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Return of Private Foundation
Form990-PF or Section 4947(a)(1) Nonexempt Charitable Trust
',!;I Treated as a Private Foundation
Note. The foundation may be able to use a copy of this return to satisfy state reporting requirements
2011
DepartmentoftheTreasury
InternalRevenueService
For calendar year 2011, or tax year beginning 10-01-2011 , and ending 09-30-2012
G Check all that apply r In1t1al return r In1t1al return of a former public charity r Final return
Name of foundation
A mended r return r Address change r Name change
A Employer identification number
THE MILSTEINFAMILYFOUNDATION
95-4824595
B Telephone number (see page 10 of the instructions)
Number and street (or PO box number 1fmail 1snot delivered to street address) Room/suite
16027 VENTURABLVD
(818) 995-7965
''
City or town, state, and ZIP code C If exemption application 1spending, check here ~
ENCINO, CA 91436
D 1. Foreign organizations, check here ~
H Check type of organ1zat1on P"Section 501(c)(3) exempt private foundation 2. Foreign organizations meeting the 85% test,
'
~
r Section 494 7(a)(l) nonexempt charitable trust r Other taxable private foundation
check here and attach computation
I Fair market value of all assets at end J Accounting method P"Cash r Accrual
E If private foundation status was terminated
'
under section 507( b)( l)(A), check here ~
of year (from Part II, col. (c),
!me 16)..,.$ 14,675,930
r Other (specify) - F If the foundation 1sin a 60-month temnmat1on
(Part I, column (d) must be on cash basis.)
'
under section 507( b)( 1)( B), check here ~
Sa Gross rents
9 Income mod1f1cat1ons
0
t Add lines 13 through 23 60,737 60,737 0
26 Total expenses and disbursements. Add Imes 24 and 25 1,705,667 60,737 1,644,930
3 Accounts receivable,..
Less allowance for doubtful accounts,..
4 Pledges receivable,..
Less allowance for doubtful accounts,..
5 Grants receivable
6 Receivables due from officers, directors, trustees, and other
d1squal1f1ed persons (attach schedule) (see page 15 of the
1nstruct1ons).
7 Other notes and loans receivable (attach schedule),..
,fl
4' 24
u
and complete lines 24 through 26 and lines 30 and 31.
Unrestricted
'
~
,:::; 25 Temporarily restricted
-,:::;
26 Permanently restricted
ca
!::
Foundations that do not follow SFAS 117, check here ...p-
::::l and complete lines 27 through 31.
u.
'- 27 Capital stock, trust principal, or current funds
0
,fl
28 Pa1d-1n or capital surplus, or land, bldg, and equipment fund
4)
,fl 29 Retained earnings, accumulated income, endowment, or other funds 14,752,536 15,327,258
,fl
ci 30 Total net assets or fund balances (see page 1 7 of the
4) 1nstruct1ons). 14,752,536 15,327,258
z
31 Total liabilities and net assets/fund balances (see page 1 7 of
the 1nstruct1ons) 14,752,536 15,327,258
1 Total net assets or fund balances at beg1nn1ng of year-Part II, column (a), line 30 (must agree
with end-of-year figure reported on prior year's return) 1 14,752,536
2 Enter amount from Part I, line 27a 2 574,722
3 Other increases not included In line 2 (1tem1ze),.. 3
4 Add lines 1, 2, and 3 4 15,327,258
5 Decreases not included In line 2 (1tem1ze),.. 5
6 Total net assets or fund balances at end of year (line 4 minus line 5 )-Part II, column (b), line 30. 6 15,327,258
Form 990-PF (2011)
Form 9 9 O- P F ( 2 O 11 ) Page 3
l:F-Til.l'ft Capita Gams an d Losses f or Tax on Investment Income
(b) How acquired
(a) List and describe the k1nd(s) of property sold (e g, real estate, (c) Date acquired (d) Date sold
P-Purchase
2-story brick warehouse, or common stock, 200 shs M LC Co) (mo, day, yr) (mo, day, yr)
D-Donat1on
la DETAIL AVAILABLE UPON REQUEST p 2001-01-01 2012-01-01
b
C
d
e
(f) Deprec1at1on allowed (g) Cost or other basis (h) Gain or (loss)
(e) Gross sales price
(or allowable) plus expense of sale (e) plus (f) minus (g)
a 93,243 -93,243
b
C
d
e
Complete only for assets showing gain 1n column (h) and owned by the foundation on 12/31/69 (I) Gains (Col (h) gain minus
(j) AdJusted basis (k) Excess of col (1) col (k), but not less than -0-) or
(i) FM V asof12/31/69 Losses (from col (h))
asof12/31/69 over col (J), 1f any
a -93,243
b
C
d
e
2 Capital gain net income or (net capital loss) { If gain, also enter 1n Part I, line 7
If (loss), enter -0- 1n Part I, line 7 } 2 -93,243
3 Net short-term capital gain or (loss) as defined 1n sections 1222(5) and (6)
Was the foundation liable for the section 4942 tax on the distributable amount of any year 1n the base period7 I Yes P- No
If"Yes," the foundation does not qualify under section 4940(e) Do not complete this part
1 Enter the appropriate amount 1n each column for each year, see page 18 of the 1nstruct1ons before making any entries
(a) (d)
(b) (c)
Base period years Calendar Net value of nonchantable-use assets D1stnbut1onratio
Adjusted qualifying d1stnbut1ons
year (or tax year beginning in) (col (b) d1v1dedby col (c))
2010 1,208,636 13,753,520 0 08788
2009 720,816 12,537,717 0 05749
2008 434,339 10,436,251 004162
2007 324,000 8,468,045 0 03826
2006 335,400 7,613,656 0 04405
4 Enter the net value ofnoncharitable-use assets for 2011 from Part X, line 5. 4 14,344,675
2 Tax under section 511 (domestic section 4947(a)(l) trusts and taxable foundations only Others enter -0-) 2
3 Add lines 1 and 2. 3 9,129
4 Subtitle A (income) tax (domestic section 4947(a)(l) trusts and taxable foundations only Others enter -0-) 4
5 Tax based on investment income. Subtract line 4 from line 3 If zero or less, enter -0-. 5 9,129
6 Credits/Payments
a 2011 estimated tax payments and 2010 overpayment credited to 2011 6a 6,000
b Exempt foreign organ1zat1ons-tax withheld at source 6b
c Tax paid with appl1cat1on for extension oft1me to file (Form 8868) 6c
d Backup w1thhold1ng erroneously withheld. 6d
7 Total credits and payments Add lines 6a through 6d. 7 6,000
8 Enter any penalty for underpayment of estimated tax Check here p- 1f Form 2220 1s attached ~ 8 7
9 Tax due. If the total ofl1nes 5 and 8 1s more than line 7, enter amount owed. ,... 9 3,136
10 Overpayment. If line 7 1s more than the total of lines 5 and 8, enter the amount overpaid. ,... 10
11 Enter the amount of line 10 to be Credited to 2012 estimated tax,... I Refunded,... 11
Part VII-A Statements Regarding Act1v1t1es
la During the tax year, did the foundation attempt to influence any national, state, or local leg1slat1on or did Yes No
1t part1c1pate or intervene 1n any pol1t1cal campa1gn7 la No
b Did 1t spend more than $100 during the year (either directly or 1nd1rectly) for pol1t1cal purposes (see page 19 of
the 1nstruct1ons for def1n1t1on)7 lb No
If the answer 1s "Yes" to 1a or 1b, attach a detailed descnptJOn of the act1v1t1es and copies of any matenals
published or d1stnbuted by the foundatJOn 1n connection with the act1v1t1es.
c D 1d the foundation file Form 1120-POL for this yea r7. le No
d Enter the amount (1fany) of tax on pol1t1cal expenditures (section 4955) imposed during the year
(1) On the foundation ,... $ ________ (2) On foundation managers ,... $ _______ _
e Enter the reimbursement (1f any) paid by the foundation during the year for pol1t1cal expenditure tax imposed
on foundation managers ,... $ _______ _
2 Has the foundation engaged 1n any act1v1t1es that have not previously been reported to the IRS7 2 No
If "Yes," attach a detailed descnpt1on of the act1v1t1es.
3 Has the foundation made any changes, not previously reported to the IRS, 1n its governing instrument, articles
of 1ncorporat1on, or bylaws, or other s1m1lar 1nstruments7 If "Yes," attach a conformed copy of the changes 3 No
4a Did the foundation have unrelated business gross income of$1,000 or more during the year7. 4a No
b If "Yes," has 1t f1led a tax return on Form 990-T for this yea r7. 4b No
5 Was there a l1qu1dat1on, term1nat1on, d1ssolut1on, or substantial contraction during the year7 5 No
If "Yes," attach the statement required by General Instruct/On T.
6 Are the requirements of section 508(e) (relating to sections 4941 through 4945) sat1sf1ed either
By language 1n the governing instrument, or
By state leg1slat1on that effectively amends the governing instrument so that no mandatory d1rect1ons
that conflict with the state law remain 1n the governing instrument? 6 Yes
7 Did the foundation have at least $5,000 in assets at any time during the year7 If "Yes," complete Part II, col (c), and Part XV 7 Yes
Sa Enter the states to which the foundation reports orw1th which 1t 1s registered (see page 19 of the
1nstruct1ons) ,...__________________________________________ _
b If the answer 1s "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G7 If "No," attach explanation. Sb Yes
9 Is the foundation cla1m1ng status as a private operating foundation w1th1n the meaning of section 4942(J)(3)
or 4 9 4 2 (J)(5) for calendar year 2 O 11 or the taxable year beg1nn1 ng In 2 O 11 (see I nstruct1ons for Pa rt XIV on
page 2 7 )7 If "Yes," complete Part XIV 9 No
10 Did any persons become substantial contributors during the tax year7 If "Yes," attach a schedule /Jstmg their names and addresses~ 10 Yes
Form 990-PF (2011)
Form 9 9 O- P F ( 2 O 11 ) Page 5
I:F-Til I'd9~1 Statements Regarding Activities (continued)
11 At any time during the year, did the foundation, directly or 1nd1rectly, own a controlled entity w1th1n the
meaning of section 512(b)(13)7 If"Yes," attach schedule (see page 20 of the 1nstruct1ons). 11 No
12 Did the foundation acquire a direct or 1nd1rect interest In any applicable insurance contract before August 17, 20087 12 No
13 Did the foundation comply with the public InspectIon requirements for its annual returns and exemption appl1cat1on7 13 Yes
Webs Ite address .,__N_,_/_A
______________________________________________ _
14 The books are In care of ... FISHMAN BLOCK DIAMOND LLP Telephone no .,_(818) 783-7140
Located at ... 16830 VENTURABLVDSUITE400 ENCINO CA ZIP +4 .,_.;;_9=1....;.4..;;..3..;;..6
_______ _
Total number of others rece1v1ng over $50,000 for professional services. ...
i:bilf:d.;I Summary of Direct Charitable Activities
List the foundation's four largest direct charitable act1v1t1esduring the tax year Include relevant stat1st1calinformation such as the number of
organizations and other benef1c1ariesserved, conferences convened, research papers produced, etc Expenses
10 Analysis ofl1ne 9
a Excess from 2 0 0 7.
b Excess from 2008.
C Excess from 2009.
d Excess from 2010. 167,345
e Excess from 2 0 11. 936,825
Form 990-PF (2011)
Form 9 9 0 - P F ( 2 0 11 ) Page 10
M:itii!tl*M Foundations see a e 27 of the instructions and Part VII-A uest1on 9
la If the foundation has received a ruling or determ1nat1on letter that It Is a private operating
foundation, and the ruling Is effective for 2011, enter the date of the ruling. ...-~------------------
b Check box to 1nd1cate whether the organIzatIon IS a private operating foundation described In section r 4942(J)(3) or r 4942(J)(5)
2a Enter the lesser of the adJusted net Tax year Prior 3 years
income from Part I or the mInImum (e) Total
(a)2011 (b) 2010 (c) 2009 (d) 2008
investment return from Part X for each
year listed.
b 85% ofl1ne 2a.
C Q ual1fy1ng d1stribut1ons from Part XII,
line 4 for each year listed.
d Amounts included in line 2c not used directly
for active conduct of exempt actIvItIes.
e Q ual1fy1ng d1stribut1ons made directly
for active conduct of exempt actIvItIes
Subtract line 2d from line 2c.
3 Complete 3a, b, or c for the
alternative test relied upon
a "Assets" alternative test-enter
(1) Value of all assets
(2) Value of assets qual1fy1ng
under section 4942(J)(3 )(B)(1)
b "Endowment" alternative test- enter 2/3
of mInImum investment return shown In
Part X, line 6 for each year listed.
C "Support" alternative test-enter
(1) Total support other than gross
investment income (interest,
d1v1dends, rents, payments
on securities loans (section
512(a)(5)), or royalties).
(2) Support from general public
and 5 or more exempt
organIzatIons as provided In
section 4942(J)(3)(B)(111).
(3) Largest amount of support
from an exempt organIzatIon
(4) Gross investment income
I :r-Tili
:t'fJ Supplementary Information (Complete this part only if the organization had $5,000 or more in
assets at any time during the year-see page 27 of the instructions.)
1 Information Regarding Foundation Managers:
a List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only 1fthey have contributed more than $5,000) (See section 507(d)(2))
b List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest
a The name, address, and telephone number of the person to whom appl1cat1ons should be addressed
b The form In which appl1cat1ons should be submitted and 1nformat1on and materials they should include
d Any restrictions or l1m1tat1ons on awards, such as by geographical areas, charitable fields, kinds of InstItutIons, or other
factors
Total. ....3b
Form 990-PF (2011)
Form 9 9 0 - P F ( 2 0 11 ) Page 12
I :F-Til ;i,.~!lit~J Ana IYSIS 0 f Income-Pro d ucmg Act1v1t1es
Enter gross amounts unless otherwise 1nd1cated Unrelated business income Excluded by section 512, 513, or 514 (e)
Related or exempt
function income
(a) (b) (c) (d)
(See page 28 of
1 Program service revenue Business code A mount Exclusion code A mount
the 1nstruct1ons )
a
b
C
d
e
f
g Fees and contracts from government agencies
2 Membership dues and assessments.
3 Interest on savings and temporary cash investments 5
4 D1v1dends and interest from securities. 603,544
5 Net rental income or (loss) from real estate
a Debt-financed property.
b Not debt-financed property.
6 Net rental income or (loss) from personal property
7 Other investment income.
8 Gain or ( loss) from sales of assets other than inventory -93,243
9 Net income or (loss) from special events
10 Gross profit or (loss) from sales of inventory.
11 Other revenue aPR0FIT FROMNPNASSETS 370,083
b
C
d
e
12 Subtotal Add columns (b), (d), and (e). 880,389
13 Total. Add line 12, columns (b), (d), and (e). . 13 _________ __;;_8~8~0~3~8;;..;;_9
(See worksheet 1n line 13 1nstruct1ons on page 28 to verify calculations )
Part XVI-B Relationshi of Activities to the Aecom lishment of Exem t Pur oses
..
Line No.
Explain below how each act1v1ty for which income
the accomplishment of the organ1zat1on's exempt
page 28 of the 1nstruct1ons)
1s reported 1n column (e) of Part XVI-A contributed importantly
purposes (other than by prov1d1ng funds for such purposes) (See
to
(a) Line No (b) Amount involved (c) Name of nonchantable exempt organIzatIon (d) Description of transfers, transactions, and sharing arrangements
2a Is the foundation directly or 1nd1rectly aff1l1ated with, or related to, one or more tax-exempt organIzatIons
described In section 5 0 1 (c) of the Code (other than section 5 0 1 (c )(3 )) or In section 5 2 7 7. .I Yes
b If"Yes," complete the following schedule
(a) Name of organIzatIon (b) Type of organIzatIon (c) Description of relat1onsh1p
Under penalties of perJury, I declare that I have examined this return, 1nclud1ng accompanying schedules and statements, and to
the best of my knowledge and belief, It Is true, correct, and complete Declaration of preparer (other than taxpayer or f1duc1ary) Is
based on all 1nformat1on ofwh1ch preparer has any knowledge
i 2012-12-14
~ ~
****** ******
Signature of officer or trustee Date Title
Date PTIN
~
-:l) Check 1f self-
:::c
C
Preparer's ~ STEVEN J FISHMAN CPA employed ~r
::r.:, Signature
ii) >,
'":..-
v.i -fC
.::.:,i::o Firm's name ~ Fishman Block Diamond LLP Firm's EIN ~
i::f:::.,t,
t ,j) 16830 Ventura Blvd Ste 400
Cl.:i
Firm's address ~ EncIno,CA 914361726 Phone no (818) 783-7140
May the IRS discuss this return with the preparer shown above7 See InstructIons ...P-Yes I No
General Rule-
P" For an organization fIlIng Form 990, 990-EZ, or 990-Ff" that received, during the year, $5,000 or more ( In money or
property) from any one contributor Complete Parts I and II
Special Rules
1
1 For a section 501 ( c )(3) organization fIlIng Form 990 or 990-EZ, that met the 33 /3% support test of the regulations
under sections 509( a)( 1) and 170( b)( 1)(A)(vI), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (1) Form 990, Part VIII, line 1h, or (11)Form 990-EZ, line 1 Complete Parts I and II
1 For a section 501 ( c )(7), ( 8), or ( 10) organization fIlIng Form 990, or 990-EZ, that received from any one contributor,
during the year, aggregate contributions of more than $1,000 for use exclus1vely for relIgIous, charitable,
scIentIfIc, literary, or educational purposes, or the prevention of cruelty to children or animals Complete Parts I, II, and
Ill
1 For a section 501 ( c )(7), ( 8), or ( 10) organization fIlIng Form 990, or 990-EZ, that received from any one contributor,
during the year, contributions for use exclus1vely for relIgIous, charitable, etc , purposes, but these contributions did
not aggregate to more than $1,000 If this box Is checked, enter here the total contributions that were received during
the year for an exclus1vely relIgIous, charitable, etc, purpose Do not complete any of the parts unless the General Rule
applies to this organization because It received nonexclusIvely relIgIous, charitable, etc , contributions of $5,000 or more
during the year . . . . . . . . . . . . . . . . . . . . . . . . . ,... $
Caution. An Organization that Is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-Ff"), but It must answer "No" on Part IV, line 2 of its Form 990, or check the box In the heading of its
Form 990-EZ, or on line 2 of its Form 990-Ff", to certify that It does not meet the fIlIng requirements of Schedule B ( Form 990,
990-EZ, or 990-Ff")
For Paperwork Reduction Pct Notice, see the Instructions Cat No 30613X Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
for Form 990, 990-EZ, or 990-PF
Schedule B (Form 990, 990-EZ, or 990-PF) (2011) Page _1_ of _1_ of Part I
Name of organization Employer identification number
THE MILSTEIN FAMILYFOUNDATION
95-4824595
-- 1 Person p
ADAM
16027
GILA MILSTEIN
VENTURA BLVD 550
Payroll r
$ 1,400,000 Noncash r
ENCINO, CA 91436 (Complete Part II 1f there 1s
a noncash contribution )
-- Person r
Payroll r
$ Noncash r
(Complete Part II 1f there 1s
a noncash contribution )
-- Person r
Payroll r
$ Noncash r
(Complete Part II 1f there 1s
a noncash contribution )
-- Person r
Payroll r
$ Noncash r
(Complete Part II 1f there 1s
a noncash contribution )
-- Person r
Payroll r
$ Noncash r
(Complete Part II 1f there 1s
a noncash contribution )
-- Person r
Payroll r
$ Noncash r
(Complete Part II 1f there 1s
a noncash contribution )
--
--
--
--
--
--
--
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
--
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
--
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
--
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
THE CENTER FUND FOR ISRAEL N/A CHARITY GENERAL USE 5,000
3622 LYCKAN PARKWAY SUITE
6002
DURHAM,NC 27707
LEHO SHEET YAD - LOS ANGELES N/A CHARITY GENERAL USE 3,600
13079 CHANDLER BLVD
SHERMAN OAKS,CA 91401
ISRAEL CLOSE UPPO BOX 16135 N/A CHARITY GENERAL USE 5,000
NEWPORT BEACH, CA 92659
PEF ISRAEL FOR SHU RAT HA'DIN N/A CHARITY GENERAL USE 10,000
317 M7ADISON AVENUE SUITE
607
NEWYORK,NY 10017
STAND WITH USPO BOX 341069 N/A CHARITY GENERAL USE 175,000
LOS ANGELES,CA 90034
POSTAGE 7 7
BANK CHARGES 20 20
ANNUAL FEE 65 65
Name Address
ADAM GILA MILSTEIN 16027 VENTURA BLVD 550
ENCINO,CA 91436
lefile GRAPHIC print - DO NOT PROCESS I As Filed Data - I DLN:934913490000321