-
TIN:
Form
990-PF
Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
Do not enter social security numbers on this form as it may be made public.
Go to
www.irs.gov/Form990PF
for instructions and the latest information.
OMB No. 1545-0052
20
20
Open to Public Inspection
For calendar year 2020, or tax year beginning
01-01-2020
, and ending
12-31-2020
Name of foundation
The Clayton Homes Foundation
Number and street (or P.O. box number if mail is not delivered to street address)
5000 Clayton Road
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Maryville
,
TN
37804
A Employer identification number
81-4369351
B
Telephone number (see instructions)
(865) 380-3000
C
If exemption application is pending, check here
G
Check all that apply:
Initial return
Initial return of a former public charity
Final return
Amended return
Address change
Name change
D 1.
Foreign organizations, check here.............
2
. Foreign organizations meeting the 85%
test, check here and attach computation ...
E
If private foundation status was terminated
under section 507(b)(1)(A), check here .......
H
Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here .......
I
Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)
$
2,681,949
J
Accounting method:
Cash
Accrual
Other (specify)
(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)
1
Contributions, gifts, grants, etc., received (attach schedule)
2
Check
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
b
Gross sales price for all assets on line 6a
7
Capital gain net income (from Part IV, line 2)
...
0
8
Net short-term capital gain
.........
9
Income modifications
...........
10a
Gross sales less returns and allowances
b
Less: Cost of goods sold
....
c
Gross profit or (loss) (attach schedule)
.....
11
Other income (attach schedule)
.......
12
Total.
Add lines 1 through 11
........
0
0
0
13
Compensation of officers, directors, trustees, etc.
0
0
0
0
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
297
0
0
0
b
Accounting fees (attach schedule)
.......
c
Other professional fees (attach schedule)
....
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
297
0
0
0
25
Contributions, gifts, grants paid
.......
2,248,254
2,248,254
26
Total expenses and disbursements.
Add lines 24 and 25
2,248,551
0
0
2,248,254
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-2,248,551
b
Net investment income
(if negative, enter -0-)
0
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
1
Cash—non-interest-bearing
.............
4,930,500
2,681,949
2,681,949
2
Savings and temporary cash investments
.........
3
Accounts receivable
Less: allowance for doubtful accounts
4
Pledges receivable
Less: allowance for doubtful accounts
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)
Less: allowance for doubtful accounts
8
Inventories for sale or use
..............
9
Prepaid expenses and deferred charges
..........
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
.......
c
Investments—corporate bonds (attach schedule)
.......
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
4,930,500
2,681,949
2,681,949
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
)
23
Total liabilities
(add lines 17 through 22)
.........
0
0
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
4,930,500
2,681,949
25
Net assets with donor restrictions
............
Foundations that do not follow FASB ASC 958, check here
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)
.....
4,930,500
2,681,949
30
Total liabilities and net assets/fund balances
(see instructions)
.
4,930,500
2,681,949
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return)
...............
1
4,930,500
2
Enter amount from Part I, line 27a
.....................
2
-2,248,551
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
2,681,949
5
Decreases not included in line 2 (itemize)
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
2,681,949
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.)
1a
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
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
b
c
d
e
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
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
...................
3
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
SECTION 4940(e) REPEALED ON DECEMBER 20, 2019 - DO NOT COMPLETE
1
Reserved
(a)
Reserved
(b)
Reserved
(c)
Reserved
(d)
Reserved
2
Reserved
...........................
2
3
Reserved
...........................
3
4
Reserved
...........................
4
5
Reserved
...........................
5
6
Reserved
...........................
6
7
Reserved
...........................
7
8
Reserved
,..........................
8
Form
990-PF
(2020)
Form 990-PF (2020)
Page
4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a
Exempt operating foundations described in section 4940(d)(2), check here
and enter “N/A" on line 1.
Date of ruling or determination letter:
(attach copy of letter if necessary–see instructions)
b
Reserved
................................
1
0
c
All other domestic foundations enter 1.39% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
2
0
3
Add lines 1 and 2
...........................
3
0
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
4
0
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
0
6
Credits/Payments:
a
2020 estimated tax payments and 2019 overpayment credited to 2020
6a
0
b
Exempt foreign organizations—tax withheld at source
......
6b
0
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
0
d
Backup withholding erroneously withheld
...........
6d
0
7
Total credits and payments. Add lines 6a through 6d
..............
7
0
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
0
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
0
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
11
Enter the amount of line 10 to be:
Credited to 2021 estimated tax
Refunded
11
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
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.
$
0
(2)
On foundation managers.
$
0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
Yes
7
Did the foundation have at least $5,000 in assets at any time during the year?
If "Yes," complete Part II, col. (c),
and Part XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
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 address
N/A
14
The books are in care of
Tax Department
Telephone no.
(865) 380-3000
Located at
5000 Clayton Road
Maryville
TN
ZIP+4
37804
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2020, did the foundation have an interest in or a signature or other authority over
Yes
No
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
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?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(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)?
...............
Yes
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.)
.......
Yes
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
Organizations relying on a current notice regarding disaster assistance check here
........
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?
.............
Yes
No
If "Yes," list the years
20
,
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.
20
,
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?
......................
Yes
No
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))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
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
Organizations relying on a current notice regarding disaster assistance check here
.........
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?
..........
Yes
No
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?
.....................
Yes
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?
Yes
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?
.................
Yes
No
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
Kevin Clayton
President
0.00
0
0
0
5000 Clayton Road
Maryville
,
TN
37804
Linda Ponce
Secretary
0.00
0
0
0
5000 Clayton Road
Maryville
,
TN
37804
Susan Brown
Director
0.00
0
0
0
5000 Clayton Road
Maryville
,
TN
37804
James Stariha
Director
0.00
0
0
0
5000 Clayton Road
Maryville
,
TN
37804
2
Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a)
Name and address of each employee paid more than $50,000
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
NONE
Total
number of other employees paid over $50,000
...................
0
Form
990-PF
(2020)
Form 990-PF (2020)
Page
7
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
(continued)
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
NONE
Total
number of others receiving over $50,000 for professional services
.............
0
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
Family Promise Inc.
450,000
2
United Way
359,000
3
Next Step Network, Inc.
300,000
4
RV / Manufactured Home Heritage Foundation
300,000
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
0
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
0
b
Average of monthly cash balances
.......................
1b
4,987,350
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
4,987,350
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation)
.............
1e
0
2
Acquisition indebtedness applicable to line 1 assets
..................
2
0
3
Subtract line 2 from line 1d
.........................
3
4,987,350
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
74,810
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
4,912,540
6
Minimum investment return.
Enter 5% of line 5
..................
6
245,627
Part XI
Distributable Amount
(see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here
and do not complete this part.)
1
Minimum investment return from Part X, line 6
....................
1
245,627
2a
Tax on investment income for 2020 from Part VI, line 5
......
2a
b
Income tax for 2020. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
0
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
245,627
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
245,627
6
Deduction from distributable amount (see instructions)
.................
6
0
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1
...
7
245,627
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
2,248,254
b
Program-related investments—total from Part IX-B
..................
1b
0
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
b
Cash distribution test (attach the required schedule)
.................
3b
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
2,248,254
5
Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
income. Enter 1% of Part I, line 27b. See instructions
.................
5
0
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
2,248,254
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
245,627
2
Undistributed income, if any, as of the end of 2020:
a
Enter amount for 2019 only
.......
0
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2020:
a
From 2015
......
b
From 2016
......
c
From 2017
......
d
From 2018
......
1,232,481
e
From 2019
......
459,592
f
Total
of lines 3a through e
........
1,692,073
4
Qualifying distributions for 2020 from Part
XII, line 4:
$
2,248,254
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
.....
245,627
e
Remaining amount distributed out of corpus
2,002,627
5
Excess distributions carryover applied to 2020.
0
0
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
3,694,700
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
0
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
0
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
0
e
Undistributed income for 2019. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
0
f
Undistributed income for 2020. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2021
..........
0
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions)
.......
0
8
Excess distributions carryover from 2015 not
applied on line 5 or line 7 (see instructions)
...
0
9
Excess distributions carryover to 2021.
Subtract lines 7 and 8 from line 6a
......
3,694,700
10
Analysis of line 9:
a
Excess from 2016
....
b
Excess from 2017
....
c
Excess from 2018
....
1,232,481
d
Excess from 2019
....
459,592
e
Excess from 2020
....
2,002,627
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
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
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.)
1
Information Regarding Foundation Managers:
a
List 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).)
b
List 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.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or email address of the person to whom applications should be addressed:
b
The form in which applications should be submitted and information and materials they should include:
c
Any submission deadlines:
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Form
990-PF
(2020)
Form 990-PF (2020)
Page
11
Part XV
Supplementary Information
(continued)
3 Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
A HAND UP FOR WOMEN
PO Box 3216
Knoxville
,
TN
37927
PC
Assist women trapped in addiction, abuse, poverty and despair to pursue a more self sufficient lifestyle
750
ANXIOUS FOR NOTHING INC
2654 West Lychburgh Salem Turnpike
Bedford
,
VA
24523
PC
Children's services
6,090
ARROWMONT SCHOOL OF ARTS & CRAFTS
PO Box 567
Gatlinburg
,
TN
37738
PC
Art education classes and scholarships
1,000
BLOUNT COUNTY EDUCATION FOUNDATION
831 Grandview Drive
Maryville
,
TN
37803
PC
Promote academic excellence in Blount County Schools
35,000
BLOUNT COUNTY YOUTH COURT
391 Court Street
Maryville
,
TN
37804
PC
Reduce recidivism reat in Blount County for teenagers who participate
3,000
BUCKINGHAM COUNTY DEPARTMENT OF SOCIAL SERVICES
13360 West James Anderson Highway
Buckingham
,
VA
23921
PC
Provides economic assistance and family service programs to needy families
2,150
CARECUTS OF KNOXVILLE
519 Williams Street
Knoxville
,
TN
37917
PC
Provides free haircuts, meals, clothing and transportation for homeless and less fortunate
5,000
CITY OF REFUGE PULASKI
249 Dora Highway
Pulaski
,
VA
24301
PC
Care for needy youth and families, help with camp scholoarships
360
CONCORD BAPTIST CHURCH
11704 Kingston Pike
Knoxville
,
TN
37934
PC
Provides economic assistance and family service programs to needy families
500
DEPARTMENT OF FINANCE AT AUBURN UNIVERSITY
405 West Magnolia Avenue
Auburn
,
AL
36849
PC
Expand educational opportunities
1,500
DUKE CANCER INSTITUTE
DUMC Box 3139
Durham
,
NC
27710
PC
Cancer patient support programs
3,800
EAGLETON BALL PARK
2600 East Broadway Ave
Maryville
,
TN
37802
PC
Ballpark expansion
10,000
FAMILY PROMISE INC
71 Summit Avenue
Summit
,
NJ
17901
PC
Family Homelessness initiative
450,000
FAMILY PROMISE OF BLOUNT COUNTY INC
PO Box 4457
Maryville
,
TN
37802
PC
General organizational support
7,500
FAMILY PROMISE OF KNOXVILLE
3545 Middlebrook Pike
Knoxville
,
TN
37921
PC
Family Homelessness initiative
7,500
FRIENDS OF TENNESSEE'S BABIES WITH SPECIAL NEEDS
517 Crawford Street
Maryville
,
TN
37804
PC
Serving children from firth ot age 3 with disabilities
5,000
FRIES COMMUNITY CENTER
316 West Main Street
Fries
,
VA
24330
PC
Provides Sports For Area Youth, Seasonal Swimming, Duck Pin Bowling, and Senior Activities to our community.
370
GIRLS INCORPORATED OF TENNESSEE VALLEY
PO Box 7040
Oak Ridge
,
TN
37831
PC
General organizational support
5,000
GREAT SMOKY MOUNTAIN COUNCIL
1333 Old Weisgarber Road
Knoxville
,
TN
37909
PC
General organizational support
30,000
HARBOURS GATE
PO Box 1110
Louisville
,
TN
37777
PC
Community outreach center
5,000
HELEN ROSS MCNABB FOUNDATION
200 Tech Center Drive
Knoxville
,
TN
37912
PC
CenterPointe Expansion Campaign
2,500
HELPING OVERCOME POVERTYS EXISTENCE INC
680 West main Street
Wytheville
,
VA
24382
PC
General organizational support
500
HENRY COUNTY FOOD PANTRY
3321 Fairystone Park Highway
Bassett
,
VA
24055
PC
General organizational support
1,100
IJAMS NATURE CENTER
2915Island Home Avenue
Knoxville
,
TN
37920
PC
General organizational support
10,000
INNOVATIVE EDUCATION PARTNERSHIP
425 Alcoa Trail
Maryville
,
TN
37804
PC
Establish, maintain, operate and conduct primary and secondary schools
100,000
JUNIOR ACHIEVEMENT
2135 North Charles G Seivers Blvd
Clinton
,
TN
37716
PC
Expand educational opportunities
12,000
KEC KNOXVILLE ENTREPRENEUR CENTER
17 Market Square
Knoxville
,
TN
37902
PC
Serving entrepreneurs through mentors and networking
7,500
KERBELA SHRINE CIRCUS
315 Mimosa Avenue
Knoxville
,
TN
37920
PC
General organizational support
3,800
KNOX EDUCATION FOUNDATION
400 West Summitt Hill Drive
Knoxville
,
TN
37902
PC
Aid in transforming public education in Knox County
250,000
KNOXVILLE CHILDRENS THEATRE
109 East Churchhill Avenue
Knoxville
,
TN
37917
PC
General organizational support
15,000
KNOXVILLE FOP #2
801 East 5th Avenue
Knoxville
,
TN
37917
PC
General organizational support
1,000
LEADERSHIP BLOUNT COUNTY
502 East Lamar Alexander Pkwy
Maryville
,
TN
37804
PC
Strategic Partner Sponsorship
5,000
LORDS CHILD
8769 Chapman Hwy
Knoxville
,
TN
37920
PC
Ending child hunger
1,500
MAKE A WISH GREATER VIRGINIA
2810 North Parham Road
Richmond
,
VA
23294
PC
General organizational support
1,390
MARANTHA BAPTIST CHURCH
1040 Lower Flat Creek Road
Alexander
,
NC
28701
PC
General organizational support
500
MARINE TOYS FOR TOTS
18251 Quantico Gateway Drive
Triangle
,
VA
22172
PC
General organizational support
3,000
MARTINSVILLE HENRY COUNTY SPCA
132 Joseph Martin Highway
Martinsville
,
VA
24112
PC
Pet adoption services
1,100
MARYVILLE CITY SCHOOLS FOUNDATION
833 Cedar Street
Maryville
,
TN
37803
PC
Promote academic excellence in Maryville City Schools
2,500
MARYVILLE KIWANIS FOUNDATION
576 North Foothills Plaza Drive
Maryville
,
TN
37801
PC
General organizational support
7,500
MOMENTS OF HOPE OUTREACH
13400 Hanover Courthouse Road
Hanover
,
VA
23069
PC
Building Repairs
4,550
MORRISTOWN HAMBLEN HOSPITAL FOUNDATION
1621 West Morris Boulevard
Morristown
,
TN
37813
PC
Jingle Run for the Hope 5K
14,000
MUSE KNOXVILLE
PO Box 6204
Knoxville
,
TN
37914
PC
Children's Educational Learning
105,000
NATIONAL KIDNEY FOUNDATION
30 East 33rd Street
New York
,
NY
10016
PC
Positive help for patients, donors and recipients
10,000
NEXT STEP NETWORK INC
2005 Longest Avenue
Louisville
,
KY
40204
PC
Aiding families to gain access to high quality homes
300,000
OPERATION CITYSCAPE INC
123 West Broad Street
Cookeville
,
TN
38501
PC
General organizational support
5,000
PLEASANT GROVE BAPTIST CHURCH
3736 Tuckaleechee Pike
Maryville
,
TN
37804
PC
General organizational support
125
PLENTY INC
570 Eccles Avenue
San Franciso
,
CA
94080
PC
General organizational support
1,362
PROVISION CARES FOUNDATION
2095 Lakeside Centre Way
Knoxville
,
TN
37922
PC
Bill Williamson Memorial Golf Tournament
10,000
REBUILDING TOGETHER KNOXVILLE
118 North Peters Road
Knoxville
,
TN
37923
PC
Provides reapirs, modifications and energy upgrades to low income homes
5,000
RESCUE MISSION OF ROANOKE INC
402 4th Street SE
Roanoke
,
VA
24013
PC
General organizational support
1,100
ROCKINGHAM COUNTY ANIMAL SHELTER
250 Cherokee Camp Road
Reidsville
,
NC
27320
PC
Pet adoption services
6,792
RVMH HERITAGE FOUNDATION
21565 Executive Parkway
Elkhart
,
IN
46514
PC
General organizational support
300,000
SALVATION ARMY
PO Box 848
Alcoa
,
TN
37701
PC
Angel Tree for Christmas gifts
15,500
SALVATION ARMY CENTRAL VIRGINIA AREA
2 West Grace Street
Richmond
,
VA
23220
PC
General organizational support
1,050
SCHAS
2015 Bearden Place
Knoxville
,
TN
37917
PC
Assisting Senior Citizens with home and social needs
7,500
SECOND HARVEST FOOD BANK
136 Harvest Lane
Maryville
,
TN
37801
PC
General organizational support
10,000
SERTOMA CENTER
1400 East 5th Avenue
Knoxville
,
TN
37917
PC
General organizational support
5,000
SEYMOUR COMMUNITY CHURCH
994 South Old Sevierville Pike
Seymour
,
TN
37865
PC
General organizational support
125
SHOP WITH A COP OF BLOUNT COUNTY
940 East Lamar Alexander Parkway
Maryville
,
TN
37804
PC
General organizational support
2,500
SOUTHSIDE CRISIS PREGNANCY CENTER INC
PO Box 281
Farmville
,
VA
23901
PC
General organizational support
1,250
SOUTHSIDE SPCA
7352 Patrick Henry Highway
Meherrin
,
VA
23954
PC
Pet adoption services
1,600
SPARK
116 Childress Street SW
Knoxville
,
TN
37920
PC
Assisting individuals with disabilities
5,000
ST JOSEPHS VILLA
8000 Brook Road
Richmond
,
VA
23227
PC
General organizational support
1,390
SUSANNAHS HOUSE INC
923 Dameron Avenue NW
Knoxville
,
TN
37921
PC
General organizational support
5,000
TENNESSEE KIDS BELONG
1229 Lakeview Drive
Franklin
,
TN
37067
PC
General organizational support
25,000
TN ACHIEVES
PO Box 2723
Knoxville
,
TN
37901
PC
General organizational support
40,000
UNITED WAY OF BLOUNT COUNTY
1615 East Broadway Ave
Maryville
,
TN
37802
PC
General organizational support
359,000
Total
.................................
3a
2,248,254
b
Approved for future payment
Total
.................................
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.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
4
Dividends and interest from securities
....
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not 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
............
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
0
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
0
(See worksheet in line 13 instructions to verify calculations.)
Part XVI-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
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?
...........
Yes
No
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.
May the IRS discuss this return
with the preparer shown below?
See instructions.
Yes
No
Signature of officer or trustee
Date
Title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's Signature
Date
Check if self-
employed
PTIN
Firm's name
Firm's EIN
Firm's address
Phone no.
Form
990-PF
(2020)
Additional Data
Software ID:
Software Version:
Form 990PF - Special Condition Description:
Special Condition Description
-
TIN:
TY 2020 LegalFeesSchedule
Name:
The Clayton Homes Foundation
EIN:
81-4369351
Category
Amount
Net Investment Income
Adjusted Net Income
Disbursements for Charitable Purposes
Legal Fees
297
0
0
0