| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| 2011 FORM 990-PF TAX PREP FEE | 750 | 750 |
| Grantee's Name | Grantee's Address | Grant Date | Grant Amount | Grant Purpose | Amount Expended By Grantee | Any Diversion By Grantee? | Dates of Reports By Grantee | Date of Verification | Results of Verification |
|---|---|---|---|---|---|---|---|---|---|
|
F ALBERT KLEIN TRUST UNDER WILL C/O US BANK NA |
201 JEFFERSON BURLINGTON,IA526015250 |
2012-01-03 | 22,648 | FOR SUPPORT OF GREAT RIVER MEDICAL CENTER 1221 S GEAR AVENUE; W BURLINGTON, IA 52655-1679 | NO | 7/2/2012 | 2012-07-02 | PAYMENT IS USED FOR INTENDED USE | |
|
F ALBERT KLEIN TRUST UNDER WILL C/O US BANK NA |
201 JEFFERSON BURLINGTON,IA526015250 |
2012-04-02 | 22,648 | FOR SUPPORT OF GREAT RIVER MEDICAL CENTER 1221 S GEAR AVENUE, W. BURLINGTON, IA 52655-1679 | NO | 7/2/2012 | 2012-07-02 | PAYMENT IS USED FOR PURPOSE INTENDED | |
|
F ALBERT KLEIN TRUST UNDER WILL C/O US BANK NA |
201 JEFFERSON BURLINGTON,IA526015250 |
2012-07-02 | 22,648 | FOR SUPPORT OF GREAT RIVER MEDICAL CENTER 1221 S. GEAR AVENUE, W. BURLINGTON, IA 52655-1679 | NO | 7/2/2012 | 2012-07-02 | PAYMENT IS USED FOR PURPOSE INTENDED |
| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| NUVEEN CORE BD FD CL I | AT COST | 367,754 | 397,665 |
| NUVEEN INFLATION PRO SEC CL I | AT COST | 136,446 | 164,435 |
| PIMCO TOTAL RETURN FD INST | AT COST | 376,766 | 406,861 |
| CREDIT SUISSE COMMOD RET STRAT | AT COST | 276,434 | 267,817 |
| NUVEEN HIGH INC BD FD I | AT COST | 211,842 | 219,689 |
| T ROWE PRICE INTL BD FD | AT COST | 200,543 | 209,460 |
| AMER CENT EQUITY INC CL INSTL | AT COST | 1,112,711 | 1,281,502 |
| NUVEEN REAL ESTATE SEC FD CL I | AT COST | 301,681 | 404,142 |
| NEUBERGER BERMN GENESIS INSTL | AT COST | 127,899 | 154,776 |
| T ROWE PRIC MID CAP GRW FD #64 | AT COST | 334,622 | 347,209 |
| ABERDEEN FDS EMRGN MKT INSTL | AT COST | 403,944 | 453,920 |
| LAUDUS INTL MKMSTRS FD SEL | AT COST | 423,203 | 426,214 |
| SCOUT INT'L FUND | AT COST | 423,203 | 426,787 |
| Description | Beginning of Year - Book Value | End of Year - Book Value | End of Year - Fair Market Value |
|---|---|---|---|
| ACCRUED INCOME | 19,807 | 5,977 | 5,977 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| FOREIGN TAXES PAID | 681 | 681 | 0 | |
| EXCISE TAXES PAID | 3,388 | 0 | 0 | |
| 2011 FORM 990-PF BAL DUE | 1,051 | 0 | 0 |