Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0052
2020
Open to Public Inspection
For calendar year 2020, or tax year beginning 10-01-2020 , and ending 09-30-2021
Name of foundation
Washington Square Health Foundation
 
Number and street (or P.O. box number if mail is not delivered to street address)875 North Michigan Ave 3516
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Chicago, IL60611
A Employer identification number

36-1210140
B Telephone number (see instructions)

(312) 664-6488
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$21,569,801J 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) 79,209
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 334,821 334,821  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 529,970
b Gross sales price for all assets on line 6a 1,973,133
7 Capital gain net income (from Part IV, line 2)... 529,970
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances 0
b Less: Cost of goods sold.... 0
c Gross profit or (loss) (attach schedule)..... 0  
11 Other income (attach schedule)....... 0 0 0
12 Total. Add lines 1 through 11........ 944,000 864,791 0
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 434,821 43,482   391,339
14 Other employee salaries and wages...... 7,358 736   6,622
15 Pension plans, employee benefits....... 155,762 15,576   140,186
16a Legal fees (attach schedule)......... Click to see attachment 11,050 1,105 0 9,945
b Accounting fees (attach schedule)....... Click to see attachment 42,199 4,220 0 37,979
c Other professional fees (attach schedule).... Click to see attachment 4,136 414 0 3,722
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 38,713 2,356 0 21,205
19 Depreciation (attach schedule) and depletion... Click to see attachment 5,450 545 0
20 Occupancy.............. 65,989 6,599   59,390
21 Travel, conferences, and meetings....... 243 24   219
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 62,747 6,275 0 56,472
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 828,468 81,332 0 727,079
25 Contributions, gifts, grants paid....... 585,263 507,915
26 Total expenses and disbursements. Add lines 24 and 25 1,413,731 81,332 0 1,234,994
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -469,731
b Net investment income (if negative, enter -0-) 783,459
c Adjusted net income (if negative, enter -0-)... 0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2020)
Form 990-PF (2020)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............. 2,132,642 998,121 998,121
2 Savings and temporary cash investments......... 2,321,122 1,473,167 1,473,167
3 Accounts receivable bullet8,020
Less: allowance for doubtful accounts bullet   10,492 8,020 8,020
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet   0 0 0
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)..... 0 0 0
7 Other notes and loans receivable (attach schedule) bullet0
Less: allowance for doubtful accounts bullet0 0 0 0
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges.......... 28,509 35,628 35,628
10a Investments—U.S. and state government obligations (attach schedule) 0 0 0
b Investments—corporate stock (attach schedule)....... 12,830,815 Click to see attachment17,703,341 17,703,341
c Investments—corporate bonds (attach schedule)....... 302,834 Click to see attachment296,520 296,520
11 Investments—land, buildings, and equipment: basis bullet0
Less: accumulated depreciation (attach schedule) bullet0 0   0
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 543,768 Click to see attachment664,216 664,216
14 Land, buildings, and equipment: basis bullet81,402
Less: accumulated depreciation (attach schedule) bullet56,519 26,563 Click to see attachment24,883 24,883
15 Other assets (describe bullet) Click to see attachment512,654 Click to see attachment365,905 Click to see attachment365,905
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 18,709,399 21,569,801 21,569,801
Liabilities 17 Accounts payable and accrued expenses.......... 50,543 52,932
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons 0 0
21 Mortgages and other notes payable (attach schedule)...... 0 0
22 Other liabilities (describe bullet) Click to see attachment524,358 Click to see attachment621,952
23 Total liabilities (add lines 17 through 22)......... 574,901 674,884
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........... 18,134,498 20,894,917
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)..... 18,134,498 20,894,917
30 Total liabilities and net assets/fund balances (see instructions). 18,709,399 21,569,801
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
18,134,498
2
Enter amount from Part I, line 27a .....................
2
-469,731
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
3,230,150
4
Add lines 1, 2, and 3 ..........................
4
20,894,917
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
20,894,917
Form 990-PF (2020)
Form 990-PF (2020)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1 a Securities      
b
c
d
e
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 1,973,133   1,443,163 529,970
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a     0 529,970
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 2 529,970
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 0
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
SECTION 4940(e) REPEALED ON DECEMBER 20, 2019 - DO NOT COMPLETE
1 Reserved
(a)
Reserved 		(b)
Reserved 		(c)
Reserved 		(d)
Reserved
2
Reserved...........................
2
3
Reserved...........................
3
4
Reserved...........................
4
5
Reserved...........................
5
6
Reserved...........................
6
7
Reserved...........................
7
8
Reserved,..........................
8
Form 990-PF (2020)
Form 990-PF (2020)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b Reserved................................ 1 10,890
c All other domestic foundations enter 1.39% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2  
3 Add lines 1 and 2........................... 3 10,890
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 10,890
6 Credits/Payments:
a 2020 estimated tax payments and 2019 overpayment credited to 2020 6a 20,000
b Exempt foreign organizations—tax withheld at source...... 6b  
c Tax paid with application for extension of time to file (Form 8868)... 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 20,000
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 9,110
11 Enter the amount of line 10 to be: Credited to 2021 estimated taxBullet9,110 RefundedBullet 11 0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletIL
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2020 or the taxable year beginning in 2020? See the instructions for Part XIV.
    If "Yes," complete Part XIV .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 5
    Part VII-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletWWW.WSHF.ORG
    14
    The books are in care ofbulletHOWARD NOCHUMSON Telephone no.bullet (312) 664-6488

    Located atbullet875 NORTH MICHIGAN AVE STE 3516CHICAGOIL ZIP+4bullet60611
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2020, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?......................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?...............
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).......
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ........
    1b
     
    No
    ........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2020?.............
    1c
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2020, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2020?.............
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?......................
    b
    If "Yes," did it have excess business holdings in 2020 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2020.)..................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2020?
    4b
     
    No
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 6
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?.............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?.....
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ......
    5b
     
     
    .........bullet
    c
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?..........
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?.....................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .................
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    Barbara Berendt Director
    2.000     		8,500 0 0
    875 North Michigan Ave
    Chicago,IL60611
    Catherine M Creticos MD Director
    2.000     		8,750 0 0
    875 North Michigan Ave
    Chicago,IL60611
    Sandy Goldberg PhD Director
    2.000     		8,750 0 0
    875 North Michigan Ave
    Chicago,IL60611
    William N Werner MD MPH Board Chair / Director
    2.000     		20,750 0 0
    875 North Michigan Ave
    Chicago,IL60611
    William B Friedeman Secretary / Director
    2.000     		10,250 0 0
    875 North Michigan Ave
    Chicago,IL60611
    James M Snyder Treasurer / Director
    2.000     		9,500 0 0
    875 North Michigan Ave
    Chicago,IL60611
    Howard Nochumson Executive Director & President
    40.000     		214,660 97,046 0
    875 North Michigan Ave
    Chicago,IL60611
    Catherine Kapella MPH Associate Director & Vice President
    40.000     		153,661 58,460 0
    875 North Michigan Ave
    Chicago,IL60611
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
     
    Total number of other employees paid over $50,000...................bullet  
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 7
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
     
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1 None 0
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet0
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 8
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    19,548,524
    b
    Average of monthly cash balances.......................
    1b
    1,597,140
    c
    Fair market value of all other assets (see instructions)................
    1c
    77,923
    d
    Total (add lines 1a, b, and c).........................
    1d
    21,223,587
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
     
    3
    Subtract line 2 from line 1d.........................
    3
    21,223,587
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    318,354
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    20,905,233
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    1,045,262
    Part XI
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    1,045,262
    2a
    Tax on investment income for 2020 from Part VI, line 5......
    2a
    10,890
    b
    Income tax for 2020. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    10,890
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    1,034,372
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    1,034,372
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
    1,034,372
    Part XII
    Qualifying Distributions (see instructions)
    1
    Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
    a
    Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........
    1a
    1,234,994
    b
    Program-related investments—total from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
    0
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    1,234,994
    5
    Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
    income. Enter 1% of Part I, line 27b. See instructions.................
    5
     
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    1,234,994
    Note: The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
    the section 4940(e) reduction of tax in those years.
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2019     		(c)
    2019     		(d)
    2020
    1 Distributable amount for 2020 from Part XI, line 7 1,034,372
    2 Undistributed income, if any, as of the end of 2020:
    a Enter amount for 2019 only....... 0
    b Total for prior years:2018, 2017, 2016 0
    3 Excess distributions carryover, if any, to 2020:
    a From 2015...... 101,432
    b From 2016...... 522,795
    c From 2017...... 319,254
    d From 2018...... 430,743
    e From 2019...... 672,248
    fTotal of lines 3a through e........ 2,046,472
    4Qualifying distributions for 2020 from Part
    XII, line 4: bullet$ 1,234,994
    a Applied to 2019, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		0
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		0
    d Applied to 2020 distributable amount..... 1,034,372
    e Remaining amount distributed out of corpus 200,622
    5 Excess distributions carryover applied to 2020.   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 2,247,094
    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......     		 
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		0
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2020. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2021 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8 Excess distributions carryover from 2015 not
    applied on line 5 or line 7 (see instructions) ...     		101,432
    9Excess distributions carryover to 2021.
    Subtract lines 7 and 8 from line 6a ......     		2,145,662
    10 Analysis of line 9:
    a Excess from 2016.... 522,795
    b Excess from 2017.... 319,254
    c Excess from 2018.... 430,743
    d Excess from 2019.... 672,248
    e Excess from 2020.... 200,622
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 10
    Part XIV
    Private Operating Foundations (see instructions and Part VII-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2020, enter the date of the ruling....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2020 (b) 2019 (c) 2018 (d) 2017
             
    b 85% of line 2a .........          
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part X, line 6 for each year listed...     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    HOWARD NOCHUMSON
    875 NORTH MICHIGAN AVE SUITE 3516
    CHICAGO,IL60611
    (312) 664-6488
    bThe form in which applications should be submitted and information and materials they should include:
    Visit the website for the organization's grant guidelines & application: http://wshf.org/general-guidelines/
    cAny submission deadlines:
    GRANT SUBMISSIONS WERE ACCEPTED ON A CONTINUOUS ROLLING BASIS FOR EITHER THE 12/1 OR 6/1 DEADLINES.
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    NONE
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 11
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    A Silver Lining Foundation
    134 N LaSalle Street Suite 2050
    Chicago,IL60602     		NONE PC Matching Grant to Support A Silver Lining Foundation's Mammography Program 25,000
    A Silver Lining Foundation
    134 N LaSalle Street Suite 2050
    Chicago,IL60602     		NONE PC Dr. Sandy Goldberg's Board of Director Grant to A Silver Lining Foundation for Mammography 7,500
    A Silver Lining Foundation
    134 N LaSalle Street Suite 2050
    Chicago,IL60602     		NONE PC Dr. Catherine M. Creticos' Board of Director Grant to A Silver Lining Foundation for Mammography 1,750
    A Silver Lining Foundation
    134 N LaSalle Street Suite 2050
    Chicago,IL60602     		NONE PC Special Designated Grant to A Silver Lining Foundation for Mammography Services 3,500
    Advocate Charitable Foundation
    3075 Highland Pkwy 600
    Downers Grove,IL60515     		NONE PC William N. Werner's Board of Director Grant to the Angelo P. Creticos, MD Cancer Center at Advocate Illinois Masonic Medical Center 1,500
    Advocate Charitable Foundation
    3075 Highland Pkwy 600
    Downers Grove,IL60515     		NONE PC Dr. Catherine M. Creticos' Board of Director Grant to the Angelo P. Creticos, MD Lectureship Fund at Advocate Illinois Masonic Medical Center 1,000
    Advocate Charitable Foundation
    3075 Highland Pkwy 600
    Downers Grove,IL60515     		NONE PC Dr. Catherine M. Creticos' Board of Director Grant to the Anastasia and Angelo P. Creticos, MD Medical Innovation Endowment at Advocate Illinois Masonic Medical Center 500
    Alexian Brothers Bonaventure House
    825 West Wellington
    Chicago,IL60657     		NONE PC Dr. Catherine M. Creticos' Board of Director Grant to Alexian Brothers Bonaventure House 1,250
    American Cancer Society Illinois Division
    225 N Michigan Ave Suite 1200
    Chicago,IL60601     		NONE PC Catherine Kapella, MPH's Board Officer Grant to the American Cancer Society in Memory of Benedykt Baginski 1,000
    American Cancer Society Illinois Division
    225 N Michigan Ave
    Chicago,IL60601     		NONE PC Catherine Kapella, MPH's Board Officer Grant to the American Cancer Society in Memory of Janusz Ziminski 1,500
    Ann & Robert H Lurie Children's Hospital of Chicago
    225 E Chicago Ave Box 4
    Chicago,IL60611     		NONE PC Hematology, Oncology and Stem Cell Transplantation Fellowship Program 30,000
    Ann & Robert H Lurie Children's Hospital of Chicago
    225 E Chicago Ave Box 4
    Chicago,IL60611     		NONE PC Hematology, Oncology and Stem Cell Transplantation Fellowship Program 30,000
    Boulder Community Health Foundation
    PO Box 19320
    Boulder,CO80308     		NONE PC Mr. William B. Friedeman's Board of Director Grant in honor of Charlotte Mills Dohms, born at Foothills Hospital, March 18, 2021 1,000
    Boulder community Health Foundation
    PO Box 19320
    Boulder,CO80308     		NONE PC Mr. William B. Friedeman's Board of Director Grant to the Boulder Community Health Foundation 2,000
    Chicago Chesed Fund
    7045 Ridgeway
    Lincolnwood,IL60712     		NONE PC Howard Nochumson's Board of Director Grant to the Chicago Chesed Fund for Program Support 1,000
    Chicago Chesed Fund
    7045 Ridgeway
    Lincolnwood,IL60712     		NONE PC New Freezer Unit 13,750
    Chicago Chesed Fund
    7045 Ridgeway
    Lincolnwood,IL60712     		NONE PC Emergency Funding for Forklift 5,800
    Chicago Chesed Fund
    7045 Ridgeway
    Lincolnwood,IL60712     		NONE PC Howard Nochumson's Board of Director Grant for Program Support 1,000
    Chicago Chesed Fund
    7045 Ridgeway
    Lincolnwood,IL60712     		NONE PC Howard Nochumson's Board of Director Grant to the Chicago Chesed Fund for Program Support 1,000
    Chicago Hearing Society
    6610 N Clark St
    Chicago,IL60626     		NONE PC CHS Hearing Health Clinic Audiology Testing Equipment 10,349
    Clearbrook
    1825 W Central
    Arlington Heights,IL60005     		NONE PC PRI FORGIVENESS 7,788
    Community Foundation Boulder County
    1123 Spruce Street
    Boulder,CO80302     		NONE PC Mr. William B. Friedeman's Board of Director Grant to the Community Foundation Boulder County for the Covid-19 Relief Fund 2,000
    CommunityHealthNFP
    2611 W Chicago Ave
    Chicago,IL60657     		NONE PC Patient Advisory Committee and Health Education Program 12,470
    Council on Foundations
    1828 L Street NW Suite 300
    Washington,DC20036     		NONE PC Foundation Designated Grant 3,000
    Covenant World Relief
    8303 W Higgins Rd
    Chicago,IL60631     		NONE PC Dr. William N. Werner's Board of Director Grant to Covenant World Relief 2,000
    Dion's Chicago Dream
    180 N Windmere Circle
    Matteson,IL60443     		NONE PC Dr. Catherine M. Creticos' Board of Director Grant to Dion's Chicago Dream 750
    Easter Seals Metropolitan Chicago
    1939 W 13th Street Ste 300
    Chicago,IL60608     		NONE PC Coordinated Pandemic Response for a Vulnerable Population 10,250
    Erie Family Health Center
    1701 West Superior Street 3rd Floor
    Chicago,IL60622     		NONE PC Reshaping Diabetes Prevention and Management in the Context of COVID-19 12,500
    Forefront
    208 South LaSalle Street Suite 1540
    Chicago,IL60604     		NONE PC Foundation Designated Grant 760
    Franciscan Tertiary Province Of The Sacred Heart Inc
    1801 35th Street
    Oak Brook,IL60523     		NONE PC Spread the Health 5,000
    Friends of the Children- Chicago
    15112 S Pulaski Road
    Chicago,IL60623     		NONE PC Mr. William B. Friedeman's Board of Director Grant to Friends of the Children- Chicago for the new youth and mindfulness program for youth ages 6-9 living in Austin and North Lawndale 500
    Gilda's Club Chicago
    537 N Wells St
    Chicago,IL60654     		NONE PC Remote Service Delivery for COVID-19 and Beyond 12,500
    Grantmakers In Health
    1100 Connecticut Avenue NW Suite 12
    00
    Washington,DC20036     		NONE PC Foundation Designated Grant 3,250
    Howard Brown Memorial Clinic
    4025 N Sheridan Rd
    Chicago,IL60601     		NONE PC Breaking Down Barriers: Howard Brown Health's Clinical Research Patient Navigator 10,080
    Howard Brown Memorial Clinic
    4025 N Sheridan Rd
    Chicago,IL60613     		NONE PC Dr. Catherine M. Creticos' Board of Director Grant to Howard Brown Health Center for Clinical Research 1,500
    JET - Jewish Education Team Inc
    6708 N Francisco Avenue
    Chicago,IL60645     		NONE PC Howard Nochumson's Board of Director Grant to Jewish Education Team for Program Support 1,000
    JourneyCare
    2050 Claire Court
    Glenview,IL60004     		NONE PC Hospice and Palliative Medicine Fellowship Program 25,000
    JourneyCare
    2050 Claire Court
    Glenview,IL60004     		NONE PC Hospice and Palliative Medicine Fellowship Program 25,000
    Lakeview Pantry
    3945 N Sheridan Rd
    Chicago,IL60613     		NONE PC Executive Committee Grant for Food Pantry Initiative Grant to Lakeview Pantry 25,000
    Mary's Place
    PO Box 1711
    Seattle,WA98111     		NONE PC Mr. William B. Friedeman's Board of Director Grant to Mary's Place in honor of Nelle Friedeman's second birthday 1,000
    North Park Friendship Center
    3448 W Foster
    Chicago,IL60625     		NONE PC Dr. William N. Werner's Board of Director Grant to North Park Friendship Center 3,000
    North Side Housing & Support Services
    4410 N Ravenswood Suite 101
    Chicago,IL60640     		NONE PC Stay Home, Stay Safe 7,025
    NorthShore University HealthSystem Research Institute
    1001 University Place
    Evanston,IL60201     		NONE PC Advanced Diffusion Tensor MRI for Breast Cancer 26,819
    NorthShore University HealthSystem Research Institute
    1001 University Place
    Evanston,IL60201     		NONE PC Advanced Diffusion Tensor MRI for Breast Cancer 26,819
    Northwestern University
    750 North Lake Shore Drive Suite 54
    2
    Chicago,IL60611     		NONE PC Emergency Department Patients: Increasing Social Work staffing to balance staffing complement in addressing Non-Medical visits 25,000
    Northwestern University
    750 North Lake Shore Dr Suite 542
    Chicago,IL60611     		NONE PC Catherine Kapella, MPH's Board Officer Grant to Northwestern University to advance the research of Dr. Amani Fawzi 5,000
    Project Seed of Suburban Chicago Inc
    6045 N Monticello Avenue
    Chicago,IL60659     		NONE PC Howard Nochumson's Board of Director Grant to Project Seed of Suburban Chicago for Program Support 500
    Project Seed of Suburban Chicago Inc
    6045 N Monticello Avenue
    Chicago,IL60659     		NONE PC Howard Nochumson's Board of Director Grant to Project Seed of Suburban Chicago for Program Support 2,000
    Ray Graham Association for People with Disabilities
    901 Warrenville Rd Suite 500
    Lisle,IL60532     		NONE PC Dr. Catherine M. Creticos' Board of Director Grant to the Hanson Center Therapeutic Riding Program at Ray Graham Association for People with Disabilities. 750
    Rosalind Franklin University of Medicine and Science
    3333 Green Bay Road
    Chicago,IL60064     		NONE PC The WSHF Nursing Scholarship Program 12,500
    Roseland Community Hospital
    45 W 111th Street
    Chicago,IL60628     		NONE PC Barbara Berendt's Board of Director Grant to Roseland Community Hospital for Program Support 7,500
    Roseland Community Hospital
    45 W 111th Street
    Chicago,IL60628     		NONE PC PRI FORGIVENESS 33,920
    Roseland Community Hospital
    45 W 111th Street
    Chicago,IL60628     		NONE PC PRI FORGIVENESS 35,640
    Shirley Ryan Ability Lab
    355 E Erie Street
    Chicago,IL60611     		NONE PC Advance Human Ability Campaign 50,000
    St John's Episcopal Church
    PO Box 1690
    Jackson,WY83001     		NONE PC William B. Friedeman's Board of Director Grant to St. John's Episcopal Church to help defray costs for Outreach-Soup Kitchen 1,000
    St Leonard's House
    2100 W Warren Blvd
    Chicago,IL60612     		NONE PC Integrated Behavioral and Physical Health Care for Reentering Citizens 4,800
    The American Committee for the Weizmann Institute of Science
    180 N LaSalle Street Suite 3110
    Chicago,IL60601     		NONE PC Master's Student Scholarship: Supporting Excellence in Science 10,000
    The Children's Clinic
    320 Oak Park
    Chicago,IL60302     		NONE PC Support of Oral Health Care Program that treats Patients with Special Health Care Needs during COVID-19 pandemic 9,243
    The Kedzie CenterExpanded Mental Health Services Of Chicago Nfp
    4141 N Kedzie Ave Suite 2
    Chicago,IL60618     		NONE PC Dr. William N. Werner's Board of Director Grant to The Kedzie Center 1,000
    Torah Academy of Buffalo Grove
    720 Armstrong Drive
    Buffalo Grove,IL60089     		NONE PC Howard Nochumson's Board of Director Grant to Torah Academy of Buffalo Grovefor Annual Defibrillator Training and Needed Preventative Covid Supplies 1,000
    University of Illinois Foundation
    PO BOX 734500
    Chicago,IL60673     		NONE PC Developing More Comprehensive, Rigorous Approachesto Evaluate Costs andCost- effectiveness for Community-based Interventions Focused on Underserved Communities 5,000
    Zacharias Sexual Abuse Center
    4232 Dempster Street
    Skokie,IL60076     		NONE PC New Virtual Services 15,000
    Total .................................bullet 3a 585,263
    bApproved for future payment
    Total .................................bullet 3b 0
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3 Interest on savings and temporary cash
    investments ...........     		         
    4 Dividends and interest from securities....     14 334,821  
    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 ............     		    18 529,970  
    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).. 0 864,791 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    864,791
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 13
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below?
    See instructions.
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    		 Firm's EIN SmallBullet
    Firm's address SmallBullet


    		 Phone no.
    Form 990-PF (2020)
    Additional Data


    Software ID: 20011424
    Software Version: 2020v4.0


    Form 990PF - Special Condition Description:
    Special Condition Description
    Schedule B
    (Form 990, 990-EZ,
    or 990-PF)
    Department of the Treasury
    Internal Revenue Service
    Schedule of Contributors

    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
    OMB No. 1545-0047
    2020
    Name of the organization
    Washington Square Health Foundation
     
    Employer identification number

    36-1210140
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ






    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......... Arrow Bullet $  
    Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
    or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2
    Name of organization
    Washington Square Health Foundation
          		Employer identification number
    36-1210140
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    1
    ZENDT TRUST
     
    C/O Bank of America 100 Westminster
    Street
    Providence, RI02903

    		$ 7,107


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    2
    Small Business Administration
     
    409 3rd St SW
     
    Washington, DC20416

    		$ 72,102


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Page 3
    Name of organization
    Washington Square Health Foundation
          		Employer identification number

    36-1210140
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Page 4
    Name of organization
    Washington Square Health Foundation
          		Employer identification number

    36-1210140
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Additional Data


    Software ID: 20011424
    Software Version: 2020v4.0

    TY 2020 AccountingFeesSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    20011424
    Software Version:
    2020v4.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Accounting Fees 42,199 4,220   37,979

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

    TY 2020 DepreciationSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    20011424
    Software Version:
    2020v4.0
    Description of Property Date Acquired Cost or Other Basis Prior Years' Depreciation Computation Method Rate /
    Life (# of years)    		 Current Year's Depreciation Expense Net Investment Income Adjusted Net Income Cost of Goods Sold Not Included
    Equipment           5,450 545    

    TY 2020 GeneralExplanationAttachment
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    20011424
    Software Version:
    2020v4.0
    Identifier Return Reference Explanation
    Item G - Reason for Amended Return Filing 990-PF Header The Form 990-PF was amended to reflect the total compensation paid to William N Werner, MD, MPH.

    TY 2020 InvestmentsCorpBondsSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    20011424
    Software Version:
    2020v4.0
    Name of Bond End of Year Book Value End of Year Fair Market Value
    CORPORATE BONDS 296,520 296,520

    TY 2020 InvestmentsCorpStockSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    20011424
    Software Version:
    2020v4.0
    Name of Stock End of Year Book Value End of Year Fair Market Value
    DOM. SMALL CAP MUTUAL FUNDS 2,665,770 2,665,770
    DOM. LARGE CAP MUTUAL FUNDS 6,331,737 6,331,737
    DOMESTIC EQUITY FUNDS 63,975 63,975
    INTERNATIONAL EQUITY FUNDS 3,687,991 3,687,991
    DOM. MIDDLE CAP MUTUAL FUNDS 2,779,885 2,779,885
    COMMINGLED EQUITY FUNDS 105,743 105,743
    Equities 2,068,240 2,068,240

    TY 2020 InvestmentsOtherSchedule2
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    20011424
    Software Version:
    2020v4.0
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    LONG-TERM GROWTH EQUITY FUND FMV 181,809 181,809
    DIVIDEND APPRECIATION INDEX FMV 482,407 482,407

    TY 2020 LandEtcSchedule2
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    20011424
    Software Version:
    2020v4.0
    Category / Item Cost / Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
    EQUIPMENT 81,402 56,519 24,883 24,883


    TY 2020 LegalFeesSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    20011424
    Software Version:
    2020v4.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    LEGAL FEES 11,050 1,105   9,945


    TY 2020 OtherAssetsSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    20011424
    Software Version:
    2020v4.0
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    RENT SECURITY DEPOSIT 6,971 6,971 6,971
    PROGRAM RELATED INVESTMENTS 505,683 358,934 358,934


    TY 2020 OtherExpensesSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    20011424
    Software Version:
    2020v4.0
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INSURANCE 5,333 534   4,799
    OFFICE SUPPLIES 21,434 2,143   19,291
    BOARD DIRECTED PROGRAMS 954 95   859
    DUES & SUBSCRIPTIONS 6,341 634   5,707
    SERVICE CONTRACTS 16,840 1,684   15,156
    BANK CHARGES 1,623 163   1,460
    EXECUTIVE DIRECTOR EXPENSE 570 57   513
    BOARD MEETINGS 9,082 908   8,174
    ASSOCIATE DIRECTOR EXPENSE 570 57   513


    TY 2020 OtherIncreasesSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    20011424
    Software Version:
    2020v4.0
    Description Amount
    Unrealized Gains 3,230,150


    TY 2020 OtherLiabilitiesSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    20011424
    Software Version:
    2020v4.0
    Description Beginning of Year - Book Value End of Year - Book Value
    EMPLOYEE BENEFIT PLAN 524,358 621,952


    TY 2020 OtherProfessionalFeesSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    20011424
    Software Version:
    2020v4.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    CONSULTING FEES 4,136 414   3,722


    TY 2020 TaxesSchedule
    Name:
    Washington Square Health Foundation
    EIN:
    36-1210140
    Software ID:
    20011424
    Software Version:
    2020v4.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FEDERAL EXCISE TAX 15,152      
    Payroll Tax 23,561 2,356   21,205