29491237o?10?3 990-PF x . . OMB No 1545o052 Return of Private Foundation y or Section 4947(a)(1) Trust Treated as Private Foundation 201 7 Form > Do not enter social security numbers on this form as it may be made public. , 2017, and ending I > For calendar year 2017 or tax year beginning Employer identification number THOMAS' 6 6 - O7 8 9 6 97 Telephone number (see instructmns) 340-779-2564 O GRATITUDE AMERICA, LTD ROYAL PALM PROFES S IONAL BUILDING 9053 ESTATE THOMAS, SUITE 101 ST ' 00802 VI y Initial return of a former public charity # Amended return Name chan e i Initial return Final return Address chan e G Check all that apply' 9 9 here and attach computation I Fair market value of all assets at end of year Accounting method lCash D Other (SpeCIfY) -------------- F My Ana'YSis 0f Revenue and EXPENSES he total Of amounts In if private foundation status was terminated 3 2 e (a) Revenue and (b) Net investment (c) Adjusted net (d) Disbursements income income for charitable ITICZITI D expenses per books columns (b). c), and (d) may not necessarily equal the amounts in column (a) (see instructions) ) 1 I I] If the foundation is in a 50.month termination under section 507(b)(l)(B), check here (Part I, column (d) must be on cash baSlS ) 8, 863, 864 . @ I] >D under section 507(b)(1)(A). check here DAccrua'l 'K (from Part II' comm" (0' [me ,6) > 2 Foreign organizations meeting the 85% test, check A11 ( Check type of organization. Section 501(c)(3) exempt private foundation if D Section 4947(a)(l) nonexemp charitable trust HOther taxable private foundatio'n/ E J if exemption application is pending, check here D 1 Foreign organizations, check here H > $ Open to Public inspection 1 > Go to www.irs.gov/Fonn990PF for instructions and the latest information gtgfngngtggu'Qeslazfgw c Gross profit or (loss) (attach schedule) x 11 Other income (attach schedule) SEE STATEMENT 1 12 Total. Addlineslthroughll or "1 t 25) m<-l>I-Hn-2-ZU> mmmzmtxm 02> 02-H>Im?o R 13 Compensation of officers, directors, trustees, etc 14 Other employee salaries and wages 15 Pen5ion plans, employee benefits 10,820. 1,143,975. 0. SEE ST. 2 163 Legal lees (attach schedule). 10,820. 1,143,976. 0. 7 12 . 712 . 238,174. 238,174. 238,886, 238, 886. b Accounting lees (attach sch) c tithe professional lees (attach sch) 17 Interest . 18 Taxes (attach sdieduleXsee instrs). 19 DepreCIation (attach schedule) and depletion 20 Occupancy 21 Travel, conferences, and meetings 22 Printing and publications 23 Other expenses (attach schedule) 24 Total operating and administrative expenses. Add linesl3 througl'i23 . . . SEE STATEMENT 3 25 Contributions giftsgrantspmd 26 Total expenses and disbursements. Addline524and25 27 . HEART XV.1'250'000.1,260,000. . . . 1,4981886. 0. 0 1,498,886. 1 7 mi- V A W 7 w M24 Subtract line 26 from line 12; , 3 Excess oi revenue over expenses and disbursements. . -- - 3 54 , 9 l 0 . [3 Net investment income (il negative. enter -0-) c Adlusted net Income (ii negative. enter -0-) . 1 I [ . BAA For Paperwork Reduction Act Notice, see instructions. ET- I l 11 l 4 3 , 9 7 6 . WWII I, TEEAOSML 08/25/17 I Form 990-PF (2017) 6411 Form 990-PF (2017) GRATITUDE AMERICA, LTD 66-0789697 Attached schedules and amounts in the description Part "Balance Sheets 1 2 3 Beginning of year column should be for end-of--year amounts only (See instructions ) Cash - non-interest-bearing Savmgs and temporary cash investments Accounts receivable .. . > Less; allowance for doubtful accounts ' 4 Pledges receivable . . ' Less. allowance for doubtful accounts ' 6 Receivables due from officers, directors, trustees, and other (a) Book Value . Page 2 End of year (b) Book Value (c) Fair Market Value 4 , 459, 553 , 3,437,853. . 1 3,437,853. 1.-.- 3....-1 . -L .-. 3. -J Grants receivable disqualified persons (attach schedule) (see instructions) . (n-ti'ntntn) 7 Other notes and loans receivable (attach sch) . ' Less. allowance for doubtful accounts > 8 9 Inventories for sale or use Prepaid expenses and deferred charges 10a investments - U. S and state government obligations (attach schedule) b lnvestments- corporate stock (attach schedule) STATEMENT 4 . 4 , 805, 254 . 5,472,044. 5,426,011. 9, 264, 807 , 8,909,897. 8,863,864. c investments - corporate bonds (attach schedule) 11 investments - land, bUildings, and equment ba5is Less accumulated depreciation 100 M-IMMM) -ll'TIZ UHTICZ>F>W UZC'l'l mm-q-r-m>-r (attach schedule) . . > 12 13 investments - mortgage loans ---------investments - other (attach schedule) 14 Land, buildings, and equment basrs> 15 Lessz accumulated depreCIation (attach schedule) Other assets (describe > .. . * ) 16 Total assets (to be completed by all fiIErs see the instructions. Also, see page 1, item 1) 17 18 19 Accounts payable and accrued expenses . . Grants payable. Deferred revenue. 20 Loans from officers, directors, trustees, & other disqualified persons. 21 Mortgages and other notes payable (attach schedule) 22 Other liabilities (describe> 23 Total liabilities (add lines 17 through 22) .. Foundations that follow SFAS 117, check here and complete lines 24 through 26, and lines 30 and 31 . ) 24 Unrestricted.. . . 25 Temporarily restricted 26 Permanently restricted . . . 0, *3] . Foundations that do not follow SFAS 117,check here 9, 2644, 807, 8,909,897. 9 , 2 644, 807 , 8409,2397. 8,909,897. fl and complete lines 27 through 31. 27 Capital stock, trust principal, or current funds 28 Paid-in orcapital surplus, or land, bldg., and eqmpmentfund . 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) ... . 9, 264 , 807 . .. ' Em ill lAnalysis of Changes'in Net Assets or Fund Balances 0301th Total net assets or fund balances at beginning of year - Part ll, column (a), line 30 (must agree With end-of-year figure reported on prior year's return) BAA Enter amountfrom Partl,iine 27a.. Other increases not included in line 2 (itemize) Addlinesl,2,and3.. . .. . .... > . .. . .. . ..... Decreases not included in line 2 (itemize) .. > Total net assets or fund balances at end of year (line 4 minus line 5) - Part ll, column (b), line 30 TEEAOBOZL 08124! i 7 05015de 1 9L264,807. -354,910. 48,909,897. 8,909,897. Form 990-PF (2017) Form 990-131; (2017) GRATITUDE AMERICA, 66-0789697 LTD Page3 IEa'rtRLVQ'CSpital Gains andEsses for Tax on lnvestmentTcome (D) How acquired (a) List and describe the kind(s) of property sold (for example, real estate, 2--story brick warehouse, or common stock, 200 shares MLC Company) P - Purchase D - Donation (C) Date acquired (mo . day. yr) (d) Date sold (rho . day, yr) P 1a SEE ATTACHED b c d e (e) Gross sales price a b c d (f) De rec'ation allowed (6r al1owable) (9) Cost or other baSlS plus expense of sale 7,468,333. (h) Gain or loss ((e) plus (f) mis'ius (21)) 6,568,916. 899,417. e Complete only for assets showmg gain in column (h) and owned by the foundation on 12/31/69 (k) Excess of col (i) (j) Adiusted bass (i) FMV as of 12/31/69 over col (1), if any as of 12/31/69 (i) Gains (Col. (h) gain minus col (k), but not less than -0-) or Losses (from col (h)) a 899 , 417 . b c d e 2 Capital gain net income or (net capital loss). . . -[11%ST5'),aEgtSTSE 1'2 12211 II; [.123 g 14 3 Net short-term capital gain or (loss) as defined in sections 122(5) and (6). If gain, also enter in Part I, line 8, column (c) See instructions if (loss), enter O-- 2 899 417 , . 3 0, 1, in Part I line 8 [Bang/QT 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 Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period? D Yes No it 'Yes,' the foundation doesn't 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. (3a) (b CaleTiEls; pgglrogoygf ear beg/[mm In) (c Adjusted qualifymg distributions Y 2016 2015 2014 2013 2012 2 Total of line 1, column (d) DistribuTizan ratio (col (b) drvrded by col. (c)) 477,501. 122,434. 9,603,702. 2,465,270. . .. 2 0 . 099385 . 3 0 . 049693 4 9, 134, 556 . 5 Multiply line 4 by line 3 5 453, 923. 6 Enter 1% of net investment income (1% of Part I, line 27b) 6 11,440 , 7 465,363. 8 l , 498,886 . Average distribution ratio for the 5- ear base period- diVide the total on line 2 by 5 0, or by the number of years the foundation as been in eXIstence if less than 5 years 4 . .. 0.049721 0.049664 . 3 . ( Net va1ue of noncharitabIe-use assets Enter the net value of noncharitable-use assets for 2017 from Part X, line 5 7 Add lmesSand 6. ----- 8 Enter qualifying distributions from Part XII, line 4 If line 8 is equal to or greater than line 7, check the box in Part VI, line lb, and complete that part usmg a 1% tax rate See the Part VI instructions. BAA TEEA0303L 08/24/17 * Form 990-PF'(2017) Form 990-PF(2017) GRATITUDE AMERICA, [Part VI LTD 3 66-0789697 Page 4 'Excise Tax Based on Investment Income (Section 4940(a), 49400;), 4940(e), or 4948 - see instructions) 1 a Exempt operating foundations described In section 4940(d)(2), check here . > U and enter 'N/A' on line 1. Date of ruling or determination letter; (attach copy of letter if necessary - see instructions) b Domestic foundations that meet tie-$5630?) 719-40(e) requuements In Part V, nw+ 1---,Er-t-g.u' . 1 1 1, 440 . check here. > land enter 1% of Part I, line 27b l c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part1, line 12, cal (b). 2 e - - ..E.m.m-m-..m-w Tax under section 511 (domestic section 4947(a)(l) trusts and taxable foundations only, others, enter --0-) 2 0. 3 Add linesl and2 3 11,440. 4 4 0. 5 11 I 440 . Subtitle A (Income) tax (domestic section 4947(a)(1) trusts and taxable foundations only, others, enter -0-) 5 Tax based on investment"Income. Subtract line 4 from line 3. If zero or less, enter -06 Credits/Payments a 2017 estimated tax prnts and 2016 overpayment credited to 2017 b Exempt foreign organizations - tax Withheld at source . . . . .. . . c Tax paid With application for extenSIon of time to file (Form 8868) d Backup withholding erroneously Withheld . . 7 Total credits and payments Add lines 6a through 6d 8 Enter any penalty for underpayment of estimated tax Check here . ; 6a 6b i Se 20 , 000 . . 6d . . . . . If Form 2220 is attached 9 Tax due. If the total of lines 5 and 8 Is more than line 7, enter amount owed . . . 10 Overpayment lf line 7 is more than the total of lines 5 and 8, enter the amount overpaid 11 Enter the amount of line IO to be' Credited to 2018 estimated tax . 5 . . . 8 , 4 80 i V, -- * W 7 8 . "a y a 20 000 80 . T 9 10 . T 11 . Refunded 0. 8 , 4 80 . O. [Part VII-A lStatements Regarding Activities 1 a During the tax year, did the foundation attempt to Influenceany national, state, or local legislation or did it partICIpate or intervene In any political campaign? . . . Yes No X b Did It spend more than $100 during the year (either directly or indirectly)for political purposes? See the Instructions for the definition . X It 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 My "a N m-y 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 > $ 0 . (2) On foundation managers >$ X 0 l e Enter the reimbursement (If any) pamng the year for political expenditure tax ImposWGfoundation managers 2 . b $ 0 , i l ".4- W - 4 Has the foundation engaged In any actIVItIes that have not preVIously been reported to the IRS?. X If 'Yes,' attach a detailed description of the actIVItIes. 3 L Has the foundation made any change5, not preVIously reported to the IRS, in its governing instrument, articles "s of Incorporation, or bylaws, or at er Similar Instruments? If 'Yes,' attach a conformed copy of the changes 43 Did the foundation have unrelated busmess gross Income of $1,000 or more during the year?. b If 'Yesf has It filed a tax return on Form 990-T for this year? 5 Was there a IIqUIdation, termination, dissolution, or substantial contraction during the year? it 'Yes,' attach the statement requned by General Instruction T. 6 Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either; 0 By language in the governing instrument, or X X N A X 0 By state legislation that effectively amends the governing Instrument so that no mandatory directions that conflict With the state law remain In the governing Instrument? . .. 7 A 5 , y 3 I, i i I.. X - -j 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 8a Enter the states to which the foundation reports or With which it Is registered. See Instructions . "HQ X . > , 1 NY 1 b If the answer Is 'Yes' to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney General as (or deSIgnate) of each state as required by General Instniction 6.7 If 'No,' attach explanation. 9 10 ,1 Ed. - -..J X Is the foundation claiming status as a private operating foundation Within the meaning of section 494206? or 4942(1)(5) --- .W -s -45 A for calendar year 2017 or the tax year beginning in 2017? See the Instructions for Part XIV If 'Yes' comp ete Part XIV X /j/ Did any persons become substantial contributorsduring the tax year?If 'Yes.' attach a schedule listing their names and addresses . . . .. BAA TEEAO304L 08/24J17 J .. 10 X Form 990-PF (2017) Form 990-PF(2017) GRATITUDE AMERICA, LTD 66-0789697 P3965 [Part VII-A IStatements Regarding Activities (continued) Yes 11 No At any time during the year, did the foundation, directly or Indirectly, own a controlled entity Within the meaning of section 512(b)(13)? If 'Yes,' attach schedule See Instructions 12 Did the foundation make a distribution to a donor adVIsed fund over which the foundation or a disqualified person had adVIsory prIVIleges? If Yes, attach statement See Instructions 13 Did the foundation comply With the public Inspection requirements for Its annual returns and exemption application? WebSIte address . T N/A 340- Telephone no. > 14 The books are in care of > ERIKA KELLERHALS Located at r .9953. semi; sages-systems-.S.T.1H.OMS.YL-. ZIP +4 * 998.02-Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF In lieu of Form 1041 - check here 15 and enter the amount of tax-exempt Interest received or accrued during the year . . . . . >I 15 I 16 At any time during calendar year 2017, did the foundation have an Interest In or a Signature or other authority over a bank, securities, or other finanCIal account In a foreign country. 16 X See the Instructions for exceptions and filing requuements for FInCEN Form 114 If 'Yes,' enter the name of the foreign country > [Tran VII-B WStatements Regarding Activities for Which Form 4720 May Be Required Yes File Form 4720 if any item is checked in the 'Yes' column, unless an exception applies. 1 a During the year, did the foundation (either directly or Indirectly) (1) Engage in the sale or exchange, or Ieasmg of property With a disqualified person? . DYes No Yes No Yes Yes No No DYes No ['Yes .No No (2) Borrow money from, lend money to, or othermse extend credit to (or accept It from).a disqualified person7.. . (3) Furnish goods, serwces, or faculties 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)? . (6) Agree to pay money or property to a overnment offICIal? (Exception. Check 'No' If the foundation agreed to make a grant to or o emplo the offICIal for a period after termination of government serVIce, If terminating Within 9 days.) . .. . . b If any answer Is 'Yes' to 1a(1)-36), did any of the acts fail to qualify under the exceptions described In Regulations section 53.4941 (d) or In a current notice regarding disaster aSSIstance? See instructions Organizations relying on a current notice regarding disaster aSSIstance, check here . > D c Did the foundation engage in a grior year in ang of the acts described In la, other than excepted acts, that were not corrected before t e first day of t e tax year beginning In 20177. , X Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private operating foundation defined In section 4942(1)(3) or 4942(1)(5)). a At the end of tax year 2017, did the foundation have any undistributed income (lines 6d and 6e, Part Xlll) for tax year(s) beginning before 2017 . . . . .. . .. . 20 , 20 , 20 DYes .No , 20 .m If 'Yes,' list the years > b Are there any years listed In 2a for which the foundation is not applying the prOVIsIons of section 4942(a)(2) (relating to incorrect valuation of assets) to the year's undistributed income? (If applying section 4942(a)(2) to all years listed, answer 'No' and attach statement - see instructions) . c If the prOVISIons of section 4942(a)(2) are being applied to any of the years listedin 2a, list the years here , 20 2b N/A , 20 3a Did the foundation hold more than a 2% direct or Indirect Interest In any business enterprise at any time during the year. . .. . . . , 20 EA- - A.-s..i ,-.. .04 542.11 . > 20 #7 2 1c . . D Yes b If 'Yes,' did It have excess busmess holdings In 2017 as a result of (1) any purchase by the foundation or disqualified persons after Ma 26,1969, the lapse of the Sgear period (or longer period approved by the Commissmner under sec Ion 4943(c) ) to dispose of hol Ings achIred 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 busmess holdings in 2017. ) 4a Did the foundation invest duringtheyear anyamount in a manner that would jeopardizeIts charitable purposes?. . . . . b Did the foundation make any investment in a prior year (but after December 31,1969) that could jeopardize Its charitable purgose'r that had not been removed from Hieopardy before the first day of the tax year beginning in . No , ,. M5" -,. ..- Hi." .MD 313 N/A 43 X 4b x Form 990-PF (2017) BAA TEEAO305L 08/2441 7 Form 990-PF (2017) GRATITUDE AMERICA, LTD 66 -0789697 Page 6 [Part VII-ET Statements Regarding retivitieyor Which Form 4720 May Be Required (continued) 5 a During the year, dId the foundation pay or Incur any amount to; (1) Carry on propaganda, or otherWIse attempt to Influence legislation (section 4945(e))7 . . . . (2) Influence the outcome of any speCIfIc public election (see section 4955), or to carry on, directly or Indirectly. any voter registration drive7 (3) Prowde a grant to an indIVIdual for travel, study, or other Similar purposes7. No . Yes b .t 5Q , No . [I Yes Yes Yes No 3 I of ., a , w (it No 3;, k (4) Prowde a grant to an organization other than a charitable, etc.organization described In section 4945(d)(4)(A)? See instructions No (5) Provide for any purpose other than religious, charitable, soientific, literary, or educational purposes, or for the prevention of cruelty to children or animals?. No b If any answer is 'Yes' to 5a(1)- $5), did any of the transactions fail to qualify under the exceptions described In Regulations section 5 4945 or in a current notice regarding disaster aSSIStance? See Instructions Organizations relying on acurrent notice regarding disaster aSSIstance, check here. c If the answer Is 'Yes' to question 5a(4), does the foundation claim exemptionfrom the tax because It maintained expenditure responSIbIlIty for the grant? If 'Yes,' attach the statement requued by Regulations section 53 4945-5(d). T . *3 33; .21; f f - >n A N/A DYes END 6a Did the foundation, during the ear, receive any funds, directly or Indirectly, to pay premiums on a personal benefit contract DYes' I No b Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? If 'Yes' to 6b, file Form 8870. . 4 2 7 7a At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction? DYes b If ',Yes' did the foundation receive any proceeds or have any net income attributable to the transaction? 6b No 7b N/A Part VIII [Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees, and Contractors 1 List all officers, directors, trustees, and foundation managers and their compensation. See instructions. (b) Title, and average (C) Compensation (d) Contributions to (e) Expense account, (a) Name and address dew/gig? $653335] (lefnrtgt Etta-3d, pegglgylejedtgefgtrarfeitd other allowances compensation .RchAR-D 39.511 gggggggggggggg PRESIDENT o. o. o. o. o. o. o. 0. 0. o. o. o. .535 .LEKLNEIQN. AYE -4.T.H.ELQQE - - 1 . 00 NEW YORK, NY 10022 ngtBREy-K." mono; ----------- VICE PRESIDE .515 .LEXTNEIQN. AYE -slit.P1093 - - 1 . 00 NEW YORK, NY 10022 3.1239; A; REELERH-Atg ggggggggg SECRETARY 9.0g3. asTATE .1389th so;T.E. ; 91. - 1 . 00 ST . THOMAS, VT 00802 jgygA. A; EggLERH-Ags --------- TREASURER 9053 ESTATE THOMASL SUITE 101 l . 00 ST. THOMAS, VI 00802 2 Compensation of five highest-paid employees (other than those included on line 1 - see instructions). If none, enter 'NONE.' (d)Contributions to (b) Title, and average (a) Name and address of each employee (e) Expense account, employee benefit hours per week (c) Compensation paid more than $50,000 other allowances plans and deferred devoted to pOSitlon compensation Total number of other employees paid over $50,000 BAA P TEEA0306L 08/2441 7 0 Form 990-PF (2017) Form 990ePF (2017) GRATITUDE AMERICA, LTD 66-0789697 Page7 Part VIII ' llnformation About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees, and Contractors (continued) 3 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 EQNEJ................................... ..................................... 7 Total number of others receivmg over $50,000 for professnonal servrces .. . . . . . . > 0 Part IX-A Summary of Direct Charitable Activities List the foundation's four largest direct charitable actIVIties during the tax year. Include relevant statistical Information such as the number of Expenses organizations and other benefioaries served, conferences convened, research papers produced, etc. 1 MIL ................................................... 2 ----------------------------------------------------- 3 ------------------------------------------------------ 4 ------------------------------------------------------ lPart IX-B lSummaryof Program-Related Investments (see instructions) Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount 1 LILA- ................................................... 2 ----------------------------------------------------- All other program-related investments. See instructions 3 ------------------------------------------------------ TotaI.Addlinesithrough3... . . . . . . . BAA . . .. . . > 0. Form 990-PF (20I7) TEEAO307L 08/24] I 7 66-0789697 Page8 LTD Pa'H2XvslfMinimum Investment Return (AII domestic foundations must complete this part. Foreign foundations, see Instructions.) Form 990-PF(2017) GRATITUDE AMERICA, 1 2212 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. . b Average of monthly cash balances 13 1b C Fair market value of all other assets (see instructions) 1c dTotal (add lines Ia b, and c) 1d 5,208,163. 4,065,498. 9,273,661. w e Reduction claimed for blockage or other factors reportedon lines Ia and to (attach detailed explanation) . . AchISItion indebtedness applicable to line I assets Subtract line 2 from line 1d 4 Cash deemed held for charitable actIVIties Enter I-I/2% of line 3 5 Net value of noncharitable--use assets. Subtract line 4 from line 3 Enter here andon Part V, line 4 6 Minimum investment return. Enter 5% of line 5 2 (for greater amount, see Instructions) . 1e 0. 9,273,661. 4 5 6 . 139,105. 9,134,556. 456, 728. 9.5mm; Distributable Amount (see instructions) (Section 4942(1)(3) and (5)(5) private operating foundations and certain foreign organizations, check here> Band do not complete this part.) 1 Minimum investment return from Part X, line 6 456,728. 2a Tax on investment income for 2017 from Part VI, line 5 ..... b Income tax for 2017. (This does not include the tax from Part VI ) . . c Add lines 2a and 2b . 3 Distributable amount before adjustments. Subtract line 2c from line I 4 Recoveries of amounts treated as qualifying distributions . . 5 6 7 23 11 , 440 . 2b 11,440. 445,288. 445,288. Add lines 3 and 4 Deduction from distributable amount (see instructions) Distributable amount as adjusted Subtract line 6 from line 5 Enter here andon Part XIII, line 1 445,288. 3 Amounts set ads for speCific charitable proiects that satisfy the' a SUItability test (prior IRS approval reqmred). b Cash distribution test (attach the reqUIred schedule). 4 Qualifying distributions. Add lines Ia through 3b. Enter here and on Part V, line 8, and Part XIII, line 4 Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment income Enter 1% of Part I, line 27b. See instructions . 6 1,498,886. gl b Program--related investments - total from Part IX-8 2 Amounts paid to achIre assets used (or held for use) directly in carrying out charitable, etc. ,purposes N-l-l all) Amounts paid (including administrative expenses) to accomplish charitable, etc, purposes a Expenses, contributions, gifts, etc. - total from Part I, column (d), line 26 . . . . boom U'nl 1 E5 -'%Xlli,.a Qualifying Distributions (see instructions) Adjusted qualifying distributions. Subtract line 5 from line 4 1,498,886. 11, 440. 1,487,446. 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 BAA Form 990-PF (201 7) TEEADBOEL 09] I 2!] 7 Page9 66-0789697 (see instructions) Undistributed Income (6) (b) 2017 Years prior to 2016 445,288. Part XI, ount for 2017 from . 1 Distributable am . . line 7 end of 2017; ome, if any, as of the 2 Undistributed inc y onl 2016 a Enter amount for #20 ..J 20 #, 20 rs; yea or pri bTotaI for 7; 201 to , any if , s carryover 3 Excess distribution . 12 20 a From b From 2013 , c From 2014 . dFrom 2015 . . . 16 20 9 From . rough e . th 3a es lin f Total of Part om fr 17 20 for s tribution 4 Qualifying dis 1,498,886, XII,Iine4; P an Iine 2a , but not more th a Applied to 2016 prior years ributed income of b Applied to undistd - see instructions) (Election requue us butions out of corp . . c Treated as distri see instructions) ed uir req ion (Elect 445,288. tributable amount d Applied to 2017 dis t of corpus. ount distributed ou 0. e Remaining am 6 . 2017 carryover applied to the Excess distributions , (d) mn lu co in ars (If an amount appe be shown in column (a) ) same amount must Enter the net total indicated below; of each column as ct Iine 5 3f, 4c, and 4e Subtra a Corpus. Add lines . . Subtract istributed income . b Prior years' und e 2b. . Iine4 from lin uted rib ist und nt of prior years' c Enter the amou h a notice of defICienc has income for whic tion 942(a) on which the sec . been issued, or ed . . ss se as y usl vio tax has been pre ble from line 6b. Taxa d Subtract line 6c tructions . . . . . amount - see ins e 4a from for 2016. Subtract lin e Undistributed incomeunt - see instructions .. . .. line 2a Taxable amo btract Iines come for 2017. Su must be nt t Undistributed in ou am s Thi 1 e . . .. 4d and 5 from lin . distributed in 2018 of out s d as distribution 7 Amounts treatey reqmrements imposed by corpus to satisf ) (Election )d(F) or 4942(g)(3 section 170(b)( ctions) tru ins e se e may be reqUIr from 2012 not butions carryover 8 Excess distri e 5 or line (see instructions). applied on lin to 2018. butions carryover 9 Excess distri 7 and 8 from [me Be Subtract lines line 9' 10 Analysis of . . a Excess from 2013 14 20 b Excess from .. c Excess from 2015 .. 16 20 d Excess from 1 , 053, 598. . 7 201 e Excess from II I . I. I 5 BAA 17 TEEA0309L OBIZ4l Form 990-PF (2017) GRATITUDE AMERICA, LTD 66-0 789697 ITDart'v)(IV We] Private Operating Foundations (see instructions and Part VII-A, question 9) Page 10 N/A 1 a If the foundation has received a ruling or determination letter that it is a private operating foundation, and the ruling is effective for 2017, enter the date of the ruling . h b Check box to indicate whether the foundation is a private operating foundation described in section [I 4942(j)(3) or I I 4942(1)(5) // 23 Enter the lesser of the adjusted net Tax year Prior 3 years (8) Total/ income from Part I or the minimum (a) 2017 (b) 2016 (c) 2015 (d) 2014 / investment return from Part X for each year listed . . / / b85% of line 2a c Qualifying distributions from Part XII, line 4 for each year listed / d Amounts included in line 2c not used directly / for active conduct of exempt actiwties e Qualifying distributions made directly for active conduct of exem t actiwties Subtract line 2d from line 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)(l) b E'ndowment' 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) Suppmt from general public and 5 or / / more exempt organizations as prowded in section 4942(I)(3)(B)(lll). (3) Largest amount of support from an exempt organization . (4) Gross investment income /'/ PartEXV X173] Supplementary Information (Complete this part only if the foundation had $5,000 or more in assets at any time during the year - see instructions.) 1 lnforrnation Regarding Foundation'Managers. a List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation before the close of any tax year (but only if they have contributed more than $5. 000). (See section 507(d)(2) ) NONE 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 NONE 2 lnforrnation Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs; Check here * I if the foundation only makes contributions to preselected charitable organizations and does not accept unsoIICIted requests for funds. If the foundation makes gifts, grants, etc. to indIVIduaIs or organizations under other conditions, complete Items 2a, b, c, andd See instructions a The name, address, and telephone number or email address of the person to whom applications should be addressed; 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 factors; BAA TEEAO3IOL 09I14Ji7 Form 990-PF (2017) Form 990-PF (2017) GRATITUDE AMERICA, LTD 66-0789697 Page 11 @mxyj Supplementary Information (continued) 3 Grants and Contributions Paid During the Year or Approved for Future Payment If recipient is an indiVidual, F Reelpient show any relationship to d t gtlartus '0?" any foundation manager Name and address (home or busmess) i I Purpose of grant or t or substantial contributor Amount contribution reCIpien a Paid during the year SEE STATEMENT 5 I I I I I Total. . .. .. .. . . .. . . . .. .. . .* 33 1,260,000. b Approved for future payment I Total BAA .. . . . .. . . TEEAOSOIL 03/24ii7 P 3b Form sell-PF (2017) Form 990-PF (2017) 66-0789697 GRATITUDE AMERICA, LTD Page 12 lid XVI-AgIAnstis of Income-Producing Activities Enter gross amounts unless othermse indicated. Unrelated busmess income I Program sewice revenue. 1 Excluded by section 512, 513, or 514 (a) (b) (C) (d) Relatedga exempt Busmess code Amount Exclu5'0" code Amount function income (See instructions) a b c d e f g Fees and contracts from government agenCIes 2 Membership dues and assessments 3 4 Interest on savmgs and temporary cash investments DiVidends and interest from securities 5 14 14 Net rental income or (loss) from real estate; ' . .. ' 3* far . i W 14 4 I 578 . 89, 161 . ' " . N 5 r r 5 a Debt-financed property b Not debt-financed property 6 Net rental income or (loss) from personal property 7 Other investment income 8 Gem or (loss) from sales of assets other than inventory 9 10 11 14 18 Net income or (loss) from speCIal events Gross profit or (loss) from sales of inventory Other revenue; - f 10 I 820 . 3 99 I 417 I a5 .. . ' a b c d e 12 Subtotal Add columns (b), (d), and (e) f5. .. t . 13 Total. Add line 12, columns (b), (d), and (e) (See worksheet in line 13 instructions to verify calculations.) art Line No. BAA on o to e c l, 143 I 976. 13 1 143 976 I ment 0 Explain below how each actIVI 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 prowding funds for such purposes). (See instructions.) TEEAOSOZL 08124417 Form BEELQK- Form 990-PF(2017) 66-0789697 GRATITUDE AMERICA, LTD Page 13 IPart XVII' Ilnformation Regarding Transfers to and Transactions and Relationships With Noncharitable Exempt Organizations Yes 1 No Did the organization directly or indirectly engage in any of the followmg With any other organization described In section 501 (c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations? I a Transfers from the reporting foundation to a noncharitable exempt organIzatIon of; 13(1) 1a(2) (1) Cash (2) Other assets b Other transactions; (1) (2) (3) (4) L Sales of assets to a noncharitable exempt organization . Purchases of assets from a noncharitable exempt organization Rental of faculties, eqUipment, or other assets Reimbursement arrangements. (5) Loans or loan guarantees . . .. . (6) Performance of serwces or membership or fundraismg soliatations c Sharing of faCIIities, equment, mailing lists, other assets, or paid employees X X WWI 1b0) 113(2) 1b(3) 113(4) X X X X 1b(5) X 1b(6) X 1c X d If the answer to any of the above is 'Yes,' complete the followmg schedule. Column (b) should alwa 5 show the fair market value of the goods, other assets, or sewices given by the reporting foundation. If the foundation received less than air market value in transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or sewices received. (a) Line no. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements N/A 23 Is the foundation directly or indirectly affiliated With, or related to, one or more tax-exempt organizations .. EIYes described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527? b If 'Yes,' complete the followmg schedule. (a) Name of organization (b) Type of organization (c) Description of relationship .No N/A A I . Under penalties I er ury, I declare that I have correct. and co pI Declaration of preparer ( Sign Here mined this return, including accompanying schedules and statements, and to the best of my knowledge and belief. It is true, er than taxpayer) is based on all information of which preparer has any knowledge 1 a 3 Z / A4 f Signature otm'hcer or trustee Print/Type preparer's name Paid DAVID M . Preparer Use Only Fi'm'sname 7 Flrm'saddress F HASSON a I 5 May the IRS discuss this returnIIivith tlgeI 7 1 Date I / 1 III"? Prewgkgaty DA . preparer s own e ow See i uctions PRESIDENT X Yes Check LI II 0&2 WgReIf-employed SECKENDORF HASSON AND REILLY CPA'S LZC / 3000 MARCUS AVE STE 1W5 LAKE SUCCESS, NY 11042-1009 I INo PTIN P0003522 8 Firm'sE'N * 90-0436485 Phoneno 5164888400 Form 990-PF (2017) BAA TEEA0503L 0824117 2017 ' CLIENT GRATITUD FEDERAL STATEMENTS PAGE 1 GRATITUDE AMERICA, LTD ROYAL PALM PROFESSIONAL BUILDING 66-0789697 8/01/18 05202PM STATEMENT 1 FORM 990-PF, PART I, LINE 11 OTHER INCOME (A) (B) NET (C) REVENUE INVESTMENT ADJUSTED ML M W OTHER INVESTMENT INCOME . .. $ TOTAL $ 10, 820. $ 104820. $ 10, 820. 10,820. 0. STATEMENT 2 FORM 990-PF, PART I, LINE 16A LEGAL FEES LEGAL FEES . .. $ TOTAL $ (A) (B) NET (C) (D) EXPENSES PER BOOKS INVESTMENT INCOME ADJUSTED NET INCOME CHARITABLE PURPOSES 712. 712. $ $ 0. $ 0. $ 712. 712. STATEMENT 3 FORM 990-PF, PART I, LINE 23 OTHER EXPENSES (A) EXPENSES PER BOOKS CONSULTING EXPENSE FEDERAL EXCISE TAX MISCELLANEOUS FEES. . STATE FILING FEES . $ . TOTAL $ (B) NET INVESTMENT INCOME 235, 000. 2, 451. 473. 250. 238, 174. $ (C) ADJUSTED NET INCOME (D) CHARITABLE PURPOSES $ 0. $ 0. $ 235, 000 . 2,451. 473. 250. 238,174. STATEMENT 4 FORM 990-PF, PART II, LINE 103 INVESTMENTS - CORPORATE STOCKS CORPORATE STOCKS PUBLICLY TRADED STOCKS VALUATION METHOD COST BOOK VALUE s L 472, 044 . $ TOTAL $ 5,472,044. $ FAIR MARKET VALUE 5, 4&011. 5,426,011. 2017 ' CLIENT GRATITUD FEDERAL STATEMENTS PAGE 2 GRATITUDE AMERICA, LTD ROYAL PALM PROFESSIONAL BUILDING 66-0789697 8/01/18 05'02PM STATEMENTS FORM 990-PF, PART XV, LINE 3A RECIPIENT PAID DURING THE YEAR NAME AND ADDRESS DONEE RELATIONSHIP FOUNDATION STATUS PURPOSE OF GRANT AMOUNT 5 50,000. BRUCE & MARSHA MOSKOWITZ FOUNDATION 223 SUNSET AVE., SUITE 200 PALM BEACH FL 33480 NONE 501 C 3 GENERAL CHARITABLE PURPOSES CROHN'S COLITIS FOUNDATION OF AMERICA 120 BROADWAY NEW YORK NY 10271 NONE 501 C 3 GENERAL CHARITABLE PURPOSES 10,000. ASSOCIATION MIND EDUCATION ROME ITALY NONE 501 C3 GENERAL CHARITABLE PURPOSES 60,000. CANCER RESEARCH WELLNESS INSTITUTE 316 MD VALLEY CENTER NO 230 CARMEL CA 93922 501 C 3 GENERAL CHARITABLE PURPOSES 75,000. CHOPRA FOUNDATION 2013 COSTA DEL MAR RD CARLBAD CA 92009 501 C 3 GENERAL CHARITABLE PURPOSES 50,000. FRIENDS OF ELTON JOHN 1 BLYTHE RD LONDON UNITED KINGDOM 501 C 3 GENERAL CHARITABLE PURPOSES 15,000. INDEPENDENT FEATURE PROJECT 30 JOHN ST BROOKLYN NY 11201 501 C 3 GENERAL CHARITABLE PURPOSES 10,000. INTERNATIONAL PEACE INSTITUTE INC 777 UNITED NATIONS PLAZA, 4TH FLOOR NEW YORK NY 10017 501 C 3 GENERAL CHARITABLE PURPOSES 375,000. JTCC 5200 PAINT BRANCH PARKWAY COLLEGE PARK MD 20740 501 C 3 GENERAL CHARITABLE PURPOSES 25,000. KUHN FOUNDATION 357 WAVERLY DR PASADENA CA 91105 501 C 3 GENERAL CHARITABLE PURPOSES 150,000. MET ORCHESTRA MUSICIAN PO BOX 230549 501 C 3 GENERAL CHARITABLE PURPOSES 50,000. MIT 600 MEMORIAL DR W98-308 CAMBRIDGE MA 02139 501 C 3 GENERAL CHARITABLE PURPOSES 150,000. 2017 ' CLIENT GRATITUD FEDERAL STATEMENTS GRATITUDE AMERICA, LTD ROYAL PALM PROFESSIONAL BUILDING PAGE 3 66-0789697 8/01/18 05;02PM STATEMENTSICONHNUED) FORM 990-PF, PART xv, LINE 3A RECIPIENT PAID DURING THE YEAR NAME AND ADDRESS NAUTILUS THINK INC 360 W. 36TH ST 78 NEW YORK NY 10018 DONEE RELATIONSHIP FOUNDATION STATUS 501 C 3 PURPOSE OF GRANT GENERAL CHARITABLE PURPOSES 3 AUWOUNT 25,000. THE FILM SOCIETY OF LINCOLN CENTER 7o LINCOLN CENTER PLAZA,4TH FLOOR NEW YORK NY 10023 501 C 3 GENERAL CHARITABLE PURPOSES 25,000. THE INTER POLICE & FIRE CHAPLAINS Assoc. 9393 PARDEE RD TAYLOR MI 48180 501 C 3 GENERAL CHARITABLE PURPOSES 50,000. THE LEUKEMIA & LYMPHOMA SOCIETY 3 INTERNATIONAL DR RYE BROOK NY 10573 501 C 3 GENERAL CHARITABLE PURPOSES 5,000. THE O'GORMAN GARDEN 23 WEST 129TH STREET NEW YORK NY 10027 501 C 3 GENERAL CHARITABLE PURPOSES 30,000. UJA FEDERATION OF NEW YORK DIVISION SUITES 296 130 E. 59TH ST NEW YORK NY 10002 501 c 3 GENERAL CHARITABLE PURPOSES 50,000. UNIVERSITY OF ARIZONA FOUNDATION 1609 NORTH WARREN, SUITE 105B TUCSON AZ 85724 501 C 3 GENERAL CHARITABLE PURPOSES 50,000. WALK MS 167 DEEPDALE DR MIDDLETOWN NJ 07748 501 C 3 GENERAL CHARITABLE PURPOSES 5,000. TOTAL 37'1j26070007 Gratitude America, LTD Part IV CapitaI Gain and Losses for Tax on Investment Income (b) How (c) Date Acquired Acquired (e) Date Sold Name 5,000 000 APPIAN CORPORATION CL A 1,000 000 AQUANTIA CORP 5,000 000 ARDMORE SHIPPING CORPORATION 10,000 000 AT&T INC 5 350 11-01-66 5,000 000 ATENTO S A 1,000 000 BANDWIDTH INC CL A 5,000 000 BRUNSWICK CORP 1,000 000 CASA SYSTEMS INC 1,000 000 CATALENT INC 1,000 000 DENALI THERAPEUTICS INC 1,000 000 DESPEGAR COM CORP 5,000 000 EDITAS MEDICINE INC 2,000 000 FORESCOUT TECHNOLOGIES INC 500 000 FOUR SEASONS ED CAYMAN INC ADR 1,000 000 GODADDY INC CL A 1,000 000 GW PHARMACEUTICAE PLC ADR 5,000 000 HOULIHAN LOKEY INC CL A 2,500 000 IQVIA HOLDINGS INC 5,000 000 JAMES RIV GROUP HLDGS LTD 5,000 000 JIANPU TECHNLGY INC A 1,000 000 MONGODB INC CL A 1,000 000 NABRIVA THERAPEUTICS AG 1,000 000 NEXA RESOURCES SA 2,000 000 NORWEGIAN CRUISE LINE HOLDINGS 1,000 000 OM ASSET MANAGEMENT PLC 5,000 000 ONEMAIN HLDGS INC 5,000 000 ORION ENGINEERED CARBONS S A 5,000 000 ORION ENGINEERED CARBONS S A 5,000 000 PATTERN ENERGY GROUP INC CL A 5,000 000 PO GROUP HOLDINGS INC 2,500 000 QUDIAN INC ADR 2,500 000 QUDIAN INC ADR 1,000 000 REV GROUP, INC 1,000 000 RHYTHM PHARMACEUTICALS INC 500 000 RISE EDUCATION CAYMAN LTD 1,000 000 ROKU INC COM CL A 500 000 RYB EDUCATION INC 5,000 000 SAILPOINT TECHNOLOGIES HOLDING 250 000 SEA LIMITED ADR 250 000 SEA LIMITED ADR 2,500 000 SENDGRID INC 2,500 000 SENDGRID INC 10,000 000 SPIRIT REALTY CAP 6 000 12-31-19 500 000 TRIBUNE MEDIA COMPANY CLASS A 10,000 000 TWO HARBORS INVSTMNT C 7 2599C 1,000 000 US FOODS HOLDING CORP 1,150 000 ZTO EXPRESS 3,200 000 EDITAS MEDICINE INC 25,000 000 TENCENT HLDGS LTD UNSPON ADR 12,500,000 TENCENT HLDGS LTD UNSPON ADR 1,000,000 000 WESTERN DIGITAL C 7 3/8 4-01-23 100,000 000 WESTERN DIGITAL C 7 3/3 4-01-23 Total Vntv'V'U'V'U'D'DV'U'D'0'D'D'O'U'D'D'D'U'D'U'O'U'O'DCDVPO'D'D'U'OV'V'D'D'D'U'U'DRO'D'U'D'OTVVV Quantity 11/16/2017 11/3/2017 1112812017 1012512017 1111012017 1111012017 9111/2017 1211512017 9/27/2017 12/8/2017 9120/2017 1215/2017 1012712017 1118/2017 1214/2017 1217/2017 1012512017 1112812017 111812017 11/16/2017 1011912017 9120/2017 1012712017 1111512017 11/15/2017 1211312017 1214/2017 1117/2017 1011812017 912912017 1011812017 1011812017 1011312017 101512017 1012012017 9128/2017 9127/2017 1111712017 1012012017 1012012017 1111512017 1111512017 912612017 1113012017 11/16/2017 1112912017 10/27/2016 312/2016 61612016 711812016 61112016 6/1/2016 11/16/2017 660789697 (f) Gross Sales Price 99,907 (3) Cost or other Basis 101,250 (h) Gain or (loss) (1,343) 11/3/2017 9,091 9,000 91 1113012017 39,543 249,477 45.668 21.454 284,787 13,954 39,103 22,204 30,827 126,803 50,921 4,999 46,383 123,866 207,035 255,638 195,039 41,372 31,111 40,500 250,000 45,000 20,000 264,493 13,000 39,100 18,000 26,000 130,000 44,000 5,000 47,320 115,000 210,000 255,625 195,000 40,000 24,000 (957) (523) 668 1,454 20,294 954 3 4,204 4,827 (3,197) 6,921 (1) (937) 8,866 (2,965) 13 39 1,372 7,111 1013012017 1111012017 1111012017 1012512017 12/15/2017 9/27/2017 12/8/2017 9120/2017 1216/2017 1012712017 1119/2017 1215/2017 12/7/2017 1012612017 11/28/2017 11/1012017 1111612017 1011912017 9120/2017 8,188 8,500 (312) 1012712017 16,654 108,511 16,067 125,999 115,541 116,291 117,974 87,542 80,781 74,908 27,253 27,031 8,577 26,533 13,062 69,854 3.981 3,834 45,720 45,348 250,094 20,644 248,588 28,818 16,028 77,793 1,038,864 519,432 1,094,994 1,094,244 7,468,333 16,000 108,700 15,700 128,750 115,500 116,250 117,000 87,500 60,000 60,000 27,250 17,000 7,250 14,000 9,250 60,000 3.750 3,750 40,000 40,000 250,000 20,609 250,000 28,300 22,425 102,199 566,006 298,878 1,041,000 1,041,060 6,568,916 654 (189) 367 (2,751) 41 41 974 42 20,781 14,908 3 10,031 1.327 12,533 3,812 9,854 231 84 5,720 5,348 94 34 (1,412) 518 (6,397) (24,406) 472,858 220,554 53,994 53,184 899,417 1111712017 1112712017 1211412017 121512017 11/8/2017 1012012017 101512017 10/18/2017 10/18/2017 1011312017 10/6/2017 1012012017 9129/2017 9127/2017 1111712017 1012012017 1012012017 1111512017 1111512017 9/29/2017 11/30/2017 1112212017 1113012017 911312017 10/10/2017 8114/2017 8114/2017 1012/2017 911912017 i