Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletInformation about Form 990-PF and its instructions is at www.irs.gov/form990pf.
OMB No. 1545-0052
2015
Open to Public Inspection
For calendar year 2015, or tax year beginning 01-01-2015 , and ending 12-31-2015
Name of foundation
JIM & RUTH COUTURE CHARITABLE FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)40 ELMWOOD AVENUE
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
FITCHBURG, MA01420
A Employer identification number

04-6722346
B Telephone number (see instructions)

(978) 345-4610
C bullet
G Check all that apply:

D 1. bullet
2. bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$260,301J Accounting method:
 
(Part I, column (d) must be on cash basis.)
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) 20,000
2 Check bullet Sch. B .............
3 Interest on savings and temporary cash investments 23 23 23
4 Dividends and interest from securities... 22,220 22,220 22,220
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10  
b Gross sales price for all assets on line 6a  
7 Capital gain net income (from Part IV, line 2)... 0
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 42,243 22,243 22,243
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0 0 0 0
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 500 0 0 0
c Other professional fees (attach schedule)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 237 0 0 0
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 224 0 0 0
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 961 0 0 0
25 Contributions, gifts, grants paid....... 42,493 42,493
26 Total expenses and disbursements. Add lines 24 and 25 43,454 0 0 42,493
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -1,211
b Net investment income (if negative, enter -0-) 22,243
c Adjusted net income (if negative, enter -0-)... 22,243
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2015)
Form 990-PF (2015)
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............. 55,282 54,071 54,071
2 Savings and temporary cash investments......... 320,100 320,100 206,230
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
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) 375,382 374,171 260,301
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 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........ 0 0
28 Paid-in or capital surplus, or land, bldg., and equipment fund 0 0
29 Retained earnings, accumulated income, endowment, or other funds 375,382 374,171
30 Total net assets or fund balances (see instructions)..... 375,382 374,171
31 Total liabilities and net assets/fund balances (see instructions). 375,382 374,171
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
375,382
2
Enter amount from Part I, line 27a .....................
2
-1,211
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
374,171
5
Decreases not included in line 2 (itemize) bullet
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30 .
6
374,171
Form 990-PF (2015)
Form 990-PF (2015)
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.)
1a
b
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
b
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
b
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2  
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 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))
2014 40,560 285,095 0.142268
2013 38,755 226,877 0.170819
2012 33,440 219,895 0.152073
2011 34,764 254,727 0.136476
2010 26,460 257,035 0.102943
2
Total of line 1, column (d) .....................
20.704579
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
0.140916
4
Enter the net value of noncharitable-use assets for 2015 from Part X, line 5.....
4
269,840
5
Multiply line 4 by line 3......................
5
38,025
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
222
7
Add lines 5 and 6........................
7
38,247
8
Enter qualifying distributions from Part XII, line 4.............
8
42,493
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 (2015)
Form 990-PF (2015)
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 Bullet and enter “N/A" on line 1. Bracket
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b 1 222
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........................... 3 222
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- ..... 5 222
6 Credits/Payments:
a 2015 estimated tax payments and 2014 overpayment credited to 2015 6a  
b Exempt foreign organizations—tax withheld at source...... 6b
c Tax paid with application for extension of time to file (Form 8868)... 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 0
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 222
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 2015 estimated taxBullet   RefundedBullet 11  
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see 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$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
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)
    bulletMA
    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 2015 or the taxable year beginning in 2015 (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. Click to see attachment...............................
    10
    Yes
     
    Form 990-PF (2015)
    Form 990-PF (2015)
    Page 5
    Part VII-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. (see instructions) .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement (see instructions).................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletN/A
    14
    The books are in care ofbulletJAMES B COUTURE Telephone no.bullet (978) 345-4610

    Located atbullet40 ELMWOOD AVEFITCHBURGMA ZIP+4bullet01420
    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 2015, 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 FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR). If "Yes", enter the name of the foreign country bullet  
    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 instructions)? ........
    1b
     
     
    ........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 2015?.............
    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 2015, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2015?.............
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?......................
    b
    If "Yes," did it have excess business holdings in 2015 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 2015.)..................
    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 2015?
    4b
     
    No
    Form 990-PF (2015)
    Form 990-PF (2015)
    Page 6
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required (Continued)
    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 4945(d)(4)(A)? (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 (2015)
    Form 990-PF (2015)
    Page 7
    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
    JAMES B COUTURE TRUSTEE/MANAGER
    5.00     		0 0 0
    40 ELMWOOD AVENUE
    FITCHBURG,MA01420
    RUTH A COUTURE TRUSTEE/MANAGER
    1.00     		0 0 0
    40 ELMWOOD AVENUE
    FITCHBURG,MA01420
    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  
    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 instructions.
    3  
    Total. Add lines 1 through 3.........................bullet0
    Form 990-PF (2015)
    Form 990-PF (2015)
    Page 8
    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
    219,272
    b
    Average of monthly cash balances.......................
    1b
    54,677
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    273,949
    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
    273,949
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    4,109
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    269,840
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    13,492
    Part XI
    Distributable Amount bullet
    1
    Minimum investment return from Part X, line 6....................
    1
    13,492
    2a
    Tax on investment income for 2015 from Part VI, line 5......
    2a
    222
    b
    Income tax for 2015. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    222
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    13,270
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    13,270
    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
    13,270
    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
    42,493
    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
    42,493
    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
    222
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    42,271
    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 (2015)
    Form 990-PF (2015)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2014     		(c)
    2014     		(d)
    2015
    1 Distributable amount for 2015 from Part XI, line 7 13,270
    2 Undistributed income, if any, as of the end of 2015:
    a Enter amount for 2014 only....... 0
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2015:
    a From 2010...... 26,460
    b From 2011...... 34,992
    c From 2012...... 22,885
    d From 2013...... 28,305
    e From 2014...... 26,779
    fTotal of lines 3a through e........ 139,421
    4Qualifying distributions for 2015 from Part
    XII, line 4: bullet$ 42,493
    a Applied to 2014, 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 2015 distributable amount..... 13,270
    e Remaining amount distributed out of corpus 29,223
    5 Excess distributions carryover applied to 2015. 0 0
    (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 5 168,644
    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 2014. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2016. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2015 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8Excess distributions carryover from 2010 not
    applied on line 5 or line 7 (see instructions) ...     		26,460
    9Excess distributions carryover to 2016.
    Subtract lines 7 and 8 from line 6a ......     		142,184
    10 Analysis of line 9:
    a Excess from 2011.... 34,992
    b Excess from 2012.... 22,885
    c Excess from 2013.... 28,305
    d Excess from 2014.... 26,779
    e Excess from 2015.... 29,223
    Form 990-PF (2015)
    Form 990-PF (2015)
    Page 10
    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 2015, 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) 2015 (b) 2014 (c) 2013 (d) 2012
             
    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).)
    JAMES B COUTURE
    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 address of the person to whom applications should be addressed:
    JAMES B COUTURE
    40 ELMWOOD DRIVE
    FITCHBURG,MA01420
    (978) 345-4610
    bThe form in which applications should be submitted and information and materials they should include:
    N/A
    cAny submission deadlines:
    N/A
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    CONTRIBUTIONS MADE ONLY TO PRE-SELECTED CHARITABLE ORGANIZATIONS.
    Form 990-PF (2015)
    Form 990-PF (2015)
    Page 11
    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
    AARP
    PO BOX 93207
    LONG BEACH,CA90809     		    TO ASSIST WITH THEIR GOALS 15
    ABLINOOJI INC
    PO BOX 444
    HAYWARD,WI54843     		    TO ASSIST WITH THEIR GOALS 100
    AMERICAN CANCER SOCIETY
    350 PLANTATION STREET
    WORCESTER,MA01604     		    TO ASSIST WITH THEIR GOALS 150
    AMERICAN DIABETES ASSOCIATION
    107 N BEAUREGARD ST
    ALEXANDRIA,VA22311     		    TO ASSIST WITH THEIR GOALS 50
    AMERICAN HEART ASSOCIATION
    7272 GREENVILLE AVE
    DALLAS,TX75231     		    TO ASSIST WITH THEIR GOALS 50
    AMERICAN KIDNEY FUND
    PO BOX 1837
    MERRIFIELD,VA22311     		    TO ASSIST WITH THEIR GOALS 35
    AMERICAN RED CROSS
    29 MAIN STREET SUITE 5
    LEOMINSTER,MA01453     		    TO ASSIST WITH THEIR GOALS 200
    THE FOUNDATION FOR ANIMAL CARE AND EDUCATION
    10455 SORRENTO VALLEY RD SUITE 208
    SAN DIEGO,CA92121     		    TO ASSIST WITH THEIR GOALS 50
    ARBOR DAY FOUNDATION
    100 ARBOR AVE
    NEBRASKA CITY,NE68410     		    TO ASSIST WITH THEIR GOALS 85
    BASILICA OF THE NATIONAL SHRINE OF THE IMMACULATE CONCEPTION
    400 MICHIGAN AVE NE
    WASHINGTON,DC20017     		    TO ASSIST WITH THEIR GOALS 150
    BEACON OF HOPE
    62 WEST ST
    LEOMINSTER,MA01453     		    TO ASSIST WITH THEIR GOALS 100
    BETHANY HEALTH CARE CENTER
    97 BETHANY RD
    FRAMINGHAM,MA01702     		    TO ASSIST WITH THEIR GOALS 50
    BOSTON RESCUE MISSION
    39 KINGSTON ST
    BOSTON,MA02111     		    TO ASSIST WITH THEIR GOALS 71
    BOYS TOWN
    14100 CRAWFORD STREET
    BOYS TOWN,NE68010     		    TO ASSIST WITH THEIR GOALS 175
    COPD FOUNDATION
    20 F STREET NW SUITE 200A
    WASHINGTON,DC20001     		    TO ASSIST WITH THEIR GOALS 50
    CAPUCHIN FRIARS
    220 37TH ST
    PITTSBURGH,PA15201     		    TO ASSIST WITH THEIR GOALS 25
    CARE NET
    PO BOX 511 515 MAIN ST
    FITCHBURG,MA01420     		    TO ASSIST WITH THEIR GOALS 125
    CATHEDRAL OF PINES
    TEN HALE HILL RD
    RINDGE,NH03461     		    TO ASSIST WITH THEIR GOALS 50
    CATHOLIC CHARITIES
    10 HAMMOND ST
    WORCESTER,MA01610     		    TO ASSIST WITH THEIR GOALS 150
    CATHOLIC EXTENSION
    150 SOUTH WACKER DRIVE SUITE 2000
    CHICAGO,IL60606     		    TO ASSIST WITH THEIR GOALS 25
    CATHOLIC HOME MISSIONS
    3211 FOURTH STREET NE
    WASHINGTON,DC20017     		    TO ASSIST WITH THEIR GOALS 24
    CATHOLIC TV
    34 CHESTNUT STREET PO BOX 9196
    WATERTOWN,MA02471     		    TO ASSIST WITH THEIR GOALS 950
    CHILD MEDICAL CONNECTIONS
    171 JOHNSON ST 212
    LEOMINSTER,MA01453     		    TO ASSIST WITH THEIR GOALS 350
    CHRIST CHURCH
    569 MAIN ST
    FITCHBURG,MA01420     		    TO ASSIST WITH THEIR GOALS 1,200
    CHRISTIAN APPALACHIAN PROJECT
    6550 SOUTH KY RT 321 PO BOX 459
    HAGERHILL,KY41222     		    TO ASSIST WITH THEIR GOALS 470
    COLUMBIAN FATHERS
    65 FERRY RD
    BRISTOL,RI02809     		    TO ASSIST WITH THEIR GOALS 35
    COUNCIL OF INDIAN NATIONS
    1310 E RIVERVIEW DR
    PHOENIX,AZ85034     		    TO ASSIST WITH THEIR GOALS 30
    CROSS CATHOLIC OUTREACH
    2700 N MILITARY TRAIL SUITE 240 PO
    BOX 273908
    BOCA RATON,FL33427     		    TO ASSIST WITH THEIR GOALS 100
    CYSTIC FIBROSIS FOUNDATION
    6931 ARLINGTON ROAD 2ND FLOOR
    BETHESDA,MD20814     		    TO ASSIST WITH THEIR GOALS 125
    DEFENDERS OF WILDLIFE
    1130 17TH STREET NW
    WASHINGTON,DC20036     		    TO ASSIST WITH THEIR GOALS 30
    FEED THE CHILDREN
    333 N MERIDIAN AVE
    OKLAHOMA CITY,OK73107     		    TO ASSIST WITH THEIR GOALS 210
    FEEDING AMERICA
    35 E WACKER DRIVE SUITE 2000
    CHICAGO,IL60601     		    TO ASSIST WITH THEIR GOALS 250
    FR JOHN DOLAN MS
    49 ELM STREET
    WORCESTER,MA01609     		    TO ASSIST WITH HIS RELIGIOUS GOALS 100
    FR JOHN HUGHES MS
    49 ELM STREET
    WORCESTER,MA01609     		    TO ASSIST WITH HIS RELIGIOUS GOALS 100
    FR LAURIE LEGER MS
    49 ELM STREET
    WORCESTER,MA01609     		    TO ASSIST WITH HIS RELIGIOUS GOALS 100
    FR RICHARD TRAINOR
    49 ELM STREET
    WORCESTER,MA01609     		    TO ASSIST WITH HIS RELIGIOUS GOALS 250
    FR TED LAPERLE
    49 ELM STREET
    WORCESTER,MA01609     		    TO ASSIST WITH HIS RELIGIOUS GOALS 50
    FR TOM SICKLER MS
    49 ELM STREET
    WORCESTER,MA01609     		    TO ASSIST WITH HIS RELIGIOUS GOALS 100
    FRANCISCAN MISSION
    PO BOX 130
    WATERFORD,WI53185     		    TO ASSIST WITH THEIR RELIGIOUS GOALS 227
    FRANCISCAN GUEST HOUSE
    26 BEACH AVE
    KENNEBUNK,ME04043     		    TO ASSIST WITH THEIR GOALS 100
    HABITAT FOR HUMANITY
    637 LANCASTER ST
    LEOMINSTER,MA01453     		    TO ASSIST WITH THEIR GOALS 25
    HAITIAN OUTREACH
    50 NINTH AVE SOUTH SUITE 203
    HOPKINS,MN55343     		    TO ASSIST WITH THEIR GOALS 400
    HELP FOR HOMELESS CHILDREN
    23 MILL STREET
    LEOMINSTER,MA01453     		    TO ASSIST WITH THEIR GOALS 300
    IMMACULATE HEART OF MARY SCHOOL
    282 STILL RIVER RD
    STILL RIVER,MA01467     		    TO ASSIST WITH THEIR GOALS 360
    INTERNATIONAL FELLOWSHIP OF CHRISTIANS AND JEWS
    30 NORTH LASALLE ST SUITE 4300
    CHICAGO,IL60602     		    TO ASSIST WITH THEIR RELIGIOUS GOALS 150
    JAMES PELLETIER SCHOLARSHIP FUND
    121 STOCKBRIDGE HALL
    UMASS AMHERST,MA01003     		    TO ASSIST WITH THEIR GOALS 50
    KNIGHTS OF COLUMBUS
    484 LANCASTER ST
    LEOMINSTER,MA01453     		    TO ASSIST WITH THEIR GOALS 50
    LADIES OF ST ANN
    605 38TH ST PO BOX 59
    CANYON,TX79015     		    TO ASSIST WITH THEIR GOALS 100
    LAST MILE RIDE
    44 SOUTH MAIN STREET
    RANDOLPH,VT05060     		    TO ASSIST WITH THEIR GOALS 100
    MAKE A WISH FOUNDATION
    4742 N 24TH ST SUITE 400
    PHOENIX,AZ85016     		    TO ASSIST WITH THEIR GOALS 220
    MARCH OF DIMES
    112 TURNPIKE ROAD SUITE 300
    WESTBOROUGH,MA01581     		    TO ASSIST WITH THEIR GOALS 45
    MARIST CARE CENTER
    9 HOPE AVE SUITE 500
    WALTHAM,MA02453     		    TO ASSIST WITH THEIR GOALS 25
    MARY BETH BENISON ALS FUND
    PO BOX 227
    SHREWSBURY,MA01545     		    TO ASSIST WITH THEIR GOALS 100
    MEMORIAL SLOAN KETTERING CANCER CENTER
    1275 YORK AVENUE
    NEW YORK,NY10065     		    TO ASSIST WITH THEIR GOALS 25
    MERCY HOME FOR BOYS & GIRLS
    1140 WEST JACKSON BOULEVARD
    CHICAGO,IL60607     		    TO ASSIST WITH THEIR GOALS 325
    MLPOA INC
    PO BOX 693
    RINDGE,NH03461     		    TO ASSIST WITH THEIR GOALS 50
    MONTACHUSETT OPPORTUNITY COUNCIL
    133 PRICHARD STREET
    FITCHBURG,MA01420     		    TO ASSIST WITH THEIR GOALS 400
    MORGAN MEMORIAL
    1010 HARRISON AVE
    BOSTON,MA02119     		    TO ASSIST WITH THEIR GOALS 50
    NASHUA RIVER WATERSHED ASSOCIATION
    592 MAIN ST
    GROTON,MA01450     		    TO ASSIST WITH THEIR GOALS 120
    NATIONAL AUDUBON SOCIETY
    255 SHERMAN HOLLOW RD
    HUNTINGTON,VT05462     		    TO ASSIST WITH THEIR GOALS 65
    NATIONAL PARKS CONSERVATION ASSOCIATION
    777 6TH STREET NW SUITE 700
    WASHINGTON,DC20001     		    TO ASSIST WITH THEIR GOALS 25
    NATIONAL PRO-LIFE ALLIANCE
    5211 PORT ROYAL ROAD SUITE 500
    SPRINGFIELD,VA22151     		    TO ASSIST WITH THEIR GOALS 50
    NOTRE DAME HEALTH CARE CENTER
    555 PLANTATION ST
    WORCESTER,MA01605     		    TO ASSIST WITH THEIR GOALS 50
    NATIONAL RESOURCES DEFENSE COUNCIL
    40 WEST 20TH STREET
    NEW YORK,NY10011     		    TO ASSIST WITH THEIR GOALS 20
    OFFICE OF THE DIACONATE
    66 BROOKS DRIVE
    BRAINTREE,MA02184     		    TO ASSIST WITH THEIR GOALS 99
    OPERATION WINCHENDON CARES
    26 LAKEVIEW DR
    WINCHENDON,MA01475     		    TO ASSIST WITH THEIR GOALS 100
    OUR FATHER'S HOUSE
    PO BOX 7251
    FITCHBURG,MA01420     		    TO ASSIST WITH THEIR GOALS 215
    PINE STREET INN
    444 HARRISON AVE
    BOSTON,MA02118     		    TO ASSIST WITH THEIR GOALS 100
    PROBLEM PREGNANCY
    495 PLEASANT ST
    WORCESTER,MA01609     		    TO ASSIST WITH THEIR GOALS 50
    REV THEODORE LAPERLE
    46 WOODLAND STREET
    FITCHBURG,MA01420     		    TO ASSIST WITH HIS RELIGIOUS GOALS 50
    SACRED HEART DAYCARE
    100 CENTRAL STREET
    GARDNER,MA01440     		    TO ASSIST WITH THEIR GOALS 100
    SACRED HEART MONESTARY
    1005 W 8TH STREET
    YANKTON,SD57078     		    TO ASSIST WITH THEIR GOALS 31
    THE SALVATION ARMY
    739 WATER STREET
    FITCHBURG,MA01420     		    TO ASSIST WITH THEIR GOALS 200
    SHRINERS HOSPITALS
    PO BOX 1525
    RANSON,WV25438     		    TO ASSIST WITH THEIR GOALS 10
    SIERRA CLUB
    85 SECOND STREET 2ND FLOOR
    SAN FRANCISCO,CA94105     		    TO ASSIST WITH THEIR GOALS 89
    SIOUX NATION RELIEF FUND
    2401 EGLIN ST
    RAPID CITY,SD57703     		    TO ASSIST WITH THEIR GOALS 35
    SISTERS OF MT THABOR
    1295 BALD EAGLE LAKE RD
    ORTONVILLE,MI48462     		    TO ASSIST WITH THEIR GOALS 50
    SMILE TRAIN
    PO BOX 96231
    WASHINGTON,DC200906231     		    TO ASSIST WITH THEIR GOALS 25
    SOCIETY OF THE DIVINE SAVIOR
    1303 MILWAUKEE DRIVE
    SALVATORIAN CENTER,WI53062     		    TO ASSIST WITH THEIR GOALS 15
    SPECIAL OLYMPICS MASSACHUSETTS
    512 FOREST ST
    MARLBOROUGH,MA01752     		    TO ASSIST WITH THEIR GOALS 150
    ST JOSEPH'S CHURCH
    49 WOODLAND ST
    FITCHBURG,MA01420     		    TO ASSIST WITH THEIR GOALS 25,300
    ST JOSEPH INDIAN SCHOOL
    PO BOX 300
    CHAMBERLAIN,SD573250300     		    TO ASSIST WITH THEIR GOALS 275
    ST JUDE CHILDREN'S HOSPITAL
    501 ST JUDE PLACE
    MEMPHIS,TN38105     		    TO ASSIST WITH THEIR GOALS 200
    ST FRANCIS HOUSE
    39 BOYLSTON ST
    BOSTON,MA02116     		    TO ASSIST WITH THEIR GOALS 184
    ST ANTHONY'S CHURCH
    84 SALEM ST FITCHBURG
    FITCHBURG,MA01420     		    TO ASSIST WITH THEIR RELIGIOUS GOALS 130
    BASILICA OF THE NATIONAL SHRINE OF ST ANN
    1233 ST ANN ST
    SCRANTON,PA18504     		    TO ASSIST WITH THEIR GOALS 50
    ST BERNARD'S PARISH AT ST CAMILLUS CHURCH
    333 MECHANIC ST
    FITCHBURG,MA01420     		    TO ASSIST WITH THEIR GOALS 50
    ST BONAVENTURE INDIAN MISSION
    PO BOX 610
    THOREAU,NM87323     		    TO ASSIST WITH THEIR GOALS 511
    ST DENIS CHURCH
    23 MANCHAUG ST
    DOUGLAS,MA01516     		    TO ASSIST WITH THEIR GOALS 96
    ST EDWARD THE CONFESSOR CHURCH
    10 CHURCH ST
    WESTMINSTER,MA01473     		    TO ASSIST WITH THEIR GOALS 50
    ST FRANCIS HOME
    39 BOYLSTON ST
    BOSTON,MA02116     		    TO ASSIST WITH THEIR GOALS 225
    ST LABRE INDIAN SCHOOL
    ST LABRE INDIAN SCHOOL
    ASHLAND,MT59004     		    TO ASSIST WITH THEIR GOALS 610
    ST LAWRENCE SEMINARY
    301 CHURCH STREET
    MT CALVARY,WI53057     		    TO ASSIST WITH THEIR GOALS 25
    ST LEO'S CHURCH
    128 MAIN ST
    LEOMINSTER,MA01453     		    TO ASSIST WITH THEIR GOALS 50
    ST VINCENT DE PAUL SOCIETY
    58 PROGRESS PARKWAY
    MARYLAND HEIGHTS,MO63043     		    TO ASSIST WITH THEIR GOALS 1,650
    STEPHEN DINATALE
    24 BEACON ST
    BOSTON,MA02133     		    TO ASSIST WITH HIS ENVIORNMENTAL GOALS 200
    THE ARC
    564 MAIN ST
    FITCHBURG,MA01420     		    TO ASSIST WITH THEIR GOALS 280
    THE AUTISM RESOURCE CENTER
    71 STERLING ST
    WEST BOYLSTON,MA01583     		    TO ASSIST WITH THEIR GOALS 100
    THE JIMMY FUND
    10 BROOKLINE PLACE WEST
    BROOKLINE,MA024457226     		    TO ASSIST WITH THEIR GOALS 75
    THE MONTACHUSETTS CHORALE
    1400 MAIN ST
    LEOMINSTER,MA01453     		    TO ASSIST WITH THEIR GOALS 100
    THE NATURE CONSERVANCY
    4245 N FAIRFAX DRIVE SUITE 100
    ARLINGTON,VA22203     		    TO ASSIST WITH THEIR GOALS 45
    THE NAVIGATORS
    PO BOX 6079
    ALBERT LEA,MN560076679     		    TO ASSIST WITH THEIR GOALS 25
    THE PASSIONIST COMMUNITY
    111 S RIDGE ST
    RYE BROOK,NY10573     		    TO ASSIST WITH THEIR GOALS 100
    THE SACRED HEART SOUTHERN MISSIONS
    6050 HWY 161
    WALLS,MS38680     		    TO ASSIST WITH THEIR GOALS 25
    THE WILDERNESS SOCIETY
    1615 M ST NW
    WASHINGTON,DC20036     		    TO ASSIST WITH THEIR GOALS 25
    UNICEF
    125 MAIDEN LANE
    NEW YORK,NY10038     		    TO ASSIST WITH THEIR GOALS 50
    UNITED NEIGHBORS OF FITCHBURG
    18 FAIRMOUNT ST
    FITCHBURG,MA01420     		    TO ASSIST WITH THEIR GOALS 150
    UNITED SERVICE ORGANIZATION
    PO BOX 96860
    WASHINGTON,DC200777677     		    TO ASSIST WITH THEIR GOALS 66
    UNITED STATES OLYMPIC COMMITTEE
    1 OLYMPIC PLAZA
    COLORADO SPRINGS,CO80909     		    TO ASSIST WITH THEIR GOALS 465
    WORCESTER INTERFAITH
    111 PARK AVE
    WORCESTER,MA01609     		    TO ASSIST WITH THEIR GOALS 200
    WOUNDED WARRIORS PROJECT
    150 CAMBRIDGE PARK DRIVE SUITE 202
    CAMBRIDGE,MA02140     		    TO ASSIST WITH THEIR GOALS 50
    WQPH
    PO BOX 589
    MEDFORD,MA02155     		    TO ASSIST WITH THEIR GOALS 100
    WINCHENDON SPRINGS LAKE ASSOCIATION
    146 BEACH VIEW DR
    WINCHENDON,MA01475     		    TO ASSIST WITH THEIR GOALS 100
    Total .................................bullet 3a 42,493
    bApproved for future payment
    Total .................................bullet 3b 0
    Form 990-PF (2015)
    Form 990-PF (2015)
    Page 12
    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....          
    3
    Interest on savings and temporary cash investments ...........     		    14 23  
    4 Dividends and interest from securities....     14 22,220  
    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 ............     		         
    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).. 0 22,243 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    1322,243
    (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 (2015)
    Form 990-PF (2015)
    Page 13
    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 501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    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) 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 name SmallBullet
    		 Firm's EIN SmallBullet
    Firm's address SmallBullet


    		 Phone no.
    Form 990-PF (2015)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description
    Schedule B
    (Form 990, 990-EZ,
    or 990-PF)
    Department of the Treasury
    Internal Revenue Service
    Schedule of Contributors
    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
    OMB No. 1545-0047
    2015
    Name of the organization
    JIM & RUTH COUTURE CHARITABLE FOUNDATION
     
    Employer identification number

    04-6722346
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ





    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......... Arrow Bullet $  
    Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
    Form 990-EZ or on 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) (2015)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2
    Name of organization
    JIM & RUTH COUTURE CHARITABLE FOUNDATION
          		Employer identification number
    04-6722346
    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
     
     

    JAMES B COUTURE  
    40 ELMWOOD AVE
     
    FITCHBURG, MA01420

    		$ 20,000


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

       
     
     

    		$  


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

       
     
     

    		$  


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

       
     
     

    		$  


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

       
     
     

    		$  


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

       
     
     

    		$  


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
    Page 3
    Name of organization
    JIM & RUTH COUTURE CHARITABLE FOUNDATION
          		Employer identification number

    04-6722346
    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) (2015)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
    Page 4
    Name of organization
    JIM & RUTH COUTURE CHARITABLE FOUNDATION
          		Employer identification number

    04-6722346
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No.from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No.from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No.from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No.from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

    Additional Data


    Software ID:  
    Software Version:  

    TY 2015 AccountingFeesSchedule
    Name:
    JIM & RUTH COUTURE CHARITABLE FOUNDATION
    EIN:
    04-6722346
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING FEES 500 0 0 0

    TY 2015 OtherExpensesSchedule
    Name:
    JIM & RUTH COUTURE CHARITABLE FOUNDATION
    EIN:
    04-6722346
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    OFFICE EXPENSES 138 0 0 0
    STATE FILING FEE 35 0 0 0
    MISCELLANEOUS EXPENSE 51 0 0 0


    TY 2015 SubstantialContributorsSch
    Name:
    JIM & RUTH COUTURE CHARITABLE FOUNDATION
    EIN:
    04-6722346
    Name Address
    JAMES B COUTURE 40 ELMWOOD AVENUE
    FITCHBURG,MA01420


    TY 2015 TaxesSchedule
    Name:
    JIM & RUTH COUTURE CHARITABLE FOUNDATION
    EIN:
    04-6722346
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    IRS - EXCISE TAX 237 0 0 0