Yale University Tax Questionnaire
Calendar Year 2007 or Year Ended on or Within the Fiscal Year Ended June 30, 2008
FUND
NAME:
END OF YEAR %
Partner Name OWNERSHIP OF
CAPITAL:
Yale University
Yale University Retirement Plan for Staff Employees
Yale University Retiree Health Benefits Coverage Trust
See Question 2. Enter Name of Yale Entity Partner or Member:
See Question 2. Enter Name of Yale Entity Partner or Member:
Yes No
1 Has this fund generated Unrelated Business Taxable Income (Loss)) (UBTI(L)) during the year?
Note: If this Fund generated UBTI(L) and conducts business in any of the following states, please be sure If yes, please NOTE: If IRC Section
download and 514(c)(9) applies for
to complete the UBTI State Allocation section at the bottom of the UBTI Summary:
complete the UBTI partners who are
Alabama,Arkansas,California,Colorado,Idaho,Illinois,Indiana,Kansas,Louisiana,Maryland, Schedule for Yale qualified
Massachusetts,Michigan,Mississippi,Missouri,Montana,New York,Nebraska, North and each Yale organizations and the
Dakota,Oklahoma,Oregon,Rhode Island,Utah or West Virginia. affiliate that is a fund generated no
partner in the Fund other UBTI(L) during
the year, answer No
to Question 1.
Yes No
2 Is any Yale affiliated entity other than Yale University, Yale University Retirement Plan for Staff
Employees or Yale University Retiree Health Benefits Coverage Trust a partner in the Fund? (i.e.,
Is the partner a Yale special purpose holding entity such as an LP or LLC?)
If Question 2 is Yes, If Question 2 is No,
please enter Partner but Question 1 is Yes,
Name above and please click the box,
complete the State below, and complete
Allocation and the State Allocation
Apportionment Info and Apportionment
Worksheet. Worksheet.
Yes No
3 Did this Fund withhold any state taxes or make composite state tax payments on behalf of Yale or
a Yale affiliate (including withholding or composite tax payments passed through from lower tier
investments of Fund) during its 2007 tax year?
If Yes, please
complete the State
Withholding
Schedule.
Yes No
4 Has the Fund engaged in one or more reportable transactions (other than notional principal
contracts) during the 2007 tax year? (See Note 1 below).
If Yes, please provide
the information
required for Partner
to complete IRS
Form 8886 and State
disclosures for each
reportable
transaction.
Yes No
5 Has the Fund engaged in a notional principal contract (as defined in IRS Notice 2002-35 and as
clarified in IRS Notice 2006-16) during the 2007 tax year? (See Note 2 below).
If yes, please provide
the filed Form 8886
as acknowledgment
that Fund has
complied with its
separate disclosure
obligation.
Yes No
6 Is the Fund a non-U.S. partnership?
If yes, please If no, skip to Question
complete the 8.
Transfers to Foreign
LPs
Yes No
7 Did the Fund provide the information required for the partner to complete Form 8865 with the
partner's Year-End Tax Information?
If no, please provide
the Form 8865
information with this
questionnaire. Please
refer to instructions
for this form on
www.irs.gov
Yes No
8 Did the Fund file Form 8865 on behalf of its partners?
If yes, please provide the following:
Name and Address of non U.S. Partnership for which a
Form 8865 was filed:
Yes No
9 Did the Fund hold any non-U.S. investments or enter into any foreign transactions?
If no, STOP.
Yes No
10 Did the Fund withhold any non-U.S. tax during the year?
If yes, please
complete the Foreign
Tax Withholding
Schedule for Yale
and each Yale
affiliate that is a
partner in the Fund.
Yes No
11 Did the Fund transfer any property in a transaction described in Internal Revenue Code (IRC)
Section 6038B(a)(1)(A) directly or indirectly to a non-U.S. corporation during the period July 1, 2007
to June 30, 2008 (or calendar year 2007 if Fund reports on a calendar year basis)?
If yes, please
complete the
attached Form 926
Disclosure.
Yes No
12 Did the Fund own a direct or indirect interest in a non U.S. corporation?
If yes, please
complete attached
Form 5471 Analysis
PLEASE COMPLETE THE APPROPRIATE CONTACT INFORMATION BELOW :
Name:
Company:
Title:
Address:
Telephone #:
FAX #:
Email address:
Date
completed:
[Note 1] Listed transactions are one of the five categories of transactions included in the definition of reportable transactions (IRS Regulation 1.6011-4(b)). A list of the current Listed
Transactions is available at www.irs.gov. Certain States (e.g. California and New York) may have additional disclosure requirements. If you require additional information or have any
questions regarding reportable transactions, consult your tax advisor.
[Note 2] IRS Notice 2006-16 states that a taxpayer that, solely by reason of its direct or indirect interest in a pass-through Fund, participated in certain notional principal contracts is not
required to file a Form 8886. The taxpayer is relieved of this disclosure obligation provided that the pass-through Fund complies with its separate disclosure obligation and the taxpayer
receives acknowledgment of this compliance. The acknowledgment can be a copy of the Form 8886 filed by the pass-through Fund and must be received by the taxpayer prior to the time it
files its tax return
18e255d3-7296-4bfa-814e-5dac7bf03cd1.xls1/20/2012
Yale University and Affiliated Entities
UBTI Summary
6/30/2008
Please complete a UBTI Summary for Yale and each Yale affiliate that is a partner in the Fund
FUND NAME: 0 Partner Name:
Amount Exempt
Deductions Under IRC Sec.
Related to UBTI 514(c)(9) for
(Enter as positive Net Income (Loss) Qualified Net Amount to be Description of UBTI
Gross UBTI number) Reported as UBTI Organizations Reported as UBTI Activity
K-1 Line Number
1 Ordinary Income (loss) - -
2 Rental Income (loss) - -
5 Interest income - -
6a Dividend income - -
8 Net short-term capital gain (loss) - -
9 Net long term capital gain (loss) - -
10 1231 Gain/Loss - -
11A Other portfolio income (loss) - -
11C Sec. 1256 contracts & straddles - -
11F Other income - -
13A-F Charitable contributions - -
-
13G-V Other Deductions - -
Total - - - - -
16D-F Foreign source gross income
16G-K Foreign source deductions
17A Post-1986 Depreciation Adjustment
17B Adjusted Gain/Loss
17F Other AMT Items
Does the Fund conduct business in any of the following states: Alabama, Arkansas, California,
Colorado, Idaho, Illinois, Indiana, Kansas, Louisiana, Maryland, Massachusetts,
Michigan, Mississippi, Missouri, Montana, New York, Nebraska, North Dakota, Oklahoma, Oregon, Rhode Island, Utah If yes, please complete the State
or West Virginia? Allocation section beginning on
Line 50 of the UBTI Summary.
Yale University and Affiliated Entities
UBTI Summary
6/30/2007
Name of Entity: 0 Partnership Name: 0
INSTRUCTIONS: Please indicate the amount if UBTI allocable to each of following states. If the UBTI relates to debt-
financed property, please allocate UBTI based on the location of the debt-financed property.
Net Amount to be Alabama Arkansas California Colorado Idaho
K-1 Line Number Reported as UBTI
DO NOT CHANGE
1 Ordinary Income (loss) -
2 Rental Income (loss) -
5 Interest income -
6a Dividend income -
8 Net short-term capital gain (loss) -
9 Net long term capital gain (loss) -
10 1231 Gain/Loss -
11A Other portfolio income (loss) -
11C Sec. 1256 contracts & straddles -
11F Other income -
13A-F Charitable contributions -
13G-V Other Deductions -
Total - - - - - -
Illinois Indiana Kansas Louisiana Maryland Massachusetts Michigan Mississippi
- - - - - - - -
Missouri Montana New York Nebraska North Dakota Oklahoma Oregon Rhode Island
- - - - - - - -
Utah West Virginia Other Total Check (Should = -0-)
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- - - - -
Allocation and Apportionment Information
12/31/2007 Please only input in the cells shaded yellow
FUND NAME: 0
Property Factor Information: For each state in which the fund owns property, please input the information indicated on the template using the fund's balance sheet.
For beginning of the year information, use the fund's balance sheet as of 12/31/06.
For end of year information, use the fund's balance sheet as of 12/31/07.
If the fund has a fiscal year end, use the most recently issued K-1 date for end of year information and the
immediately preceding K-1 date for beginning of year information.
If none of the property information is applicable to the fund, please indicate this below with a brief explanation
(e.g. "The fund's only assets at the beginning and end of the year consisted of cash, receivables, and
marketable securities")
Explanation of Property Factor:
Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia
Property
Beginning of Year:
Land
Buildings (original cost)
Accumulated Depreciation
Other Depreciable Assets (original cost)
Accumulated Depreciation
Depletable Assets, Net
Other Tangible Assets
CIP
Inventory
Total Beginning - - - - - - - - - - -
End of Year
Land
Buildings (original cost)
Accumulated Depreciation
Other Depreciable Assets (original cost)
Accumulated Depreciation
Depletable Assets, Net
Other Tangible Assets
CIP
Inventory
Total Ending - - - - - - - - - - -
Rent Expense
Payroll
Total Payroll
Sales
Gross Rental Receipts
Interest Income
Proceeds from the sale of property
Gains
Other Receipts
Total Receipts - - - - - - - - - - -
Allocation and Apportionment Information
12/31/2007
FUND NAME:
Property Factor Information:
Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maryland Massachusetts Maine
Property
Beginning of Year:
Land
Buildings (original cost)
Accumulated Depreciation
Other Depreciable Assets (original cost)
Accumulated Depreciation
Depletable Assets, Net
Other Tangible Assets
CIP
Inventory
Total Beginning - - - - - - - - - - -
End of Year
Land
Buildings (original cost)
Accumulated Depreciation
Other Depreciable Assets (original cost)
Accumulated Depreciation
Depletable Assets, Net
Other Tangible Assets
CIP
Inventory
Total Ending - - - - - - - - - - -
Rent Expense
Payroll
Total Payroll
Sales
Gross Rental Receipts
Interest Income
Proceeds from the sale of property
Gains
Other Receipts
Total Receipts - - - - - - - - - - -
Allocation and Apportionment Information
12/31/2007
FUND NAME:
Property Factor Information:
Michigan Minnesota Mississippi Missouri Montana Nebraska New Jersey New Hampshire New Mexico New York NY City
Property
Beginning of Year:
Land
Buildings (original cost)
Accumulated Depreciation
Other Depreciable Assets (original cost)
Accumulated Depreciation
Depletable Assets, Net
Other Tangible Assets
CIP
Inventory
Total Beginning - - - - - - - - - - -
End of Year
Land
Buildings (original cost)
Accumulated Depreciation
Other Depreciable Assets (original cost)
Accumulated Depreciation
Depletable Assets, Net
Other Tangible Assets
CIP
Inventory
Total Ending - - - - - - - - - - -
Rent Expense
Payroll
Total Payroll
Sales
Gross Rental Receipts
Interest Income
Proceeds from the sale of property
Gains
Other Receipts
Total Receipts - - - - - - - - - - -
Allocation and Apportionment Information
12/31/2007
FUND NAME:
Property Factor Information:
North Dakota Nevada Ohio Oklahoma Oregon North Carolina Pennsylvania Rhode Island South Carolina South Dakota Tennessee
Property
Beginning of Year:
Land
Buildings (original cost)
Accumulated Depreciation
Other Depreciable Assets (original cost)
Accumulated Depreciation
Depletable Assets, Net
Other Tangible Assets
CIP
Inventory
Total Beginning - - - - - - - - - - -
End of Year
Land
Buildings (original cost)
Accumulated Depreciation
Other Depreciable Assets (original cost)
Accumulated Depreciation
Depletable Assets, Net
Other Tangible Assets
CIP
Inventory
Total Ending - - - - - - - - - - -
Rent Expense
Payroll
Total Payroll
Sales
Gross Rental Receipts
Interest Income
Proceeds from the sale of property
Gains
Other Receipts
Total Receipts - - - - - - - - - - -
Allocation and Apportionment Information
12/31/2007
FUND NAME:
Property Factor Information:
Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Other/Non U.S. Total
Property
Beginning of Year:
Land -
Buildings (original cost) -
Accumulated Depreciation -
Other Depreciable Assets (original cost) -
Accumulated Depreciation -
Depletable Assets, Net -
Other Tangible Assets -
CIP -
Inventory -
Total Beginning - - - - - - - - - -
End of Year
Land -
Buildings (original cost) -
Accumulated Depreciation -
Other Depreciable Assets (original cost) -
Accumulated Depreciation -
Depletable Assets, Net -
Other Tangible Assets -
CIP -
Inventory -
Total Ending - - - - - - - - - -
Rent Expense -
Payroll
Total Payroll -
Sales
Gross Rental Receipts -
Interest Income -
Proceeds from the sale of property -
Gains -
Other Receipts -
Total Receipts - - - - - - - - - -
Yale University Tax Questionnaire
Calendar Year 2007 or Year Ended on or Within the Fiscal Year Ended June 30, 2008
STATE WITHHOLDING SCHEDULE
FUND NAME: 0 Partner Name:
Instructions: Please complete the following schedule for Yale and each Yale affiliate that is a
partner in the Fund and fax copies of state withholding statements to the Yale University Tax
Department FAX # (203) 432-6215
Note: If withholding occurred at a lower tier level, please provide information related to each
lower tier entity's share of tax withheld.
Amount of
Amount of Composite State
Name of Withholding Income Tax Income Tax
Fund EIN State Withholding Payments
Yale University Tax Questionnaire
Calendar Year 2007 or Year Ended on or Within the Fiscal Year Ended June 30, 2008
Fund Name: 0
FORM 8865 DISCLOSURE INFORMATION
TRANSFERS REPORTABLE UNDER IRC SECTION 6038B
Capital Contributions for the Tax Year July 1, 2007 to June 30, 2008 made directly to the Fund
or made to an underlying non U.S. partnership of the Fund (please specify):
Note: If more than one Yale entity invests in this Fund, please complete a separate column for
each Yale partner. Please list Partner's gross capital contributions (not including
management fees).
Partner Name: Partner Name: Partner Name:
YALE ENTITY PARTNER:
Date of Transfer Capital Contribution Capital Contribution Capital Contribution
(MM/DD/YY) (Indicate Currency) (Indicate Currency) (Indicate Currency)
Yale University Tax Questionnaire
Calendar Year 2007 or Year Ended on or Within the Fiscal Year Ended June 30, 2008
FUND NAME: 0 Partner Name:
FOREIGN TAX WITHHOLDING SCHEDULE
Is Fund
requesting a
Type of Amount Subject Amount of Tax Withholding refund of
Country Withholding to Withholding Withheld Tax Rate withholding?
Yale University Tax Questionnaire
Calendar Year 2007 or Year Ended on or Within the Fiscal Year Ended June 30, 2008
FUND NAME: 0
Form 926 Disclosure Information
Country of
Transferor Transferee Organization or
Transferor Partnership Name Identifying # Transferee Corporation Identifying # Address Incorporation
Yale University Tax Questionnaire
Calendar Year 2007 or Year Ended on or Within the Fiscal Year Ended June 30, 2008
FUND NAME: 0
Form 926 Disclosure Information
Yale University Tax Questionnaire
Calendar Year 2007 or Year Ended on or Within the Fiscal Year Ended June 30, 2008
FUND NAME:
Form 926 Disclosure Information
Foreign law Date of Total Amount CFC PFIC
Transferor Partnership Name Characterization Transfer Transferred (yes/no) (yes/no) Description of Property Transferred
Yale University Tax Questionnaire
Calendar Year 2007 or Year Ended on or Within the Fiscal Year Ended June 30, 2008
FUND NAME:
Form 926 Disclosure Information
Yale University Tax Questionnaire
Calendar Year 2007 or Year Ended on or Within the Fiscal Year Ended June 30, 2008
FUND NAME: 0
Form 5471 Filing Analysis
Yes No
1 Is the Fund a non U.S. Corporation?
2 If the Fund is a partnership, does the partnership
own an interest in a non U.S. corporation?
If no, stop and
If yes, complete return to
below questionnaire
Enter name of non U.S. corporation:
Beginning of Year End of Year
Enter Fund's % ownership of non U.S. Corporation
3 If the Fund is a partnership, and you answered "Yes" to the
previous question, to your knowledge, has the partnership filed a
Form 5471 for its interest in the non U.S. corporation?
If yes, please If no, stop and
complete the return to
information, below questionnaire
Name of partnership filing Form 5471:
IRS Service Center where filed: