Form990
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2012
Open to Public Inspection
A For the 2012 calendar year, or tax year beginning 04-01-2012 , 2012, and ending 03-31-2013
BCheck if applicable:
CName of organization
C A CANNON CHAR TRUST #1 (#190)
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1525 W WT HARRIS BLVD D1114-044
 
Room/suite
City or town, state or country, and ZIP + 4
CHARLOTTE, NC28288
D Employer identification number

56-6132354
E Telephone number

G Gross receipts $ 38,734,511
F Name and address of principal officer:
WELLS FARGO BANK
1525 WEST W T HARRIS BLVD
CHARLOTTE,NC28288
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
N/A
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1986
M State of legal domicile: NC
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: THE CANNON CHARITABLE TRUST NO 1 AWARDS GRANTS TO VARIOUS ORGANIZATIONS SPECIFIED IN THE GOVERNING TRUST DOCUMENT PRIMARILY FOR HEALTHCARE, HIGHER EDUCATION AND SUPPORT FOR CHURCHES.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 5
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 2
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...... 5 0
6 Total number of volunteers (estimate if necessary) ............. 6  
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) .........   0
9 Program service revenue (Part VIII, line 2g) .........   0
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 10,771,613 10,027,537
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)   0
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 10,771,613 10,027,537
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 7,381,106 7,540,225
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 1,170,564 1,233,182
16a Professional fundraising fees (Part IX, column (A), line 11e).....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 237,830 427,423
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 8,789,500 9,200,830
19 Revenue less expenses. Subtract line 18 from line 12....... 1,982,113 826,707
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 167,798,680 169,296,877
21 Total liabilities (Part X, line 26)............. 0 0
22 Net assets or fund balances. Subtract line 21 from line 20..... 167,798,680 169,296,877
Part II
Signature Block
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 officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2012)
Form 990 (2012)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III ...............
1
Briefly describe the organization’s mission: THE CANNON CHARITABLE TRUST NO 1 AWARDS GRANTS TO VARIOUS ORGANIZATIONS SPECIFIED IN THE GOVERNING TRUST DOCUMENT PRIMARILY FOR HEALTHCARE, HIGHER EDUCATION AND SUPPORT FOR CHURCHES.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 3,016,225 including grants of $ 3,016,225 ) (Revenue $   )
CMC-NORTHEAST MEDICAL CENTER 920 CHURCH STREET NORTH CONCORD NC 28025 TO PROVIDE FUNDS FOR THE GENERAL SUPPORT OF THE HOSPITAL
4b (Code:   ) (Expenses $ 690,000 including grants of $ 690,000 ) (Revenue $   )
WINGATE UNIVERSITY PO BOX 159 WINGATE NC 28174 TO PROVIDE FUNDS FOR THE GENERAL SUPPORT OF THE UNIVERSITY
4c (Code:   ) (Expenses $ 250,000 including grants of $ 250,000 ) (Revenue $   )
LENOIR-RHYNE COLLEGE CAMPUS BOX 7163 HICKORY NC 28603 TO PROVIDE FUNDS FOR THE GENERAL SUPPORT OF THE COLLEGE
(Code:   ) (Expenses $   including grants of $ 3,584,000 ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $ 3,584,000 ) (Revenue $   )
4e Total program service expensesMediumBullet3,956,225
Form 990 (2012)
Form 990 (2012)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? ...
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If “Yes,” complete Schedule C, Part II........
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C,
Part III............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part I........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If “Yes,” complete Schedule D, Part II...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III ....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,” complete Schedule D, Part IV..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part V......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If “Yes,” complete Schedule D, Part VI....................
11a
 
No
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X
11e
 
No
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.........................
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI and XII .................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional
12b
 
No
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the United States? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the United States? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I (see instructions)....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If “Yes,” complete Schedule H....
20a
 
No
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
Form 990 (2012)
Form 990 (2012)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J.......................
23
 
No
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I........
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I...................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II..........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If “Yes,” complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2...
35b
 
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V ...............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
0
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
0
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
 
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes,” to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2012)
Form 990 (2012)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI ...............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
5
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
2
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
 
No
14
Did the organization have a written document retention and destruction policy? .........
14
 
No
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletWELLS FARGO BANK868 NORTH CHURCH STREETCONCORDNC280254350 (704) 262-2347
Form 990 (2012)
Form 990 (2012)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII ...............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) JOSEPH C HUNTER........................................................................
CO-TRUSTEE
 2.00
.......................   		X           141,966 0 0
(2) EDWIN OUTEN........................................................................
CO-TRUSTEE
 2.00
.......................   		X           141,966 0 0
(3) WILLIAM C CANNON........................................................................
CO-TRUSTEE
 2.00
.......................   		X           0 19,480 0
(4) ROBERT C HAYES........................................................................
CHAIRMAN/CO-TRUSTEE
 2.00
.......................   		X           0 19,480 0
(5) WELLS FARGO BANK........................................................................
CORPORATE TRUSTEE
 40.00
.......................   		  X         949,251 70,128 0
























Form 990 (2012)
Form 990 (2012)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;


























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 1,233,183 109,088 0
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet3
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
 
No
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet  
Form 990 (2012)
Form 990 (2012)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response to any question in this Part VIII ..............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet  
Program Service Revenue Business Code
2a
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet  
Other Revenue 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 4,711,323     4,711,323
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 34,023,188  
b Less: cost or other basis and sales expenses 28,706,974  
c Gain or (loss) 5,316,214  
d Net gain or (loss)..........MediumBullet 5,316,214     5,316,214
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet  
12 Total revenue. See Instructions......MediumBullet 10,027,537     10,027,537
Form 990 (2012)
Form 990 (2012)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response to any question in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 7,540,225 7,540,225
2 Grants and other assistance to individuals in the United States. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 1,233,182   1,233,182  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages        
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....        
9 Other employee benefits .......        
10 Payroll taxes ...........        
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 16,427   16,427  
c Accounting ........... 400   400  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........        
12 Advertising and promotion ....        
13 Office expenses ....... 3,990 1,995 1,995  
14 Information technology ......        
15 Royalties ..        
16 Occupancy ...........        
17 Travel ............        
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 1,818 909 909  
20 Interest ...........        
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .....        
23 Insurance ..............        
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a FOREIGN TAXES 225,270 112,635 112,635  
b CANNON SHARED PROPERTY 111,466 55,733 55,733  
c INVESTMENT EXPENSE 51,580 25,790 25,790  
d ADR FEES 8,236 4,118 4,118  
e All other expenses 8,236 4,118 4,118  
25 Total functional expenses. Add lines 1 through 24e 9,200,830 7,745,523 1,455,307 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2012)
Form 990 (2012)
Page 11
Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ............. 8,064 1 51,068
2 Savings and temporary cash investments ......... 991,462 2 7,257,506
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net .............   4  
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use ..............   8  
9 Prepaid expenses and deferred charges ..........   9  
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a  
b Less: accumulated depreciation ..... 10b     10c  
11 Investments—publicly traded securities .......... 166,799,154 11 161,988,303
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 .....   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ...........   15  
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 167,798,680 16 169,296,877
Liabilities 17 Accounts payable and accrued expenses .........   17  
18 Grants payable .................   18  
19 Deferred revenue ................   19  
20 Tax-exempt bond liabilities .............   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................   25  
26 Total liabilities. Add lines 17 through 25......... 0 26 0
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..............   27  
28 Temporarily restricted net assets ...........   28  
29 Permanently restricted net assets ...........   29  
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........ 167,798,680 30 168,765,231
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32 531,646
33 Total net assets or fund balances ........... 167,798,680 33 169,296,877
34 Total liabilities and net assets/fund balances ........ 167,798,680 34 169,296,877
Form 990 (2012)
Form 990 (2012)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI ...............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
10,027,537
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
9,200,830
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
826,707
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
167,798,680
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
671,490
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
169,296,877
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII ..............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If “Yes,” to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
 
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits
3b
 
 
Form 990 (2012)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
C A CANNON CHAR TRUST #1 (#190)
 
Employer identification number

56-6132354
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization? ................
11g(i)
 
No
(ii) A family member of a person described in (i) above? ......................
11g(ii)
 
No
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
No
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization in col. (i) listed in your governing document? (v) Did you notify the organization in col. (i) of your support? (vi) Is the organization in col. (i) organized in the U.S.? (vii) Amount of monetary support
Yes No Yes No Yes No
(A) FIRST MISSIONARY BAP CHUR
  		561572870 1 Yes   Yes   Yes   52,000
(B) GLENROCK BAPTIST CHURCH
  		571043889 1 Yes   Yes   Yes   12,000
(C) GRACE LUTHERAN CHURCH
  		561040991 1 Yes   Yes   Yes   34,000
(D) LUTHERAN THEO SOUTHEN SEM
  		570327888 7 Yes   Yes   Yes   50,000
(E) MIDWAY UMC
  		560791340 1 Yes   Yes   Yes   15,000
(F) NEW BIRTH BAPTIST CHURCH
  		743052478 1 Yes   Yes   Yes   20,000
(G) LIFE WAY BAPTIST CHURCH
  		582451048 1 Yes   Yes   Yes   10,000
(H) PROSPECT PRESBYTERIAN CH
  		560754112 1 Yes   Yes   Yes   23,000
(I) PROVIDENCE PRESBY CHURCH
  		570471778 1 Yes   Yes   Yes   50,000
(J) EAST PICKENS BAPTIST CHUR
  		570523995 1 Yes   Yes   Yes   15,000
(K) WOODLEAF UMC
  		562113420 1 Yes   Yes   Yes   6,000
(L) YORK BAPTIST ASSOC
  		570426922 1 Yes   Yes   Yes   15,000
(M) LEES-MCRAE COLLEGE
  		560529953 2 Yes   Yes   Yes   250,000
(N) CATAWBA COLLEGE
  		560530251 2 Yes   Yes   Yes   250,000
(O) LENOIR-RHYNE COLLEGE
  		560556753 2 Yes   Yes   Yes   250,000
(P) LIVINGSTONE COLLEGE
  		560603922 2 Yes   Yes   Yes   181,000
(Q) CMC-NORTHEAST MEDICAL CEN
  		208776473 3 Yes   Yes   Yes   3,016,225
(R) WINGATE UNIVERSITY
  		566049935 2 Yes   Yes   Yes   690,000
(S) BETHEL BAPTIST CHURCH
  		561717806 1 Yes   Yes   Yes   20,000
(T) EASTSIDE BAPTIST
  		200855278 1 Yes   Yes   Yes   10,000
(U) BOYS AND GIRLS CLUB
  		560577630 7 Yes   Yes   Yes   108,000
(V) BOGER'S CHAPEL UMC
  		560186375 1 Yes   Yes   Yes   15,000
(W) FIRST BAPTIST CHURCH
  		561317291 1 Yes   Yes   Yes   20,000
(X) FIRST CHRISTIAN UCC
  		560543253 1 Yes   Yes   Yes   10,000
(Y) GRACE BAPTIST CHURCH
  		560857926 1 Yes   Yes   Yes   25,000
(Z) GETHSEMANE MISS BAP CH
  		561287627 1 Yes   Yes   Yes   25,000
(AA) NORWOOD CHURCH OF THE NAZ
  		581371049 1 Yes   Yes   Yes   10,000
(AB) ST MATTHEWS EPISCOPAL CH
  		566064806 1 Yes   Yes   Yes   20,000
(AC) THYATIRA PRESBYTERIAN CHU
  		561236037 1 Yes   Yes   Yes   3,500
(AD) TRINITY CHURCH OF THE NAZ
  		576081999 1 Yes   Yes   Yes   20,000
(AE) CHURCH OF GOD CHILDRENS H
  		560599234 7 Yes   Yes   Yes   75,000
(AF) ST JAMES EVANGELICAL
  		560591309 1 Yes   Yes   Yes   25,000
(AG) PRICE MEMORIAL AME ZION
  		561084954 1 Yes   Yes   Yes   47,000
(AH) ST MARK'S LUTHERAN CHURCH
  		566072354 1 Yes   Yes   Yes   10,000
(AI) UNITY UMC
  		561247737 1 Yes   Yes   Yes   40,000
(AJ) CONCORDIA LUTHERAN CHURCH
  		561997338 1 Yes   Yes   Yes   30,000
(AK) CABARRUS COUNTY LIBRARY
  		562581471 6 Yes   Yes   Yes   200,000
(AL) ROCK HILL AME ZION CHURCH
  		561958850 1 Yes   Yes   Yes   20,000
(AM) CENTER GROVE ROAD CHURCH
  		241843594 1 Yes   Yes   Yes   15,000
(AN) MT VERNON PRESBY CHURCH
  		320128329 1 Yes   Yes   Yes   15,000
(AO) MT ZION MISSIONARY BAPTIS
  		204659252 1 Yes   Yes   Yes   10,000
(AP) MT ZION UNITED CHURCH OF
  		566082928 1 Yes   Yes   Yes   5,000
(AQ) NEW BEGINNING BAPTIST CHU
  		571031381 1 Yes   Yes   Yes   25,000
(AR) WESTSIDE CH OF THE NAZ
  		566170610 1 Yes   Yes   Yes   10,000
(AS) WEST OAKBORO BAPTIST CHUR
  		561391494 1 Yes   Yes   Yes   35,000
(AT) PARKERS CHAPEL AME ZION
  		561294294 1 Yes   Yes   Yes   15,000
(AU) SOUTH CHINA GROVE UMC
  		262661502 1 Yes   Yes   Yes   19,000
(AV) WEST BURLINGTON CHURCH OF
  		731633226 1 Yes   Yes   Yes   5,000
(AW) UNIITED PRESBYTERIAN CHUR
  		561403069 1 Yes   Yes   Yes   25,000
(AX) SOUTH CHINA GROVE CHURCH
  		561606084 1 Yes   Yes   Yes   53,000
(AY) JACKSON PARK UMC
  		561131506 1 Yes   Yes   Yes   7,200
(AZ) CENTRAL UMC
  		560603902 1 Yes   Yes   Yes   10,000
(BA) ALL SAINTS EPISCOPAL CH
  		560787605 1 Yes   Yes   Yes   35,000
(BB) N KANNAPOLIS UMC
  		560001441 1 Yes   Yes   Yes   20,000
(BC) NEW KIRK BPTIST CHURCH
  		570988996 1 Yes   Yes   Yes   10,000
(BD) UNITED LOVE BAPTIST CHURC
  		561258395 1 Yes   Yes   Yes   10,000
(BE) LIVING WATER CHURCH OF GO
  		561352565 1 Yes   Yes   Yes   35,000
(BF) MT GALLANT CHURCH OF GOD
  		578732619 1 Yes   Yes   Yes   25,000
(BG) STANLEY COMUNITY COLLEGE
  		560994111 2 Yes   Yes   Yes   250,000
(BH) STANLY REGIONAL MEDICAL C
  		560556760 2 Yes   Yes   Yes   96,000
(BI) ST JOHN'S LUTHERAN CHURCH
  		560599230 1 Yes   Yes   Yes   15,000
(BJ) ST LUKE'S LUTHERN CHURCH
  		566047434 1 Yes   Yes   Yes   10,000
(BK) ROWAN-CABARRUS COMM COLLE
  		561731864 2 Yes   Yes   Yes   189,000
(BL) APPLACHIAN REGIONAL HEALT
  		201067022 3 Yes   Yes   Yes   250,000
(BM) BETHL AME ZION CHURCH
  		581579300 1 Yes   Yes   Yes   15,000
(BN) BETHPAGE UMC
  		561389037 1 Yes   Yes   Yes   16,000
(BO) CANTON BAPTIST CHURCH
  		561232494 1 Yes   Yes   Yes   15,000
(BP) CENTRAL BAPTIST CHURCH
  		570737712 1 Yes   Yes   Yes   10,000
(BQ) CHARITY BAPTIST CHURCH
  		561749250 1 Yes   Yes   Yes   15,000
(BR) CHRIST EPISCOPAL CHURCH
  		566047521 1 Yes   Yes   Yes   10,000
(BS) CONCORD CHRH OF NAZARENE
  		566170590 1 Yes   Yes   Yes   5,000
(BT) FIRST BAPTIST OF GOLD HIL
  		561535868 1 Yes   Yes   Yes   10,000
(BU) EBENEZER EVANGELICAL LUTH
  		561315896 1 Yes   Yes   Yes   15,000
(BV) FIRST CHURCH OF GOD
  		566167596 1 Yes   Yes   Yes   10,000
(BW) FIRST PRESBYTERIAN CHURC
  		236398337 1 Yes   Yes   Yes   10,000
(BX) FIRST PRESBYTERIAN
  		560529969 1 Yes   Yes   Yes   10,000
(BY) FIRST PRIMITIVE BAPTIST C
  		561149291 1 Yes   Yes   Yes   9,000
(BZ) FLINT HILL BAPTIST CHURCH
  		570741653 1 Yes   Yes   Yes   5,000
(CA) FRANKLIN HEIGHTS BAPTIST
  		560883984 1 Yes   Yes   Yes   7,300
(CB) FREEDOM CHRISTIAN CHURCH
  		561582701 1 Yes   Yes   Yes   15,000
(CC) FRIENDSHIP FREEWILL BAPTI
  		561529293 1 Yes   Yes   Yes   8,000
(CD) FRIENDSHIP UMC
  		561388710 1 Yes   Yes   Yes   15,000
(CE) GILMORE CHAPEL AME ZION
  		561384563 1 Yes   Yes   Yes   15,000
(CF) GRACE EVANGELICAL LUTHERA
  		561119038 1 Yes   Yes   Yes   10,000
(CG) HILLSIDE PRESBYTERIAN CHU
  		123216547 1 Yes   Yes   Yes   10,000
(CH) MAIN STREET BAPTIST CHURC
  		561821137 1 Yes   Yes   Yes   13,000
(CI) MCGILL AVE BAPTIST CHURCH
  		560585245 1 Yes   Yes   Yes   35,000
(CJ) MIFORD HILLS UMC
  		560791341 1 Yes   Yes   Yes   10,000
(CK) MISSION 217 BAPTIST CHURC
  		454337155 1 Yes   Yes   Yes   10,000
(CL) MISSION BAPTIST CHURCH
  		561187930 1 Yes   Yes   Yes   40,000
(CM) MTOLIVE EVANGELICAL LUTH
  		561764587 1 Yes   Yes   Yes   10,000
(CN) NORTH MAIN BAPTIST CHURCH
  		581313646 1 Yes   Yes   Yes   20,000
(CO) OAKLAND BAPTIST CHURCH
  		570792932 1 Yes   Yes   Yes   10,000
(CP) PHEIFFER uNIVERSITY
  		560529990 2 Yes   Yes   Yes   200,000
(CQ) PICKEN'S 12 MILE BAPTIST
  		570527739 1 Yes   Yes   Yes   20,000
(CR) PLEASANT GROVE BAPTIST CH
  		562188365 1 Yes   Yes   Yes   35,000
(CS) ROCKY RIDGE UMC
  		566170457 1 Yes   Yes   Yes   10,000
(CT) RODDEY BAPTIST
  		570699159 1 Yes   Yes   Yes   10,000
(CU) ST ANDREW'S EPISCOPAL CHU
  		581488820 1 Yes   Yes   Yes   15,000
Total                 7,540,225

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2012

Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
C A CANNON CHAR TRUST #1 (#190)
 
Employer identification number
56-6132354
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) Concordia Lutheran Church
5300 Poplar Tent Rd
Concord,NC28027 		56-0585245   23,000       Faith Community Nurse Program
(2) First Missionary Baptist Church
POB 1322
Concord,NC28026 		56-1572870   32,000       Faith Nurse Community Program
(3) South China Grove Church of God
163 Third Ave
China Grove,NC28023 		56-1606084   19,000       Building Repair Project
(4) Westside Church of the Nazarene
4700 Isenhour Rd
Kannapolis,NC28081 		56-6170610   10,000       Complete Building Program
(5) Church of God Children's Home
3485 Orphange Circle
Concord,NC560599234 		  75,000        
(6) Lees McRae College
375 College Dr
Banner Elk,NC28604 		56-0529953   250,000       Avery Residence Hall Renovation
(7) Rock Hill AME Zion Church
3620 Rock Hill Church Road
Concord,NC28027 		56-1958850   20,000       Debt Reduction
(8) Rowan Cabarrus Community College Foundation Inc
PO Box 1595
Salisbury,NC28145 		56-1731864   189,000       Operational Support North Campus Facilities
(9) Stanly Regional Medical Center
PO Box 1489
Albemarle,NC28002 		56-0556760   96,000       Cancer Support Resource Center/Advocacy Center Director/Case Manager
(10) Boys and Girls Club of Cabarrus County Inc
PO Box 1405
Concord,NC28026 		56-0577630   108,000       Safety procedures upgrade/Play and Fitness structure
(11) Bethel Baptist Church
2474 Dale Earnhardt Blvd
Kannapolis,NC28083 		56-1717806   20,000       Debt reduction
(12) Christ Episcopal Church
3430 Old US Hwy 70
Cleveland,NC27013 		  10,000        
(13) Freedom Christian Worship center - Church of God
607 China Grove Hwy 152 East
Rockwell,NC28138 		56-1582701   15,000       Food Pantry Buiding Project
(14) Gethsemane Missionary Baptist Church
719 South Caldwell Street
Salisbury,NC28144 		56-1287627   25,000       After school tutoring & youth mentoring program
(15) Living Water Church of God
120 S Little Texas Road
Kannapolis,NC28083 		56-1352565   35,000       Support for the Faith Community Healthcare Provider
(16) Mt Gallant Church of God
11105 Mount Gallant Rd
Rock Hill,SC29732 		57-8732619   25,000       Remodel children's church
(17) Unity UMC
8505 Unity Church Rd
Kannapolis,NC28081 		56-1247737   40,000       Mobile meals ministry
(18) Central UMC
30 Union St North
Concord,NC28025 		56-0603902   10,000       Parlor Renovation Project
(19) First Christian United Church of Christ
PO Box 1678
Burlington,NC272161678 		56-0543253   10,000       A/C replacement & Parking Lot Project
(20) First Missionary Baptist Church
PO Box 1322
Concord,NC28026 		56-1572870   20,000       Summer Youth Project
(21) Mt Vernon Presbyterian Church
435 Carson Rd
Woodleaf,NC27054 		32-0128329   15,000       Community Garden Multi Purpose Building
(22) New Birth Baptist Church
600 Annafrel St
Rock Hill,SC29730 		74-3052478   20,000       Replace Heat Pump & Minor Improvment
(23) Providence Presbytery
515 Oakland Ave
Rock Hill,SC29730 		57-0471778   50,000       New cabin construction at Bethelwoods Camp & Conference Center for York SC on behalf of 22 york county presbyterian churches
(24) St James Evangelical Lutheran Church
104 Union Street South
Concord,NC28025 		56-0591309   25,000       Window replacement project
(25) All Saint's Episcopal Church
252 Lake Concord RD NE
Concord,NC28025 		56-0787605   35,000       Debt Reduction
(26) Cabarrus County fbo Library System
PO Box 707
Concord,NC28026 		56-2581471   200,000       Supplemental funding for the Cabarrus County public library
(27) Carolinas Medical Center - Northeast
920 Church Street N
Concord,NC28025 		20-8776473   3,016,225       Required 40% distribution
(28) Catawba College
2300 West Innes Street
Salisbury,NC28144 		56-0530251   250,000       Remodel of Salisbury-Rowan Residence Hall
(29) Centergrove Road Church of Christ
2306 Centergrove Rd
Kannapolis,NC28083 		56-6017710   15,000       Mortgage Assistance, HVAC Replacement
(30) Concordia Lutheran Church
185 Concordia Church Rd
China Grove,NC28023 		56-1997338   7,000       Senior lunch program
(31) First Baptist Church
586 Vincent Street
Norwood,NC28124 		56-1317291   20,000       Sanctuary repair
(32) Glenrock Baptist Church
PO Box 151
Fort Mill,SC29716 		57-1043889   12,000       Van project,debt reduction,limited parking lot paving
(33) Grace Lutheran Church
PO Box 891
Concord,NC28025 		56-1040091   34,000       Faith community health ministry
(34) Lenoir Rhyne University
LR Box 7546
Hickory,NC28601 		56-0556753   250,000       Replacement of admin building's HVAC system & relocation of tele- communication & fiber optic system
(35) Life Way Baptist Church
PO Box 98
York,SC29745 		58-2451048   10,000       Sound & Lighting systems,seating for new facility
(36) Livingstone College
701 W Monroe St
Salisbury,NC28144 		56-0603922   181,000       Capital improvementsto Varick auditorium & Tubman Theater
(37) Lutheran Theological Southern Seminary
4201 North Main Street
Columbia,SC29203 		57-0327888   50,000       Establish wireless network for campus; updating 4 clasrooms & 1 auditorium
(38) Midway UMC
108 Bethpage Rd
Kannapolis,NC28081 		56-0791340   15,000       Acoustical renovation of sanctuary
(39) New Beginnings Baptist Church
706 Old North Main Street
Clover,SC29710 		57-1031381   25,000       Support of Gold's kitchen project
(40) Price Memorial AME Zion Church
PO Box 692
Concord,NC28026 		56-1084954   32,000       Building improvements including a/c repair/ replacement & sound system upgrade request
(41) Prospect Presbyterian Church
9425 WNC 152 Highway
Mooresville,NC28115 		56-0754112   23,000       Faith community health ministry
(42) St Marks Lutheran Church
326 North Main Street
China Grove,NC28023 		56-6072354   10,000       Sanctuary floor renovation
(43) United Presbyterian Church
PO Box 28
Woodleaf,NC27054 		56-1403036   25,000       Facility expansion project
(44) Wingate University
PO Box 159
Wingate,NC28174 		56-6049935   690,000       New & renovated campus housing
(45) Woodleaf UMC
PO Box 299
Woodleaf,NC27054 		56-2113420   6,000       Faith community nurse program
(46) Appalachian Regional Healthcare System Inc
PO Box 2600
Boone,NC28607 		20-1067022   250,000       Post- Acute Care Facility
(47) Bethel AME Zion Church
2219 Dale Earnhardt Blvd
Kannapolis,NC28083 		58-1579300   15,000       Capital Campaign
(48) Bethpage UMC
109 Felowship Ave
Kannapolis,NC28081 		56-1389037   16,000       Sanctuary A/C Replacement
(49) Boger's Chapel UMC
1775 Flowes Store Rd
Concord,NC28025 		56-0186375   15,000       Sanctuary Florr Restoration
(50) Canton Baptist Church
24615 Endy Rd
Albermarle,NC28001 		56-1232494   15,000       Refurbursing projects
(51) Central Baptist Church
PO Box 689
York,SC29745 		57-0737712   10,000       Various projects
(52) Charity Baptist Church
2420 Brantley Rd
Kannapolis,NC28083 		56-1749250   15,000       Repair roof for main sanctuary, metal flashing and gutter damage
(53) East Pickens Baptist Church
2244 Gentry Memorial Hwy
Pickens,SC29671 		57-0523995   15,000       Miracle building project
(54) Eastside Baptist Church
199 Elgin Dr NE
Concord,NC28025 		20-0855278   10,000       Renovation of vestibule and parking area
(55) Ebenezer Evangelical Lutheran Church
4914 Old Beatty Ford
China Grove,NC28023 		56-1315895   15,000       HVAC replacement
(56) First Baptist of Gold Hill
16141 Old Beatty Ford Rd
Gold Hill,NC28071 		56-1535868   10,000       Paving ifront of church
(57) First Church of God
231 Corban Ave
SW Concord,NC28025 		56-6167596   10,000       Parking lot project
(58) First Presbyterian Church
POB 789
Concord,NC28026 		23-6398337   10,000       Memorial garden improvements
(59) First Presbyterian Church
508 West Davis St
Burlington,NC27216 		56-0529969   10,000       Facility Upgrade Project
(60) First Primitive Baptist Church
307 Broad Dr
SW Concord,NC28027 		56-1149291   9,000       A/C Repair
(61) Franklin Heights Baptist Church
532 Wright Ave
Kannapolis,NC28083 		56-0883984   7,300       Scouting Project, including scholarships
(62) Friendship FWB Church
532 West 22nd St
Kannaplois,NC28081 		56-1529293   8,000       Restoration of HVAC and Containment
(63) Friendship UMC
4695 Mt Pleasant Rd
South Concord,NC28025 		56-1388710   15,000       Efficient lighting for softball field
(64) Gilmore Chapel AME Zion Church
762 Central Dr
Concord,NC28027 		56-1384563   15,000       HVAC replacement and other projects
(65) Grace Baptist Church
644 Edgemont St
Albermarle,NC28001 		56-0857926   25,000       Various projects, steeple repair, sanctuary repair & exterior work
(66) Grace Evangelical Lutheran Church
3020 Grace Church Rd
Salisbury,NC28147 		56-1119038   10,000       Family Life Center- Sound System Project
(67) Hillside Presbyterian Church
3743 Maple Ave
Burlington,NC27215 		12-3216547   10,000       HVAC Replacement
(68) Jackson Park United Methodist Church
715 Mabel Ave
Kannapois,NC28081 		56-1131506   7,200       Boiler replacement
(69) Main Street Baptist
POB 62
China Grove,NC28023 		56-1821137   13,000       Paving project
(70) McGill Avenue Baptist Church
5300 Poplar Tent Rd
Concord,NC28027 		56-0585245   35,000       Debt reduction
(71) Milford Hills UMC
1630 Stateville Blvd
Salisbury,NC28144 		56-0791341   10,000       Debt reduction
(72) Mission 217 Baptist Church
465 S Cannon Blvd
Kannapolis,NC28083 		45-4331716   10,000       Sanctuary equipment
(73) Mission Baptist Church
12444 Mission Church Rd
Locust,NC28097 		56-1187930   40,000       Building re-use project, expansion of children's space
(74) Mt Olive Evangelical Lutheran Church
9400 Gold Hill
Mt Pleasant,NC28124 		56-1764587   10,000       Renovation of fellowship building
(75) Mt Zion Missionary Baptist Church
401 Wall Street
Albermarle,NC28001 		20-4659252   10,000       Facility upgrade projects
(76) New Kirk Baptist Church
175 Museum Rd
Rock Hill,SC29732 		57-0988996   10,000       New family life center gym completion
(77) North Kannapolis UMC
1307 North Main St
Kannapolis,NC28081 		56-6001441   20,000       Debt reduction
(78) North Main Baptist Church
1501 N Main St
Salisbury,NC28144 		58-1313646   20,000       Repair and remodeling of sanctuary & other needed repairs
(79) Oakland Baptist Church
1067 Oakland Ave
Rock Hill,SC29732 		57-0792932   10,000       Debt reduction
(80) Parkers Chapel AME Zion Church
578 Old Charlotte Road
Concord,NC28027 		56-1294294   15,000       HVAC Replacement
(81) Pfeiffer University
PO Box960
Misenheimer,NC28109 		56-0529990   200,000       Harris Hall renovation & marketing/branding support
(82) Pickens- 12 Mile Baptist Association
POB 902
Pickens,SC29671 		57-0527739   20,000       Mary's House operations
(83) Pleasant Grove Baptist Church
17236 Frog Pond Rd
Oakboro,NC28129 		56-2188365   35,000       Sanctuary renovation & remodeling
(84) Price Memorial AME Zion Church
POB 692
Concord,NC28026 		56-1084954   15,000       Renovation project - additional grant
(85) Rocky Ridge UMC
1428 Old Charlotte Rd
Concord,NC28027 		56-6170457   10,000       Family Life Center construction
(86) Roddey Baptist Church
PO Box 36
Catawba,SC29704 		57-0699159   10,000       FFinish land project for Family Life Center
(87) Norwood Church of the Nazarene
POB1099
Norwood,NC28128 		58-1371049   10,000       Parking Lot Improvement
(88) Saint Andrew's Episcopal Church
PO Box 849 Rt 70
Haw River,NC27258 		58-1488820   15,000       Window protection & community garden water project
(89) South China Grove Church of God
163 Third Ave
China Grove,NC28023 		56-1606084   53,000       Faith Community Nurse & Renovation of FCN facility
(90) St John's Lutheran Church
100 St Johns Church Rd
Concord,NC28025 		56-0599230   15,000       Installation of heat pump system
(91) St Lukes Lutheran Church
11020 NC Hwy 801
Mt Ulla,NC28125 		56-0599230   10,000       Fellowship building capital campaign support
(92) St Matthews Episcopal Church San Matoe Ministry
4401 Stateville Blvd
Statesville,NC28147 		56-6064806   20,000       Parish house renovation project
(93) Stanly Community College Stanly Community College Foundation
141 College Dr
Albermarle,NC28001 		56-0994111   250,000       Allied health campus concentration project
(94) Trinity United Presbyterian Church of Salisbury
PO Box 1046
Salisbury,NC28145 		56-1357571   20,000       Heating and Air Condition systems renovation
(95) United Love Baptist Church
11487 Flowes Store Rd
Midland,NC28107 		56-1258395   10,000       Foundation work
(96) West Oakboro
16803 Silver Rd
Oakboro,NC28129 		56-1391494   35,000       Debt reduction
(97) York Baptist Assocaition
434 Museum Rd
Rock Hill,SC29732 		57-0426922   15,000       York County Christian Women's Job Corps
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
 
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2012

Schedule I (Form 990) 2012
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance












Part IV
Supplemental Information.
Complete this part to provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Identifier Return Reference Explanation
910 EXPLANATION FOR FORM 990, SCHEDULE I, PART 1, LINE 2 ORGANIZATIONS ARE REQUIRED TO SUBMIT A DETAILED LIST OF ACTIVITIES FOR WHICH THE GRANT FUNDS WERE USED, AT THE END OF THE YEAR.
Schedule I (Form 990) 2012


Additional Data


Software ID:  
Software Version:  


SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
C A CANNON CHAR TRUST #1 (#190)
 
Employer identification number

56-6132354
Identifier Return Reference Explanation
EXPLANATION FOR FORM 990, PAGE 2, PART III, LINE 4d   TO PROVIDE GENERAL SUPPORT FOR THE VARIOUS CHARITIES.
DESCRIPTION OF REASONABLE EFFORTS UNDERTAKEN FORM 990, PAGE 6, PART VI, LINE 2 ROBIN C HAYES AND WILLIAM C CANNON JR ARE COUSINS
FORM 990, PAGE 6, PART VI, LINE 11-DESCRIPTION OF PROCESS FOR REVIEW   WELLS FARGO AS CO-TRUSTEE IS RESPONSIBLE FOR THE PREPARATION OF FORM 990 BASED ON THE FINANCIAL DATA CONTAINED IN OUR RECORDS. UPON COMPLETION, A COPY OF FORM 990 IS FORWARDED TO LEGAL REPRESENTATIVES OF THE GOVERNING BODY AND THE CO-TRUSTEES FOR REVIEW AND APPROVAL. ONCE APPROVED BY THOSE PARTIES, FORM 990 IS THEN FILED WITH THE FEDERAL TAXING AUTHORITY BY THE REGULATORY DEADLINE.
EXPLANATION FOR FORM 990, PAGE 6, PART VI, LINE 12c   THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY BY ALL MEMBERS OF THE GOVERNING BODY.
DESCRIPTION OF PROCESS FOR DETERMINING COMPENSATION FORM 990, PAGE 6, PART VI, LINE 15b THE FEE AND COMPENSATION ARRANGEMENT FOR THE CANNON TRUST 1 IS DETERMINED BY THE TRUSTEES. VARIOUS BASIS POINTS ARE USED TO ARRIVE AT THE COMPENSATION OF THE CORPORATE TRUSTEE AS WELL TWO MEMBERS THE BOARD OF TRUSTEES WHO RECEIVE COMPENSATION..
DESCRIPTION FOR MAKING DOCUMENTS PUBLIC FORM 990, PAGE 6, PART VI, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENT,FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. THE AVAILABILITY OF THIS INFORMATION IS COMMUNICATED TO GRANTEES BY A LETTER EACH YEAR AND AN ADVERTISEMENT IS PLACED ANNUALLY IN A LOCAL NEWSPAPER.
EXPLANATION FOR FORM 990, PART XI, LINE 9   Mutual Fund Tax Effective Date Before TYE $25.84, Mutual Fund Posting Date After TYE $ -80.94 Roc Basis Adjustment -$664,039.20 , Accrued Interest Paid Differ TY Effectuve Current TY-4,668.61, Sales with loss posting next ty efffective-$2,701.82, Rounding$-24.91
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2012

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
C A CANNON CHAR TRUST #1 (#190)
 
Employer identification number

56-6132354
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1) C A CANNON TRUST NO 3

1525 WEST W T HARRIS BLVD

CHARLOTTE,NC28288
58-1360259 		SUPPORTING ORGANIZATION NC 501(C)(3) 11(D)-TYPE III-O NA- FILING ORGANIZATION DOES NOT INDIRECTLY CONTROL RELATED ORG'S
 
 
No












For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No












Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
 
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved





Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under section 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V—UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation

Additional Data


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