TY 2020 Form 990PF

- TIN:

Form990-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.
bullet

Go 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
ROUBACK FAMILY FOUNDATION 100127

Number and street (or P.O. box number if mail is not delivered to street address)UMB BANK NA P O BOX 415044 M/S
Room/suite

City or town, state or province, country, and ZIP or foreign postal code
KANSAS CITY, MO641416692

A Employer identification number

48-6143203

B Telephone number (see instructions)

(816) 860-7711

C If exemption application is pending, check here bullet

G Check all that apply: Initial returnInitial return of a former public charity
Final returnAmended return
Address change Name change

D 1. Foreign organizations, check here............. bullet

2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet

E If private foundation status was terminated
under section 507(b)(1)(A), check here ....... bullet

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 ....... bullet

I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16) bullet

$4,203,572J Accounting method: Cash Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)

	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...	34,725		34,403
5a	Gross rents............	52,265		52,265
b	Net rental income or (loss) 42,492
6a	Net gain or (loss) from sale of assets not on line 10		116,180
b	Gross sales price for all assets on line 6a 833,682
7	Capital gain net income (from Part IV, line 2)...			116,180
8	Net short-term capital gain.........				0
9	Income modifications...........
10a	Gross sales less returns and allowances
b	Less: Cost of goods sold....
c	Gross profit or (loss) (attach schedule).....
11	Other income (attach schedule).......		4,484	4,155
12	Total. Add lines 1 through 11........	207,654		207,003
13	Compensation of officers, directors, trustees, etc.	43,918		21,959		21,959
14	Other employee salaries and wages......			0	0	0
15	Pension plans, employee benefits.......			0	0
16a	Legal fees (attach schedule).........		1,314	329	0	986
b	Accounting fees (attach schedule).......		800	0	0	800
c	Other professional fees (attach schedule)....					0
17	Interest...............					0
18	Taxes (attach schedule) (see instructions)...		344	344		0
19	Depreciation (attach schedule) and depletion...		0	0
20	Occupancy..............
21	Travel, conferences, and meetings.......			0	0
22	Printing and publications..........			0	0
23	Other expenses (attach schedule).......		12,273	12,273
24	Total operating and administrative expenses.
	Add lines 13 through 23..........	58,649		34,905	0	23,745
25	Contributions, gifts, grants paid.......	174,600				174,600
26	Total expenses and disbursements. Add lines 24 and 25	233,249		34,905	0	198,345
27	Subtract line 26 from line 12:
a	Excess of revenue over expenses and disbursements	-25,595
b	Net investment income (if negative, enter -0-)			172,098
c	Adjusted net income (if negative, enter -0-)...				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	Beginning of year	End of year
Part II		Balance Sheets	(a) Book Value	(b) Book Value	(c) Fair Market Value
	1	Cash—non-interest-bearing.............
	2	Savings and temporary cash investments.........	77,987	143,966	143,966
	3	Accounts receivable
		Less: allowance for doubtful accounts		0	0
	4	Pledges receivable
		Less: allowance for doubtful accounts
	5	Grants receivable.................
	6	Receivables due from officers, directors, trustees, and other
		disqualified persons (attach schedule) (see instructions).....
	7	Other notes and loans receivable (attach schedule)
		Less: allowance for doubtful accounts 0
	8	Inventories for sale or use..............
	9	Prepaid expenses and deferred charges..........
	10a	Investments—U.S. and state government obligations (attach schedule)
	b	Investments—corporate stock (attach schedule).......
	c	Investments—corporate bonds (attach schedule).......
	11	Investments—land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	12	Investments—mortgage loans.............
	13	Investments—other (attach schedule)..........	1,864,098	1,772,278	4,059,606
	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)	1,942,085	1,916,244	4,203,572
	17	Accounts payable and accrued expenses..........
	18	Grants payable.................
	19	Deferred revenue.................
	20	Loans from officers, directors, trustees, and other disqualified persons
	21	Mortgages and other notes payable (attach schedule)......
	22	Other liabilities (describe )
	23	Total liabilities (add lines 17 through 22).........		0
		Foundations that follow FASB ASC 958, check here
		and complete lines 24, 25, 29 and 30.
	24	Net assets without donor restrictions...........
	25	Net assets with donor restrictions............
		Foundations that do not follow FASB ASC 958, check here
		and complete lines 26 through 30.
	26	Capital stock, trust principal, or current funds........	1,942,085	1,916,244
	27	Paid-in or capital surplus, or land, bldg., and equipment fund
	28	Retained earnings, accumulated income, endowment, or other funds
	29	Total net assets or fund balances (see instructions).....	1,942,085	1,916,244
	30	Total liabilities and net assets/fund balances (see instructions).	1,942,085	1,916,244

Part III

Analysis of Changes in Net Assets or Fund Balances

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) ...............

1,942,085

Enter amount from Part I, line 27a .....................

-25,595

Other increases not included in line 2 (itemize) bullet

Add lines 1, 2, and 3 ..........................

1,916,490

Decreases not included in line 2 (itemize) bullet

246

Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .

1,916,244

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	35. APPLE COMPUTER INC		2018-12-13	2020-01-09
b	55. CONSTELLATION BRANDS INC CLASS A		2017-08-10	2020-01-09
c	5. DANAHER CORP		2011-06-08	2020-01-09
d	130. PROGRESSIVE CORP OHIO		2019-07-11	2020-01-09
e	90. SOUTHWEST AIRLINES CO		2018-06-14	2020-01-09
	5. STRYKER CORP		2017-08-10	2020-01-09
	63.8465 GOVT NATIONAL MTG ASSN II DTD 8/1/2005 5.0000% 8/20/2020		2006-01-23	2020-01-21
	63.8465 GOVT NATIONAL MTG ASSN II DTD 8/1/2005 5.0000% 8/20/2020		2016-05-18	2020-01-21
	25000. AUTONATION INC DTD 2/1/2012 5.500% 2/1/2020		2015-09-09	2020-02-03
	50.8325 GOVT NATIONAL MTG ASSN II DTD 8/1/2005 5.0000% 8/20/2020		2006-01-23	2020-02-20
	50.8325 GOVT NATIONAL MTG ASSN II DTD 8/1/2005 5.0000% 8/20/2020		2016-05-18	2020-02-20
	1740. SEAFARER OVERSEAS GROWTH & INCOME FD I		2018-03-26	2020-03-05
	1503. OAKMARK INTERNATIONAL FUND INSTITUTIONAL		2019-02-22	2020-03-05
	196.528 VANGUARD INSTITUTIONAL INDEX		2019-12-24	2020-03-05
	180.093 VANGUARD INSTITUTIONAL INDEX		2018-12-19	2020-03-05
	285. BANK OF AMERICA CORP		2018-03-15	2020-03-12
	100. COMCAST CORP NEW		2019-09-13	2020-03-12
	95. EOG RESOURCES INC		2015-08-13	2020-03-12
	35. EOG RESOURCES INC		2020-01-09	2020-03-12
	10. FISERV INC		2018-09-13	2020-03-12
	60. RAYTHEON CO		2020-01-09	2020-03-12
	5. SALESFORCE.COM INC		2018-08-08	2020-03-12
	25000. AMERIPRISE FINANCIAL INC DTD 3/11/2010 5.300% 3/15/2020		2015-12-17	2020-03-16
	40.128 GOVT NATIONAL MTG ASSN II DTD 8/1/2005 5.0000% 8/20/2020		2006-01-23	2020-03-20
	40.128 GOVT NATIONAL MTG ASSN II DTD 8/1/2005 5.0000% 8/20/2020		2016-05-18	2020-03-20
	140. SOUTHWEST AIRLINES CO		2018-06-14	2020-03-25
	52. UNITED RENTALS INC		2019-04-11	2020-03-25
	29.3735 GOVT NATIONAL MTG ASSN II DTD 8/1/2005 5.0000% 8/20/2020		2006-01-23	2020-04-20
	29.3735 GOVT NATIONAL MTG ASSN II DTD 8/1/2005 5.0000% 8/20/2020		2016-05-18	2020-04-20
	60. ABBOTT LABORATORIES		2018-09-13	2020-05-14
	235. COMCAST CORP NEW		2019-11-13	2020-05-14
	70. HONEYWELL INTERNATIONAL INC		2016-03-10	2020-05-14
	18.5695 GOVT NATIONAL MTG ASSN II DTD 8/1/2005 5.0000% 8/20/2020		2006-01-23	2020-05-20
	18.5695 GOVT NATIONAL MTG ASSN II DTD 8/1/2005 5.0000% 8/20/2020		2016-05-18	2020-05-20
	20. BROADCOM INC		2020-01-09	2020-06-11
	225. CISCO SYSTEMS INC		2020-01-09	2020-06-11
	175. KELLOGG CO		2019-10-10	2020-06-11
	7.715 GOVT NATIONAL MTG ASSN II DTD 8/1/2005 5.0000% 8/20/2020		2006-01-23	2020-06-22
	7.715 GOVT NATIONAL MTG ASSN II DTD 8/1/2005 5.0000% 8/20/2020		2016-05-18	2020-06-22
	18. DOCUSIGN INC.		2020-06-11	2020-07-09
	20. FACEBOOK INC - A SHS		2014-12-22	2020-07-09
	3.8535 GOVT NATIONAL MTG ASSN II DTD 8/1/2005 5.0000% 8/20/2020		2006-01-23	2020-07-20
	3.8535 GOVT NATIONAL MTG ASSN II DTD 8/1/2005 5.0000% 8/20/2020		2016-05-18	2020-07-20
	1537. MANNING & NAPIER INTL. DISCOVERY CL Z		2017-06-06	2020-08-10
	9.436 TRIBUTARY SMALL CO INSTITUTIONAL PLUS		2019-12-13	2020-08-10
	367.564 TRIBUTARY SMALL CO INSTITUTIONAL PLUS		2019-01-08	2020-08-10
	1319. DEVELOPED MARKETS INDEX FUND ADMIRAL CL		2017-05-08	2020-08-10
	78. ACTIVISION BLIZZARD INC		2019-09-13	2020-08-13
	3. AMAZON COM INC		2016-06-08	2020-08-13
	18. APPLE COMPUTER INC		2016-02-11	2020-08-13
	50000. GOVT NATIONAL MTG ASSN II DTD 8/1/2005 5.0000% 8/20/2020		2016-05-18	2020-08-20
	22. ABBOTT LABORATORIES		2018-01-11	2020-09-03
	12. ABBVIE INC		2020-05-14	2020-09-03
	19. ACTIVISION BLIZZARD INC		2019-09-13	2020-09-03
	6. ADOBE SYSTEMS INC		2017-02-09	2020-09-03
	5. ALPHABET INC		2018-12-13	2020-09-03
	3. AMAZON COM INC		2016-06-08	2020-09-03
	394.852 BAILLIE GIFFORD INTL ALPHA - INSTL		2020-08-10	2020-09-03
	7. BECTON DICKINSON & CO		2018-01-11	2020-09-03
	42. BROWN FORMAN CORPORATION CLASS B		2018-05-10	2020-09-03
	9. CME GROUP INC		2018-11-19	2020-09-03
	10. COSTCO WHOLESALE CORP		2020-08-13	2020-09-03
	4. COSTAR GROUP INC		2019-11-13	2020-09-03
	23. DANAHER CORP		2011-06-08	2020-09-03
	25. DISNEY WALT HOLDING CO		2018-12-13	2020-09-03
	13. DOCUSIGN INC.		2020-03-12	2020-09-03
	17. DOLLAR GENERAL CORP		2019-02-14	2020-09-03
	75. DUKE WEEKS REALTY CORP		2019-08-15	2020-09-03
	14. ECOLAB INC		2018-09-13	2020-09-03
	14. EDWARDS LIFESCIENCES CORP		2020-05-14	2020-09-03
	20. FACEBOOK INC - A SHS		2019-07-11	2020-09-03
	21. FISERV INC		2018-09-13	2020-09-03
	18. FIVE BELOW INC		2019-02-14	2020-09-03
	19. GOLDMAN SACHS GROUP INC		2020-01-09	2020-09-03
	10. HOME DEPOT INC		2018-06-14	2020-09-03
	10. INTUIT INC		2019-01-10	2020-09-03
	34. ISHARES TR S&P MIDCAP 400 INDEX FUND		2011-01-19	2020-09-03
	24. J P MORGAN CHASE & CO		2015-05-05	2020-09-03
	6. LOCKHEED MARTIN CORP		2020-03-12	2020-09-03
	4. LULULEMON ATHLETICA INC		2020-07-09	2020-09-03
	84.752 MANNING & NAPIER INTL. DISCOVERY CL Z		2017-06-06	2020-09-03
	22. MARSH & MCLENNAN COMPANY INC		2019-11-13	2020-09-03
	10. MASTERCARD INC - CLASS A		2015-03-12	2020-09-03
	34. MERCK & CO INC		2018-11-19	2020-09-03
	42. MICROSOFT CORP		2018-04-12	2020-09-03
	5. NEXTERA ENERGY INC		2016-02-11	2020-09-03
	33. NIKE INC CLASS B		2018-08-08	2020-09-03
	4. NVIDIA CORP		2020-05-14	2020-09-03
	7. O'REILLY AUTOMOTIVE INC		2020-06-11	2020-09-03
	3. REGENERON PHARMACEUTICALS INC		2020-07-09	2020-09-03
	15. ROCKWELL INTERNATIONAL CORP		2020-08-13	2020-09-03
	20. SALESFORCE.COM INC		2018-08-08	2020-09-03
	45. STARBUCKS CORP		2020-06-11	2020-09-03
	9. STRYKER CORP		2017-08-10	2020-09-03
	20. TEXAS INSTRUMENTS INC		2019-09-13	2020-09-03
	7. THERMO ELECTRON CORP		2011-08-10	2020-09-03
	28. TWITTER INC		2020-03-12	2020-09-03
	15. UNION PACIFIC CORP		2019-07-11	2020-09-03
	9. UNITEDHEALTH GROUP INC		2018-07-11	2020-09-03
	707.338 DEVELOPED MARKETS INDEX FUND ADMIRAL CL		2017-05-08	2020-09-03
	18. VISA INC		2016-09-15	2020-09-03
	21. WASTE MANAGEMENT INC DEL		2018-11-19	2020-09-03
	10. ACCENTURE PLC - CL A		2018-09-13	2020-09-03
	73. APPLE COMPUTER INC		2016-02-11	2020-09-10
	74. FISERV INC		2018-09-13	2020-09-10
	25000. CONSTELLATION ENERGY GROUP I DTD 12/14/2010 5.150% 12/1/2020		2015-09-09	2020-10-02
	740. JPMORGAN ULTRA-SHORT INCOME ETF		2020-03-05	2020-10-02
	25. BECTON DICKINSON & CO		2018-01-11	2020-10-15
	22. LOCKHEED MARTIN CORP		2020-03-12	2020-10-15
	25000. UNITED STATES TREASURY NOTES DTD 10/31/2018 2.875% 10/31/2020		2020-02-07	2020-11-02
	817. JPMORGAN ULTRA-SHORT INCOME ETF		2020-03-05	2020-11-04
	41. CME GROUP INC		2018-11-19	2020-11-13
	16. SALESFORCE.COM INC		2018-08-08	2020-11-13
	6. VISA INC		2016-09-15	2020-11-13
	408. JPMORGAN ULTRA-SHORT INCOME ETF		2020-03-05	2020-11-25
	15000. REPUBLIC SERVICES INC DTD 5/21/2012 3.550% 6/1/2022		2016-09-27	2020-12-09
	16. DANAHER CORP		2011-06-08	2020-12-10
	26. MICROSOFT CORP		2018-04-12	2020-12-10
	40. NIKE INC CLASS B		2018-08-08	2020-12-10
	79. WASTE MANAGEMENT INC DEL		2018-11-19	2020-12-10
	CAPITAL GAIN DIVIDENDS	P
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(e) Gross sales price		(g) Cost or other basis plus expense of sale	(h) Gain or (loss) (e) plus (f) minus (g)
a	10,808	5,591	5,217
b	10,640	10,754	-114
c	785	196	589
d	9,580	9,960	-380
e	4,892	4,688	204
	1,048	720	328
	10	10
	10	10
	25,000	25,000
	7	7
	7	7
	20,010	22,819	-2,809
	30,781	33,908	-3,127
	53,570	52,596	974
	49,090	35,827	13,263
	5,877	7,617	-1,740
	3,531	4,696	-1,165
	3,046	7,871	-4,825
	1,122	3,089	-1,967
	959	811	148
	8,711	12,546	-3,835
	702	727	-25
	25,000	25,000
	5	5
	5	6	-1
	5,589	7,288	-1,699
	4,989	6,491	-1,502
	5	5
	5	6	-1
	5,499	4,106	1,393
	8,355	10,838	-2,483
	8,806	6,589	2,217
	5	5
	5	6	-1
	5,897	6,108	-211
	9,866	10,421	-555
	11,180	10,932	248
	5	5
	5	6	-1
	3,787	1,602	2,185
	4,870	1,631	3,239
	2	2
	2	2
	38,394	28,722	9,672
	230	276	-46
	8,972	9,358	-386
	17,398	17,851	-453
	6,358	4,359	1,999
	9,527	2,181	7,346
	8,298	1,681	6,617
	4	4
	2,332	1,296	1,036
	1,102	1,081	21
	1,522	1,062	460
	2,985	699	2,286
	8,194	5,353	2,841
	10,072	2,181	7,891
	5,891	5,769	122
	1,663	1,579	84
	3,341	2,412	929
	1,565	1,763	-198
	3,490	3,363	127
	3,408	2,256	1,152
	4,628	900	3,728
	3,339	2,833	506
	2,989	860	2,129
	3,368	2,026	1,342
	2,903	2,470	433
	2,865	2,190	675
	1,206	1,011	195
	5,768	4,019	1,749
	2,101	1,703	398
	2,224	2,346	-122
	3,973	4,607	-634
	2,756	1,998	758
	3,388	2,051	1,337
	6,496	3,134	3,362
	2,456	1,548	908
	2,340	1,871	469
	1,529	1,255	274
	2,178	1,584	594
	2,597	2,312	285
	3,466	894	2,572
	2,912	2,600	312
	9,193	3,947	5,246
	1,408	561	847
	3,762	2,664	1,098
	2,081	1,278	803
	3,309	2,876	433
	1,758	1,913	-155
	3,442	3,510	-68
	5,212	2,907	2,305
	3,895	3,253	642
	1,794	1,296	498
	2,846	2,600	246
	2,937	415	2,522
	1,167	772	395
	2,889	2,571	318
	2,855	2,295	560
	9,436	9,294	142
	3,763	1,477	2,286
	2,349	1,947	402
	2,400	1,723	677
	8,292	1,704	6,588
	7,018	6,000	1,018
	25,000	25,000
	37,527	37,466	61
	5,874	5,583	291
	8,479	6,861	1,618
	25,000	25,000
	41,429	41,365	64
	6,809	7,091	-282
	3,993	2,293	1,700
	1,265	492	773
	20,714	20,657	57
	15,688	15,278	410
	3,573	626	2,947
	5,493	2,150	3,343
	5,510	3,229	2,281
	9,078	6,053	3,025
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121
			6,121

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			5,217
b			-114
c			589
d			-380
e			204
			328





			-2,809
			-3,127
			974
			13,263
			-1,740
			-1,165
			-4,825
			-1,967
			148
			-3,835
			-25


			-1
			-1,699
			-1,502

			-1
			1,393
			-2,483
			2,217

			-1
			-211
			-555
			248

			-1
			2,185
			3,239


			9,672
			-46
			-386
			-453
			1,999
			7,346
			6,617

			1,036
			21
			460
			2,286
			2,841
			7,891
			122
			84
			929
			-198
			127
			1,152
			3,728
			506
			2,129
			1,342
			433
			675
			195
			1,749
			398
			-122
			-634
			758
			1,337
			3,362
			908
			469
			274
			594
			285
			2,572
			312
			5,246
			847
			1,098
			803
			433
			-155
			-68
			2,305
			642
			498
			246
			2,522
			395
			318
			560
			142
			2,286
			402
			677
			6,588
			1,018

			61
			291
			1,618

			64
			-282
			1,700
			773
			57
			410
			2,947
			3,343
			2,281
			3,025

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	116,180
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

SECTION 4940(e) REPEALED ON DECEMBER 20, 2019 - DO NOT COMPLETE

1 Reserved

(a) Reserved	(b) Reserved	(c) Reserved	(d) Reserved

Reserved...........................

Reserved,..........................

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 and enter “N/A" on line 1.
	Date of ruling or determination letter: (attach copy of letter if necessary–see instructions)
b	Reserved................................	1	2,392
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	0
3	Add lines 1 and 2...........................	3	2,392
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	2,392
6	Credits/Payments:

a	2020 estimated tax payments and 2019 overpayment credited to 2020	6a	700
b	Exempt foreign organizations—tax withheld at source......	6b	0
c	Tax paid with application for extension of time to file (Form 8868)...	6c	0
d	Backup withholding erroneously withheld ...........	6d

7	Total credits and payments. Add lines 6a through 6d..............		7	700
8	Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached.		8	0
9	Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......		9	1,692
10	Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...		10
11	Enter the amount of line 10 to be: Credited to 2021 estimated tax0	Refunded	11	0

Part VII-A

Statements Regarding Activities

During the tax year, did the foundation attempt to influence any national, state, or local legislation or did

Yes

it participate or intervene in any political campaign? ....................

Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions

for the definition.................................

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.

Did the foundation file Form 1120-POL for this year?.....................

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

Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed

on foundation managers. bullet

Has the foundation engaged in any activities that have not previously been reported to the IRS?.......

If "Yes," attach a detailed description of the activities.

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....

Did the foundation have unrelated business gross income of $1,000 or more during the year?........

If "Yes," has it filed a tax return on Form 990-T for this year?...................

Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........

If "Yes," attach the statement required by General Instruction T.

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?................

Yes

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..................................

Yes

Enter the states to which the foundation reports or with which it is registered (see instructions)

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 .

Yes

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 .............................

Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names

and addresses. ...............................

Form 990-PF (2020)

Page 5

Part VII-A

Statements Regarding Activities (continued)

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 .............

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.................

Did the foundation comply with the public inspection requirements for its annual returns and exemption application?

Yes

Website address bullet

The books are in care of bullet

UMB BANK NA Telephone no. bullet

(816) 860-7711

Located at bullet

1010 GRANDKANSAS CITYMO ZIP+4 bullet

64106

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

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

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? YesNo

(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)

a disqualified person?......................YesNo

(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? YesNo

(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? YesNo

(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)?...............YesNo

(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.).......YesNo

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 ........

Organizations relying on a current notice regarding disaster assistance check here........ bullet

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?.............

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)):

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?.............YesNo

If "Yes," list the years bullet

20, 20, 20, 20

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.) ..............

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

Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at

any time during the year?......................YesNo

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.)..................

Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?

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?

Form 990-PF (2020)

Page 6

Part VII-B

Statements Regarding Activities for Which Form 4720 May Be Required (continued)

During the year did the foundation pay or incur any amount to:

Yes

(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? YesNo

(2) Influence the outcome of any specific public election (see section 4955); or to carry

on, directly or indirectly, any voter registration drive?.............YesNo

(3) Provide a grant to an individual for travel, study, or other similar purposes? YesNo

(4) Provide a grant to an organization other than a charitable, etc., organization described

in section 4945(d)(4)(A)? See instructions................YesNo

(5) Provide for any purpose other than religious, charitable, scientific, literary, or

educational purposes, or for the prevention of cruelty to children or animals?.....YesNo

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 ......

Organizations relying on a current notice regarding disaster assistance check here......... bullet

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?..........YesNo

If "Yes," attach the statement required by Regulations section 53.4945–5(d).

Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on

a personal benefit contract?.....................YesNo

Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....

If "Yes" to 6b, file Form 8870.

At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction? YesNo

If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? ....

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? .................YesNo

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
UMB BANK N A	TRUSTEE 1	43,918
1010 GRAND KANSAS CITY,MO64106	TRUSTEE 1	43,918

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 (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
NONE

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)

Page 8

Part X

Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)

Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,

purposes:

Average monthly fair market value of securities...................

1,948,069

Average of monthly cash balances.......................

151,095

Fair market value of all other assets (see instructions)................

1,926,754

Total (add lines 1a, b, and c).........................

4,025,918

Reduction claimed for blockage or other factors reported on lines 1a and

1c (attach detailed explanation) .............

Acquisition indebtedness applicable to line 1 assets..................

Subtract line 2 from line 1d.........................

4,025,918

Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see

instructions) .............................

60,389

Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4

3,965,529

Minimum investment return. Enter 5% of line 5..................

198,276

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.)

Minimum investment return from Part X, line 6....................

198,276

Tax on investment income for 2020 from Part VI, line 5......

2,392

Income tax for 2020. (This does not include the tax from Part VI.)...

Add lines 2a and 2b............................

2,392

Distributable amount before adjustments. Subtract line 2c from line 1............

195,884

Recoveries of amounts treated as qualifying distributions................

Add lines 3 and 4............................

195,884

Deduction from distributable amount (see instructions).................

Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...

195,884

Part XII

Qualifying Distributions (see instructions)

Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:

Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........

198,345

Program-related investments—total from Part IX-B..................

Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,

purposes...............................

Amounts set aside for specific charitable projects that satisfy the:

Suitability test (prior IRS approval required)....................

Cash distribution test (attach the required schedule) .................

Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4

198,345

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.................

Adjusted qualifying distributions. Subtract line 5 from line 4..............

198,345

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)

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					195,884
2 Undistributed income, if any, as of the end of 2020:
a Enter amount for 2019 only.......				174,201
b Total for prior years:20, 20, 20			0
3 Excess distributions carryover, if any, to 2020:
a From 2015......	0
b From 2016......	0
c From 2017......	0
d From 2018......	0
e From 2019......	0
fTotal of lines 3a through e........		0
4Qualifying distributions for 2020 from Part
XII, line 4: $ 198,345
a Applied to 2019, but not more than line 2a				174,201
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 2020 distributable amount.....					24,144
e Remaining amount distributed out of corpus		0
5 Excess distributions carryover applied to 2020.		0			0
(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		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 2019. Subtract line 4a from line 2a. Taxable amount—see instructions .............				0
f Undistributed income for 2020. Subtract lines 4d and 5 from line 1. This amount must be distributed in 2021 ..........					171,740
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 2015 not applied on line 5 or line 7 (see instructions) ...		0
9Excess distributions carryover to 2021. Subtract lines 7 and 8 from line 6a ......		0
10 Analysis of line 9:
a Excess from 2016....	0
b Excess from 2017....	0
c Excess from 2018....	0
d Excess from 2019....	0
e Excess from 2020....	0

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 section4942(j)(3) or4942(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) 2020	(b) 2019	(c) 2018	(d) 2017	(e) Total

b 85% of line 2a .........
c Qualifying distributions from Part XII, line 4 for each year listed .....
d Amounts included in line 2c not used directly for active conduct of exempt activities ..........
e Qualifying distributions made directly for active conduct of exempt activities. Subtract line 2d from line 2c ....
3 Complete 3a, b, or c for the alternative test relied upon:
a “Assets" alternative test—enter:
(1) Value of all assets ......
(2) Value of assets qualifying under section 4942(j)(3)(B)(i)
b “Endowment" alternative test— enter 2/3 of minimum investment return shown in Part X, line 6 for each year listed...
c “Support" alternative test—enter:
(1) Total support other than gross investment income (interest, dividends, rents, payments on securities loans (section 512(a)(5)), or royalties) ....
(2) Support from general public and 5 or more exempt organizations as provided in section 4942(j)(3)(B)(iii)....
(3) Largest amount of support from an exempt organization
(4) Gross investment income

Part XV

Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)

1Information Regarding Foundation Managers:

aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)

NONE

bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.

NONE

2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:

Check here bullet

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

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)

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)		Foundation status of recipient	Purpose of grant or contribution	Amount
aPaid during the year
BETHANY COLLEGE 335 E SWENSSON ST LINDSBORG,KS674561897	NONE	PC	PROJECT SUPPORT	42,600
HEARTSPRING 8700 E 29TH ST N WICHITA,KS672262169	NONE	PC	PROJECT SUPPORT	40,000
RUSSELL REGIONAL HOSPITAL 200 S MAIN ST RUSSELL,KS676652997	NONE	PC	PROJECT SUPPORT	65,000
SALVATION ARMY 5550 PRAIRIE STON PARKAWAY HOFFMAN ESTATES,IL60192	NONE	PC	GENERAL OPERATING SUPPORT	4,000
TRINITY UNITED METHODIST CHURCH SCHOOL PO BOX 426 RUSSELL,KS67665	NONE	PC	CHURCH SCHOOL BOOKS AND	5,000
GORHAM COMMUNITY CHURCH SCHOOL ATTN CAROL LEGLEITER 17639 LINCOLN ROAD GORHAM,KS67640	NONE	PC	CHURCH SCHOOL BOOKS AND	2,000
FORT HAYS STATE UNIVERSITY 600 PARK STREET HAYS,KS676014009	NONE	PC	SCHOLARSHIP SUPPORT FOR	500
CORONADO AREA COUNCIL BOY SCOUTS 644 S OHIO SALINA,KS67402	NONE	PC	RUSSELL COUNTY BOY SCOUT	11,500
GIRL SCOUTS OF KANSAS HEARTLAND 360 LEXINGTON RD WICHITA,KS67218	NONE	PC	RUSSELL COUNTY GIRL SCOUT	4,000
Total ................................. 3a				174,600

bApproved for future payment

Total ................................. 3b

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	(e) Related or exempt function income (See instructions.)
a
b
c
d
e
f
gFees and contracts from government agencies
2 Membership dues and assessments....
3 Interest on savings and temporary cash investments ...........
4 Dividends and interest from securities....			14	34,725
5 Net rental income or (loss) from real estate:
aDebt-financed property......
bNot debt-financed property.....			16	42,492
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	116,180
9 Net income or (loss) from special events:
10 Gross profit or (loss) from sales of inventory
11 Other revenue: aROYALTY INCOME			10	4,155
bEXCISE TAX REFUND			1	329
c
d
e
12 Subtotal. Add columns (b), (d), and (e)..				197,881

13Total. Add line 12, columns (b), (d), and (e)..................

197,881

(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 (2020)

Page 13

Part XVII

Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations

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

Transfers from the reporting foundation to a noncharitable exempt organization of:

(1) Cash...................................

1a(1)

(2) Other assets.................................

1a(2)

Other transactions:

(1) Sales of assets to a noncharitable exempt organization....................

1b(1)

(2) Purchases of assets from a noncharitable exempt organization..................

1b(2)

(3) Rental of facilities, equipment, or other assets.......................

1b(3)

(4) Reimbursement arrangements...........................

1b(4)

(5) Loans or loan guarantees.............................

1b(5)

(6) Performance of services or membership or fundraising solicitations................

1b(6)

Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............

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

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

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 instructions. 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 (2020)

Additional Data

Software ID:
Software Version:

Form 990PF - Special Condition Description:

Special Condition Description

- TIN:

TY 2020 AccountingFeesSchedule

Name:

ROUBACK FAMILY FOUNDATION 100127

EIN:

48-6143203

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
TAX PREPARATION FEE (NON-ALLOC	800			800

- TIN:

TY 2020 LegalFeesSchedule

Name:

ROUBACK FAMILY FOUNDATION 100127

EIN:

48-6143203

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
LEGAL FEES - PRINCIPAL (ALLOCA	1,314	329		986

- TIN:

TY 2020 OtherDecreasesSchedule

Name:

ROUBACK FAMILY FOUNDATION 100127

EIN:

48-6143203

Description	Amount
CORPORATE ACTION ADJUSTMENT	202
ROUNDING	3
ACCRUED INTEREST PAID	41

- TIN:

TY 2020 OtherExpensesSchedule

Name:

ROUBACK FAMILY FOUNDATION 100127

EIN:

48-6143203

Description	Revenue and Expenses per Books	Net Investment Income
RENTAL EXPENSES	9,773	9,773
ROYALTY EXPENSES	2,300	2,300
OTHER ADMINISTRATION FEES	200	200

- TIN:

TY 2020 OtherIncomeSchedule2

Name:

ROUBACK FAMILY FOUNDATION 100127

EIN:

48-6143203

Description	Revenue And Expenses Per Books	Net Investment Income	Adjusted Net Income
ROYALTY INCOME	4,155	4,155
EXCISE TAX REFUND	329	0

- TIN:

TY 2020 TaxesSchedule

Name:

ROUBACK FAMILY FOUNDATION 100127

EIN:

48-6143203

Category	Amount	Net Investment Income
STATE INCOME TAXES - PRINCIPAL	3	3
STATE INCOME TAXES - INCOME	19	19
FOREIGN TAXES ON QUALIFIED FOR	214	214
FOREIGN TAXES ON NONQUALIFIED	108	108