TY 2023 Form 990PF

Part II		Balance Sheets	Beginning of year	End of year
Part II		Balance Sheets	(a) Book Value	(b) Book Value	(c) Fair Market Value
	1	Cash—non-interest-bearing.............	23,416	5,550
	2	Savings and temporary cash investments.........
	3	Accounts receivable
		Less: allowance for doubtful accounts
	4	Pledges receivable
		Less: allowance for doubtful accounts
	5	Grants receivable.................
	6	Receivables due from officers, directors, trustees, and other
		disqualified persons (attach schedule) (see instructions).....
	7	Other notes and loans receivable (attach schedule)
		Less: allowance for doubtful accounts
	8	Inventories for sale or use..............
	9	Prepaid expenses and deferred charges..........
	10a	Investments—U.S. and state government obligations (attach schedule)
	b	Investments—corporate stock (attach schedule).......	58,341	List of Attached Documents: // Content 58,341	129,016
	c	Investments—corporate bonds (attach schedule).......
	11	Investments—land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	12	Investments—mortgage loans.............
	13	Investments—other (attach schedule)..........
	14	Land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	15	Other assets (describe )
	16	Total assets (to be completed by all filers—see the
		instructions. Also, see page 1, item I)	81,757	63,891	129,016
	17	Accounts payable and accrued expenses..........
	18	Grants payable.................
	19	Deferred revenue.................
	20	Loans from officers, directors, trustees, and other disqualified persons
	21	Mortgages and other notes payable (attach schedule)......
	22	Other liabilities (describe )
	23	Total liabilities (add lines 17 through 22).........	0	0
		Foundations that follow FASB ASC 958, check here
		and complete lines 24, 25, 29 and 30.
	24	Net assets without donor restrictions...........	81,757	63,891
	25	Net assets with donor restrictions............
		Foundations that do not follow FASB ASC 958, check here
		and complete lines 26 through 30.
	26	Capital stock, trust principal, or current funds........
	27	Paid-in or capital surplus, or land, bldg., and equipment fund
	28	Retained earnings, accumulated income, endowment, or other funds
	29	Total net assets or fund balances (see instructions).....	81,757	63,891
	30	Total liabilities and net assets/fund balances (see instructions).	81,757	63,891

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

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	0
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	0
5	Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- .....	5	0
6	Credits/Payments:

a	2023 estimated tax payments and 2022 overpayment credited to 2023	6a
b	Exempt foreign organizations—tax withheld at source......	6b
c	Tax paid with application for extension of time to file (Form 8868)...	6c
d	Backup withholding erroneously withheld ..........	6d

7	Total credits and payments. Add lines 6a through 6d..............	7
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
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	Refunded	11

(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
CANDACE FRIE	PRESIDENT 0.00	0	0	0
8702 IRIS STREET ARVADA,CO80005

		(a) Corpus	(d) 2023
1 Distributable amount for 2023 from Part X, line 7			0
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......	45,681
c From 2020......	44,532
d From 2021......	46,110
e From 2022......	43,452
f Total of lines 3a through e ........		179,775
4Qualifying distributions for 2023 from Part
XI, line 4: $ 35,639
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)........		35,639
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).)
6Enter the net total of each column as indicated below:
a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5		215,414
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 ..........			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) .......
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 ......		215,414
10 Analysis of line 9:
a Excess from 2019....	45,681
b Excess from 2020....	44,532
c Excess from 2021....	46,110
d Excess from 2022....	45,392
e Excess from 2023....	35,639

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)		Foundation status of recipient	Purpose of grant or contribution	Amount
aPaid during the year
ACLU FOUNDATION OF COLORADO 303 E 17TH AVE STE 350 Denver,CO80203		EOF	CHARITY	50
ALTERNATIVES PREGNANCY CENTER 23 INVERNESS WAY EAST STE 101 Englewood,CO80112		EOF	CHARITY	100
ALUMNAE ASSOC OF THE COLLEGE OF ST 357 GOULD ST Winona,MN55987		EOF	CHARITY	100
ALZHEIMERS ASSOC OF CO 455 N SHERMAN ST STE 500 Denver,CO80203		EOF	CHARITY	100
AMERICAN INDIAN COLLEGE 8333 GREENWOOD BLVD Denver,CO802214488		EOF	CHARITY	200
AMER LUNG ASSOC IN CO PO BOX 70350 Philadelphia,PA191760350		EOF	CHARITY	50
AMNESTY INTERNATIONAL 311 W 43RD ST 7TH FL New York,NY10036		EOF	CHARITY	100
ARTHRITIS FND OF CO 1355 S COLORADO BLVD STE C-608 Denver,CO80222		EOF	CHARITY	50
ARVADA CENTER FT PERFORMING ARTS 6901 WADSWORTH BLVD Arvada,CO80003		EOF	CHARITY	1,100
ARVADA HISTORICAL SOCIETY 7307 GRANDVIEW AVE Arvada,CO80002		EOF	CHARITY	50
BAYAUD ENTERPRISES 333 W BAYAUD AVE Denver,CO80223		EOF	CHARITY	50
BEYOND HOME PO BOX 740130 Arvada,CO80006		EOF	CHARITY	500
BOYS HOPE GIRLS HOPE COLORADO 3090 S JAMAICA CT STE 212 Aurora,CO80014		EOF	CHARITY	100
BREAD FOR THE WORLD INSTITUTE 425 3RD ST SW STE 1200 Washington,DC20024		EOF	CHARITY	100
BRENNAN CENTER FOR JUSTICE 120 BROADWAY STE 1750 New York,NY10271		EOF	CHARITY	100
CALL TO ACTION 1301 2ND AVE S A306 Minneapolis,MN55403		EOF	CHARITY	50
CARIN CLINIC 5150 ALLISON ST Arvada,CO80002		EOF	CHARITY	1,100
CATHOLIC RELIEF SERVICES 228 W LEXINGTON ST Baltimore,MD212013443		EOF	CHARITY	1,100
CENTER FOR ACTION CONTEMPLATION PO BOX 12464 Albuquerque,NM87195		EOF	CHARITY	300
CENTRO HUMANITARIO 2830 LAWRENCE ST Denver,CO80205		EOF	CHARITY	800
CHILDRENS DIABETES FOUNDATION 3025 S PARKER RD STE 110 Aurora,CO80014		EOF	CHARITY	1,000
CHILDRENS HOSPITAL OF CO FDN 13123 E 16TH AVE BOX 045 Aurora,CO80045		EOF	CHARITY	100
CLEAN WATER FUND 1444 EYE ST NW STE 400 Washington,DC20005		EOF	CHARITY	50
COLORADO BAR FOUNDATION 1290 BROADWAY STE 1700 Denver,CO80203		EOF	CHARITY	300
CO COALITION FOR THE HOMELESS 2111 CHAMPA ST Denver,CO80205		EOF	CHARITY	100
COLORADO HOSTING ASYLUM NETWORK 11757 W KEN CARYL AVE STE F BOX 414 Littleton,CO80127		EOF	CHARITY	100
COLORADO INSTITUTE FOR PUBLIC LIFE 820 S MONACO PKWY 501 Denver,CO80224		EOF	CHARITY	1,500
COLORADO PUBLIC RADIO 9409 S ALTON CT Englewood,CO80112		EOF	CHARITY	1,280
CO PUBLIC TELEVISION 12 2900 WELTON ST 100 Denver,CO80205		EOF	CHARITY	125
COLORADO RAILROAD MUSEUM 17155 W 44TH AVE Golden,CO80403		EOF	CHARITY	100
COLORADO SYMPHONY 1000 14TH ST NO 15 Denver,CO80202		EOF	CHARITY	250
COMMUNITY TABLE 8555 W 57TH AVE Arvada,CO80002		EOF	CHARITY	1,300
CONTEMPLATIVE OUTREACH OF CO 3650 YATES ST Denver,CO80212		EOF	CHARITY	100
COUSTEAU SOCIETY PO BOX 706 Etna,NH037500506		EOF	CHARITY	100
CREATIVE VISIONS 106 E 6TH AVE 100-205 Austin,TX78702		EOF	CHARITY	100
DAVIS PHINNEY FDN FOR PARKINSONS 357 S MCCASLIN BLVD STE 105 Louisville,CO80027		EOF	CHARITY	200
DENVER BOTANIC GARDENS 1007 YORK ST Denver,CO80206		EOF	CHARITY	110
DENVER CAATHOLIC WORKER SOUP KITCH PO BOX 27255 Denver,CO80227		EOF	CHARITY	1,000
DENVER MUSEUM OF NATURE SCIENCE 2001 COLORADO BLVD Denver,CO80205		EOF	CHARITY	119
EASTER SEALS 393 S HARLAN STE 250 Denver,CO80226		EOF	CHARITY	50
EMILY GRIFFITH FOUNDATION 1860 LINCOLN ST 605 Denver,CO80203		EOF	CHARITY	600
ENERGY OUTREACH COLORADO 303 E 17TH AVE 405 Denver,CO80203		EOF	CHARITY	100
ENVIROMENT COLORADO RESEARCH 1543 WAZEE ST 400 Denver,CO80202		EOF	CHARITY	35
EQUAL JUSTICE INITIATIVE 122 COMMERCE ST Montgomery,AL36104		EOF	CHARITY	1,000
FRIENDS OF BROOMFIELD 11815 SAULSBURY ST Broomfield,CO80020		EOF	CHARITY	450
FCNL EDUCATION FUND 245 2ND ST NE Washington,DC20002		EOF	CHARITY	50
FOOD FOR THE POOR 6401 LYONS ROAD COCONUT CREEK,FL33073		EOF	CHARITY	50
FRIENDS OF NCR 115 E ARMOUR BLVD Kansas City,MO64111		EOF	CHARITY	50
GIFFORDS LAW CTR TO PREVENT GUN VIO PO BOX 98162 Washington,DC20090		EOF	CHARITY	100
GINNYS KIDS 1175 S EATON CT Denver,CO80232		EOF	CHARITY	350
GUNDERSON LUTHERAN MEDICAL FDN 1900 SOUTH AVE La Crosse,WI54601		EOF	CHARITY	100
HABITAT FOR HUMANITY OF DENVER 7535 E HAMDEN AVE STE 600 Denver,CO80231		EOF	CHARITY	100
HAVEN OF HOPE 1101 W 7TH AVE Denver,CO80204		EOF	CHARITY	700
HEIFER INTERNATIONAL 1 WORLD AVENUE Little Rock,AR72202		EOF	CHARITY	400
HISTORY OF COLORADO 1200 BROADWAY Denver,CO80203		EOF	CHARITY	70
HUMAN RIGHTS DEFENSE CENTER PO BOX 1151 Lake Worth Beach,FL33460		EOF	CHARITY	500
INSIDE OUT YOUTH SERVICES 223 N WAHSATCH AVE STE 101 Colorado Springs,CO80903		EOF	CHARITY	100
INTERFAITH ALLIANCE FDN OF COLO 1373 GRANT ST Denver,CO80203		EOF	CHARITY	100
JEFFERSON COUNTY LIBRARY FOUNDATION 10790 W 580TH AVE 200 Wheat Ridge,CO80033		EOF	CHARITY	100
JUST FAITH MINISTRIES PO BOX 221348 Louisville,KY40252		EOF	CHARITY	4,500
LEAGUE OF WOMEN VOTERS EDUCATION FD 1233 20TH ST STE 500 Washington,DC20036		EOF	CHARITY	50
LEUKEMIA LYMPHOMA SOCIETY 720 S COLORADO BLVD Denver,CO80246		EOF	CHARITY	500
LOUSIANA SPCA 1700 MARDI GRAS BLVD New Orleans,LA70114		EOF	CHARITY	50
LOYOLA UNIV OF NEW ORLEANS FDN 7214 ST CHARLES AVE New Orleans,LA70118		EOF	CHARITY	200
MARIA DROSTE COUNSELING CENTER 1355 S COLORADO BLVD Denver,CO80222		EOF	CHARITY	500
MARYKNOLL LAY MISSIONERS PO BOX 307 Maryknoll,NY105450307		EOF	CHARITY	100
MISSION TO MAGADAN 225 CORDOVA ST Anchorage,AK99501		EOF	CHARITY	100
MOTHER CABRINI SHRINE 20189 CABRINI BLVD Golden,CO80401		EOF	CHARITY	600
MOUNT ST VINCENT HOME 4159 LOWELL BLVD Denver,CO80211		EOF	CHARITY	100
MT ST BENEDICT 620 SUMMIT AVE Crookston,MN56716		EOF	CHARITY	100
NAACP EMPOWERMENT PROGRAMS 4805 MT HOPE DR Baltimore,MD21215		EOF	CHARITY	75
NATIONAL FEDERATION OF THE BLIND CO 2233 W SHEPPARD AVE Littleton,CO80120		EOF	CHARITY	50
NATIONAL WILDLIFE FEDERATION PO BOX 153 Merrifield,VA221161583		EOF	CHARITY	50
NATIONAL WWII MUSEUM 945 MAGAZINE ST New Orleans,LA70130		EOF	CHARITY	50
NETWORK EDUCATION PROGRAM 820 FIRST STREET NE STE 350 Washington,DC200028065		EOF	CHARITY	50
NEW ORLEANS HABITAT FOR HUMANITY 2900 ELYSIAN FIELDS AVE New Orleans,LA70122		EOF	CHARITY	200
NEWCOMERS FUND 4500 CHERRY CREEK DRIVE S STE 900 Denver,CO80246		EOF	CHARITY	1,100
OBAMA FOUNDATION 5235 S HARPER CT STE 1140 Chicago,IL60615		EOF	CHARITY	100
OXFAM 77 N WASHINGTON ST STE 500 Boston,MA021141908		EOF	CHARITY	50
PARKINSONS FOUNDATION 200 SE 1ST ST STE 800 Miami,FL33131		EOF	CHARITY	50
PAX CHRISTI USA 415 MICHIGAN AVE NE STE 240 Washington,DC200174503		EOF	CHARITY	100
PROJECT ANGEL HEART 4950 WASHINGTON ST Denver,CO80216		EOF	CHARITY	100
PROJECT EL SALVADOR PO BOX 300105 Denver,CO802030105		EOF	CHARITY	100
RALSTON HOUSE 10795 W 58TH AVE Arvada,CO80002		EOF	CHARITY	150
RARE SISTERS BATTEN FOUNDATION PO BOX 746561 Arvada,CO80006		EOF	CHARITY	250
REAL LIFE COLORADO 4000 S WADSWORTH BLVD STE 010 Littleton,CO80123		EOF	CHARITY	200
RECONCILE NEW ORLEANS INC 1631 ORETHA CASTLE HALEY BLVD New Orleans,LA70113		EOF	CHARITY	100
RED ROCKS CC FOUNDATION 13300 W SIXTH AVE BOX 1 Denver,CO802281255		EOF	CHARITY	1,000
ROCKY MOUNTAIN HORSE RESCUE 9190 ALKIRE ST Arvada,CO80005		EOF	CHARITY	50
ROCKY MOUNTAIN PBS 2101 ARAPAHOE ST Denver,CO80205		EOF	CHARITY	1,200
SAN ALFONSO MISSION PO BOX 745876 Arvada,CO80006		EOF	CHARITY	1,000
SEVERE WEATHER SHELTER NETWORK PO BOX 620564 Littleton,CO80162		EOF	CHARITY	500
SHE IS SAFE 515 E CROSSVIULLE RD STE 310 Roswell,GA30075		EOF	CHARITY	100
SISTERS OF ST FRANCIS 1001 14TH ST NW Rochester,MN55901		EOF	CHARITY	100
SOUTHERN POVERTY LAW CENTER 400 WASHINGTON AVE Montgomery,AL36104		EOF	CHARITY	1,100
ST ANTHONY HOSPITAL FOUNDATION 11600 W 2ND PL Denver,CO80228		EOF	CHARITY	50
ST LABRE INDIAN SCHOOL ASHLAND Ashland,MT59004		EOF	CHARITY	100
ST MARYS UNIVERSITY 700 TERRACE HEIGHTS 21 Winona,MN559871399		EOF	CHARITY	100
THE ACTION CENTER 8755 W 14TH AVE Denver,CO80215		EOF	CHARITY	100
THE BLUE BENCH PO BOX 5082 Denver,CO80217		EOF	CHARITY	50
THE BRADY CENTER 840 FIRST AVE NE STE 400 Washington,DC20002		EOF	CHARITY	100
THE CARTER CENTER 453 JOHN LEWIS FREEDOM PARKWAY NE Atlanta,GA30307		EOF	CHARITY	50
THE DENVER POST SAESON TO SHARE 5990 WASHINGTON ST Denver,CO80216		EOF	CHARITY	100
THE GATHERING PLACE 1535 HIGH ST Denver,CO80218		EOF	CHARITY	100
THE RISING CHURCH 7500 W 57TH AVE Arvada,CO80002		EOF	CHARITY	200
THE WILD ANIMAL SANCTUARY 1946 COUNTY ROAD 53 Keenesburg,CO80643		EOF	CHARITY	100
TWO PONDS PRESERVATION FOUNDATION 9010 W 80TH AVE Arvada,CO80005		EOF	CHARITY	75
UNITED NEGRO COLLEGE FUND 1805 7TH ST NW Washington,DC20001		EOF	CHARITY	400
VETERANS 8702 IRIS ST Arvada,CO80005		EOF	CHARITY	50
VOTE SMART 1153 24TH ST Des Moines,IA50311		EOF	CHARITY	100
WARREN VILLAGE 1323 GILPIN ST Denver,CO802182552		EOF	CHARITY	100
WORLD CENTRAL KITCHEN 1342 FLORIDA AVE NW Washington,DC20009		EOF	CHARITY	200
Total ................................. 3a				35,639

	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)	18,335
2	Check .............
3	Interest on savings and temporary cash investments
4	Dividends and interest from securities...
5a	Gross rents............
b	Net rental income or (loss)
6a	Net gain or (loss) from sale of assets not on line 10
b	Gross sales price for all assets on line 6a
7	Capital gain net income (from Part IV, line 2)...
8	Net short-term capital gain.........
9	Income modifications...........
10a	Gross sales less returns and allowances
b	Less: Cost of goods sold....
c	Gross profit or (loss) (attach schedule).....
11	Other income (attach schedule).......
12	Total. Add lines 1 through 11........	18,335		0
13	Compensation of officers, directors, trustees, etc.
14	Other employee salaries and wages......
15	Pension plans, employee benefits.......
16a	Legal fees (attach schedule).........
b	Accounting fees (attach schedule).......
c	Other professional fees (attach schedule)....	List of Attached Documents: // Content	550
17	Interest...............
18	Taxes (attach schedule) (see instructions)...
19	Depreciation (attach schedule) and depletion...
20	Occupancy..............
21	Travel, conferences, and meetings.......
22	Printing and publications..........
23	Other expenses (attach schedule).......	List of Attached Documents: // Content	12
24	Total operating and administrative expenses.
	Add lines 13 through 23..........	562		0		0
25	Contributions, gifts, grants paid.......	35,639				35,639
26	Total expenses and disbursements. Add lines 24 and 25	36,201		0		35,639
27	Subtract line 26 from line 12:
a	Excess of revenue over expenses and disbursements	-17,866
b	Net investment income (if negative, enter -0-)			0
c	Adjusted net income (if negative, enter -0-)...				0

(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
(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

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


(a) Name and address of each employee paid more than $50,000	(b) Title, and average hours per week devoted to position	(c) Compensation	(d) Contributions to employee benefit plans and deferred compensation	(e) Expense account, other allowances
NONE









Total number of other employees paid over $50,000...................				0

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	(e) Total

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

bApproved for future payment

Total ................................. 3b				0

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	(e) Related or exempt function income (See instructions.)
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 ....
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 ............
9 Net income or (loss) from special events:
10 Gross profit or (loss) from sales of inventory
11 Other revenue: a
b
c
d
e
12 Subtotal. Add columns (b), (d), and (e) ..

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.

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

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.)

(a) Line No.	(b) Amount involved	(c) Name of noncharitable exempt organization	(d) Description of transfers, transactions, and sharing arrangements

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