Form 990-T Exempt Organization Business Income Tax Return OMB No. 1545-0687 (and proxy tax under section 6033(e)) For calendar year 2015 or other tax year beginning 10/01, 2015, and ending 9/30, 2016 2015 G Information about Form 990-T and its instructions is available at www.irs.gov/form990t. Department of the Treasury Internal Revenue Service G Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c). Open to Public Inspection for 501(c) Organizations Only A Check box if Check box if name changed and see instructions. D Employer identification number address changed (Employees trust, see instructions.) B Exempt under section Print X 501( C )( 3 ) or FOUNDATION, INC. 59-2191587 Type 829 RIVERSIDE AVE E Unrelated business activity 408(e) 220(e) codes (See instructions.) JACKSONVILLE, FL 32204 408A 530(a) 529(a) 453220 532000 C Book value of all assets at F Group exemption number (See instructions.)g end of year G Check organization type..... 45,958,547. G X 501(c) corporation 501(c) trust 401(a) trust Other trust H Describe the organization s primary unrelated business activity. G RETAIL SALES/RENTAL REVENUE I During the tax year, was the corporation a subsidiary in an affiliated group or a parent-subsidiary controlled group?.... G Yes X No If Yes, enter the name and identifying number of the parent corporation.... G J The books are in care of G SUSAN SURBER, DIR OF FINANCE Telephone numberg (904)-356-6857 Part I Unrelated Trade or Business Income (A) Income (B) Expenses (C) Net 1 a Gross receipts or sales... 256,809. b Less returns and allowances.... 28,602. c BalanceG 1 c 228,207. 2 Cost of goods sold (Schedule A, line 7)....................... 2 195,262. 3 Gross profit. Subtract line 2 from line 1c...................... 3 32,945. 32,945. 4 a Capital gain net income (attach Schedule D).................. 4 a b Net gain (loss) (Form 4797, Part II, line 17) (attach Form 4797)............. 4 b c Capital loss deduction for trusts.............................. 4 c 5 Income (loss) from partnerships and S corporations (attach statement).......................................... 5 6 Rent income (Schedule C)................................... 6 7 Unrelated debt-financed income (Schedule E)................. 7 8 Interest, annuities, royalties, and rents from controlled organizations (Schedule F).. 8 148,069. 107,304. 40,765. 9 Investment income of a section 501(c)(7), (9), or (17) organization (Sch G).... 9 10 Exploited exempt activity income (Schedule I)................ 10 11 Advertising income (Schedule J)............................. 11 12 Other income (See instructions; attach schedule)............. SEE STATEMENT 1 12 30,537. 30,537. 13 Total. Combine lines 3 through 12............................ 13 211,551. 107,304. 104,247. Part II Deductions Not Taken Elsewhere (See instructions for limitations on deductions.) (Except for contributions, deductions must be directly connected with the unrelated business income.) 14 Compensation of officers, directors, and trustees (Schedule K)............................................ 14 15 Salaries and wages.................................................................................... 15 9,356. 16 Repairs and maintenance............................................................................... 16 16,670. 17 Bad debts............................................................................................. 17 18 Interest (attach schedule)............................................................................... 18 19 Taxes and licenses..................................................................................... 19 4,071. 20 Charitable contributions (See instructions for limitation rules)............................................. 20 21 Depreciation (attach Form 4562)............................................. 21 30,440. 22 Less depreciation claimed on Schedule A and elsewhere on return............. 22 a 22 b 30,440. 23 Depletion.............................................................................................. 23 24 Contributions to deferred compensation plans............................................................ 24 25 Employee benefit programs............................................................................. 25 7,435. 26 Excess exempt expenses (Schedule I).................................................................. 26 27 Excess readership costs (Schedule J)................................................................... 27 28 Other deductions (attach schedule)................................................ SEE...... STATEMENT............... 2. 28 40,559. 29 Total deductions. Add lines 14 through 28............................................................... 29 108,531. 30 Unrelated business taxable income before net operating loss deduction. Subtract line 29 from line 13....... 30 31 Net operating loss deduction (limited to the amount on line 30).............. SEE...... STATEMENT............... 3........ 31-4,284. 32 Unrelated business taxable income before specific deduction. Subtract line 31 from line 30................. 32-4,284. 33 Specific deduction (Generally $1,000, but see line 33 instructions for exceptions).......................... 33 34 Unrelated business taxable income. Subtract line 33 from line 32. If line 33 is greater than line 32, enter the smaller of zero or line 32.. 34-4,284. BAA For Paperwork Reduction Act Notice, see instructions. TEEA0205L 10/12/15 Form 990-T (2015)
Form 990-T (2015) 59-2191587 Page 3 Schedule C Rent Income (From Real Property and Personal Property Leased With Real Property) (see instructions) 1 Description of property REAL PROPERTY Total 2 Rent received or accrued 3(a) Deductions directly connected with (a) From personal property (b) From real and personal property the income in columns 2(a) and 2(b) (if the percentage of rent for personal (if the percentage of rent for personal (attach schedule) property is more than 10 but not property exceeds 50 or if the rent is more than 50) based on profit or income) SEE STATEMENT 5 148,069. 107,304. Total (c) Total income. Add totals of columns 2(a) and 2(b). Enter here and on page 1, Part I, line 6, column (A)............... G Schedule E Unrelated Debt-Financed Income (see instructions) 148,069. (b) Total deductions. Enter here and on page 1, Part 148,069. I, line 6, column (B)...... G 107,304. 3 Deductions directly connected with or allocable to 1 Description of debt-financed property 2 Gross income from or allocable to debtfinanced debt-financed property property (a) Straight line (b) Other deductions depreciation (attach sch) (attach schedule) 4 Amount of average 5 Average adjusted basis of 6 Column 4 7 Gross income 8 Allocable deductions acquisition debt on or or allocable to debt-financed divided by reportable (column 2 x (column 6 x total of allocable to debt-financed property (attach schedule) property (attach schedule) column 5 column 6) columns 3(a) and 3(b)) Enter here and on page 1, Enter here and on page 1, Part I, line 7, column (A). Part I, line 7, column (B). Totals............................................................................ G Total dividends-received deductions included in column 8..................................................... G Schedule F Interest, Annuities, Royalties, and Rents From Controlled Organizations (see instructions) Exempt Controlled Organizations 1 Name of controlled 2 Employer 3 Net unrelated 4 Total of specified 5 Part of column 4 6 Deductions directly organization identification income (loss) payments made that is included in connected with number (see instructions) the controlling income in column 5 organization s gross income Nonexempt Controlled Organizations 7 Taxable Income 8 Net unrelated 9 Total of specified 10 Part of column 9 that is 11 Deductions directly income (loss) payments made included in the controlling connected with income (see instructions) organization s gross income in column 10 Totals.................................................................. BAA TEEA0203L 10/12/15 Add columns 5 and 10. Enter Add columns 6 and 11. Enter here and on page 1, Part I, line here and on page 1, Part I, line 8, column (A). 8, column (B). Form 990-T (2015)
Form 990-T (2015) 59-2191587 Page 4 Schedule G Investment Income of a Section 501(c)(7), (9), or (17) Organization (see instructions) 1 Description of income 2 Amount of income 3 Deductions directly connected 4 Set-asides (attach schedule) 5 Total deductions and set-asides (column 3 (attach schedule) plus column 4) Enter here and on page 1, Enter here and on page 1, Part I, line 9, column (A). Part I, line 9, column (B). Totals........................... G Schedule I Exploited Exempt Activity Income, Other Than Advertising Income (see instructions) 2 Gross 3 Expenses directly 4 Net income (loss) 5 Gross income from 6 Expenses 7 Excess exempt unrelated connected with from unrelated trade activity that is not attributable to expenses (column 6 1 Description of exploited activity business production or business (column unrelated business column 5 minus column 5, but income from of unrelated 2 minus column 3). income not more than trade or business income If a gain, compute column 4). business columns 5 through 7. Enter here and Enter here and Enter here and on page 1, on page 1, on page 1, Part I, line 10, Part I, line 10, Part II, line 26. column (A). column (B). Totals............................. G Schedule J Advertising Income (See instructions) Part I Income From Periodicals Reported on a Consolidated Basis 1 Name of periodical 2 Gross 3 Direct 4 Advertising gain or 5 Circulation 6 Readership 7 Excess readership advertising advertising (loss) (col 2 minus income costs costs (col 6 minus col income costs col 3). If a gain, 5, but not more than compute col 5 col 4). through 7. Totals (carry to Part II, line (5))..... G Part II Income From Periodicals Reported on a Separate Basis (For each periodical listed in Part II, fill in columns 2 through 7 on a line-by-line basis.) 2 Gross 3 Direct 4 Advertising gain or 5 Circulation 6 Readership 7 Excess readership advertising advertising (loss) (col 2 minus income costs costs (col 6 minus col 1 Name of periodical income costs col 3). If a gain, 5, but not more than compute cols 5 col 4). through 7. Totals from Part I G Enter here and Enter here and Enter here and on page 1, on page 1, on page 1, Part I, line 11, Part I, line 11, Part II, line 27. column (A) column (B). Totals, Part II (lines 1-5)............ G Schedule K Compensation of Officers, Directors, and Trustees (see instructions) 1 Name 2 Title 3 Percent of time devoted 4 Compensation attributable to unrelated business to business Total. Enter here and on page 1, Part II, line 14........................................................... G BAA TEEA0204 L 10/12/15 Form 990-T (2015)
Depreciation and Amortization OMB No. 1545-0172 Form 4562 (Including Information on Listed Property) 2015 G Attach to your tax return. Department of the Treasury Attachment Internal Revenue Service (99) G Information about Form 4562 and its separate instructions is at www.irs.gov/form4562. Sequence No. 179 Name(s) shown on return Identifying number FOUNDATION, INC. 59-2191587 Business or activity to which this form relates FORM 990-T Part I Election To Expense Certain Property Under Section 179 Note: If you have any listed property, complete Part V before you complete Part I. 1 Maximum amount (see instructions)..................................................................... 1 2 Total cost of section 179 property placed in service (see instructions)..................................... 2 3 Threshold cost of section 179 property before reduction in limitation (see instructions)...................... 3 4 Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -0-................................ 4 5 Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less, enter -0-. If married filing separately, see instructions............................................................................. 5 6 (a) Description of property (b) Cost (business use only) (c) Elected cost 7 Listed property. Enter the amount from line 29...................................... 7 8 Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 7....................... 8 9 Tentative deduction. Enter the smaller of line 5 or line 8................................................. 9 10 Carryover of disallowed deduction from line 13 of your 2014 Form 4562.................................... 10 11 Business income limitation. Enter the smaller of business income (not less than zero) or line 5 (see instrs).. 11 12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11.................... 12 13 Carryover of disallowed deduction to 2016. Add lines 9 and 10, less line 12........ G 13 Note: Do not use Part II or Part III below for listed property. Instead, use Part V. Part II 14 Special Depreciation Allowance and Other Depreciation (Do not include listed property.) (See instructions.) Special depreciation allowance for qualified property (other than listed property) placed in service during the tax year (see instructions).............................................................................. 15 Property subject to section 168(f) election............................................................. 15 16 Other depreciation (including ACRS).................................................................... 16 Part III MACRS Depreciation (Do not include listed property.) (See instructions.) Section A 17 MACRS deductions for assets placed in service in tax years beginning before 2015......................... 17 18 If you are electing to group any assets placed in service during the tax year into one or more general asset accounts, check here...................................................................... G Section B Assets Placed in Service During 2015 Tax Year Using the General Depreciation System (a) (b) Month and (c) Basis for depreciation (d) (e) (f) (g) Depreciation Classification of property year placed (business/investment use Recovery period Convention Method deduction in service only see instructions) 19 a 3-year property.......... b 5-year property.......... c 7-year property.......... d 10-year property......... e 15-year property......... f 20-year property......... g 25-year property......... 25 yrs S/L h Residential rental 27.5 yrs MM S/L property................. 27.5 yrs MM S/L i Nonresidential real 39 yrs MM S/L property................. MM S/L Section C Assets Placed in Service During 2015 Tax Year Using the Alternative Depreciation System 20a Class life................ S/L b 12-year.................. 12 yrs S/L c 40-year.................. 40 yrs MM S/L Part IV Summary (See instructions.) 21 Listed property. Enter amount from line 28............................................................. 21 22 Total. Add amounts from line 12, lines 14 through 17, lines 19 and 20 in column (g), and line 21. Enter here and on the appropriate lines of your return. Partnerships and S corporations see instructions..................................... 22 30,440. 23 For assets shown above and placed in service during the current year, enter the portion of the basis attributable to section 263A costs........................ 23 BAA For Paperwork Reduction Act Notice, see separate instructions. FDIZ0812L 10/27/15 Form 4562 (2015) 14 30,440.
Form 8868 (Rev January 2014) Application for Extension of Time To File an Exempt Organization Return OMB No. 1545-1709 GFile a separate application for each return. Department of the Treasury Internal Revenue Service GInformation about Form 8868 and its instructions is at www.irs.gov/form8868.? If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box...................................... G X? If you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part II (on page 2 of this form). Do not complete Part II unless you have already been granted an automatic 3-month extension on a previously filed Form 8868. Electronic filing (e-file). You can electronically file Form 8868 if you need a 3-month automatic extension of time to file (6 months for a corporation required to file Form 990-T), or an additional (not automatic) 3-month extension of time. You can electronically file Form 8868 to request an extension of time to file any of the forms listed in Part I or Part II with the exception of Form 8870, Information Return for Transfers Associated With Certain Personal Benefit Contracts, which must be sent to the IRS in paper format (see instructions). For more details on the electronic filing of this form, visit www.irs.gov/efile and click on e-file for Charities & Nonprofits. Part I Automatic 3-Month Extension of Time. Only submit original (no copies needed). A corporation required to file Form 990-T and requesting an automatic 6-month extension check this box and complete Part I only..... All other corporations (including 1120-C filers), partnerships, REMICs, and trusts must use Form 7004 to request an extension of time to file income tax returns. Enter filer s identifying number, see instructions Type or print File by the due date for filing your return. See instructions. Name of exempt organization or other filer, see instructions. Number, street, and room or suite number. If a P.O. box, see instructions. City, town or post office, state, and ZIP code. For a foreign address, see instructions. G Employer identification number (EIN) or FOUNDATION, INC. 59-2191587 829 RIVERSIDE AVE JACKSONVILLE, FL 32204 Social security number (SSN) X Enter the Return code for the return that this application is for (file a separate application for each return)........................... 07 Application Return Application Return Is For Code Is For Code Form 990 or Form 990-EZ 01 Form 990-T (corporation) 07 Form 990-BL 02 Form 1041-A 08 Form 4720 (individual) 03 Form 4720 (other than individual) 09 Form 990-PF 04 Form 5227 10 Form 990-T (section 401(a) or 408(a) trust) 05 Form 6069 11 Form 990-T (trust other than above) 06 Form 8870 12? The books are in the care of G SUSAN SURBER, DIR OF FINANCE Telephone No. G (904)-356-6857 Fax No. G? If the organization does not have an office or place of business in the United States, check this box................................ G? If this is for a Group Return, enter the organization s four digit Group Exemption Number (GEN). If this is for the whole group, check this box...... G. If it is for part of the group, check this box.... G and attach a list with the names and EINs of all members the extension is for. 1 I request an automatic 3-month (6 months for a corporation required to file Form 990-T) extension of time until 8/15, 20 17, to file the exempt organization return for the organization named above. The extension is for the organization s return for: G calendar year 20 or G X tax year beginning 10/01, 20 15, and ending 9/30, 20 16. 2 If the tax year entered in line 1 is for less than 12 months, check reason: Initial return Final return Change in accounting period 3 a If this application is for Forms 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any nonrefundable credits. See instructions................................................................ 3 a$ b If this application is for Forms 990-PF, 990-T, 4720, or 6069, enter any refundable credits and estimated tax payments made. Include any prior year overpayment allowed as a credit............................. 3 b$ c Balance due. Subtract line 3b from line 3a. Include your payment with this form, if required, by using EFTPS (Electronic Federal Tax Payment System). See instructions..................................... 3 c$ Caution. If you are going to make an electronic funds withdrawal (direct debit) with this Form 8868, see Form 8453-EO and Form 8879-EO for payment instructions. BAA For Privacy Act and Paperwork Reduction Act Notice, see instructions. FIFZ0501L 12/31/13 0. 0. 0. Form 8868 (Rev 1-2014)
2015 FEDERAL STATEMENTS PAGE 1 FOUNDATION, INC. 59-2191587 STATEMENT 1 FORM 990-T, PART I, LINE 12 OTHER INCOME CATERING COMMISSION............................................................................ $ 19,623. LICENSING & REPRODUCTION..................................................................... 1,364. PHOTOGRAPHY PERMITS............................................................................ 9,550. TOTAL $ 30,537. STATEMENT 2 FORM 990-T, PART II, LINE 28 OTHER DEDUCTIONS ADVERTISING........................................................................................ $ 10,660. BANK FEES........................................................................................... 3,247. DUES................................................................................................... 165. INSURANCE........................................................................................... 5,547. PROFESSIONAL SERVICES......................................................................... 2,144. SECURITY............................................................................................. 3,589. TELEPHONE & UTILITIES......................................................................... 15,207. TOTAL $ 40,559. STATEMENT 3 FORM 990-T, PART II, LINE 31 NET OPERATING LOSS DEDUCTION LOSS LOSS YEAR ORIGINAL PREVIOUSLY LOSS ENDING LOSS USED AVAILABLE 9/30/08 $ 25,802. $ 0. $ 25,802. 9/30/09 25,626. 0. 25,626. 9/30/10 20,823. 0. 20,823. 9/30/11 42,255. 0. 42,255. 9/30/12 9,881. 0. 9,881. 9/30/13 9,898. 0. 9,898. 9/30/14 9,174. 0. 9,174. 9/30/15 9,393. 0. 9,393. NET OPERATING LOSS AVAILABLE.................................................................. $ 152,852. TAXABLE INCOME....................................................................................... $ -4,284. NET OPERATING LOSS DEDUCTION (LIMITED TO TAXABLE INCOME)....................... $ 0. STATEMENT 4 FORM 990-T, SCHEDULE A, LINE 4B OTHER COST OF GOODS SOLD ADVERTISING & PROMOTION........................................................................ $ 3,041. EVENT COSTS.......................................................................................... 3,608. LICENSES & FEES.................................................................................... 480. MERCHANT FEES....................................................................................... 5,805. REPAIRS & MAINTENANCE........................................................................... 823. SUPPLIES............................................................................................... 1,482. TRAVEL.................................................................................................. 2,452. TOTAL $ 17,691.
2015 FEDERAL STATEMENTS PAGE 2 FOUNDATION, INC. 59-2191587 STATEMENT 5 FORM 990-T, SCHEDULE C, LINE 3 DEDUCTIONS DIRECTLY CONNECTED WITH INCOME REAL PROPERTY CLEANING AND MAINTENANCE.................................................................. $ 2,155. GARDENING......................................................................................... 4,923. INSURANCE......................................................................................... 2,411. WAGES AND SALARIES........................................................................... 67,928. CONTRACT SERVICES-AUDIO/VISUAL......................................................... 4,271. TABLE/CHAIR RENTAL........................................................................... 6,642. SUPPLIES........................................................................................... 3,162. SECURITY........................................................................................... 12,146. MERCHANT FEES................................................................................... 3,666. TOTAL $ 107,304.
2015 GENERAL ELECTIONS PAGE 1 FOUNDATION, INC. 59-2191587 ELECTION TO WAIVE NET OPERATING LOSS CARRYBACK PURSUANT TO IRC SECTION 172(B), THE ORGANIZATION HEREBY ELECTS TO RELINQUISH THE ENTIRE CARRYBACK PERIOD WITH RESPECT TO THE NET OPERATING LOSS INCURRED FOR THE TAX YEAR ENDED 9/30/16.
2015 FEDERAL WORKSHEETS PAGE 3 FOUNDATION, INC. 59-2191587 COMPUTATION OF COST OF GOODS SOLD (FORM 990-T) 1. INVENTORY AT START OF YEAR................................................................ 90,125. 2. PURCHASES.......................................................................................... 177,098. 3. COST OF LABOR.................................................................................... 52,319. 4. ADDITIONAL 263A COSTS........................................................................ 0. 5. OTHER COSTS....................................................................................... 17,691. 6. TOTAL (ADD LINES 1 THROUGH 5)............................................................ 337,233. 7. INVENTORY AT END OF YEAR................................................................... 141,971. 8. COST OF GOODS SOLD (SUBTRACT LINE 7 FROM LINE 6)............................... 195,262. COMPUTATION OF 2015 NET OPERATING LOSS 1. TOTAL INCOME.................................................................................... 104,247. 2. TOTAL DEDUCTIONS.............................................................................. 108,531. 3. UNRELATED BUSINESS TAXABLE INCOME (LINE 1 LESS LINE 2)..................... -4,284. 2015 NET OPERATING LOSS........................................................................ 4,284.