-
TIN:
Form
990-PF
Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
Do not enter social security numbers on this form as it may be made public.
Go to
www.irs.gov/Form990PF
for instructions and the latest information.
OMB No. 1545-0052
20
19
Open to Public Inspection
For calendar year 2019, or tax year beginning
01-01-2019
, and ending
12-31-2019
Name of foundation
ZITRIN FOUNDATION
C/O BREGANTE COMPANY LLP
Number and street (or P.O. box number if mail is not delivered to street address)
301 BATTERY STREET 2 MEZZANINE
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SAN FRANCISCO
,
CA
94111
A Employer identification number
26-4650967
B
Telephone number (see instructions)
(415) 824-5974
C
If exemption application is pending, check here
G
Check all that apply:
Initial return
Initial return of a former public charity
Final return
Amended return
Address change
Name change
D 1.
Foreign organizations, check here.............
2
. Foreign organizations meeting the 85%
test, check here and attach computation ...
E
If private foundation status was terminated
under section 507(b)(1)(A), check here .......
H
Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here .......
I
Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)
$
9,903,245
J
Accounting method:
Cash
Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)
Part I
Analysis of Revenue and Expenses
(The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).)
(a)
Revenue and
expenses per
books
(b)
Net investment
income
(c)
Adjusted net
income
(d)
Disbursements
for charitable
purposes
(cash basis only)
1
Contributions, gifts, grants, etc., received (attach schedule)
286,006
2
Check
.............
3
Interest on savings and temporary cash investments
673
673
4
Dividends and interest from securities
...
16,592
16,592
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
1,171,585
b
Gross sales price for all assets on line 6a
2,533,055
7
Capital gain net income (from Part IV, line 2)
...
1,171,585
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
........
1,474,856
1,188,850
13
Compensation of officers, directors, trustees, etc.
0
0
0
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
37,145
37,145
0
c
Other professional fees (attach schedule)
....
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
14,110
2,380
0
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
41,405
41,405
0
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
6,921
843
0
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
99,581
81,773
0
25
Contributions, gifts, grants paid
.......
321,262
321,262
26
Total expenses and disbursements.
Add lines 24 and 25
420,843
81,773
321,262
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
1,054,013
b
Net investment income
(if negative, enter -0-)
1,107,077
c
Adjusted net income
(if negative, enter -0-)
...
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2019)
Form 990-PF (2019)
Page
2
Part II
Balance Sheets
Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year
End of year
(a)
Book Value
(b)
Book Value
(c)
Fair Market Value
1
Cash—non-interest-bearing
.............
2
Savings and temporary cash investments
.........
121,460
240,772
240,772
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
39,615
0
0
8
Inventories for sale or use
..............
9
Prepaid expenses and deferred charges
..........
746
13,809
13,809
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
.......
4,378,880
5,349,737
9,648,664
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)
..........
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
4,854
0
0
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
4,545,555
5,604,318
9,903,245
17
Accounts payable and accrued expenses
..........
720
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
720
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
25
Net assets with donor restrictions
............
Foundations that do not follow FASB ASC 958, check here
and complete lines 26 through 30.
26
Capital stock, trust principal, or current funds
........
3,825,389
3,825,389
27
Paid-in or capital surplus, or land, bldg., and equipment fund
0
0
28
Retained earnings, accumulated income, endowment, or other funds
720,166
1,778,209
29
Total net assets or fund balances
(see instructions)
.....
4,545,555
5,603,598
30
Total liabilities and net assets/fund balances
(see instructions)
.
4,545,555
5,604,318
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
4,545,555
2
Enter amount from Part I, line 27a
.....................
2
1,054,013
3
Other increases not included in line 2 (itemize)
3
4,030
4
Add lines 1, 2, and 3
..........................
4
5,603,598
5
Decreases not included in line 2 (itemize)
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
5,603,598
Form
990-PF
(2019)
Form 990-PF (2019)
Page
3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a)
List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)
(b)
How acquired
P—Purchase
D—Donation
(c)
Date acquired
(mo., day, yr.)
(d)
Date sold
(mo., day, yr.)
1 a
1360 SHS ACTIVISION BLIZZARD INC
P
2017-02-15
2019-03-04
b
637 SHS ADOBE INC
P
2017-09-08
2019-03-18
c
115 SHS AUDENTES THERAPEUTICS INC
D
2019-09-11
2019-12-24
d
7 SHS AMAZON.COM INC
P
2008-12-31
2019-05-03
e
35 SHS AMAZON.COM INC
P
2008-12-31
2019-05-03
6 SHS AMAZON.COM INC
P
2008-12-31
2019-12-12
23 SHS AMAZON.COM INC
P
2009-05-27
2019-12-12
9 SHS AMAZON.COM INC
D
2019-09-11
2019-12-12
777 SHS AUTODESK INC
P
2017-05-26
2019-09-09
720 SHS CHEGG INC
P
2017-08-08
2019-08-30
8428 SHS EROS INTERNATIONAL
P
2017-05-17
2019-04-01
1461 SHS ETSY INC
P
2018-06-08
2019-02-06
711 SHS ETSY INC
P
2018-06-08
2019-08-05
407 SHS EXACT SCIENCES CORP
P
2012-12-21
2019-06-03
252 SHS EXACT SCIENCES CORP
P
2012-12-21
2019-10-18
127 SHS EXACT SCIENCES CORP
D
2019-09-11
2019-10-18
397 SHS FACEBOOK INC
P
2013-01-28
2019-05-14
354 SHS FACEBOOK INC
P
2013-01-28
2019-05-20
43 SHS FACEBOOK INC
P
2013-09-16
2019-05-20
298 SHS FACEBOOK INC
P
2013-09-16
2019-06-03
6142 SHS FLEXION THERAPEUTICS INC
P
2016-02-17
2019-02-05
2128 SHS FLEXION THERAPEUTICS INC
P
2016-11-21
2019-02-05
3097 SHS IMPINJ INC
P
2016-11-16
2019-01-28
2464 SHS JD.COM INC
P
2017-07-10
2019-05-28
813 SHS JD.COM INC
P
2017-09-15
2019-05-28
1340 SHS JD.COM INC
P
2018-08-23
2019-05-28
334 SHS NETFLIX COM INC
P
2012-01-10
2019-02-20
301 SHS NETFLIX COM INC
P
2012-01-10
2019-04-05
271 SHS NETFLIX COM INC
P
2012-01-10
2019-06-03
244 SHS NETFLIX COM INC
P
2012-01-10
2019-06-27
153 SHS NETFLIX COM INC
P
2012-01-10
2019-09-18
73 SHS NETFLIX COM INC
D
2019-09-11
2019-09-18
759 SHS RINGCENTRAL INC
P
2016-04-29
2019-04-18
1380 SHS RINGCENTRAL INC
P
2016-04-29
2019-09-18
731 SHS RINGCENTRAL INC
P
2016-04-29
2019-10-30
399 SHS ROKU INC
P
2018-07-27
2019-10-31
538 SHS ROKU INC
P
2018-07-27
2019-12-24
199 SHS ROKU INC
D
2019-09-11
2019-10-31
304 SHS TELADOC HEALTH INC
P
2017-08-11
2019-10-21
148 SHS TELADOC HEALTH INC
D
2019-09-11
2019-10-21
3684 SHS TWITTER INC
P
2018-12-17
2019-10-30
0.5 SH UBER TECHNOLOGIES INC - CASH IN LIEU
D
2019-09-11
2019-09-27
56 SHS UBER TECHNOLOGIES INC
D
2019-09-11
2019-09-27
2284 SHS 2U INC
P
2015-08-27
2019-12-31
2386 SHS 2U INC
P
2015-12-03
2019-12-31
137 SHS 2U INC
D
2019-09-11
2019-01-23
(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
56,353
63,373
-7,020
b
167,192
99,439
67,753
c
6,714
3,705
3,009
d
13,402
365
13,037
e
67,008
1,824
65,184
10,296
313
9,983
39,469
1,778
37,691
15,444
16,407
-963
113,695
89,218
24,477
28,243
9,720
18,523
75,780
92,102
-16,322
79,180
49,029
30,151
47,219
23,860
23,359
40,266
4,399
35,867
24,420
2,724
21,696
12,307
13,792
-1,485
73,684
12,875
60,809
65,332
11,480
53,852
7,936
1,955
5,981
53,760
13,546
40,214
82,771
78,220
4,551
28,677
38,304
-9,627
46,118
95,916
-49,798
66,523
98,976
-32,453
21,949
36,887
-14,938
36,177
44,644
-8,467
118,127
2,218
115,909
110,918
1,999
108,919
94,373
1,800
92,573
87,500
1,620
85,880
44,380
1,016
43,364
21,175
21,044
131
79,804
14,094
65,710
172,934
25,625
147,309
115,860
13,574
102,286
58,635
19,498
39,137
72,880
26,291
46,589
29,244
29,802
-558
20,909
10,039
10,870
10,179
10,075
104
109,391
133,606
-24,215
16
17
-1
1,725
1,904
-179
49,933
80,752
-30,819
52,162
58,985
-6,823
2,995
2,660
335
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
-7,020
b
67,753
c
3,009
d
13,037
e
65,184
9,983
37,691
-963
24,477
18,523
-16,322
30,151
23,359
35,867
21,696
-1,485
60,809
53,852
5,981
40,214
4,551
-9,627
-49,798
-32,453
-14,938
-8,467
115,909
108,919
92,573
85,880
43,364
131
65,710
147,309
102,286
39,137
46,589
-558
10,870
104
-24,215
-1
-179
-30,819
-6,823
335
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
1,171,585
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
335,614
8,105,937
0.041403
2017
335,535
6,626,280
0.050637
2016
378,076
5,460,101
0.069243
2015
240,237
6,676,361
0.035983
2014
281,101
6,738,522
0.041716
2
Total
of line 1, column (d)
.....................
2
0.238982
3
Average distribution ratio for the 5-year base period—divide the total on line 2 by 5.0, or by the number of years the foundation has been in existence if less than 5 years
......
3
0.047796
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
8,976,398
5
Multiply line 4 by line 3
......................
5
429,036
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
11,071
7
Add lines 5 and 6
........................
7
440,107
8
Enter qualifying distributions from Part XII, line 4
,.............
8
321,262
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See the Part VI instructions.
Form
990-PF
(2019)
Form 990-PF (2019)
Page
4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a
Exempt operating foundations described in section 4940(d)(2), check here
and enter “N/A" on line 1.
Date of ruling or determination letter:
(attach copy of letter if necessary–see instructions)
b
Domestic foundations that meet the section 4940(e) requirements in Part V, check
1
22,142
here
and enter 1% of Part I, line 27b
...................
c
All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
2
0
3
Add lines 1 and 2
...........................
3
22,142
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
22,142
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
13,809
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
30,000
d
Backup withholding erroneously withheld
...........
6d
0
7
Total credits and payments. Add lines 6a through 6d
..............
7
43,809
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
0
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
21,667
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
21,667
Refunded
11
0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition)
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
0
(2)
On foundation managers.
$
0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
Yes
7
Did the foundation have at least $5,000 in assets at any time during the year?
If "Yes," complete Part II, col. (c),
and Part XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
NV
,
CA
b
If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G?
If "No," attach explanation
.
8b
Yes
9
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
or 4942(j)(5) for calendar year 2019 or the taxable year beginning in 2019? See the instructions for Part XIV.
If "Yes," complete Part XIV
.............................
9
No
10
Did any persons become substantial contributors during the tax year?
If "Yes," attach a schedule listing their names
and addresses.
...............................
10
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
5
Part VII-A
Statements Regarding Activities
(continued)
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions
.............
11
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement. See instructions
.................
12
No
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
N/A
14
The books are in care of
ELIZABETH ZITRIN
Telephone no.
(415) 824-5974
Located at
C/O 301 BATTERY STREET 2 MEZZANINE
SAN FRANCISCO
CA
ZIP+4
94111
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1)
Engage in the sale or exchange, or leasing of property with a disqualified person?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(5)
Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)?
...............
Yes
No
(6)
Agree to pay money or property to a government official? (
Exception.
Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.)
.......
Yes
No
b
If any answer is "Yes" to 1a(1)–(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions
........
1b
Organizations relying on a current notice regarding disaster assistance check here
........
c
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2019?
.............
1c
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2019, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2019?
.............
Yes
No
If "Yes," list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer "No" and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
......................
Yes
No
b
If "Yes," did it have excess business holdings in 2019 as a result of
(1)
any purchase by the foundation
or disqualified persons after May 26, 1969;
(2)
the lapse of the 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or
(3)
the lapse of the 10-, 15-, or 20-year first phase holding period?
(Use Schedule C, Form 4720, to determine
if the foundation had excess business holdings in 2019.)
..................
3b
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2019?
4b
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
6
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
(continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
No
b
If any answer is "Yes" to 5a(1)–(5), did
any
of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions
......
5b
Organizations relying on a current notice regarding disaster assistance check here
.........
c
If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant?
..........
Yes
No
If "Yes," attach the statement required by Regulations section 53.4945–5(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract?
.....................
Yes
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
....
6b
No
If "Yes" to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
Yes
No
b
If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction?
....
7b
8
Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment during the year?
.................
Yes
No
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1
List all officers, directors, trustees, foundation managers and their compensation. See instructions
(a)
Name and address
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(If not paid, enter
-0-)
(d)
Contributions to employee benefit plans and deferred compensation
(e)
Expense account,
other allowances
ELIZABETH ZITRIN
PRESIDENT
1.00
0
0
0
34 HILL STREET
SAN FRANCISCO
,
CA
941102313
2
Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a)
Name and address of each employee paid more than $50,000
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
NONE
Total
number of other employees paid over $50,000
...................
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
7
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
(continued)
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
NONE
Total
number of others receiving over $50,000 for professional services
.............
0
Part IX-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
NONE
0
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
NONE
0
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
8
Part X
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations, see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities
...................
1a
8,798,359
b
Average of monthly cash balances
.......................
1b
300,926
c
Fair market value of all other assets (see instructions)
................
1c
13,809
d
Total
(add lines 1a, b, and c)
.........................
1d
9,113,094
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation)
.............
1e
0
2
Acquisition indebtedness applicable to line 1 assets
..................
2
0
3
Subtract line 2 from line 1d
.........................
3
9,113,094
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
136,696
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
8,976,398
6
Minimum investment return.
Enter 5% of line 5
..................
6
448,820
Part XI
Distributable Amount
(see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here
and do not complete this part.)
1
Minimum investment return from Part X, line 6
....................
1
448,820
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
22,142
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
22,142
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
426,678
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
426,678
6
Deduction from distributable amount (see instructions)
.................
6
0
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1
...
7
426,678
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
321,262
b
Program-related investments—total from Part IX-B
..................
1b
0
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
b
Cash distribution test (attach the required schedule)
.................
3b
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
321,262
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
321,262
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
426,678
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
271,531
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
b
From 2015
......
c
From 2016
......
d
From 2017
......
e
From 2018
......
f
Total
of lines 3a through e
........
0
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
321,262
a
Applied to 2018, but not more than line 2a
271,531
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
.....
49,731
e
Remaining amount distributed out of corpus
0
5
Excess distributions carryover applied to 2019.
0
0
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
0
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
0
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
0
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
0
e
Undistributed income for 2018. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
0
f
Undistributed income for 2019. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2020
..........
376,947
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions)
.......
0
8
Excess distributions carryover from 2014 not
applied on line 5 or line 7 (see instructions)
...
0
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
0
10
Analysis of line 9:
a
Excess from 2015
....
b
Excess from 2016
....
c
Excess from 2017
....
d
Excess from 2018
....
e
Excess from 2019
....
Form
990-PF
(2019)
Form 990-PF (2019)
Page
10
Part XIV
Private Operating Foundations
(see instructions and Part VII-A, question 9)
1a
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2019, enter the date of the ruling
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2019
(b)
2018
(c)
2017
(d)
2016
b
85% of line 2a
.........
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed
...
c
“Support" alternative test—enter:
(1)
Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
....
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
(3)
Largest amount of support
from an exempt organization
(4)
Gross investment income
Part XV
Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
ELIZABETH ZITRIN
C/O 301 BATTERY STREET 2 MEZZANINE
SAN FRANCISCO
,
CA
94111
(415) 824-5974
b
The form in which applications should be submitted and information and materials they should include:
NO PRESCRIBED APPLICATION FORM. LETTER FROM THE REQUESTING ORGANIZATION OR INDIVIDUAL STATING THE TAX STATUS OF THE APPLICANT AND THE AMOUNT AND PURPOSE FOR WHICH FUNDS ARE BEING REQUESTED.
c
Any submission deadlines:
NONE
d
Any 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)
a
Paid during the year
ACLU FOUNDATION OF NORTHERN CA 94-0279770
39 DRUMM STREET
SAN FRANCISCO
,
CA
94111
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS AND SERVICES
10,000
AMERICAN CONSTITUTION SOCIETY FOR LAW AND POLICY 52-2313694
1333 H STREET NW 11TH FLOOR
WASHINGTON
,
DC
20005
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS AND SERVICES
1,000
CITY ARTS & LECTURES INC 94-2788795
1955 SUTTER STREET
SAN FRANCISCO
,
CA
94115
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS AND SERVICES
5,000
COMMONWEALTH CLUB OF CALIFORNIA 94-0399260
555 POST STREET
SAN FRANCISCO
,
CA
94102
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS AND SERVICES
2,500
DEATH PENALTY INFORMATION CENTER 36-4056815
1015 18TH STREET NW SUITE 704
WASHINGTON
,
DC
20036
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS AND SERVICES
10,000
EQUAL JUSTICE INITIATIVE (EJI) 63-1135091
122 COMMERCE STREET
MONTGOMERY
,
AL
36104
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS AND SERVICES
10,000
FLORENCE IMMIGRANT & REFUGEE RIGHTS PROJECT 86-0658103
PO BOX 654
FLORENCE
,
AZ
85132
NONE
501(C)3
PROVIDING FREE LEGAL & SOCIAL SERVICES TO DETAINED IMMIGRANTS IN ARIZONA
5,000
GIFFORDS LAW CENTER TO PREVENT GUN VIOLENCE 46-4638549
268 BUSH STREET 555
SAN FRANCISCO
,
CA
94104
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS AND SERVICES
23,200
JEWISH FAMILY & COMMUNITY SERVICES EAST BAY 94-3250304
2484 SHATTUCK AVE SUITE 210
BERKELEY
,
CA
94704
NONE
501(C)3
PROVIDING SUPPORT TO THE REFUGEES WELCOME FUND
10,000
LAWYERS FOR GOOD GOVERNMENT FOUNDATION INC (L4GG) 81-4543775
10685B HAZELHURST DRIVE SUITE 19646
HOUSTON
,
TX
77043
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS AND SERVICES
15,000
LEGAL SERVICES FOR CHILDREN 51-0169463
1254 MARKET STREET 3RD FLOOR
SAN FRANCISCO
,
CA
94102
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS AND SERVICES
10,000
MOTHER JONES MAGAZINE BY FOUNDATION FOR NATIONAL PROGRESS 94-2282759
222 SUTTER STREET SUITE 600
SAN FRANCISCO
,
CA
94108
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS AND SERVICES
500
PRESIDENT-BOARD OF TRUSTEES SANTA CLARA COLLEGE (NCIP) 94-1156617
500 EL CAMINO REAL
SANTA CLARA
,
CA
95053
NONE
501(C)3
PROVIDING SUPPORT FOR THE NORTHERN CALIFORNIA INNOCENCE PROJECT AND SANTA CLARA LAW
9,750
PROJECT ON GOVERNMENT OVERSIGHT INC (POGO) 52-1739443
1100 G STREET NW SUITE 500
WASHINGTON
,
DC
20005
NONE
501(C)3
PROVIDING SUPPORT FOR THE CONSTITUTION PROJECT AT POGO'S CONSTITUTION DAY EVENT
5,000
REFUGEE & IMMIGRANT CENTER FOR EDUCATION & LEGAL SERVICES-RAICES 74-2436920
2800 IH-35 SOUTH SUITE 215
AUSTIN
,
TX
78704
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS AND SERVICES
5,000
GLOBAL CONSERVATION FORCE 47-4499248
PO BOX 956
OCEANSIDE
,
CA
92049
NONE
501(C)3
PROVIDING SUPPORT FOR THE GLOBAL CONSERVATION FORCE - NKOMBE RHINO
33,000
SAN FRANCISCO PUBLIC PRESS MISSION LOCAL 27-1275141
44 PAGE STREET SUITE 504
SAN FRANCISCO
,
CA
94102
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS AND SERVICES
10,000
CARINGBRIDGE 42-1529394
2750 BLUE WATER ROAD SUITE 275
EAGAN
,
MN
55121
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS AND SERVICES
100
SOUTHERN CENTER FOR HUMAN RIGHTS 62-1025326
83 POPLAR STREET NW
ATLANTA
,
GA
30303
NONE
501(C)3
SUPPORT THE CONSTITUTIONAL & HUMAN RIGHTS OF THE POORS
34,000
STEWARDS OF THE COAST AND REDWOODS 94-3039895
PO BOX 2
DUNCANS MILLS
,
CA
95430
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS AND SERVICES
1,000
THE MARSH A BREEDING GROUND FOR NEW PERFORMANCE 94-3142152
1062 VALENCIA STREET
SAN FRANCISCO
,
CA
94110
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS AND SERVICES
5,000
VARIOUS ORGANIZED CHARITABLE DONATIONS UNDER 250
VARIOUS ORGANIZED CHARITABLE
DONATIONS
SAN FRANCISCO
,
CA
94111
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS AND SERVICES
300
WIKIMEDIA FOUNDATION 20-0049703
1 MONTGOMERY STREET SUITE 1600
SAN FRANCISCO
,
CA
94104
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS AND SERVICES
50
WITNESS TO INNOCENCE 20-2394229
1501 CHERRY STREET
PHILADELPHIA
,
PA
19102
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS AND SERVICES
55,100
CALIFORNIA FILM INSTITUTE 94-2498062
1001 LOOTENS PLACE SUITE 220
SAN RAFAEL
,
CA
94901
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS AND SERVICES
1,300
CALIFORNIA INNOCENCE PROJECT 95-2944594
225 CEDAR STREET
SAN DIEGO
,
CA
92101
NONE
501(C)3
GENERAL SUPPORT OF PROGRMAS AND SERVICES
1,000
CENTER FOR DEATH PENALTY LITIGATION 56-1939274
123 WEST MAIN STREET SUITE 700
DURHAM
,
NC
27701
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS & SERVICES
5,000
THE CENTER FOR INVESTIGATIVE REPORTING 94-2434026
1400 65TH STREET SUITE 200
EMERYVILLE
,
CA
94608
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS & SERVICES
1,000
CENTER FOR INDEPENDENT DOCUMENTARY 04-2738458
1300 SOLDIERS FIELD ROAD SUITE 5
BOSTON
,
MA
02135
NONE
501(C)3
GIFT FOR THE DOCUMENTARY CRIP CAMP
25,000
DOCTORS WITHOUT BORDERS 13-3433452
40 RECTOR STREET 16TH FLOOR
NEW YORK
,
NY
10006
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS & SERVICES
1,000
DOGWOOD ANIMAL RESCUE 81-1178819
1415 FULTON ROAD SUITE 205
SANTA ROSA
,
CA
95403
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS & SERVICES
500
EQUAL RIGHTS ADVOCATES 23-7217027
1170 MARKET STREET SUITE 700
SAN FRANCISCO
,
CA
94102
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS & SERVICES
512
INJUSTICE WATCH 47-4537172
55 E JACKSON BLVD SUITE 640
CHICAGO
,
IL
60604
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS & SERVICES
100
INTERNATIONAL RESCUE COMMITTE 13-5660870
122 EAST 42ND STREET
NEW YORK
,
NY
10168
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS & SERVICES
1,000
KIVA 71-0992446
875 HOWARD STREET SUITE 340
SAN FRANCISCO
,
CA
94103
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS & SERVICES
200
INNOCENCE PROJECT INC 32-0077563
40 WORTH STREET SUITE 701
NEW YORK
,
NY
10013
NONE
501(C)3
GIFT FOR THE KOREY WISE INNOCENCE PROJECT
10,000
MIDWEST INNOCENCE PROJECT (MIP) 43-1914499
3619 BROADWAY BLVD SUITE 2
KANSAS CITY
,
MO
64111
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS & SERVICES
100
NATIONAL ASSOCIATION OF THE BAHAMAS 65-0525850
11260 SW 138TH STREET
MIAMI
,
FL
33176
NONE
501(C)3
GENERAL SUPPORT OF EMERGENCY ASSISTANCE
500
NEW VISION SANTA ROSA FOUNDATION 68-0074807
50 OLD COURTHOUSE SQUARE SUITE 110
SANTA ROSA
,
CA
95404
NONE
501(C)3
SUPPORTING THE NEW VISION FOUNDATION'S SMALL BUSINESS FLOOD RELIEF FUND
500
PENNSYLVANIANS FOR ALTERNATIVES TO THE DEATH PENALTY (PADP) 23-2890982
PO BOX 21373
YORK
,
PA
17402
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS & SERVICES
100
PASO DEL NORTE COMMUNITY FOUNDATION 46-1997449
221 N KANSAS STREET SUITE 1900
EL PASO
,
TX
79901
NONE
501(C)3
SUPPORTING THE EL PASO VICTIMS RELIEF FUND
500
INNOCENCE PROJECT INC 32-0077563
40 WORTH STREET SUITE 701
NEW YORK
,
NY
10013
NONE
501(C)3
GIFT FOR THE INNOCENCE PROJECT IN HONOR OF MADDY DELONE
5,000
UNIVERSITY OF COLORADO FOUNDATION 84-6049811
1800 N GRANT STREET SUITE 725
DENVER
,
CO
80203
NONE
501(C)3
GIFT FOR THE CAPITAL VOIR TRAINING FUND AT THE UNIVERSITY OF COLORADO BOULDER LAW SCHOOL
5,000
SOCIAL GOOD FUND - WOMEN'S MARCH BAY AREA 46-1323531
12651 SAN PABLO AVE 5473
RICHMOND
,
CA
94805
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS & SERVICES
250
YELLOWHAMMER FUND 82-1822204
PO BOX 1565
TUSCALOOSA
,
AL
35403
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS & SERVICES
1,000
ALZHEIMER'S DISEASE AND RELATED DISORDERS ASSOCIATION 13-3039601
225 NORTH MICHIGAN AVENUE SUITE
1700
CHICAGO
,
IL
60601
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS & SERVICES
200
CENTRAL AMERICAN RESOURCE CENTER (CARECEN SF) 94-3036508
3101 MISSION STREET SUITE 101
SAN FRANCISCO
,
CA
94110
NONE
501(C)3
GENERAL SUPPORT OF PROGRAMS & SERVICES
1,000
Total
.................................
3a
321,262
b
Approved for future payment
Total
.................................
3b
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
12
Part XVI-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
Unrelated business income
Excluded by section 512, 513, or 514
(e)
Related or exempt
function income
(See instructions.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
14
673
4
Dividends and interest from securities
....
14
16,592
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not debt-financed property
.....
6
Net rental income or (loss) from personal property
7
Other investment income
.....
8
Gain or (loss) from sales of assets other than
inventory
............
18
1,171,585
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
0
1,188,850
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
1,188,850
(See worksheet in line 13 instructions to verify calculations.)
Part XVI-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
instructions.)
Form
990-PF
(2019)
Form 990-PF (2019)
Page
13
Part XVII
Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
1
Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
Yes
No
a
Transfers from the reporting foundation to a noncharitable exempt organization of:
(1)
Cash
...................................
1a(1)
No
(2)
Other assets
.................................
1a(2)
No
b
Other transactions:
(1)
Sales of assets to a noncharitable exempt organization
....................
1b(1)
No
(2)
Purchases of assets from a noncharitable exempt organization
..................
1b(2)
No
(3)
Rental of facilities, equipment, or other assets
.......................
1b(3)
No
(4)
Reimbursement arrangements
...........................
1b(4)
No
(5)
Loans or loan guarantees
.............................
1b(5)
No
(6)
Performance of services or membership or fundraising solicitations
................
1b(6)
No
c
Sharing of facilities, equipment, mailing lists, other assets, or paid employees
..............
1c
No
d
If the answer to any of the above is "Yes," complete the following schedule. Column
(b)
should always show the fair market value
of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
in any transaction or sharing arrangement, show in column
(d)
the value of the goods, other assets, or services received.
(a)
Line No.
(b)
Amount involved
(c)
Name of noncharitable exempt organization
(d)
Description of transfers, transactions, and sharing arrangements
2a
Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
described in section 501(c) (other than section 501(c)(3)) or in section 527?
...........
Yes
No
b
If "Yes," complete the following schedule.
(a)
Name of organization
(b)
Type of organization
(c)
Description of relationship
Sign Here
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
May the IRS discuss this return
with the preparer shown below
(see instr.)
Yes
No
Signature of officer or trustee
Date
Title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's Signature
Date
Check if self-
employed
PTIN
Firm's name
Firm's EIN
Firm's address
Phone no.
Form
990-PF
(2019)
Additional Data
Software ID:
Software Version:
Form 990PF - Special Condition Description:
Special Condition Description