- + (8 & ‘J ron 990-PF~ or Section 4947(aX1) Trust Treated as Private Foundation > Do not enter social security numbers on this form as it may be made public. Go to www.irs goviForm990PF for instructions and te latest information. feturn of Private Foundation 2949123702105 8 2017 [Opento Public nspection For calendar year 2017 or axyear beginning ZO17, and ending 7 Regt eR a \I[TUDE AMERICA, LTD 66-0789657 (OVAL, PALM PROFESSIONAL BUILDING 1B Tansire noe Gas ROR) 9053 ESTATE THOMAS, SUITE 101 |i _‘3a0-779-2564 eee ae eee (Cf exemption appticabon ws pending, check here > & Greckal bat pair [Jintal tum nal eta of former ub cRaTty |) 1 grag guna, ck re o Final return [Amended return eee a Address change _[-|Name change 2 Fro cass masta be BY ek heck Section SOT chantable tr HW” Gheck ype of organization: [section 4947(2)(1) nonexer coe exempt prvate foundation [V7 rust ter trae pra foun | T Far ariel vue of asses at end of yar (an Pat conn) ie 16) *s 8,863,864 iT Acc ‘ eat [ower sent counting method [xJoash | JAccrval column (6) rut Be on Gash Basis F ee ard sah computa natant wa erases er secten SOKA, checks [J] ie edn tenn nan tite ker oie +O) Part! JAnalysis of Revenue and Expenses (he tll anouris calurns (),(),and ay not eves. Serly equal the amounts in column (3) (Gee'mstructions) (Revenue and | (@) Net rvestrent Senses per Becks | © “come (© Adused net ( Dsbursements ‘srchantabie spores (cash Basis only) Tennant ee GN) 144,578. 144,578. 44 tt i omar “89,161 89.161. Bret nce ray 6 ame ore 0 tu inl aaa ee 599,417. Rocraseres ase] eats a4 7. Capt genet cae (fom Pat i) 399, 417 9 tere oder 1s gear bles caster uel beagle ths) oar) 1 Or came atch sree) SEE STATEMENT 1 12 Teta poss roy 10,820 10,820. D143. 976. 7 4 6 6a Leal ce (tac sre, bb caning es anaes) De ent eh) Tan eta stato Depreoaton tae ‘sul ard een Tir, coranes, aed meet Prt an ucaons Ota eae sles ae waaes Pens ling emoizyes Benet SEE ST.2 TTas. S76 Tz Taz. ‘ter expenses (otscn send) ‘SEE STATEMENT 3] 238,174 238,174. “al oparating and stminisratve pean haloes 13 ough 2, 238,886. 238,886. Como gas owes. = PART XV, Yee e BNA 7.260.000 7.250.000. 1,498, 886. 1,498, 886. aa tre 25 tom eT 2 cn rena veges Det iveseent ican i epsne eter 0) -354,910. 1,143,576. © Adustd netincome negate, et 0) ‘BAA For Paperwork Reduction Act Notice, see inst tructions. Form $90-PF 2017)Foor 990-PF (@017) GRATITUDE AMERICA, LTD [Park Balance Sheets ergs attach Seite Beganng of year 66-0789697 Page 2 End of year (@) Book Value. Wibaak Vale | Far aat Vate wamao> 1 Cash — non mierest bearing 2 Savings end temporary cash investments 3 Accounts receivable - _ Less: allowance for doubtful accounts * ~ = 4. Pledges recervable . Les, allowance tor doubt acounts 5 rants recenable 6 ecevabes de fom oficrs, crete, sles, ard er dlsquaed persons (atch schode)(See scion) 7 erste and an aca tach ch)» ‘Less. allowance for doubtful accounts *~ 8 Inventories for sale or use - 9. Prepaid expenses and deferred charges 10a Investments ~ U.S. and state government ‘obligations (attach schedule) Dimestnens — corporate stock (stach schedule) STATEMENT 4 « vesinents — corporate bands (eth sete) 11 Investments ~ land, buidings, and equipment basis Less acunwited deprenaton (tach shel) 12. Investments ~ mortgage loans 18 Investments ~ other (attach schedule) 14 Land, buildings, and equpment basis _ Less curate epretabon (atach shel) + 15. Other assets (desenibe » = j 16 Total assets (o be completed by aires See the mevuctons, Also, see page 1 iter) 4, 459, 553. 3,437, 853.| 3,437, 853 4,805,254, 5,472, 044.[ 5,426,011. 9, 264, 807 8,909, 897 8,863,864. oo Recounis payable and acciued expenses Grants payable Deterred revenue, Loans rom oie, directors, buses, & ober qahied pecans Mocgages and ter notes payable (tach schedule) Other lables (describe ) Be RSBses otal lablities (ad tines 17 trough 22) BO wamaur mz omoz>r>a ozen #eRR8 Foundations that follow SFAS 117, check here El and compete lines 28 through 26, and tines 30 and 31 24 Unvestncted 25 Temporary resbctes 25 Permanenly restcted Foundations that do not follw SFAS 117, check here »[[] Sed Complete lines 27 trough 3 Ceptal stock, ust panel, cuent funds Padma atl sus, a ep an egret ad aed es, zt ecare ee ct ot Total net ascts or fund balances ee nstuctons), Toa lbies and net assetfund balances (see instructions) 9,264, 807. 8,909, 897 9,264, 807 8,909, 857 9,264, 807 8,909, 897 Ti[Analysis of Changes in Net Assets or Fund Balances Total net assets or fund balances at beginning of year ~ Part Il column (8), line 30 (must agree with (Pa 1 ‘end-of-year figure reported on prior year's relura) 1 9, 264, 807 2 Enter amount from Part |, line 273 2 354,910, 3 Ober increases not nuded i ine 2 (itemize) . 3 4 Add ines 1,2, and 3 e a 7, 303, 897 5 Daxeses notin nine 2 tem) ee 2 5 6 Total net assets or fund balances at end of year (line 4 minus line 5) — Part Ti, column @), line 30 S 3, 903, 857 BAR TEENS Ow Ferm 990-PF (2017)Form 990-PF (2017) GRATITUDE AMERICA, LTD [ParIVe{Capital Gains and Losses for Tax on Investment Income 66-0789697 Page 3 SSS SS SESS Oe IES CV ame, Sar ma] as Ja SEE ATTACHED PR : 5 ———— Toa ol] — Sao ores Teena Tp oo aoe (@r allowable) Plus expense of sale (@e) plus () minus (@)) 2 7,468, 333. 6, 568, 916.) 899, 417 bo © I A © I Ss oy aa sie pw ata ad oad be on STS fare an aa onli Ct aan 0 FAY ef 29169 Onis eee Snes 2 1 899,417. b T © 1 @ = 1 © : Tan, aso mar Fatt? 2 cantata toon wont cannes] FRITS REST ey : a 2 Net trem cotl uo os) os deed seibors 1220) od. Wag, sone mPa tw 8, eck) Soo bt oe neers ® oe + ods 0 [PartsVaR]| Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income. (For optional use by domestic prvate foundations subjec othe secon 43403) tax on net mvesiment income ) If section 4940(4)() spptes, leave this part blank Was the foundation able for the section 4942 tax on the distnbulable amount of any year inthe base pen U1 Yes," the foundation doesn't qualfy under section 4940(¢). Do not complete ths part 3? [ves Enter The appropnate amount in each column foreach year, see the msructons before makng any enn, @ © © Base ods years Adjusted ualfing distibutons Net She of Dstabsfon rato caren fear rier year nonchantabieuse assets Ceol vided bye.) Ceding nh 2016 477,501. 9,603, 702. 0.049721, 2018 322,434. 2,465,270. 0.089664 2014 2013 2012 2 Total of line 1, column (4) 2 0.099385 2 Average dstbwon tt fo he Byer base penad ~ rade te total on ine 2 by 50, o by the numer of years he foundation Has been fr onance if ess than 8 yeors 3 0.049693, 4. Enter the net value of nonchantable-use assets for 2017 from Part X, line 5. 4 9,134, 556. 5 Mutiply ine 4 by tne 3 5 453,923. 6 Enter 1% of net investment income (1% of Pat | ine 276) 6 13,440. 7 Add ines 5 and 6 7 465,363. 8 Enter qualiying dstrbutons ftom Part Xi, ine 4 8 1,498, 086 Clie 8 1s equal io or greater than tne 7, check the box in Part VI ne 1b, and complete that part using 1% tax rate See the . Part Vi insttuctons, BAK Tea ose For BFF) |Form 990-PF 2017) GRATITUDE AMERICA, LTD. 2 66-0789697 Part Vi_ [Excise Tax Based on Investment income (Section 4940), 4S40(b), 4940(@), or 4948 — see instructions) “abt ong untae deren econ ASNOK2) check Pe Lf and enier'N/A one. foams ear i Dato rg a etermnaon ete: {attach copy of eter ifnecessary ~ see instructions) ‘b Domestic foundations that meet the section 4940(e) requirements in Part V, -la check here. © [and enter 1% of Prt, he 278 «Al ter does otters eter 2% of in 7. emp fren ergenzebons ener 4% Pane 12, () |. | - 2 Tax under secton 511 (domestic section 4947(a)1) trusts and taxable foundations only, others, enter -0-) u 9. 3 Aad ines 1 and 2 ry ii, 440. 4 Subtitle A (income) tax (omestic section 4947(2)(1) trusts and taxable foundations only, others, enter 0) [4 5 Tax based on investment income. Subtract in 4 trom line 3. I 2er0 oF less, enter 0 3 i440 6 Credits Payments ‘207 esata rs and 216 ocpger crete a 217 6 | bbExempt foreign orgenizations — tax withheld at source 68) | Tax paid wih appieton for extension of te to fle (Form 8868) el 20,000. ; ddBackup withosing erroneously withheld 6a _ 7. Total credits and payrnents Ad nes 6a through 6d 7 20,006. 18 Enter any penalty fr underpayment of estimated tax Check here 8 80 Tax ue ett fines Sard mare ane 7, eter amount owed 3 0. 10 Overpayment ine mare ten he tl fines $d, enter te aut overpaid fio 480 11_ Ents the amu of ie 10 to be Credited to 2018 estimated tax G 8,480.| Refunded. +[ 71 0 [Part VICA [Statements Regarding Activities 1a Dating the tax year, cd he foundaton atest tg niuence any national, stale or loca elation or dt Yes [No parlsbate or intervene in ery poliieal campaign? Tal x Qt zen mare an 100g he yer eter acy enh fr pol pages tad tx tthe answer "Yes! to ta or tb, attach adetaled descpton ofthe aces and copies of any materalspublshed for distributed by the foundation n conection wath the activities Did the foundation file Form 1120-POL for this year? ‘Enter the amount (it any) of tax on political expenditures (Section 4956) imposed duning the year: 1) On the foundation > $ 0. @ On foundation managers > S «se ran try QT LTE aig yar er pt acti ae spat) ‘foundation manages. = $ 2: How tendon ergsed m ay Ebest Fave a reves Sen reported tthe RS? Yes, attach a detailed description of the activities 3 Has the foundation made any changes, not previously reported to the IRS, mts governing instrument, articles ‘of incorporation, oF bylaws, or other sirmlar inttuments? If Yes, ailach a Gonformed copy of the changes ‘4a Did the foundation have unrelated business gross income of $1,000 or mare dunng the year? Dit "Yes, has it filed a tax return on Form 990-7 for this year? ‘5 Was hare iqudtn, ermsbon, dsslitor, or substantalcorrattan dung the yar? I1-Yes, allach the statement requred by Generat Instruction T. 6 Are the equrements of section 508(e) (relating to sections 4941 through 4945) satisfied ether: © By language in the governing instrument, of = By state legisation tat effectively amends the governing instument so that no mandatory directions that confit - vith te state lew remain in the governing wistument? : 7 Od the fundaton have at east $5,000 nase a ary tne dug the yen? "Yes compete Part cl (), and Part XV 7 ‘a Enter the states to which the foundetion reports or wth which it registered, See instructions . ny. bite anew Yer to ine 7 bias he oudabanfrshad&epy of ary 90 PF he Arey General (or designate) ef exc ae a equ by General Instucton GP Na tach elation 9 Is the foundaton laming status asa pvate operating foundation wit the menung of secon 48424) or 4942035) {or calendar year 2017 oF the tax year beginning in 2017? See the mstrucions for Part XW. If "Yes, complete Part XW 10. Od any persons become substantia contribs dug he tax yer? I Yes, atcha schedule isting he rames ‘and addresses x BAR osm S807F @017)Form 990-PF (2017) GRATITUDE AMERICA, LTD 66-0789697 Pages Part VI-A_[Statements Regarding Activities (continued) TT Atany ime dunng the year did the foundaten, drecty or mdrecty, own 2 controlled ent Sua he moan of chy SSO G)? Hes! at ses’ See matron 12 ithe fundaton me, dette oa donor adn fund ove whch he oundaton or @ squalid person had SGnsory pavieges? Hes, shach Stement See msiuctons 13 Dd the foundation comply wh the public inspection requirements forts annual retums and exemton application? Website address _ = 14. The books are m care of * ERIK —- Telephone ho. * ~ 340: Located at 9053 ESTATE THOMAS, SUITE 101 ST THOMAS VI ~~ 2P+4™ oos02 15. Section 49471) nonexemgk eantabe trusts ting Form SB0.AF meu of Form TOA] ~ check here and ener he amaunt of taxesempt interest received er accrued during the year 116 Atany tme during calendar year 2017, di the foundation have an igerestm or 2 signature or other authonty over 3 bank, securihes, or other fnancal account ia foregn county? ‘See the structions for exceptions and fling requirements for FinGEN Form 114 if'Yes, enter the name ofthe foreign county [Part VitB [Statements Regarding Activities for Which Form 4720 May Be Required File Form 4720 i any item is checked n the "Yes" column, unless an exception applies. ‘1a During the year, ch the foundatin (ether dectly or indirectly) (0) Engage inthe sale or exchange, oF leasing of property wih a disqualified person? {ves [xno ® Borrow money from, lend money to, or otherwise extend credit to (or accept it from) @ sisqualfied person? Yes. f]No @ Furnish goods, services, or tacites to (or accept them from) a disqualified person? Yes. [ilNo ) Pay compensation to, or pay ot reimburse the exoenses of, 2 disqualified person? Yes [x]No Taster any come oases o 2 dsauaiied person (or make any of ether avaiable © Tre bendider ose ora domaitod pasar Oe oY [ves io yee to pay money or property o a government ota? (Exception, Check No! the © Waratah ran aS toy fal ee sea ser ernaten GF goverment serace,emnating wih 58 daye) [vee {ino bifany answer is "Yex fo 14(1)~(, di any ofthe acts fa to quality under the exceptions deserbed n Remains se8uba 35 2381.8 cin & Chet nce repaetng easter aseslonce? See instructors ‘Organizations relying on a cisrent notice regarding diester assistance, check here “Oo «Dd the foundation engage in a prior year in any ofthe acts desorbed in Ta, othe than excepted ct, that ware not corrected Betare the ist day ofthe lax year begining 20177 2. Taxes on faire to cstnbutencome (secon 494) (doesnot apy for years the foundation was 2 private operating foundation defmed wy secon 43624)@) or 43403) 2 At een of tax yeat 2017, he foundation have any undistibued ncome (nes Sd es Bar xt ort year) beginang betore 207 Wes, ist the years 20,2020 «20 bb Are there any years listed n 2a for which the foundetion is not applying the provisions of section 4942(2)(2) (elating to incortect valuation of assets) to the year's undistributed income? (I appiying section 4342(a)(2) to all years listed, answer No! and attach statement ~ see instructions ) «i tne prowstons of section 442192) are beng applied to any of he year sted n 22, st he years here cies tamer ae rae 38 bd the ountation old more han a 2% dec or ect nest any business items any eda he year Oves bit Yes” didi have excess business holdings in 2017 as a result of (1) any purchase by the foundation of dsuslied persons afte ay 26,1968) te ape othe 8 year period (ot lorge! peed approved by the Commissioner uncer section 4543(€)(}) to aspose of holdings acquired by git or bequest; or the lapse of the 10-, 154 or 20.year fst phase holing pened? (Use Schedule C, Form 4720, to SSetermune i he foundation had excess busihess holaings ih 2017), 4aOud the foundation vest durng the year any amount n manner that would jeopardize ts chantable purposes?, . ie bbDid the foundavon rake any investment im 2 por year (ut after December 31,1966) that could apariae 1s ranable pupeee hal hoe tal ben tersoved wth eopadybelvet tst Coy oF the tax year beginning in 20177 Clves fino | Yes [ No BAK Teeaamst os? Form 990-°F (O17)Form 990-PF (2017) GRATITUDE AMERICA, LTD 66-0789697 Page 6 [Part VI-E] Statements Regarding Activities for Which Farm 4720 Nay Be Required (continued) “a Dunn te year, te Fundaton pay neu any amount (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? Infuene the outcome of any spect public electon (see secton 4955), oo eat © on Sracty onanecty, ary ser regan owe? © » ES @ Prowde a grant to an individual fr travel, study, or other silar purposes? (© Prone a grant to an arganization other than a chentable, etc, organization described wn section 945(6)()(0)? See instructions ©) Provide for ary purpose other than religious, chantable,scientitc, Werary, of ‘educational purposes, or forthe prevention f eucly chidren oc andi? bit any answer is Yes’ ta 59(1)—G), ad any ofthe tansactions fal to quality under the exceptions dead in equine secon 50 teh cr 3 cae ake easing Slade ssostaa _| See nstuctons 30) COxganzations relying on a current notice regarding disaster assistance, check here “Oo OF cf the answers "Yes to question SG, does the foundeton cai exertion rm the tor because mowained expendi fesponsbty forthe gant? N/A [ves [Jno C'¥es, attach the statement required by Regulations section 53 4345 -5(). 6 Did the foundation, dung the year, receve any funds, drecty or ndvecly, to pay premiums on 3 persona beneit coavact? ¥ ¥ ane [ves [xno ‘Did the foundation, dunng the year, pay premiums, directly or mare, on a personal beneft contract? X It °¥es' to 6b, tle Form 8870. i 7a any tne durng the tax year, wos the foundation a party toa probed tax sheer transaction? [ves fio |_|" “| 'bit-Yes, 6d he foundation recewe any proceeds o have ary net ncome atibutble tothe transaction? Part Vill_ information About Officers, Directors, Trustees, Foundation Managers, Highly Paik and Contractors 1. Lista officers, directors, trustees, and foundation managers and thelr compensation. See instructions. — (eye, and average (Compensation | ()ConrbuIONS | wy erpenae account (Nome ond adéress aewied Bpoaton | Gm ty" | plate and deteres | ter alowances ‘ampersaion RICHARD _KAGW — ___] PRESIDENT 0 0. ° 1E in | 1.00 NEW YORK, WY 10022 _| VICE PRESIDE 0 0 o Z| 1-00 SECRETARY 0. 0 1.00 LI _| TREASURER o 0. 0 ‘ES TI 3, St 7] 1.00 ST. THOMAS, VT_00802 2 CompensaUon of five highest pad employes (oer ha ose cluded on ie 1 se insirueona). none, enter NONE." [@) Tite, nd average (@Conbrbutions to (@) Name and adress ofeach employee Mraseyee beret, | © Expense account, pad more than $80,000 tats pecmeck | (©) Compensauon |" smbloye benett, | © Exeerar esc ‘conpeneston TOE Total numberof aler employees pad over $50,000, | a BAA TeeAtne. Ozu Form S80°F a7)Form 990:PF (2017) GRATITUDE AMERICA, LTD 66-0789697 Page? [Part Vil“ Jinformation About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees, and Contractors (continued) ‘3 Five highest-paid independent contractors for professional services. See instructions. none, enter NONE. (@ Name and address of each person pard more than $50,000 () Type of service (Weorpensaion "Total number of others receiving over $50,000 for professional senes| Ei 0 [Part I-A ] Summary of Direct Charitable Activities sth founda ons cule et hartate acts dung the ax yearn relevant lata wfoaton such asthe uber ot Expenses ugsnaabons and eter bane cares send, coneences conned esearch pagers odd, 1 NZ [Part X-B [Summary of Program-Related Investments (cee Instructions) ‘Describe the to terest progra-elaed evesens made by the fundaton ding te tax year on nes 1 and Fount TNA Total Aad ines 1 trough 3 =I 0 BAA Form 990F 2017)Form 990-PF (2017) GRATITUDE AMERICA, LTD 66-0789697 Page PartXe, see instructions.) jum Investment Return (All domeste foundations must complete This part. Foreign foundations, 1 Farr market value of assets not used (or held for use) directly carnyng out chrtabl, ete . purposes: 2 Average monthly fair markel value of Secures. 5,208, 163. b Average of monthiy cash balances 4,065, 498 Fax market vale of all other assets (see structions) 4 Total (dd ines 12, b, and «) 3,213, 661. € Reduction clamed for blockage or other factors reported on lines Ta and 1c (attach detailed explanation) te 2 Acquistion indebledness appiceble to line 1 assets 9. 3 Subtract line 2 from ine Ie S| 9,273, 661. 4. Cash deemed held for chantable actives. Enter 1-112% of line 3 (for greater emourt, see mstucions). 4 139, 105. 5. Netvalue of nonchartablesuse assets, Subiract ine 4 from ine 3 Enter here and on Part V, tine 4 5 | 9,134,556. 6 Minimum investment return. Enter 5% of line 5 6 456, 728. BSTEXIN Distributable Amount (See instructions) (Section 4942()(@) and ()G) private operating foundations ‘and certain foreign organizations, check here™ [ Jand do not complete this part.) TT Minimum investment return from Part X, line & 7 456,728. 2a Tax on investment ncome for 2017 from Part VI ne 5 [2a] 11,440. ‘Income tax for 2017. CTs does not elude the tax trom Pat Vi) (5) 6 Add tines 2a and 26 2¢ 11,440. 3 Distrbutable amount before adjustments, Subtract line 2c from line 1 3 445, 288. 4 Recoveries of amounis treated as qualifng disinbutons 4 5 Add lines 3 and 4 5 445, 288. 6 Deduction from distnbutable amount (see instructions) é 7 Distributable amount as adusted Subirac ine 6 from tne § Enter here and on Part Xl ine 1 7 445, 268. ([E&AREIB Qualifying Distributions (see instructions) uns pad (including administrative expenses) to accomplish chantable, etc , purposes. jee] 1, Epareelcattaocte, gis te Wal om Pat erin, tne 28 Ta]__1,498, 886. bb Program-elated investments ~ total from Part XB. 7] 2. Aemounts paid to acqure assels used (or held for use) directly in corying out chantable, e., purposes 2 3 BOR es no FS approval requregy nna Snel he bbCash distabuton test attach the required schedule). 4 Qualifying distributions. Ads ines 12 through 3b. Enter here and on Part V, line 8; and Part Xil, ine & 1,458, 886. 5 Foundatons that quality under section 4540() for he reduced rate of tax on nel vesiment income Enier 10! Pat ime 270, See mnstructons 5 11,440. 6 Adjusted qualifying distributions. Subtract line § from hne 4 e[ 4,467, 446- Note: The amount on ine 6 wl be used in Part V, column (t), on subsequent years when calculating whether the foundation vais for the section 4340(@) reduction of tax in those years. Form 9807F GOTom 990-PF 2017) GRATITUDE AMERICA, LTD (ParkXill undistributed Income (Gee instructions) 1 Dap aout or 2017 trom Part XI, Ba | © ‘Years prot to 2016 66-0789697 Page 9 ©. 2016 ©. 2007 | 445,288. 2 Unde ncae, any, a5 tend of 27; ‘a Enter amount for 2016 only Tot for preryears: 20 _ 2 Ph begun titans eyo fan, TT ~ |aFrom 2012 bb From 2013, ceFrom 2018 urpose of grant or re rected (oes i tay Areunt Name and address (home or business) or substantial contributor | Teciprent Pad ding te year SEE STATEMENT ‘5 Total > 3a 1,260,000. rove Tor tre payment Toit =a BAR TEES AT Form S507F QO)