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 04-01-2023 , and ending 03-31-2024
Name of foundation
THE GENE ROMAN FAMILY FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)12250 FOXBOROUGH DRIVE
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MOKENA, IL60448
A Employer identification number

30-0177368
B Telephone number (see instructions)

(708) 606-1449
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$1,676
J 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) 42,315
2 Check right arrow.............
3 Interest on savings and temporary cash investments 0    
4 Dividends and interest from securities...      
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10  
b Gross sales price for all assets on line 6a  
7 Capital gain net income (from Part IV, line 2)... 0
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)..... 0  
11 Other income (attach schedule)....... 0    
12 Total. Add lines 1 through 11........ 42,315 0  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc.        
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule)......... 361      
b Accounting fees (attach schedule)....... 575      
c Other professional fees (attach schedule).... 0      
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... 0      
19 Depreciation (attach schedule) and depletion... 0    
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... 7,738      
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 8,674 0   0
25 Contributions, gifts, grants paid....... 35,748 35,748
26 Total expenses and disbursements. Add lines 24 and 25 44,422 0   35,748
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -2,107
b Net investment income (if negative, enter -0-) 0
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......... -4,474 1,676 1,676
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  
7 Other notes and loans receivable (attach schedule) right arrow  
Less: allowance for doubtful accounts right arrow     0  
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     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) -4,474 1,676 1,676
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons   0
21 Mortgages and other notes payable (attach schedule)......   0
22 Other liabilities (describe right arrow) 0 0
23 Total liabilities (add lines 17 through 22).........   0
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here right arrow
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions...........    
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here right arrow
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........ -4,474 1,676
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)..... -4,474 1,676
30 Total liabilities and net assets/fund balances (see instructions). -4,474 1,676
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
-4,474
2
Enter amount from Part I, line 27a .....................
2
-2,107
3
Other increases not included in line 2 (itemize) right arrowClick to see attachment
List of Attached Documents:
// Content
3
8,257
4
Add lines 1, 2, and 3 ..........................
4
1,676
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
1,676
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 0
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 0
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 0
6 Credits/Payments:
a 2023 estimated tax payments and 2022 overpayment credited to 2023 6a  
b Exempt foreign organizations—tax withheld at source...... 6b  
c Tax paid with application for extension of time to file (Form 8868)... 6c  
d Backup withholding erroneously withheld .......... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7  
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......right arrow 9 0
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...right arrow 10  
11 Enter the amount of line 10 to be: Credited to 2024 estimated taxright arrow0 Refundedright arrow 11  
Form 990-PF (2023)
Form 990-PF (2023)
Page 4
Part VI-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. right arrow$   (2) On foundation managers.right arrow$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.right arrow$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
round bullet By language in the governing instrument, or
round bullet By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument? ................
6
Yes
 
7
Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
and Part XIV..................................
7
Yes
 
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
right arrowIL
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 arrowwww.generoman.org
14
The books are in care ofright arrowSANDRA L PECCIA Telephone no.right arrow (708) 606-1449

Located atright arrow12250 FOXBOROUGH DRIVEMOKENAIL ZIP+4right arrow60448
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
 
 
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
 
 
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
SANDRA L PECCIA PRES/SECTR/TREAS
8.00
0 0 0
12250 FOXBOROUGH DRIVE
MOKENA,IL60448
ANGELA ISBELL V. PRES.
1.50
0 0 0
437 ANN LANE
NEW LENOX,IL60451
CINDY HILL BOARD MEMBER
0.25
0 0 0
2255 PALMER RANCH DR
NEW LENOX,IL60451
ROBERT SLOVIN BOARD MEMBER
0.25
0 0 0
21620 WILLIAMSBURG CT
FRANKFORT,IL60423
GERRY BERZINS BOARD MEMBER
1.50
0 0 0
6173 PRINCETON LANE
PALOS HEIGHTS,IL60465
MICHELE ROMAN BOARD MEMBER
1.50
0 0 0
22943 S BIG RUN DRIVE
FRANKFORT,IL60423
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 FUNDS ARE DISTRIBUTED TO CANCER VICTIMS TO PAY MEDICAL EXPENSES AND OTHER ITEMS RELATING TO THEIR WELL-BEING. ONE HUNDRED SIXTY-TWO INDIVIDUALS HAVE BEEN OUR BENEFICIARIES THIS FISCAL YEAR. 8,673
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
13,100
c
Fair market value of all other assets (see instructions)................
1c
0
d
Total (add lines 1a, b, and c).........................
1d
13,100
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
 
3
Subtract line 2 from line 1d.........................
3
13,100
4
Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
instructions) .............................
4
197
5
Net value of noncharitable-use assets. Subtract line 4 from line 3. ............
5
12,903
6
Minimum investment return. Enter 5% (0.05) of line 5................
6
645
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
645
2a
Tax on investment income for 2022 from Part V, line 5.......
2a
0
b
Income tax for 2022. (This does not include the tax from Part V.) ...
2b
 
c
Add lines 2a and 2b............................
2c
0
3
Distributable amount before adjustments. Subtract line 2c from line 1............
3
645
4
Recoveries of amounts treated as qualifying distributions................
4
 
5
Add lines 3 and 4............................
5
645
6
Deduction from distributable amount (see instructions).................
6
 
7
Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
7
645
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
35,748
b
Program-related investments—total from Part VIII-B..................
1b
 
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
35,748
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 7 645
2 Undistributed income, if any, as of the end of 2022:
a Enter amount for 2022 only.......  
b Total for prior years:20 , 20, 20  
3 Excess distributions carryover, if any, to 2022:
a From 2018...... 20,326
b From 2019...... 16,773
c From 2020...... 15,345
d From 2021...... 28,585
e From 2022...... 26,963
f Total of lines 3a through e ........ 107,992
4Qualifying distributions for 2023 from Part
XI, line 4: right arrow$ 35,748
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)........
0
d Applied to 2023 distributable amount.....  
e Remaining amount distributed out of corpus 35,748
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 5 143,740
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 .............
0
f Undistributed income for 2023. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2024 ..........
645
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) ...
20,326
9 Excess distributions carryover to 2024.
Subtract lines 7 and 8 from line 6a ......
123,414
10 Analysis of line 9:
a Excess from 2019.... 16,773
b Excess from 2020.... 15,345
c Excess from 2021.... 28,585
d Excess from 2022.... 26,963
e Excess from 2023.... 35,748
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).)
NONE
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.
NONE
2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here right arrow
aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
SANDRA L PECCIA
12250 FOXBOROUGH DRIVE
MOKENA,IL60448
(708) 606-1449
bThe form in which applications should be submitted and information and materials they should include:
REQUEST FOR ASSISTANCE FORM AND DOCTOR OR CLINIC REFERRAL.
cAny submission deadlines:
NONE
dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
THIS FOUNDATION ONLY PROVIDES ASSISTANCE FOR CANCER PATIENTS.
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
BRENNEN BOYKIN


1041 NERGE ROAD APT 304
ELK GROVE VILLAGE,IL60007
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
HAROLD BARNEY


5330 S HARPER APT 202
CHICAGO,IL60615
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 315
JOSE VARGAS MARQUEZ


2857 W 38th STREET
CHICAGO,IL60632
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
ADOLPHO ACOSTA


2049 N LATROBE STREET
CHICAGO,IL60639
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
NINA KHARULI


2043 WINDEMERE CIRCLE
SCHAUMBURG,IL60194
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
NICOLLE JOHNSON


7731 BUFFALO GROVE ROAD
LOVES PARK,IL61111
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
BOUVIER JACKSON


8410 S BURLEY 1F
CHICAGO,IL60617
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
ANDERA THARPE


11022 S GREEN STREET
CHICAGO,IL60643
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
JAMES COPP


1312 W MONROE STREET
CHICAGO,IL60607
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
RODOLFO AGUILOR JACOBO


1338 E INDIAN TRAIL APT C
AURORA,IL60505
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
MARIA PINE


913 N 8th AVENUE 3
MAYWOOD,IL60153
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
SVIAHOSLOV BOICHOK


3446 N HARLEM AVENUE
CHICAGO,IL60634
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
MICHELLE RENEE BANKS


3301 W ARLINGTON ST 322
CHICAGO,IL60624
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
DOROTHY JONES


3052 W 119th ST APT 3D
MERRIONETTE PARK,IL60803
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
TERRI MEAKENS


6920 S CRANDON AVE APT 103
CHICAGO,IL60649
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
MARIA ONDRAGON CARBAJAL


1926 SHEILA STREET
WOODSTOCK,IL60098
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
KAREN TARTT


1113 TALL TIMBER ROAD APT 104
SCHUAMBURG,IL60173
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
CELENE ADAMS


1751 W 48th STREET
CHICAGO,IL60609
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
DEIDRE CHILDS


4906 N WHIPPLE GARDEN APT
CHICAGO,IL60625
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
DENNIS MILLER


PO BOX 15
SEATONVILLE,IL61359
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
KIM PETTIFORD


2701 S INDIANA APT 210
CHICAGO,IL60616
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
VANESSSA CROUT


3523 GREENDALE DR APT 10
ROCKFORD,IL61109
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
YAMELIN E TEJERA RODRIGUEZ


7553 W BELMONT APT 1S
CHICAGO,IL60634
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
ALEXANDRIA ABRAHAM


8500 S MUSKEGON
CHICAGO,IL60617
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
NITZAIOLA GONZALEZ


3441 CHICAGO ROAD APT 2A
STEGER,IL60475
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
DIANE ROLLINGS


6809 S MAPLEWOOD AVENUE
CHICAGO,IL60629
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
SPENCER WARREN


1914 N DRAKE APT 1S
CHICAGO,IL60647
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
LAMONT BARKDALE


1123 S RICHMOND
CHICAGO,IL60612
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 150
SUE CASEY


85 GRAYS LANE
DECATUR,IL62520
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
ANGEL PANTOJAS


5418 W THOMAS
CHICAGO,IL60651
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 372
SUSAN KRAMER


1700 NEWTON DRIVE 508
MORRIS,IL60450
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 270
JACKIE BULLOCK


7846 S PAULINA APT 1
CHICAGO,IL60620
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 264
SERGIO DOMINGUEZ


5712 N KIMBALL
CHICAGO,IL60659
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
YOLANDA MARILLO


819 E NEW YORK ST APT A
AURORA,IL60505
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
ROSALINA GONZALEZ


6107 S MAYFIELD
CHICAGO,IL60638
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 244
GEORGE BACAS


9141 BARBERRY LANE
DES PLAINES,IL60016
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
HYKUA TAKKIB


6212 W 64th PLACE
CHICAGO,IL60638
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
ELVA OCHOA ROMERO


1216 CAROL STREET
PARK RIDGE,IL60068
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
MELINDA SEGAL


1703 N SHEFFIELD 1
CHICAGO,IL60614
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
ALLYNE CUNNINGHAM


1104 N PLUM GROVE RD 201
SCHAUMBURG,IL60173
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
GRAZYNA CHRUSCICKA


3049 N AUSTIN
CHICAGO,IL60631
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
IRMA GOLVEZ RODORTE


408 NORTHFIELD DRIVE
JOLIET,IL60435
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
LASHON HARPER


22604 PARKVIEW DRIVE
RICHTON PARK,IL60471
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
IDA COHEN


14800 KETELLAR DR 6E
MIDLOTHIAN,IL60445
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 264
TANISHA ESKRIDGE


609 N MEADOWS
ADDISON,IL60101
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
BARBARA BREWER


3043 N MASON AVE APT 1
CHICAGO,IL60634
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
GREGORY GRAY


7900 S PAXTON APT 1A
CHICAGO,IL60617
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
FLOREBERTO AMBROSIO CARMONA


4839 S LOOMIS BLVD FLOOR 2
CHICAGO,IL60619
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
BRENDA GRAVES


9824 EGGLESTON
CHICAGO,IL60628
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
VICTOR SANCHEZ


4925 W SUPERIOR
CHICAGO,IL60644
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
QUEEN BIBBS


21606 CYNTHIA AVENUE
SAUK VILLAGE,IL60411
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
SHEILA ADAMS


523 S STATE STREET
SPRINGFIELD,IL62704
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
TOMAS ARROYO


8536 S KOLIN AVENUE
CHICAGO,IL60652
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
MARIA RIVERA


5682 W HIGGINS AVE APT 1GW
CHICAGO,IL60630
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 150
TRILLA MURRAY


740 E 43rd STREET APT 1001
CHICAGO,IL60653
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 100
RAFAEL CRUDUP


4211 W FULLERTON APT 1A
CHICAGO,IL60639
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 100
KEITH JOHNSON


114 N LONG AVENUE 1-D
CHICAGO,IL60644
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 100
DARNELL NELSON


2253 S MILLARD
CHICAGO,IL60623
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 100
JUANA ZAVALA


2858 S CHRISTIANA
CHICAGO,IL60623
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 100
KWABENE STEWART


2949 N AUSTIN AVE APT 2
CHICAGO,IL60634
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 275
LARRY SPURLOCK


514 S VAN BUREN
BATAVIA,IL60510
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 150
ROSA PAGAN


6650 BELDEN AVE APT 124
CHICAGO,IL60607
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
LILIANA PEREZ


4851 S KEATING
CHICAGO,IL60632
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
MANUEL FAVEIA


1935 25th AVENUE
MAYWOOD,IL60153
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 180
ROBIN WAGNER


14534 S LOWE AVENUE
RIVERDALE,IL60827
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
RANDY HOUSER


45W 349 KESLINGER ROAD
ELBURN,IL60119
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
ANTHONY WILLIAMS


679 AURORA AVENUE
AURORA,IL60505
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 250
NALLELEY CHACON


5636 W 79th STREET
BURBANK,IL60459
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 250
LUIS PINTOR


706 ABE STREET
JOLIET,IL60432
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 100
DON HOOVER


8200 S ELLIS AVE APT 310
CHICAGO,IL60619
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 156
CORESHA GIBBS


8955 S ADA STREET
CHICAGO,IL60620
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 250
TANYA FIELDS


7818 S ADA STREET
CHICAGO,IL60620
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
RUTH TORRES


2248 N MENARD AVENUE
CHICAGO,IL60639
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
DWAINE LEE


4937 W WEST END BASEMENT
CHICAGO,IL60644
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
LORIE BROWN


7018 S CREIGER AVE APT 311
CHICAGO,IL60649
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
SHAHIDA SIDDIQUI


531 VERDE DRIVE
SCHAUMBURG,IL60173
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
VANQUI CHEN


3341 S ARCHER AVENUE
CHICAGO,IL60608
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 150
ISAAC FELIX


1428 S AUSTIN APT BSMT
CICERO,IL60804
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
RUBEN GARCIA


3201 S 53rd COURT
CICERO,IL60804
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
MOHAMMED KHAN


6337 N TALMAN APT 2
CHICAGO,IL60659
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 145
JHOAN VILLANEVA


1814 N MAYFIELD AVENUE
CHICAGO,IL60639
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 100
NIANG LAM LUN


1557 GOLDEN OAKS PARKWAY
AURORA,IL60506
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
DEVON BLAXON


827 GREENBRIAR LANE
UNIVERSITY PARK,IL60484
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
PERCY O'CONNER


7228 S RIDGELAND AVENUE
CHICAGO,IL60649
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 250
EDUARDO SAMPEDRO


1339 SCOVILLE AVE APT 2
BERWYN,IL60402
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
LATESE SCOTT


720 E 131st STREET
RIVERDALE,IL60827
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 150
JACQUELINE COBBINS


1633 MADISON ST APT 2010S
CHICAGO,IL60612
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 150
MICHAEL ORNELAS


NO PERMANENT ADDRESS
HOMELESS,IL00000
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 175
CALEB JONES


1733 GODDARD LANE
HANOVER PARK,IL60133
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
RITA PERRY


1231 LEE STREET
DES PLAINES,IL60018
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 150
JOHNNIE MAE BOOKER


826 E 42nd STREET 1ST FLR
CHICAGO,IL60653
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
BETTYE SANDERS


7941 S ARTESIAN
CHICAGO,IL60652
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
WARREN IRBY


1428 BROADWAY
BLUE ISLAND,IL60406
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 150
VICTORIA BARRIENTOS


2435 W 34th STREET
CHICAGO,IL60608
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 175
BRENDA LONGSTREET


3939 W IOWA ST BSMT EAST
CHICAGO,IL60651
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
URSZULA MACIEJCZYK


10353 DEARLOVE RD APT 2H
GLENVIEW,IL60025
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 203
YVETTE WILLIS


900 CEDAR RIDGE LANE
RICHTON PARK,IL60471
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
GILBERTO MONTES FLORES


952 S KILBOURN
CHICAGO,IL60624
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
STEVEN PICKRUM


5416 GRANGE AVENUE
OAK FOREST,IL60452
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 150
SYLVIA THOMPSON


12248 S PRINCETON
CHICAGO,IL60628
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
JUDITH BOWIE


554 CLYDE AVENUE
CALUMET CITY,IL60409
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
LEE MOSELEY


2710 W JACKSON BLVD 102
CHICAGO,IL60612
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
DARRICK JACKSON


6030 N SHERIDAN APT 907
CHICAGO,IL60660
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
ROSEMARY SLAUTER


1401 S BLUE ISLAND AVE 291
CHICAGO,IL60608
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
JEFFERY BIRDWELL


532 SHADYWOOD LANE
ELK GROVE VILLAGE,IL60007
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
SARAH ARDIZZONE


3411 W 72nd PLACE
CHICAGO,IL60629
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 175
ZUOYI LIU


336 W CERMAK ROAD
CHICAGO,IL60616
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 150
JAMAAL McDAVIS


2613 W LATROBE
PEORIA,IL61605
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 150
WILLIE KENNEDY


7528 S EGGLESTON
CHICAGO,IL60620
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 50
CAROLYN THOMAS


1025 S PLEASANT AVENUE
OAK PARK,IL60302
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 150
EDUARDO SOLAR


5719 S ARCHER 2nd FLR
CHICAGO,IL60638
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 150
SHARON YOLICH


3139 S PARNELL AVENUE
CHICAGO,IL60616
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
KIMBERLY TORRES


2934 5th AVENUE
ROCK ISLAND,IL61201
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
MICHAEL HENDERSON


823 N FRANCISCO BSMNT
CHICAGO,IL60622
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
ELTON KING JR


323 FONTANA DRIVE
YORKVILLE,IL60560
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 100
JODY BURKE


241 OTTAWA BEND DR APT 309E
MORRIS,IL60450
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 244
NOREEN BERGMAN TYSON


313 BIRCHWOOD LANE
BLOOMINGDALE,IL60108
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 125
ROGELIIO ALANIZ SALGADO


1431 S 50th AVENUE
CICERO,IL60804
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
FRANKLIN OMENE


6940 S EUCLID AVENUE
CHICAGO,IL60649
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 100
NIKOLE LOCKHART


1853 E 81st STREET 2N
CHICAGO,IL60617
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 206
MELVIN KIMES


7928 S UNION
CHICAGO,IL60620
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
TRENT HARVILLE


8526 S EUCLID AVENUE
CHICAGO,IL60617
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 126
WIESKAW KOSIEK


18 E OLD WILLOW RD APT 531N
PROSPECT HEIGHTS,IL60070
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 150
BING HU MAI


2701 S UNION AVENUE
CHICAGO,IL60616
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 190
HENRY WRIGHT


5901 W CORCORAN PLACE
CHICAGO,IL60644
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 150
JOSE ROMAN


21727 RICHMOND ROAD
MATTESON,IL60443
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 150
BYRON JORDON


2631 S INDIANA AVE APT 408
CHICAGO,IL60616
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 106
MARILYN BARNES


6532 S HERMITAGE AVE 2
CHICAGO,IL60636
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
RITA DUNCAN


17106 GREENWOOD AVENUE
SOUTH HOLLAND,IL60473
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
OSCAR PEREZ


2135 N MEADE AVENUE
CHICAGO,IL60639
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
JACQUELINE RENTERIA


1324 W 18th PL 2ND FLR REAR
CHICAGO,IL60608
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
MARIA GOLINDO


308 E 116 STREET
CHICAGO,IL60628
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
MARIO HERRERA


2347 121st STREET
BLUE ISLAND,IL60406
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
TROY WALKER


909 W 54th STREET
CHICAGO,IL60609
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
ANTHONY WILLIAMS


6425 S LOWE AVE APT 303
CHICAGO,IL60621
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
ARACELY ACUNA


15244 MILLAED AVENUE
MIDLOTHIAN,IL60445
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
JOSE ORTEGA


412 MACKINAW AVENUE
CALUMET CITY,IL60409
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
LUCRECIA MERCADO


2039 N KEDZIE
CHICAGO,IL60647
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
MARIA VELAQUEZ


3310 S 58th COURT
CICERO,IL60804
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
FREDRICK BRIDGES


15430 DREXEL AVENUE
DOLTON,IL60419
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
TELENA VAUGHN


3826 W POLK ST FLOOR 2
CHICAGO,IL60624
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
SUSANA ESPINOZA


7321 W FULLERTON APT 11
ELMWOOD PARK,IL60707
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
CAMARON BRANCH


902 RIDGE DRIVE APT 6
DEKALB,IL60115
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
RAYMOND PAJEDA


8733 S WALLACE
CHICAGO,IL60620
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
GLORIA WHITE


123 N AUSTIN BLVD
CHICAGO,IL60644
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
LAURA BAHENA


5023 S SEELEY Ist FLR
CHICAGO,IL60609
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
VICKIE KNIGHT


1427 E 72nd STREET
CHICAGO,IL60619
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
DAVID THROPE


1444 GLEN ELLYN ROAD
GLENDALE HEIGHTS,IL60139
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
JEARLEANE HALL


1611 S RACINE APT 601
CHICAGO,IL60608
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
VALERIE CORDON


209 W 11th STREET
PECATONICA,IL61063
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
KWYNTA ROBERTS


5916 LAUREL LANE APT 2011
WILLOWBROOK,IL60527
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
GERARDO RODRIGUEZ SALAZAR


3619 W 57th PLACE
CHICAGO,IL60629
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
SOLOMON TORRES


5538 CARMEL DRIVE
HANOVER PARK,IL60133
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 150
JANETTE KENERSON


18840 KEELER AVENUE
COUNTRY CLUB HILLS,IL60478
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
YVONNE WESLEY


1510 S KEDVALE AVE APT 2
CHICAGO,IL60623
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
PATRICIA ANNE MAKER MACINNES


23219 CENTRAL PARK AVENUE
RICHTON PARK,IL60471
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
LAWRENCE ELLIS


7004 S CLYDE APT 2C
CHICAGO,IL60649
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
JOYCE MOORE


7435 S KINGSTON APT 308
CHICAGO,IL60649
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 200
RAY BROWN


20681 GRAND HAVEN DRIVE
FRANKFORT,IL60423
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 300
FELICIA DANIEL


15927 GAUGER AVENUE
HARVEY,IL60426
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 150
CARYN LYONS


1822 VERMONT ST APT 2N
BLUE ISLAND,IL60406
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 135
ANGEL SANTIAGO


9205 S 53rd COURT
OAK LAWN,IL60453
NONE PUBLIC AS DETERMINED BYBENEFICIARY OF GRANT 353
Total .................................right arrow 3a 35,748
bApproved for future payment
Total ................................. right arrow 3b  
Form 990-PF (2023)
Form 990-PF (2023)
Page 12
Part XV-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
Related or exempt
function income
(See instructions.)
1Program service revenue: (a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
gFees and contracts from government agencies          
2 Membership dues and assessments ....          
3 Interest on savings and temporary cash
investments ...........
900003 0 14 0  
4 Dividends and interest from securities ....          
5 Net rental income or (loss) from real estate:
aDebt-financed property......          
bNot debt-financed property.....          
6 Net rental income or (loss) from personal property          
7 Other investment income .....          
8 Gain or (loss) from sales of assets other than
inventory ............
         
9 Net income or (loss) from special events:          
10 Gross profit or (loss) from sales of inventory          
11 Other revenue: a
b
c
d
e
12 Subtotal. Add columns (b), (d), and (e) .. 0 0  
13Total. Add line 12, columns (b), (d), and (e)..................
13
0
(See worksheet in line 13 instructions to verify calculations.)
Part XV-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
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 GeneralExplanationAttachment
Name:
THE GENE ROMAN FAMILY FOUNDATION
EIN:
30-0177368
Identifier Return Reference Explanation
  SUBSTANTIAL CONTRIBUTORS PART VII-A QUESTION #10 MR & MRS GLENN HORTON MR ADAM ROMAN MR & MRS GLENN HORTON MR ADAM ROMAN MR & MRS GLENN HORTON MR ADAM ROMAN MR & MRS GLENN HORTON MR ADAM ROMAN MR & MRS GLENN HORTON MR ADAM ROMAN MR & MRS GLENN HORTON MR ADAM ROMAN MR & MRS GLENN HORTON MR ADAM ROMAN MR & MRS GLENN HORTON MR ADAM ROMAN MR & MRS GLENN HORTON MR ADAM ROMAN MR & MRS GLENN HORTON MR ADAM ROMAN MR & MRS GLENN HORTON MR ADAM ROMAN

TY 2023 OtherExpensesSchedule
Name:
THE GENE ROMAN FAMILY FOUNDATION
EIN:
30-0177368
Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
POSTAGE 244      
OFFICE EXPENSES 283      
FUNDRAISING EVENT COSTS 6,747      
TELEPHONE 449      
IL FILING FEE 15      


TY 2023 OtherIncreasesSchedule
Name:
THE GENE ROMAN FAMILY FOUNDATION
EIN:
30-0177368
Description Amount
ADJUST - ACCUM O/S GRANT PAYMENTS 8,257