greg Hansen Director
    1.0     		0 0 0
    24 1st Ave NE
    Aberdeen,SD57401
    Ashley Goebel Director
    1.0     		0 0 0
    50 22nd Street East
    West Fargo,ND58078
    Scott Fischer Director
    1.0     		0 0 0
    719 Memorial Highway
    Bismarck,ND58504
    Lance Mullen Director - AS OF 7/2019
    1.0     		0 0 0
    2000 W 31ST ST
    LAWRENCE,KS66046
    TAMMY ALBERTS DIRECTOR - AS OF 7/2019
    1.0     		0 0 0
    3901 NORTH LOUISE AVE
    SIOUX FALLS,SD57107
    SANDEEP BOWENAPALLY DIRECTOR - AS OF 7/2019
    1.0     		0 0 0
    3901 NORTH LOUISE AVENUE
    SIOUX FALLS,SD57107
    LIZ STATZ SECRETARY
    1.0     		0 0 0
    3600 MINNESOTA DRIVE SUITE 700
    MINNEAPOLIS,MN55435
    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
     
    Total number of other employees paid over $50,000...................bullet  
    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
     
    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  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    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
    0
    b
    Average of monthly cash balances.......................
    1b
    37,881
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    37,881
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    37,881
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    568
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    37,313
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    1,866
    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.)
    1
    Minimum investment return from Part X, line 6....................
    1
    1,866
    2a
    Tax on investment income for 2019 from Part VI, line 5......
    2a
    0
    b
    Income tax for 2019. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    0
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    1,866
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    6,000
    5
    Add lines 3 and 4............................
    5
    7,866
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
    7,866
    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
    254,384
    b
    Program-related investments—total from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
    0
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
    0
    b
    Cash distribution test (attach the required schedule) .................
    3b
    0
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    254,384
    5
    Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
    income. Enter 1% of Part I, line 27b. See instructions.................
    5
    0
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    254,384
    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 7,866
    2 Undistributed income, if any, as of the end of 2019:
    a Enter amount for 2018 only....... 0
    b Total for prior years:2017, 2016, 2015 0
    3 Excess distributions carryover, if any, to 2019:
    a From 2014...... 208,982
    b From 2015...... 232,861
    c From 2016...... 223,678
    d From 2017...... 227,921
    e From 2018...... 253,696
    fTotal of lines 3a through e........ 1,147,138
    4Qualifying distributions for 2019 from Part
    XII, line 4: bullet$ 254,384
    a Applied to 2018, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		 
    d Applied to 2019 distributable amount..... 7,866
    e Remaining amount distributed out of corpus 246,518
    5 Excess distributions carryover applied to 2019.    
    (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 1,393,656
    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......     		 
    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) .......     		 
    8 Excess distributions carryover from 2014 not
    applied on line 5 or line 7 (see instructions) ...     		208,982
    9Excess distributions carryover to 2020.
    Subtract lines 7 and 8 from line 6a ......     		1,184,674
    10 Analysis of line 9:
    a Excess from 2015.... 232,861
    b Excess from 2016.... 223,678
    c Excess from 2017.... 227,921
    d Excess from 2018.... 253,696
    e Excess from 2019.... 246,518
    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....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    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.)
    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).)
    NONE
    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.
    NONE
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    PATRICK MCADARAGH
    3600 MINNESOTA DRIVE SUITE 700
    MINNEAPOLIS,MN55435
    (952) 844-2600
    bThe form in which applications should be submitted and information and materials they should include:
    LETTER INCLUDING DESCRIPTION OF INTENDED USE, ADDRESS, AND TELEPHONE NUMBER OF ORGANIZATION.
    cAny submission deadlines:
    FOUNDATION BOARD MEETS SEMI-ANNUALLY
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    NONE
    Form 990-PF (2019)
    Form 990-PF (2019)
    Page 11
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    Abbott House
    909 Court Merrill
    Mitchell,SD57301     		NONE PC Purchase cameras, window alarms, and monitoring system for all 3 Bridges homes and apts in Mitchell, SD. 1,500
    Abused Adult Resource Center
    218 W Broadway
    Bismarck,ND58501     		NONE PC Purchase activites and materials for children in their 2 shelters who are homeless with their mothers. 1,000
    Accelerate
    1908 W 42nd Street Suite B
    Sioux Falls,SD57105     		NONE PC Funds to be used for the Accelerate Tuition Scholarship Fund to assist low income families with children with Autism and/or other developmental disabilities. 1,500
    Aid Inc
    314 West Main Street
    Mandan,ND58554     		NONE PC Providing assistance to victims of a Mandan apartment building fire July 14, 2019. Assistance includes deposits, application fees, rent, food, laundry vouchers, etc. 1,500
    American Cancer Society
    950 Blue Gentian Road
    Eagan,MN55121     		NONE PC Sponsor Midco team in Play4ACure Martin County. 1,500
    American Cancer Society
    1315 SW Arrowhead Road
    Topeka,KS66604     		NONE PC Sponsor Kansas employees in KS Relay for Life. 2,000
    ANAMOOSE AREA COMMUNITY FOUNDATION
    PO Box 387
    BISMARCK,ND585020387     		NONE PC Funds to be used for updating Fire Department suits and other equipment, replace main street sidewalks, park benches, and purchase a new fire truck. 2,000
    Bemidji Parks & Recreation Department
    1351 5th Street NW
    Bemidji,MN56601     		NONE GOV Purchase equipment for the Drum FIT program. Equip to include: 15 fitness balls, 15 pair drumsticks, 15 ball stands, 1 ball inflator, 1 storage bag. 1,200
    Best Friends Mentoring Program
    135 W Villard Street PO Box 542
    DIckinson,ND58601     		NONE PC Additional Fall grant after board meeting. 2,500
    Big Brothers Big Sisters of the Black Hills
    425 Kansas City Street
    Rapid City,SD57701     		NONE PC Purchase 2 new computer stations for case managers. 1,000
    Bis-Man Mentor Squad (Dacotah Foundation)
    600 S 2nd Street Suite 308
    Bismarck,ND58504     		NONE PC Funds to be used for Mentor recruitment, Mentor training, and mentor background checks. 1,000
    Black Hills Area Habitat for Humanity
    610 E Omaha Street
    Rapid City,SD57701     		NONE PC Purchase materials for the construction of 5 new homes. 1,500
    Black Hills Special Services Cooperative
    2884 Dickson Drive
    Sturgis,SD57785     		NONE GOV Purchase 2 Automated External Debrillators (AEDs). 3,000
    Bluejacket Robotics Booster Club
    PO Box 251
    Cambridge,MN55008     		NONE PC Funds will cover hotels, food, bussing and entrance fees for competitions. 1,500
    Bridging the Dental Gap
    1223 South 12th Street Suite 1
    Bismarck,ND58504     		NONE PC Purchase equipment, instruments and supplies to support dental care to resdients in long-term care facilites in the Bismarck-Mandan area. 1,000
    Call to Freedom Inc
    1800 W 12th Street Suite 100
    Sioux Falls,SD57104     		NONE PC Purchase equipment to implement a training program to educate service professionals and implement screening to better identify victims of human trafficking. 1,000
    Canton Robotics Club
    800 N Main Street
    Canton,SD57013     		NONE GOV Purchase updated computers that can handle running CAD 3D software. 2,000
    Caregiver Response Effort & Service Team
    820 Winnebago Avenue Suite 2
    Fairmont,MN56031     		NONE PC Purchase participant handbooks, food for trainings, and marketing costs for the Healthy Living classes. 1,000
    CCRI Inc
    2903 15th Street South
    Moorhead,MN56560     		NONE PC Funds will go to their Greatest Need Fund that help funds projects such as remodeling homes to make them handicap accessible and to help with medical needs. 2,000
    Center for Technology and Business
    2720 East Broadway Avenue
    Bismarck,ND58501     		NONE PC Funds will be used to create teleconferencing space in their conference room. 1,000
    Charles Hall Youth Services
    PO Box 1995
    Bismarck,ND58502     		NONE PC Purchase a new server, laptops, desktops and monitors. 2,500
    Communities in Schools of Mid-America(CIS)
    1919 Delaware Street
    Lawrence,KS66046     		NONE PC Purchase a new computer server for their main office. 2,000
    Community Violence Intervention Center
    211 South 4th Street
    Grand Forks,ND58201     		NONE PC Purchase nutritional staples, gas and food cards to provide clients in need as they leave the shelter. 2,500
    Companions for Children - Youth Mentoring
    308 2nd Avenue SW Suite 7
    Minot,ND58701     		NONE PC Purchase a new computer. 1,200
    Compass Center The
    1704 S Cleveland Avenue Suite 3
    Sioux Falls,SD57103     		NONE PC Purchase closed circuit audio/visual equipment to allow for Parent-Child Interaction therapy. 2,500
    CREATE Makerspace
    202 S Main Street Suite 530
    Aberdeen,SD57401     		NONE PC Purchase learning games, STEM books, manipulatives, and materials needed to provide high-quality classroom experiences and self-directed learning. 1,500
    CreateND
    802 North 5th Street
    Casselton,ND58012     		NONE PC Offer reduced team membership fees and cover tournament expenses and educational expenses. 1,000
    CUB SCOUT PACK 212 (CELEBRATION METHODIST)
    500 Pasque Flower Trail
    Brandon,SD57005     		NONE PC Replace their Pinewood Derby track. 1,000
    DakotAbilities
    1116 S 4th Avenue
    Sioux Falls,SD57105     		NONE PC Nathan Stallinga spoke at our fall Foundation board meeting and we presented him a check for $1500. 1,500
    Doland City of
    106 N 2nd Street E PO Box 126
    Doland,SD57436     		NONE GOV Add a splash pad, public restrooms and reconfigure the existing tennis/basketball court and ADA compliant playground equipment to Doland's City Park. 2,000
    Domestic Violence Crisis Center
    PO Box 881
    Minot,ND58702     		NONE PC Purchase and install keyless locks on shelter entrances. 3,100
    Douglas County Historical Society
    1047 Massachusetts Street
    Lawrence,KS66044     		NONE PC Upgrade their server, increase storage space, replace outdated workstations, update software. 1,000
    Douglas County Housing Inc
    1600 Haskell Avenue
    Lawrence,KS66044     		NONE PC Funds will be used to provide refurbished laptop and desktop computers to low-income housing families. 2,000
    Douglas County Visiting Nurses Association
    200 Maine Street Suite C
    Lawrence,KS66044     		NONE PC Purchase 20 weighted blankets and 6 hearing amplifiers to help Home Health and Hospice patients. 1,000
    Down Home
    2102 12th Street North
    Fargo,ND58102     		NONE PC Purchase mattresses for the clients they serve. 3,000
    East Central Regional Library
    244 South Birch Street
    Cambridge,MN55008     		NONE GOV Expand and refresh their current play and learn kits to include early STEM activities. 1,000
    East Middle School
    4860 Homestead Street
    Rapid City,SD57703     		NONE GOV Purchase a RedCat Audio system for the classroom. 1,500
    Ely Area Food Shelf
    15 West Conan Street
    Ely,MN55731     		NONE PC Additional Fall grant after board meeting. 2,500
    Falls Hunger Coalition
    1000 5th Street
    International Falls,MN56649     		NONE PC Purchase food for the Food Pantry. 2,500
    Family Visitation Center
    311 E 14th Street
    Sioux Falls,SD57104     		NONE PC Replace existing carpeting on the entire garden level. 1,000
    Feeding South Dakota
    1111 N Creek Drive
    Sioux Falls,SD57107     		NONE PC The summer interns collected food for Feeding South Dakota and the foundation supported their efforts by contributing $1,000. 1,000
    First Lawrence United Methodist Church
    946 Vermont Street
    Lawrence,KS66044     		NONE PC Funds will be used for Jubiliee Caf, which is a free breakfast served at the church Tuesday and Friday am. 1,000
    FirstLink
    4357 13th Avenue South Suite 107L
    Fargo,ND58103     		NONE PC Update current equipment, 3 computers, 10 headsets, 6 phone lifters, 2 monitors, 1 laptop, NEC recording unit. 1,500
    Fork Real Community Cafe Inc
    324 St Joseph
    Rapid City,SD57701     		NONE PC Purchase serving plates and a commercial dishwasher. 1,000
    Friends Against Abuse
    407 4th Street
    International Falls,MN56649     		NONE PC Purchase QPR supplies. QPR is short for Question, Persuade, Refer and is a suicide prevention program. 1,000
    Friends of the Griggs County Public Library
    PO Box 546
    Cooperstown,ND58425     		NONE PC Purchase audio books and STEM kits for children. 1,000
    Glory House of Sioux Falls
    4000 S West Avenue PO Box 88145
    Sioux Falls,SD57109     		NONE PC Pilot project to provide peer mentoring to new clients. 1,000
    Good Samaritan Hospital Association
    800 S Main Avenue
    Rugby,ND58368     		NONE PC Purchase a state-of-the-art ambulance, installed with a power cot and power loader and 800 MHz radio. 2,500
    Grand Forks Foundation for Education Inc
    2400 47th Avenue S
    Grand Forks,ND58201     		NONE PC Purchase a wheel-chair accessible rocker swing for new ADA compliant playground. 2,000
    Grand Forks Senior Center
    620 4th Avenue South
    Grand Forks,ND58201     		NONE PC Purchase & install a large screen Tv and blu-ray player. 1,000
    Guardian and Protective Services Inc
    3801 LockPOrt St Suite 4
    Bismarck,ND58503     		NONE PC Purchase 1 computer. 1,300
    Habitat for Humanity of Beadle County
    PO Box 759
    Huron,SD57350     		NONE PC Put fencing around a backyard on a busy street for a habitat family with a disabled child. 1,500
    Harvey Volunteer Fire Department
    PO Box 3 713 Alder Avenue
    Harvey,ND58341     		NONE GOV Replacing their SCBA/Air Packs. 2,500
    Headwaters School of Music and the Arts
    519 Minnesota Avenue NW
    Bemidji,MN56601     		NONE PC Funds will be used for Music Education Scholarships. 1,000
    Headwaters Science Center
    413 Beltrami Avenue NW
    Bemidji,MN56601     		NONE PC Additional fall grant after board meeting. 2,500
    Heartland Community Health Center
    346 Maine Street Suite 150
    Lawrence,KS66044     		NONE PC Update their websites content, organization, navigation, functionality, and search engine optimization for patients. 1,500
    Heartview Foundation
    101 East Broadway Avenue
    Bismarck,ND58501     		NONE PC Renovation to add 16 additional treatment beds. 1,500
    Heaven's Table Food Shelf
    909 Winnebago Avenue PO Box 745
    Fairmont,MN56031     		NONE PC Purchase food for the BackPack program for students. 2,500
    Holy Family-St Mary's School
    1001 17th Avenue South
    Grand Forks,ND58201     		NONE PC Purchase materials and equipment for STEM instruction in preschool-5th grade. 1,000
    Hope Blooms
    758 34th Street N Suite O
    Fargo,ND58102     		NONE PC Purchase and install a video surveillance system. 1,000
    Horace Mann Elementary School
    902 Anamosa Street
    Rapid City,SD57701     		NONE GOV Purchase a set of Orff instruments. 3,000
    Hub Area Habitat for Humanity
    126 South Main Street
    Aberdeen,SD57401     		NONE PC Build new homes in the Aberdeen area. 1,500
    Jeremiah Program
    3104 Fiechtner Drive S
    Fargo,ND58103     		NONE PC Funding will support 3 vital services. They offer Empowerment training, Individual coaching, Life Skills. 1,000
    Joe Foss Squadron Commemorative Air Force
    812 E Dove Trail
    SUITE 110
    Sioux Falls,SD57108     		NONE PC Support educational programs they offer. 1,000
    John Hoeven Elementary PTA
    3400 13th Street SE
    Minot,ND58701     		NONE PC Add a ground covering around the playground that makes the entire area accessible for all abilities. 1,000
    Junior Achievement of South Dakota
    1000 N West Avenue
    Sioux Falls,SD57104     		NONE PC Sioux Falls 2019-2020 Special Event Stock Market Challenge. 3,000
    Just Food of Douglas County KS
    1000 E 11th Street
    Lawrence,KS66046     		NONE PC Support 1 year implementation of a Mobile Food Pantry. 2,000
    Just Kidding Child Care Center
    516 Production Street Suite 100
    Aberdeen,SD57401     		NONE PC Purchase an indoor play and exercise set. 1,000
    Kansas Big Brothers Big Sisters
    2518 Ridge Court
    Lawrence,KS66046     		NONE PC Funds will allow them to match two at-risk youth. 2,500
    Kids In Need Foundation
    2719 Patton Road
    Roseville,MN55113     		NONE PC Purchase school supplies. 1,000
    Koochiching Aging Options
    1000 Fifth Street
    International Falls,MN56649     		NONE PC Reimburse volunteer drivers for mileage costs. 1,000
    Lake Agassiz Habitat for Humanity
    210 11 Street N
    Moorhead,MN56560     		NONE PC Pay for building materials for 3 homes. 1,000
    Lakes Center for Youth and Families
    20 Lake Street N Suite 103
    Forest Lake,MN55025     		NONE PC Purchase a trailer for pick-up and drop off of equipment. 2,000
    Lawrence Habitat for Humanity
    720 Connecticut Street
    Lawrence,KS66044     		NONE PC Purchase an enclosed cargo trailer. 2,000
    Lawrence Inter-Denominational Nutrition Kitchen I
    1000 Kentucky
    Lawrence,KS66044     		NONE PC Purchase kitchen appliances-ranges, freezers, etc. 2,000
    Lawrence River City Cosmopolitan Club
    PO Box 442441
    Lawrence,KS66044     		NONE PC Purchase and distribute diabetes care information, personal glucose test supplies and support material. 2,000
    Lincoln High School
    2900 S Cliff Avenue
    Sioux Falls,SD57105     		NONE GOV Convert a conference room into a Student Success Center. 1,500
    Littlefork Baptist Church
    621 4th Avenue PO Box 257
    Littlefork,MN56653     		NONE PC Purchase food for the Food Pantry. 1,000
    Madison Central School Educational Fndn
    800 9th Street NE
    Madison,SD57042     		NONE PC Help teachers buy equipment for classroom use. 1,000
    Mandan Golden Age Club Inc
    301 15th Street NW
    Mandan,ND58554     		NONE PC Re-line the existing pipes to the rest rooms. 1,000
    Mapleton Elementary School
    300 1Street Street
    Mapleton,ND58059     		NONE GOV Purchase a reading intervention. 1,000
    Mapleton Volunteer Fire Department
    651 2nd Street PO Box 100
    Mapleton,ND58059     		NONE GOV Purchase a portable generator. 1,009
    Marcus P Beebe Memorial Library
    120 Main Street
    Ipswich,SD57451     		NONE GOV Install landscaping around the building . 1,500
    Mercer Cty Women's Action and Resource Ctr
    PO Box 940
    Beulah,ND58523     		NONE PC Purchase food for the Food Pantry. 3,000
    Milaca High School Robotics Team
    500 Highway 23 West
    Milaca,MN56353     		NONE GOV Purchase parts, tools and competition costs. 1,000
    Minnehaha County Emergency Mgt Rescue Squad
    608 Sigler
    Sioux Falls,SD57104     		NONE GOV Purchase water rescue gear. 2,000
    Minnesota West Community & Technical Clg
    1593 11th Avenue
    Granite Falls,MN56241     		NONE GOV Funds to be used for registration fees, transportation and lodging at competitions. 1,000
    TWIN CITIES REGIONAL SCIENCE FAIRS
    13570 GROVE DRIVE BOX 277
    MAPLE GROVE,MN55311     		NONE PC Printing costs and supplies for the Science Fair. 1,500
    Mitchell Area Safehouse
    1809 N Wisconsin Street
    Mitchell,SD57301     		NONE PC Replace a gate to their fenced in backyard. 1,500
    Mobridge Senior Citizens Center
    616 6th Avenue West
    Mobridge,SD57601     		NONE PC Purchase handicap acccessible bus. 1,000
    Nameless Coalition for the Homeless
    PO Box 353
    Bemidji,MN56601     		NONE PC Support opening the center 1 month earlier. 2,000
    New Pathways
    310 Ashland Street South
    Cambridge,MN55008     		NONE PC Additional Fall grant after board meeting. 2,500
    Northern Cass Destination Imagination
    16021 18th Street SE
    Hunter,ND58048     		NONE GOV Offer reduced fees and help purchase competition materials, travel expenses and registration fees. 1,000
    Northern Hills Area CASA
    741 N 5th Street
    Spearfish,SD57783     		NONE PC Funds will support training and supervision of Court appointed special advocate volunteers. 1,500
    Northland Counseling Center
    900 5th Street Suite 305
    International Falls,MN56649     		NONE PC Purchase technology for new mental health center. 1,000
    Our Home Inc
    334 3rd Street SW
    Huron,SD57350     		NONE PC Offset hardship costs and offer a new program of meditation and yoga to help youth manage stress. 1,500
    Pancreatic Cancer Action Network
    1500 Rosecrans Avenue Suite 200
    Manhattan Beach,CA90266     		NONE PC Support of the Walkie Talkies Team participating in the Purplestride Sioux Falls event. 2,500
    PATH Inc
    1202 Westrac Dr
    Fargo,ND58103     		NONE PC New program School Based Targeted Case Management Funds will help with transporation, beds, food, etc. 1,500
    People Reaching Out to People (PROP)
    14700 Martin Drive
    Eden Prairie,MN55345     		NONE PC Support Summer Food for Kids program. 1,000
    Pick City Municipal Fire Department
    18 1st Lane SE
    Pick City,ND58545     		NONE GOV Replace fire hoses. 1,000
    Pierre Area Referral Service
    2520 E Franklin Street
    Pierre,SD57501     		NONE PC Moving expenses to relocate to new building. 1,000
    Pine Ridge Reservation Emergency Relief
    PO Box 1243
    Pine Ridge,SD57770     		NONE PC Water for residents of the Pine Ridge Reservation that was flooded and they had no drinking water. 1,500
    Plains Art Museum Art Autism
    704 First Avenue N
    Fargo,ND58102     		NONE PC Support the Art Plus Autism program that uses art to help participants with ASD to communicate. 1,000
    REACH Literacy
    2101 W 41st Street Suite 23
    Sioux Falls,SD57105     		NONE PC Incorporate digital literacy into their existing program. 1,000
    Red River High School Robotics
    2211 17th Avenue S
    Grand Forks,ND58201     		NONE GOV Purchase a VEX IQ field for robotics. 1,000
    Reynolds City of
    PO Box 176
    Reynolds,ND58275     		NONE GOV Renovate existing park shelter. 1,000
    Rolla Volunteer Fire Department
    314 1st Avenue SE
    Rolla,ND58367     		NONE GOV Purchase Heavy rescue equipment. 2,500
    Salvation Army of Grand Forks
    1600 University Avenue
    Grand Forks,ND58203     		NONE PC Purchase financial education materials for their Pathway to hope program. 1,000
    Salvation Army of Minot
    715 Western Avenue
    Minot,ND58701     		NONE PC Purchase personal care supplies for their guests. 1,000
    Salvation Army The - Sioux Falls
    800 N Cliff Avenue
    Sioux Falls,SD57103     		NONE PC Purchase food for the weekend meals program. 1,000
    Science from Scientists
    11001 Hampshire Avenue S c/o Braun
    Bloomington,MN55438     		NONE PC STEM program for two schools in Forest Lake, MN. 1,500
    Servants of Shelter of Koochiching County
    900 5th Street Suite 212
    International Falls,MN56649     		NONE PC Replace the roof on their emergency shelter. 1,000
    Sioux Falls Public Schools Education Fndn
    PO Box 560
    Sioux Falls,SD57101     		NONE PC Support the Innovation in Education Grant program. 1,000
    Soup Cafe
    PO Box 881
    Bismarck,ND58501     		NONE PC Purchase computers to be used by homeless and low-income persons to apply for jobs. 2,500
    South Dakota Guardianship Program Inc
    PO Box 794
    Pierre,SD57501     		NONE PC Funds are used for cases where there is no ability to pay. 1,500
    Spearfish Peaks Special Olympics
    1305 Riverview Circle
    Belle Fourche,SD57717     		NONE PC Funds to be used for travel expenses to get to state and area competitions. 2,000
    SPURS Therapeutic Riding Center
    1006 130th Street
    Aberdeen,SD57401     		NONE PC Replace the footing in their indoor arena. 1,500
    St Francis House
    1301 E Austin
    Sioux Falls,SD57103     		NONE PC Expand their phone system from 5 to 20 phones. 4,000
    Survivors Joining for Hope
    100 S Spring Avenue Suite 200
    Sioux Falls,SD57104     		NONE PC Assist families impacted by suicide loss. 1,000
    Teach for America - South Dakota
    P O Box 368
    Mission,SD57555     		NONE PC Funds will be used for the professional developmen 2,500
    Team STEAM Robotics
    2910 Haskell Avenue
    Lawrence,KS66046     		NONE GOV Purchase competition and practice robots. 1,500
    Terebinth Refuge
    110 2nd Street South Suite 231
    Waite Park,MN56387     		NONE PC Development of Women's Employment Readiness Program. 1,500
    The Journey Home
    420 South Washington
    Aberdeen,SD57401     		NONE PC Fund their emergency shelter program. 1,000
    Tonganoxie Elementary School Tech Dept
    1180 S East Street
    Tonganoxie,KS66086     		NONE GOV Purchase a set of DASH robots. 2,000
    Toy Lending Library of South Dakota
    2011 West 26th Street Suite 203
    Sioux Falls,SD57105     		NONE PC Create 50 new toy boxes and toys for boxes. 1,500
    Tracy's Sanctuary House
    908 N 8th Street
    Bismarck,ND58501     		NONE PC Repairs to their main sewer lin. 1,000
    uCodeGirl
    325 5th Street N
    Fargo,ND58102     		NONE PC Help keep program costs low. 2,000
    Welcome House Inc
    1902 E Thayer Avenue
    Bismarck,ND58504     		NONE GOV Provide bus passes for the families they serve. 1,500
    Well Being Development
    PO Box 714
    Ely,MN55731     		NONE PC Funds will support the Healthy Living Program Surface Pro 4 laptops and accessories. 1,000
    Wellspring dba WellFully
    PO Box 1087
    Rapid City,SD57709     		NONE PC Purchase computers for the teen development program. 1,000
    Western Wellness Foundation Inc
    1156 21st Street West PO Box 542
    Dickinson,ND58601     		NONE PC Purchase a color laser Jet Managed MFP-copier/printer/scanner and fax machine. 1,500
    Working Against Violence
    527 Quincy Street
    Rapid City,SD57701     		NONE PC Reseal surface and repaint the lines in the parking lot. 1,000
    Youth & Family Services Inc
    1920 Plaza Boulevard PO Box 2813
    Rapid City,SD57709     		NONE PC Purchase and install video surveillance equipment for the East Adams Street Facility in Rapid City, SD. 1,500
    YWCA Cass Clay
    3100 12th Avenue N
    Fargo,ND58102     		NONE PC Purchase a new, single stack oven. 2,000
    YWCA-Minot
    205 3rd Avenue SE
    Minot,ND58701     		NONE PC Purchase additional security cameras and secure door locks for the women's shelter. 1,000
    350org
    20 JAY ST SUITE 732
    BROOKLYN,NY11201     		NONE PC Operating Expenses 100
    ALS Association of MNNDSD
    1919 UNIVERSITY AVE W STE 175
    ST PAUL,MN55104     		NONE PC Operating Expenses 325
    Altru Health Foundation
    2501 DEMERS AVE
    GRAND FORKS,ND58201     		NONE SO I Operating Expenses 200
    Alzheimer's Association
    225 N Michigan Avenue 17th Floor
    Chicago,IL60601     		NONE PC Operating Expenses 170
    American Foundation for Suicide Prevention
    199 WATER ST 11TH FLOOR
    NEW YORK,NY10038     		NONE PC Operating Expenses 50
    American Heart Association
    6500 Technology Center Drive Suite
    Indianapolis,IN46278     		NONE PC Operating Expenses 100
    American Red Cross
    2518 Ridge Ct
    Lawrence,KS66046     		NONE PC Operating Expenses 250
    Argyle Volunteer Fire Dept
    67 FIRE DEPT AVE
    DEFUNIAK SPRINGS,FL32435     		NONE GOV Operating Expenses 50
    ASPCA
    424 E 92nd Street
    New York,ND10128     		NONE PC Operating Expenses 300
    Avera McKennan Foundation
    1325 S CLIFF AVE
    SIOUX FALLS,SD57105     		NONE PC Operating Expenses 215
    Awakening Grace Foundation
    5022 IBEX AVE
    ORANGE CITY,IA51041     		NONE PC Operating Expenses 30
    Back Pack Buddies
    1941 4th Street SW
    Minot,ND58701     		NONE PC Operating Expenses 20
    Baker University
    618 EIGHTH ST
    BALDWIN CITY,KS66006     		NONE PC Operating Expenses 950
    Ballard Center
    708 Elm Street
    Lawrence,KS66044     		NONE PC Operating Expenses 450
    Big Brothers Big Sisters of the Black Hills
    425 KANSAS CITY ST
    RAPID CITY,SD57701     		NONE PC Operating Expenses 370
    Bismarck Cancer Center
    500 N 8th St
    Bismarck,ND58501     		NONE SO I Operating Expenses 370
    Boy Scouts of America - Central MN Council
    1191 Scout Drive
    Sartell,MN56377     		NONE PC Operating Expenses 750
    Boy Scouts of America - Sioux Council
    800 WEST AVE
    SIOUX FALLS,SD57104     		NONE PC Operating Expenses 775
    Boys & Girls Club of Lawrence
    PO Box 748
    Lawrence,KS66044     		NONE PC Operating Expenses 200
    Breathe Bravely
    305 W 29th Street
    Sioux Falls,SD57105     		NONE PC Operating Expenses 500
    Butterfly House & Aquarium
    4320 S OXBOW AVE
    SIOUX FALLS,SD57106     		NONE PC Operating Expenses 800
    Central Cass Dollars for Scholars
    3600 Minnesota Drive No 700
    Minneapolis,MN55435     		NONE PC Operating Expenses 50
    Children's Home Society
    801 N Sycamore Avenu PO Box 1749
    Sioux Falls,SD57101     		NONE PC Operating Expenses 700
    Circle of Friends Humane Society
    4375 N Washington Street
    Grand Forks,ND58203     		NONE PC Operating Expenses 350
    Community Violence Intervention Center
    211 S 4th Street
    Grand Forks,ND58201     		NONE PC Operating Expenses 100
    Companions for Children
    308 2ND AVE SW 7
    MINOT,ND58701     		NONE PC Operating Expenses 50
    Cottonwood Foundation
    2801 W 31st Street
    Lawrence,KS66047     		NONE PC Operating Expenses 200
    Dakota Medical Foundation
    4141 28th Ave S
    FARGO,ND58104     		NONE PC Operating Expenses 50
    Dakota State University Foundation
    820 N Washington Avenue
    Madison,SD57042     		NONE PC Operating Expenses 500
    Dakota Zoo
    602 Riverside Park Rd
    BISMARCK,ND58504     		NONE PC Operating Expenses 500
    DakotAbilities
    1116 S 4th Avenue
    Sioux Falls,SD57105     		NONE PC Operating Expenses 500
    Douglas County Visiting Nurses Associations
    200 MAINE ST
    LAWRENCE,KS66044     		NONE PC Operating Expenses 200
    Dress for Success Sioux Falls
    300 West 11th Street
    Sioux Falls,SD57104     		NONE PC Operating Expenses 525
    Edinbrook Elementary School
    8925 Zane Ave N
    BROOKLYN PARK,MN55443     		NONE PC Operating Expenses 150
    Essentia Health Foundation
    400 E THIRD ST
    DULUTH,MN55805     		NONE PC Operating Expenses 50
    Farm Rescue
    PO Box 28
    Horace,ND58047     		NONE PC Operating Expenses 50
    Feeding South Dakota
    4701 N Westport Avenue
    Sioux Falls,SD57107     		NONE PC Operating Expenses 675
    For Belle's Sake Rescue & Rehabilitation
    PO BOX 243
    SAWYER,ND58781     		NONE PC Operating Expenses 365
    Furry Friends Rockin Rescue
    PO Box 7364
    Bismarck,ND58507     		NONE PC Operating Expenses 100
    GiGi's Playhouse Fargo
    3224 20th Street S
    Fargo,ND58104     		NONE PC Operating Expenses 100
    Girls Scout Troop 40274
    301 S 7th Avenue
    Brandon,SD57005     		NONE PC Operating Expenses 500
    Great Plains Food Bank
    1720 3rd Ave N
    FARGO,ND58102     		NONE PC Operating Expenses 50
    Happy Pig Haven Inc
    25188 468th Ave
    BALTIC,SD57003     		NONE PC Operating Expenses 250
    Harrisburg Endeavor PTO
    2401 W 95th St
    SIOUX FALLS,SD57108     		NONE PC Operating Expenses 40
    Helpline Center
    1000 N West Ave Suite 310
    SIOUX FALLS,SD57104     		NONE PC Operating Expenses 75
    History Club of Sioux Falls
    758 S Phillips Ave
    SIOUX FALLS,SD57104     		NONE PC Operating Expenses 500
    Homeward Animal Shelter
    1201 28th Avenue N
    Fargo,ND58102     		NONE PC Operating Expenses 150
    Humane Society of the Black Hills
    1820 E Saint Patrick St
    RAPID CITY,SD57703     		NONE PC Operating Expenses 150
    Junior Achievement of South Dakota
    1000 N West Avenue Suite 110
    Sioux Falls,SD57104     		NONE PC Operating Expenses 825
    Juvenile Diabetes Research Foundation
    1305 W 18th St PO Box 5039
    Sioux Falls,SD57117     		NONE PC Operating Expenses 50
    Kansas Big Brothers & Big Sisters
    2518 RIDGE COURT
    LAWRENCE,KS66046     		NONE PC Operating Expenses 250
    Lake Agassiz Habitat for Humanity
    210 11th St N
    MOORHEAD,MN56560     		NONE PC Operating Expenses 350
    Laundry With Love
    3600 Minnesota Drive No 700
    Minneapolis,MN55435     		NONE PC Operating Expenses 100
    Leukemia & Lymphoma Society
    3600 Minnesota Drive No 700
    Minneapolis,MN55435     		NONE PC Operating Expenses 450
    Lifescape
    2501 W 26TH ST
    SIOUX FALLS,SD57105     		NONE PC Operating Expenses 50
    Living Lands & Waters
    17624 Rte 84 N
    East Moline,IL61244     		NONE PC Operating Expenses 100
    Lunch is Served
    1600 E 12th Street
    Sioux Falls,SD57103     		NONE PC Operating Expenses 100
    Lutheran Social Services of South Dakota
    705 E 41ST ST STE 200
    SIOUX FALLS,SD57105     		NONE PC Operating Expenses 430
    Middlebury College
    700 Exchange St
    Middlebury,VT05753     		NONE PC Operating Expenses 200
    NAMI SD
    PO Box 88808
    Sioux Falls,SD57109     		NONE PC Operating Expenses 150
    National Parks Conservation Association
    777 6TH ST NW SUITE 700
    WASHINGTON,DC20001     		NONE PC Operating Expenses 25
    Northern State University Foundation
    620 15th Avenue SE
    Aberdeen,SD57401     		NONE PC Operating Expenses 850
    Parent Advocates for Spanish Immersion Inc
    3704 S Alpine Avenue
    Sioux Falls,SD57710     		NONE PC Operating Expenses 300
    Planned Parenthood Federation
    123 William Street 10th Floor
    New York,NY10038     		NONE PC Operating Expenses 100
    Rape and Abuse Crisis Center of Fargo
    317 8th Street N
    Fargo,ND58102     		NONE PC Operating Expenses 100
    Rebuilding Together Fargo-Moorhead Area
    700 Main Avenue Suite 10
    Fargo,ND58103     		NONE PC Operating Expenses 100
    Ronald McDonald House Charities of South Dakota
    825 S Lake Avenue
    Sioux Falls,SD57104     		NONE PC Operating Expenses 350
    Ronald McDonald House Charities-Red River Valley
    1330 18th Avenue S
    Fargo,ND58103     		NONE PC Operating Expenses 700
    Salvation Army - Sioux Falls
    1600 University Avenue
    Grand Forks,ND58203     		NONE PC Operating Expenses 150
    Salvation Army - Watertown
    1600 University Avenue
    Grand Forks,ND58203     		NONE PC Operating Expenses 100
    Sanford Health Foundation North
    520 Main Ave 700
    FARGO,ND58103     		NONE PC Operating Expenses 100
    Second Harvest Heartland
    7101 WINNETKA AVENUE N
    BROOKLYN PARK,MN55428     		NONE PC Operating Expenses 100
    Shattuck-St Mary's School
    1000 Shumway Ave
    FARIBAULT,MN55021     		NONE PC Operating Expenses 200
    Sioux Empire Brass Society
    1500 E 30th Street
    Sioux Falls,SD57105     		NONE PC Operating Expenses 200
    Sioux Empire Pit Rescue
    2704 S 2nd Avenue
    Sioux Falls,SD57105     		NONE PC Operating Expenses 500
    Sioux Falls Area Humane Society
    3720 E Benson Road
    Sioux Falls,SD57104     		NONE PC Operating Expenses 1,150
    Sioux Falls Hope Coalition
    2211 W CHERRYWOOD CIRCLE
    SIOUX FALLS,SD57108     		NONE PC Operating Expenses 250
    Souris Valley United Way
    1941 4th Street SW
    Minot,ND58701     		NONE PC Operating Expenses 240
    South Dakota Masonic Charities
    520 S 1st Ave
    SIOUX FALLS,SD57104     		NONE PC Operating Expenses 100
    South Dakota Symphony
    301 S Main Ave
    SIOUX FALLS,SD57104     		NONE PC Operating Expenses 600
    Special Olympics South Dakota
    800 E I-90 Lane
    Sioux Falls,SD57104     		NONE PC Operating Expenses 120
    St Louis Park Emergency Program
    6812 W Lake St
    Minneapolis,MN55426     		NONE PC Operating Expenses 100
    Star Legacy Foundation
    7820 Terrey Pine Ct Suite 80
    Eden Prairie,MN55347     		NONE PC Operating Expenses 100
    Stockyards Ag Experience
    200 N Cherapa Place
    Sioux Falls,SD57103     		NONE PC Operating Expenses 100
    Sun Dial Manor Foundation
    410 2nd St S
    BRISTOL,SD57219     		NONE SO I Operating Expenses 255
    Susan G Komen 3 Day
    55 E Jackson Boulevard Suite 1010
    Chicago,IL60604     		NONE PC Operating Expenses 500
    Susan G Komen Great Plains
    55 E Jackson Boulevard Suite 1010
    Chicago,IL60604     		NONE PC Operating Expenses 250
    Teach for America
    25 Broadway 12th Floor
    NEW YORK,NY10004     		NONE PC Operating Expenses 500
    Tennis & Education Inc (The Fort)
    100 FEDERAL DR
    FORT SNELLING,MN55111     		NONE PC Operating Expenses 500
    The Compass Center
    1704 S Cleveland Ave
    SIOUX FALLS,SD57103     		NONE PC Operating Expenses 50
    TNT Kid's Fitness
    2800 Main Avenue
    Fargo,ND58103     		NONE PC Operating Expenses 100
    Toy Lending Library of Sioux Falls
    401 S Spring Ave
    SIOUX FALLS,SD57104     		NONE PC Operating Expenses 50
    Tracy's Sanctuary House
    908 N 8th Street
    Bismarck,ND58501     		NONE PC Operating Expenses 50
    Tunnel2Towers
    2361 HYLAN BLVD
    STATEN ISLAND,NY10306     		NONE PC Operating Expenses 100
    Volunteers of America Dakotas
    1309 W 51st St
    SIOUX FALLS,SD57105     		NONE PC Operating Expenses 500
    Wags and Whiskers Animal Rescue of MN
    PO Box 304
    SHAKOPEE,MN55379     		NONE PC Operating Expenses 250
    Wikimedia Foundation Inc
    PO BOX 98204
    WASHINGTON,DC20090     		NONE PC Operating Expenses 21
    Woodland Elementary School Council
    W Gages Lake Rd
    GRAYSLAKE,IL60030     		NONE PC Operating Expenses 250
    World vision Foundation
    PO BOX 9716
    FEDERAL WAY,WA98063     		NONE SO I OPERATING EXPENSES 50
    JUNIOR ACHIEVEMENT OF SOUTH DAKOTA
    1000 N WEST AVENUE
    SIOUX FALLS,SD57104     		NONE PC Junior achievement Bowl-a-thon. 2,500
    Total .................................bullet 3a 238,830
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2019)
    Form 990-PF (2019)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    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 ...........     		         
    4 Dividends and interest from securities....          
    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.....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		         
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e)..      
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
     
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		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? ...........
    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.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below
    (see instr.)
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    		 Firm's EIN SmallBullet
    Firm's address SmallBullet


    		 Phone no.
    Form 990-PF (2019)
    Additional Data


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    Special Condition Description