Form990-PF

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

Number and street (or P.O. box number if mail is not delivered to street address)P O BOX 3168   Room/suite
City or town, state, and ZIP code
PORTLAND, OR97208
A Employer identification number

87-6115493
B Telephone number (see instructions)

(503) 275-4327
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$1,002,830
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      
4 Dividends and interest from securities...... 23,248 23,248  
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 56,082
b Gross sales price for all assets on line 6a 469,523
7 Capital gain net income (from Part IV, line 2)... 56,082
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........ 79,330 79,330  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 15,569 14,012   1,557
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)....... 1,500 0 0 1,500
c Other professional fees (attach schedule)....       0
17 Interest...............       0
18 Taxes (attach schedule) (see instructions) 1,059 442   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)....... 1     1
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 18,129 14,454 0 3,058
25 Contributions, gifts, grants paid........ 42,500 42,500
26 Total expenses and disbursements. Add lines 24 and 25 60,629 14,454 0 45,558
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 18,701
b Net investment income (if negative, enter -0-) 64,876
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
Assets 1 Cash—non-interest-bearing...............      
2 Savings and temporary cash investments.......... 11,142 26,035 26,035
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet   351 0 0
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 bullet0      
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)........ 739,911 Click to see attachment771,626 845,409
c Investments—corporate bonds (attach schedule)........ 153,082 Click to see attachment125,521 131,386
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans..............      
13 Investments—other (attach schedule)...........     0
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 904,486 923,182 1,002,830
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable...................    
19 Deferred revenue..................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22)..........   0
Net Assets or Fund Balances bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted....................    
25 Temporarily restricted................    
26 Permanently restricted................    
bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds......... 904,486 923,182
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).................... 904,486 923,182
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 904,486 923,182
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)............... 1 904,486
2 Enter amount from Part I, line 27a..................... 2 18,701
3 Other increases not included in line 2 (itemize) bullet 3 0
4 Add lines 1, 2, and 3.......................... 4 923,187
5 Decreases not included in line 2 (itemize) bulletClick to see attachment 5 5
6 Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30. 6 923,182
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 10000. BARCLAYS 24MO DJUBS 10/12/12   2010-10-07 2012-10-12
b 12. CF INDUSTRIES HOLDINGS INC     2012-10-12
c 25. MCKESSON CORPORATION   2011-11-21 2012-10-12
d 69. STARBUCKS CORP     2012-10-12
e 10000. BNP 24MO EEM CALLABLE 10/17/12   2010-10-07 2012-10-17
.3333 KRAFT FOODS GROUP INC   2012-09-19 2012-10-18
133. MICROSOFT CORP COM     2012-10-23
432.943 DRIEHAUS SELECT CREDIT FUND   2011-07-20 2012-11-06
80.711 DRIEHAUS SELECT CREDIT FUND   2011-08-22 2012-11-06
503.687 LOOMIS SAYLES STRATEGIC ALPHA FUND Y     2012-11-06
32. P N C FINANCIAL SERVICES GROUP INC   2012-03-14 2012-11-06
80. VALERO ENERGY CORP   2012-09-19 2012-11-06
57. EATON CORP   2012-06-24 2012-12-03
1685.469 AMER CENT DIVERSIFI BOND INS     2012-12-14
96. B M C SOFTWARE INC     2012-12-14
81. E M C CORPORATION   2012-04-23 2012-12-14
69. FOOT LOCKER INC     2012-12-14
33. HOME DEPOT INC   2012-02-24 2012-12-14
50. KRAFT FOODS GROUP INC     2012-12-14
53. MACYS INC   2012-08-10 2012-12-14
49. MACYS INC   2012-11-06 2012-12-14
25. UNITED TECHNOLOGIES CORP   2003-10-08 2012-12-14
124.532 ABERDEEN FDS EMRGN   2012-01-04 2013-01-04
10. APPLE COMPUTER INC   2010-08-13 2013-01-04
85. DOLLAR TREE INC     2013-01-04
111. LOWES CO INC   2012-12-14 2013-01-04
60.883 NEUBERGER BERMAN GENESIS INSTL FD   2009-04-13 2013-01-04
33.338 NEUBERGER BERMAN GENESIS INSTL FD   2012-01-04 2013-01-04
104.904 NEUBERGER BERMAN GENESIS INSTL FD     2013-01-04
71.504 NEUBERGER BERMAN GENESIS INSTL FD   2011-08-22 2013-01-04
72. STARBUCKS CORP     2013-01-04
. DELL INC     2013-01-09
44. ALLERGAN INC     2013-01-25
39. CVS CAREMARK CORP   2012-02-24 2013-01-25
52. CAPITAL ONE FINANCIAL CORP     2013-01-25
110.497 FORWARD INTERNATIONAL REAL ESTATE   2012-06-22 2013-01-25
91. GENERAL ELEC CO   2012-05-02 2013-01-25
48.239 GOLDMAN SACHS M C VALUE CL INST   2011-06-27 2013-01-25
36. JARDEN CORP   2012-09-19 2013-01-25
1. KRAFT FOODS GROUP INC   2012-09-19 2013-01-25
185.351 NUVEEN MID CAP GRWTH OPP FD CL I   2009-04-13 2013-01-25
49. POLARIS INDS INC     2013-01-25
18. STARZ A   2012-11-06 2013-01-25
534.745 MORGAN DEMPSEY SMALL MICRO CAP VALUE   2013-01-04 2013-01-25
166. BANK OF AMERICA CORP   2012-08-23 2013-02-19
101. FREEPORT MCMORAN COPPER GOLD     2013-02-19
28. NATIONAL-OILWELL INC   2012-09-19 2013-02-19
95.286 NEUBERGER BERMAN GENESIS INSTL FD   2009-04-13 2013-02-19
99.869 NEUBERGER BERMAN GENESIS INSTL FD   2012-01-04 2013-02-19
168. STAPLES INC   2012-09-19 2013-02-19
133. STAPLES INC   2012-05-02 2013-02-19
694.215 MORGAN DEMPSEY SMALL MICRO CAP VALUE   2013-01-04 2013-02-19
57. EATON CORP PLC   2012-11-30 2013-02-19
75. ROYAL CARIBBEAN CRUISES LTD   2013-01-25 2013-02-19
543.424 EATON VANCE GLOBAL MACRO FD CL I   2012-08-29 2013-03-05
42. EMERSON ELECTRIC CO   2012-01-04 2013-03-05
54. TERADATA CORP DEL     2013-03-05
358.665 TURNER SPECTRUM FUND INSTL   2012-09-19 2013-03-05
43. INGERSOLL RAND PLC   2012-11-06 2013-03-05
161. GENERAL ELEC CO     2013-03-21
262.398 GOLDMAN SACHS M C VALUE CL INST     2013-03-21
39. HOME DEPOT INC   2012-06-11 2013-03-21
19. HOME DEPOT INC   2012-02-24 2013-03-21
814.911 NUVEEN HIGH INCOME BOND FD CL I   2009-06-29 2013-03-21
1159.593 NUVEEN INFLATION PRO SEC CL I   2012-01-19 2013-03-21
4. SCHLUMBERGER LTD ISIN #AN8068571086     2013-03-21
33. SCHLUMBERGER LTD ISIN #AN8068571086   2012-05-24 2013-03-21
3. SCHLUMBERGER LTD ISIN #AN8068571086   2012-09-19 2013-03-21
.5 JARDEN CORP   2012-09-19 2013-03-26
283.298 EATON VANCE GLOBAL MACRO FD CL I   2013-02-19 2013-04-16
136. FIFTH THIRD BANCORP   2012-08-23 2013-04-16
40. RIO TINTO PLC A D R   2013-03-05 2013-04-16
1. APPLE COMPUTER INC   2010-08-13 2013-04-24
7. APPLE COMPUTER INC     2013-04-24
265. LSI CORPORATION   2012-09-19 2013-04-24
9.992 NEUBERGER BERMAN GENESIS INSTL FD   2009-04-13 2013-04-24
27.893 NEUBERGER BERMAN GENESIS INSTL FD   2012-01-04 2013-04-24
7.157 NEUBERGER BERMAN GENESIS INSTL FD   2012-01-19 2013-04-24
37.334 NEUBERGER BERMAN GENESIS INSTL FD   2013-03-21 2013-04-24
76.367 NEUBERGER BERMAN GENESIS INSTL FD     2013-04-24
30.643 NEUBERGER BERMAN GENESIS INSTL FD   2013-04-16 2013-04-24
25. PIONEER NAT RES CO   2011-11-30 2013-04-24
364.913 ROBECO BOSTON PARTNERS L S RSRCH     2013-04-24
303. STAPLES INC     2013-04-24
679.866 TCW EMERGING MARKETS INCOME FUND   2013-03-21 2013-04-24
15000. RBC 4YR SPX NOTE 4/29/13   2009-04-24 2013-04-29
. LAUDUS ROSEN INTL S C FD CL INV     2013-05-17
330. BANK OF AMERICA CORP     2013-05-23
10. CF INDUSTRIES HOLDINGS INC   2012-10-23 2013-05-23
88. CA INC     2013-05-23
39. CITIGROUP INC   2012-05-02 2013-05-23
38. EDISON INTL   2013-04-24 2013-05-23
47. EDISON INTL   2012-03-27 2013-05-23
46. RIO TINTO PLC A D R     2013-05-23
32. UNITED HEALTH GROUP INC   2012-04-05 2013-05-23
68. WILLIAMS COS INC   2012-09-19 2013-05-23
37. COVIDIEN PLC   2012-06-23 2013-05-23
8000. RBC 4YR GSCI COMMODITY 5/28/13   2009-05-22 2013-05-28
125.075 AMER CENT DIVERSIFI BOND INS   2012-03-02 2013-07-24
60.971 AMER CENT DIVERSIFI BOND INS   2012-07-05 2013-07-24
61. CVS CAREMARK CORP     2013-07-24
72. CONAGRA FOODS INC     2013-07-24
38. DEVON ENERGY CORPORATION   2013-04-24 2013-07-24
10. INTL BUSINESS MACHINES CORP   2012-09-19 2013-07-24
20. INTL BUSINESS MACHINES CORP     2013-07-24
129.078 NUVEEN MID CAP GRWTH OPP FD CL I   2009-04-13 2013-07-24
109.516 NUVEEN MID CAP GRWTH OPP FD CL I   2013-01-04 2013-07-24
39.58 NUVEEN MID CAP GRWTH OPP FD CL I   2012-05-24 2013-07-24
43.309 NUVEEN MID CAP GRWTH OPP FD CL I   2012-08-10 2013-07-24
3.38 NUVEEN MID CAP GRWTH OPP FD CL I   2013-03-05 2013-07-24
121. ORACLE CORPORATION     2013-07-24
1435.403 PIMCO TOTAL RETURN FUND INST   2011-03-16 2013-07-24
104. VERIZON COMMUNICATIONS     2013-07-24
55. WALGREEN CO   2012-12-14 2013-07-24
432.392 ABERDEEN FDS EMRGN   2012-01-04 2013-08-26
133.156 ABERDEEN FDS EMRGN   2012-09-19 2013-08-26
1296.516 ABERDEEN FDS EMRGN     2013-08-26
24.01 ABERDEEN FDS EMRGN   2012-12-14 2013-08-26
87. GLAXO SMITHKLINE P L C A D R     2013-08-26
225. ISHARES MSCI EMERGING MARKETS ETF     2013-08-26
113. ISHARES MSCI EMERGING MARKETS ETF     2013-08-26
37. ISHARES MSCI EMERGING MARKETS ETF   2013-01-25 2013-08-26
103. MERCK AND CO INC     2013-08-26
37. MOTOROLA SOLUTIONS INC   2012-12-14 2013-08-26
33. OCCIDENTAL PETROLEUM CORPORATION   2010-08-13 2013-08-26
156.617 ROBECO BOSTON PARTNERS L S RSRCH   2013-03-21 2013-08-26
417.945 TURNER SPECTRUM FUND INSTL     2013-08-26
. CIT GROUP INC     2013-09-16
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 10,566   10,000 566
b 2,530   2,412 118
c 2,237   1,950 287
d 3,257   3,619 -362
e 10,000   10,000  
16   14 2
3,726   4,014 -288
4,299   4,511 -212
801   797 4
5,123   5,000 123
1,894   1,979 -85
2,422   2,579 -157
2,973   2,461 512
18,810   18,577 233
3,854   4,071 -217
1,997   2,486 -489
2,233   2,089 144
2,047   1,552 495
2,318   2,088 230
2,027   2,017 10
1,874   2,019 -145
2,010   1,027 983
2,002   1,621 381
5,293   2,503 2,790
3,352   4,148 -796
3,967   3,820 147
3,049   1,738 1,311
1,670   1,566 104
5,254   5,000 254
3,581   3,068 513
4,011   3,634 377
4     4
4,690   4,010 680
2,022   1,719 303
2,938   2,175 763
2,000   1,744 256
2,015   1,797 218
2,016   1,797 219
2,104   1,910 194
47   43 4
8,693   4,708 3,985
4,525   4,181 344
290   242 48
5,973   5,937 36
2,031   1,378 653
3,453   4,017 -564
1,953   2,299 -346
5,039   2,720 2,319
5,281   4,691 590
2,374   2,034 340
1,879   2,034 -155
7,977   7,713 264
3,490   2,961 529
2,650   2,890 -240
5,369   5,336 33
2,358   2,010 348
3,181   4,092 -911
4,003   3,935 68
2,288   2,070 218
3,753   3,412 341
11,498   9,266 2,232
2,677   2,023 654
1,304   894 410
7,587   5,810 1,777
13,799   13,370 429
294   146 148
2,428   2,165 263
221   225 -4
22   20 2
2,796   2,802 -6
2,198   2,007 191
1,826   2,072 -246
406   250 156
2,840   4,435 -1,595
1,669   2,011 -342
529   285 244
1,478   1,310 168
379   346 33
1,978   2,000 -22
4,046   4,000 46
1,623   1,616 7
2,881   2,330 551
4,678   4,681 -3
3,788   4,220 -432
6,357   6,309 48
28,574   15,000 13,574
15     15
4,343   2,676 1,667
1,883   2,048 -165
2,403   2,199 204
1,959   1,285 674
1,820   2,023 -203
2,251   2,046 205
2,024   2,355 -331
1,981   1,711 270
2,512   2,309 203
2,404   2,084 320
9,350   8,000 1,350
1,340   1,387 -47
653   682 -29
3,756   2,733 1,023
2,647   2,199 448
2,141   2,030 111
1,968   2,063 -95
3,936   3,882 54
6,648   3,279 3,369
5,640   4,958 682
2,038   1,823 215
2,230   2,000 230
174   161 13
3,908   4,076 -168
15,474   15,646 -172
5,227   5,369 -142
2,803   2,028 775
5,984   5,630 354
1,843   2,000 -157
17,944   18,823 -879
332   376 -44
4,517   4,256 261
8,635   10,402 -1,767
4,337   4,961 -624
1,420   1,631 -211
4,908   4,609 299
2,105   2,006 99
2,907   2,500 407
2,108   1,998 110
4,719   4,595 124
54     54
      71
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       566
b       118
c       287
d       -362
e        
      2
      -288
      -212
      4
      123
      -85
      -157
      512
      233
      -217
      -489
      144
      495
      230
      10
      -145
      983
      381
      2,790
      -796
      147
      1,311
      104
      254
      513
      377
      4
      680
      303
      763
      256
      218
      219
      194
      4
      3,985
      344
      48
      36
      653
      -564
      -346
      2,319
      590
      340
      -155
      264
      529
      -240
      33
      348
      -911
      68
      218
      341
      2,232
      654
      410
      1,777
      429
      148
      263
      -4
      2
      -6
      191
      -246
      156
      -1,595
      -342
      244
      168
      33
      -22
      46
      7
      551
      -3
      -432
      48
      13,574
      15
      1,667
      -165
      204
      674
      -203
      205
      -331
      270
      203
      320
      1,350
      -47
      -29
      1,023
      448
      111
      -95
      54
      3,369
      682
      215
      230
      13
      -168
      -172
      -142
      775
      354
      -157
      -879
      -44
      261
      -1,767
      -624
      -211
      299
      99
      407
      110
      124
      54
       
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 56,082
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 52,855 951,445 0.055552
2010 48,579 989,389 0.0491
2009 56,670 904,965 0.062621
2008 38,529 820,854 0.046938
2007 43,676 1,143,622 0.038191
2 Total of line 1, column (d) ...................... 2 0.252402
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 0.05048
4 Enter the net value of noncharitable-use assets for 2012 from Part X, line 5..... 4 987,473
5 Multiply line 4 by line 3....................... 5 49,848
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 649
7 Add lines 5 and 6......................... 7 50,497
8 Enter qualifying distributions from Part XII, line 4.............. 8 45,558
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See
the Part VI instructions.
Form 990-PF (2012)
Form 990-PF (2012)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see page 18 of the instructions)
1a Bulletand enter “N/A” on line 1. Bracket
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b 1 1,298
hereBulletand enter 1% of Part I, line 27b...................
c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2............................ 3 1,298
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 1,298
6 Credits/Payments:
a 2012 estimated tax payments and 2011 overpayment credited to 2012 6a 612
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.............. 7 612
8 Enter any penalty for underpayment of estimated tax. 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.......Bullet 9 686
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 taxBullet0 Refunded Bullet 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. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If “Yes,” attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If “Yes,” attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If “Yes,” has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If “Yes,” attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
  • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If “Yes,” complete Part II, col. (c), and Part XV.
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletUT
    b
    If the answer is “Yes” to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If “No,” attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2012 or the taxable year beginning in 2012 (see instructions for Part XIV)?
    If “Yes,” complete Part XIV.............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If “Yes,” attach a schedule listing their names and addresses.
    10
     
    No
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. (see instructions) .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement (see instructions).................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbullet  
    14
    The books are in care ofbulletUS BANK Telephone no.bullet (503) 275-4327
    Located atbullet555 SW OAKPORTLANDOR ZIP+4bullet97204
    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
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2012?
    4b
     
    No
    5a
    During the year did the foundation pay or incur any amount to:
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?...............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 509(a)(1), (2), or (3), or section 4940(d)(2)? (see instructions)........
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?........
    b
    If any answer is “Yes” to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance (see instructions)? ......
    5b
     
     
    .........bullet
    c
    If the answer is “Yes” to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?............
    If “Yes,” attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?........................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?....
    6b
     
    No
    If “Yes” to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 6
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation (see instructions).
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation
    (If not paid, enter
    -0-)
    (d) Contributions to
    employee benefit plans
    and deferred compensation
    (e) Expense account,
    other allowances
    US BANK TRUSTEE
    1
    17,069    
    PO BOX 3168
    PORTLAND,OR97208
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE.”
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation
    (e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet 0
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1
     
    2  
    3  
    4  
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 7
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See page 24 of the instructions.
    3  
    Total. Add lines 1 through 3..........................bullet  
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,
    see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    982,606
    b
    Average of monthly cash balances.......................
    1b
    19,905
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    1,002,511
    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
    1,002,511
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see
    instructions) .............................
    4
    15,038
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    987,473
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    49,374
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    49,374
    2a
    Tax on investment income for 2012 from Part VI, line 5......
    2a
    1,298
    b
    Income tax for 2012. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    1,298
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    48,076
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    48,076
    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
    48,076
    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
    45,558
    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
    45,558
    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
    45,558
    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 48,076
    2 Undistributed income, if any, as of the end of 2012:
    a Enter amount for 2011 only....... 0
    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....... 4,080
    d From 2010....... 724
    e From 2011....... 6,505
    fTotal of lines 3a through e......... 11,309
    4Qualifying distributions for 2012 from Part
    XII, line 4: bullet$ 45,558
    a Applied to 2011, but not more than line 2a 0
    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..... 45,558
    e Remaining amount distributed out of corpus 0
    5 Excess distributions carryover applied to 2012. 2,518 2,518
    (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 8,791
    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 ..........
    0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (see
    instructions) .............
    0
    8Excess distributions carryover from 2007 not
    applied on line 5 or line 7 (see instructions) ...
    0
    9Excess distributions carryover to 2013.
    Subtract lines 7 and 8 from line 6a ......
    8,791
    10 Analysis of line 9:
    a Excess from 2008.... 0
    b Excess from 2009.... 1,562
    c Excess from 2010.... 724
    d Excess from 2011.... 6,505
    e Excess from 2012....  
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 9
    Part XIV
    Private Operating Foundations (see instructions and Part VII-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2012, enter the date of the ruling.......bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........
    Tax year Prior 3 years (e) Total
    (a) 2012 (b) 2011 (c) 2010 (d) 2009
             
    b 85% of line 2a .........          
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....
             
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ....
             
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....
             
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets” alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)
             
    b “Endowment” alternative test— enter 2⁄3
    of minimum investment return shown in
    Part X, line 6 for each year listed...
             
    c “Support” alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....
             
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....
             
    (3) Largest amount of support
    from an exempt organization
             
    (4) Gross investment income          
    Part XV
    Supplementary Information (Complete this part only if the organization had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail of the person to whom applications should be addressed:
    RANDALL GRUNINGER US BANK
    170 S MAIN STREET
    SALT LAKE CITY,UT84101
    (801) 534-6045
    bThe form in which applications should be submitted and information and materials they should include:
    CONTACT ABOVE
    cAny submission deadlines:
    CONTACT ABOVE
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    UNDERPRIVILEDGED CHILDREN, PREFERENCE FOR UTAH ORGANIZATIONS
    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
    ASSITANCE LEAGUE OF SALT LAKE CITY
    2060 EAST 3300 SOUTH
    SALT LAKE CITY,UT84109
    NONE PUBLIC GENERAL SUPPORT 1,000
    CHILDREN SERVICE
    SOCIETY OF UTAH
    124 SOUTH 400 EAST ST 400
    SALT LAKE CITY,UT84111
    NONE PUBLIC SPECIAL NEEDS ADOPTION 2,000
    CROSSROADS URBAN CENTER
    ATTN GLENN L BAILEY
    347 SOUTH 400 EAST
    SALT LAKE CITY,UT84111
    NONE PUBLIC CHILDREN SERVICES 2,000
    GUADALUPE SCHOOLS
    ATTN VICTORIA M MORI
    340 GOSHEN STREET
    SALT LAKE CITY,UT84104
    NONE PUBLIC EARLY LEARNING CENTER 1,000
    KOSTOPULOS DREAM
    FOUNDATION
    2500 EMIGRATION CANYON
    SALT LAKE CITY,UT84108
    NONE PUBLIC SUMMER CAMP SCHOLARSHIPS 2,000
    NATIONAL ABILITY CENTER
    PO BOX 682799
    PARK CITY,UT84068
    NONE PUBLIC GENERAL SUPPORT 2,000
    ODYSSEY HOUSE
    ATTN ADAM COHEN
    344 EAST 100 SOUTH 301
    SALT LAKE CITY,UT84111
    NONE PUBLIC GENERAL SUPPORT 2,000
    PRIMARY CHILDRENS MEDICAL CENTER
    CHARITABLE FUNDING
    100 N MEDICAL DRIVE
    SALT LAKE CITY,UT84158
    NONE PUBLIC GENERAL SUPPORT 2,000
    SALT LAKE DONATED DENTAL SERVICES
    1383 S 900 W 128
    SALT LAKE CITY,UT84104
    NONE PUBLIC GENERAL SUPPORT 2,000
    SOUTH VALLEY SANCTUARY
    ATTN HEATHER MASTERTON
    PO BOX 1028
    SALT LAKE CITY,UT84084
    NONE PUBLIC GENERAL SUPPORT 2,000
    THE CHILDREN'S CENTER
    1855 EAST MEDICAL DRIVE
    SALT LAKE CITY,UT84112
    NONE PUBLIC GENERAL SUPPORT 2,000
    THE ROAD HOME
    210 S RIO GRANDE STREET
    SLAT LAKE CITY,UT84101
    NONE PUBLIC CHILDREN'S SERVICES PROGRAM 2,500
    UTAH YOUTH VILLAGE
    5800 S HIGHLAND DRIVE
    SALT LAKE CITY,UT84121
    NONE PUBLIC FAMILIES FIRST PROGRAM 2,500
    UTAH FOOD BANK
    ATTN LINDA MOORE
    3150 SOUTH 900 WEST
    SALT LAKE CITY,UT84119
    NONE PUBLIC GENERAL SUPPORT 2,000
    VOLUNTEERS OF AMERICA
    HOMELESS YOUTH RESOURCE CENTER
    511 WEST 200 SOUTH 160
    SALT LAKE CITY,UT84101
    NONE PUBLIC CHILDREN'S SERVICES 2,500
    YWCA OF SALT LAKE CITY
    322 EAST 300 SOUTH
    SALT LAKE CITY,UT84111
    NONE PUBLIC CHILDREN'S ADVOCACY & 2,000
    BAD DOG REDISCOVERS AMERICA
    230 SOUTH 500 WEST SUITE 220
    SALT LAKE CITY,UT84101
    NONE PUBLIC GENERAL SUPPORT 2,000
    BIG BROTHERS BIG SISTERS
    OF UTAH
    151 EAST 5600 SOUTH
    SALT LAKE CITY,UT84107
    NONE PUBLIC TWO MATCHES FOR ONE YEAR 2,000
    BOYS & GIRLS CLUBS OF
    GREATER SALT LAKE
    675 EAST 2100 SOUTH
    SALT LAKE CITY,UT84106
    NONE PUBLIC PROGRAM OPERATION 2,000
    NEIGHBORHOOD HOUSE
    ATTN JANETTE SCHIMPF
    1050 WEST 500 SOUTH
    SALT LAKE CITY,UT84104
    NONE PUBLIC CHILDREN'S DAY CARE CENTER 2,000
    SPECIAL OLYMPICS OF UTAH
    ATTN GLENN LANHAM
    243 EAST 400 SOUTH 111
    SALT LAKE CITY,UT84111
    NONE PUBLIC GENERAL SUPPORT 2,000
    DISCOVERY GATEWAY
    444 WEST 100 SOUTH
    SALT LAKE CITY,UT84101
    NONE PUBLIC GENERAL SUPPORT 1,000
    Total .................................bullet 3a 42,500
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 11
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code
    (b)
    Amount
    (c)
    Exclusion code
    (d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3Interest on savings and temporary cash investments          
    4 Dividends and interest from securities....     14 23,248  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6Net rental income or (loss) from personal property          
    7 Other investment income.....          
    8Gain or (loss) from sales of assets other than inventory     18 56,082  
    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)..   79,330  
    13Total. Add line 12, columns (b), (d), and (e)..................
    1379,330
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow
    Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2012)
    Form 990-PF (2012)
    Page 12
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section
    Yes
    No
    501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is “Yes,” complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527?...........
    b
    If “Yes,” complete the following schedule.
    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer or fiduciary) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below
    (see instr.)?
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's namebullet



    Firm's addressbullet







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


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2012 AccountingFeesSchedule
    Name:
    JOHN AND DORA LANG CHARITABLE FOUNDATION
    EIN: 87-6115493
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAX PREPARATION FEE 1,500     1,500

    TY 2012 InvestmentsCorpBondsSchedule
    Name:
    JOHN AND DORA LANG CHARITABLE FOUNDATION
    EIN: 87-6115493
    Name of Bond End of Year Book Value End of Year Fair Market Value
    NUVEEN HIGH INCOME BOND FD 43,650 46,424
    ROYAL BK CANADA 4/29/13    
    ROYAL BK OF CANADA 5/28/13    
    BARCLAYS BK PLC 5/7/14 12,074 16,983
    BNP PARIBAS 10/17/12    
    BARCLAYS BANK 10/12/12    
    AMER CENT DIVERSIFI BOND INS 47,091 45,098
    ISHARES JP MORGAN EM BOND 13,188 13,192
    SPDR BARCLAYS INTL TREAS BD FD 9,518 9,689

    TY 2012 InvestmentsCorpStockSchedule
    Name:
    JOHN AND DORA LANG CHARITABLE FOUNDATION
    EIN: 87-6115493
    Name of Stock End of Year Book Value End of Year Fair Market Value
    AMERICAN TOWER CORP 2,031 2,224
    BANK OF AMERICA CORP 3,401 3,174
    CITIGROUP 4,158 5,918
    EXXON MOBIL 2,554 2,925
    GENERAL ELECTRIC    
    HOME DEPOT INC    
    INTERNATIONAL BUSINESS MACHINE    
    MICROSOFT CORP 4,515 4,692
    PFIZER INC 3,551 5,774
    UNITED TECHNOLOGIES CORP 3,179 4,528
    WELLS FARGO & CO 3,364 5,661
    ACE LIMITED 2,017 2,526
    SCHLUMBERGER LTD 4,080 4,860
    NUVEEN MID CAP GRWTH OPP 12,809 15,887
    NUVEEN REAL ESTATE SECS 38,310 46,239
    IPATH GSCI TOTAL RETURN 6,341 6,157
    ISHARES MSCI EMERGING MKTS 12,011 11,371
    NEUBERGER BERMAN GENESIS 6,110 6,989
    PIMCO TOTAL RETURN 99,534 94,830
    SCOUT INTERNATIONAL 43,205 53,858
    ALLERGAN INC    
    ANADARKO PETROLEUM 4,634 5,765
    APPLE INC 5,127 3,814
    BMC SOFTWARE    
    DOLLAR TREE    
    EATON CORP 2,049 2,685
    FOOT LOCKER 2,088 2,138
    MCKESSON CORPORATION    
    OCCIDENTAL PETROLEUM    
    STARBUCKS CORP    
    TERADATA CORP    
    NUVEEN GLOBL INFRAS 44,740 51,900
    GOLDMAN SACHS 11,945 16,181
    IPATH DOW JONES UBS COMMODITY 6,353 5,254
    SPDR BARCLAYS CAPITAL    
    BOEING CO 2,578 4,700
    CAPITAL ONE FINANCIAL    
    DOVER CORP 2,667 4,402
    JARDEN CORP 2,140 3,098
    MACYS INC 3,529 3,851
    MASTERCARD 1,205 3,364
    NATIONAL OILWELL VARCO    
    POLARIS INDS 2,792 3,359
    PRUDENTIAL FINANCIAL 1,876 2,807
    SLM CORP 2,059 3,113
    UNITED HEALTH GROUP INC 2,296 3,008
    ABERDEEN FDS EMRGN MKT 30,195 28,326
    CREDIT SUISSE COMM 30,214 26,791
    DRIEHAUS ACTIVE INCOME 9,924 9,583
    DRIEHAUS SELECT CREDIT FUND 8,151 8,077
    LAUDUS INTL MARKETMASTERS 63,033 79,168
    LOOMIS SAYLES STRAT 7,787 7,752
    SPDR DJ WILSHIRE INTL 14,340 15,251
    TFS MARKET NEUTRAL FUND 7,265 7,483
    CF INDUSTRIES HOLDING INC    
    CVS CAREMARK CORP    
    DOW CHEM CO 1,960 2,650
    E M C CORPORATION    
    EDISON INTL    
    EMERSON ELEC CO    
    FIFITH THIRD BANCORP    
    GILEAD SCIENCES INC 2,129 5,155
    GOOGLE INC CL A 4,794 6,131
    KRAFT FOODS INC CL A    
    LSI CORPORATION    
    MARATHON OIL CORPORATION 3,475 4,011
    MAXIM INTEGRATED PROD INC 3,125 3,429
    P N C FINANCIAL SERVICES GR 2,322 2,174
    PIONEER NAT RES CO    
    WILLIAMS COS INC    
    STAPLES INC 1,970 1,773
    VALERO ENERGY CORP    
    COVIDIEN PLC    
    GLAXO SMITHKLINE PLC    
    NIELSEN HOLDINGS NV 2,012 2,442
    BLACKROCK EMERGING MKTS 12,721 12,782
    E I I INTL PPTY I 8,291 10,773
    EATON VANCE GLOBAL MACRO FD CL 6,755 6,428
    FORWARD INTERNATIONAL R/E 8,377 8,387
    INV BALANCE RISK COMM STR Y 10,920 9,058
    TURNER SPECTRUM FUND INSTL    
    NUVEEN INFLATION PRO SEC CL 31,884 30,300
    PYXIS LONG SHORT EQUIT Z    
    TCW EMERGING MKTS INC FD 12,793 11,524
    TCW EMERGING MKTS LOCAL 2,122 1,941
    AOL INC 4,100 3,804
    BEST BUY CO INC 1,975 3,113
    BORG WARNER INC 2,009 2,636
    CA INC 1,843 2,196
    CATERPILLAR INC 2,022 2,002
    CHEVRON CORP 2,019 1,944
    CISCO SYS INC 2,999 2,929
    CONAGRA FOODS INC 1,841 1,669
    D R HORTON INC 2,023 1,496
    EMERSON ELEC CO 2,051 2,135
    ILLINOIS TOOL WORKSINC 2,644 2,822
    INTERNATIONAL PAPER CO 2,043 2,016
    KOHLS CORP 2,032 1,967
    LIBERTY MEDIA CORP DELAWARE 1,771 2,649
    LINCOLN NATL CORP IND 2,621 2,477
    LOWES CO INC 2,763 3,380
    MONDELEZ INTERNATIONAL 3,967 4,839
    MONSANTO CO 2,011 2,192
    MOODYS CORP 2,026 2,180
    MORGAN STANLEY 2,386 2,830
    NRG ENERGY INC 2,061 2,405
    OWENS III INC 2,081 2,041
    PITNEY BOWES INC 2,004 2,110
    SYMANTEC CORP 2,474 2,772
    TYSON FOODS INC 2,046 2,913
    ROYAL CARIBBEAN CRUISES LTD 2,021 2,144
    HIGHLAND LONG SHORT EQ FD 8,928 10,215
    MORGAN DEMPSEY SM MICRO CAP V 5,660 6,741
    NEUBERGER BERMAN LONG SH 2,748 2,907
    OPPENHEIMER DEVELOPING MKTS 16,586 17,792
    PARAMETRIC EMERGING MKTS INC 16,011 16,762
    ROBECO BOSTON PARTNERS L S RES 10,738 10,842
    T ROWE PRICE MID CAP GRWTH FD 15,315 16,048

    TY 2012 OtherDecreasesSchedule
    Name:
    JOHN AND DORA LANG CHARITABLE FOUNDATION
    EIN: 87-6115493
    Description Amount
    ADJUSTMENT FOR ROUNDING 5


    TY 2012 OtherExpensesSchedule
    Name:
    JOHN AND DORA LANG CHARITABLE FOUNDATION
    EIN: 87-6115493
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ADR FEES 1 0   1


    TY 2012 TaxesSchedule
    Name:
    JOHN AND DORA LANG CHARITABLE FOUNDATION
    EIN: 87-6115493
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 4 4   0
    FEDERAL TAX PAYMENT - PRIOR YE 5 0   0
    FEDERAL ESTIMATES - PRINCIPAL 612 0   0
    FOREIGN TAXES ON QUALIFIED FOR 366 366   0
    FOREIGN TAXES ON NONQUALIFIED 72 72   0