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
FORD S N & ADA FUND PFDN
 
Number and street (or P.O. box number if mail is not delivered to street address)4900 TIEDEMAN ROAD OH-01-49-0381
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
BROOKLYN, OH44144
A Employer identification number

34-0842282
B Telephone number (see instructions)

(419) 525-7661
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$14,287,992J 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      
4 Dividends and interest from securities... 197,947 197,606  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 1,236,169
b Gross sales price for all assets on line 6a 2,731,404
7 Capital gain net income (from Part IV, line 2)... 1,236,169
8 Net short-term capital gain......... 0
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)....... Click to see attachment
List of Attached Documents:
// Content
6,152 5,391  
12 Total. Add lines 1 through 11........ 1,440,268 1,439,166  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 51,582 38,686   12,895
14 Other employee salaries and wages......   0 0 0
15 Pension plans, employee benefits.......   0 0  
16a Legal fees (attach schedule).........       0
b Accounting fees (attach schedule)....... Click to see attachment
List of Attached Documents:
// Content
1,050 0 0 1,050
c Other professional fees (attach schedule)....       0
17 Interest...............       0
18 Taxes (attach schedule) (see instructions)... Click to see attachment
List of Attached Documents:
// Content
20,693 1,104   0
19 Depreciation (attach schedule) and depletion... 0 0  
20 Occupancy..............        
21 Travel, conferences, and meetings.......   0 0  
22 Printing and publications..........   0 0  
23 Other expenses (attach schedule)....... Click to see attachment
List of Attached Documents:
// Content
5,679 4,879   800
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 79,004 44,669 0 14,745
25 Contributions, gifts, grants paid....... 759,738 759,738
26 Total expenses and disbursements. Add lines 24 and 25 838,742 44,669 0 774,483
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 601,526
b Net investment income (if negative, enter -0-) 1,394,497
c Adjusted net income (if negative, enter -0-)... 0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2023)
Form 990-PF (2023)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing.............      
2 Savings and temporary cash investments......... 213,590 304,467 304,467
3 Accounts receivable right arrow  
Less: allowance for doubtful accounts right arrow     0 0
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 arrow0      
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).......... 11,800,895 Click to see attachment
List of Attached Documents:
// Content
12,404,646 		13,983,525
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) 12,014,485 12,709,113 14,287,992
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
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........ 12,014,485 12,709,113
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)..... 12,014,485 12,709,113
30 Total liabilities and net assets/fund balances (see instructions). 12,014,485 12,709,113
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
12,014,485
2
Enter amount from Part I, line 27a .....................
2
601,526
3
Other increases not included in line 2 (itemize) right arrowClick to see attachment
List of Attached Documents:
// Content
3
94,309
4
Add lines 1, 2, and 3 ..........................
4
12,710,320
5
Decreases not included in line 2 (itemize) right arrowClick to see attachment
List of Attached Documents:
// Content
5
1,207
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
12,709,113
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 600. APPLE INC   2009-02-03 2023-08-18
b 50. AVALONBAY COMMUNITIES INC   2019-05-30 2023-02-02
c 125. BALL CORP   2019-05-30 2023-02-02
d 350. CMS ENERGY CORP   2018-01-03 2023-06-28
e 575. DANAHER CORP   2013-02-22 2023-08-02
725. WALT DISNEY CO   2006-09-28 2023-12-14
126.41 FANNIE MAEDTD 11/1/1998 6.50000% 11/1/20   2001-11-09 2023-02-27
124.29 FANNIE MAEDTD 11/1/1998 6.50000% 11/1/20   2001-11-09 2023-03-27
122.16 FANNIE MAEDTD 11/1/1998 6.50000% 11/1/20   2001-11-09 2023-04-25
119.98 FANNIE MAEDTD 11/1/1998 6.50000% 11/1/20   2001-11-09 2023-05-25
117.78 FANNIE MAEDTD 11/1/1998 6.50000% 11/1/20   2001-11-09 2023-06-26
114.49 FANNIE MAEDTD 11/1/1998 6.50000% 11/1/20   2001-11-09 2023-07-25
112.3 FANNIE MAEDTD 11/1/1998 6.50000% 11/1/20   2001-11-09 2023-08-25
110.09 FANNIE MAEDTD 11/1/1998 6.50000% 11/1/20   2001-11-09 2023-09-25
107.87 FANNIE MAEDTD 11/1/1998 6.50000% 11/1/20   2001-11-09 2023-10-25
106.05 FANNIE MAEDTD 11/1/1998 6.50000% 11/1/20   2001-11-09 2023-11-27
104.22 FANNIE MAEDTD 11/1/1998 6.50000% 11/1/20   2001-11-09 2023-12-26
849.53 FANNIE MAE POOL 645356   2002-05-24 2023-02-27
844.03 FANNIE MAE POOL 645356   2002-05-24 2023-03-27
838.49 FANNIE MAE POOL 645356   2002-05-24 2023-04-25
832.92 FANNIE MAE POOL 645356   2002-05-24 2023-05-25
827.31 FANNIE MAE POOL 645356   2002-05-24 2023-06-26
821.68 FANNIE MAE POOL 645356   2002-05-24 2023-07-25
816.01 FANNIE MAE POOL 645356   2002-05-24 2023-08-25
810.31 FANNIE MAE POOL 645356   2002-05-24 2023-09-25
804.58 FANNIE MAE POOL 645356   2002-05-24 2023-10-25
798.81 FANNIE MAE POOL 645356   2002-05-24 2023-11-27
793.01 FANNIE MAE POOL 645356   2002-05-24 2023-12-26
18862.04 GOLDMAN SACHS INTL EQUITY INSIGHTS FUND     2023-02-02
18796.04 GOLDMAN SACHS INTL EQUITY INSIGHTS FUND     2023-09-21
340. HOME DEPOT INC     2023-12-14
1950. INTEL CORP   1990-12-05 2023-08-18
950. JP MORGAN CHASE & CO   2009-05-08 2023-08-18
15142.42 JOHCM INTERNATIONAL SELECT     2023-02-02
400. MASTERCARD INC   2013-02-22 2023-02-02
250. MCDONALDS CORP   2003-08-04 2023-12-14
1200. NEXTERA ENERGY INC   2020-06-29 2023-12-14
300. PARKER HANNIFIN CORP COM   2020-06-29 2023-09-21
600. RAYTHEON TECHNOLOGIES CORP   2006-09-28 2023-12-14
1050. REPUBLIC SERVICES INC   2013-02-22 2023-08-02
125. ROPER TECHNOLOGIES INC   2018-01-03 2023-08-18
225. SHERWIN WILLIAMS CO COM   2018-01-03 2023-06-28
150. THERMO FISHER SCIENTIFIC INC   2009-02-03 2023-02-02
125. XCEL ENERGY INC   2019-05-30 2023-02-02
13686.51 CHARITABLE REAL ASSETS FUND   2021-04-27 2023-08-02
525. ACCENTURE PLC   2013-02-22 2023-12-14
CAPITAL GAIN DIVIDENDS P    
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CAPITAL GAIN 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 103,620   1,964 101,656
b 9,171   10,073 -902
c 7,098   7,621 -523
d 20,537   15,621 4,916
e 148,639   26,567 122,072
67,975   22,169 45,806
3   13 -10
2   9 -7
2   9 -7
2   9 -7
2   9 -7
3   14 -11
2   9 -7
2   9 -7
2   9 -7
2   8 -6
2   8 -6
5   13 -8
6   13 -7
6   13 -7
6   13 -7
6   13 -7
6   13 -7
6   13 -7
6   14 -8
6   14 -8
6   14 -8
6   14 -8
242,000   248,630 -6,630
247,732   229,370 18,362
119,892   76,471 43,421
62,965   2,331 60,634
141,466   34,869 106,597
332,225   361,000 -28,775
150,334   20,815 129,519
72,429   5,585 66,844
75,319   71,488 3,831
114,951   53,852 61,099
48,995   21,852 27,143
159,666   32,949 126,717
60,679   32,519 28,160
57,272   31,030 26,242
88,269   5,492 82,777
8,705   7,160 1,545
150,000   136,384 13,616
180,195   39,170 141,025
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
      10,841
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       101,656
b       -902
c       -523
d       4,916
e       122,072
      45,806
      -10
      -7
      -7
      -7
      -7
      -11
      -7
      -7
      -7
      -6
      -6
      -8
      -7
      -7
      -7
      -7
      -7
      -7
      -8
      -8
      -8
      -8
      -6,630
      18,362
      43,421
      60,634
      106,597
      -28,775
      129,519
      66,844
      3,831
      61,099
      27,143
      126,717
      28,160
      26,242
      82,777
      1,545
      13,616
      141,025
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
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 1,236,169
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 19,384
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 19,384
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 19,384
6 Credits/Payments:
a 2023 estimated tax payments and 2022 overpayment credited to 2023 6a 24,345
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  
7 Total credits and payments. Add lines 6a through 6d.............. 7 24,345
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. Click to see attachment
List of Attached Documents:
// Content
8 107
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 4,854
11 Enter the amount of line 10 to be: Credited to 2024 estimated taxright arrow4,854 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$   (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 arrowOH
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 arrow  
14
The books are in care ofright arrowKEYBANK NA Telephone no.right arrow (419) 525-7661

Located atright arrow4900 TIEDEMAN RD OH01490150BROOKLYNOH ZIP+4right arrow44144
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
KEYBANK N A TRUSTEE
5 		51,582    
4900 TIEDEMAN RD
BROOKLYN,OH44144
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 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
13,554,853
b
Average of monthly cash balances.......................
1b
0
c
Fair market value of all other assets (see instructions)................
1c
0
d
Total (add lines 1a, b, and c).........................
1d
13,554,853
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
13,554,853
4
Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
instructions) .............................
4
203,323
5
Net value of noncharitable-use assets. Subtract line 4 from line 3. ............
5
13,351,530
6
Minimum investment return. Enter 5% (0.05) of line 5................
6
667,577
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
667,577
2a
Tax on investment income for 2022 from Part V, line 5.......
2a
19,384
b
Income tax for 2022. (This does not include the tax from Part V.) ...
2b
 
c
Add lines 2a and 2b............................
2c
19,384
3
Distributable amount before adjustments. Subtract line 2c from line 1............
3
648,193
4
Recoveries of amounts treated as qualifying distributions................
4
0
5
Add lines 3 and 4............................
5
648,193
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
648,193
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
774,483
b
Program-related investments—total from Part VIII-B..................
1b
0
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes...............................
2
0
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)....................
3a
0
b
Cash distribution test (attach the required schedule) .................
3b
0
4
Qualifying distributions. Add lines 1a through 3b. Enter here and on Part XII, line 4. .......
4
774,483
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 7 648,193
2 Undistributed income, if any, as of the end of 2022:
a Enter amount for 2022 only....... 641,170
b Total for prior years:20 , 20, 20 0
3 Excess distributions carryover, if any, to 2022:
a From 2018...... 0
b From 2019...... 0
c From 2020...... 0
d From 2021...... 0
e From 2022...... 0
f Total of lines 3a through e ........ 0
4Qualifying distributions for 2023 from Part
XI, line 4: right arrow$ 774,483
a Applied to 2022, but not more than line 2a 641,170
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..... 133,313
e Remaining amount distributed out of corpus 0
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 0
b Prior years’ undistributed income. Subtract
line 4b from line 2b .......... 		0
c Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed...... 		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 .......... 		514,880
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) ... 		0
9 Excess distributions carryover to 2024.
Subtract lines 7 and 8 from line 6a ...... 		0
10 Analysis of line 9:
a Excess from 2019.... 0
b Excess from 2020.... 0
c Excess from 2021.... 0
d Excess from 2022.... 0
e Excess from 2023.... 0
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:
DANA HAMMOND TRUST OFFICER
42 NORTH MAIN ST KEYBANK NA TRU
MANSFIELD,OH44902
(419) 525-7665
bThe form in which applications should be submitted and information and materials they should include:
APPROPRIATE INFORMATION, INCLUDING INTENDED USE
cAny submission deadlines:
NONE
dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
RICHLAND COUNTY, OHIO RESIDENTS; PRIMARILY USED FOR SICK, AGED AND EDUCATION
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

CATHOLIC CHARITIES

125 E 105TH ST
NEW YORK,NY10029 		NONE PC MEDICAL ASSTANCE FOR NEEDY 379,000

FRIENDLY HOUSE

380 N MULBERRY
MANSFIELD,OH44902 		NONE PC CAMPERSHIP ASSISTANCE 10,000

RICHLAND COUNTY FOUNDATION

181 S MAIN ST
MANSFIELD,OH44902 		NONE PC GENERAL OPERATING 58,483

AKRON CHILDRENS HOSPITAL FOUNDATION

1 PERKINS SQ
AKRON,OH443081063 		NONE PC GENERAL OPERATING 50,000

NORTH CENTRAL STATECOLLEGE FOUNDATION

2441 KENWOOD CIRCLE
MANSFIELD,OH44906 		NONE PC GENERAL OPERATING 87,723

OHIOHEALTH FOUNDATION

3430 OHIOHEALTH PARKWAY
COLUMBUS,OH43202 		NONE PC GENERAL OPERATING 100,000

THE OHIO STATE UNIVERSITY AT MANSFIELD

1760 UNIVERSITY DR
MANSFIELD,OH44906 		NONE PC GENERAL OPERATING 32,032

THIRD STREET FAMILY HEALTH SERVICES

600 W 3RD ST
MANSFIELD,OH44906 		NONE PC GENERAL OPERATING 42,500
Total .................................right arrow 3a 759,738
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 ........... 		         
4 Dividends and interest from securities ....     14 197,947  
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 1,236,169  
9 Net income or (loss) from special events:          
10 Gross profit or (loss) from sales of inventory          
11 Other revenue:
aPARTNERSHIP/S-CORP 		    14 5,391  
bFEDERAL TAX REFUND     14 761  
c
d
e
12 Subtotal. Add columns (b), (d), and (e) ..   1,440,268  
13Total. Add line 12, columns (b), (d), and (e)..................
13
1,440,268
(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:
FORD S N & ADA FUND PFDN
EIN:
34-0842282
Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
TAX PREPARATION FEE (NON-ALLOC 1,050     1,050

TY 2023 InvestmentsOtherSchedule2
Name:
FORD S N & ADA FUND PFDN
EIN:
34-0842282
Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
00206R102 AT&T INC AT COST 17,348 11,293
023135106 AMAZON COM INC AT COST 2,691 106,358
03027X100 AMERICAN TOWER CORP      
03076C106 AMERIPRISE FINANCIAL      
060505104 BANK OF AMERICA CORP AT COST 108,593 137,205
09857L108 BOOKING HOLDINGS INC      
125896100 CMS ENERGY CORP      
20030N101 COMCAST CORP AT COST 43,978 48,235
20825C104 CONOCOPHILLIPS      
22160K105 COSTCO WHOLESALE COR AT COST 27,827 181,522
235851102 DANAHER CORP DEL      
254687106 WALT DISNEY CO      
437076102 HOME DEPOT INC      
458140100 INTEL CORP      
464287465 ISHARES MSCI EAFE IN AT COST 489,871 555,330
478160104 JOHNSON & JOHNSON AT COST 28,589 82,289
57060D108 MARKETAXESS HOLDINGS      
580135101 MCDONALDS CORP      
609207105 MONDELEZ INTERNATION      
701094104 PARKER HANNIFIN CORP      
742718109 PROCTER & GAMBLE CO AT COST 41,825 113,569
74340W103 PROLOGIS INC AT COST 14,379 29,993
760759100 REPUBLIC SERVICES IN      
G29183103 EATON CORP PLC      
9983223V1 PARADIGM EQTYS I LIQ      
74456QBK1 PUBLIC SERVICE ELECT      
1941989B5 KT SMALL CAP FUND AT COST 626,487 670,320
641224415 NEUBERGER BERMAN EME      
037833100 APPLE INC      
13321L108 CAMECO CORP AT COST 39,590 172,400
72201F490 PIMCO INCOME FUND $0      
02079K305 ALPHABET INC AT COST 11,487 181,597
83369FQ26 SOCIETE GENERALE      
98419M100 XYLEM INC AT COST 16,655 25,731
38148LAE6 GOLDMAN SACHS GROUP      
665859104 NORTHERN TR CORP      
998154223 CHARITABLE INTL EQUI AT COST 1,628,617 1,580,696
91324P102 UNITEDHEALTH GROUP I AT COST 12,145 26,324
824348106 SHERWIN WILLIAMS CO      
46625H100 JP MORGAN CHASE & CO      
G1151C101 ACCENTURE PLC      
38142V845 GOLDMAN SACHS INTL E      
594918104 MICROSOFT CORP AT COST 959 122,213
31390F5R6 FANNIE MAEDTD 6/1/20 AT COST 1,885 827
058498106 BALL CORP      
998142406 CHARITABLE CORE FIXE AT COST 1,757,966 1,682,567
74144T108 T ROWE PRICE GROUP I      
46653M849 JOHCM INTERNATIONAL      
G8994E103 TRANE TECHNOLOGIES P AT COST 6,942 18,293
002824100 ABBOTT LABS AT COST 27,255 49,532
58933Y105 MERCK & CO INC      
75513E101 RAYTHEON TECHNOLOGIE      
053484101 AVALONBAY COMMUNITIE      
G5960L103 MEDTRONIC PLC      
883556102 THERMO FISHER SCIENT      
31380WD76 FANNIE MAEDTD 11/1/1 AT COST 439 109
998152330 CHARITABLE REAL ASSE AT COST 621,512 693,251
78409V104 S&P GLOBAL INC AT COST 10,840 22,026
00287Y109 ABBVIE INC      
064058100 BANK OF NEW YORK MEL AT COST 9,684 11,711
35671D857 FREEPORT-MCMORAN INC AT COST 39,474 153,252
98389B100 XCEL ENERGY INC      
464287200 ISHARES CORE S&P 500 AT COST 104,254 238,815
30161MAL7 EXELON GENERATION CO      
74006E769 PRAXIS IMPACT BOND F AT COST 925,072 905,033
46137V357 INVESCO S&P 500 EQUA AT COST 388,250 485,235
00846U101 AGILENT TECHNOLOGIES      
713448CM8 PEPSICO INCDTD 2/28/      
776696106 ROPER TECHNOLOGIES I      
57636Q104 MASTERCARD INC      
998142411 CHARITABLE ALTERNATI      
68622V106 ORGANON & CO      
65339F101 NEXTERA ENERGY INC      
74256W584 PRINCIPAL MIDCAP FUN AT COST 347,000 436,405
998142405 CHARITABLE U S EQUIT AT COST 3,673,032 3,794,924
72201U638 PIMCO MORTAGE OPP &      
169656105 CHIPOTLE MEXICAN GRI      
998418100 PROTEUS SPC-1825 CAP AT COST 1,380,000 1,446,470

TY 2023 OtherDecreasesSchedule
Name:
FORD S N & ADA FUND PFDN
EIN:
34-0842282
Description Amount
PY PENDING SALES ADJ 14
PY RETURN OF CAPITAL ADJ 295
COST BASIS ADJ 898


TY 2023 OtherExpensesSchedule
Name:
FORD S N & ADA FUND PFDN
EIN:
34-0842282
Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
STATE FILING/TAXES PAID 800 0   800
INVESTMENT EXPENSES-DIVIDEND I 3 3   0
FROM PARTNERSHIP/S-CORP 4,876 4,876   0


TY 2023 OtherIncomeSchedule2
Name:
FORD S N & ADA FUND PFDN
EIN:
34-0842282
Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
FEDERAL TAX REFUND 761 0  
FROM PARTNERSHIP/S-CORP 5,391 5,391  


TY 2023 OtherIncreasesSchedule
Name:
FORD S N & ADA FUND PFDN
EIN:
34-0842282
Description Amount
PARTNERSHIP ADJ 94,309


TY 2023 TaxesSchedule
Name:
FORD S N & ADA FUND PFDN
EIN:
34-0842282
Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
FOREIGN TAXES 1,104 1,104   0
FEDERAL TAX PAYMENT - PRIOR YE 513 0   0
FEDERAL ESTIMATES - PRINCIPAL 19,076 0   0