TY 2015 Form 990 Schedule O

efile Public Visual Render ObjectId: 201740839349300029 - Submission: 2017-03-24 TIN: 04-3507028

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
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Attach to Form 990 or 990-EZ.
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Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

THE PINE BANKS PARK FOUNDATION INC
C/O C HENRY KEZER

Employer identification number

04-3507028

Return Reference	Explanation
FORM 990, PART VI, SECTION B, LINE 11	FORM 990 IS DELIVERED TO THE BOARD OF TRUSTEES OF THE ORGANIZATION, UPON WHICH FORM 990 IS REVIEWED BY THE THE BOARD. IF ANY CHANGES OR ERRORS ARE NOTED, FORM 990 IS RETURNED, CHANGED, AND RE-SUBMITTED FOR THE APPROVAL OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 12C	THE BOARD OF TRUSTEES MEETS ANNUALLY TO MONITOR AND ENFORCE THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. THE SIZE OF THE ORGANIZATION IS SMALL, WITH NO COMPENSATED EMPLOYEES, AND MONITORING ANY POTENTIAL CONFLICTS OF INTEREST ARE RELATIVELY EASY.
FORM 990, PART VI, SECTION B, LINE 15	THE PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S KEY EMPLOYEES AND OFFICERS WOULD BE SUBJECT TO APPROVAL OF THE BOARD OF TRUSTEES. CURRENTLY THERE ARE NO COMPENSATED EMPLOYEES OR OFFICERS.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION KEEPS COPIES OF ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. COPIES OF THE DOCUMENTS CAN BE VIEWED AT THE ORGANIZATION'S OFFICE AT 350 MAIN STREET, MALDEN, MA.
FORM 990, PART IX, LINE 11G	FACILITIES MAINTENANCE: PROGRAM SERVICE EXPENSES 93,370. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 93,370.
FORM 990, PART XI, LINE 9:	BOOK TO TAX DEPRECIATION ADJUSTMENT 11,149.
FORM 990 PART XII, LINE 2C	THERE WAS NO CHANGE TO THE COMMITTEE THAT OVERSEES THE AUDIT FOR FISCAL YEAR ENDED JUNE 30, 2016.
FORM 4562	ELECTION NOT TO CLAIM THE ADDITIONAL FIRST YEAR DEPRECIATION ALLOWABLE UNDER IRC SEC. 168(K) THE PINE BANKS PARK FOUNDATION, INC. 350 MAIN STREET MALDEN, MA 02148 EMPLOYER IDENTIFICATION NUMBER: 04-3507028 FOR THE YEAR ENDED JUNE 30, 2016 THE PINE BANKS PARK FOUNDATION, INC HEREBY ELECTS, PURSUANT TO IRC SEC. 168(K)(2)(D)(III), NOT TO CLAIM THE ADDITIONAL DEPRECIATION ALLOWABLE UNDER IRC SEC. 168(K) FOR THE FOLLOWING QUALIFYING PROPERTY PLACED IN SERVICE DURING THE TAX YEAR ENDING JUNE 30, 2016: ALL PROPERTY IN THE 5 YEAR CLASS SEE ATTACHED FORM 4562

Return Reference

Explanation

FORM 990, PART VI, SECTION B, LINE 11

FORM 990 IS DELIVERED TO THE BOARD OF TRUSTEES OF THE ORGANIZATION, UPON WHICH FORM 990 IS REVIEWED BY THE THE BOARD. IF ANY CHANGES OR ERRORS ARE NOTED, FORM 990 IS RETURNED, CHANGED, AND RE-SUBMITTED FOR THE APPROVAL OF THE BOARD OF DIRECTORS.

FORM 990, PART VI, SECTION B, LINE 12C

THE BOARD OF TRUSTEES MEETS ANNUALLY TO MONITOR AND ENFORCE THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. THE SIZE OF THE ORGANIZATION IS SMALL, WITH NO COMPENSATED EMPLOYEES, AND MONITORING ANY POTENTIAL CONFLICTS OF INTEREST ARE RELATIVELY EASY.

FORM 990, PART VI, SECTION B, LINE 15

THE PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S KEY EMPLOYEES AND OFFICERS WOULD BE SUBJECT TO APPROVAL OF THE BOARD OF TRUSTEES. CURRENTLY THERE ARE NO COMPENSATED EMPLOYEES OR OFFICERS.

FORM 990, PART VI, SECTION C, LINE 19

THE ORGANIZATION KEEPS COPIES OF ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. COPIES OF THE DOCUMENTS CAN BE VIEWED AT THE ORGANIZATION'S OFFICE AT 350 MAIN STREET, MALDEN, MA.

FORM 990, PART IX, LINE 11G

FACILITIES MAINTENANCE: PROGRAM SERVICE EXPENSES 93,370. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 93,370.

FORM 990, PART XI, LINE 9:

BOOK TO TAX DEPRECIATION ADJUSTMENT 11,149.

FORM 990 PART XII, LINE 2C

THERE WAS NO CHANGE TO THE COMMITTEE THAT OVERSEES THE AUDIT FOR FISCAL YEAR ENDED JUNE 30, 2016.

FORM 4562

ELECTION NOT TO CLAIM THE ADDITIONAL FIRST YEAR DEPRECIATION ALLOWABLE UNDER IRC SEC. 168(K) THE PINE BANKS PARK FOUNDATION, INC. 350 MAIN STREET MALDEN, MA 02148 EMPLOYER IDENTIFICATION NUMBER: 04-3507028 FOR THE YEAR ENDED JUNE 30, 2016 THE PINE BANKS PARK FOUNDATION, INC HEREBY ELECTS, PURSUANT TO IRC SEC. 168(K)(2)(D)(III), NOT TO CLAIM THE ADDITIONAL DEPRECIATION ALLOWABLE UNDER IRC SEC. 168(K) FOR THE FOLLOWING QUALIFYING PROPERTY PLACED IN SERVICE DURING THE TAX YEAR ENDING JUNE 30, 2016: ALL PROPERTY IN THE 5 YEAR CLASS SEE ATTACHED FORM 4562

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

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