Form990-PF
Click to see attachment

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0052
2020
Open to Public Inspection
For calendar year 2020, or tax year beginning 01-01-2020 , and ending 12-31-2020
Name of foundation
Carlsen Muir Family Foundation
 
Number and street (or P.O. box number if mail is not delivered to street address)107 Jumper Court
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Folsom, CA95630
A Employer identification number

82-3157713
B Telephone number (see instructions)

(916) 351-5596
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$16,221,946J 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 113 113 113
4 Dividends and interest from securities...      
5a Gross rents............ 1,401,252 1,401,252 1,401,252
b Net rental income or (loss) 771,940
6a Net gain or (loss) from sale of assets not on line 10  
b Gross sales price for all assets on line 6a  
7 Capital gain net income (from Part IV, line 2)...  
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 1,401,365 1,401,365 1,401,365
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 2,500      
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 2,500 2,500 2,500  
c Other professional fees (attach schedule)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 5,132      
19 Depreciation (attach schedule) and depletion... Click to see attachment 189,786 189,786 186,909
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see list of attachments 439,873 439,873 9,451  
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 639,791 632,159 198,860 0
25 Contributions, gifts, grants paid....... 800,760 800,760
26 Total expenses and disbursements. Add lines 24 and 25 1,440,551 632,159 198,860 800,760
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -39,186
b Net investment income (if negative, enter -0-) 769,206
c Adjusted net income (if negative, enter -0-)... 1,202,505
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............. 47,954 152,191 152,191
2 Savings and temporary cash investments......... 466,911 565,785 565,785
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).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet8,622,241
Less: accumulated depreciation (attach schedule) bullet576,303 8,232,847 Click to see attachment8,045,938 15,340,000
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
14 Land, buildings, and equipment: basis bullet43,162
Less: accumulated depreciation (attach schedule) bullet3,027 43,012 Click to see attachment40,135 40,135
15 Other assets (describe bullet) Click to see attachment176,346 Click to see attachment123,835 Click to see attachment123,835
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 8,967,070 8,927,884 16,221,946
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........... 8,967,070  
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)..... 8,967,070 8,927,884
30 Total liabilities and net assets/fund balances (see instructions). 8,967,070 8,927,884
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
8,967,070
2
Enter amount from Part I, line 27a .....................
2
-39,186
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
8,927,884
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
8,927,884
Form 990-PF (2020)
Form 990-PF (2020)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1a
b
c
d
e
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a
b
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2  
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
SECTION 4940(e) REPEALED ON DECEMBER 20, 2019 - DO NOT COMPLETE
1 Reserved
(a)
Reserved 		(b)
Reserved 		(c)
Reserved 		(d)
Reserved
2
Reserved...........................
2
3
Reserved...........................
3
4
Reserved...........................
4
5
Reserved...........................
5
6
Reserved...........................
6
7
Reserved...........................
7
8
Reserved,..........................
8
Form 990-PF (2020)
Form 990-PF (2020)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b Reserved................................ 1 10,692
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 10,692
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 10,692
6 Credits/Payments:
a 2020 estimated tax payments and 2019 overpayment credited to 2020 6a 12,000
b Exempt foreign organizations—tax withheld at source...... 6b  
c Tax paid with application for extension of time to file (Form 8868)... 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 12,000
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 1,308
11 Enter the amount of line 10 to be: Credited to 2021 estimated taxBullet1,308 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
     
    No
    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)
    bullet
    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 addressbulletN/A
    14
    The books are in care ofbulletJuno Commercial Real Estate Telephone no.bullet (916) 359-2814

    Located atbullet401 Watt Avenue Suite 200SacramentoCA ZIP+4bullet95864
    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
    James R Carlsen President
    1.00     		500    
    107 Jumper Ct
    Folsom,CA95630
    Beth Carlsen CFO
    1.00     		500    
    107 Jumper Ct
    Folsom,CA95630
    David Leland Carlsen Director
    1.00     		500    
    107 Jumper Ct
    Folsom,CA95630
    Kathleen Marie Carlsen Director
    1.00     		500    
    107 Jumper Ct
    Folsom,CA95630
    Mac Carlsen Director
    1.00     		500    
    107 Jumper Ct
    Folsom,CA95630
    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  
    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.............bullet  
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 8
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    0
    b
    Average of monthly cash balances.......................
    1b
    616,420
    c
    Fair market value of all other assets (see instructions)................
    1c
    15,559,358
    d
    Total (add lines 1a, b, and c).........................
    1d
    16,175,778
    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
     
    3
    Subtract line 2 from line 1d.........................
    3
    16,175,778
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    242,637
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    15,933,141
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    796,657
    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
    796,657
    2a
    Tax on investment income for 2020 from Part VI, line 5......
    2a
    10,692
    b
    Income tax for 2020. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    10,692
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    785,965
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    785,965
    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
    785,965
    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
    800,760
    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
    800,760
    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
    800,760
    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 7 785,965
    2 Undistributed income, if any, as of the end of 2020:
    a Enter amount for 2019 only....... 180,535
    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$ 800,760
    a Applied to 2019, but not more than line 2a 180,535
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		0
    d Applied to 2020 distributable amount..... 620,225
    e Remaining amount distributed out of corpus  
    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  
    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 ..........     		165,740
    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 ......     		 
    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....  
    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).)
    James R Carlsen
    Beth Carlsen
    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
    American Cancer Society
    1545 River Park Drive Suite 100
    Sacramento,CA95815     		    Attack cancer from every angle. Promote healthy lifestyles to help you prevent cancer. Research cancer and its causes to find more answers and better treatments. Fight for lifesaving policy changes. Provide everything from emotional support to the latest cancer information for those who have been touched by cancer. 6,800
    American Red Cross
    1565 Exposition Blvd
    Sacramento,CA95815     		NA   The American Red Cross, also known as The American National Red Cross, is a non-profit humanitarian organization that provides emergency assistance, disaster relief, and disaster preparedness education in the United States. 15,000
    Anne Carlsen Center
    PO Box 8000
    Jamestown,ND58402     		    To assist in a $13 million Building Fund to construct a new state of the art Anne Carlsen Center 10,000
    Big BrothersBig Sisters
    800 Howe Avenue Suite 440
    Sacramento,CA95825     		NA   To provide children facing adversity with professionally-supported one-to-one mentoring relationships that impact their lives forever. To increase the number of successful mentoring relationships for all children who need them, contributing to brighter futures, better schools, and stronger communities. 25,000
    Boy Scouts of America-GEC
    PO Box 1355
    Sacramento,CA95853     		NA   Help prepare young people to serve, lead, experience adventure, develop character, and shape future leaders. 10,000
    Brady Center
    840 First Street NE Suite 400
    Washington,DC20002     		NA   Too often guns in the home result in tragedies and too often these tragedies occur because there is unsafe access to those guns. There are over 300 million guns in America. Most are owned by law-abiding citizens without harmful or dangerous intent, yet a gun in the home results in more than two-thirds of all gun deaths. Nearly 1.7 million children live in a home with a loaded, unlocked gun. Every year thousands of kids are killed by firearms as a result. Our mission is to make sure our children are safe.Millions of guns are sold every year with no questions asked transactions. Only 60 percent of all gun sales are conducted with a background check. Today, eight states have background checks across all gun sales. Every day, 89 people die from gun violence. Policies such as expanding background checks to cover all gun sales would help keep guns out of the hands of criminals, felons, domestic abusers, and other illegal purchasers. Background checks are supported by 90 percent of Americans, 1,000
    California Waterfowl Assoc
    1346 Blue Oak Blvd
    Roseville,CA95678     		NA   California Waterfowl finds its strength in a set of clear core values. These values define our organization and guide us in our hunt for a better California. Stewardship: Finding Common GroundCalifornia Waterfowl serves as a bridge to connect hunters and non-hunters, public and private interests, young and old toward a common goal of conserving and enjoying our natural resources. By building strong partnerships and family involvement, the Association is connecting with Californians of all interests to inspire stewardship of our wetlands and wildlife resources.Heritage: Hunter DrivenCalifornia Waterfowl believes that hunting deeply connects people to the natural world and generates the knowledge and commitment to conserve our treasured resources. This passion for active involvement in nature motivates hunters to make vital investments in conserving California for our children and grandchildren. Education: Focused on the FutureCalifornia Waterfowl stimulates youths and adults to value wa 2,500
    Cure Alzeimer's Fund
    34 Washington Street Suite 200
    Wellesley Hills,MA02481     		NA   Cure Alzheimer's Fund distributed grants for the Alzheimer's Genome Project initiative. After three years and approximately $3 million, the Project delivered it's first major milestone on time and on budget which was the identification of over 70 new genes conferring either risk for or protection against Alzheimer's disease. Confirmation and follow-up study are now underway to determine the genes with the highest potential for development of effective therapies. Headquartered at Massachusetts General Hospital, the Project includes researchers from several other United States research institutions. 5,000
    First Tee Sacramento
    3704 Marconi Avenue Suite 1
    Sacramento,CA95821     		NA   The First Tee started as a way to bring an affordable junior golf program to youth and communities that did not have them. This supports character education in youths. 5,000
    Cystic Fibrosis Foundation
    1540 River Park Dr Ste 215
    Sacramento,CA95815     		NA   The mission of the Cystic Fibrosis Foundation is to cure cystic fibrosis and to provide all people with the disease the opportunity to lead full, productive lives by funding research and drug development, promoting individualized treatment, and ensuring access to high-quality, specialized care. 1,000
    First Response Chaplains
    14806 Echo Ridge Road
    Nevada City,CA95959     		NA   To support Pastor Toby in his efforts to ease suffering in disaster impacted areas all over the world. 5,000
    Folsom Athletic Boosters
    PO Box 6162
    Folsom,CA95763     		NA   Help student athletes who may need funds for equipment, transportation or fees. 1,500
    Girl Scouts Heart of Central CA
    6601 Elvas Avenue
    Sacramento,CA95819     		NA   Science Technology Engineering and Math (STEM) programs have caught on quickly at GSHCC because Girl Scouts are curious, motivated and adventurous by nature. Our organization is uniquely positioned to address gender inequity in STEM education and enrichment locally. We recognize that STEM educational opportunities for girls are necessary now more than ever. In order to provide girls with empowering, hands-on STEM learning opportunities, GSHCC opened the regions first girl-led, girl-build STEM Center + MakerSpace in November 2017. This unique facility will host a variety of structured and open-format maker and design-thinking activities that encourage girls to embrace the spirit of scientific discovery in their lives. The STEM Center + MakerSpace is an investment in the next generation of Go-getters, Innovators, Risk-takers, and Leaders (G.I.R.L.s), and will serve as a hub for girl innovation, exploration and discovery for Girl Scouts throughout our 18-county region. 10,000
    Guide Dogs of America
    13445 Glenoaks Boulevard
    Sylmar,CA91342     		NA   Puppy raisers are the cornerstone of our training program at Guide Dogs of America. At the heart of every successful guide dog team is a puppy raiser who embraced the opportunity to raise a special puppy, teach him to feel safe in the world, and help him learn the skills necessary to become a well-mannered canine citizenPuppies are placed with carefully screened foster families, known as puppy raisers, when they are 8 weeks old. The puppy raisers job is to provide a loving first home, teach basic obedience and proper house manners to stay off furniture, not to jump on counters, not to chew inappropriate items in the home, etc. They also provide ongoing urban socialization, carefully exposing the dogs to a wide variety of public settings and teaching them to be calm and confident in all situations. Thanks to our dedicated puppy raisers, the dogs are well prepared to return to GDA at 16 to 18 months old, when they begin 4 to 6 months of formal guide-work training.GDA supports our puppy r 5,000
    HART of Folsom
    PO Box 6327
    Folsom,CA95763     		NA   Assist in general operations of temporarily housing feeding dinner to the homeless of Folsom, CA during the months of December through March. 5,000
    Journey Church
    450 Blue Ravine
    Folsom,CA95630     		NA   Deferred Maintenance Building $5,000 The Balance for General Operations, Missions, Evangelism, Disaster Assistance, Support for PCUSA 20,460
    National Parks Foundation
    1110 Vermont Avenue NW
    Washington,DC20005     		NA   We focus on promoting programs and projects that protect precious landscapes and wilderness, historical sites, and places of cultural significance.We work to keep trails clear through our Active Trails program, partner with collaborators like the White House to get kids outdoors through Open OutDoors for Kids, and most importantly, raise and allocate critical funds to keep our national parks safe. And with the ongoing support of fellow park lovers, well continue for years to come. 1,000
    Operation Hope
    859 E Vista Way
    Vista,CA92084     		NA   General Operations of Emergency Bridge Housing 50,000
    Powerhouse Ministries
    311 Market Street
    Folsom,CA95630     		NA   Support the Women and Childrens Transformation Center. They strive to break the cycle of life-destroying forces and choices. The children of PTC benefit from excellent care, counseling and community, giving them the hope of a much brighter future. The Powerhouse Transformation Center is one of the few no-cost residential recovery programs in Northern California. The center addresses all aspects of a womans life within a safe, caring community. We know for life transformation there are no quick fixes. The program is tailored to each womans personal development needs, dreams and life goals. It consists of five phases and lasts approximately two years. 75,000
    Regents of U of Michigan
    500 S State Street
    Ann Arbor,MI48109     		NA   To encourage excellence for the final projects of Professor Peter Allens Real Estate Development class. The final goal being to develop open minded, creative, and progressive thinkers who will ultimately enter into the career of Real Estate Development. 2,000
    Seneca Hospital
    PO Box 160
    Chester,CA96020     		NA   Seneca Hospital Auxiliary volunteer service support 2,500
    SF Marin Food Bank
    900 Pennsylvania Avenue
    San Francisco,CA94107     		NA   Home Delivered GroceriesFor thousands of homebound residents in San Francisco, a weekly knock on the door brings a delivery of fresh groceries and a friendly visit. Every bag includes a balance of nutritious foods such as fresh fruits and vegetables, low-fat dairy, lean protein, and whole grains. Thanks to the support of the San Francisco Department of Aging and Adult Services (DAAS), we continue to expand this program that serves as a lifeline for so many people.Many participants are unable to visit our pantries because of mobility challenges, but they still have the desire and ability to prepare meals at home. They benefit greatly from the autonomy that comes with cooking and preparing their own meals with fresh groceries delivered to their homes. 25,000
    Theatre for Children
    2700 Capitol Avenue
    Sacramento,CA95816     		NA   $150,000 Last portion of $250,000 Pledge of $26million Building Fund for new theatre. Sponsored Box Office 10,000
    Ticket to Dream
    1400 Rocky Ridge Drive Suite 280
    Roseville,CA95661     		NA   Ticket to Dream Foundation is dedicated to creating hope and opportunity for foster children across the nation, so they can just be kids 12,500
    Twin Lakes Food Bank
    327 Montrose Drive
    Folsom,CA95630     		NA   Every human being has a fundamental right to access to food. No person deserves to go hungry. The reality is that food insecurity impacts one in six Americans who report running out of food at least once a year. We serve individuals, families, senior citizens and homeless who are desperate for groceries for themselves and their families.Money goes to general operations 10,000
    Young Life
    PO Box 826
    Folsom,CA95763     		NA   Help hire and train staff and provide essential administrative support to the area. Also support operating expenses such as salaries and other ministry costs and can help send kids to Young Life camps. 2,000
    Albion College
    618 East Porter Street
    Albion,MI49224     		NA   Mission of the organization: An independent, coeducational, residential college founded more than 175 years ago, Albion is committed to the liberal arts tradition. Historically related to the United Methodist Church, the College is dedicated to preserving the values of the past, to serving the needs of the present and to anticipating the goals of the future. 5,000
    Better Life Foundation
    4725 Moore Way
    Carmichael,CA95608     		NA   Mission of the organization: The mission of the Better LifeFoundation is to imwove the lives of those affected with blood cancers by funding research and educational programs. The f oundation is based in Carmichael, California 2,500
    Center Post Traumatic Growth
    11344 Coloma Rd Suite 347
    Gold River,CA95670     		NA   Mission : The mission of the Center for Post Traumatic Growth is to promote and support the healing of combat veterans, law enforcement, first responders, and their families, from the wounds of war and human trauma 3,000
    Cody's Fresh Start
    6138 Reed Way
    Arvada,CO80003     		NA   Mission: Cody's Fresh Start Charity Works is committed to providing a fresh start to those impacted by the disease of addiction and to raise addiction awareness. We focus on ending the stigma, providing treatment scholarships, supporting those in recovery, and supporting family members affected by the disease. 2,000
    Congressional Sportsman's Foundatio
    110 North Carolina Ave
    SE,DC20003     		NA   MISSION: CSF's mission is to work with Congress, governors, and state legislatures to protect and advance hunting, angling, recreational shooting and trapping. 2,000
    Folsom's Hope
    107 Jumper Court
    Folsom,CA95630     		NA   'Ibis is the eleventh school year the Folsom STARS After School Program has been in operation. The Folsom STARS Program grew out of a desire to meet the needs of at-risk students in Folsom. The mission of the Folsom STARS program is to provide holistic support to at-risk students outside of the school day, so that they can be successful in their traditional classroom setting. The program is housed on the campus of Theodore Judah Elementary School in Folsom, California. As the attached program description states, this program is comprised of students from both Theodore Judah and Blanche Sprentz Elementary Schools, as both schools are located within the area of Folsom with the greatest percentage of poverty. 15,000
    Forrest Park Forever
    5595 Grand Drive in Forest Park
    St Louis,MO63112     		NA   Mission: Founded in 1986, Forest Park Forever is a private nonprofit conservancy that works in partnership with the City of St. Louis and the Department of Parks, Recreation and Forestry to restore, maintain and sustain Forest Park as one of America's greatest urban public parks. 20,000
    Hands for an African Child
    63 Natoma Street Suite 100
    Folsom,CA95630     		NA   MISSION: Bring homeless orphaned children into loving family homes with mothers and fathers, where they will feel God's love for them and become self-reliant adults, breaking the cycle of poverty. We are creating a self-sustaining agriculture based farming community with elementary, secondary and trade schools. This community will reach out to the local villages with clean water initiatives, education on personal hygiene, sanitation and improved farming techniques. There will also be a medical/dental clinic which will used for the community and visiting "medical mission trips". The children will be taught of God's love for them and to live by Christian principles and values. 10,000
    JennaPatrick Foundation of Hope
    400 Capitol Mall Suite 1800
    Sacramento,CA95814     		NA   The mission of Jenna & Patrick's Foundation of Hope is to support and promote research, to find a cure or treatment for Cystinosis, and provide support to affected individuals and families. 5,000
    Make a Wish
    2800 Club Center Drive
    Sacramento,CA95835     		NA   Mission: Make-A-Wish creates life-changing wishes for children with critical illnesses. Every34 minutes Make-A-Wish grants the wish of a child diagnosed with a critical illness in the United States and its territories. We believe that a wish experiencecan be a game-changer. This one belief guides us in everything we do. It inspires us to grant wishes that change the lives of the kids we serve. 20,000
    Nevada Children's Cancer Fund
    3 550 Barron Way 9A
    Reno,NV89511     		NA   Our mission is to enhancethe quality of life for children with cancer and their families by providing financial assistanceand comp assio nate support programs while advocating for increased research funds and raising public awareness. 10,000
    Sacramento Self Help Housing
    PO Box 188445
    Sacramento,CA95833     		NA   Mission: Sacramento Self-Help Housing is a non-profit organization that works to improve the living conditions and increase the self-sufficiency of individuals living at or below the poverty level in Sacramento. 10,000
    United Way California Capital Regio
    10389 Old Placerville Road
    Sacramento,CA95827     		NA   Mission: United Way California Capital Region mission is to build stronger, healthier and more compassionate communities. We are dedicated to improving the lives of families and children in Amador, El Dorado, Placer, Sacramento and Yolo Counties. 2,000
    Broadway Cares Equity Fights Aids
    165 West 46th Street Suite 1300
    New York,NY10036     		    Broadway Cares/Equity Fights AIDS helps men, women and children across the country and across the street receive lifesaving medications, health care, nutritious meals, counseling and emergency financial assistance. 5,000
    Devine Savior Catholic Church
    9079 Greenback Ln
    Orangevale,CA95662     		NA   Church support 10,000
    Folsom Athletics Foundation
    PO Box 835
    Folsom,CA95763     		NA   Non-profit service organization working to assist the administration of community youth sports 1,000
    Home Aid Sacramento
    1536 Eureka Road
    Roseville,CA95661     		    HomeAid Sacramento builds and renovates temporary, transitional and permanent housing for homeless children, women, men, veterans, and families who have experience a life-altering event and are rendered temporarily homeless. Our goal is to enable them to take the critical steps toward achieving lives of self-sufficiency. 250,000
    National Wild Turkey Federation
    Post Office Box 530
    Edgefield,SC29824     		NA   The mission of the National Wild Turkey Federation is no less urgent today than when it was founded in 1973. What we do in the coming decades will be instrumental in not only enhancing wild turkey populations but also in the continuation of hunting and quality wildlife habitat for countless species. 5,000
    Restaurant Workers Community Founda
    575 Grand St Apt E1507
    New York,NY10002     		  POF Restaurant Workers Community Foundation raises and distributes funds to grow the power of workers in public discourse and workplace policies on wages, equity and health 10,000
    Sacramento SPCA
    6201 Florin Perkins Rd
    Sacramento,CA95828     		    The Sacramento SPCA is committed to saving lives and finding new homes for the greatest number of animals by providing medical care, working on behavior and training, developing partnerships within the community and with rescue groups, hosting adoption events, maintaining a strong foster program, providing free services to seniors to keep their pets, operating a low-cost spay/neuter clinic, as well as, on-site and mobile low-cost wellness and vaccine clinics. 30,000
    Improve your tomorrow
    3780 Rosin Ct Suite 240
    Sacramento,CA95834     		NA   The life path for black and Latino boys is often the same. They leave high school without graduating, struggle to find employment, commit a crime and then find themselves in jail. The majority of which return to a community plagued by high unemployment, violence and a lack of hope. This cycle is known as the school to prison pipeline and frequently repeats generation, after generation, after generation. Improve Your Tomorrow, otherwise known as IYT was created in 2013 to break the school to prison pipeline by helping young men of color get to and through college. IYT started with seventeen students at Valley High School in South Sacramento, these seventeen laid the foundation for what is now the largest education nonprofit only serving young men of color in the country. IYT currently serves over 1000 young men of color through three academic programs including the IYT College Academy, IYT Continue to Dream Academy and IYT U. 15,000
    Lake Almanor Fishing Association
    PO Box 1938
    Chester,CA96020     		    In 1980, concerned fishermen, business people and the Chester/Lake Almanor Chamber of Commerce formed the Almanor Fishing Association. The main purpose of the Association is the enhancement and preservation of a high quality fishing resource in Lake Almanor. In addition, assuring its continual availability to everyone wishing to enjoy the sport of fishing. 2,500
    Midland Public Schools
    600 E Carpenter St
    Midland,MI48640     		    Public School.Midland Public Schools is committed to creating an equitable andanti-racist system that honors and elevates all! 2,500
    Napa Valley Community Foundation
    3299 CLAREMONT WAY
    Napa,CA94558     		    To mobilize resources, promote philanthropy and provide leadership on vital community issues in Napa County. 10,000
    St Louis Foundation
    2 Oak Knoll Park
    St Louis,MO63105     		NA   The St. Louis Community Foundation inspires purposeful philanthropy that connects community and donors to build and preserve a more equitable and vibrant region, now and forever.We are committed to our fundamental roles of helping donors create personal legacies, investing donor funds for maximum returns with minimum risk, and playing a leadership role in tackling our communities most challenging needs. 15,000
    St Louis Integrated Health Network
    1520 Market Street
    St Louis,MO63103     		    The St. Louis Integrated Health Network, through collaboration and partnership, strives for quality, accessible and affordable health care services for all residents of Metropolitan St. Louis, with an emphasis on the medically underserved. 5,000
    United Way St Louis
    910 N 11th St
    St Louis,MO63101     		NA   United Way of Greater St. Louis is proud to serve 16 counties in Illinois and Missouri with a population of nearly 3 million people. Working with 164 local nonprofits, weve created a strong network and safety net for our community members. Explore the regions we serve and our network nonprofits providing critical and immediate resources to people in the St. Louis region. 5,000
    Weave
    1900 K Street
    Sacramento,CA95811     		    promote safe and healthy relationships and support survivors of sexual assault, domestic violence and sex trafficking. 10,000
    Total .................................bullet 3a 800,760
    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 ...........     		      113  
    4 Dividends and interest from securities....          
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....     16 771,940  
    6 Net rental income or (loss) from personal property          
    7 Other investment income.....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		         
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e)..   772,053  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    772,053
    (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: 20011551
    Software Version: 2020v4.0


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2020 AccountingFeesSchedule
    Name:
    Carlsen Muir Family Foundation
    EIN:
    82-3157713
    Software ID:
    20011551
    Software Version:
    2020v4.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Hullen Accountancy 2,500 2,500 2,500 0

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

    TY 2020 AmortizationSchedule
    Name:
    Carlsen Muir Family Foundation
    EIN:
    82-3157713
    Software ID:
    20011551
    Software Version:
    2020v4.0
    Description of Amortized Expenses Date Acquired, Completed, or Expended Amount Amortized Deduction for Prior Years Amortization Method Current Year Amortization Net Investment Income Adjusted Net Income Total Amount of Amortization
    Standard lease renewal 2017-12-01 49,647 40,543 5.0000 9,104     49,647
    Commissions 2019-03-01 70,366 29,319 2.0000 35,183     64,502
    Commissions 2019-08-15 46,196 3,208 6.0000 7,699     10,907
    Legal 2019-03-15 1,050 438 2.0000 525     963

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    TY 2020 DepreciationSchedule
    Name:
    Carlsen Muir Family Foundation
    EIN:
    82-3157713
    Software ID:
    20011551
    Software Version:
    2020v4.0
    Description of Property Date Acquired Cost or Other Basis Prior Years' Depreciation Computation Method Rate /
    Life (# of years)    		 Current Year's Depreciation Expense Net Investment Income Adjusted Net Income Cost of Goods Sold Not Included
    Seaport 185 Bldg 2017-12-01 836,967 367,388 SL 37.4000 22,379 22,379 22,379  
    Seaport 185 Bldg 2017-12-01 35,939 17,077 SL 39.0000 922 922 922  
    Building 2017-12-01 3,479,330 996,201 SL 39.0000 89,214 89,214 89,214  
    Tenant Improvements 2017-12-01 2,901,383 976,658 SL 39.0000 74,394 74,394 74,394  
    T\I Lighting 2019-12-13 27,000 150 SL 15.0000 1,800 1,800    
    T\I Bathrooms 2019-12-19 16,162   SL 15.0000 1,077 1,077    

    TY 2020 InvestmentsLandSchedule2
    Name:
    Carlsen Muir Family Foundation
    EIN:
    82-3157713
    Software ID:
    20011551
    Software Version:
    2020v4.0
    Category/ Item Cost/Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
    Buildings 7,253,619 576,303 6,677,316 11,811,800
    Land 1,368,622   1,368,622 3,528,200

    TY 2020 LandEtcSchedule2
    Name:
    Carlsen Muir Family Foundation
    EIN:
    82-3157713
    Software ID:
    20011551
    Software Version:
    2020v4.0
    Category / Item Cost / Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
    Improvements 43,162 3,027 40,135 40,135


    TY 2020 OtherAssetsSchedule
    Name:
    Carlsen Muir Family Foundation
    EIN:
    82-3157713
    Software ID:
    20011551
    Software Version:
    2020v4.0
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    Net Intangible Assets 176,346 123,835 123,835


    TY 2020 OtherExpensesSchedule
    Name:
    Carlsen Muir Family Foundation
    EIN:
    82-3157713
    Software ID:
    20011551
    Software Version:
    2020v4.0
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Amortization 52,511 52,511 9,104  
    Bank Fees 99 99 99  
    Reimbursement -73 -73 -73  
    Rental Expenses 387,015 387,015    
    State Registry 150 150 150  
    Supplies 171 171 171  


    TY 2020 TaxesSchedule
    Name:
    Carlsen Muir Family Foundation
    EIN:
    82-3157713
    Software ID:
    20011551
    Software Version:
    2020v4.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Federal taxes 5,122      
    FTB 10