Page 1 of 50
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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,
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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)
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‘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
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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,
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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)
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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
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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/eup.eps.irs.gov/mefenprdisdi/proxy/pri 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
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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)
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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:(/eup.eps.irs.gov/mefftrdprdlsdifproxy/printSub 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)
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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:/eup.eps.irs.gov/mefferdprdfsdi/proxy/prineSub
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://eup.eps.its.gov/mefirrdprd/sdi/proxy/printSub 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://eup.eps.irs.gov/mef/rrdprd/sdi/proxy/printSub 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://eup.eps.irs.gov/mefirrdprd/sdi/proxy/printSub
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://eup.cps.irs.gov/mofirrdprd/sdi/proxy/printSub
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://eup.eps.irs.gov/metierdpr
‘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
https://eup.eps.irs.gov/mef/dprd/sdi/proxy/printSub
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//eup.eps.irs.gov/mef/imdprd/sdli/proxy/printSub 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
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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]
https://eup.eps.irs.gov/met/rrdprd/sdi/proxy/printSub 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!/eup.eps.irs.gov/met/mrdprd/sdi/proxy/printSub 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,
/eup.eps.irs.gov/metftrdprd/sdi/proxy/printSub 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
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‘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
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No. from Part Description of noncash property given Peete: ate teived
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Note Pat Desctption of naneash property van FUv (oreatinat) | pate rcetved
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‘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! If tional space is nended,
Pan
No. trdt Pot (0) Purpose of git (6) Use of ait (6) Description of how oft Is held
Ter Transierofgh
Transforea's name, address, and ZIP 4 Relationship of transferor to transferee
wo. parti (b Purpose oF it (© Useof at (@) Bescrption of how at i ets
Tay Teanster orgie
‘Teansfores's namo, adéress, end ZIP 4 Relationship af transferor to ransforew
wo wl pa (oy Purpone oft (e)Uee ofa {@) Description of how ot hal
To Tensier ora
“Transforoo's name, address, end ZIP & Relationship of transferor to transferee
en (e Purpoee ot (e)Use ote (@) description of how gt ha
Tey Transtar oro
“Transforess name, addiwss, and ZIP 4 Rolationship of transferor to twansforee
‘Schedule B (Form 980, S90-EZ, or 90-PF) (2048)
https: /feup.eps.irs.gowinef/mdprd/sdi/proxy/printSub 2728/2019 Page $0 of 50
GRAPHIC prin
T¥ 2017 Taxes Schedule
Name: Chick-fil
30 NOT PROCESS | ORIGINAL DATA Production
I-A Foundation Ine
EIN: 26-2343206
93491516009946]
Category
Amount
Net Investment
Income
Adjusted Net
Disbursements
for Charitable
Purposes
EMPLOYER FICA EXPENSE
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