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
SIMMONS FOUNDATION - PERKINSTHOMPSON
 

Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 426 ONE CANAL PLAZA   Room/suite
City or town, state, and ZIP code
PORTLAND, ME04112
A Employer identification number

01-0277832
B Telephone number (see instructions)

(207) 774-2635
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$2,591,918J 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      
4 Dividends and interest from securities...... 72,094 72,094  
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 222,759
b Gross sales price for all assets on line 6a 1,318,506
7 Capital gain net income (from Part IV, line 2)... 562,575
8 Net short-term capital gain......... 10,720
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........ 294,853 634,669 10,720
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 1,750 875   875
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule)......... Click to see attachment 8,520 4,260   4,260
b Accounting fees (attach schedule)....... Click to see attachment 2,100 700   1,400
c Other professional fees (attach schedule).... Click to see attachment 18,906 18,906    
17 Interest...............        
18 Taxes (attach schedule) (see instructions) Click to see attachment 2,727      
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings....... 455 228   227
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 132 66   66
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 34,590 25,035   6,828
25 Contributions, gifts, grants paid........ 137,400 137,400
26 Total expenses and disbursements. Add lines 24 and 25 171,990 25,035   144,228
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 122,863
b Net investment income (if negative, enter -0-) 609,634
c Adjusted net income (if negative, enter -0-)... 10,720
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............... 14,916 14,558 14,558
2 Savings and temporary cash investments.......... 74,401 58,849 58,849
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) 459,602 Click to see attachment350,799 350,799
b Investments—corporate stock (attach schedule)........ 1,757,774 Click to see attachment1,999,374 1,999,374
c Investments—corporate bonds (attach schedule)........ 157,489 Click to see attachment165,506 165,506
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 bullet3,848
Less: accumulated depreciation (attach schedule) bullet3,598 250 Click to see attachment250 250
15 Other assets (describe bullet) Click to see attachment3,517 Click to see attachment2,582 Click to see attachment2,582
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 2,467,949 2,591,918 2,591,918
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) Click to see attachment8,795 Click to see attachment9,901
23 Total liabilities (add lines 17 through 22).......... 8,795 9,901
Net Assets or Fund Balances bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted.................... 2,459,154 2,582,017
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    
30 Total net assets or fund balances (see page 17 of the
instructions).................... 2,459,154 2,582,017
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 2,467,949 2,591,918
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 2,459,154
2 Enter amount from Part I, line 27a..................... 2 122,863
3 Other increases not included in line 2 (itemize) bullet 3  
4 Add lines 1, 2, and 3.......................... 4 2,582,017
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 2,582,017
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 Abbott Labs 145 shrs P 2012-11-01 2012-12-04
b Chubb Corporation 260 shrs P 2011-08-31 2012-04-27
c Dover Corp 165 shrs P 2012-01-15 2012-11-01
d JP Morgan Chase 165 shrs P 2011-08-31 2012-04-27
e JP Morgan Chase 220 shrs P 2012-11-01 2012-11-06
Microsoft Corp 235 shrs P 2012-04-27 2012-11-01
Occidential Petroleum 105 shrs P 2012-04-27 2012-09-24
Prudential Finl Inc 150 shrs P 2012-04-27 2012-12-04
State Street Corp 170 shrs P 2011-08-31 2012-04-27
Teva Pharm Indus ADR 205 shrs P 2012-04-27 2012-09-24
TJX Cos Inc 550 shrs P 2011-11-08 2012-06-27
United Parcel Service 140 shrs P 2012-01-31 2012-12-04
US Bancorp 250 shrs P 2011-08-31 2012-06-27
Utilities Select Sector 365 shrs P 2012-06-27 2012-09-24
Vanguard Fste Emerging 735 shrs P 2012-04-27 2012-11-01
Vanguard Mid-cap ETF 435 shrs P 2012-04-27 2012-12-04
Wells Fargo & Co 150 shrs P 2011-08-31 2012-06-27
Thermo Electron 170 shrs P 2012-04-27 2012-12-04
Dell Inc 2290 shrs P 2011-02-04 2012-08-09
3M Co 105 shrs P 2001-01-01 2012-04-27
3M Co 200 shrs P 2001-01-01 2012-06-27
3M Co 135 shrs P 2001-01-01 2012-11-01
3M Co 105 shrs P 2001-01-01 2012-11-06
AFLAC Inc 850 shrs P 2001-01-01 2012-04-27
Air Products & Chemicals 110 shrs P 2010-03-10 2012-04-27
Air Products & Chemicals 160 shrs P 2010-03-10 2012-06-27
Apache Corp 270 shrs P 2009-04-24 2012-04-27
Apple Computer Inc 138 shrs P 2006-03-22 2012-04-27
Apple Computer Inc 24 shrs P 2006-03-22 2012-06-27
AT&T Inc 465 shrs P 2001-01-01 2012-04-27
BHP Billiton Ltd 210 shrs P 2010-05-20 2012-04-27
BHP Billiton Ltd 140 shrs P 2010-05-20 2012-06-27
Coca Cola Co 290 shrs P 2001-01-01 2012-04-27
Coca Cola Co 250 shrs P 2001-01-01 2012-06-27
Coca Cola Co 155 shrs P 2001-01-01 2012-08-09
Coca Cola Co 250 shrs P 2001-01-01 2012-11-01
ConocoPhillips 275 shrs P 2010-05-24 2012-06-27
CSX Corp 415 shrs P 2009-04-24 2012-04-27
CSX Corp 655 shrs P 2009-04-24 2012-06-27
CSX Corp 655 shrs P 2009-04-24 2012-09-24
Dominion Res Inc 180 shrs P 2009-04-24 2012-04-27
Dominion Res Inc 420 shrs P 2009-04-24 2012-06-27
Dupont E I De Nemours 175 shrs P 2010-03-10 2012-04-27
Dupont E I De Nemours 350 shrs P 2010-03-10 2012-06-27
EMC Corp 325 shrs P 2008-07-10 2012-04-27
EMC Corp 745 shrs P 2008-07-10 2012-06-27
ExxonMobil 250 shrs P 2001-01-01 2012-06-27
ExxonMobil 105 shrs P 2001-01-01 2012-11-06
FHLB 4.5% 50000 P 2006-03-02 2012-11-15
FNMA 4.375% 50000 P 2005-09-14 2012-09-15
General Electric 2240 shrs P 2001-01-01 2012-04-27
General Electric 500 shrs P 2001-01-01 2012-06-27
Genuine Parts Co 145 shrs P 2008-07-10 2012-04-27
Genuine Parts Co 315 shrs P 2008-07-10 2012-06-27
Home Depot Inc 810 shrs P 2002-08-09 2012-04-27
Home Depot Inc 520 shrs P 2002-08-09 2012-06-27
Intel Corp 410 shrs P 2008-12-24 2012-12-04
Ishares TR MSCI EAFE Index 200 shrs P 2008-03-06 2012-04-27
Ishares TR MSCI EAFE Index 500 shrs P 2009-02-17 2012-06-27
JP Morgan Chase 50 shrs P 2008-10-17 2012-04-27
Johnson & Johnson 250 shrs P 2001-01-01 2012-06-27
Johnson & Johnson 210 shrs P 2001-01-01 2012-11-01
Johnson & Johnson 260 shrs P 2001-01-01 2012-11-06
Met Life 350 shrs P 2009-02-04 2012-04-27
Occidential Petroleum 25 shrs P 2009-12-22 2012-09-24
Occidential Petroleum 115 shrs P 2009-12-22 2012-12-04
Pfizer Inc 830 shrs P 2001-01-01 2012-04-27
Pfizer Inc 500 shrs P 2001-01-01 2012-06-27
Pfizer Inc 380 shrs P 2001-01-01 2012-08-09
Proctor & Gamble 320 shrs P 2001-01-01 2012-04-27
Proctor & Gamble 250 shrs P 2001-01-01 2012-06-27
Proctor & Gamble 140 shrs P 2001-01-01 2012-08-09
Schlumberger Ltd 350 shrs P 2010-04-30 2012-04-27
State Street Corp 35 shrs P 2009-02-17 2012-04-27
Stryker Corp 450 shrs P 2009-02-17 2012-04-27
US Bancorp 280 shrs P 2010-06-24 2012-06-27
Vanguard Intl Value Fd 807 shrs P 2009-12-22 2012-04-27
Verizon Communications 260 shrs P 2001-01-01 2012-04-27
Wells Fargo & Co 305 shrs P 2009-02-17 2012-06-27
Ishares Gold Trust P 2012-07-01 2012-12-31
(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 9,371 0 9,525 -154
b 19,024 0 16,155 2,869
c 9,778 0 10,322 -544
d 7,141 0 6,214 927
e 9,423 0 9,372 51
6,876 0 7,532 -656
9,122 0 9,622 -500
7,828 0 9,222 -1,394
7,864 0 6,079 1,785
8,241 0 9,371 -1,130
23,089 0 16,542 6,547
10,252 0 10,920 -668
7,854 0 5,820 2,034
13,271 0 13,401 -130
30,892 0 31,495 -603
35,291 0 35,505 -214
4,887 0 3,900 987
10,810 0 9,355 1,455
28,215 0 31,854 -3,639
9,388 0 623 8,765
17,460 0 1,187 16,273
12,038 0 801 11,237
9,546 0 623 8,923
38,241 0 16,977 21,264
9,415 0 8,167 1,248
12,310 0 11,880 430
25,604 0 18,627 6,977
83,098 0 8,535 74,563
13,756 0 1,484 12,272
15,182 0 16,891 -1,709
15,586 0 12,597 2,989
8,657 0 8,398 259
22,248 0 868 21,380
19,060 0 748 18,312
12,270 0 273 11,997
9,337 0 440 8,897
14,896 0 10,641 4,255
9,296 0 4,315 4,981
14,220 0 6,811 7,409
14,007 0 6,811 7,196
9,354 0 5,290 4,064
22,612 0 12,343 10,269
9,418 0 6,176 3,242
17,314 0 11,580 5,734
9,207 0 4,326 4,881
17,984 0 9,916 8,068
20,775 0 796 19,979
9,614 0 334 9,280
48,706 0 48,706 0
50,000 0 50,375 -375
44,217 0 1,606 42,611
10,005 0 359 9,646
9,507 0 5,641 3,866
18,389 0 12,254 6,135
42,143 0 22,721 19,422
26,785 0 14,586 12,199
8,175 0 5,822 2,353
10,802 0 14,198 -3,396
23,999 0 18,339 5,660
2,164 0 2,040 124
16,720 0 684 16,036
15,019 0 575 14,444
18,488 0 712 17,776
12,593 0 10,268 2,325
2,172 0 2,039 133
8,452 0 9,379 -927
19,098 0 677 18,421
11,302 0 408 10,894
9,078 0 310 8,768
20,512 0 1,007 19,505
14,950 0 786 14,164
9,351 0 440 8,911
25,770 0 25,260 510
1,619 0 814 805
24,493 0 18,732 5,761
8,796 0 6,423 2,373
23,620 0 25,000 -1,380
10,467 0 10,718 -251
9,937 0 4,391 5,546
58 0 0 58
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 0 0 0 -154
b 0 0 0 2,869
c 0 0 0 -544
d 0 0 0 927
e 0 0 0 51
0 0 0 -656
0 0 0 -500
0 0 0 -1,394
0 0 0 1,785
0 0 0 -1,130
0 0 0 6,547
0 0 0 -668
0 0 0 2,034
0 0 0 -130
0 0 0 -603
0 0 0 -214
0 0 0 987
0 0 0 1,455
0 0 0 -3,639
0 0 0 8,765
0 0 0 16,273
0 0 0 11,237
0 0 0 8,923
0 0 0 21,264
0 0 0 1,248
0 0 0 430
0 0 0 6,977
0 0 0 74,563
0 0 0 12,272
0 0 0 -1,709
0 0 0 2,989
0 0 0 259
0 0 0 21,380
0 0 0 18,312
0 0 0 11,997
0 0 0 8,897
0 0 0 4,255
0 0 0 4,981
0 0 0 7,409
0 0 0 7,196
0 0 0 4,064
0 0 0 10,269
0 0 0 3,242
0 0 0 5,734
0 0 0 4,881
0 0 0 8,068
0 0 0 19,979
0 0 0 9,280
0 0 0 0
0 0 0 -375
0 0 0 42,611
0 0 0 9,646
0 0 0 3,866
0 0 0 6,135
0 0 0 19,422
0 0 0 12,199
0 0 0 2,353
0 0 0 -3,396
0 0 0 5,660
0 0 0 124
0 0 0 16,036
0 0 0 14,444
0 0 0 17,776
0 0 0 2,325
0 0 0 133
0 0 0 -927
0 0 0 18,421
0 0 0 10,894
0 0 0 8,768
0 0 0 19,505
0 0 0 14,164
0 0 0 8,911
0 0 0 510
0 0 0 805
0 0 0 5,761
0 0 0 2,373
0 0 0 -1,380
0 0 0 -251
0 0 0 5,546
0 0 0 58
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 2 562,575
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 10,720
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 149,866 2,464,219 0.060817
2010 137,674 2,424,287 0.056789
2009 145,742 2,288,470 0.063685
2008 91,129 2,658,653 0.034276
2007 178,840 3,135,315 0.057041
2 Total of line 1, column (d) ...................... 2 0.272608
3 Average distribution ratio for the 5-year base period—divide the total on line 2 by 5, or by
the number of years the foundation has been in existence if less than 5 years. . . 		3 0.054522
4 Enter the net value of noncharitable-use assets for 2012 from Part X, line 5..... 4 2,488,981
5 Multiply line 4 by line 3....................... 5 135,704
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 6,096
7 Add lines 5 and 6......................... 7 141,800
8 Enter qualifying distributions from Part XII, line 4.............. 8 144,228
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 6,096
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 0
3 Add lines 1 and 2............................ 3 6,096
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 6,096
6 Credits/Payments:
a 2012 estimated tax payments and 2011 overpayment credited to 2012 6a 1,320
b Exempt foreign organizations—tax withheld at source....... 6b
c Tax paid with application for extension of time to file (Form 8868) 6c 6,000
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. : -7320 7 7,320
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. Click to see attachment 8 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 1,216
11 Enter the amount of line 10 to be: Credited to 2013 estimated taxBullet1,216 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)
    bulletME
    b
    If the answer is “Yes” to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If “No,” attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2012 or the taxable year beginning in 2012 (see instructions for Part XIV)?
    If “Yes,” complete Part XIV.............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If “Yes,” attach a schedule listing their names and addresses.
    10
     
    No
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. (see instructions) .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement (see instructions).................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletN/A
    14
    The books are in care ofbulletPAUL RAUSCH CPA Telephone no.bullet (207) 774-2635
    Located atbulletPO BOX 426 ONE CANAL PLAZAPORTLANDME ZIP+4bullet04112
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041.........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ......bullet
    15  
    16
    At any time during calendar year 2012, did the foundation have an interest in or a signature or other authority over
    a bank, securities, or other financial account in a foreign country? .................
    16
     
    No
    See instructions for exceptions and filing requirements for Form TD F 90-22.1. If "Yes", enter the name of the foreign country bullet  
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 5
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the “Yes” column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?.........................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?.................
    (6) Agree to pay money or property to a government official? (Exception. Check “No”
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).........
    b
    If any answer is “Yes” to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance (see page 20 of the instructions)?...
    1b
     
    No
    .........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2012?.............
    1c
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2012, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2012?...............
    If “Yes,” list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer “No” and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?.........................
    b
    If “Yes,” did it have excess business holdings in 2012 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2012.)....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2012?
    4b
     
    No
    5a
    During the year did the foundation pay or incur any amount to:
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?...............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 509(a)(1), (2), or (3), or section 4940(d)(2)? (see instructions)........
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?........
    b
    If any answer is “Yes” to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance (see instructions)? ......
    5b
     
     
    .........bullet
    c
    If the answer is “Yes” to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?............
    If “Yes,” attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?........................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?....
    6b
     
    No
    If “Yes” to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 6
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation (see instructions).
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to
    employee benefit plans
    and deferred compensation     		(e) Expense account,
    other allowances
    ROBERT WOODWARD Pres.
    1.00     		50 0 0
    115 NORTH HIGH STREET
    BRIDGTON,ME04009
    STEPHEN G WOODWARD 1st VP
    1.00     		50 0 0
    208 LUFKIN ROAD
    NORTH YARMOUTH,ME04097
    DOROTHY WENTWORTH 2nd VP
    1.00     		50 0 0
    55 HARDY ROAD
    FALMOUTH,ME04105
    PAUL H RAUSCH Treas.
    2.00     		1,250 0 0
    97 CENTER STREET
    AUBURN,ME04210
    SUZANNE G W MCGUFFEY Trustee
    1.00     		50 0 0
    207 LUFKIN ROAD
    NORTH YARMOUTH,ME04097
    ROBERT ARANSON MD Trustee
    1.00     		50 0 0
    20 LOOKOUT DRIVE
    FREEPORT,ME04032
    TINA JENNINGS Trustee
    1.00     		50 0 0
    208 LUFKIN ROAD
    NORTH YARMOUTH,ME04097
    REV ANITA WHITE Trustee
    1.00     		50 0 0
    15 FOREST AVE
    AUBURN,ME04210
    SAMUEL WOODWARD Trustee
    1.00     		50 0 0
    912 ROOSEVELT TRAIL APT 8
    WINDHAM,ME04062
    JOHN R OPPERMAN ESQ Trustee
    1.00     		50 0 0
    25 WOODMONT STREET
    PORTLAND,ME04102
    ELIZABETH FAULKNER Trustee
    1.00     		50 0 0
    111 POND ROAD
    STANDISH,ME04084
    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 0
    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.............bullet0
    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
    2,511,896
    b
    Average of monthly cash balances.......................
    1b
    14,738
    c
    Fair market value of all other assets (see instructions)................
    1c
    250
    d
    Total (add lines 1a, b, and c).........................
    1d
    2,526,884
    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
    2,526,884
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see
    instructions) .............................
    4
    37,903
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    2,488,981
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    124,449
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    124,449
    2a
    Tax on investment income for 2012 from Part VI, line 5......
    2a
    6,096
    b
    Income tax for 2012. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    6,096
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    118,353
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    118,353
    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
    118,353
    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
    144,228
    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
    144,228
    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
    6,096
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    138,132
    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 7 118,353
    2 Undistributed income, if any, as of the end of 2012:
    a Enter amount for 2011 only....... 18,881
    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$ 144,228
    a Applied to 2011, but not more than line 2a 18,881
    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..... 118,353
    e Remaining amount distributed out of corpus 6,994
    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 6,994
    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 ......     		6,994
    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.... 6,994
    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).)
    NONE
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    NONE
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail of the person to whom applications should be addressed:
    PAUL RAUSCH CO PERKINS THOMPSON
    ONE CANAL PLAZA
    PORTLAND,ME04101
    (207) 774-2635
    bThe form in which applications should be submitted and information and materials they should include:
    SEE ATTACHED SCHEDULE
    cAny submission deadlines:
    THERE ARE NO SUBMISSION DEADLINES
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    SEE ATTACHED SCHEDULE
    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
    LADAWN QUARTER HORSE THERAPUTIC RIDING CTR
    995 GOODWINS MILLS ROAD
    DAYTON,ME04094     		  Exempt OutreachChildren's 1,900
    SEEDS OF INDEPENDENCE
    PO BOX 8
    FREEPORT,ME04032     		  Exempt SessionReboundProject 1,000
    THE ATLANTIC CHALLENGE FOUNDATION
    643 MAIN STREET
    ROCKLAND,ME04871     		  Exempt ProgramScholarship 2,000
    DENMARK ARTS CENTER
    PO BOX 30
    DENMARK,ME04022     		  Exempt ResidenceArtist-in-Program 3,000
    PREBLE STREET RESOURCE CENTER
    PO BOX 1459
    PORTLAND,ME04104     		  Exempt FoodEmergencyProgram 5,000
    THE SUMMER CAMP
    8 CHURCH STREET
    BRIDGTON,ME04009     		  Exempt ScholarshipCampProgram 3,000
    GOOD SHEPHERD FOOD BANK
    PO BOX 1807
    AUBURN,ME04211     		  Exempt MatchingAgencyProgram 5,000
    WILLOWIND THERAPEUTIC RIDING CTR
    1140 STATE HIGHWAY 3
    BAR HARBOR,ME04609     		  Exempt AccessibleHandicappedBathroom Project 2,000
    PORTLAND SYMPHONY ORCHESTRA
    50 MONUMENT SQ 2ND FLOOR
    PORTLAND,ME04104     		  Exempt CommunityEducation &Programs 5,000
    PLANNED PARENTHOOD OF NORTHERN NE
    443 CONGRESS STREET 3RD FLR
    PORTLAND,ME04101     		  Exempt Care ProgramMaine Fair 4,000
    CAMP SUNSHINE AT SEBAGO LAKE
    35 ACADIA ROAD
    CASCO,ME04015     		  Exempt SponsorshipFamilyProgram 4,000
    MAINE HOUSING & BUILDING MATERIALS EXCHANGE
    102 LISBON STREET
    LISBON,ME04250     		  Exempt ReplacementHeaterProject 5,000
    SEXUAL ASSUALT RESPONSE SERVICES
    PO BOX 1371
    PORTLAND,ME04104     		  Exempt AdvocateResponse TeamProgram 3,500
    ITN AMERICA
    90 BRIDGE STREET
    WESTBROOK,ME04092     		  Exempt ProjectSustainablility 1,000
    NEW ENGLAND SCHOOL OF METALWORK
    7 ALBISTON WAY
    AUBURN,ME04210     		  Exempt OutreachFuture Welder'sProgram 5,000
    LAKE REGION SENIOR SERVICE
    PO BOX 816
    BRIDGTON,ME04009     		  Exempt TransportationSeniorProgram 6,000
    CANCER COMMUNITY CENTER
    778 MAIN STREET
    SOUTH PORTLAND,ME04106     		  Exempt Wellness Program 4,000
    THE PROGRESS CENTER
    35 COTTAGE STREET
    NORWAY,ME04268     		  Exempt Soup Kitchen 5,000
    THE OPPORTUNITY ALLIANCE
    50 MONUMENT SQUARE
    PORTLAND,ME04101     		  Exempt ProgramAfter School 6,000
    JOBS FOR MAINE GRADUATES
    45 COMMERCE DRIVE STE 9
    AUGUSTA,ME04330     		  Exempt LiteracyFinancialProgram 2,500
    AROOSTOOK MENTAL HEALTH SRV
    PO BOX 1018
    CARIBOU,ME04736     		  Exempt Camp ProgramTeen Leadership 2,500
    GOODWILL INDUSTRIES OF NNE
    353 CUMBERLAND AVE
    PORTLAND,ME04101     		  Exempt PoweredBatteryHoyer Lift 5,200
    MAINE IRISH CHILDREN'S PROGRAM
    PO BOX 3122
    PORTLAND,ME04104     		  Exempt EducationCross CulturalProject 3,000
    CHILDREN'S MUSEUM & THEATER OF MAINE
    142 FREE STREET
    PORTLAND,ME04101     		  Exempt Peter PanProject 1,800
    SOUTHERN MAINE AGENCY ON AGING
    136 US ROUTE ONE
    SCARBOROUGH,ME04074     		  Exempt ProgramFamily Caregiver 4,000
    YMCA OF SOUTHERN MAINE
    3 POMERLEAU DRIVE
    BIDDEFORD,ME04005     		  Exempt Room UpgradeChildcare CenterProject 3,000
    MAINE IRISH HERITAGE CENTER
    PO BOX 7588
    PORTLAND,ME04112     		  Exempt StorytellersMaine IrishProject 3,000
    WAYSIDE FOOD PROGRAM
    PO BOX 1278
    PORTLAND,ME04102     		  Exempt Meals Program 6,000
    HEBRON ACADEMY
    PO BOX 309
    HEBRON,ME04238     		  Exempt ProgramTuition 5,000
    UNIVERSITY OF SOUTHERN MAINE
    96 FALMOUTH STREET
    PORTLAND,ME04103     		  Exempt ProgramScholarship 10,000
    GOULD ACADEMY
    39 CHURCH STREET
    BETHEL,ME04217     		  Exempt ProgramScholarship 5,000
    BIDDEFORD FREE CLINIC
    189 ALFRED STREET
    BIDDEFORD,ME04005     		  Exempt ProgramPharmacy 4,000
    MAINE COLLEGE OF ART
    522 CONGRESS STREET
    PORTLAND,ME04101     		  Exempt OutreachCommunity 1,800
    SEEDS OF PEACE
    370 LEXINGTON AVE STE 1201
    NEW YORK,NY10017     		  Exempt LeadershipYouthProgram 3,000
    THE FRIENDS OF DAPONTE STRING QUARTET
    PO BOX 401
    DAMARISCOTTA,ME04543     		  Exempt ProgramIn-schools 1,200
    GOOD SHEPHERD FOOD BANK
    PO BOX 1807
    AUBURN,ME04211     		  Exempt ProgramFood 2,500
    PREBLE STREET RESOURCE CENTER
    18 PORTLAND STREET
    PORTLAND,ME04101     		  Exempt ProgramFood 2,500
    Total .................................bullet 3a 137,400
    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          
    4 Dividends and interest from securities....     14 72,094  
    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     14 222,759  
    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)..   294,853  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13294,853
    (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:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2012 AccountingFeesSchedule
    Name:
    SIMMONS FOUNDATION - PERKINSTHOMPSON
    EIN: 01-0277832
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Clark, Friel and Joyce Tax and financial stmt 2,100 700   1,400

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

    TY 2012 GainLossSaleOtherAssetsSch
    Name:
    SIMMONS FOUNDATION - PERKINSTHOMPSON
    EIN: 01-0277832
    Name Date Acquired How Acquired Date Sold Purchaser Name Gross Sales Price Basis Basis Method Sales Expenses Total (net) Accumulated Depreciation
    Investments   Purchased 2012-12   1,318,506 1,095,747     222,759  

    TY 2012 GeneralExplanationAttachment
    Name:
    SIMMONS FOUNDATION - PERKINSTHOMPSON
    EIN: 01-0277832
    Identifier Return Reference Explanation
    Part XV Line 2   LINE 2B THERE ARE NO PRESCRIBED FORMS FOR THE SUBMISSION OF APPLICATIONS. HOWEVER, THE FOLLOWING INFORMATION MUST BE PROVIDED: 1) THE APPLICANT'S TAX EXEMPT NUMBER 2) A COPY OF THE ORGANIZATION'S HANDBOOK 3) A BRIEF OUTLINE OF THE HISTORY OF THE ORGANIZATION 4) THE CHARITABLE PURPOSE OF THE APPLICANT ORGANIZATION 5) DETAILS REGARDING THE SPECIFIC REQUEST MADE AS PART OF THE APPLICATION FOR FUNDS LINE 2D THE FOUNDATION DOES NOT MAKE AWARDS TO INDIVIDUALS OR ORGANIZATIONS WITHOUT VALID FEDERAL INCOME TAX EXEMPTIONS. AWARDS ARE GENERALLY RESTRICTED TO ORGANIZATIONS OPERATING WITHIN MAINE.

    TY 2012 InvestmentsCorpBondsSchedule
    Name:
    SIMMONS FOUNDATION - PERKINSTHOMPSON
    EIN: 01-0277832
    Name of Bond End of Year Book Value End of Year Fair Market Value
    Ishares Barclays Tips Bonds Fund 600 shrs 72,846 72,846
    Ishares Ibox $ Invest Grade Corp Bonds 550 shrs 66,545 66,545
    SPDR Barclays Capital Inter Term Credit Bond ETF 750 shrs 26,115 26,115

    TY 2012 InvestmentsCorpStockSchedule
    Name:
    SIMMONS FOUNDATION - PERKINSTHOMPSON
    EIN: 01-0277832
    Name of Stock End of Year Book Value End of Year Fair Market Value
    3M Co. 205 shrs 19,034 19,034
    Abbott Labs 235 shrs 15,393 15,393
    Allergan Inc. 325 shrs 29,813 29,813
    Apple Inc 81 shrs 43,106 43,106
    AT&T Inc 480 shrs 16,181 16,181
    Boeing Co 280 shrs 21,101 21,101
    Capital One Finl Corp 500 shrs 28,965 28,965
    Chevron Corp 275 shrs 29,738 29,738
    Chubb Corporation 270 shrs 20,336 20,336
    Coca Cola Co 480 shrs 17,400 17,400
    Conocophillips 390 shrs 22,616 22,616
    Cons Staples Select Sector 425 shrs 14,832 14,832
    Costco Whsl Corp 205 shrs 20,240 20,240
    CVS/Caremark Corp 200 shrs 9,670 9,670
    Deere & Co. 275 shrs 23,766 23,766
    Discover Financial Services 775 shrs 29,876 29,876
    Dover Corp 160 shrs 10,514 10,514
    Dupont E I De Nemours & Co. 430 shrs 19,341 19,341
    Ebay Inc Com 265 shrs 13,514 13,514
    EMC Corp 1180 shrs 29,854 29,854
    Express Scripts Hldg Co 385 shrs 20,790 20,790
    Exxon Mobil Corp 520 shrs 45,006 45,006
    General Electric 1360 shrs 28,546 28,546
    General Mills 375 shrs 15,157 15,157
    Genuine Parts Co. 440 shrs 27,975 27,975
    Gilead Sciences Inc 325 shrs 23,871 23,871
    Google Inc Cl A 50 shrs 35,369 35,369
    Home Depot Inc. 395 shrs 24,431 24,431
    Intel Corp 990 shrs 20,414 20,414
    Ishares Gold Trust 3340 shrs 54,373 54,373
    Ishares Tr Dj US Home Construction 1355 shrs 28,672 28,672
    Johnson & Johnson Inc. 205 shrs 14,371 14,371
    JPMorgan Chase & Co 455 shrs 20,006 20,006
    McDonalds Corp 325 shrs 28,668 28,668
    Microsoft Corp 760 shrs 20,299 20,299
    Motorola Solutions Inc 675 shrs 37,584 37,584
    Nextera Energy Inc 280 shrs 19,373 19,373
    Occidental Pertroleum Corp 70 shrs 5,363 5,363
    Omnicom Group 500 shrs 24,980 24,980
    Oracle Corporation 895 shrs 29,821 29,821
    Pfizer Inc 828 shrs 20,766 20,766
    Philip Morris Intl 255 shrs 21,328 21,328
    Phillips 66 250 shrs 13,275 13,275
    Pimco Commodity Real Return 7158 shrs 47,531 47,531
    Procter & Gamble Co 450 shrs 30,550 30,550
    Prudential Finl Inc 305 shrs 16,266 16,266
    Qualcomm Inc 445 shrs 27,528 27,528
    Schlumberger Limited 215 shrs 14,899 14,899
    State Street Corp 515 shrs 24,210 24,210
    Thermo Fisher Scientific 390 shrs 24,874 24,874
    TJX Cos Inc 730 shrs 30,989 30,989
    United Parcel Srv Inc B 110 shrs 8,110 8,110
    United Technologies 125 shrs 10,251 10,251
    Unitedhealth Group Inc 160 shrs 8,678 8,678
    US Bancorp Del New 800 shrs 25,552 25,552
    Vanguard Mid-Cap ETF 1590 shrs 131,080 131,080
    Vanguard MSCI EAFE ETF 3165 shrs 111,503 111,503
    Vanguard MSCI Emerging ETF 5320 shrs 236,900 236,900
    Vanguard REIT ETF 860 shrs 56,588 56,588
    Vanguard Small Cap Growth ETF 600 shrs 53,418 53,418
    Vanguard Small Cap Value ETF 540 shrs 39,231 39,231
    Verizon Communications 490 shrs 21,202 21,202
    Wal-Mart Stores Inc 210 shrs 14,328 14,328
    Watson Pharmaceutical Inc 225 shrs 21,930 21,930
    Wells Fargo & Co New 820 shrs 28,028 28,028

    TY 2012 InvestmentsGovtObligationsSch
    Name:
    SIMMONS FOUNDATION - PERKINSTHOMPSON
    EIN: 01-0277832
    US Government Securities - End of Year Book Value:

    350,799
    US Government Securities - End of Year Fair Market Value:

    350,799
    State & Local Government Securities - End of Year Book Value:


     
    State & Local Government Securities - End of Year Fair Market Value:


     


    TY 2012 LandEtcSchedule2
    Name:
    SIMMONS FOUNDATION - PERKINSTHOMPSON
    EIN: 01-0277832
    Category / Item Cost / Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
    Equipment 3,848 3,598 250  


    TY 2012 LegalFeesSchedule
    Name:
    SIMMONS FOUNDATION - PERKINSTHOMPSON
    EIN: 01-0277832
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Perkins Thompson Legal 8,520 4,260   4,260


    TY 2012 OtherAssetsSchedule
    Name:
    SIMMONS FOUNDATION - PERKINSTHOMPSON
    EIN: 01-0277832
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    Accrued investment income 3,517 2,582 2,582
    Accrued investment income 3,517 2,582 2,582
    Accrued investment income 3,517 2,582 2,582


    TY 2012 OtherAssetsSchedule
    Name:
    SIMMONS FOUNDATION - PERKINSTHOMPSON
    EIN: 01-0277832
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    Accrued investment income 3,517 2,582 2,582
    Accrued investment income 3,517 2,582 2,582
    Accrued investment income 3,517 2,582 2,582


    TY 2012 OtherAssetsSchedule
    Name:
    SIMMONS FOUNDATION - PERKINSTHOMPSON
    EIN: 01-0277832
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    Accrued investment income 3,517 2,582 2,582
    Accrued investment income 3,517 2,582 2,582
    Accrued investment income 3,517 2,582 2,582


    TY 2012 OtherExpensesSchedule
    Name:
    SIMMONS FOUNDATION - PERKINSTHOMPSON
    EIN: 01-0277832
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Office expenses 132 66   66


    TY 2012 OtherLiabilitiesSchedule
    Name:
    SIMMONS FOUNDATION - PERKINSTHOMPSON
    EIN: 01-0277832
    Description Beginning of Year - Book Value End of Year - Book Value
    Deferred excise tax 8,516 5,117
    Excise tax payable 279 4,784
    Deferred excise tax 8,516 5,117
    Excise tax payable 279 4,784


    TY 2012 OtherLiabilitiesSchedule
    Name:
    SIMMONS FOUNDATION - PERKINSTHOMPSON
    EIN: 01-0277832
    Description Beginning of Year - Book Value End of Year - Book Value
    Deferred excise tax 8,516 5,117
    Excise tax payable 279 4,784
    Deferred excise tax 8,516 5,117
    Excise tax payable 279 4,784


    TY 2012 OtherProfessionalFeesSchedule
    Name:
    SIMMONS FOUNDATION - PERKINSTHOMPSON
    EIN: 01-0277832
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    People United Bank Investment fees 18,906 18,906    


    TY 2012 TaxesSchedule
    Name:
    SIMMONS FOUNDATION - PERKINSTHOMPSON
    EIN: 01-0277832
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Excise tax 2,727