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
ADAMS WILLIAM T TR UW PLUNKETT XXX-XX-XXXX
 
Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 1330
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
HYANNIS, MA02601
A Employer identification number

04-6024004
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$797,493J 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... 21,042 21,042  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 27,639
b Gross sales price for all assets on line 6a 298,644
7 Capital gain net income (from Part IV, line 2)... 27,639
8 Net short-term capital gain......... 0
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 48,681 48,681  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 11,260 11,260    
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 1,296 231   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 35 35    
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 13,316 12,251 0 0
25 Contributions, gifts, grants paid....... 44,254 44,254
26 Total expenses and disbursements. Add lines 24 and 25 57,570 12,251 0 44,254
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -8,889
b Net investment income (if negative, enter -0-) 36,430
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............. 20,380 27,526 27,526
2 Savings and temporary cash investments.........      
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)      
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).......... 758,762 Click to see attachment740,929 769,967
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) 779,142 768,455 797,493
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........ 779,142 768,455
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)..... 779,142 768,455
31 Total liabilities and net assets/fund balances (see instructions). 779,142 768,455
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
779,142
2
Enter amount from Part I, line 27a .....................
2
-8,889
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
770,253
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
1,798
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30 .
6
768,455
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 32. CALIFORNIA RESOURCES CORPORATION   2014-07-25 2015-01-13
b 20. AMERISOURCEBERGEN CORP   2014-06-13 2015-01-29
c 40. SMUCKER J M CO NEW   2014-01-31 2015-02-06
d 40. KOHL'S CORP   2014-01-31 2015-02-12
e 434.995 BUFFALO SMALL CAP FD #1444   2013-06-13 2015-02-13
584.566 HARTFORD MUT FDS INC MIDCAP FD CL Y FD# 229   2013-06-13 2015-02-13
651.506 PERKINS MID CAP VALUE FUND INSTITUTIONAL CLASS   2013-06-17 2015-02-13
649.297 ROYCE SPECIAL EQUITY FD #327   2013-06-13 2015-02-13
1555.841 VANGUARD INFLTN PRTCTD SEC FD #5119   2013-11-29 2015-02-13
30. CVS CORP   2013-11-26 2015-02-19
20. APPLE COMPUTER, INC   2013-06-27 2015-02-20
50. NATIONAL-OILWELL INC   2013-11-26 2015-03-17
50. NATIONAL-OILWELL INC   2013-11-26 2015-03-18
50. CME GROUP INC   2013-11-26 2015-04-06
70. EXXON MOBIL CORP COM   2010-06-24 2015-04-08
40. AMERISOURCEBERGEN CORP   2014-05-19 2015-04-20
30. ABBOTT LABS CO   2014-01-31 2015-05-01
10. ABBVIE INC   2014-01-31 2015-05-01
30. AGILENT TECHNOLOGIES INC COM   2014-01-31 2015-05-01
10. AMERICAN EXPRESS CO   2014-02-04 2015-05-01
20. AMERICAN INTL GROUP INC COM NEW   2013-11-26 2015-05-01
10. AMERIPRISE FINANCIAL INC   2013-11-26 2015-05-01
10. ANADARKO PETROLEUM   2015-04-08 2015-05-01
10. APPLE COMPUTER, INC   2013-06-27 2015-05-01
70. APPLIED MATERIALS   2013-11-26 2015-05-01
20. BOEING CO   2014-01-31 2015-05-01
10. CIT GROUP INC COM NEW   2013-11-26 2015-05-01
10. CME GROUP INC   2013-11-26 2015-05-01
10. CVS CORP   2013-11-26 2015-05-01
20. CAMERON INTERNATIONAL CORP   2014-01-31 2015-05-01
30. CENTURYTEL INC COM   2013-11-26 2015-05-01
20. CITIGROUP INC.   2014-01-31 2015-05-01
30. CITIZENS FINANCIAL GROUP INC   2015-04-15 2015-05-01
10. CITRIX SYS INC COM   2014-04-24 2015-05-01
20. COLGATE PALMOLIVE CO   2012-04-12 2015-05-01
10. COMCAST CORP SPECIAL CL A   2014-01-31 2015-05-01
30. DANAHER CORP   2011-04-21 2015-05-01
10. DEVON ENERGY CORPORATIOIN NE COM   2014-01-31 2015-05-01
20. E I DUPONT DE NEMOURS INC   2014-01-31 2015-05-01
20. EVERSOURCE ENERGY   2014-01-31 2015-05-01
30. FIDELITY NATL INFORMATION SV   2013-11-26 2015-05-01
10. GENUINE PARTS CO   2014-01-31 2015-05-01
30. INTERNATIONAL PAPER CO   2013-08-16 2015-05-01
10. KOHL'S CORP   2014-01-31 2015-05-01
10. LAS VEGAS SANDS CORP COM   2014-10-30 2015-05-01
30. MARSH & MCLENNAN CORP   2014-01-31 2015-05-01
10. MCDONALDS CORP   2014-01-31 2015-05-01
20. METLIFE INC   2014-06-17 2015-05-01
70. MICROSOFT CORPORATION   2014-01-31 2015-05-01
20. MORGAN STANLEY GROUP INC. DEAN   2014-03-13 2015-05-01
10. NORTHERN TRUST CORP   2014-01-31 2015-05-01
10. OCCIDENTAL PETROLEUM CO   2014-01-31 2015-05-01
50. ORACLE CORPORATION   2013-05-20 2015-05-01
10. PVH CORP COM   2015-04-15 2015-05-01
10. PEPSICO INCORPORATED   2014-01-31 2015-05-01
10. PRAXAIR INCORPORATED COMMON   2013-11-26 2015-05-01
10. ROCKWELL COLLINS INC COM   2014-01-31 2015-05-01
20. SYNCHRONY FINANCIAL   2015-02-12 2015-05-01
30. TJX COMPANIES INC.   2014-01-31 2015-05-01
30. TEXAS INSTRUMENTS   2013-11-26 2015-05-01
10. TIME WARNER INC   2013-11-26 2015-05-01
20. UNITEDHEALTH GROUP INC COM   2013-11-26 2015-05-01
20. VISA INC. - CL A   2014-01-31 2015-05-01
30. WISCONSIN ENERGY CORP   2014-01-31 2015-05-01
20. INGERSOLL-RAND PLC SHS   2013-11-26 2015-05-01
10. SEAGATE TECHNOLOGY PLC SHS   2014-01-31 2015-05-01
10. CHECK POINT SOFTWARE TECHNOLOGIES LTD   2011-07-14 2015-05-01
10. NIELSEN N V   2015-04-10 2015-05-01
755.903 PIMCO INVESTMENT GRADE CORP BOND FUND CLASS I   2010-09-22 2015-05-05
10. BLACKROCK INC CL A   2013-11-26 2015-05-22
40. CENTURYTEL INC COM   2013-11-26 2015-05-22
60. COMCAST CORP SPECIAL CL A   2014-01-31 2015-05-22
40. MARSH & MCLENNAN CORP   2014-01-31 2015-05-22
20. MICROSOFT CORPORATION   2014-01-31 2015-05-27
20. CHECK POINT SOFTWARE TECHNOLOGIES LTD   2011-07-14 2015-05-27
20. MARSH & MCLENNAN CORP   2014-01-31 2015-06-04
10. ORACLE CORPORATION   2012-09-13 2015-06-04
16. CHEMOURS COMPANY   2014-01-31 2015-07-09
10. LAS VEGAS SANDS CORP COM   2014-10-30 2015-07-15
30. LAS VEGAS SANDS CORP COM   2015-04-30 2015-07-23
50. AMERICAN EXPRESS CO   2014-02-04 2015-07-27
5. AMERICAN EXPRESS CO   2009-05-19 2015-07-29
20. AMERICAN EXPRESS CO   2015-01-20 2015-07-29
20. CITRIX SYS INC COM   2014-04-24 2015-07-30
10. CVS CORP   2013-11-26 2015-08-06
60. AGILENT TECHNOLOGIES INC COM   2014-01-31 2015-08-18
60. AGILENT TECHNOLOGIES INC COM   2013-08-16 2015-08-19
50. PRAXAIR INCORPORATED COMMON   2013-11-26 2015-08-24
60. CAMERON INTERNATIONAL CORP   2014-01-31 2015-08-26
90. METLIFE INC   2014-06-17 2015-10-05
30. MCDONALDS CORP   2014-05-29 2015-10-09
30. CIT GROUP INC COM NEW   2013-11-26 2015-10-16
20. HOME DEPOT INC   2014-06-18 2015-10-22
20. MCDONALDS CORP   2014-01-31 2015-10-26
10. MCDONALDS CORP   2014-01-31 2015-10-27
30. TEXAS INSTRUMENTS   2013-11-26 2015-10-28
40. CITRIX SYS INC COM   2014-01-31 2015-11-13
20. CITRIX SYS INC COM   2014-02-03 2015-11-20
100. INTERNATIONAL PAPER CO   2014-01-31 2015-12-02
50. UNITED TECHNOLOGIES   2014-02-04 2015-12-07
10. ABBOTT LABS CO   2013-01-15 2015-12-31
10. ABBVIE INC   2014-01-31 2015-12-31
10. AMERICAN INTL GROUP INC COM NEW   2014-10-29 2015-12-31
20. CIT GROUP INC COM NEW   2013-11-26 2015-12-31
10. CITIGROUP INC.   2014-10-29 2015-12-31
10. EVERSOURCE ENERGY   2014-01-31 2015-12-31
10. GENUINE PARTS CO   2014-01-31 2015-12-31
10. GILEAD SCIENCES INC   2015-08-18 2015-12-31
10. MCKESSON HBOC INC COM   2015-04-20 2015-12-31
10. MICROSOFT CORPORATION   2014-01-31 2015-12-31
10. NORTHERN TRUST CORP   2014-01-31 2015-12-31
72.317 PIMCO INVESTMENT GRADE CORP BOND FUND CLASS I   2010-09-22 2015-12-31
43.316 EPOCH US SMALL MID CAP EQUITY FD #37   2015-05-05 2015-12-31
322.036 TDAM CORE BOND FUND #20   2015-02-13 2015-12-31
10. TEXAS INSTRUMENTS   2013-11-26 2015-12-31
10. TIME WARNER INC   2013-11-26 2015-12-31
441.015 VANGUARD INTERMEDIATE TERM TREASURY ADMIRAL   2010-12-17 2015-12-31
467.662 VANGUARD SHORT-TERM FED-ADM #549   2013-11-29 2015-12-31
10. VISA INC. - CL A   2014-01-31 2015-12-31
10. WEC ENERGY GROUP INC   2014-01-31 2015-12-31
10. NIELSEN HOLDINGS PLC EUR   2015-04-10 2015-12-31
10. SEAGATE TECHNOLOGY PLC SHS   2014-01-31 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 131   249 -118
b 1,906   1,435 471
c 4,527   3,877 650
d 2,754   2,014 740
e 14,103   12,507 1,596
17,572   14,367 3,205
13,082   15,084 -2,002
14,869   14,275 594
40,421   40,047 374
3,078   1,998 1,080
2,583   1,128 1,455
2,388   3,679 -1,291
2,376   3,679 -1,303
4,630   4,087 543
5,894   4,734 1,160
4,529   2,691 1,838
1,397   1,027 370
640   498 142
1,254   1,273 -19
776   841 -65
1,157   989 168
1,252   1,089 163
939   861 78
1,281   564 717
1,397   1,228 169
2,894   2,474 420
450   497 -47
907   817 90
1,001   666 335
1,094   1,207 -113
1,080   923 157
1,073   955 118
778   764 14
668   607 61
1,351   972 379
582   517 65
2,473   1,598 875
685   592 93
1,481   1,221 260
974   874 100
1,889   1,530 359
914   813 101
1,618   1,418 200
729   504 225
529   617 -88
1,693   1,369 324
978   934 44
1,042   1,119 -77
3,392   2,595 797
749   628 121
735   601 134
804   848 -44
2,208   1,695 513
1,036   1,092 -56
953   802 151
1,227   1,261 -34
975   753 222
629   679 -50
1,968   1,706 262
1,656   1,282 374
856   628 228
2,264   1,498 766
1,313   1,090 223
1,482   1,274 208
1,337   1,121 216
595   531 64
839   566 273
448   461 -13
8,035   8,905 -870
3,686   3,053 633
1,357   1,231 126
3,462   3,104 358
2,362   1,826 536
947   741 206
1,658   1,132 526
1,157   913 244
436   323 113
200   238 -38
542   617 -75
1,653   1,762 -109
3,742   1,834 1,908
379   124 255
1,515   1,737 -222
1,513   1,152 361
1,095   666 429
2,377   2,123 254
2,309   2,038 271
5,306   6,303 -997
3,612   3,620 -8
4,269   4,723 -454
3,078   2,878 200
1,220   1,491 -271
2,481   1,599 882
2,246   1,868 378
1,117   934 183
1,732   1,282 450
3,114   2,179 935
1,500   1,055 445
4,016   4,702 -686
4,776   5,519 -743
453   333 120
595   498 97
626   525 101
802   994 -192
523   524 -1
510   437 73
860   813 47
1,015   1,175 -160
1,990   2,299 -309
560   371 189
728   601 127
717   852 -135
459   504 -45
3,185   3,256 -71
557   427 130
650   628 22
4,966   5,172 -206
5,009   5,031 -22
787   545 242
515   425 90
469   472 -3
368   531 -163
      2,909
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       -118
b       471
c       650
d       740
e       1,596
      3,205
      -2,002
      594
      374
      1,080
      1,455
      -1,291
      -1,303
      543
      1,160
      1,838
      370
      142
      -19
      -65
      168
      163
      78
      717
      169
      420
      -47
      90
      335
      -113
      157
      118
      14
      61
      379
      65
      875
      93
      260
      100
      359
      101
      200
      225
      -88
      324
      44
      -77
      797
      121
      134
      -44
      513
      -56
      151
      -34
      222
      -50
      262
      374
      228
      766
      223
      208
      216
      64
      273
      -13
      -870
      633
      126
      358
      536
      206
      526
      244
      113
      -38
      -75
      -109
      1,908
      255
      -222
      361
      429
      254
      271
      -997
      -8
      -454
      200
      -271
      882
      378
      183
      450
      935
      445
      -686
      -743
      120
      97
      101
      -192
      -1
      73
      47
      -160
      -309
      189
      127
      -135
      -45
      -71
      130
      22
      -206
      -22
      242
      90
      -3
      -163
       
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 27,639
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)
If section 4940(d)(2) applies, leave this part blank.
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period?
If "Yes," the foundation does not qualify under section 4940(e). Do not complete this part.
1 Enter the appropriate amount in each column for each year; see instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in) 		(b)
Adjusted qualifying distributions 		(c)
Net value of noncharitable-use assets 		(d)
Distribution ratio
(col. (b) divided by col. (c))
2014 40,617 851,011 0.047728
2013 29,431 801,144 0.036736
2012 41,616 753,941 0.055198
2011 79,532 761,628 0.104424
2010 22,554 758,919 0.029719
2
Total of line 1, column (d) .....................
20.273805
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
0.054761
4
Enter the net value of noncharitable-use assets for 2015 from Part X, line 5.....
4
833,561
5
Multiply line 4 by line 3......................
5
45,647
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
364
7
Add lines 5 and 6........................
7
46,011
8
Enter qualifying distributions from Part XII, line 4.............
8
44,254
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 1 729
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........................... 3 729
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- ..... 5 729
6 Credits/Payments:
a 2015 estimated tax payments and 2014 overpayment credited to 2015 6a 1,385
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 1,385
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 10 656
11 Enter the amount of line 10 to be: Credited to 2015 estimated taxBullet656 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
     
    No
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletMA
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2015 or the taxable year beginning in 2015 (see instructions for Part XIV)?
    If "Yes," complete Part XIV.............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    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
    Yes
     
    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 Trustee
    1     		11,260    
    143 North Main Street
    Concord,NH03302
    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
    831,722
    b
    Average of monthly cash balances.......................
    1b
    14,533
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    846,255
    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
    846,255
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    12,694
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    833,561
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    41,678
    Part XI
    Distributable Amount bullet
    1
    Minimum investment return from Part X, line 6....................
    1
    41,678
    2a
    Tax on investment income for 2015 from Part VI, line 5......
    2a
    729
    b
    Income tax for 2015. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    729
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    40,949
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    40,949
    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
    40,949
    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
    44,254
    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
    44,254
    5
    Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
    income. Enter 1% of Part I, line 27b (see instructions).................
    5
    0
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    44,254
    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 40,949
    2 Undistributed income, if any, as of the end of 2015:
    a Enter amount for 2014 only....... 963
    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...... 0
    e From 2014...... 0
    fTotal of lines 3a through e........ 0
    4Qualifying distributions for 2015 from Part
    XII, line 4: bullet$ 44,254
    a Applied to 2014, but not more than line 2a 963
    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..... 40,949
    e Remaining amount distributed out of corpus 2,342
    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 2,342
    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 ......     		2,342
    10 Analysis of line 9:
    a Excess from 2011.... 0
    b Excess from 2012.... 0
    c Excess from 2013.... 0
    d Excess from 2014.... 0
    e Excess from 2015.... 2,342
    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).)
    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
    PLUNKETT MEMORIAL HOSPITAL
    PO BOX 187
    ADAMS,MA01220     		NONE HOSPITAL DAILY OPERATIONS 44,254
    Total .................................bullet 3a 44,254
    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 21,042  
    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 27,639  
    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)..   48,681  
    13Total. Add line 12, columns (b), (d), and (e)..................
    1348,681
    (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:
    ADAMS WILLIAM T TR UW PLUNKETT XXX-XX-XXXX
    EIN:
    04-6024004
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAX PREPARATION FEE (NON-ALLOC 725 725    

    TY 2015 InvestmentsOtherSchedule2
    Name:
    ADAMS WILLIAM T TR UW PLUNKETT XXX-XX-XXXX
    EIN:
    04-6024004
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    TOTAL FIXED INCOME      
    TOTAL EQUITIES      

    TY 2015 OtherDecreasesSchedule
    Name:
    ADAMS WILLIAM T TR UW PLUNKETT XXX-XX-XXXX
    EIN:
    04-6024004
    Description Amount
    CASH ACCRUAL ADJUSTING ENTRY 449
    RETURN OF CAPITAL ADJUSTMENT 1,225
    BASIS ADJUSTMENT 124


    TY 2015 OtherExpensesSchedule
    Name:
    ADAMS WILLIAM T TR UW PLUNKETT XXX-XX-XXXX
    EIN:
    04-6024004
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    OTHER NON-ALLOCABLE EXPENSE - 35 35   0


    TY 2015 TaxesSchedule
    Name:
    ADAMS WILLIAM T TR UW PLUNKETT XXX-XX-XXXX
    EIN:
    04-6024004
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 71 71   0
    FEDERAL ESTIMATES - PRINCIPAL 1,065 0   0
    FOREIGN TAXES ON QUALIFIED FOR 147 147   0
    FOREIGN TAXES ON NONQUALIFIED 13 13   0