Form990-PF
Click to see attachment

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0052
2020
Open to Public Inspection
For calendar year 2020, or tax year beginning 01-01-2020 , and ending 12-31-2020
Name of foundation
HENRY SCHEIN CARES FOUNDATION INC
 
% JENNIFER KIM FIELD
Number and street (or P.O. box number if mail is not delivered to street address)135 DURYEA ROAD
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MELVILLE, NY11747
A Employer identification number

26-4137268
B Telephone number (see instructions)

(631) 843-5500
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$1,649,257J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule) 151,565
2 Check bullet.............
3 Interest on savings and temporary cash investments 19,480 19,480  
4 Dividends and interest from securities...      
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10  
b Gross sales price for all assets on line 6a  
7 Capital gain net income (from Part IV, line 2)...  
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 171,045 19,480  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0      
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 39,633 0 0 39,633
c Other professional fees (attach schedule)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)...        
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 5,164 0 0 5,164
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 44,797 0 0 44,797
25 Contributions, gifts, grants paid....... 510,884 471,851
26 Total expenses and disbursements. Add lines 24 and 25 555,681 0 0 516,648
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -384,636
b Net investment income (if negative, enter -0-) 19,480
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2020)
Form 990-PF (2020)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing.............      
2 Savings and temporary cash investments......... 2,003,008 1,648,538 1,648,538
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet   837    
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet) Click to see attachment5,149 Click to see attachment719 Click to see attachment719
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 2,008,994 1,649,257 1,649,257
Liabilities 17 Accounts payable and accrued expenses.......... 14,133  
18 Grants payable................. 311,253 350,285
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22)......... 325,386 350,285
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions........... 1,580,291 1,209,894
25 Net assets with donor restrictions............ 103,317 89,078
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds    
29 Total net assets or fund balances (see instructions)..... 1,683,608 1,298,972
30 Total liabilities and net assets/fund balances (see instructions). 2,008,994 1,649,257
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return) ...............
1
1,683,608
2
Enter amount from Part I, line 27a .....................
2
-384,636
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
1,298,972
5
Decreases not included in line 2 (itemize) bullet
5
 
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
1,298,972
Form 990-PF (2020)
Form 990-PF (2020)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1a
b
c
d
e
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a
b
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2  
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
SECTION 4940(e) REPEALED ON DECEMBER 20, 2019 - DO NOT COMPLETE
1 Reserved
(a)
Reserved 		(b)
Reserved 		(c)
Reserved 		(d)
Reserved
2
Reserved...........................
2
3
Reserved...........................
3
4
Reserved...........................
4
5
Reserved...........................
5
6
Reserved...........................
6
7
Reserved...........................
7
8
Reserved,..........................
8
Form 990-PF (2020)
Form 990-PF (2020)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b Reserved................................ 1 271
c All other domestic foundations enter 1.39% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2  
3 Add lines 1 and 2........................... 3 271
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 271
6 Credits/Payments:
a 2020 estimated tax payments and 2019 overpayment credited to 2020 6a  
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 400
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 400
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 129
11 Enter the amount of line 10 to be: Credited to 2021 estimated taxBullet129 RefundedBullet 11  
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
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)
    bulletNY
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2020 or the taxable year beginning in 2020? See the instructions for Part XIV.
    If "Yes," complete Part XIV .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
    Yes
     
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 5
    Part VII-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletWWW.HSCARESFOUNDATION.ORG
    14
    The books are in care ofbulletJENNIFER KIM FIELD Telephone no.bullet (631) 843-5500

    Located atbullet135 DURYEA ROADMELVILLENY ZIP+4bullet11747
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2020, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?......................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?...............
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).......
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ........
    1b
     
    No
    ........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2020?.............
    1c
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2020, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2020?.............
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?......................
    b
    If "Yes," did it have excess business holdings in 2020 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2020.)..................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2020?
    4b
     
    No
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 6
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?.............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?.....
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ......
    5b
     
    No
    .........bullet
    c
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?..........
    If "Yes," attach the statement required by Regulations section 53.4945–5(d). Click to see attachment
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?.....................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .................
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    JENNIFER KIM FIELD VICE PRESIDENT, EXECUTIVE DIR.
    1.0     		0 0 0
    135 DURYEA ROAD
    MELVILLE,NY11747
    STANLEY BERGMAN CO-CHAIRMAN
    1.0     		0 0 0
    135 DURYEA ROAD
    MELVILLE,NY11747
    DR LOUIS W SULLIVAN CO-CHAIRMAN
    1.0     		0 0 0
    135 DURYEA ROAD
    MELVILLE,NY11747
    STEVEN KESS PRESIDENT
    1.0     		0 0 0
    135 DURYEA ROAD
    MELVILLE,NY11747
    HOWARD STAPLER VICE PRESIDENT
    1.0     		0 0 0
    135 DURYEA ROAD
    MELVILLE,NY11747
    SUSAN VASSALLO THRU 320 VICE PRESIDENT
    1.0     		0 0 0
    135 DURYEA ROAD
    MELVILLE,NY11747
    MICHAEL AMODIO TREASURER
    1.0     		0 0 0
    135 DURYEA ROAD
    MELVILLE,NY11747
    MICHAEL ETTINGER SECRETARY
    1.0     		0 0 0
    135 DURYEA ROAD
    MELVILLE,NY11747
    GERRY BENJAMIN DIRECTOR
    1.0     		0 0 0
    135 DURYEA ROAD
    MELVILLE,NY11747
    JAMES BRESLAWSKI DIRECTOR
    1.0     		0 0 0
    135 DURYEA ROAD
    MELVILLE,NY11747
    GERARD MEUCHNER DIRECTOR
    1.0     		0 0 0
    135 DURYEA ROAD
    MELVILLE,NY11747
    STEVEN PALADINO DIRECTOR
    1.0     		0 0 0
    135 DURYEA ROAD
    MELVILLE,NY11747
    ROBERT PONZO DIRECTOR
    1.0     		0 0 0
    135 DURYEA ROAD
    MELVILLE,NY11747
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
     
    Total number of other employees paid over $50,000...................bullet  
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 7
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
     
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 8
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    0
    b
    Average of monthly cash balances.......................
    1b
    1,825,773
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    1,825,773
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    1,825,773
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    27,387
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    1,798,386
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    89,919
    Part XI
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    89,919
    2a
    Tax on investment income for 2020 from Part VI, line 5......
    2a
    271
    b
    Income tax for 2020. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    271
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    89,648
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    89,648
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
    89,648
    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
    516,648
    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
    516,648
    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
    516,648
    Note: The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
    the section 4940(e) reduction of tax in those years.
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2019     		(c)
    2019     		(d)
    2020
    1 Distributable amount for 2020 from Part XI, line 7 89,648
    2 Undistributed income, if any, as of the end of 2020:
    a Enter amount for 2019 only.......  
    b Total for prior years:2018, 2017, 2016  
    3 Excess distributions carryover, if any, to 2020:
    a From 2015......  
    b From 2016......  
    c From 2017......  
    d From 2018......  
    e From 2019......  
    fTotal of lines 3a through e........  
    4Qualifying distributions for 2020 from Part
    XII, line 4: bullet$ 516,648
    a Applied to 2019, but not more than line 2a  
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		 
    d Applied to 2020 distributable amount..... 89,648
    e Remaining amount distributed out of corpus 427,000
    5 Excess distributions carryover applied to 2020.    
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 427,000
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		 
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		 
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		 
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    f Undistributed income for 2020. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2021 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		 
    8 Excess distributions carryover from 2015 not
    applied on line 5 or line 7 (see instructions) ...     		 
    9Excess distributions carryover to 2021.
    Subtract lines 7 and 8 from line 6a ......     		427,000
    10 Analysis of line 9:
    a Excess from 2016....  
    b Excess from 2017....  
    c Excess from 2018....  
    d Excess from 2019....  
    e Excess from 2020.... 427,000
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 10
    Part XIV
    Private Operating Foundations (see instructions and Part VII-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2020, enter the date of the ruling....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2020 (b) 2019 (c) 2018 (d) 2017
             
    b 85% of line 2a .........          
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part X, line 6 for each year listed...     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 11
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    Albany Area Primary Health Care Inc
    204 North Westover Boulevard
    Albany,GA31707     		no relationship PC Disaster relief 1,000
    Alpha Omega International
    50 West Edmonston Drive suite 206
    Rockville,MD20852     		no relationship PC Alpha Omega Holocaust Survivors 18,000
    American Association of Orthodontists
    401 North Lindbergh Boulevard
    St Louis,MO63141     		no relationship PC MISWPT 5,000
    American Heart Association
    7272 Greenville Avenue
    Dallas,TX75231     		no relationship PC general support 2,500
    Americares
    88 Hamilton Avenue
    Stamford,CT06902     		no relationship PC General support and disaster relief 15,684
    Bethany House
    102 Whitehouse Avenue
    Roosevelt,NY11575     		no relationship PC Back to school and Holiday cheer 4,300
    Children's Health Fund
    215 West 25th Street
    New York,NY10027     		no relationship PC General support and Disaster Relief 30,000
    Children's Tumor Foundation
    370 Lexington Avenue Suite 2100
    New York,NY10017     		no relationship PC general support 1,000
    Coastal Family Health Centers
    PO Box 475
    Biloxi,MS39533     		no relationship PC disaster relief 1,000
    Direct Relief International
    6100 Wallace Brecknell Road
    Santa Barbara,CA93117     		no relationship PC general support and disaster relief 15,684
    Espoir Youth Program
    570 Main Street
    westbury,NY11590     		no relationship PC back to school and holiday cheer 13,900
    Family and Children's Association
    31 Main Street
    Hempstead,NY11550     		no relationship PC back to school and holiday cheer 8,600
    Family Service League
    1444 Fifth Avenue
    bay shore,NY11706     		no relationship PC back to school and holiday cheer 15,700
    Gaslini hospital
    Via Gerolamo Gaslini 5
    genova   16147
    IT     		no relationship PC general support 5,578
    GLMAHealth Professionals Advancing LGBTQ Equality
    1133 19th Street NW suite 302
    washington,DC20036     		no relationship PC general support 1,000
    GLO Good Foundation
    923 Fifth Avenue
    new york,NY10021     		no relationship PC general support (COVID) 5,000
    Greenville Drive LLC
    935 South Main Street
    Greevnille,SC29601     		no relationship NC general support 10,625
    Harvard School of Dental Medicine
    Office of Development Alumni Rela
    Princeton,NJ08542     		no relationship PC general support 50,000
    Heart to Heart International
    PO Box 15566
    Lenexa,KS66285     		no relationship PC general support and disaster relief 59,479
    Hispanic Counseling Center
    344 Fulton Avenue
    hempstead,NY11550     		no relationship PC back to school and holiday cheer 13,600
    International Medical Corps
    12400 Wilshire Boulevard Suite 150
    los angeles,CA90025     		no relationhsip PC general support (COVID) 5,000
    Long Island Council on Alcoholism and Drug Depend
    1025 Old Country Road Suite 221
    westbury,NY11590     		no relationship PC general support 1,500
    Long Island Lutheran Middle & High School
    131 Brookville Road
    Brookville,NY11545     		no relationship PC general support 6,000
    National Association of Free & Charitable Clinics
    1800 Diagonal Road Suite 600
    alexandria,VA22314     		no relationship PC disaster relief 5,000
    National Found for Ctr of Disease Control & Preve
    600 Peachtree Street NE Suite 100
    atlanta,GA30308     		no relationship PC disaster relief 10,000
    Northwell Health Foundation (Cohen)
    2000 Marcus Avenue
    new hyde park,NY11042     		no relationship PC practice pink 35,000
    Professional Baseball Athletics Trainers Society
    2001 Blake Street
    denver,CO80205     		no relationship NC Global Community Outreach 10,000
    Project HOPE
    255 Carter Hall Lane
    milwood,VA22646     		no relationship PC general support (COVID) 5,000
    SCO Family of Services
    1 Alexander Place
    GLEN COVE,NY11542     		NO RELATIONSHIP PC back to school and holiday cheer 5,800
    Social Service Volunteers of Nassau Inc
    60 Charles Lindbergh Boulevard
    unioindale,NY11553     		no relationship PC Back to School and Holiday Cheer 13,600
    Special Olympics International
    1133 19th Street NW
    washington,DC20036     		no relationship PC disaster relief 5,000
    Stony Brook Foundation (Children's hospital)
    100 Nicholls Road
    stonybrook,NY11794     		no relationship PC practice pink 5,000
    Stop Soldier Suicide
    PO Box 110605
    durham,NC27709     		no relationship PC general support 1,000
    Suffolk County Dental Society
    150 Motor Parkway
    hauppauge,NY11788     		no relationship NC give kids a smile 5,000
    The American Association of Dental Office Managers
    125 Half Mile Road Suite 200
    red bank,NJ07701     		no relationship NC general support 24,500
    The Raymar Children's Fund
    523 Christie Street
    hempstead,NY11550     		no relationship PC Back to School and Holiday Cheer 2,800
    The University of British Columbia
    204 2199 Westbrook Mall
    vancouver   V6T 1Z3
    CA     		no relationship PC general support 21,600
    The Viscardi Center
    201 IU Willets Road
    albertson,NY11507     		no relationship PC general support 20,000
    University of Southern CA School of Dentistry
    220 Montgomery Street
    san francisco,CA94104     		no relationship PC general support 7,500
    WellLife Network
    142-02 20th Avenue 3rd Floor
    flushing,NY11351     		no relationship PC Back to School and Holiday Cheer 3,400
    Youth Environmental Services
    75 grand avenue
    massapequa,NY11758     		no relationship PC Back to School and Holiday Cheer 4,300
    Career Design in Dentistry
    8031 Linda Vista Road
    san diego,CA92111     		no relationship PF general support -2,000
    iBright LLC
    1156 Quail Meadow
    irvine,CA92603     		no relationship NC general support -799
    Total .................................bullet 3a 471,851
    bApproved for future payment
    American Association of Orthodontists
    410 North Lindbergh Boulevard
    st louis,MO63141     		no relationship PC Access to Care 5,000
    Arnold P Gold Foundation
    619 East Palisade Avenue
    Englewood Cliffs,NJ07632     		No relationship PC Access to Care 30,000
    Bethany House
    102 Whitehouse Avenue
    Roosevelt,NY11575     		No relationship PC Access to Care 1,200
    Children's Health Fund
    215 West 25th Street
    new york,NY10027     		No relationship PC Access to Care 25,000
    Crescentcare
    1631 Elysian Fields Avenue
    New Orleans,LA70117     		No relationship PC Disaster/Covid Relief 1,000
    Espoir Youth Program
    570 Main Street
    Westbury,NY11590     		No relationship PC Access to Care 1,000
    Family and Children's Association
    31 Main Street
    Hempstead,NY11550     		No relationship PC Access to Care 2,600
    Family Service League
    1444 Fifth Avenue
    Bay Shore,NY11706     		No relationship PC Access to Care 5,400
    Hispanic Counseling Center
    344 Fulton Avenue
    Hempstead,NY11550     		No relationship PC Access to Care 4,600
    ICD Section USA Foundation
    619 Professional Drive
    Gaithersburg,MD20879     		No relationship PC Access to Care 20,000
    International Association for Dental Research
    2001 Blake Street
    Denver,CO80205     		No relationship PC Access to Care 20,000
    Marillac Community Health Centers
    PO Box 4145
    new orleans,LA70178     		No relationship PC Disaster/Covid Relief 1,000
    MedShare International
    3240 Clifton Springs Road
    Decatur,GA30034     		No relationship PC Disaster/Covid Relief 10,000
    National Association of Community Health Centers
    7501 Wisconsin Avenue
    Bethesda,MD63141     		No relationship PC Disaster/Covid Relief 60,000
    National Network for Oral Health Access
    181 East 56th Street
    Denver,CO80216     		No relationship PC Disaster/Covid Relief 1,000
    Northwell Health Foundation
    2000 Marcus Avenue
    New Hyde Park,NY11042     		no relationship PC access care 30,000
    SCO Family of Services
    1 Alexander Place
    glen cove,NY11542     		no relationship PC access care 1,600
    Social Service Volunteers of Nassau Inc
    60 Charles Lindbergh Boulevard
    Uniondale,NY11553     		no relationship PC access care 5,400
    Special Olympics Louisiana Inc
    46 Louis Prima Drive
    Covington,LA70433     		no relationship PC Disaster/Covid Relief 2,500
    Special Olympics Mississippi
    2906 North State Street
    Jackson,MS39216     		no relationship PC Disaster/Covid Relief 2,500
    St Vincent de Paul Society NSW
    2 C West Street
    Lewisham NSW   2049
    AS     		no relationship PC Disaster/Covid Relief 10,210
    The American Association of Dental Office Managers
    125 Half Mile Road Suite 200
    red bank,NJ07701     		no relationship NC Access To Care 49,000
    The Raymar Children's Fund
    523 Christie Street
    South Hempstead,NY11550     		no relationship PC Access To Care 600
    The University of British Columbia
    204 2199 Westbrook Mall
    Vancouver   V6T 1Z3
    CA     		no relationship PC Access To Care 48,400
    The University of Sydney USA Foundation
    15 Roszel Road
    Princeton,NJ08540     		no relationship PC access to care 10,675
    WellLife Network
    3600 Route 112
    coram,NY11550     		no relationship PC access to care 1,000
    Youth Environmental Services
    75 Grand Avenue
    Massapequa,NY11758     		no relationship PC access to care 600
    Total .................................bullet 3b 350,285
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3 Interest on savings and temporary cash
    investments ...........     		    14 19,480  
    4 Dividends and interest from securities....          
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income.....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		         
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e)..   19,480  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    19,480
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 13
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

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


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


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    Form 990PF Part XV Line 3 - Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    Albany Area Primary Health Care Inc204 North Westover Boulevard
    Albany,GA31707     		no relationship PC Disaster relief 1,000
    Alpha Omega International50 West Edmonston Drive suite 206
    Rockville,MD20852     		no relationship PC Alpha Omega Holocaust Survivors 18,000
    American Association of Orthodontists401 North Lindbergh Boulevard
    St Louis,MO63141     		no relationship PC MISWPT 5,000
    American Heart Association7272 Greenville Avenue
    Dallas,TX75231     		no relationship PC general support 2,500
    Americares88 Hamilton Avenue
    Stamford,CT06902     		no relationship PC General support and disaster relief 15,684
    Bethany House102 Whitehouse Avenue
    Roosevelt,NY11575     		no relationship PC Back to school and Holiday cheer 4,300
    Children's Health Fund215 West 25th Street
    New York,NY10027     		no relationship PC General support and Disaster Relief 30,000
    Children's Tumor Foundation370 Lexington Avenue Suite 2100
    New York,NY10017     		no relationship PC general support 1,000
    Coastal Family Health CentersPO Box 475
    Biloxi,MS39533     		no relationship PC disaster relief 1,000
    Direct Relief International6100 Wallace Brecknell Road
    Santa Barbara,CA93117     		no relationship PC general support and disaster relief 15,684
    Espoir Youth Program570 Main Street
    westbury,NY11590     		no relationship PC back to school and holiday cheer 13,900
    Family and Children's Association31 Main Street
    Hempstead,NY11550     		no relationship PC back to school and holiday cheer 8,600
    Family Service League1444 Fifth Avenue
    bay shore,NY11706     		no relationship PC back to school and holiday cheer 15,700
    Gaslini hospitalVia Gerolamo Gaslini 5
    genova   16147
    IT     		no relationship PC general support 5,578
    GLMAHealth Professionals Advancing LGBTQ Equality1133 19th Street NW suite 302
    washington,DC20036     		no relationship PC general support 1,000
    GLO Good Foundation923 Fifth Avenue
    new york,NY10021     		no relationship PC general support (COVID) 5,000
    Greenville Drive LLC935 South Main Street
    Greevnille,SC29601     		no relationship NC general support 10,625
    Harvard School of Dental MedicineOffice of Development Alumni Rela
    Princeton,NJ08542     		no relationship PC general support 50,000
    Heart to Heart InternationalPO Box 15566
    Lenexa,KS66285     		no relationship PC general support and disaster relief 59,479
    Hispanic Counseling Center344 Fulton Avenue
    hempstead,NY11550     		no relationship PC back to school and holiday cheer 13,600
    International Medical Corps12400 Wilshire Boulevard Suite 150
    los angeles,CA90025     		no relationhsip PC general support (COVID) 5,000
    Long Island Council on Alcoholism and Drug Depend1025 Old Country Road Suite 221
    westbury,NY11590     		no relationship PC general support 1,500
    Long Island Lutheran Middle & High School131 Brookville Road
    Brookville,NY11545     		no relationship PC general support 6,000
    National Association of Free & Charitable Clinics1800 Diagonal Road Suite 600
    alexandria,VA22314     		no relationship PC disaster relief 5,000
    National Found for Ctr of Disease Control & Preve600 Peachtree Street NE Suite 100
    atlanta,GA30308     		no relationship PC disaster relief 10,000
    Northwell Health Foundation (Cohen)2000 Marcus Avenue
    new hyde park,NY11042     		no relationship PC practice pink 35,000
    Professional Baseball Athletics Trainers Society2001 Blake Street
    denver,CO80205     		no relationship NC Global Community Outreach 10,000
    Project HOPE255 Carter Hall Lane
    milwood,VA22646     		no relationship PC general support (COVID) 5,000
    SCO Family of Services1 Alexander Place
    GLEN COVE,NY11542     		NO RELATIONSHIP PC back to school and holiday cheer 5,800
    Social Service Volunteers of Nassau Inc60 Charles Lindbergh Boulevard
    unioindale,NY11553     		no relationship PC Back to School and Holiday Cheer 13,600
    Special Olympics International1133 19th Street NW
    washington,DC20036     		no relationship PC disaster relief 5,000
    Stony Brook Foundation (Children's hospital)100 Nicholls Road
    stonybrook,NY11794     		no relationship PC practice pink 5,000
    Stop Soldier SuicidePO Box 110605
    durham,NC27709     		no relationship PC general support 1,000
    Suffolk County Dental Society150 Motor Parkway
    hauppauge,NY11788     		no relationship NC give kids a smile 5,000
    The American Association of Dental Office Managers125 Half Mile Road Suite 200
    red bank,NJ07701     		no relationship NC general support 24,500
    The Raymar Children's Fund523 Christie Street
    hempstead,NY11550     		no relationship PC Back to School and Holiday Cheer 2,800
    The University of British Columbia204 2199 Westbrook Mall
    vancouver   V6T 1Z3
    CA     		no relationship PC general support 21,600
    The Viscardi Center201 IU Willets Road
    albertson,NY11507     		no relationship PC general support 20,000
    University of Southern CA School of Dentistry220 Montgomery Street
    san francisco,CA94104     		no relationship PC general support 7,500
    WellLife Network142-02 20th Avenue 3rd Floor
    flushing,NY11351     		no relationship PC Back to School and Holiday Cheer 3,400
    Youth Environmental Services75 grand avenue
    massapequa,NY11758     		no relationship PC Back to School and Holiday Cheer 4,300
    Career Design in Dentistry8031 Linda Vista Road
    san diego,CA92111     		no relationship PF general support -2,000
    iBright LLC1156 Quail Meadow
    irvine,CA92603     		no relationship NC general support -799
    Total ...............................bullet 3a 471,851
    bApproved for future payment
    American Association of Orthodontists410 North Lindbergh Boulevard
    st louis,MO63141     		no relationship PC Access to Care 5,000
    Arnold P Gold Foundation619 East Palisade Avenue
    Englewood Cliffs,NJ07632     		No relationship PC Access to Care 30,000
    Bethany House102 Whitehouse Avenue
    Roosevelt,NY11575     		No relationship PC Access to Care 1,200
    Children's Health Fund215 West 25th Street
    new york,NY10027     		No relationship PC Access to Care 25,000
    Crescentcare1631 Elysian Fields Avenue
    New Orleans,LA70117     		No relationship PC Disaster/Covid Relief 1,000
    Espoir Youth Program570 Main Street
    Westbury,NY11590     		No relationship PC Access to Care 1,000
    Family and Children's Association31 Main Street
    Hempstead,NY11550     		No relationship PC Access to Care 2,600
    Family Service League1444 Fifth Avenue
    Bay Shore,NY11706     		No relationship PC Access to Care 5,400
    Hispanic Counseling Center344 Fulton Avenue
    Hempstead,NY11550     		No relationship PC Access to Care 4,600
    ICD Section USA Foundation619 Professional Drive
    Gaithersburg,MD20879     		No relationship PC Access to Care 20,000
    International Association for Dental Research2001 Blake Street
    Denver,CO80205     		No relationship PC Access to Care 20,000
    Marillac Community Health CentersPO Box 4145
    new orleans,LA70178     		No relationship PC Disaster/Covid Relief 1,000
    MedShare International3240 Clifton Springs Road
    Decatur,GA30034     		No relationship PC Disaster/Covid Relief 10,000
    National Association of Community Health Centers7501 Wisconsin Avenue
    Bethesda,MD63141     		No relationship PC Disaster/Covid Relief 60,000
    National Network for Oral Health Access181 East 56th Street
    Denver,CO80216     		No relationship PC Disaster/Covid Relief 1,000
    Northwell Health Foundation2000 Marcus Avenue
    New Hyde Park,NY11042     		no relationship PC access care 30,000
    SCO Family of Services1 Alexander Place
    glen cove,NY11542     		no relationship PC access care 1,600
    Social Service Volunteers of Nassau Inc60 Charles Lindbergh Boulevard
    Uniondale,NY11553     		no relationship PC access care 5,400
    Special Olympics Louisiana Inc46 Louis Prima Drive
    Covington,LA70433     		no relationship PC Disaster/Covid Relief 2,500
    Special Olympics Mississippi2906 North State Street
    Jackson,MS39216     		no relationship PC Disaster/Covid Relief 2,500
    St Vincent de Paul Society NSW2 C West Street
    Lewisham NSW   2049
    AS     		no relationship PC Disaster/Covid Relief 10,210
    The American Association of Dental Office Managers125 Half Mile Road Suite 200
    red bank,NJ07701     		no relationship NC Access To Care 49,000
    The Raymar Children's Fund523 Christie Street
    South Hempstead,NY11550     		no relationship PC Access To Care 600
    The University of British Columbia204 2199 Westbrook Mall
    Vancouver   V6T 1Z3
    CA     		no relationship PC Access To Care 48,400
    The University of Sydney USA Foundation15 Roszel Road
    Princeton,NJ08540     		no relationship PC access to care 10,675
    WellLife Network3600 Route 112
    coram,NY11550     		no relationship PC access to care 1,000
    Youth Environmental Services75 Grand Avenue
    Massapequa,NY11758     		no relationship PC access to care 600
    Total ................................bullet 3b 350,285
    Schedule B
    (Form 990, 990-EZ,
    or 990-PF)
    Department of the Treasury
    Internal Revenue Service
    Schedule of Contributors

    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
    OMB No. 1545-0047
    2020
    Name of the organization
    HENRY SCHEIN CARES FOUNDATION INC
     
    Employer identification number

    26-4137268
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ






    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......... Arrow Bullet $  
    Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
    or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2
    Name of organization
    HENRY SCHEIN CARES FOUNDATION INC
          		Employer identification number
    26-4137268
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    1
    Schwab Charitable Fund
    211 Main street
     
    san francisco, CA94105

    		$ 20,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    2
    Henry Schein Inc
    135 Duryea Road
     
    melville, NY11747

    		$ 18,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    3
    Colgate-Palmolive Company
    PO Box 30
     
    topeka, KS66601

    		$ 16,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    4
    Claire Friedlander Family Foundatio
    223 Wall Street 411
     
    huntington, NY11743

    		$ 15,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    5
    Jewish Communal Fund
    575 Madison avenue
     
    new york, NY10022

    		$ 10,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    6
    Edward B Shils Entrepreneurial Fun
    135 Duryea Road
     
    melville, NY11747

    		$ 5,000


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Page 3
    Name of organization
    HENRY SCHEIN CARES FOUNDATION INC
          		Employer identification number

    26-4137268
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Page 4
    Name of organization
    HENRY SCHEIN CARES FOUNDATION INC
          		Employer identification number

    26-4137268
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Additional Data


    Software ID:  
    Software Version:  

    TY 2020 AccountingFeesSchedule
    Name:
    HENRY SCHEIN CARES FOUNDATION INC
    EIN:
    26-4137268
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    AUDIT & TAX PREP 39,633 0 0 39,633

    Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

    TY 2020 DepreciationSchedule
    Name:
    HENRY SCHEIN CARES FOUNDATION INC
    EIN:
    26-4137268
    Description of Property Date Acquired Cost or Other Basis Prior Years' Depreciation Computation Method Rate /
    Life (# of years)    		 Current Year's Depreciation Expense Net Investment Income Adjusted Net Income Cost of Goods Sold Not Included

    Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

    TY 2020 ExpenditureResponsibilityStmt
    Name:
    HENRY SCHEIN CARES FOUNDATION INC
    EIN:
    26-4137268
    Grantee's Name Grantee's Address Grant Date Grant Amount Grant Purpose Amount Expended By Grantee Any Diversion By Grantee? Dates of Reports By Grantee Date of Verification Results of Verification
    Greenville Drive LLC
          		935 SOUTH MAIN STREET
    GREEVNILLE,SC29601     		2020-05-13 10,625 Charitable Donation to support the 2020 'Health Awareness Partnership' Program. 10,625 NO 11/15/2021   Typically grantor requests a report 1-year from issuing the grant, however, due to COVID is allowing for 18 month+ for reports. No independent verification has been made due to timing nor does the grantor envision any issues to arise as these are long-standing partnerships with annual grants towards the same program.
    Professional Baseball Athletics Training
          		2001 BLAKE STREET
    denver,CO80205     		2020-05-13 10,000 Charitable Donation to support the 2020 'Promoting a Lifetime of Activity for Youth' Program. 10,000 NO 11/15/2021   Typically grantor requests a report 1-year from issuing the grant, however, due to COVID is allowing for 18 month+ for reports. No independent verification has been made due to timing nor does the grantor envision any issues to arise as these are long-standing partnerships with annual grants towards the same program.
    Suffolk County Dental Society
          		150 MOTOR PARKWAY
    HAUPPAUGE,NY11788     		2020-05-13 5,000 Charitable Donation to support the efforts that this org. provides to the Give Kids A Smile. 5,000 NO 11/15/2021   Typically grantor requests a report 1-year from issuing the grant, however, due to COVID is allowing for 18 month+ for reports. No independent verification has been made due to timing nor does the grantor envision any issues to arise as these are long-standing partnerships with annual grants towards the same program.
    The American Assoc of Office Dental Mgrs
          		125 HALF MILE ROAD SUITE 200
    red bank,NJ07701     		2020-04-15 24,500 Charitable Donation to support the 2020 'Green Leader Award' program. 24,500 NO 11/15/2021   Typically grantor requests a report 1-year from issuing the grant, however, due to COVID is allowing for 18 month+ for reports. No independent verification has been made due to timing nor does the grantor envision any issues to arise as these are long-standing partnerships with annual grants towards the same program.

    TY 2020 GeneralExplanationAttachment
    Name:
    HENRY SCHEIN CARES FOUNDATION INC
    EIN:
    26-4137268
    Identifier Return Reference Explanation
    FORM 990-PF, HEADER, ITEM G -INITIAL RETURN OF A FORMER PUBLIC CHARITY FORM 990-PF, HEADER, ITEM G -INITIAL RETURN OF A FORMER PUBLIC CHARITY ON JANUARY 28, 2021 HENRY SCHEIN CARES FOUNDATION, INC. FILED REQUEST FOR MISCELLANEOUS DETERMINATION (FORM 8940) WITH THE INTERNAL REVENUE SERVICE ("IRS") FOR RECLASSIFICATION OF FOUNDATION STATUS. (I.E., VOLUNTARY REQUEST FROM A PUBLIC CHARITY FOR PRIVATE FOUNDATION STATUS EFFECTIVE JANUARY 1, 2020) THE ORGANIZATION RECEIVED communication from the IRS in a letter dated July 1, 2021 indicating that they determined that the organization is a private foundation defined in section 509(a) of the Code beginning for the year ending December 31, 2020.
    Form 990-PF, Part VII-A, line 10, Substantial contributors: FORM 990-PF, PART VII-A, LINE 10, SUBSTANTIAL CONTRIBUTORS 1) Claire Friedlander Family Foundation 223 Wall Street, #411 Huntington, NY 11743 2) Colgate-Palmolive Company P.O. Box 30 Topeka, KS 66601 3) Henry Schein, Inc. 135 Duryea Road Melville, NY 11747

    TY 2020 OtherAssetsSchedule
    Name:
    HENRY SCHEIN CARES FOUNDATION INC
    EIN:
    26-4137268
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    INTEREST RECEIVABLE 5,149 719 719


    TY 2020 OtherExpensesSchedule
    Name:
    HENRY SCHEIN CARES FOUNDATION INC
    EIN:
    26-4137268
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    BANK AND CREDIT CARD FEES 5,164 0 0 5,164