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Form990-PF Or Section 4947(A)(1) Trust Treated As Private Foundation Do Not Enter Social Security Numbers on This Form As It May Be Made Public

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Form990-PF Or Section 4947(A)(1) Trust Treated As Private Foundation Do Not Enter Social Security Numbers on This Form As It May Be Made Public l , Return of Private Foundation OMB No 1545-0052 Form990-PF or Section 4947(a)(1) Trust Treated as Private Foundation Do not enter social security numbers on this form as it may be made public. 2014 ' • Department of the Treasury ► Instructions is at www.irs.gov/four Internal Revenue Service ► Information about Form 990-PF and its separate For calendar y ear 2014 or tax y ear be g inning 12/01 , 2014 , and endin g 11/30, 20 15 Name of foundation A Employer identification number JACK ADJMI FAMILY FOUNDATION. INC, 13-3202295 Number and street ( or P 0 box number if mad is not delivered to street address) Room / suite B Telephone number (see instructions) (212) 629-9600 463 SEVENTH AVENUE, 4TH FLOOR City or town , state or province, country, and ZIP or foreign postal code q C If exemption application is . ► pending, check here - - • - - - NEW YORK, NY 10018 G Check all that apply: Initial return Initial return of a former public charity q D 1 Foreign organizations, check here. ► Final return Amended return 2 Foreign organ izations meeting the q 85% test, check here and attach . ► Address change9a Name change computation . H Check type of organization : X Section 501 (c)(3) exempt private foundation E If private foundation status was terminated Section ) nonexem t charitable trust Other taxable p rivate foundation q 4947( l )( 1 p under section 507(bx1XA), check here , ► I Fair market value of all assets at J Accountin9 method : X Cash Accrual F If the foundation is in a 60-month termination end of year (from Part 11, col. (c), line Other ( specify ) ________________ ___ _ _ _ under section 507(b)(1)(B), check here . 16) ► $ 1, 062, 7 3 2. (Part 1, column (d) must be on cash basis) Analysis of Revenue and Expenses (The (d) Disbursements (a) Revenue and (b) Net investment (c) Adjusted net for charitable total of amounts in columns (b), (c), and (d) expenses per may not necessarily equal the amounts in income income purposes column (a) (see instructions books ( cash basis only) CC 1 Contributions , grits, grants , etc , received (attach schedule ) , 4,276,581 . O the foundation is not required to N 2 Check if ► attach Sch B . , 3 Interest on savings and temporary cash investments. cV 4 Dividends and interest from securities . 12, 12. 5a Gross rents . ... ...... ... 0- Q b Net rental income or (loss) 6a Net gain or ( loss) from sale of assets not on line 10 11,318 . b Gross sales puce for all 30 , 037. w w assets on line 6a > 7 Capital gain net income (from Part IV, line 2) . 11,318. 7- ix 8 Net short - term capital gain . 9 Income modifications . 0 10a Gross sales less returns and allowances , , , , b Less Cost of goods sold , c Gross profit or (loss ) ( attach schedule) . , , 11 Other income ( attach schedule ) . , , , , 12 Total. Add lines 1 through 11 4, 287, 911. 11,330. 13 Compensation of officers , directors, trustees, etc 0 r---r3 f/! y 14 Other employee salaries and wages . 15 Pension plans, employee benefits . , , , , X 16a Legal fees (attach schedule ) . , , , , , , , W b Accounting fees (attach schedule) . , > c Other professional fees (attach schedule). L^ ] 9. OGU 1 17 Interest . 2 18 Taxes ( attach schedule) (see instructions )[ 2 ], 4,672. S 19 Depreciation (attach schedule ) and depletion Cl 20 Occupancy . 21 Travel, conferences , and meetings . cc 22 Printing and publications , . 23 Other expenses (attach schedule)A.Tc{i . 913. 407. 506 24 Total operating and administrative expenses. d Add lines 13 through 23 . ....... 5, 594. 416. 506 0 25 Contributions , gifts, grants paid ... .. , 3, 963, 851. 3 , 963, 851 26 Total expenses and disbursements Add lines 24 and 25 3,969,44 5. 416. 3,964, 357 27 Subtract line 26 from line 12 a Excess of revenue over expenses and disbursements , 318,466. b Net investment income ( if negative , enter -0-) 10,914. c Adjusted net income ( if negative, enter -0-), , SSA For Paperwork Reduction Act Notice, see instructions . Form yyU-Yt- (2014) 4E1410 1 000 5847HS 3846 J17878 ti Forme90-PF (2014) JACK ADJMI FAMILY FOUNDATION, INC. 13-3202295 Paget ® Attached schedules and amounts in the Beginning of year End of year Balance Sheets description column should be for end-of-year amounts only (See instructions) (a) Book Value (b) Book Value (c) Fair Market Value 1 Cash - non-interest-bearing ......... ..... .. 583, 276. 1, 014, 462. 1,014,462 2 Savings and temporary cash investments ......... 172, 221. 48,270. 48,270 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 disqualified persons (attach schedule) (see instructions) , , , 7 Other notes and loans receivable (attach schedule) ► _ _ _ _ Less. allowance for doubtful accounts ► - _ _ - - - _ - _ - - _ d 8 Inventories for sale or use .................. 9 Prepaid expenses and deferred charges . 10a Investments - U S and state government obligations (attach schedule), b Investments - corporate stock (attach schedule) ....... c Investments - corporate bonds (attach schedule)....... 11 Investments - land, buildings, ► and equipment basis __________________ Less accumulated depreciation ► (attach schedule) ------------------- 12 Investments - mortgage loans . 13 Investments - other (attach schedule) , , 14 Land, buildings, and ► ' equipment basis __________________ Less accumulated depreciation ► (attach schedule) ___________________ 15 Other assets (describe ► ________________ __ ) 16 Total assets (to be completed by all filers - see the instructions. Also, see page 1, item I) , 755, 497. 1, 062, 732. 1,062,732 17 Accounts payable and accrued expenses , , , . 18 Grants payable . W 19 Deferred revenue . 20 Loans from officers, directors, trustees, and other disqualified persons 21 Mortgages and other notes payable (attach schedule) . J 22 Other liabilities (describe ) ► ------------------- 23 Total liabilities (add lines 17 through 22) . 0 0 Foundations that follow SFAS 117, check here. ► and complete lines 24 through 26 and lines 30 and 31. m 24 Unrestricted . 25 Temporarily restricted . 9 26 Permanently restricted . LL Foundations that do not follow SFAS 117, ... ► 0 check here and complete lines 27 through 31. , 27 Capital stock, trust principal, or current funds 28 Paid-in or capital surplus, or land, bldg , and equipment fund , , , , 29 Retained earnings, accumulated income, endowment, or other funds 755, 497. 1, 062, 732. m 30 Total net assets or fund balances (see instructions), 755,497. 1,062,732. Z 31 Total liabilities and net assets/fund balances . (see instructions) . ........................ 755, 497. 1,062,732. Anal sis of Chang es in Net Assets or Fund Balances I Total net assets or fund balances at beginning of year - Part II, column (a), line 30 (must agree with end-of-year figure reported on prior years return), , , , , , , , , , , , , , , , , , , , , , , , , 1 755,497 318,466 2 Enter amount from Part I, line 27a ................. .... .. 2 3 Other increases not included in line 2 (itemize) ►_______________________________ 3 1,073,963 4 Add lines 1, 2, and 3 . .. ... , 4 5 Decreases not included* in. line. ATCH 4 . g 11, 231 ----- ------------------------ 6 Total net assets or fund balances at end of ear line 4 minus line 5 - Part II, .column b , line 30 . 6 1, 062, 732 Form 990-PF (2014) JSA 4E1420 1 000 5847HS 3846 J17878 JACK ADJMI FAMILY FOUNDATION, INC. 13-3202295 Form 990-PF (2014) Page 3 ffgNM Capital Gains and Losses for Tax on Investment Income (b) How (c) Date ()a List and describe the kinds() of property sold (a g real estate, acquired (d) Date sold 2-story brick warehouse, or common stock, 200 shs MLC Co) P-Purchase (mo,day, yr.) D - Donation (mo., day, yr) la SEE PART IV SCHEDULE b c d e (f) Depreciation 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 b c d e Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (I) Gains (Col (h) gain minus Adjusted basis (k) Excess of col (i) col (k), but not less than -0-) or (i) M V. as of 12/31/69 (1) F as of 12/31/69 over col. Q), if any Losses (from col. (h)) a b c d e If gain, also enter in Part I, line 7 2 Capital gain net income or (net capital loss) { If (loss), enter -0- in Part I, line 7 } 2 11,318. 3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6), If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0- in Part I, line 8 3 0 FUMM Qualification Under Section 4940 ( e) for Reduced Tax on Net Investment Income (For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.) If section 4940(d)(2) applies, leave this part blank. Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base penod7 Yes M No If "Yes," the foundation does not qualify under section 4940 (e). Do not complete this part. I Fntar the- annrnnriata amnrint in Par--h enliimn fnr aarh vaar• spa tha instnirhnns b fnre making any entrlAS ( d) Base period years Distribut ion ratio calendar yearlortaxyearbeginningin) Adj usted qualifying distributions Net value of nonchantable-use assets (col (b)dividedby col (c)) 2013 3,776,775. 470,202. 8.032239 2012 3,769,863. 166,830. 22.597033 2011 2,569,371. 126,484. 20.313803 2010 2,115,709. 272,430.
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