-
TIN:
Form
990-PF
Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
Do not enter social security numbers on this form as it may be made public.
Go to
www.irs.gov/Form990PF
for instructions and the latest information.
OMB No. 1545-0047
20
23
Open to Public Inspection
For calendar year 2023, or tax year beginning
01-01-2023
, and ending
12-31-2023
Name of foundation
BLUESTONE GIVING FOUNDATION
% Sarah Sundberg
Number and street (or P.O. box number if mail is not delivered to street address)
270 MAIN ST N STE 300
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
STILLWATER
,
MN
550826788
A Employer identification number
46-5218477
B
Telephone number (see instructions)
C
If exemption application is pending, check here
G
Check all that apply:
Initial return
Initial return of a former public charity
Final return
Amended return
Address change
Name change
D 1.
Foreign organizations, check here.............
2
. Foreign organizations meeting the 85%
test, check here and attach computation ...
E
If private foundation status was terminated
under section 507(b)(1)(A), check here .......
H
Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here .......
I
Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)
$
13,820
J
Accounting method:
Cash
Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)
Part I
Analysis of Revenue and Expenses
(The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).)
(a)
Revenue and
expenses per
books
(b)
Net investment
income
(c)
Adjusted net
income
(d)
Disbursements
for charitable
purposes
(cash basis only)
1
Contributions, gifts, grants, etc., received (attach schedule)
34,974
2
Check
.............
3
Interest on savings and temporary cash investments
0
0
0
4
Dividends and interest from securities
...
0
0
0
5a
Gross rents
............
0
0
0
b
Net rental income or (loss)
0
6a
Net gain or (loss) from sale of assets not on line 10
0
b
Gross sales price for all assets on line 6a
0
7
Capital gain net income (from Part IV, line 2)
...
0
8
Net short-term capital gain
.........
9
Income modifications
...........
0
10a
Gross sales less returns and allowances
0
b
Less: Cost of goods sold
....
0
c
Gross profit or (loss) (attach schedule)
.....
0
0
11
Other income (attach schedule)
.......
0
0
0
12
Total.
Add lines 1 through 11
........
34,974
0
0
13
Compensation of officers, directors, trustees, etc.
0
0
0
0
14
Other employee salaries and wages
......
0
0
0
0
15
Pension plans, employee benefits
.......
0
0
0
0
16a
Legal fees (attach schedule)
.........
0
0
0
0
b
Accounting fees (attach schedule)
.......
0
0
0
0
c
Other professional fees (attach schedule)
....
0
0
0
0
17
Interest
...............
0
0
0
0
18
Taxes (attach schedule) (see instructions)
...
0
0
0
0
19
Depreciation (attach schedule) and depletion
...
0
0
0
20
Occupancy
..............
0
0
0
0
21
Travel, conferences, and meetings
.......
0
0
0
0
22
Printing and publications
..........
0
0
0
0
23
Other expenses (attach schedule)
.......
List of Attached Documents:
// Content
194
0
0
0
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
194
0
0
0
25
Contributions, gifts, grants paid
.......
29,895
29,895
26
Total expenses and disbursements.
Add lines 24 and 25
30,089
0
0
29,895
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
4,885
b
Net investment income
(if negative, enter -0-)
0
c
Adjusted net income
(if negative, enter -0-)
...
0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(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
1
Cash—non-interest-bearing
.............
8,935
13,820
13,820
2
Savings and temporary cash investments
.........
0
0
0
3
Accounts receivable
Less: allowance for doubtful accounts
0
0
0
4
Pledges receivable
Less: allowance for doubtful accounts
0
0
0
5
Grants receivable
.................
0
0
0
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)
.....
0
0
7
Other notes and loans receivable (attach schedule)
Less: allowance for doubtful accounts
0
0
8
Inventories for sale or use
..............
0
0
0
9
Prepaid expenses and deferred charges
..........
0
0
0
10a
Investments—U.S. and state government obligations (attach schedule)
0
b
Investments—corporate stock (attach schedule)
.......
0
c
Investments—corporate bonds (attach schedule)
.......
0
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
0
12
Investments—mortgage loans
.............
0
0
0
13
Investments—other (attach schedule)
..........
0
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
0
15
Other assets (describe
)
0
0
0
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
8,935
13,820
13,820
17
Accounts payable and accrued expenses
..........
0
0
18
Grants payable
.................
0
0
19
Deferred revenue
.................
0
0
20
Loans from officers, directors, trustees, and other disqualified persons
0
0
21
Mortgages and other notes payable (attach schedule)
......
0
22
Other liabilities (describe
)
List of Attached Documents:
// Content
0
List of Attached Documents:
// Content
0
23
Total liabilities
(add lines 17 through 22)
.........
0
0
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
8,935
13,820
25
Net assets with donor restrictions
............
0
0
Foundations that do not follow FASB ASC 958, check here
and complete lines 26 through 30.
26
Capital stock, trust principal, or current funds
........
27
Paid-in or capital surplus, or land, bldg., and equipment fund
28
Retained earnings, accumulated income, endowment, or other funds
29
Total net assets or fund balances
(see instructions)
.....
8,935
13,820
30
Total liabilities and net assets/fund balances
(see instructions)
.
8,935
13,820
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
8,935
2
Enter amount from Part I, line 27a
.....................
2
4,885
3
Other increases not included in line 2 (itemize)
3
4
Add lines 1, 2, and 3
..........................
4
13,820
5
Decreases not included in line 2 (itemize)
5
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
13,820
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.)
1a
b
c
d
e
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-)
or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
Excess of col. (i)
over col. (j), if any
a
b
c
d
e
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
3
Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8
...................
3
0
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
and enter “N/A" on line 1.
Date of ruling or determination letter:
(attach copy of letter if necessary–see instructions)
1
0
b
All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
2
3
Add lines 1 and 2
...........................
3
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
4
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
6
Credits/Payments:
a
2023 estimated tax payments and 2022 overpayment credited to 2023
6a
0
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
0
d
Backup withholding erroneously withheld
..........
6d
0
7
Total credits and payments. Add lines 6a through 6d
..............
7
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
0
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
11
Enter the amount of line 10 to be:
Credited to 2024 estimated tax
0
Refunded
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.
$
0
(2)
On foundation managers.
$
0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
.........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
No
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)
MN
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
Yes
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 address
http://www.bluestonemd.com/about-us/bluestone-giving-foundation/
14
The books are in care of
Sarah Christian
Telephone no.
(612) 409-2932
Located at
270 MAIN ST N STE 300
STILLWATER
MN
ZIP+4
550826788
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2023, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
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)
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
........
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
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer "No" and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
..............................
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
.........
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
Evelyn Polster
List of Attached Documents:
// Content
Board Member
0.00
0
0
0
W175N5253 Highridge Dr
Menomonee
,
WI
53051
John Henly
List of Attached Documents:
// Content
Board Member
0.00
0
0
0
1769 Hickory Hill Dr
Eagan
,
MN
55122
Becky Thalacker
List of Attached Documents:
// Content
Board Member
0.00
0
0
0
631 N Washington Ave
New Richmond
,
WI
54017
Melina Hoehn
List of Attached Documents:
// Content
Board Member
0.00
0
0
0
535 Selby Ave 4
St Paul
,
MN
55102
Nancy MacLeslie
List of Attached Documents:
// Content
Board Member
0.00
0
0
0
14290 Oldfield Rd N
Stillwater
,
MN
55082
Sarah Keenan
List of Attached Documents:
// Content
Board Member
0.00
0
0
0
240 85th St
Clear Lake
,
WI
54005
Sarah Christian
List of Attached Documents:
// Content
Board Member
0.00
0
0
0
4605 Helmo Ave N
Oakdale
,
MN
55128
Amy Eaton
List of Attached Documents:
// Content
Board Member
0.00
0
0
0
1414 State Rd 46
Balsam Lake
,
WI
54956
Erika Hall
List of Attached Documents:
// Content
Board Member
0.00
0
0
0
327 Division St
Neenah
,
WI
54956
Brian Holsten
List of Attached Documents:
// Content
Board Member
0.00
0
0
0
1855 Campfire Drive East
Waconia
,
MN
55387
Diana Bernard
List of Attached Documents:
// Content
Board Member
0.00
0
0
0
1020 Gage Court
Spring Hill
,
FL
34608
Martha Etzell
List of Attached Documents:
// Content
Board Member
0.00
0
0
0
2009 Roe Crest Drive
North Mankato
,
MN
56003
2
Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a)
Name and address of each employee paid more than $50,000
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
Total
number of other employees paid over $50,000
...................
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
Total
number of others receiving over $50,000 for professional services
.............
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
Supporting various individuals that have requested assistance from the Giving Foundation
29,895
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
.........................
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
0
b
Average of monthly cash balances
.......................
1b
7,079
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
7,079
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation)
List of Attached Documents:
// Content
.............
1e
0
2
Acquisition indebtedness applicable to line 1 assets
..................
2
0
3
Subtract line 2 from line 1d
.........................
3
7,079
4
Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
instructions)
.............................
4
106
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3.
............
5
6,973
6
Minimum investment return.
Enter 5% (0.05) of line 5
................
6
349
Part X
Distributable Amount
(see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here
and do not complete this part.)
1
Minimum investment return from Part IX, line 6
..................
1
2a
Tax on investment income for 2022 from Part V, line 5
.......
2a
b
Income tax for 2022. (This does not include the tax from Part V.)
...
2b
c
Add lines 2a and 2b
............................
2c
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
4
Recoveries of amounts treated as qualifying distributions
................
4
5
Add lines 3 and 4
............................
5
6
Deduction from distributable amount (see instructions)
.................
6
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1
...
7
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
29,895
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)
List of Attached Documents:
// Content
.................
3b
0
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part XII, line 4.
.......
4
29,895
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
2
Undistributed income, if any, as of the end of 2022:
a
Enter amount for 2022 only
.......
b
Total for prior years:
20
,
20
,
20
3
Excess distributions carryover, if any, to 2022:
a
From 2018
......
b
From 2019
......
c
From 2020
......
d
From 2021
......
e
From 2022
......
f
Total
of lines 3a through e
........
4
Qualifying distributions for 2023 from Part
XI, line 4:
$
a
Applied to 2022, but not more than line 2a
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
c
Treated as distributions out of corpus (Election
required—see instructions)
........
d
Applied to 2023 distributable amount
.....
e
Remaining amount distributed out of corpus
5
Excess distributions carryover applied to 2023.
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
e
Undistributed income for 2022. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
f
Undistributed income for 2023. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2024
..........
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions)
.......
8
Excess distributions carryover from 2018 not
applied on line 5 or line 7 (see instructions)
...
9
Excess distributions carryover to 2024.
Subtract lines 7 and 8 from line 6a
......
10
Analysis of line 9:
a
Excess from 2019
....
b
Excess from 2020
....
c
Excess from 2021
....
d
Excess from 2022
....
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
......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part IX for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2023
(b)
2022
(c)
2021
(d)
2020
0
0
0
0
0
b
85% (0.85) of line 2a
.........
0
0
0
0
0
c
Qualifying distributions from Part XI,
line 4 for each year listed
.....
29,895
45,350
28,475
23,382
127,102
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
0
0
0
0
0
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
29,895
45,350
28,475
23,382
127,102
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
0
0
0
10,954
10,954
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
0
0
0
0
0
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part IX, line 6 for each year listed
..
233
431
469
307
1,440
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)
....
0
0
0
0
0
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
0
0
0
0
0
(3)
Largest amount of support
from an exempt organization
0
0
0
0
0
(4)
Gross investment income
0
0
0
0
0
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.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
N A
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
N A
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
Bluestone Giving Foundation
270 Main Street N Ste 300
Stillwater
,
MN
55082
(612) 409-2932
Giving@BluestoneMD.com
b
The form in which applications should be submitted and information and materials they should include:
N A
c
Any submission deadlines:
N A
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
N A
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)
a
Paid during the year
Bluestone Giving Foundation
6950 E Point Douglas Road S
Cottage Grove
,
MN
55016
No
I
Escort for appointment
160
Bluestone Giving Foundation
1824 Old Hudson Road
Rm 420
St Paul
,
MN
55119
No
I
Pedal Machine
40
Bluestone Giving Foundation
2345 Helen St N
North St Paul
,
MN
55109
No
I
Self cleaning litter box for companion
182
Bluestone Giving Foundation
6352 Central Ave NE
48
Fridley
,
MN
55432
No
I
Prescription Medicine
409
Bluestone Giving Foundation
105 Ring Ave S
Apt 11
Canby
,
MN
56220
No
I
Therapy Art Book
21
Bluestone Giving Foundation
2437 29th Ave S
Apt 2
Minneapolis
,
MN
55406
No
I
Light Therapy Lamp
51
Bluestone Giving Foundation
11350 Martin Street NW
Coon Rapids
,
MN
55433
No
I
Intervention fidget item
43
Bluestone Giving Foundation
6950 E Point Douglas Road S
Cottage Grove
,
MN
55016
No
I
Therapeutic robotic pet
134
Bluestone Giving Foundation
7900 Austin Way
Apt 29
Inver Grove Heights
,
MN
55077
No
I
Sound machine
28
Bluestone Giving Foundation
7900 Austin Way
Apt 29
Inver Grove Heights
,
MN
55077
No
I
Intervention fidget item
20
Bluestone Giving Foundation
6352 Central Ave NE
58
Fridley
,
MN
55432
No
I
Wheelchair
134
Bluestone Giving Foundation
4953 Aldrich Ave S
Minneapolis
,
MN
55419
No
I
Tablet for brain stimulation games
127
Bluestone Giving Foundation
1109 Hazel St N
St Paul
,
MN
55119
No
I
Smart Video Calling Device
87
Bluestone Giving Foundation
9058 Buchanan Trail
Inver Grove Heights
,
MN
55076
No
I
Side zipping pants
53
Bluestone Giving Foundation
123 Unavailable
St Paul
,
MN
55117
Employee
I
Rent
300
Bluestone Giving Foundation
9056 Buchanan Trail
Apt 23
Inver Grove Heights
,
MN
55077
No
I
Light Therapy Lamp
21
Bluestone Giving Foundation
4600 52nd Ave
Kenosha
,
WI
53144
No
I
Prescription Medicine
242
Bluestone Giving Foundation
19 Kistler Ct
La Crescent
,
MN
55947
No
I
Elliptical Style Machine
167
Bluestone Giving Foundation
3146 Minnehaha Ave S
Apt 4
Minneapolis
,
MN
55406
No
I
Jetted Bath Mat
140
Bluestone Giving Foundation
4307 159th Court W
Rosemount
,
MN
55068
No
I
Pocket Talker
183
Bluestone Giving Foundation
6950 E Point Douglas Road S
RM 9
Cottage Grove
,
MN
55016
No
I
Escort for appointment
336
Bluestone Giving Foundation
105 E Walnut St
Apt 509
Mankato
,
MN
56001
No
I
Heating Pads
60
Bluestone Giving Foundation
414 10th St S
Cleveland
,
MN
56017
No
I
Wheelchair
138
Bluestone Giving Foundation
725 Town Center Parkway
Lino Lakes
,
MN
55014
No
I
Transportation to appointment
100
Bluestone Giving Foundation
1640 155th Lane NW
Apt 237
Andover
,
MN
55304
No
I
Light Therapy Lamp
27
Bluestone Giving Foundation
10130 County Road 23
Brainerd
,
MN
56401
No
I
Pedal Machine
34
Bluestone Giving Foundation
10875 River Hills Circle
Brainerd
,
MN
56401
No
I
Heating Pad
25
Bluestone Giving Foundation
1525 Northway Drive
Apt 112
St Cloud
,
MN
56303
No
I
Wheelchair
199
Bluestone Giving Foundation
6485 71st Ave SW
Motley
,
MN
56466
No
I
Blood pressure monitor and cuff
38
Bluestone Giving Foundation
2502 Oak Street
Brainerd
,
MN
56401
No
I
Compression stockings
50
Bluestone Giving Foundation
2700 62nd St E
Inver Grove Heights
,
MN
55076
No
I
Clothes
84
Bluestone Giving Foundation
940 Selby Ave
Apt 302
St Paul
,
MN
55104
No
I
4 wheeled walker with seat
390
Bluestone Giving Foundation
2235 Rockwood Avenue
Rm 905
St Paul
,
MN
55116
No
I
Lift Chair
45
Bluestone Giving Foundation
103 York Street
Pine River
,
MN
56474
No
I
Bidet
99
Bluestone Giving Foundation
6352 Central Ave NE
Fridley
,
MN
55432
No
I
Transportation to appointment
155
Bluestone Giving Foundation
2348 Aurora Circle
Apt 30A
River Falls
,
WI
54022
No
I
Laundry Detergent
27
Bluestone Giving Foundation
3733 23rd Ave S
214
Minneapolis
,
MN
55407
No
I
Collections bill
51
Bluestone Giving Foundation
1173 Dewey St
Apt 104
Wabasso
,
MN
56293
No
I
Moving Expenses
123
Bluestone Giving Foundation
129 Country Manor Ct
Eagle Lake
,
MN
56024
No
I
Food
100
Bluestone Giving Foundation
1625 Selby Ave
st paul park
,
MN
55071
No
I
Sound machine and nightlight
20
Bluestone Giving Foundation
160 Western Ave S
Apt 515
St Paul
,
MN
55102
No
I
Electric bill
130
Bluestone Giving Foundation
141 E 2nd Ave
214
McGregor
,
MN
55760
No
I
Flip phone
53
Bluestone Giving Foundation
5118 North Cherryvale Ave
Room 20
Appleton
,
WI
54913
No
I
Wall Calendar
11
Bluestone Giving Foundation
240 Charles Ave
Apt 2
Saint Paul
,
MN
55103
No
I
Thera Cane Massager
93
Bluestone Giving Foundation
400 3rd Ave NE
Apt 114
Crosby
,
MN
56441
No
I
Lock box for medicine
49
Bluestone Giving Foundation
310 N 6th St
Unit 2
Brainerd
,
MN
56401
No
I
Dental CT Scan
330
Bluestone Giving Foundation
410 E River Rd
Apt 406
Brainerd
,
MN
56401
No
I
Moving Expenses
420
Bluestone Giving Foundation
155 S 5th Ave
Minneapolis
,
MN
55401
No
I
Compression stockings
20
Bluestone Giving Foundation
6900 East Point Douglas Road South
Apt 40
Cottage Grove
,
MN
55016
No
I
Beginning guitar book
14
Bluestone Giving Foundation
439 141st st
Beaver Creek
,
MN
56116
No
I
Diabetic shoes
160
Bluestone Giving Foundation
844 West River Road
Champlin
,
MN
55316
No
I
Palm grips contrature cushion
16
Bluestone Giving Foundation
155 S 5th Ave
Minneapolis
,
MN
55401
No
I
Compression stockings
14
Bluestone Giving Foundation
3950 N Main Street
Rm 211
Racine
,
WI
53402
No
I
Foam bed mattress
200
Bluestone Giving Foundation
2700 62nd St E
Inver Grove Heights
,
MN
55076
No
I
Clothes
34
Bluestone Giving Foundation
1466 Larpenteur Ave
Apt 4
Falcon Heights
,
MN
55113
No
I
Dental Crown
200
Bluestone Giving Foundation
3421 53rd Ave N
Apt 301
Brooklyn Center
,
MN
55429
No
I
Shoes
55
Bluestone Giving Foundation
1011 Bryant Ave
Apt 2
South St Paul
,
MN
55075
No
I
Protein Powder
64
Bluestone Giving Foundation
822 Northwood Ct NW
Willmar
,
MN
56201
No
I
Bathroom scale
34
Bluestone Giving Foundation
10507 S Chicago Rd
205b
Oak Creek
,
WI
53154
No
I
Seat Cushion
25
Bluestone Giving Foundation
105 E Walnut St
Apt 709
Mankato
,
MN
56001
No
I
Pill organizer
4
Bluestone Giving Foundation
101 Kari Lane
Brainerd
,
MN
56401
No
I
Medication Dispenser
76
Bluestone Giving Foundation
11201 595th Ave
Parkers Prairie
,
MN
56361
No
I
Air Purifier
114
Bluestone Giving Foundation
525 2nd St SE
Osseo
,
MN
55369
No
I
Bridging Services
320
Bluestone Giving Foundation
homeless
La Crescent
,
MN
55947
No
I
Hospital stay
342
Bluestone Giving Foundation
17411 S Crystal Springs Rd
Grand Rapids
,
MN
55744
No
I
Lift Chair
43
Bluestone Giving Foundation
16500 92nd ave n
223
Maple Grove
,
MN
55311
No
I
Moving Expenses
300
Bluestone Giving Foundation
208 Albert Ave NW
Apt 10
FERTILE
,
MN
56540
No
I
Shower Grab Bars
58
Bluestone Giving Foundation
1700 Freeman Dr Trlr 49
Saint Peter
,
MN
56082
No
I
Orthopedic Pillow
87
Bluestone Giving Foundation
3029 Mary Court
Maplewood
,
MN
55109
No
I
Shower bench
289
Bluestone Giving Foundation
5401 69th Ave N
Brooklyn Center
,
MN
55429
No
I
Moving Expenses
120
Bluestone Giving Foundation
2315 Hillcrest Dr
Apt 3
Brainerd
,
MN
56401
No
I
Cardiac Row Machine
280
Bluestone Giving Foundation
260 Magnus Johnson St NE
7
Kimball
,
MN
55353
No
I
Therapeutic robotic pet
200
Bluestone Giving Foundation
9327 County Rd11
Breezy Point
,
MN
56472
No
I
Medication Dispenser
73
Bluestone Giving Foundation
548 1st Ave S
Motley
,
MN
56466
No
I
Dental bill
125
Bluestone Giving Foundation
1230 SE 4th St
Grand Rapids
,
MN
55744
No
I
Felt electrode pads
50
Bluestone Giving Foundation
11065 Berry Ave
Leota
,
MN
56153
No
I
Gas card
50
Bluestone Giving Foundation
313 Greeley St S
Stillwater
,
MN
55082
No
I
Moving Expenses
400
Bluestone Giving Foundation
611 N Highway 86
LAKEFIELD
,
MN
56150
No
I
Walker basket
26
Bluestone Giving Foundation
3300 Rice Street
Apt 220
Little Canada
,
MN
55126
No
I
Toilet Riser
124
Bluestone Giving Foundation
109 3rd Ave NE
109
Freeport
,
MN
56331
No
I
Dental Work
150
Bluestone Giving Foundation
20810 Cadwell Ave
Brainerd
,
MN
56401
No
I
Shower Grab Bars
43
Bluestone Giving Foundation
homeless
La Crescent
,
MN
55947
No
I
Hospital Stay
342
Bluestone Giving Foundation
410 East River Road
Apt 811
Brainerd
,
MN
56401
No
I
Heated Blanket
35
Bluestone Giving Foundation
3434 Heritage Dr
apt 409
Edina
,
MN
55435
No
I
Journal
22
Bluestone Giving Foundation
3501 Douglas Drive N
16
Crystal
,
MN
55422
No
I
Clock
32
Bluestone Giving Foundation
6121 Brooklyn Blvd
103
Brooklyn Center
,
MN
55429
No
I
Vet bill
150
Bluestone Giving Foundation
710 28th Street SE
Apt 140
Brainerd
,
MN
56401
No
I
Lavender oil
8
Bluestone Giving Foundation
19 Kistler Ct
La Crescent
,
MN
55947
No
I
Heating Pad
26
Bluestone Giving Foundation
304 Course Lane
Apt 3
Bigfork
,
MN
56628
No
I
Rent
300
Bluestone Giving Foundation
1824 Old Hudson Road
St Paul
,
MN
55106
No
I
Smart plugs
83
Bluestone Giving Foundation
10669 Ulysses St NE
Blaine
,
MN
55434
No Relationship
I
Tricycle
320
Bluestone Giving Foundation
613 7th St
11
Madison Lake
,
MN
56063
No Relationship
I
Air Purifier
253
Michelle Beech
223 Buchanan St
Winona
,
MN
55987
No
I
Two dental crowns
994
Diane Hanson
602 8th Ave SW
Austin
,
MN
55912
No
I
Full set of dentures
1,148
Sherrie Hart
502 E 26th St
Apt 5
Minneapolis
,
MN
55404
No
I
Dental Work
1,573
Chelcee Blesener
123 Unavailable
St Paul
,
MN
55117
Employee
I
Rent
2,150
Patrick Engelhardt
6490 Central Ave NE
204
Fridley
,
MN
55432
No
I
Moving Expenses
816
Marjorie Wheeler
2437 29th Ave S
Apt 2
Minneapolis
,
MN
55406
No
I
Past due gas bill for heat
559
Anna Tanger
2975 Village Square Dr
Hartland
,
WI
53029
No
I
Lightweight Wheelchair
650
Casey McMillan
123 Unavailable
St Paul
,
MN
55117
Employee
I
Exterminator
1,749
Liz Freeberg
123 Unavailable
St Paul
,
MN
55117
Employee
I
Car insurance
1,000
Shannon Young
123 Unavailable
St Paul
,
MN
55117
Employee
I
Rent
1,000
Sarah Bellile
123 Unavailable
St Paul
,
MN
55117
Employee
I
Cremation Services
2,340
Chelcee Blesener
123 Unavailable
St Paul
,
MN
55117
Employee
I
Outstanding bill
806
Paula Inselman
677 Brianna Drive
223
Sartell
,
MN
56377
No
I
General Anesthesia
650
Holly Conrey
123 Unavailable
St Paul
,
MN
55117
Employee
I
Cancer treatment
1,000
Jaycee Ryan
123 Unavailable
St Paul
,
MN
55117
Employee
I
Dental Surgery
1,000
Alan Musielewicz
400 Western Ave N
Apt 134
St Paul
,
MN
55103
No
I
Moving Expenses
550
Carnecia Armstrong
123 Unavailable
St Paul
,
MN
55117
Employee
I
Rent
500
Total
.................................
3a
29,895
b
Approved for future payment
Total
.................................
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.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
0
0
0
b
0
0
0
c
0
0
0
d
0
0
0
e
0
0
0
f
0
0
0
0
0
0
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
0
0
0
3
Interest on savings and temporary cash
investments
...........
0
0
0
4
Dividends and interest from securities
....
0
0
0
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
0
0
0
b
Not debt-financed property
.....
0
0
0
6
Net rental income or (loss) from personal property
0
0
0
7
Other investment income
.....
0
0
0
8
Gain or (loss) from sales of assets other than
inventory
............
0
0
0
9
Net income or (loss) from special events:
0
0
0
10
Gross profit or (loss) from sales of inventory
0
0
0
11
Other revenue:
a
0
0
0
b
0
0
0
c
0
0
0
d
0
0
0
e
0
0
0
12
Subtotal. Add columns (b), (d), and (e)
..
0
0
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
0
(See worksheet in line 13 instructions to verify calculations.)
Part XV-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
Explain below how each activity for which income is reported in column (e) of Part 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?
...........
Yes
No
b
If "Yes," complete the following schedule.
(a)
Name of organization
(b)
Type of organization
(c)
Description of relationship
Sign Here
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
May the IRS discuss this return
with the preparer shown below?
See instructions.
Yes
No
Signature of officer or trustee
Date
Title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's Signature
Date
Check if self-
employed
PTIN
Firm's name
Firm's EIN
Firm's address
Phone no.
Form
990-PF
(2023)
Additional Data
Software ID:
23017649
Software Version:
V2.0
Form 990PF - Special Condition Description:
Special Condition Description
-
TIN:
Schedule B
(Form 990)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Attach to Form 990, 990-EZ, or 990-PF.
Go to
www.irs.gov/Form990
for the latest information.
OMB No. 1545-0047
20
23
Name of the organization
BLUESTONE GIVING FOUNDATION
Employer identification number
46-5218477
Organization type
(check one):
Filers of:
Section:
Form 990 or 990-EZ
501(c)(
) (enter number) organization
4947(a)(1) nonexempt charitable trust
not
treated as a private foundation
527 political organization
Form 990-PF
501(c)(3) exempt private foundation
4947(a)(1) nonexempt charitable trust treated as a private foundation
501(c)(3) taxable private foundation
Check if your organization is covered by the
General Rule
or a
Special Rule.
Note:
Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.
Special Rules
For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33
1
/3
% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of
(1)
$5,000 or
(2)
2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.
For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000
exclusively
for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.
For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions
exclusively
for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an
exclusively
religious, charitable, etc., purpose. Don't complete any of the parts unless the
General Rule
applies to this organization because it received
nonexclusively
religious, charitable, etc., contributions totaling $5,000 or more during the year
.........
$
Caution:
An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it
must
answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613X
Schedule B (Form 990) (2023)
Schedule B (Form 990) (2023)
Page
2
Name of organization
BLUESTONE GIVING FOUNDATION
Employer identification number
46-5218477
Part I
Contributors
Contributors
(see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
1
Bluestone Employees
270 Main Street N Ste 300
Stillwater
,
MN
55082
$
34,974
Person
Payroll
Noncash
(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
$
Person
Payroll
Noncash
(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
$
Person
Payroll
Noncash
(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
$
Person
Payroll
Noncash
(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
$
Person
Payroll
Noncash
(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
$
Person
Payroll
Noncash
(Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)
Schedule B (Form 990) (2023)
Page
3
Name of organization
BLUESTONE GIVING FOUNDATION
Employer identification number
46-5218477
Part II
Noncash Property
(see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
$
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
$
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
$
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
$
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
$
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
$
Schedule B (Form 990) (2023)
Schedule B (Form 990) (2023)
Page
4
Name of organization
BLUESTONE GIVING FOUNDATION
Employer identification number
46-5218477
Part III
Exclusively
religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns
(a)
through
(e) and
the following line entry. For organizations completing Part III, enter the total of
exclusively
religious, charitable, etc., contributions of
$1,000 or less
for the year. (Enter this information once. See instructions.)
$
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift
(c) Use of gift
(d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP 4
Relationship of transferor to transferee
(a)
No. from Part I
(b) Purpose of gift
(c) Use of gift
(d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP 4
Relationship of transferor to transferee
(a)
No. from Part I
(b) Purpose of gift
(c) Use of gift
(d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP 4
Relationship of transferor to transferee
(a)
No. from Part I
(b) Purpose of gift
(c) Use of gift
(d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP 4
Relationship of transferor to transferee
Schedule B (Form 990) (2023)
Additional Data
Software ID:
Software Version:
-
TIN:
TY 2023 OtherExpensesSchedule
Name:
BLUESTONE GIVING FOUNDATION
EIN:
46-5218477
Software ID:
23017649
Software Version:
V2.0
Description
Revenue and Expenses per Books
Net Investment Income
Adjusted Net Income
Disbursements for Charitable Purposes
MN Attorney General Fee
25
0
0
0
Tax E Filing Cost
169
0
0
0