Form990-PF

Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Nonexempt Charitable Trust
Treated as a Private Foundation
Note. The foundation may be able to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0052
2010
For calendar year 2010, or tax year beginning 01-01-2010 , and ending 12-31-2010
G
Check all that apply:
Name of foundation
THE SEMLER FAMILY FOUNDATION INC
2800320600 / V05701004

Number and street (or P.O. box number if mail is not delivered to street address)C/O JPMORGAN CHASE BANKNAPOBOX 3038   Room/suite
City or town, state, and ZIP code
MILWAUKEE, WI53201
A Employer identification number

20-3523866
B Telephone number (see page 10 of the instructions)

(414) 977-1210
C bullet
D 1. bullet
H Check type of organization:
2. bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$1,771,349J Accounting method:
 
(Part I, column (d) must be on cash basis.)
E bullet
F bullet
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see page 11 of the instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet
3 Interest on savings and temporary cash investments 33 33  
4 Dividends and interest from securities...... 37,188 37,224  
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 114,672
b Gross sales price for all assets on line 6a 1,240,373
7 Capital gain net income (from Part IV, line 2)... 120,704
8 Net short-term capital gain.........  
9 Income modifications...........  
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)....... Click to see attachment 120 0  
12 Total. Add lines 1 through 11........ 152,013 157,961  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0 0   0
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule).......        
c Other professional fees (attach schedule).... Click to see attachment 8,932 8,932   0
17 Interest...............        
18 Taxes (attach schedule) (see page 14 of the instructions) Click to see attachment 346 346   0
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 81 358   81
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 9,359 9,636   81
25 Contributions, gifts, grants paid........ 90,500 90,500
26 Total expenses and disbursements. Add lines 24 and 25 99,859 9,636   90,581
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 52,154
b Net investment income (if negative, enter -0-) 148,325
c Adjusted net income (if negative, enter -0-)...  
For Privacy Act and Paperwork Reduction Act Notice, see page 30 of the instructions.
Cat. No. 11289X Form 990-PF (2010)
Form 990-PF (2010)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)		 Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............... 11,121 558 558
2 Savings and temporary cash investments.......... 67,390 41,607 40,607
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see page 15 of the
instructions)....................      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use...............      
9 Prepaid expenses and deferred charges...........      
10a Investments—U.S. and state government obligations (attach schedule) 106,296    
b Investments—corporate stock (attach schedule)........ 698,933 Click to see attachment1,049,949 1,187,782
c Investments—corporate bonds (attach schedule)........ 473,560 Click to see attachment503,067 542,402
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans..............      
13 Investments—other (attach schedule)........... 185,000    
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 1,542,300 1,595,181 1,771,349
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable...................    
19 Deferred revenue..................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22).......... 0 0
Net Assets or Fund Balances bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted....................    
25 Temporarily restricted................    
26 Permanently restricted................    
bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds......... 1,542,300 1,595,181
28 Paid-in or capital surplus, or land, bldg., and equipment fund 0 0
29 Retained earnings, accumulated income, endowment, or other funds 0 0
30 Total net assets or fund balances (see page 17 of the
instructions).................... 1,542,300 1,595,181
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 1,542,300 1,595,181
Part III Analysis of Changes in Net Assets or Fund Balances
1 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 year’s return)............... 1 1,542,300
2 Enter amount from Part I, line 27a...................... 2 52,154
3 Other increases not included in line 2 (itemize) bulletClick to see attachment 3 1,029
4 Add lines 1, 2, and 3.......................... 4 1,595,483
5 Decreases not included in line 2 (itemize) bulletClick to see attachment 5 302
6 Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30.. 6 1,595,181
Form 990-PF (2010)
Form 990-PF (2010)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.) 		(b) How acquired
P—Purchase
D—Donation 		(c) Date acquired
(mo., day, yr.) 		(d) Date sold
(mo., day, yr.)
1 a PUBLICLY TRADED SECURITIES      
b DB COMMODITY INDEX TRACKING FUND P    
c DB COMMODITY INDEX TRACKING FUND P    
d DB COMMODITY INDEX TRACKING FUND SEC 1256 P    
e DB COMMODITY INDEX TRACKING FUND BASIS ADJUSTMENT RE: SALE P    
CAPITAL GAINS DIVIDENDS P    
(e) Gross sales price (f) Depreciation allowed
(or allowable) 		(g) Cost or other basis
plus expense of sale 		(h) Gain or (loss)
(e) plus (f) minus (g)
a 1,239,443   1,125,701 113,742
b     69 -69
c 108     108
d 6,522     6,522
e       -529
930     930
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l) Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i) F.M.V. as of 12/31/69 (j) Adjusted basis
as of 12/31/69 		(k) Excess of col. (i)
over col. (j), if any
a       113,742
b       -69
c       108
d       6,522
e       -529
      930
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 120,704
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 pages 13 and 17 of the instructions).
If (loss), enter -0- in Part I, line 8 . . . . . . . . . . . . . 		Bracket 3  
Part V
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 period?
If “Yes,” the foundation does not qualify under section 4940(e). Do not complete this part.
1 Enter the appropriate amount in each column for each year; see page 18 of the instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in) 		(b)
Adjusted qualifying distributions 		(c)
Net value of noncharitable-use assets 		(d)
Distribution ratio
(col. (b) divided by col. (c))
2009 83,220 1,519,112 0.054782
2008 102,519 1,786,164 0.057396
2007 103,106 2,125,981 0.048498
2006 126,100 1,970,682 0.063988
2005 0 1,932,166 0.0
2 Total of line 1, column (d) ...................... 2 0.224664
3 Average distribution ratio for the 5-year base period—divide the total on line 2 by 5, or by
the number of years the foundation has been in existence if less than 5 years. . . 		3 0.044933
4 Enter the net value of noncharitable-use assets for 2010 from Part X, line 5..... 4 1,654,130
5 Multiply line 4 by line 3....................... 5 74,325
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 1,483
7 Add lines 5 and 6......................... 7 75,808
8 Enter qualifying distributions from Part XII, line 4.............. 8 90,581
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See
the Part VI instructions on page 18.
Form 990-PF (2010)
Form 990-PF (2010)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see page 18 of the instructions)
1a Bulletand enter “N/A” on line 1. Bracket
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b 1 1,483
hereBulletand enter 1% of Part I, line 27b...................
c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2............................ 3 1,483
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-). 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 1,483
6 Credits/Payments:
a 2010 estimated tax payments and 2009 overpayment credited to 2010 6a  
b Exempt foreign organizations—tax withheld at source....... 6b
c Tax paid with application for extension of time to file (Form 8868) 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 0
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. 8 6
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 1,489
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2011 estimated taxBullet   Refunded Bullet 11  
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see page 19 of
the instructions for definition)?.............................
1b
 
No
If the answer is “Yes” to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If “Yes,” attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? 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 year?........
4a
 
No
b
If “Yes,” has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If “Yes,” attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If “Yes,” complete Part II, col. (c), and Part XV.
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see page 19 of the
    instructions)bulletIN
    b
    If the answer is “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 G? If “No,” attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2010 or the taxable year beginning in 2010 (see instructions for Part XIV on
    page 27)? If “Yes,” complete Part XIV...........................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If “Yes,” attach a schedule listing their names and addresses.
    10
     
    No
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. (see page 20 of the instructions) .......
    11
     
    No
    12
    Did the foundation acquire a direct or indirect interest in any applicable insurance contract before August 17, 2008?
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletN/A
    14
    The books are in care ofbulletJPMORGAN CHASE BANK NA Telephone no.bullet (317) 684-3057
    Located atbullet1 EAST OHIO STREETINDIANAPOLISIN ZIP+4bullet46277
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041.........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ......bullet
    15  
    16
    At any time during calendar year 2010, did the foundation have an interest in or a signature or other authority over
    a bank, securities, or other financial account in a foreign country? .................
    16
     
    No
    See page 20 of the instructions for exceptions and filing requirements for Form TD F 90-22.1. If "Yes", enter the name of the foreign country bullet  
    Form 990-PF (2010)
    Form 990-PF (2010)
    Page 5
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the “Yes” column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?.........................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?.................
    (6) Agree to pay money or property to a government official? (Exception. Check “No”
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).........
    b
    If any answer is “Yes” to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance (see page 20 of the instructions)?...
    1b
     
     
    .........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2010?.............
    1c
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2010, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2010?...............
    If “Yes,” list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer “No” and attach statement—see page 20 of the instructions.) .........
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business
    enterprise at any time during the year?.....................
    b
    If “Yes,” did it have excess business holdings in 2010 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2010.)....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2010?
    4b
     
    No
    5a
    During the year did the foundation pay or incur any amount to:
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?...............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 509(a)(1), (2), or (3), or section 4940(d)(2)? (see page 22 of the instructions)...
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?........
    b
    If any answer is “Yes” to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance (see page 22 of the instructions)?
    5b
     
     
    .........bullet
    c
    If the answer is “Yes” to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?............
    If “Yes,” attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay
    premiums on a personal benefit contract?....................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?....
    6b
     
    No
    If “Yes” to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    Form 990-PF (2010)
    Form 990-PF (2010)
    Page 6
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation (see page 22 of the instructions).
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to
    employee benefit plans
    and deferred compensation     		(e) Expense account,
    other allowances
    JERRY D SEMLER PRESIDENT
    1.00     		0 0 0
    8015 HEYWARD DRIVE
    INDIANAPOLIS,IN46250
    ROSEMARY R SEMLER VICE-PRESIDENT
    1.00     		0 0 0
    8015 HEYWARD DRIVE
    INDIANAPOLIS,IN46250
    MICHAEL R SEMLER TREASURER
    1.00     		0 0 0
    8015 HEYWARD DRIVE
    INDIANAPOLIS,IN46250
    KIMBERLY D HAMILTON SECRETARY
    1.00     		0 0 0
    8015 HEYWARD DRIVE
    INDIANAPOLIS,IN46250
    MARY D DODSON DIRECTOR
    1.00     		0 0 0
    8015 HEYWARD DRIVE
    INDIANAPOLIS,IN46250
    JOHN R SEMLER DIRECTOR
    1.00     		0 0 0
    8015 HEYWARD DRIVE
    INDIANAPOLIS,IN46250
    KRISTIN D TERRELL DIRECTOR
    1.00     		0 0 0
    8015 HEYWARD DRIVE
    INDIANAPOLIS,IN46250
    JEFFREY R SEMLER DIRECTOR
    1.00     		0 0 0
    8015 HEYWARD DRIVE
    INDIANAPOLIS,IN46250
    SALLY D BUTLER DIRECTOR
    1.00     		0 0 0
    8015 HEYWARD DRIVE
    INDIANAPOLIS,IN46250
    2 Compensation of five highest-paid employees (other than those included on line 1—see page 23 of the instructions).
    If none, enter “NONE.”
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet 0
    3 Five highest-paid independent contractors for professional services (see page 23 of the instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1
     
    2  
    3  
    4  
    Form 990-PF (2010)
    Form 990-PF (2010)
    Page 7
    Part IX-B
    Summary of Program-Related Investments (see page 23 of the instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See page 24 of the instructions.
    3  
    Total. Add lines 1 through 3...........................bullet0
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,
    see page 24 of the instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    1,541,812
    b
    Average of monthly cash balances.......................
    1b
    137,508
    c
    Fair market value of all other assets (see page 24 of the instructions)............
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    1,679,320
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) ..............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d..........................
    3
    1,679,320
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see page 25
    of the instructions) ............................
    4
    25,190
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    1,654,130
    6
    Minimum investment return. Enter 5% of line 5...................
    6
    82,707
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    82,707
    2a
    Tax on investment income for 2010 from Part VI, line 5......
    2a
    1,483
    b
    Income tax for 2010. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    1,483
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    81,224
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4.............................
    5
    81,224
    6
    Deduction from distributable amount (see page 25 of the instructions)...........
    6
    0
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII,
    line 1.................................
    7
    81,224
    Part XII
    Qualifying Distributions (see page 25 of the instructions)
    1
    Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
    a
    Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........
    1a
    90,581
    b
    Program-related investments—total from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes................................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    90,581
    5
    Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
    income. Enter 1% of Part I, line 27b (see page 26 of the instructions)............
    5
    1,483
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4...............
    6
    89,098
    Note: The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
    the section 4940(e) reduction of tax in those years.
    Form 990-PF (2010)
    Form 990-PF (2010)
    Page 8
    Part XIII
    Undistributed Income (see page 26 of the instructions)
    (a)
    Corpus     		(b)
    Years prior to 2009     		(c)
    2009     		(d)
    2010
    1 Distributable amount for 2010 from Part XI, line 7 81,224
    2 Undistributed income, if any, as of the end of 2010:
    a Enter amount for 2009 only....... 0
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2010:
    a From 2005.......  
    b From 2006....... 5,519
    c From 2007.......  
    d From 2008....... 14,001
    e From 2009....... 7,824
    fTotal of lines 3a through e......... 27,344
    4Qualifying distributions for 2010 from Part
    XII, line 4: bullet$ 90,581
    a Applied to 2009, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election required—see page 26 of the instructions)    		 0
    c Treated as distributions out of corpus (Election
    required—see page 26 of the instructions)...     		0
    d Applied to 2010 distributable amount..... 81,224
    e Remaining amount distributed out of corpus 9,357
    5 Excess distributions carryover applied to 2010. 0 0
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 36,701
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ...........     		0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		0
    d Subtract line 6c from line 6b. Taxable
    amount—see page 27 of the instructions ...     		0
    e Undistributed income for 2009. Subtract line
    4a from line 2a. Taxable amount—see page 27
    of the instructions ...........     		0
    f Undistributed income for 2010. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2011 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (see page 27
    of the instructions) ...........     		0
    8Excess distributions carryover from 2005 not
    applied on line 5 or line 7 (see page 27 of the
    instructions) .............     		0
    9Excess distributions carryover to 2011.
    Subtract lines 7 and 8 from line 6a ......     		36,701
    10 Analysis of line 9:
    a Excess from 2006.... 5,519
    b Excess from 2007....  
    c Excess from 2008.... 14,001
    d Excess from 2009.... 7,824
    e Excess from 2010.... 9,357
    Form 990-PF (2010)
    Form 990-PF (2010)
    Page 9
    Part XIV
    Private Operating Foundations (see page 27 of the instructions and Part VII-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2010, enter the date of the ruling.......bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2010 (b) 2009 (c) 2008 (d) 2007
             
    b 85% of line 2a .........          
    c Qualifying distributions 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 Qualifying distributions 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 qualifying
    under section 4942(j)(3)(B)(i)    		          
    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,
    dividends, 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)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XV
    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.)
    1Information Regarding Foundation Managers:
    aList 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 if they have contributed more than $5,000). (See section 507(d)(2).)
    bList 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.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number of the person to whom applications should be addressed:
    JERRY D SEMLER
    8015 HEYWARD DRIVE
    INDIANAPOLIS,IN46250
    (317) 285-1615
    bThe form in which applications should be submitted and information and materials they should include:
    SUBMIT LETTER DESCRIBING NEED FOR AND PURPOSE OF REQUESTED CONTRIBUTION
    cAny submission deadlines:
    NONE
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    NONE
    Form 990-PF (2010)
    Form 990-PF (2010)
    Page 10
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    BISHOP CHATARD HIGH SCHOOL
    5885 N CRITTENDEN AVENUE
    INDIANAPOLIS,IN462202840     		NONE PUBLIC CHARITY PROGRAM SUPPORT 5,000
    BOWEN CENTER AT BALL STATE UNIVERSITY
    2800 W BETHEL AVENUE
    MUNCIE,IN47304     		NONE PUBLIC CHARITY PROGRAM SUPPORT 1,000
    BOY SCOUTS - CROSSROADS COUNCIL
    PO BOX 1966
    INDIANAPOLIS,IN462061966     		NONE PUBLIC CHARITY PROGRAM SUPPORT 6,000
    CENTER FOR LEADERSHIP DEVELOPMENT
    2425 DR MARTIN LUTHER KING JR ST
    INDIANAPOLIS,IN462085546     		NONE PUBLIC CHARITY PROGRAM SUPPORT 2,000
    CHILDREN'S MUSEUM OF INDIANAPOLIS
    3000 N MERIDIAN STREET
    INDIANAPOLIS,IN462084716     		NONE PUBLIC CHARITY PROGRAM SUPPORT 5,000
    CHRISTEL HOUSE FOUNDATION
    10 W MARKET STREET SUITE 1990
    INDIANAPOLIS,IN462042973     		NONE PUBLIC CHARITY PROGRAM SUPPORT 1,000
    CHURCH FEDERATION OF GREATER INDIANAPOLIS
    1100 W 42ND ST SUITE 345
    INDIANAPOLIS,IN462083345     		NONE PUBLIC CHARITY PROGRAM SUPPORT 2,500
    CORNEA RESEARCH FOUNDATION OF AMERICA
    9002 N MERIDIAN STREET SUITE 212
    INDIANAPOLIS,IN46260     		NONE PUBLIC CHARITY PROGRAM SUPPORT 1,000
    HOOSIER SALON
    714 EAST 65TH STREET
    INDIANAPOLIS,IN462201610     		NONE PUBLIC CHARITY PROGRAM SUPPORT 500
    INDIANA HISTORICAL SOCIETY
    450 W OHIO STREET
    INDIANAPOLIS,IN462023269     		NONE PUBLIC CHARITY PROGRAM SUPPORT 5,000
    INDIANA REPERTORY THEATRE
    140 W WASHINGTON ST
    INDIANAPOLIS,IN46204     		NONE PUBLIC CHARITY PROGRAM SUPPORT 2,500
    INDIANA YOUTH INSTITUTE
    603 E WASHINGTON ST STE 800
    INDIANAPOLIS,IN46204     		NONE PUBLIC CHARITY PROGRAM SUPPORT 1,500
    INDIANAPOLIS ZOOLOGICAL SOCIETY
    1200 WEST WASHINGTON STREET
    INDIANAPOLIS,IN462224552     		NONE PUBLIC CHARITY PROGRAM SUPPORT 5,000
    IU FOUNDATION-SCHOOL OF MEDICINE-KOCH CHAIR
    PO BOX 500
    BLOOMINGTON,IN47402     		NONE PUBLIC CHARITY PROGRAM SUPPORT 5,000
    LAKE MAXINKUCKEE ENVIRONMENTAL COUNCIL
    PO BOX 187
    CULVER,IN46511     		NONE PUBLIC CHARITY PROGRAM SUPPORT 1,000
    MARIAN UNIVERSITY
    3200 COLD SPRING RD
    INDIANAPOLIS,IN462221997     		NONE PUBLIC CHARITY PROGRAM SUPPORT 13,500
    PURDUE UNIVERSITY
    403 W STATE STREET
    WEST LAFAYETTE,IN479072056     		NONE PUBLIC CHARITY PROGRAM SUPPORT 5,000
    SAGAMORE INSTITUTE FOR POLICY RESEARCH
    1630 N MERIDIAN ST STE 450
    INDIANAPOLIS,IN462021437     		NONE PUBLIC CHARITY PROGRAM SUPPORT 2,500
    SYCAMORE FOUNDATION
    201 NORTH INNLINOIS ST SUITE 1701
    INDIANAPOLIS,IN46204     		NONE PUBLIC CHARITY PROGRAM SUPPORT 500
    UNITED CATHOLIC APPEAL
    PO BOX 1410
    INDIANAPOLIS,IN462061410     		NONE PUBLIC CHARITY PROGRAM SUPPORT 25,000
    Total .................................bullet 3a 90,500
    bApproved for future payment
    Total ..................................bullet 3b 0
    Form 990-PF (2010)
    Form 990-PF (2010)
    Page 11
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See page 28 of
    the instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3Interest on savings and temporary cash investments     14 33  
    4 Dividends and interest from securities....     14 37,188  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6Net rental income or (loss) from personal property          
    7 Other investment income.....     14    
    8Gain or (loss) from sales of assets other than inventory     18 114,672  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory..          
    11 Other revenue: aEXCISE TAX REFUND     01 120  
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e).. 0 152,013 0
    13Total. Add line 12, columns (b), (d), and (e)...................
    13152,013
    (See worksheet in line 13 instructions on page 28 to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the organization’s exempt purposes (other than by providing funds for such purposes). (See
    page 28 of the instructions.)
    Form 990-PF (2010)
    Form 990-PF (2010)
    Page 12
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section
    Yes
    No
    501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash....................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements............................
    1b(4)
     
    No
    (5) Loans or loan guarantees..............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is “Yes,” complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527?...........
    b
    If “Yes,” complete the following schedule.
    (a) Name of organization (b) Type of organization (c) Description of relationship
    SignHere
    Under penalties of perjury, I declare that I have examined this return, including 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 fiduciary) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    Signature of officer or trustee Date Title
    PaidPreparersUseOnly Preparer's SignatureBullet Date PTIN
    Firm's namebullet



    Firm's addressbullet







         		Firm's EINbullet
    Phone no.
    Form 990-PF (2010)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2010 InvestmentsCorpBondsSchedule
    Name:
    THE SEMLER FAMILY FOUNDATION INC
    2800320600 / V05701004
    EIN: 20-3523866
    Name of Bond End of Year Book Value End of Year Fair Market Value
    VANGUARD FIXED INCOME SECS F INTR TRM CP PT (FUND 71) - 3239.983 SHS 33,761 32,141
    ISHARES BARCLAYS TIPS BOND FUND - 307 SHS 32,051 33,009
    EATON VANCE MUT FDS TR FLT RT CL I - 9453.169 SHS 70,050 84,700
    JPM HIGH YIELD FD - SEL FUND 3580 5.91% - 10252.904 SHS 62,910 83,561
    JPM SHORT DURATION BOND FD - SEL FUND 3133 1.36% - 20363.598 SHS 224,916 223,389
    DREYFUS/LAUREL FDS TR PRM EMRGN MK I - 2368.225 SHS 33,426 34,245
    JPM STR INC OPP FD FUND 3844 2.33% - 2880.39 SHS 29,178 34,075
    JPM INTL CURRENCY INCOME FD INCOME FUND 1.28% - 1536.167 SHS 16,775 17,282

    TY 2010 InvestmentsCorpStockSchedule
    Name:
    THE SEMLER FAMILY FOUNDATION INC
    2800320600 / V05701004
    EIN: 20-3523866
    Name of Stock End of Year Book Value End of Year Fair Market Value
    MATTHEWS PACIFIC TIGER FD - 1507.506 SHS 29,010 35,336
    T ROWE PRICE INTERNATIONAL FUNDS INC NEW ASIA FUND - 2008.788 SHS 32,000 38,529
    SPDR S&P 500 ETF TRUST - 576 SHS 64,245 72,432
    ISHARES S&P MIDCAP 400 INDEX FUND - 603 SHS 43,683 54,686
    ARBITRAGE FUNDS - I CL I - 2573.218 SHS 33,761 32,911
    JPM US REAL ESTATE FD - SEL FUND 3037 - 3335.346 SHS 35,862 51,965
    JPM MARKET EXPANSION INDEX FD - SEL FUND 3708 - 5412.65 SHS 36,433 58,240
    JPM ASIA 3 FD - SEL FUND 1134 - 1580.209 SHS 44,970 59,858
    VANGUARD MSCI EMERGING MARKETS ETF - 1516 SHS 66,231 72,989
    JPM US LRGE CAP CORE PLUS FD - SEL FUND 1002 - 4251.47 SHS 81,586 87,878
    POWERSHARES DB COMMODITY INDEX TRACKING FUND - 2133 SHS 51,402 58,764
    MANNING & NAPIER FUND INC 3 SERIES - 5423.924 SHS 97,521 104,519
    EATON VANCE MUT FDS TR GLOBAL MACRO - I - 5126.278 SHS 52,881 52,647
    SPDR GOLD TRUST - 145 SHS 11,564 20,114
    ARTIO INTERNATIONAL 3 II - I - 2775.103 SHS 33,344 34,578
    MS SPX MKT PLS NOTE 04/07/11 I- 40000 SHS 40,000 48,706
    JPM RESEARCH MARKET NEUTRAL FD - SEL FUND - SEL - 2159.655 SHS 33,743 33,345
    HIGHBRIDGE DYNAMIC COMM STRG FD -SEL STRATEGY FUND - SE - 1088.086 SHS 16,713 21,076
    GS EAFE NOTE 05/12/11 -15000 SHS 15,000 14,532
    DB BREN SPX 08/29/11 INITIAL LEVEL-08/06/10 SPX:1121.64 - 20000 SHS 20,000 21,523
    DB SARN SPX 09/07/12 90/100/100/100-10%BUFFER- 5.5%MAXRTRN - 25000 SHS 25,000 26,446
    HSBC BREN EAFE 10/6/11 10%BUF-2XLEV-7.34%CAP-14.68%MAXRTRN- 20000 SHS 20,000 20,278
    HSBC CONT BUFF EQ SPX 04/27/12 75% CNT BAR-10.6%CPN- 30%CAP - 25000 SHS 25,000 26,250
    CS BREN ASIA BASKET 11/9/11 10%BUF - 14.75%MAXRTN - 25000 SHS 25,000 24,203
    CS BREN EAFE 11/9/11 10%BUF-2XLEV-8.857%CAP- 17.714%MAXRTN- 20000 SHS 20,000 19,634
    GS BREN MID 12/02/11 10%BUF-2XLEV-6.85%CAP- 13.7%MAXRTN- 35000 SHS 35,000 36,171
    DB BREN EAFE 01/06/12 10%BUF-2XLEV-8.33%CAP- 16.66%MAXRTN- 15000 SHS 15,000 15,000
    DB BREN ASIA BASKET 01/06/12 - 14.3%MAXRTN- 25000 SHS 25,000 25,178
    SG CONT BUFF EQ SPX 06/29/12 75% CNT BAR- 4.5%CPN- 30%CAP- 20000 SHS 20,000 19,994

    TY 2010 OtherDecreasesSchedule
    Name:
    THE SEMLER FAMILY FOUNDATION INC
    2800320600 / V05701004
    EIN: 20-3523866
    Description Amount
    ADJUSTMENT TO CARRYING VALUE/BASIS 302


    TY 2010 OtherExpensesSchedule
    Name:
    THE SEMLER FAMILY FOUNDATION INC
    2800320600 / V05701004
    EIN: 20-3523866
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    BANK FEES & CHECK ORDER 81 0   81
    DB COMMODITY INDEX TRACKING FUND 0 358   0


    TY 2010 OtherIncomeSchedule2
    Name:
    THE SEMLER FAMILY FOUNDATION INC
    2800320600 / V05701004
    EIN: 20-3523866
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    EXCISE TAX REFUND 120   120


    TY 2010 OtherIncreasesSchedule
    Name:
    THE SEMLER FAMILY FOUNDATION INC
    2800320600 / V05701004
    EIN: 20-3523866
    Description Amount
    RETURN OF CAPITAL 1,029


    TY 2010 OtherProfessionalFeesSchedule
    Name:
    THE SEMLER FAMILY FOUNDATION INC
    2800320600 / V05701004
    EIN: 20-3523866
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT MANAGEMENT FEES 8,932 8,932   0


    TY 2010 TaxesSchedule
    Name:
    THE SEMLER FAMILY FOUNDATION INC
    2800320600 / V05701004
    EIN: 20-3523866
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAX WITHHELD 346 346   0