TY 2013 Form 990PF

- TIN:

Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation

or Section 4947(a)(1) Trust Treated as Private Foundation

Do not enter Social Security numbers on this form as it may be made public. By law, the IRS cannot redact the information on the form.
bullet

Information about Form 990-PF and its instructions is at www.irs.gov/form990pf.

OMB No. 1545-0052

2013

Open to Public Inspection

For calendar year 2013, or tax year beginning 01-01-2013 , and ending 12-31-2013

Name of foundation
CHARLES P & MARGARET E POLK FOUNDATION

Number and street (or P.O. box number if mail is not delivered to street address)301 NORTH STREET Room/suite

City or town, state or province, country, and ZIP or foreign postal code
MILLERSBURG, PA17061

A Employer identification number

23-6296772

B Telephone number (see instructions)

(717) 692-2613

C If exemption application is pending, check here bullet

G Check all that apply: Initial returnInitial return of a former public charity
Final returnAmended return
Address changeName change

D 1. Foreign organizations, check here ............. bullet

2. Foreign organizations meeting the 85% test,
check here and attach computation ........... bullet

E If private foundation status was terminated
under section 507(b)(1)(A), check here ......... bullet

H Check type of organization: Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trustOther taxable private foundation

I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16) bullet

$42,729,803J Accounting method: Cash Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)

F If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here ......... bullet

	Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).)	(a) Revenue and expenses per books		(b) Net investment income	(c) Adjusted net income	(d) Disbursements for charitable purposes (cash basis only)


1	Contributions, gifts, grants, etc., received (attach schedule)	10,000
2	Check
3	Interest on savings and temporary cash investments	3		3	3
4	Dividends and interest from securities......	784,087		784,087	784,087
5a	Gross rents..............
b	Net rental income or (loss)
6a	Net gain or (loss) from sale of assets not on line 10		142,184
b	Gross sales price for all assets on line 6a 4,517,115
7	Capital gain net income (from Part IV, line 2)...			142,184
8	Net short-term capital gain.........				110,579
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).......		2,022,038	263,737	1,758,301
12	Total. Add lines 1 through 11........	2,958,312		1,190,011	2,652,970
13	Compensation of officers, directors, trustees, etc.	107,198		10,720		96,479
14	Other employee salaries and wages......	960,800		54,222		906,578
15	Pension plans, employee benefits.......	176,993		5,124		171,869
16a	Legal fees (attach schedule).........		1,146	737		409
b	Accounting fees (attach schedule).......		13,866	13,866
c	Other professional fees (attach schedule)....		32,338	28,442		3,896
17	Interest...............	29,134		29,134
18	Taxes (attach schedule) (see instructions)		293,264	137,095		156,169
19	Depreciation (attach schedule) and depletion...		441,803	92,205
20	Occupancy..............	455,486		239,245		216,241
21	Travel, conferences, and meetings.......	10,707				10,707
22	Printing and publications..........
23	Other expenses (attach schedule).......		672,379	259,273		413,104
24	Total operating and administrative expenses.
	Add lines 13 through 23..........	3,195,114		870,063		1,975,452
25	Contributions, gifts, grants paid........	15,000				15,000
26	Total expenses and disbursements. Add lines 24 and 25	3,210,114		870,063		1,990,452
27	Subtract line 26 from line 12:
a	Excess of revenue over expenses and disbursements	-251,802
b	Net investment income (if negative, enter -0-)			319,948
c	Adjusted net income (if negative, enter -0-)...				2,652,970

For Paperwork Reduction Act Notice, see instructions.

Cat. No. 11289X Form 990-PF (2013)

Form 990-PF (2013)

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
Part II		Balance Sheets		(a) Book Value	(b) Book Value	(c) Fair Market Value
	1	Cash—non-interest-bearing...............		-39,225	-18,257	-18,257
	2	Savings and temporary cash investments..........		223,054	110,066	110,066
	3	Accounts receivable
		Less: allowance for doubtful accounts
	4	Pledges receivable
		Less: allowance for doubtful accounts
	5	Grants receivable.................
	6	Receivables due from officers, directors, trustees, and other
		disqualified persons (attach schedule) (see instructions).....
	7	Other notes and loans receivable (attach schedule)
		Less: allowance for doubtful accounts
	8	Inventories for sale or use...............
	9	Prepaid expenses and deferred charges...........		4,000	4,800	4,800
	10a	Investments—U.S. and state government obligations (attach schedule)		380,466	297,558	302,833
	b	Investments—corporate stock (attach schedule)........		12,928,933	13,173,829	11,805,433
	c	Investments—corporate bonds (attach schedule)........		1,128,796	1,229,149	1,753,809
	11	Investments—land, buildings, and equipment: basis 2,872,590
		Less: accumulated depreciation (attach schedule) 369,318		2,539,958	2,503,272	2,872,356
	12	Investments—mortgage loans..............
	13	Investments—other (attach schedule)...........
	14	Land, buildings, and equipment: basis 20,076,094
		Less: accumulated depreciation (attach schedule) 10,009,433		10,163,744	10,066,661	25,898,763
	15	Other assets (describe )		100,656	0	0
	16	Total assets (to be completed by all filers—see the
		instructions. Also, see page 1, item I)		27,430,382	27,367,078	42,729,803
		17	Accounts payable and accrued expenses..........		16,060	16,467
18		Grants payable...................
19		Deferred revenue..................
20		Loans from officers, directors, trustees, and other disqualified persons
21		Mortgages and other notes payable (attach schedule)......		808,556	996,647
22		Other liabilities (describe )
23		Total liabilities (add lines 17 through 22)..........		824,616	1,013,114
		Foundations that follow SFAS 117, check here
		and complete lines 24 through 26 and lines 30 and 31.
	24	Unrestricted....................
	25	Temporarily restricted................
	26	Permanently restricted................
		Foundations that do not follow SFAS 117, check here
		and complete lines 27 through 31.
	27	Capital stock, trust principal, or current funds.........
	28	Paid-in or capital surplus, or land, bldg., and equipment fund
	29	Retained earnings, accumulated income, endowment, or other funds		26,605,766	26,353,964
	30	Total net assets or fund balances (see page 17 of the
		instructions)....................		26,605,766	26,353,964
	31	Total liabilities and net assets/fund balances (see page 17 of
		the instructions)..................		27,430,382	27,367,078

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	26,605,766
2	Enter amount from Part I, line 27a.....................	2	-251,802
3	Other increases not included in line 2 (itemize)	3
4	Add lines 1, 2, and 3..........................	4	26,353,964
5	Decreases not included in line 2 (itemize)	5
6	Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30.	6	26,353,964

Form 990-PF (2013)

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	LONG TERM STOCKS	P	2010-01-01	2013-12-31
b	SHORT TERM STOCKS	P	2013-01-01	2013-12-31
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	3,385,829	0	3,354,224	31,605
b	1,131,286	0	1,020,707	110,579
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	0	0	0	31,605
b	0	0	0	110,579
c
d
e

2	Capital gain net income or (net capital loss)	If gain, also enter in Part I, line 7 If (loss), enter -0- in Part I, line 7	2	142,184
3	Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
	If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0- in Part I, line 8 . . . . . . . . . . . . . . . .		3	110,579

Part V

Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income

(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)

If section 4940(d)(2) applies, leave this part blank.

Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period? Yes No

If "Yes," the foundation does not qualify under section 4940(e). Do not complete this part.

1 Enter the appropriate amount in each column for each year; see page 18 of the instructions before making any entries.
(a) Base period years Calendar year (or tax year beginning in)	(b) Adjusted qualifying distributions	(c) Net value of noncharitable-use assets	(d) Distribution ratio (col. (b) divided by col. (c))
2012	2,893,919	14,530,018	0.199168
2011	3,173,019	14,003,064	0.226595
2010	2,037,509	14,594,495	0.139608
2009	2,037,509	14,758,567	0.138056
2008	2,064,263	15,062,990	0.137042

2	Total of line 1, column (d) ......................	2	0.840469
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	0.168094
4	Enter the net value of noncharitable-use assets for 2013 from Part X, line 5.....	4	15,156,331
5	Multiply line 4 by line 3.......................	5	2,547,688
6	Enter 1% of net investment income (1% of Part I, line 27b)...........	6	3,199
7	Add lines 5 and 6.........................	7	2,550,887
8	Enter qualifying distributions from Part XII, line 4..............	8	3,082,894
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 (2013)

Page 4

Part VI

Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see page 18 of the instructions)

1a	Exempt operating foundations described in section 4940(d)(2), check hereand enter “N/A" on line 1.
	Date of ruling or determination letter: (attach copy of letter if necessary–see instructions)
b	Domestic foundations that meet the section 4940(e) requirements in Part V, check	1	3,199
	hereand 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	3,199
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	3,199
6	Credits/Payments:

a	2013 estimated tax payments and 2012 overpayment credited to 2013	6a	4,800
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	4,800
8	Enter any penalty for underpayment of estimated tax. Check hereif Form 2220 is attached.		8
9	Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......		9
10	Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...		10	1,601
11	Enter the amount of line 10 to be: Credited to 2014 estimated tax1,601	Refunded	11

Part VII-A

Statements Regarding Activities

During the tax year, did the foundation attempt to influence any national, state, or local legislation or did

Yes

it participate or intervene in any political campaign? ....................

Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see page 19 of

the instructions for definition)?............................

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.

Did the foundation file Form 1120-POL for this year?.....................

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

Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed

on foundation managers. bullet

Has the foundation engaged in any activities that have not previously been reported to the IRS?.......

If "Yes," attach a detailed description of the activities.

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....

Did the foundation have unrelated business gross income of $1,000 or more during the year?........

If "Yes," has it filed a tax return on Form 990-T for this year?...................

Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........

If "Yes," attach the statement required by General Instruction T.

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?................

Yes

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.

Yes

Enter the states to which the foundation reports or with which it is registered (see instructions)

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 .

Yes

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 2013 or the taxable year beginning in 2013 (see instructions for Part XIV)?

If "Yes," complete Part XIV.............................

Yes

Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names and addresses.

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) .............

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).................

Did the foundation comply with the public inspection requirements for its annual returns and exemption application?

Yes

Website address bullet

N/A

The books are in care of bullet

POLK FOUNDATION Telephone no. bullet

(717) 692-2613

Located at bullet

301 NORTH STMILLERSBURGPA ZIP+4 bullet

17061

Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —Check here......... bullet

and enter the amount of tax-exempt interest received or accrued during the year ...... bullet

16 At any time during calendar year 2013, did the foundation have an interest in or a signature or other authority over YesNo

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 (2013)

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

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? YesNo

(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)

a disqualified person?.........................YesNo

(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? YesNo

(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? YesNo

(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)?.................YesNo

(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.).........YesNo

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)?...

Organizations relying on a current notice regarding disaster assistance check here......... bullet

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 2013?.............

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)):

At the end of tax year 2013, did the foundation have any undistributed income (lines 6d

and 6e, Part XIII) for tax year(s) beginning before 2013?...............YesNo

If "Yes," list the years bullet

20, 20, 20, 20

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.) ..............

If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.

20, 20, 20, 20

Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at

any time during the year?.........................YesNo

If "Yes," did it have excess business holdings in 2013 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 2013.)....................

Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?

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 2013?

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))? YesNo

(2) Influence the outcome of any specific public election (see section 4955); or to carry

on, directly or indirectly, any voter registration drive?...............YesNo

(3) Provide a grant to an individual for travel, study, or other similar purposes? YesNo

(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)........YesNo

(5) Provide for any purpose other than religious, charitable, scientific, literary, or

educational purposes, or for the prevention of cruelty to children or animals?........YesNo

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)? ......

Organizations relying on a current notice regarding disaster assistance check here......... bullet

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?............YesNo

If "Yes," attach the statement required by Regulations section 53.4945–5(d).

Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on

a personal benefit contract?........................YesNo

Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?....

If "Yes" to 6b, file Form 8870.

At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction? YesNo

If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....

Form 990-PF (2013)

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
ROBERT RISSINGER	CHAIRMAN 2.00	12,000	0	0
900 MANOR DRIVE MILLERSBURG,PA17061	CHAIRMAN 2.00	12,000	0	0
JUDY PAUL	SECRETARY/ADMINISTRA 40.00	45,200	4,520	0
RD1 BOX 85 KLINGERSTOWN,PA17941	SECRETARY/ADMINISTRA 40.00	45,200	4,520	0
DAVID HAWLEY	TREASURER 2.00	12,000	0	0
575 UNION STREET MILLERSBURG,PA17061	TREASURER 2.00	12,000	0	0
RICHARD IBBERSON	BOARD MEMBER 2.00	12,000	0	0
239 MOORE STREET MILLERSBURG,PA17061	BOARD MEMBER 2.00	12,000	0	0
J BRUCE WALTER	VICE-CHAIRMAN 2.00	12,000	0	0
423 SHAFFER ROAD MILLERSBURG,PA17061	VICE-CHAIRMAN 2.00	12,000	0	0
CRYSTAL L ALTLAND	ADMINISTRATOR DESIGN 40.00	61,998	3,100	0
701 KENTUCKY DRIVE ELIZABETHVILLE,PA17023	ADMINISTRATOR DESIGN 40.00	61,998	3,100	0

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
JILL HOOVER	ASST ADMINISTRATOR 40.00	64,163	6,416	0
366 MOORE ST MILLERSBURG,PA17061	ASST ADMINISTRATOR 40.00	64,163	6,416	0
RANDY CONFAIR	PROPERTY MNG 40.00	54,222	5,422	0
298 NELSON TERRACE MILLERSBURG,PA17061	PROPERTY MNG 40.00	54,222	5,422	0






Total number of other employees paid over $50,000...................				2

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
RET ASSOCIATES	CONSTRUCTION	163,000
HILLSIDE DR DALMATIA,PA17017	CONSTRUCTION	163,000

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	OPERATE AND MAINTAIN LOW-INCOME APARTMENT COMPLEXES ANDAN ASSISTED LIVING PERSONAL CARE FACILITY FOR QUALIFYINGELDERLY PERSONS	2,325,050
2


3


4

Form 990-PF (2013)

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	OPERATE AND MAINTAIN LOW-INCOME APARTMENT COMPLEXES ANDAN ASSISTED LIVING PERSONAL CARE FACILITY FOR QUALIFYINGELDERLY PERSONS	516,311
2	MAINTAIN PROPERTY FOR MEDICAL CENTER	215,172
All other program-related investments. See page 24 of the instructions.
3		153,580

Total. Add lines 1 through 3......................... bullet

885,063

Part X

Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,
see instructions.)

Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,

purposes:

Average monthly fair market value of securities...................

Average of monthly cash balances.......................

Fair market value of all other assets (see instructions)................

Total (add lines 1a, b, and c).........................

Reduction claimed for blockage or other factors reported on lines 1a and

1c (attach detailed explanation) .............

Acquisition indebtedness applicable to line 1 assets..................

Subtract line 2 from line 1d.........................

Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see

instructions) .............................

Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4

Minimum investment return. Enter 5% of line 5..................

Part XI

Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here bullet

and do not complete this part.)

Minimum investment return from Part X, line 6....................

Tax on investment income for 2013 from Part VI, line 5......

Income tax for 2013. (This does not include the tax from Part VI.)...

Add lines 2a and 2b............................

Distributable amount before adjustments. Subtract line 2c from line 1............

Recoveries of amounts treated as qualifying distributions................

Add lines 3 and 4............................

Deduction from distributable amount (see instructions).................

Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII,

line 1................................

Part XII

Qualifying Distributions (see instructions)

Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:

Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........

Program-related investments—total from Part IX-B..................

Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,

purposes...............................

Amounts set aside for specific charitable projects that satisfy the:

Suitability test (prior IRS approval required)....................

Cash distribution test (attach the required schedule) .................

Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4

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).................

Adjusted qualifying distributions. Subtract line 5 from line 4..............

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 (2013)

Page 8

Part XIII

Undistributed Income (see instructions)

		(a) Corpus	(d) 2013
1 Distributable amount for 2013 from Part XI, line 7			0
2 Undistributed income, if any, as of the end of 2013:
a Enter amount for 2012 only.......
b Total for prior years:20, 20, 20
3 Excess distributions carryover, if any, to 2013:
a From 2008.......	2,064,263
b From 2009.......	2,014,261
c From 2010.......	2,040,802
d From 2011.......	3,176,737
e From 2012.......	2,898,437
fTotal of lines 3a through e.........		12,194,500
4Qualifying distributions for 2013 from Part
XII, line 4: $ 3,082,894
a Applied to 2012, 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 2013 distributable amount.....
e Remaining amount distributed out of corpus		3,082,894
5 Excess distributions carryover applied to 2013.
(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		15,277,394
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 2012. Subtract line 4a from line 2a. Taxable amount—see instructions .............
f Undistributed income for 2013. Subtract lines 4d and 5 from line 1. This amount must be distributed in 2014 ..........			0
7 Amounts treated as distributions out of corpus to satisfy requirements imposed by section 170(b)(1)(F) or 4942(g)(3) (see instructions) .............
8Excess distributions carryover from 2008 not applied on line 5 or line 7 (see instructions) ...		2,064,263
9Excess distributions carryover to 2014. Subtract lines 7 and 8 from line 6a ......		13,213,131
10 Analysis of line 9:
a Excess from 2009....	2,014,261
b Excess from 2010....	2,040,802
c Excess from 2011....	3,176,737
d Excess from 2012....	2,898,437
e Excess from 2013....	3,082,894

Form 990-PF (2013)

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 2013, enter the date of the ruling....... bullet

b Check box to indicate whether the organization is a private operating foundation described in section4942(j)(3) or4942(j)(5)

2a Enter the lesser of the adjusted net income from Part I or the minimum investment return from Part X for each year listed ..........	Tax year	Prior 3 years			(e) Total
	(a) 2013	(b) 2012	(c) 2011	(d) 2010	(e) Total
	757,817	726,501	700,153	729,725	2,914,196
b 85% of line 2a .........	644,144	617,526	595,130	620,266	2,477,066
c Qualifying distributions from Part XII, line 4 for each year listed .....	3,082,894	2,898,437	3,176,737	2,040,802	11,198,870
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 ....	3,082,894	2,898,437	3,176,737	2,040,802	11,198,870
3 Complete 3a, b, or c for the alternative test relied upon:
a “Assets" alternative test—enter:
(1) Value of all assets ......					0
(2) Value of assets qualifying under section 4942(j)(3)(B)(i)					0
b “Endowment" alternative test— enter 2/3 of minimum investment return shown in Part X, line 6 for each year listed...	505,211	484,336	466,769	486,483	1,942,799
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) ....					0
(2) Support from general public and 5 or more exempt organizations as provided in section 4942(j)(3)(B)(iii)....					0
(3) Largest amount of support from an exempt organization					0
(4) Gross investment income					0

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

if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. (see instructions) to individuals or organizations under
other conditions, complete items 2a, b, c, and d.

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 (2013)

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)		Foundation status of recipient	Purpose of grant or contribution	Amount
aPaid during the year
MILLERSBURG FIRE CO 325 CENTER ST PO BOX 151 MILLERSBURG,PA17061		PUBLIC	VOLUNTARY DONATION	5,000
GRACE UNITED METHODIST CHURCH 982 MEDICAL ROAD MILLERSBURG,PA17061		CHURCH	VOLUNTARY DONATION	10,000
Total ................................. 3a				15,000

bApproved for future payment

Total ................................. 3b

Form 990-PF (2013)

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	(e) Related or exempt function income (See instructions.)
aLOW INCOME HOUSING RENTS					529,361
bPERSONAL CARE CENTER ROOM AND BOARD					1,143,406
cPERSONAL CARE SERVICES					85,224
dMEDICAL CENTER RENTAL					263,737
eMISC					310
f
gFees and contracts from government agencies
2 Membership dues and assessments....
3 Interest on savings and temporary cash investments ............					3
4 Dividends and interest from securities....					784,087
5 Net rental income or (loss) from real estate:
aDebt-financed property......
bNot debt-financed property.....
6 Net rental income or (loss) from personal property .............
7 Other investment income.....
8 Gain or (loss) from sales of assets other than inventory .............					142,184
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)..					2,948,312

13Total. Add line 12, columns (b), (d), and (e)..................

132,948,312

(See worksheet in line 13 instructions to verify calculations.)

Part XVI-B

Relationship of Activities to the Accomplishment of Exempt Purposes

Line No.	Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See instructions.)
1A	PRODUCES REVENUES TO PAY FOR EXPENSES OF OPERATING LOW-RENTAL HOUSING
1B	PRODUCES REVENUES TO PAY FOR EXPENSES OF OPERATING ELDERLY CARE FACILITY
1C	PRODUCES REVENUES TO PAY FOR EXPENSES IN THE SUPPORT OF QUALITY ELDER CARE
1D	PRODUCES REVENUES TO PAY FOR EXPENSES IN THE SUPPORT OF QUALITY ELDER & MEDICAL CARE
1E	MISCELLANEOUS UNRESTRICTED INCOME RELATED TO OPERATIONS
3	PRODUCES REVENUES FOR THE OPERATION AND FUTURE CONSTRUCTION OF NEW FACILITIES
4	PRODUCES REVENUES FOR THE OPERATION AND FUTURE CONSTRUCTION OF NEW FACILITIES
8	PRODUCES REVENUES FOR THE OPERATION AND FUTURE CONSTRUCTION OF NEW FACILITIES

Form 990-PF (2013)

Page 12

Part XVII

Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations

Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political

Yes

organizations?

Transfers from the reporting foundation to a noncharitable exempt organization of:

(1) Cash...................................

1a(1)

(2) Other assets.................................

1a(2)

Other transactions:

(1) Sales of assets to a noncharitable exempt organization....................

1b(1)

(2) Purchases of assets from a noncharitable exempt organization..................

1b(2)

(3) Rental of facilities, equipment, or other assets.......................

1b(3)

(4) Reimbursement arrangements...........................

1b(4)

(5) Loans or loan guarantees.............................

1b(5)

(6) Performance of services or membership or fundraising solicitations................

1b(6)

Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............

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

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?...........YesNo

If "Yes," complete the following schedule.

(a) Name of organization	(b) Type of organization	(c) Description of relationship

Sign Here

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer or fiduciary) is based on all information of which preparer has any knowledge.
				May the IRS discuss this return with the preparer shown below (see instr.)? Yes No
	Signature of officer or trustee	Date	Title

Paid Preparer Use Only	Print/Type preparer's name	Preparer's Signature	Date	Check if self- employed	PTIN
	Firm's name Firm's address			Firm's EIN
				Phone no.

Form 990-PF (2013)

Additional Data

Software ID:
Software Version:

Form 990PF - Special Condition Description:

Special Condition Description

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Name of the organization

CHARLES P & MARGARET E POLK FOUNDATION

Employer identification number

23-6296772

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi) and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year ......................... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 2

Name of organization CHARLES P & MARGARET E POLK FOUNDATION

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
1	GUY KAHLER 301 NORTH STREET MILLERSBURG, PA17061	$10,000	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 3

Name of organization CHARLES P & MARGARET E POLK FOUNDATION

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 4

Name of organization
CHARLES P & MARGARET E POLK FOUNDATION

Employer identification number

23-6296772

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

$
Use duplicate copies of Part III if additional space is needed.

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Additional Data

Software ID:
Software Version:

- TIN:

TY 2013 AccountingFeesSchedule

Name:

CHARLES P & MARGARET E POLK FOUNDATION

EIN: 23-6296772

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
VARIOUS PAYROLL, MONTHLY	13,866	13,866

- TIN:

TY 2013 AllOthProgRltdInvestmentsSch

Name:

CHARLES P & MARGARET E POLK FOUNDATION

EIN: 23-6296772

Category	Amount
ADMINISTRATION EXPENSES	153,580

- TIN:

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

TY 2013 DepreciationSchedule

Name:

CHARLES P & MARGARET E POLK FOUNDATION

EIN: 23-6296772

Description of Property	Date Acquired	Cost or Other Basis	Prior Years' Depreciation	Computation Method	Rate / Life (# of years)	Current Year's Depreciation Expense
ROOF REPAIRS	2000-07-31	43,295	15,768	SL	39.00	1,037
LANDSCAPING	2000-10-31	7,500	7,500	200DB	5.00
FLOORING AND PAINTING	2000-10-31	7,980	7,980	200DB	5.00
LANDSCAPING	2000-10-31	7,500	7,500	200DB	5.00
FLOORING AND PAINTING	2000-10-31	70,655	70,655	200DB	5.00
ROOF REPAIRS	2000-07-31	47,700	17,376	SL	39.00	1,143
LANDSCAPING	2000-10-31	7,500	7,500	200DB	5.00
FLOORING AND PAINTING	2000-10-31	2,265	2,265	200DB	5.00
ROOF REPAIRS	2002-02-11	14,779	14,779	200DB	5.00
FLOORING AND PAINTING	2000-10-31	8,337	8,337	200DB	5.00
LANDSCAPING	2001-06-30	2,839	2,839	200DB	5.00
LIGHTING IMPROVEMENTS	2001-07-23	1,687	1,687	200DB	5.00
MISC EQUIPMENT	2000-06-30	13,885	13,885	200DB	5.00
VEHICLE	2000-06-30	10,708	10,708	200DB	5.00
OFFICE EQUIPMENT	2000-06-30	17,175	17,175	200DB	5.00
COMPUTER EQUIPMENT	2002-09-27	5,668	5,668	200DB	5.00
CARPETING	2001-12-21	1,256	1,256	200DB	5.00
APPLIANCES	2000-06-30	1,061	1,061	200DB	5.00
PAPERING AND PAINTING	2001-03-23	11,346	11,346	200DB	5.00
CARPETING	2001-05-18	2,215	2,215	200DB	5.00
CARPETING	2001-12-21	1,910	1,910	200DB	5.00
INCLINATOR	2001-05-10	4,450	4,450	200DB	5.00
OFFICE FURNITURE	2001-02-02	25,213	25,213	200DB	5.00
FURNITURE	2001-06-30	20,785	20,785	200DB	5.00
OUTSIDE PORCH FURNITURE	2001-06-30	16,290	16,290	200DB	5.00
GLASS DINING ROOM TABLES	2001-09-07	5,170	5,170	200DB	5.00
KITCHEN EQUIPMENT	2001-09-13	1,415	1,415	200DB	5.00
PORTABLE SOUND SYSTEM	2001-09-21	1,187	1,187	200DB	5.00
PIANO	2001-10-08	10,297	10,297	200DB	5.00
COMPUTER	2001-11-13	1,508	1,508	SL	3.00
300 MOORE ST	1983-06-30	923,080	769,145	SL	40.00	23,077
CARPETING AND FLOORING	1996-06-30	7,624	7,621	SL	10.00
LANDSCAPING	1996-06-30	6,672	6,671	SL	10.00
CARPETING AND FLOORING	1997-06-30	4,732	4,731	SL	10.00
INCLINATOR	1997-06-30	1,800	1,800	SL	10.00
PAINTING AND IMPROVEMENTS	1997-06-30	7,372	7,366	SL	15.00
IMPROVEMENTS AND REMODELING	1998-06-30	107,278	103,704	SL	15.00	3,574
CARPETING AND FLOORING	1998-06-30	12,559	12,559	SL	10.00
INCLINATORS AND ELEVATORS	1998-06-30	16,480	16,480	SL	10.00
LANDSCAPING	1998-06-30	1,909	1,909	SL	10.00
INCLINATORS AND ELEVATORS	1999-04-21	11,330	11,330	SL	10.00
401-403 MOORE ST	1985-06-30	990,472	990,472	SL	15.00
CARPET	1993-06-30	2,168	2,168	SL	10.00
GARAGE AND GAZEBO	1994-06-30	39,938	18,466	SL	40.00	998
FENCING	1994-06-30	2,940	2,940	SL	10.00
CARPETING	1994-06-30	7,959	7,959	SL	10.00
ROOF	1995-06-30	6,488	2,836	SL	40.00	162
FLOORING	1995-06-30	8,551	8,551	SL	7.00
FENCING	1997-06-30	680	680	SL	10.00
IMPROVEMENTS	1997-06-30	9,723	9,721	SL	15.00
FLOORING AND CARPETING	1998-06-30	7,206	7,206	SL	10.00
PLUMBING	1998-06-30	1,151	1,151	SL	10.00
IMPROVEMENTS	1999-07-20	35,253	31,529	SL	15.00	2,350
CARPETING	1999-11-04	4,476	4,476	SL	7.00
ROOF MAINTENANCE	1999-11-12	3,950	3,463	SL	15.00	263
IMPROVEMENTS	2001-06-30	4,934	1,420	SL	40.00	123
401 CENTER STREET	1987-06-30	379,408	379,408	SL	15.00
BUILDING 401 CENTER	1989-06-30	899,051	899,051	SL	15.00
ELEVATOR	1989-06-30	38,000	38,000	SL	10.00
BUILDING 401 CENTER	1990-06-30	266,675	266,675	SL	15.00
RENOVATIONS	1992-06-30	21,590	21,590	SL	15.00
RENOVATIONS/KITCHEN	1993-06-30	30,148	30,148	SL	15.00
ROOF	1993-06-30	16,035	16,035	SL	15.00
FLOORING	1998-06-30	1,445	1,445	SL	10.00
CARPETING	1999-01-18	4,746	4,746	SL	7.00
IMPROVEMENTS	2001-06-30	17,090	4,928	SL	40.00	427
ROOF	2001-05-30	25,020	7,277	SL	40.00	626
423-425 RACE AND NORTH BUILDING	1998-08-01	194,444	70,485	SL	40.00	4,861
FLOORING	1998-08-01	2,112	2,112	SL	10.00
PERSONAL CARE BUILDING	2000-04-30	5,597,139	1,705,449	SL	40.00	139,928
FURNITURE	1990-06-30	9,232	9,232	SL	7.00
TELEPHONE SYSTEM	1991-06-30	2,500	2,500	SL	7.00
COPIER	1991-06-30	1,833	1,833	SL	7.00
SNOWBLOWER	1991-06-30	1,413	1,413	SL	7.00
MISC EQUIPMENT	1991-06-30	2,780	2,780	SL	7.00
MISC EQUIPMENT	1992-06-30	4,083	4,083	SL	7.00
APPLIANCES	1993-06-30	6,564	6,564	SL	7.00
SNOWBLOWERS-3	1994-06-30	2,920	2,920	SL	7.00
OFFICE FURNITURE	1994-06-30	474	474	SL	7.00
APPLIANCES	1995-06-30	13,053	13,053	SL	7.00
APPLIANCES	1996-06-30	5,870	5,870	SL	7.00
LAWN MOWER	1996-06-30	2,150	2,150	SL	7.00
FIRE EXTINGUISHERS	1996-06-30	509	509	SL	7.00
CURB STOPS	1996-06-30	418	418	SL	7.00
STAIRCHAIR	1997-06-30	9,148	9,148	SL	7.00
MISC EQUIP	1997-06-30	851	851	SL	7.00
MISC EQUIP	1998-06-30	551	551	SL	7.00
OFFICE FURNITURE	1998-06-30	2,681	2,681	SL	7.00
COMPUTER SYSTEMS	1998-06-30	15,450	15,450	SL	5.00
APPLIANCES	1983-06-30	9,900	9,900	SL	10.00
GENERATOR	1983-06-30	5,000	5,000	SL	10.00
TABLES AND CHAIRS	1983-06-30	911	911	SL	10.00
APPLIANCES	1993-06-30	430	430	SL	7.00
WATER HEATERS/APPLIANCES	1998-06-30	5,206	5,206	SL	7.00
APPLIANCES	1985-06-30	24,960	24,960	SL	10.00
SOCIAL ROOM FURNITURE	1988-06-30	1,033	1,033	SL	10.00
FURNITURE	1993-06-30	2,266	2,266	SL	10.00
APPLIANCES	1994-06-30	4,056	4,056	SL	7.00
SIMPLEX TIME RECORDER CO	1999-06-18	1,983	1,982	SL	7.00
INCLINATORS/ELEVATORS	1999-10-22	3,980	3,980	SL	7.00
APPLIANCES	1987-06-30	10,004	10,004	SL	10.00
APPLIANCES	1989-06-30	16,500	16,500	SL	10.00
APPLIANCES	1993-06-30	869	869	SL	10.00
TABLES AND CHAIRS	1993-06-30	4,601	4,601	SL	10.00
APPLIANCES	1998-06-30	668	666	SL	7.00
FURNITURE	1998-06-30	251	251	SL	7.00
APPLIANCES	1998-08-01	279	279	SL	7.00
FURNISHINGS AND EQUIPMENT	2000-06-30	1,157,076	1,157,076	SL	7.00
BUILDING 365 NORTH	1999-08-01	91,531	30,697	SL	40.00	2,288
BUILDING 330 MOORE ST	1999-09-01	4,500	1,507	SL	40.00	113
CARPETING	1999-09-01	2,019	2,019	SL	5.00
BUILDING 336 MOORE ST	1999-10-01	143,612	47,568	SL	40.00	3,590
CARPETING	1999-10-01	7,823	7,823	SL	5.00
SHED AND GARAGE DEMO	1999-10-01	2,000	663	SL	40.00	50
BUILDING 338 MOORE	1999-10-01	67,101	22,233	SL	40.00	1,678
CARPETING	1999-10-01	4,480	4,480	SL	5.00
BUILDING 364 MOORE STREET	2000-06-30	56,437	17,696	SL	40.00	1,411
BUILDING 366 MOORE ST	2000-06-30	62,028	19,452	SL	40.00	1,551
BUILDING 372 MOORE ST	2000-05-23	85,497	26,980	SL	40.00	2,137
BUILDING 427-429 RACE STREET	2000-10-06	153,245	46,770	SL	40.00	3,831
BUILDING RACE ST HANDY MKT	2000-06-30	85,708	26,877	SL	40.00	2,143
WALKWAY	2001-05-31	7,100	2,069	SL	40.00	178
STORE FIXTURES AND EQUIPMENT	2000-06-30	21,426	21,426	SL	5.00
IMPROVEMENTS	2003-01-20	13,289	3,293	SL	40.00	332
TRUCK	2003-04-09	4,931	4,931	SL	7.00
CHAIRS	2003-05-29	3,780	3,780	SL	7.00
COMPUTER-MIS	2003-10-15	3,540	3,540	SL	3.00
358 MOORE ST	2003-12-01	94,959	21,828	SL	40.00	2,374
342-354 MOORE STREET	2003-12-01	210,421	48,297	SL	40.00	5,261
FIREPROOF SAFE	2004-12-15	1,600	1,600	SL	7.00
FURNITURE AND EQUIPMENT	2004-01-01	506,191	506,191	SL	7.00
445 CENTER STREET	2004-04-01	65,904	14,420	SL	40.00	1,648
FURNACE FOR 445 CENTER STREET	2004-03-18	3,950	3,948	SL	7.00
ROOF FOR 401-403 MOORE STREET	2004-12-22	28,228	15,056	SL	15.00	1,882
PPC BUILDING IMPROVEMENTS	2002-01-01	6,791,051	1,575,653	SL	40.00	169,776
PPC BUILDING RENOVATIONS	2004-12-31	57,060	11,416	SL	40.00	1,427
PPC PHASE 2 IMPROVEMENTS	2003-12-01	442,463	119,574	SL	40.00	11,062
LAND-MEDICAL ROAD	2000-02-01	547,548		SL	0.00
SNOWBLOWER	1996-06-30	1,562	1,562	SL	7.00
ELEVATOR	1985-06-30	42,794	42,794	SL	10.00
PAVING	1985-06-30	5,870	5,870	SL	10.00
COMPUTER - MIS	2005-01-17	4,582	4,580	SL	5.00
NEW VEHICLE	2005-09-13	14,414	14,414	SL	7.00
AIR CONDITIONER	2005-09-26	7,930	7,930	SL	7.00
NEW ROOF - 338 MOORE	2005-11-03	4,754	2,272	SL	15.00	317
OFFICE REMODEL	2005-04-05	27,493	5,324	SL	40.00	687
REPLACEMENT WINDOWS	2006-10-09	70,200	29,250	SL	15.00	4,680
REPLACEMENT WINDOWS	2006-10-29	67,500	27,750	SL	15.00	4,500
ROOF REPLACEMENT-445 CENTER ST	2007-04-04	18,535	6,798	SL	15.00	1,235
FREDERICK CENTER-LAND ONLY	2007-01-01	989,881		SL	0.00
FREDERICK CENTER IMPROVEMENTS	2007-03-19	11,704	1,684	SL	40.00	293
NEW VEHICLE	2008-11-13	2,258	1,346	SL	7.00	323
BOILER-FRED CENTER	2008-07-07	7,567	4,865	SL	7.00	1,081
FREDERICK REMODEL	2008-07-18	16,900	1,868	SL	40.00	423
FREDERICK REMODEL 2010	2010-12-01	99,170	5,165	SL	40.00	2,479
FREDERICK REMODEL 2011	2011-07-01	48,721	1,827	SL	40.00	1,218
FREDERICK CHILLER UNIT	2011-07-01	46,138	9,887	SL	7.00	6,591
GENERATOR	2011-10-12	142,659	17,832	SL	10.00	14,266
CARPETING	2012-10-30	3,739	125	SL	5.00	748
REPAVING	2012-06-22	5,450	68	SL	40.00	136
REPAVING	2012-06-22	5,750	72	SL	40.00	144
AWNING	2013-06-30	10,530		SL	40.00	132
FRONT REMODEL	2013-06-30	169,705		SL	40.00	2,121
TRUCK	2013-06-30	23,522		SL	7.00	1,680
INTERCOM	2013-06-30	104,278		SL	7.00	7,448

- TIN:

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

TY 2013 GainLossSaleOtherAssetsSch

Name:

CHARLES P & MARGARET E POLK FOUNDATION

EIN: 23-6296772

Name	Date Acquired	How Acquired	Date Sold	Purchaser Name	Gross Sales Price	Basis	Basis Method	Sales Expenses	Total (net)	Accumulated Depreciation
LONG TERM STOCK SALES		Purchased			3,385,829	3,354,224			31,605
SHORT TERM STOCK SALES		Purchased			1,131,286	1,020,707			110,579

- TIN:

TY 2013 InvestmentsCorpBondsSchedule

Name:

CHARLES P & MARGARET E POLK FOUNDATION

EIN: 23-6296772

Name of Bond	End of Year Book Value	End of Year Fair Market Value
CORPORATE BONDS	1,229,149	1,753,809

- TIN:

TY 2013 InvestmentsCorpStockSchedule

Name:

CHARLES P & MARGARET E POLK FOUNDATION

EIN: 23-6296772

Name of Stock	End of Year Book Value	End of Year Fair Market Value
US	12,956,787	11,563,689
FOREIGN	217,042	241,744

- TIN:

TY 2013 InvestmentsGovtObligationsSch

Name:

CHARLES P & MARGARET E POLK FOUNDATION

EIN: 23-6296772

US Government Securities - End of Year Book Value:

297,558

US Government Securities - End of Year Fair Market Value:

302,833

State & Local Government Securities - End of Year Book Value:

State & Local Government Securities - End of Year Fair Market Value:

- TIN:

TY 2013 InvestmentsLandSchedule2

Name:

CHARLES P & MARGARET E POLK FOUNDATION

EIN: 23-6296772

Category/ Item	Cost/Other Basis	Accumulated Depreciation	Book Value	End of Year Fair Market Value
LAND AND BLDS - RENTED	2,325,042	369,318	1,955,724
LAND AND BLDS - NOT RENTED	547,548		547,548

- TIN:

TY 2013 LandEtcSchedule2

Name:

CHARLES P & MARGARET E POLK FOUNDATION

EIN: 23-6296772

Category / Item	Cost / Other Basis	Accumulated Depreciation	Book Value	End of Year Fair Market Value
BLDGS AND EQUIPMENT	20,076,094	10,009,433	10,066,661

- TIN:

TY 2013 LegalFeesSchedule

Name:

CHARLES P & MARGARET E POLK FOUNDATION

EIN: 23-6296772

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
VARIOUS CONSULTATION	1,146	737		409

- TIN:

TY 2013 MortgagesAndNotesPayableSch

Name:

CHARLES P & MARGARET E POLK FOUNDATION

EIN: 23-6296772

Total Mortgage Amount: 996647

- TIN:

TY 2013 OtherAssetsSchedule

Name:

CHARLES P & MARGARET E POLK FOUNDATION

EIN: 23-6296772

Description	Beginning of Year - Book Value	End of Year - Book Value	End of Year - Fair Market Value
CONSTRUCTION IN PROCESS	100,656
CONSTRUCTION IN PROCESS	100,656
CONSTRUCTION IN PROCESS	100,656

- TIN:

TY 2013 OtherAssetsSchedule

Name:

CHARLES P & MARGARET E POLK FOUNDATION

EIN: 23-6296772

Description	Beginning of Year - Book Value	End of Year - Book Value	End of Year - Fair Market Value
CONSTRUCTION IN PROCESS	100,656
CONSTRUCTION IN PROCESS	100,656
CONSTRUCTION IN PROCESS	100,656

- TIN:

TY 2013 OtherAssetsSchedule

Name:

CHARLES P & MARGARET E POLK FOUNDATION

EIN: 23-6296772

Description	Beginning of Year - Book Value	End of Year - Book Value	End of Year - Fair Market Value
CONSTRUCTION IN PROCESS	100,656
CONSTRUCTION IN PROCESS	100,656
CONSTRUCTION IN PROCESS	100,656

- TIN:

TY 2013 OtherExpensesSchedule

Name:

CHARLES P & MARGARET E POLK FOUNDATION

EIN: 23-6296772

Description	Revenue and Expenses per Books	Net Investment Income	Disbursements for Charitable Purposes
INSURANCE	87,909	13,720	74,189
REPAIRS AND MAINT	220,507	150,580	69,926
SUPPLIES	22,480		22,480
INSPECTIONS AND PERMITS	162	45	117
DIRECTOR FEES	48,000	48,000
OFFICE EXPENSE	7,843	3,393	4,450
DUES AND SUBSCRIPTIONS	487	250	237
FOOD FOR RESIDENTS	103,657		103,657
EQUIPMENT CONTRACTS	133,034	40,737	92,296
ADVERTISING	19,021	655	18,366
TELEPHONE	10,972	1,893	9,079
PERSONAL CARE SERVICES	10,878		10,878
BUILDING DECOR	5,247		5,247
RESIDENT ACTIVITY	2,182		2,182

- TIN:

TY 2013 OtherIncomeSchedule2

Name:

CHARLES P & MARGARET E POLK FOUNDATION

EIN: 23-6296772

Description	Revenue And Expenses Per Books	Net Investment Income	Adjusted Net Income
PERSONAL CARE CENTER ROOM AND BOARD	1,143,406		1,143,406
LOW INCOME HOUSING RENTS	529,361		529,361
PERSONAL CARE SERVICES	85,224		85,224
MEDICAL CENTER RENTAL	263,737	263,737
MISC	310		310

- TIN:

TY 2013 OtherProfessionalFeesSchedule

Name:

CHARLES P & MARGARET E POLK FOUNDATION

EIN: 23-6296772

Category	Amount	Net Investment Income	Disbursements for Charitable Purposes
VARIOUS ADMIN	91		91
VARIOUS CLERGY	3,805		3,805
VARIOUS INVESTMENT FEES	28,442	28,442

- TIN:

TY 2013 TaxesSchedule

Name:

CHARLES P & MARGARET E POLK FOUNDATION

EIN: 23-6296772

Category	Amount	Net Investment Income	Disbursements for Charitable Purposes
REAL ESTATE	196,992	127,354	69,638
PAYROLL TAX	91,754	5,223	86,531
INVESTMENT INCOME TAX	4,518	4,518