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
THE CLEMENTS FAMILY CHARITABLE TRUST
C/O THOMAS CLEMENTS III
Number and street (or P.O. box number if mail is not delivered to street address)1025 FLEMING STREET
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
KEY WEST, FL33040
A Employer identification number

34-1748724
B Telephone number (see instructions)

(207) 939-6272
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$2,926,258J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check right arrow.............
3 Interest on savings and temporary cash investments 1,854 1,854  
4 Dividends and interest from securities... 67,756 67,756  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 111,390
b Gross sales price for all assets on line 6a 303,310
7 Capital gain net income (from Part IV, line 2)... 111,390
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........ 181,000 181,000  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 12,500 7,500   5,000
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule)......... Click to see attachment
List of Attached Documents:
// Content
8,500 0   8,500
b Accounting fees (attach schedule)....... Click to see attachment
List of Attached Documents:
// Content
2,500 0   2,500
c Other professional fees (attach schedule).... Click to see attachment
List of Attached Documents:
// Content
4,255 4,255   0
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)....... Click to see attachment
List of Attached Documents:
// Content
40 40   0
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 27,795 11,795   16,000
25 Contributions, gifts, grants paid....... 231,600 231,600
26 Total expenses and disbursements. Add lines 24 and 25 259,395 11,795   247,600
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -78,395
b Net investment income (if negative, enter -0-) 169,205
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2023)
Form 990-PF (2023)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing.............      
2 Savings and temporary cash investments......... 104,231 93,650 93,650
3 Accounts receivable right arrow  
Less: allowance for doubtful accounts right arrow        
4 Pledges receivable right arrow  
Less: allowance for doubtful accounts right arrow        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) right arrow  
Less: allowance for doubtful accounts right arrow        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis right arrow  
Less: accumulated depreciation (attach schedule) right arrow        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 2,182,558 Click to see attachment
List of Attached Documents:
// Content
2,080,734 		2,832,608
14 Land, buildings, and equipment: basis right arrow  
Less: accumulated depreciation (attach schedule) right arrow        
15 Other assets (describe right arrow)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 2,286,789 2,174,384 2,926,258
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe right arrow)    
23 Total liabilities (add lines 17 through 22)......... 0 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........ 2,286,789 2,174,384
27 Paid-in or capital surplus, or land, bldg., and equipment fund 0 0
28 Retained earnings, accumulated income, endowment, or other funds 0 0
29 Total net assets or fund balances (see instructions)..... 2,286,789 2,174,384
30 Total liabilities and net assets/fund balances (see instructions). 2,286,789 2,174,384
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
2,286,789
2
Enter amount from Part I, line 27a .....................
2
-78,395
3
Other increases not included in line 2 (itemize) right arrow
3
0
4
Add lines 1, 2, and 3 ..........................
4
2,208,394
5
Decreases not included in line 2 (itemize) right arrowClick to see attachment
List of Attached Documents:
// Content
5
34,010
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
2,174,384
Form 990-PF (2023)
Form 990-PF (2023)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1 a 1,018.74 SHS VANGUARD WELLINGTON FUND   2020-12-29 2023-12-04
b 788.64 SHS VANGUARD TOTAL BD MARKET INDX FD   2017-07-25 2023-12-07
c 371.31 SHS VANGUARD WELLINGTON FUND   2010-08-30 2023-12-04
d 532.90 SHS VANGUARD WELLINGTON FUND   2020-12-29 2023-05-25
e 788.64 SHS VANGUARD TOTAL BD MARKET INDX FD   2017-07-25 2023-12-07
191.63 SHS VANGUARD WELLINGTON FUND   2010-06-30 2023-05-26
595.32 SHS VANGUARD WELLINGTONFUND   2010-08-30 2023-12-07
CAPITAL GAINS DIVIDENDS P    
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 73,288   77,719 -4,431
b 7,500   8,494 -994
c 26,712   18,131 8,581
d 36,776   40,655 -3,879
e 7,500   8,494 -994
13,224   9,357 3,867
43,000   29,070 13,930
95,310     95,310
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       -4,431
b       -994
c       8,581
d       -3,879
e       -994
      3,867
      13,930
      95,310
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 2 111,390
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 2,352
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 2,352
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 2,352
6 Credits/Payments:
a 2023 estimated tax payments and 2022 overpayment credited to 2023 6a 2,968
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld .......... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 2,968
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......right arrow 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...right arrow 10 616
11 Enter the amount of line 10 to be: Credited to 2024 estimated taxright arrow616 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
Yes
 
7
Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
and Part XIV..................................
7
Yes
 
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
right arrowFL
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 arrowN/A
14
The books are in care ofright arrowMARINER WEALTH ADVISORS Telephone no.right arrow (973) 507-9790

Located atright arrow1 GIRALDA FARMS SUITE 130MADISONNJ ZIP+4right arrow07940
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........right arrow
and enter the amount of tax-exempt interest received or accrued during the year ........right arrow
15
 
16 At any time during calendar year 2023, did the foundation have an interest in or a signature or other authority over YesNo
a bank, securities, or other financial account in a foreign country? .................
16   No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country right arrow
Form 990-PF (2023)
Form 990-PF (2023)
Page 5
Part VI-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
1a(1)
 
No
(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person? ..............................
1a(2)
 
No
(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
1a(3)
 
No
(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
1a(4)
Yes
 
(5) Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)? ......................
1a(5)
 
No
(6) Agree to pay money or property to a government official? (Exception. Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.) ...............
1a(6)
 
No
b
If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
1b
 
No
c
Organizations relying on a current notice regarding disaster assistance check here ........right arrow
d
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2023? .............
1d
 
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2023, did the foundation have any undistributed income (Part XII, lines 6d
and 6e) for tax year(s) beginning before 2023?....................
2a
 
No
If "Yes," list the years right arrow20, 20, 20, 20
b
Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to all years listed, answer "No" and attach statement—see instructions.) ..............
2b
 
 
c
If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
right arrow20, 20, 20, 20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year? ..............................
3a
 
No
b
If "Yes," did it have excess business holdings in 2023 as a result of (1) any purchase by the foundation
or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
if the foundation had excess business holdings in 2023.) .....................
3b
 
 
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
 
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2023? ..
4b
 
No
Form 990-PF (2023)
Form 990-PF (2023)
Page 6
Part VI-B
Statements Regarding Activities for Which Form 4720 May Be Required (continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........
5a(1)
 
No
(2) Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive? ....................
5a(2)
 
No
(3) Provide a grant to an individual for travel, study, or other similar purposes? .............
5a(3)
 
No
(4) Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions ........................
5a(4)
 
No
(5) Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals? .............
5a(5)
 
No
b
If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
5b
 
 
c
Organizations relying on a current notice regarding disaster assistance check .........right arrow
d
If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant? .................
5d
 
 
If "Yes," attach the statement required by Regulations section 53.4945–5(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract? .............................
6a
 
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
6b
 
No
If "Yes" to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
7a
 
No
b
If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....
7b
 
 
8
Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment during the year? .........................
8
 
No
Part VII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
(a) Name and address (b) Title, and average
hours per week
devoted to position 		(c) Compensation
 (If not paid, enter
-0-) 		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
other allowances
THOMAS CLEMENTS III TRUSTEE
2.00 		0 0 0
1025 FLEMING STREET
KEY WEST,FL33040
ROBERT M CLEMENTS TRUSTEE
0.00 		0 0 0
1025 FLEMING STREET
KEY WEST,FL33040
TYLER M CLEMENTS TRUSTEE
2.00 		7,500 0 0
1025 FLEMING STREET
KEY WEST,FL33040
JOHN B CLEMENTS TRUSTEE
1.00 		2,500 0 0
1025 FLEMING STREET
KEY WEST,FL33040
ALICE B CLEMENTS TRUSTEE
1.00 		2,500 0 0
1025 FLEMING STREET
KEY WEST,FL33040
2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a) Name and address of each employee paid more than $50,000 (b) Title, and average
hours per week
devoted to position 		(c) Compensation (d) Contributions to
employee benefit
plans and deferred
compensation 		(e) Expense account,
other allowances
NONE
Total number of other employees paid over $50,000...................right arrow 0
Form 990-PF (2023)
Form 990-PF (2023)
Page 7
Part VII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors (continued)
3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
NONE
Total number of others receiving over $50,000 for professional services.............right arrow0
Part VIII-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
1  
2  
3  
4  
Part VIII-B
Summary of Program-Related Investments (see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
1  
2  
All other program-related investments. See instructions.
3  
Total. Add lines 1 through 3.........................right arrow0
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
2,843,392
b
Average of monthly cash balances.......................
1b
59,284
c
Fair market value of all other assets (see instructions)................
1c
0
d
Total (add lines 1a, b, and c).........................
1d
2,902,676
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation) .............
1e
0
2
Acquisition indebtedness applicable to line 1 assets..................
2
0
3
Subtract line 2 from line 1d.........................
3
2,902,676
4
Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
instructions) .............................
4
43,540
5
Net value of noncharitable-use assets. Subtract line 4 from line 3. ............
5
2,859,136
6
Minimum investment return. Enter 5% (0.05) of line 5................
6
142,957
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
142,957
2a
Tax on investment income for 2022 from Part V, line 5.......
2a
2,352
b
Income tax for 2022. (This does not include the tax from Part V.) ...
2b
 
c
Add lines 2a and 2b............................
2c
2,352
3
Distributable amount before adjustments. Subtract line 2c from line 1............
3
140,605
4
Recoveries of amounts treated as qualifying distributions................
4
0
5
Add lines 3 and 4............................
5
140,605
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
140,605
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
247,600
b
Program-related investments—total from Part VIII-B..................
1b
0
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes...............................
2
 
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)....................
3a
 
b
Cash distribution test (attach the required schedule) .................
3b
 
4
Qualifying distributions. Add lines 1a through 3b. Enter here and on Part XII, line 4. .......
4
247,600
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 7 140,605
2 Undistributed income, if any, as of the end of 2022:
a Enter amount for 2022 only....... 0
b Total for prior years:20 , 20, 20 0
3 Excess distributions carryover, if any, to 2022:
a From 2018...... 18,153
b From 2019...... 43,033
c From 2020...... 67,916
d From 2021...... 91,919
e From 2022...... 78,627
f Total of lines 3a through e ........ 299,648
4Qualifying distributions for 2023 from Part
XI, line 4: right arrow$ 247,600
a Applied to 2022, but not more than line 2a 0
b Applied to undistributed income of prior years
(Election required—see instructions)..... 		0
c Treated as distributions out of corpus (Election
required—see instructions)........ 		0
d Applied to 2023 distributable amount..... 140,605
e Remaining amount distributed out of corpus 106,995
5 Excess distributions carryover applied to 2023. 0 0
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6Enter the net total of each column as
indicated below:
a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 406,643
b Prior years’ undistributed income. Subtract
line 4b from line 2b .......... 		0
c Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed...... 		0
d Subtract line 6c from line 6b. Taxable amount
—see instructions ........... 		0
e Undistributed income for 2022. Subtract line
4a from line 2a. Taxable amount—see
instructions ............. 		0
f Undistributed income for 2023. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2024 .......... 		0
7 Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions) ....... 		0
8 Excess distributions carryover from 2018 not
applied on line 5 or line 7 (see instructions) ... 		18,153
9 Excess distributions carryover to 2024.
Subtract lines 7 and 8 from line 6a ...... 		388,490
10 Analysis of line 9:
a Excess from 2019.... 43,033
b Excess from 2020.... 67,916
c Excess from 2021.... 91,919
d Excess from 2022.... 78,627
e Excess from 2023.... 106,995
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

ABORTION CARE NETWORK

1300 I ST NW STE 400E
WASHINGTON,DC20005 		NONE PUBLIC CHARITY GENERAL FUNDING 500

ACADEMY FOR TEACHERS

10 WEST 90TH STREET NO 9
NEW YORK,NY10024 		NONE PUBLIC CHARITY GENERAL FUNDING 500

AMERICAN RADIO RELAY LEAGUE

225 MAIN STREET
NEWINGTON,CT061111494 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000

ASCENSION OUTREACH

C/O THE CHURCH OF THE ASCENSION 12
WEST 11TH ST
NEW YORK,NY10011 		NONE PUBLIC CHARITY GENERAL FUNDING 500

BAGADUCE LENDING LIBRARY

49 SOUTH ST
BLUE HILL,ME04614 		NONE PUBLIC CHARITY GENERAL FUNDING 500

BLINKNOW FOUNDATION

PO BOX 453
MENDHAM,NJ07945 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000

BLUE HILL FIRE DEPARTMENT

PO BOX 1167
BLUE HILL,ME046141167 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000

BLUE HILL HERITAGE TRUST

PO BOX 222
BLUE HILL,ME04614 		NONE PUBLIC CHARITY GENERAL FUNDING 1,500

BLUE HILL HISTORICAL SOCIETY

PO BOX 710
BLUE HILL,ME04614 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000

BLUE HILL PUBLIC LIBRARY

5 PARKER POINT ROAD
BLUE HILL,ME04614 		NONE PUBLIC CHARITY GENERAL FUNDING 12,500

BLUE HILL YMCA

32 MINES ROAD
BLUE HILL,ME04614 		NONE PUBLIC CHARITY GENERAL FUNDING 2,500

CENTER FOR REPRODUCTIVE RIGHTS

199 WATER STREET 22ND FLOOR
NEW YORK,NY10038 		NONE PUBLIC CHARITY GENERAL FUNDING 500

CHANTICLEER

44 PAGE STREET SUITE 500
SAN FRANCISCO,CA94102 		NONE PUBLIC CHARITY GENERAL FUNDING 500

CHOATE ROSEMARY HALL FOUNDATION

333 CHRISTIAN STREET
WALLINGFORD,CT06492 		NONE PUBLIC CHARITY GENERAL FUNDING 5,000

CHURCH OF THE ASCENSION

12 WEST 11TH STREET
NEW YORK,NY10011 		NONE PUBLIC CHARITY GENERAL FUNDING 24,000

CITY HARVEST

6 E 32ND ST
NEW YORK,NY10016 		NONE PUBLIC CHARITY GENERAL FUNDING 500

CLASSICAL KUSC

1149 S HILL STREET
LOS ANGELES,CA90015 		NONE PUBLIC CHARITY GENERAL FUNDING 500

COMMUNITY FOUNDATION OF THE FLORIDA KEYS

300 SOUTHARD ST 201
KEY WEST,FL33040 		NONE PUBLIC CHARITY GENERAL FUNDING 15,000

CONSUMER REPORTS

101 TRUMAN AVENUE
YONKERS,NY10703 		NONE PUBLIC CHARITY GENERAL FUNDING 1,100

CREATIVE PORTLAND

84 FREE STREET
PORTLAND,ME04101 		NONE PUBLIC CHARITY GENERAL FUNDING 6,000

DOCTORS WITHOUT BORDERS

40 RECTOR ST
NEW YORK,NY10006 		NONE PUBLIC CHARITY GENERAL FUNDING 6,000

DOWNEAST COMMUNITY PARTNERS

248 BUCKSPORT RD
ELLSWORTH,ME04605 		NONE PUBLIC CHARITY GENERAL FUNDING 7,500

DOWNTOWN WOMEN'S CENTER

325 S LOS ANGELES STREET
LOS ANGELES,CA90013 		NONE PUBLIC CHARITY GENERAL FUNDING 500

EAST BLUE HILL LIBRARY ASSOCATION

9 CURTIS COVE ROAD
EAST BLUE HILL,ME04629 		NONE PUBLIC CHARITY GENERAL FUNDING 31,000

EAST BLUE HILL VILLAGE IMPROVEMENT ASSOCIATION

P O BOX 59
EAST BLUE HILL,ME04629 		NONE PUBLIC CHARITY GENERAL FUNDING 500

EVERYTOWN FOR GUN SAFETY

PO BOX 3886
NEW YORK,NY10163 		NONE PUBLIC CHARITY GENERAL FUNDING 500

FIRST CHURCH OF CHRIST SCIENTIST KEY WEST

327 ELIZABETH STREET
KEY WEST,FL33040 		NONE PUBLIC CHARITY GENERAL FUNDING 3,000

FIRST CONGREGATIONAL CHURCH

PO BOX 444
BLUE HILL,ME04614 		NONE PUBLIC CHARITY GENERAL FUNDING 2,000

FRIENDS OF 40 PRADO

PO BOX 12444
SAN LUIS OBISPO,CA93406 		NONE PUBLIC CHARITY GENERAL FUNDING 500

FRIENDS OF BLUE HILL BAY

PO BOX 1633
BLUE HILL,ME04614 		NONE PUBLIC CHARITY GENERAL FUNDING 750

FRIENDS OF BOGARDUS GARDEN

C/O V WEIL 90 WEST BROADWAY 4
NEW YORK,NY10007 		NONE PUBLIC CHARITY GENERAL FUNDING 500

FRIENDS OF DUANE PARK

55 HUDSON ST
NEW YORK,NY10013 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000

FRIENDS OF KEY WEST LIBRARY

700 FLEMING STREET
KEY WEST,FL33040 		NONE PUBLIC CHARITY GENERAL FUNDING 5,000

FRIENDS OF PORTLAND ADULT EDUCATION

PO BOX 3185
PORTLAND,ME04104 		NONE PUBLIC CHARITY GENERAL FUNDING 1,500

GEORGE STEVENS ACADEMY

PO BOX 816
BLUE HILL,ME04614 		NONE PUBLIC CHARITY GENERAL FUNDING 2,500

HAWKEN SCHOOL

PO BOX 8002
GATES MILLS,OH440408002 		NONE PUBLIC CHARITY GENERAL FUNDING 5,500

HEALTHY PENINSULA

PO BOX 945
BLUE HILL,ME04614 		NONE PUBLIC CHARITY GENERAL FUNDING 1,500

HOSPICE OF HANCOCK COUNTY

14 MCKENZIE AVENUE
ELLSWORTH,ME04605 		NONE PUBLIC CHARITY GENERAL FUNDING 500

HOSPITAL FOR SPECIAL SURGERY

535 E 70TH ST
NEW YORK,NY10021 		NONE PUBLIC CHARITY GENERAL FUNDING 500

JONATHAN FISHER MEMORIAL INC

PO BOX 527
BLUE HILL,ME04614 		NONE PUBLIC CHARITY GENERAL FUNDING 1,500

JUDSON MEMORIAL CHURCH

2800 BLACK RD
JOLIET,IL60435 		NONE PUBLIC CHARITY GENERAL FUNDING 2,500

KEY WEST FRINGE

600 WHITE STREET
KEY WEST,FL33045 		NONE PUBLIC CHARITY GENERAL FUNDING 3,000

KNEISEL HALL

PO BOX 648
BLUE HILL,ME04614 		NONE PUBLIC CHARITY GENERAL FUNDING 500

KOLLEGEWIDGWOK SAILING EDUCATION ASSOCATION

PO BOX 168
BLUE HILL,ME04614 		NONE PUBLIC CHARITY GENERAL FUNDING 500

KPCC SOUTHERN CALIFORNIA PUBLIC RADIO

PO BOX 511489
LOS ANGELES,CA900518044 		NONE PUBLIC CHARITY GENERAL FUNDING 500

LAKEVIEW CEMETARY FOUNDATION

12316 EUCLID AVENUE
CLEVELAND,OH44106 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000

LAUREL SCHOOL

ONE LYMAN CIRCLE
SHAKER HEIGHTS,OH44122 		NONE PUBLIC CHARITY GENERAL FUNDING 1,500

MAINE COLLEGE OF ART AND DESIGN

522 CONGRESS STREET
PORTLAND,ME04101 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000

MAINE ISLAND TRAIL ASSOCIATION- ADJUSTMENT FOR GRANT REPORTED 2022

58 FORE ST
PORTLAND,ME041014849 		NONE PUBLIC CHARITY GENERAL FUNDING -9,000

MAINE ISLAND TRAIL ASSOCIATION

58 FORE ST
PORTLAND,ME041014849 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000

MAINE ORGANIC FARMERS AND GARDENERS

PO BOX 170
UNITY,ME04988 		NONE PUBLIC CHARITY GENERAL FUNDING 500

MAINE PUBLIC RADIO

PO BOX 3480
LEWISTON,ME042433480 		NONE PUBLIC CHARITY GENERAL FUNDING 500

MARIN COUNTRY DAY SCHOOL

5221 PARADISE DRIVE
CORTE MADERA,CA94925 		NONE PUBLIC CHARITY GENERAL FUNDING 500

MARINE CORPS SCHOLARSHIP FOUNDATION

909 N WASHINGTON STREET STE 400
ALEXANDRIA,VA22314 		NONE PUBLIC CHARITY GENERAL FUNDING 500

METROPOLITAN MUSEUM OF ART

GRACIE STATION BOX 814
NEW YORK,NY101300087 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000

MISS PORTER'S SCHOOL

60 MAIN STREET
FARMINTON,CT06032 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000

MONROE COUNTY EDUCATION FOUNDATION

PO BOX 2561
KEY WEST,FL33045 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000

NATIONAL NETWORK OF ABORTION FUNDS

9450 SW GEMINI DR PMB 16009
BEAVERTON,OR97008 		NONE PUBLIC CHARITY GENERAL FUNDING 500

NATURAL RESOURCE DEFENSE COUNCIL

40 W 20TH 11TH
NEW YORK,NY10011 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000

NETWORK FOR ANIMALS

PO BOX 518
BARNSTABLE,MA02630 		NONE PUBLIC CHARITY GENERAL FUNDING 500

NEW SURRY THEATRE

18 UNION ST
BLUE HILL,ME04614 		NONE PUBLIC CHARITY GENERAL FUNDING 500

NEW YORK PRESBYTERIAN HOSPITAL

525 EAST 68TH STREET
NEW YORK,NY10021 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000

NICHOLS DAY CAMP

4 ELLSWORTH RD SUITE D
BLUE HILL,ME04614 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000

NORTHERN LIGHT BLUE HILL HOSPITAL

57 WATER ST
BLUE HILL,ME04614 		NONE PUBLIC CHARITY GENERAL FUNDING 2,000

OLD FIREHOUSE PRESERVATION INC

PO BOX 5563
KEY WEST,FL33040 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000

ONE ISLAND FAMILY

801 GEORGIA ST
KEY WEST,FL33040 		NONE PUBLIC CHARITY GENERAL FUNDING 5,000

PACIFIC WILDLIFE CARE

1387 MAIN ST
MORRO BAY,CA93442 		NONE PUBLIC CHARITY GENERAL FUNDING 500

PENINSULA AMBULANCE CORP

PO BOX 830
BLUE HILL,ME04614 		NONE PUBLIC CHARITY GENERAL FUNDING 500

PERFORMING ARTS CENTER OF KEY WEST

5901 WEST COLLEGE ROAD
KEY WEST,FL33043 		NONE PUBLIC CHARITY GENERAL FUNDING 15,000

PLANNED PARENTHOOD

123 WILLIAM ST 10TH FLOOR
NEW YORK,NY10038 		NONE PUBLIC CHARITY GENERAL FUNDING 500

PORTLAND MUSEUM OF ART

SEVEN CONGRESS SQUARE
PORTLAND,ME04101 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000

PREBLE STREET

55 PORTLAND STREET
PORTLAND,ME04101 		NONE PUBLIC CHARITY GENERAL FUNDING 1,500

RADCLIFFE INSTITUTE FUND

10 GARDEN STREET
CAMBRIDGE,MA02138 		NONE PUBLIC CHARITY GENERAL FUNDING 500

RED BARN THEATRE

319 DUVAL STREET
KEY WEST,FL33040 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000

ROLDA ROMANIAN LEAGUE IN DEFENSE OF ANIMALS

PO BOX 4874
CROFTON,MD21114 		NONE PUBLIC CHARITY GENERAL FUNDING 500

SAN LUIS OBISPO INTERNATIONAL MOUNTAIN BICYCLING ASSOCIATION

PO BOX 320280
BOULDER,CO80308 		NONE PUBLIC CHARITY GENERAL FUNDING 500

SAN LUIS OBISPO REPERTORY THEATRE

P O BOX 122
SAN LUIS OBISPO,CA93406 		NONE PUBLIC CHARITY GENERAL FUNDING 20,500

SEWICKLEY ACADEMY

315 ACADEMY AVENUE
SEWICKLEY,PA15143 		NONE PUBLIC CHARITY GENERAL FUNDING 500

SHAW INSTITUTE

55 MAIN STREET
BLUE HILL,ME04614 		NONE PUBLIC CHARITY GENERAL FUNDING 500

SLO BICYCLE COALITION

860 PACIFIC ST 105
SAN LUIS OBISPO,CA93401 		NONE PUBLIC CHARITY GENERAL FUNDING 500

SMARTSHARE HOUSING SOLUTIONS

PO BOX 15034
SAN LUIS OBISPO,CA93406 		NONE PUBLIC CHARITY GENERAL FUNDING 500

SNOW LEOPARD TRUST

4649 SUNNYSIDE AVE N 325
SEATTLE,WA98103 		NONE PUBLIC CHARITY GENERAL FUNDING 500

SOUTH FLORIDA SYMPHONY KEY WEST SYMPHONY ORCHESTRA

221 SW 3RD AVE
FORT LAUDERDALE,FL33312 		NONE PUBLIC CHARITY GENERAL FUNDING 5,000

ST BERNARD'S SCHOOL

4 EAST 98TH STREET
NEW YORK,NY10029 		NONE PUBLIC CHARITY GENERAL FUNDING 2,500

STAR OF THE SEA FOUNDATION

5640 MALONEY AVENUE
KEY WEST,FL33040 		NONE PUBLIC CHARITY GENERAL FUNDING 2,000

STILES HALL

2400 BANCROFT WAY
BERKELEY,CA94704 		NONE PUBLIC CHARITY GENERAL FUNDING 500

TAKING THE REINS

3919 1/2 RIGALI AVENUE
LOS ANGELES,CA90039 		NONE PUBLIC CHARITY GENERAL FUNDING 500

THE AUTHORS GUILD FOUNDATION

31 E 32ND ST 7TH FLOOR
NEW YORK,NY10016 		NONE PUBLIC CHARITY GENERAL FUNDING 250

THE DAVID SHELDRICK WILDLIFE TRUST

25283 CABOT RD SUITE 101
LAGUNA HILLS,CA92653 		NONE PUBLIC CHARITY GENERAL FUNDING 500

THE HUDSON REVIEW

684 PARK AVENUE
NEW YORK,NY10021 		NONE PUBLIC CHARITY GENERAL FUNDING 500

THE MIDNIGHT MISSION

601 SAN PEDRO ST
LOS ANGELES,CA90014 		NONE PUBLIC CHARITY GENERAL FUNDING 500

THE TELLING ROOM

225 COMMERCIAL ST SUITE 201
PORTLAND,ME04101 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000

TREE OF LIFE

PO BOX 1329
BLUE HILL,ME04614 		NONE PUBLIC CHARITY GENERAL FUNDING 2,000

TRIAL AND ERROR

PO BOX 153
MADAWASKA,ME04736 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000

UNIVERSITY HIGH SCHOOL

3065 JACKSON ST
SAN FRANCISCO,CA94115 		NONE PUBLIC CHARITY GENERAL FUNDING 500

WESLEYAN UNIVERSITY

318 HIGH ST
MIDDLETOWN,CT06459 		NONE PUBLIC CHARITY GENERAL FUNDING 500

WHOLE CHILDREN

41 RUSSELL ST
HADLEY,MA01035 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000

WOMANKIND INC

3142 NORTHSIDE DRIVE
KEY WEST,FL33040 		NONE PUBLIC CHARITY GENERAL FUNDING 1,000
Total .................................right arrow 3a 231,600
bApproved for future payment
Total ................................. right arrow 3b 0
Form 990-PF (2023)
Form 990-PF (2023)
Page 12
Part XV-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
Related or exempt
function income
(See instructions.)
1Program service revenue: (a)
Business code 		(b)
Amount 		(c)
Exclusion code 		(d)
Amount
a
b
c
d
e
f
gFees and contracts from government agencies          
2 Membership dues and assessments ....          
3 Interest on savings and temporary cash
investments ........... 		    14 1,854  
4 Dividends and interest from securities ....     14 67,756  
5 Net rental income or (loss) from real estate:
aDebt-financed property......          
bNot debt-financed property.....          
6 Net rental income or (loss) from personal property          
7 Other investment income .....          
8 Gain or (loss) from sales of assets other than
inventory ............ 		    18 111,390  
9 Net income or (loss) from special events:          
10 Gross profit or (loss) from sales of inventory          
11 Other revenue: a
b
c
d
e
12 Subtotal. Add columns (b), (d), and (e) .. 0 181,000 0
13Total. Add line 12, columns (b), (d), and (e)..................
13
181,000
(See worksheet in line 13 instructions to verify calculations.)
Part XV-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
DownArrow 		Explain below how each activity for which income is reported in column (e) of Part XV-A contributed importantly to
the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
instructions.)
Form 990-PF (2023)
Form 990-PF (2023)
Page 13
Part XVI
Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
1
Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
Yes
No
a
Transfers from the reporting foundation to a noncharitable exempt organization of:
(1) Cash...................................
1a(1)
 
No
(2) Other assets.................................
1a(2)
 
No
b
Other transactions:
(1) Sales of assets to a noncharitable exempt organization....................
1b(1)
 
No
(2) Purchases of assets from a noncharitable exempt organization..................
1b(2)
 
No
(3) Rental of facilities, equipment, or other assets.......................
1b(3)
 
No
(4) Reimbursement arrangements...........................
1b(4)
 
No
(5) Loans or loan guarantees.............................
1b(5)
 
No
(6) Performance of services or membership or fundraising solicitations................
1b(6)
 
No
c
Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
1c
 
No
d
If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
(a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
2a
Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
b
If "Yes," complete the following schedule.

(a) Name of organization (b) Type of organization (c) Description of relationship
Sign Here
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
right arrow right arrow
May the IRS discuss this return
with the preparer shown below?
See instructions.
Signature of officer or trustee Date Title
Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date Check if self-
employed right arrow		 PTIN
Firm's name SmallBullet
 Firm's EIN SmallBullet
Firm's address SmallBullet


 Phone no.
Form 990-PF (2023)
Additional Data


Software ID:  
Software Version:  


Form 990PF - Special Condition Description:
Special Condition Description

TY 2023 AccountingFeesSchedule
Name:
THE CLEMENTS FAMILY CHARITABLE TRUST
 
C/O THOMAS CLEMENTS III
EIN:
34-1748724
Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
TAX RETURN PREPARATION 2,500 0   2,500

TY 2023 InvestmentsOtherSchedule2
Name:
THE CLEMENTS FAMILY CHARITABLE TRUST
 
C/O THOMAS CLEMENTS III
EIN:
34-1748724
Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
PRINCIPAL CASH A AT COST 4,517 4,517
PRINCIPAL CASH B AT COST 448 448
VANGUARD TOTAL BD MARKET VBTLX A AT COST 97,264 87,691
VANGUARD TOTAL BD MARKET VBTLX B AT COST 84,704 76,367
VANGUARD WELLINGTON FUND OPEN-ENDED FUND ADM CL VWENX A AT COST 1,078,927 1,522,159
VANGUARD WELLINGTON FUND OPEN-ENDED FUND ADM CL VWENX B AT COST 795,873 1,122,425
INCOME CASH A AT COST 11,001 11,001
INCOME CASH B AT COST 8,000 8,000

TY 2023 LegalFeesSchedule
Name:
THE CLEMENTS FAMILY CHARITABLE TRUST
 
C/O THOMAS CLEMENTS III
EIN:
34-1748724
Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
LEGAL FEES 8,500 0   8,500


TY 2023 OtherDecreasesSchedule
Name:
THE CLEMENTS FAMILY CHARITABLE TRUST
 
C/O THOMAS CLEMENTS III
EIN:
34-1748724
Description Amount
2022/2023 CORRECTING ADJUSTMENT 7,510
2023 CHECKS IN TRANSIT 17,500
ADJUSTMENT - 2022 GRANT CHECK 2216 9,000


TY 2023 OtherExpensesSchedule
Name:
THE CLEMENTS FAMILY CHARITABLE TRUST
 
C/O THOMAS CLEMENTS III
EIN:
34-1748724
Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
BANK FEE 40 40   0


TY 2023 OtherProfessionalFeesSchedule
Name:
THE CLEMENTS FAMILY CHARITABLE TRUST
 
C/O THOMAS CLEMENTS III
EIN:
34-1748724
Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
INVESTMENT MANAGEMENT FEES 4,255 4,255   0