3376 11/15/2017 1:36 PM

Form

Return of Private Foundation

990-PF

0MB No. 1545-0052

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 of the Treasury
Internal Revenue Service

~ Information about Form 990-PF and its se arate instructions is at www.irs. ovlform990 f.
For calendar year 2016 or tax year beginning
, and ending
A

Name of foundation

I

WEST 72ND STREET #248

Room/suite

B

G Check all that apply:

§

§

NY 10069

loitial rntum
Final return
Address change

l!I

loiUalo,tum of a fo~e, publicoha,lty
Amended return
Name change

H Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
Cash
Accrual
I Fair market value of all assets at
J Accounting method:
end of year (from Part II, col. (c),
Other (specify) ..............................

n

line 16) ~

I

Part

1
2
3
4
5a
Q)

b

::l

s::
Q)

6a

>

b

&

7
8
9
10a

$

n

l!I

D

36,017,785

(Part I column

(d)

(a) Revenue and

amountsin columns /b), /c), and /d) may not necessarilyequal
the amountsin column /a) /sea instructions).)

expenses per
books

Contributions,
gifts,grants,etc,, received(attachschedule)
Check~
if the foundation
is notrequiredto attachSch.·B
Interest on savings and temporary cash investments
Dividends and interest from securities
Gross rents
Net rental income or (loss)

D

STMT 1

Other expenses(att. sch.)

+:I

24

Total operating and administrative expenses.

C.

25

Contributions,gilts, grants paid

26

Total expensesand disbursements.Addlines24 and25 .
Subtract line 26 from line 12:
Excessof revenueover expensesand disbursements
Net investment income (if negative, enter -0-)
Adjusted net income (if neaative, enter -0-) .

15

C.

><

w

16a
b

g? C
+:I
I!! 17
....
Ill

·2

·e
"t:,

<(
"t:,

s::

18
19
20

21

I!!
Q)

0

a

b
C

(d) Disbursements
for charitable
purposes
(cash basis only)

(c) Adjusted net
income

25,000,000
126,357

126,357

126,357

126,357

126,357

0

2

1,264

···············sTMT··3·

For Paperwork Reduction Act Notice, see instructions.
DAA

If the foundation is in a 60-month termination
under section 507(b)(1)(B),check here

(b) Net investment
income

32,315,575

Add lines 13 through 23 .

27

F

If private foundation status was terminatedunder
section 507(b)(1)(A), check here

I ...

23

14

Q)

s::

2. Foreign organizations meeting the
85% test, check here and attach computation
E

D
D
.... D
.... D
.... D
....

0

22

Ill

Q)

1. Foreign organizations,check here

....

0

C)

Ill

D

Capital gain net income (from Part IV, line 2) .
Net short-term capital gain .
Income modifications

n,

12
13

If exemption application is pending, check here

7,189,218

·s::

11

C

7,189,218

Grosssalespricefor all assetson line 6a

Gross sales less returns and allowances

,/

must be on cash basis. J

Less: Cost of goods sold
I
Gross profit or (loss) (attach schedule)
Other income (attach schedule)..
Total. Add lines 1 throuah 11 .
Compensation of officers, directors, trustees, etc.
Other employee salaries and wages
Pension plans, employee benefits .
Legal fees (attach schedule) .
Accounting fees (attach schedule) .
Otherprofessional
fees (attachschedule)
Interest
Taxes(attachschedule)(seeinstructions)
.. STMT
Depreciation
(attachschedule)and depletion
Occupancy
Travel, conferences, and meetings .
Printing and publications

b
C

LJ

Analysis of Revenue and Expenses /The total of

Net gain or (loss)from sale of assetsnot on line 10

Telephone number (see instructions)

631-331-0515

City or town, state or province, country, and ZIP or foreign postal code

NEW YORK

Employer Identification number

20-1982204

MERCER FAMILY FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)

119

Open to Public Inspection

25
1,289
19,025,582
19,026,871

0

0

0

0

0
19,025,582
19,025,582

13,288,704
126,357
126,357
Fonm 990-PF (2016)

 3376 11/15/20171:36PM

Form 990-PF (2016)

Part II

MERCER FAMILY

Balance Sheets

20 - 1982204

FOUNDATI 0 N

Attachedschedulesand amountsin the descriptioncolumn
shouldbe for end-of-yearamountsonly. (See instructions.)

Cash - non-interest-bearing ..

2

Savings and temporary cash investments

3

Accounts receivable ~

4

Pledges receivable ~ ... ..
Less: allowance for doubtful accounts ~

5

Grants receivable . . . . . .
Receivables due from officers, directors, trustees, and other

2

End of year

(a) BookValue

(b) BookValue

12,302

1

Paae

Beginning of year

(c) FairMarketValue

1,505,967

1,505,967

34,508,082

34,508,082

Less: allowance for doubtful accounts ~

6

disqualified persons (attach schedule) (see
instructions)

7

Othernotesandloansreceivable
(att.schedule)
~

·o

Less: allowance for doubtful accounts ~

J!!
Cl)
Ill
Ill

8

Inventories for sale or use

9

Prepaid expenses and deferred charges

10a

<(

Investments- U.S.and state governmentobligations(attachschedule)

SEE sTM'ii 4

b

Investments - corporate stock (attach schedule) .

C

Investments - corporate bonds (attach schedule) .

11

22,716,779

Investments
- land,buildings,
andequipment:
basis~
Less:accumulated
depreciation
(attachsch.)~ ...

12

Investments - mortgage loans .

13

Investments - other (attach schedule) .

14

Land,buildings,
andequipment:
basis~

15

Other assets (describe~

16

Total assets (to be completed by all filers - see the

17

Accounts payable and accrued expenses .

18

Grants payable

19

Deferred revenue

Less:accumulated
depreciation
(attachsch.)~

SEE STATEMENT5

22,729,081

instructions. Also see oaae 1 item I\.

Ill

Cl)

~ 20
:c
cu 21
::::i

Cl)
(.)

Other liabilities (describe ~

23

Total liabilities (add lines 17 throuah 22) .

24

cu
iii 25
al

26

"C

C:

::I

u.

...
0

J!!
Cl)
Ill
Ill

-

<(

Cl)

z

)

0

and
31. .

~

0

LJ

Unrestricted
Temporarily restricted
Permanently restricted ...
Foundations that do not follow SFAS 117, check here
and complete lines 27 through 31 .

27

Capital stock, trust principal, or current funds .

28

Paid-in or capital surplus, or land, bldg., and equipment fund

29

Retained earnings, accumulated income, endowment, or other funds

30

Total net assets or fund balances (see instructions)

31

Total liabilities and net assets/fund balances (see

~ ~

instructions)

Prtlll
a

36,017,785

Mortgagesand other notes payable(attachschedule)

22

Ill

3,736

36,017,785

Loans from officers, directors, trustees, and other disqualified persons

Foundations that follow SFAS 117, check here
and complete lines 24 through 26 and lines 30

C:

3,736

)

22,729,081
22,729,081

36,017,785
36,017,785

22,729,081

36,017,785

A na1vs1sof Chanaes in Net Assets or Fund Balances

1 Total net assets or fund balances at beginning of year - Part 11,column (a), line 30 (must agree with
end-of-year figure reported on prior year's return)

2 Enter amount from Part I, line 27a

1
2

3 Other increases not included in line 2 (itemize) ~

3

4 Add lines 1, 2, and 3

4

5 Decreases not included in line 2 (itemize) ~ .

5

6 Total net assets or fund balances at end of vear /line 4 minus line 5\ - Part II column lb\, line 30 .

6

22,729,081
13,288,704

36,017,785
36,017,785
Fonn 990-PF (2016)

DAA

 3376 11/15/2017 1:36 PM

Form 990-PF (2016)

. Pa rt IV

20-1982204

MERCER FAMILY FOUNDATION

CaP1·taI Gains

(b) How acquired
P - Purchase
D - Donation

(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)

1a

Page

3

an d Losses f or T ax on Investment ncome
(c) Date acquired
(mo., day, yr,)

(d) Date sold
(mo., day, yr.)

N/A

b
C

d

e
(e) Gross sales price

(f) Depreciation allowed
(or allowable)

(g) Cost or other basis
plus expense of sale

(h) Gain or (loss)
(e) plus (f) minus (g)

a

b
C

d

e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(I) F.M.V. as of 12/31/69

(I) Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col. (h))

(k) Excess of col. (i)

0) Adjusted basis
as of 12/31/69

over col. (i), if any

a

b
C

d

e
2 Capital gain net income or (net capital loss)

[

If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7

}

2

}

3

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) (see instructions). If (loss), enter -0- in
Part I line 8.

·PartV

Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income

(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)
If section 4940(d)(2) applies, leave this part blank.

D Yes

Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period?

~

No

If "Yes," the foundation does not qualify under section 4940(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)
Base period years
Calendar year (or tax year beginning in)

(b)
Adjusted qualifying distributions

2015
2014
2013
2012
2011

(d)
Distribution ratio
(col. (b) divided by col. (c))

(c)
Net value of noncharitable-use assets

24,542.516
18,298.080
13,487,091
11,669,718
7,095,233

2 Total of line 1, column (d) .
3 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 .

2

4 Enter the net value of noncharitable-use assets for 2016 from Part X, line 5

4

5 Multiply line 4 by line 3

5

6 Enter 1% of net investment income (1% of Part I, line 27b)

6

1 264

7 Add lines 5 and 6

7

1,264

8 Enter qualifying distributions from Part XII, line 4

8

3

0

19 025 582

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

DAA

990-PF (2016)

 3376 11/15/2017 1:36 PM

Form 990-PF (2016) MERCER FAMILY FOUNDATION
20-1982204
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948 - see instructions)

1a

Exempt operating foundations described in section 4940(d)(2), check here ~
Date of ruling or determination letter: __... _...........

LJ and enter "N/A" on line 1.

_. . . (attach copy of letter if necessary-see

Page

4

}

instructions)

b

Domestic foundations that meet the section 4940(e) requirements in Part V, check

c

here~
~ and enter 1% of Part I, line 27b ........ _..............
__...................
_.. _. _.. _.................
All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of

l__,_,..c2~6,;;_;;;.

1--1.;.._1-,,
_____
.

Part I, line 12, col. (b).

0

2

Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) .

2

3

Add lines 1 and 2

3

4

Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-).

4

5

Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0-

5

1,264

6

Credits/Payments:

7

7,702

a
b

2016 estimated tax payments and 2015 overpayment credited to 2016 .

6a

Exempt foreign organizations - tax withheld at source .

6b

c

Tax paid with application for extension of time to file (Form 8868) .

6c

d

Backup withholding erroneously withheld

6d

7
8

Total credits and payments. Add lines 6a through 6d .

9

Enter any penalty for underpayment of estimated tax. Che~k h~r~ ·

8

Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed

~

9

1O

Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid

~

10

11

Enter the amount of line 10 to be: Credited to 2017 estimated tax~

~

11

Part VII-A
1a

Refunded

6,438

Statements Reaardmg Activities

During the tax year, did the foundation attempt to influence any national, state, or local legislation or did it

Yes

No

. 1-1
I J\._1 a--t----t--

participate or intervene in any political campaign? _.

b

0

7,702

0 if F~r~ 2220
i~-~it~~h~d. ·
6,438 ·

1,264

Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see
Instructions for the definition)?

.......................

1-1
I J\._1 b--t----t--

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.

N /1\.1--1c-+-~t---

c

Did the foundation file Form 1120-POL for this year?

d

Enter the amount (if any) of tax on political expenditures (section 4955) 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

2

_

on foundation managers. ~ $ ---~----Has the foundation engaged in any activities that have not previously been reported to the IRS?

2

X

3
4a

X
X

5

X

If "Yes," attach a detailed description of the activities.

3

Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles of

4a

Did the foundation have unrelated business gross income of $1,000 or more during the year?

incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes
b
5

If "Yes," has it filed a tax return on Form 990-T for this year?

.........•••••••••••••••••••••••••••••••••
N'/l\ 4b

Was there a liquidation,termination,dissolution,or substantialcontractionduringthe year?
If "Yes,"attach the statementrequiredby GeneralInstructionT.

6

Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
• By language in the governing instrument, or
• By state legislation that effectively amends the governing instrument so that no mandatory directions that

7

conflict with the state law remain in the governing instrument? .

6

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 XV

7

X
X

8b

X

Ba Enter the states to which the foundation reports or with which it is registered (see instructions) ~

NONE
b

If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney General
(or designate) of each state as required by General Instruction G? If "No," attach explanation

9

Is the foundation claiming status as a private operating foundation within the meaning of section 4942U)(3) or
49420)(5) for calendar year 2016 or the taxable year beginning in 2016 (see instructions for Part XIV)? If "Yes,"
complete Part XIV ..

10

Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their
names and addresses .

10
Fann

DAA

X

9

990-PF

X
(2016)

 3376 11/15/2017 1:36 PM

Form 990-PF (2016)

Part VII-A

MERCER FAMILY

FOUNDATION

20-1982204

Page
Yes

11

No

At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the

X

11

meaning of section 512(b)(13)? If "Yes," attach schedule (see instructions).

12

5

Statements ReAardina Activities (continued)

Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified

12
13

person had advisory privileges? If "Yes," attach statement (see instructions)

13

Did the foundation comply with the public inspection requirements for its annual returns and exemption application? .

14

Website address~
The books are in care of ~

1-l(l!\

240

REBEKAH MERCER

Telephone no.~.

RiVERSIDE.
BLVD.

Located at ~ NEW
,,... YORK..

NY

ZIP+4 ~

X
X

Ei3i.:.:33i,~osis
..
10069

15

Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 - Check here

16

At any time during calendar year 2016, did the foundation have an interest in or a signature or other authority

No

over a bank, securities, or other financial account in a foreign country? .

X

and enter the amount of tax-exempt interest received or accrued during the year .

See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes," enter the name of
the foreian country ~

Part Vll-B

Statements ReQardina Activities for Which Form 4720 Mav Be Reauired

File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.

1a

During the year did the foundation (either directly or indirectly):

(1) Engage in the sale or exchange, or leasing of property with a disqualified person? .
(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from) a
disqualified person?
(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? .
(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
(5) Transfer any income or assets to a disqualified person (or make any of either available for
the benefit or use of a disqualified person)?

Yes

No

D Yes [!I No

D Yes [!I No

(6) Agree to pay money or property to a government official? (Exception. Check "No" if the

foundation agreed to make a grant to or to employ the official for a period after
termination of government service, if terminating within 90 days.) .
b

D Yes [!I No

If any answer is "Yes" to 1a(1)-(6), did any of the acts fail to qualify under the exceptions described in Regulations

N/A
..:
D

section 53.4941(d)-3 or in a current notice regarding disaster assistance (see instructions)?
Organizations relying on a current notice regarding disaster assistance check here .

c

Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts, that

N /l!\ t--1c'-+--+--

were not corrected before the first day of the tax year beginning in 2016?.
2

1b
l--'-"--1-1-

Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 49420)(3) or 49420)(5)):

a

At the end of tax year 2016, did the foundation have any undistributed income (lines 6d and
6e, Part XIII) for tax year(s) beginning before 2016?
If "Yes," list the years ~

20

, 20

, 20

b

Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)

c

(relating to incorrect valuation of assets) to the year's undistributed income? (If applying section 4942(a)(2) to
all years listed, answer "No" and attach statement - see instructions.)
If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
~ 20
, 20
, 20
, 20
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise

3a

b

D Yes [!I No

, 20

at any time during the year?
If "Yes," did it have excess business holdings in 2016 as a result of (1) any purchase by the foundation or

l'1(l!\ _2b___

_

D Yes [!I No

disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved by the
Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3) the lapse of
the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine if the
foundation had excess business holdings in 2016.)
4a

b

Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes? .
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beainnina in 2016? .

4b
Form

DAA

990-PF

X
(2016)

 3376 11/15/20171:36PM

MERCER FAMILY FOUNDATION

Form 990-PF (2016)

Part VII-B
5a

20-1982204

Paqe

6

Statements Reaardina Activities for Which Form 4720 Mav Be Reauired (continued)

During the year did the foundation pay or incur any amount to:

D Yes

(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?

~

No

(2) Influence the outcome of any specific public election (see section 4955); or to carry on,

B I

directly or indirectly, any voter registration drive? .
(3) Provide a grant to an individual for travel, study, or other similar purposes?
(4) Provide a grant to an organization other than a charitable, etc., organization described in

section 4945(d)(4)(A)? (see instructions)
(5) Provide for any purpose other than religious, charitable, scientific, literary, or educational
purposes, or for the prevention of cruelty to children or animals?
b

If any answer is "Yes" to 5a(1)-(5), did any of the transactions fail to qualify under the exceptions described in

No

Yes

No

D Yes
D Yes

~

No

~

No

N/A
··········-~·o

Regulations section 53.4945 or in a current notice regarding disaster assistance (see instructions)?

5b

Organizations relying on a current notice regarding disaster assistance check here
c

Yes

If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the tax

?:l/Pt.
D Yes

because it maintained expenditure responsibility for the grant? .

'

D No

If "Yes," attach the statement required by Regulations section 53.4945-S(d).
6a

Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums

D Yes

on a personal benefit contract? .

b

~

No

Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?

If "Yes" to 6b, file Fom1 8870.
7a

D Yes

At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?

b

6b

If 'Yes," did the foundation receive any proceeds or have any net income attributable to the transaction?

~ No
N/A

X

7b

Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors

Part VIII

1 List all officers, directors, trustees, foundation managers and their compensation (see instructions).
Title,andaverage
hoursperweek
devotedto position

(b)

(a)

REBEKAH

240

Nameand address

MERCER

RIVERSIDE

BLVD

NEW YORK
NY

10069

(c) Compensation

(If not paid,
enter-0-)

(d) Contributions
to
acoount,
employeebenefit (e) Expense
otherallowances
plansanddeferred
oompensation

DIRECTOR
10.00

0

0

0

························

2

Compensation of five highest-paid employees (other than those included on line 1 - see instructions). If none, enter
"NONE."
Title,andaverage
hoursperweek
devotedto position

(b)
(a)

Nameand addressof eachemployeepaid morethan$50,000

(c) Compensation

(d) Contributions
to
account,
employeebenefit (e) Expense
otherallowances
plansanddeferred
oompensation

NONE

...

···············

Total number of other employees paid over $50,000 .

...

0

Fonm990-PF (2016)

DM

 3376 11/15/2017 1:36 PM

Form 990-PF (2016)

Part VIII
3

MERCER FAMILY FOUNDATION

20-1982204

Page

7

Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors (continued)

Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE."
(a) Name and address of each person paid more than $50,000

(b) Type of service

(c) Compensation

NONE
···········

,,

.. ..
,

..

Total number of others receiving over $50,000 for professional services .

Part IX-A

Summary of Direct Charitable Activities

List the foundation's four largest direct charitable activities during the tax year. Include relevant statistical infom1ation such as the number of
organizations and other beneficiaries served, conferences convened, research papers produced, etc.

Expenses

~/A

1

2 ..
.

3

,

...

.,,,,

.

... ..
,

4
.....

Summarv of Promam-Related Investments (see instructions)

Part IX-8

Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.

~/A.

1
,

2

''''

Amount

....

...
,,,,,,,,

...

...

,.

All other program-related investments. See instructions.

3

Total. Add lines 1 throuoh 3

..
Fom1

OM

990-PF (2016)

 3376 11/15/2017 1:36 PM

Form 990-PF (2016)

Part X
1

MERCER FAMILY FOUNDATION

20-1982204

Page

8

Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,
see instructions.)

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

Average of monthly cash balances .

1b

C

Fair market value of all other assets (see instructions)

d

Total (add lines 1a, b, and c)

e

Reduction claimed for blockage or other factors reported on lines 1a and

0
0
0
0

1c
1d

......

1c (attach detailed explanation)

I 1e I

0

2

Acquisition indebtedness applicable to line 1 assets

2

3

Subtract line 2 from line 1d

3

0
0

4

Cash deemed held for charitable activities. Enter 1½% of line 3 (for greater amount, see

4
5
6

0
0
0

instructions)

5
6

Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
Minimum investment return. Enter 5% of line 5 .

Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations
and certain foreic:moroanizations check here .... and do not comolete this oart.)

Part XI

n

1

Minimum investment return from Part X, line 6 .

2a

Tax on investment income for 2016 from Part VI, line 5

.......
·r·2a·1·
I

2b

1

1 264

I

b

Income tax for 2016. (This does not include the tax from Part VI.)

C

Add lines 2a and 2b

2c

Distributable amount before adjustments. Subtract line 2c from line 1 .

3

4

Recoveries of amounts treated as qualifying distributions

4

5
6

Add lines 3 and 4

5
6

3

7

,,,

...

Deduction from distributable amount (see instructions) .
Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII,
line 1 .

a

0

7

Part XII
1

1,264

Qualifying Distributions (see instructions)

Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
Expenses, contributions, gifts, etc. - total from Part I, column (d), line 26 .

1a

Program-related investments - total from Part IX-B.

1b

b
2

Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,

3

Amounts set aside for specific charitable projects that satisfy the:

purposes

·········

······

19,025

582

2

a

Suitability test (prior IRS approval required) .

3a

b

Cash distribution test (attach the required schedule) ..

3b

4

Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4

4

19 025 582

5

Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment income.

6

Adjusted qualifying distributions. Subtract line 5 from line 4

5
6

1.264
19 024,318

Enter 1% of Part I, line 27b (see instructions)

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 4940(e) reduction of tax in those years.
Fann

DAA

990-PF (2016)

 3376 11/15/2017 1:36 PM

20-1982204

MERCER FAMILY FOUNDATION
Undistributed Income (see instructions

Form 990-PF (2016)

Part XIII

Distributable amount for 2016 from Part XI,

1

Par1e 9

(a)

(b)

(c)

(d)

Corpus

Years prior to 2015

2015

2016

0

line 7
Undistributed income, if any, as of the end of 2016:

2

a Enter amount for 2015 only.
b Total for prior years: 20 __

, 20

--

,20 __

Excess distributions carryover, if any, to 2016:
a From 2011

3

7,105,215
11,677,197
13,492,358
18,300,979
24,544,570

b From 2012
c From 2013

d From 2014
e From 2015
f

75,120,319

Total of lines 3a through e .

Qualifying distributions for 2016 from Part XII,

4

line 4: ~

19,025,582

$

a Applied to 2015, but not more than line 2a
b Applied to undistributed income of prior years

(Election required - see instructions) ..
c Treated as distributions out of corpus (Election

required - see instructions)
d Applied to 2016 distributable amount
e Remaining amount distributed out of corpus .

19,025,582

Excess distributions carryover applied to 2016 .

5

(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:
a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5

94,145,901

b Prior years' undistributed income. Subtract

line 4b from line 2b
C

Enter the amount of prior years' undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed .

d Subtract line 6c from line 6b. Taxable

amount - see instructions
e Undistributed income for 2015. Subtract line

4a from line 2a. Taxable amount - see
instructions
f

Undistributed income for 2016. Subtract lines
4d and 5 from line 1. This amount must be

0

distributed in 2017
7

Amounts treated as distributions out of corpus
to satisfy requirements imposed by section
170(b)(1)(F) or 4942(9)(3) (Election may be
required-see

8

instructions) .

Excess distributions carryover from 2011 not

7,105,215

applied on line 5 or line 7 (see instructions)

9

Excess distributions carryover to 2017.

87,040,686

Subtract lines 7 and 8 from line 6a
10

Analysis of line 9:

a

Excess from 2012

b

Excess from 2013

C

Excess from 2014

d

Excess from 2015

e

Excess from 2016 .

11,677,197
13,492,358
18,300,979
24,544,570
19,025,582
Form

DAA

990-PF (2016)

 3376 11/15/2017 1:36 PM

Form 990-PF (2016)

Part XIV
1a

MERCER FAMILY

FOUNDATION

20-1982204

10

If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2016, enter the date of the ruling ..

b
2a

Page

Private Operatina Foundations (see instructions and Part VII-A question 9

....

.n

Check box to indicate whether the foundation is a private operatin!:l foundation described in section
Tax year
Prior 3 years
Enter the lesser of the adjusted ·net
(a) 2016
(b) 2015
(c) 2014
income from Part I or the minimum

4942(i)(3) or

I I 4942(i)(5l
(e) Total

(d) 2013

investment return from Part X for
each year listed .

. ..

b

85% of line 2a

C

Qualifying distributions from Part XII,

d

Amountsincludedin line 2c not used directly

line 4 for each year listed .

. ..

for activeconductof exemptactivities.

e

Qualifying distributions made directly
for active conduct of exempt activities.
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

(2) Value of assets qualifying under
section 49420)(3)(B)(i) .

b

"Endowment" alternative test - enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed .

C

"Support" alternative test - enter:
(1) Total support other than gross
investment income (interest,
dividends, rents, payments on
securities loans (section
512(a)(5)), or royalties)

(2) Support from general public
and 5 or more exempt
organizations as provided in
section 49420)(3)(B)(iii) .

(3) Largest amount of support from
an exempt organization ...
(4) Gross investment income

Part XV
1

a

Supplementary Information (Complete this part only if the foundation had $5,000 or more in assets at
any time during the year - see instructions.)

Information Regarding Foundation Managers:
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).)

N/A
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.

N/A
2

lnfonmation 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 e-mail address of the person to whom applications should be addressed:

N/A
b

The form in which applications should be submitted and information and materials they should include:

c

Any submission deadlines:

d

Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other

N/A
N/A
factors:

N/A
DM

Fann

990-PF (2016)

 3376 11/15/2017 1:36 PM

Form 990-PF (2016)

MERCER FAMILY

FOUNDATION

20-1982204

Page 11

Part XV
Supplementary Information (continued)
3 G rans
t and Cont n'bufions Pal'd DurmQ the Y ear or A,ooroved for Fut ure p avment

Recipient
Name and address(home or business)
a

If recipient is an individual,
show any relationshipto
any foundation manager
or substantial contributor

Foundation
status of
recipient

Purpose of grant or
contribution

Amount

Paid duringthe year

SEE

STATEMENT 6
19,025,582

Total
b

~

3a

~

3b

19,025,582

Approved for future payment

N/A

Total.
DAA

Fonm

990-PF (2016)

 3376 11/15/2017 1:36 PM

Form 990-PF (2016)

part XVI-A

MERCER FAMILY

20-1982204

FOUNDATION

Page 12

Analvsis of lncome-Producina Activities
Excludedbysection512,513,or 514

Unrelatedbusinessincome

Enter gross amounts unless otherwise indicated.
(a)

Businesscode

(c)

(b)

Exclusion
code

Amount

(e)

Relatedor exempt

(d)

functionincome

Amount

(See instructions.)

1 Program service revenue:

a
b
C

d

e
f
g

Fees and contracts from government agencies ..

2 Membership dues and assessments

126,357

3 Interest on savings and temporary cash investments ..

4 Dividends and interest from securities

5 Net rental income or (loss) from real estate:
a Debt-financed property .
b Not debt-financed property .
6 Net rental income or (loss) from personal property.
7 Other investment income
8 Gain or (loss) from sales of assets other than inventory .
9 Net income or (loss) from special events .
10 Gross profit or (loss) from sales of inventory .
11 Other revenue: a
b

7,189,218

C

d

e
12 Subtotal. Add columns (b), (d), and (e).

0

13 Total. Add line 12, columns (b), (d), and (e)

7,315,575
7,315,575

0
13

(See worksheet in line 13 instructions to verify calculations.)

-

Pa rt XVI B
Line No.

T

Re Iations h"ID o f A ct1v1t1es
. ..
to th e A ccomo r1shment of Exemot Purooses
Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to the
accomplishment of the foundation's exempt purposes (other than by providing funds for such purposes). (See instructions.)

N/A

Fonn

DM

990-PF

(2016)

 3376 11/15/2017 1:36 PM

Form 990-PF (2016)

Part XVII

MERCER FAMILY FOUNDATION

20-1982204

Page

Yes

Did the organization directly or indirectly engage in any of the following with any other organization described

1

13

Information Regarding Transfers To and Transactions and Relationships With Noncharitable
Exemot 0 raanizat1ons
No

in section 501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political
organizations?
a Transfers from the reporting foundation to a noncharitable exempt organization of:

(1) Cash

1a/1l

(2) Other assets

1a/2l

X
X

b Other transactions:

(1) Sales of assets to a noncharitable exempt organization .

1b(1)

(2) Purchases of assets from a noncharitable exempt organization .

1b(2)

(3) Rental of facilities, equipment, or other assets.

1b(3)

(4) Reimbursement arrangements .

1b(4)

(5) Loans or loan guarantees

1b(5)

(6) Performance of services or membership or fundraising solicitations

X
X
X
X
X
X
X

1b(6)

································

C Sharing of facilities, equipment, mailing lists, other assets, or paid employees.

1c

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 anv transaction or sharin~ arranqement, show in column (d) the value of the qoods, 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

2a Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations

D Yes

described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527?.

I!]

No

b If "Yes, compe
I te the f oIIowInq sc hedue.
I
(a) Name of organization

(b) Type of organization

(c) Description of relationship

N/A

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

Sign
Here

with the preparer shown below

(see instructions)?

~

I
Signature of officer or trustee
PrinVType preparers name

Paid
Preparer
Use Only

Date

~

D D

No

DIRECTOR
Title

Preparers signature

Date

Check

I!] if

self-employed

JACQUELYN JAMES VARGA
Firm's name ~
Firm's address ~

JACQUELYN JAMES VARGA

GOLUB, LACAPRA, WILSON & DETIBERIIS,
2 ROOSEVELTAVE
PRT JEFF STA, NY 11776-3337

LLP

11/15/17
PTIN
Firm's EIN ~
Phone no.

P00289558
11-3501980
631-331-0515
Form

DM

Yes

990-PF

(2016)

 3376 Mercer Family Foundation
20-1982204
FYE: 12/31/2016

11/15/2017 1:36 PM

Federal Statements

Statement 1 - Form 990-PF, Part I. Line 6a - Sale of Assets
Description
Date
Sale
Sold
Price
MEDALLION INVESMENTS
7,189,218
$
$
TOTAL $
7,189,218
$

How
Received
Cost

Whom
Sold

Expense
PURCHASE
$
0 $

Date
Acquin ~d
Net
Gain/ Loss

Depreciation

$
0 $

7,189,218
7,189,218

$
0 $

Statement 2 - Form 990-PF, Part I, Line 18 - Taxes
Description
Net
Investment

Total

Adjusted
Net

Charitable
Purpose

FEDERAL EXCISE TAX
1,264 $
-----1, 2 64 $

$

TOTAL

$

$

0 $

======

$

------

0 $

----0

======

Statement 3 - Form 990-PF. Part I. Line 23 - Other Expenses
Description
Net
Investment

Total

Adjusted
Net

Charitable
Purpose

$

$

$

$

$

25
25 $

0 $

0 $

EXPENSES
BANK CHARGES
TOTAL

0

Statement 4 - Form 990-PF. Part II. Line 10b - Corporate Stock Investments
Description
Beginning
of Year

End of
Year

Basis of
Valuation

34,508,082
34,508,082

MARKET

Fair Market
Value

MEDALLION INVESTMENTS
TOTAL

$
$

22,716,779
22,716,779

$
$

$
$

34,508,082
34,508,082

1-4

 3376 Mercer Family Foundation
20-1982204
FYE: 12/31/2016

11/15/2017 1:36 PM

Federal Statements

Statement 5 - Form 990-PF. Part II, Line 15 - Other Assets

Description
PREPAID FEDERAL EXCISE TAXES
TOTAL

Beginning
of Year
$
-----$

======

End of
Year
0

$
$

3,736
3,736

Fair Market
Value
$
$

-----======

3,736
3,736

Statement 6 - Form 990-PF. Part XV, Line 3a - Grants and Contributions Paid During the
Year

Name
Relationship

Status

Address
Purpose

Address
Amount

THE HEARTLAND INSTITUE
19 SO. LASALLE STE #903
CHICAGO IL 60603
NON PROFIT
DONATION
800,000
MUSEUM OF NATURAL HISTORY
CPW@ 79TH STREET
NEW YORK NY 10024
NON PROFIT
DONATION
625,000
MEDIA RESERACH CENTER
1900 CAMPUS COMMONSDRIVE RESTON VA 20191
NON PROFIT
DONATION
2,000,000
THE GEORGE W. BUSH FOUND.
PO BOX 600610
DALLAS TX 75360
NON PROFIT
DONATION
1,972,245
THE BARRY GOLDWATER INSTITUTE
500 E. CORONADOROAD
PHOENIX AZ 85004
NON PROFIT
DONATION
500,000
MANHATTANINST. FOR POLICY RESEARCH 52 VANDERBILT AVENUE
NEW YORK NY 10017
NON PROFIT
DONATION
300,000
FOUNDATION FOR CULTURAL REVIEWING
900 BROADWAY
NEW YORK NY 10003
NON PROFIT
DONATION
150,000
CHERISH FREEDOM FOUNDATION
1006 CAMERON STREET
ALEXANDRA VA 22314
NON PROFIT
DONATION
50,000
1200 NEW HAMPSHIRE AVE NW WASHINGTON DC 20036
THE BECKET FUND
NON PROFIT
DONATION
250,000
214 MASS AVE NW
HERITAGE FOUNDATION
WASHINGTON DC 20002
NON PROFIT
DONATION
500,000
575 GREENWICH STREET
MOVING PICTURES INSTITUTE
NEW YORK NY 10013
NON PROFIT
DONATION
800,000
3780 VERMONT 100A
THE CALVIN COOLIDGE FOUNDATION
PLYMOUTH VT 05056
NON PROFIT
DONATION
80,000
667 EAST BIG BEAVER ROAD TROY MI 48083
LAW ENFORCEMENT EDUCATION FUND
NON PROFIT
DONATION
204,837
PO BOX 1279
OISM
CAVE JUNCTION OR 97523
NON PROFIT
DONATION
200,000
GOVERNMENT ACCOUNTABILITY INSTITUTE TALLAHASSE
TALLAHASSEE FL 32301
NON PROFIT
DONATION
2,000,000
245 5TH AVENUE
CLASSROOM INC.
NEW YORK NY 10037
NON PROFIT
DONATION
40,000
1730 M STREET NW
THE PHILANTHROPY ROUNDTABLE
WASHINGTON DC 20036
NON PROFIT
DONATION
10,000
11480 COMMERCEPARK DRIVE RESTON VA 20191-1556
YOUNG AMERICA'S FOUNDATION
NON PROFIT
DONATION
100,000
100 MASSACHUSETTS AVE NW WASHINGTON DC 20001
CATO INSTITUTE
NON PROFIT
DONATION
300,000
KING'S COLLEGE
56 BROADWAY
NEW YORK NY 10004
NON PROFIT
DONATION
300,000
95 PINE STREET
SUCESS ACADEMY CHARTER SCHOOLS
NEW YORK NY 10005
NON PROFIT
DONATION
50,000

5-6

 3376 Mercer Family Foundation
20-1982204
FYE: 12/31/2016

11/15/2017 1:36PM

Federal Statements

Statement 6 - Form 990-PF, Part XV, Line 3a - Grants and Contributions Paid During the
Year {continued)

Name
Relationship
GATESTONE INSTITUTE

Status

Address
Purpose

750 3RD AVENUE
DONATION
NON PROFIT
RECLAIM NEW YORK INC
597 5TH AVENUE
DONATION
NON PROFIT
AMERICAN TRANSPARENCY
200 S. FRONTAGE ROAD
DONATION
NON PROFIT
CENTER FOR UNION FACTS
1090 VERMONT AVE NW
DONATION
NON PROFIT
PO BOX 1624
TEXAS FREEDOM NETWORK
DONTAION
NON PROFIT
JOB CREATORS ALLIANCE
FIVE CONCOURSE PARKWAY
DONATION
NON PROFIT
1800 DIAGONAL RD S-280
DONORS TRUST
NON PROFIT
DONATION
MATHEMATICAL SCIENCES RESEARCH INST UCLA-BERKELEY CAMPUS
NON PROFIT
DONATION
FED ENFOR HOMELANDSEC FOUNDATION
110 E 59TH STREET
NON PROFIT
DONATION
COMPACT FOR AMERICAN ED FD
2323 CLEAR LAKE CITY BLVD
NON PROFIT
DONATION
CTR FOR THE STUDY OF CARBON DIOXIDE 5219 S. RESEDA STREET
NON PROFIT
DONATION
THE AMERICAN CONSERVATIVE UNION
1331 HST NW
NON PROFIT
DONATION
CO2 COALITION
1621 NORTH KENT ST #603
NON PROFIT
DONATION
CLEVELAND 2016 HOST COMMITTEE INC.
334 EUCLID AVENUE
NON PROFIT
DONATION
LONDON CENTER FOR POLICY RESEARCH
10 WEST STREET
NON PROFIT
DONATION
THE FRICK COLLECTION
lE 70TH STREET
NON PROFIT
DONATION
THE FAMILY LEADER FOUNDATION
PO BOX 42245
NON PROFIT
DONATION
REV THE VOTE FOUNDATION, INC.
1209 ORANGE ST CORP TRUST
NON PROFIT
DONATION
THE ROCKEFELLER UNIVERSITY
1230 YORK AVENUE
NON PROFIT
DONATION
ALLIANCE FOR SCHOOL CHOICE
1020 19TH STREET NW
NON PROFIT
DONATION
WALKING WITH THE WOUNDED
20037 DOVE HILL ROAD
NON PROFIT
DONATION
THE LAND TRUST OF NAPA COUNTY
1700 SOSCOL AVENUE
NON PROFIT
DONATION
LINCOLN NETWORK
PO BOX 7 4 0 8 3 8
NON PROFIT
DONATION
TOTAL

Address
Amount
NEW YORK NY 10017-2703
100,000
NEW YORK NY 10017
1,600,000
BURR RIDGE IL 60527
250,000
WASHINGTON DC 20005-4961
250,000
AUSTIN TX 73301
5,000
ATLANTA GA 30328
100,000
ALEXANDRIA VA 22314
2,250,000
BERKELEY CA 94720
400,000
NEW YORK NY 10022
50,000
HOUSTON TX 77062
13,500
GILBERT AZ 85298-0587
125,000
WASHINGTON DC 20005
250,000
ARLINGTON VA 22209
150,000
CLEVELAND OH 44114
500,000
NY NY 10004
150,000
NEW YORK NY 10021
20,000
URBANDALE IA 50323
750,000
WILMINGTON DE 19801-0C00
500,000
NEW YORK NY 10065
10,000
WASHINGTON DC 20036
100,000
CULPEPER VA 22701
100,000
NAPA CA 94559
20,000
ATLANTA GA 30374-0838
100,000
19,025,582

6

 3376 11/15/2017 1:36 PM

Schedule B

0MB No. 1545-0047

Schedule of Contributors

(Form 990, 990-EZ,
or 990-PF)

...,.Attach to Form 990, Form 990-EZ, or Form 990-PF.

Department of the Treasury
Internal Revenue Service

...,. lnfonnation about Schedule B (Fonn 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

2016

Name of the organization

:MERCER FAMILY

Employer identification number

20-1982204

FOUNDATION

Organization type (check one):
Filers of:
Form 990 or 990-EZ

Form 990-PF

Section:
) (enter number) organization
D 501(c)(
D 4947(a)(1) nonexempt charitable trust not treated as a private foundation
D 527 political organization

~

501(c)(3) exempt private foundation

D 4947(a)(1) nonexempt charitable trust treated as a private foundation
D 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 990, 990-EZ, or 990-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

D For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33 /3 % support test of the
1

regulations under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part 11,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 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

D For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one
contributor, during the year, total contributions of i:nore 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, 11,and Ill.

D For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one
contributor, during the year, contributions exclusively for religious, charitable, etc., purposes, but no such
contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received
during the year for an exclusively religious, charitable, etc., purpose. Don't 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 isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer "No" on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on its
Form 990-PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions for Fonn 990, 990-EZ, or 990-PF.

DAA

Schedule B (Fonn 990, 990-EZ, or 990-PF) (2016)

 3376 11/15/2017 1:36 PM

PAGE 1 OF 1

Schedule B Form 990 990-EZ, or 990-PF 2016

Name of organization

MERCER FAMILY FOUNDATION
Part I

Pae 2

Employer identification number

20-1982204

Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.

(a)

(b)

(c)

(d)

No.

Name address and ZIP+ 4

Total contributions

TYPe of contribution

1

ROBERT MERCER
PO BOX 1507

~

Person
Payroll

.sii'om·:s'.Roo:k·

..... NY.ii7go·

$

. 2s~o.oo,()()()_

Noncash

(Complete Part II for
noncash contributions.)

(a)

(b)

(c)

(d)

No.

Name address and ZIP + 4

Total contributions

Type of contribution

§

Person
Payroll

$

Noncash

(Complete Part II for
noncash contributions.)
(a)

(b)

(c)

(d)

No.

Name, address, and ZIP + 4

Total contributions

TYPe of contribution

§

Person
Payroll

$

Noncash

(Complete Part II for
noncash contributions.)
(a)

(b)

(c)

(d)

No.

Name address and ZIP + 4

Total contributions

Type of contribution

§

Person
Payroll

$

Noncash

(Complete Part II for
noncash contributions.)
(a)

(b)

(c)

No.

Name address and ZIP + 4

Total contributions

(d)
Type of contribution

§

Person
Payroll

$

Noncash

(Complete Part II for
noncash contributions.)
(a)

(b)

(c)

(d)

No.

Name address and ZIP + 4

Total contributions

TYoe of contribution
Person
Payroll

$

Noncash

§

(Complete Part II for
noncash contributions.)
Schedule B (Form 990,990-EZ,or 990-PF)(2016)
DM

 3376 11/15/2017 1:36 PM

MERCER FAMILY FOUNDATION
Form

990-W

(Worksheet)
Departmentof the Treasury
Internal Revenue Sel\lice

20-1982204

FORM 990-PF

ESTIMATES

Estimated Tax on Unrelated Business Taxable
Income for Tax-Exempt Organizations

0MB No. 1545-0976

2017

(and on Investment Income for Private Foundations)
Keep for your records. Do not send to the Internal Revenue Service.

1

Unrelated business taxable income expected in the tax year .

2

Tax on the amount on line 1. See instructionsfor tax computation

2

3

Alternative minimum tax. See instructions

3

4

Total. Add lines 2 and 3

4

5

Estimated tax credits. See instructions

5

6

Subtract line 5 from line 4

6

7

Other taxes. See instructions

7

8

Total. Add lines 6 and 7

8

9

Credit for federal tax paid on fuels. See instructions .

9

10a

Subtract line 9 from line 8. Note: If less than $500, the organization is
not required to make estimated tax payments. Private foundations, see
instructions

b

10a

1,264

10b

1,264

Enter the tax shown on the 2016 return. See instructions. Caution: If
zero or the tax year was for less than 12 months, skip this line and
enter the amount from line 10a on line 10c

c

2017 Estimated Tax. Enter the smaller of line 10a or line 10b. If the organization is required to
skip line 1Ob, enter the amount from line 10a on line 10c
(a)

11

(b)

(c)

(d)

Installment due dates. See
instructions

12

1,264

10c

11

05/15/17

06/15/17

09/15/17

12/15/17

Required installments. Enter
25% of line 10c in columns (a)
through (d). But see instructions
if the organization uses the
annualized income installment
method, the adjusted seasonal
installment method, or is a "large
organization."

13

instructions

14

12

1,264

13

1,264

2016 Overpayment. See

Payment due (Subtract line 13
from line 12) .

14

For Paperwork Reduction Act Notice, see instructions.

DAA

Form

990-W

(2017)