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
2023
Open to Public Inspection
For calendar year 2023, or tax year beginning 01-01-2023 , and ending 12-31-2023
Name of foundation
PRIME HEALTH FOUNDATION 10026400
 
Number and street (or P.O. box number if mail is not delivered to street address)UMB BANK NA P O BOX 415044 M/S
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
KANSAS CITY, MO641416692
A Employer identification number

43-1057862
B Telephone number (see instructions)

(816) 860-1933
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$4,515,348J 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... 90,607 90,607  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 96,031
b Gross sales price for all assets on line 6a 1,144,849
7 Capital gain net income (from Part IV, line 2)... 96,031
8 Net short-term capital gain......... 0
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)....... 6,012    
12 Total. Add lines 1 through 11........ 192,650 186,638  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 73,690 36,845   36,845
14 Other employee salaries and wages......   0 0 0
15 Pension plans, employee benefits.......   0 0  
16a Legal fees (attach schedule)......... Click to see attachment
List of Attached Documents:
// Content
7,076 1,769 0 5,307
b Accounting fees (attach schedule).......        
c Other professional fees (attach schedule)....       0
17 Interest...............       0
18 Taxes (attach schedule) (see instructions)... Click to see attachment
List of Attached Documents:
// Content
1,469 965   0
19 Depreciation (attach schedule) and depletion... 0 0  
20 Occupancy..............        
21 Travel, conferences, and meetings.......   0 0  
22 Printing and publications..........   0 0  
23 Other expenses (attach schedule)....... Click to see attachment
List of Attached Documents:
// Content
12,312 12,312    
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 94,547 51,891 0 42,152
25 Contributions, gifts, grants paid....... 28,500 28,500
26 Total expenses and disbursements. Add lines 24 and 25 123,047 51,891 0 70,652
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 69,603
b Net investment income (if negative, enter -0-) 134,747
c Adjusted net income (if negative, enter -0-)... 0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2023)
Form 990-PF (2023)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing.............      
2 Savings and temporary cash investments......... 106,178 248,408 248,408
3 Accounts receivable right arrow  
Less: allowance for doubtful accounts right arrow     0 0
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 arrow0      
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 right arrow  
Less: accumulated depreciation (attach schedule) right arrow        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 3,462,350 3,387,926 4,266,940
14 Land, buildings, and equipment: basis right arrow  
Less: accumulated depreciation (attach schedule) right arrow        
15 Other assets (describe right arrow)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 3,568,528 3,636,334 4,515,348
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe right arrow)    
23 Total liabilities (add lines 17 through 22).........   0
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........ 3,568,528 3,636,334
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds    
29 Total net assets or fund balances (see instructions)..... 3,568,528 3,636,334
30 Total liabilities and net assets/fund balances (see instructions). 3,568,528 3,636,334
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return) ...............
1
3,568,528
2
Enter amount from Part I, line 27a .....................
2
69,603
3
Other increases not included in line 2 (itemize) right arrowClick to see attachment
List of Attached Documents:
// Content
3
1,784
4
Add lines 1, 2, and 3 ..........................
4
3,639,915
5
Decreases not included in line 2 (itemize) right arrowClick to see attachment
List of Attached Documents:
// Content
5
3,581
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
3,636,334
Form 990-PF (2023)
Form 990-PF (2023)
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 57. ENPHASE ENERGY INC   2022-04-14 2023-01-13
b 1148. FORD MOTOR CO   2022-06-10 2023-01-13
c 109. ON SEMICONDUCTOR   2022-08-11 2023-01-13
d 65.03 FHR 4104 AJ 1.5% 15 SEP 2027   2012-09-26 2023-01-17
e 79.68 FHR 4142 AT 1.75% 15 DEC 2032   2013-05-16 2023-01-17
279.55 FN MA4448 1.5% 01 OCT 2031   2022-12-02 2023-01-25
86. ENPHASE ENERGY INC   2022-04-14 2023-01-30
1368.662 AMER CENT MID CAP VAL-I   2013-09-27 2023-02-08
676.685 PRINCIPAL MIDCAP FUND-R6   2012-08-31 2023-02-08
614.653 TRIBUTARY SMALL COMP-INST+   2020-11-24 2023-02-08
257.021 VANGUARD SML CAP INDX-ADM   2021-04-05 2023-02-08
3. AMAZON COM INC   2016-05-12 2023-02-09
16. AMGEN INC   2022-12-15 2023-02-09
32. ELEVANCE HEALTH INC   2022-04-14 2023-02-09
66. APPLE COMPUTER INC   2021-12-09 2023-02-09
14. BERKSHIRE HATHAWAY INC-CL B   2022-03-10 2023-02-09
19. BOEING CO   2022-12-15 2023-02-09
28. CVS CORPORATION   2022-09-16 2023-02-09
22. CHEVRONTEXACO CORP   2021-05-13 2023-02-09
64. CORTEVA INC   2022-09-16 2023-02-09
9. COSTCO WHOLESALE CORP   2020-08-13 2023-02-09
14. DANAHER CORP   2008-11-10 2023-02-09
10. DEERE & CO   2021-10-14 2023-02-09
28. DEVON ENERGY CORP   2022-09-16 2023-02-09
27. DISNEY WALT HOLDING CO   2022-03-10 2023-02-09
8. DOLLAR GENERAL CORP   2022-11-10 2023-02-09
7. GOLDMAN SACHS GROUP INC   2020-01-09 2023-02-09
3. GRAINGER W W INC   2022-11-10 2023-02-09
6. HOME DEPOT INC   2018-05-10 2023-02-09
10. INTUIT INC   2019-01-10 2023-02-09
23. J P MORGAN CHASE & CO   2015-05-05 2023-02-09
14. LILLY ELI & COMPANY   2022-03-10 2023-02-09
5. LULULEMON ATHLETICA INC   2022-12-15 2023-02-09
9. MASTERCARD INC - A   2023-01-13 2023-02-09
7. MCKESSON HBOC INC   2022-10-13 2023-02-09
34. MICROSOFT CORP   2021-11-11 2023-02-09
47. MORGAN STANLEY DEAN WITTER & CO   2020-11-13 2023-02-09
6. NETFLIX COM INC   2022-12-15 2023-02-09
20. NEXTERA ENERGY INC   2016-02-11 2023-02-09
11. NUCOR CORP   2021-08-12 2023-02-09
12. NVIDIA CORP   2020-05-14 2023-02-09
10. O'REILLY AUTOMOTIVE INC   2020-06-11 2023-02-09
67. ON SEMICONDUCTOR   2022-08-11 2023-02-09
18. PALO ALTO NETWORKS INC   2022-06-10 2023-02-09
11. PEPSICO INC   2022-01-13 2023-02-09
10. PIONEER NATURAL RESOURCES CO   2020-12-10 2023-02-09
29. PRINCIPAL FINANCIAL GROUP   2022-10-13 2023-02-09
45. QUANTA SERVICES INC   2021-11-11 2023-02-09
46. SCHWAB CHARLES CORP   2021-10-14 2023-02-09
3. SERVICENOW INC   2023-01-30 2023-02-09
12. BLOCK INC   2023-01-30 2023-02-09
11. TESLA INC   2021-04-15 2023-02-09
7. THERMO ELECTRON CORP   2010-07-20 2023-02-09
6. UNION PACIFIC CORP   2019-07-11 2023-02-09
8. UNITED RENTALS INC   2020-10-15 2023-02-09
11. UNITEDHEALTH GROUP INC   2018-07-11 2023-02-09
10. VERTEX PHARMACEUTICALS INC   2022-09-16 2023-02-09
18. VISA INC-CLASS A SHARES   2016-10-13 2023-02-09
10. ACCENTURE PLC-CL A   2018-09-13 2023-02-09
85.83 FHR 4104 AJ 1.5% 15 SEP 2027   2012-09-26 2023-02-15
77.86 FHR 4142 AT 1.75% 15 DEC 2032   2013-05-16 2023-02-15
262.19 FN MA4448 1.5% 01 OCT 2031   2022-12-02 2023-02-27
242. BIOMARIN PHARMACEUTICAL INC   2023-02-09 2023-03-09
56. DOLLAR GENERAL CORP   2022-11-10 2023-03-09
40. LULULEMON ATHLETICA INC   2022-12-15 2023-03-09
81. PIONEER NATURAL RESOURCES CO   2020-12-10 2023-03-09
134.36 FHR 4104 AJ 1.5% 15 SEP 2027   2012-09-26 2023-03-15
75.22 FHR 4142 AT 1.75% 15 DEC 2032   2013-05-16 2023-03-15
252.1 FN MA4448 1.5% 01 OCT 2031   2022-12-02 2023-03-27
124. CORTEVA INC   2022-03-10 2023-04-13
238. DEVON ENERGY CORP   2022-09-16 2023-04-13
251. PRINCIPAL FINANCIAL GROUP   2022-10-13 2023-04-13
63. UNION PACIFIC CORP   2019-07-11 2023-04-13
67. UNITED RENTALS INC   2020-10-15 2023-04-13
178.53 FHR 4104 AJ 1.5% 15 SEP 2027   2012-09-26 2023-04-17
88.98 FHR 4142 AT 1.75% 15 DEC 2032   2013-05-16 2023-04-17
245.49 FN MA4448 1.5% 01 OCT 2031   2022-12-02 2023-04-25
248. CVS CORPORATION   2022-09-16 2023-05-11
85. CORTEVA INC   2022-09-16 2023-05-11
338. CORTEVA INC   2022-03-10 2023-05-11
37. DEERE & CO   2022-02-10 2023-05-11
126.71 FHR 4104 AJ 1.5% 15 SEP 2027   2012-09-26 2023-05-15
76.04 FHR 4142 AT 1.75% 15 DEC 2032   2013-05-16 2023-05-15
241. BLOCK INC   2023-03-09 2023-05-18
279.61 FN MA4448 1.5% 01 OCT 2031   2022-12-02 2023-05-25
79. AMGEN INC   2022-12-15 2023-06-15
226. DISNEY WALT HOLDING CO   2022-04-14 2023-06-15
94.32 FHR 4104 AJ 1.5% 15 SEP 2027   2012-09-26 2023-06-15
84.55 FHR 4142 AT 1.75% 15 DEC 2032   2013-05-16 2023-06-15
62. GOLDMAN SACHS GROUP INC   2020-08-13 2023-06-15
284.65 FN MA4448 1.5% 01 OCT 2031   2022-12-02 2023-06-26
20. LILLY ELI & COMPANY   2022-03-10 2023-07-13
6. O'REILLY AUTOMOTIVE INC   2020-06-11 2023-07-13
47. QUANTA SERVICES INC   2021-11-11 2023-07-13
65.88 FHR 4104 AJ 1.5% 15 SEP 2027   2012-09-26 2023-07-17
69.95 FHR 4142 AT 1.75% 15 DEC 2032   2013-05-16 2023-07-17
954.764 AMER CENT MID CAP VAL-I   2013-09-27 2023-07-24
6315.513 BLACKROCK EQTY DVDND-K   2021-08-17 2023-07-24
628.333 PRINCIPAL MIDCAP FUND-R6   2012-08-31 2023-07-24
20000. US TREASURY NOTE/BOND 2% 15 AUG 2025   2017-05-30 2023-07-24
40000. US TREASURY NOTE/BOND 1.625% 15 MAY 2026   2020-12-16 2023-07-24
304.34 FN MA4448 1.5% 01 OCT 2031   2022-12-02 2023-07-25
58. DANAHER CORP   2008-11-10 2023-08-10
316. MICROCHIP TECHNOLOGY INC   2023-03-09 2023-08-10
132. ON SEMICONDUCTOR   2022-07-14 2023-08-10
75. QUANTA SERVICES INC   2021-11-11 2023-08-10
25. THERMO ELECTRON CORP   2010-07-20 2023-08-10
78.02 FHR 4104 AJ 1.5% 15 SEP 2027   2012-09-26 2023-08-15
80.31 FHR 4142 AT 1.75% 15 DEC 2032   2013-05-16 2023-08-15
30000. US TREASURY N/B 2.5% 15 AUG 2023   2015-12-17 2023-08-15
288.68 FN MA4448 1.5% 01 OCT 2031   2022-12-02 2023-08-25
103. ADVANCED MICRO DEVICES INC   2023-07-13 2023-09-14
70. PEPSICO INC   2023-05-11 2023-09-14
4. PEPSICO INC   2022-01-13 2023-09-14
399. SCHWAB CHARLES CORP   2021-10-14 2023-09-14
68.14 FHR 4104 AJ 1.5% 15 SEP 2027   2012-09-26 2023-09-15
72.71 FHR 4142 AT 1.75% 15 DEC 2032   2013-05-16 2023-09-15
286.41 FN MA4448 1.5% 01 OCT 2031   2022-12-02 2023-09-25
450. DELTA AIR LINES INC   2023-08-10 2023-10-12
12. O'REILLY AUTOMOTIVE INC   2020-06-11 2023-10-12
60. QUANTA SERVICES INC   2021-03-15 2023-10-12
209. SHOPIFY INC - CLASS A   2023-08-10 2023-10-12
.3333 VERALTO CORP   2008-11-10 2023-10-13
59.27 FHR 4104 AJ 1.5% 15 SEP 2027   2012-09-26 2023-10-16
66.8 FHR 4142 AT 1.75% 15 DEC 2032   2013-05-16 2023-10-16
257.99 FN MA4448 1.5% 01 OCT 2031   2022-12-02 2023-10-25
19. VERALTO CORP   2008-11-10 2023-10-26
302. ON SEMICONDUCTOR   2022-08-11 2023-11-09
90.57 FHR 4104 AJ 1.5% 15 SEP 2027   2012-09-26 2023-11-15
61.54 FHR 4142 AT 1.75% 15 DEC 2032   2013-05-16 2023-11-15
265.05 FN MA4448 1.5% 01 OCT 2031   2022-12-02 2023-11-27
117.95 FHR 4104 AJ 1.5% 15 SEP 2027   2012-09-26 2023-12-15
65.9 FHR 4142 AT 1.75% 15 DEC 2032   2013-05-16 2023-12-15
7294.468 DOUBLELINE TTL RTRN BND-I   2020-02-06 2023-12-26
237.32 FN MA4448 1.5% 01 OCT 2031   2022-12-02 2023-12-26
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(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 13,974   10,897 3,077
b 14,559   14,692 -133
c 7,082   7,255 -173
d 65   65  
e 80   80  
280   254 26
18,264   15,610 2,654
22,364   21,365 999
23,102   10,278 12,824
17,622   17,770 -148
25,024   26,884 -1,860
293   108 185
3,857   4,258 -401
15,550   16,579 -1,029
10,067   11,559 -1,492
4,303   4,538 -235
3,995   3,491 504
2,525   2,861 -336
3,710   2,353 1,357
3,993   3,936 57
4,493   3,026 1,467
3,581   301 3,280
4,082   3,286 796
1,698   1,866 -168
3,064   3,603 -539
1,831   2,028 -197
2,573   1,697 876
1,986   1,822 164
1,894   1,124 770
4,194   2,051 2,143
3,251   1,484 1,767
4,797   3,725 1,072
1,548   1,638 -90
3,325   3,387 -62
2,541   2,481 60
9,110   10,348 -1,238
4,651   2,677 1,974
2,171   1,744 427
1,472   561 911
1,820   1,382 438
2,662   958 1,704
8,159   4,108 4,051
5,653   4,460 1,193
2,979   2,984 -5
1,904   1,919 -15
2,213   1,191 1,022
2,609   2,282 327
6,833   5,263 1,570
3,666   3,590 76
1,384   1,330 54
907   962 -55
2,264   2,693 -429
3,978   345 3,633
1,217   1,028 189
3,590   1,516 2,074
5,340   2,805 2,535
2,922   2,902 20
4,124   1,476 2,648
2,848   1,723 1,125
86   86  
78   78  
262   239 23
22,483   27,083 -4,600
12,198   14,199 -2,001
12,052   13,104 -1,052
16,383   9,645 6,738
134   135 -1
75   75  
252   229 23
7,766   6,625 1,141
13,140   15,863 -2,723
18,827   19,754 -927
12,457   10,792 1,665
24,930   12,692 12,238
179   179  
89   89  
245   223 22
17,088   25,338 -8,250
4,816   5,227 -411
19,149   17,172 1,977
13,724   14,474 -750
127   127  
76   76  
14,286   18,581 -4,295
280   254 26
18,010   21,025 -3,015
21,020   29,789 -8,769
94   95 -1
85   85  
21,013   12,970 8,043
285   259 26
8,720   5,321 3,399
5,740   2,465 3,275
9,324   5,497 3,827
66   66  
70   70  
15,448   14,904 544
123,531   134,363 -10,832
23,129   9,543 13,586
18,895   19,788 -893
36,969   40,694 -3,725
304   277 27
14,919   1,245 13,674
26,348   26,366 -18
12,923   7,109 5,814
15,005   6,832 8,173
13,655   1,234 12,421
78   78  
80   80  
30,000   30,000  
289   263 26
11,040   11,949 -909
12,708   13,666 -958
726   698 28
23,785   29,994 -6,209
68   68  
73   73  
286   261 25
15,760   20,179 -4,419
11,016   4,930 6,086
10,679   5,305 5,374
11,148   11,816 -668
24   3 21
59   59  
67   67  
258   235 23
1,338   143 1,195
19,373   18,310 1,063
91   91  
62   62  
265   241 24
118   118  
66   66  
64,556   79,858 -15,302
237   216 21
      14,728
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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       3,077
b       -133
c       -173
d        
e        
      26
      2,654
      999
      12,824
      -148
      -1,860
      185
      -401
      -1,029
      -1,492
      -235
      504
      -336
      1,357
      57
      1,467
      3,280
      796
      -168
      -539
      -197
      876
      164
      770
      2,143
      1,767
      1,072
      -90
      -62
      60
      -1,238
      1,974
      427
      911
      438
      1,704
      4,051
      1,193
      -5
      -15
      1,022
      327
      1,570
      76
      54
      -55
      -429
      3,633
      189
      2,074
      2,535
      20
      2,648
      1,125
       
       
      23
      -4,600
      -2,001
      -1,052
      6,738
      -1
       
      23
      1,141
      -2,723
      -927
      1,665
      12,238
       
       
      22
      -8,250
      -411
      1,977
      -750
       
       
      -4,295
      26
      -3,015
      -8,769
      -1
       
      8,043
      26
      3,399
      3,275
      3,827
       
       
      544
      -10,832
      13,586
      -893
      -3,725
      27
      13,674
      -18
      5,814
      8,173
      12,421
       
       
       
      26
      -909
      -958
      28
      -6,209
       
       
      25
      -4,419
      6,086
      5,374
      -668
      21
       
       
      23
      1,195
      1,063
       
       
      24
       
       
      -15,302
      21
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
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 96,031
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  
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 1,873
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 1,873
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 1,873
6 Credits/Payments:
a 2023 estimated tax payments and 2022 overpayment credited to 2023 6a 504
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  
7 Total credits and payments. Add lines 6a through 6d.............. 7 504
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.......right arrow 9 1,369
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...right arrow 10  
11 Enter the amount of line 10 to be: Credited to 2024 estimated taxright arrow0 Refundedright arrow 11 0
Form 990-PF (2023)
Form 990-PF (2023)
Page 4
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$   (2) On foundation managers.right arrow$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.right arrow$  
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:
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 arrowMO
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 2023 or the taxable year beginning in 2023? 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
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 arrow  
14
The books are in care ofright arrowUMB BANK NA Telephone no.right arrow (816) 860-1933

Located atright arrow1010 GRANDKANSAS CITYMO ZIP+4right arrow64106
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 2023, 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
Form 990-PF (2023)
Form 990-PF (2023)
Page 5
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)
Yes
 
(5) Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)? ......................
1a(5)
 
No
(6) Agree to pay money or property to a government official? (Exception. Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.) ...............
1a(6)
 
No
b
If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
1b
 
No
c
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 2023? .............
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 2023, did the foundation have any undistributed income (Part XII, lines 6d
and 6e) for tax year(s) beginning before 2023?....................
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
 
No
b
If "Yes," did it have excess business holdings in 2023 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 2023.) .....................
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 2023? ..
4b
 
No
Form 990-PF (2023)
Form 990-PF (2023)
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
UMB BANK N A CO-TRUSTEE
1 		37,027    
1010 GRAND
KANSAS CITY,MO64106
PATRICIA MANSUR CO-TRUSTEE
8 		36,663    
421 W 68TH ST
KANSAS CITY,MO641131918
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 (2023)
Form 990-PF (2023)
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 arrow  
Form 990-PF (2023)
Form 990-PF (2023)
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
3,972,467
b
Average of monthly cash balances.......................
1b
209,820
c
Fair market value of all other assets (see instructions)................
1c
0
d
Total (add lines 1a, b, and c).........................
1d
4,182,287
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
4,182,287
4
Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
instructions) .............................
4
62,734
5
Net value of noncharitable-use assets. Subtract line 4 from line 3. ............
5
4,119,553
6
Minimum investment return. Enter 5% (0.05) of line 5................
6
205,978
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
205,978
2a
Tax on investment income for 2022 from Part V, line 5.......
2a
1,873
b
Income tax for 2022. (This does not include the tax from Part V.) ...
2b
 
c
Add lines 2a and 2b............................
2c
1,873
3
Distributable amount before adjustments. Subtract line 2c from line 1............
3
204,105
4
Recoveries of amounts treated as qualifying distributions................
4
0
5
Add lines 3 and 4............................
5
204,105
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
204,105
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
70,652
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
0
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)....................
3a
0
b
Cash distribution test (attach the required schedule) .................
3b
0
4
Qualifying distributions. Add lines 1a through 3b. Enter here and on Part XII, line 4. .......
4
70,652
Form 990-PF (2023)
Form 990-PF (2023)
Page 9
Part XII
Undistributed Income (see instructions)
(a)
Corpus 		(b)
Years prior to 2022 		(c)
2022 		(d)
2023
1 Distributable amount for 2023 from Part X, line 7 204,105
2 Undistributed income, if any, as of the end of 2022:
a Enter amount for 2022 only....... 0
b Total for prior years:20 , 20, 20 0
3 Excess distributions carryover, if any, to 2022:
a From 2018...... 126,983
b From 2019...... 100,574
c From 2020...... 43,231
d From 2021...... 93,114
e From 2022...... 69,393
f Total of lines 3a through e ........ 433,295
4Qualifying distributions for 2023 from Part
XI, line 4: right arrow$ 70,652
a Applied to 2022, 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 2023 distributable amount..... 70,652
e Remaining amount distributed out of corpus 0
5 Excess distributions carryover applied to 2023. 133,453 133,453
(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 5 299,842
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 2022. Subtract line
4a from line 2a. Taxable amount—see
instructions ............. 		0
f Undistributed income for 2023. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2024 .......... 		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 2018 not
applied on line 5 or line 7 (see instructions) ... 		0
9 Excess distributions carryover to 2024.
Subtract lines 7 and 8 from line 6a ...... 		299,842
10 Analysis of line 9:
a Excess from 2019.... 94,104
b Excess from 2020.... 43,231
c Excess from 2021.... 93,114
d Excess from 2022.... 69,393
e Excess from 2023....  
Form 990-PF (2023)
Form 990-PF (2023)
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 2023, 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) 2023 (b) 2022 (c) 2021 (d) 2020
         
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).)
NA
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.
NA
2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here right arrow
aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
bThe form in which applications should be submitted and information and materials they should include:
cAny submission deadlines:
dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Form 990-PF (2023)
Form 990-PF (2023)
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

ARTS TECH

1522 HOLMES ST
KANSAS CITY,MO641081536 		NONE PC SUPPORT OF CHARITABLE 3,500

AFTER THE HARVEST

6320 BROOKSIDE PLAZA STE 504
KANSAS CITY,MO64113 		NONE PC SUPPORT OF CHARITABLE 5,000

YMCA OF GREATER KANSAS CITY

3100 BROADWAY STREET SUITE 1020
KANSAS CITY,MO64111 		NONE PC SUPPORT OF CHARITABLE 5,000

ROSEDALE DEVELOPMENT ASSOCIATION

1403 SOUTHWEST BLVD
KANSAS CITY,KS66103 		NONE PC SUPPORT OF CHARITABLE 5,000

HEARTLAND OUTREACH PROVIDERS

1215 NW HWY 7
BLUE SPRINGS,MO64014 		NONE PC SUPPORT OF CHARITABLE 5,000

URBAN SCHOLASTIC CENTER

4835 SHAWNEE DR
KANSAS CITY,KS66106 		NONE PC SUPPORT OF CHARITABLE 5,000
Total .................................right arrow 3a 28,500
bApproved for future payment
Total ................................. right arrow 3b  
Form 990-PF (2023)
Form 990-PF (2023)
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 90,607  
5 Net rental income or (loss) from real estate:
aDebt-financed property......          
bNot debt-financed property.....          
6 Net rental income or (loss) from personal property          
7 Other investment income .....          
8 Gain or (loss) from sales of assets other than
inventory ............ 		    18 96,031  
9 Net income or (loss) from special events:          
10 Gross profit or (loss) from sales of inventory          
11 Other revenue:
aOTHER REVENUE 		    1 6,012  
b
c
d
e
12 Subtotal. Add columns (b), (d), and (e) ..   192,650  
13Total. Add line 12, columns (b), (d), and (e)..................
13
192,650
(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 (2023)
Form 990-PF (2023)
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 (2023)
Additional Data


Software ID:  
Software Version:  


Form 990PF - Special Condition Description:
Special Condition Description

TY 2023 LegalFeesSchedule
Name:
PRIME HEALTH FOUNDATION 10026400
EIN:
43-1057862
Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
LEGAL FEES - PRINCIPAL (ALLOCA 7,076 1,769   5,307


TY 2023 OtherDecreasesSchedule
Name:
PRIME HEALTH FOUNDATION 10026400
EIN:
43-1057862
Description Amount
ACCRUED INTEREST PAID - C/O 2,952
MUTUAL FUND INCOME TIMING ADJUSTMENT 574
WASH SALE ADJUSTMENT 55


TY 2023 OtherExpensesSchedule
Name:
PRIME HEALTH FOUNDATION 10026400
EIN:
43-1057862
Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
OTHER ALLOCABLE EXPENSE-PRINCI 5,308 5,308   0
OTHER NON-ALLOCABLE EXPENSE - 7,000 7,000   0
OTHER EXPENSE (NON-DEDUCTIBLE 4 4   0


TY 2023 OtherIncreasesSchedule
Name:
PRIME HEALTH FOUNDATION 10026400
EIN:
43-1057862
Description Amount
REFUND OF FEES 1,400
COST BASIS ADJUSTMENT 383
ROUNDING 1


TY 2023 TaxesSchedule
Name:
PRIME HEALTH FOUNDATION 10026400
EIN:
43-1057862
Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
FEDERAL ESTIMATES - PRINCIPAL 504 0   0
FOREIGN TAXES ON QUALIFIED FOR 793 793   0
FOREIGN TAXES ON NONQUALIFIED 172 172   0