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
LOUISVILLE PROTESTANT ALTENHEIM
 

Number and street (or P.O. box number if mail is not delivered to street address)936 BARRET AVENUE   Room/suite
City or town, state, and ZIP code
LOUISVILLE, KY40204
A Employer identification number

61-0449634
B Telephone number (see instructions)

(502) 327-9520
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$4,763,528J 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) 75,688
2 Check bullet
3 Interest on savings and temporary cash investments 35,288 35,288  
4 Dividends and interest from securities...... 63,139 63,139  
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 278,020
b Gross sales price for all assets on line 6a 3,551,789
7 Capital gain net income (from Part IV, line 2)...  
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)....... Click to see attachment 2,198,799   2,198,799
12 Total. Add lines 1 through 11........ 2,650,934 98,427 2,198,799
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc.        
14 Other employee salaries and wages...... 1,512,614   1,215,701  
15 Pension plans, employee benefits....... 418,221   418,221  
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule).......        
c Other professional fees (attach schedule).... Click to see attachment 25,365   25,365  
17 Interest...............        
18 Taxes (attach schedule) (see instructions)        
19 Depreciation (attach schedule) and depletion... Click to see attachment 134,110   134,110
20 Occupancy..............        
21 Travel, conferences, and meetings....... 4,921   4,921  
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 674,777 30,730 644,047  
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 2,770,008 30,730 2,442,365 0
25 Contributions, gifts, grants paid........ 0 0
26 Total expenses and disbursements. Add lines 24 and 25 2,770,008 30,730 2,442,365 0
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -119,074
b Net investment income (if negative, enter -0-) 67,697
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............... 2,656 22,761 22,761
2 Savings and temporary cash investments..........      
3 Accounts receivable bullet7,886
Less: allowance for doubtful accounts bullet   5,593 7,886 7,886
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............... 17,986 15,655 15,655
9 Prepaid expenses and deferred charges........... 22,879    
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)........ 4,315,519 Click to see attachment4,214,418  
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 bullet5,067,226
Less: accumulated depreciation (attach schedule) bullet3,683,855 1,420,863 Click to see attachment1,383,371 4,717,226
15 Other assets (describe bullet) Click to see attachment186,934 Click to see attachment210,191  
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 5,972,430 5,854,282 4,763,528
Liabilities 17 Accounts payable and accrued expenses.......... 42,771 56,716
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) Click to see attachment100,768 Click to see attachment87,749
23 Total liabilities (add lines 17 through 22).......... 143,539 144,465
Net Assets or Fund Balances bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted.................... 5,828,891 5,709,817
25 Temporarily restricted................    
26 Permanently restricted................    
bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds.........    
28 Paid-in or capital surplus, or land, bldg., and equipment fund    
29 Retained earnings, accumulated income, endowment, or other funds    
30 Total net assets or fund balances (see page 17 of the
instructions).................... 5,828,891 5,709,817
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 5,972,430 5,854,282
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 5,828,891
2 Enter amount from Part I, line 27a..................... 2 -119,074
3 Other increases not included in line 2 (itemize) bullet 3  
4 Add lines 1, 2, and 3.......................... 4 5,709,817
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 5,709,817
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.)
1a
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
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
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  
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      
2010      
2009      
2008      
2007      
2 Total of line 1, column (d) ...................... 2  
3 Average distribution ratio for the 5-year base period—divide the total on line 2 by 5, or by
the number of years the foundation has been in existence if less than 5 years. . . 		3  
4 Enter the net value of noncharitable-use assets for 2012 from Part X, line 5..... 4  
5 Multiply line 4 by line 3....................... 5  
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6  
7 Add lines 5 and 6......................... 7  
8 Enter qualifying distributions from Part XII, line 4.............. 8  
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: 1986-04-16(attach copy of letter if necessary–see instructions)
b 1 N/A
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  
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  
6 Credits/Payments:
a 2012 estimated tax payments and 2011 overpayment credited to 2012 6a  
b Exempt foreign organizations—tax withheld at source....... 6b
c Tax paid with application for extension of time to file (Form 8868) 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7  
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
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
 
 
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
     
     
    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)
    bulletKY
    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
    Yes
     
    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 addressbulletWWW.THEALTHENHEIM.ORG
    14
    The books are in care ofbulletMILES BURKHOLDER Telephone no.bullet (502) 584-7417
    Located atbullet936 BARRET AVENUE936 BARRET AVENUELOUISVILLEKY ZIP+4bullet40204
    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
     
     
    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
    MICHAEL BUSICKClick to see attachment PRESIDENT
    5.00     		0 0 0
    2314 SUNSET LANE
    2314 SUNSET LANE
    CRESTWOOD,KY40014
    WILLIAM ROBERTSClick to see attachment VICE PRES
    5.00     		0 0 0
    5402 MERRIBROOK LANE
    5402 MERRIBROOK LANE
    PROSPECT,KY40059
    DR PETER BURRClick to see attachment VICE PRES
    1.00     		0 0 0
    5007 LONGKNIFE RUN
    5007 LONGKNIFE RUN
    LOUISVILLE,KY40207
    DAVID BURKHOLDERClick to see attachment SECRETARY
    1.00     		0 0 0
    8222 ST ANDREWS VILLAGE DR
    8222 ST ANDREWS VILLAGE DR
    LOUISVILLE,KY40241
    JAMES BROWNClick to see attachment BOARD MEMBER
    1.00     		0 0 0
    504 WICKFIELD DR
    504 WICKFIELD DR
    LOUISVILLE,KY40245
    HELEN BURKHOLDERClick to see attachment BOARD MEMBER
    1.00     		0 0 0
    8222 ST ANDREWS VILLAGE DR
    8222 ST ANDREWS VILLAGE DR
    LOUISVILLE,KY40241
    DR BOB WYNKOOPClick to see attachment BOARD MEMBER
    1.00     		0 0 0
    8017 ALBRECHT CIRCLE
    8017 ALBRECHT CIRCLE
    LOUISVILLE,KY40241
    MATTHEW GIBSONClick to see attachment BOARD MEMBER
    1.00     		0 0 0
    11921 TAZWELL DR 3
    11921 TAZWELL DR 3
    LOUISVILLE,KY40245
    ROSALYN CAROTHERSClick to see attachment BOARD MEMBER
    1.00     		0 0 0
    2327 LIME KILN LN C
    2327 LIME KILN LN C
    LOUISVILLE,KY40222
    KAY MATTONClick to see attachment BOARD MEMBER
    1.00     		0 0 0
    44 CALUMET RD
    44 CALUMET RD
    LOUISVILLE,KY40207
    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
    D MILES BURKHOLDERClick to see attachment ADMINSTRATOR
    40.00     		71,038 3,452  
    511 VINELEAF DR
    511 VINELEAF DR
    LOUISVILLE,KY40222
    VALERIE NABOZNYClick to see attachment DIR NURSING
    40.00     		67,727 3,386  
    3122 PENDLETON RD
    3122 PENDLETON RD
    PENDLETON,KY40055
    MARK KITCHENClick to see attachment DIR MAINTENA
    40.00     		56,963    
    1520 BERRY BLVD
    1520 BERRY BLVD
    LOUISVILLE,KY40215
    JEANETTE CURRYClick to see attachment CHARGE NURSE
    40.00     		53,976 2,699  
    1306 CALLA DR
    1306 CALLA DR
    CLARKSVILLE,IN47129
    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
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1 THE LOUISVILLE PROTESTANT ALTENHEIM (THE "ALTENHEIM") WAS FOUNDED IN 1906 AS A LONG-TERM CARE FACILITY IN LOUISVILLE, KENTUCKY. IT IS A CONTINUING CARE RETIREMENT COMMUNITY WITH FOUR LEVELS OF CARE: INDEPENDENT LIVING; PERSONAL CARE; INTERMEDIATE CARE; AND NURSING HOME BEDS. 2,770,008
    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 N/A  
    2  
    All other program-related investments. See page 24 of the instructions.
    3  
    Total. Add lines 1 through 3..........................bullet  
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,
    see 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
    0
    b
    Average of monthly cash balances.......................
    1b
    0
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    0
    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
    0
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see
    instructions) .............................
    4
    0
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    0
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    0
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
     
    2a
    Tax on investment income for 2012 from Part VI, line 5......
    2a
     
    b
    Income tax for 2012. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
     
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
     
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
     
    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
     
    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 ..........
    1a
    0
    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
    96,621
    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
    96,621
    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
    96,621
    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  
    2 Undistributed income, if any, as of the end of 2012:
    a Enter amount for 2011 only.......  
    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$ 96,621
    a Applied to 2011, but not more than line 2a  
    b Applied to undistributed income of prior years
    (Election required—see instructions)......     		 
    c Treated as distributions out of corpus (Election
    required—see instructions).........     		96,621
    d Applied to 2012 distributable amount.....  
    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 96,621
    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 ..........     		 
    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
    1986-04-16
    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
    0       0
    b 85% of line 2a .........          
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....     		96,621 722,048 426,000 630,000 1,874,669
    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 ....     		96,621 722,048 426,000 630,000 1,874,669
    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...     		        0
    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).)
    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
    Total .................................bullet 3a  
    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
    aNURSING HOME FEES     8 2,198,799  
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3Interest on savings and temporary cash investments     14 35,288  
    4 Dividends and interest from securities....     14 63,139  
    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         278,020
    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)..   2,297,226 278,020
    13Total. Add line 12, columns (b), (d), and (e)..................
    132,575,246
    (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.)
    1A DIRECT CHARGES TO INDIVIDUALS FOR CARE AT NURSING HOME.
    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:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description
    Schedule B
    (Form 990, 990-EZ,
    or 990-PF)
    Department of the Treasury
    Internal Revenue Service
    Schedule of Contributors
    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    OMB No. 1545-0047
    2012
    Name of the organization
    LOUISVILLE PROTESTANT ALTENHEIM
     
    Employer identification number

    61-0449634
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ





    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......................... Arrow Bullet   $    
    Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990; or check the box on line H of its
    Form 990-EZ or on Part I, line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2012)

    Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
    Page 2
    Name of organization
    LOUISVILLE PROTESTANT ALTENHEIM
          		Employer identification number

    61-0449634
    Part I
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    		     
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    1
     
     

    STITZEL BENEFICIARY INCOME TRUST    
    JP MORGAN CHASE
    JP MORGAN CHASE  
    LOUISVILLE, KY   40202

    		$75,688


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

         
     
       

    		$  


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

         
     
       

    		$  


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

         
     
       

    		$  


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

         
     
       

    		$  


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

         
     
       

    		$  


    (Complete Part II if there is a noncash contribution.)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

    Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
    Page 3
    Name of organization
    LOUISVILLE PROTESTANT ALTENHEIM
          		Employer identification number

    61-0449634
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    		     
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

    Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
    Page 4
    Name of organization
    LOUISVILLE PROTESTANT ALTENHEIM
          		Employer identification number

    61-0449634
    Part III
    Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
    that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
    For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
    contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a) No.
    from
    Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
           
     
    (a) No.
    from
    Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
           
     
    (a) No.
    from
    Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
           
     
    (a) No.
    from
    Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
           
     
    Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

    Additional Data


    Software ID:  
    Software Version:  

    TY 2012 CompensationExplanation
    Name:
    LOUISVILLE PROTESTANT ALTENHEIM
    EIN: 61-0449634
    Person Name Explanation
    MICHAEL BUSICK  
    WILLIAM ROBERTS  
    DR PETER BURR  
    DAVID BURKHOLDER  
    JAMES BROWN  
    HELEN BURKHOLDER  
    DR BOB WYNKOOP  
    MATTHEW GIBSON  
    ROSALYN CAROTHERS  
    KAY MATTON  

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

    TY 2012 DepreciationSchedule
    Name:
    LOUISVILLE PROTESTANT ALTENHEIM
    EIN: 61-0449634
    Description of Property Date Acquired Cost or Other Basis Prior Years' Depreciation Computation Method Rate /
    Life (# of years)    		 Current Year's Depreciation Expense Net Investment Income Adjusted Net Income Cost of Goods Sold Not Included
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    COMPUTER MONITOR 2007-11-02 600 500 S/L 5.0000 100      
    COMPUTER PROCESSING UNIT 2007-11-02 890 742 S/L 5.0000 148      
    SMALL REFRIGERATOR 2010-01-04 125 83 S/L 3.0000 42      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    HON FILE CABINET -L008 2006-11-28 118 118 S/L 5.0000        
    HON FILE CABINET -L007 2006-11-28 118 118 S/L 5.0000        
    HON FILE CABINET -378 2008-04-01 119 89 S/L 5.0000 24      
    COMPUTER PROCESSING UNIT 2007-07-20 658 581 S/L 5.0000 77      
    COMPUTER MONITOR 2007-07-20 550 486 S/L 5.0000 64      
    TELEVISION 2009-02-03 480 280 S/L 5.0000 96      
    COMPUTER MONITOR 2007-07-20 550 486 S/L 5.0000 64      
    HON FILE CABINET -183R 2006-11-28 118 118 S/L 5.0000        
    SHREDDER 2008-06-25 100 100 S/L 3.0000        
    REFRIGERATOR 2008-12-11 140 140 S/L 3.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    COPIER - SHARP 2007-02-06 3,299 2,317 S/L 7.0000 471      
    MEDICATION REFRIGERATOR 2010-01-04 125 83 S/L 3.0000 42      
    TELEVISION 2009-09-29 997 449 S/L 5.0000 199      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    LEATHER SOFA 2009-10-02 700 506 S/L 3.0000 194      
    2 LEATHER CLUB CHAIRS 2009-10-02 500 361 S/L 3.0000 139      
    BOOK SHELF 2009-03-05 121 114 S/L 3.0000 7      
    4 A/C UNITS 2003-01-03 9,596 9,596 S/L 7.0000        
    2 A/C UNITS 2003-01-03 4,798 4,798 S/L 7.0000        
    42" TELEVISION 2008-08-13 988 675 S/L 5.0000 198      
    DVD PLAYER 2010-05-20 172 86 S/L 3.0000 57      
    DVD PLAYER 2009-03-05 98 93 S/L 3.0000 5      
    2 A/C UNITS 2003-01-03 4,798 4,798 S/L 7.0000        
    HON FILE CABINET -R226 2006-12-20 150 107 S/L 7.0000 22      
    HON FILE CABINET -335E 2006-11-28 118 86 S/L 7.0000 17      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    LAPTOP COMPUTER 2010-04-23 591 187 S/L 5.0000 118      
    IC NURSES STATION 2008-09-23 19,310 6,276 S/L 10.0000 1,931      
    ICE MACHINE 2004-02-05 3,704 3,704 S/L 5.0000        
    6 A/C UNITS 2003-01-03 14,394 14,394 S/L 7.0000        
    GE WASHER 2009-07-29 582 281 S/L 5.0000 117      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    2 REFRIGERATORS 2009-05-28 220 189 S/L 3.0000 31      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    DRESSER 1995-01-01 250 250 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    DRESSER 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2009-02-03 480 467 S/L 3.0000 13      
    TELEVISION 2009-02-03 480 467 S/L 3.0000 13      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    TELEVISION 2009-02-03 480 467 S/L 3.0000 13      
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2009-02-03 480 467 S/L 3.0000 13      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2009-02-03 480 467 S/L 3.0000 13      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2009-02-03 480 467 S/L 3.0000 13      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2009-02-03 480 467 S/L 3.0000 13      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2009-02-03 480 467 S/L 3.0000 13      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2009-02-03 480 467 S/L 3.0000 13      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2009-02-03 480 467 S/L 3.0000 13      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2009-02-03 480 467 S/L 3.0000 13      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2009-02-03 480 467 S/L 3.0000 13      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2009-02-03 480 467 S/L 3.0000 13      
    A/C UNIT 2003-01-03 2,400 2,400 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2009-02-13 397 386 S/L 3.0000 11      
    A/C UNIT 2003-01-03 4,800 4,800 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    2 TELEVISIONS 2009-02-13 794 772 S/L 3.0000 22      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2009-02-13 397 386 S/L 3.0000 11      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2009-02-13 397 386 S/L 3.0000 11      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2009-02-13 397 386 S/L 3.0000 11      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2009-02-13 397 386 S/L 3.0000 11      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2009-02-13 397 386 S/L 3.0000 11      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2009-02-13 397 386 S/L 3.0000 11      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2009-02-13 397 386 S/L 3.0000 11      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2009-02-13 397 386 S/L 3.0000 11      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2008-08-13 319 319 S/L 3.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2008-08-13 319 319 S/L 3.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    TELEVISION 2009-02-03 397 364 S/L 3.0000 33      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    TELEVISION 2009-02-13 397 288 S/L 7.0000 57      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    2 TELEVISIONS 2009-02-13 794 728 S/L 3.0000 66      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2008-08-13 319 319 S/L 3.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TELEVISION 2008-08-13 319 319 S/L 3.0000        
    WHEELCHAIR LIFT 2008-06-11 13,610 6,805 S/L 7.0000 1,945      
    4 BEDS 1995-01-01 1,124 1,124 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    ELEVATOR 2011-06-30 93,575 3,119 S/L 15.0000 6,239      
    STAIRLIIFT 2011-03-21 4,500 482 S/L 7.0000 643      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 381 381 S/L 7.0000        
    DRESSER/MIRROR 1995-01-01 250 250 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 381 381 S/L 7.0000        
    DRESSER 1995-01-01 250 250 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 381 381 S/L 7.0000        
    END TABLE 1995-01-01 250 250 S/L 7.0000        
    END TABLE 1995-01-01 250 250 S/L 7.0000        
    END TABLE 1995-01-01 250 250 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 381 381 S/L 7.0000        
    DRESSER 1995-01-01 250 250 S/L 7.0000        
    END TABLE 1995-01-01 250 250 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 381 381 S/L 7.0000        
    DRESSER 1995-01-01 250 250 S/L 7.0000        
    END TABLE 1995-01-01 250 250 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    END TABLE 1995-01-01 250 250 S/L 7.0000        
    DRESSER 1995-01-01 250 250 S/L 7.0000        
    END TABLE 1995-01-01 250 250 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 381 381 S/L 7.0000        
    DRESSER 1995-01-01 250 250 S/L 7.0000        
    END TABLE 1995-01-01 250 250 S/L 7.0000        
    BEAUTY SHOP 1995-01-01 2,399 2,399 S/L 7.0000        
    HAIR DRESSING VANITY 2008-10-31 1,512 666 S/L 7.0000 216      
    PEDESTAL CHAIR 2008-10-31 1,451 639 S/L 7.0000 207      
    DRYER CHAIR 2008-10-31 425 187 S/L 7.0000 61      
    DRYER CHAIR 2008-10-31 425 187 S/L 7.0000 61      
    DRYER 2008-10-31 145 64 S/L 7.0000 21      
    DRYER 2009-10-31 145 64 S/L 7.0000 21      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 381 381 S/L 7.0000        
    DRESSER 1995-01-01 250 250 S/L 7.0000        
    END TABLE 1995-01-01 250 250 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED BRASS 1995-01-01 381 381 S/L 7.0000        
    DRESSER 1995-01-01 250 250 S/L 7.0000        
    END TABLE 1995-01-01 250 250 S/L 7.0000        
    BED BRASS 1995-01-01 381 381 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    FRIDGE 2010-09-08 429 429 S/L 7.0000        
    MICROWAVE 2010-07-20 300 61 S/L 7.0000 43      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 381 381 S/L 7.0000        
    TABLE 1995-01-01 250 250 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 381 381 S/L 7.0000        
    END TABLE 1995-01-01 250 250 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 381 381 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    FRIDGE 2010-11-09 429 72 S/L 7.0000 61      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 381 381 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 381 381 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    DENTIST CHAIR/LIGHT 2009-08-13 1,480 493 S/L 7.0000 212      
    END TABLE 1995-01-01 250 250 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    MICROWAVE 1995-01-01 200 200 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 381 381 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    FILE CABINET MEDICAL RECORDS 1995-01-01 119 119 S/L 7.0000        
    FILE CABINET MEDICAL RECORDS 1995-01-01 119 119 S/L 7.0000        
    HIRSH FILE CABINET MEDICAL RECORDS 1995-01-01 119 119 S/L 7.0000        
    HIRSH FILE CABINET MEDICAL RECORDS 1995-01-01 119 119 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    FILE CABINET-HON 1995-01-01 119 119 S/L 7.0000        
    DRAWER FILE CABINET MEDICAL RECORDS 1995-01-01 119 119 S/L 7.0000        
    2 DRAWER FILE CABINET MEDICAL RECORDS 1995-01-01 220 220 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    HON FILE CABINET 1995-01-01 119 119 S/L 7.0000        
    FILE CABINET 1995-01-01 119 119 S/L 7.0000        
    HON FILE CABINET 1995-01-01 119 119 S/L 7.0000        
    HON FILE CABINET 1995-01-01 119 119 S/L 7.0000        
    HON FILE CABINET 1995-01-01 119 119 S/L 7.0000        
    HON FILE CABINET 1995-01-01 119 119 S/L 7.0000        
    HON FILE CABINET 1995-01-01 119 119 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    TOASTER 1995-01-01 500 500 S/L 7.0000        
    SCOTSMAN ICE-MACHINE 2005-10-25 2,575 2,575 S/L 7.0000        
    VULCAN STOVE 2008-01-16 6,733 3,767 S/L 7.0000 962      
    VULCAN STEAMER 2009-03-04 5,064 2,050 S/L 7.0000 723      
    MEAT SLICER 2010-12-24 1,464 209 S/L 7.0000 209      
    TRUE FREEZER-- REACH IN 2010-01-18 3,483 954 S/L 7.0000 497      
    TRUE FREEZER-- REACH IN 2006-02-08 2,899 2,450 S/L 7.0000 414      
    TRUE FREEZER-- REACH IN 2007-01-05 3,079 2,199 S/L 7.0000 440      
    A/C UNIT 2003-01-03 2,399 2,399 S/L 7.0000        
    BED 1995-01-01 281 281 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    BEDSIDE TABLE 1995-01-01 250 250 S/L 7.0000        
    GENERAL POWER-VEESNAKE 2009-08-03 480 166 S/L 7.0000 68      
    HUSKY PRO COMPRESSER 2010-06-16 9,528 1,701 S/L 7.0000 1,362      
    WATER HEATER-100 GAL 2004-04-16 5,000 4,702 S/L 7.0000 298      
    WATER HEATER-100 GAL 2006-04-06 5,560 4,526 S/L 7.0000 795      
    A/C UNIT 2011-05-26 1,875 156 S/L 7.0000 268      
    A/C UNIT 2011-09-15 1,875 89 S/L 7.0000 268      
    A/C UNIT 2011-09-15 1,875 89 S/L 7.0000 268      
    WATER HEATER-100 GAL 2006-11-28 4,950 3,595 S/L 7.0000 707      
    WATER HEATER 2007-01-01 7,829 5,592 S/L 7.0000 1,119      
    CRAFTSMAN SOCKET SET 2009-02-22 86 84 S/L 3.0000 2      
    GRILL 2010-03-29 269 99 S/L 5.0000 53      
    PRESSURE WASHER 2008-08-08 3,379 1,649 S/L 7.0000 483      
    GAS BLOWER 2009-08-11 456 213 S/L 5.0000 91      
    2006 FORD RANGER 2008-02-28 14,514 11,129 S/L 5.0000 2,902      
    BUS 2007-01-23 51,805 50,942 S/L 5.0000 863      
    HOT WATER HEATER 2007-01-23 7,829 5,499 S/L 7.0000 1,118      
    PNEUMATIC AIR COMPRESSOR 2007-04-17 9,771 6,630 S/L 7.0000 1,396      
    A/C UNIT 2003-01-03 2,400 2,400 S/L 7.0000        
    A/C UNIT 2003-01-03 2,400 2,400 S/L 7.0000        
    A/C UNIT 2003-01-03 2,400 2,400 S/L 7.0000        
    A/C UNIT 2003-01-03 2,400 2,400 S/L 7.0000        
    REFRIGERATOR 1995-01-01 429 429 S/L 7.0000        
    PRINTER/ COPIER/ FAX MACHINE 2011-12-30 450   S/L 5.0000 90      
    A/C UNIT 2003-01-03 2,400 2,400 S/L 7.0000        
    A/C UNIT 2003-01-03 2,400 2,400 S/L 7.0000        
    TV 2009-03-16 229 130 S/L 5.0000 46      
    CHAIN SAW 2009-11-24 477 199 S/L 5.0000 95      
    BIRD CAGE 2007-08-31 751 651 S/L 5.0000 100      
    CPU 2007-07-20 658 658 S/L 3.0000        
    CHAIR 2009-05-22 320 122 S/L 7.0000 46      
    A/C UNIT 2003-01-03 2,400 2,400 S/L 7.0000        
    MONITOR 2007-07-20 550 550 S/L 3.0000        
    CPU 2007-07-20 658 658 S/L 3.0000        
    DRESSER 1995-01-01 250 250 S/L 7.0000        
    HOBART FOOD PROCESSOR 2008-08-12 1,963 958 S/L 7.0000 281      
    SIDEWALK IN FRONT OF BUILDING 2007-10-03 9,300 2,635 S/L 15.0000 620      
    CHAPEL ROOF REPAIR 2007-09-28 4,800 1,360 S/L 15.0000 320      
    WOOD FLOOR- PATIO 2007-08-02 4,229 1,198 S/L 15.0000 282      
    PC WOOD FLOOR 2008-11-02 13,345 2,817 S/L 15.0000 890      
    ROOF 2009-10-30 65,650 3,556 S/L 40.0000 1,641      
    FLOOR IC NURSES STATION 2010-03-16 27,080 3,159 S/L 15.0000 1,806      
    NEW CABINETS- KITCHEN 2010-05-15 7,855 1,777 S/L 7.0000 1,122      
    NEC PHONE SYSTEM 2006-02-02 7,408 7,408 S/L 3.0000        
    PC WOOD FLOOR- DINING ROOM 2008-08-31 7,942 1,738 S/L 15.0000 530      
    2 APARTMENT RENOVATIONS 2010-07-02 10,000 1,000 S/L 15.0000 667      
    SECURITY CAMERA- OUTSIDE 2010-03-31 1,116 651 S/L 3.0000 372      
    REPLACE INSULATED UNIT- REC AREA 2009-06-02 4,920 1,816 S/L 7.0000 703      
    ROOF REMOVE LIGHTNING RODS, CABLES+VENTS 2009-09-21 16,663 2,499 S/L 15.0000 1,111      
    WOODEN BLINDS-IC DINING ROOM 2008-08-08 1,598 780 S/L 7.0000 228      
    WOODEN BLINDS-PC DINING ROOM 2008-08-08 1,598 780 S/L 7.0000 228      
    LIGHTING-PC DINING ROOM 2008-08-07 590 288 S/L 7.0000 84      
    PATIO LIGHTS- SUNROOM 2008-08-12 950 464 S/L 7.0000 135      
    SPRINKLER SYSTEM 2006-04-21 8,900 3,362 S/L 15.0000 594      
    REPLACE 4"DRAIN PIPE & 30 FT WATER LINE 2006-06-06 5,900 2,196 S/L 15.0000 393      
    ELECTRICAL WORK FOR CABLE INSTALL 2009-02-10 2,800 544 S/L 15.0000 187      
    WINDOWS 2009-06-02 4,920 847 S/L 15.0000 328      
    WINDOWS 2010-08-25 1,050 93 S/L 15.0000 70      
    WINDOWS 2010-10-08 1,470 123 S/L 15.0000 98      
    ROOF WORK 2008-05-01 9,050 2,212 S/L 15.0000 604      
    5 WINDOWS 2011-09-20 1,360 23 S/L 15.0000 90      
    HAND RAILS 2ND FLOOR 2011-06-01 2,950 115 S/L 15.0000 196      
    PAINT-2ND FLOOR UPDATE 2011-06-01 1,552 181 S/L 5.0000 310      
    STITZEL WING 1950-01-01 169,757 169,757 S/L 30.0000        
    CHAPEL 1970-01-01 29,002 29,002 S/L 30.0000        
    IC WING 1989-01-01 1,996,175 1,465,239 S/L 30.0000 66,540      
    ADMINISTRATIVE BULDING AND IMPROVEMENTS 2030-03-01 647,081 647,081 S/L 30.0000        
    FURNITURE AND FIXTURES 1980-01-01 258,698 258,698 S/L 7.0000        
    LAND -- BARRETT AVENUE 2030-01-01 350,000     30.0000        
    BUILDING IMPROVEMENTS 1990-03-01 671,997 479,432 S/L 30.0000 22,400      
    ELEVATOR 2012-04-20 7,464   S/L 15.0000 332      
    ROOF REPAIRS 2012-07-09 7,010   S/L 20.0000 175      
    LIFT 2012-08-08 2,660   S/L 10.0000 111      
    ICE MACHINE AND ELECTRIC 2012-04-25 4,736   S/L 7.0000 451      
    WATER HEATER AND RADIATOR 2012-10-04 7,544   S/L 10.0000 189      
    3RD FLOOR RENOVATION 2012-12-30 67,205   S/L 5.0000     134,110  

    TY 2012 EmployeeCompensationExpln
    Name:
    LOUISVILLE PROTESTANT ALTENHEIM
    EIN: 61-0449634
    Employee Explanation
    D MILES BURKHOLDER  
    VALERIE NABOZNY  
    MARK KITCHEN  
    JEANETTE CURRY  

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

    TY 2012 GainLossSaleOtherAssetsSch
    Name:
    LOUISVILLE PROTESTANT ALTENHEIM
    EIN: 61-0449634
    Name Date Acquired How Acquired Date Sold Purchaser Name Gross Sales Price Basis Basis Method Sales Expenses Total (net) Accumulated Depreciation
    STOCKYARDS BANK TRUST ACCT 1990-06 DONATION 2012-03   3,551,789 3,273,769     278,020  

    TY 2012 InvestmentsCorpStockSchedule
    Name:
    LOUISVILLE PROTESTANT ALTENHEIM
    EIN: 61-0449634
    Name of Stock End of Year Book Value End of Year Fair Market Value
      4,214,418  

    TY 2012 LandEtcSchedule2
    Name:
    LOUISVILLE PROTESTANT ALTENHEIM
    EIN: 61-0449634
    Category / Item Cost / Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
      4,717,226 3,683,855 1,033,371 4,717,226
      350,000   350,000  


    TY 2012 OtherAssetsSchedule
    Name:
    LOUISVILLE PROTESTANT ALTENHEIM
    EIN: 61-0449634
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    CASH SURRENDER OF LIFE INS 186,934 210,191  


    TY 2012 OtherExpensesSchedule
    Name:
    LOUISVILLE PROTESTANT ALTENHEIM
    EIN: 61-0449634
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    EXPENSES        
    ACTIVITY SERVICES 10,060   10,060  
    MARKETING SUPPLIES 32,583   32,583  
    MISCELLANEOUS EXPENSES 46,617   46,617  
    DIETARY SUPPLIES 167,927   167,927  
    HOUSEKEEPING EXPENSES 74,362   74,362  
    PROPERTY INSURANCE 118,879   118,879  
    OTHER INSURANCE 7,369   7,369  
    NURSING SUPPLIES 10,050   10,050  
    HEALTH PROVIDER FEES 12,769   12,769  
    REPAIRS AND MAINTENANCE 37,470   37,470  
    UTILITIES 125,961   125,961  
    TRUST ACCOUNT FEES 30,730 30,730    


    TY 2012 OtherIncomeSchedule2
    Name:
    LOUISVILLE PROTESTANT ALTENHEIM
    EIN: 61-0449634
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    NURSING HOME FEES 2,198,799   2,198,799


    TY 2012 OtherLiabilitiesSchedule
    Name:
    LOUISVILLE PROTESTANT ALTENHEIM
    EIN: 61-0449634
    Description Beginning of Year - Book Value End of Year - Book Value
    ACCRUED VACATION 44,719 47,204
    ACCRUED PROFIT SHARING 32,389  
    DEFERRED REVENUE 23,660 40,545


    TY 2012 OtherProfessionalFeesSchedule
    Name:
    LOUISVILLE PROTESTANT ALTENHEIM
    EIN: 61-0449634
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
      25,365   25,365