-
TIN:
Form
990-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
20
12
Open to Public Inspection
For calendar year 2012, or tax year beginning
08-01-2012
, and ending
07-31-2013
Name of foundation
RIDGEWAY EM-CHARITTUW
Number and street (or P.O. box number if mail is not delivered to street address)
PO BOX 2907 - TRUST TAX DEPT
Room/suite
City or town, state, and ZIP code
WILSON
,
NC
278942907
A Employer identification number
54-6202908
B
Telephone number (see instructions)
(540) 665-4254
C
If exemption application is pending, check here
G
Check all that apply:
Initial return
Initial return of a former public charity
Final return
Amended return
Address change
Name change
D 1.
Foreign organizations, check here .............
2.
Foreign organizations meeting the 85% test,
check here and attach computation ...........
H
Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
I
Fair market value of all assets at end
of year
(from Part II, col. (c),
line 16)
$
1,653,762
J
Accounting method:
Cash
Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)
E
If private foundation status was terminated
under section 507(b)(1)(A), check here .........
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here .........
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)
1
Contributions, gifts, grants, etc., received (attach schedule)
2
Check
3
Interest on savings and temporary cash investments
1,457
1,457
4
Dividends and interest from securities
......
41,619
41,619
5a
Gross rents
..............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
112,906
b
Gross sales price for all assets on line 6a
1,463,666
7
Capital gain net income (from Part IV, line 2)
...
112,906
8
Net short-term capital gain
.........
0
9
Income modifications
...........
10a
Gross sales less returns and allowances
b
Less: Cost of goods sold
....
c
Gross profit or (loss) (attach schedule)
.....
11
Other income (attach schedule)
.......
12
Total.
Add lines 1 through 11
........
155,982
155,982
13
Compensation of officers, directors, trustees, etc.
22,625
22,625
14
Other employee salaries and wages
......
0
0
0
15
Pension plans, employee benefits
.......
0
0
16a
Legal fees (attach schedule)
.........
0
b
Accounting fees (attach schedule)
.......
c
Other professional fees (attach schedule)
....
1,468
1,468
17
Interest
...............
0
18
Taxes (attach schedule) (see instructions)
3,785
1,055
0
19
Depreciation (attach schedule) and depletion
...
0
0
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
0
0
22
Printing and publications
..........
0
0
23
Other expenses (attach schedule)
.......
180
180
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
28,058
23,860
0
1,468
25
Contributions, gifts, grants paid
........
78,296
78,296
26
Total expenses and disbursements.
Add lines 24 and 25
106,354
23,860
0
79,764
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
49,628
b
Net investment income
(if negative, enter -0-)
132,122
c
Adjusted net income
(if negative, enter -0-)
...
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
1
Cash—non-interest-bearing
...............
2
2
2
Savings and temporary cash investments
..........
42,350
66,847
66,847
3
Accounts receivable
Less: allowance for doubtful accounts
0
0
4
Pledges receivable
Less: allowance for doubtful accounts
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)
Less: allowance for doubtful accounts
0
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)
........
670,161
711,487
782,946
c
Investments—corporate bonds (attach schedule)
........
751,072
760,369
745,688
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
..............
13
Investments—other (attach schedule)
...........
81,644
57,564
58,279
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
1,545,227
1,596,269
1,653,762
17
Accounts payable and accrued expenses
..........
18
Grants payable
...................
19
Deferred revenue
..................
20
Loans from officers, directors, trustees, and other disqualified persons
21
Mortgages and other notes payable (attach schedule)
......
22
Other liabilities (describe
)
23
Total liabilities
(add lines 17 through 22)
..........
0
Foundations that follow SFAS 117, check here
and complete lines 24 through 26 and lines 30 and 31.
24
Unrestricted
....................
25
Temporarily restricted
................
26
Permanently restricted
................
Foundations that do not follow SFAS 117, check here
and complete lines 27 through 31.
27
Capital stock, trust principal, or current funds
.........
1,545,227
1,596,269
28
Paid-in or capital surplus, or land, bldg., and equipment fund
29
Retained earnings, accumulated income, endowment, or other funds
30
Total net assets or fund balances
(see page 17 of the
instructions)
....................
1,545,227
1,596,269
31
Total liabilities and net assets/fund balances
(see page 17 of
the instructions)
..................
1,545,227
1,596,269
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
1,545,227
2
Enter amount from Part I, line 27a
.....................
2
49,628
3
Other increases not included in line 2 (itemize)
3
1,414
4
Add lines 1, 2, and 3
..........................
4
1,596,269
5
Decreases not included in line 2 (itemize)
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30
.
6
1,596,269
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
105. ACCO BRANDS CORP COMMON
2011-11-21
2012-08-08
b
349.614 AMERICAN CENTURY DIVERSIFIED BOND FUND #
2011-06-17
2012-08-08
c
110. ANIXTER INTERNATIONAL INC
2011-08-18
2012-08-08
d
90. CANON INC COMMON
2011-08-18
2012-08-08
e
70. CARNIVAL CORP PAIRED CTF 1 COM
2011-08-18
2012-08-08
363.393 DOUBLELINE TOTAL RETURN BOND FUND
2011-11-21
2012-08-08
290. ERSTE BK DER OESTER SPAR-ADR
2012-08-08
90. ERSTE BK DER OESTER SPAR-ADR
2011-06-17
2012-08-08
40. JUPITER TELECOMMUNICATIONS CO LTD ADR
2011-11-21
2012-08-08
354.002 METROPOLITAN WEST TOTAL RETURN BOND FUND
2011-06-17
2012-08-08
40. NOVO-NORDISK A S ADR
2011-08-18
2012-08-08
50. POLARIS INDUSTRIES INC
2011-11-21
2012-08-08
767.255 STERLING CAPITAL CORPORATE FUND NAME&CUSIP CHGE TO 85917K710
2011-08-18
2012-08-08
514.575 STERLING CAPITAL TOTAL RETURN BOND FUND
2012-08-08
756.639 STERLING CAPITAL INTERMEDIATE U.S. GOVERNMENT FUND INST CL FUN
2012-04-04
2012-08-08
9878.978 STERLING CAPITAL INTERMEDIATE U.S. GOVERNMENT FUND INST CL FU
2011-06-17
2012-08-08
40. TARGET CORP COM
2011-08-18
2012-08-08
65. TRACTOR SUPPLY COMPANY COMMON
2011-11-21
2012-08-08
140. WAL-MART DE MEXICO
2011-08-18
2012-08-08
25. AFFILIATED MANAGERS GROUP INC
2011-11-21
2012-08-17
170. L'AIR LIQUIDE-UNSPONS ADR COMMON
2011-08-18
2012-08-17
100. ADR AMERICA MOVIL S A DE CV
2011-08-18
2012-08-17
336.093 AMERICAN CENTURY DIVERSIFIED BOND FUND #
2011-06-17
2012-08-17
100. ATLAS COPCO AB SPONS
2011-08-18
2012-08-17
413.896 DOUBLELINE TOTAL RETURN BOND FUND
2011-11-21
2012-08-17
30. NOVOZYMES A/S UNSPONS ADR
2011-08-18
2012-08-17
15. NOVOZYMES A/S UNSPONS ADR
2011-06-17
2012-08-17
110. PROGESSIVE CORP., OHIO COMMON
2011-08-18
2012-08-17
80. SCHNEIDER ELECTRIC SA UNSPON ADR
2011-06-17
2012-08-17
10. SCHNEIDER ELECTRIC SA UNSPON ADR
2011-06-17
2012-08-17
60. SMITHFIELD FOODS INC
2011-11-21
2012-08-17
150. TESCO PLC SPONS ADR
2012-08-17
70. QIAGEN N.V.
2012-08-17
90. ALTERA CORP COM
2012-10-25
220. ALTERA CORP COM
2011-08-18
2012-10-25
90. AMERICAN EXPRESS COMPANY
2012-04-04
2012-10-25
460. BG GROUP PLC SPON ADR
2011-08-18
2012-10-25
100. BECTON DICKINSON & CO. COMMON
2011-08-18
2012-10-25
14. BLACKROCK INC COMMON
2011-08-18
2012-10-25
70. CME GROUP INC COMMON
2012-10-25
120. CIMAREX ENERGY CO COMMON
2011-08-18
2012-10-25
200. COMCAST CORP NEW CL A SPL
2011-08-18
2012-10-25
240. DANAHER CORP COMMON
2011-08-18
2012-10-25
187.295 DOUBLELINE TOTAL RETURN BOND FUND
2011-11-21
2012-10-25
40. ECOLABS INC
2011-11-21
2012-10-25
50. ECOLABS INC
2011-08-18
2012-10-25
35. FLOWSERVE CORP COM
2011-11-21
2012-10-25
19. GOOGLE INC CL A
2012-10-25
30. GRAINGER W.W. INC COMMON
2011-08-18
2012-10-25
40. J. B. HUNT
2012-08-08
2012-10-25
160. ICF INTERNATIONAL INC COMMON
2011-08-18
2012-10-25
30. INTERCONTINENTALEXCHANGE INC COMMON
2012-10-25
15. MASTERCARD INC - CLASS A
2011-06-17
2012-10-25
170. MCCORMICK & CO INC COM
2011-08-18
2012-10-25
60. MEADWESTVACO CORP.
2011-11-21
2012-10-25
231.114 METROPOLITAN WEST TOTAL RETURN BOND FUND
2011-06-17
2012-10-25
240. MILLER HERMAN INC COM
2011-08-18
2012-10-25
270. NAT'L INSTRUMENTS CORP COMMON
2011-08-18
2012-10-25
40. NAT'L INSTRUMENTS CORP COMMON
2012-08-08
2012-10-25
130. NEWFIELD EXPL CO COM
2011-11-21
2012-10-25
200. NEWFIELD EXPL CO COM
2011-08-18
2012-10-25
20. NOBLE ENERGY INC
2012-08-08
2012-10-25
60. NOBLE ENERGY INC
2011-08-18
2012-10-25
20. NOVARTIS AG
2012-08-08
2012-10-25
40. NOVARTIS AG
2011-08-18
2012-10-25
45. NOVOZYMES A/S UNSPONS ADR
2011-08-18
2012-10-25
60. OGE ENERGY CORP COMMON
2011-11-21
2012-10-25
30. O'REILLY AUTOMOTIVE INC COMMON
2012-08-08
2012-10-25
110. PALL CORPORATION COMMON
2012-10-25
110. PETROLEO BRASILEIR COMMON
2011-06-17
2012-10-25
10. PRAXAIR,INC
2011-08-18
2012-10-25
60. PROCTOR AND GAMBLE COMPANY
2011-08-18
2012-10-25
330. PROGESSIVE CORP., OHIO COMMON
2011-08-18
2012-10-25
110. PROGESSIVE CORP., OHIO COMMON
2011-11-21
2012-10-25
120. ROCHE HOLDING LTD ADR
2011-08-18
2012-10-25
240. SCHWAB CHARLES CORP NEW
2011-11-21
2012-10-25
150. SCHWAB CHARLES CORP NEW
2011-08-18
2012-10-25
90. SCRIPPS NETWORKS INTERACTIVE CL A COMMON
2011-11-21
2012-10-25
120. SCRIPPS NETWORKS INTERACTIVE CL A COMMON
2012-10-25
55. JM SMUCKER CO COMMON
2011-08-18
2012-10-25
20. JM SMUCKER CO COMMON
2012-08-08
2012-10-25
331.865 STERLING CAPITAL CORPORATE FUND NAME&CUSIP CHGE TO 85917K710
2011-08-18
2012-10-25
97.465 STERLING CAPITAL SECURITIZED OPPORTUNITIES NAME&CUSIP CHGE TO 8
2012-08-08
2012-10-25
101.481 STERLING CAPITAL TOTAL RETURN BOND FUND
2006-03-16
2012-10-25
50. TARGET CORP COM
2011-08-18
2012-10-25
250. TEXAS INSTRUMENTS INCORPORATED
2012-10-25
110. THOR INDS INC COMMON
2011-11-21
2012-10-25
95. 3M COMPANY COMMON
2011-08-18
2012-10-25
15. TRACTOR SUPPLY COMPANY COMMON
2011-11-21
2012-10-25
60. URS CORP NEW
2011-11-21
2012-10-25
300. UNILEVER N V NY SHS NEW F
2012-10-25
140. COVIDIEN PLC
2012-10-25
220. LAZARD LTD
2012-10-25
60. AGCO CORPORATION COMMON
2011-11-21
2012-12-12
50. BG GROUP PLC SPON ADR
2011-08-18
2012-12-12
40. CENTENE CORP
2012-08-08
2012-12-12
30. CENTENE CORP
2011-11-21
2012-12-12
60. CHICAGO BRIDGE & IRON CO NV
2011-11-21
2012-12-12
40. COLUMBIA SPORTSWEAR CO
2011-11-21
2012-12-12
80. DARLING INTERNATIONAL INC COMMON
2011-11-21
2012-12-12
40. FANUC LTD ADR
2011-06-17
2012-12-12
50. FRESENIUS MED CARE
2011-08-18
2012-12-12
50. HOYA CORP SPONSORED ADR
2012-08-08
2012-12-12
150. HOYA CORP SPONSORED ADR
2011-08-18
2012-12-12
60. IDEX CORP
2011-11-21
2012-12-12
50. MCGRAW HILL INCORPORATED
2012-10-25
2012-12-12
30. MEDTRONIC INC
2012-10-25
2012-12-12
90. SAFEWAY INC
2011-11-21
2012-12-12
60. SMITHFIELD FOODS INC
2011-11-21
2012-12-12
80. SONOVA HOLDING AG
2011-08-18
2012-12-12
60. THE TIMKEN COMPANY COMMON
2011-11-21
2012-12-12
70. TRINITY INDS INC
2011-11-21
2012-12-12
200. TURKIYE GARANTI BANKASI A.S.
2011-08-18
2012-12-12
100. PENTAIR LTD COMMON
2011-11-21
2012-12-12
50. QIAGEN N.V.
2011-11-21
2012-12-12
25. APACHE CORPORATION COMMON
2012-10-25
2013-02-21
6. APPLE COMPUTER CORPORATION COMMON
2012-10-25
2013-02-21
70. ARM HOLDINGS PLC -SPONS ADR
2011-08-18
2013-02-21
235.148 ARTISAN INTERNATIONAL SMALL CAP FUND # 1
2012-11-01
2013-02-21
70. BROADRIDGE FINANCIAL SOLUTIONS LLC COMMO
2011-11-21
2013-02-21
30. CATERPILLAR INCORPORATED
2012-10-25
2013-02-21
50. CHICAGO BRIDGE & IRON CO NV
2011-11-21
2013-02-21
70. COCHLEAR LIMITED UNSPONS ADR
2011-08-18
2013-02-21
73.116 COHEN & STEERS REALTY SHARES INSTITUTION
2011-06-17
2013-02-21
4489.22 CREDIT SUISSE COMMODITY RETURN STRATEGY INSTITUTIONAL SHS FD 2
2013-02-21
344.214 CREDIT SUISSE COMMODITY RETURN STRATEGY INSTITUTIONAL SHS FD 2
2012-04-09
2013-02-21
700. LI & FUNG LIMITED UNSPONS ADR
2011-08-18
2013-02-21
960. LI & FUNG LIMITED UNSPONS ADR
2012-04-04
2013-02-21
50. L'OREAL SA ADR
2011-08-18
2013-02-21
30. LVMH MOET-HENNESSEY UNSPON ADR
2011-08-18
2013-02-21
60. MEADWESTVACO CORP.
2011-11-21
2013-02-21
30. NORDSON CORP
2011-11-21
2013-02-21
50. SAFEWAY INC
2011-11-21
2013-02-21
40. SCHLUMBERGER LTD
2011-08-18
2013-02-21
60. SCHNEIDER ELECTRIC SA UNSPON ADR
2011-06-17
2013-02-21
50. SMITHFIELD FOODS INC
2011-11-21
2013-02-21
3520.393 STERLING CAPITAL SECURITIZED OPPORTUNITI
2012-08-08
2013-02-21
40. THOR INDS INC COMMON
2011-11-21
2013-02-21
70. TRINITY INDS INC
2011-11-21
2013-02-21
50. URS CORP NEW
2011-11-21
2013-02-21
90. XINYI GLASS HOLDINGS LTD
2012-08-08
2013-02-21
80. ARCOS DORADOS HOLDINGS, INC
2012-12-12
2013-02-21
50. QIAGEN N.V.
2011-11-21
2013-02-21
70. QIAGEN N.V.
2012-10-25
2013-02-21
40. AIA GROUP LTD
2012-04-04
2013-04-11
20. ABBOTT LABORATORIES
2012-10-25
2013-04-11
50. ABBVIE INC COMMON
2012-10-25
2013-04-11
20. AFFILIATED MANAGERS GROUP INC
2011-11-21
2013-04-11
15. AIR PRODUCTS AND CHEMICALS INC
2012-10-25
2013-04-11
50. ALTRIA GROUP INC
2012-10-25
2013-04-11
50. ADR AMERICA MOVIL S A DE CV
2011-08-18
2013-04-11
140. ADR AMERICA MOVIL S A DE CV
2013-04-11
11116.024 AMERICAN CENTURY DIVERSIFIED BOND FUND #
2013-04-11
1916.456 AMERICAN CENTURY DIVERSIFIED BOND FUND #
2012-04-09
2013-04-11
704.518 AMERICAN CENTURY DIVERSIFIED BOND FUND #
2013-04-11
30. AUTOMATIC DATA PROCESSING INC
2012-10-25
2013-04-11
8. BLACKROCK INC COMMON
2011-08-18
2013-04-11
30. CHEVRON TEXACO CORP COMMON
2012-10-25
2013-04-11
120. COCA COLA COMPANY
2012-10-25
2013-04-11
30. COLUMBIA SPORTSWEAR CO
2011-11-21
2013-04-11
40. CONOCOPHILLIPS COM
2012-10-25
2013-04-11
20. DBS GROUP HLDGS LTD SPONSORED ADR F/K/A DEVELOPMENT BK SINGAPORE L
2011-08-18
2013-04-11
50. DARLING INTERNATIONAL INC COMMON
2011-11-21
2013-04-11
20. DISNEY WALT COMPANY
2012-10-25
2013-04-11
3102.263 DOUBLELINE TOTAL RETURN BOND FUND
2011-11-21
2013-04-11
50. EXXON MOBIL CORPORATION
2012-10-25
2013-04-11
20. FANUC LTD ADR
2011-06-17
2013-04-11
60. FREEPORT-MCM COPR GOLD CL B
2012-10-25
2013-04-11
50. GAZPROM
2011-08-18
2013-04-11
10. HSBC HLDGS PLC ADR
2012-04-04
2013-04-11
20. HSBC HLDGS PLC ADR
2012-10-25
2013-04-11
110. INTEL CORPORATION
2012-10-25
2013-04-11
14. INTERNATIONAL BUSINESS MACHINES CORP
2012-10-25
2013-04-11
60. J P MORGAN CHASE & CO
2012-10-25
2013-04-11
45. JOHNSON & JOHNSON
2012-10-25
2013-04-11
30. ESTEE LAUDER COMMON
2012-10-25
2013-04-11
35. MCDONALDS CORPORATION
2012-10-25
2013-04-11
30. MONDELEZ INTERNATIONAL INC. COMMON
2012-10-25
2013-04-11
50. NESTLE SA ADR
2011-08-18
2013-04-11
50. NEWS CORP CL A
2012-10-25
2013-04-11
8. NOVO-NORDISK A S ADR
2012-10-25
2013-04-11
30. OGE ENERGY CORP COMMON
2011-11-21
2013-04-11
25. OCCIDENTAL PETE CORP
2012-10-25
2013-04-11
40. PEPSICO INCORPORATED
2012-10-25
2013-04-11
50. PHILIP MORRIS INTERNATIONAL
2012-10-25
2013-04-11
10. PHILLIPS 66 COMMON
2012-10-25
2013-04-11
20. PRAXAIR,INC
2011-08-18
2013-04-11
50. PROCTOR AND GAMBLE COMPANY
2011-08-18
2013-04-11
20. RIO TINTO PLC SPONSORED ADR
2012-10-25
2013-04-11
40. ROCHE HOLDING LTD ADR
2011-08-18
2013-04-11
30. ROYAL DUTCH SHELL PLC SPONSORED
2012-10-25
2013-04-11
10. SABMILLER PLC
2012-10-25
2013-04-11
40. SAFEWAY INC
2011-11-21
2013-04-11
30. SMITHFIELD FOODS INC
2011-11-21
2013-04-11
7022.106 STERLING CAPITAL CORPORATE FUND-I
2011-08-18
2013-04-11
3530.166 STERLING CAPITAL SECURITIZED OPPORTUNITI
2012-08-08
2013-04-11
100. SWATCH GROUP AG
2011-08-18
2013-04-11
30. TARGET CORP COM
2011-08-18
2013-04-11
40. TESCO PLC SPONS ADR
2011-11-21
2013-04-11
50. THE TIMKEN COMPANY COMMON
2011-11-21
2013-04-11
40. FINA S A SPONSORED
2012-10-25
2013-04-11
25. UNITED TECHNOLOGIES CORPORATION
2012-10-25
2013-04-11
30. WAL MART STORES INCORPORATED
2012-10-25
2013-04-11
40. WALGREEN COMPANY
2012-10-25
2013-04-11
20. AGCO CORPORATION COMMON
2011-11-21
2013-07-11
70. AIA GROUP LTD
2013-02-21
2013-07-11
270. AIA GROUP LTD
2012-04-04
2013-07-11
127. L'AIR LIQUIDE-UNSPONS ADR COMMON
2011-08-18
2013-07-11
210. L'AIR LIQUIDE-UNSPONS ADR COMMON
2013-07-11
15. AIR PRODUCTS AND CHEMICALS INC
2012-10-25
2013-07-11
10. ALLERGAN INC
2013-04-11
2013-07-11
360. ALLIANZ COMMON
2011-08-18
2013-07-11
120. ALLIANZ COMMON
2013-07-11
90. ALTRIA GROUP INC
2012-10-25
2013-07-11
12. AMAZON INC COMMON
2013-04-11
2013-07-11
30. ANHEUSER-BUSCH INBEV NV SPN ADR
2013-07-11
4. APPLE COMPUTER CORPORATION COMMON
2012-10-25
2013-07-11
40. ARM HOLDINGS PLC -SPONS ADR
2012-08-08
2013-07-11
180. ARM HOLDINGS PLC -SPONS ADR
2013-07-11
75.836 ARTISAN INTERNATIONAL SMALL CAP FUND # 1
2012-11-01
2013-07-11
30. ATLAS COPCO AB SPONS
2011-08-18
2013-07-11
110. ATLAS COPCO AB SPONS
2013-07-11
20. AUTOMATIC DATA PROCESSING INC
2012-10-25
2013-07-11
160. BG GROUP PLC SPON ADR
2012-08-08
2013-07-11
35. BG GROUP PLC SPON ADR
2011-08-18
2013-07-11
80. BAYERISCHE MOTOREN WERKE (BMW) UNSPONS A
2013-02-21
2013-07-11
60. BROADCOM CORP CL A COMMON
2013-04-11
2013-07-11
50. BROADRIDGE FINANCIAL SOLUTIONS LLC COMMO
2011-11-21
2013-07-11
20. CSL LIMITED ADR
2013-04-11
2013-07-11
130. CSL LIMITED ADR
2011-08-18
2013-07-11
30. CAMERON INT'L CORP COM
2013-04-11
2013-07-11
10. CANADIAN NATL RY CO
2013-04-11
2013-07-11
40. CANADIAN NATL RY CO
2011-08-18
2013-07-11
10. CANADIAN PACIFIC RAILWAY LTD. COMMON
2013-02-21
2013-07-11
35. CATERPILLAR INCORPORATED
2013-07-11
60. CENTENE CORP
2012-08-08
2013-07-11
10. CENTENE CORP
2011-11-21
2013-07-11
20. CERNER CORP COMMON
2013-04-11
2013-07-11
10. CHEVRON TEXACO CORP COMMON
2012-10-25
2013-07-11
30. CHICAGO BRIDGE & IRON CO NV
2011-11-21
2013-07-11
180. COCA COLA COMPANY
2012-10-25
2013-07-11
50. COCHLEAR LIMITED UNSPONS ADR
2013-07-11
20. COLUMBIA SPORTSWEAR CO
2011-11-21
2013-07-11
30. COMCAST CORP NEW CL A
2013-02-21
2013-07-11
60. CONOCOPHILLIPS COM
2012-10-25
2013-07-11
15. COSTCO WHOLESALE CORP
2013-04-11
2013-07-11
30. DANAHER CORP COMMON
2013-04-11
2013-07-11
50. DARLING INTERNATIONAL INC COMMON
2011-11-21
2013-07-11
75. DASSAULT SYSTEMS COMMON
2011-08-18
2013-07-11
15. DIAGEO PLC SPONSORED ADR
2013-07-11
20. DISNEY WALT COMPANY
2012-10-25
2013-07-11
20. EBAY INC
2013-04-11
2013-07-11
15. EDWARDS LIFESCIENCES CORP COMMON
2013-04-11
2013-07-11
105. EXXON MOBIL CORPORATION
2012-10-25
2013-07-11
80. FANUC LTD ADR
2013-07-11
150. FANUC LTD ADR
2013-07-11
40. FLOWSERVE CORP COM
2011-11-21
2013-07-11
15. FRANKLIN RESOURCES INC
2012-10-25
2013-07-11
70. FREEPORT-MCM COPR GOLD CL B
2013-07-11
150. FRESENIUS MED CARE
2013-07-11
110. GAZPROM
2013-02-21
2013-07-11
120. GAZPROM
2011-08-18
2013-07-11
190. GENERAL ELECTRIC COMPANY
2013-07-11
20. GILEAD SCIENCES INC
2013-04-11
2013-07-11
60. HSBC HLDGS PLC ADR
2012-10-25
2013-07-11
40. HSBC HLDGS PLC ADR
2012-04-04
2013-07-11
30. ICICI BANK LIMITED SPONS ADR
2012-08-08
2013-07-11
110. ICICI BANK LIMITED SPONS ADR
2013-07-11
30. IDEX CORP
2011-11-21
2013-07-11
70. IMPERIAL OIL LTD COMMON
2011-08-18
2013-07-11
30. IMPERIAL OIL LTD COMMON
2012-12-12
2013-07-11
30. INFORMATICA CORP
2013-04-11
2013-07-11
10. INTERCONTINENTALEXCHANGE INC COMMON
2013-04-11
2013-07-11
20. INTERNATIONAL BUSINESS MACHINES CORP
2012-10-25
2013-07-11
50. INTUIT INC COMMON
2013-04-11
2013-07-11
4. INTUITIVE SURGICAL INC
2012-10-25
2013-07-11
20. JGC CORPORATION
2012-12-12
2013-07-11
50. JGC CORPORATION
2013-07-11
80. J P MORGAN CHASE & CO
2012-10-25
2013-07-11
55. JOHNSON & JOHNSON
2012-10-25
2013-07-11
90. JUNIPER NETWORKS INC
2013-04-11
2013-07-11
120. L'OREAL SA ADR
2011-08-18
2013-07-11
70. L'OREAL SA ADR
2013-07-11
30. ESTEE LAUDER COMMON
2012-10-25
2013-07-11
400. LONZA GROUP AG ADR
2011-08-18
2013-07-11
160. LONZA GROUP AG ADR
2013-02-21
2013-07-11
50. MERCK & CO INC
2012-10-25
2013-07-11
40. MONDELEZ INTERNATIONAL INC. COMMON
2012-10-25
2013-07-11
50. MONSANTO CO COMMON
2013-04-11
2013-07-11
130. MTN GROUP LTD ADR
2011-08-18
2013-07-11
120. NESTLE SA ADR
2012-10-25
2013-07-11
80. NESTLE SA ADR
2013-07-11
40. NEWFIELD EXPL CO COM
2011-11-21
2013-07-11
10. NEWS CORP COMMON NEW CL A W/I
2012-10-25
2013-07-11
50. NOKIAN RENKAAT OYJ
2012-12-12
2013-07-11
90. NOKIAN RENKAAT OYJ
2012-04-04
2013-07-11
10. NORDSON CORP
2011-11-21
2013-07-11
14. NOVO-NORDISK A S ADR
2012-10-25
2013-07-11
20. OGE ENERGY CORP COMMON
2011-11-21
2013-07-11
50. ORACLE SYSTEM CORPORATION
2012-10-25
2013-07-11
120. PETROLEO BRASILEIRO SA PETROBRAS
2012-10-25
2013-07-11
40. PHILIP MORRIS INTERNATIONAL
2012-10-25
2013-07-11
20. PHILLIPS 66 COMMON
2012-10-25
2013-07-11
2893.077 PIMCO COMMODITY REAL RETURN STRATEGY INS
2013-07-11
10. POLARIS INDUSTRIES INC
2011-11-21
2013-07-11
20. POTASH CORP SASKATCHEWAN
2012-10-25
2013-07-11
20. PRAXAIR,INC
2011-08-18
2013-07-11
20. PRICE GROUP INC FORMERLY AKA PRICE TO ROWE & ASSOC
2013-04-11
2013-07-11
40. PROCTOR AND GAMBLE COMPANY
2011-08-18
2013-07-11
20. PROCTOR AND GAMBLE COMPANY
2012-08-08
2013-07-11
50. RIO TINTO PLC SPONSORED ADR
2012-10-25
2013-07-11
40. ROCHE HOLDING LTD ADR
2011-08-18
2013-07-11
10. ROCHE HOLDING LTD ADR
2012-08-08
2013-07-11
60. ROYAL DUTCH SHELL PLC SPONSORED
2012-10-25
2013-07-11
20. SABMILLER PLC
2012-10-25
2013-07-11
70. SAP AKTIENGESELLSCHAFT
2011-08-18
2013-07-11
50. SASOL LTD SPONSORED ADR
2011-08-18
2013-07-11
200. SCHNEIDER ELECTRIC SA UNSPON ADR
2013-07-11
180. SCHNEIDER ELECTRIC SA UNSPON ADR
2011-08-18
2013-07-11
200. SMITHFIELD FOODS INC
2011-11-21
2013-07-11
60. SMITHFIELD FOODS INC
2012-08-08
2013-07-11
80. SONOVA HOLDING AG
2013-07-11
80. SONOVA HOLDING AG
2011-08-18
2013-07-11
40. STARBUCKS CORPORATIONS COMMON
2013-04-11
2013-07-11
140. SVENSKA HANDELSB-A
2013-07-11
60. SWATCH GROUP AG
2011-08-18
2013-07-11
40. SWATCH GROUP AG
2013-02-21
2013-07-11
170. SYSMEX CORP
2013-07-11
140. TAIWAN SEMICONDUCTOR MFG LTD SPONSORED ADR
2013-07-11
180. TAIWAN SEMICONDUCTOR MFG LTD SPONSORED ADR
2011-08-18
2013-07-11
130. TEXAS INSTRUMENTS INCORPORATED
2011-08-18
2013-07-11
40. THOR INDS INC COMMON
2011-11-21
2013-07-11
40. THE TIMKEN COMPANY COMMON
2011-11-21
2013-07-11
80. FINA S A SPONSORED
2012-10-25
2013-07-11
320. TURKIYE GARANTI BANKASI A.S.
2013-07-11
720. TURKIYE GARANTI BANKASI A.S.
2011-08-18
2013-07-11
40. TWENTY FIRST CENTURY FOX INC COMMON
2012-10-25
2013-07-11
10. URS CORP NEW
2012-08-08
2013-07-11
30. URS CORP NEW
2011-11-21
2013-07-11
50. UNICHARM CORP
2013-04-11
2013-07-11
450. UNICHARM CORP
2011-08-18
2013-07-11
20. UNION PACIFIC CORP
2013-04-11
2013-07-11
25. UNITED TECHNOLOGIES CORPORATION
2012-10-25
2013-07-11
40. WPP PLC
2011-08-18
2013-07-11
40. WAL MART STORES INCORPORATED
2012-10-25
2013-07-11
30. WALGREEN COMPANY
2012-10-25
2013-07-11
40. XILINX INC
2012-10-25
2013-07-11
140. XINYI GLASS HOLDINGS LTD
2013-07-11
70. ARCOS DORADOS HOLDINGS, INC
2013-04-11
2013-07-11
30. BUNGE LIMITED
2013-02-21
2013-07-11
30. BUNGE LIMITED
2012-04-04
2013-07-11
10. PENTAIR LTD COMMON
2011-11-21
2013-07-11
10. PENTAIR LTD COMMON
2012-08-08
2013-07-11
CAPITAL GAIN DIVIDENDS
P
(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
880
1,078
-198
b
3,933
3,818
115
c
6,588
5,574
1,014
d
3,112
4,090
-978
e
2,396
2,113
283
4,088
4,055
33
2,645
4,155
-1,510
821
2,223
-1,402
2,615
2,596
19
3,830
3,721
109
6,126
4,276
1,850
3,717
2,945
772
8,102
7,757
345
5,707
4,924
783
8,202
8,149
53
107,088
105,112
1,976
2,503
1,975
528
5,940
4,662
1,278
4,047
3,450
597
2,971
2,165
806
4,000
3,822
178
2,617
2,349
268
3,758
3,670
88
2,371
1,983
388
4,689
4,619
70
776
853
-77
388
465
-77
2,169
1,965
204
1,002
1,274
-272
125
159
-34
1,165
1,373
-208
2,398
2,795
-397
1,225
973
252
2,729
3,198
-469
6,671
7,693
-1,022
4,957
5,183
-226
9,703
9,520
183
7,512
7,790
-278
2,610
2,158
452
3,821
3,921
-100
6,915
7,732
-817
7,083
4,098
2,985
12,446
10,039
2,407
2,135
2,090
45
2,760
2,130
630
3,450
2,266
1,184
4,547
3,279
1,268
12,815
9,476
3,339
5,974
3,922
2,052
2,285
2,196
89
2,939
3,262
-323
3,877
4,025
-148
6,752
4,030
2,722
10,513
7,704
2,809
1,760
1,513
247
2,547
2,429
118
4,594
4,284
310
6,357
6,247
110
942
1,060
-118
3,508
5,316
-1,808
5,396
9,989
-4,593
1,819
1,784
35
5,457
5,042
415
1,218
1,182
36
2,436
2,233
203
1,236
1,279
-43
3,412
3,042
370
2,500
2,612
-112
6,842
6,432
410
2,354
3,267
-913
1,043
949
94
4,221
3,627
594
7,478
5,894
1,584
2,493
2,007
486
5,827
4,960
867
3,211
2,645
566
2,007
1,803
204
5,590
3,515
2,075
7,453
4,879
2,574
4,688
3,898
790
1,705
1,522
183
3,564
3,355
209
999
998
1
1,128
1,028
100
3,141
2,468
673
6,983
7,220
-237
4,003
2,753
1,250
8,317
7,381
936
1,378
1,076
302
2,006
2,066
-60
10,986
9,950
1,036
7,689
6,881
808
6,477
6,209
268
2,947
2,586
361
854
1,035
-181
1,845
1,568
277
1,384
1,089
295
2,503
2,264
239
2,245
1,903
342
1,356
1,100
256
1,161
1,021
140
1,737
1,692
45
967
1,112
-145
2,901
3,206
-305
2,728
2,042
686
2,840
2,735
105
1,284
1,249
35
1,591
1,722
-131
1,354
1,373
-19
1,820
1,258
562
2,749
2,392
357
2,397
1,877
520
1,008
676
332
4,793
3,614
1,179
888
679
209
1,871
2,054
-183
2,666
3,673
-1,007
2,938
1,674
1,264
5,510
5,027
483
1,592
1,525
67
2,723
2,480
243
2,632
1,887
745
2,506
2,589
-83
3,208
2,990
218
35,465
41,307
-5,842
2,719
2,826
-107
1,795
2,387
-592
2,462
4,397
-1,935
1,448
1,143
305
1,033
957
76
2,057
1,513
544
2,006
1,293
713
1,132
957
175
3,071
3,052
19
898
1,226
-328
1,126
1,144
-18
35,732
36,049
-317
1,465
1,001
464
2,882
1,877
1,005
2,064
1,722
342
1,216
961
255
1,016
1,010
6
1,074
679
395
1,504
1,236
268
690
578
112
750
633
117
2,162
1,716
446
3,109
1,732
1,377
1,308
1,159
149
1,780
1,604
176
1,052
1,174
-122
2,945
3,352
-407
123,610
122,128
1,482
21,311
21,196
115
7,834
7,827
7
1,983
1,742
241
2,115
1,233
882
3,625
3,301
324
4,959
4,435
524
1,769
1,427
342
2,409
2,281
128
1,015
902
113
886
688
198
1,211
1,003
208
35,304
34,621
683
4,448
4,496
-48
529
510
19
1,985
2,355
-370
405
584
-179
533
444
89
1,066
990
76
2,375
2,376
-1
2,977
2,677
300
2,972
2,492
480
3,716
3,200
516
2,018
1,837
181
3,585
3,053
532
915
796
119
3,628
3,130
498
1,581
1,207
374
1,349
1,274
75
2,112
1,521
591
2,106
2,015
91
3,216
2,745
471
4,800
4,386
414
622
448
174
2,262
1,898
364
3,996
3,022
974
961
1,003
-42
2,442
1,653
789
1,961
2,025
-64
530
430
100
1,057
765
292
771
686
85
74,785
70,993
3,792
35,902
36,149
-247
2,904
2,189
715
2,082
1,481
601
711
743
-32
2,762
1,993
769
1,976
1,993
-17
2,389
1,934
455
2,347
2,255
92
1,943
1,414
529
1,087
862
225
1,268
1,154
114
4,891
3,902
989
3,253
2,855
398
5,379
5,177
202
1,455
1,159
296
894
1,164
-270
5,499
3,748
1,751
1,833
1,654
179
3,319
2,887
432
3,595
3,230
365
2,779
2,830
-51
1,710
2,449
-739
1,584
1,077
507
7,130
4,548
2,582
1,888
1,621
267
759
595
164
2,785
2,785
1,437
1,161
276
2,855
3,299
-444
625
724
-99
2,453
2,430
23
2,085
2,024
61
1,389
1,089
300
602
629
-27
3,916
1,869
2,047
1,930
1,945
-15
1,000
979
21
4,001
2,773
1,228
1,245
1,170
75
3,035
2,978
57
3,274
2,352
922
546
363
183
983
959
24
1,234
1,100
134
1,836
1,132
704
7,365
6,653
712
1,454
1,880
-426
1,254
952
302
1,332
1,208
124
3,857
3,421
436
1,732
1,591
141
2,042
1,861
181
1,006
688
318
9,740
5,597
4,143
1,835
1,804
31
1,330
1,003
327
1,119
1,156
-37
981
1,261
-280
9,794
9,442
352
2,017
2,064
-47
3,782
4,037
-255
2,234
1,249
985
2,098
1,890
208
1,998
2,467
-469
4,893
5,061
-168
791
980
-189
863
1,402
-539
4,531
4,086
445
1,116
1,032
84
3,300
2,970
330
2,200
1,776
424
1,165
1,051
114
4,273
4,611
-338
1,731
1,021
710
2,911
2,828
83
1,247
1,292
-45
1,159
1,019
140
1,785
1,585
200
3,859
3,825
34
3,205
3,249
-44
1,712
2,168
-456
1,547
1,305
242
3,867
2,538
1,329
4,402
3,323
1,079
4,922
3,912
1,010
1,801
1,679
122
4,064
2,743
1,321
2,371
2,082
289
2,045
1,837
208
3,114
2,472
642
1,246
1,005
241
2,419
2,308
111
1,201
1,061
140
5,164
5,349
-185
2,435
2,423
12
8,131
7,704
427
5,421
4,766
655
1,016
1,636
-620
150
111
39
1,082
1,042
40
1,947
2,184
-237
732
431
301
2,296
2,230
66
708
507
201
1,591
1,546
45
1,571
2,662
-1,091
3,618
3,509
109
1,149
895
254
16,577
18,877
-2,300
1,001
589
412
796
807
-11
2,349
1,898
451
1,546
1,540
6
3,228
2,418
810
1,614
1,326
288
2,161
2,507
-346
2,558
1,653
905
640
446
194
4,005
4,051
-46
1,000
859
141
5,213
3,453
1,760
2,185
2,157
28
3,039
2,717
322
2,735
2,259
476
6,569
4,576
1,993
1,971
1,305
666
1,779
1,746
33
1,779
1,258
521
2,772
2,357
415
3,018
2,563
455
1,764
1,313
451
1,176
1,130
46
5,457
4,189
1,268
2,598
2,159
439
3,340
1,964
1,376
4,826
3,340
1,486
2,008
1,001
1,007
2,410
1,594
816
4,026
3,986
40
1,189
1,574
-385
2,675
2,434
241
1,196
855
341
475
381
94
1,426
1,033
393
556
629
-73
5,002
4,162
840
3,185
2,841
344
2,489
1,934
555
3,578
1,988
1,590
3,101
3,007
94
1,456
1,061
395
1,667
1,299
368
2,197
1,774
423
816
884
-68
2,222
2,198
24
2,222
2,039
183
606
361
245
606
434
172
67
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
-198
b
115
c
1,014
d
-978
e
283
33
-1,510
-1,402
19
109
1,850
772
345
783
53
1,976
528
1,278
597
806
178
268
88
388
70
-77
-77
204
-272
-34
-208
-397
252
-469
-1,022
-226
183
-278
452
-100
-817
2,985
2,407
45
630
1,184
1,268
3,339
2,052
89
-323
-148
2,722
2,809
247
118
310
110
-118
-1,808
-4,593
35
415
36
203
-43
370
-112
410
-913
94
594
1,584
486
867
566
204
2,075
2,574
790
183
209
1
100
673
-237
1,250
936
302
-60
1,036
808
268
361
-181
277
295
239
342
256
140
45
-145
-305
686
105
35
-131
-19
562
357
520
332
1,179
209
-183
-1,007
1,264
483
67
243
745
-83
218
-5,842
-107
-592
-1,935
305
76
544
713
175
19
-328
-18
-317
464
1,005
342
255
6
395
268
112
117
446
1,377
149
176
-122
-407
1,482
115
7
241
882
324
524
342
128
113
198
208
683
-48
19
-370
-179
89
76
-1
300
480
516
181
532
119
498
374
75
591
91
471
414
174
364
974
-42
789
-64
100
292
85
3,792
-247
715
601
-32
769
-17
455
92
529
225
114
989
398
202
296
-270
1,751
179
432
365
-51
-739
507
2,582
267
164
276
-444
-99
23
61
300
-27
2,047
-15
21
1,228
75
57
922
183
24
134
704
712
-426
302
124
436
141
181
318
4,143
31
327
-37
-280
352
-47
-255
985
208
-469
-168
-189
-539
445
84
330
424
114
-338
710
83
-45
140
200
34
-44
-456
242
1,329
1,079
1,010
122
1,321
289
208
642
241
111
140
-185
12
427
655
-620
39
40
-237
301
66
201
45
-1,091
109
254
-2,300
412
-11
451
6
810
288
-346
905
194
-46
141
1,760
28
322
476
1,993
666
33
521
415
455
451
46
1,268
439
1,376
1,486
1,007
816
40
-385
241
341
94
393
-73
840
344
555
1,590
94
395
368
423
-68
24
183
245
172
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
112,906
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
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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?
Yes
No
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
81,909
1,569,682
0.052182
2010
81,055
1,593,552
0.050864
2009
67,939
1,507,969
0.045053
2008
80,728
1,353,628
0.059638
2007
81,154
1,556,211
0.052148
2
Total
of line 1, column (d)
......................
2
0.259885
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
0.051977
4
Enter the net value of noncharitable-use assets for 2012 from Part X, line 5
.....
4
1,592,963
5
Multiply line 4 by line 3
.......................
5
82,797
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
1,321
7
Add lines 5 and 6
.........................
7
84,118
8
Enter qualifying distributions from Part XII, line 4
..............
8
79,764
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
Exempt operating foundations described in section 4940(d)(2), check here
and enter “N/A” on line 1.
Date of ruling or determination letter:
(attach copy of letter if necessary–see instructions)
b
Domestic foundations that meet the section 4940(e) requirements in Part V, check
1
2,642
here
and enter 1% of Part I, line 27b
...................
c
All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
2
0
3
Add lines 1 and 2
............................
3
2,642
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-).
4
0
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
2,642
6
Credits/Payments:
a
2012 estimated tax payments and 2011 overpayment credited to 2012
6a
2,112
b
Exempt foreign organizations—tax withheld at source
.......
6b
c
Tax paid with application for extension of time to file (Form 8868)
6c
0
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
2,112
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
0
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
530
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
11
Enter the amount of line 10 to be:
Credited to 2013 estimated tax
0
Refunded
11
0
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.
$
(2)
On foundation managers.
$
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
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)
VA
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 address
14
The books are in care of
BRANCH BANKING & TRUST COMPANY
Telephone no.
(540) 665-4254
Located at
38 ROUSE AVE
WINSCHESTER
VA
ZIP+4
22601
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—Check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
......
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
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?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
.........................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(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)?
.................
Yes
No
(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.)
.........
Yes
No
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
Organizations relying on a current notice regarding disaster assistance check here
.........
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?
...............
Yes
No
If “Yes,” list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer “No” and attach statement—see instructions.)
..............
2b
No
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
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?
.........................
Yes
No
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))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
...............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(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)
........
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
........
Yes
No
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
Organizations relying on a current notice regarding disaster assistance check here
.........
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?
............
Yes
No
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?
........................
Yes
No
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?
Yes
No
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
BRANCH BANKING AND TRUST COMPANY
TRUSTEE
1
22,625
38 ROUSE AVE
WINCHESTER
,
VA
22601
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
...................
0
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
NONE
Total
number of others receiving over $50,000 for professional services
.............
0
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
..........................
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
1,571,446
b
Average of monthly cash balances
.......................
1b
45,775
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
1,617,221
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation)
.............
1e
0
2
Acquisition indebtedness applicable to line 1 assets
..................
2
0
3
Subtract line 2 from line 1d
.........................
3
1,617,221
4
Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see
instructions)
.............................
4
24,258
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
1,592,963
6
Minimum investment return.
Enter 5% of line 5
..................
6
79,648
Part XI
Distributable Amount
(see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here
and do not complete this part.)
1
Minimum investment return from Part X, line 6
....................
1
79,648
2a
Tax on investment income for 2012 from Part VI, line 5
......
2a
2,642
b
Income tax for 2012. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
2,642
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
77,006
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
77,006
6
Deduction from distributable amount (see instructions)
.................
6
0
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII,
line 1
................................
7
77,006
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
79,764
b
Program-related investments—total from Part IX-B
..................
1b
0
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
0
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
0
b
Cash distribution test (attach the required schedule)
.................
3b
0
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
79,764
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
0
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
79,764
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
77,006
2
Undistributed income, if any, as of the end of 2012:
a
Enter amount for 2011 only
.......
18,523
b
Total for prior years:
2010
,
20
,
20
0
3
Excess distributions carryover, if any, to 2012:
a
From 2007
.......
0
b
From 2008
.......
0
c
From 2009
.......
0
d
From 2010
.......
0
e
From 2011
.......
0
f
Total
of lines 3a through e
.........
0
4
Qualifying distributions for 2012 from Part
XII, line 4:
$
79,764
a
Applied to 2011, but not more than line 2a
18,523
b
Applied to undistributed income of prior years
(Election required—see instructions)
......
0
c
Treated as distributions out of corpus (Election
required—see instructions)
.........
0
d
Applied to 2012 distributable amount
.....
61,241
e
Remaining amount distributed out of corpus
0
5
Excess distributions carryover applied to 2012.
0
0
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
0
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
...........
0
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
......
0
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
0
e
Undistributed income for 2011. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
0
f
Undistributed income for 2012. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2013
..........
15,765
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (see
instructions)
.............
0
8
Excess distributions carryover from 2007 not
applied on line 5 or line 7 (see instructions)
...
0
9
Excess distributions carryover to 2013.
Subtract lines 7 and 8 from line 6a
......
0
10
Analysis of line 9:
a
Excess from 2008
....
0
b
Excess from 2009
....
0
c
Excess from 2010
....
0
d
Excess from 2011
....
0
e
Excess from 2012
....
0
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
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
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.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
NONE
b
List 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
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. (see instructions) to individuals or organizations under
other conditions, complete items 2a, b, c, and d.
a
The name, address, and telephone number or e-mail of the person to whom applications should be addressed:
DENA KANE
38 ROUSS AVE
WINCHESTER
,
VA
226014738
(540) 665-4218
b
The form in which applications should be submitted and information and materials they should include:
WRITTEN REQUEST - MUST DEMONSTRATE NEED AND QUALIFICATIONS WITHIN PARAMETERS OF FOUNDATION PURPOSE.
c
Any submission deadlines:
MAY 31, ANNUALLY
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
CHARITIES MUST BE IN WINCHESTER AND SURROUNDING AREAS. EMPHASIS IS PLACED ON PERSONAL SERVICES.
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)
a
Paid during the year
AMERICAN CANCER SOCIETY
PO BOX 720366
OKLAHOMA CITY
,
OK
73162
NONE
PUBLIC CHARITY
GENERAL FUNDS
500
BILLY GRAHAM EVANGELISTIC ASSN
1 BILLY GRAHAM PARKWAY
CHARLOTTE
,
NC
28201
NONE
PUBLIC CHARITY
GENERAL FUNDS
9,716
FERRUM COLLEGE
COLLEGE RELATIONS OFFICE
FERRUM
,
VA
24088
NONE
PUBLIC CHARITY
SCHOLARSHIP FUNDS
9,716
DAUGHTERS OF THE
AMERICAN REVOLUTION
1776 D STREET NW - ADM BLDG
WASHINGTON
,
DC
20006
NONE
PUBLIC CHARITY
GENERAL FUNDS
9,716
ADULT CARE CENTER OF THE NORTHERN
SHENANDOAH VALLEY INC
115 WOLFE ST
WINCHESTER
,
VA
22601
NONE
PUBLIC CHARITY
TO ASSIST NEEDY ELDERLY
1,300
AMERICAN RED CROSS
561 FORTRESS DR
WINCHESTER
,
VA
22603
NONE
PUBLIC CHARITY
EMERGENCY ASSISTANCE
900
BIG BROTHERSBIG SISTERS OF
WINCHESTER FREDERICK & CLARKE CNTY
121 YOUTH DEVELOPMENT COURT
WINCHESTER
,
VA
22601
NONE
PUBLIC CHARITY
GENERAL FUNDS
1,100
BLUE RIDGE AREA FOOD BANK
P O BOX 937
VERONA
,
VA
24482
NONE
PUBLIC CHARITY
PUBLIC ASSISTANCE FOR NEEDY
1,500
BLUE RIDGE HOSPICE INC
333 WEST CORK ST
WINCHESTER
,
VA
22604
NONE
PUBLIC CHARITY
GENERAL FUNDS
1,200
C-CAP OF WINCHESTER
PO BOX 2112
WINCHESTER
,
VA
22604
NONE
PUBLIC CHARITY
GENERAL FUNDS
1,200
CHILD ASSAULT PREVENTION PROGRAM
125 YOUTH DEVELOPMENT COURT
WINCHESTER
,
VA
22602
NONE
PUBLIC CHARITY
GENERAL FUNDS
1,000
CONCERN HOTLINE
P O BOX 2032
WINCHESTER
,
VA
22601
NONE
PUBLIC CHARITY
GENERAL FUNDS
400
FREE MEDICAL CLINIC OF WINCHESTER
301 N CAMERON ST SUITE 100
WINCHESTER
,
VA
22601
NONE
PUBLIC CHARITY
GENERAL FUNDS
1,500
KIDS ARE OUR CONCERN (CLEAN)
123 YOUTH DEVELOPMENT COURT
WINCHESTER
,
VA
22602
NONE
PUBLIC CHARITY
GENERAL FUNDS
500
LEARY EDUCATIONAL FOUNDATION
P O BOX 3160
WINCHESTER
,
VA
22604
NONE
PUBLIC CHARITY
GENERAL FUNDS
500
UNITED WAY OF WINCHESTER
FREDERICK & CLARKE COUNTIES
PO BOX 460
WINCHESTER
,
VA
22604
NONE
PUBLIC CHARITY
GENERAL FUNDS
800
WILLIAM AND HENRY EVANS HOME INC
330 EAST LEICESTER ST
WINCHESTER
,
VA
22601
NONE
PUBLIC CHARITY
GENERAL FUNDS
400
HEALTHY FAMILIES OF THE
NORTHERN SHENANDOAH VALLEY
P O BOX 146
GORE
,
VA
22637
NONE
PUBLIC CHARITY
GENERAL FUNDS
900
NATIONAL DIVISION OF GENERAL BOARD
GLOBAL MISSIONS OF UMC
475 RIVERSIDE DRIVE
NEW YORK
,
NY
10115
NONE
PUBLIC CHARITY
GENERAL FUNDS
9,716
SALVATION ARMY OF WINCHESTER
P O BOX 2745
WINCHESTER
,
VA
22604
NONE
PUBLIC CHARITY
GENERAL FUNDS
900
VIRGINIA UNITED METHODIST FAMILY
SERVICES
3900 WEST BROAD ST
RICHMOND
,
VA
23230
NONE
PUBLIC CHARITY
ASSIST NEEDY FAMILIES
19,432
THE LAUREL CENTER
POST OFFICE BOX 14
WINCHESTER
,
VA
22604
NONE
EXEMPT
GENERAL FUNDS
1,400
BOYS AND GIRLS CLUB OF NORTHERN
WINCHESTER
121 YOUTH DEVELOPMENT COURT
WINCHESTER
,
VA
22602
NONE
EXEMPT
COMMUNITY
1,000
WINCHESTER EDUCATION FOUNDATION
14 NORTH BRADDOCK STREET
WINCHESTER
,
VA
22601
NONE
EXEMPT
EDUCATIONAL
3,000
Total
.................................
3a
78,296
b
Approved for future payment
Total
.................................
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.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash investments
14
1,457
4
Dividends and interest from securities
....
14
41,619
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not debt-financed property
.....
6
Net rental income or (loss) from personal property
7
Other investment income
.....
8
Gain or (loss) from sales of assets other than inventory
18
112,906
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
..
11
Other revenue:
a
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
155,982
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
155,982
(See worksheet in line 13 instructions to verify calculations.)
Part XVI-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
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?
...........
Yes
No
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.
May the IRS discuss this return
with the preparer shown below
(see instr.)?
Yes
No
Signature of officer or trustee
Date
Title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's Signature
Date
Check if self-
employed
PTIN
Firm's name
Firm's address
Firm's EIN
Phone no.
Form
990-PF
(2012)
Additional Data
Software ID:
Software Version:
Form 990PF - Special Condition Description:
Special Condition Description
-
TIN:
TY 2012 OtherIncreasesSchedule
Name:
RIDGEWAY EM-CHARITTUW
EIN:
54-6202908
Description
Amount
DIFF IN MUTUAL FDS REC/REPORTED
1,405
ADJUSTMENT FOR ROUNDING
9