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 07-01-2012 , and ending 06-30-2013
Name of foundation
THE HEAD FAMILY FOUNDATION
 

Number and street (or P.O. box number if mail is not delivered to street address)11100 WAYZATA BOULEVARDROOM/SUITE 230Room/suite
City or town, state, and ZIP code
MINNETONKA, MN55305
A Employer identification number

20-2032551
B Telephone number (see instructions)

(952) 681-2891
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$5,423,882
J Accounting method:
 
(Part I, column (d) must be on cash basis.)
E bullet
F bullet
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see 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) 1,000,000
2 Check bullet
3 Interest on savings and temporary cash investments 201,617 201,617 201,617
4 Dividends and interest from securities...... 44,434 43,966 44,434
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 175,349
b Gross sales price for all assets on line 6a 2,267,043
7 Capital gain net income (from Part IV, line 2)... 797,365
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 1,421,400 1,042,948 246,051
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc.        
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule).......        
c Other professional fees (attach schedule).... 6,245 3,056   3,056
17 Interest...............        
18 Taxes (attach schedule) (see instructions) 590 590    
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule).......        
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 6,835 3,646   3,056
25 Contributions, gifts, grants paid........ 188,350 188,350
26 Total expenses and disbursements. Add lines 24 and 25 195,185 3,646   191,406
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 1,226,215
b Net investment income (if negative, enter -0-) 1,039,302
c Adjusted net income (if negative, enter -0-)... 246,051
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............... 48,964 466 466
2 Savings and temporary cash investments.......... 216,867 44,779 44,779
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see page 15 of the
instructions)....................      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use...............      
9 Prepaid expenses and deferred charges...........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)........ 1,605,408 Click to see attachment699,415 699,415
c Investments—corporate bonds (attach schedule)........ 171,930    
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans..............      
13 Investments—other (attach schedule)........... 2,000,000 Click to see attachment4,679,222 4,679,222
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 4,043,169 5,423,882 5,423,882
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable...................    
19 Deferred revenue..................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet) Click to see attachment1,526  
23 Total liabilities (add lines 17 through 22).......... 1,526 0
Net Assets or Fund Balances bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted....................    
25 Temporarily restricted................    
26 Permanently restricted................    
bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds.........    
28 Paid-in or capital surplus, or land, bldg., and equipment fund    
29 Retained earnings, accumulated income, endowment, or other funds 4,041,643 5,423,882
30 Total net assets or fund balances (see page 17 of the
instructions).................... 4,041,643 5,423,882
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 4,043,169 5,423,882
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 4,041,643
2 Enter amount from Part I, line 27a..................... 2 1,226,215
3 Other increases not included in line 2 (itemize) bulletClick to see attachment 3 156,024
4 Add lines 1, 2, and 3.......................... 4 5,423,882
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 5,423,882
Form 990-PF (2012)
Form 990-PF (2012)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)
(b) How acquired
P—Purchase
D—Donation
(c) Date acquired
(mo., day, yr.)
(d) Date sold
(mo., day, yr.)
1 a 9289S UNITED HEALTH GROUP INC D   2013-01-29
b 4539S ADP INC D   2013-01-29
c 200S UNITED HEALTH GROUP D   2013-02-11
d 160S STERICYCLE INC D   2013-02-11
e 1385S MEDTRONIC D   2013-02-11
100S ADP INC D   2013-02-11
60S STERICYCLE INC D   2013-02-25
(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 522,495   56,157 466,338
b 271,335   26,212 245,123
c 11,434   1,403 10,031
d 15,182   3,090 12,092
e 64,734   11,806 52,928
6,065   664 5,401
5,814   362 5,452
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       466,338
b       245,123
c       10,031
d       12,092
e       52,928
      5,401
      5,452
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 2 797,365
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 117,903 3,738,591 0.031537
2010 38,691 1,756,751 0.022024
2009 96,865 1,169,316 0.082839
2008 77,261 751,551 0.102802
2007 96,196 1,026,489 0.093714
2 Total of line 1, column (d) ...................... 2 0.332916
3 Average distribution ratio for the 5-year base period—divide the total on line 2 by 5, or by
the number of years the foundation has been in existence if less than 5 years
. . .
3 0.066583
4 Enter the net value of noncharitable-use assets for 2012 from Part X, line 5..... 4 4,769,766
5 Multiply line 4 by line 3....................... 5 317,585
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 10,393
7 Add lines 5 and 6......................... 7 327,978
8 Enter qualifying distributions from Part XII, line 4.............. 8 191,406
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See
the Part VI instructions.
Form 990-PF (2012)
Form 990-PF (2012)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see page 18 of the instructions)
1a Bulletand enter “N/A” on line 1. Bracket
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b 1 20,786
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 20,786
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 20,786
6 Credits/Payments:
a 2012 estimated tax payments and 2011 overpayment credited to 2012 6a 1,699
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 1,699
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. Click to see attachment 8 26
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 19,113
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2013 estimated taxBullet   Refunded Bullet 11  
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see page 19 of
the instructions for definition)?............................
1b
 
No
If the answer is “Yes” to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If “Yes,” attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If “Yes,” attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If “Yes,” has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If “Yes,” attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
  • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If “Yes,” complete Part II, col. (c), and Part XV.
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletMN
    b
    If the answer is “Yes” to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If “No,” attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2012 or the taxable year beginning in 2012 (see instructions for Part XIV)?
    If “Yes,” complete Part XIV.............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If “Yes,” attach a schedule listing their names and addresses.
    10
    Yes
     
    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.HEADFOUNDATION.COM
    14
    The books are in care ofbulletCEANN COMPANY LLC Telephone no.bullet (952) 681-2891
    Located atbullet11100 WAYZATA BOULEVARD SUITE 230MINNETONKAMN ZIP+4bullet55305
    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
    MARTHA M HEADClick to see attachment PRESIDENT
    1.00
    0 0 0
    11100 WAYZATA BOULEVARD STE 230
    11100 WAYZATA BOULEVARD STE 230
    MINNETONKA,MN55305
    MARTHA E H KIRWINClick to see attachment SECRETARY
    1.00
    0 0 0
    11100 WAYZATA BOULEVARD STE 230
    11100 WAYZATA BOULEVARD STE 230
    MINNETONKA,MN55305
    VIRGINIA R HEADClick to see attachment TREASURER
    1.00
    0 0 0
    11100 WAYZATA BOULEVARD STE 230
    11100 WAYZATA BOULEVARD STE 230
    MINNETONKA,MN55305
    CHRISTOPHER KIRWANClick to see attachment DIRECTOR
    1.00
    0 0 0
    11100 WAYZATA BOULEVARD STE 230
    11100 WAYZATA BOULEVARD STE 230
    MINNETONKA,MN55305
    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
    NONE
    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
     
    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
    4,649,376
    b
    Average of monthly cash balances.......................
    1b
    193,026
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    4,842,402
    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
    4,842,402
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see
    instructions) .............................
    4
    72,636
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    4,769,766
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    238,488
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    238,488
    2a
    Tax on investment income for 2012 from Part VI, line 5......
    2a
    20,786
    b
    Income tax for 2012. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    20,786
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    217,702
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    217,702
    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
    217,702
    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
    191,406
    b
    Program-related investments—total from Part IX-B..................
    1b
     
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    191,406
    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
    191,406
    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 7 217,702
    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....... 13,149
    c From 2009....... 40,511
    d From 2010.......  
    e From 2011.......  
    fTotal of lines 3a through e......... 53,660
    4Qualifying distributions for 2012 from Part
    XII, line 4: bullet$ 191,406
    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).........
     
    d Applied to 2012 distributable amount..... 191,406
    e Remaining amount distributed out of corpus  
    5 Excess distributions carryover applied to 2012. 26,296 26,296
    (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 27,364
    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 ..........
    0
    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 ......
    27,364
    10 Analysis of line 9:
    a Excess from 2008....  
    b Excess from 2009.... 27,364
    c Excess from 2010....  
    d Excess from 2011....  
    e Excess from 2012....  
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 9
    Part XIV
    Private Operating Foundations (see instructions and Part VII-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2012, enter the date of the ruling.......bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........
    Tax year Prior 3 years (e) Total
    (a) 2012 (b) 2011 (c) 2010 (d) 2009
             
    b 85% of line 2a .........          
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....
             
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ....
             
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....
             
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets” alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)
             
    b “Endowment” alternative test— enter 2⁄3
    of minimum investment return shown in
    Part X, line 6 for each year listed...
             
    c “Support” alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....
             
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....
             
    (3) Largest amount of support
    from an exempt organization
             
    (4) Gross investment income          
    Part XV
    Supplementary Information (Complete this part only if the organization had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    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
    AAA FOUNDATION
    5400 AUTO CLUB WAY
    MINNEAPOLIS,MN55416
      CHARITY GENERAL SUPPORT 500
    ABBOTT NORTHWESTERN HOSPITAL FOUNDA
    800 E 28TH ST
    MINNEAPOLIS,MN55485
      CHARITY GENERAL SUPPORT 750
    ADVENTURE UNLIMITED
    201 SOUTH QUEBEC STREET
    GREENWOOD VILLAGE,CO80110
      CHARITY ASSIST STUDENTS 300
    AMERICAN CANCER SOCIETY
    501 MINNESOTA AVE
    BRECKENRIDGE,MN56520
      CHARITY ASSIST CANCER PEOPLE 3,000
    AMERICAN RED CROSS
    1201 WEST RIVER PKWY
    MINNEAPOLIS,MN55454
      CHARITY GENERAL SUPPORT 1,000
    ANGELMAN SYNDROM FOUNDATION
    4255 WESTBROOK DRIVE
    SUITE 219
    AURORA,IL60504
      CHARITY GENERAL SUPPORT 250
    ANIMAL HUMANE SOCIETY
    845 MEADOW LANE N
    GOLDEN VALLEY,MN55422
      CHARITY ASSIST DOGS IN NEED 500
    ARC OF MINNESOTA
    770 TRANSFER ROAD 26
    ST PAUL,MN55114
      CHARITY ASSIST LOW INCOME PEOPLE 300
    ARTHRITIS FOUNDATION
    1876 MINNEHAHA AVE W 1
    ST PAUL,MN55104
      CHARITY SUPPORT ARTHRITIS RESEARCH 500
    ASCENTION PLACE INC
    1803 BRYANT AVENUE N
    MINNEAPOLIS,MN55411
      CHARITY ASSIST PEOPLE IN NEED 300
    ASHER STUDENT FOUNDATION
    PO BOX 491296
    LOS ANGELES,CA90049
      CHARITY ASSIST STUDENTS 300
    BOLDER OPTIONS
    2100 STEVENS AVE S
    MINNEAPOLIS,MN55404
      CHARITY GENERAL SUPPORT 500
    BOY SCOUTS OF AMERICA
    PO BOX 152079
    IRVING,TX750152079
      CHARITY GENERAL SUPPORT 250
    BRECK SCHOOL
    123 OTTAWA AVENUE NORTH
    MINNEAPOLIS,MN55422
      CHARITY ASSIST STUDENTS 1,500
    CARINGBRIDGE
    PO BOX 6032
    ALBERT LEA,MN560076632
      CHARITY GENERAL SUPPORT 500
    CATHOLIC CHARITIES
    1200 2ND AVE S
    MINNEAPOLIS,MN55403
      CHARITY GENERAL SUPPORT 2,500
    CEDAR CAMPS
    1314 PARKVIEW VALLEY
    MANCHESTER,MO63011
      CHARITY SUPPORT CAMP TUITIONS 750
    CENTER OF THE AMERICAN EXPERIMENT
    12 SOUTH 6TH STREET
    MINNEAPOLIS,MN55402
      CHARITY GENERAL SUPPORT 1,800
    CHARITIES REVIEW COUNCIL
    2610 UNIVERSITY AVE WEST
    ST PAUL,MN551142007
      CHARTIY GENERAL SUPPORT 250
    CHILDRENS HOSPITALS & CLINICS OF MN
    2910 CENTRE POINT DRIVE
    ROSEVILLE,MN55113
      CHARITY ASSIST CHILDREN 500
    CHILDRENS THEATRE COMPANY
    2400 3RD AVE S
    MINNEAPOLIS,MN55404
      CHARITY SUPPRT THEATRE 500
    CITIZENS LEAGUE
    213 E 4TH ST
    SUITE 425
    ST PAUL,MN55101
      CHARITY GENERAL SUPPORT 250
    COMO ZOO AND CONSERVATORY SOCIETY
    1225 ESTABROOK DR
    ST PAUL,MN55103
      CHARITY SUPPORT ZOOLOGICAL SOCIETY 500
    COURAGE CENTER
    3915 GOLDEN VALLEY RD
    MINNEAPOLIS,MN55422
      CHARITY ASSIST LOW INCOME PEOPLE 1,000
    COWLES CENTER FOR DANCE
    528 HENNEPIN AVE
    MINNEAPOLIS,MN55403
      CHARITY ART APPRECIATION 1,000
    DOCTORS WITHOUT BOARDERS
    333 SEVENTH AVE
    NEW YORK,NY10001
      CHARITY ASSIST CHILDREN 500
    FAMILY AND CHILDRENS SERVICE
    414 SOUTH EIGHTH STREET
    MINNEAPOLIS,MN55404
      CHARITY ASSIST CHILDREN 500
    FRIENDS OF THE BASILLICA OF ST MARY
    PO BOX 50010
    MINNEAPOLIS,MN55405
      CHARITY GENERAL SUPPORT 250
    FRIENDS OF THE HENNEPIN CO LIBRARY
    300 NICOLLET MALL
    N-290
    MINNEAPOLIS,MN55401
      CHARITY GENERAL SUPPORT 2,500
    GIRLSCOUT COUNCIL OF GREATER MPLS
    5601 BROOKLYN BLVD
    BROOKLYN CENTER,MN55429
      CHARITY GENERAL SUPPORT 300
    GLOBAL DEAF CONNECTION
    38TH AVE S
    MINNEAPOLIS,MN55406
      CHARITY ASSIST DEAF PEOPLE 500
    GRAYWOLF PRESS
    2402 UNIVERSITY AVE
    ST PAUL,MN55114
      CHARITY LITERARY APPRECIATION 29,750
    GREATER MPLS COUNCIL OF CHURCHES
    1001 EAST LAKE STREET
    MINNEAPOLIS,MN55407
      CHARITY GENERAL SUPPORT 100
    GREATER TWIN CITIES UNITED WAY
    404 SOUTH EIGHTH STREET
    MINNEAPOLIS,MN55405
      CHARITY GENERAL SUPPORT 18,000
    GREATER TWIN CITIES YOUTH SYMPHONIE
    408 ST PETER STREET
    ST PAUL,MN55102
      CHARITY MUSIC APPRECIATION 300
    GUILD INC
    118 NORTH FOURTH AVE
    ANN ARBOR,MI48104
      CHARITY ART APPRECIATION 1,000
    GUTHRIE THEATER FOUNDATION
    PO BOX 86
    MINNEAPOLIS,MN55486
      CHARITY ART APPRECIATION 1,000
    HENNEPIN HISTORY MUSEUM
    2303 3RD AVE S
    MINNEAPOLIS,MN55404
      CHARITY GENERAL SUPPORT 200
    HOMEWARD BOUND
    PO BOX 1056
    MONTICELLO,MN55362
      CHARITY SUPPORT DOGS IN NEED 1,000
    JUNGLE THEATRE
    2951 LYNDALE AVE S
    MINNEAPOLIS,MN55408
      CHARITY ART APPRECIATION 500
    KENYA CHILDRENS FUND
    PO BOX 4159
    HOPKINS,MN55343
      CHARITY ASSIST CHILDREN 500
    KENYON COLLEGE
    1 KENYON COLLEGE
    GAMBIER,OH43022
      CHARITY ASSIST STUDENTS 10,000
    KENYON REVIEW
    1 KENYON COLLEGE
    GAMBIER,OH43022
      CHARITY ASSIST STUDENTS 500
    LAKE MINNETONKA ASOCIATION
    PO BOX 248
    EXCELSIOR,MN55331
      CHARITY SUPPORT THE LAKE COMMUNITY 350
    LEAGUE OF WOMEN VOTERS OF MPLS
    81 S NINTH ST SUITE 335
    MINNEAPOLIS,MN55402
      CHARITY GENERAL SUPPORT 300
    IFP MN CENTER FOR MEDIA ARTS
    2446 UNIVERSITY AVE W
    ST PAUL,MN55114
      CHARITY ART APPRECIATION 500
    LONGYEAR MUSEUM
    1125 BOYLSTON ST
    CHESTNUT HILL,MA02467
      CHARITY GENERAL SUPPORT 400
    MARY BAKER EDDY LIBRARY
    200 MASSACHUSETTS AVE
    BOSTON,MA02115
      CHARITY ART APPRECIATION 500
    MAYO FOUNDATION
    200 1ST ST SW
    ROCHESTER,MN55905
      CHARITY MEDICAL EDUCATION AND RESEARCH 500
    MEADOWBROOK COLLABORATIVE
    4072 MEADOWBROOK LN
    ST LOUIS PARK,MN55426
      CHARITY GENERAL SUPPORT 500
    MICRO GRANTS
    1035 EAST FRANKLIN AVE
    MINNEAPOLIS,MN55404
      CHARITY ASSIST LOW INCOME PEOPLE 1,200
    MILL CITY SUMMER OPERA
    3208 WEST LAKE ST
    MINNEAPOLIS,MN55416
      CHARITY GENERAL SUPPORT 500
    MINNEAPOLIS COMMUNITY AND TECHNICAL
    1501 HENNEPIN AVE
    MINNEAPOLIS,MN55403
      CHARITY SUPPORT STUDENTS 1,000
    MINNEAPOLIS FOOD SHARE
    1001 EAST LAKE ST
    MINNEAPOLIS,MN554070509
      CHARITY GENERAL SUPPORT 1,000
    MINNEAPOLIS INSTITUTE OF ARTS
    2400 3RD AVE S
    MINNEAPOLIS,MN55405
      CHARITY ART APPRECIATION 15,350
    MINNEAPOLIS OPERA
    620 NORTH FIRST STREET
    MINNEAPOLIS,MN55401
      CHARITY SUPPORT ARTS 3,000
    MINNEAPOLIS PUBLIC SCHOOLS
    1250 W BROADWAY AVE
    MINNEAPOLIS,MN554112533
      SCHOOL SUPPORT CHESS 200
    MINNEAPOLIS URBAN LEAGUE
    220 16TH AVE N
    MINNEAPOLIS,MN55411
      CHARITY GENERAL SUPPORT 550
    MINNESOTA HISTORICAL SOCIETY
    345 W KELLOGG BLVD
    ST PAUL,MN551021906
      CHARITY GENERAL SUPPORT 1,000
    MINNESOTA LANDSCAPE ARBORETUM
    3675 ARBORETUM DRIVE
    CHASKA,MN55318
      CHARITY GENERAL SUPPORT 500
    MINNESOTA ORCHESTRA
    1111 NICOLLET MALL
    MINNEAPOLIS,MN55403
      CHARITY MUSIC APPRECIATION 3,000
    MINNESOTA PUBLIC RADIO
    480 CEDAR ST
    ST PAUL,MN55101
      CHARITY GENERAL SUPPORT 3,500
    MINNESOTA STATE HORTICULTURAL SOCIE
    2705 LINCOLN DRIVE
    ROSEVILLE,MN55113
      CHARITY GENERAL SUPPORT 250
    MINNESOTA STREETCAR MUSEUM
    PO BOX 14467
    MINNEAPOLIS,MN554140467
      CHARITY GENERAL SUPPORT 250
    MINNESOTA VISITING NURSE AGENCY
    3433 BROADWAY ST NE 300
    MINNEAPOLIS,MN55413
      CHARITY GENERAL SUPPORT 300
    MINNETONKA CENTER FOR THE ARTS
    2240 NORTH SHORE DRIVE
    WAYZATA,MN55391
      CHARITY SUPPORT THE ARTS 350
    MN ZOO FOUNDATION
    13000 ZOO BOULEVARD
    APPLE VALLEY,MN55124
      CHARITY WILDLIFE CONSERVATION AND SUPPORT 300
    NATIONAL FEDERATION OF THE BLIND MN
    100 EAST 22ND ST
    MINNEAPOLIS,MN55404
      CHARITY ASSISTANCE TO THE BLIND 300
    OBERHOLTZER FOUNDATION
    818 3RD AVE 305
    EXCELSIOR,MN55331
      CHARITY PROTECTION OF WOODLANDS 600
    PAGE EDUCATION FOUNDATION
    PO BOX 581254
    MINNEAPOLIS,MN554581254
      CHARITY ASSIST STUDENTS 5,400
    PEOPLE FOR PARKS
    PO BOX 24901
    MINNEAPOLIS,MN55424
      CHARITY PARKLAND CONSERVATION 250
    PLANNED PARENTHOOD
    434 WEST 33RD STREET
    NEW YORK,NY100012601
      CHARITY SPPORT REPRODUCTIVE HEALTH 1,000
    PRINCIPIA
    13201 CLAYTON ROAD
    ST LOUIS,MO63131
      CHARITY ASSIST STUDENTS 7,500
    PROJECT FOR PRIDE IN LIVING
    1035 EAST FRANKLIN AVE
    MINNEAPOLIS,MN55404
      CHARITY SUPPORT PEOPLE IN NEED 500
    SALVATION ARMY
    PO BOX 131240
    ROSEVILLE,MN55113
      CHARITY ASSIST PEOPLE IN NEED 4,500
    SCIENCE MUSEUM OF MINNESOTA
    120 WEST KELLOGG BLVD
    ST PAUL,MN55102
      CHARITY SUPPORT SCIENCE EDUCATION 1,000
    ST LOUIS PARK ROTARY FOUNDATION
    PO BOX 26728
    ST LOUIS PARK,MN55426
      CHARITY GENERAL SUPPORT 500
    ST MARK'S CHURCH
    519 OAK GROVE STREET
    MINNEAPOLIS,MN55403
      CHARITY GENERAL SUPPORT 500
    ST PAUL'S SCHOOL FOR BOYS
    11152 FALLS ROAD
    LUTHERVILLETIMONIUM,MD21022
      CHARITY ASSIST STUDENTS 550
    TEACH FOR AMERICA TWIN CITIES
    401 2ND AVE N STE 200
    MINNEAPOLIS,MN55401
      CHARITY GENERAL SUPPORT 1,000
    THE BRIDGE
    2200 EMERSON AVE S
    MINNEAPOLIS,MN55405
      CHARITY GENERAL SUPPORT 500
    TREE TRUST
    2350 WYCLIFF STREET 200
    ST PAUL,MN55414
      CHARITY ASSIST NATURE 500
    TUBMAN FAMILY ALLIANCE
    3111 FIRST AVE S
    MINNEAPOLIS,MN55408
      CHARITY ASSIST FAMILIES IN DISTRESS 1,000
    TWIN CITIES HABITAT FOR HUMANITY
    3001 4TH ST SE
    MINNEAPOLIS,MN55414
      CHARITY GENERAL SUPPORT 1,000
    TWIN CITIES PUBLIC TELEVISION
    172 EAST 4TH STREET
    ST PAUL,MN55101
      CHARITY GENERAL SUPPORT 1,000
    TWINWEST CHAMBER FOUNDATION
    10700 OLD CO RD 15
    SUITE 170
    PLYMOUTH,MN55441
      CHARITY GENERAL SUPPORT 5,000
    UNITED NEGRO COLLEGE FUND
    PO BOX 1021
    MERRIFIELD,VA22116
      CHARITY ASSIST STUDENTS 500
    UNIVERSITY OF MINNESOTA FOUNDATION
    PO BOX 7080
    MINNEAPOLIS,MN55170
      CHARITY ASSIST STUDENTS 3,000
    UNIVERSITY OF MN ALUMNI ASSOCIAION
    200 OAK ST SE STE 200
    MINNEAPOLIS,MN554552040
      CHARITY GENERAL SUPPORT 1,000
    USO
    PO BOX 96322
    WASHINGTON,DC200906322
      CHARITY SUPPORT THE TROOPS 500
    WALKER ART CENTER
    1750 HENNEPIN AVE
    MINNEAPOLIS,MN55403
      CHARITY ART APPRECIATION 5,000
    WASHBURN CHILD GUIDE CENTER
    2430 NICOLLET AVE
    MINNEAPOLIS,MN55404
      CHARITY GENERAL SUPPORT 250
    WAYZATA HISTORICAL SOCIETY
    402 EAST LAKE STREET
    WAYZATA,MN55391
      CHARITY GENERAL SUPPORT 250
    WEISMAN ART MUSEUM
    333 EAST RIVER ROAD
    MINNEAPOLIS,MN55455
      CHARITY ART APPRECIATION 500
    WOMANS CLUB OF MINNEAPOLIS
    410 OAK GROVE STREET
    MINNEAPOLIS,MN554033294
      CHARITY GENERAL SUPPORT 10,000
    WOMANVENTURE
    2324 UNIVERSITY AVE WEST
    ST PAUL,MN55114
      CHARITY GENERAL SUPPORT 500
    YWCA OF MINNEAPOLIS
    1130 NICOLLET MALL
    MINNEAPOLIS,MN55403
      CHARITY GENERAL SUPPORT 300
    ZENON DANCE
    528 HENNEPIN AVE
    MINNEAPOLIS,MN55403
      CHARITY GENERAL SUPPORT 1,000
    ACUITY MEDICAL
    117 GIBRALTER ROAD
    ANNAPOLIS,MD21401
        MEDICAL SUPPORT 500
    VIRGINA HARRIS CHRISTIAN MUESEUM
    40 GROVE ST
    SUITE 150
    WELLESLEY,MA02482
        GENERAL SUPPORT 10,000
    PEOPLE RESPSOC PRISM
    730 FLORIDA AVE S
    GOLDEN VALLEY,MN55426
        GENERAL SUPPORT 250
    Total .................................bullet 3a 188,350
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 11
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code
    (b)
    Amount
    (c)
    Exclusion code
    (d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3Interest on savings and temporary cash investments     14 201,617  
    4 Dividends and interest from securities....     14 44,434  
    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     14 175,349  
    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)..   421,400  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13421,400
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow
    Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 12
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section
    Yes
    No
    501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is “Yes,” complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527?...........
    b
    If “Yes,” complete the following schedule.
    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer or fiduciary) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below
    (see instr.)?
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's namebullet



    Firm's addressbullet







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


    Software ID:  
    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
    THE HEAD FAMILY FOUNDATION
     
    Employer identification number

    20-2032551
    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
    THE HEAD FAMILY FOUNDATION
     
    Employer identification number

    20-2032551
    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
     
     

    MARTHA M HEAD    
    1616 W 22ND STREET
       
    MINNEAPOLIS, MN   55405

    $1,000,000


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

         
     
       

    $  


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

         
     
       

    $  


    (Complete Part II if there is a noncash contribution.)
    (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
    THE HEAD FAMILY FOUNDATION
     
    Employer identification number

    20-2032551
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
         
    (a) No.
    from
    Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (see instructions)
    (d)
    Date received
    1
    5,239 SHARES ADP INC STOCK   $305,198 2012-12-24
    (a) No.
    from
    Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (see instructions)
    (d)
    Date received
    1
    1,089 SHARES UNITED HEALTH GROUP   $59,645 2012-12-24
    (a) No.
    from
    Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (see instructions)
    (d)
    Date received
    1
    560 SHARES STERICYCLE INC STOCKS   $52,533 2012-12-24
    (a) No.
    from
    Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (see instructions)
    (d)
    Date received
    1
    2,185 SHARES MEDTRONIC STOCK   $93,114 2012-12-24
    (a) No.
    from
    Part I
    (b)
    Description of noncash property given
    (c)
    FMV (or estimate)
    (see instructions)
    (d)
    Date received
    1
    9,000 SHARES UNITED HEALTH GROUP   $489,510 2012-12-31
    (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
    THE HEAD FAMILY FOUNDATION
     
    Employer identification number

    20-2032551
    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:
    THE HEAD FAMILY FOUNDATION
    EIN: 20-2032551
    Person Name Explanation
    MARTHA M HEAD  
    MARTHA E H KIRWIN  
    VIRGINIA R HEAD  
    CHRISTOPHER KIRWAN  

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

    TY 2012 GainLossSaleOtherAssetsSch
    Name:
    THE HEAD FAMILY FOUNDATION
    EIN: 20-2032551
    Name Date Acquired How Acquired Date Sold Purchaser Name Gross Sales Price Basis Basis Method Sales Expenses Total (net) Accumulated Depreciation
    63S CH ROBINSON WORLDWIDE 2011-06 PURCHASE 2012-07   3,606 4,873     -1,267  
    71S CH ROBINSON WORLDWIDE 2011-06 PURCHASE 2012-07   3,974 5,491     -1,517  
    91S PRECISION CASTPARTS CORP   PURCHASE 2012-08   13,963 12,145     1,818  
    126S CH ROBINSON WORLDWIDE 2011-06 PURCHASE 2012-08   6,617 9,689     -3,072  
    117S CH ROBINSON WORLDWIDE 2011-12 PURCHASE 2012-08   6,145 7,775     -1,630  
    85S NESTLE SA   PURCHASE 2012-08   5,244 4,281     963  
    185S AMPHENOL COPR 2011-04 PURCHASE 2012-08   11,400 9,950     1,450  
    1000S SPDR BARCLAYS   PURCHASE 2012-11   39,229 41,550     -2,321  
    885S CSX CORP   PURCHASE 2012-12   17,364 14,431     2,933  
    85S CNOOC LTD   PURCHASE 2012-12   17,878 14,961     2,917  
    82S APACHE CORP 2012-08 PURCHASE 2012-12   6,288 6,774     -486  
    772S ABB LTD   PURCHASE 2012-12   14,976 14,455     521  
    625S WISDOM TREE JAPAN TOTAL DIV FD   PURCHASE 2012-12   20,862 21,825     -963  
    500S AMEX SPECTOR SPDR TRUST   PURCHASE 2012-12   35,389 34,520     869  
    495S AFLAC INC   PURCHASE 2012-12   26,121 26,100     21  
    465S AMPHENOL CORP   PURCHASE 2012-12   28,428 22,912     5,516  
    415S ABBOTT LABS   PURCHASE 2012-12   26,663 20,544     6,119  
    325S BHP LTD   PURCHASE 2012-12   23,289 25,499     -2,210  
    170S APACHE CORP   PURCHASE 2012-12   13,035 12,376     659  
    115S BLACKROCK INC   PURCHASE 2012-12   22,498 17,571     4,927  
    1,000S AMEX UTILITIES SELECT SECTOR   PURCHASE 2012-12   35,019 31,490     3,529  
    1,000S AMEX MATERIALS SELECT   PURCHASE 2012-12   36,179 38,659     -2,480  
    25,000 FACE FED FARM CREDIT   PURCHASE 2013-01   25,675 25,000     675  
    25,000 FACE BURNSVILLE MN   PURCHASE 2013-01   26,058 25,000     1,058  
    970S FPL GROUP CAP   PURCHASE 2013-01   24,603 23,998     605  
    945S TELEFONICA SA   PURCHASE 2013-01   13,834 26,758     -12,924  
    809S PAYCHEX INC   PURCHASE 2013-01   25,798 26,135     -337  
    605S WASTE MANAGEMENT INC   PURCHASE 2013-01   21,114 20,287     827  
    478S HSBC HOLDINGS PLC   PURCHASE 2013-01   26,007 25,103     904  
    455S HJ HEINZ CO   PURCHASE 2013-01   26,703 22,344     4,359  
    440S FMC TECHNOLOGIES   PURCHASE 2013-01   19,434 8,046     11,388  
    415S ILLINOIS TOOL WORKS   PURCHASE 2013-01   26,045 19,788     6,257  
    35S VODAFONE GROUP PLC   PURCHASE 2013-01   916 1,114     -198  
    33S PEPSICO 2012-07 PURCHASE 2013-01   2,350 2,287     63  
    325S PEPSICO   PURCHASE 2013-01   23,139 16,071     7,068  
    312S TRANSOCEAN LTD   PURCHASE 2013-01   17,179 26,463     -9,284  
    310S JP MORGAN CHASE & CO   PURCHASE 2013-01   14,213 10,397     3,816  
    300S WALMART STORES INC   PURCHASE 2013-01   20,490 15,897     4,593  
    260S NORTHROP GRUMMAN CORP   PURCHASE 2013-01   17,430 13,001     4,429  
    235S PERRIGO CO   PURCHASE 2013-01   24,511 19,820     4,691  
    225S PNC FINANCIAL SERVICES GROUP   PURCHASE 2013-01   13,344 14,045     -701  
    220S INTERCONTINENTAL EXCHANGE   PURCHASE 2013-01   28,521 27,948     573  
    1390S STAPLES INC   PURCHASE 2013-01   16,610 18,865     -2,255  
    110S TRANSOCEAN LTD   PURCHASE 2013-01   6,057 5,400     657  
    104S PRECISION CASTPARTS CORP   PURCHASE 2013-01   19,433 12,901     6,532  
    1000S VODAFONE GROUP PLC   PURCHASE 2013-01   26,200 28,293     -2,093  
    1000 FACE JP MORGAN CHASE & CO   PURCHASE 2013-01   26,340 25,000     1,340  
    85S EDISON INTL   PURCHASE 2013-02   4,073 3,243     830  
    69S THERMO FISHER SCIENTIFIC   PURCHASE 2013-02   5,094 3,889     1,205  
    65S DIAGEO PLC   PURCHASE 2013-02   7,653 4,948     2,705  
    520S STARWOOD HOTELS   PURCHASE 2013-02   32,208 23,569     8,639  
    51S SCHLUMBERGER LTD 2012-08 PURCHASE 2013-02   4,000 3,615     385  
    48S 3M CO   PURCHASE 2013-02   4,927 4,215     712  
    47S MCKESSON CORP   PURCHASE 2013-02   4,808 4,259     549  
    46S GOLDMAN SACHS GROUP   PURCHASE 2013-02   6,926 8,022     -1,096  
    411S SCHLUMBERGER LTD   PURCHASE 2013-02   28,234 30,795     -2,561  
    400S JOHNSON & JOHNSON   PURCHASE 2013-02   30,076 25,672     4,404  
    33S JOHNSON & JOHNSON   PURCHASE 2013-02   2,481 1,465     1,016  
    25S NORDSTROM INC   PURCHASE 2013-02   1,378 1,044     334  
    200S SAP AKTIENGESELLSCHAFT   PURCHASE 2013-02   15,961 14,332     1,629  
    19S COLGATE PAMOLIVE   PURCHASE 2013-02   2,077 1,484     593  
    1835S TAIWAN SEMICONDUCTER   PURCHASE 2013-02   32,993 20,717     12,276  
    145S NESTLE SA   PURCHASE 2013-02   10,206 6,909     3,297  
    140S QUALCOMM   PURCHASE 2013-02   9,378 8,768     610  
    130S REPUBLIC SERVICES INC   PURCHASE 2013-02   4,088 4,205     -117  
    940S KOMATSU   PURCHASE 2013-02   24,034 20,465     3,569  
    492S RECKITT BENCKISER GROUP   PURCHASE 2013-02   34,487 26,902     7,585  
    300S MCKESSON CORP   PURCHASE 2013-02   30,956 26,277     4,679  
    300S 3M CO   PURCHASE 2013-02   31,244 22,895     8,349  
    2985S TESCO PLC   PURCHASE 2013-02   16,987 22,259     -5,272  
    20S APPLE INC   PURCHASE 2013-02   9,020 4,729     4,291  
    200S GOLDMAN SACHS GROUP   PURCHASE 2013-02   31,415 26,298     5,117  
    315S MCDONALDS   PURCHASE 2013-02   29,978 18,063     11,915  
    200S SAP AKTIENGESLLSCHAFT   PURCHASE 2013-02   15,960 5,969     9,991  
    287S CHEVRON   PURCHASE 2013-02   33,171 22,428     10,743  

    TY 2012 InvestmentsCorpBondsSchedule
    Name:
    THE HEAD FAMILY FOUNDATION
    EIN: 20-2032551
    Name of Bond End of Year Book Value End of Year Fair Market Value
    25,000 FED FARM CREDIT BANK    
    1,000 SPDR BARCLAYS CAPITAL    
    970 FPL GROUP CAP    
    1,000 JPMORGAN CHASE & CO    
    25,000 BURNSVILLE MINN    
    1035 VODAFONE GROUP PLC    

    TY 2012 InvestmentsCorpStockSchedule
    Name:
    THE HEAD FAMILY FOUNDATION
    EIN: 20-2032551
    Name of Stock End of Year Book Value End of Year Fair Market Value
    470S ACCENTURE LTD 33,821 33,821
    570S AMERICAN EXPRESS CO 42,613 42,613
    650S AMPHENOL CORP    
    170S APACHE CORP    
    80S APPLE INC 31,723 31,723
    600S ADP INC 41,316 41,316
    505S BAXTER INTL INC 34,981 34,981
    320S BERKSHIRE HATHAWAY INC 35,814 35,814
    115S BLACKROCK INC    
    377S CH ROBINSON WORLDWIDE INC    
    440S FMC TECHNOLOGIES INC    
    246S GOLDMAN SACHS GROUP INC    
    415S ILLINOIS TOOL WORKS INC.    
    220S INTERCONTINENTALEXCHANGE INC.    
    380S MCDONALDS CORP    
    325S MCKESSON CORP    
    660S NIKE INC 42,029 42,029
    600S NORDSTROM INC. 35,964 35,964
    325S PEPSICO INC    
    235S PERRIGO CO    
    195S PRECISION CASTPARTS CORP    
    500S QUALCOMM INC. 30,545 30,545
    1100S REPUBLIC SERVICES INC 37,334 37,334
    360S SCHLUMBERGER LTD    
    520S STARWOOD HOTELS & RESORTS WW IN    
    500S THERMO FISCHER SCIENTIFIC INC 42,315 42,315
    405S UNITED TECHNOLOGIES CORP 37,641 37,641
    772S ABB LTD    
    495S AFLAC INC    
    325S BHP BILLITON LIMITED    
    85S CNOOC-CHINA NATIONAL OFFSHOR    
    300S DIAGED PLC 34,485 34,485
    478S HSBC    
    940S KOMATSU JPY    
    500S NESTLE S.A 32,738 32,738
    492S RECKITT BENCKISTER PLC    
    400S SAP AG    
    1835S TAIWAN SEMICONDUCTOR    
    945S TELEFONICA SA    
    2985S TESCO PLC    
    312S TRANSOCEAN    
    415S ABBOTT LABS    
    287S CHEVRON CORP    
    600S COLGATE PALMOLIVE CO 34,374 34,374
    885S CSX CORP    
    700S EDISON INTL COM 33,712 33,712
    455S HEINZ HJ CO    
    433S JOHNSON & JOHNSON    
    310S JP MORGAN CHASE & CO    
    260S NORTHROP GRUMMAN CORP    
    809S PAYCHEX INC    
    225S PNC FINANCIAL SERVICES GRPU    
    1390S STAPLES INC    
    300S WAL MART STORES    
    605S WASTE MANAGEMENT    
    348S 3M CO    
    26S SPDR S&P 500 ETF TRUST    
    420S I SHARES MSCI ALL COUNTRY ASIA    
    172S I SHARES MSCI EAFE    
    978S VANGUARD EMERGING MARKETS    
    625S WISDOMTREE JAPAN HEDGED EQUITY    
    500S AMEX ENERGY SELECT    
    1000S AMEX MATERIALS    
    1000S AMEX UTILITIES    
    194S I SHARES DOW JONES SELECT    
    800S MEDTRONIC INC 41,176 41,176
    340S STERICYCLE INC 37,546 37,546
    600S UNITED HEALTH GROUP 39,288 39,288

    TY 2012 InvestmentsOtherSchedule2
    Name:
    THE HEAD FAMILY FOUNDATION
    EIN: 20-2032551
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    MINNWEST BANK SUBORDINATED NOTE FMV 2,000,000 2,000,000
    ISHARES DJ SELECT DIVIDEND INDEX FMV 210,465 210,465
    JPM LARGE CAP GROWTH FD - SEL FMV 342,754 342,754
    SPDR S&P 500 EFT TRUST FMV 476,608 476,608
    ISHARES CORE S&P MID-CAP ETF FMV 358,397 358,397
    ISHARES MSCI EAFE INDEX FUND FMV 297,559 297,559
    MFS INTL VALUE-I FMV 448,871 448,871
    ISHARES MSCI ALL COUTNRY ASIA FMV 274,781 274,781
    ISHARES MSCI CHINA INDEX FD FMV 21,860 21,860
    VANGUARD FTSE EMERGING MARKETS EFT FMV 167,710 167,710
    ISHARES MSCI ACWI INDEX FUND FMV 69,250 69,250
    INCOME TAX RECEIVABLE FMV 10,967 10,967

    TY 2012 OtherIncreasesSchedule
    Name:
    THE HEAD FAMILY FOUNDATION
    EIN: 20-2032551
    Description Amount
    BOOK UNREALIZED GAINS 156,024


    TY 2012 OtherLiabilitiesSchedule
    Name:
    THE HEAD FAMILY FOUNDATION
    EIN: 20-2032551
    Description Beginning of Year - Book Value End of Year - Book Value
    INCOME TAX PAYABLE 1,526  


    TY 2012 OtherProfessionalFeesSchedule
    Name:
    THE HEAD FAMILY FOUNDATION
    EIN: 20-2032551
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    LOWRY HILL FEES 2,469 1,234   1,235
    JP MORGAN FEES 3,643 1,822   1,821
    WELLS FARGO BANK CHARGES 133      


    TY 2012 TaxesSchedule
    Name:
    THE HEAD FAMILY FOUNDATION
    EIN: 20-2032551
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 590 590