Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0052
2020
Open to Public Inspection
For calendar year 2020, or tax year beginning 01-01-2020 , and ending 12-31-2020
Name of foundation
The Clements Foundation Inc
 
% Foundation Source
Number and street (or P.O. box number if mail is not delivered to street address)Foundation Source 501 Silverside Rd
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Wilmington, DE198091377
A Employer identification number

06-1480882
B Telephone number (see instructions)

(800) 839-1754
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ...
bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$1,211,656
J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books
(b) Net investment
income
(c) Adjusted net
income
(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule) 272
2 Check bullet.............
3 Interest on savings and temporary cash investments 5,542 5,542  
4 Dividends and interest from securities... 2,912 2,912  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 22,313
b Gross sales price for all assets on line 6a 157,367
7 Capital gain net income (from Part IV, line 2)... 22,313
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)....... 26 26  
12 Total. Add lines 1 through 11........ 31,065 30,793  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0      
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule).......        
c Other professional fees (attach schedule).... 5,116 5,116    
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... 8,069 62    
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... 10,889 11   10,878
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 24,074 5,189   10,878
25 Contributions, gifts, grants paid....... 508,500 508,500
26 Total expenses and disbursements. Add lines 24 and 25 532,574 5,189   519,378
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -501,509
b Net investment income (if negative, enter -0-) 25,604
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2020)
Form 990-PF (2020)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing.............      
2 Savings and temporary cash investments......... 1,073,493 542,623 542,623
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)....... 300,486 Click to see attachment329,847 669,033
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 1,373,979 872,470 1,211,656
Liabilities 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 bullet)    
23 Total liabilities (add lines 17 through 22)......... 0 0
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions...........    
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds 1,373,979 872,470
29 Total net assets or fund balances (see instructions)..... 1,373,979 872,470
30 Total liabilities and net assets/fund balances (see instructions). 1,373,979 872,470
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
1,373,979
2
Enter amount from Part I, line 27a .....................
2
-501,509
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
872,470
5
Decreases not included in line 2 (itemize) bullet
5
 
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
872,470
Form 990-PF (2020)
Form 990-PF (2020)
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
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 157,367   135,054 22,313
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
Excess of col. (i)
over col. (j), if any
a       22,313
b
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
Bracket 2 22,313
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ...................
Bracket 3  
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
SECTION 4940(e) REPEALED ON DECEMBER 20, 2019 - DO NOT COMPLETE
1 Reserved
(a)
Reserved
(b)
Reserved
(c)
Reserved
(d)
Reserved
2
Reserved...........................
2
3
Reserved...........................
3
4
Reserved...........................
4
5
Reserved...........................
5
6
Reserved...........................
6
7
Reserved...........................
7
8
Reserved,..........................
8
Form 990-PF (2020)
Form 990-PF (2020)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b Reserved................................ 1 356
c All other domestic foundations enter 1.39% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2  
3 Add lines 1 and 2........................... 3 356
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 356
6 Credits/Payments:
a 2020 estimated tax payments and 2019 overpayment credited to 2020 6a 6,800
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 6,800
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 6,444
11 Enter the amount of line 10 to be: Credited to 2021 estimated taxBullet400 RefundedBullet 11 6,044
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 the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
Yes
 
If "Yes," attach the statement required by General Instruction T.Click to see attachment
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
  • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletCT
    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 2020 or the taxable year beginning in 2020? 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 (2020)
    Form 990-PF (2020)
    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 addressbullet  
    14
    The books are in care ofbulletFoundation Source Telephone no.bullet (800) 839-1754

    Located atbullet501 Silverside Road Suite 123WilmingtonDE ZIP+4bullet198091377
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2020, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?......................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?...............
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).......
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ........
    1b
     
     
    ........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2020?.............
    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 2020, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2020?.............
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?......................
    b
    If "Yes," did it have excess business holdings in 2020 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 2020.)..................
    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 2020?
    4b
     
    No
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 6
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?.............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?.....
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ......
    5b
     
     
    .........bullet
    c
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?..........
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?.....................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .................
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation
    (If not paid, enter
    -0-)
    (d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    Ben Clements Dir, Sec
    1.0
    0 0 0
    Foundation Source 501 Silverside Rd
    Wilmington,DE198091377
    Jeffrey Clements Dir
    1.0
    0 0 0
    Foundation Source 501 Silverside Rd
    Wilmington,DE198091377
    John Clements Dir, Treas
    1.0
    0 0 0
    Foundation Source 501 Silverside Rd
    Wilmington,DE198091377
    Marilyn Clements Dir
    1.0
    0 0 0
    Foundation Source 501 Silverside Rd
    Wilmington,DE198091377
    Paula Clements Sager Dir, Pres, Chairperson
    1.0
    0 0 0
    Foundation Source 501 Silverside Rd
    Wilmington,DE198091377
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation
    (e) Expense account,
    other allowances
     
    Total number of other employees paid over $50,000...................bullet  
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 7
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
     
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2020)
    Form 990-PF (2020)
    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
    551,673
    b
    Average of monthly cash balances.......................
    1b
    823,351
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    1,375,024
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    1,375,024
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    20,625
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    1,354,399
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    67,720
    Part XI
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    67,720
    2a
    Tax on investment income for 2020 from Part VI, line 5......
    2a
    356
    b
    Income tax for 2020. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    356
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    67,364
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    67,364
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
    67,364
    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
    519,378
    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
    519,378
    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
    519,378
    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 (2020)
    Form 990-PF (2020)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus
    (b)
    Years prior to 2019
    (c)
    2019
    (d)
    2020
    1 Distributable amount for 2020 from Part XI, line 7 67,364
    2 Undistributed income, if any, as of the end of 2020:
    a Enter amount for 2019 only.......  
    b Total for prior years:2018, 2017, 2016  
    3 Excess distributions carryover, if any, to 2020:
    a From 2015...... 87,167
    b From 2016...... 222,028
    c From 2017...... 234,607
    d From 2018...... 80,618
    e From 2019...... 454,767
    fTotal of lines 3a through e........ 1,079,187
    4Qualifying distributions for 2020 from Part
    XII, line 4: bullet$ 519,378
    a Applied to 2019, but not more than line 2a  
    b Applied to undistributed income of prior years
    (Election required—see instructions).....
     
    c Treated as distributions out of corpus (Election
    required—see instructions)........
     
    d Applied to 2020 distributable amount..... 67,364
    e Remaining amount distributed out of corpus 452,014
    5 Excess distributions carryover applied to 2020.    
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 1,531,201
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........
     
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......
     
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........
     
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............
     
    f Undistributed income for 2020. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2021 ..........
    0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......
     
    8 Excess distributions carryover from 2015 not
    applied on line 5 or line 7 (see instructions) ...
    87,167
    9Excess distributions carryover to 2021.
    Subtract lines 7 and 8 from line 6a ......
    1,444,034
    10 Analysis of line 9:
    a Excess from 2016.... 222,028
    b Excess from 2017.... 234,607
    c Excess from 2018.... 80,618
    d Excess from 2019.... 454,767
    e Excess from 2020.... 452,014
    Form 990-PF (2020)
    Form 990-PF (2020)
    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 2020, enter the date of the ruling....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........
    Tax year Prior 3 years (e) Total
    (a) 2020 (b) 2019 (c) 2018 (d) 2017
             
    b 85% of line 2a .........          
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....
             
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........
             
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....
             
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)
             
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part X, line 6 for each year listed...
             
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....
             
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....
             
    (3) Largest amount of support
    from an exempt organization
             
    (4) Gross investment income          
    Part XV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    Marilyn Clements
    Paula Clements Sager
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 11
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    Foundation
    status of
    recipient
    Purpose of grant or
    contribution
    Amount
    Name and address (home or business)
    aPaid during the year
    ALLIANCE FOR GLOBAL JUSTICE
    225 E 26TH ST STE 1
    TUCSON,AZ85713
    N/A PC The Movement For Black Lives Program 10,000
    AMERICAN PROMISE EDUCATION FUND INC
    33 BRADFORD ST
    CONCORD,MA01742
    N/A PC General & Unrestricted 25,000
    BOSTON MEDICAL CENTER CORPORATION
    801 MASSACHUSETTS AVE 1ST FL
    BOSTON,MA02118
    N/A PC Corona Virus Relief Fund 10,000
    CASA MARIANELLA
    821 GUNTER ST
    AUSTIN,TX78702
    N/A PC General & Unrestricted 5,000
    CONTEMPLATIVE LIFE INC
    PO BOX 342306
    AUSTIN,TX78734
    N/A PC General & Unrestricted 20,000
    DEFY VENTURES INC
    PO BOX 102117
    PASADENA,CA91189
    N/A PC General & Unrestricted 25,000
    EAST BAY COMMUNITY ACTION PROGRAM
    610 WAMPANOAG TRL
    RIVERSIDE,RI02915
    N/A PC Food Pantry Program 5,000
    EQUAL JUSTICE INITIATIVE
    122 COMMERCE ST
    MONTGOMERY,AL36104
    N/A PC General & Unrestricted 10,000
    FIRST NATIONS DEVELOPMENT INSTITUTE
    2432 MAIN ST 2ND FL
    LONGMONT,CO80501
    N/A PC General & Unrestricted 15,000
    FREE SPEECH FOR PEOPLE INC
    505 W 38TH ST UNIT A4
    AUSTIN,TX78705
    N/A PC General & Unrestricted 25,000
    FREE SPEECH FOR PEOPLE INC
    505 W 38TH ST UNIT A4
    AUSTIN,TX78705
    N/A PC the hiring of a campaign director fund 75,000
    GRAMEEN RESEARCH INC
    500 W CUMMINGS PARK STE 5200
    WOBURN,MA01801
    N/A PC Yunus Social Business Program 100,000
    GUARDIAN ORG FOUNDATION
    900 17TH ST NW STE 250
    WASHINGTON,DC20006
    N/A PC General & Unrestricted 10,000
    HEAD COUNT INC
    104 W 29TH ST 11TH FL
    NEW YORK,NY10001
    N/A PC General & Unrestricted 10,000
    MEADOWBROOK WALDORF ASSOCIATION
    300 KINGSTOWN RD
    WEST KINGSTON,RI02892
    N/A PC Meadowbrook Rising campaign 25,000
    MOVEON EDUCATION FUND
    CO RSM 2021 L ST NW NO 400
    WASHINGTON,DC20036
    N/A PC General & Unrestricted 5,000
    NEW GEORGIA PROJECT INCORPORATED
    830 GLENWOOD AVE SE STE 510-221
    ATLANTA,GA30316
    N/A PC General & Unrestricted 10,000
    PAN MASSACHUSETTS CHALLENGE TRUST
    77 4TH AVE
    NEEDHAM,MA02494
    N/A PC General & Unrestricted 10,000
    PARTNERS IN HEALTH A NONPROFIT CORPORATION
    PO BOX 996
    FREDERICK,MD21705
    N/A PC General & Unrestricted 10,000
    PHOENIX CHAMBER MUSIC SOCIETY
    PO BOX 34235
    PHOENIX,AZ85067
    N/A PC the Composer-in-Residence program 41,000
    REFUGEE & IMMIGRANT CENTER FOR EDUCATION & LEGAL S
    1305 N FLORES ST
    SAN ANTONIO,TX78212
    N/A PC General & Unrestricted 5,000
    SUMMER SEARCH NEW YORK CITY
    90 BROAD ST STE 701
    NEW YORK,NY10004
    N/A PC General & Unrestricted 12,500
    SUNRISE MOVEMENT EDUCATION FUND
    50 F ST NW STE 700
    WASHINGTON,DC20001
    N/A PC General & Unrestricted 20,000
    TIDES FOUNDATION
    PO BOX 399389
    SAN FRANCISCO,CA94139
    N/A PC Movement Voter Project 10,000
    TIDES FOUNDATION
    PO BOX 399389
    SAN FRANCISCO,CA94139
    N/A PC Movement Voter Project 10,000
    WIKIMEDIA FOUNDATION INC
    PO BOX 98204
    WASHINGTON,DC20090
    N/A PC General & Unrestricted 5,000
    Total .................................bullet 3a 508,500
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code
    (b)
    Amount
    (c)
    Exclusion code
    (d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3 Interest on savings and temporary cash
    investments ...........
        14 5,542  
    4 Dividends and interest from securities....     14 2,912  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income.....          
    8 Gain or (loss) from sales of assets other than
    inventory ............
        18 22,313  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue:
    aCLASS ACTION LAWSUIT PROCEEDS
        01 26  
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e)..   30,793  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    30,793
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow
    Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 13
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below?
    See instructions.
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    Firm's EIN SmallBullet
    Firm's address SmallBullet


    Phone no.
    Form 990-PF (2020)
    Additional Data


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    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

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    TY 2020 DepreciationSchedule
    Name:
    The Clements Foundation Inc
    EIN:
    06-1480882
    Description of Property Date Acquired Cost or Other Basis Prior Years' Depreciation Computation Method Rate /
    Life (# of years)
    Current Year's Depreciation Expense Net Investment Income Adjusted Net Income Cost of Goods Sold Not Included

    TY 2020 InvestmentsCorpStockSchedule
    Name:
    The Clements Foundation Inc
    EIN:
    06-1480882
    Name of Stock End of Year Book Value End of Year Fair Market Value
    2U INC 1,292 1,000
    ACCENTURE PLC 1,223 3,396
    ACTIVISION BLIZZARD INC 2,744 3,714
    AGILENT TECHNOLOGIES INC 1,038 1,659
    ALIBABA GROUP HOLDING LTD 2,770 4,422
    ALIGN TECHNOLOGY, INC 2,192 4,809
    ALPHABET INC CL A 2,996 7,011
    ALPHABET INC CL C 4,722 10,511
    AMAZON COM 5,494 19,542
    AMEDISYS INC - COMMON STOCK 2,087 4,400
    AMERIPRISE FINANCIAL INC 2,475 4,275
    ANALOG DEVICES INC 8,982 11,523
    ANSYS INC 1,977 4,729
    APPLE INC 1,892 6,900
    ARCH CAPITAL GROUP LTD 21,095 118,311
    AUTODESK, INC 2,959 3,664
    BERKSHIRE HATHAWAY INC. CLASS 3,723 5,797
    BLACKLINE INC 1,913 4,935
    BLACKROCK INC 2,297 3,608
    BOOKING HOLDINGS INC 6,353 8,909
    BRIGHT HORIZONS FAMILY SOLUTIO 1,575 2,076
    CANADIAN NATL RAILWAY CO 1,165 1,977
    CARMAX INC 3,266 5,101
    CARRIER GLOBAL 1,169 2,527
    CATALENT INC 819 1,665
    CHEMED CORP 1,988 3,728
    CME GROUP, INC 2,454 2,549
    CONAGRA FOODS INC 2,019 2,357
    COSTAR GROUP, INC 3,723 8,319
    CROWN CASTLE INTL 2,910 4,457
    DANAHER CORP 2,693 4,221
    DEXCOM, INC 1,442 3,697
    DOCUSIGN INC 1,517 6,224
    ECOLAB INC 2,929 4,327
    EDWARDS LIFESCIENCES 1,746 5,474
    ESTEE LAUDER COMPANIES INC 3,103 3,727
    FACEBOOK INC 8,418 14,204
    FASTENAL COMPANY 2,289 4,151
    FIDELITY NATIONAL INFORMATION 1,464 1,556
    FIRST REPUBLIC BANK 3,423 3,820
    FIVE BELOW INC 2,786 4,200
    GENTEX CORPORATION 1,763 2,036
    GLOBANT SA 2,060 6,311
    GUARDANT HEALTH INC 2,722 3,866
    GUIDEWIRE SOFTWARE INC 1,648 2,188
    HEALTHCARE SVCS GROUP INC 2,633 2,473
    HEICO CORP 2,604 5,031
    HENRY JACK & ASSOC INC 2,469 2,430
    IAC INTERACTIVE CORP 2,374 3,408
    IDEXX CORP 1,849 3,999
    IHS MARKIT LTD 2,208 3,593
    ILLUMINA INC COM 3,235 3,700
    INSULET CORPORATION 1,502 2,045
    INTUIT 1,637 2,659
    JACOBS ENGINEERING GP 2,610 3,596
    JP MORGAN CHASE 3,226 4,447
    KEYSIGHT TECHNOLOGIES INC 3,764 5,019
    KKR & CO INC 1,808 2,794
    LINDE PLC COM 1,295 2,108
    LOWES COMPANIES INC 2,871 5,939
    LULULEMON ATHLETICA INC 1,280 2,088
    MASTERCARD INC 2,591 9,280
    MATCH GROUP INC 3,641 6,652
    MERCK & CO INC 1,286 1,636
    MICROSOFT CORP 7,623 22,465
    NATIONAL INSTRUMENTS CORPORATI 1,694 2,109
    NEOGEN CORPORATION 890 1,427
    NETFLIX INC 1,900 2,704
    NEW ALTERNATIVES FD INC 37,749 53,598
    NIKE INC-CL B 3,542 6,508
    NOMAD FOODS LIMITED 2,325 3,432
    NVIDIA CORP 2,152 4,700
    OKTA INC 669 2,034
    OLD DOMINION FREIGHT LINES 1,123 2,342
    OTIS WORLDWIDE CORP 1,529 1,824
    PAYCOM SOFTWARE 2,437 6,332
    PAYPAL HOLDINGS, INC 2,000 11,944
    PLURALSIGHT INC 1,438 1,111
    PROTO LABS INC 1,933 3,528
    QUALCOMM INC 3,259 3,351
    RITCHIE BROS AUCTIONEERS 2,440 5,216
    ROCHE HOLDING LTD ADR 1,493 1,797
    ROCKWELL AUTOMATION INC 4,938 6,019
    ROLLINS INC 2,752 4,102
    S&P GLOBAL INC COM 2,764 4,602
    SALESFORCE.COM 5,393 9,346
    SBA COMMUNICATIONS CORP 1,438 2,539
    SERVICE NOW 2,034 3,853
    SMITH A O CORP DEL COM 1,206 1,206
    SPLUNK INC 1,803 2,378
    SPOTIFY TECHNOLOGY SA 1,452 3,147
    STARBUCKS CORP COM 2,372 4,279
    TAIWAN SEMICONDUCTOR MFG CO LT 1,093 3,271
    TELADOC INC 1,662 3,199
    THE BLACKSTONE GROUP INC CL A 1,373 1,944
    THE HAIN CELESTIAL GROUP, INC 1,524 2,289
    THERMO FISHER SCIENTIFIC INC 1,602 3,260
    TJX COMPANIES INC 710 1,434
    TYLER TECHNOLOGIES, INC 3,759 6,548
    UNITED RENTALS INC 1,173 2,319
    UNITEDHEALTH GROUP INC 5,080 9,118
    VEEVA SYSTEMS INC 1,795 5,445
    VERISK ANALYTICS, INC 2,670 4,775
    VISA INC 8,342 19,905
    WALT DISNEY HOLDINGS CO 4,680 7,247
    WEST PHARMA SVCS INC 2,132 4,816
    ZOETIS INC 3,706 4,800

    TY 2020 LiquidationExplanationStmt
    Name:
    The Clements Foundation Inc
    EIN:
    06-1480882
    Statement:
    As explained below, the Foundation has no plans for dissolution. This statement is submitted to report the distribution of certain assets during the year. The distributions resulted in a substantial contraction of assets. The following information is submitted in accordance with Treasury Regulation Section 1.6043-3(a)(1) and the Form 990-PF instructions: During the taxable year ending December 31, 2020, the Foundation made distributions from assets from sources other than current income. Collectively, the distributions in excess of current income totaled $508,500. This amount represents 25% or more of the Foundation's net assets of $1,601,422 (as measured by fair market value) at the beginning of the Foundation's taxable year ending December 31, 2020. Although the Foundation technically experienced a substantial contraction, it will continue in existence and has no plans for dissolution. The Foundation made distributions of cash to the grantees listed in the attachment to Part XV, Line 3a; each such grant was made solely for the charitable purpose specified therein.


    TY 2020 OtherExpensesSchedule
    Name:
    The Clements Foundation Inc
    EIN:
    06-1480882
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Administrative Fees 10,828     10,828
    Bank Charges 11 11    
    State or Local Filing Fees 50     50


    TY 2020 OtherIncomeSchedule2
    Name:
    The Clements Foundation Inc
    EIN:
    06-1480882
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    Class Action Lawsuit Proceeds 26 26  


    TY 2020 OtherProfessionalFeesSchedule
    Name:
    The Clements Foundation Inc
    EIN:
    06-1480882
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Investment Management Services 5,116 5,116    


    TY 2020 TaxesSchedule
    Name:
    The Clements Foundation Inc
    EIN:
    06-1480882
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    990-PF Estimated Tax for 2020 6,800      
    990-PF Excise Tax for 2019 1,207      
    Foreign Tax Paid 62 62