efile Public Visual Render
ObjectId: 202210609349100616 - Submission: 2022-03-01
TIN: 13-6169215
Form
990-PF
Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
Do not enter social security numbers on this form as it may be made public.
Go to
www.irs.gov/Form990PF
for instructions and the latest information.
OMB No. 1545-0052
20
20
Open to Public Inspection
For calendar year 2020, or tax year beginning
07-01-2020
, and ending
06-30-2021
Name of foundation
The Carl Marks Foundation Inc
% Foundation Source
Number and street (or P.O. box number if mail is not delivered to street address)
Foundation Source 501 Silverside Rd
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Wilmington
,
DE
198091377
A Employer identification number
13-6169215
B
Telephone number (see instructions)
(800) 839-1754
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)
$
25,513,185
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)
0
2
Check
.............
3
Interest on savings and temporary cash investments
729
729
4
Dividends and interest from securities
...
360,714
360,714
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
1,352,025
b
Gross sales price for all assets on line 6a
1,930,172
7
Capital gain net income (from Part IV, line 2)
...
1,352,025
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)
.......
3,006
12
Total.
Add lines 1 through 11
........
1,716,474
1,713,468
13
Compensation of officers, directors, trustees, etc.
0
14
Other employee salaries and wages
......
80,500
80,500
15
Pension plans, employee benefits
.......
6,158
6,158
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
c
Other professional fees (attach schedule)
....
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
16,600
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
30,889
205
30,684
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
134,147
205
117,342
25
Contributions, gifts, grants paid
.......
1,257,640
1,257,640
26
Total expenses and disbursements.
Add lines 24 and 25
1,391,787
205
1,374,982
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
324,687
b
Net investment income
(if negative, enter -0-)
1,713,263
c
Adjusted net income
(if negative, enter -0-)
...
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2020)
Page 2
Form 990-PF (2020)
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
.........
660,902
1,466,963
1,466,963
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)
.......
8,326,542
7,845,168
24,046,222
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)
8,987,444
9,312,131
25,513,185
17
Accounts payable and accrued expenses
..........
18
Grants payable
.................
19
Deferred revenue
.................
20
Loans from officers, directors, trustees, and other disqualified persons
21
Mortgages and other notes payable (attach schedule)
......
22
Other liabilities (describe
)
23
Total liabilities
(add lines 17 through 22)
.........
0
0
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
25
Net assets with donor restrictions
............
Foundations that do not follow FASB ASC 958, check here
and complete lines 26 through 30.
26
Capital stock, trust principal, or current funds
........
27
Paid-in or capital surplus, or land, bldg., and equipment fund
28
Retained earnings, accumulated income, endowment, or other funds
8,987,444
9,312,131
29
Total net assets or fund balances
(see instructions)
.....
8,987,444
9,312,131
30
Total liabilities and net assets/fund balances
(see instructions)
.
8,987,444
9,312,131
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return)
...............
1
8,987,444
2
Enter amount from Part I, line 27a
.....................
2
324,687
3
Other increases not included in line 2 (itemize)
3
4
Add lines 1, 2, and 3
..........................
4
9,312,131
5
Decreases not included in line 2 (itemize)
5
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
9,312,131
Form
990-PF
(2020)
Page 3
Form 990-PF (2020)
Page
3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a)
List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)
(b)
How acquired
P—Purchase
D—Donation
(c)
Date acquired
(mo., day, yr.)
(d)
Date sold
(mo., day, yr.)
1 a
Publicly-traded Securities
b
c
d
e
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
1,930,172
578,147
1,352,025
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-)
or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
Excess of col. (i)
over col. (j), if any
a
1,352,025
b
c
d
e
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
1,352,025
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
SECTION 4940(e) REPEALED ON DECEMBER 20, 2019 - DO NOT COMPLETE
1
Reserved
(a)
Reserved
(b)
Reserved
(c)
Reserved
(d)
Reserved
2
Reserved
...........................
2
3
Reserved
...........................
3
4
Reserved
...........................
4
5
Reserved
...........................
5
6
Reserved
...........................
6
7
Reserved
...........................
7
8
Reserved
,..........................
8
Form
990-PF
(2020)
Page 4
Form 990-PF (2020)
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
Reserved
................................
1
23,814
c
All other domestic foundations enter 1.39% 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
23,814
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
23,814
6
Credits/Payments:
a
2020 estimated tax payments and 2019 overpayment credited to 2020
6a
24,000
b
Exempt foreign organizations—tax withheld at source
......
6b
0
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
400
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
24,400
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
586
11
Enter the amount of line 10 to be:
Credited to 2021 estimated tax
586
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 the instructions
for the definition
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
(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)
NY
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 2020 or the taxable year beginning in 2020? See the instructions for Part XIV.
If "Yes," complete Part XIV
.............................
9
No
10
Did any persons become substantial contributors during the tax year?
If "Yes," attach a schedule listing their names
and addresses.
...............................
10
No
Form
990-PF
(2020)
Page 5
Form 990-PF (2020)
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
Foundation Source
Telephone no.
(800) 839-1754
Located at
501 Silverside Road Suite 123
Wilmington
DE
ZIP+4
198091377
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 2020, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1)
Engage in the sale or exchange, or leasing of property with a disqualified person?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(5)
Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)?
...............
Yes
No
(6)
Agree to pay money or property to a government official? (
Exception.
Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.)
.......
Yes
No
b
If any answer is "Yes" to 1a(1)–(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions
........
1b
Organizations relying on a current notice regarding disaster assistance check here
........
c
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2020?
.............
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 2020, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2020?
.............
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 2020 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 2020.)
..................
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 2020?
4b
No
Form
990-PF
(2020)
Page 6
Form 990-PF (2020)
Page
6
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
(continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
No
b
If any answer is "Yes" to 5a(1)–(5), did
any
of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions
......
5b
Organizations relying on a current notice regarding disaster assistance check here
.........
c
If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant?
..........
Yes
No
If "Yes," attach the statement required by Regulations section 53.4945–5(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract?
.....................
Yes
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
....
6b
No
If "Yes" to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
Yes
No
b
If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction?
....
7b
8
Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment during the year?
.................
Yes
No
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1
List all officers, directors, trustees, foundation managers and their compensation. See instructions
(a)
Name and address
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(If not paid, enter
-0-)
(d)
Contributions to employee benefit plans and deferred compensation
(e)
Expense account,
other allowances
Andrew M Boas
Co-Pres, Dir, Chairman
1.0
0
0
0
Foundation Source 501 Silverside Rd
Wilmington
,
DE
198091377
Carol A Boas
Treas, Dir
1.0
0
0
0
Foundation Source 501 Silverside Rd
Wilmington
,
DE
198091377
Carol L Boas
Assistant Treas, Dir
1.0
0
0
0
Foundation Source 501 Silverside Rd
Wilmington
,
DE
198091377
Rick Boas
Dir, VP, Vice Chair
1.0
0
0
0
Foundation Source 501 Silverside Rd
Wilmington
,
DE
198091377
Mark Claster
Co-Pres, Dir
1.0
0
0
0
Foundation Source 501 Silverside Rd
Wilmington
,
DE
198091377
Susan B Claster
Dir, VP, Vice Chair
1.0
0
0
0
Foundation Source 501 Silverside Rd
Wilmington
,
DE
198091377
Kate Liebman
Sec
20.0
0
0
0
Foundation Source 501 Silverside Rd
Wilmington
,
DE
198091377
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
SUSAN SHANKMAN
Program Admin
40.0
80,500
575 RIVERSIDE AVE STE 202A
WESTPORT
,
CT
06880
Total
number of other employees paid over $50,000
...................
Form
990-PF
(2020)
Page 7
Form 990-PF (2020)
Page
7
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
(continued)
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
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
(2020)
Page 8
Form 990-PF (2020)
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
19,159,606
b
Average of monthly cash balances
.......................
1b
1,189,638
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
20,349,244
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
20,349,244
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
305,239
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
20,044,005
6
Minimum investment return.
Enter 5% of line 5
..................
6
1,002,200
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
1,002,200
2a
Tax on investment income for 2020 from Part VI, line 5
......
2a
23,814
b
Income tax for 2020. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
23,814
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
978,386
4
Recoveries of amounts treated as qualifying distributions
................
4
5
Add lines 3 and 4
............................
5
978,386
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
978,386
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
1,374,982
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
1,374,982
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
1,374,982
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
(2020)
Page 9
Form 990-PF (2020)
Page
9
Part XIII
Undistributed Income
(see instructions)
(a)
Corpus
(b)
Years prior to 2019
(c)
2019
(d)
2020
1
Distributable amount for 2020 from Part XI, line 7
978,386
2
Undistributed income, if any, as of the end of 2020:
a
Enter amount for 2019 only
.......
b
Total for prior years:
2018
,
2017
,
2016
3
Excess distributions carryover, if any, to 2020:
a
From 2015
......
1,637,144
b
From 2016
......
1,251,862
c
From 2017
......
1,489,473
d
From 2018
......
1,638,381
e
From 2019
......
1,591,450
f
Total
of lines 3a through e
........
7,608,310
4
Qualifying distributions for 2020 from Part
XII, line 4:
$
1,374,982
a
Applied to 2019, but not more than line 2a
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
c
Treated as distributions out of corpus (Election
required—see instructions)
........
d
Applied to 2020 distributable amount
.....
978,386
e
Remaining amount distributed out of corpus
396,596
5
Excess distributions carryover applied to 2020.
(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
8,004,906
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
e
Undistributed income for 2019. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
f
Undistributed income for 2020. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2021
..........
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 2015 not
applied on line 5 or line 7 (see instructions)
...
1,637,144
9
Excess distributions carryover to 2021.
Subtract lines 7 and 8 from line 6a
......
6,367,762
10
Analysis of line 9:
a
Excess from 2016
....
1,251,862
b
Excess from 2017
....
1,489,473
c
Excess from 2018
....
1,638,381
d
Excess from 2019
....
1,591,450
e
Excess from 2020
....
396,596
Form
990-PF
(2020)
Page 10
Form 990-PF (2020)
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 2020, 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)
2020
(b)
2019
(c)
2018
(d)
2017
b
85% of line 2a
.........
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed
...
c
“Support" alternative test—enter:
(1)
Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
....
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
(3)
Largest amount of support
from an exempt organization
(4)
Gross investment income
Part XV
Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
Andrew M Boas
Mark Claster
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or email address of the person to whom applications should be addressed:
b
The form in which applications should be submitted and information and materials they should include:
c
Any submission deadlines:
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Form
990-PF
(2020)
Page 11
Form 990-PF (2020)
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
ACADEMY FOR JEWISH RELIGION
28 WELLS AVE
YONKERS
,
NY
10701
N/A
PC
Charitable Event
3,600
AMERICAN FRIENDS OF SHALVA ISRAEL INC
315 FIFTH AVE 6TH FL
NEW YORK
,
NY
10016
N/A
PC
General & Unrestricted
25,000
ANN & ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGO
225 EAST CHICAGO AVE BOX 4
CHICAGO
,
IL
60611
N/A
PC
Endowed Emergency Fund for Patients and Families and Critical Care Research Disparities Fund
97,290
ARBOR BROTHERS INC
56 EAST 126TH ST 1
NEW YORK
,
NY
10035
N/A
PC
General & Unrestricted
10,000
BE THE MATCH FOUNDATION
500 N 5TH ST
MINNEAPOLIS
,
MN
55401
N/A
PC
2021 Vaccine Study Fund
15,000
BE THE MATCH FOUNDATION
500 N 5TH ST
MINNEAPOLIS
,
MN
55401
N/A
PC
General & Unrestricted
7,000
BERNARD M BARUCH COLLEGE
ONE BERNARD BARUCH WAY BOX A-1603
NEW YORK
,
NY
10010
N/A
GOV
The Zicklin School of Business, Graduate School
500
CHERRY CREEK SCHOOLS FOUNDATION
4700 SOUTH YOSEMITE ST SUITE 1
GREENWOOD VILLAGE
,
CO
80111
N/A
PC
General & Unrestricted
50,000
CLASP HOMES INC
246 POST RD E
WESTPORT
,
CT
06880
N/A
PC
General & Unrestricted
5,000
CONNECTICUT FOOD BANK INC
2 RESEARCH PKWY
WALLINGFORD
,
CT
06492
N/A
PC
General & Unrestricted
6,000
CONNECTICUT ZOOLOGICAL SOCIETY INC
1875 NOBLE AVE
BRIDGEPORT
,
CT
06610
N/A
PC
General & Unrestricted
5,000
CORNELL UNIVERSITY
260 DAY HALL
ITHACA
,
NY
14853
N/A
PC
Cornell University Prison Education Program
1,000
CORNELL UNIVERSITY - COLLEGE OF VETERINARY MEDICIN
PO BOX 37334
BOONE
,
IA
50037
N/A
PC
Patient Assistance Program and Chester Hartenstein DVM' 45 Memorial Lecture Series
10,000
CYPRESS HILLS LOCAL DEVELOPMENT CORPORATION INC
625 JAMAICA AVE
BROOKLYN
,
NY
11208
N/A
PC
College Persistence Program
35,000
DOULA PROGRAM TO ACCOMPANY AND COMFORT INC
55 EXCHANGE PL STE 402
NEW YORK
,
NY
10005
N/A
PC
General & Unrestricted
5,000
DRUGS FOR NEGLECTED DISEASESINITIATIVE NORTH AMERI
40 RECTOR ST 16TH FL
NEW YORK
,
NY
10006
N/A
PC
General & Unrestricted
2,000
DUKE UNIVERSITY
PO BOX 90581
DURHAM
,
NC
27708
N/A
PC
General & Unrestricted
5,000
EDITH AND CARL MARKS JEWISH COMMUNITY HOUSE OF BEN
7802 BAY PKWY
BROOKLYN
,
NY
11214
N/A
PC
General & Unrestricted
56,000
ENCOURAGE KIDS FOUNDATION
1560 BROADWAY STE 600
NEW YORK
,
NY
10036
N/A
PC
General & Unrestricted
2,500
FACING HISTORY AND OURSELVES NATIONAL FOUNDATION
150 BROADWAY STE 2100
NEW YORK
,
NY
10038
N/A
PC
General & Unrestricted
2,500
FAIRFIELD COUNTYS COMMUNITY FOUNDATION INC
40 RICHARDS AVE
NORWALK
,
CT
06854
N/A
PC
General & Unrestricted
2,000
FAIRFIELD COUNTYS COMMUNITY FOUNDATION INC
40 RICHARDS AVE
NORWALK
,
CT
06854
N/A
PC
Social Ventures Partners Fund
5,000
FAIRFIELD UNIVERSITY
1073 N BENSON ROAD
FAIRFIELD
,
CT
06824
N/A
PC
Regina A. Quick Center 30th Anniversary Fund
500
FEDERATION FOR JEWISH PHILANTHROPY OF UPPER FAIRFI
4200 PARK AVE SUITE 300
BRIDGEPORT
,
CT
06604
N/A
PC
General & Unrestricted
15,000
FIGURE SKATING IN HARLEM INC
361 WEST 125TH ST 4TH FLOOR
NEW YORK
,
NY
10027
N/A
PC
General & Unrestricted
31,000
FIVER CHILDRENS FOUNDATION INC
519 8TH AVE 24TH FLOOR
NEW YORK
,
NY
10018
N/A
PC
General & Unrestricted
35,000
FORDHAM UNIVERSITY
45 COLUMBUS AVE 8TH FL
NEW YORK
,
NY
10023
N/A
PC
Fordham Law School Feerick Center/Dilley Program
10,000
FRIENDS OF BAXTER STATE PARK
PO BOX 322
BELFAST
,
ME
04915
N/A
PC
General & Unrestricted
2,000
FRIENDS OF LANE
2501 W ADDISON ST
CHICAGO
,
IL
60618
N/A
PC
Senior Graduation Fund
1,000
FRIENDS OF THE CHILDREN NEW YORK
PO BOX 1649
NEW YORK
,
NY
10026
N/A
PC
General & Unrestricted
35,000
FRIENDS OF THE NORWALK RIVER VALLEY TRAIL INC
PO BOX 174
GEORGETOWN
,
CT
06829
N/A
PC
General & Unrestricted
250
GABBY KRAUSE FOUNDATION
7200 S ALTON WAY STE B130
CENTENNIAL
,
CO
80112
N/A
PC
General & Unrestricted
1,200
GO PHILANTHROPIC CHARITABLE FUND
PO BOX 601
CONIFER
,
CO
80433
N/A
PC
Fund for books, Softies Program and computers
10,000
HOFSTRA UNIVERSITY
126 HOFSTRA UNIVERSITY MEMORIAL HAL
HEMPSTEAD
,
NY
11549
N/A
PC
Hofstra Law School Child and Family Advocacy Program
100,000
HOMES WITH HOPE INC
59 MYRTLE AVE
WESTPORT
,
CT
06880
N/A
PC
General & Unrestricted
6,000
IMPACTISRAEL INC
4340 EAST-W HWY STE 202
BETHESDA
,
MD
20814
N/A
PC
General & Unrestricted
1,800
IMPACTISRAEL INC
4340 EAST-W HWY STE 202
BETHESDA
,
MD
20814
N/A
PC
Graduate Program
50,000
INSTITUTE OF NOETIC SCIENCES
101 SAN ANTONIO RD
PETALUMA
,
CA
94952
N/A
PC
General & Unrestricted
2,000
INTERFAITH NUTRITION NETWORK
211 FULTON AVE
HEMPSTEAD
,
NY
11550
N/A
PC
General & Unrestricted
1,000
JAMES WHITCOMB RILEY MEMORIAL ASSOCIATION
30 S MERIDIAN ST STE 200
INDIANAPOLIS
,
IN
46204
N/A
PC
IUDM program sponsored by Riley Childrens Foundation
1,500
JEWISH FAMILY SERVICE OF STAMFORD INC
196 GREYROCK PL
STAMFORD
,
CT
06901
N/A
PC
General & Unrestricted
5,000
JEWISH HOME LIFECARE MANHATTAN
120 W 106TH ST
NEW YORK
,
NY
10025
N/A
PC
Geriatric Career Development Program
35,000
JEWISH MUSEUM
1109 5TH AVE
NEW YORK
,
NY
10128
N/A
PC
Charitable Event
2,500
JUNIOR ACHIEVEMENT USA - GREATER FAIRFIELD COUNTY
835 MAIN ST
BRIDGEPORT
,
CT
06604
N/A
PC
General & Unrestricted
2,000
LACEY HORWITCH SCHOLARSHIP FOUNDATION
3216 HIGHLAND RD
NORTHBROOK
,
IL
60062
N/A
PC
General & Unrestricted
1,000
LANE TECH SOFTBALL BOOSTER CLUB
5259 N LA CROSSE AVE
CHICAGO
,
IL
60630
N/A
PC
General & Unrestricted
1,000
LEARNING ALLY
20 ROSZEL RD
PRINCETON
,
NJ
08540
N/A
PC
General & Unrestricted
7,000
LEUKEMIA & LYMPHOMA SOCIETY - CONNECTICUT WESTCHES
3 LANDMARK SQ STE 330
STAMFORD
,
CT
06901
N/A
PC
General & Unrestricted
2,500
LEUKEMIA RESEARCH FOUNDATION INC
191 WAUKEGAN RD
NORTHFIELD
,
IL
60093
N/A
PC
General & Unrestricted
1,000
LIGHT MY WAY CAREER DAY INC
336 CENTRAL PARK W APT 11B
NEW YORK
,
NY
10025
N/A
PC
General & Unrestricted
5,000
MAKE THE ROAD NEW YORK
301 GROVE ST
BROOKLYN
,
NY
11237
N/A
PC
General & Unrestricted
10,000
MARCH OF DIMES FOUNDATION
112 TPKE ROAD STE 300
WESTBOROUGH
,
MA
01581
N/A
PC
in support of the Yale School of Medicine Community Van
1,000
MARIA DROSTE COUNSELING SERVICES
171 MADISON AVE STE 400
NEW YORK
,
NY
10016
N/A
PC
Charitable Event
2,000
MARIA DROSTE COUNSELING SERVICES INC
1354 HANCOCK ST STE 209
QUINCY
,
MA
02169
N/A
PC
General & Unrestricted
2,000
NEW HEIGHTS YOUTH INC
2472 BROADWAY PMB 112
NEW YORK
,
NY
10025
N/A
PC
General & Unrestricted
31,000
NORTHWELL HEALTH FOUNDATION
2000 MARCUS AVE 2ND FL
NEW HYDE PARK
,
NY
11042
N/A
PC
House Calls Program and Long Island Jewish Home Health Program
8,000
NORTHWELL HEALTH FOUNDATION
2000 MARCUS AVE 2ND FL
NEW HYDE PARK
,
NY
11042
N/A
PC
2020 Cohen Children's Circle Golf Classic Fund
5,000
NORTHWELL HEALTH FOUNDATION
2000 MARCUS AVE 2ND FL
NEW HYDE PARK
,
NY
11042
N/A
PC
Feinstein Institutes for Medical Research
15,000
NORTHWELL HEALTH FOUNDATION
2000 MARCUS AVE 2ND FL
NEW HYDE PARK
,
NY
11042
N/A
PC
Katz Institute for Women's Health
10,000
NORTHWELL HEALTH FOUNDATION
2000 MARCUS AVE 2ND FL
NEW HYDE PARK
,
NY
11042
N/A
PC
Research Fund
70,000
POSITIVE DIRECTIONS-THE CENTER FOR PREVENTION AND
90 POST ROAD W
WESTPORT
,
CT
06880
N/A
PC
General & Unrestricted
500
PROSPECTS OPPORTUNITY AND ENRICHMENT INC
25 PROSPECT ST
RIDGEFIELD
,
CT
06877
N/A
PC
General & Unrestricted
1,500
PROTEUS FUND INC
15 RESEARCH DR STE B
AMHERST
,
MA
01002
N/A
PC
Third Wave Fund
15,000
ROCKING THE BOAT INC
812 EDGEWATER RD
BRONX
,
NY
10474
N/A
PC
General & Unrestricted
35,000
ROGER WILLIAMS UNIVERSITY
1 OLD FERRY RD
BRISTOL
,
RI
02809
N/A
PC
General & Unrestricted
7,500
ROW NEW YORK INC
163 AMSTERDAM AVE STE 1108
NEW YORK
,
NY
10023
N/A
PC
General & Unrestricted
31,000
SERRV INTERNATIONAL INC
532 BALTIMORE BLVD STE 409
WESTMINSTER
,
MD
21157
N/A
PC
General & Unrestricted
1,500
SETTLEMENT MUSIC SCHOOL OF PHILADELPHIA
PO BOX 63966
PHILADELPHIA
,
PA
19147
N/A
PC
General & Unrestricted
2,000
SOCIAL GOOD FUND
PO BOX 5473
RICHMOND
,
CA
94805
N/A
PC
Wildfire Project
30,000
SOLIDAIRE NETWORK
52 CRESCENT AVE APT 1
MALDEN
,
MA
02148
N/A
PC
Pooled Fund - Aligned Giving Strategy (AGS) for the Movement for Black Lives
20,000
SOLIDAIRE NETWORK
52 CRESCENT AVE APT 1
MALDEN
,
MA
02148
N/A
PC
Annual Fund
40,000
SOUTH EAST CONSORTIUM FOR SPECIAL SERVICES INC
740 W BOSTON POST RD
MAMARONECK
,
NY
10543
N/A
PC
General & Unrestricted
10,000
STAR FOUNDATION INC
182 WOLFPIT AVE
NORWALK
,
CT
06851
N/A
PC
General & Unrestricted
3,000
STREETSQUASH INC
40 WEST 116TH ST
NEW YORK
,
NY
10026
N/A
PC
General & Unrestricted
35,000
THE CONSERVATIVE SYNAGOGUE INC
30 HILLSPOINT RD
WESTPORT
,
CT
06880
N/A
PC
General & Unrestricted
50,000
THE CONSERVATIVE SYNAGOGUE INC
30 HILLSPOINT RD
WESTPORT
,
CT
06880
N/A
PC
Kol Nidre Appeal Fund
10,000
THE MULTIPLE MYELOMA RESEARCH FOUNDATION INC
383 MAIN AVE 5TH FL
NORWALK
,
CT
06851
N/A
PC
General & Unrestricted
7,500
TIDES FOUNDATION
PO BOX 399389
SAN FRANCISCO
,
CA
94139
N/A
PC
2106F Movement Voter Fund
20,000
UNITED JEWISH APPEAL FEDERATION OF JEWISH PHILANTH
PO BOX 4227
NEW YORK
,
NY
10261
N/A
PC
General & Unrestricted
30,000
UNITED JEWISH APPEAL FEDERATION OF JEWISH PHILANTH
PO BOX 4227
NEW YORK
,
NY
10261
N/A
PC
Annual Fund
15,000
UNITED JEWISH APPEAL FEDERATION OF JEWISH PHILANTH
PO BOX 4227
NEW YORK
,
NY
10261
N/A
PC
the NY Lions Fund
6,000
UNITED STATES HOLOCAUST MEMORIAL MUSEUM
100 RAOUL WALLENBERG PL SW
WASHINGTON
,
DC
20024
N/A
PC
General & Unrestricted
10,000
UNIVERSITY OF PENNSYLVANIA SCHOOL OF NURSING
418 CURIE BLVD
PHILADELPHIA
,
PA
19104
N/A
PC
General & Unrestricted
2,500
UNIVERSITY SETTLEMENT SOCIETY OF NEW YORK
184 ELDRIDGE ST 3RD FL
NEW YORK
,
NY
10002
N/A
PC
General & Unrestricted
2,000
WILDERNESS ON WHEELS FOUNDATION
PO BOX 1007
WHEAT RIDGE
,
CO
80034
N/A
PC
General & Unrestricted
2,500
WILTON LIBRARY ASSOCIATION INCORPORATED
137 OLD RIDGEFIELD RD
WILTON
,
CT
06897
N/A
PC
General & Unrestricted
500
Total
.................................
3a
1,257,640
b
Approved for future payment
Total
.................................
3b
Form
990-PF
(2020)
Page 12
Form 990-PF (2020)
Page
12
Part XVI-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
Unrelated business income
Excluded by section 512, 513, or 514
(e)
Related or exempt
function income
(See instructions.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
14
729
4
Dividends and interest from securities
....
14
360,714
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
1,352,025
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
Federal Tax Refund
01
3,006
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
1,716,474
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
1,716,474
(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
(2020)
Page 13
Form 990-PF (2020)
Page
13
Part XVII
Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
1
Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
Yes
No
a
Transfers from the reporting foundation to a noncharitable exempt organization of:
(1)
Cash
...................................
1a(1)
No
(2)
Other assets
.................................
1a(2)
No
b
Other transactions:
(1)
Sales of assets to a noncharitable exempt organization
....................
1b(1)
No
(2)
Purchases of assets from a noncharitable exempt organization
..................
1b(2)
No
(3)
Rental of facilities, equipment, or other assets
.......................
1b(3)
No
(4)
Reimbursement arrangements
...........................
1b(4)
No
(5)
Loans or loan guarantees
.............................
1b(5)
No
(6)
Performance of services or membership or fundraising solicitations
................
1b(6)
No
c
Sharing of facilities, equipment, mailing lists, other assets, or paid employees
..............
1c
No
d
If the answer to any of the above is "Yes," complete the following schedule. Column
(b)
should always show the fair market value
of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
in any transaction or sharing arrangement, show in column
(d)
the value of the goods, other assets, or services received.
(a)
Line No.
(b)
Amount involved
(c)
Name of noncharitable exempt organization
(d)
Description of transfers, transactions, and sharing arrangements
2a
Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
described in section 501(c) (other than section 501(c)(3)) or in section 527?
...........
Yes
No
b
If "Yes," complete the following schedule.
(a)
Name of organization
(b)
Type of organization
(c)
Description of relationship
Sign Here
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
2022-02-09
May the IRS discuss this return
with the preparer shown below?
See instructions.
Yes
No
Signature of officer or trustee
Date
Title
Paid Preparer Use Only
Print/Type preparer's name
Jeffrey D Haskell
Preparer's Signature
Date
Check if self-
employed
PTIN
P01345770
Firm's name
FOUNDATION SOURCE
Firm's EIN
Firm's address
ONE HOLLOW LN STE 212
LAKE SUCCESS
,
NY
11042
Phone no.
(800) 839-1754
Form
990-PF
(2020)
Additional Data
Software ID:
Software Version:
Form 990PF - Special Condition Description:
Special Condition Description