Exempt Organization Business Income Tax Return

Transcription

1 Form OMB No For alendar year 2016 or other tax year eginning, and ending. Information aout Form 0-T and its instrutions is availale at Department of the Treasury Open to Puli Inspetion for Internal Revenue Servie Do not enter SSN numers on this form as it may e made puli if your organization is a 501(). 501() Organizations Only Employer identifiation numer A Chek ox if Name of organization ( Chek ox if name hanged and see instrutions.) D (Employees' trust, see address hanged instrutions.) B Exempt under setion Print THE WINTHROP ROCKEFELLER FOUNDATION or E Unrelated usiness ativity odes 501( )( ) Numer, street, and room or suite no. If a P.O. ox, see instrutions. (See instrutions.) Type 408(e) 220(e) 225 EAST MARKHAM STREET, NO A 530(a) City or town, state or provine, ountry, and ZIP or foreign postal ode 52(a) LITTLE ROCK, AR Book value of all assets C at end of year F Group exemption numer (See instrutions.) 12,731,558. G Chek organization type X 501() orporation 501() trust 401(a) trust Other trust H Desrie the organization's primary unrelated usiness ativity. INVESTMENTS I During the tax year, was the orporation a susidiary in an affiliated group or a parent-susidiary ontrolled group? ~~~~~~ Yes X No If "Yes," enter the name and identifying numer of the parent orporation. J The ooks are in are of ANDREA M. DOBSON Telephone numer (501) Part I Unrelated Trade or Business Inome (A) Inome (B) Expenses (C) Net 1 a Gross reeipts or sales Less returns and allowanes Balane ~~~ 12 Other inome (See instrutions; attah shedule) ~~~~~~~~~~~~ Total. Comine lines 3 through ,552. 1,552. Part II Dedutions Not Taken Elsewhere (See instrutions for limitations on dedutions.) (Exept for ontriutions, dedutions must e diretly onneted with the unrelated usiness inome.) T Cost of goods sold (Shedule A, line 7) ~~~~~~~~~~~~~~~~~ Gross profit. Sutrat line 2 from line 1 ~~~~~~~~~~~~~~~~ 4 a Capital gain net inome (attah Shedule D) ~~~~~~~~~~~~~~~ Net gain (loss) (Form 477, Part II, line 17) (attah Form 477) ~~~~~~ Capital loss dedution for trusts ~~~~~~~~~~~~~~~~~~~~ Inome (loss) from partnerships and S orporations (attah statement) ~~~ Rent inome (Shedule C) ~~~~~~~~~~~~~~~~~~~~~~ Unrelated det-finaned inome (Shedule E) ~~~~~~~~~~~~~~ Interest, annuities, royalties, and rents from ontrolled organizations (Sh. F)~ Investment inome of a setion 501()(7), (), or (17) organization (Shedule G) Exploited exempt ativity inome (Shedule I) ~~~~~~~~~~~~~~ Advertising inome (Shedule J) ~~~~~~~~~~~~~~~~~~~~ Compensation of offiers, diretors, and trustees (Shedule K) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Salaries and wages ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Repairs and maintenane Bad dets ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Interest ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Taxes and lienses ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Charitale ontriutions (See instrutions for limitation rules) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Depreiation (attah Form 4562) Less depreiation laimed on Shedule A and elsewhere on return Depletion Contriutions to deferred ompensation plans Exempt Organization Business Inome Tax Return (and proxy tax under setion 6033(e)) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Total dedutions. Add lines 14 through 28 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ a ~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Employee enefit programs ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Exess exempt expenses (Shedule I) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Exess readership osts (Shedule J) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other dedutions ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Unrelated usiness taxale inome efore net operating loss dedution. Sutrat line 2 from line 13 ~~~~~~~~~~~~ Net operating loss dedution (limited to the amount on line 30) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ SEE STATEMENT 17 Unrelated usiness taxale inome efore speifi dedution. Sutrat line 31 from line 30 ~~~~~~~~~~~~~~~~~ Speifi dedution (Generally $1,000, ut see line 33 instrutions for exeptions) ~~~~~~~~~~~~~~~~~~~~~ 21 22a ,552. STMT 16 1,552. 1,552. 1,552. 1,00 34 Unrelated usiness taxale inome. Sutrat line 33 from line 32. If line 33 is greater than line 32, enter the smaller of zero or line LHA For Paperwork Redution At Notie, see instrutions. Form 0-T (2016) THE WINTHROP ROCKEFELLER FO

2 Form 0-T (2016) THE WINTHROP ROCKEFELLER FOUNDATION Part III Tax Computation 35 Organizations Taxale as Corporations. See instrutions for tax omputation. Controlled group memers (setions 1561 and 1563) hek here See instrutions and: a Enter your share of the $50,000, $25,000, and $,25,000 taxale inome rakets (in that order): $ $ $ Enter organization's share of: Additional 5 tax (not more than $11,750) $ Additional 3 tax (not more than $100,000) ~~~~~~~~~~~~~ $ Trusts Taxale at Trust Rates. See instrutions for tax omputation. Inome tax on the amount on line 34 from: Tax rate shedule or Shedule D (Form 1041) ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Proxy tax. See instrutions ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Tax on Non-Compliant Faility Inome. See instrutions ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 40 Total. Add lines 37, 38 and 3 to line 35 or 36, whihever applies Part IV Tax and Payments 41a Foreign tax redit (orporations attah Form 1118; trusts attah Form 1116) ~~~~~~~~ 41a d e Total redits. Add lines 41a through 41d ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Sutrat line 41e from line 40 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other taxes. Chek if from: Form 4255 Form 8611 Form 867 Form 8866 Other Total tax. Add lines 42 and 43 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 45 a Payments: A 2015 overpayment redited to 2016 ~~~~~~~~~~~~~~~~~~~ 2016 estimated tax payments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Tax deposited with Form 8868 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ d Foreign organizations: Tax paid or withheld at soure (see instrutions) ~~~~~~~~~~ f Credit for small employer health insurane premiums (Attah Form 841) ~~~~~~~~ 45f g Other redits and payments: Form 243 Form 4136 Other Total 45g 46 Total payments. Add lines 45a through 45g ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Estimated tax penalty (see instrutions). Chek if Form 2220 is attahed ~~~~~~~~~~~~~~~~~~~ Tax due. If line 46 is less than the total of lines 44 and 47, enter amount owed ~~~~~~~~~~~~~~~~~~~ 48 4 Overpayment. If line 46 is larger than the total of lines 44 and 47, enter amount overpaid ~~~~~~~~~~~~~~ 50 Enter the amount of line 4 you want: Credited to 2017 estimated tax Refunded Part V Statements Regarding Certain Ativities and Other Information (see instrutions) 51 At any time during the 2016 alendar year, did the organization have an interest in or a signature or other authority Yes No Sign Here Inome tax on the amount on line 34 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Alternative minimum tax Other redits (see instrutions) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~ General usiness redit. Attah Form 3800 ~~~~~~~~~~~~~~~~~~~~~~ Credit for prior year minimum tax (attah Form 8801 or 8827) ~~~~~~~~~~~~~~ e Bakup withholding (see instrutions) ~~~~~~~~~~~~~~~~~~~~~~~~ over a finanial aount (ank, seurities, or other) in a foreign ountry? If YES, the organization may have to file FinCEN Form 114, Report of Foreign Bank and Finanial Aounts. If YES, enter the name of the foreign ountry here Paid Preparer Use Only During the tax year, did the organization reeive a distriution from, or was it the grantor of, or transferor to, a foreign trust? ~~~~~~~~~ If YES, see instrutions for other forms the organization may have to file. Enter the amount of tax-exempt interest reeived or arued during the tax year $ Under penalties of perjury, I delare that I have examined this return, inluding aompanying shedules and statements, and to the est of my knowledge and elief, it is true, orret, and omplete. Delaration of preparer (other than taxpayer) is ased on all information of whih preparer has any knowledge d 45a d 45e e Page 2 Signature of offier Date COFO Title May the IRS disuss this return with the preparer shown elow (see instrutions)? X Yes No Print/Type preparer's name Preparer's signature Date Chek if PTIN self- employed MICHELLE MANN 0/12/17 P Firm's name JPMS COX, PLLC Firm's EIN CANTRELL ROAD, SUITE 301 Firm's address LITTLE ROCK, AR Phone no Form 0-T (2016) = = X X THE WINTHROP ROCKEFELLER FO

3 Form 0-T (2016) THE WINTHROP ROCKEFELLER FOUNDATION Page 3 Shedule A - Cost of Goods Sold. Enter method of inventory valuation N/A 1 Inventory at eginning of year ~~~ 1 6 Inventory at end of year ~~~~~~~~~~~~ 6 2 Purhases ~~~~~~~~~~~ 2 7 Cost of goods sold. Sutrat line 6 3 Cost of laor~~~~~~~~~~~ 3 from line 5. Enter here and in Part I, 4 a Additional setion 263A osts line 2 ~~~~~~~~~~~~~~~~~~~~ 7 ~~~~~~~~ 4a 8 Do the rules of setion 263A (with respet to Other osts ~~~ 4 property produed or aquired for resale) apply to 5 Total. Add lines 1 through 4 5 the organization? Shedule C - Rent Inome (From Real Property and Personal Property Leased With Real Property) (see instrutions) 1. Desription of property Yes No (a) 2. From personal property (if the perentage of rent for personal property is more than 10 ut not more than 50 ) Rent reeived or arued () From real and personal property (if the perentage of rent for personal property exeeds 50 or if the rent is ased on profit or inome) 3(a) Dedutions diretly onneted with the inome in olumns 2(a) and 2() Total Total () Total inome. Add totals of olumns 2(a) and 2(). Enter () Total dedutions. here and on line 6, olumn (A) Part I, line 6, olumn (B) Shedule E - Unrelated Det-Finaned Inome (see instrutions) 3. Dedutions diretly onneted with or alloale 2. Gross inome from to det-finaned property 1. Desription of det-finaned property or alloale to detfinaned property (a) Straight line depreiation () Other dedutions 4. Amount of average aquisition 5. Average adjusted asis 6. Column 4 divided 7. Gross inome 8. Alloale dedutions det on or alloale to det-finaned of or alloale to y olumn 5 reportale (olumn (olumn 6 x total of olumns property det-finaned property 2 x olumn 6) 3(a) and 3()) Part I, line 7, olumn (A). Part I, line 7, olumn (B). Totals ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Total dividends-reeived dedutions inluded in olumn 8 Form 0-T (2016) THE WINTHROP ROCKEFELLER FO

4 Form 0-T (2016) THE WINTHROP ROCKEFELLER FOUNDATION Shedule F - Interest, Annuities, Royalties, and Rents From Controlled Organizations (see instrutions) Exempt Controlled Organizations 1. Name of ontrolled organization 2. Employer 3. Net unrelated inome 4. Total of speified 5. Part of olumn 4 that is 6. Dedutions diretly identifiation (loss) (see instrutions) payments made inluded in the ontrolling onneted with inome numer organization's gross inome in olumn 5 Page 4 Nonexempt Controlled Organizations 7. Taxale Inome 8. Net unrelated inome (loss). Total of speified payments 1 Part of olumn that is inluded 11. Dedutions diretly onneted (see instrutions) made in the ontrolling organization's with inome in olumn 10 gross inome Totals J Shedule G - Investment Inome of a Setion 501()(7), (), or (17) Organization (see instrutions) 1. Desription of exploited ativity 1. Desription of inome 2. Amount of inome 2. Gross unrelated usiness inome from trade or usiness line 10, ol. (A). 3. Expenses diretly onneted with prodution of unrelated usiness inome line 10, ol. (B). Part I, line, olumn (A). 4. Net inome (loss) from unrelated trade or usiness (olumn 2 minus olumn 3). If a gain, ompute ols. 5 through 7. Add olumns 5 and 1 Part I, line 8, olumn (A). Add olumns 6 and 11. Part I, line 8, olumn (B). 3. Dedutions Total dedutions diretly onneted 4. Set-asides 5. and set-asides (ol. 3 plus ol. 4) 5. Gross inome 6. Expenses from ativity that attriutale to is not unrelated olumn 5 usiness inome Part I, line, olumn (B). Totals Shedule I - Exploited Exempt Ativity Inome, Other Than Advertising Inome (see instrutions) 7. Exess exempt expenses (olumn 6 minus olumn 5, ut not more than olumn 4). Enter here and on page 1, Part II, line 26. Totals Shedule J - Advertising Inome (see instrutions) Part I Inome From Periodials Reported on a Consolidated Basis 1. Name of periodial 2. Gross 3. Diret advertising advertising osts inome 4. Advertising gain or (loss) (ol. 2 minus ol. 3). If a gain, ompute ols. 5 through Cirulation 6. Readership inome osts 7. Exess readership osts (olumn 6 minus olumn 5, ut not more than olumn 4). Totals (arry to Part II, line (5)) Form 0-T (2016) THE WINTHROP ROCKEFELLER FO

5 Form 0-T (2016) THE WINTHROP ROCKEFELLER FOUNDATION Part II Inome From Periodials Reported on a Separate Basis (For eah periodial listed in Part II, fill in olumns 2 through 7 on a line-y-line asis.) Totals from Part I 1. Name of periodial 2. Gross 3. Diret advertising advertising osts inome line 11, ol. (A). line 11, ol. (B). 4. Advertising gain or (loss) (ol. 2 minus ol. 3). If a gain, ompute ols. 5 through Cirulation 6. Readership inome osts 7. Exess readership osts (olumn 6 minus olumn 5, ut not more than olumn 4). Enter here and on page 1, Part II, line 27. Totals, Part II (lines 1-5) Shedule K - Compensation of Offiers, Diretors, and Trustees (see instrutions) 3. Perent of 4. Compensation attriutale Title time devoted to 1. Name 2. to unrelated usiness usiness Total. Part II, line 14 Page 5 Form 0-T (2016) THE WINTHROP ROCKEFELLER FO

6 THE WINTHROP ROCKEFELLER FOUNDATION }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-T INCOME (LOSS) FROM PARTNERSHIPS STATEMENT 16 AND S CORPORATIONS }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} DESCRIPTION AMOUNT }}}}}}}}}}} }}}}}}}}}}}}}} CONE MIDSTREAM PARTNERS 1,552. }}}}}}}}}}}}}} TOTAL TO FORM 0-T, PAGE 1, LINE 5 1,552. ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-T NET OPERATING LOSS DEDUCTION STATEMENT 17 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} LOSS PREVIOUSLY LOSS AVAILABLE TAX YEAR LOSS SUSTAINED APPLIED REMAINING THIS YEAR }}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}} 12/31/11 7,476. 7,476. 7, /31/12 3,722. 3,722. }}}}}}}}}}}}}} 3,722. }}}}}}}}}}}}}} NOL CARRYOVER AVAILABLE THIS YEAR 47,18. 47,18. ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~ 41 STATEMENT(S) 16, THE WINTHROP ROCKEFELLER FO

7 Form (Rev. January 2017) Department of the Treasury Internal Revenue Servie Type or print File y the due date for filing your return. See instrutions. Appliation Is For 2 3a File a separate appliation for eah return. Information aout Form 8868 and its instrutions is at Eletroni filing (e-file). You an eletronially file Form 8868 to request a 6-month automati extension of time to file any of the forms listed elow with the exeption of Form 8870, Information Return for Transfers Assoiated With Certain Personal Benefit Contrats, for whih an extension request must e sent to the IRS in paper format (see instrutions). For more details on the eletroni filing of this form, visit lik on Charities & Non-Profits, and lik on e-file for Charities and Non-Profits. All orporations required to file an inome tax return other than Form 0-T (inluding 1120-C filers), partnerships, REMICs, and trusts must use Form 7004 to request an extension of time to file inome tax returns. Name of exempt organization or other filer, see instrutions. Numer, street, and room or suite no. If a P.O. ox, see instrutions. 225 EAST MARKHAM STREET, NO. 200 City, town or post offie, state, and ZIP ode. For a foreign address, see instrutions. LITTLE ROCK, AR Return Code Appliation Is For Balane due. Sutrat line 3 from line 3a. Inlude your payment with this form, if required, Enter filer's identifying numer Caution: If you are going to make an eletroni funds withdrawal (diret deit) with this Form 8868, see Form 8453-EO and Form 887-EO for payment instrutions. LHA For Privay At and Paperwork Redution At Notie, see instrutions. Form 8868 (Rev ) 3a 3 3 $ $ $ OMB No Employer identifiation numer (EIN) or Soial seurity numer (SSN) Enter the Return Code for the return that this appliation is for (file a separate appliation for eah return) Form 0 or Form 0-EZ Form 0-BL Form 4720 (individual) Form 0-PF 8868 Appliation for Automati Extension of Time To File an Exempt Organization Return Automati 6-Month Extension of Time. Only sumit original (no opies needed). THE WINTHROP ROCKEFELLER FOUNDATION Form 0-T (se. 401(a) or 408(a) trust) Form 0-T (trust other than aove) 06 Form ANDREA M. DOBSON The ooks are in the are of 225 EAST MARKHAM STREET, STE LITTLE ROCK, AR Telephone No. (501) Fax No. If the organization does not have an offie or plae of usiness in the United States, hek this ox~~~~~~~~~~~~~~~~~ If this is for a Group Return, enter the organization's four digit Group Exemption Numer (GEN). If this is for the whole group, hek this ox. If it is for part of the group, hek this ox and attah a list with the names and EINs of all memers the extension is for. 1 I request an automati 6-month extension of time until NOVEMBER 15, 2017, to file the exempt organization return Return Code Form 0-T (orporation) 07 Form 1041-A Form 4720 (other than individual) Form 5227 Form 606 for the organization named aove. The extension is for the organization's return for: X alendar year 2016 or tax year eginning, and ending. If the tax year entered in line 1 is for less than 12 months, hek reason: Initial return Final return Change in aounting period If this appliation is for Forms 0-BL, 0-PF, 0-T, 4720, or 606, enter the tentative tax, less any nonrefundale redits. See instrutions. If this appliation is for Forms 0-PF, 0-T, 4720, or 606, enter any refundale redits and estimated tax payments made. Inlude any prior year overpayment allowed as a redit. y using EFTPS (Eletroni Federal Tax Payment System). See instrutions , THE WINTHROP ROCKEFELLER FO