Professional Documents
Culture Documents
Form
9 90 -PF
OMB No 1545-0052
^O J 7
06 /3 0, 20 11
L_J Initial return of a former public charity Address change Name change
Final return
31-1633189
Telephone number ( see page 10 of the instructions,
(651)
If exemption application is pending , check here . .
466-8710
. . . . . . ^ H 01 ^
Un
ST.
PAUL , MN 55164-0713
X Section 501(c)(3) exempt private foundation
Other taxable p rivate foundation
E
2 Foreign organizations meeting the 85% test , check here and attach computation If private foundation status was terminated under section 507(b )(ttALcheck here . F
Fair market value of all assets at end J Accounting method Accrual Cash of year (from Part 11, col (c), line Other (specify) -----------(Part 1, column (d) must be on cash basis.) 16) ^ $ 20 760. 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 pa g e 11 of the instructions))
1 Contributions fts grants, etc , received ( attach schedule)
I,. El
If t h e f oun d ation is to a 60 -mont h termination under section 507(b)( 1)(B(, check here . ^
(d) Disbursements
(c) Adjusted net income for charitable purposes ( cash basis onl y)
2 3
Check ^
5a Gross rents . . . . . . . . . . . . . . . .
b Net rental income or (loss) d 6a Net gain or (loss) from sale of assets not on line 10 b Gross sales price for all 114,399 . assets on line 6a
22 , 464 .
7 r 8 9
Capital gain nt intome(ro (t1cPar^ {V, t ^) hlr^Vlfr Net short-terms capital gain Income modifications . . . . . . . . .
Q , U)
22 , 464.
10 a Gross sales less idturps and allowances b Less Cost of goods said
11
12
13
131. 22 , 595
STMT 1 22 , 464.
NON NON
14 y 15
. . . . . . .
NONE
NON E
Q 90
164.
101.
131.
33
19 E 20
Depreciation (attach schedule) and depletion , Occupancy . . . . . . . . . . . . . . . . Travel, conferences, and meetings . . . . Printing and publications . . . . . . . . . . . . . Other expenses (attach schedule) NON NON NON
fl 21 to 22 r 23 0 24
NON
a
25
26
265.
107 000.
131. 131.
NON NON
33
107 , 000
107 265.
- 84 670 .
107 , 033
27
a
b Net investment income (if negative, enter -0-) c Adjusted net income (if ne g ative, enter -0-). .
For Paperwork Reduction Act Notice, see page 30 of the instructions . OE 1410 1 000
22 , 333.
SSA Form 990-PI (2010)
35514300
Form 990-PF(2010) Balance Sheets Attached schedules and amounts in the description column should be f or endo f -year amounts only ( See i nstructions ) Beginning of year
31-1633189
End of year
Page 2
( a) Book Value
( b) Book Value
1 2 3 4
Cash - non-interest-bearing . . . . . . . . . . . . . . . . . Savings and temporary cash investments . . . .. . . . . Accounts receivable ^ -----------------------Less- allowance for doubtful accounts ^ -------------Pledges receivable ^ ------------------------Less allowance for doubtful accounts ^ ______________ Grants receivable . . . . . . . . . . . . . . . Receivables due from officers, directors , trustees , and other
disqualified persons ( attach schedule ) ( see page 15 of the instructions)
13 , 485.
20 760.
20 , 760
5 6
Other notes and loans receivable ( attach schedule) ^ Less: allowance for doubtful accounts ^ NONE -------------Inventories for sale or use Prepaid expenses and deferred charges . .
8 9
91 , 944.
12 13
14
. . . . . . . . . . . . . . . .
15 16
105 429.
20 , 760.
20 , 760
M 21 22 23
Mortgages and other notes payable ( attach schedule) , , , , , Other liabilities ( describe ^ -------------------)
Foundations that follow SFAS 117, check here ^ and complete lines 24 through 26 and lines 30 and 31.
W 24 25 co 26 Unrestricted . . . . . . . . . . . . . . . . . Temporarily restricted . . . . . . . , , , , , , , , , , , , , , , , , , , ,
Permanently restricted . . . . . . . . . . . . . . . . . . . .
LL
0 27
28 29
Foundations that do not follow SFAS 117, check here and complete lines 27 through 31.
Paid-in or capital surplus, or land, bldg , and equipment fund
30
or f un d b a l ances
( see page
1 7 of t h e
Z
31
instructions ),,,,,,,,,,,,,,,,,,
Total liabilities and net assets /fund balances ( see page 17 of the instructions ) . . ....................
105 429.
20 , 760.
105 429.
20 , 760.
------------------------------------4 Add lines 1 , 2, and 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ___ 5 Decreases not included in line 2 (itemize) ^ 6 Total net assets or fund balances at end of year ( line 4 minus line 5) - Part II , column ( b), line 30
SEE STATEMENT 5
3
4 5 6
1.
20 , 760. 20 , 760. Form 990-PF (20101
35514300
31-1633189
Form 990-PF (2010) Page 3 How acquired D-D asn .na
97TIM
la
b c d e
a b c d e
Complete only for assets showing gain in column ( h) and owned by the foundation on 12 / 31/69 ( i) F M.V. as of 12/31/69 ( j) Adjusted basis as of 12 / 31 /69 ( k) Excess of cot. (i) over col. (j), if any ( 1) Gains (Col. (h) gain minus col . ( k), but not less than -0-) or Losses (from col. (h))
a b c d e 2 Capital gain net income or (net capital loss) If gain , also enter in Part I. line 7 { If (loss), enter -0- in Part I , line 7 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 pages 13 and 17 of the instructions). If (loss) , enter -0- In Part I, line 8. ............................... } 2 22 , 464.
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? ElYes No If "Yes," the foundation does not qualify under section 4940 ( e) Do not complete this part. 1 Enter the appropriate amount in each column for each year, see page 18 of the instructions before making any entries.
Base pe riod years
Calendar year ( or tax year beginning in)
4 5 6 7 8
22 , 323.
223.
Enter 1%of net investment income ( 1% of Part I , line 27b) , , , , , , , , , , , , , , , , , , , , Addlines5and6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . Enter qualifying distributions from Part XII, line 4 Part VI instructions on page 18. . . . . . . . . . . . . . , , , , , ,
22 , 546. 107,033.
If line 8 is enual to or greater than line 7 . check the box in Part VI . line 1b . and complete t hat D art using a 1% tax rate . See the
JSA
OE 1430 1 000
35514300
Form990-PF (2010)
31-1633189
^ and enter 'N/A" on line 1 .
Page 4
age 18 of the instructions)
Excise Ta x Based on Investment Income (Section 4940 ( a). 4940 (b). 4940( e). or 4948 - see
la Exempt operating foundations described in section 4940(d)(2), check here Date of ruling or determination letter -------------( attach copy of ruling letter rf necessary - see instructions) b Domestic foundations that meet the section 4940(e) requirements in Part V, check
223.
^ FU and 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 3 4 5 6 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) Add lines 1 and 2 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) , . , Tax based on investment income . Subtract line 4 from line 3. If zero or less, enter -0- . . . . . . . . . . . . . Credits/Payments a 2010 estimated tax payments and 2009 overpayment credited to 2010 , , , , b Exempt foreign organizations-tax withheld at source d Backup withholding erroneously withheld 7 8 9 10 11 . . . . . . . . . . . . c Tax paid with application for extension of time to file (Form 8868) , , , , , , , . . . . . . . . . . . . . . . . . Total credits and payments. Add lines 6a through 6d . . . . . Enter any penalty for underpayment of estimated tax Check here 6a 6b 6c 6d 101. NONE NONE , . , 2
here
3 4
223. NONE
223.
7
8
101. 122.
Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed
9
10 Ii Yes 1a
Overpayment . If line 7 is more than the total of lines 5 and 8, enter the amount overpaid , , , , , , , Enter the amount of line 10 to be Credited to 2011 estimated tax ^ Refunded
No X
, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
12) On foundation managers ^ $
1c
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed on foundation managers ^ $ 2 X Has the foundation engaged in any activities that have not previously been reported to the IRS? , , , , , , , , , , , , , , If "Yes,"attach a detailed description of the activities Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes . . . . . . . . . . . , 3 4a 4b 5 X X X
e 2
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year? . . . . . . . . . . . . . . . . Was there a liquidation, termination, dissolution, or substantial contraction during the year? , , , , , , , , , , , , , , , , If "Yes,"attach the statement required by General Instruction T Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either: By language in the governing instrument, or By state legislation that effectively amends the governing instrument so that no mandatory directions that conflict with the state law remain in the governing instrument? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b If "Yes," has it filed a tax return on Form 990-T for this year? , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 5
6 7
X X
7 8a
Did the foundation have at least $5,000 in assets at any time during the year? If "Yes,"complete Part 11, col (c), and Part XV Enter the states to which the foundation reports or with which it is registered (see page 19 of the
STMT 6 instructions) ^ ------------------------------------------------------------------b 9 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 G21f "No,"attach explanation . . . . . . . . . . . . . . . . . Is the foundation claiming status as a private operating foundation within the meaning of section 4942(()(3) or 4942(j)(5) for calendar year 2010 or the taxable year beginning in 2010 (see instructions for Part XIV on page 9 X 27)? If "Yes," complete Part XIV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names and addresses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8b X
10
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31-1633189
Page 5
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 page 20 of the instructions) . . . . . . . . . . . . . . . . . . 11 X X X Did the foundation acquire a direct or indirect interest in any applicable insurance contract before August 17, 20087 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 13 Did the foundation comply with the public inspection requirements for its annual returns and exemption application? . . . . . Website address
12
13
14
15 16
N]A----------- -------------------------------------BANK The books are in care of Telephone no ^ -_(651) 466_8710__-__-_-_ N.-A --------------------NQ71 __ __ ______ ZIP+4 Located at ^ 101 _E_FIFTH_ ST_ ST_PAUL Section 4947( a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 - Check here . . . . . . and enter the amount of tax-exempt interest received or accrued during the year . . . . . . . . . . . . . . . . . . ^ 15 At any time during calendar year 2010, did the foundation have an interest in or a signature or other authority over a bank , securities , or other financial account in a foreign country? See page 20 of the instructions for exceptions and filing the name of the forei g n count ry . . . . . . . . . . . . . . . . . . . . . . . . . . . for Form TD F 90-22 1 If "Yes," enter requirements . . . . . ^ Q Yes 16 No X
Yes
No
(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 foundation agreed to make a grant to or to employ the official for a " No" if the period after
L1 No
u Yes
a No
b If any answer is "Yes" to la(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 page 22 of the instructions )? c Did the foundation 2 engage in a prior year in any of the acts income ( section 4942 ) described in la, other than . . . .. . . . acts, that 1c X a private lb Organizations relying on a current notice regarding disaster assistance check here . . . . . . . . . . . . . . ^ excepted was were not corrected before the first day of the tax year beginning in 2010? . . . . . . . . . . . . . . . . . . . . . . . . . . . Taxes on failure to distribute ( does not apply for years the foundation operating foundation defined in section 4942 (j)( 3) or 4942 (j )(5)) a At the end of tax year 2010, did the foundation have any undistributed income ( lines 6d and 6e, Part XIII) for tax year ( s) beginning before 20102 . . . . . . . . . . . . . . . . . . . . . . . . . If "Yes," list the years ^ _---______ --------- ,---------b Are there any years listed ( relating to incorrect in 2a for which the foundation u Yes a No
4942(a))2) to 2b
4942 ( a)(2)
all years listed , answer "No " and attach statement - see page 22 of the instructions .) . .
. . . . . . . . . . . . . . . . . . .
c If the provisions of section 4942 ( a)(2) are being applied to any of the years listed in 2a, list the years here ^ ---- ' ---------- '---------- '---------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 disqualified Commissioner under section the 10 -, 15-, or 20-year business holdings . . . . . . . . . . , , . , . , , , , , , in 2010 as a result of (1) any purchase u Yes u X No or
by the foundation
5-year period ( or longer period approved by the by gift or bequest , or (3) the lapse of C, Form 4720, to determine if the 3b 4a X Schedule
. . . . . . . . . . .
4a Did the foundation invest during the year any amount in a manner that would j eopardize its charitable purposes? . . . . . . . b Did the foundation make any investment in a prior year ( but after December 31, 1969 ) that could jeopardize its charitable ouroose that had not been removed from ieooardv before the first day of the tax year beamnina in 20107
4b
35514300
ORO"
5a
31-1633189 Statements Regarding Activities for Which Form 4720 May Be Required (continued)
. Yes Yes Yes No
Page 6
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 509(a)(1), (2), or (3), or section 4940(d)(2)? (see page 22 of the 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? . . . . . . . . . . . . . . . . .
X No X No
0 Yes Yes
No
a No . 5b
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 page 22 of the instructions)? Organizations relying on a current notice regarding disaster assistance check here . . . . . . . . . . . . . . . ^
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) F ]Y es No
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . EA N o , , _ . . , _ , _ Y es E]Yes No 7b 6b X
b Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? If "Yes" to 6b, file Form 8870 7a b At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction? , If 'Yes," did the foundation receive any proceeds or have any net income attributable to the transactions
Information About Officers, Directors , Trustees, Foundation Managers , Highly Paid Employees, and Contractors
1 List all officers , directors, trustees , foundation managers and their compensation ( see Dage 22 of the instructions).
( a) Name and address
(b) Title, and average hours per week devoted to p osition (c) Compensation ( If not paid , enter -o -) ( d) Contributions to employee benefit plans and deferred com p ensation
--------
------------------------
-0--------------------------------------
-0_
_0-
--------------------------------------
--------------------------------------
Compensation of five highest-paid employees (other than those included on line 1 - see page 23 of the 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 lc) Compensation (d) Contributions to employee benefit pl an s and deferre d (e) Expense account, o ther allowances
-------------------------------------NONE
NONE
NONE
NONE
----------------------------------------------------------------------------------------------------------------------------------------------------Total number of other employees paid over $50 ,000 ..................................... . . No- I NONE Form 990-PF (2010)
35514300
31-1633189
Form 990-PF (2010) Page 7
Information About Officers, Directors, Trustees, Foundation Managers , Highly Paid Employees, and Contractors (continued)
s rive nignesipata maepenaeni contraciors Tor proressionaf services ( see pag e is or the mstrucuonsf . IT none , enter
( a) Name and address of each person paid more than $50,000 (b) Type of service
tnvrvt. -
(c) Compensation
---------------------------------------------------------NONE
NONE
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------Total number of others receivin g over $50,000 for p rofessional services . . ^ NONE
1 NONE -----------------------------------------------z
------ -- --- - -
---------------------------------------------------------------------------------------------------------------------------------------------------------
3 ----------------------------------------------------------------------------4 -----------------------------------------------------------------------------
I Ii' :U
Describe the two largest program -related investments made by the foundation during the tax year on lines 1 and 2
35514300
Form 990-PF ( 20 10) 31-1633189 Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,
Page 8
la
3
4
.... ...... . ......... Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see page 25 of the instructions) ................................................
2 3
5
6
Net value of noncharitable-use assets . Subtract line 4 from line 3 Enter here and on Part V, line 4
4 5
Minimu m investmen t return . Enter 5% of line 5 . .. . . . . . . . . .. . . . . . . . . . . . . . . .. . Distributable Amount (see page 25 of the instructions) (Section 4942(j)(3) and (j)(5) private operating and do not complete this part.) foundations and certain foreign organizations check here ^ . . . . . . . . . . . . . . Minimum investment return from Part X, line 6 . . . . . . . . . . . . . Tax on investment income for 2010 from Part VI, line 5 , . _ . _ 2a 223 . 2b Income tax for 2010. (This does not include the tax from Part VI.) Add lines 2a and 2b ............................... ........... Distributable amount before adjustments Subtract line 2c from line 1 . . . . . . . . . . . . . . . .. Recoveries of amounts treated as qualifying distributions . . . . . . . . . . . . . . . . . . . . . . . . . Add lines 3 and 4 . . . . .. . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . Deduction from distributable amount (see page 25 of the instructions) . . . . . Distributable amount as adjusted Subtract line 6 from line 5. Enter here and on Part XIII, ........ ..... line1 ...................................... 1
1 2a b c 3 4 5 6 7
3,562.
2c 3 4 5 6 7
Amounts paid (including administrative expenses ) to accomplish charitable , etc., purposesExpenses , contributions , gifts, etc - total from Part I, column ( d), line 26 , , , , , , , , , , , , , , , , , Program - related investments - total from Part IX-B
Amounts paid to acquire assets used ( or held for use) directly in carrying out charitable, etc., purposes ........................ .......................
la 1b
2
107 , 033.
3 a b
4
Amounts set aside for specific charitable projects that satisfy the Suitability test ( prior IRS approval required ) . . . . . . . . . . . . . . . . . Cash distribution test ( attach the required schedule)
. . . _ . . . . . . . . _
, _ , , .
3a 3b
4
Qualifying distributions . Add lines la through 3b. Enter here and on Part V, line 8, and Part XIII , line 4
, 033.
5 6
Foundations that qualify under section 4940 (e) for the reduced rate of tax on net investment income. 5 Enter 1 % of Part I, line 27b ( see page 26 of the instructions ) , , , , , , , , , , , , , , , , , , , , , 223. _ _ . . .. . . 6 Adjusted qualifying distributions . Subtract line 5 from line 4 106 , 810. Note - The amount on line 6 will be used in Part V, column ( b), in subsequent years when cal culati ng whether the foundation qualifies for the section 4940 ( e) reduction of tax in those years.
Form 990-PF (2010)
35514300
10
31-1633189
Form 990-PF ( 2010) Page 9
line 7
2
....................
. . . . . . . . , 20 , 20 NON
3 , 339.
NON
29 , 814.
NONE NONE
Total of lines 3a through e . . . . . . . . . . . Qualifying distributions for 2010 from Part XII,
line 4 ^ $
107,033.
NON
NON
Treated as distributions out of corpus ( Election required - see page 26 of the instructions ) . . . . . . . Remaining amount distributed out of corpus . . Excess distributions carryover applied to 2010 (if an amount appears in column (d), the same amount must be shown in column (a) )
NON
3 , 339.
103 , 694.
NON NONE
6
a
409 687.
NON
b Prior years' undistributed 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 . . . . . . . . . . Taxable line 6c from line 6b d Subtract amount - see page 27 of the instructions e Undistributed income for 2009 . Subtract line 4a from line 2a Taxable amount - see page 27 of the instructions . . . . . . . . . . . f Undistributed income for 2010 Subtract lines 4d and 5 from line 1 This amount must be distributed in 2011 ............... Amounts treated as distributions out of corpus to satisfy requirements imposed by section 170(b)(1)(F) or 4942 ( g((3) (see page 27 of the
NON
NON NON
NONE
instructions ) . . . . . . . .
8
. .
NON
29 r $14 .
Excess distributions carryover from 2005 not applied on line 5 or line 7 (see page 27 of the instructions) . . . . . . . . . . . . . . . .
9
10 a b c d e
Excess
Subtract lines 7 and 8 from line 6a , , , , , , , Analysis of line 9 Excess from 2006 . . . Excess from 2007 . Excess from 2008 . Excess from 2009 . . . Excess from 2010 . . . NONE NONE 125 , 823. 150
, 356.
Form 990-PF (2010)
103,694.
35514300
11
Form 990-PF (20 10 ) 31-16 33189 FOFT.api Private O p erating Foundations (see p a g e 27 of the instructions and Part VII-A, q uestion 9 )
1a b
2a
If the foundation has received a ruling or determination letter that it is a private operating foundation , and the ruling Is effective for 2010 , enter the date of the ruling . . . . . . . . ^ Check box to indicate whether the foundation is a orlvate ooerattna foundation described In section
Enter the lesser of the adjusted net income from Part I or the minimum investment return from Part X for each year listed _ _ _ _ _ _ _ 85%of Ime 2a
Qualifying distributions from Part XII, line 4 for each year listed
4942 ( 11(3) or
4942111(5)
( e ) T ota l
Tax year
( a) 2010 (b) 2009
Prior 3 years
( c) 2008 (d) 2007
b
C
Amounts included in line 2c not used directly for active conduct of exempt activities . . . . .
Qualifying
distributions made directly for active conduct of exempt activities Subtract line 2d from line 2c . . . . . .
3 a
Complete 3a, b, or c for the alternative test relied upon 'Assets' alternative test - enter (1) (2) Value of all assets . Value of assets qualifying under section b 4942(II(3((BI(i1. . . 'Endowment' alternative enter 2/3 . . test-
of minimum invest-
'Support' alternative test - enter (1) Total support other than gross investment income (interest, dividends, rents, payments on securities loans (section 512(a55((,
or royalties)
(2)
. . . . ,
Support from general public and 5 or more exempt organizations as provided in section 4942
(I)(3)(BIGo( . . .
(3)
. . .
Supplementary Information (Complete this part only if the foundation had $5 , 000 or more in assets at any time during the year - see page 28 of the instructions.)
1 a Information Regarding Foundation Managers: List 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) N/A List 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. N/A 2 Information Regarding Contribution , Grant , Gift, Loan, Scholarship , etc., Programs Check here ^ MX if the foundation only makes contributions to preselected charitable organizations and does not accept unsolicited requests for funds. If the foundation makes gifts, grants, etc. (see page 28 of the instructions) to individuals or organizations under other conditions, complete items 2a, b, c, and d a The name, address, and telephone number of the person to whom applications should be addressed-
b The form in which applications should be submitted and information and materials they should include
d Any restrictions or limitations on awards , such as by geographical areas , charitable fields , kinds of institutions , or other factors:
J0A OE1490 1000 Form 990-PF (2010)
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12
31-1633189
Form 990 PF (2010) Page 11
Supplementary Information (continued) Grants and Contributions Paid Durina the Year or Aooroved for Future Payment
Recipient Name and address ( home or business )
If recipient is an individual , show any relationsh i p to an y n macontrinager butor or s ntial Foundation sta t us o f
recipient
Amount
Total
............................................... . NO- 3a
107 000.
Total
35514300
13
31-1633189
Form 990-PF (2010) Page 12
1 Prc gram service revenue. a b c d e If 9 Fees and contracts from government agencies 2 Me mbership dues and assessments , , . , 3 Int, rest on savings and temporary cash investments 4 Dn dends and interest from securities 5 Ne rental income or ( loss) from real estate
a b
. . . . . . . . ,
18
8 Gai n or (loss ) from sales of assets other than inventory 9 Ne income or ( loss) from special events
22 , 464.
. .
10 Gn ss profit or ( loss) from sales of inventory . 11 Otl er revenue a b c d e 12 Su )total Add columns ( b), (d), and (e) . . . 13 Total . Add line 12, columns (b), (d), and (e) . . . . (See worksheet in line 13 instructions on page 29 to verify calculations.)
01
131.
22
. . . . . . . . . . . . . . . 13
595
22,59S.
NOT APPLICABLE
35514300
14
Page 13 31-163 3189 Transfers To and Transactions and Relationships With Noncharitable Information Regarding Exempt Organizations directly or indirectly ( other than engage section in any of the following with any other organization 527, relating to described political Yes No
Did
the
organization 501(c)
in section
of the Code
501(c)(3 )
organizations ) or in section
organizations? a Transfers from the reporting foundation to a nonchantable exempt organization of (1) Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) Other assets b Other transactions (1) Sales of assets to a noncharitable exempt organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) Purchases of assets from a noncharitable exempt organization (3) Rental of facilities, equipment , or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . lb(1) 1b(2) 1b(3) lb(4) 1b(5) lb(6) 1c the fair X X X X X X X market . . . . . . . . . ............... . . a(1) 1a(2) X X
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(4) Reimbursement arrangements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (5) Loans or loan guarantees c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (6) Performance of services or membership or fundraising solicitations . . . . Sharing of facilities, equipment, mailing lists, other assets, or paid employees . . . . . . . . . . . . . . . . . . . . . . . answer to any of the above is "Yes," complete given the following reporting schedule foundation Column If the (b) should always received show value of the goods, other assets, or services by the foundation
d If the
less than
fair market
2a
h
Is
the
foundation
directly
or
indirectly
affiliated
with,
or
related
to,
one
or
more
. .
tax-exempt
. . . .
organizations
. . . . . . . u Yes No
described in section 501(c) of the Code (other than section 501(c)13)) or in section 5277 . . If "Voc " rmmnlotp tho fnllnwinn cchnrfudn (al Name of organization ( b) Type of organization
. . . .
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 or fiduciary ) is based on all informationof which preparer has any knowledge l^c^S Signature of officer or trustee Print /Type preparer ' s name Pr rer's signat
Use Only
FORM 990-PF - PART IV CAPITAL (AINS AND LnSSFS FOR TAX ON INVESTMENT INCOME
Kind of Property Gross sale price less ex enses of sale Depreciation allowed / allowable Cost or other Description FMV 9 as of Adl. basis as of 9 Excess of FMV over ad basis D Date acquired Gain or ( loss ) Date sold
47.00
1.309 CALVERT SOCIAL EQUITY PORT CL A PROPERTY TYPE: SECURITIES 40.00 1132.672 CALVERT SOCIAL EQUITY PORT CL A PROPERTY TYPE: SECURITIES 33,663.00 7.147 NEW ALTERNATIVES FD INC PROPERTY TYPE: SECURITIES 304.00 821.151 NEW ALTERNATIVES FD INC PROPERTY TYPE: SECURITIES 28,202.00 2.329 PARNASSUS FD SBI PROPERTY TYPE: SECURITIES 82.00 1024.683 PARNASSUS FD SBI PROPERTY TYPE: SECURITIES 29,644.00
12/24/2009 7.00 12/03/2008 6,728.00 01/04/2010 -23.00 12/31/2008 4,069.00 12/30/2009 12.00 12/30/2008 11,671.00
12/20/2010
12/20/2010
40,391.00
12/21/2010
281.00
12/21/2010
32,271.00
12/20/2010
94.00
12/20/2010
41,315.00
......
.........................................
22,464.
35514300
16
31-1633189
FORM 990PF, PART I - OTHER INCOME --------------------------------REVENUE AND EXPENSES PER BOOKS
DESCRIPTION
STATEMENT
XD576
2000
12:07:05
35514300
17
31-1633189
FORM 990PF, PART I - OTHER PROFESSIONAL FEES -------------------------------------------REVENUE AND EXPENSES PER BOOKS
DESCRIPTION
CHARITABLE PURPOSES
(A
164. --------------
131. --------------
33. --------------
TOTALS
164. --------------
131. ---------------------------
33. --------------
12:07:05
35514300 18
STATEMENT
31-1633189
DESCRIPTION
STATEMENT
X D576
2000
35514300
19
31-1633189
DESCRIPTION
QK5372 F938
10/14/2011
12:07:05
35514300 20
STATEMENT
31-1633189
FORM 990PF,
PART III
DESCRIPTION
AMOUNT
ROUNDING
TOTAL
1. ----------------------------------------
STATEMENT
XD576
2 000
35514300
21
31-1633189
STATEMENT
XD576 2 000
35514300
22
31-1633189 FARVIEW FOUNDATION 35514300 FORM 990PF, PART XV, LINE 3 - CONTRIBUTIONS, GIFTS, GRANTS PAID ---------------------------------------------------------------
RECIPIENT NAME: INSTITUTE NOETIC SCIENCE ADDRESS: 101 SAN ANTONIO ROAD PETALUMA, CA 94952-9524 RELATIONSHIP:
2,000.
RECIPIENT NAME: FRIENDS OF THE EARTH ADDRESS: 1717 MASSACHUSETTS AV, SUITE 600 WASHINGTON, DC 20036 RELATIONSHIP: NONE PURPOSE OF GRANT: ENVIRONMENTAL FOUNDATION STATUS OF RECIPIENT: N/A
TMnTTTTT n1' (2PTTMT DATn
10,000.
3,000.
31-1633189 FARVIEW FOUNDATION 35514300 FORM 990PF, PART XV, LINE 3 - CONTRIBUTIONS, GIFTS, GRANTS PAID ---------------------------------------------------------------
RECIPIENT NAME:
JUSTICE THROUGH MUSIC ADDRESS:
PO BOX 9576 WASHINGTON, DC 20016 RELATIONSHIP: NONE PURPOSE OF GRANT: VOTING ACTIVISM
FOUNDATION STATUS OF RECIPIENT: N/A AMOUNT OF GRANT PAID ............................................
20,000.
RECIPIENT NAME: PITZER COLLEGE ADDRESS: 1050 NORTH MILLS ROAD CLAREMONT , CA 91711 RELATIONSHIP: NONE PURPOSE OF GRANT: GENERAL SUPPORT FOUNDATION STATUS OF RECIPIENT: N/A AMOUNT OF GRANT PAID ............................................
2,000.
RECIPIENT NAME: PUTNEY SCHOOL ADDRESS: 418 HOUGHTON BROOK RD PUTNEY, VT 05346 RELATIONSHIP: NONE PURPOSE OF GRANT: GENERAL SUPPORT FOUNDATION STATUS OF RECIPIENT: N/A AMOUNT OF GRANT PAID ............................................
2,000.
STATEMENT
X05762000
12:07:05
35514300
24
31-1633189 FARVIEW FOUNDATION 35514300 FORM 990PF, PART XV, LINE 3 - CONTRIBUTIONS, GIFTS, GRANTS PAID ---------------------------------------------------------------
RECIPIENT NAME:
5,000.
RECIPIENT NAME: PACIFIC ENVIRONMENT ADDRESS: 251 KEARNY STREET, 2ND FLOOR SAN FRANCISCO, CA 94108 RELATIONSHIP: NONE PURPOSE OF GRANT: FUNDING FOUNDATION STATUS OF RECIPIENT: N/A AMOUNT OF GRANT PAID ............................................
1,000.
RECIPIENT NAME: FCNL EDUCATION FUND ADDRESS: 245 SECOND STREET, NE WASHINGTON, DC 20002 RELATIONSHIP: NONE PURPOSE OF GRANT: FUNDING FOUNDATION STATUS OF RECIPIENT: N/A
............................................
3,000.
STATEMENT
XD5762000
35514300
25
1615 N STREET, NW WASHINGTON, DC 20036 RELATIONSHIP: NONE PURPOSE OF GRANT: GENERAL SUPPORT
FOUNDATION STATUS OF RECIPIENT: N/A
............................................
2,000.
RECIPIENT NAME: CLASS ACTS ARTS INC ADDRESS: 8100 GEORGIA AVENUE SILVER SPRING, MD 20910 RELATIONSHIP: NONE PURPOSE OF GRANT: FUNDING FOUNDATION STATUS OF RECIPIENT: N/A AMOUNT OF GRANT PAID ............................................
1,000.
RECIPIENT NAME: THE MARYLAND VOTERS FOR ANIMALS ADDRESS: P.O. BOX 6423 ANNAPOLIS, MD 21401 RELATIONSHIP: NONE PURPOSE OF GRANT: GENERAL SUPPORT FOUNDATION STATUS OF RECIPIENT: N/A
............................................
6,000.
STATEMENT
XD5762000
10 -
12:07:05
35514300
26
............................................
1,000.
RECIPIENT NAME: WILD EARTH GUARDIANS ADDRESS: 312 MONTEZUMA AVE, SUITE A SANTA FE, NM 87501 RELATIONSHIP: NONE PURPOSE OF GRANT: FUNDING FOUNDATION STATUS OF RECIPIENT: N/A AMOUNT OF GRANT PAID ............................................
2,000.
............................................
2,000.
STATEMENT
11
XD576 2 000
35514300
27
RECIPIENT NAME: BACK TO THE WILD RESCUE ADDRESS: P.O. BOX 423 CASTALLA, OH 44824 RELATIONSHIP: NONE
& REHAB
10,000.
RECIPIENT NAME: FRIENDS OF FREDERICK COUNTY ADDRESS: 4 EAST CHURCH STREET FREDERICK, MD 21701 RELATIONSHIP: NONE PURPOSE OF GRANT: GENERAL SUPPORT FOUNDATION STATUS OF RECIPIENT: N/A AMOUNT OF GRANT PAID ............................................
10,000.
RECIPIENT NAME: AMAZON WATCH ADDRESS: 1350 CONN. AVE. NW #1100 WASHINGTON, DC 20036 RELATIONSHIP: NONE PURPOSE OF GRANT: GENERAL SUPPORT FOUNDATION STATUS OF RECIPIENT: N/A
............................................
2,000.
STATEMENT
XD576
12
2000
35514300
28
RECIPIENT NAME: INTERSPECIES COMMUNICATION PROJECT ADDRESS: 301 HIDDEN MEADOW FRIDAY HARBOR, WA 98250 RELATIONSHIP:
3,000.
RECIPIENT NAME: ENVIRONMENTAL FILM FESTIVAL ADDRESS: 1228 1/2 31ST STREET NW WASHINGTON, DC 20007 RELATIONSHIP: NONE PURPOSE OF GRANT: GENERAL SUPPORT FOUNDATION STATUS OF RECIPIENT: N/A AMOUNT OF GRANT PAID ............................................
2,000.
MD 20818-1223
............................................
2,000.
13 -
31-1633189 FARVIEW FOUNDATION 35514300 FORM 990PF, PART XV, LINE 3 - CONTRIBUTIONS, GIFTS, GRANTS PAID -----------------------------------------------------------------------------------------------------------------------------
2,000.
RECIPIENT NAME: ALL SPECIES PROJECT ADDRESS: 5644 CHARLOTTE KANSAS CITY, MO 64110 RELATIONSHIP: NONE PURPOSE OF GRANT: ENVIRONMENTAL FOUNDATION STATUS OF RECIPIENT: N/A AMOUNT OF GRANT PAID ..........
4,000.
RECIPIENT NAME: BIONEERS COLLECTIVE HERITAGE INST ADDRESS: 1607 PASEO DE PERALTA, SUITE 3 SANTA FE, NM 87501 RELATIONSHIP: NONE PURPOSE OF GRANT: ENVIRONMENTAL FOUNDATION STATUS OF RECIPIENT: N/A
IM(TTNTT r)P (')1TTT M^TTI
1,000.
STATEMENT
XD576
14 -
2000
35514300
30
31-1633189 FARVIEW FOUNDATION 35514300 FORM 990PF, PART XV, LINE 3 - CONTRIBUTIONS, GIFTS, GRANTS PAID ---------------------------------------------------------------
RECIPIENT NAME: UPAYA ZEN CENTER ADDRESS: 1404 CERRO GORDO ROAD SANTA FE, NM 87501 RELATIONSHIP: NONE
1,000.
RECIPIENT NAME: BOULDER INSTITUTE FOR NATURE & HUMAN SPIRIT ADDRESS: 18679 W 60TH AVE BOULDER, CO 80403 RELATIONSHIP: NONE PURPOSE OF GRANT: ENVIRONMENTAL FOUNDATION STATUS OF RECIPIENT: N/A AMOUNT OF GRANT PAID ............................................
2,000.
RECIPIENT NAME: JANE GOODALL INSTITUTE ADDRESS: 8700 GEORGIA AVE SILVER SPRING, MD 20910 RELATIONSHIP: NONE PURPOSE OF GRANT: EDUCATION FOUNDATION STATUS OF RECIPIENT: N/A AMOUNT OF GRANT PAID ............................................
3,000.
STATEMENT
X1)576
15
2000
12:07:05
35514300
31
31-1633189 FARVIEW FOUNDATION 35514300 FORM 990PF, PART XV, LINE 3 - CONTRIBUTIONS, GIFTS, GRANTS PAID ---------------------------------------------------------------
PO BOX 693
NEW YORK, NY 10013 RELATIONSHIP: NONE
2,000.
CA 94126
NONE PURPOSE OF GRANT: SOCIAL FOUNDATION STATUS OF RECIPIENT: N/A AMOUNT OF GRANT PAID ............................................
1,000.
TOTAL GRANTS
PAID:
107,000. -----------------------------
16 -
OMB No 1545-0092
2010
31-1633189
la
b 2 3 4
Enter the short-term gain or (loss), if any, from Schedule D-1, line 1b . . . . . . . . . . . . . . . . . . . . Short-term capital gain or (loss) from Forms 4684, 6252, 6781, and 8824, , , , , , , , , , , , , , , , , , ,
lb 2 3 4 5
-4
Net short-term gain or (loss) from partnerships, S corporations, and other estates or trusts _ . . . _ . . . Short-term capital loss carryover. Enter the amount, if any, from line 9 of the 2009 Capital Loss Carryover Worksheet ........................... _ 5 Net short-term gain or (loss). Combine lines 1a through 4 in column (f). Enter here and on line 13, column (3) on the back . . ^ T1 l1 Lonq-Term Capital Gains and Losses - Assets Held More Than One Year
(a) Description of property (Example 100 shares 7% preferred of Z" Co (b) Date acquired (mo, day, yr) (c) Date sold (mo, day, yr ) (d) Sales price
-4
( f) Gain or ( loss) for Subt r act (e) from (d)
6a
b Enter the long-term gain or (loss), if any, from Schedule D-1, line 6b, , , , , , , , , , , , , , , , , , , , , , 7 8 9 10 11 12 Long-term capital gain or (loss) from Forms 2439, 4684, 6252, 6781, and 8824 , , , , , , , , , , , , , , ,
6b 7 8 9 10 11 12 (
22 , 468
Net long-term gain or (loss) from partnerships, S corporations, and other estates or trusts , , , , , , , , , , , Capital gain distributions,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ,,,,,,,, Gain from Form 4797, Part I , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Long-term capital loss carryover. Enter the amount, if any, from line 14 of the 2009 Capital Loss Carryover Worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Net long -term gain or (loss). Combine lines 6a through 11 in column (f). Enter here and on line 14a, column (3) on the back . . ^
) 22 , 468
For Paperwork Reduction Act Notice, see the Instructions for Form 1041.
35514300
33
Page 2
Summary of Parts I and II Caution : Read the instructions before completing this part.
13 14 Net short-term gain or (loss ) . . . . . . . . . . . . . . . . . . . Net long -term gain or (loss): a Total for year,,,,,,,,,,,,,,,,,,,,,,,,,,,, b Unrecaptured section 1250 gain (see line 18 of the wrksht.). , , c 28% rate gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 14a 14b 14c
(3) Total
-4 22 , 468.
22 , 464. 15 15 Total net gain or (loss). Combine lines 13 and 14a , , . . . . . ^ Note : If line 15, column (3), is a net gain, enter the gain on Form 1041, line 4 (or Form 990-T, Part 1, line 4a) If lines 14a and 15, column (2), are net gains, go to Part V, and do not complete Part IV If line 15, column (3), is a net loss, complete Part IV and the Capital Loss Carryover Worksheet, as necessary
16
Capital Loss Limitation Enter here and enter as a (loss) on Form 1041, line 4 (or Form 990-T, Part I, line 4c, if a trust), the smaller of: . . . a The loss on line 15, column (3) or b $3,000
16
Note : If the loss on line 15, column (3), is more than $3,000, or if Form 1041, page 1, line 22 (or Form 990-T, line 34), is a loss, complete the Capital Loss Carryover Worksheet on page 7 of the instructions to figure your capital loss carryover
17
22 23 24 25
21 amount from line 4g; otherwise, enter -0- . . ^ Subtract line 21 from line 20 If zero or less, enter -0- . . . . . . . . . . . Subtract line 22 from line 17. If zero or less, enter -0- . . . . .. . . . . . . . Enter the smaller of the amount on line 17 or $2,300 , , , , , . . . . _ . Is the amount on line 23 equal to or more than the amount on line 247 B Yes. Skip lines 25 and 26; go to line 27 and check the "No" box. No. Enter the amount from line 23 , Subtract line 25 from line 24 Are the amounts on lines 22 and 26 the same?
u YeS. Skip lines 27 thru 30 , go to line 31 u NO . Enter the smaller of line 17 or line 22
22 23 24
26 27
25 26
27
28 29 30 31
Enter the amount from line 26 (If line 26 is blank, enter -0-) . . . . . . . . . . 1 28 29 Subtract line 28 from line 27 . . . . . . . . . .. . . . . . . .. . . . . . Multiply line 29 by 15%( 15) . . . . . . . . . . . . .. . . . . . . . . . . . .. . . . Figure the tax on the amount on line 23. Use the 2010 Tax Rate Schedule for Estates and Trusts (see the Schedule G instructions in the instructions for Form 1041) . . . . . . . . . . . . . . . . . . . . . Add lines 30 and 31 ................................. Figure the tax on the amount on line 17. Use the 2010 Tax Rate Schedule for Estates and Trusts (see the Schedule G instructions in the instructions for Form 1041) , , , , , , , , , , , , , , Tax on all taxable income . Enter the smaller of line 32 or line 33 here and on Form 1041, Schedule G, line la (or Form 990-T, line 36) . . . . . . . . . . . .
30 31 32 33 34
Schedule D (Form 1041) 2010
32 33 34
35514300
34
0MB No 1545-0092
2010
( f) Gain or (loss) Subtract ( e) from (d)
LEM
Short-Term Capital Gains and Losses - Assets Held One Year or Less
( a) Description of property (Example 100 sh 7% preferred of 'Z* Co) (d) Sales price
lb Total. Combine the amounts in column (f) Enter here and on Schedule D, line lb
For Paperwork Reduction Act Notice, see the Instructions for Form 1041 .
JSA 0F1221 3 000
. I
-4.00
35514300
35
Schedule D-1 (Form 1041) 2010 Name of estate or trust as shown on Form 1041 Do not enter name and employer identification number if shown on the other side Employer identification number
Page 2
FARVIEW FOUNDATION 35514300 Long-Term Capital Gains and Losses - Assets Held More Than One Year
(a) Description of property ( Example 100 sh. 7% preferred of 'Z' Co ) ( b) Date ( c) Date sold acquired day, ( mo , yr)
31-1633189
(e) Cost or other basis (see instructions) (f) Gain or (loss) Subtract (e) from (d)
6a 1132.672 CALVERT SOCIAL E QUITY PORT CL A 821.151 NEW ALTERNATIVES FD INC 1024.683 PARNASSUS FD SBI
6b Total. Combine the amounts in column (f). Enter here and on Schedule D, line 6b
35514300
36