| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| TAX RETURN PREPERATION FEES | 6,800 | 3,400 | 0 | 3,400 |
| Description of Property | Date Acquired | Cost or Other Basis | Prior Years' Depreciation | Computation Method | Rate / Life (# of years) |
Current Year's Depreciation Expense | Net Investment Income | Adjusted Net Income | Cost of Goods Sold Not Included |
|---|
| Identifier | Return Reference | Explanation |
|---|---|---|
| Contribution Election | Form 990-PF, Part XIII, Line 7 Regulation 53.4942(a)-3(c)(2)(iv) | Pursuant to Reg. 53.4942(a)-3(c)(2)(iv), the above referenced foundation hereby elects to distribute all contributions of property so that the individual making the contributions is not subject to the section 170(e)(1)(B)(ii) limitations. The Foundation elects to apply excess distributions from prior years to satisfy the requirement of Section 170(b)(1)(F), or 4942(g)(3). The Foundation makes this election pursuant to Reg. 53.4942(a)-3(c)(1)(iv) in such prior tax years: 2006 $240,000 The Foundation acknowledges that the 2010 donations received satisfy the requirements imposed by IRC Section 170(e)(1)(B)(ii). The Foundation is deemed to qualify as a conduit organization and the required distributions were made. _________________________________________ _Trustee_ _________ Signature of Officer, Director or Trustee Title Date |
| Name of Stock | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| CORPORATE STOCK | 1,951,838 | 6,162,266 |
| Category / Item | Cost / Other Basis | Accumulated Depreciation | Book Value | End of Year Fair Market Value |
|---|
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| IL ANNUAL REPORT FILING FEE | 15 | 0 | 0 | 15 |
| IL CHARITY BUREAU FUND | 300 | 0 | 0 | 300 |
| MISCELLANEOUS | 140 | 140 | 0 | 0 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| Miscellaneous | 1,392 | 1,392 | 0 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| INVESTMENT EXCISE TAX | 7,000 | 0 | 0 | 0 |