Form990-PF
Click to see attachment

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0052
2018
Open to Public Inspection
For calendar year 2018, or tax year beginning 01-01-2018 , and ending 12-31-2018
Name of foundation
CAPEL TRUST FBO MONTGOMERY HOSPITAL
 
Number and street (or P.O. box number if mail is not delivered to street address)6325 S RAINBOW BLVD STE 300
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
LAS VEGAS, NV89118
A Employer identification number

51-0160511
B Telephone number (see instructions)

(888) 730-4933
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$2,051,937J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 58,189 56,389  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 79,886
b Gross sales price for all assets on line 6a 479,556
7 Capital gain net income (from Part IV, line 2)... 79,886
8 Net short-term capital gain......... 0
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule)....... Click to see attachment 7,179    
12 Total. Add lines 1 through 11........ 145,254 136,275  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 30,461 22,846   7,615
14 Other employee salaries and wages......   0 0 0
15 Pension plans, employee benefits.......   0 0  
16a Legal fees (attach schedule).........       0
b Accounting fees (attach schedule)....... Click to see attachment 995 0 0 995
c Other professional fees (attach schedule)....       0
17 Interest...............       0
18 Taxes (attach schedule) (see instructions)... Click to see attachment 879 879   0
19 Depreciation (attach schedule) and depletion... 0 0  
20 Occupancy..............        
21 Travel, conferences, and meetings.......   0 0  
22 Printing and publications..........   0 0  
23 Other expenses (attach schedule).......        
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 32,335 23,725 0 8,610
25 Contributions, gifts, grants paid....... 107,000 107,000
26 Total expenses and disbursements. Add lines 24 and 25 139,335 23,725 0 115,610
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 5,919
b Net investment income (if negative, enter -0-) 112,550
c Adjusted net income (if negative, enter -0-)... 0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2018)
Form 990-PF (2018)
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......... 66,372 110,370 110,370
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet     0 0
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet0      
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 1,883,692 Click to see attachment1,842,479 1,941,567
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 1,950,064 1,952,849 2,051,937
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22).........   0
Net Assets or Fund Balances Foundations that follow SFAS 117, check here bullet
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 bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds........ 1,950,064 1,952,849
28 Paid-in or capital surplus, or land, bldg., and equipment fund    
29 Retained earnings, accumulated income, endowment, or other funds    
30 Total net assets or fund balances (see instructions)..... 1,950,064 1,952,849
31 Total liabilities and net assets/fund balances (see instructions). 1,950,064 1,952,849
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
1,950,064
2
Enter amount from Part I, line 27a .....................
2
5,919
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
130
4
Add lines 1, 2, and 3 ..........................
4
1,956,113
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
3,264
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30 .
6
1,952,849
Form 990-PF (2018)
Form 990-PF (2018)
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 8. ABBOTT LABS   2017-11-13 2018-01-10
b 3. AETNA INC-NEW   2014-06-09 2018-01-10
c 8. AGILENT TECHNOLOGIES INC   2017-09-07 2018-01-10
d 1. ALPHABET INC/CA   2016-01-22 2018-01-10
e 4. AMERICAN TOWER REIT   2017-06-05 2018-01-10
2. AMGEN INC   2015-01-21 2018-01-10
4. APPLE INC   2010-07-12 2018-01-10
2. AVERY DENNISON CORP   2015-06-11 2018-01-10
3. AVERY DENNISON CORP   2017-09-07 2018-01-10
20. BANK OF AMERICA CORP   2017-01-11 2018-01-10
7. BAXTER INTL INC   2017-12-15 2018-01-10
8. CDW CORP/DE   2015-10-01 2018-01-10
6. CENTENE CORP DEL   2014-11-11 2018-01-10
16. CENTERPOINT ENERGY INC   2017-09-07 2018-01-10
5. CHEVRON CORP   2016-06-14 2018-01-10
12. CITIZENS FINANCIAL GROUP INC   2017-01-11 2018-01-10
13. COMCAST CORP CLASS A   2011-02-11 2018-01-10
3. CUMMINS INC.   2017-11-13 2018-01-10
8. DELTA AIR LINES INC   2013-07-08 2018-01-10
8. DOWDUPONT INC   2013-10-07 2018-01-10
6. EMCOR GROUP INC COM   2016-12-13 2018-01-10
5. EXXON MOBIL CORPORATION   2017-09-07 2018-01-10
16. GENERAL MOTORS CO   2016-01-22 2018-01-10
4. GILEAD SCIENCES INC   2014-03-12 2018-01-10
28. HP INC   2017-05-04 2018-01-10
3. HOME DEPOT INC   2009-03-30 2018-01-10
10. INTEL CORP   2015-01-21 2018-01-10
6. JPMORGAN CHASE & CO   2015-05-18 2018-01-10
16. JABIL CIRCUIT INC COM   2015-12-21 2018-01-10
4. JOHNSON & JOHNSON   2017-08-01 2018-01-10
4. LEAR CORP   2013-09-20 2018-01-10
8. LINCOLN NATL CORP IND   2013-04-22 2018-01-10
7. LOWES COS INC   2013-11-04 2018-01-10
6. MICROSOFT CORP   1997-12-26 2018-01-10
14. NETAPP INC   2017-01-11 2018-01-10
2. NORTHROP GRUMMAN CORP   2014-01-22 2018-01-10
2. NVIDIA CORP   2016-04-12 2018-01-10
22. ON SEMICONDUCTOR CORP   2017-11-13 2018-01-10
7. PROLOGIS INC   2016-09-13 2018-01-10
4. PRUDENTIAL FINL INC   2015-08-13 2018-01-10
5. RAYMOND JAMES FINL INC   2017-11-13 2018-01-10
4. STANLEY BLACK DECKER INC   2016-09-13 2018-01-10
10. SYSCO CORP   2016-06-14 2018-01-10
5. TJX COMPANIES INC   2016-09-13 2018-01-10
8. TARGET CORP   2017-09-07 2018-01-10
7. TORO CO   2017-06-05 2018-01-10
5. TYSON FOODS INC CL A DEL   2017-12-15 2018-01-10
3. UNITEDHEALTH GROUP INC   2015-02-25 2018-01-10
6. VALERO ENERGY CORP   2014-04-30 2018-01-10
6. VMWARE INC   2017-03-02 2018-01-10
5. WAL MART STORES INC   2016-10-31 2018-01-10
22. CDW CORP/DE   2015-10-01 2018-02-20
97. TORO CO   2017-06-05 2018-02-20
106. CDW CORP/DE   2015-10-01 2018-03-20
108. DOWDUPONT INC   2013-10-07 2018-03-20
15. GILEAD SCIENCES INC   2017-06-26 2018-03-20
65. GILEAD SCIENCES INC   2014-03-12 2018-03-20
87. LOWES COS INC   2013-11-04 2018-03-20
6. NORTHROP GRUMMAN CORP   2014-01-22 2018-03-20
188. COMCAST CORP CLASS A   2011-02-11 2018-05-03
16. NETAPP INC   2017-01-11 2018-05-03
3207.94 ABERDEEN EMERG MARKETS-INST 840     2018-06-05
854.701 INVESCO INTERNATIONAL GROWTH FD     2018-06-05
3274.088 EATON VANCE GLOB MACRO ADV-I 208   2017-12-27 2018-06-05
304.646 FID ADV EMER MKTS INC- CL I 607   2016-10-06 2018-06-05
181.62 OAKMARK INTERNATIONAL-INST #2886   2017-05-04 2018-06-05
1243.094 JPMORGAN HIGH YIELD FUND SS 3580     2018-06-05
1962.923 T ROWE CORPORATE INCOME FD #112     2018-06-05
2278.224 PRINCIPAL GL MULT STRAT-INST #4684     2018-06-05
800. SPDR DJ WILSHIRE INTERNATIONAL REAL     2018-06-05
100. VANGUARD REIT VIPER   2016-08-19 2018-06-05
9. ABBOTT LABS   2017-11-13 2018-06-06
4. ABBVIE INC   2018-03-20 2018-06-06
3. AETNA INC-NEW   2014-06-09 2018-06-06
7. AGILENT TECHNOLOGIES INC   2017-09-07 2018-06-06
3. AMERICAN TOWER REIT   2017-06-05 2018-06-06
3. AMGEN INC   2015-01-21 2018-06-06
4. APPLE INC   2010-07-12 2018-06-06
7. APPLIED INDL TECHNOLOGIES INC COM   2018-02-20 2018-06-06
5. AVERY DENNISON CORP   2015-06-11 2018-06-06
19. BANK OF AMERICA CORP   2017-01-11 2018-06-06
8. BAXTER INTL INC   2017-12-15 2018-06-06
6. CENTENE CORP DEL   2014-11-11 2018-06-06
15. CENTERPOINT ENERGY INC   2017-09-07 2018-06-06
4. CHEVRON CORP   2016-06-14 2018-06-06
11. CISCO SYSTEMS INC   2018-03-20 2018-06-06
12. CITIZENS FINANCIAL GROUP INC   2017-01-11 2018-06-06
2. COSTCO WHOLESALE CORP   2018-03-20 2018-06-06
3. CUMMINS INC.   2017-11-13 2018-06-06
8. DELTA AIR LINES INC   2013-07-08 2018-06-06
6. EMCOR GROUP INC COM   2016-12-13 2018-06-06
4. EXXON MOBIL CORPORATION   2017-09-07 2018-06-06
11. GENERAL MOTORS CO   2016-01-22 2018-06-06
23. HP INC   2017-05-04 2018-06-06
3. HOME DEPOT INC   2009-03-30 2018-06-06
15. HUNTSMAN CORP   2018-03-20 2018-06-06
11. INTEL CORP   2015-01-21 2018-06-06
6. JPMORGAN CHASE & CO   2015-05-18 2018-06-06
16. JABIL CIRCUIT INC COM   2015-12-21 2018-06-06
3. JOHNSON & JOHNSON   2017-08-01 2018-06-06
3. LEAR CORP   2013-09-20 2018-06-06
7. LINCOLN NATL CORP IND   2013-04-22 2018-06-06
15. MACY'S INC   2018-05-03 2018-06-06
7. MICROSOFT CORP   1997-12-26 2018-06-06
9. NETAPP INC   2017-01-11 2018-06-06
1. NORTHROP GRUMMAN CORP   2014-01-22 2018-06-06
3. NVIDIA CORP   2016-04-12 2018-06-06
23. ON SEMICONDUCTOR CORP   2017-11-13 2018-06-06
7. PROLOGIS INC   2016-09-13 2018-06-06
5. PRUDENTIAL FINL INC   2015-08-13 2018-06-06
6. RAYMOND JAMES FINL INC   2017-11-13 2018-06-06
3. STANLEY BLACK DECKER INC   2016-09-13 2018-06-06
8. SYSCO CORP   2016-06-14 2018-06-06
5. TJX COMPANIES INC   2016-09-13 2018-06-06
8. TARGET CORP   2017-09-07 2018-06-06
6. TYSON FOODS INC CL A DEL   2017-12-15 2018-06-06
2. UNITEDHEALTH GROUP INC   2015-02-25 2018-06-06
5. VALERO ENERGY CORP   2014-04-30 2018-06-06
5. VMWARE INC   2017-03-02 2018-06-06
5. WAL MART STORES INC   2016-10-31 2018-06-06
10. CENTENE CORP DEL   2014-11-11 2018-07-03
115. DELTA AIR LINES INC   2013-07-08 2018-07-03
18. NETAPP INC   2017-01-11 2018-07-03
44. STANLEY BLACK DECKER INC   2016-09-13 2018-07-03
42. AETNA INC-NEW   2014-06-09 2018-08-09
16. CENTENE CORP DEL   2014-11-11 2018-08-09
92. LINCOLN NATL CORP IND   2013-04-22 2018-08-09
82. RAYMOND JAMES FINL INC   2017-11-13 2018-08-09
86. TYSON FOODS INC CL A DEL   2017-12-15 2018-08-09
7. VMWARE INC   2017-03-02 2018-08-09
161. GENERAL MOTORS CO   2016-01-22 2018-09-19
7. UNITEDHEALTH GROUP INC   2015-02-25 2018-09-19
101. EXPEDITORS INTL WASH INC   2018-07-03 2018-10-16
642.638 HARBOR INTERNATION FD INST #2011     2018-10-24
902.253 INVESCO INTERNATIONAL GROWTH FD     2018-11-26
260. VANGUARD REIT VIPER     2018-11-26
CAPITAL GAIN DIVIDENDS P    
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 470   442 28
b 550   237 313
c 565   521 44
d 1,101   725 376
e 550   527 23
366   315 51
695   149 546
236   125 111
354   277 77
608   457 151
479   457 22
577   326 251
631   284 347
437   478 -41
643   507 136
538   434 104
529   156 373
541   508 33
445   153 292
592   318 274
491   435 56
431   394 37
687   472 215
315   317 -2
614   527 87
575   70 505
425   365 60
659   399 260
430   376 54
575   531 44
729   285 444
663   251 412
658   348 310
526   90 436
847   497 350
616   241 375
445   70 375
497   476 21
430   359 71
488   357 131
470   416 54
685   481 204
613   485 128
380   372 8
565   468 97
463   486 -23
405   407 -2
672   344 328
565   344 221
773   542 231
498   351 147
1,566   897 669
6,022   6,739 -717
7,955   4,322 3,633
7,216   4,291 2,925
1,155   1,069 86
5,007   5,148 -141
7,470   4,322 3,148
2,082   722 1,360
5,818   2,253 3,565
1,076   568 508
49,049   44,000 5,049
30,000   25,466 4,534
33,068   35,000 -1,932
4,000   4,301 -301
5,000   4,768 232
9,000   9,162 -162
18,000   19,855 -1,855
25,402   25,000 402
32,224   32,298 -74
7,977   8,663 -686
568   497 71
397   455 -58
527   237 290
443   456 -13
416   395 21
546   472 74
775   149 626
494   505 -11
533   312 221
558   434 124
594   523 71
708   284 424
385   448 -63
493   406 87
482   490 -8
500   434 66
396   372 24
427   508 -81
428   153 275
472   435 37
325   315 10
479   325 154
541   433 108
580   70 510
484   458 26
622   401 221
653   399 254
466   376 90
366   398 -32
601   214 387
473   220 253
594   472 122
717   105 612
658   319 339
334   120 214
784   105 679
603   497 106
462   359 103
494   447 47
591   499 92
426   361 65
526   388 138
471   372 99
629   468 161
413   488 -75
492   229 263
614   286 328
740   451 289
423   351 72
1,250   473 777
5,636   2,193 3,443
1,408   639 769
5,831   5,291 540
8,144   3,321 4,823
2,208   758 1,450
6,147   2,891 3,256
7,464   6,819 645
5,134   6,999 -1,865
1,072   632 440
5,761   4,754 1,007
1,852   803 1,049
6,831   7,386 -555
36,881   35,951 930
29,016   22,716 6,300
20,771   22,357 -1,586
      21,263
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       28
b       313
c       44
d       376
e       23
      51
      546
      111
      77
      151
      22
      251
      347
      -41
      136
      104
      373
      33
      292
      274
      56
      37
      215
      -2
      87
      505
      60
      260
      54
      44
      444
      412
      310
      436
      350
      375
      375
      21
      71
      131
      54
      204
      128
      8
      97
      -23
      -2
      328
      221
      231
      147
      669
      -717
      3,633
      2,925
      86
      -141
      3,148
      1,360
      3,565
      508
      5,049
      4,534
      -1,932
      -301
      232
      -162
      -1,855
      402
      -74
      -686
      71
      -58
      290
      -13
      21
      74
      626
      -11
      221
      124
      71
      424
      -63
      87
      -8
      66
      24
      -81
      275
      37
      10
      154
      108
      510
      26
      221
      254
      90
      -32
      387
      253
      122
      612
      339
      214
      679
      106
      103
      47
      92
      65
      138
      99
      161
      -75
      263
      328
      289
      72
      777
      3,443
      769
      540
      4,823
      1,450
      3,256
      645
      -1,865
      440
      1,007
      1,049
      -555
      930
      6,300
      -1,586
       
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 79,886
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)

If section 4940(d)(2) applies, leave this part blank.
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period?
If "Yes," the foundation does not qualify under section 4940(e). Do not complete this part.
1 Enter the appropriate amount in each column for each year; see instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in) 		(b)
Adjusted qualifying distributions 		(c)
Net value of noncharitable-use assets 		(d)
Distribution ratio
(col. (b) divided by col. (c))
2017 104,990 2,273,314 0.046184
2016 105,206 2,200,946 0.0478
2015 86,633 2,229,475 0.038858
2014 131,997 2,313,854 0.057046
2013 96,134 2,117,209 0.045406
2
Total of line 1, column (d) .....................
2
0.235294
3
Average distribution ratio for the 5-year base period—divide the total on line 2 by 5.0, or by the number of years the foundation has been in existence if less than 5 years ......
3
0.047059
4
Enter the net value of noncharitable-use assets for 2018 from Part X, line 5......
4
2,283,218
5
Multiply line 4 by line 3......................
5
107,446
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
1,126
7
Add lines 5 and 6........................
7
108,572
8
Enter qualifying distributions from Part XII, line 4,.............
8
115,610
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 (2018)
Form 990-PF (2018)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket includes lines 1a and 1b
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 1,126
hereBulletand enter 1% of Part I, line 27b...................
c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 1,126
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 1,126
6 Credits/Payments:
a 2018 estimated tax payments and 2017 overpayment credited to 2018 6a 1,464
b Exempt foreign organizations—tax withheld at source...... 6b
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 1,464
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 338
11 Enter the amount of line 10 to be: Credited to 2019 estimated taxBullet282 RefundedBullet 11 56
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)
    bulletNC
    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 2018 or the taxable year beginning in 2018? See the instructions for Part XIV.
    If "Yes," complete Part XIV .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 5
    Part VII-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletN/A
    14
    The books are in care ofbulletWELLS FARGO BANK NA Telephone no.bullet (888) 730-4933

    Located atbullet100 N MAIN ST MAC D4001-117WINSTON SALEMNC ZIP+4bullet27101
    15
    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
    15
     
    16 At any time during calendar year 2018, 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 the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet  
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?......................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?...............
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).......
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ........
    1b
     
    No
    ........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2018?.............
    1c
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2018, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2018?.............
    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 2018 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 2018.)..................
    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 2018?
    4b
     
    No
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 6
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (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
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .................
    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
    Wells Fargo Bank NA TRUSTEE
    1     		30,461    
    100 N MAIN ST MAC D4001-117
    WINSTON SALEM,NC27101
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet 0
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 7
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 8
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    2,221,309
    b
    Average of monthly cash balances.......................
    1b
    96,679
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    2,317,988
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    2,317,988
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    34,770
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    2,283,218
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    114,161
    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.)
    1
    Minimum investment return from Part X, line 6....................
    1
    114,161
    2a
    Tax on investment income for 2018 from Part VI, line 5......
    2a
    1,126
    b
    Income tax for 2018. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    1,126
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    113,035
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    113,035
    6
    Deduction from distributable amount (see instructions).................
    6
    0
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
    113,035
    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
    115,610
    b
    Program-related investments—total from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
    0
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
    0
    b
    Cash distribution test (attach the required schedule) .................
    3b
    0
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    115,610
    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
    1,126
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    114,484
    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 (2018)
    Form 990-PF (2018)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2017     		(c)
    2017     		(d)
    2018
    1 Distributable amount for 2018 from Part XI, line 7 113,035
    2 Undistributed income, if any, as of the end of 2018:
    a Enter amount for 2017 only....... 101,846
    b Total for prior years:2016, 2015, 20 0
    3 Excess distributions carryover, if any, to 2018:
    a From 2013...... 0
    b From 2014...... 0
    c From 2015...... 0
    d From 2016...... 0
    e From 2017...... 0
    fTotal of lines 3a through e........ 0
    4Qualifying distributions for 2018 from Part
    XII, line 4: bullet$ 115,610
    a Applied to 2017, but not more than line 2a 101,846
    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 2018 distributable amount..... 13,764
    e Remaining amount distributed out of corpus 0
    5 Excess distributions carryover applied to 2018. 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 0
    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 2017. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2018. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2019 ..........     		99,271
    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
    8 Excess distributions carryover from 2013 not
    applied on line 5 or line 7 (see instructions) ...     		0
    9Excess distributions carryover to 2019.
    Subtract lines 7 and 8 from line 6a ......     		0
    10 Analysis of line 9:
    a Excess from 2014.... 0
    b Excess from 2015.... 0
    c Excess from 2016.... 0
    d Excess from 2017.... 0
    e Excess from 2018.... 0
    Form 990-PF (2018)
    Form 990-PF (2018)
    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 2018, 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) 2018 (b) 2017 (c) 2016 (d) 2015
             
    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 foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    NONE
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    NONE
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2018)
    Form 990-PF (2018)
    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
    FIRST HEALTH OF THE CAROLINAS
    155 MEMORIAL DRIVE
    PINEHURST,NC28374     		NONE PC GENERAL OPERATING 107,000
    Total .................................bullet 3a 107,000
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3 Interest on savings and temporary cash
    investments ...........     		         
    4 Dividends and interest from securities....     14 58,189  
    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 79,886  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue:
    aFEDERAL TAX REFUND     		    1 7,179  
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e)..   145,254  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    145,254
    (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 (2018)
    Form 990-PF (2018)
    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) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.

    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below
    (see instr.)?
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    		 Firm's EIN SmallBullet
    Firm's address SmallBullet


    		 Phone no.
    Form 990-PF (2018)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2018 AccountingFeesSchedule
    Name:
    CAPEL TRUST FBO MONTGOMERY HOSPITAL
    EIN:
    51-0160511
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAX PREPARATION FEE (NON-ALLOC 995     995

    TY 2018 GeneralExplanationAttachment
    Name:
    CAPEL TRUST FBO MONTGOMERY HOSPITAL
    EIN:
    51-0160511
    Identifier Return Reference Explanation
    The compensation reported in column (c) is calculated based on periodic market values and/or the applicable fee agreement. It is not determined on an hourly basis and the reference to one hour per week is an estimate only. Corporate trustee services include, but are not limited to, administrative services such as fiduciary accounting, custody of assets, complying with tax filing requirements, complying with distribution provisions, and complying with federal and state laws applicable to private foundations, plus asset management services such as creating asset allocation strategies, investments reporting and reallocating and rebalancing of portfolios as necessary.

    TY 2018 InvestmentsOtherSchedule2
    Name:
    CAPEL TRUST FBO MONTGOMERY HOSPITAL
    EIN:
    51-0160511
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    464287887 ISHARES SP SMALL-CAP AT COST 30,248 40,333
    683974604 OPPENHEIMER DEVELOPI AT COST 67,165 68,549
    256210105 DODGE & COX INCOME F AT COST 151,827 145,671
    77957P105 T ROWE PRICE SHORT T AT COST 47,532 46,452
    74255L696 PRINCIPAL GL MULT ST      
    315920702 FID ADV EMER MKTS IN      
    464287879 ISHARES S&P SMALL CA AT COST 41,977 47,466
    003021714 ABERDEEN EMERG MARKE      
    339128100 JP MORGAN MID CAP VA AT COST 12,977 18,895
    957663701 WESTERN ASSET INTERM AT COST 154,000 147,717
    464287507 ISHARES TR S & P MID AT COST 40,632 76,388
    464287234 ISHARES TR MSCI EMER AT COST 81,807 75,776
    74925K581 ROBECO BP LNG/SHRT R AT COST 107,000 99,699
    464287614 ISHARES RUSSELL 1000 AT COST 56,778 71,346
    04314H758 ARTISAN SMALL CAP FU AT COST 7,915 10,447
    04314H402 ARTISAN INTERNATIONA AT COST 50,000 60,608
    277911491 EATON VANCE FLOATING AT COST 32,000 30,898
    922908553 VANGUARD REIT VIPER AT COST 64,141 82,027
    741478101 T ROWE CORPORATE INC AT COST 74,817 68,923
    464287606 ISHARES S&P MIDCAP 4 AT COST 36,551 56,413
    413838723 OAKMARK INTERNATIONA AT COST 64,232 60,519
    09258N505 BLACKROCK GL L/S CRE      
    044820504 ASHMORE EMERG MKTS C AT COST 36,813 35,165
    78463X863 SPDR DJ WILSHIRE INT AT COST 26,278 26,152
    4812C0803 JPMORGAN HIGH YIELD AT COST 61,838 57,033
    92837F458 VIRTUS CEREDEX M/C V AT COST 30,000 22,558
    411511306 HARBOR INTERNATION F      
    464287598 ISHARES RUSSELL 1000 AT COST 56,463 59,412
    008882532 AIM INTERNATIONAL GR      
    277923264 EATON VANCE GLOB MAC      
    466313103 JABIL CIRCUIT INC CO AT COST 5,120 5,404
    682189105 ON SEMICONDUCTOR COR AT COST 6,813 5,201
    00817Y108 AETNA INC-NEW      
    46625H100 JPMORGAN CHASE & CO AT COST 5,516 8,102
    40434L105 HP INC AT COST 6,097 6,629
    37045V100 GENERAL MOTORS CO      
    037833100 APPLE COMPUTER INC C AT COST 2,087 8,833
    060505104 BANK AMER CORP AT COST 5,844 6,308
    15135B101 CENTENE CORP DEL AT COST 2,793 6,803
    12514G108 CDW CORP/DE      
    64110D104 NETAPP INC AT COST 4,757 7,996
    891092108 TORO CO      
    91913Y100 VALERO ENERGY CORP AT COST 4,410 5,773
    20030N101 COMCAST CORP CLASS A      
    231021106 CUMMINS INC. AT COST 6,767 5,346
    902494103 TYSON FOODS INC CL A      
    174610105 CITIZENS FINANCIAL G AT COST 5,859 4,816
    744320102 PRUDENTIAL FINL INC AT COST 5,181 4,730
    854502101 "STANLEY BLACK & DEC      
    928563402 VMWARE INC AT COST 5,506 8,365
    002824100 ABBOTT LABORATORIES AT COST 6,901 9,041
    478160104 JOHNSON & JOHNSON AT COST 6,504 6,323
    871829107 SYSCO CORP AT COST 5,093 6,579
    931142103 WAL MART STORES INC AT COST 5,398 7,173
    67066G104 NVIDIA CORP AT COST 1,370 5,207
    02079K107 ALPHABET INC/CA AT COST 5,076 7,249
    03027X100 AMERICAN TOWER REIT AT COST 6,189 7,435
    548661107 LOWES COS INC      
    872540109 TJX COS INC NEW AT COST 5,139 6,174
    166764100 CHEVRON CORP AT COST 5,071 5,440
    071813109 BAXTER INTL INC COM AT COST 7,188 7,240
    458140100 INTEL CORP AT COST 5,070 6,523
    754730109 RAYMOND JAMES FINL I      
    00846U101 AGILENT TECHNOLOGIES AT COST 6,445 6,679
    30231G102 EXXON MOBIL CORPORAT AT COST 3,738 4,364
    87612E106 TARGET CORP AT COST 6,495 7,336
    521865204 LEAR CORP AT COST 3,206 5,529
    247361702 DELTA AIR LINES INC      
    031162100 AMGEN INC AT COST 5,033 6,229
    053611109 AVERY DENNISON CORP AT COST 4,678 6,737
    29084Q100 EMCOR GROUP INC COM AT COST 6,075 5,014
    375558103 GILEAD SCIENCES INC      
    437076102 HOME DEPOT INC AT COST 1,113 8,247
    534187109 LINCOLN NATL CORP IN      
    594918104 MICROSOFT CORP AT COST 1,333 9,040
    666807102 NORTHROP GRUMMAN COR AT COST 2,647 5,388
    91324P102 UNITEDHEALTH GROUP I AT COST 3,555 7,723
    15189T107 CENTERPOINT ENERGY I AT COST 6,425 6,069
    26078J100 DOWDUPONT INC      
    74340W103 PROLOGIS INC AT COST 5,033 5,755
    01973R101 ALLISON TRANSMISSION AT COST 7,892 6,630
    17275R102 CISCO SYSTEMS INC AT COST 7,217 7,019
    447011107 HUNTSMAN CORP AT COST 7,170 4,533
    00287Y109 ABBVIE INC AT COST 7,284 5,900
    31641Q763 FIDELITY NEW MRKTS I AT COST 71,698 63,323
    22160K105 COSTCO WHOLESALE COR AT COST 7,442 8,148
    743315103 PROGRESSIVE CORP OHI AT COST 7,814 7,541
    316389584 FIDELITY ADV INTER R AT COST 17,000 15,330
    989207105 ZEBRA TECHNOLOGIES C AT COST 8,934 8,758
    901165100 TWEEDY BROWNE FD GLO AT COST 36,000 32,881
    03820C105 APPLIED INDL TECHNOL AT COST 7,500 5,610
    665859104 NORTHERN TRUST CORP AT COST 7,684 5,768
    29261A100 ENCOMPASS HEALTH COR AT COST 7,809 6,108
    55616P104 MACY'S INC AT COST 7,177 6,790
    464288489 ISHARES FTSE EPRA/NA AT COST 16,962 15,137
    56585A102 MARATHON PETROLEUM C AT COST 7,239 5,370
    29977A105 EVERCORE PARTNERS IN AT COST 7,141 4,795
    00770G847 JOHCM INTERNATIONAL AT COST 20,000 16,821
    09260C703 BLACKROCK GL L/S CRE AT COST 68,000 63,858

    TY 2018 OtherDecreasesSchedule
    Name:
    CAPEL TRUST FBO MONTGOMERY HOSPITAL
    EIN:
    51-0160511
    Description Amount
    MUTUAL FUND TIMING DIFFERENCE 381
    PY RETURN OF CAPITAL ADJUSTMENT 2,883


    TY 2018 OtherIncomeSchedule2
    Name:
    CAPEL TRUST FBO MONTGOMERY HOSPITAL
    EIN:
    51-0160511
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    FEDERAL TAX REFUND 7,179 0  


    TY 2018 OtherIncreasesSchedule
    Name:
    CAPEL TRUST FBO MONTGOMERY HOSPITAL
    EIN:
    51-0160511
    Description Amount
    COST BASIS ADJUSTMENT 130


    TY 2018 TaxesSchedule
    Name:
    CAPEL TRUST FBO MONTGOMERY HOSPITAL
    EIN:
    51-0160511
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 711 711   0
    FOREIGN TAXES ON NONQUALIFIED 168 168   0