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efta-efta01362368DOJ Data Set 10CorrespondenceEFTA Document EFTA01362368
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EFTA DisclosureText extracted via OCR from the original document. May contain errors from the scanning process.
Part XVII
Pace 13
Form 990-P; (2016)
Information Regarding Transfers To and Transactions and Relationships With Noncharitable
Exempt Organizations
I
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
(1) Cash
Yes
No
la(1)
No
(2) Other assets
b Other transactions
(1) Sales of assets to a nonchantable exempt organization
la(2)
No
16(1)
No
(2) Purchases of assets from a nonchantable exempt organization
lb(2)
No
(3) Rental of facilities, equipment, or other assets
lb(3)
No
(4) Reimbursement arrangements
lb(4)
No
(5) Loans or loan guarantees
Ib(5)
No
(6) Performance of services or membership or fundraising solicitations
lb(6)
No
c Shanng 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 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) of the Code (other than section 501(c)(3)) or in section 5277
0 Yes
RI No
b If "Yes,- complete the following schedule
(a) Name of organization
(b) Type of organization
(e) Descnption 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
h
12017-05-15
May the IRS discuss this return
with the preparer shown below
I
S gnature of officer or trustee
Date
Title
(see instr p S Yes 0 He
Paid
Preparer
Use Only
Print/Type preparers name
DAVID N HASSON CPA
Preparers Signature
Date
Check if self-
employed ii 0
PTIN
P00035228
Firm's name lk
SHR CPAS LLC
Firm's EIN p.
Firm's address IR
3000 MARCUS AVE STE 3W4
LAKE SUCCESS, NY 110421009
Phone no
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
Form 990-PF (2016)
DB-SDNY-0051756
SDNY_GM_00197940
EFTA01362368
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