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
BF & ROSE H PERKINS FOUNDATION
 

Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 1064   Room/suite
City or town, state, and ZIP code
SHERIDAN, WY82801
A Employer identification number

83-0138740
B Telephone number (see instructions)

(307) 674-8871
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$9,428,191J 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...... 176,376 176,376  
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 421,164
b Gross sales price for all assets on line 6a 2,068,404
7 Capital gain net income (from Part IV, line 2)... 421,164
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)....... Click to see attachment 21,565 21,565  
12 Total. Add lines 1 through 11........ 619,105 619,105  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 12,000 1,500   10,500
14 Other employee salaries and wages...... 44,637     44,637
15 Pension plans, employee benefits....... 3,323     3,323
16a Legal fees (attach schedule)......... Click to see attachment 423 135   288
b Accounting fees (attach schedule)....... Click to see attachment 5,370 2,685   2,685
c Other professional fees (attach schedule).... Click to see attachment 70,278 38,015   32,263
17 Interest...............        
18 Taxes (attach schedule) (see instructions) Click to see attachment 5,964 238    
19 Depreciation (attach schedule) and depletion... Click to see attachment 915    
20 Occupancy.............. 6,585 1,317   5,268
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 9,361 2,630   6,731
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 158,856 46,520   105,695
25 Contributions, gifts, grants paid........ 670,343 670,343
26 Total expenses and disbursements. Add lines 24 and 25 829,199 46,520   776,038
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -210,094
b Net investment income (if negative, enter -0-) 572,585
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2012)
Form 990-PF (2012)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)		 Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............... 49 49 49
2 Savings and temporary cash investments.......... 451,664 122,282 122,282
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) bullet2,575,454
Less: allowance for doubtful accounts bullet   2,799,338 Click to see attachment2,575,454 2,575,454
8 Inventories for sale or use...............      
9 Prepaid expenses and deferred charges........... 2,362    
10a Investments—U.S. and state government obligations (attach schedule) 636,993 486,459 486,459
b Investments—corporate stock (attach schedule)........ 4,538,247 Click to see attachment5,266,778 5,266,778
c Investments—corporate bonds (attach schedule)........ 998,328 Click to see attachment932,703 932,703
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans..............      
13 Investments—other (attach schedule)........... 2,658 Click to see attachment28,464 28,464
14 Land, buildings, and equipment: basis bullet49,603
Less: accumulated depreciation (attach schedule) bullet39,474 8,184 Click to see attachment10,129 16,000
15 Other assets (describe bullet) Click to see attachment2 Click to see attachment2 Click to see attachment2
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 9,437,825 9,422,320 9,428,191
Liabilities 17 Accounts payable and accrued expenses.......... 2,234 6,474
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).......... 2,234 6,474
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......... 619,299 619,299
28 Paid-in or capital surplus, or land, bldg., and equipment fund    
29 Retained earnings, accumulated income, endowment, or other funds 8,816,292 8,796,547
30 Total net assets or fund balances (see page 17 of the
instructions).................... 9,435,591 9,415,846
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 9,437,825 9,422,320
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 9,435,591
2 Enter amount from Part I, line 27a..................... 2 -210,094
3 Other increases not included in line 2 (itemize) bulletClick to see attachment 3 190,349
4 Add lines 1, 2, and 3.......................... 4 9,415,846
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 9,415,846
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 612-CONOCOPHILLIPS P 2011-10-05 2012-08-17
b 218-CATERPILLAR INC P 2009-06-09 2012-02-08
c 11.09-HARBOR INTERNATIONAL FUND P 2002-11-26 2012-11-15
d 963-IPATH DJ - UBS COMMODITY INDEX T P 2011-04-07 2012-12-11
e 191-PEABODY ENERGY CORPORATION P 2010-10-19 2012-03-05
58.11-T ROWE PRICE MID CAP GROWTH FU P 2003-09-17 2012-02-13
1300-WASTE MANAGEMENT INC P 2011-08-26 2012-09-27
323-GILEAD SCIENCES INC. P 2012-05-04 2012-12-11
248-COSTCO WHOLESALE CORPORATION P 2003-08-22 2012-08-03
233.897-HARBOR INTERNATIONAL FUND P 2003-01-06 2012-11-15
343-JOHNSON & JOHNSON P 2000-10-17 2012-09-13
257.423-T ROWE PRICE MID CAP GROWTH P 2001-12-18 2012-02-13
344.511-T ROWE PRICE MID CAP GROWTH P 2004-01-05 2012-02-13
47-GOOGLE INC P 2012-03-22 2012-10-01
459-DISNEY WALT CO HOLDINGS P 2008-11-12 2012-07-05
354.051-HARBOR INTERNATIONAL FUND P 2003-02-20 2012-11-15
300-JOHNSON & JOHNSON P 2000-11-10 2012-09-13
132.45-T ROWE PRICE MID CAP GROWTH F P 2002-03-01 2012-02-13
501.002-T ROWE PRICE MID CAP GROWTH P 2004-12-30 2012-02-13
925-IPATH DJ - UBS COMMODITY INDEX T P 2012-02-13 2012-12-11
145-EXXON MOBIL CORPORATION P 1998-08-07 2012-04-05
309.36-HARBOR INTERNATIONAL FUND P 2003-08-22 2012-11-15
68-JOHNSON & JOHNSON P 2009-06-09 2012-09-13
127.032-T ROWE PRICE MID CAP GROWTH P 2002-04-02 2012-02-13
835.399-T ROWE PRICE MID CAP GROWTH P 2008-09-05 2012-02-13
306-PHILLIPS 66 P 2011-10-05 2012-05-09
82-EXXON MOBIL CORPORATION P 1998-09-04 2012-04-05
300.947-HARBOR INTERNATIONAL FUND P 2003-09-03 2012-11-15
246-JP MORGAN CHASE & COMPANY P 2007-08-01 2012-12-11
508.13-T ROWE PRICE MID CAP GROWTH F P 2002-05-15 2012-02-13
1528.273-T ROWE PRICE MID CAP VALUE P 2009-09-14 2012-02-13
326-TIFFANY & CO P 2011-12-23 2012-07-05
50000-FED NATL MTG ASSN NOTES 4 P 2007-10-02 2012-09-15
300.947-HARBOR INTERNATIONAL FUND P 2003-09-10 2012-11-15
0.333333-KRAFT FOODS GROUP INC P 2008-10-02 2012-10-26
390.421-T ROWE PRICE MID CAP GROWTH P 2002-05-22 2012-02-13
1730.104-T ROWE PRICE MID CAP VALUE P 2009-10-13 2012-02-13
747-VERIZON COMMUNICATIONS P 2011-10-05 2012-05-04
50000-FED NATL MTG ASSN NOTES 4 P 2007-10-02 2012-05-18
296.419-HARBOR INTERNATIONAL FUND P 2003-09-17 2012-11-15
173-KRAFT FOODS GROUP INC P 2008-10-02 2012-11-02
41.152-T ROWE PRICE MID CAP GROWTH F P 2002-06-12 2012-02-13
50000-TARGET CORP 5 P 2007-10-02 2012-03-01
135-ABBOTT LABORATORIES P 2001-04-19 2012-05-25
54-GOOGLE INC P 2010-06-09 2012-10-01
701.59-HARBOR INTERNATIONAL FUND P 2004-12-30 2012-11-15
32.333333-KRAFT FOODS GROUP INC P 2008-10-02 2012-11-05
145.096-T ROWE PRICE MID CAP GROWTH P 2002-06-26 2012-02-13
343-TARGET CORPORATION P 2000-07-14 2012-08-03
263-ABBOTT LABORATORIES P 2001-12-03 2012-05-25
87.008-HARBOR INTERNATIONAL FUND P 2002-03-01 2012-05-25
964.474-HARBOR INTERNATIONAL FUND P 2006-12-08 2012-12-11
121.666667-KRAFT FOODS GROUP INC P 2009-06-09 2012-11-05
107.34-T ROWE PRICE MID CAP GROWTH F P 2002-07-05 2012-02-13
63-TARGET CORPORATION P 2002-04-02 2012-08-03
214-AIR PRODUCTS & CHEMICALS P 2001-05-23 2012-02-28
110.133-HARBOR INTERNATIONAL FUND P 2002-04-02 2012-05-25
605.886-HARBOR INTERNATIONAL FUND P 2006-12-08 2012-11-15
1132-MERCK & CO INC P 2010-02-17 2012-12-13
157.431-T ROWE PRICE MID CAP GROWTH P 2002-11-26 2012-02-13
50000-US TREASURY NOTES 4 P 2002-03-01 2012-01-03
200-AIR PRODUCTS & CHEMICALS P 2001-12-03 2012-02-28
461.112-HARBOR INTERNATIONAL FUND P 2002-05-15 2012-05-25
50000-HEWLETT PACKARD CO 5 P 2007-10-02 2012-03-01
71-MERCK & CO INC P 2010-03-31 2012-12-13
148.561-T ROWE PRICE MID CAP GROWTH P 2003-01-06 2012-02-13
925.926-VANGUARD 500 INDEX FUND - SI P 2009-06-09 2012-12-26
17.022-AMERICAN EUROPACIFIC GROWTH F P 2002-03-01 2012-12-11
305.623-HARBOR INTERNATIONAL FUND P 2002-05-22 2012-05-25
181-INTEL CORPORATION P 2002-06-26 2012-09-13
614-METLIFE INC P 2009-06-09 2012-04-11
101.42-T ROWE PRICE MID CAP GROWTH F P 2003-02-20 2012-02-13
9469.697-VANGUARD GNMA FUND 36 P 2009-02-13 2012-02-13
138.907-AMERICAN EUROPACIFIC GROWTH P 2002-04-02 2012-12-11
164.962-HARBOR INTERNATIONAL FUND P 2002-06-26 2012-05-25
400-INTEL CORPORATION P 2005-10-25 2012-09-13
263-METLIFE INC P 2010-05-13 2012-04-11
59.447-T ROWE PRICE MID CAP GROWTH F P 2003-08-22 2012-02-13
2707.75-VANGUARD GNMA FUND 36 P 2009-09-14 2012-02-13
326.58-AMERICAN EUROPACIFIC GROWTH F P 2002-05-15 2012-12-11
96.278-HARBOR INTERNATIONAL FUND P 2002-07-05 2012-05-25
400-INTEL CORPORATION P 2006-01-17 2012-09-13
617-PEABODY ENERGY CORPORATION P 2009-02-12 2012-03-05
57.687-T ROWE PRICE MID CAP GROWTH F P 2003-09-03 2012-02-13
10172.94-VANGUARD SHORT-TERM INVESTM P 2009-02-13 2012-02-13
56-APPLE COMPUTER INC P 2007-11-01 2012-03-22
171.792-HARBOR INTERNATIONAL FUND P 2002-11-26 2012-05-25
59-INTEL CORPORATION P 2009-06-09 2012-09-13
347-PEABODY ENERGY CORPORATION P 2009-06-09 2012-03-05
58.794-T ROWE PRICE MID CAP GROWTH F P 2003-09-10 2012-02-13
995-VERIZON COMMUNICATIONS P 2007-12-03 2012-05-04
(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 35,075   30,060 5,015
b 24,833   8,369 16,464
c 641   303 338
d 40,176   50,136 -9,960
e 5,989   9,587 -3,598
3,373   2,300 1,073
41,703   42,403 -700
24,752   16,387 8,365
24,057   7,723 16,334
13,519   6,500 7,019
23,645   16,565 7,080
14,943   9,993 4,950
19,999   15,000 4,999
35,617   30,473 5,144
22,171   9,464 12,707
20,464   9,000 11,464
20,681   14,256 6,425
7,689   5,000 2,689
29,083   25,000 4,083
38,590   40,192 -1,602
12,302   4,844 7,458
17,881   9,850 8,031
4,688   3,805 883
7,374   5,000 2,374
48,495   42,338 6,157
9,643   8,932 711
6,957   2,626 4,331
17,395   9,850 7,545
10,537   10,766 -229
29,497   20,000 9,497
35,609   30,000 5,609
17,681   21,010 -3,329
50,000   49,505 495
17,395   9,850 7,545
15   12 3
22,664   15,000 7,664
40,311   35,000 5,311
30,102   26,829 3,273
50,000   50,568 -568
17,133   9,850 7,283
7,792   6,159 1,633
2,389   1,500 889
50,000   51,593 -1,593
8,432   5,839 2,593
40,922   26,145 14,777
40,552   30,000 10,552
1,444   1,151 293
8,423   5,000 3,423
21,312   10,647 10,665
16,427   13,738 2,689
4,671   2,621 2,050
60,000   60,743 -743
5,434   3,367 2,067
6,231   3,700 2,531
3,914   2,665 1,249
19,471   9,839 9,632
5,913   3,500 2,413
35,020   38,159 -3,139
50,457   42,238 8,219
9,139   5,000 4,139
50,273   49,582 691
18,197   9,140 9,057
24,757   15,000 9,757
50,000   50,590 -590
3,165   2,670 495
8,624   4,800 3,824
100,000   66,715 33,285
706   451 255
16,409   10,000 6,409
4,215   3,249 966
21,642   20,317 1,325
5,887   3,000 2,887
104,924   100,000 4,924
5,758   3,800 1,958
8,857   5,000 3,857
9,315   9,252 63
9,270   11,512 -2,242
3,451   2,300 1,151
30,002   29,000 1,002
13,537   9,006 4,531
5,169   3,000 2,169
9,315   10,312 -997
19,345   17,149 2,196
3,349   2,300 1,049
109,155   100,000 9,155
33,701   10,586 23,115
9,224   4,697 4,527
1,374   972 402
10,880   12,366 -1,486
3,413   2,300 1,113
40,097   40,224 -127
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       5,015
b       16,464
c       338
d       -9,960
e       -3,598
      1,073
      -700
      8,365
      16,334
      7,019
      7,080
      4,950
      4,999
      5,144
      12,707
      11,464
      6,425
      2,689
      4,083
      -1,602
      7,458
      8,031
      883
      2,374
      6,157
      711
      4,331
      7,545
      -229
      9,497
      5,609
      -3,329
      495
      7,545
      3
      7,664
      5,311
      3,273
      -568
      7,283
      1,633
      889
      -1,593
      2,593
      14,777
      10,552
      293
      3,423
      10,665
      2,689
      2,050
      -743
      2,067
      2,531
      1,249
      9,632
      2,413
      -3,139
      8,219
      4,139
      691
      9,057
      9,757
      -590
      495
      3,824
      33,285
      255
      6,409
      966
      1,325
      2,887
      4,924
      1,958
      3,857
      63
      -2,242
      1,151
      1,002
      4,531
      2,169
      -997
      2,196
      1,049
      9,155
      23,115
      4,527
      402
      -1,486
      1,113
      -127
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 2 421,164
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 17,577
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 824,513 7,014,468 0.117545
2010 524,586 6,537,586 0.080242
2009 612,693 5,862,427 0.104512
2008 597,543 6,591,969 0.090647
2007 653,520 7,139,584 0.091535
2 Total of line 1, column (d) ...................... 2 0.484481
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 0.096896
4 Enter the net value of noncharitable-use assets for 2012 from Part X, line 5..... 4 6,959,754
5 Multiply line 4 by line 3....................... 5 674,372
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 5,726
7 Add lines 5 and 6......................... 7 680,098
8 Enter qualifying distributions from Part XII, line 4.............. 8 1,014,578
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 5,726
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 5,726
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 5,726
6 Credits/Payments:
a 2012 estimated tax payments and 2011 overpayment credited to 2012 6a 2,000
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 2,000
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 3,726
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
 
 
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)
    bulletWY, CA
    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 addressbulletWWW.PERKINSFOUNDATION.ORG
    14
    The books are in care ofbulletBF ROSE H PERKINS FOUNDATION Telephone no.bullet (307) 674-8871
    Located atbullet45 EAST LOUCKS STSHERIDANWY ZIP+4bullet82801
    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
    STEVE CARROLLClick to see attachment TREASURER
    5.00     		2,400 0 0
    PO BOX 1064
    SHERIDAN,WY82801
    GEORGE FLETCHERClick to see attachment TRUSTEE
    5.00     		2,400 0 0
    PO BOX 1064
    SHERIDAN,WY82801
    MIKE PILCHClick to see attachment TRUSTEE
    5.00     		2,400 0 0
    PO BOX 1064
    SHERIDAN,WY82801
    VICTOR GARBERClick to see attachment CHAIRMAN
    5.00     		2,400 0 0
    PO BOX 1064
    SHERIDAN,WY82801
    PADDY BARDClick to see attachment VICE CHAIR.
    5.00     		2,400 0 0
    PO BOX 1064
    SHERIDAN,WY82801
    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 MEDICAL EXPENSE ASSISTANCE TO 67 CHILDREN 79,843
    2 SCHOOL DENTAL FLOURIDE PROGRAM - PROVIDING ORAL FLOURIDE TREATMENTS TO ALL ELEMENTARY SCHOOL STUDENTS OF SHERIDAN COUNTY SCHOOL DISTRICT 2. 32,263
    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 EDUCATIONAL LOANS TO 50 STUDENTS 238,540
    2  
    All other program-related investments. See page 24 of the instructions.
    3  
    Total. Add lines 1 through 3..........................bullet238,540
    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
    6,595,810
    b
    Average of monthly cash balances.......................
    1b
    469,930
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    7,065,740
    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
    7,065,740
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see
    instructions) .............................
    4
    105,986
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    6,959,754
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    347,988
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    347,988
    2a
    Tax on investment income for 2012 from Part VI, line 5......
    2a
    5,726
    b
    Income tax for 2012. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    5,726
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    342,262
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    462,424
    5
    Add lines 3 and 4............................
    5
    804,686
    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
    804,686
    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
    776,038
    b
    Program-related investments—total from Part IX-B..................
    1b
    238,540
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    1,014,578
    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
    5,726
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    1,008,852
    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 7 804,686
    2 Undistributed income, if any, as of the end of 2012:
    a Enter amount for 2011 only....... 729,072
    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$ 1,014,578
    a Applied to 2011, but not more than line 2a 729,072
    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..... 285,506
    e Remaining amount distributed out of corpus  
    5 Excess distributions carryover applied to 2012.    
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5  
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ...........     		 
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		 
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		 
    e Undistributed income for 2011. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    f Undistributed income for 2012. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2013 ..........     		519,180
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (see
    instructions) .............     		 
    8Excess distributions carryover from 2007 not
    applied on line 5 or line 7 (see instructions) ...     		 
    9Excess distributions carryover to 2013.
    Subtract lines 7 and 8 from line 6a ......     		 
    10 Analysis of line 9:
    a Excess from 2008....  
    b Excess from 2009....  
    c Excess from 2010....  
    d Excess from 2011....  
    e Excess from 2012....  
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 9
    Part XIV
    Private Operating Foundations (see instructions and Part VII-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2012, enter the date of the ruling.......bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2012 (b) 2011 (c) 2010 (d) 2009
             
    b 85% of line 2a .........          
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ....     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets” alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment” alternative test— enter 2⁄3
    of minimum investment return shown in
    Part X, line 6 for each year listed...     		         
    c “Support” alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XV
    Supplementary Information (Complete this part only if the organization had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail of the person to whom applications should be addressed:
    BF ROSE H PERKINS FOUNDATION
    PO BOX 1064
    SHERIDAN,WY82801
    (307) 674-8871
    bThe form in which applications should be submitted and information and materials they should include:
    CONTACT FOUNDATION OFFICE FOR APPLICATION
    cAny submission deadlines:
    NONE
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    GENERALLY APPLICANTS MUST BE RESIDENTS OF SHERIDAN COUNTY, WYOMING, UNDER AGE 21, AND SHOW FINANCIAL NEED. ADDITIONAL RESTRICTION INFORMATION IS AVAILABLE FROM THE FOUNDATION OFFICE.
    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
    67 CHILDREN WITH
    FINANCIAL NEED
    SHERIDAN COUNTY,WY82801     		NONE INDIVIDUAL MEDICAL & DENTAL EXPENSES 79,843
    SHERIDAN COLLEGE FOUNDATION
    PO BOX 6328
    SHERIDAN,WY82801     		NONE EXEMPT ORG. THORNE RIDER BLDG FUND 550,000
    VOLUNTEERS OF AMERICA
    1876 SOUTH SHERIDAN AVE
    SHERIDAN,WY82801     		NONE EXEMPT ORG. CAMP POSTCARD & CHILD EMPOWER FD 17,000
    N WY SCOTTISH RITE LANGUAGE CLINIC
    PO BOX R
    SHERIDAN,WY82801     		NONE EXEMPT ORG. SUPPORT OPERATIONS 20,000
    PEOPLE ASSISTANCE MANAGMENT INC
    2560 N MAIN STREET
    SHERIDAN,WY82801     		NONE EXEMPT ORG. SUPPORT OPERATIONS 3,500
    Total .................................bullet 3a 670,343
    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....     14 176,376  
    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.....     16 21,525  
    8Gain or (loss) from sales of assets other than inventory     18 421,164  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory..          
    11 Other revenue: aMISCELLANEOUS INCOME     14 40  
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e)..   619,105  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13619,105
    (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:
    BF & ROSE H PERKINS FOUNDATION
    EIN: 83-0138740
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INDIRECT ACCOUNTING FEES 5,370 2,685   2,685

    TY 2012 CompensationExplanation
    Name:
    BF & ROSE H PERKINS FOUNDATION
    EIN: 83-0138740
    Person Name Explanation
    STEVE CARROLL  
    GEORGE FLETCHER  
    MIKE PILCH  
    VICTOR GARBER  
    PADDY BARD  

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    TY 2012 DepreciationSchedule
    Name:
    BF & ROSE H PERKINS FOUNDATION
    EIN: 83-0138740
    Description of Property Date Acquired Cost or Other Basis Prior Years' Depreciation Computation Method Rate /
    Life (# of years)    		 Current Year's Depreciation Expense Net Investment Income Adjusted Net Income Cost of Goods Sold Not Included
    FULLY DEPRECIATED - SEE LIST 1998-01-01 24,832 24,832 200DB 7.0000        
    CHECK PRINTER 1999-07-26 567 567 200DB 7.0000        
    OFFICE CHAIR 2001-11-21 575 575 200DB 7.0000        
    COMPUTER & MONITOR 2002-11-01 2,813 2,813 200DB 5.0000        
    VACUUM CLEANER 2004-12-28 292 292 200DB 7.0000        
    COPY MACHINE 2006-07-31 1,864 1,614 200DB 7.0000 167      
    SCANNER 2006-10-18 400 346 200DB 7.0000 36      
    WIRING 1992-10-31 336 205 S/L 31.5000 10      
    CARPET 1992-10-31 3,522 2,148 S/L 31.5000 112      
    DRAPES 1992-10-31 2,694 1,643 S/L 31.5000 85      
    PAINTING & DRAPES 1992-11-30 2,664 1,617 S/L 31.5000 85      
    ARTWORK - SEE LIST 1994-09-30 3,772              
    DELL OPTIPLEX DESKTOP 2008-01-28 1,645 1,361 200DB 5.0000 189      
    SCANNER 2009-04-08 767 546 200DB 5.0000 88      
    PRINTER/COPIER/FAX 2012-10-08 2,861   200DB 5.0000 143      

    TY 2012 GeneralExplanationAttachment
    Name:
    BF & ROSE H PERKINS FOUNDATION
    EIN: 83-0138740
    Identifier Return Reference Explanation
    GENERAL ELECTIONS   YEAR ENDED: DECEMBER 31, 2012 83-0138740 B.F. & ROSE H. PERKINS FOUNDATION P.O. BOX 1064 SHERIDAN, WY 82801 ELECTING OUT OF BONUS DEPRECIATION ALLOWANCE FOR 5-YEAR PROPERTY THE TAXPAYER ELECTS OUT OF FIRST-YEAR BONUS DEPRECIATION ALLOWANCE UNDER IRC SECTION 168(K) FOR 5-YEAR DEPRECIABLE PROPERTY ACQUIRED AFTER DECEMBER 31, 2007. THIS ELECTION APPLIES TO ALL SUCH QUALIFIED BONUS DEPRECIATION PROPERTY PLACED IN SERVICE DURING THE TAX YEAR.

    TY 2012 InvestmentsCorpBondsSchedule
    Name:
    BF & ROSE H PERKINS FOUNDATION
    EIN: 83-0138740
    Name of Bond End of Year Book Value End of Year Fair Market Value
    FIRST INTERSTATE TRUST AGENCY ACCT    
    12177.447-VANGUARD GNMA FUND 36    
    50000-HEWLETT PACKARD CO 5    
    50000-TARGET CORP 5    
    100000-HSBC FINANCE CORPORATION 102,087 102,087
    50000-PACCAR INC 53,427 53,427
    10172.94-VANGUARD SHORT-TERM INVESTM    
    51595.67-VANGUARD HIGH YIELD CORPORA 315,250 315,250
    15389.891-VANGUARD INTERMEDIATE TERM 158,824 158,824
    23281.97-OPPENHEIMER INTERNATIONAL B 153,195 153,195
    11238.402-TEMPLETON GLOBAL BOND FUND 149,920 149,920

    TY 2012 InvestmentsCorpStockSchedule
    Name:
    BF & ROSE H PERKINS FOUNDATION
    EIN: 83-0138740
    Name of Stock End of Year Book Value End of Year Fair Market Value
    FIRST INTERSTATE TRUST AGENCY ACCT    
    754-ABBOTT LABORATORIES 49,387 49,387
    414-AIR PRODUCTS & CHEMICALS    
    415-APACHE CORPORATION 32,578 32,578
    186-APPLE COMPUTER INC 98,984 98,984
    1302-BAKER HUGHES INC 53,184 53,184
    995-BB&T CORPORATION 28,964 28,964
    613-CATERPILLAR INC 54,930 54,930
    627-CELGENE CORP 49,201 49,201
    748-CHEVRON CORP 80,889 80,889
    3103-CISCO SYSTEMS INC 60,972 60,972
    612-CONOCOPHILLIPS    
    357-COSTCO WHOLESALE CORPORATION 35,247 35,247
    607-DEERE & COMPANY 52,457 52,457
    995-DISNEY WALT CO HOLDINGS 49,541 49,541
    2728-EMC CORPORATION 69,018 69,018
    1069-EMERSON ELECTRIC COMPANY 56,614 56,614
    939-EXXON MOBIL CORPORATION 81,270 81,270
    6358-FORD MOTOR COMPANY 82,336 82,336
    2227-GENERAL ELECTRIC COMPANY 46,745 46,745
    360-GILEAD SCIENCES INC. 26,442 26,442
    5012-HUNTINGTON BANCSHARES INC 32,027 32,027
    819-ILLINOIS TOOL WORKS INC 49,803 49,803
    1672-INTEL CORPORATION 34,477 34,477
    711-JOHNSON & JOHNSON    
    1341-JOHNSON CONTROLS INC 41,128 41,128
    2381-JP MORGAN CHASE & COMPANY 104,690 104,690
    982-KRAFT FOODS INC    
    803-MCDONALDS CORPORATION 70,833 70,833
    558-MCKESSON CORPORATION 54,104 54,104
    1192-MICROSOFT CORPORATION 31,838 31,838
    1572-MONDELEZ INTERNATIONAL INC 40,012 40,012
    833-NORTHERN TRUST CORPORATION 41,783 41,783
    1946-ORACLE CORPORATION 64,841 64,841
    644-PHILIP MORRIS INTERNATIONAL 53,864 53,864
    934-QUALCOMM INC 57,777 57,777
    986-SCHLUMBERGER LIMITED 68,328 68,328
    722-TARGET CORPORATION 42,721 42,721
    326-TIFFANY & CO    
    1619-U S BANCORP DEL 51,711 51,711
    1076-UNITEDHEALTH GROUP INC 58,362 58,362
    1742-VERIZON COMMUNICATIONS    
    1300-WASTE MANAGEMENT INC    
    3700.069-VANGUARD 500 INDEX FUND 401,531 401,531
    13859.50-LKCM SMALL CAP EQ INSTITUTI 314,472 314,472
    8960.748-MORGAN STANLEY INST MID CAP 299,289 299,289
    4031.406-T ROWE PRICE MID CAP GROWTH    
    3258.377-T ROWE PRICE MID CAP VALUE    
    10300.39-AMERICAN EUROPACIFIC GROWTH 423,861 423,861
    8752.383-EATON VANCE TAX-MANAGED 425,191 425,191
    3499.215-HARBOR INTERNATIONAL FUND 217,371 217,371
    6262.914-OPPENHEIMER DEVELOPING MARK 218,451 218,451
    7595-VANGUARD EMERGING MARKETS ETF 338,205 338,205
    23368.471-HARBOR COMMODITY REAL RTN 166,384 166,384
    963-IPATH DJ- UBS COMMODITY INDEX    
    488-BHP BILLITON LIMITED ADR 38,269 38,269
    870-ROCHE HOLDINGS LTD SPONS 43,721 43,721
    843-TEVA PHARMACEUTICAL INDUSTRIES 31,478 31,478
    1685-EXELON CORPORATION 50,112 50,112
    351-INTERNATIONAL BUSINESS MACHINES 67,234 67,234
    877-METLIFE INC    
    1155-PEABODY ENERGY CORPORATION    
    729-PROCTER & GAMBLE COMPANY 49,492 49,492
    826-PEPSICO INC 56,523 56,523
    643-BERKSHIRE HATHAWAY INC CL B 57,677 57,677
    1944-CITIGROUP INC 76,905 76,905
    827-DU PONT E I DE NEMOURS & COMPANY 37,197 37,197
    54-GOOGLE INC    
    1203-MERCK & CO INC    
    670-NEXTERA ENERGY INC 46,357 46,357

    TY 2012 InvestmentsOtherSchedule2
    Name:
    BF & ROSE H PERKINS FOUNDATION
    EIN: 83-0138740
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    ACCRUED DIVIDENDS RECEIVABLE FMV 28,464 28,464

    TY 2012 LandEtcSchedule2
    Name:
    BF & ROSE H PERKINS FOUNDATION
    EIN: 83-0138740
    Category / Item Cost / Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
    OFFICE EQUIPMENT AND FIXTURES 49,603 39,474 10,129 16,000


    TY 2012 LegalFeesSchedule
    Name:
    BF & ROSE H PERKINS FOUNDATION
    EIN: 83-0138740
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INDIRECT LEGAL FEES 423 135   288


    TY 2012 OtherAssetsSchedule
    Name:
    BF & ROSE H PERKINS FOUNDATION
    EIN: 83-0138740
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    MINERAL INTERESTS 2 2 2


    TY 2012 OtherExpensesSchedule
    Name:
    BF & ROSE H PERKINS FOUNDATION
    EIN: 83-0138740
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    EXPENSES        
    BANK CHARGES 154 77   77
    INSURANCE 2,778 1,389   1,389
    OFFICE SUPPLIES 4,042 808   3,234
    POSTAGE AND DELIVERY 356 71   285
    REPAIRS & MAINTENANCE 50 10   40
    TELEPHONE 1,377 275   1,102
    WORKERS COMPENSATION 604     604


    TY 2012 OtherIncomeSchedule2
    Name:
    BF & ROSE H PERKINS FOUNDATION
    EIN: 83-0138740
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    MINERAL LEASE INCOME 21,525 21,525  
    MISCELLANEOUS INCOME 40 40  


    TY 2012 OtherIncreasesSchedule
    Name:
    BF & ROSE H PERKINS FOUNDATION
    EIN: 83-0138740
    Description Amount
    UNREALIZED APPRECIATION OF INVESTMENTS 190,349


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    TY 2012 OtherNotesLoansRcvblLongSch
    Name:
    BF & ROSE H PERKINS FOUNDATION
    EIN: 83-0138740

    Borrower's Name Relationship to Insider Original Amount of Loan Balance Due Date of Note Maturity Date Repayment Terms Interest Rate Security Provided by Borrower Purpose of Loan Description of Lender Consideration Consideration FMV
    STUDENT LOANS NONE   2,575,454       0 %   EDUCATIONAL PURPOSES   2,575,454

    TY 2012 OtherProfessionalFeesSchedule
    Name:
    BF & ROSE H PERKINS FOUNDATION
    EIN: 83-0138740
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT MANAGEMENT 38,015 38,015    
    DENTAL HYGENISTS - FLOURIDE RINS 32,263     32,263


    TY 2012 TaxesSchedule
    Name:
    BF & ROSE H PERKINS FOUNDATION
    EIN: 83-0138740
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    EXCISE TAXES 5,726      
    CALIFORNIA FILING FEES 60 60    
    FOREIGN TAXES 178 178