-
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
NORMAN RAAB FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)
PO BOX 31086
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SEATTLE
,
WA
98103
A Employer identification number
23-7006390
B
Telephone number (see instructions)
(206) 632-1014
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)
$
24,007,782
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
...
471,546
471,546
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
413,617
b
Gross sales price for all assets on line 6a
3,687,151
7
Capital gain net income (from Part IV, line 2)
...
413,617
8
Net short-term capital gain
.........
9
Income modifications
...........
10a
Gross sales less returns and allowances
b
Less: Cost of goods sold
....
c
Gross profit or (loss) (attach schedule)
.....
11
Other income (attach schedule)
.......
9,071
6,114
12
Total.
Add lines 1 through 11
........
894,234
891,277
13
Compensation of officers, directors, trustees, etc.
97,000
0
97,000
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
27,207
0
27,207
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
9,010
1,750
7,260
c
Other professional fees (attach schedule)
....
122,833
117,810
5,023
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
51,812
7,747
0
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
16,319
0
16,319
21
Travel, conferences, and meetings
.......
2,065
0
2,065
22
Printing and publications
..........
463
0
463
23
Other expenses (attach schedule)
.......
3,514
0
3,514
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
330,223
127,307
158,851
25
Contributions, gifts, grants paid
.......
1,048,700
1,048,700
26
Total expenses and disbursements.
Add lines 24 and 25
1,378,923
127,307
1,207,551
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-484,689
b
Net investment income
(if negative, enter -0-)
763,970
c
Adjusted net income
(if negative, enter -0-)
...
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2019)
Form 990-PF (2019)
Page
2
Part II
Balance Sheets
Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year
End of year
(a)
Book Value
(b)
Book Value
(c)
Fair Market Value
1
Cash—non-interest-bearing
.............
75,269
19,224
19,224
2
Savings and temporary cash investments
.........
1,159,040
817,907
817,907
3
Accounts receivable
Less: allowance for doubtful accounts
4
Pledges receivable
Less: allowance for doubtful accounts
5
Grants receivable
.................
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)
.....
7
Other notes and loans receivable (attach schedule)
Less: allowance for doubtful accounts
8
Inventories for sale or use
..............
9
Prepaid expenses and deferred charges
..........
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
.......
8,221,465
7,897,653
17,562,358
c
Investments—corporate bonds (attach schedule)
.......
4,995,057
5,253,946
5,608,293
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
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)
14,450,831
13,988,730
24,007,782
17
Accounts payable and accrued expenses
..........
9,065
7,029
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)
.........
9,065
7,029
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
........
0
0
27
Paid-in or capital surplus, or land, bldg., and equipment fund
0
0
28
Retained earnings, accumulated income, endowment, or other funds
14,441,766
13,981,701
29
Total net assets or fund balances
(see instructions)
.....
14,441,766
13,981,701
30
Total liabilities and net assets/fund balances
(see instructions)
.
14,450,831
13,988,730
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
14,441,766
2
Enter amount from Part I, line 27a
.....................
2
-484,689
3
Other increases not included in line 2 (itemize)
3
24,624
4
Add lines 1, 2, and 3
..........................
4
13,981,701
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
13,981,701
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
FIRST MANHATTAN CO., PUBLICLY TRADED SECURITIES
b
c
d
e
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
3,687,151
3,273,534
413,617
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
413,617
b
c
d
e
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
413,617
3
Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8
...................
3
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)
If section 4940(d)(2) applies, leave this part blank.
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period?
Yes
No
If "Yes," the foundation does not qualify under section 4940(e). Do not complete this part.
1
Enter the appropriate amount in each column for each year; see instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in)
(b)
Adjusted qualifying distributions
(c)
Net value of noncharitable-use assets
(d)
Distribution ratio
(col. (b) divided by col. (c))
2018
1,183,551
22,123,740
0.053497
2017
1,095,752
21,921,832
0.049985
2016
1,183,465
21,030,716
0.056273
2015
1,216,179
20,744,604
0.058626
2014
1,239,023
21,483,913
0.057672
2
Total
of line 1, column (d)
.....................
2
0.276053
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
0.055211
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
22,872,455
5
Multiply line 4 by line 3
......................
5
1,262,811
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
7,640
7
Add lines 5 and 6
........................
7
1,270,451
8
Enter qualifying distributions from Part XII, line 4
,.............
8
1,207,551
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
15,279
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
15,279
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
15,279
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
14,500
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
0
7
Total credits and payments. Add lines 6a through 6d
..............
7
14,500
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
779
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
Refunded
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 Instructions
for definition)
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
0
(2)
On foundation managers.
$
0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
Yes
7
Did the foundation have at least $5,000 in assets at any time during the year?
If "Yes," complete Part II, col. (c),
and Part XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
WA
,
PA
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
RAABFOUNDATION.ORG
14
The books are in care of
SARA RAAB MCINERNY
Telephone no.
(206) 632-1014
Located at
PO BOX 31086
SEATTLE
WA
ZIP+4
98103
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
STEPHEN F RAAB
CHAIR
20.00
1,500
0
0
PO BOX 31086
SEATTLE
,
WA
98103
WHITNEY RAAB
TRUSTEE
2.00
1,500
0
0
PO BOX 31086
SEATTLE
,
WA
98103
SARA RAAB MCINERNY
EXECUTIVE DIRECTOR
35.00
85,000
15,413
0
PO BOX 31086
SEATTLE
,
WA
98103
STEPHEN BLEYER
TRUSTEE
2.00
1,500
0
0
PO BOX 31086
SEATTLE
,
WA
98103
MARIELLEN BRICKLEY-RAAB
TRUSTEE
2.00
1,500
0
0
PO BOX 31086
SEATTLE
,
WA
98103
EMILY LOWMON
TRUSTEE
2.00
1,500
0
0
PO BOX 31086
SEATTLE
,
WA
98103
TRYG MCINERNY
TRUSTEE
2.00
1,500
0
0
PO BOX 31086
SEATTLE
,
WA
98103
ANN RAAB
TRUSTEE
2.00
1,500
0
0
PO BOX 31086
SEATTLE
,
WA
98103
ISABEL RAAB
TRUSTEE
2.00
1,500
0
0
PO BOX 31086
SEATTLE
,
WA
98103
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
FIRST MANHATTAN COMPANY
INVESTMENT MANAGEMENT
117,810
399 PARK AVENUE
NEW YORK
,
NY
10022
Total
number of others receiving over $50,000 for professional services
.............
0
Part IX-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
2
3
4
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
0
Form
990-PF
(2019)
Form 990-PF (2019)
Page
8
Part X
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations, see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities
...................
1a
21,472,135
b
Average of monthly cash balances
.......................
1b
1,748,632
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
23,220,767
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
23,220,767
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
348,312
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
22,872,455
6
Minimum investment return.
Enter 5% of line 5
..................
6
1,143,623
Part XI
Distributable Amount
(see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here
and do not complete this part.)
1
Minimum investment return from Part X, line 6
....................
1
1,143,623
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
15,279
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
15,279
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
1,128,344
4
Recoveries of amounts treated as qualifying distributions
................
4
2,907
5
Add lines 3 and 4
............................
5
1,131,251
6
Deduction from distributable amount (see instructions)
.................
6
0
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1
...
7
1,131,251
Part XII
Qualifying Distributions
(see instructions)
1
Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
a
Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26
..........
1a
1,207,551
b
Program-related investments—total from Part IX-B
..................
1b
0
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
b
Cash distribution test (attach the required schedule)
.................
3b
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
1,207,551
5
Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
income. Enter 1% of Part I, line 27b. See instructions
.................
5
0
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
1,207,551
Note:
The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
the section 4940(e) reduction of tax in those years.
Form
990-PF
(2019)
Form 990-PF (2019)
Page
9
Part XIII
Undistributed Income
(see instructions)
(a)
Corpus
(b)
Years prior to 2018
(c)
2018
(d)
2019
1
Distributable amount for 2019 from Part XI, line 7
1,131,251
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
0
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
187,487
b
From 2015
......
197,485
c
From 2016
......
141,218
d
From 2017
......
13,607
e
From 2018
......
120,329
f
Total
of lines 3a through e
........
660,126
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
1,207,551
a
Applied to 2018, but not more than line 2a
0
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
.....
1,131,251
e
Remaining amount distributed out of corpus
76,300
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
736,426
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
..........
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)
.......
0
8
Excess distributions carryover from 2014 not
applied on line 5 or line 7 (see instructions)
...
187,487
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
548,939
10
Analysis of line 9:
a
Excess from 2015
....
197,485
b
Excess from 2016
....
141,218
c
Excess from 2017
....
13,607
d
Excess from 2018
....
120,329
e
Excess from 2019
....
76,300
Form
990-PF
(2019)
Form 990-PF (2019)
Page
10
Part XIV
Private Operating Foundations
(see instructions and Part VII-A, question 9)
1a
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2019, enter the date of the ruling
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2019
(b)
2018
(c)
2017
(d)
2016
b
85% of line 2a
.........
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed
...
c
“Support" alternative test—enter:
(1)
Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
....
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
(3)
Largest amount of support
from an exempt organization
(4)
Gross investment income
Part XV
Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or email address of the person to whom applications should be addressed:
b
The form in which applications should be submitted and information and materials they should include:
c
Any submission deadlines:
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Form
990-PF
(2019)
Form 990-PF (2019)
Page
11
Part XV
Supplementary Information
(continued)
3
Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
826 VALENCIA
826 VALENCIA ST
SAN FRANCISCO
,
CA
94110
PC
EDUCATION
25,000
A NEW WAY OF LIFE REENTRY PROJECT
PO BOX 875288
LOS ANGELES
,
CA
90087
PC
HUMAN SERVICES
2,500
ADHA INSTITUTE FOR ORAL HEALTH
444 NORTH MICHIGAN AVE SUITE 3400
CHICAGO
,
IL
60611
PC
EDUCATION
1,000
AIM HIGH FOR HIGH SCHOOL
PO BOX 410715
SAN FRANCISCO
,
CA
941410715
PC
EDUCATION
20,000
ANN SILVERMAN COMMUNITY HEALTH CLINIC
595 WEST STATE ST
DOYLESTOWN
,
PA
18901
PC
HUMAN SERVICES
25,000
ANN SILVERMAN COMMUNITY HEALTH CLINIC
595 WEST STATE ST
DOYLESTOWN
,
PA
18901
PC
HUMAN SERVICES
1,000
ARBORETUM FOUNDATION
2300 ARBORETUM DRIVE EAST
SEATTLE
,
WA
98112
PC
EDUCATION
1,000
BRYN MAWR FILM INSTITUTE
824 W LANCASTER AVENUE
BRYN MAWR
,
PA
19010
PC
EDUCATION
1,250
BUCKS COUNTY AUDUBON SOCIETY
2877 CREAMERY ROAD
NEW HOPE
,
PA
18938
PC
HUMAN SERVICES
1,000
BUCKS COUNTY SPCA
PO BOX 277
LAHASKA
,
PA
18931
PC
HUMAN SERVICES
2,500
CAMPING UNLIMITED FOR THE DEVELOPMENTALLY DISABLED
C/O CAMP KREM 102 BROOK LANE
BOULDER CREEK
,
CA
95006
PC
HUMAN SERVICES
50,000
CEASEFIRE PENNSYLVANIA EDUCATION FUND
PO BOX 60095
PHILADELPHIA
,
PA
19102
PC
EDUCATION
1,000
CENTRAL BUCKS AMBULANCE AND RESCUE UNIT
455 EAST STREET
DOYLESTOWN
,
PA
18901
PC
HUMAN SERVICES
10,000
COLORADO COALITION FOR THE HOMELESS
2111 CHAMPA ST
DENVER
,
CO
80205
PC
HUMAN SERVICES
1,000
COLORADO CRIMINAL JUSTICE REFORM COALITION
1212 MARIPOSA ST 6
DENVER
,
CO
80204
PC
HUMAN SERVICES
1,000
COLORADO PET PANTRY
PO BOX 323
BOULDER
,
CO
80306
PC
HUMAN SERVICES
500
COUNTY THEATER INC
PO BOX 779
DOYLESTOWN
,
PA
18901
PC
EDUCATION
1,000
EAGLEVILLE HOSPITAL FOUNDATION
100 EAGLEVILLE RD
EAGLEVILLE
,
PA
19403
PC
HUMAN SERVICES
2,000
EARTHCORPS
6310 NE 74TH STREET SUITE 201E
SEATTLE
,
WA
98115
PC
EDUCATION
20,000
EQUAL JUSTICE INITIATIVE
122 COMMERCE ST
MONTGOMERY
,
AL
36104
PC
HUMAN SERVICES
400
EXTRAFOODORG
907 SIR FRANCIS DRAKE BLVD
KENTFIELD
,
CA
94904
PC
HUMAN SERVICES
25,000
EXTRAFOODORG
907 SIR FRANCIS DRAKE BLVD
KENTFIELD
,
CA
94904
PC
HUMAN SERVICES
2,500
FACING HISTORY AND OURSELVES
16 HURD ROAD
BROOKLINE
,
MA
02445
PC
EDUCATION
50,000
FAMILY SERVICE ASSOCIATION OF BUCKS COUNTY
4 CORNERSTONE DRIVE
LANGHORNE
,
PA
19047
PC
EDUCATION
2,500
FOOD BANK OF THE ROCKIES
10700 E 45TH AVENUE
DENVER
,
CO
80239
PC
HUMAN SERVICES
4,500
FORWORDS LITERACY LAB
361 THIRD ST SUITE I
SAN RAFAEL
,
CA
94901
PC
EDUCATION
5,000
GIFFORDS LAW CENTER TO PREVENT GUN VIOLENCE
268 BUSH STREET 555
SAN FRANCISCO
,
CA
94104
PC
EDUCATION
50,000
GREYHOUND FRIENDS FOR LIFE
PO BOX 549
FULTON
,
CA
95439
PC
HUMAN SERVICES
5,000
HONEYBEES FOR HEROES
1 BLUEBERRY LN
PERKASIE
,
PA
18944
PC
HUMAN SERVICES
500
HOPE HOUSE OF COLORADO
6475 BENTON ST BLDG A
ARVADA
,
CO
80003
PC
HUMAN SERVICES
2,000
HOSPICE BY THE BAY
17 E SIR FRANCIS DRAKE BLVD
LARKSPUR
,
CA
94939
PC
HEALTH AND RESEARCH
5,000
HUMAN KIND NOW
3487 16TH ST
SAN FRANCISCO
,
CA
94114
PC
HEALTH AND RESEARCH
1,000
HUMANITIES WASHINGTON
130 NICKERSON STREET SUITE 304
SEATTLE
,
WA
98109
PC
EDUCATION
20,000
ICIVICS INC
1035 CAMBRIDGE ST SUITE 21B
CAMBRIDGE
,
MA
02141
PC
EDUCATION
25,000
JEWISH FAMILY AND CHILDREN'S SERVICE (JFCS) OF GREATER PHILADELPHIA
2100 ARCH STREET 5TH FLOOR
PHILADELPHIA
,
PA
19103
PC
HUMAN SERVICES
25,000
JEWISH FAMILY AND CHILDREN'S SERVICES - SF
PO BOX 159004
SAN FRANCISCO
,
CA
941159004
PC
EDUCATION
25,000
JOHNS HOPKINS COMPREHENSIVE DIABETES CENTER
5200 EASTERN AVENUE MFL CENTER
TOWER SUITE 355
BALTIMORE
,
MD
21224
PC
HEALTH AND RESEARCH
50,000
JOHNS HOPKINS UNIVERSITY- BLUE JAYS UNLIMITED
3400 NORTH CHARLES STREET
BALTIMORE
,
MD
21218
PC
EDUCATION
3,000
JOHNS HOPKINS UNIVERSITY- BLUE JAYS UNLIMITED
3400 NORTH CHARLES STREET
BALTIMORE
,
MD
21218
PC
EDUCATION
1,200
JOHNS HOPKINS WILMER EYE INSTITUTE
WILMER 112 600 NORTH WOLFE STREET
BALTIMORE
,
MD
212879015
PC
HEALTH AND RESEARCH
50,000
KRUCKEBERG BOTANIC GARDEN FOUNDATION
PO BOX 60035
SHORELINE
,
WA
981600035
PC
EDUCATION
1,000
KUOW PUGET SOUND PUBLIC RADIO
PO BOX 84148
SEATTLE
,
WA
981245448
PC
EDUCATION
2,500
LEAGUE OF WOMEN VOTERS OF PA CITIZEN EDUCATION FUND
226 FORSTER ST
HARRISBURG
,
PA
17102
PC
EDUCATION
1,000
LENAPE VALLEY FOUNDATION
500 NORTH WEST STREET
DOYLESTOWN
,
PA
18901
PC
EDUCATION
2,000
LIBRARY FOUNDATION OF LOS ANGELES
630 W 5TH STREET
LOS ANGELES
,
CA
90071
PC
EDUCATION
1,000
LITERACY SOURCE
3200 NE 125TH ST
SEATTLE
,
WA
98125
PC
EDUCATION
20,000
LOS ANGELES REGIONAL FOOD BANK
1734 E 41ST STREET
LOS ANGELES
,
CA
90058
PC
HUMAN SERVICES
400
LOS ANGELES REGIONAL FOOD BANK
1734 E 41ST STREET
LOS ANGELES
,
CA
90058
PC
HUMAN SERVICES
1,500
MAGEE REHAB HOSPITAL FOUNDATION
1513 RACE STREET
PHILADELPHIA
,
PA
19102
PC
HEALTH AND RESEARCH
40,000
MARIAN ANDERSON HISTORICAL SOCIETY
762 S MARTIN ST
PHILADELPHIA
,
PA
191461822
PC
EDUCATION
500
MARIN HUMANE SOCIETY
171 BEL MARIN KEYS BOULEVARD
NOVATO
,
CA
94949
PC
HUMAN SERVICES
20,000
MARIN SENIOR COORDINATING COUNCIL
930 TAMALPAIS AVENUE
SAN RAFAEL
,
CA
94901
PC
HUMAN SERVICES
25,000
MARINE MAMMAL CENTER
2000 BUNKER ROAD FORT CRONKHITE
SAUSALITO
,
CA
94965
PC
EDUCATION
10,000
MCPHS UNIVERSITY
179 LONGWOOD AVE
BOSTON
,
MA
02115
PC
EDUCATION
2,500
MIGHTY WRITERS
1501 CHRISTIAN ST
PHILADELPHIA
,
PA
19146
PC
EDUCATION
15,000
MISSISSIPPI FOOD NETWORK INC
PO BOX 411
JACKSON
,
MS
39205
PC
HUMAN SERVICES
500
MY FRIEND'S PLACE
PO BOX 3867
HOLLYWOOD
,
CA
90078
PC
HUMAN SERVICES
2,500
NATIONAL ASSOCIATION OF MENTAL ILLNESS (NAMI)
PO BOX 355
WARRINGTON
,
PA
189760355
PC
EDUCATION
2,500
NATIONAL MUSEUM OF AMERICAN JEWISH HISTORY
101 SOUTH INDEPENDENCE MALL EAST
PHILADELPHIA
,
PA
19106
PC
EDUCATION
4,000
NETWORK OF VICTIM ASSISTANCE
2370 YORK ROAD SUITE B-1
JAMISON
,
PA
18929
PC
EDUCATION
15,000
NETWORK OF VICTIM ASSISTANCE
2370 YORK ROAD SUITE B-1
JAMISON
,
PA
18929
PC
EDUCATION
3,000
NORTH CASCADES INSTITUTE
810 STATE ROUTE 20
SEDROWOOLLEY
,
WA
982841239
PC
EDUCATION
1,000
NORTHFIELD MOUNT HERMON SCHOOL
ONE LAMPLIGHTER WAY
MOUNT HERMON
,
MA
01354
PC
EDUCATION
500
OCEANA INC
1025 CONNECTICUT AVE NW SUITE 200
WASHINGTON
,
DC
20036
PC
EDUCATION
500
PEACEKEEPER SOCIETY
PO BOX 441
HARRAH
,
WA
989330441
PC
HUMAN SERVICES
1,000
PENN-JERSEY EDUCATIONAL RADIO
PO BOX 191
SERGEANTSVILLE
,
NJ
08557
PC
EDUCATION
500
PLANNED PARENTHOOD FEDERATION OF AMERICA INC
123 WILLIAM ST
NEW YORK
,
NY
10038
PC
HUMAN SERVICES
530
PLANNED PARENTHOOD FEDERATION OF AMERICA INC
123 WILLIAM ST
NEW YORK
,
NY
10038
PC
HUMAN SERVICES
2,500
PLANNED PARENTHOOD OF THE ROCKY MOUNTAINS INC
7155 E 38TH AVE
DENVER
,
CO
80207
PC
HUMAN SERVICES
1,000
PROGRESSIVE ANIMAL WELFARE SOCIETY (PAWS)
PO BOX 1037
LYNNWOOD
,
WA
98046
PC
HUMAN SERVICES
500
REFUGEE WOMEN'S ALLIANCE
4008 MARTIN LUTHER KING JR WAY S
SEATTLE
,
WA
98108
PC
EDUCATION
15,000
SAFE CROSSINGS FOUNDATION
1402 3RD AVENUE SUITE 1322
SEATTLE
,
WA
98101
PC
HUMAN SERVICES
2,500
SANDY HOOK PROMISE FOUNDATION
PO BOX 3489
NEWTOWN
,
CT
06470
PC
EDUCATION
25,000
SAVE THE CHILDREN FEDERATION INC
501 KINGS HIGHWAY EAST SUITE 400
FAIRFIELD
,
CT
06825
PC
HUMAN SERVICES
1,100
SEATTLE AQUARIUM
1483 ALASKAN WAY PIER 59
SEATTLE
,
WA
98101
PC
EDUCATION
1,000
SEATTLE ARTS & LECTURES
340 15TH AVE E SUITE 301
SEATTLE
,
WA
98112
PC
EDUCATION
20,000
SF-MARIN FOOD BANK
900 PENNSYLVANIA AVE
SAN FRANCISCO
,
CA
94109
PC
HUMAN SERVICES
25,000
SF-MARIN FOOD BANK
900 PENNSYLVANIA AVE
SAN FRANCISCO
,
CA
94109
PC
HUMAN SERVICES
10,000
SOLEBURY TOWNSHIP HISTORICAL SOCIETY
DRAWER 525
SOLEBURY
,
PA
18963
PC
EDUCATION
500
SOUND ACTION
PO BOX 845
VASHON
,
WA
98070
PC
EDUCATION
2,500
SOUTHERN POVERTY LAW CENTER INC
400 WASHINGTON AVE
MONTGOMERY
,
AL
36104
PC
HUMAN SERVICES
70
SPREAD THE VOTE
8601 LINCOLN BLVD SUITE 180/569
LOS ANGELES
,
CA
90045
PC
EDUCATION
2,500
TABBY'S PLACE
1100 HIGHWAY 202
RINGOES
,
NJ
08552
PC
HUMAN SERVICES
2,500
TEAM READ
PO BOX 94042
SEATTLE
,
WA
98124
PC
EDUCATION
25,000
THE CEDARS OF MARIN
PO BOX 947
ROSS
,
CA
94957
PC
HEALTH
25,000
THE FREE LIBRARY OF NEW HOPE & SOLEBURY
93 WEST FERRY STREET
NEW HOPE
,
PA
18938
PC
EDUCATION
10,000
THE FREE LIBRARY OF NEW HOPE & SOLEBURY
93 WEST FERRY STREET
NEW HOPE
,
PA
18938
PC
EDUCATION
500
THE GATHERING PLACE A REFUGE FOR REBUILDING LIVES
1535 HIGH STREET
DENVER
,
CO
80218
PC
EDUCATION
15,000
THE GATHERING PLACE A REFUGE FOR REBUILDING LIVES
1535 HIGH STREET
DENVER
,
CO
80218
PC
HUMAN SERVICES
10,000
THE PHILADELPHIA ORCHESTRA ASSOCIATION
ONE SOUTH BROAD ST 14TH FLOOR
PHILADELPHIA
,
PA
19107
PC
ARTS
3,500
UNITED WAY OF BUCKS COUNTY
413 HOOD BOULEVARD
FAIRLESS HILLS
,
PA
19030
PC
HUMAN SERVICES
25,000
UNIVERSITY CHILD DEVELOPMENT SCHOOL
5062 NINTH AVE NE
SEATTLE
,
WA
98105
PC
EDUCATION
1,000
UNIVERSITY CHILD DEVELOPMENT SCHOOL
5062 NINTH AVE NE
SEATTLE
,
WA
98105
PC
EDUCATION
2,500
US HOLOCAUST MEMORIAL MUSEUM
100 RAOUL WALLENBERG PLACE SW
WASHINGTON
,
DC
20024
PC
EDUCATION
25,000
VASSAR COLLEGE
124 RAYMOND AVENUE BOX 725
POUGHKEEPSIE
,
NY
12604
PC
EDUCATION
500
VENTURES
2100 24TH AVE S STE 380
SEATTLE
,
WA
98144
PC
EDUCATION
10,000
WELLSPRING FAMILY SERVICES
1900 RAINIER AVENUE SOUTH
SEATTLE
,
WA
98144
PC
EDUCATION
20,000
WEST PHILADELPHIA ALLIANCE FOR CHILDREN
5070 PARKSIDE AVENUE SUITE 1414
PHILADELPHIA
,
PA
19131
PC
EDUCATION
20,000
WEST PHILADELPHIA ALLIANCE FOR CHILDREN
5070 PARKSIDE AVENUE SUITE 1414
PHILADELPHIA
,
PA
19131
PC
EDUCATION
1,250
WESTSIDE BABY
10002 14TH AVE SW
SEATTLE
,
WA
98146
PC
HUMAN SERVICES
2,500
WHYY INC
150 N 6TH STREET
PHILADELPHIA
,
PA
19106
PC
EDUCATION
1,000
WOODLAND PARK ZOO
5500 PHINNEY AVE N
SEATTLE
,
WA
98103
PC
EDUCATION
20,000
WORLD WILDLIFE FUND INC
1250 24TH ST NW
WASHINGTON
,
DC
20037
PC
EDUCATION
500
WRAPPING PRESENCE DPC
PO BOX 236
SOLEBURY
,
PA
18963
PC
HUMAN SERVICES
500
ZENO
1404 E YESLER WAY SUITE 204
SEATTLE
,
WA
98122
PC
EDUCATION
25,000
Total
.................................
3a
1,048,700
b
Approved for future payment
FACING HISTORY AND OURSELVES
16 HURD ROAD
BROOKLINE
,
MA
02445
PC
EDUCATION
100,000
JEWISH FAMILY AND CHILDREN'S SERVICES
PO BOX 159004
SAN FRANCISCO
,
CA
941159004
PC
EDUCATION
25,000
Total
.................................
3b
125,000
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
471,546
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
413,617
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
FOREIGN TAXES REFUND
14
6,114
b
OTHER INCOME
01
457
c
RECOVERY OF GRANT
2,500
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
0
891,734
2,500
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
894,234
(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.)
11C
RETURNED GRANT
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