Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
right arrowDo not enter social security numbers on this form as it may be made public.
right arrowGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
For calendar year 2022, or tax year beginning 01-01-2022 , and ending 12-31-2022
Name of foundation
THE SUSAN STEIN SHIVA FOUNDATION
FKA THE SUSAN S SHIVA FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)BAKER TILLY 66 HUDSON BLVD E 2200
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
NEW YORK, NY10001
A Employer identification number

27-3493774
B Telephone number (see instructions)

(212) 697-6900
C right arrow
G Check all that apply:

D 1. Foreign organizations, check here............. right arrow
2. Foreign organizations meeting the 85%
test, check here and attach computation ... right arrow
E right arrow
H Check type of organization:
F right arrow
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)right arrow$7,498,075J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check right arrow.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 90,081 90,081  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 231,937
b Gross sales price for all assets on line 6a 656,341
7 Capital gain net income (from Part IV, line 2)... 231,937
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule)....... Click to see attachment
List of Attached Documents:
// Content
100,768 49,019  
12 Total. Add lines 1 through 11........ 422,786 371,037  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0 0   0
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment
List of Attached Documents:
// Content
34,607 0   34,607
c Other professional fees (attach schedule).... Click to see attachment
List of Attached Documents:
// Content
46,269 46,539   0
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment
List of Attached Documents:
// Content
61,816 10,816   0
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment
List of Attached Documents:
// Content
1,404 0   1,095
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 144,096 57,355   35,702
25 Contributions, gifts, grants paid....... 1,065,205 1,065,205
26 Total expenses and disbursements. Add lines 24 and 25 1,209,301 57,355   1,100,907
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -786,515
b Net investment income (if negative, enter -0-) 313,682
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2022)
Form 990-PF (2022)
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............. 320,488 51,364 277,864
2 Savings and temporary cash investments.........      
3 Accounts receivable right arrow  
Less: allowance for doubtful accounts right arrow        
4 Pledges receivable right arrow  
Less: allowance for doubtful accounts right arrow        
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) right arrow  
Less: allowance for doubtful accounts right arrow        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule) 174,981 Click to see attachment
List of Attached Documents:
// Content
0 		25,289
b Investments—corporate stock (attach schedule).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis right arrow  
Less: accumulated depreciation (attach schedule) right arrow        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 8,467,038 Click to see attachment
List of Attached Documents:
// Content
8,192,022 		7,194,522
14 Land, buildings, and equipment: basis right arrow  
Less: accumulated depreciation (attach schedule) right arrow        
15 Other assets (describe right arrow) Click to see attachment
List of Attached Documents:
// Content
400 		Click to see attachment
List of Attached Documents:
// Content
400 		Click to see attachment
List of Attached Documents:
// Content
400
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 8,962,907 8,243,786 7,498,075
Liabilities 17 Accounts payable and accrued expenses..........   67,394
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 right arrow)    
23 Total liabilities (add lines 17 through 22)......... 0 67,394
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here right arrow
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions...........    
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here right arrow
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........ 0 0
27 Paid-in or capital surplus, or land, bldg., and equipment fund 0 0
28 Retained earnings, accumulated income, endowment, or other funds 8,962,907 8,176,392
29 Total net assets or fund balances (see instructions)..... 8,962,907 8,176,392
30 Total liabilities and net assets/fund balances (see instructions). 8,962,907 8,243,786
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return) ...............
1
8,962,907
2
Enter amount from Part I, line 27a .....................
2
-786,515
3
Other increases not included in line 2 (itemize) right arrow
3
0
4
Add lines 1, 2, and 3 ..........................
4
8,176,392
5
Decreases not included in line 2 (itemize) right arrow
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
8,176,392
Form 990-PF (2022)
Form 990-PF (2022)
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 FROM PASS-THROUGH ENTITIES - LTCG P    
b FROM PASS-THROUGH ENTITIES - STCG P    
c FROM PASS-THROUGH ENTITIES - SECTION 1231 P    
d DISTRIBUTION IN EXCESS OF COST BASIS P    
e CHARLES SCHWAB #5112 - STCG P    
(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 199,819     199,819
b 7,313     7,313
c 21,568     21,568
d 2,974     2,974
e 424,667   424,404 263
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       199,819
b       7,313
c       21,568
d       2,974
e       263
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 2 231,937
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Form 990-PF (2022)
Form 990-PF (2022)
Page 4
Part V
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here right arrow 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) 1 4,360
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 4,360
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 4,360
6 Credits/Payments:
a 2022 estimated tax payments and 2021 overpayment credited to 2022 6a 22,572
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 5,000
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 27,572
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2221 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......right arrow 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...right arrow 10 23,212
11 Enter the amount of line 10 to be: Credited to 2023 estimated taxright arrow23,212 Refundedright arrow 11 0
Part VI-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. right arrow$ 0(2) On foundation managers.right arrow$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.right arrow$ 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
Yes
 
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
Yes
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
round bullet By language in the governing instrument, or
round bullet By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument? ................
6
Yes
 
7
Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
and Part XIV..................................
7
Yes
 
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
right arrowNY
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 2022 or the taxable year beginning in 2022? See the instructions for Part XIII.
If "Yes," complete Part XIII .............................
9
 
No
10
Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
and addresses. ...............................
10
 
No
Form 990-PF (2022)
Form 990-PF (2022)
Page 5
Part VI-A
Statements Regarding Activities (continued)
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
11
 
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement. See instructions.................
12
 
No
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
 
Website addressright arrowN/A
14
The books are in care ofright arrowBAKER TILLY US LLP Telephone no.right arrow (212) 697-6900

Located atright arrow66 HUDSON BLVD E SUITE 2200NEW YORKNY ZIP+4right arrow10001
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........right arrow
and enter the amount of tax-exempt interest received or accrued during the year ........right arrow
15
 
16 At any time during calendar year 2022, 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 right arrow
Part VI-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
1a(1)
 
No
(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person? ..............................
1a(2)
 
No
(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
1a(3)
 
No
(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
1a(4)
 
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)? ......................
1a(5)
 
No
(6) Agree to pay money or property to a government official? (Exception. Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.) ...............
1a(6)
 
No
b
If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
1b
 
 
c
Organizations relying on a current notice regarding disaster assistance check here ........right arrow
d
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2022? .............
1d
 
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2022, did the foundation have any undistributed income (Part XII, lines 6d
and 6e) for tax year(s) beginning before 2022?....................
2a
 
No
If "Yes," list the years right arrow20, 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.
right arrow20, 20, 20, 20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year? ..............................
3a
Yes
 
b
If "Yes," did it have excess business holdings in 2022 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 2022.) .....................
3b
 
No
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 2022? ..
4b
 
No
Form 990-PF (2022)
Form 990-PF (2022)
Page 6
Part VI-B
Statements Regarding Activities for Which Form 4720 May Be Required (continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........
5a(1)
 
No
(2) Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive? ....................
5a(2)
 
No
(3) Provide a grant to an individual for travel, study, or other similar purposes? .............
5a(3)
 
No
(4) Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions ........................
5a(4)
 
No
(5) Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals? .............
5a(5)
 
No
b
If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
5b
 
 
c
Organizations relying on a current notice regarding disaster assistance check .........right arrow
d
If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant? .................
5d
 
 
If "Yes," attach the statement required by Regulations section 53.4945–5(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract? .............................
6a
 
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
6b
 
No
If "Yes" to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
7a
 
No
b
If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....
7b
 
 
8
Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment during the year? .........................
8
 
No
Part VII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
(a) Name and address (b) Title, and average
hours per week
devoted to position 		(c) Compensation
 (If not paid, enter
-0-) 		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
other allowances
ALEXANDRA SHIVA TRUSTEE
1.00 		0 0 0
5 EAST 9TH STREET
NEW YORK,NY10003
JONATHAN SHERMAN TRUSTEE
1.00 		0 0 0
5 EAST 9TH STREET
NEW YORK,NY10003
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...................right arrow 0
Form 990-PF (2022)
Form 990-PF (2022)
Page 7
Part VII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors (continued)
3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
NONE
Total number of others receiving over $50,000 for professional services.............right arrow0
Part VIII-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
1  
2  
3  
4  
Part VIII-B
Summary of Program-Related Investments (see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
1  
2  
All other program-related investments. See instructions.
3  
Total. Add lines 1 through 3.........................right arrow0
Form 990-PF (2022)
Form 990-PF (2022)
Page 8
Part IX
Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities...................
1a
196,010
b
Average of monthly cash balances.......................
1b
483,946
c
Fair market value of all other assets (see instructions)................
1c
8,264,066
d
Total (add lines 1a, b, and c).........................
1d
8,944,022
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
8,944,022
4
Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
instructions) .............................
4
134,160
5
Net value of noncharitable-use assets. Subtract line 4 from line 3. ............
5
8,809,862
6
Minimum investment return. Enter 5% (0.05) of line 5................
6
440,493
Part X
Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow and do not complete this part.)
1
Minimum investment return from Part IX, line 6..................
1
440,493
2a
Tax on investment income for 2022 from Part V, line 5.......
2a
4,360
b
Income tax for 2022. (This does not include the tax from Part V.) ...
2b
15,908
c
Add lines 2a and 2b............................
2c
20,268
3
Distributable amount before adjustments. Subtract line 2c from line 1............
3
420,225
4
Recoveries of amounts treated as qualifying distributions................
4
0
5
Add lines 3 and 4............................
5
420,225
6
Deduction from distributable amount (see instructions).................
6
0
7
Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
7
420,225
Part XI
Qualifying Distributions (see instructions)
1
Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
a
Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........
1a
1,100,907
b
Program-related investments—total from Part VIII-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 XII, line 4. .......
4
1,100,907
Form 990-PF (2022)
Form 990-PF (2022)
Page 9
Part XII
Undistributed Income (see instructions)
(a)
Corpus 		(b)
Years prior to 2021 		(c)
2021 		(d)
2022
1 Distributable amount for 2022 from Part X, line 7 420,225
2 Undistributed income, if any, as of the end of 2022:
a Enter amount for 2021 only....... 0
b Total for prior years:20, 20, 20 0
3 Excess distributions carryover, if any, to 2022:
a From 2017...... 176,883
b From 2018......  
c From 2019...... 444,398
d From 2020...... 503,737
e From 2021...... 529,535
f Total of lines 3a through e ........ 1,654,553
4Qualifying distributions for 2022 from Part
XI, line 4: right arrow$ 1,100,907
a Applied to 2021, 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 2022 distributable amount..... 420,225
e Remaining amount distributed out of corpus 680,682
5 Excess distributions carryover applied to 2022. 0 0
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6Enter the net total of each column as
indicated below:
a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 2,335,235
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 2021. Subtract line
4a from line 2a. Taxable amount—see
instructions ............. 		0
f Undistributed income for 2022. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2023 .......... 		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 2017 not
applied on line 5 or line 7 (see instructions) ... 		176,883
9 Excess distributions carryover to 2023.
Subtract lines 7 and 8 from line 6a ...... 		2,158,352
10 Analysis of line 9:
a Excess from 2018....  
b Excess from 2019.... 444,398
c Excess from 2020.... 503,737
d Excess from 2021.... 529,535
e Excess from 2022.... 680,682
Form 990-PF (2022)
Form 990-PF (2022)
Page 10
Part XIII
Private Operating Foundations (see instructions and Part VI-A, question 9)
1a If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2022, enter the date of the ruling ...... right arrow
 
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 IX for each
year listed .......... 		Tax year Prior 3 years (e) Total
(a) 2022 (b) 2021 (c) 2020 (d) 2019
         
b 85% (0.85) of line 2a .........          
c Qualifying distributions from Part XI,
line 4 for each year listed ..... 		         
d Amounts included in line 2c not used directly
for active conduct of exempt activities .......... 		         
e Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c .... 		         
3 Complete 3a, b, or c for the
alternative test relied upon:
a “Assets" alternative test—enter:
(1) Value of all assets ......          
(2) Value of assets qualifying
under section 4942(j)(3)(B)(i)		          
b “Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part IX, line 6 for each year listed .. 		         
c “Support" alternative test—enter:
(1) Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties) .... 		         
(2) Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii).... 		         
(3) Largest amount of support
from an exempt organization		          
(4) Gross investment income          
Part XIV
Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1Information Regarding Foundation Managers:
aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here right arrow
aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
THE SUSAN S SHIVA FOUNDATION
C/O BAKER TILLY US LLP 66 HUDSON
BLVD E SUITE 2200
NEW YORK,NY10001
(212) 697-6900
bThe form in which applications should be submitted and information and materials they should include:
NO SPECIFIC FORM IS REQUIRED. A LETTER SUMMARIZING THE REQUEST SUPPORTED BY APPROPRIATE BROCHURES OR MATERIAL IS REQUIRED.
cAny submission deadlines:
NONE
dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
GRANTS ARE GENERALLY RESTRICTED TO HEALTH CARE, EDUCATION AND THE ARTS AND ARE ISSUED AT THE DISCRETION OF THE BOARD OF DIRECTORS.
Form 990-PF (2022)
Form 990-PF (2022)
Page 11
Part XIV
Supplementary Information (continued)
3 Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
 Foundation
status of
recipient 		Purpose of grant or
contribution 		Amount
Name and address (home or business)
aPaid during the year

ACLU

125 BROAD ST
NEW YORK,NY10004 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

ALEX FUND

63 BENEDICT AVE
NEW YORK,NY10591 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

AMER FRIENDS OF JORDAN RIVER VILLAGE

244 MADISON AVE SUITE 482
NEW YORK,NY10016 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

AMERICA GIVES INC

PO BOX 3262
WASHINGTON,DC20010 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 5,000

AMER COMM FOR WEIZMANN INST OF SCIENCE

633 3RD AVE NEW YORK
NEW YORK,NY10017 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 5,000

AMERI FRIENDS OF THE ISRAELI OPERA

200 E 74TH STR
NEW YORK,NY10021 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 3,600

AMERICAN FRIEND SOF BATSHEVA DANCE CO

1201 BROADWAY SUITE 802
NEW YORK,NY10001 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 2,500

AMERICAN FRIENDS OF KESHET EILON

25 TRINITY PASS RD
POUND RIDGE,NY105761526 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 58,900

AMERICAN FRIENDS OF THE HEBREW UNIVERSITY

199 WATER ST 11TH FLOOR
NEW YORK,NY10038 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 5,000

BARBARA D SHERMAN MEMORIAL SCHOLARSHIP

C/O BAKER TILLY US LLP
NEW YORK,NY10119 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 5,000

BROOKLYN ACADEMY OF MUSIC

30 LAFAYETTE AVE
BROOKLYN,NY11217 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

CARNEGIE HALL SOCIETY INC

881 7TH AVE
NEW YORK,NY10019 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 6,500

CENTRAL PARK CONSERVANCY

14 EAST 60TH STREET
NEW YORK,NY10022 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

CITY HARVEST

6 EAST 32ND STREET 5TH FLOOR
NEW YORK,NY10016 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

CITYMEALS-ON-WHEELS

355 LEXINGTON AVE 3
NEW YORK,NY10017 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

COALITION FOR THE HOMELESS

129 FULTON STREET
NEW YORK,NY10038 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

CONGREGATION EMANU-EL

2125 WESTCHESTER AVENUE EAST
RYE,NY10580 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,975

CUNNIFF-DIXON FOUNDATION

PO BOX 800
ESSEX,CT06426 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

DANCE THEATRE OF HARLEM

466 W 152ND ST
NEW YORK,NY10031 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 3,000

DOCTORS WITHOUT BORDERS

40 RECTOR ST 16TH FLOOR
NEW YORK,NY10006 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

DOLPHINS CHALLENGE CANCER

347 DON SHULA DR
MIAMI GARDENS,FL33056 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 5,000

FACEBOOK COMMUNITY FUND

1601 WILLOW ROAD
MENLO PARK,CA94025 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,500

FAIRVOTE

6930 CARROLL AVE SUITE 240
TAKOMA PARK,MD20912 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 10,000

FEEDING AMERICA

161 NORTH CLARK STREET SUITE 700
CHICAGO,IL60601 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

FRIENDS OF THE HIGH LINE INC

820 WASHINGTON STREET
NEW YORK,NY10014 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 5,000

FOUNTAIN HOUSE

425 W 47TH ST
NEW YORK,NY10036 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 500

GOD'S LOVE WE DELIVER

166 6TH AVE
NEW YORK,NY10013 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

GOODFOUNDATION

306 W 37TH ST
NEW YORK,NY10018 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 10,363

HABITAT FOR HUMANITY NEW YORK CITY

111 JOHN ST 23RD FLOOR
NEW YORK,NY10038 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

HONESTREPORTINGCOM

PO BOX 23858
NEW YORK,NY10087 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI

1 GUSTAVE L LEVY PL
NEW YORK,NY10029 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 25,000

INTERNATIONAL RESCUE COMMITTEE

122 EAST 42ND STREET
NEW YORK,NY10168 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 5,000

J STREET EDUCATION FUND

PO BOX 66073
WASHINGTON,DC20035 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 10,000

JESSYE NORMAN SCHOOL OF ARTS

739 GREENE STREET
AUGUSTA,GA30901 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 5,000

KIDSAVE INTERNATIONAL INC

100 CORPORATE POINTE NO 380
CULVER CITY,CA90230 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 2,500

LAMBDA LEGAL

120 WALL ST 19TH FLOOR
NEW YORK,NY10005 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

LINCOLN SQUARE SYNOGOGUE

180 AMSTERDAM AVENUE
NEW YORK,NY10023 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 2,500

LOOK WHAT SHE DID

137 N LARCHMONT BLVD STE 437
LOS ANGELES,CA90004 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

MARIA DROSTE COUNSELING SERVICES

171 MADISON AVE SUITE 400
NEW YORK,NY10016 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

NEW YORK CITY BALLET

20 LINCOLN CENTER PLAZA
NEW YORK,NY10023 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 2,500

NEW YORK LIVE ARTS

219 W 19TH ST
NEW YORK,NY10011 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,500

NEW YORK PUBLIC RADIO

160 VARICK STREET
NEW YORK,NY10013 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,500

NEW YORK SHAKESPEARE FESTIVAL

425 LAFAYETTE ST
NEW YORK,NY10003 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 250,000

NEXT FOR AUTISM

1430 BROADWAY 8TH FLOOR
NEW YORK,NY10018 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 7,500

NIGHTINGALE-BAMFORD SCHOOL

20 E 92ND ST
NEW YORK,NY10128 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 10,000

OPERATION SMILE INC

3641 FACULTY BLVD
VIRGINIA BEACH,VA23453 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

PLANNED PARENTHOOD

123 WILLIAM STREET NO 10 FL
NEW YORK,NY10038 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

RAZOM INC

140 2ND AVE SUITE 305
NEW YORK,NY10003 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 2,575

REUT USA

10960 WILSHIRE NO 700
LOS ANGELES,CA90024 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 2,500

ROSS SCHOOL FOUNDATION

PO BOX 582
ROSS,CA94957 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 50,000

SESAME WORKSHOP

1900 BROADWAY
NEW YORK,NY10023 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

ST JUDE CHILDREN'S RESEARCH HOSPITAL

220 E 42ND ST
NEW YORK,NY10017 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

SUCCESS ACADEMY CHARTER SCHOOLS INC

95 PINE STREET 6TH FL
NEW YORK,NY10005 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 10,000

THE CARNEGIE HALL CORPORATION

881 SEVENTH AVENUE
NEW YORK,NY10019 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 2,500

THE CHURCH

48 MADISON STREET
SAG HARBOR,NY11963 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 5,000

THE COMMON GOOD

767 LEXINGTON AVE SUITE 602
NEW YORK,NY10065 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

THE DOE FUND

345 E 102ND ST 305
NEW YORK,NY10029 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

THE FILM FORUM

209 W HOUSTON ST
NEW YORK,NY10014 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 5,000

THE FORTUNE SOCIETY

2976 NORTHERN BLVD
LONG ISLAND CITY,NY11101 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 10,600

THE FRICK COLLECTION

1 E 70TH ST
NEW YORK,NY10021 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,500

THE METROPOLITAN MUSEUM OF ART

1000 5TH AVE
NEW YORK,NY10028 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 2,500

THE METROPOLITAN OPERA

30 LINCOLN CENTER PLAZA
NEW YORK,NY10023 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 25,000

THE PUBLIC THEATER

425 LAFAYETTE ST
NEW YORK,NY10003 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 200,000

THE ROUNDABOUT THEATER

227 W 42ND ST
NEW YORK,NY10036 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

THE WINDWARD SCHOOL

1275 MAMARONECK AVENUE
WHITE PLAINS,NY10605 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 3,000

THIRTEEN

825 EIGHTH AVENUE
NEW YORK,NY10019 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

TYPE MEDIA CENTER

116 EAST 16TH ST NO 8TH FL
NEW YORK,NY10003 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 5,000

UCP OF NYC

80 MAIDEN LANE
NEW YORK,NY10038 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 3,000

UNICEF USA

125 MAIDEN LANE
NEW YORK,NY10038 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

UNITED STATES HOLOCAUST MEMORIAL MUSEUM

100 RAOUL WALLENBERG PL SW
WASHINGTON,DC20024 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

US - UKRAINE FOUNDATION

1090 VERMONT AVE NW STE 600
WASHINGTON,DC20005 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 10,000

USA FOR UHNCR

1310 L STREET NW SUITE 450
WASHINGTON,DC20005 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 5,000

VASSAR COLLEGE

124 RAYMOND AVE
POUGHKEEPSIE,NY12604 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 230,000

VISITING NURSE SERVICES OF NEW YORK

220 EAST 42ND STREET
NEW YORK,NY10017 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 1,000

WOMEN'S MEDIA CENTER

320 W 37TH ST
NEW YORK,NY10018 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 10,000

NOVA UKRAINE

963 MEARS CT
STANFORD,CA94305 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 2,183

FROM K-1'S

66 HUDSON BLVD E SUITE 2200
NEW YORK,NY10001 		NONE 501(C)(3) TAX EXEMPT GENERAL CHARITABLE SUPPORT 9
Total .................................right arrow 3a 1,065,205
bApproved for future payment
Total ................................. right arrow 3b 0
Form 990-PF (2022)
Form 990-PF (2022)
Page 12
Part XV-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
Related or exempt
function income
(See instructions.)
1Program service revenue: (a)
Business code 		(b)
Amount 		(c)
Exclusion code 		(d)
Amount
a
b
c
d
e
f
gFees and contracts from government agencies          
2 Membership dues and assessments ....          
3 Interest on savings and temporary cash
investments ........... 		         
4 Dividends and interest from securities ....     14 90,081  
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 .....     14 100,768  
8 Gain or (loss) from sales of assets other than
inventory ............ 		    18 231,937  
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) .. 0 422,786 0
13Total. Add line 12, columns (b), (d), and (e)..................
13
422,786
(See worksheet in line 13 instructions to verify calculations.)
Part XV-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
DownArrow 		Explain below how each activity for which income is reported in column (e) of Part XV-A contributed importantly to
the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
instructions.)
Form 990-PF (2022)
Form 990-PF (2022)
Page 13
Part XVI
Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
1
Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
Yes
No
a
Transfers from the reporting foundation to a noncharitable exempt organization of:
(1) Cash...................................
1a(1)
 
No
(2) Other assets.................................
1a(2)
 
No
b
Other transactions:
(1) Sales of assets to a noncharitable exempt organization....................
1b(1)
 
No
(2) Purchases of assets from a noncharitable exempt organization..................
1b(2)
 
No
(3) Rental of facilities, equipment, or other assets.......................
1b(3)
 
No
(4) Reimbursement arrangements...........................
1b(4)
 
No
(5) Loans or loan guarantees.............................
1b(5)
 
No
(6) Performance of services or membership or fundraising solicitations................
1b(6)
 
No
c
Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
1c
 
No
d
If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
(a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
2a
Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
b
If "Yes," complete the following schedule.

(a) Name of organization (b) Type of organization (c) Description of relationship
Sign Here
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
right arrow right arrow
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 Check if self-
employed right arrow		 PTIN
Firm's name SmallBullet
 Firm's EIN SmallBullet
Firm's address SmallBullet


 Phone no.
Form 990-PF (2022)
Additional Data


Software ID:  
Software Version:  


Form 990PF - Special Condition Description:
Special Condition Description

TY 2022 AccountingFeesSchedule
Name:
THE SUSAN STEIN SHIVA FOUNDATION
 
FKA THE SUSAN S SHIVA FOUNDATION
EIN:
27-3493774
Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
ACCOUNTING FEES 34,607 0   34,607

TY 2022 InvestmentsGovtObligationsSch
Name:
THE SUSAN STEIN SHIVA FOUNDATION
 
FKA THE SUSAN S SHIVA FOUNDATION
EIN:
27-3493774
US Government Securities - End of Year Book Value:

0
US Government Securities - End of Year Fair Market Value:

25,289
State & Local Government Securities - End of Year Book Value:


0
State & Local Government Securities - End of Year Fair Market Value:


0


TY 2022 InvestmentsOtherSchedule2
Name:
THE SUSAN STEIN SHIVA FOUNDATION
 
FKA THE SUSAN S SHIVA FOUNDATION
EIN:
27-3493774
Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
FILM INVESTMENT - BLEED OUT AT COST 3,347 3,347
FILM INVESTMENT - FANTASY ISLAND AT COST 5,912 5,912
FILM INVESTMENT- FATHER'S & SON'S AT COST 3,571 3,571
FILM INVESTMENT- MUSICAL PROJECT AT COST 14,286 14,286
FILM INVESTMENT - NIGHT SCHOOL AT COST 3,529 3,529
FILM INVESTMENT - NOTES ON BLINDNESS AT COST 10,679 10,679
FILM INVESTMENT - RULES TO LIVE BY AT COST 2,500 2,500
FILM INVESTMENT- SHOOTING THE MAFIA AT COST 18,434 18,434
FILM INVESTMENT - THE APOLLO AT COST 14,291 14,291
FILM INVESTMENT- THE BISBEE AT COST 13,636 13,636
FILM INVESTMENT- THE BLUE WALL AT COST 17,924 17,924
FILM INVESTMENT- THE FEELING OF BEING WATCHED AT COST 6,667 6,667
FILM INVESTMENT- THE FOURTH ESTATE AT COST 7,274 7,274
FILM INVESTMENT - THE REAGAN YEARS AT COST 131 131
FILM INVESTMENT ON HOLD WITH IMPACT PARTNERS AT COST 42,123 42,123
GS MOUNT KELLETT CAPITAL PARTNERS AT COST 79,899 4,123
HCP ABSOLUTE RETURN FUND OFFSHORE FEEDER LP AT COST 1,280,138 920,364
K-1 OAKMARK GLOBAL EQUITY LP AT COST 1,669,813 1,644,865
K-1 HCP ENERGY AND NATURAL RESOURCES FUND LP AT COST 328,252 573,010
K-1 HCP REAL ESTATE FUND LP AT COST 349,560 418,928
K-1 HMI CAPITAL PARTNERS AT COST 1,912,978 1,108,653
K-1 WGI EMERGING MARKETS FUND LLC AT COST 785,777 782,459
TYBOUME LONG OPPORTUNITIES (OFFSHORE) FUND AT COST 1,325,943 1,282,458
FILM INVESTMENT - CITIZEN ALLIES AT COST 10,000 10,000
FILM INVESTMENT - HOLLYWOOD SEXUALS ASSA AT COST 4,762 4,762
FILM INVESTMENT - JACINTA AT COST 9,444 9,444
FILM INVESTMENT - LOVE & STUFF AT COST 5,902 5,902
FILM INVESTMENT - THE TELEVISION EVENT AT COST 27,615 27,615
FILM INVESTMENT - THE THEATRE OF ALL POS AT COST 18,000 18,000
FILM INVESTMENT - I2 AT COST 5,850 5,850
FILM INVESTMENT - US KIDS AT COST 17,596 17,596
FILM INVESTMENT - GIVING VOICE AT COST 23,809 23,809
FILM INVESTMENT - LITTLE G DEVELOPMENT AT COST 1,759 1,759
FILM INVESTMENT - FATHOM AT COST 2,460 2,460
FILM INVESTMENT - UNTITLED MISSOURI PROJECT AT COST 2,500 2,500
FILM INVESTMENT - ATHLETE A AT COST 8,627 8,627
FILM INVESTMENT - THE GRAB AT COST 8,333 8,333
FILM INVESTMENT - UNTITLED PENNY LANE AT COST 158 158
FILM INVESTMENT - MIJA DEVELOPMENT AT COST 2,500 2,500
FILM INVESTMENT - A SONG FOR SUMMER & WINTER AT COST 3,226 3,226
FILM INVESTMENT - THE OIL WAR AT COST 2,500 2,500
FILM INVESTMENT - MIJA COMPLETION AT COST 10,526 10,526
FILM INVESTMENT - THE EMPIRE OF EBONY AT COST 3,200 3,200
FILM INVESTMENT - UNTITLED VACCINE RACE PROJECT AT COST 20,000 20,000
FILM INVESTMENT - AILEY AT COST 4,348 4,348
FILM INVESTMENT - GAMECHANGER FILMS AT COST 50,000 50,000
FILM INVESTMENT - UNTITLED BABY DOE AT COST 3,493 3,493
FILM INVESTMENT - INDIGO GIRLS AT COST 48,750 48,750

TY 2022 OtherAssetsSchedule
Name:
THE SUSAN STEIN SHIVA FOUNDATION
 
FKA THE SUSAN S SHIVA FOUNDATION
EIN:
27-3493774
Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
DISTRIBUTION RECEIVABLE 400 400 400


TY 2022 OtherExpensesSchedule
Name:
THE SUSAN STEIN SHIVA FOUNDATION
 
FKA THE SUSAN S SHIVA FOUNDATION
EIN:
27-3493774
Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
BANK FEES 345 0   345
FILING FEES 750 0   750
MISC EXPENSES 309 0   0


TY 2022 OtherIncomeSchedule2
Name:
THE SUSAN STEIN SHIVA FOUNDATION
 
FKA THE SUSAN S SHIVA FOUNDATION
EIN:
27-3493774
Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
INVESTMENT LOSS FROM FILM INVESTMENTS -52 -52 -52
FILM INVESTMENT RECOUPMENT INCOME 25,051 25,051 25,051
SUBTRACT: UBTI FROM INVESTMENT INCOME FROM PASS-THROUGH ENTITIES   -51,749  
INVESTMENT INCOME FROM PASS-THROUGH ENTITIES 75,212 75,212 75,212
OTHER INCOME 557 557 557


TY 2022 OtherProfessionalFeesSchedule
Name:
THE SUSAN STEIN SHIVA FOUNDATION
 
FKA THE SUSAN S SHIVA FOUNDATION
EIN:
27-3493774
Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
INVESTMENT MANAGEMENT FEES 46,269 46,539   0


TY 2022 TaxesSchedule
Name:
THE SUSAN STEIN SHIVA FOUNDATION
 
FKA THE SUSAN S SHIVA FOUNDATION
EIN:
27-3493774
Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
FROM PASS-THROUGH ENTITIES-FOREIGN TAXES 10,816 10,816   0
FEDERAL EXCISE TAXES 41,000 0   0
STATE TAXES 10,000 0   0