Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletInformation about Form 990-PF and its instructions is at www.irs.gov/form990pf.
OMB No. 1545-0052
2014
Open to Public Inspection
For calendar year 2014, or tax year beginning 2014, and ending , 20
Name of foundation
HARRY & THELMA SURRENA MEMORIAL
 

Number and street (or P.O. box number if mail is not delivered to street address)P O BOX 603   Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SHERIDAN, WY82801
A Employer identification number

23-7435554
B Telephone number (see instructions)

(307) 672-6494
C bullet
G Check all that apply:

D 1. bullet
2. bullet
E bullet
H Check type of organization:
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$5,753,112J Accounting method:
 
(Part I, column (d) must be on cash basis.)
F bullet
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).............. 1,500
2 Check bullet
Sch. B ...............
3 Interest on savings and temporary cash investments 17,491 17,229  
4 Dividends and interest from securities...... 139,187 139,187  
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 197,967
b Gross sales price for all assets on line 6a 944,844
7 Capital gain net income (from Part IV, line 2)... 197,967
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........ 356,145 354,383  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 38,982 19,491   19,491
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 2,500 1,875   625
c Other professional fees (attach schedule).... Click to see attachment 31,995 31,995    
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 6,396 1,914   1,491
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule).......        
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 79,873 55,275   21,607
25 Contributions, gifts, grants paid........ 290,000 290,000
26 Total expenses and disbursements. Add lines 24 and 25 369,873 55,275   311,607
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -13,728
b Net investment income (if negative, enter -0-) 299,108
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2014)
Form 990-PF (2014)
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.......... 313,095 136,087 136,087
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) 126,246 150,000 169,076
b Investments—corporate stock (attach schedule)........ 2,903,285 Click to see attachment2,639,322 3,741,720
c Investments—corporate bonds (attach schedule)........ 1,251,091 Click to see attachment1,653,248 1,621,104
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) Click to see attachment22,982 Click to see attachment22,982 Click to see attachment85,125
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 4,616,699 4,601,639 5,753,112
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) Click to see attachment1,723 Click to see attachment391
23 Total liabilities (add lines 17 through 22).......... 1,723 391
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......... 2,443,594 2,443,594
28 Paid-in or capital surplus, or land, bldg., and equipment fund    
29 Retained earnings, accumulated income, endowment, or other funds 2,171,382 2,157,654
30 Total net assets or fund balances (see instructions)...... 4,614,976 4,601,248
31 Total liabilities and net assets/fund balances (see instructions).. 4,616,699 4,601,639
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 4,614,976
2 Enter amount from Part I, line 27a..................... 2 -13,728
3 Other increases not included in line 2 (itemize) bullet 3  
4 Add lines 1, 2, and 3.......................... 4 4,601,248
5 Decreases not included in line 2 (itemize) bullet 5  
6 Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30. 6 4,601,248
Form 990-PF (2014)
Form 990-PF (2014)
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 1457.72-VANGUARD EMERGING MARKETS ST P 2015-04-01 2015-10-15
b 53-APPLE COMPUTER INC P 2009-10-05 2015-03-30
c 374-CITIGROUP INC P 2013-11-26 2015-03-30
d 297-JP MORGAN CHASE & COMPANY P 2000-03-03 2015-03-30
e 0.4-SOUTH32 LTD P 2009-09-17 2015-06-29
1441.75-VANGUARD EMERGING MARKETS ST P 2014-11-19 2015-10-15
272-APPLE COMPUTER INC P 2009-10-05 2015-03-05
38-COSTCO WHOLESALE CORPORATION P 2009-10-22 2015-03-30
40-MCKESSON CORPORATION P 2012-09-13 2015-03-30
20.4-SOUTH32 LTD P 2009-09-17 2015-07-09
7396.45-DFA COMMODITY STRATEGY PORTF P 2015-04-01 2015-10-14
104-APPLE COMPUTER INC P 2011-01-06 2015-03-30
4-COSTCO WHOLESALE CORPORATION P 2010-05-14 2015-03-30
220-MICROSOFT CORPORATION P 2012-10-17 2015-03-30
60-SOUTH32 LTD P 2010-03-12 2015-07-09
142-FIREEYE INC P 2014-12-12 2015-03-30
225-BAKER HUGHES INC P 2012-03-05 2015-03-30
88-DEERE & COMPANY P 2011-07-11 2015-03-30
50000-MINNESOTA STATE GO UNLTD 3 P 2009-10-23 2014-11-01
60-SOUTH32 LTD P 2010-06-02 2015-07-09
50000-HP INC 2.65% 01/06/2016 P 2013-12-09 2015-10-16
169-BB&T CORPORATION P 2012-04-12 2015-03-30
121-DISNEY WALT CO HOLDINGS P 2009-01-15 2015-03-30
193-MONDELEZ INTERNATIONAL INC P 2010-06-02 2015-03-30
141.6-SOUTH32 LTD P 2013-01-22 2015-07-09
50000-HEWLETT-PACKARD CO 2.125% 13 S P 2013-11-21 2015-09-14
45-BERKSHIRE HATHAWAY INC - CL B P 2010-02-17 2015-03-30
97-DU PONT E I DE NEMOURS & COMPANY P 2010-10-26 2015-03-30
66-NATIONAL OILWELL VARCO INC P 2013-01-29 2015-03-30
153-TARGET CORPORATION P 2004-04-19 2015-03-30
45000-AT&T INC .9% 12/02/2016 P 2013-11-21 2015-09-14
92-BHP BILLITON LIMITED ADR P 2009-09-17 2015-03-30
388-EMC CORPORATION P 2010-02-24 2015-03-30
126-NORDSTROM INC P 2014-01-21 2015-03-30
140-TERADATA CORP P 2013-08-23 2015-03-30
515-NATIONAL OILWELL VARCO INC P 2013-01-29 2015-09-14
122-BRISTOL MYERS SQUIBB COMPANY P 2013-02-05 2015-03-30
123-EMERSON ELECTRIC COMPANY P 2001-02-05 2015-03-30
712.86-OPPENHEIMER DEVELOPING MARKET P 2012-12-03 2015-04-01
193-U S BANCORP DEL P 2013-11-26 2015-03-30
15-CHEMOURS CO/THE P 2011-03-03 2015-08-12
19-CATERPILLAR INC P 2010-05-14 2015-03-31
70-EXXON MOBIL CORPORATION P 1983-06-24 2015-03-30
95-PEPSICO INC P 1996-05-29 2015-03-30
98-UNION PACIFIC CORPORATION P 2013-11-20 2015-03-30
118-CHEMOURS CO/THE P 2010-10-26 2015-08-12
150-CATERPILLAR INC P 2011-10-25 2015-03-31
668-FORD MOTOR COMPANY P 2012-07-05 2015-03-30
77-PHILIP MORRIS INTERNATIONAL P 2011-09-26 2015-03-30
130-UNITEDHEALTH GROUP INC P 2011-05-19 2015-03-30
45-CHEMOURS CO/THE P 2011-10-25 2015-08-12
162-CATERPILLAR INC P 2012-08-03 2015-03-31
465-GENERAL ELECTRIC COMPANY P 2008-12-02 2015-03-30
128-PROCTER & GAMBLE COMPANY P 2003-06-16 2015-03-30
182.861-VANGUARD INFLATION-PROTECTED P 2011-04-06 2015-04-01
10-AMAZON.COM INC P 2014-02-05 2015-03-30
104-CELGENE CORP P 2012-12-11 2015-03-30
0.889-GENERAL MOTORS CO P 2013-11-27 2014-11-28
108-QUALCOMM INC P 2000-03-03 2015-03-30
754.893-VANGUARD INFLATION-PROTECTED P 2011-10-25 2015-04-01
38-AMAZON.COM INC P 2014-02-05 2015-07-27
0.8-CHEMOURS CO P 2010-10-26 2015-07-21
0.808-GENERAL MOTORS CO WARRANTS EXP P 2013-11-30 2014-12-01
317-ROCHE HOLDINGS LTD SPONS ADR P 2012-12-11 2015-03-30
LITIGATION PROCEEDS P 2013-10-30 2015-10-31
116-AMERICAN EXPRESS COMPANY P 2013-08-29 2015-03-30
55-CHEVRON CORP P 2003-06-16 2015-03-30
0.808-GENERAL MOTORS CO WARRANTS EXP P 2013-11-30 2014-12-01
78-SCHLUMBERGER LIMITED P 2011-11-23 2015-03-30
51-APACHE CORPORATION P 2012-08-20 2015-03-30
366-CISCO SYSTEMS INC P 2004-02-25 2015-03-30
123-GILEAD SCIENCES INC. P 2012-05-04 2015-03-30
538-SKYWORKS SOLUTIONS INC. P 2013-08-23 2015-03-31
(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 43,819   50,000 -6,181
b 6,659   1,414 5,245
c 19,382   19,859 -477
d 18,188   15,907 2,281
e 3     3
43,339   50,000 -6,661
34,360   7,259 27,101
5,782   2,209 3,573
9,144   3,517 5,627
130     130
45,266   50,000 -4,734
13,066   4,957 8,109
609   231 378
9,018   6,513 2,505
383     383
5,669   4,216 1,453
14,303   10,812 3,491
7,815   7,359 456
50,000   50,000  
383     383
49,206   51,225 -2,019
6,616   5,257 1,359
12,842   2,432 10,410
7,031   3,662 3,369
905     905
50,000   50,999 -999
6,557   3,430 3,127
7,053   4,561 2,492
3,290   4,381 -1,091
12,624   6,701 5,923
45,102   44,992 110
4,345   6,346 -2,001
9,884   6,789 3,095
10,096   7,498 2,598
6,071   8,540 -2,469
19,920   34,184 -14,264
8,021   4,509 3,512
6,992   4,545 2,447
25,000   24,202 798
8,467   7,598 869
148   200 -52
1,526   1,227 299
5,996   303 5,693
9,149   2,928 6,221
10,773   7,787 2,986
1,163   1,350 -187
12,051   13,599 -1,548
10,805   6,419 4,386
5,911   4,954 957
15,711   6,585 9,126
444   499 -55
13,015   13,918 -903
11,677   8,005 3,672
10,575   5,920 4,655
4,826   4,728 98
3,741   3,455 286
12,385   4,305 8,080
27     27
7,423   6,946 477
19,922   21,000 -1,078
20,233   13,129 7,104
10   9 1
10     10
10,844   8,046 2,798
790     790
9,080   8,407 673
5,875   2,067 3,808
4     4
6,593   5,202 1,391
3,102   4,559 -1,457
10,087   8,575 1,512
12,303   3,120 9,183
53,018   13,531 39,487
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       -6,181
b       5,245
c       -477
d       2,281
e       3
      -6,661
      27,101
      3,573
      5,627
      130
      -4,734
      8,109
      378
      2,505
      383
      1,453
      3,491
      456
       
      383
      -2,019
      1,359
      10,410
      3,369
      905
      -999
      3,127
      2,492
      -1,091
      5,923
      110
      -2,001
      3,095
      2,598
      -2,469
      -14,264
      3,512
      2,447
      798
      869
      -52
      299
      5,693
      6,221
      2,986
      -187
      -1,548
      4,386
      957
      9,126
      -55
      -903
      3,672
      4,655
      98
      286
      8,080
      27
      477
      -1,078
      7,104
      1
      10
      2,798
      790
      673
      3,808
      4
      1,391
      -1,457
      1,512
      9,183
      39,487
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 2 197,967
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 -16,123
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))
2013 303,292 5,560,400 0.054545
2012 258,436 5,125,398 0.050423
2011 244,959 4,807,448 0.050954
2010 234,756 4,609,464 0.050929
2009 207,821 4,402,615 0.047204
2 Total of line 1, column (d) ...................... 2 0.254055
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 0.050811
4 Enter the net value of noncharitable-use assets for 2014 from Part X, line 5..... 4 5,532,056
5 Multiply line 4 by line 3....................... 5 281,089
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6 2,991
7 Add lines 5 and 6......................... 7 284,080
8 Enter qualifying distributions from Part XII, line 4.............. 8 311,607
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 (2014)
Form 990-PF (2014)
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 Bulletand enter “N/A" on line 1. Bracket
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b 1 2,991
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  
3 Add lines 1 and 2........................... 3 2,991
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 2,991
6 Credits/Payments:
a 2014 estimated tax payments and 2013 overpayment credited to 2014 6a 2,600
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 2,600
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 391
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2015 estimated taxBullet   RefundedBullet 11  
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see Instructions
for definition)?.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletWY
    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 2014 or the taxable year beginning in 2014 (see instructions for Part XIV)?
    If "Yes," complete Part XIV.............................
    9
     
    No
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 5
    Part VII-A
    Statements Regarding Activities (continued)
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    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 ofbulletMOHATT RINALDO JOHNSON & GODWIN Telephone no.bullet (307) 672-6494
    Located atbulletPO BOX 603SHERIDANWY ZIP+4bullet82801
    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 2014, 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  
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 6
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?........................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?.................
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).........
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance (see instructions)? ........
    1b
     
    No
    .........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2014?.............
    1c
     
     
    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 2014, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2014?...............
    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 2014 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 2014.)....................
    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 2014?
    4b
     
    No
    5a
    During the year did the foundation pay or incur any amount to:
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?...............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? (see instructions)..................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?........
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance (see instructions)? ......
    5b
     
     
    .........bullet
    c
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?............
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?.......................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    Form 990-PF (2014)
    Form 990-PF (2014)
    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
    RALPH C ROBINSON TRUSTEE
    4.00     		12,994 0 0
    PO BOX 27
    BUFFALO,WY82834
    JOHN PRADERE TRUSTEE
    4.00     		12,994 0 0
    PO BOX 603
    SHERIDAN,WY82801
    ROBERT WYATT TRUSTEE
    4.00     		12,994 0 0
    PO BOX 603
    SHERIDAN,WY82081
    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  
    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
     
    2  
    3  
    4  
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 8
    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 N/A  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    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
    5,409,363
    b
    Average of monthly cash balances.......................
    1b
    121,813
    c
    Fair market value of all other assets (see instructions)................
    1c
    85,125
    d
    Total (add lines 1a, b, and c).........................
    1d
    5,616,301
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
     
    3
    Subtract line 2 from line 1d.........................
    3
    5,616,301
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    84,245
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    5,532,056
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    276,603
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    276,603
    2a
    Tax on investment income for 2014 from Part VI, line 5......
    2a
    2,991
    b
    Income tax for 2014. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    2,991
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    273,612
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    273,612
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
    273,612
    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
    311,607
    b
    Program-related investments—total from Part IX-B..................
    1b
     
    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
    311,607
    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
    2,991
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    308,616
    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 (2014)
    Form 990-PF (2014)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2013     		(c)
    2013     		(d)
    2014
    1 Distributable amount for 2014 from Part XI, line 7 273,612
    2 Undistributed income, if any, as of the end of 2014:
    a Enter amount for 2013 only....... 20,092
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2014:
    a From 2009.......  
    b From 2010.......  
    c From 2011.......  
    d From 2012.......  
    e From 2013.......  
    fTotal of lines 3a through e.........  
    4Qualifying distributions for 2014 from Part
    XII, line 4: bullet$ 311,607
    a Applied to 2013, but not more than line 2a 20,092
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions).........     		 
    d Applied to 2014 distributable amount..... 273,612
    e Remaining amount distributed out of corpus 17,903
    5 Excess distributions carryover applied to 2014.    
    (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 17,903
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ...........     		 
    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......     		 
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		 
    e Undistributed income for 2013. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    f Undistributed income for 2014. 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) .......     		 
    8Excess distributions carryover from 2009 not
    applied on line 5 or line 7 (see instructions) ...     		 
    9Excess distributions carryover to 2015.
    Subtract lines 7 and 8 from line 6a ......     		17,903
    10 Analysis of line 9:
    a Excess from 2010....  
    b Excess from 2011....  
    c Excess from 2012....  
    d Excess from 2013....  
    e Excess from 2014.... 17,903
    Form 990-PF (2014)
    Form 990-PF (2014)
    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 2014, 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) 2014 (b) 2013 (c) 2012 (d) 2011
             
    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:
    SURRENA MEMORIAL FUND
    BOX 27
    BUFFALO,WY82834
    (307) 684-5574
    bThe form in which applications should be submitted and information and materials they should include:
    WRITTEN APPLICATION
    cAny submission deadlines:
    NONE
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    CHARITABLE, RELIGIOUS, SCIENTIFIC, & EDUCATIONAL PURPOSES IN THE U.S.
    Form 990-PF (2014)
    Form 990-PF (2014)
    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
    BREAD OF LIFE
    PO BOX 909
    BUFFALO,WY82834     		NONE EXEMPT ORG. GENERAL OPERATIONS 10,000
    BUFFALO SENIOR CENTER
    671 W FETTERMAN
    BUFFALO,WY82834     		NONE EXEMPT ORG. GENERAL OPERATIONS 10,000
    CHILDREN'S CENTER - BUFFA
    151 KLONDIKE
    BUFFALO,WY82834     		NONE EXEMPT ORG. GENERAL OPERATIONS 50,000
    JOHNSON COUNTY LIBRARY
    FOUNDATION
    171 N ADAMS
    BUFFALO,WY82834     		NONE EXEMPT ORG. GENERAL OPERATIONS 10,000
    JOHNSON COUNTY YMCA
    101 SOUTH KLONDIKE
    BUFFALO,WY82834     		NONE EXEMPT ORG. GENERAL OPERATIONS 20,000
    METHODIST CHURCH
    OF BUFFALO WYOMING
    132 N ADAMS AVE
    BUFFALO,WY82834     		NONE EXEMPT ORG. GENERAL OPERATIONS 5,000
    MOUNTAIN PLAINS HERITAGE
    PO BOX 27
    BUFFALO,WY82834     		NONE EXEMPT ORG. GENERAL OPERATIONS 3,000
    CLEARMONT COMMUNITY LIBRA
    PO BOX 26
    CLEARMONT,WY82835     		NONE EXEMPT ORG. GENERAL OPERATIONS 5,000
    TONGUE RIVER BRANCH
    LIBRARY
    PO BOX 909
    RANCHESTER,WY82839     		NONE EXEMPT ORG. GENERAL OPERATIONS 5,000
    TONGUE RIVER CHILD'S
    PLACE
    84 DAYTON STREET
    RANCHESTER,WY82839     		NONE EXEMPT ORG. GENERAL OPERATIONS 10,000
    CHILDREN'S CENTER
    863 HIGHLAND AVE
    SHERIDAN,WY82801     		NONE EXEMPT ORG. GENERAL OPERATIONS 30,000
    GENESIS FOUNDATION
    444 CRESCENT DR
    SHERIDAN,WY82801     		NONE EXEMPT ORG. GENERAL OPERATIONS 35,000
    HABITAT FOR HUMANITY - BUFFALO
    615 BURRITT AVE
    BUFFALO,WY82834     		NONE EXEMPT ORG. GENERAL OPERATIONS 10,000
    LUNCH TOGETHER SOUP KITCHEN
    102 S CONNER ST
    SHERIDAN,WY82801     		NONE EXEMPT ORG. GENERAL OPERATIONS 10,000
    METHODIST CHURCH
    OF SHERIDAN WYOMING
    215 W WORKS
    SHERIDAN,WY82801     		NONE EXEMPT ORG. GENERAL OPERATIONS 5,000
    SCOTTISH RITE CHILDHOOD
    LANGUAGE CLINIC C/O TOM NEIGHBORS
    8 RIVERBEND COURT
    SHERIDAN,WY82801     		NONE EXEMPT ORG. GENERAL OPERATIONS 5,000
    SENIOR CITIZENS COUNCIL
    211 SMITH STREET
    SHERIDAN,WY82801     		NONE EXEMPT ORG. GENERAL OPERATIONS 10,000
    SHERIDAN COLLEGE
    FOUNDATION
    3059 COFFEEN AVE
    SHERIDAN,WY82801     		NONE EXEMPT ORG. GENERAL OPERATIONS 10,000
    SHERIDAN COUNTY LIBRARY
    FOUNDATION INC
    335 W ALGER
    SHERIDAN,WY82801     		NONE EXEMPT ORG. GENERAL OPERATIONS 5,000
    SHERIDAN COUNTY YMCA
    417 NORTH JEFFERSON
    SHERIDAN,WY82801     		NONE EXEMPT ORG. GENERAL OPERATIONS 20,000
    VOLUNTEERS OF AMERICA OF
    WYOMING AND MONTANA
    PO BOX 6291
    SHERIDAN,WY82801     		NONE EXEMPT ORG. HOMELESS SHELTER 5,000
    STORY BRANCH LIBRARY
    PO BOX 188
    STORY,WY82842     		NONE EXEMPT ORG. GENERAL OPERATIONS 5,000
    STORY COMMUNITY CHURCH
    PO BOX 415
    STORY,WY82842     		NONE EXEMPT ORG. GENERAL OPERATIONS 5,000
    THE FOOD GROUP
    PO BOX 1500
    SHERIDAN,WY82801     		NONE EXEMPT ORG. GENERAL OPERATIONS 2,000
    CHILD ADVOCACY CENTER
    40 E WORKS ST
    SHERIDAN,WY82801     		NONE EXEMPT ORG GENERAL OPERATIONS 5,000
    Total .................................bullet 3a 290,000
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2014)
    Form 990-PF (2014)
    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 17,491  
    4 Dividends and interest from securities....     14 139,187  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6
    Net rental income or (loss) from personal property .............     		         
    7 Other investment income.....          
    8
    Gain or (loss) from sales of assets other than inventory .............     		    18 197,967  
    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)..   354,645  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13354,645
    (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 (2014)
    Form 990-PF (2014)
    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
    Yes
    No
    organizations?
    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 namebullet



    Firm's addressbullet







         		Firm's EINbullet
    Phone no.
    Form 990-PF (2014)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2014 AccountingFeesSchedule
    Name:
    HARRY & THELMA SURRENA MEMORIAL
    EIN: 23-7435554
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING FEES 2,500 1,875   625

    TY 2014 InvestmentsCorpBondsSchedule
    Name:
    HARRY & THELMA SURRENA MEMORIAL
    EIN: 23-7435554
    Name of Bond End of Year Book Value End of Year Fair Market Value
    BLACKROCK INC 50,000 56,745
    CSX CORP 6.25% 50,884 55,676
    DODGE & COX INCOME FUND 150,000 149,739
    HEWLETT PACKARD 2.125    
    HEWLWTT PACKARD 2.650    
    MCKESSON CORP 50,114 50,189
    AT&T .900    
    GENERAL ELECTRIC CAP 5.1% 100,000 109,418
    LILLY ELI & CO 26,815 26,622
    EATON CORP 50,137 50,421
    OPPENHEIMER INTERNATIONAL BOND FUND 200,000 179,100
    WELLPOINT 2.3    
    TEMPLETON GLOBAL BOND FUND 200,000 175,152
    US BANCORP    
    VANGUARD HIGH YIELD CORPORATE PORT 300,000 300,970
    VANGUARD INTERMEDIATE-TERM INVEST 50,000 49,683
    VANGUARD SHORT TERM CORP FUND 50,000 49,069
    EASTON VANCE FLOATING RATE FUND 150,000 142,352
    ANTHEM INC 50,318 50,587
    ERGENAL MTRS CORP   750
    PUBLIC STORAGE 25,000 25,590
    TENNESSEE VALLEY AUTHORITY 49,980 49,510
    VANGUARD SHORT-TERM INVESTMENT GRADE 100,000 99,531

    TY 2014 InvestmentsCorpStockSchedule
    Name:
    HARRY & THELMA SURRENA MEMORIAL
    EIN: 23-7435554
    Name of Stock End of Year Book Value End of Year Fair Market Value
    AMAZON 13,129 23,784
    AMERICAN EXPRESS 59,864 60,752
    APACHE CORPORATION 56,313 42,784
    APPLE COMPUTER INC 72,615 143,161
    BAKER HUGHES INC 79,359 87,660
    BB&T CORPORATION 41,136 45,880
    BERKSHIRE HATHAWAY INC - CL B 24,782 43,118
    BOEING CO 24,398 59,228
    BRISTOL MYERS SQUIBB 33,335 59,821
    CATERPILLAR INC    
    CALGENE 38,399 95,468
    CHEVRON CORP 21,270 38,897
    CISCO SYSTEMS 38,308 52,305
    CITIGROUP 147,032 150,879
    COSTCO WHOLESALE CORPORATION 19,753 54,710
    DEERE & COMPANY 54,351 53,762
    DISNEY WALT CO HOLDINGS    
    DU PONT E I DE NEMOURS & COMPANY 40,222 56,680
    EMC CORPORATION 65,651 78,791
    EMERSON ELECTRIC CO 25,155 37,926
    EXELON CORPORATION 56,036 46,822
    EXXON MOBIL CORP 14,692 48,155
    FORD MOTOR COMPANY 54,807 72,122
    GENERAL ELECTRIC CO 62,019 93,093
    GENERAL MOTORS   17,987
    GILEAD SCIENCES INC. 35,492 99,696
    JACOBS ENGINEERING 60,572 46,000
    JOHNSON CONTROLS INC    
    J.P. MORGAN CHASE & CO 80,474 143,085
    MCKESSON CORPORATION 26,642 54,176
    MICROSOFT CORPORATION 56,814 96,173
    MONDELEZ INTERNATIONAL INC 33,956 70,948
    NATIONAL OILWELL VARCO INC    
    NORDSTROM 55,937 61,297
    PEPSICO 19,897 66,117
    PHILIP MORRIS INTERNATIONAL 37,122 51,007
    PROCTOR & GAMBLE CO 27,473 45,763
    QUALCOMM INC 26,521 49,200
    SCHLUMBERGER LIMITED 35,803 41,268
    SKYWORKS SOLUTIONS INC 32,544 99,949
    SOUTHERN CO 6,839 45,100
    TARGET CORP 58,634 85,901
    TERADATA CORP 59,799 28,757
    US BANCORP 51,457 55,129
    UNION PACIFIC 55,942 62,902
    UNITEDHEALTH GROUP INC 55,571 122,609
    PUBLIC STORAGE 6.50% PFD    
    TENN VALLEY AUTH 6/1/28    
    ROUCHE HOLDINGS LTD    
    BHP BILLITON LIMITED ADR    
    GS-INTERNATIONAL SML CAP INSIGHTS    
    OPPENHEIMER MAIN ST SMALL CAP    
    T ROWE PRICE MID CAP FUND 50,000 80,540
    T ROWE PRICE MID CAP VALUE FUND 50,000 65,552
    AMERICAN EUROPACIFIC GROWTH FUND    
    HARBOR INTERNATIONAL FUND    
    OPPENHEIMER DEVELOPING MARKETS FUND    
    PRINCIPAL GOLBAL REAL ESTATE SEC    
    WARRANTS    
    AMERICAN EUROPACIFIC GROWTH FUND 93,447 118,929
    BHP BILLITON LIMITED ADR 52,508 23,220
    DFA EMERGING MARKETS SMALL CAP 50,000 44,495
    DFA US SMALL CAP PORTFOLIO 50,000 47,755
    FIREEYE INC 31,293 27,562
    GOLDMAN SACHS INTERNATIONAL SMALL CA 50,000 55,355
    HARBOR INTERNATIONAL FUND 88,089 119,061
    MOTORS LIQUIDATIONS CO GUC TRUST   1,652
    OPPENHEIMER DEVELOPING MARKETS FD 100,798 89,925
    OPPENHEIMER MAIN STREET SMALL & MID 50,000 68,249
    ROCHE HOLDINGS AG SPN ADR EACH REP 65,440 84,539
    WALT DISNEY 47,632 126,024

    TY 2014 OtherAssetsSchedule
    Name:
    HARRY & THELMA SURRENA MEMORIAL
    EIN: 23-7435554
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    MINERAL RIGHTS 22,982 22,982 85,125


    TY 2014 OtherLiabilitiesSchedule
    Name:
    HARRY & THELMA SURRENA MEMORIAL
    EIN: 23-7435554
    Description Beginning of Year - Book Value End of Year - Book Value
    FEDERAL TAXES PAYABLE 1,723 391


    TY 2014 OtherProfessionalFeesSchedule
    Name:
    HARRY & THELMA SURRENA MEMORIAL
    EIN: 23-7435554
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT MANAGEMENT FEES 31,995 31,995    


    TY 2014 TaxesSchedule
    Name:
    HARRY & THELMA SURRENA MEMORIAL
    EIN: 23-7435554
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    PAYROLL TAXES 2,982 1,491   1,491
    EXCISE TAXES 2,991      
    FOREIGN TAXES 423 423