Form990-PF
Click to see list of attachments

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
THEODORE L CROSS
FAMILY CHARITABLE FOUNDATION

Number and street (or P.O. box number if mail is not delivered to street address)100 MERRICK ROAD   Room/suite
City or town, state, and ZIP code
ROCKVILLE CENTRE, NY11570
A Employer identification number

04-3254361
B Telephone number (see instructions)

(516) 478-6000
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$17,918,717J 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)  
2 Check bullet
3 Interest on savings and temporary cash investments 274 274 274
4 Dividends and interest from securities...... 321,881 321,881 321,881
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 703,746
b Gross sales price for all assets on line 6a 5,887,417
7 Capital gain net income (from Part IV, line 2)... 703,746
8 Net short-term capital gain......... 590,602
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 1,025,901 1,025,901 912,757
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).... Click to see attachment 61,810 61,810    
17 Interest...............        
18 Taxes (attach schedule) (see instructions) Click to see attachment 11,654 2,034    
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see list of attachments 9,653 29   9,624
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 83,117 63,873   9,624
25 Contributions, gifts, grants paid........ 880,000 880,000
26 Total expenses and disbursements. Add lines 24 and 25 963,117 63,873   889,624
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 62,784
b Net investment income (if negative, enter -0-) 962,028
c Adjusted net income (if negative, enter -0-)... 912,757
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.......... 4,911,085 925,967 925,967
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........... 22,956 13,336 22,956
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)........ 5,087,317 Click to see attachment13,144,839 13,801,886
c Investments—corporate bonds (attach schedule)........      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans..............      
13 Investments—other (attach schedule)........... 7,100,000 Click to see attachment3,100,000 3,167,908
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 17,121,358 17,184,142 17,918,717
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable...................    
19 Deferred revenue..................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22)..........   0
Net Assets or Fund Balances bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted....................    
25 Temporarily restricted................    
26 Permanently restricted................    
bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds.........    
28 Paid-in or capital surplus, or land, bldg., and equipment fund    
29 Retained earnings, accumulated income, endowment, or other funds 17,121,358 17,184,142
30 Total net assets or fund balances (see page 17 of the
instructions).................... 17,121,358 17,184,142
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 17,121,358 17,184,142
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 17,121,358
2 Enter amount from Part I, line 27a..................... 2 62,784
3 Other increases not included in line 2 (itemize) bullet 3  
4 Add lines 1, 2, and 3.......................... 4 17,184,142
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 17,184,142
Form 990-PF (2012)
Form 990-PF (2012)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.) 		(b) How acquired
P—Purchase
D—Donation 		(c) Date acquired
(mo., day, yr.) 		(d) Date sold
(mo., day, yr.)
1a
b
c
d
e
(e) Gross sales price (f) Depreciation allowed
(or allowable) 		(g) Cost or other basis
plus expense of sale 		(h) Gain or (loss)
(e) plus (f) minus (g)
a
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l) Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i) F.M.V. as of 12/31/69 (j) Adjusted basis
as of 12/31/69 		(k) Excess of col. (i)
over col. (j), if any
a
b
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 703,746
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 3 590,602
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 794,929 17,611,530 0.04514
2010 7,500 13,407,399 0.00056
2009 7,976 131,247 0.06077
2008   151,004  
2007   152,015  
2 Total of line 1, column (d) ...................... 2 0.10647
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 0.02129
4 Enter the net value of noncharitable-use assets for 2012 from Part X, line 5..... 4 17,854,248
5 Multiply line 4 by line 3....................... 5 380,171
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 9,620
7 Add lines 5 and 6......................... 7 389,791
8 Enter qualifying distributions from Part XII, line 4.............. 8 889,624
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 9,620
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 9,620
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 9,620
6 Credits/Payments:
a 2012 estimated tax payments and 2011 overpayment credited to 2012 6a 22,961
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 22,961
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 13,341
11 Enter the amount of line 10 to be: Credited to 2013 estimated taxBullet13,341 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
 
No
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
     
    No
    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)
    bulletNJ
    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 addressbulletN/A
    14
    The books are in care ofbulletJOHN W HALLORAN CPA Telephone no.bullet (516) 478-6000
    Located atbullet100 MERRICK ROAD SUITE 304WROCKVILLE CENTRENY ZIP+4bullet11570
    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
     
    No
    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
     
    No
    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
     
    No
    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
    JOHN W HALLORAN TRUSTEE
    0.00     		0    
    11 FIELD DAISY LANE
    EAST NORTHPORT,NY11731
    ADRIENNE CANNELLA Trustee
    5.00     		0    
    83-04 267TH STREET
    FLORAL PARK,NY11004
    LISA W POWNALL-GRAY Trustee
    5.00     		0    
    42 LORDS HIGHWAY
    WESTON,CT06883
    AMANDA B CROSS Trustee
    5.00     		0    
    1349 BAY DRIVE
    SANIBEL,FL33957
    MARY CROSS Trustee
    5.00     		0    
    ONE CAMPBELTON CIRCLE
    PRINCETON,NJ08540
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE.”
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet  
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1
     
    2  
    3  
    4  
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 7
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    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
    14,405,152
    b
    Average of monthly cash balances.......................
    1b
    1,564,995
    c
    Fair market value of all other assets (see instructions)................
    1c
    2,155,993
    d
    Total (add lines 1a, b, and c).........................
    1d
    18,126,140
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
     
    3
    Subtract line 2 from line 1d.........................
    3
    18,126,140
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see
    instructions) .............................
    4
    271,892
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    17,854,248
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    892,712
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    892,712
    2a
    Tax on investment income for 2012 from Part VI, line 5......
    2a
    9,620
    b
    Income tax for 2012. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    9,620
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    883,092
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    883,092
    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
    883,092
    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
    889,624
    b
    Program-related investments—total from Part IX-B..................
    1b
     
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    889,624
    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
    9,620
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    880,004
    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 7 883,092
    2 Undistributed income, if any, as of the end of 2012:
    a Enter amount for 2011 only....... 749,158
    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$ 889,624
    a Applied to 2011, but not more than line 2a 749,158
    b Applied to undistributed income of prior years
    (Election required—see instructions)......     		 
    c Treated as distributions out of corpus (Election
    required—see instructions).........     		0
    d Applied to 2012 distributable amount..... 140,466
    e Remaining amount distributed out of corpus  
    5 Excess distributions carryover applied to 2012.    
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5  
    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 ..........     		742,626
    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
             
    b 85% of line 2a .........          
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ....     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets” alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment” alternative test— enter 2⁄3
    of minimum investment return shown in
    Part X, line 6 for each year listed...     		         
    c “Support” alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XV
    Supplementary Information (Complete this part only if the organization had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 10
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    SPECIAL OLYMPICS - CT CHAPTER
    2666 STATE STREET SUITE 1
    HAMDEN,CT06517     		NONE N/A GENERAL 5,000
    YALE UNIVERSITY OFFICE OF DEVELOPME
    PO BOX 2038
    NEW HAVEN,CT06521     		NONE N/A GENERAL 5,000
    THE LOWER EAST SIDE GIRLS CLUB
    56 E 1ST STREET
    NEW YORK,NY10003     		NONE N/A GENERAL 5,000
    THE DOE FUND
    232 EAST 84TH STREET
    NEW YORK,NY10028     		NONE N/A GENERAL 2,500
    THE CARL V BINI FUND
    18 HERVEY STREET
    STATEN ISLAND,NY10309     		NONE N/A GENERAL 2,500
    THE ALI FORNEY CENTER
    224 W 35TH STREET 15TH FLOOR
    NEW YORK,NY10001     		NONE N/A GENERAL 5,000
    TEAM RUBICON
    1030 W HILLCREST BLVD
    INGLEWOOD,CA90301     		NONE N/A GENERAL 5,000
    RADCLIFF INSTITUTE
    10 GARDEN ST
    CAMBRIDGE,MA02138     		NONE N/A GENERAL 5,000
    SERVICE WOMAN'S ACTION NETWORK
    220 E 23 STREET SUITE 509
    NEW YORK,NY10010     		NONE N/A GENERAL 5,000
    PROJECT HORSESHOE FARM
    745 HORSHOE BEND
    GREENSBORO,AL36744     		NONE N/A GENERAL 25,000
    NORTH SHORE LIJ HEALTH SYSTEM FOUND
    125 COMMUNITY DRIVE
    GREAT NECK,NY11021     		NONE N/A GENERAL 2,500
    NORTH SHORE ANIMAL LEAGUE OF AMERIC
    25 DAVIS AVENUE
    PORT WASHINGTON,NY11050     		NONE N/A GENERAL 2,500
    MEMORIAL SLOAN KETTERING CANCER CEN
    PO BOX 27106
    NEW YORK,NY10087     		NONE N/A GENERAL 15,000
    MELLILO CENTER FOR MENTAL HEALTH
    113 GLEN COVE AVENUE
    GLEN COVE,NY11542     		NONE N/A GENERAL 10,000
    LEE MEMORIAL HEALTH SYSTEM FOUNDATI
    9800 S HEALTH PARK DRIVE 210
    FORT MYERS,FL33908     		NONE N/A GENERAL 50,000
    INNOVATIONS OF POVERTY ACTION
    101 WHITNEY AVE
    NEW HAVEN,CT06510     		NONE N/A GENERAL 2,500
    HUMAN TRAFFICKING AWARENESS PARTNER
    PO BOX 1113
    SANIBEL,FL33957     		NONE N/A GENERAL 2,500
    DISABILITY OPPORTUNITY FUND
    201 IU WILLETS ROAD
    ALBERTSON,NY11507     		NONE N/A GENERAL 2,500
    COMMACK VOLUNTEER AMBULANCE CORPS
    200 BURR ROAD
    COMMACK,NY11725     		NONE N/A GENERAL 2,500
    CHILD FIRST
    267 GRANT STREET
    BRIDGEPORT,CT06610     		NONE N/A GENERAL 10,000
    CARDINAL MCCLOSKY COMMUNITY SERVICE
    115 E STEVENS AVE SUITE LL5
    VALHALLA,NY10595     		NONE N/A GENERAL 5,000
    BOB WOODRUFF FOUNDATION
    PO BOX 955
    BRISTOW,VA20136     		NONE N/A GENERAL 5,000
    ACLU FOUNDATION
    125 BROAD STREET 18TH FLOOR
    NEW YORK,NY10005     		NONE N/A GENERAL 5,000
    ACCESS YOUTH ACADEMY
    9370 WAPLES STREET SUITE 101
    SAN DIEGO,CA92121     		NONE N/A GENERAL 10,000
    HABITAT FOR HUMANITY OF LI
    643 MIDDLE COUNTRY ROAD
    MIDDLE ISLAND,NY11953     		NONE N/A GENERAL 5,000
    BIG BROTHERS BIG SISTERS - LI
    145 SYCAMORE AVE
    ISLANDIA,NY11749     		NONE N/A GENERAL 10,000
    MASSACHUSETTS INSTITUTE OF TECHNOLO
    120 VASSAR ST BUILDING W35-276
    CAMBRIDGE,MA02139     		NONE N/A GENERAL 5,000
    ST ANTHONY'S HIGH SCHOOL
    275 WOLF HILL ROAD
    MELVILLE,NY11747     		NONE N/A GENERAL PURPOSES 5,000
    HOUR CHILDREN
    13-07 37TH AVE
    LONG ISLAND CITY,NY11101     		NONE N/A GENERAL PURPOSES 2,500
    YWCA OF PRINCETON
    59 ROBESON PLACE
    PRINCETON,NJ08540     		NONE N/A General Purpose 2,500
    YMCA OF PRINCETON
    59 PAUL ROBESON PLACE
    PRINCETON,NJ08540     		NONE N/A General Purpose 2,500
    TRENTON AREA SOUP KITCHEN TASK
    72 1/2 ESCHER ST
    TRENTON,NJ08609     		NONE N/A General Purpose 3,000
    SWEET BRIAR COLLEGE
    PO BOX 1051
    SWEET BRIAR,VA24595     		NONE N/A General Purpose 3,500
    SEEING EYE FOUNDATION
    PO BOX 375
    MORRISTOWN,NJ07963     		NONE N/A General Purpose 3,000
    SAVE - A FRIEND TO HOMELESS ANIMALS
    900 HERRINGTOWN RD
    PRINCETON,NJ08542     		NONE N/A General Purpose 1,500
    PRINCETON SYMPHONY ORCHESTRA
    PO BOX 250
    PRINCETON,NJ08542     		NONE N/A General Purpose 5,000
    PRINCETON PUBLIC LIBRARY
    65 WITHERSPOON ST
    PRINCETON,NJ08542     		NONE N/A General Purpose 5,000
    PRINCETON HOSPITAL
    253 WITHERSPOON ST
    PRINCETON,NJ08540     		NONE N/A General Purpose 15,000
    PLANNED PARENTHOOD OF MERCER COUNTY
    437 E STATE ST
    TRENTON,NJ08608     		NONE N/A General Purpose 10,000
    NANTUCKET HISTORICAL ASSOCIATION
    15 BROAD ST
    NANTUCKET,MA02554     		NONE N/A General Purpose 5,000
    NANTUCKET COTTAGE HOSPITAL
    57 PROSPECT ST
    NANTUCKET,MA02554     		NONE N/A General Purpose 10,000
    NANTUCKET CONSERVATION FOUNDATION
    118 CLIFF ROAD
    NANTUCKET,MA02554     		NONE N/A General Purpose 10,000
    NANTUCKET ATHENEUM
    1 INDIA ST
    NANTUCKET,MA02554     		NONE N/A General Purpose 5,000
    METROPOLITAN OPERA
    LINCOLN PLAZA
    NEW YORK,NY10023     		NONE N/A General Purpose 5,000
    MCCARTER THEATER COMPANY
    91 UNIVERSITY PLAZA
    PRINCETON,NJ08540     		NONE N/A General Purpose 8,000
    HOSPICE CARE OF PRINCETON
    253 WITHERSPOON ST
    PRINCETON,NJ08540     		NONE N/A General Purpose 5,000
    HOSPICE CARE OF NANTUCKET
    57 PROSPECT ST
    NANTUCKET,MA02554     		NONE N/A General Purpose 5,000
    HOLLINS UNIVERSITY
    PO BOX 9658
    ROANOKE,VA24020     		NONE N/A General Purpose 6,000
    DOCTORS WITHOUT BOARDERS
    333 SEVENTH AVE 2ND FLOOR
    NEW YORK,NY10001     		NONE N/A General Purpose 5,000
    DEPT OF COMPARATIVE LIT - PRINCETON
    133 B EAST PYNE
    PRINCETON,NJ08542     		NONE N/A General Purpose 20,000
    CRISIS MINISTRY OF PRINCETON AND TR
    123 E HANOVER ST
    TRENTON,NJ08608     		NONE N/A General Purpose 5,000
    ARTS COUNCIL OF PRINCETON
    102 WITHERSPOON ST
    PRINCETON,NJ08542     		NONE N/A General Purpose 5,000
    AMNESTY INTERNATIONAL
    5 PENN PLAZA 16TH FLOOR
    NEW YORK,NY10001     		NONE N/A General Purpose 5,000
    AMERICAN UNIVERSITY IN CAIRO
    420 FIFTH AVE 3RD FLOOR
    NEW YORK,NY10018     		NONE N/A General Purpose 15,000
    YOUNG SURVIVAL COALITION YSC
    61 BROADWAY SUITE 2235
    NEW YORK,NY10006     		NONE N/A General Purpose 2,500
    WOUNDED WARRIOR PROJECT
    4899 BELFORT ROAD SUITE 300
    JACKSONVILLE,FL32256     		NONE N/A General Purpose 2,500
    WOMEN'S FUNDING NETWORK
    505 SANSOME ST
    SAN FRANCISCO,CA94111     		NONE N/A General Purpose 5,000
    WOMEN IN THE WORLD FOUNDATION
    555 WEST 18TH ST
    NEW YORK,NY10011     		NONE N/A General Purpose 2,500
    WELLNESS IN THE SCHOOLS
    PO BOX 250832
    NEW YORK,NY10025     		NONE N/A General Purpose 10,000
    UNICEF SCHOOLS FOR AFRICA
    125 MAIDEN LANE
    NEW YORK,NY10038     		NONE N/A General Purpose 2,500
    THERE WITH CARE
    2825 WILDERNESS PLACE SUITE 100
    BOULDER,CO80301     		NONE N/A General Purpose 10,000
    IMMOKALEE FOUNDATION THE
    3960 RADIO ROAD SUITE 207
    NAPLES,FL34104     		NONE N/A General Purpose 2,500
    COUNCIL OF FASHION DESIGNERS OF AME
    1412 BROADWAY SUITE 2006
    NEW YORK,NY10018     		NONE N/A General Purpose 5,000
    CLIMATE REALITY PROJECT THE
    901 E STREET NW SUITE 610
    WASHINGTON,DC20004     		NONE N/A General Purpose 5,000
    ARNOLD P GOLD FOUNDATION THE
    619 PALISADE AVE
    ENGLEWOOD CLIFFS,NJ07632     		NONE N/A General Purpose 5,000
    STUDIO IN A SCHOOL
    410 WEST 59TH ST
    NEW YORK,NY10019     		NONE N/A General Purpose 5,000
    SPIRIT OF GOODWILL BAND
    C/O GOODWILL INDUSTRIES OF SOUTH FL
    MIAMI,FL33142     		NONE N/A General Purpose 2,500
    ROOT CAUSE
    ONE CANAL PLACE 3RD FLOOR
    CAMBRIDGE,MA02141     		NONE N/A General Purpose 2,500
    ROBIN HOOD FOUNDATION
    826 BROADWAY 9TH FLOOR
    NEW YORK,NY10003     		NONE N/A General Purpose 50,000
    PUPPIES BEHIND BARS
    10 EAST 40TH ST 19TH FLOOR
    NEW YORK,NY10016     		NONE N/A General Purpose 5,000
    PROJECT ALS
    3960 BROADWAY SUITE 420
    NEW YORK,NY10032     		NONE N/A General Purpose 5,000
    PREP FOR PREP
    328 WEST 71ST ST
    NEW YORK,NY10023     		NONE N/A General Purpose 25,000
    POSSE FOUNDATION
    14 WALL ST SUITE 8A-60
    NEW YORK,NY10005     		NONE N/A General Purpose 2,500
    PLANNED PARENTHOOD
    434 WEST 33RD ST
    NEW YORK,NY10001     		NONE N/A General Purpose 50,000
    PLAN USA
    155 PLAN WAY
    WARWICK,RI02886     		NONE N/A General Purpose 5,000
    PERKINS SCHOOL FOR THE BLIND
    175 NORTH BEACON ST
    WATERTOWN,MA02472     		NONE N/A General Purpose 25,000
    PARTNERS IN HEALTH
    888 COMMONWEALTH AVE 3RD FL
    BOSTON,MA02215     		NONE N/A General Purpose 10,000
    PACE CENTER FOR GIRLS
    3760 SCHOOLHOUSE RD W
    FT MYERS,FL33916     		NONE N/A General Purpose 5,000
    OPERATION GRATITUDE
    16444 REFUGIO ROAD
    ENCINO,CA91436     		NONE N/A General Purpose 2,500
    OPEN DOOR SHELTER NORWALK
    4 MERRITT ST
    SOUTH NORWALK,CT06854     		NONE N/A General Purpose 5,000
    NEW YORK CARES
    214 W 29TH ST 5TH FL
    NEW YORK,NY10001     		NONE N/A General Purpose 10,000
    NATIONAL DOMESTIC WORKERS ALLIANCE
    330 7TH AVE 19TH FLOOR
    NEW YORK,NY10001     		NONE N/A General Purpose 2,500
    NATIONAL COALITION FOR HOMELESS VET
    333 1/2 PENNSYLVANIA AVE SE
    WASHINGTON,DC20003     		NONE N/A General Purpose 2,500
    NAACP LEGAL DEFENSE AND EDUCATIONAL
    99 HUDSON ST SUITE 1600
    NEW YORK,NY10013     		NONE N/A General Purpose 7,500
    MS FOUNDATION FOR WOMEN
    12 METRO TECH CENTER 26TH FLOOR
    BROOKLYN,NY11201     		NONE N/A General Purpose 25,000
    MCLEAN HOSPITAL
    115 MILL ST
    BELMONT,MA02478     		NONE N/A General Purpose 10,000
    LONG ISLAND CARES
    10 DAVIDS DRIVE
    HAUPPAUGE,NY11788     		NONE N/A General Purpose 10,000
    KIDS IN NEED FOUNDATION
    3077 KETTERING BLVD SUITE 114
    DAYTON,OH45439     		NONE N/A General Purpose 2,500
    KANZIUS CANCER RESEARCH FOUNDATION
    130 WEST 8TH ST SUITE 216
    ERIE,PA16501     		NONE N/A GENERAL PURPOSES 10,000
    JOE TORRE SAFE AT HOME FOUNDATION
    PO BOX 1037 MIDTOWN STATION
    NEW YORK,NY10018     		NONE N/A GENERAL PURPOSES 5,000
    HUMAN RIGHTS WATCH
    350 FIFTH AVE 34TH FLOOR
    NEW YORK,NY10118     		NONE N/A GENERAL PURPOSES 55,000
    HUMAN RIGHTS CAMPAIGN FOUNDATION
    1640 RHODE ISLAND AVE NW
    WASHINGTON,DC20036     		NONE N/A GENERAL PURPOSES 5,000
    HOT BREAD KITCHEN
    1590 PARK AVE
    NEW YORK,NY10029     		NONE N/A GENERAL PURPOSES 2,500
    HEIFER INTERNATIONAL
    1 WORLD AVE
    LITTLE ROCK,AR72202     		NONE N/A GENERAL PURPOSES 2,500
    HARRY CHAPIN FOOD BANK
    3760 FOWLER ST
    FORT MYERS,FL33901     		NONE N/A GENERAL PURPOSES 5,000
    HARRIS CENTER AT MASS GENERAL HOSPI
    165 CAMBRIDGE ST SUITE 600
    BOSTON,MA02114     		NONE N/A GENERAL PURPOSES 10,000
    GLOBAL GIVING
    1023 15TH ST NW 12TH FLOOR
    WASHINGTON,DC20005     		NONE N/A GENERAL PURPOSES 2,500
    GIVE WELL AKA 'THE CLEAR FUND'
    320 7TH AVE 232
    BROOKLYN,NY11215     		NONE N/A GENERAL PURPOSES 2,500
    FRIENDS OF LAUREL HOUSE
    1616 WASHINGTON BLVD
    STAMFORD,CT06902     		NONE N/A GENERAL PURPOSES 10,000
    FRIENDS IN DEED
    594 BROADWAY SUITE 706
    NEW YORK,NY10012     		NONE N/A GENERAL PURPOSES 2,500
    FISH FRIENDS IN SERVICE HERE
    1630 PERIWINKLE WAY UNIT B
    SANIBEL,FL33957     		NONE N/A GENERAL PURPOSES 5,000
    DING DARLING SOCIETY
    PO BOX 565
    SANIBEL,FL33957     		NONE N/A GENERAL PURPOSES 5,000
    CREATIVE CAPITAL
    65 BLEECKER ST 7TH FLOOR
    NEW YORK,NY10012     		NONE N/A GENERAL PURPOSES 2,500
    COMMON GROUND
    505 8TH AVE 15TH FLOOR
    NEW YORK,NY10018     		NONE N/A GENERAL PURPOSES 2,500
    CITY HARVEST
    DONOR SYSTEMS 575 8TH AVE 4TH FL
    NEW YORK,NY10018     		NONE N/A GENERAL PURPOSES 10,000
    CHICKEN EGG PICTURES
    24 UNION SQUARE EAST 5TH FLOOR
    NEW YORK,NY10003     		NONE N/A GENERAL PURPOSES 2,500
    BRENNAN CENTER FOR JUSTICE AT NYU
    161 AVENUE OF THE AMERICAS 12TH FL
    NEW YORK,NY10013     		NONE N/A GENERAL PURPOSES 10,000
    BLESSINGS IN A BACKPACK
    1839 BROWNSBORO ROAD
    LOUISVILLE,KY40206     		NONE N/A GENERAL PURPOSES 5,000
    BILLY IRELAND CARTOON LIBRARY MUSEU
    27 W 17TH AVENUE MALL
    COLUMBUS,OH43210     		NONE N/A GENERAL PURPOSES 5,000
    AUDUBON CONNECTICUT
    185 EAST FLAT HILL ROAD
    SOUTHBURY,CT06488     		NONE N/A GENERAL PURPOSES 5,000
    AMFAR
    120 WALL STREET 13TH FLOOR
    NEW YORK,NY10005     		NONE N/A GENERAL PURPOSES 5,000
    AMERICAN HEART ASSOCIATION
    7272 GREENVILLE AVENUE
    DALLAS,TX75231     		NONE N/A GENERAl 5,000
    Total .................................bullet 3a 880,000
    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
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3Interest on savings and temporary cash investments     14   274
    4 Dividends and interest from securities....     14   321,881
    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         703,746
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory..          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e)..     1,025,901
    13Total. Add line 12, columns (b), (d), and (e)..................
    131,025,901
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 12
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section
    Yes
    No
    501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is “Yes,” complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527?...........
    b
    If “Yes,” complete the following schedule.
    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer or fiduciary) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below
    (see instr.)?
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's namebullet



    Firm's addressbullet







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


    Software ID: 12000229
    Software Version: 2012v2.0


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2012 InvestmentsCorpStockSchedule
    Name:
    THEODORE L CROSS
    FAMILY CHARITABLE FOUNDATION
    EIN: 04-3254361
    Software ID:12000229
    Software Version:2012v2.0
    Name of Stock End of Year Book Value End of Year Fair Market Value
    87,391.3 SH PIMCO FDS - CSTY 1,000,000 1,022,478
    168,750.4 SH VANGUARD ST BOND - CSTY 1,800,000 1,793,817
    103,761.21 SH DODGE & COX INCOME - CSTY 1,400,000 1,438,130
    17,632.737 SH T ROWE PRICE NEW - CSTY 800,000 738,988
    67,087.651 SH HANSBERGER INSTL - CSTY 870,127 1,034,492
    80,873.928 SH LAUDUS TR - CSTY 700,000 644,789
    48,407.569 SH ARTISAN FDS INC - CSTY 600,000 644,789
    46,598.322 SH FIRST EAGLE OVERSEAS - CST 1,000,000 1,041,928
    19,697.965 SH DODGE & COX INTL - CSTY 600,000 682,338
    18,199.438 SH VAN ECK FDS - CSTY 400,000 307,207
    15,866.3 SH VANGUARD 500 INDEX - CSTY 1,500,000 1,721,811
    985 SH TENCENT HOLDINGS - DSM 27,761 31,644
    235 SH SHIRE PLC - DSM 24,226 21,662
    700 SH SABMILLER PLC 29,117 32,144
    290 SH YUM BRANDS INC - DSM 18,880 19,256
    120 SH W W GRAINGER INC - DSM 23,053 24,284
    250 SH VISA INC CLASS A - DSM 29,203 37,895
    265 SH UNION PACIFIC CORP - DSM 32,623 33,316
    780 SH TJX COMPANIES - DSM 33,455 33,111
    425 SH THE ESTEE LAUDER CORP - DSM 25,244 25,441
    615 SH STARBUCKS - DSM 27,870 32,982
    350 SH SCHLUMBERGER LTD - DSM 26,581 24,255
    235 SH PRECISION CASTPART - DSM 39,196 44,514
    550 SH MONSANTO CO - DSM 42,946 52,058
    810 SH LAS VEGAS SANDS CORP - DSM 42,618 37,390
    69 SH INTUITIVE SURGICAL - DSM 35,680 33,836
    43 SH GOOGLE INC CL A - DSM 26,943 30,417
    2,155 SH GENERAL ELECTRIC - DSM 43,591 45,233
    295 SH FAMILY DOLLAR STORES - DSM 17,221 18,706
    725 SH FACEBOOK INC CL A - DSM 15,155 19,300
    560 SH ECOLAB INC - GRG 35,153 40,264
    950 SH EBAY INC - DSM 41,482 48,448
    980 SH DOLLAR GENERAL - DSM 44,421 43,208
    500 SH DISCOVERY COMMUNICATION - DSM 23,869 31,740
    55 SH DAVITA HEALTHCARE PARTNERS - DSM 6,162 6,079
    430 SH COGNIZANT TECHNOLOGY - DSM 30,794 31,769
    750 SH CELGENE CORP - DSM 56,936 58,853
    164 SH APPLE INC - DSM 96,613 87,276
    515 SH ALLERGAN INC - DSM 47,888 47,241
    1,225 SH UNILEVER N V - GRG 41,503 46,918
    1,625 SH SABMILER PLC - GRG 67,452 74,621
    600 SH PERNOD-RICARD SA -GRG 63,164 69,169
    1,775 SH NESTLE S A SPONS 110,513 115,574
    1,475 SH HEINEKEN HOLDING -GRG 68,750 80,576
    1,175 SH DIAGEO PLC - GRG 30,101 34,131
    1,125 SH COMPAGNIE FINANCIERE - GRG 71,662 87,960
    850 SH BRITISH AMERICAN TOBACCO - GRG 44,078 43,122
    625 SH ANHEUSER BUSCH INBEV - GRG 46,122 54,631
    1,825 SH WELLS FARGO - GRG 62,427 62,379
    10 SH WASHINGTON POST - GRG 3,931 3,652
    100 SH SCRIPPS NETWORK INTER CL A - GRG 4,764 5,792
    130 SH MASTERCARD INC CLASS A - GRG 54,868 63,866
    1,250 SH PHILLIP MORRIS INTL - GRG 108,225 104,550
    250 SH MARTIN MARIETTA MATERIALS - GRG 21,738 23,570
    75 SH HASBRO INC - GRG 2,702 2,693
    350 SH COMCAST CORP - GRG 10,279 12,572
    450 SH BROWN FORMAN CORP - GRG 23,954 27,675
    1,350 SH BERKSHIRE HATHAWAY INC - GRG 109,973 121,095
    1,225 SH ALTRIA GROUP - GRG 36,956 38,514
    4,422 SH SPDR S&P 500 ETF TRUST - ADV1 520,469 629,737
    100 SH BANK OF UTICA - ADV1 26,400 36,000
    3,400 SH VODAFONE GROUP PLC    
    100 SH BANK OF UTICA    
    33,700 SH S&P 500 ETF TRUST    
    1,500 SH PEPSICO INC    
    1,650 SH MARATHON PETROLEUM CORP    
    3,300 SH MARATHON OIL CORP    
    3,000 SH JOHNSON & JOHNSON    
    4,500 SH INTEL CORP    
    2,600 SH HONEYWELL INTERNATIONAL INC    
    10,000 SH GENERAL ELECTRIC CO    
    1600 SH COCA-COLA    

    TY 2012 InvestmentsOtherSchedule2
    Name:
    THEODORE L CROSS
    FAMILY CHARITABLE FOUNDATION
    EIN: 04-3254361
    Software ID:12000229
    Software Version:2012v2.0
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    51,993.07 SH PIMCO GLOBAL ADV AT COST    
    93,632.96 SH VANGUARD ST BOND INDEX AT COST    
    8,643.042 SH T ROWE PRICE NEW ERA AT COST    
    77,101.002 SH HANSBERGER INSTL AT COST    
    58,275.058 SH LAUDUS TR - MONDRIAN AT COST    
    24,096.386 SH ARTISAN FUNDS EMRGING MKTS AT COST    
    46,598.322 SH FIRST EAGLE OVERSEAS FUND AT COST    
    19,697.965 SH DODGE & COX INTERNATIONAL AT COST    
    8,756.567 SH VAN ECKS FD AT COST    
    15,866.3 SH VANGUARD 500 INDEX FUND AT COST    
    THE TAP FUND LTD AT COST 500,000 466,061
    NYES LEDGE CAPITAL OFFSHORE FUND AT COST 1,300,000 1,356,378
    THE WEATHERLOW OFFSHORE FUND AT COST 1,300,000 1,345,469

    TY 2012 OtherExpensesSchedule
    Name:
    THEODORE L CROSS
    FAMILY CHARITABLE FOUNDATION
    EIN: 04-3254361
    Software ID:12000229
    Software Version:2012v2.0
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TRAVEL 2,556     2,556
    SUPPLIES 609     609
    POSTAGE 92     92
    LOSS ON CURRENCY EXCHANGE 29 29    
    INSURANCE 1,076     1,076
    DUES & MEMBERSHIPS 1,195     1,195
    CONVENTION & CONFERENCES 4,100     4,100
    BANK CHARGES -4     -4


    TY 2012 OtherProfessionalFeesSchedule
    Name:
    THEODORE L CROSS
    FAMILY CHARITABLE FOUNDATION
    EIN: 04-3254361
    Software ID:12000229
    Software Version:2012v2.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT ADVISOR FEES 61,810 61,810 0 0


    TY 2012 TaxesSchedule
    Name:
    THEODORE L CROSS
    FAMILY CHARITABLE FOUNDATION
    EIN: 04-3254361
    Software ID:12000229
    Software Version:2012v2.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAX 2,034 2,034    
    FEDERAL EXCISE 9,620