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
VAN SLOUN FOUNDATION
 

Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 116 1787E SCOTCH PINE LANE   Room/suite
City or town, state, and ZIP code
WESTPORT POINT, MA02791
A Employer identification number

04-6691809
B Telephone number (see page 10 of the instructions)

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$7,931,555
J 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) 301,573
2 Check bullet
3 Interest on savings and temporary cash investments 1,600 1,600 1,600
4 Dividends and interest from securities...... 154,379 154,379 154,379
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 52,443
b Gross sales price for all assets on line 6a 620,907
7 Capital gain net income (from Part IV, line 2)... 109,906
8 Net short-term capital gain......... 37,298
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........ 509,995 265,885 193,277
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 25,000     25,000
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... 2,350 2,350 2,350  
c Other professional fees (attach schedule).... 29,337 29,337 29,337  
17 Interest...............        
18 Taxes (attach schedule) (see page 14 of the instructions) 4,977 4,261   250
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings....... 5,956      
22 Printing and publications.......... 1,245      
23 Other expenses (attach schedule).......        
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 68,865 35,948 31,687 25,250
25 Contributions, gifts, grants paid........ 339,000 339,000
26 Total expenses and disbursements. Add lines 24 and 25 407,865 35,948 31,687 364,250
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 102,130
b Net investment income (if negative, enter -0-) 229,937
c Adjusted net income (if negative, enter -0-)... 161,590
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...............   1,224 1,224
2 Savings and temporary cash investments.......... 666,178 1,270,478 1,270,478
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........... 2,480    
10a Investments—U.S. and state government obligations (attach schedule) 1,828,656 Click to see attachment764,747 764,747
b Investments—corporate stock (attach schedule)........ 4,705,724 Click to see attachment5,466,043 5,466,043
c Investments—corporate bonds (attach schedule)........   Click to see attachment429,063 429,063
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) 7,203,038 7,931,555 7,931,555
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.................... 7,203,038 7,931,555
25 Temporarily restricted................    
26 Permanently restricted................    
bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds.........    
28 Paid-in or capital surplus, or land, bldg., and equipment fund    
29 Retained earnings, accumulated income, endowment, or other funds    
30 Total net assets or fund balances (see page 17 of the
instructions).................... 7,203,038 7,931,555
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 7,203,038 7,931,555
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 7,203,038
2 Enter amount from Part I, line 27a...................... 2 102,130
3 Other increases not included in line 2 (itemize) bulletClick to see attachment 3 626,387
4 Add lines 1, 2, and 3.......................... 4 7,931,555
5 Decreases not included in line 2 (itemize) bullet 5  
6 Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30.. 6 7,931,555
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 500 SHS ADOBE SYSTEMS P 2006-07-25 2010-07-16
b 300 SHS ANALOG DEVICES D 1999-01-04 2010-07-16
c 200 SHS CHURCH AND DWIGHT D 2004-11-12 2010-07-16
d 1550 FORTUNE BRANDS D 2008-12-04 2010-12-10
e 500 SHS FORTUNE BRANDS P 2009-04-22 2010-12-10
500 SHS FORTUNE BRANDS P 2010-06-15 2010-12-10
1500 SHS GLACIER BANCORP P 2006-03-27 2010-06-15
1000 SHS GLACIER BANCORP P 2008-03-27 2010-06-15
500 SHS JOHNSON AND JOHNSON D 1992-10-22 2010-07-16
1000 SHS MEDTRONIC P 2002-03-14 2010-06-15
500 SHS PROCTER AND GAMBLE D 1992-05-14 2010-07-16
200 SHS POTASH CORP OF SASKATCHEWAN P 2009-08-18 2010-08-31
700 SHS POTASH CORP OF SASKATCHEWAN P 2009-10-19 2010-08-31
2000 SHS STATE STREET P 2001-03-27 2010-06-15
2000 SHS SYSCO P 2006-03-27 2010-06-15
500 SHS SYSCO P 2009-10-19 2010-06-15
CAPITAL GAIN DISTRIBUTION P 2000-01-01 2010-12-31
(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 13,798   13,503 295
b 8,783   4,728 4,055
c 12,987   6,180 6,807
d 97,465   60,556 36,909
e 31,446   17,471 13,975
31,446   23,136 8,310
23,288   31,020 -7,732
15,526   19,489 -3,963
29,626   10,150 19,476
38,567   37,288 1,279
30,837   16,767 14,070
29,217   18,792 10,425
102,272   74,876 27,396
76,243   99,525 -23,282
61,509   63,735 -2,226
15,377   13,785 1,592
2,520     2,520
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       295
b       4,055
c       6,807
d       36,909
e       13,975
      8,310
      -7,732
      -3,963
      19,476
      1,279
      14,070
      10,425
      27,396
      -23,282
      -2,226
      1,592
      2,520
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 2 109,906
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 37,298
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 298,125 6,422,213 0.046421
2008 304,070 7,143,468 0.042566
2007 330,250 7,641,744 0.043217
2006 304,625 7,038,379 0.043281
2005 401,651 6,637,591 0.060512
2 Total of line 1, column (d) ...................... 2 0.235996
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 0.047199
4 Enter the net value of noncharitable-use assets for 2010 from Part X, line 5..... 4 7,290,580
5 Multiply line 4 by line 3....................... 5 344,108
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 2,299
7 Add lines 5 and 6......................... 7 346,407
8 Enter qualifying distributions from Part XII, line 4.............. 8 364,250
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 2,299
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 2,299
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 2,299
6 Credits/Payments:
a 2010 estimated tax payments and 2009 overpayment credited to 2010 6a 2,000
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 2,000
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 9 299
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$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
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)bulletMA
    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 addressbullet  
    14
    The books are in care ofbulletAMERICAN RESEARCH AND MANAGEME Telephone no.bullet (508) 748-1665
    Located atbullet145 FRONT STREETMARIONMA ZIP+4bullet02738
    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
    NEIL VAN SLOUN TRUSTEE
    0
    0 0 0
    SCOTCH PINE LANE
    WESTPORT POINT,MA02791
    SYLVIA VAN SLOUN TRUSTEE
    0
    0 0 0
    SCOTCH PINE LANE
    WESTPORT POINT,MA02791
    DENNIS VAN SLOUN TRUSTEE
    0
    0 0 0
    17230 CLEAR SPRING LANE
    MINNETONKA,MN55345
    JOSEPH VAN SLOUN EXECUTIVE DIREC
    0
    25,000 0 0
    3527 JIDANA LANE
    MINNETONKA,MN55345
    DAVID B TITUS TRUSTEE
    0
    0 0 0
    PO BOX 1219
    MARION,MA02738
    EVERETT M DAVIS DIRECTOR
    0
    0 0 0
    43 COVE CIRCLE
    MARION,MA02738
    NANCY VAN SLOUN DIRECTOR
    0
    0 0 0
    30 WEST POINT DRIVE
    TONKA BAY,MN55331
    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  
    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.............bullet  
    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...........................bullet  
    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
    6,429,576
    b
    Average of monthly cash balances.......................
    1b
    972,028
    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
    7,401,604
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) ..............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d..........................
    3
    7,401,604
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see page 25
    of the instructions) ............................
    4
    111,024
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    7,290,580
    6
    Minimum investment return. Enter 5% of line 5...................
    6
    364,529
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    364,529
    2a
    Tax on investment income for 2010 from Part VI, line 5......
    2a
    2,299
    b
    Income tax for 2010. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    2,299
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    362,230
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4.............................
    5
    362,230
    6
    Deduction from distributable amount (see page 25 of the instructions)...........
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII,
    line 1.................................
    7
    362,230
    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
    364,250
    b
    Program-related investments—total from Part IX-B..................
    1b
     
    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
    364,250
    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
    2,299
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4...............
    6
    361,951
    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 7 362,230
    2 Undistributed income, if any, as of the end of 2010:
    a Enter amount for 2009 only....... 22,919
    b Total for prior years:20, 20, 20  
    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.........  
    4Qualifying distributions for 2010 from Part
    XII, line 4: bullet$ 364,250
    a Applied to 2009, but not more than line 2a 22,919
    b Applied to undistributed income of prior years
    (Election required—see page 26 of the instructions)
     
    c Treated as distributions out of corpus (Election
    required—see page 26 of the instructions)...
     
    d Applied to 2010 distributable amount..... 341,331
    e Remaining amount distributed out of corpus  
    5 Excess distributions carryover applied to 2010.    
    (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  
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ...........
     
    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......
     
    d Subtract line 6c from line 6b. Taxable
    amount—see page 27 of the instructions ...
     
    e Undistributed income for 2009. Subtract line
    4a from line 2a. Taxable amount—see page 27
    of the instructions ...........
     
    f Undistributed income for 2010. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2011 ..........
    20,899
    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) ...........
     
    8Excess distributions carryover from 2005 not
    applied on line 5 or line 7 (see page 27 of the
    instructions) .............
     
    9Excess distributions carryover to 2011.
    Subtract lines 7 and 8 from line 6a ......
     
    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).)
    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:
    JOSEPH VAN SLOUN
    3527 JIDANA LANE
    MINNETONKA,MN55345
    (508) 748-1665
    bThe form in which applications should be submitted and information and materials they should include:
    LETTER REQUESTING FUNDS
    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
    BENJAMIN WILLIAMS
    3900 DLANCEY ST
    PHILADELPHIA,PA19104
    NONE PUBLIC SCHOLARSHIP 1,000
    FITCHBURG STATE COLLEGE
    160 PEARL STREET
    FITCHBURG,MA01420
    NONE PUBLIC SCHOLARSHIP 1,000
    SCOTT BORGES
    200 WESTBORO ROAD
    NORTH GRAFTON,MA01536
    NONE PUBLIC SCHOLARSHIP 1,000
    MADELINE BROWN
    1365 GORTNER AVE
    SAINT PAUL,MN55108
    NONE PUBLIC SCHOLARSHIP 1,000
    KATHRYN NAREM
    100 PURPOSE ROAD
    PIPPA PASSES,KY41844
    NONE PUBLIC SCHOLARSHIP 1,000
    KAMI LEE VICKERMAN
    CPO 2142
    BEREA,KY40404
    NONE PUBLIC SCHOLARSHIP 1,000
    WESTPORT FISHERMANS ASSOCIATIO
    PO BOX 83
    WESTPORT POINT,MA02791
    NONE PUBLIC UNRESTRICTED 2,000
    KATE KRANTZ
    PO BOX 172750
    BOZEMAN,MT59717
    NONE PUBLIC SCHOLARSHIP 1,000
    JESSICA WILLEMSSEN
    PO BOX 5201
    NEW LONDON,CT06320
    NONE PUBLIC SCHOLARSHIP 1,000
    RAILS TO TRAILS
    2121 WARD CT 5TH FLOOR
    WASHINGTON,DC20037
    NONE PUBLIC UNRESTRICTED 1,000
    DUCKS UNLIMITED
    1 WATERFOWL WAY
    MEMPHIS,TN38120
    NONE PUBLIC UNRESTRICTED 4,000
    MN MASONIC CANCER CENTER
    200 OAK ST SE SUITE 300
    MINNEAPOLIS,MN55455
    NONE PUBLIC UNRESTRICTED 5,000
    MONTANA STATE HORTICULTURAL DP
    1501 SOUTH 11TH AVE
    BOZEMAN,MT59717
    NONE PUBLIC UNRESTRICTED 4,000
    MN LANDSCAPE ARBORETUM FDT
    3675 ARBORETUM DRIVE
    CHASKA,MN55318
    NONE PUBLIC UNRESTRICTED 10,000
    LANDSCAPE PLANT DEV CENTER
    PO BOX 444
    MOUND,MN55364
    NONE PUBLIC UNRESTRICTED 5,000
    STUDENT CONSERVATION ASSOC
    689 RIVER RD PO BOX 550
    CHARLESTOWN,NH03603
    NONE PUBLIC UNRESTRICTED 8,000
    BLITHEWOLD INC
    101 FERRY ROAD
    BRISTOL,RI02809
    NONE PUBLIC UNRESTRICTED 10,000
    FRIENDS ACADEMY
    1088 TUCKER ROAD
    NORTH DARTMOUTH,MA02747
    NONE PUBLIC UNRESTRICTED 6,000
    HORTICULTURAL RESEARCH INSTIT
    1000 VERMONT AVE NW
    WASHINGTON,DC20005
    NONE PUBLIC UNRESTRICTED 2,000
    WESTPORT LAND CONSERVATION TST
    PO BOX 3975 1100D MAIN RD
    WESTPORT,MA02790
    NONE PUBLIC UNRESTRICTED 1,000
    PERKINS SCHOOL FOR THE BLIND
    175 NORTH BEACON ST
    WATERTOWN,MA02472
    NONE PUBLIC UNRESTRICTED 7,000
    DEMAREST LLOYD CENTER FOR ENVI
    430 POTOMSKA RD
    SOUTH DARTMOUTH,MA02748
    NONE PUBLIC UNRESTRICTED 4,000
    WESTPORT RIVER WATERSHED ALL
    PO BOX 3427
    WESTPORT,MA02790
    NONE PUBLIC UNRESTRICTED 10,000
    FRED HUTCHINSON CANCER RESEARC
    1100 FAIRVIEW AVE N BOX 19024
    SEATTLE,WA98109
    NONE PUBLIC UNRESTRICTED 20,000
    FRIENDS ACADEMY
    1088 TUCKER ROAD
    NORTH DARTMOUTH,MA02747
    NONE PUBLIC GIRLS SPORTS PROG 6,000
    CHOATE ROSEMANY HALL
    333 CHRISTIAN STREET
    WALLINGFORD,CT06492
    NONE PUBLIC GIRLS SPORTS PROG 1,000
    BEREA COLLEGE
    CPO 2142
    BEREA,KY40404
    NONE PUBLIC UNRESTRICTED 10,000
    CONNECTICUT COLLEGE
    270 MOHEGAN AVE BOX 5201
    NEW LONDON,CT06320
    NONE PUBLIC ENDOWMENT 2,000
    ALICE LLOYD COLLEGE
    100 PURPOSE ROAD
    PIPPA PASSES,KY41844
    NONE PUBLIC UNRESTRICTED 30,000
    CAMP SUNSHINE
    35 ACADIA ROAD
    CASCO,ME04015
    NONE PUBLIC UNRESTRICTED 6,000
    UNNIVERSITY OF PENNSYLVANIA
    RM 2050 RYAN 3900 DELANCY ST
    PHILADELPHIA,PA19104
    NONE PUBLIC UNRESTRICTED 30,000
    MASSACHUSETTS AUDUBON SOCIETY
    208 SOUTH GREAT RD
    LINCOLN,MA01773
    NONE PUBLIC UNRESTRICTED 10,000
    MORRIS ANIMAL FOUNDATION
    10200 E GIRARD AVE SUITE B 430
    DENVER,CO80231
    NONE PUBLIC UNRESTRICTED 30,000
    DORCAS WIDOWS FUND
    574 PRAIRIE CENTER DR
    EDEN PRAIRIE,MN55344
    NONE PUBLIC UNRESTRICTED 1,000
    REDWOOD CITY HERITAGE
    PO BOX 1273
    REDWOOD CITY,CA94064
    NONE PUBLIC LATHROP HOUSE 1,000
    WESTPORT YOUTH ATHLETIC ASSOC
    PO BOX 1567
    WESTPORT,MA02790
    NONE PUBLIC UNRESTRICTED 5,000
    FAXON ANIMAL LEAGUE
    474 DURFEE STREET
    FALL RIVER,MA02720
    NONE PUBLIC UNRESTRICTED 40,000
    GUIDING EYES FOR THE BLIND
    611 GRANITE SPRINGS RD
    YORKTOWN HEIGHTS,NY10598
    NONE PUBLIC UNRESTRICTED 2,000
    THE RAPTOR CENTER
    1365 GORTNER AVE
    SAINT PAUL,MN55108
    NONE PUBLIC UNRESTRICTED 2,000
    NEADS
    PO BOX 213
    WEST BOYLSTON,MA01583
    NONE PUBLIC UNRESTRICTED 5,000
    GUIDE DOG FOUNDATION FOR BLIND
    371 EAST JERICHO TURNPIKE
    SMITHTOWN,NY11787
    NONE PUBLIC UNRESTRICTED 4,000
    AMERICAS VET DOGS
    371 EAST JERICHO TURNPIKE
    SMITHTOWN,NY11787
    NONE PUBLIC UNRESTRICTED 15,000
    UNIVERSITY OF MN
    1365 GORTNER AVENUE
    SAINT PAUL,MN55108
    NONE PUBLIC RAPTOR CENTER 5,000
    FRONTIER NURSING CENTER
    132 FNS DRIVE
    WENDOVER,KY41775
    NONE PUBLIC UNRESTRICTED 8,000
    CUMMINGS SCHOOL FOR VETERINARY
    200 WESTBORO ROAD
    NORTH GRAFTON,MA01536
    NONE PUBLIC UNRESTRICTED 8,000
    MINNESOTA LANDSCAPE ABORETUM
    3675 ARBORETUM DRIVE
    CHASKA,MN55318
    NONE PUBLIC UNRESTRICTED 1,000
    LANDSCAPE PLANT DEVELOPMENT
    PO BOX 444
    MOUND,MN55364
    NONE PUBLIC UNRESTRICTED 800
    MINNESOTA STATE HORTICULTURAL
    1365 GORTNER AVE
    SAINT PAUL,MN55108
    NONE PUBLIC UNRESTRICTED 200
    DORCAS WIDOWS FUND
    574 PRAIRIE CENTER DRIVE
    EDEN PRAIRIE,MN55344
    NONE PUBLIC UNRESTRICTED 500
    PAMELA KATTEN MEMORIAL LEUKEMI
    1100 FAIRVIEW AVE N
    SEATTLE,WA98109
    NONE PUBLIC UNRESTRICTED 500
    UNIVERSITY OF MN MASONIC CTR
    200 OAK ST SE SUITE 300
    MINNEAPOLIS,MN55455
    NONE PUBLIC UNRESTRICTED 500
    MN LANDSCAPE ABORETUM
    3675 ARBORETUM DRIVE
    CHASKA,MN55318
    NONE PUBLIC UNRESTRICTED 500
    TABOR ACADEMY
    FRONT STREET
    MARION,MA02738
    NONE PUBLIC UNRESTRICTED 250
    BOWDOIN COLLEGE
    4100 COLLEGE STATION
    BRUNSWICK,ME04011
    NONE PUBLIC UNRESTRICTED 1,750
    BENTLEY COLLEGE
    175 FOREST STREET
    WALTHAM,MA02452
    NONE PUBLIC UNRESTRICTED 750
    WATOTO CHARITABLE TRUST
    SCHADAULISTRI LENK 3775
    SW
    NONE PUBLIC UNRESTRICTED 250
    UNIVERSITY OF MINNESOTA
    1365 GORTNER AVE
    SAINT PAUL,MN55108
    NONE PUBLIC UNRESTRICTED 800
    AMERICAS VET DOGS
    371 EAST JERICHO TURNPIKE
    SMITHTOWN,NY11787
    NONE PUBLIC UNRESTRICTED 700
    THE RAPTOR CENTER
    1365 GORTNER AVENUE
    SAINT PAUL,MN55108
    NONE PUBLIC UNRESTRICTED 500
    WESTPORT FISHERMANS ASSOCIATIO
    PO BOX 83
    WESTPORT POINT,MA02791
    NONE PUBLIC UNRESTRICTED 1,000
    TABOR ACADEMY
    FRONT STREET
    MARION,MA02738
    NONE PUBLIC UNRESTRICTED 1,000
    Total .................................bullet 3a 339,000
    bApproved for future payment
    Total ..................................bullet 3b  
    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 1,600  
    4 Dividends and interest from securities....     14 154,379  
    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 52,443  
    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)..   208,422  
    13Total. Add line 12, columns (b), (d), and (e)...................
    13208,422
    (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
    Schedule B
    (Form 990, 990-EZ,
    or 990-PF)
    Department of the Treasury
    Internal Revenue Service
    Schedule of Contributors
    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    OMB No. 1545-0047
    2010
    Name of organization
    VAN SLOUN FOUNDATION
     
    Employer identification number

    04-6691809
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ





    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule—
    Special Rules
    ......................... Arrow Bullet   $    
    Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
    Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

    Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
    Page 1 of 1 of Part I
    Name of organization
    VAN SLOUN FOUNDATION
     
    Employer identification number

    04-6691809
    Part I
    Contributors (see Instructions)
         
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Aggregate contributions
    (d)
    Type of contribution
    1
     
     

    MR AND MRS NEIL J VAN SLOUN    
    SCOTCH PINE LANE
       
    WESTPORT POINT, MA   02791

    $301,573




    (Complete Part II if there is
    a noncash contribution.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Aggregate contributions
    (d)
    Type of contribution
     
     
     

         
     
       

    $  




    (Complete Part II if there is
    a noncash contribution.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Aggregate contributions
    (d)
    Type of contribution
     
     
     

         
     
       

    $  




    (Complete Part II if there is
    a noncash contribution.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Aggregate contributions
    (d)
    Type of contribution
     
     
     

         
     
       

    $  




    (Complete Part II if there is
    a noncash contribution.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Aggregate contributions
    (d)
    Type of contribution
     
     
     

         
     
       

    $  




    (Complete Part II if there is
    a noncash contribution.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Aggregate contributions
    (d)
    Type of contribution
     
     
     

         
     
       

    $  




    (Complete Part II if there is
    a noncash contribution.)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

    Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
    Page 1 of 1 of Part II
    Name of organization
    VAN SLOUN FOUNDATION
     
    Employer identification number

    04-6691809
    Part II
    Noncash Property (see Instructions)
         
    (a) No.
    from
    Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (see instructions)
    (d)
    Date received
    1
    VARIOUS PUBLICALLY TRADED STOCK   $201,573 2010-12-07
    (a) No.
    from
    Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (see instructions)
    (d)
    Date received
     
    $    
    (a) No.
    from
    Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (see instructions)
    (d)
    Date received
     
    $    
    (a) No.
    from
    Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (see instructions)
    (d)
    Date received
     
    $    
    (a) No.
    from
    Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (see instructions)
    (d)
    Date received
     
    $    
    (a) No.
    from
    Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (see instructions)
    (d)
    Date received
     
    $    
    Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

    Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
    Page 1 of 1 of Part III
    Name of organization
    VAN SLOUN FOUNDATION
     
    Employer identification number

    04-6691809
    Part III
    Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
    aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
    For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
    contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
    (a) No.
    from
    Part I
    (b)
    Purpose of gift
    (c)
    Use of gift
    (d)
    Description of how gift is held
     
    (e)
    Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
           
     
    (a) No.
    from
    Part I
    (b)
    Purpose of gift
    (c)
    Use of gift
    (d)
    Description of how gift is held
     
    (e)
    Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
           
     
    (a) No.
    from
    Part I
    (b)
    Purpose of gift
    (c)
    Use of gift
    (d)
    Description of how gift is held
     
    (e)
    Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
           
     
    (a) No.
    from
    Part I
    (b)
    Purpose of gift
    (c)
    Use of gift
    (d)
    Description of how gift is held
     
    (e)
    Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
           
     
    Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

    Additional Data


    Software ID:  
    Software Version:  

    TY 2010 AccountingFeesSchedule
    Name:
    VAN SLOUN FOUNDATION
    EIN: 04-6691809
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    BENOIT AND MCARDLE PC 2,350 2,350 2,350 0

    TY 2010 InvestmentsCorpBondsSchedule
    Name:
    VAN SLOUN FOUNDATION
    EIN: 04-6691809
    Name of Bond End of Year Book Value End of Year Fair Market Value
    AT & T DUE 11/15/11 104,583 104,583
    GENERAL ELECTRIC DUE 11/21/11 103,244 103,244
    BERKSHIRE HATHAWAY DUE 4/15/12 103,999 103,999
    DUPONT EI NEMOUR DUE 11/15/12 117,237 117,237

    TY 2010 InvestmentsCorpStockSchedule
    Name:
    VAN SLOUN FOUNDATION
    EIN: 04-6691809
    Name of Stock End of Year Book Value End of Year Fair Market Value
    ANALOG DEVICES 226,019 226,019
    JOHNSON AND JOHNSON 179,365 179,365
    MEDTRONIC    
    MERCK 79,288 79,288
    MICROSOFT 111,640 111,640
    FISERV 184,464 184,464
    PROCTER AND GAMBLE 180,124 180,124
    STATE STREET    
    DOVER 233,800 233,800
    GENERAL ELECTRIC 128,030 128,030
    PEPSICO 111,061 111,061
    ENCANA 209,664 209,664
    PLUM CREEK TIMBER 56,175 56,175
    ADP 101,816 101,816
    CHURCH AND DWIGHT 207,060 207,060
    TRANSCANADA 133,140 133,140
    NOVARTIS 132,637 132,637
    EXXON MOBIL 182,800 182,800
    ADOBE SYSTEMS 76,950 76,950
    GLACIER BANCORP    
    SYSCO    
    JOHN WILEY CLASS A 113,100 113,100
    CHEVRON TEXACO 182,500 182,500
    ILLINOIS TOOLWORKS 106,800 106,800
    OCCIDENTAL PETE 122,625 122,625
    EXPEDITORS INTERNATIONAL 163,800 163,800
    WATERS CORPORATION 194,274 194,274
    FORTUNE BRANDS    
    JG BOSWELL 150,000 150,000
    REALTY INCOME CORP 102,600 102,600
    KEWEENAU LAND ASSN LTD 55,650 55,650
    STRYKER CORP 107,400 107,400
    ALTRIA CORP 184,650 184,650
    CME GROUP 144,787 144,787
    FIRST POTOMAC REALTY 84,100 84,100
    GOLDMAN SACHS 96,600 96,600
    JP MORGAN CHASE 101,240 101,240
    PHILIP MORRIS INTERNATIONAL 190,222 190,222
    USB CAPITAL VII 99,440 99,440
    CENOVUS ENERGY 239,328 239,328
    IMPERIAL OIL 121,560 121,560
    POTASH CORP OF SASKATCHEWAN    
    CISCO SYSTEMS 50,575 50,575
    EMC 68,700 68,700
    NESTLE S A ADR 88,230 88,230
    PRIVATE BANCORP 52,940 52,940
    NORTHERN OIL AND GAS 10,884 10,884
    ROYAL DUTCH SHELL 100,005 100,005

    TY 2010 InvestmentsGovtObligationsSch
    Name:
    VAN SLOUN FOUNDATION
    EIN: 04-6691809
    US Government Securities - End of Year Book Value:

     
    US Government Securities - End of Year Fair Market Value:

     
    State & Local Government Securities - End of Year Book Value:


    764,747
    State & Local Government Securities - End of Year Fair Market Value:


    764,747


    TY 2010 OtherDecreasesSchedule
    Name:
    VAN SLOUN FOUNDATION
    EIN: 04-6691809
    Description Amount
    UNREALIZED GAINS AND LOSSES 626,387


    TY 2010 OtherProfessionalFeesSchedule
    Name:
    VAN SLOUN FOUNDATION
    EIN: 04-6691809
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT AND ADVISORY FEES 29,337 29,337 29,337 0


    TY 2010 TaxesSchedule
    Name:
    VAN SLOUN FOUNDATION
    EIN: 04-6691809
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FEDERAL EXCISE TAX 466 0 0 0
    COMMONWEALTH OF MASSACHUSETTS 250 0 0 250
    FOREIGN TAX 4,261 4,261 0 0