efile Public Visual Render
ObjectId: 201611449349100006 - Submission: 2016-05-23
TIN: 13-7106277
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.
Information about Form 990-PF and its instructions is at
www.irs.gov/form990pf
.
OMB No. 1545-0052
20
15
Open to Public Inspection
For calendar year 2015, or tax year beginning
01-01-2015
, and ending
12-31-2015
Name of foundation
THE SEXTON FAMILY FOUNDATION
C/O O GRIFFITH SEXTON
% O GRIFFITH SEXTON
Number and street (or P.O. box number if mail is not delivered to street address)
410 COCONUT PALM ROAD
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
VERO BEACH
,
FL
32963
A Employer identification number
13-7106277
B
Telephone number (see instructions)
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)
$
5,829,311
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)
1,019,200
2
Check
Sch. B
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
107,896
107,596
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
-15,702
b
Gross sales price for all assets on line 6a
356,476
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)
.......
3,186
12
Total.
Add lines 1 through 11
........
1,114,580
107,596
13
Compensation of officers, directors, trustees, etc.
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
9,200
0
0
9,200
c
Other professional fees (attach schedule)
....
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
9,388
1,202
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
18,588
1,202
0
9,200
25
Contributions, gifts, grants paid
.......
322,750
322,750
26
Total expenses and disbursements.
Add lines 24 and 25
341,338
1,202
0
331,950
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
773,242
b
Net investment income
(if negative, enter -0-)
106,394
c
Adjusted net income
(if negative, enter -0-)
...
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2015)
Page 2
Form 990-PF (2015)
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
.............
2
Savings and temporary cash investments
.........
25,945
159,213
159,213
3
Accounts receivable
Less: allowance for doubtful accounts
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)
.......
3,548,336
3,666,266
5,670,098
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
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)
3,574,281
3,825,479
5,829,311
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
Foundations that follow SFAS 117, check here
and complete lines 24 through 26 and lines 30 and 31.
24
Unrestricted
..................
25
Temporarily restricted
...............
26
Permanently restricted
...............
Foundations that do not follow SFAS 117, check here
and complete lines 27 through 31.
27
Capital stock, trust principal, or current funds
........
28
Paid-in or capital surplus, or land, bldg., and equipment fund
29
Retained earnings, accumulated income, endowment, or other funds
3,574,281
3,825,479
30
Total net assets or fund balances
(see instructions)
.....
3,574,281
3,825,479
31
Total liabilities and net assets/fund balances
(see instructions)
.
3,574,281
3,825,479
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 30 (must agree with end-of-year figure reported on prior year’s return)
...............
1
3,574,281
2
Enter amount from Part I, line 27a
.....................
2
773,242
3
Other increases not included in line 2 (itemize)
3
4
Add lines 1, 2, and 3
..........................
4
4,347,523
5
Decreases not included in line 2 (itemize)
5
522,044
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30
.
6
3,825,479
Form
990-PF
(2015)
Page 3
Form 990-PF (2015)
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
7,010.736 SHS INFLATION-PROTECT SEC ADM
2013-01-17
b
17,985.612 SHS HIGH-YIELD CORP FUND ADM
2015-12-11
c
1,462.273 SHS TOTAL STOCK MKT IDX ADM
2015-12-23
d
CAPITAL GAIN DIVIDENDS
P
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
180,000
198,557
-18,323
b
100,000
134,457
-34,457
c
75,000
39,398
35,602
d
1,476
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
-18,557
b
-34,457
c
35,602
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
-15,702
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))
2014
270,085
5,219,773
0.051743
2013
218,260
4,759,860
0.045854
2012
184,800
3,645,044
0.050699
2011
178,850
3,635,674
0.049193
2010
170,875
3,204,001
0.053332
2
Total
of line 1, column (d)
.....................
2
0.250821
3
Average distribution ratio for the 5-year base period—divide the total on line 2 by 5, or by
the number of years the foundation has been in existence if less than 5 years
.
.
.
3
0.050164
4
Enter the net value of noncharitable-use assets for 2015 from Part X, line 5
.....
4
5,181,149
5
Multiply line 4 by line 3
......................
5
259,907
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
1,064
7
Add lines 5 and 6
........................
7
260,971
8
Enter qualifying distributions from Part XII, line 4
.............
8
331,950
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
(2015)
Page 4
Form 990-PF (2015)
Page
4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see page 18 of the 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
1,064
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
1,064
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
1,064
6
Credits/Payments:
a
2015 estimated tax payments and 2014 overpayment credited to 2015
6a
8,186
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
8,186
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
7,122
11
Enter the amount of line 10 to be:
Credited to 2015 estimated tax
7,122
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
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 XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
CT
,
FL
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 2015 or the taxable year beginning in 2015 (see 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
Yes
Form
990-PF
(2015)
Page 5
Form 990-PF (2015)
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
14
The books are in care of
O GRIFFITH SEXTON
Telephone no.
(206) 275-4600
Located at
410 COCONUT PALM ROAD
VERO BEACH
FL
ZIP+4
32963
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 2015, 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 instructions for exceptions and filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR). 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 2015?
.............
1c
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 2015, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2015?
.............
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
No
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 2015 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 2015.)
..................
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 2015?
4b
No
Form
990-PF
(2015)
Page 6
Form 990-PF (2015)
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:
(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
No
Form
990-PF
(2015)
Page 7
Form 990-PF (2015)
Page
7
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
O GRIFFITH SEXTON
TRUSTEE
0
0
410 COCONUT PALM ROAD
VERO BEACH
,
FL
32963
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
...................
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
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
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
Form
990-PF
(2015)
Page 8
Form 990-PF (2015)
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
5,187,294
b
Average of monthly cash balances
.......................
1b
72,756
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
5,260,050
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
5,260,050
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
78,901
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
5,181,149
6
Minimum investment return.
Enter 5% of line 5
..................
6
259,057
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
259,057
2a
Tax on investment income for 2015 from Part VI, line 5
......
2a
1,064
b
Income tax for 2015. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
1,064
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
257,993
4
Recoveries of amounts treated as qualifying distributions
................
4
5
Add lines 3 and 4
............................
5
257,993
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
257,993
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
331,950
b
Program-related investments—total from Part IX-B
..................
1b
0
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
0
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
0
b
Cash distribution test (attach the required schedule)
.................
3b
0
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
331,950
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
1,064
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
330,886
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
(2015)
Page 9
Form 990-PF (2015)
Page
9
Part XIII
Undistributed Income
(see instructions)
(a)
Corpus
(b)
Years prior to 2014
(c)
2014
(d)
2015
1
Distributable amount for 2015 from Part XI, line 7
257,993
2
Undistributed income, if any, as of the end of 2015:
a
Enter amount for 2014 only
.......
0
b
Total for prior years:
2013
,
2012
,
2011
0
3
Excess distributions carryover, if any, to 2015:
a
From 2010
......
12,901
b
From 2011
......
c
From 2012
......
4,804
d
From 2013
......
e
From 2014
......
12,434
f
Total
of lines 3a through e
........
30,139
4
Qualifying distributions for 2015 from Part
XII, line 4:
$
331,950
a
Applied to 2014, 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 2015 distributable amount
.....
257,993
e
Remaining amount distributed out of corpus
73,957
5
Excess distributions carryover applied to 2015.
(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
104,096
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 2014. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
0
f
Undistributed income for 2016. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2015
..........
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 2010 not
applied on line 5 or line 7 (see instructions)
...
12,901
9
Excess distributions carryover to 2016.
Subtract lines 7 and 8 from line 6a
......
91,195
10
Analysis of line 9:
a
Excess from 2011
....
b
Excess from 2012
....
4,804
c
Excess from 2013
....
d
Excess from 2014
....
12,434
e
Excess from 2015
....
73,957
Form
990-PF
(2015)
Page 10
Form 990-PF (2015)
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 2015, 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)
2015
(b)
2014
(c)
2013
(d)
2012
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 organization 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).)
O GRIFFITH SEXTON
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.
NA
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. (see instructions) to individuals or organizations under
other conditions, complete items 2a, b, c, and d.
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
(2015)
Page 11
Form 990-PF (2015)
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
BOYS AND GIRLS CLUB OF INDIAN RIVER COUNTY
1729 17TH AVE
VERO BEACH
,
FL
32960
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - provide a safe, structured and positive environment for young people after school, during holidays and summer vacation.
11,000
CAMP BOGGY CREEK
30500 BRANTLEY BRANCH ROAD
EUSTIS
,
FL
32736
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - SUPPORT A YEAR ROUND CAMP SERVING SERIOUSLY ILL CHILDREN
5,000
DEERFIELD ACADEMY
7 BOYDEN LANE
DEERFIELD
,
MA
01342
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION- SUPPORT FOR FOUR YEAR COLLEGE - PREPARATORY SCHOOL SERVICES SCHOLARSHIPS
2,500
ADVANCING NATIVE MISSIONS
PO BOX 5303
CHARLOTTESVILLE
,
VA
22905
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - HELP NATIVE MISSIONARIES
10,000
MEMORIAL SLOAN KETTERING CANCER CENTER
1275 YORK AVENUE
NEW YORK
,
NY
10021
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - SUPPORT FOR CANCER TREATMENT AND RESEARCH
2,500
COOKE FOUNDATION FOR SPECIAL EDUCATION
475 RIVERSIDE DRIVE SUITE 730
NEW YORK
,
NY
101150797
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - OFFER SPECIAL EDUCATION, CONSULTING AND TRAINING SERVICES FOR STUDENTS
10,000
UNITED WAY OF GREENWICH
1 LAFAYETTE COURT
GREENWICH
,
CT
06830
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - HELP RESOLVE PRESSING COMMUNITY EDUCATION, INCOME AND HEALTH ISSUES
35,000
PEACE TREES VIETNAM
1301 5TH AVE SUITE 2500
SEATTLE
,
WA
98101
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - SPONSOR MINE RISK EDUCATION, SURVIVOR ASSISTANCE, CITIZEN DIPLOMACY TRIPS
5,000
GREENWICH HOSPITAL
5 PERRYRIDGE ROAD
GREENWICH
,
CT
068304697
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - MEET CHANGING COMMUNITY HEALTHCARE NEEDS.
1,000
PRINCETON UNIVERSITY
BOX 46
PRINCETON
,
NJ
085440046
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - SUPPORT FOR SCHOOL SERVICES AND SCHOLARSHIPS
5,000
COTTAGE 1886 FOUNDATION INC
51 PROSPECT AVENUE
PRINCETON
,
NJ
08540
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - FOSTER, PROMOTE AND SUPPORT THE EDUCATIONAL, CULTURAL & OTHER CHARITABLE ACTIVITIES OF THE UNIVERSITY COTTAGE CLUB
2,500
AMVETS
421 45TH AVENUE SOUTH
ST PETERSBURG
,
FL
33705
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - ASSISTING VETERANS AND SPONSORING PROGRAMS THAT SERVE OUR COUNTY AND CITIZENS
500
CIVIL WAR TRUST
1156 15TH ST NW STE 900
WASHINGTON
,
DC
20005
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - devoted to the preservation of our nation's endangered Civil War battlefields
1,000
ROBIN HOOD FOUNDATION
111 BROADWAY
NEW YORK
,
NY
10006
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - ALLEVIATE PROBLEMS CAUSED BY POVERTY
5,000
GREENWICH EMERGENCY MEDICAL SERVICES
1111 EAST PUTNAM AVENUE
RIVERSIDE
,
CT
06878
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - SUPPORT ADVANCED LIFE SUPPORT MEDICAL CARE
500
STANFORD GRADUATE SCHOOL OF BUSINESS
655 KNIGHT WAY
STANFORD
,
CA
94305
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - SUPPORT FOR SCHOOL SERVICES AND SCHOLARSHIPS
10,000
AMOGERONE VOLUNTEER FIRE COMPANY
PO BOX 121
GREENWICH
,
CT
06836
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - COMMUNITY FIRE FIGHTING AND EMERGENCY ASSISTANCE
500
DENISON ANNUAL FUND
100 SOUTH ROAD
GRANVILLE
,
OH
43023
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - SCHOLARSHIP FUNDING, SUPPORT FOR EDUCATIONAL SERVICES
2,500
EAST HARLEM SCHOOL
340 EAST 104TH STREET
NEW YORK
,
NY
10029
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - EDUCATIONAL SUPPORT SERVICES FOR LOW INCOME FAMILIES
2,500
BOYS AND GIRLS CLUB OF GREENWICH
4 HORSENECK LANE
GREENWICH
,
CT
06830
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - providing high-quality educational programs, building a sense of character and citizenship, maintaining diversity, and offering kids a safe, nurturing, and affordable environment
2,500
ECKERD COLLEGE
4200 54TH AVENUE SOUTH
ST PETERSBURG
,
FL
33711
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - SUPPORT FOR SCHOOL SERVICES AND SCHOLARSHIPS
7,500
STEADMAN PHILIPPON RESEARCH INSTITUTE
181 WEST MEADOW DRIVE SUITE 1000
VAIL
,
CO
81657
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - research into the causes, prevention and treatment of orthopedic disorders.
1,000
JONES INSTITUTE FOR REPRODUCTIVE MEDICINE
601 COLLEY AVENUE
NORFOLK
,
VA
23507
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - Assisted Reproductive Technology Research
5,000
REACH
1027 Farmington Ave
FARMINGTON
,
CT
06032
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - assist in Employment, Education and Housing Opportunities for low income families
7,500
NORWALK COMMUNITY COLLEGE FOUNDATION
188 RICHARDS AVENUE
NORWALK
,
CT
068541655
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - SUPPORT FOR SCHOOL SERVICES AND SCHOLARSHIPS
2,500
POSSE FOUNDATION
14 WALL STREET SUITE 8A-60
NEW YORK
,
NY
10005
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - identifies, recruits, and trains student leaders from public high schools
5,000
ADOPT-A-DOG
62 BOWMAN AVENUE
RYE BROOK
,
NY
10573
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - SUPPORT ADOPTION AND PROMOTE WELFARE OF ANIMALS
500
GUIDING EYES FOR THE BLIND
611 GRANITE SPRINGS ROAD
YORKTOWN HEIGHTS
,
NY
10598
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - training guide dogs to lead the blind and visually impaired
2,500
BUCKNELL UNIVERSITY
MOORE AVENUE
LEWISBURG
,
PA
17837
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - SUPPORT FOR SCHOOL SERVICES AND SCHOLARSHIPS
5,000
SALVATION ARMY
170 NORTH REGENET STREET
PORT CHESTER
,
NY
10573
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - bring assistance to the poor, destitute and hungry
1,000
INDIAN RIVER MEDICAL CENTER FOUNDATION
1000 36TH STREET
VERO BEACH
,
FL
32960
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - provide comprehensive, high quality medical services
5,000
FOP - INDIAN RIVER
242 OFFICE PLAZA
TALLAHASSEE
,
FL
32301
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - used to supplement the officers medical and educational expenses.
500
INDIAN RIVER COMMUNITY FOUNDATION
4625 HIGHWAY A1A
VERO BEACH
,
FL
32963
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - build a stronger community through donor-driven philanthropy.
5,000
INDIAN RIVER COUNTY VOLUNTEER AMBULANCE SQUAD
3401 INDIAN RIVER DR E
VERO BEACH
,
FL
32963
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - provide free non-emergency transportation for ambulatory and wheelchair passengers
500
SMILE TRAIN
41 MADISON AVE 28TH FLOOR
NEW YORK
,
NY
10010
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - provides free cleft surgery to poor children in developing countries.
500
JOHN'S ISLAND FOUNDATION
3055 CARDINAL DRIVE
VERO BEACH
,
FL
32963
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - raises funds from the John's Island community for the purpose of making grants for capital needs and special projects
5,000
HIBISCUS CHILDREN'S CENTER
2400 NE DIXIE HWY
JENSEN BEACH
,
FL
349575949
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - To rebuild and repair the lives of abused and neglected children
1,000
HOSPITAL FOR SPECIAL SURGERY
535 E 70TH STREET
NEW YORK
,
NY
10021
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - specialty hospital for orthopedics and rheumatology
1,000
PETER MICHAEL FOUNDATION
1 GATE SIX ROAD BUILDING B SUITE 2
SAUSALITO
,
CA
94965
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - discover and underwrite the most promising tools and technologies for the identification, treatment and management of prostate cancer
2,500
VNA FOUNDATION
20 N WACKER DR SUITE 3118
CHICAGO
,
IL
60606
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - helping the medically underserved in the Chicago metropolitan area.
500
FIBROLAMELLAR CANCER FOUNDATION
20 Horseneck Lane 2nd Floor
GREENWICH
,
CT
06830
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - Find a cure and treatment options of FIBROLAMELLAR CANCER
15,000
USO
PO BOX 96860
WASHINGTON
,
DC
200906860
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - provide services to lift the spirits of Americas troops and their families
500
INDIAN RIVER LAND TRUST
80 ROYAL PALM POINTE SUITE 301
VERO BEACH
,
FL
32960
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - promote the preservation, conservation and improvement of Indian River County's natural resources and special places for the benefit of the general public and future generations.
2,500
NATIONAL WORLD WAR II MUSEUM
945 MAGAZINE STREET
NEW ORLEANS
,
LA
70130
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - support for museum that displays WWII artifacts
500
LEARNING ALLIANCE
PO BOX 643446
VERO BEACH
,
FL
32964
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - delivering the latest advances in science-based education techniques to area teachers
5,000
VERO BEACH VOLUNTEER FIRE DEPARTMENT
PO BOX 2222
VERO BEACH
,
FL
32961
NONE
CHARITABLE CONTRIBUTION -PROVIDE ASSISTANCE TO FIREFIGHTERS FAMILYS AND OTHER CHARITABLE ORGANIZATIONS IN THE COMMUNITY
250
VIETNAM VETERANS MEMORIAL
DISTRICT OF COLUMBIA
WASHINGTON DC
,
DC
20024
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - supporting the place of healing for those affected by the Vietnam war
2,500
GREENWICH POLICE SILVER SHIELD ASSOCIATION
11 HAVEMEYER PLACE
GREENWICH
,
CT
06830
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - help to to provide police services to the citizens and business community of The Town of Greenwich.
500
CURESEARCH FOR CHILDREN'S CANCER
4400 EAST WEST HIGHWAY SUITE 6000
BETHESDA
,
MD
20814
NONE
PUBLIC CHARITY
CHARITABLE CONTRIBUTION - CHILDREN'S CANCER RESERACH
8,500
DOCTORS WITHOUT BORDERS
333 7TH AVENUE
NEW YORK
,
NY
10001
NONE
PC
CHARITABLE CONTRIBUTION -help people worldwide where the need is greatest, delivering emergency medical aid to people affected by conflict, epidemics, disasters or exclusion from health care.
2,500
PRINCETON UNIVERSITY FRIENDS
ONE WASHINGTON ROAD
PRINCETON
,
NJ
08544
NONE
PC
CHARITABLE CONTRIBUTION - play a vital role in supporting the acquisitions and operations of the Library. unique opportunities to participate in special events.
80,500
SPECIAL OPERATIONS FUND
901 NORTH STUART STREET
ARLINGTON
,
VA
22203
NONE
PC
CHARITABLE CONTRIBUTION - PROVIDES ESSENTIAL SUPPORT TO THOSE WHO ARE SERVING OUR COUNTRY IN SENSITIVE MISSIONS AROUND THE WORLD.
7,500
WATERSIDE SCHOOL
770 PACIFIC ST
STAMFORD
,
CT
06902
NONE
PC
CHARITABLE CONTRIBUTION - providing a rigorous academic and moral education to children regardless of circumstances.
1,000
BOOKS FOR AFRICA
26 EAST EXCHANGE STREET SUITE 411
SAINT PAUL
,
MN
55101
NONE
PROVIDE BOOKS FOR THE POOR IN AFRICA.
2,000
COOLE OBSERVATIONS
59300 OVERSEAS HWY
MARATHON
,
FL
33050
NONE
PROVIDE ACCESS TO ASTRONOMICAL OBSERVATORY FOR THE PUBLIC.
7,000
DANNY & RON'S RESCUE
PO BOX 604
CAMDEN
,
FL
29021
NONE
SUPPORT ADOPTION OF PET ANIMALS.
3,000
DARIEN EMERGENCY MEDICAL SERVICES
602 GERRY WAY
DARIEN
,
WI
53114
NONE
SUPPORT EMERGENCY MEDICAL SERVICES
2,500
FISHER HOUSE FOUNDATION
111 ROCKVILLE PIKE SUITE 420
ROCKVILLE
,
MD
20850
NONE
PROVIDE HOUSING TO FAMILIES OF RECOVERING MILITARY MEN AND WOMEN.
5,000
INDIAN RIVER GOLF FOUNDATION
4595 22ND LANE
VERO BEACH
,
FL
32966
NONE
PROVIDE SPORTSMANSHIP EDUCATION.
1,000
MORADA WAY ARTS AND CULTURAL DISTRICT
151 MORADA WAY
ISLAMORADA
,
FL
33036
NONE
PROMOTE CREATIVE ARTS AND CULTURAL ACTIVITIES
1,000
MEDICAL UNIVERSITY OF SOUTH CAROLINA FOUNDATION
18 BEE ST MSC 450
CHARLESTON
,
SC
29425
NONE
SUPPORT EDUCATION, RESEARCH, PATIENT CARE, AND OTHER MEDICAL GOALS.
500
VERO BEACH POLICE BENEVOLENT ASSOCIATION
4401 41ST ST
VERO BEACH
,
FL
32967
NONE
SUPPORT POLICE FORCE
500
Total
.................................
3a
322,750
b
Approved for future payment
Total
.................................
3b
Form
990-PF
(2015)
Page 12
Form 990-PF (2015)
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
...........
4
Dividends and interest from securities
....
14
107,896
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
............
18
-15,702
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
..
11
Other revenue:
a
EXCISE TAX REFUND
01
3,186
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
95,380
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
95,380
(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
(2015)
Page 13
Form 990-PF (2015)
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) of the Code (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) of the Code (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.
2016-05-15
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
DARCY A LOUGHRAN
Preparer's Signature
Date
Check if self-
employed
PTIN
P00429203
Firm's name
FRANKEL LOUGHRAN STARR VALLONE-WA
Firm's EIN
Firm's address
7900 SE 28TH STREET STE 226
MERCER ISLAND
,
WA
98040
Phone no.
(206) 275-4600
Form
990-PF
(2015)
Additional Data
Software ID:
Software Version:
Form 990PF - Special Condition Description:
Special Condition Description