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
SUSAN AND DAVID SAMRICK FAMILY
FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)435 ROYAL PLAZA DRIVE
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
FORT LAUDERDALE, FL33301
A Employer identification number

38-3507526
B Telephone number (see instructions)

(954) 523-4991
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$3,004,964J 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) 565,000
2 Check bullet.............
3 Interest on savings and temporary cash investments 21,179 21,179  
4 Dividends and interest from securities... 45,801 45,801  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 33,715
b Gross sales price for all assets on line 6a 1,619,411
7 Capital gain net income (from Part IV, line 2)... 33,715
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........ 665,695 100,695  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0 0   0
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 200 200   0
c Other professional fees (attach schedule).... Click to see attachment 23,433 23,433   0
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 149 149   0
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 13,379 2,562   0
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 37,161 26,344   0
25 Contributions, gifts, grants paid....... 254,542 254,542
26 Total expenses and disbursements. Add lines 24 and 25 291,703 26,344   254,542
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 373,992
b Net investment income (if negative, enter -0-) 74,351
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......... 281,647 364,054 364,054
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) 304,204 Click to see attachment271,207 274,987
b Investments—corporate stock (attach schedule)....... 1,198,728 Click to see attachment1,207,482 1,559,133
c Investments—corporate bonds (attach schedule)....... 205,409 Click to see attachment276,051 290,747
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 223,049 Click to see attachment468,235 516,043
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 2,213,037 2,587,029 3,004,964
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 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........... 2,213,037 2,587,029
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)..... 2,213,037 2,587,029
30 Total liabilities and net assets/fund balances (see instructions). 2,213,037 2,587,029
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return) ...............
1
2,213,037
2
Enter amount from Part I, line 27a .....................
2
373,992
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
2,587,029
5
Decreases not included in line 2 (itemize) bullet
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
2,587,029
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 JEFFERIES [3056] RETURN OF PRINCIPAL   2020-01-01 2020-12-31
b JEFFERIES [4114] PUBLICLY TRADED SECURITIES      
c JEFFERIES [4114] PUBLICLY TRADED SECURITIES      
d JEFFERIES [9493] PUBLICLY TRADED SECURITIES      
e JEFFERIES [9493] PUBLICLY TRADED SECURITIES      
JEFFERIES [1102] PUBLICLY TRADED SECURITIES      
JEFFERIES [1102] PUBLICLY TRADED SECURITIES      
JEFFERIES [3056] US TBILLS REDEMPTIONPUBLICLY TRADED SECURITIES   2020-02-27 2020-03-31
JEFFERIES [9493] PUBLICLY TRADED SECURITIES   2019-05-02 2020-03-17
JEFFERIES [9493] PUBLICLY TRADED SECURITIES      
JEFFERIES [4114] PUBLICLY TRADED SECURITIES   2018-09-04 2020-07-23
(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 1,031   1,031 0
b 308,675   301,211 7,464
c 233,938   219,321 14,617
d 19,874   19,941 -67
e 48,198   49,062 -864
405,032   423,605 -18,573
180,154   149,128 31,026
389,535   389,535 0
3,849   4,622 -773
16,170   16,262 -92
12,955   11,978 977
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       0
b       7,464
c       14,617
d       -67
e       -864
      -18,573
      31,026
      0
      -773
      -92
      977
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 33,715
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 1,033
c All other domestic foundations enter 1.39% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 1,033
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 1,033
6 Credits/Payments:
a 2020 estimated tax payments and 2019 overpayment credited to 2020 6a 2,592
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 2,592
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 1,559
11 Enter the amount of line 10 to be: Credited to 2021 estimated taxBullet1,559 RefundedBullet 11 0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletMI
    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 ofbulletSUSAN SAMRICK Telephone no.bullet (954) 523-4991

    Located atbullet435 ROYAL PLAZA DRIVEFT LAUDERDALEFL ZIP+4bullet33301
    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
    Yes
     
    ........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
    SUSAN SAMRICK DIRECTOR
    2.00     		0 0 0
    435 ROYAL PLAZA DRIVE
    FORT LAUDERDALE,FL33301
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet 0
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 7
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet0
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 8
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    2,215,172
    b
    Average of monthly cash balances.......................
    1b
    326,019
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    2,541,191
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    2,541,191
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    38,118
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    2,503,073
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    125,154
    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
    125,154
    2a
    Tax on investment income for 2020 from Part VI, line 5......
    2a
    1,033
    b
    Income tax for 2020. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    1,033
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    124,121
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    124,121
    6
    Deduction from distributable amount (see instructions).................
    6
    0
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
    124,121
    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
    254,542
    b
    Program-related investments—total from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    254,542
    5
    Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
    income. Enter 1% of Part I, line 27b. See instructions.................
    5
    0
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    254,542
    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 7 124,121
    2 Undistributed income, if any, as of the end of 2020:
    a Enter amount for 2019 only....... 0
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2020:
    a From 2015...... 96,337
    b From 2016...... 229,231
    c From 2017...... 86,665
    d From 2018...... 263,309
    e From 2019...... 261,046
    fTotal of lines 3a through e........ 936,588
    4Qualifying distributions for 2020 from Part
    XII, line 4: bullet$ 254,542
    a Applied to 2019, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		0
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		0
    d Applied to 2020 distributable amount..... 124,121
    e Remaining amount distributed out of corpus 130,421
    5 Excess distributions carryover applied to 2020. 0 0
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 1,067,009
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		0
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2020. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2021 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8 Excess distributions carryover from 2015 not
    applied on line 5 or line 7 (see instructions) ...     		96,337
    9Excess distributions carryover to 2021.
    Subtract lines 7 and 8 from line 6a ......     		970,672
    10 Analysis of line 9:
    a Excess from 2016.... 229,231
    b Excess from 2017.... 86,665
    c Excess from 2018.... 263,309
    d Excess from 2019.... 261,046
    e Excess from 2020.... 130,421
    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).)
    SUSAN SAMRICK
    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 ISRAEL EDUCATION FOUNDATION
    251 H STREET NW
    WASHINGTON,DC20001     		NONE PC EDUCATION 85,000
    B'NAI AVIV
    1410 INDIAN TRACE
    WESTON,FL33326     		NONE PC GENERAL PURPOSE 7,742
    CHABAD OF WESTERN MICHIGAN
    2615 MICHIGAN NE
    GRAND RAPIDS,MI49506     		NONE PC GENERAL PURPOSE 104,000
    HILLEL OF BROWARD & PALM BEACH
    777 GLADES ROAD BLDG LY-3A
    BOCA RATON,FL33431     		NONE PC COMMUNITY WELFARE 18,000
    JEWISH FEDERATION OF BROWARD COUNTY
    5890 SOUTH PINE ISLAND ROAD
    DAVIE,FL33328     		NONE PC GENERAL PURPOSE 18,000
    NOVA SOUTHEASTERN UNIVERSITY MUSEUM OF ART
    3301 COLLEGE AVE
    FORT LAUDERDALE,FL333147796     		NONE PC EDUCATION 20,000
    CHABAD OF PHOENIX
    2110 EAST LINCOLN DRIVE
    PHOENIX,AZ85016     		NONE PC GENERAL PURPOSE 1,800
    Total .................................bullet 3a 254,542
    bApproved for future payment
    Total .................................bullet 3b 0
    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 21,179  
    4 Dividends and interest from securities....     14 45,801  
    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 33,715  
    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).. 0 100,695 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    100,695
    (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
    SUSAN AND DAVID SAMRICK FAMILY
    FOUNDATION
    Employer identification number

    38-3507526
    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
    SUSAN AND DAVID SAMRICK FAMILY
    FOUNDATION         		Employer identification number
    38-3507526
    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
    THE MILL STEEL COMPANY
     
    5116 36TH STREET SE
     
    GRAND RAPIDS, MI49512

    		$ 565,000


    (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
    SUSAN AND DAVID SAMRICK FAMILY
    FOUNDATION         		Employer identification number

    38-3507526
    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
    SUSAN AND DAVID SAMRICK FAMILY
    FOUNDATION         		Employer identification number

    38-3507526
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Additional Data


    Software ID:  
    Software Version:  

    TY 2020 AccountingFeesSchedule
    Name:
    SUSAN AND DAVID SAMRICK FAMILY
     
    FOUNDATION
    EIN:
    38-3507526
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAX PREP FEES 200 200   0

    TY 2020 GeneralExplanationAttachment
    Name:
    SUSAN AND DAVID SAMRICK FAMILY
     
    FOUNDATION
    EIN:
    38-3507526
    Identifier Return Reference Explanation
      STATEMENT 1 TO FORM 4720 THE FOUNDATION IS FILING THE FORM 4720 TO PROVIDE NOTICE OF A MISTAKE WHICH COULD TRIGGER AN INCORRECT SELF-DEALING TAX AGAINST THE SUSAN BETH SAMRICK TRUST UAD 2/25/93 (THE "TRUST") FOR TAX YEAR 2020. ALTHOUGH THE SELF-DEALING TAX SHOULD NOT APPLY TO THE TRUST AS EXPLAINED MORE FULLY BELOW, THE TRUST HAS, IN THE ALTERNATIVE AND WITHOUT CONCEDING THE SELF-DEALING TAX, SUBMITTED A REQUEST FOR RELIEF TO IRS UNDER SEPARATE COVER.FACTSSUSAN SAMRICK IS THE SURVIVING WIDOW OF THE RECENTLY DECEASED DAVID SAMRICK. DAVID SAMRICK PASSED AWAY RECENTLY ON MAY 14, 2021, AFTER A LONG AND PAINFUL BATTLE WITH LUNG DISEASE. DAVID SAMRICK HAD BEEN THE RECIPIENT OF A LUNG TRANSPLANT IN 2020 AND SUFFERED THROUGH THAT SURGERY, AND THE AFTERMATH OF THAT INTENSIVE SURGERY, FOR ALL OF 2020 AND UNTIL HE PASSED AWAY IN 2021. SUSAN SAMRICK IS THE GRANTOR OF THE TRUST.THE SAMRICKS ARE CHARITABLE PEOPLE WHO CONTRIBUTE TO MANY CHARITABLE CAUSES. TO FACILITATE THEIR ABILITY TO GIVE MONEY TO CHARITY THE SAMRICKS CREATED THE SUSAN AND DAVID SAMRICK FAMILY FOUNDATION (THE "FOUNDATION"). THE FOUNDATION IS A CHARITY THAT PROVIDES MONEY TO VARIOUS CHARITABLE CAUSES IN THE UNITED STATES AND THE WORLD.TO ASSIST THE SAMRICKS WITH THE PROPER ADMINISTRATION AND THE PROPER TAX COMPLIANCE OF THE TRUST AND THE FOUNDATION, THE SAMRICKS ENGAGED JEFFERIES. JEFFERIES IS A PRIVATE WEALTH MANAGEMENT FIRM BASED IN CHICAGO. JEFFERIES' WEBSITE EXPLAINS THAT JEFFERIES PROVIDES COMPREHENSIVE SERVICES, SOPHISTICATED ADVISORS, CUSTOMIZED INVESTMENT SOLUTIONS, FULL-BALANCE SHEET ADVICE AND CUSTOMIZED REPORTING. THE SAMRICKS HAVE RELIED ON JEFFERIES FOR MANY YEARS WITHOUT ANY INCIDENT AND THEREFORE, SUCH RELIANCE WAS REASONABLE.IN ADDITION TO DAVID SAMRICK'S ILLNESS IN 2020 AND EVENTUAL PASSING IN 2021, THE WORLD WAS ALSO SIMULTANEOUSLY STRUCK WITH THE WORLDWIDE COVID PANDEMIC. DURING THE TURMOIL OF DAVID SAMRICK'S EXTENSIVE ILLNESS AND SURGERY IN 2020 AND THE WORLDWIDE COVID PANDEMIC, JEFFERIES MADE A MISTAKE IN THE ADMINISTRATION OF THE TRUST AND THE FOUNDATION. IN 2020, ONE OF THE JEFFERIES REPRESENTATIVES ACCIDENTALLY USED ONE OF THE FOUNDATION'S BROKERAGE ACCOUNTS TO FUND A CAPITAL CALL FOR THE TRUST AND ACCIDENTALLY USED ONE OF THE TRUST'S ACCOUNTS TO FUND A CAPITAL CALL FOR THE FOUNDATION. IN OTHER WORDS, THE JEFFERIES STAFF MEMBER INADVERTENTLY "MIXED UP" THE ACCOUNTS AND USED THE INCORRECT ACCOUNTS TO FUND THE SEPARATE CAPITAL CALLS.THIS ERROR WAS SWIFTLY CORRECTED AS SOON AS IT WAS DISCOVERED IN 2021. JEFFERIES IS A RELIABLE AND TRUSTED ADVISOR TO THE SAMRICKS. THIS ERROR OCCURRED AT A TIME WHEN ALL WERE OVERWHELMED WITH MR. SAMRICK'S TRANSPLANT SURGERY AND THE WORLDWIDE COVID PANDEMIC. THE JEFFERIES ORGANIZATION, LIKE MOST ORGANIZATION IN THE UNITED STATES DURING 2020, INCLUDING THE IRS, WAS DEALING WITH OFFICE CLOSURES AS A RESULT OF THE PANDEMIC. THESE FACTORS CONTRIBUTED TO THIS MISTAKE BY JEFFERIES. NEVERTHELESS, AS SOON AS THE MISTAKE WAS DISCOVERED, IT WAS QUICKLY CORRECTED.UPON THE ADVICE OF ITS TAX ATTORNEY AND TAX ADVISORS, THE FOUNDATION HAS ATTACHED THE FORM 4720 TO ITS 2020 TAX RETURN AND REPORTED THE INADVERTENT USE OF THE FOUNDATION FUNDS FOR THE BENEFIT OF THE TRUST AND ITS GRANTOR AS A SELF-DEALING TRANSACTION. HOWEVER, IN THIS SPECIFIC CASE, THE TRUST DID NOT PARTICIPATE IN THE ACT OF SELF-DEALING, RATHER THE SELF-DEALING WAS AN ACT OF JEFFERIES. THEREFORE, THE TRUST SHOULD NOT BE LIABLE FOR ANY SELF-DEALING TAX AND HAS REQUESTED RELIEF FROM THE TAX.LEGAL ANALYSISLAWSECTION 4941(A)(1) IMPOSES A TAX ON EACH ACT OF SELF-DEALING BETWEEN A DISQUALIFIED PERSON AND A PRIVATE FOUNDATION. THE RATE OF TAX SHALL BE EQUAL TO 10 PERCENT OF THE AMOUNT INVOLVED WITH RESPECT TO THE ACT OF SELF-DEALING FOR EACH YEAR (OR PART THEREOF) IN THE TAXABLE PERIOD. THE TAX IMPOSED BY THIS PARAGRAPH SHALL BE PAID BY ANY DISQUALIFIED PERSON (OTHER THAN A FOUNDATION MANAGER ACTING ONLY AS SUCH) WHO PARTICIPATES IN THE ACT OF SELF-DEALING. (EMPHASIS ADDED).DEFINED TERMSTHE TERM "SELF-DEALING" MEANS ANY DIRECT OR INDIRECT "TRANSFER TO, OR USE BY OR FOR THE BENEFIT OFA DISQUALIFIED PERSON OF THE INCOME OR ASSETS OF A PRIVATE FOUNDATION". IRC SECTION 4941(D)(1)(E). THE TERM "DISQUALIFIED PERSON" MEANS:WITH RESPECT TO A PRIVATE FOUNDATION, A PERSON WHO IS (A) A SUBSTANTIAL CONTRIBUTOR TO THE FOUNDATION, (B) A FOUNDATION MANAGER, (C) AN OWNER OF MORE THAN 20 PERCENT OF (I) THE TOTAL COMBINED VOTING POWER OF A CORPORATION, (II) THE PROFITS INTEREST OF A PARTNERSHIP, OR (III) THE BENEFICIAL INTEREST OF A TRUST OR UNINCORPORATED ENTERPRISE, WHICH IS A SUBSTANTIAL CONTRIBUTOR TO THE FOUNDATION, (D) A MEMBER OF THE FAMILY (AS DEFINED IN SUBSECTION (D)) OF ANY INDIVIDUAL DESCRIBED IN SUBPARAGRAPH (A), (B), OR (C), (E) A CORPORATION OF WHICH PERSONS DESCRIBED IN SUBPARAGRAPH (A), (B), (C), OR (D) OWN MORE THAN 35 PERCENT OF THE TOTAL COMBINED VOTING POWER, (F) A PARTNERSHIP IN WHICH PERSONS DESCRIBED IN SUBPARAGRAPH (A), (B), (C), OR (D) OWN MORE THAN 35 PERCENT OF THE PROFITS INTEREST, (G) A TRUST OR ESTATE IN WHICH PERSONS DESCRIBED IN SUBPARAGRAPH (A), (B), (C), OR (D) HOLD MORE THAN 35 PERCENT OF THE BENEFICIAL INTEREST, (H) ONLY FOR PURPOSES OF SECTION 4943, A PRIVATE FOUNDATION (I) WHICH IS EFFECTIVELY CONTROLLED (DIRECTLY OR INDIRECTLY) BY THE SAME PERSON OR PERSONS WHO CONTROL THE PRIVATE FOUNDATION IN QUESTION, OR (II) SUBSTANTIALLY ALL OF THE CONTRIBUTIONS TO WHICH WERE MADE (DIRECTLY OR INDIRECTLY) BY THE SAME PERSON OR PERSONS DESCRIBED IN SUBPARAGRAPH (A), (B), OR (C), OR MEMBERS OF THEIR FAMILIES (WITHIN THE MEANING OF SUBSECTION (D)), WHO MADE (DIRECTLY OR INDIRECTLY) SUBSTANTIALLY ALL OF THE CONTRIBUTIONS TO THE PRIVATE FOUNDATION IN QUESTION, AND (I) ONLY FOR PURPOSES OF SECTION 4941, A GOVERNMENT OFFICIAL (AS DEFINED IN SUBSECTION (C)).ANALYSISIN THIS CASE, ALTHOUGH THE TRUST MAY BE DEFINED AS A DISQUALIFIED PERSON AND WHILE THE "USE BY OR FOR THE BENEFIT OF A DISQUALIFIED PERSON" IS AN ACCURATE DESCRIPTION OF THE INADVERTENT VIOLATION HERE, THE TAX IMPOSED BY 4941(A)(1) "SHALL BE PAID BY ANY DISQUALIFIED PERSONWHO PARTICIPATES IN THE ACT OF SELF-DEALING." (EMPHASIS ADDED) IN THE SITUATION AT HAND, THE TRUST DID NOT PARTICIPATE IN THE ACT OF SELF-DEALING. INSTEAD, JEFFERIES PARTICIPATED IN THE ACT OF SELF-DEALING, AS THE JEFFERIES REPRESENTATIVE WAS THE PERSON WHO MADE THE MISTAKE AND ACCIDENTALLY FUNDED THE TRUST'S CAPITAL CALL WITH THE FOUNDATION ACCOUNT. THE TRUST WAS NOT EVEN AWARE THAT THE MISTAKE WAS MADE IN 2020. AS SUCH, THE TRUST DID NOT PARTICIPATE. PURSUANT TO SECTION 4941, THE DISQUALIFIED PERSON WHO PARTICIPATES IN THE ACT OF SELF-DEALING IS REQUIRED TO PAY THE TAX. SINCE THE TRUST DID NOT PARTICIPATE, THE TRUST IS NOT SUBJECT TO THE SELF-DEALING TAX.FURTHERMORE, EVEN THOUGH JEFFERIES "PARTICIPATED" IN THE ACT OF SELF-DEALING, JEFFERIES IS NOT A "DISQUALIFIED PERSON" PURSUANT TO THE DEFINITION ABOVE. AS SUCH, NO SELF-DEALING TAX IS OWED BY JEFFERIES PURSUANT TO SECTION 4941(A)(1).IN ADDITION, EVEN IF THE SELF DEALING TAX APPLIED TO THE TRUST, THE IRS SHOULD PROVIDE RELIEF. IN THE ANALOGOUS SITUATION OF IRA ROLLOVERS, WHERE A BROKER INADVERTENTLY USES AN INCORRECT ACCOUNT, THE IRS HAS PROVIDED RELIEF FROM THE TAX IMPOSED. SEE PLR XXX-XX-XXXX; PLR XXX-XX-XXXX; PLR XXX-XX-XXXX.THE TRUST SHOULD BE GRANTED A FIRST TIME ABATEMENT OF SELF-DEALING TAXEVEN IF THE SELF DEALING TAX APPLIED TO THE TRUST, THE IRS CERTAINLY RECOGNIZES THAT TAXPAYERS CAN MAKE MISTAKES AND ONE-TIME ALLOWANCES SHOULD BE GIVEN. FOR EXAMPLE, THE IRS NATIONAL TAXPAYER ADVOCATE IN HER REPORT TO CONGRESS, 2006 TNT 9-26, EXPLAINS THAT A ONE-TIME ABATEMENT OF VARIOUS PENALTIES FOR FAILURES SHOULD BE ALLOWED. THE TRUST HAS NOT PREVIOUSLY REQUESTED RELIEF FROM ANY SELF DEALING TAX. THEREFORE, WHEN ALL THE FACTS AND CIRCUMSTANCES ARE CONSIDERED THE IRS SHOULD ALLOW A FIRST-TIME RELIEF OF THE SELF DEALING TAX.RELIANCE ON PROFESSIONAL ASSISTANCEIN THIS SITUATION, THE SAMRICKS, WHO ARE NOT TAX LAWYERS, CPAS, TAX RETURN PREPARERS, ENROLLED AGENTS, OR OTHER FINANCIAL PROFESSIONALS, ENGAGED PROFESSIONALS TO ASSIST THEM IN THE REQUIRED ADMINISTRATION AND TAX COMPLIANCE FOR THE FOUNDATION AND THE TRUST. THE REPRESENTATIVE AT JEFFERIES MADE A MISTAKE AND THE TRUST WAS NOT AWARE OF THE MISTAKE AND DID NOT PARTICIPATE IN THE MISTAKE. AS SUCH, THE IRS SHOULD PROVIDE RELIEF TO THE TRUST AND ABATE ANY SELF-DEALING TAX.COVIDTHE COVID PANDEMIC STRUCK IN FEBRUARY 2020. AS A RESULT OF COVID, JEFFERIES, LIKE THE IRS, AND ALL OTHER BUSINESSES IN THE UNITED STATES, WAS DEALING WITH OFFICE CLOSURES, STAFF TRANSITIONING TO AT-HOME WORK AND A MYRIAD OF OTHER "UNKNOWNS". CERTAINLY THE CHAOS OF THE WORLDWIDE COVID PANDEMIC CONTRIBUTED TO THIS INADVERTENT ERROR AT HAND. THE IRS HAS RECOGNIZED THE EFFECTS THAT COVID HAS HAD ON BUSINESSES AND TAXPAYERS. IN FACT, 2020 WAS SO CHAOTIC THAT THE IRS ISSUED COVID RELIEF STOPPING COLLECTION ACTION AND ALLOWING TAXPAYERS DELAYED FILING AND PAYMENT TIMES. SEE, E.G. IR 2020-59, HTTPS://WWW.IRS.GOV/NEWSROOM/IRS-UNVEILS-NEW-PEOPLE-FIRST-INITIATIVE-COVID-19-EFFORT-TEMPORARILY-ADJUSTS-SUSPEN. AS A RESULT, EVEN IF THE SELF-DEALING TAX AT HAND WAS APPLICABLE, IT SHOULD BE ABATED.CONCLUSIONTHE APPLICATION OF THE SELF-DEALING TAX IN THIS CASE WOULD BE ESPECIALLY HARSH AND UNJUST. THE TRUST DID NOT CONSCIOUSLY OR RECKLESSLY FAIL TO TIMELY PAY THE TAX AT ISSUE. THIS IS NOT A CASE WHERE A TAXPAYER SIMPLY DECIDED TO IGNORE THE RULES AND NEEDS TO BE PUNISHED OR PENALIZED. ON THE CONTRARY, THE TRUST DID WHAT A REASONABLE PERSON WITHOUT TAX AND ACCOU

    TY 2020 InvestmentsCorpBondsSchedule
    Name:
    SUSAN AND DAVID SAMRICK FAMILY
     
    FOUNDATION
    EIN:
    38-3507526
    Name of Bond End of Year Book Value End of Year Fair Market Value
    AT&T INC GLOBAL NT 4.35% 25,236 28,624
    BANK AMER CORP FLTG RATE SR NT SER M 14,084 15,243
    BANK AMER CORP FXD TO FLTG RT SR NT SER 13,735 14,447
    BOOKING HLDGS INC SR NT 4.5% 25,791 29,734
    BROADCOM CORP JUL 15 13,979 14,051
    CHARTER COMMUNICATIONS OPER LLC 13,895 13,937
    CHENIERE CORPUS CHRISTI HLDGS LLC GTD FXT RT SR SECD NT 14,081 15,129
    CITIGROUP INC FLTG RATE SR NT 1.655% 14,255 14,240
    ENERGY TRANSFERS PARTNERS L P 13,211 14,124
    FNMA GTD PASS THRU POOL#534179 708 328
    G N M A PASS THRU POOL 510989X 902 254
    G N M A PASS THRU POOL 544853X 3,362 2,715
    G N M A PASS THRU POOL 781289X 1,998 1,203
    GINNIE MAE CMO/SERIES 2005-3 JD-MX-FIXED RT 2,069 1,774
    GOLDMAN SACHS GROUP INC FLOATING RT NT 11,594 12,464
    HOLLYFRONTIER CORP FXD RT SR NT 26,862 29,034
    J P MORGAN CHASE & CO FIXED TO FLOATING RT SR NOTE 25,807 27,867
    MORGAN STANLEY SR NT FIXED / FLOATING 14,114 14,266
    MYLAN N V ISN#U62854AA246 3.950% 13,143 13,730
    WELLS FARDO & CO MEDIUM TERM SR NTS 1.654% 13,000 13,362
    WELLS FARGO & CO NEW FLTG RT NT 1.444% 14,225 14,221

    TY 2020 InvestmentsCorpStockSchedule
    Name:
    SUSAN AND DAVID SAMRICK FAMILY
     
    FOUNDATION
    EIN:
    38-3507526
    Name of Stock End of Year Book Value End of Year Fair Market Value
    ABBOTT LABS COM 4,861 4,818
    ABBVIE INC COM 17,306 23,359
    ACCENTURE PLC IRELAND CLASS SHS 2,266 4,963
    ACTIVISION BLIZZARD INC COM 13,534 20,984
    ADYEN N V ADR 2,418 2,784
    AIA GROUP LTD SPONSORED ADR 5,241 7,664
    AIR LEASE CORP NON CUM PERP 5,304 6,078
    AKAMAI TECHNOLOGIES INC COM 12,511 18,478
    ALCON SA ACT NOM 2,986 3,167
    ALLSTATE CORP COM 8,597 9,124
    ALLSTATE CORP SUB DEB FIXED TO FLTG RATE JAN 15 9,889 10,670
    ALPHABET INC CAP STK CL A 15,018 28,042
    ALPHABET INC CAP STK CL C 5,569 12,263
    AMADEUS IT HLDG SA ADS 2,468 2,480
    AMAZON COM INC 7,623 13,028
    AMERICAN FINL GROUP INC OHIO SUB 4,891 5,100
    AON PLC REGISTERED 2,031 2,113
    APPLE INC COM 10,158 39,807
    APTIV PLC SHS COM 3,495 7,296
    ASML HLDG N V N Y REGISTRY SHS NEW 2,193 5,853
    ASPEN INS HLDGS LTD DEP SHS #BMGC53842040 2,582 2,679
    ASPEN INS HLDGS LTD VAR NON CUM 13,842 13,530
    AT&T INC COM 9,922 7,017
    AT&T INC DEP SHS REPSTG 5,429 5,753
    ATHENE HLDG LTD DEP SH REPSTG 10,330 11,483
    ATHENE HLDG LTD DEP SHS 10,425 11,701
    ATLAS COPCO AB SPON ADR NEW REPSTG 1,975 3,627
    AUTOZONE INC COM 10,382 11,854
    BALL CORP COM 5,076 7,082
    BANK AMER CORP DEP MAY 16 5,740 6,142
    BANK AMER CORP DEP SHS JUNE 25 10,122 11,088
    BANK AMER CORP DEP SHS NV 3 3,796 4,036
    BANK AMER CORP DEP SHS SEPT 17 6,528 7,120
    BERKLEY W R CORP 2,356 2,385
    BERKLEY W R CORP 4,815 5,234
    BLACK KNIGHT INC COM 7,105 9,100
    BLOCK H & R INC 8,331 6,931
    BOEING CO COM 13,602 7,920
    BOOZ ALLEN HAMILTON 8,546 9,154
    BOSTON SCIENTIFIC CORP 6,111 5,141
    BRISTOL MYERS SQUIBB CO COM 28,346 31,821
    BROADRIDGE FINL SOLUTIONS 3,752 5,668
    CANADIAN PAC RY LTD COM 5,575 13,174
    CAPITAL ONE FINL CORP COM 7,615 8,995
    CAPITAL ONE FINL CORP DEP 10,250 11,248
    CBRE GROUP INC CL A 4,552 7,526
    CDK GLOBAL INC COM 4,344 4,457
    CERNER CORP COM 6,256 8,554
    CISCO SYSTEMS INC 10,036 13,246
    CITIGROUP INC DEP SHS NOV 15 6,460 6,747
    CITIGROUP INC DEP SHS SEPT 30 20,179 20,704
    CITIZENS FINL GP INC START APRIL 6 2,285 2,451
    CITIZENS FINL GROUP INC 2,623 2,807
    CLOROX CO COM 7,389 8,481
    COMCAST CORP CL A 14,212 19,702
    COMERICA INC COM 9,349 13,127
    CROWN HLDGS INC COM 9,277 9,820
    CSL LTD SPONSORED ADR ISIN#US12637N2045 3,928 7,050
    D R HORTON INC COM 7,379 10,820
    DANAHER CORP COM 4,266 11,773
    DAVITA INC COM 8,848 12,914
    DEVON ENERGY CORP 8,107 9,043
    DISCOVERY COMMUNICATIONS INC 4,105 4,348
    DISNEY WALT CO DISNEY COM 9,041 12,501
    DOLLAR GEN CORP 6,482 7,781
    DSV AS ADR ISIN#US26251A1088 1,965 6,302
    DTE ENERGY CO COM 9,718 10,077
    DTE ENERGY CORP 7,644 7,748
    DTE ENERGY CORP JR 5,485 5,835
    DUKE ENERGY CORP DEP SHS 5,696 6,244
    DUKE ENERGY CORP JR 3,230 3,596
    DYNATRACE INC COM 8,767 9,995
    ENBRIDGE INC PFD 5,534 5,784
    EQUITABLE HLDGS INC DEP 7,861 8,418
    EXPERIAN PLC SPON ADR 2,905 5,352
    F5 NETWORKS INC COM 7,506 9,325
    FACEBOOK INC CL A 9,131 16,663
    FEDEX CORP COM 6,067 9,346
    FERRARI N V SHS 2,299 3,443
    FIFTH THIRD BANCORP 14,230 14,444
    FISERV INC COM 9,609 10,475
    FLIR SYS INC COM 3,189 3,901
    FMC CORP NEW 7,256 10,803
    FORTINET INC COM 8,744 8,919
    FULTON FINL CORP PA DEP 2,714 2,762
    GILEAD SCIENCES INC 3,445 2,971
    GLOBE LIFE INC JR 583 597
    GOLDMAN SACHS GROUP 24,772 25,991
    HARTFORD FINL SVCS GROUP 13,043 13,170
    HCA HEALTHCARE INC COM 5,501 10,690
    HDFC BK LTD ADR 3,710 5,781
    HOLOGIC INC COM 6,999 11,216
    HUNTINGTON BANCSHARES INC 11,987 11,617
    ICON PLC LTD SHS 1,354 3,315
    INTEL CORP COM 3,667 3,388
    INTUIT INCORPORATED COM 3,427 11,016
    JPMORGAN CHASE & CO DEP 4.75% AFT DEC 1 5,258 5,819
    JPMORGAN CHASE & CO DEP SH 6.0% AFT MARCH 1 14,168 15,294
    KEYCORP NEW DEP 11,886 12,528
    LENNAR CORP CL A 4,531 6,784
    LOCKHEAD MARTIN CORP COM 7,819 7,100
    LONZA GROUP AG 2,496 2,563
    LULULEMON ATHLETICA INC COM 2,813 4,524
    LVMH MOET HENNESSY LOUIS VUITTON ADR 1,934 5,488
    MARKETAXESS HLDGS INC COM 7,062 10,270
    MERCADOLIBRE INC COM 3,733 11,727
    METLIFE INC 4,954 5,343
    METTLER-TOLEDO INTL INC COM 2,769 4,559
    MICROSOFT CORP COM 12,693 31,139
    MORGAN STANLEY DEP SHS FXD TO FLT NON CUM DIV 6.375 2,174 2,296
    MORGAN STANLEY DEP SHS OCT 15 12,979 13,882
    MORGAN STANLEY DEP SHS QRTLY BASIS 10,888 11,201
    NATIONAL RURAL UTILIS COOP 4,993 5,827
    NESTLE SA SPONSORED ADR REPSTG 2,919 4,359
    NEXTERA ENERGY CAP HLDGS INC 4,235 4,688
    NISOURCE INC DEP SHS 4,975 5,328
    NORTONLIFELOCK INC COM 7,455 8,104
    NOVO NORDISK A.S. ADR FORMERLY NOVO 4,618 9,500
    NVIDIA CORP COM 4,446 10,444
    NXP SEMICONDUCTORS NV COM 6,759 12,085
    ONEOK INC NEW COM 10,364 10,439
    PARTNERRE LTD #BMG686031441 2,557 2,513
    PERKINELMER INC COM 9,296 10,476
    PERNOD RICHARD S A ADR 3,678 4,180
    PFIZER INC COM 8,337 9,460
    PNC FINL SVCS GROUP INC 17,960 18,023
    PROCTER & GAMBLE CO COM 7,890 9,183
    PROGRESSIVE CORP OH COM 8,375 10,382
    PRUDENTIAL FINL INC 9,985 10,980
    PRUDENTIAL FINL INC JR SEPT 1 5,916 6,143
    PS BUSINESS PKS INC 2,616 2,903
    PTC INC COM 5,838 10,286
    PUBLIC STORAGE DEP SHS 10,357 11,487
    QUALCOMM INC 5,278 13,863
    QUEST DIAGNOSTICS INC COM 8,481 8,819
    RACKSPACE TECHNOLOGY INC COM 4,228 4,593
    REGIONS FINL CORP NEW 9,984 11,290
    REINSURANCE GROUP AMER INC SUB DEB FXD/FLTG EXP JUNE 15 10,073 10,816
    RESMED INC COM 1,694 3,188
    SCHLUMBERGER LTD COM 9,577 10,522
    SCHWAB CHARLES CORP NEW COM 6,659 8,380
    SELECTIVE INS GROUP INC DEP 5,571 5,581
    SHOPIFY INC CL A 405 3,396
    SIKA AG ADR 2,728 4,030
    SMITH & NEPHEW P L C SPONSORED ADR NEW 4,579 4,048
    SOUTHERN CO COM 2,669 2,767
    SOUTHERN CO JR SUB NTS 8,383 9,099
    SPIRE INC DEP SHS REPSTG 2,480 2,663
    STATE STR CORP 21,560 23,032
    STERIS PLC SHS 1,745 2,843
    TAIWAN SEMICONDUCTOR MFG CO SPONSORED ADR ISIN#US8740391003 2,488 8,178
    TENCENT HLDGS LTD ADR ISIN#US88032Q1094 2,610 4,385
    TRUIST FINL CORP 5,315 5,811
    UNION PAC CORP COM 4,606 8,537
    UNITED PARCEL SVC INC CL B 20,273 26,270
    UNITEDHEALTH GROUP INC COM 6,664 12,975
    UNUM GROUP JR 5,039 5,364
    US BANCORP DEL DEP 12,457 12,397
    US BANCORP DEL DEPOSITARY 3,392 3,704
    VALLEY NATL BANCORP NON CUM 6,167 6,366
    VALLEY NATL BANCORP PERP PFD 4,614 4,738
    VERISK ANALYTICS INC COM 3,754 9,757
    VERIZON COMMUNICATIONS INC 9,671 11,515
    VISA INC COM CL A 8,563 21,654
    VOYA FINL INC 17,274 19,116
    WELLSFARGO & CO 11,055 11,707
    WELLSFARGO & CO 17,227 18,067
    WELLSFARGO & CO NEW DEP DEC 15 2,692 2,875
    WINTRUST FNL CORP DEP 7,733 8,490

    TY 2020 InvestmentsGovtObligationsSch
    Name:
    SUSAN AND DAVID SAMRICK FAMILY
     
    FOUNDATION
    EIN:
    38-3507526
    US Government Securities - End of Year Book Value:

    271,207
    US Government Securities - End of Year Fair Market Value:

    274,987
    State & Local Government Securities - End of Year Book Value:


    0
    State & Local Government Securities - End of Year Fair Market Value:


    0


    TY 2020 InvestmentsOtherSchedule2
    Name:
    SUSAN AND DAVID SAMRICK FAMILY
     
    FOUNDATION
    EIN:
    38-3507526
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    AMERICAN TOWER REIT COM AT COST 12,916 25,364
    CROWN CASTLE INTL CORP NEW COM AT COST 12,434 17,193
    DIGITAL RLTY TR INC COM AT COST 6,505 6,417
    EXTRA SPACE STORAGE AT COST 7,516 9,848
    MILLER CONVERTIBLE BOND FUND CLASS I AT COST 186,840 215,446
    PROLOGIS INC COM AT COST 9,617 9,368
    FLORIDA FUND II LLC AT COST 72,459 72,459
    CAPITAL DYNAMICS GLOBAL AT COST 51,290 51,290
    MONROE CAPITAL OPPORTUNISTIC FUND AT COST 14,908 14,908
    DUE FROM SUSAN SAMRICK TRUST AT COST 93,750 93,750

    TY 2020 OtherExpensesSchedule
    Name:
    SUSAN AND DAVID SAMRICK FAMILY
     
    FOUNDATION
    EIN:
    38-3507526
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT EXPENSES 21 21   0
    K1 FLORIDA FUND II 2,541 2,541   0
    OTHER EXPENSE 10,817 0   0


    TY 2020 OtherProfessionalFeesSchedule
    Name:
    SUSAN AND DAVID SAMRICK FAMILY
     
    FOUNDATION
    EIN:
    38-3507526
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT FEES 23,433 23,433   0


    TY 2020 TaxesSchedule
    Name:
    SUSAN AND DAVID SAMRICK FAMILY
     
    FOUNDATION
    EIN:
    38-3507526
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAX WITHHELD 149 149   0