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sd-10-EFTA01372518Dept. of JusticeOther

EFTA Document EFTA01372518

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) Ca

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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) Ca

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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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