Form990-PF
Click to see attachment
Click to see attachmentClick to see attachment

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
For calendar year 2021, or tax year beginning 01-01-2021 , and ending 12-31-2021
Name of foundation
David & Janet Polak 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

45-4797578
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$84,029,483J 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) 0
2 Check bullet.............
3 Interest on savings and temporary cash investments 1,484 1,484  
4 Dividends and interest from securities... 710,705 710,705  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 1,764,784
b Gross sales price for all assets on line 6a 61,967,796
7 Capital gain net income (from Part IV, line 2)... 1,288,244
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 969,791 1,029,257  
12 Total. Add lines 1 through 11........ 3,446,764 3,029,690  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 235,550     235,550
14 Other employee salaries and wages...... 61,000     61,000
15 Pension plans, employee benefits....... 35,140     35,140
16a Legal fees (attach schedule)......... Click to see attachment 23,115 0 0 23,115
b Accounting fees (attach schedule).......        
c Other professional fees (attach schedule).... Click to see attachment 439,482 398,604   40,878
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 221,960 13,725    
19 Depreciation (attach schedule) and depletion...      
20 Occupancy.............. 74,004     74,004
21 Travel, conferences, and meetings....... 56,776     56,776
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 669,224 518,825   102,412
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 1,816,251 931,154 0 628,875
25 Contributions, gifts, grants paid....... 2,266,312 2,266,312
26 Total expenses and disbursements. Add lines 24 and 25 4,082,563 931,154 0 2,895,187
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -635,799
b Net investment income (if negative, enter -0-) 2,098,536
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......... 3,036,171 5,727,416 5,727,416
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) 33,783,681 Click to see attachment25,956,247 26,219,478
b Investments—corporate stock (attach schedule)....... 9,776,068 Click to see attachment11,487,851 16,458,266
c Investments—corporate bonds (attach schedule).......   Click to see attachment1,000,149 1,047,600
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 21,159,666 Click to see attachment22,141,023 30,548,462
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet) Click to see attachment3,342,999 Click to see attachment4,150,100 Click to see attachment4,028,261
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 71,098,585 70,462,786 84,029,483
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...........    
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 71,098,585 70,462,786
29 Total net assets or fund balances (see instructions)..... 71,098,585 70,462,786
30 Total liabilities and net assets/fund balances (see instructions). 71,098,585 70,462,786
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
71,098,585
2
Enter amount from Part I, line 27a .....................
2
-635,799
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
70,462,786
5
Decreases not included in line 2 (itemize) bullet
5
 
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
70,462,786
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 Publicly-traded Securities      
b Passthrough K1 Capital Gain/(Loss)      
c LATITUDE MGMT REAL ESTATE CAPITAL III INC P 2014-05-14 2021-01-21
d LATITUDE MGMT REAL ESTATE CAPITAL III INC P 2014-05-14 2021-06-01
e LATITUDE MGMT REAL ESTATE CAPITAL III INC P   2021-06-30
LATITUDE MGMT REAL ESTATE CAPITAL III INC P   2021-07-23
LATITUDE MGMT REAL ESTATE CAPITAL III INC P   2021-09-15
LATITUDE MGMT REAL ESTATE CAPITAL III INC P 2015-08-24 2021-10-20
LATITUDE MGMT REAL ESTATE CAPITAL III INC P 2015-11-30 2021-11-29
LATITUDE MGMT REAL ESTATE CAPITAL III INC P 2015-12-28 2021-12-17
(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 61,542,796   61,283,184 259,612
b       1,028,632
c 25,000   25,000  
d 25,000   25,000  
e 100,000   100,000  
75,000   75,000  
50,000   50,000  
50,000   50,000  
50,000   50,000  
50,000   50,000  
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       259,612
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 1,288,244
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  
3 Add lines 1 and 2........................... 3 29,170
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 29,170
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 43,700
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 43,700
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 14,530
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet14,530 RefundedBullet 11  
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? Click to see attachment....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changesClick to see attachment....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
Yes
 
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
Yes
 
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.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 XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletCA, DE
    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 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 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 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)
    Yes
     
    (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
     
    No
    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
    Yes
     
    If "Yes," attach the statement required by Regulations section 53.4945–5(d). Click to see attachment
    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
    David PolakClick to see attachment Dir
    1.0     		0 0 0
    Foundation Source 501 Silverside Rd
    Wilmington,DE198091377
    Janet PolakClick to see attachment Dir
    1.0     		0 0 0
    Foundation Source 501 Silverside Rd
    Wilmington,DE198091377
    Jeff PolakClick to see attachment Dir, Pres, Executive Dir
    40.0     		235,550 11,000 0
    Foundation Source 501 Silverside Rd
    Wilmington,DE198091377
    Robert PolakClick to see attachment Dir
    1.0     		0 0 0
    Foundation Source 501 Silverside Rd
    Wilmington,DE198091377
    Jonathan SeltzerClick to see attachment Dir
    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
    Noreen L Rubio ADMINISTRATIVE ASST
    40.0     		61,000    
    3850 N Wilke Rd
    Arlington Heights,IL60004
    Total number of other employees paid over $50,000...................bullet  
    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
    Polak Investors LLC Investment Mgmt 383,363
    1880 Century Park East Suite 811
    Los Angeles,CA90067
    Foundation Source Administrative 87,942
    55 Walls Drive 3rd Fl
    Fairfield,CT06824
    Total number of others receiving over $50,000 for professional services.............bullet  
    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 AKLA PROGRAM - WILL INTRODUCE PARTICIPANTS TO EXCITING & INSPIRING NEW WAYS OF LOOKING AT THEIR JEWISH VALUES & CONNECT THEM WITHIN THEIR OWN LIVES & LA JEWISH COMMUNITY 36,022
    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 OCTHEALTH LLC-PROMOTE HEALTH OF PPL AFFECTED BY AGE-RELATED MACULAR DEGENERATION, ADVANCE SCIENTIFIC UNDERSTANDING, PROVIDE EARLY INTERVENTION AND ACCESS TO SCREENING 250,000
    2 CYWAT TECHNOLOGIES LTD - TO PROMOTE THE HEALTH OF PEOPLE WHO ARE AFFECTED BY POLLUTED DRINKING WATER BY FUNDING THE DEVELOPMENT OF A WATER MONITORING SYSTEM 250,000
    All other program-related investments. See instructions.
    3 Click to see attachment 307,101
    Total. Add lines 1 through 3.........................bullet807,101
    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
    45,444,507
    b
    Average of monthly cash balances.......................
    1b
    4,515,382
    c
    Fair market value of all other assets (see instructions)................
    1c
    31,526,077
    d
    Total (add lines 1a, b, and c).........................
    1d
    81,485,966
    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
    81,485,966
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    1,222,289
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    80,263,677
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    4,013,184
    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
    4,013,184
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    29,170
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
    70,431
    c
    Add lines 2a and 2b............................
    2c
    99,601
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    3,913,583
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    3,913,583
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
    7
    3,913,583
    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 3,913,583
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 3,646,806
    b Total for prior years:2019, 2018, 2017  
    3 Excess distributions carryover, if any, to 2021:
    a From 2016......  
    b From 2017......  
    c From 2018......  
    d From 2019......  
    e From 2020......  
    f Total of lines 3a through e ........  
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 3,702,288
    a Applied to 2020, but not more than line 2a 3,646,806
    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 2021 distributable amount..... 55,482
    e Remaining amount distributed out of corpus 0
    5 Excess distributions carryover applied to 2021.    
    (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 0
    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 2021. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2022 ..........     		3,858,101
    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 2016 not
    applied on line 5 or line 7 (see instructions) ...     		 
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		0
    10 Analysis of line 9:
    a Excess from 2017....  
    b Excess from 2018....  
    c Excess from 2019....  
    d Excess from 2020....  
    e Excess from 2021.... 0
    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).)
    NONE
    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
    AMCHA INITIATIVE
    517 BETHANY CURVE
    SANTA CRUZ,CA95060     		N/A PC General & Unrestricted 20,000
    AMERICAN FRIENDS OF ISRAELI NAVY SEALS INC
    138 W 133RD ST
    NEW YORK,NY10030     		N/A PC to provide scholarships to seven candidates and gift vouchers for soldiers in financial need at Passover of 2022 34,100
    AMERICAN FRIENDS OF THE ISRAEL MUSEUM
    545 5TH AVE RM 920
    NEW YORK,NY10017     		N/A PC General & Unrestricted 5,000
    AMERICAN FRIENDS OF THE ISRAEL PHILHARMONIC ORCHES
    555 W 5TH ST 35TH FL
    LOS ANGELES,CA90013     		N/A PC General & Unrestricted 15,000
    AMERICAN SOCIETY FOR TECHNION-ISRAEL INST OF TECH
    55 EAST 59TH ST 14TH FLOOR
    NEW YORK,NY10022     		N/A PC Pilot of the ATS Polak Family Israel Institute 30,000
    AMERICAN SOCIETY FOR TECHNION-ISRAEL INST OF TECH
    55 EAST 59TH ST 14TH FLOOR
    NEW YORK,NY10022     		N/A PC General & Unrestricted 200,000
    AMERICAN YOUTH SYMPHONY INC
    841 APOLLO ST STE 344
    EL SEGUNDO,CA90245     		N/A PC General & Unrestricted 5,000
    AMERICANS FOR BEN-GURION UNIVERSITY INC
    1001 AVE OF THE AMERICAS FL 19
    NEW YORK,NY10018     		N/A PC Support of Part Two - Phase Two of the Ben-Gurion Digital Archives Transformation Project 100,000
    AMERICANS FOR BEN-GURION UNIVERSITY INC
    1001 AVE OF THE AMERICAS FL 19
    NEW YORK,NY10018     		N/A PC Support of Part Two - Phase One of the Ben-Gurion Digital Archives Transformation Project collections) of the Ben-Gurion Digital Archives Transformation Project 100,000
    ASSOC FOR THE STUDY OF THE MIDDLE EAST AND AFRICA
    PO BOX 2241
    BALA CYNWYD,PA19004     		N/A PC General & Unrestricted 5,000
    AYN RAND INST CENTER FOR ADVANCEMNT OF OBJECTIVISM
    6 HUTTON CENTRE DR STE 600
    SANTA ANA,CA92707     		N/A PC Free Books to Teachers program, ARC-I's work in Israel, and funding to develop an essay-contest appeal to schools in the LA area 37,500
    BARAK BALLET
    1709 STEWART ST
    SANTA MONICA,CA90404     		N/A PC General & Unrestricted 5,000
    BEIT TSHUVAH
    8831 VENICE BLVD
    LOS ANGELES,CA90034     		N/A PC General & Unrestricted 5,000
    BUCKLEY SCHOOL
    3900 STANSBURY AVE
    SHERMAN OAKS,CA91423     		N/A PC General & Unrestricted 10,000
    CEDARS-SINAI MEDICAL CENTER
    8700 BEVERLY BLVD
    W HOLLYWOOD,CA90048     		N/A PC the Polak Family Fellowship in Precision Healthcare, supporting the Board of Governors Innovation Center 100,000
    CEDARS-SINAI MEDICAL CENTER
    8700 BEVERLY BLVD
    W HOLLYWOOD,CA90048     		N/A PC General & Unrestricted 25,000
    CENTRAL FUND OF ISRAEL
    461 CENTRAL AVE
    CEDARHURST,NY11516     		N/A PC General & Unrestricted 35,000
    COMMITTEE FOR ACCURACY IN MIDDLE EAST REPORTING IN
    PO BOX 35040
    BOSTON,MA02135     		N/A PC General & Unrestricted 10,000
    CONCERN FOUNDATION
    11111 W OLYMPIC BLVD STE 214
    LOS ANGELES,CA90064     		N/A PC General & Unrestricted 6,000
    CROHNS AND COLITIS FOUNDATION OF AMERICA
    3010 WESTCHESTER AVE
    PURCHASE,NY10577     		N/A PC General & Unrestricted 2,500
    CUFI CHURCH ASSOCIATION
    PO BOX 1307
    SAN ANTONIO,TX78295     		N/A PC General & Unrestricted 20,000
    DAVID HOROWITZ FREEDOM CENTER
    14724 VENTURA BLVD STE 820
    SHERMAN OAKS,CA91403     		N/A PC General & Unrestricted 15,000
    ENDOWMENT FOR MIDDLE EAST TRUTH
    700 STONINGTON RD
    SILVER SPRING,MD20902     		N/A PC General & Unrestricted 20,000
    FOUNDATION FOR ECONOMIC EDUCATION INC
    1819 PEACHTREE RD NE STE 300
    ATLANTA,GA30309     		N/A PC General & Unrestricted 5,000
    FOUNDATION FOR INDIVIDUAL RIGHTS IN EDUCATION INC
    510 WALNUT ST STE 1250
    PHILADELPHIA,PA19106     		N/A PC General & Unrestricted 5,000
    FRIENDS OF ELNET
    5215 OLD ORCHARD RD STE 880
    SKOKIE,IL60077     		N/A PC General & Unrestricted 100,000
    FRIENDS OF ISRAEL SCI-TECH SCHOOLS INC
    477 MADISON AVE 6TH FL
    NEW YORK,NY10022     		N/A PC General & Unrestricted 5,000
    FRIENDS OF SHEBA MEDICAL CENTER INC
    6505 WILSHIRE BLVD STE 615
    LOS ANGELES,CA90048     		N/A PC General & Unrestricted 10,000
    FRIENDS OF THE ISRAEL DEFENSE FORCES
    60 E 42ND ST
    NEW YORK,NY10165     		N/A PC sponsor 12 IMPACT! Scholars 48,000
    FRIENDS OF THE ISRAEL DEFENSE FORCES - LOS ANGELES
    6505 WILSHIRE BLVD STE 625
    LOS ANGELES,CA90048     		N/A PC sponsor 13 additional IMPACT! Scholarship students 52,000
    HAROLD GRINSPOON FOUNDATION
    67 HUNT ST STE 100
    AGAWAM,MA01001     		N/A SO I General & Unrestricted 18,000
    HAROLD GRINSPOON FOUNDATION
    67 HUNT ST STE 100
    AGAWAM,MA01001     		N/A SO I To support children receiving the monthly gift of Jewish children's books through PJ Library domestic communities as well as Latin America and Scotland 88,612
    HILLSDALE COLLEGE
    33 E COLLEGE ST
    HILLSDALE,MI49242     		N/A PC General & Unrestricted 5,000
    HONEST REPORTING COM INC
    165 E 56TH ST 2ND FL
    NEW YORK,NY10022     		N/A PC General & Unrestricted 5,000
    IMERMAN ANGELS
    205 W RANDOLPH ST 19TH FL
    CHICAGO,IL60606     		N/A PC General & Unrestricted 5,000
    ISRAEL CANCER RESEARCH FUND INC
    52 VANDERBILT AVE S1510
    NEW YORK,NY10017     		N/A PC Research Career Development Award Program 49,500
    ISRAEL CHRISTIAN NEXUS
    11039 MCCORMICK ST
    N HOLLYWOOD,CA91601     		N/A PC General & Unrestricted 1,000
    ISRAEL EMERGENCY ALLIANCE - STANDWITHUS
    PO BOX 341069
    LOS ANGELES,CA90034     		N/A PC General & Unrestricted 200,000
    ISRAEL TENNIS CENTERS FOUNDATION INC
    165 E 56TH ST 2ND FL
    NEW YORK,NY10022     		N/A PC General & Unrestricted 5,000
    JEWBELONG INC
    60 FERNWOOD RD
    SUMMIT,NJ07901     		N/A PC General & Unrestricted 5,000
    JEWISH FEDERATION COUNCIL OF GREATER LOS ANGELES
    6505 WILSHIRE BLVD STE 800
    LOS ANGELES,CA90048     		N/A PC book costs for PJ Library Program 18,000
    JEWISH FEDERATION COUNCIL OF GREATER LOS ANGELES
    6505 WILSHIRE BLVD STE 800
    LOS ANGELES,CA90048     		N/A PC General & Unrestricted 40,000
    JEWISH FEDERATION COUNCIL OF GREATER LOS ANGELES
    6505 WILSHIRE BLVD STE 800
    LOS ANGELES,CA90048     		N/A PC expanding the Community Security Initiative (CSI) 75,000
    JEWISH WOMENS THEATRE
    3435 OCEAN PARK BLVD STE 107 85
    SANTA MONICA,CA90405     		N/A PC General & Unrestricted 2,500
    LAWFARE PROJECT INC
    633 THIRD AVE 21ST FLOOR
    NEW YORK,NY10017     		N/A PC General & Unrestricted 25,000
    LOS ANGELES JEWISH HOME FOR THE AGING
    7150 TAMPA AVE
    RESEDA,CA91335     		N/A PC General & Unrestricted 25,000
    LOS ANGELES PHILHARMONIC ASSOCIATION
    151 S GRAND AVE
    LOS ANGELES,CA90012     		N/A PC General & Unrestricted 5,000
    MAKE A WISH FOUNDATION OF GREATER LOS ANGELES
    11390 W OLYMPIC BLVD STE 300
    LOS ANGELES,CA90064     		N/A PC General & Unrestricted 15,000
    MANHATTAN INSTITUTE FOR POLICY RESEARCH INC
    52 VANDERBILT AVE
    NEW YORK,NY10017     		N/A PC General & Unrestricted 5,000
    MASSACHUSETTS INSTITUTE OF TECHNOLOGY
    600 MEMORIAL DR BLDG W98-300
    CAMBRIDGE,MA02139     		N/A PC MISTI MIT - Israel Summer Program 40,000
    MIDDLE EAST FORUM
    1650 MARKET ST STE 3600
    PHILADELPHIA,PA19103     		N/A PC annual Israel Victory Project 40,000
    MIDDLE EAST MEDIA AND RESEARCH INSTITUTE INC
    PO BOX 27837
    WASHINGTON,DC20038     		N/A PC General & Unrestricted 5,000
    MOISHE HOUSE
    441 SAXONY RD NO BARN 2
    ENCINITAS,CA92024     		N/A PC to support community building efforts in Los Angeles 50,000
    MUSEUM ASSOCIATES
    5905 WILSHIRE BLVD
    LOS ANGELES,CA90036     		N/A PC General & Unrestricted 5,000
    PACIFIC LEGAL FOUNDATION
    555 CAPITOL MALL STE 1290
    SACRAMENTO,CA95814     		N/A PC General & Unrestricted 5,000
    PARDES INSTITUTE OF JEWISH STUDIES NORTH AMERICA
    54 W 40TH ST
    NEW YORK,NY10018     		N/A PC General & Unrestricted 5,000
    PERFORMING ARTS CENTER OF LOS ANGELES COUNTY
    135 N GRAND AVE
    LOS ANGELES,CA90012     		N/A PC General & Unrestricted 5,000
    PRAGER UNIVERSITY FOUNDATION
    15021 VENTURA BLVD 552
    SHERMAN OAKS,CA91403     		N/A PC General & Unrestricted 50,000
    PROCLAIMING JUSTICE TO THE NATIONS INC
    PO BOX 682711
    FRANKLIN,TN37068     		N/A PC General & Unrestricted 30,000
    REMEMBER US THE HOLOCAUST BNAI MITZVAH PROJECT
    1112 MONTANA AVE 182
    SANTA MONICA,CA90403     		N/A PC General & Unrestricted 3,600
    REPORT INC-RESEARCHEVALUATIONPROMOTING ORG RESP
    PMB 225 1121 N BETHLEHEM PIKE STE 6
    SPRING HOUSE,PA19477     		N/A PC NGO Monitor 50,000
    ROAD RUNNERS CLUB OF AMERICA
    9854 NATIONAL BLVD 534
    LOS ANGELES,CA90034     		N/A PC Los Angeles Running Club's yearly track permits from the City of Santa Monica 5,000
    SIMON WIESENTHAL CENTER INC
    1399 S ROXBURY 2ND FL
    LOS ANGELES,CA90035     		N/A PC Moriah Films' comprehensive documentary about the life and legacy of David Ben-Gurion 70,000
    STUDENTS RUN AMERICA
    5252 CREBS AVE
    TARZANA,CA91356     		N/A PC General & Unrestricted 5,000
    THE JEWISH INSTITUTE FOR NATIONAL SECURITY OF AMER
    1101 14TH ST NW STE 1030
    WASHINGTON,DC20005     		N/A PC General & Unrestricted 100,000
    THE MAPLE COUNSELING CENTER
    439 N CANON DR STE 209
    BEVERLY HILLS,CA90210     		N/A PC General & Unrestricted 5,000
    THE OPEN TEMPLE
    1422 ELECTRIC AVE
    VENICE,CA90291     		N/A PC General & Unrestricted 10,000
    TRIBE MEDIA CORP
    3250 WILSHIRE BLVD STE 1250
    LOS ANGELES,CA90010     		N/A PC General & Unrestricted 50,000
    TURNING POINT USA INC
    4940 EAST BEVERLY RD
    PHOENIX,AZ85044     		N/A PC General & Unrestricted 50,000
    UNITED STATES HOLOCAUST MEMORIAL MUSEUM
    100 RAOUL WALLENBERG PL SW
    WASHINGTON,DC20024     		N/A PC General & Unrestricted 5,000
    UNIVERSITY OF SOUTHERN CALIFORNIA
    3551 TROUSDALE PKWY ADM 160
    LOS ANGELES,CA90089     		N/A PC Furthering the mission of the USC Center for the Political Future 50,000
    WASHINGTON INSTITUTE FOR NEAR EAST POLICY
    1111 19TH ST NW STE 500
    WASHINGTON,DC20036     		N/A PC General & Unrestricted 5,000
    Total .................................bullet 3a 2,266,312
    bApproved for future payment
    Total .................................bullet 3b  
    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 1,484  
    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 ............     		525990 496,644 18 1,268,140  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue:
    aK-1 Inc/Loss     		525990 -79,481 14 1,036,290  
    bSTATE TAX REFUND     01 11,927  
    cCLASS ACTION LAWSUIT PROCEEDS     01 399  
    dFOREIGN CURRENCY GAIN     01 656  
    e
    12 Subtotal. Add columns (b), (d), and (e) .. 417,163 3,029,601  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    3,446,764
    (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.)
    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 AllOthProgRltdInvestmentsSch
    Name:
    David & Janet Polak Foundation
    EIN:
    45-4797578
    Category Amount
    CYWAT TECHNOLOGIES LTD - TO PROMOTE THE HEALTH OF PEOPLE WHO ARE AFFECTED BY POLLUTED DRINKING WATER BY FUNDING THE DEVELOPMENT OF A WATER MONITORING SYSTEM 7,101
    BIO-ACTIVES SYNERGIO LTD. - TO PROMOTE HEALTH BY FUNDING RESEARCH INTO DEVELOPING NON-HAZARDOUS, NATURAL PRODUCTS THAT DO NOT ENDANGER HUMAN HEALTH 100,000
    BARAK BALLET - TO DEVELOP AND PRODUCE A LIVE DANCE PERFORMANCE ENTITLED MEMORYHOUSE 200,000

    TY 2021 CompensationExplanation
    Name:
    David & Janet Polak Foundation
    EIN:
    45-4797578
    Person Name Explanation
    Jeff Polak * DAVID POLAK (DIRECTOR), JANET POLAK (DIRECTOR) AND JEFF POLAK PRESIDENT/DIRECTOR/EXECUTIVE DIRECTOR), OF DAVID & JANET POLAK FOUNDATION (THE "FOUNDATION"), ARE PRINCIPALS AT THE INVESTMENT MANAGEMENT FIRM POLAK INVESTORS, LLC, A DISQUALIFIED PERSON WHICH PROVIDES INVESTMENT MANAGEMENT SERVICES TO THE FOUNDATION. IN THE TAXABLE YEAR ENDING DECEMBER 31, 2021, THE FOUNDATION PAID $383,363 FOR INVESTMENT MANAGEMENT SERVICES RENDERED BY SUCH DISQUALIFIED PERSON, AS REPORTED IN PART I, LINE 16C. THE REASONABLENESS OF THE PROFESSIONAL FEES WAS ESTABLISHED BY AN OUTSIDE COMPENSATION COMMITTEE, WHICH REVIEWED THE RATES CHARGED BY COMPARABLE INVESTMENT MANAGEMENT FIRMS.

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

    TY 2021 DepreciationSchedule
    Name:
    David & Janet Polak Foundation
    EIN:
    45-4797578
    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

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

    TY 2021 ExpenditureResponsibilityStmt
    Name:
    David & Janet Polak Foundation
    EIN:
    45-4797578
    Grantee's Name Grantee's Address Grant Date Grant Amount Grant Purpose Amount Expended By Grantee Any Diversion By Grantee? Dates of Reports By Grantee Date of Verification Results of Verification
    NEUROVISION IMAGING LLC
          		1395 GARDEN HIGHWAY SUITE 250
    SACRAMENTO,CA95833     		2014-12-17 250,000 PRI INVEST-SEE GEN EXPLAN FOR PURPOSE & ADDTL DETAILS RE AMT, AMT EXPENDED, & LACK OF DIVERSION   NO SEE GENERAL EXPLANATION FOR REPORT DATES   THE GRANTOR HAS NO REASON TO DOUBT THE ACCURACY OR RELIABILITY OF THE REPORTS FROM THE GRANTEE; THEREFORE, NO INDEPENDENT VERIFICATION OF THE REPORTS WERE MADE.
    BRUIN BIOMETRICS LLC
          		10960 WILSHIRE BLVD SUITE 950
    LOS ANGELES,CA90024     		2015-05-13 250,000 PRI INVEST-SEE GENERAL EXPLANATION FOR PURPOSE & ADDTL DETAILS RE AMT EXPENDED & LACK OF DIVERSION   NO SEE GENERAL EXPLANATION FOR REPORT DATES   THE GRANTOR HAS NO REASON TO DOUBT THE ACCURACY OR RELIABILITY OF THE REPORTS FROM THE GRANTEE; THEREFORE, NO INDEPENDENT VERIFICATION OF THE REPORTS WERE MADE.
    BIOP MEDICAL LTD
          		10 HAELIAV ST
    RAMAT GAN   5252263
    IS     		2017-04-21 250,000 PRI INVEST-SEE GENERAL EXPLANATION FOR PURPOSE & ADDTL DETAILS RE AMT EXPENDED & LACK OF DIVERSION   NO SEE GENERAL EXPLANATION FOR REPORT DATES   THE GRANTOR HAS NO REASON TO DOUBT THE ACCURACY OR RELIABILITY OF THE REPORTS FROM THE GRANTEE; THEREFORE, NO INDEPENDENT VERIFICATION OF THE REPORTS WERE MADE.
    ONLINE DISRUPTIVE TECHNOLOGIES INC
          		MATAM ADV TECH PK BLD 23 POBX 15050
    HAIFA   3190501
    IS     		2017-04-21 250,000 PRI INVEST-SEE GENERAL EXPLANATION FOR PURPOSE & ADDTL DETAILS RE AMT EXPENDED & LACK OF DIVERSION   NO SEE GENERAL EXPLANATION FOR REPORT DATES   THE GRANTOR HAS NO REASON TO DOUBT THE ACCURACY OR RELIABILITY OF THE REPORTS FROM THE GRANTEE; THEREFORE, NO INDEPENDENT VERIFICATION OF THE REPORTS WERE MADE.
    ORGENESIS LTD
          		ARAD STREET 9
    TEL AVIV    
    IS     		2017-04-21 305,498 PRI INVEST-SEE GENERAL EXPLANATION FOR PURPOSE & ADDTL DETAILS RE AMT EXPENDED & LACK OF DIVERSION   NO SEE GENERAL EXPLANATION FOR REPORT DATES   THE GRANTOR HAS NO REASON TO DOUBT THE ACCURACY OR RELIABILITY OF THE REPORTS FROM THE GRANTEE; THEREFORE, NO INDEPENDENT VERIFICATION OF THE REPORTS WERE MADE.
    BRYN PHARMA LLC FKA EPI-NOW LLC
          		518 NORTH HILLCREST ROAD
    BEVERLY HILLS,CA90210     		2018-07-13 250,000 PRI INVEST-SEE GENERAL EXPLANATION FOR PURPOSE & ADDTL DETAILS RE AMT EXPENDED & LACK OF DIVERSION   NO SEE GENERAL EXPLANATION FOR REPORT DATES   THE GRANTOR HAS NO REASON TO DOUBT THE ACCURACY OR RELIABILITY OF THE REPORTS FROM THE GRANTEE; THEREFORE, NO INDEPENDENT VERIFICATION OF THE REPORTS WERE MADE.
    CYWAT TECHNOLOGIES LTD
          		168 JABOTINSKY ST
    BNEI BRAK    
    IS     		2018-11-26 250,000 PRI INVEST-SEE GEN EXPLAN FOR PURPOSE & ADDTL DETAILS RE AMT, AMT EXPENDED, & LACK OF DIVERSION   NO SEE GENERAL EXPLANATION FOR REPORT DATES   THE GRANTOR HAS NO REASON TO DOUBT THE ACCURACY OR RELIABILITY OF THE REPORTS FROM THE GRANTEE; THEREFORE, NO INDEPENDENT VERIFICATION OF THE REPORTS WERE MADE.
    BIO-ACTIVES SYNERYGIO LTD FKA YB MO CHO
          		HITECH VIL 4/9 GIVAT RAM POB 39231
    JERUSALEM   9129102
    IS     		2018-04-20 250,000 PRI INVEST-SEE GENERAL EXPLANATION FOR PURPOSE & ADDTL DETAILS RE AMT EXPENDED & LACK OF DIVERSION   NO SEE GENERAL EXPLANATION FOR REPORT DATES   THE GRANTOR HAS NO REASON TO DOUBT THE ACCURACY OR RELIABILITY OF THE REPORTS FROM THE GRANTEE; THEREFORE, NO INDEPENDENT VERIFICATION OF THE REPORTS WERE MADE.
    BIO-ACTIVES SYNERYGIO LTD FKA YB MO CHO
          		HITECH VIL 4/9 GIVAT RAM POB 39231
    JERUSALEM   9129102
    IS     		2018-07-19 250,000 PRI INVEST-SEE GENERAL EXPLANATION FOR PURPOSE & ADDTL DETAILS RE AMT EXPENDED & LACK OF DIVERSION   NO SEE GENERAL EXPLANATION FOR REPORT DATES   THE GRANTOR HAS NO REASON TO DOUBT THE ACCURACY OR RELIABILITY OF THE REPORTS FROM THE GRANTEE; THEREFORE, NO INDEPENDENT VERIFICATION OF THE REPORTS WERE MADE.
    MAXQ AI LTD
          		96 YIGAL ALON STREET ENTRANCE A
    TEL AVIV   6789140
    IS     		2019-03-19 250,000 PRI INVEST-SEE GENERAL EXPLANATION FOR PURPOSE & ADDTL DETAILS RE AMT EXPENDED & LACK OF DIVERSION   NO     THE GRANTOR HAS NO REASON TO DOUBT THE ACCURACY OR RELIABILITY OF THE REPORTS FROM THE GRANTEE; THEREFORE, NO INDEPENDENT VERIFICATION OF THE REPORTS WERE MADE.
    EXTHERA MEDICAL CORPORATION
          		757 ARNOLD DRIVE SUITE B
    MARTINEZ,CA94553     		2019-12-19 250,000 PRI INVEST-SEE GENERAL EXPLANATION FOR PURPOSE & ADDTL DETAILS RE AMT EXPENDED & LACK OF DIVERSION   NO SEE GENERAL EXPLANATION FOR REPORT DATES   THE GRANTOR HAS NO REASON TO DOUBT THE ACCURACY OR RELIABILITY OF THE REPORT FROM THE GRANTEE; THEREFORE, NO INDEPENDENT VERIFICATION OF THE REPORT WAS MADE.
    YONALINK LTD
          		HADASSAH EIN KEREM HOSP POB 12000
    JERUSALEM   9112001
    IS     		2019-11-12 250,000 PRI INVEST-SEE GENERAL EXPLANATION FOR PURPOSE & ADDTL DETAILS RE AMT EXPENDED & LACK OF DIVERSION   NO SEE GENERAL EXPLANATION FOR REPORT DATES   THE GRANTOR HAS NO REASON TO DOUBT THE ACCURACY OR RELIABILITY OF THE REPORT FROM THE GRANTEE; THEREFORE, NO INDEPENDENT VERIFICATION OF THE REPORT WAS MADE.
    AMICROBE INC
          		3142 TIGER RUN COURT 103
    CARLSBAD,CA92010     		2019-10-31 250,000 PRI INVEST-SEE GENERAL EXPLANATION FOR PURPOSE & ADDTL DETAILS RE AMT EXPENDED & LACK OF DIVERSION   NO SEE GENERAL EXPLANATION FOR REPORT DATES   THE GRANTOR HAS NO REASON TO DOUBT THE ACCURACY OR RELIABILITY OF THE REPORT FROM THE GRANTEE; THEREFORE, NO INDEPENDENT VERIFICATION OF THE REPORT WAS MADE.
    OCTHEALTH LLC
          		1395 GARDEN HIGHWAY SUITE 250
    SACRAMENTO,CA95833     		2021-06-08 250,000 PRI INVEST-SEE GENERAL EXPLANATION FOR PURPOSE & ADDTL DETAILS RE AMT EXPENDED & LACK OF DIVERSION   NO SEE GENERAL EXPLANATION FOR REPORT DATES   NONE NECESSARY
    BIO-ACTIVES SYNERGIO LTD
          		HI-TECH VILLAGE UNIT 4/9 POB39231
    GIVAT RAM   9129102
    IS     		2021-10-12 100,000 PRI INVEST-SEE GENERAL EXPLANATION FOR PURPOSE & ADDTL DETAILS RE AMT EXPENDED & LACK OF DIVERSION   NO SEE GENERAL EXPLANATION FOR REPORT DATES   NONE NECESSARY
    CYWAT TECHNOLOGIES LTD
          		168 JABOTINSKY ST
    BNEI BRAK    
    IS     		2021-06-15 100,000 PRI INVEST-SEE GENERAL EXPLANATION FOR PURPOSE & ADDTL DETAILS RE AMT EXPENDED & LACK OF DIVERSION   NO SEE GENERAL EXPLANATION FOR REPORT DATES   THE GRANTOR HAS NO REASON TO DOUBT THE ACCURACY OR RELIABILITY OF THE REPORTS FROM THE GRANTEE; THEREFORE, NO INDEPENDENT VERIFICATION OF THE REPORTS WERE MADE.

    TY 2021 GeneralExplanationAttachment
    Name:
    David & Janet Polak Foundation
    EIN:
    45-4797578
    Identifier Return Reference Explanation
    part I line 6A (990-PF) PART I LINE 6A (990-PF) RECONCILIATION OF NET GAIN/(LOSS) FROM SALES OF ASSETS NOT INCLUDED IN PART IV TOTAL INCLUDED IN PART IV: (DETAILS BELOW) NET GAIN/(LOSS): $1,268,140 TOTAL NOT INCLUDED IN PART IV: PASSTHROUGH K-1 CAPITAL GAIN/(LOSS) - UBI NET GAIN/(LOSS): $496,644 TOTAL PART I, LINE 6A: $1,764,784 DETAILS OF ASSETS INCLUDED IN PART IV: PUBLICLY-TRAIDED SECURITIES GROSS SALES PRICE: $61,461,953 BOOK BASIS: $61,303,288 NET GAIN/(LOSS): $158,665 PASSTHROUGH K-1 CAPITAL GAIN/(LOSS) - NON UBI NET GAIN/(LOSS): $1,028,632 SALES OF OTHER ITEMIZED ASSETS GROSS SALES PRICE: $505,843 BOOK BASIS: $425,000 NET GAIN/(LOSS): $80,843
    Form 8865 Form 8865 The Foundation has prepared this form to the best of its ability based on the limited information provided to it by the investment on which the Foundation is reporting and on the basis of having received no information to the contrary. Any missing or incomplete information is due to the Foundation's inability to obtain such information and is not a willful attempt to withhold such information.
    Form 990-PF Form 990-PF One or more partnerships have provided a Schedule K-3 for the tax year in which they have checked one or more of the boxes in Part I but not provided sufficient back-up information to allow the Foundation to verify why such boxes were checked or the extent to which the checking of such boxes affects any item on this return. The Foundation has prepared this return to the best of its ability and without any foreign filings for such partnerships based on the information provided to it by these partnerships and on the basis of having received no information to the contrary. Any missing or incomplete information is due to the Foundation's inability to obtain such information and is not a willful attempt to withhold such information.

    TY 2021 InvestmentsCorpBondsSchedule
    Name:
    David & Janet Polak Foundation
    EIN:
    45-4797578
    Name of Bond End of Year Book Value End of Year Fair Market Value
    EDISON INTL BOND PERPETUAL - 5 1,000,149 1,047,600

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    David & Janet Polak Foundation
    EIN:
    45-4797578
    Name of Stock End of Year Book Value End of Year Fair Market Value
    AMERICAN AXLE & MFG HOLDINGS I 251,018 205,260
    ARCH COAL, INC 84,323 91,320
    B2 GOLD CORP COM NPV 150,587 165,846
    BANK OF AMERICA CORP 113,640 533,880
    BARRICK GOLD CORPORATION 757,502 475,000
    BAYER A G SPONSORED ADR 198,370 106,080
    BERRY PLASTICS GROUP INC 220,739 368,900
    BP PLC SPONSORED ADR 102,249 79,890
    CAMECO CORPORATION 19,784 21,810
    CENTURY ALUMINUM COMPANY 150,170 198,720
    CHENIERE ENERGY INC 200,948 304,260
    CITIGROUP INC 248,049 301,950
    CLIFFS NATURAL RESOURCES INC. 122,035 174,160
    COMPASS MINERALS INTERNATIONAL 202,745 204,320
    COMSTOCK RES INC 82,955 121,350
    CONSOL ENERGY, INC 73,339 68,130
    CONSTELLIUM NV 136,767 107,460
    COPPER MOUNTAIN MINI NG CORP 78,225 379,052
    COTERRA ENERGY INC 312,903 361,266
    CROWN HOLDINGS INC 185,100 553,100
    CVS CAREMARK CORP 466,000 1,031,600
    DANA HOLDING CP 68,217 114,100
    ELDORADO GOLD CORP COM NPV 218,701 168,300
    ENDEAVOUR MINING CORP 206,264 218,696
    FIDELITY CONSERV INC BD FD 8,589 8,586
    FIRST QUANTUM MINERALS LTD 17,953 48,000
    FLUTTER ENTERTAINMENT ORD SHS 59,804 70,875
    FTS INTERNATIONAL INC 321,080 378,473
    GENERAL MOTORS 361,740 586,300
    GOLD FIELDS LTD ADS 140,581 285,740
    GOLDEN STAR RESOURCES LTD 13,940 15,320
    GRAFTECH INTERNATIONAL LTD 294,224 295,750
    GRAPHIC PACKAGING CORP COM STK 41,828 58,500
    HALLIBURTON COMPANY 226,736 137,220
    HOLCIM LTD SPON ADS 57,245 100,900
    HOLCIM N 513,587 495,500
    HUDBAY MINERALS INC 186,121 217,500
    IVANHOE MINES LTD 60,260 246,000
    JAPAN SMALLER CAPITALIZATION F 365,092 360,446
    JET2 PLC 78,926 151,021
    JOHNSON & JOHNSON 231,728 427,675
    KAZATOMPROM JSC NAC GDR 147,503 367,500
    KIRKLAND LAKE GOLD LTD 289,047 365,426
    MARKET VECTORS VIETNAM ETF 40,705 42,480
    MERCK & CO INC 362,950 613,120
    MICRON TECHNOLOGY 325,144 1,117,801
    MICROSOFT CORP 28,785 336,320
    NEWMONT GOLDCORP CORPORATION 574,088 983,389
    NEXGEN ENERGY LTD 83,653 117,990
    NOVAGOLD RESOURCES 108,485 137,200
    NUVEEN MLT STR I&G 9,760 9,760
    OCEANAGOLD CORPORATION COM 142,250 103,800
    ORGANON & CO 18,170 24,360
    PEABODY ENERGY CORP 60,905 50,350
    PFIZER INC 441,678 1,062,900
    PHILIP MORRIS INTL 8,916 9,500
    PRETIUM RESOURCES INC 109,012 169,080
    TEVA PHARMACEUTICAL INDUSTRIES 36,513 8,010
    THE MOSAIC CO 261,023 275,030
    TOREX GOLD RESOURCES 181,332 155,700
    TPG RE FINANCE TRUST INC 2,013 1,232
    TRUIST FINANCIAL CORPORATION 30,848 58,550
    TURQUOISE HILL RESOURCES LTD 98,774 98,700
    UNITED STATES STEEL CORP 23,905 23,810
    VALARIS LTD WTS EXP 04/29/2028 220,170 314
    VALARIS PLC COM CL A 161,969  
    VIATRIS ORD SHS 90,189 87,688

    TY 2021 InvestmentsGovtObligationsSch
    Name:
    David & Janet Polak Foundation
    EIN:
    45-4797578
    US Government Securities - End of Year Book Value:

    23,334,689
    US Government Securities - End of Year Fair Market Value:

    23,402,860
    State & Local Government Securities - End of Year Book Value:


    2,621,558
    State & Local Government Securities - End of Year Fair Market Value:


    2,816,618


    TY 2021 InvestmentsOtherSchedule2
    Name:
    David & Janet Polak Foundation
    EIN:
    45-4797578
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    AIR U.S. LIFE FUND III, LP   2,074,320 2,073,099
    AIR US LIFE FUND IV, LP   2,069,383 2,133,872
    ALPHA WAVE (F/K/A FALCON EDGE)   557,691 1,487,359
    ALTAIR - PACIFIC COAST CPTL PT   714,364 942,515
    ALTAIR DIRECT LENDING FUND, LL   171,854 156,702
    ALTAIR EUROPEAN R E OPPORTUNIT   659,098 308,408
    ALTAIR SENIOR HOUSING FUND (AE   188,269 618,063
    ANAGENESIS CAPITAL PARTNERS SB   1,120,878 1,783,921
    ASM CONNAUGHT HOUSE FUND III L   1,000,000 1,289,574
    AVANTE CAPITAL PARTNERS SBIC I   146,430 142,105
    BROAD ST REAL ESTATE CREDIT PT   60,000 244,636
    BW GAS & CONVENIENCE ONSHORE F   249,192 3,082,224
    DORCHESTER CAPITAL SECONDARIES   461,887 581,433
    ENLIGHTENMENT CAPITAL SOLUTION   1,256,641 2,640,217
    FIRST EAGLE CLO EQUITY FUND I,   643,264 612,135
    FOURTHSTONE SMALL-CAP FINANCIA   315,314 404,796
    GOLDMAN SACHS VINTAGE FUND V L   302,066 134,705
    GRANITE CREEK FLEXCAP II, L.P   795,402 1,232,897
    GS DISTRESSED OPPORTUNITIES FU   133,187 203,944
    GSO CAPITAL SOLUTIONS FUND II   6,436 5,737
    GSO CAPITAL SOLUTIONS FUND II   77,877 51,753
    GSO CAPITAL SOLUTIONS FUND II   287,881 153,222
    GSO ENERGY SELECT OPPORTUNITIE   321,560 303,953
    GSO ENERGY SELECT OPPORTUNITIE   58,054 51,753
    GSO ENERGY SELECT OPPORTUNITIE   1,409 1,256
    GSO ENERGY SELECT OPPORTUNITIE   41,371 36,346
    LATITUDE MGMT REAL ESTATE CAPI   75,000 65,274
    LATITUDE MGMT REAL ESTATE CAPI   2,000,000 2,011,389
    PCCP EQUITY VII, LP   1,883,263 3,243,232
    PCCP EQUITY VIII, LP   665,012 794,793
    QS CAPITAL STRATEGIES II, L.P   281,655 264,946
    SILVERVIEW CREDIT OPPORTUNITES   172,223 179,901
    SILVERVIEW CREDIT OPPORTUNITES   1,592,815 1,646,743
    THE EDGBASTON ASIAN EQUITY TRU   1,350,605 1,258,937
    BERNIE L MADOFF - CLAIM RECEIV   406,622 406,622

    TY 2021 LegalFeesSchedule
    Name:
    David & Janet Polak Foundation
    EIN:
    45-4797578
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    General Consultations 23,115     23,115


    TY 2021 OtherAssetsSchedule
    Name:
    David & Janet Polak Foundation
    EIN:
    45-4797578
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    PRI - AMICROBE, INC   250,000 250,000
    PRI - BARAK BALLET   200,000 200,000
    PRI - BIOP MEDICAL   250,000 250,000
    PRI - BRUIN_BIOMETRICS   250,000 250,000
    PRI - BRYN PHARMA LLC F/K/A EP   250,000 250,000
    PRI - CYWAT TECH   507,100 507,101
    PRI - EXTHERA MEDICAL CORP   250,000 250,000
    PRI - MAXQ AI, LTD   250,000 250,000
    PRI - MOTHERS CHOICE   250,000 250,000
    PRI - MOTHERS CHOICE (2)   250,000 250,000
    PRI - OCTHEALTH LLC - 15,000 U   250,000 250,000
    PRI - ONLINE DISRUPTIVE   250,000 250,000
    PRI - ORGENESIS - 32,052 SHARE   294,398 183,658
    PRI - ORGENESIS WTS - 32,052 U   11,100  
    PRI - SER A1 PFD (82,175 UNITS   250,000 250,000
    PRI - SER A2 PFD (15,408 UNITS   37,502 37,502
    PRI - SYNERGIO BIO ACTIVES LTD   100,000 100,000
    PRI - YONALINK LTD   250,000 250,000


    TY 2021 OtherExpensesSchedule
    Name:
    David & Janet Polak Foundation
    EIN:
    45-4797578
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Administrative Fees 87,942     87,942
    Bank Charges 2,837 2,837    
    Cell Phone Expense 1,699     1,699
    Foundation Dues & Memberships 3,600     3,600
    Insurance Premiums 1,192     1,192
    K-1 Exp AIR U.S. LIFE FUND III 132,085 132,085    
    K-1 Exp AIR US LIFE FUND IV, L 22,556 22,556    
    K-1 Exp ALPHA WAVE (F/K/A FALC 11,471 11,471    
    K-1 Exp ALTAIR - PACIFIC COAST 17,488 17,205    
    K-1 Exp ALTAIR DIRECT LENDING 1,732 1,732    
    K-1 Exp ALTAIR SENIOR HOUSING 3,165 3,099    
    K-1 Exp ANAGENESIS CAPITAL PAR 168,069 164,680    
    K-1 Exp AVANTE CAPITAL PARTNER 21,404 21,020    
    K-1 Exp BW GAS & CONVENIENCE O 534 57    
    K-1 Exp ENLIGHTENMENT CAPITAL 19,851 19,779    
    K-1 Exp FIRST EAGLE CLO EQUITY 16,202 11,170    
    K-1 Exp FOURTHSTONE SMALL-CAP 5,756 5,756    
    K-1 Exp GRANITE CREEK FLEXCAP 9,486 9,349    
    K-1 Exp GSO CAPITAL SOLUTIONS 3,306 828    
    K-1 Exp GSO CAPITAL SOLUTIONS 5,058 5,053    
    K-1 Exp GSO ENERGY SELECT OPPO 37,274 3,604    
    K-1 Exp GSO ENERGY SELECT OPPO 1,011 906    
    K-1 Exp GSO ENERGY SELECT OPPO 25 25    
    K-1 Exp GSO ENERGY SELECT OPPO 2,050 398    
    K-1 Exp PCCP EQUITY VII, LP 32,641 32,634    
    K-1 Exp PCCP EQUITY VIII, LP 6,306 6,305    
    K-1 Exp QS CAPITAL STRATEGIES 41,033 40,894    
    K-1 Exp SILVERVIEW CREDIT OPPO 1,071 1,071    
    K-1 Exp THE EDGBASTON ASIAN EQ 4,401 4,311    
    Postage/Delivery Service 160     160
    Registered Agent Fee 125     125
    State or Local Filing Fees 290     290
    Website Hosting/Support 547     547
    PARKING FEES 6,857     6,857


    TY 2021 OtherIncomeSchedule2
    Name:
    David & Janet Polak Foundation
    EIN:
    45-4797578
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    K-1 Inc/Loss AIR US LIFE FUND IV, LP -242 -242  
    K-1 Inc/Loss ALTAIR - PACIFIC COAST CPTL PTNRS EQU 300 5,627  
    K-1 Inc/Loss ALTAIR DIRECT LENDING FUND, LLC 2,465 2,465  
    K-1 Inc/Loss ALTAIR SENIOR HOUSING FUND (AEW), LLC -27,958 26  
    K-1 Inc/Loss ANAGENESIS CAPITAL PARTNERS SBIC FUND 206,444 295,357  
    K-1 Inc/Loss AVANTE CAPITAL PARTNERS SBIC III, LP 16,149 16,488  
    K-1 Inc/Loss BW GAS & CONVENIENCE ONSHORE FUND, LP -102,921    
    K-1 Inc/Loss ENLIGHTENMENT CAPITAL SOLUTIONS FUND 70,016 72,443  
    K-1 Inc/Loss FIRST EAGLE CLO EQUITY FUND I, LP 154,554 142,034  
    K-1 Inc/Loss FOURTHSTONE SMALL-CAP FINANCIALS FD L 6,201 6,201  
    K-1 Inc/Loss GRANITE CREEK FLEXCAP II, L.P 152,194 152,008  
    K-1 Inc/Loss GSO CAPITAL SOLUTIONS FUND II AIV-1 L -27    
    K-1 Inc/Loss GSO CAPITAL SOLUTIONS FUND II AIV-2 L 86,482 58,507  
    K-1 Inc/Loss GSO CAPITAL SOLUTIONS FUND II LP 26,683 26,344  
    K-1 Inc/Loss GSO ENERGY SELECT OPPORTUNITIES FUND 137,046 -1,239  
    K-1 Inc/Loss GSO ENERGY SELECT OPPORTUNITIES FUND 3,609 1,225  
    K-1 Inc/Loss PCCP EQUITY VII, LP -16,352 9,325  
    K-1 Inc/Loss PCCP EQUITY VIII, LP 6,008 5,585  
    K-1 Inc/Loss QS CAPITAL STRATEGIES II, L.P 22,688 22,578  
    K-1 Inc/Loss SILVERVIEW CREDIT OPPORTUNITES OFFSHO 157,272 157,272  
    K-1 Inc/Loss THE EDGBASTON ASIAN EQUITY TRUST 56,198 56,198  
    Class Action Lawsuit Proceeds 399 399  
    Foreign Currency Gain 656 656  
    State Tax Refund 11,927    


    TY 2021 OtherProfessionalFeesSchedule
    Name:
    David & Janet Polak Foundation
    EIN:
    45-4797578
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    WEBSITE DEVELOPMENT 10,878     10,878
    Investment Management Services 398,604 398,604    
    Philanthropic Consulting Srvcs 15,000     15,000
    LOGO DESIGN SERVICES 15,000     15,000


    TY 2021 TaxesSchedule
    Name:
    David & Janet Polak Foundation
    EIN:
    45-4797578
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    990-PF Estimated Tax for 2021 15,300      
    990-T Extension for 2020 124,500      
    Foreign Tax Paid 13,725 13,725    
    STATE UBTI TAX 2020 55,800      
    STATE UBTI TAX 2019 12,635