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
2011
For calendar year 2011, or tax year beginning 01-01-2011 , and ending 12-31-2011
G
Check all that apply:
Name of foundation
KINGSBURY MEMORIAL FOUNDATION 50217170
 

Number and street (or P.O. box number if mail is not delivered to street address)P O BOX 3168   Room/suite
City or town, state, and ZIP code
PORTLAND, OR97208
A Employer identification number

81-6078134
B Telephone number (see page 10 of the instructions)

(503) 275-4327
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$1,259,311
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) 0
2 Check bullet
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities...... 28,205 28,205  
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 35,317
b Gross sales price for all assets on line 6a 395,385
7 Capital gain net income (from Part IV, line 2)... 35,317
8 Net short-term capital gain......... 0
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)....... 4,688 4,688  
12 Total. Add lines 1 through 11........ 68,210 68,210  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 15,286 13,757   1,529
14 Other employee salaries and wages......   0 0 0
15 Pension plans, employee benefits.......   0 0  
16a Legal fees (attach schedule).........       0
b Accounting fees (attach schedule)....... 1,500 0 0 1,500
c Other professional fees (attach schedule)....       0
17 Interest...............       0
18 Taxes (attach schedule) (see page 14 of the instructions) 606 339   0
19 Depreciation (attach schedule) and depletion... 0 0  
20 Occupancy..............        
21 Travel, conferences, and meetings.......   0 0  
22 Printing and publications..........   0 0  
23 Other expenses (attach schedule).......        
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 17,392 14,096 0 3,029
25 Contributions, gifts, grants paid........ 65,000 65,000
26 Total expenses and disbursements. Add lines 24 and 25 82,392 14,096 0 68,029
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -14,182
b Net investment income (if negative, enter -0-) 54,114
c Adjusted net income (if negative, enter -0-)... 0
For Privacy Act and Paperwork Reduction Act Notice, see page 30 of the instructions.
Cat. No. 11289X Form 990-PF (2011)
Form 990-PF (2011)
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...............   766 766
2 Savings and temporary cash investments.......... 32,274 39,938 39,938
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet     0 0
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 bullet0      
8 Inventories for sale or use...............      
9 Prepaid expenses and deferred charges...........      
10a Investments—U.S. and state government obligations (attach schedule) 171,487 Click to see attachment171,487 176,633
b Investments—corporate stock (attach schedule)........ 791,545 Click to see attachment762,942 830,682
c Investments—corporate bonds (attach schedule)........ 187,025 Click to see attachment192,765 195,912
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans..............      
13 Investments—other (attach schedule)...........     0
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet) 1,272 1,522 15,380
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 1,183,603 1,169,420 1,259,311
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
Net Assets or Fund Balances bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted....................    
25 Temporarily restricted................    
26 Permanently restricted................    
bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds......... 1,183,603 1,169,420
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).................... 1,183,603 1,169,420
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 1,183,603 1,169,420
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 1,183,603
2 Enter amount from Part I, line 27a..................... 2 -14,182
3 Other increases not included in line 2 (itemize) bulletClick to see attachment 3 236
4 Add lines 1, 2, and 3.......................... 4 1,169,657
5 Decreases not included in line 2 (itemize) bulletClick to see attachment 5 237
6 Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30. 6 1,169,420
Form 990-PF (2011)
Form 990-PF (2011)
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 . ENRON CORP     2011-01-21
b 50. ALLSTATE CORP   2009-05-07 2011-01-24
c 175. AMGEN INC COMMON STOCK     2011-01-24
d 189. COMCAST CORP CL A     2011-01-24
e 148. MEDTRONIC INC COMMON STOCK   2001-10-19 2011-01-24
100. STATE STR CORP     2011-01-24
80. ABERCROMBIE & FITCH CO CL A   2010-03-24 2011-02-01
100. ALLSTATE CORP     2011-02-01
40. AMGEN INC COMMON STOCK     2011-02-01
76. IPATH DOW JONES UBS COMMODITY   2007-07-16 2011-02-01
110. BEST BUY CO INC   2010-02-10 2011-02-01
95. COACH INC   2009-12-04 2011-02-01
150. COMCAST CORP CL A   2009-11-19 2011-02-01
200. CONOCOPHILLIPS     2011-02-01
130. E BAY INC   2010-03-24 2011-02-01
82. EXELON CORPORATION   2005-11-02 2011-02-01
171.698 NUVEEN SMALL CAP SELECT FD CL Y   1995-03-17 2011-02-01
67. MEDTRONIC INC COMMON STOCK     2011-02-01
335. SCHWAB CHARLES CORP     2011-02-01
80. STATE STR CORP     2011-02-01
87. VERIZON COMMUNICATIONS   2001-10-19 2011-02-01
80. WMS INDS INC   2010-03-24 2011-02-01
100. ALLSTATE CORP   2005-03-30 2011-03-07
17. APPLE INC   2005-01-26 2011-03-07
50. BERKSHIRE HATHAWAY INC CL B   2010-02-24 2011-03-07
270.085 NUVEEN SMALL CAP SELECT FD CL Y   2003-02-20 2011-03-07
441.127 NUVEEN SMALL CAP SELECT FD CL Y   2003-04-14 2011-03-07
3. JOHNSON & JOHNSON   2001-10-19 2011-03-07
96. MICROSOFT CORP   2001-10-19 2011-03-07
31. PROCTER & GAMBLE CO   2002-03-19 2011-03-07
57. VERIZON COMMUNICATIONS     2011-03-07
105. CISCO SYS INC   2008-04-16 2011-05-03
41. ECOLAB INC   2002-06-11 2011-05-03
45. EXXON MOBIL CORP   2001-10-19 2011-05-03
14. ILLINOIS TOOL WORKS   2006-08-16 2011-05-03
70. J P MORGAN CHASE CO   2008-09-26 2011-05-03
19. JOHNSON & JOHNSON   2001-10-19 2011-05-03
378. KEYCORP NEW   2011-03-07 2011-05-03
46. MICROSOFT CORP     2011-05-03
48. THE MOSAIC CO   2011-01-24 2011-05-03
44. PEPSICO INC   2001-10-19 2011-05-03
2. PRAXAIR INC   2003-12-22 2011-05-03
10. PROCTER & GAMBLE CO   2002-03-19 2011-05-03
21. 3M CO   2002-12-18 2011-05-03
26. UNITED PARCEL SERVICE INC CL B   2001-10-19 2011-05-03
3. UNITED TECHNOLOGIES CORP   2004-01-05 2011-05-03
16. WAL MART STORES INC   2004-10-21 2011-05-03
67. WELLS FARGO & CO NEW   2002-04-09 2011-05-03
306. WINDSTREAM CORP   2011-02-01 2011-05-03
18. APACHE CORP   2004-07-06 2011-05-23
37. EXELON CORPORATION   2005-11-02 2011-05-23
89. GENERAL ELEC CO   2001-10-19 2011-05-23
11. ILLINOIS TOOL WORKS   2006-08-16 2011-05-23
6. JOHNSON & JOHNSON   2001-10-19 2011-05-23
19. MC DONALD'S CORP   2008-12-09 2011-05-23
63. MICROSOFT CORP   2004-02-26 2011-05-23
83. ORACLE CORPORATION   2006-12-05 2011-05-23
13. PEPSICO INC   2001-10-19 2011-05-23
3. PRAXAIR INC   2003-12-22 2011-05-23
26. PROCTER & GAMBLE CO   2002-03-19 2011-05-23
53. TARGET CORPORATION   2001-10-19 2011-05-23
3. UNITED PARCEL SERVICE INC CL B   2001-10-19 2011-05-23
8. UNITED TECHNOLOGIES CORP   2004-01-05 2011-05-23
19. WAL MART STORES INC   2004-10-21 2011-05-23
.6 CITIGROUP INC   2011-01-24 2011-05-25
19. CATERPILLAR INC   2011-02-01 2011-06-27
145. CISCO SYS INC   2008-12-09 2011-06-27
33. CLIFFS NATURAL RESOURCES INC   2010-03-24 2011-06-27
45. ECOLAB INC   2002-06-11 2011-06-27
31. EXELON CORPORATION   2005-11-02 2011-06-27
21. EXXON MOBIL CORP   2001-10-19 2011-06-27
18. EXXON MOBIL CORP   2001-11-02 2011-06-27
6. GOOGLE INC CL A   2008-11-04 2011-06-27
40. HEWLETT PACKARD CO   2010-01-26 2011-06-27
131. ISHARES MSCI EMERGING MKTS E T F   2006-06-22 2011-06-27
30. J P MORGAN CHASE CO   2008-11-04 2011-06-27
5. JOHNSON & JOHNSON   2001-10-19 2011-06-27
23. JOHNSON & JOHNSON   2002-07-25 2011-06-27
25. MC DONALD'S CORP   2008-12-09 2011-06-27
20. MEDTRONIC INC COMMON STOCK   2007-01-24 2011-06-27
17. NATIONAL OILWELL VARCO INC   2011-02-01 2011-06-27
34. PEPSICO INC   2001-10-19 2011-06-27
30. PRAXAIR INC   2003-12-22 2011-06-27
33. PROCTER & GAMBLE CO   2002-03-19 2011-06-27
1. SCHLUMBERGER LTD   2004-01-07 2011-06-27
25. 3M CO   2003-01-17 2011-06-27
2. UNITED PARCEL SERVICE INC CL B   2001-10-19 2011-06-27
35. UNITED PARCEL SERVICE INC CL B   2002-01-03 2011-06-27
10. UNITED PARCEL SERVICE INC CL B   2003-02-20 2011-06-27
14. UNITED TECHNOLOGIES CORP   2004-01-05 2011-06-27
23. UNITED TECHNOLOGIES CORP   2004-07-15 2011-06-27
35. WAL MART STORES INC   2006-04-04 2011-06-27
25. ACE LTD   2011-05-03 2011-06-27
. ROYAL DUTCH PETE NY REG N GLDR 1.25     2011-07-01
56.6 CITIGROUP INC   2011-01-24 2011-07-27
89.4 CITIGROUP INC   2011-05-23 2011-07-27
30. QUALCOMM INC   2003-02-20 2011-07-27
73. WELLS FARGO & CO NEW   2002-04-09 2011-07-27
116. SUNTRUST BKS INC   2011-02-01 2011-08-05
95. BANK OF AMERICA CORP   2010-09-03 2011-08-08
215. BANK OF AMERICA CORP   2010-03-24 2011-08-08
40. CITIGROUP INC     2011-08-08
317. ON SEMICONDUCTOR CORPORATION   2011-02-01 2011-08-11
66. CAMERON INTL CORP   2011-02-01 2011-08-12
18. APPLE INC   2008-02-22 2011-09-19
. BANK OF AMERICA CORP     2011-09-21
. M B N A CORP     2011-09-28
90. B M C SOFTWARE INC   2010-03-24 2011-10-10
67. ABBOTT LABS   2008-06-26 2011-10-12
69. AMERICAN TOWER CORP   2011-02-01 2011-10-12
176. BRUNSWICK CORP   2011-02-01 2011-10-12
64. CAPITAL ONE FINANCIAL CORP   2011-05-23 2011-10-12
36. CHEVRONTEXACO CORP     2011-10-12
111. CITIGROUP INC   2011-05-23 2011-10-12
135. DISNEY WALT CO   2010-02-10 2011-10-12
220. FORD MOTOR CO   2011-02-01 2011-10-12
80. HEWLETT PACKARD CO   2010-03-24 2011-10-12
79. ILLINOIS TOOL WORKS   2006-08-16 2011-10-12
58. THERMO FISHER SCIENTIFIC INC   2011-05-03 2011-10-12
86. UNITED HEALTH GROUP INCORPORATED   2011-02-01 2011-10-12
56. WHITING PETROLEUM CORP   2011-02-01 2011-10-12
20000. BANK OF NEW YORK MTN 5.125% 11/01/11   2007-05-07 2011-11-01
25000. SUNTRUST BANK MTN 3.000% 11/16/11   2008-12-16 2011-11-16
10000. BARCLAYS 24MO 200% SPX 11/25/11   2009-11-20 2011-11-25
25000. METLIFE INC 6.125% 12/01/11   2002-06-10 2011-12-01
CAPITAL GAIN DIVIDENDS P    
(e) Gross sales price (f) Depreciation allowed
(or allowable)
(g) Cost or other basis
plus expense of sale
(h) Gain or (loss)
(e) plus (f) minus (g)
a 146     146
b 1,568   1,378 190
c 10,050   10,091 -41
d 4,451   4,498 -47
e 5,614   6,479 -865
4,809   4,088 721
4,039   3,557 482
3,155   4,940 -1,785
2,215   2,102 113
3,782   3,922 -140
3,799   3,929 -130
5,146   3,473 1,673
3,457   2,226 1,231
14,378   7,688 6,690
4,062   3,520 542
3,473   4,210 -737
2,481   2,385 96
2,567   2,972 -405
6,127   6,213 -86
3,807   3,291 516
3,138   4,098 -960
3,405   3,322 83
3,149   5,376 -2,227
5,993   609 5,384
4,283   3,971 312
3,973   2,986 987
6,489   5,142 1,347
181   176 5
2,454   2,758 -304
1,906   1,375 531
2,054   2,450 -396
1,823   2,483 -660
2,137   945 1,192
3,884   1,830 2,054
808   628 180
3,198   3,056 142
1,257   1,112 145
3,300   3,512 -212
1,175   1,242 -67
3,421   3,631 -210
3,046   2,086 960
210   76 134
654   443 211
2,041   1,270 771
1,938   1,322 616
269   142 127
887   837 50
1,958   1,655 303
3,941   3,996 -55
2,180   805 1,375
1,557   1,900 -343
1,711   3,329 -1,618
620   494 126
393   351 42
1,559   1,134 425
1,518   1,677 -159
2,755   1,564 1,191
920   616 304
308   114 194
1,742   1,153 589
2,627   1,691 936
219   153 66
687   380 307
1,049   994 55
24   30 -6
1,905   1,852 53
2,167   2,518 -351
2,824   2,380 444
2,448   1,037 1,411
1,307   1,592 -285
1,628   854 774
1,395   719 676
2,872   2,209 663
1,398   2,003 -605
5,995   3,837 2,158
1,195   1,242 -47
326   293 33
1,501   1,118 383
2,049   1,492 557
770   1,064 -294
1,191   1,265 -74
2,344   1,612 732
3,096   1,137 1,959
2,081   1,463 618
80   27 53
2,297   1,576 721
142   102 40
2,491   1,925 566
712   585 127
1,187   664 523
1,950   1,043 907
1,836   1,633 203
1,614   1,669 -55
53     53
2,200   2,785 -585
3,475   3,621 -146
1,653   514 1,139
2,108   1,803 305
2,530   3,599 -1,069
707   1,282 -575
1,600   3,771 -2,171
1,117   1,751 -634
2,368   3,626 -1,258
3,183   3,577 -394
7,371   2,149 5,222
11     11
12     12
3,290   3,488 -198
3,513   3,566 -53
3,865   3,575 290
3,161   3,576 -415
2,820   3,481 -661
3,545   3,727 -182
3,267   4,495 -1,228
4,625   3,982 643
2,565   3,568 -1,003
2,068   4,257 -2,189
3,668   3,545 123
3,190   3,525 -335
4,039   3,599 440
2,155   3,599 -1,444
20,000   20,080 -80
25,000   25,475 -475
11,862   10,000 1,862
25,000   25,295 -295
      42
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       146
b       190
c       -41
d       -47
e       -865
      721
      482
      -1,785
      113
      -140
      -130
      1,673
      1,231
      6,690
      542
      -737
      96
      -405
      -86
      516
      -960
      83
      -2,227
      5,384
      312
      987
      1,347
      5
      -304
      531
      -396
      -660
      1,192
      2,054
      180
      142
      145
      -212
      -67
      -210
      960
      134
      211
      771
      616
      127
      50
      303
      -55
      1,375
      -343
      -1,618
      126
      42
      425
      -159
      1,191
      304
      194
      589
      936
      66
      307
      55
      -6
      53
      -351
      444
      1,411
      -285
      774
      676
      663
      -605
      2,158
      -47
      33
      383
      557
      -294
      -74
      732
      1,959
      618
      53
      721
      40
      566
      127
      523
      907
      203
      -55
      53
      -585
      -146
      1,139
      305
      -1,069
      -575
      -2,171
      -634
      -1,258
      -394
      5,222
      11
      12
      -198
      -53
      290
      -415
      -661
      -182
      -1,228
      643
      -1,003
      -2,189
      123
      -335
      440
      -1,444
      -80
      -475
      1,862
      -295
       
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 35,317
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))
2010 52,916 1,248,599 0.04238
2009 50,005 1,139,766 0.043873
2008 74,127 1,326,935 0.055863
2007 75,933 1,519,494 0.049973
2006 62,817 1,455,716 0.043152
2 Total of line 1, column (d) ...................... 2 0.235241
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 0.047048
4 Enter the net value of noncharitable-use assets for 2011 from Part X, line 5..... 4 1,308,200
5 Multiply line 4 by line 3....................... 5 61,549
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 541
7 Add lines 5 and 6......................... 7 62,090
8 Enter qualifying distributions from Part XII, line 4.............. 8 68,029
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 (2011)
Form 990-PF (2011)
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 1 541
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............................ 3 541
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- ..... 5 541
6 Credits/Payments:
a 2011 estimated tax payments and 2010 overpayment credited to 2011 6a 423
b Exempt foreign organizations—tax withheld at source....... 6b
c Tax paid with application for extension of time to file (Form 8868) 6c 0
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 423
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 118
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 2012 estimated taxBullet   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$   (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)bulletMT
    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 2011 or the taxable year beginning in 2011 (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 ofbulletUS BANK Telephone no.bullet (503) 275-4327
    Located atbullet555 SW OAKPORTLANDOR ZIP+4bullet97204
    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 2011, 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 (2011)
    Form 990-PF (2011)
    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
     
    No
    .........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 2011?.............
    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 2011, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2011?...............
    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
     
    No
    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 2011 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 2011.)....................
    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 2011?
    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 (2011)
    Form 990-PF (2011)
    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
    US BANK TRUSTEE
    1
    16,786    
    PO BOX 3168
    PORTLAND,OR97208
    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 (2011)
    Form 990-PF (2011)
    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
    1,300,031
    b
    Average of monthly cash balances.......................
    1b
    28,091
    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
    1,328,122
    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
    1,328,122
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see page 25
    of the instructions) ...........................
    4
    19,922
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    1,308,200
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    65,410
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    65,410
    2a
    Tax on investment income for 2011 from Part VI, line 5......
    2a
    541
    b
    Income tax for 2011. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    541
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    64,869
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    64,869
    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
    64,869
    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
    68,029
    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
    0
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
    0
    b
    Cash distribution test (attach the required schedule) .................
    3b
    0
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    68,029
    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
    541
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    67,488
    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 (2011)
    Form 990-PF (2011)
    Page 8
    Part XIII
    Undistributed Income (see page 26 of the instructions)
    (a)
    Corpus
    (b)
    Years prior to 2010
    (c)
    2010
    (d)
    2011
    1 Distributable amount for 2011 from Part XI, line 7 64,869
    2 Undistributed income, if any, as of the end of 2011:
    a Enter amount for 2010 only....... 0
    b Total for prior years:2009, 20, 20 0
    3 Excess distributions carryover, if any, to 2011:
    a From 2006....... 0
    b From 2007....... 0
    c From 2008....... 1,531
    d From 2009....... 0
    e From 2010....... 0
    fTotal of lines 3a through e......... 1,531
    4Qualifying distributions for 2011 from Part
    XII, line 4: bullet$ 68,029
    a Applied to 2010, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election required—see page 26 of the instructions)
    0
    c Treated as distributions out of corpus (Election
    required—see page 26 of the instructions)...
    0
    d Applied to 2011 distributable amount..... 64,869
    e Remaining amount distributed out of corpus 3,160
    5 Excess distributions carryover applied to 2011. 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 4,691
    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 2010. Subtract line
    4a from line 2a. Taxable amount—see page 27
    of the instructions ...........
    0
    f Undistributed income for 2011. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2011 ..........
    0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (see page 27
    of the instructions) ...........
    0
    8Excess distributions carryover from 2006 not
    applied on line 5 or line 7 (see page 27 of the
    instructions) .............
    0
    9Excess distributions carryover to 2012.
    Subtract lines 7 and 8 from line 6a ......
    4,691
    10 Analysis of line 9:
    a Excess from 2007.... 0
    b Excess from 2008.... 1,531
    c Excess from 2009.... 0
    d Excess from 2010.... 0
    e Excess from 2011.... 3,160
    Form 990-PF (2011)
    Form 990-PF (2011)
    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 2011, 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) 2011 (b) 2010 (c) 2009 (d) 2008
             
    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:
    DEB SCHROEDEL - US BANK
    PO BOX 5000
    GREAT FALLS,MT59403
    (406) 455-1072
    bThe form in which applications should be submitted and information and materials they should include:
    CONTACT ABOVE REPRESENTATIVE
    cAny submission deadlines:
    NO SUBMISSION DEADLINES
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    CHARITABLE AND EDUCATIONAL PURPOSES WITHIN MONTANA CONCENTRATING IN THE GREAT FALLS AREA.
    Form 990-PF (2011)
    Form 990-PF (2011)
    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
    SHODAIR CHILDREN'S HOSPITAL
    PO BOX 5539
    HELENA,MT59604
    NONE PUBLIC GENERAL SUPPORT 5,000
    SPECIAL OLYMPICS MONTANA
    PO BOX 3507
    GREAT FALLS,MT59403
    NONE PUBLIC GENERAL SUPPORT 4,000
    AMERICAN DIABETES ASSOCIATION
    3203 3RD AVENUE NORTH STE 203
    BILLINGS,MT59101
    NONE PUBLIC GENERAL SUPPORT 2,500
    MONTANA COUNCIL BOY SCOUT
    OF AMERICA
    820 17TH AVE SOUTH
    GREAT FALLS,MT59405
    NONE PUBLIC GENERAL SUPPORT 4,800
    CENTER FOR MENTAL HEALTH
    PO BOX 1653
    GREAT FALLS,MT59403
    NONE PUBLIC GENERAL SUPPORT 2,500
    CHILDREN'S ONCOLOGY CAMP FOUNDATION
    PO BOX 1450
    MISSOULA,MT59806
    NONE PUBLIC GENERAL SUPPORT 4,000
    EAGLE MOUNT - GREAT FALLS
    9 3RD STREET NORTH STE 1
    GREAT FALLS,MT59401
    NONE PUBLIC GENERAL SUPPORT 2,500
    EASTER SEALSGOODWILL-NRM
    4400 CENTRAL AVE
    GREAT FALLS,MT59405
    NONE PUBLIC GENERAL SUPPORT 7,500
    GREAT FALLS AMERICAN LEGION BBALL
    PO BOX 2768
    GREAT FALLS,MT59403
    NONE PUBLIC GENERAL SUPPORT 1,500
    INTERMOUNTAIN CHILDREN'S HOME
    500 S LAMBORN ST
    HELENA,MT59601
    NONE PUBLIC GENERAL SUPPORT 4,000
    MCLAUGHLIN RESEARCH
    INSTITUTE
    1520 23RD ST SOUTH
    GREAT FALLS,MT59405
    NONE PUBLIC GENERAL SUPPORT 5,000
    MT MARROW PROGRAM
    1117 CASTLE BUTTE ROAD
    LEWISTOWN,MT59457
    NONE PUBLIC GENERAL SUPPORT 2,500
    MT SCHOOL FOR THE DEAF & BLIND FDN
    PO BOX 6576
    GREAT FALLS,MT594066576
    NONE PUBLIC GENERAL SUPPORT 4,240
    NORTHWEST BURN FOUNDATION
    1515 NW 52ND STREET STE A
    SEATTLE,WA98107
    NONE PUBLIC GENERAL SUPPORT 2,000
    OVARIAN CANCER SURVIVORS
    FOUNDATION
    416 COVENTRY COURT
    HELENA,MT59601
    NONE PUBLIC SCHOLARSHIP 2,000
    PARIS GIBSON SQUARE MUSEUM OF ART
    1400 1ST AVENUE NORTH
    GREAT FALLS,MT59401
    NONE PUBLIC GENERAL SUPPORT 2,153
    SCOTTISH RITE CHILDHOOD
    LANGUAGE CTR
    1304 13TH STREET SOUTH
    GREAT FALLS,MT59405
    NONE PUBLIC GENERAL SUPPORT 4,000
    UNIVERSITY OF GREAT FALLS
    1301 20TH ST SOUTH
    GREAT FALLS,MT59405
    NONE PUBLIC GENERAL SUPPORT 4,807
    Total .................................bullet 3a 65,000
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2011)
    Form 990-PF (2011)
    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 28,205  
    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 35,317  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory..          
    11 Other revenue: aPARTNERSHIP INCOME     14 4,688  
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e)..   68,210  
    13Total. Add line 12, columns (b), (d), and (e)..................
    1368,210
    (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.)
    11 0
    Form 990-PF (2011)
    Form 990-PF (2011)
    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 (2011)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2011 AccountingFeesSchedule
    Name:
    KINGSBURY MEMORIAL FOUNDATION 50217170
    EIN: 81-6078134
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAX PREPARATION FEE (NON-ALLOC 1,500     1,500

    TY 2011 InvestmentsCorpBondsSchedule
    Name:
    KINGSBURY MEMORIAL FOUNDATION 50217170
    EIN: 81-6078134
    Name of Bond End of Year Book Value End of Year Fair Market Value
    BANK OF NEW YORK CO 5.125    
    SUNTRUST BANK 3.000    
    METLIFE INC 6.125    
    TARGET CORP 5.875 25,118 25,210
    WAL MART STORES INC 20,456 20,226
    BARCLAYS BANK PLC 5.45 25,347 25,540
    BARCLAYS BANK PLC C D ZERO CPN    
    CISCO SYSTEMS 2.900 11/17/2014 15,254 15,869
    BARCLAYS BANK 06/10/2013 10,000 12,388
    BARCLAYS BANK 04/10/2015 10,000 10,067
    AMERICAN CENTY INTL BOND 24,180 24,500
    DREIHAUS ACTIVE INCOME FUND 26,234 24,403
    ISHARES BARCLAYS TIPS BOND 23,579 25,088
    ISHARES JPMORGAN EM BOND 12,597 12,621

    TY 2011 InvestmentsCorpStockSchedule
    Name:
    KINGSBURY MEMORIAL FOUNDATION 50217170
    EIN: 81-6078134
    Name of Stock End of Year Book Value End of Year Fair Market Value
    ABBOTT LABS 4,200 4,667
    ALLSTATE CORP    
    AMGEN INC    
    APACHE CORP 4,841 9,239
    APPLE INC 2,149 18,225
    BANK OF AMERICA CORP    
    CISCO SYS INC 2,730 2,712
    COMCAST CORP    
    CONOCOPHILLLIPS    
    ECOLAB INC 2,651 6,590
    EXELON CORPORATION 4,944 4,337
    EXXON MOBIL CORP 6,276 14,070
    GENERAL ELEC CO 16,676 9,152
    GOOGLE INC 3,227 5,813
    ILLINOIS TOOL WKS 4,035 4,484
    INTEL CORP 12,458 12,731
    J P MORGAN CHASE & CO 11,837 9,909
    JOHNSON & JOHNSON 7,582 9,115
    MCDONALDS CORP 4,677 8,127
    MEDTRONIC INC    
    MICROSOFT CORP 7,469 7,139
    ORACLE CORPORATION 7,379 10,440
    PEPSICO INC 7,195 9,554
    PFIZER INC 20,159 11,469
    PRAXAIR INC 2,718 6,949
    PROCTOR & GAMBLE CO 7,325 9,006
    QUALCOMM INC 2,697 9,846
    STATE STR CORP 5,325 6,045
    TARGET CORPORATION 3,788 6,249
    UNITED PARCEL SERVICE INC 4,076 5,416
    UNITED TECHNOLOGIES CORP 5,734 9,282
    VERIZON COMMUNICATIONS 7,752 10,271
    WAL MART STORES INC 5,518 6,872
    WELLS FARGO & CO 6,522 7,165
    3M CO 3,304 4,413
    SCHLUMBERGER LTD 5,221 8,470
    FAM MID CAPITAL INDEX    
    FAM REAL ESTATE SECURITIES    
    FAM SMALL CAP SELECT    
    ISHARES MSCI EMERGING MKTS 21,974 23,902
    LAUDUS INTL MRKTMASTERS INV 58,000 53,782
    COACH INC 4,290 4,212
    GOLDMAN SACHS GROUP INC 7,936 4,431
    MASTERCARD INC CL A 3,423 5,592
    SCHWAB CHARLES CORP    
    ISHARES S&P PREF STK INDX FD 38,943 37,009
    ABERCROMBIE & FITCH CO    
    B M C SOFTWARE INC    
    BERKSHIRE HATHAWAY INC    
    BEST BUY CO INC    
    CLIFFS NATURAL RESOURCES INC 1,226 1,060
    DISNEY WALT CO    
    E BAY INC    
    FREEPORT MCMORAN COPPER GOLD 3,677 3,679
    GENERAL MILLS INC 4,854 5,657
    STARBUCKS 5,225 8,742
    WMS INDS INC    
    IPATH DOW JONES UBS COMMODITY 47,302 39,030
    SCOUT INTERNATIONAL FUND 46,000 42,184
    HEWLETT PACKARD    
    BAXTER INTL INC 4,462 4,008
    BOEING CO 3,579 4,034
    BRISTOL MYERS SQUIBB CO 5,363 5,956
    CATERPILLAR INC 1,755 1,631
    CHEVRON CORPORATION 4,721 5,214
    DISCOVERY COMMUNICATIONS INC 4,375 4,384
    DOVER CORP 4,377 4,644
    E M C CORPORATION 3,484 2,693
    EATON CORP 4,361 4,353
    EXPRESS SCRIPTS 5,891 5,765
    FIFTH THIRD BANCORP 3,724 4,083
    GILEAD SCIENCES INC 3,612 3,643
    MACYS INC 3,611 4,055
    NATIONAL OILWELL VARCO INC 2,233 2,040
    NOBLE ENERGY INC 3,650 4,153
    OCCIDENTAL PETROLEUM CORP 3,645 4,123
    P G E CORP 3,529 3,133
    PRUDENTIAL FINANCIAL INC 8,520 7,668
    ACE LTD 1,869 1,963
    TYCO INTERNATIONAL LTD 3,589 3,737
    HIGHLAND LONG SHORT EQUITY Z 15,909 15,637
    NUVEEN MID CAP INDEX FUND 94,000 109,519
    NUVEEN REAL ESTATE SECURITY CL 31,690 38,197
    NUVEEN SMALL CAP SELECT FD 64,645 71,323
    SPDR DJ WILSHIRE INTERNATIONAL 28,282 23,554
    TFS MARKET NEITRAL FUND 9,813 9,417
    WINDSTREAM CORP 1,423 1,280
    WALLGREEN 3,515 3,438

    TY 2011 InvestmentsGovtObligationsSch
    Name:
    KINGSBURY MEMORIAL FOUNDATION 50217170
    EIN: 81-6078134
    US Government Securities - End of Year Book Value:

    171,487
    US Government Securities - End of Year Fair Market Value:

    176,633
    State & Local Government Securities - End of Year Book Value:


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


     


    TY 2011 OtherDecreasesSchedule
    Name:
    KINGSBURY MEMORIAL FOUNDATION 50217170
    EIN: 81-6078134
    Description Amount
    RECEIVED VS REPORTED SECURITIES 237


    TY 2011 OtherIncomeSchedule2
    Name:
    KINGSBURY MEMORIAL FOUNDATION 50217170
    EIN: 81-6078134
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    PARTNERSHIP INCOME 4,688 4,688  


    TY 2011 OtherIncreasesSchedule
    Name:
    KINGSBURY MEMORIAL FOUNDATION 50217170
    EIN: 81-6078134
    Description Amount
    RECEIVED VS REPORTED SECURITIES PRIOR YR 236


    TY 2011 TaxesSchedule
    Name:
    KINGSBURY MEMORIAL FOUNDATION 50217170
    EIN: 81-6078134
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FEDERAL ESTIMATES - PRINCIPAL 267 0   0
    FOREIGN TAXES ON QUALIFIED FOR 302 302   0
    FOREIGN TAXES ON NONQUALIFIED 37 37   0