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1
Form990-Pf
Return of Private Foundation 0MBNo1545-0052

Depulmtnl ol !ht Treuury


ln"rntl RevenueService
or Section 4947lall11NonexemptChant.ableTrust Treated 111 Private Foundation
Noto The orgamzauonmay be eble to use a copy of this return to satisfy state reporting requirements
2002
For the calendar vear Z00Z or tax vear b101nn1na 10101 Z00Z 1nd 1nd1n11 09/30 .2003
G Check.ell that apply D
lmt1al return D Final return I I Amended return I l Address change I I Namechange
Nameol org1nu11lon A Employer 1dantif1c1honnumber
Usotho IRS
label
THE MILSTEIN FAMILY FOUNDATION 95-4824595
Numberand slr111 (or P D bu number II mill 11nol dtllwtrtd lo ,1ru1 address> B T1lepbon1 number(111 p1g1 10 ol 1b1
Otherwua, 1n11rucllons)
print
16027 VENTURABLVD #550
13231933-9306
or typo
Clly or IOWO 11111 10 ZIP + 4 C II 111mp11on1p:llutlD11 ls
pealllngchick 1r1 ~o
See Spec1f1c
Instructions
D 1 Foreignorg1nlz1llons,
chickh111 ~o
ENCINO- CA Cl1436 2 Foreignor\1nu11lo11
m111/1g
Ih1
H Check type of org11niz11tIon 00
Section 501(c)(3)exempt priv11tefound11t1on
as, IHI C ICkh1r1 1t11ch
comp11t1Uon
and
~o
II Section 4947(a)(1) nonexempt ch11rn11ble
trust II Other taxable private foundation
E II prlute lo111ll1tlon
1111111
wu I11ra1n1IIIID
I Fair market value of all assets at end J Accounting method 00 Cash D Accruol checkh1r1 Iii-
unllerHclIon607(b>I.IKAI
of year (from Part II, col le), hne D Other
(spec,
fy) F 11lhel1uad1Uon
11In 1 60-moatb
lerml~~
16)~ S 2.402.694. (Part I, column (d) must be on cash b11sIs
) unller11c11on
S07(b}(l)(BJ,
checkhere
Analy111 of Revenue and Expenses (TheIoI1Iol lalRnenu1an lb) NII IIIVHlmeal lei Adju1tell111 ldl Dlsbur11m1nI1
1moun1S
In columns (bl,(cl,1nll(d)maynolnecn11r1ly1qu1I npen1n per Income Income !or chulI1bl1purp1se1
the1mounlsin calumn11)(111p1a1IDol lhe1n11rucIl1ns)) booh lush b11l1oniv)
1 Contributions, gifts, grants, etc. received (an sch) 807-200. SEE SCHEDr- E 4
Check Iii-D II thelouallallon1111111q11111d
101111ch
Scb B
2 01stribut1onsfrom spl1t-mterest trusts

\ 3 Interest on savingsand temporary cash investments


4 01v1dends
and interest from securnIes 115.142. 115-142. 115.142.
5a Gross rents
b (Net rental income or !loss) I
R 6a Net gam or (loss) from sale of assets not on hne 10
0

0 7
b Gronsalesprlu lor 111u1eI1onhna81
Capitalgamnet mcome !from Part IV, hne 21
n
u 8 Net short-term capital gam
0 9 Income mod1f1cauons
10a Grosssales less returns
and allowances I
b less Cost of goods sold I
C Grossprofit or (loss) (att sch I
11 Other mcome (att sch )
12 Total (oddImes1throuoh 11) 922.342. 115 142 1, 5 142.
0 13 Compensationof officers. directors. trustees, etc
p
0 14 Other employee salaries end wages
r 15 Pensionplans, employee benefits
a
t 16a
I
legal IHI (111scht
a~~ 900. 900.
,~I
n b Acca11nllngl111(111
r:+--SEE
g
C
and 17 ''"" '"'"'""' ,, ''" "ifi\E
Interest
A
d 18 Taxes (attach sche Bi!!@SU~ 2-950. 2-970.
m 19
I
n 20
Oeprec1auon(att s
Occupancy
l- nd depletion
(/)
!!:
'ond.QG[.)EN'UT
I
1 21 Tr11vel,conference
r 22 Prmtmg andpubllca ions
a 23 01h11
u:pensas
(111schI Sli:li: SCHEDUT..E5 20
I
I 24 Total operating and adm1n1stnhve expenses
D
UI 0 Add Imes 13 through 23 3-870- 3 870.
:;--' E.- 25 Contributions, gifts, grants paid 55-600. 5'i.60n.
.,-P
,.-
G
,
...
:.c'. on
26 Total e,cpenses and disbursements Add Imes
14 ond15) 59.470. 59 470.
27 Subtract hne 26 from hne 12
1 Exceu of revenue over expenses and disbursement! 862.872.
b Net 1nvastment income hf negative, enter -0-1 115 142.
142.
C Ad1usted net income hf neaatIve enter -0-)
For Piperworlr. Reduction Act Notice, see the 1nshuctions
115
Farm990-PF 12002) g
2FDPFI 02F 01/23/03
3'~
Form990-Pf l2002) THE MILSTEIN FAMILY FOCJNDATION Q5-4R24595 Page
At11cb1d1cllld11l11
ind IIIOllnll
la th,
l:fUIII Balance Sheets d11crlp1lon columnshouldbl !or and-
ol-vur 1mo111111
only (SH l111ruc1/111)
Beginningof year
1,1 Book.Value lbl BoakValue
Endof year
(cl F11rMarket Value
1 Cash - non-interest-bearing 20-714. 26 246. 26.243.
2 Savings and temporary cash investments 26.707. 50.770. 50-770.
3 Accounts receivable ,..
----... --- . - .. -- - . - - - - - -
Less allowance for doubtful accounts ,..
4 Pledges receivable ... --
Less allowance for doubitUlaCCciuflis.-- - - - - - - - - - - - -
5 Grants receivable
---------
6RtUIYlrlu dut ho~ ofliCl!I,d1t1clon,lruslHI 1ndolhll
d11q111!1
ltd p1uon1IIIICII
scbHu, p1g1IS 011111 11111,
J
A 7 1
,~1:r,d
~~~:i-~t !:tn, ...
less allowance for doubtful accounts..._
e 8 Inventories for sale or use -------------
I
9 Prepa1dexpenses and deferred charges
10, lnw111m111s-U S and11,11
1owa111m1111
obhg1t1on1 111sell)
nw111m11111
b corpon1111ock (1Usell) 896-698. 1-661 840. 1-696 050.
C lnwu1m1111s-
corpon11bonds(1111cll) 549.505. 617.641. 629.631.
11 lnw111m1n11 land b11lld111g1
....
ind 1q11lpm1alb1111 - - - - - - - - - - - - - - - _
lus 1Cc11m11!111ddepreci1Hon...
(1111cb
1cllld11l1)
12 Investments-mortgage loans ----------------
13 Investments-other (att sch)
14 Land b111ld1ng1
1q111pm1n1b11!1
ind ...
- - _ - - - - - - - -
Len 1cc11m11l11tdd1prec11tlon
....
llnacb1ell1d11l1~
15 Other essets escribe ..._
----------------
.. -
- - - - - - - - - - - - - - - - -- -I
16 Toh1I nuts Ito be completed by all filers - see page 16 of
the 1nstruct10ns)Also. see page 1, nem I) 1.493 i:;24. 2.356.497. 2.402 694.
17 Accounts peyeble and accrued expenses
L
I 18 Grants payable

b 19 Deferred revenue
I 20 Loan,lromolliun dlr,cton 1r111tu1,
andOllltrd11q111hll1d
penan1
I Mong-guand01ller110111
I 21 p1y111(111sell)
I Other hab1l1t1es(describe ..._ )
22
I
e -----------------
23 Total h1b1hties (edd Imes 17 through 22)
N Organ,ut,ons th1t follow SFAS117,check here .,.[x]
t 1nd complete lines 24 through 26 and hnu 30 .and31
A 24 Unres1r1cted 1. 493,624. 2,356.497.
25 Temporarilyrestricted
I 26 Permanently restricted
Organizations that do not follow SFAS 117,
or
F
u
checlr:here ind compJeta line, 21 through 31 ...o
n
27 Capnal stock. trust principal. or current funds
d 28 Pe1d-m or capnal surplus. or land, bldg, and equipment fund
8 29 11111/1111111r1111g1
1cc111111l1ttd
/1co11111ndow111enl,
or otherl11nd1 .
I 30 Total net assets or fund b1lnces (see page 16 of the

n 1nstruct1onsl 1-493-624. 2 356-497.


C
e 31 Total h1b1ht1es and net usats/fund b1l1nces (see piige 16
of the ms1ruct1ons) 1 493.624. 2 356.497 .
l:(\jijjl Analysis of Changes in Net Assets or Fund Balances
1 Totiilnet assets or fund balences at beginningof year - Pert II. column (Zl),l1ne 30 1 1-493. 624.
(must agree with end-of-year figure reported on prior year's return)
2 Enter amount from Part I, hne 271 2 862.872.
3 Other increases not included m line 2 (itemize)..._ 3
4 Add Imes 1, 2, and 3
----------------------~------------------ 4 2.356.496.
5 Decreases not inclucfea'1n/me 2 (1tem1zel1111- 5
6 Total net assets or fund balances at end of ve;({i1~e-4~~n~S i,~e-51 -~-
Pe;i1i. C~I~~~ ibi -11n~
j()- - - - - - - - - - 6 2.356.496.
Form 990-PF (10011

2FDPF2 OIF 01/23/03


.
Form99D-PF(ZDDZ) THE MIT,STEIN FAMILY FOUNDATION
11 Capital Gains and Losses for Tax on Investment Income
95-4824595 Page

ibJ How (cl Date


(11 L,st and describe the kmd(slof propertysold leg. realestate, acquired ldl Datesold
acquired
2-story brick warehouse,or commonstock, 200 shs MLCCo) P-Purchase (mo, day,yr I
D-Donat1on (mo dey,yr I
1I
b
d
Ill Deprec1at1on
allowed lgl Cost or other basis lhl Gemor llossl
(el Grosssales price
(or ellowablel plus expense of sale (el plus lfl minus(gl
I
b

d
Completeonly for assets showinggain in column{h)andownedby the foundationon 12/31/69
Ill Gains(Col (h) gainminus
(JI AdJustedbem lkl Excess of col t,I col (k). but not less than -0-)or
hi FM V as of 12/31/69 as of 12/31/69 over col {J),1f any Losses !fromcol (hll
I
b
C

d

If gain,also enter in Part I, hne 7
z Capitalgarnnet incomeor (net capital loss) If (loss),enter -O- rn Part I, hne 7 z
'
3 Net short-term capital gain or (loss)as defined in sections 1222(5)and 16)

.
If gain,also enter 1nPart I. line 8, column(cl (see pages12 and 17 of the 1nstruct1ons)
If (loss).enter -0- in Part I, hne 8
} 3
Qual1ficat1on Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optionaluse by domestic private foundationssubIect to the section 4940Ia)tu on net rnvestmentrncome)

If section 4940{d)l2)applies, leavethis part blank

Was the orgamzat1onhable for the section 4942 tax on the d1smbutableamountof any year in the baseperiod? D Yes D No
If "Yes, the organ1zat1on
does not quahfr under section 4940le} Donot complete this part

1 Enter the appropriateamountin eachcolumn for eachyear, see page 17 of the instructions before makingany entries

111 (bl lei l_dl


Basftperiod years Calendarrear Net value D1str1but1on
ratio
or tax year beginningrn AdIusted qualifying d1str1but1ons of noncharnable-useassets (col (bl d,v1dedby col tell
2001
2000
1999
1998
1997

z Total of hne 1, column(d) z


3 Avera;e d1stribut1onratio for the 5-year baseperiod-d1v1dethe total on hne 2 by 5. or by
the numberof years the foundationhasbeen in existence 1f less than 5 years 3

4 Enter the net valueof noncharnable-useassets for 2002 from Part X, hne 5 4

5 Multiply line 4 by lrne 3 5

6 Enter 1% of net investment rncome(1% of Part I, line 27b) 6

7 Add Imes 5 and 6 7

8 Enter qualifying d1stribut1onsfrom Part XII, hne 4 8


If line 8 Is equalto or greater than line 7, check the box rn Part VI, lrne 1b, andcomplete that part using a 1% tax rate See
the Part VI instructions on page 17
ZfDPF3 OIF D1/23/D3
Form 990-PF 120021
4

s 5-4R245Cl5 4
.
Form99D-PF
(ZDDZJ 'l'UE MIL!=!TEIN F~VIT,V FOUNDATION
Excise Tex Based on Investment Income (Section 4940Tel. 4940(b), 4940 a , or 4948- ne p;
P111
17of the ,n,tr
1 a Exemptoperating foundationsdescribed m section 4940{d)(2).check here D and enter "N/A" on lme 1
Dateof ruling letter !attach copy of ruhng letter 1f necessary - see 1nstruct1ons)
----------------
b DomesticorganIzatIonsthat meet the section 4940(e) requirements m Par1V, check 1 2.303.
here ~D and enter 1% of Part I, line 27b
c All other domestic organIzatIonsenter 2% of lme 27b h1mpIlor11gn
orgnlntion1antar 4,.ol Pin 1,I1n112 col (bl
z Tax under section 511 (domesticsection 4947(a)(1)trusts andtaxable foundationsonly Othersenter -0-) 2
3 Add Imes 1 and 2 3 2.303.
4 Subtitle A !income)tax (domesticsection 4947(1111)
trusts andtaxable foundationsonly Othersenter -0-) 4
5 Tax based on investment income Subtract lme 4 from lme 3 If zero or less, enter -0- 5 2.303.
6 Credits/Payments
,1 2002 esumstedtax paymentsand 2001 overpaymentcredited to 2002 6a 1. 500.
b Exempt foreign org1mzatIons- tax wnhheld at source 6b
c Tax p11dwith 11pphcat1on
for extension of time to file (Form8868) 6c
d Backupwithholding erroneouslywithheld 6d
7 Total credits andpayments Add Imes 611through 6d) 7 1-500.
8 Enter any penalty for underpaymentof estimated tax Checkhere [i] of Form2220 ISattached 8
9 Tax due If the total of lines 5 and 8 Is more than line 7, enter amount owed ~ 9 803.
10 Overpayment If lme 7 Is more than the total of Imes 5 and 8. enter the amount overpaid ~ 10
IRefunded~
.
11 Enter the amountof lme 10 to be Credited to 2003 estimated tax ...
' Statements Regarding Activ1t1es
11

No
1 a Ourmg the tax year. did the org1mz1tIonattempt to influence any national,state, or local legislation or did
It pertIcIpateor intervene m eny political campaign?
,. Yes
X
b Did II spendmore than S100 during the veer (either directly or indirectly) for polnIcal purposes(see page
18 of the instructions for def1mt1on)? lb X
If the answer Is '"Yes" to 1a or 1b, attach a detailed description of the 11ctIv1t1es
andcopies of any materials
publishedor distributed by the organIzatIonm connectionwith the actIvnIes
c 01dthe organIz1tIonfile Form 1120-POL for this year? 1, X
d Enter the amount(If any)of tax on political expenditures(section 4955) imposedduring the year
11)Onthe org11nizatIon... S 0. 121Onorg11niz11tIon
managers S 0.
e Enter the reimbursement(1f any)p111d
by the organizationdurmg the veer for political expenditure tax imposed
on organIz1tIonmanagers ~$ 0. '
z Hasthe organizationengagedmany 11ctIvItIesthat havenot previously been reported to the IRS? 2 X
If '"Yes... attach II detailed description of the 1ctIvIt1es
3 Hasthe organizationmadeany changes,not previously reported to the IRS,m Its governinginstrument,
articles of mcorporatIon.or bylaws, or other sImIlar instruments?If "Yes," attachII conformed copy of the changes 3 X
4 01dthe org11nIz111onhaveunrelatedbusinessgross mcomeof $1,000 or more durmg the year? 4 X
b If "Yes," hesn filed a tax return on Form 990-T for this year? N/A 4b
5 Was there a hqu1dat1on, termmauon.d1ssolut1on or substantialcontraction during the year? N/A 5 X
If 'Yes, attach the statementrequired by GeneralInstruction T
6 Are the requirements of section 508(e)(relating to sections 4941 through4945) satisfied either

By languagem the governinginstrument, or

By state leg1slat1on
that effectively amendsthe governinginstrument so that no mandatoryd1rectrons
6 X
that conflict with the state law remam m the governinginstrument?
7 Did the org1nizetIonhaveat least $5,000 m assetsat any time durmgthe year? If '"Yes." complete Part II, col le). end Port XV 7 X
8 Enter the states to which the foundationreports or with which It Is registered !see page 19 of the
mstrucuons)....
- -CALIFORNIA
- - - - --- ---- - - - - - - - -- ----- - - - - - - - - - - -- - ----- - - - - - - - - - ------ - - - - - - - - -- --- --
b If the answer Is Yes to line 7, hasthe organizationfurnished a copy of Form 990-PF to the Attorney
General!or designate)of eachstate as required by GeneralInstruction G? If "No," attach explanation Sb X
9 Is the organIzatIonclaiming status as a private operating foundationwIthm the meaningof section 4942(J)(3)
or 4942(J)(5)for calendaryear 2002 or the taxable year begmnmgm 2002 (see mstructIons for Part XIV on
page25)7 If "Yes," complete Part XIV 9 X
0 Did any personsbecomesubstantialcontributors during the tax year? If 'Yes," attacha schedulehstmg their namesandaddress 10 X
1 01dthe organizationcomplywith the public mspectIonrequirements for ns annualreturns andexemption 1pphcat1on? 11 X
Web site address _______________________________________________________________________ ____________ _
12 Thcbooksoreoncareof~ BARAK, RICHTER AND DROR, CPA'S Telephoneno ~--p~_~)~~~::~~-q~---

13
~:::::~
:~~i,iir~!~1;e:~;-~-h!1~~:}t~~tI~s-o~f~{
~ 9-q~~--------~o ZIP+
4
- - - -~
andenter the amountof tax-exempt interest received or accruedduring the year NA 13
ZFDPF4OZF O1/23/03 Form 990-PF (2002)
5

5 ,. 5
Statements Regarding Activ1t1es for Which Form 4720 May Be Required
file Form 4720 1f 1ny item II checked 1n the "Yes column, unl111 an exception 1pphe1 Yes No
11 Ourrng the year did the org1mzat1on(either directly or rnd1rectly)
(11 Engagem the sale or exchange,or leasrngof property with II d1squahf1ed
person? ov .. 00No
(21 Borrowmoneyfrom, lendmonevto, or otherwiseextend credit to (or accept It from)
a d1squahf1ed
person? ov .. 00 No
131 Furnishgoods.services, or f1c1l1t1esto (or accept them from)a d1squ1hf1edperson? 0Yes 00 No
141 Paycompens1t1onto, or payor reimbursethe expenses of. a d1squal1f1ed
person? ov .. 00 No
151 Transfer any rncomeor assetsto a d1squ1hf1edperson (or makeany of either available
for the benefit or use of a d1squahf1ed
person)? ov .. 00 No
161 Agree to paymoneyor property to II governmentoff1c1111?
!Exception Check."No"
1f the org1mzat1on
agreedto make a grant to or to employ the off1c11Ifor a period
of governmentservice, If term1natmgwnhm 90 days)
after termm11t1on ov .. 00 No
b If anyanswer 1s"YesHto 11(1)-(6), did any of the acts fail to qualify under the exceptions described m
Regulationssection 53 4941(d)-3 or ma current notice regardmgdisaster assistance(see page 19 of the mstruct1ons)? N/ A lb
Orgamzat1ons
relymg on a current notice regardingdisaster assistancecheck.here ..,. D
c 01dthe orgamzat1on engagema prior year many of the acts described m la, other than excepted acts.
that were not corrected before the first dayof the tax year beg1nnmgm 20027 le X
2 Taxes on failure to d1str1butemcome(section 4942) (doesnot apply for years the org1mzat1on
was a private operatingfoundationdefined 1nsection 4942(1)(3)or 4942(J)(5))
a At the end of the tax year 2002, did the organizationhaveany und1str1buted
mcome(Imes 6d 0Y11 00 No
and 6e, Part XIII) for tax yeads) begmmngbefore 20021
If "Yes," hst the years..,.
b Are there any years listed m 2; f;r-.,;h~Ch- no,-
the Or-g8n1z1t10-n-,S OiSictro; 4942(1)(2)-- - - - - - - - - - -
;ppiy;ng-the provisio-nS
(relating to incorrect valuationof assets)to the year's undistributedmcome?(If applyingsection 4942(1)(2)
to all years listed, answer "No" andattach statement - see page 19 of the mstruct1ons) N/A 2b
c If the prov1s1ons
of section 4942(1)(2)are bemgappliedto any of the years hsted m 211,hst the years here
... ------------- ------------- ------------- -------------
3 a 01dthe organ1zat1on
hold more thana 2% direct or 1nd1rectinterest m eny business
enterprise at any time during the yeer7 Ovas 00 No
b If "Yes," did It haveexcess businessholdingsm 2002 as a result of 10 any purchaseby the organ1z11t1on
or d1squahf1ed
personsafter May 26. 1969. 121the lapseof the 5-year period (or longer period approved
by the Commissionerunder section 4943(c)l7))to disposeof holdingsacquired by gift or bequest.or (31
the lapseof the 10-, 15-, or 20-year first phaseholdingperiod? (UseScheduleC, Form 4720. to determine
If the org1mz1t1on
hadexcess businessholdingsm 20021 N/A 3b
4 1 01dthe organizationmvest durmg the year anyamountma the mannerthat would 1eop1rd1ze
Its charitable purposes? 41 X
b 01dthe org1mzat1on
make any investment ma prior year (but after December31, 1969) that could 1eop1rd1ze
1tscharitable
purposethat hadnot been removed from Jeopardybefore the first dayof the tax year begmnmgm 20027 4b X
5 1 Ourmgthe year did the org11mz1t1onpay or mcur anyamountto
111 Carry on propaganda,or otherwise attempt to influence leg1sl11t1on
(section 4945(ell? ov .. 00 No
121 Influence the outcomeof any spec1f1cpubhcelection (see section 4955), or to carry on.
directly or md1rectly,any voter reg1str1t1on drive? 0Yas 00 No
131 Providea grant to an 1nd1v1dualfor travel. study, or other s1m1larpurposes? 0Yes 00 No
141 Providea grant to an orgamzattonother thana charitable, etc, org11mz1t1on
described
,n section509(all1I.111.or 131,ar section4940ldll117 0Yes [xJ No
151 Provide for any purposeother than rehg1ous.charitable, sc1ent1f1c.
literary, or
educationalpurposes,or for the preventionof cruelty to children or animals? 0Yes 00 No
b If anyenswer 1s"Yes" to 51(1)-(51.did any of the transactionsfail to qualify under the exceptions described 1n
Regulationssection 53 4945 or ma current notice regardmgdisaster assistance(see page20 of the 1nstruct1ons)? N/A Sb
Org1mzat1ons
relymg on a current notice regardmgdisaster assistancecheck.here ...o
c If the answer 1s"'Yes'"to question 5a(4),doesthe orgamzattonclaim exemption from the tax
because1tmamtamedexpenditure respons1b1hty for the grant? Dves 0No
If' Yes, attach the statementrequired by Regulationssection 53 4945-S(d) N/A
6 a Cid the org1mz11t1on,
durmg the year, receive any funds, directly or md1rectly,to pay
premiumson a personalbenefit contract? D Yes [x] No
b 01dthe organ1z1t1on.
during the year, pay premiums,directly or md1rectly,on a personalbenefit contract? 6b X
If b I f1I F rm 7
Farm 990-PF 110011
2FDPF6 Dlf 01/26/02
6
,,,. THE MILSTEIN
990PFl20021 FAMILY FOUNDATION 95-4824595 Page &
l:fiil!JIIIInformation About Officers, Directors. Trustees, Foundation Managers, Highly Paid Employees,
---- and Contractors
1 .
List 111officers directors trustees foundation managers and their compenuhon f11e page 20 of the 1nstruct1onsJ
(bl Title and average (cl Compens11t1on (di Conulbullons10
(1) Nameandaddress hours per week llf not paid, enter 1111ploy11
bl111ll1pl111
(el Expenseaccount,
devotedto n0s1t10n :o-i and d1!1ud comp111111laa other allowances

SEE SCHEDULE 1

2 Compensation of five h1ghest-p11demployees lather than those included on hne 1 - see page 20 of the 1n1truction1)
If none, enter '"NONE..
lb) Title andaverage Id) Conlrlbollons10 fel Expenseaccount,
Iii N1m111111
1ddr111 of 11ch 1raploy11 p1id more than S60 DOD hours per week le) Compensat1on 1mployH b1nefll pl1n1
other allowances
devotedto [10sItIon 1nll ll1f1rrd c:omp1.as11lan

NONE

over $50.000
Total numberof other employeesp111d ... 1
3 Five h1ghest-p11d1ndepandentcontractors for professional services - (see page 20 of the 1n1tructionsl If none, enter
NONE.
111Nameandaddressof eachpersonpaidmore than$50,000 lbl Typeof service lcl Compensation

NONE

Total numberof others receiving over $50,000 for professionalservices ... 1

IQ&W Summary of Direct Charitable Act1v1t1es


List the foundation'sfour largest direct charitableactIv1tIesduringthe tax year Includerelevent statistical mformat1onsuchas the numbe Expenses
of organIzatIonsandother benef1c1ar1es served.conferencesconvened,researchpapersproduced,etc
1
N/A

Form 990-PF (20021

2fDPFS OIF 01/23/03


7
Page 7
hrm 990-PF (1002) THE MILSTEIN FAMILY FOUNDATION 95-4824595
l@i&Q:1Summary of Program-Related Investments !see page 21 of the mstruct,onsl
Describethe two larges1program-related investmentsmadeby the foundationduring the tax year on Imes 1 and 2 Amount

All other program-related investments See page21 of the mstructIons


3

Total Add Imes 1 through3 ...


Minimum Investment Return (All domestic foundatronsmust complete this part Foreign foundations.
see page21 of the mstruct1ons)
Fair mark.etvalueof assets not used (or held for use) directly m carrying out charitable, etc
purposes
a Averagemonthly fair market valueof securities 11 1 885 943.
b Averageof monthly cashbalances 1b 62 217.
c Fair market valueof all other assets (see page22 of the instructions) 1c
d Total (addlines la, b, andcl 1d 1 948 160.
a Reductionclaimed for blockageor other factors reported on lines la and
le (attachdetailed explanation) 11
z Acqu1sn1on
indebtednessapplicableto hne 1 assets z
3 Subtractlme 2 from hne 1d 3 1 948 160.
4 Cashdeemedheld for charitableactIvItIes Enter 1 1/2% of line 3 (for greater amount,see
page22 of the instructions) 4
5 Nat nlua of nonchautable-use HHb Subtract hne 4 from line 3 Enter here andon Part V, line 4 1
6 M1mmuminvestment return Enter 5% of hne 5 8
Distributable Amount !see pege 23 of the mstruct,onsl!Section4942!J)l31
end (Jl!51privateopere11ng
found111ons
andcertain foreign orgamz11tIons
check here ... II and do not complete this part I
1 Mm1mummvestmentreturn from Part X, hne 6 1 95.947.
z a Tax on investment mcome for 2002 from Part VI, hne 5 I Z1 I 2.303.
b Incometax for 2002 (This does not include the tax from Part VI ) I Zb l
c Add lines 211and 2b Ze 2-303-
3 D1stnbutableamountbefore 11d1ustments Subtract 1me2c from line 1 3 93-644.
4 a Recoveriesof amountstreated as quahfying d1strIbut1ons I 41 I
b Incomed1stribut1onsfrom section 4947(a)(2)trusts I 4b I
c Add Imes 411and4b 4c
5 Add Imes 3 and4c 5 93-644.
6 Deductionfrom d1str1butable
amount(see page23 of the instructions) 6
7 D1st11butlblaamount as adiusted Subtract line 6 from /me 5 Enter here andon Part XIII,
line 1 7 Q3 644
.
lifiiPi1JI
Qualifying D1stribut1ons !see pege 23 ol the mstruc11onsl
1 Amountspaid hnc1ud1ng
admInIstratIveexpenses)to accomplishcharitable,etc purposes
a Expenses,contnbut1ons,gifts, etc - total from Part I, column(di. hne 26 11 59.470.
b Program-related investments - Total from Part IX-B 1b
z Amountspaid to acquire assets used(or held for use) directly In carrying out charitable, etc
purposes 2
3 Amountsset aside for spec1f1ccharrtablepro1ectsthat satisfy the
a Su1tab1hty
test (prior IRSapprovalrequired) 31
b Cashd1str1but1on
test (attachthe required schedule) 3b
4 Q1111ify1ng
d11h1but1on1Add lines la through 3b Enter here andon Part V, hne 8 andPart XIII, line 4 4 59-470.
5 Org1mzat1ons
that qualify under section 4940(e) for the reduced rate of tax on net investment
income Enter 1% of Part I, line 27b !see page24 of the mstruct1ons) 5
6 AdJusted qualifying d11trabuhon1 Subtract hne 5 from line 4 6 59.470.
Note The amounton line 6 will be used m Part V. column(bl, in subsequentyears when calculaungwhether the foundation
qualifies for the section 4940(e) reduction of tax in those years
2F0Pf7 Olf 01123103 Form 990-PF !20021
8
hrm 990-Pf (20021 THE MILSTEIN FAMILY FOUNDATION 95-4824595 Page8

liillilll Undistributed Income !see page24 of the 1nstruct1onsl


11) lb) lei ldl
Corpus Yearsprior to 2001 2001 2002
1 01stnbuti11ble
amount tor 2002 from Part XI,
hne 7 93.644.
2 Undistributedincome,1f any, as of the end of 2001
1 Enter amountfor 2001 only 13.992.
b Total for prior years 01 0.
3 E:xcessd1str1but1ons
carryover, 1f any, to 2002
a From 1997
b From1998
C From1999
d From2000
From2001
I Total of lines 311throughe 0.
4 Quahfymgd1stribut1onsfor 2002 from Part
XII,line 4 II>- s 5~,470,
a Applied to 2001, but not more than lme 211 13.992.
b Apphedto undistributed mcomeof prior years
(Electionrequired - see page24 of the 1nstruct10ns) 0.
c Treatedas distributions out of corpus (Electron
required - see page24 of the mstruct10ns)
d Apphedto 2002 distributable amount 45 478.
11 Remammgamountdistributed out of corpus 0.
5 E:xcessdistributions carryover apphedto 2002 0. 0.
Of anamountappearsm column (d), the same
amountmust be shownm column(a))
6 Entar the net total of each column 11
1nd1catedbelow
a Corpus Add Imes 3f, 4c, and4e Subtract lme 5 0.
b Prior years' undistributed income Subtract
hne 4b from hne 2b 0.
c Enter the amountof prior years' und1str1buted
mcomefor which a notice of def1c1encyhasbeen
issued,or on which the section 4942(1)ta:xhas
been previously assessed
d Subtract hne 6c from hne 6b Taxable
amount- see page24 of the mstruc110ns 0.
11Undistributedincome for 2001 Subtract hne 411from
hne 211Ta:xableamount-see page24 of the 1nstrucllon1 0.
I Undistributedincome for 2002 Subtract
Imes 4d and 5 from hne 1 This amountmust be
d1str1butedm 2003 48.166.
7 Amountstreated as d1str1but10ns out of corpus to
satisfy requirements imposedby section 170(b)(1)(E)
or 4942lg)IJ)!see page24 of the mstruct1ons)
8 E:xcessd1str1buuons carryover from 1997 not apphed
on lme 5 or hne 7 (see page25 of the mstruct10ns) 0.
9 Excess d11tnbution1 carryovar to 2003
Subtract Imes 7 and 8 from lme 611 0.
10 Analysis of line 9
I E:xcessfrom 1998
b E:xcessfrom 1999
c E:xcessfrom 2000
d E:xcessfrom 2001
11E:xcessfrom 2002
Form 990-PF 12002)

ZFOPrl OIF 01/23103


9
,,.mm-PF110021 THE MILSTEIN FAMILY F UNDATION 5-4 Poge9
Private Operating Foundations lsee poge25 of the mstruct,onsend Port VII-A,quest,on 9)
11 If the foundationhes received a rulmgor determ1mn1on letter that It 1sa private operating
foundation,and the ruling1seffective for 2002. enter the date of the rulmg
b Check box to 1nd1cate whether the orgamz1t1on1sII private operatma foundauondescribed m section D
...'---=~------
0 4942()IJ
4942I1ll 3l or I 5
21 Enter the lesser of the Tax year Prior 3 years
1d1ustednet income from lal 2002 lbl 2001 lc12000 ldl 1999 lol Tatel
Part I or the mm1mum
investmentreturn from Part
X for eachyear listed
b 85% of line 2o
c Qual1fymgd1stnbut10nsfrom Part
XU.lme 4 for eachyear hsted
d Amo11n11
lncl11hdin hne 2c nol
used tllreclly lor 1ellve cond11c1
ol n1mp1 1clhlllH
a Quellfymgd1stnbut1ons
made
directly for active conduct of
exempt acuvnies Subtract lme 2d
from lme 2c
3 Complete3a, b, or c for the
alternative test rehed upon
a "Assets" alternative test - enter
11) Valueof 11IIassets
f2I V1lu11
ol 111111 11u11ifylng
under11c:Ilon
4942(J)(3)(Sl(O
b 'Endowment" alternative test -
Enter 2/3 of minimum
investment return shown m
Part X, line 6 for each year
hsted
C 'Support" 11ltern11t1ve
test - enter
111 Total support other than
riross investment mcome
nterest, d1v1dends, rents,
paymentson securities
loons(section512loll5ll,
or royalties)
IZI Supporllromgentrll
pabllcandfl 01mor1
uempl 0Ig1nluI1ons
u provldldIn 11ctlon
4942!Jl(3HB)(1l1)
131 lugesI11no111I
al 1appon
lromIII IHOlpl
org1nIz1II011

. 141 Gross investment mcome


Supplemental"( Information (Complete this part only If ~he orgl!nizat1on had $5.000 or more in
assets at any time during the yaar - see page 25 of the 1nstruct1ons.)
Information Regarding Foundation Managau
a list any managersof the foundationwho have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only 1f they have contributed more than $5,000) (See section 507(d)(2))

SEE SCHEDULE 6
b List any managersof the foundationwho own 10% or more of the stock of a corporationfor an equally large portion of the ownershrp
of II partnershipor other entity) of which the found1111on
hasa TO%or greater interest

NONE
2 Information Aagard1ngContnbution, Grant, Gift, loan, Scholar1h1p,etc, Programs
Checkhere ., [xJ 1f the organIz11tIon only makes contributions to preselected charitable organn:atIonsand does not accept unsol1cnedrequests for funds
If the organizationmakes g1hs, grants, etc. (see page 25 of the mstruct1ons)to indIvIdu11ls
or org11mzatIons under other cond1tIons,complete items 211.b, c. and d
a The name,address,and telephone numberof the person to whom 11pphc11t1ons
shouldbe addressed

b The form In which 11pphc11t1ons


shouldbe submitted and information and materials they should mclude

c Any subm1ss1on
deadlines

d Any restrictions or hmIt11tIons


on awards, such as by geographicalareas. charitable fields. kinds of instItutIons. or other factors

2f0.P91 Dlf Dl/23/03 Form 990-Pf 12002)


10
,.,. ,,,_., 120021THE MIL TEIN FAM Y OUNDATION Page10
Supplementary Information (continued)
Grants and Contributions Paid During the Year or Approved for Future Payment
Rec1p1ent II r1clplen1 Is 1n 1ndlvldu1I, Foundation
show 11yr1l11iooshlp 10 Purpose of grant or
status of Amount
1ny lo11nd11lon
m1n1g1r contr1but10n
Nameandaddress(homeor business) or 1ut11111u/1I
cHtrl/Jutor rec1p1ent
I Paid during the year

SEE SCHEDULE 7 55,600.

Total .. 31 55.600 .
b Approved for future payment

Total .. 3b
Form 990-PF (2002)

2fDP92 OIF 04/23/01


11
Form 990-Pf 120021 THE MILSTEIN FAMILY FOUNDATION 95-4824595 Page11

IWil:i'IRIAnalysis of Income-Producing Activ1t1as


Enter gross amountsunless otherwise rnd1cated Unrelatedbusinessrncome Excludedby sect10n512, 513, or 514 lei
A1l1tlll or uempl
11) lb) lei ldl lanctlaa lncom1
Busln11, A111011n1 hct111lon cod, Amo1111 (Su p1g1 28 ol
1 Programservice revenue cod, lh1 lnslrucllons)
I
b
C

d
e
I
g Feesandcontracts from governmentagencies
2 Membershipduesandassessments
3 Interest on savingsandtemporary cashinvestments
4 D1v1dends
andinterest from securities 90000 115-142.
5 Net rental incomeor (loss) from real estate
I Debt-frnanced property
b Not debt-financed property
6 Net rental incomeor (loss) from personalproperty
7 Other investment rncome
8 61/0 or Uon) lrom uln ol 11111101h1r1h11lnuntory
9 Net rncomeor (loss) from special events
10 Grossprofit or (loss) from sales of inventory
11 Other revenue I
b
C

d
e
12 Subtotal Addcolumnslb).Id),and le) 115.142.
13 Total Addline 12, columnslb), Id),end lei .. 13----=1..,_1.,._5.._
..,_14....:-2.._
(Seeworksheet in hne 13 rnstruct1onson page26 to verify calculations)

Relationship of Activities to the Accomplishment of Exempt Purposes


Explernbelow how eachact1v1tyfor which income 1sreported rn column(e) of Part XVI-A contributed importantly to
Lina No the accomplishmentof the organ1zat1on
s exempt purposes(other than by providing funds for such purposes) (See

" page26 of the rnstruct1ons)

ZF0PI I 02F 01/23/03 Form 990-PF 12002)


12
Farm 990-PF (20021 THE MILSTEIN FAMILY FOUNDATION 95-4824595 Pagel
2
Information Regarding Transfers To and Transactions and Relationships With Noncharitable
ltlil4911Exempt Organizations
1 01dthe org11mzat1on
directly or indirectly engagein any of the following with any other organizationdescribed in section YH No
501(c) of the Codelather than secuon 501(c)(J)orgamzauons)or in section 527, relating to poht1calorganizations?
1 Transfers from the reporting organ1zat1on
to a nonch11r1t11ble
exempt orgamzat1on
of
111 Cash 11111 X
(21 Other assets 11121 X
b Other Transactions
111 Salesof assetsto II noncharnableexempt org11n1z11t1on 1bl11 X
121 Purchasesof assets from a nonchantableexempt organIz1mon 1bl21 X
131 Rentalof f11c1ht1es.equipment,or other assets 1bl31 X
141 Reimbursement arrangements 1bl41 X
ISi Loansor loanguarantees 1bl51 X
161 Performanceof services or membershipor fundra1singsohc1tat1ons 1bl61 X
c Sharingof fac1ht1es.equipment,malling hsts. or other assets,or paidemployees le X
d If the answer to any of the above1s"Yes," complete the following schedule Columnlb) shouldalways show the fair market
If the orgamz11t1on
value of the goods,other assets.or services given by the reporting organ1zat1on received less than fair
market value in any transactionor sharingarrangement.show 1ncolumn (di the valueof the goods,other assets, or services
received
lal Line no (bl Amountinvolved (cl Nameof noncharitableexempt organ1z11t1on ldlOescr1pt1onof transfers. transactions,andsharingarrangements
NIA

2 a Is the orgamz1t1on
directly or indirectly al f 1l1ated
with, or related to, one or more tax-exempt org11mzat1ons
described m section 501(c) of the Code(other than section 501(c)(J))or m section 5271 Ores [x]No
b If 'Yes " complete the following schedule
la) Nameof ora11mz11t1on lbl T....e of orn11mzat1on (cl OescrcDt1on
of rel11t10nsh10
NIA

p
Under penal ofpequry, I declare~~xammed thlS return, including accompanyingschedules and s10tements,and to 1he beS1of my knowledge
andbeh , It 1strue. correct, enc complete l11ratIon
of preparer (other thantaxpayer or fiduciary) 1sbasedon all information of which preparer has
I
~any kno
I
ledge
;,(,._
- _
-,
.\i
\01 03 ~ ..v..
l>Z1'2.
~
re5',cAe,.d::::
I
Signatureof officer or trust e Date Tttle
Preparer's SSNor PTIN
Sign
Date Check If self- (SH s,..-. on p1g1 ZB

H
Paud Preparer's
Pre- signature
~ BEN BARAK -vz_~~ ) )-4:..p ~
employed ~ D of lh1 ln11ruc1lon1I

P00369353
r parar's
~ BARAK. RICHTER & DRQR. CPAS EIN~ 95-4809947
a Use firm I nam1 (or youn
Only II 11ll-1mploy1d) 5967 w 3RD ST., SUITE 102 Phoneno
1dll1111,ind ZIP code
L'"' ANGEL"'" - CA cion">6 1323l0'>3-9306
Form 990-PF 120021

ZF0PIZ 0IF 10/18/01


15
SCHEDULE B
(Form990, 990-EZ, Schedule of Contributors
or 990-PFI
D1p111m111
al lbe Tr11I11ry
Supplemenbry lnform1t1on for
hne 1 of Form 990, 990-EZ and 990-PF lsee 1nstructionsl
2002
Internal Rn1nue S1nlc1
Namethe organ1zat1on Employer 1danhrrution number

THE MILSTEIN FAMILY FOTncrnATION


Organ1ution type (check one)

Filers of Section

Form990 or 990-EZ D 501lcll ) (enter number)orgamzat1on

D 4947(a)(1)nonexemptcharnabletrust not treated 11sII private foundation

D 527 pol1t1cal
org11n1zat1on

Form990-PF D 501(c)(3)exempt private foundation

D 4947(8)(1)nonexempt charitabletrust treated as a private foundation

[X] 501(c)(3)taxable private foundation

Check1fyour orgamzauon1scovered by the Gener.alRule or a Spacial Rule !Note Onlya section 501lc)(7),(8),or (10)
can check bodes) for both the GeneralRuleand a SpecialRule - see instructions)
0rg11mzat1on

Gener11Rule -

[xJ For organizationsf1hngForm990. 990-EZ, or 990-PF that received. duringthe tax year. $5.000 or more hn moneyor property)from any
one contributor (CompleteParts I and II)
Special Rules -

D For a section 501(c)(3)organizationf1hngForm990, or Form 990-EZ. that met the 33 1/3% supporttest of the regulationsunder
509(a)(1)/170(b)(1)(A)(v1)
and received from any one contributor.duringthe year, a contr1but1on
of the greater of $5,000 or 2% of the amounton line
1 of these forms (CompleteParts I and II)

D For a section 501(c)(7).(8). or (10) 0rg11mzat1on


filing Farm 990. or Farm 990-EZ, that received from any one contributor,duringthe year, aggregate
contr1but1ons or bequests of more than $1,000 far use exclusivelyfor rehg10us.charitable,sc1entif1c,literary, or educationalpurposes. or the
preventionof cruelty ta children or animals (CompleteParts I, II,and Ill)

D For II section 501(d(7), (8), or (10) organ1zat10n


filing Form990, or Form 990-EZ, that received from any one contributor.duringthe year, same
c0ntr1but1ons for use exclusivelyfor rel1g1ous,charitable.etc. purposes, but these contr1but1onsdid not aggregate to more than S 1,000 Of this
box 1schecked, enter here the total contributionsthat were received duringthe year for an exclusivelyrelrg1ous,charitable.etc , purpose Donot
completeany of the Parts unless the General Rule applies to this orgamz11t1on beceuse 1treceived nonexclus1velyreligious,charitable.etc,
contributionsof $5,000 or mare duringthe year ) ._ S ________ _

Caution Orgamzauansthat are not covered by the GeneralRuleand/or the SpecialRulesdo not file ScheduleB (Form990, 990-EZ, or 990-PF), but they must
check the box in the headingof their Form 990, Farm 990-EZ. or on hne 1 of their Form990-PF, ta certify that they do not meet the f1hngrequirementsof
ScheduleB (Form990, 990-EZ, or 990-PFI

Fa ,-,...t. ...... Ad 111aa.-a.1m1ra::11as ScheduleB (Form 990 or 990-EZ,or 990-PFI(20021


I F- tm _. F- IIO-Z.

2990B1 0lf 01/23/03


16
ScheduleB (Farm990 or 990-EZ, or 990-PF) (2002) Page 1 to of Part I
Nameof organization mp oyer 1denti ,cation number

ltiill Contributors
11) (bl lei (di
No Name, address, and ZIP + 4 Aggregate contribut1on1 Type of contnbution

_l_ TUVIA &: GILA MILSTEIN Person [xJ


Payroll D
16027 VENTURA BLVD #550 s 707,200. Noncuh D
(CompletePart II 1fa
ENCINO, CA 91436 noncashcontnbut10n)

(1) (bl (cl (di


No N1m1,addreu, andZIP + 4 Aggregatecontr1bution1 Type of contr1but10n

_2_ MERAV MILSTEIN Person [xJ


Payroll D
16027 VENTURA BLVD #550 s 50,000. Nonc11h D
(CompletePart II if a
ENCINO, CA 91436 noncashcontnbuuon)

lal (bl lei (di


No Name, address, and ZIP + 4 Aggregatecontr1but10n1 Type of contr1bution

_3 LYRON MILSTEIN Person [xJ


Payroll D
16027 VENTURA BLVD #550 s 50,000. Nonu1h D
!CompletePart II if a
ENCINO, CA 91436 noncashcontnbut1on)

lal lb) lei ldl


No Name, 1ddr111, and ZIP + 4 Aggregate contnbut1on1 Type of contr1butaon

-- Person D
Payroll D
s Nonc11h D
(CompletePart II If a
noncashcontribut10n)

(al lb) lei ldl


No Name, lddr111, and ZIP + 4 Aggregate contr1b11tions Type of contribution

-- Ptuon D
Payroll D
s Nonc11h D
(CompletePart II 1fa
noncashcontr1but1on)

la) lb) lcl ldl


No Name, lddr111, and ZIP + 4 Aggregate contr1bution1 Type of contr1bation

-- Penon D
Payroll D
s Nonush D
(CompletePart /l 1f a
noncashcontr1but1on)

ScheduleB !Form990 or 990-EZ,or 990-PFI120021


299082 0ZF 01/23/03
Federal Attachments
N1m1b>II illow1 on IIIUIII lh11Ul/e11lo1Numb1r

OUNDATION

FORM 990-PF PART VIII - OFFICERS, DIRECTORS, TRUSTEES, KEY EMP'S SCHEDULE 1

NAME AND ADDRESS TITLE HRS/WEEK

TUVIA MILSTEIN PRESIDENT & CEO PART TIM


16027 VENTURA BLVD., #550
ENCINO, CA, 91436

CONTRIBS TO EXPENSE ACCT


COMPENSATION BENFT PLANS & 0TH ALLOWS

0 0 0

NAME AND ADDRESS TITLE HRS/WEEK

GILA MILSTEIN SECRETARY PART TIM


16027 VENTURA BLVD., #550
ENCINO, CA, 91436

CONTRIBS TO EXPENSE ACCT


COMPENSATION BENFT PLANS & 0TH ALLOWS

0 0 0

FORM 990-PF PART I - ACCOUNTING FEES SCHEDULE 2

BOOK NET INVES ADJUSTED CHARITBL


ACCOUNTING FEES REVENUE INCOME NET INCOME PURPOSES

BARAK, RICHTER AND DROR 900. 0. 0. 900.

TOTAL 900. 0. 0. 900.

FORM 990-PF PART I - TAXES SCHEDULE 3


II ii
BOOK NET INVES ADJUSTED CHARITBL
TAXES REVENUE INCOME NET INCOME PURPOSES

2001 TAXES 1450. 0. 0. 2970.


2002 TAXES 1500. 0. 0. 0.

TOTAL 2950. 0. 0. 2970.

2ATTSC Oli/14/01
8
Federal Attachments 2002
N1m1(slu shownon r11urn ldenllllc11lonN11mb1r

rHE MILSTEIN FAMILY FOUNDATION 95-4824595

FORM 990-PF PART I - CONTRIBUTIONS, GIFTS, GRANTS, ETC. SCHEDULE 4

(NOT OPEN FOR PUBLIC INSPECTION)

CONTRIBUTION

CASH CONTRIBUTION:

CONTRIBUTOR NAME: TUVIA & GILA MILSTEIN


CONTRIBUTOR ADDR: 16027 VENTURA BLVD #550
ENCINO, CA 91436 707200

CASH CONTRIBUTION:

CONTRIBUTOR NAME: MERAVMILSTEIN


CONTRIBUTOR ADDR: 16027 VENTURA BLVD #550
ENCINO, CA 91436 50000

CASH CONTRIBUTION:

CONTRIBUTOR NAME: LYRON MILSTEIN


CONTRIBUTOR ADDR: 16027 VENTURA BLVD #550
ENCINO, CA 91436 50000

TOTAL TO FORM 990PF PART I, LINE lA 807200

FORM 990-PF PART I - OTHER EXPENSES SCHEDULE 5

BOOK NET INVES ADJUSTED CHARITBL


DESCRIPTION REVENUE INCOME NET INCOME PURPOSES

MISC 20. 0. o. o.
TOTAL TO FORM 990PF PART I, LINE 23 20. o. o. o.

FORM 990-PF PART XV - OVER $5,000 AND OVER 2% CONTRIBUTOR SCHEDULE 6

NAMES OF FOUNDATIONMANAGERS:

TUVIA MILSTEIN
GILA MILSTEIN

ZATTSC 0&/14101
Federal Attachments 200~
lhm1(1) n ,hownan r1tur11 i,,nullutloo Numbar

rHE MIL~TEIN FAMILY FOUNDATION '15-48245'15

FORM 990-PF PART XV - GRANTS AND CONTRIBUTIONS PAID DURING YEAR SCHEDULE 7

AMOUNT

RECIPIENT NAME: MESIVTA OF GREATER LOS ANGELES


STREET ADDRESS:
CITY, STATE, ZIP CODE: LOS ANGELES, CA

PURPOSE OF GRANT OR CONTRIBUTION:

GENERAL USE

AMOUNT PAID 5000.

RECIPIENT NAME: ASHREINU - JEWISH ED NETWORK


STREET ADDRESS:
CITY, STATE, ZIP CODE: LOS ANGELES, CA

PURPOSE OF GRANT OR CONTRIBUTION:

GENERAL USE

AMOUNT PAID 5000.

RECIPIENT NAME: FRIENDS OF THE IDF


STREET ADDRESS:
CITY, STATE, ZIP CODE: LOS ANGELES, CA

PURPOSE OF GRANT OR CONTRIBUTION:

GENERAL USE

AMOUNT PAID 1000.

RECIPIENT NAME: PEF ISRAEL ENDOWMENTFUND


STREET ADDRESS:
CITY, STATE, ZIP CODE: NEW YORK, NY

PURPOSE OF GRANT OR CONTRIBUTION:

GENERAL USE

AMOUNT PAID 5000.

RECIPIENT NAME: CHILDREN'S HOSPITAL OF LA


STREET ADDRESS:
CITY, STATE, ZIP CODE: LOS ANGELES, CA

PURPOSE OF GRANT OR CONTRIBUTION:

2ATISC 0!t/14/01
0
Federal Attachments 200~
N1m11b)
H sllawnoa re1urn lll1n1lllc11lanNumbtr

EIN FAMILY FOUNDAT N

FORM 990-PF PART XV - GRANTS AND CONTRIBUTIONS PAID DURING YEAR CONTINUE 7

AMOUNT

GENERAL USE

AMOUNT PAID 1000.

RECIPIENT NAME: YAD B'YAD


STREET ADDRESS:
CITY, STATE, ZIP CODE: LOS ANGELES, CA

PURPOSE OF GRANT OR CONTRIBUTION:

GENERAL USE

AMOUNT PAID 3000.

RECIPIENT NAME: CHABAD ISRAEL HOUSE


STREET ADDRESS:
CITY, STATE, ZIP CODE: LOS ANGELES, CA

PURPOSE OF GRANT OR CONTRIBUTION:

GENERAL USE

AMOUNT PAID 3600.

RECIPIENT NAME: PEYLIM LEV L'ACHIM


STREET ADDRESS:
CITY, STATE, ZIP CODE: LOS ANGELES, CA

PURPOSE OF GRANT OR CONTRIBUTION:

GENERAL USE

AMOUNT PAID 10000.

RECIPIENT NAME: AISH HA TORAH


STREET ADDRESS:
CITY, STATE, ZIP CODE: LOS ANGELES, CA

PURPOSE OF GRANT OR CONTRIBUTION:

GENERAL USE

AMOUNT PAID 22000.

2ATISC 0S/14/01
Ml
lnve~lmcnl Socur111cs
ML Stern & Co., Corporole Heodquarler,
8\'iO Wilshire Boulevard, Be\uly I hlh, CA 9021 I (323) 65H-440Uor {HOU)
76'l-22UO www 1111,ILI II u1111
Q~
1~
~+ ,o~~e,
c;-o,...,.u...,

Account Number
55786926
For the Period
09/01/2003 to 09/30/2003
Page
4 of 11 I I MILSTEIN FAMILY FOUNDATION
Account Executive: EZRA SASSON

INVESTMENTS First Average Estimated Estimated %of Estimated


Stm~ol/ Purchase Purchase Markel Market Entire Annual
us1p Date - - Quantity Price Price Value Income =
-
Description

MONEYMARKEiFUNDS
- - - - - - -

26.666860 '
- - - --- - - - ---

1 see .
- - - - - - -

$2666686
Portfolio

406
-
=
.
:..__..,;;;
SHORTTERM1Nc-R:JN&r-MM-et"A
/7-f}A'f 'flELDl o-50%-

MUNICIPALBONDS -=
=
CASHACCOUNTTYPE 01
KERNCNTYCALIFPENSION
OBLIG 492279AS3 08/01/02 40,000 33 933 38 762 $1550480 2 36 Nol Available
--
CAPAPPRECBOOKENTRY
O"lo08/15/19
AAA/ Aaa
==
-==
TOTAL MUNICIPALBONDS 40.000.000 $15,50480 $0.00
CORPORATEBONDS
CASHACCOUNT TYPE01
HOUSEHOLD FINANCE
CORP 441812GDO 11/26/02 50,000 100ODO 113521 $56.76050 865 $3 25000
NOTESBOOKENTRY
6 5% 11/15/08
A / A1 "
HOUSEHOLD FINANCE
CORP 44181ELLO 09/16/02 25.000 100ODD 103085 $25.77125 393 $185000
SENIORNOTESBOOKENTRY
7 4% 09/15/12
A / Al
PACIFICGAS& ELECCO 694308DV6 0.1/22/03 50.000 97 000 102000 $51.00000 7 77 $4 40000
1ST& REFMTG91AREGISTERED
aB%os,01124
CCC /83

fAG F J o.F r-"

a.,111c=n ae CONSIOE;nr-o
THIS STATEf..1EtlT SHAll
-
FINAL AS TO ALL SECURITIES POSITIONS SECURITIES MOVEMENTS MONEY AEC(IVED 01c;mmsco
- .....
, I" n,r-rnrMt 1rv ltl Wf"tllll 1r; TO Tf 1r nnM./f'H ~f \fJ,Vif~ WIT!l!tJ 10 DAYS AF Trl"l AE('(IPT
OR JOIJRl~AL tNTRIF.S

Sit>('
Account Number For the Period Page MILSTEIN FAMILY FOUNDATION
55786926 09/01/2003 to 09/30/2003 5 of 11 Account Executive: EZRA SASSON

INVESTMENTS - (Continued) First Average Estimated Estimated %of Estimated


S~m'?ol/ Purchase Purchase Market Market Entire Annual
Description us1p Date Quantity Price Price Value Portfolio Income
PACIFICGAS& ELECTRIC
CO 694308EG8 02121/03 50,000 96 000 103250 $5162500 7 87 $4.12500
REGISTERED
8 25%11/01/22
CCC/83
TOTAL-CORPORATE
BONDS 175,000000 $185,156.75 $13,625.00
MORTGAGE
BACKED
CASHACCOUNT - TYPE01
FEDERAL NATLMTGASSNREMICPA 31393B5L5 07/21/03 100,000 100777 98 813 $82.33552 1255 $4 58285
CTFSGTDSER2003-50CLD BOOK
5 5%06/25/33
PRINCIPALREMAINING$83.324.59
FEDERAL HMLNMTGCORPMULTICL 31393GFC3 03/18/03 15,000 99 998 99 287 $3 09365 047 $17137
CTFSGTDSER2545CLKJ BOOKE
5 5% 12/15/32
PRINCIPAL REMAINING$3,115.87
FEDERAL HMLNMTGCORPMULTICL 31393KE43 08/15/03 100,000 49 243 100365 $35.01217 5 33 $1 91866
CTFSGTDSER2576CLC BOOKEN
5 5%02/15/33
PRINCIPALREMAINING$34.88485
FEDERAL HMLNMTGCORPMULTICL 31393MAD3 07/21/03 100,000 10025 100 137 $3332064 508 $183012
CTFSGTDSER2579CLDNBOOKE
5 5%03/15/23
PRINCIPALREMAINING$33.27506
,-,
FEDERAL HMLNMTGCORPMULTICL 31393P3R3 07/25/03 50,000 100000 100 156 $4887777 7 45 $268409
CTFSGTDSER2601CLDNBOOKE
5 5%04/15/23
PRINCIPALREMAINING$48.80165
( CI-Gf:" ').-- (';:.,r
MJ.
In, e,~rmenf Securrlre5
ML Stern & Co., Corporole Hcadquarlcrs
Heverly I lilb, Ct\ Y021 I (323) (,SK-4400
8J5fl W1l.slurc HoulcvJrJ, 111 (Hlltl) 7h'l-2.WO \v\\ \\ 11d-.1l 111 '-0111
;~a,.,..,u;,c..

Account Number For the Period Page I MILSTEIN FAMILY FOUNDATION


55786926 09/01/2003 to 09/30/2003 6 of 11 I Account Executivec EZRA SASSON

INVESTMENTS - (Continued) First Average Estimated Estimated %of Estimated


S~mt?ol/ Purchase Purchase Market Market Entire Annual
Description us1p Date Quantity Price Price Value Portfolio Income
FEDERAL HMLN MTGASSNMULTICL 313930HH8 06/10'03 60.000 100 136 100349 $28.39709 433 $155640
CTFSGTDSER2619CL KABOOKE =
5 5%05/15/23
- -
'
~

-- -
.;
PRINCIPAL
FEDERAL
REMAININGS28.298.34
HMLN MTGCORPMULTICL 31393R4W7 09/17/03 110,000 97 951 98 250 $10612579 16 16 $5.94088 - --
=
CTFSGTDSER2617CL CBBOOKE
5 5%05/15/20
PRINCIPAL REMAINING5108.01608
=-=
=
FEDERALNATLMTGASSNRF.MIC
CTFSGTDSER2003-99CLBGBOO
6%06/25/33
PA 31393TRE8 09/24/03 85.000 100000 98 750 $83.93750 1279 $510000 -
-
=
PRINCIPALREMAININGSBS.000
00
GOVERNMENT NATLMTGASSNREMIC 38373SYB7 03/26/03 25.000 10050 100233 $7 86930 1 20 $43180
CTFSGTDSER2003-19CLGCBOO
5 5% 12/16131
AAA/AAA
PRINCIPAL REMAININGS7.851.01
TOTALMORTGAGE
BACKED 645,000.000 ~:,r.fl;r 'I' $428,969 43 $24,216 17
Asselswitha valuelesslhanzeroarenotusedto delerrmne
% of Enl1re
Portfolio

Secunt1es pricesmayvaryfromactualliqu1dalion value Pricesshownshouldonlybe usedas a generalguideto portfoliovalue Pricesarereceived


fromvanouspricingseivices However, pncIngseivIcesaresometimesunableto providetimely1nformat1on
WherepncIngsourcesarenot readily
available,particularly
on certaindebtsecuntIes,
estimatedpncesmaybe generatedbya matnxsystemtakingvariousfactorsintocons1derat10n Where
secuntIeshavenotbeenpriced,suchsecuntIes havenotbeenincludedIntheAccountValueSummaryinformation
Q
at thebeginning orthisstatement
Averagepurchasepnceinformation hasbeenobtainedfromvanoussourcesbelievedto be reliable It Is providedonlyas a convenience
andshouldnot
be relieduponfortaxpreparat,on
or deterrmnmg
actualprofit/loss

'Est1111ated
AnnualIncomeon MunicipalLeasesandMortgageBackedSecuritiesIs basedon currentpnnc1pal
remaining
andwillbe loweras pnnc1pal
Is
returned ~ /"
(A-c,t: 3 i;-.!--f
S'll)(
NASD THIS STATEMENT SHALL BE CONSIDERED FINAL AS TO ALL SECURITIES POSITIONS SECURITICS MOVEMENTS MONEY RECEIVED CJISBUASEO OR JOUArJAL Nlfl1CS
UNLESS YOU REPORT ANY DISCREPANCY IN WRITING TO THE BRANCH MANAGER WITHIM 10 DAYS AFlEll REC[IPT
. I <
,
Account Name MILSTEIN
Statement Date 09/01/2003 to 09/30/2003
----
INVESTMENT
SERVICES, INC .
Celebrating 20 Year,,

PORTFOLIO VALUE
Al a dfaull for opn and mutual funds NFS d1lermlnu cost bas11 using Iha avuao cost singl1 cat,gory (ACSC) m1thod How1V11r if th mutual fund poslllon's cost basis tracking mathod Is
idanllrid cosl (10 COST) Chat Identification Is raflactad For all other ucurltlu NFS dalermlnH cost basil u1Jng the ID Cos! mathod NFS' coil basis lnlormallon may not corrupond to a
customar's cost basl1 lnform111on records If a customer used Iha s~c1f1c share ldanhricallon method prior lo Iha tlm1 Iha! such method tracking was made available by NFS Such cosl bu11
associated gain/Ion and holdlng penod lnlormallon may not raflecl all adjustm1nts n1c1uary for ta)( rapor1lng purposu Cosl basis mformahon for debl secunUes has nol been adJuSled ,~
amor1Izallon or accrellon

Secunt11!s available through UBOC lnveslmanl Services Inc Unless lhey are cer11ficales of deposII within applicable insurance hm1h are nol bank deposits are not obhgat10ns of, or
guaranlHd by UDOC lnwslmenl Services Inc, any bank, or any subsidiary or alnllala thereof, are not insured or guaranlHd by lhe FDIC or unless lhey are gcrwrnmenl sacurllIes by any
other governmanl agency; lnvolw lnvestmenl risk lncludlng the posslbte loss of prtnclpal

CASH AND CASH EQUIVALENfS 1.40%


Symbol/Cu sip Price on Current Prior Esllmal1d
Cuen hon
Money Mar cu
Accounl T
uanlll 09/30/03 Markel Value Market Value Annual Income

HIGHMARK OIVERS~IEDMMKT
CLA HMVXX 24,10347 St 00 $24,10347 $2321527 $16372
7 OAYAVGNETYIELD 37% CASH
Es11mated
Yield O67%
Dividend
OpuonReinvest
Tow Cash and Cash Eqwvalcnu $24,103 47 $163 72

EQUITIES 22.14%
Symbol/Cu sip Pnce on Current Prior EsI1mat1d Total Unrealized
Oascn'1;11on Accounl T:z:2! guanlllx 09130/03 Markel Valye f.Aarl<:IValue Annual Income Cost Basis Gain {Lon}
&Jw1y
BACCAPITAL TRICAPSECSNEW BACPRW 2000 $26 438 $52,87600 152 78000 SJ 50000 J l,oro.
ISSUE PFO7~, 12/15n031 CASH
Es11rnatedY1eld
661"11
H & Q HEALTHCARE FOSHBENINT HOH 4 160 $17 66 $73,46560 $73 499 60 16015748 $13 308 12
Dividend
OptionCash CASH
FINrn1731s,.
UNIONBANCAL UBI 10000 12545 12>450000 $25360000 $1843750 2JT:'.r.c:o.:,
05/l5no19 CASH
Estimated
Yield 7 24%
To1al Equ11y $380 841 60 $21,937 50 $60.157 48 $13 308 12
Total Eqwucs $380,841 60 $21,937 50 SiU,til 111 $13,308 12
Q
3 t r.tJ7

Page 4 of 8 UIIOC INVrsrM[N I srnv1cr.s, INC /\ccounc c.1mc-dwuh NAtion.1.I


fm.1nc1.1I
ServicesI.LC, Member NYS[, ~IPC
030930 280 007190436

rAGe LJ oF A'
I I I I
Account Number. DBP-003930 Ut:iUL
Account Name MILSTEIN
S1a1emenl Date 09/01/2003 to 09/30/2003 INVESTMENT
SERVICES,INC .
Cele6rat1'ng20 Year<1

,,

FIXED INCOME 17.33%


Fot an e)l'planalion of fix1d 1ncom11
pricing plHH sH the last pag1 Esllma1ed Estlmal1d
Symbol/Cuslp Prlc on Cuunt e,r1mald r,10, Esllmaled Tolal Unrallzed
D1scrlet1on Accouril T:i:e: 9:uanlll)! O!J/JO/OJ Markel Valu t,,brket Value Annual Income Co11 Duis CnCL
0 u>
Corporate Bond,
ISRAELSI $BO-AJUBILEE
6 200% 465138WJ5 100000 110000 110000000 $10000000 $610000
06/01/2006 CASH
NextInterestPayable12/01/03
ISRAELSI $BOA 3JUBILEE 5 600% 46513EAC6 100000 $10000 $10000000 $10000000 $560000
05/01/2007 CASH
NextInterest
Payable11/01/03
ISRAELSI I 00 3no JUBILEEISSUE 465\JECG5 100000 $98115 $98 12500 $9999500 $450000
SERA 4 50%05/01/2008 CASH
NextInterest
Payable11/01/UJ
Toial Corpora1c Donw 300,000000 $298,12500 $16300 00
Toial Faud lncornc 300 000000 $798,12500 $16,30000 '
:;oco C\CV()

MlJTIJAL FUNDS 59.13%


Symbol/Cu sip Price on Current Pnor Estimated Tolal Unruhzed
Dtscrl2tlon
Fixtd Income
DODGE & COXINCOME
Account T:t211

OOOIX
guanhlj'.

12,369389
09/J0/OJ

$1292
M'arkef Va/1J11

$289,012
51
Market Value

128303452
Annual Income

$13,86902
Cost BISII
.,
'.l.J',,-5.;,;~
Gain jLossj

Es11mated
Yield 4 79% CASH
01Vldend
Op11onRemvest
VANGUARD GNMAADMIRAL VFUX 31426385 $1056 $331,862
63 $324,93319 $1691447 1326,44432 15,41831
EsumatedYield 5 09% CASH
Or.11dend
OptionReinvest
VANGUAnO SHOnrTERMFEDERAL VSGOX 37 167766 $1066 $39620839 139167500 11285845 138829902 SI 90937
ADMIRAL CASH
Estimated
Yield 3 24%
Dividend
OpuonRainvest
To1al F1:uJ Income SI D17003 53 $43,64194 $71043 34 $13,32768
Toial Mutual Funds $1,017,08353 $43,64194 $714,74334 $13 327 68

Total Sccuriu~J Q $1,696,05013 $81,87944 $77t,36J 82 $26 63580

TOT AL PORTFOLIO VALUE $1,72D,153SD S82,D4316 tn4 ,!!00112'" $26,63580


I (;,f,,16'110
'
Page5of8 UUOC INVE.STMLNTSLRVICCS,INC Al.countcarrn:Jw,chN,1t1on.,Jfm..rnc1alServicesLLC, MemberNYS[, SIPC
030930280007196436
fA-Ge .J ~~ s
13

Form 2220 Underpayment of Estimated Tax by Corporations 0MBNo 1545-0142

Dep1r1men1al Ille Tr111ury


Internal Rnnue Service
See aepar1te 1nstruchon1
..,. Att1c:h to the corponhon's tax return
2002
Name Employerldanllflnllan number

THE MILSTEIN FAMILY FOUNDATION 5


Noh In most cases. the corp0rat10ndoes not need to file Form 2220 (See Part I below for exceptions) The IRSwill figure any penalty
owed and bill the corporet1onIf the corporation does not need to file Form 2220. n may still use n to figure the penalty Enter the
emount from hne 34 on the estimated tax penalty hne of the corporat10n'sincome tax return. but do not attach Form 2220

1(;1;111
Reasonsfor F1hng- Checkthe boxes below that applyto the corpor11t1on If any boxes are checked. the corpor111I0n
must
file Form 2220, even 1f It doesnot owe the penalty If the box on lme 1 or lme 2 applies.the corporationmay be able to
lower or ehmmatethe penalty

D The corporationIs usmgthe annualizedincome installment method


2 D The corporationIs usmgthe ad1ustedseasonalinstallment method
3 D The corporation Is a "large corporation" figuring its first required installment basedon the pnor year's tax

.' . F111urin11
the UnderDavment

4 Total tax (see instructions) 4 2-303.

51 Personalholdingcompanytax (SchedulePH(Form 1120), hne 26) includedon hne 4 51


b look-back interest includedon lme 4 under section 460(bH2)for completed
long-term contracts or section 167(g)for deprec1at1on
under the income forecast
method c

Credit for Federaltax paid on fuels (see instructions) Sc


.Sd
d Total Add Imes Sathrough Sc
6 Sublract hne Sd from lme 4 If the result Is less than $500. do not complete or file this form
The corporationdoes not owe the penalty 6 2.303.
7 Enterthe tax 'iown on the f-/l\for,1ns 200/hncomiJax 'AIJJrn
bee mstr3:t1oni'Caution: If zero or tl;le tax
fiear was or less t n mont s, s 1pt 1s line an en er the amount from line 6 on
ne 8 7

8 Enter thesmaller of lme 6 or lme 7 If the corporation Is required to skip hne 7, enter the amountfrom lme 6 8 2-303.
9 Installment due dates Enter m columns(a) through(d) the la) lb) lei ldl
15thdayof the 4th (Form990-PF !,Ion Use5th
month),6th, 9th. and 12th monthsof the corporat1on's
tax year 9 02/17/03 03/17/03 06/16103 09115103
10 Required 1nstallmenta If the box on lme 1 and/or
hne 2 aboveIs checked. enter the amountsfrom
ScheduleA, line 40 If the box on lme 3 (but not 1
or 21Is checked, see instructions for the amounts
to enter If noneof these boxes are checked,
enter 25% of lme 8 abovem eachcolumn 10 576 571 57' 576
11 Estimatedtax paidor credited for eachperiod !see
mstruct1ons)For column(a)only, enter the amount
from hne 11 on lme 15 11 1-500
Complete lines 12 through 18 of one column
I
before going to the ned column
12 EnI1r1moun1,
11any,fromlln1 1Bol th1pr1cldlngcolumn -
12 !' 92A 341
13 AddImes 11 and 12 13 ' 92A 34!
Add amountson Imes 16 and 17 of the precedingcol
- 14 r r 227
14
15 Subtract hne 14 from lme 13 11mo or less enter-o- 15 1.500 92A 341 0
16 If the amounton hne 15 Is zero, subtract hne 13 from !
lme 14 Otherwise, enter -0- 16
17 Underpayment If hne 15 Is less than or equalto hne
10, subtract lme 15 from line 10 Then go to line 12
of the next column Otherwise. go to hne 18 17 227 576
18 Overpayment If line 10 Is less than hne 15, subtract
lme 10 from line 15 Thengo to lme12 of the next col 'l24 341
18
Complete Part Ill on page 2 to figure the penalty If there are no 11ntr111
on hne 17, no penalty 11 owed

For Paperwork Reduction Act Notice, 111 separate instructions Form 2220 12002)
222201 OlF 12/19/02
14
Form2220 (20021 Page 2

l@jjl Figuring the Penalty


19 Enterthe date of paymentor the 15thdayof the 3rd lal lbl lei ldl
month after the close of the tax year. whichever 1searlier
(see mstruct10ns)IForm990-PFand Form990-T filers
Use5th monthinsteadof 3rd month) 19
20 Numberof days from due date of installment on lme 9
to the date shown on Jme 19 20

21 Number ol d1ys on llne 20 alter 4/1~/2002 and b1!011 1/1/2003 21

22 Underpaymenton hne 17 x Numberof dayson hne 21 x 6% 22 s s s s


365
23 Number ol d1y1 on line 20 alter 12/31/2002 and before 4/1/2003 23

24 Underpaymenton lme 17 x Numberof dayson lme 23 x 5% 24 s s s s


365
25 Number ol d1y1 on hne 20 alter 3/31/2003 and before 7/1/2003 25

26 Underpaymenton tme 17 x Numberof dayson line 25 x


365
.... 26 s s s t

27 Number of days on hne 20 alter 6/30/2003 and before 10/1/2003 27

28 Underpayme'lton hne 17 x Numberof dayson hne 27 x 1a 28 s s s $


365
29 Number ol d1y1 an1111
20 1f11r 9/30/2003 and b1lor1 1/1/2004 29

30 Underpaymenton lme 17 x Numberof dayson hne 29 x % 30 s s s s


365
31 Numbar ol daysonl1n1 20 1fm 12/31/2003 ind b1lore 2/16/2004 31

32 Underpaymenton 1me17 x Numberof dayson 1me31 x % 32 s s s s


366
33 Addlines 22. 24, 26, 28, 30, and 32 33 s s s s
34 Panalty Addcolumnslal through(di,of line 33 Enter the total here andon Form 1120, hne 33, Form 1120-A. lme 29, or the
comparablelme for other mcometax returns 34 s 12.
For underpayments p11dafter March 31, 2003 For Imes 26, 28, 30, and 32, use the penalty interest rate for eachcalendarquarter, which the IRSwill determine during
the first month in the precedingquarter Theserates are pubhshedquarterly in an IRSNews Releaseand in a revenue ruhng in the Internal RevenueBulletin To obt11n
this 1nformat1on
on the Internet, access the IRSs Web Site at www ir1 gov Youcanalso call 1-800-829-1040 to get interest rate information

Form2220 12002)
DATE DUE PAYMENTBALANCE DAYS RATE PENALTY

10/02/02 0 1500 1500- 138 5 0


2/17/03 576 0 924- 28 5 0
3/17/03 576 0 348- 14 5 0
3/31/03 0 0 348- 77 5 0
6/16/03 575 0 227 14 5 0
6/30/03 0 0 227 77 5 2
9/15/03 576 0 803 15 5 2
9/30/03 0 0 803 77 5 8
12/16/03 0 0 0 0 0 0

TOTAL 12

222202 01 F 12118/02

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