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

Transcription

1 Form 99-T Exempt Organization Business Income Tax Return (and proxy tax under section 633(e)) OMB No For calendar year 216 or other tax year beginning, 216, and ending, 2. Department of the Treasury Information about Form 99-T and its instructions is available at 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(c)(3). 51(c)(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 48(e) 22(e) Type 3 S MERIDIAN ST, SUITE 7 E Unrelated business activity codes (See instructions.) 48A 53(a) City or town, state or province, country, and ZIP or foreign postal code 529(a) INDIANAPOLIS, IN C Book value of all assets F Group exemption number (See instructions.) at end of year 1,2,746,667 G Check organization type 51(c) corporation 51(c) trust 41(a) 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 256,61 256,61 b Net gain (loss) (Form 4797, Part II, line 17) (attach Form 4797) 4b 867, ,412 c Capital loss deduction for trusts c 5 Income (loss) from partnerships and S corporations (attach statement) 5 (1,718,544) (1,718,544) 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(c)(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 (594,522) (594,522) 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 ,83 16 Repairs and maintenance Bad debts Interest (attach schedule) Taxes and licenses ,81 2 Charitable contributions (See instructions for limitation rules) Depreciation (attach Form 4562) , Less depreciation claimed on Schedule A and elsewhere on return.. 22a 22b 2, Depletion , Contributions to deferred compensation plans Employee benefit programs , Excess exempt expenses (Schedule I) Excess readership costs (Schedule J) Other deductions (attach schedule) ,49 29 Total deductions. Add lines 14 through ,927 3 Unrelated business taxable income before net operating loss deduction. Subtract line 29 from line 13 3 (1,31,449) 31 Net operating loss deduction (limited to the amount on line 3) Unrelated business taxable income before specific deduction. Subtract line 31 from line (1,31,449) 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 (1,31,449) For Paperwork Reduction Act Notice, see instructions. Cat. No J Form 99-T (216)

2 Page 2 Form 99-T (216) Part III 35 Tax Computation 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): (2) $ (3) $ (1) $ 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 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 35c e Tax and Payments 41a b c d e a b c d e f g Foreign tax credit (corporations attach Form 1118; trusts attach Form 1116) Other credits (see instructions) General business credit. Attach Form 38 (see instructions).... Credit for prior year minimum tax (attach Form 881 or 8827).... Total credits. Add lines 41a through 41d Subtract line 41e from line During the tax year, did the organization receive a distribution from, or was it the grantor of, or transferor to, a foreign trust?. If YES, see instructions for other forms the organization may have to file. 89,416 Enter the amount of tax-exempt interest received or accrued during the tax year $ Other taxes. Check if from: Form 4255 Form 8611 Form Form a 41b 41c 41d Other (attach schedule). Total tax. Add lines 42 and ,916 Payments: A 215 overpayment credited to a 216 estimated tax payments b Tax deposited with Form c Foreign organizations: Tax paid or withheld at source (see instructions). 45d Backup withholding (see instructions) e Credit for small employer health insurance premiums (Attach Form 8941). 45f Other credits and payments: Form 2439 Form 4136 Other Total 45g 957, Total payments. Add lines 45a through 45g 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.. 49 Enter the amount of line 49 you want: Credited to 217 estimated tax 25, 77,916 5 Refunded 5 Part V Statements Regarding Certain Activities and Other Information (see instructions) At any time during the 216 calendar year, did the organization have an interest in or a signature or other authority Yes No 51 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 53 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. Sign Here Signature of officer Paid Preparer Use Only Date Print/Type preparer s name Preparer s signature NICOLE M BENCIK Firm s name Firm s address CROWE HORWATH LLP May the IRS discuss this return with the preparer shown below (see instructions)? Yes No Title Date :12:48-6'' Check if self-employed Firm s EIN 3815 RIVER CROSSING PARKWAY, SUITE 3, POST OFFICE BOX 4977, INDIANAPOLIS, IN Phone no. PTIN P (317) Form 99-T (216)

3 Form 99-T (216) 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) (a) 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 (b) 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(a) Deductions directly connected with the income in columns 2(a) and 2(b) (attach schedule) Total Total (b) Total deductions. (c) Total income. Add totals of columns 2(a) and 2(b). 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) % (a) 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). (b) Other deductions (attach schedule) No 8. Allocable deductions (column 6 total of columns 3(a) and 3(b)) Enter here and on page 1, Part I, line 7, column (B). Totals Total dividends-received deductions included in column Form 99-T (216)

4 Form 99-T (216) 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(c)(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 (216)

5 Form 99-T (216) 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 % 3,126 (2) % (3) % (4) % Total. Enter here and on page 1, Part II, line ,126 Form 99-T (216)

6 Form 99T Part I, Line 5 Income (loss) from Partnership and S Corporations Name of Partnership EIN UBI INVESTMENTS (1) Abrams Capital Partners II, LP ,876 (2) AG REALTY FUND IX, LP (3) ALPINE INVESTORS V, LP ,955 (4) Archlight Energy Partners Fund IV LP ,287 (5) BAUPOST VALUE PARTNERS, L.P.-IV ,396 (6) Carmel Partners Investment Fund IV, LP ,748 (7) CHARLESBANK EQUITY FUND VII, LP ,43 (8) Charlesbank Equity Fund VIII, LP ,31 (9) Energy Capital Partners Mezzanine Opportunities Fund A, LP ,147 (1) ENERGY SPECTRUM PARTNERS VII LP ,637 (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 ,747 (14) H.I.G. Growth Buyouts & Equity Fund II, L. P ,645 (15) Iron Point Real Estate Partners II ,799 (16) IRON POINT REAL ESTATE PARTNERS III, LP ,19 (17) Lime Rock Partners VI, L. P ,862 (18) MERCED PARTNERS IV, L.P ,835 (19) NATURAL GAS PARTNERS IX, LP ,455 (2) OCM REAL ESTATE OPPORTUNITIES FUND III, LP ,226 (21) RETHINK EDUCATION, LP (22) RIVA CAPITAL PARTNERS IV, LP ,41 (23) Starwood Captial Hospitality Fund I-3, LP ,169 (24) Stonehill Institutional Partners LP ,153 (25) Stonelake Opportunity Partners III, LP ,294 (26) TAILWATER E&P Opportunity Fund II, LP ,84 (27) VENTURE INVESTMENT ASSOCIATES VI, LP ,772 (28) WALTON STREET REAL ESTATE FUND V, LP ,872 Total for Part I, Line 5-1,718,544

7 Form 99T Part II, Line 19 Taxes and Licenses Description Amount INVESTMENT EXPENSE (1) AZ STATE INCOME TAX 5 (2) CA STATE INCOME TAX 1 (3) CT STATE INCOME TAX 113 (4) DC STATE INCOME TAX 25 (5) GA STATE INCOME TAX 1,287 (6) HI STATE INCOME TAX 876 (7) IL STATE INCOME TAX 637 (8) MD STATE INCOME TAX 541 (9) MA STATE INCOME TAX 31 (1) MN STATE INCOME TAX 588 (11) NM STATE INCOME TAX 5 (12) NY STATE INCOME TAX 25 (13) TN STATE INCOME TAX 398 Total 5,81 Total for Part II, Line 19 5,81

8 Form 99T Part II, Line 2 Charitable Contributions Year Generated Amount Generated Amount Used in Prior Years Amount Used in Current Year Amount Remaining 215 1,243 1, ,568 1, Totals 2,811 2,811 Contribution Carryover Expires

9 Form 99T Part II, Line 28 Other Deductions Description Amount INVESTMENT EXPENSE (1) OCCUPANCY 7,21 (2) LEGAL FEES 7,832 (3) ACCOUNTING FEES 17,45 (4) CONSULTING/OTHER PROFESSIONAL FEES 436,59 (5) TRAVEL 2,365 (6) OTHER MISCELLANEOUS EXPENSE 13,133 Total 484,49 Total for Part II, Line ,49

10 Form 99T Part II, Line 31 Net Operating Loss Deduction Carryforward Schedule Year Generated Amount Generated Amount Used in Prior Years Amount Used in Current Year Amount Remaining 215 3,1,824 3,1, ,31,449 1,31, Totals 4,33,273 4,33,273 NOL Expires

11 Form 38 Department of the Treasury Internal Revenue Service (99) Name(s) shown on return General Business Credit Information about Form 38 and its separate instructions is at You must attach all pages of Form 38, pages 1, 2, and 3, to your tax return. } Identifying number OMB No Attachment Sequence No. 22 LUMINA FOUNDATION FOR EDUCATION, INC Part I Current Year Credit for Credits Not Allowed Against Tentative Minimum Tax (TMT) (See instructions and complete Part(s) III before Parts I and II) 1 General business credit from line 2 of all Parts III with box A checked Passive activity credits from line 2 of all Parts III with box B checked 2 3 Enter the applicable passive activity credits allowed for 216 (see instructions) Carryforward of general business credit to 216. Enter the amount from line 2 of Part III with box C checked. See instructions for statement to attach Carryback of general business credit from 217. Enter the amount from line 2 of Part III with box D checked (see instructions) Add lines 1, 3, 4, and Part II Allowable Credit 7 Regular tax before credits: Individuals. Enter the sum of the amounts from Form 14, lines 44 and 46, or the sum of the amounts from Form 14NR, lines 42 and Corporations. Enter the amount from Form 112, Schedule J, Part I, line 2; or the applicable line of your return Estates and trusts. Enter the sum of the amounts from Form 141, Schedule G, lines 1a and 1b; or the amount from the applicable line of your return Alternative minimum tax: Individuals. Enter the amount from Form 6251, line Corporations. Enter the amount from Form 4626, line Estates and trusts. Enter the amount from Schedule I (Form 141), line 56.. } Add lines 7 and a Foreign tax credit a b Certain allowable credits (see instructions) b c Add lines 1a and 1b c 11 Net income tax. Subtract line 1c from line 9. If zero, skip lines 12 through 15 and enter -- on line Net regular tax. Subtract line 1c from line 7. If zero or less, enter Enter 25% (.25) of the excess, if any, of line 12 over $25, (see instructions) Tentative minimum tax: } Individuals. Enter the amount from Form 6251, line Corporations. Enter the amount from Form 4626, line Estates and trusts. Enter the amount from Schedule I (Form 141), line Enter the greater of line 13 or line Subtract line 15 from line 11. If zero or less, enter Enter the smaller of line 6 or line C corporations: See the line 17 instructions if there has been an ownership change, acquisition, or reorganization. For Paperwork Reduction Act Notice, see separate instructions. Cat. No F Form 38 (216)

12 Form 38 (216) Page 2 Part II Allowable Credit (Continued) Note: If you are not required to report any amounts on lines 22 or 24 below, skip lines 18 through 25 and enter -- on line Multiply line 14 by 75% (.75) (see instructions) Enter the greater of line 13 or line Subtract line 19 from line 11. If zero or less, enter Subtract line 17 from line 2. If zero or less, enter Combine the amounts from line 3 of all Parts III with box A, C, or D checked Passive activity credit from line 3 of all Parts III with box B checked Enter the applicable passive activity credit allowed for 216 (see instructions) Add lines 22 and Empowerment zone and renewal community employment credit allowed. Enter the smaller of line 21 or line Subtract line 13 from line 11. If zero or less, enter Add lines 17 and Subtract line 28 from line 27. If zero or less, enter Enter the general business credit from line 5 of all Parts III with box A checked Reserved Passive activity credits from line 5 of all Parts III with box B checked Enter the applicable passive activity credits allowed for 216 (see instructions) Carryforward of business credit to 216. Enter the amount from line 5 of Part III with box C checked and line 6 of Part III with box G checked. See instructions for statement to attach Carryback of business credit from 217. Enter the amount from line 5 of Part III with box D checked (see instructions) Add lines 3, 33, 34, and Enter the smaller of line 29 or line Credit allowed for the current year. Add lines 28 and 37. Report the amount from line 38 (if smaller than the sum of Part I, line 6, and Part II, lines 25 and 36, see instructions) as indicated below or on the applicable line of your return. Individuals. Form 14, line 54, or Form 14NR, line Corporations. Form 112, Schedule J, Part I, line 5c }.... Estates and trusts. Form 141, Schedule G, line 2b Form 38 (216)

13 Form 38 (216) Page 3 Name(s) shown on return Identifying number LUMINA FOUNDATION FOR EDUCATION, INC Part III General Business Credits or Eligible Small Business Credits (see instructions) Complete a separate Part III for each box checked below (see instructions). A General Business Credit From a Non-Passive Activity E Reserved B General Business Credit From a Passive Activity F Reserved C General Business Credit Carryforwards G Eligible Small Business Credit Carryforwards D General Business Credit Carrybacks H Reserved I If you are filing more than one Part III with box A or B checked, complete and attach first an additional Part III combining amounts from all Parts III with box A or B checked. Check here if this is the consolidated Part III (a) Description of credit Note: On any line where the credit is from more than one source, a separate Part III is needed for each pass-through entity. 1a Investment (Form 3468, Part II only) (attach Form 3468) a b Reserved b c Increasing research activities (Form 6765) c d Low-income housing (Form 8586, Part I only) d e Disabled access (Form 8826) (see instructions for limitation) e f Renewable electricity, refined coal, and Indian coal production (Form 8835) 1f g Indian employment (Form 8845) g h Orphan drug (Form 882) h i New markets (Form 8874) i j Small employer pension plan startup costs (Form 8881) (see instructions for limitation) 1j k Employer-provided child care facilities and services (Form 8882) (see instructions for limitation) k l Biodiesel and renewable diesel fuels (attach Form 8864) l m Low sulfur diesel fuel production (Form 8896) m n Distilled spirits (Form 896) n o Nonconventional source fuel (carryforward only) o p Energy efficient home (Form 898) p q Energy efficient appliance (carryforward only) q r Alternative motor vehicle (Form 891) r s Alternative fuel vehicle refueling (Form 8911) s t Reserved t u Mine rescue team training (Form 8923) u v Agricultural chemicals security (carryforward only) v w Employer differential wage payments (Form 8932) w x Carbon dioxide sequestration (Form 8933) x y Qualified plug-in electric drive motor vehicle (Form 8936) y z Qualified plug-in electric vehicle (carryforward only) z aa New hire retention (carryforward only) aa bb General credits from an electing large partnership (Schedule K-1 (Form 165-B)) 1bb zz Other. Enhanced oil recovery (Form 883) and certain other credits... 1zz 2 Add lines 1a through 1zz and enter here and on the applicable line of Part I 2 3 Enter the amount from Form 8844 here and on the applicable line of Part II. 3 4a Investment (Form 3468, Part III) (attach Form 3468) a b Work opportunity (Form 5884) b c Biofuel producer (Form 6478) c d Low-income housing (Form 8586, Part II) d e Renewable electricity, refined coal, and Indian coal production (Form 8835) 4e f Employer social security and Medicare taxes paid on certain employee tips (Form 8846) 4f g Qualified railroad track maintenance (Form 89) g h Small employer health insurance premiums (Form 8941) h i Increasing research activities (Form 6765) i j Reserved j z Other z 5 Add lines 4a through 4z and enter here and on the applicable line of Part II. 5 6 Add lines 2, 3, and 5 and enter here and on the applicable line of Part II.. 6 (b) If claiming the credit from a pass-through entity, enter the EIN (c) Enter the appropriate amount Form 38 (216)

14 Form 38 (216) Page 3 Name(s) shown on return Identifying number LUMINA FOUNDATION FOR EDUCATION, INC Part III General Business Credits or Eligible Small Business Credits (see instructions) Complete a separate Part III for each box checked below (see instructions). A General Business Credit From a Non-Passive Activity E Reserved B General Business Credit From a Passive Activity F Reserved C General Business Credit Carryforwards G Eligible Small Business Credit Carryforwards D General Business Credit Carrybacks H Reserved I If you are filing more than one Part III with box A or B checked, complete and attach first an additional Part III combining amounts from all Parts III with box A or B checked. Check here if this is the consolidated Part III (a) Description of credit Note: On any line where the credit is from more than one source, a separate Part III is needed for each pass-through entity. 1a Investment (Form 3468, Part II only) (attach Form 3468) a b Reserved b c Increasing research activities (Form 6765) c d Low-income housing (Form 8586, Part I only) d e Disabled access (Form 8826) (see instructions for limitation) e f Renewable electricity, refined coal, and Indian coal production (Form 8835) 1f g Indian employment (Form 8845) g h Orphan drug (Form 882) h i New markets (Form 8874) i j Small employer pension plan startup costs (Form 8881) (see instructions for limitation) 1j k Employer-provided child care facilities and services (Form 8882) (see instructions for limitation) k l Biodiesel and renewable diesel fuels (attach Form 8864) l m Low sulfur diesel fuel production (Form 8896) m n Distilled spirits (Form 896) n o Nonconventional source fuel (carryforward only) o p Energy efficient home (Form 898) p q Energy efficient appliance (carryforward only) q r Alternative motor vehicle (Form 891) r s Alternative fuel vehicle refueling (Form 8911) s t Reserved t u Mine rescue team training (Form 8923) u v Agricultural chemicals security (carryforward only) v w Employer differential wage payments (Form 8932) w x Carbon dioxide sequestration (Form 8933) x y Qualified plug-in electric drive motor vehicle (Form 8936) y z Qualified plug-in electric vehicle (carryforward only) z aa New hire retention (carryforward only) aa bb General credits from an electing large partnership (Schedule K-1 (Form 165-B)) 1bb zz Other. Enhanced oil recovery (Form 883) and certain other credits... 1zz 2 Add lines 1a through 1zz and enter here and on the applicable line of Part I 2 3 Enter the amount from Form 8844 here and on the applicable line of Part II. 3 4a Investment (Form 3468, Part III) (attach Form 3468) a b Work opportunity (Form 5884) b c Biofuel producer (Form 6478) c d Low-income housing (Form 8586, Part II) d e Renewable electricity, refined coal, and Indian coal production (Form 8835) 4e f Employer social security and Medicare taxes paid on certain employee tips (Form 8846) 4f g Qualified railroad track maintenance (Form 89) g h Small employer health insurance premiums (Form 8941) h i Increasing research activities (Form 6765) i j Reserved j z Other z 5 Add lines 4a through 4z and enter here and on the applicable line of Part II. 5 6 Add lines 2, 3, and 5 and enter here and on the applicable line of Part II.. 6 (b) If claiming the credit from a pass-through entity, enter the EIN (c) Enter the appropriate amount Form 38 (216)

15 Form 38 (216) Page 3 Name(s) shown on return Identifying number LUMINA FOUNDATION FOR EDUCATION, INC Part III General Business Credits or Eligible Small Business Credits (see instructions) Complete a separate Part III for each box checked below (see instructions). A General Business Credit From a Non-Passive Activity E Reserved B General Business Credit From a Passive Activity F Reserved C General Business Credit Carryforwards G Eligible Small Business Credit Carryforwards D General Business Credit Carrybacks H Reserved I If you are filing more than one Part III with box A or B checked, complete and attach first an additional Part III combining amounts from all Parts III with box A or B checked. Check here if this is the consolidated Part III (a) Description of credit Note: On any line where the credit is from more than one source, a separate Part III is needed for each pass-through entity. 1a Investment (Form 3468, Part II only) (attach Form 3468) a b Reserved b c Increasing research activities (Form 6765) c d Low-income housing (Form 8586, Part I only) d e Disabled access (Form 8826) (see instructions for limitation) e f Renewable electricity, refined coal, and Indian coal production (Form 8835) 1f g Indian employment (Form 8845) g h Orphan drug (Form 882) h i New markets (Form 8874) i j Small employer pension plan startup costs (Form 8881) (see instructions for limitation) 1j k Employer-provided child care facilities and services (Form 8882) (see instructions for limitation) k l Biodiesel and renewable diesel fuels (attach Form 8864) l m Low sulfur diesel fuel production (Form 8896) m n Distilled spirits (Form 896) n o Nonconventional source fuel (carryforward only) o p Energy efficient home (Form 898) p q Energy efficient appliance (carryforward only) q r Alternative motor vehicle (Form 891) r s Alternative fuel vehicle refueling (Form 8911) s t Reserved t u Mine rescue team training (Form 8923) u v Agricultural chemicals security (carryforward only) v w Employer differential wage payments (Form 8932) w x Carbon dioxide sequestration (Form 8933) x y Qualified plug-in electric drive motor vehicle (Form 8936) y z Qualified plug-in electric vehicle (carryforward only) z aa New hire retention (carryforward only) aa bb General credits from an electing large partnership (Schedule K-1 (Form 165-B)) 1bb zz Other. Enhanced oil recovery (Form 883) and certain other credits... 1zz 2 Add lines 1a through 1zz and enter here and on the applicable line of Part I 2 3 Enter the amount from Form 8844 here and on the applicable line of Part II. 3 4a Investment (Form 3468, Part III) (attach Form 3468) a b Work opportunity (Form 5884) b c Biofuel producer (Form 6478) c d Low-income housing (Form 8586, Part II) d e Renewable electricity, refined coal, and Indian coal production (Form 8835) 4e f Employer social security and Medicare taxes paid on certain employee tips (Form 8846) 4f g Qualified railroad track maintenance (Form 89) g h Small employer health insurance premiums (Form 8941) h i Increasing research activities (Form 6765) i j Reserved j z Other z 5 Add lines 4a through 4z and enter here and on the applicable line of Part II. 5 6 Add lines 2, 3, and 5 and enter here and on the applicable line of Part II.. 6 (b) If claiming the credit from a pass-through entity, enter the EIN (c) Enter the appropriate amount Form 38 (216)

16 Form 38 (216) Page 3 Name(s) shown on return Identifying number LUMINA FOUNDATION FOR EDUCATION, INC Part III General Business Credits or Eligible Small Business Credits (see instructions) Complete a separate Part III for each box checked below (see instructions). A General Business Credit From a Non-Passive Activity E Reserved B General Business Credit From a Passive Activity F Reserved C General Business Credit Carryforwards G Eligible Small Business Credit Carryforwards D General Business Credit Carrybacks H Reserved I If you are filing more than one Part III with box A or B checked, complete and attach first an additional Part III combining amounts from all Parts III with box A or B checked. Check here if this is the consolidated Part III (a) Description of credit Note: On any line where the credit is from more than one source, a separate Part III is needed for each pass-through entity. 1a Investment (Form 3468, Part II only) (attach Form 3468) a b Reserved b c Increasing research activities (Form 6765) c d Low-income housing (Form 8586, Part I only) d e Disabled access (Form 8826) (see instructions for limitation) e f Renewable electricity, refined coal, and Indian coal production (Form 8835) 1f g Indian employment (Form 8845) g h Orphan drug (Form 882) h i New markets (Form 8874) i j Small employer pension plan startup costs (Form 8881) (see instructions for limitation) 1j k Employer-provided child care facilities and services (Form 8882) (see instructions for limitation) k l Biodiesel and renewable diesel fuels (attach Form 8864) l m Low sulfur diesel fuel production (Form 8896) m n Distilled spirits (Form 896) n o Nonconventional source fuel (carryforward only) o p Energy efficient home (Form 898) p q Energy efficient appliance (carryforward only) q r Alternative motor vehicle (Form 891) r s Alternative fuel vehicle refueling (Form 8911) s t Reserved t u Mine rescue team training (Form 8923) u v Agricultural chemicals security (carryforward only) v w Employer differential wage payments (Form 8932) w x Carbon dioxide sequestration (Form 8933) x y Qualified plug-in electric drive motor vehicle (Form 8936) y z Qualified plug-in electric vehicle (carryforward only) z aa New hire retention (carryforward only) aa bb General credits from an electing large partnership (Schedule K-1 (Form 165-B)) 1bb zz Other. Enhanced oil recovery (Form 883) and certain other credits... 1zz 2 Add lines 1a through 1zz and enter here and on the applicable line of Part I 2 3 Enter the amount from Form 8844 here and on the applicable line of Part II. 3 4a Investment (Form 3468, Part III) (attach Form 3468) a b Work opportunity (Form 5884) b c Biofuel producer (Form 6478) c d Low-income housing (Form 8586, Part II) d e Renewable electricity, refined coal, and Indian coal production (Form 8835) 4e f Employer social security and Medicare taxes paid on certain employee tips (Form 8846) 4f g Qualified railroad track maintenance (Form 89) g h Small employer health insurance premiums (Form 8941) h i Increasing research activities (Form 6765) i j Reserved j z Other z 5 Add lines 4a through 4z and enter here and on the applicable line of Part II. 5 6 Add lines 2, 3, and 5 and enter here and on the applicable line of Part II.. 6 (b) If claiming the credit from a pass-through entity, enter the EIN (c) Enter the appropriate amount Form 38 (216)

17 Form 38 (216) Page 3 Name(s) shown on return Identifying number LUMINA FOUNDATION FOR EDUCATION, INC Part III General Business Credits or Eligible Small Business Credits (see instructions) Complete a separate Part III for each box checked below (see instructions). A General Business Credit From a Non-Passive Activity E Reserved B General Business Credit From a Passive Activity F Reserved C General Business Credit Carryforwards G Eligible Small Business Credit Carryforwards D General Business Credit Carrybacks H Reserved I If you are filing more than one Part III with box A or B checked, complete and attach first an additional Part III combining amounts from all Parts III with box A or B checked. Check here if this is the consolidated Part III (a) Description of credit Note: On any line where the credit is from more than one source, a separate Part III is needed for each pass-through entity. 1a Investment (Form 3468, Part II only) (attach Form 3468) a b Reserved b c Increasing research activities (Form 6765) c d Low-income housing (Form 8586, Part I only) d e Disabled access (Form 8826) (see instructions for limitation) e f Renewable electricity, refined coal, and Indian coal production (Form 8835) 1f g Indian employment (Form 8845) g h Orphan drug (Form 882) h i New markets (Form 8874) i j Small employer pension plan startup costs (Form 8881) (see instructions for limitation) 1j k Employer-provided child care facilities and services (Form 8882) (see instructions for limitation) k l Biodiesel and renewable diesel fuels (attach Form 8864) l m Low sulfur diesel fuel production (Form 8896) m n Distilled spirits (Form 896) n o Nonconventional source fuel (carryforward only) o p Energy efficient home (Form 898) p q Energy efficient appliance (carryforward only) q r Alternative motor vehicle (Form 891) r s Alternative fuel vehicle refueling (Form 8911) s t Reserved t u Mine rescue team training (Form 8923) u v Agricultural chemicals security (carryforward only) v w Employer differential wage payments (Form 8932) w x Carbon dioxide sequestration (Form 8933) x y Qualified plug-in electric drive motor vehicle (Form 8936) y z Qualified plug-in electric vehicle (carryforward only) z aa New hire retention (carryforward only) aa bb General credits from an electing large partnership (Schedule K-1 (Form 165-B)) 1bb zz Other. Enhanced oil recovery (Form 883) and certain other credits... 1zz 2 Add lines 1a through 1zz and enter here and on the applicable line of Part I 2 3 Enter the amount from Form 8844 here and on the applicable line of Part II. 3 4a Investment (Form 3468, Part III) (attach Form 3468) a b Work opportunity (Form 5884) b c Biofuel producer (Form 6478) c d Low-income housing (Form 8586, Part II) d e Renewable electricity, refined coal, and Indian coal production (Form 8835) 4e f Employer social security and Medicare taxes paid on certain employee tips (Form 8846) 4f g Qualified railroad track maintenance (Form 89) g h Small employer health insurance premiums (Form 8941) h i Increasing research activities (Form 6765) i j Reserved j z Other z 5 Add lines 4a through 4z and enter here and on the applicable line of Part II. 5 6 Add lines 2, 3, and 5 and enter here and on the applicable line of Part II.. 6 (b) If claiming the credit from a pass-through entity, enter the EIN (c) Enter the appropriate amount Form 38 (216)

18 Form 38 (216) Page 3 Name(s) shown on return Identifying number LUMINA FOUNDATION FOR EDUCATION, INC Part III General Business Credits or Eligible Small Business Credits (see instructions) Complete a separate Part III for each box checked below (see instructions). A General Business Credit From a Non-Passive Activity E Reserved B General Business Credit From a Passive Activity F Reserved C General Business Credit Carryforwards G Eligible Small Business Credit Carryforwards D General Business Credit Carrybacks H Reserved I If you are filing more than one Part III with box A or B checked, complete and attach first an additional Part III combining amounts from all Parts III with box A or B checked. Check here if this is the consolidated Part III (a) Description of credit Note: On any line where the credit is from more than one source, a separate Part III is needed for each pass-through entity. 1a Investment (Form 3468, Part II only) (attach Form 3468) a b Reserved b c Increasing research activities (Form 6765) c d Low-income housing (Form 8586, Part I only) d e Disabled access (Form 8826) (see instructions for limitation) e f Renewable electricity, refined coal, and Indian coal production (Form 8835) 1f g Indian employment (Form 8845) g h Orphan drug (Form 882) h i New markets (Form 8874) i j Small employer pension plan startup costs (Form 8881) (see instructions for limitation) 1j k Employer-provided child care facilities and services (Form 8882) (see instructions for limitation) k l Biodiesel and renewable diesel fuels (attach Form 8864) l m Low sulfur diesel fuel production (Form 8896) m n Distilled spirits (Form 896) n o Nonconventional source fuel (carryforward only) o p Energy efficient home (Form 898) p q Energy efficient appliance (carryforward only) q r Alternative motor vehicle (Form 891) r s Alternative fuel vehicle refueling (Form 8911) s t Reserved t u Mine rescue team training (Form 8923) u v Agricultural chemicals security (carryforward only) v w Employer differential wage payments (Form 8932) w x Carbon dioxide sequestration (Form 8933) x y Qualified plug-in electric drive motor vehicle (Form 8936) y z Qualified plug-in electric vehicle (carryforward only) z aa New hire retention (carryforward only) aa bb General credits from an electing large partnership (Schedule K-1 (Form 165-B)) 1bb zz Other. Enhanced oil recovery (Form 883) and certain other credits... 1zz 2 Add lines 1a through 1zz and enter here and on the applicable line of Part I 2 3 Enter the amount from Form 8844 here and on the applicable line of Part II. 3 4a Investment (Form 3468, Part III) (attach Form 3468) a b Work opportunity (Form 5884) b c Biofuel producer (Form 6478) c d Low-income housing (Form 8586, Part II) d e Renewable electricity, refined coal, and Indian coal production (Form 8835) 4e f Employer social security and Medicare taxes paid on certain employee tips (Form 8846) 4f g Qualified railroad track maintenance (Form 89) g h Small employer health insurance premiums (Form 8941) h i Increasing research activities (Form 6765) i j Reserved j z Other z 5 Add lines 4a through 4z and enter here and on the applicable line of Part II. 5 6 Add lines 2, 3, and 5 and enter here and on the applicable line of Part II.. 6 (b) If claiming the credit from a pass-through entity, enter the EIN (c) Enter the appropriate amount Form 38 (216)

19 SCHEDULE D (Form 112) Department of the Treasury Internal Revenue Service Name Capital Gains and Losses OMB No 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. Information about Schedule D (Form 112) and its separate instructions is at 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 (d) Proceeds (sales price) (e) 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 (e) from column (d) and combine the result with column (g) 91,81 91,81 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 (d) Proceeds (sales price) (e) Cost (or other basis) (g) Adjustments to gain or loss from Form(s) 8949, Part II, line 2, column (g) 11 Enter gain from Form 4797, line 7 or ,81 (h) Gain or (loss) Subtract column (e) from column (d) and combine the result with column (g) 165, , 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) ,529 91,81 17 Net capital gain. Enter excess of net long-term capital gain (line 15) over net short-term capital loss (line 7) , Add lines 16 and 17. Enter here and on Form 112, page 1, line 8, or the proper line on other returns. If the corporation has qualified timber gain, also complete Part IV ,61 Note: If losses exceed gains, see Capital losses in the instructions. For Paperwork Reduction Act Notice, see the Instructions for Form 112. Cat. No. 1146M Schedule D (Form 112) 216

20 Form 222 Department of the Treasury Internal Revenue Service Name Underpayment of Estimated Tax by Corporations Attach to the corporation s tax return. Information about Form 222 and its separate instructions is at 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(b)(2) for completed long-term contracts or section 167(g) for depreciation under the income forecast method.. 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 215 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 (a) (b) (c) (d) 9 Installment due dates. Enter in columns (a) through (d) the 15th day of the 4th (Form 99-PF filers: Use 5th month), 6th, 9th, and 12th months of the corporation s tax year /15/216 6/15/216 9/15/216 12/15/216 1 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 (a) only, enter the amount from line 11 on line 15. See instructions 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 (216)