| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| WILLIAM D. BOGYNSKA, CPA, P.C. | 2,290 | 1,718 | 0 | 572 |
| 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 |
|---|---|---|---|---|---|---|---|---|---|
| DELL COMPUTER - FINANCE | 2011-11-08 | 920 | 91 | 5.0000 | 31 | ||||
| BROTHER COLOR PRINTER | 2011-10-27 | 477 | 91 | 5.0000 | 16 | ||||
| DELL COMPUTER - ADMIN | 2011-08-01 | 579 | 91 | 5.0000 | 48 | ||||
| DELL COMPUTER | 2010-06-25 | 559 | 56 | 91 | 5.0000 | 65 | |||
| SCANNER | 2011-03-25 | 450 | 91 | 5.0000 | 68 | ||||
| DELL COMPUTER - SERVER | 2010-06-25 | 559 | 56 | 91 | 5.0000 | 112 | |||
| STOVE | 2008-06-13 | 578 | 299 | 91 | 5.0000 | 116 | 116 | ||
| PRINTER | 2008-01-31 | 400 | 233 | 91 | 5.0000 | 67 | |||
| COMPUTER - GRANTS | 2007-12-14 | 1,318 | 814 | 91 | 5.0000 | 264 | |||
| SCANNER | 2007-10-12 | 1,136 | 738 | 91 | 5.0000 | 57 | |||
| COMPUTER - FINANCE | 2007-02-15 | 1,137 | 889 | 91 | 5.0000 | 190 | |||
| PAVING-SPAULDING | 2004-11-05 | 1,430 | 582 | 67 | 6.67 % | 95 | |||
| IMPROVEMENTS T/H(LIFE) | 2002-06-10 | 19,984 | 6,210 | 85 | 3.64 % | 727 | 727 | ||
| NEW ROOF TREEHOUSE(LIFE) | 2001-12-20 | 2,239 | 732 | 85 | 3.64 % | 81 | 81 | ||
| STRUCTURAL IMP. T/H(LIFE) | 2001-12-20 | 13,379 | 4,394 | 85 | 3.64 % | 487 | 487 | ||
| TREEHOUSE(LIFE) | 2001-12-20 | 94,784 | 31,158 | 85 | 3.64 % | 3,447 | 3,447 | ||
| LIGHTING T/H (REM) | 2002-08-13 | 535 | 159 | 85 | 3.64 % | 19 | 19 | ||
| STRUCTURAL IMP T/H (REM) | 2002-03-05 | 13,086 | 4,185 | 85 | 3.64 % | 476 | 476 | ||
| SPRINKLER T/H (REM) | 2002-02-10 | 1,493 | 480 | 85 | 3.64 % | 54 | 54 | ||
| BUILDING-SPAULDING | 2001-04-21 | 71,230 | 17,730 | 87 | 2.56 % | 1,826 | |||
| NEW ROOF TREEHOUSE (REM) | 2001-12-20 | 1,429 | 470 | 85 | 3.64 % | 52 | 52 | ||
| STRUCTURAL IMP. T/H (REM) | 2001-12-20 | 11,560 | 3,798 | 85 | 3.64 % | 420 | 420 | ||
| TREEHOUSE (REMAINDER) | 2001-12-20 | 60,513 | 19,892 | 85 | 3.64 % | 2,201 | 2,201 |
| Identifier | Return Reference | Explanation |
|---|---|---|
| FORM 990-PF, PAGE 6, PART VII-B, QUESTIONS 5A(4) & 5C:-----------------------------------------------------STATEMENT REQUIRED BY REGULATIONS SECTION 53.4945-5(D):------------------------------------------------------(I) NAME AND ADDRESS OF GRANTEE: PENDLETON FOUNDATION TRUST P.O. BOX 218 PENDLETON, OR 97801 THE PENDLETON FOUNDATION TRUST IS A SECTION 509(A)(3) TYPE III SUPPORTING ORGANIZATION THAT IS NOT FUNCTIONALLY INTEGRATED.(II) DATE AND AMOUNT OF GRANT: OCTOBER 15, 2010, $2,500(III) PURPOSE OF THE GRANT: FEASIBILITY STUDY OF RENOVATION OF HISTORIC BUILDING(IV) AMOUNTS EXPENDED BY THE GRANTEE: AS OF FEBRUARY 28, 2011, THE GRANTEE HAD SPENT $53,262 OUT OF $56,744 RAISED FOR THIS PURPOSE.(V) WHETHER THE GRANTEE HAS DIVERTED ANY FUNDS: TO THE KNOWLEDGE OF THE GRANTOR, THE GRANTEE HAS NOT DIVERTED ANY PORTION OF THE FUNDS RECEIVED.(VI) DATES OF ANY REPORTS RECEIVED FROM THE GRANTOR: THE GRANTOR RECEIVED VARIOUS REPORTS (AND EMAILS AND TELEPHONE CONVERSATIONS) FROM THE GRANTEE AT VARIOUS DATES TO COMPLY WITH THE EXPENDITURE RESPONSIBILITY REGULATIONS. A FINAL REPORT FROM THE GRANTEE WAS DATED FEBRUARY 28, 2011.(VII) DATE AND RESULTS OF ANY VERIFICATION OF THE GRANTEE'S REPORTS: ON DECEMBER 9, 2010, THE GRANTOR SPOKE VIA TELEPHONE WITH A MEMBER OF THE ARCHITECTURAL FIRM AND A MEMBER OF THE CONSULTING FIRM WHO WERE PERFORMING THE FEASIBILITY STUDY. THEY BOTH CONFIRMED THE STATUS OF THE PROJECT. gRANTOR HAS NO REASON TO DOUBT THE ACCURACY OR RELIABILITY OF THE GRANTEE'S REPORTS. NOTE 2 | ||
| FORM 990-PF, PAGE 6, PART VII-B, QUESTIONS 5A(4) & 5C:-----------------------------------------------------STATEMENT REQUIRED BY REGULATIONS SECTION 53.4945-5(D):------------------------------------------------------(I) NAME AND ADDRESS OF GRANTEE: COMPASSION & CHOICES OF OREGON P.O. BOX 6404 PORTLAND, OR 97228 IN 2011 COMPASSION & CHOICES OF OREGON, AN OREGON NONPROFIT CORPORATION, (TIN 33-1230393) TRANSITIONED FROM A SUBORDINATE ORGANIZATION OF THE CENTRAL ORGANIZATION COMPASSION IN DYING FEDERATION OF AMERICA (TIN 91-1592328) TO A SUBORDINATE ORGANIZATION OF THE CENTRAL ORGANIZATION COMPASSION & CHOICES, AN IRC 501(C)(3) EXEMPT ORGANIZATION DESCRIBED IN IRC 509(A)(2), WITH A GROUP EXEMPTION NUMBER 5274 (TIN 84-1328829).(II) DATE AND AMOUNT OF GRANT: DECEMBER 9, 2011, $5,000(III) PURPOSE OF THE GRANT: SURVEY AND RESEARCH PRACTICES OF HOSPICES IN OREGON WITH RESPECT TO THE OREGON DEATH WITH DIGNITY ACT; EDUCATE HOSPICE ADMINISTRATORS OF ITS PROVISIONS.(IV) AMOUNTS EXPENDED BY THE GRANTEE: AS OF APRIL 30, 2012, THE GRANTEE HAD SPENT $4,032 OF THE GRANT AMOUNT.(V) WHETHER THE GRANTEE HAS DIVERTED ANY FUNDS: TO THE KNOWLEDGE OF THE GRANTOR, THE GRANTEE HAS NOT DIVERTED ANY PORTION OF THE FUNDS RECEIVED.(VI) DATES OF ANY REPORTS RECEIVED FROM THE GRANTOR: GRANTOR HAS RECEIVED INTERIM REPORTS FROM GRANTEE MARCH 9, 2012 AND APRIL 17, 2012 DETAILING THE GRANTEE'S ACTIVITIES AND EXPENDITURES. (VII) DATE AND RESULTS OF ANY VERIFICATION OF THE GRANTEE'S REPORTS: TO DATE, THE GRANTOR HAS NOT INDEPENDENTLY VERIFIED INFORMATION IN THE GRANTEE'S REPORTS. GRANTOR HAS NO REASON TO DOUBT THE ACCURACY OR RELIABILITY OF THE GRANTEE'S REPORTS. NOTE 1 |
| Name of Bond | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| SEE SCHEDULE I | 48,971 | 11,034 |
| Name of Stock | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| SEE SCHEDULE I | 13,475,823 | 12,620,702 |
| Category/ Item | Cost/Other Basis | Accumulated Depreciation | Book Value | End of Year Fair Market Value |
|---|---|---|---|---|
| Land | 263,821 | 263,821 | 738,000 | |
| Buildings | 843,768 | 100,090 | 743,678 | 802,000 |
| Machinery and Equipment | 8,742 | 5,848 | 2,894 | 2,894 |
| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| SEE SCHEDULE I | AT COST | 5,741,495 | 5,806,040 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| THEDE CULPEPPER MOORE MUNRO SILLIMAN LLP | 1,566 | 1,566 | 0 | 0 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| Rental Expenses | 7,632 | 7,632 | ||
| VEHICLE EXPENSE | 755 | 755 | ||
| GRANT MANAGEMENT EXPENSE | 1,991 | 1,991 | ||
| BANK CHARGES | 547 | 547 | ||
| DUES & SUBSCRIPTIONS | 1,002 | 307 | 695 | |
| INVESTMENT EXPENSES | 127 | 127 | ||
| OFFICE EXPENSES | 6,798 | 3,399 | 3,399 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| RECOVERY PRIOR YR. GRANTS | 890 | ||
| Other Investment Income | 2,328 | 2,328 |
| Description | Beginning of Year - Book Value | End of Year - Book Value |
|---|---|---|
| SECURITY DEPOSIT | 1,400 | 1,400 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| INVESTMENT MANAGERS | 94,849 | 94,849 | 0 | 0 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| FOREIGN TAX WITHHOLDING | 12,069 | 12,069 | ||
| OREGON DEPT. OF JUSTICE | 1,135 | 1,135 | ||
| FEDERAL EXCISE | 4,512 | |||
| PROPERTY | 12,385 | 12,385 |