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2101 E COAST HIGHWAY SUITE 300 CORONA DEL MAR CA 92625 PRESIDENT 5.00 0 0 0 HENRY SAMUELI 2101 E COAST HIGHWAY SUITE 300 CORONA DEL MAR CA 92625 VICE PRESIDENT 1.00 0 0 0 MICHAEL SCHULMAN 2101 E COAST HIGHWAY SUITE 300 CORONA DEL MAR CA 92625 SECRETARY & CFO 1.00 0 0 0 ERIN SAMUELI 2101 E COAST HIGHWAY SUITE 300 CORONA DEL MAR CA 92625 DIRECTOR 1.00 0 0 0 GERALD SOLOMON 2101 E COAST HIGHWAY SUITE 300 CORONA DEL MAR CA 92625 EXECUTIVE DIRECTOR 10.00 101637 2740 0 MICHELLE FREEMAN 2101 E COAST HIGHWAY SUITE 300 CORONA DEL MAR CA 92625 PROGRAM MANAGER 40.00 135295 5412 0 WAYAN KAUFMAN 2101 E COAST HIGHWAY SUITE 300 CORONA DEL MAR CA 92625 EXECUTIVE ASSISTANT 40.00 76271 763 0 VICTORIA TORRES 2101 E COAST HIGHWAY SUITE 300 CORONA DEL MAR CA 92625 PROGRAM MANAGER 40.00 51231 0 0 0 H&S VENTURES 2101 E COAST HIGHWAY SUITE 300 CORONA DEL MAR CA 92625 PROFESSIONAL MANAGEMENT SERVICES 118702 0 0 0 3686972 12856 3699828 0 0 3699828 55497 3644331 182217 182217 147567 147567 34650 0 34650 0 34650 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ORANGE COUNTY 1 FEDERATION WAY SUITE 205 IRVINE CA 92603 NONE PC RELIGIOUS 5000 HUMAN OPTIONS PO BOX 53745 IRVINE CA 92619 NONE PC SOCIAL SERVICES 20000 I-5 FREEDOM NETWORK 160 AVENIDA GRANADA SAN CLEMENTE CA 92672 NONE PC SOCIAL SERVICES 25000 INNOVATE EDUCATE PO BOX 9919 SANTA FE NM 87504 NONE PC EDUCATION 25000 INSIDE THE OUTDOORS 200 KALMUS DRIVE COSTA MESA CA 92626 NONE PC EDUCATION 30000 INSTITUTE OF INTEGRATIVE PAIN MANAGEMENT 4088 E WINDSONG STREET SPRINGFIELD MO 65809 NONE PC HEALTH 10000 IRVINE ICE FOUNDATION 888 RIDGE VALLEY IRVINE CA 92618 NONE PC SOCIAL SERVICES 150000 JEWISH COMMUNITY CENTER OF OC 1 FEDERATION WAY SUITE 210 IRVINE CA 92603 NONE PC RELIGIOUS 25000 JEWISH COMMUNITY FOUNDATION OF LOS ANGELES 6505 WILSHIRE BLVD SUITE 1200 LOS ANGELES CA 90048 NONE PC RELIGIOUS 150000 JEWISH FEDERATION & FAMILY OF OC 1 FEDERATION WAY SUITE 210 IRVINE CA 92603 NONE PC RELIGIOUS 85000 JEWISH FUNDERS NETWORK 150 WEST 30TH STREET SUITE 900 NEW YORK NY 10001 NONE PC RELIGIOUS 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150 OHIO'S HOSPICE OF DAYTON 324 WILMINGTON AVE DAYTON OH 45420 NONE PC HEALTH 190000 ONEOC 1901 E FOURTH STREET STE 100 SANTA ANA CA 92705 NONE PC EDUCATION 73092 ORANGE COAST COLLEGE 2701 FAIRVIEW RD COSTA MESA CA 92626 NONE PC EDUCATION 50000 ORANGE COUNTY UNITED WAY 18012 MITCHELL AVE SOUTH IRVINE CA 92614 NONE PC SOCIAL SERVICES 150000 ORANGEWOOD FOUNDATION 1575 EAST 17TH STREET SANTA ANA CA 92705 NONE PC SOCIAL SERVICES 15000 PLANNED PARENTHOOD FEDERATION OF AMERICA 123 WILLIAM ST 10TH FLOOR NEW YORK NY 10038 NONE PC HEALTH 50000 PLANNED PARENTHOOD 700 S TUSTIN ST ORANGE CA 92866 NONE PC HEALTH 50000 PROGRAM FOR TORTURE VICTIMS 3550 WILSHIRE BLVD STE 1906 LOS ANGELES CA 90010 NONE PC SOCIAL SERVICES 10000 QUAN AM BUDDHIST MEDITATION 12670 18TH STREET REDLANDS CA 92373 NONE PC RELIGIOUS 1000 SANTA CLARA UNIVERSITY SCHOOL OF LAW 500 EL CAMINO REAL SANTA CLARA CA 95053 NONE PC EDUCATION 5000 SEGERSTROM CENTER FOR THE ARTS 600 TOWN CENTER DRIVE COSTA MESA CA 92626 NONE PC ARTS 102500 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SERVICES 30000 TELLURIDE SCIENCE RESEARCH CENTER PO BOX 2429 TELLURIDE CO 81435 NONE PC SOCIAL SERVICES 50000 TEMPLE BETH EL 2A LIBERTY ALISO VIEJO CA 92656 NONE PC RELIGIOUS 150000 TESLA SCIENCE CENTER OF WARDENCLYFFE PO BOX 552 SHOREHAM NY 11786 NONE PC EDUCATION 5000 THANG LONG YOUTH EDUCATION GROUP 11642 DORADA AVE GARDEN GROVE CA 82840 NONE PC SOCIAL SERVICES 1000 THE 1939 CLUB 8950 W OLYMPIC BLVD SUITE 437 BEVERLY HILLS CA 90211 NONE PC RELIGIOUS 650 THE NATIONAL ACADEMY OF ENGINEERING 500 FIFTH STREET - NW WASHINGTON DC 20001 NONE PC EDUCATION 30000 TIDES FOUNDATION PO BOX 399385 SAN FRANCISCO CA 94139 NONE PC HEALTH/SOCIAL SERVICES 20000 UCI FOUNDATION 903 W PELTASON IRVINE CA 92697 NONE PC EDUCATION/HEALTH 1400381 UCSF FOUNDATION PO BOX 45339 SAN FRANCISCO CA 94145 NONE PC HEALTH 1000 UNIVERSITY OF CA BERKELEY 1995 UNIVERSITY AVENUE SUITE 400 BERKELEY CA 94704 NONE PC EDUCATION 5000 UNIVERSITY OF MARYLAND BALTIMORE FOUNDATION 620 W LEXINGTON STREET BALTIMORE MD 21201 NONE PC HEALTH 50000 UNIVERSITY OF MINNESOTA FOUNDATION 420 DELAWARE STREET SE MMC 505 MINNEAPOLIS MD 55455 NONE PC HEALTH 25000 USA WARRIORS ICE HOCKEY 13424 QUERY MILL ROAD NORTH POTOMAC MD 20878 NONE PC SOCIAL SERVICES 5000 USC LEONARD DAVIS SCHOOL OF GERONTOLOGY 3715 MCCLINTOCK AVENUE SUITE 110 LOS ANGELES CA 90089 NONE PC HEALTH 10000 VIRGINIA COMMONWEALTH UNIVERSITY 800 EAST LEIGH STREET SUITE 3200 RICHMOND VA 23298 NONE PC HEALTH 75000 WOMEN'S STEP HOUSE OF ORANGE COUNTY PO BOX 3676 LAGUNA HILLS CA 92654 NONE PC HEALTH 5000 YOUNG LIVES REDEEMED 1105 EAST COMMONWEALTH AVE SUITE A-2 FULLERTON CA 92831 NONE PC SOCIAL SERVICES 10000 6583781 0 14 2311 18 127441 0 129752 0 129752 0 0 0 0 0 0 0 0 0 0 X X 1 HENRY SAMUELI 2018 GRANTOR TRUST SOUTH DAKOTA TRUST COMPANY TRUSTEE 201 S PHILLIPS AVE STE 200 SIOUX FALLS SD 57104 726781 X 2 HS MANAGEMENT LP 2101 E COAST HIGHWAY SUITE 300 CORONA DEL MAR CA 92625 2443117 X 3 SUSAN FAYE SAMUELI 2018 GRANTOR TRUST SOUTH DAKOTA TRUST COMPANY TRUSTEE 201 S PHILLIPS AVE STE 200 SIOUX FALLS SD 57104 7758523 X 1 STOCKS 726781 2020-12-31 2 STOCKS 2443117 2020-12-31 3 STOCKS 7758523 2020-12-31 ACCOUNTING FEES 5000 1250 2000 SOFTWARE - WEBSITE 2008-01-11 14700 14700 SL 3.000000000000 0 0 SOFTWARE - IOS APP 2012-12-01 6000 6000 SL 3.000000000000 0 0 GRANTMAKING WEBSITE 2013-09-12 3500 3500 SL 3.000000000000 0 0 GRANTMAKING WEBSITE 2013-10-03 3695 3695 SL 3.000000000000 0 0 LAPTOP 2016-01-29 1273 1273 SL 3.000000000000 0 0 LAPTOP 2016-09-12 2652 2652 SL 3.000000000000 0 0 LAPTOP 2017-07-21 1900 1583 SL 3.000000000000 317 0 LAPTOP 2018-03-28 2437 1625 SL 3.000000000000 542 0 DELL COMPUTERS WK & MF - DESKTOP 2019-01-11 2463 821 SL 3.000000000000 821 0 DELL MARKETING - DELL DESKTOP GERALD 2019-04-22 1214 303 SL 3.000000000000 405 0 SURFACE LAPTOP - VICTORIA TORRES 2019-05-10 1723 383 SL 3.000000000000 574 0 TV SCREENS 2019-06-03 3233 629 SL 3.000000000000 1078 0 BLACKBAUD SOFTWARE 2019-09-30 1688 SL 0.000000000000 0 0 BLACKBAUD SOFTWARE 2019-10-31 1688 SL 0.000000000000 0 0 BLACKBAUD SOFTWARE 2020-03-31 175 SL 0.000000000000 0 0 DELL XPS 13 LAPTOP - GS 2020-01-31 2070 SL 3.000000000000 690 0 DELL LAPTOP - LAYLAH BULMAN 2020-02-23 2048 SL 3.000000000000 626 0 DELL LAPTOP - MICHELLE FREEMAN 2020-09-20 2086 SL 3.000000000000 231 0 DISPOSAL OF ASSETS 2020-01 PURCHASED 2020-12 271 COST 0 -271 PART XIII STATEMENT/ELECTION TO TREAT PRIVATE FOUNDATION AS A CONDUIT FOUNDATIONPURSUANT TO IRC SECTION 170(B)(1)(F) AND REG. SECTION 1.170A-9(H)(2), THE SAMUELI FOUNDATION HEREBY ELECTS TO BE TREATED AS A "CONDUIT" FOUNDATION FOR THE 2020 TAX YEAR. THE FOLLOWING ARE DISTRIBUTIONS MADE OUT OF CORPUS PURSUANT TO IRC SECTION 4942(H):2017 - $979,6312018 - $1,826,1472019 - $1,239,2462020 - $6,883,397 PART XIII ELECTION TO TREAT UNUSED PRIOR YEAR CORPUS DISTRIBUTIONS AS CURRENT YEAR CORPUS DISTRIBUTIONSPURSUANT TO REG. SECTION 53.4942(A)-3(C)(2)(IV), THE SAMUELI FOUNDATION HEREBY ELECTS TO TREAT, AS CURRENT DISTRIBUTION OUT OF CORPUS, THE FOLLOWING UNUSED PRIOR TAX YEAR'S DISTRIBUTIONS THAT WERE TREATED AS CORPUS DISTRIBUTIONS UNDER REG. SECTION 53.4942(A)-3(D)(1)(III) IN SUCH PRIOR TAX YEAR: 2017 - $979,6312018 - $1,826,1472019 - $1,239,2462020 - $6,883,397 SOFTWARE - WEBSITE 14700 14700 0 SOFTWARE - IOS APP 6000 6000 0 GRANTMAKING WEBSITE 3500 3500 0 GRANTMAKING WEBSITE 3695 3695 0 LAPTOP 1900 1900 0 DELL COMPUTERS WK & MF - DESKTOP 2463 1642 821 DELL MARKETING - DELL DESKTOP GERALD 1214 708 506 SURFACE LAPTOP - VICTORIA TORRES 1723 957 766 TV SCREENS 3233 1707 1526 BLACKBAUD SOFTWARE 1688 0 1688 BLACKBAUD SOFTWARE 1688 0 1688 BLACKBAUD SOFTWARE 175 0 175 DELL XPS 13 LAPTOP - GS 2070 690 1380 DELL LAPTOP - LAYLAH BULMAN 2048 626 1422 DELL LAPTOP - MICHELLE FREEMAN 2086 231 1855 LEGAL FEES 131884 32971 52754 OTHER ASSETS 1029 1029 RESEARCH AND DEVELOPMENT 150040 0 150040 OFFICE 77803 38902 0 INSURANCE 21174 10587 0 POSTAGE 8125 4063 0 TELEPHONE AND INTERNET 5135 1284 2568 ADVERTISING 3134 1402 1567 BENEFIT PLAN ADMINISTRATION 1370 137 1096 PAYROLL PROCESSING 998 100 798 CUSTODIAL FEES 500 125 250 DUES AND SUBSCRIPTIONS 355 0 355 BANK FEES 26 26 0 PAYROLL LIABILITIES 3030 0 OTHER LIABILITIES 0 30 CONSULTING FEES 203154 0 203154 MANAGEMENT FEES 6193 2477 0 OUTSIDE SERVICES 4685 0 4685 PAYROLL TAX 19346 3869 15476 FEDERAL TAX 2300 0 0 TAXES & LICENSES 170 0 0 PROPERTY TAXES 71 35 35 STATE TAX 810 0 0