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 BRAVE HEART FOUNDATION INC
 

Number and street (or P.O. box number if mail is not delivered to street address)8425 WOODFIELD CROSSING BLVDROOM/SUITE 100Room/suite
City or town, state, and ZIP code
INDIANAPOLIS, IN46240
A Employer identification number

27-0720856
B Telephone number (see page 10 of the instructions)

(317) 366-4631
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$2,711,991
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) 292,003
2 Check bullet
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities...... 39,745 39,745 39,745
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 34,573
b Gross sales price for all assets on line 6a 1,430,387
7 Capital gain net income (from Part IV, line 2)... 34,573
8 Net short-term capital gain......... 24,475
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 366,321 74,318 64,220
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc.        
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... 2,171      
c Other professional fees (attach schedule).... 1,865      
17 Interest...............        
18 Taxes (attach schedule) (see page 14 of the instructions) 535      
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings....... 1,635      
22 Printing and publications..........        
23 Other expenses (attach schedule)....... 13,173      
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 19,379 0   0
25 Contributions, gifts, grants paid........ 205,500 205,500
26 Total expenses and disbursements. Add lines 24 and 25 224,879 0   205,500
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 141,442
b Net investment income (if negative, enter -0-) 74,318
c Adjusted net income (if negative, enter -0-)... 64,220
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.......... 17,249    
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see page 15 of the
instructions)....................      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use...............      
9 Prepaid expenses and deferred charges...........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)........ 2,301,269 Click to see attachment2,650,756 2,711,991
c Investments—corporate bonds (attach schedule)........      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans..............      
13 Investments—other (attach schedule)...........      
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 2,318,518 2,650,756 2,711,991
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.................... 2,318,518 2,650,756
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).................... 2,318,518 2,650,756
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 2,318,518 2,650,756
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 2,318,518
2 Enter amount from Part I, line 27a..................... 2 141,442
3 Other increases not included in line 2 (itemize) bulletClick to see attachment 3 190,796
4 Add lines 1, 2, and 3.......................... 4 2,650,756
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 2,650,756
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 LINCOLN NATIONAL CORP. P 2011-12-21 2011-12-29
b DEERE & CO. D 2010-11-19 2011-09-22
c NOBLE ENERGY INC. D 2010-11-19 2011-06-23
d DIRECT TV CLASS A P 2011-05-18 2011-06-23
e ECOLAB D 2010-11-19 2011-04-06
PEPSICO D 2010-11-19 2011-06-23
ORACLE CORP. P 2011-04-27 2011-09-22
EMERSON ELEC. CO. D 2010-11-19 2011-06-23
PEPSICO D 2010-11-19 2011-09-22
CITIGROUP INC. P 2011-04-13 2011-06-23
EXXON MOBIL CORP. D 2010-11-19 2011-06-23
PRAXAIR D 2010-11-19 2011-09-22
ALBEMARLE CORP P 2011-04-06 2011-06-23
FRANKLIN RES. INC. D 2010-11-19 2011-06-23
PROCTER & GAMBLE D 2010-11-19 2011-04-13
HEWLETT PACKARD CO. P 2011-01-26 2011-05-18
FRANKLIN RES. INC. D 2010-11-19 2011-09-22
SCHLUMBERGER LTD D 2010-11-19 2011-06-23
MICROSOFT CORP P 2011-01-26 2011-04-27
HARRIS CORP. D 2010-11-19 2011-06-23
SELECT SECTOR SPDR CONSUMER DISCRETI D 2010-11-19 2011-09-22
EL PASO CORP P 2011-01-14 2011-11-14
HARRIS CORP. D 2010-11-19 2011-07-13
STERICYCLE INC. D 2010-11-19 2011-06-23
LINCOLN NATIONAL CORP. P 2011-01-04 2011-01-06
HEWLETT PACKARD CO. D 2010-11-19 2011-05-18
STERICYCLE INC. D 2010-11-19 2011-09-22
TEVA PHARMACEUTICAL D 2010-11-19 2011-04-27
INTERNATIONAL BUSINESS MACHINES D 2010-11-19 2011-06-23
THERMO FISHER SCIENTIFIC INC. D 2010-11-19 2011-06-23
APPLE COMPUTER D 2010-11-19 2011-06-23
MCDONALDS CORP D 2010-11-19 2011-06-23
VISA INC. CLASS A D 2010-11-19 2011-09-22
APPLE COMPUTER D 2010-11-19 2011-09-22
MEDCO HEALTH SOLUTIONS D 2010-11-19 2011-06-23
WALMART D 2010-11-19 2011-06-23
CHURCH & DWIGHT D 2010-11-19 2011-09-22
MEDCO HEALTH SOLUTIONS D 2010-11-19 2011-07-21
COSTCO WHSL CORP. NEW D 2010-11-19 2011-06-23
METLIFE D 2010-11-19 2011-06-23
DANAHAR CORP D 2010-11-19 2011-09-22
MICROSOFT CORP D 2010-11-19 2011-04-27
(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 303,715   292,003 11,712
b 5,269   6,028 -759
c 22,639   22,351 288
d 6,580   7,019 -439
e 48,315   45,810 2,505
21,683   20,726 957
1,682   2,104 -422
8,162   8,568 -406
38,260   40,935 -2,675
13,195   15,470 -2,275
18,540   16,874 1,666
559   551 8
13,941   12,677 1,264
13,444   12,865 579
53,620   54,545 -925
361   469 -108
9,525   11,461 -1,936
24,811   23,028 1,783
525   579 -54
11,947   12,523 -576
2,960   3,066 -106
34,421   26,280 8,141
33,571   36,084 -2,513
32,351   26,816 5,535
311,300   311,096 204
36,126   41,732 -5,606
6,265   5,721 544
31,309   34,461 -3,152
26,236   23,098 3,138
18,753   15,375 3,378
22,624   21,590 1,034
26,865   26,077 788
7,568   6,617 951
6,774   5,243 1,531
15,625   17,400 -1,775
7,386   7,557 -171
16,800   25,775 -8,975
45,363   42,660 2,703
44,838   37,522 7,316
15,070   14,493 577
4,525   4,626 -101
56,786   55,939 847
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       11,712
b       -759
c       288
d       -439
e       2,505
      957
      -422
      -406
      -2,675
      -2,275
      1,666
      8
      1,264
      579
      -925
      -108
      -1,936
      1,783
      -54
      -576
      -106
      8,141
      -2,513
      5,535
      204
      -5,606
      544
      -3,152
      3,138
      3,378
      1,034
      788
      951
      1,531
      -1,775
      -171
      -8,975
      2,703
      7,316
      577
      -101
      847
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 34,573
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 24,475
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 277,600    
2009 179,500    
2008      
2007      
2006      
2 Total of line 1, column (d) ...................... 2  
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  
4 Enter the net value of noncharitable-use assets for 2011 from Part X, line 5..... 4 2,502,179
5 Multiply line 4 by line 3....................... 5  
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 743
7 Add lines 5 and 6......................... 7 743
8 Enter qualifying distributions from Part XII, line 4.............. 8 205,500
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 1 743
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............................ 3 743
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- ..... 5 743
6 Credits/Payments:
a 2011 estimated tax payments and 2010 overpayment credited to 2011 6a  
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  
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. Click to see attachment 8 4
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 747
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 taxBullet0 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)bulletIN
    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 addressbulletN/A
    14
    The books are in care ofbulletLARA CHANDLER BELSLEY Telephone no.bullet (317) 918-8000
    Located atbullet2113 E 62ND STREET 107INDIANAPOLISIN ZIP+4bullet46220
    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
     
     
    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
    WILLIAM GRIFFITHClick to see attachment CHAIRMAN
    5.00
    0 0 0
    3922 EAST 79TH STREET
    INDIANAPOLIS,IN46240
    GERRY GRIFFITHClick to see attachment TREASURER
    5.00
    0 0 0
    3922 EAST 79TH STREET
    INDIANAPOLIS,IN46240
    JAMES MULHOLLANDClick to see attachment SECRETARY
    1.00
    0 0 0
    1248 WRIGHT STREET
    INDIANAPOLIS,IN46203
    KIM WALTONClick to see attachment MEMBER
    1.00
    0 0 0
    8245 OLD FARM ROAD
    INDIANAPOLIS,IN46256
    DAVID MCDANIELClick to see attachment MEMBER
    1.00
    0 0 0
    8555 N RIVER ROAD SUITE 300
    INDIANAPOLIS,IN46240
    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
     
    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 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
    2,540,283
    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
    2,540,283
    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
    2,540,283
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see page 25
    of the instructions) ...........................
    4
    38,104
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    2,502,179
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    125,109
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    125,109
    2a
    Tax on investment income for 2011 from Part VI, line 5......
    2a
    743
    b
    Income tax for 2011. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    743
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    124,366
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    124,366
    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
    124,366
    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
    205,500
    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
    205,500
    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
    743
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    204,757
    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 7 124,366
    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....... 179,530
    e From 2010....... 277,750
    fTotal of lines 3a through e......... 457,280
    4Qualifying distributions for 2011 from Part
    XII, line 4: bullet$ 205,500
    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..... 124,366
    e Remaining amount distributed out of corpus 81,134
    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 5 538,414
    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 ..........
    0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (see page 27
    of the instructions) ...........
     
    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 ......
    538,414
    10 Analysis of line 9:
    a Excess from 2007....  
    b Excess from 2008....  
    c Excess from 2009.... 179,530
    d Excess from 2010.... 277,750
    e Excess from 2011.... 81,134
    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).)
    WILLIAM AND GERRY GRIFFITH
    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
    AUSTIN COMMUNITY FOUND
    PO BOX 5159
    AUSTIN,TX78763
        OFFER COMMUNITY ASSISTANCE 10,000
    AMERICAN BAPTIST MEN
    1350 N DELAWARE STREET
    INDIANAPOLIS,IN46202
        OFFER COMMUNITY ASSISTANCE 3,000
    ASSOCIATION OF SMALL FOUN
    1720 N STREET NW
    WASHINGTON,DC20036
        OFFER COMMUNITY SERVICE 1,000
    ATTUDINAL HEALING CONN
    3278 WEST STREET
    OAKLAND,CA94608
        OFFER COMMUNITY ASSISTANCE 2,000
    BREBEUF PREPATORY SCHOOL
    2801 WEST 86TH STREET
    INDIANAPOLIS,IN46268
        IMPROVE EDUCATIONAL PROGRAMS 2,000
    BROADWAY CARES
    165 WEST 46TH STREET
    1300
    NEW YORK,NY10036
        SUPPORT MEDICAL FIELD 5,000
    BROOKE'S PLACE
    50 EAST 91ST STREET
    SUITE 103
    INDIANAPOLIS,IN46268
        IMPROVE EDUCATIONAL PROGRAMS 5,000
    CAMP HEALING TREE
    8111 S EMERSON AVE
    INDIANAPOLIS,IN46237
        OFFER COMMUNITY SUPPORT 5,000
    CHAUCIE'S PLACE
    4607 E 106 STREET
    CARMEL,IN46033
        OFFER COMMUNITY ASSISTANCE 5,000
    CHILDREN'S BUREAU
    1575 DR MARTIN LUTHER
    KING JR ST
    INDIANAPOLIS,IN46202
        OFFER COMMUNITY ASSISTANCE 2,000
    CHRISTAMORE HOUSE
    502 NORTH TREMONT STREET
    INDIANAPOLIS,IN46222
        OFFER COMMUNITY ASSISTANCE 5,000
    CICOA FOUNDATION
    4755 KINGSWAY DRIVE
    SUITE 200
    INDIANAPOLIS,IN46205
        OFFER COMMUNITY ASSISTANCE 1,000
    CLASS EDUCATION INC
    PO BOX 314
    CARMEL,IN46082
        IMPROVE EDUCATIONAL PROGRAMS 1,000
    COBURN PLACE
    604 EAST 38TH STREET
    INDIANAPOLIS,IN46205
        OFFER COMMUNITY ASSISTANCE 3,500
    COCODA-COMPANION COMM
    609 EAST 29TH STREET
    INDIANAPOLIS,IN46205
        OFFER COMMUNITY ASSISTANCE 3,000
    COMMUNITY HOSPITAL FOUNDATION
    1500 N RITTER AVE
    INDIANAPOLIS,IN46219
        OFFER COMMUNITY ASSISTANCE 2,000
    COMMUNITY HEALTH NETWORK
    1500 N RITTER AVE
    INDIANAPOLIS,IN46219
        OFFER COMMUNITY ASSISTANCE 5,000
    DAYSPRINGS CENTER
    PO BOX 44105
    INDIANAPOLIS,IN46244
        OFFER COMMUNITY ASSISTANCE 2,500
    DESERT ROSE FOUNDATION
    PO BOX 1754
    MARTINSVILLE,IN46151
        OFFER COMMUNITY ASSISTANCE 1,000
    DYSLEXIA INSTITUTE OF INDIANA
    8395 KEYSTONE CROSSING
    SUITE 102
    INDIANAPOLIS,IN46240
        OFFER COMMUNITY ASSISTANCE 2,000
    DOMESTIC VIOLENCE NETWORK
    9539 VALPARAISO COURT
    INDIANAPOLIS,IN46268
        OFFER COMMUNITY ASSISTANCE 2,000
    EASTER SEALS CROSSROADS
    4740 KINGSWAY DRIVE
    INDIANAPOLIS,IN46205
        OFFER COMMUNITY ASSISTANCE 2,000
    FAMILIES FOR HOPE
    1219 N WITTFIELD ST
    INDIANAPOLIS,IN46229
        OFFER COMMUNITY ASSISTANCE 1,000
    GLEANERS FOOD BANK
    1102 EAST 16TH STREET
    INDIANAPOLIS,IN46202
        OFFER COMMUNITY ASSISTANCE 2,000
    GOOD SAMARITAN NETWORK
    PO BOX 339
    NOBLESVILLE,IN46061
        OFFER COMMUNITY ASSISTANCE 2,000
    GOODWILL INDUSTRIES
    1635 W MICHIGAN STREET
    INDIANAPOLIS,IN46222
        OFFER COMMUNITY ASSISTANCE 2,000
    HABITAT FOR HUM JOHNSON
    PO BOX 302
    FRANKLIN,IN46131
        OFFER COMMUNITY ASSISTANCE 1,000
    HABITAT FOR HUM HAMILTON
    17917 HOLLOW BROOK COURT
    NOBLESVILLE,IN46062
        OFFER COMMUNITY ASSISTANCE 3,000
    HAMILTON COUNTY CHAPLAIN
    HAMILTON COUNTY SHERIFFS
    DEPARTMENT
    NOBLESVILLE,IN46060
        SUPPORT RELIGIOUS PROGRAMS 5,000
    HAPPY HOLLOW CHILD CAMP
    615 N ALABAMA STREET
    228
    INDIANAPOLIS,IN46204
        IMPROVE EDUCATIONAL PROGRAMS 1,000
    HERRON HIGH SCHOOL
    110 EAST 16TH STREET
    INDIANAPOLIS,IN46202
        IMPROVE EDUCATIONAL PROGRAMS 1,000
    HOPE CRISIS RESPONSE NETW
    PO BOX 2123
    ELKHART,IN46515
        OFFER COMMUNITY ASSISTANCE 7,000
    HORIZON HOUSE
    1033 EAST WASHINGTON ST
    INDIANAPOLIS,IN46202
        OFFER COMMUNITY ASSISTANCE 3,000
    HUMANE SOCIETY OF HAMILTON COUNTY
    1721 PLEASANT STREET
    SUITE B
    NOBLESVILLE,IN46060
        OFFER COMMUNITY ASSISTANCE 2,000
    HUMANE SOCIETY OF INDY
    7929 N MICHIGAN RD
    INDIANAPOLIS,IN46268
        OFFER COMMUNITY ASSISTANCE 1,000
    THE HUDSON SCHOOL
    6001 PARK AVENUE
    HOBOKEN,NJ07030
        SUPPORT EDUCATIONAL PROGRAMS 1,000
    HVAF OF INDIANA
    964 N PENNSYLVANIA STREET
    INDIANAPOLIS,IN46204
        OFFER COMMUNITY ASSISTANCE 1,000
    INDIANA 4-H FOUNDATION
    615 W STATE STREET
    WEST LAFAYETTE,IN47907
        CONSERVATION OF ENVIRONMENT 1,000
    INDIANA BLIND CHILDREN'S FOUNDATION
    7725 N COLLEGE AVE
    INDIANAPOLIS,IN46240
        SUPPORT EDUCATIONAL PROGRAMS 1,000
    INDIANA CHAPTER MULT SCLE
    7301 GEORGETOWN ROAD
    INDIANAPOLIS,IN46268
        SUPPORT MEDICAL FIELD 1,000
    INDIANA CRISIS ASSISTANCE
    5868 EAST 71ST STREET
    SUITE E-340
    INDIANAPOLIS,IN46220
        OFFER COMMUNITY ASSISTANCE 1,000
    IMPD CLOTHE-A-CHILD
    50 N ALABAMA
    ROOM E 211
    INDIANAPOLIS,IN46204
        OFFER COMMUNITY ASSISTANCE 3,000
    INDIANA MATH & SCIENCE ACADEMY
    4575 WEST 38TH STREET
    INDIANAPOLIS,IN46222
        SUPPORT EDUCATIONAL PROGRAMS 1,000
    INDIANA MOTHER'S MILK BAN
    6820 PARKDALE PLACE
    SUITE 109
    INDIANAPOLIS,IN46254
        SUPPORT MEDICAL FIELD 3,000
    INDIANA STATE POLICE
    1415 SHELBY STREET
    INDIANAPOLIS,IN46203
        OFFER COMMUNITY ASSISTANCE 2,000
    INDIANAPOLIS PUBLIC SCHOOLS
    120 E WALNUT ST
    INDIANAPOLIS,IN46204
        OFFER COMMUNITY ASSISTANCE 1,000
    INDIANAPOLIS ZOO SOC
    1200 WEST WASHINGTON ST
    INDIANAPOLIS,IN46222
        CONSERVATION OF ENVIRONMENT 1,000
    IVY TECH COMMUNITY COLLEGE - CENTRA
    50 W FALL CREEK PRKWY N
    INDIANAPOLIS,IN46208
        SUPPORT EDUCATIONAL PROGRAMS 5,000
    JAMESON INC
    PO BOX 31156
    2001 BRIDGEPORT RD
    INDIANAPOLIS,IN46231
        OFFER COMMUNITY ASSISTANCE 1,000
    JOY'S HOUSE
    2028 E BROAD RIPPLE AVE
    INDIANAPOLIS,IN46220
        OFFER COMMUNITY ASSISTANCE 1,000
    KALEIDOSCOPE YOUTH CENTER
    4186 N BROADWAY STREET
    INDIANAPOLIS,IN46205
        OFFER COMMUNITY ASSISTANCE 1,000
    KEEP INDIANAPOLIS BEAUTIFUL
    1029 FLETCHER AVENUE 100
    INDIANAPOLIS,IN46203
        OFFER COMMUNITY ASSISTANCE 5,000
    KEY CONSUMER ORGANIZATION
    2506 WILLOWBROOK PARKWAY
    INDIANAPOLIS,IN46205
        OFFER COMMUNITY ASSISTANCE 1,000
    LITTLE RED DOOR
    1801 N MERIDIAN STREET
    INDIANAPOLIS,IN46202
        SUPPORT MEDICAL FIELD 5,000
    LITTLE SISTERS OF POOR
    2345 WEST 86TH STREET
    INDIANAPOLIS,IN46260
        SUPPORT MEDICAL FIELD 1,000
    LUTHERAN CHILD AND FAMILY SERVICES
    1525 N RITTER AVENUE
    INDIANAPOLIS,IN46219
        OFFER COMMUNITY ASSISTANCE 2,000
    MARTIN LUTHER KING COMMUNITY CENTER
    40 WEST 40TH STREET
    INDIANAPOLIS,IN46208
        OFFER COMMUNITY ASSISTANCE 3,000
    MAMA'S CUPBOARD
    206 E 2ND STREET
    SHERIDAN,IN46069
        OFFER COMMUNITY ASSISTANCE 2,000
    MENNONITE DISASTER SRVC
    1018 MAIN STREET
    AKRON,PA17501
        SUPPORT RELIGIOUS PROGRAMS 2,000
    MENTAL HEALTH AMERICA OF GREATER IN
    301 EAST 38TH STREET
    INDIANAPOLIS,IN46205
        OFFER COMMUNITY ASSISTANCE 1,000
    OUTREACH FOR THE HOMELESS
    PO BOX 11416
    INDIANAPOLIS,IN46201
        OFFER COMMUNITY ASSISTANCE 3,000
    PEACE LEARNING CENTER
    6040 DELONG ROAD
    INDIANAPOLIS,IN46254
        IMPROVE EDUCATIONAL PROGRAMS 2,000
    RILEY CHILDREN'S FOUND
    30 S MERIDIAN STREET
    SUITE 200
    INDIANAPOLIS,IN46204
        SUPPORT MEDICAL FIELD 2,000
    RONALD MCDONALD HOUSE
    ONE KROC DRIVE
    OAK BROOK,IL60523
        SUPPORT MEDICAL FIELD 3,000
    SECOND HELPINGS
    1121 SOUTHEASTERN AVENUE
    INDIANAPOLIS,IN46202
        OFFER COMMUNITY ASSISTANCE 3,000
    SEND SE NEIGHBOR DEV
    1030 ORANGE STREET
    INDIANAPOLIS,IN46203
        OFFER COMMUNITY ASSISTANCE 3,000
    SENSE (SE NGHBRHD SCHOOL OF EXCLNCE
    1601 BARTH AVENUE
    INDIANAPOLIS,IN46203
        IMPROVE EDUCATIONAL PROGRAMS 9,000
    SOCIETY OF ST VINCENT
    3001 EAST 30TH STREET
    INDIANAPOLIS,IN46218
        OFFER COMMUNITY ASSISTANCE 3,000
    THE HOPE FUND INC
    831 A NORTH EDMONDSON AVE
    INDIANAPOLIS,IN46219
        OFFER COMMUNITY ASSISTANCE 1,000
    THE JULIAN CENTER
    2011 N MERIDIAN STREET
    INDIANAPOLIS,IN46202
        OFFER COMMUNITY ASSISTANCE 2,000
    THE PEYBACK FOUNDATION
    6325 N GUILFORD
    SUITE 201
    INDIANAPOLIS,IN46220
        OFFER COMMUNITY ASSISTANCE 1,000
    THE SALVATION ARMY
    3100 NORTH MERIDIAN ST
    INDIANAPOLIS,IN46208
        OFFER COMMUNITY ASSISTANCE 5,000
    WILD HEART ASSOCIATION
    PO BOX 33252
    INDIANAPOLIS,IN46203
        OFFER COMMUNITY ASSISTANCE 1,000
    UNITED CHRISTMAS SE
    3901 NORTH MERIDIAN STREE
    INDIANAPOLIS,IN46208
        OFFER COMMUNITY ASSISTANCE 6,500
    UNITED METHODIST COMM
    475 RIVERSIDE DRIVE
    ROOM 1522
    NEW YORK,NY10115
        OFFER COMMUNITY ASSISTANCE 2,000
    WHEELER MISSION
    205 E NEW YORK STREET
    INDIANAPOLIS,IN46204
        OFFER COMMUNITY ASSISTANCE 1,500
    UNITED WAY OF CENTRAL INDIANA
    3901 N MERIDIAN STREET
    INDIANAPOLIS,IN46208
        OFFER COMMUNITY ASSISTANCE 6,500
    YMCA CAMP TECUMSEH
    12635 W TECUMSEH BEND RD
    BROOKSTON,IN47923
        OFFER COMMUNITY ASSISTANCE 3,000
    Total .................................bullet 3a 205,500
    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....         39,745
    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         34,573
    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)..     74,318
    13Total. Add line 12, columns (b), (d), and (e)..................
    1374,318
    (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.)
    4 HELPS PROVIDE FOR LONGEVITY OF FOUNDATION
    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
    Schedule B
    (Form 990, 990-EZ,
    or 990-PF)
    Department of the Treasury
    Internal Revenue Service
    Schedule of Contributors
    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    OMB No. 1545-0047
    2011
    Name of organization
    THE BRAVE HEART FOUNDATION INC
     
    Employer identification number

    27-0720856
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ





    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......................... Arrow Bullet   $    
    Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
    Form 990-EZ or on Part I, line 2, of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2011)

    Page 2
    Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
    Name of organization
    THE BRAVE HEART FOUNDATION INC
     
    Employer identification number

    27-0720856
    Part I
    Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
         
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
    1
     
     

    WILLIAM AND GERRY GRIFFITH    
    3922 EAST 79TH STREET
       
    INDIANAPOLIS, IN   46240

    $292,003




    (Complete Part II if there is a noncash contribution.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
     
     
     

         
     
       

    $  




    (Complete Part II if there is a noncash contribution.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
     
     
     

         
     
       

    $  




    (Complete Part II if there is a noncash contribution.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
     
     
     

         
     
       

    $  




    (Complete Part II if there is a noncash contribution.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
     
     
     

         
     
       

    $  




    (Complete Part II if there is a noncash contribution.)
    (a)
    No.
    (b)
    Name, address, and ZIP + 4
    (c)
    Total contributions
    (d)
    Type of contribution
     
     
     

         
     
       

    $  




    (Complete Part II if there is a noncash contribution.)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

    Page 3
    Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
    Name of organization
    THE BRAVE HEART FOUNDATION INC
     
    Employer identification number

    27-0720856
    Part II
    Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
         
    (a) No.
    from
    Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (see instructions).
    (d)
    Date received
    1
    15,716 SHARES OF LINCOLN NTNL'   $292,003 2011-12-21
    (a) No.
    from
    Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (see instructions).
    (d)
    Date received
     
    $    
    (a) No.
    from
    Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (see instructions).
    (d)
    Date received
     
    $    
    (a) No.
    from
    Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (see instructions).
    (d)
    Date received
     
    $    
    (a) No.
    from
    Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (see instructions).
    (d)
    Date received
     
    $    
    (a) No.
    from
    Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (see instructions).
    (d)
    Date received
     
    $    
    Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

    Page 4
    Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
    Name of organization
    THE BRAVE HEART FOUNDATION INC
     
    Employer identification number

    27-0720856
    Part III
    Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
    that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
    For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
    contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  

    Use duplicate copies of Part III if additional space is needed
    (a) No.
    from
    Part I
    (b)
    Purpose of gift
    (c)
    Use of gift
    (d)
    Description of how gift is held
     
    (e)
    Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
           
     
    (a) No.
    from
    Part I
    (b)
    Purpose of gift
    (c)
    Use of gift
    (d)
    Description of how gift is held
     
    (e)
    Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
           
     
    (a) No.
    from
    Part I
    (b)
    Purpose of gift
    (c)
    Use of gift
    (d)
    Description of how gift is held
     
    (e)
    Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
           
     
    (a) No.
    from
    Part I
    (b)
    Purpose of gift
    (c)
    Use of gift
    (d)
    Description of how gift is held
     
    (e)
    Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
           
     
    Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

    Additional Data


    Software ID:  
    Software Version:  

    TY 2011 AccountingFeesSchedule
    Name:
    THE BRAVE HEART FOUNDATION INC
    EIN: 27-0720856
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING FEES 2,171      

    TY 2011 CompensationExplanation
    Name:
    THE BRAVE HEART FOUNDATION INC
    EIN: 27-0720856
    Person Name Explanation
    WILLIAM GRIFFITH  
    GERRY GRIFFITH  
    JAMES MULHOLLAND  
    KIM WALTON  
    DAVID MCDANIEL  

    TY 2011 InvestmentsCorpStockSchedule
    Name:
    THE BRAVE HEART FOUNDATION INC
    EIN: 27-0720856
    Name of Stock End of Year Book Value End of Year Fair Market Value
      2,650,756 2,711,991

    TY 2011 OtherExpensesSchedule
    Name:
    THE BRAVE HEART FOUNDATION INC
    EIN: 27-0720856
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    EXPENSES        
    BANK FEES 10,464      
    DUES 695      
    SUPPLIES 1,419      
    INSURANCE 595      


    TY 2011 OtherIncreasesSchedule
    Name:
    THE BRAVE HEART FOUNDATION INC
    EIN: 27-0720856
    Description Amount
    ADJUSTMENT FOR STEPPED UP BASIS 190,796


    TY 2011 OtherProfessionalFeesSchedule
    Name:
    THE BRAVE HEART FOUNDATION INC
    EIN: 27-0720856
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ADMINISTRATIVE FEES 1,865      


    TY 2011 TaxesSchedule
    Name:
    THE BRAVE HEART FOUNDATION INC
    EIN: 27-0720856
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAX ON DIVIDENDS 535