efile Public Visual Render
ObjectId: 202231199349100203 - Submission: 2022-04-29
TIN: 01-0761416
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
01-01-2020
, and ending
12-31-2020
Name of foundation
HORMEL FOODS CORPORATION CHARTIBLE TR
% JANET HOGAN
Number and street (or P.O. box number if mail is not delivered to street address)
1 HORMEL PL
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
AUSTIN
,
MN
559123673
A Employer identification number
01-0761416
B
Telephone number (see instructions)
C
If exemption application is pending, check here
G
Check all that apply:
Initial return
Initial return of a former public charity
Final return
Amended return
Address change
Name change
D 1.
Foreign organizations, check here.............
2
. Foreign organizations meeting the 85%
test, check here and attach computation ...
E
If private foundation status was terminated
under section 507(b)(1)(A), check here .......
H
Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here .......
I
Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)
$
179,949
J
Accounting method:
Cash
Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)
Part I
Analysis of Revenue and Expenses
(The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).)
(a)
Revenue and
expenses per
books
(b)
Net investment
income
(c)
Adjusted net
income
(d)
Disbursements
for charitable
purposes
(cash basis only)
1
Contributions, gifts, grants, etc., received (attach schedule)
1,500,000
2
Check
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
0
b
Gross sales price for all assets on line 6a
0
7
Capital gain net income (from Part IV, line 2)
...
8
Net short-term capital gain
.........
9
Income modifications
...........
10a
Gross sales less returns and allowances
b
Less: Cost of goods sold
....
c
Gross profit or (loss) (attach schedule)
.....
11
Other income (attach schedule)
.......
12
Total.
Add lines 1 through 11
........
1,500,000
0
13
Compensation of officers, directors, trustees, etc.
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
c
Other professional fees (attach schedule)
....
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
39,476
0
39,476
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
39,476
0
39,476
25
Contributions, gifts, grants paid
.......
1,798,902
1,798,902
26
Total expenses and disbursements.
Add lines 24 and 25
1,838,378
0
1,838,378
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-338,378
b
Net investment income
(if negative, enter -0-)
0
c
Adjusted net income
(if negative, enter -0-)
...
0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(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
.............
518,327
179,949
179,949
2
Savings and temporary cash investments
.........
0
0
0
3
Accounts receivable
0
Less: allowance for doubtful accounts
0
0
0
0
4
Pledges receivable
0
Less: allowance for doubtful accounts
0
0
0
0
5
Grants receivable
.................
0
0
0
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
..............
0
0
0
9
Prepaid expenses and deferred charges
..........
0
0
0
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
.......
c
Investments—corporate bonds (attach schedule)
.......
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
0
0
0
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)
518,327
179,949
179,949
17
Accounts payable and accrued expenses
..........
0
0
18
Grants payable
.................
0
0
19
Deferred revenue
.................
0
0
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
........
518,327
179,949
27
Paid-in or capital surplus, or land, bldg., and equipment fund
0
0
28
Retained earnings, accumulated income, endowment, or other funds
0
0
29
Total net assets or fund balances
(see instructions)
.....
518,327
179,949
30
Total liabilities and net assets/fund balances
(see instructions)
.
518,327
179,949
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
518,327
2
Enter amount from Part I, line 27a
.....................
2
-338,378
3
Other increases not included in line 2 (itemize)
3
4
Add lines 1, 2, and 3
..........................
4
179,949
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
179,949
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.)
1a
b
c
d
e
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-)
or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
Excess of col. (i)
over col. (j), if any
a
b
c
d
e
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
3
Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8
...................
3
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
0
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
0
3
Add lines 1 and 2
...........................
3
0
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
4
0
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
0
6
Credits/Payments:
a
2020 estimated tax payments and 2019 overpayment credited to 2020
6a
0
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
0
d
Backup withholding erroneously withheld
...........
6d
0
7
Total credits and payments. Add lines 6a through 6d
..............
7
0
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
0
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
0
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
11
Enter the amount of line 10 to be:
Credited to 2021 estimated tax
0
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 the instructions
for the definition
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
0
(2)
On foundation managers.
$
0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
Yes
7
Did the foundation have at least $5,000 in assets at any time during the year?
If "Yes," complete Part II, col. (c),
and Part XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
MN
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
www.hormelfoods.com/about/contact-us/donation...
14
The books are in care of
James Fleming
Telephone no.
(507) 437-5233
Located at
1 HORMEL PL
AUSTIN
MN
ZIP+4
559123673
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
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.
2020
,
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
No
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
Janet L Hogan
President & Director
1.00
0
0
0
1 Hormel Place
Austin
,
MN
55912
Gary L Jamison
Treasurer
1.00
0
0
0
1 Hormel Place
Austin
,
MN
55912
James N Sheehan
Assistant Treasurer & Director
1.00
0
0
0
1 Hormel Place
Austin
,
MN
55912
Mark A Coffey
Secretary & Director
1.00
0
0
0
1 Hormel Place
Austin
,
MN
55912
Brian D Johnson
Assistant Secretary
1.00
0
0
0
1 Hormel Place
Austin
,
MN
55912
Wendy A Watkins
Vice President & Director
10.00
0
0
0
1 Hormel Place
Austin
,
MN
55912
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
...................
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
NONE
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
0
b
Average of monthly cash balances
.......................
1b
830,742
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
830,742
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
830,742
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
12,461
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
818,281
6
Minimum investment return.
Enter 5% of line 5
..................
6
40,914
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
40,914
2a
Tax on investment income for 2020 from Part VI, line 5
......
2a
0
b
Income tax for 2020. (This does not include the tax from Part VI.)
...
2b
0
c
Add lines 2a and 2b
............................
2c
0
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
40,914
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
40,914
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
40,914
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
1,838,378
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
1,838,378
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
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
1,838,378
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
40,914
2
Undistributed income, if any, as of the end of 2020:
a
Enter amount for 2019 only
.......
1,308,393
b
Total for prior years:
2018
,
2017
,
2016
11,231,629
3
Excess distributions carryover, if any, to 2020:
a
From 2015
......
1,640,678
b
From 2016
......
1,909,463
c
From 2017
......
1,310,641
d
From 2018
......
8,011,525
e
From 2019
......
1,308,393
f
Total
of lines 3a through e
........
14,180,700
4
Qualifying distributions for 2020 from Part
XII, line 4:
$
1,838,378
a
Applied to 2019, but not more than line 2a
1,308,393
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 2020 distributable amount
.....
40,914
e
Remaining amount distributed out of corpus
489,071
5
Excess distributions carryover applied to 2020.
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
14,669,771
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
11,231,629
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
...........
11,231,629
e
Undistributed income for 2019. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
0
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)
.......
0
8
Excess distributions carryover from 2015 not
applied on line 5 or line 7 (see instructions)
...
1,640,678
9
Excess distributions carryover to 2021.
Subtract lines 7 and 8 from line 6a
......
13,029,093
10
Analysis of line 9:
a
Excess from 2016
....
1,909,463
b
Excess from 2017
....
1,310,641
c
Excess from 2018
....
8,011,525
d
Excess from 2019
....
1,308,393
e
Excess from 2020
....
489,071
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).)
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
Austin Area Commission for the Arts
Austin Area Artworks
300 Main St N
Austin
,
MN
55912
PC
Community Support
15,000
Austin Aspires Inc
301 N Main St Suite 104
Austin
,
MN
55912
PC
Community Support
77,667
Austin Symphony Orchestra Society
2110 7th Ave SW
Austin
,
MN
55912
PC
Community Support
5,000
Austin Symphony Orchestra Society
2110 7th Ave SW
Austin
,
MN
55912
PC
Community Support
5,000
Austin Youth Hockey Assoc Inc
PO Box 111
Austin
,
MN
55912
PC
Community Support
500
Autism Speaks Inc
1060 State Road 2nd Floor
Princeton
,
NJ
08540
NC
Community Support
5,000
Books for Africa Inc
370 Selby Ave Ste 305
St Paul
,
MN
55102
PC
Community Support
5,000
Boys and Girls Club of Sparta Inc
1000 E Montgomery St
Sparta
,
WI
54656
PC
Community Support
2,000
Channel One Food Bank
131 35th ST SE
Rochester
,
MN
55904
PC
Community Support
5,000
Child Assistance Res and Ed Team In
aka Kossuth Cty CARE Team
109 No Lantry ST
Algona
,
IA
50511
PC
Community Support
2,000
City of Austin
City Hall
500 4th Ave NE
Austin
,
MN
55912
GOV
Community Support
10,000
Dutchtown Jumpers
105 11th St SE
Austin
,
MN
55912
PC
Community Support
2,000
Farm Foundation NFP
1301 W 22nd St Ste 906
Oak Brook
,
IL
60523
PC
Community Support
10,000
Find the Cause Inc
150 Wood Road Suite 300
c/o KMC Productions Inc
Braintree
,
MA
02184
PC
Community Support
10,000
Food For The Poor Inc
6401 Lyons Rd
Coconut Creek
,
FL
33073
PC
Community Support
10,000
Giving Back Fund Inc
5757 W Century Blvd
Suite 410
Los Angeles
,
CA
90045
PC
Community Support
2,000
Harvey D Johnson Am Legion Post 295
232 Mill Road
Northfield
,
NJ
06225
NC
Community Support
2,000
Harvey D Johnson Am Legion Post 295
232 Mill Road
Northfield
,
NJ
06225
NC
Community Support
2,000
Hormel Historic Home
208 4th AVE NW
Attn Autism Friendly Austin
Austin
,
MN
55912
PC
Community Support
2,000
Hormel Historic Home
208 4th AVE NW
Attn Autism Friendly Austin
Austin
,
MN
55912
PC
Community Support
1,500
Hosea Feed Hungry and Homeless Inc
8 East Lake Drive NE
Atlanta
,
GA
30317
Community Support
2,000
Jeff Michner Scholarship Fund
314 Osprey Drive
Cape May CH
,
NJ
08210
PC
Community Support
5,000
Joshua's Heart Foundation Inc
PO Box 640342
Miami
,
FL
33164
PC
Community Support
2,000
Joshua's Heart Foundation Inc
PO Box 640342
Miami
,
FL
33164
PC
Community Support
8,000
Kansas Food Bank Warehouse Inc
1919 E Douglas Ave
Wichita
,
KS
67211
PC
Community Support
2,000
Madison County Finance and Payroll
PO Box 575
138 North Court Street
Wampsville
,
NY
13163
GOV
Community Support
2,000
Madison County Finance and Payroll
PO Box 575
138 North Court Street
Wampsville
,
NY
13163
GOV
Community Support
2,000
Make-A-Wish
1919 University Ave W
Suite 415
St Paul
,
MN
55104
PC
Community Support
15,000
Make-A-Wish
1919 University Ave W
Suite 415
St Paul
,
MN
55104
PC
Community Support
20,000
Make-A-Wish
1919 University Ave W
Suite 415
St Paul
,
MN
55104
PC
Community Support
3,722
Mower County Humane Society Inc
101 22nd St SE
Austin
,
MN
55912
PC
Community Support
2,325
Mower County Humane Society Inc
101 22nd St SE
Austin
,
MN
55912
PC
Community Support
1,925
National Association of the Deaf
8630 Fenton St
Suite 820
Silver Spring
,
MD
20910
PC
Community Support
5,000
National Restaurant Assoc Ed Founda
2055 L Street NW Suite 702
Washington
,
DC
20036
NC
Community Support
10,000
Operation Gratitude
PO Box 260257
Encino
,
CA
914260257
PC
Community Support
5,000
Osceola Chamber Main Street
115 E Washington St
PO Box 425
Osceola
,
IA
50213
PC
Community Support
12,000
Pacelli High School
311 4th ST NW
Austin
,
MN
55912
NC
Community Support
4,005
PayItForward Inc
64456 230th St
Dexter
,
MN
55926
PC
Community Support
5,000
Project I Am NFP
7923 S Paxton Ave
Chicago
,
IL
60617
PC
Community Support
2,000
Project I Am NFP
7923 S Paxton Ave
Chicago
,
IL
60617
PC
Community Support
2,000
Ronald McDonald House Charities
818 Fulton St SE
Attn Libby Myhran
Minneapolis
,
MN
55414
PC
Community Support
5,000
Salvation Army Northern Division
2445 Prior Ave North
Roseville
,
MN
55113
PC
Community Support
5,000
Share Our Strength
1030 15th St NW
Suite 1100W
Washington
,
DC
20005
PC
Community Support
5,000
Share Our Strength
1030 15th St NW
Suite 1100W
Washington
,
DC
20005
PC
Community Support
25,000
Slice Out Hunger Inc
244 Fifth Ave S-260
New York
,
NY
10001
PC
Community Support
10,000
Solutions for Change Inc
722 W California Avenue
Vista
,
CA
92083
PC
Community Support
2,000
Thielen Foundation Inc
314 First Ave N
Ste 200
Minneapolis
,
MN
55401
PC
Community Support
5,000
Thielen Foundation Inc
314 First Ave N
Ste 200
Minneapolis
,
MN
55401
PC
Community Support
5,000
Tommy Watkins Foundation
PO Box 456
Fort Myers
,
FL
33902
PC
Community Support
10,000
United Negro College Fund Inc
1805 7th St NW
Washington
,
DC
20001
PC
Community Support
5,000
United Negro College Fund Inc
1805 7th St NW
Washington
,
DC
20001
PC
Community Support
5,000
United Negro College Fund Inc
1805 7th St NW
Washington
,
DC
20001
PC
Community Support
10,000
United Way-Mower County
111 N Main St Suite 202
PO Box 605
Austin
,
MN
55912
PC
Community Support
3,500
USO of Metro Washington Baltimore I
PO Box 1710
Fort Myer
,
VA
22211
NC
Community Support
5,000
Vista Teen Outreach
1611 A So Melrose 324
Vista
,
CA
92081
PC
Community Support
2,000
We Cancerve Movement Inc
2206 Old Emmerton Road
Suite 100 273
Bel Air
,
MD
21015
PC
Community Support
2,000
We Cancerve Movement Inc
2206 Old Emmerton Road
Suite 100 273
Bel Air
,
MD
21015
PC
Community Support
1,500
We Cancerve Movement Inc
2206 Old Emmerton Road
Suite 100 273
Bel Air
,
MD
21015
PC
Community Support
2,000
Women are Dreamers Too
295 West Crossvile Road
Suite 840
Roswell
,
GA
30075
PC
Community Support
5,000
Young Men's Christian Association
402 N Market
Wichita
,
KS
67202
PC
Community Support
16,000
YourCause LLC
6506 W Park Blvd Ste 306
PMB 370
Plano
,
TX
75094
NC
Community Support
29,896
YourCause LLC
6505 W Park Blvd Ste 306
PMB 369
Plano
,
TX
75093
NC
Community Support
20,379
YourCause LLC
6505 W Park Blvd Ste 306
PMB 369
Plano
,
TX
75093
NC
Community Support
18,481
YourCause LLC
6505 W Park Blvd Ste 306
PMB 369
Plano
,
TX
75093
NC
Community Support
14,235
YourCause LLC
6505 W Park Blvd Ste 306
PMB 369
Plano
,
TX
75093
NC
Community Support
1,748
Archbishop Bergan Catholic Schools
422 E 4th St
Fremont
,
NE
68025
NC
Education
30
Austin Community Education Fund
329 N Main St Suite 102
Austin
,
MN
55912
NC
Education
3,675
Austin Public Schools
Independent School Dist 492
401 3rd Ave NW
Austin
,
MN
55912
GOV
Education
5,785
Austin Public Schools
Independent School Dist 492
401 3rd Ave NW
Austin
,
MN
55912
GOV
Education
1,138
Austin Public Schools
Independent School Dist 492
401 3rd Ave NW
Austin
,
MN
55912
GOV
Education
6,000
Child Nutrition - District 197
1897 Delaware Ave
Mendota Heights
,
MN
55118
GOV
Education
5,000
Christ Greenfeild Lutheran School
425 N Greenfeild Road
Gilbert
,
AZ
85234
NC
Education
3,000
Claremont McKenna College
400 N Claremont Blvd
Claremont
,
CA
91711
PC
Education
10,000
Dekalb County School District
1780 Montral Road
Sam Moss Building
Tucker
,
GA
30084
GOV
Education
3,300
DeLaSalle High School
One DeLaSalle Dr
Minneapolis
,
MN
55401
NC
Education
360
Dowling Catholic High School
1400 Buffalo Rd
West Des Moines
,
IA
50265
NC
Education
5,000
Dubuque Community School District
2300 Chaney Road
Dubuque
,
IA
52001
GOV
Education
3,395
Foundation for Lincoln Public Schoo
5905 O Street
Lincoln
,
NE
68510
PC
Education
5,000
Horatio Alger Assoc
Suite 320
99 Canal Center Plaza
Alexandria
,
VA
22314
PC
Education
25,000
Iowa State Univ Foundation
2505 University Blvd
PO Box 2230
Ames
,
IA
50010
PC
Education
14,000
Knoxville Community School District
309 West Main St
Knoxville
,
IA
501382657
GOV
Education
5,000
Lindenwood College
209 S Kingshighway St
St Charles
,
MO
63301
PC
Education
1,000
Mayer Lutheran High School
305 5th St NE
Mayer
,
MN
55360
NC
Education
2,515
Middlebury College
700 Exchange Street
Middlebury
,
VT
05753
PC
Education
1,000
Mueller Magnet Elementary School
2500 E 18th St
Wichita
,
KS
67214
GOV
Education
3,525
National Merit Scholarship Corp
1560 Sherman Avenue
Suite 200
Evanston
,
IL
60201
PC
Education
135,000
Ortiz Elementary School
3361 Arkansas
Wichita
,
KS
67204
GOV
Education
1,599
Pleasant Valley Elementary School
2000 W 29th Street
Wichita
,
KS
67204
GOV
Education
854
Ridgewater College Foundation
2101 15th Ave NW
Willmar
,
MN
56201
PC
Education
1,000
St Paul Academy Summit School
1712 Randolph Ave
St Paul
,
MN
55105
PC
Education
100
The Blake School
110 Blake Rd South
Hopkins
,
MN
55343
PC
Education
100
Univ of Minnesota Foundation
200 SE Oak St 500
PO Box 860266
Minneapolis
,
MN
55486
PC
Education
2,000
Univ of Minnesota Foundation
200 SE Oak St 500
PO Box 860266
Minneapolis
,
MN
55486
PC
Education
5,000
Wellesley College
106 Central St
Wellesley
,
MA
02481
PC
Education
5,000
YourCause LLC
6505 W Park Blvd Ste 306
PMB 369
Plano
,
TX
75093
NC
Education
63,763
YourCause LLC
6505 W Park Blvd Ste 306
PMB 369
Plano
,
TX
75093
NC
Education
36,940
YourCause LLC
6505 W Park Blvd Ste 306
PMB 369
Plano
,
TX
75093
NC
Education
19,798
YourCause LLC
6505 W Park Blvd Ste 306
PMB 369
Plano
,
TX
75093
NC
Education
36,130
YourCause LLC
6505 W Park Blvd Ste 306
PMB 369
Plano
,
TX
75093
NC
Education
27,278
YourCause LLC
6505 W Park Blvd Ste 306
PMB 369
Plano
,
TX
75093
NC
Education
52,730
YourCause LLC
6505 W Park Blvd Ste 306
PMB 369
Plano
,
TX
75093
NC
Education
60,995
YourCause LLC
6505 W Park Blvd Ste 306
PMB 369
Plano
,
TX
75093
NC
Education
62,573
YourCause LLC
6505 W Park Blvd Ste 306
PMB 369
Plano
,
TX
75093
NC
Education
100,590
After-School All Stars
5900 Willshire Blvd
Suite 2000
Los Angeles
,
CA
90036
PC
Hunger
10,000
Alameda Co Comm Food Bank
7900 Edgewater Dr
Oakland
,
CA
94621
PC
Hunger
10,000
Algona Community School District
Algona Community School
600 S Hale St Attn Joe Carter
Algona
,
IA
50511
GOV
Hunger
10,000
Arkansas Foodbank
4301 W 65th St
Little Rock
,
AR
72209
PC
Hunger
10,000
Associated Charities
517 Colorado Ave
La Junta
,
CO
81050
PC
Hunger
2,500
Aurora Area Interfaith Food Pantry
PO Box 2602
1110 Jericho Rd
Aurora
,
IL
60507
PC
Hunger
10,000
BackpackBuddy Org Inc
145 Waterside Circle
Winfield
,
WV
25213
PC
Hunger
2,000
BackpackBuddy Org Inc
145 Waterside Circle
Winfield
,
WV
25213
PC
Hunger
2,000
Barron Area Clergy Assoc Inc
Cupboard and Closet
827 E LaSalle Ave
Barron
,
WI
54812
PC
Hunger
10,000
Beloit Meals on Wheels Inc
424 College St
PO Box 326
Beloit
,
WI
53512
PC
Hunger
3,000
Boys and Girls Club Food Program
1299 Locust Street
Dubuque
,
IA
52001
PC
Hunger
5,000
Browerville Area Food Shelf
250 4th St W Apt 8
Browerville
,
MN
56348
PC
Hunger
7,000
Capital Area Food Bank Inc
4900 Puerto Rico Ave NE
Washington
,
DC
20017
PC
Hunger
2,500
Caritas Inc
2840 Prairie Ave
Beloit
,
WI
53511
PC
Hunger
7,000
Chad Greenway's Lead the Way Founda
59 Cavalier Boulevard
Suite 310
Florence
,
KY
41042
PC
Hunger
10,000
Chad Greenway's Lead the Way Founda
59 Cavalier Boulevard
Suite 310
Florence
,
KY
41042
PC
Hunger
5,500
ChefLucasFood
3763 Linden Lane
Eagan
,
MN
55123
PC
Hunger
2,000
ChefLucasFood
3763 Linden Lane
Eagan
,
MN
55123
PC
Hunger
2,000
Community Health Ministry Inc
246 E 9th St
Alma
,
KS
66401
PC
Hunger
10,000
Conscious Alliance
2525 Arapahoe Ave
Ste E4-182
Boulder
,
CO
80302
PC
Hunger
10,000
Conscious Alliance
2525 Arapahoe Ave
Ste E4-182
Boulder
,
CO
80302
PC
Hunger
10,000
Conscious Alliance
2525 Arapahoe Ave
Ste E4-182
Boulder
,
CO
80302
PC
Hunger
25,000
Conscious Alliance
2525 Arapahoe Ave
Ste E4-182
Boulder
,
CO
80302
PC
Hunger
40,000
Couleecap Inc
201 Melby St
Westby
,
WI
54667
PC
Hunger
10,000
Dubuque Rescue Mission
398 Main St
PO Box 147
Dubuque
,
IA
520040147
PC
Hunger
5,000
Eagle Bend Senior Citizens Center I
Meals on Wheels
PO Box 214
Eagle Bend
,
MN
56446
PC
Hunger
4,000
Eagle's Healing Nest
310 US Hwy 71 N
Sauk Centre
,
MN
56378
PC
Hunger
2,000
Emergency Food Box Inc
109 S 3rd St
PO Box 391
Marshalltown
,
IA
50158
PC
Hunger
5,000
Feeding America
35 E Wacker DR Suite 2000
Chicago
,
IL
60601
PC
Hunger
65,000
Feeding America
35 E Wacker DR Suite 2000
Chicago
,
IL
60601
PC
Hunger
10,000
Feeding America
35 E Wacker DR Suite 2000
Chicago
,
IL
60601
PC
Hunger
46,000
FeedMore Foundation of Western NY
100 James E Casey Dr
Buffalo
,
NY
14206
PC
Hunger
5,000
Greater Chicago Food Depository
4100 W Ann Lurie Pl
Chicago
,
IL
60632
PC
Hunger
10,000
Gtr Harlem Chamber of Commerce
200A West 136th St
New York
,
NY
10030
PC
Hunger
2,000
Helping Hands Food Pantry
PO Box 412
Knoxville
,
IA
50138
PC
Hunger
5,000
Henderson Food Bank
PO Box 104
Henderson
,
TX
756530104
PC
Hunger
10,000
Home And Away Ministries
Ruby s Pantry
5833 Pecan Street
North Branch
,
MN
55056
PC
Hunger
10,000
Hosea Feed Hungry and Homeless Inc
8 East Lake Drive NE
Atlanta
,
GA
30317
NC
Hunger
10,000
Hot Meals on Wheels Inc
PO Box 371
Austin
,
MN
55912
PC
Hunger
10,000
House of Charity Inc
510 South 8th St
Minneapolis
,
MN
55404
NC
Hunger
5,000
Las Animas Helping Hands
811 Hurd Ave
PO Box 576
Las Animas
,
CO
810541467
PC
Hunger
2,500
Lifescape Community Services
705 Kilburn Ave
Rockford
,
IL
61101
PC
Hunger
5,000
Long Prairie Emergency Food Pantry
PO Box 165
Long Prairie
,
MN
56347
PC
Hunger
7,000
Marion Cty Senior Nutrition
County of Marion IA
308 E Montgomery ST
Knoxville
,
IA
50138
NC
Hunger
5,000
Maryland Food Bank Inc
2200 Halethorpe Farms Road
Baltimore
,
MD
21227
PC
Hunger
2,500
Melrose Area Food Shelf
402 2nd St SE
Melrose
,
MN
56352
PC
Hunger
10,000
Nevada Community Cupboard
1110 11th St
Attn Gil Peterson
Nevada
,
IA
50201
NC
Hunger
5,000
North Texas Food Bank
3677 Mapleshade Lane
Plano
,
TX
75075
PC
Hunger
5,000
Pelican Rapids Comm Food Shelf Inc
54 1st St NW
PO Box 592
Pelican Rapids
,
MN
56572
PC
Hunger
10,000
Prairie Five Comm Action Council In
Chippewa County Food Shelf
719 N 7th St Ste 302
Montevideo
,
MN
56265
PC
Hunger
10,000
River Bend Foodbank
4010 Kimmel Dr
Davenport
,
IA
52802
PC
Hunger
10,000
Rochelle Christian Food Pantry
770 West Lincoln Ave
Rochelle
,
IL
61068
PC
Hunger
5,000
SCICAP - Clarke Co Food Pantry
114 S Fillmore St
PO Box 142
Osceola
,
IA
50213
PC
Hunger
10,000
Second Harvest Food Bank
San Joaquin Stanislaus Cty Inc
1220 Vanderbilt Circle
Manteca
,
CA
95337
PC
Hunger
10,000
Second Harvest Food Bank
San Joaquin Stanislaus Cty Inc
1220 Vanderbilt Circle
Manteca
,
CA
95337
PC
Hunger
2,000
Second Harvest Heartland
1140 Gervaise Ave
St Paul
,
MN
55109
PC
Hunger
5,000
Second Harvest Heartland
1140 Gervaise Ave
St Paul
,
MN
55109
PC
Hunger
5,000
Second Harvest Heartland
1140 Gervaise Ave
St Paul
,
MN
55109
PC
Hunger
10,000
So Alameda Co Comm - Raza Mental He
La Familia Counseling Center
26081 Mocine Ave
Hayward
,
CA
94544
PC
Hunger
10,000
Sparta Area School District
201 E Franklin St
Sparta
,
WI
54656
GOV
Hunger
1,846
St Vincent de Paul Society
617 3rd Ave NW
Faribault
,
MN
55021
NC
Hunger
10,000
St Mary's Food Bank Alliance
2831 N 31st Ave
Phoenix
,
AZ
85009
PC
Hunger
5,000
The Lords Diner
Catholic Diocese of Wichita
520 N Broadway
Wichita
,
KS
67202
NC
Hunger
10,000
United Way-West Central MN
311 4th St SW
PO Box 895
Willmar
,
MN
56201
PC
Hunger
10,000
Total
.................................
3a
1,798,902
b
Approved for future payment
Total
.................................
3b
0
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
...........
4
Dividends and interest from securities
....
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not debt-financed property
.....
6
Net rental income or (loss) from personal property
7
Other investment income
.....
8
Gain or (loss) from sales of assets other than
inventory
............
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
0
0
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
0
(See worksheet in line 13 instructions to verify calculations.)
Part 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.
2022-04-28
May the IRS discuss this return
with the preparer shown below?
See instructions.
Yes
No
Signature of officer or trustee
Date
Title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's Signature
Date
Check if self-
employed
PTIN
Firm's name
Firm's EIN
Firm's address
Phone no.
Form
990-PF
(2020)
Additional Data
Software ID:
20012075
Software Version:
V1.0
Part VI Line 7 - Tax Paid with the Original Return:
0
Form 990PF - Special Condition Description:
Special Condition Description