Form990-PF
Click to see attachment

Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Nonexempt Charitable Trust
Treated as a Private Foundation
Note. The foundation may be able to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0052
2012
Open to Public Inspection
For calendar year 2012, or tax year beginning 01-01-2012 , and ending 12-31-2012
Name of foundation
REPUBLIC NATIONAL DISTRIBUTING COMPANY
FOUNDATION INC

Number and street (or P.O. box number if mail is not delivered to street address)ONE NATIONAL DRIVE   Room/suite
City or town, state, and ZIP code
ATLANTA, GA30336
A Employer identification number

45-3842838
B Telephone number (see instructions)

(404) 472-2245
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$29,261J 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) 380,000
2 Check bullet
3 Interest on savings and temporary cash investments 11 11 11
4 Dividends and interest from securities......      
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10  
b Gross sales price for all assets on line 6a  
7 Capital gain net income (from Part IV, line 2)...  
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........ 380,011 11 11
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)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)        
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 517 517    
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 517 517   0
25 Contributions, gifts, grants paid........ 482,561 482,561
26 Total expenses and disbursements. Add lines 24 and 25 483,078 517   482,561
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -103,067
b Net investment income (if negative, enter -0-) 0
c Adjusted net income (if negative, enter -0-)... 11
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...............   29,261 29,261
2 Savings and temporary cash investments..........      
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)      
b Investments—corporate stock (attach schedule)........      
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)...........      
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)   29,261 29,261
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   29,261
30 Total net assets or fund balances (see page 17 of the
instructions)....................   29,261
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 0 29,261
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  
2 Enter amount from Part I, line 27a..................... 2 -103,067
3 Other increases not included in line 2 (itemize) bulletClick to see attachment 3 154,279
4 Add lines 1, 2, and 3.......................... 4 51,212
5 Decreases not included in line 2 (itemize) bulletClick to see attachment 5 21,951
6 Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30. 6 29,261
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.)
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  
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      
2010      
2009      
2008      
2007      
2 Total of line 1, column (d) ...................... 2  
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  
4 Enter the net value of noncharitable-use assets for 2012 from Part X, line 5..... 4  
5 Multiply line 4 by line 3....................... 5  
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6  
7 Add lines 5 and 6......................... 7  
8 Enter qualifying distributions from Part XII, line 4.............. 8  
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 0
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  
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  
6 Credits/Payments:
a 2012 estimated tax payments and 2011 overpayment credited to 2012 6a  
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  
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  
11 Enter the amount of line 10 to be: Credited to 2013 estimated taxBullet   Refunded Bullet 11  
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see page 19 of
the instructions for definition)?............................
1b
 
No
If the answer is “Yes” to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If “Yes,” attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If “Yes,” attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If “Yes,” has it filed a tax return on Form 990-T for this year?...................
4b
 
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)
    bulletGA
    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.Click to see attachment
    10
    Yes
     
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. (see instructions) .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement (see instructions).................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletN/A
    14
    The books are in care ofbulletDENNIS BASHUK Telephone no.bullet (404) 472-2242
    Located atbulletONE NATIONAL DRIVEATLANTAGA ZIP+4bullet30336
    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
    DENNIS BASHUK Foundation Mgr.
    3.00     		0    
    ONE NATIONAL DRIVE
    ATLANTA,GA30336
    GREGORY JOHNSON VP/TREASURER
    1.00     		0    
    ONE NATIONAL DRIVE
    ATLANTA,GA30336
    TOM COLE President
    1.00     		0    
    809 JEFFERSON HIGHWAY
    NEW ORLEANS,LA70121
    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
    0
    b
    Average of monthly cash balances.......................
    1b
    103,712
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    103,712
    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
    103,712
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see
    instructions) .............................
    4
    1,556
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    102,156
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    5,108
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    5,108
    2a
    Tax on investment income for 2012 from Part VI, line 5......
    2a
     
    b
    Income tax for 2012. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
     
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    5,108
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    5,108
    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
    5,108
    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
    482,561
    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
    482,561
    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
     
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    482,561
    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 5,108
    2 Undistributed income, if any, as of the end of 2012:
    a Enter amount for 2011 only.......  
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2012:
    a From 2007.......  
    b From 2008.......  
    c From 2009.......  
    d From 2010.......  
    e From 2011.......  
    fTotal of lines 3a through e.........  
    4Qualifying distributions for 2012 from Part
    XII, line 4: bullet$ 482,561
    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).........     		0
    d Applied to 2012 distributable amount..... 5,108
    e Remaining amount distributed out of corpus 477,453
    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 5 477,453
    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) ...     		 
    9Excess distributions carryover to 2013.
    Subtract lines 7 and 8 from line 6a ......     		477,453
    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.... 477,453
    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
    YOUNG LEADERSHIP COUNCIL
    PO BOX 56909
    NEW ORLEANS,LA70156     		NONE PUBLIC COMMUNITY SERVICE 5,000
    VILLAGE FAMILY SERVICES
    1201 25ST STREET SOUTH
    FARGO,ND58103     		NONE PUBLIC COMMUNITY SERVICE 1,000
    UNIVERSITY OF THE INCARNATE WORD
    4301 BROADWAY
    SAN ANTONIO,TX78209     		NONE PUBLIC EDUCATIONAL 3,000
    UNIVERSITY OF MD SCHOOL OF MEDICINE
    685 W BALTIMORE STREET
    BALTIMORE,MD21201     		NONE PUBLIC EDUCATIONAL 10,000
    UNIVERSITY OF LA-LAFAYETTE FOUNDATI
    600 E ST MARY BLVD
    LAFAYETTE,LA70505     		NONE PUBLIC EDUCATIONAL 1,750
    UNITED WAY
    1805 HARNEY STREET
    OMAHA,NE68102     		NONE PUBLIC COMMUNITY SERVICE 5,300
    UNITED CEREBRAL PALSY
    2700 W 81 STREET
    HIALEAH,FL33016     		NONE PUBLIC MEDICAL 5,000
    UJA-FEDERATION OF NEW YORK
    130 E 59TH STREET
    NEW YORK,NY10022     		NONE PUBLIC RELIGIOUS 14,800
    UCSF MEDICAL CENTER
    505 PARNASSUS AVE
    SAN FRANCISCO,CA94143     		NONE PUBLIC MEDICAL 18,870
    UCP OF CENTRAL FLORIDA
    3305 S ORANGE AVE
    ORLANDO,FL32806     		NONE PUBLIC MEDICAL 20,000
    TUREK AUBERT MEMORIAL SCHOLARSHIP F
    PO BOX 372278
    DENVER,CO80237     		NONE PUBLIC EDUCATIONAL 500
    TRANSPLANTS FOR CHILDREN
    7550 IH 10 WEST SUITE 104
    SAN ANTONIO,TX78229     		NONE PUBLIC MEDICAL 1,000
    TOYS FOR TOTS
    SERGEANT ANTHONEY S COATS
    OMAHA,NE68111     		NONE PUBLIC COMMUNITY SERVICE 4,563
    TONY'S PROSTATE CANCER RESEARCH
    PO BOX 7456
    HOUSTON,TX77246     		NONE PUBLIC MEDICAL 2,800
    THE HOME FRONT CARES
    1120 N CIRCLE DRIVE 7
    COLORADO SPRINGS,CO80909     		NONE PUBLIC COMMUNITY SERVICE 1,500
    THE GABRIEL HOUSE
    2885 DENVER AVE
    DENVER,CO80220     		NONE PUBLIC COMMUNITY SERVICE 1,000
    THE DENVER FOUNDATION
    55 MADISON STREET
    DENVER,CO80206     		NONE PUBLIC EDUCATIONAL 1,500
    THE CHILDREN'S SHELTER
    2939 W WOODLAWN
    SAN ANTONIO,TX78228     		NONE PUBLIC COMMUNITY SERVICE 3,000
    THE CHILDREN'S FUND INC
    PO BOX 56303
    HOUSTON,TX77256     		NONE PUBLIC COMMUNITY SERVICE 800
    THE 2012 TAMPA BAY HOST COMMITTEE I
    101 E KENNEDY BLVD
    TAMPA,FL33602     		NONE PUBLIC COMMUNITY SERVICE 25,000
    STEHLIN FOUNDATION FOR CANCER RESEA
    10301 STELLA LINK ROAD STE A
    HOUSTON,TX77025     		NONE PUBLIC MEDICAL 5,000
    STARLIGHT CHILDREN'S FOUNDATION
    750 POTOMAC STREET STE 101
    AURORA,CO80011     		NONE PUBLIC MEDICAL 750
    SHRINERS HOSPITAL FOR CHILDREN
    3100 SAMFORD AVE
    SHREVEPORT,LA71103     		NONE PUBLIC MEDICAL 1,000
    SENIOR SUPPORT SERVICES
    846 E 18TH AVE
    DENVER,CO80218     		NONE PUBLIC COMMUNITY SERVICE 1,000
    SEMINOLE REGION CHARITY GOLF TOURNA
    PO BOX 3070
    BOCA RATON,FL33431     		NONE PUBLIC COMMUNITY SERVICE 10,000
    SECOND HARVEST FOOD BANK
    700 EDWARDS AVE
    NEW ORLEANS,LA70123     		NONE PUBLIC COMMUNITY SERVICE 23,077
    SCRAMBLE FOR KIDS
    830 OAK TREE DR
    ARDMORE,OK73401     		NONE PUBLIC COMMUNITY SERVICE 1,250
    SCIENCE MUSEUM OF VIRGINIA FOUNDATI
    PO BOX 11624
    RICHMOND,VA23230     		NONE PUBLIC EDUCATIONAL 5,000
    SAN ANTONIO SPORTS
    100 MONTANA STREET
    SAN ANTONIO,TX78203     		NONE PUBLIC EDUCATIONAL 1,000
    SAN ANTONIO LIVESTOCK EXPOSITION
    PO BOX 200230
    SAN ANTONIO,TX78220     		NONE PUBLIC CUMMUNITY SERVICE 5,000
    SAN ANTONIO LIVESTOCK EXPOSITION-DE
    PO BOX 200230
    SAN ANTONIO,TX78220     		NONE PUBLIC COMMUNITY SERVICE 943
    SAN ANTONIO FOOD BANK
    5200 W OLD US HIGHWAY 90
    SAN ANTONIO,TX78227     		NONE PUBLIC COMMUNITY SERVICE 4,000
    SAFEWAY FOUNDATION
    5918 STONERIDGE MALL ROAD
    PLEASANTON,CA94588     		NONE PUBLIC COMMUNITY SERVICE 9,300
    RONALD MCDONALD HOUSE
    2330 MONUMENT AVE
    RICHMOND,VA23220     		NONE PUBLIC COMMUNITY SERVICE 3,500
    RONALD MCDONALD HOUSE
    350 ERKENBRECHER AVE
    CINCINNATI,OH45229     		NONE PUBLIC MEDICAL 300
    RISING STAR LEARNING CENTER
    8849 WALKERS LANE
    KIRKLAND,OH44094     		NONE PUBLIC EDUCATIONAL 300
    REY FEO SCHOLARSHIP INC
    11514 JONES MALTSBERGER ROAD
    SAN ANTONIO,TX78216     		NONE PUBLIC EDUCATIONAL 5,000
    REMEMBERING THE BRAVE FOUNDATION
    PO BOX 584
    ALLISON PARK,PA15010     		NONE PUBLIC COMMUNITY SERVICE 2,000
    RED ROBIN FOUNDATION
    6312 S FIDDLERS GREEN CIRCLE 200
    GREENWOOD VILLAGE,CO80111     		NONE PUBLIC EDUCATIONAL 1,000
    PRAY FOR GRAY
    PO BOX 446
    FARGO,ND58107     		NONE PUBLIC RELIGIOUS 1,000
    PALM BEACH INDIA ASSOCIATION
    PO BOX 31225
    PALM BEACH GARDENS,FL33420     		NONE PUBLIC COMMUNITY SERVICE 2,000
    OSU ALUMNI ASSOCIATION-TULSA CHAPTE
    700 N GREENWOOD AVE
    TULSA,OK74106     		NONE PUBLIC EDUCATIONAL 2,500
    OKLAHOMA CITY POLICE ATHLETIC LEAGU
    1925 DOWNING STREET
    OKLAHOMA CITY,OK73120     		NONE PUBLIC COMMUNITY SERVICE 2,500
    NEW ORLEANS MISSION
    1129 BARONNE STREET
    NEW ORLEANS,LA70113     		NONE PUBLIC COMMUNITY SERVICE 250
    NATIONAL MULTIPLE SCLEROSIS SOCIETY
    4237 SALISBURY ROAD
    JACKSONVILLE,FL32216     		NONE PUBLIC MEDICAL 500
    NATIONAL JEWISH HEALTH
    1400 JACKSON STREET
    DENVER,CO80206     		NONE PUBLIC MEDICAL 1,000
    MT VERNON LADIES ASSOCIATION
    1250 EYE STREET NW STE 400
    WASHINGTON,DC20005     		NONE PUBLIC COMMUNITY SERVICE 10,000
    MARILLAC CLINIC
    2420 W 26TH AVE SUITE 100D
    DENVER,CO80211     		NONE PUBLIC MEDICAL 1,500
    MARCH OF DIMES-COLORADO
    1325 S COLORADO BLVD STE B-508
    DENVER,CO80222     		NONE PUBLIC MEDICAL 1,600
    MARCH OF DIMES- TX
    104 SW 6TH AVE 301
    AMARILLO,TX79101     		NONE PUBLIC MEDICAL 500
    MAKE A WISH FOUNDATION-NORTH TEXAS
    6655 DESEO
    IRVING,TX75039     		NONE PUBLIC COMMUNITY SERVICE 9,336
    MAKE-A-WISH FOUNDATION-NORTH DAKOTA
    1102 43RD STREET S E
    FARGO,ND58103     		NONE PUBLIC COMMUNITY SERVICE 1,000
    LSU ATHLETICS TRADITION FUND
    PO BOX 25095
    BATON ROUGE,LA70894     		NONE PUBLIC EDUCATIONAL 5,072
    LOUISIANA RESTAURANT ASSOCIATION
    2700 N ARNOULT
    METAIRIE,LA70002     		NONE PUBLIC COMMUNITY SERVICE 2,500
    LO BELLO DE SAN ANTONIO WOMEN'S CLU
    PO BOX 782163
    SAN ANTONIO,TX78278     		NONE PUBLIC COMMUNITY SERVICE 5,000
    LEUKEMIA LYMPHOMA SOCIETY
    5353 W DARTMOUTH AVE
    DENVER,CO80227     		NONE PUBLIC MEDICAL RESEARCH 2,300
    LAKE OCONEE LUTHERAN CHURCH
    1089 GREENSBORO ROAD
    EATONTON,GA31024     		NONE PUBLIC RELIGIOUS 500
    JUVENILE DIABETES RESEARCH FOUNDATI
    9400 N CENTRAL EXPY
    DALLAS,TX75231     		NONE PUBLIC EDUCATIONAL 250
    JOEY WILKINS FOUNDATION
    636 S MAIN STREET
    GRAPEVINE,TX76051     		NONE PUBLIC COMMUNITY SERVICE 5,000
    IMAGINE FOUNDATION
    1400 DIXON STREET
    LAFAYETTE,CO80026     		NONE PUBLIC COMMUNITY SERVICE 1,000
    HOUSTON LIVESTOCK SHOW RODEO
    PO BOX 20070
    HOUSTON,TX77225     		NONE PUBLIC COMMUNITY SERVICE 1,500
    HOSPICE PALLIATIVE CARE OF WESTERN
    3090 B NORTH 12TH STREET
    GRAND JUNCTION,CO81506     		NONE PUBLIC MEDICAL 1,250
    HISTIO CURE FOUNDATION
    PO BOX 6446
    FOLSOM,CA95763     		NONE PUBLIC COMMUNITY SERVICE 1,000
    GIFT OF LIFE FOUNDATION
    PO BOX 6945
    CINCINNATI,OH45106     		NONE PUBLIC MEDICAL 300
    FOUNDATION FOR HISTORICAL LOUSINANA
    502 NORTH BLVD
    BATON ROUGE,LA70802     		NONE PUBLIC EDUCATIONAL 2,000
    FOREKIDS FOUNDATION INC
    11005 LAPALCO BLVD
    AVONDALE,LA70094     		NONE PUBLIC COMMUNITY SERVICE 5,000
    FOOD BANK OF THE ROCKIES
    10700 E 45TH AVE
    DENVER,CO80239     		NONE PUBLIC COMMUNITY SERVICE 1,150
    FOOD BANK FOR THE HEARTLAND
    10525 J STREET
    OMAHA,NE68127     		NONE PUBLIC COMMUNITY SERVICE 2,500
    FLORIDA RESTAURANT LODGING ASSOCIAT
    PO BOX 566263
    MIAMI,FL33256     		NONE PUBLIC COMMUNITY SERVICE 3,550
    FAMILY ROAD OF GREATER BATON ROUGE
    323 E AIRPORT AVE
    BATON ROUGE,LA70806     		NONE PUBLIC COMMUNITY SERVICE 1,000
    FAMILY CHILDREN'S SERVICES
    1112 S MEMORIAL DRIVE
    TULSA,OK74112     		NONE PUBLIC COMMUNITY SERVICE 1,500
    ESCAPE FAMILY RESOURCE CENTER
    1721 PECH ROAD 300
    HOUSTON,TX77055     		NONE PUBLIC COMMUNITY SERVICE 2,500
    DESTIN CHARITY WINE AUCTION FOUNDAT
    PO BOX 5396
    NICEVILLE,FL33541     		NONE PUBLIC COMMUNITY SERVICE 5,000
    DENVER RESCUE MISSION
    1130 PARK AVE W
    DENVER,CO80205     		NONE PUBLIC COMMUNITY SERVICE 750
    DALLAS CHILDREN'S CHARITIES
    15707C COIT ROAD SUITE 152
    DALLAS,TX75248     		NONE PUBLIC COMMUNITY SERVICE 2,500
    DALLAS CHILDREN'S ADVOCACY CENTER
    PO BOX 720338
    DALLAS,TX75372     		NONE PUBLIC COMMUNITY SERVICE 1,250
    CULINARIA PREV NEW WORLD WINE FOOD
    6338 N NEW BRAUNFELS AVE
    SAN ANTONIO,TX78209     		NONE PUBLIC COMMUNITY SERVICE 1,000
    CRAFT WORKS FOUNDATION
    248 CENTENNIAL PARKWAY SUITE 100
    LOUISVILLE,CO80027     		NONE PUBLIC COMMUNITY SERVICE 500
    COMMUNITY UNITED METHODIST CHURCH
    8680 FT SMALLWOOD ROAD
    PASADENA,MD21122     		NONE PUBLIC COMMUNITY SERVICE 500
    COMMUNITY AIDS RESOURCE EDUC SVCS
    629 PIONEER STREET
    KALAMAZOO,MI49008     		NONE PUBLIC COMMUNITY SERVICE 1,000
    COLORADO RESTURANT ASSOC EDUCATION
    439 E 7TH AVE
    DENVER,CO80203     		NONE PUBLIC EDUCATIONAL 2,500
    COLLEGE SUCCESS FOUNDATION
    PO BOX 1976
    WOODINVILLE,WA98072     		NONE PUBLIC COMMUNITY SERVICE 15,000
    CITY YEAR SAN ANTONIO
    109-B N SAN SABA
    SAN ANTONIO,TX78207     		NONE PUBLIC COMMUNITY SERVICE 1,000
    CHILDREN'S NATIONAL MEDICAL CENTER
    801 ROEDER ROAD SUITE 300
    SILVER SPRINGS,MD20901     		NONE PUBLIC MEDICAL 5,000
    CHILDREN'S HARBOR INC
    19425 SW 58TH MNR
    FT LAUDERDALE,FL33332     		NONE PUBLIC COMMUNITY SERVICE 3,200
    CHILDREN'S DIABETES FOUNDATION
    4380 SOUTH SYRACUSE STREET
    DENVER,CO80237     		NONE PUBLIC MEDICAL RESEARCH 2,000
    CENTRAL TEXAS MOTORCYCLE CHARITIES
    608 E 49TH ST
    AUSTIN,TX78751     		NONE PUBLIC COMMUNITY SERVICE 500
    CENTER CITY OF AMARILLO INC
    1000 S POLK STREET
    AMARILLO,TX79101     		NONE PUBLIC CULTURAL 2,500
    BOYS GIRLS CLUB OF BROWARD COUNTY
    877 NW 61ST STREET
    FT LAUDERDALE,FL33309     		NONE PUBLIC COMMUNITY SERVICE 500
    BIG BUDDY PROGRAM
    1415 MAIN STREET
    BATON ROUGE,LA70802     		NONE PUBLIC COMMUNITY SERVICE 200
    BIG BROTHER BIG SISTERS
    501 N GRAND BLVD 100
    ST LOUIS,MO63103     		NONE PUBLIC COMMUNITY SERVICE 1,000
    BEAM INC DISTRIBUTORS FOUNDATION
    510 LAKE COOK ROAD
    DEERFIELD,IL60015     		NONE PUBLIC COMMUNITY SERVICE 17,000
    AUTISM SPEAKS
    410 Bagby St Memorial Dr
    Houston,TX77002     		NONE PUBLIC MEDICAL RESEARCH 1,000
    AUCTION OF WASHINGTON WINES
    1201 WESTERN AVENUE SUITE 450
    SEATTLE,WA98101     		NONE PUBLIC EDUCATIONAL 5,000
    ARAPAHOE HOUSE
    8801 LIPAN STREET - THORNTON
    COLORADO,CO80260     		NONE PUBLIC COMMUNITY SERVICE 1,650
    ANY BABY CAN
    217 HOWARD STREET
    SAN ANTONIO,TX78212     		NONE PUBLIC CHARITABLE 600
    AMERICAN RED CROSS
    2025 E STREET NW
    WASHINGTON,DC20006     		NONE PUBLIC COMMUNITY SERVICE 50,000
    AMERICAN RED CROSS
    6710 W SUNRISE BLVD 111
    PLANTATION,FL33313     		NONE PUBLIC COMMUNITY SERVICE 5,000
    AMERICAN HEART ASSOC
    208 S LASALLE ST 1500
    CHICAGO,IL60604     		NONE PUBLIC MEDICAL RESEARCH 9,000
    AMERICAN DIABETES ASSOCIATION
    1701 NORTH BEAUREGARD STREET
    ALEXANDRIA,VA22311     		NONE PUBLIC MEDICAL RESEARCH 4,350
    AMERICAN CANCER SOCIETY
    1430 PRUDENTIAL DR
    JACKSONVILLE,FL32207     		NONE PUBLIC MEDICAL RESEARCH 2,000
    AMERICAN CANCER SOCIETY
    9850 NICHOLAS STREET 200
    OMAHA,NE68114     		NONE PUBLIC MEDICAL RESEARCH 1,000
    AMERICAN CANCER SOCIETY
    250 WILLIAMS STREET NW
    ATLANTA,GA30303     		NONE PUBLIC MEDICAL RESEARCH 32,700
    AMERICAN CANCER SOCIETY
    2255 S ONEIDA ST
    DENVER,CO80224     		NONE PUBLIC MEDICAL RESEARCH 500
    AMERICAN CANCER SOCIETY
    8900 JOHN W CARPENTER FREEWAY
    DALLAS,TX75247     		NONE PUBLIC MEDICAL RESEARCH 5,000
    AMERICAN SCORES DALLAS
    2633 MCKINNEY AVENUE ST130-348
    DALLAS,TX75204     		NONE PUBLIC COMMUNITY SERVICE 2,500
    ALLIED ARTS
    1015 N BROADWAY STE 200
    OKLOHOMA CITY,OK73102     		NONE PUBLIC COMMUNITY SERVICE 5,000
    ACTORS THEATRE OF LOUISVILLE
    316 WEST MAIM STREET
    LOUISVILLE,KY40202     		NONE NONPROFIT COMMUNITY SERVICE 10,000
    Total .................................bullet 3a 482,561
    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 11  
    4 Dividends and interest from securities....          
    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          
    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)..   11  
    13Total. Add line 12, columns (b), (d), and (e)..................
    1311
    (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
    Schedule B
    (Form 990, 990-EZ,
    or 990-PF)
    Department of the Treasury
    Internal Revenue Service
    Schedule of Contributors
    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    OMB No. 1545-0047
    2012
    Name of the organization
    REPUBLIC NATIONAL DISTRIBUTING COMPANY
    FOUNDATION INC
    Employer identification number

    45-3842838
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ





    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......................... Arrow Bullet   $    
    Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990; or check the box on line H of its
    Form 990-EZ or on Part I, line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2012)

    Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
    Page 2
    Name of organization
    REPUBLIC NATIONAL DISTRIBUTING COMPANY
    FOUNDATION INC         		Employer identification number

    45-3842838
    Part I
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    		     
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    1
     
     

    REPUBLIC NATIONAL    
    ONE NATIONAL DRIVE
       
    ATLANTA, GA   30336

    		$380,000


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

         
     
       

    		$  


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

         
     
       

    		$  


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

         
     
       

    		$  


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

         
     
       

    		$  


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

         
     
       

    		$  


    (Complete Part II if there is a noncash contribution.)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

    Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
    Page 3
    Name of organization
    REPUBLIC NATIONAL DISTRIBUTING COMPANY
    FOUNDATION INC         		Employer identification number

    45-3842838
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    		     
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

    Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
    Page 4
    Name of organization
    REPUBLIC NATIONAL DISTRIBUTING COMPANY
    FOUNDATION INC         		Employer identification number

    45-3842838
    Part III
    Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
    that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
    For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
    contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a) No.
    from
    Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
           
     
    (a) No.
    from
    Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
           
     
    (a) No.
    from
    Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
           
     
    (a) No.
    from
    Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
           
     
    Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

    Additional Data


    Software ID: 12000229
    Software Version: 2012v2.0

    TY 2012 OtherDecreasesSchedule
    Name:
    REPUBLIC NATIONAL DISTRIBUTING COMPANY
    FOUNDATION INC
    EIN: 45-3842838
    Software ID:12000229
    Software Version:2012v2.0
    Description Amount
    NON DEDUCTIBLE DONATIONS 21,951


    TY 2012 OtherExpensesSchedule
    Name:
    REPUBLIC NATIONAL DISTRIBUTING COMPANY
    FOUNDATION INC
    EIN: 45-3842838
    Software ID:12000229
    Software Version:2012v2.0
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    OFFICE SUPPLIES 114 114    
    BANK CHARGES 403 403    


    TY 2012 OtherIncreasesSchedule
    Name:
    REPUBLIC NATIONAL DISTRIBUTING COMPANY
    FOUNDATION INC
    EIN: 45-3842838
    Software ID:12000229
    Software Version:2012v2.0
    Description Amount
    Transfer of equity from RNDC Foundation (20-4321215) 154,279


    TY 2012 SubstantialContributorsSch
    Name:
    REPUBLIC NATIONAL DISTRIBUTING COMPANY
    FOUNDATION INC
    EIN: 45-3842838
    Software ID:12000229
    Software Version:2012v2.0
    Name Address
    REPUBLIC NATIONAL DISTRIBUTING CO ONE NATIONAL DRIVE
    ATLANTA,GA30336