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Page 1 of 50 [efile GRAPHIC print - 00 NOT PROCESS [ ORIGINAL DATA - Production Din: 95451 316000548] aot «0990-PF Return of Private Foundation ereitininan orsactons49(0(2) Tu teste ts eundain 2017 SERammamariarMensammart | ren For calendar yoor 2017, or tax year beginning 01-04-2017 and ending 12-51-2037 Se oR RTE ER wees pare een cnmee ee eee © esengton oteten peer cake] Tarkaroaemy Clinton Chil amotio niccnsay | ea.engnopeting eens Ey Pinal return Clamended return 2. Foreign organizations meeting the 85% fees Se ‘check ype of ongenzaven: WZlsecton$03(0(2) exempt privet ounaston i pnmterancton san ap writes |) section 4947¢8)(1) noncxampt charitable trust__Clother texable private fouretion Fair merket value of all assets at end Accounting method: CI Cash BA Accruel | # ifthe foundation is in 8 60-manch terminetion o Deere aes = Seaman i a (Port £, column (G1) must Be on cash basis) Part mak ofimvewemaemenerti toy meee To name Jo meme SSE aoceer ec arisaas sa on eT akSten 1 Beeb a aa ea ah aad San 2 Gnecch Clie unos ot ened ach eda : _ i inmates eas densa) an ee: 4) lve ond ere tm rearier fe Grenrems Seer 3 Ga Net gain or (loss) from sale of assets not on line 10. Fo commemumeme 7 Cooper nantoana fom the Wai) oo 4 4S Aetsecementtgah ss 9 income modifications 6 6 6 ee ee = 10a Gross sales less returns and allowances iH eee aero co cE oe face eer ga este ecee aaa J 5 Comprar ties dred, aa a fe our ener samen eo oe = Fe eine = a Bite topes aactseemey Ls fig ae J | oa pea oan 4 oe & ‘Other professional fees (attach schedule) .. fe 12.984] 146,857 27 nme een i 18 Te (atne shot) atarucond) | | Z is Depecon corer ereatelontesiein | ERS 7 [20° cccupancy : | i /sttle anne eu eecusl tnt 7 a eee B22 oneepeecs(onach scenic) 2... | fig aa mae S | 24 Total operating and administrative expanses, hetps:// 2/28/2019 Page 2 of 50 Part Analysis of Revenue and Expenses cre) |g) prerve ane fa danseente aunts els), 306 ayaa coor [OO memaamere |e) rotation [crn *__tetone sean meu) a ncn) too (eof ona ey) ‘Rad nes 13 roURIS Tse — a 106805 25 Contibutions, ats, orans paid eae Taaaal 3572.80 26. Total expenses and disbursements lines 24 and 2 sara] 4 tossing 27 Subied ine 26 fom ne 1 Excess of venue over expenses and anend sisuureemonte Net Investment income (ir negative, enter -0-) 3 _cjusted net incomaif negate, eter-02) For Paperwork Reduation Act Wotice, see instructions CHE No, TRB Form BOOP GOT) hups:ifeup.eps.i .-govimefirndprd/sdi/proxy/priniSub 2/28/2019 Page 3 of 50 ‘Form 990-PR (2017) - ee § 9 Preptd exensesanddefered cherges | a Glo Detered revere. oe eee B]20 —toans rom omears, rectors, trstoes, and other dequlified persons Bfat rorgages and other nates peyobe Catach schedvie). ba Ala Other fiabllities (describe | Lae le ‘17 ea | Foundations that do not follow SFAS 117, check hare AZ) 3 ‘and complete linos 27 through 34. a? Copital stock, trust principal, or curentfunds . 6... ey, Shoe Retained earings, accumulated income, endowment, or other funds 1#21,053) "G07, 30] Blo rotetnatassets or fund balances (ose hsttens) ve easy earaa 3 Pelee paseo llleata te 6 [al 2 Form 890-PF (2017) 2728/2019) Page 4 of 50 form 990-9 (2047) rage Pajt IV Capital Galne avd Loess Tor Tax on Tnvectmant Team @ @ @ © st and dese the kins) of property Sold (rea esate, towered 1 oateSenuired | oaldan Est Sees ear tor rt Frets | Gas satin | Sto. oF oF 7, ©. erect sowet cost or Sar oss ean es) eee {oF ellowable) plus expense of sale (e) plus (f) minus ¢¢ @ Complete only for assets Showing goIR column (9) ANd Swed bythe foundation oh TSUTES : T o Cy 0 7 Geins (Co. fn) gain minus eae ‘Adusted bass Excots ef: () cot (bok nat less than “D) oF Mm. a5 of 12/31/69 ssor7/33/68 over coi U), Sry Lasse (rom e369). . © L Tipale, Sao eer Pant tne 7 2 Capital gale net income or (net cal oss) wes emar'S npr tne7 . 13 Net short-term capital gain o (ss) a8 defined in sacons 1222(5) ane (6) 2 gin st tr Parte 8 alu (0) se nso) 1 eee infon'h ine epee Fare V— Qualification Tie Sin 44940(6) for Reduced Tax on Net Tnveatna (For optional use by domestic pnvate foundations subject to We section 4940) tex on nel investment ineame.) section 4540(4)(2}eppls, eave this pert lan. tL sn Income |Wae the foundation table for the section 4342 tax on the distributable emount of any yer in the base perleg? O ves O wo Ess the foundation does not gully under seciny a@40(e), Do nat complete tu pare Enter he epprosrate amount in each column foreach yer; see netuctions before making Shy nti @) © : ©, crac ztn Stet sails ctebtors | Nevo of wandaate ie asses ost etre rae eu 2 nd 9780) 2016 2015; 20% 2013 2 Total of ne 7 causa ce) 7 roe 2 Average dstbution rv forthe 5-year bee paid vide hott en tne 2 by 5,2 by he ‘umber of veers the foundation hae Daan In eustonce less than S Yetls ee 44 Enqetre net vale cf nonctartable-use asl for 027 fom Pale eS S Mutiby tine 4 BytIng Fs eee eae : 6 Entar 1% ofr nvesmentincome (46 oF Pret, ne27b) LLL 7 Acdiines Sand6. Hit 8 Encarquatiyng dstibtions trom Par XI, hed | || 3flne & sequal oor great than tine 7, cick the ox nate Vi in 2, ond compe that pa insinctions, |tipsi/eup.eps.irs.govi print Sub € using 8156 ta ate See he PAVE Form S50-PF @0z7) 2/28/2019 Page 5 of 50 om 890-9, (2027) Page 4 Pat VI__ Excise Tax Gased on Investment income (Section 4940(a), ABAO{D), 4B40(@), or 4540 vee MiatncOnSy 1%) Bret operating Foaton geste in etn 494001), chek ree] ans ener Wat on tre Sate of rng rte eter: 2012.06-0{ attach copy of letter nectar ee tection) Domest rndatons ht nat the eon 4940) elements in PY, ce 1 ° need Clasereritbofrintineanm ttt eee ee Alter coments odatone ete 2 fre 27, ong erin re of Pot ne, 2. Tavunder set 511 (domes ston 49470) mate and toa oud ony. tes eter-0) | 3 Aidinest a2 net ne ee nn omer ee 3 n 4 Sie came) dees etn (9) re a ade endnotes eer -09 a 3 Tax bused on Ivesinent Income, Sa Ine dor ine raeworasy enero EE 3 & Gresturoymerte > 20:7 ered texpoyments nd 206 vepeynent abt 2017 | 6a exempt ioegrorenaatens-toistedatooute ns [eB € Tax pe appleton for oercon eine foe fon sate) © © Pe 4 Shon wieidg eroneiaywiiheds ss se es. DO 7 Tot cet and payments a8 es tah 6, 2 a ® ener eny penalty for underpayment of imate tn. checks] fom 220 td * 9 Taxdve. fhe tealefineeSerdeis more tan ne Z,eweramoumtowed n,m Cp s 10, Overpaymont ine ismortnan he a ornes Sa 8 eer heamaunt overpaid, | ESS 14_tertne avo ne 10tbu teed at arnt te neronaea bt Part VIEA Statements Regarding Activites Tur Uetex yar, fhe ination ater osc Sy Tenn, Ha ioe SHEN ver] ne Ltpancpaeorinene hay patcslomgagy ee en ee es vo ws « Pmpeepae b Dultspew more tan #10 sng he oar dec erry fr peal upese (oe eons tokens altered seer eee eerie eras (dae 1 he answer ts "es" to Aa or 4b, atch a coated deseripton othe activites and copes ofeny mates ubished cr distributed by the foundation in connection with the atts. {© Di the Foundaten fle Form 1420-POL fortis Year ss se ee ee ee ee [te No. Enter tv amount (any) of taxon poten expenctues (nection 4955) posed durig the veer (2) on tne rundcton. mg (2) on founcaton managers. 4 1 Enter the reimbursement (any) oat bythe foundation dung te yon for police expendi fx Imposed con Foundation managers, Pe § 2 ies the foundation engaged many acute that have not proveuly been reportee tothe RS? = se | No 10" each a doated cescigton ofthe act, 3 Has the foundavon mace any changes, not previousy reported tothe IRS, in ts governing instrument, articles of Incorporation, Bylaws, of eter sila instruments? Yes," attach a conformed copy ofthe changes) © = |B No ‘4a Did the foundation have unrated busses gross income of $1,000 or mare durng the your’, vs sss [aw —[We 1b iF" hes it Med a tax return on Fon 9BO-T for ths Year ee ee ew ee ee ee Lae 5 Waster a nuiation, termination, cssolution, or substantial contracton during the year? vee we ww a PB Ne 1 "¥," attach the statement requled by General Instuction TD © arene requirements of eection 508(0) (rating to sectons 4941 through 4945) slsed her + By lengusge in the goversing tren, a *+ By sate lepslaton Cot effectively amends the governing nctrument so that ne mandatory dedons that conc nth th state aw remein nthe governing Instrument? vv ve ee ee LO YO 7d te Foundation have atleast $5,000 in assets at any tne durog the year "Yes," complete Part, cote, id Ee Hess oder vee eve eee aHe cert deere teseaereece reer seereer Ut aH ae ‘8a. Enter the states to whch the fountation reports oF when which es egisiered (se nsrelons)| we 1b sf the enswer ts "Yes" to tne 7, has the Foundtlanfemishad 2 coay of Form 280-FF to te Attrney Geer (or designate) of each seat as raged by Genera Instuction G? FH," attach expiration $9 3 | ver 9 Is the foundetion cling status exo vate operating Foundation within the meaning of section é942((3) 1 4942(,15) fer enlendaryeor 2017 or the taxable yoar beeing in 2017 (ae introns for Part IVI? Utes complete PMV ee ee ee LB No 40 id ony persons become sustantial contributors during the tx year? Fas atta » sched lating the ames 20d adresses SSS ecu atr ae SCRPREE No. Form 990-PF 2017) https:/eup.eps.irs gov/mel/rdprd/sdi/proxy/printSub 282019 Page 6 of SO tern soo a017 aes aie vilca Statements Regarding Reece (ninoae) A At any rng yen ed enc rey or ee, 07 GOTT SW 12 rennnge eslon SAOKS) Hen? ach sede. oe nica) nn | tne 12 barre oncaen main ate oda adsl oer wh oun oid eon ed sorry poaagurit ass atan mainen (es ating) er nen ne laa [ye 13, the teunon col wn tpt secon aromas fr sens res an exempt pcs?” Cit Trae Mets sores Pan cue nana 14 Thebook a cae of PEAT GS Techore ns PO 2B Lact an ON vo aH aria aes 25 ser 45470) rvenenpt cane nate fngFom 504% neuf form OeA—cheawes ns as ss andemer taut aetonp es SN Cad te eye A yg 48. Any ome ern etn or 3017, ha untae ve on are noe sontrcter ubery exer es [ Ro ‘ban nate oer art acum aire omy? ws te Sn neurone fo exept sa tog equa PCE Fer 14, ap orcan Banks ancl Acun Fae ee te era Tare vii-B Statements Regarding Actives fr WHEN Forms 4770 Way Be Reged ie Frnv4720 any em is checked ithe "Yer columns vies receptor soon I sn Darna he ver tuna (ltr dey error (G) Eng ne an er oxen ne of opty ho ate pase? a (2) Borrow money from, lend maney to, or otherwise extend credit to (or accept it from) Ove i Camuitespeets se cnet tests + Ely, Qe (2) Frm es serns oats 6 (6th an)» auc pen? ver fine (2) rar compen ray of err there ors eae pret te (3) ater any ceo sso dead pean ornate et ter sole Iemometormmcvamaitecyenene nn en ene. yyy Bing (ey age tory nnay pope tes avert en (owapan Chk A teagan ord ate a attr ely efi erated ‘oor teaton gore se, eg wD PRRISS ss Cl ame ng © tony nero a1, any he aca ly nr ee sido ain damn astitgaerhearecentempinoaaiacated were Lal [no rane rif on a careevottaegedng Save cannes eB EY «De the tance egos no pr yun ny ho apres nt ahr an pS, here ok corn! doe ty tte tcp egoing 20. g te] Ino 2 TWneren ore ote kxore don <8) es a ap yn enti var fe Spurn uno aed eto #42019) 4302015) a Mtc end otecyur 2017, 2 he nace av any ned name(s ede Put or ox yours eat wove ITE nn ne Tf "Yes," list the years Pe 20, 20, 20, 2 Oves Zine ethan ested 2a Whe he uaa ht pig th roo of elon be) treing ocr wane ses} Years endowed mem! Uf ppg seton ero toys tea ener and achat aman ne ORD) 2 the postr tin 49202) big epi sy ote years 2 yo ere wn nn TO 24 iste ranann pl ore tana 2 aco net ur ay been etri t tyre oui ever s Reena ve me Wren" dd hve ros bss hegsn 017 ri ef (ay Guth eatin {duet pans afer Hoy 2,195 (2) eto napa or one seed etd bya commoner ide econ e317) pee mage cured aero or) the pect we 0 15 2oyen i mae ole pee Sched Pm 472 terme Wine into aden bates ling m2OITL se 2» 44 i theteunaion vent dang year any ree ina hare’ that wold jnpran ts rata pipower = ae be © Bi the fanaton make any vexinen n ory (oft Decrees tt cls opiate hadi oupin tt hana eraved ten preyseure tei coyerbeemryer egearginsai7? [as |__| no hutps:f/eup.eps.irs.govémet/mdprdisdifproxy/printSub Farm 990-PF 20073 2/28/2019 Page 7 of 50 Form 990-9(2017) ogo 6 Part VII-B Statements Regarding Activities for Which Form 4730 May Be Reguired (Caminued) _— '38 Goring the year cd te fosnation pay or er eny amount to: “Gy cary on propapance, or othervie atemptt nfuance legato (secon 48486) Elves no (2) Influence the outcome of enyspecte publ ection ena secon 4955); or teary on, recy ornare, any ver vegireton eve. vw eet es vee ne (3) Provide a grant to an india for travel, study, orate sitar purposes? we ne (4) Provge rant to an organization other then cartable, et, oranzatlondoscrbed tn section A545(@NANAY? (Se ItruCiOns) ee (8) Provide fo any purpose other than religious, charkable, sn, lary, or Clyee Hine ‘educational purposes, or fore prevention of rey to eisen or animals... send ‘st any ansrer is "es" to $2(2)-(5), dd any of he Eansacriars fl to qubty under the exceptons descr BEe Ragulaons section 534945 or no curent notice regraing aster assstanc (S08 INSTUCIOTY? swe wee sb Orgniztons eying on a eurent note regordng sar assistance check het ve we PY tf te answer is "Yes" to question 5a(8), does the foundetlon im exemption trom the taxtecous maintained omenditra responsiblity forthe gant» vs ws ee yay CD ne 1195" atach the statement routed by Regultions section $3.4945-5( {64 Did tne founcation, during the year, receve any funds, recy oF Indeely,to pay sremiums on Apertonal bereft tee ve ee et et ee Clyes ne Dic the foundation, during he year pe premiums, direc or ndediy, on a percoral banat contectz—~ °°? | oo No 11s" to 6, fe Form 8870 7a Ac anytime daring the tx year, waste foundation a pry to rote tae seer ansee509? Ch veg no ‘bit yas, cs th foundation receive any orecees or heve snot ncere aibutable tothe transaction? > YS", » Form 990-PF (5017) https: t/ 2128/2019 Page 8 of 50 m 990-05 (2017) Page 7, Information About Officers, Directors, Trustees, Foundation Managers, Highly Pald Employes, Part VIKI and Contractors “CEUTA oiieie ireetors rusteqa, Foundation managers aod Heir compensation (awe ineteNaIORS © Tite andaverage | () cumpensaton Ct | corauo\tleampuyes| pares sano (2) Nome one aderess hours par week | “not paid, enter | Cortbutons nerpoyes | | Expense account (oy cares ton sony | bevels and detered | () cer Paes Ippeouorear 7 q 7 rae ae tty Se rea q ql 3 mento Bee "| 7 3 Bet acc ae q a 3 ‘iar G4 30369" 2 Compensation of ive Nahest-pald employees (other than thats Taclndod on lind 3gee Tatvucions). HW none’ ener "WORE? canebalons to o Tie, a average tivsoyes beret | Excense acount Nome and eddress of each employee pata ours per week | (c) Compensation i oy Eng pom ‘move than $50,000 (b) devoted to postion fa) emperaanente|| eee Taian SSOCIATE DIRECTOR wae 14.57 ‘5200 BUFFINGTON ROAD ae ATLANTA, GA 30349. ‘Total smber of other enwoyaes pad ver $50,000. ep peretie i a 3 Fine highest-paid independent contractor for profesional savices (Sos nsiraalons) nota eter "WOWE (a) Name and edarass of each person paid more than $80,000. (2) Type of sarvlon (© compensation OPE: pecKH Ne pa sea 75.108 1800 CENTURY PLACE SUITE 250 ATLANTA, GA. 30305, GRERCON 25,5 1230 PeACHTREE STREET NE ‘MTUANTALGA 30309 , ‘Total number of eiers receiving over $80,000 for professional eervees, yyy gv bitps:// 2728/2019 Page 9 of 50 Part IX-A_Summary of Direct Charitable Activities TBS ooo "ee Grr cae cts dr ew re Tce GOS AUTRES REST WS | —p iuatons an har neces sere, corns mene, ash Saget sce a xpenses Part DCB __ Summary of Program Related Investments (ee metrucions) tes veins radeb the undaton Greg he oxen ah 1S THEE Allein progam reine Fvestment, Sea Tstractons 2 ‘Tota nee orewas sepsrerseoaricrrseioat al Form 9S0-PF Goi) 2282019 Page 10 of SO asm $50-690:7) rage Par€ X_Minimura Tavestivent Return (it comestfounalon si cola Ws pa Foi unions we emueiONg) 7 Teirerke vue of sess roused (or el fr us) deci ncaryng ak ehaabe ee, parpnes: 2 Average monthly fa merket value ofsecuRtes ee 1s 2 b Menge ofmonbiyrhbeleess ee ee LLY 38 SRS © Foirmariet valuta other osats (ecintractonshe ve ves ve vv ee ee Ee ° 4 Tota (odd tnes $8, and te ne es Hee aaee a Tas © Recucton claimed for Hectage or thet fore rend ay e(@tachdetaed xplnatn). vv ee ee ee ee LB 2 Austin indetecressappcabietolne Sass La @ 3 Swwadine 2homiie ee ee ee ee ee 2 3s 4 Cash doemed hls or hortoble scntes. Enter 1/28 fin 3 or greater amour, sae mance vette eet eens aaa “ an 5 Net value of nonchartable-use assets Surat ne em Ine3 ree ei on Pate = S01 82 6 Minimum investment return ite Sho oflne Ss se ssw oe tu lee 020 Pare xy DItHbutae Amount (se nsctons) (Sealon TAGS] Sd CHE) SS Goa TOURS end TST cegenutorschcknareD>_ and do not compete tis ar) T Wininam mvestrontreurn fom PERK Ne6 ss ve ss vy LE Tee 2a Taxon ivesenen came for3947 em PaeVIjine Se ee ee La Income tax for 2017 (7h does ntIncoe the acto at VE). «Lab © Add tnes29 and 20, vv ee a eve aeceeeesearnsn tae ° 3 Detrbutble amoure before ashstrans, Suite ine 2c famine te ee 3 Tam 4 Racovereof amounts Wesed os qulivingdtibulons. ss = indi tues Send acai ec aca a oes eeeeee aged cee 3 as © Desucen rom dstibubie moun (eeinarucionss s 7__Distributable amount a adjusted. 59 ne & nie 5. Eter her and on Part xt, ine 7 nas Pare XIT_ Qualifying Distributions (see Instrctons) Amounts pid (nding serie expense) to cconglahGFeMaBE i FIO Expenses contributions Ms, ec—toa om Part, oan (0,498.26, vv eee ae 13 suo5s.88 1 Prorerrrated imverarentstotal om Pat 3. s+ a 18 ° 2 Amounts ald to accu esses used (or held for ure) rat carving out chara, tc Dimes ete estticnetetiae aia ce eeseceeeea trial ¢ Amounts ak esie for specie charable prjet that sat te: 2 Sutabity tet prorIRS approve FEQUIEA). ee ee ee a ¢ cashatsreanen test (anach te raqured sede). eet lise é 4 Qualityingeistbutons, Al nesta trsugh 3. eer hove and Gn Par he 8 end Far Xt nes Lak Tass 15 Foundevers ta quay ure sersr 43406) forthe redoed rate fen or ne Ives Ineame Ester 1b ef Par ne 27b 98 sues we ee ee eee LB © Adjumted quauying sation. Subtac the 5 fom the 4. ey é is Notre ani i Ble a nt Vann (igen yes wen eg weber Ne onTST wT Torn 990-PF (U7) Intps:(/ 2728/2019 Form 350-66 (2017) Pait XU Undistributed income (Ses instructions) Page 11 of 50 paged Distibutsle aun er 2017 from Part Xe 7 Undstributed income, Hany, a8 ofthe end of 2017: Enter amount fr 2036 only. es = “otal for sior years: 2015," 2014, 2013, Excess debuions caryover, if any, te 2037; i} corse oy, Years pro to 2036 ©. 206 wy, air Tans From2ms. 2. From 20a ss. Tam Fom2cis. 1 1 ETE From 2016 2 2. 37.2 Total ons 3a hough aw ss 2 » 3 a From2012 ee ® ‘ ‘ 4 uatiyng disvtbuters for 2017 om Part Na, nea: 1.055.155 ‘Apple to 2016, bit noe ore fan line 28 ‘Apped to undsetbutesinceme of pir yoare (ection requrad~oue nstucsorghs ses Treated os dstrinucons ut or campus (Beton tequrad—see hueons). wt ses + ‘Applied to 2017 alsrioutabe amount. “sy. Ta Remaining amount distbutad ou corpus xeees distributors cv'yovereppied to 2017. (tan amount appears in cote (4), the ‘same aunt must be shown ih eolumn (2) 6 Enter the net total of each column a8 Indicated below? ‘corpus A tins 3, 4, and 4a. Subrct ine 5 Prior years" uncistibutesineame. Subtract lige b romline 2b. ss = ee © Ente the amount of prior years’ unditibutnd Income for mhin eroce of decency hes been issued, ofan whic the con 4992(3) tox hasbeen prevously astested. ss 4 Subtract ine Ge fTom ie 6b Taxabe amount “seeinsivclonse ss 4 Uncistbutes Income for 2616, subtroet ne 4a rom Ine 22. Tanabe amount~ee instudionss sie eee nee ee Unaistbuted income fr 2047. ubbect lines 4d and § from fine 1. Ths amount mast bedinbitedm 2018 vy eet es so 7 Amounts Pesto 96 cixtbutons out of rps to satis rulrentets imposed by section 179{)(1)F) or 49420X3) (Besson may be required~ ee insuucters) Gwe 18 Excess dotbutionscamyover fram 2012 not apoted ontne Bor le? (ese strong)» =. 9 Excess distributions carryover to 2088, Sublet ines Pend @ fromiine Soe ee ss 10 Analysis cf ine ‘8 Boeess fam 2013. 6. B excess from 2088 | Sas fe sxe fom 2035.) 765 Breese fom 2036, 1. Sr fe boeass fom 2077, 1s Ta 535) hitps:f/ Form 990-PF (2017) 2/28/2019 Page 12 of SO orm 330-0F (2017) “2age 10 . Patt XIV Private Operating Foundations (Gea insiructiona and Part VIA, question 5) athe foundation has recived a ruling or determination le thet fs = pavate operating foundation, and the ruling Is effectve for 204, enter the date OF te rulnge Pes 1b Chace box to inccae whether the orgenization I 3 private operating feundatkn deserted In secton Cl 494243) or LI aoazenis) ‘2a. Enter the loeser ofthe aausted net Tax year ror 3 youre invent ret fra Pa Xf och @07 wae (e205 ae yeuristtds ns see te b ssw offing © Qualvng lenoutone from Part x, fine Toceech yearlistede eee 6 4 Amounts ncudea in ine 2¢ rot se Gracy for seve conde of emt save ete te © Qualrying clatnutions mie arety fovadtve conauet of eempe setvite. Subtract ne 2 rom ine 20. > 3 Complete 3a, ov eforthe ‘ternative test eed upon: 9 "Assets alternative tester: (4) Voleof al isetss ee. (2) Value of assets aualving under sation 4942) 318)0) bb “Erdonmient”axernaive test enter 2/3 Dr murmur uestment cet soem fn Pate line lr eben year eta © "Support alternative tst— enter: (3) Total support athar tan goes Investment Income (interest, {lends es, payments conser less (aseson 512(aX65)), oreoyaltieg)« (2) Support fom general pute and 5 of more exempt ‘organizatione ac eroded ia cection A9A2QIONO. ss (@) Largest emount of supe from an exept organication (2) ross nestment ore Part xy Supplementary Information (Complete this part only W the organization had $5,000 or more In a assets at any time during the year—see instructions.) Taiformation Regarding Foundation Managers: ‘Use any managers of the founeacan na have corrbuted more than 2% ofthe otal contributions received by he fundaion Defoe the close of any tax year (et anly they Neve conarlxted mare thay $5,000), (Soe selon SO7ON) Na ‘BUR ay managers of he Tounasoan wis on 10% oe are Oe sak Tw corpOPRNon (or an Saal rae Poon TS ‘iersip of partnership or other entity) of wbich the foundation hes 220% fr reat inerest- ae ae ‘Loan, Scholarship, ete Programs: ‘chock nore be] ithe foundation only makes contributions to preselected charltable orgentetions and does not accept Uunsolioted requests for funds he foundation makes GIs, grants, ot. (see Mstucion} te Indus er organizations under ‘ter concttons complete ens 24 , and (e) Total ‘The name adress, and Telephone number or 6A aaeress of ta person To Whom applications shoul be aaereared hice Foundation ine 15200 aUPHINGTON ROAD RIANTA, GA 30349. 904) 768-6000 'B The form in which appbications shou be subrated and iormation and mate they sd aud {INFORMATION ABOUT OUR TRUE INSPIRATION AWARDS CAW BE FOUND ON OUR WEBSITE AT WWIH.CHICKELL AFOUNDATION.ORG Ay submission dealines: NONE «ny resriclons or Hmtavons on awards, such as by geographical ares, harkable fds, Kinds of stuns, or other face THE GHIC&FL-8 FOUNDATION ACCEPTS REQUESTS FOR FUNDING THROUGH OUR TRUE INGPIRATION AWARDS PROGRAM. THOSE REQUESTS HUST PERTAIN SPECIFICALLY TO THE FOLLOWING AREAS (AS DEFINED ON OUR WEBSITE): ORGANIIZRTIONS THAT SUPPORT AND [ERCOURAGE YOLTH ENTREFRENEURSHIP, PROMOTE INNOVATIVE EOUCATION, AND THE BEV= OPMENT OF EMERGING LEADERSHIP, Form 990-PF (3017) htips://eup.cps.irs.gow/mef/trdprd/sdi/proxy/printSub 2728/2019 orm 990-5, (2037) Page 13 of 50 go 12 Part XV _ Supplementary infortiation (continued) 3 Grants and Contributions Paid During the Year or Approved for Future Payment ——__erbiet | fom raaounmipte” | Famten | purpose of grantor coe are ard adress (rome or bosmess) |_ary‘oundaten menager | Tepe fenton © Fae dong oe year See Adina Det abe fear sea oasooe er reaa ba T hooroed Rare ore Sec tional bat Tab Yoh A a hutps:/ Form 990-PF (2017) 2N8/2019 Page 14 of 50 For 990-PF (2047) Page 12 Part XVI-A Analysis of Income-Produeing Activities oe] 7 ca eae ee 1 ga ea ene ace] nls | eaSrene | afta [rtoneey : : {9 Fees and contracts rom government agencies 2 Membership dues and assasements. 2 interest on sovings ard temporery cash levestments ts ere es 4 Dividends and intra From securtess 5. Net ental income or (loss) om rea state 2 Debt-fnancad propery ss Dot cebttinanced property, ss ss {6 Net ental ince or (las) tom persone property 7 otnerinestmant income ys + 1B Gain o (ust) from sales of scat ther than 9 Net income (oss) from Spec ever: * 20 Gross profi or {os) trom cales of Inventory 41. Other revenue » a 12 SLBioIaL. Aad columns (@), (@), end so. 413 Total. Aine 12, ois (b), (2), ane ace eceecee et eecronaeaets Sa Ronstadt nine reas eh sean” Part SWE Relationship at Active to tha Accomplahmen tT EXERTE PUTpOeS Ue no, | SBI rw aah airy fr wich sett coune ta oR eso ISGOTET Ee accomplishment ofthe foundavon's exemoe purposes (ater than by prowaing tus er such purpose) Cee irarsctions) THA [artes seaviCts USED TOR GHARTTABLE ROTATE Farm S90-PF 7017) :Hfeup.eps.irs,gov/mel/trdprd/sdi/proxy/printSub 2/28/2019 Page 15 of 50 Form 990-6 (2037) age 13 7 Information Regarding Transfers To and Transactions and Relationships with NoncharTtable Port XVII_pxempt Organizations : ST Did eroaraation drei or indrecty engage in say ofthe faloning wth aay other organization Gexorbed I 2edion SOT (0 of tne Cade (otner ten sector 801(6)(3)arganizatons) orm secuen £27, wating te ole! organ eatons? Yee | No {9 Transfrs trom the resting foundation to 2 noncherltbleexemet epanlation of feet ees aree eC eee eer Pec ae No (Gy io nee fe Hees oF bare are ec Pe ig a ees EEE can Other transacions (4) Seles of assets toa noncrartable exempt organization, © ee ee ee ee ee ee fat] [ne (2) Purchases of assets trom a nonchantable exempt organization, es ve sy pv vt ew ee RBC P Nes ) Renal of actes, equipment, orether assets ee ee fe Re: (4) Reimbursement arrangements... se bee es tect —T we: (3) Loans or loan guarantees... : pect gsee eaererreceo a teres sear tere aga Ne (6) Performence of services or membersip or tundrasng sotctatens. ee faBKO NL Ne: € Sharing of acts, equipment, maitng Tats, other assets, or paid omployees. © sve vv eo ae No I the answer to any of the above is, "Yes," complete the following schedule. Colum (b) should always show the fair market value ofthe goods, omer asset, or Sarvs given ay the repeting foundation, If Se foun on rveved eas Can fet mora value In ny tanséction or sharing arrangement, shaw Wn clurn (8) evalu a the goods, rar asres, or services roo ved e)ucene | (by Amant inves | (e) ars otnowmataie eum engeniaten | (4) Beton van, tasers, wl mas oranges ‘asthe foundeton decor Inaecty esd Wi or Flated Wo, one or ore tavexeme argaTiaaUOT 20774 FELOWSH OF CHRISTIAN ATHLETES % fuaoaye YOUTH CAMPS AND 1.300 aiiSi3 = FORREST AVENUE SUITE SUPPORT PROGRAMS, PROVIDES {as BASEBALL SOCCER, AND tara, cn 30386 EACROSSE,SOME OF WATCH ARE htips:// 2/28/2019 Page 28 of 50 E ecpiet Tereaperis aniraincua, | Foundation Purpose a era ‘Aroune ‘show any reatonahis to | "sats of entation Tame indaddres treme orbuaneny } anffoundotan manager | recent | adress (heme or business) | Spot conus ROT PRODED IN WHE FURTC ScH00L SYSTEM, [auRoRA crmisrian SCHOOI7255 Fe (COMMUNETY PRODECTS 750 SuttiaN ROAD. RuRORA tL 60806 [St war's RYKEN INGZ2O00 CAM re [comMUNITY PROREETS 750 calves aonb LEONARDTOWN, MD_ 20650, ase const cunistian7s07 re [communi paooecrs 3000 aumioine sure xcksowvatteyre 32246 [en manon scioo orsrarcr eb me [COMMUNITY PROMEETS 195 FoNtog ensy COTTAGES AVENUE |[Mueksvnkea 17580 Tiazssen rary caroouc wica re [communi pRORECTS 350 ScooL1320 woODSTOCK ROAD : ROSWELL GA 30075 vas Bove EASKETBALL BOOSTERS re [communi PROMETS 750 {7eie pusHARD STREET FOUNTAIN VALLEY, 92708, Saxerow cHarsrian ACADENres0 re [COMMUNITY PRORECTS 500 WaerNoIDs ROAD {SRINGTON, KY 40503, | LOVEWORKS LEADERSHIIOV W MAIN fe [comansTy FROCTS| 350 STREET RORMAN,OK 73069, union acttevewent OF Graco re Sm DISCOVERY GFATER 12,500] eesti” ROBO. ALANA, CA 30328, CALVARY REFUGE CENTERPO BOK 2ABA % Rosia SUPPORT 2,000 FOREST PARK, GA. 30208 PAUL ANDERSON YOUTH HOE WcRO re Heirs Youn wen (6-20 aT. 7,000 ox ses RISK/STRUGGLING WT LEGAL ICALIA. GA s0e7a Ennagrs, SUBSTANCE ABUSE, Ere, CREATE A ees Stage TiRoUGH PRocRAWS Lxe Ure SILLS, VOCATIONAL, ANG PHYSICAL TeaiNG. TESS AT WORK INCATTN MARVIN Fe WwoRKrORCe READINESS 1000 BUSSEY PO Box 91585, PROGRAM TANT GA 20368 SUNIOR ACHIEVEMENT USAR re YOUTH PROGRAW SUPPORT 169,000 ELGRADO SFRINGS,.CO 80906 {CADESY OF CHILDRENS THEATRE re [oun TieaTRE PROGRAM S000 le viceRs ORE CoLoRADO SPRINGS, CO 60918 Frees At WORK INCATIN MARVIN rc wonkroRCr READINESS 00 |- BUSSEY PO BOX 91588, Progam TLANTA, GA 30364 PALL ANDERSON YOUTH HOME INGO re Hewes vouNG wen (4620 a 1.000 Box 528 ISK/STRUGGLING WAT! LEGAL. VIDALTA, GA a0474 EHARGES, SUBSTANCE ABUSE, ETC. CREATE A FRESH staat HT:ROUGH PROGRAMS LIKE LiFe SKILLS, VOCATIONAL AND Pascal renin. CAVARY REFUGE CENTERFO Ox 2468 rc ‘COMMUNITY PROGRAM SURFORT 33508 FOREST PARK, GA 30298 WOODRUTT ARTS CENTERIZ=0 re [cS EDUCATION SUPPORT 100,000 Prociiate sTRe=T ATLANTA GA 30300 ‘ATLANTA URBAN FOBATTNLASHER re {NSERITY YOUTH CAMPS AND 388 avis PB 178 3200 DAL SUPPORT PROGRAMS BASEBALL, IRTUANT 2 "3006 S9ccER, AND IACROSSE. SOME Seinen ate NOT PROVED IN Tre pus SoHo SvSTEH, hitpsi//eup.eps.irs.govimef/dprd/sdi/proxy/printSub 2728/2019 Page 29 of 50 htips:/feup.eps.irs.gowimef/redprd/sdi/proxy/printSub : Recoient Treapien an ncivcual, | Pauncaton Purpose o grat or “amet sevvanycescenaipie’ | “tan? coneribtion Name and address (home or business) | 2 foundatin manager | recent {ome orbusness) | Srkipeertal bute Teens At WORK INGATIN MARVIN 7 woRK-ORGE READINESS Tt BUssev PO BOX 91508 PROGRAM ATLANTA, GA. 30368 [cauvany RerUce CENTERPO BOK 2468 Fe [CORON SUPPORT PROGRAN 708 Font PARK FOREST PARK, CA 20298 Fie Ack An LL CATE STAGE me TAVILY SUPPORT PROGRAM 10000 CaceR Fons282 NORTHSIDE Parka ATLANTA. GA 20327 Frees Ar WORK INCATTH WARN *e WORKFORCE READINESS 40.000 BUsSeY FO BOX 91588, pRocRaM ATLANTA, GA 30368 reaws ar wom INCATIN VAREN * WoRkrORCE READINESS 7.000 user pO Box o1s88 PROGRAM ATLA, GA 20868 URSA LEAGUE OF GREATER ATLANTA * four surPoRr 7500 225 PeaCI TRE STREET ATLANTA. GA 30803 TELLOWGHIP OF CRISTIAN ATRETES Pe fuRsan Yours canes an 25,000 ATTN SHANE WILLIAMSON 8701 LEEDS SuePoR" PROGRAMS. PROVIDES n BASEBALL SOCCER, AND Fansas cu, mo 62:20 TACROSSE SOME OF rics ARE Nor pROvibeD IN re PuBLIC Schoot srater. PTE SALVATION ARNYG:5 SLATERS ca PROVIDING SHELTER TO 50.000 lane MULNERABL= POPULATIONS IN ALDXANORIA VR 22324 [THE THE ATLANTA AREA, Da OF GEORGIA DIeCovERY CENTER me DISCOVERY CENTER AT. 32,500 330 ABERNATHY ROAD ATLANTA, CA 30528, [ATLANTA POLICE FOUNDATTONa? rc CONNUNTTY SUPPORT B00 PEACHES STREET ATTA 30303 NaTIOWAL NOMUMENTS FOUNDATION Pe PARK PROSECT 250.000 Iheaas i7im Sraeer ATLANTA Gn 20368 [sare nero anawra scnoo.sas0 rc PROGRAM SUPPORT 70,000} evour staeer ATLANTA. Gh 30318 HOLLIS INNOVATION ACADENY225 re FTECHNOWATION PROGRAM 27,500 lexi steer ar, 30338 Fre rian FoucaTION FOUNDATION me HEOU STUDENTS TO SxSW 7.60 85 WoODSTOGE ROAD SUITE 430-198 ROSWELL, GA. 30078 TaroeSceNTss2 w 22ND STaEET re FFECHNOWATION PROGRAR 72500 {0s ANGELES, cA 80007 PEACE PREP ACADEMSPO BOX $2608 *e YOUTH EDUCATION 25,000 ATLANTA, GA 30316 MOREHOUSE SCHOOL OF MEDICINE7Z0 7 EDUCATION 25,000 Westview pave aan 30510 [axons 9 yoUNG FOUNDATION260 Pe PROGRAM SUFFORT 5:00 tamstacer ATLANTA.CA 30318 [ATLANTA pantweastnr auSiNeSs & Pe VOLES MEDICAL Cuinie 5,000 EDUCATION? ANDREW YOUNG ireRnaTiOnAL Bu TNA CA 30303, Fe mission conrinuesiaas Fe [ScieRAL SUPPORT 3.000 souTs7m sreesr SF Louts,M0 63104 PEACE PREP ACADEMYPO BOX B2601 Fe SuRER PROGRAeY SUPPORT 72.500 ATLANTA, GA 30344 Fe [COOK PARK PROIECT 50,000 2/28/2019 Page 30 of 50 Recipient Trreepent an iraaval, | Foundation Dorpese of grant o° Tune ‘how ay ceatonans to’ | “statue? centrbstor se ond bacrees [Romer busines) | any foundation manager | repent "ame ang access (nome er business} |

Arproved far tare payment fvoCoWARD ACADENTIS62 RUGEY re [EDUCATION PROGRAWEING 5.000 Ave ATLANTA, GA 30337 SHEPHERD CENTER FOUNDATIONDOZ0 me ivicyeonmunire 100,060 PEACHTREE RO NW PRochamnc TATA, GA 20909 Fe ican PROGEAFING a0 htips:// 28/2019 Page 34 of 50 pers Tiesopentisavnavidon, | Feundoion | Suvom raat ‘aroun ‘Sowany eaccnaipto’ | ‘Sasa’ nt tn Tore ad ales Thane orbuseay | arv exten matouee | reopen ‘SURAT COLLEGE OF HRT EDESA Benen Sivan x 31409 asia £08 Funai ATOATA ewic commun To900 incaos wchonin’ one st seosisnaanes ruantacch sosie ATLANTA ComuNT FOOD BANCTSE 7 EME|SonORNTY S00 oben owe mon Stosteanne seta sos ‘MIDWEST FOOD BANK NFP220_ pc |CIVIC/COMMUNTTY 5,000 | | aResoe cover rosea SkGimnce CY, ca srze6 RAISING EXECTATIONS NERO BOX me eaicjconnoniny 3500 sheae eos Srthira. cn soate Lavron svave uwvenarrvaoee fe EBAEATSONAL PROGRAMING 73000 steven Stare sc Sano oe soz erenarion HOPE INCTO7 WILSHIRE ba eicjecninnere 08 Seu Sh hose SEosconme ‘ogiaae cx 50019 EQUGIA HISTOR GOCEWIOgW ts exicressomny so00 eerStemeet Feostainnn Shines 31408 BOYS 8 Gls CLUBS 0 WORTIWEST ve eivigeonmoniv ee0 Seance ast, stoshaonnhe orton soto inom ove YOUTH iNCISO WARQUIS ve ewicjeonnanare Sano Save seochasnane FRYEPTEMLIE GA 3038 SPiNAN COLLEGES SPELHAN UN cs uceTOn OGG 00 Sunt ok So Fens ar work nero Box 1560 Fe Tyonironce nenoines 80 Raut oS moc ATIANTA MISSION? 0 50K 1807 re ewvicieonannre 0000 Brean Seocaane ‘Wo LONGER BOUND INEATES PvE 7 ewicjconranare Sa0 Grove ans seoStaris nmin Gk scot So COWL OF czoRGiAINcIoE Fe SOUATIONAL PROGRAING a0 TeAcTREE Sipest Ne Lent loGR aaa soso CARRIE STERI=-ITT HOME COST cs GaCEOnNITY 3.000 Fas SD roca ibnicn Se doyS canis aus neo UAT re EEviCICOMMIRTY 7.000 {Shs eacsnae ne ste 0 ‘mosravonne rca gatos su COLLEGE 0 vOK GOLDS ve OOCaTIONAL mOGRANS ave TUN BR GA SOLO [AcE Wovo coueetoo minrOse cs EoUCATIONAL PROGRAMING 16560 PPA PASSES xv a4B44 [CURT APONTE srecraL re eicreononrr 75,500 sovenrEStas eDatiogs avewe srosranane tears [aHrACR oa0s TREAT W wGODAUrF Ass CaATER re eugeomonr 7.000 INelaw Seacrest hu seockionsne Scan cA. 30308 octetion?e uveRsiry Am oeL fe eovcxTIn mara 7,000 estbaiiranaeveacnnee ROM Ae tara a3 cs ivciconmuny 00 hups:// ROGRARING 2/28/2019 Page 35 of 50 ~ Rept “fyeopent ca waits | Foundten | Pape or gant or Toran sho any reatonmp | Sams of tone Nene ind areata or Bares) | fount manegar | eee RORY ONVERST IZ BECO ake ILANTA,GA 30929 WEISPRING LING NCIDHD ca Gris ResiDaTTAL 7050 Souevato se corre Souc ion reese ATLANTA, GA Sot? SPAMISY COMMUNITY CENTERSDD re ewcicommnre a0 EASTERN AVENUE rRocannene Soe sour TLABAVA INSTITUTE FOR DEAF re EDUCATIONAL PROGRAMA 18 Stiworo ax oe : TALADEGN AL 3st61 Sub uencenshar UNIVERSITY EOUCATION PRORAAMIG 250 7 SAND Une 89 SE 100 antabo, re 32019 EAST LAKE FOUNDATION NCZEEE 7 excise 15.000 Aston on se Faoctasnane Atta A 90017 SHOR URIVERSITI EKEOUTVE 7 evicconmonre erry aca Pnosracinne UOT A 30529 YOUNG HATS COLLEGE COMEGE % EouCaTIOn PROSRANING T3900 Sinest FOUN HASRIGA 30587 Yew LsAoERS counerLAaos re ewe coun ro frisconsin ave nw Sbiss Rossa fwastinavon,oe 20026 ‘METIONAL CARES MENTORING re ENTORING FROGRIO “oo MOVeMENT INS PN SOREN 23RO [noon | [Retro 1000s UESE OF Mi OzanSi00 me EDUCATIONAL PROGRARVANG 25.000 Geran unt avence SEIN woKOUy mo 65725 4 GARE FOR AIDS INC GRANT COVE re Eicon sa sac Feocsnvmnns ATLANTA. 0985 ORGIA HLTA coUuEGE PREP re FOUCRTION PROGR 7.00 Scrootzor e ewewe srt MULEDGAMLE ox 068 THE METHODIST Home oF We SOUTH rs enescononar za Seon conan nor MERGE AVE Seochavemne acon, cn Sesee WAGOR ACHIEVEMENT OF GEORGIA re Da WEA DOUGLASS HS "as,000 |NG9s Noamisioe Cavett ANANTA.GA S008 RST a00KF319# STREET Nw ie UTERAGY PRGGRAM FUNDING 2am WASHINGTON, OC 20008 TENSH FEDERATION OF GREATER Re ewicrconmname 5000 ‘itantatago Shane REET PRoseannG AraNtAs on 30509, aur vine we TER FoR Pe eercconnanae 75000 MATURAL URBAN AGALCULPO BOK prosaic Soo 26ST POM, Ga sen64 Sgr rea ea Eee ESET 505 bttps:// 2228/2019 (GRAPHIC print DO NOT PROCESS J ORIGINAL DATA Production TY 2017 Accounting Fees Schedule Name: Chick-fil-A Foundation Inc EIN: 26-2343206 Page 36 of 50 73491316000936] Category ‘Amount Net Investment | Adjusted Net | Disbursements | Income Income for Charitable Purposes CAPINCROUSE 24512] 37,232 hitps:// ‘sdilproxy/printSub 2/28/2019 Page 38 of 50 [efile GRAPHIC print - DO NOT PROCESS] ORIGINAL DATA - Production Din; 93491316000945) TY 2017 Land, Etc. Schedule Nam EIN: 26-2343206 Chick-fil-A Foundation Inc Category / Item Cost / Other | Accumutated | Book Value | End of Year Basis Depreciation F ket OFFICE EQUIPMENT 1,191 3491 | 28/2019 Page 39 of 50 "GRAPHIC print DO NOT PROCESS. Din: 954075 16009086] TY 2017 Legal Fees Schedi : Name: Chick-fil-A Foundation Inc EIN: 26-2343208 Category ‘Amount — | Net Investment | Adjusted Net | Disbursements Income Income for Charitable Purposes [Rsioveenour ex] | httpsi// 2/28/2019 [efile GRAPHIC print . DO NOT PROCESS [ORIGINAL DATA production] bin S313 16000006] TY 2017 Other Expenses Schedule Page 40 of 50 Name: Chick-fil-A Foundation Ine EIN: 26-2343206 ‘Deseription ‘evenue and] Natinvestment | Adjurtod Net | Disbursements for Expenses por Theome ‘income “Charitable Books Purposes AOVERTISING EXPENSES 135,685 100,588 [ADASORY BOARD MEETINGS @ EXP, 22,856] a as Doss 500 sea LURGILETY INSURANCE 12,650 22830 PROGRAM EXPENSES 94,640 559,939 OFFICE EXPENSES 3.885 3865 OUTSIDE CONTRACT SERVICES e742 6742 MISCELLANEOUS ie hups:// 159 2/28/2019 Page 41 of 50 7349156005586] ile GRAPHIC print - DO NOT PROCESS [ ORIGINAL DATA TY 2017 Other Income Schedule Name: Chick-fil-A Foundation Inc EIN: 26-2343205 eseription Revenue And | Net investment | Adjusted Net Expenses Per Income Income Booke BARTER INCOME 50,000] 2/28/2019 . Page 42 of 50 sile GRAPHIC print - DO NOT PROCESS [ORIGINAL BATA ~ Production TY 2017 Other Increases Schedule 33491316000048] Name: Chick-fil-A Foundation Ine EIN: 26-2343206 Description ‘Amount ROUNDING AMOUNT | hitpsi!/ 2/28/2019 Page 43 of 50 ‘GRARNTC TY 2017 Other Liabi ‘ies Schedule Chick-fil-A Foundation Ine 7349131, 60059.0) ‘ACCRUED PAYROLL TAXES https:/eup.eps.irs gov/mefirdprd/sdi/proxy/printSub Beginning of Year = Book Value 0 Book Value 517 2/28/2019 Page 44 of 50 75491316000946) [sfite GRAPHIC print = DO NOT PROCESS TY 2017 Other Professional Fees Schedule Name: Chick-fil-A Foundation Inc EIN: 26-2343206 Category Amount — | Net Investment | Adjusted Net | Disbursements Income Income for Charitable Purposes HOPE-BECR AN INC, 75,168 IC) JACKSON SPALDING a 3.365 CREAXTON s705 37,603] KWL CONMUNICATIONS 10a En) EXPERIENTGROUP 19.970 20,085) hups://eup.eps.irs gov/meflndprd/sdiiproxy/printSub 2/28/2019 Page 45 of 50 Done sowwisTeooneN8] [elle GHAPITS print 00 NOT PROCESS [ORG WALOATA-Prommction Schedule B ‘il OM No. 1545-0047 Pom ee Scneaa of Satna [-susiie-ietsaner pare 1 ee tT aa 2018 ame ar the organization Trnplover idantication number Chicicrta Foundoton ine 26-7341006 Organization type (check one} Filers of: Section: eee 501(0y(3 (enter number) organization D) 4947(0)(1) nonexempt charitable trust not treated as a private foundation Ti 27 potticel organization Form 990.PF C. 501(c3¢3) exempt private foundation 5) 4947(@)(1) nonexempt charitable tus! treated as a private foundation D1 501(0)() taxable private foundation ‘Check if your organization is covered by the General Rule or a Special Rule Note. Only a section 601(c)(7), (8), oF (10) erganzation can check boxoe for both the General Rule and @ Special Rule. See instructions, General Rule {Foran otgarization fing Form 880, 900-E7, or 980-PF thal ecsves, ucng the year, eonttbutonsttang $5,000 or more in ‘money or oter property from any éne contibuer, Complete Pans | andl See nsiictons for determining con buto's tl contibutons ‘Special Rules [For an organiztion described in section 601(0\.) fing Form £90 or 980-E2 that met the 3375% support test ofthe regulations ~ under sections 508(a)1) and 170(0)(1)(A)v), thet checked Schedule A (Form 980 or 990-E2), Pat ne 13, 16e, or 160, and that received from any one contibutor, ring the year, total cortrbutons of the greater oF (1) $5,000 or (2) 2% ofthe amount on i} Farm 980, Part Vil ne th, or (i) Form G60-E2, Ine 1. Complete Parts! and I, [C)Fer an organization described in section 601(0)(7), (8), 0 (10) fing Ferm 960 of 920-E2 that received from any one contr, ‘during the year, toll contfoutions of mare than $1,000 exolisvaly for agieus, cartable, scintif, Horry, of adusatanal ppurpeses, oF forthe prevention of crusty to child or animals. Complete Pars | i and I, {[] Foran organization deserved in section 501(6(7), (8) 0° (10) fing Ferm $90 or 990-27 that ceived frm any one contributor, ‘darng the year, cnirbtlons axclstoly fr religus, entabe, ac, purposes, but no such contains lolaled mare than $7,000, Ifhis box & checked, ener here the toa contibulons tha! vere fees aur the yea for an exeushely ekpous charade, ot, purpose. Dont completa any ofthe parte unos the Goneral Rule apo to ths organization because relved nonexolish felgios, chartabe, etc, contrtons eating $5,000 or mare cur the year. ws Caution. An organization that isnt coverod bythe General Rule and/or the Special Rules doesnt fle Schedule B (Form 990, '980-E2. or 290-FF), butt must answer No" on Part IV, Ine 2, ofits Form 680, or check the box on ne H ofits Form 990-EZ or on ts Form 960EF, Pat tine 2, to cert that doesnt meet the ling reauirements of Scnecile B (Form $90, {980-£2, or 880-PF) For Paperwork Redaction Ae Noto, so tho wavacone ane See TcheduteB Form Gb, OEE, or OPA) OTE) focrorn 60, 00.62, 0r 0, / 2/28/2019 ‘Schetule 8 Form 990, 900-2, 07 990-PF) (2018) Page 46 of 50 Page 2 Wome of organization Employer Wentication wimber Chicka Feundetion Inc peestios Pan "ConUTbUEOrS (es msactone) Ue con copne Pa cients ono @ @ © @ No. Name, address..and Z1P + 4 ‘otal contributions | Type of contribution Porson ow 4 orn ne. Payrot! 5200 Bungion ROSE i Oo 210220670 Noneash 7 nee ee, {Canptte Pr inn @ ® © @ No. Name, address, and ZIP + 4 Total contributions | Type of contribution Person @ IARSHALL WILKINS Payroll o ‘801 BENNETT PLACE $5209 Noneash oO RRORVILLE, THS78G———} eee (Complete Par ifr rena onions (a) & © (a No. Name, address, and ZIP + 4 Total contributions | _type of contribution Porson O sa Payrott o Noneash a (Complete Pet for eonessh ‘sontrutons) ay b © (a No. _Name, address, and ZIP + 4 ‘Total contributions | _ Type of contribution Person o Payroll a 1] noneash ad (Cepek et ernie (a) ib) ia No. _Name, address, and ZIP + 4 ‘Total contributions | Type of contribution Person oO Payroll 8] Noncash g {Compt Pat for noncash saributons (a) (e (6) @ No. Name, address, and ZIP +4 Total contributions | Type of contribution Person Payroll $] Noncash (Gongioe Patter ranean ‘Sevtutong hhtips:// ‘shade (om $50, S502, or HOP) OTH 2/28/2019 ‘Schedule B (Form 980, 90.62, 0 090-PF) (2018) Rome of organization Chicks Faundatin Inc Page 47 of 50 Pages Enployer WontWication member 262315006 Fae TRAST FORTY sacar aS TTT NO ® (b) Ke) (a) No. from Patt | Deserintion of nencash property given eee Date received SLL Oo a Fu (etna i No. from Part | Description of noncash property given pth ene Date received () ©) FIV (o8 eatiatn} (a) No. from Part Description of noneash property elven TY (or oatimat Date received (@) | {o) er (a) no. tom Pat Descrision of nena property hen Fav oreetinat) | pate Sceved w @ ©) @ No. from Part Description of noncash property given Peete: ate teived o ) mI e Note Pat Desctption of naneash property van FUv (oreatinat) | pate rcetved https://cup.eps.irs.gow/mef/rrdprd/sdi/proxy/printSub ‘Sade 8 Form 90, SHEL, or 2728/2019 Page 48 of 50 ‘Schedule & (Form 980, 9042, or 990-PF) (2018) Pages ame of organization ei Chicken Foundation tne er Tdentiication nimber 252343106 “Exclusively religious, charitable, ate, contributions to organizations deseribod in eection 6O1/e)7), (Bor (10) that foal more than $1,000 forthe year from any one contributor. Complete columns (a) through (e) and tho folowing line entry. For ‘organizations competing Patil enter the total of exclusively religous, charitable, et., contributions of $1,000 oF tose for the year. (Entor tis information once, See Instructions). Use duplicate copies of Par! 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