Form990-PF

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

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

26-1622017
B Telephone number (see instructions)

(800) 839-1754
C bullet
G Check all that apply:

D 1. bullet
2. bullet
H Check type of organization:
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$12,057,765J 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) 1,510,000
2 Check bullet
3 Interest on savings and temporary cash investments 614 614  
4 Dividends and interest from securities...... 319,363 318,326  
5a Gross rents..............      
b Net rental income or (loss) -125,786
6a Net gain or (loss) from sale of assets not on line 10 Click to see attachment -529,294
b Gross sales price for all assets on line 6a 5,219,717
7 Capital gain net income (from Part IV, line 2)... 0
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 52,008 67,623  
12 Total. Add lines 1 through 11........ 1,352,691 386,563  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc.        
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule)......... Click to see attachment 24,551     24,551
b Accounting fees (attach schedule).......        
c Other professional fees (attach schedule).... Click to see attachment 52,364 48,103   4,261
17 Interest............... 80,715 6,312   73,996
18 Taxes (attach schedule) (see instructions) Click to see attachment 32,989     23,395
19 Depreciation (attach schedule) and depletion... Click to see attachment 14,181    
20 Occupancy.............. 7,200     7,200
21 Travel, conferences, and meetings....... 1,060 1,060    
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 118,334 79,544   38,782
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 331,394 135,019   172,185
25 Contributions, gifts, grants paid........ 1,440,008 1,440,008
26 Total expenses and disbursements. Add lines 24 and 25 1,771,402 135,019   1,612,193
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -418,711
b Net investment income (if negative, enter -0-) 251,544
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2012)
Form 990-PF (2012)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)		 Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing...............      
2 Savings and temporary cash investments.......... 3,740,250 2,883,787 2,883,787
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see page 15 of the
instructions)....................      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use...............      
9 Prepaid expenses and deferred charges...........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)........ 660,945 Click to see attachment3,174,507 3,165,554
c Investments—corporate bonds (attach schedule)........ 3,097,060    
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans..............      
13 Investments—other (attach schedule)........... 3,301,045 Click to see attachment4,553,084 4,671,488
14 Land, buildings, and equipment: basis bullet1,351,117
Less: accumulated depreciation (attach schedule) bullet14,181   Click to see attachment1,336,936 1,336,936
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 10,799,300 11,948,314 12,057,765
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)......   Click to see attachment1,500,000
22 Other liabilities (describe bullet)   Click to see attachment67,725
23 Total liabilities (add lines 17 through 22)..........   1,567,725
Net Assets or Fund Balances bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted....................    
25 Temporarily restricted................    
26 Permanently restricted................    
bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds.........    
28 Paid-in or capital surplus, or land, bldg., and equipment fund    
29 Retained earnings, accumulated income, endowment, or other funds 10,799,300 10,380,589
30 Total net assets or fund balances (see page 17 of the
instructions).................... 10,799,300 10,380,589
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 10,799,300 11,948,314
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 10,799,300
2 Enter amount from Part I, line 27a..................... 2 -418,711
3 Other increases not included in line 2 (itemize) bullet 3  
4 Add lines 1, 2, and 3.......................... 4 10,380,589
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 10,380,589
Form 990-PF (2012)
Form 990-PF (2012)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.) 		(b) How acquired
P—Purchase
D—Donation 		(c) Date acquired
(mo., day, yr.) 		(d) Date sold
(mo., day, yr.)
1 a Publicly-traded securities      
b Passthrough K1 Capital Gain      
c Loss on Futures      
d
e
(e) Gross sales price (f) Depreciation allowed
(or allowable) 		(g) Cost or other basis
plus expense of sale 		(h) Gain or (loss)
(e) plus (f) minus (g)
a 5,219,717   5,701,984 -482,267
b       12,050
c       -59,467
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l) Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i) F.M.V. as of 12/31/69 (j) Adjusted basis
as of 12/31/69 		(k) Excess of col. (i)
over col. (j), if any
a       -482,267
b       12,050
c       -59,467
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 -529,684
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 . . . . . . . . . . . . . . . . 		Bracket 3  
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)

If section 4940(d)(2) applies, leave this part blank.
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period?
If “Yes,” the foundation does not qualify under section 4940(e). Do not complete this part.
1 Enter the appropriate amount in each column for each year; see page 18 of the instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in) 		(b)
Adjusted qualifying distributions 		(c)
Net value of noncharitable-use assets 		(d)
Distribution ratio
(col. (b) divided by col. (c))
2011 1,035,268 10,027,074 000.103247
2010 1,045,593 10,444,073 000.100114
2009 891,815 11,119,347 000.080204
2008 655,333 9,254,261 000.070814
2007      
2 Total of line 1, column (d) ...................... 2 000.354379
3 Average distribution ratio for the 5-year base period—divide the total on line 2 by 5, or by
the number of years the foundation has been in existence if less than 5 years. . . 		3 000.070876
4 Enter the net value of noncharitable-use assets for 2012 from Part X, line 5..... 4 10,735,260
5 Multiply line 4 by line 3....................... 5 760,872
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 2,515
7 Add lines 5 and 6......................... 7 763,387
8 Enter qualifying distributions from Part XII, line 4.............. 8 2,963,310
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 2,515
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 2,515
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 2,515
6 Credits/Payments:
a 2012 estimated tax payments and 2011 overpayment credited to 2012 6a 4,000
b Exempt foreign organizations—tax withheld at source....... 6b
c Tax paid with application for extension of time to file (Form 8868) 6c 2,000
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. Tax Paid Original Return: 6000 7 6,000
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. Click to see attachment 8 2
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 3,483
11 Enter the amount of line 10 to be: Credited to 2013 estimated taxBullet3,483 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
Yes
 
b
If “Yes,” has it filed a tax return on Form 990-T for this year?...................
4b
Yes
 
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)
    bulletCA, DE, MD
    b
    If the answer is “Yes” to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If “No,” attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2012 or the taxable year beginning in 2012 (see instructions for Part XIV)?
    If “Yes,” complete Part XIV.............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If “Yes,” attach a schedule listing their names and addresses.
    10
     
    No
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. (see instructions) .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement (see instructions).................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbullet  
    14
    The books are in care ofbullet   Telephone no.bullet (800) 839-1754
    Located atbullet501 Silverside Road Suite 123WilmingtonDE ZIP+4bullet198091377
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041.........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ......bullet
    15  
    16
    At any time during calendar year 2012, did the foundation have an interest in or a signature or other authority over
    a bank, securities, or other financial account in a foreign country? .................
    16
     
    No
    See instructions for exceptions and filing requirements for Form TD F 90-22.1. If "Yes", enter the name of the foreign country bullet  
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 5
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the “Yes” column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?.........................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?.................
    (6) Agree to pay money or property to a government official? (Exception. Check “No”
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).........
    b
    If any answer is “Yes” to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance (see page 20 of the instructions)?...
    1b
     
    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
    Thomas M Scruggs Jr Pres/Sec/Dir
    020.00     		0    
    501 Silverside Ste 123
    Wilmington,DE19809
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE.”
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
     
    Total number of other employees paid over $50,000...................bullet  
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
     
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1
     
    2  
    3  
    4  
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 7
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See page 24 of the instructions.
    3  
    Total. Add lines 1 through 3..........................bullet  
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,
    see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    6,541,598
    b
    Average of monthly cash balances.......................
    1b
    2,934,971
    c
    Fair market value of all other assets (see instructions)................
    1c
    1,523,354
    d
    Total (add lines 1a, b, and c).........................
    1d
    10,999,923
    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
    101,182
    3
    Subtract line 2 from line 1d.........................
    3
    10,898,741
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see
    instructions) Click to see attachment.............................
    4
    163,481
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    10,735,260
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    536,763
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    536,763
    2a
    Tax on investment income for 2012 from Part VI, line 5......
    2a
    2,515
    b
    Income tax for 2012. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    2,515
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    534,248
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    534,248
    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
    534,248
    Part XII
    Qualifying Distributions (see instructions)
    1
    Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
    a
    Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 Click to see attachment..........
    1a
    1,612,193
    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
    1,351,117
    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
    2,963,310
    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
    2,515
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    2,960,795
    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 7 534,248
    2 Undistributed income, if any, as of the end of 2012:
    a Enter amount for 2011 only.......  
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2012:
    a From 2007.......  
    b From 2008....... 236,450
    c From 2009....... 342,946
    d From 2010....... 530,229
    e From 2011....... 543,347
    fTotal of lines 3a through e......... 1,652,972
    4Qualifying distributions for 2012 from Part
    XII, line 4: bullet$ 2,963,310
    a Applied to 2011, but not more than line 2a  
    b Applied to undistributed income of prior years
    (Election required—see instructions)......     		 
    c Treated as distributions out of corpus (Election
    required—see instructions).........     		 
    d Applied to 2012 distributable amount..... 534,248
    e Remaining amount distributed out of corpus 2,429,062
    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 4,082,034
    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 ......     		4,082,034
    10 Analysis of line 9:
    a Excess from 2008.... 236,450
    b Excess from 2009.... 342,946
    c Excess from 2010.... 530,229
    d Excess from 2011.... 543,347
    e Excess from 2012.... 2,429,062
    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).)
    Thomas M Scruggs Jr
    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 of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 10
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    A J MUSTE MEMORIAL INSTITUTE
    339 LAFAYETTE ST
    NEW YORK,NY10012     		N/A 509a1 General Unrestricted 1,000
    A JEWISH VOICE FOR PEACE INC
    1611 TELEGRAPH AVE
    OAKLAND,CA94612     		N/A 509a1 General Unrestricted 1,000
    ALLIANCE FOR GLOBAL JUSTICE
    1247 E ST SE
    WASHINGTON,DC20003     		N/A 509a1 Courage to Resist Bradley Manning Support Network 1,000
    ALLIANCE FOR GLOBAL JUSTICE
    1247 E ST SE
    WASHINGTON,DC20003     		N/A 509a1 Nicaragua News Service 500
    CENTER FOR CUBAN STUDIES INC
    231 W 29TH ST 4TH FL
    NEW YORK,NY10001     		N/A 509a2 General Unrestricted 500
    AMERICANS UNITED - SEP OF CHURCH & STATE
    1301 K ST NW STE 850E
    WASHINGTON,DC20005     		N/A 509a1 General Unrestricted 1,000
    CENTER FOR ECONOMIC AND POLICY RESEARCH
    1611 CONNECTICUT AVE NW NO 400
    WASHINGTON,DC20009     		N/A 509a1 General Unrestricted 500,000
    CISPES EDUCATION FUND
    1525 NEWTON ST NW
    WASHINGTON,DC20010     		N/A 509a1 General Unrestricted 1,000
    COMMON DREAMS INC
    PO BOX 443
    PORTLAND,ME04112     		N/A 509a1 General Unrestricted 1,000
    COUNCIL FOR SECULAR HUMANISM INC
    3965 RENSCH RD
    AMHERST,NY14228     		N/A 509a2 General Unrestricted 1,000
    CROSSROADS FUND
    3411 W DIVERSEY AVE STE 20
    CHICAGO,IL60647     		N/A 509a1 General Unrestricted 500
    CULTURAL SURVIVAL INC
    215 PROSPECT ST
    CAMBRIDGE,MA02139     		N/A 509a1 Xavante News Dissemination and General Unrestricted 15,000
    FOUNDATION FOR NATIONAL PROGRESS
    222 SUTTER ST STE 600
    SAN FRANCISCO,CA94108     		N/A 509a2 Charitable Event 2,500
    FOUNDATION FOR NATIONAL PROGRESS
    222 SUTTER ST STE 600
    SAN FRANCISCO,CA94108     		N/A 509a2 General Unrestricted 1,000
    GLOBAL LEFT FORUM INC
    365 5TH AVE STE 6115
    NEW YORK,NY10016     		N/A 509a1 General Unrestricted 500
    GREENPEACE FUND INC
    702 H ST NW STE 300
    WASHINGTON,DC20001     		N/A 509a1 General Unrestricted 1,000
    INDEPENDENT MEDIA INSTITUTE
    1881 HARMON ST
    BERKELEY,CA94703     		N/A 509a1 General Unrestricted 1,000
    INDEPENDENT WORLD TELEVISION INC
    234 HOLLIDAY ST
    BALTIMORE,MD21202     		N/A 509a1 Support Refurbishing of New Buildings in Baltimore Maryland 237,758
    INDEPENDENT WORLD TELEVISION INC
    234 HOLLIDAY ST
    BALTIMORE,MD21202     		N/A 509a1 First of Three Installments for Additional Construction on Baltimore Building 100,000
    INDEPENDENT WORLD TELEVISION INC
    234 HOLLIDAY ST
    BALTIMORE,MD21202     		N/A 509a1 General Unrestricted 330,000
    INSTITUTE FOR PUBLIC AFFAIRS
    2040 N MILWAUKEE 2ND FL
    CHICAGO,IL60647     		N/A 509a1 General Unrestricted 5,000
    INSTITUTE FOR SOCIAL AND CULTURAL COMMUNICATIONS INC
    18 MILLFIELD ST
    WOODS HOLE,MA02543     		N/A 509a1 General Unrestricted 5,000
    INSTITUTE FOR THE ADVANCEMENT OF JOURNALISTIC CLARITY dba COUNTER PUNCH
    PO BOX 228
    PETROLIA,CA95558     		N/A 509a1 Save CounterPunch From Being Disappeared 10,000
    INSTITUTE FOR THE ADVANCEMENT OF JOURNALISTIC CLARITY dba COUNTER PUNCH
    PO BOX 228
    PETROLIA,CA95558     		N/A 509a1 General Unrestricted 5,000
    JUST FOREIGN POLICY
    4410 MASSACHUSETTS AVE NW 290
    WASHINGTON,DC20016     		N/A 509a1 General Unrestricted 160,000
    LEAGUE TO SAVE LAKE TAHOE
    2608 LAKE TAHOE BLVD
    S LAKE TAHOE,CA96150     		N/A 509a2 General Unrestricted 500
    MEDIA FREEDOM FOUNDATION
    PO BOX 571
    COTATI,CA94931     		N/A 509a1 General Unrestricted 5,000
    MONTHLY REVIEW FOUNDATION
    146 W 29TH ST RM 6W
    NEW YORK,NY10001     		N/A 509a2 General Unrestricted 5,000
    NORTH AMERICAN CONGRESS ON LATIN AMERICA
    53 WASHINGTON SQ S FL 4W
    NEW YORK,NY10012     		N/A 509a2 General Unrestricted 30,000
    PACIFICA REPORTERS AGAINST CENSORSHIP
    PO BOX 381
    TOLEDO,OR97391     		N/A 509a2 General Unrestricted 1,000
    POSITIVE FUTURES NETWORK
    284 MADRONA WAY NE STE 116
    BAINBRIDGE IS,WA98110     		N/A 509a1 General Unrestricted 1,000
    PROGRESSIVE INC
    409 E MAIN ST
    MADISON,WI53703     		N/A 509a2 General Unrestricted 5,000
    PROMETHEUS RADIO PROJECT
    PO BOX 42158
    PHILADELPHIA,PA19101     		N/A 509a2 General Unrestricted 1,000
    PUBLIC INTEREST PICTURES INCORPORATED
    612 FLOWER AVE
    VENICE,CA90291     		N/A 509a1 General Unrestricted 1,000
    SIERRA CLUB FOUNDATION
    85 2ND ST STE 750
    SAN FRANCISCO,CA94105     		N/A 509a1 General Unrestricted 1,000
    TRUTHOUT
    PO BOX 276414
    SACRAMENTO,CA95827     		N/A 509a1 Culinary Outreach to Past and Potential Donors 250
    TRUTHOUT
    PO BOX 276414
    SACRAMENTO,CA95827     		N/A 509a1 General Unrestricted 1,000
    TRUTHOUT
    PO BOX 276414
    SACRAMENTO,CA95827     		N/A 509a1 General Unrestricted 1,000
    VENEZUELA ANALYSIS
    148 HARRISON AVE
    HARRISON,NY10528     		N/A 509a1 General Unrestricted 5,000
    Total .................................bullet 3a 1,440,008
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 11
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3Interest on savings and temporary cash investments     14 614  
    4 Dividends and interest from securities.... 525990 1,037 14 318,326  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....     16 -125,786  
    6Net rental income or (loss) from personal property          
    7 Other investment income.....          
    8Gain or (loss) from sales of assets other than inventory 525990 390 18 -529,684  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory..          
    11 Other revenue: aPassthrough K-1 Income 525990 -15,615 14 67,623  
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e).. -14,188 -268,907  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13-283,095
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 12
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section
    Yes
    No
    501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is “Yes,” complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527?...........
    b
    If “Yes,” complete the following schedule.
    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer or fiduciary) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below
    (see instr.)?
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's namebullet



    Firm's addressbullet







         		Firm's EINbullet
    Phone no.
    Form 990-PF (2012)
    Additional Data


    Software ID: 12000057
    Software Version: 12.19.1011.1
    Part VI Line 7 - Tax Paid Original Return: 6000


    Form 990PF - Special Condition Description:
    Special Condition Description
    Schedule B
    (Form 990, 990-EZ,
    or 990-PF)
    Department of the Treasury
    Internal Revenue Service
    Schedule of Contributors
    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    OMB No. 1545-0047
    2012
    Name of the organization
    Quitiplas Foundation
     
    Employer identification number

    26-1622017
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ





    Form 990-PF




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

    Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
    Page 2
    Name of organization
    Quitiplas Foundation
          		Employer identification number

    26-1622017
    Part I
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    		     
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    1
     
     

    Thomas M Scruggs Jr    
    14 Maybeck Twin Drive
       
    Berkeley, CA   94708

    		$1,500,000


    (Complete Part II if there is a noncash contribution.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    2
     
     

    Independent World Television Inc    
    234 Holliday St 605
       
    Baltimore, MD   21202

    		$10,000


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

         
     
       

    		$  


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

         
     
       

    		$  


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

         
     
       

    		$  


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

         
     
       

    		$  


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

    Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
    Page 3
    Name of organization
    Quitiplas Foundation
          		Employer identification number

    26-1622017
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    		     
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    (a) No.
    from
    Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (see instructions)     		(d)
    Date received
     
    		$    
    Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

    Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
    Page 4
    Name of organization
    Quitiplas Foundation
          		Employer identification number

    26-1622017
    Part III
    Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
    that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
    For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
    contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a) No.
    from
    Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
           
     
    (a) No.
    from
    Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
           
     
    (a) No.
    from
    Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
           
     
    (a) No.
    from
    Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
           
     
    Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

    Additional Data


    Software ID: 12000057
    Software Version: 12.19.1011.1

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

    TY 2012 DepreciationSchedule
    Name:
    Quitiplas Foundation
    EIN: 26-1622017
    Software ID:12000057
    Software Version:12.19.1011.1
    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
    231-235 HOLLIDAY ST - BUILDINGS IMPROVEMENTS 2012-04-30 833,813   Straight-line 3950.0000000000 % 14,181      

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

    TY 2012 GainLossSaleOtherAssetsSch
    Name:
    Quitiplas Foundation
    EIN: 26-1622017
    Software ID:12000057
    Software Version:12.19.1011.1
    Name Date Acquired How Acquired Date Sold Purchaser Name Gross Sales Price Basis Basis Method Sales Expenses Total (net) Accumulated Depreciation
    Publicly-traded securities         5,219,717 5,701,984     -482,267  
    Passthrough K1 Capital Gain                 12,050  
    Loss on Futures                 -59,467  
    Passthrough UBI Capital Gain                 390  

    TY 2012 GeneralExplanationAttachment
    Name:
    Quitiplas Foundation
    EIN: 26-1622017
    Software ID:12000057
    Software Version:12.19.1011.1
    Identifier Return Reference Explanation

    TY 2012 InvestmentsCorpStockSchedule
    Name:
    Quitiplas Foundation
    EIN: 26-1622017
    Software ID:12000057
    Software Version:12.19.1011.1
    Name of Stock End of Year Book Value End of Year Fair Market Value
    490000 shares of ADVANCED CELL TECHNOLOGIES INC ACTC 50,297 27,293
    522 shares of AMAZON.COM INC AMZN 100,349 130,954
    252 shares of APPLE INC. AAPL 151,152 134,108
    48915 shares of CHIMERA INVESTMENT CIM 151,063 127,668
    1470 shares of CITIGROUP INC 49,961 58,153
    80000 shares of CITIGROUP FUNDING INC CONTIGENT ROS SPX OTC 800,000 812,800
    4330 shares of CITIZENS INC CIA 48,852 47,847
    2400 shares of IMMUNOCELLULAR THERAPEUTICS IMUC 6,250 4,608
    3649 shares of INTEL CORP INTC 100,065 75,242
    14721 shares of iSHARES INC ETF EEMA 812,603 847,783
    25071 shares of iSHARES TRUST MSCI EURO FINL EUFN 445,517 496,406
    101000 shares of LEGEND OIL AND GAS LOGL 99,478 6,060
    2550 shares of LOWES COS INC LOW 50,192 90,576
    853 shares of NETFLIX.COM INC NFLX 99,982 78,979
    28410 shares of RENTECH INC RTK 50,012 74,718
    1850 shares of ROCKWOOD HOLDINGS ROC 99,577 91,501
    37600 shares of RODINA LITHIUM INC RDNAF 8,906 5,922
    1720 shares of US BANCORP USB 50,251 54,936

    TY 2012 InvestmentsOtherSchedule2
    Name:
    Quitiplas Foundation
    EIN: 26-1622017
    Software ID:12000057
    Software Version:12.19.1011.1
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    ENTERPRISE PRODUCTS PARTNERS LP EPD   127,137 151,091
    GREEN LANTERN, INC.   120,000 120,000
    OPEN CURRENCY FUTURES   141,360 141,360
    SANDRIDGE MISSISSIPPIAN TRUST I SDT   46,435 23,756
    UBS GAVEA FUND LLC   1,044,442 1,041,706
    REPUBLIC OF ARGENTINA SECUR SER V 8.75 06/02/17   579,380 663,750
    REPUBLIC OF VENEZUELA 10.75 Due 09-19-13   1,989,330 2,055,000
    GS INVESTMENT PARTNERS LLC   505,000 474,825

    TY 2012 LandEtcSchedule2
    Name:
    Quitiplas Foundation
    EIN: 26-1622017
    Software ID:12000057
    Software Version:12.19.1011.1
    Category / Item Cost / Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
    231-235 HOLLIDAY ST - BUILDINGS 817,543 13,949 803,594 803,594
    231-235 HOLLIDAY ST - IMPROVEMENTS 16,269 232 16,037 16,037
    231-235 HOLLIDAY ST - LAND 517,305   517,305 517,305


    TY 2012 LegalFeesSchedule
    Name:
    Quitiplas Foundation
    EIN: 26-1622017
    Software ID:12000057
    Software Version:12.19.1011.1
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Legal Fees - Charitable-Use Building Purchase 24,551     24,551


    TY 2012 MortgagesAndNotesPayableSch 
    Name:
    Quitiplas Foundation
    EIN: 26-1622017
    Software ID:12000057
    Software Version:12.19.1011.1
    Total Mortgage Amount: 1500000

    Item No. 1
    Lender's Name ARCADIA FINANCE COMPANY LLC
    Lender's Title  
    Relationship to Insider None
    Original Amount of Loan 1000000
    Balance Due 1000000
    Date of Note 2012-04
    Maturity Date 2015-04
    Repayment Terms Monthly Interest Payments
    Interest Rate 0000000000.070000000000
    Security Provided by Borrower Liens
    Purpose of Loan Building Purchase
    Description of Lender Consideration Cash
    Consideration FMV 1000000

    Item No. 2
    Lender's Name J FILM LLC
    Lender's Title  
    Relationship to Insider None
    Original Amount of Loan 500000
    Balance Due 500000
    Date of Note 2012-04
    Maturity Date 2015-04
    Repayment Terms Monthly Interest Payments
    Interest Rate 0000000000.070000000000
    Security Provided by Borrower Liens
    Purpose of Loan Building Purchase
    Description of Lender Consideration Cash
    Consideration FMV 500000


    TY 2012 OtherExpensesSchedule
    Name:
    Quitiplas Foundation
    EIN: 26-1622017
    Software ID:12000057
    Software Version:12.19.1011.1
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Administrative Fees 20,000     20,000
    State Filing Fees 25     25
    K-1 expenses UBS Gavea Fund LLC 77,417 77,417    
    K-1 expenses Sandridge Mississippian Trust I 2,127 2,127    
    K-1 expenses Enterprise Products Partners LP 8      
    Property Insurance - charitable-use building 8,684     8,684
    Other closing expenses 8,803     8,803
    Loan payment late fee 292     292
    Utilities - charitable-use building 978     978


    TY 2012 OtherIncomeSchedule2
    Name:
    Quitiplas Foundation
    EIN: 26-1622017
    Software ID:12000057
    Software Version:12.19.1011.1
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    Passthrough K-1 income UBS Gavea Fund LLC 65,558 65,358  
    Passthrough K-1 loss Enterprise Products Partners LP -16,034 -219  
    Passthrough K-1 income Sandridge Mississippian Trust I 2,484 2,484  


    TY 2012 OtherLiabilitiesSchedule
    Name:
    Quitiplas Foundation
    EIN: 26-1622017
    Software ID:12000057
    Software Version:12.19.1011.1
    Description Beginning of Year - Book Value End of Year - Book Value
    Open Currency Futures   12,600
    Open Options   55,125


    TY 2012 OtherProfessionalFeesSchedule
    Name:
    Quitiplas Foundation
    EIN: 26-1622017
    Software ID:12000057
    Software Version:12.19.1011.1
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Investment Management Fees 48,103 48,103    
    Appraisal Services 2,700     2,700
    Security System Install and Service 1,561     1,561


    TY 2012 TaxesSchedule
    Name:
    Quitiplas Foundation
    EIN: 26-1622017
    Software ID:12000057
    Software Version:12.19.1011.1
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Excise Tax 2011 4,025      
    Excise Tax 2012 4,000      
    UBTI Tax 2011 1,569      
    Property Taxes - Charitable-Use Building 23,395     23,395