-
TIN:
Form
990-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
20
11
For calendar year 2011, or tax year beginning
04-01-2011
, and ending
03-31-2012
G
Check all that apply:
Initial return
Initial return of a former public charity
Final return
Amended return
Address change
Name change
Name of foundation
TRIXIE PUFF CHARITABLE PRIVATE FDN
Number and street (or P.O. box number if mail is not delivered to street address)
PO BOX 75000
Room/suite
City or town, state, and ZIP code
DETROIT
,
MI
482753302
A Employer identification number
22-6866487
B
Telephone number (see page 10 of the instructions)
(313) 222-6297
C
If exemption application is pending, check here
D 1.
Foreign organizations, check here .
H
Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
2.
Foreign organizations meeting the 85% test,
check here and attach computation
I
Fair market value of all assets at end
of year
(from Part II, col. (c),
line 16)
$
2,462,497
J
Accounting method:
Cash
Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)
E
If private foundation status was terminated
under section 507(b)(1)(A), check here
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here
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)
1
Contributions, gifts, grants, etc., received (attach schedule)
2
Check
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
......
52,589
52,589
5a
Gross rents
..............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
24,438
b
Gross sales price for all assets on line 6a
166,077
7
Capital gain net income (from Part IV, line 2)
...
24,438
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)
.......
94
94
12
Total.
Add lines 1 through 11
........
77,121
77,121
13
Compensation of officers, directors, trustees, etc.
23,712
23,712
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)
.......
c
Other professional fees (attach schedule)
....
35,367
35,367
0
17
Interest
...............
0
18
Taxes (attach schedule) (see page 14 of the instructions)
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
..........
59,079
59,079
0
0
25
Contributions, gifts, grants paid
........
102,000
102,000
26
Total expenses and disbursements.
Add lines 24 and 25
161,079
59,079
0
102,000
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
-83,958
b
Net investment income
(if negative, enter -0-)
18,042
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
1
Cash—non-interest-bearing
...............
2
Savings and temporary cash investments
..........
4,839
2,612
2,612
3
Accounts receivable
Less: allowance for doubtful accounts
0
0
4
Pledges receivable
Less: allowance for doubtful accounts
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)
Less: allowance for doubtful accounts
0
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)
........
2,200,891
2,119,160
2,459,885
c
Investments—corporate bonds (attach schedule)
........
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
..............
13
Investments—other (attach schedule)
...........
0
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
2,205,730
2,121,772
2,462,497
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
)
23
Total liabilities
(add lines 17 through 22)
..........
0
Foundations that follow SFAS 117, check here
and complete lines 24 through 26 and lines 30 and 31.
24
Unrestricted
....................
25
Temporarily restricted
................
26
Permanently restricted
................
Foundations that do not follow SFAS 117, check here
and complete lines 27 through 31.
27
Capital stock, trust principal, or current funds
.........
2,205,730
2,121,772
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)
....................
2,205,730
2,121,772
31
Total liabilities and net assets/fund balances
(see page 17 of
the instructions)
..................
2,205,730
2,121,772
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
2,205,730
2
Enter amount from Part I, line 27a
.....................
2
-83,958
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
2,121,772
5
Decreases not included in line 2 (itemize)
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30
.
6
2,121,772
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
456.25 PACE SELECT ADVISORS TR INTL EMG MKT EQU
2009-11-17
2011-04-18
b
189.588 PACE SELECT ADVISORS TR LARGE CO GRW EQY
2009-11-17
2011-04-18
c
195.872 PACE SELECT ADVISORS TR LARGE CO VALUE E
2009-11-17
2011-04-18
d
450.725 PACE SELECT ADVISORS TR SM/MD CO GRO EQT
2009-11-17
2011-04-18
e
209.373 PACE SELECT ADVISORS TR SM/MD CO VAL EQT
2003-05-09
2011-04-18
400.318 PACE SELECT ADVISORS TR INTL EMG MKT EQU
2009-11-17
2011-04-26
265.081 PACE SELECT ADVISORS TR LARGE CO GRW EQY
2009-11-17
2011-04-26
171.923 PACE SELECT ADVISORS TR LARGE CO VALUE E
2009-11-17
2011-04-26
407.978 PACE SELECT ADVISORS TR SM/MD CO GRO EQT
2009-11-17
2011-04-26
188.085 PACE SELECT ADVISORS TR SM/MD CO VAL EQT
2003-05-09
2011-04-26
205.747 PACE SELECT ADVISORS TR INTL EMG MKT EQU
2009-11-17
2011-07-14
191.367 PACE SELECT ADVISORS TR LARGE CO GRW EQY
2009-11-17
2011-07-14
78.488 PACE SELECT ADVISORS TR LARGE CO VALUE E
2009-11-17
2011-07-14
282.642 PACE SELECT ADVISORS TR SM/MD CO GRO EQT
2009-11-17
2011-07-14
118.912 PACE SELECT ADVISORS TR SM/MD CO VAL EQT
2003-05-09
2011-07-14
53.126 PACE SELECT ADVISORS TR GOVT SECS FIXED
2011-06-22
2011-07-22
307.575 PACE SELECT ADVISORS TR GOVT SECS FIXED
2009-11-17
2011-07-22
24.776 PACE SELECT ADVISORS TR INTL EQUITY INVS
2010-12-16
2011-08-15
5.98 PACE SELECT ADVISORS TR INTL EMG MKT EQU
2010-12-16
2011-08-15
20.35 PACE SELECT ADVISORS TR LARGE CO GRW EQY
2010-12-16
2011-08-15
22.828 PACE SELECT ADVISORS TR LARGE CO VALUE E
2010-12-16
2011-08-15
15.86 PACE SELECT ADVISORS TR INTL FIXED INCOM
2009-11-17
2011-08-15
7.717 PACE SELECT ADVISORS TR SM/MD CO GRO EQT
2009-11-17
2011-08-15
4.327 PACE SELECT ADVISORS TR SM/MD CO VAL EQT
2003-05-09
2011-08-15
3.486 PACE SELECT ADVISORS TR SM/MD CO VAL EQT
2010-12-16
2011-08-15
15.593 PACE SELECT ADVISORS TR STRATEGIC FXD IN
2010-07-22
2011-08-15
17.012 PACE SELECT ADVISORS TR GOVT SECS FIXED
2009-11-17
2011-08-15
62.244 PACE SELECT ADVISORS TR INTL EQUITY INVS
2010-12-16
2011-08-17
14.961 PACE SELECT ADVISORS TR INTL EMG MKT EQU
2010-12-16
2011-08-17
19.117 PACE SELECT ADVISORS TR LARGE CO GRW EQY
2010-12-16
2011-08-17
32.726 PACE SELECT ADVISORS TR LARGE CO GRW EQY
2009-11-17
2011-08-17
57.545 PACE SELECT ADVISORS TR LARGE CO VALUE E
2010-12-16
2011-08-17
39.401 PACE SELECT ADVISORS TR INTL FIXED INCOM
2009-11-17
2011-08-17
19.881 PACE SELECT ADVISORS TR SM/MD CO GRO EQT
2009-11-17
2011-08-17
19.868 PACE SELECT ADVISORS TR SM/MD CO VAL EQT
2003-05-09
2011-08-17
38.747 PACE SELECT ADVISORS TR STRATEGIC FXD IN
2010-06-22
2011-08-17
42.498 PACE SELECT ADVISORS TR GOVT SECS FIXED
2009-11-17
2011-08-17
266.901 PACE SELECT ADVISORS TR INTL EQUITY INVS
2010-12-16
2011-09-20
18.621 PACE SELECT ADVISORS TR INTL EMG MKT EQU
2010-12-16
2011-09-20
44.66 PACE SELECT ADVISORS TR INTL EMG MKT EQU
2009-11-17
2011-09-20
203.505 PACE SELECT ADVISORS TR LARGE CO GRW EQY
2009-11-17
2011-09-20
196.733 PACE SELECT ADVISORS TR LARGE CO VALUE E
2010-12-16
2011-09-20
38.407 PACE SELECT ADVISORS TR LARGE CO VALUE E
2009-11-17
2011-09-20
80.255 PACE SELECT ADVISORS TR INTL FIXED INCOM
2011-08-23
2011-09-20
82.877 PACE SELECT ADVISORS TR INTL FIXED INCOM
2009-11-17
2011-09-20
78.483 PACE SELECT ADVISORS TR SM/MD CO GRO EQT
2009-11-17
2011-09-20
81.191 PACE SELECT ADVISORS TR SM/MD CO VAL EQT
2003-05-09
2011-09-20
154.155 PACE SELECT ADVISORS TR STRATEGIC FXD IN
2010-06-22
2011-09-20
170.497 PACE SELECT ADVISORS TR GOVT SECS FIXED
2009-11-17
2011-09-20
153.173 PACE SELECT ADVISORS TR GOVT SECS FIXED
2011-10-20
2011-10-24
335.176 PACE SELECT ADVISORS TR GOVT SECS FIXED
2009-11-17
2011-10-24
13.404 PACE SELECT ADVISORS TR INTL EQUITY INVS
2010-12-16
2011-11-16
3.195 PACE SELECT ADVISORS TR INTL EMG MKT EQU
2009-11-17
2011-11-16
10.071 PACE SELECT ADVISORS TR LARGE CO GRW EQY
2009-11-17
2011-11-16
11.342 PACE SELECT ADVISORS TR LARGE CO VALUE E
2009-11-17
2011-11-16
8.436 PACE SELECT ADVISORS TR INTL FIXED INCOM
2011-06-22
2011-11-16
3.889 PACE SELECT ADVISORS TR SM/MD CO GRO EQT
2009-11-17
2011-11-16
3.884 PACE SELECT ADVISORS TR SM/MD CO VAL EQT
2003-05-09
2011-11-16
7.852 PACE SELECT ADVISORS TR STRATEGIC FXD IN
2011-09-22
2011-11-16
8.715 PACE SELECT ADVISORS TR GOVT SECS FIXED
2009-11-17
2011-11-16
48.606 PACE SELECT ADVISORS TR INTL EMG MKT EQU
2009-11-17
2011-12-14
242.851 PACE SELECT ADVISORS TR LARGE CO GRW EQY
2009-11-17
2011-12-14
84.952 PACE SELECT ADVISORS TR LARGE CO VALUE E
2009-11-17
2011-12-14
162.965 PACE SELECT ADVISORS TR SM/MD CO GRO EQT
2009-11-17
2011-12-14
42.825 PACE SELECT ADVISORS TR STRATEGIC FXD IN
2011-09-22
2011-12-14
390.675 PACE SELECT ADVISORS TR STRATEGIC FXD IN
2003-05-09
2011-12-14
65.517 PACE SELECT ADVISORS TR INTL EQUITY INVS
2009-11-17
2012-01-24
15.41 PACE SELECT ADVISORS TR INTL EMG MKT EQU
2009-11-17
2012-01-24
47.923 PACE SELECT ADVISORS TR LARGE CO GRW EQY
2009-11-17
2012-01-24
52.539 PACE SELECT ADVISORS TR LARGE CO VALUE E
2009-11-17
2012-01-24
44.17 PACE SELECT ADVISORS TR INTL FIXED INCOM
2011-06-22
2012-01-24
17.953 PACE SELECT ADVISORS TR SM/MD CO GRO EQT
2009-11-17
2012-01-24
17.668 PACE SELECT ADVISORS TR SM/MD CO VAL EQT
2003-05-09
2012-01-24
39.683 PACE SELECT ADVISORS TR STRATEGIC FXD IN
2011-11-22
2012-01-24
43.233 PACE SELECT ADVISORS TR GOVT SECS FIXED
2011-11-22
2012-01-24
9.62 PACE SELECT ADVISORS TR GOVT SECS FIXED
2011-11-22
2012-01-24
552.112 PACE SELECT ADVISORS TR GOVT SECS FIXED
2009-11-17
2012-01-24
37.655 PACE SELECT ADVISORS TR INTL EQUITY INVS
2009-11-17
2012-02-16
8.682 PACE SELECT ADVISORS TR INTL EMG MKT EQU
2009-11-17
2012-02-16
27.177 PACE SELECT ADVISORS TR LARGE CO GRW EQY
2009-11-17
2012-02-16
30.44 PACE SELECT ADVISORS TR LARGE CO VALUE E
2009-11-17
2012-02-16
26.178 PACE SELECT ADVISORS TR INTL FIXED INCOM
2011-04-20
2012-02-16
10.141 PACE SELECT ADVISORS TR SM/MD CO GRO EQT
2009-11-17
2012-02-16
10.028 PACE SELECT ADVISORS TR SM/MD CO VAL EQT
2003-05-09
2012-02-16
23.517 PACE SELECT ADVISORS TR STRATEGIC FXD IN
2011-11-22
2012-02-16
25.785 PACE SELECT ADVISORS TR GOVT SECS FIXED
2009-11-17
2012-02-16
305.272 PACE SELECT ADVISORS TR INTL EQUITY INVS
2009-11-17
2012-03-07
70.479 PACE SELECT ADVISORS TR INTL EMG MKT EQU
2009-11-17
2012-03-07
216.976 PACE SELECT ADVISORS TR LARGE CO GRW EQY
2009-11-17
2012-03-07
247.14 PACE SELECT ADVISORS TR LARGE CO VALUE E
2009-11-17
2012-03-07
84.44 PACE SELECT ADVISORS TR INTL FIXED INCOM
2011-05-23
2012-03-07
123.621 PACE SELECT ADVISORS TR INTL FIXED INCOM
2011-11-22
2012-03-07
1.913 PACE SELECT ADVISORS TR INTL FIXED INCOM
2009-11-17
2012-03-07
83.285 PACE SELECT ADVISORS TR SM/MD CO GRO EQT
2009-11-17
2012-03-07
82.145 PACE SELECT ADVISORS TR SM/MD CO VAL EQT
2009-12-17
2012-03-07
147.486 PACE SELECT ADVISORS TR STRATEGIC FXD IN
2011-02-23
2012-03-07
40.014 PACE SELECT ADVISORS TR STRATEGIC FXD IN
2011-08-23
2012-03-07
42.698 PACE SELECT ADVISORS TR GOVT SECS FIXED
2012-02-22
2012-03-07
164.044 PACE SELECT ADVISORS TR GOVT SECS FIXED
2009-11-17
2012-03-07
(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
6,479
5,607
872
b
3,559
2,941
618
c
3,420
2,926
494
d
7,761
5,427
2,334
e
3,781
3,103
678
5,897
4,920
977
5,174
4,111
1,063
3,083
2,569
514
7,327
4,912
2,415
3,519
2,787
732
2,864
2,529
335
3,651
2,968
683
1,362
1,173
189
4,980
3,403
1,577
2,143
1,762
381
704
706
-2
4,078
4,235
-157
304
313
-9
76
83
-7
360
365
-5
360
378
-18
200
197
3
120
93
27
66
64
2
54
59
-5
230
223
7
230
234
-4
760
787
-27
190
207
-17
332
343
-11
568
508
60
900
952
-52
500
491
9
300
239
61
300
294
6
575
551
24
575
585
-10
3,040
3,376
-336
224
258
-34
536
549
-13
3,600
3,156
444
3,012
3,254
-242
588
574
14
984
1,005
-21
1,016
1,032
-16
1,200
945
255
1,200
1,203
-3
2,300
2,169
131
2,300
2,348
-48
2,036
2,054
-18
4,454
4,615
-161
154
170
-16
39
39
182
156
26
182
169
13
101
103
-2
61
47
14
61
58
3
117
118
-1
117
120
-3
555
597
-42
4,213
3,767
446
1,335
1,269
66
2,441
1,962
479
638
641
-3
5,817
5,491
326
760
849
-89
190
189
1
900
743
157
900
785
115
500
538
-38
300
216
84
300
262
38
575
589
-14
575
575
128
128
7,343
7,603
-260
456
488
-32
114
107
7
540
422
118
540
455
85
300
318
-18
180
122
58
180
149
31
345
348
-3
345
355
-10
3,648
3,956
-308
912
866
46
4,320
3,365
955
4,320
3,692
628
965
1,012
-47
1,413
1,487
-74
22
24
-2
1,440
1,003
437
1,440
1,210
230
2,171
2,073
98
589
591
-2
570
570
2,190
2,259
-69
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
872
b
618
c
494
d
2,334
e
678
977
1,063
514
2,415
732
335
683
189
1,577
381
-2
-157
-9
-7
-5
-18
3
27
2
-5
7
-4
-27
-17
-11
60
-52
9
61
6
24
-10
-336
-34
-13
444
-242
14
-21
-16
255
-3
131
-48
-18
-161
-16
26
13
-2
14
3
-1
-3
-42
446
66
479
-3
326
-89
1
157
115
-38
84
38
-14
-260
-32
7
118
85
-18
58
31
-3
-10
-308
46
955
628
-47
-74
-2
437
230
98
-2
-69
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
24,438
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
.
.
.
.
.
.
.
.
.
.
.
.
.
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?
Yes
No
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
163,146
2,328,056
0.070078
2009
234,900
1,214,397
0.193429
2008
252,818
814,833
0.31027
2007
276,618
1,275,870
0.216807
2006
243,578
1,409,808
0.172774
2
Total
of line 1, column (d)
......................
2
0.963358
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
0.192672
4
Enter the net value of noncharitable-use assets for 2011 from Part X, line 5
.....
4
2,368,503
5
Multiply line 4 by line 3
.......................
5
456,344
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
180
7
Add lines 5 and 6
.........................
7
456,524
8
Enter qualifying distributions from Part XII, line 4
..............
8
102,000
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
Exempt operating foundations described in section 4940(d)(2), check here
and enter “N/A” on line 1.
Date of ruling or determination letter:
(attach copy of letter if necessary–see instructions)
b
Domestic foundations that meet the section 4940(e) requirements in Part V, check
1
361
here
and 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
361
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
361
6
Credits/Payments:
a
2011 estimated tax payments and 2010 overpayment credited to 2011
6a
76
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
76
8
Enter any
penalty
for underpayment of estimated tax.
Check here
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
.......
9
285
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
11
Enter the amount of line 10 to be:
Credited to 2012 estimated tax
Refunded
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.
$
(2)
On foundation managers.
$
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
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)
PA
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
Yes
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 address
14
The books are in care of
COMERICA BANK
Telephone no.
(877) 405-1091
Located at
101 NORTH MAIN STREET
ANNARBOR
MI
ZIP+4
48104
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—Check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
......
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
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?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
.........................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(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)?
.................
Yes
No
(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.)
.........
Yes
No
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
Organizations relying on a current notice regarding disaster assistance check here
.........
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?
...............
Yes
No
If “Yes,” list the years
20
,
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.
20
,
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?
.....................
Yes
No
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))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
...............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(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)
...
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
........
Yes
No
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
Organizations relying on a current notice regarding disaster assistance check here
.........
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?
............
Yes
No
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?
....................
Yes
No
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?
Yes
No
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
COMERICA BANK
TRUSTEE
2
13,442
PO BOX 75000 M/C 3300
DETROIT
,
MI
482753300
PETER A SMITH
DIRECTOR
1
2,770
400 SOUTHPOINTE BLVD
CANONSBURG
,
PA
15317
LORETTA E STANA
DIRECTOR
10
7,500
678 STANA LANE
RUFFS DALE
,
PA
15679
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
...................
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
.............
0
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
..........................
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
2,397,072
b
Average of monthly cash balances
.......................
1b
7,500
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
2,404,572
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
2,404,572
4
Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see page 25
of the instructions)
...........................
4
36,069
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
2,368,503
6
Minimum investment return.
Enter 5% of line 5
..................
6
118,425
Part XI
Distributable Amount
(see page 25 of the instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here
and do not complete this part.)
1
Minimum investment return from Part X, line 6
....................
1
118,425
2a
Tax on investment income for 2011 from Part VI, line 5
......
2a
361
b
Income tax for 2011. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
361
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
118,064
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
118,064
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
118,064
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
102,000
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
102,000
5
Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
income. Enter 1% of Part I, line 27b (see page 26 of the instructions)
............
5
0
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
102,000
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
118,064
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
.......
174,732
b
From 2007
.......
215,388
c
From 2008
.......
212,240
d
From 2009
.......
174,423
e
From 2010
.......
46,817
f
Total
of lines 3a through e
.........
823,600
4
Qualifying distributions for 2011 from Part
XII, line 4:
$
102,000
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
.....
102,000
e
Remaining amount distributed out of corpus
0
5
Excess distributions carryover applied to 2011.
16,064
16,064
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
807,536
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
8
Excess distributions carryover from 2006 not
applied on line 5 or line 7 (see page 27 of the
instructions)
.............
158,668
9
Excess distributions carryover to 2012.
Subtract lines 7 and 8 from line 6a
......
648,868
10
Analysis of line 9:
a
Excess from 2007
....
215,388
b
Excess from 2008
....
212,240
c
Excess from 2009
....
174,423
d
Excess from 2010
....
46,817
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
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
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.)
1
Information Regarding Foundation Managers:
a
List 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
b
List 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.
NONE
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. (see page 28 of the instructions) to individuals or organizations
under other conditions, complete items 2a, b, c, and d.
a
The name, address, and telephone number of the person to whom applications should be addressed:
BEVERLY SUCHENEK
PO BOX 75000 M/C 3300
DETROIT
,
MI
482753300
(313) 222-6297
b
The form in which applications should be submitted and information and materials they should include:
NO SPECIFIC FORM
c
Any submission deadlines:
NO DEADLINES ACTIVITIES SHOULD BE CONCENTRATED IN THE AREAS OF PREVENTION OF
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
CRUELTY TO CHILDREN OR ANIMALS, RELIGIOUS, CHARITABLE,SCIENTIFIC, LITERARY, EDUCATION, YOUTH DEVELOPMENT, MEDICAL RESEARCH AND CUMMUNITY DEVELOPMENT
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)
a
Paid during the year
GOOD SHEPHERD SCHOOL
1024 MAPLE WAY
BRADDOCK
,
PA
15104
NONE
EXEMPT
SUPPORT
2,000
ST JOHN THE BAPTIST SCHOOL
504 BROADWAY
SCOTTDALE
,
PA
15683
NONE
EXEMPT
SUOPORT
2,000
ANIMAL FRIENDS OF CENTRAL WEST
VIRGINIA
252 BREWER ROAD
MORGANTOWN
,
WV
26508
NONE
EXEMPT
SUPPORT
1,000
GEIBEL MIDDLE SENIOR HIGH SCHOOL
611 E CRAWFORD AVENUE
CONNELLSVILLE
,
PA
15425
NONE
EXEMPT
SUPPORT
2,000
CONN AREA CATHOLIC SCHOOL
110 N PROSPECT STREET
CONNELLSVILLE
,
PA
15425
NONE
EXEMPT
SUPPORT
2,000
VERNA MONTESSORI SCHOOL
268 PRITTSTOWN ROAD
MT PLEASANT
,
PA
15666
NONE
EXEMPT
SUPPORT
2,000
CLELIAN HEIGHTS SCHOOL
235 CLELIAN HEIGHTS LANE
GREENSBURG
,
PA
15601
NONE
EXEMPT
SUPPORT
3,000
SCOTTDALE PUBLIC LIBRARY
106 SPRING STREET
SCOTTDALE
,
PA
15683
NONE
EXEMPT
SUPPORT
2,000
MT PLEASANT FREE PUBLIC LIBRARY
120 S CHURCH STREET
MT PLEASANT
,
PA
15666
NONE
EXEMPT
SUPPORT
2,000
SETON HILL UNIVERSITY
1 SETON HILL DRIVE
GREENSBURG
,
PA
15601
NONE
EXEMPT
SUPPORT
5,000
ST SEBASTIAN SCHOOL
815 BROAD AVENUE
BELLE VERNON
,
PA
15012
NONE
EXEMPT
SUPPORT
2,000
FAYETTE FRIENDS OF ANIMALS
PO BOX 1282
UNIONTOWN
,
PA
15401
NONE
EXEMPT
SUPPORT
2,000
SCOTTDALE COMMUNITY POOL
115 PIONEER WAY
SCOTTDALE
,
PA
15683
NONE
EXEMPT
SUPPORT
1,000
PET ADOPTION LEAGUE
150 SPRING STREET
YUKON
,
PA
15698
NONE
EXEMPT
SUPPORT
2,000
ST URSULA FOOD PANTRY
PO BOX 18
PURSGLOVE
,
WV
26546
NONE
EXEMPT
SUPPORT
2,000
ACTION FOR ANIMALS INC
386 STATE ROUTE 217
LATROBE
,
PA
15650
NONE
EXEMPT
SUPPORT
1,000
ACTION FOR ANIMALS HUMANE SOCIETY
PO BOX 814
LATROBE
,
PA
15650
NONE
EXEMPT
SUPPORT
1,000
BELLE VERNON VOLUNTEER FIRE
DEPARTMENT
SPEER AND ARCH STREET
BELLE VERNON
,
PA
15012
NONE
EXEMPT
SUPPORT
1,000
CATHOLIC RELIEF SERVICES
228 W LEXINGTON STREET
BALTIMORE
,
MD
21201
NONE
EXEMPT
SUPPORT
2,000
THE CHILDREN'S INSTITUTE
1405 SHADY AVENUE
PITTSBURGH
,
PA
15217
NONE
EXEMPT
SUPPORT
2,000
DUNBAR COMMUNITY LIBRARY
PO BOX 306
DUNBAR
,
PA
15431
NONE
EXEMPT
SUPPORT
3,000
EAST HUNTINGTON VOLUNTEER FIRE
COMPANY
RR3
TARRS
,
PA
15688
NONE
EXEMPT
SUPPORT
1,000
EVERSON VOLUNTEER FIRE DEPARTMENT
114 JONES STREET
EVERSON
,
PA
15631
NONE
EXEMPT
SUPPORT
1,000
FAYETTE COUNTY COMMUNITY ACTION
AGENCY
108 N BEESON AVENUE
UNIONTOWN
,
PA
15401
NONE
EXEMPT
SUPPORT
1,000
FRANCISCAN UNIVERSITY
1235 UNIVERSITY BOULEVARD
STEUBENVILLE
,
OH
43952
NONE
EXEMPT
SUPPORT
10,000
FCCAA FOOD BANK
119 N BEESON BOULEVARD
UNIONTOWN
,
PA
15401
NONE
EXEMPT
SUPPORT
2,000
GREATER PITTSBURG COMMUNITY
FOOD BANK
1 NORTH LINDEN STREET
DUQUESNE
,
PA
15110
NONE
EXEMPT
SUPPORT
2,000
MASONTOWN VOLUNTEER FIRE DEPARTMENT
221 NORTH WASHINGTON STREET
MASONTOWN
,
PA
15461
NONE
EXEMPT
SUPPORT
1,000
PET FRIENDS
P O BOX 484
IRWIN
,
PA
15642
NONE
EXEMPT
SUPPORT
1,000
PITTSBURGH COMMUNITY FOOD BANK
1 NORTH LINDEN STREET
DUQUESNE
,
PA
15110
NONE
EXEMPT
SUPPORT
2,000
TURKEYTOWN-SOUTH HUNTINGDON
TOWNSHIP VOL FIRE DEPARTMENT
90 SUPERVISORS DRIVE
WEST NEWTON
,
PA
15089
NONE
EXEMPT
SUPPORT
1,000
UNIONTOWN PUBLIC LIBRARY
24 JEFFERSON STREET
UNIONTOWN
,
PA
15401
NONE
EXEMPT
SUPPORT
2,000
UNIVERSITY OF DETROIT MERCY
200 JEFFERSON STREET SE SUITE 220
GRAND RAPIDS
,
MI
49503
NONE
EXEMPT
SUPPORT
2,000
THE WAY INCORPORATED
P O BOX 361
LATROBE
,
PA
15650
NONE
EXEMPT
SUPPORT
4,000
WESTMORELAND COMMUNITY FOOD BANK
100 DEVONSHIRE DRIVE
DELMONT
,
PA
15626
NONE
EXEMPT
SUPPORT
2,000
YUKON- SOUTH HUNTINGDON TOWNSHIP
VOLUNTEER FIRE COMPANY
124 HIGHWAY STREET
YUKON
,
PA
15698
NONE
EXEMPT
SUPPORT
1,000
ST RAPHAEL'S SCHOOL
1118 CHISLETT STREET
PITTSBURG
,
PA
15206
NONE
EXEMPT
SUPPORT
7,000
ANGELS OF MERCY
3 LAWN AVENUE
UNIONTOWN
,
PA
15401
NONE
EXEMPT
SUPPORT
2,000
CARNEGIE FREE LIBRARY OF CONNELLSVI
299 S PITTSBURG STREET
CONNELLSVILLE
,
PA
15425
NONE
EXEMPT
SUPPORT
2,000
CURA PERSONALIS
5704 ROLAND AVENUE
BALTIMORE
,
MD
21210
NONE
EXEMPT
SUPPORT
5,000
DUNBAR VOLUNTEER FIRE DEPARTMENT
1 FIREMANS LANE
DUNBAR
,
PA
15431
NONE
EXEMPT
SUPPORT
1,000
FALLEN TIMBER ANIMAL SHELTER
1680 FALLEN TIMBER ROAD
ELIZABETH
,
PA
15037
NONE
EXEMPT
SUPPORT
2,000
NHS FOUNDATION
121 ST EDWARD LANE
HERMINIE
,
PA
15637
NONE
EXEMPT
SUPPORT
3,000
RENDU SERVICES
C/O SISTERS OF CHARITY
453 PECHIN ROAD
DUNBAR
,
PA
15431
NONE
EXEMPT
SUPPORT
3,000
VISITATION CHURCH
740 WALNUT STREET
MT PLEASENT
,
PA
15666
NONE
EXEMPT
SUPPORT
2,000
Total
.................................
3a
102,000
b
Approved for future payment
Total
.................................
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.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash investments
14
4
Dividends and interest from securities
....
14
52,589
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not debt-financed property
.....
6
Net rental income or (loss) from personal property
7
Other investment income
.....
8
Gain or (loss) from sales of assets other than inventory
18
24,438
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
..
11
Other revenue:
a
OTHER REVENUE
14
94
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
77,121
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
77,121
(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.
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?
...........
Yes
No
b
If “Yes,” complete the following schedule.
(a)
Name of organization
(b)
Type of organization
(c)
Description of relationship
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.
Signature of officer or trustee
Date
Title
Preparer's Signature
Date
Check if self-
employed
PTIN
Firm's name
Firm's address
Firm's EIN
Phone no.
Form
990-PF
(2011)
Additional Data
Software ID:
Software Version:
Form 990PF - Special Condition Description:
Special Condition Description
-
TIN:
TY 2011 InvestmentsCorpStockSchedule
Name:
TRIXIE PUFF CHARITABLE PRIVATE FDN
EIN:
22-6866487
Name of Stock
End of Year Book Value
End of Year Fair Market Value
MUTUAL FUNDS
2,119,160
2,459,885