EFTA Document EFTA01378848

Form 990- P F (2015) Page 5 Part VII -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(0)(13) If "Yes," attach schedule (see instructions) 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) 13 Did the foundation comply with the public inspection requirements for its annual returns and exemption application> Website address loN/A 11 No 12 No 13 Yes 14 The books are in care of *ERIKA KELLERHA LS Located at Telephone no ZIP +4 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 ► I is 16 At any time during calendar year 2015, did the foundation have an interest in or a signature or other authority over a bank, secunties, or other financial account in a foreign country? See instructions for exceptions and filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FEAR) If 'Yee, enter the name of the foreign country lo ►r Part VII -B Yes 16 No No Statements Regarding Activities for Which Form 4720 May Be Required File Form 4720 If any Item is checked In the "Yee column, unless an exception applies. la 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> r Yes 71. No (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from) a disqualified person> r Yes 71. No (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? r Yes I No (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person> r Yes rie 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)? r Yes 71. 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 r Yes 17 No b If any answer is 'Yes" to 1a(1 )-(6), did anyof 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)' Organizations relying on a current notice regarding disaster assistance check here ► r Did the foundation engage in a prior year in any of the acts described in la, other than excepted acts, that were not corrected before the first day of the tax year beginning in 2015> 2 Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private operating foundation defined in section 49420)(3) or 49420)(5 )) a At the end of tax year 2015, did the foundation have any undistributed income (lines 6d and 6e, Part XIII ) for tax year(s) beginning before 2015> r yes r.7. No If -Yes,' list the years 00 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 a 9 42(a)(2) to allyears listed, answer "No' and attach statement—see instructions ) c If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here 10 20 20 20 20 3a Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at any time dunng the year> r Yes P No b If 'Yes,' did it have excess business holdings in 2015 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-, IS-, or 20-year first phase holding period?(Use Schedule C, Form 4720, to determine if the foundation had excess business holdings in 2015 ) 4a Did the foundation invest dunng the year any amount in a manner that would Jeopardize its charitable purposes? 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 2015 7 Yes No lb No Sc No 2b No 3b 4a 46 No No No CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL SDNY_GM_00222297 Forn 990-PF (2015) DB-SDNY-0076113 EFTA01378848