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efta-01345327DOJ Data Set 10OtherEFTA01345327
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DOJ Data Set 10
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efta-01345327
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Form 990-PF (2016)
Part XIV
Private Operating Foundations (see instructions and Part VII-A, question 9)
Page 10
la If the foundation has received a ruling or determination letter that it is a pnvate operating
foundation, and the ruling is effective for 2016, enter the date of the ruling
►
b Check box to indicate whether the organization is a private operating foundation described in section K 4942(7)(3) or K 4942;j)(5)
2a Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for each
year listed .
.
.
.
.
.
.
.
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b 85% of line 2a
c Qualifying distributions from Part XII,
line 4 for each year listed .
.
.
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d Amounts included in line 2c not used
directly for active conduct of exempt
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 49420)(3)03)(i)
b 'Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed.
.
.
c "Support" alternative test—enter
(1) Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(8)(5)), or royalties) .
(2) Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(8)(m).
(3) Largest amount of support
from an exempt organization
(4) Gross investment income
Part XV
Tax year
(a) 2016
Prior 3 years
(b) 2015
(c) 2014
(d) 20.3
(e) Total
Supplementary Information (Complete this part only if the organization had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a east any managers of the foundation who have contnbuted 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 ► 2 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 (see instructions) to individuals or organizations under
other conditions, complete items 2a, b, c, and d
a The name, address, and telephone number or email address of the person to whom applications should be addressed
b The form in which applications should be submitted and information and materials they should include
c Any submission deadlines
d Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
Form 990-PF (2016)
DB-SDNY-0031609
SDNY_GM_00 177793
EFTA01345327
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