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
CLARA SALTUS TRUST UW XXX-XX-XXXX
 
Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 477
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CONCORD, NH033020477
A Employer identification number

02-6004790
B Telephone number (see instructions)

(877) 773-1229
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$7,171,627J 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... 151,974 151,974  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 325,445
b Gross sales price for all assets on line 6a 2,940,361
7 Capital gain net income (from Part IV, line 2)... 325,445
8 Net short-term capital gain......... 0
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule)....... Click to see attachment 6,476    
12 Total. Add lines 1 through 11........ 483,895 477,419  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 73,478 73,478    
14 Other employee salaries and wages......   0 0 0
15 Pension plans, employee benefits.......   0 0  
16a Legal fees (attach schedule).........       0
b Accounting fees (attach schedule)....... Click to see attachment 725 725 0 0
c Other professional fees (attach schedule)....       0
17 Interest...............       0
18 Taxes (attach schedule) (see instructions)... Click to see attachment 1,632 1,632   0
19 Depreciation (attach schedule) and depletion... 0 0  
20 Occupancy..............        
21 Travel, conferences, and meetings.......   0 0  
22 Printing and publications..........   0 0  
23 Other expenses (attach schedule)....... Click to see attachment 1,510 1,510    
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 77,345 77,345 0 0
25 Contributions, gifts, grants paid....... 369,250 369,250
26 Total expenses and disbursements. Add lines 24 and 25 446,595 77,345 0 369,250
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 37,300
b Net investment income (if negative, enter -0-) 400,074
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......... 180,418 317,912 317,912
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet     0 0
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet0      
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule) 1,621,400 Click to see attachment1,828,431 1,822,328
b Investments—corporate stock (attach schedule)....... 3,574,115 Click to see attachment3,232,131 3,540,891
c Investments—corporate bonds (attach schedule)....... 1,491,251 Click to see attachment1,524,516 1,490,496
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........     0
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 6,867,184 6,902,990 7,171,627
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable..................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22).........   0
Net Assets or Fund Balances bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted..................    
25 Temporarily restricted...............    
26 Permanently restricted...............    
bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds........ 6,867,184 6,902,990
28 Paid-in or capital surplus, or land, bldg., and equipment fund    
29 Retained earnings, accumulated income, endowment, or other funds    
30 Total net assets or fund balances (see instructions)..... 6,867,184 6,902,990
31 Total liabilities and net assets/fund balances (see instructions). 6,867,184 6,902,990
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
6,867,184
2
Enter amount from Part I, line 27a .....................
2
37,300
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
6,904,484
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
1,494
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30 .
6
6,902,990
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 204. CALIFORNIA RESOURCES CORPORATION   2013-12-05 2015-01-13
b 48. CALIFORNIA RESOURCES CORPORATION   2014-07-25 2015-01-13
c 3702.551 BUFFALO SMALL CAP FD #1444   2013-06-14 2015-01-27
d 4711.526 HARTFORD MUT FDS INC MIDCAP FD CL Y FD# 229   2013-06-17 2015-01-27
e 5774.905 PERKINS MID CAP VALUE FUND INSTITUTIONAL CLASS   2014-01-23 2015-01-27
5666.093 ROYCE SPECIAL EQUITY FD #327   2014-01-23 2015-01-27
5195.669 VANGUARD INFLTN PRTCTD SEC FD #5119   2010-11-22 2015-01-27
140. AMERISOURCEBERGEN CORP   2014-06-13 2015-01-29
270. SMUCKER J M CO NEW   2013-12-05 2015-02-06
280. KOHL'S CORP   2013-12-05 2015-02-12
250. CVS CORP   2013-12-05 2015-02-19
60. APPLE COMPUTER, INC   2014-09-10 2015-02-20
50. APPLE COMPUTER, INC   2013-07-01 2015-02-20
5000. AT&T INC 4.45% 05/15/2021 DTD 04/29/11   2013-06-18 2015-02-26
5000. AT&T INC 4.45% 05/15/2021 DTD 04/29/11   2015-01-28 2015-02-26
30000. AT&T INC 4.45% 05/15/2021 DTD 04/29/11   2011-05-11 2015-02-26
5000. GEN ELEC CAP CORP 1.625% 07/02/2015 DTD 07/02/2012   2012-09-10 2015-02-26
15000. GEN ELEC CAP CORP 1.625% 07/02/2015 DTD 07/02/2012   2012-09-10 2015-02-26
5000. GEN ELEC CAP CORP 1.625% 07/02/2015 DTD 07/02/2012   2015-01-28 2015-02-26
60000. WAL-MART STORES INC 1.50% 10/25/2015 DTD 10/25/10   2013-06-17 2015-02-26
400. NATIONAL-OILWELL INC   2013-12-05 2015-03-17
370. NATIONAL-OILWELL INC   2013-12-05 2015-03-18
75000. COCA COLA CO 1.500% 11/15/2015 DTD 11/15/10   2013-06-17 2015-04-02
400. CME GROUP INC   2013-12-05 2015-04-06
528. EXXON MOBIL CORP COM   1986-10-27 2015-04-08
360. ABBOTT LABS CO   2013-01-15 2015-04-09
180. ABBVIE INC   2013-12-05 2015-04-09
320. AGILENT TECHNOLOGIES INC COM   2013-12-05 2015-04-09
150. AMERICAN EXPRESS CO   2015-01-20 2015-04-09
200. AMERICAN INTL GROUP INC COM NEW   2014-10-29 2015-04-09
70. AMERICAN INTL GROUP INC COM NEW   2013-12-05 2015-04-09
70. AMERISOURCEBERGEN CORP   2014-05-19 2015-04-09
70. AMERIPRISE FINANCIAL INC   2015-02-04 2015-04-09
40. AMERIPRISE FINANCIAL INC   2013-12-05 2015-04-09
160. ANADARKO PETROLEUM   2015-04-08 2015-04-09
260. APPLE COMPUTER, INC   2013-07-01 2015-04-09
690. APPLIED MATERIALS   2013-12-05 2015-04-09
80. BLACKROCK INC CL A   2013-12-05 2015-04-09
200. BOEING CO   2013-12-05 2015-04-09
190. CIT GROUP INC COM NEW   2013-12-05 2015-04-09
110. CME GROUP INC   2013-12-05 2015-04-09
140. CVS CORP   2013-12-05 2015-04-09
170. CAMERON INTERNATIONAL CORP   2013-12-05 2015-04-09
400. CENTURYTEL INC COM   2013-12-05 2015-04-09
180. CITIGROUP INC.   2014-10-29 2015-04-09
80. CITIGROUP INC.   2013-12-05 2015-04-09
200. CITIZENS FINANCIAL GROUP INC   2015-03-30 2015-04-09
130. CITRIX SYS INC COM   2014-01-22 2015-04-09
80. CITRIX SYS INC COM   2014-04-24 2015-04-09
140. COLGATE PALMOLIVE CO   2000-07-13 2015-04-09
150. COMCAST CORP SPECIAL CL A   2013-12-05 2015-04-09
260. DANAHER CORP   2013-12-05 2015-04-09
10. DEVON ENERGY CORPORATIOIN NE COM   2014-08-26 2015-04-09
140. DEVON ENERGY CORPORATIOIN NE COM   2013-12-05 2015-04-09
210. E I DUPONT DE NEMOURS INC   2013-12-05 2015-04-09
20. ECOLAB INC COM   2013-12-05 2015-04-09
270. EVERSOURCE ENERGY   2013-12-05 2015-04-09
280. FIDELITY NATL INFORMATION SV   2013-12-05 2015-04-09
100. GENUINE PARTS CO   2013-12-05 2015-04-09
110. HOME DEPOT INC   2014-06-18 2015-04-09
290. INTERNATIONAL PAPER CO   2013-12-05 2015-04-09
140. KOHL'S CORP   2013-12-05 2015-04-09
60. LAS VEGAS SANDS CORP COM   2014-10-30 2015-04-09
330. MARSH & MCLENNAN CORP   2013-12-05 2015-04-09
70. MCDONALDS CORP   2014-05-29 2015-04-09
80. MCDONALDS CORP   2014-01-10 2015-04-09
210. METLIFE INC   2014-06-17 2015-04-09
710. MICROSOFT CORPORATION   2013-12-05 2015-04-09
370. MORGAN STANLEY GROUP INC. DEAN   2014-03-13 2015-04-09
20. NORTHERN TRUST CORP   2014-06-18 2015-04-09
170. NORTHERN TRUST CORP   2014-01-23 2015-04-09
120. OCCIDENTAL PETROLEUM CO   2014-07-25 2015-04-09
60. OCCIDENTAL PETROLEUM CO   2013-12-05 2015-04-09
530. ORACLE CORPORATION   2013-12-05 2015-04-09
160. PEPSICO INCORPORATED   2008-12-04 2015-04-09
130. PRAXAIR INCORPORATED COMMON   2013-12-05 2015-04-09
150. ROCKWELL COLLINS INC COM   2014-10-28 2015-04-09
230. SYNCHRONY FINANCIAL   2015-02-12 2015-04-09
270. TJX COMPANIES INC.   2013-12-05 2015-04-09
380. TEXAS INSTRUMENTS   2013-12-05 2015-04-09
190. TIME WARNER INC   2013-12-05 2015-04-09
5000. US TREASURY BOND 2.5% 08/15/2023 DTD 08/15/2013   2015-01-27 2015-04-09
100. UNITED TECHNOLOGIES   2014-02-04 2015-04-09
220. UNITEDHEALTH GROUP INC COM   2008-12-04 2015-04-09
120. VISA INC. - CL A   2015-02-04 2015-04-09
160. VISA INC. - CL A   2013-12-05 2015-04-09
300. WISCONSIN ENERGY CORP   2013-12-05 2015-04-09
200. INGERSOLL-RAND PLC SHS   2013-12-05 2015-04-09
120. SEAGATE TECHNOLOGY PLC SHS   2014-02-03 2015-04-09
90. SEAGATE TECHNOLOGY PLC SHS   2015-01-27 2015-04-09
160. CHECK POINT SOFTWARE TECHNOLOGIES LTD   2014-08-28 2015-04-09
80. NIELSEN N V   2015-04-06 2015-04-09
232.394 INVESCO INTERNATIONAL GROWTH FUND INSTITUTIONAL CLASS   2010-11-22 2015-04-13
240. AMERISOURCEBERGEN CORP   2014-05-19 2015-04-20
20. BLACKROCK INC CL A   2013-12-05 2015-05-22
290. CENTURYTEL INC COM   2013-12-05 2015-05-22
400. COMCAST CORP SPECIAL CL A   2013-12-05 2015-05-22
300. MARSH & MCLENNAN CORP   2013-12-05 2015-05-22
140. MICROSOFT CORPORATION   2007-09-19 2015-05-27
100. CHECK POINT SOFTWARE TECHNOLOGIES LTD   2013-12-05 2015-05-27
40. CHECK POINT SOFTWARE TECHNOLOGIES LTD   2014-08-28 2015-05-27
100. MARSH & MCLENNAN CORP   2013-12-05 2015-06-04
60. ORACLE CORPORATION   2013-12-05 2015-06-04
75000. U S TREASURY NOTE 4.875% 08/15/2016 DTD 08/15/2006   2011-12-09 2015-06-19
108. CHEMOURS COMPANY   2013-12-05 2015-07-09
120. LAS VEGAS SANDS CORP COM   2014-10-30 2015-07-15
180. LAS VEGAS SANDS CORP COM   2015-04-30 2015-07-23
10. AMERICAN EXPRESS CO   2015-01-20 2015-07-27
330. AMERICAN EXPRESS CO   2014-02-04 2015-07-27
165. AMERICAN EXPRESS CO   2009-01-12 2015-07-29
100. CITRIX SYS INC COM   2014-04-24 2015-07-30
70. CVS CORP   2013-12-05 2015-08-06
420. AGILENT TECHNOLOGIES INC COM   2013-12-05 2015-08-18
420. AGILENT TECHNOLOGIES INC COM   2013-12-05 2015-08-19
60000. CATERPILLAR FINL SE 2.05% 08/01/2016 DTD 07/29/2011   2013-06-18 2015-08-21
5000. CATERPILLAR FINL SE 2.05% 08/01/2016 DTD 07/29/2011   2015-04-09 2015-08-21
35000. COMCAST CORP 2.85% 01/15/2023 DTD 01/14/2013   2013-06-18 2015-08-21
5000. COMCAST CORP 2.85% 01/15/2023 DTD 01/14/2013   2015-01-28 2015-08-21
15000. ONTARIO PROVINCE OF 1.65% 09/27/2019 DTD 09/27/2012   2013-04-05 2015-08-21
30000. U S TREASURY NOTE 4.875% 08/15/2016 DTD 08/15/2006   2011-12-09 2015-08-21
340. PRAXAIR INCORPORATED COMMON   2013-12-05 2015-08-24
420. CAMERON INTERNATIONAL CORP   2013-12-05 2015-08-26
75000. U S TREASURY NOTE 4.875% 08/15/2016 DTD 08/15/2006   2012-03-15 2015-09-16
630. METLIFE INC   2014-06-17 2015-10-05
160. MCDONALDS CORP   2008-10-20 2015-10-09
230. CIT GROUP INC COM NEW   2013-12-05 2015-10-16
90. HOME DEPOT INC   2014-06-18 2015-10-22
120. MCDONALDS CORP   2008-10-20 2015-10-26
104. MCDONALDS CORP   2008-10-20 2015-10-27
230. TEXAS INSTRUMENTS   2013-12-05 2015-10-28
5000. GEN ELEC CAP CORP 5.625% 09/15/2017 DTD 09/24/07   2015-04-09 2015-10-30
75000. GEN ELEC CAP CORP 5.625% 09/15/2017 DTD 09/24/07   2013-06-17 2015-10-30
17000. GENERAL ELEC CAP 3.45% 05/15/2024 DTD 05/15/2014 CALLABLE 02/13   2015-02-26 2015-10-30
280. CITRIX SYS INC COM   2014-04-24 2015-11-13
88000. GE CAP INTL FNDG 0.9640% 04/15/2016 DTD 10/26/2015   2015-10-30 2015-11-16
8000. GENERAL ELEC CAP 3.45% 05/15/2024 DTD 05/15/2014 CALLABLE 02/13/   2015-02-26 2015-11-16
15000. U S TREASURY NOTE 4.875% 08/15/2016 DTD 08/15/2006   2015-01-27 2015-11-16
75000. U S TREASURY NOTE 4.875% 08/15/2016 DTD 08/15/2006   2013-06-13 2015-11-16
160. CITRIX SYS INC COM   2014-02-03 2015-11-20
700. INTERNATIONAL PAPER CO   2013-12-05 2015-12-02
324. UNITED TECHNOLOGIES   2014-10-28 2015-12-07
90. NORTHERN TRUST CORP   2014-01-23 2015-12-31
80. VISA INC. - CL A   2013-12-05 2015-12-31
CAPITAL GAIN DIVIDENDS P    
(e) Gross sales price (f) Depreciation allowed
(or allowable) 		(g) Cost or other basis
plus expense of sale 		(h) Gain or (loss)
(e) plus (f) minus (g)
a 836   1,674 -838
b 197   419 -222
c 115,853   99,327 16,526
d 135,975   111,833 24,142
e 114,747   130,985 -16,238
126,354   120,547 5,807
137,114   136,801 313
13,343   9,995 3,348
30,555   27,695 2,860
19,276   15,443 3,833
25,649   16,547 9,102
7,749   6,022 1,727
6,458   2,931 3,527
5,404   5,460 -56
5,404   5,497 -93
32,424   30,474 1,950
5,021   5,053 -32
15,064   15,159 -95
5,021   5,026 -5
60,462   61,048 -586
19,105   29,366 -10,261
17,580   27,163 -9,583
75,494   75,923 -429
37,036   31,238 5,798
44,459   4,449 40,010
16,942   10,706 6,236
10,830   8,956 1,874
13,598   12,404 1,194
11,872   13,054 -1,182
11,261   10,502 759
3,941   3,392 549
7,948   4,849 3,099
8,744   9,268 -524
4,997   4,243 754
14,279   13,784 495
32,796   15,241 17,555
15,439   11,550 3,889
29,706   23,587 6,119
30,621   26,455 4,166
8,648   9,512 -864
9,994   8,590 1,404
14,284   9,267 5,017
8,205   9,448 -1,243
14,338   12,324 2,014
9,368   9,428 -60
4,164   4,092 72
4,997   4,870 127
8,383   7,940 443
5,159   4,856 303
9,790   3,682 6,108
8,865   7,037 1,828
22,228   19,198 3,030
650   748 -98
9,095   8,605 490
15,112   12,613 2,499
2,315   2,068 247
13,484   11,054 2,430
19,079   14,081 4,998
9,295   8,062 1,233
12,619   8,796 3,823
15,823   13,166 2,657
10,849   7,721 3,128
3,570   3,705 -135
18,769   15,571 3,198
6,752   7,068 -316
7,716   7,288 428
10,816   11,753 -937
29,451   23,059 6,392
13,557   11,625 1,932
1,421   1,284 137
12,074   10,530 1,544
9,348   11,605 -2,257
4,674   5,454 -780
22,908   18,557 4,351
15,419   8,347 7,072
15,916   15,981 -65
14,584   12,285 2,299
6,910   7,803 -893
18,535   16,885 1,650
21,905   16,198 5,707
16,270   11,996 4,274
5,255   5,291 -36
11,791   10,937 854
26,104   4,347 21,757
7,958   7,944 14
10,610   8,101 2,509
14,687   12,435 2,252
13,579   11,168 2,411
6,547   6,106 441
4,910   5,157 -247
13,597   11,218 2,379
3,660   3,678 -18
8,120   6,395 1,725
27,175   16,040 11,135
7,372   5,897 1,475
9,835   8,935 900
23,080   18,766 4,314
17,715   14,155 3,560
6,630   4,018 2,612
8,292   6,136 2,156
3,317   2,793 524
5,787   4,718 1,069
2,618   2,101 517
78,861   84,636 -5,775
1,347   1,579 -232
6,508   7,410 -902
9,920   10,266 -346
748   868 -120
24,696   15,998 8,698
12,502   3,101 9,401
7,567   6,069 1,498
7,663   4,633 3,030
16,642   16,280 362
16,166   16,280 -114
60,743   61,055 -312
5,062   5,066 -4
34,290   34,948 -658
4,899   5,112 -213
14,952   15,089 -137
31,300   33,692 -2,392
36,084   41,796 -5,712
25,285   23,341 1,944
77,968   83,415 -5,447
29,880   32,695 -2,815
16,417   9,033 7,384
9,357   11,515 -2,158
11,166   7,196 3,970
13,476   6,774 6,702
11,621   5,871 5,750
13,278   9,804 3,474
5,500   5,413 87
82,500   80,088 2,412
19,000   17,922 1,078
21,795   16,037 5,758
88,134   88,000 134
8,238   8,431 -193
15,485   15,502 -17
77,423   81,074 -3,651
12,003   8,489 3,514
28,111   31,779 -3,668
30,949   16,536 14,413
6,555   5,545 1,010
6,295   4,050 2,245
      11,774
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       -838
b       -222
c       16,526
d       24,142
e       -16,238
      5,807
      313
      3,348
      2,860
      3,833
      9,102
      1,727
      3,527
      -56
      -93
      1,950
      -32
      -95
      -5
      -586
      -10,261
      -9,583
      -429
      5,798
      40,010
      6,236
      1,874
      1,194
      -1,182
      759
      549
      3,099
      -524
      754
      495
      17,555
      3,889
      6,119
      4,166
      -864
      1,404
      5,017
      -1,243
      2,014
      -60
      72
      127
      443
      303
      6,108
      1,828
      3,030
      -98
      490
      2,499
      247
      2,430
      4,998
      1,233
      3,823
      2,657
      3,128
      -135
      3,198
      -316
      428
      -937
      6,392
      1,932
      137
      1,544
      -2,257
      -780
      4,351
      7,072
      -65
      2,299
      -893
      1,650
      5,707
      4,274
      -36
      854
      21,757
      14
      2,509
      2,252
      2,411
      441
      -247
      2,379
      -18
      1,725
      11,135
      1,475
      900
      4,314
      3,560
      2,612
      2,156
      524
      1,069
      517
      -5,775
      -232
      -902
      -346
      -120
      8,698
      9,401
      1,498
      3,030
      362
      -114
      -312
      -4
      -658
      -213
      -137
      -2,392
      -5,712
      1,944
      -5,447
      -2,815
      7,384
      -2,158
      3,970
      6,702
      5,750
      3,474
      87
      2,412
      1,078
      5,758
      134
      -193
      -17
      -3,651
      3,514
      -3,668
      14,413
      1,010
      2,245
       
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 2 325,445
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 354,810 7,475,832 0.047461
2013 351,706 7,248,152 0.048524
2012 338,529 6,968,551 0.04858
2011 345,974 6,956,950 0.049731
2010 332,990 6,792,735 0.049021
2
Total of line 1, column (d) .....................
20.243317
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
0.048663
4
Enter the net value of noncharitable-use assets for 2015 from Part X, line 5.....
4
7,379,119
5
Multiply line 4 by line 3......................
5
359,090
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
4,001
7
Add lines 5 and 6........................
7
363,091
8
Enter qualifying distributions from Part XII, line 4.............
8
369,250
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 4,001
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 4,001
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 4,001
6 Credits/Payments:
a 2015 estimated tax payments and 2014 overpayment credited to 2015 6a 4,048
b Exempt foreign organizations—tax withheld at source...... 6b
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 4,048
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 47
11 Enter the amount of line 10 to be: Credited to 2015 estimated taxBullet47 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$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletNH
    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. ...............................
    10
     
    No
    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 addressbullet  
    14
    The books are in care ofbulletTD Bank NA Telephone no.bullet (877) 773-1229

    Located atbullet143 NORTH MAIN STREETCONCORDNH ZIP+4bullet03302
    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
     
    No
    ........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 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
     
    No
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?......................
    b
    If "Yes," did it have excess business holdings in 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
    TD Bank NA Trustee
    1     		73,478    
    143 North Main Street
    Concord,NH033020477
    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.........................bullet  
    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
    7,161,581
    b
    Average of monthly cash balances.......................
    1b
    329,910
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    7,491,491
    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
    7,491,491
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    112,372
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    7,379,119
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    368,956
    Part XI
    Distributable Amount bullet
    1
    Minimum investment return from Part X, line 6....................
    1
    368,956
    2a
    Tax on investment income for 2015 from Part VI, line 5......
    2a
    4,001
    b
    Income tax for 2015. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    4,001
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    364,955
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    364,955
    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
    364,955
    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
    369,250
    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
    369,250
    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
    4,001
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    365,249
    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 7 364,955
    2 Undistributed income, if any, as of the end of 2015:
    a Enter amount for 2014 only....... 0
    b Total for prior years:2013, 20, 20 0
    3 Excess distributions carryover, if any, to 2015:
    a From 2010...... 0
    b From 2011...... 0
    c From 2012...... 0
    d From 2013...... 13,766
    e From 2014...... 0
    fTotal of lines 3a through e........ 13,766
    4Qualifying distributions for 2015 from Part
    XII, line 4: bullet$ 369,250
    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..... 364,955
    e Remaining amount distributed out of corpus 4,295
    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 18,061
    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 ......     		18,061
    10 Analysis of line 9:
    a Excess from 2011.... 0
    b Excess from 2012.... 0
    c Excess from 2013.... 13,766
    d Excess from 2014.... 0
    e Excess from 2015.... 4,295
    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).)
    NONE
    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.
    NONE
    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
    THE SISTERS OF ST ANNE BETHANY
    25 HILLSIDE AVENUE
    ARLINGTON,MA024765818     		NONE 501(C)(3) DAILY OPERATIONS 184,625
    CONCORD HOSPITAL
    RICHARD FORD
    C/O ACCOUNTING DEPT
    CONCORD,NH03301     		NONE 501(C)(3) DAILY OPERATIONS 184,625
    Total .................................bullet 3a 369,250
    bApproved for future payment
    Total .................................bullet 3b  
    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....     14 151,974  
    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 ............     		    18 325,445  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory..          
    11 Other revenue:
    a990PF REFUND     		    1 6,461  
    bMISC INC RCVD     1 15  
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e)..   483,895  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13483,895
    (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 AccountingFeesSchedule
    Name:
    CLARA SALTUS TRUST UW XXX-XX-XXXX
    EIN:
    02-6004790
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAX PREPARATION FEE (NON-ALLOC 725 725    

    TY 2015 InvestmentsCorpBondsSchedule
    Name:
    CLARA SALTUS TRUST UW XXX-XX-XXXX
    EIN:
    02-6004790
    Name of Bond End of Year Book Value End of Year Fair Market Value
    65000 ANHEUSER-BUSCH 1.375% 64,959 64,784
    55000 BK OF NOVA SCOTIA 1.1% 55,032 54,968
    80000 BERKSHIRE HATHAWAY 5.40% 89,076 86,833
    40000 CISCO SYSTEMS INC 4.95% 43,369 43,712
    19000 GE CAPITAL INTL 3.373% 19,000 19,344
    80000 JPMORGAN CHASE & CO 6% 89,500 86,405
    75000 ONTARIO PROVINCE OF 1.65 75,053 74,061
    65000 PROVINCE OF QUEBEC 2.75% 65,842 65,766
    40000 TOYOTA MOTOR CREDIT 2.00 40,553 40,323
    35000 US BANCORP 1.95% 35,111 35,215
    80000 WACHOVIA CORP 5.75% 88,472 86,407
    65000 WALMART STORES INC 3.25% 69,177 68,501
    12819.788 FIDELITY HIGH INCOME 119,133 101,917
    25580.558 TDAM 5 TO 10 YEAR CO 263,344 258,364
    12930.503 TDAM 1 TO 5 CORP BD 130,526 129,305
    25638.784 VANGUARD SHORT-TERM 276,369 274,591

    TY 2015 InvestmentsCorpStockSchedule
    Name:
    CLARA SALTUS TRUST UW XXX-XX-XXXX
    EIN:
    02-6004790
    Name of Stock End of Year Book Value End of Year Fair Market Value
    70 ADVANCE AUTO PARTS INC 10,814 10,536
    600 DICKS SPORTING GOODS INC C 23,873 21,210
    260 GENUINE PARTS CO 20,960 22,331
    370 HOME DEPOT INC 29,585 48,933
    440 KOHLS CORP 24,267 20,957
    270 PVH CORP COM 29,008 19,886
    710 TJX COMPANIES INC 44,402 50,346
    620 TIME WARNER INC 39,144 40,095
    510 CVS HEALTH CORPORATION USD 36,098 49,863
    366 COLGATE PALMOLIVE CO 9,626 24,383
    414 PEPSICO INCORPORATED 21,361 41,367
    190 SMUCKER J M CO NEW 22,938 23,435
    580 ANADARKO PETROLEUM 47,783 28,176
    460 DEVON ENERGY CORPORATION N 28,273 14,720
    640 OCCIDENTAL PETROLEUM CO 58,519 43,270
    1050 AMERICAN INTL GROUP INC C 52,616 65,069
    440 AMERIPRISE FINANCIAL INC 48,732 46,825
    170 BLACKROCK INC CL A 50,123 57,888
    810 CIT GROUP INC COM NEW 39,517 32,157
    430 CME GROUP INC 32,744 38,958
    880 CITIGROUP INC 45,009 45,540
    1380 CITIZENS FINANCIAL GROUP 34,397 36,142
    710 FIDELITY NATL INFORMATION 35,705 43,026
    600 FIDELITY NATIONAL FINANCIA 22,704 20,802
    1520 FIRST DATA CORP - CLASS A 24,344 24,350
    430 MARSH & MCLENNAN CORP 20,289 23,844
    1010 MORGAN STANLEY 31,734 32,128
    440 NORTHERN TRUST CORP 26,596 31,653
    1110 SYNCHRONY FINANCIAL 35,071 33,755
    710 VISA INC - CL A 44,553 68,153
    790 FINANCIAL INC 36,456 29,159
    190 ALLERGAN PLC 56,402 59,375
    910 ABBOTT LABS CO 22,402 40,868
    830 ABBVIE INC 41,704 49,169
    470 GILEAD SCIENCES INC 53,655 47,559
    250 MCKESSON CORP 52,992 49,308
    560 UNITEDHEALTH GROUP INC 11,066 65,878
    720 INGERSOLL-RAND PLC SHS 41,055 39,809
    510 BOEING CO 67,461 73,741
    640 DANAHER CORP SHS BEN INT 47,256 59,443
    1800 GENERAL ELECTRIC CO 42,970 56,070
    150 NORFOLK SOUTHERN CORP 12,456 12,689
    500 ROCKWELL COLLINS INC 36,335 46,150
    520 NIELSEN HOLDINGS PLC EUR 23,888 24,232
    680 SEAGATE TECHNOLOGY PLC SHS 34,134 24,929
    360 CHECK POINT SOFTWARE TECH 22,088 29,297
    70 ALPHABET INC CL-C 41,144 53,122
    930 APPLE COMPUTER INC 57,011 97,892
    1760 APPLIED MATERIALS 29,462 32,859
    290 F5 NETWORKS INC COM 30,068 28,118
    1667 MICROSOFT CORPORATION 47,683 92,485
    1280 ORACLE CORPORATION 43,446 46,758
    740 TEXAS INSTRUMENTS 31,544 40,559
    540 E I DUPONT DE NEMOURS INC 30,856 35,964
    80 ECOLAB INC 8,270 9,150
    730 CENTURYLINK INC COM 22,492 18,367
    670 EVERSOURCE ENERGY 27,431 34,217
    710 PPL CORP 24,008 24,232
    780 WEC ENERGY GROUP INC 32,332 40,022
    11021.096 INVESCO INTERNATIONA 303,301 346,503
    5456.897 HARBOR INTERNATIONAL 324,971 324,303
    51779.783 EPOCH US SMALL MID C 585,007 548,866

    TY 2015 InvestmentsGovtObligationsSch
    Name:
    CLARA SALTUS TRUST UW XXX-XX-XXXX
    EIN:
    02-6004790
    US Government Securities - End of Year Book Value:

    1,828,431
    US Government Securities - End of Year Fair Market Value:

    1,822,328
    State & Local Government Securities - End of Year Book Value:


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


     


    TY 2015 OtherDecreasesSchedule
    Name:
    CLARA SALTUS TRUST UW XXX-XX-XXXX
    EIN:
    02-6004790
    Description Amount
    GE BONDS & ROUNDING ADJUSTMENT 1,494


    TY 2015 OtherExpensesSchedule
    Name:
    CLARA SALTUS TRUST UW XXX-XX-XXXX
    EIN:
    02-6004790
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    STATE/PROBATE FEES 755 755   0
    OTHER NON-ALLOCABLE EXPENSE - 755 755   0


    TY 2015 OtherIncomeSchedule2
    Name:
    CLARA SALTUS TRUST UW XXX-XX-XXXX
    EIN:
    02-6004790
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    990PF REFUND 6,461 0  
    MISC INC RVCD 15 0  


    TY 2015 TaxesSchedule
    Name:
    CLARA SALTUS TRUST UW XXX-XX-XXXX
    EIN:
    02-6004790
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 506 506   0
    FOREIGN TAXES ON QUALIFIED FOR 1,036 1,036   0
    FOREIGN TAXES ON NONQUALIFIED 90 90   0