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
THE SAMUEL EPSTEIN FOUNDATION
 

Number and street (or P.O. box number if mail is not delivered to street address)C/O PNC BANK NA PO BOX 94651   Room/suite
City or town, state, and ZIP code
CLEVELAND, OH44101
A Employer identification number

25-6311365
B Telephone number (see page 10 of the instructions)

(800) 622-8036
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$4,376,515
J Accounting method:
 
(Part I, column (d) must be on cash basis.)
E bullet
F bullet
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see page 11 of the instructions).) (a) Revenue and
expenses per
books
(b) Net investment
income
(c) Adjusted net
income
(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities...... 109,642 109,642  
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 666,057
b Gross sales price for all assets on line 6a 4,566,796
7 Capital gain net income (from Part IV, line 2)... 666,057
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)....... 742 742  
12 Total. Add lines 1 through 11........ 776,441 776,441  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 36,489 18,244   18,244
14 Other employee salaries and wages......   0 0 0
15 Pension plans, employee benefits.......   0 0  
16a Legal fees (attach schedule)......... 3,510 0 0 3,510
b Accounting fees (attach schedule)....... 700 0 0 700
c Other professional fees (attach schedule).... 2,419 2,419   0
17 Interest...............       0
18 Taxes (attach schedule) (see page 14 of the instructions) 2,966 1,255   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)....... 17     17
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 46,101 21,918 0 22,471
25 Contributions, gifts, grants paid........ 164,200 164,200
26 Total expenses and disbursements. Add lines 24 and 25 210,301 21,918 0 186,671
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 566,140
b Net investment income (if negative, enter -0-) 754,523
c Adjusted net income (if negative, enter -0-)... 0
For Privacy Act and Paperwork Reduction Act Notice, see page 30 of the instructions.
Cat. No. 11289X Form 990-PF (2011)
Form 990-PF (2011)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing...............      
2 Savings and temporary cash investments.......... 199,293 197,289 197,289
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet     0 0
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see page 15 of the
instructions)....................      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet0      
8 Inventories for sale or use...............      
9 Prepaid expenses and deferred charges...........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)........ 2,459,745 1,493,919 1,449,747
c Investments—corporate bonds (attach schedule)........ 1,372,140 2,908,030 2,729,479
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans..............      
13 Investments—other (attach schedule)...........     0
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 4,031,178 4,599,238 4,376,515
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......... 4,031,178 4,599,238
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).................... 4,031,178 4,599,238
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 4,031,178 4,599,238
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 4,031,178
2 Enter amount from Part I, line 27a..................... 2 566,140
3 Other increases not included in line 2 (itemize) bulletClick to see attachment 3 4,456
4 Add lines 1, 2, and 3.......................... 4 4,601,774
5 Decreases not included in line 2 (itemize) bulletClick to see attachment 5 2,536
6 Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30. 6 4,599,238
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 160. AT&T INC   2008-07-25 2011-04-20
b 140. AMAZON.COM INC COM   2010-03-18 2011-04-20
c 10. AMERICAN ELEC PWR INC COM   2010-10-06 2011-04-20
d 610. AMERICAN ELEC PWR INC COM   2009-12-09 2011-04-20
e 10. AMERISOURCEBERGEN CORP COM   2010-10-06 2011-04-20
10. AMGEN INC COM   2010-10-06 2011-04-20
220. AMGEN INC COM   2008-12-05 2011-04-20
220. APACHE CORP COM   2008-08-19 2011-04-20
10. APPLE COMPUTER INC COM   2010-10-06 2011-04-20
30. BANK OF AMER CORP COM   2010-03-18 2011-04-20
20. BROADCOM CORP CL A   2010-10-06 2011-04-20
600. BROADCOM CORP CL A   2009-06-24 2011-04-20
10. CAPITAL ONE FINANCIAL CORP COM   2010-01-14 2011-04-20
10. CELANESE CORP-SERIES A   2010-10-06 2011-04-20
10. CENTURYTEL INC COM   2010-10-06 2011-04-20
10. CHEVRONTEXACO CORP COM   2010-10-06 2011-04-20
1180. CISCO SYS INC COM   2006-01-20 2011-04-20
40. CISCO SYS INC COM   2010-10-06 2011-04-20
100. CITIGROUP INC COM   2010-10-06 2011-04-20
600. COACH INC COM   2009-08-07 2011-04-20
20. COACH INC COM   2010-10-06 2011-04-20
10. CUMMINS ENGINE INC COM   2010-01-14 2011-04-20
340. DOLBY LABORATORIES INC CLASS A   2010-01-14 2011-04-20
10. DOLLAR TREE INC   2010-10-06 2011-04-20
10. DOVER CORP COM   2010-10-06 2011-04-20
20. EMC CORPORATION   2010-10-06 2011-04-20
350. EMERSON ELEC CO COM   2010-03-18 2011-04-20
10. EMERSON ELEC CO COM   2010-10-06 2011-04-20
1000. FORD MTR CO DEL COM PAR $0.01   2010-05-07 2011-04-20
1390. FORD MTR CO DEL COM PAR $0.01   2010-01-14 2011-04-20
40. GENERAL ELEC CO COM   2010-03-18 2011-04-20
30. GENERAL MILLS INC COM   2010-10-06 2011-04-20
800. GENERAL MILLS INC COM   2009-06-01 2011-04-20
10. HERSHEY FOODS CORP COM   2010-06-16 2011-04-20
10. HEWLETT PACKARD CO COM   2010-06-16 2011-04-20
20. INTEL CORP COM   2008-07-16 2011-04-20
20. J P MORGAN CHASE & CO COM   2010-10-06 2011-04-20
10. JOHNSON & JOHNSON COM   2010-10-06 2011-04-20
10. LIMITED INC COM   2010-10-06 2011-04-20
20. MATTEL INC COM   2010-10-06 2011-04-20
10. MERCK & CO INC   2010-01-14 2011-04-20
350. METLIFE INC COM   2009-09-22 2011-04-20
10. METLIFE INC COM   2010-10-06 2011-04-20
20. MICROSOFT CORP COM   2010-10-06 2011-04-20
140. NATIONAL OIL-WELL INC COM   2010-10-06 2011-04-20
20. ORACLE CORP COM   2010-10-06 2011-04-20
10. PPG INDS INC COM   2010-10-06 2011-04-20
10. PEPSICO INC COM   2010-10-06 2011-04-20
520. PEPSICO INC COM   2000-06-08 2011-04-20
40. PFIZER INC COM   2010-01-14 2011-04-20
10. PROCTER & GAMBLE CO COM   2010-02-04 2011-04-20
10. SMUCKER J M CO COM NEW   2010-01-14 2011-04-20
10. 3M COMPANY COM   2010-10-06 2011-04-20
320. 3M COMPANY COM   2009-08-07 2011-04-20
10. UNION PAC CORP COM   2010-10-06 2011-04-20
10. UNITED TECHNOLOGIES CORP COM   2010-10-06 2011-04-20
10. UNITEDHEALTH GROUP INC COM   2010-10-06 2011-04-20
10. VIACOM INC   2010-10-06 2011-04-20
10. WAL MART STORES INC COM   2010-10-06 2011-04-20
20. WELLS FARGO & CO NEW COM   2010-03-18 2011-04-20
20. WISCONSIN ENERGY CORP COM   2010-10-06 2011-04-20
10. COOPER INDUSTRIES PLC SEDOL B40K911 ISIN IE00B40K9117   2010-10-06 2011-04-20
220. CORE LABORATORIES N V COM   2010-06-16 2011-04-20
75000. FEDERAL HOME LOAN MTG CORP MULTICLASS MTG PARTN CTF GTD   2006-04-21 2011-05-13
75000. FEDERAL NATL MTG ASSN NT DTD 11-23-01 5.375% DUE 11-15-11   2006-04-21 2011-05-13
230. AT&T INC   2008-07-25 2011-05-16
19. AT&T INC   2010-10-06 2011-05-16
304. ALLERGAN INC COM   2010-03-18 2011-05-16
10. ALLERGAN INC COM   2010-10-06 2011-05-16
104. AMERICAN EXPRESS CO COM   2009-11-24 2011-05-16
820. AMERISOURCEBERGEN CORP COM   2010-02-04 2011-05-16
10. AMERISOURCEBERGEN CORP COM   2010-10-06 2011-05-16
398. AMERIPRISE FINANCIAL INC   2010-01-14 2011-05-16
10. AMERIPRISE FINANCIAL INC   2010-10-06 2011-05-16
110. AMERIPRISE FINANCIAL INC   2011-04-20 2011-05-16
188. APPLE COMPUTER INC COM   2009-06-01 2011-05-16
2715.456 ARTISAN SMALL CAP VALUE FD 963   2010-06-07 2011-05-16
11637.897 ARTISAN MID CAP VALUE FUND FD 1464   2010-06-07 2011-05-16
320. BAKER HUGHES INC COM   2011-04-20 2011-05-16
291. BANK OF AMER CORP COM   2010-03-18 2011-05-16
1982.782 BARON ASSET FD SMALL CAP FD   2010-06-07 2011-05-16
274. BORG WARNER AUTO COM   2011-04-20 2011-05-16
590. CAPITAL ONE FINANCIAL CORP COM   2010-01-14 2011-05-16
20. CAPITAL ONE FINANCIAL CORP COM   2010-10-06 2011-05-16
160. CELANESE CORP-SERIES A   2010-06-16 2011-05-16
560. CELANESE CORP-SERIES A   2009-06-01 2011-05-16
540. CENTURYTEL INC COM   2010-06-01 2011-05-16
487. CHEVRONTEXACO CORP COM   2010-10-06 2011-05-16
100. CHUBB CORP COM   2011-04-20 2011-05-16
20. CHUBB CORP COM   2010-10-06 2011-05-16
350. CHUBB CORP COM   2009-08-07 2011-05-16
10. CITIGROUP INC   2010-10-06 2011-05-16
384. CITIGROUP INC   2010-05-07 2011-05-16
90. COCA COLA CO COM   2011-04-20 2011-05-16
350. COCA COLA CO COM   2010-10-06 2011-05-16
210. CUMMINS ENGINE INC COM   2010-01-14 2011-05-16
253. DEERE & CO COM   2011-04-20 2011-05-16
275. DISNEY WALT CO COM   2011-04-20 2011-05-16
465. DOLLAR TREE INC   2010-01-14 2011-05-16
5. DOLLAR TREE INC   2010-10-06 2011-05-16
510. DOVER CORP COM   2010-10-06 2011-05-16
273. DU PONT E I DE NEMOURS & CO COM   2010-10-06 2011-05-16
120. DU PONT E I DE NEMOURS & CO COM   2011-04-20 2011-05-16
20. EMC CORPORATION   2010-10-06 2011-05-16
979. EMC CORPORATION   2009-12-09 2011-05-16
530. EATON CORP COM   2011-04-20 2011-05-16
660. EBAY INC COM   2011-04-20 2011-05-16
370. EQUITY RESIDENTIAL PPTYS TR SBI   2010-06-01 2011-05-16
479. EXXON MOBIL CORP COM   2009-06-24 2011-05-16
150. EXXON MOBIL CORP COM   2011-04-20 2011-05-16
19700.638 FIDELITY ADVISOR FLOATING HIGH INCOME FUND I   2010-06-07 2011-05-16
5224.663 FIDELITY ADVISOR FLOATING HIGH INCOME FUND I   2010-03-18 2011-05-16
1068. GENERAL ELEC CO COM   2010-03-18 2011-05-16
50. GOOGLE INC CL A   2008-02-08 2011-05-16
2696.659 HARBOR FD INTL FD   2010-06-07 2011-05-16
1882.438 HARDING LOEVNER EMERGING MARKETS PORTOFLIO FUND   2008-03-27 2011-05-16
630. HERSHEY FOODS CORP COM   2010-06-01 2011-05-16
46. HESS CORPORATION   2011-04-20 2011-05-16
450. HEWLETT PACKARD CO COM   2010-06-16 2011-05-16
747. INTEL CORP COM   2008-07-16 2011-05-16
82. INTERNATIONAL BUSINESS MACHS CORP COM   2009-06-01 2011-05-16
415. J P MORGAN CHASE & CO COM   2009-06-01 2011-05-16
20. J P MORGAN CHASE & CO COM   2010-10-06 2011-05-16
249. LAUDER ESTEE COS INC CL A   2011-04-20 2011-05-16
930. LIMITED INC COM   2010-06-01 2011-05-16
1080. MATTEL INC COM   2010-06-01 2011-05-16
234. MERCK & CO INC   2010-01-14 2011-05-16
20. MICROSOFT CORP COM   2010-10-06 2011-05-16
1440. MICROSOFT CORP COM   1996-06-17 2011-05-16
670. NATIONAL OIL-WELL INC COM   2010-10-06 2011-05-16
580. NORTHEAST UTILS COM   2011-04-20 2011-05-16
300. ORACLE CORP COM   2005-01-05 2011-05-16
20. ORACLE CORP COM   2010-10-06 2011-05-16
150. PPG INDS INC COM   2010-03-18 2011-05-16
360. PFIZER INC COM   2010-01-14 2011-05-16
430. PFIZER INC COM   2010-10-06 2011-05-16
20. PRICE T ROWE GROUP INC COM   2010-10-06 2011-05-16
350. PRICE T ROWE GROUP INC COM   2009-08-07 2011-05-16
90. PRICE T ROWE GROUP INC COM   2011-04-20 2011-05-16
20. PROCTER & GAMBLE CO COM   2010-10-06 2011-05-16
620. PROCTER & GAMBLE CO COM   2009-09-22 2011-05-16
19315.613 PRUDENTIAL JENNISON 20/20 FOCUS FUND 451   2010-06-07 2011-05-16
390. QUALCOMM INC COM   2011-04-20 2011-05-16
6015.623 RS EMERGING MARKETS FUND CLASS A FUND 126   2010-06-07 2011-05-16
201. SHIRE PHARMACEUTICAL GROUP SPONSORED ADR   2010-03-18 2011-05-16
10. SHIRE PHARMACEUTICAL GROUP SPONSORED ADR   2010-10-06 2011-05-16
80. SHIRE PHARMACEUTICAL GROUP SPONSORED ADR   2011-04-20 2011-05-16
10. SMUCKER J M CO COM NEW   2010-10-06 2011-05-16
370. SMUCKER J M CO COM NEW   2010-01-14 2011-05-16
190. STARBUCKS CORP COM   2011-04-20 2011-05-16
540. STARBUCKS CORP COM   2010-06-01 2011-05-16
610. TEXAS INSTRS INC COM   2011-04-20 2011-05-16
430. TIFFANY & CO NEW COM   2011-04-20 2011-05-16
183. UNION PAC CORP COM   2010-05-07 2011-05-16
10. UNITED TECHNOLOGIES CORP COM   2010-10-06 2011-05-16
71. UNITED TECHNOLOGIES CORP COM   2009-06-01 2011-05-16
578. UNITEDHEALTH GROUP INC COM   2010-03-18 2011-05-16
20. UNITEDHEALTH GROUP INC COM   2010-10-06 2011-05-16
500. VANGUARD TOTAL BOND MARKET ETF   2009-03-26 2011-05-16
1792. VANGUARD TOTAL BOND MARKET ETF   2010-06-07 2011-05-16
546. VIACOM INC   2009-06-29 2011-05-16
10. VIACOM INC   2010-10-06 2011-05-16
10. WAL MART STORES INC COM   2010-10-06 2011-05-16
370. WAL MART STORES INC COM   2007-12-27 2011-05-16
570. WALGREEN CO COM   2011-04-20 2011-05-16
715. WELLS FARGO & CO NEW COM   2009-08-07 2011-05-16
20. WISCONSIN ENERGY CORP COM   2010-10-06 2011-05-16
1020. WISCONSIN ENERGY CORP COM   2009-06-24 2011-05-16
430. COOPER INDUSTRIES PLC SEDOL B40K911 ISIN IE00B40K9117   2010-01-14 2011-05-16
160. COOPER INDUSTRIES PLC SEDOL B40K911 ISIN IE00B40K9117   2010-10-06 2011-05-16
130. COVIDIEN PLC ISIN IE00B68SQD29 SEDOL B68SQD2   2011-04-20 2011-05-16
444. COVIDIEN PLC ISIN IE00B68SQD29 SEDOL B68SQD2   2010-01-14 2011-05-16
22375.215 VANGUARD FIXED INCOME SECS FD INC INTER TERM US TREAS PORTFO   2010-07-15 2011-05-17
2069.536 VANGUARD INFLATION-PROTECTED SECURITIES FD #119   2009-08-07 2011-05-17
92. AON CORP COM   2011-05-16 2011-05-19
24. BROADCOM CORP CL A   2011-05-16 2011-05-19
5. QUALCOMM INC COM   2011-04-20 2011-05-19
49. UNITED PARCEL SERVICE INC CL B   2011-05-16 2011-05-19
12. SCHLUMBERGER LTD COM   2011-05-16 2011-05-25
11. SCHLUMBERGER LTD COM   2011-05-16 2011-05-25
61. QUALCOMM INC COM   2011-04-20 2011-05-26
85. ST JUDE MEDICAL INC COM   2011-05-16 2011-06-01
76. CHARLES SCHWAB CORP NEW   2011-05-16 2011-06-07
128. BANK NEW YORK MELLON CORP COM   2011-05-16 2011-06-08
46. HESS CORPORATION   2011-04-20 2011-06-08
16. ALTERA CORP COM   2011-05-16 2011-06-09
14. ALTERA CORP COM   2011-05-16 2011-06-10
1. INTERNATIONAL BUSINESS MACHS CORP COM   2009-06-01 2011-06-13
5. INTERNATIONAL BUSINESS MACHS CORP COM   2011-05-19 2011-06-13
42. CHARLES SCHWAB CORP NEW   2011-05-16 2011-06-13
7. INTERNATIONAL BUSINESS MACHS CORP COM   2009-06-01 2011-06-14
23. EXPEDITORS INTL WASH INC COM   2011-05-16 2011-06-15
36. HESS CORPORATION   2011-04-20 2011-06-15
21. BED BATH & BEYOND INC COM   2011-05-16 2011-06-16
17. BED BATH & BEYOND INC COM   2011-05-16 2011-06-17
24. EXPEDITORS INTL WASH INC COM   2011-05-16 2011-06-17
103. ABBOTT LABS COM   2011-05-16 2011-06-20
34. AIR PRODS & CHEM INC COM   2011-05-16 2011-06-20
12. AVALONBAY CMNTYS INC COM   2011-05-16 2011-06-20
7. EXXON MOBIL CORP COM   2011-05-19 2011-06-20
10. EXXON MOBIL CORP COM   2009-06-24 2011-06-20
22. GENERAL DYNAMICS CORP COM   2011-05-16 2011-06-20
219. KEYCORP NEW COM   2011-05-16 2011-06-20
36. MERCK & CO INC   2010-01-14 2011-06-20
18. NESTLE S A SPONSORED ADR REPSTG REG SH   2011-05-16 2011-06-20
19. WAL MART STORES INC COM   2007-12-27 2011-06-20
7. WAL MART STORES INC COM   2011-05-19 2011-06-20
75. WASTE MANAGEMENT INC NEW COM   2011-05-16 2011-06-20
24. GREEN DOT CORP CLASS A   2011-05-16 2011-06-22
28. GREEN DOT CORP CLASS A   2011-05-16 2011-06-22
34. THE TRAVELERS COS INC   2011-05-16 2011-06-22
17. INGERSOLL-RAND PLC SEDOL: B633030   2011-05-16 2011-06-27
14. INGERSOLL-RAND PLC SEDOL: B633030   2011-05-16 2011-06-29
27. INGERSOLL-RAND PLC SEDOL: B633030   2011-05-16 2011-06-30
8176.043 DODGE & COX INCOME FD COM   2011-05-16 2011-07-05
10292.144 PIMCO FDS PAC INVT MGMT SER TOTAL RETURN FD INSTL CL   2010-06-07 2011-07-05
41. PFIZER INC COM   2011-05-19 2011-07-06
14. PFIZER INC COM   2010-10-06 2011-07-06
43. ACCENTURE PLC CLASS A ISIN IE00B4BNMY34 SEDOL B4BNMY3   2011-05-16 2011-07-06
90. PFIZER INC COM   2010-10-06 2011-07-08
20. ALTERA CORP COM   2011-05-16 2011-07-13
47. DISNEY WALT CO COM   2011-04-20 2011-07-14
37. ACCENTURE PLC CLASS A ISIN IE00B4BNMY34 SEDOL B4BNMY3   2011-05-16 2011-07-14
123. PFIZER INC COM   2010-10-06 2011-07-15
25. INGERSOLL-RAND PLC SEDOL: B633030   2011-05-16 2011-07-21
26. DISNEY WALT CO COM   2011-04-20 2011-07-26
118. DISNEY WALT CO COM   2011-04-20 2011-07-27
51. OCCIDENTAL PETE CORP COM   2011-06-08 2011-07-27
18. BURBERRY GROUP PLC SPONSORED ADR   2011-05-16 2011-07-29
1. CHIPOTLE MEXICAN GRIL CL A   2011-05-16 2011-07-29
58. EMC CORPORATION   2011-05-19 2011-07-29
49. JUNIPER NETWORKS INC COM   2011-05-16 2011-07-29
30. MARRIOTT INTL INC NEW CL A   2011-05-16 2011-07-29
30. MARRIOTT INTL INC NEW CL A   2011-05-16 2011-07-29
9. POLO RALPH LAUREN CORP CL A   2011-05-16 2011-07-29
29. INGERSOLL-RAND PLC SEDOL: B633030   2011-05-16 2011-07-29
32. INGERSOLL-RAND PLC SEDOL: B633030   2011-05-16 2011-07-29
23. OCCIDENTAL PETE CORP COM   2011-05-16 2011-08-02
66. REYNOLDS AMERICAN INC   2011-05-16 2011-08-03
38. SUCCESSFACTORS INC   2011-05-16 2011-08-03
35. MARRIOTT INTL INC NEW CL A   2011-05-16 2011-08-04
39. MARRIOTT INTL INC NEW CL A   2011-05-16 2011-08-04
12. OCCIDENTAL PETE CORP COM   2011-05-16 2011-08-04
12. OCCIDENTAL PETE CORP COM   2011-05-16 2011-08-04
18. VALEANT PHARMACEUTICALS INTE ISIN CA91911K1021 SEDOL B41NYV4   2011-07-29 2011-08-05
70. ALPHA NATURAL RESOURCES INC   2011-05-16 2011-08-09
243. CITIGROUP INC   2010-05-07 2011-08-09
10. CITIGROUP INC   2011-05-19 2011-08-09
9. INTERNATIONAL BUSINESS MACHS CORP COM   2011-06-20 2011-08-09
12. MCDONALDS CORP COM   2011-07-25 2011-08-09
42. WAL MART STORES INC COM   2007-12-27 2011-08-09
30. ACCENTURE PLC CLASS A ISIN IE00B4BNMY34 SEDOL B4BNMY3   2011-05-16 2011-08-09
7. BURBERRY GROUP PLC SPONSORED ADR   2011-05-16 2011-08-10
25. DISNEY WALT CO COM   2011-04-20 2011-08-10
10. INTERNATIONAL BUSINESS MACHS CORP COM   2011-08-10 2011-08-10
22. PHILIP MORRIS INTERNAT-W/I   2011-05-16 2011-08-10
54. QUEST DIAGNOSTICS INC COM   2011-05-16 2011-08-10
124. ATMEL CORP COM   2011-05-16 2011-08-11
20. MCDONALDS CORP COM   2011-07-18 2011-08-11
12. COACH INC COM   2011-05-16 2011-08-12
155. CHARLES SCHWAB CORP NEW   2011-05-16 2011-08-12
62. BURBERRY GROUP PLC SPONSORED ADR   2011-05-16 2011-08-17
49. QUEST DIAGNOSTICS INC COM   2011-05-16 2011-08-17
23. MCDONALDS CORP COM   2011-07-18 2011-08-24
10. APACHE CORP COM   2008-09-30 2011-08-31
15. APACHE CORP COM   2011-05-16 2011-08-31
20. GOLDMAN SACHS GROUP INC COM   2011-05-16 2011-08-31
107. URBAN OUTFITTERS INC   2011-05-16 2011-09-07
47. AT&T INC   2011-05-19 2011-09-08
6. INTEL CORP COM   2011-05-19 2011-09-08
39. INTEL CORP COM   2008-07-16 2011-09-08
12. VMWARE INC CLASS A   2011-05-16 2011-09-09
54. B A S F A G SPONSORED ADR   2011-05-16 2011-09-12
94. HSBC HLDGS PLC SPONS ADR NEW   2011-05-16 2011-09-12
194. LINCOLN NATIONAL CORP IND COM   2011-05-16 2011-09-12
13. INTERNATIONAL BUSINESS MACHS CORP COM   2011-06-20 2011-09-14
22. MCDONALDS CORP COM   2011-06-28 2011-09-14
3. MASTERCARD INC CL A   2011-07-07 2011-09-20
22. SCHLUMBERGER LTD COM   2011-05-16 2011-09-20
18. RED HAT INC COM   2011-05-16 2011-09-22
9. SCHLUMBERGER LTD COM   2011-05-16 2011-09-22
13. BORG WARNER AUTO COM   2011-04-20 2011-09-23
12. DEERE & CO COM   2011-04-20 2011-09-23
5. DU PONT E I DE NEMOURS & CO COM   2011-05-19 2011-09-23
17. DU PONT E I DE NEMOURS & CO COM   2010-10-06 2011-09-23
9. DEERE & CO COM   2011-04-20 2011-09-26
23. DU PONT E I DE NEMOURS & CO COM   2010-10-06 2011-09-26
24. MCDONALDS CORP COM   2011-05-16 2011-09-28
55. PG&E CORP COM   2011-05-16 2011-09-28
3. GOOGLE INC CL A   2008-02-08 2011-10-03
21. SCHLUMBERGER LTD COM   2011-05-16 2011-10-03
23. RED HAT INC COM   2011-05-16 2011-10-04
10. SCHLUMBERGER LTD COM   2011-05-16 2011-10-04
5. MASTERCARD INC CL A   2011-07-07 2011-10-12
25. MCDONALDS CORP COM   2011-05-16 2011-10-12
5. AMAZON.COM INC COM   2011-05-19 2011-10-19
3. CHIPOTLE MEXICAN GRIL CL A   2011-05-16 2011-10-20
26. GREEN MTN COFFEE ROASTERS INC   2011-07-21 2011-10-20
32. GREEN MTN COFFEE ROASTERS INC   2011-06-20 2011-10-20
44. JUNIPER NETWORKS INC COM   2011-05-16 2011-10-21
33. JUNIPER NETWORKS INC COM   2011-05-16 2011-10-21
37. AMERIPRISE FINANCIAL INC   2011-08-09 2011-10-24
52. AMERIPRISE FINANCIAL INC   2010-01-14 2011-10-24
556. BANK OF AMER CORP COM   2010-03-18 2011-10-24
116. ILLINOIS TOOL WORKS INC COM   2011-05-16 2011-10-24
47. NORTHROP GRUMMAN CORP COM   2011-05-16 2011-10-24
137. SUNTRUST BANKS INC COM   2011-05-16 2011-10-24
47. APACHE CORP COM   2008-09-30 2011-10-25
103. COMCAST CORP NEW CL A   2011-05-16 2011-10-25
33. CONOCOPHILLIPS   2011-05-16 2011-10-25
56. HESS CORPORATION   2011-04-20 2011-10-25
37. MCDONALDS CORP COM   2011-05-16 2011-10-25
17. OCCIDENTAL PETE CORP COM   2011-05-16 2011-10-25
33. PEABODY ENERGY CORP COM   2011-05-16 2011-10-25
22. PEPSICO INC COM   2011-05-16 2011-10-25
21. TARGET CORP   2011-05-16 2011-10-25
203. US BANCORP DEL COM NEW   2011-05-16 2011-10-25
10. MASTERCARD INC CL A   2011-05-16 2011-11-02
14. DEERE & CO COM   2011-04-20 2011-11-07
12. DEERE & CO COM   2011-04-20 2011-11-08
13. DEERE & CO COM   2011-04-20 2011-11-08
5. DEERE & CO COM   2011-05-19 2011-11-09
7. DEERE & CO COM   2011-04-20 2011-11-09
10. AMERICAN EXPRESS CO COM   2011-05-19 2011-11-16
6. INTERNATIONAL BUSINESS MACHS CORP COM   2011-08-10 2011-11-16
1. INTERNATIONAL BUSINESS MACHS CORP COM   2009-06-01 2011-11-16
50. PG&E CORP COM   2011-05-16 2011-11-16
6. PRUDENTIAL FINANCIAL INC COM   2011-05-19 2011-11-16
35. PRUDENTIAL FINANCIAL INC COM   2011-05-16 2011-11-16
34. STANLEY BLACK & DECKER INC   2011-05-16 2011-11-16
11. AMERICAN EXPRESS CO COM   2011-10-24 2011-11-17
11. EXPRESS SCRIPTS INC   2011-05-16 2011-11-17
5. EXPRESS SCRIPTS INC   2011-05-19 2011-11-17
7. INTERNATIONAL BUSINESS MACHS CORP COM   2009-06-01 2011-11-18
39. EMC CORPORATION   2011-06-14 2011-11-22
31. EXPRESS SCRIPTS INC   2011-05-16 2011-11-22
21. EXPRESS SCRIPTS INC   2011-05-16 2011-11-23
16. AMERICAN TOWER SYS CORP CL A   2011-10-03 2011-11-28
4. AMERICAN TOWER SYS CORP CL A   2011-05-16 2011-12-05
10. AMERICAN TOWER SYS CORP CL A   2011-10-03 2011-12-05
45. DISNEY WALT CO COM   2011-04-20 2011-12-05
7. INTERNATIONAL BUSINESS MACHS CORP COM   2009-06-01 2011-12-05
9. JOHNSON & JOHNSON COM   2011-06-20 2011-12-05
12. MCDONALDS CORP COM   2011-05-16 2011-12-05
48. ORACLE CORP COM   2011-05-19 2011-12-05
13. ORACLE CORP COM   2011-05-19 2011-12-06
22. ORACLE CORP COM   2011-06-29 2011-12-06
28. ORACLE CORP COM   2011-06-29 2011-12-07
14. DU PONT E I DE NEMOURS & CO COM   2010-10-06 2011-12-13
16. JOHNSON & JOHNSON COM   2011-06-20 2011-12-13
11. UNITED TECHNOLOGIES CORP COM   2011-05-19 2011-12-13
19. APACHE CORP COM   2008-09-30 2011-12-14
4. CHIPOTLE MEXICAN GRIL CL A   2011-05-16 2011-12-14
26. CONOCOPHILLIPS   2011-05-16 2011-12-14
10. DU PONT E I DE NEMOURS & CO COM   2010-10-06 2011-12-14
145. FIFTH THIRD BANCORP COM   2011-05-16 2011-12-14
30. GOLDMAN SACHS GROUP INC COM   2011-05-16 2011-12-14
46. MCDONALDS CORP COM   2011-05-16 2011-12-14
23. NESTLE S A SPONSORED ADR REPSTG REG SH   2011-05-16 2011-12-14
5. PPG INDS INC COM   2011-05-19 2011-12-14
22. PPG INDS INC COM   2011-08-09 2011-12-14
21. PEPSICO INC COM   2011-05-16 2011-12-14
39. PRUDENTIAL FINANCIAL INC COM   2011-05-16 2011-12-14
34. TARGET CORP   2011-11-02 2011-12-14
52. WAL MART STORES INC COM   2007-12-27 2011-12-14
9. ACE LIMITED ISIN CH0044328745 SEDOL B3BQMF6   2011-05-19 2011-12-14
63. TYCO INTERNATIONAL LTD SEDOL: B64GC98   2011-11-16 2011-12-14
20. AMERICAN TOWER SYS CORP CL A   2011-05-16 2011-12-16
21. COGNIZANT TECHNOLOGY SOLUTION CL A   2011-05-16 2011-12-16
10. INTERNATIONAL BUSINESS MACHS CORP COM   2009-06-01 2011-12-16
6. COSTCO WHSL CORP NEW COM   2011-09-16 2011-12-19
26. DISNEY WALT CO COM   2011-04-20 2011-12-19
33. DU PONT E I DE NEMOURS & CO COM   2010-10-06 2011-12-19
38. ARCOS DORADOS HOLDINGS INC A ISIN VGG0457F1071 SEDOL B529PQ0   2011-10-21 2011-12-19
16. RALPH LAUREN CORP   2011-05-16 2011-12-20
66. ARCOS DORADOS HOLDINGS INC A ISIN VGG0457F1071 SEDOL B529PQ0   2011-10-21 2011-12-20
58. AVAGO TECHNOLOGIES LTD SEDOL B3WS2X9   2011-05-16 2011-12-20
10. INTERNATIONAL BUSINESS MACHS CORP COM   2009-06-01 2011-12-21
16. PHILIP MORRIS INTERNAT-W/I   2011-05-16 2011-12-21
13. LAUDER ESTEE COS INC CL A   2011-04-20 2011-12-22
4. MASTERCARD INC CL A   2011-05-16 2011-12-22
23. WHOLE FOOD MT INC COM   2011-05-16 2011-12-23
CAPITAL GAIN DIVIDENDS P    
(e) Gross sales price (f) Depreciation allowed
(or allowable)
(g) Cost or other basis
plus expense of sale
(h) Gain or (loss)
(e) plus (f) minus (g)
a 4,829   5,074 -245
b 25,764   18,580 7,184
c 355   362 -7
d 21,643   21,100 543
e 405   313 92
556   555 1
12,236   12,338 -102
27,297   23,446 3,851
3,447   2,889 558
366   514 -148
786   700 86
23,568   14,572 8,996
505   418 87
476   334 142
396   403 -7
1,077   840 237
19,954   22,281 -2,327
676   896 -220
451   418 33
34,156   18,233 15,923
1,139   862 277
1,079   531 548
16,238   17,364 -1,126
572   491 81
668   541 127
557   402 155
20,307   17,160 3,147
580   538 42
15,020   13,361 1,659
20,878   16,207 4,671
814   730 84
1,139   1,111 28
30,367   21,895 8,472
566   493 73
411   473 -62
422   422  
879   800 79
644   626 18
392   277 115
535   475 60
340   398 -58
15,417   13,793 1,624
440   394 46
515   487 28
10,930   6,500 4,430
679   556 123
936   747 189
673   678 -5
34,985   23,517 11,468
817   775 42
637   620 17
741   622 119
937   897 40
29,987   23,468 6,519
953   830 123
859   729 130
443   343 100
476   364 112
537   544 -7
571   606 -35
598   581 17
665   496 169
21,293   16,510 4,783
79,193   74,355 4,838
76,946   75,305 1,641
7,160   7,294 -134
591   547 44
24,894   19,360 5,534
819   667 152
5,230   4,320 910
34,678   22,765 11,913
423   313 110
24,723   16,698 8,025
621   500 121
6,833   6,800 33
62,813   26,280 36,533
49,041   37,772 11,269
261,853   201,452 60,401
22,012   23,648 -1,636
3,472   4,985 -1,513
51,433   37,772 13,661
20,133   20,457 -324
31,642   24,610 7,032
1,073   809 264
8,027   4,591 3,436
28,095   12,289 15,806
22,896   18,746 4,150
49,631   40,908 8,723
6,496   6,130 366
1,299   1,122 177
22,737   16,867 5,870
413   418 -5
15,863   15,504 359
6,108   6,121 -13
23,754   20,839 2,915
23,245   11,156 12,089
22,337   23,724 -1,387
11,283   11,564 -281
28,123   15,304 12,819
302   245 57
32,543   27,611 4,932
14,521   12,531 1,990
6,383   6,639 -256
547   402 145
26,795   16,535 10,260
27,422   28,318 -896
21,450   20,869 581
22,011   16,596 5,415
38,573   33,314 5,259
12,079   12,825 -746
194,642   185,186 9,456
51,620   50,000 1,620
21,167   19,480 1,687
26,012   25,771 241
171,669   125,907 45,762
94,273   74,882 19,391
35,966   30,240 5,726
3,451   3,705 -254
17,941   21,221 -3,280
17,666   15,778 1,888
13,840   8,894 4,946
17,865   15,224 2,641
861   800 61
24,997   23,565 1,432
38,669   23,441 15,228
28,574   23,478 5,096
8,751   9,309 -558
493   487 6
35,481   11,220 24,261
45,063   31,105 13,958
20,804   19,825 979
10,236   3,972 6,264
682   556 126
13,332   9,730 3,602
7,546   6,977 569
9,013   7,473 1,540
1,240   1,033 207
21,700   16,944 4,756
5,580   5,994 -414
1,343   1,220 123
41,620   35,868 5,752
333,194   259,795 73,399
22,156   21,385 771
152,616   125,907 26,709
18,872   13,457 5,415
939   680 259
7,511   7,379 132
753   616 137
27,854   22,899 4,955
6,701   7,020 -319
19,046   13,920 5,126
21,313   21,412 -99
29,601   28,125 1,476
18,508   13,004 5,504
890   729 161
6,316   3,917 2,399
29,050   19,409 9,641
1,005   686 319
40,668   38,373 2,295
145,755   144,113 1,642
27,010   12,696 14,314
495   364 131
560   544 16
20,705   17,823 2,882
25,661   24,212 1,449
20,013   21,064 -1,051
631   581 50
32,192   20,590 11,602
26,824   18,578 8,246
9,981   7,930 2,051
7,259   6,980 279
24,793   21,858 2,935
257,539   260,000 -2,461
27,856   25,000 2,856
4,833   4,901 -68
810   802 8
287   274 13
3,636   3,627 9
1,010   999 11
930   905 25
3,483   3,345 138
4,227   4,404 -177
1,224   1,334 -110
3,355   3,635 -280
3,385   3,705 -320
709   759 -50
612   663 -51
163   108 55
814   853 -39
671   737 -66
1,149   759 390
1,078   1,211 -133
2,588   2,900 -312
1,106   1,151 -45
898   931 -33
1,146   1,264 -118
5,354   5,573 -219
3,098   3,109 -11
1,582   1,528 54
558   575 -17
797   695 102
1,601   1,639 -38
1,791   1,864 -73
1,286   1,432 -146
1,122   1,117 5
1,007   915 92
371   389 -18
2,793   2,912 -119
795   931 -136
923   1,086 -163
1,979   2,143 -164
740   850 -110
616   699 -83
1,228   1,348 -120
109,559   110,476 -917
113,317   114,757 -1,440
853   863 -10
291   243 48
2,663   2,425 238
1,809   1,564 245
879   947 -68
1,860   1,976 -116
2,256   2,085 171
2,417   2,138 279
1,025   1,248 -223
1,053   1,093 -40
4,704   4,962 -258
5,145   5,261 -116
872   807 65
326   274 52
1,517   1,614 -97
1,150   1,929 -779
951   1,087 -136
970   1,081 -111
1,218   1,194 24
1,070   1,447 -377
1,196   1,580 -384
2,195   2,335 -140
2,293   2,561 -268
1,086   1,237 -151
1,048   1,261 -213
1,156   1,406 -250
1,080   1,217 -137
1,072   1,217 -145
698   975 -277
1,976   3,383 -1,407
7,268   9,811 -2,543
299   414 -115
1,497   1,486 11
1,016   1,059 -43
2,094   2,023 71
1,602   1,690 -88
299   314 -15
793   1,051 -258
1,652   1,655 -3
1,447   1,520 -73
2,510   3,106 -596
1,253   1,810 -557
1,734   1,737 -3
644   717 -73
1,844   2,719 -875
2,782   2,779 3
2,372   2,818 -446
2,069   1,949 120
1,025   1,021 4
1,537   1,839 -302
2,327   2,831 -504
2,673   3,476 -803
1,310   1,466 -156
121   142 -21
785   824 -39
1,052   1,101 -49
3,167   4,924 -1,757
3,639   4,888 -1,249
3,369   5,793 -2,424
2,201   2,138 63
1,927   1,851 76
1,052   959 93
1,554   1,811 -257
745   824 -79
555   741 -186
780   985 -205
819   1,125 -306
204   267 -63
694   780 -86
599   844 -245
954   1,056 -102
2,154   1,967 187
2,376   2,516 -140
1,513   1,546 -33
1,242   1,728 -486
896   1,053 -157
570   823 -253
1,672   1,599 73
2,205   2,074 131
1,154   997 157
922   821 101
1,770   2,563 -793
2,178   2,756 -578
930   1,732 -802
694   1,299 -605
1,647   1,576 71
2,315   2,182 133
3,686   9,524 -5,838
5,588   6,695 -1,107
2,649   3,051 -402
2,672   3,824 -1,152
4,462   4,800 -338
2,497   2,572 -75
2,336   2,362 -26
3,348   4,511 -1,163
3,410   3,001 409
1,457   1,724 -267
1,270   1,945 -675
1,360   1,567 -207
1,138   1,060 78
5,109   5,098 11
3,588   2,791 797
1,047   1,313 -266
897   1,125 -228
982   1,219 -237
370   433 -63
518   656 -138
492   511 -19
1,138   980 158
190   108 82
1,980   2,287 -307
319   387 -68
1,860   2,221 -361
2,302   2,519 -217
523   549 -26
490   659 -169
223   303 -80
1,299   759 540
871   1,054 -183
1,313   1,857 -544
883   1,258 -375
906   875 31
238   211 27
594   534 60
1,676   1,892 -216
1,352   759 593
571   599 -28
1,149   973 176
1,538   1,659 -121
412   449 -37
697   714 -17
875   909 -34
607   643 -36
1,011   1,064 -53
831   971 -140
1,679   1,940 -261
1,283   1,094 189
1,785   1,857 -72
432   459 -27
1,736   1,817 -81
2,839   4,246 -1,407
4,485   3,731 754
1,247   1,425 -178
404   446 -42
1,777   1,659 118
1,348   1,492 -144
1,874   2,475 -601
1,790   1,825 -35
3,015   2,505 510
610   622 -12
2,838   2,950 -112
1,163   1,056 107
1,377   1,554 -177
1,845   1,085 760
493   508 -15
906   1,093 -187
1,436   1,515 -79
749   851 -102
2,189   2,123 66
1,316   1,464 -148
1,671   2,011 -340
1,804   1,085 719
1,243   1,097 146
1,436   1,275 161
1,485   1,116 369
1,577   1,409 168
      33
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       -245
b       7,184
c       -7
d       543
e       92
      1
      -102
      3,851
      558
      -148
      86
      8,996
      87
      142
      -7
      237
      -2,327
      -220
      33
      15,923
      277
      548
      -1,126
      81
      127
      155
      3,147
      42
      1,659
      4,671
      84
      28
      8,472
      73
      -62
       
      79
      18
      115
      60
      -58
      1,624
      46
      28
      4,430
      123
      189
      -5
      11,468
      42
      17
      119
      40
      6,519
      123
      130
      100
      112
      -7
      -35
      17
      169
      4,783
      4,838
      1,641
      -134
      44
      5,534
      152
      910
      11,913
      110
      8,025
      121
      33
      36,533
      11,269
      60,401
      -1,636
      -1,513
      13,661
      -324
      7,032
      264
      3,436
      15,806
      4,150
      8,723
      366
      177
      5,870
      -5
      359
      -13
      2,915
      12,089
      -1,387
      -281
      12,819
      57
      4,932
      1,990
      -256
      145
      10,260
      -896
      581
      5,415
      5,259
      -746
      9,456
      1,620
      1,687
      241
      45,762
      19,391
      5,726
      -254
      -3,280
      1,888
      4,946
      2,641
      61
      1,432
      15,228
      5,096
      -558
      6
      24,261
      13,958
      979
      6,264
      126
      3,602
      569
      1,540
      207
      4,756
      -414
      123
      5,752
      73,399
      771
      26,709
      5,415
      259
      132
      137
      4,955
      -319
      5,126
      -99
      1,476
      5,504
      161
      2,399
      9,641
      319
      2,295
      1,642
      14,314
      131
      16
      2,882
      1,449
      -1,051
      50
      11,602
      8,246
      2,051
      279
      2,935
      -2,461
      2,856
      -68
      8
      13
      9
      11
      25
      138
      -177
      -110
      -280
      -320
      -50
      -51
      55
      -39
      -66
      390
      -133
      -312
      -45
      -33
      -118
      -219
      -11
      54
      -17
      102
      -38
      -73
      -146
      5
      92
      -18
      -119
      -136
      -163
      -164
      -110
      -83
      -120
      -917
      -1,440
      -10
      48
      238
      245
      -68
      -116
      171
      279
      -223
      -40
      -258
      -116
      65
      52
      -97
      -779
      -136
      -111
      24
      -377
      -384
      -140
      -268
      -151
      -213
      -250
      -137
      -145
      -277
      -1,407
      -2,543
      -115
      11
      -43
      71
      -88
      -15
      -258
      -3
      -73
      -596
      -557
      -3
      -73
      -875
      3
      -446
      120
      4
      -302
      -504
      -803
      -156
      -21
      -39
      -49
      -1,757
      -1,249
      -2,424
      63
      76
      93
      -257
      -79
      -186
      -205
      -306
      -63
      -86
      -245
      -102
      187
      -140
      -33
      -486
      -157
      -253
      73
      131
      157
      101
      -793
      -578
      -802
      -605
      71
      133
      -5,838
      -1,107
      -402
      -1,152
      -338
      -75
      -26
      -1,163
      409
      -267
      -675
      -207
      78
      11
      797
      -266
      -228
      -237
      -63
      -138
      -19
      158
      82
      -307
      -68
      -361
      -217
      -26
      -169
      -80
      540
      -183
      -544
      -375
      31
      27
      60
      -216
      593
      -28
      176
      -121
      -37
      -17
      -34
      -36
      -53
      -140
      -261
      189
      -72
      -27
      -81
      -1,407
      754
      -178
      -42
      118
      -144
      -601
      -35
      510
      -12
      -112
      107
      -177
      760
      -15
      -187
      -79
      -102
      66
      -148
      -340
      719
      146
      161
      369
      168
       
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 2 666,057
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 199,346 4,299,053 0.04637
2009 176,819 3,847,425 0.045958
2008 182,375 5,197,444 0.035089
2007 179,405 6,105,917 0.029382
2006 259,553 5,582,629 0.046493
2 Total of line 1, column (d) ...................... 2 0.203292
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 0.040658
4 Enter the net value of noncharitable-use assets for 2011 from Part X, line 5..... 4 4,516,040
5 Multiply line 4 by line 3....................... 5 183,615
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 7,545
7 Add lines 5 and 6......................... 7 191,160
8 Enter qualifying distributions from Part XII, line 4.............. 8 186,671
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 15,090
hereBulletand enter 1% of Part I, line 27b...................
c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2............................ 3 15,090
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 15,090
6 Credits/Payments:
a 2011 estimated tax payments and 2010 overpayment credited to 2011 6a 1,700
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 1,700
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 13,390
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2012 estimated taxBullet   Refunded Bullet 11 0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see page 19 of
the instructions for definition)?............................
1b
 
No
If the answer is “Yes” to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If “Yes,” attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If “Yes,” attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If “Yes,” has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If “Yes,” attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
  • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If “Yes,” complete Part II, col. (c), and Part XV.
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see page 19 of the
    instructions)bulletPA
    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 ofbulletPNC BANK NA Telephone no.bullet (800) 622-8036
    Located atbulletP O BOX 94651CLEVELANDOH ZIP+4bullet441014651
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041.........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ......bullet
    15  
    16
    At any time during calendar year 2011, did the foundation have an interest in or a signature or other authority over
    a bank, securities, or other financial account in a foreign country? .................
    16
     
    No
    See page 20 of the instructions for exceptions and filing requirements for Form TD F 90-22.1. If "Yes", enter the name of the foreign country bullet  
    Form 990-PF (2011)
    Form 990-PF (2011)
    Page 5
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the “Yes” column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?.........................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?.................
    (6) Agree to pay money or property to a government official? (Exception. Check “No”
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).........
    b
    If any answer is “Yes” to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance (see page 20 of the instructions)?...
    1b
     
    No
    .........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2011?.............
    1c
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2011, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2011?...............
    If “Yes,” list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer “No” and attach statement—see page 20 of the instructions.) .........
    2b
    Yes
     
    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
     
    No
    .........bullet
    c
    If the answer is “Yes” to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?............
    If “Yes,” attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay
    premiums on a personal benefit contract?....................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?....
    6b
     
    No
    If “Yes” to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    Form 990-PF (2011)
    Form 990-PF (2011)
    Page 6
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation (see page 22 of the instructions).
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation
    (If not paid, enter
    -0-)
    (d) Contributions to
    employee benefit plans
    and deferred compensation
    (e) Expense account,
    other allowances
    PNC BANK NA TRUSTEE
    4
    36,489    
    P O BOX 94651
    CLEVELAND,OH441014651
    2 Compensation of five highest-paid employees (other than those included on line 1—see page 23 of the instructions).
    If none, enter “NONE.”
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation
    (e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet 0
    3 Five highest-paid independent contractors for professional services (see page 23 of the instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1
     
    2  
    3  
    4  
    Form 990-PF (2011)
    Form 990-PF (2011)
    Page 7
    Part IX-B
    Summary of Program-Related Investments (see page 23 of the instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See page 24 of the instructions.
    3  
    Total. Add lines 1 through 3..........................bullet  
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,
    see page 24 of the instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    4,584,812
    b
    Average of monthly cash balances.......................
    1b
    0
    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
    4,584,812
    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
    4,584,812
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see page 25
    of the instructions) ...........................
    4
    68,772
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    4,516,040
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    225,802
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    225,802
    2a
    Tax on investment income for 2011 from Part VI, line 5......
    2a
    15,090
    b
    Income tax for 2011. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    15,090
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    210,712
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    210,712
    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
    210,712
    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
    186,671
    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
    186,671
    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
    186,671
    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 7 210,712
    2 Undistributed income, if any, as of the end of 2011:
    a Enter amount for 2010 only....... 0
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2011:
    a From 2006....... 0
    b From 2007....... 0
    c From 2008....... 0
    d From 2009....... 0
    e From 2010....... 0
    fTotal of lines 3a through e......... 0
    4Qualifying distributions for 2011 from Part
    XII, line 4: bullet$ 186,671
    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..... 186,671
    e Remaining amount distributed out of corpus 0
    5 Excess distributions carryover applied to 2011. 0 0
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 0
    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 ..........
    24,041
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (see page 27
    of the instructions) ...........
    0
    8Excess distributions carryover from 2006 not
    applied on line 5 or line 7 (see page 27 of the
    instructions) .............
    0
    9Excess distributions carryover to 2012.
    Subtract lines 7 and 8 from line 6a ......
    0
    10 Analysis of line 9:
    a Excess from 2007.... 0
    b Excess from 2008.... 0
    c Excess from 2009.... 0
    d Excess from 2010.... 0
    e Excess from 2011.... 0
    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.
    NONE
    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
    BOYS TOWN JERUSALEM FDN OF AMER
    1 PENN PLAZA - SUITE 6250
    NEW YORK,NY101190002
    NONE PUBLIC GENERAL SUPPORT 10,800
    JEWISH FEDERATIONS OF N AMERICA
    25 BROADWAY ST STE 1700
    NEW YORK,NY100041010
    NONE PUBLIC GENERAL SUPPORT 10,800
    JEWISH NATIONAL FUND (KEREN
    42 EAST 69TH STREET
    NEW YORK,NY100215093
    NONE PUBLIC GENERAL SUPPORT 10,800
    KEREN-OR INC
    350 7TH AVENUE -SUITE 701
    NEW YORK,NY100011942
    NONE PUBLIC GENERAL SUPPORT 10,800
    AMERICAN ASSOCIATION FOR
    BIKUR CHOLIM HOSP - JERUSALEM INC
    156 FIFTH AVENUE
    NEW YORK,NY100107002
    NONE PUBLIC GENERAL SUPPORT 10,800
    AMER FRIENDS - MAGEN DAVID
    352 SEVENTH AVE STE 400
    NEW YORK,NY100015189
    NONE PUBLIC GENERAL SUPPORT 10,800
    HILLEL ACADEMY OF PITTSBURGH
    5685 BEACH STREET
    PITTSBURGH,PA15217
    NONE PUBLIC GENERAL SUPPORT 10,800
    ISRAEL CANCER RESEARCH FUND
    1290 AVE OF THE AMERICAS - RM 550
    NEW YORK,NY101040500
    NONE PUBLIC GENERAL SUPPORT 10,800
    NATIONAL JEWISH HEALTH
    1400 JACKSON STREET - ROOM M116
    DENVER,CO802062762
    NONE PUBLIC GENERAL SUPPORT 10,800
    YESHIVA UNIVERSITY
    500 WEST 185TH STREET
    NEW YORK,NY100333201
    NONE PUBLIC GENERAL SUPPORT 10,800
    SCHOLARSHIP AMERICA
    ONE SCHOLARSHIP WAY
    SAINT PETER,MN56082
    NONE PUBLIC SCHOLARSHIP 56,200
    Total .................................bullet 3a 164,200
    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....     14 109,642  
    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.....     18 742  
    8Gain or (loss) from sales of assets other than inventory     18 666,057  
    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)..   776,441  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13776,441
    (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:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2011 AccountingFeesSchedule
    Name:
    THE SAMUEL EPSTEIN FOUNDATION
    EIN: 25-6311365
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    PNC BANK, NA 700     700

    TY 2011 LegalFeesSchedule
    Name:
    THE SAMUEL EPSTEIN FOUNDATION
    EIN: 25-6311365
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    LEGAL FEES - PRINCIPAL (ALLOCA 3,510     3,510


    TY 2011 OtherDecreasesSchedule
    Name:
    THE SAMUEL EPSTEIN FOUNDATION
    EIN: 25-6311365
    Description Amount
    POSTED SUBSEQ YR FOR CURR YR 2,227
    COST BASIS ADJUSTEMENT 309


    TY 2011 OtherExpensesSchedule
    Name:
    THE SAMUEL EPSTEIN FOUNDATION
    EIN: 25-6311365
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    MISC FOUNDATION EXPENSES 17 0   17


    TY 2011 OtherIncreasesSchedule
    Name:
    THE SAMUEL EPSTEIN FOUNDATION
    EIN: 25-6311365
    Description Amount
    POSTED CURR YR FOR PR YR 4,204
    NONDIVIDEND DISTRIBUTION 251
    ROUNDING ADJUSTMENT 1


    TY 2011 OtherProfessionalFeesSchedule
    Name:
    THE SAMUEL EPSTEIN FOUNDATION
    EIN: 25-6311365
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    CUSTODIAN & MANAGEMENT FEES (A 2,419 2,419    


    TY 2011 TaxesSchedule
    Name:
    THE SAMUEL EPSTEIN FOUNDATION
    EIN: 25-6311365
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 20 20   0
    FEDERAL TAX PAYMENT - PRIOR YE 11 0   0
    FEDERAL ESTIMATES - PRINCIPAL 1,700 0   0
    FOREIGN TAXES ON QUALIFIED FOR 1,003 1,003   0
    FOREIGN TAXES ON NONQUALIFIED 232 232   0