efile Public Visual Render
ObjectId: 202340979349100909 - Submission: 2023-04-07
TIN: 95-4738423
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
21
Open to Public Inspection
For calendar year 2021, or tax year beginning
06-01-2021
, and ending
05-31-2022
Name of foundation
MARY JO AND HANK GREENBERG
ANIMAL WELFARE FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)
9903 SANTA MONICA BOULEVARD 837
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
BEVERLY HILLS
,
CA
90212
A Employer identification number
95-4738423
B
Telephone number (see instructions)
(310) 557-8100
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)
$
10,448,567
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)
2
Check
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
292,637
292,637
292,637
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
3,450,178
b
Gross sales price for all assets on line 6a
14,016,743
7
Capital gain net income (from Part IV, line 2)
...
3,450,178
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
........
3,742,815
3,742,815
292,637
13
Compensation of officers, directors, trustees, etc.
155,000
155,000
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
3,345
3,345
c
Other professional fees (attach schedule)
....
359,225
359,225
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
16,446
16,446
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
534,016
534,016
0
25
Contributions, gifts, grants paid
.......
6,847,500
6,847,500
26
Total expenses and disbursements.
Add lines 24 and 25
7,381,516
534,016
6,847,500
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-3,638,701
b
Net investment income
(if negative, enter -0-)
3,208,799
c
Adjusted net income
(if negative, enter -0-)
...
292,637
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2021)
Page 2
Form 990-PF (2021)
Page
2
Part II
Balance Sheets
Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year
End of year
(a)
Book Value
(b)
Book Value
(c)
Fair Market Value
1
Cash—non-interest-bearing
.............
2,653,330
2,069,684
2
Savings and temporary cash investments
.........
3
Accounts receivable
Less: allowance for doubtful accounts
4
Pledges receivable
Less: allowance for doubtful accounts
5
Grants receivable
.................
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)
.....
7
Other notes and loans receivable (attach schedule)
Less: allowance for doubtful accounts
8
Inventories for sale or use
..............
9
Prepaid expenses and deferred charges
..........
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
.......
c
Investments—corporate bonds (attach schedule)
.......
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
12,030,712
8,481,324
10,448,567
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
14,684,042
10,551,008
10,448,567
17
Accounts payable and accrued expenses
..........
-591
18
Grants payable
.................
1,200,000
1,380,000
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
)
633,068
5
23
Total liabilities
(add lines 17 through 22)
.........
1,833,068
1,379,414
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
12,850,974
9,171,594
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)
.....
12,850,974
9,171,594
30
Total liabilities and net assets/fund balances
(see instructions)
.
14,684,042
10,551,008
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
12,850,974
2
Enter amount from Part I, line 27a
.....................
2
-3,638,701
3
Other increases not included in line 2 (itemize)
3
4
Add lines 1, 2, and 3
..........................
4
9,212,273
5
Decreases not included in line 2 (itemize)
5
40,679
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
9,171,594
Form
990-PF
(2021)
Page 3
Form 990-PF (2021)
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
TOTAL PERSHING ADVISOR ACCT # XBW-297130
P
2001-01-01
2022-01-01
b
c
d
e
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
14,016,743
10,566,565
3,450,178
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-)
or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
Excess of col. (i)
over col. (j), if any
a
3,450,178
b
c
d
e
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
3,450,178
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
Form
990-PF
(2021)
Page 4
Form 990-PF (2021)
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)
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
3
Add lines 1 and 2
...........................
3
44,602
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
4
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
44,602
6
Credits/Payments:
a
2021 estimated tax payments and 2020 overpayment credited to 2021
6a
40,000
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
40,000
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
272
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
4,874
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
11
Enter the amount of line 10 to be:
Credited to 2022 estimated tax
0
Refunded
11
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.
$
(2)
On foundation managers.
$
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
.........
4a
Yes
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
Yes
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)
CA
b
If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G?
If "No," attach explanation
.
8b
Yes
9
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
or 4942(j)(5) for calendar year 2021 or the taxable year beginning in 2021? 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
(2021)
Page 5
Form 990-PF (2021)
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
N/A
14
The books are in care of
ORGANIZATION
Telephone no.
(310) 477-5252
Located at
11400 W OLYMPIC BLVD 16TH FL
LOS ANGELES
CA
ZIP+4
900641550
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 2021, 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
No
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 2021?
.............
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 2021, did the foundation have any undistributed income (Part XII, lines 6d
and 6e) for tax year(s) beginning before 2021?
....................
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 2021 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 2021.)
.....................
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 2021?
..
4b
No
Form
990-PF
(2021)
Page 6
Form 990-PF (2021)
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
MARJORIE LOEB
Vice President
1.00
0
9903 SANTA MONICA BLVD 837
BEVERLY HILLS
,
CA
90212
ROBERT FERBER
Vice President
1.00
0
9903 SANTA MONICA BLVD 837
BEVERLY HILLS
,
CA
90212
ANDREA LEFLERE
Vice President
1.00
0
9903 SANTA MONICA BLVD 837
BEVERLY HILLS
,
CA
90212
MATT ZARCUFSCY
President
1.00
0
9903 SANTA MONICA BLVD 837
BEVERLY HILLS
,
CA
90212
2
Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a)
Name and address of each employee paid more than $50,000
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
NONE
Total
number of other employees paid over $50,000
...................
Form
990-PF
(2021)
Page 7
Form 990-PF (2021)
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
GAYTAN & LEEVAN LLP
AUDIT FEES AND TAX PREP
3,345
11400 W OLYMPIC BLVD16TH FLOOR
LOS ANGELES
,
CA
90064
BRAVE WARROR ADVISORS
INVESTMENT SERVICES
359,225
12 EAST 49TH STREET 24TH FLOOR
NEW YORK
,
NY
10017
Total
number of others receiving over $50,000 for professional services
.............
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
.........................
Form
990-PF
(2021)
Page 8
Form 990-PF (2021)
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
0
b
Average of monthly cash balances
.......................
1b
0
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
0
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
3
Subtract line 2 from line 1d
.........................
3
0
4
Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
instructions)
.............................
4
0
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3.
............
5
0
6
Minimum investment return.
Enter 5% (0.05) of line 5
................
6
0
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
2a
Tax on investment income for 2021 from Part V, line 5
.......
2a
44,602
b
Income tax for 2021. (This does not include the tax from Part V.)
...
2b
c
Add lines 2a and 2b
............................
2c
44,602
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
44,602
4
Recoveries of amounts treated as qualifying distributions
................
4
5
Add lines 3 and 4
............................
5
44,602
6
Deduction from distributable amount (see instructions)
.................
6
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1
...
7
0
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
6,847,500
b
Program-related investments—total from Part VIII-B
..................
1b
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
6,847,500
Form
990-PF
(2021)
Page 9
Form 990-PF (2021)
Page
9
Part XII
Undistributed Income
(see instructions)
(a)
Corpus
(b)
Years prior to 2020
(c)
2020
(d)
2021
1
Distributable amount for 2021 from Part X, line 7
0
2
Undistributed income, if any, as of the end of 2021:
a
Enter amount for 2020 only
.......
b
Total for prior years:
20
,
20
,
20
3
Excess distributions carryover, if any, to 2021:
a
From 2016
......
876,717
b
From 2017
......
1,338,414
c
From 2018
......
d
From 2019
......
6,302,500
e
From 2020
......
8,662,000
f
Total
of lines 3a through e
........
17,179,631
4
Qualifying distributions for 2021 from Part
XI, line 4:
$
6,847,500
a
Applied to 2020, but not more than line 2a
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
c
Treated as distributions out of corpus (Election
required—see instructions)
........
0
d
Applied to 2021 distributable amount
.....
e
Remaining amount distributed out of corpus
6,847,500
5
Excess distributions carryover applied to 2021.
(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
24,027,131
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
e
Undistributed income for 2019. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
f
Undistributed income for 2021. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2022
..........
0
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions)
.......
8
Excess distributions carryover from 2016 not
applied on line 5 or line 7 (see instructions)
...
876,717
9
Excess distributions carryover to 2022.
Subtract lines 7 and 8 from line 6a
......
23,150,414
10
Analysis of line 9:
a
Excess from 2017
....
1,338,414
b
Excess from 2018
....
c
Excess from 2019
....
6,302,500
d
Excess from 2020
....
8,662,000
e
Excess from 2021
....
6,847,500
Form
990-PF
(2021)
Page 10
Form 990-PF (2021)
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 2021, 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)
2021
(b)
2020
(c)
2019
(d)
2018
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:
ANIMAL WELFARE FOUNDATION
9903 SANTA MONICA BOULEVARD 837
BEVERLY HILLS
,
CA
90212
(310) 557-8100
GREENBERGFOUNDATION@ICLOUD.COM
b
The form in which applications should be submitted and information and materials they should include:
COMPLETELY FILLED QUESTIONNAIRE AND FINANCIAL INFORMATION REQUESTED
c
Any submission deadlines:
NO
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
GRANTS ARE GIVEN TO 501(C)(3) ORGANIZATIONS THAT RESCUE, PROVIDE CARE, HOUSING AND SERVICES FOR HOMELESS AND NEGLECTED ANIMALS, ESPECIALLY DOGS AND CATS, LOCATED PRIMARILY IN CALIFORNIA.
Form
990-PF
(2021)
Page 11
Form 990-PF (2021)
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
OLD ENGLISH SHEEPDOG RESCUE
820 WILSON PLACE
SANTA MONICA
,
CA
90405
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
55,000
THE RESCUE TRAIN
11271 VENTURA BLVD SUITE 405
STUDIO CITY
,
CA
91604
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
100,000
SANTE DXOR FOUNDATION
PO BOX 29076
LOS ANGELES
,
CA
90029
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
75,000
ANIMALS RULE PLACEMENT FOUNDATION
305 NORTH HARBOR BLVD
SAN PEDRO
,
CA
90731
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
32,000
THE BRITTANY FOUNDATION
PO BOX 738
ACTON
,
CA
93510
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
50,000
SAVE A KITTY INC
16654 SOLEDAD CANYON RD 242
CANYON COUNTRY
,
CA
91387
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
105,000
NEW BEGINNINGS FOR ANIMALS
PO BOX 2444
MISSION VIEJO
,
CA
92691
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
10,000
VOICE FOR THE ANIMALS FOUNDATION
2633 LINCOLN AVE 202
SANTA MONICA
,
CA
90405
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
30,000
CATS IN NEED OF HUMAN CARE -RIVERSI
6353 GREYSON WAY
RIVERSIDE
,
CA
92516
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
30,000
CARECATCANINE ASSISTANCE REFERAL ED
PO BOX 56631
SHERMAN OAKS
,
CA
90209
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
50,000
THE NATURE OF WILDWORKS
PO BOX 109
TOPANGA
,
CA
90290
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
70,000
THE PEPPER FOUNDATION
3940 LAUREL CANYON BLVD 735
STUDIO CITY
,
CA
91604
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
30,000
LHASA HAPPY HOMES RESCUE INC
1158 26TH STREET 190
SANTA MONICA
,
CA
90403
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
35,000
PAWSLA
1150 SOUTH HOPE ST A
LOS ANGELES
,
CA
90015
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
75,000
ACE OF HEARTS DOG RESCUE
1201 N LARRABEE ST SUITE 303
WEST HOLLYWOOD
,
CA
90069
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
95,000
FERAL CAT CARETAKERS' COALITION
11956 DOROTHY ST 7
LOS ANGELES
,
CA
90049
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
60,000
STRAY CAT ALLIANCE
PO BOX 661277
LOS ANGELES
,
CA
90066
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
600,000
MARLEY'S PIT STOP RESCUE
PO BOX 90811
LOS ANGELES
,
CA
90009
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
35,000
YGGDRASIL URBAN WILDLIFE RESCUE
5961 SHERWOOD DRIVE
OAKLAND
,
CA
94611
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
20,000
PET HOPE
PO BOX 69493
LOS ANGELES
,
CA
90069
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
10,000
ROTTWEILER RESCUE OF LOS ANGELES IN
PO BOX 564
SUN VALLEY
,
CA
91352
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
25,000
A DOG'S LIFE RESCUE
357 S FAIRFAX AVENUE 282
LOS ANGELES
,
CA
90036
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
35,000
FORTE ANIMAL RESCUE
PO BOX 10085
MARINA DEL REY
,
CA
90292
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
65,000
THE LUCKY DUCK RESCUE SANCTUARY
PO BOX 4513
SUNLAND
,
CA
91041
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
30,000
PET RESCUE OF UNWANTED DOGS PROUD
13570 SOUTH ACADEMY AVENUE
KINGSBURG
,
CA
93631
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
80,000
SHELTER TRANSPORT ANIMAL RESCUE TEA
PO BOX 4792
VALLEY VILLAGE
,
CA
91617
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
150,000
KITTEN RESCUE
3519 CASITAS AVENUE
LOS ANGELES
,
CA
90039
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
100,000
FIX NATION INC
7680 CLYBOURN AVENUE
LOS ANGELES
,
CA
91352
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
175,000
HELP HOME FOR EVERY LIVING PET
852 N WESTERN AVENUE
SAN PEDRO
,
CA
90732
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
40,000
LOS ANGELES RABBIT FOUNDATION
PO BOX 252124
LOS ANGELES
,
CA
90025
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
30,000
LITTLE ANGELS PROJECT
29348 ROADSIDE DRIVE UNIT B
AGOURA HILLS
,
CA
91301
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
75,000
HUMANE SOCIETY OF TRUCKEE-TAHOE
10961 STEVENS LANE
TRUCKEE
,
CA
96161
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
200,000
WILDLIFE CARE OF SOUTHERN CALIFORNI
PO BOX 941476
SIMI VALLEY
,
CA
93065
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
25,000
WOLF CONNECTION
PO BOX 504
ACTON
,
CA
93510
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
125,000
WILDCARE
76 ALBERT PARK LANE
SAN RAFAEL
,
CA
94901
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
30,000
SOUTHLAND COLLIE RESCUE
PO BOX 1596
BREA
,
CA
92822
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
50,000
WESTSIDE GERMAN SHEPHARD RESCUE
3016 SOUTH HILL STREET
LOS ANGELES
,
CA
90007
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
65,000
HEALTHCARE FOR HOMELESS ANIMALS
PO BOX 7401
THOUSAND OAKS
,
CA
91359
N/A
501 C3
TO SUPPORT THE GENERAL OPERATIONS OF THE ORGANIZATION
150,000
MEOOWZRESQ
960 N Tustin St 200
Orange
,
CA
92867
NONE
CHARITY
20,000
CARSON CATS
P O BOX 211
MANHATTAN BEACH
,
CA
90267
NONE
CHARITY
60,000
RETURN TO FREEDOM
Jalama Rd
Lompoc
,
CA
93438
NONE
CHARITY
410,000
WAGS AND WALKS
1517 N Point St Ste 494
San Francisco
,
CA
94123
NONE
CHARITY
120,000
ANGELS IN TRAINING
265 AGOURA ROAD
CALABASAS
,
CA
91302
NONE
CHARITY
20,000
BASIC NEEDS FOUNDATION
PO BOX 413
HARBOR CITY
,
CA
90710
NONE
CHARITY
40,000
A WISH FOR ANIMALS
24551 Del Prado Ave
Dana Point
,
CA
92629
NONE
CHARITY
70,000
LAST CHANCE FOR ANIMALS
8033 Sunset Blvd 835
Los Angeles
,
CA
90046
NONE
CHARITY
400,000
ALL ABOUT EQUINE ANIMAL RESCUE
140-174 2201 Francisco Dr
El Dorado Hills
,
CA
95762
NONE
CHARITY
100,000
ANIMAL RESCUE MISSION
1125 N Fairfax Ave 461572
W Hollywood
,
CA
90046
NONE
CHARITY
40,000
MARINE MAMMAL CARE CENTER OF LA
3601 S Gaffey St
San Pedro
,
CA
90731
NONE
CHARITY
150,000
BIG SUNDAY
6111 Melrose Ave
Los Angeles
,
CA
90038
NONE
CHARITY
50,000
AMERICAN SANCTUARY ASSOCIATION
9632 Christine View Court
Las Vegas
,
NV
89129
NONE
CHARITY
65,000
ANGEL HANZ FOR THE HOMELESS
PO Box 10716
Burbank
,
CA
91510
NONE
CHARITY
20,000
CALIFORNIA COASTAL HORSE RESCUE
PO Box 1646
Oak view
,
CA
93022
NONE
CHARITY
70,000
HUMANE AMERICA ANIMAL FDN ADOPT-A-P
500 HUMANE WAY
POMONA
,
CA
91766
NONE
CHARITY
-21,500
CENTER FOR ANIMAL PROTECTION AND ED
PO Box 67176
Scotts Valley
,
CA
95067
NONE
CHARITY
40,000
COMPASSION WITHOUT BORDERS
1130 Butler Ave
Santa Rosa
,
CA
95407
NONE
CHARITY
70,000
DEITY ANIMAL RESCUE AND FOUNDATION
148 South Doheny Dr
Beverly Hills
,
CA
90211
NONE
CHARITY
60,000
DODWOOD ANIMAL RESCUE
1415 Fulton Road Ste 205 Box 432
Santa Rosa
,
CA
95403
NONE
CHARITY
50,000
THE REAL BARK
3740 SUNSET BLVD
LOS ANGELES
,
CA
90026
NONE
CHARITY
20,000
FAST FRIENDS GREYHOUND ADOPTION OF
1210 N Cypress St
La Habra
,
CA
90631
NONE
CHARITY
30,000
FEEDING PETS OF THE HOMELESS
400 W King St 200
Carson City
,
NV
89703
NONE
CHARITY
50,000
GOLDEN OLDIES CAT RESCUE
PO BOX 683
Montery
,
CA
93942
NONE
CHARITY
35,000
GREAT PYRENEES ASSN OF S CALIFORNIA
18122 Rancho Ave
San Bernadino
,
CA
92407
NONE
CHARITY
65,000
HEART-HEALTHCARE AND EMERGENCY ANIM
PO Box 974
Yorba Linda
,
CA
92885
NONE
CHARITY
75,000
HIT LIVING FOUNDATION
5811 SALOMA AVE
VAN NUYS
,
CA
91411
NONE
CHARITY
20,000
I STAND WITH MY PACK
10736 Jefferson Blvd 273
Culver City
,
CA
90230
NONE
CHARITY
65,000
INLAND VALLEY HUMANE SOCIETY
500 Humane Way
Pomona
,
CA
91766
NONE
CHARITY
25,000
LEAVE NO PAWS BEHIND
1047 E Amar Rd
West Covina
,
CA
91792
NONE
CHARITY
30,000
LILY'S LEGACY SENIOR DOG SANTUARY
PO Box 751002
Petaluma
,
CA
94975
NONE
CHARITY
70,000
MUTTLY CREW INC
24001 Muirlands Boulevard 391
Lake Forest
,
CA
92630
NONE
CHARITY
15,000
NEW LIFE ANIMAL SANTUARY
PO Box 902
Lake Elsinore
,
CA
92531
NONE
CHARITY
45,000
PAW PARENT
310 N Indian Hill Blvd 800
Claremont
,
CA
91711
NONE
CHARITY
30,000
RANCHO COASTAL HUMANE SOCIETY
389 Requeza St
Encinitas
,
CA
92024
NONE
CHARITY
50,000
RESCUE ROCK
8033 Sunset Blvd 1157
Los Angeles
,
CA
90046
NONE
CHARITY
75,000
SANTA YNEZ VALLEY HUMANE SOCIETY
111 Commerce Dr
Buellton
,
CA
93427
NONE
CHARITY
50,000
SOUTHERN CALIFORNIA ABYSSINIAN RESC
PO Box 57
Whittier
,
CA
90608
NONE
CHARITY
25,000
STRAY PAWS ANIMAL HAVEN
9858 Rush St
South El Monte
,
CA
91733
NONE
CHARITY
10,000
TAKING IT TO THE STREETS WITH LORI
3681 Sunnyside Dr
Riverside
,
CA
92506
NONE
CHARITY
12,000
THE MCKEE PROJECT
301 W SPRING VALLEY PL
Tucson
,
AZ
85704
NONE
CHARITY
35,000
WONDER DOG RESCUE
287 Davis Lane
Penngrove
,
CA
94951
NONE
CHARITY
50,000
LINDA BLAIR WORLDHEART FOUNDATION
10061 Rvierside Drive
Toluca Lake
,
CA
91602
NONE
CHARITY
150,000
A PURPOSEFUL RESCUE
PO BOX 351901
Los Angeles
,
CA
90035
NONE
CHARITY
50,000
WILDLIFE LEARNING CENTER
16027 Yarnell Street
Sylmar
,
CA
91342
NONE
CHARITY
100,000
FRIENDS OF CHULA VISTA ANIMAL CARE
130 Beyer Way
Chula Vista
,
CA
91911
NONE
CHARITY
15,000
PAW WORKS
350 West Hillcrest Drive
Thousand Oaks
,
CA
91360
NONE
CHARITY
100,000
PAWS FOR LIFE K9 RESCUE
1158 26th St
Santa Monica
,
CA
90403
NONE
CHARITY
350,000
SPAY NEUTER PROJECT LOS ANGELES
15321 Brand Blvd
Mission Hills
,
CA
91345
NONE
CHARITY
100,000
ADOPT ME RESCUE
6615 FALLBROOK AVE
WEST HILLS
,
CA
91307
N/A
CHARITY
5,000
CARE 4 PAWS
P O BOX 60524
SANTA BARBARA
,
CA
93160
N/A
CHARITY
25,000
K-9 PLACEMENT AND ASSISTANCE LEAGUE
5473 OVERPASS ROAD
SANTA BARBARA
,
CA
93110
N/A
CHARITY
20,000
KITTY OF ANGELS INC
11301 W OLYMPIC BLVD SUITE 341
LOS ANGELES
,
CA
90064
N/A
CHARITY
20,000
LOST HEARTS AND SOULS HORSE RESCUE
616 HUNTER LANE
SANTA ROSA
,
CA
95404
N/A
CHARITY
15,000
MOTE MARINE LABORATORY AQUARIUM
1600 KEN THOMPSON PARKWAY
SARASOTA
,
FL
34236
N/A
CHARITY
25,000
NATIONAL WILDLIFE FEDERATION
P O BOX 1583
MERRIFIELD
,
VA
22116
N/A
CHARITY
100,000
OUTTA THE CAGE
16350 VENTURA BLVD D517
LOS ANGELES
,
CA
91436
N/A
CHARITY
15,000
PET RESCUE PILOTS
931 MANHATTAN AVE SUITE 3
BROOKLYN
,
NY
11222
N/A
CHARITY
25,000
Total
.................................
3a
6,847,500
b
Approved for future payment
Total
.................................
3b
Form
990-PF
(2021)
Page 12
Form 990-PF (2021)
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
900001
292,637
14
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
4
Dividends and interest from securities
....
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not debt-financed property
.....
6
Net rental income or (loss) from personal property
7
Other investment income
.....
8
Gain or (loss) from sales of assets other than
inventory
............
3,450,178
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)
..
292,637
3,450,178
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
3,742,815
(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
(2021)
Page 13
Form 990-PF (2021)
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.
2023-04-07
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
Raymond Gaytan CPA
Preparer's Signature
Date
Check if self-
employed
PTIN
P00599617
Firm's name
Gaytan & Leevan LLP
Firm's EIN
73-1690684
Firm's address
11400 W Olympic Blvd Ste 1600
Los Angeles
,
CA
90064
Phone no.
(310) 477-5252
Form
990-PF
(2021)
Additional Data
Software ID:
21013475
Software Version:
2021v4.1
Form 990PF - Special Condition Description:
Special Condition Description