Exempt Organization Business Income Tax Return (and proxy tax under section 6033(e))

Transcription

1 11/9/218 1:27:28 AM Return Lumina Foundation for Education, Inc Form 99-T Exempt Organization Business Income Tax Return (and proxy tax under section 633) OMB No For calendar year 217 or other tax year beginning, 217, and ending, 2. Department of the Treasury Go to for instructions and the latest information. Open to Public Inspection for Internal Revenue Service Do not enter SSN numbers on this form as it may be made public if your organization is a 51(3). 51(3) Organizations Only Check box if Name of organization ( Check box if name changed and see instructions.) A address changed D Employer identification number (Employees trust, see instructions.) B Exempt under section LUMINA FOUNDATION FOR EDUCATION, INC. Print 51( C ) ( 3 ) Number, street, and room or suite no. If a P.O. box, see instructions or Type 3 S MERIDIAN ST, SUITE 7 E Unrelated business activity codes (See instructions.) 48A 53 City or town, state or province, country, and ZIP or foreign postal code 529 INDIANAPOLIS, IN C Book value of all assets at end of year F Group exemption number (See instructions.) G Check organization type 51 corporation 51 trust 41 trust Other trust H Describe the organization s primary unrelated business activity. PASSIVE INVESTMENTS I During the tax year, was the corporation a subsidiary in an affiliated group or a parent-subsidiary controlled group?.. Yes No If Yes, enter the name and identifying number of the parent corporation. J The books are in care of JULIE K. SHEWMAKER Telephone number (317) Part I Unrelated Trade or Business Income (A) Income (B) Expenses (C) Net 1a Gross receipts or sales b Less returns and allowances c Balance 1c 2 Cost of goods sold (Schedule A, line 7) Gross profit. Subtract line 2 from line 1c a Capital gain net income (attach Schedule D) a 1,17,854 1,17,854 b Net gain (loss) (Form 4797, Part II, line 17) (attach Form 4797) 4b c Capital loss deduction for trusts c 5 Income (loss) from partnerships and S corporations (attach statement) 5 (2,693,374) (2,693,374) 6 Rent income (Schedule C) Unrelated debt-financed income (Schedule E) Interest, annuities, royalties, and rents from controlled organizations (Schedule F) 8 9 Investment income of a section 51(7), (9), or (17) organization (Schedule G) 9 1 Exploited exempt activity income (Schedule I) Advertising income (Schedule J) Other income (See instructions; attach schedule) Total. Combine lines 3 through (1,522,52) (1,522,52) Part II Deductions Not Taken Elsewhere (See instructions for limitations on deductions.) (Except for contributions, deductions must be directly connected with the unrelated business income.) 14 Compensation of officers, directors, and trustees (Schedule K) , Salaries and wages , Repairs and maintenance Bad debts Interest (attach schedule) Taxes and licenses ,267 2 Charitable contributions (See instructions for limitation rules) Depreciation (attach Form 4562) , Less depreciation claimed on Schedule A and elsewhere on return.. 22a 22b 3, Depletion Contributions to deferred compensation plans Employee benefit programs , Excess exempt expenses (Schedule I) Excess readership costs (Schedule J) Other deductions (attach schedule) ,47 29 Total deductions. Add lines 14 through ,78 3 Unrelated business taxable income before net operating loss deduction. Subtract line 29 from line 13 3 (2,24,598) 31 Net operating loss deduction (limited to the amount on line 3) Unrelated business taxable income before specific deduction. Subtract line 31 from line (2,24,598) 33 Specific deduction (Generally $1,, but see line 33 instructions for exceptions) Unrelated business taxable income. Subtract line 33 from line 32. If line 33 is greater than line 32, enter the smaller of zero or line (2,24,598) For Paperwork Reduction Act Notice, see instructions. Cat. No J Form 99-T (217)

2 11/9/218 1:27:28 AM Return Lumina Foundation for Education, Inc Form 99-T (217) Page 2 Part III Tax Computation 35 Organizations Taxable as Corporations. See instructions for tax computation. Controlled group members (sections 1561 and 1563) check here See instructions and: a Enter your share of the $5,, $25,, and $9,925, taxable income brackets (in that order): (1) $ (2) $ (3) $ b Enter organization s share of: (1) Additional 5% tax (not more than $11,75) $ (2) Additional 3% tax (not more than $1,) $ c Income tax on the amount on line c 36 Trusts Taxable at Trust Rates. See instructions for tax computation. Income tax on the amount on line 34 from: Tax rate schedule or Schedule D (Form 141) Proxy tax. See instructions Alternative minimum tax Tax on Non-Compliant Facility Income. See instructions Total. Add lines 37, 38 and 39 to line 35c or 36, whichever applies Part IV Tax and Payments 41a Foreign tax credit (corporations attach Form 1118; trusts attach Form 1116). 41a b Other credits (see instructions) b c General business credit. Attach Form 38 (see instructions) c d Credit for prior year minimum tax (attach Form 881 or 8827) d e Total credits. Add lines 41a through 41d e 42 Subtract line 41e from line Other taxes. Check if from: Form 4255 Form 8611 Form 8697 Form 8866 Other (attach schedule) Total tax. Add lines 42 and a Payments: A 216 overpayment credited to a 25, b 217 estimated tax payments b c Tax deposited with Form c d Foreign organizations: Tax paid or withheld at source (see instructions). 45d e Backup withholding (see instructions) e f Credit for small employer health insurance premiums (Attach Form 8941). 45f g Other credits and payments: Form 2439 Form 4136 Other Total 45g 46 Total payments. Add lines 45a through 45g , 47 Estimated tax penalty (see instructions). Check if Form 222 is attached Tax due. If line 46 is less than the total of lines 44 and 47, enter amount owed Overpayment. If line 46 is larger than the total of lines 44 and 47, enter amount overpaid , 5 Enter the amount of line 49 you want: Credited to 218 estimated tax 25, Refunded 5 Part V Statements Regarding Certain Activities and Other Information (see instructions) 51 At any time during the 217 calendar year, did the organization have an interest in or a signature or other authority over a financial account (bank, securities, or other) in a foreign country? If YES, the organization may have to file FinCEN Form 114, Report of Foreign Bank and Financial Accounts. If YES, enter the name of the foreign country here Yes 52 During the tax year, did the organization receive a distribution from, or was it the grantor of, or or to, a foreign trust?. If YES, see instructions for other forms the organization may have to file. 53 Enter the amount of tax-exempt interest received or accrued during the tax year $ 95,669 Sign Here Paid Preparer Use Only 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. May the IRS discuss this return with the preparer shown below CEO (see instructions)? Yes No Signature of officer Date Title Print/Type preparer s name Preparer s signature Date PTIN Check if NICOLE M BENCIK 11/9/218 self-employed P Firm s name CROWE LLP Firm s EIN Firm s address 3815 RIVER CROSSING PARKWAY, SUITE 3, INDIANAPOLIS, IN Phone no. (317) Form 99-T (217) No

3 Form 8868 (Rev. January 217) Department of the Treasury Internal Revenue Service Application for Automatic Extension of Time To File an Exempt Organization Return File a separate application for each return. Information about Form 8868 and its instructions is at OMB No Electronic filing (e-file). You can electronically file Form 8868 to request a 6-month automatic extension of time to file any of the forms listed below with the exception of Form 887, Information Return for Transfers Associated With Certain Personal Benefit Contracts, for which an extension request must be sent to the IRS in paper format (see instructions). For more details on the electronic filing of this form, visit click on Charities & Non-Profits, and click on e-file for Charities and Non-Profits. Automatic 6-Month Extension of Time. Only submit original (no copies needed). All corporations required to file an income tax return other than Form 99-T (including 112-C filers), partnerships, REMICs, and trusts must use Form 74 to request an extension of time to file income tax returns. Enter filer's identifying number, see instructions Name of exempt organization or other filer, see instructions. Employer identification number (EIN) or Type or print Lumina Foundation for Education Number, street, and room or suite no. If a P.O. box, see instructions. Social security number (SSN) File by the due date for 3 S. Meridian St. filing your City, town or post office, state, and ZIP code. For a foreign address, see instructions. return. See instructions. Indianapolis, IN 4624 Enter the Return Code for the return that this application is for (file a separate application for each return) Application Is For Return Code Form 99 or Form 99-EZ 1 Form 99-BL 2 Form 472 (individual) 3 Form 99-PF 4 Form 99-T (sec. 41 or 48 trust) 5 Form 99-T (trust other than above) 6 Application Is For Return Code Form 99-T (corporation) 7 Form 141-A 8 Form 472 (other than individual) 9 Form Form Form The books are in the care of Julie K. Shewmaker Telephone No Fax No. If the organization does not have an office or place of business in the United States, check this box If this is for a Group Return, enter the organization s four digit Group Exemption Number (GEN). If this is for the whole group, check this box.... If it is for part of the group, check this box.... and attach a list with the names and EINs of all members the extension is for. 1 I request an automatic 6-month extension of time until November 15, 2 18, to file the exempt organization return for the organization named above. The extension is for the organization s return for: calendar year 2 17 or tax year beginning, 2, and ending, 2. 2 If the tax year entered in line 1 is for less than 12 months, check reason: Initial return Final return Change in accounting period 3a If this application is for Forms 99-BL, 99-PF, 99-T, 472, or 669, enter the tentative tax, less any nonrefundable credits. See instructions. 3a $ b If this application is for Forms 99-PF, 99-T, 472, or 669, enter any refundable credits and estimated tax payments made. Include any prior year overpayment allowed as a credit. 3b $ 25 c Balance due. Subtract line 3b from line 3a. Include your payment with this form, if required, by using EFTPS (Electronic Federal Tax Payment System). See instructions. 3c $ Caution: If you are going to make an electronic funds withdrawal (direct debit) with this Form 8868, see Form 8453-EO and Form 8879-EO for payment instructions. For Privacy Act and Paperwork Reduction Act Notice, see instructions. Cat. No D Form 8868 (Rev )

4 11/9/218 1:27:28 AM Return Lumina Foundation for Education, Inc Form 99-T (217) Page 3 Schedule A Cost of Goods Sold. Enter method of inventory valuation 1 Inventory at beginning of year 1 2 Purchases Cost of labor a Additional section 263A costs (attach schedule).... 4a b Other costs (attach schedule) 4b 5 Total. Add lines 1 through 4b 5 6 Inventory at end of year Cost of goods sold. Subtract line 6 from line 5. Enter here and in Part I, line Do the rules of section 263A (with respect to produced or acquired for resale) apply to the organization? Schedule C Rent Income (From Real Property and Personal Property Leased With Real Property) (see instructions) 1. Description of (1) (2) (3) (4) (1) (2) (3) (4) From personal (if the percentage of rent for personal is more than 1% but not more than 5%) 2. Rent received or accrued 1. Description of debt-financed From real and personal (if the percentage of rent for personal exceeds 5% or if the rent is based on profit or income) 2. Gross income from or allocable to debt-financed Yes 3 Deductions directly connected with the income in columns 2 and 2 (attach schedule) Total Total Total deductions. Total income. Add totals of columns 2 and 2. Enter Enter here and on page 1, here and on page 1, Part I, line 6, column (A)... Part I, line 6, column (B) Schedule E Unrelated Debt-Financed Income (see instructions) 3. Deductions directly connected with or allocable to debt-financed (1) (2) (3) (4) 4. Amount of average acquisition debt on or allocable to debt-financed (attach schedule) 5. Average adjusted basis of or allocable to debt-financed (attach schedule) 6. Column 4 divided by column 5 (1) % (2) % (3) % (4) % Straight line depreciation (attach schedule) 7. Gross income reportable (column 2 column 6) Enter here and on page 1, Part I, line 7, column (A). Other deductions (attach schedule) No 8. Allocable deductions (column 6 total of columns 3 and 3) Enter here and on page 1, Part I, line 7, column (B). Totals Total dividends-received deductions included in column Form 99-T (217)

5 11/9/218 1:27:28 AM Return Lumina Foundation for Education, Inc Form 99-T (217) Page 4 Schedule F Interest, Annuities, Royalties, and Rents From Controlled Organizations (see instructions) Exempt Controlled Organizations (1) (2) (3) 1. Name of controlled organization (4) Nonexempt Controlled Organizations 2. Employer identification number 3. Net unrelated income (loss) (see instructions) 4. Total of specified payments made 5. Part of column 4 that is included in the controlling organization s gross income 6. Deductions directly connected with income in column 5 7. Taxable Income 8. Net unrelated income (loss) (see instructions) 9. Total of specified payments made 1. Part of column 9 that is included in the controlling organization s gross income 11. Deductions directly connected with income in column 1 (1) (2) (3) (4) Add columns 5 and 1. Enter here and on page 1, Part I, line 8, column (A). Add columns 6 and 11. Enter here and on page 1, Part I, line 8, column (B). Totals Schedule G Investment Income of a Section 51(7), (9), or (17) Organization (see instructions) 3. Deductions 4. Set-asides 5. Total deductions 1. Description of income 2. Amount of income directly connected and set-asides (col. 3 (attach schedule) (attach schedule) plus col. 4) (1) (2) (3) (4) Enter here and on page 1, Part I, line 9, column (A). Enter here and on page 1, Part I, line 9, column (B). Totals Schedule I Exploited Exempt Activity Income, Other Than Advertising Income (see instructions) (1) (2) (3) (4) 1. Description of exploited activity 2. Gross unrelated business income from trade or business Enter here and on page 1, Part I, line 1, col. (A). 3. Expenses directly connected with production of unrelated business income Enter here and on page 1, Part I, line 1, col. (B). 4. Net income (loss) from unrelated trade or business (column 2 minus column 3). If a gain, compute cols. 5 through Gross income from activity that is not unrelated business income 6. Expenses attributable to column 5 7. Excess exempt expenses (column 6 minus column 5, but not more than column 4). Enter here and on page 1, Part II, line 26. Totals Schedule J Advertising Income (see instructions) Part I Income From Periodicals Reported on a Consolidated Basis (1) (2) (3) (4) 1. Name of periodical 2. Gross advertising income 3. Direct advertising costs 4. Advertising gain or (loss) (col. 2 minus col. 3). If a gain, compute cols. 5 through Circulation income 6. Readership costs 7. Excess readership costs (column 6 minus column 5, but not more than column 4). Totals (carry to Part II, line (5)).. Form 99-T (217)

6 11/9/218 1:27:28 AM Return Lumina Foundation for Education, Inc Form 99-T (217) Page 5 Part II Income From Periodicals Reported on a Separate Basis (For each periodical listed in Part II, fill in columns 2 through 7 on a line-by-line basis.) 1. Name of periodical 2. Gross advertising income 3. Direct advertising costs 4. Advertising gain or (loss) (col. 2 minus col. 3). If a gain, compute cols. 5 through Circulation income 6. Readership costs 7. Excess readership costs (column 6 minus column 5, but not more than column 4). (1) (2) (3) (4) Totals from Part I Enter here and on page 1, Part I, line 11, col. (A). Enter here and on page 1, Part I, line 11, col. (B). Enter here and on page 1, Part II, line 27. Totals, Part II (lines 1 5).... Schedule K Compensation of Officers, Directors, and Trustees (see instructions) 1. Name 2. Title 3. Percent of 4. Compensation attributable to time devoted to business unrelated business (1) OFFICERS 1 % 33,851 (2) % (3) % (4) % Total. Enter here and on page 1, Part II, line ,851 Form 99-T (217)

7 11/9/218 1:27:28 AM Return Lumina Foundation for Education, Inc Form 99T Part I, Line 5 Income (loss) from Partnership and S Corporations Name of Partnership EIN UBI ALTERNATIVE INVESTMENTS (1) Abrams Capital Partners II, LP ,28 (2) AG REALTY FUND IX, LP ,276 (3) ALPINE INVESTORS V, LP ,332 (4) Archlight Energy Partners Fund IV LP ,159 (5) BAUPOST VALUE PARTNERS, L.P.-IV ,935 (6) Carmel Partners Investment Fund IV, LP ,349 (7) CENTRE LANE PARTNERS III, LP ,357 (8) CHARLESBANK EQUITY FUND VII, LP ,941 (9) Charlesbank Equity Fund VIII, LP ,28 (1) ENERGY SPECTRUM PARTNERS VII LP ,63 (11) H.I.G. CAPITAL PARTNERS IV, L.P (12) H.I.G. CAPITAL PARTNERS V, L.P ,991 (13) H.I.G. EUROPE CAPITAL PARTNERS, L.P (14) H.I.G. Growth Buyouts & Equity Fund II, L. P ,98 (15) HIGHFIELDS CAPITAL IV LP (16) Iron Point Real Estate Partners II ,729 (17) IRON POINT REAL ESTATE PARTNERS III, LP ,745 (18) KUEMPER HOLDINGS V, LLC ,136 (19) Lime Rock Partners VI, L. P ,414,458 (2) MERCED PARTNERS IV, L.P ,437 (21) MERCED PARTNERS V, L.P ,869 (22) NATURAL GAS PARTNERS IX, LP ,483 (23) OCM REAL ESTATE OPPORTUNITIES FUND III, LP ,986 (24) PARTNERS FOR GROWTH V LP ,848 (25) RETHINK EDUCATION, LP ,86 (26) RIVA CAPITAL PARTNERS IV, LP ,499 (27) Starwood Captial Hospitality Fund I-3, LP ,658 (28) Stonehill Institutional Partners LP ,996 (29) Stonelake Opportunity Partners III, LP ,236 (3) TAILWATER E&P Opportunity Fund II, LP ,784 (31) Tailwater Energy Fund III, L.P ,377,79 (32) VENTURE INVESTMENT ASSOCIATES VI, LP ,99 (33) WALTON STREET REAL ESTATE FUND V, LP ,43 (34) Whitman/Peterson Partners III LP ,235 Total for Part I, Line 5-2,693,374

8 11/9/218 1:27:28 AM Return Lumina Foundation for Education, Inc Form 99T Part II, Line 19 Taxes and Licenses Description Amount INVESTMENT EXPENSE (1) AL STATE INCOME TAX 1,146 (2) AZ STATE INCOME TAX 3,658 (3) AR STATE INCOME TAX 137 (4) CT STATE INCOME TAX 1,83 (5) DC STATE INCOME TAX 25 (6) GA STATE INCOME TAX 55 (7) HI STATE INCOME TAX 791 (8) IL STATE INCOME TAX 1,36 (9) IN STATE INCOME TAX 1,945 (1) MD STATE INCOME TAX 833 (11) MN STATE INCOME TAX 1,3 (12) MO STATE INCOME TAX 225 (13) NM STATE INCOME TAX 5 (14) NY STATE INCOME TAX 25 (15) NC STATE INCOME TAX 6 (16) SC STATE INCOME TAX 449 (17) TN STATE INCOME TAX 55 (18) VA STATE INCOME TAX 5,418 (19) WI STATE INCOME TAX 32 Total 2,267 Total for Part II, Line 19 2,267

9 11/9/218 1:27:28 AM Return Lumina Foundation for Education, Inc Form 99T Part II, Line 2 Charitable Contributions Year Generated Amount Generated Amount Used in Prior Years Amount Used in Current Year Amount Converted to NOL Amount Remaining 215 1,243 1, ,568 1, ,341 2, Totals 5,152 5,152 Contribution Carryover Expires

10 11/9/218 1:27:28 AM Return Lumina Foundation for Education, Inc Form 99T Part II, Line 28 Other Deductions Description Amount INVESTMENT EXPENSE (1) OCCUPANCY 7,85 (2) LEGAL FEES 2,583 (3) ACCOUNTING FEES 18,65 (4) CONSULTING/OTHER PROFESSIONAL FEES 518,654 (5) TRAVEL 1,714 (6) OTHER MISCELLANEOUS EXPENSE 8,784 Total 575,47 Total for Part II, Line ,47

11 11/9/218 1:27:28 AM Return Lumina Foundation for Education, Inc Form 99T Part II, Line 31 Net Operating Loss Deduction Carryforward Schedule Year Generated Amount Generated Converted Contributions Amount Used in Prior Years Amount Used in Current Year Amount Remaining 215 3,1,824 3,1, ,31,449 1,31, ,24,598 2,24, Totals 6,543,871 6,543,871 NOL Expires

12 11/9/218 1:27:28 AM Return Lumina Foundation for Education, Inc SCHEDULE D (Form 112) Department of the Treasury Internal Revenue Service Name Capital Gains and Losses Attach to Form 112, 112-C, 112-F, 112-FSC, 112-H, 112-IC-DISC, 112-L, 112-ND, 112-PC, 112-POL, 112-REIT, 112-RIC, 112-SF, or certain Forms 99-T. Go to for instructions and the latest information. OMB No Employer identification number LUMINA FOUNDATION FOR EDUCATION, INC Part I Short-Term Capital Gains and Losses Assets Held One Year or Less See instructions for how to figure the amounts to enter on the lines below. This form may be easier to complete if you round off cents to whole dollars. 1a Totals for all short-term transactions reported on Form 199-B for which basis was reported to the IRS and for which you have no adjustments (see instructions). However, if you choose to report all these transactions on Form 8949, leave this line blank and go to line 1b b Totals for all transactions reported on Form(s) 8949 with Box A checked Totals for all transactions reported on Form(s) 8949 with Box B checked Totals for all transactions reported on Form(s) 8949 with Box C checked Proceeds (sales price) Cost (or other basis) (g) Adjustments to gain or loss from Form(s) 8949, Part I, line 2, column (g) 4 Short-term capital gain from installment sales from Form 6252, line 26 or (h) Gain or (loss) Subtract column from column and combine the result with column (g) 4,671 4,671 5 Short-term capital gain or (loss) from like-kind exchanges from Form Unused capital loss carryover (attach computation) ( ) 7 Net short-term capital gain or (loss). Combine lines 1a through 6 in column h Part II Long-Term Capital Gains and Losses Assets Held More Than One Year See instructions for how to figure the amounts to enter on the lines below. This form may be easier to complete if you round off cents to whole dollars. 8a Totals for all long-term transactions reported on Form 199-B for which basis was reported to the IRS and for which you have no adjustments (see instructions). However, if you choose to report all these transactions on Form 8949, leave this line blank and go to line 8b b Totals for all transactions reported on Form(s) 8949 with Box D checked Totals for all transactions reported on Form(s) 8949 with Box E checked Totals for all transactions reported on Form(s) 8949 with Box F checked Proceeds (sales price) Cost (or other basis) (g) Adjustments to gain or loss from Form(s) 8949, Part II, line 2, column (g) 4,671 (h) Gain or (loss) Subtract column from column and combine the result with column (g) 46,937 46, Enter gain from Form 4797, line 7 or , Long-term capital gain from installment sales from Form 6252, line 26 or Long-term capital gain or (loss) from like-kind exchanges from Form Capital gain distributions (see instructions) Net long-term capital gain or (loss). Combine lines 8a through 14 in column h Part III Summary of Parts I and II 16 Enter excess of net short-term capital gain (line 7) over net long-term capital loss (line 15) Net capital gain. Enter excess of net long-term capital gain (line 15) over net short-term capital loss (line 7) 17 1,166,183 4,671 1,166, Add lines 16 and 17. Enter here and on Form 112, page 1, line 8, or the proper line on other returns.. 18 Note: If losses exceed gains, see Capital losses in the instructions. 1,17,854 For Paperwork Reduction Act Notice, see the Instructions for Form 112. Cat. No. 1146M Schedule D (Form 112) 217

13 11/9/218 1:27:28 AM Return Lumina Foundation for Education, Inc Form 222 Department of the Treasury Internal Revenue Service Name Underpayment of Estimated Tax by Corporations Attach to the corporation s tax return. Go to for instructions and the latest information. Employer identification number OMB No LUMINA FOUNDATION FOR EDUCATION, INC Note: Generally, the corporation isn't required to file Form 222 (see Part II below for exceptions) because the IRS will figure any penalty owed and bill the corporation. However, the corporation may still use Form 222 to figure the penalty. If so, enter the amount from page 2, line 38 on the estimated tax penalty line of the corporation s income tax return, but do not attach Form 222. Part I Required Annual Payment 1 Total tax (see instructions) a Personal holding company tax (Schedule PH (Form 112), line 26) included on line 1 2a b Look-back interest included on line 1 under section 46(2) for completed long-term contracts or section 167(g) for depreciation under the income forecast method.. 2b c Credit for federal tax paid on fuels (see instructions) c d Total. Add lines 2a through 2c d 3 Subtract line 2d from line 1. If the result is less than $5, do not complete or file this form. The corporation doesn't owe the penalty Enter the tax shown on the corporation s 216 income tax return. See instructions. Caution: If the tax is zero or the tax year was for less than 12 months, skip this line and enter the amount from line 3 on line Required annual payment. Enter the smaller of line 3 or line 4. If the corporation is required to skip line 4, enter the amount from line Part II Reasons for Filing Check the boxes below that apply. If any boxes are checked, the corporation must file Form 222 even if it doesn't owe a penalty. See instructions. 6 The corporation is using the adjusted seasonal installment method. 7 The corporation is using the annualized income installment method. 8 The corporation is a large corporation figuring its first required installment based on the prior year's tax. Part III Figuring the Underpayment 9 Installment due dates. Enter in columns through the 15th day of the 4th (Form 99-PF filers: Use 5th month), 6th, 9th, and 12th months of the corporation s tax year Required installments. If the box on line 6 and/or line 7 above is checked, enter the amounts from Schedule A, line 38. If the box on line 8 (but not 6 or 7) is checked, see instructions for the amounts to enter. If none of these boxes are checked, enter 25% (.25) of line 5 above in each column Estimated tax paid or credited for each period. For column only, enter the amount from line 11 on line 15. See instructions /15/217 6/15/217 9/15/217 12/15/217 Complete lines 12 through 18 of one column before going to the next column. 12 Enter amount, if any, from line 18 of the preceding column Add lines 11 and Add amounts on lines 16 and 17 of the preceding column Subtract line 14 from line 13. If zero or less, enter If the amount on line 15 is zero, subtract line 13 from line 14. Otherwise, enter Underpayment. If line 15 is less than or equal to line 1, subtract line 15 from line 1. Then go to line 12 of the next column. Otherwise, go to line Overpayment. If line 1 is less than line 15, subtract line 1 from line 15. Then go to line 12 of the next column Go to Part IV on page 2 to figure the penalty. Do not go to Part IV if there are no entries on line 17 no penalty is owed. For Paperwork Reduction Act Notice, see separate instructions. Cat. No L Form 222 (217)

14 11/9/218 1:27:28 AM Return Lumina Foundation for Education, Inc Form 222 (217) Page 2 Part IV Figuring the Penalty 19 Enter the date of payment or the 15th day of the 4th month after the close of the tax year, whichever is earlier. (C Corporations with tax years ending June 3 and S corporations: Use 3rd month instead of 4th month. Form 99-PF and Form 99-T filers: Use 5th month instead of 4th month.) See instructions Number of days from due date of installment on line 9 to the date shown on line Number of days on line 2 after 4/15/217 and before 7/1/ Underpayment on line 17 Number of days on line % (.4) 22 $ $ $ $ 23 Number of days on line 2 after 6/3/217 and before 1/1/ Underpayment on line 17 Number of days on line % (.4) 24 $ $ $ $ 25 Number of days on line 2 after 9/3/217 and before 1/1/ Underpayment on line 17 Number of days on line % (.4) 26 $ $ $ $ 27 Number of days on line 2 after 12/31/217 and before 4/1/ Underpayment on line 17 Number of days on line % (.4) 28 $ $ $ $ 29 Number of days on line 2 after 3/31/218 and before 7/1/ Underpayment on line 17 Number of days on line *% 3 $ $ $ $ 31 Number of days on line 2 after 6/3/218 and before 1/1/ Underpayment on line 17 Number of days on line *% 32 $ $ $ $ 33 Number of days on line 2 after 9/3/218 and before 1/1/ Underpayment on line 17 Number of days on line *% 34 $ $ $ $ 35 Number of days on line 2 after 12/31/218 and before 3/16/ Underpayment on line 17 Number of days on line *% 36 $ $ $ $ 37 Add lines 22, 24, 26, 28, 3, 32, 34, and $ $ $ $ 38 Penalty. Add columns through of line 37. Enter the total here and on Form 112, line 33; or the comparable line for other income tax returns $ *Use the penalty interest rate for each calendar quarter, which the IRS will determine during the first month in the preceding quarter. These rates are published quarterly in an IRS News Release and in a revenue ruling in the Internal Revenue Bulletin. To obtain this information on the Internet, access the IRS website at You can also call to get interest rate information. Form 222 (217)

15 11/9/218 1:27:28 AM Return Lumina Foundation for Education, Inc Form 222 (217) Page 3 Schedule A Adjusted Seasonal Installment Method and Annualized Income Installment Method See instructions. Form 112S filers: For lines 1, 2, 3, and 21, below, taxable income refers to excess net passive income or the amount on which tax is imposed under section 1374, whichever applies. Part I Adjusted Seasonal Installment Method Caution: Use this method only if the base period percentage for any 6 consecutive months is at least 7%. See instructions. 1 Enter taxable income for the following periods. First 3 months First 5 months First 8 months First 11 months a Tax year beginning in a b Tax year beginning in b c Tax year beginning in c 2 Enter taxable income for each period for the tax year beginning in 217. See the instructions for the treatment of extraordinary items Enter taxable income for the following periods. First 4 months First 6 months First 9 months Entire year a Tax year beginning in a b Tax year beginning in b c Tax year beginning in c 4 Divide the amount in each column on line 1a by the amount in column on line 3a Divide the amount in each column on line 1b by the amount in column on line 3b Divide the amount in each column on line 1c by the amount in column on line 3c Add lines 4 through Divide line 7 by a Divide line 2 by line a b Extraordinary items (see instructions) b c Add lines 9a and 9b c 1 Figure the tax on the amount on line 9c using the instructions for Form 112, Schedule J, line 2 or comparable line of corporation s return a Divide the amount in columns through on line 3a by the amount in column on line 3a a b Divide the amount in columns through on line 3b by the amount in column on line 3b b c Divide the amount in columns through on line 3c by the amount in column on line 3c c 12 Add lines 11a through 11c Divide line 12 by Multiply the amount in columns through of line 1 by columns through of line 13. In column, enter the amount from line 1, column Enter any alternative minimum tax for each payment period. See instructions Enter any other taxes for each payment period. See instructions Add lines 14 through For each period, enter the same type of credits as allowed on Form 222, lines 1 and 2c. See instructions Total tax after credits. Subtract line 18 from line 17. If zero or less, enter Form 222 (217)

16 11/9/218 1:27:28 AM Return Lumina Foundation for Education, Inc Form 222 (217) Page 4 Part II Annualized Income Installment Method 2 Annualization periods (see instructions) First months First months First months First months 21 Enter taxable income for each annualization period. See instructions for the treatment of extraordinary items Annualization amounts (see instructions) a Annualized taxable income. Multiply line 21 by line a b Extraordinary items (see instructions) b c Add lines 23a and 23b c 24 Figure the tax on the amount on line 23c using the instructions for Form 112, Schedule J, line 2, or comparable line of corporation s return Enter any alternative minimum tax for each payment period (see instructions) Enter any other taxes for each payment period. See instructions Total tax. Add lines 24 through For each period, enter the same type of credits as allowed on Form 222, lines 1 and 2c. See instructions Total tax after credits. Subtract line 28 from line 27. If zero or less, enter Applicable percentage % 5% 75% 1% 31 Multiply line 29 by line Part III Required Installments Note: Complete lines 32 through 38 of one column before completing the next column. 1st installment 2nd installment 3rd installment 4th installment 32 If only Part I or Part II is completed, enter the amount in each column from line 19 or line 31. If both parts are completed, enter the smaller of the amounts in each column from line 19 or line Add the amounts in all preceding columns of line 38. See instructions Adjusted seasonal or annualized income installments. Subtract line 33 from line 32. If zero or less, enter Enter 25% (.25) of line 5 on page 1 of Form 222 in each column. Note: Large corporations, see the instructions for line 1 for the amounts to enter Subtract line 38 of the preceding column from line 37 of the preceding column Add lines 35 and Required installments. Enter the smaller of line 34 or line 37 here and on page 1 of Form 222, line 1. See instructions. 38 Form 222 (217)

17 11/9/218 1:27:28 AM Return Lumina Foundation for Education, Inc Form 4626 Department of the Treasury Internal Revenue Service Alternative Minimum Tax Corporations Attach to the corporation s tax return. Go to for instructions and the latest information. OMB No Name Employer identification number LUMINA FOUNDATION FOR EDUCATION, INC Note: See the instructions to find out if the corporation is a small corporation exempt from the alternative minimum tax (AMT) under section Taxable income or (loss) before net operating loss deduction (2,24,598) 2 Adjustments and preferences: a Depreciation of post a b Amortization of certified pollution control facilities b c Amortization of mining exploration and development costs c d Amortization of circulation expenditures (personal holding companies only) d e Adjusted gain or loss e f Long-term contracts f g Merchant marine capital construction funds g h Section 833 deduction (Blue Cross, Blue Shield, and similar type organizations only) h i Tax shelter farm activities (personal service corporations only) i j Passive activities (closely held corporations and personal service corporations only) j k Loss limitations k l Depletion l m Tax-exempt interest income from specified private activity bonds m n Intangible drilling costs n o Other adjustments and preferences o 3 Pre-adjustment alternative minimum taxable income (AMTI). Combine lines 1 through 2o ,936 (1,23) 344,839 (1,89,26) 4 Adjusted current earnings (ACE) adjustment: a ACE from line 1 of the ACE worksheet in the instructions a (1,89,26) b Subtract line 3 from line 4a. If line 3 exceeds line 4a, enter the difference as a negative amount. See instructions b c Multiply line 4b by 75% (.75). Enter the result as a positive amount.... 4c d Enter the excess, if any, of the corporation s total increases in AMTI from prior year ACE adjustments over its total reductions in AMTI from prior year ACE adjustments. See instructions. Note: You must enter an amount on line 4d (even if line 4b is positive) d e ACE adjustment. If line 4b is zero or more, enter the amount from line 4c... 4e If line 4b is less than zero, enter the smaller of line 4c or line 4d as a negative amount } 5 Combine lines 3 and 4e. If zero or less, stop here; the corporation does not owe any AMT (1,89,26) 6 Alternative tax net operating loss deduction. See instructions Alternative minimum taxable income. Subtract line 6 from line 5. If the corporation held a residual interest in a REMIC, see instructions Exemption phase-out (if line 7 is $31, or more, skip lines 8a and 8b and enter -- on line 8c): a Subtract $15, from line 7. If completing this line for a member of a controlled group, see instructions. If zero or less, enter a b Multiply line 8a by 25% (.25) b c Exemption. Subtract line 8b from $4,. If completing this line for a member of a controlled group, see instructions. If zero or less, enter c 9 Subtract line 8c from line 7. If zero or less, enter Multiply line 9 by 2% (.2) Alternative minimum tax foreign tax credit (AMTFTC). See instructions Tentative minimum tax. Subtract line 11 from line Regular tax liability before applying all credits except the foreign tax credit Alternative minimum tax. Subtract line 13 from line 12. If zero or less, enter --. Enter here and on Form 112, Schedule J, line 3, or the appropriate line of the corporation s income tax return For Paperwork Reduction Act Notice, see separate instructions. Cat. No I Form 4626 (217)

18 11/9/218 1:27:28 AM Return Lumina Foundation for Education, Inc Form 4626, Line 6 Alternative Tax Net Operating Loss Deduction Year Generated Amount Generated Converted Contributions Amount Used in Prior Years Amount Used in Current Year Amount Remaining 215 2,63,123 46,978 2,16, ,89,26 1,89, Totals 3,953,149 46,978 3,96,171 AMT NOL Expires

19 11/9/218 1:27:28 AM Return Lumina Foundation for Education, Inc Form 8949 Department of the Treasury Internal Revenue Service Name(s) shown on return Sales and Other Dispositions of Capital Assets Go to for instructions and the latest information. File with your Schedule D to list your transactions for lines 1b, 2, 3, 8b, 9, and 1 of Schedule D. OMB No Attachment Sequence No. 12A Social security number or taxpayer identification number LUMINA FOUNDATION FOR EDUCATION, INC Before you check Box A, B, or C below, see whether you received any Form(s) 199-B or substitute statement(s) from your broker. A substitute statement will have the same information as Form 199-B. Either will show whether your basis (usually your cost) was reported to the IRS by your broker and may even tell you which box to check. Part I Short-Term. Transactions involving capital assets you held 1 year or less are short term. For long-term transactions, see page 2. Note: You may aggregate all short-term transactions reported on Form(s) 199-B showing basis was reported to the IRS and for which no adjustments or codes are required. Enter the totals directly on Schedule D, line 1a; you aren't required to report these transactions on Form 8949 (see instructions). You must check Box A, B, or C below. Check only one box. If more than one box applies for your short-term transactions, complete a separate Form 8949, page 1, for each applicable box. If you have more short-term transactions than will fit on this page for one or more of the boxes, complete as many forms with the same box checked as you need. (A) Short-term transactions reported on Form(s) 199-B showing basis was reported to the IRS (see Note above) (B) Short-term transactions reported on Form(s) 199-B showing basis wasn't reported to the IRS (C) Short-term transactions not reported to you on Form 199-B 1 Description of (Example: 1 sh. XYZ Co.) Date acquired (Mo., day, yr.) Date sold or disposed of (Mo., day, yr.) Proceeds (sales price) (see instructions) Cost or other basis. See the Note below and see Column in the separate instructions Adjustment, if any, to gain or loss. If you enter an amount in column (g), enter a code in column (f). See the separate instructions. (f) Code(s) from instructions (g) Amount of adjustment (h) Gain or (loss). Subtract column from column and combine the result with column (g) SHORT-TERM GAIN/LOSS FROM INVESTMENTS 1,5 1,5 SHORT-TERM ORDINARY GAIN/LOSS FROM INVESTMENTS 3,666 3,666 2 Totals. Add the amounts in columns,, (g), and (h) (subtract negative amounts). Enter each total here and include on your Schedule D, line 1b (if Box A above is checked), line 2 (if Box B above is checked), or line 3 (if Box C above is checked) 4,671 4,671 Note: If you checked Box A above but the basis reported to the IRS was incorrect, enter in column the basis as reported to the IRS, and enter an adjustment in column (g) to correct the basis. See Column (g) in the separate instructions for how to figure the amount of the adjustment. For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No Z Form 8949 (217)

20 11/9/218 1:27:28 AM Return Lumina Foundation for Education, Inc Form 8949 (217) Attachment Sequence No. 12A Page 2 Name(s) shown on return. Name and SSN or taxpayer identification no. not required if shown on other side Social security number or taxpayer identification number LUMINA FOUNDATION FOR EDUCATION, INC Before you check Box D, E, or F below, see whether you received any Form(s) 199-B or substitute statement(s) from your broker. A substitute statement will have the same information as Form 199-B. Either will show whether your basis (usually your cost) was reported to the IRS by your broker and may even tell you which box to check. Part II Long-Term. Transactions involving capital assets you held more than 1 year are long term. For short-term transactions, see page 1. Note: You may aggregate all long-term transactions reported on Form(s) 199-B showing basis was reported to the IRS and for which no adjustments or codes are required. Enter the totals directly on Schedule D, line 8a; you aren't required to report these transactions on Form 8949 (see instructions). You must check Box D, E, or F below. Check only one box. If more than one box applies for your long-term transactions, complete a separate Form 8949, page 2, for each applicable box. If you have more long-term transactions than will fit on this page for one or more of the boxes, complete as many forms with the same box checked as you need. (D) Long-term transactions reported on Form(s) 199-B showing basis was reported to the IRS (see Note above) (E) Long-term transactions reported on Form(s) 199-B showing basis wasn't reported to the IRS (F) Long-term transactions not reported to you on Form 199-B 1 Description of (Example: 1 sh. XYZ Co.) Date acquired (Mo., day, yr.) Date sold or disposed of (Mo., day, yr.) Proceeds (sales price) (see instructions) Cost or other basis. See the Note below and see Column in the separate instructions Adjustment, if any, to gain or loss. If you enter an amount in column (g), enter a code in column (f). See the separate instructions. (f) Code(s) from instructions (g) Amount of adjustment (h) Gain or (loss). Subtract column from column and combine the result with column (g) LONG-TERM GAIN/LOSS FROM INVESTMENTS 41,437 41,437 LONG-TERM ORDINARY GAIN/LOSS FROM INVESTMENTS 5,5 5,5 2 Totals. Add the amounts in columns,, (g), and (h) (subtract negative amounts). Enter each total here and include on your Schedule D, line 8b (if Box D above is checked), line 9 (if Box E above is checked), or line 1 (if Box F above is checked) 46,937 46,937 Note: If you checked Box D above but the basis reported to the IRS was incorrect, enter in column the basis as reported to the IRS, and enter an adjustment in column (g) to correct the basis. See Column (g) in the separate instructions for how to figure the amount of the adjustment. Form 8949 (217)

21 11/9/218 1:27:28 AM Return Lumina Foundation for Education, Inc Form 4797 Department of the Treasury Internal Revenue Service Name(s) shown on return Sales of Business Property (Also Involuntary Conversions and Recapture Amounts Under Sections 179 and 28F(2)) Attach to your tax return. Go to for instructions and the latest information. Identifying number OMB No Attachment Sequence No. 27 LUMINA FOUNDATION FOR EDUCATION, INC Enter the gross proceeds from sales or exchanges reported to you for 217 on Form(s) 199-B or 199-S (or substitute statement) that you are including on line 2, 1, or 2. See instructions Part I Sales or Exchanges of Property Used in a Trade or Business and Involuntary Conversions From Other Than Casualty or Theft Most Property Held More Than 1 Year (see instructions) 2 Description of Date acquired (mo., day, yr.) Date sold (mo., day, yr.) Gross sales price Depreciation allowed or allowable since acquisition (f) Cost or other basis, plus improvements and expense of sale (g) Gain or (loss) Subtract (f) from the sum of and 1231 GAIN OR LOSS FROM PASSTHROUGH 759, ,246 3 Gain, if any, from Form 4684, line Section 1231 gain from installment sales from Form 6252, line 26 or Section 1231 gain or (loss) from like-kind exchanges from Form Gain, if any, from line 32, from other than casualty or theft Combine lines 2 through 6. Enter the gain or (loss) here and on the appropriate line as follows: Partnerships (except electing large partnerships) and S corporations. Report the gain or (loss) following the instructions for Form 165, Schedule K, line 1, or Form 112S, Schedule K, line 9. Skip lines 8, 9, 11, and 12 below. Individuals, partners, S corporation shareholders, and all others. If line 7 is zero or a loss, enter the amount from line 7 on line 11 below and skip lines 8 and 9. If line 7 is a gain and you didn t have any prior year section 1231 losses, or they were recaptured in an earlier year, enter the gain from line 7 as a long-term capital gain on the Schedule D filed with your return and skip lines 8, 9, 11, and 12 below. 8 Nonrecaptured net section 1231 losses from prior years. See instructions Subtract line 8 from line 7. If zero or less, enter --. If line 9 is zero, enter the gain from line 7 on line 12 below. If line 9 is more than zero, enter the amount from line 8 on line 12 below and enter the gain from line 9 as a long-term capital gain on the Schedule D filed with your return. See instructions Part II Ordinary Gains and Losses (see instructions) 1 Ordinary gains and losses not included on lines 11 through 16 (include held 1 year or less): 759, , Loss, if any, from line ( ) 12 Gain, if any, from line 7 or amount from line 8, if applicable Gain, if any, from line Net gain or (loss) from Form 4684, lines 31 and 38a Ordinary gain from installment sales from Form 6252, line 25 or Ordinary gain or (loss) from like-kind exchanges from Form Combine lines 1 through For all except individual returns, enter the amount from line 17 on the appropriate line of your return and skip lines a and b below. For individual returns, complete lines a and b below: a If the loss on line 11 includes a loss from Form 4684, line 35, column (ii), enter that part of the loss here. Enter the part of the loss from income-producing on Schedule A (Form 14), line 28, and the part of the loss from used as an employee on Schedule A (Form 14), line 23. Identify as from Form 4797, line 18a. See instructions.. 18a b Redetermine the gain or (loss) on line 17 excluding the loss, if any, on line 18a. Enter here and on Form 14, line 14 18b For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 1386I Form 4797 (217)