Form990-PF
Click to see attachment

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
GILBERT M AND MARTHA H HITCHCOCK
FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)209 SOUTH 19TH STREET NO 151
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
OMAHA, NE68102
A Employer identification number

47-6025723
B Telephone number (see instructions)

(402) 345-0043
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$16,309,958
J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books
(b) Net investment
income
(c) Adjusted net
income
(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet Sch. B .............
3 Interest on savings and temporary cash investments 163,551 143,481  
4 Dividends and interest from securities... 222,136 222,136  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 827,935
b Gross sales price for all assets on line 6a 4,200,007
7 Capital gain net income (from Part IV, line 2)... 827,935
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 1,213,622 1,193,552  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0 0   0
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... 3,145 3,145   0
c Other professional fees (attach schedule).... 68,472 68,472   0
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... 10,901 10,901   0
19 Depreciation (attach schedule) and depletion...      
20 Occupancy.............. 15,307 15,307   0
21 Travel, conferences, and meetings....... 405 405   0
22 Printing and publications..........        
23 Other expenses (attach schedule)....... 7,216 7,216   0
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 105,446 105,446   0
25 Contributions, gifts, grants paid....... 929,300 929,300
26 Total expenses and disbursements. Add lines 24 and 25 1,034,746 105,446   929,300
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 178,876
b Net investment income (if negative, enter -0-) 1,088,106
c Adjusted net income (if negative, enter -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......... 424,981 576,891 576,891
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule) 3,130,635 Click to see attachment3,367,305 3,434,875
b Investments—corporate stock (attach schedule)....... 6,496,018 Click to see attachment6,602,027 9,879,239
c Investments—corporate bonds (attach schedule)....... 2,774,006 Click to see attachment2,458,293 2,418,953
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 12,825,640 13,004,516 16,309,958
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable..................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22)......... 0 0
Net Assets or Fund Balances bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted..................    
25 Temporarily restricted...............    
26 Permanently restricted...............    
bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds........ 8,302,655 8,302,655
28 Paid-in or capital surplus, or land, bldg., and equipment fund 0 0
29 Retained earnings, accumulated income, endowment, or other funds 4,522,985 4,701,861
30 Total net assets or fund balances (see instructions)..... 12,825,640 13,004,516
31 Total liabilities and net assets/fund balances (see instructions). 12,825,640 13,004,516
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
12,825,640
2
Enter amount from Part I, line 27a .....................
2
178,876
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
13,004,516
5
Decreases not included in line 2 (itemize) bullet
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30 .
6
13,004,516
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 45,000 TEXTRON INC NT 6.20% DTD 09/17/2009 P 2014-02-26 2015-01-02
b 936 SH GENERAL MILLS INC P 2012-08-03 2015-01-06
c 30,000 US TREASURY NOTE 0.25% DTD 12/15/2012 P 2014-09-29 2015-01-08
d 60,000 METROPOLITAN LIFE GLOBAL FDG I NT 144A 3.125% DTD 01/11/2011 P 2014-05-30 2015-01-22
e 139.490 SH FNMA GTD PASSTHRU CTF POOL #AM1886 3.29S% P 2014-09-19 2015-01-26
409.1050 SH MEDTRONIC INC P 2012-03-28 2015-01-26
3,112.895 SH MEDTRONIC INC P 2010-10-26 2015-01-26
10,000 US TREASURY NOTE 0.625% DTD 09/30/2012 P 2013-06-07 2015-01-28
5,000 NORTH CAROLINA HSG FIN AGY HOM REV REF BDS SERIES TAXABLE 2.777% P 2014-04-25 2015-02-02
50 SH AFLAC INC COM P 2007-09-26 2015-02-05
55 SH AGILENT TECHNOLOGIES INC COM P 2014-02-20 2015-02-05
25 SH AIR PRODS & CHEMS INC P 2005-04-21 2015-02-05
15 SH BLACKROCK INC COM P 2010-11-03 2015-02-05
85 SH CHEVRON TEXACO CORP P 2011-05-10 2015-02-05
200 SH CISCO SYS INC P 2008-01-11 2015-02-05
85 SH CITIGROUP INC COM NEW P 2014-02-07 2015-02-05
125 SH COMCAST CORP CL A P 2010-11-29 2015-02-05
385 SH EMC CORP-MASS COM P 2013-08-15 2015-02-05
55 SH EOG RES INC P 2014-09-19 2015-02-05
105 SH EXXON MOBIL CORP COM P 1983-02-14 2015-02-05
155 SH GENERAL ELECTRIC CO COM P 1971-04-29 2015-02-05
260 SH INTEL CORPORATION P 2011-06-03 2015-02-05
30 SH INTL BUSINESS MACHS CORP COM P 1972-01-10 2015-02-05
48.517 SH J P MORGAN CHASE & CO P 2005-03-04 2015-02-05
61.483 SH J P MORGAN CHASE & CO P 2008-01-11 2015-02-05
25 SH KEYSIGHT TECHNOLOGIES INC COM P 2013-10-02 2015-02-05
70 SH KOHLS CORP P 2011-03-01 2015-02-05
40 SH MOHAWK INDS INC COM P 2009-07-01 2015-02-05
375 SH NIKE INC P 2011-08-19 2015-02-05
55 SH PHILIP MORRIS INTL INC COM P 2010-06-24 2015-02-05
100 SH PROCTER & GAMBLE CO COM P 2007-07-06 2015-02-05
145 SH TEXAS INSTRS INC P 2009-07-01 2015-02-05
75 SH 3M CO P 1972-05-23 2015-02-05
130 SH U.S. BANCORP COM P 2011-08-22 2015-02-05
20,000 US TREASURY BOND 3.625% DTD 08/15/2013 P 2013-12-20 2015-02-05
25 SH UNITED TECHNOLOGIES CORP COM P 2013-07-09 2015-02-05
155 SH MEDTRONIC PLC SHS P 2015-01-26 2015-02-05
15,000 US TREASURY NOTE 0.25% DTD 12/15/2012 P 2014-08-29 2015-02-17
45,000 US TREASURY NOTE 0.25% DTD 12/15/2012 P 2014-09-29 2015-02-17
1,325 SH INTEL CORPORATION P 2011-06-03 2015-02-19
1,261 SH QUALCOMM INC COM P 2011-08-22 2015-02-19
139.990 FNMA GTD PASSTHRU CTF POOL #AM1886 3.290% DTD P 2014-09-19 2015-02-25
40,000 GENWORTH HLDGS INC SR GLBL 4.80% DTD 12/10/2013 P 2014-11-07 2015-02-25
45,000 MOSAIC CO NEW SR NT 3.75% DTD 10/24/2011 P 2013-11-06 2015-02-27
10,000 MOSAIC CO NEW SR NT 3.75% DTD 10/24/2011 P 2013-12-11 2015-02-27
1,457.280 HELIOS LEASING I LLC SECD NT 2.018% DTDF 06/19/2012 P 2012-06-12 2015-02-28
45,000 BURLINGTON NORTHN SANTA FE LLC DEB 3.75% DTD 03/07/2014 P 2014-05-29 2015-03-04
15,000 BURLINGTON NORTHN SANTA FE LLC DEB 3.75% DTD 03/07/2014 P 2014-06-18 2015-03-04
20,000 US TREASURY BOND 4.750% DTD 02/15/07 P 2014-08-29 2015-03-04
10,000 US TREASURY BOND 4.750% DTD 02/15/07 P 2014-12-09 2015-03-04
7,143.920 SMALL BUSINESS ADMIN GTD LN POOL CTFS 2.8775 DTD 09/21/2011 P 2014-11-07 2015-03-10
30,000 BERKSHIRE HATHAWAY INC DEL SR NT 2.10% DTD 08/14/2014 P 2014-08-07 2015-03-11
35,000 BANK OF NEW YORK INC MEDIUM TERM SUB NTS TRANCHE #SB 00170 4.95% DTD P 2009-11-06 2015-03-15
60,000 MEDTRONIC INC SR NT 3.00% DTD 03/16/2010 P 2010-03-11 2015-03-15
556.620 ALTITUDE INVTS 16 LLC SECD NT 2.492% DTD 05/30/2014 P 2014-05-20 2015-03-16
25,000 VERIZON COMMUNICATIONS INC NT 5.15% DTD 09/18/2013 P 2013-09-11 2015-03-16
25,000 VERIZON COMMUNICATIONS INC NT 5.15% DTD 09/18/2013 P 2014-06-19 2015-03-16
2,892 SH INTEL CORPORATION P 2011-06-03 2015-03-18
794.000 VERIZON COMMUNICTIONS INC 144A NT 4.272% DTD 03/13/2015 P 2015-03-16 2015-03-20
174.220 FNMA GTD PASSTHRU CTF POOL #AM1886 3.290% DTD P 2014-09-19 2015-03-25
65,000 AMERICAN EXPRESS CO CUB DEB VAR RATE DTD 08/01/2006 P 2007-01-23 2015-04-08
130.901 SH LEAR CORP COM NEW P 2011-04-18 2015-04-14
343.099 SH LEAR CORP COM NEW P 2011-04-25 2015-04-14
43,224.40 US TREASURY NOTE 0.50% DTD 04/15/2010 P 2011-03-10 2015-04-15
25,000 WHIRLPOOL CORP MEDIUM TERM NTS TRANCHE #TR 00052 4.85% DTD P 2011-06-02 2015-04-23
20,000 WHIRLPOOL CORP MEDIUM TERM NTS TRANCHE #TR 00052 4.85% DTD P 2011-06-02 2015-04-23
5,000 WHIRLPOOL CORP MEDIUM TERM NTS TRANCHE #TR 00052 4.85% DTD P 2014-10-30 2015-04-23
141.13 FNMA GTD PASSTHRU CTF POOL #AM1886 3.290% DTD P 2014-09-19 2015-04-27
10,000 INTEL CORP SR NT 4.80% DTD 09/19/2011 P 2015-02-05 2015-04-30
291 SH 3M CO P 1972-05-23 2015-05-07
120,000 US TREASURY NOTE 0.25% DTD 12/15/2012 P 2015-03-30 2015-05-11
70 SH AFLAC INC COM P 2007-09-26 2015-05-14
95 SH AGILENT TECHNOLOGIES INC COM P 2014-02-20 2015-05-14
35 SH AIR PRODS & CHEMS INC P 2005-04-21 2015-05-14
110 SH APPLE COMPUTER INCORPORATED P 2012-03-27 2015-05-14
140 SH AVNET INC COM P 2012-05-11 2015-05-14
15 SH BLACKROCK INC COM P 2010-11-03 2015-05-14
65 SH CAPITAL ONE FINANCIAL CORP COM P 2014-06-06 2015-05-14
65 SH CARNIVAL CORP PAIRED CTF P 2015-04-14 2015-05-14
80 SH CHEVRONTEXACO CORP P 2011-05-10 2015-05-14
167.206 SH CISCO SYS INC P 2008-01-11 2015-05-14
47.794 SH CISCO SYS INC P 2009-07-01 2015-05-14
60 SH CITIGROUP INC COM NEW P 2014-02-07 2015-05-14
80 SH CITIGROUP INC COM NEW P 2014-03-27 2015-05-14
892 SH COCA COLA CO. COM P 1982-03-18 2015-05-14
120 SH COMCAST CORP CL A P 2010-11-29 2015-05-14
205 SH DENTSPLY INTL INC NEW COM P 2013-10-22 2015-05-14
260 SH EMC CORP-MASS COM P 2013-08-15 2015-05-14
55 SH EOG RES INC P 2014-09-19 2015-05-14
115 SH EXXON MOBIL CORP COM P 1983-02-14 2015-05-14
85 SH FLOWSERVE CORP COM P 2010-11-29 2015-05-14
160 SH GENERAL ELEC CO COM P 1971-04-29 2015-05-14
95 SH GENERAL MILLS INC P 2012-08-03 2015-05-14
10 SH HERSHEY FOODS CORP COM P 2015-02-05 2015-05-14
35,000 INTEL CORP SR NT 4.80% DTD 09/19/2011 P 2014-09-09 2015-05-14
5,000 INTEL CORP SR NT 4.80% DTD 09/19/2011 P 2014-11-05 2015-05-14
5,000 INTEL CORP SR NT 4.80% DTD 09/19/2011 P 2015-02-05 2015-05-14
25 SH INTERCONTINENTAL EXCHANGE, INC COM P 2012-05-11 2015-05-14
20 SH INTL BUSINESS MACHS CORP COM P 1972-01-10 2015-05-14
115 SH J P MORGAN CHASE & CO P 2005-03-04 2015-05-14
110 SH JACOBS ENGR GROUP INC COM P 2013-12-06 2015-05-14
15 SH KEYSIGHT TECHNOLOGIES INC COM P 2014-02-20 2015-05-14
70 SH KOHLS CORP P 2011-03-01 2015-05-14
5 SH LEAR CORP COM NEW P 2011-04-18 2015-05-14
45 SH M & T BK CORP COM P 2014-02-07 2015-05-14
10 SH MARKEL CORP COM P 2014-02-07 2015-05-14
145 SH MICROSOFT CORP P 2005-03-04 2015-05-14
30 SH MICROCHIP TECHNOLOGY INC P 2015-02-19 2015-05-14
25 SH MOHAWK INDS INC COM P 2009-07-01 2015-05-14
45 SH NIKE INC P 2011-08-19 2015-05-14
100 SH NOVARTIS AG SPONSORED ADR P 2010-04-15 2015-05-14
125 SH OMNICOM GROUP INC P 2012-03-22 2015-05-14
160 SH ORACLE CORPORATION COM P 2010-05-20 2015-05-14
135 SH PERKINELMER INC P 2014-12-19 2015-05-14
60 SH PHILIP MORRIS INTL INC COM P 2010-06-24 2015-05-14
90 SH PROCTER & GAMBLE CO COM P 2007-07-06 2015-05-14
65 SH SCHLUMBERGER LTD. COM P 2013-02-22 2015-05-14
85 SH SCRIPPS NETWORKS INTERACT IN CL A COM P 2014-09-23 2015-05-14
115 SH TEXAS INSTRS INC P 2009-07-01 2015-05-14
25 SH 3M CO P 1972-05-23 2015-05-14
45 SH TOWERS WATSON & CO CL A P 2012-06-22 2015-05-14
7 SH TRAVELERS COS INC COM P 2011-09-27 2015-05-14
38 SH TRAVELERS COS INC COM P 2013-02-22 2015-05-14
140 SH U.S. BANCORP COM P 2011-08-22 2015-05-14
20 SH UNITED TECHNOLOGIES CORP COM P 2013-07-09 2015-05-14
65 SH VARIAN MED SYS INC COM P 2012-06-25 2015-05-14
140 SH VERIZON COMMUNICATIONS COM P 2014-04-08 2015-05-14
115 SH WESTAR ENERGY INC P 2014-06-12 2015-05-14
205 SH XCEL ENERGY INC COM P 2013-05-31 2015-05-14
45 SH AON PLC SHS CL A P 2012-06-26 2015-05-14
35 SH ACCENTURE PLC CLASS A ORDINARY SHARES P 2015-03-18 2015-05-14
160 SH MEDTRONIC PLC SHS P 2015-01-26 2015-05-14
125,000 US TREASURY NOTE 0.625% DTD 09/30/2012 P 2013-06-07 2015-05-18
65,000 US TREASURY NOTE .025% DTD 12/15/2012 P 2014-08-29 2015-05-18
30,000 US TREASURY NOTE 0.25% DTD 12/15/2012 P 2015-03-30 2015-05-18
75,000 US TREASURY NOTE 0.25% DTD 12/15/2012 P 2014-12-30 2015-05-18
55,000 MORGAN STANLEY SR NT F 4.75% DTD 03/22/2012 P 2013-07-18 2015-05-19
5,000 MORGAN STANELY SR NT F 4.75% DTD 03/22/2012 P 2014-09-26 2015-05-19
152.84 FNMA GTD PASSTHRU CTF POOL #AM1886 3.290% DTD P 2014-09-19 2015-05-26
1,092 SH NIKE INC P 2011-08-19 2015-05-28
1,464.56 HELIOS LEASING I LLC SECD NT 2.018% DTD 06/19/2012 P 2012-06-12 2015-05-29
559.70 ALTITUDE INVTS 16 LLC SECD NT 2.492% DTD 06/19/2012 P 2014-05-20 2015-06-14
142.190 FNMA GTD PASSTHRU CTF POOL #AM1886 3.290% DTD 05/30/2014 P 2014-09-19 2015-06-25
10,000 US TREASURY NOTE 0.625% DTD 09/30/2012 P 2013-06-11 2015-07-07
30,000 CARGILL INC SR NT 144A 3.25% DTD 11/08/2011 P 2013-05-07 2015-07-10
15,000 CARGILL INC SR NT 144A 3.25% DTD 11/08/2011 P 2014-02-11 2015-07-10
50,000 DIRECTV HLDGS LLC DIRECTV SR NT 3.80% DTD 03/08/2012 P 2012-11-21 2015-07-10
5,000 DIRECTV HLDGS LLC DIRECTV SR NT 3.80% DTD 03/08/2012 P 2012-11-29 2015-07-10
5,000 DIRECTV HLDGS LLC / DIRECTV FING CO INC SR NT 3.95% DTD 12/11/2014 P 2014-12-02 2015-07-10
1,478 SH FLOWSERVE CORP COM P 2010-11-29 2015-07-10
260 SH FLOWSERVE CORP COM P 2014-12-19 2015-07-10
153.87 FNMA GTD PASSTHRU CTF POOL #AM1886 3.290% DTD P 2014-09-19 2015-07-27
12 SH MARKEL CORP COM P 2013-11-01 2015-07-30
32 SH MARKET CORP COM P 2014-02-07 2015-07-30
177 SH MOHAWK INDS INC COM P 2009-07-01 2015-07-30
143.260 FNMA GTD PASSTHRU CTF POOL #AM1886 3.290% DTD P 2014-09-19 2015-08-25
476 SH INTL BUSINESS MACHS CORP COM P 1972-01-10 2015-08-26
1,4781.89 HELIOS LEASING I LLC SECD NT 2.018% DTD 06/19/2012 P 2012-06-12 2015-08-29
2,776.16 SMALL BUSINESS ADMIN GTD LN POOL CTFS 2.877% DTD 09/21/2011 P 2014-11-07 2015-09-10
562.79 ALTITUDE INVTS 16 LLC SECD NT 2.492% DTD 05/30/2014 P 2014-05-20 2015-09-14
35,000 US TREASURY NOTE 0.25% DTD 12/15/2012 P 2015-07-29 2015-09-14
143.78 FNMA GTD PASSTHRU CTF POOL #AM1886 3.290% DTD P 2014-09-19 2015-09-25
2,386 SH WESTAR ENERGY INC P 2014-06-12 2015-10-05
1,066 SH XCEL ENERGY INC COM P 2013-05-31 2015-10-05
35,000 US TREASURY NOTE 0.25% DTD 12/15/2012 P 2015-07-29 2015-10-06
30,000 US TREASURY NOTE 0.25% DTD 12/15/2012 P 2015-07-29 2015-10-08
55,000 US TREASURY NOTE 0.25% DTD 12/15/2012 P 2015-07-29 2015-10-13
155.42 FNMA GTD PASSTHRU CTF POOL #AM1886 3.290% DTD P 2014-09-19 2015-10-26
1,557 SH KOHLS CORP P 2011-03-01 2015-10-26
370 SH LEAR CORP COM NEW P 2011-04-18 2015-10-26
1,362 SH SCRIPPS NETWORKS INTERACT IN CL A COM P 2014-09-23 2015-10-28
389 SH SCRIPPS NETWORKS INTERACT IN CL A COM P 2015-01-09 2015-10-28
25,000 US TREASURY NOTE 0.625% DTD 09/30/2012 P 2014-04-11 2015-11-04
1,109 SH HERSHEY FOODS CORP COM P 2015-01-06 2015-11-12
35 SH HERSHEY FOODS CORP COM P 2015-02-05 2015-11-12
372 SH HERSHEY FOODS CORP COM P 2015-05-01 2015-11-12
25,000 FHLMC 4.75% DTD 10/21/2005 P 2005-10-28 2015-11-17
25,000 FHLMC 4.75% DTD 10/21/2005 P 2010-12-10 2015-11-17
319 SH LEAR CORP COM NEW P 2011-04-18 2015-11-20
80 SH LEAR CORP COM NEW P 2015-07-30 2015-11-20
207 SH LEAR CORP COM NEW P 2015-07-30 2015-11-23
144.86 FNMA GTD PASSTHRU CTF POOL #AM1886 3.290% DTD P 2014-09-19 2015-11-25
1,479.25 HELIOS LEASING I LLC SECD NT 2.018% DTD 06/19/2012 P 2012-06-12 2015-11-28
5,000 MONTANA ST BRD HSG SINGLE FAMILY PROG DBS A AMT 2.65% DTD 05/30/2013 P 2013-05-01 2015-12-01
5,000 MONTANA ST BRD HSG SINGLE FAMILY PROG DBS A AMT 2.65% DTD 05/30/2013 P 2013-05-01 2015-12-01
85,000 STATE STR BK & TR CO SB NT FLT VAR RATE DTD 12/08/2005 P 2009-08-25 2015-12-08
565.90 ALTITUDE INVTS 16 LLC SECD NT 2.492% DTD 05/30/2014 P 2014-05-20 2015-12-14
20,000 US TREASURY NOTE 0.25% DTD 12/15/2012 P 2015-07-29 2015-12-15
156.47 FNMA GTD PASSTHRU CTF POOL #AM1886 3.290% DTD P 2014-09-19 2015-12-28
100 SH MICROSOFT CORP P 2005-03-04 2015-01-09
150 SH NIKE INC P 2013-09-10 2015-01-09
100 SH UNION PACIFIC CORP COM P 2013-01-11 2015-01-09
50 SH UNION PACIFIC CORP COM P 2012-11-05 2015-01-09
200 SH WALGREENS BOOTS ALLIANCE INC COM P 2012-10-31 2015-01-09
200 SH ABBVIE INC COM P 2013-05-13 2015-01-26
125 SH EXPRESS SCRIPTS HLDG CO COM P 2012-11-05 2015-01-26
200 SH GILEAD SCIENCES INC COM P 2013-10-16 2015-01-26
150 SH STRYKER CORP P 2012-11-07 2015-01-26
125 SH NIKE INC P 2013-09-10 2015-01-29
107 SH APPLE COMPUTER INCORPORATED P 2012-03-27 2015-05-05
25 SH BLACKROCK INC COM P 2013-01-11 2015-05-05
250 SH COMCAST CORP CL A P 2013-05-13 2015-05-05
100 SH WALT DISNEY CO COM P 2013-05-13 2015-05-05
125 SH WALT DISNEY CO COM P 2002-11-05 2015-05-05
25 SH WALT DISNEY CO COM P 2012-12-12 2015-05-05
50 SH GOLDMAN SACHS GROUP INC COM P 2012-11-05 2015-05-05
100 SH HOME DEPOT INC P 2013-05-13 2015-05-05
150 SH HOME DEPOT INC P 2012-11-05 2015-05-05
100 SH J P MORGAN CHASE & CO P 2012-11-05 2015-05-05
25 SH MCDONALDS CORP COM P 2013-05-13 2015-05-05
125 SH NIKE INC P 2013-09-10 2015-05-05
75 SH WALGREENS BOOTS ALLIANCE INC COM P 2012-10-31 2015-05-05
50 SH QUALCOMM INC COM P 2014-05-07 2015-09-08
125.36 SH QUALCOMM INC COM P 2012-01-12 2015-09-08
474.64 SH QUALCOMM INC COM P 2011-08-22 2015-09-08
200 SH WAL MART STORES INC P 2012-10-31 2015-10-14
25 SH WAL MART STORES INC P 2012-11-07 2015-10-14
100 SH WAL MART STORES INC P 2012-11-05 2015-10-14
75 SH WAL MART STORES INC P 2012-11-09 2015-10-14
100 SH WAL MART STORES INC P 2015-01-29 2015-10-14
50 SH WAL MART STORES INC P 2014-12-03 2015-10-14
CAPITAL GAINS 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 45,516   45,498 18
b 49,029   36,116 12,913
c 30,001   30,014 -13
d 61,466   61,440 26
e 139   135 4
31,481   16,113 15,368
239,537   112,189 127,348
9,957   9,912 45
5,000   5,000 0
3,039   2,855 184
2,176   2,287 -111
3,775   1,441 2,334
5,373   2,494 2,879
9,258   8,854 404
5,430   5,214 216
4,115   4,179 -64
7,104   2,526 4,578
10,406   10,102 304
5,270   5,753 -483
9,664   396 9,268
3,787   152 3,635
8,777   5,722 3,055
4,725   93 4,632
2,751   1,823 928
3,486   2,576 910
861   712 149
4,726   3,780 946
6,664   1,429 5,235
34,983   15,031 19,952
4,533   2,545 1,988
8,654   6,147 2,507
7,960   3,151 4,809
12,462   274 12,188
5,712   2,669 3,043
25,034   19,187 5,847
3,002   2,461 541
11,615   11,927 -312
15,008   15,004 4
45,023   45,018 5
45,314   29,162 16,152
89,321   58,912 30,409
140   136 4
34,279   35,062 -783
47,541   44,205 3,336
10,565   9,907 658
1,457   1,457 0
47,572   46,825 747
15,857   15,348 509
27,309   26,063 1,246
13,654   13,481 173
7,144   7,347 -203
30,401   29,997 404
35,000   35,000 0
60,000   59,995 5
557   557 0
26,721   24,919 1,802
26,721   27,771 -1,050
88,428   63,650 24,778
794   767 27
174   169 5
68,582   69,051 -469
14,861   6,001 8,860
38,951   16,598 22,353
43,224   44,956 -1,732
27,850   25,047 2,803
22,280   19,993 2,287
5,570   5,467 103
141   137 4
10,829   11,361 -532
46,135   1,063 45,072
120,075   120,028 47
4,467   3,997 470
3,991   3,950 41
5,161   2,017 3,144
14,171   9,648 4,523
6,416   4,684 1,732
5,564   2,494 3,070
5,485   5,238 247
3,065   3,095 -30
8,674   8,333 341
4,852   4,359 493
1,387   904 483
3,274   2,950 324
4,366   3,799 567
37,027   591 36,436
6,774   2,425 4,349
10,568   9,362 1,206
7,012   6,822 190
4,993   5,753 -760
9,993   434 9,559
4,852   2,992 1,860
4,375   157 4,218
5,390   3,666 1,724
960   1,056 -96
36,416   37,074 -658
5,202   5,388 -186
5,202   5,680 -478
6,017   3,116 2,901
3,477   62 3,415
7,596   4,321 3,275
4,870   6,439 -1,569
529   476 53
4,527   3,780 747
571   229 342
5,530   5,071 459
7,755   5,421 2,334
7,051   3,663 3,388
1,488   1,513 -25
4,575   893 3,682
4,654   1,804 2,850
10,391   5,386 5,005
9,708   6,264 3,444
7,093   3,650 3,443
6,996   5,907 1,089
5,209   2,776 2,433
7,254   5,533 1,721
5,979   5,025 954
5,608   6,627 -1,019
6,378   2,499 3,879
4,073   91 3,982
6,050   2,654 3,396
719   351 368
3,904   3,078 826
6,209   2,874 3,335
2,382   1,969 413
5,686   3,769 1,917
6,999   6,747 252
4,128   4,109 19
6,853   5,960 893
4,492   2,055 2,437
3,391   3,109 282
12,189   12,312 -123
124,692   123,870 822
65,053   65,013 40
30,025   30,007 18
75,062   75,009 53
58,336   57,459 877
5,303   5,287 16
153   148 5
111,676   43,771 67,905
1,465   1,465 0
560   560 0
142   138 4
9,997   9,915 82
30,795   31,094 -299
15,398   14,950 448
50,302   50,797 -495
5,030   5,093 -63
4,887   4,966 -79
72,809   52,021 20,788
12,808   15,053 -2,245
154   149 5
10,598   6,390 4,208
28,262   17,347 10,915
35,490   6,323 29,167
143   139 4
68,613   1,479 67,134
1,472   1,472 0
2,776   2,855 -79
563   563 0
35,012   35,014 -2
144   139 5
91,526   85,254 6,272
37,611   30,993 6,618
35,016   35,010 6
30,013   30,009 4
55,019   55,014 5
155   151 4
69,305   84,079 -14,774
44,054   16,962 27,092
78,312   106,190 -27,878
22,367   29,254 -6,887
24,916   24,817 99
94,634   115,038 -20,404
2,987   3,695 -708
31,744   34,881 -3,137
25,000   24,610 390
25,000   25,000 0
40,114   14,624 25,490
10,060   8,349 1,711
26,082   21,602 4,480
145   140 5
1,479   1,479 0
5,000   5,000 0
5,000   5,000 0
85,000   85,000 0
566   566 0
20,000   20,000 0
156   152 4
4,711   2,526 2,185
14,386   10,011 4,375
11,545   6,540 5,005
5,773   3,097 2,676
15,210   7,064 8,146
12,464   8,948 3,516
10,588   7,821 2,767
21,434   12,919 8,515
13,804   7,918 5,886
11,840   8,343 3,497
13,503   9,385 4,118
9,147   5,503 3,644
14,520   10,774 3,746
11,083   6,732 4,351
13,854   6,257 7,597
2,771   1,249 1,522
9,845   6,165 3,680
10,817   7,676 3,141
16,225   9,355 6,870
6,439   4,213 2,226
2,397   2,519 -122
12,545   8,343 4,202
6,229   2,649 3,580
2,745   3,953 -1,208
6,882   7,019 -137
26,058   22,174 3,884
12,186   14,925 -2,739
1,523   1,834 -311
6,093   7,314 -1,221
4,570   5,428 -858
6,093   8,768 -2,675
3,046   4,243 -1,197
5,786     5,786
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       18
b       12,913
c       -13
d       26
e       4
      15,368
      127,348
      45
      0
      184
      -111
      2,334
      2,879
      404
      216
      -64
      4,578
      304
      -483
      9,268
      3,635
      3,055
      4,632
      928
      910
      149
      946
      5,235
      19,952
      1,988
      2,507
      4,809
      12,188
      3,043
      5,847
      541
      -312
      4
      5
      16,152
      30,409
      4
      -783
      3,336
      658
      0
      747
      509
      1,246
      173
      -203
      404
      0
      5
      0
      1,802
      -1,050
      24,778
      27
      5
      -469
      8,860
      22,353
      -1,732
      2,803
      2,287
      103
      4
      -532
      45,072
      47
      470
      41
      3,144
      4,523
      1,732
      3,070
      247
      -30
      341
      493
      483
      324
      567
      36,436
      4,349
      1,206
      190
      -760
      9,559
      1,860
      4,218
      1,724
      -96
      -658
      -186
      -478
      2,901
      3,415
      3,275
      -1,569
      53
      747
      342
      459
      2,334
      3,388
      -25
      3,682
      2,850
      5,005
      3,444
      3,443
      1,089
      2,433
      1,721
      954
      -1,019
      3,879
      3,982
      3,396
      368
      826
      3,335
      413
      1,917
      252
      19
      893
      2,437
      282
      -123
      822
      40
      18
      53
      877
      16
      5
      67,905
      0
      0
      4
      82
      -299
      448
      -495
      -63
      -79
      20,788
      -2,245
      5
      4,208
      10,915
      29,167
      4
      67,134
      0
      -79
      0
      -2
      5
      6,272
      6,618
      6
      4
      5
      4
      -14,774
      27,092
      -27,878
      -6,887
      99
      -20,404
      -708
      -3,137
      390
      0
      25,490
      1,711
      4,480
      5
      0
      0
      0
      0
      0
      0
      4
      2,185
      4,375
      5,005
      2,676
      8,146
      3,516
      2,767
      8,515
      5,886
      3,497
      4,118
      3,644
      3,746
      4,351
      7,597
      1,522
      3,680
      3,141
      6,870
      2,226
      -122
      4,202
      3,580
      -1,208
      -137
      3,884
      -2,739
      -311
      -1,221
      -858
      -2,675
      -1,197
      5,786
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 2 827,935
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 928,871 16,480,426 0.056362
2013 813,849 15,553,879 0.052325
2012 787,395 14,710,305 0.053527
2011 775,150 14,773,777 0.052468
2010 668,800 14,412,005 0.046406
2
Total of line 1, column (d) .....................
20.261088
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
0.052218
4
Enter the net value of noncharitable-use assets for 2015 from Part X, line 5.....
4
16,356,206
5
Multiply line 4 by line 3......................
5
854,088
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
10,881
7
Add lines 5 and 6........................
7
864,969
8
Enter qualifying distributions from Part XII, line 4.............
8
929,300
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 10,881
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 10,881
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 10,881
6 Credits/Payments:
a 2015 estimated tax payments and 2014 overpayment credited to 2015 6a 17,252
b Exempt foreign organizations—tax withheld at source...... 6b
c Tax paid with application for extension of time to file (Form 8868)... 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 17,252
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. Click to see attachment 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 6,371
11 Enter the amount of line 10 to be: Credited to 2015 estimated taxBullet6,371 RefundedBullet 11 0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see Instructions
for definition)?.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
  • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletNE
    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 addressbulletN/A
    14
    The books are in care ofbulletNEELY KOUNTZE Telephone no.bullet (402) 345-0043

    Located atbullet209 SOUTH 19TH STREET SUITE 151OMAHANE ZIP+4bullet68102
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041.......bullet
    and enter the amount of tax-exempt interest received or accrued during the year ......bullet
    15  
    16 At any time during calendar year 2015, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country?
    16   No
    See instructions for exceptions and filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR). If "Yes", enter the name of the foreign country bullet  
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?......................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?...............
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).......
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance (see instructions)? ........
    1b
     
     
    ........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2015?.............
    1c
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2015, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2015?.............
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?......................
    b
    If "Yes," did it have excess business holdings in 2015 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2015.)..................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2015?
    4b
     
    No
    Form 990-PF (2015)
    Form 990-PF (2015)
    Page 6
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required (Continued)
    5a
    During the year did the foundation pay or incur any amount to:
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?.............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? (see instructions)................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?.....
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance (see instructions)? ......
    5b
     
    No
    .........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
    NEELY KOUNTZE PRESIDENT/TRUSTEE
    0.00
    0 0 0
    209 SOUTH 19TH STREET SUITE 151
    OMAHA,NE68102
    MARY L KOUNTZE VICE PRESIDENT/TRUSTEE
    0.00
    0 0 0
    PO BOX 513
    BOCA GRANDE,FL33921
    JOHN Q BACHMAN SECRETARY/TRUSTEE
    0.00
    0 0 0
    10250 REGENCY CIRCLE SUITE 300
    OMAHA,NE68114
    JOHN W WEBSTER TREASURER/TRUSTEE
    0.00
    0 0 0
    12910 PIERCE STREET SUITE 320
    OMAHA,NE68144
    JAMES E LANDEN TRUSTEE
    0.00
    0 0 0
    1120 SOUTH 101 STREET
    OMAHA,NE68124
    TOWER KOUNTZE TRUSTEE
    0.00
    0 0 0
    5208 CUMING STREET
    OMAHA,NE68132
    W RUSSELL BOWIE III TRUSTEE
    0.00
    0 0 0
    4174 CHICAGO STREET
    OMAHA,NE68131
    ELIZABETH MALLORY KOUNTZE TRUSTEE
    0.00
    0 0 0
    35 FILBERT AVENUE
    SAUSALITO,CA94965
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation
    (e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet 0
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1
     
    2  
    3  
    4  
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet0
    Form 990-PF (2015)
    Form 990-PF (2015)
    Page 8
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    16,212,402
    b
    Average of monthly cash balances.......................
    1b
    392,883
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    16,605,285
    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
    16,605,285
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    249,079
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    16,356,206
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    817,810
    Part XI
    Distributable Amount bullet
    1
    Minimum investment return from Part X, line 6....................
    1
    817,810
    2a
    Tax on investment income for 2015 from Part VI, line 5......
    2a
    10,881
    b
    Income tax for 2015. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    10,881
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    806,929
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    806,929
    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
    806,929
    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
    929,300
    b
    Program-related investments—total from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    929,300
    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
    10,881
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    918,419
    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 7 806,929
    2 Undistributed income, if any, as of the end of 2015:
    a Enter amount for 2014 only....... 73,399
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2015:
    a From 2010......  
    b From 2011......  
    c From 2012......  
    d From 2013......  
    e From 2014......  
    fTotal of lines 3a through e........ 0
    4Qualifying distributions for 2015 from Part
    XII, line 4: bullet$ 929,300
    a Applied to 2014, but not more than line 2a 73,399
    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..... 806,929
    e Remaining amount distributed out of corpus 48,972
    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 48,972
    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 ......
    48,972
    10 Analysis of line 9:
    a Excess from 2011....  
    b Excess from 2012....  
    c Excess from 2013....  
    d Excess from 2014....  
    e Excess from 2015.... 48,972
    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 e-mail address of the person to whom applications should be addressed:
    NEELY KOUNTZE
    209 SOUTH 19TH STREET SUITE 151
    OMAHA,NE68102
    (402) 345-0043
    bThe form in which applications should be submitted and information and materials they should include:
    GRANT REQUESTS AND SCHOLARSHIP AWARDS PROCEDURES HAVE BEEN ESTABLISHED BY THE FOUNDATION. THE GRANT REQUESTS ARE OPEN TO 501(C)(3) ORGANIZATIONS. THE GRANT REQUESTS ARE TO INCLUDE THE BASICS OF THE REQUEST IN ADDITION TO A LETTER CONTAINING THE ESSENTIAL INFORMATION SUCH AS THE PROJECT CONTEMPLATED, SOURCE OF FUNDS, TIMELINE OF IMPLEMENTATION, ETC. THE ORIGINAL GRANT REQUEST AND EIGHT COPIES ARE TO BE SENT TO THE FOUNDATION FOR THE BOARD OF TRUSTEES' REVIEW. GRANTEES ARE NOTIFIED IN WRITING OF THE FOUNDATION'S DECISIONS.
    cAny submission deadlines:
    NOVEMBER 30 OF EACH YEAR
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    PRIMARILY NEBRASKA AND WESTERN IOWA PRIVATE EDUCATIONAL INSTITUTIONS, RELIGIOUS ORGANIZATIONS, HEALTH ORGANIZATIONS, ARTS AND RELATED ORGANIZATIONS
    Form 990-PF (2015)
    Form 990-PF (2015)
    Page 11
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    Foundation
    status of
    recipient
    Purpose of grant or
    contribution
    Amount
    Name and address (home or business)
    aPaid during the year
    ABIDE NETWORK INC
    3335 FOWLER ST
    OMAHA,NE68111
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 15,000
    BELLEVUE UNIVERSITY
    1000 GALVIN ROAD SOUTH
    BELLEVUE,NE68005
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 75,000
    BLUE BARN THEATRE
    1106 S 10TH STREET
    OMAHA,NE68108
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 6,000
    BOY SCOUTS OF AMERICA
    12401 WEST MAPLE ROAD
    OMAHA,NE68164
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 10,000
    BROWNELL-TALBOT SCHOOL
    400 N HAPPY HOLLOW BLVD N
    OMAHA,NE68132
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 35,800
    COLUMBIA UNIVERSITY
    116TH STREET AND BROADWAY
    NEW YORK,NY10027
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 1,000
    COMPLETELY KIDS
    2566 ST MARYS AVENUE
    OMAHA,NE68105
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 50,000
    DOUGLAS COUNTY SEPARATE JUVENILE COURT
    1445 K STREET
    LINCOLN,NE685098910
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 8,000
    DURHAM MUSEUM
    801 S 10TH STREET
    OMAHA,NE68108
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 10,000
    EL MUSEO LATINO
    4701 S 25TH STREET
    OMAHA,NE681072728
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 5,000
    FOOD BANK FOR THE HEARTLAND
    10525 J STREET
    OMAHA,NE68127
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 10,000
    FRIENDSHIP HOME
    PO BOX 85358
    LINCOLN,NE68501
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 10,000
    HATTIE B MUNROE HOME
    4420 DEWEY AVENUE
    OMAHA,NE68105
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 1,000
    HEARTLAND HOPE MISSION
    5210 S 21ST STREET
    OMAHA,NE681072728
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 27,500
    JENNIE EDMUNDSON MEMORIAL HOSPITAL
    933 EAST PIERCE STREET
    COUNCIL BLUFFS,IA51503
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 5,000
    KEVIN O'CONNOR SCHOLARSHIP FUND INC
    C/O GREAT WESTERN BANK 9290 WEST
    DODGE ROAD
    OMAHA,NE68114
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 20,000
    KIDS CAN COMMUNITY CENTER
    4860 Q STREET
    OMAHA,NE68117
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 5,000
    LAURITZEN GARDENS
    100 BANCROFT STREET
    OMAHA,NE68108
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 30,000
    METHODIST HOSPITAL FOUNDATION
    8401 WEST DODGE ROAD SUITE 225
    OMAHA,NE68114
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 25,000
    MID-AMERICA ARTS ALLIANCE
    2679 FARNAM STREET SUITE 204
    OMAHA,NE68131
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 10,000
    MUSEUM OF NEBRASKA ART
    2401 CENTRAL AVE
    KEARNEY,NE68847
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 10,000
    NEBRASKA HUMANE SOCIETY
    8929 FORT STREET
    OMAHA,NE68134
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 30,000
    NEBRASKA KIDNEY FOUNDATION
    11725 ARBOR STREET
    OMAHA,NE68144
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENTTO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 10,000
    NEBRASKA SHAKESPEARE FESTIVAL
    2500 CALIFORNIA PLZ
    OMAHA,NE681780133
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 6,000
    NORTHSTAR FOUNDATION
    4242 N 49TH STREET
    OMAHA,NE68104
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 75,000
    OMAHA CHILDREN'S MUSEUM
    500 S 20TH STREET
    OMAHA,NE68102
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 5,000
    OMAHA PUBLIC LIBRARY FOUNDATION
    215 SOUTH 15TH STREET
    OMAHA,NE68102
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 115,000
    OMAHA SYMPHONY
    1605 HOWARD STREET
    OMAHA,NE681022797
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 15,000
    ONEWORLD COMMUNITY HEALTH CENTER
    4920 S 30TH STREET
    OMAHA,NE68107
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 10,000
    OPERA OMAHA
    1850 FARNAM STREET
    OMAHA,NE68102
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 10,000
    OUTLOOK NEBRASKA INC
    4125 S 72ND STREET
    OMAHA,NE68127
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 5,000
    RADIO TALKING BOOK SERVICES
    7101 NEWPORT AVE SUITE 205
    OMAHA,NE681522162
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 10,000
    RELEASE MINISTRIES
    3223 N 45TH STREET
    OMAHA,NE68104
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 5,000
    RESCUE MISSION DBA OPEN DOOR MISSION
    2828 N 23RD STREET EAST
    OMAHA,NE68110
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 30,000
    SALVATION ARMY
    3612 CUMING STREET
    OMAHA,NE68131
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 110,000
    SIENAFRANCIS HOUSE
    1702 NICHOLAS STREET
    OMAHA,NE68101
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 20,000
    THE NATURE CONSERVANCY
    1025 LEAVENWORTH STREET
    OMAHA,NE68102
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 40,000
    TRINITY CATHEDRAL
    109 N 18TH STREET
    OMAHA,NE68101
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 5,000
    UNITED WAY OF THE MIDLANDS
    1805 HARNEY STREET
    OMAHA,NE68102
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 25,000
    UNIVERSITY OF NEBRASKA FOUNDATION
    2285 SOUTH 67TH STREET
    OMAHA,NE68106
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 12,000
    UNO SCHOLARSHIP - PLANETARIUM
    6001 DODGE STREET
    OMAHA,NE68182
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 1,500
    UNO SCHOLARSHIP - SCIENCE
    6001 DODGE STREET
    OMAHA,NE68182
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 1,000
    VISITING NURSES ASSOCIATION
    1941 S 42ND STREET SUITE 200
    OMAHA,NE68105
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 2,000
    VOICES OF OMAHA
    PO BOX 24711
    OMAHA,NE681240711
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 2,500
    WOMEN'S CENTER FOR ADVANCEMENT
    225 S 29TH ST
    OMAHA,NE68131
    NONE PUBLIC CHARITY TO FURTHER THE CHARITABLE PURPOSE OF THE RECIPIENT 15,000
    Total .................................bullet 3a 929,300
    bApproved for future payment
    Total .................................bullet 3b 0
    Form 990-PF (2015)
    Form 990-PF (2015)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code
    (b)
    Amount
    (c)
    Exclusion code
    (d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3
    Interest on savings and temporary cash investments ...........
        14 163,551  
    4 Dividends and interest from securities....     14 222,136  
    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 ............
        18 827,935  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory..          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e).. 0 1,213,622 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    131,213,622
    (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:
    GILBERT M AND MARTHA H HITCHCOCK
     
    FOUNDATION
    EIN:
    47-6025723
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING FEES 3,145 3,145   0

    TY 2015 GeneralExplanationAttachment
    Name:
    GILBERT M AND MARTHA H HITCHCOCK
     
    FOUNDATION
    EIN:
    47-6025723
    Identifier Return Reference Explanation
      FORM 990-PF, PAGE 10, PART XV, LINE 2B GRANT REQUEST PROCEDURES:THE FOUNDATION ASKS EACH REQUESTING ORGANIZATION TO PRESENT ITS GRANT REQUEST IN THE FOLLOWING MANNER:1) A LETTER SUMMARY, ONE PAGE IN LENGTH ONLY, TO ACQUAINT TRUSTEES WITH BASICS OF THE REQUEST INCLUDING THE SPECIFIC AMOUNT REQUESTED. REQUESTS GENERALLY SHOULD BE PAYOUT IN ONE YEAR. 2) A LETTER, NO MORE THAN 5 PAGES IN LENGTH, CONTAINING THE ESSENTIAL INFORMATION, I.E. PROJECT CONTEMPLATED, COST, SOURCE OF FUNDS; TIMELINE FOR IMPLEMENTATION; SPECIFIC AMOUNT OF THE GRANT REQUEST; HOW PROJECT WOULD BE CONTINUED AFTER GRANT PAYOUT; 3) CURRENT ANNUAL OPERATING BUDGET, LATEST AUDITED FINANCIAL STATEMENTS, INCLUDING MANAGEMENT LETTER FROM AUDITOR, IF ANY4) IRS RULING LETTER UNDER 501(C)(3) OR 509(A) OF THE INTERNAL REVENUE CODE OF 1954, AS AMENDED. THIS LETTER MUST INDICATE (AND THE ORGANIZATION MUST BE WILLING TO SIGN A GRANT AGREEMENT DECLARING) THAT THE REQUESTING ORGANIZATION IS: A) EXEMPT FROM FEDERAL INCOME TAXATION UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1954, AS AMENDED AND B) NOT A PRIVATE FOUNDATION, AS DEFINED IN SECTION 509 OF SAID CODE.5) A STATEMENT OF THE THREE TOP MEASURABLE RESULTS YOU EXPECT TO ACCOMPLISH IF THIS GRANT IS APPROVED AND YOUR PROJECT GOES FORWARD.AN ORIGINAL AND EIGHT (8) COPIES OF YOUR GRANT REQUEST. PLEASE INCLUDE ONLY ONE COPY OF ITEMS (2)-(5). PACKAGE SHOULD BE ADDRESSED TO MR. NEELY KOUNTZE, PRESIDENT AT THE ADDRESS BELOW. WE DO NOT ACCEPT FAX REQUESTS. WE DO REQUIRE THAT YOU PROVIDE A CONTACT NAME WITH AN E-MAIL ADDRESS.YOU WILL RECEIVE ACKNOWLEDGEMENT OF YOUR REQUEST. REQUESTS FOR GRANTS ARE CONSIDERED BY THE FULL BOARD OF TRUSTEES AT THEIR ANNUAL MEETING GRANTS AWARD MEETING HELD BY LATE MAY OF EACH YEAR. ORGANIZATIONS ARE NOTIFIED IN WRITING OF THE BOARD'S DECISION REGARDING THEIR REQUEST, BY EARLY JUNE FOLLOWING THE MAY MEETING.GRANTS APPROVED MAY BE PAID IN ONE PAYMENT OR IN PAYMENTS OVER SEVERAL YEARS AS CASH BECOMES AVAILABLE. ACCEPTED GRANT AGREEMENTS INCLUDE THE OBLIGATION OF FUTURE REPORTING ON THE USE OF THE FUNDS GRANTED AND THE GRANT AGREEMENT IS EXPECTED TO BE EXECUTED AND RETURNED TIMELY TO THE HITCHCOCK FOUNDATION.PREFERENCE FOR CERTAIN PROGRAMS IS NOT A JUDGEMENT ON THE MERITS OF THOSE THAT ARE NOT SUPPORTED. RATHER, IT IS A REFLECTION OF THE FOUNDATION'S BELIEF THAT ADHERENCE TO ITS PROGRAMS, WHICH ARE CAREFULLY STRUCTURED AND REGULARLY REVIEWED, LEADS TO EFFECTIVE USE OF ITS RESOURCES.ALL GRANT REQUESTS MUST BE RECEIVED BY THE FOUNDATION BY NOVEMBER 30.GILBERT M. AND MARTHA H. HITCHCOCK FOUNDATION P.O. BOX 31219OMAHA, NE 68131-0219402-345-0043

    TY 2015 InvestmentsCorpBondsSchedule
    Name:
    GILBERT M AND MARTHA H HITCHCOCK
     
    FOUNDATION
    EIN:
    47-6025723
    Name of Bond End of Year Book Value End of Year Fair Market Value
    CHUBB CORP 6.800% 11/15/31 63,858 78,133
    TOSCO CORP 8.125% 02/15/30 56,134 56,259
    AMERICAN EXPRESS CO 6.800% 09/01/66 0 0
    CATERPILLAR INC 7.900% 12/15/18 55,585 64,352
    KIMBERLY CLARK CORP 6.125% 08/01/17 59,114 64,463
    ACE INA HOLDINGS 5.900% 6/15/19 49,494 55,935
    BANK NEW YORK 4.950% 3/15/15 0 0
    STATE STR BK & TR .082938% 12/08/15 0 0
    MEDTRONIC INC 3.000% 3/15/15 0 0
    UBS PFD FDG TR V 6.243% 5/29/49 46,685 45,115
    US BANCORP 7.189% PFD 87,299 67,578
    OCCIDENTAL PETE CORP SR NT 1.75% DUE 02/15/17 64,446 65,130
    PACIFICORP 6.25% DUE 10/15/37 60,916 68,033
    UNITED TECHNOLOGIES CORP NT 6.125% DUE 07/15/38 66,828 67,013
    WAL MART STORES INC NT 5.625% DUE 04/15/41 67,491 65,426
    WHIRLPOOL CORP MEDIUM TERM NTS 4.85% DUE 06/15/21 0 0
    BB&T CORPORATION 2.15% DUE 03/22/2017 60,838 60,463
    DIRECTV HLDGS LLC SR NT 3.80% DUE 03/15/2022 0 0
    HELIOS LEASING I LLC SECD NT 2.018% DUE 05/29/2024 54,947 54,242
    PEPSICO INC SR NT 4.875% DUE 11/01/2040 65,924 58,767
    PFIZER INC SR NT 6.20% DYE 03/15/2019 29,462 28,125
    PRICOA GLBL FDG I VAR RATE DUE 06/24/2016 64,551 64,957
    AMER HONDA FIN CORP MTN 1.60% DTD 02/19/2013 60,471 59,545
    AMERICAN TOWER TR I SECD 3.07% DTD 03/15/2013 61,522 58,751
    CARGILL INC SR NT 3.25% DTD 11/08/2011 0 0
    GENERAL ELEC CAP CORP MEDIUM TERM NTS DTD 11/15/2007 68,808 67,880
    JP MORGAN CHASE BANK NA SUB NT 6.00% DTD 09/24/2007 60,300 58,804
    MORGAN STANLEY SR NT F 4.75% DTD 03/22/2012 0 0
    MOSAIC CO NEW SR NT 3.75% DTD 10/24/2011 0 0
    VERIZON COMMUNICATIONS INC NT 5.15% DTD 09/18/2013 0 0
    ALTITUDE INVTS 16 LLC SECD NT 2.492% DTD 05/30/2014 26,103 26,101
    ANADARKO PETE CORP SR GIBL NT 3.45% DTD 07/07/2014 38,500 35,534
    BANK AMER CORP FR 4.125% DTD 01/21/2014 62,083 61,971
    BERKSHIRE HATHAWAY INC DEL SR NOTE 2.10% DTD 08/14/2014 0 0
    BURLINGTON NORTHN SANTA FE LLC DEB 3.75% DTD 03/07/2014 0 0
    CHURCH & DWIGHT INC SR NT 2.45% DTD 12/09/2014 49,969 49,739
    CITIGROUP INC NT 2.55% DTD 04/08/2014 59,952 60,244
    DIRECTV HLDGS LLC SR NT 3.95% DTD 12/11/2014 0 0
    DOW CHEM CO SR NT 3.00% DTD 11/14/2012 53,854 52,653
    GENWORTH HLDGS INC SR GLBL 4.80% DTD 12/10/2013 0 0
    GOLDMAN SACHS GROUP INC SUB NT 6.45% DTD 04/18/2006 57,844 56,523
    HARTFORD FINL SVCS GROUP INC SR NT 5.50% DTD 03/23/2010 55,406 55,350
    INTEL CORP SR NT 4.80% DTD 09/19/2011 0 0
    METROPOLITAN LIFE GLOBAL FDG NT 3.125% DTD 01/11/2011 0 0
    NEWELL RUBBERMAID INC SR GLBL NT 4.00% DTD 06/14/2012 41,319 38,390
    ORACLE CORP SR GLBL NT 6.125% DTD 07/08/2009 62,144 60,460
    PRUDENTIAL FINL INC MTNS BOOK FR 7.375% DTD 06/08/2009 52,418 52,223
    SMALL BUSINESS ADMIN GTD LN POOL CTFS 2.877% DTD 09/21/2011 44,848 45,175
    TEXTRON INC NT 6.20% DTD 09/17/2009 0 0
    TEXTRON INC NT 3.65% DTD 01/30/2014 51,062 50,312
    WELLS FARGO & CO NEW PERP PFD CL A SER K DTD 02/08/2008 74,466 67,519
    BECTON DICKINSON & CO SR GLBL NT 3.3734% DTD 12/15/2014 30,314 30,256
    BURLINGTON NORTHN SANTA FE CP SR GLBL DEB 4.55% DTD 08/18/2014 32,081 28,961
    BURLINGTON NORTHN SANTA FE LLC DEB 4.15% DTD 03/09/2015 19,935 18,127
    CME GROUP INC SR GLBL NT 3.00% DTD 03/09/2015 44,033 44,147
    CARGILL INC SR NT 144A 4.10% DTD 10/29/2012 18,794 18,236
    DIRECTV HLDGS LLC DIRECTV SR GLBL NT 5.15% DTD 03/08/2012 23,325 23,309
    METROPOLITAN LIFE GLOBAL FDG I FR 2.30% DTD 04/10/2014 60,882 60,014
    MORGAN STANLEY SR NT F 3.75% DTD 02/25/2013 61,560 61,456
    MOSAIC CO NEW SR NT 1.45% DTD 11/15/2013 57,505 50,534
    NEWELL RUBBERMAID INC NT 4.00% DTD 11/19/2014 10,450 9,231
    QUALCOMM INC SR NT 4.80% DTD 05/20/2015 54,705 48,868
    VERIZON COMMUNICATIONS INC GLBL NT 4.272% DTD 07/15/2015 54,932 51,460
    WHIRLPOOL CORP SERA MTN NT 4.70% DTD 06/01/2012 55,136 53,189

    TY 2015 InvestmentsCorpStockSchedule
    Name:
    GILBERT M AND MARTHA H HITCHCOCK
     
    FOUNDATION
    EIN:
    47-6025723
    Name of Stock End of Year Book Value End of Year Fair Market Value
    3M CO - 1,165 SH 4,254 175,496
    CHEVRON CORP - 1,661 SH 63,996 149,424
    COCA-COLA CO - 5,000 SH 3,314 214,800
    EXXON MOBIL CORP - 2,291 SH 8,611 178,583
    GENERAL ELECTRIC CO - 3,290 SH 3,221 102,484
    INTERNATIONAL BUSINESS MACHINES CORP - 526 SH 0 0
    AIR PRODUCTS & CHEMICALS INC - 941 SH 72,684 122,434
    JP MORGAN CHASE & CO - 2,462 SH 92,502 162,566
    MEDTRONIC INC - 3,207 SH 246,779 246,682
    MICROSOFT CORP - 3,038 SH 76,740 168,548
    CISCO SYSTEMS INC - 4,377 SH 81,503 118,857
    TEXAS INSTRUMENTS INC - 2,399 SH 52,126 131,489
    AFLAC INC - 1,516 SHARES 85,814 90,808
    COMCAST CORP CL A - 2,654 SHARES 53,637 149,765
    PROCTER & GAMBLE CO - 2,015 SHARES 110,627 160,011
    AVNET INC - 2,836 SHARES 72,130 121,494
    JACOBS ENGINEERING GROUP INC - 2,353 SHARES 97,906 98,708
    MOHAWK INDUSTRIES INC - 367 SHARES 13,110 69,506
    BLACKROCK INC - 241 SHARES 40,073 82,065
    FLOWSERVE CORP - 1,823 SHARES 0 0
    ORACLE CORP - 3,385 SHARES 77,230 123,654
    PHILIP MORRIS INTERNATIONAL - 1,510 SHARES 81,446 132,744
    NOVARTIS AG ADR - 2,153 SHARES 107,387 185,244
    SCHLUMBERGER LTD - 1,405 SHARES 90,286 97,999
    CITIGROUP INC COM - 3,906 SHARES 108,126 150,386
    E M C CORP MASS COM - 5,271 SHARES 111,485 135,359
    INTEL CORP COM - 4,477 SHARES 0 0
    KOHLS CORP COM - 1,697 SHARES 0 0
    LEAR CORP COM NEW - 1,168 SHARES 0 0
    NIKE INC CL B - 1,512 SHARES 0 0
    QUALCOMM INC COM - 1,261 SHARES 0 0
    TRAVELERS COS INC COM - 1,118 SHARES 55,992 126,177
    US BANCORP DEL COM NEW - 2,870 SHARES 58,913 122,463
    AON PLC SHS CL A - 965 SHARES 44,060 88,983
    APPLE INC - 2,365 SHARES 178,615 248,940
    DENTSPLY INTL INC NEW - 4,342 SHARES 175,367 264,211
    GENERAL MILLS INC - 1,955 SHARES 76,465 112,725
    INTERCONTINENTALEXCHANGE INC - 606 SHARES 94,608 155,294
    OMNICOM GROUP INC - 2,559 SHARES 132,595 193,614
    TOWERS WATSON & CO CL A - 737 SHARES 42,923 94,675
    VARIAN MED SYS INC - 1,207 SHARES 69,987 97,526
    AMERICAN EXPRESS - 800 SHARES 44,840 55,640
    APPLE INC - 600 SHARES 49,826 63,156
    AUTOMATIC DATA PROCESSING INC - 900 SHARES 45,266 76,248
    BERKSHIRE HATHAWAY INC DEL - 500 SHARES 43,011 66,020
    BLACKROCK INC - 200 SHARES 34,260 68,104
    BOEING CO - 500 SHARES 36,068 72,295
    CHEVRON CORP - 525 SHARES 22,343 47,229
    COMCAST CORP - 1,050 SHARES 34,336 59,252
    DANAHER CORP - 700 SHARES 43,388 65,016
    DISNEY WALT CO - 550 SHARES 26,968 57,794
    ECOLAB INC - 475 SHARES 32,980 54,331
    EXPRESS SCRIPTS HLDG CO - 725 SHARES 45,002 63,372
    EXXON MOBIL CORP - 625 SHARES 8,994 48,719
    FISERV INC - 1,000 SHARES 37,385 91,460
    GOOGLE INC CL A - 125 SHARES 0 0
    HOME DEPOT INC - 550 SHARES 33,948 72,738
    HONEYWELL INTERNATIONAL INC - 675 SHARES 42,202 69,910
    INTERNATIONAL BUSINESS MACHINES CORP - 300 SHARES 22,293 41,286
    INTERNATIONAL PAPER CO - 1,050 SHARES 36,934 39,585
    JP MORGAN CHASE & CO - 1,050 SHARES 44,105 69,332
    JOHNSON & JOHNSON - 600 SHARES 42,435 61,632
    KIMBERLY CLARK CORP - 500 SHARES 40,135 63,650
    MASTERCARD INC CL A - 800 SHARES 37,710 77,888
    MCDONALDS CORP - 625 SHARES 56,457 73,838
    MICROSOFT CORP - 1,600 SHARES 40,416 88,768
    MONDELEZ INTL INC CL A - 1,300 SHARES 34,303 58,292
    ORACLE CORP - 1,300 SHARES 31,467 47,489
    PEPSICO INC - 500 SHARES 37,275 49,960
    PFIZER INC - 1,925 SHARES 49,484 62,139
    PROCTER & GAMBLE CO - 550 SHARES 33,945 43,676
    QUALCOMM INC COM - 650 SHARES 0 0
    SCHLUMBERGER LTD - 700 SHARES 46,950 48,825
    STERICYCLE INC - 450 SHARES 47,877 54,270
    STRYKER CORP - 650 SHARES 34,071 60,411
    UNION PAC CORP - 550 SHARES 33,930 43,010
    UNITED TECHNOLOGIES CORP - 575 SHARES 47,423 55,240
    VERIZON COMMUNICATIONS INC - 1,025 SHARES 46,723 47,376
    WAL MART STORES INC - 450 SHARES 0 0
    WALGREEN BOOTS ALLIANCE INC - 725 SHARES 24,935 61,737
    WELLS FARGO & CO NEW - 1,300 SHARES 43,484 70,668
    AGILENT TECHNOLOGIES INC COM - 2,061 SHARES 78,418 86,170
    M & T BK CORP COM - 932 SHARES 104,540 112,940
    MARKEL CORP COM - 191 SHARES 101,702 168,720
    UNITED TECHNOLOGIES CORP - 1,432 SHARES 146,343 137,572
    ABBVIE INC COM - 1,000 SHARES 35,416 59,240
    GILEAD SCIENCES INC COM - 600 SHARES 40,094 60,714
    GOLDMAN SACHS GROUP INC - 350 SHARES 42,390 63,081
    NIKE INC CL B - 1,200 SHARES 38,474 75,000
    XCEL ENERGY INC COM - 3,149 SHARES 90,776 113,081
    ACCENTURE PLC CLASS A ORDINARY - 1,371 SHARES 113,440 143,270
    CAPITAL ONE FINL CORP - 1,621 SHARES 130,394 117,004
    CARNIVAL CORP PAIRED CTF - 4,375 SHARES 187,311 238,350
    EOG RES INC - 1,161 SHARES 116,930 82,187
    KEYSIGHT TECHNOLOGIES INC - 3,574 SHARES 119,319 101,251
    PERKINELMER INC - 2,977 SHARES 130,256 159,478
    SCRIPPS NETWORKS INTERACT IN CL A - 1,447 SHARES 0 0
    VERIZON COMMUNICATIONS INC - 2,852 SHARES 137,799 131,819
    WESTAR ENERGY INC - 2,501 SHARES 0 0
    METLIFE INC - 700 SHARES 38,510 33,747
    KRAFT HEINZ CO - 2,011 SHARES 142,599 146,320
    MICROCHIP TECHNOLOGY INC - 2,282 SHARES 115,060 106,204
    NEXTERA ENERGY INC - 1,186 SHARES 118,721 123,214
    PRICELINE GRP INC - 70 SHARES 83,270 89,247
    TEAM HEALTH HOLDINGS INC - 1,904 SHARES 112,740 83,567
    TEGNA INC - 3,582 SHARES 95,515 91,413
    ALPHABET INC CAP STK CL A - 125 SHARES 47,573 97,251
    OCCIDENTAL PETE CORP - 250 SHARES 19,680 16,903
    3M CO - 350 SHARES 57,374 52,724
    UNITEDHEALTH GROUP INC - 550 SHARES 59,702 64,702

    TY 2015 InvestmentsGovtObligationsSch
    Name:
    GILBERT M AND MARTHA H HITCHCOCK
     
    FOUNDATION
    EIN:
    47-6025723
    US Government Securities - End of Year Book Value:

    2,719,708
    US Government Securities - End of Year Fair Market Value:

    2,760,307
    State & Local Government Securities - End of Year Book Value:


    647,597
    State & Local Government Securities - End of Year Fair Market Value:


    674,568


    TY 2015 OtherExpensesSchedule
    Name:
    GILBERT M AND MARTHA H HITCHCOCK
     
    FOUNDATION
    EIN:
    47-6025723
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ADMINISTRATIVE EXPENSE 4,366 4,366   0
    POSTAGE 500 500   0
    MEMBERSHIPS 750 750   0
    INSURANCE 1,600 1,600   0


    TY 2015 OtherProfessionalFeesSchedule
    Name:
    GILBERT M AND MARTHA H HITCHCOCK
     
    FOUNDATION
    EIN:
    47-6025723
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    BANK AND MANAGEMENT FEES 68,405 68,405   0
    FOREIGN CONVERSION EXPENSE 67 67   0


    TY 2015 TaxesSchedule
    Name:
    GILBERT M AND MARTHA H HITCHCOCK
     
    FOUNDATION
    EIN:
    47-6025723
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 901 901   0
    FEDERAL INCOME TAXES 10,000 10,000   0