Form990-PF
Click to see attachment

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 04-01-2011 , and ending 03-31-2012
G
Check all that apply:
Name of foundation
KINGS DAUGHTERS HOME FOR OLD PEOPLE
 

Number and street (or P.O. box number if mail is not delivered to street address)C/O TWO RIVERS BANK 222 N MAIN   Room/suite
City or town, state, and ZIP code
BURLINGTON, IA52601
A Employer identification number

42-0627329
B Telephone number (see page 10 of the instructions)

(319) 753-9130
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$0J 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) 713
2 Check bullet
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities...... 78,109 78,109 78,109
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 Click to see attachment 29,178
b Gross sales price for all assets on line 6a 558,961
7 Capital gain net income (from Part IV, line 2)... 2,296
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule)....... Click to see attachment 57,066   57,066
12 Total. Add lines 1 through 11........ 165,066 80,405 135,175
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc.        
14 Other employee salaries and wages...... 104,730   31,419 73,311
15 Pension plans, employee benefits....... 8,012   2,404 5,608
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 2,991   997 1,994
c Other professional fees (attach schedule).... Click to see attachment 13,102 13,102    
17 Interest...............        
18 Taxes (attach schedule) (see page 14 of the instructions) Click to see attachment 1,480   493 987
19 Depreciation (attach schedule) and depletion... Click to see attachment 15,724   5,237
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 66,064   22,022 44,042
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 212,103 13,102 62,572 125,942
25 Contributions, gifts, grants paid........ 2,675 2,675
26 Total expenses and disbursements. Add lines 24 and 25 214,778 13,102 62,572 128,617
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -49,712
b Net investment income (if negative, enter -0-) 67,303
c Adjusted net income (if negative, enter -0-)... 72,603
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...............   1  
2 Savings and temporary cash investments.......... 145,195 169,159  
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see page 15 of the
instructions)....................      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use...............      
9 Prepaid expenses and deferred charges...........      
10a Investments—U.S. and state government obligations (attach schedule) 187,705 Click to see attachment34,598  
b Investments—corporate stock (attach schedule)........ 486,052 Click to see attachment672,432  
c Investments—corporate bonds (attach schedule)........ 678,606 Click to see attachment491,283  
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans..............      
13 Investments—other (attach schedule)........... 490,850 Click to see attachment577,394  
14 Land, buildings, and equipment: basis bullet339,232
Less: accumulated depreciation (attach schedule) bullet244,706 100,697 Click to see attachment94,526  
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 2,089,105 2,039,393 0
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.................... 2,089,105 2,039,393
25 Temporarily restricted................    
26 Permanently restricted................    
bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds.........    
28 Paid-in or capital surplus, or land, bldg., and equipment fund    
29 Retained earnings, accumulated income, endowment, or other funds    
30 Total net assets or fund balances (see page 17 of the
instructions).................... 2,089,105 2,039,393
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 2,089,105 2,039,393
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 2,089,105
2 Enter amount from Part I, line 27a..................... 2 -49,712
3 Other increases not included in line 2 (itemize) bullet 3  
4 Add lines 1, 2, and 3.......................... 4 2,039,393
5 Decreases not included in line 2 (itemize) bullet 5  
6 Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30. 6 2,039,393
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.)
1a
b
c
d
e
(e) Gross sales price (f) Depreciation allowed
(or allowable) 		(g) Cost or other basis
plus expense of sale 		(h) Gain or (loss)
(e) plus (f) minus (g)
a
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l) Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i) F.M.V. as of 12/31/69 (j) Adjusted basis
as of 12/31/69 		(k) Excess of col. (i)
over col. (j), if any
a
b
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 2,296
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 119,822 1,981,767 0.060462
2009 120,471 1,880,056 0.064078
2008 132,741 1,904,746 0.069690
2007 118,756 2,132,178 0.055697
2006 150,886 2,131,930 0.070774
2 Total of line 1, column (d) ...................... 2 0.320701
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 0.064140
4 Enter the net value of noncharitable-use assets for 2011 from Part X, line 5..... 4 0
5 Multiply line 4 by line 3....................... 5  
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 673
7 Add lines 5 and 6......................... 7 673
8 Enter qualifying distributions from Part XII, line 4.............. 8 128,617
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 1 673
hereBulletand enter 1% of Part I, line 27b...................
c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2  
3 Add lines 1 and 2............................ 3 673
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-). 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 673
6 Credits/Payments:
a 2011 estimated tax payments and 2010 overpayment credited to 2011 6a 1,480
b Exempt foreign organizations—tax withheld at source....... 6b
c Tax paid with application for extension of time to file (Form 8868) 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 1,480
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. Click to see attachment 8 3
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 804
11 Enter the amount of line 10 to be: Credited to 2012 estimated taxBullet804 Refunded Bullet 11  
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see page 19 of
the instructions for definition)?............................
1b
 
No
If the answer is “Yes” to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If “Yes,” attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If “Yes,” attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If “Yes,” has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If “Yes,” attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If “Yes,” complete Part II, col. (c), and Part XV.
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see page 19 of the
    instructions)bullet
    b
    If the answer is “Yes” to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If “No,” attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2011 or the taxable year beginning in 2011 (see instructions for Part XIV on
    page 27)? If “Yes,” complete Part XIV..........................
    9
    Yes
     
    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 addressbulletN/A
    14
    The books are in care ofbulletTWO RIVERS BANK TRUST Telephone no.bullet (319) 753-9130
    Located atbullet222 N MAIN STBURLINGTONIA ZIP+4bullet52601
    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
     
     
    See page 20 of the instructions for exceptions and filing requirements for Form TD F 90-22.1. If "Yes", enter the name of the foreign country bullet  
    Form 990-PF (2011)
    Form 990-PF (2011)
    Page 5
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the “Yes” column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?.........................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?.................
    (6) Agree to pay money or property to a government official? (Exception. Check “No”
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).........
    b
    If any answer is “Yes” to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance (see page 20 of the instructions)?...
    1b
     
     
    .........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2011?.............
    1c
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2011, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2011?...............
    If “Yes,” list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer “No” and attach statement—see page 20 of the instructions.) .........
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business
    enterprise at any time during the year?.....................
    b
    If “Yes,” did it have excess business holdings in 2011 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2011.)....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2011?
    4b
     
    No
    5a
    During the year did the foundation pay or incur any amount to:
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?...............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 509(a)(1), (2), or (3), or section 4940(d)(2)? (see page 22 of the instructions)...
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?........
    b
    If any answer is “Yes” to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance (see page 22 of the instructions)?
    5b
     
     
    .........bullet
    c
    If the answer is “Yes” to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?............
    If “Yes,” attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay
    premiums on a personal benefit contract?....................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?....
    6b
     
    No
    If “Yes” to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    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
    OLIVE SULLIVANClick to see attachment PRESIDENT
    0.00     		0 0 0
    222 N MAIN
    BURLINGTON,IA52601
    BETTY EVANSClick to see attachment VICE PRESIDE
    0.00     		0 0 0
    222 N MAIN
    BURLINGTON,IA52601
    MARY HARTClick to see attachment SECRETARY
    0.00     		0 0 0
    222 N MAIN
    BURLINGTON,IA52601
    MARILYN GARRETTClick to see attachment SECRETARY
    0.00     		0 0 0
    222 N MAIN
    BURLINGTON,IA52601
    KAY KENTClick to see attachment TREASURER
    0.00     		0 0 0
    222 N MAIN
    BURLINGTON,IA52601
    JUDY BROCKETClick to see attachment DIRECTOR
    0.00     		0 0 0
    222 N MAIN
    BURLINGTON,IA52601
    PAT LATTYClick to see attachment DIRECTOR
    0.00     		0 0 0
    222 N MAIN
    BURLINGTON,IA52601
    CHARLOTTE COURSEYClick to see attachment DIRECTOR
    0.00     		0 0 0
    222 N MAIN
    BURLINGTON,IA52601
    MARY DISSELHORSTClick to see attachment DIRECTOR
    0.00     		0 0 0
    222 N MAIN
    BURLINGTON,IA52601
    MONIKA DOWELLClick to see attachment DIRECTOR
    0.00     		0 0 0
    222 N MAIN
    BURLINGTON,IA52601
    NELLY GUNDRUMClick to see attachment DIRECTOR
    0.00     		0 0 0
    222 N MAIN
    BURLINGTON,IA52601
    JEANETTE FISHERClick to see attachment DIRECTOR
    0.00     		0 0 0
    222 N MAIN
    BURLINGTON,IA52601
    LOIS FORTClick to see attachment DIRECTOR
    0.00     		0 0 0
    222 N MAIN
    BURLINGTON,IA52601
    GLORIA JEWETTClick to see attachment DIRECTOR
    0.00     		0 0 0
    222 N MAIN
    BURLINGTON,IA52601
    VIVIAN KELLERClick to see attachment DIRECTOR
    0.00     		0 0 0
    222 N MAIN
    BURLINGTON,IA52601
    PHYLLIS ROXLAUClick to see attachment DIRECTOR
    0.00     		0 0 0
    222 N MAIN
    BURLINGTON,IA52601
    SHARON WALDENClick to see attachment DIRECTOR
    0.00     		0 0 0
    222 N MAIN
    BURLINGTON,IA52601
    PHYLLIS WILLEYClick to see attachment DIRECTOR
    0.00     		0 0 0
    222 N MAIN
    BURLINGTON,IA52601
    JUDY TOMKINSClick to see attachment DIRECTOR
    0.00     		0 0 0
    222 N MAIN
    BURLINGTON,IA52601
    2 Compensation of five highest-paid employees (other than those included on line 1—see page 23 of the instructions).
    If none, enter “NONE.”
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet  
    3 Five highest-paid independent contractors for professional services (see page 23 of the instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1 OPERATION OF A FACILITY FOR THE LONG-TERM CARE, COMFORT AND MAINTENANCE OF ELDERLY PERSONS 210,623
    2 PROVIDING CAMP SCHOLARSHIPS FOR NEEDY CHILDREN WITHIN THE COMMUNITY, AND CHRISTMAS GIFTS TO NURSING HOME PATIENTS THAT WOULD OTHERWISE NOT RECEIVE ANY GIFTS 2,675
    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 N/A  
    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
    0
    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
    0
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
     
    3
    Subtract line 2 from line 1d.........................
    3
    0
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see page 25
    of the instructions) ...........................
    4
    0
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    0
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    0
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
     
    2a
    Tax on investment income for 2011 from Part VI, line 5......
    2a
     
    b
    Income tax for 2011. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
     
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
     
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
     
    6
    Deduction from distributable amount (see page 25 of the instructions)...........
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII,
    line 1................................
    7
     
    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
    128,617
    b
    Program-related investments—total from Part IX-B..................
    1b
     
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    128,617
    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
    673
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    127,944
    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  
    2 Undistributed income, if any, as of the end of 2011:
    a Enter amount for 2010 only.......  
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2011:
    a From 2006.......  
    b From 2007.......  
    c From 2008.......  
    d From 2009.......  
    e From 2010.......  
    fTotal of lines 3a through e.........  
    4Qualifying distributions for 2011 from Part
    XII, line 4: bullet$ 128,617
    a Applied to 2010, but not more than line 2a  
    b Applied to undistributed income of prior years
    (Election required—see page 26 of the instructions)    		  
    c Treated as distributions out of corpus (Election
    required—see page 26 of the instructions)...     		 
    d Applied to 2011 distributable amount.....  
    e Remaining amount distributed out of corpus 128,617
    5 Excess distributions carryover applied to 2011.    
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 128,617
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ...........     		 
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		 
    d Subtract line 6c from line 6b. Taxable
    amount—see page 27 of the instructions ...     		 
    e Undistributed income for 2010. Subtract line
    4a from line 2a. Taxable amount—see page 27
    of the instructions ...........     		 
    f Undistributed income for 2011. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2011 ..........     		 
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (see page 27
    of the instructions) ...........     		 
    8Excess distributions carryover from 2006 not
    applied on line 5 or line 7 (see page 27 of the
    instructions) .............     		 
    9Excess distributions carryover to 2012.
    Subtract lines 7 and 8 from line 6a ......     		 
    10 Analysis of line 9:
    a Excess from 2007....  
    b Excess from 2008....  
    c Excess from 2009....  
    d Excess from 2010....  
    e Excess from 2011....  
    Form 990-PF (2011)
    Form 990-PF (2011)
    Page 9
    Part XIV
    Private Operating Foundations (see page 27 of the instructions and Part VII-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2011, enter the date of the ruling.......bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2011 (b) 2010 (c) 2009 (d) 2008
    0       0
    b 85% of line 2a .........          
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....     		128,617 119,822 120,993 133,437 502,869
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ....     		    3,416 4,374 7,790
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		128,617 119,822 117,577 129,063 495,079
    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...     		        0
    c “Support” alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XV
    Supplementary Information (Complete this part only if the organization had $5,000 or more in
    assets at any time during the year—see page 27 of the instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number of the person to whom applications should be addressed:
    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
    VARIOUS NURSING HOME PATIENTS
    VARIOUS
    BURLINGTON,IA52601     		NONE   PROVIDE CHRISTMAS GIFTS 675
    CAMP LOOKOUT
    2977 MISSISSIPPI RIVER RD
    MONTROSE,IA52639     		NONE   PROVIDE CAMPERSHIPS FOR CHILDREN 2,000
    Total .................................bullet 3a 2,675
    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
    aROOM AND BOARD FOR ELDERLY         57,066
    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 78,109  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6Net rental income or (loss) from personal property          
    7 Other investment income.....          
    8Gain or (loss) from sales of assets other than inventory     18 29,178  
    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)..   107,287 57,066
    13Total. Add line 12, columns (b), (d), and (e)..................
    13164,353
    (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.)
    1A THE ORGANIZATION OPERATES A RETIREMENT HOME FOR THE CARE
    1A COMFORT AND MAINTENANCE OF THE ELDERLY, AND COLLECTS ROOM
    1A AND BOARD FROM RESIDENTS AS A PARTIAL OFFSET TO THE
    1A FACILITY'S OPERATING EXPENSES
    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)
    Yes
     
    (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
    1a(1) 130,925 KING'S DAUGHTERS HOME THIS ENTITY SERVES A A 501(C)(2) TITLE HOLDING ENTITY FOR THE KINGS DAUGHTERS HOME FOR OLD PEOPLE. DURING THE YEAR, EXCESS CASH FUNDS ARE TRANSFERRED TO THE TRUST FOR INVESTMENT AND ALL INVESTMENT INCOME IS TRANSFERRED BACK TO THE HOME ON A QUARTERLY BASIS.
    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:
    KINGS DAUGHTERS HOME FOR OLD PEOPLE
    EIN: 42-0627329
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INDIRECT ACCOUNTING FEES 2,991   997 1,994

    TY 2011 CompensationExplanation
    Name:
    KINGS DAUGHTERS HOME FOR OLD PEOPLE
    EIN: 42-0627329
    Person Name Explanation
    OLIVE SULLIVAN  
    BETTY EVANS  
    MARY HART  
    MARILYN GARRETT  
    KAY KENT  
    JUDY BROCKET  
    PAT LATTY  
    CHARLOTTE COURSEY  
    MARY DISSELHORST  
    MONIKA DOWELL  
    NELLY GUNDRUM  
    JEANETTE FISHER  
    LOIS FORT  
    GLORIA JEWETT  
    VIVIAN KELLER  
    PHYLLIS ROXLAU  
    SHARON WALDEN  
    PHYLLIS WILLEY  
    JUDY TOMKINS  

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    TY 2011 DepreciationSchedule
    Name:
    KINGS DAUGHTERS HOME FOR OLD PEOPLE
    EIN: 42-0627329
    Description of Property Date Acquired Cost or Other Basis Prior Years' Depreciation Computation Method Rate /
    Life (# of years)    		 Current Year's Depreciation Expense Net Investment Income Adjusted Net Income Cost of Goods Sold Not Included
    ELEVATOR 1990-08-16 19,143 19,143 S/L 10.0000        
    ELEVATOR MOTOR 1994-07-13 1,525 1,525 S/L 10.0000        
    TV 1992-11-12 891 891 S/L 10.0000        
    AMANA FREEZER 1994-10-11 662 662 S/L 10.0000        
    AMANA AIR CONDITIONER 1994-10-11 715 715 S/L 10.0000        
    CURIO TABLE 1995-06-14 481 481 S/L 10.0000        
    AIR CONDITIONER & FURNACE 1996-12-10 9,235 9,235 S/L 10.0000        
    APPLIANCES 1998-03-10 1,831 1,831 S/L 10.0000        
    ROCKING CHAIR 1999-06-09 86 86 S/L 10.0000        
    VACUUM 1999-08-10 532 532 S/L 10.0000        
    CLOTHES DRYER 2003-03-11 364 296 S/L 10.0000 25   8  
    MAYTAG REFRIGERATOR 2005-08-01 1,182 650 S/L 10.0000 118   39  
    REFINISHING FURNITURE 2006-08-17 3,786 2,434 S/L 7.0000 541   180  
    MAYTAG DISHWASHER 2006-09-12 576 370 S/L 7.0000 82   27  
    CROSLEY 20 CU FT FREEZER 2007-11-13 760 380 S/L 7.0000 109   36  
    RANGE 2008-02-12 434 217 S/L 7.0000 31   10  
    FLAT SCREEN TV 2008-02-12 1,567 784 S/L 7.0000 112   37  
    REFRIGERATOR 2008-09-09 535 301 200DB 7.0000 67   22  
    FAUCET & VANITY CABINET 2008-12-22 509 286 200DB 7.0000 64   21  
    FREEZER 2009-06-20 1,308 507 200DB 7.0000 229   76  
    DISHWASHER 2009-09-08 567 220 200DB 7.0000 99   33  
    COMPUTER SYSTEM 2011-01-11 762 152 200DB 5.0000 244   81  
    REMODELING IMPRVMNT 1990-06-30 28,083 28,083 S/L 15.0000        
    REMODELING 1991-09-11 3,144 3,144 S/L 15.0000        
    ELECTRICAL WORK 1992-04-17 4,922 4,922 S/L 15.0000        
    ASPHALT DRIVEWAY 1993-05-13 1,600 1,600 S/L 15.0000        
    REMODELING 1992-08-13 871 871 S/L 15.0000        
    CARPET 1992-10-14 398 398 S/L 15.0000        
    REMODELING 1992-12-23 7,300 7,300 S/L 15.0000        
    REMODELING 1993-02-12 9,916 9,916 S/L 15.0000        
    WIRING 1993-02-12 316 316 S/L 15.0000        
    PLUMBING 1993-03-12 3,890 3,890 S/L 15.0000        
    CARPET 1993-03-10 793 793 S/L 15.0000        
    WIRING 1993-03-10 3,342 3,342 S/L 15.0000        
    REMODELING 1992-10-14 1,829 1,829 S/L 15.0000        
    ROOF 1994-09-14 12,330 12,330 S/L 15.0000        
    2ND STORY BATHROOM 2009-12-09 1,083 207 150DB 15.0000 88   29  
    INTERIOR REMODELING 1996-07-29 19,935 19,271 S/L 15.0000 664   221  
    CARPET 1996-12-18 1,957 1,892 S/L 15.0000 65   22  
    KITCHEN REMODEL 1997-12-09 20,379 18,341 S/L 15.0000 1,359   453  
    CARPET 1998-03-03 2,049 1,844 S/L 15.0000 137   46  
    INTERIOR REMODELING 1997-04-08 10,517 9,465 S/L 15.0000 701   234  
    HANDRAIL 1997-05-13 4,233 3,810 S/L 15.0000 282   94  
    REMODEL 1998-12-08 1,950 1,625 S/L 15.0000 130   43  
    SIDEWALK 1999-04-13 1,225 939 S/L 15.0000 82   27  
    NEW SIGN 1999-06-11 60 46 S/L 15.0000 4   1  
    ENTRY DOOR/GARAGE 1999-07-13 374 287 S/L 15.0000 25   8  
    CEILING FANS 1999-07-13 254 195 S/L 15.0000 17   6  
    CEILING FANS 1999-08-10 1,285 985 S/L 15.0000 86   29  
    CARPET 1999-08-19 2,000 1,533 S/L 15.0000 133   44  
    WINDOW 1999-10-12 259 199 S/L 15.0000 17   6  
    CARPET 1999-11-09 446 342 S/L 15.0000 30   10  
    DEPOSIT ON PORCH 2000-01-12 600 460 S/L 15.0000 40   13  
    GARAGE DOOR W/ OPENER 2000-01-12 918 704 S/L 15.0000 61   20  
    CONCRETE 2000-02-08 1,975 1,514 S/L 15.0000 132   44  
    STORM WINDOWS 2000-05-09 2,948 2,064 S/L 15.0000 197   66  
    STORM DOORS 2000-06-14 494 346 S/L 15.0000 33   11  
    SERVICE TO 2ND FLOOR 2001-01-10 432 303 S/L 15.0000 29   10  
    LANDSCAPING 2001-05-09 2,354 1,491 S/L 15.0000 157   52  
    CARPET RM 11 2004-06-08 450 195 S/L 15.0000 17   6  
    RE ROOF HOUSE/GARAGE 2004-07-09 16,650 7,215 S/L 15.0000 629   210  
    BASEMENT REMODEL - BEAUTY SHOP 2004-05-12 11,065 4,797 S/L 15.0000 418   139  
    REMODEL/RECONSTRUCTION 2006-05-31 27,769 8,331 S/L 15.0000 1,851   617  
    HEAT & SMOKE DETECTORS 2006-04-26 7,920 2,376 S/L 15.0000 528   176  
    CARPETING 2006-05-03 3,887 1,166 S/L 15.0000 259   86  
    WATER HEATER 2006-05-09 3,591 1,077 S/L 15.0000 239   80  
    CONCRETE WORK; WALL SIDEWALK DRIVEWAY 2007-06-04 5,930 1,383 S/L 15.0000 395   132  
    BOILER 2007-10-09 11,997 2,799 S/L 15.0000 800   267  
    PARKING BLOCKS 2007-12-06 450 105 S/L 15.0000 30   10  
    SOUTH SIDE BATH REMODEL 2008-06-10 14,703 8,272 200DB 7.0000 1,837   612  
    WEST WALL CONSTRUCTION 2008-06-10 907 510 200DB 7.0000 113   38  
    BIDET 2008-06-19 551 310 200DB 7.0000 69   23  
    CARPETING 2008-08-12 1,320 743 200DB 7.0000 165   55  
    ARBOR 2009-06-09 270 52 150DB 15.0000 22   7  
    REPLACEMENT SIDEWALK 2009-12-08 350 67 150DB 15.0000 28   9  
    POOL REPAIRS 2010-05-14 8,000 533 150DB 15.0000 747   249  
    ASPHALT DRIVEWAY 2010-05-11 8,755 584 150DB 15.0000 817   272  
    FLAG POLE & LIGHTING 2010-11-09 1,202 172 200DB 7.0000 294   98  
    ELEVATOR REPAIR 2012-03-14 5,083   S/L 10.0000 42   14  
    FURNITURE 2011-10-11 1,619   200DB 7.0000 231   77  
    KITCHEN & BAHROOM WINDOWS 2012-03-14 2,851   S/L 39.0000 3   1  

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    TY 2011 GainLossSaleOtherAssetsSch
    Name:
    KINGS DAUGHTERS HOME FOR OLD PEOPLE
    EIN: 42-0627329
    Name Date Acquired How Acquired Date Sold Purchaser Name Gross Sales Price Basis Basis Method Sales Expenses Total (net) Accumulated Depreciation
    JOHNSTON PA BOND 2005-01 PURCHASE 2011-08   50,000 50,000        
    FEDERAL HOME LOAN 2004-11 PURCHASE 2011-11   50,000 49,822     178  
    MORGAN STANLEY 6.25% 2007-01 PURCHASE 2012-01   75,000 75,000        
    ROYCE VALUE FUND 2010-02 PURCHASE 2011-05   10,000 7,366     2,634  
    VANGUARD S/T INDEX 2008-08 PURCHASE 2011-05   62,365 60,053     2,312  
    SPDR TR UTILITIES 2009-07 PURCHASE 2011-05   6,534 5,559     975  
    CONOCOPHILLIPS 2009-07 PURCHASE 2011-05   1,911 1,019     892  
    SPDR TR UTILITIES 2009-07 PURCHASE 2011-05   3,799 2,154     1,645  
    PEPSICO 2009-07 PURCHASE 2011-05   3,424 2,837     587  
    WALGREENS 2009-07 PURCHASE 2011-05   2,091 1,445     646  
    ISHARES S&P MIDCAP 2010-07 PURCHASE 2011-05   15,015 11,448     3,567  
    ISHARES DJ US TELECOM 2009-07 PURCHASE 2011-05   3,594 2,608     986  
    NOVARTIS 2009-07 PURCHASE 2011-05   2,950 2,028     922  
    SPDR TR FINANCIAL 2009-07 PURCHASE 2011-05   1,576 1,157     419  
    ISHARES RUSSELL 2000 2010-02 PURCHASE 2011-05   10,341 7,580     2,761  
    GNMA POOL 2003-12 PURCHASE 2011-05   284 321     -37  
    GNMA POOL 2003-12 PURCHASE 2011-07   21 23     -2  
    GNMA POOL 2003-12 PURCHASE 2011-08   94 106     -12  
    KINDER MORGAN 2011-02 PURCHASE 2011-08   31 33     -2  
    GNMA POOL 2003-12 PURCHASE 2011-09   20 23     -3  
    OPPENHEIMER 2011-07 PURCHASE 2011-10   2,307 2,442     -135  
    PIMCO 2010-07 PURCHASE 2011-10   5,836 6,133     -297  
    TEMPLETON GLOBAL 2011-07 PURCHASE 2011-10   7,398 8,029     -631  
    HARBOR INTL 2006-12 PURCHASE 2011-10   2,559 2,334     225  
    RANIER CAPITAL 2011-02 PURCHASE 2011-10   803 930     -127  
    ROYCE VALUE 2010-02 PURCHASE 2011-10   1,097 982     115  
    US TREASURY NOTE 2008-02 PURCHASE 2011-10   51,495 51,112     383  
    ROYCE VALUE 2010-02 PURCHASE 2011-10   29,289 25,452     3,837  
    CITIGROUP 2006-12 PURCHASE 2011-10   101,075 100,587     488  
    GE CAPITAL CORP 2007-01 PURCHASE 2011-10   10,439 10,029     410  
    ISHARES RUSSELL 2000 2010-02 PURCHASE 2011-10   29,425 26,095     3,330  
    SPDR TR FINANCIAL 2009-07 PURCHASE 2011-10   6,060 5,783     277  
    GNMA POOL 2003-12 PURCHASE 2011-10   20 23     -3  
    APOLLO GROUP 2009-07 PURCHASE 2011-10   2,355 3,488     -1,133  
    GNMA POOL 2003-12 PURCHASE 2011-11   21 23     -2  
    KINDER MORGAN 2011-11 PURCHASE 2011-11   40 40        
    GNMA POOL 2003-12 PURCHASE 2011-12   107 121     -14  
    GNMA POOL 2003-12 PURCHASE 2012-01   22 24     -2  
    AMGEN 2009-07 PURCHASE 2012-01   6,902 5,205     1,697  
    KINDER MORGAN 2009-07 PURCHASE 2012-02   67 32     35  
    PIMCO 2010-07 PURCHASE 2012-03   4 4        
    GNMA POOL 2003-12 PURCHASE 2012-03   75 85     -10  
    GNMA POOL 2003-12 PURCHASE 2011-04   129 146     -17  
    GNMA POOL 2003-12 PURCHASE 2011-05   20 23     -3  
    GNMA POOL 2003-12 PURCHASE 2012-02   70 79     -9  

    TY 2011 GeneralExplanationAttachment
    Name:
    KINGS DAUGHTERS HOME FOR OLD PEOPLE
    EIN: 42-0627329
    Identifier Return Reference Explanation
    GENERAL ELECTIONS   YEAR ENDED: MARCH 31, 2012 42-0627329 KINGS DAUGHTERS HOME FOR OLD PEOPLE C/O TWO RIVERS BANK 222 N MAIN BURLINGTON, IA 52601 ELECTING OUT OF BONUS DEPRECIATION ALLOWANCE FOR ALL ELIGIBLE DEPRECIABLE PROPERTY THE TAXPAYER ELECTS OUT OF FIRST-YEAR BONUS DEPRECIATION ALLOWANCE UNDER IRC SECTION 168(K) FOR ALL ELIGIBLE ASSET CLASSES OF DEPRECIABLE PROPERTY ACQUIRED AFTER DECEMBER 31, 2007. THIS ELECTION APPLIES TO ALL ELIGIBLE DEPRECIABLE PROPERTY PLACED IN SERVICE DURING THE TAX YEAR.

    TY 2011 InvestmentsCorpBondsSchedule
    Name:
    KINGS DAUGHTERS HOME FOR OLD PEOPLE
    EIN: 42-0627329
    Name of Bond End of Year Book Value End of Year Fair Market Value
    BOEING 50,247  
    CITIGROUP    
    GE CAPITAL CORP 90,211  
    GOLDMAN SACHS 25,025  
    GOLDMAN SACHS SENIOR NOTE 50,176  
    LEHMAN BROTHERS HOLDING 50,065  
    MERRILL LYNCH 149,670  
    MORGAN STANLEY 5.375% 24,970  
    MORGAN STANLEY 5.625%    
    OCCIDENTAL PETROLEUM 50,919  

    TY 2011 InvestmentsCorpStockSchedule
    Name:
    KINGS DAUGHTERS HOME FOR OLD PEOPLE
    EIN: 42-0627329
    Name of Stock End of Year Book Value End of Year Fair Market Value
    AMGEN    
    APOLLO GROUP    
    AUTODESK 3,695  
    BERKSHIRE HATHAWAY CLASS B 5,799  
    CINTAS 6,804  
    COMPASS MINERALS 2,723  
    CONOCOPHILLIPS 4,075  
    EBAY 5,006  
    ETF VANGUARD REIT 22,575  
    EXXON MOBIL 3,466  
    GENERAL DYNAMICS 5,437  
    HARBOR INTERNATIONAL 56,580  
    IQ GLOBAL RESOURCES 59,248  
    IQ HEDGE MULTI STRATEGY 21,632  
    ISHARES MSCI ACWI INDEX 43,589  
    ISHARES RUSSELL 2000    
    ISHARES TR S&P MIDCAP 31,291  
    ISHARES DJ US TELCOM 1,738  
    JOHNSON & JOHNSON 5,695  
    MASTERCARD 4,222  
    MEDTRONIC 5,236  
    MICROSOFT 4,729  
    NOVARTIS 4,056  
    PAYCHEX 5,041  
    PEPSICO 5,675  
    RAINIER MID CAP 24,070  
    ROYCE VALUE    
    SPDR TR ENERGY 4,595  
    SPDR TR FINANCIAL    
    SPDR TR INDUSTRIAL 4,308  
    SPDR TR TECHNOLOGY 3,625  
    SPDR TR MATERIALS 2,529  
    SPDR TR UTILITIES    
    SPDR TR CONSUMER DISCRETIONARY 5,618  
    US BANCORP 5,222  
    VANGUARD MSCI EMERGING 32,909  
    WALGREEN 2,889  
    WESTERN UNION 4,712  
    ARBRITRAGE FUND 20,000  
    DISCOVER FINANCIAL 4,546  
    EXELON CORP 4,273  
    GATEWAY FUND 20,000  
    ISHARES BARCLAYS INTERMED 32,091  
    ISHARES TR BOXXX 129,235  
    JP MORGAN CHASE 6,947  
    PFIZER 4,168  
    PROCTOR & GAMBLE 6,620  
    SYSCO 5,922  
    VICTORY FUND 30,000  
    KINDER MORGAN 5,120  
    LOWES 4,721  

    TY 2011 InvestmentsGovtObligationsSch
    Name:
    KINGS DAUGHTERS HOME FOR OLD PEOPLE
    EIN: 42-0627329
    US Government Securities - End of Year Book Value:

    9,547
    US Government Securities - End of Year Fair Market Value:

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


    25,051
    State & Local Government Securities - End of Year Fair Market Value:


     


    TY 2011 InvestmentsOtherSchedule2
    Name:
    KINGS DAUGHTERS HOME FOR OLD PEOPLE
    EIN: 42-0627329
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    ISHARES TR BARCLAYS AT COST 104,608  
    ISHARES TR IBOXX AT COST    
    PIMCO TOTAL RETURN AT COST 153,327  
    TEMPLETON GLBAL INCOME AT COST 196,294  
    VANGUARD S/T BOND AT COST    
    OPPENHEIMER AT COST 123,057  
    MISCELLANEOUS AT COST 108  

    TY 2011 LandEtcSchedule2
    Name:
    KINGS DAUGHTERS HOME FOR OLD PEOPLE
    EIN: 42-0627329
    Category / Item Cost / Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
    EQUIPMENT 339,232 244,706 94,526  


    TY 2011 OtherExpensesSchedule
    Name:
    KINGS DAUGHTERS HOME FOR OLD PEOPLE
    EIN: 42-0627329
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    EXPENSES        
    UTILITIES 15,191   5,064 10,127
    ADVERTISING 82   27 55
    GROCERIES 9,257   3,086 6,171
    INSURANCE 15,549   5,183 10,366
    MISCELLANEOUS 4,844   1,615 3,229
    CONTRACT LABOR 3,283   1,094 2,189
    REPAIRS AND MAINTENANCE 15,019   5,006 10,013
    SUPPLIES 908   303 605
    PEST CONTROL 356   119 237
    LAWN CARE 1,575   525 1,050


    TY 2011 OtherIncomeSchedule2
    Name:
    KINGS DAUGHTERS HOME FOR OLD PEOPLE
    EIN: 42-0627329
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    ROOM AND BOARD FOR ELDERLY 57,066   57,066


    TY 2011 OtherProfessionalFeesSchedule
    Name:
    KINGS DAUGHTERS HOME FOR OLD PEOPLE
    EIN: 42-0627329
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TRUSTEE FEES 13,102 13,102    


    TY 2011 TaxesSchedule
    Name:
    KINGS DAUGHTERS HOME FOR OLD PEOPLE
    EIN: 42-0627329
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FEDERAL EXCISE TAX 1,480   493 987