Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0052
2020
Open to Public Inspection
For calendar year 2020, or tax year beginning 01-01-2020 , and ending 12-31-2020
Name of foundation
CHARLES N SMITH TRUST FOR RILEY HOSPITAL
 
Number and street (or P.O. box number if mail is not delivered to street address)10 S DEARBORN IL1-0111
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CHICAGO, IL60603
A Employer identification number

35-6213457
B Telephone number (see instructions)

(800) 496-2583
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$2,823,124J 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)  
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 51,407 51,407  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 180,483
b Gross sales price for all assets on line 6a 1,026,091
7 Capital gain net income (from Part IV, line 2)... 180,483
8 Net short-term capital gain......... 0
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 231,890 231,890  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 18,421 8,809   9,612
14 Other employee salaries and wages......   0 0 0
15 Pension plans, employee benefits.......   0 0  
16a Legal fees (attach schedule).........       0
b Accounting fees (attach schedule).......        
c Other professional fees (attach schedule)....       0
17 Interest...............       0
18 Taxes (attach schedule) (see instructions)... Click to see attachment 2,383 1,338   0
19 Depreciation (attach schedule) and depletion... 0 0  
20 Occupancy..............        
21 Travel, conferences, and meetings.......   0 0  
22 Printing and publications..........   0 0  
23 Other expenses (attach schedule).......        
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 20,804 10,147 0 9,612
25 Contributions, gifts, grants paid....... 104,106 104,106
26 Total expenses and disbursements. Add lines 24 and 25 124,910 10,147 0 113,718
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 106,980
b Net investment income (if negative, enter -0-) 221,743
c Adjusted net income (if negative, enter -0-)... 0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2020)
Form 990-PF (2020)
Page 2
Part II Balance Sheets 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............. 16,283 3,001 3,001
2 Savings and temporary cash investments......... 14,231 41,920 41,920
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet     0 0
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet0      
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)....... 1,631,642 Click to see attachment1,659,521 2,141,984
c Investments—corporate bonds (attach schedule)....... 293,470 Click to see attachment369,209 386,724
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 241,074 Click to see attachment229,913 249,495
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 2,196,700 2,303,564 2,823,124
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22).........   0
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions...........    
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........ 2,196,700 2,303,564
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)..... 2,196,700 2,303,564
30 Total liabilities and net assets/fund balances (see instructions). 2,196,700 2,303,564
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
2,196,700
2
Enter amount from Part I, line 27a .....................
2
106,980
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
2,261
4
Add lines 1, 2, and 3 ..........................
4
2,305,941
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
2,377
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
2,303,564
Form 990-PF (2020)
Form 990-PF (2020)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1 a 5. CORTEVA INC     2020-01-13
b 4. CORTEVA INC     2020-01-13
c 5. CORTEVA INC     2020-01-14
d 6. CORTEVA INC     2020-01-14
e 2. CORTEVA INC     2020-01-14
1.208 CORTEVA INC   2019-04-08 2020-01-14
.792 CORTEVA INC   2018-04-09 2020-01-14
1. CORTEVA INC   2019-04-08 2020-01-14
6. CORTEVA INC     2020-01-15
7. CORTEVA INC     2020-01-15
3. CORTEVA INC     2020-01-15
1. CORTEVA INC   2019-06-27 2020-01-15
4. CORTEVA INC   2019-06-27 2020-01-15
5. CORTEVA INC     2020-01-15
1. CORTEVA INC   2019-06-28 2020-01-15
1. CORTEVA INC   2019-06-28 2020-01-16
1. CORTEVA INC   2019-06-28 2020-01-16
1. CORTEVA INC   2019-06-28 2020-01-16
16. QUALCOMM INC   2019-05-01 2020-01-23
. MERCK & CO INC     2020-01-24
8. EOG RESOURCES INC     2020-01-28
1. EOG RESOURCES INC   2016-05-23 2020-01-28
1. EOG RESOURCES INC   2016-05-24 2020-01-29
1. EOG RESOURCES INC   2016-05-24 2020-01-29
6. EOG RESOURCES INC     2020-01-29
6. EOG RESOURCES INC     2020-01-29
6. EOG RESOURCES INC   2016-08-05 2020-01-29
7. EOG RESOURCES INC     2020-01-30
2. EOG RESOURCES INC   2016-09-15 2020-01-30
43. ABBVIE INC     2020-02-11
9. ADOBE SYS INC   2013-05-09 2020-02-11
9. ALEXION PHARMACEUTICALS INC   2019-03-14 2020-02-11
7. ALPHABET INC-CL C     2020-02-11
1. ALPHABET INC-CL C   2019-10-25 2020-02-11
3. ALPHABET INC-CL A     2020-02-11
2. AMAZON COM INC     2020-02-11
5. AMAZON COM INC     2020-02-11
9. AMERICAN EXPRESS CO     2020-02-11
21. AMERICAN EXPRESS CO     2020-02-11
48. APPLE COMPUTER INC     2020-02-11
14. AUTOMATIC DATA PROCESSING INC     2020-02-11
4. AUTOMATIC DATA PROCESSING INC   2019-08-14 2020-02-11
144. BANK OF AMERICA CORPORATION     2020-02-11
21. BERKSHIRE HATHAWAY INC DEL CL B     2020-02-11
90. BOSTON SCIENTIFIC CORP     2020-02-11
53. BRISTOL MYERS SQUIBB CO   2019-11-20 2020-02-11
18. BROADCOM INC   2013-05-31 2020-02-11
10. CHARTER COMMUNICATIONS INC-A     2020-02-11
63. CITIGROUP INC NEW     2020-02-11
44. COCA-COLA CO     2020-02-11
72. COMCAST CORP NEW CL A     2020-02-11
52. COMCAST CORP NEW CL A     2020-02-11
18. DIAMONDBACK ENERGY INC     2020-02-11
17. DIAMONDBACK ENERGY INC     2020-02-11
20. DISNEY WALT CO     2020-02-11
25.792 DUPONT DE NEMOURS INC-W/D     2020-02-11
6.208 DUPONT DE NEMOURS INC-W/D   2019-04-08 2020-02-11
29. ELECTRONIC ARTS     2020-02-11
11. FACEBOOK INC-A   2020-01-08 2020-02-11
16. FACEBOOK INC-A     2020-02-11
6. FIDELITY NATL INFORMATION SVCS INC   2019-08-14 2020-02-11
22. FIDELITY NATL INFORMATION SVCS INC     2020-02-11
21. FISERV INC     2020-02-11
39. FISERV INC     2020-02-11
15. GENERAL DYNAMICS CORP     2020-02-11
21. HOME DEPOT INC     2020-02-11
35. HONEYWELL INTL INC     2020-02-11
14. INTERCONTINENTALEXCHANGE GROUP, INC     2020-02-11
125. KEYCORP NEW     2020-02-11
29. LILLY ELI & CO     2020-02-11
25. LOWES COS INC   2011-09-28 2020-02-11
44. MARATHON PETROLEUM CORPORATION     2020-02-11
20. MARATHON PETROLEUM CORPORATION     2020-02-11
25. MASTERCARD INC - CLASS A     2020-02-11
10. MCDONALDS CORP   2019-06-10 2020-02-11
33. MERCK & CO INC     2020-02-11
17. MERCK & CO INC   2019-03-14 2020-02-11
113. MICROSOFT CORP     2020-02-11
60. MONDELEZ INTERNATIONAL-W/I     2020-02-11
102. MORGAN STANLEY DEAN WITTER & CO NEW     2020-02-11
4. NETFLIX.COM INC   2018-09-13 2020-02-11
3. NETFLIX.COM INC   2019-05-16 2020-02-11
14. NEXTERA ENERGY INC     2020-02-11
22. NORFOLK SOUTHN CORP     2020-02-11
9. NORTHROP GRUMMAN CORP     2020-02-11
2. NORTHROP GRUMMAN CORP   2019-05-20 2020-02-11
14. NVIDIA CORP     2020-02-11
4. O'REILLY AUTOMOTIVE INC     2020-02-11
33. PAYPAL HOLDINGS INC     2020-02-11
33. PEPSICO INC     2020-02-11
123. PFIZER INC     2020-02-11
17. PHILIP MORRIS INTERNATIONAL     2020-02-11
18. PIONEER NAT RES CO     2020-02-11
28. PROCTER & GAMBLE CO   2019-06-05 2020-02-11
24. ROSS STORES INC     2020-02-11
9. SALESFORCE.COM INC     2020-02-11
20. SALESFORCE.COM INC     2020-02-11
20. STANLEY BLACK & DECKER,INC.     2020-02-11
29. TEXAS INSTRS INC     2020-02-11
15. TEXAS INSTRS INC     2020-02-11
7. THERMO ELECTRON CORP     2020-02-11
27. UNION PAC CORP     2020-02-11
12. UNITED TECHNOLOGIES CORP     2020-02-11
31. UNITEDHEALTH GROUP INC     2020-02-11
9. VERTEX PHARMACEUTICALS INC     2020-02-11
18. VISA INC CLASS A SHARES     2020-02-11
22. WASTE CONNECTIONS INC     2020-02-11
47. WELLS FARGO & CO NEW     2020-02-11
10. WEX INC     2020-02-11
13. YUM BRANDS INC     2020-02-11
32. ZIMMER HLDGS INC     2020-02-11
19. ALLEGION PLC     2020-02-11
10. ACCENTURE PLC     2020-02-11
12. LINDE PLC     2020-02-11
20. LINDE PLC     2020-02-11
24. CHUBB LTD     2020-02-11
23. NXP SEMICONDUCTORS NV     2020-02-11
800. JPMORGAN BETABUILDERS JAPAN ETF     2020-02-13
366. JPMORGAN BETABUILDERS JAPAN ETF   2018-07-19 2020-02-13
392. ISHARES CORE MSCI EAFE ETF   2017-06-28 2020-03-06
1046. ISHARES CORE MSCI EAFE ETF     2020-03-06
468.518 FIDELITY 500 INDEX-INST PRM   2018-01-02 2020-03-17
439.739 FIDELITY INTL INDX-INST PRM   2018-01-02 2020-03-18
86. JPMORGAN BETABUILDERS EUROPE ETF   2018-07-12 2020-03-18
196. JPMORGAN BETABUILDERS EUROPE ETF   2019-04-05 2020-03-18
641. JPMORGAN BETABUILDERS EUROPE ETF   2019-04-05 2020-03-18
129.879 SIX CIRCLES ULTR SHRT DUR   2018-10-19 2020-04-23
895. ISHARES US TREASURY BOND ETF   2020-03-06 2020-04-24
1790.353 SIX CIRCLES US UNCONSTR EQ   2018-10-19 2020-04-27
228. ISHARES TR 7-10 YR TREAS INDEX FD     2020-05-06
134. SPDR TR UNIT SER 1     2020-06-10
26. ISHARES TR 20+ TREAS INDEX FD   2019-09-24 2020-06-17
147. ISHARES CORE MSCI EAFE ETF   2017-06-29 2020-06-17
520.887 VANGUARD TOT BD MKT IDX-ADM   2016-10-20 2020-06-17
172.968 VANGUARD TTL INTL BND-ADM   2017-04-10 2020-06-17
1914.666 VANGUARD TOT BD MKT IDX-ADM     2020-08-17
1901.639 VANGUARD TTL INTL BND-ADM     2020-08-17
2248.069 VANGUARD TOT BD MKT IDX-ADM     2020-09-22
2286.328 VANGUARD TTL INTL BND-ADM     2020-09-22
. WELLS FARGO & CO NEW     2020-10-14
314.321 FIDELITY INTL INDX-INST PRM     2020-10-26
282.979 FIDELITY 500 INDEX-INST PRM     2020-10-26
496. JPMORGAN BETABUILDERS EUROPE ETF     2020-10-26
2291.699 SIX CIRCLES ULTR SHRT DUR   2018-10-19 2020-10-30
527.051 VANGUARD TOT BD MKT IDX-ADM   2019-11-22 2020-10-30
1686.252 VANGUARD TOT BD MKT IDX-ADM   2018-10-02 2020-10-30
7007.786 PIMCO FDS PAC INVT MGMT SER HIGH YLD FD INSTL CL   2020-05-06 2020-11-12
464. JPMORGAN BETABUILDERS EUROPE ETF     2020-12-15
720. JPMORGAN BETABUILDERS EUROPE ETF   2019-04-05 2020-12-15
1. JPM ACCESS MULTI-STRATEGY FUND II RIC ENDOWMENTS & FOUNDATIONS & OT   2018-01-01 2020-12-31
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(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 142   156 -14
b 114   134 -20
c 143   168 -25
d 172   203 -31
e 57   67 -10
34   36 -2
23   27 -4
28   30 -2
172   180 -8
201   208 -7
86   89 -3
29   30 -1
115   118 -3
143   148 -5
29   30 -1
29   30 -1
29   30 -1
29   30 -1
1,470   1,384 86
44     44
617   648 -31
77   81 -4
77   81 -4
77   83 -6
453   496 -43
460   527 -67
454   542 -88
520   631 -111
150   183 -33
4,102   3,362 740
3,332   398 2,934
909   1,212 -303
10,556   4,309 6,247
1,508   1,260 248
4,559   1,993 2,566
4,298   3,574 724
10,745   2,260 8,485
1,196   909 287
2,792   2,523 269
15,463   3,548 11,915
2,512   2,027 485
718   657 61
5,015   2,862 2,153
4,791   4,021 770
3,795   1,916 1,879
3,562   2,990 572
5,699   705 4,994
5,255   2,721 2,534
4,969   3,707 1,262
2,625   1,961 664
3,206   2,821 385
2,315   2,138 177
1,316   1,427 -111
1,243   1,765 -522
2,838   2,161 677
1,347   2,388 -1,041
324   537 -213
3,148   2,786 362
2,290   2,353 -63
3,332   1,703 1,629
898   786 112
3,293   1,404 1,889
2,599   1,744 855
4,827   3,686 1,141
2,793   2,509 284
5,046   1,329 3,717
6,216   2,427 3,789
1,328   816 512
2,450   1,842 608
4,195   2,324 1,871
3,034   504 2,530
2,428   3,333 -905
1,104   1,216 -112
8,310   1,503 6,807
2,139   2,011 128
2,830   2,093 737
1,458   1,384 74
21,379   4,556 16,823
3,541   2,190 1,351
5,687   3,141 2,546
1,483   1,483  
1,112   1,085 27
3,816   2,107 1,709
4,666   3,182 1,484
3,309   2,509 800
735   626 109
3,733   3,369 364
1,564   1,010 554
3,965   2,885 1,080
4,818   3,285 1,533
4,666   4,318 348
1,511   1,514 -3
2,476   2,525 -49
3,524   2,989 535
2,858   1,927 931
1,713   1,358 355
3,807   2,733 1,074
3,299   1,858 1,441
3,801   1,600 2,201
1,966   1,761 205
2,352   2,325 27
4,993   3,031 1,962
1,887   1,465 422
8,926   2,976 5,950
2,201   1,090 1,111
3,707   1,379 2,328
2,196   1,136 1,060
2,264   2,593 -329
2,132   922 1,210
1,339   1,182 157
5,100   3,613 1,487
2,583   1,248 1,335
2,130   882 1,248
2,609   1,910 699
4,348   3,654 694
3,905   2,020 1,885
3,117   2,319 798
19,464   19,102 362
8,918   8,784 134
22,692   24,039 -1,347
60,456   64,050 -3,594
41,253   44,148 -2,895
12,814   19,093 -6,279
1,394   2,132 -738
3,177   4,735 -1,558
10,577   15,487 -4,910
1,291   1,300 -9
25,218   24,952 266
18,745   17,778 967
27,630   23,830 3,800
42,743   21,259 21,484
4,174   3,733 441
8,520   8,970 -450
6,027   5,735 292
3,980   3,753 227
22,325   20,941 1,384
44,080   41,303 2,777
26,190   23,765 2,425
53,180   49,947 3,233
13     13
12,620   13,500 -880
33,400   26,585 6,815
11,316   11,983 -667
23,009   22,940 69
6,077   5,845 232
19,442   17,470 1,972
62,369   57,604 4,765
12,110   10,642 1,468
18,792   17,394 1,398
26,618   18,778 7,840
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
      9,577
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       -14
b       -20
c       -25
d       -31
e       -10
      -2
      -4
      -2
      -8
      -7
      -3
      -1
      -3
      -5
      -1
      -1
      -1
      -1
      86
      44
      -31
      -4
      -4
      -6
      -43
      -67
      -88
      -111
      -33
      740
      2,934
      -303
      6,247
      248
      2,566
      724
      8,485
      287
      269
      11,915
      485
      61
      2,153
      770
      1,879
      572
      4,994
      2,534
      1,262
      664
      385
      177
      -111
      -522
      677
      -1,041
      -213
      362
      -63
      1,629
      112
      1,889
      855
      1,141
      284
      3,717
      3,789
      512
      608
      1,871
      2,530
      -905
      -112
      6,807
      128
      737
      74
      16,823
      1,351
      2,546
       
      27
      1,709
      1,484
      800
      109
      364
      554
      1,080
      1,533
      348
      -3
      -49
      535
      931
      355
      1,074
      1,441
      2,201
      205
      27
      1,962
      422
      5,950
      1,111
      2,328
      1,060
      -329
      1,210
      157
      1,487
      1,335
      1,248
      699
      694
      1,885
      798
      362
      134
      -1,347
      -3,594
      -2,895
      -6,279
      -738
      -1,558
      -4,910
      -9
      266
      967
      3,800
      21,484
      441
      -450
      292
      227
      1,384
      2,777
      2,425
      3,233
      13
      -880
      6,815
      -667
      69
      232
      1,972
      4,765
      1,468
      1,398
      7,840
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
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 2 180,483
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 3,082
c All other domestic foundations enter 1.39% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 3,082
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 3,082
6 Credits/Payments:
a 2020 estimated tax payments and 2019 overpayment credited to 2020 6a 2,700
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 2,700
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 382
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2021 estimated taxBullet0 RefundedBullet 11 0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
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)
    bulletIN
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2020 or the taxable year beginning in 2020? See the instructions for Part XIV.
    If "Yes," complete Part XIV .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 5
    Part VII-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletNA
    14
    The books are in care ofbulletJP MORGAN CHASE BANK NA Telephone no.bullet (800) 496-2583

    Located atbullet10 S DEARBORN ST MC IL 1-0111CHICAGOIL ZIP+4bullet60603
    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
     
     
    .........bullet
    c
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?..........
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?.....................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .................
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    JP MORGAN CHASE BANK NA TRUSTEE
    2     		18,421    
    10 S DEARBORN ST MC IL 1-0111
    CHICAGO,IL60603
    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...................bullet 0
    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
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    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
    2,481,918
    b
    Average of monthly cash balances.......................
    1b
    32,611
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    2,514,529
    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
    2,514,529
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    37,718
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    2,476,811
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    123,841
    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
    123,841
    2a
    Tax on investment income for 2020 from Part VI, line 5......
    2a
    3,082
    b
    Income tax for 2020. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    3,082
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    120,759
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    120,759
    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
    120,759
    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
    113,718
    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
    113,718
    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
    113,718
    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 7 120,759
    2 Undistributed income, if any, as of the end of 2020:
    a Enter amount for 2019 only....... 82,054
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2020:
    a From 2015...... 0
    b From 2016...... 0
    c From 2017...... 0
    d From 2018...... 0
    e From 2019...... 0
    fTotal of lines 3a through e........ 0
    4Qualifying distributions for 2020 from Part
    XII, line 4: bullet$ 113,718
    a Applied to 2019, but not more than line 2a 82,054
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		0
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		0
    d Applied to 2020 distributable amount..... 31,664
    e Remaining amount distributed out of corpus 0
    5 Excess distributions carryover applied to 2020. 0 0
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 0
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		0
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2020. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2021 ..........     		89,095
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8 Excess distributions carryover from 2015 not
    applied on line 5 or line 7 (see instructions) ...     		0
    9Excess distributions carryover to 2021.
    Subtract lines 7 and 8 from line 6a ......     		0
    10 Analysis of line 9:
    a Excess from 2016.... 0
    b Excess from 2017.... 0
    c Excess from 2018.... 0
    d Excess from 2019.... 0
    e Excess from 2020.... 0
    Form 990-PF (2020)
    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
    RILEY CHILDRENS FOUNDATION
    30 SOUTH MERIDIAN STREET 200
    INDIANAPOLIS,IN46204     		NONE PC GENERAL 52,053
    INDIANAPOLIS RETIREMENT HOME
    1731 N CAPITAL
    INDIANAPOLIS,IN46204     		NONE PC GENERAL 52,053
    Total .................................bullet 3a 104,106
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3 Interest on savings and temporary cash
    investments ...........     		         
    4 Dividends and interest from securities....     14 51,407  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income.....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		    18 180,483  
    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)..   231,890  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    231,890
    (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

    TY 2020 InvestmentsCorpBondsSchedule
    Name:
    CHARLES N SMITH TRUST FOR RILEY HOSPITAL
    EIN:
    35-6213457
    Name of Bond End of Year Book Value End of Year Fair Market Value
    921937603 VANGUARD TOTAL BOND    
    92203J308 VANGUARD TTL INTL BN 50,797 51,953
    83002G108 SIX CIRCLES ULTRA SH    
    464287432 ISHARES 20+ YEAR TRE 48,889 50,000
    464287440 ISHARES 7-10 YEAR TR    
    74440Y884 PGIM HIGH YIELD-Q 90,476 104,205
    83002G702 SIX CIRCLES GLOBAL B 101,540 101,685
    83002G884 SIX CIRCLES CREDIT O 52,400 53,333
    92206C870 VANGUARD INT-TERM CO 25,107 25,548

    TY 2020 InvestmentsCorpStockSchedule
    Name:
    CHARLES N SMITH TRUST FOR RILEY HOSPITAL
    EIN:
    35-6213457
    Name of Stock End of Year Book Value End of Year Fair Market Value
    101137107 BOSTON SCIENTIFIC CO    
    110122108 BRISTOL-MYERS SQUIBB    
    172967424 CITIGROUP INC    
    254687106 WALT DISNEY CO/THE    
    369550108 GENERAL DYNAMICS COR    
    437076102 HOME DEPOT INC    
    438516106 HONEYWELL INTERNATIO    
    493267108 KEYCORP    
    532457108 ELI LILLY & CO    
    548661107 LOWE'S COS INC    
    594918104 MICROSOFT CORP    
    609207105 MONDELEZ INTERNATION    
    617446448 MORGAN STANLEY    
    666807102 NORTHROP GRUMMAN COR    
    713448108 PEPSICO INC    
    717081103 PFIZER INC    
    723787107 PIONEER NATURAL RESO    
    742718109 PROCTER & GAMBLE CO/    
    854502101 STANLEY BLACK & DECK    
    882508104 TEXAS INSTRUMENTS IN    
    907818108 UNION PACIFIC CORP    
    949746101 WELLS FARGO & CO    
    988498101 YUM] BRANDS INC    
    00724F101 ADOBE INC.    
    02079K107 ALPHABET INC-CL C    
    02079K305 ALPHABET INC-CL A    
    16119P108 CHARTER COMMUNICATIO    
    20030N101 COMCAST CORP-CLASS A    
    26875P101 EOG RESOURCES INC    
    26884L109 EQT CORP    
    30303M102 FACEBOOK INC-CLASS A    
    31620M106 FIDELITY NATIONAL IN    
    57636Q104 MASTERCARD INC - A    
    58933Y105 MERCK & CO. INC.    
    65339F101 NEXTERA ENERGY INC    
    67103H107 O'REILLY AUTOMOTIVE    
    78462F103 SPDR S&P 500 ETF TRU 236,921 441,178
    91324P102 UNITEDHEALTH GROUP I    
    92532F100 VERTEX PHARMACEUTICA    
    92826C839 VISA INC-CLASS A SHA    
    94106B101 WASTE CONNECTIONS IN    
    96208T104 WEX INC    
    G0176J109 ALLEGION PLC    
    G1151C101 ACCENTURE PLC-CL A    
    H1467J104 CHUBB LTD    
    002824100 ABBOTT LABORATORIES    
    023135106 AMAZON.COM INC    
    037833100 APPLE INC    
    060505104 BANK OF AMERICA CORP    
    084670702 BERKSHIRE HATHAWAY I    
    25278X109 DIAMONDBACK ENERGY I    
    45866F104 INTERCONTINENTAL EXC    
    46432F842 ISHARES CORE MSCI EA    
    655844108 NORFOLK SOUTHERN COR    
    67066G104 NVIDIA CORP    
    718172109 PHILIP MORRIS INTERN    
    913017109 UNITED TECHNOLOGIES    
    98956P102 ZIMMER BIOMET HOLDIN    
    025816109 AMERICAN EXPRESS CO    
    053015103 AUTOMATIC DATA PROCE    
    191216100 COCA-COLA CO/THE    
    285512109 ELECTRONIC ARTS INC    
    315911727 FIDELITY INTL INDX-I 174,000 190,782
    315911750 FIDELITY 500 INDEX-I 599,501 740,358
    778296103 ROSS STORES INC    
    11135F101 BROADCOM INC    
    46641Q688 JPM BTABLDRS DEV ASI 25,183 27,195
    46641Q696 JPMORGAN BETABUILDER 73,533 81,858
    46641Q712 JPMORGAN BETABUILDER 66,355 78,092
    46641Q720 JPMORGAN BETABUILDER 24,688 28,079
    56585A102 MARATHON PETROLEUM C    
    64110L106 NETFLIX INC    
    70450Y103 PAYPAL HOLDINGS INC    
    79466L302 SALESFORCE.COM INC    
    83002G306 SIX CIRCLES US UNCON 222,922 299,563
    83002G405 SIX CIRCLES INTL UNC 184,468 195,941
    G5494J103 LINDE PLC    
    00287Y109 ABBVIE INC    
    015351109 ALEXION PHARMACEUTIC    
    22052L104 CORTEVA INC    
    26614N102 DUPONT DE NEMOURS IN    
    337738108 FISERV INC    
    580135101 MCDONALD'S CORP    
    747525103 QUALCOMM INC    
    N6596X109 NXP SEMICONDUCTORS N    
    46434G103 ISHARES CORE MSCI EM 51,950 58,938

    TY 2020 InvestmentsOtherSchedule2
    Name:
    CHARLES N SMITH TRUST FOR RILEY HOSPITAL
    EIN:
    35-6213457
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    48219B911 JPM ACCESS MULTI-STR AT COST 988 1,000
    HFGAPBWF1 JPM ACCESS MULTI-STR AT COST 228,925 248,495

    TY 2020 OtherDecreasesSchedule
    Name:
    CHARLES N SMITH TRUST FOR RILEY HOSPITAL
    EIN:
    35-6213457
    Description Amount
    2020 TRANSACTIONS POSTED IN 2021 2,366
    ROUNDING 11


    TY 2020 OtherIncreasesSchedule
    Name:
    CHARLES N SMITH TRUST FOR RILEY HOSPITAL
    EIN:
    35-6213457
    Description Amount
    RETURN OF CAPITAL ADJUSTMENT 27
    2019 TRANSACTIONS POSTED IN 2020 2,234


    TY 2020 TaxesSchedule
    Name:
    CHARLES N SMITH TRUST FOR RILEY HOSPITAL
    EIN:
    35-6213457
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 1 1   0
    FEDERAL ESTIMATES - INCOME 1,045 0   0
    FOREIGN TAXES ON QUALIFIED FOR 1,215 1,215   0
    FOREIGN TAXES ON NONQUALIFIED 122 122   0