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 03-01-2010 , and ending 02-28-2011
G
Check all that apply:
Name of foundation
SAMUEL SCHNEIDER FOUNDATION INC
 

Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 519   Room/suite
City or town, state, and ZIP code
TAYLORSVILLE, NC28681
A Employer identification number

13-6101811
B Telephone number (see page 10 of the instructions)

(828) 632-8181
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$1,265,378J 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      
4 Dividends and interest from securities...... 13,698 13,698  
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 -853
b Gross sales price for all assets on line 6a 110,566
7 Capital gain net income (from Part IV, line 2)... 0
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).......      
12 Total. Add lines 1 through 11........ 12,845 13,698  
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 9,711 9,711   0
17 Interest...............        
18 Taxes (attach schedule) (see page 14 of the instructions) Click to see attachment 151 151   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 -160 14   0
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 9,702 9,876   0
25 Contributions, gifts, grants paid........ 35,500 35,500
26 Total expenses and disbursements. Add lines 24 and 25 45,202 9,876   35,500
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -32,357
b Net investment income (if negative, enter -0-) 3,822
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...............      
2 Savings and temporary cash investments.......... 165,220 43,902 43,902
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)      
b Investments—corporate stock (attach schedule)........ 812,775 Click to see attachment901,736 1,189,515
c Investments—corporate bonds (attach schedule)........ 30,000 Click to see attachment30,000 31,961
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans..............      
13 Investments—other (attach schedule)...........      
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) 1,007,995 975,638 1,265,378
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......... 0 0
28 Paid-in or capital surplus, or land, bldg., and equipment fund 0 0
29 Retained earnings, accumulated income, endowment, or other funds 1,007,995 975,638
30 Total net assets or fund balances (see page 17 of the
instructions).................... 1,007,995 975,638
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 1,007,995 975,638
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 1,007,995
2 Enter amount from Part I, line 27a...................... 2 -32,357
3 Other increases not included in line 2 (itemize) bullet 3 0
4 Add lines 1, 2, and 3.......................... 4 975,638
5 Decreases not included in line 2 (itemize) bullet 5 0
6 Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30.. 6 975,638
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        
b
c
d
e
(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 110,566   111,419 -853
b
c
d
e
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       -853
b
c
d
e
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 -853
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 25,650 872,780 0.029389
2008 0 899,052 0.0
2007 10,000 484,518 0.020639
2006 6,000 67,451 0.088953
2005 21,578 79,243 0.272302
2 Total of line 1, column (d) ...................... 2 0.411283
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 0.082257
4 Enter the net value of noncharitable-use assets for 2010 from Part X, line 5..... 4 1,099,547
5 Multiply line 4 by line 3....................... 5 90,445
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 38
7 Add lines 5 and 6......................... 7 90,483
8 Enter qualifying distributions from Part XII, line 4.............. 8 35,500
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 76
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 76
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 76
6 Credits/Payments:
a 2010 estimated tax payments and 2009 overpayment credited to 2010 6a 492
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.............. 7 492
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 416
11 Enter the amount of line 10 to be: Credited to 2011 estimated taxBullet416 Refunded Bullet 11 0
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)bulletNJ, NC
    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 ofbulletALBERT SCHNEIDER Telephone no.bullet (828) 632-8181
    Located atbulletPO BOX 519TAYLORSVILLENC ZIP+4bullet28681
    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
    AGNES SCHNEIDER TRUSTEE
    0.00     		0 0 0
    324 EARLWOOD ROAD
    STATESVILLE,NC28677
    JENNIFER BRINKLEY TRUSTEE
    0.00     		0 0 0
    199 STONEGATE LANE
    STATESVILLE,NC28677
    CAROLINE MCPHERSON TRUSTEE
    0.00     		0 0 0
    313 AUGUSTA DRIVE
    STATESVILLE,NC28677
    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
    987,838
    b
    Average of monthly cash balances.......................
    1b
    128,453
    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
    1,116,291
    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
    1,116,291
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see page 25
    of the instructions) ............................
    4
    16,744
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    1,099,547
    6
    Minimum investment return. Enter 5% of line 5...................
    6
    54,977
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    54,977
    2a
    Tax on investment income for 2010 from Part VI, line 5......
    2a
    76
    b
    Income tax for 2010. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    76
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    54,901
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4.............................
    5
    54,901
    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
    54,901
    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
    35,500
    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
    35,500
    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
    0
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4...............
    6
    35,500
    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 54,901
    2 Undistributed income, if any, as of the end of 2010:
    a Enter amount for 2009 only....... 11,290
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2010:
    a From 2005.......  
    b From 2006.......  
    c From 2007.......  
    d From 2008.......  
    e From 2009.......  
    fTotal of lines 3a through e......... 0
    4Qualifying distributions for 2010 from Part
    XII, line 4: bullet$ 35,500
    a Applied to 2009, but not more than line 2a 11,290
    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..... 24,210
    e Remaining amount distributed out of corpus 0
    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 0
    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 ..........     		30,691
    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 ......     		0
    10 Analysis of line 9:
    a Excess from 2006....  
    b Excess from 2007....  
    c Excess from 2008....  
    d Excess from 2009....  
    e Excess from 2010....  
    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).)
    AGNES SCHNEIDER
    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:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    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
    BARIUM SPRINGS HOME FOR CHILDREN
    POST OFFICE BOX 1
    BARIUM SPRINGS,NC28010     		NONE PUBLIC CHARITY FOSTER CARE; FAMILY COUNSELING; BEHAVIORAL TREATMENT 5,000
    DOVE HOUSE CHILDRENS ADVOCACY CENTER
    2407 SIMONTON ROAD
    STATESVILLE,NC28625     		NONE PUBLIC CHARITY RAPID AND EFFECTIVE RESPONSE TO REPORTED CHILD SEXUA 2,500
    FIFTH STREET MINISTRIES
    POST OFFICE BOX 5217
    STATESVILLE,NC28687     		NONE PUBLIC CHARITY PROVIDE CLOTHING, FOOD, HEALTHCARE, AND SAFE SANCTUA 5,000
    IREDELL CHRISTIAN MINISTRIES
    322 EAST FRONT STREET
    STATESVILLE,NC28677     		NONE PUBLIC CHARITY CRISIS CENTER AND FOOD PANTRY 1,000
    STATESVILLE MONTESSORI SCHOOL PTO
    1012 HARMONY DRIVE
    STATESVILLE,NC28677     		NONE PUBLIC CHARITY EDUCATION 5,000
    TEMPLE EMANUEL
    201 OAKWOOD DRIVE
    WINSTON SALEM,NC27103     		NONE PUBLIC CHARITY PUBLIC SUPPORT 6,000
    SMILE TRAIN
    41 MADISON AVE
    NEW YORK,NY10010     		NONE PUBLIC CHARITY PUBLIC SUPPORT 1,000
    UNITED WAY
    301 N MAIN ST
    WINSTON SALEM,NC27101     		NONE PUBLIC CHARITY PUBLIC SUPPORT 1,000
    NC MASONIC FOUNDATION - LEE LODGE
    PO BOX 6506
    RALEIGH,NC27628     		NONE PUBLIC CHARITY PUBLIC SUPPORT 1,000
    MITCHELL COMMUNITY COLLEGE
    500 WEST BROAD ST
    STATESVILLE,NC28677     		NONE PUBLIC CHARITY PUBLIC SUPPORT 5,000
    ST JUDE CHILDREN'S HOSPITAL
    501 ST JUDE PLACE
    MEMPHIS,TN38105     		NONE PUBLIC CHARITY PUBLIC SUPPORT 500
    SUSAN G KOMEN FOR THE CURE
    1106 BURKE ST NW
    WINSTON SALEM,NC27101     		NONE PUBLIC CHARITY PUBLIC SUPPORT 500
    BOY SCOUTS OF AMERICA
    6600 SILAS CREEK PARKWAY
    WINSTON SALEM,NC27106     		NONE PUBLIC CHARITY PUBLIC SUPPORT 1,000
    COOL SPRINGS VOLUNTEER FIRE DEPT
    641 MOCKSVILLE HWY
    STATESVILLE,NC28625     		NONE PUBLIC CHARITY PUBLIC SUPPORT 1,000
    Total .................................bullet 3a 35,500
    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          
    4 Dividends and interest from securities....     14 13,698  
    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.....          
    8Gain or (loss) from sales of assets other than inventory     18 -853  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory..          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e).. 0 12,845 0
    13Total. Add line 12, columns (b), (d), and (e)...................
    1312,845
    (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:
    SAMUEL SCHNEIDER FOUNDATION INC
    EIN: 13-6101811
    Name of Bond End of Year Book Value End of Year Fair Market Value
    30,000 CATERPILLAR FIN SERV CRP POWERNOTE 30,000 31,961

    TY 2010 InvestmentsCorpStockSchedule
    Name:
    SAMUEL SCHNEIDER FOUNDATION INC
    EIN: 13-6101811
    Name of Stock End of Year Book Value End of Year Fair Market Value
    29 SHS ALCATEL-LUCENT ADR 249 142
    724 SHS AT&T, INC 1,874 20,547
    108 SHS COMCAST CORP 461 2,782
    40 SHS FRONTIER COMMUNICATIONS CORP 0 340
    8 SHS LSI CORP 55 50
    14 SHS NCR CORP 37 267
    84 SHS QWEST COMMUNICATIONS INTERNATIONAL INC 225 573
    14 SHS TERADATA CORP 0 669
    168 SHS VERIZON COMMUNICATIONS 831 6,203
    105 SHS VODAFONE GROUP PLC 146 3,005
    1000 SHS ALCOA INC 16,007 16,850
    400 SHS AMERICAN EXPRESS COMPANY 16,369 17,428
    36 SHS AOL INC 852 751
    600 SHS ARCHER-DANIELS-MIDLND CO 18,606 22,308
    300 SHS BANK NEW YORK MELLON CORP 7,856 9,117
    200 SHS BECTON DICKINSON & CO 16,592 16,000
    200 SHS BROWN-FORMAN CORP CL A 9,280 13,808
    600 SHS C T S CORPORATION COMMON 5,487 7,116
    1000 SHS CABLEVISION SYSTEMS NY GROUP CL A 23,606 36,850
    200 SHS CAMPBELL SOUP COMPANY 7,127 6,732
    1000 SHS CBS CORP 12,354 24,050
    400 SHS CHURCHILL DOWNS INC 17,800 16,700
    2500 SHS CINCINNATI BELL INC 6,539 6,600
    400 SHS CIRCOR INTL INC 17,028 15,860
    100 SHS COCA-COLA COMPANY 5,968 6,392
    500 SHS CONSTELLATION BRANDS INC CL A 6,661 10,160
    300 SHS COOPER INDUSTRIES LTD 8,581 19,305
    200 SHS CRANE COMPANY 3,158 9,448
    200 SHS DEERE & CO 7,530 18,030
    500 SHS DIEBOLD INC 18,528 17,580
    1200 SHS DIRECTV CLASS A COMMON 24,080 55,164
    300 SHS DISH NETWORK 3,500 6,975
    200 SHS DONALDSON COMPANY INC 8,175 11,260
    300 SHS DR PEPPER SNAPPLE GROUP INC. 6,744 10,818
    200 SHS ENERGIZER HOLDINGS 8,944 13,366
    600 SHS FERRO CORP 10,332 9,552
    200 SHS GATX CORP 7,308 6,938
    1500 SHS GAYLORD ENTERTAINMENT CORP 38,616 54,045
    400 SHS GENERAL MILLS INC 11,740 14,856
    200 SHS GENUINE PARTS CO COM 7,971 10,538
    500 SHS GERBER SCIENTIFIC INC 2,386 4,125
    500 SHS GRAFTECH INTERNATIONAL 3,799 10,005
    300 SHS GREAT PLAINS ENERGY INC 4,572 5,760
    880 SHS GRIFFON CORP 7,480 10,613
    300 SHS GRUPO TELEVISA S A 7,498 7,086
    600 SHS HALLIBURTON COMPANY 17,254 28,164
    100 SHS HERSHEY COMPANY 4,267 5,232
    700 SHS INTERMEC INC 7,542 7,861
    200 SHS ITT CORP 11,989 11,586
    1000 SHS JANUS CAPITAL GROUP INC 9,061 13,430
    2000 SHS JOURNAL COMMUNICATIONS 4,026 12,280
    800 SHS KAMAN CORPORATION 22,232 25,496
    300 SHS KRAFT FOODS INC 8,917 9,552
    500 SHS LEGG MASON INC 11,573 18,125
    100 SHS LIBERTY MEDIA CAP SER A 1,878 7,256
    80 SHS LIBERTY MEDIA CORP STARZ.COM SERIES A 2,364 5,616
    250 SHS MADISON SQUARE GARDEN INC CLASS A 4,856 7,123
    1000 SHS MAGNETEK INC 4,448 2,020
    1000 SHS MIDAS GROUP INC. 14,971 7,730
    200 SHS MILLICOM INTL CELLULAR 19,542 17,520
    300 SHS MODINE MANUFACTURING CO. 4,034 4,440
    400 SHS NATIONAL FUEL GAS CO. 17,045 29,160
    600 SHS NCR CORP NEW 10,529 11,460
    200 SHS NORTHERN TRUST CORP 11,166 10,314
    500 SHS O REILLY AUTOMOTIVE INC 17,653 27,790
    300 SHS OIL-DRI CORP OF AMERICA 5,134 6,093
    2000 SHS ROLLS ROYCE P L C 15,898 20,240
    600 SHS ROWAN COMPANIES 16,214 25,602
    1500 SHS RPC INC 13,107 29,370
    800 SHS SARA LEE CORP 14,415 13,696
    200 SHS SENSIENT TECHNOLOGIES 5,445 6,676
    600 SHS SONESTA INTL HOTELS 9,392 11,982
    300 SHS STATE STR CORP 13,789 13,416
    500 SHS STD MOTOR PRODUCTS COM 3,361 5,815
    400 SHS STERLING BANCORP 5,740 4,016
    500 SHS SWEDISH MATCH 10,728 15,798
    400 SHS TELEPHONE & DATA SYS INC 19,262 13,460
    800 SHS THOMAS & BETTS CORP 29,176 44,312
    400 SHS TIME WARNER INC 11,771 15,280
    424 SHS TOOTSIE ROLL IND INC 10,280 12,126
    300 SHS TREDEGAR CORPORATION 5,414 5,856
    125 SHS TYCO ELECTRONICS LTD 4,829 4,505
    300 SHS TYCO INTL LTD 12,337 13,602
    1000 SHS UNITED STATES CELLULAR CORP 57,817 49,980
    400 SHS VIACOM INC 13,359 20,456
    800 SHS WELLS FARGO COMPANY 24,275 25,808
    300 SHS WESTAR ENERGY INC 7,488 7,800
    300 SHS ZEP INC 4,206 4,707

    TY 2010 OtherExpensesSchedule
    Name:
    SAMUEL SCHNEIDER FOUNDATION INC
    EIN: 13-6101811
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    BANK CHARGES 14 14   0
    990 PF TAXES -174 0   0


    TY 2010 OtherProfessionalFeesSchedule
    Name:
    SAMUEL SCHNEIDER FOUNDATION INC
    EIN: 13-6101811
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT MANAGEMENT FEES 9,711 9,711   0


    TY 2010 TaxesSchedule
    Name:
    SAMUEL SCHNEIDER FOUNDATION INC
    EIN: 13-6101811
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    NJ TAXES 55 55   0
    FOREIGN DIVIDEND TAXES 96 96   0