Instrumentl eFile Render
Object ID: 202022819349100922 - Rendered 2024-05-04
TIN: 87-0649164
Form
990-PF
Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
Do not enter social security numbers on this form as it may be made public.
Go to
www.irs.gov/Form990PF
for instructions and the latest information.
OMB No. 1545-0052
20
19
Open to Public Inspection
For calendar year 2019, or tax year beginning
01-01-2019
, and ending
12-31-2019
Name of foundation
The Ray and Tye Noorda Foundation
% CAROLE DUMAS
Number and street (or P.O. box number if mail is not delivered to street address)
333 South 520 West Suite 101
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Lindon
,
UT
84042
A Employer identification number
87-0649164
B
Telephone number (see instructions)
(801) 225-6731
C
If exemption application is pending, check here
G
Check all that apply:
Initial return
Initial return of a former public charity
Final return
Amended return
Address change
Name change
D 1.
Foreign organizations, check here.............
2
. Foreign organizations meeting the 85%
test, check here and attach computation ...
E
If private foundation status was terminated
under section 507(b)(1)(A), check here .......
H
Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here .......
I
Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)
$
235,302,612
J
Accounting method:
Cash
Accrual
Other (specify)
(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)
1
Contributions, gifts, grants, etc., received (attach schedule)
150,000
2
Check
.............
3
Interest on savings and temporary cash investments
3,071
3,071
4
Dividends and interest from securities
...
7,053,148
7,053,148
5a
Gross rents
............
2,329
2,329
b
Net rental income or (loss)
2,329
6a
Net gain or (loss) from sale of assets not on line 10
14,364,523
b
Gross sales price for all assets on line 6a
229,129,019
7
Capital gain net income (from Part IV, line 2)
...
14,364,523
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)
.......
-1,311,140
-1,282,204
12
Total.
Add lines 1 through 11
........
20,261,931
20,140,867
13
Compensation of officers, directors, trustees, etc.
0
14
Other employee salaries and wages
......
212,041
106,020
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
83,004
41,502
0
0
b
Accounting fees (attach schedule)
.......
17,225
8,613
0
8,613
c
Other professional fees (attach schedule)
....
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
239,753
96,590
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
4,555
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
1,368,121
1,313,052
83,462
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
1,924,699
1,565,777
0
92,075
25
Contributions, gifts, grants paid
.......
33,772,064
33,772,064
26
Total expenses and disbursements.
Add lines 24 and 25
35,696,763
1,565,777
0
33,864,139
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-15,434,832
b
Net investment income
(if negative, enter -0-)
18,575,090
c
Adjusted net income
(if negative, enter -0-)
...
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2019)
Form 990-PF (2019)
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
1
Cash—non-interest-bearing
.............
14,394,784
57,864,128
57,864,128
2
Savings and temporary cash investments
.........
3
Accounts receivable
100,000
Less: allowance for doubtful accounts
13,622
100,000
100,000
4
Pledges receivable
Less: allowance for doubtful accounts
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)
Less: allowance for doubtful accounts
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)
.......
99,968,899
69,033,751
82,217,146
c
Investments—corporate bonds (attach schedule)
.......
107,974,400
78,287,141
83,756,284
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
5,627,044
5,904,168
11,365,054
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
227,978,749
211,189,188
235,302,612
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
)
23
Total liabilities
(add lines 17 through 22)
.........
0
0
Foundations that follow FASB ASC 958, check here
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
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
227,978,749
211,189,188
29
Total net assets or fund balances
(see instructions)
.....
227,978,749
211,189,188
30
Total liabilities and net assets/fund balances
(see instructions)
.
227,978,749
211,189,188
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
227,978,749
2
Enter amount from Part I, line 27a
.....................
2
-15,434,832
3
Other increases not included in line 2 (itemize)
3
4
Add lines 1, 2, and 3
..........................
4
212,543,917
5
Decreases not included in line 2 (itemize)
5
1,354,729
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
211,189,188
Form
990-PF
(2019)
Form 990-PF (2019)
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
US BANK STCG - ATTACHMENT A
b
US BANK LTCG - ATTACHMENT A
c
US BANK NON-DIV DISTRIBUTIONS
d
MERRILL LYNCH*4122 STCG - ATTACHMENT B
e
MERRILL LYNCH*4122 LTCG - ATTACHMENT B
MERRILL LYNCH-4123 STCG - ATTACHMENT C
MERRILL LYNCH-4123 LTCG - ATTACHMENT C
MERRILL LYNCH-4124 STCG - ATTACHMENT D
MERRILL LYNCH-4124 LTCG - ATTACHMENT D
MERRILL LYNCH-4125 STCG - ATTACHMENT E
MERRILL LYNCH-4125 LTCG - ATTACHMENT E
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
63,424,234
63,339,267
84,967
b
80,472,665
74,589,732
5,882,933
c
8,786
0
8,786
d
4,457,922
4,207,656
250,266
e
14,876,438
13,417,790
1,458,648
1,479,763
1,380,780
98,983
7,848,973
6,084,232
1,764,741
29,865,517
29,529,781
335,736
15,309,992
13,102,248
2,207,744
1,278,186
1,215,824
62,362
9,919,328
8,130,313
1,789,015
416,808
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
84,967
b
5,882,933
c
8,786
d
250,266
e
1,458,648
98,983
1,764,741
335,736
2,207,744
62,362
1,789,015
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
14,364,523
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
...................
3
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)
If section 4940(d)(2) applies, leave this part blank.
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period?
Yes
No
If "Yes," the foundation does not qualify under section 4940(e). Do not complete this part.
1
Enter the appropriate amount in each column for each year; see instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in)
(b)
Adjusted qualifying distributions
(c)
Net value of noncharitable-use assets
(d)
Distribution ratio
(col. (b) divided by col. (c))
2018
36,766,818
244,738,069
0.150229
2017
40,196,499
250,698,132
0.160338
2016
32,345,054
232,020,780
0.139406
2015
27,822,573
257,702,339
0.107964
2014
4,135,250
181,209,440
0.02282
2
Total
of line 1, column (d)
.....................
2
0.580757
3
Average distribution ratio for the 5-year base period—divide the total on line 2 by 5.0, or by the number of years the foundation has been in existence if less than 5 years
......
3
0.116151
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5
......
4
229,447,071
5
Multiply line 4 by line 3
......................
5
26,650,507
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
185,751
7
Add lines 5 and 6
........................
7
26,836,258
8
Enter qualifying distributions from Part XII, line 4
,.............
8
35,314,139
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See the Part VI instructions.
Form
990-PF
(2019)
Form 990-PF (2019)
Page
4
Part VI
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
and enter “N/A" on line 1.
Date of ruling or determination letter:
(attach copy of letter if necessary–see instructions)
b
Domestic foundations that meet the section 4940(e) requirements in Part V, check
1
185,751
here
and enter 1% of Part I, line 27b
...................
c
All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% 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
185,751
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
185,751
6
Credits/Payments:
a
2019 estimated tax payments and 2018 overpayment credited to 2019
6a
165,821
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
151,000
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
316,821
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
2,054
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
129,016
11
Enter the amount of line 10 to be:
Credited to 2020 estimated tax
129,016
Refunded
11
Part VII-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 Instructions
for 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.
$
(2)
On foundation managers.
$
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
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:
By language in the governing instrument, or
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 XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
UT
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 2019 or the taxable year beginning in 2019? See the instructions for Part XIV.
If "Yes," complete Part XIV
.............................
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
Form
990-PF
(2019)
Form 990-PF (2019)
Page
5
Part VII-A
Statements Regarding Activities
(continued)
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 address
N/A
14
The books are in care of
CAROLE DUMAS
Telephone no.
(801) 932-6218
Located at
333 SOUTH 520 WEST SUITE 300
LINDON
UT
ZIP+4
84042
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over
Yes
No
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
Part VII-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?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(5)
Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)?
...............
Yes
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.)
.......
Yes
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
Organizations relying on a current notice regarding disaster assistance check here
........
c
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 2019?
.............
1c
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 2019, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2019?
.............
Yes
No
If "Yes," list the years
20
,
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.
20
,
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?
......................
Yes
No
b
If "Yes," did it have excess business holdings in 2019 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 2019.)
..................
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 2019?
4b
No
Form
990-PF
(2019)
Form 990-PF (2019)
Page
6
Part VII-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))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
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?
.....
Yes
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
Organizations relying on a current notice regarding disaster assistance check here
.........
c
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?
..........
Yes
No
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?
.....................
Yes
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?
Yes
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?
.................
Yes
No
Part VIII
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
Andy Noorda
Officer
2.0
0
0
0
333 South 520 West Suite 101
Lindon
,
UT
84042
Brent Noorda
Trustee
2.0
0
0
0
14010 Gulf Blvd APT 203
MADEIRA BEACH
,
FL
33708
2
Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a)
Name and address of each employee paid more than $50,000
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
Total
number of other employees paid over $50,000
...................
Form
990-PF
(2019)
Form 990-PF (2019)
Page
7
Part VIII
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
MERRILL LYNCH
Investment Fees
606,694
1500 MERRILL LYNCH DR NJ2-150-01-1
PENNINGTON
,
NJ
085344129
US BANK
investment Fees
547,290
PO BOX 3168 - TRUST TAX
PORTLAND
,
OR
97208
Total
number of others receiving over $50,000 for professional services
.............
Part IX-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 IX-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
INVESTMENT IN NMS LLC FOR THE PURPOSE OF EDUCATING CURRENT AND FUTURE HEALTHCARE PROFESSIONALS FOR OUTCOMES-ORIENTED, EVIDENCE BASED TO ADVANCE QUALITY & DELIVERY OF HEALTHCARE.
1,450,000
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
1,450,000
Form
990-PF
(2019)
Form 990-PF (2019)
Page
8
Part X
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
186,508,022
b
Average of monthly cash balances
.......................
1b
36,186,267
c
Fair market value of all other assets (see instructions)
................
1c
10,246,900
d
Total
(add lines 1a, b, and c)
.........................
1d
232,941,189
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
232,941,189
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
3,494,118
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
229,447,071
6
Minimum investment return.
Enter 5% of line 5
..................
6
11,472,354
Part XI
Distributable Amount
(see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here
and do not complete this part.)
1
Minimum investment return from Part X, line 6
....................
1
11,472,354
2a
Tax on investment income for 2019 from Part VI, line 5
......
2a
185,751
b
Income tax for 2019. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
185,751
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
11,286,603
4
Recoveries of amounts treated as qualifying distributions
................
4
5
Add lines 3 and 4
............................
5
11,286,603
6
Deduction from distributable amount (see instructions)
.................
6
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1
...
7
11,286,603
Part XII
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
33,864,139
b
Program-related investments—total from Part IX-B
..................
1b
1,450,000
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 V, line 8, and Part XIII, line 4
4
35,314,139
5
Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
income. Enter 1% of Part I, line 27b. See instructions
.................
5
185,751
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
35,128,388
Note:
The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
the section 4940(e) reduction of tax in those years.
Form
990-PF
(2019)
Form 990-PF (2019)
Page
9
Part XIII
Undistributed Income
(see instructions)
(a)
Corpus
(b)
Years prior to 2018
(c)
2018
(d)
2019
1
Distributable amount for 2019 from Part XI, line 7
11,286,603
2
Undistributed income, if any, as of the end of 2019:
a
Enter amount for 2018 only
.......
0
b
Total for prior years:
2017
,
2016
,
2015
0
3
Excess distributions carryover, if any, to 2019:
a
From 2014
......
b
From 2015
......
15,030,756
c
From 2016
......
20,811,293
d
From 2017
......
28,022,232
e
From 2018
......
24,852,393
f
Total
of lines 3a through e
........
88,716,674
4
Qualifying distributions for 2019 from Part
XII, line 4:
$
35,314,139
a
Applied to 2018, but not more than line 2a
0
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 2019 distributable amount
.....
11,286,603
e
Remaining amount distributed out of corpus
24,027,536
5
Excess distributions carryover applied to 2019.
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
112,744,210
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
0
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
0
e
Undistributed income for 2018. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
0
f
Undistributed income for 2019. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2020
..........
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 2014 not
applied on line 5 or line 7 (see instructions)
...
9
Excess distributions carryover to 2020.
Subtract lines 7 and 8 from line 6a
......
112,744,210
10
Analysis of line 9:
a
Excess from 2015
....
15,030,756
b
Excess from 2016
....
20,811,293
c
Excess from 2017
....
28,022,232
d
Excess from 2018
....
24,852,393
e
Excess from 2019
....
24,027,536
Form
990-PF
(2019)
Form 990-PF (2019)
Page
10
Part XIV
Private Operating Foundations
(see instructions and Part VII-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 2019, enter the date of the ruling
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2019
(b)
2018
(c)
2017
(d)
2016
b
85% of line 2a
.........
c
Qualifying distributions from Part XII,
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 X, 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 XV
Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
List 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).)
b
List 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
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or email address of the person to whom applications should be addressed:
b
The form in which applications should be submitted and information and materials they should include:
c
Any submission deadlines:
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Form
990-PF
(2019)
Form 990-PF (2019)
Page
11
Part XV
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)
a
Paid during the year
AMERICAN DIABETES ASSOCIATION
PO BOX 11454
ALEXANDRIA
,
VA
22312
NONE
PC
HUMANITARIAN
100,000
FOOD & CARE COALITION
299 E 900 S
Provo
,
UT
84606
NONE
PC
HUMANITARIAN
280,000
NATIONAL MULTIPLE SCLEROSIS SOCIETY
PO BOX 4527
New York
,
NY
10163
NONE
PC
HUMANITARIAN
100,000
PRIMARY CHILDREN'S HOSPITAL FOUNDATION
100 NORTH MARIO CAPECCHI DR
SALT LAKE CITY
,
UT
84113
NONE
PC
HUMANITARIAN
200,000
KIDS ON THE MOVE INC
475 West 260 North
OREM
,
UT
84057
NONE
PC
HUMANITARIAN
170,000
KOSTOPULOS DREAM FOUNDATION
475 West 260 North
OREM
,
UT
84057
NONE
PC
HUMANITARIAN
80,000
FRIENDS OF WASATCH MENTAL HEALTH FOUNDATION
750 N 200 W STE 301
PROVO
,
UT
84601
NONE
PC
HUMANITARIAN
12,000
FREEDOM CEMETERY PRESERVATION FOUNDATION
770 E 9000 S
SANDY
,
UT
84094
NONE
PC
HUMANITARIAN
5,000
THE CENTER FOR WOMEN AND CHILDREN IN CRISIS
PO BOX 1075
PROVO
,
UT
84603
NONE
PC
HUMANITARIAN
200,000
PLAYWORKS UTAH
1214 E Wilmington Ave
SUITE 102
SALT LAKE CITY
,
UT
84106
NONE
PC
HUMANITARIAN
480,000
ST JOSEPH'S HOSPITALS FOUNDATION
2700 W Dr Martin Luther King Jr
SUITE 310
TAMPA
,
FL
33607
NONE
PC
HUMANITARIAN
200,000
UTAH COUNCIL FOR THE BLIND
250 North 1950 West
SALT LAKE CITY
,
UT
84116
NONE
PC
HUMANITARIAN
120,000
Utah Schools for the Deaf and Blind
742 Harrison Blvd
OGDEN
,
UT
84404
NONE
PC
HUMANITARIAN
120,000
UTAH VALLEY UNIVERSITY FOUNDATION
800 West University Parkway MS111
OREM
,
UT
84058
NONE
PC
HUMANITARIAN
80,000
WEBER STATE UNIVERSITY
4018 University Circle
OGDEN
,
UT
84408
NONE
PC
HUMANITARIAN
3,080,000
THE ROAD HOME
210 S Rio Grande Street
SALT LAKE CITY
,
UT
84101
NONE
PC
HUMANITARIAN
84,000
RESCUE MISSION OF SALT LAKE
463 S 400 W
SALT LAKE CITY
,
UT
84101
NONE
PC
HUMANITARIAN
27,300
THE STRAIGHTER WAY FOUNDATION
1308 NORTH 800 WEST
SARATOGA SPRINGS
,
UT
84045
NONE
PC
HUMANITARIAN
200,000
AMERICAN RED CROSS
555 East 300 South Suite 200
SALT LAKE CITY
,
UT
84102
NONE
PC
HUMANITARIAN
28,000
PKD FOUNDATION
8330 Ward Parkway Suite 510
KANSAS CITY
,
MO
64114
NONE
PC
HUMANITARIAN
24,000
COLLEGE OF NURSING UNIVERSITY OF UTAH
10 South 2000 East
SALT LAKE CITY
,
UT
84112
NONE
PC
HUMANITARIAN
80,000
HABITAT FOR HUMANITY
340 S Orem Blvd
OREM
,
UT
84058
NONE
PC
HUMANITARIAN
120,000
HERITAGE SCHOOLS INC
5600 N HERITAGE SCHOOL DR
PROVO
,
UT
84604
NONE
PC
HUMANITARIAN
120,000
UPSCHALE MUSIC FOUNDATION
650 S STATE STREET
OREM
,
UT
84058
NONE
PC
HUMANITARIAN
32,000
SPECIAL OLYMPICS UTAH
1400 S FOOTHILL DRIVE SUITE 238
SALT LAKE CITY
,
UT
84108
NONE
PC
HUMANITARIAN
5,000
HYDROCEPHALUS CLINICAL RESEARCH
333 S 520 W
Lindon
,
UT
84042
NONE
PC
HUMANITARIAN
435,000
ALZHEIMER'S ASSOCIATION UTAH CHAPTER
855 EAST 4800 SOUTH SUITE 100
SALT LAKE CITY
,
UT
84107
NONE
PC
HUMANITARIAN
200,000
BUILD
2385 BAY ROAD
REDWOOD CITY
,
CA
64063
NONE
PC
HUMITARIAN
750,000
FAMILY INDEPENDENCE INITIATIVE
1203 PRESERVATION PARK WAY 100
OAKLAND
,
CA
94612
NONE
PC
HUMANITARIAN
250,000
FIRST PLACE FOR YOUTH
42617TH STREET
OAKLAND
,
CA
94612
NONE
PC
HUMANITARIAN
1,000,000
FOCUS POINTS
2501 E 48TH AVENUE
DENVER
,
CO
80216
NONE
PC
HUMANITARIAN
425,000
GIVEDIRECTLY
PO BOX 3221
NEW YORK
,
NY
10008
NONE
PC
HUMANITARIAN
400,000
ROOM TO GROW
7 WEST 30th STREET
NEW YORK
,
NY
10001
NONE
PC
HUMANITARIAN
500,000
THERAPY ANIMALS OF UTAH
2459 WEST 300 NORTH
PROVO
,
UT
84601
NONE
PC
HUMANITARIAN
2,400
THE ALS ASSOCIATION
10855 DOVER STREET SUITE 200
WESTMINISTER
,
CO
80021
NONE
PC
HUMANITARIAN
60,000
MYAGRO FARMS
3161 CATALINA ISLAND ROAD
WEST SACRAMENTO
,
CA
95691
NONE
PC
HUMANITARIAN
600,000
ONE ACRE FUND
80 BROAD STREET SUITE 2500
NEW YORK
,
NY
10004
NONE
PC
HUMANITARIAN
1,200,000
ONEGOAL
215 WEST SUPERIOR STREET SUITE 700
CHICAGO
,
IL
60654
NONE
PC
HUMANITARIAN
500,000
ROCKY MOUNTAIN INSTITUTE
22830 TWO RIVERS ROAD
BASALT
,
CO
81621
NONE
PC
HUMANITARIAN
500,000
SANERGY
28 PARK STREET NO 3
BROOKLINE
,
MA
02446
NONE
PC
HUMANITARIAN
300,000
SHRINERS CHILDREN'S HOSPITAL
1275 EAST FAIRFAX ROAD
SALT LAKE CITY
,
UT
84103
NONE
PC
HUMANITARIAN
100,000
SOLUTIONS PROJECT
PO BOX 3202 4900 SHATTUCK AVENUE
OAKLAND
,
CA
94609
NONE
PC
HUMANITARIAN
100,000
VISIONSPRING
505 8TH AVENUE SUITE 12-A-07
NEW YORK
,
NY
10018
NONE
PC
HUMANITARIAN
500,000
Arrive Utah
21 E 100 N
Suite 102
American Fork
,
UT
84003
NONE
PC
Humanitarian
382,278
FRIENDS FOR SIGHT
6715 South 1300 East Suite 250
SALT LAKE CITY
,
UT
84121
none
PC
HUMANITARIAN
65,000
HEALTHCARE WITHOUT HARM
12355 Sunrise Valley Dr
SUITE 680
RESTON
,
VA
20191
NONE
PC
HUMANITARIAN
1,000,000
HURST WOOD FOUNDATION
1875 S GENEVA RD
OREM
,
UT
84058
NONE
PC
HUMANITARIAN
-150,000
LANTERN HOUSE
269 West 33rd Street
OGDEN
,
UT
84401
NONE
PC
HUMANITARIAN
24,000
LDS HUMANITARIAN FUND
1450 N University Ave
PROVO
,
UT
84604
NONE
PC
HUMANITARIAN
3,392,006
LIVING GOODS
1875 K Street NW
SUITE 400
WASHINGTON
,
DC
20006
NONE
PC
HUMANITARIAN
500,000
MUSO
3254 19th St
SAN FRANCISCO
,
CA
94110
NONE
PC
HUMANITARIAN
540,000
PROXIMITY DESIGNS
No 24 Saya San Road Tharthana Ye
Bahan Township
,
Yangon
BM
NONE
PC
HUMANITARIAN
500,000
ROCKY MOUNTAIN UNIVERSITY FOUNDATION
122 East 1700 South
BLDG C
PROVO
,
UT
84606
NONE
PC
HUMANITARIAN
30,000
ROOTS CAPITAL
130 Bishop Allen Drive
2ND FLOOR
CAMBRIDGE
,
MA
02139
NONE
PC
HUMANITARIAN
1,000,000
VOLUNTEERS OF AMERICA
1660 Duke Street
ALEXANDRIA
,
VA
22314
NONE
PC
HUMANITARIAN
125,000
YMCA OF NORTHERN UTAH
3216 S Highland Dr
STE 200
SALT LAKE CITY
,
UT
84106
NONE
PC
HUMANITARIAN
5,000
Ashoka - All America
1700 North moore Stereet Ste 2000
ARLINGTON
,
VA
22209
NONE
PC
HUMANITARIAN
275,000
Blue Ventures Conservation
Level 2 Annex Omnibus
London
N7 9DP
UK
NONE
PC
HUMANITARIAN
500,000
Child and Family Support Center
PO Box 6055
LOGAN
,
UT
84341
NONE
PC
HUMANITARIAN
100,000
D-Rev
695 Minnesota St
San Francisco
,
CA
94107
NONE
PC
HUMANITARIAN
520,000
Educate Girls
Suite 201 Durolite House
Andheri West
,
Mumbai
400053
IN
NONE
PC
HUMANITARIAN
500,000
Educate
PO box 12302
DENVER
,
CO
80212
NONE
PC
HUMANITARIAN
200,000
Fundacion Gaia Amasonas
Carrera 17 39 75
Bogot
100110
CO
NONE
PC
HUMANITARIAN
500,000
Green Energy
Lewis Clark Law School
10015 SW Terwilliger Blvd
PORTLAND
,
OR
97219
NONE
PC
HUMANITARIAN
60,000
Helen Keller International
One Dag Hammarskjold Plaza
2ND FLOOR
NEW YORK
,
NY
10017
NONE
PC
HUMANITARIAN
1,000,000
Integrate Health
PO Box 605
MEDWAY
,
MA
02053
NONE
PC
HUMANITARIAN
250,000
Medic Mobile
3254 19th Street Floor Two
SAN FRANCISCO
,
CA
94110
NONE
PC
HUMANITARIAN
500,000
Prime Coalition
One Broadway
FLOOR 12
CAMBRIDGE
,
MA
02142
NONE
PC
HUMANITARIAN
1,000,000
Project Read
550 North University Ave 215
PROVO
,
UT
84601
NONE
PC
HUMANITARIAN
25,000
Regents of the University of California
1111 FRANKLIN ST
OAKLAND
,
CA
94607
NONE
PC
HUMANITARIAN
1,046,580
Sanku (Project Healthy Children)
PO Box 38568
Dar es Salaam
TZ
NONE
PC
HUMANITARIAN
75,000
The Against Malaria Foundation
PO Box 7247-6370
Phildelphia
,
PA
191706370
NONE
PC
HUMANITARIAN
1,000,000
The BOMA Project
PO Box 1865
4927 Main Street
Manchester Center
,
VT
05255
NONE
PC
HUMANITARIAN
400,000
Uncharted
2330 Broadway St 107
DENVER
,
CO
80205
NONE
PC
HUMANITARIAN
172,500
University of Utah Health Sciences
515 East 100 South Suite 300
SALT LAKE CITY
,
UT
84102
NONE
PC
HUMANITARIAN
160,000
Utah Clean Energy
1014 2nd Avenue
SALT LAKE CITY
,
UT
84103
NONE
PC
HUMANITARIAN
60,000
BRIDGE LIBERIA
1344 Holly Leaf Way
Diamond Bar
,
CA
91765
NONE
PC
HUMANITARIAN
500,000
UTAH REGIONAL HOUSING
688 W 100 N
Provo
,
UT
84601
NONE
PC
HUMANITARIAN
1,000,000
INTERMOUNTAIN FOUNDATION
36 S STATE STREET
SALT LAKE CITY
,
UT
84111
NONE
PC
HUMANITARIAN
80,000
U of U SCHOOL OF SOCIAL & BEHAVIORAL SCIENCE
CAROLYN AND KEM GARDNER COMMONS SUI
260 S CENTRAL CAMPUS DR
SALT LAKE CITY
,
UT
84112
NONE
HUMANITARIAN
150,000
VILLAGE ENTERPRISE
751 Laurel St PMB 222
San Carolos
,
CA
94065
NONE
HUMANITARIAN
250,000
EVADENCE ACTION - Dispenser for Safe Water
1101 K St NW Suite 900
Washington
,
DC
20005
NONE
PC
HUMANITARIAN
1,000,000
NEUROWORX
90 W Albion Village Way
SANDY
,
UT
84070
NONE
PC
HUMANITARIAN
650,000
NO MEANS NO WORLDWIDE
6100 Cortaderia St NE APT 3613
Albuquerque
,
NM
87111
NONE
PC
HUMANITARIAN
125,000
BICYCLE COLLECTIVE
2312 S West Temple
SALT LAKE CITY
,
UT
84115
NONE
PC
HUMANITARIAN
125,000
UNIVERSITY OF UTAH - Health Science Development
515 East 100 South Suite 300
SASLT LAKE CITY
,
UT
84102
NONE
PC
HUMANITARIAN
160,000
AMERICAN INDIAN SERVICES
3115 East Lion Lane Suite 320
SALT LAKE CITY
,
UT
84121
NONE
PC
HUMANITARIAN
20,000
BUILDING TOMORROW
615 N Alabama Street Suite D
INDIANAPOLIS
,
IN
46204
NONE
PC
HUMANITARIAN
25,000
TRACY AVIARY
589 East 1300 South
SALT LAKE CITY
,
MA
84105
NONE
PC
HUMANITARIAN
25,000
RE-VOLV
5 Third Street Suite 424
SAN FRANCISCO
,
CA
94103
NONE
PC
HUMANITARIAN
35,000
ALLIANCE HOUSE
1724 South Main Street
SALT LAKE CITY
,
UT
84115
HUMANITARIAN
100,000
Total
.................................
3a
33,772,064
b
Approved for future payment
Total
.................................
3b
Form
990-PF
(2019)
Form 990-PF (2019)
Page
12
Part XVI-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.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
14
3,071
4
Dividends and interest from securities
....
14
7,053,148
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not debt-financed property
.....
16
2,329
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
14,364,523
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
21,423,071
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
21,423,071
(See worksheet in line 13 instructions to verify calculations.)
Part XVI-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
Explain below how each activity for which income is reported in column (e) of Part XVI-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
(2019)
Form 990-PF (2019)
Page
13
Part XVII
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?
...........
Yes
No
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.
May the IRS discuss this return
with the preparer shown below
(see instr.)
Yes
No
Signature of officer or trustee
Date
Title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's Signature
Date
Check if self-
employed
PTIN
Firm's name
Firm's EIN
Firm's address
Phone no.
Form
990-PF
(2019)
Additional Data
Software ID:
Software Version:
Form 990PF - Special Condition Description:
Special Condition Description