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
2012
Open to Public Inspection
For calendar year 2012, or tax year beginning 01-01-2012 , and ending 12-31-2012
Name of foundation
Chase Family Foundation
 

Number and street (or P.O. box number if mail is not delivered to street address)Foundation Source 501 Silverside Rd   Room/suite
City or town, state, and ZIP code
Wilmington, DE198091377
A Employer identification number

31-6038352
B Telephone number (see instructions)

(800) 839-1754
C bullet
G Check all that apply:

D 1. bullet
2. bullet
H Check type of organization:
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$16,708,779J 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 instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities...... 427,318 427,318  
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 Click to see attachment -233,436
b Gross sales price for all assets on line 6a 466,792
7 Capital gain net income (from Part IV, line 2)... 0
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........ 193,882 427,318  
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).......        
c Other professional fees (attach schedule).... Click to see attachment 75,920 75,920    
17 Interest...............        
18 Taxes (attach schedule) (see instructions) Click to see attachment 9,367 574    
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 61,654 658   60,996
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 146,941 77,152   60,996
25 Contributions, gifts, grants paid........ 721,001 721,001
26 Total expenses and disbursements. Add lines 24 and 25 867,942 77,152   781,997
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -674,060
b Net investment income (if negative, enter -0-) 350,166
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2012)
Form 990-PF (2012)
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.......... 828,035 327,364 327,364
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)........ 11,723,196 Click to see attachment11,549,807 16,381,415
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) 12,551,231 11,877,171 16,708,779
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 12,551,231 11,877,171
30 Total net assets or fund balances (see page 17 of the
instructions).................... 12,551,231 11,877,171
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 12,551,231 11,877,171
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 12,551,231
2 Enter amount from Part I, line 27a..................... 2 -674,060
3 Other increases not included in line 2 (itemize) bullet 3  
4 Add lines 1, 2, and 3.......................... 4 11,877,171
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 11,877,171
Form 990-PF (2012)
Form 990-PF (2012)
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 Publicly-traded Securities      
b
c
d
e
(e) Gross sales price (f) Depreciation allowed
(or allowable) 		(g) Cost or other basis
plus expense of sale 		(h) Gain or (loss)
(e) plus (f) minus (g)
a 466,792   700,231 -232,414
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l) Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i) F.M.V. as of 12/31/69 (j) Adjusted basis
as of 12/31/69 		(k) Excess of col. (i)
over col. (j), if any
a       -232,414
b
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 -232,414
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 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))
2011 712,052 16,091,365 000.044251
2010 643,461 15,105,610 000.042597
2009 896,752 13,763,336 000.065155
2008 904,335 17,070,115 000.052978
2007 739,675 18,147,940 000.040758
2 Total of line 1, column (d) ...................... 2 000.245739
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. . . 		3 000.049148
4 Enter the net value of noncharitable-use assets for 2012 from Part X, line 5..... 4 16,588,422
5 Multiply line 4 by line 3....................... 5 815,288
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 3,502
7 Add lines 5 and 6......................... 7 818,790
8 Enter qualifying distributions from Part XII, line 4.............. 8 781,997
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.
Form 990-PF (2012)
Form 990-PF (2012)
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 7,003
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 7,003
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 7,003
6 Credits/Payments:
a 2012 estimated tax payments and 2011 overpayment credited to 2012 6a 6,500
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.............. Tax Paid Original Return: 6500 7 6,500
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. Click to see attachment 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 503
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 2013 estimated taxBullet   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 instructions)
    bullet
    b
    If the answer is “Yes” to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If “No,” attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2012 or the taxable year beginning in 2012 (see instructions for Part XIV)?
    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 instructions) .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement (see instructions).................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbullet  
    14
    The books are in care ofbulletco Foundation Source Telephone no.bullet (800) 839-1754
    Located atbullet501 Silverside Road Suite 123WilmingtonDE ZIP+4bullet198091377
    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 2012, 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 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 (2012)
    Form 990-PF (2012)
    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 2012?.............
    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 2012, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2012?...............
    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 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 2012 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 2012.)....................
    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 2012?
    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 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 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 (2012)
    Form 990-PF (2012)
    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 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
    Alison M Chase Vice Chair
    001.00     		0    
    Foundation Source 501 Silverside Rd
    Wilmington,DE19809
    Barbara K Chase Trustee
    001.00     		0    
    Foundation Source 501 Silverside Rd
    Wilmington,DE19809
    Dave Chase Chairman
    001.00     		0    
    Foundation Source 501 Silverside Rd
    Wilmington,DE19809
    Dawn K Chase Trustee
    001.00     		0    
    Foundation Source 501 Silverside Rd
    Wilmington,DE19809
    Lee Molen Chase Sec
    001.00     		0    
    Foundation Source 501 Silverside Rd
    Wilmington,DE19809
    Michael Clooney Trustee
    001.00     		0    
    Foundation Source 501 Silverside Rd
    Wilmington,DE19809
    Joseph C Hill Trustee
    001.00     		0    
    Foundation Source 501 Silverside Rd
    Wilmington,DE19809
    2 Compensation of five highest-paid employees (other than those included on line 1—see 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 instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    PNC Bank Wealth Management Investment Management 75,920
    201 E 5th Steeet
    Cincinnati,OH45202
    Foundation Source Administrative 60,996
    55 Walls Drive 3rd Fl
    Fairfield,CT06824
    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 (2012)
    Form 990-PF (2012)
    Page 7
    Part IX-B
    Summary of Program-Related Investments (see 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 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
    16,279,409
    b
    Average of monthly cash balances.......................
    1b
    561,629
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    16,841,038
    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
    16,841,038
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see
    instructions) Click to see attachment.............................
    4
    252,616
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    16,588,422
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    829,421
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    829,421
    2a
    Tax on investment income for 2012 from Part VI, line 5......
    2a
    7,003
    b
    Income tax for 2012. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    7,003
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    822,418
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    822,418
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII,
    line 1................................
    7
    822,418
    Part XII
    Qualifying Distributions (see 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 Click to see attachment..........
    1a
    781,997
    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
    781,997
    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 instructions).................
    5
     
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    781,997
    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 (2012)
    Form 990-PF (2012)
    Page 8
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2011     		(c)
    2011     		(d)
    2012
    1 Distributable amount for 2012 from Part XI, line 7 822,418
    2 Undistributed income, if any, as of the end of 2012:
    a Enter amount for 2011 only....... 781,498
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2012:
    a From 2007.......  
    b From 2008.......  
    c From 2009.......  
    d From 2010.......  
    e From 2011.......  
    fTotal of lines 3a through e.........  
    4Qualifying distributions for 2012 from Part
    XII, line 4: bullet$ 781,997
    a Applied to 2011, but not more than line 2a 781,498
    b Applied to undistributed income of prior years
    (Election required—see instructions)......     		 
    c Treated as distributions out of corpus (Election
    required—see instructions).........     		 
    d Applied to 2012 distributable amount..... 499
    e Remaining amount distributed out of corpus  
    5 Excess distributions carryover applied to 2012.    
    (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  
    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 instructions ...........     		 
    e Undistributed income for 2011. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    f Undistributed income for 2012. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2013 ..........     		821,919
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (see
    instructions) .............     		 
    8Excess distributions carryover from 2007 not
    applied on line 5 or line 7 (see instructions) ...     		 
    9Excess distributions carryover to 2013.
    Subtract lines 7 and 8 from line 6a ......     		 
    10 Analysis of line 9:
    a Excess from 2008....  
    b Excess from 2009....  
    c Excess from 2010....  
    d Excess from 2011....  
    e Excess from 2012....  
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 9
    Part XIV
    Private Operating Foundations (see 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 2012, 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) 2012 (b) 2011 (c) 2010 (d) 2009
             
    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 instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    NONE
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    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 (2012)
    Form 990-PF (2012)
    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
    9 LIVES RESCUE
    PO BOX 75183
    COLORADO SPGS,CO80970     		N/A 509a1 General Unrestricted 100
    ACADIA WILD LIFE FOUNDATION
    PO BOX 207
    MOUNT DESERT,ME04660     		N/A 509a1 General Unrestricted 100
    ADVENTURE CYCLING ASSOCIATION
    150 E PINE ST
    MISSOULA,MT59802     		N/A 509a1 General Unrestricted 1,000
    ADVOC FOR SURVIVORS OF TORTURE & TRAUMA
    431 E BELVEDERE AVE
    BALTIMORE,MD21212     		N/A 509a1 General Unrestricted 5,000
    ANIMAL HAVEN INC
    251 CENTRE ST
    NEW YORK,NY10013     		N/A 509a1 General Unrestricted 1,000
    APPALACHIAN MOUNTAIN CLUB
    5 JOY ST
    BOSTON,MA02108     		N/A 509a1 General Unrestricted 10,000
    ARTISTS FOR HUMANITY INC
    100 W 2ND ST
    BOSTON,MA02127     		N/A 509a1 General Unrestricted 500
    BARD COLLEGE
    PO BOX 5000
    ANNANDALE,NY12504     		N/A 509a1 General Unrestricted 2,000
    BEST FRIENDS ANIMAL SOCIETY
    5001 ANGEL CANYON RD
    KANAB,UT84741     		N/A 509a1 General Unrestricted 2,500
    BOSTON CAMERATA INC
    PO BOX 120751
    BOSTON,MA02112     		N/A 509a2 General Unrestricted 1,000
    BOSTON COLLEGE ANNUAL FUND
    140 COMMONWEALTH AVE
    CHESTNUT HILL,MA02467     		N/A 509a1 Endowment for the Integrated Sciences Scholarship Fund 15,000
    BRIDGE OVER TROUBLED WATERS INC
    47 W ST
    BOSTON,MA02111     		N/A 509a1 General Unrestricted 5,000
    CAMP RUNOIA ALUMNAE ORGANIZATION
    PO BOX 450
    BELGRADE LAKES,ME04918     		N/A 509a1 Camper Scholoarships Fund 5,000
    CARINGBRIDGE
    1715 YANKEE DOODLE RD STE 301
    EAGAN,MN55121     		N/A 509a1 General Unrestricted 500
    CHARITY NAVIGATOR
    139 HARRISTOWN RD STE 201
    GLEN ROCK,NJ07452     		N/A 509a1 General Unrestricted 500
    CHILDREN & ADULTS WITH ATTENTION-DEFICIT HYPERACTIVITY DISORDER
    8181 PROFESSIONAL PL STE 150
    LANDOVER,MD20785     		N/A 509a2 General Unrestricted 2,000
    CHILDRENS MUSEUM INC
    950 TROUT BROOK DR
    WEST HARTFORD,CT06119     		N/A 509a2 Roaring Brook Nature Center 2,000
    CHURCH WORLD SERVICE INC
    PO BOX 968
    ELKHART,IN46515     		N/A 509a1 General Unrestricted 20,000
    CIRCLE OF LIFE ARTS FOR ALL INC
    50 CHAPMAN PL BOX 3
    EAST HARTFORD,CT06108     		N/A 509a1 General Unrestricted 1,000
    CIVA CHRISTIANS IN VISUAL ARTS
    225 GRAPEVINE RD
    WENHAM,MA01984     		N/A 509a2 General Unrestricted 500
    COMPASSION INTERNATIONAL INCORPORATED
    12290 VOYAGER PKWY
    COLORADO SPRINGS,CO80921     		N/A 509a2 General Fund 10,000
    COMPASSION INTERNATIONAL INCORPORATED
    12290 VOYAGER PKWY
    COLORADO SPRINGS,CO80921     		N/A 509a2 Leadership Training Project 10,000
    CONGREGATIONAL CHURCH OF TOPSFIELD MASSACHUSETTS INC
    9 E COMMON ST
    TOPSFIELD,MA01983     		N/A 509a1 General Unrestricted 25,000
    CONTAINERS 2 CLINICS INC
    1000 GREAT PLAIN AVE STE 3
    NEEDHAM,MA02492     		N/A 509a1 General Unrestricted 5,000
    COOPERATIVE FOR ASSISTANCE AND RELIEF EVERYWHERE INC - CARE
    PO BOX 1871
    MERRIFIELD,VA22116     		N/A 509a1 General Unrestricted 20,000
    COVENANT HOUSE
    460 W 41ST ST
    NEW YORK,NY10036     		N/A 509a1 General Unrestricted 3,000
    DARTMOUTH COLLEGE
    6066 DEVELOPMENT OFC
    HANOVER,NH03755     		N/A 509a1 Bibi to Bibi 2,000
    DISABLED SPORTS USA -NEW ENGLAND DISABLED SPORTS
    PO BOX 26
    LINCOLN,NH03251     		N/A 509a2 General Unrestricted 5,000
    EAST COAST GREENWAY ALLIANCE INC
    5315 HIGHGATE DR STE 105
    DURHAM,NC27713     		N/A 509a1 For Work in Connecticut 5,000
    EASTERN UNIVERSITY - EVANGELICALS FOR SOCIAL ACTION INC
    1300 EAGLE RD
    ST DAVIDS,PA19087     		N/A 509a1 General Unrestricted 5,000
    ENVIRONMENTAL DEFENSE FUND INCORPORATED
    1875 CONNECTICUT AVE NW STE 600
    WASHINGTON,DC20009     		N/A 509a1 General Unrestricted 2,500
    ESSEX COUNTY GREEN BELT ASSOCIATION INC
    82 EASTERN AVE
    ESSEX,MA01929     		N/A 509a1 General Unrestricted 10,000
    FARMINGTON RIVER WATERSHED ASSOCIATION INC
    749 HOPMEADOW ST
    SIMSBURY,CT06070     		N/A 509a2 General Unrestricted 4,000
    FARMINGTON VALLEY TRAILS COUNCIL
    PO BOX 576
    TARIFFVILLE,CT06081     		N/A 509a1 General Unrestricted 1,000
    FOODSHARE INC
    450 WOODLAND AVE
    BLOOMFIELD,CT06002     		N/A 509a1 General Unrestricted 5,000
    FRIENDS OF MAITI NEPAL A NON-PROFIT CORPORATION
    63 COMMERCIAL WHARF
    BOSTON,MA02110     		N/A 509a2 General Unrestricted 1,000
    GIFTS OF LOVE INC
    PO BOX 463
    AVON,CT06001     		N/A 509a1 General Unrestricted 2,000
    GRAMEEN AMERICA INC
    1460 BROADWAY 8TH FL
    NEW YORK,NY10036     		N/A 509a1 General Unrestricted 2,000
    GRAMEEN FOUNDATION USA
    1101 15TH ST NW 3RD FL
    WASHINGTON,DC20005     		N/A 509a1 General Unrestricted 1,000
    HABITAT FOR HUMANITY INTERNATIONAL INC
    1276 S 500 W
    SALT LAKE CTY,UT84101     		N/A 509a1 General Unrestricted 3,000
    HARTFORD CHORALE INC
    233 PEARL ST STE 17
    HARTFORD,CT06103     		N/A 509a2 General Unrestricted 1,000
    HEIFER PROJECT INTERNATIONAL
    1 WORLD AVE
    LITTLE ROCK,AR72202     		N/A 509a1 General Unrestricted 1,000
    HOPE FOR HAITI INC
    1021 5TH AVE N
    NAPLES,FL34102     		N/A 509a1 General Unrestricted 5,000
    HOSPICE CARE CORPORATION
    RT 92 S G RD
    ARTHURDALE,WV26520     		N/A 509a1 General Unrestricted 1,000
    INTERNATIONAL RESCUE COMMITTEE INC
    122 E 42ND ST
    NEW YORK,NY10168     		N/A 509a1 General Unrestricted 15,000
    INTERVARSITY CHRISTIAN FELLOWSHIP- USA
    6400 SCHROEDER RD
    MADISON,WI53711     		N/A 509a2 General Unrestricted 2,000
    IPSWICH RIVER WATERSHED ASSOCIATION INC
    PO BOX 576
    IPSWICH,MA01938     		N/A 509a2 General Unrestricted 10,000
    LAND TRUST ALLIANCE INCORPORATED
    1660 L ST NW STE 1100
    WASHINGTON,DC20036     		N/A 509a1 National Work Northeast Program for all Volunteer Land Trusts 20,000
    LONG ISLAND RIDING FOR THE HANDICAPPED ASSOC INC
    PO BOX 352
    GLEN HEAD,NY11545     		N/A 509a2 General Unrestricted 1,000
    LUNG CANCER RESEARCH FOUNDATION
    800 3RD AVE 4TH FL
    NEW YORK,NY10022     		N/A 509a1 General Unrestricted 500
    LWALA COMMUNITY ALLIANCE INC
    PO BOX 60688
    NASHVILLE,TN37206     		N/A 509a1 General Unrestricted 5,000
    MASSACHUSETTS AUDUBON SOCIETY INC
    208 S GREAT RD
    LINCOLN,MA01773     		N/A 509a1 Ipswich River Wildlife Sanctuary Division 25,000
    MASSACHUSETTS GENERAL HOSPITAL-THE SCHWARTZ CENTER FOR COMPASSIONATE HEALTH
    165 CAMBRIDGE ST STE 600
    BOSTON,MA02114     		N/A 509a1 General Unrestricted 8,663
    MEMORIAL UNITED METHODIST CHURCH
    867 W AVON RD
    AVON,CT06001     		N/A 509a1 General Unrestricted 20,000
    MEMORIAL UNITED METHODIST CHURCH
    867 W AVON RD
    AVON,CT06001     		N/A 509a1 Debt Reduction Fund 20,000
    NATIONAL PUBLIC RADIO INC
    635 MASS AVE NW
    WASHINGTON,DC20001     		N/A 509a1 WNPR Division 1,000
    NATIVE AMERICAN HERITAGE ASSOCIATION
    830 JOHN MARSHALL HWY STE F
    FRONT ROYAL,VA22630     		N/A 509a1 General Unrestricted 4,000
    NEW ENGLAND INSTITUTE OF RELIGIOUS RESEARCH INC
    18 CROOKED LN
    LAKEVILLE,MA02347     		N/A 509a1 General Unrestricted 50,000
    NEW HAMPSHIRE COMMUNITY LOAN FUND
    7 WALL ST
    CONCORD,NH03301     		N/A 509a1 General Unrestricted 5,000
    NEW OPPORTUNITY SCHOOL FOR WOMEN INC
    204 CHESTNUT ST
    BEREA,KY40403     		N/A 509a1 General Unrestricted 500
    NEW TRIBES MISSION INC
    1000 E 1ST ST
    SANFORD,FL32771     		N/A 509a1 Work of Randy and Diana Smyth 1,500
    NEW YORK RESTORATION PROJECT
    254 W 31ST ST FL 10
    NEW YORK,NY10001     		N/A 509a1 General Unrestricted 1,000
    POLARIS PROJECT
    PO BOX 53315
    WASHINGTON,DC20009     		N/A 509a1 General Unrestricted 5,738
    PRESBYTERIANS FOR RENEWAL INC
    8134 NEW LAGRANGE RD
    LOUISVILLE,KY40222     		N/A 509a1 General Unrestricted 4,000
    PUPPIES BEHIND BARS INC
    263 W 38 ST STE 4E
    NEW YORK,NY10018     		N/A 509a1 General Unrestricted 1,000
    RANDOLPH COUNTY COMMUNITY ARTS COUNCIL
    PO BOX 3111
    ELKINS,WV26241     		N/A 509a1 General Unrestricted 2,000
    REVELS INC
    80 MOUNT AUBURN ST
    WATERTOWN,MA02472     		N/A 509a2 General Unrestricted 500
    RIPON COLLEGE BOARD OF TRUSTEES
    PO BOX 248
    RIPON,WI54971     		N/A 509a1 General Unrestricted 5,000
    SALT LAKE CITY BICYCLE COLLECTIVE
    PO BOX 2400
    SALT LAKE CTY,UT84110     		N/A 509a1 General Unrestricted 7,500
    SALVATION ARMY NATIONAL CORP
    615 SLATERS LN PO BOX 269
    ALEXANDRIA,VA22314     		N/A 509a1 Victims of Hurricane Sandy 1,138
    SALVATION ARMY NATIONAL CORP
    615 SLATERS LN PO BOX 269
    ALEXANDRIA,VA22314     		N/A 509a1 Greater Hartford Area 10,000
    SALVATION ARMY NATIONAL CORP
    615 SLATERS LN PO BOX 269
    ALEXANDRIA,VA22314     		N/A 509a1 Southern New England Area 10,000
    SAT-7 NORTH AMERICA
    PO BOX 2770
    EASTON,MD21601     		N/A 509a1 General Unrestricted 4,000
    SAVEKITTY FOUNDATION
    PO BOX 260096
    BELLEROSE,NY11426     		N/A 509a1 General Unrestricted 1,000
    SILENT SPRING INSTITUTE INC
    29 CRAFT ST
    NEWTON,MA02458     		N/A 509a1 General Unrestricted 1,000
    SIM USA INCORPORATED
    14830 CHOATE CIR
    CHARLOTTE,NC28273     		N/A 509a1 Work of Corey and Katie Garrett 2,000
    SIMMONS COLLEGE
    300 THE FENWAY
    BOSTON,MA02115     		N/A 509a1 School of Health Sciences Pilot Program in Interdisciplinary Studies 25,000
    SIMSBURY LAND TRUST INC
    PO BOX 634
    SIMSBURY,CT06070     		N/A 509a1 General Unrestricted 12,000
    SIMSBURY LAND TRUST INC
    PO BOX 634
    SIMSBURY,CT06070     		N/A 509a1 2012 Stewardship Campaign 8,162
    ST JOHN SCHOOL OF THE ARTS INC 108 ESTATE ENIGNED & CONTANT
    PO BOX 180
    ST JOHN,VI00831     		N/A 509a1 General Unrestricted 100
    THE FISTULA FOUNDATION
    1900 THE ALAMEDA STE 500
    SAN JOSE,CA95126     		N/A 509a1 General Unrestricted 1,000
    THE GREATER BOSTON FOOD BANK INC
    70 S BAY AVE
    BOSTON,MA02118     		N/A 509a1 General Unrestricted 10,000
    THE NATIONAL MILITARY FAMILY ASSOCIATION INC
    2500 N VAN DORN ST STE 102
    ALEXANDRIA,VA22302     		N/A 509a1 General Unrestricted 2,000
    THE NATURE CONSERVANCY - MAINE CHAPTER
    FORT ANDROSS 14 MAINE ST 401
    BRUNSWICK,ME04011     		N/A 509a1 TNCs Work in Africa 25,000
    THE SEVEN HILLS SCHOOLS
    5400 RED BANK RD
    CINCINNATI,OH45227     		N/A 509a1 Student Scholarships Fund 5,000
    THE TRUST FOR PUBLIC LAND
    101 WHITNEY AVE 2ND FL
    NEW HAVEN,CT06510     		N/A 509a1 Connecticut Projects 25,000
    THE TRUST FOR PUBLIC LAND - MONTPELIER VERMONT
    3 SHIPMAN PL
    MONTPELIER,VT05602     		N/A 509a1 Androscoggin Headwaters 50,000
    THE TRUST FOR PUBLIC LAND - MONTPELIER VERMONT
    3 SHIPMAN PL
    MONTPELIER,VT05602     		N/A 509a1 Androscoggin Headwaters 50,000
    THEATERWORKS INC
    233 PEARL ST
    HARTFORD,CT06103     		N/A 509a2 General Unrestricted 1,000
    TILLETT FOUNDATION INC - ARTS ALIVE
    TILLETT GARDENS 4126 ANNAS RETREAT
    ST THOMAS,VI00802     		N/A 509a1 General Unrestricted 400
    TRUSTEES OF RESERVATIONS
    572 ESSEX ST
    BEVERLY,MA01915     		N/A 509a1 General Unrestricted 5,000
    UNIVERSITY OF ROCHESTER
    910 GENESEE ST STE 200
    ROCHESTER,NY14611     		N/A 509a1 Barbara Taylor Scholarship Fund 100
    UTAH YOUTH VILLAGE
    5790 S HIGHLAND DR
    SALT LAKE CTY,UT84121     		N/A 509a1 General Unrestricted 5,000
    WARM BLANKETS CHILDRENS FOUNDATION
    5105 TOLLVIEW DR STE 155
    ROLLING MDWS,IL60008     		N/A 509a1 General Unrestricted 3,000
    WASATCH PUBLIC MEDIA
    PO BOX 510730
    SALT LAKE CTY,UT84151     		N/A 509a1 General Unrestricted 5,000
    WGBH EDUCATIONAL FOUNDATION
    PO BOX 55875
    BOSTON,MA02205     		N/A 509a1 General Unrestricted 5,000
    WORLD RELIEF CORP OF NATIONAL ASSOCIATION OF EVANGELICALS
    7 E BALTIMORE ST
    BALTIMORE,MD21202     		N/A 509a1 General Unrestricted 500
    WORLD WILDLIFE FUND INC
    1250 24TH ST NW PO BOX 97180
    WASHINGTON,DC20090     		N/A 509a1 General Unrestricted 2,500
    YORKVILLE COMMON PANTRY
    8 E 109TH ST
    NEW YORK,NY10029     		N/A 509a1 General Unrestricted 2,000
    YOUTH ENRICHMENT SERVICES INC
    412 MASSACHUSETTS AVE
    BOSTON,MA02118     		N/A 509a1 Challenge Grant for Operation Snow Sport and Unrestricted 5,000
    ZACHARY AND ELIZABETH M FISHER CENTER FOR ALZHEIMERS RESEARCH FDN
    ONE INTREPID SQ 46TH ST 12TH
    NEW YORK,NY10036     		N/A 509a1 General Unrestricted 2,000
    ZOOLOGICAL SOCIETY OF CINCINNATI
    3400 VINE ST
    CINCINNATI,OH45220     		N/A 509a1 Rhino Program 10,000
    ZOOLOGICAL SOCIETY OF CINCINNATI
    3400 VINE ST
    CINCINNATI,OH45220     		N/A 509a1 Signature Rhino 12,000
    Total .................................bullet 3a 721,001
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2012)
    Form 990-PF (2012)
    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 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....     14 427,318  
    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 -233,436  
    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)..   193,882  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13193,882
    (See worksheet in line 13 instructions 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 foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2012)
    Form 990-PF (2012)
    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
    Sign Here
    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
    May the IRS discuss this return
    with the preparer shown below
    (see instr.)?
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's namebullet



    Firm's addressbullet







         		Firm's EINbullet
    Phone no.
    Form 990-PF (2012)
    Additional Data


    Software ID: 12000057
    Software Version: 12.15.422.1
    Part VI Line 7 - Tax Paid Original Return: 6500


    Form 990PF - Special Condition Description:
    Special Condition Description

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

    TY 2012 GainLossSaleOtherAssetsSch
    Name:
    Chase Family Foundation
    EIN: 31-6038352
    Software ID:12000057
    Software Version:12.15.422.1
    Name Date Acquired How Acquired Date Sold Purchaser Name Gross Sales Price Basis Basis Method Sales Expenses Total (net) Accumulated Depreciation
    Publicly-traded Securities         466,792 700,231     -233,439  

    TY 2012 GeneralExplanationAttachment
    Name:
    Chase Family Foundation
    EIN: 31-6038352
    Software ID:12000057
    Software Version:12.15.422.1
    Identifier Return Reference Explanation

    TY 2012 InvestmentsCorpStockSchedule
    Name:
    Chase Family Foundation
    EIN: 31-6038352
    Software ID:12000057
    Software Version:12.15.422.1
    Name of Stock End of Year Book Value End of Year Fair Market Value
    1500 shares of 3M CO 126,960 139,275
    4000 shares of ABBOTT LABS 215,724 262,000
    1700 shares of APPLE INC. 217,164 904,693
    10397 shares of ARTISAN INTERNATIONAL FUND 244,150 255,656
    5000 shares of ATT CORP COM NEW 139,355 168,550
    10354 shares of BLACKROCK GLOBAL ALLOC I 200,000 205,321
    10000 shares of BLACKROCK INTL OPPTY PORTF INSTI CLASS 281,162 342,600
    3500 shares of CHEVRON CORP 165,563 378,490
    2800 shares of CHUBB CORP 142,817 210,896
    8000 shares of COCA-COLA CO 209,781 290,000
    2000 shares of DEERE CO 172,972 172,840
    1200 shares of DEVON ENERGY CORPORATION 84,929 62,448
    4605 shares of EAGLE SMALL CAP GROWTH I 180,000 201,504
    3600 shares of EMERSON ELECTRIC CO. 138,348 190,656
    2406 shares of EOG RESOURCES INC 57,332 290,621
    2430 shares of EXPRESS SCRIPTS HOLDING CO. 74,915 131,220
    5800 shares of EXXON MOBIL CORP 242,279 501,990
    50559 shares of FIDELITY ADVISOR FLOATING RATE HIGH INCOME CL I 488,765 501,545
    8000 shares of GENERAL ELECTRIC CO 321,666 167,920
    4000 shares of GENERAL MILLS INC 98,074 161,680
    1500 shares of GOLDMAN SACHS GROUP 160,889 191,340
    8000 shares of HARBOR FDS INTL FD 339,370 496,960
    10094 shares of HARDING LOEVNER INTL EQU 150,000 160,902
    6000 shares of INTEL CORP 187,294 123,720
    2000 shares of INTERNATIONAL BUSINESS MACHINES 215,949 383,100
    2500 shares of ISHARES BARCLAYS TIPS BOND FUND 249,188 303,525
    3500 shares of ISHARES COHEN STEERS REALTY MAJORS INDEX FUND 181,669 274,890
    5500 shares of ISHARES IBOXX INVESTMENT GRADE CORPORATE BOND FD 546,395 665,445
    7000 shares of ISHARES MSCI EMERGING MARKETS INDEX FD 207,865 310,450
    7000 shares of ISHARES MSCI PACIFIC EX-JAPAN 219,626 329,980
    2400 shares of ISHARES NASDAQ BIOTECHNOLOGY 161,147 329,328
    3000 shares of ISHARES TR S P MIDCAP 400 INDEX FD 180,546 305,100
    5000 shares of JOHNSON JOHNSON 251,886 350,500
    3000 shares of JP MORGAN CHASE CO 2,131 131,907
    2600 shares of MACYS INC 78,805 101,452
    3150 shares of MCDONALDS CORP 200,962 277,862
    2000 shares of MERCK CO INC. 93,606 81,880
    6800 shares of MICROSOFT CORPORATION 244,498 181,626
    1000 shares of MONSANTO CO 82,623 94,650
    1000 shares of NATL OILWELL VARCO 78,824 68,350
    4600 shares of NEXTERA ENERGY, INC 147,659 318,274
    2225 shares of NORTHROP GRUMMAN CORP 76,373 150,366
    6000 shares of ORACLE CORP 7,742 199,920
    3000 shares of PEPSICO INC 136,041 205,290
    224 shares of PERKINS SMALL CAP VALUE FUND CLASS I 4,610 4,717
    4000 shares of PFIZER INC. 150,599 100,316
    53737 shares of PIMCO TOTAL RETURN FUND 591,556 604,007
    1000 shares of PRAXAIR INC. 76,773 109,450
    13819 shares of PROCTER GAMBLE CO 369,150 938,171
    3000 shares of QUALCOMM INC 91,730 185,579
    3000 shares of SCHLUMBERGER LTD 180,509 207,896
    2000 shares of SEADRILL LTD 74,760 73,600
    13011 shares of T ROWE PRICE MID CAP VALUE 296,452 312,773
    3000 shares of T. ROWE PRICE ASSOCIATES 123,668 195,351
    2500 shares of TARGET CORPORATION 81,666 147,925
    21708 shares of TEMPLETON GLOBAL BD 300,000 289,580
    2568 shares of TEVA PHARMECEUTICAL SP ADR 94,390 95,889
    4200 shares of UNITED TECHNOLOGIES CORP 169,457 344,442
    1000 shares of VANGUARD SM-CAP ETF 75,835 80,900
    25379 shares of VANGUARD TOTAL BOND MARKET INDEX FUND SIGNAL SHARE 256,872 281,452
    4000 shares of VERIZON COMMUNICATIONS 114,453 173,080
    2000 shares of WAL-MART STORES INC. 95,694 136,460
    4000 shares of WALGREEN CO 146,998 148,040
    5500 shares of WALT DISNEY HOLDINGS CO. 150,911 273,845
    3000 shares of WASTE MANAGEMENT INC. 100,680 101,220

    TY 2012 OtherExpensesSchedule
    Name:
    Chase Family Foundation
    EIN: 31-6038352
    Software ID:12000057
    Software Version:12.15.422.1
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Administrative Fees 60,996     60,996
    Bank Charges 658 658    


    TY 2012 OtherProfessionalFeesSchedule
    Name:
    Chase Family Foundation
    EIN: 31-6038352
    Software ID:12000057
    Software Version:12.15.422.1
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Investment Management Services 75,920 75,920    


    TY 2012 TaxesSchedule
    Name:
    Chase Family Foundation
    EIN: 31-6038352
    Software ID:12000057
    Software Version:12.15.422.1
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Estimated Tax for 2012 6,500      
    Excise Tax for 2011 2,293      
    Foreign Tax Paid 574 574