Return of Private Foundation

Transcription

1 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, and ending Name of foundation A Employer identification number MARY K. CHAPMAN FOUNDATION C/O DONNE W. PITMAN Number and street (or P.O. box number if mail is not delivered to street address) Room/suite B Telephone number ONE WARREN PLACE, 6100 S. YALE AVE OMB No City or town, state, and ZIP code C If exemption application is pending, check here~ G Check all that apply: Initial return Initial return of a former public charity D1. Foreign organizations, check here ~~ Final return Amended return Foreign organizations meeting the 85% test, Address change Name change 2. check here and attach computation ~~~~ H Check type of organization: X Section 501(c)(3) exempt private foundation E If private foundation status was terminated Section 4947(a)(1) nonexempt charitable trust Other taxable private foundation under section 507(b)(1)(A), check here ~ I Fair market value of all assets at end of year J Accounting method: Cash X Accrual F If the foundation is in a 60-month termination (from Part II, col. (c), line 16) Other (specify) under section 507(b)(1)(B), check here ~ $ 164,294,318. (Part I, column (d) must be on cash basis.) Part I Analysis of Revenue and Expenses (a) Revenue and (b) Net investment (c) Adjusted net (d) Disbursements (The total of amounts in columns (b), (c), and (d) may not for charitable purposes necessarily equal the amounts in column (a).) expenses per books income income (cash basis only) 1 Contributions, gifts, grants, etc., received ~~~ N/A 2 Check X if the foundation is not required to attach Sch. B Interest on savings and temporary 3 cash investments ~~~~~~~~~~~~~~ 4 Dividends and interest from securities~~~~~ 3,806,978. 3,806,978. STATEMENT 1 Revenue Operating and Administrative Expenses 5a Gross rents ~~~~~~~~~~~~~~~~ b Net rental income or (loss) 6a Net gain or (loss) from sale of assets not on line 10 ~~ Gross sales price for all b assets on line 6a ~~ 13,191, Capital gain net income (from Part IV, line 2) ~~~~~ 8 Net short-term capital gain ~~~~~~~~~ 9 Income modifications~~~~~~~~~~~~ Gross sales less returns 10a and allowances ~~~~ 11 b Less: Cost of goods sold ~ c Gross profit or (loss) ~~~~~~~~~~~~ 12 Total. Add lines 1 through Compensation of officers, directors, trustees, etc. ~~~ 15 Pension plans, employee benefits ~~~~~~ 16a Legal fees~~~~~~~~~~~~~~~~~ STMT 3 b Accounting fees ~~~~~~~~~~~~~~ STMT 4 c Other professional fees ~~~~~~~~~~~ STMT PF TULSA, OK Other income ~~~~~~~~~~~~~~~ Other employee salaries and wages~~~~~~ Interest ~~~~~~~~~~~~~~~~~~ Taxes~~~~~~~~~~~~~~~~~~~ STMT 6 Depreciation and depletion ~~~~~~~~~ Occupancy ~~~~~~~~~~~~~~~~ Travel, conferences, and meetings ~~~~~~ Printing and publications ~~~~~~~~~~ Other expenses ~~~~~~~~~~~~~~ STMT 7 Total operating and administrative expenses. Add lines 13 through 23 ~~~~~ Contributions, gifts, grants paid ~~~~~~~ Total expenses and disbursements. Add lines 24 and 25 Subtract line 26 from line 12: a Excess of revenue over expenses and disbursements ~ b Net investment income (if negative, enter -0-) ~~~ c Adjusted net income (if negative, enter -0-) LHA For Paperwork Reduction Act Notice, see instructions. Return of Private Foundation or Section 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation 950, , , STATEMENT 2 4,747,923. 4,757, , , , , , ,351. 2,568. 1, , ,688. 2, , , , , , ,356. 6,371. 2,985. 8,998. 8, , , , ,389. 3, , , , ,613. 1,109, , ,262. 6,662,778. 6,662,778. 7,772, ,357. 6,989, ,024,474. 4,022,100. N/A Form 990-PF (2011)

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6 MARY K. CHAPMAN FOUNDATION Form 990-PF (2011) C/O DONNE W. PITMAN Part VII-B Statements Regarding Activities for Which Form 4720 May Be Required (continued) 5a During the year did the foundation pay or incur any amount to: (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ~~~~~~~~~~~~~ (2) Influence the outcome of any specific public election (see section 4955); or to carry on, directly or indirectly, any voter registration drive? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ (3) Provide a grant to an individual for travel, study, or other similar purposes? ~~~~~~~~~~~~~~~~~ (4) Provide a grant to an organization other than a charitable, etc., organization described in section 509(a)(1), (2), or (3), or section 4940(d)(2)? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ (5) Provide for any purpose other than religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ b If any answer is "Yes" to 5a(1)-(5), did any of the transactions fail to qualify under the exceptions described in Regulations section or in a current notice regarding disaster assistance (see instructions)? ~~~~~~~~~~~~~~~~~~~~~~~~ N/A Organizations relying on a current notice regarding disaster assistance check here ~~~~~~~~~~~~~~~~~~~~~ c If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the tax because it maintained expenditure responsibility for the grant?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ N/A If "Yes," attach the statement required by Regulations section (d). 6a Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes X No b Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ~~~~~~~~~~~~~~~~ 6b X If "Yes" to 6b, file Form a At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction? ~~~~~~~~~ Yes X No b If "Yes," did the foundation receive any proceeds or have any net income attributable to the transaction? N/A 7b Part VIII Information About 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 (b) Title, and average (c) Compensation (d) Contributions to (e) Expense hours per week devoted employee benefit plans (If not paid, and deferred account, other to position enter -0-) compensation allowances J. JERRY DICKMAN MANAGER & CO-TRUSTEE 6100 S. YALE AVE., SUITE 1816 TULSA, OK , DONNE PITMAN MANAGER & CO-TRUSTEE 6100 S. YALE AVE., SUITE 1816 TULSA, OK , Yes Yes Yes Yes Yes Yes X X X X X No No No No No No 5b Page 6 2 Compensation of five highest-paid employees (other than those included on line 1). If none, enter "NONE." (a) Name and address of each employee paid more than $50,000 (b) Title, and average hours per week devoted to position (c) Compensation NONE (d) Contributions to employee benefit plans and deferred compensation (e) Expense account, other allowances Total number of other employees paid over $50,000 0 Form 990-PF (2011)

7 MARY K. CHAPMAN FOUNDATION Form 990-PF (2011) C/O DONNE W. PITMAN Part VIII Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees, and Contractors (continued) 3 Five highest-paid independent contractors for professional services. If none, enter "NONE." (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation NONE Page 7 Total number of others receiving over $50,000 for professional services Part IX-A Summary of Direct Charitable Activities List the foundation's four largest direct charitable activities during the tax year. Include relevant statistical information such as the Expenses number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. 1 N/A - THE MARY K. CHAPMAN FOUNDATION IS A NON-OPERATING PRIVATE FOUNDATION WHICH MAKES GIFTS TO CHARITABLE ORGANIZATIONS. THE FOUNDATION DOES NOT OPERATE 0. 2 ANY FACILITY OR INSTITUTION UNDERTAKING A CHARITABLE, EDUCATIONAL OR RELIGIOUS ENDEAVOR Part IX-B Summary of Program-Related Investments Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. 1 N/A Amount 2 3 All other program-related investments. See instructions. Total. Add lines 1 through 3 J 0. Form 990-PF (2011)

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