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
THOMAS M GROSSMAN FAMILY
CHARITABLE TRUST
Number and street (or P.O. box number if mail is not delivered to street address)4350 BAKER RD NO 230
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MINNETONKA, MN55343
A Employer identification number

27-3369472
B Telephone number (see instructions)

(952) 893-1277
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$1,352,922
J 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)  
2 Check bullet Sch. B .............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 49,187 49,187  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 48,735
b Gross sales price for all assets on line 6a 1,371,545
7 Capital gain net income (from Part IV, line 2)... 48,735
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........ 97,922 97,922 0
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).......        
c Other professional fees (attach schedule)....        
17 Interest...............        
18 Taxes (attach schedule) (see instructions)...        
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... 7,500 7,500 0 0
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 7,500 7,500 0 0
25 Contributions, gifts, grants paid....... 530,000 530,000
26 Total expenses and disbursements. Add lines 24 and 25 537,500 7,500 0 530,000
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -439,578
b Net investment income (if negative, enter -0-) 90,422
c Adjusted net income (if negative, enter -0-)... 0
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.............      
2 Savings and temporary cash investments......... 1,777,110 1,337,532 1,352,922
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) 1,777,110 1,337,532 1,352,922
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 1,777,110 1,337,532
30 Total net assets or fund balances (see instructions)..... 1,777,110 1,337,532
31 Total liabilities and net assets/fund balances (see instructions). 1,777,110 1,337,532
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 30 (must agree with end-of-year figure reported on prior year’s return) ...............
1
1,777,110
2
Enter amount from Part I, line 27a .....................
2
-439,578
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
1,337,532
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
1,337,532
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.)
1 a AMERICAN EXPRESS CO P 2012-09-17 2015-09-15
b BANK OF NEW YOUR MELLON P 2012-09-17 2015-06-18
c CATERPILLAR FINANCIAL SERVICE P 2012-09-17 2015-03-26
d CITIGROUP INC P 2012-09-17 2015-01-15
e JOHN DEERE CAPITAL CORP P 2012-09-17 2015-04-17
DEUTSCHE BANK P 2012-09-17 2015-03-30
DOMINION RESOURCES INC P 2012-09-17 2015-09-01
FREDDIE MAC P 2012-09-27 2015-08-28
GOLDMAN SACHS GROUP INC P 2012-09-25 2015-01-15
JP MORGAN CHASE & CO P 2012-09-14 2015-01-20
KFW P 2012-09-17 2015-04-24
NEXTERA ENERGY CAPITAL P 2012-09-18 2015-06-01
ONTARIO - PROVICE OF P 2012-09-17 2015-05-26
PNC FUNDING CORP P 2012-09-17 2015-02-08
PEPSICO INC P 2012-09-17 2015-03-05
ROYAL BANK OF CANADA P 2012-09-17 2015-03-13
TEVA PHARMA FIN P 2012-09-17 2015-01-23
TOTAL CAPITAL INTL P 2012-09-18 2015-01-23
TOYOTA MOTOR CREDIT CORP P 2012-09-17 2015-02-17
WAL-MART STORES INC P 2012-09-25 2015-01-23
WELLPOINT INC P 2012-09-25 2015-01-23
WELL FARGO CO MTN P 2012-09-17 2015-04-15
AETNA INC NEW P 2012-11-05 2015-01-13
AETNA INC NEW P 2012-11-07 2015-01-13
AETNA INC NEW P 2014-05-14 2015-06-22
AMERICAN INTL GROUP INC P 2013-04-24 2015-03-02
AMERICAN INTL GROUP INC P 2013-04-24 2015-06-26
AMERICAN WATER WORKS CO P 2013-06-13 2015-03-02
AMERICAN WATER WORKS CO P 2013-06-13 2015-03-02
AMERICAN WATER WORKS CO P 2013-06-12 2015-06-26
AMERICAN WATER WORKS CO P 2013-06-13 2015-06-26
AMERICAN WATER WORKS CO P 2013-07-05 2015-06-26
APPLE INC P 2013-08-26 2015-06-26
APPLE INC P 2013-09-16 2015-06-26
AVAGO TECHNOLOGIES P 2012-12-19 2015-06-26
AVAGO TECHNOLOGIES P 2013-02-21 2015-06-26
AVAGO TECHNOLOGIES P 2013-08-27 2015-06-26
AVAGO TECHNOLOGIES P 2012-12-19 2015-11-03
BNP PARIBAS SPON ADR P 2013-04-05 2015-06-26
BRIDGESTONE CORP ADR P 2013-07-05 2015-06-04
BRIDGESTONE CORP ADR P 2013-09-17 2015-06-04
BRIDGESTONE CORP ADR P 2013-09-17 2015-06-26
CHINA TELECOM ADR P 2012-12-19 2015-04-21
CHINA TELECOM ADR P 2013-01-24 2015-04-21
CHINA TELECOM ADR P 2013-02-21 2015-04-21
CHINA TELECOM ADR P 2013-03-28 2015-04-21
CHINA TELECOM ADR P 2013-04-08 2015-04-21
CHINA TELECOM ADR P 2013-04-08 2015-06-26
CHUBB LIMITED P 2012-09-17 2015-03-02
CHUBB LIMITED P 2012-09-17 2015-06-26
CITIGROUP INC P 2012-09-17 2015-06-26
CUMMINS INC P 2013-11-05 2015-06-26
CUMMINS INC P 2013-11-05 2015-10-09
CVS HEALTH CORP P 2013-01-24 2015-06-26
DAIHATSU MOTOR CO. LTD ADR P 2012-12-12 2015-02-24
DBS GROUP HLDGS LTD ADR P 2014-01-07 2015-06-23
DBS GROUP HLDGS LTD ADR P 2014-02-07 2015-06-23
DOLLAR GENERAL CORP P 2014-03-25 2015-06-22
HITACHI LTD ADR P 2014-01-06 2015-12-24
HSBC HLDGS PLC ADR P 2014-03-20 2015-06-26
ILLINOIS TOOL WORKS INC P 2013-03-20 2015-06-26
IMPERIAL BRANDS PLC ADR P 2012-09-17 2015-01-13
IMPERIAL BRANDS PLC ADR P 2012-10-09 2015-01-13
IMPERIAL BRANDS PLC ADR P 2013-02-21 2015-01-13
IMPERIAL BRANDS PLC ADR P 2013-03-28 2015-01-13
ITOCHU CORP ADR P 2013-01-24 2015-04-21
ITOCHU CORP ADR P 2012-12-21 2015-04-21
ITOCHU CORP ADR P 2012-09-17 2015-04-22
ITOCHU CORP ADR P 2012-12-21 2015-04-22
ITOCHU CORP ADR P 2012-10-18 2015-06-04
ITOCHU CORP ADR P 2012-10-09 2015-06-26
J SAINSBURY SPN ADR NEW P 2013-05-22 2015-06-26
J SAINSBURY SPN ADR NEW P 2013-05-28 2015-06-26
J SAINSBURY SPN ADR NEW P 2013-05-23 2015-06-26
KDDI CORP ADR P 2013-01-22 2015-04-30
KDDI CORP ADR P 2013-01-22 2015-06-04
KDDI CORP ADR P 2013-01-22 2015-06-26
KEYCORP NEW P 2014-01-07 2015-06-26
KEYCORP NEW P 2014-01-08 2015-06-26
KEYCORP NEW P 2014-03-13 2015-06-26
L BRANDS INC P 2013-08-01 2015-01-13
LORILLARD INC COM P 2013-09-24 2015-02-23
MACY'S INC P 2012-09-17 2015-06-22
MORGAN STANLEY GRP INC P 2013-11-05 2015-01-13
MORGAN STANLEY GRP INC P 2014-05-14 2015-06-26
MYLAN INC P 2013-11-11 2015-03-02
MYLAN INC P 2013-11-12 2015-03-02
NIELSEN N.V. EUR 0.07 P 2013-02-01 2015-06-26
NIKE INC CL B P 2014-09-08 2015-09-23
NXP SEMICONDUCTORS NV P 2014-03-13 2015-06-26
OW LARGE CAP STRATEGIES FD P 2013-01-24 2015-06-26
OW LARGE CAP STRATEGIES FD P 2013-02-21 2015-06-26
OW LARGE CAP STRATEGIES FD P 2013-03-18 2015-06-26
OW LARGE CAP STRATEGIES FD P 2013-03-28 2015-06-26
OW LARGE CAP STRATEGIES FD P 2014-01-13 2015-06-26
OW LARGE CAP STRATEGIES FD P 2014-05-21 2015-06-26
OW REAL RETURN FUND P 2012-05-08 2015-03-17
OW REAL RETURN FUND P 2013-03-28 2015-03-17
OW REAL RETURN FUND P 2012-12-19 2015-03-17
OW SMALL & MID CAP FUND P 2012-05-08 2015-06-26
OW SMALL & MID CAP FUND P 2012-10-08 2015-06-26
OW SMALL & MID CAP FUND P 2012-09-17 2015-06-26
OW SMALL & MID CAP FUND P 2013-01-24 2015-06-26
PANDORA A/S ADR P 2014-02-26 2015-06-26
PANDORA A/S ADR P 2014-02-26 2015-08-07
PFIZER INC P 2013-04-24 2015-06-22
PFIZER INC P 2014-05-14 2015-06-22
QUALCOMM INC P 2012-11-27 2015-03-02
QUALCOMM INC P 2013-02-21 2015-03-02
QUALCOMM INC P 2012-12-19 2015-03-02
QUALCOMM INC P 2012-11-27 2015-06-22
RSA INS GRP INC SPON ADR P 2013-02-20 2015-06-26
RSA INS GRP INC SPON ADR P 2013-02-21 2015-06-26
RSA INS GRP INC SPON ADR P 2013-06-19 2015-06-26
RSA INS GRP INC SPON ADR P 2013-03-28 2015-06-26
RSA INS GRP INC SPON ADR P 2013-03-22 2015-07-29
RSA INS GRP INC SPON ADR P 2013-03-25 2015-07-29
RSA INS GRP INC SPON ADR P 2013-06-12 2015-07-29
RSA INS GRP INC SPON ADR P 2013-03-28 2015-07-29
RSA INS GRP INC SPON ADR P 2013-03-25 2015-07-30
RSA INS GRP INC SPON ADR P 2013-03-25 2015-09-04
SINOPEC/CHINA PETE&CHM ADR P 2012-12-19 2015-06-26
SINOPEC/CHINA PETE&CHM ADR P 2013-02-21 2015-06-26
SKANDINAVISKA ENSKILDA ADR P 2013-11-13 2015-02-23
SKANDINAVISKA ENSKILDA ADR P 2013-11-14 2015-02-23
SKANDINAVISKA ENSKILDA ADR P 2013-11-13 2015-02-24
SKY PLC ADR P 2014-03-14 2015-06-03
SKY PLC ADR P 2014-02-25 2015-06-03
SKY PLC ADR P 2014-03-14 2015-06-26
SUMITOMO METAL MIN CO LTD P 2013-08-19 2015-06-26
SUMITOMO METAL MIN CO LTD P 2013-09-18 2015-06-26
SUMITOMO METAL MIN CO LTD P 2013-09-18 2015-10-09
SVENSKA CL AKTIBLGT ADR P 2013-10-18 2015-06-03
SVENSKA CL AKTIBLGT ADR P 2013-10-17 2015-06-26
SVENSKA CL AKTIBLGT ADR P 2013-10-16 2015-06-26
SVENSKA CL AKTIBLGT ADR P 2013-10-18 2015-06-26
TERADATA CORP P 2014-06-25 2015-06-26
TERADATA CORP P 2014-06-25 2015-10-09
THERMO FISHER SCIENTIFIC P 2012-10-18 2015-06-26
TIM PARTICIPACOES SA ADR P 2013-03-20 2015-06-26
TIM PARTICIPACOES SA ADR P 2013-02-21 2015-10-09
TIM PARTICIPACOES SA ADR P 2012-12-19 2015-10-09
TIM PARTICIPACOES SA ADR P 2013-03-20 2015-10-09
TOKYO GAS LTD ADR P 2012-09-17 2015-06-04
TOKYO GAS LTD ADR P 2012-09-17 2015-06-26
UNION PACIFIC CORP P 2013-09-24 2015-01-13
UNION PACIFIC CORP P 2013-08-26 2015-06-26
UNITED RENTALS INC P 2014-03-20 2015-06-26
UNITED RENTALS INC P 2014-05-15 2015-06-26
VALERO ENERGY NEW P 2014-01-06 2015-06-26
VALERO ENERGY NEW P 2014-01-06 2015-08-13
VIACOM INC CL B NEW P 2013-04-05 2015-06-26
VIACOM INC CL B NEW P 2014-05-14 2015-06-26
VIACOM INC CL B NEW P 2013-04-05 2015-09-23
WHARF HOLDINGS ADR P 2014-02-27 2015-06-26
WILMAR INTERNATIONAL ADR P 2014-02-07 2015-06-26
WILMAR INTERNATIONAL ADR P 2014-02-10 2015-06-26
YUM BRANDS INC P 2014-10-10 2015-12-09
ZIMMER BIOMET HOLDINGS INC P 2012-09-17 2015-06-26
AMERICAN WATER WORKS CO P 2015-01-23 2015-03-02
ASTRAZENECA PLC P 2014-10-30 2015-09-24
ASTRAZENECA PLC P 2015-01-14 2015-09-24
ASTRAZENECA PLC P 2015-01-23 2015-09-24
ATOS P 2015-06-22 2015-06-26
BNP PARIBAS SPON ADR P 2015-01-23 2015-09-24
BOMBARDIER INC CL B P 2015-01-13 2015-01-20
BOMBARDIER INC CL B P 2015-01-14 2015-01-20
BRIDGESTONE CORP ADR P 2015-01-23 2015-06-04
CAMERON INTL CORP P 2015-06-22 2015-09-04
CAMERON INTL CORP P 2015-06-22 2015-09-23
CDW CORP/DE P 2015-03-02 2015-06-26
CDW CORP/DE P 2015-04-20 2015-06-26
CDW CORP/DE P 2015-03-02 2015-11-09
CHINA TELECOM ADR P 2015-01-23 2015-06-26
CHUBB LIMITED P 2015-01-23 2015-06-26
CONOCOPHILLIPS P 2015-01-13 2015-06-26
CONOCOPHILLIPS P 2015-01-23 2015-06-26
CUMMINS INC P 2015-01-23 2015-06-26
DISCOVER FINANCIAL SVCS P 2015-03-02 2015-06-26
EDISON INTERNATIONAL P 2015-03-02 2015-06-26
ELECTRIC PWR DEV CORP P 2015-06-10 2015-06-29
ENCANA CORP P 2015-04-20 2015-06-26
ENCANA CORP P 2015-04-21 2015-06-26
HITACHI LTD ADR P 2014-06-26 2015-06-26
HITACHI LTD ADR P 2015-01-23 2015-06-26
HSBC HLDGS PLC ADR P 2015-01-23 2015-06-26
ILLINOIS TOOL WORKS INC P 2015-01-23 2015-06-26
ING GROEP N.V. CVA NTFL P 2015-04-10 2015-06-26
ING GROEP N.V. CVA NTFL P 2015-04-13 2015-06-26
KDDI CORP ADR P 2015-01-23 2015-06-04
KEYCORP NEW P 2015-01-23 2015-10-09
KIRBY CORP P 2014-06-25 2015-06-22
KIRBY CORP P 2015-01-23 2015-06-22
L BRANDS INC P 2014-02-07 2015-01-13
MYLAN INC P 2014-09-08 2015-03-02
MYLAN INC P 2015-01-23 2015-03-02
MYLAN NV P 2015-03-02 2015-04-09
MYLAN NV P 2015-03-02 2015-04-28
MYLAN NV P 2015-03-02 2015-06-26
MYLAN NV P 2015-03-02 2015-10-09
NIKE INC CL B P 2014-09-08 2015-06-26
NIKE INC CL B P 2014-10-10 2015-06-26
NIKE INC CL B P 2015-01-23 2015-06-26
ORIX CORP P 2014-07-30 2015-06-05
ORIX CORP P 2014-08-01 2015-06-05
ORIX CORP P 2014-09-09 2015-06-05
ORIX CORP P 2014-09-09 2015-06-29
ORIX CORP P 2015-01-26 2015-06-29
ORIX CORP P 2014-09-10 2015-06-29
OW FIXED INCOME FUND P 2015-04-02 2015-06-26
OW FIXED INCOME FUND P 2015-04-21 2015-06-26
OW FIXED INCOME FUND P 2015-04-27 2015-06-26
OW REAL RETURN FUND P 2014-05-21 2015-03-17
OW SMALL & MID CAP FUND P 2015-05-26 2015-06-26
PVH CORP P 2015-03-02 2015-06-26
QUALCOMM INC P 2015-01-23 2015-06-22
RAYTHEON CO NEW P 2014-09-08 2015-06-26
RAYTHEON CO NEW P 2014-10-10 2015-06-26
RAYTHEON CO NEW P 2015-01-23 2015-06-26
ROYAL CARIBBEAN CRUISES LD P 2015-03-02 2015-06-26
RSA INS GRP INC SPON ADR P 2015-01-23 2015-06-26
SIAM COMM BANK UNSP ADR P 2015-06-23 2015-06-26
SKANDINAVISKA ENSKILDA ADR P 2015-01-23 2015-02-23
SUMITOMO METAL MIN CO LTD P 2015-01-23 2015-10-09
TERADATA CORP P 2015-01-23 2015-06-26
THERMO FISHER SCIENTIFIC P 2015-01-13 2015-06-26
TOKYO GAS LTD ADR P 2015-01-23 2015-06-04
UNILEVER NV P 2015-01-23 2015-06-03
UNILEVER NV P 2014-10-31 2015-06-03
UNILEVER NV P 2014-10-31 2015-06-26
UNILEVER NV P 2014-10-30 2015-06-26
UNION PACIFIC CORP P 2015-01-23 2015-06-26
VALEANT PH INT INC P 2015-04-28 2015-06-26
VALEANT PH INT INC P 2015-04-28 2015-10-21
VALERO ENERGY NEW P 2015-01-23 2015-08-13
VIACOM INC CL B NEW P 2014-05-14 2015-03-02
WHARF HOLDINGS ADR P 2015-01-23 2015-06-26
WILMAR INTERNATIONAL ADR P 2015-01-23 2015-06-26
YUM BRANDS INC P 2015-01-13 2015-06-22
YUM BRANDS INC P 2015-01-23 2015-06-22
YUM BRANDS INC P 2015-01-13 2015-06-26
YUM BRANDS INC P 2014-10-10 2015-06-26
YUM BRANDS INC P 2014-09-08 2015-06-26
ZIMMER BIOMET HOLDINGS INC P 2015-01-23 2015-06-26
(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 30,000   30,702 -702
b 30,000   30,909 -909
c 30,000   30,185 -185
d 21,000   22,143 -1,143
e 30,000   30,077 -77
30,000   30,773 -773
30,000   30,499 -499
70,000   70,072 -72
30,000   31,266 -1,266
30,000   31,038 -1,038
30,000   30,080 -80
30,000   29,967 33
30,000   30,161 -161
30,000   31,082 -1,082
30,000   30,065 -65
30,000   30,246 -246
30,270   31,107 -837
30,053   29,978 75
30,000   30,156 -156
30,228   30,569 -341
30,091   30,109 -18
30,000   31,081 -1,081
906   443 463
2,718   1,292 1,426
3,224   1,884 1,340
1,667   1,244 423
1,255   829 426
1,061   813 248
265   203 62
2,468   2,023 445
247   203 44
247   201 46
1,276   721 555
5,105   2,591 2,514
693   161 532
693   168 525
1,387   367 1,020
612   161 451
2,736   2,188 548
293   273 20
1,075   966 109
945   878 67
1,099   831 268
733   553 180
366   253 113
733   508 225
733   496 237
591   496 95
1,142   765 377
1,020   765 255
1,978   1,202 776
671   660 11
568   660 -92
2,633   1,312 1,321
1,741   2,259 -518
624   538 86
936   775 161
1,962   1,385 577
859   1,170 -311
1,627   1,728 -101
927   631 296
449   378 71
1,797   1,507 290
899   724 175
449   350 99
118   110 8
474   434 40
1,906   1,707 199
476   434 42
1,337   1,023 314
809   583 226
878   1,154 -276
88   116 -28
878   1,158 -280
1,212   576 636
446   230 216
1,306   633 673
1,004   884 120
386   341 45
2,316   2,067 249
2,116   1,430 686
3,088   2,015 1,073
2,099   1,168 931
2,715   2,180 535
1,381   1,060 321
2,885   2,039 846
866   620 246
1,371   977 394
578   410 168
3,071   1,709 1,362
48,048   37,100 10,948
37,102   28,565 8,537
25,316   20,000 5,316
66,941   53,134 13,807
46,114   42,200 3,914
8,754   8,272 482
22,715   32,038 -9,323
4,108   5,644 -1,536
15,743   22,300 -6,557
7,906   7,017 889
49,631   44,500 5,131
14,908   13,511 1,397
10,745   9,933 812
1,630   965 665
432   241 191
515   464 51
1,202   1,022 180
727   624 103
364   322 42
727   629 98
3,036   2,808 228
812   1,138 -326
130   182 -52
195   283 -88
227   318 -91
396   448 -52
119   134 -15
396   453 -57
79   91 -12
199   223 -24
378   447 -69
428   437 -9
856   864 -8
541   521 20
60   59 1
978   927 51
2,275   2,157 118
325   314 11
1,682   1,541 141
702   639 63
702   613 89
64   68 -4
1,996   2,007 -11
664   629 35
266   244 22
133   134 -1
1,498   1,681 -183
1,760   2,521 -761
3,343   1,472 1,871
1,605   1,992 -387
155   300 -145
361   666 -305
52   105 -53
547   559 -12
1,191   1,229 -38
1,134   796 338
1,462   1,180 282
2,245   2,359 -114
449   468 -19
1,205   999 206
699   500 199
667   627 40
667   831 -164
873   1,255 -382
1,002   1,026 -24
607   640 -33
729   765 -36
744   694 50
2,264   1,339 925
1,327   1,413 -86
642   722 -80
1,925   2,147 -222
642   713 -71
1,178   1,153 25
143   139 4
663   1,010 -347
442   688 -246
586   586 0
1,634   1,359 275
952   816 136
726   759 -33
1,815   1,904 -89
857   759 98
886   932 -46
510   566 -56
2,484   2,508 -24
932   980 -48
671   732 -61
2,364   2,408 -44
1,948   2,216 -268
1,573   1,641 -68
228   272 -44
1,140   1,358 -218
1,677   1,827 -150
1,006   1,147 -141
697   704 -7
464   472 -8
863   746 117
431   377 54
669   702 -33
327   334 -7
1,994   2,881 -887
399   397 2
2,116   1,356 760
2,885   2,402 483
1,154   1,092 62
1,756   1,443 313
3,641   2,885 756
1,766   1,443 323
1,492   2,020 -528
1,627   1,229 398
542   438 104
1,085   965 120
1,155   1,184 -29
231   245 -14
539   524 15
589   599 -10
368   294 74
1,104   1,096 8
10,078   10,223 -145
57,835   58,770 -935
29,523   30,000 -477
872   1,212 -340
2,590   2,700 -110
1,165   1,072 93
1,012   1,076 -64
492   493 -1
1,968   1,910 58
984   1,072 -88
1,204   1,187 17
617   675 -58
643   663 -20
301   307 -6
385   449 -64
749   879 -130
669   648 21
547   583 -36
855   835 20
214   194 20
1,091   968 123
1,091   946 145
975   1,209 -234
2,289   2,045 244
1,050   2,045 -995
699   488 211
1,413   1,662 -249
401   480 -79
486   488 -2
1,388   1,092 296
1,388   1,118 270
918   728 190
459   347 112
1,835   1,446 389
1,132   1,175 -43
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       -702
b       -909
c       -185
d       -1,143
e       -77
      -773
      -499
      -72
      -1,266
      -1,038
      -80
      33
      -161
      -1,082
      -65
      -246
      -837
      75
      -156
      -341
      -18
      -1,081
      463
      1,426
      1,340
      423
      426
      248
      62
      445
      44
      46
      555
      2,514
      532
      525
      1,020
      451
      548
      20
      109
      67
      268
      180
      113
      225
      237
      95
      377
      255
      776
      11
      -92
      1,321
      -518
      86
      161
      577
      -311
      -101
      296
      71
      290
      175
      99
      8
      40
      199
      42
      314
      226
      -276
      -28
      -280
      636
      216
      673
      120
      45
      249
      686
      1,073
      931
      535
      321
      846
      246
      394
      168
      1,362
      10,948
      8,537
      5,316
      13,807
      3,914
      482
      -9,323
      -1,536
      -6,557
      889
      5,131
      1,397
      812
      665
      191
      51
      180
      103
      42
      98
      228
      -326
      -52
      -88
      -91
      -52
      -15
      -57
      -12
      -24
      -69
      -9
      -8
      20
      1
      51
      118
      11
      141
      63
      89
      -4
      -11
      35
      22
      -1
      -183
      -761
      1,871
      -387
      -145
      -305
      -53
      -12
      -38
      338
      282
      -114
      -19
      206
      199
      40
      -164
      -382
      -24
      -33
      -36
      50
      925
      -86
      -80
      -222
      -71
      25
      4
      -347
      -246
      0
      275
      136
      -33
      -89
      98
      -46
      -56
      -24
      -48
      -61
      -44
      -268
      -68
      -44
      -218
      -150
      -141
      -7
      -8
      117
      54
      -33
      -7
      -887
      2
      760
      483
      62
      313
      756
      323
      -528
      398
      104
      120
      -29
      -14
      15
      -10
      74
      8
      -145
      -935
      -477
      -340
      -110
      93
      -64
      -1
      58
      -88
      17
      -58
      -20
      -6
      -64
      -130
      21
      -36
      20
      20
      123
      145
      -234
      244
      -995
      211
      -249
      -79
      -2
      296
      270
      190
      112
      389
      -43
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 48,735
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 714,905 2,456,465 0.291030
2013 776,349 2,639,298 0.294150
2012 432,008 4,052,715 0.106597
2011 27,422 3,161,134 0.008675
2010 0 865,869 0.000000
2
Total of line 1, column (d) .....................
20.700452
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
0.140090
4
Enter the net value of noncharitable-use assets for 2015 from Part X, line 5.....
4
1,612,836
5
Multiply line 4 by line 3......................
5
225,942
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
904
7
Add lines 5 and 6........................
7
226,846
8
Enter qualifying distributions from Part XII, line 4.............
8
530,000
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 1 904
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........................... 3 904
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- ..... 5 904
6 Credits/Payments:
a 2015 estimated tax payments and 2014 overpayment credited to 2015 6a 7,723
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 7,723
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 6,819
11 Enter the amount of line 10 to be: Credited to 2015 estimated taxBullet6,819 RefundedBullet 11 0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see 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)
    bulletMN
    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 ofbulletDAVE NORTON Telephone no.bullet (952) 893-1277

    Located atbullet4350 BAKER RD SUITE 230MINNETONKAMN ZIP+4bullet55343
    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
    THOMAS GROSSMAN PRESIDENT
    0.00
    0 0 0
    4350 BAKER ROAD
    MINNETONKA,MN55343
    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
    0
    b
    Average of monthly cash balances.......................
    1b
    0
    c
    Fair market value of all other assets (see instructions)................
    1c
    1,637,397
    d
    Total (add lines 1a, b, and c).........................
    1d
    1,637,397
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    1,637,397
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    24,561
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    1,612,836
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    80,642
    Part XI
    Distributable Amount bullet
    1
    Minimum investment return from Part X, line 6....................
    1
    80,642
    2a
    Tax on investment income for 2015 from Part VI, line 5......
    2a
    904
    b
    Income tax for 2015. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    904
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    79,738
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    79,738
    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
    79,738
    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
    530,000
    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
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    530,000
    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
    904
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    529,096
    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 79,738
    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......  
    b From 2011......  
    c From 2012...... 156,304
    d From 2013...... 651,686
    e From 2014...... 596,374
    fTotal of lines 3a through e........ 1,404,364
    4Qualifying distributions for 2015 from Part
    XII, line 4: bullet$ 530,000
    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..... 79,738
    e Remaining amount distributed out of corpus 450,262
    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 1,854,626
    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) ...
    0
    9Excess distributions carryover to 2016.
    Subtract lines 7 and 8 from line 6a ......
    1,854,626
    10 Analysis of line 9:
    a Excess from 2011....  
    b Excess from 2012.... 156,304
    c Excess from 2013.... 651,686
    d Excess from 2014.... 596,374
    e Excess from 2015.... 450,262
    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).)
    THOMAS GROSSMAN
    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 email address 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 (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
    UNIVERSITY OF MINNESOTA FOUNDATION
    200 OAK STEET SOUTHEAST SUITE 500
    MINNEAPOLIS,MN55455
    NONE PUBLIC CHARITY GENERAL OPERATING 530,000
    Total .................................bullet 3a 530,000
    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 ...........
             
    4 Dividends and interest from securities....     14 49,187  
    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 ............
        18 48,735  
    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 97,922 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    1397,922
    (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

    TY 2015 OtherExpensesSchedule
    Name:
    THOMAS M GROSSMAN FAMILY
     
    CHARITABLE TRUST
    EIN:
    27-3369472
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT FEES 3,279 3,279 0 0
    FOREIGN TAX 158 158 0 0
    BOND PREMIUMS 4,063 4,063 0 0


    TY 2015 SubstantialContributorsSch
    Name:
    THOMAS M GROSSMAN FAMILY
     
    CHARITABLE TRUST
    EIN:
    27-3369472
    Name Address
    THOMAS GROSSMAN 4350 BAKER ROAD
    MINNETONKA,MN55343