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
THE ROOTS AND WINGS FOUNDATION INC
 
Number and street (or P.O. box number if mail is not delivered to street address)7107 GREENWOOD AVE N SUITE A
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SEATTLE, WA98103
A Employer identification number

32-0581904
B Telephone number (see instructions)

(608) 273-3100
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$119,566,113
J 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) 126,085
2 Check bullet.............
3 Interest on savings and temporary cash investments 2,521 2,521  
4 Dividends and interest from securities... 1,573,825 1,573,825  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 -2,811,273
b Gross sales price for all assets on line 6a 18,795,974
7 Capital gain net income (from Part IV, line 2)...  
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ -1,108,842 1,576,346  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 114,000 5,700   108,300
14 Other employee salaries and wages...... 81,017     81,017
15 Pension plans, employee benefits....... 16,198     16,198
16a Legal fees (attach schedule)......... 18,750 18,750    
b Accounting fees (attach schedule).......        
c Other professional fees (attach schedule).... 811,518 811,518    
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... 32,812 32,812    
19 Depreciation (attach schedule) and depletion...      
20 Occupancy.............. 59,145     59,145
21 Travel, conferences, and meetings....... 1,555     1,555
22 Printing and publications..........        
23 Other expenses (attach schedule)....... 67,662     67,662
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 1,202,657 868,780   333,877
25 Contributions, gifts, grants paid....... 15,283,700 15,283,700
26 Total expenses and disbursements. Add lines 24 and 25 16,486,357 868,780   15,617,577
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -17,595,199
b Net investment income (if negative, enter -0-) 707,566
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2020)
Form 990-PF (2020)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing.............      
2 Savings and temporary cash investments......... 16,280,566 15,587,048 15,587,048
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
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 bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)....... 97,507,285 Click to see attachment80,651,982 103,979,065
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 113,787,851 96,239,030 119,566,113
Liabilities 17 Accounts payable and accrued expenses..........   17,469
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).........   17,469
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........... 113,787,851 96,221,561
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........    
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)..... 113,787,851 96,221,561
30 Total liabilities and net assets/fund balances (see instructions). 113,787,851 96,239,030
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
113,787,851
2
Enter amount from Part I, line 27a .....................
2
-17,595,199
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
28,909
4
Add lines 1, 2, and 3 ..........................
4
96,221,561
5
Decreases not included in line 2 (itemize) bullet
5
 
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
96,221,561
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 PUBLICLY TRADED SECURITIES P 2019-01-01 2020-12-31
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 18,795,974   21,607,247 -2,811,273
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       -2,811,273
b
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
Bracket 2 -2,811,273
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 9,835
c All other domestic foundations enter 1.39% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2  
3 Add lines 1 and 2........................... 3 9,835
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 9,835
6 Credits/Payments:
a 2020 estimated tax payments and 2019 overpayment credited to 2020 6a  
b Exempt foreign organizations—tax withheld at source...... 6b  
c Tax paid with application for extension of time to file (Form 8868)... 6c 3,000
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 3,000
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. Click to see attachment 8 52
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 6,887
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 taxBullet   RefundedBullet 11  
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (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)
    bulletWI, WA
    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 addressbulletWWW.ROOTSWINGS.ORG
    14
    The books are in care ofbulletJOHN F SUBY & ASSOCIATES SC Telephone no.bullet (608) 273-3100

    Located atbullet2901 W BELTLINE HIGHWAY SUITE 201MADISONWI ZIP+4bullet53713
    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
     
     
    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
    JUDITH FAULKNER PRESIDENT
    1.00
    0 0 0
    2901 W BELTLINE HWY STE 201
    MADISON,WI53713
    GORDON FAULKNER SECRETARY
    1.00
    0 0 0
    2901 W BELTLINE HWY STE 201
    MADISON,WI53713
    SHANA DALL'OSTO EXECUTIVE DI
    32.00
    114,000 0 0
    2901 W BELTLINE HWY STE 201
    MADISON,WI53713
    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
    NICOLE SMITH PROGRAM OFFI
    24.00
    72,888    
    7107 GREENWOOD AVE N STE A
    SEATTLE,WA98103
    Total number of other employees paid over $50,000...................bullet  
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 7
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    PROVIDENT TRUST COMPANY INVESTMENT MGMT 546,384
    N16 W23217 STONE RIDGE DR
    STE 310
    WAUKESHA,WI53188
    JOHN F SUBY & ASSOCIATES SC ADVISORY 265,134
    2901 WEST BELTLINE HWY
    SUITE 201
    MADISON,WI53713
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1 N/A  
    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
    88,932,151
    b
    Average of monthly cash balances.......................
    1b
    23,920,465
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    112,852,616
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
     
    3
    Subtract line 2 from line 1d.........................
    3
    112,852,616
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    1,692,789
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    111,159,827
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    5,557,991
    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
    5,557,991
    2a
    Tax on investment income for 2020 from Part VI, line 5......
    2a
    9,835
    b
    Income tax for 2020. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    9,835
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    5,548,156
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    5,548,156
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
    5,548,156
    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
    15,617,577
    b
    Program-related investments—total from Part IX-B..................
    1b
     
    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
    15,617,577
    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
     
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    15,617,577
    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 5,548,156
    2 Undistributed income, if any, as of the end of 2020:
    a Enter amount for 2019 only....... 452,965
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2020:
    a From 2015......  
    b From 2016......  
    c From 2017......  
    d From 2018......  
    e From 2019......  
    fTotal of lines 3a through e........  
    4Qualifying distributions for 2020 from Part
    XII, line 4: bullet$ 15,617,577
    a Applied to 2019, but not more than line 2a 452,965
    b Applied to undistributed income of prior years
    (Election required—see instructions).....
     
    c Treated as distributions out of corpus (Election
    required—see instructions)........
     
    d Applied to 2020 distributable amount..... 5,548,156
    e Remaining amount distributed out of corpus 9,616,456
    5 Excess distributions carryover applied to 2020.    
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 9,616,456
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........
     
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......
     
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........
     
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............
     
    f Undistributed income for 2020. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2021 ..........
    0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......
     
    8 Excess distributions carryover from 2015 not
    applied on line 5 or line 7 (see instructions) ...
     
    9Excess distributions carryover to 2021.
    Subtract lines 7 and 8 from line 6a ......
    9,616,456
    10 Analysis of line 9:
    a Excess from 2016....  
    b Excess from 2017....  
    c Excess from 2018....  
    d Excess from 2019....  
    e Excess from 2020.... 9,616,456
    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 e-mail address of the person to whom applications should be addressed:
    SHANA DALL'OSTO
    7107 GREENWOOD AVE N SUITE A
    SEATTLE,WA98103
    (608) 273-3100
    bThe form in which applications should be submitted and information and materials they should include:
    N/A
    cAny submission deadlines:
    N/A
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    N/A
    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
    ACCESS COMMUNITY HEALTH NETWORK
    600 W FULTON ST
    SUITE 200
    CHICAGO,IL60661
    NONE   ADDRESSING SOCIAL DETERMINANTS 200,300
    ADVOCACY AND BENEFIT COUNSELING
    32 N BASSETT ST
    MADISON,WI53703
    NONE   GENERAL OPERATIONS 30,000
    ALAMEDA HEALTH SYSTEM
    350 FRANK H OGAWA
    PLAZA 900
    OAKLAND,CA94612
    NONE   PROGRAMS FOR HEALTH EQUITY 150,000
    AMERICAN ACADEMY OF PEDIATRICS
    345 PARK BLVD
    ITASCA,IL60143
    NONE   CATCH RESIDENCY GRANTS 20,000
    AMERICAN CIVIL LIBERTIES UNION
    125 BROAD ST
    18TH FLOOR
    NEW YORK,NY10004
    NONE   GENERAL OPERATIONS 100,200
    ARC COMMUNITY SERVICES
    2001 W BELTLINE HWY
    STE 102
    MADISON,WI53713
    NONE   UNRESTRICTED 50,000
    ASSOCIATION OF FREE & CHARITABLE CL
    1405 CAPITOL DR
    PEWAUKEE,WI53072
    NONE   NATIONAL & WISCONSIN BRANCH 750
    BADGER CHILDHOOD CANCER NETWORK
    2215 ATWOOD AVE
    MADISON,WI53704
    NONE   GENERAL OPERATIONS 10,000
    BOSTON MEDICAL CENTER
    ONE BOSTON MEDICAL CTR PL
    BOSTON,MA02118
    NONE   PROJECT REACH 200,000
    BOYS AND GIRLS CLUB OF DANE CTY
    1818 W BELTLINE HWY
    MADISON,WI53713
    NONE   GENERAL OPERATIONS 20,000
    BRADY CENTER TO PREVENT GUN VIOLENC
    840 FIRST STREET NE
    SUITE 400
    WASHINGTON,DC20002
    NONE   GENERAL OPERATIONS 50,000
    BRIARPATCH YOUTH SERVICES
    2720 RIMROCK RD
    MADISON,WI53713
    NONE   GENERAL OPERATIONS 40,000
    CAMBRIDGE HEALTH FOUNDATION
    230 HIGHLAND AVE
    1ST FLOOR
    SOMERVILLE,MA02143
    NONE SOUNK COMMUNITY HEALTH IMPROVEMENTS 250,000
    CENTRAL CITY CONCERN
    232 NW 6TH AVE
    PORTLAND,OR97209
    NONE   COVID 19 MASS TESTING EVENTS 20,000
    REACH OUT AND READ INC
    89 SOUTH STREET
    BOSTON,MA02111
    NONE   GENERAL OPERATIONS 40,000
    CHIPPEWA VALLEY FREE CLINIC
    836 RICHARD DR
    EAU CLAIRE,WI54701
    NONE   COMPREHENSIVE HEALTH CARE 15,000
    PUBLIC HEALTH MADISON AND DANA CTY
    210 MARTIN LUTHER KING JR
    ROOM 508
    MADISON,WI53703
    NONE GOVT NURSE-FAMILY PARTNERSHIP PROGRAM 30,000
    COMBAT BLINDNESS INTERNATIONAL
    PO BOX 5332
    MADISON,WI53705
    NONE   GENERAL OPERATIONS 10,000
    COMMUNITY JUSTICE INC
    214 N HAMILTON ST
    STE 101
    MADISON,WI53703
    NONE   GENERAL OPERATIONS 30,000
    COMMUNITY SHARES OF WISCONSIN
    612 W MAIN STREET
    STE 200
    MADISON,WI53703
    NONE   GENERAL OPERATIONS 20,000
    CONTRA COSTA REGIONAL HEALTH
    50 DOUGLAS DR
    STE 310-A
    MARTINEZ,CA94553
    NONE   COMMUNITY CRISIS RESPONSE 315,000
    CUMBERLAND MEMORIAL HOSPITAL
    1110 7TH AVE
    CUMBERLAND,WI54829
    NONE   MENTAL HEALTH AWARENESS 40,000
    DANE COUNTY LIBRARY SERVICE
    1874 S STOUGHTON RD
    MADISON,WI53716
    NONE GOVT PLAY LITERACY PROJECT 5,000
    DENVER HEALTH FOUNDATION
    777 BANNOCK ST
    MC0111
    DENVER,CO80204
    NONE   DENVER HEALTH ANCHOR FRAMEWORK 275,000
    DOCTORS WITHOUT BORDERS
    PO BOX 5030
    HAGERSTOWN,MD21741
    NONE   GENERAL OPERATIONS 250,000
    DOMESTIC ABUSE INTERVENTION SERVICE
    2102 FORDEM AVE
    MADISON,WI53704
    NONE   GENERAL OPERATIONS 45,000
    EAST BOSTON NEIGHBORHOOD HEALTH
    10 GOVE ST
    EAST BOSTON,MA02128
    NONE   HEALTH CARE FOR THE UNINSURED 150,000
    EDGERTON HOSPITAL CAPITAL FDN
    11101 N SHERMAN RD
    EDGERTON,WI53534
    NONE SOUNK IMPROVE DIAGNOSTIC CAPABILITIES 55,000
    EDUCATION FUND TO STOP GUN VIOLENCE
    805 15TH STREET NW
    SUITE 410
    WASHINGTON,DC20005
    NONE   GENERAL OPERATIONS 30,000
    END DOMESTIC ABUSE WISCONSIN
    1400 E WASHINGTON AVE
    SUITE 227
    MADISON,WI53703
    NONE   GENERAL OPERATIONS 20,000
    ESKENAZI HEALTH FOUNDATION
    725 ESKENAZI AVE
    FL 5
    INDIANAPOLIS,IN46202
    NONE   PROGRAMMING AND CARE 175,000
    FORKS COMMUNITY HOSPITAL FDN
    530 BOGACHIEL WAY
    FORKS,WA98331
    NONE   NURSERY CAPITAL EQUIPMENT 80,000
    FDN FOR MADISON PUBLIC SCHOOLS
    101 NOB HILL RD
    STE 300
    MADISON,WI53713
    NONE   GENERAL OPERATIONS 80,000
    GOLDEN VALLEY HEALTH CENTERS
    737 W CHILDS AVE
    MERCED,CA95341
    NONE SO FOUNDATIONAL OPERATIONAL SUPPORT 50,000
    GRACE CLINIC
    800 W CANAL DR
    KENNEWICK,WA99336
    NONE   MENTAL AND BEHAVIORAL HEALTHCARE 25,000
    HENRY W GRADY FOUNDATION
    192 PEACHTREE ST
    SUITE 820
    ATLANTA,GA30303
    NONE   INTEGRATED BEHAVIORAL HEALTH SERVICE 450,000
    GRANT REGIONAL HEALTH CENTER
    507 S MONROE ST
    LANCASTER,WI53813
    NONE   SONOSITE ULTRASOUND SYSTEM 35,000
    HARRIS COUNTY HOSPITAL DISTRICT
    2525 HOLLY HALL
    STE 292
    HOUSTON,TX77054
    NONE   COVID-19 RELATED GREATEST NEEDS 350,000
    HENNEPIN HEALTHCARE FOUNDATION
    701 PARK AVE
    LSB-3
    MINNEAPOLIS,MN55415
    NONE   REDLEAF CENTER FOR FAMILY HEALING 350,000
    HURLEY FOUNDATION
    1 HURLEY PLAZA
    FLINT,MI48503
    NONE   FOOD FARMACY, PED PVT ROOMS 200,000
    JOURNEY MENTAL HEALTH CENTER
    25 KESSEL CT
    STE 105
    MADISON,WI53711
    NONE   GENERAL OPERATIONS 60,000
    JPS FOUNDATION
    1223 S MAIN ST
    FORT WORTH,TX76104
    NONE SOUNK ACCESS, CARE AND OUTCOMES 325,000
    KIDS FORWARD
    555 W WASHINGTON AVE
    STE 200
    MADISON,WI53703
    NONE   GENERAL OPERATIONS 40,000
    KLICKITAT VALLEY HEALTH MEMORIAL
    310 S ROOSEVELT ST
    GOLDENVALE,WA98620
    NONE   EMERGENCY DEPARTMENT SAFE ROOM 20,000
    LA CLINICA DEL VALLE HEALTH CENTER
    3617 S PACIFIC HWY
    MEDFORD,OR97501
    NONE   MOBILE HEALTH CENTER OUTREACH 20,000
    LAHAI HEALTH
    19820 SCRIBER LAKE RD
    STE 2
    LYNWOOD,WA98036
    NONE   2021 PHINNY NEIGHBORHOOD ASSOC. 20,000
    LAKE AREA FREE CLINIC
    856 B ARMOUR RD
    STE B
    OCONOMOWOC,WI53066
    NONE   DENTAL SERVICE AND BEHAVIORAL HEALTH 50,000
    LAKESHORE COMMUNITY HEALTH CARE
    PO BOX 959
    SHEBOYGAN,WI53082
    NONE   EMBEDDING DENTAL HYGIENIST 35,000
    COMMUNITY HEALTH CENTER OF LANE CTY
    2073 OLYMPIC ST
    SPRINGFIELD,OR974773413
    NONE GOVT SCHOOL-BASED HEALTH CENTER 35,000
    LITERACY NETWORK
    701 DANE ST
    MADISON,WI53713
    NONE   GENERAL OPERATIONS 15,000
    LOWER UMPQUA HOSPITAL FDN
    600 RANCH ROAD
    REEDSPORT,OR97467
    NONE   COUNSELING AND TOOLS FOR K-12 30,000
    MADISON PUBLIC LIBRARY FOUNDATION
    201 W MIFFLIN ST
    MADISON,WI53703
    NONE   DREAM BUS BOOKMOBILE 10,000
    MADISON READING PROJECT
    1337 GREENWAY CROSS
    STE 186
    MADISON,WI53713
    NONE   GENERAL OPERATIONS 15,000
    MADISON-AREA URBAN MINISTRY
    2115 S PARK ST
    MADISON,WI53713
    NONE   PARENTING INSIDE-OUT AND UNRESTRICTE 30,000
    METHODIST HOSPITALS FOUNDATION
    600 GRANT STREET
    GARY,IN46402
    NONE SOUNK MATERNAL-INFANT CARE PROGRAM 200,000
    MIDDLETON OUTREACH MINISTRY
    3502 PARAMETER ST
    MIDDLETON,WI53562
    NONE   GENERAL OPERATIONS 25,000
    MILE BLUFF MEDICAL CENTER
    1050 DIVISION ST
    MAUSTON,WI53948
    NONE SOUNK PATIENT FINANCIAL ADVOCATES 100,000
    MORE SMILES WISCONSIN
    630 E WASHINGTON AVE
    MADISON,WI53703
    NONE   GENERAL OPERATIONS 15,000
    NEW COMMUNITY CLINIC
    622 BODART ST
    GREEN BAY,WI54301
    NONE   PROMOTION OF MENTAL HEALTH SERVICES 10,000
    NEIGHBORCARE HEALTH
    1200 12TH AVE S
    STE 901
    SEATTLE,WA98144
    NONE   STRONG MINDS, STRONG COMMUNITIES 65,000
    NEW VENTURE FUND
    1201 CONNECTICUT AVE NW
    STE 300
    WASHINGTON,DC20036
    NONE   FUND FOR A SAFER FUTURE 50,000
    NYC HEALTH HOSPITALS
    125 WORTH ST
    5TH FLOOR
    NEW YORK,NY10013
    NONE   COVID-19 RESEARCH AND TESTING 375,000
    ONE BROOKLYN HEALTH SYSTEMS
    1 BROOKDALE PLZ
    BROOKLYN,NY11212
    NONE   OBHS FARM SHARE AND FAMILY SUPPORT 275,000
    ONE CITY SCHOOLS
    2012 FISHER ST
    MADISON,WI53713
    NONE   GENERAL OPERATIONS 20,000
    OPEN ARMS FREE CLINIC
    PO BOX 678
    ELKHORN,WI53121
    NONE   EXPAND BEHAVIORAL HEALTH SERVICES 30,000
    NATIONAL NETWORK OF ABORTION FUNDS
    PO BOX 473
    EAU CLAIRE,WI54702
    NONE   GENERAL OPERATIONS 10,000
    OSCEOLA COMMUNITY HEALTH
    PO BOX 218
    OSCEOLA,WI54020
    NONE SOUNK EARLY CHILDHOOD PROGRAMMING 30,000
    OUTSIDE IN
    1132 SW 13TH AVE
    PORTLAND,OR97205
    NONE   ROSE PROGRAM 15,000
    PARKLAND FOUNDATION
    1341 W MOCKINGBIRD LN
    NUMBER 1100E
    DALLAS,TX75247
    NONE   HOMEWARD BOUND-DALLAS DEFLECTS CTR 350,000
    PENINSULA COMMUNITY HEALTH SERVICES
    PO BOX 960
    BREMERTON,WA98337
    NONE   MOBILE PROGRAM AND OUTREACH 30,000
    PHYSICIANS FOR HUMAN RIGHTS
    256 W 38TH ST
    9TH FLOOR
    NEW YORK,NY10018
    NONE   GENERAL OPERATIONS 30,000
    PLANNED PARENTHOOD OF WISCONSIN
    302 NORTH JACKSON ST
    MILWAUKEE,WI53202
    NONE   GENERAL OPERATIONS 750,450
    RAPE CRISIS CENTER
    2801 COHO ST
    STE 301
    MADISON,WI53713
    NONE   GENERAL OPERATIONS 20,000
    DANE COUNTY PARENTS COUNCIL
    2096 RED ARROW TRAIL
    FITCHBURG,WI53711
    NONE   GENERAL OPERATIONS 100,000
    RED CABOOSE CHILD CARE CENTER
    654 WILLIAMSON ST
    MADISON,WI53703
    NONE   SCHOLARSHIP FUND 16,000
    REEDSBURG AREA MEDICAL CENTER
    2030 RIDGEVIEW DR
    REEDSBURG,WI53959
    NONE SOUNK PATIENT CARE AND PROGRAM SUPPORT 50,000
    RISE WISCONSIN
    1334 DEWEY CT
    MADISON,WI53703
    NONE   GENERAL OPERATIONS 80,000
    SALEM FREE CLINICS
    1300 BROADWAY ST NE
    SALEM,OR97301
    NONE   MENTAL HEALTH CARE AND MANAGEMENT 25,000
    HEALTHCARE FOR THE HOMELESS NETWORK
    401 5TH AVE
    STE 1000
    SEATTLE,WA98104
    NONE GOVT ESSENTIAL NEEDS FOR THE HOMELESS 25,000
    SECOND HARVEST FOODBANK
    2802 DAIRY DR
    MADISON,WI53718
    NONE   GENERAL OPERATIONS 50,000
    SHARE OUR STRENGTH
    PO BOX 75475
    BALTIMORE,MD21275
    NONE   NO KID HUNGRY CAMPAIGN 40,000
    SIMPSON STREET FREE PRESS
    PO BOX 6307
    MONONA,WI53713
    NONE   GENERAL OPERATIONS 6,000
    SIXTEENTH ST COMMUNITY HEALTH CTR
    1337 S CESAR E CHAVEZ DR
    MILWAUKEE,WI53204
    NONE   BEHAVIORAL HEALTH AND COVID-19 135,000
    SKY LAKES MEDICAL CENTER
    2865 DAGGETT AVE
    KLAMATH FALLS,OR97601
    NONE SOUNK CASE MANAGEMENT 100,000
    SOUTH GEORGIA MEDICAL CENTER
    PO BOX 1727
    VALDOSTA,GA31603
    NONE   WOMEN AND INFANT SERVICES 175,000
    ST CROIX REGIONAL MEDICAL CENTER
    235 E STATE STREET
    ST CROIX FALLS,WI54024
    NONE   PATHWAYS HUB AND PEDIATRICS 85,000
    ST VINCENT DE PAUL
    PO BOX 259686
    MADISON,WI53725
    NONE   GENERAL OPERATIONS 25,000
    SUMMIT PACIFIC MEDICAL FOUNDATION
    600 E MAIN STREET
    ELMA,WA98541
    NONE   SUMMIT FIGHTS HUNGER CAMPAIGN 25,000
    TENANT RESOURCE CENTER
    1202 WILLIAMSON ST
    MADISON,WI53703
    NONE   EVICTION PREVENTION 15,000
    THE BROOKLYN HOSPITAL FOUNDATION
    121 DEKALB AVE
    BROOKLYN,NY11201
    NONE SOUNK EMERGENCY PREPAREDNESS INITIATIVE 300,000
    THE COOPER FOUNDATION
    3 COOPER PLAZA
    SUITE 500
    CAMDEN,NJ08103
    NONE   COVID-19 ASSISTANCE 250,000
    THE INSTITUTE FOR FAMILY HEALTH
    2006 MADISON AVE
    NEW YORK,NY10038
    NONE   ESSENTIAL HEALTH SERVICES 150,000
    NORTHLAKES COMMUNITY CLINIC
    7665 US HIGHWAY 2
    IRON RIVER,WI54847
    NONE   FARM TO PATIENT PROGRAM 75,000
    THE METROHEALTH FOUNDATION
    2500 METROHEALTH DR TOWER
    135-A
    CLEVELAND,OH44109
    NONE   METROHEALTH TRANSFORMATION CAMPAIGN 4,000,000
    THE OLYMPIA FREE CLINIC
    PO BOX 6310
    OLYMPIA,WA98507
    NONE   ONGOING PROGRAM OPERATIONS 10,000
    THE PLAYING FIELD INC
    3910 MINERAL POINT RD
    MADISON,WI53705
    NONE   GENERAL OPERATIONS 30,000
    THE ROAD HOME DANE COUNTY
    890 W WINGRA DR
    MADISON,WI53715
    NONE   GENERAL OPERATIONS 30,000
    US FUNDS FOR UNICEF
    125 MAIDEN LN
    NEW YORK,NY10038
    NONE   GENERAL OPERATIONS 100,000
    UMC FOUNDATION
    1800 W CHARLESTON BLVD
    STE 508
    LAS VEGAS,NV89102
    NONE   PEDIATRIC CRITICAL CARE TRANSPORT 200,000
    UNITED WAY OF DANE COUNTY
    PO BOX 7548
    MADISON,WI53707
    NONE   MISC. PROGRAM SUPPORT 250,000
    UNITY CARE NW
    1616 CORNWALL AVE
    STE 205
    BELLINGHAM,WA98225
    NONE   VEGGIE RX 20,000
    UNIVERSITY OF MISSISSIPPI FDN
    406 UNIVERSITY AVE
    OXFORD,MS38655
    NONE   CHILDREN'S WITH MS CAPITAL CAMPAIGN 300,000
    UNIVERSITY OF WISCONSIN FOUNDATION
    US BANK LOCKBOX 78807
    MILWAUKEE,WI53278
    NONE   GREATEST NEEDS FND, ODYSSEY, & WAISM 75,000
    VALLEY MEDICAL CENTER FOUNDATION
    2400 CLOVE DR
    SAN JOSE,CA95128
    NONE   HEALING FOR ENTERPRISE HEALTHCARE 300,000
    VALLEYWISE HEALTH FOUNDATION
    2901 E CAMELBACK RD
    STE 202
    PHOENIX,AZ85016
    NONE   REFUGEE CLINIC 225,000
    VERA COURT NEIGHBORHOOD CENTER
    614 VERA CT
    MADISON,WI53704
    NONE   GENERAL OPERATIONS 20,000
    VOLUNTEERS IN MEDICINE CLINIC
    2260 MARCOLA RD
    SPRINGFIELD,OR97477
    NONE   PRIMARY AND BEHAVIORAL HEALTHCARE 35,000
    VOLUNTEERS IN MEDICINE CLINIC CASC
    2300 NE NEFF RD
    BEND,OR97701
    NONE   NURSING SUPPORT AND COORDINATION 35,000
    W A V E EDUCATIONAL FUND
    PO BOX 170393
    MILWAUKEE,WI53223
    NONE   UNRESTRICTED 10,000
    WACO FAMILY PRACTICE FOUNDATION
    1600 PROVIDENCE DR
    WACO,TX76707
    NONE SOUNK BUILDING FAMILY MEDICINE CAMPAIGN 100,000
    WESTERN WISCONSIN HEALTH
    1100 BERGSLIEN ST
    BALDWIN,WI54002
    NONE   SUBSTANCE USE DISORDER CAMPAIGN 35,000
    WI ALLIANCE FOR INFANT HEALTH
    133 S BUTLER ST
    STE 340
    MADISON,WI53703
    NONE   GENERAL OPERATIONS 15,000
    WOMEN'S MEDICAL FUND
    PO BOX 248
    MADISON,WI53701
    NONE   GENERAL OPERATIONS 75,000
    YAKIMA FAMILY FARM WORKERS
    PO BOX 190
    TOPPENISH,WA98948
    NONE   CHILDREN'S VILLAGE 175,000
    YMCA MADISON
    101 E MIFFLIN ST
    STE 100
    MADISON,WI53703
    NONE   GENERAL OPERATIONS 45,000
    ACCESS COMMUNITY HEALTH CENTERS
    2901 WEST BELTLINE HWY
    SUITE 120
    MADISON,WI53713
    NONE   GENERAL OPERATIONS 100,000
    Total .................................bullet 3a 15,283,700
    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 ...........
        14 2,521  
    4 Dividends and interest from securities....     14 1,573,825  
    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 -2,811,273  
    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)..   -1,234,927  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    -1,234,927
    (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
    Schedule B
    (Form 990, 990-EZ,
    or 990-PF)
    Department of the Treasury
    Internal Revenue Service
    Schedule of Contributors

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

    32-0581904
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ






    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......... Arrow Bullet $  
    Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
    or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2
    Name of organization
    THE ROOTS AND WINGS FOUNDATION INC
     
    Employer identification number
    32-0581904
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    1
    JUDITH R FAULKNER 2018 NONQUALIFIED
    2901 W BELTLINE HWY STE 201
     
    MADISON, WI53713

    $ 126,085


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
     
     
     
     

    $  


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
     
     
     
     

    $  


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
     
     
     
     

    $  


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
     
     
     
     

    $  


    (Complete Part II for noncash contributions.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
     
     
     
     

    $  


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

    32-0581904
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    (a)
    No. from Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (See instructions)
    (d)
    Date received
     
    $    
    (a)
    No. from Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (See instructions)
    (d)
    Date received
     
    $    
    (a)
    No. from Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (See instructions)
    (d)
    Date received
     
    $    
    (a)
    No. from Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (See instructions)
    (d)
    Date received
     
    $    
    (a)
    No. from Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (See instructions)
    (d)
    Date received
     
    $    
    (a)
    No. from Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (See instructions)
    (d)
    Date received
     
    $    
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Page 4
    Name of organization
    THE ROOTS AND WINGS FOUNDATION INC
     
    Employer identification number

    32-0581904
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No. from Part I
    (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I
    (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I
    (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I
    (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Additional Data


    Software ID:  
    Software Version:  

    TY 2020 InvestmentsCorpStockSchedule
    Name:
    THE ROOTS AND WINGS FOUNDATION INC
    EIN:
    32-0581904
    Name of Stock End of Year Book Value End of Year Fair Market Value
      80,651,982 103,979,065

    TY 2020 LegalFeesSchedule
    Name:
    THE ROOTS AND WINGS FOUNDATION INC
    EIN:
    32-0581904
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
      18,750 18,750    


    TY 2020 OtherExpensesSchedule
    Name:
    THE ROOTS AND WINGS FOUNDATION INC
    EIN:
    32-0581904
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    EXPENSES        
    COMPUTER EXPENSE 14,923     14,923
    DUES AND SUBSCIPTIONS 6,778     6,778
    GRANT DATABASE SUBSCRIPTION 12,662     12,662
    INSURANCE 8,478     8,478
    OFFICE EXPENSES 8,448     8,448
    OTHER CONSULTING 14,008     14,008
    TRAINING & CONFERENCES 2,365     2,365


    TY 2020 OtherIncreasesSchedule
    Name:
    THE ROOTS AND WINGS FOUNDATION INC
    EIN:
    32-0581904
    Description Amount
    TIMING DIFFERENCE 28,909


    TY 2020 OtherProfessionalFeesSchedule
    Name:
    THE ROOTS AND WINGS FOUNDATION INC
    EIN:
    32-0581904
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ADVISORY FEES 265,134 265,134    
    INVESTMENT MANAGEMENT FEES 546,384 546,384    


    TY 2020 TaxesSchedule
    Name:
    THE ROOTS AND WINGS FOUNDATION INC
    EIN:
    32-0581904
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    EXCISE TAXES 2,472 2,472    
    FOREIGN TAXES 30,340 30,340