-
TIN:
Form
990-PF
Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
Do not enter social security numbers on this form as it may be made public.
Go to
www.irs.gov/Form990PF
for instructions and the latest information.
OMB No. 1545-0052
20
19
Open to Public Inspection
For calendar year 2019, or tax year beginning
10-01-2019
, and ending
09-30-2020
Name of foundation
E L AND R F HALLBERG FOUNDATION VIRGINIA L
Number and street (or P.O. box number if mail is not delivered to street address)
10 S DEARBORN IL1-0111
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CHICAGO
,
IL
60603
A Employer identification number
75-6356892
B
Telephone number (see instructions)
(800) 496-2583
C
If exemption application is pending, check here
G
Check all that apply:
Initial return
Initial return of a former public charity
Final return
Amended return
Address change
Name change
D 1.
Foreign organizations, check here.............
2
. Foreign organizations meeting the 85%
test, check here and attach computation ...
E
If private foundation status was terminated
under section 507(b)(1)(A), check here .......
H
Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here .......
I
Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)
$
3,880,728
J
Accounting method:
Cash
Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)
Part I
Analysis of Revenue and Expenses
(The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).)
(a)
Revenue and
expenses per
books
(b)
Net investment
income
(c)
Adjusted net
income
(d)
Disbursements
for charitable
purposes
(cash basis only)
1
Contributions, gifts, grants, etc., received (attach schedule)
2
Check
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
91,455
91,455
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
115,237
b
Gross sales price for all assets on line 6a
1,125,936
7
Capital gain net income (from Part IV, line 2)
...
115,237
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)
.......
555
12
Total.
Add lines 1 through 11
........
207,247
206,692
13
Compensation of officers, directors, trustees, etc.
71,859
38,659
33,200
14
Other employee salaries and wages
......
0
0
0
15
Pension plans, employee benefits
.......
0
0
16a
Legal fees (attach schedule)
.........
0
b
Accounting fees (attach schedule)
.......
c
Other professional fees (attach schedule)
....
0
17
Interest
...............
0
18
Taxes (attach schedule) (see instructions)
...
2,103
2,103
0
19
Depreciation (attach schedule) and depletion
...
0
0
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
0
0
22
Printing and publications
..........
0
0
23
Other expenses (attach schedule)
.......
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
73,962
40,762
0
33,200
25
Contributions, gifts, grants paid
.......
153,000
153,000
26
Total expenses and disbursements.
Add lines 24 and 25
226,962
40,762
0
186,200
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-19,715
b
Net investment income
(if negative, enter -0-)
165,930
c
Adjusted net income
(if negative, enter -0-)
...
0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2019)
Form 990-PF (2019)
Page
2
Part II
Balance Sheets
Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year
End of year
(a)
Book Value
(b)
Book Value
(c)
Fair Market Value
1
Cash—non-interest-bearing
.............
1,511
-2,036
-2,036
2
Savings and temporary cash investments
.........
42,349
41,353
41,353
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)
.......
2,519,991
2,321,230
2,880,967
c
Investments—corporate bonds (attach schedule)
.......
587,500
754,742
796,242
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
151,165
167,600
164,202
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
3,302,516
3,282,889
3,880,728
17
Accounts payable and accrued expenses
..........
18
Grants payable
.................
19
Deferred revenue
.................
20
Loans from officers, directors, trustees, and other disqualified persons
21
Mortgages and other notes payable (attach schedule)
......
22
Other liabilities (describe
)
23
Total liabilities
(add lines 17 through 22)
.........
0
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
25
Net assets with donor restrictions
............
Foundations that do not follow FASB ASC 958, check here
and complete lines 26 through 30.
26
Capital stock, trust principal, or current funds
........
3,302,516
3,282,889
27
Paid-in or capital surplus, or land, bldg., and equipment fund
28
Retained earnings, accumulated income, endowment, or other funds
29
Total net assets or fund balances
(see instructions)
.....
3,302,516
3,282,889
30
Total liabilities and net assets/fund balances
(see instructions)
.
3,302,516
3,282,889
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return)
...............
1
3,302,516
2
Enter amount from Part I, line 27a
.....................
2
-19,715
3
Other increases not included in line 2 (itemize)
3
88
4
Add lines 1, 2, and 3
..........................
4
3,282,889
5
Decreases not included in line 2 (itemize)
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
3,282,889
Form
990-PF
(2019)
Form 990-PF (2019)
Page
3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a)
List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)
(b)
How acquired
P—Purchase
D—Donation
(c)
Date acquired
(mo., day, yr.)
(d)
Date sold
(mo., day, yr.)
1 a
33. DISNEY WALT CO
2019-10-25
b
8. ACCENTURE PLC
2019-10-25
c
11. ACCENTURE PLC
2019-10-28
d
21. NISOURCE INC
2019-11-11
e
27. NISOURCE INC
2019-11-11
22. NISOURCE INC
2019-11-12
56. NISOURCE INC
2019-11-12
5. NISOURCE INC
2015-12-03
2019-11-12
5. NISOURCE INC
2015-12-03
2019-11-13
35. CELGENE CORP.
2019-11-21
94. CELGENE CORP.
2019-11-21
50. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-25
5. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-25
2. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-25
1. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-25
61. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-26
1692.713 JPM LARGE CAP GROW FD - USD - R6 ISIN US48121L8413
2015-04-15
2019-11-26
10. RTS BRISTOL-MYERS SQUIBB-CVR
2019-11-21
2019-11-27
1876.416 EQUINOX IMP SYSTEM MACRO-I
2018-07-10
2019-12-09
1903.568 CRM LNG/SHRT OPPORT-INST
2020-01-09
1. CORTEVA INC
2015-06-18
2020-01-13
13. CORTEVA INC
2020-01-13
10. CORTEVA INC
2020-01-13
13. CORTEVA INC
2020-01-14
13. CORTEVA INC
2020-01-14
5. CORTEVA INC
2020-01-14
3. CORTEVA INC
2020-01-14
2. CORTEVA INC
2018-04-09
2020-01-14
2.394 CORTEVA INC
2018-04-09
2020-01-15
13.606 CORTEVA INC
2019-04-08
2020-01-15
18. CORTEVA INC
2020-01-15
8. CORTEVA INC
2020-01-15
2. CORTEVA INC
2019-06-27
2020-01-15
10. CORTEVA INC
2019-06-27
2020-01-15
11. CORTEVA INC
2020-01-15
1922.608 CRM LNG/SHRT OPPORT-INST
2018-01-18
2020-01-16
5. CORTEVA INC
2019-06-28
2020-01-16
3. CORTEVA INC
2019-06-28
2020-01-16
2. CORTEVA INC
2019-06-28
2020-01-16
1884.433 EQUINOX IMP SYSTEM MACRO-I
2018-07-10
2020-01-16
38. QUALCOMM INC
2019-05-01
2020-01-23
1. QUALCOMM INC
2019-05-01
2020-01-23
19. EOG RESOURCES INC
2020-01-28
3. EOG RESOURCES INC
2016-05-02
2020-01-28
2. EOG RESOURCES INC
2016-05-02
2020-01-29
2. EOG RESOURCES INC
2020-01-29
1. EOG RESOURCES INC
2016-05-19
2020-01-29
14. EOG RESOURCES INC
2020-01-29
14. EOG RESOURCES INC
2020-01-29
14. EOG RESOURCES INC
2020-01-29
19. EOG RESOURCES INC
2020-01-30
5. EOG RESOURCES INC
2020-01-30
1490.567 ARTISAN INTL VAL-INST
2010-03-12
2020-02-10
4805.108 CULLEN HIGH DIVIDEND EQUITY FUND
2013-03-18
2020-02-10
568. JPMORGAN BETABUILDERS JAPAN ETF
2018-07-19
2020-02-10
632. JPMORGAN BETABUILDERS JAPAN ETF
2018-07-19
2020-02-10
13. ELECTRONIC ARTS
2018-09-20
2020-02-25
17. ELECTRONIC ARTS
2020-02-25
4. ACCENTURE PLC
2014-04-03
2020-02-25
20. ACCENTURE PLC
2020-02-26
50. DISNEY WALT CO
2020-03-04
115. WELLS FARGO & CO NEW
2020-03-04
2868.318 FIDELITY INTL INDX-INST PRM
2018-01-18
2020-03-06
3. ALEXION PHARMACEUTICALS INC
2019-03-14
2020-03-11
1. ALEXION PHARMACEUTICALS INC
2019-03-14
2020-03-11
2. DUPONT DE NEMOURS INC-W/D
2015-06-18
2020-03-11
60.394 DUPONT DE NEMOURS INC-W/D
2020-03-11
14.606 DUPONT DE NEMOURS INC-W/D
2019-04-08
2020-03-11
6. ALEXION PHARMACEUTICALS INC
2019-03-14
2020-03-12
4. ALEXION PHARMACEUTICALS INC
2019-03-14
2020-03-12
9. ALEXION PHARMACEUTICALS INC
2019-03-14
2020-03-13
577.054 FIDELITY INTL INDX-INST PRM
2018-01-18
2020-03-16
6138.308 JPM GL RES ENH IDX FD - USD - R6 ISIN US48129C2070
2020-03-16
29. UNITED TECHNOLOGIES CORP
2020-03-31
31. COMCAST CORP NEW CL A
2020-04-16
54. COMCAST CORP NEW CL A
2018-01-11
2020-04-16
1. COMCAST CORP NEW CL A
2018-01-11
2020-04-16
36. COMCAST CORP NEW CL A
2020-04-16
5. COMCAST CORP NEW CL A
2018-10-19
2020-04-16
8. ROSS STORES INC
2018-12-11
2020-04-16
9. ROSS STORES INC
2018-12-11
2020-04-16
10. ROSS STORES INC
2018-12-11
2020-04-16
31. ROSS STORES INC
2020-04-16
4. ABBVIE INC
2019-09-16
2020-04-27
1. ADOBE SYS INC
2012-11-05
2020-04-27
1. ALPHABET INC-CL C
2012-07-11
2020-04-27
1. AMAZON COM INC
2015-02-02
2020-04-27
4. AMERICAN EXPRESS CO
2018-07-18
2020-04-27
3. APPLE COMPUTER INC
2009-11-03
2020-04-27
1. AUTOMATIC DATA PROCESSING INC
2018-10-19
2020-04-27
14. BANK OF AMERICA CORPORATION
2012-11-08
2020-04-27
3. BERKSHIRE HATHAWAY INC DEL CL B
2017-04-20
2020-04-27
6. BOSTON SCIENTIFIC CORP
2016-09-15
2020-04-27
4. BRISTOL MYERS SQUIBB CO
2019-11-20
2020-04-27
1. BROADCOM INC
2020-04-27
1. CHARTER COMMUNICATIONS INC-A
2020-04-27
4. CITIGROUP INC NEW
2011-10-17
2020-04-27
3. COCA-COLA CO
2018-04-13
2020-04-27
5. COMCAST CORP NEW CL A
2018-10-19
2020-04-27
3. DIAMONDBACK ENERGY INC
2017-05-15
2020-04-27
1. ELECTRONIC ARTS
2018-11-27
2020-04-27
1. FACEBOOK INC-A
2014-10-29
2020-04-27
3. FIDELITY NATL INFORMATION SVCS INC
2020-04-27
4. FISERV INC
2019-01-23
2020-04-27
1. GENERAL DYNAMICS CORP
2016-08-11
2020-04-27
1. HOME DEPOT INC
2011-09-29
2020-04-27
2. HONEYWELL INTL INC
2010-02-01
2020-04-27
1. INTERCONTINENTALEXCHANGE GROUP, INC
2017-01-30
2020-04-27
9. KEYCORP NEW
2020-04-27
2. LILLY ELI & CO
2020-04-27
2. LOWES COS INC
2011-08-04
2020-04-27
156. MARATHON PETROLEUM CORPORATION
2020-04-27
1. MASTERCARD INC - CLASS A
2009-07-16
2020-04-27
3. MERCK & CO INC
2020-04-27
7. MICROSOFT CORP
2009-01-29
2020-04-27
4. MONDELEZ INTERNATIONAL-W/I
2011-08-16
2020-04-27
6. MORGAN STANLEY DEAN WITTER & CO NEW
2013-01-16
2020-04-27
1. NEXTERA ENERGY INC
2016-10-18
2020-04-27
2. NORFOLK SOUTHN CORP
2017-01-30
2020-04-27
1. NORTHROP GRUMMAN CORP
2016-09-15
2020-04-27
1. NVIDIA CORP
2017-10-03
2020-04-27
1. O'REILLY AUTOMOTIVE INC
2017-05-04
2020-04-27
4. PAYPAL HOLDINGS INC
2018-01-26
2020-04-27
2. PEPSICO INC
2014-10-07
2020-04-27
8. PFIZER INC
2015-04-08
2020-04-27
1. PHILIP MORRIS INTERNATIONAL
2017-08-01
2020-04-27
2. PIONEER NAT RES CO
2015-12-08
2020-04-27
2. PROCTER & GAMBLE CO
2019-06-05
2020-04-27
2. SALESFORCE.COM INC
2018-04-13
2020-04-27
1. STANLEY BLACK & DECKER,INC.
2015-11-09
2020-04-27
3. TEXAS INSTRS INC
2016-02-05
2020-04-27
1. THERMO ELECTRON CORP
2020-01-13
2020-04-27
2. UNITEDHEALTH GROUP INC
2012-01-19
2020-04-27
1. VISA INC CLASS A SHARES
2015-10-19
2020-04-27
4. WASTE CONNECTIONS INC
2016-07-25
2020-04-27
1. WEX INC
2016-05-02
2020-04-27
2. YUM BRANDS INC
2020-04-27
3. ZIMMER HLDGS INC
2020-04-27
1. ALLEGION PLC
2015-10-27
2020-04-27
3. LINDE PLC
2018-12-11
2020-04-27
2. CHUBB LTD
2009-01-26
2020-04-27
1. ASML HOLDING NV-NY REG SHS
2020-03-04
2020-04-27
2. NXP SEMICONDUCTORS NV
2019-02-19
2020-04-27
19. ADOBE SYS INC
2020-05-04
3. ADOBE SYS INC
2013-05-09
2020-05-04
350. ISHARES TR 7-10 YR TREAS INDEX FD
2020-05-08
506.446 FIDELITY 500 INDEX-INST PRM
2018-01-18
2020-06-03
762.029 MFS INTL INTRINSIC VALUE-R6
2013-02-12
2020-06-03
1501.502 SIX CIRCLES ULTR SHRT DUR
2019-02-05
2020-06-03
12. ABBVIE INC
2019-09-16
2020-06-09
1. ALPHABET INC-CL C
2012-08-13
2020-06-09
1. ALPHABET INC-CL A
2013-02-08
2020-06-09
1. AMAZON COM INC
2015-02-02
2020-06-09
6. AMERICAN EXPRESS CO
2020-06-09
10. APPLE COMPUTER INC
2009-11-03
2020-06-09
4. AUTOMATIC DATA PROCESSING INC
2018-10-19
2020-06-09
30. BANK OF AMERICA CORPORATION
2012-11-08
2020-06-09
4. BERKSHIRE HATHAWAY INC DEL CL B
2017-04-20
2020-06-09
1. BIOGEN IDEC INC
2020-03-11
2020-06-09
19. BOSTON SCIENTIFIC CORP
2020-06-09
11. BRISTOL MYERS SQUIBB CO
2019-11-20
2020-06-09
4. BROADCOM INC
2020-06-09
3. CHARTER COMMUNICATIONS INC-A
2020-06-09
13. CITIGROUP INC NEW
2020-06-09
9. COCA-COLA CO
2018-04-13
2020-06-09
15. COMCAST CORP NEW CL A
2020-06-09
7. DIAMONDBACK ENERGY INC
2017-05-15
2020-06-09
4. ELECTRONIC ARTS
2020-06-09
5. FACEBOOK INC-A
2014-10-29
2020-06-09
6. FIDELITY NATL INFORMATION SVCS INC
2014-12-18
2020-06-09
12. FISERV INC
2020-06-09
3. GENERAL DYNAMICS CORP
2020-06-09
5. HOME DEPOT INC
2011-09-29
2020-06-09
8. HONEYWELL INTL INC
2010-02-01
2020-06-09
3. INTERCONTINENTALEXCHANGE GROUP, INC
2020-06-09
2. INTUIT
2020-06-09
26. KEYCORP NEW
2020-06-09
7. LILLY ELI & CO
2020-06-09
7. LOWES COS INC
2020-06-09
5. MASTERCARD INC - CLASS A
2009-07-16
2020-06-09
3. MCDONALDS CORP
2019-06-10
2020-06-09
11. MERCK & CO INC
2020-06-09
24. MICROSOFT CORP
2009-01-29
2020-06-09
13. MONDELEZ INTERNATIONAL-W/I
2020-06-09
22. MORGAN STANLEY DEAN WITTER & CO NEW
2020-06-09
2. NETFLIX.COM INC
2018-09-13
2020-06-09
4. NEXTERA ENERGY INC
2016-10-18
2020-06-09
5. NORFOLK SOUTHN CORP
2020-06-09
3. NORTHROP GRUMMAN CORP
2020-06-09
3. NVIDIA CORP
2017-10-03
2020-06-09
1. O'REILLY AUTOMOTIVE INC
2017-05-04
2020-06-09
10. PAYPAL HOLDINGS INC
2018-01-26
2020-06-09
7. PEPSICO INC
2014-10-07
2020-06-09
26. PFIZER INC
2020-06-09
4. PHILIP MORRIS INTERNATIONAL
2020-06-09
6. PIONEER NAT RES CO
2020-06-09
6. PROCTER & GAMBLE CO
2019-06-05
2020-06-09
7. SALESFORCE.COM INC
2020-06-09
4. STANLEY BLACK & DECKER,INC.
2020-06-09
9. TEXAS INSTRS INC
2016-02-05
2020-06-09
1. THERMO ELECTRON CORP
2020-01-13
2020-06-09
6. UNION PAC CORP
2020-06-09
7. UNITEDHEALTH GROUP INC
2020-06-09
2. VERTEX PHARMACEUTICALS INC
2014-09-09
2020-06-09
4. VISA INC CLASS A SHARES
2015-10-19
2020-06-09
4. WASTE CONNECTIONS INC
2016-07-25
2020-06-09
3. WEX INC
2016-05-02
2020-06-09
6. YUM BRANDS INC
2018-11-27
2020-06-09
6. ZIMMER HLDGS INC
2017-11-10
2020-06-09
4. ALLEGION PLC
2020-06-09
7. LINDE PLC
2018-12-11
2020-06-09
5. CHUBB LTD
2009-01-26
2020-06-09
2. ASML HOLDING NV-NY REG SHS
2020-06-09
4. NXP SEMICONDUCTORS NV
2019-02-19
2020-06-09
45. BERKSHIRE HATHAWAY INC DEL CL B
2020-06-24
88. KEYCORP NEW
2020-06-30
10. KEYCORP NEW
2020-06-30
65. PFIZER INC
2020-06-30
22. KEYCORP NEW
2020-07-01
7. KEYCORP NEW
2020-07-01
39. KEYCORP NEW
2020-07-01
1. KEYCORP NEW
2018-10-08
2020-07-01
17. KEYCORP NEW
2018-10-08
2020-07-01
1. KEYCORP NEW
2018-10-08
2020-07-01
16. KEYCORP NEW
2018-10-08
2020-07-01
33. KEYCORP NEW
2020-07-02
1. KEYCORP NEW
2018-10-19
2020-07-02
34. KEYCORP NEW
2018-10-19
2020-07-02
2. KEYCORP NEW
2018-10-19
2020-07-02
192. PFIZER INC
2020-07-10
9. PFIZER INC
2018-10-30
2020-07-10
23. GENERAL DYNAMICS CORP
2020-08-04
7. GENERAL DYNAMICS CORP
2018-12-13
2020-08-04
3. GENERAL DYNAMICS CORP
2018-12-13
2020-08-04
24. PHILIP MORRIS INTERNATIONAL
2018-10-24
2020-08-04
10. PHILIP MORRIS INTERNATIONAL
2020-08-04
2. PHILIP MORRIS INTERNATIONAL
2018-10-24
2020-08-04
6003.431 VANGUARD TOT BD MKT IDX-ADM
2019-02-07
2020-08-17
1941.329 VANGUARD TTL INTL BND-ADM
2019-02-11
2020-08-17
4721.03 VANGUARD TOT BD MKT IDX-ADM
2019-02-07
2020-09-18
1546.392 VANGUARD TTL INTL BND-ADM
2019-02-11
2020-09-21
33. AUTOMATIC DATA PROCESSING INC
2020-09-30
5. AUTOMATIC DATA PROCESSING INC
2019-08-14
2020-09-30
4. AUTOMATIC DATA PROCESSING INC
2020-05-04
2020-09-30
1. AUTOMATIC DATA PROCESSING INC
2020-05-04
2020-09-30
8. AUTOMATIC DATA PROCESSING INC
2020-05-04
2020-09-30
15. INTERCONTINENTALEXCHANGE GROUP, INC
2020-09-30
6. INTERCONTINENTALEXCHANGE GROUP, INC
2017-01-31
2020-09-30
9. INTERCONTINENTALEXCHANGE GROUP, INC
2020-09-30
4. ALLEGION PLC
2020-09-30
4. ALLEGION PLC
2020-09-30
6. ALLEGION PLC
2020-09-30
CAPITAL GAIN DIVIDENDS
P
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
4,334
3,222
1,112
b
1,465
669
796
c
2,021
900
1,121
d
551
227
324
e
705
312
393
573
325
248
1,458
1,004
454
130
96
34
131
96
35
3,781
3,870
-89
10,155
8,787
1,368
105
115
-10
10
12
-2
4
5
-1
2
2
130
140
-10
78,051
50,428
27,623
21
23
-2
18,220
19,458
-1,238
19,207
19,485
-278
28
28
369
356
13
285
292
-7
372
423
-51
372
428
-56
143
165
-22
86
99
-13
57
66
-9
69
80
-11
391
404
-13
516
535
-19
229
238
-9
57
59
-2
287
296
-9
314
325
-11
19,303
19,680
-377
144
148
-4
86
89
-3
58
59
-1
18,524
19,542
-1,018
3,492
3,287
205
92
87
5
1,464
1,426
38
231
248
-17
154
165
-11
154
163
-9
77
80
-3
1,056
1,133
-77
1,073
1,153
-80
1,059
1,228
-169
1,412
1,715
-303
376
455
-79
55,106
35,284
19,822
81,879
71,500
10,379
13,934
13,628
306
15,507
15,164
343
1,378
1,476
-98
1,792
1,906
-114
791
316
475
3,953
1,722
2,231
5,910
5,349
561
4,683
5,559
-876
110,000
129,463
-19,463
251
404
-153
84
135
-51
73
159
-86
2,233
5,390
-3,157
540
1,243
-703
476
808
-332
306
539
-233
718
1,212
-494
17,000
26,046
-9,046
94,223
107,805
-13,582
2,742
3,546
-804
1,154
917
237
2,009
2,284
-275
38
42
-4
1,341
1,422
-81
187
180
7
701
645
56
789
726
63
877
806
71
2,711
2,476
235
337
283
54
346
34
312
1,275
285
990
2,378
363
2,015
334
412
-78
847
47
800
141
143
-2
325
133
192
564
495
69
221
140
81
250
226
24
268
42
226
507
192
315
184
115
69
140
134
6
191
180
11
107
311
-204
117
84
33
188
76
112
378
184
194
392
322
70
134
151
-17
218
34
184
280
77
203
92
58
34
102
97
5
323
168
155
205
41
164
4,093
11,015
-6,922
263
18
245
252
189
63
1,218
182
1,036
205
87
118
235
123
112
243
125
118
333
238
95
344
212
132
297
179
118
392
249
143
484
340
144
269
186
83
306
277
29
75
116
-41
160
273
-113
236
213
23
315
239
76
113
107
6
346
149
197
340
332
8
585
104
481
170
77
93
351
199
152
116
94
22
175
178
-3
351
332
19
99
64
35
554
482
72
211
92
119
291
300
-9
191
185
6
6,621
729
5,892
1,046
133
913
42,572
36,581
5,991
55,000
48,968
6,032
35,000
22,245
12,755
15,000
15,015
-15
1,155
848
307
1,457
326
1,131
1,456
393
1,063
2,608
363
2,245
664
618
46
3,442
157
3,285
632
574
58
847
285
562
786
660
126
294
298
-4
730
444
286
675
621
54
1,267
170
1,097
1,592
575
1,017
767
384
383
440
401
39
632
541
91
385
726
-341
479
340
139
1,195
379
816
850
378
472
1,287
980
307
492
454
38
1,284
169
1,115
1,271
310
961
293
174
119
587
586
1
389
283
106
1,049
597
452
909
143
766
1,557
91
1,466
601
603
-2
912
699
213
4,545
625
3,920
687
284
403
1,101
454
647
861
741
120
1,026
501
525
960
593
367
1,029
635
394
1,086
537
549
419
249
170
1,577
850
727
925
652
273
944
901
43
303
411
-108
631
862
-231
714
640
74
1,222
835
387
574
425
149
1,182
448
734
349
332
17
1,074
552
522
2,177
436
1,741
546
187
359
800
308
492
378
199
179
524
282
242
573
536
37
800
664
136
450
257
193
1,508
1,124
384
695
230
465
701
602
99
449
370
79
8,006
8,525
-519
1,071
950
121
122
112
10
2,105
2,235
-130
264
245
19
85
80
5
456
583
-127
12
20
-8
197
348
-151
12
20
-8
187
328
-141
400
602
-202
12
18
-6
399
607
-208
24
36
-12
6,474
6,737
-263
303
383
-80
3,386
3,735
-349
1,032
1,203
-171
441
515
-74
1,846
2,139
-293
774
890
-116
154
177
-23
70,000
63,270
6,730
45,000
43,688
1,312
55,000
49,755
5,245
36,000
34,800
1,200
4,585
4,836
-251
695
821
-126
556
572
-16
139
143
-4
1,116
1,144
-28
1,500
873
627
596
349
247
898
528
370
396
259
137
395
261
134
596
386
210
20,442
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-)
or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
Excess of col. (i)
over col. (j), if any
a
1,112
b
796
c
1,121
d
324
e
393
248
454
34
35
-89
1,368
-10
-2
-1
-10
27,623
-2
-1,238
-278
13
-7
-51
-56
-22
-13
-9
-11
-13
-19
-9
-2
-9
-11
-377
-4
-3
-1
-1,018
205
5
38
-17
-11
-9
-3
-77
-80
-169
-303
-79
19,822
10,379
306
343
-98
-114
475
2,231
561
-876
-19,463
-153
-51
-86
-3,157
-703
-332
-233
-494
-9,046
-13,582
-804
237
-275
-4
-81
7
56
63
71
235
54
312
990
2,015
-78
800
-2
192
69
81
24
226
315
69
6
11
-204
33
112
194
70
-17
184
203
34
5
155
164
-6,922
245
63
1,036
118
112
118
95
132
118
143
144
83
29
-41
-113
23
76
6
197
8
481
93
152
22
-3
19
35
72
119
-9
6
5,892
913
5,991
6,032
12,755
-15
307
1,131
1,063
2,245
46
3,285
58
562
126
-4
286
54
1,097
1,017
383
39
91
-341
139
816
472
307
38
1,115
961
119
1
106
452
766
1,466
-2
213
3,920
403
647
120
525
367
394
549
170
727
273
43
-108
-231
74
387
149
734
17
522
1,741
359
492
179
242
37
136
193
384
465
99
79
-519
121
10
-130
19
5
-127
-8
-151
-8
-141
-202
-6
-208
-12
-263
-80
-349
-171
-74
-293
-116
-23
6,730
1,312
5,245
1,200
-251
-126
-16
-4
-28
627
247
370
137
134
210
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
115,237
3
Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8
...................
3
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)
If section 4940(d)(2) applies, leave this part blank.
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period?
Yes
No
If "Yes," the foundation does not qualify under section 4940(e). Do not complete this part.
1
Enter the appropriate amount in each column for each year; see instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in)
(b)
Adjusted qualifying distributions
(c)
Net value of noncharitable-use assets
(d)
Distribution ratio
(col. (b) divided by col. (c))
2018
196,149
3,665,971
0.053505
2017
172,601
3,827,020
0.045101
2016
174,236
3,554,003
0.049025
2015
183,514
3,420,413
0.053653
2014
185,948
3,652,158
0.050915
2
Total
of line 1, column (d)
.....................
2
0.252199
3
Average distribution ratio for the 5-year base period—divide the total on line 2 by 5.0, or by the number of years the foundation has been in existence if less than 5 years
......
3
0.05044
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
3,709,124
5
Multiply line 4 by line 3
......................
5
187,088
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
1,659
7
Add lines 5 and 6
........................
7
188,747
8
Enter qualifying distributions from Part XII, line 4
,.............
8
186,200
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See the Part VI instructions.
Form
990-PF
(2019)
Form 990-PF (2019)
Page
4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a
Exempt operating foundations described in section 4940(d)(2), check here
and enter “N/A" on line 1.
Date of ruling or determination letter:
(attach copy of letter if necessary–see instructions)
b
Domestic foundations that meet the section 4940(e) requirements in Part V, check
1
3,319
here
and enter 1% of Part I, line 27b
...................
c
All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
2
0
3
Add lines 1 and 2
...........................
3
3,319
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
4
0
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
3,319
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
1,328
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
0
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
1,328
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
1,991
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
0
Refunded
11
0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition)
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
(2)
On foundation managers.
$
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
Yes
7
Did the foundation have at least $5,000 in assets at any time during the year?
If "Yes," complete Part II, col. (c),
and Part XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
TX
b
If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G?
If "No," attach explanation
.
8b
Yes
9
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
or 4942(j)(5) for calendar year 2019 or the taxable year beginning in 2019? See the instructions for Part XIV.
If "Yes," complete Part XIV
.............................
9
No
10
Did any persons become substantial contributors during the tax year?
If "Yes," attach a schedule listing their names
and addresses.
...............................
10
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
5
Part VII-A
Statements Regarding Activities
(continued)
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions
.............
11
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement. See instructions
.................
12
No
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
N/A
14
The books are in care of
JP MORGAN CHASE BANK NA
Telephone no.
(800) 496-2583
Located at
10 S DEARBORN ST MC IL1-0111
CHICAGO
IL
ZIP+4
60603
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1)
Engage in the sale or exchange, or leasing of property with a disqualified person?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(5)
Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)?
...............
Yes
No
(6)
Agree to pay money or property to a government official? (
Exception.
Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.)
.......
Yes
No
b
If any answer is "Yes" to 1a(1)–(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions
........
1b
No
Organizations relying on a current notice regarding disaster assistance check here
........
c
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2019?
.............
1c
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2019, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2019?
.............
Yes
No
If "Yes," list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer "No" and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
......................
Yes
No
b
If "Yes," did it have excess business holdings in 2019 as a result of
(1)
any purchase by the foundation
or disqualified persons after May 26, 1969;
(2)
the lapse of the 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or
(3)
the lapse of the 10-, 15-, or 20-year first phase holding period?
(Use Schedule C, Form 4720, to determine
if the foundation had excess business holdings in 2019.)
..................
3b
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2019?
4b
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
6
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
(continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
No
b
If any answer is "Yes" to 5a(1)–(5), did
any
of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions
......
5b
Organizations relying on a current notice regarding disaster assistance check here
.........
c
If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant?
..........
Yes
No
If "Yes," attach the statement required by Regulations section 53.4945–5(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract?
.....................
Yes
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
....
6b
No
If "Yes" to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
Yes
No
b
If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction?
....
7b
8
Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment during the year?
.................
Yes
No
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1
List all officers, directors, trustees, foundation managers and their compensation. See instructions
(a)
Name and address
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(If not paid, enter
-0-)
(d)
Contributions to employee benefit plans and deferred compensation
(e)
Expense account,
other allowances
JP MORGAN CHASE BANK NA
CO-TRUSTEE
2
51,271
10 S DEARBORN ST MC IL1-0111
CHICAGO
,
IL
60603
DOUG WINKER
CO-TRUSTEE
2
20,588
PO BOX 6865
ROUND ROCK
,
TX
786836865
2
Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a)
Name and address of each employee paid more than $50,000
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
NONE
Total
number of other employees paid over $50,000
...................
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
7
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
(continued)
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
NONE
Total
number of others receiving over $50,000 for professional services
.............
0
Part IX-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
2
3
4
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
N/A
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
Form
990-PF
(2019)
Form 990-PF (2019)
Page
8
Part X
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations, see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities
...................
1a
3,685,953
b
Average of monthly cash balances
.......................
1b
79,655
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
3,765,608
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation)
.............
1e
0
2
Acquisition indebtedness applicable to line 1 assets
..................
2
0
3
Subtract line 2 from line 1d
.........................
3
3,765,608
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
56,484
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
3,709,124
6
Minimum investment return.
Enter 5% of line 5
..................
6
185,456
Part XI
Distributable Amount
(see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here
and do not complete this part.)
1
Minimum investment return from Part X, line 6
....................
1
185,456
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
3,319
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
3,319
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
182,137
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
182,137
6
Deduction from distributable amount (see instructions)
.................
6
0
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1
...
7
182,137
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
186,200
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
186,200
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
186,200
Note:
The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
the section 4940(e) reduction of tax in those years.
Form
990-PF
(2019)
Form 990-PF (2019)
Page
9
Part XIII
Undistributed Income
(see instructions)
(a)
Corpus
(b)
Years prior to 2018
(c)
2018
(d)
2019
1
Distributable amount for 2019 from Part XI, line 7
182,137
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
151,892
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
0
b
From 2015
......
0
c
From 2016
......
0
d
From 2017
......
0
e
From 2018
......
0
f
Total
of lines 3a through e
........
0
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
186,200
a
Applied to 2018, but not more than line 2a
151,892
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
0
c
Treated as distributions out of corpus (Election
required—see instructions)
........
0
d
Applied to 2019 distributable amount
.....
34,308
e
Remaining amount distributed out of corpus
0
5
Excess distributions carryover applied to 2019.
0
0
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
0
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
0
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
0
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
0
e
Undistributed income for 2018. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
0
f
Undistributed income for 2019. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2020
..........
147,829
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions)
.......
0
8
Excess distributions carryover from 2014 not
applied on line 5 or line 7 (see instructions)
...
0
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
0
10
Analysis of line 9:
a
Excess from 2015
....
0
b
Excess from 2016
....
0
c
Excess from 2017
....
0
d
Excess from 2018
....
0
e
Excess from 2019
....
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
10
Part XIV
Private Operating Foundations
(see instructions and Part VII-A, question 9)
1a
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2019, enter the date of the ruling
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2019
(b)
2018
(c)
2017
(d)
2016
b
85% of line 2a
.........
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed
...
c
“Support" alternative test—enter:
(1)
Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
....
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
(3)
Largest amount of support
from an exempt organization
(4)
Gross investment income
Part XV
Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
NONE
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
NONE
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
DOUG WINKER
PO BOX 6865
ROUND ROCK
,
TX
786836865
(817) 261-8419
b
The form in which applications should be submitted and information and materials they should include:
LETTER DESCRIBING ORGANIZATIONS, PURPOSE, AMOUNT & EXEMPTION LETTER
c
Any submission deadlines:
NONE
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
NONE
Form
990-PF
(2019)
Form 990-PF (2019)
Page
11
Part XV
Supplementary Information
(continued)
3
Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
HOUSING CHANNEL
4200 SOUTH FWY STE 307
FORT WORTH
,
TX
76115
NONE
PC
GENERAL
5,000
VAN CLIBURN FOUNDATION
2525 RIDGMAR BLVD
FORT WORTH
,
TX
76116
NONE
PC
GENERAL
5,000
MOBILE LOAVES AND FISHES INC
9301 HOG EYE ROAD STE 950
AUSTIN
,
TX
78724
NONE
PC
GENERAL
5,000
INCE FOUNDATION INC
33 MOULTON STREET
CAMBRIDGE
,
MA
02138
NONE
PC
GENERAL
5,000
AUSTIN SYMPHONY ORCHESTRA SOCIETY INC
1101 RED RIVER ST
AUSTIN
,
TX
78701
NONE
PC
GENERAL
30,000
GUARDIANSHIP SERVICES INC
603 W MAGNOLIA STE 205
FORT WORTH
,
TX
76104
NONE
PC
GENERAL
2,000
ACOUSTICAL SOCIETY OF AMERICA
SUITE 1NO1 2 HUNTINGTON QUADRANGLE
MELVILLE
,
NY
117474502
NONE
PC
GENERAL
5,000
ARK HOUSE FOUNDATION
PO BOX 833656
RICHARDSON
,
TX
750833656
NONE
PC
GENERAL
5,000
CHRISTIAN CHURCH FOUNDATION
130 E WASHINGTON ST
INDIANAPOLIS
,
IN
462061986
NONE
PC
GENERAL
5,000
UNIVERSITY OF TEXAS AUSTIN LONGHORN FOUNDATIO
PO BOX 7399
AUSTIN
,
TX
787121080
NONE
PC
GENERAL
5,000
FIRST CHRISTIAN CHURCH
910 S COLLINS
ARLINGTON
,
TX
76010
NONE
PC
GENERAL
1,000
PARAMOUNT THEATRE FOR THE PERFORMIN
713 CONGRESS AVENUE
AUSTIN
,
TX
78701
NONE
PC
GENERAL
75,000
GREATER AUSTIN PERFORMING ARTS CENTER
PO BOX 301449
AUSTIN
,
TX
787030025
NONE
PC
GENERAL
5,000
Total
.................................
3a
153,000
b
Approved for future payment
Total
.................................
3b
Form
990-PF
(2019)
Form 990-PF (2019)
Page
12
Part XVI-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
Unrelated business income
Excluded by section 512, 513, or 514
(e)
Related or exempt
function income
(See instructions.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
4
Dividends and interest from securities
....
14
91,455
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not debt-financed property
.....
6
Net rental income or (loss) from personal property
7
Other investment income
.....
8
Gain or (loss) from sales of assets other than
inventory
............
18
115,237
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
FEDERAL TAX REFUND
1
555
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
207,247
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
207,247
(See worksheet in line 13 instructions to verify calculations.)
Part XVI-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
instructions.)
Form
990-PF
(2019)
Form 990-PF (2019)
Page
13
Part XVII
Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
1
Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
Yes
No
a
Transfers from the reporting foundation to a noncharitable exempt organization of:
(1)
Cash
...................................
1a(1)
No
(2)
Other assets
.................................
1a(2)
No
b
Other transactions:
(1)
Sales of assets to a noncharitable exempt organization
....................
1b(1)
No
(2)
Purchases of assets from a noncharitable exempt organization
..................
1b(2)
No
(3)
Rental of facilities, equipment, or other assets
.......................
1b(3)
No
(4)
Reimbursement arrangements
...........................
1b(4)
No
(5)
Loans or loan guarantees
.............................
1b(5)
No
(6)
Performance of services or membership or fundraising solicitations
................
1b(6)
No
c
Sharing of facilities, equipment, mailing lists, other assets, or paid employees
..............
1c
No
d
If the answer to any of the above is "Yes," complete the following schedule. Column
(b)
should always show the fair market value
of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
in any transaction or sharing arrangement, show in column
(d)
the value of the goods, other assets, or services received.
(a)
Line No.
(b)
Amount involved
(c)
Name of noncharitable exempt organization
(d)
Description of transfers, transactions, and sharing arrangements
2a
Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
described in section 501(c) (other than section 501(c)(3)) or in section 527?
...........
Yes
No
b
If "Yes," complete the following schedule.
(a)
Name of organization
(b)
Type of organization
(c)
Description of relationship
Sign Here
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
May the IRS discuss this return
with the preparer shown below
(see instr.)
Yes
No
Signature of officer or trustee
Date
Title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's Signature
Date
Check if self-
employed
PTIN
Firm's name
Firm's EIN
Firm's address
Phone no.
Form
990-PF
(2019)
Additional Data
Software ID:
Software Version:
Form 990PF - Special Condition Description:
Special Condition Description