2017-11-10T14:42:26-06:00 2016-12-31 Foundation Source One Hollow Ln Ste 212 Lake Success NY 11042 990PF 2016-01-01 200857287 The Florence Forgotson Charitable Foundation Inc % Foundation Source FLOR 8008391754 Foundation Source 501 Silverside Rd Wilmington DE 198091377 CAROL A HINZ president 8008391754 2017-11-01 true Jeffrey D Haskell P01345770 8008391754 24.187.244.114 06391520173145000023 2017-11-10 P D1C4C64F5DE6A8B6330749B9C284B5FAFE420F11 9D59D74B225D538E4555D08F8D8ED29667824494 2016 2017-02-10 21:41:12Z X 2602362 X 0 X 32 32 187875 187869 15839 1329301 14674 1239 204985 202575 132240 62240 70000 10116 4761 5355 2154 2008 4149 4149 19348 817 18528 168007 73975 93883 54250 54250 222257 73975 148133 -17272 128600 40670 33901 33901 2495 2495 2495 2955400 2952304 2565966 13605 13605 3009675 3002305 2602362 7200 10275 6827 7200 17102 X 3002475 2985203 3002475 2985203 3009675 3002305 3002475 -17272 2985203 2985203 PUBLICLY-TRADED SECURITIES 1329301 1313462 15839 15839 ALLOCATED TO UBTI - ACQUISITION INDEBTED -1165 -1165 14674 false 225915 2929481 0.077118 56242 3305151 0.017016 93821 2443863 0.03839 127572 2347632 0.054341 103008 2654997 0.038798 0.225663 0.045133 2373412 107119 1286 108405 148133 X 1286 1286 1286 600 687 1287 X 1 1 false false false false false false false true true DE NJ true false false false false true Foundation Source 8008391754 501 Silverside Road Suite 123 Wilmington DE 198091377 false false false false true false false false false false false false false false false false false false false false false Lynn Cole Foundation Source 501 Silverside Rd Wilmington DE 198091377 VP / Dir 25.0 62240 0 0 Carol Ann Hinz Foundation Source 501 Silverside Rd Wilmington DE 198091377 Pres / Dir / Sec 25.0 70000 0 0 2402966 32227 0 2435193 25638 2409555 36143 2373412 118671 118671 1286 3 1289 117382 117382 117382 148133 0 0 0 0 148133 1286 146847 117382 136526 2014 2013 2012 148133 136526 11607 0 0 105775 0 0 NONE NONE X 180 TURNING LIVES AROUND INC 1 BETHANY RD STE 3 HAZLET NJ 07730 N/A PC General & Unrestricted 1000 AMERICAN RED CROSS - JERSEY COAST CHAPTER 1540 W PARK AVE TINTON FALLS NJ 07724 N/A PC General & Unrestricted 1750 ARC OF NEW JERSEY INC 1158 WAYSIDE RD TINTON FALLS NJ 07712 N/A PC Work Opportunity Center 1000 BOYS & GIRLS CLUB OF MONMOUTH COUNTY 1201 MONROE AVE ASBURY PARK NJ 07712 N/A PC General & Unrestricted 750 CARETTES INC OF MORRIS COUNTY PO BOX 2203 MORRISTOWN NJ 07962 N/A PC General & Unrestricted 250 CHINESE AMERICAN ARTS COUNCIL INCORPORATED 456 BROADWAY 3RD FL NEW YORK NY 10013 N/A PC General & Unrestricted 2000 CHINESE THEATER WORKS INC 37-18 NORTHERN BLVD 105 LONG ISLAND CITY NY 11101 N/A PC General & Unrestricted 2000 CONFUCIUS FOUNDATION INC 3901 MAIN ST STE 203 FLUSHING NY 11354 N/A PC General & Unrestricted 4000 EASTERN MONMOUTH AREA CHAMBER OF COMMERCE ED 8 RECKLESS PL NO 1 RED BANK NJ 07701 N/A PC General & Unrestricted 10000 FEEDING AMERICA 35 E WACKER DR STE 2000 CHICAGO IL 60601 N/A PC General & Unrestricted 750 FOODBANK OF MONMOUTH AND OCEAN COUNTIES INC 3300 RTE 66 NEPTUNE NJ 07753 N/A PC General & Unrestricted 750 HABCORE INC 788 SHREWSBURY AVE STE 2151 TINTON FALLS NJ 07724 N/A PC General & Unrestricted 1750 HOMES FOR OUR TROOPS INC 6 MAIN ST TAUNTON MA 02780 N/A PC General & Unrestricted 5000 LUNCH BREAK PO BOX 2215 RED BANK NJ 07701 N/A PC General & Unrestricted 750 NEW JERSEY BLIND CITIZENS ASSOCIATION INC 18 BURLINGTON AVE LEONARDO NJ 07737 N/A PC General & Unrestricted 1000 NEW JERSEY STATE FEDERATION OF WOMENS CLUBS 164 BROAD ST RED BANK NJ 07701 N/A PC General & Unrestricted 2000 POLICE ATHLETIC LEAGUE INC 34 1/2 E 12TH ST NEW YORK NY 10003 N/A PC General & Unrestricted 5000 SELFHELP COMMUNITY SERVICES INC 520 8TH AVE NEW YORK NY 10018 N/A PC General & Unrestricted 4000 SMILE TRAIN INC 41 MADISON AVE 28TH FL NEW YORK NY 10010 N/A PC General & Unrestricted 2000 ST JUDE CHILDRENS RESEARCH HOSPITAL INC 262 DANNY THOMAS PL MS512 MEMPHIS TN 38105 N/A PC General & Unrestricted 2500 THE CHILDRENS HOSPITAL OF PHILADELPHIA FOUNDATION PO BOX 781352 PHILADELPHIA PA 19178 N/A PC General & Unrestricted 5000 WHITE BOX LTD 329 BROOME ST NEW YORK NY 10002 N/A PC General & Unrestricted 1000 54250 14 32 525990 6 14 187869 525990 1165 18 14674 Federal Tax Refund 01 1239 1171 203814 204985 false false false false false false false false false false Part I Line 6a Net Gain/Loss from Sales of Assets Not Included in Part IV Part I, Line 6a (990-PF) Name: Publicly-traded Securities Gross Sales Price: $1,329,301 Book Basis: $1,313,462 Net Gain/(Loss): $15,839 Allocated to UBTI-Acquisition Indebtedness: $(1,165) Total Net Gain/(Loss) included in Part IV: $14,674 Aloccated to UBTI-Acquisition Indebtedness: $1,165 Part I, Line 6a Total: $15,839 SEA CONTAINERS 10.5% 05/15/12 13605 1,000 LITHIUM X ENERGY 1695 1670 10 ANTHEM INC @ $145.00 5859 2936 10 APPLE INC @ $110.00 5361 8049 10 CHEETAH MOBILE @ $11.00 2018 2031 10 HAWAIIAN HOLDINGS @ $55.00 1578 2881 10 SPDR DOW JONES @ $180.00 1871 140 10 SPDR TR @ $225.00 3701 10 10 WYNN RESORTS @ $89.00 2151 2012 10,000 DIGITAL DOMAIN MED 67400 10,005,000 SAVI MEDIA GRP 41123 100 AURIS MED HLDG @ $2.50 1663 775 100 FOUNDATION MED @ $40.00 2882 1260 100 US OIL FUND @ $11.00 3662 269 103 AURIS MED HLDG @ $2.50 1629 2037 15,000 UR ENERGY INC 9615 7967 150 VIRTUSA CORP 3665 3768 16,000 BARCLAYS BANK 160000 142720 160,000 HEMP INC 70905 5520 18,000 UBS AG 180000 180000 19,000 UBS AG 190000 170810 2,000 PLATINUM GROUP METAL 3761 2860 20 ALTRIA GROUP @ $70.00 3076 2673 20 CISCO SYSTEMS @ $30.00 5250 5006 20 COCA COLA @ $40.00 6988 6713 20 ISHARES @ $137.50 2336 1940 20 PFIZER INC @ $32.00 5322 5283 20 PROCTER GAMBLE @ $85.00 9256 9361 20 VERIZON COM @ $55.00 5165 4910 20,000 BARCLAYS BANK 200000 184800 20,000 BARCLAYS BANK 200000 195200 20,000 GOLDMAN SACHS GROUP 200000 177400 20,000 GS FINANCE CORP 200000 200000 20,000 JPMORGAN CHASE 200000 198800 200 WEIGHT WATCHERS @ $9.00 4625 5254 25 RUTH'S HOSPITALITY @ $17.50 5289 3464 25,000 REGEN BIOPHARMA INC 2505 2051 3,909 SHARESPOST 100 FUND 100000 104887 30 PROSHARES TRUST @ $41.00 2512 3462 37 CHIPOTLE MEX GRILL @ $220 3171 1225 40,000 GOLDMAN SACHS GROUP 400000 363600 40,000 UBS AG 400000 358000 5 NVIDIA CORP @ $65.00 13418 23201 5 NVIDIA CORP @ $70.00 4208 19619 5,000 CREDIT SUISSE 50000 41900 50 SEARS HOLDING @ $5.00 3434 3398 500 AERIE PHARMACEUTICALS 10850 18923 500 HIMAX TECHNOLOGIES 3870 3020 710,000 GTX CORP 44050 4331 75,000 3D PIONEER SYSTEMS 16440 270 9,000 BARCLAYS BANK 90000 79560 Administrative Fees 15103 15103 DUES & MEMBERSHIPS 2797 2797 Payroll Processing Fees 1100 550 550 State or Local Filing Fees 78 78 BANK CHARGES 270 267 Federal Tax Refund 1239 OPEN SHORT OPTIONS 6827