Tax Return Chack List
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Tax Return Chack List document sample
Document Sample


C o? Y
,",'990'PF Returnof PrivateFoundation
or Section 4947{aX1)Nonexempt Charitable Trust
OMB No. 1545-0052
Department the Treasury
ot
InlernalRevenueSeryice Note: Ihe foundation
Treated as a Private Foundation
be able to use a copv of this return to sallsfvsfafe requhements.
2@06
For calendar year 2(X)6,or tax year beginning , 2(X)6,and ending , 20
G Checkall that apply: I Initialreturn f Finalreturn fl Amendedreturn I Addresschange f Namechange
A Employer identification number
Use the IRS Name of foundation
label. WIfIAI{IFUIID s2 i 7076191
Otherwise, Numberand street(or P.O.box numberil mailis not delivered streeladdress)
to B Telephone number (seepage 11 of the instructions)
print
or type.
ilE
15908 198rh ST. { {25 ) {85.8862
See Specific City or town, state, and ZIP code C lf exemptionapplication pending,
is checkhere > [
lnstructions. wo0DtftvtltE.A 98072-7016
ut D 1. Foreign organizations, check here . > I
H Checktype of organization: Section501(cX3)
fl exemptprivatefoundation 2. Foreign organizations meetingthe 85%otest, n
foundation check here and attach computation > Ll
Section49a7(aX1) nonexempt trust Ll Othertaxable
charitable
E lf private foundation status was terminated
I Fairmarketvalueof all assetsat end J Accounting method: Casn fl Accrual
U under section 507(bX1XA), check here > Ll
-
of year (from Part ll, col. (c), Ll Other (specify) - F lf the foundationis in a 60-monthtermination
l i n e16) ) $ 3 1 ,2 6 9 .3 5 l, column (d) must be on cash undersection 507(b)0XB), check here > -
Ll
Anafysis of Revenue and Expenses fhe btalof (d) Disbursements
for charitable
amounts columns (c), (d)may necessarily
in (b), and not equal purposes
the amounts in column (a) (see page 11 of the instructions).) (cashbasis only)
1 gifts,
Contributions, grants, received
etc., (attach
schedule)
2 Check isnot to Sch.
> Zl if thefoundation requiredattach B
3 cash
Interest savings temporary investments
on and
4 Dividends and interestfrom securities
5a Gross rents
b Net rentalincomeor (loss)
(u
= 6a Net gain or (loss)from sale of assetsnot on line 10
c b Grosssalespricefor all assets line6a
on
o
o 7 Capitalgain net income(fromPart lV, line 2)
E 8 Net shod-termcapitalgain
I Incomemodifications
sales returns allowances
10a Gross less and
b Less:Cost of goods sold
c Grossprofit or (loss)(attachschedule)
11 Other income(attachschedule)
12 Total.Add lines1 throuoh1'l
o 13 Compensation officers,
of trustees,
directors, etc.
o
at, 14 Otheremployee
g salariesand wages
a 15 Pension plans,employee benefits
CL
x 16a Legalfees (attachschedule)
ul
(lt b Accounting fees (attachschedule)
.= c Other orofessional fees (attachschedule)
o
17 Interest
.2 18 (seepage 14 of the instructions)
.g
E 19 schedule) and depletion
T' 20
E 21 Travel,conferences, and meetings
tr 22 Printing
(! and publications
c'| 23 Otherexpenses
g
(attachschedule)
G
24 Total operating and administrative expenses.
o Add lines13 through 23
CL
25 Contributions, gifts,grantspaid 4,300.00
o Add lines24 and25
27 Subtractline 26 from line 12:
a Excess revenue
of overexpenses disbursemenls
and
b Net investmentincome (if negative,
enter-0-)
For Privacy Act and Paperwork Reduction Act Notice, see the instructions. C at.N o.11289X 990-PF (2006)
Form990-PF(2006) Page 2
End of year
EFFm Bahnce lfjf[.3,.ijT#j::fi$lT;:111.,1ff
sheets l$y.fi:ffiijili {c} Fajr Market Value
0
.96
31,269.35
o
o,
o
(E
o
@
o
tr
s
o
c0
1f
tr
IL
o
at
o
o
o
o
z
in Net Assets or F Balances
1 Total net assetsor fund balances beginning year-Part ll, column(a),line 30 (mustagreewith
at of
end-of-year figurereportedon prioryear'sreturn) 23,435.38
2 Enteramountfrom Part l, line 27a 3,861.97
3 Other increases includedin line 2 0temize)
not )' 3,972.00
4 Add lines1. 2. and 3 31
c Decreases not includedin line2 (itemize)
) 0
6 Total net assets or fund balancesat end of 4 minusline l l , col umn 31,269.35
rorm990-PF recoot
Form 990-PF (2000)
Gains and Losses for Tax on InvestmentIncome
(a) List and describethe kind(s)of propertysold (e.9.,real estate, {d) Date sold
2-storv brick warehouse: common stock, 200 shs. MLC Co.)
or (mo., day, yr.)
(9) Cost or other basis
(€) Gross sales price plus expenseo{ sale
Completeonly for assetsshowinggain in column(h)and ownedby the foundation 1?31/69
on
(l) Gains(Col.(h)gain minus
(k) Excessof col. (i) col. (k), but not less than -0-) or
(i) F.M.V. of 12131/69
as {ll AdJustedbasis
Losses(from col. (h))
as of 12131/69 overcol. 0, if any
in
2 capital gain net incomeor (net capitalloss) { tt oain' also enter Partl' line 7 }
' t lf (loss), enter-0- in Part l, line 7 J
3 Net short-term capitalgain or (loss)as definedin sections1222(5) and (6):
lf gain,also enterin Part l, line8, column(c) (seepages13 and 18 of the instructions)
enter-0- in Part I, lineB
Qualification Under Section for ReducedTax on Net lnvestment lncome
(Foroptionaluse by domesticprivatefoundations income.)
subjectto the section4940(al on net investment
tax
applies,leavethis part blank.
lf section4940(dX2)
Was the foundation amountof any year in the base period? [
liablefor the section 4942tax on the distributable Yes n No
lf "Yes,"the foundationdoes not qualifyundersection4940(e). not completethis part.
Do
1 Enterthe amountin eachcolumnfor each before
19 of the instructions entries.
(a) (d)
Base period years Distributionratio
Calendaryear (or tax year divided by col. (c))
2005
2003
2002
2 Total of line 1, column(d)
3 Average distributionratiofor the S-yearbase period-divide the total on line2 by 5, or by the
numberof years the foundationhas been in existenceif less than 5 years
4 Enterthe net valueof noncharitable-use
assetsfor 2006from PartX, line 5 .
line
5 Multiply 4 by line3
income(1o/o Part l, line27b)
6 Enter1% of net investment of
7 Add lines5 and 6
I Enterqualifying from PartXll, line 4
distributions
lf line 8 is equalto or greaterthan line 7, check the box in Part Vl, line lb, and completethat part usinga 1yo tax rate. See
the Part Vl instructions page 19.
on
rorm990-PF tzoool
Form 990-PF (2006) eage 4
ExciseTax Basedon InvestmentIncome or 4948-see paqe 19 of
'la Exempt foundations
operating insection
described check )
4940(d)(2), here [ and enter "N/A" on line 1.
Dateof rulingletter: (attach copy of ruling letter if necessary*see instructions)
b Domestic foundations that meet the section 9a0(e) requirementsin Part V, check 1 20 20
here ) [ and enter1%o Part l, line 27b
of
c Afl other domesticfoundations enter2Voof line 27b. Exemptforeignorganizations enler4o/o
of Partl, line12, col. (b)
2 Tav rrndcr scc:tinn 51 1 ldomestic section 49471a)l1l
trrrsis encl taxable forrndations onlv. Others enter -0J 2 0
3 Add lines1 and 2 3 20 20
A Sr rhtiila A finnnmo\ i (dnmpqtin 4 0
5 Tax based on investmentincome. Subtractline4 from line 3. lf zeroor less,enter -0- 5 20 20
6 Credits/Payments:
2ooa estimalecl tax oavments ancJ 2005 overoavment creciitecl io 2006 I 6a I i
^
b Exemptforeignorganizations-tax
withheldat source 6b
c Tav naid urith ennlinafion fnr ovfcnsinn nf time to file fForm 8868\ 6c
d R e c k u n w ith h o lclin o e r r o n e o r r slv with h e ld 6d
7 Total creditsand payments.
Add lines6a through6d 7
fl Fntpr anrr nonaltw fnr rrndarnarrmcnt nf cciimaled lav Chack here l- if Fnrm 222O is atiachecl I
I Tax due. lf the total of lines5 and I is morethan line 7. enteramount owed 9 20 20
10 Overpayment,lf line 7 is morethan the total of lines5 and 8, enterthe amount overpaid 10
11 Enter amount line10 to be:Credited 2d)7 estimated >
the of to tax Refunded 11
Statements ReqardinqActivities
'f a f)rrrinn tho iav vaar dirl lho fnrrndatinn r+lamnt tn inflrrpnno enrr nstional clala nr lncal leniclalinn nr r|icl il Yes No
parlicipate intervene any political
or in campaign? 1a
b Did it spend morethan $100duringthe year(either directlyor indirectly) politicalpurposes
for (seepage20
of the instructions definition)?
for 1b
lf the answer rs "Yes" to la or lb, attach a detaileddescriptionaf the activitiesand copiesof any materials
published distibuted by the foundationin connectionwith the activities.
or
'lc {
c Did the foundation Form 1120-POL this year?
file for
d Enterthe amount(if any)of tax on political expenditures (section 4955)imposedduringthe year:
( 1) ont he fo u n d a ti o n ^ > $ -(2 } O n fo u n d ati onmanagers' } $
e Enter reimbursement any)paidby thefoundation
the (if duringthe yearfor political expenditure imposed
tax on
>
foundationmanagers. $ _-.-=--
Has the foundation engagedin any activities that havenot previously to
been reported the IRS? . 2
lf "Yes," attacha detaileddescriptionof the activities.
Hasthe foundation madeanychanges, previouslynot reported the lRS,in its governing
to instrument, of
articles
incorporation, bylaws, othersimilar
or or instruments?"Yes,"
/f a
attach conformed copyof the changes 3
4a Did the foundation have unrelaled business gross incomeof $1,000or more duringthe year? 4a
b lf "Yes," has it filed a tax return on Form 990-T for this year? 4b
5 Was there a liquidation, termination, or
dissolution, substantial contraction duringthe year? 5
lf 'Yes," attach the statement required by General lnstruction T.
Are the requirements section508(e)
of (relating sections4941 through4945)satisfied
to either:
o By language the governing
in instrument, or
. By state legislation effectively
that amendsthe governing instrument that no mandatory
so that
directions
conflictwith the state law remainin the governing instrument? 6
7 Didthefoundation at least
have $5,000 assets anytimeduring year? "Yes,"
in at the lf complete ll,col.(c),and W.
Part Part 7
8a Enter the states to which the foundationreports or with which it is registered(see page 20 of the
>
instructions) YtqEia
lf the answeris "Yes"io line 7, has the foundation to
furnished copy of Form990-PF the Attorney
a General
(or designate)of each state as requiredby GenerallnstructionG? lf "No," attach explanation 8b {
ls the foundation claimingstatusas a privateoperating foundation withinthe meaning section4942(jX3)
of
or a9a2(j)(5) calendar
for year 2006 or the taxableyear beginning 2006 (seeinstructions Part XIV on
in for
page 2B)?lf "Yes," complete Part XIV . I
Did any personsbecomesubstantialcontributorsduringthe taxyear? lf "Yes,"attacha schedulelistingtheir
names and addresses 10
rorm990-PF reooot
Form 990-PF(2006)
Statements Activities Continued
lla At any time during the year, did the foundation, own a controlledentity within the
directlyor indirectly,
meaningof section512(bX13)? "Yes,"attachschedule.
lf (seeinstructions)
b lf"Yes,"didthefoundationhaveabindingwrittencontractineffectonAugustlT,2006,coveringtheinterest,
rents,royalties,
and annuitiesdescribedin the attachment line 11a?
for
12 Did the foundation acquirea direct or indirectinterestin any applicableinsurancecontract?
13 Didthefoundation comply thepublic
with inspection tor
requirements its annual and
returns exemption application?
address> qry.l-v!!-a4!tq!{-.9!f,
Website ""
14 Thebooksarein careot >-19!tll!!:!!!!3lt!,-- --- Tetephone )--------F-!?l?!!:!-5,?9
no.
Located >-99-ql-.-q{[gt{9!,.9qlli{9:-f4-
at ..-..-- ztp+4 >,---"----.lz9l-q'lq!t-
15 nonexempt
Section4947(a)(1) trustsfiling Form990-PFin lieu of Form 1041-Check here
charitable > U
and enterthe amountof tax-exemptinterestreceived accruedduringthe
or > lr s
Statements Regardinq Activities for Which Form 47
fi
Fife Form 472{J any item is checked in the "Yes" column, unless an exception applies.
1a Duringthe year did the foundation (either directlyor indirectly):
(1) Engagein the sale or exchange, leasingof propertywith a disqualified
or person? n Y." fl Ho
(2) Borrowmoneyfrom, lend moneyto, or otherwise extendcreditto (or accept it from)a
person?
disqualified fl Yes Z Ho
(3) Furnishgoods,services, facilities (or acceptthem from)a disqualified
or to person? [ v"" Z] No
(4) Pay compensation or pay or reimburse expenses a disqualified
to. the of, person? [ Yes Z] tto
(5) Transfer incomeor assetsto a disqualified
any person(or makeany of eitheravailable for
the benefit useof a disqualified
or person)? D yr" Z tto
(6) Agree to pay money or propertyto a government official?(Exception.Check "No" if
the foundationagreedto make a grant to or to employthe officialfor a period after
termination of government service, if terminating within 90 days.) - fl Ye' Zl No
lf anyanswer "Yes"to 1a(1)-(6), any of the actsfailto qualify
is did the
under exceptions in
described Regulations
section 53.4941(d)-3 in a current
or noticeregarding disaster (see
assistance page22 of the instructions)?
Organizations relyingon a currentnoticeregarding disasterassistance check here > n
Did the foundation engagein a prioryear in any of the acts described 1a, otherthan exceptedacts,that
in
were not correctedbeforethe first day of the tax year beginning 2006? in
Taxeson failureto distributeincome(section 4942)(doesnot applyfor yearsthe foundation was a private
operating foundation definedin section4942(iX3) a9 2$(5)):
or
At the end of tax year2006,did the foundation haveany undistributed income(lines and _
6d
6e, Part Xlll)for tax year(s) beginning before2006? Ll Yes Z uo
lf " Y es , "lis tt he y e a rs 2 0 .., , 2 0 ." .. , 2 0 ...
> 20.
Are thereany yearslistedin 2a for whichthe foundation not applying provisions section4942(a)(2\
is the of
(relating incorrect
to valuation assets) the year's undistributed
of to income?(lf applyingsection 4942(a)(2)
to aff years listed,answer"No" and attachstatement-see page22 of the inslructions.).
lf the provisions section 4942(a)(2) beingappliedto any of the yearslistedin 2a, list the yearshere.
of are
> 20 - . . _ , 20 ._ .. , 2 0 20.
3a Did the foundation hold more than a 2o/o direct or indirect interest in anv business
enterprise at any time during the year? I Y". Z tto
lf "Yes," did it haveexcessbusiness holdingsin 2006 as a resultof (1) any purchase the foundation
by or
disqualified personsafterMay 26, 1969;(2)the lapseof the 5-yearperiod(or longerperiodapprovedby the
Commissioner undersection4943(c)(7)) disposeof holdingsacquiredby gift or bequest; (3) the lapse
to or
of the 10-, '15-, or 20-year first phase holding period? (Use ScheduleC, Form 4720, to determineif the
foundation had excess buslness holdings in 2006.)
4a Didthe foundation investduringthe yearany amount a manner wouldjeopardize charitable
rn that its purposes?
b Didthefoundation make investmenta prior
any in year after
(but December , 1969) could
31 that jeopardize charitable
its
that had not been
rorm990-PF rzooot
Form 990-PF{2006)
Statements Activities for Which Form 472O Be tinued
5a Duringthe year did the foundation pay or incurany amountto:
(1) Carryon propaganda, otherwise
or attemptto influence legislation(section4945(e)? n Yes E tto
(2) Influence outcomeof any specificpublicelection(seesection4955);or to carryon,
the
any
directlyor indirectly, voter registration drive? fl Yes Z tto
(3) Providea grantto an individual travel,study,or other similarpurposes?
for [ ves Z] tto
(4) Provide grantio an organization
a otherthana charitable, etc.,organization described in
(2), (see
section509(a)(1), or (3),or section4940(dX2)? instructions) . I Y"" U No
(5) Provide for any purpose other than religious, charitable, scientific, literary, or _
educationalpurposes. or for the preventionof cruelty to children or animals? Ll Yes lll tto
lf any answer "Yes"to 5a(1)-(5), any of the transactions to qualifyunderthe exceptions
is did fail in
described
Regulations section 53.4945 in a current
or noticeregarding disaster assistance page23 of the instructions)?
(see
Organizations relyingon a currentnoticeregarding disasterassistance check here
c lf the answeris "Yes" to question5a(4), does the foundation claim exemption from the tax
becauseit maintained expenditure responsibility the grant?
for [ y." I tto
lf "Yes," attach the statement requiredby Regulations section 53.4945-5(d).
6a Did the foundation, duringthe year,receive funds,directlyor indirectly, pay premiums_
any to
on a personal benefitcontract? - Yes Zltto
b Did the foundation, during year,pay premiums,
the directly indirectly, a personal
or on benetit contract?
lf vou answered "Yes"to 6b. a/sofile Form 8870.
7a At anytimeduring taxyear, thefoundationpa'tyto a prohibited shelter
the was a tax transaction? n yes M No
b lf ves. did the foundationreceive or have anv net income attributableto the transaction?
Information About Officers, Directors, Trustees, FoundationManagers,Highly Paid Employees,
and Contractors
List all foundatlon manaqers and thear 23 of the instruc
(bl Title, and average (c) Compensation (d) Contributions
to Expenseaccount,
(a) Name and address nours per weeK (lf not paid, enter employeebenefit plans {6)
otherallowances
devotedto position -0-) and deferredcomoensation
l9!t-4 !l!lti!!t-
-t!,. Trustee -0. .0- -0-
t{. PA
606 Bedford Garlisle, it0it
St.,
{qrs-l-'_Wter!- Tru*ee .0- -0- -0.
il. St.. itiilnit----
606 Bedford Garlisle.
2 Compensationof five highest-paidemployees(other than those included on line l-see page 24 of the instructions),
lf none. enter "NONE."
(b) Title,and average (e) Expenseaccount,
(al Name and addressof each employeepard more than $50,000 nours per weeK
devotedto position other allowances
Total numberof other over $50,000
rorm990-PF reooot
Form 990-PF(2006) Page 7
firo'mii
and Contractors Confrnued
3 Five highest-paid independent contractors for professional services {see page 24 of the instructions), lf none, enter
"NONE."
{a) Name and addressof each personpaid more than $50,000 (c) Compen$ation
Total numberof othersreceivinq
over servtces
EHllil?t Summary of Direct Charitable Activities
List the foundation'sfour largestdirect charitableactivitiesduring the tax year. Includerelevantstatistjcalinformationsuch as the number
Expenses
of organizationsand other beneficiaries served,conferenc€s convened,researchpapersproduced,etc.
1 gl9_qtl_!T_*gp_q$gl_?-eqg.e
9-qp-!_l|9!!!t_tqetsj_9_trgqi-9!_t_e_9-cli-911
s4,300.00
-Related Investments 24 of the instruc
Describethe two largestprogram-related
investmentsmade by the foundationduring the tax year on lines 1 and 2
All other program-related See page 25 of the instructions.
investments.
3
Total. Add lines 1
rorm9S)-PF rzooot
Form 990-PF(2006) Page 8
Elfrt must completethis part. Foreignfoundations,
Minimum InvestmentReturn (Alldomesticfoundations
see page 25 of the instructions.)
1 Fair market value of as$etsnot used (or held for use) directly in carryingout charitable,
etc.,
purposes:
a Averagemonthlyfair marketvalueof securities 24,455.22
b Averageof monthlycash balances 773.52
c Fair marketvalueof all other assets(seepage25 of the instructions)
d Total {add lines]a, b, and c) 28,228.74
e Reduction claimedfor blockageor otherfactorsreportedon lines1a and
.lc (attach | re I - -
detailed explanation)
2 Acquisition indebtedness applicable to line 1 assets
3 Subtractline 2 from line 1d 28,228.74
4 Cash deemedheld for charitable Enler11/zYo line 3 (for greateramount,see page 26
activities. at
of the instructions) 423.4?
5 assets,Subtract 4 fromline3. Enter
Net valueof noncharitable-use line hereand on PartV, line4 27.805.31
6 Minimum investmentreturn. Enter5% of line 5
DistributableAmount (seepage 26 of the instructions)
(Section private
4942(iX3) {)(5)
and operating
foundations
and certain check here) n and do not complete part.)
this
1 Minimuminvestment returnfrom Part X. line 6 1,390.27
2a Tax on investment incomefor 2006 from Part Vl. line 5 .
b Incometax for 2006.flhis does not includethe tax from PartVl.)
c Add lines2a and 2b 20.20
3 Distributableamountbeforeadiustments. Subtractline2c from line 1 1,370.07
4 Recoveries amountstreatedas qualifying
of distributions
5 Add lines3 and 4 1,370.07
6 Deduction from distributableamount(seepage26 of the instructions) .
7 Distributable amount as adiusted.Subtract line 6 from line 5. Enter here and on Part Xlll.
line1
Im[ QualifyingDistributions(seepage 26 of the instructions)
Amountspaid (including administrative to
expenses) accomplish etc., purposes:
charitable,
Expenses, contributions, gifts,etc"*total from Part l, column(d),line 26 . 4,368.97
Program-related investments*total from Part lX-B
Amounts paid to acquireassets used (or held for use) directly in carryingout charitable, etc.,
purposes
Amountsset asidefor specificcharitable projectsthat satisfythe:
test (priorIRS approvalrequired).
a Suitability
b Cash distribution test (attachthe required schedule)
4 Qualifying Add
distributions. lines through Enter
1a 3b. and V,
here on Part line8, andPart Xlll,line4 4,368.97
5 Foundations that qualifyundersectiona940(e) the reducedrateof tax on net investment
for income.
Enter1Ysof ParI I, line 27b (seepage 27 ot the instructions)
Adjusted qualifyingdistributions.Subtractline 5 from line4 4,368.97
Note:Ihe amount on line 6 will be used in Part V, column (b), in subsequenlyearswhen calculatingwhether the foundation
qualifies for the section 4940(e)reductian af tax in fhose years.
rorm990-PF reooel
Form 990-PF(2006)
Undistributed Income 27 of the i
{o
2006
Distributable amountfor 2006 from Paft Xl.
line7 1.370.07
Undistributed income, any, of theendof 2005:
if as
a Enteramountfor 2005 only
b Total prior
for years: -,2O
20 -,2A -
3 Excess distributions if
carryover, any,to 2006:
a From2001
b From 2002
c From2003
d From2004
e From2005
f Total of lines3a throughe
4 Quatifying for
distributions 2006from PartXll,
t ine+ : - > $ 4 ,3 6 8 .9 7
a Appliedto 2005, but not more than line 2a
b Applied undistributed ofprior
to income years(Election
page
required-see 27 of theinstructions)
Treated drstributions of corpus(Election
as out
required-see page 27 of the instructions)
d Appliedto 2006 distributable amount
e Remaining amountdistributed of corpus
out
5 Excess distributions carryover to
applied 2006.
(lf an amount appears column (d), the same
in
amount must be shown in column (a).)
Enter the net total of each column as
indicated below:
a Corpus. Add lines3f, 4c, and4e. Subtract 5 line
b Prior years' undistributed income. Subtract
line4b from line2b
Enterthe amountof prior years'undistributed
income whicha notice deficiency been
for of has
issued, on whichthe section4942(a) has
or tax
beenpreviously assessed
Subtract line 6c from line 6b. Taxable
amount-see page27 of the instructions
Undistributed incomefor 2005. Subtractline
4a from line 2a. Taxableamount-see page
27 ot Ihe instructions
Undistributed incomefor 2006.Subtractlines
4d and 5 from line 'l . This amount must be
in
distributed 2OA7
Amounts treatedas distributions of corpus
out
to satisfy requirements imposed by section
170(b)(1)(E)4942(gX3)
or (seepage 28 of the
instructions)
Excessdistributions carryover from 2001 not
applied line5 or llne7 (seepage28 of the
on
instructions)
9 Excess distributions carryover to 2007.
Subtractlines7 and I from line 6a
10 Analysis line9:
of
a Excesslrom 2OO2
b Excessfrom 2003
c Excessfrom 2004
d Excessfrom 2005
e Excessfrom 2006
rorm990-PF taoooi
Form 990-PF (2006) Page 10
Private Foundations and Part
28 of the instructions
la lf the foundation has received a ruling or determinationletter that it is a private operating
fou nd atio n,andt her u|ingis ef f ec t iv ef or 200 6 'e n t e r t h e d a t e o f t h e r u | i n g >
b Checkbox to indicate whether foundation a
the is foundationdescribedin section
2a Enter the lesser of the adjusted net
{e) Total
income from Part I or the minimum
investment return from Part X for
each year listed
of
b B5o/o line 2a
c Qualifying distributionsfrom PartXll,
line 4 for each year listed
d Amounts in
includedline notused
2c directly
foraclive of activities
conduct exempt
e Qualifying made directly
distributions
for activeconductof exemptactivities.
Subtractline 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 49420X3XBXD
b "Endowment" test-enter % of
alternative
minimum investment returnshownin Part
X, line 6 for each year listed
c "Support" alternative test*enter:
(1) Total support other than gross
investmentincome (interest,
dividends,rents, paymentson
securitiesloans (section
512(aX5)), royalties)
or
(2) Support from general public
and 5 or more exempt
organizations provided in
as
section 4942[X3XBXiiD
(3) Largest amount of support from
an exempt organization
(4) Gross investment income
SupplementaryInformation (Completethis part only if the foundation had $5,000or more in assets
at any time during the year-see page 28 of the instructions.)
I Information RegardingFoundationManagers:
a List any managers the foundation
of who havecontributed of received the foundation
morelhan 2o/o the total contributions by
beforethe close of any tax year (but only if they havecontributed
morethan $5,000). (Seesection507(dX2).)
jointly Out lessthan$5lXXl
JohnH. andJaneJ. Winant, indiuidually)
b List any managers the foundation
of who own 10% or moreof the stock of a corporation an equallylargeportionof the
(or
ownership a partnership other entity)of which the foundation
of or has a 10% or greaterinterest.
iloilE
tnfor
- Check here > n it the foundation only makescontributions preselected
to charitableorganizations does not accept
and
unsolicitedrequstsfor funds. lf the foundationmakesgifts, grants,etc. (see page 28 of the instructions) individuals
to or
organizationsunderotherconditions, completeitems2a, b, c, and d.
a The name,address,and telephonenumberof the personto whom applications
shouldbe addressed:
schedule
Seeattached
b The form in which applications and matedals
shouldbe submittedand information they shouldinclude:
Seeattached
schedule
c Any submission
deadlines:
iloftE
d Any restrictions limitations awards,such as by geographical
or on areas,charitablefields, kinds of institutions, other
or
factors:
Seeattachedschedule
rorm990-PF rzoool
Form 990-PF(2006) Page 1'l
lnformation inued)
3 Grants and Contributions Paid the Year or for Future
Recipient show any relationshipto
any foundationmanager
Nameand address(homeor business) or substantial
contributor
a Paid during the year
Seeattachedschedule
Total
b Approved for future payment
rorm99O-PF tzooot
:,
Form990-PF(2006) eage12
Activities
Excludedsection 513, 514
by 512, or (e)
Enter nts unlessothenriseindicated.
Relatedor exempt
Tross {unction income
(Seepage 29 of
the instructions.)
I Pr{gram servicerevenue:
a
b
c
d
e
t
g Feesandcontracts fromgovernment agencies
2 Membership dues and assessments
3 on
Interest savings temporary
and cashinvestments
4 Dividends and interestfrom securities
5 Net rentalincomeor (loss) from realestate:
a Debt-financed property
b Not debt-financed property
6 Net rentalincomeor (loss) from personalproperty
7 Other inveslment income
I Gain (loss) sales assets than
or lrom of other inventory
9 Net incomeor (loss) from specialevents
10 Gross profit or (loss)from sales of inventory
11 Other revenue:a
b
c
d
e
1 2 Subtotal.Add columns(b),(d),and (e)
1 3 Total, Add line 12, columns(b),(d),and (e) 1,010.08
in
worksheet line 13 instructions on 29 to
of Activities to the
Line No. Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
V the ac_c_omplishment of the foundation's exempt purposes (other than by providing funds for such purposes). (See
paqe 29 of the instructions.)
rorm9S)-PF rzoool
Form 990-PF(2006)
InformationRegarding Transfers To and
i,i,
1 Didthe organizationdirectly indirectly
or engage any oJthe following
in with any otherorganizarion o**lo"o No
in section501(c) the code (other
of th"n s"Jtion 5ol (cxg)organizatioris) in section 527,relatingto
or potilical
organizations?
a Transfers from the reporiingfoundation a noncharitable
to exemptorganization of:
(1) Cash
(2) Other assets
b Othertransactions:
{c} Name of noncharitable exempt organization
2a |s t hef ounda ti o n d i re c tl y o ri n d i re c tl y a ffi | i atedw i th,orrel atedto,on" o;m
describedin sections01(c)of the cobe loftreilnan sections01(c)(3))
lf "Yes."
es, a iho
schedule
or in sections2z? D Yes mNo
(a) Name oi organization (b) Type of organization (cl Descnotion of
v | | U 9 | P c ' l a | U v 5Ulp 9 r Ju r y' Io e cla r e th a tlh a Ve e Xa m|nedthi sretU rn''j nc|LJdi ngaccompanyi ngs':h99u|e.S "no.
oerret'lt rs true' correct' and compleie' Declaratron preparei or lorirerthan taxfayer or irou6ia{r;rs basedon ail information irh,cn prepare,has any
of knowredge
\
o
o L )#s,--
Date preparer,sSSN or pTlN
l D> I
ct) Check if {See Signature on page 3.t
o self-emp 'oyeo > _ | of the instructrons.)
€95 5t?"tt?5" L-J I
a ocL o
-o )
Frrm s name (or yours
't
self-employed). address. D EIN> i
a n d Z IP c ode' 7
norm990-PF 1zooel
Form 990-PF (2006) THE WINANT FUND EIN 52-7076191
Schedule:PartI.Item 18: Taxes
$ 55.29 tax on investmentincome for 2005 tax year
Schedule: Part I. Item 23: Other Expenses
$68.97 wire transferfees (Smith Barney)
$24.00 office supplies(paper,ink, envelopes,
stamps)
-
Schedule: Part II. Item 10(b): Investments CorporateStock
Market value as of 12/3112006:
l. 100 shares AT&T Inc.
of $ 3,575.00
2. 100 shares Honeywell International
of S 4,524.00
3. 200 shares Motorola Inc.
of $ 4,112.00
4. 100shares WellsFargoCo.
of S 7,112.00
4. 200 shares GeneralMotors pf
of $ 3,780.00
5. 210.617shares Putnam[nt'l New Oppt.
of $ 3,578.39
Class A mutual fund
TOTAL: 526,681.39
Schedule: Part XV. Item 2: Information regardingproerams
A) Addressapplicationsto:
The Winant Fund -OR- John H. Winant
15908NE 198th St. 606 N. BedfordSt.
Woodinville,WA 98072 Carlisle,PA 17013
B) Form of Application: There is no specificformat for applications, they should
but
include: The name, address,telephonenumber and e-mail addressof the
applicantand the organizationon whosebehalf the applicationis made; a
descriptionof the organizationand its activities;a descriptionof the project to be
funded; the amount requestedfrom the Fund; the specific purpose to which the
amountwill be put; the budgetfor the project; and a list of any other sourcesof
funding.
C) Deadlines: N/A
D) Restrictions or limitations: At this time, grants from the Fund are usually limited
to no more than $500 per project. The priorities of the Fund are the relief of the
poor, the distressed the underprivileged,
or especiallychildren; the elimination of
prejudice and discrimination; and the prevention of cruelty to, and promotion of
the welfare of, children and animals.
(2006)
Form990-PF THE WINANTFUND EIN52-7076191
Schedule: Part XV. ltem 3: Summarvof Grantsand Contributions
Relationto
manager Amountin
or Foundation U .S.
Recipient contributor status Purposeof Grant Dollars
'SUCCESS"program Funded small
11 grants Peace
to Corps 4000.0(
J.S.Peace
Corps Volunteers provide
to assistanceto
103MateeviciSt. needy and
children elderly residents
in
^hisinau Mnldnva None N/A Molrlnvan villenpc
.KARAssociation Providedclothing school
and supplies
to 300.0(
23OtetsPaisiiSt. indigent
children
-{askovo- Brrloaria None N/A
4300.00
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