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
Chase Family Foundation
 

Number and street (or P.O. box number if mail is not delivered to street address)Foundation Source 501 Silverside Rd   Room/suite
City or town, state, and ZIP code
Wilmington, DE198091377
A Employer identification number

31-6038352
B Telephone number (see page 10 of the instructions)

(800) 839-1754
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$15,522,732J Accounting method:
 
(Part I, column (d) must be on cash basis.)
E bullet
F bullet
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see page 11 of the instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities...... 395,434 395,434  
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 Click to see attachment 63,613
b Gross sales price for all assets on line 6a 1,969,852
7 Capital gain net income (from Part IV, line 2)... 98,000
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 459,047 493,434  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc.        
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule).......        
c Other professional fees (attach schedule).... Click to see attachment 68,446 68,446    
17 Interest...............        
18 Taxes (attach schedule) (see page 14 of the instructions) Click to see attachment 9,829 336    
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 59,614     59,614
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 137,889 68,782   59,614
25 Contributions, gifts, grants paid........ 652,438 652,438
26 Total expenses and disbursements. Add lines 24 and 25 790,327 68,782   712,052
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -331,280
b Net investment income (if negative, enter -0-) 424,652
c Adjusted net income (if negative, enter -0-)...  
For Privacy Act and Paperwork Reduction Act Notice, see page 30 of the instructions.
Cat. No. 11289X Form 990-PF (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...............      
2 Savings and temporary cash investments.......... 342,819 828,035 828,035
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see page 15 of the
instructions)....................      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use...............      
9 Prepaid expenses and deferred charges...........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)........ 12,539,692 Click to see attachment11,723,196 14,694,697
c Investments—corporate bonds (attach schedule)........      
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) 12,882,511 12,551,231 15,522,732
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.........    
28 Paid-in or capital surplus, or land, bldg., and equipment fund    
29 Retained earnings, accumulated income, endowment, or other funds 12,882,511 12,551,231
30 Total net assets or fund balances (see page 17 of the
instructions).................... 12,882,511 12,551,231
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 12,882,511 12,551,231
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 12,882,511
2 Enter amount from Part I, line 27a..................... 2 -331,280
3 Other increases not included in line 2 (itemize) bullet 3  
4 Add lines 1, 2, and 3.......................... 4 12,551,231
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 12,551,231
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 Publicly-traded Securities      
b
c
d
e
(e) Gross sales price (f) Depreciation allowed
(or allowable) 		(g) Cost or other basis
plus expense of sale 		(h) Gain or (loss)
(e) plus (f) minus (g)
a 1,969,852   1,871,852 98,000
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l) Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i) F.M.V. as of 12/31/69 (j) Adjusted basis
as of 12/31/69 		(k) Excess of col. (i)
over col. (j), if any
a       98,000
b
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 98,000
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 643,461 15,105,610 000.042597
2009 896,752 13,763,336 000.065155
2008 904,335 17,070,115 000.052978
2007 739,675 18,147,940 000.040758
2006 636,672 15,125,358 000.042093
2 Total of line 1, column (d) ...................... 2 000.243581
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. . . 		3 000.048716
4 Enter the net value of noncharitable-use assets for 2011 from Part X, line 5..... 4 16,091,365
5 Multiply line 4 by line 3....................... 5 783,907
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 4,247
7 Add lines 5 and 6......................... 7 788,154
8 Enter qualifying distributions from Part XII, line 4.............. 8 712,052
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 8,493
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  
3 Add lines 1 and 2............................ 3 8,493
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-). 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 8,493
6 Credits/Payments:
a 2011 estimated tax payments and 2010 overpayment credited to 2011 6a 6,200
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.............. Tax Paid Original Return: 6200 7 6,200
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. Click to see attachment 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 2,293
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  
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)bullet
    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 ofbulletFoundation Source Telephone no.bullet (800) 839-1754
    Located atbullet501 Silverside Road Suite 123WilmingtonDE ZIP+4bullet198091377
    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
     
     
    .........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
     
     
    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
    Yes
     
    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
    Alison M Chase Vice Chair
    001.00     		0    
    Foundation Source 501 Silverside Rd
    Wilmington,DE19809
    Barbara K Chase Trustee
    001.00     		0    
    Foundation Source 501 Silverside Rd
    Wilmington,DE19809
    Dave Chase Chairman
    001.00     		0    
    Foundation Source 501 Silverside Rd
    Wilmington,DE19809
    Michael Clooney Trustee
    001.00     		0    
    Foundation Source 501 Silverside Rd
    Wilmington,DE19809
    Joseph C Hill Trustee
    001.00     		0    
    Foundation Source 501 Silverside Rd
    Wilmington,DE19809
    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
    Foundation Source Administrative Services 59,614
    55 Walls Drive Suite 302
    Fairfield,CT06824
    PNC Bank Wealth Management Investment Management Services 68,446
    201 E 5th Street
    Cincinnati,OH45202
    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 (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
    15,794,139
    b
    Average of monthly cash balances.......................
    1b
    542,272
    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
    16,336,411
    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
     
    3
    Subtract line 2 from line 1d.........................
    3
    16,336,411
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see page 25
    of the instructions) Click to see attachment...........................
    4
    245,046
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    16,091,365
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    804,568
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    804,568
    2a
    Tax on investment income for 2011 from Part VI, line 5......
    2a
    8,493
    b
    Income tax for 2011. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    8,493
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    796,075
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    796,075
    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
    796,075
    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 Click to see attachment..........
    1a
    712,052
    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
    712,052
    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
     
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    712,052
    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 7 796,075
    2 Undistributed income, if any, as of the end of 2011:
    a Enter amount for 2010 only....... 697,475
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2011:
    a From 2006.......  
    b From 2007.......  
    c From 2008.......  
    d From 2009.......  
    e From 2010.......  
    fTotal of lines 3a through e.........  
    4Qualifying distributions for 2011 from Part
    XII, line 4: bullet$ 712,052
    a Applied to 2010, but not more than line 2a 697,475
    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 2011 distributable amount..... 14,577
    e Remaining amount distributed out of corpus  
    5 Excess distributions carryover applied to 2011.    
    (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 2010. Subtract line
    4a from line 2a. Taxable amount—see page 27
    of the instructions ...........     		 
    f Undistributed income for 2011. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2011 ..........     		781,498
    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 2006 not
    applied on line 5 or line 7 (see page 27 of the
    instructions) .............     		 
    9Excess distributions carryover to 2012.
    Subtract lines 7 and 8 from line 6a ......     		 
    10 Analysis of line 9:
    a Excess from 2007....  
    b Excess from 2008....  
    c Excess from 2009....  
    d Excess from 2010....  
    e Excess from 2011....  
    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).)
    NONE
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (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
    ADVENTURE CYCLING ASSOCIATION
    PO BOX 8308
    MISSOULA,MT59807     		N/A 509(a)(1) General Unrestricted 1,000
    ADVOC SURVIVORS OF TORTURE AND TRAU
    431 E BELVEDERE AVE
    BALTIMORE,MD21212     		N/A 509(a)(1) General Unrestricted 4,000
    AMNESTY INTERNATIONAL OF THE USA IN
    5 PENN PLZ FL 16
    NEW YORK,NY10001     		N/A 509(a)(1) Prisioners of Concience Program 1,000
    ANIMAL HAVEN INC
    251 CENTRE ST
    NEW YORK,NY10013     		N/A 509(a)(1) General Unrestricted 1,000
    APPALACHIAN MOUNTAIN CLUB
    5 JOY ST
    BOSTON,MA02108     		N/A 509(a)(1) Trail/Hut Maintenance-NH White Mntns /Debt Reduction 10,000
    ARTISTS FOR HUMANITY INC
    100 W 2ND ST
    BOSTON,MA02127     		N/A 509(a)(1) General Unrestricted 500
    ATTENTION DEFICIT DISORDER ASSOCIAT
    PO BOX 7557
    WILMINGTON,DE19803     		N/A 509(a)(1) General Unrestricted 1,000
    BARD COLLEGE
    PO BOX 5000
    ANNANDALE,NY12504     		N/A 509(a)(1) Bard Prison Initiative Program 3,500
    BEST FRIENDS ANIMAL SOCIETY
    5001 ANGEL CANYON RD
    KANAB,UT84741     		N/A 509(a)(1) General Unrestricted 5,000
    BIKES NOT BOMBS INC
    284 AMORY ST
    JAMAICA PLAIN,MA02130     		N/A 509(a)(1) General Unrestricted 500
    BOSTON CAMERATA INC
    45 ASH ST
    AUBURNDALE,MA02466     		N/A 509(a)(2) General Unrestricted 1,000
    BOSTON COLLEGE ANNUAL FUND
    140 COMMONWEALTH AVENUE
    CHESTNUT HILL,MA02467     		N/A 509(a)(1) The Dr. Joseph C. Hill Research Assistantship in Support of Integrated Sciences 10,000
    BRIDGE OVER TROUBLED WATERS INC
    47 W ST
    BOSTON,MA02111     		N/A 509(a)(1) General Unrestricted 5,000
    CAMP RUNOIA ALUMNAE ORGANIZATION
    PO BOX 450
    BELGRADE LAKES,ME04918     		N/A 509(a)(1) Camper Scholarship Fund 1,000
    CHILDREN ADULTS WITH ATTENTION-DE
    8181 PROFESSIONAL PL STE 150
    LANDOVER,MD20785     		N/A 509(a)(2) General Unrestricted 1,500
    CHURCH WORLD SERVICE INC
    PO BOX 968
    ELKHART,IN46515     		N/A 509(a)(1) General Unrestricted 20,000
    CIRCLE OF LIFE ARTS FOR ALL INC
    50 CHAPMAN PL BOX 3
    EAST HARTFORD,CT06108     		N/A 509(a)(1) General Unrestricted 1,000
    CIVA CHRISTIANS IN VISUAL ARTS
    255 GRAPEVINE RD
    WENHAM,MA01984     		N/A 509(a)(2) General Unrestricted 500
    COMPASSION INTERNATIONAL INCORPORAT
    12290 VOYAGER PKWY
    COLORADO SPGS,CO80921     		N/A 509(a)(2) General Fund Leadership Training Program 20,000
    CONGREGATIONAL CHURCH OF TOPSFIELD
    9 E COMMON ST
    TOPSFIELD,MA01983     		N/A 509(a)(1) Debt Reduction General Fund 20,000
    CONTAINERS 2 CLINICS INC
    PO BOX 446
    DOVER,MA02030     		N/A 509(a)(1) General Unrestricted 1,000
    COOPERATIVE FOR ASSISTANCE AND RELI
    PO BOX 1871
    MERRIFIELD,VA22116     		N/A 509(a)(1) General Unrestricted 10,000
    COOPERATIVE FOR ASSISTANCE AND RELI
    PO BOX 1871
    MERRIFIELD,VA22116     		N/A 509(a)(1) Civics Education for Marginalized Communities in Upper Egypt 10,000
    COVENANT HOUSE
    460 W 41ST ST
    NEW YORK,NY10036     		N/A 509(a)(1) General Unrestricted 4,000
    DARTMOUTH COLLEGE
    6066 DEVELOPMENT OFC
    HANOVER,NH03755     		N/A 509(a)(1) Gino Franco Luigi Zarbin M.D. Memorial Fund 1,000
    DISABLED SPORTS USA -NEW ENGLAND DI
    PO BOX 26
    LINCOLN,NH03251     		N/A 509(a)(2) General Unrestricted 5,000
    EAST COAST GREENWAY ALLIANCE INC
    5315 HIGHGATE DR STE 105
    DURHAM,NC27713     		N/A 509(a)(1) General Unrestricted 5,000
    ENVIRONMENTAL DEFENSE FUND INCORPOR
    1875 CONNECTICUT AVE NW STE 600
    WASHINGTON,DC20009     		N/A 509(a)(1) General Unrestricted 4,000
    ESSEX COUNTY GREEN BELT ASSOCIATION
    82 EASTERN AVE
    ESSEX,MA01929     		N/A 509(a)(1) General Unrestricted 12,000
    FARMINGTON RIVER WATERSHED ASSOCIAT
    749 HOPMEADOW ST
    SIMSBURY,CT06070     		N/A 509(a)(2) General Unrestricted 4,000
    FARMINGTON VALLEY TRAILS COUNCIL
    PO BOX 576
    TARIFFVILLE,CT06081     		N/A 509(a)(1) General Unrestricted 1,000
    FOODSHARE INC
    450 WOODLAND AVE
    BLOOMFIELD,CT06002     		N/A 509(a)(1) General Unrestricted 5,000
    FRIENDS OF MAITI NEPAL A NON-PROFIT
    63 COMMERCIAL WHARF APT 6
    BOSTON,MA02110     		N/A 509(a)(2) General Unrestricted 1,000
    GRAMEEN AMERICA INC
    1440 BROADWAY FL 10
    NEW YORK,NY10018     		N/A 509(a)(1) General Unrestricted 2,000
    GRAMEEN FOUNDATION USA
    1101 15TH ST NW 3RD FL
    WASHINGTON,DC20005     		N/A 509(a)(1) General Unrestricted 1,000
    HABITAT FOR HUMANITY INTERNATIONAL
    1276 S 500 W
    SALT LAKE CTY,UT84101     		N/A 509(a)(1) General Unrestricted 3,000
    HABITAT FOR HUMANITY INTERNATIONAL
    PO BOX 1933
    HARTFORD,CT06144     		N/A 509(a)(1) Hartford CT Area 2,000
    HARTFORD CHORALE INC
    233 PEARL ST STE 17
    HARTFORD,CT06103     		N/A 509(a)(2) General Unrestricted 1,000
    HEIFER PROJECT INTERNATIONAL
    1 WORLD AVE
    LITTLE ROCK,AR72202     		N/A 509(a)(1) General Unrestricted 1,000
    HOPE FOR HAITI INC
    1021 5TH AVE N
    NAPLES,FL34102     		N/A 509(a)(1) General Unrestricted 5,000
    HOSPICE CARE CORPORATION
    PO BOX 760
    ARTHURDALE,WV26520     		N/A 509(a)(1) General Unrestricted 1,000
    INTERNATIONAL RESCUE COMMITTEE INC
    122 E 42ND ST
    NEW YORK,NY10168     		N/A 509(a)(1) General Unrestricted 10,000
    INTERVARSITY CHRISTIAN FELLOWSHIP
    6400 SCHROEDER RD
    MADISON,WI53711     		N/A 509(a)(2) General Unrestricted 2,000
    IPSWICH RIVER WATERSHED ASSOCIATION
    PO BOX 576
    IPSWICH,MA01938     		N/A 509(a)(2) General Unrestricted 4,000
    LAND TRUST ALLIANCE INCORPORATED
    1660 L ST NW STE 1100
    WASHINGTON,DC20036     		N/A 509(a)(1) General Unrestricted 1,000
    LONG ISLAND RIDING FOR THE HANDICAP
    PO BOX 352
    GLEN HEAD,NY11545     		N/A 509(a)(2) General Unrestricted 1,000
    LWALA COMMUNITY ALLIANCE INC
    PO BOX 60688
    NASHVILLE,TN37206     		N/A 509(a)(1) General Unrestricted 2,000
    MASSACHUSETTS AUDUBON SOCIETY INC
    208 S GREAT RD GORDON HALL
    LINCOLN,MA01773     		N/A 509(a)(1) Challenge Grant for Ipswich River Wildlife Sanctuary Phase II 25,000
    MEMORIAL UNITED METHODIST CHURCH
    867 W AVON RD
    AVON,CT06001     		N/A 509(a)(1) General Fund Debt Reduction 40,000
    MODEL A FORD FOUNDATION INC
    PO BOX 95151
    NONANTUM,MA02495     		N/A 509(a)(1) Museum Project 1,000
    NATIONAL PUBLIC RADIO INC
    635 MASS AVE NW
    WASHINGTON,DC20001     		N/A 509(a)(1) For WNPR Division 500
    NATIVE AMERICAN HERITAGE ASSOCIATIO
    12085 QUAAL RD
    BLACK HAWK,SD57718     		N/A 509(a)(1) General Unrestricted 4,000
    NEW ENGLAND INSTITUTE OF RELIGIOUS
    18 CROOKED LN
    LAKEVILLE,MA02347     		N/A 509(a)(1) General Unrestricted 50,000
    NEW HAMPSHIRE COMMUNITY LOAN FUND
    7 WALL ST
    CONCORD,NH03301     		N/A 509(a)(1) General Unrestricted 5,000
    NEW OPPORTUNITY SCHOOL FOR WOMEN IN
    204 CHESTNUT ST
    BEREA,KY40403     		N/A 509(a)(1) General Unrestricted 500
    NEW YORK RESTORATION PROJECT
    254 W 31ST ST FL 10
    NEW YORK,NY10001     		N/A 509(a)(1) General Unrestricted 1,000
    PINE STREET INN HOUSING II INC
    444 HARRISON AVE
    BOSTON,MA02118     		N/A 509(a)(1) General Unrestricted 500
    POLARIS PROJECT
    PO BOX 53315
    WASHINGTON,DC20009     		N/A 509(a)(1) General Unrestricted 5,738
    PRESBYTERIANS FOR RENEWAL INC
    8134 NEW LAGRANGE RD
    LOUISVILLE,KY40222     		N/A 509(a)(1) General Unrestricted 4,000
    PRISON FELLOWSHIP MINISTRIES
    44180 RIVERSIDE PKWY
    LANSDOWNE,VA20176     		N/A 509(a)(1) Angel Tree General Fund 20,000
    PUPPIES BEHIND BARS INC
    10 E 40TH ST FL 19
    NEW YORK,NY10016     		N/A 509(a)(1) General Unrestricted 1,000
    RANDOLPH COUNTY COMMUNITY ARTS COUN
    PO BOX 3111
    ELKINS,WV26241     		N/A 509(a)(1) General Unrestricted 2,000
    RAVI ZACHARIAS INTERNATIONAL MINIST
    4725 PEACHTREE CORNERS CIR STE 250
    NORCROSS,GA30092     		N/A 509(a)(1) General Unrestricted 10,000
    REVELS INC
    80 MOUNT AUBURN ST
    WATERTOWN,MA02472     		N/A 509(a)(2) General Unrestricted 600
    RIPON COLLEGE BOARD OF TRUSTEES OF
    PO BOX 248
    RIPON,WI54971     		N/A 509(a)(1) Student Scholarships, Faculty Enhancement and Building Fund 5,000
    SALT LAKE CITY BICYCLE COLLECTIVE
    2312 S W TEMPLE
    SALT LAKE CTY,UT84115     		N/A 509(a)(1) General Unrestricted 6,000
    SALVATION ARMY NATIONAL CORP
    615 SLATERS LN PO BOX 269
    ALEXANDRIA,VA22314     		N/A 509(a)(1) Greater Hartford Southern New England 20,000
    SAT-7 NORTH AMERICA
    PO BOX 2770
    EASTON,MD21601     		N/A 509(a)(1) General Unrestricted 4,000
    SAVEKITTY FOUNDATION
    PO BOX 260096
    BELLEROSE,NY11426     		N/A 509(a)(1) General Unrestricted 1,000
    SIM USA INCORPORATED
    14830 CHOATE CIR
    CHARLOTTE,NC28273     		N/A 509(a)(1) For the Work of Randy and Diana Smyth 2,000
    SIMMONS COLLEGE
    300 THE FENWAY
    BOSTON,MA02115     		N/A 509(a)(1) The Simmons Fund School of Nursing and Health Sciences 20,000
    SIMSBURY LAND TRUST INC
    PO BOX 634
    SIMSBURY,CT06070     		N/A 509(a)(1) General Unrestricted 12,000
    ST JOHN SCHOOL OF THE ARTS INC 108
    PO BOX 180
    ST JOHN,VI00831     		N/A 509(a)(1) General Unrestricted 1,000
    STUDENT CONSERVATION ASSOCIATION IN
    PO BOX 550
    CHARLESTOWN,NH03603     		N/A 509(a)(1) General Unrestricted 6,000
    THE CHILDRENS MUSEUM INC
    950 TROUT BROOK DR
    WEST HARTFORD,CT06119     		N/A 509(a)(2) Roaring Brook Nature Center 2,000
    THE FISTULA FOUNDATION
    1900 THE ALAMEDA STE 500
    SAN JOSE,CA95126     		N/A 509(a)(1) General Unrestricted 1,000
    THE GREATER BOSTON FOOD BANK INC
    70 S BAY AVE
    BOSTON,MA02118     		N/A 509(a)(1) General Unrestricted 10,000
    THE NATIONAL MILITARY FAMILY ASSOCI
    2500 N VAN DORN ST STE 102
    ALEXANDRIA,VA22302     		N/A 509(a)(1) General Unrestricted 2,000
    THE NATURE CONSERVANCY - MAINE CHAP
    FORT ANDROSS 14 MAINE ST 401
    BRUNSWICK,ME04011     		N/A 509(a)(1) Maine Chapter/ African Grasslands Program 25,000
    THE SALVATION ARMY
    1801 EDINBURGH ST
    RAWLINS,WY82301     		N/A 509(a)(1) Greater Boston Area 4,000
    THE SEVEN HILLS SCHOOLS
    5400 RED BANK RD
    CINCINNATI,OH45227     		N/A 509(a)(1) General Unrestricted 5,000
    THE TRUST FOR PUBLIC LAND
    101 WHITNEY AVE 2ND FL
    NEW HAVEN,CT06510     		N/A 509(a)(1) CT Area Androscoggin Project 50,000
    THE TRUST FOR PUBLIC LAND WASHINGT
    660 PENNSYLVANIA AVE SE
    WASHINGTON,DC20003     		N/A 509(a)(1) New Hampshire or Maine Area, Androscoggin Headwaters/Umbagog Area Project 50,000
    THEATERWORKS INC
    ONE GOLD ST
    HARTFORD,CT06103     		N/A 509(a)(2) General Unrestricted 1,000
    TILLETT FOUNDATION INC - ARTS ALIVE
    TILLETT GARDENS 4126 ANNAS RETREAT
    ST THOMAS,VI00802     		N/A 509(a)(1) General Unrestricted 500
    U S ENGLISH FOUNDATION INC
    1747 PENNSYLVANIA AVE NW
    WASHINGTON,DC20006     		N/A 509(a)(1) General Unrestricted 1,000
    UNITED STATES FUND FOR UNICEF
    125 MAIDEN LN
    NEW YORK,NY10038     		N/A 509(a)(1) Art in a Bag Project 1,000
    UNITED WAY OF MASSACHUSETTS BAY INC
    51 SLEEPER ST
    BOSTON,MA02210     		N/A 509(a)(1) General Unrestricted 4,000
    UNIVERSITY OF ROCHESTER
    910 GENESEE ST STE 200
    ROCHESTER,NY14611     		N/A 509(a)(1) Nursing School-Barbara Taylor Scholarship Fund 100
    UTAH YOUTH VILLAGE
    5790 HIGHLAND DR
    SALT LAKE CTY,UT84121     		N/A 509(a)(1) General Unrestricted 2,000
    WARM BLANKETS CHILDRENS FOUNDATION
    5105 TOLLVIEW DR STE 155
    ROLLING MDWS,IL60008     		N/A 509(a)(1) General Unrestricted 3,000
    WASATCH PUBLIC MEDIA
    PO BOX 510730
    SALT LAKE CTY,UT84151     		N/A 509(a)(1) General Unrestricted 5,000
    WORLD WILDLIFE FUND INC
    1250 24TH ST NW
    WASHINGTON,DC20037     		N/A 509(a)(1) General Unrestricted 2,000
    YORKVILLE COMMON PANTRY
    8 E 109TH ST
    NEW YORK,NY10029     		N/A 509(a)(1) General Unrestricted 2,000
    YOUTH ENRICHMENT SERVICES INC
    412 MASSACHUSETTS AVE
    BOSTON,MA02118     		N/A 509(a)(1) General Unrestricted 2,000
    ZACHARY AND ELIZABETH M FISHER CENT
    ONE INTREPID SQ 46TH ST 12TH
    NEW YORK,NY10036     		N/A 509(a)(1) General Unrestricted 1,000
    ZOOLOGICAL SOCIETY OF CINCINNATI
    3400 VINE ST
    CINCINNATI,OH45220     		N/A 509(a)(1) Signature Rhino Project 12,500
    ZOOLOGICAL SOCIETY OF CINCINNATI
    3400 VINE ST
    CINCINNATI,OH45220     		N/A 509(a)(1) Signature Rhino Project 12,000
    Total .................................bullet 3a 652,438
    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....     14 395,434  
    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 63,613  
    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)..   459,047  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13459,047
    (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 (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: 11000218
    Software Version: 2011.0.0
    Part VI Line 7 - Tax Paid Original Return: 6200


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2011 GeneralExplanationAttachment
    Name:
    Chase Family Foundation
    EIN: 31-6038352
    Software ID:11000218
    Software Version:2011.0.0
    Identifier Return Reference Explanation

    TY 2011 InvestmentsCorpStockSchedule
    Name:
    Chase Family Foundation
    EIN: 31-6038352
    Software ID:11000218
    Software Version:2011.0.0
    Name of Stock End of Year Book Value End of Year Fair Market Value
    1500 shares of 3M CO MMM 126,960 122,595
    4000 shares of ABBOTT LABS ABT 215,724 224,920
    1700 shares of APPLE INC. AAPL 217,164 688,500
    10397 shares of ARTISAN INTERNATIONAL FUND ARTIX 244,150 206,167
    5000 shares of ATT CORP COM NEW T 139,355 151,200
    10354 shares of BLACKROCK GLOBAL ALLOC I MALOX 200,000 188,858
    10000 shares of BLACKROCK INTL OPPTY PORTF INSTI CLASS BISIX 281,162 294,200
    3500 shares of CHEVRONTEXACO CORP CVX 165,563 372,400
    2800 shares of CHUBB CORP CB 142,817 193,816
    4000 shares of COCA-COLA CO KO 209,781 279,880
    800 shares of DEERE CO DE 74,506 61,880
    1000 shares of DEVON ENERGY CORPORATION DVN 70,101 62,000
    4605 shares of EAGLE SMALL CAP GROWTH I HSIIX 180,000 175,902
    3600 shares of EMERSON ELECTRIC CO. EMR 138,348 167,724
    2406 shares of EOG RESOURCES INC EOG 57,332 237,015
    5800 shares of EXXON MOBIL CORP XOM 242,279 491,608
    50310 shares of FIDELITY ADVISOR FLOATING RATE HIGH INCOME CL I FFRIX 486,300 484,485
    8000 shares of GENERAL ELECTRIC CO GE 321,666 143,280
    4000 shares of GENERAL MILLS INC GIS 98,074 161,640
    1500 shares of GOLDMAN SACHS GROUP GS 160,889 135,645
    8000 shares of HARBOR FDS INTL FD HAINX 339,370 419,600
    10094 shares of HARDING LOEVNER INTL EQU HLMIX 150,000 134,859
    6000 shares of INTEL CORP INTC 187,294 145,500
    2000 shares of INTERNATIONAL BUSINESS MACHINES IBM 215,949 367,760
    2500 shares of ISHARES BARCLAYS TIPS BOND FUND TIP 249,188 291,725
    3500 shares of ISHARES COHEN STEERS REALTY MAJORS INDEX FUND ICF 181,669 245,770
    5500 shares of ISHARES IBOXX INVESTMENT GRADE CORPORATE BOND FD LQD 546,394 625,680
    7000 shares of ISHARES MSCI EMERGING MARKETS INDEX FD EEM 207,865 265,580
    7000 shares of ISHARES MSCI PACIFIC EX-JAPAN EPP 219,626 272,510
    2400 shares of ISHARES NASDAQ BIOTECHNOLOGY IBB 161,147 250,440
    3000 shares of ISHARES TR S P MIDCAP 400 INDEX FD IJH 180,546 262,830
    5000 shares of JOHNSON JOHNSON JNJ 251,886 327,900
    3000 shares of JP MORGAN CHASE CO JPM 117,090 99,750
    2600 shares of MACYS INC M 78,805 83,668
    2650 shares of MCDONALDS CORP MCD 152,467 265,875
    3000 shares of MEDCO HEALTH SOLUTIONS INC. MHS 122,068 167,700
    2000 shares of MERCK CO INC. MRK 93,606 75,400
    3000 shares of METLIFE INC. MET 187,059 93,540
    6800 shares of MICROSOFT CORPORATION MSFT 244,498 176,528
    1000 shares of MONSANTO CO MON 82,623 70,070
    4600 shares of NEXTERA ENERGY, INC NEE 147,659 280,048
    2225 shares of NORTHROP GRUMMAN CORP NOC 76,373 130,118
    6000 shares of ORACLE CORP ORCL 91,820 153,900
    3000 shares of PEPSICO INC PEP 136,041 199,050
    5814 shares of PERKINS SMALL CAP VALUE T FUND JSCVX 132,755 118,374
    4000 shares of PFIZER INC. PFE 150,599 86,560
    52496 shares of PIMCO TOTAL RETURN FUND PTTRX 577,461 570,637
    1000 shares of PRAXAIR INC. PX 76,773 106,900
    13819 shares of PROCTER GAMBLE CO PG 369,150 921,865
    3000 shares of QUALCOMM INC QCOM 91,730 164,100
    3000 shares of SCHLUMBERGER LTD SLB 180,509 204,930
    12380 shares of T ROWE PRICE MID CAP VALUE TRMCX 281,472 264,804
    3000 shares of T. ROWE PRICE ASSOCIATES TROW 123,668 170,850
    2500 shares of TARGET CORPORATION TGT 81,666 128,050
    21708 shares of TEMPLETON GLOBAL BD TGBAX 300,000 268,524
    2568 shares of TEVA PHARMECEUTICAL SP ADR TEVA 94,390 103,644
    4200 shares of UNITED TECHNOLOGIES CORP UTX 169,457 306,978
    500 shares of VANGUARD SM-CAP ETF VB 36,410 34,835
    25228 shares of VANGUARD TOTAL BOND MARKET INDEX FUND SIGNAL SHARE VBTSX 255,206 277,510
    4000 shares of VERIZON COMMUNICATIONS VZ 114,453 160,480
    2000 shares of WAL-MART STORES INC. WMT 95,694 119,520
    4000 shares of WALGREEN CO WAG 146,998 132,240
    5500 shares of WALT DISNEY HOLDINGS CO. DIS 150,911 206,250
    3000 shares of WASTE MANAGEMENT INC. WM 100,680 98,130

    TY 2011 OtherExpensesSchedule
    Name:
    Chase Family Foundation
    EIN: 31-6038352
    Software ID:11000218
    Software Version:2011.0.0
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Administrative Fees 59,614     59,614


    TY 2011 OtherProfessionalFeesSchedule
    Name:
    Chase Family Foundation
    EIN: 31-6038352
    Software ID:11000218
    Software Version:2011.0.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Investment Management Services 68,446 68,446    


    TY 2011 TaxesSchedule
    Name:
    Chase Family Foundation
    EIN: 31-6038352
    Software ID:11000218
    Software Version:2011.0.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Estimated Tax for 2011 6,200 0 0 0
    Excise Tax for 2010 3,293 0 0 0
    Foreign Tax Paid 336 336 0 0