Case File
efta-01372518DOJ Data Set 10OtherEFTA01372518
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01372518
Pages
1
Persons
0
Integrity
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Form 990- PF (2015)
Part XVII
Page 13
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) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political
organizations,
a Transfers from the reporting foundation to a nonchantable exempt organization of
Yes
No
(1) Cash
la(1)
No
(2) Other assets
b Other transactions
(1) Sales of assets to a nonchantable exempt organization
la(2)
No
11)(1)
No
(2) Purchases of assets from a nonchantable exempt organization
M(2)
No
(3) Rental of facilities, equipment, or other assets
lb(3)
No
(4) Reimbursement arrangements
lb(4)
No
(5) Loans or loan guarantees
lb(5)
No
(6)Performance of services or membership or fundraising solicitations
lb( 6)
No
c Sharing of facilities, equipment, mailing lists, other assets, or paid employees
Sc
No
d if the answer to any of the above is "Yes: complete the following schedule Column (b) should always show the fair ma ket 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 shanng arrangement, show in column (d) the value of the goods, other assets, or services received
(a) Line No
(b) Amount involved
(c) Name of nonchantable exempt organizataan
(d) Descnption of transfers, transactions, and shanng anangefneMs
2a Is the foundation directly or mdi ectly affiliated with, or related to, one or more tax-exempt organizations
described in section 501(c) of the Code (other than section 501(c )(3)) or in section 527 z
Fres
Re No
b
'Yes; complete the following schedule
(a) Name of organization
(b) Type of organszat n
(c) Description of relationship
Under penalties of penury, I declare that I have exam ned 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
Sign
Here
12016-11.09
May the, IRS discuss this
Iflt6rn
with the preparer show"
Signature of officer or trustee
Date
Title
twi-Ohv
(:ee !ng: I, ryes INo
Pnnt/Type preparer's name
DAVID M HASSON
CPA
Preparer's Signature
Date
Check if self-
employed 6 r
PT IN
Paid
PfeParer
Use
Firm's name 6
Firm's
SHR CPAS LLC
N a
Only
Firm's address P.
LAKE SUCCESS, NY
Phone n.
110421009
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
Form 990-PF (2015)
DB-SDNY-0066240
SDNY_GM_00212424
EFTA01372518
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