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
Theda and Tamblin Clark Smith Family
foundation Inc
% Foundation Source
Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 372
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
NEENAH, WI54957
A Employer identification number

39-6125329
B Telephone number (see instructions)

(303) 419-4714
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$56,092,538J 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) 0
2 Check right arrow.............
3 Interest on savings and temporary cash investments 126,103 126,103  
4 Dividends and interest from securities... 1,136,129 1,136,129  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 1,331,564
b Gross sales price for all assets on line 6a 42,316,179
7 Capital gain net income (from Part IV, line 2)... 1,326,398
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule)....... Click to see attachment
List of Attached Documents:
// Content
105,755 119,088  
12 Total. Add lines 1 through 11........ 2,699,551 2,707,718  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 55,000     55,000
14 Other employee salaries and wages...... 155,729     155,729
15 Pension plans, employee benefits....... 11,722     11,722
16a Legal fees (attach schedule)......... Click to see attachment
List of Attached Documents:
// Content
717 0 0 717
b Accounting fees (attach schedule).......        
c Other professional fees (attach schedule).... Click to see attachment
List of Attached Documents:
// Content
203,690 196,190   7,500
17 Interest............... 268 268    
18 Taxes (attach schedule) (see instructions)... Click to see attachment
List of Attached Documents:
// Content
32,926 3,673    
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings....... 4,616     4,616
22 Printing and publications.......... 350     350
23 Other expenses (attach schedule)....... Click to see attachment
List of Attached Documents:
// Content
370,917 256,782   93,893
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 835,935 456,913 0 329,527
25 Contributions, gifts, grants paid....... 2,498,675 2,498,675
26 Total expenses and disbursements. Add lines 24 and 25 3,334,610 456,913 0 2,828,202
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -635,059
b Net investment income (if negative, enter -0-) 2,250,805
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......... 2,755,765 813,700 813,700
3 Accounts receivable right arrow25,368
Less: allowance for doubtful accounts right arrow     25,368 25,368
4 Pledges receivable right arrow  
Less: allowance for doubtful accounts right arrow        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) right arrow  
Less: allowance for doubtful accounts right arrow        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule) 7,148,238 Click to see attachment
List of Attached Documents:
// Content
4,280,946 		4,145,247
b Investments—corporate stock (attach schedule)....... 27,183,393 Click to see attachment
List of Attached Documents:
// Content
27,687,909 		33,512,366
c Investments—corporate bonds (attach schedule)....... 4,228,106 Click to see attachment
List of Attached Documents:
// Content
7,446,091 		7,426,087
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).......... 7,183,373 Click to see attachment
List of Attached Documents:
// Content
7,602,470 		10,169,770
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) 48,498,875 47,856,484 56,092,538
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) 7,332  
23 Total liabilities (add lines 17 through 22)......... 7,332 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........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds 48,491,543 47,856,484
29 Total net assets or fund balances (see instructions)..... 48,491,543 47,856,484
30 Total liabilities and net assets/fund balances (see instructions). 48,498,875 47,856,484
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
48,491,543
2
Enter amount from Part I, line 27a .....................
2
-635,059
3
Other increases not included in line 2 (itemize) right arrow
3
 
4
Add lines 1, 2, and 3 ..........................
4
47,856,484
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
47,856,484
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 Publicly-traded Securities      
b Passthrough K1 Capital Gain/(Loss)      
c GEMSSTOCK CAV OFFSHORE, LP P 2022-09-02 2023-06-02
d MILLENIUM INTERNATIONAL HEDGEFOCUS FUND LTD P 2023-01-03 2023-08-14
e NORTH ROCK FUND, LTD P 2022-11-28 2023-08-01
(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 39,483,502   38,147,769 1,335,733
b       157,988
c 1,258,350   1,500,000 -241,650
d 1,060,379   1,000,000 60,379
e 513,948   500,000 13,948
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       1,335,733
b        
c       -241,650
d       60,379
e       13,948
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 1,326,398
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 31,286
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2  
3 Add lines 1 and 2........................... 3 31,286
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 31,286
6 Credits/Payments:
a 2023 estimated tax payments and 2022 overpayment credited to 2023 6a 20,957
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 16,700
d Backup withholding erroneously withheld .......... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 37,657
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
8 149
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 6,222
11 Enter the amount of line 10 to be: Credited to 2024 estimated taxright arrow6,222 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
Yes
 
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
Yes
 
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 arrowWI
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 arrowFoundation Source Telephone no.right arrow (800) 839-1754

Located atright arrow55 WALLS DRIVE FL 3FairfieldCT ZIP+4right arrow06824
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
David W Radford Dir, Sec
3.0 		11,000 0 0
PO BOX 372
NEENAH,WI54957
Carlton Smith Dir, Pres
3.0 		11,000 0 0
PO BOX 372
NEENAH,WI54957
Oliver Pierce Smith Dir, Treas
3.0 		11,000 0 0
PO BOX 372
NEENAH,WI54957
Kristina M Vaccaro Dir
3.0 		11,000 0 0
PO BOX 372
NEENAH,WI54957
Marc B Vaccaro Dir, chair
3.0 		11,000 0 0
PO BOX 372
NEENAH,WI54957
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
JOY RADFORD EXECUTIVE DIRECTOR
40.0 		153,229    
PO BOX 372
NEENAH,WI54957
Total number of other employees paid over $50,000...................right arrow  
Form 990-PF (2023)
Form 990-PF (2023)
Page 7
Part VII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors (continued)
3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
BNY Mellon Bank Investment Mgmt 86,018
200 park avenue 54th floor
NEW YORK,NY10166
Foundation Source Administrative 84,253
55 Walls Drive 3rd Fl
Fairfield,CT06824
Goldman Sachs Investment Mgmt 63,395
10100 santa monica blvd STE 2600
LOS ANGELES,CA90067
Total number of others receiving over $50,000 for professional services.............right arrow  
Part VIII-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
1  
2  
3  
4  
Part VIII-B
Summary of Program-Related Investments (see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
1  
2  
All other program-related investments. See instructions.
3  
Total. Add lines 1 through 3.........................right arrow  
Form 990-PF (2023)
Form 990-PF (2023)
Page 8
Part IX
Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities...................
1a
42,074,455
b
Average of monthly cash balances.......................
1b
3,240,965
c
Fair market value of all other assets (see instructions)................
1c
10,009,356
d
Total (add lines 1a, b, and c).........................
1d
55,324,776
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation) .............
1e
 
2
Acquisition indebtedness applicable to line 1 assets..................
2
0
3
Subtract line 2 from line 1d.........................
3
55,324,776
4
Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
instructions) .............................
4
829,872
5
Net value of noncharitable-use assets. Subtract line 4 from line 3. ............
5
54,494,904
6
Minimum investment return. Enter 5% (0.05) of line 5................
6
2,724,745
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
2,724,745
2a
Tax on investment income for 2022 from Part V, line 5.......
2a
31,286
b
Income tax for 2022. (This does not include the tax from Part V.) ...
2b
 
c
Add lines 2a and 2b............................
2c
31,286
3
Distributable amount before adjustments. Subtract line 2c from line 1............
3
2,693,459
4
Recoveries of amounts treated as qualifying distributions................
4
 
5
Add lines 3 and 4............................
5
2,693,459
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
2,693,459
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
2,828,202
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
2,828,202
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 2,693,459
2 Undistributed income, if any, as of the end of 2022:
a Enter amount for 2022 only.......  
b Total for prior years:20 , 20, 20  
3 Excess distributions carryover, if any, to 2022:
a From 2018......  
b From 2019......  
c From 2020......  
d From 2021......  
e From 2022...... 146,222
f Total of lines 3a through e ........ 146,222
4Qualifying distributions for 2023 from Part
XI, line 4: right arrow$ 2,828,202
a Applied to 2022, but not more than line 2a  
b Applied to undistributed income of prior years
(Election required—see instructions)..... 		 
c Treated as distributions out of corpus (Election
required—see instructions)........ 		 
d Applied to 2023 distributable amount..... 2,693,459
e Remaining amount distributed out of corpus 134,743
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 5 280,965
b Prior years’ undistributed income. Subtract
line 4b from line 2b .......... 		 
c Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed...... 		 
d Subtract line 6c from line 6b. Taxable amount
—see instructions ........... 		 
e Undistributed income for 2022. Subtract line
4a from line 2a. Taxable amount—see
instructions ............. 		 
f Undistributed income for 2023. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2024 .......... 		0
7 Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions) ....... 		 
8 Excess distributions carryover from 2018 not
applied on line 5 or line 7 (see instructions) ... 		 
9 Excess distributions carryover to 2024.
Subtract lines 7 and 8 from line 6a ...... 		280,965
10 Analysis of line 9:
a Excess from 2019....  
b Excess from 2020....  
c Excess from 2021....  
d Excess from 2022.... 146,222
e Excess from 2023.... 134,743
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.
2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here right arrow
aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
bThe form in which applications should be submitted and information and materials they should include:
cAny submission deadlines:
dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Form 990-PF (2023)
Form 990-PF (2023)
Page 11
Part XIV
Supplementary Information (continued)
3 Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
 Foundation
status of
recipient 		Purpose of grant or
contribution 		Amount
Name and address (home or business)
aPaid during the year

1000 GENERATIONS INC

PO BOX 213
ELKHORN,WI53121 		N/A PC NE Wisconsin fund 2,500

1000 GENERATIONS INC

PO BOX 213
ELKHORN,WI53121 		N/A PC General & Unrestricted 20,000

A Kaveggia

Homeless Shelter
Madison,WI53704 		NONE I Hardship Assistance Grant 6,500

ALANO SOCIETY INC

511 N CARROLL ST
MADISON,WI53703 		N/A PC General & Unrestricted 2,500

ALI FORNEY CENTER

307 W 38TH ST FL 2
NEW YORK,NY10018 		N/A PC General & Unrestricted 5,000

BIG BROTHERS BIG SISTERS OF EAST CENTRAL WISCONSIN

1331 AMERICAN DR
NEENAH,WI54956 		N/A PC General & Unrestricted 37,500

BOYS & GIRLS BRIGADE ASSOCIATION INC

109 W COLUMBIAN AVE
NEENAH,WI54956 		N/A PC General & Unrestricted 1,250

BOYS & GIRLS CLUB FOX VALLEY INC

160 S BADGER AVE
APPLETON,WI54914 		N/A PC General & Unrestricted 50,000

BOYS & GIRLS CLUBS OF ELKHART COUNTY INC

PO BOX 614
GOSHEN,IN46527 		N/A PC Refresh, Renew, Re-engage: Upping our Game to Support Teens 54,000

BOYS AND GIRLS CLUB OF DANE COUNTY INC

5215 VERONA RD
FITCHBURG,WI53711 		N/A PC General & Unrestricted 10,000

BOYS AND GIRLS CLUB OF DANE COUNTY INC

5215 VERONA RD
FITCHBURG,WI53711 		N/A PC AVID/TOPS Programs 92,000

BRIDGE PROJECT INC

515 CANAL ST 1C
NEW YORK,NY10013 		N/A PC General & Unrestricted 26,750

CASA OF THE FOX CITIES INC

1500 N CASALOMA DR STE 401
APPLETON,WI54913 		N/A PC General & Unrestricted 15,000

CHANGE IS SIMPLE INCORPORATED

100 CUMMINGS CTR STE 227Q
BEVERLY,MA01915 		N/A PC classroom support fund 8,375

CHILDRENS HOSPITAL OF WISCONSIN FOUNDATION INC

PO BOX 1997 FINANCE DEPT
MILWAUKEE,WI53201 		N/A PC Child Advocacy Center 15,000

CHRISTINE ANN DOMESTIC ABUSE SERVICES INC

206 ALGOMA BLVD
OSHKOSH,WI54901 		N/A PC General & Unrestricted 2,500

CHRISTINE ANN DOMESTIC ABUSE SERVICES INC

206 ALGOMA BLVD
OSHKOSH,WI54901 		N/A PC Next Step Capital Campaign FUND 100,000

COMING HOME PROJECT

11650 COUNTY RD 536
ROCKWALL,TX75087 		N/A PC General & Unrestricted 8,500

COMMUNITY CLOTHES CLOSET INC

1465-B OPPORTUNITY WAY
MENASHA,WI54952 		N/A PC General & Unrestricted 52,500

COMMUNITY FOR HOPE OF GREATER OSHKOSH INC

2700 W 9TH AVE STE 100
OSHKOSH,WI54904 		N/A PC General & Unrestricted 23,750

COMMUNITY FOUNDATION FOR THE FOX VALLEY REGION INC

4455 W LAWRENCE ST
APPLETON,WI54914 		N/A PC Non-profit Leadership Initiative 2,500

COMMUNITY FOUNDATION FOR THE FOX VALLEY REGION INC

4455 W LAWRENCE ST
APPLETON,WI54914 		N/A PC Non-Profit Leadership Initiative 15,000

COMPASSION INTERNATIONAL INCORPORATED

12290 VOYAGER PKWY
COLORADO SPRINGS,CO80921 		N/A PC General & Unrestricted 6,500

COTS INC

819 S W AVE
APPLETON,WI54915 		N/A PC General & Unrestricted 30,000

COTS INC

819 S W AVE
APPLETON,WI54915 		N/A PC Removing Barriers from Homelessness to Independent Living program 30,000

CROSSROADS AT BIG CREEK INC

2041 MICHIGAN ST
STURGEON BAY,WI54235 		N/A PC General & Unrestricted 1,250

D Davidson

3158 Vista Grande
Carlsbad,CA92009 		NONE I Hardship Assistance Grant 6,500

D O'Conner

183 Spruce Street
Eastsound,WA98245 		NONE I Hardship Assistance Grant 6,500

DEEP LIVING LAB

49 N SAN MATEO DR
SAN MATEO,CA94401 		N/A PC General & Unrestricted 2,500

ELISHA D SMITH PUBLIC LIBRARY

440 FIRST ST
MENASHA,WI54952 		N/A GOV General & Unrestricted 2,500

EXCEPTIONAL EQUESTRIANS COMPANY

1130 ORLANDO DR
DE PERE,WI54115 		N/A PC General & Unrestricted 30,000

FATHER CARRS PL 2B

1062 N KOELLER ST
OSHKOSH,WI54902 		N/A PC General & Unrestricted 1,000

FIRST AID ARTS

PO BOX 31325
SEATTLE,WA98103 		N/A PC General & Unrestricted 84,500

FOX CITIES PERFORMING ARTS CENTER INC

400 W COLLEGE AVE
APPLETON,WI54911 		N/A PC General & Unrestricted 5,000

FOX VALLEY LUTHERAN HIGH SCHOOL FEDERATION INC

5300 N MEADE ST
APPLETON,WI54913 		N/A PC Help Families in Need: Tuition Assistance FUND 20,000

FOX VALLEY SYMPHONY ORCHESTRA ASSOCIATION INC

54 PARK PL STE 200
APPLETON,WI54914 		N/A PC Fox Valley Symphony Orchestra Beers, Brats and Beethoven FUND 5,000

FRIENDS OF MORAN STATE PARK

PO BOX 1961
EASTSOUND,WA98245 		N/A PC General & Unrestricted 2,500

FRIENDS OF PLUM & PILOT ISLANDS INC

PO BOX 61
WASHINGTON IS,WI54246 		N/A PC General & Unrestricted 5,000

FRIENDS OF THE NEENAH PUBLIC LIBRARY

PO BOX 569
NEENAH,WI54957 		N/A PC General & Unrestricted 2,500

FUTURE NEENAH INC

135 W WISCONSIN AVE
NEENAH,WI54956 		N/A PC General & Unrestricted 1,250

FUTURE STARS THEATRE COMPANY

1130 JONATHON LN
NEENAH,WI54956 		N/A PC General & Unrestricted 3,000

GIFT OF ADOPTION FUND INC

1200 SHERMER RD STE 111
NORTHBROOK,IL60062 		N/A PC Adoption Assistance FUND - Forever Families in Wisconsin 25,000

GLOUCESTER EDUCATION FOUNDATION INC

185 MAIN ST
GLOUCESTER,MA01930 		N/A PC Gloucester public schools PROGRAMS 8,375

GORDON BUBOLZ NATURE PRESERVE INC

4815 N LYNNDALE DR
APPLETON,WI54913 		N/A PC General & Unrestricted 1,250

GREEN BAY BOTANICAL GARDEN INC

2600 LARSEN RD
GREEN BAY,WI54303 		N/A PC General & Unrestricted 1,250

GROTON SCHOOL

282 FARMERS ROW
GROTON,MA01450 		N/A PC General & Unrestricted 7,500

HABITAT FOR HUMANITY INTERNATIONAL INC

921 MIDWAY RD
MENASHA,WI54952 		N/A PC Rock the Block PROGRAM 70,000

HABITAT FOR HUMANITY OF OSHKOSH INC

2559 BADGER AVE
OSHKOSH,WI54904 		N/A PC Rock the Block Oshkosh PROGRAM 30,000

HABITAT FOR HUMANITY OF OSHKOSH INC

2559 BADGER AVE
OSHKOSH,WI54904 		N/A PC Charitable Event 5,000

HEADSUP FOX CITIES CORP

PO BOX 41
GREENVILLE,WI54942 		N/A PC General & Unrestricted 10,000

HEALING ABUSE WORKING FOR CHANGE INC

27 CONGRESS ST
SALEM,MA01970 		N/A PC the Gloucester Office of HAWC - Healing Abuse Working for Change 8,375

HEALING ARTS CENTER

PO BOX 304
EASTSOUND,WA98245 		N/A PC General & Unrestricted 1,250

HECKRODT WETLAND RESERVE INC

1305 PLANK RD
MENASHA,WI54952 		N/A PC General & Unrestricted 5,500

HECKRODT WETLAND RESERVE INC

1305 PLANK RD
MENASHA,WI54952 		N/A PC General Support/Underserved Population Programming 25,000

HIMALAYAN INTERNATIONAL INSTITUTE OF YOGA SCI & PH

952 BETHANY TPKE
HONESDALE,PA18431 		N/A PC Cameroon Youth Literacy and Library Program 60,000

HIMALAYAN INTERNATIONAL INSTITUTE OF YOGA SCI & PH

952 BETHANY TPKE
HONESDALE,PA18431 		N/A PC General & Unrestricted 2,500

HOPE CLINIC AND CARE CENTER INC

1814 APPLETON RD
MENASHA,WI54952 		N/A PC Children Thrive FUND 20,000

HOPE CLINIC AND CARE CENTER INC

1814 APPLETON RD
MENASHA,WI54952 		N/A PC General & Unrestricted 2,500

INLAND COUNTIES LEGAL SERVICES INC

1040 IOWA AVE STE 106
RIVERSIDE,CA92507 		N/A PC General & Unrestricted 15,000

INTERNATIONAL BIRD RESCUE

4369 CORDELIA RD
FAIRFIELD,CA94534 		N/A PC General & Unrestricted 1,500

J Crowder

382 N Wilson Street
Kimberly,WI54136 		NONE I Hardship Assistance Grant 6,500

K Watford

10210 US HWY 14
Mazomanie,WI53560 		NONE I Hardship Assistance Grant 6,500

LEAVEN INC

1475 OPPORTUNITY WAY
MENASHA,WI54952 		N/A PC General & Unrestricted 2,500

LEAVEN INC

1475 OPPORTUNITY WAY
MENASHA,WI54952 		N/A PC LEAVEN Eat Drink Sing Fundraiser 2,000

LEAVEN INC

1475 OPPORTUNITY WAY
MENASHA,WI54952 		N/A PC Needy Children's Fund 40,000

LEAVEN INC

1475 OPPORTUNITY WAY
MENASHA,WI54952 		N/A PC Charitable Event 750

LIFE ELEMENTAL INCORPORATED

47726 ASPEN RD
SOLDIER GROVE,WI54655 		N/A PC General & Unrestricted 32,500

LIFECAMPUSA INC

PO BOX 180382
DELAFIELD,WI53018 		N/A PC General & Unrestricted 5,000

LIGHTHOUSE YOUTH CENTER INC

5641 N 68TH ST
MILWAUKEE,WI53218 		N/A PC General & Unrestricted 5,000

MADISON ICE INC

725 FORWARD DR
MADISON,WI53711 		N/A PC Skating & Hockey Programs for Underprivileged Youth and Disabled Youth 13,000

MADTOWN BMX INC

PO BOX 557
DEFOREST,WI53532 		N/A PC fund to support Building a Strider track 6,000

MARTHAS VINEYARD BOYS AND GIRLS CLUB INCORPORATED

PO BOX 654
EDGARTOWN,MA02539 		N/A PC General & Unrestricted 51,750

MCMSA FOUNDATION

5335 FAR HILLS AVE STE 217
DAYTON,OH45429 		N/A PC General & Unrestricted 2,500

MERCY IN DEED

608 E FOREST AVE
NEENAH,WI54956 		N/A PC General & Unrestricted 5,000

MOZAYIK

1934 MELROSE ST
MADISON,WI53704 		N/A PC General & Unrestricted 80,000

MOZAYIK

1934 MELROSE ST
MADISON,WI53704 		N/A PC General & Unrestricted 17,500

NEIGHBORHOOD HOUSING SERVICES OF GREEN BAY INC

437 S JACKSON ST
GREEN BAY,WI54301 		N/A PC Thriving Neighbors, Thriving Kids 10,000

NORTHERN SKY THEATER INC

9058 COUNTY RD A
FISH CREEK,WI54212 		N/A PC General & Unrestricted 5,000

NOVA COUNSELING SERVICES INC

3240 JACKSON ST
OSHKOSH,WI54901 		N/A PC General & Unrestricted 41,250

OHIO SUICIDE PREVENTION FOUNDATION

175 S 3RD ST STE 700
COLUMBUS,OH43215 		N/A PC General & Unrestricted 5,000

OPAL COMMUNITY LAND TRUST

PO BOX 1133
EASTSOUND,WA98245 		N/A PC General & Unrestricted 7,500

ORCAS FAMILY CONNECTIONS

374 N BEACH RD
EASTSOUND,WA98245 		N/A PC General & Unrestricted 25,000

ORCAS ISLAND COMMUNITY FOUNDATION

PO BOX 1496
EASTSOUND,WA98245 		N/A PC Cornerstone and Partners in Philanthropy 10,000

OSHKOSH AREA COMMUNITY PANTRY INC

2551 JACKSON ST
OSHKOSH,WI54901 		N/A PC General & Unrestricted 5,000

PAINE ART CENTER & GARDENS INC

1410 ALGOMA BLVD
OSHKOSH,WI54901 		N/A PC General & Unrestricted 19,000

PAINE ART CENTER & GARDENS INC

1410 ALGOMA BLVD
OSHKOSH,WI54901 		N/A PC Historic Preservation/Capital Maintenance Plan 50,000

PATHWAYS TO CITIZENSHIP

120 STEVENS AVE
SOLANA BEACH,CA92075 		N/A PC General & Unrestricted 2,500

PERUVIAN HEARTS

24918 GENESEE TRAIL RD
GOLDEN,CO80401 		N/A PC The Theda and Tamblin Clark Smith International Scholars Program within Peruvian Hearts 36,000

PILLARS INC

605 E HANCOCK ST
APPLETON,WI54911 		N/A PC General & Unrestricted 42,500

PLAYING FIELD INC

3910 MINERAL POINT RD
MADISON,WI53705 		N/A PC The World We Imagine Campaign 40,000

PREVENTION ACTION ALLIANCE

6171 HUNTLEY RD STE G
COLUMBUS,OH43229 		N/A PC General & Unrestricted 5,000

PROVIDENCE MINISTRIES INC

3435 SHAWANO AVE
GREEN BAY,WI54313 		N/A PC Financial aid fund for students 5,000

REACH COUNSELING SERVICES INC

1509 S COMMERCIAL ST
NEENAH,WI54956 		N/A PC Therapy Program for Survivors of Sexual Violence 20,000

RIDGES SANCTUARY INC

8166 HWY 57
BAILEYS HARBOR,WI54202 		N/A PC General & Unrestricted 1,250

RIVERVIEW GARDENS INC

1101 S ONEIDA ST
APPLETON,WI54915 		N/A PC ServiceWorks - For Workplace Development and Food Security 20,000

RIVERVIEW GARDENS INC

1101 S ONEIDA ST
APPLETON,WI54915 		N/A PC General & Unrestricted 6,000

ROCKY NECK ART COLONY INC

6 WONSON ST
GLOUCESTER,MA01930 		N/A PC workshop fund and art education of all ages 8,375

ROOM TO GROW NATIONAL INC

424 E 147TH ST FL 5
BRONX,NY10455 		N/A PC General Support of Room to Grow (RtG) 80,000

SAFE COMMUNITY COALITION OF MADISON AND DANE COUNT

2352 S PARK ST STE 302
MADISON,WI53713 		N/A PC General & Unrestricted 75,000

SAMUEL AND ALTHEA STROUM JEWISH COMMUNITY CENTER O

3801 E MERCER WAY
MERCER ISLAND,WA98040 		N/A PC General & Unrestricted 5,175

SAN JUAN PRESERVATION TRUST

468 ARGYLE AVE STE B
FRIDAY HARBOR,WA98250 		N/A PC General & Unrestricted 1,250

SOLUTIONS RECOVERY INC

621 EVANS ST
OSHKOSH,WI54901 		N/A PC General Operations 25,000

SOLUTIONS RECOVERY INC

621 EVANS ST
OSHKOSH,WI54901 		N/A PC General & Unrestricted 5,000

SOUTHERN WISCONSIN BIRD ALLIANCE INC

211 S PATERSON ST STE 340
MADISON,WI53703 		N/A PC Empowering Kids through Nature Discovery! The Madison Audubon Education Program 10,000

ST JOSEPH FOOD PROGRAM INC

1465A OPPORTUNITY WAY
MENASHA,WI54952 		N/A PC General & Unrestricted 2,500

ST JOSEPH FOOD PROGRAM INC

1465A OPPORTUNITY WAY
MENASHA,WI54952 		N/A PC Backpack Food Assistance Program 30,000

ST MARY CENTRAL HIGH SCHOOL

1050 ZEPHYR DR
NEENAH,WI54956 		N/A PC Tuition Assistance Support fund 15,000

SUN VALLEY COMMUNITY CENTER

1260 DECATUR ST
DENVER,CO80204 		N/A PC General & Unrestricted 30,000

THE OSHKOSH BOYS AND GIRLS CLUB

PO BOX 411
OSHKOSH,WI54903 		N/A PC General & Unrestricted 3,500

THE OSHKOSH BOYS AND GIRLS CLUB

PO BOX 411
OSHKOSH,WI54903 		N/A PC Be Great Graduate Mentoring Program 50,000

THE TANDANA FOUNDATION INC

2933 LOWER BELLBROOK RD
SPRING VALLEY,OH45370 		N/A PC Women's Literacy, Leadership, and Enterprise in Bandiagara District, Mali 25,000

THE TANDANA FOUNDATION INC

2933 LOWER BELLBROOK RD
SPRING VALLEY,OH45370 		N/A PC General & Unrestricted 5,000

THEDACARE FAMILY OF FOUNDATIONS INC

PO BOX 8025
APPLETON,WI54912 		N/A PC Neenah, WI programs 5,000

THEDACARE FAMILY OF FOUNDATIONS INC

PO BOX 8025
APPLETON,WI54912 		N/A PC "It's Our Time Now" Campaign 150,000

THREADS OF HOPE INC

8020 PLEASANT VALLEY RD
LARSEN,WI54947 		N/A PC General & Unrestricted 20,000

TRI-COUNTY COMMUNITY DENTAL CLINIC INC

9 TRI PARK WAY
APPLETON,WI54914 		N/A PC Robert Glass Focus on the Children fund 30,000

TRI-COUNTY COMMUNITY DENTAL CLINIC INC

9 TRI PARK WAY
APPLETON,WI54914 		N/A PC General & Unrestricted 2,500

UNIVERSITY OF DENVER

2201 E ASBURY AVE RM 4674
DENVER,CO80208 		N/A PC General & Unrestricted 10,000

UNIVERSITY OF WISCONSIN FOUNDATION

US BANK LOCKBOX 78807
MILWAUKEE,WI53278 		N/A PC Center for Healthy Minds 5,000

VALOR CLASSICAL CHRISTIAN ACADEMY INC

PO BOX 323
NEENAH,WI54957 		N/A PC General & Unrestricted 18,000

VILLAGE HEALTH PARTNERSHIP

1601 E 19TH AVE STE 4450
DENVER,CO80218 		N/A PC General & Unrestricted 2,000

VILLAGE OF SISTER BAY

PO BOX 769
SISTER BAY,WI54234 		N/A GOV Christmas Light Display fund 5,000

W Jung

1102 Gallagher Street
Green Bay,WI54303 		NONE I Hardship Assistance Grant 6,500

WAYLAND ACADEMY

101 N UNIVERSITY AVE
BEAVER DAM,WI53916 		N/A PC General & Unrestricted 22,000

WAYLAND ACADEMY

101 N UNIVERSITY AVE
BEAVER DAM,WI53916 		N/A PC Carla Radford Scholarship Fund and Karlie A. Fund 1,000

WEGERZYN GARDENS FOUNDATION

1301 E SIEBENTHALER AVE
DAYTON,OH45414 		N/A PC New Building Fund 20,000

WHEELCHAIRS FOR NIGERIA

1542 PALM AVE SW
SEATTLE,WA98116 		N/A PC General & Unrestricted 2,500

WINNEBAGO AREA LITERACY COUNCIL

106 WASHINGTON AVE
OSHKOSH,WI54901 		N/A PC General & Unrestricted 45,500

WISCONSIN INDEPENDENT CHRISTIAN SCHOOLS INC

3450 VINLAND ST
OSHKOSH,WI54901 		N/A PC General & Unrestricted 5,000

WISCONSIN INDEPENDENT CHRISTIAN SCHOOLS INC

3450 VINLAND ST
OSHKOSH,WI54901 		N/A PC Academic Assistance FUND for Those Who Struggle Most 20,000

WISCONSIN LAW ENFORCEMENT DEATH RESPONSE -LEDR- TE

4519 FIELD AVE
MCFARLAND,WI53558 		N/A PC General & Unrestricted 7,000

WOMENS FUND FOR THE FOX VALLEY REGION INC

4455 W LAWRENCE ST
APPLETON,WI54914 		N/A SO I Charitable Event 750

YOUTH GO INC

213 NICOLET BLVD
NEENAH,WI54956 		N/A PC General & Unrestricted 20,000

YWCA MADISON INC

101 E MIFFLIN ST STE 100
MADISON,WI53703 		N/A PC General & Unrestricted 1,000
Total .................................right arrow 3a 2,498,675
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 ........... 		    14 126,103  
4 Dividends and interest from securities ....     14 1,136,129  
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 ............ 		525990 4,726 18 1,326,838  
9 Net income or (loss) from special events:          
10 Gross profit or (loss) from sales of inventory          
11 Other revenue:
aK-1 Inc/Loss 		525990 -13,585 14 118,416  
bFederal Tax Refund     01 36  
cCLASS ACTION LAWSUIT PROCEEDS     01 719  
dROYALTY INCOME     01 169  
e
12 Subtotal. Add columns (b), (d), and (e) .. -8,859 2,708,410  
13Total. Add line 12, columns (b), (d), and (e)..................
13
2,699,551
(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


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Software Version:  


Form 990PF - Special Condition Description:
Special Condition Description

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TY 2023 DepreciationSchedule
Name:
Theda and Tamblin Clark Smith Family
 
foundation Inc
EIN:
39-6125329
Description of Property Date Acquired Cost or Other Basis Prior Years' Depreciation Computation Method Rate /
Life (# of years)		 Current Year's Depreciation Expense Net Investment Income Adjusted Net Income Cost of Goods Sold Not Included

TY 2023 GeneralExplanationAttachment
Name:
Theda and Tamblin Clark Smith Family
 
foundation Inc
EIN:
39-6125329
Identifier Return Reference Explanation
PART I LINE 6A PART I LINE 6A (990-PF) RECONCILIATION OF NET GAIN/(LOSS) FROM SALES OF ASSETS NOT INCLUDED IN PART IV TOTAL INCLUDED IN PART IV: (DETAILS BELOW) NET GAIN/(LOSS): $1,326,838 TOTAL NOT INCLUDED IN PART IV: PASSTHROUGH K-1 CAPITAL GAIN/(LOSS) - UBI NET GAIN/(LOSS): $4,726 TOTAL PART I, LINE 6A: $1,331,564 DETAILS OF ASSETS INCLUDED IN PART IV: PUBLICLY-TRAIDED SECURITIES GROSS SALES PRICE: $39,483,502 BOOK BASIS: $38,147,329 NET GAIN/(LOSS): $1,336,173 PASSTHROUGH K-1 CAPITAL GAIN/(LOSS) - NON UBI NET GAIN/(LOSS): $157,988 GEMSSTOCK CAV OFFSHORE, LP GROSS SALES PRICE: $1,258,350 BOOK BASIS: $1,500,000 NET GAIN/(LOSS): $(241,650) MILLENIUM INTERNATIONAL HEDGEFOCUS FUND GROSS SALES PRICE: $1,060,379 BOOK BASIS: $1,000,000 NET GAIN/(LOSS): $60,379 NORTH ROCK FUND, LTD GROSS SALES PRICE: $513,948 BOOK BASIS: $500,000 NET GAIN/(LOSS): $13,948

TY 2023 InvestmentsCorpBondsSchedule
Name:
Theda and Tamblin Clark Smith Family
 
foundation Inc
EIN:
39-6125329
Name of Bond End of Year Book Value End of Year Fair Market Value
ABBVIE INC - 3.200% - 11/21/20 97,028 88,915
ABBVIE INC - 4.500% - 05/14/20 66,424 68,619
ADOBE SYSTEMS INC - 3.250% - 0 44,087 44,217
AIR PRODUCTS AND CHEMICALS INC 245,026 246,278
ALEXANDRIA REAL ESTATE E BOND 41,985 39,373
ALEXANDRIA REAL ESTATE EQ - 4. 61,006 63,184
AMAZON COM - 4.800% - 12/05/20 74,474 75,486
AMAZON INC - 1.650% - 05/12/20 101,369 94,600
AMERICAN WTR CAPE CORP - 2.800 154,567 156,820
AON CORP - 2.800% - 05/15/2030 135,462 137,684
APPLE - 3.000% - 11/01/2027 244,565 244,952
AT&T INC - 4.500% - 05/15/2035 107,716 111,054
BANK AMERICA CORP - 0.976% - 0 129,014 132,842
BANK OF AMERICA - 3.950% - 04/ 118,549 118,010
BANK OF MONTREAL - 0.949% - 01 246,099 251,769
BERKSHIRE HATHAWAY - 1.850% - 162,383 164,672
BLACKROCK INC - 2.400% - 04/30 96,215 98,393
BNY MELLONC ORP SER J - 4.410% 243,211 244,423
BOEING CO - 2.750% - 02/01/202 99,325 100,520
BP CAP MKTS - 2.721% - 01/12/2 149,539 144,036
BROADCOM INC - 3.500% - 01/15/ 82,510 76,764
CARRIER GLOBAL CORP - 2.242% - 42,006 42,644
CHUBB INA HOLDINGS INC - 1.375 61,437 63,442
CITIGROUP BOND - 4.450% - 09/2 95,576 92,786
CITIGROUP INC NOTE CALL MAKE W 90,663 92,259
COMCAST CORP - 4.400% - 08/15/ 60,771 61,847
COMCAST CORP NEW NOTE - 5.350% 55,604 56,892
COSTCO - 1.600% - 04/20/2030 80,306 72,920
DOW CHEMICAL CO SER B - 4.800% 108,615 109,113
DOWDUPONT INC - 4.725% - 11/15 61,247 61,935
EBAY INC - 1.900% - 03/11/2025 86,012 81,699
EOG RES INC - 3.900% - 04/01/2 136,175 138,368
FISERV INC - 4.200% - 10/01/20 54,370 54,763
FISERV INC NOTE CALL MAKE WHOL 93,908 84,750
FORTIVE CORP SER B NOTE - 3.15 61,121 61,281
GILEAD SCIENCES - 4.600% - 09/ 128,638 131,700
HOME DEPOT - 1.375% - 03/15/20 60,843 53,192
INGERSOLL-RAND INC - 3.550% - 138,883 139,586
INTERCONTINENTAL EXCHANGE INC 60,623 62,321
JPMORGAN CHASE - 4.565% - 06/1 80,029 78,368
JPMORGAN CHASE NOTE CALL - 1.5 165,759 169,450
KLA CORP - 4.650% - 07/15/2032 55,341 56,288
KRAFT HEINZ FOOD - 5.000% - 07 108,936 110,817
KROGER CO - 1.700% - 01/15/203 69,888 60,719
L3HARRIS TECHNOLOGIES INC - 3. 138,087 138,484
LAM RESEARCH - 4.000% - 03/15/ 70,111 69,114
MICROSOFT CORP - 4.200% - 11/0 135,111 135,669
MITSUBISHI - 1.640% - 10/13/20 184,350 188,543
MORGAN STANLEY MTN - 1.164% - 160,172 164,585
MORGAN STANLEY SER I MTN CALL 93,592 87,569
NORTHERN TR CORP NOTE - 3.150% 232,038 234,712
ORACLE CORP - 3.900% - 05/15/2 79,579 67,027
ORACLE CORP NOTE CALL MAKE WHO 54,974 51,330
OTIS WORLDWIDE SER B - 2.056% 61,823 62,491
PHILIP MORRIS INTERNATIONAL IN 134,259 135,516
PROLOGIS LP - 2.250% - 04/15/2 60,599 62,154
PRUDENTIAL FINL INC S BOOK SER 61,456 63,178
ROPER TECHNOLOGIES INC - 2.350 134,009 135,576
SANTANDER UK GROUP HOLDINGS NO 182,501 190,065
SHERWIN-WILLIAMS CO - 3.450% - 135,742 137,143
SIMON PPTY GROUP LP NT - 2.650 47,557 42,782
SOUTHERN CO GAS CAP - 5.150% - 60,977 61,966
T MOBILE - 3.875% - 04/15/2030 73,693 66,437
T MOBILE USA INC - 3.500% - 04 73,124 74,911
TOTAL SYSTEMS SERVICES - 4.800 66,914 64,448
TOYOTA - 1.800% - 02/13/2025 78,427 77,386
UNION PAC CORP - 2.375% - 05/0 81,182 82,714
UNION PACIFIC - 3.150% - 03/01 39,979 39,820
UNITEDHEALTH GROUP INC - 1.150 58,723 55,567
US BANCORP MTN - 4.548% - 07/2 68,924 70,989
XCEL ENERGY INC - 3.400% - 06/ 220,883 226,160

TY 2023 InvestmentsCorpStockSchedule
Name:
Theda and Tamblin Clark Smith Family
 
foundation Inc
EIN:
39-6125329
Name of Stock End of Year Book Value End of Year Fair Market Value
BLACKROCK INDEX FDS INTL FD K 2,226,432 2,281,349
EATON VANCE INCOME FD OF BOSTO 1,964,697 2,031,520
FEDERATED INSTI HIGH YIELD BD 1,950,197 2,043,928
GOLDMAN SACHS TACTICAL TILT OV 2,284,875 2,248,421
ISHARES S&P 500 INDEX FUND CL 9,927,364 11,389,412
MULTI MANAGER U.S. SMALL CAP E 1,761,721 1,983,584
MULTI-MANAGER INTERNATIONAL EQ 2,191,970 2,290,687
STATE STREET EMERGING MARKETS 628,881 644,240
VANGUARD TOTAL STOCK MARKET ET 4,751,772 8,599,225

TY 2023 InvestmentsGovtObligationsSch
Name:
Theda and Tamblin Clark Smith Family
 
foundation Inc
EIN:
39-6125329
US Government Securities - End of Year Book Value:

4,280,946
US Government Securities - End of Year Fair Market Value:

4,145,247
State & Local Government Securities - End of Year Book Value:


 
State & Local Government Securities - End of Year Fair Market Value:


 


TY 2023 InvestmentsOtherSchedule2
Name:
Theda and Tamblin Clark Smith Family
 
foundation Inc
EIN:
39-6125329
Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
ALISO CANYON LP   1,636 188
APTITUDE PARTNERS LTD   1,000,000 1,011,624
CONCORD LODGING LTD   9,695 3,397
FUGIO FUND XI PE LP   1,725,134 2,508,754
FUGIO FUND XII PE LP   450,061 518,820
FUGIO FUND XII VC LP   219,124 233,289
FUGIO PRIVATE EQUITY FUND VIII   474,682 1,393,419
FUGIO PRIVATE EQUITY FUND X, L   1,635,104 2,409,081
ICAPITAL-ARES PCS II ACCESS FU   1,087,034 1,094,959
PRINCETON FUND LTD   1,000,000 996,239

TY 2023 LegalFeesSchedule
Name:
Theda and Tamblin Clark Smith Family
 
foundation Inc
EIN:
39-6125329
Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
General Consultations 717     717


TY 2023 OtherExpensesSchedule
Name:
Theda and Tamblin Clark Smith Family
 
foundation Inc
EIN:
39-6125329
Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
Administrative Fees 84,253     84,253
Bank Charges 681 681    
Digital Subscriptions 651     651
Foundation Dues & Memberships 2,500     2,500
Indemnification Insurance 5,148     5,148
K-1 Exp FUGIO FUND XI PE LP 80,917 73,472    
K-1 Exp FUGIO FUND XII PE LP 44,488 43,491    
K-1 Exp FUGIO FUND XII VC LP 20,696 20,696    
K-1 EXP FUGIO PRIVATE EQ VIII 35,653 25,715    
K-1 EXP FUGIO PRIVATE EQ X 61,291 60,047    
K-1 Exp ICAPITAL-ARES PCS II A 33,254 32,636    
ANNUAL REGISTRATION FEES 44 44    
Office Supplies 848     848
Postage/Delivery Service 307     307
Website Hosting/Support 186     186


TY 2023 OtherIncomeSchedule2
Name:
Theda and Tamblin Clark Smith Family
 
foundation Inc
EIN:
39-6125329
Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
K-1 Inc/Loss ALISO CANYON LP 1,038 1,038  
K-1 Inc/Loss CONCORD LODGING LTD 758 758  
K-1 Inc/Loss FUGIO FUND XI PE LP -15,754 11,609  
K-1 Inc/Loss FUGIO FUND XII PE LP 1,671 6,835  
K-1 Inc/Loss FUGIO FUND XII VC LP 1,060 1,060  
K-1 Inc/Loss FUGIO PRIVATE EQ FUND VIII, LP 15,775 3,762  
K-1 Inc/Loss FUGIO PRIVATE EQ FUND X, LP 8,097 3,809  
K-1 Inc/Loss ICAPITAL-ARES PCS II ACCESS FUND, L. 92,186 89,329  
Class Action Lawsuit Proceeds 719 719  
Federal Tax Refund 36    
royalty income 169 169  


TY 2023 OtherProfessionalFeesSchedule
Name:
Theda and Tamblin Clark Smith Family
 
foundation Inc
EIN:
39-6125329
Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
Investment Management Services 196,190 196,190    
PAYROLL CONSULTING SERVICES 7,500     7,500


TY 2023 TaxesSchedule
Name:
Theda and Tamblin Clark Smith Family
 
foundation Inc
EIN:
39-6125329
Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
990-PF Estimated Tax for 2023 10,900      
990-PF Extension for 2022 11,600      
990-T Extension for 2022 300      
990-T Income Tax for 2022 4,746      
Foreign Tax Paid 3,673 3,673    
STATE INCOME TAX 2022 1,707