Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
right arrowDo not enter social security numbers on this form as it may be made public.
right arrowGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
For calendar year 2022, or tax year beginning 09-01-2022 , and ending 08-31-2023
Name of foundation
JEROME J AND DOROTHY H HOLZ FAMILY
FOUNDATION C/O DONALD TUSHAUS
Number and street (or P.O. box number if mail is not delivered to street address)10400 INNOVATION DRIVE 110
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MILWAUKEE, WI53226
A Employer identification number

36-7368506
B Telephone number (see instructions)

(414) 774-1031
C right arrow
G Check all that apply:

D 1. Foreign organizations, check here............. right arrow
2. Foreign organizations meeting the 85%
test, check here and attach computation ...
right arrow
E right arrow
H Check type of organization:
F right arrow
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)right arrow$17,513,921
J Accounting method:
 
(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)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check right arrow.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 643,996 643,996  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 926,365
b Gross sales price for all assets on line 6a 5,647,647
7 Capital gain net income (from Part IV, line 2)... 926,365
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........ 1,570,361 1,570,361 0
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 5,600 0 0 5,600
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... 12,120 0 0 12,120
c Other professional fees (attach schedule).... 107,468 107,468 0 0
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... 27,579 2,331 0 0
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... 2,164 0 0 2,164
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 154,931 109,799 0 19,884
25 Contributions, gifts, grants paid....... 901,430 901,430
26 Total expenses and disbursements. Add lines 24 and 25 1,056,361 109,799 0 921,314
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 514,000
b Net investment income (if negative, enter -0-) 1,460,562
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
Assets 1 Cash—non-interest-bearing.............      
2 Savings and temporary cash investments......... 452,521 806,089 806,089
3 Accounts receivable right arrow  
Less: allowance for doubtful accounts right arrow        
4 Pledges receivable right arrow  
Less: allowance for doubtful accounts right arrow        
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) right arrow  
Less: allowance for doubtful accounts right arrow        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)....... 13,751,098 Click to see attachment
List of Attached Documents:
// Content
10,840,874
10,840,874
c Investments—corporate bonds (attach schedule)....... 342,508 Click to see attachment
List of Attached Documents:
// Content
319,697
319,697
11 Investments—land, buildings, and equipment: basis right arrow  
Less: accumulated depreciation (attach schedule) right arrow        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 3,123,948 Click to see attachment
List of Attached Documents:
// Content
5,547,261
5,547,261
14 Land, buildings, and equipment: basis right arrow  
Less: accumulated depreciation (attach schedule) right arrow        
15 Other assets (describe right arrow)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 17,670,075 17,513,921 17,513,921
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe right arrow)    
23 Total liabilities (add lines 17 through 22)......... 0 0
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here right arrow
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions........... 17,670,075 17,513,921
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here right arrow
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)..... 17,670,075 17,513,921
30 Total liabilities and net assets/fund balances (see instructions). 17,670,075 17,513,921
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
17,670,075
2
Enter amount from Part I, line 27a .....................
2
514,000
3
Other increases not included in line 2 (itemize) right arrow
3
0
4
Add lines 1, 2, and 3 ..........................
4
18,184,075
5
Decreases not included in line 2 (itemize) right arrowClick to see attachment
List of Attached Documents:
// Content
5
670,154
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
17,513,921
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 TD AMERITRADE SHORT TERM      
b TD AMERITRADE LONG TERM      
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 504,760   573,760 -69,000
b 5,142,887   4,147,522 995,365
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       -69,000
b       995,365
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
Bracket 2 926,365
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 ...................
Bracket 3  
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 right arrow and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions) 1 20,302
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 20,302
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 20,302
6 Credits/Payments:
a 2022 estimated tax payments and 2021 overpayment credited to 2022 6a 23,720
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 23,720
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.......right arrow 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...right arrow 10 3,418
11 Enter the amount of line 10 to be: Credited to 2023 estimated taxright arrow3,418 Refundedright arrow 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. right arrow$ 0(2) On foundation managers.right arrow$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.right arrow$ 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:
round bullet By language in the governing instrument, or
round bullet 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)
right arrowWI
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 addressright arrowWWW.HOLZFAMILYFOUNDATION.COM
14
The books are in care ofright arrowJARED KNOKE Telephone no.right arrow (414) 774-1031

Located atright arrow10400 INNOVATION DRIVE SUITE 110MILWAUKEEWI ZIP+4right arrow53226
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........right arrow
and enter the amount of tax-exempt interest received or accrued during the year ........right arrow
15
 
16 At any time during calendar year 2022, did the foundation have an interest in or a signature or other authority over YesNo
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 right arrow
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)
Yes
 
(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
 
No
c
Organizations relying on a current notice regarding disaster assistance check here ........right arrow
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 right arrow20, 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.
right arrow20, 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 .........right arrow
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
JEROME J WEIS TRUSTEE-PRESIDENT
2.00
700 0 0
141 N WATER STREET UNIT 43
MILWAUKEE,WI53202
BARBARA HOLZ WEIS TRUSTEE-VICE PRESIDENT
2.00
700 0 0
S75 W13361 COURTLAND LN
MUSKEGO,WI53150
JUDITH HOLZ STATHAS TRUSTEE-SECRETARY
2.00
700 0 0
W136 S7646 FAIRFIELD DR
MUSKEGO,WI53150
TRACI S WEIS TRUSTEE
2.00
700 0 0
105 DAMP CRANE LANE
BILTMORE LAKE,NC28715
DAVID WEIS TRUSTEE
2.00
700 0 0
S75 W13361 COURTLAND LN
MUSKEGO,WI53150
WILLIAM STATHAS TRUSTEE
2.00
700 0 0
W136 S7646 FAIRFIELD DR
MUSKEGO,WI53150
DONALD H TUSHAUS TRUSTEE-TREASURER
2.00
700 0 0
1209 E SWEETBRIAR LN
HARTLAND,WI53029
LOUIS WHITEHEART TRUSTEE
2.00
700 0 0
105 DAMP CRANE LANE
BILTMORE LAKE,NC28715
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...................right arrow 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
DONALDSON CAPITAL MGMT LLC INVESTMENT ADVISORS 107,468
20 NW FIRST ST 5TH FLOOR
EVANSVILLE,IN47708
Total number of others receiving over $50,000 for professional services.............right arrow0
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.........................right arrow0
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
17,984,316
b
Average of monthly cash balances.......................
1b
814,582
c
Fair market value of all other assets (see instructions)................
1c
0
d
Total (add lines 1a, b, and c).........................
1d
18,798,898
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
18,798,898
4
Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
instructions) .............................
4
281,983
5
Net value of noncharitable-use assets. Subtract line 4 from line 3. ............
5
18,516,915
6
Minimum investment return. Enter 5% (0.05) of line 5................
6
925,846
Part X
Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow and do not complete this part.)
1
Minimum investment return from Part IX, line 6..................
1
925,846
2a
Tax on investment income for 2022 from Part V, line 5.......
2a
20,302
b
Income tax for 2022. (This does not include the tax from Part V.) ...
2b
 
c
Add lines 2a and 2b............................
2c
20,302
3
Distributable amount before adjustments. Subtract line 2c from line 1............
3
905,544
4
Recoveries of amounts treated as qualifying distributions................
4
0
5
Add lines 3 and 4............................
5
905,544
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
905,544
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
921,314
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
 
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
921,314
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 7 905,544
2 Undistributed income, if any, as of the end of 2022:
a Enter amount for 2021 only....... 894,462
b Total for prior years:20, 20, 20 0
3 Excess distributions carryover, if any, to 2022:
a From 2017......  
b From 2018......  
c From 2019......  
d From 2020......  
e From 2021......  
f Total of lines 3a through e ........ 0
4Qualifying distributions for 2022 from Part
XI, line 4: right arrow$ 921,314
a Applied to 2021, but not more than line 2a 894,462
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..... 26,852
e Remaining amount distributed out of corpus 0
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).)
6Enter the net total of each column as
indicated below:
a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 0
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 ..........
878,692
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 ......
0
10 Analysis of line 9:
a Excess from 2018....  
b Excess from 2019....  
c Excess from 2020....  
d Excess from 2021....  
e Excess from 2022....  
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 ...... right arrow
 
b Check box to indicate whether the organization is a private operating foundation described in section or
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.)
1Information Regarding Foundation Managers:
aList 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).)
bList 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.
2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here right arrow
aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
JEROME J DOROTHY H HOLZ FAMILY FOUN
PO BOX 487
HALES CORNERS,WI53130
(414) 768-2347
HOLZFAMILYFOUNDATION@GMAIL.COM
bThe form in which applications should be submitted and information and materials they should include:
NAME, ADDRESS, PHONE NUMBER, AND EMAIL ADDRESS OF APPLICANT ORGANIZATION. NAME OF ANY AFFILIATED ORGANIZATIONS. PURPOSE FOR REQUEST. AMOUNT REQUESTED, AMOUNT RECEIVED FROM THE HOLZ FAMILY FOUNDATION IN THE PRIOR YEAR, AND OTHER SOURCES OF FUNDING. TAX EXEMPT STATUS. GEOGRAPHIC FOCUS. FIT TO HOLZ FAMILY FOUNDATION GRANT GIVING FOCUS. CONFIRMATION OF EMPLOYMENT INCLUSION. FUNDRAISING INFORMATION AND ORGANIZATION BUDGET. ORGANIZATIONS ARE ASKED TO INCLUDE THE FOLLOWING DOCUMENTS WITH APPLICATIONS; A DETAILED DESCRIPTION OF THE PROPOSED PROGRAM, PROGRAM BUDGET, PRIOR YEAR GRANT REPORT, DOCUMENTATION CONFIRMING TAX EXEMPT STATUS, AND MOST RECENT 990 FORMS.
cAny submission deadlines:
COMPLETED GRANT APPLICATIONS ARE ACCEPTED BETWEEN JANUARY 1ST AND MAY 1ST IN EACH YEAR.
dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
GRANTS ARE MADE ONLY TO OPERATING NON-PROFIT ORGANIZATIONS EXEMPT FROM FEDERAL TAXATION UNDER THE INTERNAL REVENUE CODE. APPLICANT ORGANIZATIONS MUST CONFIRM STATUS AS AN EQUAL OPPORTUNITY EMPLOYER THAT COMPLIES WITH ALL LAWS AND REGULATIONS PROHIBITING EMPLOYMENT OR OTHER DISCRIMINATION. APPLICANT ORGANIZATIONS MUST AFFIRM A COMMITMENT NOT TO DISCRIMINATE AGAINST ANY EMPLOYEE, APPLICANT FOR EMPLOYMENT, CUSTOMER, VOLUNTEER OR ANY PERSON ELIGIBLE FOR SERVICES BY THEIR ORGANIZATION BECAUSE OF AGE, RACE, RELIGION, COLOR, HANDICAP, SEX, PHYSICAL CONDITION, DEVELOPMENTAL DISABILITY, GENDER IDENTITY AND EXPRESSION, SEXUAL ORIENTATION OR NATIONAL ORIGIN. GRANTS ARE NOT MADE TO INDIVIDUALS. GRANTS ARE NOT MADE FOR GENERAL FUND RAISING, DEFICIT FINANCING, OR LOANS. GRANTS ARE NOT MADE FOR RELIGIOUS PURPOSES. GRANTS ARE NOT MADE TO LABOR OR POLITICAL ORGANIZATIONS.
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)
aPaid during the year

ARTISTS WORKING IN EDUCATION

4315 W VLIET STREET
MILWAUKEE,WI53208
  PUBLIC TRUCK STUDIO PROGRAM 5,000

ARTWORKS FOR MILWAUKEE

207 E BUFFALO ST STE 600
MILWAUKEE,WI53202
  PUBLIC INTERNSHIPS FOR HIGH SCHOOL STUDENTS 5,000

AUDIO AND BRAILLE LITERACY ENHANCEMENT INC

803 W WELLS STREET
MILWAUKEE,WI53233
  PUBLIC BRAILLE TRANSCRIPTION PROGRAM FOR BLIND CHILDREN 5,000

BEYOND VISION INC

1540 SOUTH 108TH ST
WEST ALLIS,WI53214
  PUBLIC WORKFORCE DEVELOPMENT & TRAINING PROGRAM 5,000

BIG BROTHERS BIG SISTERS OF METRO MILW INC

788 N JEFFERSON STREET STE 600
MILWAUKEE,WI53202
  PUBLIC MENTORING PROGRAM 20,000

BOYS & GIRLS CLUBS OF GREATED MILWAUKEE INC

1558 N 6TH ST
MILWAUKEE,WI53212
  PUBLIC SPARK EARLY LITERACY PROGRAM 5,000

CHILDREN'S DYSLEXIA CENTER-MILWAUKEE

3000 W WISCONSIN AVE
MILWAUKEE,WI53201
  PUBLIC ONE ON ONE TUTORING PROGRAM 50,000

CHOSEN INC

400 TRAVIS LANE 30
WAUKESHA,WI53189
  PUBLIC EQUIP,ENGAGE,ENCOURAGE PROGRAM 5,000

CITY ON A HILL

2224 W KILBOURN AVE
MILWAUKEE,WI53233
  PUBLIC LITERACY PROGRAM 5,000

COALITION FOR CHINDRENYOUTH & FAMILIES

6737 W WASHINGTON ST SUITE 2353
MILWAUKEE,WI53214
  PUBLIC FAMILY SUPPORT PROGRAMS 5,000

COLLEGE POSSIBLE MILWAUKEE

1515 N RIVERCENTER DR STE 105
MILWAUKEE,WI53212
  PUBLIC COLLEGE ACCESS PROGRAM 5,000

DOWN SYNDROM ASSOCIATION OF WISCONSIN INC

11709 W CLEVELAND AVE SUITE 2
WEST ALLIS,WI53227
  PUBLIC EMPLOYMENT EDUCATION CLASSES 5,000

EMANUEL UCC

10627 W FOREST HOME AVE
HALES CORNERS,WI53130
  PUBLIC HANDBELL MAINTENANCE 4,000

EVANS SCHOLARS FOUNDATION

2501 PATRIOT BLVD
GLENVIEW,IL60026
  PUBLIC SUPPORT SCHOLARSHIP PROGRAM OF CADDIES FROM MILWAUKEE AND WAUKESHA COUNTIES 25,000

FIRST STAGE MILWAUKEE

325 W WALNUT STREET
MILWAUKEE,WI53212
  PUBLIC NEXT STEPS PROGRAM 5,000

FRANKILN PUBLIC LIBRARY FOUNDATION

9151 W LOOMIS ROAD
FRANKLIN,WI53132
  PUBLIC GREAT DECISIONS DISCUSSION PROGRAM 1,500

FRIENDS OF BOERNER BOTANICAL GARDENS INC

9400 BOERNER DRIVE
HALES CORNERS,WI53130
  PUBLIC STUDENT PROGRAMMING 15,000

FRIENDS OF THE DOMES

524 S LAYTON BLVD
MILWAUKEE,WI53215
  PUBLIC SCHOOL FIELD TRIP PROGRAMS 15,000

GPS EDUCATION PARTNERS

N19 W 24075 RIVERWOOD DR SUITE 300
WAUKESHA,WI53188
  PUBLIC YOUTH APPRENTICESHIP PROGRAM 10,000

HEAR WISCONSIN INC

10243 W NATIONAL AVE
WEST ALLIS,WI53227
  PUBLIC CHILD AND FAMILY PROGRAM 2,500

HEBRON HOUSING SERVICES

1166 QUAIL CT SUITE 400
PEWAUKEE,WI53072
  PUBLIC SHELTER STAFFING 5,000

HISTORIC HAYMARKET MILWAUKEE

800 W WELLS STREET
MILWAUKEE,WI53233
  PUBLIC WISCONSIN WONDERS CAPITAL CAMPAIGN 125,000

HOPE STREET MINISTRY

2522 W CAPITOL DR
MILWAUKEE,WI53206
  PUBLIC YOUTH PROGRAMMING 5,000

HUNGER TASK FORCE

5000 W ELECTRIC AVENUE
WEST MILWAUKEE,WI53219
  PUBLIC EMERGENCY FOOD PROGRAM 60,000

JEWISH FAMILY SERVICES INC

1300 N JACKSON ST
MILWAUKEE,WI53202
  PUBLIC BRADLEY CROSSING RESOURCE CENTER 10,000

JUNIOR ACHIEVEMENT OF WISCONSIN INC

11111 W LIBERTY DR
MILWAUKEE,WI53224
  PUBLIC TECHNICAL SCHOLARS PROGRAM 5,000

KIDS FROM WISCONSIN

640 S 84TH STREET
MILWAUKEE,WI53214
  PUBLIC MILWAUKEE PROGRAMMING 1,000

KINSHIP MKE INC

2610 N MARTIN LUTHER KING DR
MILWAUKEE,WI53212
  PUBLIC FOOD PROGRAMS 10,000

MALAIKA EARLY LEARNING CENTER

125 W AUER ST
MILWAUKEE,WI53212
  PUBLIC EARLY CHILDHOOD EDUCATION PROGRAMS 5,000

MILWAUKEE CENTER FOR INDEPENDENCE INC

2020 W WELLS STREET
MILWAUKEE,WI53233
  PUBLIC COMMERCIAL KITCHEN EQUIPMENT 5,000

MILWAUKEE HABITAT FOR HUMANITY

3726 N BOOTH STREET
MILWAUKEE,WI53212
  PUBLIC COST OF HOME INITIATIVE 20,000

MILWAUKEE HOMELESS VETERANS INITIATIVE

6300 W NATIONAL AVE
WEST ALLIS,WI53214
  PUBLIC EMERGENCY FOOD PANTRY 5,000

MILWAUKEE PBS

1036 N 8TH STREET
MILWAUKEE,WI53233
  PUBLIC PROGRAM UNDERWRITING FOR ANTIQUES ROADSHOW AND DANIEL TIGER'S NEIGHBORHOOD 40,000

MILWAUKEE PUBLIC MUSEUM

800 W WELLS STREET
MILWAUKEE,WI53233
  PUBLIC EDUCATION PROGRAMS 75,000

MILWAUKEE YOUTH SYMPHONY ORCHESTRA INC

325 W WALNUT STREET
MILWAUKEE,WI53212
  PUBLIC COMMUNITY PARTNERSHIP PROGRAM 10,000

MS-JUST KEEP MOVING INC

W228 N791 WESTMOUND DR
WAUKESHA,WI53186
  PUBLIC EQUIPMENT 5,600

PENFIELD CHILDREN'S CENTER

833 N 26TH ST
MILWAUKEE,WI53233
  PUBLIC EARLY EDUCATION AND CARE PROGRAM 5,000

PROJECT CONCERN OF CUDAHY-ST FRANCIS INC

3672 E PLANKINTON AVENUE
CUDAHY,WI53110
  PUBLIC FOOD AND PERSONAL CARE ITEMS 3,000

SAFE & SOUND INC

801 W MICHIGAN STREET
MILWAUKEE,WI53233
  PUBLIC YOUTH ORGANIZING EFFORTS 25,000

SECURE FUTURES FOUNDATION INC

710 N PLANKINTON AVE SUITE 1400
MILWAUKEE,WI53203
  PUBLIC FINANCIAL EDUCATION PROGRAMS 2,000

SILVER SPRING NEIGHBOURHOOD CENTER

5460 N 64TH ST
MILWAUKEE,WI53217
  PUBLIC EMERGENCY SERVICES FOOD PANTRY 5,000

TEENS GROW GREENS INC

322 E MICHIGAN STREET STE 204
MILWAUKEE,WI53202
  PUBLIC TEENS GROW GREENS INTERNSHIP PROGRAM 20,000

UNITED COMMUNITY CENTER

1028 S 9TH STREET
MILWAUKEE,WI53204
  PUBLIC UNITY COMMUNITY CENTER'S YOUTH VOLUNTEER CORPS (YVC) 20,000

UWM RESEARCG FOUNDACTION INC

1440 EAST NORTH AVE
MILWAUKEE,WI53202
  PUBLIC ENTREPENEURSHIP EDUCATION PROGRAMS 5,000

VILLAGE OF HALES CORNERS

5635 S NEW BERLIN ROAD
HALES CORNERS,WI53130
  PUBLIC ANNUAL 4TH OF JULY PARADE AND FESTIVITIES 20,000

VILLAGE OF HALES CORNERS-FIRE DEPARTMENT

10000 W FOREST HOME AVENUE
HALES CORNERS,WI53130
  PUBLIC PROTECTIVE EQUIPMENT AND TRAINING 20,930

VILLAGE OF HALES CORNERS-POLICE DEPARTMENT

5635 S NEW BERLIN ROAD
HALES CORNERS,WI53130
  PUBLIC POLICE BODY WORN CAMERAS 40,900

VISION FORWARD ASSOCIATION

912 N HAWLEY ROAD
MILWAUKEE,WI53213
  PUBLIC VISION REHABILITATION SERVICES FOR CHILDREN WHO ARE BLIND OR VISUALLY IMPAIRED 5,000

WISCONSIN ADAPTIVE SPORTS ASSOCIATION

715 TALON TRAIL
BROOKFIELD,WI53005
  PUBLIC PHYSICAL EDUCATION PROGRAM 5,000

WISCONSIN AUTOMOBILE AND TRUCK DEALERS FOUNDATION

150 E GILMAN ST
MADISON,WI53703
  PUBLIC TALENT FOR TOMORROW PROGRAM 30,000

WISCONSIN HERO OUTDOORS FUND

W329 S690 HWY C
DELAFIELD,WI53018
  PUBLIC OPERATIONS 20,000

WISCONSIN MASONIC FOUNDATION

36575 SUNSET DRIVE
DOUSMAN,WI53118
  PUBLIC WISCONSIN HIGH SCHOOL GRADUATE SCHOLARSHIP PROGRAM FOR STUDENTS IN MILWAUKEE & WAUKESHA COUNTIES 5,000

ZACHARIAH'S ACRES INC

16575 PATRICIA LANE
BROOKFIELD,WI53005
  PUBLIC POP UP SHOPS IN GREATER WAUKESHA AND MILWAUKEE COMMUNITIES AND OUTDOOR CLASSROOM 35,000

ZOOLOGICAL SOCIETY OF MILWAUKEE COUNTY

10005 W BLUE MOUND ROAD
MILWAUKEE,WI53226
  PUBLIC ANIMAL AMBASSADOR CONTINUUM 50,000
Total .................................right arrow 3a 901,430
bApproved for future payment
Total ................................. right arrow 3b 0
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.)
1Program service revenue: (a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
gFees and contracts from government agencies          
2 Membership dues and assessments ....          
3 Interest on savings and temporary cash
investments ...........
         
4 Dividends and interest from securities ....     14 643,996  
5 Net rental income or (loss) from real estate:
aDebt-financed property......          
bNot 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 ............
    18 926,365  
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 1,570,361 0
13Total. Add line 12, columns (b), (d), and (e)..................
13
1,570,361
(See worksheet in line 13 instructions to verify calculations.)
Part XV-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
DownArrow
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? ...........
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.
right arrow 2023-11-28 right arrow
May the IRS discuss this return
with the preparer shown below?
See instructions.
Signature of officer or trustee Date Title
Paid Preparer Use Only Print/Type preparer's name JARED KNOKE CPA Preparer's Signature   Date2023-11-13 Check if self-
employed right arrow
PTIN P01670645
Firm's name SmallBulletTUSHAUS & ASSOCIATES LLC
 
Firm's EIN SmallBullet46-1588286  
Firm's address SmallBullet10400 W INNOVATION DR STE 110
 
MILWAUKEE, WI53226
Phone no. (414) 774-1031
Form 990-PF (2022)
Additional Data


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