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
INTACT CHARITABLE TRUST USA
 
% John C Treacy
Number and street (or P.O. box number if mail is not delivered to street address)605 HIGHWAY 169 N STE 800
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
PLYMOUTH, MN554416533
A Employer identification number

23-2441567
B Telephone number (see instructions)

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$238,896J 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) 472,900
2 Check right arrow.............
3 Interest on savings and temporary cash investments 16,134 16,134 16,134
4 Dividends and interest from securities... 0 0 0
5a Gross rents............      
b Net rental income or (loss)  
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........ 489,034 16,134 16,134
Operating and Administrative Expenses 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)....... Click to see list of attachments
List of Attached Documents:
// Content
3,101 0 3,101 0
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 3,101 0 3,101 0
25 Contributions, gifts, grants paid....... 559,800 559,800
26 Total expenses and disbursements. Add lines 24 and 25 562,901 0 3,101 559,800
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -73,867
b Net investment income (if negative, enter -0-) 16,134
c Adjusted net income (if negative, enter -0-)... 13,033
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............. 295,463 238,896 238,896
2 Savings and temporary cash investments.........      
3 Accounts receivable right arrow  
Less: allowance for doubtful accounts right arrow        
4 Pledges receivable right arrow  
Less: allowance for doubtful accounts right arrow        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)..... 0 0  
7 Other notes and loans receivable (attach schedule) right arrow  
Less: allowance for doubtful accounts right arrow   0 0  
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
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 right arrow  
Less: accumulated depreciation (attach schedule) right arrow     0  
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........   0  
14 Land, buildings, and equipment: basis right arrow  
Less: accumulated depreciation (attach schedule) right arrow     0  
15 Other assets (describe right arrow) 0 0 0
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 295,463 238,896 238,896
Liabilities 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 right arrow) Click to see attachment
List of Attached Documents:
// Content
0 		Click to see attachment
List of Attached Documents:
// Content
0
23 Total liabilities (add lines 17 through 22)......... 0 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........ 295,463 238,896
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)..... 295,463 238,896
30 Total liabilities and net assets/fund balances (see instructions). 295,463 238,896
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
295,463
2
Enter amount from Part I, line 27a .....................
2
-73,867
3
Other increases not included in line 2 (itemize) right arrowClick to see attachment
List of Attached Documents:
// Content
3
17,300
4
Add lines 1, 2, and 3 ..........................
4
238,896
5
Decreases not included in line 2 (itemize) right arrow
5
 
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
238,896
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) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 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 ................... 		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) 1 224
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........................... 3 224
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- ..... 5 224
6 Credits/Payments:
a 2023 estimated tax payments and 2022 overpayment credited to 2023 6a 136
b Exempt foreign organizations—tax withheld at source...... 6b  
c Tax paid with application for extension of time to file (Form 8868)... 6c 200
d Backup withholding erroneously withheld .......... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 336
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.......right arrow 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...right arrow 10 112
11 Enter the amount of line 10 to be: Credited to 2024 estimated taxright arrow112 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$ 0(2) On foundation managers.right arrow$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.right arrow$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
 
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
 
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)
right arrow
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 arrowintactspecialty.com
14
The books are in care ofright arrowJohn Treacy Telephone no.right arrow (952) 852-6033

Located atright arrow605 HIGHWAY 169 N STE 800PLYMOUTHMN ZIP+4right arrow554416533
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)
 
No
(5) Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)? ......................
1a(5)
 
No
(6) Agree to pay money or property to a government official? (Exception. Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.) ...............
1a(6)
 
No
b
If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
1b
 
 
c
Organizations relying on a current notice regarding disaster assistance check here ........right arrow
d
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 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
 
No
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
CARMEN DUARTEClick to see attachment
List of Attached Documents:
// Content
TRUSTEE
2.00 		0 0 0
SUITE 1801
BOSTON,MA02109
JOSEPH SCHMITTClick to see attachment
List of Attached Documents:
// Content
TRUSTEE
2.00 		0 0 0
605 HIGHWAY 169 NORTH
SUITE 800
PLYMOUTH,MN55441
CQ
JOHN C TREACYClick to see attachment
List of Attached Documents:
// Content
TRUSTEE
2.00 		0 0 0
605 HIGHWAY 169 NORTH
SUITE 800
PLYMOUTH,MN55441
AMERICA GLAUDEClick to see attachment
List of Attached Documents:
// Content
TRUSTEE
2.00 		0 0 0
150 ROYALL STREET
CANTON,MA02021
DEBORAH BURKEClick to see attachment
List of Attached Documents:
// Content
TRUSTEE
2.00 		0 0 0
605 HIGHWAY 169 NORTH STE 800
PLYMOUTH,MN55441
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...................right arrow  
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.............right arrow  
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
0
b
Average of monthly cash balances.......................
1b
288,884
c
Fair market value of all other assets (see instructions)................
1c
0
d
Total (add lines 1a, b, and c).........................
1d
288,884
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation) Click to see attachment
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
288,884
4
Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
instructions) .............................
4
4,333
5
Net value of noncharitable-use assets. Subtract line 4 from line 3. ............
5
284,551
6
Minimum investment return. Enter 5% (0.05) of line 5................
6
14,228
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
14,228
2a
Tax on investment income for 2022 from Part V, line 5.......
2a
224
b
Income tax for 2022. (This does not include the tax from Part V.) ...
2b
0
c
Add lines 2a and 2b............................
2c
224
3
Distributable amount before adjustments. Subtract line 2c from line 1............
3
14,004
4
Recoveries of amounts treated as qualifying distributions................
4
0
5
Add lines 3 and 4............................
5
14,004
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
14,004
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
559,800
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) Click to see attachment
List of Attached Documents:
// Content
.................
3b
0
4
Qualifying distributions. Add lines 1a through 3b. Enter here and on Part XII, line 4. .......
4
559,800
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 14,004
2 Undistributed income, if any, as of the end of 2022:
a Enter amount for 2022 only....... 16,059
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 ........ 0
4Qualifying distributions for 2023 from Part
XI, line 4: right arrow$ 559,800
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).)
6Enter the net total of each column as
indicated below:
a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 0
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...... 		 
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 ............. 		16,059
f Undistributed income for 2023. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2024 .......... 		14,004
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 ...... 		0
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 ...... 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).)
bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here right arrow
aThe name, address, and telephone number or 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
BUFFALO CITY MISSION


100 E TUPPER STREET
BUFFALO,NY14203 		No Relationship PC DONATION 10,000
HUDSON COMMUNITY FOUNDATION


49 EAST MAIN STREET
HUDSON,OH44236 		No Relationship POF DONATION 500
HEROES FOR CHILDREN


1701 GATEWAY BLVD 410
RICHARDSON,TX75080 		No Relationship PC DONATION 1,000
GIRL SCOUTS OF SOUTHERN NEW ENG


500 GREENWICH AVENUE
WARWICK,RI02886 		No Relationship PC DONATION 500
BROWN UNIVERSITY


BOX 1893
PROVIDENCE,RI029120010 		No Relationship PC DONATION 500
FAR


FOUNDATION FOR ARIDIB RESEARCH
PO BOX 151714
CHEVY CHASE,MD20815 		No Relationship POF DONATION 500
MSU ADVANCEMENT


534 BIRCH ROAD
LANSING,MI48824 		No Relationship PC DONATION 50
CRETINDERHAM HALL


550 S ALBERT STREET
ST PAUL,MN55116 		No Relationship PC DONATION 500
PLUS FOUNDATION


5353 WAYZATA BLVD
SUITE 600
MINNEAPOLIS,MN55416 		No Relationship POF DONATION 2,500
OUACHITA BAPIST UNIVERSITY


410 OUACHITA
BOX 3754
ARKADELPHIA,AR71998 		No Relationship PC DONATION 100
KATY ELKS 2628 SWEETHEART PROGRAM


1050 KATY FORT BEND ROAD
KATY,TX77493 		No Relationship PC DONATION 2,000
UNIVERSITY OF COLORADO FOUNDATION


PO BOX 17126
DENVER,CO802171559 		No Relationship POF DONATION 2,000
EMMAUS INC


PO BOX 568
ATTN MARGOT REGAN
HAVERHILL,MA01831 		No Relationship PC DONATION 3,500
CHRISTOPHER AND DANA REEVE FOUNDATI


636 MORRIS TURNPIKE
SUITE A
SHORT HILLS,NJ07078 		No Relationship POF DONATION 1,500
LA CREME ANGELS INC


650 TERRACE
HASBROUCK HEIGHTS,NJ07604 		No Relationship PC DONATION 3,000
CALIFORNIA MARITIME ACADEMY FOUNDAT


200 MARITIME ACADEMY DRIVE
VALLEJO,CA94590 		No Relationship POF DONATION 5,000
SCHOLARSHIP AMERICA


PO BOX 772514
DETROIT,MI482772514 		No Relationship PC DONATION 7,000
PROJECT CAMERON'S STORY


7 FAXON STREET
GLEN FALLS,NY12801 		No Relationship PC DONATION 500
INSURANCE INDUSTRY CHARITABLE FOUND


1999 AVENUE OF THE STARS
LOS ANGELES,CA90067 		No Relationship POF DONATION 5,000
DARTMOUTH COLLEGE


6066 DEVELOPMENT OFFICE
HANOVER,NH03755 		No Relationship PC DONATION 500
XAVIER HS


30 W 16TH STREET
NEW YORK,NY10011 		No Relationship PC DONATION 250
INSURANCE INDUSTRY CHARITABLE FOUND


2021 AVENUE OF THE STARS
SUITE 800
LOS ANGELES,CA90067 		No Relationship POF DONATION 1,000
AMERICAN CANCER SOCIETY


PO BOX 6704
HAGERSTOWN,MD21741 		No Relationship PC DONATION 250
NATIONAL MULTIPLE SCLEROSIS SOCIETY


UPPER MIDWEST
2829 UNIVERSITY AVE SE STE 900
MINNEAPOLIS,MN55414 		No Relationship PC DONATIONS 1,500
UNITED SOUTH END SETTLEMENTS


48 RUTLAND STREET
BOSTON,MA02118 		No Relationship PC DONATIONS 20,000
SCHOOL ON WHEELS


100 LAUREL STEET SUITE 121 E
BRIDGEWATER,MA02333 		No Relationship PC DONATION 5,000
NEIGHBORHOOD BOYS AND GIRLS CLUB


2501 WEST IRVING PARK ROAD
CHICAGO,IL60618 		No Relationship PC DONATION 15,000
NORTHSIDE ACHIEVEMENT ZONE


1964 N 2ND STREET
MINNEAPOLIS,MN55411 		No Relationship PC DONATION 15,000
FOUNDATION FOR PUBLIC AFFAIRS


2121 K STREET NW SUITE 900
WASHINGTON,DC20037 		No Relationship POF DONATION 1,500
ST JUDES CHILDREN'S RESEARCH HOSPIT


262 DANNY THOMAS PL
MEMPHIS,TN381053678 		No Relationship PC DONATION 500
INSURANCE INDUSTRY CHARITABLE FOUND


2121 AVENUE OF THE STARS
SUITE 800
ORANGE,CA90067 		No Relationship PC DONATION 2,500
UNIVERSITY OF ST THOMAS


ACTUARIAL DEPARTMENT
2115 SUMMIT AVENUE
ST PAUL,MN55105 		No Relationship PC DONATION 1,500
GIRL SCOUT TROOP 18378


708 HUTCHINSON ROAD
ATTN SIMONE MORGAN TROOP LEADER
WATERTOWN,MN55388 		No Relationship PC DONATION 1,500
RBS CENTER FOR WOMEN IN BUSINESS


SUPPORT FUND RUTGERS UNIVERSITY FOU
335 GEORGE STREET 4000
NEW BRUNSWICK,NJ08901 		No Relationship POF DONATION 20,000
SMILE TRAIN INC


41 MADISON AVE
NEW YORK,NY10010 		No Relationship PC DONATION 1,500
INSURANCE INDUSTRY CHARITABLE FOUND


2121 AVENUE OF THE STARS
SUITE 800
LOS ANGELES,CA90067 		No Relationship POF DONATION 3,000
BARNEY AND BARBNEY FOUNDATION


9171 TOWNE CENTRE DRIVE STE 100
SAN DIEGO,CA92112 		No Relationship POF DONATION 7,500
INSURANCE INDUSTRY CHARITABLE FOUND


2121 AVENUE OF THE STARS
SUITE 800
LOS ANGELES,CA90067 		No Relationship POF DONATION 15,400
CHRYSALIS CENTER INC


255 HOMESTEAD AVENUE
HARTFORD,CT06112 		No Relationship PC DONATIONS 5,000
CHRYSALIS CENTER INC


255 HOMESTEAD AVENUE
HARTFORD,CT06112 		No Relationship PC DONATION 3,000
WHITE PONY EXPRESS


3380 VINCENT ROAD
PLEASANT HILL,CA94523 		No Relationship PC DONATION 5,000
CHILDREN ACROSS AMERICA


9C MEDWAY ROAD
SUITE 208
MILFORD,MA01757 		No Relationship PC DONATION 500
PAN MASSACHUSETTS CHALLENGE


77 4TH AVE
NEEDHAM,MA02494 		No Relationship PC DONATION 1,000
PERSONAL BEST CHARITY


250 EAST MAIN STREET
NORTON,MA02766 		No Relationship PC DONATION 5,000
THE LEUKEMIA AND LYMPHOMA SOCIETY


2346 POST ROAD
SUITE 202
WARWICK,RI02886 		No Relationship PC DONATION 1,500
FOUNDATION FIGHTING BLINDNESS


PO BOX 45933
BALTIMORE,MD212975933 		No Relationship POF DONATION 2,500
AMIS INC


607 PEACHTREE STREET NE
ATLANTA,GA30308 		No Relationship PC DONATION 1,500
THE FACIAL PAIN RESEARCH FOUNDAT


2653 SW 87TH DRIVE SUITE A
GAINSVILLE,FL326089133 		No Relationship POF DONATION 2,500
COLLEGE POSSIBLE


755 PRIOR AVE N SUITE 200
ST PAUL,MN55104 		No Relationship PC DOANATION 2,500
CRETINDERHAM HALL


550 S ALBERT STREET
ST PAUL,MN55116 		No Relationship PC DONATION 500
ST DAVID'S CENTER FOR CHILD AND FAM


FAMILY DEVELOPEMENT
3395 PLYMOUTH RD
MINNETONKA,MN55305 		No Relationship PC DONATION 2,500
PINKY SWEAR FOUNDATION


5555 W 78TH STREET SUITE E
EDINA,MN55439 		No Relationship POF DONATION 2,500
YOUTH FRONTIERS INC


5215 EDINA INDUSTRIAL BLVD 400
MINNEAPOLIS,MN55439 		No Relationship PC DONATION 2,500
HOUSTON ASSOCIATION OF INSURANCE AG


7700 SAN FELIPE 310
HOUSTON,TX77063 		No Relationship PC DONATION 3,000
ZION ANIMAL LOVERS


PO BOX 214
SPRINGDALE,UT84767 		No Relationship PC DONATION 500
BARNEY AND BARNEY FOUNDATION


9171 TOWNE CENTRE DRIVE
SUITE 100
SAN DIEGO,CA92122 		No Relationship POF DONATION 7,500
BARNEY AND BARBNEY FOUNDATION


9171 TOWNE CENTRE DRIVE
STE 100
SAN DIEGO,CA92112 		No Relationship POF DONATION 7,500
SCHOLARSHIP AMERICA


PO BOX 772414
DETROIT,MI56082 		No Relationship PC DONATION 45,000
FRIENDS OF RCACP


PO BOX 7858
ROANOKE,VA24019 		No Relationship PC DONATION 500
IMA FOUNDATION


400 E DOUGLAS
SUITE 400
WICHITA,KS67202 		No Relationship POF DONATION 500
BECAUSE ANIMALS MATTER


44 W STATE STREET
HURRICANE,UT84737 		No Relationship PC DONATION 500
KAKO'O MAUL


COUNCIL FOR NATIVE HAWAIIAN
91 1270 KINOIKI STREET
KAPOLEI,HI96707 		No Relationship PC DONATION 5,000
MAUI FOOD BANK


760 KOLU STREET
WAILUKU,HI96793 		No Relationship PC DONATION 5,000
DEIRDRE'S HOUSE


8 COURT STREET
MORRISTOWN,NJ07960 		No Relationship PC DONATION 25,000
HOMEAID COLORADO


7721 W 6TH AVENUE
UNIT A
LAKEWOOD,CO80214 		No Relationship PC DONATION 350
MOUNTAIN SHADOWS FOUNDATION


1040 LOS VALLECITOS BLVD
SAN MARCOS,CA92069 		No Relationship POF DONATION 2,000
ORANGEWOOD FOUNDATION


1575 E 17TH STREET
SANTA ANA,CA92705 		No Relationship POF DONATION 5,000
SOCIETY OF ST VINCENT DE PAUL


25 FOURTH STREET
NORTH PROVIDENCE,RI02911 		No Relationship PC DONATION 1,500
CRAVEABLES


2617 PUMPING STATION ROAD
APPOMATTOX,VA24522 		No Relationship PC DONATION 5,000
THE PINK FROG FOUNDATION


PO BOX 250444
ATLANTA,GA30325 		No Relationship POF DONATION 3,000
IICF OHIO CHAPTER


2121 AVENUE OF THE STARS
SUITE 800
LOS ANGELES,CA90067 		No Relationship PC DONATION 1,000
PEDIATRIC BRAIN TUMOR FOUNDATION


6065 ROSWELL ROAD
NE SUITE 505
ATLANTA,GA30328 		No Relationship POF DONATION 3,500
INSURANCE INDUSTRY CHARITABLE FOUND


2121 AVENUE OF THE STARS
SUITE 800
LOS ANGELES,CA90067 		No Relationship POF DONATION 1,500
BOXES TO BOOTS


28 CHAMBERLAIN HWY
BERLIN,CT06037 		No Relationship PC DONATION 2,000
THE WOMENS LUNCH PLACE


67 NEWBURY STREET
BOSTON,MA02116 		No Relationship PC DONATION 2,500
UNITED WAY OF THE LOWER EASTERN SHO


803 N SALISBURY BLVD
STE 2100
SALISBURY,MD21801 		No Relationship PC DONATION 750
UNITED WAY OF GREATER CLEVELAND OSW


1100 SUPERIOR AVENUE
CLEVELAND,OH44114 		No Relationship PC DONATION 500
SCIENCE MUSEUM OF MINNESOTA


12 W KELLOGG BLVD
ST PAUL,MN55102 		No Relationship PC DONATION 1,500
IMA FOUNDATION


9393 W 110TH STREET
SUITE 600
OVERLAND PARK,KS66210 		No Relationship POF DONATION 7,500
SPECIAL OLYMPICS COLORADO


12450 E ARAPAHOE ROAD
SUITE C
CENTENNIAL,CO80112 		No Relationship PC DONATION 2,000
INSURANCE INDUSTRY CHARITABLE FOUND


148 N DOGWOOD
ORANGE,CA90067 		No Relationship POF DONATION 5,000
THE LITTLE GUILD


285 SHARIB GOSHEN TURNPIKE WEST
CORNWALL,CT06796 		No Relationship PC DONATION 1,500
THE LEUKEMIA AND LYMPHOMA SOCIETY


3 INTERNATIONAL DRIVE
RYE BROOK,NY10573 		No Relationship PC DONATION 500
THE SURETY AND FIDELITY ASSOCIATION


1140 19TH STREET NW 500
WASHINGTON,DC20036 		No Relationship PC DONATION 10,000
ALS ASSOCIATION


5881 GLENRIDGE DRIVE
SUITE 200
ATLENTA,GA30328 		No Relationship PC DONATION 750
NEW JERSEY BLIND CITIZEN ASSOCIATIO


18 BURLINGTON AVENUE
LEONARDO,NJ07737 		No Relationship PC DONATION 1,500
WOMENS GENERAL AUXILLARY TO SHRINER


215 RADIO DRIVE
SUITE 100
WOODBURY,MN55125 		No Relationship PC DONATION 500
SHRINERS HOSPITAL FOR CHILDREN


TWIN CITIES
215 RADIO DRIVE SUITE 100
WOODBURY,MN55125 		No Relationship PC DONATION 1,500
OOIDA FOUNDATION INC


PO BOX 1000
GRAIN VALLEY,MO640291000 		No Relationship POF DONATION 5,000
FOOD BANK OF THE ROCKIES


10700 E 45TH AVENUE
DENVER,CO80239 		No Relationship PC DONATION 500
INSURANCE INDUSTRY CHARITABLE FOUND


2121 AVENUE OF THE STARS
SUITE 800
LOS ANGELES,CA90067 		No Relationship POF DONATION 1,500
SCHOOL ON WHEELS


100 LAUREL STREET
SUITE 121 E
BRIDGEWATER,MA02333 		No Relationship PC DONATION 50,000
2023 STATE VOLLEYBALL EVENT SPONSOR


12450 E ARAPAHOE ROAD
SUITE C
CENTENNIAL,CO80112 		No Relationship PC DONATION 5,000
ROCKY MOUNTAIN BIGHORN SOCIETY


PO BOX 349
CLIFTON,CO81520 		No Relationship PC DONATION 500
CHERRY CREEK SCHOOLS FOUNDATION


4700 SOUTH YOSEMITE STREET
SUITE 273
GEENWOOD VILLAGE,CO80111 		No Relationship POF DONATION 500
EMMAUS INC


PO BOX 568
ATTN GRETCHEN ARNTZ
HAVERHILL,MA01831 		No Relationship PC DONATION 800
YMCA OF GREATER BOSTON


316 HUNTINGTON AVENUE
BOSTON,MA02115 		No Relationship PC DONATION 500
UNITED SOUTH END SETTLEMENTS


48 RUTLAND STREET
BOSTON,MA02118 		No Relationship PC DONATION 1,200
CONNECTICUT FOOD SHARE


2 RESEARCH PARKWAY
WALLINGFORD,CT06492 		No Relationship PC DONATION 2,500
CHILDREN'S SPECIALIZED HOSPITAL FOU


150 NEW PROVIDENCE ROAD
MOUNTAINSIDE,NJ07092 		No Relationship POF DONATION 2,500
FAMILY PROMISE OF MORRIS COUNTY


PO BOX 1494
MORRISTOWN,NJ07962 		No Relationship PC DONATIONS 1,500
AMERICAN FOUNDATION FOR SUICIDE PRE


199 WATER STREET
11TH FLOOR
NEW YORK,NY10038 		No Relationship POF DONATION 7,500
HABITAT FOR HUMANITIES OF NYC


111 JOHN STREET
23RD FLOOR
NEW YORK,NY10038 		No Relationship PC DONATION 2,500
BETH LUCE MEMORIAL GRANT FUND LASAL


8605 WEST CHEITENHAM AVENUE
COLLEGE HIGH SCHOOL
WNDMOOR,PA19038 		No Relationship PC DONATION 1,250
HOME AT LAST DOG RESCUE


PO BOX 1341
NORTH WALES,PA19454 		No Relationship PC DONATION 1,250
SALEM POLICE DEPARTMENT NATIONAL


CHILD SAFETY
1002 WOODLET MEADOW LANE
MIDLOTHIAN,VA23114 		No Relationship PC DONATION 2,500
FEEDING SOUTHWEST VIRGINIA


1025 ELECTRIC ROAD
SALEM,VA24153 		No Relationship EOF DONATION 2,500
FAMILY PROMISE OF FORSYTH COUNTY


PO BOX 3305
CUMMING,GA30028 		No Relationship PC DONATION 2,500
SCF


PO BOX 30763
KNOXVILLE,TN37930 		No Relationship PC DONATION 1,000
THE NEIGHBORHOOD BOYS AND GIRLS CLU


2501 W IRVING PARK ROAD
CHICAGO,IL60618 		No Relationship PC DONATION 2,500
HARVESTERS COMMUNITY FOOD NETWORK


3801 TOPPING AVENUE
KANSAS CITY,MO64129 		No Relationship PC DONATION 1,000
CHILDRENS HOSPITAL COLORADE FOUNDAT


13123 16TH AVENUE
BOX 045
AURORA,CO80045 		No Relationship POF DONATION 1,250
CHERRY CREEK SCHOOLS FOUNDATION


4700 SOUTH YOSEMITE
SUITE 273
GREENWOOD VILLAGE,CO80111 		No Relationship POF DONATION 1,000
FOOD BANK OF THE ROCKIES


10700 E 45TH AVENUE
DENVER,CO80239 		No Relationship PC DONATION 1,250
CHILDRENS HOSPITAL OF LOS ANGELES


4650 SUNSET BLVD
29
LOS ANGELES,CA90027 		No Relationship PC DONATION 1,000
CATERINA'S CLUB


451 W LINCOLN AVENUE 251
ANAHEIM,CA92805 		No Relationship PC DONATION 2,500
SAN FRANCISCOM MARIN FOOD BANK


900 PENNSYLVANIA AVENUE
SAN FRANCISCO,CA94107 		No Relationship PC DONATION 1,250
CONTRA COSTA FOOD BANK


4010 NELSON AVENUE
CONCORD,CA94520 		No Relationship PC DONATION 1,250
FRIENDSHIP SERVICE CENTER INC


PO BOX 1896
NEW BRITAIN,CT06050 		No Relationship PC DONATION 2,100
CHRYALIS CENTER INC


255 HOMESTEAD AVENUE
HARTFORD,CT06112 		No Relationship PC DONATION 1,800
WALLIN EDUCATION PARTNERS


451 LEXINGTON PARKWAY
N SUITE 100
ST PAUL,MN55104 		No Relationship PC DONATION 20,000
JEREMIAH PROGRAM


729 N WASHINGTON AVENUE
SUITE 600
MINNEAPOLIS,MN55401 		No Relationship PC DONATION 5,000
BENTLEY UNIVERSITY


175 FOREST ST
LACAVA 284
WALTHAM,MA02452 		No Relationship PC DONATION 250
TALL SHIPS AMERICA


PO BOX 1459
NEWPORT,RI028400996 		No Relationship PC DONATION 500
SPECIAL OLYMPICS NEW HAMPSHIRE


PO BOX 3598
CONCORD,NH03302 		No Relationship PC DONATION 1,500
GOOD GRIEF


38 ELM STREET
MORRISTOWN,NJ07960 		No Relationship PC DONATION 250
FEEDING SOUTHWEST VIRGINIA


1025 ELECTRIC ROAD
SALEM,VA24153 		No Relationship PC DONATION 25,000
THE STATEMAN FOUNDATION


2308 FOXHAVEN DRIVE
FRANKLIN,TN37069 		No Relationship POF DONATION 3,000
TRUE NORTH LEGACY FOUNDATION


500 1ST STREET
CEDAR RAPIDS,IA52401 		No Relationship POF DONATION 5,000
THE ACTUARIAL FOUNDATION


1515 E WOODFIELD ROAD
SUIT 625
SCHAUMBURG,IL60173 		No Relationship POF DONATION 25,000
FOOD BANK OF THE ROCKIES


10070 E 45TH AVENUE
DENVER,CO80239 		No Relationship PC DONATION 500
ZION ANIMAL LOVERS


PO BOX 214
SPRINGDALE,UT84757 		No Relationship PC DONATION 500
CALIFORNIA STATE UNIVERSITY MARITIM


200 MARITIME ACADEMY DRIVE
VALLEJO,CA94590 		No Relationship PC DONATION 500
CALIFORNIA MARITIME ACADEMY FOUNDAT


200 MARITIME ACADEMY DRIVE
VALLEJO,CA94590 		No Relationship POF DONATION 5,000
Total .................................right arrow 3a 559,800
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     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
gFees and contracts from government agencies          
2 Membership dues and assessments ....   0   0 0
3 Interest on savings and temporary cash
investments ........... 		  0 14 16,134 0
4 Dividends and interest from securities ....   0   0 0
5 Net rental income or (loss) from real estate:
aDebt-financed property......   0   0 0
bNot 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 16,134 0
13Total. Add line 12, columns (b), (d), and (e)..................
13
16,134
(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
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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.
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Form 990-PF (2023)
Additional Data


Software ID: 23017649
Software Version: V2.0


Form 990PF - Special Condition Description:
Special Condition Description

TY 2023 OtherExpensesSchedule
Name:
INTACT CHARITABLE TRUST USA
EIN:
23-2441567
Software ID:
23017649
Software Version:
V2.0
Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
Massachusetts Filing Fee 70 0 70 0
Minnesota Registration Fee 25 0 25 0
Miscellaneous Fees 2,806 0 2,806 0
IRS Tax Payment 200 0 200 0


TY 2023 OtherIncreasesSchedule
Name:
INTACT CHARITABLE TRUST USA
EIN:
23-2441567
Software ID:
23017649
Software Version:
V2.0
Description Amount
Sweep Account Activity 17,300