Form990-PF

Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Nonexempt Charitable Trust
Treated as a Private Foundation
Note. The foundation may be able to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0052
2012
Open to Public Inspection
For calendar year 2012, or tax year beginning 01-01-2012 , and ending 12-31-2012
Name of foundation
KOEPLIN FAMILY FOUNDATION
 
% FOUNDATION MANAGEMENT GROUP
Number and street (or P.O. box number if mail is not delivered to street address)1000 SECOND AVENUE 34th floorSuiteRoom/suite
City or town, state, and ZIP code
SEATTLE, WA981041022
A Employer identification number

41-1268766
B Telephone number (see instructions)

(206) 667-0300
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$1,958,546
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) 0
2 Check bullet
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities...... 66,887 66,887  
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 24,789
b Gross sales price for all assets on line 6a 602,861
7 Capital gain net income (from Part IV, line 2)... 24,789
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)....... -35,938 172  
12 Total. Add lines 1 through 11........ 55,738 91,848  
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).... 20,038 10,438   9,600
17 Interest...............        
18 Taxes (attach schedule) (see instructions) 1,415 613    
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... 35     35
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 21,488 11,051   9,635
25 Contributions, gifts, grants paid........ 27,000 127,013
26 Total expenses and disbursements. Add lines 24 and 25 48,488 11,051   136,648
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 7,250
b Net investment income (if negative, enter -0-) 80,797
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2012)
Form 990-PF (2012)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing...............      
2 Savings and temporary cash investments.......... 105,395 264,219 264,219
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) 77,118 86,898 86,898
b Investments—corporate stock (attach schedule)........ 1,027,444 Click to see attachment1,135,015 1,135,015
c Investments—corporate bonds (attach schedule)........ 712,993 Click to see attachment463,565 463,565
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans..............      
13 Investments—other (attach schedule)...........      
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet) Click to see attachment11,880 Click to see attachment8,849 Click to see attachment8,849
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 1,934,830 1,958,546 1,958,546
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable................... 500,000 400,000
19 Deferred revenue..................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22).......... 500,000 400,000
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 1,434,830 1,558,546
30 Total net assets or fund balances (see page 17 of the
instructions).................... 1,434,830 1,558,546
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 1,934,830 1,958,546
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 1,434,830
2 Enter amount from Part I, line 27a..................... 2 7,250
3 Other increases not included in line 2 (itemize) bulletClick to see attachment 3 116,466
4 Add lines 1, 2, and 3.......................... 4 1,558,546
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 1,558,546
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 50 SH EL PASO CORPORATION   2011-09-22 2012-01-25
b .64 SH EXELON CORP   2011-10-07 2012-03-16
c 36 SH AECOM TECHNOLOGY CORP   2011-06-08 2012-06-07
d 9 SH AECOM TECHNOLOGY CORP   2011-08-25 2012-06-07
e 23 SH ULTRA PETROLEUM CORP   2012-08-29 2012-10-04
25 SH ADTRAN INC   2011-10-26 2012-03-16
80 SH HORMEL FOODS CORPORATION   2011-05-18 2012-03-01
40 SH GENESEE & WYOMING INC A   2011-04-14 2012-04-04
30 SH MEDNAX INC   2011-08-23 2012-05-23
50 SH QUESTCOR PHARM INC   2012-05-24 2012-07-11
25 SH WATERS CORP   2012-03-19 2012-07-11
10 SH HAIN CELESTIAL GROUP INC   2012-02-03 2012-08-22
20 SH SOLARWINDS INC   2012-02-15 2012-08-22
10 SH HAIN CELESTIAL GROUP INC   2012-02-03 2012-10-05
50 SH SOLARWINDS INC   2012-02-15 2012-10-11
50 SH DOLLAR TREE INC   2012-02-21 2012-11-14
22 SH NXP SIMICONDUCTORS   2011-04-01 2012-01-19
12 SH NXP SIMICONDUCTORS   2011-07-01 2012-01-19
6 SH POTASH CP OF SASKATCHEWAN INC   2011-05-12 2012-04-30
6 SH POTASH CP OF SASKATCHEWAN INC   2011-08-05 2012-04-30
50 SH NTT DOCOMO INC   2011-09-22 2012-05-09
97 SH OGX PETROLEO E   2011-07-13 2012-06-11
15 SH PRECISION DRILLING COR   2011-07-01 2012-06-29
24 SH PRECISION DRILLING COR   2012-03-15 2012-06-29
27 SH PRECISION DRILLING COR   2012-04-25 2012-06-29
12 SH BRIDGESTONE CORP   2011-10-07 2012-09-25
6 SH BRIDGESTONE CORP   2012-02-28 2012-09-25
22 SH SOFTBANK CORP   2012-04-04 2012-09-20
6 SH TOYOTA MOTOR CORP   2012-02-08 2012-09-14
132 SH ALCATEL-LUCENT   2012-01-09 2012-12-31
5 SH GOLDCORP INC   2012-09-19 2012-12-20
6 SH CITRIX SYSTEMS INC   2011-05-17 2012-01-24
12 SH CTRIP.COM INTL LTD   2011-05-17 2012-01-10
7 SH CTRIP.COM INTL LTD   2011-05-17 2012-01-12
5 SH CTRIP.COM INTL LTD   2011-06-13 2012-01-12
1 SH CTRIP.COM INTL LTD   2011-06-13 2012-01-17
6 SH CTRIP.COM INTL LTD   2011-11-29 2012-01-17
3 SH DEERE & CO   2011-05-17 2012-01-23
1 SH ESTEE LAUDER CO INC CL A   2011-05-17 2012-01-31
2 SH FMC TECHNOLOGIES INC   2011-05-17 2012-01-30
6 SH PEABODY ENERGY CORP   2011-08-25 2012-01-10
5 SH PEABODY ENERGY CORP   2011-08-31 2012-01-10
3 SH VARIAN MEDICAL SYS INC   2011-05-17 2012-01-23
4 SH ABERCROMBIE & FITCH CO   2011-08-16 2012-02-02
1 SH ABERCROMBIE & FITCH CO   2011-08-16 2012-02-02
3 SH ABERCROMBIE & FITCH CO   2011-08-22 2012-02-02
1 SH ABERCROMBIE & FITCH CO   2011-10-07 2012-02-02
4 SH ABERCROMBIE & FITCH CO   2012-01-10 2012-02-02
3 SH ABERCROMBIE & FITCH CO   2012-01-10 2012-02-02
3 SH ABERCROMBIE & FITCH CO   2012-01-13 2012-02-02
2 SH CITRIX SYSTEMS INC   2011-05-17 2012-02-22
3 SH DEERE & CO   2011-05-17 2012-02-03
2 SH DEERE & CO   2011-05-17 2012-02-09
2 SH DEERE & CO   2011-05-17 2012-02-13
5 SH EDWARD LIFESCIENCES CP   2011-05-17 2012-02-14
12 SH GENERAL MILLS INC   2011-09-22 2012-02-24
4 SH GENERAL MILLS INC   2011-09-22 2012-02-27
5 SH GENERAL MILLS INC   2011-09-22 2012-02-28
1 SH INTUITIVE SURGICAL INC   2011-05-17 2012-02-06
2 SH LINKEDIN CORP-A   2011-11-17 2012-02-22
1 SH CELGENE CORP   2011-09-21 2012-03-19
5 SH CITRIX SYSTEMS INC   2011-05-17 2012-03-07
3 SH CITRIX SYSTEMS INC   2011-05-17 2012-03-28
5 SH DEERE & CO   2011-05-17 2012-03-07
3 SH DEERE & CO   2011-05-17 2012-03-07
3 SH ESTEE LAUDER CO INC CL A   2011-05-17 2012-03-16
2 SH SCHLUMBERGER LTD   2011-06-09 2012-03-23
1 SH SCHLUMBERGER LTD   2011-10-13 2012-03-23
2 SH SCHLUMBERGER LTD   2011-12-07 2012-03-23
2 SH SHIRE PLC   2011-05-17 2012-03-19
5 SH CERNER CORP   2011-05-17 2012-04-25
6 SH CH ROBINSON WORLDWIDE INC   2011-05-17 2012-04-25
7 SH CH ROBINSON WORLDWIDE INC   2011-05-17 2011-04-26
2 SH CITRIX SYSTEMS INC   2011-05-17 2012-04-09
1 SH CITRIX SYSTEMS INC   2011-08-29 2012-04-09
5 SH CLIFFS NATURAL RESOURCES INC   2011-05-17 2012-04-27
3 SH O'REILLY AUTOMOTIVE INC   2011-05-17 2012-04-19
4 SH PERRIGO CO   2011-05-17 2012-04-30
1 SH PRICELINE.COM INC   2011-05-17 2012-04-10
9 SH VARIAN MEDICAL SYS INC   2011-05-17 2012-04-26
3 SH VARIAN MEDICAL SYS INC   2011-06-22 2012-04-26
4 SH VERISIGN INC   2011-05-17 2012-04-24
3 SH YUM BRANDS INC   2011-05-17 2012-04-16
5 SH AUTODESK INC DELAWARE   2012-03-13 2012-05-18
4 SH AUTODESK INC DELAWARE   2012-03-16 2012-05-18
5 SH AUTODESK INC DELAWARE   2012-03-19 2012-05-18
4 SH AUTODESK INC DELAWARE   2012-03-21 2012-05-18
1 SH AUTODESK INC DELAWARE   2012-03-21 2012-05-18
4 SH AUTODESK INC DELAWARE   2012-03-27 2012-05-18
1 SH BAIDU INC   2011-05-17 2012-05-09
3 SH BAIDU INC   2011-05-17 2012-05-11
3 SH CLIFFS NATURAL RESOURCES INC   2011-05-17 2012-05-01
4 SH CLIFFS NATURAL RESOURCES INC   2011-06-08 2012-05-01
19 SH COGNIZANT TECH SOLUTIONS CL A   2011-05-17 2012-05-07
12 SH COGNIZANT TECH SOLUTIONS CL A   2011-05-17 2012-05-07
4 SH COGNIZANT TECH SOLUTIONS CL A   2011-06-10 2012-05-07
3 SH FMC TECHNOLOGIES INC   2011-05-17 2012-05-08
4 SH FOSSIL INC   2012-02-10 2012-05-16
2 SH FOSSIL INC   2012-03-08 2012-05-16
3 SH GOLDMAN SACHS GROUP INC   2012-04-17 2012-05-11
5 SH GOLDMAN SACHS GROUP INC   2012-04-17 2012-05-14
14 SH JP MORGAN CHASE & CO   2011-05-17 2012-05-17
2 SH LINKEDIN CORP-A   2011-11-17 2012-05-02
6 SH MICROSOFT CORP   2012-01-06 2012-05-04
9 SH MICROSOFT CORP   2012-01-06 2012-05-15
3 SH MICROSOFT CORP   2012-01-09 2012-05-15
6 SH MICROSOFT CORP   2012-01-09 2012-05-15
7 SH MICROSOFT CORP   2012-01-19 2012-05-16
8 SH MICROSOFT CORP   2012-01-23 2012-05-16
5 SH NETAPP INC COM   2011-11-17 2012-05-24
4 SH NETAPP INC COM   2011-12-22 2012-05-24
7 SH ORACLE CORP   2011-06-13 2012-05-18
2 SH ORACLE CORP   2011-09-16 2012-05-18
2 SH RALPH LAUREN CORP CL A   2011-06-09 2012-05-21
4 SH CAMERON INTERNATIONAL CORP   2012-02-06 2012-06-21
3 SH CAMERON INTERNATIONAL CORP   2012-02-08 2012-06-21
7 SH FACEBOOK INC CL-A   2012-05-23 2012-06-05
5 SH JPMORGAN CHASE & CO   2011-11-30 2012-06-04
2 SH JPMORGAN CHASE & CO   2011-12-07 2012-06-04
2 SH JPMORGAN CHASE & CO   2012-01-24 2012-06-04
4 SJ JPMORGAN CHASE & CO   2012-01-25 2012-06-04
2 SH JPMORGAN CHASE & CO   2012-02-27 2012-06-04
3 SH JPMORGAN CHASE & CO   2012-03-13 2012-06-04
1 SH OCCIDENTAL PETROLEUM CORP   2011-08-31 2012-06-21
4 SH INFORMATICA CORP   2012-05-04 2012-07-06
5 SH INFORMATICA CORP   2012-06-15 2012-07-06
16 SH FACEBOOK INC CL-A   2012-05-23 2012-08-02
2 SH LINKEDIN CORP-A   2011-11-23 2012-08-02
1 SH LINKEDIN CORP-A   2011-11-23 2012-08-02
2 SH LINKEDIN CORP-A   2012-03-09 2012-08-02
1 SH LINKEDIN CORP-A   2012-03-09 2012-08-02
2 SH BAIDU INC   2011-10-20 2012-09-06
1 SH BAIDU INC   2012-02-13 2012-09-10
1 SH BIOGEN IDEC INC   2011-10-05 2012-09-27
3 SH CATERPILLAR INC   2012-01-17 2012-09-27
4 SH PERRIGO CO   2012-02-08 2012-09-13
4 SH SCHLUMBERGER LTD   2012-08-09 2012-09-18
2 SH CAMERON INTERNATIONAL CORP   2012-02-08 2012-10-24
2 SH CAMERON INTERNATIONAL CORP   2012-02-08 2012-10-26
4 SH CAMERON INTERNATIONAL CORP   2012-04-26 2012-10-26
4 SH CAMERON INTERNATIONAL CORP   2012-04-26 2012-10-31
5 SH CAMERON INTERNATIONAL CORP   2012-07-27 2012-10-31
2 SH CATERPILLAR INC   2012-01-17 2012-10-10
2 SH CATERPILLAR INC   2012-01-20 2012-10-10
2 SH CATERPILLAR INC   2012-01-26 2012-10-10
1 SH CATERPILLAR INC   2012-01-26 2012-10-15
2 SH CATERPILLAR INC   2012-02-03 2012-10-15
2 SH CATERPILLAR INC   2012-04-13 2012-10-15
4 SH CITRIX SYSTEMS INC   2012-08-10 2012-10-15
5 SH CITRIX SYSTEMS INC   2012-08-14 2012-10-15
2 SH SHIRE PLC   2012-04-12 2012-10-02
2 SH ALTERA CORP   2011-11-29 2012-11-02
1 SH ALTERA CORP   2011-11-29 2012-11-07
3 SH ALTERA CORP   2012-05-01 2012-11-07
5 SH ALTERA CORP   2012-05-18 2012-11-07
6 SH CABOT OIL & GAS CORP   2012-06-27 2012-11-28
3 SH SCHLUMBERGER LTD   2012-08-10 2012-11-08
2 SH CONCHO RES INC   2012-09-06 2012-12-28
14 SH GAP INC   2012-09-18 2012-12-04
4 SH GAP INC   2012-09-18 2012-12-04
1 SH GAP INC   2012-09-18 2012-12-04
11 SH GAP INC   2012-09-28 2012-12-04
7 SH MICHAEL KORS HOLDINGS LTD   2012-03-23 2012-12-27
2 SH SCHLUMBERGER LTD   2012-08-10 2012-12-14
4 SH SCHLUMBERGER LTD   2012-08-14 2012-12-14
5 SH SCHLUMBERGER LTD   2012-08-16 2012-12-14
25,000 GM ACCEPTANCE CORP 7%   2002-11-15 2012-02-01
1,164 SH AT&T INC   2009-04-27 2012-09-06
25,000 WELLS FARGO CO 5 1/8%, 9/1/12   2009-04-27 2012-09-04
50,000 MS STEP UP 5%, 8/31/25   2010-08-26 2012-11-30
50,000 GE CAPITAL CORP 5.625%, 12/15/17   2002-12-20 2012-12-17
50,000 GE CAPITAL CORP 5%, 12/15/12   2002-12-20 2012-12-17
50,000 GE CAPITAL CORP 5.4%, 12/15/14   2002-12-20 2012-12-17
50,000 GE CAPITAL CORP 5.4%, 12/15/17   2002-12-10 2012-12-17
8 SH CONS EDISON INC (HLDG CO)   2008-05-15 2012-01-05
12 SH CONS EDISON INC (HLDG CO)   2008-06-26 2012-01-05
22 SH EATHERFORD INTERNATIONAL LTD   2010-04-29 2012-01-04
35 SH WEATHERFORD INTERNATIONAL LTD   2010-10-28 2012-01-04
20 SH WEATHERFORD INTERNATIONAL LTD   2010-11-05 2012-01-04
26 SH GREAT PLAINS ENERGY INC   2007-07-25 2012-03-09
14 SH RANGE RESOURCES CORP   2008-05-20 2012-03-26
18 SH SEADRILL LTD   2010-11-08 2012-03-09
11 SH SEADRILL LTD   2010-11-08 2012-04-11
14 SH SEADRILL LTD   2011-02-08 2012-04-11
84 SH HUTCHISON TELECOMMUNICATIONS   2009-05-12 2012-05-09
6 SH RANGE RESOURCES CORP   2008-05-20 2012-05-04
6 SH RANGE RESOURCES CORP   2009-12-16 2012-05-04
5 SH RANGE RESOURCES CORP   2011-01-25 2012-05-04
17 SH ANNALY CAPITAL MGMT INC   2007-07-25 2012-06-26
55 SH COLONIAL PROPERTIES TR ALABAMA   2007-07-25 2012-07-13
.67 SH DUKE ENERGY CORP   2007-07-25 2012-07-03
27 SH GREAT PLAINS ENERGY INC   2007-07-25 2012-08-07
16 SH GREAT PLAINS ENERGY INC   2009-10-30 2012-08-07
8 SH GREAT PLAINS ENERGY INC   2010-12-03 2012-08-07
18 SH ACTIVISION BLIZZARD INC   2010-07-16 2012-09-07
46 SH ACTIVISION BLIZZARD INC   2010-08-10 2012-09-07
48 SH ACTIVISION BLIZZARD INC   2010-09-30 2012-09-07
38 SH SANOFI CVR RTS 123120   2011-05-05 2012-09-26
167 SH SANOFI CVR RTS 123020   2011-06-07 2012-09-26
27 SH ULTRA PETROLEUM CORP   2007-07-25 2012-10-04
45 SH COACH INC   2009-11-02 2012-02-01
60 SH FMC TECHNOLOGIES INC   2009-06-22 2012-02-15
85 SH GENTEX CORP   2010-04-22 2012-02-01
50 SH NORDSON CP   2010-04-22 2012-02-02
25 SH PERRIGO CO   2008-11-25 2012-02-08
35 SH SMUCKER JM CO COM   2009-05-14 2012-02-21
55 SH ADTRAN INC   2011-02-17 2012-03-16
30 SH GARDNER DENVER INC   2011-01-27 2012-03-21
50 SH SKYWORKS SOLUTIONS INC   2011-01-14 2012-03-16
40 SH HITTITE MICROWAVE CORP   2009-09-22 2012-06-05
45 SH KIRBY CORP   2011-04-01 2012-07-18
42 SH ENERGEN CORP   2011-07-20 2012-08-23
25 SH UNITED NATURAL FOODS INC   2010-06-10 2012-09-20
25 SH UNITED NATURAL FOODS INC   2010-06-10 2012-09-21
50 SH DRESSER-RAND GROUP INC   2011-01-27 2012-10-03
45 SH INFORMATICA CORP   2009-02-25 2012-10-03
35 SH ULTA SALON COS & FRAG INC   2011-01-14 2012-10-11
45 SH APTARGROUP INC   2011-10-10 2012-11-15
12 SH CREDIT SUISSE GROUP   2009-08-19 2012-01-13
11 SH NOVRTIS AG   2008-06-04 2012-01-20
6 SH CHINA MOBILE LTD   2008-06-18 2012-02-14
20 SH KAO COPR   2009-06-16 2012-02-14
38 SH MTN GRP LTD   2009-12-23 2012-02-29
13 SH MTN GRP LTD   2009-12-24 2012-02-29
9 SH MTN GRP LTD   2010-03-24 2012-02-29
17 SH MTN GRP LTD   2001-04-20 2012-02-29
4 SH POTASH CP OF SASKATCHEWAN INC   2009-08-19 2012-02-14
6 SH REED ELSEVIER PLC   2009-07-09 2012-02-16
1 SH SOCIEDAD QUIMICA Y MINERA   2008-08-21 2012-02-14
2 SH SOCIEDAD QUIMICA Y MINERA   2008-09-09 2012-02-14
19 SH VODAFONE GP PLC   2008-06-04 2012-02-14
38 SH SUN HUNG KAI PPTYS LTD   2009-11-11 2012-03-22
13 SH SUN HUNG KAI PPTYS LTD   2010-07-21 2012-03-22
34 SH EXPERIAN GP LTD   2008-06-04 2012-04-03
36 SH KDDI CORP   2009-06-23 2012-04-09
16 SH KDDI CORP   2009-07-01 2012-04-09
12 SH KDDI CORP   2009-07-17 2012-04-09
12 SH KDDI CORP   2009-12-01 2012-04-09
12 SH KDDI CORP   2009-12-24 2012-04-09
11 SH POTASH CP OF SASKATCHEWAN INC   2009-08-19 2012-04-30
40 SHGAFISA S A   2010-05-13 2012-05-17
14 SH GAFISA S A   2010-07-21 2012-05-17
2 SH NOVO NORDISK A/S   2008-10-15 2012-05-31
4 SH NOVO NORDISK A/S   2008-11-26 2012-05-31
3 SH BASF   2009-02-23 2012-06-28
11 SH BAYTEX ENERGY CP   2011-03-23 2012-06-22
3 SH BAYTEX ENERGY CP   2011-04-15 2012-06-22
6 SH BAYTEX ENERGY CP   2011-05-20 2012-06-22
11 SH BG GROUP PLC   2010-01-25 2012-06-07
4 SH CREDIT SUISSE GROUP   2009-08-19 2012-06-27
8 SH CREDIT SUISSE GROUP   2010-07-21 2012-06-27
1 SH DIAGEO PLC   2008-11-10 2012-06-19
2 SH DIAGEO PLC   2009-06-12 2012-06-19
8 SH DIAGEO PLC   2009-06-24 2012-06-19
10 SH LVMH MOET HENNESSY LOUIS VUITT   2010-05-10 2012-06-18
24 SH PENN WEST PETE LTD   2011-02-10 2012-06-19
9 SH PENN WEST PETE LTD   2011-04-15 2012-06-19
18 SH PRECISION DRILLING COR   2011-06-24 2012-06-29
22 SH SCHNEIDER ELEC SA   2009-09-16 2012-06-28
24 SH SUBSEA 7   2011-05-25 2012-06-07
21 SH RIO TINTO PLC   2010-11-16 2012-07-19
140 SH TURKIYE GARANTI BANKASI   2010-07-30 2012-07-27
21 SH CSL LTD   2011-07-06 2012-08-08
.333 SH JUPITER TELECOM   2009-06-23 2012-08-24
7 SH LVMH MOET HENNESSY LOUIS VUITT   2010-05-10 2012-08-20
18 SH LVMH MOET HENNESSY LOUIS VUITT   2011-03-24 2012-08-20
4 SH VODAFONE GP PLC   2008-06-04 2012-08-17
10 SH REED ELSEVIER PLC   2009-07-09 2012-09-17
4 SH REED ELSEVIER PLC   2009-07-24 2012-09-26
2 SH REED ELSEVIER PLC   2009-11-13 2012-09-26
13 SH SAGE GRP   2009-12-10 2012-09-17
4 SH SODEXO   2009-05-27 2012-09-20
14 SH TESCO PLC   2008-06-04 2012-09-19
4 SH BUNZL PLC   2008-06-04 2012-10-17
2 SH NOVO NORDISK A/S   2008-11-26 2012-10-08
39 SH VODAFONE GP PLC   2008-06-04 2012-10-17
22 SH EXPERIAN GROUP LTD   2008-06-04 2012-11-09
25 SH SAGE GROUP   2009-12-10 2012-11-05
12 SH SAGE GROUP   2010-02-10 2012-11-05
22 SH ALCATEL-LUCENT   2009-09-09 2012-12-18
140 SH ALCATEL-LUCENT   2010-05-27 2012-12-18
51 SH ALCATEL-LUCENT   2010-10-29 2012-12-18
82 SH ALCATEL-LUCENT   2010-11-04 2012-12-18
43 SH ALCATEL-LUCENT   2011-08-12 2012-12-18
15 SH ALCATEL-LUCENT   2011-08-12 2012-12-31
140 SH ALCATEL-LUCENT   2011-12-22 2012-12-31
17 SH FRESENIUS MEDICAL CARE AG&CO   2008-06-04 2012-12-14
6 SH FRESENIUS MEDICAL CARE AG&CO   2008-06-04 2012-12-21
18 SH GOLDCORP INC   2011-05-16 2012-12-20
13 SH GOLDCORP INC   2011-08-05 2012-12-20
9 SH SAP AG   2008-06-04 2012-12-05
12 SH TESCO PLC   2008-06-04 2012-12-06
11 SH TESCO PLC   2008-10-17 2012-12-06
8 SH TESCO PLC   2009-02-18 2012-12-06
1 SH CME GROUP INC   2009-09-08 2012-01-10
1 SH CME GROUP INC   2010-01-20 2012-01-10
1 SH CME GROUP INC   2010-11-04 2012-01-19
1 SH GOOGLE INC CL A   2010-05-20 2012-01-10
3 SH SCHLUMBERGER LTD   2009-08-12 2012-01-12
2 SH SCHLUMBERGER LTD   2009-08-12 2012-01-13
2 SH SCHLUMBERGER LTD   2009-08-12 2012-01-17
3 SH SCHLUMBERGER LTD   2009-08-12 2012-01-20
1 SH SCHLUMBERGER LTD   2010-01-20 2012-01-20
6 SH AMERICAN TOWER REIT COM   2009-08-12 2012-02-07
2 SH INTERCONTINENTAL EXCHANGE INC   2011-03-17 2012-03-26
13 SH ORACLE CORP   2009-08-12 2012-03-21
3 SH SCHLUMBERGER LTD   2010-01-20 2012-03-21
2 SH SCHLUMBERGER LTD   2010-02-22 2012-03-21
1 SH SCHLUMBERGER LTD   2010-07-28 2012-03-21
4 SH SCHLUMBERGER LTD   2010-07-28 2012-03-22
3 SH SCHLUMBERGER LTD   2010-10-11 2012-03-22
1 SH SCHLUMBERGER LTD   2010-10-11 2012-03-23
1 SH APPLE INC   2009-08-12 2012-04-24
2 SH OCCIDENTAL PETROLEUM CORP   2009-09-17 2012-04-16
1 SH BAIDU INC   2011-05-17 2012-05-25
4 SH NETAPP INC   2011-02-17 2012-05-22
2 SH NETAPP INC   2011-02-24 2012-05-22
7 SH NETAPP INC   2011-02-24 2012-05-24
6 SH NETAPP INC   2011-03-11 2012-05-24
2 SH OCCIDENTAL PETROLEUM CORP   2009-12-23 2012-05-04
3 SH OCCIDENTAL PETROLEUM CORP   2009-12-23 2012-05-09
11 SH ORACLE CORP   2009-08-12 2012-05-16
5 SH ORACLE CORP   2009-08-12 2012-05-18
19 SH ORACLE CORP   2009-10-12 2012-05-18
7 SH ORACLE CORP   2009-10-12 2012-05-18
11 SH ORACLE CORP   2010-01-20 2012-05-18
7 SH CONCHO RES INC   2011-05-17 2012-06-19
2 SH CONCHO RES INC   2011-05-17 2012-06-21
14 SH EMC CORP MASS   2011-05-17 2012-06-14
6 SH EMC CORP MASS   2011-05-17 2012-06-21
3 SH FMC TECHNOLOGIES INC   2011-05-17 2012-06-20
8 SH JPMORGAN CHASE & CO   2011-05-17 2012-06-04
2 SH OCCIDENTAL PETROLEUM CORP   2009-12-23 2012-06-15
8 SH OCCIDENTAL PETROLEUM CORP   2011-05-17 2012-06-21
2 SH RALPH LAUREN CORP CL A   2011-06-23 2012-06-29
6 SH UNITEDHEALTH GP   2011-05-17 2012-06-18
4 SH AMERICAN TOWER REIT COM   2009-08-12 2012-07-10
1 SH COSTCO WHOLESALE CORP   2009-08-12 2012-07-30
6 SH EMC CORP MASS   2011-05-17 2012-07-16
6 SH LAS VEGAS SANDS CORPORATION   2011-05-17 2012-07-26
4 SH LAS VEGAS SANDS CORPORATION   2011-05-17 2012-07-26
21 SH TD AMERITRADE HOLDING CORP   2011-05-17 2012-07-02
13 SH UNITEDHEALTH GP INC   2011-05-17 2012-07-19
7 SH UNITEDHEALTH GP INC   2011-05-17 2012-07-25
4 SH VERISIGN INC   2011-05-17 2012-07-10
4 SH BAIDU INC   2011-05-17 2011-08-23
4 SH LAS VEGAS SANDS CORPORATION   2011-05-17 2011-08-23
1 SH PRICELINE.COM INC   2011-05-17 2012-08-08
1 SH PRICELINE.COM INC   2011-08-05 2012-08-08
3 SH UNION PACIFIC CORP   2011-05-17 2012-08-15
1 SH BAIDU INC   2011-06-06 2012-09-06
1 SH INTERCONTINENTALEXCHANGE INC   2011-03-17 2012-09-06
3 SH BAIDU INC   2011-05-17 2012-09-10
3 SH QUALCOMM INC   2009-08-12 2012-09-26
3 SH SHIRE PLC   2011-05-17 2012-09-20
4 SH SHIRE PLC   2011-05-17 2012-09-27
15 SH AMERITRADE HOLDING CORP   2011-05-17 2012-09-21
12 SH AMERITRADE HOLDING CORP   2011-05-17 2012-09-27
5 SH ALTERA CORP   2011-05-17 2012-10-24
3 SH AMERICAN TOWER REIT.COM   2009-08-12 2012-10-17
1 SH APPLE INC   2009-08-12 2012-10-26
3 SH DANAHER CORPORATION   2009-08-12 2012-10-18
32 SH EMC CORP MASS   2011-05-17 2012-10-24
6 SH FMC TECHNOLOGIES INC   2011-05-17 2012-10-24
7 SH FMC TECHNOLOGIES INC   2011-05-17 2012-10-26
1 SH GOOGLE INC CL A   2010-07-08 2012-10-19
1 SH INTERCONTINENTALEXCHANGE INC   2011-04-06 2012-10-17
1 SH INTERCONTINENTALEXCHANGE INC   2011-05-17 2012-10-17
2 SH O'REILLY AUTOMOTIVE INC   2011-05-17 2012-10-05
4 SH O'REILLY AUTOMOTIVE INC   2011-05-17 2012-10-16
2 SH O'REILLY AUTOMOTIVE INC   2011-05-17 2012-10-18
2 SH SALESFORCE.COM INC   2011-01-24 2012-10-24
2 SH SHIRE PLC   2011-05-17 2012-10-02
2 SH VISA INC CL A   2011-05-17 2012-10-24
6 SH ALTERA CORP   2011-05-17 2012-11-02
5 SH ALTERA CORP   2011-10-14 2012-11-02
2 SH APPLE INC   2009-08-12 2012-11-08
2 SH CONCHO RES INC   2011-05-17 2012-11-08
1 SH EDWARD LIFESCIENCES CORP   2011-05-17 2012-11-20
2 SH EDWARD LIFESCIENCES CORP   2011-06-03 2012-11-20
12 SH EXPRESS SCRIPTS HOLDING CO   2011-05-17 2012-11-06
4 SH ILL TOOL WORKS INC   2011-05-17 2012-11-15
6 SH ILL TOOL WORKS INC   2011-05-17 2012-11-20
3 SH ILL TOOL WORKS INC   2011-05-17 2012-11-27
2 SH INTERCONTINENTAL EXCHANGE INC   2011-05-17 2012-11-14
11 SH VERISIGN INC   2011-05-17 2012-11-16
6 SH VERISIGN INC   2011-05-17 2012-11-27
4 SH VERISIGN INC   2011-09-21 2012-11-27
1 SH VISA INC CL A   2011-05-17 2012-11-28
1 SH APPLE INC   2009-08-12 2012-12-13
1 SH APPLE INC   2009-08-12 2012-12-14
4 SH CONCHO RES INC   2011-05-17 2012-12-21
2 SH CONCHO RES INC   2011-10-06 2012-12-21
1 SH CONCHO RES INC   2011-11-29 2012-12-21
2 SH CONCHO RES INC   2011-11-29 2012-12-28
3 SH EXPRESS SCRIPTS HLDG CO   2011-05-17 2012-12-12
5 SH ILL TOOL WORKS INC   2011-05-17 2012-12-07
2 SH INTERCONTINENTAL EXCHANGE INC   2011-05-17 2012-12-11
8 SH QUALCOMM INC   2009-08-12 2012-12-14
6 SH QUALCOMM INC   2009-09-10 2012-12-14
4 SH YUM BRANDS INC   2011-05-17 2012-12-21
2 SH CNOOC LTD   2012-06-18 2012-07-27
.76 SH BRAMBLES LTD (SALE OF RIGHTS)   2012-07-12 2012-07-12
CREDIT SUISSE GROUP (SALE OF RIGHTS)   2012-08-14 2012-08-14
SUBSEA 7 S.A. (SALE OF RIGHTS)   2012-08-27 2012-08-27
CIL MOTORS LIQ CO GUC TR UBI   2012-06-12 2012-06-12
1055 SHS INERGY LP   2011-07-11 2012-01-31
407 SHS INERGY LP   2012-01-11 2012-01-31
839 SHS DCP MIDSTREAM PARTNERS   2010-10-12 2012-01-11
1114 SHS MAGELLAN MIDSTREAM   2010-10-12 2012-01-11
CAPITAL GAIN DIVIDENDS P    
(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 1,338   886 452
b 25   26 -1
c 569   990 -421
d 142   187 -45
e 504   475 29
770   778 -8
2,270   2,408 -138
2,153   2,328 -175
1,854   1,913 -59
2,089   2,015 74
1,883   2,316 -433
562   413 149
1,103   739 364
653   413 240
2,673   1,848 825
1,884   2,213 -329
420   675 -255
229   330 -101
252   307 -55
252   318 -66
821   945 -124
487   903 -416
99   218 -119
159   262 -103
179   261 -82
561   546 15
281   290 -9
445   315 130
500   485 15
178   206 -28
180   233 -53
409   488 -79
270   524 -254
165   306 -141
118   204 -86
24   41 -17
144   157 -13
261   263 -2
58   50 8
102   84 18
216   270 -54
180   248 -68
207   205 2
166   280 -114
42   70 -28
125   170 -45
42   66 -24
166   180 -14
125   135 -10
124   135 -11
148   163 -15
266   263 3
176   175 1
176   175 1
370   441 -71
461   471 -10
152   157 -5
190   196 -6
493   348 145
180   152 28
75   65 10
357   406 -49
234   244 -10
395   438 -43
237   263 -26
187   151 36
145   171 -26
73   67 6
145   151 -6
205   186 19
365   294 71
368   476 -108
419   556 -137
152   163 -11
76   57 19
312   427 -115
289   180 109
423   341 82
758   500 258
578   616 -38
193   206 -13
166   142 24
215   161 54
149   191 -42
119   164 -45
149   207 -58
118   166 -48
30   41 -11
118   169 -51
124   127 -3
369   382 -13
186   256 -70
248   345 -97
1,102   1,398 -296
673   883 -210
224   293 -69
129   125 4
288   402 -114
144   253 -109
310   354 -44
500   589 -89
482   611 -129
210   152 58
186   168 18
272   252 20
91   83 8
180   167 13
210   198 12
240   239 1
142   179 -37
114   144 -30
179   221 -42
51   58 -7
288   245 43
173   224 -51
130   170 -40
187   225 -38
156   150 6
62   68 -6
62   75 -13
125   149 -24
62   78 -16
94   130 -36
84   88 -4
121   185 -64
151   212 -61
320   515 -195
191   133 58
93   67 26
185   180 5
93   90 3
223   249 -26
109   139 -30
151   98 53
261   312 -51
440   372 68
302   297 5
102   114 -12
102   114 -12
203   204 -1
194   204 -10
243   258 -15
167   208 -41
167   212 -45
167   225 -58
83   113 -30
165   226 -61
165   212 -47
270   301 -31
338   378 -40
176   187 -11
62   70 -8
31   35 -4
92   107 -15
153   168 -15
282   243 39
204   224 -20
154   187 -33
441   505 -64
123   144 -21
32   36 -4
337   390 -53
336   328 8
136   150 -14
272   302 -30
341   375 -34
25,000   25,000  
42,840   29,968 12,872
25,000   25,000  
50,000   50,000  
50,000   50,000  
50,000   50,000  
50,000   50,000  
50,000   50,005 -5
479   332 147
718   478 240
337   406 -69
536   592 -56
307   384 -77
517   735 -218
830   1,050 -220
704   592 112
399   362 37
507   492 15
543   137 406
384   450 -66
384   294 90
320   231 89
291   242 49
1,274   1,997 -723
46   35 11
596   763 -167
353   279 74
177   153 24
217   201 16
554   502 52
578   520 58
64   89 -25
281   409 -128
592   1,483 -891
3,197   1,485 1,712
3,053   1,072 1,981
2,305   1,890 415
2,322   1,867 455
2,349   828 1,521
2,552   1,409 1,143
1,693   2,562 -869
1,964   2,175 -211
1,399   1,598 -199
1,929   1,560 369
2,161   2,569 -408
2,164   2,563 -399
1,484   829 655
1,489   829 660
2,616   2,281 335
1,511   586 925
3,362   1,296 2,066
2,060   2,122 -62
272   590 -318
607   577 30
306   408 -102
515   432 83
684   584 100
234   203 31
162   152 10
306   258 48
176   126 50
207   180 27
58   37 21
116   57 59
518   575 -57
537   566 -29
184   189 -5
538   261 277
567   472 95
252   214 38
189   164 25
189   163 26
189   161 28
462   346 116
127   522 -395
44   196 -152
268   98 170
535   188 347
193   86 107
428   635 -207
117   178 -61
233   329 -96
214   210 4
71   197 -126
143   338 -195
100   60 40
201   111 90
804   462 342
299   218 81
322   628 -306
121   235 -114
119   247 -128
220   231 -11
477   596 -119
985   1,392 -407
542   741 -199
442   367 75
3   3  
230   153 77
591   553 38
117   121 -4
390   300 90
155   130 25
78   63 15
266   199 67
320   202 118
234   340 -106
354   279 75
328   94 234
1,101   1,180 -79
366   169 197
498   383 115
239   171 68
30   82 -52
191   363 -172
69   180 -111
112   265 -153
59   161 -102
20   56 -36
189   223 -34
587   470 117
205   166 39
648   875 -227
468   600 -132
711   486 225
195   291 -96
179   190 -11
130   120 10
228   275 -47
228   331 -103
239   295 -56
618   479 139
210   162 48
137   108 29
136   108 28
220   162 58
73   68 5
378   195 183
279   252 27
387   285 102
222   205 17
148   121 27
74   60 14
286   238 48
215   190 25
73   63 10
559   166 393
176   158 18
117   127 -10
134   214 -80
67   101 -34
199   355 -156
170   287 -117
174   165 9
251   247 4
294   241 53
129   110 19
489   393 96
179   145 34
281   272 9
623   632 -9
171   180 -9
333   383 -50
146   164 -18
124   125 -1
250   349 -99
169   165 4
668   814 -146
280   251 29
351   303 48
281   130 151
97   49 48
140   164 -24
214   248 -34
141   165 -24
357   429 -72
707   656 51
361   353 8
173   142 31
446   509 -63
174   165 9
575   500 75
575   525 50
370   302 68
111   126 -15
137   126 11
326   425 -99
187   140 47
267   278 -11
350   371 -21
240   307 -67
186   245 -59
151   231 -80
224   98 126
594   166 428
161   91 70
768   874 -106
238   251 -13
280   292 -12
694   451 243
131   122 9
131   123 8
172   120 52
326   240 86
160   120 40
296   256 40
176   186 -10
275   160 115
186   277 -91
155   176 -21
1,088   332 756
162   180 -18
85   88 -3
170   173 -3
652   716 -64
235   229 6
358   343 15
182   171 11
257   245 12
452   391 61
236   213 23
157   114 43
147   80 67
529   166 363
513   166 347
318   361 -43
159   152 7
80   96 -16
154   193 -39
165   179 -14
307   286 21
261   245 16
480   373 107
360   277 83
254   215 39
393   403 -10
1     1
1     1
9     9
12     12
18,841   34,994 -16,153
7,268   9,981 -2,713
38,477   24,159 14,318
35,807   27,060 8,747
      123
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       452
b       -1
c       -421
d       -45
e       29
      -8
      -138
      -175
      -59
      74
      -433
      149
      364
      240
      825
      -329
      -255
      -101
      -55
      -66
      -124
      -416
      -119
      -103
      -82
      15
      -9
      130
      15
      -28
      -53
      -79
      -254
      -141
      -86
      -17
      -13
      -2
      8
      18
      -54
      -68
      2
      -114
      -28
      -45
      -24
      -14
      -10
      -11
      -15
      3
      1
      1
      -71
      -10
      -5
      -6
      145
      28
      10
      -49
      -10
      -43
      -26
      36
      -26
      6
      -6
      19
      71
      -108
      -137
      -11
      19
      -115
      109
      82
      258
      -38
      -13
      24
      54
      -42
      -45
      -58
      -48
      -11
      -51
      -3
      -13
      -70
      -97
      -296
      -210
      -69
      4
      -114
      -109
      -44
      -89
      -129
      58
      18
      20
      8
      13
      12
      1
      -37
      -30
      -42
      -7
      43
      -51
      -40
      -38
      6
      -6
      -13
      -24
      -16
      -36
      -4
      -64
      -61
      -195
      58
      26
      5
      3
      -26
      -30
      53
      -51
      68
      5
      -12
      -12
      -1
      -10
      -15
      -41
      -45
      -58
      -30
      -61
      -47
      -31
      -40
      -11
      -8
      -4
      -15
      -15
      39
      -20
      -33
      -64
      -21
      -4
      -53
      8
      -14
      -30
      -34
       
      12,872
       
       
       
       
       
      -5
      147
      240
      -69
      -56
      -77
      -218
      -220
      112
      37
      15
      406
      -66
      90
      89
      49
      -723
      11
      -167
      74
      24
      16
      52
      58
      -25
      -128
      -891
      1,712
      1,981
      415
      455
      1,521
      1,143
      -869
      -211
      -199
      369
      -408
      -399
      655
      660
      335
      925
      2,066
      -62
      -318
      30
      -102
      83
      100
      31
      10
      48
      50
      27
      21
      59
      -57
      -29
      -5
      277
      95
      38
      25
      26
      28
      116
      -395
      -152
      170
      347
      107
      -207
      -61
      -96
      4
      -126
      -195
      40
      90
      342
      81
      -306
      -114
      -128
      -11
      -119
      -407
      -199
      75
       
      77
      38
      -4
      90
      25
      15
      67
      118
      -106
      75
      234
      -79
      197
      115
      68
      -52
      -172
      -111
      -153
      -102
      -36
      -34
      117
      39
      -227
      -132
      225
      -96
      -11
      10
      -47
      -103
      -56
      139
      48
      29
      28
      58
      5
      183
      27
      102
      17
      27
      14
      48
      25
      10
      393
      18
      -10
      -80
      -34
      -156
      -117
      9
      4
      53
      19
      96
      34
      9
      -9
      -9
      -50
      -18
      -1
      -99
      4
      -146
      29
      48
      151
      48
      -24
      -34
      -24
      -72
      51
      8
      31
      -63
      9
      75
      50
      68
      -15
      11
      -99
      47
      -11
      -21
      -67
      -59
      -80
      126
      428
      70
      -106
      -13
      -12
      243
      9
      8
      52
      86
      40
      40
      -10
      115
      -91
      -21
      756
      -18
      -3
      -3
      -64
      6
      15
      11
      12
      61
      23
      43
      67
      363
      347
      -43
      7
      -16
      -39
      -14
      21
      16
      107
      83
      39
      -10
      1
      1
      9
      12
      -16,153
      -2,713
      14,318
      8,747
       
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 24,789
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 158,024 2,021,177 0.078184
2010 180,780 2,020,233 0.089485
2009 136,300 1,933,982 0.070476
2008 92,632 2,033,635 0.04555
2007 90,761 2,128,949 0.042632
2 Total of line 1, column (d) ...................... 2 0.326327
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 0.065265
4 Enter the net value of noncharitable-use assets for 2012 from Part X, line 5..... 4 1,949,178
5 Multiply line 4 by line 3....................... 5 127,213
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 808
7 Add lines 5 and 6......................... 7 128,021
8 Enter qualifying distributions from Part XII, line 4.............. 8 136,648
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 1 808
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............................ 3 808
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- ..... 5 808
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 600
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 1,600
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 792
11 Enter the amount of line 10 to be: Credited to 2013 estimated taxBullet792 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
 
 
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
Yes
 
b
If “Yes,” has it filed a tax return on Form 990-T for this year?...................
4b
Yes
 
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)
    bulletWA
    b
    If the answer is “Yes” to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If “No,” attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2012 or the taxable year beginning in 2012 (see instructions for Part XIV)?
    If “Yes,” complete Part XIV.............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If “Yes,” attach a schedule listing their names and addresses.
    10
     
    No
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. (see instructions) .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement (see instructions).................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbullet  
    14
    The books are in care ofbulletFOUNDATION MANAGEMENT GROUP Telephone no.bullet (206) 667-0300
    Located atbullet1000 SECOND AVENUE 34TH FLSEATTLEWA ZIP+4bullet981041022
    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
     
    No
    .........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2012?.............
    1c
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2012, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2012?...............
    If “Yes,” list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer “No” and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?.........................
    b
    If “Yes,” did it have excess business holdings in 2012 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2012.)....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2012?
    4b
     
    No
    5a
    During the year did the foundation pay or incur any amount to:
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?...............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 509(a)(1), (2), or (3), or section 4940(d)(2)? (see instructions)........
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?........
    b
    If any answer is “Yes” to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance (see instructions)? ......
    5b
     
     
    .........bullet
    c
    If the answer is “Yes” to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?............
    If “Yes,” attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?........................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?....
    6b
     
    No
    If “Yes” to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 6
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation (see instructions).
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation
    (If not paid, enter
    -0-)
    (d) Contributions to
    employee benefit plans
    and deferred compensation
    (e) Expense account,
    other allowances
    CARMELA M KOEPLIN PRESIDENT
    2.0
    0    
    1000 SECOND AVENUE 34th floor
    SEATTLE,WA981041022
    PATRICK J KOEPLIN VP/TREASURER
    2.0
    0    
    1000 SECOND AVENUE 34th floor
    SEATTLE,WA981041022
    DANIEL M ASHER SECRETARY
    2.0
    0    
    1000 SECOND AVENUE 34th floor
    SEATTLE,WA981041022
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE.”
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation
    (e) Expense account,
    other allowances
     
    Total number of other employees paid over $50,000...................bullet  
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
     
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1
     
    2  
    3  
    4  
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 7
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See page 24 of the instructions.
    3  
    Total. Add lines 1 through 3..........................bullet  
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,
    see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    1,876,485
    b
    Average of monthly cash balances.......................
    1b
    93,527
    c
    Fair market value of all other assets (see instructions)................
    1c
    8,849
    d
    Total (add lines 1a, b, and c).........................
    1d
    1,978,861
    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
    0
    3
    Subtract line 2 from line 1d.........................
    3
    1,978,861
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see
    instructions) .............................
    4
    29,683
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    1,949,178
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    97,459
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    97,459
    2a
    Tax on investment income for 2012 from Part VI, line 5......
    2a
    808
    b
    Income tax for 2012. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    808
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    96,651
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    96,651
    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
    96,651
    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
    136,648
    b
    Program-related investments—total from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
    0
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
    0
    b
    Cash distribution test (attach the required schedule) .................
    3b
    0
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    136,648
    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
    808
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    135,840
    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 96,651
    2 Undistributed income, if any, as of the end of 2012:
    a Enter amount for 2011 only....... 0
    b Total for prior years:2010, 2009, 2008  
    3 Excess distributions carryover, if any, to 2012:
    a From 2007....... 0
    b From 2008....... 0
    c From 2009....... 0
    d From 2010....... 60,414
    e From 2011....... 58,935
    fTotal of lines 3a through e......... 119,349
    4Qualifying distributions for 2012 from Part
    XII, line 4: bullet$ 136,648
    a Applied to 2011, but not more than line 2a 0
    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..... 96,651
    e Remaining amount distributed out of corpus 39,997
    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 5 159,346
    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 .............
    0
    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) ...
    0
    9Excess distributions carryover to 2013.
    Subtract lines 7 and 8 from line 6a ......
    159,346
    10 Analysis of line 9:
    a Excess from 2008.... 0
    b Excess from 2009.... 0
    c Excess from 2010.... 60,414
    d Excess from 2011.... 58,935
    e Excess from 2012.... 39,997
    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).)
    PATRICK CARMELA KOEPLIN
    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.
    NONE
    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
    BLESSED TERESA OF CALCUTTA PARISH
    PO BOX 705
    WOODINVILLE,WA98072
    NONE PUBLIC HUMAN SERVICES 105,000
    FIRST BOOK
    1319 F STREET NW SUITE 1000
    WASHINGTON,DC20004
    NONE PUBLIC EDUCATION 2,000
    POINTE DU HOC FOUNDATION
    HQ 2/75 RANGER REGIMENT
    JOINT BASE LEWIS,WA98433
    NONE PUBLIC HUMAN SERVICES 5,000
    SEATTLE UNIVERSITY
    PO BOX 222000
    SEATTLE,WA981121090
    NONE PUBLIC EDUCATION 10,000
    OREGON PROVINCE SOCIETY OF JESUS
    PO BOX 86010
    PORTLAND,OR97286
    NONE PUBLIC HUMAN SERVICES 5,000
    FROM BOARDWALK PIPELINE PARTNERS LP K-1
    9 GREENWAY PLAZA SUITE 2800
    HOUSTON,TX77046
    NONE PUBLIC PER K-1 3
    FROM BUCKEYE PARTNERS LP K-1
    5 TEK PARK
    9999 HAMILTON BLVD
    BREINIGSVILLE,PA18031
    NONE PUBLIC PER K-1 2
    FROM ENBRIDGE ENERGY PARTNERS LP K-1
    1100 LOUISIANA
    SUITE 3300
    HOUSTON,TX77002
    NONE PUBLIC PER K-1 4
    FROM ENERGY TRANSFER EQUITY LP K-1
    3738 OAK LAWN AVE
    DALLAS,TX75219
    NONE PUBLIC PER K-1 1
    FROM ENERGY TRANSFER PARTNERS LP K-1
    3738 OAK LAWN
    DALLAS,TX75219
    NONE PUBLIC PER K-1 3
    Total .................................bullet 3a 127,013
    bApproved for future payment
    BLESSED TERESA OF CALCUTTA PARISH
    PO BOX 705
    WOODINVILLE,WA98072
    NONE PUBLIC CHURCH CAPITAL CAMPAIGN 50,000
    BLESSED TERESA OF CALCUTTA PARISH
    PO BOX 705
    WOODINVILLE,WA98072
    NONE PUBLIC SOCIAL HALL CAPITAL CAMPAIGN 350,000
    Total .................................bullet 3b 400,000
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 11
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code
    (b)
    Amount
    (c)
    Exclusion code
    (d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3Interest on savings and temporary cash investments          
    4 Dividends and interest from securities....     14 66,887  
    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 24,789  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory..          
    11 Other revenue: aINCOME FROM PARTNERSHIPS 211110 -35,766 14 -172  
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e).. -35,766 91,504  
    13Total. Add line 12, columns (b), (d), and (e)..................
    1355,738
    (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


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    Form 990PF - Special Condition Description:
    Special Condition Description

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    TY 2012 DepreciationSchedule
    Name:
    KOEPLIN FAMILY FOUNDATION
    EIN: 41-1268766
    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

    TY 2012 InvestmentsCorpBondsSchedule
    Name:
    KOEPLIN FAMILY FOUNDATION
    EIN: 41-1268766
    Name of Bond End of Year Book Value End of Year Fair Market Value
    BONDS 463,565 463,565

    TY 2012 InvestmentsCorpStockSchedule
    Name:
    KOEPLIN FAMILY FOUNDATION
    EIN: 41-1268766
    Name of Stock End of Year Book Value End of Year Fair Market Value
    PUBLIC SECURITIES & PTP'S 1,135,015 1,135,015

    TY 2012 LandEtcSchedule2
    Name:
    KOEPLIN FAMILY FOUNDATION
    EIN: 41-1268766
    Category / Item Cost / Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value


    TY 2012 OtherAssetsSchedule
    Name:
    KOEPLIN FAMILY FOUNDATION
    EIN: 41-1268766
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    ACCRUED INTEREST RECEIVABLE 10,263 7,772 7,772
    DIVIDENDS RECEIVABLE 304 479 479
    PREPAID TAXES 1,313 598 598


    TY 2012 OtherExpensesSchedule
    Name:
    KOEPLIN FAMILY FOUNDATION
    EIN: 41-1268766
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    LICENSES EXPENSE 35     35


    TY 2012 OtherIncomeSchedule2
    Name:
    KOEPLIN FAMILY FOUNDATION
    EIN: 41-1268766
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    INCOME FROM PASS-THRU INVESTMENTS -35,938 172  


    TY 2012 OtherIncreasesSchedule
    Name:
    KOEPLIN FAMILY FOUNDATION
    EIN: 41-1268766
    Description Amount
    UNREALIZED GAIN 116,466


    TY 2012 OtherProfessionalFeesSchedule
    Name:
    KOEPLIN FAMILY FOUNDATION
    EIN: 41-1268766
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    MANAGEMENT FEES: FOUNDATION 12,000 2,400   9,600
    MANAGMENT GROUP        
    BROKER FEES: MORGAN STANLEY 8,038 8,038    


    TY 2012 TaxesSchedule
    Name:
    KOEPLIN FAMILY FOUNDATION
    EIN: 41-1268766
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FEDERAL EXCISE TAX EXPENSE 802      
    FOREIGN TAXES 613 613