Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0052
2020
Open to Public Inspection
For calendar year 2020, or tax year beginning 01-01-2020 , and ending 12-31-2020
Name of foundation
Moccasin Lake Foundation
 
% Foundation Source
Number and street (or P.O. box number if mail is not delivered to street address)FOUNDATION SOURCE 501 SILVERSIDE RD
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
WILMINGTON, DE198091377
A Employer identification number

91-1545081
B Telephone number (see instructions)

(800) 839-1754
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$7,282,450J 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) 8,943,462
2 Check bullet.............
3 Interest on savings and temporary cash investments 656 656  
4 Dividends and interest from securities... 163,369 163,369  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 47,067
b Gross sales price for all assets on line 6a 936,650
7 Capital gain net income (from Part IV, line 2)... 47,067
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)....... Click to see attachment 1,182 1,182  
12 Total. Add lines 1 through 11........ 9,155,736 212,274  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0      
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule)......... Click to see attachment 25,000 0 0 25,000
b Accounting fees (attach schedule)....... Click to see attachment 8,250 0 0 8,250
c Other professional fees (attach schedule).... Click to see attachment 43,046 43,046    
17 Interest...............        
18 Taxes (attach schedule) (see instructions)...        
19 Depreciation (attach schedule) and depletion...      
20 Occupancy.............. 184     184
21 Travel, conferences, and meetings.......        
22 Printing and publications.......... 69     69
23 Other expenses (attach schedule)....... Click to see attachment 14,095 4   14,091
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 90,644 43,050 0 47,594
25 Contributions, gifts, grants paid....... 6,979,417 6,979,417
26 Total expenses and disbursements. Add lines 24 and 25 7,070,061 43,050 0 7,027,011
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 2,085,675
b Net investment income (if negative, enter -0-) 169,224
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............. 1,444,279    
2 Savings and temporary cash investments......... 57,225 3,358,555 3,358,555
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)....... 2,988,803 Click to see attachment3,129,975 3,923,895
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 4,490,307 6,488,530 7,282,450
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable................. 72,000  
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) Click to see attachment452  
23 Total liabilities (add lines 17 through 22)......... 72,452 0
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions...........    
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds 4,417,855 6,488,530
29 Total net assets or fund balances (see instructions)..... 4,417,855 6,488,530
30 Total liabilities and net assets/fund balances (see instructions). 4,490,307 6,488,530
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
4,417,855
2
Enter amount from Part I, line 27a .....................
2
2,085,675
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
6,503,530
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
15,000
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
6,488,530
Form 990-PF (2020)
Form 990-PF (2020)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1 a Publicly-traded Securities      
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 936,650   889,583 47,067
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       47,067
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 47,067
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 2,352
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 2,352
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 2,352
6 Credits/Payments:
a 2020 estimated tax payments and 2019 overpayment credited to 2020 6a 1,814
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 600
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 2,414
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. Click to see attachment 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 62
11 Enter the amount of line 10 to be: Credited to 2021 estimated taxBullet62 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? Click to see attachment....................
1a
Yes
 
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
Yes
 
If "Yes," attach the statement required by General Instruction T.Click to see attachment
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)
    bulletWA
    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 addressbullet  
    14
    The books are in care ofbulletFoundation Source Telephone no.bullet (800) 839-1754

    Located atbullet501 Silverside Road Suite 123WilmingtonDE ZIP+4bullet198091377
    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
     
     
    ........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
    Lisa P Anderson Dir
    1.0     		0 0 0
    FOUNDATION SOURCE 501 SILVERSIDE RD
    WILMINGTON,DE198091377
    Michael Anderson Dir, Treas
    1.0     		0 0 0
    FOUNDATION SOURCE 501 SILVERSIDE RD
    WILMINGTON,DE198091377
    Mark Kranwinkle Dir, VP
    1.0     		0 0 0
    FOUNDATION SOURCE 501 SILVERSIDE RD
    WILMINGTON,DE198091377
    Gaye T Pigott Dir
    1.0     		0 0 0
    FOUNDATION SOURCE 501 SILVERSIDE RD
    WILMINGTON,DE198091377
    James C Pigott Dir
    1.0     		0 0 0
    FOUNDATION SOURCE 501 SILVERSIDE RD
    WILMINGTON,DE198091377
    Maureen Dina Pigott Dir, Sec
    1.0     		0 0 0
    FOUNDATION SOURCE 501 SILVERSIDE RD
    WILMINGTON,DE198091377
    Paul Pigott Dir, Pres
    1.0     		0 0 0
    FOUNDATION SOURCE 501 SILVERSIDE RD
    WILMINGTON,DE198091377
    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
     
    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
     
    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
    3,573,087
    b
    Average of monthly cash balances.......................
    1b
    3,230,251
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    6,803,338
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    6,803,338
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    102,050
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    6,701,288
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    335,064
    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
    335,064
    2a
    Tax on investment income for 2020 from Part VI, line 5......
    2a
    2,352
    b
    Income tax for 2020. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    2,352
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    332,712
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    332,712
    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
    332,712
    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
    7,027,011
    b
    Program-related investments—total from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
    0
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
    0
    b
    Cash distribution test (attach the required schedule) .................
    3b
    0
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    7,027,011
    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
    7,027,011
    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 7 332,712
    2 Undistributed income, if any, as of the end of 2020:
    a Enter amount for 2019 only.......  
    b Total for prior years:2018, 2017, 2016  
    3 Excess distributions carryover, if any, to 2020:
    a From 2015...... 8,339,707
    b From 2016...... 9,370,130
    c From 2017...... 11,193,846
    d From 2018......  
    e From 2019......  
    fTotal of lines 3a through e........ 28,903,683
    4Qualifying distributions for 2020 from Part
    XII, line 4: bullet$ 7,027,011
    a Applied to 2019, but not more than line 2a  
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		 
    d Applied to 2020 distributable amount..... 332,712
    e Remaining amount distributed out of corpus 6,694,299
    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 35,597,982
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		 
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		 
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		 
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    f Undistributed income for 2020. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2021 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		 
    8 Excess distributions carryover from 2015 not
    applied on line 5 or line 7 (see instructions) ...     		8,339,707
    9Excess distributions carryover to 2021.
    Subtract lines 7 and 8 from line 6a ......     		27,258,275
    10 Analysis of line 9:
    a Excess from 2016.... 9,370,130
    b Excess from 2017.... 11,193,846
    c Excess from 2018....  
    d Excess from 2019....  
    e Excess from 2020.... 6,694,299
    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).)
    Gaye T Pigott
    James C Pigott
    MAUREEN DINA PIGOTT
    PAUL PIGOTT
    MARK KRANWINKLE
    MICHAEL ANDERSON
    LISA P ANDERSON
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    GRANT APPS TO Paul Pigott
    1405 42nd Avenue East
    Seattle,WA98112
    moccasinlakefoundation@gmail.com
    bThe form in which applications should be submitted and information and materials they should include:
    moccasinlakefoundation.org
    cAny submission deadlines:
    moccasinlakefoundation.org
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    moccasinlakefoundation.org
    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
    1448 PROJECTS
    11715 SAND POINT WAY NE
    SEATTLE,WA98125     		N/A PC General & Unrestricted 10,000
    5TH AVENUE THEATRE ASSOCIATION
    1308 5TH AVE
    SEATTLE,WA98101     		N/A PC General & Unrestricted 10,000
    AMERICAN JEWISH JOINT DISTRIBUTION COMMITTEE INC
    220 E 42ND ST STE 400
    NEW YORK,NY10017     		N/A PC General & Unrestricted 10,000
    AMERICAN NATIONAL RED CROSS
    209 FARMINGTON AVE
    FARMINGTON,CT06032     		N/A PC relief in Beirut, Lebanon 5,000
    Methow Valley School District
    18 Twin Lakes Road
    Winthrop,WA98862     		N/A GOV General & Unrestricted 92,000
    ARLINGTON KIDS KLOSET
    135 S FRENCH AVE STE C
    ARLINGTON,WA98223     		N/A PC General & Unrestricted 1,500
    ARTSFUND
    PO BOX 19780
    SEATTLE,WA98109     		N/A PC General & Unrestricted 40,000
    BARRIER ISLAND GROUP FOR THE ARTS
    900 DUNLOP RD
    SANIBEL,FL33957     		N/A PC Annual Benefit sponsorship 10,000
    BARRIER ISLAND GROUP FOR THE ARTS
    900 DUNLOP RD
    SANIBEL,FL33957     		N/A PC General & Unrestricted 50,000
    BARRIER ISLAND GROUP FOR THE ARTS
    900 DUNLOP RD
    SANIBEL,FL33957     		N/A PC Fine Arts Program 25,000
    BIKE WORKS SEATTLE
    3709 S FERDINAND ST
    SEATTLE,WA98118     		N/A PC General & Unrestricted 10,000
    BOYS & GIRLS CLUB OF KING COUNTY - RENTON SKYWAY B
    603 STEWART ST SUITE 300
    SEATTLE,WA98101     		N/A PC General & Unrestricted 10,000
    BUILDING CHANGES
    1200 12TH AVE S STE 1200
    SEATTLE,WA98144     		N/A PC General & Unrestricted 50,000
    BUILDING CHANGES
    1200 12TH AVE S STE 1200
    SEATTLE,WA98144     		N/A PC Washington State Student and Youth Homelessness COVID-19 Response Fund 25,000
    BYRD BARR PLACE
    722 18TH AVE
    SEATTLE,WA98122     		N/A PC General & Unrestricted 10,000
    BYRD BARR PLACE
    722 18TH AVE
    SEATTLE,WA98122     		N/A PC to buy two months worth of food 30,000
    CANCER LIFELINE OF KING COUNTY
    6522 FREMONT AVE N
    SEATTLE,WA98103     		N/A PC General & Unrestricted 4,000
    CANCER PATHWAYS
    1400 BROADWAY
    SEATTLE,WA98122     		N/A PC General & Unrestricted 10,000
    CAPTIVA ISLAND HISTORICAL SOCIETY
    PO BOX 163
    CAPTIVA,FL33924     		N/A PC General & Unrestricted 12,000
    CASCADE BICYCLE CLUB
    7787 62ND AVE NE
    SEATTLE,WA98115     		N/A PC General & Unrestricted 1,000
    CASCADIA METHOW MUSIC ASSOCIATION
    PO BOX 1013
    TWISP,WA98856     		N/A PC General & Unrestricted 10,000
    CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON
    100 23RD AVE S
    SEATTLE,WA98144     		N/A PC in support of St. Martin de Porres Shelter 3,000
    CCA FOUNDATION INC
    PO BOX 775
    CAPTIVA,FL33924     		N/A PC General & Unrestricted 1,000
    CENTER FOR COMMUNITY SERVICE FUND
    1301 5TH AVE STE 1500
    SEATTLE,WA98101     		N/A PC Keep Workers Healthy and Safe Fund 50,000
    CHILD CARE RESOURCES
    1225 S WELLER ST STE 300
    SEATTLE,WA98144     		N/A PC COVID Response and Referral Center 50,000
    CHILDHAVEN
    316 BROADWAY
    SEATTLE,WA98122     		N/A PC General & Unrestricted 5,000
    CHILDREN AND YOUTH JUSTICE CENTER
    300 ELLIOTT AVE W STE 360
    SEATTLE,WA98119     		N/A PC WA State Girls' Court 50,000
    CLASSICAL 98 1
    363 MERCER ST NO 200
    SEATTLE,WA98109     		N/A PC General & Unrestricted 1,000
    CLASSROOM IN BLOOM
    PO BOX 1264
    WINTHROP,WA98862     		N/A PC General & Unrestricted 2,500
    CLIMATE SOLUTIONS
    1402 THIRD AVE SUITE 1305
    SEATTLE,WA98101     		N/A PC General & Unrestricted 4,000
    COLLEGE SUCCESS FOUNDATION
    15500 SE 30TH PL STE 200
    BELLEVUE,WA98007     		N/A PC General & Unrestricted 30,000
    COMMUNITY FOUNDATION OF NORTH CENTRAL WASHINGTON
    9 S WENATCHEE AVE
    WENATCHEE,WA98801     		N/A PC Methow Valley Community Fund 30,000
    COMMUNITY FOUNDATION OF NORTH CENTRAL WASHINGTON
    9 S WENATCHEE AVE
    WENATCHEE,WA98801     		N/A PC for Fire Relief Fund 100,000
    COMMUNITY FOUNDATION OF NORTH CENTRAL WASHINGTON
    9 S WENATCHEE AVE
    WENATCHEE,WA98801     		N/A PC General & Unrestricted 1,000
    COMMUNITY RESOURCES FOUNDATION
    9612 271ST ST NW
    STANWOOD,WA98292     		N/A PC General & Unrestricted 7,500
    CONFLUENCE GALLERY AND ART CENTER
    PO BOX 716
    TWISP,WA98856     		N/A PC General & Unrestricted 5,000
    CONSERVATION INTERNATIONAL FOUNDATION
    2011 CRYSTAL DRIVE STE 600
    ARLINGTON,VA22202     		N/A PC Pacific Oceanscape 1,000,000
    DEFENDERS OF WILDLIFE
    1130 17TH ST NW
    WASHINGTON,DC20036     		N/A PC General & Unrestricted 10,000
    DEGREES OF CHANGE
    PO BOX 1573
    TACOMA,WA98401     		N/A PC General & Unrestricted 25,000
    DING DARLING WILDLIFE SOCIETY INC
    1 WILDLIFE DR
    SANIBEL,FL33957     		N/A PC General & Unrestricted 5,000
    DONORSCHOOSE ORG
    134 W 37TH ST 11TH FL
    NEW YORK,NY10018     		N/A PC for Keep Kids Learning 2,500
    DOWNTOWN EMERGENCY SERVICE CENTER
    515 3RD AVE
    SEATTLE,WA98104     		N/A PC General & Unrestricted 1,000
    EARTHJUSTICE
    50 CALIFORNIA ST SUITE 500
    SAN FRANCISCO,CA94111     		N/A PC General & Unrestricted 100,000
    EMERGENCY FOOD NETWORK INC
    PO BOX 4373
    CHARLOTTESVILLE,VA22905     		N/A PC General & Unrestricted 10,000
    EVERGREEN CHILDRENS ASSOCIATION
    2208 NW MARKET ST STE 510
    SEATTLE,WA98107     		N/A PC General & Unrestricted 5,000
    FAMILY LAW CASA OF KING COUNTY
    810 THIRD AVE SUITE 700
    SEATTLE,WA98104     		N/A PC General & Unrestricted 2,000
    FARESTART
    700 VIRGINIA ST
    SEATTLE,WA98101     		N/A PC General & Unrestricted 63,400
    FIRST CHANCE INDUSTRIES
    1615 43RD AVE E APT 301
    SEATTLE,WA98112     		N/A PC General & Unrestricted 5,000
    FISH OF SANIBEL-CAPTIVA INC
    2430-B PERIWINKLE WAY
    SANIBEL,FL33957     		N/A PC General & Unrestricted 400,000
    FRED HUTCHINSON CANCER RESEARCH CENTER
    1100 FAIRVIEW AVE N PO BOX 19024
    SEATTLE,WA98109     		N/A PC General & Unrestricted 500
    FRIENDS OF THE WINTHROP PUBLIC LIBRARY
    PO BOX 592
    WINTHROP,WA98862     		N/A PC General & Unrestricted 250,000
    FRIENDS OF UNFPA INC
    605 3RD AVE 4TH FL
    NEW YORK,NY10158     		N/A PC General & Unrestricted 5,000
    GLOBAL PARTNERSHIPS
    1932 1ST AVE
    SEATTLE,WA98101     		N/A PC General & Unrestricted 50,000
    GREATER MAPLE VALLEY COMMUNITY CENTER
    22010 SE 248TH ST
    MAPLE VALLEY,WA98038     		N/A PC General & Unrestricted 5,000
    GREEN PLATE SPECIAL
    2115 25TH AVE S
    SEATTLE,WA98144     		N/A PC General & Unrestricted 10,000
    HARVEST AGAINST HUNGER
    1201 LST AVE SOUTH STE 327
    SEATTLE,WA98134     		N/A PC General & Unrestricted 20,000
    HISTORICAL SOCIETY OF SEATTLE & KING COUNTY
    PO BOX 80816
    SEATTLE,WA98108     		N/A PC General & Unrestricted 4,000
    HOPELINK
    PO BOX 3577
    REDMOND,WA98073     		N/A PC General & Unrestricted 4,000
    INDEPENDENT COLLEGES OF WASHINGTON
    600 STEWART ST STE 600
    SEATTLE,WA98101     		N/A PC General & Unrestricted 25,000
    INTERNATIONAL COMMUNITY HEALTH SERVICES
    720 8TH AVE S STE 100
    SEATTLE,WA98104     		N/A PC Seattle World upper school 100,000
    INVESTED
    606 OAKESDALE AVE SW NO C-202
    RENTON,WA98057     		N/A PC COVID-19 Student Fund 100,000
    ISSAQUAH FOOD & CLOTHING BANK
    179 1ST AVE SE
    ISSAQUAH,WA98027     		N/A PC General & Unrestricted 5,000
    JUNIOR ACHIEVEMENT OF WASHINGTON
    1610 PERIMETER RD
    AUBURN,WA98001     		N/A PC General & Unrestricted 10,000
    JEWISH FAMILY SERVICE
    1601 16TH AVE
    SEATTLE,WA98122     		N/A PC General & Unrestricted 10,000
    JUNIOR ACHIEVEMENT OF WASHINGTON
    1610 PERIMETER RD
    AUBURN,WA98001     		N/A PC General & Unrestricted 52,000
    KINDERING CENTER
    16120 NE 8TH ST
    BELLEVUE,WA98008     		N/A PC General & Unrestricted 25,000
    KING COUNTY LIBRARY SYSTEM FOUNDATION
    960 NEWPORT WAY NW
    ISSAQUAH,WA98027     		N/A PC General & Unrestricted 100,000
    LIGHTHOUSE FOR THE BLIND INC
    2501 S PLUM ST
    SEATTLE,WA98144     		N/A PC General & Unrestricted 6,000
    LITTLE STAR SCHOOL MONTESSORI
    PO BOX 608
    WINTHROP,WA98862     		N/A PC General & Unrestricted 15,000
    LOUP LOUP SKI EDUCATION FOUNDATION
    PO BOX 1187
    TWISP,WA98856     		N/A PC General & Unrestricted 50,000
    MEDECINS SANS FRONTIERES USA INC - DOCTORS WITHOUT
    PO BOX 5030
    HAGERSTOWN,MD21741     		N/A PC General & Unrestricted 50,000
    MEDIC ONE FOUNDATION
    11747 NE 1ST ST STE 310
    BELLEVUE,WA98005     		N/A PC General & Unrestricted 500
    METHOW ARTS ALLIANCE
    PO BOX 723
    TWISP,WA98856     		N/A PC General & Unrestricted 2,000
    METHOW AT HOME
    PO BOX 352
    TWISP,WA98856     		N/A PC General & Unrestricted 10,000
    METHOW CONSERVANCY
    PO BOX 71
    WINTHROP,WA98862     		N/A PC for Farms to Neighbors 2,500
    METHOW CONSERVANCY
    PO BOX 71
    WINTHROP,WA98862     		N/A PC for farms to neighbors 500
    METHOW FIELD INSTITUTE
    PO BOX 771
    TWISP,WA98856     		N/A PC General & Unrestricted 1,000
    METHOW MUSIC FESTIVAL ASSOCIATION
    PO BOX 249
    WINTHROP,WA98862     		N/A PC General & Unrestricted 15,000
    METHOW RECYCLES
    PO BOX 1057
    TWISP,WA98856     		N/A PC General & Unrestricted 66,500
    METHOW VALLEY CITIZENS COUNCIL
    PO BOX 774
    TWISP,WA98856     		N/A PC General & Unrestricted 10,000
    METHOW VALLEY COMMUNITY CENTER ASSOCIATION
    PO BOX 565
    TWISP,WA98856     		N/A PC General & Unrestricted 5,000
    METHOW VALLEY EDUCATION FOUNDATION
    PO BOX 40
    WINTHROP,WA98862     		N/A PC General & Unrestricted 10,000
    METHOW VALLEY FAMILY HOME CENTER ASSOCIATION
    PO BOX 1260
    WINTHROP,WA98862     		N/A PC Directed to Jamie's Place 25,000
    METHOW VALLEY HOME HEALTH AGENCY
    PO BOX 66
    TWISP,WA98856     		N/A PC General & Unrestricted 275,000
    METHOW VALLEY RIDING UNLIMITED
    PO BOX 58
    WINTHROP,WA98862     		N/A PC General & Unrestricted 14,900
    MISSION AVIATION FELLOWSHIP
    PO BOX 47
    NAMPA,ID83653     		N/A PC AGAPE/Hurricane Relief 2,500
    NATIONAL MULTIPLE SCLEROSIS SOCIETY
    733 THIRD AVE
    NEW YORK,NY10017     		N/A PC General & Unrestricted 10,000
    NATIONAL WORLD WAR II MUSEUM INC
    945 MAGAZINE ST
    NEW ORLEANS,LA70130     		N/A PC General & Unrestricted 25,000
    NEW BEGINNINGS
    PO BOX 75125
    SEATTLE,WA98175     		N/A PC General & Unrestricted 1,500
    NORTHWEST HARVEST E M M
    PO BOX 12272
    SEATTLE,WA98102     		N/A PC General & Unrestricted 55,000
    NOURISH PIERCE COUNTY
    1702 S 72ND ST STE E
    TACOMA,WA98408     		N/A PC staffing assistance 20,000
    NOURISH PIERCE COUNTY
    1702 S 72ND ST STE E
    TACOMA,WA98408     		N/A PC General & Unrestricted 5,000
    NW CHILDRENS FOUNDATION
    2100 24TH AVE S STE 320
    SEATTLE,WA98144     		N/A PC General & Unrestricted 60,000
    OKANOGAN COUNTY ANIMAL FOSTER CARE ASSOCIATION
    PO BOX 3385
    OMAK,WA98841     		N/A PC General & Unrestricted 10,000
    OKANOGAN COUNTY HISTORICAL SOCIETY INCORPORATED
    PO BOX 1129
    OKANOGAN,WA98840     		N/A PC Shafer Historical Museum 5,000
    OKANOGAN LAND TRUST
    PO BOX 325
    OKANOGAN,WA98840     		N/A PC General & Unrestricted 1,000
    OVERLAKE SERVICE LEAGUE DBA BELLEVUE LIFESPRING
    302 BELLEVUE SQ
    BELLEVUE,WA98004     		N/A PC Safeway food voucher program 10,000
    OVERLAKE SERVICE LEAGUE DBA BELLEVUE LIFESPRING
    302 BELLEVUE SQ
    BELLEVUE,WA98004     		N/A PC General & Unrestricted 5,000
    PACIFIC LEGAL FOUNDATION
    555 CAPITOL MALL STE 1290
    SACRAMENTO,CA95814     		N/A PC General & Unrestricted 15,000
    PACIFIC SCIENCE CENTER FOUNDATION
    200 2ND AVE N
    SEATTLE,WA98109     		N/A PC General & Unrestricted 100,000
    PAGE AHEAD CHILDRENS LITERACY PRGM
    1130 NW 85TH ST
    SEATTLE,WA98117     		N/A PC General & Unrestricted 60,000
    PATH
    2201 WESTLAKE AVE STE 200
    SEATTLE,WA98121     		N/A PC General & Unrestricted 10,000
    PLANNED PARENTHOOD OF THE GREAT NORTHWEST AND THE
    2001 E MADISON ST
    SEATTLE,WA98122     		N/A PC General & Unrestricted 200,000
    PLYMOUTH HOUSING GROUP
    2113 3RD AVE
    SEATTLE,WA98121     		N/A PC Key to Hope Challenge Fund 1,000
    PROVIDENCE MOUNT ST VINCENT FOUNDATION
    4831 35TH AVE SW
    SEATTLE,WA98126     		N/A PC General & Unrestricted 4,000
    RAINIER SCHOLARS
    2100 24TH AVE S STE 360
    SEATTLE,WA98144     		N/A PC General & Unrestricted 5,000
    RECOVERY CAFE
    2022 BOREN AVE
    SEATTLE,WA98121     		N/A PC General & Unrestricted 5,000
    ROOM ONE
    PO BOX 222
    TWISP,WA98856     		N/A PC General & Unrestricted 60,000
    RUSSIAN-UNITED STATES LEGAL EDUCATION FOUNDATION
    PO BOX 626
    SANIBEL,FL33957     		N/A PC General & Unrestricted 1,000
    SANIBEL COMMUNITY ASSOCIATION INC
    2173 PERIWINKLE WAY
    SANIBEL,FL33957     		N/A PC General & Unrestricted 1,000
    SANIBEL PUBLIC LIBRARY FOUNDATION INC
    770 DUNLOP RD
    SANIBEL,FL33957     		N/A PC General & Unrestricted 1,000
    SANIBEL-CAPTIVA CONSERVATION FOUNDATION INC
    PO BOX 839
    SANIBEL,FL33957     		N/A PC General & Unrestricted 20,000
    SAVE THE CHILDREN FEDERATION INC
    501 KINGS HWY EAST STE 400
    FAIRFIELD,CT06825     		N/A PC for Eastern Washingon programming support 225,000
    SAWHORSE REVOLUTION
    801 2ND AVE
    SEATTLE,WA98104     		N/A PC General & Unrestricted 10,000
    SCHOOLS OUT WASHINGTON
    801 23RD AVE S STE A
    SEATTLE,WA98144     		N/A PC General & Unrestricted 32,500
    SEATTLE ART MUSEUM
    1300 1ST AVE
    SEATTLE,WA98101     		N/A PC General & Unrestricted 25,000
    Swedish Medical Center Foundation
    747 BROADWAY
    SEATTLE,WA98122     		N/A PC To Support the Ben & Catherine Ivy Center for Advanced Brain Tumor Treatment 10,000
    SEATTLE CHILDRENS HOSPITAL FOUNDATION
    PO BOX 5371 MAIL STOP S-200
    SEATTLE,WA98145     		N/A PC General & Unrestricted 15,000
    SEATTLE CHILDRENS THEATRE ASSOCIATION
    201 THOMAS ST
    SEATTLE,WA98109     		N/A PC in support of the artist in residence partnership at Bailey Gatzert Elementary School 20,000
    SEATTLE CLEMENCY PROJECT
    1126 34TH AVE STE 208
    SEATTLE,WA98122     		N/A PC General & Unrestricted 50,000
    SEATTLE MILK FUND
    1631 15TH AVE W STE 116
    SEATTLE,WA98119     		N/A PC General & Unrestricted 3,000
    SEATTLE PARKS FOUNDATION
    105 SOUTH MAIN ST 235
    SEATTLE,WA98104     		N/A PC General & Unrestricted 10,000
    SEATTLE PUBLIC LIBRARY FOUNDATION
    1000 4TH AVE
    SEATTLE,WA98104     		N/A PC General & Unrestricted 10,000
    SEATTLE THEATRE GROUP
    911 PINE ST
    SEATTLE,WA98101     		N/A PC General & Unrestricted 5,000
    SEATTLE UNIVERSITY
    901 12TH AVE
    SEATTLE,WA98122     		N/A PC for President's Student Hardship Fund 100,000
    SEATTLES UNION GOSPEL MISSION
    PO BOX 202
    SEATTLE,WA98111     		N/A PC General & Unrestricted 8,000
    SHARED HOPE INTERNATIONAL
    PO BOX 65337
    VANCOUVER,WA98665     		N/A PC General & Unrestricted 505,000
    SHELL MUSEUM AND EDUCATIONAL FOUNDATION INC
    PO BOX 1580
    SANIBEL,FL33957     		N/A PC General & Unrestricted 5,000
    SHUNPIKE ARTS COLLECTIVE dba SHUNPIKE
    815 SEATTLE BLVD S STE 215
    SEATTLE,WA98134     		N/A PC in support of MAP Theatre 500
    SOUTHEAST ALASKA CONSERVATION COUNCIL INC-SEACC
    2207 JORDAN AVE
    JUNEAU,AK99801     		N/A PC General & Unrestricted 50,000
    SPECIAL OLYMPICS WASHINGTON
    2815 2ND AVE STE 370
    SEATTLE,WA98121     		N/A PC General & Unrestricted 1,000
    ST FRANCIS HOUSE
    PO BOX 22444
    SEATTLE,WA98122     		N/A PC General & Unrestricted 4,000
    THE COMMON ACRE
    309 PONTIUS AVE N
    SEATTLE,WA98109     		N/A PC General & Unrestricted 10,000
    THE COVE
    PO BOX 895
    TWISP,WA98856     		N/A PC General & Unrestricted 35,000
    THE EVERGLADES FOUNDATION INC
    18001 OLD CUTLER RD STE 625
    PALMETTO BAY,FL33157     		N/A PC General & Unrestricted 50,000
    THE FOODBANK AT ST MARYS
    611 20TH AVE S
    SEATTLE,WA98144     		N/A PC General & Unrestricted 15,000
    THE SALVATION ARMY
    111 QUEEN ANNE AVE N STE 300
    SEATTLE,WA98109     		N/A PC General & Unrestricted 3,000
    THE SANIBEL HISTORICAL MUSEUM AND VILLAGE INC
    PO BOX 413
    SANIBEL,FL33957     		N/A PC General & Unrestricted 1,000
    THE SEATTLE FOUNDATION
    1601 5TH AVE STE 1900
    SEATTLE,WA98101     		N/A PC for Methow Valley School District 153,000
    THE SEATTLE FOUNDATION
    1601 5TH AVE STE 1900
    SEATTLE,WA98101     		N/A PC For Little Star Montessori School 500,404
    THE SEATTLE FOUNDATION
    1601 5TH AVE STE 1900
    SEATTLE,WA98101     		N/A PC For Little Star Montessori School 7,713
    THE SEATTLE FOUNDATION
    1601 5TH AVE STE 1900
    SEATTLE,WA98101     		N/A PC COVID-19 Response Fund 100,000
    THEATRE22
    16901 22ND AVE NE
    SHORELINE,WA98155     		N/A PC General & Unrestricted 1,000
    TURNING POINT SEATTLE
    1315 N 160TH ST
    SHORELINE,WA98133     		N/A PC General & Unrestricted 1,000
    TWISPWORKS FOUNDATION
    PO BOX 264
    TWISP,WA98856     		N/A PC for Small Business Emergency Grant 25,000
    TWISPWORKS FOUNDATION
    PO BOX 264
    TWISP,WA98856     		N/A PC General & Unrestricted 150,000
    UNITED WAY OF LEE COUNTY INC
    7273 CONCOURSE DR
    FORT MYERS,FL33908     		N/A PC General & Unrestricted 25,000
    URBAN LEAGUE OF METROPOLITAN SEATTLE
    105 14TH AVE STE 200
    SEATTLE,WA98122     		N/A PC for Workforce Development programs 5,000
    WASHINGTON ENVIRONMENTAL COUNCIL
    1402 THIRD AVE SUITE 1400
    SEATTLE,WA98101     		N/A PC General & Unrestricted 50,000
    WELLSPRING FAMILY SERVICES
    1900 RAINIER AVE S
    SEATTLE,WA98144     		N/A PC General & Unrestricted 2,000
    WEST SEATTLE FOOD BANK
    3419 SW MORGAN ST
    SEATTLE,WA98126     		N/A PC Eviction Relief 30,000
    WEST SEATTLE FOOD BANK
    3419 SW MORGAN ST
    SEATTLE,WA98126     		N/A PC General & Unrestricted 10,000
    WILD SALMON CENTER
    721 NW NINTH AVE STE 300
    PORTLAND,OR97209     		N/A PC General & Unrestricted 10,000
    WINTHROP KIWANIS FOUNDATION
    PO BOX 286
    WINTHROP,WA98862     		N/A PC in support of MVSD Family Empowerment Fund 50,000
    WOODLAND PARK ZOOLOGICAL SOCIETY
    5500 PHINNEY AVE N
    SEATTLE,WA98103     		N/A PC General & Unrestricted 10,000
    WORLD AFFAIRS COUNCIL
    2200 ALASKAN WAY STE 450
    SEATTLE,WA98121     		N/A PC General & Unrestricted 5,000
    WORLD WILDLIFE FUND
    600 NORTH 36TH ST
    SEATTLE,WA98103     		N/A PC Demand Reduction initiative 10,000
    YEAR UP INC - SEATTLE CHAPTER
    2607 2ND AVE
    SEATTLE,WA98121     		N/A PC General & Unrestricted 50,000
    YOUTHCARE
    2500 NE 54TH ST
    SEATTLE,WA98105     		N/A PC General & Unrestricted 49,500
    YOUTHCARE
    2500 NE 54TH ST
    SEATTLE,WA98105     		N/A PC YouthBuild Program 100,000
    YWCA OF SEATTLE-KING COUNTY- SNOHOMISH COUNTY
    1118 FIFTH AVE
    SEATTLE,WA98101     		N/A PC General & Unrestricted 10,000
    Total .................................bullet 3a 6,979,417
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3 Interest on savings and temporary cash
    investments ...........     		    14 656  
    4 Dividends and interest from securities....     14 163,369  
    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 47,067  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue:
    aK-1 Inc/Loss     		    14 1,182  
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e)..   212,274  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    212,274
    (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
    Moccasin Lake Foundation
     
    Employer identification number

    91-1545081
    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
    Moccasin Lake Foundation
          		Employer identification number
    91-1545081
    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
    James C Pigott 2005 CLAT
    1405 42ND AVENUE EAST
     
    Seattle, WA98112

    		$ 375,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    2
    James C Pigott 2005 CLUT
    1405 42ND AVENUE EAST
     
    Seattle, WA98112

    		$ 243,370


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    3
    James C Pigott 2012 CLUT
    1405 42ND AVENUE EAST
     
    Seattle, WA98112

    		$ 2,725,092


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    4
    Pigott Gaye T
    1405 42nd Ave E
     
    Seattle, WA98112

    		$ 2,100,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    5
    Pigott James C
    1405 42nd Ave E
     
    Seattle, WA98112

    		$ 3,500,000


    (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.)
    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
    Moccasin Lake Foundation
          		Employer identification number

    91-1545081
    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
    Moccasin Lake Foundation
          		Employer identification number

    91-1545081
    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:
    Moccasin Lake Foundation
    EIN:
    91-1545081
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    General Consultations 750     750
    Tax Return Preparation/Review 7,500     7,500

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

    TY 2020 DepreciationSchedule
    Name:
    Moccasin Lake Foundation
    EIN:
    91-1545081
    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

    TY 2020 ExplanOfLegisPoliticalActvts
    Name:
    Moccasin Lake Foundation
    EIN:
    91-1545081
    Explanation:
     

    TY 2020 InvestmentsCorpStockSchedule
    Name:
    Moccasin Lake Foundation
    EIN:
    91-1545081
    Name of Stock End of Year Book Value End of Year Fair Market Value
    PACCAR INC 2,988,803 3,742,998
    RAYTHEON TECHNOLOGIES CORP 132,239 170,909
    VERIZON COMMUNICATIONS 8,933 9,988

    TY 2020 LiquidationExplanationStmt
    Name:
    Moccasin Lake Foundation
    EIN:
    91-1545081
    Statement:
    AS EXPLAINED BELOW, THE FOUNDATION HAS NO PLANS FOR DISSOLUTION. THIS STATEMENT IS SUBMITTED TO REPORT THE DISTRIBUTION OF CERTAIN ASSETS DURING THE YEAR. THE DISTRIBUTIONS RESULTED IN A SUBSTANTIAL CONTRACTION OF ASSETS. THE FOLLOWING INFORMATION IS SUBMITTED IN ACCORDANCE WITH TREASURY REGULATION SECTION 1.6043-3(A)(1) AND THE FORM 990-PF INSTRUCTIONS: DURING THE TAXABLE YEAR ENDING DECEMBER 31, 2020, THE FOUNDATION MADE DISTRIBUTIONS FROM ASSETS FROM SOURCES OTHER THAN CURRENT INCOME. COLLECTIVELY, THE DISTRIBUTIONS IN EXCESS OF CURRENT INCOME TOTALED $6,979,417. THIS AMOUNT REPRESENTS 25% OR MORE OF THE FOUNDATION'S NET ASSETS OF $8,365,404 (AS MEASURED BY FAIR MARKET VALUE) AT THE BEGINNING OF THE FOUNDATION'S TAXABLE YEAR ENDING DECEMBER 31, 2020. ALTHOUGH THE FOUNDATION TECHNICALLY EXPERIENCED A SUBSTANTIAL CONTRACTION, IT WILL CONTINUE IN EXISTENCE AND HAS NO PLANS FOR DISSOLUTION. THE FOUNDATION MADE DISTRIBUTIONS OF CASH TO THE GRANTEES LISTED IN THE ATTACHMENT TO PART XV, LINE 3A; EACH SUCH GRANT WAS MADE SOLELY FOR THE CHARITABLE PURPOSE SPECIFIED THEREIN.


    TY 2020 LegalFeesSchedule
    Name:
    Moccasin Lake Foundation
    EIN:
    91-1545081
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    General Consultations 25,000     25,000


    TY 2020 OtherDecreasesSchedule
    Name:
    Moccasin Lake Foundation
    EIN:
    91-1545081
    Description Amount
    PRIOR PERIOD ADJUSTMENT 15,000


    TY 2020 OtherExpensesSchedule
    Name:
    Moccasin Lake Foundation
    EIN:
    91-1545081
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Administrative Fees 587     587
    Administrative Set-Up Fee 9,500     9,500
    Indemnification Insurance 2,090     2,090
    K-1 Exp LAZARD LTD 4 4    
    Office Supplies 156     156
    Postage/Delivery Service 108     108
    State or Local Filing Fees 35     35
    Website Hosting/Support 1,615     1,615


    TY 2020 OtherIncomeSchedule2
    Name:
    Moccasin Lake Foundation
    EIN:
    91-1545081
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    K-1 Inc/Loss LAZARD LTD 1,182 1,182  


    TY 2020 OtherLiabilitiesSchedule
    Name:
    Moccasin Lake Foundation
    EIN:
    91-1545081
    Description Beginning of Year - Book Value End of Year - Book Value
    DEFERRED INCOME 452  


    TY 2020 OtherProfessionalFeesSchedule
    Name:
    Moccasin Lake Foundation
    EIN:
    91-1545081
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Investment Management Services 43,046 43,046