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
AMOS-CHEVES FOUNDATION INC
 
% CECIL M CHEVES
Number and street (or P.O. box number if mail is not delivered to street address)6867 MOUNTAINBROOK DRIVE   Room/suite
City or town, state, and ZIP code
COLUMBUS, GA31904
A Employer identification number

58-2634947
B Telephone number (see page 10 of the instructions)

(706) 243-8133
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$16,095,852J 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) 401,395
2 Check bullet
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities...... 408,862 408,862  
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 787,956
b Gross sales price for all assets on line 6a 1,011,765
7 Capital gain net income (from Part IV, line 2)... 787,956
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).......      
12 Total. Add lines 1 through 11........ 1,598,213 1,196,818  
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)....... Click to see attachment 11,170 0 0 11,170
c Other professional fees (attach schedule).... Click to see attachment 2,106 2,106    
17 Interest...............        
18 Taxes (attach schedule) (see page 14 of the instructions) Click to see attachment 6,135 35    
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 766     766
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 20,177 2,141 0 11,936
25 Contributions, gifts, grants paid........ 993,517 993,517
26 Total expenses and disbursements. Add lines 24 and 25 1,013,694 2,141 0 1,005,453
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 584,519
b Net investment income (if negative, enter -0-) 1,194,677
c Adjusted net income (if negative, enter -0-)...  
For Privacy Act and Paperwork Reduction Act Notice, see page 30 of the instructions.
Cat. No. 11289X Form 990-PF (2011)
Form 990-PF (2011)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)		 Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing...............      
2 Savings and temporary cash investments.......... 1,237,568 1,519,775 1,519,775
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)........ 11,209,106 Click to see attachment3,750,869 14,576,077
c Investments—corporate bonds (attach schedule)........ 25,000 0 0
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) 12,471,674 5,270,644 16,095,852
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable...................    
19 Deferred revenue..................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22)..........   0
Net Assets or Fund Balances bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted....................    
25 Temporarily restricted................    
26 Permanently restricted................    
bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds.........    
28 Paid-in or capital surplus, or land, bldg., and equipment fund    
29 Retained earnings, accumulated income, endowment, or other funds 12,471,674 5,270,644
30 Total net assets or fund balances (see page 17 of the
instructions).................... 12,471,674 5,270,644
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 12,471,674 5,270,644
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 12,471,674
2 Enter amount from Part I, line 27a..................... 2 584,519
3 Other increases not included in line 2 (itemize) bullet 3  
4 Add lines 1, 2, and 3.......................... 4 13,056,193
5 Decreases not included in line 2 (itemize) bulletClick to see attachment 5 7,785,549
6 Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30. 6 5,270,644
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 AFLAC     2011-03-15
b GENERAL ELECTRIC CAP CORP MEDIUM TERM NOTE   2004-02-10 2011-08-29
c ADOBE SYSTEMS   2010-07-01 2011-08-11
d DENDREON CORP   2010-07-01 2011-08-11
e INTUITIVE SURGICAL   2009-07-08 2011-10-31
POTASH CORP   2009-07-08 2011-10-31
POTASH CORP   2009-09-30 2011-10-31
QUALCOMM   2010-03-08 2011-10-31
RESEARCH IN MOTION   2009-07-08 2011-06-28
RESEARCH IN MOTION   2009-09-30 2011-06-28
PROSHARES TRUST   2010-08-11 2011-08-11
(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 968,559   178,774 789,785
b 25,000   25,000  
c 2,623   2,869 -246
d 1,331   3,758 -2,427
e 3,073   1,016 2,057
2,595   1,678 917
961   607 354
1,629   1,208 421
28   65 -37
1,604   3,899 -2,295
4,362   4,935 -573
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       789,785
b        
c       -246
d       -2,427
e       2,057
      917
      354
      421
      -37
      -2,295
      -573
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 2 787,956
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 912,477 15,837,480 0.057615
2009 579,461 11,085,824 0.05227
2008 1,298,880 18,581,075 0.069903
2007 534,836 15,569,224 0.034352
2006 280,199 12,678,708 0.0221
2 Total of line 1, column (d) ...................... 2 0.23624
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 0.047248
4 Enter the net value of noncharitable-use assets for 2011 from Part X, line 5..... 4 17,432,262
5 Multiply line 4 by line 3....................... 5 823,640
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 11,947
7 Add lines 5 and 6......................... 7 835,587
8 Enter qualifying distributions from Part XII, line 4.............. 8 1,005,453
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 11,947
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 11,947
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 11,947
6 Credits/Payments:
a 2011 estimated tax payments and 2010 overpayment credited to 2011 6a 8,399
b Exempt foreign organizations—tax withheld at source....... 6b
c Tax paid with application for extension of time to file (Form 8868) 6c 8,000
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 16,399
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. 8  
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 4,452
11 Enter the amount of line 10 to be: Credited to 2012 estimated taxBullet4,452 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)bulletGA
    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 ofbulletCECIL M CHEVES Telephone no.bullet (706) 243-8133
    Located atbullet6867 MOUNTAINBROOK DRIVE STE 107COLUMBUSGA ZIP+4bullet31904
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041.........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ......bullet
    15  
    16
    At any time during calendar year 2011, did the foundation have an interest in or a signature or other authority over
    a bank, securities, or other financial account in a foreign country? .................
    16
     
    No
    See page 20 of the instructions for exceptions and filing requirements for Form TD F 90-22.1. If "Yes", enter the name of the foreign country bullet  
    Form 990-PF (2011)
    Form 990-PF (2011)
    Page 5
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the “Yes” column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?.........................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?.................
    (6) Agree to pay money or property to a government official? (Exception. Check “No”
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).........
    b
    If any answer is “Yes” to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance (see page 20 of the instructions)?...
    1b
     
     
    .........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
     
    No
    .........bullet
    c
    If the answer is “Yes” to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?............
    If “Yes,” attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay
    premiums on a personal benefit contract?....................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?....
    6b
     
    No
    If “Yes” to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    Form 990-PF (2011)
    Form 990-PF (2011)
    Page 6
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation (see page 22 of the instructions).
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to
    employee benefit plans
    and deferred compensation     		(e) Expense account,
    other allowances
    CECIL M CHEVES CHAIRMAN OF THE BOARD
    0     		0    
    211 N LINTON ROAD
    COLUMBUS,GA31904
    BETTYE A CHEVES PRESIDENT,SECRETARY,TREASURER
    0     		0    
    211 N LINTON ROAD
    COLUMBUS,GA31904
    AVERY C WOLFF BOARD MEMBER
    0     		0    
    45 CASCADE ROAD
    COLUMBUS,GA31904
    LUTHER H WOLFF III BOARD MEMBER
    0     		0    
    45 CASCADE ROAD
    COLUMBUS,GA31904
    OLIVIA C BLANCHARD BOARD MEMBER
    0     		0    
    227 SUNSET ROAD
    COLUMBUS,GA31904
    WILLIAM R BLANCHARD BOARD MEMBER
    0     		0    
    227 SUNSET ROAD
    COLUMBUS,GA31904
    ELIZABETH C MEEKS BOARD MEMBER
    0     		0    
    105 MORGAN DRIVE
    LAGRANGE,GA30240
    RYAN L MEEKS BOARD MEMBER
    0     		0    
    105 MORGAN DRIVE
    LAGRANGE,GA30240
    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
     
    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
     
    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  
    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
    15,979,185
    b
    Average of monthly cash balances.......................
    1b
    1,718,543
    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
    17,697,728
    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
    0
    3
    Subtract line 2 from line 1d.........................
    3
    17,697,728
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see page 25
    of the instructions) ...........................
    4
    265,466
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    17,432,262
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    871,613
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    871,613
    2a
    Tax on investment income for 2011 from Part VI, line 5......
    2a
    11,947
    b
    Income tax for 2011. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    11,947
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    859,666
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    859,666
    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
    859,666
    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
    1,005,453
    b
    Program-related investments—total from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
    0
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
    0
    b
    Cash distribution test (attach the required schedule) .................
    3b
    0
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    1,005,453
    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
    11,947
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    993,506
    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 7 859,666
    2 Undistributed income, if any, as of the end of 2011:
    a Enter amount for 2010 only....... 0
    b Total for prior years:2009, 2008, 2007  
    3 Excess distributions carryover, if any, to 2011:
    a From 2006.......  
    b From 2007.......  
    c From 2008....... 242,226
    d From 2009....... 32,220
    e From 2010....... 127,941
    fTotal of lines 3a through e......... 402,387
    4Qualifying distributions for 2011 from Part
    XII, line 4: bullet$ 1,005,453
    a Applied to 2010, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election required—see page 26 of the instructions)    		  
    c Treated as distributions out of corpus (Election
    required—see page 26 of the instructions)...     		 
    d Applied to 2011 distributable amount..... 859,666
    e Remaining amount distributed out of corpus 145,787
    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 5 548,174
    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 ...........     		0
    f Undistributed income for 2011. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2011 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (see page 27
    of the instructions) ...........     		 
    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 ......     		548,174
    10 Analysis of line 9:
    a Excess from 2007....  
    b Excess from 2008.... 242,226
    c Excess from 2009.... 32,220
    d Excess from 2010.... 127,941
    e Excess from 2011.... 145,787
    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).)
    BETTYE A CHEVES
    CECIL M CHEVES
    ELIZABETH C MEEKS
    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
    ALS ASSOCIATION OF GEORGIA
    1955 CLIFF VALLEY WAY
    SUITE 166
    ATLANTA,GA30329     		  PUBLIC TO FUND PATIENT ASSISTANCE AND RESEARCH 2,000
    BROOKSTONE SCHOOL
    440 BRADLEY PARK DRIVE
    COLUMBUS,GA319042989     		  PUBLIC TO FUND LOCAL EDUCATION 102,500
    CROSSPOINTE CHURCH
    PO BOX 1233
    FORTSON,GA31808     		  PUBLIC TO FUND CHRISTIAN CHURCH ACTIVITIES 10,200
    CUMBERLAND LAW SCHOOL
    800 LAKESHORE DRIVE
    BIRMINGHAM,AL35229     		  PUBLIC TO FUND SCHOLARSHIPS, MOOT COURT FUND, ANNUAL FUND 200,000
    FOCUS ON TRUTH
    PO BOX 5367
    COLUMBUS,GA319060367     		  PUBLIC TO FUND BIBLE TEACHING MINISTRY 1,500
    PASTORAL INSTITUTE
    PO BOX 8649
    ATTN DEVELOPMENT
    COLUMBUS,GA319088649     		  PUBLIC TO FUND CHRISTIAN COUNSELING AND EDUCATION 50,000
    CAMPUS CRUSADE FOR CHRIST
    10726 SPRING BUCK TRAIL
    ORLANDO,FL32825     		  PUBLIC TO FUND COLLEGE CHRISTIAN MINISTRIES 6,200
    PIONEERS
    10123 WILLIAM CAREY DRIVE
    ORLANDO,FL32832     		  PUBLIC TO FUND MINISTRIES TO INTERNATIONALS 1,200
    THE NAVIGATORS
    BOX 6000
    COLORADO SPRINGS,CO80934     		  PUBLIC TO FUND MINISTRIES TO INTERNATIONALS 1,200
    HOUSE OF HEROES
    4713 MILGEN ROAD
    COLUMBUS,GA31907     		  PUBLIC TO FUND ASSISTANCE TO MILITARY FAMILIES 10,000
    HOPEGIVERS INTERNATIONAL
    PO BOX 8808
    COLUMBUS,GA31908     		  PUBLIC TO FUND AID TO INDIGENT PERSONS 25,000
    THE COLUMBUS MUSEUM
    1251 WYNNTON ROAD
    COLUMBUS,GA31906     		  PUBLIC TO FUND AID TO THE INJURED AND DISEASED 1,000
    ALZHEIMERS ASSOCIATION
    5900 RIVER ROAD SUITE 301
    COLUMBUS,GA31904     		  PUBLIC TO FUND PATIENT ASSISTANCE AND RESEARCH 15,000
    HARVESTERS INTERNATIONAL
    C/O MR ED HIRSHMAN PO BOX 22549
    HILTON HEAD,SC29925     		  PUBLIC TO FUND AID TO INDIGENT PERSONS 100,000
    THE HOUSE OF MERCY
    1532 THIRD AVENUE
    COLUMBUS,GA31901     		  PUBLIC TO FUND AID TO INDIGENT PERSONS 21,500
    COLUMBUS SCHOLARS PROJECT
    1340 13TH STREET
    COLUMBUS,GA31901     		  PUBLIC TO PROMOTE EDUCATION 10,000
    RMHC OF WEST GEORGIA INC
    1959 HAMILTON ROAD
    COLUMBUS,GA31904     		  PUBLIC TO FUND MEDICAL AID FOR THE INJURED AND INDIGENT 1,000
    BOY SCOUTS OF AMERICA
    5480 SCHATULGA ROAD
    COLUMBUS,GA31907     		  PUBLIC TO FUND CHARACTER BUILDING ACTIVITIES 1,000
    PRECEPT MINISTRIES
    7324 NOAH REID ROAD PO BOX 182218
    CHATTANOOGA,TN37422     		  PUBLIC TO FUND MINISTRY 425
    YOUNG LIFE OF GREATER COLUMBUS
    1137 LOCKWOOD AVENUE
    COLUMBUS,GA31906     		  PUBLIC TO FUND CHRISTIAN YOUTH MINISTRIES 10,000
    ST ANNE CATHOLIC CHURCH
    3502 KAY CIRCLE
    COLUMBUS,GA31907     		  PUBLIC TO FUND CHRISTIAN CHURCH ACTIVITIES 25,000
    RALLY FOUNDATION FOR CHILDHOOD CANCER RESEARCH
    5775 GLENRIDGE DRIVE SUITE 120
    ATLANTA,GA30328     		  PUBLIC TO FUND AID TO INDIGENT PERSONS 10,000
    EASTER SEALS WEST GEORGIA
    PO BOX 1690
    FORTSON,GA31808     		  PUBLIC TO FUND AID TO INJURED/DISEASED 12,000
    HISTORIC COLUMBUS FOUNDATION
    PO BOX 5312
    COLUMBUS,GA31906     		  PUBLIC TO FUND HISTORIC PRESERVATION 1,000
    GIRLS INC OF COLUMBUS
    PO BOX 3096
    COLUMBUS,GA31903     		  PUBLIC TO FUND CHARACTER BUILDING ACTIVITIES 10,000
    FELLOWSHIP OF CHRISTIAN ATHLETES
    PO BOX 8361
    COLUMBUS,GA31908     		  PUBLIC TO FUND HEALTH AND CHARACTER BUILDING ACTIVITIES 15,000
    CHILDREN HEALTHCARE OF ATLANTA
    1600 TULLIE CIRCLE NE
    ATLANTA,GA30329     		  PUBLIC TO FUND AID TO INJURED/DISEASED 1,000
    YMCA OF COLUMBUS
    118 EAST 11TH STREET
    COLUMBUS,GA31901     		  PUBLIC TO FUND CHARACTER BUILDING ACTIVITIES 1,295
    JUNIOR LEAGUE OF COLUMBUS
    583 FRANKLIN AVENUE
    COLUMBUS,OH43215     		  PUBLIC TO FUND AID TO INDIGENT PERSONS 5,000
    UNITED WAY OF THE CHATTAHOOCHEE VALLEY
    1100 5TH AVENUE
    COLUMBUS,GA31901     		  PUBLIC TO FUND THE SUPPORT OF LOCAL COMMUNITY RESOURCES 40,000
    COLUMBUS REGIONAL FOUNDATION
    PO BOX 790
    COLUMBUS,GA31901     		  PUBLIC TO FUND AID TO FAMILIES OF MEDICAL PATIENTS 3,500
    OPEN DOOR COMMUNITY HOUSE
    2405 2ND AVENUE
    COLUMBUS,GA31901     		  PUBLIC TO FUND AID TO INDIGENT PERSONS 1,000
    VALLEY INTERFAITH PROMISE
    1214 3RD AVENUE
    COLUMBUS,GA31901     		  PUBLIC TO FUND AID TO INDIGENT PERSONS 1,000
    THE STEWART COMMUNITY HOME
    1125 15TH STREET
    COLUMBUS,GA31901     		  PUBLIC TO FUND AID TO INDIGENT PERSONS 25,000
    SAMARITANS PURSE
    PO BOX 3000
    BOONE,NC28607     		  PUBLIC TO FUND AID TO INJURED/DISEASED PERSONS 5,000
    MERCYMED OF COLUMBUS
    PO BOX 1491
    COLUMBUS,GA31902     		  PUBLIC TO FUND AID TO INJURED/DISEASED PERSONS 10,000
    ROOSEVELT WARM SPRINGS DEVELOPMENT FUND
    PO BOX 1000
    WARM SPRINGS,GA31830     		  PUBLIC TO FUND AID TO INJURED/DISEASED PERSONS 10,000
    Y KIDS TRI
    24 14TH STREET
    COLUMBUS,GA31901     		  PUBLIC TO FUND CHARACTER BUILDING ACTIVITIES 11,595
    SOLDIER MARATHON
    PO BOX 1895
    FORTSON,GA31808     		  PUBLIC TO FUND COMMUNITY HEALTH AND SOCIAL ORGANIZATIONS 35,000
    CHATAHOOCHEE CHALLENGE
    801 FRONT STREET
    COLUMBUS,GA31901     		  PUBLIC TO FUND CHARACTER BUILDING ACTIVITIES 1,000
    BOYS & GIRLS CLUBS
    1429 MORRIS ROAD
    COLUMBUS,GA31907     		  PUBLIC TO FUND CHARACTER BUILDING ACTIVITIES 250
    VOICES FOR GEORGIA'S CHILDREN
    100 EDGEWOOD AVENUE NE
    SUITE 1580
    ATLANTA,GA30303     		  PUBLIC TO FUND CHARACTER BUILDING ACTIVITIES 1,200
    MOUNT PLEASANT BAPTIST CHURCH
    191 SINCLAIR STREET
    CARROLLTON,GA30117     		  PUBLIC TO FUND CHRISTIAN CHURCHES 100
    AMERICAN HEART ASSOCIATION
    1639 BRADLEY PARK DRIVE
    SUITE 500 PMB 379
    COLUMBUS,GA31904     		  PUBLIC TO FUND COMMUNITY HEALTH AND SOCIAL ORGANIZATIONS 1,000
    JACKSON COUNTY RESCUE SQUAD
    PO BOX 158
    SYLVA,NC28779     		  PUBLIC TO FUND COMMUNITY HEALTH AND SOCIAL ORGANIZATIONS 100
    GLENVILLE-CASHIERS RESCUE SQUAD
    PO BOX 919
    CASHIERS,NC28717     		  PUBLIC TO FUND COMMUNITY HEALTH AND SOCIAL ORGANIZATIONS 100
    CASHIERS-GLENVILLE VOLUNTEER FIRE DEPT
    579 FRANK ALLEN ROAD
    CASHIERS,NC28717     		  PUBLIC TO FUND COMMUNITY HEALTH AND SOCIAL ORGANIZATIONS 100
    TREES COLUMBUS
    PO BOX 1531
    COLUMBUS,GA31902     		  PUBLIC TO FUND ENVIRONMENTAL PRESERVATION 100
    KEEP COLUMBUS BEAUTIFUL COMMISSION
    685 FRONT AVENUE
    COLUMBUS,GA31901     		  PUBLIC TO FUND ENVIRONMENTAL PRESERVATION 1,600
    DAREN HIDALGO MEMORIAL FUND
    US BANK MK-WI-2024
    2311 WINDSOR STREET
    SUN PRAIRIE,WI53590     		  PUBLIC TO FUND SCHOLARSHIPS 1,000
    NATIONAL INFANTRY FOUNDATION
    1775 LEGACY WAY
    COLUMBUS,GA31903     		  PUBLIC TO FUND HISTORIC PRESERVATION 20,000
    COLUMBUS STATE UNIVERSITY FOUNDATION
    4225 UNIVERSITY AVENUE
    COLUMBUS,GA31907     		  PUBLIC TO FUND MEDICAL AID TO INDIGENT PERSONS 750
    EXPERIENCING MISSIONS INTERNATIONAL
    157 PARKMONT LANE
    DALLAS,GA30132     		  PUBLIC TO FUND MINISTRY TO INTERNATIONALISTS 250
    LEADING THE WAY
    PO BOX 20100
    ATLANTA,GA30325     		  PUBLIC TO FUND MINISTRY TO INTERNATIONALISTS 10,000
    AMERICAN CANCER SOCIETY
    233 12TH STREET 710
    COLUMBUS,GA31901     		  PUBLIC TO FUND RESEARCH AND PATIENT ASSISTANCE 500
    MAYO CLINIC
    200 1ST STREET SW
    ROCHESTER,MN55905     		  PUBLIC TO FUND RESEARCH AND PATIENT ASSISTANCE 20,000
    ROTARY FOUNDATION
    1225 DUBLIN ROAD
    COLUMBUS,GA43215     		  PUBLIC TO FUND RESEARCH AND PATIENT ASSISTANCE 25,000
    SUSAN G KOMEN 3-DAY CURE
    205 N MICHIGAN AVENUE
    SUITE 2630
    CHICAGO,IL60601     		  PUBLIC TO FUND RESEARCH AND PATIENT ASSISTANCE 1,000
    CHATTAHOOCHEE VALLEY COMMISSION COLLEGE FOUNDATION
    2602 COLLEGE DRIVE
    PHENIX CITY,AL36869     		  PUBLIC TO FUND LOCAL COLLEGES 100
    MUSCOGEE COUNTY LIBRARY FOUNDATION
    5101 HAMILTON ROAD
    COLUMBUS,GA31904     		  PUBLIC TO FUND SUPPORT TO LOCAL LIBRARIES 1,000
    SPRINGER OPERA HOUSE
    103 10TH STREET
    COLUMBUS,GA31901     		  PUBLIC TO FUND SUPPORT TO REGIONAL THEATER 15,000
    CORY DOWLESS
    6731 STONE CREEK COURT
    COLUMBUS,GA31909     		  INDIVIDUAL TO FUND SCHOLARSHIP 1,000
    TAMEKIA BROWN
    1174 BISMARCK COURT
    COLUMBUS,GA31907     		  INDIVIDUAL TO FUND SCHOLARSHIP 500
    ASHLEY VANKEMPEN
    27 EL DORADO DRIVE
    CLIFTON PARK,NJ12065     		  INDIVIDUAL TO FUND SCHOLARSHIP 1,000
    AYANNIE THOMAS
    1125 W LINDSAY DRIVE
    COLUMBUS,GA31906     		  INDIVIDUAL TO FUND SCHOLARSHIP 1,000
    MARLICIA WATTS
    PO BOX 861
    LUMPKIN,GA31815     		  INDIVIDUAL TO FUND SCHOLARSHIP 500
    MICHAEL CRANSTON
    9012 SPLENDOR COURT
    COLUMBUS,GA31904     		  INDIVIDUAL TO FUND SCHOLARSHIP 500
    TIFFANY WINCHESTER
    3352 SHIREHILL LANE
    COLUMBUS,GA31909     		  INDIVIDUAL TO FUND SCHOLARSHIP 500
    CATHERINE MASSEY
    5308 KESSINGTON DRIVE
    COLUMBUS,GA31907     		  INDIVIDUAL TO FUND SCHOLARSHIP 500
    BRANDON HARDIN
    6718 WIDGEON DRIVE
    COLUMBUS,GA31820     		  INDIVIDUAL TO FUND SCHOLARSHIP 500
    JASMINE RUTHERFORD
    25 SWEETWATER TRAIN
    CATAULA,GA31804     		  INDIVIDUAL TO FUND SCHOLARSHIP 500
    BERRELL SLAUGHTER
    471 FAIRCHASE COURT
    COLUMBUS,GA31907     		  INDIVIDUAL TO FUND SCHOLARSHIP 500
    ADAM HICKMAN
    7331 SESAME STREET
    COLUMBUS,GA31909     		  INDIVIDUAL TO FUND SCHOLARSHIP 500
    RYAN LE
    12 WYNANTSKILL WAY
    TROY,NY12180     		  INDIVIDUAL TO FUND SCHOLARSHIP 500
    LUZANNA FLORES
    8058 VETERANS PARKWAY
    COLUMBUS,GA31909     		  INDIVIDUAL TO FUND SCHOLARSHIP 500
    FABIAN HUCKE
    3533 HULSEY STREET
    COLUMBUS,GA31907     		  INDIVIDUAL TO FUND SCHOLARSHIP 500
    CALEB KLOBE
    1701 WILLIAMS COURT
    COLUMBUS,GA31904     		  INDIVIDUAL TO FUND SCHOLARSHIP 500
    MOLLIE ALLEN
    1744 LEE ROAD 250
    SALEM,AL36874     		  INDIVIDUAL TO FUND SCHOLARSHIP 500
    KODI WILLIAMS
    5706 SANDY VIEW DRIVE
    COLUMBUS,GA31907     		  INDIVIDUAL TO FUND SCHOLARSHIP 1,000
    JARED YOUNG
    3127 HUNTWOOD DRIVE
    COLUMBUS,GA31907     		  INDIVIDUAL TO FUND SCHOLARSHIP 500
    TORRENZIA LYLES
    7401 BLACKMON ROAD
    APT 904
    COLUMBUS,GA31909     		  INDIVIDUAL TO FUND SCHOLARSHIP 500
    CHELSEA KILPATRICK
    1606 48TH STREET
    PHENIX CITY,AL36867     		  INDIVIDUAL TO FUND SCHOLARSHIP 1,000
    JAMES ARD
    8020 DEERWOOD COURT
    UPATOI,GA31829     		  INDIVIDUAL TO FUND SCHOLARSHIP 500
    LAUREN BOWEN
    336 LEE ROAD 288
    SMITHS STATION,AL36877     		  INDIVIDUAL TO FUND SCHOLARSHIP 500
    ANDREW GALCZYNSKI
    8008 DEERWOOD COURT
    UPATOI,GA31829     		  INDIVIDUAL TO FUND SCHOLARSHIP 500
    JACK WARREN
    2723 FLEETWOOD DRIVE
    COLUMBUS,GA31906     		  INDIVIDUAL TO FUND SCHOLARSHIP 5,000
    NEIGHBORWORKS COLUMBUS
    18 11TH STREET
    COLUMBUS,GA31901     		  PUBLIC TO FUND HOUSING FOR INDIGENT PERSONS 150
    BAPTIST TABERNACLE
    849 SOUTH DAVIS ROAD
    LAGRANGE,GA30241     		  PUBLIC TO FUND CHRISTIAN CHURCHES 100
    CROSSPOINTE CHURCH
    PO BOX 1233
    FORTSON,GA31808     		  PUBLIC TO FUND CHRISTIAN CHURCHES 19,150
    QUEST CHURCH
    4020 WASHINGTON ROAD
    AUGUSTA,GA30907     		  PUBLIC TO FUND CHRISTIAN CHURCHES 3,500
    OAK HILL BAPTIST CHURCH
    100 LAKESIDE DRIVE
    GRIFFIN,GA30224     		  PUBLIC TO FUND CHRISTIAN CHURCHES 150
    PASTORAL INSTITUTE
    PO BOX 8649
    ATTN DEVELOPMENT
    COLUMBUS,GA319088649     		  PUBLIC TO FUND CHRISTIAN COUNSELING 2,000
    WATCHMAN FELLOWSHIP
    PO BOX 13340
    ARLINGTON,TX76094     		  PUBLIC TO FUND CHRISTIAN CHURCH MINISTRIES 50
    OPERATION SMILE
    6435 TIDEWATER DRIVE
    NORFOLK,VA23509     		  PUBLIC TO FUND AID TO SICK AND INJURED PERSONS 1,130
    CHILDREN HEALTHCARE OF ATLANTA
    1600 TULLIE CIRCLE NE
    ATLANTA,GA30329     		  PUBLIC TO FUND AID TO INJURED/DISEASED 1,000
    SMILE TRAIN
    41 MADISON AVENUE
    28TH FLOOR
    NEW YORK,NY10010     		  PUBLIC TO FUND AID TO SICK AND INJURED PERSONS 250
    SUSAN G KOMEN 3-DAY CURE
    205 N MICHIGAN AVENUE
    SUITE 2630
    CHICAGO,IL60601     		  PUBLIC TO FUND AID TO SICK AND INJURED PERSONS 100
    HOPE FOR A DAY
    PO BOX 145
    LAGRANGE,GA30240     		  PUBLIC TO FUND AID TO SICK AND INJURED PERSONS 200
    COLUMBUS REGIONAL FOUNDATION
    PO BOX 790
    COLUMBUS,GA31901     		  PUBLIC TO FUND AID TO SICK AND INJURED PERSONS 350
    MEDICAL CENTER AUXILIARY
    PO BOX 951
    COLUMBUS,GA31902     		  PUBLIC TO FUND AID TO SICK AND INJURED PERSONS 50
    TEEN CHALLENGE INTERNATIONAL
    15 W 10TH STREET
    COLUMBUS,GA31901     		  PUBLIC TO FUND CHRISTIAN YOUTH MINISTRIES 3,300
    YOUNG LIFE INTERNATIONAL
    PO BOX 520
    COLORADO SPRINGS,CO80901     		  PUBLIC TO FUND CHRISTIAN YOUTH MINISTRIES 400
    YOUNG LIFE OF GREATER COLUMBUS
    1137 LOCKWOOD AVENUE
    COLUMBUS,GA31906     		  PUBLIC TO FUND CHRISTIAN YOUTH MINISTRIES 1,600
    YOUNG LIFE PERIMETER NORTH
    PO BOX 888757
    ATLANTA,GA30356     		  PUBLIC TO FUND CHRISTIAN YOUTH MINISTRIES 300
    YOUNG LIFE AUGUSTA
    2249 WALTON WAY SUITE B
    AUGUSTA,GA30904     		  PUBLIC TO FUND CHRISTIAN YOUTH MINISTRIES 1,250
    YOUNG LIFE BALDWIN
    PO BOX 1443
    MILLEDGEVILLE,GA31059     		  PUBLIC TO FUND CHRISTIAN YOUTH MINISTRIES 1,300
    YOUNG LIFE BAKER WHITTEN-DECATUR
    5090 OLD ELLIS PT
    SUITE C
    ROSWELL,GA30076     		  PUBLIC TO FUND CHRISTIAN YOUTH MINISTRIES 1,000
    YOUNG LIFE OF GREATER ATHENS
    PO BOX 48883
    ATHENS,GA30604     		  PUBLIC TO FUND CHRISTIAN YOUTH MINISTRIES 250
    YOUNG LIFE OF AUBURN-OPELIKA
    PO BOX 1336
    AUBURN,AL36831     		  PUBLIC TO FUND CHRISTIAN YOUTH MINISTRIES 6,000
    YOUNG LIFE OF MARIETTA
    PO BOX 935
    MARIETTA,GA30061     		  PUBLIC TO FUND CHRISTIAN YOUTH MINISTRIES 150
    SAMARITANS PURSE
    PO BOX 3000
    BOONE,NC28607     		  PUBLIC TO FUND DISASTER RELIEF 1,500
    TREE HUGGERS
    C/O DISCOVERY COMMUNICATIONS
    ONE DISCOVERY PLACE
    SILVER SPRING,MD20910     		  PUBLIC TO FUND ENVIRONMENTAL PRESERVATION 150
    WORLD VISION
    PO BOX 9716
    FEDERAL WAY,WA98063     		  PUBLIC TO FUND THE FIGHT AGAINST WORLD HUNGER 372
    HARMONY HOUSE
    2891 LEWIS STREET
    KENNESAW,GA30144     		  PUBLIC TO FUND HAVENS FOR ABUSED CHILDREN 500
    EMMAUS WOMENS SHELTER
    601 BROAD STREET
    LAGRANGE,GA30240     		  PUBLIC TO FUND HAVENS FOR HOMELESS WOMEN AND CHILDREN 500
    LIVING WATER INTERNATIONAL
    PO BOX 35496
    HOUSTON,TX77235     		  PUBLIC TO FUND THE PROVIDING OF CLEAN WATER 250
    FIRST CHOICE WOMENS RESOURCE CENTER
    82 SPEEDWELL AVENUE
    MORRISTOWN,NJ07960     		  PUBLIC TO FUND AID TO UNPLANNED PREGNANCIES 100
    PIONEERS
    10123 WILLIAM CAREY DRIVE
    ORLANDO,FL32832     		  PUBLIC TO FUND INTERNATIONAL CHIRSTIAN MINISTRIES 800
    MUSCOGEE COUNTY LIBRARY FOUNDATION
    5101 HAMILTON ROAD
    COLUMBUS,GA31904     		  PUBLIC TO FUND LOCAL LIBRARIES 150
    BROOKSTONE SCHOOL
    440 BRADLEY PARK DRIVE
    COLUMBUS,GA319042989     		  PUBLIC TO FUND LOCAL EDUCATION 5,000
    ATLANTA MISSION
    2353 BOLTON ROAD
    ATLANTA,GA30318     		  PUBLIC TO FUND MISSION TO END HOMELESSNESS 100
    ARCH FOUNDATION
    MILLEDGE CENTER SUITE 100 394 S MIL
    ATHENS,GA30602     		  PUBLIC TO FUND SCHOLARSHIPS 200
    FCAUGA CAMPUS MINISTRY
    TEAM UNITED PO BOX 7476
    ATHENS,GA30604     		  PUBLIC TO FUND CHRISTIAN COLLEGE MINISTRIES 1,000
    CHATTAHOOCHEE VALLEY SPORTS HALL OF FAME
    PO BOX 2786
    COLUMBUS,GA31902     		  PUBLIC TO FUND COMMUNITY HEALTH AND SOCIAL ORGANIZATIONS 1,000
    TEEN CHALLENGE INTERNATIONAL
    15 W 10TH STREET
    COLUMBUS,GA31901     		  PUBLIC TO FUND CHRISTIAN YOUTH MINISTRIES 6,200
    MEDICAL CAMPUS OUTREACH
    642 TELFAIR STREET
    AUGUSTA,GA30901     		  PUBLIC TO FUND CHRISTIAN YOUTH MINISTRIES 200
    YOUNG LIFE LAGRANGE
    PO BOX 158
    LAGRANGE,GA30241     		    TO FUND CHRISTIAN YOUTH MINISTRIES 20,000
    Total .................................bullet 3a 993,517
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2011)
    Form 990-PF (2011)
    Page 11
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See page 28 of
    the instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3Interest on savings and temporary cash investments          
    4 Dividends and interest from securities....     14 408,862  
    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     18 787,956  
    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)..   1,196,818  
    13Total. Add line 12, columns (b), (d), and (e)..................
    131,196,818
    (See worksheet in line 13 instructions on page 28 to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the organization’s exempt purposes (other than by providing funds for such purposes). (See
    page 28 of the instructions.)
    Form 990-PF (2011)
    Form 990-PF (2011)
    Page 12
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section
    Yes
    No
    501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is “Yes,” complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527?...........
    b
    If “Yes,” complete the following schedule.
    (a) Name of organization (b) Type of organization (c) Description of relationship
    SignHere
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer or fiduciary) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    Signature of officer or trustee Date Title
    PaidPreparersUseOnly Preparer's SignatureBullet Date PTIN
    Firm's namebullet



    Firm's addressbullet







         		Firm's EINbullet
    Phone no.
    Form 990-PF (2011)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description
    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
    AMOS-CHEVES FOUNDATION INC
     
    Employer identification number

    58-2634947
    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
    AMOS-CHEVES FOUNDATION INC
          		Employer identification number

    58-2634947
    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
     
     

    CECIL M CHEVES    
    211 N LINTON ROAD
       
    COLUMBUS, GA   31904

    		$8,000




    (Complete Part II if there is a noncash contribution.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    2
     
     

    BETTYE A CHEVES    
    211 N LINTON ROAD
       
    COLUMBUS, GA   31904

    		$10,000




    (Complete Part II if there is a noncash contribution.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    3
     
     

    OLIVIA D AMOS CHARITABLE LEAD TRUST    
    6867 MOUNTAINBROOK DRIVE SUITE 107
       
    COLUMBUS, GA   31904

    		$318,395




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

    ELIZABETH CHEVES MEEKS    
    105 MORGAN DRIVE
       
    LAGRANGE, GA   30240

    		$65,000




    (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
    AMOS-CHEVES FOUNDATION INC
          		Employer identification number

    58-2634947
    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
     
    		$    
    (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
    AMOS-CHEVES FOUNDATION INC
          		Employer identification number

    58-2634947
    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:
    AMOS-CHEVES FOUNDATION INC
    EIN: 58-2634947
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING FEES 11,170     11,170

    Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

    TY 2011 DepreciationSchedule
    Name:
    AMOS-CHEVES FOUNDATION INC
    EIN: 58-2634947
    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

    TY 2011 InvestmentsCorpStockSchedule
    Name:
    AMOS-CHEVES FOUNDATION INC
    EIN: 58-2634947
    Name of Stock End of Year Book Value End of Year Fair Market Value
    MORGAN STANLEY SMITH BARNEY 3,549,843 14,376,354
    STIFEL NICOLAUS 201,026 199,723

    TY 2011 LandEtcSchedule2
    Name:
    AMOS-CHEVES FOUNDATION INC
    EIN: 58-2634947
    Category / Item Cost / Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value


    TY 2011 OtherDecreasesSchedule
    Name:
    AMOS-CHEVES FOUNDATION INC
    EIN: 58-2634947
    Description Amount
    ADJUSTMENT OF SECURITIES TO TAX BASIS 7,785,549


    TY 2011 OtherExpensesSchedule
    Name:
    AMOS-CHEVES FOUNDATION INC
    EIN: 58-2634947
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    OFFICE EXPENSES 166     166
    REGISTRATION FEES 125     125
    FUNDRAISING 475     475


    TY 2011 OtherIncomeSchedule2
    Name:
    AMOS-CHEVES FOUNDATION INC
    EIN: 58-2634947
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    FEDERAL TAX REFUND      


    TY 2011 OtherProfessionalFeesSchedule
    Name:
    AMOS-CHEVES FOUNDATION INC
    EIN: 58-2634947
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT FEES 2,106 2,106    


    TY 2011 TaxesSchedule
    Name:
    AMOS-CHEVES FOUNDATION INC
    EIN: 58-2634947
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FEDERAL TAXES 6,100      
    FOREIGN TAXES 35 35