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
Jerry & Terri Kohl Family Foundation
 

Number and street (or P.O. box number if mail is not delivered to street address)Foundation Source 501 Silverside Rd   Room/suite
City or town, state, and ZIP code
Wilmington, DE198091377
A Employer identification number

20-4757707
B Telephone number (see instructions)

(800) 839-1754
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$6,767,177J 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 153 153  
4 Dividends and interest from securities...... 124,327 124,327  
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 Click to see attachment 219,690
b Gross sales price for all assets on line 6a 2,394,752
7 Capital gain net income (from Part IV, line 2)... 219,690
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 344,170 344,170  
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 42,822 42,822    
17 Interest...............        
18 Taxes (attach schedule) (see instructions) Click to see attachment 3,777 577    
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 attachment 26,196     26,196
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 72,795 43,399   26,196
25 Contributions, gifts, grants paid........ 1,036,050 1,036,050
26 Total expenses and disbursements. Add lines 24 and 25 1,108,845 43,399   1,062,246
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -764,675
b Net investment income (if negative, enter -0-) 300,771
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.......... 457,971 288,424 288,424
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) 658,211 542,709 541,214
b Investments—corporate stock (attach schedule)........ 3,005,523 Click to see attachment3,109,281 3,629,470
c Investments—corporate bonds (attach schedule)........ 263,525 Click to see attachment105,210 104,430
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans..............      
13 Investments—other (attach schedule)........... 2,290,706 Click to see attachment1,865,637 2,203,639
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) 6,675,936 5,911,261 6,767,177
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 6,675,936 5,911,261
30 Total net assets or fund balances (see page 17 of the
instructions).................... 6,675,936 5,911,261
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 6,675,936 5,911,261
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 6,675,936
2 Enter amount from Part I, line 27a..................... 2 -764,675
3 Other increases not included in line 2 (itemize) bullet 3  
4 Add lines 1, 2, and 3.......................... 4 5,911,261
5 Decreases not included in line 2 (itemize) bullet 5  
6 Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30. 6 5,911,261
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 Publicly-traded Securities      
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 2,394,752   2,175,062 219,690
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       219,690
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 2 219,690
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 878,962 7,461,944 000.117793
2010 701,502 7,991,700 000.087779
2009 560,927 7,309,741 000.076737
2008 415,694 8,059,577 000.051578
2007 583,735 9,369,383 000.062302
2 Total of line 1, column (d) ...................... 2 000.396189
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. . . 		3 000.079238
4 Enter the net value of noncharitable-use assets for 2012 from Part X, line 5..... 4 6,731,363
5 Multiply line 4 by line 3....................... 5 533,380
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 3,008
7 Add lines 5 and 6......................... 7 536,388
8 Enter qualifying distributions from Part XII, line 4.............. 8 1,062,246
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 3,008
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 3,008
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 3,008
6 Credits/Payments:
a 2012 estimated tax payments and 2011 overpayment credited to 2012 6a 3,462
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.............. Tax Paid Original Return: 3462 7 3,462
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. Click to see attachment 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 10 454
11 Enter the amount of line 10 to be: Credited to 2013 estimated taxBullet454 Refunded Bullet 11  
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see page 19 of
the instructions for definition)?............................
1b
 
No
If the answer is “Yes” to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If “Yes,” attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If “Yes,” attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If “Yes,” has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If “Yes,” attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If “Yes,” complete Part II, col. (c), and Part XV.
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bullet
    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 ofbulletco Foundation Source Telephone no.bullet (800) 839-1754
    Located atbullet501 Silverside Road Suite 123WilmingtonDE ZIP+4bullet198091377
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041.........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ......bullet
    15  
    16
    At any time during calendar year 2012, did the foundation have an interest in or a signature or other authority over
    a bank, securities, or other financial account in a foreign country? .................
    16
     
    No
    See instructions for exceptions and filing requirements for Form TD F 90-22.1. If "Yes", enter the name of the foreign country bullet  
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 5
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the “Yes” column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?.........................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?.................
    (6) Agree to pay money or property to a government official? (Exception. Check “No”
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).........
    b
    If any answer is “Yes” to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance (see page 20 of the instructions)?...
    1b
     
     
    .........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2012?.............
    1c
     
    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
    Jerry Kohl Pres / Dir / Sec
    001.00     		0    
    Foundation Source 501 Silverside Rd
    Wilmington,DE19809
    Karyn Kohl VP
    001.00     		0    
    Foundation Source 501 Silverside Rd
    Wilmington,DE19809
    Matthew Kohl VP
    001.00     		0    
    Foundation Source 501 Silverside Rd
    Wilmington,DE19809
    Terri Marilyn Kohl Dir / Sec / Treas
    001.00     		0    
    Foundation Source 501 Silverside Rd
    Wilmington,DE19809
    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
    4,305,917
    b
    Average of monthly cash balances.......................
    1b
    324,315
    c
    Fair market value of all other assets (see instructions)................
    1c
    2,203,639
    d
    Total (add lines 1a, b, and c).........................
    1d
    6,833,871
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
     
    3
    Subtract line 2 from line 1d.........................
    3
    6,833,871
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see
    instructions) Click to see attachment.............................
    4
    102,508
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    6,731,363
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    336,568
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    336,568
    2a
    Tax on investment income for 2012 from Part VI, line 5......
    2a
    3,008
    b
    Income tax for 2012. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    3,008
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    333,560
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    333,560
    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
    333,560
    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 Click to see attachment..........
    1a
    1,062,246
    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
    1,062,246
    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
    3,008
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    1,059,238
    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 7 333,560
    2 Undistributed income, if any, as of the end of 2012:
    a Enter amount for 2011 only.......  
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2012:
    a From 2007....... 105,760
    b From 2008....... 115,028
    c From 2009....... 198,544
    d From 2010....... 308,641
    e From 2011....... 512,095
    fTotal of lines 3a through e......... 1,240,068
    4Qualifying distributions for 2012 from Part
    XII, line 4: bullet$ 1,062,246
    a Applied to 2011, but not more than line 2a  
    b Applied to undistributed income of prior years
    (Election required—see instructions)......     		 
    c Treated as distributions out of corpus (Election
    required—see instructions).........     		 
    d Applied to 2012 distributable amount..... 333,560
    e Remaining amount distributed out of corpus 728,686
    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 1,968,754
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ...........     		 
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		 
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		 
    e Undistributed income for 2011. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    f Undistributed income for 2012. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2013 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (see
    instructions) .............     		 
    8Excess distributions carryover from 2007 not
    applied on line 5 or line 7 (see instructions) ...     		105,760
    9Excess distributions carryover to 2013.
    Subtract lines 7 and 8 from line 6a ......     		1,862,994
    10 Analysis of line 9:
    a Excess from 2008.... 115,028
    b Excess from 2009.... 198,544
    c Excess from 2010.... 308,641
    d Excess from 2011.... 512,095
    e Excess from 2012.... 728,686
    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).)
    Jerry Kohl
    Terri Marilyn Kohl
    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
    ALZHEIMERS DIS & RELATED DISORDERS ASSOC
    4221 WILSHIRE BLVD STE 400
    LOS ANGELES,CA90010     		N/A 509a1 Charitable Event 1,000
    AMERICAN CONTEMPORARY BALLET INC
    5803 W OLYMPIC BLVD
    LOS ANGELES,CA90036     		N/A 509a1 General Unrestricted 1,000
    AMERICAN FRIENDS OF THE HEBREW UNIV
    ONE BATTERY PARK PLZ 25TH FL
    NEW YORK,NY10004     		N/A 509a1 General Unrestricted 25,000
    AMERICAN HEART ASSOCIATION
    816 S FIGUEROA ST
    LOS ANGELES,CA90017     		N/A 509a1 General Unrestricted 1,000
    AMERICAN HEART ASSOCIATION
    816 S FIGUEROA ST
    LOS ANGELES,CA90017     		N/A 509a1 Go Red For Women 25,000
    AMER SCTY FOR PREV OF CRUELTY TO ANIMALS
    520 8TH AVE 7TH FL
    NEW YORK,NY10018     		N/A 509a1 Charitable Event 10,000
    AMERICAN WOMEN FOR INTL UNDERSTANDING
    2100 S WOLF RD
    DES PLAINES,IL60018     		N/A 509a2 Support the International Women of Courage Celebration 2,500
    AMERICAN YOUTH SYMPHONY INC
    3424 WLSHRE BLVD STE 830
    LOS ANGELES,CA90010     		N/A 509a2 General Unrestricted 10,000
    ARMAND HAMMER MUS OF ART & CULTURAL CTR
    10899 WILSHIRE BLVD
    LOS ANGELES,CA90024     		N/A 509a3 Hammer Circle Fund 7,500
    ARMAND HAMMER MUS OF ART & CULTURAL CTR
    10899 WILSHIRE BLVD
    LOS ANGELES,CA90024     		N/A 509a3 Wild Up Project 15,000
    ART CENTER COLLEGE OF DESIGN
    1700 LIDA ST
    PASADENA,CA91103     		N/A 509a1 General Unrestricted 10,000
    ART CENTER COLLEGE OF DESIGN
    1700 LIDA ST
    PASADENA,CA91103     		N/A 509a1 Grad Art Lecture Series 4,400
    BALLET FOR ALL KIDS
    PO BOX 6413
    PINE MTN CLB,CA93222     		N/A 509a2 General Unrestricted 3,235
    BALTIMORE CLAYWORKS INC
    5707 SMITH AVE
    BALTIMORE,MD21209     		N/A 509a2 General Unrestricted 1,000
    BOYS & GIRLS CLUBS OF LA HABRA-BREA
    1211 FAHRINGER WAY
    LA HABRA,CA90631     		N/A 509a1 General Unrestricted 3,360
    BUSINESS COUNCIL FOR PEACE INC
    5 E 22ND ST
    NEW YORK,NY10010     		N/A 509a1 General Unrestricted 10,000
    CHARLES W BOWERS MUSEUM CORPORATION
    2002 N MAIN ST
    SANTA ANA,CA92706     		N/A 509a1 General Unrestricted 25,000
    CITY OF HOPE
    1055 WILSHIRE BLVD 12TH FLR
    LOS ANGELES,CA90017     		N/A 509a1 General Unrestricted 75,000
    CITY OF HOPE
    1055 WILSHIRE BLVD 12TH FLR
    LOS ANGELES,CA90017     		N/A 509a1 Kathy Merrills Moving Mountains for Midge Campain 1,000
    COMMUNITY TELEVISION OF S CALIFORNIA
    4401 W SUNSET BLVD
    LOS ANGELES,CA90027     		N/A 509a1 General Unrestricted 1,000
    CONCERN FOUNDATION
    1026 S ROBERTSON BLVD STE 300
    LOS ANGELES,CA90035     		N/A 509a1 General Unrestricted 25,000
    CONCERN FOUNDATION
    1026 S ROBERTSON BLVD STE 300
    LOS ANGELES,CA90035     		N/A 509a1 Concern Marathon Page for Anne Barnett 5,000
    ECHOES OF HOPE
    300 CONTINENTAL BLVD STE 622
    EL SEGUNDO,CA90245     		N/A 509a1 General Unrestricted 2,500
    ETM-LA INC
    847 N HOLLYWOOD WAY
    BURBANK,CA91505     		N/A 509a1 General Unrestricted 1,000
    EXCEPTIONAL CHILDRENS FOUNDATION
    8740 W WASHINGTON BLVD
    CULVER CITY,CA90230     		N/A 509a1 General Unrestricted 1,000
    FOOTHILL UNITY CENTER
    415 W CHESTNUT AVE
    MONROVIA,CA91016     		N/A 509a1 General Unrestricted 25,000
    FRACTURED ATLAS PRODUCTIONS INC
    248 W 35TH ST 10TH FLR
    NEW YORK,NY10001     		N/A 509a1 Wild Up Project 25,000
    HEART OF LOS ANGELES YOUTH INC
    2701 WILSHIRE BLVD STE 100
    LOS ANGELES,CA90057     		N/A 509a1 General Unrestricted 20,000
    HENRY E HUNTINGTON LIBRARY & ART GALLERY
    1151 OXFORD RD
    SAN MARINO,CA91108     		N/A 509a1 General Unrestricted 22,000
    INTERNATIONAL MEDICAL CORPS
    1919 SANTA MONICA BLVD STE 400
    SANTA MONICA,CA90404     		N/A 509a1 General Unrestricted 5,000
    INTERVARSITY CHRISTIAN FELLOWSHIP- USA
    6400 SCHROEDER RD
    MADISON,WI53711     		N/A 509a2 Challenge Grant for Brittni Davenport and Challenge Grant Match for Kaci Wohlfeil 1,250
    JEWISH FAMILY SERVICE OF LOS ANGELES
    3580 WILSHIRE BLVD 7TH FL
    LOS ANGELES,CA90010     		N/A 509a1 Sova Fund 20,000
    JEWISH FEDERATION OF THE GREATER SAN GABRIEL & POMONA VALLEYS
    550 S 2ND AVE
    ARCADIA,CA91006     		N/A 509a1 General Unrestricted 33,000
    JEWISH VOCATIONAL SERVICE
    6505 WILSHIRE BLVD STE 700
    LOS ANGELES,CA90048     		N/A 509a1 Debbie Powell Mentoring Program and Discretionary Fund 75,000
    JOHN F KENNEDY CENTER FOR THE PERFORMING ARTS
    2700 F ST NW
    WASHINGTON,DC20566     		N/A 509a1 General Unrestricted 25,000
    KIDS WHO CARE INC
    1300 GENDY ST
    FORT WORTH,TX76107     		N/A 509a1 General Unrestricted 3,290
    LAXART
    2640 S LA CIENEGA BLVD
    LOS ANGELES,CA90034     		N/A 509a1 Made in LA - Los Angeles Biennial Project 30,000
    LAXART
    2640 S LA CIENEGA BLVD
    LOS ANGELES,CA90034     		N/A 509a1 Liz Glynns Black Box Project 34,230
    LAXART
    2640 S LA CIENEGA BLVD
    LOS ANGELES,CA90034     		N/A 509a1 Mary Weatherford Project 7,500
    LAXART
    2640 S LA CIENEGA BLVD
    LOS ANGELES,CA90034     		N/A 509a1 Charitable Event 4,580
    LIBRARY FOUNDATION OF LOS ANGELES
    630 W 5TH ST
    LOS ANGELES,CA90071     		N/A 509a1 General Unrestricted 1,200
    LITTLE KIDS ROCK INC
    632 POMPTON AVE
    CEDAR GROVE,NJ07009     		N/A 509a1 General Unrestricted 100,000
    LOEW VISION REHABILITATION INSTITUTE
    1880 CENTURY PARK E
    LOS ANGELES,CA90067     		N/A 509a1 General Unrestricted 15,000
    LOS ANGELES PHILHARMONIC ASSOCIATION
    151 S GRAND AVE
    LOS ANGELES,CA90012     		N/A 509a2 General Unrestricted 50,000
    LUNG CANCER FOUNDATION OF AMERICA
    15 S FRANKLIN ST
    NEW ULM,MN56073     		N/A 509a1 Charitable Event 5,000
    MACHINE PROJECT
    1200 D N ALVARADO ST
    LOS ANGELES,CA90026     		N/A 509a1 Corey Fogel Performance 1,000
    METROPOLITAN ASSOCIATES
    535 S GRAND AVE
    PASADENA,CA91105     		N/A 509a2 General Unrestricted 600
    MUSE-IQUE
    750 E GREEN ST STE 305
    PASADENA,CA91101     		N/A 509a1 General Unrestricted 33,333
    MUSEUM ASSOCIATES
    5905 WILSHIRE BLVD
    LOS ANGELES,CA90036     		N/A 509a2 Barbara T. Smith Acquisition Fund 5,000
    MUSEUM ASSOCIATES
    5905 WILSHIRE BLVD
    LOS ANGELES,CA90036     		N/A 509a2 AHAN Program 5,000
    MUSEUM OF CONTEMPORARY ART
    250 S GRAND AVE
    LOS ANGELES,CA90012     		N/A 509a1 John Knight Publication 10,000
    P S ARTS
    1728 ABBOT KINNEY BLVD STE 101
    VENICE,CA90291     		N/A 509a1 General Unrestricted 2,688
    PACIFIC FESTIVAL BALLET
    5863 KANAN RD
    AGOURA HILLS,CA91301     		N/A 509a2 General Unrestricted 2,064
    PASADENA ARTS COUNCIL
    65 S GRAND AVE
    PASADENA,CA91105     		N/A 509a2 Lit Fest/ Larry Wilson Project 2,500
    PASADENA CONSERVATORY OF MUSIC
    100 N HILL AVE
    PASADENA,CA91106     		N/A 509a1 General Unrestricted 25,000
    PASADENA HOSPITAL ASSOCIATION LTD
    100 W CALIF BLVD
    PASADENA,CA91105     		N/A 509a1 General Unrestricted 30,000
    PASADENA HUMANE SOCIETY
    361 S RAYMOND AVE
    PASADENA,CA91105     		N/A 509a2 General Unrestricted 5,000
    PASADENA PLAYHOUSE STATE THEATRE OF CALIFORNIA INC
    39 S EL MOLINO AVE
    PASADENA,CA91101     		N/A 509a1 General Unrestricted 25,000
    PERFORMING ARTS CENTER OF LOS ANGELES COUNTY
    135 N GRAND AVE
    LOS ANGELES,CA90012     		N/A 509a1 Blue Ribbon and Childrens Festival 6,000
    PIECE BY PIECE
    11400 W OLYMPIC BLVD
    LOS ANGELES,CA90064     		N/A 509a1 General Unrestricted 10,000
    REGENTS UNIVERSITY OF CALIFORNIA LOS ANGELES
    10920 WILSHIRE BLVD STE 620
    LOS ANGELES,CA90024     		N/A 509a1 Division of Rheumatology 200
    RYMAN CARROLL FOUNDATION
    315 W 9TH ST STE 806
    LOS ANGELES,CA90015     		N/A 509a1 General Unrestricted 5,000
    SIERRA SUMMER FESTIVAL OF THE PERFORMING ARTS INC
    PO BOX 7710
    MAMMOTH LAKES,CA93546     		N/A 509a2 The Horton-Kohl Young Artist Award Program 4,000
    SMART FOUNDATION
    26941 CABOT RD STE 114
    LAGUNA HILLS,CA92653     		N/A 509a2 General Unrestricted 4,272
    SOCSA FOUNDATION
    PO BOX 3174
    DANA POINT,CA92629     		N/A 509a1 General Unrestricted 5,848
    TEMPLE BETH DAVID
    9677 LONGDEN AVE
    TEMPLE CITY,CA91780     		N/A 509a1 Rabbis Special Fund 20,000
    THE LOS ANGELES CHAMBER ORCHESTRA SOCIETY INC
    350 S FIGUEROA ST 183
    LOS ANGELES,CA90071     		N/A 509a2 General Unrestricted 5,000
    UNION STATION HOMELESS SERVICES
    825 E ORANGE GROVE BLVD
    PASADENA,CA91104     		N/A 509a1 General Unrestricted 10,000
    UNITED WAY INC
    1150 S OLIVE ST STE T500
    LOS ANGELES,CA90015     		N/A 509a1 General Unrestricted 50,000
    Total .................................bullet 3a 1,036,050
    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     14 153  
    4 Dividends and interest from securities....     14 124,327  
    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     18 219,690  
    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)..   344,170  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13344,170
    (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: 12000057
    Software Version: 12.19.1011.1
    Part VI Line 7 - Tax Paid Original Return: 3462


    Form 990PF - Special Condition Description:
    Special Condition Description

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

    TY 2012 GainLossSaleOtherAssetsSch
    Name:
    Jerry & Terri Kohl Family Foundation
    EIN: 20-4757707
    Software ID:12000057
    Software Version:12.19.1011.1
    Name Date Acquired How Acquired Date Sold Purchaser Name Gross Sales Price Basis Basis Method Sales Expenses Total (net) Accumulated Depreciation
    Publicly-traded Securities         2,394,752 2,175,062     219,690  

    TY 2012 GeneralExplanationAttachment
    Name:
    Jerry & Terri Kohl Family Foundation
    EIN: 20-4757707
    Software ID:12000057
    Software Version:12.19.1011.1
    Identifier Return Reference Explanation

    TY 2012 InvestmentsCorpBondsSchedule
    Name:
    Jerry & Terri Kohl Family Foundation
    EIN: 20-4757707
    Software ID:12000057
    Software Version:12.19.1011.1
    Name of Bond End of Year Book Value End of Year Fair Market Value
    EXPORT DEV CDA BD 2.25000 05/28/2015 105,210 104,430

    TY 2012 InvestmentsCorpStockSchedule
    Name:
    Jerry & Terri Kohl Family Foundation
    EIN: 20-4757707
    Software ID:12000057
    Software Version:12.19.1011.1
    Name of Stock End of Year Book Value End of Year Fair Market Value
    186 shares of 3M CO 15,071 17,270
    398 shares of ABBOTT LABS 19,328 26,069
    110 shares of AIR PRODS CHEM INC. 7,883 9,242
    47 shares of AMAZON COM 8,718 11,791
    1107 shares of AMER INTERNATIONAL GROUP INC 38,317 39,077
    172 shares of APACHE CORPORATION 11,820 13,502
    108 shares of APPLE INC. 20,855 57,475
    238 shares of BAXTER INTERNATIONAL INC. 12,106 15,865
    1934 shares of BOSTON SCIENTIFIC 11,295 11,082
    365 shares of BROADCOM CORPORATION 12,471 12,122
    381 shares of CARDINAL HEALTH INC. 16,385 15,690
    418 shares of CELGENE CORP 22,860 32,800
    969 shares of CHARLES SCHWAB CORP NEW 12,514 13,915
    211 shares of CHECK POINT SOFTWARE TECHNOLOGIES LTD 11,620 10,052
    240 shares of CHUBB CORP 13,585 18,077
    1177 shares of CISCO SYSTEMS INC 22,360 23,127
    1011 shares of CITIGROUP INC 33,213 39,995
    154 shares of CITRIX SYSTEMS INC 9,910 10,105
    226 shares of COGNIZANT TECHNOLOGY SOLUTIONS CORPORATION - CLASS 14,683 16,697
    875 shares of COMCAST CORP CL A 21,204 32,690
    706 shares of CONAGRA FOODS INC 12,071 20,827
    153 shares of COOPER COMPANIES INC 12,079 14,149
    83 shares of COSTCO WHOLESALE CORP NEW 8,129 8,195
    331 shares of DANAHER CORP 17,658 18,503
    382 shares of DEVON ENERGY CORPORATION 22,342 19,879
    294 shares of DOVER CORP 9,671 19,319
    126 shares of EBAY INC. 6,240 6,426
    100 shares of EKSPORTFINANS ASA IDX NT LKD 13 100,750 108,780
    522 shares of EMC CORP-MASS 12,990 13,207
    218 shares of EOG RESOURCES INC 22,161 26,332
    51 shares of EXXON MOBIL CORP 3,618 4,414
    112 shares of F M C CP 6,146 6,554
    455 shares of GENERAL MILLS INC 12,511 18,391
    250 shares of GOLDMAN SACHS GROUP LEVERED CAPPED 8/25/2014 250,000 264,187
    46878 shares of GOLDMAN SACHS HIGH YIELD FUND INSTITUTIONAL SHARES 311,677 342,681
    37 shares of GOOGLE INC CL A 19,593 26,173
    29694 shares of GS LOCAL EMERGING MKTS DEBT FD MUTUAL FUND - CL I 277,676 292,779
    579 shares of HALLIBURTON COMPANY 17,860 20,086
    1206 shares of HARTFORD FINANCIALSERVICES GROUP 25,082 27,063
    230 shares of HERSHEY FOODS CORP COMMON 12,698 16,611
    121 shares of HOLLYFRONTIER CORP 4,418 5,633
    251 shares of HOME DEPOT INC. 10,730 15,524
    249 shares of ILLINOIS TOOL WORKS 8,819 15,142
    87 shares of INTERNATIONAL BUSINESS MACHINES 14,223 16,665
    246 shares of INTERNATIONAL PAPER CO. 8,452 9,801
    3000 shares of ISHARES RUSSELL 2000 143,160 252,960
    297 shares of JOHNSON JOHNSON 17,083 20,820
    899 shares of JP MORGAN CHASE CO 35,148 39,528
    406 shares of JUNIPER NETWORKS 7,189 7,986
    261 shares of KIMBERLY CLARK CORP 16,934 22,036
    272 shares of KRAFT FOODS GROUP, INC. 11,412 12,368
    171 shares of LAS VEGAS SANDS CORP 8,957 7,893
    263 shares of LINEAR TECHNOLOGY CORP 8,242 9,021
    443 shares of LOWES COMPANIES INC. 10,829 15,735
    188 shares of MCDONALDS CORP 11,027 16,583
    648 shares of MEDTRONIC INC 20,501 26,581
    858 shares of MERCK CO INC. 34,038 35,127
    1338 shares of MICROSOFT CORPORATION 33,531 35,738
    816 shares of MONDELEZ INTERNATIONAL INC 21,059 20,770
    139 shares of MONSANTO CO 12,101 13,156
    178 shares of NATL OILWELL VARCO 6,568 12,166
    436 shares of NIKE INC-CL B 19,679 22,498
    515 shares of OCCIDENTAL PETROLEUM CORP 37,532 39,454
    550 shares of ORACLE CORP 14,143 18,326
    203 shares of P P G IND 19,527 27,476
    188 shares of PACCAR INC 8,425 8,499
    209 shares of PARKER HANNIFIN CP 9,046 17,778
    298 shares of PEPSICO INC 17,110 20,392
    1102 shares of PFIZER INC. 17,575 27,637
    354 shares of PNC FINANCIAL GROUP INC. 21,018 20,642
    92 shares of PRECISION CASTPARTS 14,432 17,427
    364 shares of PROCTER GAMBLE CO 18,030 24,712
    426 shares of PROGRESSIVE CORP OHIO 8,954 8,989
    293 shares of PRUDENTIAL FINCL INC 14,302 15,626
    198 shares of QUALCOMM INC 10,636 12,248
    219 shares of QUEST DIAGNOSTICS 11,628 12,761
    77 shares of SALESFORCE.COM 12,239 12,944
    3150 shares of SPRD EURO STOXX 50 ETF 94,795 109,179
    243 shares of STANLEY BLACK DECKER INC 16,553 17,975
    263 shares of STARBUCKS CORP COM 12,485 14,105
    201 shares of STATE STREET CORPORATION 8,653 9,449
    376 shares of SUNCOR ENERGY INC 13,809 12,400
    570 shares of SYSCO CORP 13,730 18,046
    337 shares of TEXAS INSTRUMENTS INC. 9,714 10,410
    350 shares of THE GOLDMAN SACHS GROUP, INC. LINKED TO SP 500 349,999 376,950
    311 shares of THERMO FISHER SCIENTIFIC INC 16,144 19,836
    379 shares of TJX COMPANIES INC 16,236 16,089
    120 shares of TRAVELERS COMPANIES INC 6,364 8,618
    622 shares of UNITED TECHNOLOGIES CORP 37,738 51,010
    114 shares of V F CORP 16,748 17,211
    641 shares of VALERO ENERGY CORP 15,256 21,871
    4080 shares of VANGUARD MSCI EMERGING MARKETS ETF 169,034 181,682
    302 shares of VERTEX PHARMCTLS INC 11,546 12,654
    230 shares of VIACOM INC. CL B 11,933 12,130
    134 shares of VISA INC 17,332 20,312
    763 shares of WALT DISNEY HOLDINGS CO. 33,057 37,990
    620 shares of WARNER CHILCOTT PLC IRELAND SHS-A 11,709 7,465
    100 shares of WATSON PHARMACEUTICALS INC. 7,866 8,600
    513 shares of WELLS FARGO CO. 14,250 17,534
    89 shares of WHOLE FOODS MARKET, INC. 8,483 8,113

    TY 2012 InvestmentsOtherSchedule2
    Name:
    Jerry & Terri Kohl Family Foundation
    EIN: 20-4757707
    Software ID:12000057
    Software Version:12.19.1011.1
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    GS HEDGE FUND OPPORTUNITIES LTD CL A SER 22   448,221 606,222
    GS REAL ESTATE MEZZANINE PARTNERS CORP LP   34,308 23,547
    GS VINTAGE FUND V LP   470,187 671,889
    NON-US EQUITY MANAGERS PORTFOLIO 5 OFFSHORE L.P.   912,921 901,981

    TY 2012 OtherExpensesSchedule
    Name:
    Jerry & Terri Kohl Family Foundation
    EIN: 20-4757707
    Software ID:12000057
    Software Version:12.19.1011.1
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Administrative Fees 25,171     25,171
    State or Local Filing Fees 1,025     1,025


    TY 2012 OtherProfessionalFeesSchedule
    Name:
    Jerry & Terri Kohl Family Foundation
    EIN: 20-4757707
    Software ID:12000057
    Software Version:12.19.1011.1
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Investment Management Services 42,822 42,822    


    TY 2012 TaxesSchedule
    Name:
    Jerry & Terri Kohl Family Foundation
    EIN: 20-4757707
    Software ID:12000057
    Software Version:12.19.1011.1
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Estimated Tax for 2012 3,200      
    Foreign Tax Paid 577 577