efile Public Visual Render
ObjectId: 201701359349104725 - Submission: 2017-05-15
TIN: 02-0788743
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
16
Open to Public Inspection
For calendar year 2016, or tax year beginning
01-01-2016
, and ending
12-31-2016
Name of foundation
ELLIS FAMILY CHARITABLE FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)
5200 E LA PALMA AVENUE
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
ANAHEIM
,
CA
92807
A Employer identification number
02-0788743
B
Telephone number (see instructions)
(714) 777-8600
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)
$
3,419,651
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)
772,670
2
Check
Sch. B
.............
3
Interest on savings and temporary cash investments
3,027
3,027
4
Dividends and interest from securities
...
114,172
96,904
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
-33,131
b
Gross sales price for all assets on line 6a
323,827
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)
.......
1,188
1,188
12
Total.
Add lines 1 through 11
........
857,926
101,119
13
Compensation of officers, directors, trustees, etc.
0
0
0
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
6,000
0
6,000
c
Other professional fees (attach schedule)
....
33,607
33,607
0
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
5,839
5,804
35
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
1,347
0
507
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
46,793
39,411
6,542
25
Contributions, gifts, grants paid
.......
1,161,063
1,161,063
26
Total expenses and disbursements.
Add lines 24 and 25
1,207,856
39,411
1,167,605
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-349,930
b
Net investment income
(if negative, enter -0-)
61,708
c
Adjusted net income
(if negative, enter -0-)
...
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2016)
Page 2
Form 990-PF (2016)
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
.............
420,186
203,512
203,512
2
Savings and temporary cash investments
.........
140,639
37,849
37,849
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)
.......
1,166,967
1,147,703
1,128,415
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)
..........
1,735,428
1,725,067
2,045,307
14
Land, buildings, and equipment: basis
12,613
Less: accumulated depreciation (attach schedule)
8,045
5,409
4,568
4,568
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
3,468,629
3,118,699
3,419,651
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 SFAS 117, check here
and complete lines 24 through 26 and lines 30 and 31.
24
Unrestricted
..................
3,468,629
3,118,699
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
30
Total net assets or fund balances
(see instructions)
.....
3,468,629
3,118,699
31
Total liabilities and net assets/fund balances
(see instructions)
.
3,468,629
3,118,699
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
3,468,629
2
Enter amount from Part I, line 27a
.....................
2
-349,930
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
3,118,699
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 30
.
6
3,118,699
Form
990-PF
(2016)
Page 3
Form 990-PF (2016)
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
295 SHS IPATH DOW JONES-UBS
P
2016-01-05
2016-02-09
b
30 SHS CONSTELLATION BRANDS INC
P
2015-07-16
2016-01-05
c
541 SHS CREDIT SUISSE COMM
P
2016-02-11
2016-07-18
d
25 SHS CUMMINS INC
P
2015-09-03
2016-07-18
e
10 SHS GOLDMAN SACHS GROUP INC
P
2016-01-05
2016-07-18
60 SHS ORACLE CORPORATION
P
2015-07-23
2016-07-18
90 SHS ORACLE CORPORATION
P
2016-01-05
2016-07-18
5 SHS PNC FINANCIAL SERVICES GROUP
P
2015-05-29
2016-01-05
15 SHS PHILIP MORRIS INTERNATIONAL
P
2015-01-29
2016-01-05
15 SHS CONSUMMER STAPLES SECTOR
P
2015-01-29
2016-01-05
15 SHS AMEX INDUSTRIAL
P
2015-01-29
2016-01-05
0.97 SHS REAL ESTATE SELECT SECT
P
2016-09-22
2016-10-07
30 SHS SUNCOR ENERGY INC
P
2015-08-05
2016-07-18
5 SHS E-TRACS ALERIAN MLP INFRASTRUCTURE
P
2015-07-23
2016-07-18
800 SHS WIDOMTREE INTL HEDGED EQ FD
P
2015-07-23
2016-01-05
2,560 SHS IPATH ETN CRUDE OIL
P
2015-01-29
2016-01-21
1,405 SHS IPATH ETN CRUDE OIL
P
2016-01-05
2016-01-21
10 SHS AMAZON COM INC
P
2012-01-24
2016-01-05
105 SHS DOW JONES-UBS COMMODITY INDEX
P
2012-01-24
2016-02-09
160 SHS DOW JONES-UBS COMMODITY INDEX
P
2012-04-19
2016-02-09
210 SHS DOW JONES-UBS COMMODITY INDEX
P
2013-02-28
2016-02-09
165 SHS DOW JONES-UBS COMMODITY INDEX
P
2013-06-10
2016-02-09
145 SHS DOW JONES-UBS COMMODITY INDEX
P
2013-11-25
2016-02-09
10 SHS DOW JONES-UBS COMMODITY INDEX
P
2014-08-05
2016-02-09
640 SHS DOW JONES-UBS COMMODITY INDEX
P
2015-01-29
2016-02-09
25 SHS IPATH ETN CRUDE OIL - BARCLAYS PLC
P
2013-02-28
2016-01-21
30 SHS IPATH ETN CRUDE OIL - BARCLAYS PLC
P
2013-06-10
2016-01-21
5 SHS BERSHIRE HATHAWAY INC
P
2014-02-26
2016-07-18
5 SHS BLACKROCK INC
P
2014-06-09
2016-01-05
10 SHS CME GROUP INC
P
2013-11-25
2016-07-18
25 SHS CONCHO RESOURCES INC
P
2015-01-29
2016-07-18
274.38 SHS EATON VANCE STRCT EM MRKT
P
2014-06-09
2016-07-18
10 SHS GOLDMAN SACHS GROUP INC
P
2011-04-05
2016-07-18
10 SHS GOLDMAN SACHS GROUP INC
P
2011-06-15
2016-07-18
10 SHS GOLDMAN SACHS GROUP INC
P
2011-10-19
2016-07-18
5 SHS GOLDMAN SACHS GROUP INC
P
2012-04-19
2016-07-18
5 SHS GOLDMAN SACHS GROUP INC
P
2012-07-02
2016-07-18
10 SHS GOLDMAN SACHS GROUP INC
P
2015-01-29
2016-07-18
90 SHS ISHARES TR MSCI EMERGING MARKETS
P
2012-01-24
2016-07-18
370 SHS ISHARES MSCI RUSSIA COMPANY
P
2014-10-22
2016-07-18
11.65 SHS MERGER FUND-INST #301
P
2014-02-26
2016-07-08
1,002.44 SHS NUVEEN HIGH YIELD MUNI BD-R 1668
P
2012-06-04
2016-11-23
205 SHS ORACLE CORPORATION
P
2011-04-05
2016-07-18
45 SHS ORACLE CORPORATION
P
2011-10-19
2016-07-18
80 SHS ORACLE CORPORATION
P
2012-01-24
2016-07-18
40 SHS ORACLE CORPORATION
P
2012-04-19
2016-07-18
25 SHS ORACLE CORPORATION
P
2013-06-10
2016-07-18
35 SHS ORACLE CORPORATION
P
2014-08-05
2016-07-18
20 SHS ORACLE CORPORATION
P
2015-01-29
2016-07-18
31.55 SHS OPPENHEIMER DEVELOPING MKT
P
2013-06-10
2016-07-18
5 SHS PHILIP NMORRIS INTERNATIONAL
P
2015-01-29
2016-07-18
20 SHS AMEX ENERGY SELECT SPDR
P
2012-10-09
2016-07-18
5 SHS AMEX FINANCIAL SELECT SPDR
P
2012-05-10
2016-01-05
30 SHS TJX COS INC NEW
P
2014-05-21
2016-01-05
335 SHS IPATH DOW JONES-USB COMMODITY INDEX
P
2010-09-28
2016-02-09
40 SHS IPATH DOW JONES-USB COMMODITY INDEX
P
2011-01-04
2016-02-09
15 SHS IPATH DOW JONES-USB COMMODITY INDEX
P
2011-06-15
2016-02-09
100 SHS IPATH DOW JONES-USB COMMODITY INDEX
P
2011-10-19
2016-02-09
60 SHS IPATH ETN CRUDE OIL - BARCLAYS PLC
P
2012-04-19
2016-01-21
250 SHS IPATH ETN CRUDE OIL - BARCLAYS PLC
P
2012-07-02
2016-01-21
300 SHS IPATH ETN CRUDE OIL - BARCLAYS PLC
P
2013-11-25
2016-01-21
5 SHS BOEING COMPANY
P
2009-09-21
2016-01-05
5 SHS CHEVRON CORP
P
2009-04-16
2016-01-05
10 SHS CHEVRON CORP
P
2009-08-05
2016-01-05
5 SHS CHEVRON CORP
P
2009-08-05
2016-07-18
10 SHS CHEVRON CORP
P
2009-09-21
2016-07-18
10 SHS CISCO SYSTEM INC
P
2009-09-21
2016-07-18
5 SHS CISCO SYSTEM INC
P
2009-09-28
2016-07-18
5 SHS EXXON MOBIL CORPORATION
P
2009-08-05
2016-01-05
10 SHS EXXON MOBIL CORPORATION
P
2009-09-21
2016-01-05
25 SHS EXXON MOBIL CORPORATION
P
2009-09-21
2016-07-18
40 SHS GENERAL ELECTRIC CO
P
2009-04-16
2016-01-05
50 SHS GENERAL ELECTRIC CO
P
2009-05-14
2016-01-05
10 SHS GENERAL ELECTRIC CO
P
2009-09-21
2016-01-05
5 SHS GOLDMAN SACHS GROUP INC
P
2010-01-27
2016-07-18
15 SHS GOLDMAN SACHS GROUP
P
2010-06-01
2016-07-18
30 SHS HOME DEPOT INC
P
2009-10-13
2016-01-05
15 SHS ISHARES TR S & P MIDCAP 400
P
2009-05-14
2016-07-18
20 SHS ISHARES TR SMALL CAP 600 INDEX
P
2009-09-21
2016-07-18
30 SHS ISHARES SILVER TR
P
2012-04-19
2016-01-05
25 SHS ISHARES SILVER TR
P
2012-07-02
2016-01-05
60 SHS ISHARES SILVER TR
P
2012-07-02
2016-07-18
210 SHS ISHARES SILVER TR
P
2013-02-28
2016-07-18
270 SHS ISHARES SILVER TR
P
2013-04-23
2016-07-18
20 SHS JOHNSON & JOHNSON
P
2009-04-16
2016-01-05
10 SHS JOHNSON & JOHNSON
P
2009-04-16
2016-07-18
5 SHS JOHNSON & JOHNSON
P
2009-08-05
2016-07-18
10 SHS JOHNSON & JOHNSON
P
2009-09-21
2016-07-18
40 SHS MICROSOFT CORP
P
2009-09-21
2016-01-05
50,000 OCCIDENTAL PETROLEUM 4.125% 6/01/16
P
2009-05-14
2016-06-01
5 SHS PROCTER & GAMBLE CO
P
2009-05-14
2016-01-05
5 SHS SPDR DJ WILSHIRE INTERNATIONAL REAL
P
2009-05-14
2016-01-05
5 SHS SPDR DJ WILSHIRE INTERNATIONAL REAL
P
2009-05-14
2016-07-18
55 SHS AMEX MATERIALS SPDR
P
2010-12-09
2016-01-05
25 SHS AMEX MATERIALS SPDR
P
2010-12-09
2016-07-18
5 SHS AMEX HEALTH CARE SPDR
P
2011-10-25
2016-01-05
15 SHS AMEX CONSUMER DISCR SPDR
P
2011-04-12
2016-01-05
20 SHS AMEX UTILITIES SPDR
P
2011-06-15
2016-01-05
15 SHS THERMO FISHER SCIENTIFIC INC
P
2010-08-30
2016-01-05
10 SHS THERMO FISHER SCIENTIFIC INC
P
2010-08-30
2016-07-18
10 SHS 3M CO
P
2009-05-14
2016-01-05
5 SHS 3M CO
P
2009-09-21
2016-07-18
10 SHS UNITED PARCEL SERVICE-CL B
P
2009-05-14
2016-01-05
5 SHS UNITED PARCEL SERVICE-CL B
P
2009-05-14
2016-07-18
5 SHS UNITED TECHNOLOGIES CORP
P
2009-04-16
2016-01-05
15 SHS UNITED HEALTH GROUP INC
P
2009-04-16
2016-01-05
5 SHS UNITED HEALTH GROUP INC
P
2009-04-16
2016-07-18
15 SHS UNITED HEALTH GROUP INC
P
2009-10-13
2016-07-18
35 SHS VANGUARD REIT VIPER
P
2009-05-14
2016-01-05
40 SHS VANGUARD REIT VIPER
P
2009-08-05
2016-01-05
30 SHS VANGUARD REIT VIPER
P
2009-08-05
2016-07-18
AMORTIZED BOND PREMIUM
P
2016-01-01
2016-12-31
CAPITAL GAINS DIVIDENDS
P
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
5,895
6,260
-365
b
4,298
3,533
765
c
2,705
2,315
390
d
2,958
3,010
-52
e
1,626
1,736
-110
2,502
2,342
160
3,753
3,212
541
465
479
-14
1,316
1,208
108
751
728
23
785
822
-37
30
30
0
831
842
-11
140
164
-24
42,234
51,601
-9,367
11,792
25,160
-13,368
6,471
8,612
-2,141
6,343
1,850
4,493
2,098
4,493
-2,395
3,198
6,544
-3,346
4,197
8,495
-4,298
3,297
6,357
-3,060
2,898
5,255
-2,357
200
371
-171
12,790
18,044
-5,254
115
546
-431
138
669
-531
730
569
161
1,666
1,572
94
1,016
832
184
3,053
2,652
401
3,545
4,390
-845
1,626
1,588
38
1,626
1,346
280
1,626
1,026
600
813
564
249
813
484
329
1,626
1,731
-105
3,202
3,732
-530
5,191
6,048
-857
180
187
-7
16,580
16,500
80
8,547
7,011
1,536
1,876
1,431
445
3,336
2,268
1,068
1,668
1,152
516
1,042
851
191
1,459
1,401
58
834
857
-23
1,015
1,092
-77
517
403
114
1,378
1,478
-100
117
75
42
2,152
1,679
473
6,695
14,207
-7,512
799
1,940
-1,141
300
733
-433
1,998
4,388
-2,390
276
1,539
-1,263
1,152
5,095
-3,943
1,382
6,621
-5,239
704
264
440
446
335
111
893
697
196
533
348
185
1,066
719
347
297
235
62
149
109
40
389
350
39
778
691
87
2,371
1,727
644
1,225
482
743
1,532
659
873
306
164
142
813
745
68
2,439
2,165
274
3,915
826
3,089
2,308
830
1,478
2,428
1,066
1,362
399
910
-511
332
658
-326
1,136
1,578
-442
3,976
5,788
-1,812
5,112
5,866
-754
2,020
1,041
979
1,230
520
710
615
303
312
1,230
607
623
2,204
1,009
1,195
50,000
52,036
-2,036
392
255
137
194
129
65
209
129
80
2,343
2,031
312
1,219
923
296
355
166
189
1,150
586
564
869
657
212
2,083
642
1,441
1,566
428
1,138
1,470
580
890
905
371
534
955
527
428
555
263
292
477
236
241
1,750
382
1,368
709
127
582
2,126
365
1,761
2,814
872
1,942
3,216
1,304
1,912
2,703
965
1,738
172
-172
1,259
1,259
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
-365
b
765
c
390
d
-52
e
-110
160
541
-14
108
23
-37
0
-11
-24
-9,367
-13,368
-2,141
4,493
-2,395
-3,346
-4,298
-3,060
-2,357
-171
-5,254
-431
-531
161
94
184
401
-845
38
280
600
249
329
-105
-530
-857
-7
80
1,536
445
1,068
516
191
58
-23
-77
114
-100
42
473
-7,512
-1,141
-433
-2,390
-1,263
-3,943
-5,239
440
111
196
185
347
62
40
39
87
644
743
873
142
68
274
3,089
1,478
1,362
-511
-326
-442
-1,812
-754
979
710
312
623
1,195
-2,036
137
65
80
312
296
189
564
212
1,441
1,138
890
534
428
292
241
1,368
582
1,761
1,942
1,912
1,738
-172
1,259
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
-33,131
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))
2015
1,398,046
3,221,048
0.434035
2014
1,150,313
3,316,591
0.346836
2013
1,077,562
3,299,981
0.326536
2012
1,190,674
3,082,247
0.386301
2011
1,216,013
3,346,139
0.363408
2
Total
of line 1, column (d)
.....................
2
1.857116
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
0.371423
4
Enter the net value of noncharitable-use assets for 2016 from Part X, line 5
......
4
3,155,777
5
Multiply line 4 by line 3
......................
5
1,172,128
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
617
7
Add lines 5 and 6
........................
7
1,172,745
8
Enter qualifying distributions from Part XII, line 4
,.............
8
1,167,605
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
(2016)
Page 4
Form 990-PF (2016)
Page
4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a
Exempt operating foundations described in section 4940(d)(2), check here
and enter “N/A" on line 1.
Date of ruling or determination letter:
(attach copy of letter if necessary–see instructions)
b
Domestic foundations that meet the section 4940(e) requirements in Part V, check
1
1,234
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
0
3
Add lines 1 and 2
...........................
3
1,234
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
1,234
6
Credits/Payments:
a
2016 estimated tax payments and 2015 overpayment credited to 2016
6a
5,400
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
5,400
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
4,166
11
Enter the amount of line 10 to be:
Credited to 2017 estimated tax
4,166
Refunded
11
0
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.
$
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 XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
CA
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 2016 or the taxable year beginning in 2016 (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
No
Form
990-PF
(2016)
Page 5
Form 990-PF (2016)
Page
5
Part VII-A
Statements Regarding Activities
(continued)
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. (see instructions)
.............
11
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement (see instructions)
.................
12
No
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
N/A
14
The books are in care of
GREG S RUMMLER
Telephone no.
(714) 777-8600
Located at
5200 E LA PALMA AVENUE
ANAHEIM
CA
ZIP+4
92807
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 2016, 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 2016?
.............
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 2016, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2016?
.............
Yes
No
If "Yes," list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer "No" and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
......................
Yes
No
b
If "Yes," did it have excess business holdings in 2016 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 2016.)
..................
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 2016?
4b
No
Form
990-PF
(2016)
Page 6
Form 990-PF (2016)
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
Form
990-PF
(2016)
Page 7
Form 990-PF (2016)
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
KENDRICK G ELLIS
PRESIDENT, CEO
1.00
0
0
0
5200 E LA PALMA AVENUE
ANAHEIM
,
CA
92807
STANLEY J ELLIS
VICE PRESIDENT
0.00
0
0
0
5200 E LA PALMA AVENUE
ANAHEIM
,
CA
92807
GREGORY S ELLIS
VICE PRESIDENT
0.00
0
0
0
5200 E LA PALMA AVENUE
ANAHEIM
,
CA
92807
KENNETH M ELLIS
VICE PRESIDENT
0.00
0
0
0
5200 E LA PALMA AVENUE
ANAHEIM
,
CA
92807
JON S ELLIS
SECRETARY
0.00
0
0
0
5200 E LA PALMA AVENUE
ANAHEIM
,
CA
92807
GREG S RUMMLER
TREASURER, CFO
1.00
0
0
0
5200 E LA PALMA AVENUE
ANAHEIM
,
CA
92807
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
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
NONE
Total
number of others receiving over $50,000 for professional services
.............
0
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
N/A
0
2
All other program-related investments. See instructions.
3
0
Total.
Add lines 1 through 3
.........................
0
Form
990-PF
(2016)
Page 8
Form 990-PF (2016)
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
2,879,080
b
Average of monthly cash balances
.......................
1b
316,824
c
Fair market value of all other assets (see instructions)
................
1c
7,931
d
Total
(add lines 1a, b, and c)
.........................
1d
3,203,835
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
3,203,835
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
48,058
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
3,155,777
6
Minimum investment return.
Enter 5% of line 5
..................
6
157,789
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
157,789
2a
Tax on investment income for 2016 from Part VI, line 5
......
2a
1,234
b
Income tax for 2016. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
1,234
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
156,555
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
156,555
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 XIII, line 1
...
7
156,555
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
1,167,605
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
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 V, line 8, and Part XIII, line 4
4
1,167,605
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
0
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
1,167,605
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
(2016)
Page 9
Form 990-PF (2016)
Page
9
Part XIII
Undistributed Income
(see instructions)
(a)
Corpus
(b)
Years prior to 2015
(c)
2015
(d)
2016
1
Distributable amount for 2016 from Part XI, line 7
156,555
2
Undistributed income, if any, as of the end of 2016:
a
Enter amount for 2015 only
.......
0
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2016:
a
From 2011
......
1,050,882
b
From 2012
......
1,039,369
c
From 2013
......
916,134
d
From 2014
......
989,571
e
From 2015
......
1,247,792
f
Total
of lines 3a through e
........
5,243,748
4
Qualifying distributions for 2016 from Part
XII, line 4:
$
1,167,605
a
Applied to 2015, 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 2016 distributable amount
.....
156,555
e
Remaining amount distributed out of corpus
1,011,050
5
Excess distributions carryover applied to 2016.
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
6,254,798
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 2015. 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 2017
..........
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 2011 not
applied on line 5 or line 7 (see instructions)
...
1,050,882
9
Excess distributions carryover to 2017.
Subtract lines 7 and 8 from line 6a
......
5,203,916
10
Analysis of line 9:
a
Excess from 2012
....
1,039,369
b
Excess from 2013
....
916,134
c
Excess from 2014
....
989,571
d
Excess from 2015
....
1,247,792
e
Excess from 2016
....
1,011,050
Form
990-PF
(2016)
Page 10
Form 990-PF (2016)
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 2016, 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)
2016
(b)
2015
(c)
2014
(d)
2013
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).)
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. (see instructions) to individuals or organizations under
other conditions, complete items 2a, b, c, and d.
a
The name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
KENDRICK G ELLIS
5200 E LA PALMA AVENUE
ANAHEIM
,
CA
92807
(714) 777-8600
b
The form in which applications should be submitted and information and materials they should include:
SEE STATEMENT 12
c
Any submission deadlines:
SEE STATEMENT 12
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
SEE STATEMENT 12
Form
990-PF
(2016)
Page 11
Form 990-PF (2016)
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
AUSTIN WALK FOR AMERICAN HEART ASSOC
7272 GREENVILLE AVE
DALLAS
,
TX
75231
NONE
N/A
HELP TO FIGHT HEART DISEASE AND STROKE
500
ASSEMBLIES OF GOD - ASIA
1445 N BOONVILLE AVE
SPRINGFIELD
,
MO
65802
NONE
N/A
PUBLICATION AND DISTRIBUTION OF BIBLES IN ASIA
30,000
ASHRAE SOUTHERN CALIFORNIA
PO BOX 80133
SAN MARINO
,
CA
91118
NONE
N/A
TO HELP FUND THE ADVANCEMENT OF TECHNOLOGY TO SERVE HUMANITY AND PROMOTE A SUSTAINABLE WORLD
1,450
BB SECOND HARVEST FOOD BANK
750 CURTNER AVENUE
SAN JOSE
,
CA
95125
NONE
N/A
FUND TO HELP HUNGRY CHILDREN
500
COME TO HIM MINISTRIES
1821 E DYER RD STE 200
SANTA ANA
,
CA
92705
NONE
N/A
PROVIDES TRANSITIONAL HOUSING, SOBER LIVING AND SUPPORTIVE SERVICES TO MEN, WOMEN AND CHILDREN
30,000
CORENET GLOBAL
4846 E SOMERTON AVE
ORANGE
,
CA
92867
NONE
N/A
INFLUENCE CHURCH DONATION
2,550
DEAN-O AND THE DYNAMOS
25016 ADELANTO
LAGUNA NIGUEL
,
CA
92677
NONE
N/A
CHRISTIAN MUSIC ARTIST FOR KIDS AND FAMILIES THAT WILL NOW BE TOURING THROUGH CHURCHES AND SCHOOLS SPONSORED BY FAITHQUEST MISSIONS AND ADVOCATING WORLD VISION CHILD SPONSORSHIP AND MISSIONAL INVOLVEMENT.
9,750
EAST VALLEY FAMILY YMCA
5142 TUJUNGA AVE
NORTH HOLLYWOOD
,
CA
91601
NONE
N/A
PROVIDING ASSISTANCE FOR ADVOCACY, FOOD SECURITY, DISEASE PREVENTION, ATHLETICS, SWIM LESSONS AND DANCE CLASSES.
1,500
ENLACE - EL SALVATOR
5405 ALTON PKWY SUITE 5A 458
IRVINE
,
CA
92604
NONE
N/A
TO HELP FUND CONSTRUCTON OF WATER WELLS IN FOREIGN COUNTRIES
150,000
ENLACE - NEPAL
5405 ALTON PKWY SUITE 5A 458
IRVINE
,
CA
92604
NONE
N/A
TO HELP FUND CONSTRUCTON OF WATER WELLS IN FOREIGN COUNTRIES
60,000
EVANGEL UNIVERSITY
1111 N GLENSTONE AVE
SPRINGFIELD
,
MO
65802
NONE
N/A
TO PROVIDE OPPORTUNITIES FOR STUDENTS TO ADVANCE.
12,851
FIRE OVER AFRICA
PO BOX 427
BRENTWOOD
,
CA
94513
NONE
N/A
FUND TO HELP TRAINING AND EQUIPPING PASTORS AND LEADERS TO REACH THE UNREACHED AND TO PLANT STRONG, HEALTHY CHURCHES IN AFRICA
42,000
HOAG CHARITY SPORTS INC
500 SUPERIOR AVE SUITE 350
NEWPORT BEACH
,
CA
92663
NONE
N/A
SUPPORT TO ADVANCE THE MISSION OF HOAG CHARITY SPORTS INC THROUGH MEANINGFUL AND INSPIRATIONAL PHILANTHROPIC PARTNERSHIPS
21,250
JUNIOR ACHIEVEMENT
301 E 17TH ST 202
COSTA MESA
,
CA
92627
NONE
N/A
TO INSPIRE THE YOUTH FOR PERSONAL GROWTH
2,000
KIDSAVE
100 CORPORATE POINTE SUITE 380
CULVER CITY
,
CA
90230
NONE
N/A
FUND ORPHANAGES TO HELP CHILDREN IN FOSTER CARE
8,500
LEUKEMIA & LYMPHOMA SOCIETY
795 THE CITY DRIVE SOUTH
ORANGE
,
CA
92868
NONE
N/A
CURE LEUKEMIA, LYMPHOMA, HODGKIN'S DISEASE AND MYELOMA, AND IMPROVE THE QUALITY OF LIFE OF PATIENTS AND THEIR FAMILIES.
1,000
MARDAN SCHOOL
1 OSBORN
IRVINE
,
CA
92604
NONE
N/A
FUND TO HELP STUDENT LEARNING AND GROWING
1,000
MEMORIAL MEDICAL CENTER FOUNDATION
18111 BROOKHURST STREET
FOUNTAIN VALLEY
,
CA
92708
NONE
N/A
FUNDING FOR HOSPITAL BUIDLING RENOVATIONS
2,960
NATIONAL MS SOCIETY
869 E FOOTHILL BLVD I
UPLAND
,
CA
91786
NONE
N/A
HELP FUND CUTTING-EDGE RESEARCH, DRIVE CHANGE THROUGH ADVOCACY, FACILITATE PROFESSIONAL EDUCATION, AND PROVIDE PROGRAMS AND SERVICES TO HELP PEOPLE WITH MS MOVE THEIR LIVES FORWARD.
500
NAT'L ASSOC OF CONG CHRISTIAN CHURCH
8473 S HOWELL AVENUE PO BOX 288
OAK CREEK
,
WI
53154
NONE
N/A
CONTRIBUTION TO THE SHARED MINISTRIES FUND (SMF), WHICH DIRECTLY SUPPORTS THE ASSOCIATION'S OPERATIONS, PROGRAMS AND SERVICES.
20,000
NEWHOPE COMMUNITY CHURCH
PO BOX 82272 HIGHLAND PARK
MANAKAU
NZ
NONE
N/A
SUPPORT CHRISTIAN MINISTRY IN NEW ZEALAND
96,412
PEDIATRIC CANCER RESEARCH FOUNDATION
9729 JERONIMO ROAD
IRVINE
,
CA
92618
NONE
N/A
TO BRING HOPE AND LIFESAVING TREATMENTS TO CHILDREN BATTLING CANCER
1,000
PROVIDENCE SPEECH & HEARING CENTER
1301 PROVIDENCE AVENUE
ORANGE
,
CA
92868
NONE
N/A
OFFER A VARIETY VARIETY OF SPEECH AND HEARING SERVICES FOR CHILDREN AND ADULTS ALIKE. ACCEPTING MOST MAJOR INSURANCE COMPANIES AND MEDICAL GROUPS, AND ALSO PROVIDE GRANTS, SCHOLARSHIPS, AND FINANCING OPTIONS FOR PATIENTS FROM LOW-INCOME FAMILIES.
2,500
ROYAL FAMILY KIDS CAMP
3000 W MACARTHUR BLVD SUITE 412
SANTA ANA
,
CA
92704
NONE
N/A
CREATE LIFE-CHANGING MOMENTS FOR CHILDREN OF ABUSE
6,440
SAVE THE WORLD FOUNDATION
48 KINGFISHER ROAD
JOHANNESBURG
SF
NONE
N/A
AIDING OUR PLANET IN MINIMIZING THE DANGER OF NATURAL DISASTER
72,000
SAMARITAN'S PURSE INT'L
PO BOX 3000
BOONE
,
NC
28607
NONE
N/A
TO MEET THE SPIRITUAL AND PHYSICAL NEEDS OF PEOPLE SUFFERING FROM WAR, POVERTY, DISASTER, DISEASE, AND FAMINE, WITH THE PURPOSE OF GLOBAL MISSIONARY WORK ATTENDANT ON HUMANITARIAN AID. THE ORGANIZATION AIMS AT SERVICE FOR THE CHURCH WORLDWIDE TO PROPAGATE
49,000
SIDE BY SIDE CHURCH
5023 E SILVERLEAF AVE
ORANGE
,
CA
92869
NONE
N/A
TO ESTABLISH AND MAINTAIN A CHURCH, TO LICENSE AND ORDAIN MINISTERS OF THE GOSPEL AND TO SUPPORT MISSIONARIES OF THEIR ACTIVITIES
138,000
TALLER SAN JOSE
801 N BROADWAY
SANTA ANA
,
CA
92701
NONE
N/A
TO EMPOWER YOUNG ADULTS WHO HAVE FALLEN THROUGH THE CRACKS OF ALL EXISTING SUPPORT SERVICES, TO MOVE OUT OF POVERTY BY TEACHING THEM HOW TO GET AND KEEP EMPLOYMENT WITH A LIVING WAGE
5,000
TEAM MICHELLE
PO BOX 16741
STAMFORD
,
CT
06905
NONE
N/A
FUND TO HELP BUILD A SCHOOL WITH BUILDON IN NEPAL
1,000
TEEN CHALLENGE - ROMANIA
5445 CHICAGO AVE
RIVERSIDE
,
CA
92507
NONE
N/A
SUPPORT AFTER-SCHOOL LEARNING CENTERS
110,340
TEEN CHALLENGE - SLOVANIA
5445 CHICAGO AVE
RIVERSIDE
,
CA
92507
NONE
N/A
SUPPORT AFTER-SCHOOL LEARNING CENTERS
72,000
TEEN CHALLENGE - SO CALIFORNIA
5445 CHICAGO AVE
RIVERSIDE
,
CA
92507
NONE
N/A
SUPPORT AFTER-SCHOOL LEARNING CENTERS
194,549
TEEN CHALLENGE-WOMEN'S GUILD
5445 CHICAGO AVE
RIVERSIDE
,
CA
92507
NONE
N/A
SUPPORT AFTER-SCHOOL LEARNING CENTERS
10,000
THE CHILD ABUSE PREVENTION CENTER
2390 E ORANGEWOOD AVE 300
ANAHEIM
,
CA
92806
NONE
N/A
DIRECTLY SERVE AT-RISK CHILDREN AND FAMILIES IN CRISIS TO PREVENT AND BREAK THE GENERATIONAL CYCLE OF CHILD ABUSE
1,011
UC REGENTS
1995 UNIVERSITY AVENUE SUITE 400
BERKELEY
,
CA
94704
NONE
N/A
TO SUPPORT SCHOOL OPERATION
500
WITH THIS RING
18340 YORBA LINDA BLVD STE 107-473
YORBA LINDA
,
CA
92886
NONE
N/A
SUPPORT DONATIONS OF WEDDING RINGS TO RAISE FUND FOR WATER WELLS IN AFRICA
3,000
Total
.................................
3a
1,161,063
b
Approved for future payment
Total
.................................
3b
0
Form
990-PF
(2016)
Page 12
Form 990-PF (2016)
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
...........
3,027
4
Dividends and interest from securities
....
114,172
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
.....
1,188
8
Gain or (loss) from sales of assets other than inventory
............
-33,131
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
85,256
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
85,256
(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.)
1
N/A
Form
990-PF
(2016)
Page 13
Form 990-PF (2016)
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.
2017-05-15
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
LARRY M KANE CPA
Preparer's Signature
Date
Check if self-
employed
PTIN
P00284803
Firm's name
GELMAN LLP
Firm's EIN
47-2310177
Firm's address
1940 E 17TH STREET
SANTA ANA
,
CA
927058606
Phone no.
(714) 667-2600
Form
990-PF
(2016)
Additional Data
Software ID:
Software Version:
Form 990PF - Special Condition Description:
Special Condition Description