Form990-PF
Click to see attachment

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
HITCHCOCK FREE ACADEMY
 

Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 155   Room/suite
City or town, state, and ZIP code
BRIMFIELD, MA01010
A Employer identification number

04-2277210
B Telephone number (see instructions)

(413) 245-9977
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$3,550,258J 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) 321,097
2 Check bullet
3 Interest on savings and temporary cash investments 1,102 1,102 1,102
4 Dividends and interest from securities...... 85,395 85,395 85,395
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 124,935
b Gross sales price for all assets on line 6a 857,200
7 Capital gain net income (from Part IV, line 2)... 124,935
8 Net short-term capital gain......... 410
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 41,933   41,933
12 Total. Add lines 1 through 11........ 574,462 211,432 128,840
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 8,755 875 875 7,880
14 Other employee salaries and wages...... 66,043     66,043
15 Pension plans, employee benefits....... 6,658     6,658
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 4,030 403 403 3,627
c Other professional fees (attach schedule).... Click to see attachment 8,170 8,170 8,170  
17 Interest............... 85      
18 Taxes (attach schedule) (see instructions) Click to see attachment 247     247
19 Depreciation (attach schedule) and depletion... Click to see attachment 3,583    
20 Occupancy.............. 39,920   10,410 29,510
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 57,195   30,037 27,158
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 194,686 9,448 49,895 141,123
25 Contributions, gifts, grants paid........ 6,000 6,000
26 Total expenses and disbursements. Add lines 24 and 25 200,686 9,448 49,895 147,123
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 373,776
b Net investment income (if negative, enter -0-) 201,984
c Adjusted net income (if negative, enter -0-)... 78,945
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............... 2,292 2,285 2,285
2 Savings and temporary cash investments.......... 44,252 290,991 291,828
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........... 3,000 1,000 1,000
10a Investments—U.S. and state government obligations (attach schedule) 22,568 Click to see attachment87,166 87,166
b Investments—corporate stock (attach schedule)........ 1,099,737 Click to see attachment1,091,679 1,100,073
c Investments—corporate bonds (attach schedule)........ 415,919 Click to see attachment480,696 489,221
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 bullet214,428
Less: accumulated depreciation (attach schedule) bullet151,144 60,257 Click to see attachment63,284 1,578,685
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 1,648,025 2,017,101 3,550,258
Liabilities 17 Accounts payable and accrued expenses.......... 2,154 1,571
18 Grants payable...................    
19 Deferred revenue.................. 2,500 1,167
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)...... 2,763  
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22).......... 7,417 2,738
Net Assets or Fund Balances bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted.................... 37,003 32,736
25 Temporarily restricted................ 757 251,407
26 Permanently restricted................ 1,602,848 1,730,220
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).................... 1,640,608 2,014,363
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 1,648,025 2,017,101
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 1,640,608
2 Enter amount from Part I, line 27a..................... 2 373,776
3 Other increases not included in line 2 (itemize) bullet 3  
4 Add lines 1, 2, and 3.......................... 4 2,014,384
5 Decreases not included in line 2 (itemize) bulletClick to see attachment 5 21
6 Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30. 6 2,014,363
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 COLUMBIA SHORT TERM BOND FUND P 2012-03-16 2012-10-01
b PUBLICLY TRADED SECURITIES P    
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 58,511   58,101 410
b 798,689   674,164 124,525
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       410
b       124,525
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 2 124,935
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 3 410
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 120,595 1,649,054 0.073130
2010 122,118 1,650,475 0.073990
2009 92,759 1,468,035 0.063186
2008 122,846 1,672,330 0.073458
2007 92,921 1,935,338 0.048013
2 Total of line 1, column (d) ...................... 2 0.331777
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 0.066355
4 Enter the net value of noncharitable-use assets for 2012 from Part X, line 5..... 4 1,760,167
5 Multiply line 4 by line 3....................... 5 116,796
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 2,020
7 Add lines 5 and 6......................... 7 118,816
8 Enter qualifying distributions from Part XII, line 4.............. 8 154,141
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 2,020
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 2,020
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 2,020
6 Credits/Payments:
a 2012 estimated tax payments and 2011 overpayment credited to 2012 6a 1,000
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 1,000
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 1,020
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)
    bulletMA
    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.Click to see attachment
    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.HITCHCOCKACADEMY.ORG
    14
    The books are in care ofbulletJOYCE SINNOTT Telephone no.bullet (413) 245-9977
    Located atbullet2 BROOKFIELD ROADBRIMFIELDMA ZIP+4bullet01010
    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
     
    No
    .........bullet
    c
    If the answer is “Yes” to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?............
    If “Yes,” attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?........................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?....
    6b
     
    No
    If “Yes” to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    Form 990-PF (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
    PATRICIA BAMBERGERClick to see attachment TRUSTEE
    1.00     		0 0 0
    2 BROOKFIELD RD
    BRIMFIELD,MA01010
    LARRY LOWENTHALClick to see attachment TRUSTEE
    1.00     		0 0 0
    2 BROOKFIELD RD
    BRIMFIELD,MA01010
    JAMES GRIESINGClick to see attachment TRUSTEE
    1.00     		0 0 0
    2 BROOKFIELD RD
    BRIMFIELD,MA01010
    MARGARET GRIESINGClick to see attachment CLERK
    1.00     		0 0 0
    2 BROOKFIELD RD
    BRIMFIELD,MA01010
    CARTER COOLEYClick to see attachment TRUSTEE
    1.00     		0 0 0
    2 BROOKFIELD RD
    BRIMFIELD,MA01010
    MIKE DEFALCOClick to see attachment TRUSTEE
    1.00     		0 0 0
    2 BROOKFIELD RD
    BRIMFIELD,MA01010
    SUSAN STAPLES-HOLTClick to see attachment VICE PRES
    1.00     		0 0 0
    2 BROOKFIELD RD
    BRIMFIELD,MA01010
    LORE KNOUSEClick to see attachment TRUSTEE
    1.00     		0 0 0
    2 BROOKFIELD RD
    BRIMFIELD,MA01010
    LEILA GLASERClick to see attachment TRUSTEE
    1.00     		0 0 0
    2 BROOKFIELD RD
    BRIMFIELD,MA01010
    ELIZABETH GOUINClick to see attachment PRESIDENT
    1.00     		0 0 0
    2 BROOKFIELD RD
    BRIMFIELD,MA01010
    BEVERLY TETREAULTClick to see attachment TRUSTEE
    1.00     		0 0 0
    2 BROOKFIELD RD
    BRIMFIELD,MA01010
    EMERSON RECOREClick to see attachment TRUSTEE
    1.00     		0 0 0
    2 BROOKFIELD RD
    BRIMFIELD,MA01010
    LINDA WRIGHTClick to see attachment TRUSTEE
    1.00     		0 0 0
    2 BROOKFIELD RD
    BRIMFIELD,MA01010
    JOYCE SINNOTTClick to see attachment TREASURER
    5.00     		8,755 0 0
    2 BROOKFIELD RD
    BRIMFIELD,MA01010
    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 OPERATION OF A COMMUNITY CULTURAL CENTER 1406 MEETINGS 22,758 TOTAL ATTENDANCE 183,752
    2 GRANT COLLEGE SCHOLARSHIPS TO LOCAL RESIDENTS 12 INDIVIDUALS 6,000
    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
    1,615,062
    b
    Average of monthly cash balances.......................
    1b
    169,910
    c
    Fair market value of all other assets (see instructions)................
    1c
    2,000
    d
    Total (add lines 1a, b, and c).........................
    1d
    1,786,972
    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
    1,786,972
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see
    instructions) .............................
    4
    26,805
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    1,760,167
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    88,008
    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
    147,123
    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
    7,018
    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
    154,141
    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
    2,020
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    152,121
    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$ 154,141
    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.....  
    e Remaining amount distributed out of corpus 154,141
    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 5 154,141
    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
     
    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
    78,945 49,741 82,524 34,890 246,100
    b 85% of line 2a ......... 67,103 42,280 70,145 29,657 209,185
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....     		154,141 121,092 122,118 93,108 490,459
    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 ....     		154,141 121,092 122,118 93,108 490,459
    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...     		58,672 54,969 55,016 48,935 217,592
    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 or e-mail of the person to whom applications should be addressed:
    GUIDANCE OFFICE
    TANTASQUA REGIONAL HIGH SCHOOL
    STURBRIDGE,MA01566
    (508) 347-9301
    bThe form in which applications should be submitted and information and materials they should include:
    REQUIREMENTS ARE: A SCHOLARSHIP APPLICATION FORM, A LETTER OF RECOMMENDATION, AND A COPY OF SCHOLASTIC RECORD WITH A GPA OF 2.5 OR HIGHER. ALL APPLICANTS MUST ALSO APPEAR FOR A PERSONAL INTERVIEW. ATTACHING A PERSONAL ESSAY AND/OR PHOTO IS OPTIONAL.
    cAny submission deadlines:
    APRIL 12, 2012
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    LIMITED TO RESIDENTS OF BRIMFIELD, FISKDALE, HOLLAND, STURBRIDGE, AND WALES, MA WHO ARE SENIORS IN HIGH SCHOOL.
    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
    ALLISON LEBRUN
    552 LEADMINE RD
    STURBRIDGE,MA01566     		NONE   COLLEGE 500
    BENGAMIN DUNBAR
    15 CARRIAGE RD
    BRIMFIELD,MA01010     		NONE   COLLEGE 500
    DESIREE HAGEN
    3 CHURCH ST
    WALES,MA01081     		NONE   COLLEGE 500
    JULIA MOLLOY
    89 HAYNES RD
    BRIMFIELD,MA01010     		NONE   COLLEGE 500
    KATHLEEN DALEY
    207 SHEPARD RD
    STURBRIDGE,MA01566     		NONE   COLLEGE 500
    KELLY CREAMER
    124 MASHPAUG RD
    STURBRIDGE,MA01566     		NONE   COLLEGE 500
    MEGAN MCINTYRE
    15 AUDUBON WAY
    STURBRIDGE,MA01566     		NONE   COLLEGE 500
    MELISSA FRIO
    30 OLD FARM RD
    STURBRIDGE,MA01566     		NONE   COLLEGE 500
    RACHEL KELLER
    126 WALES RD
    HOLLAND,MA01521     		NONE   COLLEGE 500
    RYAN PHIFER
    223 STAFFORD RD
    WALES,MA01081     		NONE   COLLEGE 500
    SARAH LACAIRE
    21 KIMBALL HILL RD
    HOLLAND,MA01521     		NONE   COLLEGE 500
    TYLER BRESSE
    61 PAIGE HILL RD
    BRIMFIELD,MA01010     		NONE   COLLEGE 500
    Total .................................bullet 3a 6,000
    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
    aSALE OF HISTORY         35
    bUSE OF FACILITIES         10,410
    cPROGRAMS & ACTIVITIES INCOME         30,002
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3Interest on savings and temporary cash investments     14 1,102  
    4 Dividends and interest from securities....     14 85,395  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6Net rental income or (loss) from personal property          
    7 Other investment income.....          
    8Gain or (loss) from sales of assets other than inventory     18 124,935  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory..          
    11 Other revenue: aFEDERAL EXCISE TAX REFUND     1 1,486  
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e)..   212,918 40,447
    13Total. Add line 12, columns (b), (d), and (e)..................
    13253,365
    (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 BOOKLET DESCRIBES THE HISTORY OF THE ACADEMY AND EXPLAINS ITS ONGOING PURPOSE
    1B ACTIVITIES RELATED TO THE OPERATION OF A COMMUNITY CULTURAL CENTER
    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
    HITCHCOCK FREE ACADEMY
     
    Employer identification number

    04-2277210
    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
    HITCHCOCK FREE ACADEMY
          		Employer identification number

    04-2277210
    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
     
     

    BLUE CROSS BLUE SHIELD OF MA    
    401 PARK DR
       
    BOSTON, MA   02215

    		$5,000


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

    COMMUNITY FOUNDATION OF WESTERN MA    
    1500 MAIN ST SUITE 2300
       
    SPRINGFIELD, MA   01115

    		$14,900


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

    MGM RESORTS INTERNATIONAL    
    3600 LAS VEGAS BLVD
       
    LAS VEGAS, NV   89109

    		$250,000


    (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.)
    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
    HITCHCOCK FREE ACADEMY
          		Employer identification number

    04-2277210
    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
    HITCHCOCK FREE ACADEMY
          		Employer identification number

    04-2277210
    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 AccountingFeesSchedule
    Name:
    HITCHCOCK FREE ACADEMY
    EIN: 04-2277210
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING & LEGAL 4,030 403 403 3,627

    TY 2012 CompensationExplanation
    Name:
    HITCHCOCK FREE ACADEMY
    EIN: 04-2277210
    Person Name Explanation
    PATRICIA BAMBERGER  
    LARRY LOWENTHAL  
    JAMES GRIESING  
    MARGARET GRIESING  
    CARTER COOLEY  
    MIKE DEFALCO  
    SUSAN STAPLES-HOLT  
    LORE KNOUSE  
    LEILA GLASER  
    ELIZABETH GOUIN  
    BEVERLY TETREAULT  
    EMERSON RECORE  
    LINDA WRIGHT  
    JOYCE SINNOTT  

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

    TY 2012 DepreciationSchedule
    Name:
    HITCHCOCK FREE ACADEMY
    EIN: 04-2277210
    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
    ORIGINAL LAND PURCHASE 2030-01-01 380              
    OLD HOTEL PROPERTY 2030-01-01 1,500              
    PARKING AREA - HOTEL LOT 1962-01-01 3,285              
    WEBSTER PLACE LAND 1965-01-01 1,500              
    CHARLES ATHLETIC FIELD 1965-01-01 1,000              
    ARTESIAN WELLS 1972-01-01 2,602              
    TENNIS COURT 1965-01-01 33,594              
    TENNIS COURT WALKWAY, LIGHTS, BACKBOARD 1977-01-01 1,639 1,639   15.0000        
    TENNIS COURT CHAIN LINK FENCE 1979-01-01 1,466 1,466   15.0000        
    GOULD LAND                  
    FAX MACHINE 1998-06-15 290 290 S/L 5.0000        
    BUILDING & IMPROVEMENTS 2030-01-01 78,826 78,826 S/L 50.0000        
    FIRE LOOP 1987-01-01 1,635 1,635 S/L 15.0000        
    ROOF 1989-06-01 9,330 9,330 S/L 15.0000        
    2 FUEL OIL TANKS 1989-12-01 1,456 1,456 S/L 15.0000        
    HANDICAP RAMP 1996-12-02 13,129 13,129 S/L 15.0000        
    HANDICAP RESTROOM 1998-07-24 13,102 11,792 S/L 15.0000 873      
    FURNITURE 2030-01-01 9,992 9,992 S/L 10.0000        
    TENNIS BALL SERVER 1975-01-01 134 134 S/L 5.0000        
    SMITH CORONA TYPEWRITER 1989-09-01 240 240 S/L 5.0000        
    PROJECTOR CART & 2 OFFICE CHAIRS 1990-01-01 302 302 S/L 5.0000        
    TV & VCR 1991-01-01 451 451 S/L 5.0000        
    16 CHAIRS & 3 CHAIR TRUCKS 1991-01-01 689 689 S/L 5.0000        
    EQUIPMENT CART 1991-01-01 139 139 S/L 5.0000        
    OFFICE CHAIRS 2000-05-03 298 298 S/L 5.0000        
    VCR 2000-02-09 70 70 S/L 5.0000        
    MODEM 2000-04-10 100 100 S/L 5.0000        
    MOTION DETECTOR 2000-04-19 575 575 S/L 5.0000        
    3 FLOOR LAMPS 2001-06-14 810 810 S/L 5.0000        
    TELEPHONE 2001-05-22 265 265 S/L 5.0000        
    CHARLES ATHLETIC FIELD STUDY 2001-04-25 1,400              
    DELL COMPUTER 2002-12-31 758 758 S/L 5.0000        
    HP 318 DIGITAL CAMERA 2002-12-31 130 130 S/L 5.0000        
    RESTROOM RENOVATIONS 2002-12-15 5,661 3,428 S/L 15.0000 377      
    CHARLES FIELD (BRIDGE & LAND SWAP) 2002-03-28 453              
    FIRE ALARM SYSTEM 2005-02-07 4,025 4,025 S/L 5.0000        
    PANASONIC TELEPHONE 2005-03-09 150 150 S/L 5.0000        
    TABLES 2005-08-31 173 173 S/L 5.0000        
    BANQUET TABLES 2006-03-09 160 160 S/L 5.0000        
    CANON COLOR COPIER 2007-01-22 180 177 S/L 5.0000 3      
    TABLES 2007-06-07 113 104 S/L 5.0000 9      
    DEHUMIDIFIERS 2007-06-29 496 446 S/L 5.0000 50      
    POP-UP GAZEBO 2007-09-04 87 75 S/L 5.0000 12      
    PRINTER 2008-04-08 306 229 S/L 5.0000 61      
    LAPTOP COMPUTER 2008-06-05 647 463 S/L 5.0000 130      
    INSULATING CURTAINS 2008-12-24 2,088 1,253 S/L 5.0000 417      
    PEERLESS STEAM BOILER 2009-11-02 8,464 1,223 S/L 15.0000 564      
    INSULATING CURTAINS 2009-03-04 1,657 939 S/L 5.0000 331      
    DELL LAPTOP COMPUTER 2009-08-14 904 437 S/L 5.0000 60      
    CAMERA 2009-07-17 205 99 S/L 5.0000 41      
    FILE CABINET (MEMEORIAL ROOM) 2010-06-29 100 30 S/L 5.0000 20      
    CHAIR (MEMEORIAL ROOM) 2010-08-05 75 21 S/L 5.0000 15      
    TABLES 2010-08-23 200 53 S/L 5.0000 40      
    EXTERNAL HARD DRIVE 2010-06-04 106 34 S/L 5.0000 21      
    HP 8500 PRINTER 2010-10-31 100 23 S/L 5.0000 20      
    VACUUM CLEANER 2011-12-31 879   S/L 5.0000 176      
    TABLES (4) 2012-12-31 1,047   S/L 5.0000        
    FIRE ESCAPE (PARTIAL COSTS) 2012-03-21 2,240              
    MARLEY REMOVABLE FLOOR 2012-08-06 2,698   S/L 5.0000 225      
    LAPTOP 2012-04-23 1,033   S/L 5.0000 138      

    TY 2012 GeneralExplanationAttachment
    Name:
    HITCHCOCK FREE ACADEMY
    EIN: 04-2277210
    Identifier Return Reference Explanation
    GENERAL ELECTIONS   YEAR ENDED: DECEMBER 31, 2012 04-2277210 HITCHCOCK FREE ACADEMY HITCHCOCK FREE ACADEMY PO BOX 155 BRIMFIELD, MA 01010 ELECTING OUT OF BONUS DEPRECIATION ALLOWANCE FOR ALL ELIGIBLE DEPRECIABLE PROPERTY THE TAXPAYER ELECTS OUT OF FIRST-YEAR BONUS DEPRECIATION ALLOWANCE UNDER IRC SECTION 168(K) FOR ALL ELIGIBLE ASSET CLASSES OF DEPRECIABLE PROPERTY ACQUIRED AFTER DECEMBER 31, 2007. THIS ELECTION APPLIES TO ALL ELIGIBLE DEPRECIABLE PROPERTY PLACED IN SERVICE DURING THE TAX YEAR.

    TY 2012 InvestmentsCorpBondsSchedule
    Name:
    HITCHCOCK FREE ACADEMY
    EIN: 04-2277210
    Name of Bond End of Year Book Value End of Year Fair Market Value
    FIXED INCOME 480,696 489,221

    TY 2012 InvestmentsCorpStockSchedule
    Name:
    HITCHCOCK FREE ACADEMY
    EIN: 04-2277210
    Name of Stock End of Year Book Value End of Year Fair Market Value
    EQUITIES 1,006,080 1,006,724
    REITS 46,721 61,281
    COMMODITIES 38,878 32,068

    TY 2012 InvestmentsGovtObligationsSch
    Name:
    HITCHCOCK FREE ACADEMY
    EIN: 04-2277210
    US Government Securities - End of Year Book Value:

    87,166
    US Government Securities - End of Year Fair Market Value:

    87,166
    State & Local Government Securities - End of Year Book Value:


     
    State & Local Government Securities - End of Year Fair Market Value:


     


    TY 2012 LandEtcSchedule2
    Name:
    HITCHCOCK FREE ACADEMY
    EIN: 04-2277210
    Category / Item Cost / Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
    BUILDING 133,843 125,738 8,105 1,212,185
    FURNITURE & EQUIPMENT 31,766 25,406 6,360 30,000
    LAND 48,819   48,819 336,500


    TY 2012 MortgagesAndNotesPayableSch 
    Name:
    HITCHCOCK FREE ACADEMY
    EIN: 04-2277210
    Total Mortgage Amount:  

    Item No. 1
    Lender's Name COUNTRY BANK
    Lender's Title  
    Relationship to Insider  
    Original Amount of Loan 8500
    Balance Due  
    Date of Note 2009-11
    Maturity Date 2012-11
    Repayment Terms 36 MONTHLY PAYMENTS
    Interest Rate 0.0600
    Security Provided by Borrower SECURITY INTEREST IN ASSETS
    Purpose of Loan NEW BOILER
    Description of Lender Consideration  
    Consideration FMV  


    TY 2012 OtherDecreasesSchedule
    Name:
    HITCHCOCK FREE ACADEMY
    EIN: 04-2277210
    Description Amount
    MISC ADJUST 21


    TY 2012 OtherExpensesSchedule
    Name:
    HITCHCOCK FREE ACADEMY
    EIN: 04-2277210
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    EXPENSES        
    PROGRAMS & ACTIVITIES EXPENSE 38,408   30,037 8,371
    OFFICE SUPPLIES 785     785
    FUNDRAISING EXPENSES 9,964     9,964
    TECHNOLOGY 1,801     1,801
    OTHER ADMINISTRATIVE EXPENSES 5,254     5,254
    OTHER CORPORATE EXPENSES 184     184
    TELEPHONE 799     799


    TY 2012 OtherIncomeSchedule2
    Name:
    HITCHCOCK FREE ACADEMY
    EIN: 04-2277210
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    SALE OF HISTORY 35   35
    USE OF FACILITIES 10,410   10,410
    PROGRAMS & ACTIVITIES INCOME 30,002   30,002
    FEDERAL EXCISE TAX REFUND 1,486   1,486


    TY 2012 OtherProfessionalFeesSchedule
    Name:
    HITCHCOCK FREE ACADEMY
    EIN: 04-2277210
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT MANAGEMENT FEE 8,170 8,170 8,170  


    TY 2012 SubstantialContributorsSch
    Name:
    HITCHCOCK FREE ACADEMY
    EIN: 04-2277210
    Name Address
    MGM RESORTS INTERNATIONAL 3600 LAS VEGAS BLVD
    LAS VEGAS,NV89109


    TY 2012 TaxesSchedule
    Name:
    HITCHCOCK FREE ACADEMY
    EIN: 04-2277210
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    REAL ESTATE TAX 247     247