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. 1545-0047
2021
Open to Public Inspection
For calendar year 2021, or tax year beginning 07-01-2021 , and ending 06-30-2022
Name of foundation
THE KLEIN FAMILY FOUNDATION INC
 
Number and street (or P.O. box number if mail is not delivered to street address)MCCABE HEIDRICH WONG 4 GATEHALL
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
PARSIPPANY, NJ070544518
A Employer identification number

52-1705026
B Telephone number (see instructions)

(973) 605-1040
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$5,438,537
J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books
(b) Net investment
income
(c) Adjusted net
income
(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet.............
3 Interest on savings and temporary cash investments 103 103  
4 Dividends and interest from securities... 104,994 104,994  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 269,138
b Gross sales price for all assets on line 6a 518,682
7 Capital gain net income (from Part IV, line 2)... 269,138
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........ 374,235 374,235  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 50,000 5,000   45,000
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... 8,900 7,900   1,000
c Other professional fees (attach schedule)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... 8,338 1,689   0
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... 45,610 45,610   0
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 112,848 60,199   46,000
25 Contributions, gifts, grants paid....... 325,000 325,000
26 Total expenses and disbursements. Add lines 24 and 25 437,848 60,199   371,000
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -63,613
b Net investment income (if negative, enter -0-) 314,036
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
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......... 175,287 70,249 70,249
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)....... 3,586,780 Click to see attachment3,628,205 5,368,288
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) 3,762,067 3,698,454 5,438,537
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........... 3,762,067 3,698,454
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)..... 3,762,067 3,698,454
30 Total liabilities and net assets/fund balances (see instructions). 3,762,067 3,698,454
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
3,762,067
2
Enter amount from Part I, line 27a .....................
2
-63,613
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
3,698,454
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
3,698,454
Form 990-PF (2021)
Form 990-PF (2021)
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 200 SHS DIAGEO PLC P 2016-10-06 2021-08-16
b 100 SHS ALBEMARLE CORP P 2017-02-17 2021-08-16
c 300 SHS BRUNSWICK CORP P 2016-10-06 2021-08-16
d 100 SHS PAYPAL HOLDINGS INC P 2016-11-15 2021-08-16
e 100 SHS PAYPAL HOLDINGS INC P 2016-12-09 2021-08-16
220 SHS STERIS PLC P 1950-01-01 2021-08-16
500 SHS BRUNSWICK CORP P 2016-10-06 2021-12-27
350 SHS FEDEX CORP P 2016-10-06 2021-12-27
350 SHS FEDEX CORP P 2016-11-15 2021-12-27
400 SHS PAYCHEX INC P 2016-10-06 2021-12-27
100 SHS SYNOPSYS INC P 2016-10-06 2021-12-27
0.1 SHS ZIMVIE INC P 1950-01-01 2022-03-01
(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 40,210   22,809 17,401
b 22,513   9,187 13,326
c 31,621   14,656 16,965
d 27,833   3,914 23,919
e 27,833   3,957 23,876
48,809   16,620 32,189
48,835   24,427 24,408
89,935   60,680 29,255
89,935   64,742 25,193
53,822   22,602 31,220
37,332   5,948 31,384
4   2 2
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       17,401
b       13,326
c       16,965
d       23,919
e       23,876
      32,189
      24,408
      29,255
      25,193
      31,220
      31,384
      2
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 2 269,138
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  
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
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 All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) 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 4,365
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 4,365
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 5,000
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 5,000
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. Click to see attachment 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 10 635
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet635 RefundedBullet 11 0
Part VI-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 XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bullet
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .Click to see attachment
    8b
     
    No
    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 2021 or the taxable year beginning in 2021? See the instructions for Part XIII.
    If "Yes," complete Part XIII .............................
    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 (2021)
    Form 990-PF (2021)
    Page 5
    Part VI-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 ofbulletANTOINETTE GEYELIN Telephone no.bullet (973) 605-1040

    Located atbulletC/O MHW 4 GATEHALL DRPARSIPPANYNJ ZIP+4bullet070544518
    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 2021, 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 VI-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? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
    Yes
     
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
    Yes
     
    (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)? ......................
    1a(5)
     
    No
    (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.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
    No
    c
    ........bullet
    d
    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 2021? .............
    1d
     
    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 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    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? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 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 2021.) .....................
    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 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-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))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    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
     
     
    c
    .........bullet
    d
    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? .................
    5d
     
     
    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? .............................
    6a
     
    No
    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?
    7a
     
    No
    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? .........................
    8
     
    No
    Part VII
    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
    ANTOINETTE GEYELIN PRES./TREAS. AND TRUSTEE
    15.00
    50,000 0 0
    C/O MCCABE HEIDRICH WONG 4 GATEHALL
    DR
    PARSIPPANY,NJ07054
    JUDITH ALBERT VICE PRES. AND TRUSTEE
    0.50
    0 0 0
    C/O MCCABE HEIDRICH WONG 4 GATEHALL
    DR
    PARSIPPANY,NJ07054
    JENNIFER KLEIN SEAMAN VICE PRES./SECRETARY AND T
    0.50
    0 0 0
    C/O MCCABE HEIDRICH WONG 4 GATEHALL
    DR
    PARSIPPANY,NJ07054
    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 (2021)
    Form 990-PF (2021)
    Page 7
    Part VII
    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 VIII-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 VIII-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 (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    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
    6,304,571
    b
    Average of monthly cash balances.......................
    1b
    320,330
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    6,624,901
    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
    6,624,901
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    99,374
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    6,525,527
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    326,276
    Part X
    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 IX, line 6..................
    1
    326,276
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    4,365
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    4,365
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    321,911
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    321,911
    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 XII, line 1 ...
    7
    321,911
    Part XI
    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
     
    b
    Program-related investments—total from Part VIII-B..................
    1b
     
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part XII, line 4.
    4
     
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 9
    Part XII
    Undistributed Income (see instructions)
    (a)
    Corpus
    (b)
    Years prior to 2020
    (c)
    2020
    (d)
    2021
    1 Distributable amount for 2021 from Part X, line 7 321,911
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 0
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016......  
    b From 2017......  
    c From 2018......  
    d From 2019......  
    e From 2020...... 113,358
    f Total of lines 3a through e ........ 113,358
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 371,000
    a Applied to 2020, 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 2021 distributable amount..... 321,911
    e Remaining amount distributed out of corpus 49,089
    5 Excess distributions carryover applied to 2021. 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 5 162,447
    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 2021. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2022 ..........
    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 2016 not
    applied on line 5 or line 7 (see instructions) ...
    0
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......
    162,447
    10 Analysis of line 9:
    a Excess from 2017....  
    b Excess from 2018....  
    c Excess from 2019....  
    d Excess from 2020.... 113,358
    e Excess from 2021.... 49,089
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 10
    Part XIII
    Private Operating Foundations (see instructions and Part VI-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 2021, 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) 2021 (b) 2020 (c) 2019 (d) 2018
             
    b 85% (0.85) of line 2a .........          
    c Qualifying distributions from Part XI,
    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 IX, 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 XIV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 11
    Part XIV
    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
    ALVIN AILEY DANCE FOUNDATION INC (AKA ALVIN AILEY AMERICAN DANCE THEATER)
    405 W 55TH STREET
    NEW YORK,NY10019
    N/A PUBLIC CHARITY UNRESTRICTED 10,000
    AMERICAN MUSEUM OF NATURAL HISTORY (AKA AMNH)
    200 CENTRAL PARK WEST
    NEW YORK,NY10004
    N/A PUBLIC CHARITY UNRESTRICTED 30,000
    BROOKLYN MUSEUM
    200 EASTERN PARKWAY
    BROOKLYN,NY11238
    N/A PUBLIC CHARITY UNRESTRICTED 5,000
    CHILDREN AID SOCIETY (AKA CHILDREN'S AID SOCIETY)
    343 LINCOLN WAY WEST
    NEW OXFORD,PA17350
    N/A PUBLIC CHARITY UNRESTRICTED 30,000
    CITY HARVEST INC (AKA CITY HARVEST)
    150 52ND STREET
    BROOKLYN,NY11232
    N/A PUBLIC CHARITY UNRESTRICTED 10,000
    CITY PARKS FOUNDATION
    830 FIFTH AVE
    NEW YORK,NY10065
    N/A PUBLIC CHARITY UNRESTRICTED 20,000
    DANCE THEATRE OF HARLEM INC (AKA DTH)
    466 WEST 152ND STREET
    NEW YORK,NY10031
    N/A PUBLIC CHARITY UNRESTRICTED 5,000
    GETTING OUT AND STAYING OUT INC
    201A EAST 124TH STREET
    NEW YORK,NY10035
    N/A PUBLIC CHARITY UNRESTRICTED 10,000
    HARLEM ACADEMY
    655 ST NICHOLAS AVENUE
    NEW YORK,NY10030
    N/A PUBLIC CHARITY UNRESTRICTED 25,000
    NATURAL RESOURCES DEFENSE COUNCIL INC (AKA NRDC)
    40 WEST 20TH STREET
    NEW YORK,NY10011
    N/A PUBLIC CHARITY UNRESTRICTED 25,000
    NEW CANAAN LIBRARY INC
    151 MAIN ST
    NEW CANAAN,CT06840
    N/A PUBLIC CHARITY UNRESTRICTED 5,000
    NEW YORK PUBLIC LIBRARY ASTOR LENOX AND TILDEN FOUNDATIONS
    455 5TH AVE 4TH FLOOR
    NEW YORK,NY10016
    N/A PUBLIC CHARITY UNRESTRICTED 20,000
    PLANNED PARENTHOOD FEDERATION OF AMERICA INC (AKA PPFA)
    123 WILLIAM ST 10TH FLOOR
    NEW YORK,NY10038
    N/A PUBLIC CHARITY UNRESTRICTED 30,000
    PLANNED PARENTHOOD OF GREATER NEW YORK INC (AKA PPGNY)
    26 BLEECKER STREET
    NEW YORK,NY10012
    N/A PUBLIC CHARITY UNRESTRICTED 30,000
    SHATTERPROOF (AKA SHATTERPROOF)
    101 MERRITT 7 CORPORATE PARK 1ST
    FLOOR
    NORWALK,CT06851
    N/A PUBLIC CHARITY UNRESTRICTED 5,000
    THE DOOR -- A CENTER OF ALTERNATIVES INC (AKA THE DOOR)
    121 AVENUE OF THE AMERICAS SUITE
    506
    NEW YORK,NY10013
    N/A PUBLIC CHARITY UNRESTRICTED 20,000
    THE URBAN ASSEMBLY INC
    90 BROAD STREET SUITE 2101
    NEW YORK,NY10004
    N/A PUBLIC CHARITY UNRESTRICTED 15,000
    TRICKLE UP (AKA TRICKLE UP PROGRAM INC)
    104 W 27TH ST 12TH FLOOR
    NEW YORK,NY10001
    N/A PUBLIC CHARITY UNRESTRICTED 30,000
    Total .................................bullet 3a 325,000
    bApproved for future payment
    Total .................................bullet 3b 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-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 ...........
        14 103  
    4 Dividends and interest from securities ....          
    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 ............
        18 269,138  
    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) .. 0 374,235 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    374,235
    (See worksheet in line 13 instructions to verify calculations.)
    Part XV-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 XV-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    8 N/A
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 13
    Part XVI
    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 (2021)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2021 AccountingFeesSchedule
    Name:
    THE KLEIN FAMILY FOUNDATION INC
    EIN:
    52-1705026
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING FEES 8,900 7,900   1,000

    TY 2021 ExplnOfNonFilingWithAGStmt
    Name:
    THE KLEIN FAMILY FOUNDATION INC
    EIN:
    52-1705026
    Statement:
    THIS ORGANIZATION IS EXEMPT FROM REGISTRATION REQUIREMENTS UNDER THE NEW JERSEY CRI ACT. PURSUANT TO THE CRI ACT, THE REGISTRATION REQUIREMENTS SHALL NOT APPLY TO ANY CHARITABLE ORGANIZATION OR ORGANIZATIONS ENGAGING IN A CHARITABLE FUND RAISING CAMPAIGN WHICH DO NOT RECEIVE GROSS CONTRIBUTIONS IN EXCESS OF $10,000 DURING A FISCAL YEAR (N.J.S.A. 45:17A-26(C)). THIS ORGANIZATION DID NOT RECEIVE CONTRIBUTIONS IN EXCESS OF $10,000 IN 2021.

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    THE KLEIN FAMILY FOUNDATION INC
    EIN:
    52-1705026
    Name of Stock End of Year Book Value End of Year Fair Market Value
    ABB LTD SPONSORED 130,007 160,380
    AIR PRODS & CHEMS INC 133,787 242,100
    ALBEMARLE CORP 45,937 104,687
    ANALOG DEVICES INC 133,934 292,180
    AUTOZONE INC 81,303 107,456
    BIOMARIN PHARMACEUTICAL INC 12,653 12,431
    COGNIZANT TECHNOLOGY SOLUTIONS CORP 100,988 134,980
    CORNING INC 58,166 78,775
    DIAGEO PLC 105,255 174,120
    DISNEY WALT CO DISNEY 184,152 141,600
    GILEAD SCIENCES INC 48,931 43,267
    HORMEL FOODS CORP 127,597 165,760
    IAC/INTERACTIVECORP 92,998 53,179
    ILLINOIS TOOL WORKS INC 62,445 91,735
    INCYTE CORP 13,176 11,395
    IONIS PHARMACEUTICALS INC 14,149 18,510
    JOHNSON CTLS INTL PLC 172,396 192,920
    LINDE PLC 73,553 129,388
    M & T BK CORP 108,978 111,573
    MEDTRONIC PLC 154,371 180,860
    MERCK & CO INC 117,448 183,720
    MICROSOFT CORP 51,677 231,147
    NEUROCRINE BIOSCIENCES INC 13,391 29,244
    NOVARTIS AG SPONSORED 48,289 59,171
    PAYCHEX INC 135,739 284,675
    PAYPAL HLDGS INC 54,792 97,776
    PPG INDS INC 116,062 114,340
    PROCTER & GAMBLE CO 86,533 143,790
    REGENERON PHARMACEUTICALS INC 50,921 88,670
    SEAGEN INC 15,328 53,082
    SHELL PLC 105,795 104,580
    STERIS PLC 60,436 164,920
    STRYKER CORP 46,573 79,850
    SYNOPSYS INC 52,479 273,330
    TELEDYNE TECHNOLOGIES INC 85,110 75,022
    TRIMBLE INC 83,951 174,690
    UNILEVER PLC 151,535 160,405
    US BANCORP DEL 158,130 139,440
    VERISK ANALYTICS INC 81,128 173,090
    VERTEX PHARMACEUTICALS INC 12,251 42,269
    WILEY JOHN & SONS INC 40,690 38,208
    ZIMMER BIOMET HLDGS INC 103,171 108,564
    ZIMVIE INC 2,434 1,649
    WEYERHAEUSER CO 99,566 99,360

    TY 2021 OtherExpensesSchedule
    Name:
    THE KLEIN FAMILY FOUNDATION INC
    EIN:
    52-1705026
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT MANAGEMENT FEES 41,262 41,262   0
    BANK CUSTODIAL FEES 3,971 3,971   0
    MISC. FEES 377 377   0


    TY 2021 TaxesSchedule
    Name:
    THE KLEIN FAMILY FOUNDATION INC
    EIN:
    52-1705026
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 1,689 1,689   0
    EXCISE TAXES 6,649 0   0