efile Public Visual Render
ObjectId: 201410289349100101 - Submission: 2014-01-28
TIN: 72-1399703
Form
990-PF
Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Nonexempt Charitable Trust
Treated as a Private Foundation
Note.
The foundation may be able to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0052
20
12
Open to Public Inspection
For calendar year 2012, or tax year beginning
09-01-2012
, and ending
08-31-2013
Name of foundation
THE ROBERT AND LOIS LUCKIE CHARITABLE FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)
600 LUCKIE DRIVE
Room/suite
City or town, state, and ZIP code
BIRMINGHAM
,
AL
352232429
A Employer identification number
72-1399703
B
Telephone number (see instructions)
(205) 879-2121
C
If exemption application is pending, check here
G
Check all that apply:
Initial return
Initial return of a former public charity
Final return
Amended return
Address change
Name change
D 1.
Foreign organizations, check here .............
2.
Foreign organizations meeting the 85% test,
check here and attach computation ...........
H
Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
I
Fair market value of all assets at end
of year
(from Part II, col. (c),
line 16)
$
2,927,128
J
Accounting method:
Cash
Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)
E
If private foundation status was terminated
under section 507(b)(1)(A), check here .........
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here .........
Part I
Analysis of Revenue and Expenses
(The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).)
(a)
Revenue and
expenses per
books
(b)
Net investment
income
(c)
Adjusted net
income
(d)
Disbursements
for charitable
purposes
(cash basis only)
1
Contributions, gifts, grants, etc., received (attach schedule)
270,000
2
Check
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
......
91,622
91,622
91,622
5a
Gross rents
..............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
94,753
b
Gross sales price for all assets on line 6a
749,714
7
Capital gain net income (from Part IV, line 2)
...
94,753
8
Net short-term capital gain
.........
42,232
9
Income modifications
...........
10a
Gross sales less returns and allowances
1,555
b
Less: Cost of goods sold
....
11,317
c
Gross profit or (loss) (attach schedule)
.....
-9,762
-9,762
11
Other income (attach schedule)
.......
12
Total.
Add lines 1 through 11
........
446,613
186,375
124,092
13
Compensation of officers, directors, trustees, etc.
0
0
0
0
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
2,461
0
0
0
c
Other professional fees (attach schedule)
....
28,707
28,707
0
0
17
Interest
...............
74
74
0
0
18
Taxes (attach schedule) (see instructions)
1,046
0
0
0
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
13,604
0
0
0
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
45,892
28,781
0
0
25
Contributions, gifts, grants paid
........
104,285
104,285
26
Total expenses and disbursements.
Add lines 24 and 25
150,177
28,781
0
104,285
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
296,436
b
Net investment income
(if negative, enter -0-)
157,594
c
Adjusted net income
(if negative, enter -0-)
...
124,092
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2012)
Page 2
Form 990-PF (2012)
Page
2
Part II
Balance Sheets
Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year
End of year
(a)
Book Value
(b)
Book Value
(c)
Fair Market Value
1
Cash—non-interest-bearing
...............
2
Savings and temporary cash investments
..........
74,264
185,798
186,699
3
Accounts receivable
Less: allowance for doubtful accounts
4
Pledges receivable
Less: allowance for doubtful accounts
5
Grants receivable
.................
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see page 15 of the
instructions)
....................
7
Other notes and loans receivable (attach schedule)
Less: allowance for doubtful accounts
8
Inventories for sale or use
...............
9
Prepaid expenses and deferred charges
...........
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
........
1,686,619
1,946,741
2,221,020
c
Investments—corporate bonds (attach schedule)
........
50,998
122,245
111,769
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
..............
13
Investments—other (attach schedule)
...........
460,015
355,291
407,640
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
2,271,896
2,610,075
2,927,128
17
Accounts payable and accrued expenses
..........
18
Grants payable
...................
19
Deferred revenue
..................
20
Loans from officers, directors, trustees, and other disqualified persons
21
Mortgages and other notes payable (attach schedule)
......
22
Other liabilities (describe
)
23
Total liabilities
(add lines 17 through 22)
..........
0
0
Foundations that follow SFAS 117, check here
and complete lines 24 through 26 and lines 30 and 31.
24
Unrestricted
....................
25
Temporarily restricted
................
26
Permanently restricted
................
Foundations that do not follow SFAS 117, check here
and complete lines 27 through 31.
27
Capital stock, trust principal, or current funds
.........
0
0
28
Paid-in or capital surplus, or land, bldg., and equipment fund
0
0
29
Retained earnings, accumulated income, endowment, or other funds
2,271,896
2,610,075
30
Total net assets or fund balances
(see page 17 of the
instructions)
....................
2,271,896
2,610,075
31
Total liabilities and net assets/fund balances
(see page 17 of
the instructions)
..................
2,271,896
2,610,075
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 30 (must agree
with end-of-year figure reported on prior year’s return)
...............
1
2,271,896
2
Enter amount from Part I, line 27a
.....................
2
296,436
3
Other increases not included in line 2 (itemize)
3
41,743
4
Add lines 1, 2, and 3
..........................
4
2,610,075
5
Decreases not included in line 2 (itemize)
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30
.
6
2,610,075
Form
990-PF
(2012)
Page 3
Form 990-PF (2012)
Page
3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a)
List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)
(b)
How acquired
P—Purchase
D—Donation
(c)
Date acquired
(mo., day, yr.)
(d)
Date sold
(mo., day, yr.)
1 a
PROTECTIVE LIFE COPR 7.25%
2012-09-04
b
ARIO INTERNATIONAL EQUITY FUND II CL I
2011-12-29
2012-09-26
c
ARIO INTERNATIONAL EQUITY FUND II CL I
2008-12-30
2012-09-26
d
ARIO INTERNATIONAL EQUITY FUND II CL I
2008-12-30
2012-09-26
e
ARIO INTERNATIONAL EQUITY FUND II CL I
2010-12-30
2012-09-26
ARIO INTERNATIONAL EQUITY FUND II CL I
2008-04-04
2012-09-26
THOMAS WHITE INTERNATIONAL FD
2012-10-01
THOMAS WHITE INTERNATIONAL FD
2011-10-26
2012-10-01
PRUDENTIAL JENNISON 20/20 FOCUS FD
2008-02-11
2012-10-01
PROTECTIVE LIFE COPR 7.25%
2012-10-12
EXXON MOBIL CORPORATION
1989-06-05
2012-12-07
EXXON MOBIL CORPORATION
2012-06-08
2012-12-07
EATON VANCE LARGE CAP VALUE FD CL A
2008-02-11
2013-01-04
CREE INCORPORATED
2004-07-14
2013-05-15
FPA CRESCENT INSTITUTIONAL
2012-12-18
2013-03-22
FPA CRESCENT INSTITUTIONAL
2012-12-18
2013-04-22
BANK OF AMERICA PRD
2009-12-18
2013-06-06
FPA CRESCENT INSTITUTIONAL
2012-12-18
2013-06-06
EATON VANCE LARGE CAP VALUE FD CL A
2013-06-11
EATON VANCE LARGE CAP VALUE FD CL A
2013-06-11
EATON VANCE LARGE CAP VALUE FD CL A
2012-03-09
2013-06-11
EATON VANCE LARGE CAP VALUE FD CL A
2008-02-11
2013-06-11
GUGGENHEIM ENHANCED EQUITY
2012-04-24
2013-06-25
SOUTHERN COMPANY
2006-09-18
2013-06-26
SOUTHERN COMPANY
2003-07-25
2013-06-26
FPA CRESCENT INSTITUTIONAL
2013-07-23
FPA CRESCENT INSTITUTIONAL
2013-08-15
PRUDENTIAL JENNISON
2013-08-16
FPA CRESCENT INSTITUTIONAL
2013-12-18
2013-08-16
FEDERATED STRATAEGIC VALUE FD
2013-08-16
EATON VANCE LARGE CAP VALUE FD CL A
2008-02-11
2012-11-11
MORGAN KEEGAN PRIVATE EQUITY FD
ENTERPRISE PRODUCTS PARTNERS LP
CAPITAL GAIN DISTRIBUTIONS RAYMOND JAMES/MORGAN KEEGAN
ENTERPRISE PRODUCTS PARTNERS LP
KINDER MORGAN ENERGY PARTNERS
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
46,800
36,224
10,576
b
973
884
89
c
1,686
1,590
96
d
2,238
2,560
-322
e
1,001
1,196
-195
20,141
31,192
-11,051
19,469
20,500
-1,031
366
340
26
15,777
13,385
2,392
4,223
3,858
365
43,772
41,965
1,807
43,772
30,684
13,088
2,197
2,286
-89
22,436
12,250
10,186
50,000
49,052
948
2,280
2,280
0
50,000
48,595
1,405
75,000
70,594
4,406
1,775
1,543
232
5,211
3,718
1,493
265
219
46
91,255
85,387
5,868
16,802
19,326
-2,524
42,651
34,683
7,968
21,326
17,680
3,646
2,350
2,206
144
35,000
32,169
2,831
25,000
19,972
5,028
50,000
45,493
4,507
25,000
21,747
3,253
725
759
-34
10,201
10,201
854
854
19,168
19,168
25
-25
599
-599
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-)
or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
Excess of col. (i)
over col. (j), if any
a
10,576
b
89
c
96
d
-322
e
-195
-11,051
-1,031
26
2,392
365
1,807
13,088
-89
10,186
948
0
1,405
4,406
232
1,493
46
5,868
-2,524
7,968
3,646
144
2,831
5,028
4,507
3,253
-34
10,201
854
19,168
-25
-599
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
94,753
3
Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
3
42,232
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)
If section 4940(d)(2) applies, leave this part blank.
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period?
Yes
No
If “Yes,” the foundation does not qualify under section 4940(e). Do not complete this part.
1
Enter the appropriate amount in each column for each year; see page 18 of the instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in)
(b)
Adjusted qualifying distributions
(c)
Net value of noncharitable-use assets
(d)
Distribution ratio
(col. (b) divided by col. (c))
2011
87,590
2,285,058
0.038332
2010
83,685
2,020,694
0.041414
2009
90,050
1,657,509
0.054329
2008
65,656
1,183,127
0.055494
2007
84,768
1,363,113
0.062187
2
Total
of line 1, column (d)
......................
2
0.251756
3
Average distribution ratio for the 5-year base period—divide the total on line 2 by 5, or by
the number of years the foundation has been in existence if less than 5 years
.
.
.
3
0.050351
4
Enter the net value of noncharitable-use assets for 2012 from Part X, line 5
.....
4
2,787,458
5
Multiply line 4 by line 3
.......................
5
140,351
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
1,576
7
Add lines 5 and 6
.........................
7
141,927
8
Enter qualifying distributions from Part XII, line 4
..............
8
104,285
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See
the Part VI instructions.
Form
990-PF
(2012)
Page 4
Form 990-PF (2012)
Page
4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see page 18 of the instructions)
1a
Exempt operating foundations described in section 4940(d)(2), check here
and enter “N/A” on line 1.
Date of ruling or determination letter:
(attach copy of letter if necessary–see instructions)
b
Domestic foundations that meet the section 4940(e) requirements in Part V, check
1
3,152
here
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
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
2
0
3
Add lines 1 and 2
............................
3
3,152
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-).
4
0
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
3,152
6
Credits/Payments:
a
2012 estimated tax payments and 2011 overpayment credited to 2012
6a
b
Exempt foreign organizations—tax withheld at source
.......
6b
c
Tax paid with application for extension of time to file (Form 8868)
6c
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
0
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
72
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
3,224
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
11
Enter the amount of line 10 to be:
Credited to 2013 estimated tax
Refunded
11
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see page 19 of
the instructions for definition)?
............................
1b
No
If the answer is “Yes” to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
0
(2)
On foundation managers.
$
0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If “Yes,” attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If “Yes,” attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If “Yes,” has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If “Yes,” attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
Yes
7
Did the foundation have at least $5,000 in assets at any time during the year?
If “Yes,” complete Part II, col. (c), and Part XV.
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
AL
b
If the answer is “Yes” to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G?
If “No,” attach explanation
.
8b
Yes
9
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
or 4942(j)(5) for calendar year 2012 or the taxable year beginning in 2012 (see instructions for Part XIV)?
If “Yes,” complete Part XIV
.............................
9
No
10
Did any persons become substantial contributors during the tax year?
If “Yes,” attach a schedule listing their names and addresses.
10
No
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. (see instructions)
.............
11
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement (see instructions)
.................
12
No
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
N/A
14
The books are in care of
JOHN WILSON CPA
Telephone no.
(205) 802-7212
Located at
2101 HIGHLAND AVE S SUITE 500
BIRMINGHAM
AL
ZIP+4
35205
15
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
16
At any time during calendar year 2012, 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?
.................
16
No
See instructions for exceptions and filing requirements for Form TD F 90-22.1. If "Yes", enter the name of the foreign country
Form
990-PF
(2012)
Page 5
Form 990-PF (2012)
Page
5
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the “Yes” column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1)
Engage in the sale or exchange, or leasing of property with a disqualified person?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
.........................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(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)?
.................
Yes
No
(6)
Agree to pay money or property to a government official? (
Exception.
Check “No”
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.)
.........
Yes
No
b
If any answer is “Yes” to 1a(1)–(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance (see page 20 of the instructions)?
...
1b
Organizations relying on a current notice regarding disaster assistance check here
.........
c
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2012?
.............
1c
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2012, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2012?
...............
Yes
No
If “Yes,” list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer “No” and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
.........................
Yes
No
b
If “Yes,” did it have excess business holdings in 2012 as a result of
(1)
any purchase by the foundation
or disqualified persons after May 26, 1969;
(2)
the lapse of the 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or
(3)
the lapse of the 10-, 15-, or 20-year first phase holding period?
(Use Schedule C, Form 4720, to determine
if the foundation had excess business holdings in 2012.)
....................
3b
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2012?
4b
No
5a
During the year did the foundation pay or incur any amount to:
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
...............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(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 instructions)
........
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
........
Yes
No
b
If any answer is “Yes” to 5a(1)–(5), did
any
of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance (see instructions)?
......
5b
Organizations relying on a current notice regarding disaster assistance check here
.........
c
If the answer is “Yes” to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant?
............
Yes
No
If “Yes,” attach the statement required by Regulations section 53.4945–5(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract?
........................
Yes
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
....
6b
No
If “Yes” to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
Yes
No
b
If yes, did the foundation receive any proceeds or have any net income attributable to the transaction?
....
7b
Form
990-PF
(2012)
Page 6
Form 990-PF (2012)
Page
6
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1
List all officers, directors, trustees, foundation managers and their compensation (see instructions).
(a)
Name and address
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(If not paid, enter
-0-)
(d)
Contributions to
employee benefit plans
and deferred compensation
(e)
Expense account,
other allowances
ROBERT E LUCKIE III
PRESIDENT
0.00
0
0
0
600 LUCKIE DRIVE
BIRMINGHAM
,
AL
35223
THOMAS G LUCKIE
VICE PRESIDENT
0.00
0
0
0
600 LUCKIE DRIVE
BIRMINGHAM
,
AL
35223
2
Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE.”
(a)
Name and address of each employee paid more than $50,000
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
NONE
Total
number of other employees paid over $50,000
...................
0
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
NONE
Total
number of others receiving over $50,000 for professional services
.............
0
Part IX-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
2
3
4
Form
990-PF
(2012)
Page 7
Form 990-PF (2012)
Page
7
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
2
All other program-related investments. See page 24 of the instructions.
3
Total.
Add lines 1 through 3
..........................
0
Part X
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations,
see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities
...................
1a
2,677,019
b
Average of monthly cash balances
.......................
1b
152,888
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
2,829,907
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation)
.............
1e
0
2
Acquisition indebtedness applicable to line 1 assets
..................
2
0
3
Subtract line 2 from line 1d
.........................
3
2,829,907
4
Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see
instructions)
.............................
4
42,449
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
2,787,458
6
Minimum investment return.
Enter 5% of line 5
..................
6
139,373
Part XI
Distributable Amount
(see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here
and do not complete this part.)
1
Minimum investment return from Part X, line 6
....................
1
2a
Tax on investment income for 2012 from Part VI, line 5
......
2a
b
Income tax for 2012. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
4
Recoveries of amounts treated as qualifying distributions
................
4
5
Add lines 3 and 4
............................
5
6
Deduction from distributable amount (see instructions)
.................
6
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII,
line 1
................................
7
Part XII
Qualifying Distributions
(see instructions)
1
Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
a
Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26
..........
1a
104,285
b
Program-related investments—total from Part IX-B
..................
1b
0
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
b
Cash distribution test (attach the required schedule)
.................
3b
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
104,285
5
Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
income. Enter 1% of Part I, line 27b (see instructions)
.................
5
0
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
104,285
Note:
The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
the section 4940(e) reduction of tax in those years.
Form
990-PF
(2012)
Page 8
Form 990-PF (2012)
Page
8
Part XIII
Undistributed Income
(see instructions)
(a)
Corpus
(b)
Years prior to 2011
(c)
2011
(d)
2012
1
Distributable amount for 2012 from Part XI, line 7
2
Undistributed income, if any, as of the end of 2012:
a
Enter amount for 2011 only
.......
b
Total for prior years:
20
,
20
,
20
3
Excess distributions carryover, if any, to 2012:
a
From 2007
.......
b
From 2008
.......
c
From 2009
.......
d
From 2010
.......
e
From 2011
.......
f
Total
of lines 3a through e
.........
4
Qualifying distributions for 2012 from Part
XII, line 4:
$
a
Applied to 2011, but not more than line 2a
b
Applied to undistributed income of prior years
(Election required—see instructions)
......
c
Treated as distributions out of corpus (Election
required—see instructions)
.........
d
Applied to 2012 distributable amount
.....
e
Remaining amount distributed out of corpus
5
Excess distributions carryover applied to 2012.
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
...........
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
e
Undistributed income for 2011. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
f
Undistributed income for 2012. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2013
..........
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (see
instructions)
.............
8
Excess distributions carryover from 2007 not
applied on line 5 or line 7 (see instructions)
...
9
Excess distributions carryover to 2013.
Subtract lines 7 and 8 from line 6a
......
10
Analysis of line 9:
a
Excess from 2008
....
b
Excess from 2009
....
c
Excess from 2010
....
d
Excess from 2011
....
e
Excess from 2012
....
Form
990-PF
(2012)
Page 9
Form 990-PF (2012)
Page
9
Part XIV
Private Operating Foundations
(see instructions and Part VII-A, question 9)
1a
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2012, enter the date of the ruling
.......
1999-05-25
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2012
(b)
2011
(c)
2010
(d)
2009
124,092
76,629
61,021
52,157
313,899
b
85% of line 2a
.........
105,478
65,135
51,868
44,333
266,814
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
104,285
87,590
83,685
90,050
365,610
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
....
0
0
0
0
0
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
104,285
87,590
83,685
90,050
365,610
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets” alternative test—enter:
(1)
Value of all assets
......
0
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
0
b
“Endowment” alternative test— enter 2⁄3
of minimum investment return shown in
Part X, line 6 for each year listed
...
92,915
76,169
67,357
55,250
291,691
c
“Support” alternative test—enter:
(1)
Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
....
0
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
0
(3)
Largest amount of support
from an exempt organization
0
(4)
Gross investment income
0
Part XV
Supplementary Information (Complete this part only if the organization had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
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).)
b
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.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. (see instructions) to individuals or organizations under
other conditions, complete items 2a, b, c, and d.
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:
c
Any submission deadlines:
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Form
990-PF
(2012)
Page 10
Form 990-PF (2012)
Page
10
Part XV
Supplementary Information
(continued)
3 Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
ADDICTION COALITION
200 UNION HILL STE 101
BIRMINGHAM
,
AL
35209
CREATE AND SUPPORT PREVENTION PROGRAMS TO ELIMINATE ADDICTION
500
ALABAMA FOREVER
2 DEXTER AVENUE
MOUNTAIN BROOK
,
AL
35213
HELP COMMUNITIES IN NEED
250
ALABAMA GOLF ASSOCIATION
1025 MONTGOMERY HIGHWAY SUITE 210
BIRMINGHAM
,
AL
35216
SCHOLARSHIP
4,500
ALABAMA POLICY INSTITUTE
402 OFFICE PART DRIVE SUITE 300
MOUNTAIN BROOK
,
AL
35223
RESEARCH AND EDUCATION
1,000
ALABAMA SCHOOL OF FINE ARTS
1800 REVEREND ABRAHAM WOODS JR BLVD
BIRMINGHAM
,
AL
35203
SCHOLARSHIPS
1,500
ALABAMA SPORTS FESTIVAL FOUNDATION
P O BOX 20327
MONTGOMERY
,
AL
36120
MENTOR PROGRAM FOR TEACHING YOUTH IMPORTANCE OF ACADEMICS, HEALTHY LIEFESTYLE AND GOOD CITIZENSHIP
500
ALABAMA SYMPHONY
3621 6TH AVENUE SOUTH
BIRMINGHAM
,
AL
35222
ENDOWMENT OF THE MUSICAL ARTS
1,500
ALYS STEPHENS CENTER
1200 10TH SVENUE SOUTH
BIRMINGHAM
,
AL
35205
EDUCATE, INSPIRE AND NUTURE THE PERFORMING ARTS
250
AMERICAN CANCER SOCIETY
1104 IRELAND WAY
BIRMINGHAM
,
AL
35205
CANCER RESEARCH AND TREATMENT
150
AMERICAN HEART ASSOCIATION
7272 GREENVILLE AVE
DALLAS
,
TX
75231
CARDIOVASCULAR DISEASE RESEARCH
500
AUBURN UNIVERSITY FOUNDATION
317 SOUTH COLLEGE STREET
AUBURN
,
AL
36849
DEVELOPE, SUPPORT AND ENCHANGE EDUCATIONAL INTEREST AND PROGRAM OF AUBURN UNIVERSITY
1,770
BALLET GUILD OF BIRMINGHAM
P O BOX 530204
BIRMINGHAM
,
AL
35253
SUPPORT THE PERFORMING ARTS
250
BBVA COMPASS BOWL
505 20TH STREET NORTH
BIRMINGHAM
,
AL
35203
SUPPORT OF LOCAL CHARITIES
1,125
BELL CENTER FOR EARLY INTERVENTION PROGRAMS
1700 29TH COURT SOUTH
BIRMINGHAM
,
AL
35209
PROVIDE TREATMENT AND THERAPY FOR SPECIAL NEEDS CHIL
500
BENEDICTINE SISTERS
916 CONVENT ROAD
CULLMAN
,
AL
35055
CHURCH
1,000
BIG BROTHERS BIG SISTERS BIRMINGHAM
1901 14TH AVENUE SOUTH
BIRMINGHAM
,
AL
35205
NUTURE CHILDREN FACING ADVERSITY
450
BIRMINGHAM BOTANICAL GARDENS
2612 LANE PARK RD
BIRMINGHAM
,
AL
35223
CONSERVATION
500
BIRMINGHAM CIVIL RIGHTS INSTITUTE
520 16TH STREET NORTH
BIRMINGHAM
,
AL
35203
CENTER FOR EDUCATION AND DISCUSSION ABOUT CIVIL AND HUMAN RIGHTS
1,000
BIRMINGHAM EDUCATION FOUNDATION
PO BOX 1476
BIRMINGHAM
,
AL
35201
ACADEMIC EXCELLENCE FOR BIRMINGHAM PUBLIC SCHOOL
4,000
BIRMINGHAM MUSIC CLUB
P O BOX 10486
BIRMINGHAM
,
AL
35202
SCHOLARSHIPS
500
CANTERBURY UNITED METHODIST CHURCH
350 OVERBROOK ROAD
BIRMINGHAM
,
AL
35213
GENERAL CHURCH OPERATIONS
700
CATHOLIC CENTER FOR CONCERN BIRMINGHAM AL
712 4TH COURT WEST
BIRMINGHAM
,
AL
35204
PROVIDE COMMUNITY SERVICES
1,000
CATHOLIC CHARITIES
2121 3RD AVENUE NORTH
BIRMINGHAM
,
AL
35203
PROVIDE COMMUNITY SERVICES
1,500
CATHOLIC FAMILY SERVICES
2121 3RD AVENUE NORTH
BIRMINGHAM
,
AL
35203
FAMILY ASSISTANCE PROGRAMS
500
CENTER FOR EXECUTIVE LEADERSHIP
200 UNION HILL STE 200
BIRMINGHAM
,
AL
35209
MISSIONS
1,440
CHANGED LIVES CHRISTIAN CENTER
1308 26TH AVE NORTH
BIRMINGHAM
,
AL
35204
TRANSITIONAL HOUSING FOR HOMELESS MEN
500
CHILDCARE RESOURCES
1904 1ST AVE N
BIRMINGHAM
,
AL
35203
PROMOTE CHILD CARE
1,000
CHILDREN'S HOSPITAL FOUNDATION
1600 7TH AVE S
BIRMINGHAM
,
AL
35233
MEDICAL CARE
1,500
CYSTIC FIBROSIS FOUNDATION-ALABAMA
200 CAHABA PARK CIRCLE SUITE 114
BIRMINGHAM
,
AL
35242
TO ASSURE THE DEVELOPMENT OF THE MEANS TO CURE AND CONTROL CYSTIC FIBROSIS AND IMPROVE QUALITY OF LIFE OF THOSE WITH THE DISEASE
3,500
DELTA DELTA DELTA FOUNDATION
PO BOX 862938
TUSCALOOSA
,
AL
35486
SCHOLARHIPS
1,000
EXCEPTIONAL FOUNDATION
1616 OXMOOR ROAD
BIRMINGHAM
,
AL
35202
CARE FOR MENTALLY AND/OR PHSICALLY CHALLENGED INDIVI
2,200
FRIENDS OF ALABAMA HERITAGE
P O BOX 870342
TUSCALOOSA
,
AL
35487
SUPPORT PUBLICATION BY U OF A "ALABAMA HERITAGE" MASGAZINE
500
GATEWAY
411 WATTERSON PARKWAY
TRUSSVILLE
,
AL
35173
CHURCH
500
HENRY MARIANNA GREENE SPECIAL EQUESTRIANS
29401 ALABAMA HWY 21 S
TALLADEGA
,
AL
35160
SPECIAL EQUESTRIAN PROGRAM FOR DISABLED CHILDREN
1,000
HIGHLAND'S CASHIERS HOSPITAL FOUNDATION
190 HOSPITAL DRIVE
HIGHLANDS
,
NC
28741
ADMINISTRATION OF GIFTS IN SUPPORT OF HEALTHCARE EXCELLENCE
250
HUMANE SOCIETY
300 SNOW DRIVE
BIRMINGHAM
,
AL
35209
HOUSING FOR NEEDY PETS
250
JDRF - ALABAMA CHAPTER
600 BEACON PARKWAY WEST STE 860
BIRMINGHAM
,
AL
35209
JUVENILE DIABETES RESEARCH
500
JUNIOR LEAGUE OF BIRMINGHAM
2212 20TH AVE S
BIRMINGHAM
,
AL
35223
PROMOTION OF VOLUNTARISM
1,000
KING'S HOME
P O BOX 162
CHELSEA
,
AL
35043
SERVING YOUTH, WOMEN AND MOTHERS WITH AT RISK CHILDREN
1,000
LEGACY OF LEADERSHIP
1200 W MONTGOMERY ROAD
TUSKEGEE
,
AL
36088
SCHOLARSHIP
1,000
LEUKEMIA & LYMPHOMA SOCIETY
100 CHASE PARK S SUITE 220
BIRMINGHAM
,
AL
35244
LEUKEMIA & LYMPHOMA MEDICAL RESEARCH
2,500
LIVE BEYOND MOBILE MEDICAL DISASTER RELIEF
P O BOX 10486
NASHVILLE
,
TN
37212
MOBILE MEDICAL DISASTER RELIEF
500
MAGIC MOMENTS
1600 7TH AVE S STE 219
BIRMINGHAM
,
AL
35205
PROVIDING SERVICES FOR CRITICALLY ILL CHILDREN
250
MAHALAKSHMI FOUNDATION
NO 21/10 2ND STREET KAMARAJ NAAGAR
CHENNAI
IN
PROVIDING SERVICES TO NEEDY CHILDREN IN CHENNAI
100
MAKE WAY PARTNERS
PO BOX 26367
BIRMINGHAM
,
AL
35260
FIGHTING HUMAN TRAFFICKING
500
MEALS ON WHEELS
3712 4TH AVENUE SOUTH
BIRMINGHAM
,
AL
35205
COMMUNITY SERVICES
500
MEDIA RESEARCH CENTER
325 S PATRICK STREET
ALEXANDRIA
,
VA
22314
MEDIA EDUCATION
2,000
MONDAY MORNING QUARTERBACK CLUB
2019 4TH AVE N
BIRMINGHAM
,
AL
35203
SCHOLARSHIPS
10,500
MOUNTAIN BROOK CITY SCHOOLS FOUNDATION
32 VINE STREET
BIRMINGHAM
,
AL
35213
EDUCATIONAL SUPPLIES
500
NICK'S KIDS CHARITIES
BOX 870323
TUSCALOOSA
,
AL
35487
PROMOTE AND SUPPORT CHILDREN'S CAUSES
2,700
PARKINSONS ASSOCIATION OF ALABAMA
912 TULIP POPLAR LN
BIRMINGHAM
,
AL
35244
MEDICAL RESEARCH
3,700
PATHWAYS
409 RICHARD ARRINGTON JR BLVD N
BIRMINGHAM
,
AL
35203
PROVIDE SERVICES FOR HOMELESS WOMEN AND CHILDREN
500
PUBLIC AFFAIRS RESEARCH
PO BOX 293931
BIRMINGHAM
,
AL
35229
PROVIDE INFORMATION TO ADD TO THE IMPROVEMENT OF STATE AND LOCAL GOVERNMENTS IN ALABAMA
500
RED MOUNTIAN THEATRE
3028 7TH AVENUE SOUTH
BIRMINGHAM
,
AL
35233
SUPPORTING OF THE ARTS
3,000
REGIONS CHARITY CLASSIC FOUNDATION
100 GRANDVIEW PLACE
BIRMINGHAM
,
AL
35243
PROMOTE CHARITIES
4,000
RISE PROGRAM
25 BISHOP PLACE
NEW BRUNSWICK
,
NJ
089011181
SCHOLARSHIPS
1,500
ROBERT REED ONCOLOGY RESEARCH FOUNDATION
PO BOX 530186
BIRMINGHAM
,
AL
35253
CANCER RESEARCH
1,000
ROTARY CLUB BIRMINGHAM TRAIL
2019 4TH AVENUE NORTH SUITE 200
BIRMINGHAM
,
AL
35203
COMUNNITY SERVICE
1,000
SAMFORD UNIVERSITY
800 LAKESHORE DRIVE
BIRMINGHAM
,
AL
35229
COLLEGE EDUCATION
500
SHOAL CREEK FOUNDATION
2830 CAHABA ROAD
BIRMINGHAM
,
AL
35223
SCHOLARSHIPS
250
SISKIN CHILDREN'S INSTITUTE
1101 CARTER STREET
CHATTANOOGA
,
TN
37402
MEDICAL SERVICES FOR CHILDREN WITH SPECIAL NEEDS
2,000
SOUTHEAST CANCER FOUNDATION
PO BOX 43524
BIRMINGHAM
,
AL
35243
CANCER RESEARCH
250
ST FRANCIS OF ASSISI
3545 CAHABA VALLEY ROAD
INDIAN SPRINGS
,
AL
35124
CHURCH
1,000
THE BIRMINGHAM ZOO
2630 CAHABA ROAD
MOUNTAIN BROOK
,
AL
35213
ZOO
250
THE FOUNDRY
PO BOX 824
BESSEMER
,
AL
35021
RESCUE MISSION AND RECOVERY CENTER
1,200
THE MUSEUM OF ART
2000 REV ABRAHAM WOODS JR BLVD
BIRMINGHAM
,
AL
35203
ART MUSEUM
2,500
THE WORKSHOPS INC
2950 WHIPPLE AVENUE
NW CANTON
,
OH
44708
PROVIDE A COMPREHENSIVE PROGRAM TO EMPLOY THOSE WITH DVELOPMENTAL DISABILITIES
2,050
UAB COLLEGE OF COMMERCE
1530 3RD AVENUE S
BIRMINGHAM
,
AL
35294
SCHOLARSHIP
500
UAB COMP CANCER CENTER
UNIVERSITY OF ALABAMA
BIRMINGHAM
,
AL
35294
CANCER RESEARCH AND TREATMENT
2,500
UAB SCHOOL OF MEDICINE
1530 3RD AVENUE S
BIRMINGHAM
,
AL
35294
SCHOLARSHIP
500
UAB SCHOOL OF NURSING
1530 3RD AVENUE S
BIRMINGHAM
,
AL
35294
SCHOLARSHIPS
5,250
UNITED WAY OF CENTRAL ALABAMA FOOD BANK
3600 8TH AVE S
BIRMINGHAM
,
AL
35232
FEED THE HOMELESS
3,500
UNIVERSITY OF ALABAMA COMMUICATION AND INFORMATION
P O BOX 870144
TUSCALOOSA
,
AL
35487
SCHOLARSHIP
500
UNIVERSITY OF ALABAMA DIGITAL MEDIA CENTER
P O BOX 870144
TUSCALOOSA
,
AL
35487
SCHOLARSHIP
2,000
UNIVERSITY OF ALABAMA
P O BOX 870144
TUSCALOOSA
,
AL
35487
SCHOLARSHIP
1,000
WOUNDED WARRIORS PROJECT
3343 PEACHTREE ROAD NE M20
ATLANTA
,
GA
30326
SERVICES FOR WOUNDED VETERANS OF MILITARY ACTIONS
700
Total
.................................
3a
104,285
b
Approved for future payment
Total
.................................
3b
0
Form
990-PF
(2012)
Page 11
Form 990-PF (2012)
Page
11
Part XVI-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
Unrelated business income
Excluded by section 512, 513, or 514
(e)
Related or exempt
function income
(See instructions.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
....
14
91,622
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not debt-financed property
.....
6
Net rental income or (loss) from personal property
7
Other investment income
.....
8
Gain or (loss) from sales of assets other than inventory
18
94,753
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
..
14
-9,762
11
Other revenue:
a
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
0
176,613
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
176,613
(See worksheet in line 13 instructions to verify calculations.)
Part XVI-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
instructions.)
Form
990-PF
(2012)
Page 12
Form 990-PF (2012)
Page
12
Part XVII
Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
1
Did the organization directly or indirectly engage in any of the following with any other organization described in section
Yes
No
501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
a
Transfers from the reporting foundation to a noncharitable exempt organization of:
(1)
Cash
...................................
1a(1)
No
(2)
Other assets
.................................
1a(2)
No
b
Other transactions:
(1)
Sales of assets to a noncharitable exempt organization
....................
1b(1)
No
(2)
Purchases of assets from a noncharitable exempt organization
..................
1b(2)
No
(3)
Rental of facilities, equipment, or other assets
.......................
1b(3)
No
(4)
Reimbursement arrangements
...........................
1b(4)
No
(5)
Loans or loan guarantees
.............................
1b(5)
No
(6)
Performance of services or membership or fundraising solicitations
................
1b(6)
No
c
Sharing of facilities, equipment, mailing lists, other assets, or paid employees
..............
1c
No
d
If the answer to any of the above is “Yes,” complete the following schedule. Column
(b)
should always show the fair market value
of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
in any transaction or sharing arrangement, show in column
(d)
the value of the goods, other assets, or services received.
(a)
Line No.
(b)
Amount involved
(c)
Name of noncharitable exempt organization
(d)
Description of transfers, transactions, and sharing arrangements
2a
Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527?
...........
Yes
No
b
If “Yes,” complete the following schedule.
(a)
Name of organization
(b)
Type of organization
(c)
Description of relationship
Sign Here
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer or fiduciary) is based on all information of which preparer has any knowledge.
2014-01-09
May the IRS discuss this return
with the preparer shown below
(see instr.)?
Yes
No
Signature of officer or trustee
Date
Title
Paid Preparer Use Only
Print/Type preparer's name
JOHN M WILSON CPA
Preparer's Signature
JOHN M WILSON CPA
Date
2014-01-09
Check if self-
employed
PTIN
P00744312
Firm's name
Firm's address
BORLAND BENEFIELD
2101 HIGHLAND AVE SUITE 500
BIRMINGHAM
,
AL
35205
Firm's EIN
63-0721243
Phone no.
(205) 802-7212
Form
990-PF
(2012)
Additional Data
Software ID:
Software Version:
Form 990PF - Special Condition Description:
Special Condition Description