Form990-PF
Click to see attachment

Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Nonexempt Charitable Trust
Treated as a Private Foundation
Note. The foundation may be able to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0052
2012
Open to Public Inspection
For calendar year 2012, or tax year beginning 10-01-2012 , and ending 09-30-2013
Name of foundation
Deborah Lincoln House
 

Number and street (or P.O. box number if mail is not delivered to street address)60 Cedar Street   Room/suite
City or town, state, and ZIP code
Belfast, ME04915
A Employer identification number

01-0226346
B Telephone number (see instructions)

(207) 338-1554
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$6,663,380
J Accounting method:
 
(Part I, column (d) must be on cash basis.)
E bullet
F bullet
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books
(b) Net investment
income
(c) Adjusted net
income
(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet
3 Interest on savings and temporary cash investments 43 43  
4 Dividends and interest from securities...... 272,410 272,410  
5a Gross rents.............. 6,000 6,000  
b Net rental income or (loss) 3,187
6a Net gain or (loss) from sale of assets not on line 10 1,048,822
b Gross sales price for all assets on line 6a 4,851,267
7 Capital gain net income (from Part IV, line 2)... 1,048,822
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)....... 264,873    
12 Total. Add lines 1 through 11........ 1,592,148 1,327,275  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 72,361     72,361
14 Other employee salaries and wages...... 181,120     181,120
15 Pension plans, employee benefits....... 34,126     34,126
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... 10,780     10,780
c Other professional fees (attach schedule).... 65,037 64,189   848
17 Interest...............        
18 Taxes (attach schedule) (see instructions) 18,548     18,548
19 Depreciation (attach schedule) and depletion... 20,311 2,813  
20 Occupancy.............. 50,871     69,843
21 Travel, conferences, and meetings....... 37     37
22 Printing and publications..........        
23 Other expenses (attach schedule)....... 187,956     187,956
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 641,147 67,002   575,619
25 Contributions, gifts, grants paid........ 264 264
26 Total expenses and disbursements. Add lines 24 and 25 641,411 67,002   575,883
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 950,737
b Net investment income (if negative, enter -0-) 1,260,273
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............... 17,184 169,149 169,148
2 Savings and temporary cash investments.......... 270,005 202,715 202,715
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)........ 3,627,221 5,338,976 5,504,650
c Investments—corporate bonds (attach schedule)........ 1,194,285 349,000 290,000
11 Investments—land, buildings, and equipment: basis bullet87,602
Less: accumulated depreciation (attach schedule) bullet67,241 23,174 Click to see attachment20,361 100,700
12 Investments—mortgage loans..............      
13 Investments—other (attach schedule)...........      
14 Land, buildings, and equipment: basis bullet418,423
Less: accumulated depreciation (attach schedule) bullet169,301 246,521 Click to see attachment249,122 392,067
15 Other assets (describe bullet) Click to see attachment4,100 Click to see attachment4,100 Click to see attachment4,100
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 5,382,490 6,333,423 6,663,380
Liabilities 17 Accounts payable and accrued expenses.......... 4,116 4,813
18 Grants payable...................    
19 Deferred revenue.................. 500  
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet) Click to see attachment1  
23 Total liabilities (add lines 17 through 22).......... 4,617 4,813
Net Assets or Fund Balances bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted.................... 5,377,873 6,328,610
25 Temporarily restricted................    
26 Permanently restricted................    
bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds.........    
28 Paid-in or capital surplus, or land, bldg., and equipment fund    
29 Retained earnings, accumulated income, endowment, or other funds    
30 Total net assets or fund balances (see page 17 of the
instructions).................... 5,377,873 6,328,610
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 5,382,490 6,333,423
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 5,377,873
2 Enter amount from Part I, line 27a..................... 2 950,737
3 Other increases not included in line 2 (itemize) bullet 3  
4 Add lines 1, 2, and 3.......................... 4 6,328,610
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 6,328,610
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 Various Securities - ST P 2012-12-31 2012-09-30
b Various Securities - LT P 2000-12-31 2013-09-30
c
d
e
(e) Gross sales price (f) Depreciation allowed
(or allowable)
(g) Cost or other basis
plus expense of sale
(h) Gain or (loss)
(e) plus (f) minus (g)
a 1,081,019   927,026 153,993
b 3,770,248   2,875,419 894,829
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l) Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i) F.M.V. as of 12/31/69 (j) Adjusted basis
as of 12/31/69
(k) Excess of col. (i)
over col. (j), if any
a       153,993
b       894,829
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
Bracket 2 1,048,822
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 . . . . . . . . . . . . . . . .
Bracket 3  
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)

If section 4940(d)(2) applies, leave this part blank.
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period?
If “Yes,” the foundation does not qualify under section 4940(e). Do not complete this part.
1 Enter the appropriate amount in each column for each year; see page 18 of the instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in)
(b)
Adjusted qualifying distributions
(c)
Net value of noncharitable-use assets
(d)
Distribution ratio
(col. (b) divided by col. (c))
2011      
2010      
2009      
2008      
2007      
2 Total of line 1, column (d) ...................... 2  
3 Average distribution ratio for the 5-year base period—divide the total on line 2 by 5, or by
the number of years the foundation has been in existence if less than 5 years
. . .
3  
4 Enter the net value of noncharitable-use assets for 2012 from Part X, line 5..... 4  
5 Multiply line 4 by line 3....................... 5  
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6  
7 Add lines 5 and 6......................... 7  
8 Enter qualifying distributions from Part XII, line 4.............. 8  
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See
the Part VI instructions.
Form 990-PF (2012)
Form 990-PF (2012)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see page 18 of the instructions)
1a Bulletand enter “N/A” on line 1. Bracket
Date of ruling or determination letter: 1995-10-04(attach copy of letter if necessary–see instructions)
b 1 N/A
hereBulletand enter 1% of Part I, line 27b...................
c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2  
3 Add lines 1 and 2............................ 3  
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-). 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5  
6 Credits/Payments:
a 2012 estimated tax payments and 2011 overpayment credited to 2012 6a  
b Exempt foreign organizations—tax withheld at source....... 6b
c Tax paid with application for extension of time to file (Form 8868) 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7  
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2013 estimated taxBullet   Refunded Bullet 11  
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see page 19 of
the instructions for definition)?............................
1b
 
No
If the answer is “Yes” to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If “Yes,” attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If “Yes,” attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If “Yes,” has it filed a tax return on Form 990-T for this year?...................
4b
 
No
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If “Yes,” attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
  • that conflict with the state law remain in the governing instrument?................
    6
     
    No
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If “Yes,” complete Part II, col. (c), and Part XV.
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bullet
    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
    Yes
     
    10
    Did any persons become substantial contributors during the tax year? If “Yes,” attach a schedule listing their names and addresses.
    10
     
    No
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. (see instructions) .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement (see instructions).................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletN/A
    14
    The books are in care ofbulletDiane F Martin Telephone no.bullet (207) 338-1554
    Located atbullet60 Cedar StreetBelfastME ZIP+4bullet04915
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041.........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ......bullet
    15  
    16
    At any time during calendar year 2012, did the foundation have an interest in or a signature or other authority over
    a bank, securities, or other financial account in a foreign country? .................
    16
     
    No
    See instructions for exceptions and filing requirements for Form TD F 90-22.1. If "Yes", enter the name of the foreign country bullet  
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 5
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the “Yes” column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?.........................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?.................
    (6) Agree to pay money or property to a government official? (Exception. Check “No”
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).........
    b
    If any answer is “Yes” to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance (see page 20 of the instructions)?...
    1b
     
    No
    .........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2012?.............
    1c
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2012, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2012?...............
    If “Yes,” list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer “No” and attach statement—see instructions.) ..............
    2b
     
    No
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?.........................
    b
    If “Yes,” did it have excess business holdings in 2012 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2012.)....................
    3b
     
    No
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2012?
    4b
     
    No
    5a
    During the year did the foundation pay or incur any amount to:
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?...............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 509(a)(1), (2), or (3), or section 4940(d)(2)? (see instructions)........
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?........
    b
    If any answer is “Yes” to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance (see instructions)? ......
    5b
     
    No
    .........bullet
    c
    If the answer is “Yes” to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?............
    If “Yes,” attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?........................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?....
    6b
     
    No
    If “Yes” to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
    No
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 6
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation (see instructions).
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation
    (If not paid, enter
    -0-)
    (d) Contributions to
    employee benefit plans
    and deferred compensation
    (e) Expense account,
    other allowances
    Sharron Walsh Director
    1.00
    0    
    97 Dockside Walsh
    Belfast,ME04915
    Randolph Mailloux Director
    1.00
    0    
    151 High Street
    Belfast,ME04915
    Cathy Reynolds Vice President
    1.00
    0    
    115 Poors Mill Road
    Morrill,ME04952
    Diane Martin Administrator
    40.00
    65,444 6,917  
    58 Bicknell Road
    Belmont,ME04952
    Bruce Starrett Director
    1.00
    0    
    31 High Street
    Belfast,ME04915
    Anita Starrett Director
    1.00
    0    
    62 Battery Road
    Belfast,ME04915
    Andrea Walker Director
    1.00
    0    
    816 Moody Mtn Road
    Searsmont,ME04973
    Michael Nickerson Treasurer
    2.00
    0    
    12 Priscilla Lane
    Belfast,ME04915
    Philip Crosby Director
    1.00
    0    
    28 Durham St
    Belfast,ME04915
    Anne Abercombie Director
    1.00
    0    
    100 Cliff Road
    Northport,ME04849
    Arthur Hayes President
    1.00
    0    
    35 Church Street
    Belfast,ME04915
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE.”
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation
    (e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet  
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1 Operation of state-licensed boarding facility for elderly women 576,376
    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
    6,051,727
    b
    Average of monthly cash balances.......................
    1b
    238,313
    c
    Fair market value of all other assets (see instructions)................
    1c
    466,867
    d
    Total (add lines 1a, b, and c).........................
    1d
    6,756,907
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
     
    3
    Subtract line 2 from line 1d.........................
    3
    6,756,907
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see
    instructions) .............................
    4
    101,354
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    6,655,553
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    332,778
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
     
    2a
    Tax on investment income for 2012 from Part VI, line 5......
    2a
     
    b
    Income tax for 2012. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
     
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
     
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
     
    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
     
    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
    575,883
    b
    Program-related investments—total from Part IX-B..................
    1b
     
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    575,883
    5
    Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
    income. Enter 1% of Part I, line 27b (see instructions).................
    5
     
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    575,883
    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  
    2 Undistributed income, if any, as of the end of 2012:
    a Enter amount for 2011 only.......  
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2012:
    a From 2007.......  
    b From 2008.......  
    c From 2009.......  
    d From 2010.......  
    e From 2011.......  
    fTotal of lines 3a through e.........  
    4Qualifying distributions for 2012 from Part
    XII, line 4: bullet$  
    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.....  
    e Remaining amount distributed out of corpus  
    5 Excess distributions carryover applied to 2012.    
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5  
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ...........
     
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......
     
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........
     
    e Undistributed income for 2011. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............
     
    f Undistributed income for 2012. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2013 ..........
     
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (see
    instructions) .............
     
    8Excess distributions carryover from 2007 not
    applied on line 5 or line 7 (see instructions) ...
     
    9Excess distributions carryover to 2013.
    Subtract lines 7 and 8 from line 6a ......
     
    10 Analysis of line 9:
    a Excess from 2008....  
    b Excess from 2009....  
    c Excess from 2010....  
    d Excess from 2011....  
    e Excess from 2012....  
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 9
    Part XIV
    Private Operating Foundations (see instructions and Part VII-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2012, enter the date of the ruling.......bullet
    1973-12-13
    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
    0     207,199 207,199
    b 85% of line 2a .........       176,119 176,119
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....
    575,883 701,189 683,221 600,533 2,560,826
    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 ....
    575,883 701,189 683,221 600,533 2,560,826
    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...
    221,852 221,494 215,270 204,546 863,162
    c “Support” alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....
             
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....
             
    (3) Largest amount of support
    from an exempt organization
             
    (4) Gross investment income          
    Part XV
    Supplementary Information (Complete this part only if the organization had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 10
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    Foundation
    status of
    recipient
    Purpose of grant or
    contribution
    Amount
    Name and address (home or business)
    aPaid during the year
    Various Individuals
    60 Cedar Street
    Belfast,ME04915
    None N/A Support of Individuals 189
    VFW
    34 Field Street
    Belfast,ME04915
    N/A Public Support 75
    Total .................................bullet 3a 264
    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 43  
    4 Dividends and interest from securities....     14 272,410  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....     16 3,187  
    6Net rental income or (loss) from personal property          
    7 Other investment income.....          
    8Gain or (loss) from sales of assets other than inventory     18 1,048,822  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory..          
    11 Other revenue: aResident Assignments         78,043
    bMiscellaneous Income         739
    cFunds Held by Others     14   186,091
    d
    e
    12 Subtotal. Add columns (b), (d), and (e)..   1,324,462 264,873
    13Total. Add line 12, columns (b), (d), and (e)..................
    131,589,335
    (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.)
    11 The organization is a lifetime care facility for elderly women. Upon entering the home, residents assign assets and future income to the Deborah Lincoln House. The organization is responsible for meeting all support and medical needs of the residents.
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 12
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section
    Yes
    No
    501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is “Yes,” complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527?...........
    b
    If “Yes,” complete the following schedule.
    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer or fiduciary) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below
    (see instr.)?
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's namebullet



    Firm's addressbullet







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


    Software ID: 12000229
    Software Version: 2012v2.0


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2012 AccountingFeesSchedule
    Name:
    Deborah Lincoln House
    EIN: 01-0226346
    Software ID:12000229
    Software Version:2012v2.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Accounting 10,780 0 0 10,780

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

    TY 2012 DepreciationSchedule
    Name:
    Deborah Lincoln House
    EIN: 01-0226346
    Software ID:12000229
    Software Version:2012v2.0
    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
    Safe Step Tub 2013-08-06 9,700   91 7.0000 231      
    Massage Table 2013-01-17 270   91 7.0000 26      
    Bed Mattress 2012-11-15 997   91 5.0000 183      
    Lamps 2012-10-03 328   91 7.0000 47      
    Living Room Picture 2013-07-15 205   91 7.0000 7      
    Office Computer 2013-07-12 403   91 5.0000 20      
    Computer Equipment 2013-06-27 283   91 5.0000 14      
    Sofa 2013-05-27 749   91 7.0000 36      
    (2) Living Rm Chairs 2013-05-10 628   91 7.0000 37      
    Valances/Cellular Shades 2013-05-10 2,105   91 5.0000 175      
    Chair 2013-04-26 329   91 7.0000 20      
    Computer 2013-04-19 705   91 5.0000 59      
    Living Room Shades 2012-11-19 685   91 5.0000 114      
    Chair 2013-04-03 449   91 7.0000 32      
    Living room lights 2013-04-02 435   91 7.0000 31      
    Fireplace mantel 2013-03-13 640   91 39.0000 10      
    Living Room Carpet 2013-04-03 1,188   91 7.0000 85      
    Television 2012-05-03 548 46 91 5.0000 110      
    Flooring - Room 5 2011-12-21 763 82 91 7.0000 109      
    Back Porch 2011-11-18 8,995 192 91 39.0000 231      
    Fire Alarm System 2012-08-08 7,695 33 91 39.0000 197      
    Windows 2012-02-22 888 13 91 39.0000 23      
    Insulation for 60 Cedar 2011-10-11 76,410 1,959 91 39.0000 1,959      
    Foundation Improvement 2011-04-14 3,400 127 87 2.56 % 87 87    
    2011 Dodge Grand Caravan 2011-07-06 27,513 6,879 91 5.0000 5,503      
    Refrigerator for Matrons 2011-01-27 469 157 91 5.0000 94      
    Electric water heater 2011-06-24 2,912 94 91 39.0000 75      
    Outside outlet wiring 2011-06-24 587 19 91 39.0000 15      
    Generator 2011-06-24 3,600 900 91 5.0000 720      
    UnImage Awning 2011-05-20 2,950 561 91 7.0000 421      
    Laundry room renovation 2011-04-28 8,705 316 91 39.0000 223      
    Carpet - dining room 2011-04-28 928 199 58 14.29 % 133      
    Freezer 2009-10-19 300 175 91 5.0000 60      
    Electrical improvements 2010-03-19 2,800 180 91 39.0000 72      
    Recliner chair for matron 2010-03-04 524 187 58 14.28 % 75      
    Dishwasher 2009-10-19 640 373 91 5.0000 128      
    Ramp 2009-09-07 744 59 91 39.0000 19      
    Washing Machine 2009-01-27 404 297 91 5.0000 81      
    Driveway Paving 2007-10-25 5,800 2,852 91 10.0000 580      
    Garage 2007-10-12 32,900 4,220 91 39.0000 844      
    Refrigerator 2008-02-15 1,514 1,414 91 5.0000 100      
    Sun Scape Awning 2008-05-08 850 751 91 5.0000 99      
    Furniture - Macleods 2006-06-06 2,115 1,963 58 7.14 % 152      
    Renovations 56 Cedar 2006-06-06 5,926 955 87 2.56 % 152 152    
    Roof 56 Cedar 2006-11-05 2,700 477 87 2.56 % 69 69    
    Kitchen windows 2006-02-03 743 128 87 2.56 % 19      
    Boiler 2004-03-01 7,457 1,640 87 2.56 % 191      
    Chimney 2004-08-01 12,221 2,557 87 2.56 % 313      
    All new windows 2000-10-01 8,400 2,582 87 2.56 % 215      
    Storm Window 1999-05-01 1,218 420 87 2.56 % 31      
    New kitchen 1998-10-01 6,079 2,125 87 2.56 % 156      
    Cabinets in kitchen 1998-09-01 1,500 1,026 87 2.56 % 38      
    Wallpaper 1997-02-01 301 123 87 2.56 % 8      
    Renovation 8 and 9 1997-03-01 4,134 1,652 87 2.56 % 106      
    Boiler 1997-04-01 1,484 590 87 2.56 % 38      
    Renovation 8 and 9 1997-04-01 2,098 895 87 2.56 % 54      
    Wiring 1997-05-01 817 402 87 2.56 % 21      
    Various 1996-01-01 931 412 87 2.56 % 24      
    Furnace 22 Cedar 1995-06-01 2,571 1,187 87 2.56 % 66 66    
    Various 24 Cedar 1995-03-01 18,230 8,122 87 2.56 % 467      
    Insulation 22 Cedar 1995-09-01 1,822 1,381 85 3.64 % 66 66    
    2 Bathrooms and porch 1991-11-01 45,137 33,442 85 3.64 % 1,642      
    Insulation 22 Cedar 1991-05-01 1,717 1,252 91 30.0000 57 57    
    House 22 Cedar 1987-01-01 69,466 59,049 91 30.0000 2,316 2,316    
    Furnace 1988-07-01 8,043 6,501 91 30.0000 268      
    Bathroom 1988-02-01 5,580 4,572 91 30.0000 186      
    Improvements 1988-01-01 1,461 1,203 91 30.0000 49      
    Drywall 1987-11-01 2,200 1,819 91 30.0000 73      
    Improvements 1987-03-01 1,512 1,283 91 30.0000 50      
    Improvements 1987-03-01 1,005 857 91 30.0000 34      
    Improvements 1986-01-01 1,851 1,637 91 30.0000 62      
    Improvements 1985-01-01 9,088 8,331 91 30.0000 303      

    TY 2012 InvestmentsLandSchedule2
    Name:
    Deborah Lincoln House
    EIN: 01-0226346
    Software ID:12000229
    Software Version:2012v2.0
    Category/ Item Cost/Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
    Land       28,800
    Buildings 87,602 67,241 20,361 71,900

    TY 2012 LandEtcSchedule2
    Name:
    Deborah Lincoln House
    EIN: 01-0226346
    Software ID:12000229
    Software Version:2012v2.0
    Category / Item Cost / Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
    Land       30,000
    Buildings 317,723 109,398 208,325 362,067
    Machinery and Equipment 50,601 45,173 5,428  
    Furniture and Fixtures 22,586 2,348 20,238  
    Auto./Transportation Equip. 27,513 12,382 15,131  


    TY 2012 OtherAssetsSchedule
    Name:
    Deborah Lincoln House
    EIN: 01-0226346
    Software ID:12000229
    Software Version:2012v2.0
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    Deposits Receivable 4,100 4,100 4,100


    TY 2012 OtherExpensesSchedule
    Name:
    Deborah Lincoln House
    EIN: 01-0226346
    Software ID:12000229
    Software Version:2012v2.0
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Vehicle Expense 1,163     1,163
    Telephone 4,283     4,283
    Residents - Supplies 3,306     3,306
    Residents - Supplemental Ins 15,495     15,495
    Residents - Other 8,176     8,176
    Residents - Medical 80,171     80,171
    Residents - Allowances 14,350     14,350
    Professional Development 1,551     1,551
    Office Supplies 3,647     3,647
    Miscellaneous 1,208     1,208
    Licenses & Fees 120     120
    Insurance 21,026     21,026
    Food and Supplies 31,123     31,123
    Dues & Subscriptions 1,058     1,058
    Bank Charges 68     68
    Advertising 1,211     1,211


    TY 2012 OtherIncomeSchedule2
    Name:
    Deborah Lincoln House
    EIN: 01-0226346
    Software ID:12000229
    Software Version:2012v2.0
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    Resident Assignments 78,043    
    Miscellaneous Income 739    
    Funds Held by Others 186,091    


    TY 2012 OtherProfessionalFeesSchedule
    Name:
    Deborah Lincoln House
    EIN: 01-0226346
    Software ID:12000229
    Software Version:2012v2.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Investment Fees 64,189 64,189 0 0
    Consulting 705 0 0 705
    All Other 143 0 0 143


    TY 2012 TaxesSchedule
    Name:
    Deborah Lincoln House
    EIN: 01-0226346
    Software ID:12000229
    Software Version:2012v2.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Payroll Tax 18,402     18,402
    All Other Taxes 146     146