-
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
10-01-2019
, and ending
09-30-2020
Name of foundation
FERN C HILL CHARITABLE TRUST IN MEMORY OF N
Number and street (or P.O. box number if mail is not delivered to street address)
10 S DEARBORN IL1-0111
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CHICAGO
,
IL
60603
A Employer identification number
43-6902153
B
Telephone number (see instructions)
(800) 496-2583
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)
$
3,611,155
J
Accounting method:
Cash
Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)
Part I
Analysis of Revenue and Expenses
(The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).)
(a)
Revenue and
expenses per
books
(b)
Net investment
income
(c)
Adjusted net
income
(d)
Disbursements
for charitable
purposes
(cash basis only)
1
Contributions, gifts, grants, etc., received (attach schedule)
2
Check
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
83,622
83,622
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
123,096
b
Gross sales price for all assets on line 6a
841,008
7
Capital gain net income (from Part IV, line 2)
...
123,096
8
Net short-term capital gain
.........
0
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
........
206,718
206,718
13
Compensation of officers, directors, trustees, etc.
45,440
27,947
17,493
14
Other employee salaries and wages
......
0
0
0
15
Pension plans, employee benefits
.......
0
0
16a
Legal fees (attach schedule)
.........
0
b
Accounting fees (attach schedule)
.......
c
Other professional fees (attach schedule)
....
0
17
Interest
...............
0
18
Taxes (attach schedule) (see instructions)
...
1,678
834
0
19
Depreciation (attach schedule) and depletion
...
0
0
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
0
0
22
Printing and publications
..........
0
0
23
Other expenses (attach schedule)
.......
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
47,118
28,781
0
17,493
25
Contributions, gifts, grants paid
.......
146,841
146,841
26
Total expenses and disbursements.
Add lines 24 and 25
193,959
28,781
0
164,334
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
12,759
b
Net investment income
(if negative, enter -0-)
177,937
c
Adjusted net income
(if negative, enter -0-)
...
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
.............
26,695
14,084
14,084
2
Savings and temporary cash investments
.........
28,625
26,944
26,944
3
Accounts receivable
Less: allowance for doubtful accounts
0
0
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
0
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)
.......
1,623,336
1,485,125
1,924,424
c
Investments—corporate bonds (attach schedule)
.......
1,233,736
1,394,749
1,482,257
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
162,619
166,751
163,446
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
3,075,011
3,087,653
3,611,155
17
Accounts payable and accrued expenses
..........
18
Grants payable
.................
19
Deferred revenue
.................
20
Loans from officers, directors, trustees, and other disqualified persons
21
Mortgages and other notes payable (attach schedule)
......
22
Other liabilities (describe
)
23
Total liabilities
(add lines 17 through 22)
.........
0
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
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
........
3,075,011
3,087,653
27
Paid-in or capital surplus, or land, bldg., and equipment fund
28
Retained earnings, accumulated income, endowment, or other funds
29
Total net assets or fund balances
(see instructions)
.....
3,075,011
3,087,653
30
Total liabilities and net assets/fund balances
(see instructions)
.
3,075,011
3,087,653
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
3,075,011
2
Enter amount from Part I, line 27a
.....................
2
12,759
3
Other increases not included in line 2 (itemize)
3
33
4
Add lines 1, 2, and 3
..........................
4
3,087,803
5
Decreases not included in line 2 (itemize)
5
150
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
3,087,653
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
31. DISNEY WALT CO
2016-12-05
2019-10-25
b
8. ACCENTURE PLC
2014-04-03
2019-10-25
c
10. ACCENTURE PLC
2014-04-03
2019-10-28
d
884.564 JPM GL RES ENH IDX FD - USD - R6 ISIN US48129C2070
2015-01-05
2019-11-08
e
20. NISOURCE INC
2014-01-15
2019-11-11
26. NISOURCE INC
2015-01-14
2019-11-11
21. NISOURCE INC
2015-03-17
2019-11-12
54. NISOURCE INC
2015-12-02
2019-11-12
5. NISOURCE INC
2015-12-03
2019-11-12
5. NISOURCE INC
2015-12-03
2019-11-13
10000. U S A NOTES
2010-02-05
2019-11-15
28. CELGENE CORP.
2015-08-11
2019-11-21
95. CELGENE CORP.
2019-03-14
2019-11-21
135. SPDR TR UNIT SER 1
2014-10-10
2019-11-21
47. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-25
5. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-25
2. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-25
3733.262 EV GLBL MACR ABS RTRN-R6
2013-03-26
2019-11-25
59. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-26
10. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-27
9. ABBVIE INC
2019-09-16
2019-12-10
2. ADOBE SYS INC
2012-11-05
2019-12-10
2. ALEXION PHARMACEUTICALS INC
2019-03-14
2019-12-10
2. ALPHABET INC-CL C
2013-04-16
2019-12-10
1. ALPHABET INC-CL A
2013-05-22
2019-12-10
2. AMAZON COM INC
2015-03-12
2019-12-10
7. AMERICAN EXPRESS CO
2018-07-18
2019-12-10
9. APPLE COMPUTER INC
2010-06-17
2019-12-10
3. AUTOMATIC DATA PROCESSING INC
2018-10-22
2019-12-10
33. BANK OF AMERICA CORPORATION
2013-04-18
2019-12-10
4. BERKSHIRE HATHAWAY INC DEL CL B
2017-04-20
2019-12-10
18. BOSTON SCIENTIFIC CORP
2016-09-15
2019-12-10
10. BRISTOL MYERS SQUIBB CO
2019-11-21
2019-12-10
4. BROADCOM INC
2013-05-31
2019-12-10
2. CHARTER COMMUNICATIONS INC-A
2016-02-09
2019-12-10
13. CITIGROUP INC NEW
2013-04-16
2019-12-10
9. COCA-COLA CO
2018-04-13
2019-12-10
25. COMCAST CORP NEW CL A
2018-01-11
2019-12-10
11. CORTEVA INC
2016-08-10
2019-12-10
3. DIAMONDBACK ENERGY INC
2017-05-15
2019-12-10
5. DISNEY WALT CO
2016-12-16
2019-12-10
6. DUPONT DE NEMOURS INC-WI
2016-08-10
2019-12-10
8. EOG RESOURCES INC
2016-05-20
2019-12-10
6. ELECTRONIC ARTS
2018-09-20
2019-12-10
4. FACEBOOK INC-A
2015-04-27
2019-12-10
7. FIDELITY NATL INFORMATION SVCS INC
2014-12-19
2019-12-10
11. FISERV INC
2019-01-24
2019-12-10
3. GENERAL DYNAMICS CORP
2016-08-19
2019-12-10
4. HOME DEPOT INC
2012-03-20
2019-12-10
7. HONEYWELL INTL INC
2010-10-22
2019-12-10
3. INTERCONTINENTALEXCHANGE GROUP, INC
2017-01-31
2019-12-10
25. KEYCORP NEW
2016-03-01
2019-12-10
5. LILLY ELI & CO
2015-07-08
2019-12-10
5. LOWES COS INC
2011-09-28
2019-12-10
13. MARATHON PETROLEUM CORPORATION
2018-03-09
2019-12-10
4. MASTERCARD INC - CLASS A
2009-05-05
2019-12-10
1. MASTERCARD INC - CLASS A
2012-10-15
2019-12-10
2. MCDONALDS CORP
2019-06-10
2019-12-10
10. MERCK & CO INC
2016-08-05
2019-12-10
23. MICROSOFT CORP
2012-07-06
2019-12-10
4. MONDELEZ INTERNATIONAL-W/I
2011-09-19
2019-12-10
8. MONDELEZ INTERNATIONAL-W/I
2012-10-15
2019-12-10
21. MORGAN STANLEY DEAN WITTER & CO NEW
2013-04-19
2019-12-10
1. NETFLIX.COM INC
2018-09-13
2019-12-10
3. NEXTERA ENERGY INC
2016-10-18
2019-12-10
4. NORFOLK SOUTHN CORP
2017-11-21
2019-12-10
2. NORTHROP GRUMMAN CORP
2016-09-16
2019-12-10
3. NVIDIA CORP
2017-10-03
2019-12-10
1. O'REILLY AUTOMOTIVE INC
2017-05-04
2019-12-10
7. PAYPAL HOLDINGS INC
2018-01-26
2019-12-10
7. PEPSICO INC
2014-10-13
2019-12-10
25. PFIZER INC
2015-07-27
2019-12-10
3. PHILIP MORRIS INTERNATIONAL
2018-10-24
2019-12-10
3. PIONEER NAT RES CO
2015-12-10
2019-12-10
6. PROCTER & GAMBLE CO
2019-06-05
2019-12-10
3. QUALCOMM INC
2019-05-01
2019-12-10
4. ROSS STORES INC
2018-12-11
2019-12-10
6. SALESFORCE.COM INC
2018-04-13
2019-12-10
4. STANLEY BLACK & DECKER,INC.
2015-12-02
2019-12-10
8. TEXAS INSTRS INC
2016-03-10
2019-12-10
5. UNION PAC CORP
2015-10-08
2019-12-10
3. UNITED TECHNOLOGIES CORP
2017-12-06
2019-12-10
7. UNITEDHEALTH GROUP INC
2013-06-24
2019-12-10
1. VERTEX PHARMACEUTICALS INC
2015-04-08
2019-12-10
3. VISA INC CLASS A SHARES
2015-10-19
2019-12-10
4. WASTE CONNECTIONS INC
2016-07-26
2019-12-10
10. WELLS FARGO & CO NEW
2012-06-05
2019-12-10
2. WEX INC
2016-05-03
2019-12-10
2. YUM BRANDS INC
2018-11-27
2019-12-10
6. ZIMMER HLDGS INC
2017-11-13
2019-12-10
3. ALLEGION PLC
2015-11-05
2019-12-10
2. ACCENTURE PLC
2014-04-22
2019-12-10
8. LINDE PLC
2018-12-11
2019-12-10
5. CHUBB LTD
2011-05-23
2019-12-10
4. NXP SEMICONDUCTORS NV
2019-02-19
2019-12-10
1627.849 CRM LNG/SHRT OPPORT-INST
2016-12-09
2020-01-09
11. CORTEVA INC
2017-02-22
2020-01-13
9. CORTEVA INC
2017-02-22
2020-01-13
11. CORTEVA INC
2017-03-13
2020-01-14
12. CORTEVA INC
2017-03-20
2020-01-14
4. CORTEVA INC
2018-04-09
2020-01-14
.667 CORTEVA INC
2019-04-08
2020-01-14
2.333 CORTEVA INC
2018-04-09
2020-01-14
1. CORTEVA INC
2019-04-08
2020-01-14
14. CORTEVA INC
2019-04-08
2020-01-15
17. CORTEVA INC
2019-06-27
2020-01-15
7. CORTEVA INC
2019-06-27
2020-01-15
1. CORTEVA INC
2019-06-27
2020-01-15
8. CORTEVA INC
2019-06-27
2020-01-15
10. CORTEVA INC
2019-06-27
2020-01-15
1. CORTEVA INC
2019-06-28
2020-01-15
1499.358 CRM LNG/SHRT OPPORT-INST
2017-05-11
2020-01-16
4. CORTEVA INC
2019-06-28
2020-01-16
4. CORTEVA INC
2019-06-28
2020-01-16
1. CORTEVA INC
2019-06-28
2020-01-16
34. QUALCOMM INC
2019-05-01
2020-01-23
17. EOG RESOURCES INC
2016-05-23
2020-01-28
3. EOG RESOURCES INC
2016-05-24
2020-01-28
1. EOG RESOURCES INC
2016-05-24
2020-01-29
2. EOG RESOURCES INC
2016-05-24
2020-01-29
1. EOG RESOURCES INC
2016-05-25
2020-01-29
12. EOG RESOURCES INC
2016-05-25
2020-01-29
12. EOG RESOURCES INC
2016-08-05
2020-01-29
12. EOG RESOURCES INC
2016-08-05
2020-01-29
17. EOG RESOURCES INC
2016-08-05
2020-01-30
4. EOG RESOURCES INC
2016-09-15
2020-01-30
10000. US TREAS 1.375% 01/31/20
2015-02-23
2020-01-31
11. ABBVIE INC
2019-09-16
2020-02-12
3. ADOBE SYS INC
2012-11-05
2020-02-12
2. ALEXION PHARMACEUTICALS INC
2019-03-14
2020-02-12
2. ALPHABET INC-CL C
2013-05-22
2020-02-12
1. ALPHABET INC-CL A
2013-12-13
2020-02-12
1. AMAZON COM INC
2015-03-12
2020-02-12
8. AMERICAN EXPRESS CO
2018-07-18
2020-02-12
13. APPLE COMPUTER INC
2010-06-17
2020-02-12
5. AUTOMATIC DATA PROCESSING INC
2018-10-22
2020-02-12
38. BANK OF AMERICA CORPORATION
2013-04-19
2020-02-12
6. BERKSHIRE HATHAWAY INC DEL CL B
2017-04-20
2020-02-12
23. BOSTON SCIENTIFIC CORP
2016-09-15
2020-02-12
14. BRISTOL MYERS SQUIBB CO
2019-11-21
2020-02-12
4. BROADCOM INC
2013-05-31
2020-02-12
3. CHARTER COMMUNICATIONS INC-A
2016-03-30
2020-02-12
16. CITIGROUP INC NEW
2013-09-19
2020-02-12
11. COCA-COLA CO
2018-04-13
2020-02-12
33. COMCAST CORP NEW CL A
2018-01-11
2020-02-12
9. DIAMONDBACK ENERGY INC
2017-05-15
2020-02-12
5. DISNEY WALT CO
2016-12-16
2020-02-12
9. DUPONT DE NEMOURS INC-WI
2017-02-22
2020-02-12
8. ELECTRONIC ARTS
2018-09-20
2020-02-12
6. FACEBOOK INC-A
2015-04-27
2020-02-12
7. FIDELITY NATL INFORMATION SVCS INC
2014-12-19
2020-02-12
16. FISERV INC
2019-01-24
2020-02-12
4. GENERAL DYNAMICS CORP
2016-08-22
2020-02-12
6. HOME DEPOT INC
2012-03-20
2020-02-12
9. HONEYWELL INTL INC
2010-10-22
2020-02-12
4. INTERCONTINENTALEXCHANGE GROUP, INC
2017-01-31
2020-02-12
33. KEYCORP NEW
2016-03-02
2020-02-12
8. LILLY ELI & CO
2015-07-09
2020-02-12
6. LOWES COS INC
2011-09-28
2020-02-12
16. MARATHON PETROLEUM CORPORATION
2018-05-14
2020-02-12
7. MASTERCARD INC - CLASS A
2012-10-15
2020-02-12
3. MCDONALDS CORP
2019-06-10
2020-02-12
13. MERCK & CO INC
2016-08-12
2020-02-12
29. MICROSOFT CORP
2013-08-09
2020-02-12
16. MONDELEZ INTERNATIONAL-W/I
2012-10-15
2020-02-12
26. MORGAN STANLEY DEAN WITTER & CO NEW
2013-04-19
2020-02-12
2. NETFLIX.COM INC
2018-09-13
2020-02-12
3. NEXTERA ENERGY INC
2016-10-18
2020-02-12
6. NORFOLK SOUTHN CORP
2017-11-21
2020-02-12
3. NORTHROP GRUMMAN CORP
2016-09-16
2020-02-12
4. NVIDIA CORP
2017-10-03
2020-02-12
1. O'REILLY AUTOMOTIVE INC
2017-05-05
2020-02-12
8. PAYPAL HOLDINGS INC
2018-01-26
2020-02-12
9. PEPSICO INC
2014-10-13
2020-02-12
32. PFIZER INC
2015-07-28
2020-02-12
5. PHILIP MORRIS INTERNATIONAL
2018-10-24
2020-02-12
5. PIONEER NAT RES CO
2016-02-12
2020-02-12
7. PROCTER & GAMBLE CO
2019-06-05
2020-02-12
7. ROSS STORES INC
2018-12-11
2020-02-12
7. SALESFORCE.COM INC
2018-04-16
2020-02-12
5. STANLEY BLACK & DECKER,INC.
2015-12-11
2020-02-12
11. TEXAS INSTRS INC
2016-03-10
2020-02-12
2. THERMO ELECTRON CORP
2020-01-13
2020-02-12
7. UNION PAC CORP
2015-10-08
2020-02-12
3. UNITED TECHNOLOGIES CORP
2017-12-06
2020-02-12
8. UNITEDHEALTH GROUP INC
2013-09-03
2020-02-12
3. VERTEX PHARMACEUTICALS INC
2015-04-08
2020-02-12
5. VISA INC CLASS A SHARES
2015-10-19
2020-02-12
6. WASTE CONNECTIONS INC
2016-07-26
2020-02-12
13. WELLS FARGO & CO NEW
2015-05-07
2020-02-12
3. WEX INC
2016-05-03
2020-02-12
4. YUM BRANDS INC
2018-11-28
2020-02-12
9. ZIMMER HLDGS INC
2017-11-14
2020-02-12
5. ALLEGION PLC
2015-11-06
2020-02-12
3. ACCENTURE PLC
2014-04-22
2020-02-12
8. LINDE PLC
2018-12-11
2020-02-12
1. CHUBB LTD
2012-01-09
2020-02-12
5. CHUBB LTD
2011-05-23
2020-02-12
6. NXP SEMICONDUCTORS NV
2019-02-19
2020-02-12
424. JPMORGAN BETABUILDERS JAPAN ETF
2018-07-19
2020-02-14
89. JPMORGAN BETABUILDERS JAPAN ETF
2018-07-19
2020-02-14
10. ELECTRONIC ARTS
2018-09-20
2020-02-25
13. ELECTRONIC ARTS
2018-11-27
2020-02-25
3. ACCENTURE PLC
2014-04-22
2020-02-25
15. ACCENTURE PLC
2014-04-22
2020-02-26
38. DISNEY WALT CO
2016-12-16
2020-03-04
87. WELLS FARGO & CO NEW
2015-05-07
2020-03-04
3. ALEXION PHARMACEUTICALS INC
2019-03-14
2020-03-11
1. ALEXION PHARMACEUTICALS INC
2019-03-14
2020-03-11
2. DUPONT DE NEMOURS INC-WI
2017-02-22
2020-03-11
13.667 DUPONT DE NEMOURS INC-WI
2019-04-08
2020-03-11
43.333 DUPONT DE NEMOURS INC-WI
2017-02-22
2020-03-11
5. ALEXION PHARMACEUTICALS INC
2019-03-14
2020-03-12
3. ALEXION PHARMACEUTICALS INC
2019-03-14
2020-03-12
600. ISHARES CORE MSCI EAFE ETF
2017-06-28
2020-03-12
6. ALEXION PHARMACEUTICALS INC
2019-03-14
2020-03-13
344.577 FIDELITY 500 INDEX-INST PRM
2019-12-10
2020-03-17
620. ISHARES MISCI EAFE INDEX FUND
2014-10-10
2020-03-18
22. UNITED TECHNOLOGIES CORP
2017-12-07
2020-03-31
1306.62 JPM GL RES ENH IDX FD - USD - R6 ISIN US48129C2070
2015-01-05
2020-04-07
23. COMCAST CORP NEW CL A
2018-01-11
2020-04-16
41. COMCAST CORP NEW CL A
2018-10-19
2020-04-16
1. COMCAST CORP NEW CL A
2019-01-29
2020-04-16
28. COMCAST CORP NEW CL A
2019-01-29
2020-04-16
4. COMCAST CORP NEW CL A
2019-01-29
2020-04-16
6. ROSS STORES INC
2018-12-11
2020-04-16
7. ROSS STORES INC
2018-12-11
2020-04-16
7. ROSS STORES INC
2018-12-11
2020-04-16
24. ROSS STORES INC
2018-12-11
2020-04-16
120. MARATHON PETROLEUM CORPORATION
2018-05-14
2020-04-27
4. ABBVIE INC
2019-09-16
2020-04-29
1. AMAZON COM INC
2015-03-12
2020-04-29
2. AMERICAN EXPRESS CO
2018-07-19
2020-04-29
3. APPLE COMPUTER INC
2010-06-17
2020-04-29
1. AUTOMATIC DATA PROCESSING INC
2018-10-22
2020-04-29
10. BANK OF AMERICA CORPORATION
2013-09-19
2020-04-29
1. BERKSHIRE HATHAWAY INC DEL CL B
2017-08-14
2020-04-29
1. BIOGEN IDEC INC
2020-03-11
2020-04-29
7. BOSTON SCIENTIFIC CORP
2016-12-05
2020-04-29
4. BRISTOL MYERS SQUIBB CO
2019-11-21
2020-04-29
2. BROADCOM INC
2013-05-31
2020-04-29
1. CHARTER COMMUNICATIONS INC-A
2016-12-15
2020-04-29
5. CITIGROUP INC NEW
2014-12-05
2020-04-29
3. COCA-COLA CO
2018-04-13
2020-04-29
6. COMCAST CORP NEW CL A
2019-01-29
2020-04-29
2. DIAMONDBACK ENERGY INC
2017-05-15
2020-04-29
1. ELECTRONIC ARTS
2018-11-27
2020-04-29
2. FACEBOOK INC-A
2015-04-27
2020-04-29
2. FIDELITY NATL INFORMATION SVCS INC
2014-12-19
2020-04-29
4. FISERV INC
2019-01-24
2020-04-29
1. GENERAL DYNAMICS CORP
2016-08-23
2020-04-29
1. HOME DEPOT INC
2012-03-20
2020-04-29
3. HONEYWELL INTL INC
2010-10-22
2020-04-29
1. INTERCONTINENTALEXCHANGE GROUP, INC
2017-01-31
2020-04-29
512. ISHARES MISCI EAFE INDEX FUND
2015-07-29
2020-04-29
9. KEYCORP NEW
2016-03-02
2020-04-29
2. LILLY ELI & CO
2015-07-10
2020-04-29
3. LOWES COS INC
2011-09-28
2020-04-29
1. MASTERCARD INC - CLASS A
2012-10-15
2020-04-29
4. MERCK & CO INC
2016-08-12
2020-04-29
9. MICROSOFT CORP
2013-08-09
2020-04-29
4. MONDELEZ INTERNATIONAL-W/I
2012-10-16
2020-04-29
8. MORGAN STANLEY DEAN WITTER & CO NEW
2013-04-19
2020-04-29
1. NETFLIX.COM INC
2018-09-13
2020-04-29
1. NEXTERA ENERGY INC
2016-10-18
2020-04-29
2. NORFOLK SOUTHN CORP
2018-03-09
2020-04-29
1. NORTHROP GRUMMAN CORP
2017-09-22
2020-04-29
1. NVIDIA CORP
2017-10-03
2020-04-29
1. O'REILLY AUTOMOTIVE INC
2017-05-05
2020-04-29
4. PAYPAL HOLDINGS INC
2018-01-26
2020-04-29
2. PEPSICO INC
2015-10-29
2020-04-29
9. PFIZER INC
2015-07-29
2020-04-29
1. PHILIP MORRIS INTERNATIONAL
2018-10-24
2020-04-29
2. PIONEER NAT RES CO
2016-03-22
2020-04-29
2. PROCTER & GAMBLE CO
2019-06-05
2020-04-29
60. SPDR TR UNIT SER 1
2014-10-10
2020-04-29
2. SALESFORCE.COM INC
2018-04-17
2020-04-29
2. STANLEY BLACK & DECKER,INC.
2016-02-11
2020-04-29
3. TEXAS INSTRS INC
2016-03-10
2020-04-29
1. THERMO ELECTRON CORP
2020-01-13
2020-04-29
2. UNION PAC CORP
2017-05-18
2020-04-29
2. UNITEDHEALTH GROUP INC
2013-09-03
2020-04-29
1. VERTEX PHARMACEUTICALS INC
2015-04-10
2020-04-29
1. VISA INC CLASS A SHARES
2015-10-19
2020-04-29
1. WASTE CONNECTIONS INC
2016-07-26
2020-04-29
1. WEX INC
2016-05-03
2020-04-29
2. YUM BRANDS INC
2018-11-28
2020-04-29
2. ZIMMER HLDGS INC
2017-11-20
2020-04-29
2. ALLEGION PLC
2015-11-19
2020-04-29
3. LINDE PLC
2018-12-11
2020-04-29
1. CHUBB LTD
2012-01-09
2020-04-29
1. ASML HOLDING NV-NY REG SHS
2020-03-04
2020-04-29
2. NXP SEMICONDUCTORS NV
2019-02-19
2020-04-29
3308.157 SIX CIRCLES ULTR SHRT DUR
2018-10-25
2020-04-30
15. ADOBE SYS INC
2012-11-05
2020-05-04
2. ADOBE SYS INC
2013-05-09
2020-05-04
263. ISHARES TR 7-10 YR TREAS INDEX FD
2019-02-21
2020-05-07
15000. US TREAS 3.5% 05/15/20
2014-07-18
2020-05-15
7. ABBVIE INC
2019-09-16
2020-06-11
1. ALPHABET INC-CL C
2014-04-17
2020-06-11
1. ALPHABET INC-CL A
2015-10-30
2020-06-11
1. AMAZON COM INC
2015-04-08
2020-06-11
4. AMERICAN EXPRESS CO
2018-07-19
2020-06-11
6. APPLE COMPUTER INC
2010-06-17
2020-06-11
3. AUTOMATIC DATA PROCESSING INC
2018-10-22
2020-06-11
18. BANK OF AMERICA CORPORATION
2013-09-19
2020-06-11
3. BERKSHIRE HATHAWAY INC DEL CL B
2017-08-14
2020-06-11
11. BOSTON SCIENTIFIC CORP
2016-12-05
2020-06-11
6. BRISTOL MYERS SQUIBB CO
2019-11-21
2020-06-11
2. BROADCOM INC
2013-05-31
2020-06-11
1. CHARTER COMMUNICATIONS INC-A
2016-12-15
2020-06-11
8. CITIGROUP INC NEW
2014-12-05
2020-06-11
6. COCA-COLA CO
2018-04-13
2020-06-11
8. COMCAST CORP NEW CL A
2019-03-14
2020-06-11
5. DIAMONDBACK ENERGY INC
2017-05-15
2020-06-11
2. ELECTRONIC ARTS
2018-11-27
2020-06-11
4. FACEBOOK INC-A
2015-04-27
2020-06-11
4. FIDELITY NATL INFORMATION SVCS INC
2014-12-19
2020-06-11
8. FISERV INC
2019-01-24
2020-06-11
2. GENERAL DYNAMICS CORP
2016-08-24
2020-06-11
3. HOME DEPOT INC
2012-03-20
2020-06-11
4. HONEYWELL INTL INC
2010-10-22
2020-06-11
1. INTERCONTINENTALEXCHANGE GROUP, INC
2017-01-31
2020-06-11
1. INTUIT
2020-02-25
2020-06-11
1633.54 JPM GL RES ENH IDX FD - USD - R6 ISIN US48129C2070
2015-01-05
2020-06-11
16. KEYCORP NEW
2016-03-04
2020-06-11
4. LILLY ELI & CO
2015-07-10
2020-06-11
4. LOWES COS INC
2011-09-28
2020-06-11
3. MASTERCARD INC - CLASS A
2012-10-15
2020-06-11
2. MCDONALDS CORP
2019-06-10
2020-06-11
6. MERCK & CO INC
2016-08-12
2020-06-11
13. MICROSOFT CORP
2013-08-23
2020-06-11
8. MONDELEZ INTERNATIONAL-W/I
2012-10-16
2020-06-11
12. MORGAN STANLEY DEAN WITTER & CO NEW
2013-11-12
2020-06-11
1. NETFLIX.COM INC
2018-09-13
2020-06-11
2. NEXTERA ENERGY INC
2016-10-18
2020-06-11
3. NORFOLK SOUTHN CORP
2018-03-09
2020-06-11
1. NORTHROP GRUMMAN CORP
2017-09-22
2020-06-11
2. NVIDIA CORP
2018-06-12
2020-06-11
1. O'REILLY AUTOMOTIVE INC
2017-05-05
2020-06-11
6. PAYPAL HOLDINGS INC
2018-07-26
2020-06-11
4. PEPSICO INC
2015-10-29
2020-06-11
15. PFIZER INC
2015-07-29
2020-06-11
2. PHILIP MORRIS INTERNATIONAL
2018-10-24
2020-06-11
4. PIONEER NAT RES CO
2016-03-22
2020-06-11
3. PROCTER & GAMBLE CO
2019-06-05
2020-06-11
4. SALESFORCE.COM INC
2018-04-18
2020-06-11
2. STANLEY BLACK & DECKER,INC.
2016-02-11
2020-06-11
6. TEXAS INSTRS INC
2016-03-10
2020-06-11
1. THERMO ELECTRON CORP
2020-01-13
2020-06-11
3. UNION PAC CORP
2017-05-18
2020-06-11
4. UNITEDHEALTH GROUP INC
2013-09-03
2020-06-11
1. VERTEX PHARMACEUTICALS INC
2015-04-13
2020-06-11
3. VISA INC CLASS A SHARES
2015-10-19
2020-06-11
3. WASTE CONNECTIONS INC
2016-07-26
2020-06-11
2. WEX INC
2016-05-03
2020-06-11
3. YUM BRANDS INC
2018-11-28
2020-06-11
4. ZIMMER HLDGS INC
2017-11-20
2020-06-11
2. ALLEGION PLC
2015-11-19
2020-06-11
4. LINDE PLC
2019-01-07
2020-06-11
3. CHUBB LTD
2012-01-09
2020-06-11
1. ASML HOLDING NV-NY REG SHS
2020-03-04
2020-06-11
3. NXP SEMICONDUCTORS NV
2019-02-19
2020-06-11
35. BERKSHIRE HATHAWAY INC DEL CL B
2017-08-14
2020-06-24
68. KEYCORP NEW
2016-03-15
2020-06-30
8. KEYCORP NEW
2018-10-08
2020-06-30
51. PFIZER INC
2016-07-05
2020-06-30
17. KEYCORP NEW
2018-10-08
2020-07-01
5. KEYCORP NEW
2018-10-08
2020-07-01
31. KEYCORP NEW
2018-10-08
2020-07-01
13. KEYCORP NEW
2018-10-19
2020-07-01
1. KEYCORP NEW
2018-10-19
2020-07-01
12. KEYCORP NEW
2018-10-19
2020-07-01
26. KEYCORP NEW
2018-10-19
2020-07-02
1. KEYCORP NEW
2018-10-19
2020-07-02
27. KEYCORP NEW
2018-10-19
2020-07-02
1. KEYCORP NEW
2018-10-19
2020-07-02
148. PFIZER INC
2016-11-09
2020-07-10
7. PFIZER INC
2018-10-30
2020-07-10
18. GENERAL DYNAMICS CORP
2017-02-10
2020-08-04
5. GENERAL DYNAMICS CORP
2018-12-13
2020-08-04
2. GENERAL DYNAMICS CORP
2018-12-13
2020-08-04
19. PHILIP MORRIS INTERNATIONAL
2018-10-24
2020-08-04
7. PHILIP MORRIS INTERNATIONAL
2018-10-24
2020-08-04
2. PHILIP MORRIS INTERNATIONAL
2018-10-24
2020-08-04
6. ABBVIE INC
2019-09-16
2020-08-10
1. ALPHABET INC-CL C
2014-04-17
2020-08-10
3. AMERICAN EXPRESS CO
2018-07-19
2020-08-10
5. APPLE COMPUTER INC
2010-06-17
2020-08-10
2. AUTOMATIC DATA PROCESSING INC
2018-10-22
2020-08-10
13. BANK OF AMERICA CORPORATION
2015-02-09
2020-08-10
1. BIOGEN IDEC INC
2020-03-11
2020-08-10
1. BOOKING HOLDINGS INC
2020-06-24
2020-08-10
8. BOSTON SCIENTIFIC CORP
2016-12-05
2020-08-10
5. BRISTOL MYERS SQUIBB CO
2019-11-21
2020-08-10
2. BROADCOM INC
2013-05-31
2020-08-10
2. CHARTER COMMUNICATIONS INC-A
2016-12-15
2020-08-10
7. CITIGROUP INC NEW
2015-07-22
2020-08-10
5. COCA-COLA CO
2018-04-13
2020-08-10
7. COMCAST CORP NEW CL A
2019-03-14
2020-08-10
2. ELECTRONIC ARTS
2018-11-27
2020-08-10
2. FACEBOOK INC-A
2015-11-18
2020-08-10
2. FIDELITY NATL INFORMATION SVCS INC
2015-01-15
2020-08-10
5. FISERV INC
2019-01-25
2020-08-10
2. HOME DEPOT INC
2012-03-20
2020-08-10
3. HONEYWELL INTL INC
2012-06-15
2020-08-10
2. INTERCONTINENTALEXCHANGE GROUP, INC
2017-01-31
2020-08-10
1. INTUIT
2020-02-25
2020-08-10
2. LILLY ELI & CO
2015-07-13
2020-08-10
3. LOWES COS INC
2011-09-28
2020-08-10
3. MASTERCARD INC - CLASS A
2012-10-15
2020-08-10
1. MCDONALDS CORP
2019-06-10
2020-08-10
5. MERCK & CO INC
2016-08-12
2020-08-10
11. MICROSOFT CORP
2013-08-23
2020-08-10
5. MONDELEZ INTERNATIONAL-W/I
2012-10-16
2020-08-10
10. MORGAN STANLEY DEAN WITTER & CO NEW
2013-11-12
2020-08-10
2. NEXTERA ENERGY INC
2016-10-18
2020-08-10
2. NORFOLK SOUTHN CORP
2018-03-09
2020-08-10
2. NORTHROP GRUMMAN CORP
2017-09-22
2020-08-10
1. NVIDIA CORP
2018-06-12
2020-08-10
1. O'REILLY AUTOMOTIVE INC
2017-05-05
2020-08-10
6. PAYPAL HOLDINGS INC
2018-07-26
2020-08-10
3. PEPSICO INC
2016-02-17
2020-08-10
2. PIONEER NAT RES CO
2016-03-22
2020-08-10
3. PROCTER & GAMBLE CO
2019-06-05
2020-08-10
3. SALESFORCE.COM INC
2018-04-18
2020-08-10
2. STANLEY BLACK & DECKER,INC.
2016-02-11
2020-08-10
4. TEXAS INSTRS INC
2016-03-10
2020-08-10
1. THERMO ELECTRON CORP
2020-01-13
2020-08-10
3. UNION PAC CORP
2017-05-18
2020-08-10
3. UNITEDHEALTH GROUP INC
2013-09-03
2020-08-10
1. VERTEX PHARMACEUTICALS INC
2015-08-11
2020-08-10
1. VISA INC CLASS A SHARES
2015-10-19
2020-08-10
2. WASTE CONNECTIONS INC
2016-07-26
2020-08-10
3. ZIMMER HLDGS INC
2017-11-20
2020-08-10
2. ALLEGION PLC
2015-11-19
2020-08-10
3. LINDE PLC
2019-01-07
2020-08-10
3. CHUBB LTD
2012-01-09
2020-08-10
2. NXP SEMICONDUCTORS NV
2019-02-19
2020-08-10
3. ABBVIE INC
2019-09-16
2020-08-14
1. AMAZON COM INC
2015-04-08
2020-08-14
1. AMERICAN EXPRESS CO
2018-07-19
2020-08-14
3. APPLE COMPUTER INC
2010-06-17
2020-08-14
1. AUTOMATIC DATA PROCESSING INC
2018-10-22
2020-08-14
9. BANK OF AMERICA CORPORATION
2015-02-09
2020-08-14
2512.563 BLACKSTONE ALT MULTI-STRAT-Y
2018-11-14
2020-08-14
6. BOSTON SCIENTIFIC CORP
2016-12-05
2020-08-14
4. BRISTOL MYERS SQUIBB CO
2019-11-21
2020-08-14
1. BROADCOM INC
2013-05-31
2020-08-14
4. CITIGROUP INC NEW
2015-07-22
2020-08-14
4. COCA-COLA CO
2018-04-13
2020-08-14
4. COMCAST CORP NEW CL A
2019-03-14
2020-08-14
5. DIAMONDBACK ENERGY INC
2017-05-15
2020-08-14
1. ELECTRONIC ARTS
2018-11-27
2020-08-14
2. FACEBOOK INC-A
2015-11-18
2020-08-14
2. FIDELITY NATL INFORMATION SVCS INC
2015-01-15
2020-08-14
4. FISERV INC
2019-01-25
2020-08-14
1. HOME DEPOT INC
2012-03-20
2020-08-14
2. HONEYWELL INTL INC
2012-06-15
2020-08-14
1. INTERCONTINENTALEXCHANGE GROUP, INC
2017-01-31
2020-08-14
1. INTUIT
2020-02-25
2020-08-14
125. ISHARES TR 7-10 YR TREAS INDEX FD
2019-02-21
2020-08-14
2. LILLY ELI & CO
2015-07-13
2020-08-14
2. LOWES COS INC
2011-09-28
2020-08-14
1. MASTERCARD INC - CLASS A
2012-10-15
2020-08-14
3. MERCK & CO INC
2016-08-12
2020-08-14
7. MICROSOFT CORP
2013-08-23
2020-08-14
4. MONDELEZ INTERNATIONAL-W/I
2014-08-13
2020-08-14
6. MORGAN STANLEY DEAN WITTER & CO NEW
2013-11-12
2020-08-14
1. NETFLIX.COM INC
2018-09-13
2020-08-14
1. NEXTERA ENERGY INC
2016-10-18
2020-08-14
2. NORFOLK SOUTHN CORP
2018-03-09
2020-08-14
1. NORTHROP GRUMMAN CORP
2017-09-22
2020-08-14
1. NVIDIA CORP
2018-06-12
2020-08-14
3. PAYPAL HOLDINGS INC
2018-10-08
2020-08-14
2. PEPSICO INC
2016-02-17
2020-08-14
2. PIONEER NAT RES CO
2016-03-30
2020-08-14
2. PROCTER & GAMBLE CO
2019-06-05
2020-08-14
3. SALESFORCE.COM INC
2018-10-08
2020-08-14
1. STANLEY BLACK & DECKER,INC.
2016-02-11
2020-08-14
3. TEXAS INSTRS INC
2016-03-10
2020-08-14
1. THERMO ELECTRON CORP
2020-01-13
2020-08-14
1. UNION PAC CORP
2017-05-18
2020-08-14
2. UNITEDHEALTH GROUP INC
2014-05-08
2020-08-14
1. VISA INC CLASS A SHARES
2015-10-19
2020-08-14
1. WASTE CONNECTIONS INC
2016-07-26
2020-08-14
2. WEX INC
2016-05-27
2020-08-14
4. YUM BRANDS INC
2018-11-28
2020-08-14
3. ZIMMER HLDGS INC
2017-11-20
2020-08-14
1. ALLEGION PLC
2015-11-19
2020-08-14
2. LINDE PLC
2019-01-07
2020-08-14
1. CHUBB LTD
2012-01-09
2020-08-14
1. ASML HOLDING NV-NY REG SHS
2020-03-05
2020-08-14
2. NXP SEMICONDUCTORS NV
2019-02-19
2020-08-14
10000. US TREAS 2.125% 08/31/20
2015-11-20
2020-08-31
24. AUTOMATIC DATA PROCESSING INC
2018-10-22
2020-09-30
2. AUTOMATIC DATA PROCESSING INC
2019-08-14
2020-09-30
4. AUTOMATIC DATA PROCESSING INC
2020-05-04
2020-09-30
1. AUTOMATIC DATA PROCESSING INC
2020-05-04
2020-09-30
5. AUTOMATIC DATA PROCESSING INC
2020-05-04
2020-09-30
11. INTERCONTINENTALEXCHANGE GROUP, INC
2017-01-31
2020-09-30
4. INTERCONTINENTALEXCHANGE GROUP, INC
2017-02-01
2020-09-30
6. INTERCONTINENTALEXCHANGE GROUP, INC
2017-02-01
2020-09-30
3. ALLEGION PLC
2015-11-19
2020-09-30
3. ALLEGION PLC
2015-11-20
2020-09-30
4. ALLEGION PLC
2015-11-20
2020-09-30
CAPITAL GAIN DIVIDENDS
P
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
4,071
3,188
883
b
1,465
632
833
c
1,837
793
1,044
d
20,000
15,843
4,157
e
525
263
262
679
399
280
547
330
217
1,406
1,041
365
130
96
34
131
96
35
10,000
9,817
183
3,025
3,075
-50
10,263
8,851
1,412
41,884
25,914
15,970
98
108
-10
10
12
-2
4
5
-1
32,890
33,786
-896
125
136
-11
21
23
-2
781
636
145
614
68
546
224
269
-45
2,692
848
1,844
1,344
453
891
3,489
747
2,742
845
721
124
2,424
349
2,075
506
432
74
1,105
382
723
886
660
226
793
423
370
618
564
54
1,260
152
1,108
934
430
504
982
650
332
485
401
84
1,071
1,057
14
282
335
-53
253
311
-58
731
520
211
386
488
-102
596
647
-51
614
683
-69
802
330
472
955
446
509
1,255
904
351
545
456
89
863
198
665
1,221
314
907
278
174
104
493
270
223
602
438
164
585
101
484
763
957
-194
1,157
73
1,084
289
47
242
390
402
-12
891
627
264
3,483
724
2,759
217
88
129
435
215
220
1,045
431
614
296
371
-75
704
376
328
754
516
238
688
422
266
644
537
107
444
251
193
726
595
131
958
667
291
957
866
91
252
267
-15
401
375
26
748
640
108
255
259
-4
460
323
137
942
717
225
632
438
194
982
443
539
858
481
377
436
364
72
1,940
490
1,450
221
123
98
548
231
317
363
199
164
536
475
61
395
182
213
198
180
18
885
665
220
373
192
181
404
159
245
1,638
1,285
353
764
341
423
479
370
109
16,425
16,328
97
312
357
-45
257
293
-36
315
362
-47
344
395
-51
115
132
-17
19
20
-1
66
77
-11
28
30
-2
402
414
-12
487
505
-18
201
208
-7
29
30
-1
230
237
-7
285
295
-10
29
30
-1
15,054
15,895
-841
115
118
-3
115
118
-3
29
30
-1
3,124
2,941
183
1,310
1,386
-76
231
247
-16
77
82
-5
154
165
-11
77
83
-6
905
1,010
-105
920
1,083
-163
908
1,083
-175
1,264
1,533
-269
300
366
-66
10,000
9,911
89
1,074
777
297
1,120
102
1,018
210
269
-59
3,035
988
2,047
1,517
539
978
2,158
374
1,784
1,067
815
252
4,241
504
3,737
890
720
170
1,327
507
820
1,366
1,002
364
973
485
488
937
783
154
1,299
152
1,147
1,601
680
921
1,271
893
378
654
490
164
1,518
1,396
122
668
935
-267
710
520
190
483
832
-349
877
911
-34
1,264
495
769
1,036
446
590
1,912
1,315
597
754
609
145
1,449
297
1,152
1,632
404
1,228
377
233
144
651
367
284
1,149
704
445
750
121
629
943
1,253
-310
2,337
332
2,005
651
603
48
1,084
823
261
5,337
950
4,387
943
427
516
1,462
534
928
758
741
17
811
376
435
1,267
805
462
1,104
703
401
1,091
717
374
392
252
140
947
680
267
1,312
906
406
1,208
1,129
79
440
446
-6
688
569
119
864
747
117
840
564
276
1,327
848
479
843
465
378
1,461
608
853
669
664
5
1,293
707
586
465
366
99
2,426
578
1,848
725
371
354
1,036
385
651
601
299
302
622
712
-90
659
273
386
422
365
57
1,426
1,006
420
692
325
367
637
239
398
1,735
1,285
450
164
70
94
819
341
478
827
555
272
10,239
10,176
63
2,150
2,135
15
1,060
877
183
1,371
1,104
267
593
239
354
2,965
1,381
1,584
4,492
4,159
333
3,543
4,806
-1,263
251
404
-153
84
135
-51
73
184
-111
505
1,158
-653
1,602
4,036
-2,434
396
673
-277
230
404
-174
28,236
36,795
-8,559
479
808
-329
30,340
37,648
-7,308
28,793
39,497
-10,704
2,080
2,707
-627
22,500
23,402
-902
856
859
-3
1,525
1,479
46
38
36
2
1,043
1,012
31
150
145
5
526
483
43
613
564
49
614
564
50
2,099
1,905
194
3,148
8,465
-5,317
330
283
47
2,371
374
1,997
183
200
-17
865
116
749
142
144
-2
247
147
100
191
177
14
310
298
12
257
144
113
248
224
24
548
76
472
495
291
204
246
280
-34
142
134
8
231
217
14
81
208
-127
114
85
29
388
165
223
270
127
143
420
326
94
136
152
-16
223
49
174
434
135
299
91
58
33
29,575
32,999
-3,424
109
101
8
312
177
135
322
60
262
284
47
237
324
253
71
1,572
299
1,273
202
106
96
326
183
143
412
371
41
236
125
111
365
290
75
330
281
49
297
179
118
390
252
138
489
349
140
267
205
62
341
322
19
77
89
-12
171
281
-110
232
213
19
17,592
11,665
5,927
320
245
75
243
179
64
350
166
184
332
332
329
215
114
583
145
438
255
128
127
180
77
103
87
50
37
136
91
45
176
182
-6
237
224
13
204
133
71
567
482
85
110
70
40
299
300
-1
208
186
22
32,850
33,115
-265
5,227
653
4,574
697
88
609
32,067
27,433
4,634
15,000
16,379
-1,379
660
495
165
1,442
537
905
1,439
744
695
2,645
381
2,264
399
400
-1
2,094
233
1,861
444
432
12
447
286
161
548
532
16
391
226
165
349
335
14
606
76
530
532
291
241
413
461
-48
279
267
12
324
319
5
226
520
-294
249
170
79
915
381
534
545
252
293
812
664
148
303
305
-2
744
148
596
586
179
407
94
58
36
287
294
-7
31,887
29,257
2,630
203
180
23
594
355
239
510
81
429
896
142
754
377
402
-25
474
380
94
2,507
446
2,061
414
213
201
551
357
194
440
371
69
502
251
251
540
435
105
330
281
49
727
522
205
416
252
164
942
537
405
524
411
113
515
538
-23
146
178
-32
398
562
-164
357
320
37
704
498
206
263
180
83
770
331
439
341
332
9
505
322
183
1,175
291
884
271
129
142
578
231
347
275
150
125
313
183
130
274
274
496
449
47
208
133
75
818
628
190
371
210
161
342
302
40
318
278
40
6,227
7,090
-863
827
869
-42
97
164
-67
1,651
1,775
-124
204
348
-144
61
102
-41
362
630
-268
151
232
-81
12
18
-6
140
214
-74
315
464
-149
12
18
-6
317
482
-165
12
18
-6
4,990
5,187
-197
235
298
-63
2,650
3,203
-553
737
859
-122
294
344
-50
1,462
1,693
-231
541
622
-81
154
177
-23
554
424
130
1,490
537
953
307
300
7
2,249
194
2,055
276
289
-13
345
213
132
299
298
1
1,773
1,615
158
311
164
147
308
280
28
656
76
580
1,207
582
625
370
423
-53
239
223
16
302
279
23
281
170
111
524
216
308
292
125
167
502
422
80
548
99
449
477
160
317
198
116
82
304
292
12
306
179
127
462
60
402
969
142
827
204
201
3
403
316
87
2,285
377
1,908
277
159
118
506
298
208
567
251
316
406
290
116
669
563
106
449
261
188
463
252
211
1,169
515
654
408
299
109
217
281
-64
402
320
82
591
372
219
320
180
140
538
221
317
409
332
77
557
322
235
950
218
732
266
136
130
196
77
119
201
100
101
415
337
78
203
133
70
729
471
258
390
210
180
243
186
57
286
212
74
3,134
381
2,753
100
100
1,366
116
1,250
139
144
-5
235
147
88
25,000
26,759
-1,759
235
123
112
253
224
29
328
38
290
210
242
-32
193
178
15
174
159
15
222
514
-292
141
85
56
521
216
305
289
125
164
396
338
58
280
49
231
318
106
212
101
58
43
307
294
13
15,178
13,039
2,139
302
179
123
310
40
270
327
47
280
251
190
61
1,459
240
1,219
224
141
83
311
179
132
484
371
113
283
125
158
412
289
123
340
281
59
464
261
203
576
247
329
275
199
76
220
281
-61
270
213
57
583
454
129
159
90
69
414
166
248
416
332
84
191
107
84
645
155
490
198
77
121
100
50
50
325
184
141
370
364
6
412
340
72
102
66
36
497
314
183
130
70
60
373
292
81
246
186
60
10,000
10,293
-293
3,335
3,604
-269
278
328
-50
556
572
-16
139
143
-4
697
715
-18
1,100
640
460
398
235
163
599
351
248
297
199
98
296
200
96
397
267
130
6,523
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
883
b
833
c
1,044
d
4,157
e
262
280
217
365
34
35
183
-50
1,412
15,970
-10
-2
-1
-896
-11
-2
145
546
-45
1,844
891
2,742
124
2,075
74
723
226
370
54
1,108
504
332
84
14
-53
-58
211
-102
-51
-69
472
509
351
89
665
907
104
223
164
484
-194
1,084
242
-12
264
2,759
129
220
614
-75
328
238
266
107
193
131
291
91
-15
26
108
-4
137
225
194
539
377
72
1,450
98
317
164
61
213
18
220
181
245
353
423
109
97
-45
-36
-47
-51
-17
-1
-11
-2
-12
-18
-7
-1
-7
-10
-1
-841
-3
-3
-1
183
-76
-16
-5
-11
-6
-105
-163
-175
-269
-66
89
297
1,018
-59
2,047
978
1,784
252
3,737
170
820
364
488
154
1,147
921
378
164
122
-267
190
-349
-34
769
590
597
145
1,152
1,228
144
284
445
629
-310
2,005
48
261
4,387
516
928
17
435
462
401
374
140
267
406
79
-6
119
117
276
479
378
853
5
586
99
1,848
354
651
302
-90
386
57
420
367
398
450
94
478
272
63
15
183
267
354
1,584
333
-1,263
-153
-51
-111
-653
-2,434
-277
-174
-8,559
-329
-7,308
-10,704
-627
-902
-3
46
2
31
5
43
49
50
194
-5,317
47
1,997
-17
749
-2
100
14
12
113
24
472
204
-34
8
14
-127
29
223
143
94
-16
174
299
33
-3,424
8
135
262
237
71
1,273
96
143
41
111
75
49
118
138
140
62
19
-12
-110
19
5,927
75
64
184
114
438
127
103
37
45
-6
13
71
85
40
-1
22
-265
4,574
609
4,634
-1,379
165
905
695
2,264
-1
1,861
12
161
16
165
14
530
241
-48
12
5
-294
79
534
293
148
-2
596
407
36
-7
2,630
23
239
429
754
-25
94
2,061
201
194
69
251
105
49
205
164
405
113
-23
-32
-164
37
206
83
439
9
183
884
142
347
125
130
47
75
190
161
40
40
-863
-42
-67
-124
-144
-41
-268
-81
-6
-74
-149
-6
-165
-6
-197
-63
-553
-122
-50
-231
-81
-23
130
953
7
2,055
-13
132
1
158
147
28
580
625
-53
16
23
111
308
167
80
449
317
82
12
127
402
827
3
87
1,908
118
208
316
116
106
188
211
654
109
-64
82
219
140
317
77
235
732
130
119
101
78
70
258
180
57
74
2,753
1,250
-5
88
-1,759
112
29
290
-32
15
15
-292
56
305
164
58
231
212
43
13
2,139
123
270
280
61
1,219
83
132
113
158
123
59
203
329
76
-61
57
129
69
248
84
84
490
121
50
141
6
72
36
183
60
81
60
-293
-269
-50
-16
-4
-18
460
163
248
98
96
130
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
123,096
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
181,003
3,359,940
0.053871
2017
164,706
3,545,168
0.046459
2016
167,116
3,399,611
0.049157
2015
181,288
3,370,928
0.05378
2014
178,291
3,576,817
0.049846
2
Total
of line 1, column (d)
.....................
2
0.253113
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
0.050623
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
3,500,915
5
Multiply line 4 by line 3
......................
5
177,227
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
1,779
7
Add lines 5 and 6
........................
7
179,006
8
Enter qualifying distributions from Part XII, line 4
,.............
8
164,334
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
3,559
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
3,559
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
4
0
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
3,559
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
1,804
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
0
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
1,804
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
1,755
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
0
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.
$
(2)
On foundation managers.
$
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
Yes
7
Did the foundation have at least $5,000 in assets at any time during the year?
If "Yes," complete Part II, col. (c),
and Part XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
AZ
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
JP MORGAN CHASE BANK NA
Telephone no.
(800) 496-2583
Located at
10 S DEARBORN ST MC IL 1-0111
CHICAGO
IL
ZIP+4
60603
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1)
Engage in the sale or exchange, or leasing of property with a disqualified person?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(5)
Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)?
...............
Yes
No
(6)
Agree to pay money or property to a government official? (
Exception.
Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.)
.......
Yes
No
b
If any answer is "Yes" to 1a(1)–(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions
........
1b
No
Organizations relying on a current notice regarding disaster assistance check here
........
c
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2019?
.............
1c
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2019, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2019?
.............
Yes
No
If "Yes," list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer "No" and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
......................
Yes
No
b
If "Yes," did it have excess business holdings in 2019 as a result of
(1)
any purchase by the foundation
or disqualified persons after May 26, 1969;
(2)
the lapse of the 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or
(3)
the lapse of the 10-, 15-, or 20-year first phase holding period?
(Use Schedule C, Form 4720, to determine
if the foundation had excess business holdings in 2019.)
..................
3b
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2019?
4b
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
6
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
(continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
No
b
If any answer is "Yes" to 5a(1)–(5), did
any
of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions
......
5b
Organizations relying on a current notice regarding disaster assistance check here
.........
c
If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant?
..........
Yes
No
If "Yes," attach the statement required by Regulations section 53.4945–5(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract?
.....................
Yes
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
....
6b
No
If "Yes" to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
Yes
No
b
If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction?
....
7b
8
Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment during the year?
.................
Yes
No
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1
List all officers, directors, trustees, foundation managers and their compensation. See instructions
(a)
Name and address
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(If not paid, enter
-0-)
(d)
Contributions to employee benefit plans and deferred compensation
(e)
Expense account,
other allowances
JP MORGAN CHASE BANK N A
TRUSTEE
2
45,440
10 S DEARBORN ST MC IL 1-0111
CHICAGO
,
IL
60603
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
2
3
4
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
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
3,446,709
b
Average of monthly cash balances
.......................
1b
107,519
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
3,554,228
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
3,554,228
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
53,313
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
3,500,915
6
Minimum investment return.
Enter 5% of line 5
..................
6
175,046
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
175,046
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
3,559
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
3,559
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
171,487
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
171,487
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
171,487
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
164,334
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
164,334
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
164,334
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
171,487
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
146,841
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
0
b
From 2015
......
0
c
From 2016
......
0
d
From 2017
......
0
e
From 2018
......
0
f
Total
of lines 3a through e
........
0
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
164,334
a
Applied to 2018, but not more than line 2a
146,841
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
.....
17,493
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
..........
153,994
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
....
0
b
Excess from 2016
....
0
c
Excess from 2017
....
0
d
Excess from 2018
....
0
e
Excess from 2019
....
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
10
Part XIV
Private Operating Foundations
(see instructions and Part VII-A, question 9)
1a
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2019, enter the date of the ruling
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2019
(b)
2018
(c)
2017
(d)
2016
b
85% of line 2a
.........
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed
...
c
“Support" alternative test—enter:
(1)
Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
....
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
(3)
Largest amount of support
from an exempt organization
(4)
Gross investment income
Part XV
Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or email address of the person to whom applications should be addressed:
b
The form in which applications should be submitted and information and materials they should include:
c
Any submission deadlines:
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Form
990-PF
(2019)
Form 990-PF (2019)
Page
11
Part XV
Supplementary Information
(continued)
3
Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
SHELTERING ARMS HOSPITAL
8254 ATLEE RD
MECHANICSVLLE
,
VA
231161844
NONE
PC
GENERAL
146,841
Total
.................................
3a
146,841
b
Approved for future payment
Total
.................................
3b
Form
990-PF
(2019)
Form 990-PF (2019)
Page
12
Part XVI-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
Unrelated business income
Excluded by section 512, 513, or 514
(e)
Related or exempt
function income
(See instructions.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
4
Dividends and interest from securities
....
14
83,622
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
123,096
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)
..
206,718
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
206,718
(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