efile Public Visual Render
ObjectId: 202302149349101115 - Submission: 2023-08-02
TIN: 46-1998245
Form
990-PF
Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
Do not enter social security numbers on this form as it may be made public.
Go to
www.irs.gov/Form990PF
for instructions and the latest information.
OMB No. 1545-0047
20
22
Open to Public Inspection
For calendar year 2022, or tax year beginning
01-01-2022
, and ending
12-31-2022
Name of foundation
RICHARD S SHINEMAN FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)
317 W 1ST STREET SUITE 101
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
OSWEGO
,
NY
13126
A Employer identification number
46-1998245
B
Telephone number (see instructions)
(315) 216-6644
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)
$
31,931,003
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)
809,148
2
Check
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
603,962
603,906
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
216,997
b
Gross sales price for all assets on line 6a
3,421,679
7
Capital gain net income (from Part IV, line 2)
...
217,068
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)
.......
List of Attached Documents:
// Content
93,283
0
0
12
Total.
Add lines 1 through 11
........
1,723,390
820,974
0
13
Compensation of officers, directors, trustees, etc.
199,802
0
0
199,802
14
Other employee salaries and wages
......
71,000
0
0
71,000
15
Pension plans, employee benefits
.......
36,011
0
0
36,011
16a
Legal fees (attach schedule)
.........
List of Attached Documents:
// Content
24,407
0
0
24,407
b
Accounting fees (attach schedule)
.......
List of Attached Documents:
// Content
13,650
0
0
13,650
c
Other professional fees (attach schedule)
....
List of Attached Documents:
// Content
135,213
78,918
0
56,295
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
List of Attached Documents:
// Content
21,247
52
0
21,195
19
Depreciation (attach schedule) and depletion
...
1,269
0
0
20
Occupancy
..............
23,847
0
0
23,847
21
Travel, conferences, and meetings
.......
3,847
0
0
3,847
22
Printing and publications
..........
931
0
0
931
23
Other expenses (attach schedule)
.......
List of Attached Documents:
// Content
68,128
0
0
73,200
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
599,352
78,970
0
524,185
25
Contributions, gifts, grants paid
.......
1,542,825
1,542,825
26
Total expenses and disbursements.
Add lines 24 and 25
2,142,177
78,970
0
2,067,010
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-418,787
b
Net investment income
(if negative, enter -0-)
742,004
c
Adjusted net income
(if negative, enter -0-)
...
0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2022)
Page 2
Form 990-PF (2022)
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
.............
350,716
370,504
370,504
2
Savings and temporary cash investments
.........
309,157
54,046
54,046
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)
148,921
List of Attached Documents:
// Content
135,002
135,002
b
Investments—corporate stock (attach schedule)
.......
37,967,680
List of Attached Documents:
// Content
30,017,869
30,017,869
c
Investments—corporate bonds (attach schedule)
.......
102,543
List of Attached Documents:
// Content
96,458
96,458
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
129,000
List of Attached Documents:
// Content
401,207
401,207
14
Land, buildings, and equipment: basis
823,876
Less: accumulated depreciation (attach schedule)
11,160
4,836
List of Attached Documents:
// Content
812,716
812,716
15
Other assets (describe
)
List of Attached Documents:
// Content
36,441
List of Attached Documents:
// Content
43,201
List of Attached Documents:
// Content
43,201
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
39,049,294
31,931,003
31,931,003
17
Accounts payable and accrued expenses
..........
10,577
12,161
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
)
List of Attached Documents:
// Content
130,100
List of Attached Documents:
// Content
38,000
23
Total liabilities
(add lines 17 through 22)
.........
140,677
50,161
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
38,908,617
31,880,842
25
Net assets with donor restrictions
............
Foundations that do not follow FASB ASC 958, check here
and complete lines 26 through 30.
26
Capital stock, trust principal, or current funds
........
27
Paid-in or capital surplus, or land, bldg., and equipment fund
28
Retained earnings, accumulated income, endowment, or other funds
29
Total net assets or fund balances
(see instructions)
.....
38,908,617
31,880,842
30
Total liabilities and net assets/fund balances
(see instructions)
.
39,049,294
31,931,003
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
38,908,617
2
Enter amount from Part I, line 27a
.....................
2
-418,787
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
38,489,830
5
Decreases not included in line 2 (itemize)
List of Attached Documents:
// Content
5
6,608,988
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
31,880,842
Form
990-PF
(2022)
Page 3
Form 990-PF (2022)
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 S/T
P
b
PUBLICLY TRADED SECURITIES L/T
P
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
462,537
467,244
-4,707
b
2,959,142
2,737,367
221,775
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
-4,707
b
221,775
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
217,068
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
-4,707
Form
990-PF
(2022)
Page 4
Form 990-PF (2022)
Page
4
Part V
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a
Exempt operating foundations described in section 4940(d)(2), check here
and enter “N/A" on line 1.
Date of ruling or determination letter:
(attach copy of letter if necessary–see instructions)
1
10,314
b
All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
2
0
3
Add lines 1 and 2
...........................
3
10,314
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
10,314
6
Credits/Payments:
a
2022 estimated tax payments and 2021 overpayment credited to 2022
6a
24,266
b
Exempt foreign organizations—tax withheld at source
......
6b
0
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
0
d
Backup withholding erroneously withheld
..........
6d
0
7
Total credits and payments. Add lines 6a through 6d
..............
7
24,266
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2221 is attached.
8
0
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
13,952
11
Enter the amount of line 10 to be:
Credited to 2023 estimated tax
13,952
Refunded
11
0
Part VI-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
0
(2)
On foundation managers.
$
0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
.........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
Yes
7
Did the foundation have at least $5,000 in assets at any time during the year?
If "Yes," complete Part II, col. (c),
and Part XIV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
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 2022 or the taxable year beginning in 2022? See the instructions for Part XIII.
If "Yes," complete Part XIII
.............................
9
No
10
Did any persons become substantial contributors during the tax year?
If "Yes," attach a schedule listing their names
and addresses.
...............................
10
No
Form
990-PF
(2022)
Page 5
Form 990-PF (2022)
Page
5
Part VI-A
Statements Regarding Activities
(continued)
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions
.............
11
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement. See instructions
.................
12
No
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
WWW.SHINEMANFOUNDATION.ORG
14
The books are in care of
EDWARD ALBERTS
Telephone no.
(315) 216-6644
Located at
317 W 1ST STREET SUITE 101
OSWEGO
NY
ZIP+4
13126
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 2022, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
Part VI-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1)
Engage in the sale or exchange, or leasing of property with a disqualified person?
...........
1a(1)
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
..............................
1a(2)
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
...........
1a(3)
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
............
1a(4)
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)?
......................
1a(5)
No
(6)
Agree to pay money or property to a government official? (
Exception.
Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.)
...............
1a(6)
No
b
If any answer is "Yes" to 1a(1)–(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions
..........
1b
c
Organizations relying on a current notice regarding disaster assistance check here
........
d
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2022?
.............
1d
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2022, did the foundation have any undistributed income (Part XII, lines 6d
and 6e) for tax year(s) beginning before 2022?
....................
2a
No
If "Yes," list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer "No" and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
..............................
3a
No
b
If "Yes," did it have excess business holdings in 2022 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 2022.)
.....................
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 2022?
..
4b
No
Form
990-PF
(2022)
Page 6
Form 990-PF (2022)
Page
6
Part VI-B
Statements Regarding Activities for Which Form 4720 May Be Required
(continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
..........
5a(1)
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
....................
5a(2)
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
.............
5a(3)
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
........................
5a(4)
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?
.............
5a(5)
No
b
If any answer is "Yes" to 5a(1)–(5), did
any
of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions
........
5b
c
Organizations relying on a current notice regarding disaster assistance check
.........
d
If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant?
.................
5d
If "Yes," attach the statement required by Regulations section 53.4945–5(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract?
.............................
6a
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
....
6b
No
If "Yes" to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
7a
No
b
If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction?
.....
7b
8
Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment during the year?
.........................
8
No
Part VII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1
List all officers, directors, trustees, foundation managers and their compensation. See instructions
(a)
Name and address
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(If not paid, enter
-0-)
(d)
Contributions to employee benefit plans and deferred compensation
(e)
Expense account,
other allowances
PAMELA CARACCIOLI
SECRETARY
3.00
0
0
0
76 WEST SENECA STREET
OSWEGO
,
NY
13126
MARGARET BARCLAY
CHAIR
3.00
0
0
0
4312 STATE ROUTE 13
PULASKI
,
NY
13142
KATHY A BARKER
DIRECTOR
3.00
0
0
0
8430 MARCO LANE
BALDWINSVILLE
,
NY
13027
TARA FITZGIBBONS
TREASURER
3.00
0
0
0
85 EAST MOHAWK STREET
OSWEGO
,
NY
13126
FLORIS PALMER-NINO
DIRECTOR
3.00
0
0
0
701 FIRST STREET
LIVERPOOL
,
NY
13088
ED ALBERTS
VICE CHAIR
3.00
0
0
0
1428 RIVERBEND DRIVE
BALDWINSVILLE
,
NY
13027
DR MICHAEL STEPHENS
DIRECTOR
3.00
0
0
0
4 PRIMPROSE PATH
OSWEGO
,
NY
13126
LINDA EAGAN
DIRECTOR
3.00
0
0
0
1477 COUNTY ROUTE 9
FULTON
,
NY
13069
NEELESH SHAH
DIRECTOR
3.00
0
0
0
2992 STATE ROUTE 48
OSWEGO
,
NY
13126
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
KAREN GOETZ REA
EXECUTIVE DIRECTOR
40.00
180,763
6,950
0
429 N FRANKLIN ST UNIT 111
SYRACUSE
,
NY
13204
PENNY HALSTEAD
OFFICE ADMINISTRATOR
40.00
71,000
3,550
0
5 NORTH 3RD STREET
FULTON
,
NY
13069
Total
number of other employees paid over $50,000
...................
0
Form
990-PF
(2022)
Page 7
Form 990-PF (2022)
Page
7
Part VII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
(continued)
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
NONE
Total
number of others receiving over $50,000 for professional services
.............
0
Part VIII-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
2
3
4
Part VIII-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
0
Form
990-PF
(2022)
Page 8
Form 990-PF (2022)
Page
8
Part IX
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations, see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities
...................
1a
32,734,456
b
Average of monthly cash balances
.......................
1b
464,002
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
33,198,458
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
33,198,458
4
Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
instructions)
.............................
4
497,977
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3.
............
5
32,700,481
6
Minimum investment return.
Enter 5% (0.05) of line 5
................
6
1,635,024
Part X
Distributable Amount
(see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here
and do not complete this part.)
1
Minimum investment return from Part IX, line 6
..................
1
1,635,024
2a
Tax on investment income for 2022 from Part V, line 5
.......
2a
10,314
b
Income tax for 2022. (This does not include the tax from Part V.)
...
2b
c
Add lines 2a and 2b
............................
2c
10,314
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
1,624,710
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
1,624,710
6
Deduction from distributable amount (see instructions)
.................
6
0
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1
...
7
1,624,710
Part XI
Qualifying Distributions
(see instructions)
1
Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
a
Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26
..........
1a
2,067,010
b
Program-related investments—total from Part VIII-B
..................
1b
0
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
0
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
b
Cash distribution test (attach the required schedule)
.................
3b
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part XII, line 4.
.......
4
2,067,010
Form
990-PF
(2022)
Page 9
Form 990-PF (2022)
Page
9
Part XII
Undistributed Income
(see instructions)
(a)
Corpus
(b)
Years prior to 2021
(c)
2021
(d)
2022
1
Distributable amount for 2022 from Part X, line 7
1,624,710
2
Undistributed income, if any, as of the end of 2022:
a
Enter amount for 2021 only
.......
0
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2022:
a
From 2017
......
b
From 2018
......
904,798
c
From 2019
......
532,412
d
From 2020
......
698,766
e
From 2021
......
529,374
f
Total
of lines 3a through e
........
2,665,350
4
Qualifying distributions for 2022 from Part
XI, line 4:
$
2,067,010
a
Applied to 2021, but not more than line 2a
0
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
0
c
Treated as distributions out of corpus (Election
required—see instructions)
........
0
d
Applied to 2022 distributable amount
.....
1,624,710
e
Remaining amount distributed out of corpus
442,300
5
Excess distributions carryover applied to 2022.
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
3,107,650
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
0
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
0
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
0
e
Undistributed income for 2021. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
0
f
Undistributed income for 2022. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2023
..........
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 2017 not
applied on line 5 or line 7 (see instructions)
...
0
9
Excess distributions carryover to 2023.
Subtract lines 7 and 8 from line 6a
......
3,107,650
10
Analysis of line 9:
a
Excess from 2018
....
904,798
b
Excess from 2019
....
532,412
c
Excess from 2020
....
698,766
d
Excess from 2021
....
529,374
e
Excess from 2022
....
442,300
Form
990-PF
(2022)
Page 10
Form 990-PF (2022)
Page
10
Part XIII
Private Operating Foundations
(see instructions and Part VI-A, question 9)
1a
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2022, enter the date of the ruling
......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part IX for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2022
(b)
2021
(c)
2020
(d)
2019
b
85% (0.85) of line 2a
.........
c
Qualifying distributions from Part XI,
line 4 for each year listed
.....
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part IX, line 6 for each year listed
..
c
“Support" alternative test—enter:
(1)
Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
....
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
(3)
Largest amount of support
from an exempt organization
(4)
Gross investment income
Part XIV
Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
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 e-mail address of the person to whom applications should be addressed:
CHENA TUCKER
317 W 1ST STREET SUITE 101
OSWEGO
,
NY
13126
(315) 216-6644
INFO@SHINEMANFOUNDATION.ORG
b
The form in which applications should be submitted and information and materials they should include:
AVAILABLE @ WWW.SHINEMANFOUNDATION.ORG
c
Any submission deadlines:
APPLICATIONS ARE ACCEPTED ON A ROLLING BASIS
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
CENTRAL NEW YORK PUBLIC CHARITIES WITH IMPACT ON OSWEGO COUNTY, NY
Form
990-PF
(2022)
Page 11
Form 990-PF (2022)
Page
11
Part XIV
Supplementary Information
(continued)
3 Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
A TINY HOME FOR GOOD INC
1222 SOUTH AVE
SYRACUSE
,
NY
13207
PC
GENERAL OPERATING
200
BLESSINGS IN A BACKPACK-FULTON CHAPTER
C/O PRINCE OF PEACE LUTHERAN CHURCH
64 GILLESPIE RD
FULTON
,
NY
13069
PC
GENERAL OPERATING
450
BLESSINGS IN A BACKPACK-OSWEGO CHAPTER
120 WEST FIFTH STREET
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
450
CENTRAL NEW YORK COMMUNITY FOUNDATION
431 EAST FAYETTE STREET SUITE 100
SYRACUSE
,
NY
13202
PC
GENERAL OPERATING
500
CENTRAL SQUARE ESSENTIALS FOR SUCCESS INC
PO BOX 159
CENTRAL SQUARE
,
NY
130360159
PC
GENERAL OPERATING
150
CHRIST OUR LIGHT CHURCH
23 NIAGARA STREET
PULASKI
,
NY
13142
PC
GENERAL OPERATING
300
ERINS ANGELS OF CNY INC
PO BOX 443
PHOENIX
,
NY
13135
PC
GENERAL OPERATING
225
FARNHAM FAMILY SERVICES
283 W 2ND STREET SUITE 200
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
1,500
FARNHAM FAMILY SERVICES
283 W 2ND STREET SUITE 200
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
500
GARRETT DUNSMOOR MEMORIAL FOUNDATION
4441 COUNTY ROUTE 4
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
2,500
H LEE WHITE MARITIME MUSEUM AT OSWEGO
PO BOX 101
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
300
HELPING HOUNDS DOG RESCUE INC
7268 CASWELL AVE
NORTH SYRACUSE
,
NY
13212
PC
GENERAL OPERATING
200
JOURNEY OF FAITH UMC (HANNIBAL BACKPACK PROGRAM)
977 COUNTY ROUTE 20
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
300
JOWONIO SCHOOL
3049 EAST GENESEE ST
SYRACUSE
,
NY
13224
PC
GENERAL OPERATING
200
KRISTINA'S HOUSE OF HOPE
192 WEST 6TH STREET
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
2,500
LIVERPOOL PUBLIC LIBRARY
310 TULIP STREET
LIVERPOOL
,
NY
13088
PC
GENERAL OPERATING
300
MEXICO CITY SCHOOL DISTRICT
16 FRAVOR ROAD
MEXICO
,
NY
13114
GOV
GENERAL OPERATING
500
MEXICO FOOD PANTRY
5863 SCENIC AVE
MEXICO
,
NY
13114
PC
GENERAL OPERATING
500
NEW YORK STATE OLD TYME FIDDLERS ASSOCIATION INC
PO BOX 24
REDFIELD
,
NY
134370024
PC
GENERAL OPERATING
500
NORTH SHORE FOOD PANTRY INC
PO BOX 165
CLEVELAND
,
NY
130420165
PC
GENERAL OPERATING
500
OSWEGO COMMUNITY YOUTH ORCHESTRA
PO BOX 295
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
500
OSWEGO COMMUNITY YOUTH ORCHESTRA
PO BOX 295
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
500
OSWEGO COUNTY HISTORICAL SOCIETY
135 EAST THIRD STREET
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
500
OSWEGO COUNTY HUMANE SOCIETY INC
110 WEST SECOND ST
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
500
OSWEGO COUNTY OPPORTUNITIES INC
239 ONEIDA ST
FULTON
,
NY
13069
PC
GENERAL OPERATING
2,500
OSWEGO COUNTY OPPORTUNITIES INC
239 ONEIDA ST
FULTON
,
NY
13069
PC
GENERAL OPERATING
500
OSWEGO HEALTH FOUNDATION
110 WEST SIXTH STREET
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
1,500
OSWEGO HEALTH FOUNDATION
110 WEST SIXTH STREET
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
2,000
OSWEGO INDUSTRIES
7 MORRILL PLACE
FULTON
,
NY
13069
PC
GENERAL OPERATING
500
OSWEGO OPERA THEATER INC
PO BOX 3039
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
1,500
OSWEGO OPERA THEATER INC
PO BOX 3039
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
500
PAWS OF CNY INC
PO BOX 2222
SYRACUSE
,
NY
13220
PC
GENERAL OPERATING
300
PEACEFUL REMEDIES
41 LAKE STREET
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
1,000
PULASKI HISTORICAL SOCIETY
3428 MAPLE AVE
PULASKI
,
NY
13142
PC
GENERAL OPERATING
500
RIVERSIDE UNITED METHODIST CHURCH
639 COUNTY ROUTE 22
PARISH
,
NY
13131
PC
GENERAL OPERATING
450
SALMON RIVER FINE ARTS CENTER
4848 N JEFFERSON ST
PULASKI
,
NY
13142
PC
GENERAL OPERATING
500
SANDY CREEK UNITED METHODIST CHURCH
PO BOX 158
SANDY CREEK
,
NY
13145
PC
GENERAL OPERATING
300
THE DESENS HOUSE
264 WEST 2ND STREET
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
500
THE RESEARCH FOUNDATION FOR SUNY
SUNY OSWEGO ORSP 210 SHELDON HALL
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
1,000
THE UPSTATE FOUNDATION INC
750 E ADAMS ST CAB326
SYRACUSE
,
NY
13210
PC
GENERAL OPERATING
500
TOY LIBRARY OF THE NORTH SHORE
1339 STATE ROUTE 49
CONSTANTIA
,
NY
13044
PC
GENERAL OPERATING
1,000
TOY LIBRARY OF THE NORTH SHORE
1339 STATE ROUTE 49
CONSTANTIA
,
NY
13044
PC
GENERAL OPERATING
500
TRUSTEES OF BOSTON UNIVERSITY
595 COMMONWEATLH AVENUE SUITE 700
BOSTON
,
MA
02215
PC
GENERAL OPERATING
500
UNITED BAPTIST CHURCH OF SCRIBA
5111 STATE ROUTE 104E MEXICO
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
225
UNITED WAY OF GREATER OSWEGO COUNTY
1 SOUTH FIRST STREET
FULTON
,
NY
13069
PC
GENERAL OPERATING
3,000
VILLAGE OF PHOENIX POLICE DEPARTMENT
455 MAIN STREET
PHOENIX
,
NY
13135
GOV
GENERAL OPERATING
2,500
WESTON T HYDE EDUCATIONAL FOUNDATION
PO BOX 3124
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
150
ZONTA INTERNATIONAL
PO BOX 5524
OSWEGO
,
NY
131265524
PC
GENERAL OPERATING
500
CATHOLIC CHARITIES OF OSWEGO COUNTY
808 WEST BROADWAY
FULTON
,
NY
13069
PC
GENERAL OPERATING
5,000
GARRETT DUNSMOOR MEMORIAL FOUNDATION
4441 COUNTY ROUTE 4
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
5,000
H LEE WHITE MARITIME MUSEUM
1 W 1ST ST
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
1,500
INTEGRATED COMMUNITY PLANNING OF OSWEGO COUNTY INC
317 WEST 1ST STREET SUITE 111
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
1,500
PAWS OF CNY INC
PO BOX 2222
SYRACUSE
,
NY
13220
PC
GENERAL OPERATING
5,000
UNITED WAY OF GREATER OSWEGO COUNTY
PO BOX 2222
SYRACUSE
,
NY
13220
PC
GENERAL OPERATING
1,500
BLESSINGS IN A BACKPACK-FULTON CHAPTER
C/O PRINCE OF PEACE LUTHERAN CHURCH
64 GILLESPIE RD
FULTON
,
NY
13069
PC
GENERAL OPERATING
5,000
KEYS
308 SHERRILL ROAD
SHERRILL
,
NY
13461
PC
GENERAL OPERATING
4,800
NEW HAVEN ELEMENTARY SCHOOL
4320 NY-104
NEW HAVEN
,
NY
13121
GOV
GENERAL OPERATING
5,000
SALMON RIVER FINE ARTS CENTER
4848 N JEFFERSON ST
PULASKI
,
NY
13142
PC
GENERAL OPERATING
5,000
TOY LIBRARY OF THE NORTH SHORE
1339 STATE ROUTE 49
CONSTANTIA
,
NY
13044
PC
GENERAL OPERATING
2,549
ART ASSOCIATION OF OSWEGO INC
PO BOX 271 FORT ONTARIO COMPLEX
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
14,720
CHILDREN'S MUSEUM OF OSWEGO
PO BOX 3172
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
45,150
CITI BOCES
179 COUNTY ROUTE 64
MEXICO
,
NY
13114
GOV
GENERAL OPERATING
50,400
CLEAR PATH FOR VETERANS INC
1223 SALT SPRINGS ROAD
CHITTENANGO
,
NY
13037
PC
GENERAL OPERATING
35,000
MINETTO HSA INC
PO BOX 189
MINETTO
,
NY
13115
PC
GENERAL OPERATING
45,450
MUSEUM OF SCIENCE & TECHNOLOGY
500 S FRANKLIN ST
SYRACUSE
,
NY
13202
PC
GENERAL OPERATING
36,530
OSWEGO COUNTY OPPORTUNITIES INC
239 ONEIDA ST
FULTON
,
NY
13069
PC
GENERAL OPERATING
50,400
OSWEGO LACROSSE FOUNDATION INC
PO BOX 5315
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
25,000
OSWEGO PUBLIC LIBRARY
120 EAST SECOND ST
OSWEGO
,
NY
13126
GOV
GENERAL OPERATING
13,900
RESTORE CNY
5869 LADD RD
BREWERTON
,
NY
13029
PC
GENERAL OPERATING
51,080
SCHROEPPEL HISTORICAL SOCIETY
68 LOCK STREET 3D
PHOENIX
,
NY
13135
PC
GENERAL OPERATING
37,056
ST LUKE HEALTH SERVICES
299 EAST RIVER ROAD
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
10,000
SYMPHORIA
250 HARRISON STREET SUITE 301
SYRACUSE
,
NY
13202
PC
GENERAL OPERATING
10,000
THE DESENS HOUSE
264 WEST 2ND STREET
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
25,000
UNITED WAY OF GREATER OSWEGO COUNTY
1 SOUTH FIRST STREET
FULTON
,
NY
13069
PC
GENERAL OPERATING
63,290
WESTON T HYDE EDUCATIONAL FOUNDATION
PO BOX 3124
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
10,000
OSWEGO ROTARY FOUNDATION INC
PO BOX 3124
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
3,500
CENTERSTATE CEO FOUNDATION
115 W FAYETTE ST
SYRACUSE
,
NY
13202
PC
GENERAL OPERATING
75,000
CENTERSTATE CEO FOUNDATION
115 W FAYETTE ST
SYRACUSE
,
NY
13202
PC
GENERAL OPERATING
50,000
THE RESEARCH FOUNDATION FOR SUNY
SUNY OSWEGO ORSP 210 SHELDON HALL
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
75,000
THE RESEARCH FOUNDATION FOR SUNY
SUNY OSWEGO ORSP 210 SHELDON HALL
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
50,000
FULTON COMMUNITY BASKETBALL
57 S POLLARD DRIVE
FULTON
,
NY
13069
PC
GENERAL OPERATING
25,000
THE DESENS HOUSE
PO BOX 3124
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
50,000
OSWEGO COLLEGE FOUNDATION
215 SHELDON HALL SUNY OSWEGO
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
100,000
OSWEGO COLLEGE FOUNDATION
215 SHELDON HALL SUNY OSWEGO
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
100,000
OSWEGO COLLEGE FOUNDATION
215 SHELDON HALL SUNY OSWEGO
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
100,000
OSWEGO COLLEGE FOUNDATION
215 SHELDON HALL SUNY OSWEGO
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
100,000
CAC FOUNDATION INC
163 SOUTH FIRST STREET
FULTON
,
NY
13069
PC
GENERAL OPERATING
30,000
CATHOLIC CHARITIES OF OSWEGO COUNTY
808 WEST BROADWAY
FULTON
,
NY
13069
PC
GENERAL OPERATING
30,000
CENTRAL NEW YORK LYM & DISEASE ALLIANCE
131 WEST SENECA STREET BOX 9
MANLIUS
,
NY
13104
PC
GENERAL OPERATING
20,000
OSWEGO COUNTY HABITAT FOR HUMANITY
PO BOX 5255
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
32,500
OSWEGO HEALTH FOUNDATION
110 WEST SIXTH STREET
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
100,000
Total
.................................
3a
1,542,825
b
Approved for future payment
CENTERSTATE CEO - FULTON BLOCK BUILDERS
115 W FAYETTE ST
SYRACUSE
,
NY
13202
PC
GENERAL OPERATING
325,000
OSWEGO HEALTH FOUNDATION
110 WEST SIXTH STREET
OSWEGO
,
NY
13069
PC
GENERAL OPERATING
100,000
SUNY OSWEGO COLLEGE FOUNDATION
219 SHELDON AVE
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
500,000
THE RESEARCH FOUNDATION FOR SUNY - OSWEGO RENAISSANCE ASSOCIATION
221 HEWITT UNION
OSWEGO
,
NY
13126
PC
GENERAL OPERATING
325,000
Total
.................................
3b
1,250,000
Form
990-PF
(2022)
Page 12
Form 990-PF (2022)
Page
12
Part XV-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
Unrelated business income
Excluded by section 512, 513, or 514
(e)
Related or exempt
function income
(See instructions.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
4
Dividends and interest from securities
....
14
603,962
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
216,997
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
GRANT FUNDS RETURNED
01
11,090
b
DEFERRED FEDERAL EXCISE TAX
01
81,732
c
LEGACY BOOK SALES
01
461
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
0
914,242
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
914,242
(See worksheet in line 13 instructions to verify calculations.)
Part XV-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
Explain below how each activity for which income is reported in column (e) of Part XV-A contributed importantly to
the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
instructions.)
Form
990-PF
(2022)
Page 13
Form 990-PF (2022)
Page
13
Part XVI
Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
1
Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
Yes
No
a
Transfers from the reporting foundation to a noncharitable exempt organization of:
(1)
Cash
...................................
1a(1)
No
(2)
Other assets
.................................
1a(2)
No
b
Other transactions:
(1)
Sales of assets to a noncharitable exempt organization
....................
1b(1)
No
(2)
Purchases of assets from a noncharitable exempt organization
..................
1b(2)
No
(3)
Rental of facilities, equipment, or other assets
.......................
1b(3)
No
(4)
Reimbursement arrangements
...........................
1b(4)
No
(5)
Loans or loan guarantees
.............................
1b(5)
No
(6)
Performance of services or membership or fundraising solicitations
................
1b(6)
No
c
Sharing of facilities, equipment, mailing lists, other assets, or paid employees
..............
1c
No
d
If the answer to any of the above is "Yes," complete the following schedule. Column
(b)
should always show the fair market value
of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
in any transaction or sharing arrangement, show in column
(d)
the value of the goods, other assets, or services received.
(a)
Line No.
(b)
Amount involved
(c)
Name of noncharitable exempt organization
(d)
Description of transfers, transactions, and sharing arrangements
2a
Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
described in section 501(c) (other than section 501(c)(3)) or in section 527?
...........
Yes
No
b
If "Yes," complete the following schedule.
(a)
Name of organization
(b)
Type of organization
(c)
Description of relationship
Sign Here
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
2023-08-02
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
RICHARD FARLEY JR CPA
Preparer's Signature
Date
2023-08-02
Check if self-
employed
PTIN
P01083459
Firm's name
BOWERS & COMPANY CPAS PLLC
Firm's EIN
20-1317788
Firm's address
120 MADISON ST - 1700 AXA TOWER II
SYRACUSE
,
NY
13202
Phone no.
(315) 234-1100
Form
990-PF
(2022)
Additional Data
Software ID:
Software Version:
Form 990PF - Special Condition Description:
Special Condition Description