j a) Form 990-PR III - t Department of the Treasury Internal Revenue Service 77 POND AVENUE

Size: px
Start display at page:

Download "j a) Form 990-PR III - t Department of the Treasury Internal Revenue Service 77 POND AVENUE"

Transcription

1 r C c Form 990-PR III - t Department of the Treasury Internal Revenue Service For calendar year 201f G Check all that apply Name of foundation Return of Private Foundation or Section 4947(a)(1) Nonexempt Charitale Trust Treated as a Private Foundation Note. The foundation may e ale to use a copy of this return to satisfy state reporting requirements. or tax year eginning 0 Initial return 0 Amended return and endin Initial return of a former pulic charity I-I Final return Address change E] Name change A Employer identification numer JOSEPH F. AND CLARA FORD FOUNDATION C/O LESLIE K. LERNER Numer and street (or P O ox numer if mail is not delivered to street address ) Room/suite B Telephone numer 77 POND AVENUE OMB No City or town, state, and ZIP code C If exemption application is pending, check here BROOKL INE MA D 11- Foreign organizations, check here H Check type of organization: Section 501(c)(3) exempt private foundation 2. Foreign organizations meeting the85% test, check here and attach computation Q Section 4947 ( a )( 1 ) nonexem p t charitale trust 0 Other taxale p rivate foundation E If p rivate foundation status was terminated I Fair market value of all assets at end of year J Accounting method: Cash Accrual under section 507()(1)(A), check here (from Part ll, col (c), line 16) = Other (specify) F If the foundation is in a 60-month termination (Part if, column (d) must e on cash asis) under section 507 ( )( 1 ) B), check here Part I Analysis of Revenue and Expenses (a) Revenue and () Net investment (c) Adjusted net (d) Disursements (rhe total of amounts in columns (), (c), and ( d) may not necessarily equal the amounts in column (a) ) expenses per ooks income income 1 Contriutions, gifts, grants, etc., received N/A 2 Check If the foundation is not required to attach Sch B for charitale purposes (cash asis only) 3 Interest on savings and temporary cash investments 2, , 136. S TATEMENT 1 r 4 Dividends and interest from securities 5a Gross rents C j a) a 7 - Net rental income or (loss) 6a Net gain or (loss ) from sale of lute 10 Gross sales price for all _ assets on line 6a V ED 1 W 4) 7 Capital gain net income (from art Co% ine 2 0 C 8 Net short-term capital gal R 9 Income modifications c I h r\ Gross sales less returns I a and allowances Less Cost of goods sold a y` c Gross profit or (loss), 11 Other income 684, , 645. S TATEMENT 2 12 Total Add lines 1 throu g h , , Compensation of officers, directors trustees, etc 26, Other employee salaries and wages 15 Pension plans, employee enefits y 116a Legal fees STMT C Accounting fees STMT 4 3, , W c Other professional fees Interest 18 Taxes STMT 5 17, , Depreciation and depletion 20 Occupancy v < 21 Travel, conferences, and meetings a 22 Printing and pulications 1, 0 23 Other expenses STMT 6 2, , Total operating and administrative. expenses. Add lines 13 through 23 58, , Contriutions, gifts, grants paid 660, , Total expenses and disursements. Add lines 24 and , Sutract line 26 from line 12: a Excess of revenue over expenses and disursements < Net investment income (if negative, enter -0 -) 654, 712. c Adjusted net income of negative enter -o-) N / A LHA For Paperwork Reduction Act Notice, see the instructions Form 990-PF (2010) 1^

2 JOSEPH F. AND CLARA FORD FOUNDATION Form 990 -PF (2010) no T.F.ST,TF. W_ T.F.RNER Page2 pad 11 EialanceSheets Attached schedules and amounts in the description Beginning of year End o f year column should e for end-of-year amounts only (a) Book Value () Book Value (c) Fair Market Value 1 Cash - non-interest-earing 57, , , Savings and temporary cash investments 1, , , Accounts receivale Less: allowance for doutful accounts 4 Pledges receivale Less: allowance for doutful accounts 5 Grants receivale 6 Receivales due from officers, directors, trustees, and other disqualified persons 7 Other notes and loans receivale Less: allowance for doutful accounts 8 Inventories for sale or use 9 Prepaid expenses and deferred charges < 10a Investments - U.S. and state government oligations Investments - corporate stock c Investments - corporate onds 11 Investments-land, uildings, and equipment asis Less accumulated depreciation 12 Investments - mortgage loans 13 Investments - other STMT 7 1, 955, , 941, , 941, Land, uildings, and equipment: asis Less accumulated depreciation 15 Other assets (descrie 16 Total assets to e com p leted y all filers 2, 014, , 982, , 982, Accounts payale and accrued expenses Grants payale m 19 Deferred revenue '= 20 Loans from officers, directors, trustees, and other disqualified persons m 21 Mortgages and other notes payale J 22 Other liailities (descrie 23 Total liailities ( add lines 17 throu g h 22 ) Foundations thatfollow SFAS 117, check here and complete lines 24 through 26 and lines 30 and Unrestricted 25 Temporarily restricted 2, 013, , 981, 773. co 26 Permanently restricted r_ Foundations that do not follow SFAS 117, check here LL and complete lines 27 through 31. y 27 Capital stock, trust principal, or current funds in 28 Paid-in or capital surplus, or land, ldg., and equipment fund 29 Retained earnings, accumulated income, endowment, or other funds Z 30 Total net assets or fund alances 2, 013, , 981, Total liailities and net assets /fund alances 2, 014, , 982, Part III Analysis of Changes in Net Assets or Fund Balances 1 Total net assets or fund alances at eginning of year - Part II, column (a), line 30 (must agree with end-of-year figure reported on prior year's return) 1 2, 013, Enter amount from Part I, line 27a 2 < > 3 Other increases not included in line 2 (itemize) Add lines 1, 2, and , Decreases not included in line 2 (itemize) Total net assets or fund alances at end of year ( line 4 minus line 5 ) - Part II column ( ), line , 773 Form 990-PF (2010)

3 JOSEPH F. AND CLARA FORD FOUNDATION Form 990-PF (2010) C / O LESLIE K. LERNER Page 3 PartIV Capital Gains and Losses for Tax on Investment Income (a) List and descrie the kind(s) of property sold (e.g., real estate, ( How acquired (c) Date acquired (d) Date sold Purchase 2-sto ry rick warehouse; or common stock, 200 shs. MLC Co. ) D Donation (mo., day, yr.) (mo., day, yr.) la C d e 2 a c d e a c d e (e) Gross sales price NONE (f) Depreciation allowed (or allowale) (g) Cost or other asis plus expense of sale (h) Gain or (loss) (e) plus (f) minus (g) Complete only for assets showing gain in column (h) and owned y the foundation on 12/31/69 (I) Gains (Col. (h) gain minus (j) Adjusted asis (k) Excess of col. (i) c ol. (k), ut not less than -0-) or (i) F.M.V. as of 12/31/69 as of 12/31/69 over col. (I), if any Losses (from col. (h)) If gain, also enter in Part I, line 7 Capital gain net income or (net capital loss) [ If (loss), enter -0- in Part I, line Net short-term capital gain or (loss) as defined in sections 1222(5) and (6): If gain, also enter in Part I, line 8, column (c). If loss enter -0- in Part I line 8 3 Part V Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income (For optional use y domestic private foundations suject to the section 4940(a) tax on net investment income.) If section 4940(d)(2) applies, leave this part lank. Was the foundation liale for the section 4942 tax on the distriutale amount of any year in the ase period? 0 Yes No If "Yes," the foundation does not qualify under section 4940(e). Do not complete this part. 1 Enter the appropriate amount in each column for each year; see instructions efore making any entries. Base periiod years Calendar year ( or tax year eginning m Adjusted qualifying () distriutions (C) Net value of noncharitale-use assets Distriution ratio (col. () divided y col. (c)) , 962, , 905, , 810, , 684, , 624, Total of line 1, column (d) Average distriution ratio for the 5-year ase period - divide the total on line 2 y 5, or y the numer of years the foundation has een in existence if less than 5 years Enter the net value of noncharitale-use assets for 2010 from Part X, line 5 4 1, 969, Multiply line 4 y line , Enter 1% of net investment income (1% of Part I, line 27) 6 6, Add lines 5 and , Enter qualifying distriutions from Part XI I, line , 000. If line 8 is equal to or greater than line 7, check the ox in Part VI, line 1, and complete that part using a 1% tax rate. See the Part VI instructions Form 990-PF (2010)

4 JOSEPH F. AND CLARA FORD FOUNDATION, Form 990-PF(2010) C/O LESLIE K. LERNER Page4 Pa rt VI Excise Tax Based on Investment Income (Section 4940(a), 4940(), 4940( e), or see instructions) Is Exempt operating foundations descried in section 4940(d)(2), check here 0 and enter 'N/A' on line 1. Date of ruling or determination letter: ( attach copy of letter if necessary -see instructions) Domestic foundations that meet the section 4940(e) requirements in Part V, check here and enter 1% 1 6, 547. of Part I, line 27 c All other domestic foundations enter 2% of line 27. Exempt foreign organizations enter 4% of Part I, line 12, col. (). 2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxale foundations only. Others enter -0-) Add lines 1 and 2 3 6, Sutitle A (income) tax (domestic section 4947(a)(1) trusts and taxale foundations only. Others enter -0-) Tax ased on investment income. Sutract line 4 from line 3. If zero or less, enter , Credits/Payments: a 2010 estimated tax payments and 2009 overpayment credited to a 11, 760. Exempt foreign organizations - tax withheld at source 6 c Tax paid with application for extension of time to file (Form 8868) 6c 3, 000. d Backup withholding erroneously withheld 6d 7 Total credits and payments. Add lines 6a through 6d 7 14, Enter any penalty for underpayment of estimated tax. Check here El if Form 2220 is attached 8 9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed 9 10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid 10 8, Enter the amount of line 10 to e: Credited to 2011 estimated tax 11110, Refunded 00, Part VII-A Statements Regarding Activities la During the tax year, did the foundation attempt to influence any national, state, or local legislation or did it participate or intervene in Yes No any political campaign9 is X Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see instructions for definition)? l X If the answer is "Yes" to la or 1, attach a detailed description of the activities and copies of any matenals pulished or distriuted y the foundation in connection with the activities. c Did the foundation file Form POL for this year? d Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year: (1) On the foundation. $ 0. (2) On foundation managers. No. $ 0. e Enter the reimursement (if any) paid y the foundation during the year for political expenditure tax imposed on foundation managers. $ 0. 2 Has the foundation engaged in any activities that have not previously een reported to the IRS? 2 X If "Yes, " attach a detailed description of the activities 3 Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles of incorporation, or ylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes 3 X 4a Did the foundation have unrelated usiness gross income of $1,000 or more during the year? 4a X If 'Yes; has it filed a tax return on Form 990-T for this year? N/A 4 5 Was there a liquidation, termination, dissolution, or sustantial contraction during the year? 5 X If "Yes," attach the statement required y General Instruction T 6 Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either: By language in the governing instrument, or By state legislation that effectively amends the governing instrument so that no mandatory directions that conflict with the state law remain in the governing instrument? 6 X 7 Did the foundation have at least $5,000 in assets at any time during the year'? 7 X If "Yes," complete Part ll, col. (c), and Part XV. 8a Enter the states to which the foundation reports or with which it is registered (see instructions) 1c X If the answer is 'Yes' to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney General (or designate) of each state as required y General Instruction G' If "No, " attach explanation 9 Is the foundation claiming status as a private operating foundation within the meaning of section 4942(l)(3) or 4942(j)(5) for calendar year 2010 or the taxale year eginning in 2010 (see instructions for Part XIV)? If "Yes, " complete Part XIV 0 Did anv persons ecome sustantial contriutors durino the tax year? lf ves. attach a schedule listina their names and addresses Form 990-PF (2010)

5 JOSEPH F. AND CLARA FORD FOUNDATION Form 990-PF ( 2010) C / O LESLIE K. LERNER Page5 Part VII - Sthtements Regarding Activities (continued) 11 At any 'hme during the year, did the foundation, directly or indirectly, own a controlled entity within the meaning of section 512()(13)? If 'Yes,' attach schedule ( see instructions) 11 X 12 Did the foundation acquire a direct or indirect interest in any applicale insurance contract efore August 17, X 13 Did the foundation comply with the pulic inspection requirements for its annual returns and exemption application? 13 X Wesite address N/A 14 The ooks are in care of LESLIE K. LERNER Telephone no Located at 7 7 POND AVE, BROOKL INE, MA ZIP Section 4947 ( a)(1) nonexempt charitale trusts filing Form 990-PF in lieu of Form Check here 0 and enter the amount of tax-exempt interest received or accrued during the year 15 N/A 16 At any time during calendar year 2010, did the foundation have an interest in or a signature or other authority over a ank, Yes No securities, or other financial account in a foreign country? 16 X See page 20 of the instructions for exceptions and filing requirements for Form TD F If 'Yes,' enter the name of the forei g n count rylo- Part VII - B Statements Regarding Activities for Which Form 4720 May Be Required File Form 4720 if any item is checked in the "Yes" column, unless an exception applies. Yes No la During the year did the foundation ( either directly or indirectly): (1) Engage in the sale or exchange, or leasing of property with a disqualified person? EJ Yes No (2) Borrow money from, lend money to, or otherwise extend credit to ( or accept it from) a disqualified person? 0 Yes No (3) Furnish goods, services, or facilities to ( or accept them from ) a disqualified person? 0 Yes No (4) Pay compensation to, or pay or reimurse the expenses of, a disqualified person? 0 Yes No (5) Transfer any income or assets to a disqualified person (or make any of either availale for the enefit or use of a disqualified person )? 0 Yes No (6) Agree to pay money or property to a government official2 (Exception. Check *No' if the foundation agreed to make a grant to or to employ the official for a period after termination of government service, if terminating within 90 days. ) Yes No If any answer is 'Yes" to la ( 1)-(6), did any of the acts fail to qualify under the exceptions descried in Regulations section ( d)-3 or in a current notice regarding disaster assistance ( see page 22 of the instructions )? N/A l Organizations relying on a current notice regarding disaster assistance check here c Did the foundation engage in a prior year in any of the acts descried in la, other than excepted acts, that were not corrected efore the first day of the tax year eginning in c X 2 Taxes on failure to distriute income ( section 4942) (does not apply for years the foundation was a private operating foundation defined in section 4942 ( l)(3) or 4942 (j)(5)): a At the end of tax year 2010, did the foundation have any undistriuted income ( lines 6d and 6e, Part XIII ) for tax year ( s) eginning efore Yes No If 'Yes," list the years Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942( a)(2) (relating to incorrect valuation of assets) to the year's undistriuted income? ( If applying section 4942( a)(2) to all years listed, answer "No " and attach statement - see instructions.) N/A 2 c If the provisions of section 4942 ( a)(2) are eing applied to any of the years listed in 2a, list the years here. 3a Did the foundation hold more than a 2% direct or indirect interest in any usiness enterprise at any time during the year9 Yes 0 No If 'Yes,' did it have excess usiness holdings in 2010 as a result of ( 1) any purchase y the foundation or disqualified persons after May 26, 1969; (2 ) the lapse of the 5-year period ( or longer period approved y the Commissioner under section 4943 ( c)(7)) to dispose of holdings acquired y gift or equest; or (3) the lapse of the 10-, 15-, or 20-year first phase holding penod7 (Use Schedule C, Form 4720, to determine if the foundation had excess usiness holdings in 2010) 3 X 4a Did the foundation invest during the year any amount in a manner that would jeopardize its charitale purposes? 4a X Did the foundation make any investment in a prior year ( ut after Decemer 31, 1969 ) that could jeopardize its charitale purpose that had not een removed from ieooardv efore the first day of the tax year eginning in X Form 990-PF (2010)

6 JOSEPH F. AND CLARA FORD FOUNDATION Part VII- B I Statements Regarding Activities for Which Form 4720 May Be Required (continued) 5a, During thg year did the foundation pay or incur any amount to: (1) Carry on propaganda, or otherwise attempt to influence legislation ( section 4945 (e))? Yes No (2) Influence the outcome of any specific pulic election ( see section 4955); or to carry on, directly or indirectly, any voter registration drive? 0 Yes No (3) Provide a grant to an individual for travel, study, or other similar purposes? 0 Yes No (4) Provide a grant to an organization other than a charitale, etc., organization descried in section 509(a )( 1), (2), or (3), or section 4940 (d)(2)? 0 Yes No (5) Provide for any purpose other than religious, charitale, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals? Yes No If any answer is 'Yes' to 5a ( 1)-(5), did any of the transactions fail to qualify under the exceptions descried in Regulations section or in a current notice regarding disaster assistance ( see instructions)? N/A 5 Organizations relying on a current notice regarding disaster assistance check here 0 c If the answer is 'Yes ' to question 5a ( 4), does the foundation claim exemption from the tax ecause it maintained expenditure responsiility for the grant? N/A Yes = No If "Yes," attach the statement required y Regulations section (d). 6a Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on a personal enefit contract? 0 Yes No Did the foundation, during the year, pay premiums, directly or indirectly, on a personal enefit contract? 6 X If "Yes" to 6, file Form a At any time during the tax year, was the foundation a party to a prohiited tax shelter transaction? Yes No If 'Yes." did the foundation receive any proceeds or have any net income attriutale to the transaction? N/A 7 Part VIII Information Aout Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees, and Contractors 1 List all officers. directors, trustees, foundation managers and their compensation. (a) Name and address () Title, and average hours er week devoted to position (c) Compensation (If not p aid enter -0 (d)contnuonsto employee eneit plans compensarn (e) Expense account, other allowances LESLIE K. LERNER TRUSTEE 77 POND AVE., NO.801 BROOKLINE, MA , , Compensation of five hiahest - naid emolovees (other than those included on line 1). It none. enter "NONE." () Title, and average (a) Name and address of each employee paid more than $50, 000 hours per week ( c) Compensation devoted to position NONE ( d) Contriutions to emp oyeee erred ans and deterred compensation (e) Ex p ense account, other allowances Total numer of other employees paid over $50, Form 990-PF (2010)

7 JOSEPH F. AND CLARA FORD FOUNDATION Form 990-PF (2010) C/O LESLIE K. LERNER Page 7 Information Aout Officers, Directors, Trustees, Foundation Managers, Highly Part VIIIJ Paid Employees, and Contractors (continued) 3 Five hiahest-paid independent contractors for professional services. If none, enter "NONE." (a) Name and address of each person paid more than $50,000 () Type of service (c) Compensation NONE Total numer of others receivin g over $50, 000 for p rofessional services 0 Part IX-A Summary of Direct Charitale Activities List the foundation's four largest direct charitale activities during the tax year. Include relevant statistical information such as the numer of organizations and other eneficiaries served, conferences convened, research papers produced, etc. 1TO FURTHER MEDICAL RESEARCH, HIGHER EDUCATION ALONG WITH GENERAL PHILANTHROPIC PURSUITS ( SEE STATEMENT 8 ) 2 Expenses Part IX- B I Summary of Proaram - Related Investments - Descrie the two largest program-related investments made y the foundation during the tax year on lines 1 and 2. Amount 1 N/A 2 All other program-related investments. See instructions. 3 Total. Add lines 1 through 3 0. Form 990-PF (2010)

8 JOSEPH F. AND CLARA FORD FOUNDATION Form 990-PF (2010) C/O LESLIE K. LERNER Page 8 Part X Minimum Investment Return (All domestic foundations must complete this part Foreign foundations, see instructions) 1 Fair market value of assets not used (or held for use) directly in carrying out charitale, etc., purposes: a Average monthly fair market value of securities Average of monthly cash alances c Fair market value of all other assets d Total (add lines la,, and c) e Reduction claimed for lockage or other factors reported on lines la and 1c (attach detailed explanation) 2 Acquisition indetedness applicale to line 1 assets 3 Sutract line 2 from line 1d 4 Cash deemed held for charitale activities. Enter 1 1/2% of line 3 (for greater amount, see instructions) 5 Net value of noncharitale - use assets. Sutract line 4 from line 3. Enter here and on Part V, line 4 le 1 49,118. Part XI Distriutale Amount (see instructions) (Section 4942(l)(3) and (j)(5) private operating foundations and certain foreign organizations check here 0 and do not complete this part.) 1 Minimum investment return from Part X, line , a Tax on investment income for 2010 from Part VI, line 5 2a 6, 547. Income tax for (This does not include the tax from Part VI.) 2 c Add lines 2a and 2 2c 6, Distriutale amount efore adjustments. Sutract line 2c from line , Recoveries of amounts treated as qualifying distriutions Add lines 3 and , Deduction from distriutale amount (see instructions) Distriutale amount as ad usted. Sutract line 6 from line 5. Enter here and on Part XIII, line Part XII a Qualifying Distriutions (see instructions) Amounts paid (including administrative expenses) to accomplish charitale, etc., purposes: Expenses, contriutions, gifts, etc. - total from Part I, column (d), line 26 la 660, 000. Program-related investments - total from Part IX-B Amounts paid to acquire assets used (or held for use) directly in carrying out charitale, etc., purposes 2 3 Amounts set aside for specific charitale projects that satisfy the: a Suitaility test (prior IRS approval required) 3a Cash distriution test (attach the required schedule) 3 4 Qualifying distriutions. Add lines la through 3. Enter here and on Part V, line 8, and Part XIII, line , Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment income. Enter 1% of Part I, line , Adjusted qualifying distriutions. Sutract line 5 from line , 453. Note. The amount on line 6 will e used in Part V, column (), in susequent years when calculating whether the foundation 4940(e) reduction of tax in those years. qualifie s for the section Form 990-PF (2010)

9 JOSEPH F. AND CLARA FORD FOUNDATION Form990-PF(2010) C/O LESLIE K. LERNER Page9 Part XIII I Undistriuted Income (see instructions) 1 Distriutale amount for 2010 from Part XI, line 7 2 Undistriuted income, if any, as of the end of 2010 a Enter amount for 2009 only Total for prior years: 3 Excess distriutions carryover, if any, to 2010: a From , 290. From c From , 595. dfrom efrom , 635. f Total of lines 3a through e 4 Qualifying distriutions for 2010 from Part Xll, line 4: $ 660, 000. a Applied to 2009, ut not more than line 2a Applied to undistriuted income of prior years (Election required - see instructions) c Treated as distriutions out of corpus (Election required - see instructions) d Applied to 2010 distriutale amount e Remaining amount distriuted out of corpus 5 Excess distriutions carryover applied to 2010 (If an amount appears in column ( d), the same amount must e shown in column (a) ) 6 Enter the net total of each column as indicated elow: (a) () Corpus Years prior to , (c) (d) , , a Corpus Add lines 3f, 4c, and 4e Sutract line 5 Prior years' undistriuted income. Sutract line 4 from line 2 c Enter the amount of prior years' undistriuted income for which a notice of deficiency has een issued, or on which the section 4942(a) tax has een previously assessed d Sutract line 6c from line 6. Taxale amount - see instructions e Undistriuted income for Sutract line 4a from line 2a. Taxale amount - see instr. f Undistriuted income for Sutract lines 4d and 5 from line 1. This amount must e distriuted in Amounts treated as distriutions out of corpus to satisfy requirements imposed y section 170()(1)(F) or 4942(g)(3) 8 Excess distriutions carryover from 2005 not applied on line 5 or line 7 9 Excess distriutions carryover to Sutract lines 7 and 8 from line 6a 10 Analysis of line 9: a Excess from , 606. Excess from , 595. c Excess from d Excess from Form 990-PF (2010)

10 JOSEPH F. AND CLARA FORD FOUNDATION Form 990-PF (2010) C/O LESLIE K. LERNER Page10 Part XIV I Private Operating Foundations (see instructions and Part VII-A, question 9) N/A 1 a If the foundation has received a ruling or determination letter that it is a private operating foundation, and the ruling is effective for 2010, enter the date of the ruling Check ox to indicate whether the founciauon is aprivate o p eratin g rounaauon aescrioea in section u '+a'+c 3 u1 u ',"+c 2 a Enter the lesser of the adjusted net Tax year Prior 3 years income from Part I or the minimum (a) 2010 () 2009 (c) 2008 (d) 2007 (e) Total investment return from Part X for each year listed 85% of line 2a c Qualifying distriutions from Part XII, line 4 for each year listed d Amounts included in line 2c not used directly for active conduct of exempt activities e Qualifying distriutions made directly for active conduct of exempt activities. Sutract line 2d from line 2c 3 Complete 3a,, or c for the alternative test relied upon: a "Assets' alternative test - enter: (1) Value of all assets (2) Value of assets qualifying under section 4942(I)(3)(B)(i) 'Endowment' alternative test - enter 2/3 of minimum investment return shown in Part X, line 6 for each year listed c 'Support alternative test - enter: (1) Total support other than gross investment income (interest, dividends, rents, payments on securities loans (section 512(a)(5)), or royalties) (2) Support from general pulic and 5 or more exempt organizations as provided in section 4942(I)(3)(B)(ui) (3) Largest amount of support from an exempt organization ( 4 ) Gross investment income Part XV Supplementary Information (Complete this part only if the foundation had $5, 000 or more in assets at any time during the year - see the instructions.) 1 Information Regarding Foundation Managers: a List any managers of the foundation who have contriuted more than 2% of the total contriutions received y the foundation efore the close of any tax year (ut only if they have contriuted more than $5,000). (See section 507(d)(2).) NONE List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the ownership of a partnership or other entity) of which the foundation has a 10% or greater interest. NONE 2 Information Regarding Contriution, Grant, Gift, Loan, Scholarship, etc., Programs: Check here if the foundation only makes contriutions to preselected charitale organizations and does not accept unsolicited requests for funds. If the foundation makes gifts, grants, etc. (see instructions) to individuals or organizations under other conditions, complete items 2a,, c, and d. a The name, address, and telephone numer of the person to whom applications should e addressed. The form in which applications should e sumitted and information and materials they should include: c Any sumission deadlines: d Any restrictions or limitations on awards, such as y geographical areas, charitale fields, kinds of institutions, or other factors: Form 990-PF (2010)

11 , Form 990-PF (2010) JOSEPH F. AND CLARA FORD FOUNDATION 11 3 Granfc and Contriutions Paid During the Year or Annroved for Future Payment Recipient If recipient is an individual, show any relationship to Foundation Purpose of grant or Name and address (home or usiness) any foundation manager status of contriution Amount or sustantial contriutor recipient a Paid during the year SEE STATEMENT 8 Total 3a Approved for future payment NONE Total Form 990-PF (2010)

12 JOSEPH F. AND CLARA FORD FOUNDATION Form 990-PF (20 10) C/O LESLIE K. LERNER Page 12 Part XVI -A Analysis of Income - Producing Activities Enter 1 cross amounts unless otherwise indicated. 1 Program service revenue: a c d e f 9 Fees and contracts from government agencies 2 Memership dues and assessments 3 Int Brest on savings and temporary cash Investments 14 2, Dividends and interest from securities 5 Net rental income or (loss) from real estate: a 6 Ne t rental income or (loss) from personal pro perty 7 Ot her investment income , Gai n or (loss) from sales of assets other tha n inventory 9 Ne t income or (loss) from special events 10 Gr o ss profit or (loss) from sales of inventory 11 Ot h er revenue: a c d e 12 Su Det-financed property Not det-financed property 13 Total. Add line 12, columns (), (d), and (e) ,781. (See worksheet in line 13 instructions to verify calculations.) Part XVI- B Unrelate d usiness income Exclu ded y section 512, 513, or 514 (e) (a) Business code () Amount ELL Sion code (d) Amount total. Add columns (), (d), and (e) Relationship of Activities to the Accomplishment of Exempt Purposes Related or exempt function income Form 990-PF (2010)

13 JOSEPH F. AND CLARA FORD FOUNDATION Form990-PF 2010 C / O LESLIE K. LERNER Pa g e 13 Part XVII Information Regarding Transfers To and Transactions and Relationships With Noncharitale Exempt Organizations Did the organization directly or indirectly engage in any of the following with any other organization descried in section 501(c) of Yes No the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations? a Transfers from the reporting foundation to a noncharitale exempt organization of (1) Cash la(l) X (2) Other assets la(2) X Other transactions: (1) Sales of assets to a noncharitale exempt organization l ( l ) X (2) Purchases of assets from a noncharitale exempt organization l ( 2 ) X (3) Rental of facilities, equipment, or other assets l (3) X (4) Reimursement arrangements l(4) X (5) Loans or loan guarantees l ( 5 ) X (6) Performance of services or memership or fundraising solicitations l ( 6 ) X c Sharing of facilities, equipment, mailing lists, other assets, or paid employees 1c X d If the answer to any of the aove is 'Yes,' complete the following schedule. Column () should always show the fair market value of the goods, other ass ets, or services given y the reporting foundation. If the foundation received less than fair market value in any transaction or sharing arrangement, sh ow in 2a Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations descried in section 501 ( c) of the Code ( other than section 501(c)(3 )) or in section Yes No If 'Yes," complete the following schedule. (a) Name of organization () Type of organization (c) Description of relationship N/A Sign Here Under pc ties of perjury, I declare that ave ex ined this return, including accompanying schedules and statements, and to the est of my knowledge and elief, it is true, correct, and com fete ecl tion of pre er er than t payer or fiduciary) is ased on all information of which preparer has any knowledge SI ature of officer or tr stee P nt/type preparer's name eparer' sl ature Paid STEVEN R. GALLANT 61 Preparer Firm's name LITMANGERSON SOCIATES, Use Only Firm's address 600 W. CUMMINGS PARK, WOBURN. MA

14 JOSEPH F. AND CLARA FORD FOUNDATION C/O FORM 990-PF INTEREST ON SAVINGS AND TEMPORARY CASH INVESTMENTS STATEMENT 1 SOURCE CITIZENS BANK - CERTIFICATE OF DEPOSIT K-1 LAKE SUCCESS SHOPPING CENTER TOTAL TO FORM 990-PF, PART I, LINE 3, COLUMN A AMOUNT 48. 2,088. 2,136. FORM 990-PF OTHER INCOME STATEMENT 2 (A) (B) (C) REVENUE NET INVEST- ADJUSTED DESCRIPTION PER BOOKS MENT INCOME NET INCOME K-1 LAKE SUCCESS SHOPPING CENTER 649,659. K-1 FELLSWAY PLAZA L.P. 34,986. TOTAL TO FORM 990-PF, PART I, LINE , , , ,645. FORM 990-PF LEGAL FEES STATEMENT 3 DESCRIPTION (A) (B) (C) (D) EXPENSES NET INVEST- ADJUSTED CHARITABLE PER BOOKS MENT INCOME NET INCOME PURPOSES LOURIE & CUTLER PC TO FM 990-PF, PG 1, LN 16A FORM 990-PF ACCOUNTING FEES STATEMENT 4 (A) (B) (C) (D) EXPENSES NET INVEST- ADJUSTED CHARITABLE DESCRIPTION PER BOOKS MENT INCOME NET INCOME PURPOSES LITMANGERSON ASSOCIATES LLP 3,000. PTO FORM 990-PF, PG 1, LN 16B 3,000. 3, , STATEMENT(S) 1, 2, 3, 4

15 JOSE-PH F. AND CLARA FORD FOUNDATION C/O FORM 990'-PF TAXES STATEMENT 5 (A) (B) (C) (D) EXPENSES NET INVEST- ADJUSTED CHARITABLE DESCRIPTION PER BOOKS MENT INCOME NET INCOME PURPOSES FEDERAL EXCISE TAX 14, , STATE TAXES PAYROLL TAXES 1,933. 1, TO FORM 990-PF, PG 1, LN 18 17, , FORM 990-PF OTHER EXPENSES STATEMENT 6 (A) (B) (C) (D) EXPENSES NET INVEST- ADJUSTED CHARITABLE DESCRIPTION PER BOOKS MENT INCOME NET INCOME PURPOSES INSURANCE MISC 1,145. 1, TELEPHONE K-1 LAKE SUCCESS CHARITABLE CONTRIBUTIONS 1,100. 1, TO FORM 990-PF, PG 1, LN 23 2,567. 2, FORM 990-PF OTHER INVESTMENTS STATEMENT 7 DESCRIPTION INVESTMENT IN PARTNERSHIP VALUATION FAIR MARKET METHOD BOOK VALUE VALUE LLV 1,941,531. 1,941,531. TOTAL TO FORM 990-PF, PART II, LINE 13 1,941,531. 1,941,531. STATEMENT(S) 5, 6, 7

16 JOSEPH F. AND CLARA FORD FOUNDATION C/O FORM 990'-PF GRANTS AND CONTRIBUTIONS STATEMENT 8 PAID DURING THE YEAR RECIPIENT NAME AND ADDRESS RECIPIENT RELATIONSHIP RECIPIENT AND PURPOSE OF GRANT STATUS AMOUNT ALBERT EINSTEIN COLLEGE 22, MORRIS PARK AVENUE BRONX, EDUCATIONAL AND NY RESEARCH AMERICAN FRIENDS OF HEBREW 33,185. ONE BATTERY PARK PLAZA NEW EDUCATIONAL AND YORK, NY RESEARCH AMERICAN SOCIETY FOR TECHNION 33, EAST 59TH STREET NEW YORK, EDUCATIONAL AND NY RESEARCH BRANDEIS UNIVERSITY 298, SOUTH STREET WALTHAM, MA EDUCATIONAL AND RESEARCH 'COMBINED JEWISH PHILANTHROPIES 73,742. 1,126 HIGH STREET BOSTON, MA EDUCATIONAL AND RESEARCH HADASSAH UNIVERSITY HOSPITAL 22,123. P.O.B JERUSALEM, ISRAEL EDUCATIONAL AND RESEARCH,HEBREW COLLEGE 22,123. '160 HERRICK ROAD NEWTON CENTRE, EDUCATIONAL AND MA RESEARCH HEBREW SENIOR LIFE 9, CENTRE STREET BOSTON, MA EDUCATIONAL AND RESEARCH STATEMENT(S) 8

17 JOSEPH F. AND CLARA FORD FOUNDATION C/O JEWISH THEOLOGICAL SEMINARY 3080 BROADWAY NEW YORK, NY EDUCATIONAL AND RESEARCH ,123. NORTHEASTERN UNIVERSITY 360 HUNTINGTON AVE BOSTON, MA EDUCATIONAL AND RESEARCH 73,742. TUFTS MEDICAL CENTER '800 WASHINGTON STREET BOSTON, MA EDUCATIONAL AND RESEARCH 27,655. WEIZMANN INSTITUTE OF SCIENCE PO BOX 26 REHOVOT, ISRAEL EDUCATIONAL AND RESEARCH 22,123.,TOTAL TO FORM 990-PF, PART XV, LINE 3A 660,000. STATEMENT(S) 8

18 Form 8868 (Rev, January, 2011) Department of the Treasury Internal Revenue Service Application for Extension of Time To File an Exempt Organization Return File a on for each return. OMB No If you are filing for an Automatic 3-Month Extension, complete only Part I and check this ox - If you are filing for an Additional ( Not Automatic ) 3-Month Extension, complete only Part II (on page 2 of this form) Do not complete Part II unless you have already een granted an automatic 3-month extension on a previously filed Form 8868 Electronic filing (e -file). You can electronically file Form 8868 if you need a 3-month automatic extension of time to file (6 months for a corporation required to file Form 990-T), or an additional (not automatic) 3-month extension of time You can electronically file Form 8868 to request an extension of time to file any of the forms listed in Part I or Part II with the exception of Form 8870, Information Return for Transfers Associated With Certain Personal Benefit Contracts, which must e sent to the IRS in paper format (see instructions). For more details on the electronic filing of this form, visit www firs ov/e file and click on e-file for Chanties & Nonprofits. Part I Automatic 3-Month Extension of Time. Only sumit original (no copies needed). A corporation required to file Form 990-T and requesting an automatic 6-month extension - check this ox and complete Part I only - All other corporations (including 1120-C filers), partnerships, REMICs, and trusts must use Form 7004 to request an extension of time to file income tax returns Type or Name of exempt organization print JOSEPH F. AND CLARA FORD FOUNDATION C/O LESLIE K. LERNER File y the due date for Numer, street, and room or suite no If a P O. ox, see instructions. filing your 77 POND AVENUE, NO. 801 return See instructions City, town or post office, state, and ZIP code. For a foreign address, see instructions. BROOKLINE, MA Employer identification numer Enter the Return code for the return that this application is for (file a separate application for each return) 0 4 Application Return Application Return Is For Code Is For Code Form Form 990-T (corp oration ) 07 Form 990-BL 02 Form 1041-A 08 Form 990-EZ 03 Form Form 990-PF 04 Form Form 990-T (sec 401 a or 408 ( a ) trust ) 05 Form Form 990-T (trust other than aove ) 06 Form LESLIE K. LERNER The ooks are In the care of 77 POND AVE - BROOKL INE, MA Telephone No FAX No If the organization does not have an office or place of usiness in the United States, check this ox LI If this is for a Group Return, enter the organization ' s four digit Group Exemption Numer (GEN). If this is for the whole group, check this ox 0 If it is for part of the group, check this ox 0 and attach a list with the names and EINs of all memers the extension is for 1 I request an automatic 3-month (6 months for a corporation required to file Form 990 -T) extension of time until MARCH 15, 2012, to file the exempt organization return for the organization named aove. The extension is for the organization ' s return for LI calendar year or tax year eginning AUG 1, 2010, and ending JUL 31, If the tax year entered in line 1 is for less than 12 months, check reason : 0 Initial return LI Final return 0 Change in accounting period 3a If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any nonrefundale credits See instructions. 3a $ 14, 760. If this application is for Form 990-PF, 990-T, 4720, or 6069, enter any refundale credits and estimated tax payments made Include any prior year overpayment allowed as a credit 3 $ 11,760. c Balance due. Sutract line 3 from line 3a Include your payment with this form, if required, Caution. If you are going to make an electronic fund withdrawal with this Form 8868, see Form 8453-EO and Form 8879-EO for payment instructions LHA For Paperwork Reduction Act Notice, see Instructions. Form 8868 (Rev )

Return of Private Foundation. Section 4947(a)(1) nonexempt charitable trust. Treated as a Private Foundation

Return of Private Foundation. Section 4947(a)(1) nonexempt charitable trust. Treated as a Private Foundation Form Part I 990-PF Analysis of Revenue and Expenses (The total of Return of Private Foundation or Section 4947(a) Nonexempt Charitale Trust Treated as a Private Foundation Department of the Treasury Internal

More information

20 1,868,631 52,936 36,314 45,000 27, ,185

20 1,868,631 52,936 36,314 45,000 27, ,185 295 8/3/215 1:9 AM Form 99-PF Return Summary For calendar year 214, or tax year eginning Sterling-Turner Foundation, and ending 74-146482 Investment Income Interest Dividends Gross rents Capital gain net

More information

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation l efile GRAPHIC print - DO NOT PROCESS As Filed Data - Form990-PF Department of the Trea^un Internal Rev enue Ser ice Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

More information

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation Form 99-PF Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation OMB No. 1545-52 217 Department of the Treasury Internal Revenue Service Do not enter social security numers

More information

Return of Private Foundation

Return of Private Foundation Form Department of the Treasury Internal Revenue Service For calendar year 01 or tax year eginning Name of foundation Numer and street (or P.O. ox numer if mail is not delivered to street address) Room/suite

More information

EXTENDED TO AUGUST 15, Return of Private Foundation. or Section 4947(a)(1) Trust Treated as Private Foundation OCT 1, 2016 SEP 30, 2017

EXTENDED TO AUGUST 15, Return of Private Foundation. or Section 4947(a)(1) Trust Treated as Private Foundation OCT 1, 2016 SEP 30, 2017 Form or Section 7(a)(1) Trust Treated as Private Foundation Department of the Treasury Do not enter social security numers on this form as it may e made pulic. Internal Revenue Service Information aout

More information

Return of Private Foundation

Return of Private Foundation Return of Private Foundation OMB. 1-00 Form 0-PF or Section 7(a)(1) nexempt Charitale Trust Department of the Treasury Treated as a Private Foundation Internal Revenue Service 00 te: The organization may

More information

or Section 4947 (a)(1) Trust Treated as Private Foundation ^01 3 Department of the Treasury (a) Revenue and

or Section 4947 (a)(1) Trust Treated as Private Foundation ^01 3 Department of the Treasury (a) Revenue and 0 c-i evt o.- 11 Form 990-PF Return of Private Foundation OMB No 1545-0052 or Section 4947 (a)(1) Trust Treated as Private Foundation ^01 3 Department of the Treasury Do not enter Social Security numers

More information

Return of Private Foundation. 990-PF or Section 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation

Return of Private Foundation. 990-PF or Section 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation Form Department of the Treasury Internal Revenue Service te. The foundation may e ale to use a copy of this return to satisfy state reporting requirements. For calendar year 0 or tax year eginning, and

More information

City or town, state or province, country, and ZIP or foreign postal code C H exemption application is pending, check here 10- El

City or town, state or province, country, and ZIP or foreign postal code C H exemption application is pending, check here 10- El Form 990-PF Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation Department of the Treasury Do not enter social security numers on this form as it may e made pulic. Internal

More information

PUBLIC DISCLOSURE COPY

PUBLIC DISCLOSURE COPY Form 990-EZ Short Form Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) OMB No. 1545-1150 Department of the

More information

Return of Private Foundation

Return of Private Foundation Form Department of the Treasury Internal Revenue Service te. The foundation may e ale to use a copy of this return to satisfy state reporting requirements. For calendar year 011 or tax year eginning, and

More information

Return of Private Foundation

Return of Private Foundation Form or Section 7(1) nexempt Charitale Trust Department of the Treasury Treated as a Private Foundation Internal Revenue Service te. The foundation may e ale to use a copy of this return to satisfy state

More information

Return of Private Foundation

Return of Private Foundation Form or Section 7(a)(1) Trust Treated as Private Foundation Department of the Treasury Do not enter Social Security numers on this form as it may e made pulic. Internal Revenue Service Information aout

More information

Return of Private Foundation OMB No or Section 4947(a)(1) Trust Treated as Private Foundation

Return of Private Foundation OMB No or Section 4947(a)(1) Trust Treated as Private Foundation Form 990-PF Return of Private Foundation OMB No. 1545-0052 or Section 4947(a)(1) Trust Treated as Private Foundation Department of the Treasury Internal Revenue Service Do not enter social security numers

More information

Return of Private Foundation

Return of Private Foundation Form Department of the Treasury Internal Revenue Service te. The foundation may e ale to use a copy of this return to satisfy state reporting requirements. For calendar year 01 or tax year eginning, and

More information

Return of Private Foundation

Return of Private Foundation Form or Section 7(a)(1) Trust Treated as Private Foundation Department of the Treasury Do not enter social security numers on this form as it may e made pulic. Internal Revenue Service Information aout

More information

Return of Private Foundation

Return of Private Foundation Form or Section 7(a)(1) Trust Treated as Private Foundation Department of the Treasury Do not enter social security numers on this form as it may e made pulic. Internal Revenue Service Information aout

More information

FILE COPY. Return of Private Foundation. or Section 4947(a)(1) Trust Treated as Private Foundation

FILE COPY. Return of Private Foundation. or Section 4947(a)(1) Trust Treated as Private Foundation Form 990-PF Department of the Treasury Internal Revenue Service Return of Private Foundation OMB No. 1545-0052 or Section 4947(a)(1) Trust Treated as Private Foundation G Do not enter social security numbers

More information

under section 507(b)(1)(B), check here q line 16) $ 464 (Part 1, column (d) must be on cash basis.) Analysis of Revenue and Expenses (The total of

under section 507(b)(1)(B), check here q line 16) $ 464 (Part 1, column (d) must be on cash basis.) Analysis of Revenue and Expenses (The total of Form 990-PF Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation Department of the Treasury Do not enter social security numers on this form as it may e made pulic. Internal

More information

Return of Private Foundation

Return of Private Foundation Form or Section 4947(a)(1) Trust Treated as Private Foundation Department of the Treasury Do not enter social security numbers on this form as it may be made public. Internal Revenue Service Information

More information

THE POETRY FOUNDATION. Form 990-PF for the Year Ended December 31, Public Disclosure Copy

THE POETRY FOUNDATION. Form 990-PF for the Year Ended December 31, Public Disclosure Copy THE POETRY FOUNDATION Form 990-PF for the Year Ended December 31, 2015 Public Disclosure Copy Form 990-PF Return of Private Foundation OMB No. 1545-0052 I or Section 4947(a)(1) Trust Treated as Private

More information

Return of Private Foundation

Return of Private Foundation Form or Section (a)(1) Trust Treated as Private Foundation Do not enter social security numers on this form as it may e made pulic. Department of the Treasury Internal Revenue Service Go to www.irs.gov/form0pf

More information

Return of Private Foundation

Return of Private Foundation Form or Section 447(a)(1) Trust Treated as Private Foundation Department of the Treasury Do not enter social security numbers on this form as it may be made public. Internal Revenue Service Information

More information

Return of Private Foundation

Return of Private Foundation Form Department of the Treasury Internal Revenue Service Note. The foundation may be able to use a copy of this return to satisfy state reporting requirements. For calendar year 2011 or tax year beginning,

More information

May 8, Ms. Ellen Porter Warlick The Paul and Margaret Porter Charitable Foundation 105 Sycamore Lane Shelby, NC

May 8, Ms. Ellen Porter Warlick The Paul and Margaret Porter Charitable Foundation 105 Sycamore Lane Shelby, NC May 8, 01 Ms. Ellen Porter Warlick The Paul and Margaret Porter Charitale Foundation 10 Sycamore Lane Shely, NC 81 Dear Ellen: Enclosed is the organization's 011 Exempt Organization return. We have prepared

More information

Return of Private Foundation. or Section 4947(a)(1) Trust Treated as Private Foundation NOV 1, 2015 OCT 31, 2016

Return of Private Foundation. or Section 4947(a)(1) Trust Treated as Private Foundation NOV 1, 2015 OCT 31, 2016 Form or Section 7(1) Trust Treated as Private Foundation Department of the Treasury Do not enter social security numers on this form as it may e made pulic. Internal Revenue Service Information aout Form

More information

Return of Private Foundation

Return of Private Foundation Form Department of the Treasury Internal Revenue Service Note. The foundation may be able to use a copy of this return to satisfy state reporting requirements. For calendar year 2012 or tax year beginning,

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF Return of Private Foundation OMB No. 1545-0052 I or Section 4947(a)(1) Trust Treated as Private Foundation Do not enter social security numbers on this form as it may be made public. À¾µ¹ Department

More information

** PUBLIC INSPECTION COPY ** EXTENDED TO NOVEMBER 15, 2018 Exempt Organization Business Income Tax Return

** PUBLIC INSPECTION COPY ** EXTENDED TO NOVEMBER 15, 2018 Exempt Organization Business Income Tax Return Form Department of the Treasury Internal Revenue Service 723701 01-22-18 For calendar year 2017 or other tax year eginning, and ending. Go to www.irs.gov/form0t for instructions and the latest information.

More information

Return of Organization Exempt From Income Tax 990 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung 2007

Return of Organization Exempt From Income Tax 990 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung 2007 Revenue Return of Organization Exempt From Income Tax 990 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except lack lung 2007 OMB No. 1545-0047 Form Department of the Treasury

More information

Exempt Organization Business Income Tax Return

Exempt Organization Business Income Tax Return Form Department of the Treasury Internal Revenue Service For calendar year 2017 or other tax year eginning, and ending. Go to www.irs.gov/form0t for instructions and the latest information. Do not enter

More information

Return of Private Foundation

Return of Private Foundation Form or Section 4947(a)(1) Trust Treated as Private Foundation Department of the Treasury Do not enter social security numbers on this form as it may be made public. Internal Revenue Service Go to www.irs.gov/form990pf

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Short Form Return of Organization Exempt From Income Tax OMB No. 1545-1150 Form Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except lack lung enefit trust or 990-EZ private foundation)

More information

TAX RETURN FILING INSTRUCTIONS

TAX RETURN FILING INSTRUCTIONS TA RETURN FILING INSTRUCTIONS FORM 990-PF FOR THE YEAR ENDING ~~~~~~~~~~~~~~~~~ DECEMBER 31, 2015 Prepared for Prepared y Amount due or refund Make check payale to Mail tax return and check (if applicale)

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF Department of the Treasury Internal Revenue Service Return of Private Foundation OMB No. 1545-0052 or Section 4947(a)(1) Trust Treated as Private Foundation G Do not enter social security numbers

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF Department of the Treasury Internal Revenue Service I Return of Private Foundation OMB No. 1545-0052 I or Section 4947(a)(1) Trust Treated as Private Foundation Do not enter Social Security

More information

Short Form Return of Organization Exempt From Income Tax 990-EZ 2009

Short Form Return of Organization Exempt From Income Tax 990-EZ 2009 OMB No. 1545-1150 Form Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except lack lung enefit trust or private foundation) Sponsoring organizations of donor advised funds and controlling

More information

a q q JUN d Operating and Adn lnietratlve Expenses Revenue _ 13 0 El Nl? S O O O c^v 'n m a N co 0 V p^ N A W N ^ ^ Q CI Q ^1 Q 41

a q q JUN d Operating and Adn lnietratlve Expenses Revenue _ 13 0 El Nl? S O O O c^v 'n m a N co 0 V p^ N A W N ^ ^ Q CI Q ^1 Q 41 I JUN d 1 814 Operating and Adn lnietratlve Expenses Revenue _ l7 Q d A Its is O 1 O1 V Q Of fj^ A W N co V p^ N A W N ^ ^ Q CI Q ^1 Q 41 c^v TI 6 13 El Nl? q t V 1 2! 1 O 1 O 1 pw Np O I io N S O O O

More information

or Section 4947(a)(1) Trust Treated as Private Foundation 2015

or Section 4947(a)(1) Trust Treated as Private Foundation 2015 'Co 0 cj J Ui Form 990-PP Return of Private Foundation OMB No. 1545-0052 or Section 4947(a)(1) Trust Treated as Private Foundation 2015 Depar,ment of the Treasury Do not enter social security numers on

More information

Return of Private Foundation

Return of Private Foundation Form or Section 447(a)(1) Trust Treated as rivate Foundation Department of the Treasury Do not enter social security numers on this form as it may e made pulic. Internal Revenue Service Information aout

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Return of Organization Exempt From Income Tax OMB No. 1545-0047 Form Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except lack lung enefit trust or private foundation) Open to

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF Return of Private Foundation OMB No. 1545-0052 or Section 4947(a)(1) Trust Treated as Private Foundation Do not enter social security numbers on this form as it may be made public. À¾µ» Department

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form Department of the Treasury Internal Revenue Service Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except lack lung enefit trust

More information

A Employer identification number KP & PHOEBE TSOLAINOS FOUNDATION INC % DUGAN, COLTHART & ZOCH, PA

A Employer identification number KP & PHOEBE TSOLAINOS FOUNDATION INC % DUGAN, COLTHART & ZOCH, PA I Return of Private Foundation Form 990-PF or Section 4947(a)(1) Trust Treated as Private Foundation Department of the Treasury I Do not enter social security numers on this form as it may e made pulic.

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF Department of the Treasury Internal Revenue Service For calendar year 2010, or tax year beginning, 2010, and ending, G Check all that apply: Initial return Initial Return of a former public

More information

r; (hack all that annly n Initial return n Final return n Amended return n Address chan oe n Name chance

r; (hack all that annly n Initial return n Final return n Amended return n Address chan oe n Name chance Cl C 2 Q n rc es r c Form 19 9O p Return of Private Foundation OMB No 1545-0052 Department of the Treasury Internal Revenue Service or Section 4947 (a)(1) Nonexempt Charitale Trust Treated as a Private

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 990 Department of the Treasury Internal Revenue Service A For the 2007 calendar year, or tax year eginning B Check if applicale: Please use IRS lael or print or type. See Specific Instructions. Return

More information

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation l efile GRAPHIC print - DO NOT PROCESS As Filed Data - Form990-PF Department of the Trea^un Internal Rev enue Ser ice Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

More information

TAX RETURN FILING INSTRUCTIONS

TAX RETURN FILING INSTRUCTIONS TA RETURN FILING INSTRUCTIONS FORM 0-PF FOR THE YEAR ENDING ~~~~~~~~~~~~~~~~~ December 31, 2015 Prepared for Prepared by Amount due or refund Make check payable to Mail tax return and check (if applicable)

More information

maloneynovotny.com Business Advisors and Certified Public Accountants

maloneynovotny.com Business Advisors and Certified Public Accountants Business Advisors and Certified Pulic Accountants Cleveland 216.363.0100 216.363.0500 (fax) Canton 3366.400 3366.401 (fax) Delaware 74362.031 74363.77 (fax) Elyria 44323.3200 44322.442 (fax) Worthington

More information

PUBLIC DISCLOSURE. EXTENDED TO NOVEMBER 15, 2018 Return of Private Foundation

PUBLIC DISCLOSURE. EXTENDED TO NOVEMBER 15, 2018 Return of Private Foundation PUBLIC DISCLOSURE ETENDED TO NOVEMBER 15, 018 Return of Private Foundation 0-PF Form OMB. 1545-005 or Section 447(a)(1) Trust Treated as Private Foundation Do not enter social security numers on this form

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax L is not required, ut if the organization chooses to file a return, e sure to file a complete return. Add lines 5, 6, and 7, to line 9 to determine gross receipts; if $1,, or more, file Form 99 instead

More information

Short Form. Return of Organization Exempt From Income Tax

Short Form. Return of Organization Exempt From Income Tax Short Form OMB. 1545-1150 Return of Organization Exempt From Income Tax Form 990-EZ Under section 501(c), 57, or 4947(a)(1) of the Internal Revenue Code 016 (except private foundations) G Do not enter

More information

Form 990-PF. Form 990-PF (2009) BAILEY-1

Form 990-PF. Form 990-PF (2009) BAILEY-1 I Form 990-PF Department of the Treasury Internal Revenue Service Return of Private Foundation or Section 4947 (a)(1) Nonexempt Charitale Trust Treated as a Private Foundation Note. The foundation may

More information

Short Form. Return of Organization Exempt From Income Tax

Short Form. Return of Organization Exempt From Income Tax Short Form OMB. 1545-1150 Return of Organization Exempt From Income Tax Form 990-EZ Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code 2015 (except private foundations) G Do not enter

More information

Public Inspection Copy

Public Inspection Copy Form Pulic Inspection Copy Check if applicale: Department of the Treasury Internal Revenue Service A B G I 990-EZ For the 0 calendar year, or tax year eginning C Name of organization Address change Name

More information

Short Form. Return of Organization Exempt From Income Tax

Short Form. Return of Organization Exempt From Income Tax Short Form OMB. 1545-1150 Return of Organization Exempt From Income Tax Form 990-EZ Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code 2015 (except private foundations) G Do not enter

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF Return of Private Foundation OMB No. 1545-0052 I or Section 4947(a)(1) Trust Treated as Private Foundation Do not enter social security numbers on this form as it may be made public. À¾µº Department

More information

Return of Private Foundation

Return of Private Foundation Form or Section 7(a)(1) Trust Treated as Private Foundation Department of the Treasury Do not enter Social Security numers on this form as it may e made pulic. Internal Revenue Service Information aout

More information

PARTNERS IN HEALTH, A NONPROFIT CORPORATION

PARTNERS IN HEALTH, A NONPROFIT CORPORATION PARTNERS IN HEALTH, A NONPROFIT CORPORATION Form Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except lack lung enefit trust or private

More information

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation l efile GRAPHIC print - DO NOT PROCESS As Filed Data - Form99-PF Department of the Trea^un Internal Rev enue Ser ice Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax 99-EZ Short Form Return of Organization Exempt From Income Tax OMB No. 1545-115 Form Under section 51(c), 527, or 4947(a)(1) of the Internal Revenue Code (except lack lung enefit trust or private foundation)

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax 990 OMB 1545-0047 Return of Organization Exempt From Income Tax Form Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except lack lung 2007 enefit trust or private foundation) Department

More information

1 `(d. Otherwise, RUST print Number and street (or P O box number if mail is not delivered to street address ) Room /suite

1 `(d. Otherwise, RUST print Number and street (or P O box number if mail is not delivered to street address ) Room /suite Form 990-PF Return of Private Foundation OMB No 1545-0052 Department of the Treasury Internal Revenue Service or Section 4947(a)(1) Nonexempt Charitale Trust 2009 Treated as a Private Foundation Note.

More information

CLIENT COPY THE GRAHAM AND CAROLYN HOLLOWAY FAMILY FOUNDATION TRUST P O BOX 989 COLLEYVILLE, TX

CLIENT COPY THE GRAHAM AND CAROLYN HOLLOWAY FAMILY FOUNDATION TRUST P O BOX 989 COLLEYVILLE, TX 6 TA RETURN CLIENT COPY Client: 44 Prepared for: P O BO 989 COLLEYVILLE, T 764 87.67.897 Prepared by: TASHA WHIDDON, CPA MCILVAIN & ASSOCIATES LLC 44 GATEWAY DRIVE, SUITE 8 COLLEYVILLE, T 764 87-4-77 Date:

More information

PUBLIC DISCLOSURE COPY Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation

PUBLIC DISCLOSURE COPY Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation Form 99-PF PUBLIC DISCLOSURE COPY Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation OMB No. 1545-52 216 Department of the Treasury Internal Revenue Service Do not enter

More information

990-PF. or Section 4947(a)(1) Trust Treated as Private Foundation VOICE OF ELIJAH INC PO BOX 2257 ROCKWALL, TX

990-PF. or Section 4947(a)(1) Trust Treated as Private Foundation VOICE OF ELIJAH INC PO BOX 2257 ROCKWALL, TX Form 990-PF OMB No. -00 Return of Private Foundation 0 or Section 97() Trust Treated as Private Foundation G Do not enter social security numbers on this form as it may be made public. G Information about

More information

KHAN CPA CORPORATION 1875 CENTURY PARK E STE 600 LOS ANGELES, CA (310)

KHAN CPA CORPORATION 1875 CENTURY PARK E STE 600 LOS ANGELES, CA (310) KHAN CPA CORPORATION 1875 CENTURY PARK E STE 600 LOS ANGELES, CA 90067-2507 (310) 286-2727 December 1, 2014 Everest Edwin Foundation 11766 Wilshire Blvd. Suite 1450 Los Angeles, CA 90025 Dear Client: Enclosed

More information

Short Form. Return of Organization Exempt From Income Tax

Short Form. Return of Organization Exempt From Income Tax Short Form OMB. 1545-1150 Return of Organization Exempt From Income Tax Form 990-EZ Under section 501(c), 57, or 4947(a)(1) of the Internal Revenue Code 017 (except private foundations) G Do not enter

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 990-EZ Short Form Return of Organization Exempt From Income Tax OMB. 1545-1150 017 Under section 501(c), 57, or 4947(a)(1) of the Internal Revenue Code (except private foundations) G Do not enter

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax 99-EZ Short Form Return of Organization Exempt From Income Tax OMB No. 1545-115 Form Under section 51(c), 527, or 4947(a)(1) of the Internal Revenue Code (except lack lung enefit trust or private foundation)

More information

Short Form. Return of Organization Exempt From Income Tax

Short Form. Return of Organization Exempt From Income Tax Short Form OMB. 1545-1150 Return of Organization Exempt From Income Tax Form 990-EZ Under section 501(c), 57, or 4947(a)(1) of the Internal Revenue Code 017 (except private foundations) G Do not enter

More information

or Section 4947(a)(1) Trust Treated as Private Foundation -654,371.

or Section 4947(a)(1) Trust Treated as Private Foundation -654,371. Form 990-PF OMB No. 1545-0052 Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation 2016 G Do not enter social security numbers on this form as it may be made public. Department

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except lack lung enefit trust or private foundation) OMB No. 1545-0047 Open to

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form Department of the Treasury Internal Revenue Service A B G I J K Address change Name change Initial return Final return/terminated Amended return Application pending Accounting Method: Wesite: Form

More information

Return of Private Foundation

Return of Private Foundation 1 990-PF Return of Private Foundation OMB No 1545-0052 Form or Section 4947(a)(1) Nonexempt Charitale Trust Department f the Treasury Treated as a Private Foundation Internal Revenue Service (77) Note

More information

Short Form. Return of Organization Exempt From Income Tax

Short Form. Return of Organization Exempt From Income Tax Short Form OMB. 1545-1150 Return of Organization xempt From Income Tax Form 990-Z Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code 2014 (except private foundations) G Do not enter

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except lack lung enefit trust or private foundation) OMB No. 1545-0047 Open to

More information

990-EZ INTERFAITH HOSPITALITY NETWORK OF GREATER ROCHESTER Telephone number F Group Exemption Number u 811 7TH ST NW

990-EZ INTERFAITH HOSPITALITY NETWORK OF GREATER ROCHESTER Telephone number F Group Exemption Number u 811 7TH ST NW Form 990-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except lack

More information

Part II Activities and Operational Information ( Continued)

Part II Activities and Operational Information ( Continued) The Society of Archishop Justus 244 Ludlowville Road 16 607 1570817 756-5681 Lou Rathun, CPA Decemer Lansing, New York 14882-9039 3 Octoer 1997 http://justus.anglican.org/soaj.html Cynthia McFarland, Vice

More information

TAX RETURN FILING INSTRUCTIONS

TAX RETURN FILING INSTRUCTIONS Caution: Forms printed within Adoe Acroat products may not meet IRS or state taxing agency specifications. When using Acroat 5.x products, uncheck the "Shrink oversized pages to paper size" and uncheck

More information

Exempt Organization Business Income Tax Return

Exempt Organization Business Income Tax Return Form OMB No. 1545-0687 For calendar year 2016 or other tax year eginning, and ending. Information aout Form 0-T and its instructions is availale at www.irs.gov/form0t. Department of the Treasury Open to

More information

Return of Private Foundation

Return of Private Foundation Form Department of the Treasury Internal Revenue Service Note. The foundation may be able to use a copy of this return to satisfy state reporting requirements. For calendar year 2012 or tax year beginning,

More information

Short Form Return of Organization Exempt From Income Tax 990-EZ 2009

Short Form Return of Organization Exempt From Income Tax 990-EZ 2009 OMB No. 1545-1150 Form Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except lack lung enefit trust or private foundation) Sponsoring organizations of donor advised funds and controlling

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 99-EZ Department of the Treasury Internal Revenue Service Revenue Expenses Short Form Return of Organization Exempt From Income Tax OMB No. 1545-115 A For the 26 calendar year, or tax year eginning

More information

ENCLOSED ARE THE ORIGINAL AND ONE COPY OF YOUR INCOME TAX RETURNS FOR THE PERIOD ENDED JUNE 30, 2009 FOR:

ENCLOSED ARE THE ORIGINAL AND ONE COPY OF YOUR INCOME TAX RETURNS FOR THE PERIOD ENDED JUNE 30, 2009 FOR: OPPORTUNITIES INDUSTRIALIZATION CENTERS OF AMERICA, INC. 1415 N. BROAD STREET PHILADELPHIA, PA 19122 DEAR CLIENT, ENCLOSED ARE THE ORIGINAL AND ONE COPY OF YOUR INCOME TA RETURNS FOR THE PERIOD ENDED JUNE

More information

Exempt Organization Business Income Tax Return

Exempt Organization Business Income Tax Return Form Department of the Treasury Internal Revenue Service 623701 01-18-17 OMB No. 1545-0687 For calendar year 2016 or other tax year eginning, and ending. Information aout Form 0-T and its instructions

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF Return of Private Foundation OMB No. 1545-0052 I or Section 4947(a)(1) Trust Treated as Private Foundation Do not enter social security numbers on this form as it may be made public. À¾µ¹ Department

More information

Exempt Organization Business Income Tax Return

Exempt Organization Business Income Tax Return Form OMB No. 1545-0687 For calendar year 2016 or other tax year eginning, and ending. Information aout Form 0-T and its instructions is availale at www.irs.gov/form0t. Department of the Treasury Open to

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Revenue Expenses 99-EZ Short Form Return of Organization Exempt From Income Tax OMB No. 1545-115 Form Under section 51(c), 527, or 4947(a)(1) of the Internal Revenue Code (except lack lung enefit trust

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 990 Department of the Treasury Internal Revenue Service OMB No. 1545-0047 Return of Organization Exempt From Income Tax 2012 Under section 501(c, 527, or 4947(a(1 of the Internal Revenue Code (except

More information

U Corporation U Trust Association U Other

U Corporation U Trust Association U Other ShortForm Return of Organization Exempt From Income Tax Form 990-EZ Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) Department of the Treasury Internal

More information

990'EZ ^'1. Short Form Return of Organization Exempt From Income Tax

990'EZ ^'1. Short Form Return of Organization Exempt From Income Tax ^'1 Form 99'EZ Department of the Treasury Internal Revenue Serece Short Form Return of Organization Exempt From Income Tax Under section 51(c), 527, or 4947( a)(1) of the Internal Revenue Code (except

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax 990-EZ Short Form Return of Organization Exempt From Income Tax OMB No. 1545-1150 Form Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except lack lung enefit trust or private foundation)

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax 990-EZ Short Form Return of Organization Exempt From Income Tax OMB No. 1545-1150 Form Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except lack lung enefit trust or private foundation)

More information

Return of Private Foundation OMB No or Section 4947(a)(1) Trust Treated as Private Foundation

Return of Private Foundation OMB No or Section 4947(a)(1) Trust Treated as Private Foundation Form 990-PF Return of Private Foundation OMB No. 1545-0052 or Section 4947(a)(1) Trust Treated as Private Foundation Do not enter social security numbers on this form as it may be made public. Department

More information

Public Charity Status and Public Support

Public Charity Status and Public Support SCHEDULE A (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Service Pulic Charity Status and Pulic Support Complete if the organization is a section 501(c)(3) organization or a section

More information

Return of Private Foundation

Return of Private Foundation Form 990-PF Return of Private Foundation OMB No. 1545-0052 I or Section 4947(a)(1) Trust Treated as Private Foundation Do not enter social security numbers on this form as it may be made public. À¾µ¹ Department

More information

Return of Organization Exempt From Income Tax 990 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung 2006

Return of Organization Exempt From Income Tax 990 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung 2006 754 9/27/27 8:59 AM Revenue Expenses Net Assets Return of Organization Exempt From Income Tax 99 Under section 51(c), 527, or 4947(a)(1) of the Internal Revenue Code (except lack lung 26 OMB No. 1545-47

More information