efile Public Visual Render
ObjectId: 201501159349100500 - Submission: 2015-04-25
TIN: 25-6577111
Form
990-PF
Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
Do not enter social security numbers on this form as it may be made public.
Information about Form 990-PF and its instructions is at
www.irs.gov/form990pf
.
OMB No. 1545-0052
20
14
Open to Public Inspection
For calendar year 2014, or tax year beginning
01-01-2014
, and ending
12-31-2014
Name of foundation
SAXMAN JR JOHN K CHARITABLE TRUST
Number and street (or P.O. box number if mail is not delivered to street address)
PNC BANK NA 620 LIBERTY AVENUE 10
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
PITTSBURGH
,
PA
152222705
A Employer identification number
25-6577111
B
Telephone number (see instructions)
(412) 762-5188
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 ...
E
If private foundation status was terminated
under section 507(b)(1)(A), check here .......
H
Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here .......
I
Fair market value of all assets at end
of year
(from Part II, col. (c),
line 16)
$
3,400,605
J
Accounting method:
Cash
Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)
Part I
Analysis of Revenue and Expenses
(The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).)
(a)
Revenue and
expenses per
books
(b)
Net investment
income
(c)
Adjusted net
income
(d)
Disbursements
for charitable
purposes
(cash basis only)
1
Contributions, gifts, grants, etc., received (attach schedule)
2
Check
Sch. B
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
73,857
73,857
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
210,580
b
Gross sales price for all assets on line 6a
1,037,995
7
Capital gain net income (from Part IV, line 2)
...
210,580
8
Net short-term capital gain
.........
0
9
Income modifications
...........
10a
Gross sales less returns and allowances
b
Less: Cost of goods sold
....
c
Gross profit or (loss) (attach schedule)
.....
11
Other income (attach schedule)
.......
12
Total.
Add lines 1 through 11
........
284,437
284,437
13
Compensation of officers, directors, trustees, etc.
35,450
17,725
17,725
14
Other employee salaries and wages
......
0
0
0
15
Pension plans, employee benefits
.......
0
0
16a
Legal fees (attach schedule)
.........
0
b
Accounting fees (attach schedule)
.......
c
Other professional fees (attach schedule)
....
0
17
Interest
...............
0
18
Taxes (attach schedule) (see instructions)
...
8,437
145
0
19
Depreciation (attach schedule) and depletion
...
0
0
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
0
0
22
Printing and publications
..........
0
0
23
Other expenses (attach schedule)
.......
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
43,887
17,870
0
17,725
25
Contributions, gifts, grants paid
.......
132,641
132,641
26
Total expenses and disbursements.
Add lines 24 and 25
176,528
17,870
0
150,366
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
107,909
b
Net investment income
(if negative, enter -0-)
266,567
c
Adjusted net income
(if negative, enter -0-)
...
0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2014)
Page 2
Form 990-PF (2014)
Page
2
Part II
Balance Sheets
Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year
End of year
(a)
Book Value
(b)
Book Value
(c)
Fair Market Value
1
Cash—non-interest-bearing
.............
2
Savings and temporary cash investments
.........
17,056
99,052
99,052
3
Accounts receivable
Less: allowance for doubtful accounts
0
0
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 instructions)
.....
7
Other notes and loans receivable (attach schedule)
Less: allowance for doubtful accounts
0
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)
.......
1,010,285
1,039,585
1,440,861
c
Investments—corporate bonds (attach schedule)
.......
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
1,675,192
1,643,136
1,860,692
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)
2,702,533
2,781,773
3,400,605
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
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
........
2,689,730
2,761,631
28
Paid-in or capital surplus, or land, bldg., and equipment fund
29
Retained earnings, accumulated income, endowment, or other funds
12,803
20,142
30
Total net assets or fund balances
(see instructions)
.....
2,702,533
2,781,773
31
Total liabilities and net assets/fund balances
(see instructions)
.
2,702,533
2,781,773
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
2,702,533
2
Enter amount from Part I, line 27a
.....................
2
107,909
3
Other increases not included in line 2 (itemize)
3
25
4
Add lines 1, 2, and 3
..........................
4
2,810,467
5
Decreases not included in line 2 (itemize)
5
28,694
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30
.
6
2,781,773
Form
990-PF
(2014)
Page 3
Form 990-PF (2014)
Page
3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a)
List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)
(b)
How acquired
P—Purchase
D—Donation
(c)
Date acquired
(mo., day, yr.)
(d)
Date sold
(mo., day, yr.)
1 a
20. AETNA INC NEW
2013-05-31
2014-01-01
b
10. ALLERGAN INC
2010-08-23
2014-01-01
c
30. ALTRIA GROUP INC
2013-05-17
2014-01-01
d
10. AMERICAN EXPRESS CO
2009-11-24
2014-01-01
e
6. APPLE INC
2013-11-27
2014-01-01
10. BAXTER INTERNATIONAL INC
2013-08-09
2014-01-01
10. B/E AEROSPACE INC
2013-05-02
2014-01-01
10. BECTON DICKINSON & CO
2013-03-15
2014-01-01
10. CBS CORP CLASS B WI
2013-05-17
2014-01-01
20. CVS CAREMARK CORP
2013-02-22
2014-01-01
10. CANADIAN PACIFIC RAILWAY LTD SEDOL 2793115
2013-11-13
2014-01-01
10. CHEVRON CORPORATION
2010-08-23
2014-01-01
10. CHUBB CORP COM
2009-08-07
2014-01-01
20. CITIGROUP INC
2010-08-23
2014-01-01
10. COCACOLA CO
2010-08-23
2014-01-01
30. COMCAST CORPORATION CL A
2011-12-22
2014-01-01
10. CONOCOPHILLIPS
2013-09-24
2014-01-01
480. D R HORTON INC
2013-03-15
2014-01-01
40. DELTA AIR LINES INC
2013-09-24
2014-01-01
10. DISNEY WALT CO
2012-06-11
2014-01-01
20. DISCOVER FINANCIAL W/I
2012-07-27
2014-01-01
10. EOG RES INC
2013-09-24
2014-01-01
20. EBAY INC
2011-02-17
2014-01-01
10. EXXON MOBIL CORP
2009-06-24
2014-01-01
50. FIFTH THIRD BANCORP
2012-09-05
2014-01-01
70. FORD MTR CO DEL COM PAR $0.01
2013-09-24
2014-01-01
10. FRANKLIN RES INC COM
2013-07-03
2014-01-01
70. GENERAL ELEC CO COM
2012-09-24
2014-01-01
10. GOLDMAN SACHS GROUP INC COM
2013-02-11
2014-01-01
10. HALLIBURTON CO
2013-05-02
2014-01-01
10. HELMERICH & PAYNE INC COM
2013-02-26
2014-01-01
20. HERSHEY FOODS CORP COM
2010-08-23
2014-01-01
10. HOME DEPOT INC COM
2012-01-11
2014-01-01
20. J P MORGAN CHASE & CO COM
2009-06-01
2014-01-01
20. JOHNSON & JOHNSON COM
2011-06-27
2014-01-01
10. LAS VEGAS SANDS CORP
2013-10-23
2014-01-01
40. MICROSOFT CORP
1996-06-17
2014-01-01
10. NIKE INC CL B
2013-03-15
2014-01-01
40. ORACLE CORP
2013-11-27
2014-01-01
10. PPG INDS INC COM
2013-11-13
2014-01-01
10. POLARIS INDS INC
2012-05-10
2014-01-01
20. PROCTER & GAMBLE CO
2013-01-30
2014-01-01
10. QUALCOMM
2011-02-17
2014-01-01
70. REGIONS FINANCIAL CORP
2013-07-03
2014-01-01
10. SCHLUMBERGER LTD COM
2013-11-04
2014-01-01
10. SHIRE PLC SPONSORED ADR
2013-09-24
2014-01-01
120. SMUCKER J M CO COM NEW
2013-09-24
2014-01-01
10. UNION PAC CORP COM
2010-08-23
2014-01-01
20. VERIZON COMMUNICATIONS COM
2013-05-17
2014-01-01
10. VISA INC CLASS A SHARES
2013-02-11
2014-01-01
40. WELLS FARGO & CO NEW COM
2009-08-07
2014-01-01
30. WISCONSIN ENERGY CORP
2009-06-24
2014-01-01
20. WYNDHAM WORLDWIDE CORP
2013-03-25
2014-01-01
30. YAHOO! INC COM
2013-07-23
2014-01-01
30. INVESCO LTD ISIN BMG491BT1088 SEDOL B28XP76
2013-05-09
2014-01-01
10. JAZZ PHARMACEUTICALS PLC SEDOL B4Q5ZN4
2013-09-24
2014-01-01
200. BAXTER INTERNATIONAL INC
2013-08-09
2014-01-09
1210. FORD MTR CO DEL COM PAR $0.01
2013-07-23
2014-01-09
320. BEST BUY INC
2013-09-24
2014-01-21
260. EBAY INC
2011-02-17
2014-01-31
400. CITIGROUP INC
2010-08-23
2014-03-10
100. NU SKIN ENTERPRISES INC
2013-12-27
2014-03-10
240. OMNICARE INC
2013-12-13
2014-03-10
120. PROCTER & GAMBLE CO
2012-11-21
2014-03-10
60. JAZZ PHARMACEUTICALS PLC SEDOL B4Q5ZN4
2013-09-24
2014-03-10
80. CELGENE CORP
2013-09-24
2014-03-17
120. PVH CORP
2012-10-18
2014-03-17
6.152 EAGLE SMALL CAP GROWTH FUND CL I
2013-12-19
2014-03-20
501.132 EAGLE SMALL CAP GROWTH FUND CL I
2010-08-23
2014-03-20
110. PPG INDS INC COM
2013-10-30
2014-03-20
1. WACHOVIA CORP
2001-01-01
2014-03-24
80. CANADIAN PACIFIC RAILWAY LTD SEDOL 2793115
2013-11-13
2014-03-28
200. CHUBB CORP COM
2009-08-07
2014-03-28
90. GOLDMAN SACHS GROUP INC COM
2013-01-23
2014-04-11
290. HALLIBURTON CO
2013-05-02
2014-04-11
200. NIKE INC CL B
2013-03-15
2014-04-11
860. FIFTH THIRD BANCORP
2012-07-27
2014-05-02
230. HERSHEY FOODS CORP COM
2010-08-23
2014-05-08
20. AETNA INC NEW
2013-05-31
2014-05-28
50. ALLERGAN INC
2010-08-23
2014-05-28
10. AMGEN INC
2014-01-21
2014-05-28
10. BOEING CO
2012-08-06
2014-05-28
20. CBS CORP CLASS B WI
2013-05-17
2014-05-28
140. CHEVRON CORPORATION
2010-08-23
2014-05-28
440. COCACOLA CO
2010-08-23
2014-05-28
20. COMCAST CORPORATION CL A
2011-12-22
2014-05-28
30. DELTA AIR LINES INC
2013-07-26
2014-05-28
10. EOG RES INC
2014-04-11
2014-05-28
10. EXXON MOBIL CORP
2009-06-24
2014-05-28
20. FRANKLIN RES INC COM
2013-07-03
2014-05-28
70. GENERAL ELEC CO COM
2012-09-24
2014-05-28
10. HELMERICH & PAYNE INC COM
2013-02-26
2014-05-28
30. J P MORGAN CHASE & CO COM
2009-06-01
2014-05-28
20. JOHNSON & JOHNSON COM
2011-06-27
2014-05-28
10. LOCKHEED MARTIN CORP
2013-11-25
2014-05-28
10. MAGNA INTERNATIONAL ISIN CA5592224011
2014-01-09
2014-05-28
10. MCKESSON HBOC INC COMMN
2013-12-27
2014-05-28
30. MICROSOFT CORP
2014-04-11
2014-05-28
30. ORACLE CORP
2013-11-27
2014-05-28
20. PACKAGING CORP OF AMERICA COM
2014-03-20
2014-05-28
20. QUALCOMM
2011-02-17
2014-05-28
10. SCHLUMBERGER LTD COM
2014-04-11
2014-05-28
10. SHIRE PLC SPONSORED ADR
2013-09-24
2014-05-28
10. UNITED TECHNOLOGIES CORP COM
2009-06-01
2014-05-28
30. WELLS FARGO & CO NEW COM
2009-08-07
2014-05-28
30. WISCONSIN ENERGY CORP
2009-06-24
2014-05-28
10. ZIMMER HOLDINGS INC
2014-03-17
2014-05-28
70. JAZZ PHARMACEUTICALS PLC SEDOL B4Q5ZN4
2013-09-24
2014-05-28
190. B/E AEROSPACE INC
2013-05-02
2014-06-27
10. GOOGLE INC-CL C
2013-10-23
2014-06-27
20. GOOGLE INC-CL C
2008-02-08
2014-06-27
200. METHANEX CORP SEDOL 2654416
2013-11-19
2014-06-27
400. YAHOO! INC COM
2013-07-23
2014-06-27
79. SHIRE PLC SPONSORED ADR
2010-08-23
2014-07-16
20. SHIRE PLC SPONSORED ADR
2013-09-24
2014-07-16
80. ALLERGAN INC
2010-08-23
2014-08-07
280. FRANKLIN RES INC COM
2013-07-03
2014-08-07
71. SHIRE PLC SPONSORED ADR
2010-08-23
2014-08-07
170. LAS VEGAS SANDS CORP
2013-10-23
2014-08-15
330. SUNCOR ENERGY INC ISIN CA8672241079 SEDOL B3NB1P2
2014-05-28
2014-08-15
130. ZIMMER HOLDINGS INC
2014-03-17
2014-08-15
30. HELMERICH & PAYNE INC COM
2013-02-26
2014-08-29
250. MICROSOFT CORP
2014-03-10
2014-08-29
280. DELTA AIR LINES INC
2013-07-26
2014-09-12
160. UNITED TECHNOLOGIES CORP COM
2009-06-01
2014-09-12
330. SUNTRUST BANKS INC COM
2014-03-10
2014-09-19
280. CROWN HOLDINGS INC
2014-06-27
2014-09-22
240. CBS CORP CLASS B WI
2013-05-17
2014-09-26
20. ALTRIA GROUP INC
2013-05-17
2014-10-01
10. APPLE INC
2013-11-27
2014-10-01
10. CVS CAREMARK CORP
2013-02-22
2014-10-01
20. COCA COLA ENTERPRISES
2014-03-10
2014-10-01
20. KROGER CO
2014-05-08
2014-10-01
240. ORACLE CORP
2013-10-23
2014-10-01
370. ORACLE CORP
2004-12-21
2014-10-01
10. PROCTER & GAMBLE CO
2012-11-21
2014-10-01
10. UNITED RENTALS INC COM
2014-09-12
2014-10-01
20. VERIZON COMMUNICATIONS COM
2013-05-17
2014-10-01
24.004 ARTISAN MID CAP VALUE FUND FD 1464
2013-11-21
2014-10-17
578.704 ARTISAN MID CAP VALUE FUND FD 1464
2013-07-23
2014-10-17
340. COCA COLA ENTERPRISES
2014-03-10
2014-10-17
30. EOG RES INC
2014-04-11
2014-10-17
40. EOG RES INC
2013-07-26
2014-10-17
180. MANPOWER GROUP INC
2013-11-04
2014-10-17
40. MANPOWER GROUP INC
2014-08-07
2014-10-17
1. DELL COMPUTER CORP NAME CHG 7/22/03 SEE 24702R101
2001-01-01
2014-10-30
160. HELMERICH & PAYNE INC COM
2013-02-26
2014-11-18
5467.601 EATON VANCE FLOATING RATE FUND CLASS I
2011-03-02
2014-12-08
500. ISHARES IBOXX $ INVESTMENT GRADE CORPORATE BOND
2009-03-26
2014-12-08
750. ISHARES TR RUSSELL1000VAL
2013-09-24
2014-12-08
360. QUANTA SVCS INC
2014-03-28
2014-12-19
CAPITAL GAIN DIVIDENDS
P
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
1,367
1,235
132
b
1,103
637
466
c
1,150
1,119
31
d
891
415
476
e
3,368
3,218
150
693
733
-40
867
631
236
1,102
923
179
627
513
114
1,435
1,029
406
1,516
1,473
43
1,251
755
496
958
482
476
1,045
764
281
406
278
128
1,547
710
837
703
709
-6
10,339
11,765
-1,426
1,088
954
134
742
462
280
1,092
720
372
1,680
1,734
-54
1,083
697
386
1,015
695
320
1,051
749
302
1,067
1,214
-147
570
460
110
1,950
1,567
383
1,761
1,525
236
513
421
92
836
637
199
1,931
952
979
819
434
385
1,165
734
431
1,851
1,309
542
785
713
72
1,496
309
1,187
786
548
238
1,525
1,410
115
1,880
1,835
45
1,444
795
649
1,645
1,501
144
737
590
147
687
689
-2
897
937
-40
1,412
1,204
208
12,445
12,822
-377
1,656
734
922
984
1,066
-82
2,206
1,573
633
1,818
1,173
645
1,242
604
638
1,465
1,257
208
1,217
830
387
1,099
994
105
1,235
884
351
13,940
14,650
-710
19,148
20,735
-1,587
7,880
12,339
-4,459
13,792
9,061
4,731
19,776
14,906
4,870
7,595
13,801
-6,206
13,974
14,197
-223
9,397
8,675
722
9,065
5,302
3,763
12,136
11,783
353
13,792
11,777
2,015
372
346
26
30,339
14,493
15,846
21,406
20,099
1,307
13
13
11,838
11,782
56
17,568
9,638
7,930
13,816
13,047
769
16,834
12,195
4,639
14,435
10,952
3,483
17,630
12,285
5,345
22,201
10,943
11,258
1,535
1,235
300
7,848
3,187
4,661
1,156
1,192
-36
1,347
733
614
1,212
1,027
185
17,206
10,564
6,642
17,868
12,241
5,627
1,039
473
566
1,211
667
544
1,050
993
57
1,014
695
319
1,105
919
186
1,864
1,567
297
1,087
637
450
1,665
1,101
564
2,009
1,309
700
1,623
1,413
210
1,018
816
202
1,833
1,618
215
1,200
1,183
17
1,251
1,057
194
1,362
1,438
-76
1,607
1,180
427
1,021
973
48
1,726
1,204
522
1,161
552
609
1,515
880
635
1,357
604
753
1,027
946
81
9,913
6,185
3,728
17,469
11,985
5,484
5,770
5,174
596
11,539
5,161
6,378
12,355
12,814
-459
13,688
11,072
2,616
19,475
5,833
13,642
4,930
2,407
2,523
12,595
5,099
7,496
15,198
12,870
2,328
16,588
4,749
11,839
11,636
12,113
-477
12,979
12,685
294
12,672
12,292
380
3,126
1,911
1,215
11,297
9,682
1,615
11,088
6,002
5,086
17,294
8,827
8,467
13,134
13,005
129
12,918
13,902
-984
13,004
12,323
681
917
746
171
992
766
226
793
514
279
875
942
-67
1,034
931
103
9,115
8,198
917
14,052
5,153
8,899
833
681
152
1,049
1,158
-109
989
1,066
-77
616
633
-17
14,855
15,000
-145
13,885
16,011
-2,126
2,728
2,978
-250
3,637
2,919
718
10,926
14,598
-3,672
2,428
3,068
-640
104
104
12,532
10,192
2,340
49,099
49,972
-873
59,336
46,428
12,908
78,898
65,571
13,327
9,842
13,255
-3,413
15,685
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
132
b
466
c
31
d
476
e
150
-40
236
179
114
406
43
496
476
281
128
837
-6
-1,426
134
280
372
-54
386
320
302
-147
110
383
236
92
199
979
385
431
542
72
1,187
238
115
45
649
144
147
-2
-40
208
-377
922
-82
633
645
638
208
387
105
351
-710
-1,587
-4,459
4,731
4,870
-6,206
-223
722
3,763
353
2,015
26
15,846
1,307
56
7,930
769
4,639
3,483
5,345
11,258
300
4,661
-36
614
185
6,642
5,627
566
544
57
319
186
297
450
564
700
210
202
215
17
194
-76
427
48
522
609
635
753
81
3,728
5,484
596
6,378
-459
2,616
13,642
2,523
7,496
2,328
11,839
-477
294
380
1,215
1,615
5,086
8,467
129
-984
681
171
226
279
-67
103
917
8,899
152
-109
-77
-17
-145
-2,126
-250
718
-3,672
-640
104
2,340
-873
12,908
13,327
-3,413
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
210,580
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
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 instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in)
(b)
Adjusted qualifying distributions
(c)
Net value of noncharitable-use assets
(d)
Distribution ratio
(col. (b) divided by col. (c))
2013
142,866
3,110,863
0.045925
2012
104,563
2,918,140
0.035832
2011
135,218
2,828,367
0.047808
2010
106,449
2,635,088
0.040397
2009
154,278
2,346,035
0.065761
2
Total
of line 1, column (d)
.....................
2
0.235723
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
0.047145
4
Enter the net value of noncharitable-use assets for 2014 from Part X, line 5
.....
4
3,329,805
5
Multiply line 4 by line 3
......................
5
156,984
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
2,666
7
Add lines 5 and 6
........................
7
159,650
8
Enter qualifying distributions from Part XII, line 4
.............
8
150,366
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See
the Part VI instructions.
Form
990-PF
(2014)
Page 4
Form 990-PF (2014)
Page
4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see page 18 of the instructions)
1a
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
5,331
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
5,331
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
5,331
6
Credits/Payments:
a
2014 estimated tax payments and 2013 overpayment credited to 2014
6a
6,152
b
Exempt foreign organizations—tax withheld at source
......
6b
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
0
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
6,152
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
0
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
821
11
Enter the amount of line 10 to be:
Credited to 2015 estimated tax
821
Refunded
11
0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see Instructions
for definition)?
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
(2)
On foundation managers.
$
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
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)
PA
b
If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G?
If "No," attach explanation
.
8b
Yes
9
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
or 4942(j)(5) for calendar year 2014 or the taxable year beginning in 2014 (see instructions for Part XIV)?
If "Yes," complete Part XIV
.............................
9
No
10
Did any persons become substantial contributors during the tax year?
If "Yes," attach a schedule listing their names
and addresses.
...............................
10
No
Form
990-PF
(2014)
Page 5
Form 990-PF (2014)
Page
5
Part VII-A
Statements Regarding Activities (continued)
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. (see instructions)
.............
11
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement (see instructions)
.................
12
No
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
N/A
14
The books are in care of
PNC BANK NA
Telephone no.
(412) 762-5188
Located at
620 LIBERTY AVENUE
PITTSBURGH
PA
ZIP+4
152222705
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 2014, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
16
No
See instructions for exceptions and filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR). If "Yes", enter the name of the foreign country
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 instructions)?
........
1b
No
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 2014?
.............
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 2014, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2014?
.............
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 2014 as a result of
(1)
any purchase by the foundation
or disqualified persons after May 26, 1969;
(2)
the lapse of the 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or
(3)
the lapse of the 10-, 15-, or 20-year first phase holding period?
(Use Schedule C, Form 4720, to determine
if the foundation had excess business holdings in 2014.)
..................
3b
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2014?
4b
No
Form
990-PF
(2014)
Page 6
Form 990-PF (2014)
Page
6
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 4945(d)(4)(A)? (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
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
PNC BANK N A
TRUSTEE
7
35,450
620 LIBERTY AVENUE
PITTSBURGH
,
PA
152222705
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
Form
990-PF
(2014)
Page 7
Form 990-PF (2014)
Page
7
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
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
Form
990-PF
(2014)
Page 8
Form 990-PF (2014)
Page
8
Part X
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations,see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities
...................
1a
3,380,513
b
Average of monthly cash balances
.......................
1b
0
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
3,380,513
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
3,380,513
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
50,708
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
3,329,805
6
Minimum investment return.
Enter 5% of line 5
..................
6
166,490
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
166,490
2a
Tax on investment income for 2014 from Part VI, line 5
......
2a
5,331
b
Income tax for 2014. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
5,331
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
161,159
4
Recoveries of amounts treated as qualifying distributions
................
4
0
5
Add lines 3 and 4
............................
5
161,159
6
Deduction from distributable amount (see instructions)
.................
6
0
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1
...
7
161,159
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
150,366
b
Program-related investments—total from Part IX-B
..................
1b
0
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
0
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
0
b
Cash distribution test (attach the required schedule)
.................
3b
0
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
150,366
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
150,366
Note:
The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
the section 4940(e) reduction of tax in those years.
Form
990-PF
(2014)
Page 9
Form 990-PF (2014)
Page
9
Part XIII
Undistributed Income
(see instructions)
(a)
Corpus
(b)
Years prior to 2013
(c)
2013
(d)
2014
1
Distributable amount for 2014 from Part XI, line 7
161,159
2
Undistributed income, if any, as of the end of 2014:
a
Enter amount for 2013 only
.......
132,616
b
Total for prior years:
20
,
20
,
20
0
3
Excess distributions carryover, if any, to 2014:
a
From 2009
......
0
b
From 2010
......
0
c
From 2011
......
0
d
From 2012
......
0
e
From 2013
......
0
f
Total
of lines 3a through e
........
0
4
Qualifying distributions for 2014 from Part
XII, line 4:
$
150,366
a
Applied to 2013, but not more than line 2a
132,616
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
0
c
Treated as distributions out of corpus (Election
required—see instructions)
........
0
d
Applied to 2014 distributable amount
.....
17,750
e
Remaining amount distributed out of corpus
0
5
Excess distributions carryover applied to 2014.
0
0
(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
0
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
0
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
0
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
0
e
Undistributed income for 2013. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
0
f
Undistributed income for 2014. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2015
..........
143,409
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions)
.......
0
8
Excess distributions carryover from 2009 not
applied on line 5 or line 7 (see instructions)
...
0
9
Excess distributions carryover to 2015.
Subtract lines 7 and 8 from line 6a
......
0
10
Analysis of line 9:
a
Excess from 2010
....
0
b
Excess from 2011
....
0
c
Excess from 2012
....
0
d
Excess from 2013
....
0
e
Excess from 2014
....
0
Form
990-PF
(2014)
Page 10
Form 990-PF (2014)
Page
10
Part XIV
Private Operating Foundations
(see instructions and Part VII-A, question 9)
1a
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2014, enter the date of the ruling
.......
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)
2014
(b)
2013
(c)
2012
(d)
2011
b
85% of line 2a
.........
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed
...
c
“Support" alternative test—enter:
(1)
Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
....
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
(3)
Largest amount of support
from an exempt organization
(4)
Gross investment income
Part XV
Supplementary Information (Complete this part only if the organization had $5,000 or more in
assets at any time during the year—see instructions.)
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 or email address 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
(2014)
Page 11
Form 990-PF (2014)
Page
11
Part XV
Supplementary Information
(continued)
3 Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
ST CLAIR CEMETERY ASSOCIATION
964 ST CLAIR WAY
GREENSBURG
,
PA
156013538
NONE
PC
GENERAL SUPPORT
2,653
ST BARNABAS INC
ATTN JAMES D TURCO
5850 MERIDIAN ROAD
GIBSONIA
,
PA
150449605
NONE
PC
GENERAL SUPPORT
13,264
ST MARGARET FOUNDATION
ATTN NICOLE DIMANOV
815 FREEPORT RD
PITTSBURGH
,
PA
152153301
NONE
PC
GENERAL SUPPORT
13,264
GLADE RUN PRESBYTERIAN CHURCH
2540 DAYTON-SMICKSBURG RD
DAYTON
,
PA
162229621
NONE
PC
GENERAL SUPPORT
1,326
BLIND & VISION REHAB SERVS
1800 W STREET
HOMESTEAD
,
PA
151202563
NONE
PC
GENERAL SUPPORT
6,632
COMMUNITY FDN OF WESTMORELAND
ATTN KIRK UTZINGER PRESIDENT
COUNTY
GREENSBURG
,
PA
156011386
NONE
PC
GENERAL SUPPORT
36,477
CONGRUITY PRESBYTERIAN CHURCH
ATTN DOROTHY MARTZ SECRETARY
136 FENNELTOWN RD
NEW ALEXANDRIA
,
PA
156702699
NONE
PC
GENERAL SUPPORT
1,326
RIDGE CHURCH UNION CEMETERY
ATTN JACOB M BLANK JR
113 MILAK RD
LATROBE
,
PA
156505180
NONE
PC
GENERAL SUPPORT
1,326
SAINT FRANCIS COMMUNITY SERVS
ATTN MELANIE OWENS VP & CFO
PO BOX 1340
SALINA
,
KS
674021340
NONE
PC
GENERAL SUPPORT
6,632
THE PITTSBURGH FOUNDATION
ATTN DUSTIN WIDDOSS
GIFT PLANNING
PITTSBURGH
,
PA
152225405
NONE
PC
GENERAL SUPPORT
36,477
CANTERBURY PL
C/O UPMC SENIOR COMMUNITIES
JODY J PAVLIK ASSIST CONTROLLER
PITTSBURGH
,
PA
152132536
NONE
PC
GENERAL SUPPORT
13,264
Total
.................................
3a
132,641
b
Approved for future payment
Total
.................................
3b
Form
990-PF
(2014)
Page 12
Form 990-PF (2014)
Page
12
Part XVI-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
Unrelated business income
Excluded by section 512, 513, or 514
(e)
Related or exempt
function income
(See instructions.)
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
73,857
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
210,580
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
..
11
Other revenue:
a
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
284,437
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
284,437
(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
(2014)
Page 13
Form 990-PF (2014)
Page
13
Part XVII
Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
1
Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
Yes
No
a
Transfers from the reporting foundation to a noncharitable exempt organization of:
(1)
Cash
...................................
1a(1)
No
(2)
Other assets
.................................
1a(2)
No
b
Other transactions:
(1)
Sales of assets to a noncharitable exempt organization
....................
1b(1)
No
(2)
Purchases of assets from a noncharitable exempt organization
..................
1b(2)
No
(3)
Rental of facilities, equipment, or other assets
.......................
1b(3)
No
(4)
Reimbursement arrangements
...........................
1b(4)
No
(5)
Loans or loan guarantees
.............................
1b(5)
No
(6)
Performance of services or membership or fundraising solicitations
................
1b(6)
No
c
Sharing of facilities, equipment, mailing lists, other assets, or paid employees
..............
1c
No
d
If the answer to any of the above is "Yes," complete the following schedule. Column
(b)
should always show the fair market value
of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
in any transaction or sharing arrangement, show in column
(d)
the value of the goods, other assets, or services received.
(a)
Line No.
(b)
Amount involved
(c)
Name of noncharitable exempt organization
(d)
Description of transfers, transactions, and sharing arrangements
2a
Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
described in section 501(c) 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) is based on all information of which preparer has any knowledge.
2015-04-23
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
Preparer's Signature
Date
Check if self-
employed
PTIN
Firm's name
Firm's EIN
Firm's address
Phone no.
Form
990-PF
(2014)
Additional Data
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Software Version:
Form 990PF - Special Condition Description:
Special Condition Description