TY 2015 Form 990PF

- TIN:

Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation

or Section 4947(a)(1) Trust Treated as Private Foundation

Do not enter social security numbers on this form as it may be made public.
bullet

Information 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
Lifeworks Foundation

Number and street (or P.O. box number if mail is not delivered to street address)PO Box 50276
Room/suite

City or town, state or province, country, and ZIP or foreign postal code
Nashville, TN372050276

A Employer identification number

62-1428468

B Telephone number (see instructions)

(615) 269-6663

C If exemption application is pending, check here bullet

G Check all that apply: Initial returnInitial return of a former public charity
Final returnAmended return
Address changeName change

D 1. Foreign organizations, check here ............. bullet

2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet

E If private foundation status was terminated
under section 507(b)(1)(A), check here ....... bullet

H Check type of organization: Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trustOther taxable private foundation

F If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here ....... bullet

I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16) bullet

$3,471,590J Accounting method: Cash Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)

	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	(d) Disbursements for charitable purposes (cash basis only)


1	Contributions, gifts, grants, etc., received (attach schedule)
2	Check Sch. B .............
3	Interest on savings and temporary cash investments	30		30
4	Dividends and interest from securities...	78,835		78,835
5a	Gross rents............
b	Net rental income or (loss)
6a	Net gain or (loss) from sale of assets not on line 10		53,842
b	Gross sales price for all assets on line 6a 1,729,184
7	Capital gain net income (from Part IV, line 2)...			53,842
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........	132,707		132,707
13	Compensation of officers, directors, trustees, etc.	40,625		4,063	36,562
14	Other employee salaries and wages......
15	Pension plans, employee benefits.......	1,117		112	1,005
16a	Legal fees (attach schedule).........
b	Accounting fees (attach schedule).......		29,950	2,995	26,955
c	Other professional fees (attach schedule)....
17	Interest...............
18	Taxes (attach schedule) (see instructions)...		5,076	2,267	2,809
19	Depreciation (attach schedule) and depletion...		303	0
20	Occupancy..............
21	Travel, conferences, and meetings.......
22	Printing and publications..........
23	Other expenses (attach schedule).......		80,882	28,149	52,733
24	Total operating and administrative expenses.
	Add lines 13 through 23..........	157,953		37,586	120,064
25	Contributions, gifts, grants paid.......	212,000			212,000
26	Total expenses and disbursements. Add lines 24 and 25	369,953		37,586	332,064
27	Subtract line 26 from line 12:
a	Excess of revenue over expenses and disbursements	-237,246
b	Net investment income (if negative, enter -0-)			95,121
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	Beginning of year	End of year
Part II		Balance Sheets	(a) Book Value	(b) Book Value	(c) Fair Market Value
	1	Cash—non-interest-bearing.............	73,439	9,439	9,439
	2	Savings and temporary cash investments.........	68,565	110,861	110,861
	3	Accounts receivable
		Less: allowance for doubtful accounts
	4	Pledges receivable
		Less: allowance for doubtful accounts
	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)
		Less: allowance for doubtful accounts
	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).......	3,604,900	3,380,977	3,331,680
	c	Investments—corporate bonds (attach schedule).......
	11	Investments—land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	12	Investments—mortgage loans.............
	13	Investments—other (attach schedule)..........
	14	Land, buildings, and equipment: basis 100,658
		Less: accumulated depreciation (attach schedule) 97,985	521	2,673	2,673
	15	Other assets (describe )	6,369	16,937	16,937
	16	Total assets (to be completed by all filers—see the
		instructions. Also, see page 1, item I)	3,753,794	3,520,887	3,471,590
	17	Accounts payable and accrued expenses..........	1,112	1,292
	18	Grants payable..................
	19	Deferred revenue.................
	20	Loans from officers, directors, trustees, and other disqualified persons	1,559	7,838
	21	Mortgages and other notes payable (attach schedule)......
	22	Other liabilities (describe )
	23	Total liabilities (add lines 17 through 22).........	2,671	9,130
		Foundations that follow SFAS 117, check here
		and complete lines 24 through 26 and lines 30 and 31.
	24	Unrestricted..................
	25	Temporarily restricted...............
	26	Permanently restricted...............
		Foundations that do not follow SFAS 117, check here
		and complete lines 27 through 31.
	27	Capital stock, trust principal, or current funds........	3,751,123	3,511,757
	28	Paid-in or capital surplus, or land, bldg., and equipment fund	0	0
	29	Retained earnings, accumulated income, endowment, or other funds	0	0
	30	Total net assets or fund balances (see instructions).....	3,751,123	3,511,757
	31	Total liabilities and net assets/fund balances (see instructions).	3,753,794	3,520,887

Part III

Analysis of Changes in Net Assets or Fund Balances

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) ...............

3,751,123

Enter amount from Part I, line 27a .....................

-237,246

Other increases not included in line 2 (itemize) bullet

Add lines 1, 2, and 3 ..........................

3,513,880

Decreases not included in line 2 (itemize) bullet

2,123

Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30 .

3,511,757

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	COACH INC	P	2013-07-17	2015-01-08
b	DIAMOND OFFSHORE DRILLING	P	2011-06-24	2015-01-08
c	MARSH & MCLENNAN CO INC	P	2013-07-26	2015-01-08
d	NEWMONT MINING CORP	P	2013-05-03	2015-01-08
e	ROCK TENN CO	P	2014-06-05	2015-01-08
	SANOFI	P	2014-05-07	2015-01-08
	AIR PRODUCTS & CHEMICALS	P	2014-10-13	2015-04-02
	HONDA MOTOR CO LTD ADR	P	2008-06-09	2015-04-22
	HONDA MOTOR CO LTD ADR	P	2008-06-24	2015-04-22
	HONDA MOTOR CO LTD ADR	P	2009-08-11	2015-04-22
	HONDA MOTOR CO LTD ADR	P	2009-11-02	2015-04-22
	HONDA MOTOR CO LTD ADR	P	2010-10-05	2015-04-22
	DOW CHEMICAL	P	2011-03-21	2015-05-07
	MICROSOFT CORP	P	2012-01-18	2015-05-07
	NOVARTIS AG-ADR	P	2014-08-07	2015-07-21
	AIR PRODUCTS & CHEMICALS	P	2014-10-13	2015-08-25
	EXPEDITORS INTL OF WASHINGTON	P	2013-12-04	2015-08-26
	TEREX CORP	P	2009-01-20	2015-08-11
	TEREX CORP	P	2010-01-07	2015-08-11
	TEREX CORP	P	2010-10-05	2015-08-11
	BAXTER INTL	P	2014-12-03	2015-09-18
	MICROSOFT CORP	P	2012-01-18	2015-10-27
	MICROSOFT CORP	P	2013-05-03	2015-10-27
	DOW CHEMICAL	P	2011-03-21	2015-12-09
	FLUOR CORP	P	2014-07-08	2015-12-01

(e) Gross sales price		(g) Cost or other basis plus expense of sale	(h) Gain or (loss) (e) plus (f) minus (g)
a	75,521	117,160	-41,639
b	33,108	68,271	-35,163
c	171,495	125,670	45,825
d	81,169	131,461	-50,292
e	132,364	102,428	29,936
	90,769	105,951	-15,182
	45,086	36,678	8,408
	35,403	33,964	1,439
	35,403	33,964	1,439
	35,403	33,964	1,439
	35,403	33,964	1,439
	35,403	33,964	1,439
	50,664	36,787	13,877
	117,212	80,935	36,277
	125,213	105,960	19,253
	95,904	85,583	10,321
	95,928	86,797	9,131
	26,140	20,904	5,236
	52,280	41,807	10,473
	52,280	41,807	10,473
	71,989	79,254	-7,265
	26,977	14,095	12,882
	26,977	14,095	12,882
	84,009	55,180	28,829
	97,084	154,699	-57,615

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			-41,639
b			-35,163
c			45,825
d			-50,292
e			29,936
			-15,182
			8,408
			1,439
			1,439
			1,439
			1,439
			1,439
			13,877
			36,277
			19,253
			10,321
			9,131
			5,236
			10,473
			10,473
			-7,265
			12,882
			12,882
			28,829
			-57,615

2	Capital gain net income or (net capital loss)	If gain, also enter in Part I, line 7 If (loss), enter -0- in Part I, line 7	2	53,842
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 ...................		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? Yes No

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	303,514	4,035,271	0.075215
2013	368,707	3,926,781	0.093895
2012	424,575	3,643,810	0.116520
2011	732,745	4,291,323	0.170750
2010	904,631	4,494,889	0.201258

Total of line 1, column (d) .....................

20.657638

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 . . .

0.131528

Enter the net value of noncharitable-use assets for 2015 from Part X, line 5.....

3,726,620

Multiply line 4 by line 3......................

490,155

Enter 1% of net investment income (1% of Part I, line 27b)...........

951

Add lines 5 and 6........................

491,106

Enter qualifying distributions from Part XII, line 4.............

332,064

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)

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	Exempt operating foundations described in section 4940(d)(2), check here and enter “N/A" on line 1.
	Date of ruling or determination letter: (attach copy of letter if necessary–see instructions)
b	Domestic foundations that meet the section 4940(e) requirements in Part V, check	1	1,902
	hereand 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	1,902
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	1,902
6	Credits/Payments:

a	2015 estimated tax payments and 2014 overpayment credited to 2015	6a	8,000
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	8,000
8	Enter any penalty for underpayment of estimated tax. Check hereif Form 2220 is attached.		8	1
9	Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......		9
10	Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...		10	6,097
11	Enter the amount of line 10 to be: Credited to 2015 estimated tax0	Refunded	11	6,097

Part VII-A

Statements Regarding Activities

During the tax year, did the foundation attempt to influence any national, state, or local legislation or did

Yes

it participate or intervene in any political campaign? ....................

Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see Instructions

for definition)?.................................

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.

Did the foundation file Form 1120-POL for this year?.....................

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

Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed

on foundation managers. bullet

$ 0

Has the foundation engaged in any activities that have not previously been reported to the IRS?.......

If "Yes," attach a detailed description of the activities.

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....

Did the foundation have unrelated business gross income of $1,000 or more during the year?........

If "Yes," has it filed a tax return on Form 990-T for this year?...................

Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........

If "Yes," attach the statement required by General Instruction T.

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?................

Yes

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..................................

Yes

Enter the states to which the foundation reports or with which it is registered (see instructions)

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 .

Yes

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.............................

Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names

and addresses. ...............................

Form 990-PF (2015)

Page 5

Part VII-A

Statements Regarding Activities (continued)

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) .............

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).................

Did the foundation comply with the public inspection requirements for its annual returns and exemption application?

Yes

Website address bullet

N/A

The books are in care of bullet

BAKER SULLIVAN HOOVER PLC Telephone no. bullet

(615) 255-6143

Located at bullet

35 PEABODY STREET SUITE 310NASHVILLETN ZIP+4 bullet

37210

Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —Check here....... bullet

and enter the amount of tax-exempt interest received or accrued during the year ...... bullet

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

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? YesNo

(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)

a disqualified person?......................YesNo

(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? YesNo

(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? YesNo

(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)?...............YesNo

(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.).......YesNo

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)? ........

Organizations relying on a current notice regarding disaster assistance check here........ bullet

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?.............

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)):

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?.............YesNo

If "Yes," list the years bullet

20, 20, 20, 20

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.) ..............

If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.

20, 20, 20, 20

Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at

any time during the year?......................YesNo

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.)..................

Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?

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?

Form 990-PF (2015)

Page 6

Part VII-B

Statements Regarding Activities for Which Form 4720 May Be Required (Continued)

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))? YesNo

(2) Influence the outcome of any specific public election (see section 4955); or to carry

on, directly or indirectly, any voter registration drive?.............YesNo

(3) Provide a grant to an individual for travel, study, or other similar purposes? YesNo

(4) Provide a grant to an organization other than a charitable, etc., organization described

in section 4945(d)(4)(A)? (see instructions)................YesNo

(5) Provide for any purpose other than religious, charitable, scientific, literary, or

educational purposes, or for the prevention of cruelty to children or animals?.....YesNo

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)? ......

Organizations relying on a current notice regarding disaster assistance check here......... bullet

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?..........YesNo

If "Yes," attach the statement required by Regulations section 53.4945–5(d).

Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on

a personal benefit contract?.....................YesNo

Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?....

If "Yes" to 6b, file Form 8870.

At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction? YesNo

If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....

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
GEORGE N BULLARD	DIRECTOR 10.00	0	0
PO BOX 50276 NASHVILLE,TN37205	DIRECTOR 10.00	0	0
PATRICIA BULLARD	TRUSTEE 25.00	40,625	1,117
PO BOX 50276 NASHVILLE,TN37205	TRUSTEE 25.00	40,625	1,117

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...................				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............. bullet

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	LIFEWORKS IS PRIMARILY A GRANT MAKING FOUNDATION ENABLING OTHER CHARITABLE ORGANIZATIONS TO FURTHER THEIR CHARITABLE ACTIVITIES. EXPENSES LISTED HERE ARE ACTUAL GRANTS MADE DURING YEAR.	204,000
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)

Page 8

Part X

Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,see instructions.)

Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,

purposes:

Average monthly fair market value of securities...................

3,541,787

Average of monthly cash balances.......................

241,584

Fair market value of all other assets (see instructions)................

Total (add lines 1a, b, and c).........................

3,783,371

Reduction claimed for blockage or other factors reported on lines 1a and

1c (attach detailed explanation) .............

Acquisition indebtedness applicable to line 1 assets..................

Subtract line 2 from line 1d.........................

3,783,371

Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see

instructions) .............................

56,751

Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4

3,726,620

Minimum investment return. Enter 5% of line 5..................

186,331

Part XI

Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here bullet

and do not complete this part.)

Minimum investment return from Part X, line 6....................

186,331

Tax on investment income for 2015 from Part VI, line 5......

1,902

Income tax for 2015. (This does not include the tax from Part VI.)...

Add lines 2a and 2b............................

1,902

Distributable amount before adjustments. Subtract line 2c from line 1............

184,429

Recoveries of amounts treated as qualifying distributions................

Add lines 3 and 4............................

184,429

Deduction from distributable amount (see instructions).................

Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...

184,429

Part XII

Qualifying Distributions (see instructions)

Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:

Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........

332,064

Program-related investments—total from Part IX-B..................

Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,

purposes...............................

Amounts set aside for specific charitable projects that satisfy the:

Suitability test (prior IRS approval required)....................

Cash distribution test (attach the required schedule) .................

Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4

332,064

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).................

Adjusted qualifying distributions. Subtract line 5 from line 4..............

332,064

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)

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					184,429
2 Undistributed income, if any, as of the end of 2015:
a Enter amount for 2014 only.......				0
b Total for prior years:20, 20, 20			0
3 Excess distributions carryover, if any, to 2015:
a From 2010......	685,409
b From 2011......	533,743
c From 2012......	245,631
d From 2013......	180,233
e From 2014......	111,799
fTotal of lines 3a through e........		1,756,815
4Qualifying distributions for 2015 from Part
XII, line 4: $ 332,064
a Applied to 2014, but not more than line 2a				0
b Applied to undistributed income of prior years (Election required—see instructions).....			0
c Treated as distributions out of corpus (Election required—see instructions)........		0
d Applied to 2015 distributable amount.....					184,429
e Remaining amount distributed out of corpus		147,635
5 Excess distributions carryover applied to 2015.		0			0
(If an amount appears in column (d), the same amount must be shown in column (a).)
6Enter the net total of each column as indicated below:
a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5		1,904,450
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) ...		685,409
9Excess distributions carryover to 2016. Subtract lines 7 and 8 from line 6a ......		1,219,041
10 Analysis of line 9:
a Excess from 2011....	533,743
b Excess from 2012....	245,631
c Excess from 2013....	180,233
d Excess from 2014....	111,799
e Excess from 2015....	147,635

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 section4942(j)(3) or4942(j)(5)

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	(e) Total

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

if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. (see instructions) to individuals or organizations under
other conditions, complete items 2a, b, c, and d.

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)

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)		Foundation status of recipient	Purpose of grant or contribution	Amount
aPaid during the year
CHEEKWOOD 1200 FOREST PARK DRIVE NASHVILLE,TN37205		PUBLIC	FURTHER CHARITY PURPOSE	1,500
HEALING STONES FOUNDATION PO BOX 50276 NASHVILLE,TN37205		PUBLIC	FURTHER CHARITY PURPOSE	204,000
KINGSWOOD UNITED METHODIST 401 W DUNDEE RD BUFFALO GROVE,IL60089		PUBLIC	FURTHER CHARITY PURPOSE	1,000
NASHVILLE SYMPHONY ONE SYMPHONY PLACE NASHVILLE,TN37201		PUBLIC	FURTHER CHARITY PURPOSE	5,000
SCMR PO BOX 2005 CHATTANOOGA,TN37409		PUBLIC	FURTHER CHARITY PURPOSE	500
Total ................................. 3a				212,000

bApproved for future payment

Total ................................. 3b				0

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	(e) Related or exempt function income (See instructions.)
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	30
4 Dividends and interest from securities....			14	78,835
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	53,842
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		132,707	0

13Total. Add line 12, columns (b), (d), and (e)..................

13132,707

(See worksheet in line 13 instructions to verify calculations.)

Part XVI-B

Relationship of Activities to the Accomplishment of Exempt Purposes

Line No.	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)

Page 13

Part XVII

Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations

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

Transfers from the reporting foundation to a noncharitable exempt organization of:

(1) Cash...................................

1a(1)

(2) Other assets.................................

1a(2)

Other transactions:

(1) Sales of assets to a noncharitable exempt organization....................

1b(1)

(2) Purchases of assets from a noncharitable exempt organization..................

1b(2)

(3) Rental of facilities, equipment, or other assets.......................

1b(3)

(4) Reimbursement arrangements...........................

1b(4)

(5) Loans or loan guarantees.............................

1b(5)

(6) Performance of services or membership or fundraising solicitations................

1b(6)

Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............

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

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?...........YesNo

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.
				May the IRS discuss this return with the preparer shown below (see instr.)? Yes No
	Signature of officer or trustee	Date	Title

Paid Preparer Use Only	Print/Type preparer's name	Preparer's Signature	Date	Check if self- employed	PTIN
	Firm's name				Firm's EIN
	Firm's address				Phone no.

Form 990-PF (2015)

Additional Data

Software ID:
Software Version:

Form 990PF - Special Condition Description:

Special Condition Description

- TIN:

TY 2015 AccountingFeesSchedule

Name:

Lifeworks Foundation

EIN:

62-1428468

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
BAKER, SULLIVAN & HOOVER, PLC	11,400	1,140		10,260
MARIE SWINFORD, CPA	18,550	1,855		16,695

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

TY 2015 DepreciationSchedule

Name:

Lifeworks Foundation

EIN:

62-1428468

Description of Property	Date Acquired	Cost or Other Basis	Prior Years' Depreciation	Computation Method	Rate / Life (# of years)	Current Year's Depreciation Expense
EQUIPMENT	1992-12-01	2,975	2,975	200DB	5.000000000000	0
EQUIPMENT	1994-07-01	1,766	1,766	200DB	5.000000000000	0
EQUIPMENT	1995-07-01	723	723	200DB	5.000000000000	0
COMPUTER	1996-07-01	4,262	4,262	200DB	5.000000000000	0
SCANNER	1997-04-11	342	342	200DB	7.000000000000	0
EQUIPMENT	1998-11-04	4,558	4,558	200DB	5.000000000000	0
COMPUTER	2000-12-02	1,774	1,774	200DB	5.000000000000	0
FURNITURE	1992-07-01	1,252	1,252	200DB	5.000000000000	0
FURNITURE	1996-07-01	38,744	38,744	200DB	7.000000000000	0
DESKS, CRENDENZA	2000-03-18	563	563	200DB	7.000000000000	0
SHELVES	2000-03-18	345	345	200DB	7.000000000000	0
Windows XP Software	2002-10-30	543	380	200DB	3.000000000000	0
CSPG-ARTWORK	2003-02-14	320	224	200DB	7.000000000000	0
FORD EXCURSION	2003-04-28	21,000	14,700	200DB	5.000000000000	0
FORD EXCURSION-REGISTRATION	2003-05-08	109	55	200DB	5.000000000000	0
PRINTER	2003-09-18	426	213	200DB	7.000000000000	0
FILE CABINET	2003-09-18	404	202	200DB	7.000000000000	0
SAFE	2004-03-04	526	263	200DB	7.000000000000	0
COMPUTER MONITOR	2004-04-03	503	252	200DB	5.000000000000	0
EQUIPMENT	2004-04-15	175	87	200DB	7.000000000000	0
FIRE PROOF FILE DRAWER CABINET	2004-10-21	841	420	200DB	5.000000000000	0
COMPUTER	2004-11-05	1,725	863	200DB	5.000000000000	0
COMPUTER HARDWARE-DVDRW PLAYER	2006-04-19	238	238	200DB	5.000000000000	0
COMPUTER	2006-07-10	1,621	1,621	200DB	5.000000000000	0
PHONE	2006-10-18	164	164	200DB	7.000000000000	0
SHELVES	2006-11-09	261	261	200DB	7.000000000000	0
SHREDDER	2007-01-10	152	152	200DB	7.000000000000	0
SHREDDER	2007-02-28	164	164	200DB	7.000000000000	0
COMPUTER	2007-08-30	703	703	200DB	5.000000000000	0
HP LASERJET COLOR PRINTER	2007-10-16	552	552	200DB	5.000000000000	0
9-1 FILE CABINETS	2007-10-09	1,049	1,049	200DB	7.000000000000	0
PRINTER	2007-12-05	203	203	200DB	5.000000000000	0
COPIER	2009-02-09	441	220	200DB	5.000000000000	0
TABLES	2008-07-10	326	155	200DB	7.000000000000	7
CELL PHONE	2009-02-09	227	98	200DB	7.000000000000	10
FURNITURE	2009-08-27	4,370	1,892	200DB	7.000000000000	195
VIDEO CARD AND FAX	2009-10-22	248	124	200DB	5.000000000000	0
I Phone	2010-07-08	347	163	200DB	5.000000000000	10
AIR CONDITIONER	2010-08-09	257	100	200DB	7.000000000000	11
CABLE MODEM-BASE STATION	2010-08-25	343	162	200DB	5.000000000000	10
NETWORK CARD, SURGE PROTECTOR ETHERNET CARD	2010-08-27	227	107	200DB	5.000000000000	7
SOFTWARE	2010-09-10	1,377		200DB	3.000000000000	0
PRINTER	2011-10-13	245		200DB	5.000000000000	0
HARD DRIVE	2012-04-04	175	63	200DB	5.000000000000	10
TELEPHONE	2012-09-10	435	155	200DB	5.000000000000	25
AC unit for office	2013-08-08	202	39	200DB	7.000000000000	18
APPLE COMPUTER	2015-11-17	2,455		200DB	5.000000000000	0

- TIN:

TY 2015 InvestmentsCorpStockSchedule

Name:

Lifeworks Foundation

EIN:

62-1428468

Name of Stock	End of Year Book Value	End of Year Fair Market Value
ACE LIMITED	118,833	151,905
AFLAC INC.	159,820	203,660
ALPHABET INC CL A	108,883	155,602
ANADARKO PETROLEUM	73,917	43,722
APACHE CORP	76,193	53,364
APPLE COMPUTER INC.	56,654	105,260
BAXALTA INC	123,052	136,605
BED BATH & BEYOND INC.	148,425	120,625
CATERPILLAR INC	129,798	101,940
CROWN HOLDINGS	151,888	152,100
CSX CORPORATION	85,381	103,800
DEVON ENERGY CORPORATION	72,528	38,400
DISCOVER FINANCIAL SVCS	106,654	107,240
DOW CHEMICAL	55,180	77,220
EOG RESOURCES	73,583	56,632
FORD MOTOR CO	61,250	49,315
GENERAL ELECTRIC	135,100	155,750
GLAXO SMITHKLINE SPD ADR	151,670	121,050
HEWLETT-PACKARD CO	57,631	60,800
HP INC	51,725	47,360
INTERNATIONAL BUSINESS MACHINES	158,291	137,620
INTERNATIONAL PAPER CO	105,335	75,400
ISHARES S&P INDEX	211,314	204,870
JACOBS ENGINEERING GRP	142,560	125,850
JOHNSON CONTROLS	154,376	118,470
MICROSOFT CORP	42,285	83,220
TOYOTA MOTOR CORP ADR	125,600	123,040
UNITED PARCEL SERVICE CL B	96,923	96,230
UNITED TECHNOLOGIES CORP	114,675	96,070
VIACOM	129,212	123,480
WALT DISNEY CO	102,241	105,080

- TIN:

TY 2015 LandEtcSchedule2

Name:

Lifeworks Foundation

EIN:

62-1428468

Category / Item	Cost / Other Basis	Accumulated Depreciation	Book Value
EQUIPMENT	2,975	2,975	0
EQUIPMENT	1,766	1,766	0
EQUIPMENT	723	723	0
COMPUTER	4,262	4,262	0
SCANNER	342	342	0
EQUIPMENT	4,558	4,558	0
COMPUTER	1,774	1,774	0
FURNITURE	1,252	1,252	0
FURNITURE	38,744	38,744	0
DESKS, CRENDENZA	563	563	0
SHELVES	345	345	0
Windows XP Software	543	543	0
CSPG-ARTWORK	320	320	0
FORD EXCURSION	21,000	21,000	0
FORD EXCURSION-REGISTRATION	109	109	0
PRINTER	426	426	0
FILE CABINET	404	404	0
SAFE	526	526	0
COMPUTER MONITOR	503	503	0
EQUIPMENT	175	175	0
FIRE PROOF FILE DRAWER CABINET	841	841	0
COMPUTER	1,725	1,725	0
COMPUTER HARDWARE-DVDRW PLAYER	238	238	0
COMPUTER	1,621	1,621	0
PHONE	164	164	0
SHELVES	261	261	0
SHREDDER	152	152	0
SHREDDER	164	164	0
COMPUTER	703	703	0
HP LASERJET COLOR PRINTER	552	552	0
9-1 FILE CABINETS	1,049	1,049	0
PRINTER	203	203	0
COPIER	441	441	0
TABLES	326	325	1
CELL PHONE	227	222	5
FURNITURE	4,370	4,272	98
VIDEO CARD AND FAX	248	248	0
I Phone	347	347	0
AIR CONDITIONER	257	240	17
CABLE MODEM-BASE STATION	343	343	0
NETWORK CARD, SURGE PROTECTOR ETHERNET CARD	227	227	0
SOFTWARE	1,377	1,377	0
PRINTER	245	245	0
HARD DRIVE	175	160	15
TELEPHONE	435	397	38
AC unit for office	202	158	44
APPLE COMPUTER	2,455	0	2,455

- TIN:

TY 2015 OtherAssetsSchedule

Name:

Lifeworks Foundation

EIN:

62-1428468

Description	Beginning of Year - Book Value	End of Year - Book Value	End of Year - Fair Market Value
DEPOSITS AT COST	850	850	850
ACCRUED INCOME RECEIVABLE	5,391	7,910	7,910
DUE FROM HEALING STONES	128	177	177
Federal Tax Deposit		8,000	8,000

- TIN:

TY 2015 OtherDecreasesSchedule

Name:

Lifeworks Foundation

EIN:

62-1428468

Description	Amount
FEDERAL INCOME TAX	2,123

- TIN:

TY 2015 OtherExpensesSchedule

Name:

Lifeworks Foundation

EIN:

62-1428468

Description	Revenue and Expenses per Books	Net Investment Income	Disbursements for Charitable Purposes
BANK CHARGES	5,733	0	5,733
CONSULTING EXPENSE	1,685	0	1,685
DUES, SUBSCRIPTIONS, & MEMBERSHIPS	4,409	0	4,409
INSURANCE EXPENSE	8,754	0	8,754
INTERNET SERVICE	868	0	868
INVESTMENT FEES	28,149	28,149	0
OFFICE SUPPLIES	1,383	0	1,383
POSTAGE	269	0	269
PUBLIC EVENTS CONCERTS AND PERFORMANCES	24,786	0	24,786
TELEPHONE/COMMUNICATIONS	4,846	0	4,846

- TIN:

TY 2015 OtherIncreasesSchedule

Name:

Lifeworks Foundation

EIN:

62-1428468

Description	Amount
Rounding	3

- TIN:

TY 2015 TaxesSchedule

Name:

Lifeworks Foundation

EIN:

62-1428468

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
PAYROLL TAXES	3,121	312		2,809
FOREIGN TAXES	1,955	1,955		0