EXTENDED TO NOVEMBER 15, 2017 Short Form Return of Organization Exempt From Income Tax. Name change C/O JENNIFER SHAER

Transcription

1 Form 990-EZ ETENDED TO NOVEMBER 15, 2017 Short Form Return of Organization Exempt From Inome Tax Uner setion 501(), 527, or 4947(a)(1) of the Internal Revenue Coe (exept private founations) OMB No Department of the Treasury Internal Revenue Servie Open to Puli Inspetion A For the 2016 alenar year, or tax year eginning an ening B Chek if appliale: C Name of organization D Employer ientifiation numer Aress hange THE ALLIED FOUNDATION INC Name hange C/O JENNIFER SHAER Initial return Numer an street (or P.O. ox, if mail is not elivere to street aress) Room/suite E Telephone numer Final return/ terminate 3 HUNTINGTON QUADRANGLE 105S Amene return City or town, state or provine, ountry, an ZIP or foreign postal oe F Group Exemption MELVILLE, NY Appliation pening Numer G Aounting Metho: Cash Arual Other (speify) H Chek if the organization is I Wesite: N/A not require to attah Sheule B J Tax-exempt status (hek only one) 501()(3) 501() ( ) (insert no.) 4947(a)(1) or 527 (Form 990, 990-EZ, or 990-PF). K Form of organization: Corporation Trust Assoiation Other Revenue Expenses Net Assets a Other revenue (esrie in Sheule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 8 Total revenue. A lines 1, 2, 3, 4, 5, 6, 7, an ,463. Grants an similar amounts pai (list in Sheule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ SEE SCHEDULE O 10 2, Printing, puliations, postage, an shipping ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other expenses (esrie in Sheule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ SEE SCHEDULE O 16 18, Total expenses. A lines 10 through , Exess or (efiit) for the year (Sutrat line 17 from line 9) ~~~~~~~~~~~~~~~~~~~~~~~~~~ 18 51, Do not enter soial seurity numers on this form as it may e mae puli. Information aout Form 990-EZ an its instrutions is at L A lines 5, 6, an 7 to line 9 to etermine gross reeipts. If gross reeipts are $200,000 or more, or if total assets (Part II, olumn (B) elow) are $500,000 or more, file Form 990 instea of Form 990-EZ $ 74,463. Part I Revenue, Expenses, an Changes in Net Assets or Fun Balanes (see the instrutions for Part I) Chek if the organization use Sheule O to respon to any question in this Part I 1 Contriutions, gifts, grants, an similar amounts reeive ~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1 74,463. LHA Program servie revenue inluing government fees an ontrats For Paperwork Reution At Notie, see the separate instrutions. ~~~~~~~~~~~~~~~~~~~~~~~ Memership ues an assessments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Investment inome 5a Gross amount from sale of assets other than inventory~~~~~~~~~~~~~ Less: ost or other asis an sales expenses ~~~~~~~~~~~~~~~~~ Gain or (loss) from sale of assets other than inventory (Sutrat line 5 from line 5a) ~~~~~~~~~~~~~~~ Gaming an funraising events Gross inome from gaming (attah Sheule G if greater than $15,000) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Gross inome from funraising events (not inluing $ from funraising events reporte on line 1) (attah Sheule G if the sum of suh gross inome an ontriutions exees $15,000) Less: iret expenses from gaming an funraising events ~~~~~~~~~~~~~~ ~~~~~~~~~~ 5a 5 6a of ontriutions Net inome or (loss) from gaming an funraising events (a lines 6a an 6 an sutrat line 6) ~~~~~~~~~ 7a Gross sales of inventory, less returns an allowanes ~~~~~~~~~~~~~ Less: ost of goos sol ~~~~~~~~~~~~~~~~~~~~~~~~~~ Gross profit or (loss) from sales of inventory (Sutrat line 7 from line 7a) 6 6 7a 7 ~~~~~~~~~~~~~~~~~~~ Benefits pai to or for memers~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Salaries, other ompensation, an employee enefits ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Professional fees an other payments to inepenent ontrators ~~~~~~~~~~~~~~~~~~~~~~~~ Oupany, rent, utilities, an maintenane ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Net assets or fun alanes at eginning of year (from line 27, olumn (A)) (must agree with en-of-year figure reporte on prior year s return) ~~~~~~~~~~~~~~~~~~~~~~~ Other hanges in net assets or fun alanes (explain in Sheule O) ~~~~~~~~~~~~~~~~~~~~~~ Net assets or fun alanes at en of year. Comine lines 18 through ,900. 2, ,

2 THE ALLIED FOUNDATION INC C/O JENNIFER SHAER Page 2 Part II Balane Sheets (see the instrutions for Part II) Chek if the organization use Sheule O to respon to any question in this Part II (A) Beginning of year (B) En of year 22 Cash, savings, an investments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2, , Lan an uilings ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 24 Other assets (esrie in Sheule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~ Total assets ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2, , Total liailities (esrie in Sheule O) ~~~~~~~~~~~~~~~~~~~~~~~~ Net assets or fun alanes (line 27 of olumn (B) must agree with line 21) 2, ,424. Part III Statement of Program Servie Aomplishments (see the instrutions for Part III) Expenses (Require for setion Chek if the organization use Sheule O to respon to any question in this Part III 501()(3) an 501()(4) What is the organization s primary exempt purpose? SEE SCHEDULE O organizations; optional for Desrie the organization s program servie aomplishments for eah of its three largest program servies, as measure y expenses. In a lear an onise others.) manner, esrie the servies provie, the numer of persons enefite, an other relevant information for eah program title. 28 SEE SCHEDULE O (Grants $ ) If this amount inlues foreign grants, hek here 28a 17, (Grants $ ) If this amount inlues foreign grants, hek here 29a (Grants $ ) If this amount inlues foreign grants, hek here 30a 31 Other program servies (esrie in Sheule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ (Grants $ ) If this amount inlues foreign grants, hek here 31a 32 Total program servie expenses (a lines 28a through 31a) 32 17,050. Part IV List of Offiers, Diretors, Trustees, an Key Employees (list eah one even if not ompensate - see the instrutions for Part IV) Chek if the organization use Sheule O to respon to any question in this Part IV (a) Name an title () Average hours () Reportale () Health enefits, (e) Estimate ompensation (Forms ontriutions to per week evote to W-2/1099-MISC) employee enefit amount of other position (if not pai, enter -0-) plans, an eferre ompensation ompensation JENNIFER SHAER MD PRESIDENT ETAN WALLS TREASURER BRIANNE CHIDICHIMO SECRETARY

3 THE ALLIED FOUNDATION INC C/O JENNIFER SHAER Page 3 Part V Other Information (Note the Sheule A an personal enefit ontrat statement requirements in the instrutions for Part V) Chek if the organization use Sh. O to respon to any question in this Part V 33 Di the organization engage in any signifiant ativity not previously reporte to the IRS? If "Yes," provie a etaile esription of eah ativity in Sheule O ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ a 38a Di the organization file Form 1120-POL for this year? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 37 a e 42a 43 Were any signifiant hanges mae to the organizing or governing ouments? If "Yes," attah a onforme opy of the amene ouments if they reflet a hange to the organization s name. Otherwise, explain the hange on Sheule O (see instrutions) ~~~~~~ 35a Di the organization have unrelate usiness gross inome of $1,000 or more uring the year from usiness ativities (suh as those reporte on lines 2, 6a, an 7a, among others)? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes" to line 35a, has the organization file a Form 990-T for the year? If "No," provie an explanation in Sheule O ~~~~~~~~~~~ Was the organization a setion 501()(4), 501()(5), or 501()(6) organization sujet to setion 6033(e) notie, reporting, an proxy tax requirements uring the year? If "Yes," omplete Sheule C, Part III ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Di the organization unergo a liquiation, issolution, termination, or signifiant isposition of net assets uring the year? If "Yes," omplete appliale parts of Sheule N Enter amount of politial expenitures, iret or iniret, as esrie in the instrutions ~~~~~ 37a 0. Di the organization orrow from, or make any loans to, any offier, iretor, trustee, or key employee or were any suh loans mae in a prior year an still outstaning at the en of the tax year overe y this return? If "Yes," omplete Sheule L, Part II an enter the total amount involve ~~~~~~~~~~~~~~ 38 N/A Setion 501()(7) organizations. Enter: Initiation fees an apital ontriutions inlue on line 9 ~~~~~~~~~~~~~~~~~~~~~ Gross reeipts, inlue on line 9, for puli use of lu failities ~~~~~~~~~~~~~~~~~~ 40a Setion 501()(3) organizations. Enter amount of tax impose on the organization uring the year uner: setion ; setion ; setion Setion 501()(3), 501()(4), an 501()(29) organizations. Di the organization engage in any setion 4958 exess enefit transation uring the year, or i it engage in an exess enefit transation in a prior year that has not een reporte on any of its prior Forms 990 or 990-EZ? If "Yes," omplete Sheule L, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Setion 501()(3), 501()(4), an 501()(29) organizations. Enter amount of tax impose on organization managers or isqualifie persons uring the year uner setions 4912, 4955, an 4958 ~~~~~ Setion 501()(3), 501()(4), an 501()(29) organizations. Enter amount of tax on line 40 reimurse y the organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ All organizations. At any time uring the tax year, was the organization a party to a prohiite tax shelter transation? If "Yes," omplete Form 8886-T ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 40e List the states with whih a opy of this return is file NY The organization s ooks are in are of JENNIFER SHAER Telephone no Loate at 3 HUNTINGTON QUADRANGLE STE 1050, MEVILLE, NY ZIP At any time uring the alenar year, i the organization have an interest in or a signature or other authority over a finanial aount in a foreign ountry (suh as a ank aount, seurities aount, or other finanial aount)? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes," enter the name of the foreign ountry: See the instrutions for exeptions an filing requirements for FinCEN Form 114, Report of Foreign Bank an Finanial Aounts (FBAR). At any time uring the alenar year, i the organization maintain an offie outsie the Unite States? ~~~~~~~~~~~~~~~~~ If "Yes," enter the name of the foreign ountry: Setion 4947(a)(1) nonexempt haritale trusts filing Form 990-EZ in lieu of Form Chek here an enter the amount of tax-exempt interest reeive or arue uring the tax year ~~~~~~~~~~~~~~~~~ 43 N/A 39a 39 N/A N/A a a N/A 44a 45a Di the organization maintain any onor avise funs uring the year? If "Yes," Form 990 must e omplete instea of Form 990-EZ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Di the organization operate one or more hospital failities uring the year? If "Yes," Form 990 must e omplete instea of Form 990-EZ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Di the organization reeive any payments for inoor tanning servies uring the year? ~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes" to line 44, has the organization file a Form 720 to report these payments? If "No," provie an explanation in Sheule O ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Di the organization have a ontrolle entity within the meaning of setion 512()(13)? ~~~~~~~~~~~~~~~~~~~~~~~~ Di the organization reeive any payment from or engage in any transation with a ontrolle entity within the meaning of setion 512()(13)? If "Yes," Form 990 an Sheule R may nee to e omplete instea of Form 990-EZ (see instrutions) a a 45 3

4 46 50 THE ALLIED FOUNDATION INC C/O JENNIFER SHAER Di the organization engage, iretly or iniretly, in politial ampaign ativities on ehalf of or in opposition to aniates for puli offie? If "Yes," omplete Sheule C, Part I Part VI Setion 501()(3) organizations only All setion 501()(3) organizations must answer questions an 52, an omplete the tales for lines 50 an 51. If "Yes," was the relate organization a setion 527 organization? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Complete this tale for the organization s five highest ompensate employees (other than offiers, iretors, trustees, an key employees) who eah reeive more than $100,000 of ompensation from the organization. If there is none, enter "None." (a) Name an title of eah employee () Average hours () Reportale () Health enefits, (e) Estimate ompensation (Forms ontriutions to per week evote to W-2/1099-MISC) employee enefit amount of other position plans, an eferre NONE ompensation ompensation Page 4 Chek if the organization use Sheule O to respon to any question in this Part VI Di the organization engage in loying ativities or have a setion 501(h) eletion in effet uring the tax year? If "Yes," omplete Sh. C, Part II Is the organization a shool as esrie in setion 170()(1)(A)(ii)? If "Yes," omplete Sheule E ~~~~~~~~~~~~~~~~~~~ a Di the organization make any transfers to an exempt non-haritale relate organization? ~~~~~~~~~~~~~~~~~~~~~~ 49a 51 f Total numer of other employees pai over $100,000 ~~~~~~~~~~~~~~~~ Complete this tale for the organization s five highest ompensate inepenent ontrators who eah reeive more than $100,000 of ompensation from the organization. If there is none, enter "None." NONE (a) Name an usiness aress of eah inepenent ontrator () Type of servie () Compensation Total numer of other inepenent ontrators eah reeiving over $100,000 ~~~~~~~~~~~~~~ 52 Di the organization omplete Sheule A? Note: All setion 501()(3) organizations must attah a omplete Sheule A Uner penalties of perjury, I elare that I have examine this return, inluing aompanying sheules an statements, an to the est of my knowlege an elief, it is true, orret, an omplete. Delaration of preparer (other than offier) is ase on all information of whih preparer has any knowlege. Sign Here = = Signature of offier JENNIFER SHAER, DIRECTOR Type or print name an title Print/Type preparer s name Preparer s signature Date Chek if PTIN self- employe Pai ROBIN ROKUSON,CPA ROBIN ROKUSON,CPA 11/07/17 P Preparer Firm s name GETTRY MARCUS CPA, P.C. Firm s EIN Use Only 9 9 Firm s aress 9 88 FROEHLICH FARM BLVD., 3RD FLOOR Phone no WOODBURY, NY May the IRS isuss this return with the preparer shown aove? See instrutions Yes Date Yes No No

5 SCHEDULE O (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Servie Name of the organization Supplemental Information to Form 990 or 990-EZ 2016 OMB No Complete to provie information for responses to speifi questions on Form 990 or 990-EZ or to provie any aitional information. Attah to Form 990 or 990-EZ. Open to Puli Information aout Sheule O (Form 990 or 990-EZ) an its instrutions is at Inspetion THE ALLIED FOUNDATION INC Employer ientifiation numer C/O JENNIFER SHAER FORM 990-EZ, PART I, LINE 10, GRANTS AND ALLOCATIONS: ACTIVITY CLASSIFICATION: CHARITY WORK GRANTEE NAME: HABITIAT FOR HUMANITY GRANTEE RELATIONSHIP: CHARITY DATE OF GIFT: 10/28/16 AMOUNT GIVEN: 2,500. FORM 990-EZ, PART I, LINE 16, OTHER EPENSES: DESCRIPTION OF OTHER EPENSES: AMOUNT: BANK CHANGES 18. NYS FILING FEE 50. DONATIONS 306. EDUCATION EPENSE 4,727. PROGRAM EPENSES 11,323. SCHOLARSHIPS 1,000. ADVERTISING 1,000. TOTAL TO FORM 990-EZ, LINE 16 18,424. FORM 990-EZ, PART III, PRIMARY EEMPT PURPOSE - IMPROVE THE HEALTH AND WELL-BEING OF PEOPLE IN THE COMMUNITY. FORM 990-EZ, PART III, LINE 28, PROGRAM SERVICE ACCOMPLISHMENTS: SUPPPORT EARLY CHILDHOOD LITERACY(SUPPORTING THE REACH OUT AND READ BOOK FAIRIES PROGRAMS). SUPPORT BREASTFEEDING (FUNDING THE BREASTFEEDING HOTLINE), LHA For Paperwork Reution At Notie, see the Instrutions for Form 990 or 990-EZ. Sheule O (Form 990 or 990-EZ) (2016)

6 SCHEDULE O (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Servie Name of the organization Supplemental Information to Form 990 or 990-EZ 2016 OMB No Complete to provie information for responses to speifi questions on Form 990 or 990-EZ or to provie any aitional information. Attah to Form 990 or 990-EZ. Open to Puli Information aout Sheule O (Form 990 or 990-EZ) an its instrutions is at Inspetion THE ALLIED FOUNDATION INC Employer ientifiation numer C/O JENNIFER SHAER DEVELOPMENT OF MILK BANK DEPOTS. PROMOTE EDUCATION (LECTURES AND TV SERIES, ALLIED APP) PROMOTE PHILANTHROPY AND COMMUNITY BULILDING (INCLUDING THE DEVELOPMENT OF THE ANDREW FIERSTEIN FUND). FORM 990-EZ, PART V, INFORMATION REGARDING PERSONAL BENEFIT CONTRACTS: THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY, OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT. THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY, OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT. LHA For Paperwork Reution At Notie, see the Instrutions for Form 990 or 990-EZ. Sheule O (Form 990 or 990-EZ) (2016)