Instrumentl eFile Render
Object ID: 202243189349104944 - Rendered 2024-05-19
TIN: 04-7024330
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. 1545-0047
20
21
Open to Public Inspection
For calendar year 2021, or tax year beginning
01-01-2021
, and ending
12-31-2021
Name of foundation
ADELSON FAMILY FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)
300 FIRST AVE
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
NEEDHAM
,
MA
02494
A Employer identification number
04-7024330
B
Telephone number (see instructions)
(781) 972-5950
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)
$
5,626,414
J
Accounting method:
Cash
Accrual
Other (specify)
MODIFIED CASH
(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)
49,822,227
2
Check
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
b
Gross sales price for all assets on line 6a
7
Capital gain net income (from Part IV, line 2)
...
0
8
Net short-term capital gain
.........
9
Income modifications
...........
10a
Gross sales less returns and allowances
b
Less: Cost of goods sold
....
c
Gross profit or (loss) (attach schedule)
.....
11
Other income (attach schedule)
.......
12
Total.
Add lines 1 through 11
........
49,822,227
0
0
13
Compensation of officers, directors, trustees, etc.
0
0
0
0
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
59,454
0
0
59,454
b
Accounting fees (attach schedule)
.......
c
Other professional fees (attach schedule)
....
3,140
0
0
3,140
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
1,000
0
0
1,000
19
Depreciation (attach schedule) and depletion
...
1,331
0
862
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
1,363
0
0
1,363
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
590,572
0
0
590,572
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
656,860
0
862
655,529
25
Contributions, gifts, grants paid
.......
78,938,686
78,938,686
26
Total expenses and disbursements.
Add lines 24 and 25
79,595,546
0
862
79,594,215
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-29,773,319
b
Net investment income
(if negative, enter -0-)
0
c
Adjusted net income
(if negative, enter -0-)
...
0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2021)
Form 990-PF (2021)
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
.............
35,397,145
5,375,157
5,375,157
2
Savings and temporary cash investments
.........
3
Accounts receivable
250,000
Less: allowance for doubtful accounts
250,000
250,000
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)
.......
c
Investments—corporate bonds (attach schedule)
.......
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
14
Land, buildings, and equipment: basis
7,012
Less: accumulated depreciation (attach schedule)
5,755
2,588
1,257
1,257
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
35,399,733
5,626,414
5,626,414
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
...........
35,399,733
5,626,414
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
29
Total net assets or fund balances
(see instructions)
.....
35,399,733
5,626,414
30
Total liabilities and net assets/fund balances
(see instructions)
.
35,399,733
5,626,414
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
35,399,733
2
Enter amount from Part I, line 27a
.....................
2
-29,773,319
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
5,626,414
5
Decreases not included in line 2 (itemize)
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
5,626,414
Form
990-PF
(2021)
Form 990-PF (2021)
Page
3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a)
List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)
(b)
How acquired
P—Purchase
D—Donation
(c)
Date acquired
(mo., day, yr.)
(d)
Date sold
(mo., day, yr.)
1a
b
c
d
e
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-)
or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
Excess of col. (i)
over col. (j), if any
a
b
c
d
e
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
3
Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8
...................
3
Form
990-PF
(2021)
Form 990-PF (2021)
Page
4
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
and enter “N/A" on line 1.
Date of ruling or determination letter:
(attach copy of letter if necessary–see instructions)
b
All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
2
0
3
Add lines 1 and 2
...........................
3
0
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
4
0
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
0
6
Credits/Payments:
a
2021 estimated tax payments and 2020 overpayment credited to 2021
6a
0
b
Exempt foreign organizations—tax withheld at source
......
6b
0
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
0
d
Backup withholding erroneously withheld
...........
6d
0
7
Total credits and payments. Add lines 6a through 6d
..............
7
0
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
0
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
0
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
11
Enter the amount of line 10 to be:
Credited to 2022 estimated tax
Refunded
11
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.
$
0
(2)
On foundation managers.
$
0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
.........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
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 XIV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
MA
,
NV
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
No
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 2021 or the taxable year beginning in 2021? 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
Form
990-PF
(2021)
Form 990-PF (2021)
Page
5
Part VI-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
Yes
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
WWW.ADELSONFOUNDATION.ORG
14
The books are in care of
JOHN CARR
Telephone no.
(702) 791-9400
Located at
410 S RAMPART BLVD SUITE 440
LAS VEGAS
NV
ZIP+4
89145
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 2021, 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 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)
Yes
(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)
Yes
(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
........
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 2021?
.............
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 2021, did the foundation have any undistributed income (Part XII, lines 6d
and 6e) for tax year(s) beginning before 2021?
....................
2a
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?
..............................
3a
No
b
If "Yes," did it have excess business holdings in 2021 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 2021.)
.....................
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 2021?
..
4b
No
Form
990-PF
(2021)
Form 990-PF (2021)
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)
Yes
(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
Yes
c
Organizations relying on a current notice regarding disaster assistance check
.........
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
Yes
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
DR MIRIAM ADELSON
TRUSTEE
1.00
0
0
0
410 S RAMPART BLVD SUITE 440
LAS VEGAS
,
NV
89145
SHELDON G ADELSON DEC 11121
TRUSTEE
1.00
0
0
0
410 S RAMPART BLVD SUITE 440
LAS VEGAS
,
NV
89145
MICHAEL BOHNEN
PRESIDENT
30.00
0
0
0
300 1ST AVENUE
NEEDHAM
,
MA
02494
2
Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a)
Name and address of each employee paid more than $50,000
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
NONE
Total
number of other employees paid over $50,000
...................
0
Form
990-PF
(2021)
Form 990-PF (2021)
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
INTERFACE OPERATIONS LLC
ACCT, IT & MGMT INCL PRES. COMP & BNFTS
482,738
410 S RAMPART BLVD SUITE 440
LAS VEGAS
,
NV
89145
ADELSON MEDICAL RESEARCH FOUNDATION
ADMINISTRATIVE SUPPORT
52,757
410 S RAMPART BLVD SUITE 440
LAS VEGAS
,
NV
89145
Total
number of others receiving over $50,000 for professional services
.............
0
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
.........................
0
Form
990-PF
(2021)
Form 990-PF (2021)
Page
8
Part IX
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations, see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities
...................
1a
0
b
Average of monthly cash balances
.......................
1b
7,581,741
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
7,581,741
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation)
.............
1e
0
2
Acquisition indebtedness applicable to line 1 assets
..................
2
0
3
Subtract line 2 from line 1d
.........................
3
7,581,741
4
Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
instructions)
.............................
4
113,726
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3.
............
5
7,468,015
6
Minimum investment return.
Enter 5% (0.05) of line 5
................
6
373,401
Part X
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 IX, line 6
..................
1
373,401
2a
Tax on investment income for 2021 from Part V, line 5
.......
2a
b
Income tax for 2021. (This does not include the tax from Part V.)
...
2b
c
Add lines 2a and 2b
............................
2c
0
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
373,401
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
373,401
6
Deduction from distributable amount (see instructions)
.................
6
0
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1
...
7
373,401
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
79,594,215
b
Program-related investments—total from Part VIII-B
..................
1b
0
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
b
Cash distribution test (attach the required schedule)
.................
3b
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part XII, line 4.
4
79,594,215
Form
990-PF
(2021)
Form 990-PF (2021)
Page
9
Part XII
Undistributed Income
(see instructions)
(a)
Corpus
(b)
Years prior to 2020
(c)
2020
(d)
2021
1
Distributable amount for 2021 from Part X, line 7
373,401
2
Undistributed income, if any, as of the end of 2021:
a
Enter amount for 2020 only
.......
0
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2021:
a
From 2016
......
121,329,857
b
From 2017
......
89,653,025
c
From 2018
......
116,239,911
d
From 2019
......
117,211,353
e
From 2020
......
99,151,576
f
Total
of lines 3a through e
........
543,585,722
4
Qualifying distributions for 2021 from Part
XI, line 4:
$
79,594,215
a
Applied to 2020, but not more than line 2a
0
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
0
c
Treated as distributions out of corpus (Election
required—see instructions)
........
0
d
Applied to 2021 distributable amount
.....
373,401
e
Remaining amount distributed out of corpus
79,220,814
5
Excess distributions carryover applied to 2021.
0
0
(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
622,806,536
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
0
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
0
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
0
e
Undistributed income for 2019. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
0
f
Undistributed income for 2021. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2022
..........
0
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions)
.......
0
8
Excess distributions carryover from 2016 not
applied on line 5 or line 7 (see instructions)
...
121,329,857
9
Excess distributions carryover to 2022.
Subtract lines 7 and 8 from line 6a
......
501,476,679
10
Analysis of line 9:
a
Excess from 2017
....
89,653,025
b
Excess from 2018
....
116,239,911
c
Excess from 2019
....
117,211,353
d
Excess from 2020
....
99,151,576
e
Excess from 2021
....
79,220,814
Form
990-PF
(2021)
Form 990-PF (2021)
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 2021, 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 IX for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2021
(b)
2020
(c)
2019
(d)
2018
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.)
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).)
DR MIRIAM ADELSON
SHELDON G ADELSON DEC 11121
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.
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
(2021)
Form 990-PF (2021)
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)
a
Paid during the year
ADELSON CAMPUS FOR JEWISH LIFE
410 S RAMPART BLVD
LAS VEGAS
,
NV
89145
PF
GENERAL CHARITABLE PURPOSES
30,000
ADELSON EDUCATIONAL INSTITUTE
9700 HILLPOINTE RD
LAS VEGAS
,
NV
89134
PC
GENERAL CHARITABLE PURPOSES
4,100,000
AHA FOUNDATION
30 7TH AVENUE SUITE 236
NEW YORK
,
NY
10011
PC
GENERAL CHARITABLE PURPOSES
36,000
AMERICA-ISRAEL FRIENDSHIP LEAGUE
1460 BROADWAY 6030
NEW YORK
,
NY
10036
PC
GENERAL CHARITABLE PURPOSES
50,000
AMERICAN ASSOCIATION FOR THE TREATMENT OF OPIOD DEPENDENCE
24 VARICK ST 4TH FLOOR
NEW YORK
,
NY
10014
PC
GENERAL CHARITABLE PURPOSES
40,000
AMERICAN FRIENDS OF BAT SHEVA DANCE
1201 BROADWAY SUITE 611
NEW YORK
,
NY
10001
PC
GENERAL CHARITABLE PURPOSES
10,000
AMERICAN FRIENDS OF IDC
116 EAST 116TH ST 11TH FLOOR
NEW YORK
,
NY
10003
PC
GENERAL CHARITABLE PURPOSES
1,000,000
AMERICAN FRIENDS OF ITIM INC
5508 HUNTINGTON PKWY
BETHESDA
,
MD
20814
PC
GENERAL CHARITABLE PURPOSES
18,000
AMERICAN FRIENDS OF LUBAVITCH
2110 LEROY PLACE NW
WASHINGTON
,
DC
20008
PC
GENERAL CHARITABLE PURPOSES
30,000
AMERICAN FRIENDS OF MAGEN DAVID ADOM
352 7TH AVE
NEW YORK
,
NY
10001
PC
GENERAL CHARIBABLE PURPOSES
1,550,000
AMERICAN FRIENDS OF UNITED JEWISH APPEAL
200 JEFFERSON PARK STE 400
WHIPPANY
,
NJ
07981
PC
GENERAL CHARITABLE PURPOSES
50,000
AMERICAN SOCIETY OF YAD VASHEM
500 5TH AVE 42ND FL
NEW YORK
,
NY
10110
PC
GENERAL CHARITABLE PURPOSES
3,900,000
ARIEL UNIVERSITY
RAMAT HAGOLAN 65
ARIEL
IS
PC
GENERAL CHARITABLE PURPOSES
14,400,000
B'NAI B'RITH YOUTH ORGANIZATION
800 8TH ST NW
WASHINGTON
,
DC
20001
PC
GENERAL CHARITABLE PURPOSES
10,000
BIRTHRIGHT ISRAEL FOUNDATION
33 EAST 33RD ST
NEW YORK
,
NY
10016
PC
GENERAL CHARITABLE PURPOSES
9,000,000
BRIGHAM AND WOMEN'S HOSPITAL
116 HUNTINGTON AVE
BOSTON
,
MA
02116
PC
GENERAL CHARITABLE PURPOSES
30,000
CAMERA
PO BOX 35040
BOSTON
,
MA
02135
PC
GENERAL CHARITABLE PURPOSES
50,000
CARIBBEAN JEWISH COMMUNITY
1483 CARROLL ST
BROOKLYN
,
NY
11213
PC
GENERAL CHARITABLE PURPOSES
18,000
CENTER FOR JEWISH COMMUNITY STUDIES
7 CHURCH LANE STE 9
BALTIMORE
,
MD
21208
PC
GENERAL CHARITABLE PURPOSES
500,000
CENTRAL FUND OF ISRAEL
980 AVENUE OF THE AMERICAS
NEW YORK
,
NY
10018
PC
GENERAL CHARITABLE PURPOSES
100,000
CHABAD OF THE UNIVERSITY OF LAS VEGAS
1261 S ARVILLE ST
LAS VEGAS
,
NV
89102
PC
GENERAL CHARITABLE PURPOSES
40,000
CHAI LIFELINE
475 SOUTH ROBERTSON BLVD
BEVERLY HILLS
,
CA
90211
PC
GENERAL CHARITABLE PURPOSES
18,000
CHELSEA JEWISH NURSING HOME
165 CAPTAINS ROW
CHELSEA
,
MA
02150
PC
GENERAL CHARITABLE PURPOSES
200,000
CITYARTS
525 BROADWAY STE 602
NEW YORK
,
NY
10012
PC
GENERAL CHARITABLE PURPOSES
45,000
CLARK COUNTY PUBLIC EDUCATION FOUNDATION
4350 SOUTH MARYLAND PKWY
LAS VEGAS
,
NV
89119
PC
GENERAL CHARITABLE PURPOSES
36,000
COMBINED JEWISH PHILANTHROPIES
126 HIGH ST
BOSTON
,
MA
02110
PC
GENERAL CHARITABLE PURPOSES
1,000,000
DESERT SPACE FOUNDATION
18 CERCHIO ALTO
LAS VEGAS
,
NV
89011
PC
GENERAL CHARITABLE PURPOSES
10,000
DRUG FREE AMERICA
5999 CENTRAL AVE SUITE 301
ST PETERSBURG
,
FL
33710
PC
GENERAL CHARITABLE PURPOSES
50,000
ENDOWMENT FOR MIDDLE EAST TRUTH
1050 CONNECTICUT AVE
WASHINGTON
,
DC
20036
PC
GENERAL CHARITABLE PURPOSES
50,000
FEELING GOOD FOUNDATION
2660 SOLACE PLACE STE A
MOUNTAIN VIEW
,
CA
94040
PC
GENERAL CHARITABLE PURPOSES
125,000
FIDELITY CHARITABLE GIFT FUND
200 SEAPORT BLVD
BN
,
MA
02210
PC
GENERAL CHARITABLE PURPOSES
250,000
FRIENDS OF ISRAEL DEFENSE FORCES
1430 BROADWAY STE 1201
NEW YORK
,
NY
10018
PC
GENERAL CHARITABLE PURPOSES
4,292,966
FRIENDS OF ISRAEL DISABLED VETERANS
1133 BROADWAY SUITE 232
NEW YORK
,
NY
10010
PC
GENERAL CHARITABLE PURPOSES
20,000
FRIENDS OF ISRAEL INITIATIVE
2950 SW 27TH AVE SUITE 100
MIAMI
,
FL
33133
PC
GENERAL CHARITABLE PURPOSES
50,000
FRIENDS OF ISRAEL SCOUTS
575 8TH AVE 11TH FL
NEW YORK
,
NY
10018
PC
GENERAL CHARITABLE PURPOSES
400,000
FRIENDS OF NAHAL HAREDI
4586 SUNDERLAND RD
TEANECK
,
NJ
07666
PC
GENERAL CHARITABLE PURPOSES
100,000
FRIENDS OF TEL AVIV SOURASKY MEDICAL CENTER
1461 FIRST AVE
NEW YORK
,
NY
10075
PC
GENERAL CHARITABLE PURPOSES
6,000,000
FRIENDS OF UNITED HATZALAH
205 EAST 42ND ST 19TH FLOOR
NEW YORK
,
NY
10017
PC
GENERAL CHARITABLE PURPOSES
250,000
FRIENDS OF ZION
410 S RAMPART BLVD
LAS VEGAS
,
NV
89145
PF
GENERAL CHARITABLE PURPOSES
1,725,385
FRIENDSHIP CIRCLE OF LV
1261 ARVILLE ST
LAS VEGAS
,
NV
89102
PC
GENERAL CHARITABLE PURPOSES
18,000
FUNDS FOR ISRAEL'S TOMORROW
1 US BANK PLAZA
ST LOUIS
,
MO
63101
PC
GENERAL CHARITABLE PURPOSES
100,000
GATEWAYS ACCESS TO JEWISH EDUCATION
333 NAHANTON ST
NEWTON
,
MA
02459
PC
GENERAL CHARITABLE PURPOSES
100,000
GIFT OF LIFE BONE MARROW FOUNDATION
800 YAMATO RD
BOCA RATON
,
FL
33431
PC
GENERAL CHARITABLE PURPOSES
25,000
GIRLS TOWN OR CHADASH
1417 CONEY ISLAND AVE
BROOKLYN
,
NY
11230
PC
GENERAL CHARITABLE PURPOSES
590,000
HASHOMER HACHADASH
ATZMON ST POB 691
UPPER NAZARETH
IS
PC
GENERAL CHARITABLE PURPOSES
2,000,000
HEBREW SENIOR LIFE
1200 CENTRE ST
BOSTON
,
MA
02131
PC
GENERAL CHARITABLE PURPOSES
1,666,666
INTERNATIONAL COALITION FOR ISRAEL - US
PO BOX 14153
NEW LIBERIA
,
LA
70562
PC
GENERAL CHARITABLE PURPOSES
100,000
IRIS
235 NICOLL ST FLOOR 2
NEW HAVEN
,
CT
06511
PC
GENERAL CHARITABLE PURPOSES
6,110
ISRAAID
PO BOX 61227
PALO ALTO
,
CA
94306
PC
GENERAL CHARITABLE PURPOSES
50,000
ISRAEL GUIDE DOG CENTER FOR THE BLIND
968 EASTON RD SUITE H
WARRINGTON
,
PA
18976
PC
GENERAL CHARITABLE PURPOSES
30,000
ISRAELI AMERICAN COUNCIL
5900 CANOGA AVE STE 390
WOODLAND HILLS
,
CA
91369
PC
GENERAL CHARITABLE PURPOSES
10,000,000
ISRAFEST FOUNDATION
324 S BEVERLY DR
BEVERLY HILLS
,
CA
90212
PC
GENERAL CHARITABLE PURPOSES
25,000
JEWISH AGENCY FOR ISRAEL N AMERICAN COUNCIL
633 THIRD AVE 32ND FL
NEW YORK
,
NY
10017
PC
GENERAL CHARITABLE PURPOSES
5,250,000
JEWISH FEDERATION OF LAS VEGAS
2317 RENAISSANCE DR
LAS VEGAS
,
NV
89119
PC
GENERAL CHARITABLE PURPOSES
750,000
JEWISH FUNDERS NETWORK
150 WEST 30TH ST SUITE 900
NEW YORK
,
NY
10001
PC
GENERAL CHARITABLE PURPOSES
50,000
JEWISH INSTITUTE FOR NATIONAL SECURITY OF AMERICA
1101 14TH STREET NW SUITE 1030
NEW YORK
,
NY
20005
PC
GENERAL CHARITABLE PURPOSES
250,000
JEWISH LIFE
16501 VENTURA BLVD
ENCINO
,
CA
91436
PC
GENERAL CHARITABLE PURPOSES
18,000
JEWISH NATIONAL FUND
42 EAST 69TH ST
NEW HAVEN
,
NY
10021
PC
GENERAL CHARITABLE PURPOSES
35,000
JEWISH NEWS SERVICE
214 LINCOLN ST
BOSTON
,
MA
02134
PC
GENERAL CHARITABLE PURPOSES
300,000
JGIVE - FRIENDS OF ASOR FUND
43 LUBLIN TERRACE
LAKEWOOD
,
NJ
08701
PC
GENERAL CHARITABLE PURPOSES
15,000
KADIMA HEBREW ACADEMY
7011 SHOUP AVE
WEST HILLS
,
CA
91307
PC
GENERAL CHARITABLE PURPOSES
50,000
LAS VEGAS YOUNG ARTISTS ORCHESTRA
75 N VALLE VERDE DR BLDG 3
HENDERSON
,
NV
89074
PC
GENERAL CHARITABLE PURPOSES
50,000
LETTER OF THE LAW
111 LIVINGSTON ST STE 1928
BROOKLYN
,
NY
11201
PC
GEBERAL CHARITABLE PURPOSES
100,000
LUBAVITCH FOUNDATION OF LEXINGTON
9 BURLINGTON ST
LEXINGTON
,
MA
02420
PC
GENERAL CHARITABLE PURPOSES
18,000
MAALEH ADUMIM FOUNDATION
1430 BROADWAY RM 1804
NEW YORK
,
NY
10018
PC
GENERAL CHARITABLE PURPOSES
20,000
MACCABEE TASK FORCE FOUNDATION
8363 W SUNSET RD STE 200
LAS VEGAS
,
NV
89110
PC
GENERAL CHARITABLE PURPOSES
5,825,559
MACHNE ISRAEL
770 EASTERN PARKWAY
BROOKLYN
,
NY
11213
PC
GENERAL CHARITABLE PURPOSES
10,000
MAX STERN ACADEMIC COLLEGE
NORTHERN DISTRICT
YEZREEL VALLEY
IS
PC
GENERAL CHARITABLE PURPOSES
10,000
MIDDLE EAST MEDIA AND RESEARCH INSTITUTE
1819 L ST NW 5TH FL
WASHINGTON
,
DC
20036
PC
GENERAL CHARITABLE PURPOSES
250,000
OSHMAN FAMILY JEWISH COMMUNITY CENTER
3921 FABIAN WAY
PALO ALTO
,
CA
94303
PC
GENERAL CHARITABLE PURPOSES
50,000
REPORT
100 SPRINGDALE RD STE A3
CHERRY HILL
,
NJ
08003
PC
GENERAL CHARITABLE PURPOSES
135,000
SMITH CENTER FOR THE PERFORMING ARTS
241 W CHARLESTON BLVD SUITE 111
LAS VEGAS
,
NV
89102
PC
GENERAL CHARITABLE PURPOSES
50,000
STANFORD UNIVERSITY
420 MONTGOMERY ST
SAN FRANCISCO
,
CA
94104
PC
GENERAL CHARITABLE PURPOSES
200,000
STOP STIGMA
2 WASHINGTON WAY SUITE 2A
LARCHMONT
,
NY
10538
PC
GENERAL CHARITABLE PURPOSES
30,000
STUDENTS SUPPORTING ISRAEL
16832 39TH AVE NORTH
PLYMOUTH
,
MN
55446
PC
GENERAL CHARITABLE PURPOSES
25,000
TEMPLE EMANUEL
385 WARD ST
NEWTON CENTRE
,
MA
02459
PC
GENERAL CHARITABLE PURPOSES
5,000
THE ROCKEFELLER UNIVERSITY
1230 YORK AVE BOX 164
NEW YORK
,
NY
10065
PC
GENERAL CHARITABLE PURPOSES
100,000
THIS WORLD JEWISH VALUES NETWORK
394 PALISADES AVE
ENGLEWOOD
,
CA
07631
PC
GENERAL CHARITABLE PURPOSES
500,000
WE CARE FOUNDATION
2216 S 6TH ST
LAS VEGAS
,
NV
89104
PC
GENERAL CHARITABLE PURPOSES
5,000
YEKIREI HATZALAR YEHUDA SHOMRON
130 CHURH ST
NEW YORK
,
NY
10007
PC
GENERAL CHARITABLE PURPOSES
42,000
ZIONIST ORGANIZATION OF AMERICA
4 EAST 34TH ST
NEW YORK
,
NY
10016
PC
GENERAL CHARITABLE PURPOSES
500,000
Total
.................................
3a
78,938,686
b
Approved for future payment
Total
.................................
3b
0
Form
990-PF
(2021)
Form 990-PF (2021)
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.)
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
...........
4
Dividends and interest from securities
....
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not debt-financed property
.....
6
Net rental income or (loss) from personal property
7
Other investment income
.....
8
Gain or (loss) from sales of assets other than
inventory
............
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
0
0
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
0
(See worksheet in line 13 instructions to verify calculations.)
Part XV-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
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
(2021)
Form 990-PF (2021)
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?
...........
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 instructions.
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
(2021)
Additional Data
Software ID:
Software Version:
Form 990PF - Special Condition Description:
Special Condition Description