-
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
06-01-2019
, and ending
05-31-2020
Name of foundation
BUSHROD H CAMPBELL & ADAH F HALL
CHARITY FUND
Number and street (or P.O. box number if mail is not delivered to street address)
HEMENWAY BARNES LLP PO BOX 96120
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
BOSTON
,
MA
021961209
A Employer identification number
04-6013598
B
Telephone number (see instructions)
(617) 227-7940
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)
$
26,391,136
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
...
467,050
467,050
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
1,632,363
b
Gross sales price for all assets on line 6a
1,632,363
7
Capital gain net income (from Part IV, line 2)
...
1,632,363
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)
.......
9,537
0
12
Total.
Add lines 1 through 11
........
2,108,950
2,099,413
13
Compensation of officers, directors, trustees, etc.
93,481
88,807
4,674
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
78,060
0
78,060
b
Accounting fees (attach schedule)
.......
3,138
1,569
1,569
c
Other professional fees (attach schedule)
....
58,987
58,987
0
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
77,700
13,306
0
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
14,288
14,163
125
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
325,654
176,832
84,428
25
Contributions, gifts, grants paid
.......
1,071,380
1,071,380
26
Total expenses and disbursements.
Add lines 24 and 25
1,397,034
176,832
1,155,808
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
711,916
b
Net investment income
(if negative, enter -0-)
1,922,581
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
.........
901,535
1,584,115
1,584,115
3
Accounts receivable
Less: allowance for doubtful accounts
4
Pledges receivable
Less: allowance for doubtful accounts
5
Grants receivable
.................
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)
.....
7
Other notes and loans receivable (attach schedule)
Less: allowance for doubtful accounts
8
Inventories for sale or use
..............
9
Prepaid expenses and deferred charges
..........
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
.......
8,067,263
8,301,417
19,963,100
c
Investments—corporate bonds (attach schedule)
.......
4,230,556
3,994,580
4,136,185
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
505,533
535,819
707,736
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)
13,704,887
14,415,931
26,391,136
17
Accounts payable and accrued expenses
..........
18
Grants payable
.................
19
Deferred revenue
.................
20
Loans from officers, directors, trustees, and other disqualified persons
21
Mortgages and other notes payable (attach schedule)
......
22
Other liabilities (describe
)
23
Total liabilities
(add lines 17 through 22)
.........
0
0
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
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
........
15,486,221
15,485,349
27
Paid-in or capital surplus, or land, bldg., and equipment fund
0
0
28
Retained earnings, accumulated income, endowment, or other funds
-1,781,334
-1,069,418
29
Total net assets or fund balances
(see instructions)
.....
13,704,887
14,415,931
30
Total liabilities and net assets/fund balances
(see instructions)
.
13,704,887
14,415,931
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
13,704,887
2
Enter amount from Part I, line 27a
.....................
2
711,916
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
14,416,803
5
Decreases not included in line 2 (itemize)
5
872
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
14,415,931
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
PUBLICLY TRADED SECURITIES
b
PUBLICLY TRADED SECURITIES
c
d
e
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
1,609,938
1,609,938
b
22,425
22,425
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-)
or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
Excess of col. (i)
over col. (j), if any
a
1,609,938
b
22,425
c
d
e
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
1,632,363
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
1,075,432
23,763,535
0.045256
2017
1,103,529
22,762,883
0.048479
2016
1,044,619
21,310,169
0.049020
2015
1,019,320
21,062,697
0.048395
2014
894,703
22,062,553
0.040553
2
Total
of line 1, column (d)
.....................
2
0.231703
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
0.046341
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
25,299,814
5
Multiply line 4 by line 3
......................
5
1,172,419
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
19,226
7
Add lines 5 and 6
........................
7
1,191,645
8
Enter qualifying distributions from Part XII, line 4
,.............
8
1,155,808
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
38,452
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
38,452
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
38,452
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
40,000
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
20,000
d
Backup withholding erroneously withheld
...........
6d
0
7
Total credits and payments. Add lines 6a through 6d
..............
7
60,000
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
263
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
21,285
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
21,285
Refunded
11
0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition)
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
0
(2)
On foundation managers.
$
0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
Yes
7
Did the foundation have at least $5,000 in assets at any time during the year?
If "Yes," complete Part II, col. (c),
and Part XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
MA
b
If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G?
If "No," attach explanation
.
8b
Yes
9
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
or 4942(j)(5) for calendar year 2019 or the taxable year beginning in 2019? See the instructions for Part XIV.
If "Yes," complete Part XIV
.............................
9
No
10
Did any persons become substantial contributors during the tax year?
If "Yes," attach a schedule listing their names
and addresses.
...............................
10
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
5
Part VII-A
Statements Regarding Activities
(continued)
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions
.............
11
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement. See instructions
.................
12
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
ARTHUR B PAGE ESQ
Telephone no.
(617) 227-7940
Located at
HEMENWAY BARNES LLP 75 STATE ST
BOSTON
MA
ZIP+4
021091466
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
NANCY B GARDINER
TRUSTEE
2.50
44,240
0
0
HEMENWAY BARNES LLP 75 STATE ST
BOSTON
,
MA
02109
ARTHUR B PAGE
TRUSTEE
2.50
44,240
0
0
HEMENWAY BARNES LLP 75 STATE ST
BOSTON
,
MA
02109
GEORGE P BEAL
TRUSTEE
1.00
5,000
0
0
BOSTON FAMILY OFFICE LLC 88 BROAD
ST
BOSTON
,
MA
02110
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
.........................
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
24,148,730
b
Average of monthly cash balances
.......................
1b
1,536,360
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
25,685,090
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
25,685,090
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
385,276
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
25,299,814
6
Minimum investment return.
Enter 5% of line 5
..................
6
1,264,991
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
1,264,991
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
38,452
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
38,452
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
1,226,539
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
1,226,539
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
1,226,539
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
1,155,808
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
1,155,808
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
1,155,808
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
1,226,539
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
1,132,830
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:
$
1,155,808
a
Applied to 2018, but not more than line 2a
1,132,830
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
.....
22,978
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
..........
1,203,561
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 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
2LIFE COMMUNITIES
30 WALLINGFORD ROAD
BRIGHTON
,
MA
02135
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
ABCD NORTH ENDWEST END NEIGHBORHOOD SERVICE CENTER (NEWE NSC)
178 TREMONT STREET
BOSTON
,
MA
02111
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
ADOLESCENT CONSULTATION SERVICES INC
189 CAMBRIDGE STREET
CAMBRIDGE
,
MA
02141
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
ALL DORCHESTER SPORTS LEAGUE INC
1565 DORCHESTER AVE
DORCHESTER
,
MA
02122
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
AMERICAN RED CROSS OF MASSACHUSETTS
101 STATION LANDING SUITE 510
MEDFORD
,
MA
02155
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
ARTISTS FOR HUMANITY INC
100 WEST SECOND STREET
BOSTON
,
MA
02127
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
BASE THE
11 WALNUT PARK
ROXBURY
,
MA
02119
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
BAY COVE HUMAN SERVICES INC
66 CANAL STREET
BOSTON
,
MA
02114
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
BOSTON CASA INC
85 MERRIMAC STREET SUITE 401
BOSTON
,
MA
02114
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
BOSTON CHINATOWN NEIGHBORHOOD CENTER (BCNC)
885 WASHINGTON STREET
BOSTON
,
MA
02111
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
BOSTON DEBATE LEAGUE INC
566 COLUMBUS AVENUE
BOSTON
,
MA
02118
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
BOSTON HEALTH CARE FOR THE HOMELESS PROGRAM
780 ALBANY STREET
BOSTON
,
MA
02118
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
BOSTON HOMETHE
2049 DORCHESTER AVENUE
BOSTON
,
MA
02124
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
BOSTON MEDICAL CENTER
801 MASSACHUSETTS AVENUE FIRST
FLOOR
BOSTON
,
MA
02118
NONE
PUBLIC CHARITY
GENERAL PURPOSE
15,000
BOSTON PARTNERS IN EDUCATION INC
44 FARNSWORTH STREET
BOSTON
,
MA
02210
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
BOSTON RESCUE MISSION
39 KINGSTON STREET
BOSTON
,
MA
02111
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
BOYS & GIRLS CLUBS OF DORCHESTER
1135 DORCHESTER AVENUE
DORCHESTER
,
MA
02125
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
BREAKTHROUGH GREATER BOSTON
PO BOX 381486
CAMBRIDGE
,
MA
02238
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
BRIDGE OVER TROUBLED WATERS
47 WEST STREET
BOSTON
,
MA
02111
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
BROOKVIEW HOUSE
2 BROOKVIEW STREET
DORCHESTER
,
MA
02124
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
CAMBRIDGE SCHOOL VOLUNTEERS INC
459 BROADWAY
CAMBRIDGE
,
MA
02138
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,000
CARITAS COMMUNITIES INC
25 BRAINTREE HILL OFFICE PARK SUITE
206
BRAINTREE
,
MA
02184
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
CASA MYRNA
38 WAREHAM STREET
BOSTON
,
MA
02118
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
CASA NUEVA VIDA INC
53 GLEN ROAD
JAMAICA PLAIN
,
MA
02130
NONE
PUBLIC CHARITY
GENERAL PURPOSE
7,000
CATHOLIC CHARITIES
275 WEST BROADWAY
SOUTH BOSTON
,
MA
02127
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
CHICA PROJECT
614 COLUMBIA ROAD UNIT REAR
DORCHESTER
,
MA
02125
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
CITY MISSION INC
185 COLUMBIA ROAD
DORCHESTER
,
MA
02121
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,000
CODMAN SQUARE HEALTH CENTER
637 WASHINGTON STREET
DORCHESTER
,
MA
02124
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
COLLEGE BOUND DORCHESTER
275 EAST COTTAGE STREET
DORCHESTER
,
MA
02125
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
COMMUNITY ACTION AGENCY OF SOMERVILLE
66-70 UNION SQUARE 104
SOMERVILLE
,
MA
02143
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
COMMUNITY FAMILYTHE
106 WYLLIS AVENUE
EVERETT
,
MA
02149
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
COMMUNITY ROWING INC
20 NONANTUM ROAD
BRIGHTON
,
MA
02135
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
COMMUNITY SERVINGS INC
18 MARBURY TERRACE
JAMAICA PLAIN
,
MA
02130
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,000
DEAF INC
215 BRIGHTON AVENUE
ALLSTON
,
MA
02134
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,000
DISCOVERING JUSTICE
ONE COURTHOUSE WAY SUITE 3120
BOSTON
,
MA
02210
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
ECONOMIC MOBILITY PATHWAYS
ONE WASHINGTON MALL 3RD FLOOR
BOSTON
,
MA
02108
NONE
PUBLIC CHARITY
GENERAL PURPOSE
4,000
ELIZABETH STONE HOUSE INC
PO BOX 300039
JAMAICA PLAIN
,
MA
02130
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
EMERGE
2464 MASSACHUSETTS AVENUE SUITE 101
CAMBRIDGE
,
MA
02140
NONE
PUBLIC CHARITY
GENERAL PURPOSE
6,000
EMMANUEL GOSPEL CENTER
2 SAN JUAN STREET
BOSTON
,
MA
02118
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
EPIPHANY SCHOOL
154 CENTRE STREET
BOSTON
,
MA
02124
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,000
FAMILIES FIRST PARENTING PROGRAMS INC
9 GALEN STREET SUITE 400
WATERTOWN
,
MA
02472
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
FAMILY NURTURING CENTER
185 COLUMBIA ROAD STE 304
DORCHESTER
,
MA
02121
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
FAMILYAID BOSTON
3815 WASHINGTON STREET
JAMAICA PLAIN
,
MA
02130
NONE
PUBLIC CHARITY
GENERAL PURPOSE
7,000
FOOD FOR FREE COMMITTEE INC
11 INMAN STREET
CAMBRIDGE
,
MA
02139
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
FRANCISCAN HOSPITAL FOR CHILDREN
30 WARREN STREET
BRIGHTON
,
MA
02135
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
FRIENDS OF ST STEPHEN'S YOUTH PROGRAMS
31 LENOX STREET
BOSTON
,
MA
02118
NONE
PUBLIC CHARITY
GENERAL PURPOSE
12,000
FRIENDS OF THE CHILDREN- BOSTON INC
184 DUDLEY STREET SUITE 100
ROXBURY
,
MA
021192556
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
GENERATIONS INCORPORATED
25 KINGSTON STREET 4TH FLOOR
BOSTON
,
MA
02111
NONE
PUBLIC CHARITY
GENERAL PURPOSE
7,000
GREATER BOSTON FOOD BANKTHE
70 SOUTH BAY AVENUE
BOSTON
,
MA
02118
NONE
PUBLIC CHARITY
GENERAL PURPOSE
20,000
GREATER BOSTON LEGAL SERVICES
197 FRIEND STREET
BOSTON
,
MA
02114
NONE
PUBLIC CHARITY
GENERAL PURPOSE
12,500
HALEY HOUSE
23 DARTMOUTH STREET
BOSTON
,
MA
02116
NONE
PUBLIC CHARITY
GENERAL PURPOSE
6,000
HEADING HOME
529 MAIN STREET SUITE 100
CHARLESTOWN
,
MA
02129
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
HEALTH CARE WITHOUT WALLS
148 LINDEN STREET SUITE 208
WELLESLEY
,
MA
02482
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
HEARTH INC
1640 WASHINGTON STREET
BOSTON
,
MA
02118
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,000
HESPERIAN HEALTH GUIDES
1919 ADDISON STREET SUITE 304
BERKELEY
,
CA
94704
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,000
HOME FOR LITTLE WANDERERSTHE
10 GUEST STREET SUITE 300
BOSTON
,
MA
02135
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,500
HOMEOWNER OPTIONS FOR MASSACHUSETTS ELDERS (HOME)
87 HALE STREET
LOWELL
,
MA
01851
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,000
HORIZONS FOR HOMELESS CHILDREN
1705 COLUMBUS AVENUE
ROXBURY
,
MA
02119
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
HYDE SQUARE TASK FORCE
PO BOX 301871
JAMAICA PLAIN
,
MA
02130
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
IMMIGRANT FAMILY SERVICES INSTITUTE
575 AMERICAN LEGION HIGHWAY
ROSLINDALE
,
MA
02131
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
INTERNATIONAL INSTITUTE OF NEW ENGLAND
2 BOLYSTON STREET 3RD FLOOR
BOSTON
,
MA
02116
NONE
PUBLIC CHARITY
GENERAL PURPOSE
11,000
INVERSANT
561 BOYLSTON STREET 4TH FLOOR
BOSTON
,
MA
02116
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
IRISH INTERNATIONAL IMMIGRANT CENTER
ONE STATE STREET 8TH FLOOR
BOSTON
,
MA
02109
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,000
LA VIDA SCHOLARS
120 MUNROE STREET
LYNN
,
MA
01901
NONE
PUBLIC CHARITY
GENERAL PURPOSE
4,000
LITTLE BROTHERS - FRIENDS OF THE ELDERLY
2 PARK PLAZA SUITE 314
BOSTON
,
MA
02116
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
MAB COMMUNITY SERVICES INC
200 IVY STREET
BROOKLINE
,
MA
02446
NONE
PUBLIC CHARITY
GENERAL PURPOSE
6,000
MARGARET FULLER NEIGHBORHOOD HOUSE INC
71 CHERRY STREET
CAMBRIDGE
,
MA
02139
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,000
MASSACHUSETTS ALLIANCE OF PORTUGUESE SPEAKERS
1046 CAMBRIDGE STREET
CAMBRIDGE
,
MA
02139
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
MASSACHUSETTS COALITION FOR THE HOMELESS
73 BUFFUM STREET
LYNN
,
MA
01902
NONE
PUBLIC CHARITY
GENERAL PURPOSE
9,000
MASSACHUSETTS SOCIETY FOR THE PREVENTION OF CRUELTY TO CHILDREN (MSPCC)
3815 WASHINGTON STREET SUITE 2
JAMAICA PLAIN
,
MA
02130
NONE
PUBLIC CHARITY
GENERAL PURPOSE
7,000
METRO HOUSING BOSTON
1411 TREMONT STREET
BOSTON
,
MA
02120
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
MISSION OF DEEDS
6 CHAPIN AVENUE
READING
,
MA
01867
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
MORE THAN WORDS
56 FELTON STREET
WALTHAM
,
MA
02453
NONE
PUBLIC CHARITY
GENERAL PURPOSE
9,000
MOTHERS FOR JUSTICE AND EQUALITY
2201 WASHINGTON STREET
ROXBURY
,
MA
02119
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
MOUNT PLEASANT HOME
301 SOUTH HUNTINGTON AVENUE
BOSTON
,
MA
02130
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
MUJERES UNIDAS AVANZANDO
54 CLAYTON STREET
DORCHESTER
,
MA
02122
NONE
PUBLIC CHARITY
GENERAL PURPOSE
9,000
MYSTIC VALLEY ELDER SERVICES
300 COMMERCIAL STREET 19
MALDEN
,
MA
02148
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
NEIGHBORHOOD OF AFFORDABLE HOUSING INC
143 BORDER STREET
EAST BOSTON
,
MA
02128
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
OPERATION ABLE OF GREATER BOSTON INC
174 PORTLAND STREET
BOSTON
,
MA
02114
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
PARTNERS FOR YOUTH WITH DISABILITIES
5 MIDDLESEX AVENUE SUITE 307
SOMERVILLE
,
MA
02145
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,000
PCI MEDIA
777 UNITED NATIONS PLAZA 5TH FL
NEW YORK
,
NY
10017
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
PEER HEALTH EXCHANGE
745 ATLANTIC AVE 8TH FLOOR
BOSTON
,
MA
02111
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,000
PHILANTHROPY MASSACHUSETTS
133 FEDERAL STREET SUITE 802
BOSTON
,
MA
02110
NONE
PUBLIC CHARITY
GENERAL PURPOSE
6,150
PLANNED PARENTHOOD LEAGUE OF MASSACHUSETTS
1055 COMMONWEALTH AVENUE
BOSTON
,
MA
02215
NONE
PUBLIC CHARITY
GENERAL PURPOSE
12,000
PLANNED PARENTHOOD OF NORTHERN NEW ENGLAND
784 HERCULES DRIVE SUITE 110
COLCHESTER
,
VT
05446
NONE
PUBLIC CHARITY
GENERAL PURPOSE
15,000
POLITICAL ASYLUM IMMIGRATION REPRESENTATION PROJECT
98 NORTH WASHINGTON STREET SUITE
106
BOSTON
,
MA
02114
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,000
PRO-CHOICE MASSACHUSETTS FOUNDATION
15 COURT SQUARE SUITE 900
BOSTON
,
MA
02108
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
PROJECT BREAD - THE WALK FOR HUNGER
145 BORDER STREET
EAST BOSTON
,
MA
02128
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
PROJECT CITIZENSHIP
4 FANEUIL SOUTH MARKET BUILDING 3RD
FLOOR
BOSTON
,
MA
02109
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
QUINCY COMMUNITY ACTION PROGRAMS INC
1509 HANCOCK STREET
QUINCY
,
MA
02169
NONE
PUBLIC CHARITY
GENERAL PURPOSE
4,000
RAW ART WORKS INC
37 CENTRAL SQUARE
LYNN
,
MA
01901
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
REACH BEYOND DOMESTIC VIOLENCE
PO BOX 540024
WALTHAM
,
MA
02454
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,000
REBUILDING TOGETHER BOSTON
PO BOX 301209
JAMAICA PLAIN
,
MA
02130
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
RESPOND INC
PO BOX 555
SOMERVILLE
,
MA
02143
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
ROGERSON COMMUNITIES
ONE FLORENCE STREET
BOSTON
,
MA
02131
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
ROOM TO GROW
142 BERKELEY STREET FL 3
BOSTON
,
MA
02116
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
ROSIE'S PLACE
889 HARRISON AVENUE
BOSTON
,
MA
02118
NONE
PUBLIC CHARITY
GENERAL PURPOSE
7,000
SELF ESTEEM BOSTON EDUCATIONAL INSTITUTE
PO BOX 301155
JAMAICA PLAIN
,
MA
02130
NONE
PUBLIC CHARITY
GENERAL PURPOSE
6,000
SOCIEDAD LATINA
1530 TREMONT STREET
ROXBURY
,
MA
02120
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
SOUTH BOSTON NEIGHBORHOOD HOUSE
136 H ST
SOUTH BOSTON
,
MA
02127
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
SPORTSMEN'S TENNIS & ENRICHMENT CENTER
950 BLUE HILL AVENUE
DORCHESTER
,
MA
02124
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
SPRINGWELL
307 WAVERLEY OAKS ROAD STE 2015
WALTHAM
,
MA
02452
NONE
PUBLIC CHARITY
GENERAL PURPOSE
2,000
ST FRANCIS HOUSE
7 BOYLSTON SQUARE
BOSTON
,
MA
02116
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
STEPPINGSTONE FOUNDATION INC
ONE APPLETON STREET 4TH FLOOR
BOSTON
,
MA
02116
NONE
PUBLIC CHARITY
GENERAL PURPOSE
7,500
STRAIGHT AHEAD MINISTRIES
791 MAIN STREET
WORCESTER
,
MA
01610
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
SUMMER SEARCH BOSTON
3840 WASHINGTON STREET
JAMAICA PLAIN
,
MA
02130
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
THOMPSON ISLAND OUTWARD BOUND EDUCATION CENTER
PO BOX 127
BOSTON
,
MA
02127
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
UPSTREAM USA
426 17TH STREET SUITE 200
OAKLAND
,
CA
94612
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
VETERANS LEGAL SERVICES
225 FRIEND STREET SUITE 504
BOSTON
,
MA
02114
NONE
PUBLIC CHARITY
GENERAL PURPOSE
6,000
VICTORY PROGRAMS INC
965 MASSACHUSETTS AVENUE
BOSTON
,
MA
02118
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
VIETNAMESE AMERICAN INITIATIVE FOR DEVELOPMENT DBA VIETAID INC
42 CHARLES STREET SUITE E
DORCHESTER
,
MA
02122
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
WALKER INC
1968 CENTRAL AVENUE
NEEDHAM
,
MA
02492
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
WEST END HOUSE INC
105 ALLSTON STREET
ALLSTON
,
MA
02134
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,000
WOMEN'S LUNCH PLACE
PO BOX 170900
BOSTON
,
MA
02117
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
YOUNG AUDIENCES OF MASSACHUSETTS INC
89 SOUTH STREET SUITE 603
BOSTON
,
MA
02111
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,000
YOUTHBUILD BOSTON
27 CENTRE STREET
BOSTON
,
MA
02119
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,000
ZUMIX
260 SUMNER STREET
EAST BOSTON
,
MA
02128
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
VOLUNTEER LAWYERS PROJECT OF THE BOSTON BAR ASSOCIATION INC
7 WINTHROP SQUARE FL 2
BOSTON
,
MA
02110
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
THE MEDICAL FOUNDATION A DIVISION OF HEALTH RESOURCES IN ACTION
2 BOYLSTON STREET 4TH FLOOR
BOSTON
,
MA
02116
NONE
PUBLIC CHARITY
GENERAL PURPOSE
63,730
SHOOTING TOUCH INC
65 SPRAGUE STREET
BOSTON
,
MA
02136
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
ROCA INC
101 PARK STREET
CHELSEA
,
MA
02150
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
CAMBRIDGE WOMEN'S CENTER
46 PLEASANT STREET
CAMBRIDGE
,
MA
02139
NONE
PUBLIC CHARITY
GENERAL PURPOSE
7,000
HARLEM LACROSSE - BOSTON
PO BOX 260982
MATTAPAN
,
MA
02126
NONE
PUBLIC CHARITY
GENERAL PURPOSE
7,000
JFY NETWORKS
44 SCHOOL STREET 1010
BOSTON
,
MA
02108
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,000
UNITARIAN UNIVERSALIST URBAN MINISTRY
10 PUTMAN STREET
ROXBURY
,
MA
02119
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,000
NATIONAL BRAILLE PRESS
88 ST STEPHEN STREET
BOSTON
,
MA
02115
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
LITTLE SISTERS OF TH ASSUMPTION FAMILY HEALTH
65 MAGNOLIA STREET
DORCHESTER
,
MA
02125
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
VIETNAME VETERANS WORKSHOP INC
17 COURT STREET
BOSTON
,
MA
02108
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
CLARKE SCHOOLS FOR HEARING & SPEECH
1 WHITMAN ROAD
CANTON
,
MA
02021
NONE
PUBLIC CHARITY
GENERAL PURPOSE
8,000
THIRD SECTOR NEW ENGLAND INC
89 SOUTH STREET SUITE 700
BOSTON
,
MA
02111
NONE
PUBLIC CHARITY
GENERAL PURPOSE
7,000
JEWISH FAMILY & CHILDREN'S SERVICE
1430 MAIN STREET
WALTHAM
,
MA
02451
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
PIERS PARK SAILING CENTER
95 MARGINAL STREET
BOSTON
,
MA
02128
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
ITALIAN HOME FOR CHILDREN
1125 CENTRE STREET
JAMAICA PLAIN
,
MA
02130
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
ELLIS MEMORIAL & ELDREDGE HOUSE
66 BERKELEY STREET
BOSTON
,
MA
02116
NONE
PUBLIC CHARITY
GENERAL PURPOSE
6,000
TRANSITION HOUSE INC
PO BOX 392016
CAMBRIDGE
,
MA
02139
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
CRISPUS ATTUCKS CHILDREN'S CENTER
105 CRAWFORD STREET
DORCHESTER
,
MA
02121
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
BREAD OF LIFE
54 EASTERN AVE
MALDEN
,
MA
02148
NONE
PUBLIC CHARITY
GENERAL PURPOSE
5,000
BOSTON CHARITABLE TRUST FUND
1 CITY HALL SQUARE ROOM M-5
BOSTON
,
MA
02201
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
UNITED WAY OF MASSACHUSETTS BAY AND MERRIMACK VALLEY
51 SLEEPER STREET
BOSTON
,
MA
02210
NONE
PUBLIC CHARITY
GENERAL PURPOSE
10,000
Total
.................................
3a
1,071,380
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
...........
4
Dividends and interest from securities
....
14
467,050
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
1,632,363
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
K1 PARK STREET CAPITAL PRIVATE EQUITY
14
12,395
b
K1 WINDSAIL CREDIT QP FUND, LP
14
-2,858
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
0
2,108,950
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
2,108,950
(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