Return of Private Foundation

Size: px
Start display at page:

Download "Return of Private Foundation"

Transcription

1 Form Department of the Treasury Internal Revenue Service For calendar year 2015 or tax year beginning Name of foundation Number and street (or P.O. box number if mail is not delivered to street address) Check if the foundation is not required to attach Sch. B Interest on savings and temporary cash investments ~~~~~~~~~~~~~~ Room/suite OMB No Open to Public Inspection City or town, state or province, country, and ZIP or foreign postal code C If exemption application is pending, check here ~ b Net rental income or (loss) 6a Net gain or (loss) from sale of assets not on line 10 ~~ Gross sales price for all b assets on line 6a ~~ 23, Capital gain net income (from Part IV, line 2) ~~~~~ 8 Net short-term capital gain ~~~~~~~~~ Income modifications~~~~~~~~~~~~ Gross sales less returns 10a and allowances ~~~~ b Less: Cost of goods sold ~ Compensation of officers, directors, trustees, etc. ~~~ a Excess of revenue over expenses and disbursements b Net investment income (if negative, enter -0-) ~~~ c Adjusted net income (if negative, enter -0-) or Section 447(a)(1) Trust Treated as Private Foundation Do not enter social security numbers on this form as it may be made public. Information about Form 0-PF and its separate instructions is at and ending A Employer identification number B Telephone number (858) G Check all that apply: Initial return Initial return of a former public charity D 1. Foreign organizations, check here ~~ Final return Amended return 2. Foreign organizations meeting the 85% test, Address change Name change check here and attach computation ~~~~ H Check type of organization: Section 501(c)(3) exempt private foundation E If private foundation status was terminated Section 447(a)(1) nonexempt charitable trust Other taxable private foundation under section 507(b)(1)(A), check here ~ I Fair market value of all assets at end of year J Accounting method: Cash Accrual F If the foundation is in a 60-month termination (from Part II, col. (c), line 16) Other (specify) under section 507(b)(1)(B), check here ~ $ 11,015,21. (Part I, column (d) must be on cash basis.) Part I Analysis of Revenue and Expenses (d) Disbursements (The total of amounts in columns (b), (c), and (d) may not (a) Revenue and (b) Net investment (c) Adjusted net for charitable purposes necessarily equal the amounts in column (a).) expenses per books income income (cash basis only) 1 Contributions, gifts, grants, etc., received ~~~ 58,57. N/A Revenue Operating and Administrative Expenses a Gross rents ~~~~~~~~~~~~~~~~ 11 c Gross profit or (loss) ~~~~~~~~~~~~ 12 Total. Add lines 1 through a Legal fees~~~~~~~~~~~~~~~~~ b Accounting fees ~~~~~~~~~~~~~~ STMT 4 c Other professional fees ~~~~~~~~~~~ STMT PF MCCARTHY FAMILY FOUNDATION, INC. POST OFFICE BO 2738 SAN DIEGO, CA Dividends and interest from securities~~~~~ Other income ~~~~~~~~~~~~~~~ Other employee salaries and wages ~~~~~~ Pension plans, employee benefits Total operating and administrative expenses. Add lines 13 through 23 ~~~~~ Total expenses and disbursements. ~~~~~~ Interest ~~~~~~~~~~~~~~~~~~ Taxes~~~~~~~~~~~~~~~~~~~ STMT 6 Depreciation and depletion ~~~~~~~~~ Occupancy ~~~~~~~~~~~~~~~~ Travel, conferences, and meetings ~~~~~~ Printing and publications ~~~~~~~~~~ Other expenses ~~~~~~~~~~~~~~ STMT 7 Contributions, gifts, grants paid ~~~~~~~ Add lines 24 and 25 Subtract line 26 from line 12: ETENDED TO NOVEMBER 15, 2016 ~ Return of Private Foundation ,13 138,13 668,37 657, STATEMENT 1 STATEMENT 2 30, ,62 STATEMENT 3 85, ,01. 1,073. 1, ,75 20,05 10, , , ,37 105,421. 6,4. 173, , ,64. 57,50 57,50 771, , , ,43 702, LHA For Paperwork Reduction Act Notice, see instructions. Form 0-PF (2015) 1 N/A

2 Form 0-PF (2015) Part II Assets Liabilities Net Assets or Fund Balances Other notes and loans receivable ~~~~~~~~ Investments - land, buildings, and equipment: basis Less: accumulated depreciation Attached schedules and amounts in the description column should be for end-of-year amounts only. Prepaid expenses and deferred charges ~~~~~~~~~~~~~ 10a Investments - U.S. and state government obligations ~~~~~~~ STMT b Investments - corporate stock ~~~~~~~~~~~~~~~~~ STMT 10 c Investments - corporate bonds ~~~~~~~~~~~~~~~~~ STMT Total assets (to be completed by all filers - see the Loans from officers, directors, trustees, and other disqualified persons 23 Total liabilities (add lines 17 through 22) Part III Balance Sheets Cash - non-interest-bearing Savings and temporary cash investments Accounts receivable Less: allowance for doubtful accounts Pledges receivable Less: allowance for doubtful accounts Foundations that follow SFAS 117, check here and complete lines 24 through 26 and lines 30 and 31. and complete lines 27 through 31. Total net assets or fund balances~~~~~~~~~~~~~~~~ Total liabilities and net assets/fund balances ~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~ Grants receivable ~~~~~~~~~~~~~~~~~~~~~~~ Receivables due from officers, directors, trustees, and other disqualified persons ~~~~~~~~~~~~~~~~~~~~~~ Less: allowance for doubtful accounts Inventories for sale or use ~~~~~~~~~~~~~~~~~~~ ~~ ~~~~~~~~ Investments - mortgage loans ~~~~~~~~~~~~~~~~~ Investments - other ~~~~~~~~~~~~~~~~~~~~~~ STMT 12 Land, buildings, and equipment: basis Less: accumulated depreciation ~~~~~~~~ Other assets (describe OFFICE EQUIPMENT ) instructions. Also, see page 1, item I) Accounts payable and accrued expenses ~~~~~~~~~~~~~ Grants payable ~~~~~~~~~~~~~~~~~~~~~~~~ Deferred revenue ~~~~~~~~~~~~~~~~~~~~~~~ Mortgages and other notes payable Other liabilities (describe Unrestricted MCCARTHY FAMILY FOUNDATION, INC. ~~~~ ~~~~~~~~~~~~~~~ ~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~ Temporarily restricted ~~~~~~~~~~~~~~~~~~~~~ Permanently restricted~~~~~~~~~~~~~~~~~~~~~ Foundations that do not follow SFAS 117, check here ~ Capital stock, trust principal, or current funds ~~~~~~~~~~~ Paid-in or capital surplus, or land, bldg., and equipment fund ~~~~ Retained earnings, accumulated income, endowment, or other funds ~ Analysis of Changes in Net Assets or Fund Balances Total net assets or fund balances at beginning of year - Part II, column (a), line 30 ) Beginning of year End of year (a) Book Value (b) Book Value (c) Fair Market Value (must agree with end-of-year figure reported on prior year's return) ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Enter amount from Part I, line 27a ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other increases not included in line 2 (itemize) TIMING DIFFERENCE Add lines 1, 2, and 3 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Decreases not included in line 2 (itemize) SEE STATEMENT 8 Total net assets or fund balances at end of year (line 4 minus line 5) - Part II, column (b), line Page 2 444, , , , ,2. 165,063. 1,78,33. 1,883,84 2,87, , ,26 334,564. 5,643,351. 5,774,34. 7,362,11. 3,774. 3,774. 3,774. 8,324,401. 8,415, ,015,21. 8,324,401. 8,415,238. 8,324,401. 8,415,238. 8,324,401. 8,415, ,324, , ,44,03. 33,855. 8,415,238. Form 0-PF (2015) 2

3 Form 0-PF (2015) MCCARTHY FAMILY FOUNDATION, INC Page 3 Part IV Capital Gains and Losses for Tax on Investment Income (a) List and describe the kind(s) of property sold (e.g., real estate, (b) How acquired (c) Date acquired (d) Date sold P - Purchase 2-story brick warehouse; or common stock, 200 shs. MLC Co.) D - Donation (mo., day, yr.) (mo., day, yr.) 1a b c d e CAPITAL GAIN DIVIDENDS TIFF PARTNERS BTR DISTRIBUTION IN ECESS OF BASIS P P P P P (e) Gross sales price (f) Depreciation allowed (g) Cost or other basis (h) Gain or (loss) (or allowable) plus expense of sale (e) plus (f) minus (g) a b c d e 23, , , , ,53 16, ,143. Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/6 (l) Gains (Col. (h) gain minus (i) F.M.V. as of 12/31/6 (j) Adjusted basis (k) Excess of col. (i) col. (k), but not less than -0-) or Losses (from col. (h)) as of 12/31/6 over col. (j), if any a b c d e 260, , ,53 16, ,143. If gain, also enter in Part I, line 7 2 Capital gain net income or (net capital loss) If (loss), enter -0- in Part I, line 7 ~~~~~~ 2 3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6): If gain, also enter in Part I, line 8, column (c). If (loss), enter -0- in Part I, line 8 3 Part V Qualification Under Section 440(e) for Reduced Tax on Net Investment Income (For optional use by domestic private foundations subject to the section 440(a) tax on net investment income.) If section 440(d)(2) applies, leave this part blank. Was the foundation liable for the section 442 tax on the distributable amount of any year in the base period? If "Yes," the foundation does not qualify under section 440(e). Do not complete this part. 1 Enter the appropriate amount in each column for each year; see the instructions before making any entries. (a) (b) (c) Base period years Calendar year (or tax year beginning in) Adjusted qualifying distributions Net value of noncharitable-use assets rqs pmo pmo N/A 657,227. ~~~~~~~~~~~~~~~~ Yes No (d) Distribution ratio (col. (b) divided by col. (c)) 583, ,613, ,46. 10,77, ,868.,835, ,48.,72, ,716. 8,5, Total of line 1, column (d) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2 Average distribution ratio for the 5-year base period - divide the total on line 2 by 5, or by the number of years the foundation has been in existence if less than 5 years ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Enter the net value of noncharitable-use assets for 2015 from Part, line 5 ~~~~~~~~~~~~~~~~~~~~~ 4 11,47,43. 5 Multiply line 4 by line 3 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5 54, Enter 1% of net investment income (1% of Part I, line 27b) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6 7, Add lines 5 and 6 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 7 556, Enter qualifying distributions from Part II, line 4~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See the Part VI instructions Form 0-PF (2015) ,464.

4 Form 0-PF (2015) MCCARTHY FAMILY FOUNDATION, INC Page 4 Part VI Excise Tax Based on Investment Income (Section 440(a), 440(b), 440(e), or see instructions) 1a Exempt operating foundations described in section 440(d)(2), check here and enter "N/A" on line 1. Date of ruling or determination letter: (attach copy of letter if necessary-see instructions) b Domestic foundations that meet the section 440(e) requirements in Part V, check here and enter 1% c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b). Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ~~~~~~~~~~~~~~~~~ a 2015 estimated tax payments and 2014 overpayment credited to 2015 ~~~~~~~~ b Exempt foreign organizations - tax withheld at source ~~~~~~~~~~~~~~~~ c Tax paid with application for extension of time to file (Form 8868) d Backup withholding erroneously withheld ~~~~~~~~~~~~~~~~~~~~~ Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached ~~~~~~~~~~~~~ 8 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed ~~~~~~~~~~~~~~~~~~~~ 10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid Enter the amount of line 10 to be: Credited to 2016 estimated tax 2,45. Refunded 11 Part VII-A Statements Regarding Activities 1a During the tax year, did the foundation attempt to influence any national, state, or local legislation or did it participate or intervene in of Part I, line 27b~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Tax under section 511 (domestic section 447(a)(1) trusts and taxable foundations only. Others enter -0-) ~~~~~~~~~ Add lines 1 and 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Subtitle A (income) tax (domestic section 447(a)(1) trusts and taxable foundations only. Others enter -0-) ~~~~~~~~ Credits/Payments: b Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see instructions for the definition)? ~~~~ If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials published or distributed by the foundation in connection with the activities. c Did the foundation file Form 1120-POL for this year? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ d Enter the amount (if any) of tax on political expenditures (section 455) imposed during the year: (1) On the foundation. $ (2) On foundation managers. $ e Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed on foundation managers. $ If "Yes," attach a detailed description of the activities. bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes ~~~~~~~~~~~~~~~~~~~~~ b If "Yes," has it filed a tax return on Form 0-T for this year? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes," attach the statement required by General Instruction T. ~~~~~~~~~~ Total credits and payments. Add lines 6a through 6d ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ any political campaign? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Has the foundation engaged in any activities that have not previously been reported to the IRS? ~~~~~~~~~~~~~~~~~~~~ Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles of incorporation, or 4a Did the foundation have unrelated business gross income of $1,000 or more during the year? ~~~~~~~~~~~~~~~~~~~~~ Was there a liquidation, termination, dissolution, or substantial contraction during the year? ~~~~~~~~~~~~~~~~~~~~~~ Are the requirements of section 508(e) (relating to sections 441 through 445) satisfied either: By language in the governing instrument, or By state legislation that effectively amends the governing instrument so that no mandatory directions that conflict with the state law remain in the governing instrument? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c), and Part V ~~~~~ 8a Enter the states to which the foundation reports or with which it is registered (see instructions) CA b If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 0-PF to the Attorney General (or designate) of each state as required by General Instruction G? If "No," attach explanation ~~~~~~~~~~~~~~~~~~~~~~~~~ Is the foundation claiming status as a private operating foundation within the meaning of section 442(j)(3) or 442(j)(5) for calendar year 2015 or the taxable year beginning in 2015 (see instructions for Part IV)? If "Yes," complete Part IV ~~~~~~~~~~~~~~ 10 Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names and addresses STMT Form 0-PF (2015) 6a 6b 6c 6d pnmno, a 1b 1c 2 3 4a 4b b 7,025. 7,025. 7,025.,52 2,45. Yes No

5 Form 0-PF (2015) MCCARTHY FAMILY FOUNDATION, INC. Part VII-A Statements Regarding Activities (continued) Section 447(a)(1) nonexempt charitable trusts filing Form 0-PF in lieu of Form Check here ~~~~~~~~~~~~~~~~~~~~~~~ and enter the amount of tax-exempt interest received or accrued during the year ~~~~~~~~~~~~~~~~~~~ 15 N/A At any time during calendar year 2015, did the foundation have an interest in or a signature or other authority over a bank, Yes No securities, or other financial account in a foreign country? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 16 1a During the year did the foundation (either directly or indirectly): 2 (1) (2) (3) (4) (5) (6) Agree to pay money or property to a government official? ( Exception. Check "No" b If any answer is "Yes" to 1a(1)-(6), did any of the acts fail to qualify under the exceptions described in Regulations c Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts, that were not corrected a At the end of tax year 2015, did the foundation have any undistributed income (lines 6d and 6e, Part III) for tax year(s) beginning b Are there any years listed in 2a for which the foundation is not applying the provisions of section 442(a)(2) (relating to incorrect c If the provisions of section 442(a)(2) are being applied to any of the years listed in 2a, list the years here. 3a At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the meaning of section 512(b)(13)? If "Yes," attach schedule (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 12 Did the foundation comply with the public inspection requirements for its annual returns and exemption application? ~~~~~~~~~~~ 13 Website address The books are in care of MCCARTHY FAMILY FOUNDATION Telephone no. (858) Located at P.O. BO 2738, SAN DIEGO, CA ZIP See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes," enter the name of the foreign country Part VII-B Statements Regarding Activities for Which Form 4720 May Be Required File Form 4720 if any item is checked in the "Yes" column, unless an exception applies. Engage in the sale or exchange, or leasing of property with a disqualified person? Borrow money from, lend money to, or otherwise extend credit to (or accept it from) a disqualified person? ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Furnish goods, services, or facilities to (or accept them from) a disqualified person? Pay compensation to, or pay or reimburse the expenses of, a disqualified person? Transfer any income or assets to a disqualified person (or make any of either available ~~~~~~~~~~~~~ ~~~~~~~~~~~~~~ for the benefit or use of a disqualified person)?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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 0 days.) ~~~~~~~~~~~~~~~~~~~~~ section (d)-3 or in a current notice regarding disaster assistance (see instructions)? ~~~~~~~~~~~~~~~~~~~~~ Organizations relying on a current notice regarding disaster assistance check here ~~~~~~~~~~~~~~~~~~~~~ before the first day of the tax year beginning in 2015?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Taxes on failure to distribute income (section 442) (does not apply for years the foundation was a private operating foundation defined in section 442(j)(3) or 442(j)(5)): before 2015? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes," list the years,,, valuation of assets) to the year's undistributed income? (If applying section 442(a)(2) to all years listed, answer "No" and attach statement - see instructions.) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ N/A,,, Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at any time during the year? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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, 16; (2) the lapse of the 5-year period (or longer period approved by the Commissioner under section 443(c)(7)) to dispose of holdings acquired by gift or bequest; or (3) the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine if the foundation had excess business holdings in 2015.) ~~~~~~~~~~~~~~~~~~~~~~ N/A 4a Did the foundation invest during 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, 16) that could jeopardize its charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2015? 4b Form 0-PF (2015) Yes Yes Yes Yes Yes Yes Yes Yes No No No No No No No No 11 1b 1c 2b 3b 4a Yes Yes Page 5 No No

6 Form 0-PF (2015) MCCARTHY FAMILY FOUNDATION, INC. Part VII-B Statements Regarding Activities for Which Form 4720 May Be Required 5a During the year did the foundation pay or incur any amount to: (1) (2) (3) (4) (5) Carry on propaganda, or otherwise attempt to influence legislation (section 445(e))? ~~~~~~~~~~~~~ Influence the outcome of any specific public election (see section 455); or to carry on, directly or indirectly, any voter registration drive? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Provide a grant to an individual for travel, study, or other similar purposes? Provide a grant to an organization other than a charitable, etc., organization described in section 445(d)(4)(A)? (see instructions) c If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the tax because it maintained expenditure responsibility for the grant?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ N/A If "Yes," attach the statement required by Regulations section (d). 6a Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on ~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Provide for any purpose other than religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ (continued) b If any answer is "Yes" to 5a(1)-(5), did any of the transactions fail to qualify under the exceptions described in Regulations section or in a current notice regarding disaster assistance (see instructions)? ~~~~~~~~~~~~~~~~~~~~~~~~ N/A Organizations relying on a current notice regarding disaster assistance check here ~~~~~~~~~~~~~~~~~~~~~ a personal benefit contract? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ b Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ~~~~~~~~~~~~~~~~ If "Yes" to 6b, file Form 887 7a At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction? ~~~~~~~~~ Yes No b If "Yes," did the foundation receive any proceeds or have any net income attributable to the transaction? N/A Part VIII Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees, and Contractors 1 List all officers, directors, trustees, foundation managers and their compensation. (a) Name and address (b) Title, and average (c) Compensation (d) Contributions to (e) Expense employee benefit plans hours per week devoted to position (If not paid, enter -0-) and deferred compensation account, other allowances RACHEL MCCARTHY HENNEFORTH PRESIDENT P.O. BO 2738 SAN DIEGO, CA JANE D. MCCARTHY SECRETARY P.O. BO 2738 SAN DIEGO, CA JAMES T. MCCARTHY DIRECTOR P.O. BO 2738 SAN DIEGO, CA DREW SUTTER TREASURER/CHIEF FINANCIAL P.O. BO 2738 SAN DIEGO, CA Compensation of five highest-paid employees (other than those included on line 1). If none, enter "." (a) Name and address of each employee paid more than $50,000 (b) Title, and average (d) Contributions to (e) Expense employee benefit plans hours per week (c) Compensation and deferred account, other devoted to position compensation allowances Yes Yes Yes Yes Yes Yes Yes No No No No No No No 5b 6b 7b Page 6 Total number of other employees paid over $50,000 0 Form 0-PF (2015)

7 Form 0-PF (2015) MCCARTHY FAMILY FOUNDATION, INC Page 7 Part VIII Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees, and Contractors (continued) 3 Five highest-paid independent contractors for professional services. If none, enter "." (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation Total number of others receiving over $50,000 for professional services Part I-A Summary of Direct Charitable Activities 0 List the foundation's four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. 1 N/A Expenses Part I-B Summary of Program-Related Investments Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. 1 N/A Amount 2 All other program-related investments. See instructions. 3 Total. Add lines 1 through 3 J Form 0-PF (2015)

8 Form 0-PF (2015) MCCARTHY FAMILY FOUNDATION, INC Part Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.) Page 8 1 Fair market value of assets not used (or held for use) directly in carrying out charitable, etc., purposes: a Average monthly fair market value of securities ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1a b c Average of monthly cash balances Fair market value of all other assets ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1b 1c d e Total (add lines 1a, b, and c) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Reduction claimed for blockage or other factors reported on lines 1a and 1d 1c (attach detailed explanation) ~~~~~~~~~~~~~~~~~~~~~~ 1e 2 Acquisition indebtedness applicable to line 1 assets ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2 3 Subtract line 2 from line 1d~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3 4 Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see instructions) ~~~~~~~~ 4 5 Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4 ~~~~~~~~~~ 5 6 Minimum investment return. Enter 5% of line 5 6 Part I Distributable Amount (see instructions) (Section 442(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here and do not complete this part.) 1 Minimum investment return from Part, line 6 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2a Tax on investment income for 2015 from Part VI, line 5 ~~~~~~~~~~~ 2a 7,025. b Income tax for (This does not include the tax from Part VI.) ~~~~~~~ 2b c Add lines 2a and 2b ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3 Distributable amount before adjustments. Subtract line 2c from line 1 ~~~~~~~~~~~~~~~~~~~~~~~ 4 5 Recoveries of amounts treated as qualifying distributions ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Add lines 3 and 4 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6 Deduction from distributable amount (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 7 Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part III, line 1 Part II Qualifying Distributions (see instructions) 1 2c ,13, , ,654, ,654, , ,47, ,7. 573,7. 7, , , ,72. 1 a b 2 3 a b Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes: Expenses, contributions, gifts, etc. - total from Part I, column (d), line 26 ~~~~~~~~~~~~~~~~~~~~~~ Program-related investments - total from Part I-B ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc., purposes ~~~~~~~~~ Amounts set aside for specific charitable projects that satisfy the: Suitability test (prior IRS approval required) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Cash distribution test (attach the required schedule) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part III, line 4 ~~~~~~~~~ Foundations that qualify under section 440(e) for the reduced rate of tax on net investment income. Enter 1% of Part I, line 27b ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Adjusted qualifying distributions. Subtract line 5 from line 4 ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Note. The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for the section 440(e) reduction of tax in those years. Form 0-PF (2015) 1a 1b 2 3a 3b , ,464. 7, ,

9 Form 0-PF (2015) MCCARTHY FAMILY FOUNDATION, INC. Part III Undistributed Income (see instructions) Page Undistributed income, if any, as of the end of 2015: a Enter amount for 2014 only ~~~~~~~ b Total for prior years: a From 2010 b From 2011 c From 2012 d From 2013 e From 2014 f Total of lines 3a through e ~~~~~~~~ 4 Qualifying distributions for 2015 from Part II, line 4: $ 645,464. a Applied to 2014, but not more than line 2a ~ b Applied to undistributed income of prior c Treated as distributions out of corpus e Remaining amount distributed out of corpus 5 Excess distributions carryover applied to 2015 ~~ (If an amount appears in column (d), the same amount must be shown in column (a).) 6 Enter the net total of each column as indicated below: Distributable amount for 2015 from Part I, line 7 ~~~~~~~~~~~~~~~~~,, Excess distributions carryover, if any, to 2015: ~~~ ~~~ ~~~ ~~~ ~~~ years (Election required - see instructions) ~ (Election required - see instructions) b Prior years' undistributed income. Subtract c Enter the amount of prior years' undistributed income for which a notice of deficiency has been issued, or on which the section 442(a) tax has been previously assessed ~~~~~~~~~~~~~~~ d Subtract line 6c from line 6b. Taxable e Undistributed income for Subtract line f Undistributed income for Subtract Excess distributions carryover to a Excess from 2011 ~ b Excess from 2012 ~ c Excess from 2013 ~ d Excess from 2014 ~ ~~~ d Applied to 2015 distributable amount ~~~ a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 ~~ line 4b from line 2b ~~~~~~~~~~~ amount - see instructions ~~~~~~~~ 4a from line 2a. Taxable amount - see instr.~ lines 4d and 5 from line 1. This amount must be distributed in 2016 ~~~~~~~~~~ Amounts treated as distributions out of corpus to satisfy requirements imposed by section 170(b)(1)(F) or 442(g)(3) (Election may be required - see instructions) ~~~~ Excess distributions carryover from 2010 not applied on line 5 or line 7 ~~~~~~~ Subtract lines 7 and 8 from line 6a ~~~~ Analysis of line : (a) (b) (c) (d) Corpus Years prior to , , , , ,641. e Excess from Form 0-PF (2015)

10 Form 0-PF (2015) MCCARTHY FAMILY FOUNDATION, INC. Part IV Private Operating Foundations (see instructions and Part VII-A, question ) 1 a If the foundation has received a ruling or determination letter that it is a private operating foundation, and the ruling is effective for 2015, enter the date of the ruling ~~~~~~~~~~~ b Check box to indicate whether the foundation is a private operating foundation described in section ~~~ 442(j)(3) or 442(j)(5) 2 a Enter the lesser of the adjusted net Tax year Prior 3 years income from Part I or the minimum (a) 2015 (b) 2014 (c) 2013 (d) 2012 (e) Total b 85% of line 2a ~~~~~~~~~~ c Qualifying distributions from Part II, d Amounts included in line 2c not e Qualifying distributions made directly 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 ~~~~~~ b c "Support" alternative test - enter: (1) (2) (3) (4) Gross investment income Part V Supplementary Information (Complete this part only if the foundation had $5,000 or more in assets at any time during the year-see instructions.) 1 2 investment return from Part for each year listed ~~~~~~~~~ line 4 for each year listed ~~~~~ used directly for active conduct of exempt activities ~~~~~~~~~ for active conduct of exempt activities. (2) Value of assets qualifying under section 442(j)(3)(B)(i) ~ "Endowment" alternative test - enter 2/3 of minimum investment return shown in Part, line 6 for each year listed ~~~~~~~~~~~~~~ Total support other than gross investment income (interest, dividends, rents, payments on securities loans (section 512(a)(5)), or royalties) ~~~~ Support from general public and 5 or more exempt organizations as provided in section 442(j)(3)(B)(iii) ~~~ Largest amount of support from an exempt organization ~~~~ Information Regarding Foundation Managers: a List any managers of the foundation who have contributed 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).) SEE STATEMENT 14 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. Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs: Check here 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 address of the person to whom applications should be addressed: SEE STATEMENT 15 b The form in which applications should be submitted and information and materials they should include: N/A Page 10 c Any submission deadlines: d Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other factors: Form 0-PF (2015) 10

11 Form 0-PF (2015) MCCARTHY FAMILY FOUNDATION, INC. Part V Supplementary Information (continued) 3 a Grants and Contributions Paid During the Year or Approved for Future Payment Recipient If recipient is an individual, show any relationship to Foundation any foundation manager status of Name and address (home or business) or substantial contributor recipient Paid during the year Purpose of grant or contribution Amount Page 11 ANGELS FOSTER FAMILY NETWORK 4420 HOTEL CIRCLE COURT, SUITE 100 SAN DIEGO, CA 2108 EPANDING CARING FAMILIES PROGRAM 11,00 BOYS & GIRLS CLUBS OF GREATER SAN DIEGO P.O. BO SAN DIEGO, CA 2177 STEPPING STONES TO S.T.E.M SUCCESS 15,00 CARLSBAD EDUCATIONAL FOUNDATION 5631 PALMER WAY, SUITE L CARLSBAD, CA 2010 MIDDLE SCHOOL SCIENCE LAB SUPERCHARGE PROJECT 10,00 CHILD ABUSE A REASON TO SURVIVE (ARTS) 200 EAST 12TH STREET NATIONAL CITY, CA 150 HEAL THERAPEUTIC ARTS PROGRAM & SOCIAL WORK TEAM 15,00 CHILDREN'S INITIATIVE REPORT CARD ON 4438 INGRAHAM STREET CHILDREN AND FAMILIES SAN DIEGO, CA 210 Total SEE CONTINUATION SHEET(S) 3a b Approved for future payment 10,00 57,50 HIV AIDS UCLA FOUNDATION (AIDS HIV ETINCTION PROJECT INSTITUTE) 1040 WILSHIRE BLVD., SUITE 60 LOS ANGELES, CA ,00 SAN DIEGO GRANTMAKERS CAPACITY BUILDING 5060 SHOREHAM PLACE, SUITE 350 SAN DIEGO, CA , Total 3b 320,00 Form 0-PF (2015) 11

12 Form 0-PF (2015) MCCARTHY FAMILY FOUNDATION, INC Page 12 Part VI-A Analysis of Income-Producing Activities Enter gross amounts unless otherwise indicated. 1 Program service revenue: a b c d e f g 3 Interest on savings and temporary cash 4 Dividends and interest from securities ~~~~~~~~ 5 Net rental income or (loss) from real estate: a b 6 Net rental income or (loss) from personal 7 Other investment income ~~~~~~~~~~~~~~ 8 Gain or (loss) from sales of assets other 10 Gross profit or (loss) from sales of inventory 11 Other revenue: a OTHER INVESTMENT INCOME b c d Fees and contracts from government agencies ~~~ 2 Membership dues and assessments ~~~~~~~~~ investments ~~~~~~~~~~~~~~~~~~~~ Debt-financed property ~~~~~~~~~~~~~ Not debt-financed property ~~~~~~~~~~~~ property ~~~~~~~~~~~~~~~~~~~~~ than inventory ~~~~~~~~~~~~~~~~~~~ Net income or (loss) from special events ~~~~~~~ ~~~~~ (See worksheet in line 13 instructions to verify calculations.) Part VI-B Unrelated business income Excluded by section 512, 513, or 514 (a) (c) (b) Exclusion (d) Business code Amount code Amount , ,343. Relationship of Activities to the Accomplishment of Exempt Purposes (e) Related or exempt function income e 12 Subtotal. Add columns (b), (d), and (e) ~~~~~~~~ 7,80 828, Total. Add line 12, columns (b), (d), and (e) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ , ,13 32,62 657,227. Line No. < Explain below how each activity for which income is reported in column (e) of Part VI-A contributed importantly to the accomplishment of the foundation's exempt purposes (other than by providing funds for such purposes) Form 0-PF (2015) 12

13 Form 0-PF (2015) MCCARTHY FAMILY FOUNDATION, INC Page 13 Part VII 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 Yes No a b c the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations? Transfers from the reporting foundation to a noncharitable exempt organization of: (1) (2) (1) (2) (3) (4) (5) (6) Cash ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other assets~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other transactions: Sales of assets to a noncharitable exempt organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Purchases of assets from a noncharitable exempt organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Rental of facilities, equipment, or other assets ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Reimbursement arrangements ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Loans or loan guarantees ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Performance of services or membership or fundraising solicitations ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Sharing of facilities, equipment, mailing lists, other assets, or paid employees ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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 N/A 1a(1) 1a(2) 1b(1) 1b(2) 1b(3) 1b(4) 1b(5) 1b(6) 1c 2a b 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 527? ~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes No If "Yes," complete the following schedule. (a) Name of organization (b) Type of organization (c) Description of relationship N/A Sign Here Paid Preparer Use Only 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. = = May the IRS discuss this return with the preparer shown below (see instr.)? PRESIDENT Yes Signature of officer or trustee Date Title Print/Type preparer's name Preparer's signature Date Check if PTIN self- employed JULIE KEENEY 11//2016 P Firm's name DELOITTE TA LLP Firm's EIN Firm's address 655 WEST BROADWAY, SUITE 700 SAN DIEGO, CA Phone no. No (61) Form 0-PF (2015)

14 Part V 3 MCCARTHY FAMILY FOUNDATION, INC Supplementary Information Grants and Contributions Paid During the Year (Continuation) Recipient Name and address (home or business) If recipient is an individual, show any relationship to any foundation manager or substantial contributor Foundation status of recipient Purpose of grant or contribution Amount CLASSICAL ACADEMIES 270 E. PENNSYLVANIA AVENUE ESCONDIDO, CA 2025 STEM MATERIALS-LAB BOOKS 10,00 COMMUNITY RESOURCE CENTER 650 SECOND STREET ENCINITAS, CA 2024 COUNSELING & THERAPEUTIC CHILDREN'S CENTER 10,00 CRISIS HOUSE 1034 NORTH MAGNOLIA AVENUE EL CAJON, CA 2020 NEW JOURNEY DOMESTIC VIOLENCE/CHILDREN MATTER PROGRAM 10,00 DIRECTORS' MATCHING GRANTS POWAY CENTER FOR THE PERFORMING ARTS 1548 ESPOLA ROAD POWAY, CA 2064 GENERAL SUPPORT 10,00 HANNAH'S HOUSE 455 FARNHAM STREET SAN DIEGO, CA 2123 TRANSITIONS FAMILY PROGRAM 15,00 HIV AIDS UCLA FOUNDATION (AIDS INSTITUTE) 1040 WILSHIRE BLVD., SUITE 60 LOS ANGELES, CA 0024 HIV ETINCTION PROJECT 150,00 HOMELESS UNITED WAY OF SAN DIEGO COUNTY 46 MURPHY CANYON ROAD SAN DIEGO, CA 2123 FUNDERS TOGETHER TO END HOMELESSNESS-SAN DIEGO 150,00 KIDS' TURN SAN DIEGO 40 MURPHY CANYON ROAD, SUITE 515 SAN DIEGO, CA 2123 CONTINUING THE CONVERSATION COUNSELING PROGRAM 10,00 LIVING COAST DISCOVERY CENTER 1000 GUNPOWDER POINT DRIVE CHULA VISTA, CA 110 SCIENCE WITHOUT BOUNDARIES 10,00 NATIONAL CENTER FOR FAMILY PHILANTHROPHY 1101 CONNECTICUT AVENUE NW, SUITE 220 WASHINGTON, DC Total from continuation sheets FRIENDS OF FAMILY ,

15 Part V 3 MCCARTHY FAMILY FOUNDATION, INC Supplementary Information Grants and Contributions Paid During the Year (Continuation) Recipient Name and address (home or business) If recipient is an individual, show any relationship to any foundation manager or substantial contributor Foundation status of recipient Purpose of grant or contribution Amount OCEAN DISCOVERY INSTITUTE (ODI) 2211 PACIFIC BEACH DRIVE, SUITE A SAN DIEGO, CA 210 AFTER-SCHOOL AND SUMMER SCIENCE PROGRAMS 15,00 OTHER/SPECIAL FOUNDATION CENTER 7 FIFTH AVENUE NEW YORK, NY GENERAL SUPPORT 2,50 PROMISES2KIDS 400 RUFFIN COURT, SUITE A SAN DIEGO, CA 2123 DIRECT SERVICES 15,00 READING LEGACIES 2750 HISTORIC DECATUR ROAD SAN DIEGO, CA 2106 GENERAL SUPPORT 10,00 SAN DIEGO GRANTMAKERS 5060 SHOREHAM PLACE, SUITE 350 SAN DIEGO, CA 2122 DUES/ANNUAL CONFERENCE/GENL OPERATING SUPPORT 13,50 SAN DIEGO PUBLIC LIBRARY FOUNDATION 330 PARK BOULEVARD SAN DIEGO, CA 2101 SCIENCE PROGRAMMING FOR UNDERSERVED YOUTH 15,00 SAN DIEGUITO ACADEMY FOUNDATION P.O. BO ENCINITAS, CA 2023 TEAM PARADO ROBOTICS 10,00 SCIENCE EDUCATION BOYS & GIRLS CLUB OF VISTA 410 W. CALIFORNIA AVENUE VISTA, CA 2083 PROJECT STP (SCIENCE, TECH, POWER) 5,00 SOMALI FAMILY SERVICE OF SAN DIEGO 6035 UNIVERSITY AVENUE, SUITE 6 SAN DIEGO, CA 2115 LEADERSHIP IN OUR AREA (LION) 15,00 SOUTH BAY COMMUNITY SERVICES 430 F STREET CHULA VISTA, CA 110 Total from continuation sheets CHILD ABUSE PREVENTION SERVICES-GENL SUPPORT 10,

16 Part V 3 MCCARTHY FAMILY FOUNDATION, INC Supplementary Information Grants and Contributions Paid During the Year (Continuation) Recipient Name and address (home or business) If recipient is an individual, show any relationship to any foundation manager or substantial contributor Foundation status of recipient Purpose of grant or contribution Amount UC SAN DIEGO 500 GILMAN DRIVE LA JOLLA, CA 203 ONCOFERTILITY SCIENCE ACADEMY 10,00 VOICES FOR CHILDREN 2851 MEADOW LARK DRIVE SAN DIEGO, CA 2123 TRANSITIONAL AGE YOUTH PROGRAM 15,00 WALDEN ENVIRONMENT FOUNDATION 2851 MEADOW LARK DRIVE SAN DIEGO, CA 2123 FOSTERING PROMISING FUTURES PROGRAM 15,00 ZOOLOGICAL SOCIETY OF SAN DIEGO P.O. BO SAN DIEGO, CA 2112 CALAVERA HILLS MIDDLE SCHOOL-INTERACTIVE SCIENCE 10,00 Total from continuation sheets

17 Schedule B (Form 0, 0-EZ, or 0-PF) Department of the Treasury Internal Revenue Service Name of the organization Schedule of Contributors Attach to Form 0, Form 0-EZ, or Form 0-PF. Information about Schedule B (Form 0, 0-EZ, or 0-PF) and its instructions is at OMB No Employer identification number Organization type (check one): MCCARTHY FAMILY FOUNDATION, INC Filers of: Section: Form 0 or 0-EZ 501(c)( ) (enter number) organization 447(a)(1) nonexempt charitable trust not treated as a private foundation 527 political organization Form 0-PF 501(c)(3) exempt private foundation 447(a)(1) nonexempt charitable trust treated as a private foundation 501(c)(3) taxable private foundation Check if your organization is covered by the General Rule or a Special Rule. Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions. General Rule For an organization filing Form 0, 0-EZ, or 0-PF that received, during the year, contributions totaling $5,000 or more (in money or property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions. Special Rules For an organization described in section 501(c)(3) filing Form 0 or 0-EZ that met the 33 1/3% support test of the regulations under sections 50(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 0 or 0-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 0, Part VIII, line 1h, or (ii) Form 0-EZ, line 1. Complete Parts I and II. For an organization described in section 501(c)(7), (8), or (10) filing Form 0 or 0-EZ that received from any one contributor, during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III. For an organization described in section 501(c)(7), (8), or (10) filing Form 0 or 0-EZ that received from any one contributor, during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,00 If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ~~~~~~~~~~~~~~~ $ Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 0, 0-EZ, or 0-PF), but it must answer "No" on Part IV, line 2, of its Form 0; or check the box on line H of its Form 0-EZ or on its Form 0-PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 0, 0-EZ, or 0-PF). LHA For Paperwork Reduction Act Notice, see the Instructions for Form 0, 0-EZ, or 0-PF. Schedule B (Form 0, 0-EZ, or 0-PF) (2015)

18 Schedule B (Form 0, 0-EZ, or 0-PF) (2015) Name of organization Employer identification number Page 2 MCCARTHY FAMILY FOUNDATION, INC Part I Contributors (see instructions). Use duplicate copies of Part I if additional space is needed. (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Type of contribution 1 JAMES & JANE MCCARTHY POST OFFICE BO 2738 SAN DIEGO, CA $ 58,57. Person Payroll Noncash (Complete Part II for noncash contributions.) (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Type of contribution $ Person Payroll Noncash (Complete Part II for noncash contributions.) (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Type of contribution $ Person Payroll Noncash (Complete Part II for noncash contributions.) (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Type of contribution $ Person Payroll Noncash (Complete Part II for noncash contributions.) (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Type of contribution $ Person Payroll Noncash (Complete Part II for noncash contributions.) (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Type of contribution Person Payroll Noncash Schedule B (Form 0, 0-EZ, or 0-PF) (2015) 18 $ (Complete Part II for noncash contributions.)

19 Schedule B (Form 0, 0-EZ, or 0-PF) (2015) Name of organization Page 3 Employer identification number MCCARTHY FAMILY FOUNDATION, INC Part II Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed. (a) No. from Part I 1 (b) Description of noncash property given 107 SHARES MICROSOFT CORPORATION (c) FMV (or estimate) (see instructions) (d) Date received $ 58,57. 12/21/15 (a) No. from Part I (b) Description of noncash property given (c) FMV (or estimate) (see instructions) (d) Date received $ (a) No. from Part I (b) Description of noncash property given (c) FMV (or estimate) (see instructions) (d) Date received $ (a) No. from Part I (b) Description of noncash property given (c) FMV (or estimate) (see instructions) (d) Date received $ (a) No. from Part I (b) Description of noncash property given (c) FMV (or estimate) (see instructions) (d) Date received $ (a) No. from Part I (b) Description of noncash property given (c) FMV (or estimate) (see instructions) (d) Date received Schedule B (Form 0, 0-EZ, or 0-PF) (2015) 1 $

20 Schedule B (Form 0, 0-EZ, or 0-PF) (2015) Name of organization Page 4 Employer identification number MCCARTHY FAMILY FOUNDATION, INC Part III (a) No. from Part I Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this info. once.) $ Use duplicate copies of Part III if additional space is needed. (b) Purpose of gift (c) Use of gift (d) Description of how gift is held (e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee (a) No. from Part I (b) Purpose of gift (c) Use of gift (d) Description of how gift is held (e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee (a) No. from Part I (b) Purpose of gift (c) Use of gift (d) Description of how gift is held (e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee (a) No. from Part I (b) Purpose of gift (c) Use of gift (d) Description of how gift is held (e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee Schedule B (Form 0, 0-EZ, or 0-PF) (2015) 20

21 MCCARTHY FAMILY FOUNDATION, INC }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-PF INTEREST ON SAVINGS AND TEMPORARY CASH INVESTMENTS STATEMENT 1 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} (A) (B) (C) REVENUE NET INVESTMENT ADJUSTED SOURCE PER BOOKS INCOME NET INCOME }}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}} INTEREST INCOME - CHECKING }}}}}}}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}} TOTAL TO PART I, LINE ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~ 21 STATEMENT(S) 1

22 MCCARTHY FAMILY FOUNDATION, INC }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-PF DIVIDENDS AND INTEREST FROM SECURITIES STATEMENT 2 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} CAPITAL (A) (B) (C) GROSS GAINS REVENUE NET INVEST- ADJUSTED SOURCE AMOUNT DIVIDENDS PER BOOKS MENT INCOME NET INCOME }}}}}} }}}}}}}}}}} }}}}}}}}}}} }}}}}}}}}}} }}}}}}}}}}} }}}}}}}}}}} DIVIDEND INCOME - INV 138,13 138,13 138,13 }}}}}}}}}}} }}}}}}}}}}} }}}}}}}}}}} }}}}}}}}}}} }}}}}}}}}}} TO PART I, LINE 4 138,13 138,13 138,13 ~~~~~~~~~~~ ~~~~~~~~~~~ ~~~~~~~~~~~ ~~~~~~~~~~~ ~~~~~~~~~~~ 22 STATEMENT(S) 2

23 MCCARTHY FAMILY FOUNDATION, INC }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-PF OTHER INCOME STATEMENT 3 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} (A) (B) (C) REVENUE NET INVEST- ADJUSTED DESCRIPTION PER BOOKS MENT INCOME NET INCOME }}}}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}} OTHER INVESTMENT INCOME FROM K-1S 30, ,62 OTHER INVESTMENT INCOME }}}}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}} TOTAL TO FORM 0-PF, PART I, LINE 11 30, ,62 ~~~~~~~~~~~~~~ ~~~~~~~~~~~~ ~~~~~~~~~~~~ 23 STATEMENT(S) 3

24 MCCARTHY FAMILY FOUNDATION, INC }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-PF ACCOUNTING FEES STATEMENT 4 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} (A) (B) (C) (D) EPENSES NET INVEST- ADJUSTED CHARITABLE DESCRIPTION PER BOOKS MENT INCOME NET INCOME PURPOSES }}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}} ACCOUNTING FEES 1,073. 1,073. }}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}} TO FORM 0-PF, PG 1, LN 16B 1,073. 1,073. ~~~~~~~~~~~~ ~~~~~~~~~~~~ ~~~~~~~~~~~~ ~~~~~~~~~~~ 24 STATEMENT(S) 4

25 MCCARTHY FAMILY FOUNDATION, INC }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-PF OTHER PROFESSIONAL FEES STATEMENT 5 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} (A) (B) (C) (D) EPENSES NET INVEST- ADJUSTED CHARITABLE DESCRIPTION PER BOOKS MENT INCOME NET INCOME PURPOSES }}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}} MANAGEMENT & ADMINISTRATIVE FEES 30,75 20,05 10,70 }}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}} TO FORM 0-PF, PG 1, LN 16C 30,75 20,05 10,70 ~~~~~~~~~~~~ ~~~~~~~~~~~~ ~~~~~~~~~~~~ ~~~~~~~~~~~ 25 STATEMENT(S) 5

26 MCCARTHY FAMILY FOUNDATION, INC }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-PF TAES STATEMENT 6 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} (A) (B) (C) (D) EPENSES NET INVEST- ADJUSTED CHARITABLE DESCRIPTION PER BOOKS MENT INCOME NET INCOME PURPOSES }}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}} FOREIGN TAES TA FILING FEES 1 1 }}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}} TO FORM 0-PF, PG 1, LN ~~~~~~~~~~~~ ~~~~~~~~~~~~ ~~~~~~~~~~~~ ~~~~~~~~~~~ 26 STATEMENT(S) 6

27 MCCARTHY FAMILY FOUNDATION, INC }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-PF OTHER EPENSES STATEMENT 7 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} (A) (B) (C) (D) EPENSES NET INVEST- ADJUSTED CHARITABLE DESCRIPTION PER BOOKS MENT INCOME NET INCOME PURPOSES }}}}}}}}}}} }}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}} POSTAGE EPENSE OTHER DEDUCTIONS - K-1 105, ,421. BANK CHARGES INSURANCE 2,65. 2,65. MISCELLANEOUS 1,287. 1,287. DUES AND SUBSCRIPTIONS TELEPHONE 1,481. 1,481. }}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}} TO FORM 0-PF, PG 1, LN ,37 105,421. 6,4. ~~~~~~~~~~~ ~~~~~~~~~~~~ ~~~~~~~~~~~~ ~~~~~~~~~~~ 27 STATEMENT(S) 7

28 MCCARTHY FAMILY FOUNDATION, INC }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-PF OTHER DECREASES IN NET ASSETS OR FUND BALANCES STATEMENT 8 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} DESCRIPTION AMOUNT }}}}}}}}}}} }}}}}}}}}}}}}} DIFFERENCE BETWEEN FAIR MARKET VALUE AND BASIS FOR CONTRIBUTED STOCK 31,543. BOOK/TA DIFFERENCE ON BLACKSTONE K-1 2,312. }}}}}}}}}}}}}} TOTAL TO FORM 0-PF, PART III, LINE 5 33,855. ~~~~~~~~~~~~~~ 28 STATEMENT(S) 8

29 MCCARTHY FAMILY FOUNDATION, INC }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-PF U.S. AND STATE/CITY GOVERNMENT OBLIGATIONS STATEMENT }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} U.S. OTHER FAIR MARKET DESCRIPTION GOV'T GOV'T BOOK VALUE VALUE }}}}}}}}}}} }}}}} }}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}} BTR PORTFOLIO - US GOVERNMENT OBLIGATIONS 166,2. 165,063. }}}}}}}}}}}}}} }}}}}}}}}}}}}} TOTAL U.S. GOVERNMENT OBLIGATIONS 166,2. 165,063. }}}}}}}}}}}}}} }}}}}}}}}}}}}} TOTAL STATE AND MUNICIPAL GOVERNMENT OBLIGATIONS }}}}}}}}}}}}}} }}}}}}}}}}}}}} TOTAL TO FORM 0-PF, PART II, LINE 10A 166,2. 165,063. ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~ 2 STATEMENT(S)

30 MCCARTHY FAMILY FOUNDATION, INC }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-PF CORPORATE STOCK STATEMENT 10 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} FAIR MARKET DESCRIPTION BOOK VALUE VALUE }}}}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}} BTR PORTFOLIO MUTUAL FUNDS - CORPORATE STOCK 3, ,885. BTR PORTFOLIO EQUITIES - CORPORATE STOCK 1,724,28. 2,677,354. BTR PORTFOLIO REIT - CORPORATE STOCK 3, , SHARES OF MICROSOFT CORP STOCK 27, ,036. }}}}}}}}}}}}}} }}}}}}}}}}}}}} TOTAL TO FORM 0-PF, PART II, LINE 10B 1,883,84 2,87,675. ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~ 30 STATEMENT(S) 10

31 MCCARTHY FAMILY FOUNDATION, INC }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-PF CORPORATE BONDS STATEMENT 11 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} FAIR MARKET DESCRIPTION BOOK VALUE VALUE }}}}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}} BTR PORTFOLIO - CORPORATE BONDS 334,26 334,564. }}}}}}}}}}}}}} }}}}}}}}}}}}}} TOTAL TO FORM 0-PF, PART II, LINE 10C 334,26 334,564. ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~ 31 STATEMENT(S) 11

32 MCCARTHY FAMILY FOUNDATION, INC }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-PF OTHER INVESTMENTS STATEMENT 12 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} VALUATION FAIR MARKET DESCRIPTION METHOD BOOK VALUE VALUE }}}}}}}}}}} }}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}} TIFF MULTI-ASSET FUND COST 1,60,765. 1,746,57. LONGLEAF PARTNERS FUND COST 1,138,0 1,100,268. LONGLEAF SMALL-CAP FUND COST 370, ,368. TIFF PARTNERS III COST 24,35 16,03. TIFF REP I COST 56, ,757. TIFF V-US COST 85, ,83. TIFF V-INT COST 103, ,066. TIFF IV COST 3, ,606. TIFF REP II COST 271, ,384. TIFF RR II COST 148,11 124,823. TPEP 2005 COST 211, ,84. TIFF 2007 COST 528, ,576. TIFF 2008 COST 201, ,221. TPEP 2010 COST 166, ,167. TIFF ROF COST 178, ,444. TIFF 2012 COST 160, ,732. TIFF SOF COST 123, ,031. TIFF PRIVATE EQUITY PARTNERS 2013 COST 113, ,673. TIFF II COST 1,701. TIFF PRIVATE EQUITY PARTNERS 2014 COST 0,257. 2,32. TIFF R&R IV COST 86, ,84. TPEP 2015 COST 35, ,783. BLACKSTONE GROUP COST 31, ,48 TIFF R&R I (K-1) COST 23,075. TIFF ARP (ABSOLUTE RETURN POOL) COST 1,080,273. }}}}}}}}}}}}}} }}}}}}}}}}}}}} TOTAL TO FORM 0-PF, PART II, LINE 13 5,774,34. 7,362,11. ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~ 32 STATEMENT(S) 12

33 MCCARTHY FAMILY FOUNDATION, INC. }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-PF LIST OF SUBSTANTIAL CONTRIBUTORS PART VII-A, LINE 10 STATEMENT 13 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} NAME OF CONTRIBUTOR ADDRESS }}}}}}}}}}}}}}}}}}} }}}}}}} JAMES AND JANE MCCARTHY PO BO 2738 SAN DIEGO, CA STATEMENT(S) 13

34 MCCARTHY FAMILY FOUNDATION, INC. }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-PF PART V - LINE 1A LIST OF FOUNDATION MANAGERS STATEMENT 14 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} NAME OF MANAGER }}}}}}}}}}}}}}} RACHEL MCCARTHY HENNEFORTH JANE D. MCCARTHY JAMES T. MCCARTHY 34 STATEMENT(S) 14

35 MCCARTHY FAMILY FOUNDATION, INC. }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-PF GRANT APPLICATION SUBMISSION INFORMATION PART V, LINES 2A THROUGH 2D STATEMENT 15 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} NAME AND ADDRESS OF PERSON TO WHOM APPLICATIONS SHOULD BE SUBMITTED }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} RACHEL K. MCCARTHY HENNEFORTH, PRESIDENT POST OFFICE BO 2738 SAN DIEGO, CA TELEPHONE NUMBER NAME OF GRANT PROGRAM }}}}}}}}}}}}}}}} }}}}}}}}}}}}}}}}}}}}} (858) MCCARTHY FAMILY FOUNDATION ADDRESS }}}}}}}}}}}}}}}}}}}}}}}}}}}}}} FORM AND CONTENT OF APPLICATIONS }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} A LETTER IDENTIFYING THE ORGANIZATION DEMONSTRATING SECTION 501(C)(3) STATUS AS A PUBLIC CHARITY, THE NATURE OF THE REQUEST AND APPROPRIATE INFORMATION. APPLICATION GUIDELINES ARE AVAILABLE BY WRITING TO THE FOUNDATION OR AT ITS WEBSITE: ANY SUBMISSION DEADLINES }}}}}}}}}}}}}}}}}}}}}}}} MARCH 15 AND SEPTEMBER 15 RESTRICTIONS AND LIMITATIONS ON AWARDS }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} FOUNDATION PUBLISHES ANNUAL APPLICATION GUIDELINES. FUNDING IN CALIFORNIA, PRIMARILY IN SAN DIEGO COUNTY. }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} 35 STATEMENT(S) 15

36 ATTACHMENT A

37 ATTACHMENT A

38 ATTACHMENT B

39 ATTACHMENT B

40 ATTACHMENT B

41 ATTACHMENT B

42 ATTACHMENT B

FILE COPY. Return of Private Foundation. or Section 4947(a)(1) Trust Treated as Private Foundation

FILE COPY. Return of Private Foundation. or Section 4947(a)(1) Trust Treated as Private Foundation Form 990-PF Department of the Treasury Internal Revenue Service Return of Private Foundation OMB No. 1545-0052 or Section 4947(a)(1) Trust Treated as Private Foundation G Do not enter social security numbers

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF Department of the Treasury Internal Revenue Service Return of Private Foundation OMB No. 1545-0052 or Section 4947(a)(1) Trust Treated as Private Foundation G Do not enter social security numbers

More information

Return of Private Foundation

Return of Private Foundation Form Department of the Treasury Internal Revenue Service Note. The foundation may be able to use a copy of this return to satisfy state reporting requirements. For calendar year 2011 or tax year beginning,

More information

Return of Private Foundation

Return of Private Foundation Form or Section 4947(a)(1) Trust Treated as Private Foundation Department of the Treasury Do not enter social security numbers on this form as it may be made public. Internal Revenue Service Information

More information

TAX RETURN FILING INSTRUCTIONS

TAX RETURN FILING INSTRUCTIONS TA RETURN FILING INSTRUCTIONS FORM 0-PF FOR THE YEAR ENDING ~~~~~~~~~~~~~~~~~ December 31, 2015 Prepared for Prepared by Amount due or refund Make check payable to Mail tax return and check (if applicable)

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF Return of Private Foundation OMB No. 1545-0052 or Section 4947(a)(1) Trust Treated as Private Foundation Do not enter social security numbers on this form as it may be made public. À¾µ» Department

More information

Return of Private Foundation

Return of Private Foundation Form or Section 447(a)(1) Trust Treated as Private Foundation Department of the Treasury Do not enter social security numbers on this form as it may be made public. Internal Revenue Service Information

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF Return of Private Foundation OMB No. 1545-0052 I or Section 4947(a)(1) Trust Treated as Private Foundation Do not enter social security numbers on this form as it may be made public. À¾µ¹ Department

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF Department of the Treasury Internal Revenue Service For calendar year 2010, or tax year beginning, 2010, and ending, G Check all that apply: Initial return Initial Return of a former public

More information

or Section 4947(a)(1) Trust Treated as Private Foundation -654,371.

or Section 4947(a)(1) Trust Treated as Private Foundation -654,371. Form 990-PF OMB No. 1545-0052 Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation 2016 G Do not enter social security numbers on this form as it may be made public. Department

More information

Return of Private Foundation

Return of Private Foundation Form or Section 4947(a)(1) Trust Treated as Private Foundation Department of the Treasury Do not enter social security numbers on this form as it may be made public. Internal Revenue Service Go to www.irs.gov/form990pf

More information

KHAN CPA CORPORATION 1875 CENTURY PARK E STE 600 LOS ANGELES, CA (310)

KHAN CPA CORPORATION 1875 CENTURY PARK E STE 600 LOS ANGELES, CA (310) KHAN CPA CORPORATION 1875 CENTURY PARK E STE 600 LOS ANGELES, CA 90067-2507 (310) 286-2727 December 1, 2014 Everest Edwin Foundation 11766 Wilshire Blvd. Suite 1450 Los Angeles, CA 90025 Dear Client: Enclosed

More information

990-PF. or Section 4947(a)(1) Trust Treated as Private Foundation VOICE OF ELIJAH INC PO BOX 2257 ROCKWALL, TX

990-PF. or Section 4947(a)(1) Trust Treated as Private Foundation VOICE OF ELIJAH INC PO BOX 2257 ROCKWALL, TX Form 990-PF OMB No. -00 Return of Private Foundation 0 or Section 97() Trust Treated as Private Foundation G Do not enter social security numbers on this form as it may be made public. G Information about

More information

THE POETRY FOUNDATION. Form 990-PF for the Year Ended December 31, Public Disclosure Copy

THE POETRY FOUNDATION. Form 990-PF for the Year Ended December 31, Public Disclosure Copy THE POETRY FOUNDATION Form 990-PF for the Year Ended December 31, 2015 Public Disclosure Copy Form 990-PF Return of Private Foundation OMB No. 1545-0052 I or Section 4947(a)(1) Trust Treated as Private

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF Return of Private Foundation OMB No. 1545-0052 I or Section 4947(a)(1) Trust Treated as Private Foundation Do not enter social security numbers on this form as it may be made public. À¾µº Department

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF Department of the Treasury Internal Revenue Service I Return of Private Foundation OMB No. 1545-0052 I or Section 4947(a)(1) Trust Treated as Private Foundation Do not enter Social Security

More information

Return of Private Foundation

Return of Private Foundation Form Department of the Treasury Internal Revenue Service Note. The foundation may be able to use a copy of this return to satisfy state reporting requirements. For calendar year 2012 or tax year beginning,

More information

Return of Private Foundation

Return of Private Foundation Form Department of the Treasury Internal Revenue Service For calendar year 2016 or tax year beginning Name of foundation Number and street (or P.O. box number if mail is not delivered to street address)

More information

Application for Automatic Extension of Time To File an. Exempt Organization Return OMB No

Application for Automatic Extension of Time To File an. Exempt Organization Return OMB No Application for Automatic Extension of Time To File an Form 8868 Exempt Organization Return OMB No. 1545-1709 (Rev. January 2017) Department of the Treasury Internal Revenue Service GFile a separate application

More information

Return of Private Foundation

Return of Private Foundation Form or Section 4947(a)(1) Trust Treated as Private Foundation Department of the Treasury Do not enter social security numbers on this form as it may be made public. Internal Revenue Service Go to www.irs.gov/form990pf

More information

CLIENT COPY THE GRAHAM AND CAROLYN HOLLOWAY FAMILY FOUNDATION TRUST P O BOX 989 COLLEYVILLE, TX

CLIENT COPY THE GRAHAM AND CAROLYN HOLLOWAY FAMILY FOUNDATION TRUST P O BOX 989 COLLEYVILLE, TX 6 TA RETURN CLIENT COPY Client: 44 Prepared for: P O BO 989 COLLEYVILLE, T 764 87.67.897 Prepared by: TASHA WHIDDON, CPA MCILVAIN & ASSOCIATES LLC 44 GATEWAY DRIVE, SUITE 8 COLLEYVILLE, T 764 87-4-77 Date:

More information

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation l efile GRAPHIC print - DO NOT PROCESS As Filed Data - Form990-PF Department of the Trea^un Internal Rev enue Ser ice Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF Return of Private Foundation OMB No. 1545-0052 or Section 4947(a)(1) Trust Treated as Private Foundation Do not enter social security numbers on this form as it may be made public. À¾µ» Department

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF Return of Private Foundation OMB No. 1545-0052 I or Section 4947(a)(1) Trust Treated as Private Foundation Do not enter social security numbers on this form as it may be made public. À¾µ¹ Department

More information

Tax Return Carryovers to 2011

Tax Return Carryovers to 2011 Caution: Forms printed from within Adobe Acrobat products may not meet IRS or state taxing agency specifications. When using Acrobat 5.x products, uncheck the "Shrink oversized pages to paper size" and

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF Return of Private Foundation OMB No. 1545-0052 or Section 4947(a)(1) Trust Treated as Private Foundation Do not enter social security numbers on this form as it may be made public. Department

More information

Return of Private Foundation

Return of Private Foundation Form or Section 447(a)(1) Trust Treated as Private Foundation Department of the Treasury Do not enter social security numbers on this form as it may be made public. Internal Revenue Service Information

More information

Return of Private Foundation

Return of Private Foundation Form Department of the Treasury Internal Revenue Service Note. The foundation may be able to use a copy of this return to satisfy state reporting requirements. For calendar year 2012 or tax year beginning,

More information

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation l efile GRAPHIC print - DO NOT PROCESS As Filed Data - Form99-PF Department of the Trea^un Internal Rev enue Ser ice Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF Department of the Treasury Internal Revenue Service Return of Private Foundation OMB No. 1545-0052 or Section 4947(a)(1) Trust Treated as Private Foundation G Do not enter social security numbers

More information

TAX RETURN FILING INSTRUCTIONS

TAX RETURN FILING INSTRUCTIONS TAX RETURN FILING INSTRUCTIONS FORM 990-PF FOR THE YEAR ENDING ~~~~~~~~~~~~~~~~~ December 31, 2016 Prepared for Prepared by Amount due or refund Make check payable to Mail tax return and check (if applicable)

More information

COPY FOR PUBLIC DISCLOSURE

COPY FOR PUBLIC DISCLOSURE Form Department of the Treasury Internal Revenue Service For calendar year 2015 or tax year beginning Name of foundation Number and street (or P.O. box number if mail is not delivered to street address)

More information

PUBLIC DISCLOSURE COPY Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

PUBLIC DISCLOSURE COPY Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation Form 99-PF PUBLIC DISCLOSURE COPY Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation OMB No. 1545-52 216 Department of the Treasury Internal Revenue Service Do not enter

More information

November 13, Elizabeth Lippincott Texas Clean Energy Coalition 327 Congress Ave., Suite 450 Austin, TX

November 13, Elizabeth Lippincott Texas Clean Energy Coalition 327 Congress Ave., Suite 450 Austin, TX vember 1, 01 Elizabeth Lippincott Texas Clean Energy Coalition 7 Congress Ave., Suite 0 Austin, T 78701-66 Dear Elizabeth, We have prepared your 01 U.S. Private Foundation Income Tax Return (Form 0-PF)

More information

F.R. BIGELOW FOUNDATION

F.R. BIGELOW FOUNDATION F.R. BIGELOW FOUNDATION 2016 Tax Filings Public Inspection Copy 600 INWOOD AVENUE NORTH SUITE 160 OAKDALE, MN 55128 TEL: (651) 636-3806 FA: (651) 636-1136 www.akinshenke.com Form or Section 447(a)(1) Trust

More information

Return of Private Foundation

Return of Private Foundation l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93491117002096 Form 990-PF Department of the Treasury Internal Revenue Serwce Return of Private Foundation OMB No 1545-0052 or Section 4947(1)

More information

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation l efile GRAPHIC print - DO NOT PROCESS As Filed Data - Form99-PF Department of the Trea^un Internal Rey erne Ser ice Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

More information

Instructions for filing Michael & Susan Dell Foundation Amended Form 990PF - Return of Private Foundation for the period ended December 31, 2008

Instructions for filing Michael & Susan Dell Foundation Amended Form 990PF - Return of Private Foundation for the period ended December 31, 2008 Instructions for filing Michael & Susan Dell Foundation Amended Form 990PF - Return of Private Foundation for the period ended December 31, 2008 ************************* Signature... The amended return

More information

Return of Private Foundation

Return of Private Foundation Form or Section 447(a)(1) Trust Treated as Private Foundation Department of the Treasury Do not enter social security numbers on this form as it may be made public. Internal Revenue Service Information

More information

Return of Private Foundation

Return of Private Foundation Form Department of the Treasury Internal Revenue Service b Net rental income or (loss) 6a Net gain or (loss) from sale of assets not on line 10 ~~ Gross sales price for all b assets on line 6a ~~ 1,6,.

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF Return of Private Foundation OMB No. 1545-0052 I or Section 4947(a)(1) Trust Treated as Private Foundation Do not enter social security numbers on this form as it may be made public. À¾µ¹ Department

More information

Return of Private Foundation

Return of Private Foundation Form or Section 4947(a)(1) Nonexempt Charitable Trust Department of the Treasury Treated as a Private Foundation Internal Revenue Service Note. The foundation may be able to use a copy of this return to

More information

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation 1 l efile GRAPHIC print - DO NOT PROCESS As Filed Data - Form990-PF Department of the Trea^un Internal Rev enue Ser ice Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

More information

Return of Private Foundation or Section 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation

Return of Private Foundation or Section 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation Form 990-PF Department of the Treasury Internal Revenue ervice Part I O P R A T I N A N D R V N U A D M I N I T R A T I V P N 17,622. Analysis of Revenue and xpenses (The total of amounts in columns (b),

More information

Return of Private Foundation

Return of Private Foundation Form or Section 4947(a)(1) Trust Treated as Private Foundation Department of the Treasury Do not enter social security numbers on this form as it may be made public. Internal Revenue Service Information

More information

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation Form 990-PF OMB No. 1545-0052 Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation 2016 Do not enter social security numbers on this form as it may be made public. Department

More information

Return of Private Foundation OMB No or Section 4947(a)(1) Trust Treated as Private Foundation

Return of Private Foundation OMB No or Section 4947(a)(1) Trust Treated as Private Foundation Form 990-PF Return of Private Foundation OMB No. 1545-0052 or Section 4947(a)(1) Trust Treated as Private Foundation Do not enter social security numbers on this form as it may be made public. Department

More information

c/o BMO Harris, NA, Attn: Trust Tax Dept. 111 W. Monroe 10C (312) City or town, state, and ZIP code

c/o BMO Harris, NA, Attn: Trust Tax Dept. 111 W. Monroe 10C (312) City or town, state, and ZIP code Form 990-PF Department of the Treasury Internal Revenue Service Return of Private Foundation OMB No. 1545-0052 or Section 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation Note. The

More information

Nail CPA Firm, Lc 4901 W 136th Street Leawood, KS 66224

Nail CPA Firm, Lc 4901 W 136th Street Leawood, KS 66224 Nail CPA Firm, Lc 01 W 16th Street Leawood, KS 66 vember 7, 018 The Bauke Family Foundation P O Box 78 Overland Park, KS 6607 The Bauke Family Foundation: Enclosed is the organization s 017 Exempt Organization

More information

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation 6/13/218 11:59:6 AM 1 217 Return THE MCKNIGHT ENDOWMENT FUND FOR Form 99-PF PUBLIC DISCLOSURE COPY Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation OMB No. 1545-52

More information

or Section 4947( a)(1) Nonexempt Charitable Trust

or Section 4947( a)(1) Nonexempt Charitable Trust 0 z Form 990-PF Return of Private Foundation OMB No 1545-0052 or Section 4947( a)(1) Nonexempt Charitable Trust Department of the Treasury Treated as a Private Foundation RID I I Internal Revenue Service

More information

Return of Private Foundation. or Section 4947 ( a)(1) Trust Treated as Private Foundation

Return of Private Foundation. or Section 4947 ( a)(1) Trust Treated as Private Foundation l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93491318010304 Form 990 -PF Department of the Treasury Internal Revenue Service Return of Private Foundation OMB 1545-0052 or Section 4947 (

More information

2015 G Do not enter social security numbers on this form as it may be made public. Open to Public

2015 G Do not enter social security numbers on this form as it may be made public. Open to Public Short Form OMB No. 1545-1150 Return of Organization Exempt From Income Tax Form 990-EZ Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) 2015 G Do not enter

More information

Return of Private Foundation

Return of Private Foundation Form Department of the Treasury Internal Revenue Service te. The foundation may be able to use a copy of this return to satisfy state reporting requirements. For calendar year 011 or tax year beginning,

More information

Short Form OMB No Return of Organization Exempt From Income Tax

Short Form OMB No Return of Organization Exempt From Income Tax Form 990-EZ Short Form OMB No. 1545-1150 Return of Organization Exempt From Income Tax Department of the Treasury Internal Revenue Service Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue

More information

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation l efile GRAPHIC print - DO NOT PROCESS As Filed Data - Form990-PF Department of the Trea^un Internal Rev enue Ser ice Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

More information

Return of Private Foundation

Return of Private Foundation l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 934911351115 Form 99-PF Department of the Treasury Internal Revenue Service Return of Private Foundation OMB No 1545-52 or Section 4947(a)(1)

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 990-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 501, 527, or 4947(a)(1) of the Internal Revenue Code (except private

More information

01E 20 Occupancy Travel, conferences, and meetings Total expenses and disbursements. Add lines 24 and ,595

01E 20 Occupancy Travel, conferences, and meetings Total expenses and disbursements. Add lines 24 and ,595 A Form 990-PF Return of Private Foundation or Section 4947(a)(1) Nonexempt Charitable Trust Department Of the Treasury Treated as a Private Foundation Internal Revenue Service Note. The foundation may

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 990-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 501, 527, or 4947(a)(1) of the Internal Revenue Code (except private

More information

Return of Private Foundation

Return of Private Foundation l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 9349128215 Form 99-PF Department of the Treasury Internal Revenue Service Return of Private Foundation OMB No 1545-52 or Section 4947(a)(1)

More information

A For the 2011 calendar year, or tax year beginning, 2011, and ending, 20 D Employer identification number

A For the 2011 calendar year, or tax year beginning, 2011, and ending, 20 D Employer identification number Form 990-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 501, 527, or 4947(a)(1) of the Internal Revenue Code (except black

More information

THE COLORADO TRUST FORM 990-PF TAX YEAR 2015

THE COLORADO TRUST FORM 990-PF TAX YEAR 2015 THE COLORADO TRUST FORM 990-PF TA YEAR 2015 Form 990-PF Return of Private Foundation OMB No. 1545-0052 I or Section 4947(a)(1) Trust Treated as Private Foundation Do not enter social security numbers on

More information

Exempt Organization Business Income Tax Return

Exempt Organization Business Income Tax Return PUBLIC DISCLOSURE EXTENDED TO NOVEMBER 15, 2018 Form Exempt Organization Business Income Tax Return 0-T For calendar year 2017 or other tax year beginning Check box if address changed B Exempt under section

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF G Check all that apply: Initial return Initial Return of a former public charity D Final return Amended return Address change Name change H Check type of organization: Section 501(c)(3) exempt

More information

Short Form. Return of Organization Exempt From Income Tax

Short Form. Return of Organization Exempt From Income Tax Short Form OMB No. 1545-1150 Return of Organization Exempt From Income Tax Form 990-EZ Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code 2014 (except private foundations) G Do not enter

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF Return of Private Foundation OMB No. 1545-0052 or Section 4947(a)(1) Trust Treated as Private Foundation Do not enter social security numbers on this form as it may be made public. À¾µ» Department

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 990-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 501, 527, or 4947(a)(1) of the Internal Revenue Code (except private

More information

Return of Private Foundation

Return of Private Foundation Form Department of the Treasury Internal Revenue Service Note. The foundation may be able to use a copy of this return to satisfy state reporting requirements. For calendar year 2011 or tax year beginning,

More information

Short Form OMB No Return of Organization Exempt From Income Tax

Short Form OMB No Return of Organization Exempt From Income Tax Form 990-EZ Short Form OMB No. 1545-1150 Return of Organization Exempt From Income Tax Department of the Treasury Internal Revenue Service Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue

More information

Return of Private Foundation

Return of Private Foundation Form Department of the Treasury Internal Revenue Service Note. The foundation may be able to use a copy of this return to satisfy state reporting requirements. For calendar year 2011 or tax year beginning,

More information

THE COLORADO TRUST FORM 990-PF TAX YEAR 2016

THE COLORADO TRUST FORM 990-PF TAX YEAR 2016 THE COLORADO TRUST FORM 990-PF TAX YEAR 2016 Form 990-PF Return of Private Foundation OMB No. 1545-0052 I or Section 4947(a)(1) Trust Treated as Private Foundation Do not enter social security numbers

More information

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation l efile GRAPHIC print - DO NOT PROCESS As Filed Data - Form990-PF Department of the Trea^un Internal Rey erne Ser ice Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

More information

** PUBLIC DISCLOSURE COPY ** Short Form Return of Organization Exempt From Income Tax

** PUBLIC DISCLOSURE COPY ** Short Form Return of Organization Exempt From Income Tax Short Form Return of Organization Exempt From Income Tax OMB No. 1545-1150 Form Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or 990-EZ private

More information

A For the 2010 calendar year, or tax year beginning, 2010, and ending, 20 D Employer identification number

A For the 2010 calendar year, or tax year beginning, 2010, and ending, 20 D Employer identification number Form 990-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 99-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 51, 527, or 4947(a)(1) of the Internal Revenue Code (except private

More information

Number and street (or P.O. box, if mail is not delivered to street address) Room/suite

Number and street (or P.O. box, if mail is not delivered to street address) Room/suite Form 990-EZ Short Form Return of Organization Exempt From Income Tax Under section 501, 527, or 4947(1) of the Internal Revenue Code (except black lung benefit trust or private foundation) Sponsoring organizations

More information

Return of Private Foundation. Section 4947(a)(1) nonexempt charitable trust. Treated as a Private Foundation

Return of Private Foundation. Section 4947(a)(1) nonexempt charitable trust. Treated as a Private Foundation Form Part I 990-PF Analysis of Revenue and Expenses (The total of Return of Private Foundation or Section 4947(a) Nonexempt Charitale Trust Treated as a Private Foundation Department of the Treasury Internal

More information

Short Form. Return of Organization Exempt From Income Tax

Short Form. Return of Organization Exempt From Income Tax Short Form OMB. 1545-1150 Return of Organization Exempt From Income Tax Form 990-EZ Under section 501(c), 57, or 4947(a)(1) of the Internal Revenue Code 016 (except private foundations) G Do not enter

More information

Return of Private Foundation

Return of Private Foundation l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93491132009394 Form990 -PF Department of the Treasury Internal Revenue Service Return of Private Foundation OMB No 1545-0052 or Section 4947(a)(1)

More information

Tax Return Carryovers to 2016

Tax Return Carryovers to 2016 NAME: Disallowing Form THE PETER G. DODGE FOUNDATION, INC. ID Number: 6-18 Description FORM 0-PF Tax Return Carryovers to 016 Originating Form Entity/ Activity St/ City Amount 0-PF ECESS DISTRIBUTIONS

More information

Short Form OMB No Return of Organization Exempt From Income Tax

Short Form OMB No Return of Organization Exempt From Income Tax Form 990-EZ Short Form OMB No. 1545-1150 Return of Organization Exempt From Income Tax Department of the Treasury Internal Revenue Service Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue

More information

Return of Private Foundation

Return of Private Foundation 99-PF Form or Section 4947(a)(1) nexempt Charitable Trust Department or me treasury Treated as a Private Foundation Internal Revenue Service te : The organization ma y be able to use a co of this return

More information

Short Form OMB No Return of Organization Exempt From Income Tax

Short Form OMB No Return of Organization Exempt From Income Tax Form 990-EZ Short Form OMB No. 1545-1150 Return of Organization Exempt From Income Tax Department of the Treasury Internal Revenue Service Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue

More information

2013 G Do not enter Social Security numbers on this form as it may be made public. Open to Public

2013 G Do not enter Social Security numbers on this form as it may be made public. Open to Public Short Form OMB No. 1545-1150 Return of Organization Exempt From Income Tax Form 990-EZ Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) 2013 Do not enter

More information

Return of Private Foundation

Return of Private Foundation Form or Section 7(1) Trust Treated as Private Foundation Department of the Treasury Do not enter social security numbers on this form as it may be made public. Internal Revenue Service Information about

More information

A For the 2009 calendar year, or tax year beginning, 2009, and ending, B Check if applicable: C

A For the 2009 calendar year, or tax year beginning, 2009, and ending, B Check if applicable: C Form 990-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black

More information

Short Form. Return of Organization Exempt From Income Tax

Short Form. Return of Organization Exempt From Income Tax Short Form OMB. 1545-1150 Return of Organization Exempt From Income Tax Form 990-EZ Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code 2015 (except private foundations) G Do not enter

More information

Government Copy MCF MISSOULA COMMUNITY FOUNDATION PO BOX 2368 MISSOULA, MT

Government Copy MCF MISSOULA COMMUNITY FOUNDATION PO BOX 2368 MISSOULA, MT 2012 TA RETURN Government Copy Client: Prepared for: MCF MISSOULA COMMUNITY FOUNDATION PO BO 2368 MISSOULA, MT 59806 406-926-3131 Prepared by: Norm Williamson CPA PLLC 1800 S Russell St, Ste 200 Missoula,

More information

Return of Private Foundation

Return of Private Foundation l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93491140003044 Form990 -PF Department of the Treasury Internal Revenue Service Return of Private Foundation OMB No 1545-0052 or Section 4947(a)(1)

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax 990 Return of Organization Exempt From Income Tax OMB No. 1545-0047 Form Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung Department of the Treasury benefit trust

More information

A For the 2010 calendar year, or tax year beginning, 2010, and ending, 20 D Employer identification number

A For the 2010 calendar year, or tax year beginning, 2010, and ending, 20 D Employer identification number Form 990-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 501, 527, or 4947(1) of the Internal Revenue Code (except black lung

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 99-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 51(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 990-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 501, 527, or 4947(a)(1) of the Internal Revenue Code (except private

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 990 Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung OMB No. 1545-0047 benefit trust or private foundation) Department

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 990-EZ Short Form Return of Organization Exempt From Income Tax OMB. -0 07 Under section 0, 7, or 97() of the Internal Revenue Code (except private foundations) G Do not enter social security numbers

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 990-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private

More information

Short Form 990-EZ Return of Organization Exempt From Income Tax

Short Form 990-EZ Return of Organization Exempt From Income Tax Form B G I Short Form 990-EZ Return of Organization Exempt From Income Tax 2013 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) Do not enter Social Security

More information

File a separate application for each return. Information about Form 8868 and its instructions is at

File a separate application for each return. Information about Form 8868 and its instructions is at Form 8868 Application for Automatic Extension of Time To File an Exempt Organization Return (Rev. January 2017) OMB No. 1545-1709 Department of the Treasury Internal Revenue Service File a separate application

More information

Short Form. Return of Organization Exempt From Income Tax

Short Form. Return of Organization Exempt From Income Tax Short Form OMB No. 1545-1150 Return of Organization Exempt From Income Tax Form 990-EZ Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private

More information