2007 Form 990PF - Quixote Foundation

Transcription

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GOVERNMENT COPY
Form
Return of Private Foundation
990-PF
Department of the Treasury
Internal Revenue Service (77)
or Section 4947(a)(1) Nonexempt Charitable Trust
Treated as a Private Foundation
Note: The foundation may be able to use a copy of this return to satisfy state reporting requirements.
For calendar year 2007, or tax year beginning
G Check all that apply:
! Initial return
Name
of
foundation
Use the IRS
!
Final return
!
Amended return
X
!
expenses per books
Operating and Administrative Expenses
Revenue
necessarily equal the amounts in column (a).)
25
26
27
a
b
c
Contributions, gifts, grants, etc., received ~~~
X if the foundation is not required to attach Sch. B
Check |!
Interest on savings and temporary
cash investments ~~~~~~~~~~~~~~
Dividends and interest from securities~~~~~
Gross rents ~~~~~~~~~~~~~~~~
Net rental income or (loss)
~~
7,655,860.
Capital gain net income (from Part IV, line 2) ~~~~~
10541111 798408 6042.FDN01
B Telephone number
(206) 783-5554
income
C If exemption application is pending, check here ~ |!
D 1. Foreign organizations, check here ~~ |!
2. Foreign organizations meeting the 85% test,
check here and attach computation ~~~~ |!
E If private foundation status was terminated
under section 507(b)(1)(A), check here ~ |!
F If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here!
~ |!
(d) Disbursements
(c) Adjusted net
for charitable purposes
income
(cash basis only)
N/A
214,177.
439,981.
214,177.
439,981.
STATEMENT 1
STATEMENT 2
883,033.
883,033.
Net short-term capital gain ~~~~~~~~~
Income modifications~~~~~~~~~~~~
Gross sales less returns
and allowances ~~~~
Less: Cost of goods sold ~
Gross profit or (loss) ~~~~~~~~~~~~
35,207.
35,207.
Other income ~~~~~~~~~~~~~~~
1,572,398.
1,572,398.
Total. Add lines 1 through 11 !!!!!!!!
123,000.
24,600.
Compensation of officers, directors, trustees, etc. ~~~
88,812.
17,762.
Other employee salaries and wages~~~~~~
18,355.
3,671.
Pension plans, employee benefits ~~~~~~
STMT
4
35,234.
0.
Legal fees ~~~~~~~~~~~~~~~~~
STMT
5
20,460.
10,230.
Accounting fees ~~~~~~~~~~~~~~
STMT 6
409,774.
118,283.
Other professional fees ~~~~~~~~~~~
494.
494.
Interest ~~~~~~~~~~~~~~~~~~
STMT
7
32,195.
9,287.
Taxes~~~~~~~~~~~~~~~~~~~
11,600.
0.
Depreciation and depletion ~~~~~~~~~
23,230.
4,646.
Occupancy ~~~~~~~~~~~~~~~~
123,780.
24,756.
Travel, conferences, and meetings ~~~~~~
Printing and publications ~~~~~~~~~~
STMT 8
81,526.
16,305.
Other expenses ~~~~~~~~~~~~~~
Total operating and administrative
968,460.
230,034.
expenses. Add lines 13 through 23 ~~~~~
1,107,310.
Contributions, gifts, grants paid ~~~~~~~
Total expenses and disbursements.
2,075,770.
230,034.
Add lines 24 and 25 !!!!!!!!!!!!
Subtract line 26 from line 12:
-503,372.
Excess of revenue over expenses and disbursements ~
1,342,364.
(if
negative,
enter
-0-)
Net investment income
~~~
Adjusted net income (if negative, enter -0-)!!!!
LHA For Privacy Act and Paperwork Reduction Act Notice, see the instructions.
723501
02-20-08
Address change
! Name change
A Employer identification number
39-1916960
Room/suite
SEATTLE, WA 98107
X Section 501(c)(3) exempt private foundation
H Check type of organization: !
! Section 4947(a)(1) nonexempt charitable trust ! Other taxable private foundation
X Cash ! Accrual
I Fair market value of all assets at end of year J Accounting method: !
(from Part II, col. (c), line 16)
! Other (specify)
22,832,568. (Part I, column (d) must be on cash basis.)
|$
Analysis of Revenue and Expenses
Part I (The
(a) Revenue and
(b) Net investment
total of amounts in columns (b), (c), and (d) may not
Net gain or (loss) from sale of assets not on line 10
Gross sales price for all
assets on line 6a ~~
2007
, and ending
label. QUIXOTE FOUNDATION, INC.
Otherwise, C/O ERIK M. HANISCH, PRESIDENT
Number and street (or P.O. box number if mail is not delivered to street address)
print
or type. 5405 LEARY AVE NW, SUITE 2
See Specific
City or town, state, and ZIP code
Instructions.
1
2
3
4
5a
b
6a
b
7
8
9
10a
b
c
11
12
13
14
15
16a
b
c
17
18
19
20
21
22
23
24
OMB No. 1545-0052
STATEMENT 3
98,400.
71,050.
14,684.
35,234.
10,230.
291,491.
0.
14,908.
18,584.
99,024.
65,221.
718,826.
1,107,310.
1,826,136.
N/A
Form 990-PF (2007)
1
2007.06030 QUIXOTE FOUNDATION, INC. C/ 6042_FD1
Form 990-PF (2007)
Part II
QUIXOTE FOUNDATION, INC.
C/O ERIK M. HANISCH, PRESIDENT
Balance Sheets
1 Cash - non-interest-bearing~~~~~~~~~~~~~~~~~~~
2 Savings and temporary cash investments ~~~~~~~~~~~~
3 Accounts receivable
Less: allowance for doubtful accounts
4 Pledges receivable
5 Grants receivable ~~~~~~~~~~~~~~~~~~~~~~~
6 Receivables due from officers, directors, trustees, and other
disqualified persons ~~~~~~~~~~~~~~~~~~~~~~
7 Other notes and loans receivable ~~~~~~~~
8 Inventories for sale or use ~~~~~~~~~~~~~~~~~~~
9 Prepaid expenses and deferred charges ~~~~~~~~~~~~~
10a Investments - U.S. and state government obligations ~~~~~~~
b Investments - corporate stock ~~~~~~~~~~~~~~~~~
c Investments - corporate bonds ~~~~~~~~~~~~~~~~~
11 Investments - land, buildings, and equipment: basis ~~
Less: accumulated depreciation ~~~~~~~~
12 Investments - mortgage loans ~~~~~~~~~~~~~~~~~
STMT 9
13 Investments - other ~~~~~~~~~~~~~~~~~~~~~~
266,184.
14 Land, buildings, and equipment: basis
STMT 10
36,075.
Less: accumulated depreciation ~~~~~~~~
15 Other assets (describe
)
9
9
Assets
Attached schedules and amounts in the description
column should be for end-of-year amounts only.
39-1916960
Beginning of year
(a) Book Value
(b) Book Value
Page 2
End of year
(c) Fair Market Value
131,284.
566,326.
566,326.
5,217.
1,178.
1,178.
21,582,649.
20,573,097.
22,034,955.
13,944.
230,109.
230,109.
21,733,094.
21,370,710.
22,832,568.
9
9
9
9
9
9
9
9
Liabilities
9
16
17
18
19
20
21
22
Total assets (to be completed by all filers) !!!!!!!!!!!!
Accounts payable and accrued expenses ~~~~~~~~~~~~~
Grants payable ~~~~~~~~~~~~~~~~~~~~~~~~
Deferred revenue ~~~~~~~~~~~~~~~~~~~~~~~
Loans from officers, directors, trustees, and other disqualified persons ~~~~
Mortgages and other notes payable ~~~~~~~~~~~~~~~
Other liabilities (describe
)
9
23 Total liabilities (add lines 17 through 22) !!!!!!!!!!!!
Foundations that follow SFAS 117, check here
!
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted ~~~~~~~~~~~~~~~~~~~~~~~~~
25 Temporarily restricted ~~~~~~~~~~~~~~~~~~~~~
26 Permanently restricted ~~~~~~~~~~~~~~~~~~~~~
X
Foundations that do not follow SFAS 117, check here
!
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds~~~~~~~~~~~
28 Paid-in or capital surplus, or land, bldg., and equipment fund ~~~~
29 Retained earnings, accumulated income, endowment, or other funds~
30 Total net assets or fund balances~~~~~~~~~~~~~~~~
0.
0.
0.
0.
21,733,094.
21,733,094.
0.
0.
21,370,710.
21,370,710.
31 Total liabilities and net assets/fund balances !!!!!!!!!!
21,733,094.
21,370,710.
Net Assets or Fund Balances
9
9
Part III
Analysis of Changes in Net Assets or Fund Balances
1 Total net assets or fund balances at beginning of year - Part II, column (a), line 30
(must agree with end-of-year figure reported on prior year's return) ~~~~~~~~~~~~~~~~~~~~~~~~~~~
2 Enter amount from Part I, line 27a ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
ADJUSTMENT TO BOOK VALUE
3 Other increases not included in line 2 (itemize)
4 Add lines 1, 2, and 3 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5 Decreases not included in line 2 (itemize)
6 Total net assets or fund balances at end of year (line 4 minus line 5) - Part II, column (b), line 30 !!!!!!!!!!!!!!!
9
9
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1
2
3
4
5
6
21,733,094.
-503,372.
140,988.
21,370,710.
0.
21,370,710.
Form 990-PF (2007)
2
Capital Gains and Losses for Tax on Investment Income
39-1916960
Form 990-PF (2007)
Part IV
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)
1a
b
c
d
e
(b) How acquired
P - Purchase
D - Donation
(c) Date acquired
(mo., day, yr.)
Page 3
(d) Date sold
(mo., day, yr.)
SEE ATTACHED STATEMENTS
(e) Gross sales price
a
b
c
d
e
(f) Depreciation allowed
(or allowable)
(g) Cost or other basis
plus expense of sale
7,655,860.
(h) Gain or (loss)
(e) plus (f) minus (g)
6,772,827.
883,033.
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(i) F.M.V. as of 12/31/69
(j) Adjusted basis
as of 12/31/69
(l) Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col. (h))
(k) Excess of col. (i)
over col. (j), if any
a
b
c
d
e
883,033.
2 Capital gain net income or (net capital loss)
i
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
j
~~~~~~~
3 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 !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Part V
883,033.
2
p
m
o
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
3
N/A
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)
If section 4940(d)(2) applies, leave this part blank.
X No
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period? ~~~~~~~~~~~~~~~~! Yes !
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 before making any entries.
(d)
(a)
(b)
(c)
Distribution ratio
Base period years
Adjusted
qualifying
distributions
Net
value
of
noncharitable-use
assets
(col.
(b)
divided
by col. (c))
Calendar year (or tax year beginning in)
2006
2005
2004
2003
2002
1,631,956.
1,170,610.
1,530,708.
1,094,766.
612,278.
23,332,038.
22,853,273.
22,638,688.
14,268,211.
8,298,045.
.069945
.051223
.067615
.076728
.073786
2 Total of line 1, column (d)~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3 Average distribution ratio for the 5-year base period - divide the total on line 2 by 5, or by the number of years
the foundation has been in existence if less than 5 years~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2
.339297
3
.067859
4 Enter the net value of noncharitable-use assets for 2007 from Part X, line 5 ~~~~~~~~~~~~~~~~~~~~~
4
23,635,090.
5 Multiply line 4 by line 3 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5
1,603,854.
6 Enter 1% of net investment income (1% of Part I, line 27b) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6
13,424.
7 Add lines 5 and 6 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7
1,617,278.
8 Enter qualifying distributions from Part XII, line 4~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
8
2,053,901.
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate.
See the Part VI instructions.
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Form 990-PF (2007)
3
39-1916960
Page 4
Part VI Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948 - see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here |! and enter "N/A" on line 1.
Form 990-PF (2007)
p
n
n
n
m
n
n
n
o
Date of ruling letter:
(attach copy of ruling letter if necessary-see instructions)
X and enter 1%
b Domestic foundations that meet the section 4940(e) requirements in Part V, check here |!
1
of Part I, line 27b~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)~~~~~~~~~
2
3 Add lines 1 and 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) ~~~~~~~~
4
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ~~~~~~~~~~~~~~~~~
5
6 Credits/Payments:
21,503.
a 2007 estimated tax payments and 2006 overpayment credited to 2007 ~~~~~~~~
6a
b Exempt foreign organizations - tax withheld at source ~~~~~~~~~~~~~~~~
6b
c Tax paid with application for extension of time to file (Form 8868)~~~~~~~~~~~
6c
d Backup withholding erroneously withheld ~~~~~~~~~~~~~~~~~~~~~
6d
7 Total credits and payments. Add lines 6a through 6d ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7
8 Enter any penalty for underpayment of estimated tax. Check here! 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
8,079. Refunded | 11
11 Enter the amount of line 10 to be: Credited to 2008 estimated tax |
Part VII-A
13,424.
0.
13,424.
0.
13,424.
21,503.
8,079.
0.
Statements Regarding Activities
1a During the tax year, did the foundation attempt to influence any national, state, or local legislation or did it participate or intervene in
any political campaign? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
b Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see instructions for definition)? ~~~~~~
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials published or
distributed by the foundation in connection with the activities.
c Did the foundation file Form 1120-POL for this year?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
d Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
0. (2) On foundation managers. | $
0.
(1) On the foundation. | $
e Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed on foundation
0.
managers. | $
2 Has the foundation engaged in any activities that have not previously been reported to the IRS? ~~~~~~~~~~~~~~~~~~~~
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
bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes ~~~~~~~~~~~~~~~~~~~~~
4a Did the foundation have unrelated business gross income of $1,000 or more during the year? ~~~~~~~~~~~~~~~~~~~~~
N/A
b If "Yes," has it filed a tax return on Form 990-T for this year? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5 Was there a liquidation, termination, dissolution, or substantial contraction during the year? ~~~~~~~~~~~~~~~~~~~~~~
If "Yes," attach the statement required by 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? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7 Did the foundation have at least $5,000 in assets at any time during the year? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes," complete Part II, col. (c), and Part XV.
8a Enter the states to which the foundation reports or with which it is registered (see instructions)
WA,WI
1a
1b
Yes No
X
X
1c
X
2
X
X
X
3
4a
4b
5
6
7
X
X
X
9
b If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney General (or designate)
X
of each state as required by General Instruction G? If "No," attach explanation ~~~~~~~~~~~~~~~~~~~~~~~~~
8b
9 Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3) or 4942(j)(5) for calendar
X
year 2007 or the taxable year beginning in 2007 (see instructions for Part XIV)? If "Yes," complete Part XIV~~~~~~~~~~~~~~
9
X
10 Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names and addresses. !!!!!!!!
10
Form 990-PF (2007)
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4
Part VII-A Statements Regarding Activities (continued)
Form 990-PF (2007)
39-1916960
Page 5
11a At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the meaning of section 512(b)(13)?
X
If "Yes," attach schedule. (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
11a
b If "Yes," did the foundation have a binding written contract in effect on August 17, 2006, covering the interest, rents, royalties, and
N/A
annuities described in the attachment for line 11a? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
11b
X
12 Did the foundation acquire a direct or indirect interest in any applicable insurance contract? ~~~~~~~~~~~~~~~~~~~~~~
12
X
13 Did the foundation comply with the public inspection requirements for its annual returns and exemption application? ~~~~~~~~~~~
13
Website address | WWW.QUIXOTEFOUNDATION.ORG
14 The books are in care of | ERIK M. HANISCH, PRESIDENT
Telephone no. | (206) 783-5554
5405
LEARY
AVE
NW,
SUITE
2,
SEATTLE,
WA
Located at |
ZIP+4 |98107
15 Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 - Check here ~~~~~~~~~~~~~~~~~~~~~~~ |!
N/A
and enter the amount of tax-exempt interest received or accrued during the year !!!!!!!!!!!!!!!!!!! | 15
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.
1a 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? ~~~~~~~~~~~~~~!
(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~!
(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ~~~~~~~~~~~~~!
X
(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ~~~~~~~~~~~~~~!
(5) Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~!
Yes No
X No
Yes !
X No
Yes !
X No
Yes !
Yes ! No
X No
Yes !
(6) Agree to pay money or property to a government official? (Exception. Check "No"
if the foundation agreed to make a grant to or to employ the official for a period after
X No
termination of government service, if terminating within 90 days.) ~~~~~~~~~~~~~~~~~~~~~! Yes !
b If any answer is "Yes" to 1a(1)-(6), did any of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance (see page 22 of the instructions)? ~~~~~~~~~~~~~~~
Organizations relying on a current notice regarding disaster assistance check here ~~~~~~~~~~~~~~~~~~~~~~|!
1b
X
c Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts, that were not corrected
X
before the first day of the tax year beginning in 2007?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1c
2 Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private operating foundation
defined in section 4942(j)(3) or 4942(j)(5)):
a At the end of tax year 2007, did the foundation have any undistributed income (lines 6d and 6e, Part XIII) for tax year(s) beginning
X No
before 2007? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~! Yes !
If "Yes," list the years |
,
,
,
.
b 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 undistributed income? (If applying section 4942(a)(2) to all years listed, answer "No" and attach
N/A
statement - see instructions.) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2b
c If the provisions of section 4942(a)(2) are being 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 business enterprise at any time
X No
during the year? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~! Yes !
b If "Yes," did it have excess business holdings in 2007 as a result of (1) any purchase by the foundation or disqualified persons after
May 26, 1969; (2) the lapse of the 5-year period (or longer period approved by the Commissioner under section 4943(c)(7)) to dispose
of holdings acquired by gift or bequest; or (3) the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C,
N/A
Form 4720, to determine if the foundation had excess business holdings in 2007.) ~~~~~~~~~~~~~~~~~~~~~~
3b
X
4a Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes? ~~~~~~~~~~~~~
4a
b Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its charitable purpose that
X
had not been removed from jeopardy before the first day of the tax year beginning in 2007? !!!!!!!!!!!!!!!!!!!!!!
4b
Form 990-PF (2007)
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5
39-1916960
(continued)
Part VII-B Statements Regarding Activities for Which Form 4720 May Be Required
5a During the year did the foundation pay or incur any amount to:
X No
(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?~~~~~~~~~~~~~! Yes !
(2) Influence the outcome of any specific public election (see section 4955); or to carry on, directly or indirectly,
X No
any voter registration drive? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~! Yes !
X No
(3) Provide a grant to an individual for travel, study, or other similar purposes? ~~~~~~~~~~~~~~~~~! Yes !
(4) Provide a grant to an organization other than a charitable, etc., organization described in section
X No
509(a)(1), (2), or (3), or section 4940(d)(2)? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~! Yes !
(5) Provide for any purpose other than religious, charitable, scientific, literary, or educational purposes, or for
X No
the prevention of cruelty to children or animals? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~! Yes !
b If any answer is "Yes" to 5a(1)-(5), did any of the transactions fail to qualify under the exceptions described in Regulations
N/A
section 53.4945 or in a current notice regarding disaster assistance (see instructions)? ~~~~~~~~~~~~~~~~~~~~~~~~
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
N/A
expenditure responsibility for the grant?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
! Yes ! No
If "Yes," attach the statement required by Regulations section 53.4945-5(d).
5b
6a Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
X No
a personal benefit contract? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~! Yes !
b Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ~~~~~~~~~~~~~~~~
If you answered "Yes" to 6b, also file Form 8870.
6b
X No
7a At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction? ~~~~~~~~~ ! Yes !
N/A
b If yes, did the foundation receive any proceeds or have any net income attributable to the transaction?
Part VIII
Page 6
X
7b
Information About Officers, Directors, Trustees, Foundation Managers, Highly
Paid Employees, and Contractors
1 List all officers, directors, trustees, foundation managers and their compensation.
(b) Title, and average
hours per week devoted
to position
(a) Name and address
ERIK M. HANISCH
5405 LEARY AVE NW, SUITE 2
SEATTLE, WA 98107
MARTHA VUKELICH-AUSTIN
SEATTLE, WA 98107
LENORE HANISCH
SEATTLE, WA 98107
(c) Compensation
(If not paid,
enter -0-)
PRES. & BOARD CHAIRMAN
(e) Expense
account, other
allowances
40.00
14,000.
SECRETARY & TREASURER
0.
0.
8.00
DIRECTOR
14,000.
0.
1,334.
40.00
14,000.
0.
0.
2 Compensation of five highest-paid employees (other than those included on line 1). If none, enter "NONE."
(b) Title and average
(a) Name and address of each employee paid more than $50,000
hours per week
(c) Compensation
devoted to position
LENORE HANISCH
6723 21ST AVE NW, SEATTLE, WA 98117
(d) Contributions to
employee benefit plans
and deferred
compensation
EXECUTIVE DIR.
40.00
81,000.
(d) Contributions to
employee benefit plans
and deferred
compensation
(e) Expense
account, other
allowances
0
Total number of other employees paid over $50,000 !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! |
Form 990-PF (2007)
723551
02-20-08
10541111 798408 6042.FDN01
6
39-1916960
Information About Officers, Directors, Trustees, Foundation Managers, Highly
Paid Employees, and Contractors (continued)
Form 990-PF (2007)
Part VIII
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
(c) Compensation
(b) Type of service
KENETA ANDERSON
62617 ELK TRAIL WAY EAST, GREENWATER, WA 98022CONSULTING
114,467.
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
number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
1
Page 7
9
0
Expenses
N/A
2
3
4
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
Amount
N/A
2
All other program-related investments. See instructions.
3
Total. Add lines 1 through 3 !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
723561
02-20-08
10541111 798408 6042.FDN01
J
0.
Form 990-PF (2007)
7
Form 990-PF (2007)
Part X
39-1916960
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 charitable, etc., purposes:
Average monthly fair market value of securities ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1a
Average of monthly cash balances ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1b
Fair market value of all other assets ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1c
Total (add lines 1a, b, and c) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1d
Reduction claimed for blockage or other factors reported on lines 1a and
0.
1c (attach detailed explanation) ~~~~~~~~~~~~~~~~~~~~~~
1e
2 Acquisition indebtedness applicable to line 1 assets ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2
3 Subtract line 2 from line 1d ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3
4 Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see instructions) ~~~~~~~~
4
5 Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4 ~~~~~~~~~~
5
6 Minimum investment return. Enter 5% of line 5 !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
6
Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain
Part XI foreign organizations check here
! and do not complete this part.)
a
b
c
d
e
1
2a
b
c
3
4
5
6
7
Page 8
9
Minimum investment return from Part X, line 6 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1
13,424.
Tax on investment income for 2007 from Part VI, line 5 ~~~~~~~~~~~
2a
Income tax for 2007. (This does not include the tax from Part VI.) ~~~~~~~
2b
Add lines 2a and 2b ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2c
Distributable amount before adjustments. Subtract line 2c from line 1 ~~~~~~~~~~~~~~~~~~~~~~~
3
Recoveries of amounts treated as qualifying distributions~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4
Add lines 3 and 4 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5
Deduction from distributable amount (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6
Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 !!!!!!!!!!!!
7
23,574,220.
420,795.
23,995,015.
0.
23,995,015.
359,925.
23,635,090.
1,181,755.
1,181,755.
13,424.
1,168,331.
0.
1,168,331.
0.
1,168,331.
Part XII Qualifying Distributions (see instructions)
1
Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
1,826,136.
a Expenses, contributions, gifts, etc. - total from Part I, column (d), line 26 ~~~~~~~~~~~~~~~~~~~~~~
1a
0.
b Program-related investments - total from Part IX-B ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1b
227,765.
2 Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc., purposes~~~~~~~~~
2
3 Amounts set aside for specific charitable projects that satisfy the:
a Suitability test (prior IRS approval required)~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3a
b Cash distribution test (attach the required schedule) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3b
2,053,901.
4 Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4~~~~~~~~~
4
5 Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
13,424.
income. Enter 1% of Part I, line 27b ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5
2,040,477.
6 Adjusted qualifying distributions. Subtract line 5 from line 4 ~~~~~~~~~~~~~~~~~~~~~~~~~~~
6
Note: The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for the section
4940(e) reduction of tax in those years.
Form 990-PF (2007)
723571
02-20-08
10541111 798408 6042.FDN01
8
Form 990-PF (2007)
Part XIII
39-1916960
Page 9
Undistributed Income (see instructions)
(a)
Corpus
(b)
Years prior to 2006
1 Distributable amount for 2007 from Part XI,
line 7 ~~~~~~~~~~~~~~~~~
2 Undistributed income, if any, as of the end of 2006:
a Enter amount for 2006 only ~~~~~~~
b Total for prior years:
,
,
3 Excess distributions carryover, if any, to 2007:
200,278.
a From 2002 ~~~
383,151.
b From 2003 ~~~
411,694.
c From 2004 ~~~
89,219.
d From 2005 ~~~
486,702.
e From 2006 ~~~
f Total of lines 3a through e ~~~~~~~~
4 Qualifying distributions for 2007 from
2,053,901.
$
Part XII, line 4:
(c)
2006
1,168,331.
0.
0.
1,571,044.
9
a Applied to 2006, but not more than line 2a ~
b Applied to undistributed income of prior
years (Election required - see instructions) ~
c Treated as distributions out of corpus
(Election required - see instructions) ~~~
d Applied to 2007 distributable amount ~~~
e Remaining amount distributed out of corpus
5 Excess distributions carryover applied to 2007 ~~
(If an amount appears in column (d), the same amount
must be shown in column (a).)
6 Enter the net total of each column as
indicated below:
a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 ~~
b Prior years' undistributed income. Subtract
line 4b from line 2b ~~~~~~~~~~~
c Enter the amount of prior years'
undistributed income for which a notice of
deficiency has been issued, or on which
the section 4942(a) tax has been previously
assessed ~~~~~~~~~~~~~~~
d Subtract line 6c from line 6b. Taxable
amount - see instructions ~~~~~~~~
e Undistributed income for 2006. Subtract line
4a from line 2a. Taxable amount - see instr.~
f Undistributed income for 2007. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2008 ~~~~~~~~~~
7 Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) ~~~~
8 Excess distributions carryover from 2002
not applied on line 5 or line 7 ~~~~~~~
9 Excess distributions carryover to 2008.
Subtract lines 7 and 8 from line 6a ~~~~
10 Analysis of line 9:
383,151.
a Excess from 2003~
411,694.
b Excess from 2004~
89,219.
c Excess from 2005~
486,702.
d Excess from 2006~
885,570.
e Excess from 2007!
723581
02-20-08
10541111 798408 6042.FDN01
(d)
2007
0.
0.
0.
1,168,331.
885,570.
0.
0.
2,456,614.
0.
0.
0.
0.
0.
0.
200,278.
2,256,336.
Form 990-PF (2007)
9
Form 990-PF (2007)
Part XIV Private Operating Foundations (see instructions and Part VII-A, question 9)
N/A
39-1916960
Page 10
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 2007, enter the date of the ruling~~~~~~~~~~~
b Check box to indicate whether the foundation is a private operating foundation described in section ~~~! 4942(j)(3) or ! 4942(j)(5)
Prior 3 years
Tax year
2 a Enter the lesser of the adjusted net
(a)
2007
(b)
2006
(c) 2005
(d) 2004
(e) Total
income from Part I or the minimum
9
b
c
d
e
3
a
investment return from Part X for
each year listed ~~~~~~~~~
85% of line 2a ~~~~~~~~~~
Qualifying distributions from Part XII,
line 4 for each year listed ~~~~~
Amounts included in line 2c not
used directly for active conduct of
exempt activities ~~~~~~~~~
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c ~~~~
Complete 3a, b, or c for the
alternative test relied upon:
"Assets" alternative test - enter:
(1) Value of all assets ~~~~~~
(2) Value of assets qualifying
under section 4942(j)(3)(B)(i) ~
b "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 public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii) ~~~
(3) Largest amount of support from
an exempt organization ~~~~
(4) Gross investment income !!!
Part XV
1
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.)
Information Regarding Foundation Managers:
a List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation before the close of any tax
year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
ERIK M. HANISCH
b 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 Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
X if the foundation only makes contributions to preselected charitable organizations and does not accept unsolicited requests for funds. If
Check here !
the foundation makes gifts, grants, etc. (see instructions) to individuals or organizations under other conditions, complete items 2a, b, c, and d.
9
a The name, address, and telephone number of the person to whom applications should be addressed:
b The form in which applications should be submitted and information and materials they should include:
c Any submission deadlines:
d Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other factors:
723601/02-20-08
10541111 798408 6042.FDN01
Form 990-PF (2007)
10
Supplementary Information (continued)
Form 990-PF (2007)
Part XV
3
Grants and Contributions Paid During the Year or Approved for Future Payment
If recipient is an individual,
Recipient
Foundation
show any relationship to
status of
any foundation manager
Name and address (home or business)
recipient
or substantial contributor
Paid
during
the
year
a
39-1916960
Purpose of grant or
contribution
SEE STATEMENT 11
Total !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
b Approved for future payment
STATEMENT 12
Total SEE
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
723611/02-20-08
10541111 798408 6042.FDN01
Page 11
Amount
9
3a
9
3b
1,107,310.
730,000.
Form 990-PF (2007)
11
Form 990-PF (2007)
Part XVI-A
39-1916960
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
1 Program service revenue:
a
b
c
d
e
f
g Fees and contracts from government agencies ~~~
2 Membership dues and assessments ~~~~~~~~~
3 Interest on savings and temporary cash
investments ~~~~~~~~~~~~~~~~~~~~
4 Dividends and interest from securities ~~~~~~~~
5 Net rental income or (loss) from real estate:
Unrelated business income
(a)
(b)
Business
Amount
code
Excluded by section 512, 513, or 514
(c)
Exclusion
code
14
14
(d)
Amount
Line No.
<
(e)
Related or exempt
function income
214,177.
439,981.
a Debt-financed property ~~~~~~~~~~~~~
b Not debt-financed property ~~~~~~~~~~~~
6 Net rental income or (loss) from personal
property ~~~~~~~~~~~~~~~~~~~~~
14
35,207.
7 Other investment income ~~~~~~~~~~~~~~
8 Gain or (loss) from sales of assets other
18
883,033.
than inventory ~~~~~~~~~~~~~~~~~~~
9 Net income or (loss) from special events ~~~~~~~
10 Gross profit or (loss) from sales of inventory ~~~~~
11 Other revenue:
a
b
c
d
e
0.
1,572,398.
12 Subtotal. Add columns (b), (d), and (e) ~~~~~~~~
13 Total. Add line 12, columns (b), (d), and (e) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 13
(See worksheet in line 13 instructions to verify calculations.)
Part XVI-B
Page 12
0.
1,572,398.
Relationship of Activities to the Accomplishment of Exempt Purposes
Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to the accomplishment of
the foundation's exempt purposes (other than by providing funds for such purposes).
723621
02-20-08
10541111 798408 6042.FDN01
Form 990-PF (2007)
12
39-1916960 Page 13
Form 990-PF (2007)
Part XVII
Information Regarding Transfers To and Transactions and Relationships With Noncharitable
Exempt Organizations
1 Did the organization directly or indirectly engage in any of the following with any other organization described 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 noncharitable exempt organization of:
X
(1) Cash ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1a(1)
X
(2) Other assets~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1a(2)
b Other transactions:
X
(1) Sales of assets to a noncharitable exempt organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1b(1)
X
(2) Purchases of assets from a noncharitable exempt organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1b(2)
X
(3) Rental of facilities, equipment, or other assets ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1b(3)
X
(4) Reimbursement arrangements ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1b(4)
X
(5) Loans or loan guarantees ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1b(5)
X
(6) Performance of services or membership or fundraising solicitations~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1b(6)
X
c Sharing of facilities, equipment, mailing lists, other assets, or paid employees ~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1c
d If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value of the goods, other assets,
or services given by the reporting foundation. If the foundation received less than fair market value in any transaction or sharing arrangement, show in
column (d) the value of the goods, other assets, or services received.
(a) Line no.
(b) Amount involved
(c) Name of noncharitable exempt organization
(d) Description of transfers, transactions, and sharing arrangements
N/A
2a Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations described
in section 501(c) of the Code (other than section 501(c)(3)) or in section 527? ~~~~~~~~~~~~~~~~~~~~~~~~~~ ! Yes
b If "Yes," complete the following schedule.
(a) Name of organization
(b) Type of organization
(c) Description of relationship
X
!
No
N/A
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 or fiduciary) is based on all information of which preparer has any knowledge.
Sign Here
Paid
Preparer's
Use Only
=
Signature of officer or trustee
Preparer's
signature
=
Firm's name (or yours
if self-employed),
address, and ZIP code
Date
=
Date
WELLSPRING GROUP P.S., CPAS
10900 NE 4TH ST., SUITE 920
BELLEVUE, WA 98004-5882
=
723622
02-20-08
10541111 798408 6042.FDN01
PRESIDENT
Title
Check if
selfemployed
EIN
9!
9
Phone no.
Preparer's SSN or PTIN
425-462-8220
Form 990-PF (2007)
13
Part IV Capital Gains and Losses for Tax on Investment Income
CONTINUATION FOR 990-PF, PART IV
39-1916960
PAGE
1 OF
16
(b) How acquired (c) Date acquired
P - Purchase
(mo., day, yr.)
D - Donation
(a) List and describe the kind(s) of property sold, e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.
1a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
GREENLIGHT PARTNERSHIP
3740 MFO DFA INTL SMALL CO
461 MFO VANGUARD INDEX TR
5645 MFO DFA INTL SMALL CO
16502 MFB NORTHERN INSTL FDS
LOSS FROM PRIOR YEAR SALE
INCOME SHORT TERM GAINS SMITH ASSET MANAGEMENT
INCOME LONG TERM GAINS SMITH ASSET MANAGEMENT
25000. US TSY 4.50 15FEB16 DUE
300000. US TSY 4.50 15FEB16 DUE
175000. HONEYWELL INTL INC NT DTD
175000. INTL LEASE FIN CORP(e) Gross sales price
(or allowable)
1,056,956.
79,697.
61,170.
45,240.
120,303.
38,830.
154,760.
250,000.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
56,956.
10,315.
2,503.
1,434.
30,655.
4,319.
23,421.
82,508.
-25,861.
-5,329.
172,587.
769.
11,482.
-4,854.
-3,646.
23,840.
286,221.
182,906.
175,407.
(i) F.M.V. as of 12/31/69
(j) Adjusted basis
as of 12/31/69
(l) Losses (from col. (h))
Gains (excess of col. (h) gain over col. (k),
but not less than "-0-")
56,956.
10,315.
2,503.
1,434.
30,655.
4,319.
23,421.
82,508.
-25,861.
-5,329.
172,587.
769.
11,482.
-4,854.
-3,646.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
2 Capital gain net income or (net capital loss) ~~
i
If (loss), enter "-0-" in Part I, line 7
j
~~~~~~
If gain, also enter in Part I, line 8, column (c).
If (loss), enter "-0-" in Part I, line 8 !!!!!!!!!!!!!!!!!!!!!!!!!!!
723591
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10541111 798408 6042.FDN01
12/26/0603/07/07
03/08/0704/11/07
03/23/0704/11/07
03/21/0704/11/07
10/31/0504/11/07
03/17/0604/11/07
03/17/0604/11/07
09/13/0510/12/07
12/31/0612/31/07
01/01/0712/31/07
01/01/0612/31/07
06/21/0602/15/07
06/21/0603/28/07
03/26/0706/22/07
05/02/0706/26/07
(h) Gain or (loss)
1,000,000.
69,382.
58,667.
43,806.
89,648.
34,511.
131,339.
167,492.
25,861.
5,329.
172,587.
24,609.
297,703.
178,052.
171,761.
(d) Date sold
(mo., day, yr.)
p
m
o
2
3
14
39-1916960
PAGE
2 OF
16
P - Purchase
(mo., day, yr.)
D - Donation
1a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
2052.97
2380.58
1780.54
1915.91
1918.16
1792.21
1689.28
1620.67
1748.94
2047.73
1347.34
1982.29
2875.65
3571.77
3468.07
FHLMC MULTICLASS 5.5%
FHLMC MULTICLASS FEDERAL
FHLMC HULTICLASS SER 2704
GNMA 2003-031 REMIC TR
GNMA 2004 022 REMIC
(or allowable)
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
2,053.
2,381.
1,781.
1,916.
1,918.
1,792.
1,689.
1,621.
1,749.
2,048.
1,347.
1,982.
2,876.
3,572.
3,468.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
06/26/0707/16/07
06/22/0707/16/07
06/26/0708/15/07
06/22/0708/15/07
06/26/0709/17/07
06/22/0709/17/07
06/26/0710/15/07
06/22/0710/15/07
06/26/0711/15/07
06/22/0711/15/07
06/26/0712/17/07
06/22/0712/17/07
08/25/0501/16/07
08/25/0501/16/07
08/25/0501/22/07
(h) Gain or (loss)
2,017.
2,374.
1,750.
1,911.
1,885.
1,787.
1,661.
1,616.
1,720.
2,042.
1,326.
1,977.
2,923.
3,599.
3,425.
36.
7.
31.
5.
33.
5.
28.
5.
29.
6.
21.
5.
-47.
-27.
43.
(i) F.M.V. as of 12/31/69
(d) Date sold
(mo., day, yr.)
(j) Adjusted basis
as of 12/31/69
36.
7.
31.
5.
33.
5.
28.
5.
29.
6.
21.
5.
-47.
-27.
43.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
i
j
~~~~~~
723591
04-27-07
10541111 798408 6042.FDN01
p
m
o
2
3
15
39-1916960
PAGE
3 OF
16
P - Purchase
(mo., day, yr.)
D - Donation
1a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
338.86 GNMA 2004-089 REMIC
3635.69 FNMA POOL #255013 5%
2288.09 FHLMC MULTICLASS SER 2704
2758.77 GNMA 2003-031 REMIC TR
3450.15 GNMA 2004 022 REMIC
337.1 GNMA 2004-089 REMIC
2909.51 FNMA POOL #255013 5%
2198.93 FHLMC MULTICLASS SER
2818.99 GNMA 2003-031 REMIC TR
3432.33 GNMA 2004 022 REMIC
335.35 GNMA 2004-089 REMIC
2423.17 FNMA POOL #255013 5%
175000 ALLIED SIGNAL INC 6.2%
175000. DU PONT E I DE NEMOURS &
175000. WRIGLEY WM JR CO WM
(or allowable)
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
339.
3,636.
2,288.
2,759.
3,450.
337.
2,910.
2,199.
2,819.
3,432.
335.
2,423.
176,131.
172,760.
170,863.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
8.
-116.
-38.
-20.
43.
7.
-92.
-36.
-21.
42.
7.
-77.
-1,455.
0.
-3,301.
(i) F.M.V. as of 12/31/69
8.
-116.
-38.
-20.
43.
7.
-92.
-36.
-21.
42.
7.
-77.
-1,455.
0.
-3,301.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
i
j
~~~~~~
723591
04-27-07
10541111 798408 6042.FDN01
08/25/0501/22/07
08/23/0501/25/07
08/25/0502/15/07
08/25/0502/16/07
08/25/0502/20/07
08/25/0502/20/07
08/23/0502/26/07
08/25/0503/15/07
08/25/0503/16/07
08/25/0503/20/07
08/25/0503/20/07
08/23/0503/26/07
09/20/0503/28/07
09/20/0503/28/07
09/20/0503/28/07
(h) Gain or (loss)
331.
3,752.
2,326.
2,779.
3,407.
330.
3,002.
2,235.
2,840.
3,390.
328.
2,500.
177,586.
172,760.
174,164.
(j) Adjusted basis
as of 12/31/69
(d) Date sold
(mo., day, yr.)
p
m
o
2
3
16
39-1916960
PAGE
4 OF
16
P - Purchase
(mo., day, yr.)
D - Donation
1a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
3361.01 GNMA 2003-031 REMIC TR
175000. TARGET CORP NT 4% DUE
3414.59 GNMA 2004 022 REMIC
333.61 GNMA 2004-089 REMIC
3393.15 FNMA POOL #255013 5%
175000. WASTE MGMT INC DEL SR NT
2887.72 GNMA 2003-031 REMIC TR
3396.95 GNMA 2004 022 REMIC
331.88 GNMA 2004-089 REMIC
3356.98 FNMA POOL #255013 5%
175000. KRAFT FOODS INC NT 5.25%
3045.51 GNMA 2003-031 REMIC TR
(or allowable)
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
2,015.
3,361.
163,742.
3,415.
334.
3,393.
180,108.
2,363.
2,888.
3,397.
332.
3,357.
175,000.
2,359.
3,046.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
-33.
-25.
-3,681.
43.
8.
-108.
-2,135.
-39.
-21.
42.
7.
-107.
0.
-39.
-22.
(i) F.M.V. as of 12/31/69
-33.
-25.
-3,681.
43.
8.
-108.
-2,135.
-39.
-21.
42.
7.
-107.
0.
-39.
-22.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
i
j
~~~~~~
723591
04-27-07
10541111 798408 6042.FDN01
08/25/0504/16/07
08/25/0504/16/07
09/20/0504/18/07
08/25/0504/20/07
08/25/0504/20/07
08/23/0504/25/07
09/20/0505/02/07
08/25/0505/15/07
08/25/0505/16/07
08/25/0505/21/07
08/25/0505/21/07
08/23/0505/25/07
09/20/0506/01/07
08/25/0506/15/07
08/25/0506/18/07
(h) Gain or (loss)
2,048.
3,386.
167,423.
3,372.
326.
3,501.
182,243.
2,402.
2,909.
3,355.
325.
3,464.
175,000.
2,398.
3,068.
(j) Adjusted basis
as of 12/31/69
(d) Date sold
(mo., day, yr.)
p
m
o
2
3
17
39-1916960
PAGE
5 OF
16
P - Purchase
(mo., day, yr.)
D - Donation
1a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
3379.4 GNMA 2004 022 REMIC
330.16 GNMA 2004-089 REMIC
2216.74 FNMA POOL #255013 5%
175000. WAL-MART STORES INC NT
3072.5 FHLMC MULTICLASS SER 2704
3322.49 GNMA 2003-031 REMIC TR
3361.93 GNMA 2004 022 REMIC
328.46 GNMA 2004-089 REMIC
2747.6 FNMA POOL #255013 5%
2499.31 GNMA 2003-031 REMIC TR
3344.56 GNMA 2004 022 REMIC
326.76 GNMA 2004-089 REMIC
2736.4 FNMA. POOL #255013 5%
(or allowable)
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
3,379.
330.
2,217.
171,141.
3,073.
3,322.
3,362.
328.
2,748.
2,383.
2,499.
3,345.
327.
2,736.
2,673.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
08/25/0506/20/07
08/25/0506/20/07
08/23/0506/25/07
09/20/0507/10/07
08/25/0507/16/07
08/25/0507/16/07
08/25/0507/20/07
08/25/0507/20/07
08/23/0507/25/07
08/25/0508/15/07
08/25/0508/16/07
08/25/0508/20/07
08/25/0508/20/07
08/23/0508/27/07
08/25/0509/17/07
(h) Gain or (loss)
3,337.
323.
2,287.
171,141.
3,123.
3,347.
3,320.
321.
2,835.
2,422.
2,518.
3,303.
320.
2,824.
2,717.
42.
7.
-70.
0.
-50.
-25.
42.
7.
-87.
-39.
-19.
42.
7.
-88.
-44.
(i) F.M.V. as of 12/31/69
(d) Date sold
(mo., day, yr.)
(j) Adjusted basis
as of 12/31/69
42.
7.
-70.
0.
-50.
-25.
42.
7.
-87.
-39.
-19.
42.
7.
-88.
-44.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
i
j
~~~~~~
723591
04-27-07
10541111 798408 6042.FDN01
p
m
o
2
3
18
39-1916960
PAGE
6 OF
16
P - Purchase
(mo., day, yr.)
D - Donation
1a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
2907.05 GNMA 2003-031 REMIC TR
3327.28 GNMA 2004 022 REMIC
325.08 GNMA 2004-089 REMIC
2496.03 FNMA POOL #255013 5%
2249.39 GNMA 2003-031 REMIC TR
3310.09 GNMA 2004 022 REMIC
323.41 GNMA 2004-089 REMIC
2275.4 FNMA POOL #255013 5%
2487. GNMA 2003-031 REMIC TR CTF
3292.98 GNMA 2004 022 REMIC
317.36 GNMA 2004-089 REMIC
2792.47 FNMA POOL #255013 5%
175000. CITIGROUP INC NT GLOBAL 6
(or allowable)
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
2,907.
3,327.
325.
2,496.
1,494.
2,249.
3,310.
323.
2,275.
1,791.
2,487.
3,293.
317.
2,792.
180,892.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
-22.
41.
7.
-80.
-25.
-17.
41.
7.
-73.
-29.
-19.
41.
7.
-89.
-2,543.
(i) F.M.V. as of 12/31/69
-22.
41.
7.
-80.
-25.
-17.
41.
7.
-73.
-29.
-19.
41.
7.
-89.
-2,543.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
i
j
~~~~~~
723591
04-27-07
10541111 798408 6042.FDN01
08/25/0509/17/07
08/25/0509/20/07
08/25/0509/20/07
08/23/0509/25/07
08/25/0510/15/07
08/25/0510/16/07
08/25/0510/22/07
08/25/0510/22/07
08/23/0510/25/07
08/25/0511/15/07
08/25/0511/16/07
08/25/0511/20/07
08/25/0511/20/07
08/23/0511/26/07
09/20/0512/04/07
(h) Gain or (loss)
2,929.
3,286.
318.
2,576.
1,519.
2,266.
3,269.
316.
2,348.
1,820.
2,506.
3,252.
310.
2,881.
183,435.
(j) Adjusted basis
as of 12/31/69
(d) Date sold
(mo., day, yr.)
p
m
o
2
3
19
39-1916960
PAGE
7 OF
16
P - Purchase
(mo., day, yr.)
D - Donation
1a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
175000. MARSHALL & ILSLEY CORP M
2091.63 GNMA 2003-031 REMIC TR
125000. BANK AMER CORP BD 5.125%
140000. J P MORGAN CHASE & CO
125000. WELLS FARGO & CO NEW 4.95
3275.97 GNMA 2004 022 REMIC
324.49 GNMA 2004-089 REMIC
2176.8 FNMA POOL #255013 5%
. 75 AT&T INC COM
100. BAXTER INTL INC
74.25 AT&T INC COM
100. MATTEL INC
150. CIT GROUP INC
550. CLEAR CHANNEL COMMUNICATION INC
(or allowable)
173,051.
1,634.
2,092.
122,275.
139,090.
122,676.
3,276.
324.
2,177.
25.
4,647.
2,536.
2,309.
8,486.
19,426.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
-1,027.
-27.
-15.
-4,625.
0.
-3,077.
41.
7.
-69.
5.
128.
542.
524.
1,269.
2,582.
(i) F.M.V. as of 12/31/69
-1,027.
-27.
-15.
-4,625.
0.
-3,077.
41.
7.
-69.
5.
128.
542.
524.
1,269.
2,582.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
i
j
~~~~~~
723591
04-27-07
10541111 798408 6042.FDN01
09/20/0512/10/07
08/25/0512/17/07
08/25/0512/17/07
09/20/0512/18/07
09/20/0512/18/07
09/20/0512/18/07
08/25/0512/20/07
08/25/0512/20/07
08/23/0512/26/07
06/08/0601/09/07
09/27/0601/09/07
06/08/0601/10/07
03/29/0601/16/07
09/27/0601/18/07
05/24/0603/19/07
(h) Gain or (loss)
174,078.
1,661.
2,107.
126,900.
139,090.
125,753.
3,235.
317.
2,246.
20.
4,519.
1,994.
1,785.
7,217.
16,844.
(j) Adjusted basis
as of 12/31/69
(d) Date sold
(mo., day, yr.)
p
m
o
2
3
20
39-1916960
PAGE
8 OF
16
P - Purchase
(mo., day, yr.)
D - Donation
1a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
400. DOW CHEMICAL CO
100. NEWELL RUBBERMAID INC
200. GENERAL MILLS INC
100. WM WRIGLEY JR CO
75. ABBOTT LABORATORIES
175. AVON PRODS INC
2450. D R HORTON INC
500. D R HORTON INC
750. D R HORTON INC
250. COCA COLA CO
125. E I DU PONT DE NEMOURS &
2600. MAXIM INTEGRATED PRODS INC
(or allowable)
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
18,140.
3,072.
11,973.
5,946.
14,821.
26,733.
4,399.
6,948.
43,299.
8,832.
13,225.
6,314.
13,316.
6,083.
80,342.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
4,140.
71.
527.
1,498.
3,446.
6,478.
1,160.
1,551.
-17,174.
-3,222.
-2,215.
482.
1,780.
720.
1,655.
(i) F.M.V. as of 12/31/69
4,140.
71.
527.
1,498.
3,446.
6,478.
1,160.
1,551.
-17,174.
-3,222.
-2,215.
482.
1,780.
720.
1,655.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
i
j
~~~~~~
723591
04-27-07
10541111 798408 6042.FDN01
08/02/0603/22/07
02/02/0704/12/07
02/02/0704/25/07
07/26/0605/03/07
09/27/0605/03/07
07/26/0605/03/07
06/08/0605/09/07
09/27/0605/09/07
03/08/0707/24/07
06/04/0707/25/07
07/18/0707/25/07
06/04/0708/08/07
02/02/0708/16/07
09/27/0608/31/07
06/04/0709/04/07
(h) Gain or (loss)
14,000.
3,001.
11,446.
4,448.
11,375.
20,255.
3,239.
5,397.
60,473.
12,054.
15,440.
5,832.
11,536.
5,363.
78,687.
(j) Adjusted basis
as of 12/31/69
(d) Date sold
(mo., day, yr.)
p
m
o
2
3
21
39-1916960
PAGE
9 OF
16
P - Purchase
(mo., day, yr.)
D - Donation
1a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
575.
150.
250.
350.
150.
400.
100.
200.
350.
175.
200.
100.
750.
100.
750.
MAXIM INTEGRATED PRODS INC
AT&T INC COM
DOW CHEMICAL CO
EASTMAN KODAK CO.
EMBARQ CORP COM STK
INTEL CORP
JOHNSON & JOHNSON
LINCOLN NATIONAL CORP IND
LINEAR TECHNOLOGY
UNITED PARCEL SERVICE INC
VERIZON COMMUNICATIONS
WEYERHAEUSER CO
CITIGROUP INC
FEDERAL HOME LN MTG CORP VT COM
FEDERAL HOME LN MTG CORP VT COM
(or allowable)
17,654.
6,249.
11,101.
9,884.
8,545.
10,552.
6,496.
13,038.
11,739.
13,214.
8,978.
6,976.
31,685.
4,439.
32,252.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
-897.
103.
-259.
1,186.
215.
2,134.
92.
475.
292.
217.
1,510.
-1,129.
-7,324.
-1,437.
-14,584.
(i) F.M.V. as of 12/31/69
-897.
103.
-259.
1,186.
215.
2,134.
92.
475.
292.
217.
1,510.
-1,129.
-7,324.
-1,437.
-14,584.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
i
j
~~~~~~
723591
04-27-07
10541111 798408 6042.FDN01
09/15/0609/04/07
06/04/0710/17/07
08/22/0710/17/07
02/28/0710/17/07
01/18/0710/17/07
02/02/0710/17/07
05/23/0710/17/07
08/22/0710/17/07
01/12/0710/17/07
02/02/0710/17/07
01/22/0710/17/07
04/26/0710/17/07
08/22/0710/23/07
08/06/0711/13/07
08/31/0711/13/07
(h) Gain or (loss)
18,551.
6,146.
11,360.
8,698.
8,330.
8,418.
6,404.
12,563.
11,447.
12,997.
7,468.
8,105.
39,009.
5,876.
46,836.
(j) Adjusted basis
as of 12/31/69
(d) Date sold
(mo., day, yr.)
p
m
o
2
3
22
39-1916960
PAGE
10 OF
16
P - Purchase
(mo., day, yr.)
D - Donation
1a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
550. FEDERAL HOME LN MTG CORP VT COM
100. FEDERAL HOME LN MTG CORP VT COM
2050. FEDERAL NATL MTG ASSN
450. COUNTRYWIDE CR INDS INC
1300. CIT GROUP INC
200. XL CAP LTD CL A
100. JOHNSON & JOHNSON
850. KRAFT FOODS INC CL A
600. ADR SANOFI-AVENTIS SPONSORED ADR
(or allowable)
24,496.
4,505.
8,200.
62,040.
4,448.
17,505.
56,299.
31,306.
9,993.
19,987.
19,985.
6,769.
29,597.
28,861.
23,234.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
-7,824.
-1,306.
104.
-65,206.
-3,872.
-16,698.
-29,026.
-13,781.
-4,698.
-9,402.
-9,404.
365.
1,115.
4,129.
11,234.
(i) F.M.V. as of 12/31/69
-7,824.
-1,306.
104.
-65,206.
-3,872.
-16,698.
-29,026.
-13,781.
-4,698.
-9,402.
-9,404.
365.
1,115.
4,129.
11,234.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
i
j
~~~~~~
723591
04-27-07
10541111 798408 6042.FDN01
08/06/0711/14/07
08/06/0711/14/07
07/18/0711/15/07
11/13/0711/20/07
10/12/0711/21/07
10/12/0711/21/07
11/16/0711/21/07
08/21/0711/27/07
02/08/0711/27/07
02/08/0711/27/07
02/08/0711/27/07
05/23/0712/07/07
04/25/0712/07/07
09/04/0712/07/07
05/29/0301/09/07
(h) Gain or (loss)
32,320.
5,811.
8,096.
127,246.
8,320.
34,203.
85,325.
45,087.
14,691.
29,389.
29,389.
6,404.
28,482.
24,732.
12,000.
(j) Adjusted basis
as of 12/31/69
(d) Date sold
(mo., day, yr.)
p
m
o
2
3
23
39-1916960
PAGE
11 OF
16
P - Purchase
(mo., day, yr.)
D - Donation
1a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
1575.75 AT&T INC COM
100. MATTEL INC
550. MATTEL INC
775. MATTEL INC
275. MATTEL INC
200. MATTEL INC
200. MATTEL INC
925. MATTEL INC
250. CIT GROUP INC
50. CIT GROUP INC
200. CIT GROUP INC
650. CIT GROUP INC 200. CIT GROUP INC
200. CIT GROUP INC 200. CIT GROUP INC
50. CIT GROUP INC
(or allowable)
53,827.
41,743.
2,304.
12,763.
17,895.
6,365.
4,628.
4,627.
21,433.
14,144.
2,828.
11,316.
36,788.
11,334.
2,835.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
13,062.
20,234.
741.
4,168.
5,784.
2,067.
1,502.
1,501.
6,984.
8,356.
1,670.
6,686.
21,740.
6,704.
1,677.
(i) F.M.V. as of 12/31/69
13,062.
20,234.
741.
4,168.
5,784.
2,067.
1,502.
1,501.
6,984.
8,356.
1,670.
6,686.
21,740.
6,704.
1,677.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
i
j
~~~~~~
723591
04-27-07
10541111 798408 6042.FDN01
06/03/0501/10/07
05/29/0301/10/07
11/03/0501/16/07
11/03/0501/16/07
11/03/0501/16/07
11/03/0501/16/07
11/03/0501/17/07
11/03/0501/17/07
11/03/0501/17/07
06/03/0301/18/07
06/03/0301/18/07
06/03/0301/18/07
06/03/0301/19/07
06/03/0301/19/07
06/03/0301/19/07
(h) Gain or (loss)
40,765.
21,509.
1,563.
8,595.
12,111.
4,298.
3,126.
3,126.
14,449.
5,788.
1,158.
4,630.
15,048.
4,630.
1,158.
(j) Adjusted basis
as of 12/31/69
(d) Date sold
(mo., day, yr.)
p
m
o
2
3
24
39-1916960
PAGE
12 OF
16
1a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
450. CIT GROUP INC
700. INTERNATIONAL PAPER CO
600. INTERNATIONAL PAPER CO 175. INTERNATIONAL PA
275. INTERNATIONAL PAPER CO 100. INTERNATIONAL PA
1250. AVON PRODS INC
100. AVON PRODS INC
800. MEADWESTVACO CORP
500. PITNEY BOWES INC
500. AT&T INC COM
(or allowable)
25,500.
23,214.
19,909.
5,831.
17,411.
9,069.
3,344.
6,575.
3,287.
46,044.
3,683.
21,388.
23,680.
22,542.
19,550.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
15,082.
-2,581.
-1,249.
-618.
-1,935.
-259.
-48.
-209.
-105.
6,839.
549.
5,769.
3,746.
3,703.
7,904.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
i
j
~~~~~~
723591
04-27-07
10541111 798408 6042.FDN01
06/03/0301/19/07
06/03/0301/25/07
06/15/0301/25/07
06/03/0301/25/07
06/03/0301/25/07
06/15/0301/25/07
06/15/0301/25/07
06/15/0501/26/07
06/15/0501/26/07
08/04/0303/07/07
08/04/0303/07/07
04/18/0503/19/07
05/29/0303/19/07
05/29/0303/19/07
06/03/0503/22/07
15,082.
-2,581.
-1,249.
-618.
-1,935.
-259.
-48.
-209.
-105.
6,839.
549.
5,769.
3,746.
3,703.
7,904.
(i) F.M.V. as of 12/31/69
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
(d) Date sold
(mo., day, yr.)
(h) Gain or (loss)
10,418.
25,795.
21,158.
6,449.
19,346.
9,328.
3,392.
6,784.
3,392.
39,205.
3,134.
15,619.
19,934.
18,839.
11,646.
(j) Adjusted basis
as of 12/31/69
P - Purchase
(mo., day, yr.)
D - Donation
p
m
o
2
3
25
39-1916960
PAGE
13 OF
16
P - Purchase
(mo., day, yr.)
D - Donation
1a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
800. NOKIA CORP SPONSORED ADR
4750. NOKIA CORP SPONSORED ADR
IDO. NEWELL RUBBERMAID INC
100. LINCOLN NATIONAL CORP IND
200. LINCOLN NATIONAL CORP IND
(or allowable)
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
18,488.
6,145.
7,681.
110,652.
15,306.
7,654.
6,150.
4,609.
4,608.
7,623.
3,061.
6,899.
13,812.
16,799.
18,407.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
6,792.
1,641.
2,028.
43,258.
4,181.
2,091.
1,700.
1,271.
1,270.
2,060.
836.
3,566.
7,146.
4,561.
5,316.
(i) F.M.V. as of 12/31/69
6,792.
1,641.
2,028.
43,258.
4,181.
2,091.
1,700.
1,271.
1,270.
2,060.
836.
3,566.
7,146.
4,561.
5,316.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
i
j
~~~~~~
723591
04-27-07
10541111 798408 6042.FDN01
04/28/0403/22/07
12/30/0304/12/07
12/30/0304/12/07
06/23/0404/12/07
10/07/0304/13/07
10/07/0304/13/07
10/07/0304/16/07
10/07/0304/16/07
10/07/0304/16/07
10/07/0304/17/07
10/07/0304/17/07
05/29/0304/18/07
05/29/0304/18/07
10/07/0304/18/07
04/18/0504/18/07
(h) Gain or (loss)
11,696.
4,504.
5,653.
67,394.
11,125.
5,563.
4,450.
3,338.
3,338.
5,563.
2,225.
3,333.
6,666.
12,238.
13,091.
(j) Adjusted basis
as of 12/31/69
(d) Date sold
(mo., day, yr.)
p
m
o
2
3
26
39-1916960
PAGE
14 OF
16
P - Purchase
(mo., day, yr.)
D - Donation
1a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
1650. AVON PRODS INC
2106. TRIBUNE CO NEW
850. PNC BANK CORP
650. PNC BANK CORP
900. COCA COLA CO
350. COCA COLA CO
750. 3M CO
(or allowable)
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
5,981.
53,881.
8,977.
20,966.
45,456.
65,512.
71,604.
62,721.
47,483.
17,468.
31,569.
25,056.
47,939.
18,936.
65,895.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
2,124.
14,335.
2,386.
7,082.
15,274.
13,926.
6,634.
20,901.
15,503.
5,242.
9,328.
7,273.
10,312.
17,227.
19,436.
(i) F.M.V. as of 12/31/69
2,124.
14,335.
2,386.
7,082.
15,274.
13,926.
6,634.
20,901.
15,503.
5,242.
9,328.
7,273.
10,312.
17,227.
19,436.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
i
j
~~~~~~
723591
04-27-07
10541111 798408 6042.FDN01
11/10/0304/25/07
11/10/0304/25/07
11/10/0304/25/07
04/18/0505/08/07
11/10/0305/09/07
08/04/0305/09/07
03/16/0606/04/07
06/18/0306/20/07
06/18/0306/21/07
07/26/0608/08/07
07/26/0608/08/07
07/26/0608/08/07
03/22/0508/16/07
03/22/0508/21/07
05/29/0308/29/07
(h) Gain or (loss)
3,857.
39,546.
6,591.
13,884.
30,182.
51,586.
64,970.
41,820.
31,980.
12,226.
22,241.
17,783.
37,627.
1,709.
46,459.
(j) Adjusted basis
as of 12/31/69
(d) Date sold
(mo., day, yr.)
p
m
o
2
3
27
39-1916960
PAGE
15 OF
16
1a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
100. AT&T INC COM
300. BRISTOL MYERS SQUIBB CO
100. CARNIVAL CORP COM PAIRED CORP & 1 SH
600. ADR DEUTSCHE TELEKOM AG ISIN # US2515661054
25. UNITED PARCEL SERVICE INC CL B
200. VERIZON COMMUNICATIONS
450. CITIGROUP INC
600. COCA COLA CO
575. COCA COLA CO
1350. INTEL CORP
(or allowable)
59,053.
10,349.
15,626.
9,539.
4,166.
8,895.
4,818.
11,244.
1,888.
8,978.
19,011.
36,247.
34,749.
36,798.
12,307.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
6,572.
1,136.
1,806.
1,101.
1,840.
1,901.
1,093.
644.
111.
2,279.
-2,604.
35,021.
33,574.
9,265.
4,623.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
i
j
~~~~~~
723591
04-27-07
10541111 798408 6042.FDN01
08/04/0508/30/07
08/04/0508/30/07
08/04/0508/31/07
08/04/0508/31/07
04/18/0510/17/07
10/18/0410/17/07
06/14/0610/17/07
04/25/0610/17/07
08/16/0610/17/07
08/23/0610/17/07
09/27/0610/23/07
01/01/0011/07/07
01/01/0011/07/07
03/06/0611/07/07
02/25/0311/15/07
6,572.
1,136.
1,806.
1,101.
1,840.
1,901.
1,093.
644.
111.
2,279.
-2,604.
35,021.
33,574.
9,265.
4,623.
(i) F.M.V. as of 12/31/69
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
(d) Date sold
(mo., day, yr.)
(h) Gain or (loss)
52,481.
9,213.
13,820.
8,438.
2,326.
6,994.
3,725.
10,600.
1,777.
6,699.
21,615.
1,226.
1,175.
27,533.
7,684.
(j) Adjusted basis
as of 12/31/69
P - Purchase
(mo., day, yr.)
D - Donation
p
m
o
2
3
28
39-1916960
PAGE
16 OF
16
1a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
1500. CITIGROUP INC
2100. ADR DEUTSCHE TELEKOM AG ISIN # US2515661054
350. JOHNSON & JOHNSON
600. WYETH LABS
1544. TRIBUNE CO NEW
CAPITAL GAINS DIVIDENDS
(or allowable)
54,669.
46,816.
46,157.
23,691.
28,485.
52,493.
195,399.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
P
P
P
P
P
P
12/06/0511/15/07
04/19/0511/21/07
04/25/0612/07/07
04/29/0412/07/07
03/29/0612/07/07
03/29/0612/20/07
37,468.
65,839.
37,098.
18,883.
28,396.
46,250.
(j) Adjusted basis
as of 12/31/69
17,201.
-19,023.
9,059.
4,808.
89.
6,243.
195,399.
17,201.
-19,023.
9,059.
4,808.
89.
6,243.
195,399.
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
i
j
~~~~~~
723591
04-27-07
10541111 798408 6042.FDN01
(d) Date sold
(mo., day, yr.)
(h) Gain or (loss)
(i) F.M.V. as of 12/31/69
P - Purchase
(mo., day, yr.)
D - Donation
p
m
o
883,033.
2
3
N/A
29
06/02/05 200DB 5.00 HY17
04/01/05 200DB 5.00 HY17
04/01/05 200DB 5.00 HY17
08/05/05 200DB 5.00 HY17
08/05/05 200DB 5.00 HY17
08/08/06 200DB 7.00 HY17
08/08/06 200DB 7.00 HY17
08/08/06 200DB 7.00 HY17
08/08/06 200DB 7.00 HY17
08/08/06 200DB 7.00 HY17
08/08/06 200DB 7.00 HY17
08/08/06 200DB 7.00 HY17
08/08/06 200DB 7.00 HY17
08/08/06 200DB 7.00 HY17
39 PALM PILOT (2)
40 APPLE IMAC G5
41 APPLE 12 IN POWERBOOK G4
44 HINGED DOOR CABINET
45 30X60 DESK
46 BOOKCASE
47 48X20 PREP TABLE
48 42" ROUND TABLE
49 4 RED/BLACK STACK CHAIRS
50 24X52 DESK
51 4 WHEAT SWIVLE CHAIRS
52 20X50 MOBILE TABLE
30
07/28/05 200DB 7.00 HY17
38 DESK AND CHAIR
728111
08-23-07
05/13/05 200DB 7.00 HY17
Line
No.
37 REFRIGERATOR
C
o
n
v
3.00 HY16
Life
12/21/00 200DB 7.00 HY17
Method
26 FURNITURE
Date
Acquired
12/21/00 SL
Description
15 COMPUTER SOFTWARE
Asset
No.
FORM 990-PF PAGE 1
2007 DEPRECIATION AND AMORTIZATION REPORT
Bus
%
Excl
(D) - Asset disposed
373.
891.
564.
337.
481.
269.
676.
548.
720.
1,090.
1,514.
1,090.
2,180.
450.
2,482.
313.
16,668.
5,408.
Unadjusted
Cost Or Basis
990-PF
Section 179
Expense
*
Reduction In
Basis
53.
127.
81.
48.
69.
38.
97.
78.
103.
567.
787.
567.
1,134.
234.
963.
122.
13,526.
5,408.
Beginning
Accumulated
Depreciation
Current
Sec 179
Expense
91.
218.
138.
83.
118.
66.
165.
134.
176.
209.
291.
209.
418.
86.
434.
55.
3,142.
0.
Current Year
Deduction
144.
345.
219.
131.
187.
104.
262.
212.
279.
776.
1,078.
776.
1,552.
320.
1,397.
177.
16,668.
5,408.
Ending
Accumulated
Depreciation
* ITC, Salvage, Bonus, Commercial Revitalization Deduction, GO Zone
373.
891.
564.
337.
481.
269.
676.
548.
720.
1,090.
1,514.
1,090.
2,180.
450.
2,482.
313.
16,668.
5,408.
Basis For
Depreciation
09/13/07 200DB 7.00 HY19C
09/13/07 200DB 7.00 HY19C
09/13/07 200DB 7.00 HY19C
09/20/07 200DB 7.00 HY19C
10/18/07 200DB 5.00 HY19B
10/24/07 200DB 5.00 HY19B
11/15/07 200DB 7.00 HY19C
11/08/07 200DB 7.00 HY19C
11/08/07 200DB 7.00 HY19C
39.00 MM19I 159,246.
39.00 MM19I
10/04/07 SL
10/04/07 SL
10/04/07 SL
59 L SHAPED DESK
60 WORKRIGHT ADJUSTABLE BASE
61 WORKRIGHT ADJUSTABLE BASE
62 WARDROBE
63 DISHWASHER
64 COMPACTOR
65 WARDROBE
66 PANEL TRACK SYSTEM
67 PANEL TRACK SYSTEM
68 LEASEHOLD IMPROVEMENTS
DESIGN & MISC LEASEHOLD
69 COSTS
70 BAMBOO FLOORING
31
09/13/07 200DB 7.00 HY19C
58 DESK
728111
08-23-07
09/13/07 200DB 7.00 HY19C
57 DESK
39.00 MM19I
09/13/07 200DB 7.00 HY19C
Bus
%
Excl
990-PF
15,024.
25,685.
1,073.
1,688.
817.
450.
729.
648.
1,475.
1,099.
1,175.
630.
1,100.
870.
4,409.
1,625.
2,365.
Unadjusted
Cost Or Basis
56 WHITE BOARD
Line
No.
09/13/07 200DB 7.00 HY19C
C
o
n
v
55 CONFERENCE CHAIRS
Life
09/13/07 200DB 7.00 HY19C
Method
54 CONFERENCE TABLE
Date
Acquired
06/21/06 200DB 5.00 HY17
Description
53 IMAC 20/20
Asset
No.
FORM 990-PF PAGE 1
Section 179
Expense
*
Reduction In
Basis
473.
Beginning
Accumulated
Depreciation
Current
Sec 179
Expense
80.
137.
851.
153.
241.
117.
90.
146.
93.
211.
157.
168.
90.
157.
124.
630.
232.
757.
Current Year
Deduction
80.
137.
851.
153.
241.
117.
90.
146.
93.
211.
157.
168.
90.
157.
124.
630.
232.
1,230.
Ending
Accumulated
Depreciation
15,024.
25,685.
159,246.
1,073.
1,688.
817.
450.
729.
648.
1,475.
1,099.
1,175.
630.
1,100.
870.
4,409.
1,625.
2,365.
Basis For
Depreciation
32
11/20/07 200DB 5.00 HY19B
75 I PHONE
728111
08-23-07
11/20/07 200DB 5.00 HY19B
74 I PHONE
* TOTAL 990-PF PG 1 DEPR
02/27/07 200DB 5.00 HY19B
Line
No.
73 MACBOOK PRO 5 IC2D
C
o
n
v
39.00 MM19I
Life
02/27/07 200DB 5.00 HY19B
Method
72 IMAC LCD 24"
Date
Acquired
10/11/07 SL
Description
71 MARMOLEUM FLOORING
Asset
No.
FORM 990-PF PAGE 1
Bus
%
Excl
266,184.
526.
526.
2,499.
1,994.
4,477.
Unadjusted
Cost Or Basis
990-PF
Section 179
Expense
*
Reduction In
Basis
24,475.
Beginning
Accumulated
Depreciation
Current
Sec 179
Expense
11,600.
105.
105.
500.
399.
24.
Current Year
Deduction
36,075.
105.
105.
500.
399.
24.
Ending
Accumulated
Depreciation
266,184.
526.
526.
2,499.
1,994.
4,477.
Basis For
Depreciation
QUIXOTE FOUNDATION, INC. C/O ERIK M. HAN
39-1916960
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
}}}}}}}}}}
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 990-PF INTEREST ON SAVINGS AND TEMPORARY CASH INVESTMENTS STATEMENT
1
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
SOURCE
}}}}}}
BOND AMORTIZATION
BOND INTEREST
FIRST BUSINESS BANK
INCOME FROM SMITH ASSET MANAGEMENT GROUP
NORTHERN TRUST - 31794
NORTHERN TRUST US GOV'T 31794
SHOREBANK
AMOUNT
}}}}}}}}}}}}}}
-7,803.
4,192.
79.
3,732.
195,958.
11,600.
6,419.
}}}}}}}}}}}}}}
214,177.
~~~~~~~~~~~~~~
TOTAL TO FORM 990-PF, PART I, LINE 3, COLUMN A
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 990-PF
DIVIDENDS AND INTEREST FROM SECURITIES
STATEMENT
2
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
CAPITAL GAINS
COLUMN (A)
GROSS AMOUNT
DIVIDENDS
AMOUNT
}}}}}}}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}}
SOURCE
}}}}}}
INCOME FROM GREENLIGHT
PARTNERSHIP
INCOME FROM SMITH ASSET
MANAGEMENT GROUP
13,327.
TOTAL TO FM 990-PF, PART I, LN 4
4,006.
9,321.
9,406.
0.
9,406.
149,644.
0.
149,644.
440,421.
191,393.
249,028.
14,672.
0.
14,672.
484.
0.
484.
7,426.
0.
7,426.
}}}}}}}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}}
635,380.
195,399.
439,981.
~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 990-PF
OTHER INCOME
STATEMENT
3
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
(A)
REVENUE
DESCRIPTION
PER BOOKS
}}}}}}}}}}}
}}}}}}}}}}}}}}
K-1 GREENLIGHT
36,915.
OTHER LOSS
-1,708.
}}}}}}}}}}}}}}
TOTAL TO FORM 990-PF, PART I, LINE 11
35,207.
~~~~~~~~~~~~~~
10541111 798408 6042.FDN01
(B)
(C)
NET INVESTADJUSTED
MENT INCOME
NET INCOME
}}}}}}}}}}}} }}}}}}}}}}}}
36,915.
-1,708.
}}}}}}}}}}}} }}}}}}}}}}}}
35,207.
~~~~~~~~~~~~ ~~~~~~~~~~~~
33
STATEMENT(S) 1, 2, 3
39-1916960
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
}}}}}}}}}}
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 990-PF
LEGAL FEES
STATEMENT
4
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
DESCRIPTION
}}}}}}}}}}}
LEGAL FEES
TO FM 990-PF, PG 1, LN 16A
(A)
EXPENSES
PER BOOKS
}}}}}}}}}}}}
35,234.
}}}}}}}}}}}}
35,234.
~~~~~~~~~~~~
(B)
(C)
(D)
NET INVESTADJUSTED
CHARITABLE
MENT INCOME
NET INCOME
PURPOSES
}}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}
0.
35,234.
}}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}
0.
35,234.
~~~~~~~~~~~~ ~~~~~~~~~~~~ ~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 990-PF
ACCOUNTING FEES
STATEMENT
5
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
(A)
EXPENSES
DESCRIPTION
PER BOOKS
}}}}}}}}}}}
}}}}}}}}}}}}
ACCOUNTING FEES
20,460.
}}}}}}}}}}}}
TO FORM 990-PF, PG 1, LN 16B
20,460.
~~~~~~~~~~~~
(B)
(C)
(D)
NET INVESTADJUSTED
CHARITABLE
MENT INCOME
NET INCOME
PURPOSES
}}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}
10,230.
10,230.
}}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}
10,230.
10,230.
~~~~~~~~~~~~ ~~~~~~~~~~~~ ~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 990-PF
OTHER PROFESSIONAL FEES
STATEMENT
6
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
(A)
EXPENSES
DESCRIPTION
PER BOOKS
}}}}}}}}}}}
}}}}}}}}}}}}
INVESTMENT FEES
114,467.
OTHER PROFESSIONAL FEES
295,307.
}}}}}}}}}}}}
TO FORM 990-PF, PG 1, LN 16C
409,774.
~~~~~~~~~~~~
(B)
(C)
(D)
NET INVESTADJUSTED
CHARITABLE
MENT INCOME
NET INCOME
PURPOSES
}}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}
114,467.
0.
3,816.
291,491.
}}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}
118,283.
291,491.
~~~~~~~~~~~~ ~~~~~~~~~~~~ ~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 990-PF
TAXES
STATEMENT
7
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
(A)
EXPENSES
DESCRIPTION
PER BOOKS
}}}}}}}}}}}
}}}}}}}}}}}}
PAYROLL TAXES
17,097.
FOREIGN TAXES
5,868.
FEDERAL TAXES
8,000.
LICENSES & FEES
1,230.
}}}}}}}}}}}}
TO FORM 990-PF, PG 1, LN 18
32,195.
~~~~~~~~~~~~
10541111 798408 6042.FDN01
(B)
(C)
(D)
NET INVESTADJUSTED
CHARITABLE
MENT INCOME
NET INCOME
PURPOSES
}}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}
3,419.
13,678.
5,868.
0.
0.
0.
0.
1,230.
}}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}
9,287.
14,908.
~~~~~~~~~~~~ ~~~~~~~~~~~~ ~~~~~~~~~~~
34
STATEMENT(S) 4, 5, 6, 7
39-1916960
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
}}}}}}}}}}
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 990-PF
OTHER EXPENSES
STATEMENT
8
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
DESCRIPTION
}}}}}}}}}}}
BUSINESS INSURANCE
OFFICE EXPENSE
CONTRACT SERVICES
PAYROLL SERVICE FEE & MISC
STAFF EXP
DEVELOPMENT & EDUCATION
TO FORM 990-PF, PG 1, LN 23
(A)
(B)
(C)
(D)
EXPENSES
NET INVESTADJUSTED
CHARITABLE
PER BOOKS MENT INCOME
NET INCOME
PURPOSES
}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}
4,402.
880.
3,522.
35,775.
7,155.
28,620.
3,436.
687.
2,749.
3,273.
655.
2,618.
34,640.
6,928.
27,712.
}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}} }}}}}}}}}}}
81,526.
16,305.
65,221.
~~~~~~~~~~~ ~~~~~~~~~~~~ ~~~~~~~~~~~~ ~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 990-PF
OTHER INVESTMENTS
STATEMENT
9
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
VALUATION
METHOD
}}}}}}}}}
COST
DESCRIPTION
}}}}}}}}}}}
SEE ATTACHED DETAIL
TOTAL TO FORM 990-PF, PART II, LINE 13
FAIR MARKET
BOOK VALUE
VALUE
}}}}}}}}}}}}}} }}}}}}}}}}}}}}
20,573,097.
22,034,955.
}}}}}}}}}}}}}} }}}}}}}}}}}}}}
20,573,097.
22,034,955.
~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 990-PF
DEPRECIATION OF ASSETS NOT HELD FOR INVESTMENT
STATEMENT 10
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
DESCRIPTION
}}}}}}}}}}}
COMPUTER SOFTWARE
FURNITURE
REFRIGERATOR
DESK AND CHAIR
PALM PILOT (2)
APPLE IMAC G5
APPLE 12 IN POWERBOOK G4
HINGED DOOR CABINET
30X60 DESK
BOOKCASE
48X20 PREP TABLE
42" ROUND TABLE
4 RED/BLACK STACK CHAIRS
24X52 DESK
4 WHEAT SWIVLE CHAIRS
10541111 798408 6042.FDN01
COST OR
ACCUMULATED
OTHER BASIS
DEPRECIATION
BOOK VALUE
}}}}}}}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}}
5,408.
5,408.
0.
16,668.
16,668.
0.
313.
177.
136.
2,482.
1,397.
1,085.
450.
320.
130.
2,180.
1,552.
628.
1,090.
776.
314.
1,514.
1,078.
436.
1,090.
776.
314.
720.
279.
441.
548.
212.
336.
676.
262.
414.
269.
104.
165.
481.
187.
294.
337.
131.
206.
564.
219.
345.
891.
345.
546.
35
STATEMENT(S) 8, 9, 10
39-1916960
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
}}}}}}}}}}
20X50 MOBILE TABLE
373.
144.
229.
IMAC 20/20
2,365.
1,230.
1,135.
CONFERENCE TABLE
1,625.
232.
1,393.
CONFERENCE CHAIRS
4,409.
630.
3,779.
WHITE BOARD
870.
124.
746.
DESK
1,100.
157.
943.
DESK
630.
90.
540.
L SHAPED DESK
1,175.
168.
1,007.
WORKRIGHT ADJUSTABLE BASE
1,099.
157.
942.
WORKRIGHT ADJUSTABLE BASE
1,475.
211.
1,264.
WARDROBE
648.
93.
555.
DISHWASHER
729.
146.
583.
COMPACTOR
450.
90.
360.
WARDROBE
817.
117.
700.
PANEL TRACK SYSTEM
1,688.
241.
1,447.
PANEL TRACK SYSTEM
1,073.
153.
920.
LEASEHOLD IMPROVEMENTS
159,246.
851.
158,395.
DESIGN & MISC LEASEHOLD COSTS
25,685.
137.
25,548.
BAMBOO FLOORING
15,024.
80.
14,944.
MARMOLEUM FLOORING
4,477.
24.
4,453.
IMAC LCD 24"
1,994.
399.
1,595.
MACBOOK PRO 5 IC2D
2,499.
500.
1,999.
I PHONE
526.
105.
421.
I PHONE
526.
105.
421.
}}}}}}}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}}
TOTAL TO FM 990-PF, PART II, LN 14
266,184.
36,075.
230,109.
~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 990-PF
GRANTS AND CONTRIBUTIONS
STATEMENT 11
PAID DURING THE YEAR
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
RECIPIENT RELATIONSHIP RECIPIENT
AND PURPOSE OF GRANT
STATUS
AMOUNT
}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}} }}}}}}}}
NONE
PUBLIC
CHARITY
1,000.
P.O. BOX 22718, OKLAHOMA CITY, OK CONTRIBUTION IN MEMORY OF EVELYN
73123
"PATT" HANISCH
RECIPIENT NAME AND ADDRESS
}}}}}}}}}}}}}}}}}}}}}}}}}}
AMERICAN CANCER SOCIETY
ARTS WISCONSIN
NONE
BOX 1054, MADISON, WI 53704
PROJECT GIRL
ASSOCIATION OF SMALL FOUNDATIONS
NONE
1720 N STREET NW, WASHINGTON, DC
20036
ASSOCIATION GRANT
10541111 798408 6042.FDN01
PUBLIC
CHARITY
25,000.
PUBLIC
CHARITY
450.
36
STATEMENT(S) 10, 11
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
39-1916960
}}}}}}}}}}
BUSINESS LEADERS FOR SENSIBLE
PRIORITIES
194 BANK ST, 3RD FLR ,
BURLINGTON, VT 05401
NONE
PUBLIC
CHARITY
PROGRESSIVE INNOVATIONS PROJECT
CALIFORNIA VOTER FOUNDATION
NONE
2616 J STREET, SUITE 8,
SACRAMENTO, CA 95816
MANAGEMENT OF ELECTRONIC
VERIFICATION NETWORK LISTSERV
CALIFORNIA VOTER FOUNDATION
NONE
PUBLIC
CHARITY
ELECTRONIC VERIFICATION NETWORK
2616 J STREET, SUITE 8,
SACRAMENTO, CA 95816
CARE USA - WESTERN REGION
NONE
PUBLIC
CHARITY
GENERAL OPERATING SUPPORT
1402 3RD AVE, SUITE 912 ,
SEATTLE, WA 98101
CENTER FOR DIGITAL DEMOCRACY
NONE
PUBLIC
CHARITY
1718 CONNECTICUT AVE NW, SUITE
200, WASHINGTON, DC 20009
CENTER FOR INDEPENDENT MEDIA
NONE
1825 CONNECTICUT AVE. NW, SUITE
625, WASHINGTON, DC 20009
PUBLIC
CHARITY
FELLOWSHIP TO A PERSON OF COLOR
CENTER FOR SOCIAL JUSTICE
NONE
1325 FOURTH AVENUE, #940,
SEATTLE, WA 98101
RECLAIM THE MEDIA
CLIMATE SOLUTIONS
NONE
219 LEGION WAY SW, SUITE 201,
OLYMPIA, WA 98501
PUBLIC
CHARITY
PUBLIC
CHARITY
VAN JONES' HONORARIUM AT THE
ENVIRONMENT, THE ECONOMY, & A CLEAN
ENERGY JOB
COUNCIL ON FOUNDATIONS
NONE
2121 CRYSTAL DR., SUITE 700,
ARLINGTON, VA 22202
ASSOCIATION GRANT
10541111 798408 6042.FDN01
PUBLIC
CHARITY
PUBLIC
CHARITY
100,000.
20,000.
20,000.
25,000.
25,000.
15,000.
3,000.
2,000.
2,260.
37
STATEMENT(S) 11
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
EARTHJUSTICE
39-1916960
}}}}}}}}}}
NONE
426 17TH STREEET, 6TH FLOOR,
OAKLAND, CA 94612
PUBLIC
CHARITY
BUILDING SOCIAL CAPITAL IN THE
PACIFIC NORTHWEST
ELECTRONIC FRONTIER FOUNDATION
NONE
454 SHOTWELL ST., SAN FRANCISCO,
CA 94110
PUBLIC
CHARITY
NONE
CA 94110
PUBLIC
CHARITY
NONE
CA 94110
PUBLIC
CHARITY
ENVIRONMENTAL GRANTMAKERS
NONE
ASSOCIATION
55 EXCHANGE PLACE, SUITE 405, NEW ASSOCIATION GRANT
YORK, NY 10005
FOUNDATION FOR NATIONAL PROGRESS
(MOTHER JONES)
222 SUTTER ST., SUITE 600, SAN
FRANCISCO, CA 94108
NONE
(MOTHER JONES)
FRANCISCO, CA 94108
NONE
(MOTHER JONES)
FRANCISCO, CA 94108
NONE
FREE PRESS
NONE
P.O. BOX 28 , NORTHAMPTON, MA
01061
10541111 798408 6042.FDN01
PUBLIC
CHARITY
PUBLIC
CHARITY
THE VENTURE FUND
PUBLIC
CHARITY
PUBLIC
CHARITY
MOTHER JONES 30TH ANNIVERSARY EVENT
PUBLIC
CHARITY
25,000.
50,000.
20,000.
30,000.
500.
25,000.
25,000.
5,000.
75,000.
38
STATEMENT(S) 11
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
GRANTMAKERS FOR EFFECTIVE
ORGANIZATIONS
1413 K STREET NW, 2ND FLOOR,
WASHINGTON, DC 20005
NONE
ASSOCIATION GRANT
39-1916960
}}}}}}}}}}
PUBLIC
CHARITY
INSTITUTE FOR AGRICULTURE & TRADE NONE
PUBLIC
POLICY
CHARITY
2105 FIRST AVE. S. ,
MINNEAPOLIS, MN 55404
MIDWEST ENVIRONMENTAL ADVOCATES
551 W. MAIN ST. , MADISON, WI
53703
MOVEMENT STRATEGY CENTER
NONE
PUBLIC
CHARITY
NONE
1611 TELEGRAPH AVENUE, SUITE 510, YOUTH MEDIA COUNCIL
OAKLAND, CA 94612
PUBLIC
CHARITY
NATIONAL COALITION ON BLACK CIVIC NONE
PUBLIC
PARTICIPATION
CHARITY
1900 L STREET, NW, SUITE 700,
WASHINGTON, DC 20036
NATIONAL WILDLIFE FEDERATION
NONE
PUBLIC
CHARITY
11100 WILDLIFE CENTER DR. ,
RESTON, VA 20190
NATURAL RESOURCES DEFENSE COUNCIL NONE
PUBLIC
CHARITY
40 WEST 20TH ST., NEW YORK, NY
10011
NORTHERN CALIFORNIA GRANTMAKERS
625 MARKET ST., 15TH FLOOR, SAN
FRANCISCON, CA 94105
PUBLIC
CHARITY
FOUNDATION LIFE SPAN TOOLKIT:
BEYOND 5% PROJECT
NORTHWEST WOMEN'S LAW CENTER
NONE
907 PINE ST., STE. 500, SEATTLE,
WA 98101
10541111 798408 6042.FDN01
NONE
PUBLIC
CHARITY
REPRODUCTIVE RIGHTS THINK TANK
200.
25,000.
25,000.
20,000.
30,000.
25,000.
25,000.
15,000.
200,000.
39
STATEMENT(S) 11
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
POPULATION COMMUNICATIONS
INTERNATIONAL
777 UNITED NATIONA PLAZA, 5TH
FLR, NEW YORK, NY 10017
NONE
PROMETHEUS RADIO PROJECT
NONE
PUBLIC
CHARITY
P.O. BOX 42158, PHILADELPHIA, PA
19101
PUBLIC
CHARITY
PROTEUS FUND
NONE
101 UNIVERSITY DRIVE, SUITE A2,
AMHERST, MA 01002
MEDIA DEMOCRACY FUND
PUBLIC INTEREST PROJECTS
NONE
80 BROAD STREET, 16TH FLOOR, NEW
YORK, NY 10004
437 MADISON AVE, 37TH FLOOR, NEW
YORK, NY 10022
THE GULF COAST FUND
SIERRA CLUB OF BC FOUNDATION
NONE
304-733 JOHNSON STREET, VICTORIA, OUR ECOVILLAGE
BC, CANADA, V8W3C7
1402 3RD AVENUE, SUITE 500,
SEATTLE, WA 98101
THE WILDERNESS SOCIETY
720 THIRD AVE, SUITE 1800,
SEATTLE, WA 98104
10,000.
100.
PUBLIC
CHARITY
RESOURCE GENERATION
30,000.
PUBLIC
CHARITY
NONE
89 SOUTH STREET, SUITE 700,
BOSTON, MA 02111
5,000.
25,000.
PUBLIC
CHARITY
NONE
25,000.
PUBLIC
CHARITY
NONE
THIRD SECTOR NEW ENGLAND
10541111 798408 6042.FDN01
PUBLIC
CHARITY
PUBLIC
CHARITY
FUNDERS' COMMITTEE FOR CIVIC
PARTICIPATION
ROCKEFELLER PHILANTHROPY ADVISORS NONE
SIGHTLINE INSTITUTE
39-1916960
}}}}}}}}}}
PUBLIC
CHARITY
30,000.
25,000.
20,000.
40
STATEMENT(S) 11
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
UNITED CHURCH OF CHRIST
NONE
US FUND FOR UNICEF
NONE
VERIFIED VOTING FOUNDATION
NONE
WHITE CENTER COMMUNITY
DEVELOPMENT ASSOCIATION
4408 DELRIDGE WAY SW, SUITE 112,
SEATTLE, WA 98106
NONE
WOMEN'S DONOR NETWORK
NONE
1170 HAMILTON COURT, MENLO PARK,
CA 94025
ASSOCIATION GRANT
39-1916960
}}}}}}}}}}
PUBLIC
CHARITY
700 PROSPECT AVE, , CLEVELAND, OH NATIONAL CONFERENCE ON MEDIA REFORM
44115
DINNER
PUBLIC
CHARITY
625 N. MICHIGAN AVE., SUITE 1801, GENERAL OPERATING SUPPORT
CHICAGO, IL 60611
PUBLIC
CHARITY
P.O. BOX 4104, CARLSBAD, CA 92018 ELECTRONIC VERIFICATION NETWORK
PUBLIC
CHARITY
FUNDS TO MERGE THIRD WORLD MAJORITY
WITH YOUTH MEDIA INSTITUTE
TOTAL TO FORM 990-PF, PART XV, LINE 3A
10541111 798408 6042.FDN01
PUBLIC
CHARITY
150.
25,000.
30,000.
20,000.
2,650.
}}}}}}}}}}}}}}
1,107,310.
~~~~~~~~~~~~~~
41
STATEMENT(S) 11
39-1916960
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
}}}}}}}}}}
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 990-PF
GRANTS AND CONTRIBUTIONS
STATEMENT 12
APPROVED FOR FUTURE PAYMENT
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
RECIPIENT RELATIONSHIP RECIPIENT
AND PURPOSE OF GRANT
STATUS
AMOUNT
}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}} }}}}}}}}
NONE
PUBLIC
CHARITY
25,000.
1402 3RD AVE, SUITE 912, SEATTLE, GENERAL OPERATING SUPPORT
WA 98101
RECIPIENT NAME AND ADDRESS
}}}}}}}}}}}}}}}}}}}}}}}}}}
CARE USA - WESTERN REGION
EARTHJUSTICE
NONE
PUBLIC
CHARITY
BUILDING SOCIAL CAPITAL IN THE
PACIFIC NORTHWEST
426 17TH STREEET, 6TH FLOOR,
OAKLAND, CA 94612
(MOTHER JONES)
FRANCISCO, CA 94108
NONE
PUBLIC
CHARITY
(MOTHER JONES)
FRANCISCO, CA 94108
NONE
NATIONAL WILDLIFE FEDERATION
NONE
THE VENTURE FUND
PUBLIC
CHARITY
PUBLIC
CHARITY
11100 WILDLIFE CENTER DR.,
RESTON, VA 20190
NATURAL RESOURCES DEFENSE COUNCIL NONE
PUBLIC
CHARITY
40 WEST 20TH ST., NEW YORK, NY
10011
NORTHWEST WOMEN'S LAW CENTER
NONE
907 PINE ST., STE. 500, SEATTLE,
WA 98101
POPULATION COMMUNICATIONS
INTERNATIONAL
777 UNITED NATIONA PLAZA, 5TH
FLR, NEW YORK, NY 10017
10541111 798408 6042.FDN01
PUBLIC
CHARITY
REPRODUCTIVE RIGHTS THINK TANK
NONE
PUBLIC
CHARITY
25,000.
25,000.
50,000.
25,000.
25,000.
400,000.
25,000.
42
STATEMENT(S) 12
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
PROTEUS FUND
NONE
101 UNIVERSITY DRIVE, SUITE A2,
AMHERST, MA 01002
MEDIA DEMOCRACY FUND
ROCKEFELLER PHILANTHROPY ADVISORS NONE
437 MADISON AVE, 37TH FLOOR, NEW
YORK, NY 10022
THE GULF COAST FUND
THE WILDERNESS SOCIETY
NONE
720 THIRD AVE, SUITE 1800,
SEATTLE, WA 98104
US FUND FOR UNICEF
39-1916960
}}}}}}}}}}
PUBLIC
CHARITY
30,000.
PUBLIC
CHARITY
50,000.
PUBLIC
CHARITY
NONE
PUBLIC
CHARITY
625 N. MICHIGAN AVE., SUITE 1801, GENERAL OPERATING SUPPORT
CHICAGO, IL 60611
TOTAL TO FORM 990-PF, PART XV, LINE 3B
10541111 798408 6042.FDN01
25,000.
25,000.
}}}}}}}}}}}}}}
730,000.
~~~~~~~~~~~~~~
43
STATEMENT(S) 12
4562
Form
OMB No. 1545-0172
9
Department of the Treasury
Internal Revenue Service
Name(s) shown on return
Depreciation and Amortization
(Including Information on Listed Property)
See separate instructions.
Part I Election To Expense Certain Property Under Section 179
9
Attachment
Sequence No. 67
Attach to your tax return.
Business or activity to which this form relates
Identifying number
FORM 990-PF PAGE 1
39-1916960
Note: If you have any listed property, complete Part V before you complete Part I.
(a) Description of property
(b) Cost (business use only)
125,000.
1
2
3
4
5
Maximum amount. See the instructions for a higher limit for certain businesses ~~~~~~~~~~~~~~~~
Total cost of section 179 property placed in service (see instructions) ~~~~~~~~~~~~~~~~~~~~~
Threshold cost of section 179 property before reduction in limitation ~~~~~~~~~~~~~~~~~~~~~~
Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -0- ~~~~~~~~~~~~~~~~~~~
Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less, enter -0-. If married filing separately, see instructions !!!!!!!!!!
1
2
3
4
5
6
2007
990-PF
500,000.
(c) Elected cost
7 Listed property. Enter the amount from line 29 ~~~~~~~~~~~~~~~~~~~
7
8 Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 7 ~~~~~~~~~~~~~~
9 Tentative deduction. Enter the smaller of line 5 or line 8 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~
10 Carryover of disallowed deduction from line 13 of your 2006 Form 4562 ~~~~~~~~~~~~~~~~~~~~
11 Business income limitation. Enter the smaller of business income (not less than zero) or line 5 ~~~~~~~~~
12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 !!!!!!!!!!!!
13
13 Carryover of disallowed deduction to 2008. Add lines 9 and 10, less line 12 !!!!
Note: Do not use Part II or Part III below for listed property. Instead, use Part V.
9
8
9
10
11
12
Part II
Special Depreciation Allowance and Other Depreciation (Do not include listed property.)
Special
allowance
for qualified New York Liberty or Gulf Opportunity Zone property (other than listed property) and cellulosic
14
biomass ethanol plant property placed in service during the tax year ~~~~~~~~~~~~~~~~~~~~~~~~~~
15 Property subject to section 168(f)(1) election ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
16 Other depreciation (including ACRS) !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Part III MACRS Depreciation (Do not include listed property.) (See instructions.)
Section A
14
15
16
17
17 MACRS deductions for assets placed in service in tax years beginning before 2007 ~~~~~~~~~~~~~~
18 If you are electing to group any assets placed in service during the tax year into one or more general asset accounts, check here !!! J !
Section B - Assets Placed in Service During 2007 Tax Year Using the General Depreciation System
(a) Classification of property
19a
b
c
d
e
f
g
h
i
20a
b
c
Part
(b) Month and
year placed
in service
3-year property
5-year property
7-year property
10-year property
15-year property
20-year property
25-year property
(c) Basis for depreciation
(business/investment use
only - see instructions)
(d) Recovery
period
6,724. 5 YRS.
16,609. 7 YRS.
(e) Convention
(f) Method
HY
HY
200DB
200DB
(g) Depreciation deduction
25 yrs.
S/L
27.5 yrs.
MM
S/L
/
Residential rental property
27.5 yrs.
MM
S/L
/
MM
S/L
/
39 yrs.
Nonresidential real property
STATEMENT 13
MM
S/L
/
Section C - Assets Placed in Service During 2007 Tax Year Using the Alternative Depreciation System
Class life
12-year
40-year
IV Summary (see instructions)
/
12 yrs.
40 yrs.
MM
21 Listed property. Enter amount from line 28 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
22 Total. Add amounts from line 12, lines 14 through 17, lines 19 and 20 in column (g), and line 21.
Enter here and on the appropriate lines of your return. Partnerships and S corporations - see instr. !!!!!!!
23 For assets shown above and placed in service during the current year, enter the
portion of the basis attributable to section 263A costs!!!!!!!!!!!!!!!!
23
716251
LHA For Paperwork Reduction Act Notice, see separate instructions.
11-03-07
10541111 798408 6042.FDN01
6,790.
1,345.
2,373.
1,092.
S/L
S/L
S/L
21
22
11,600.
Form 4562 (2007)
44
39-1916960 Page 2
Form 4562 (2007)
Listed
Property
(Include
automobiles,
certain
other
vehicles,
cellular
telephones,
certain
computers,
and
property
used for entertainment,
Part V
recreation, or amusement.)
Note: For any vehicle for which you are using the standard mileage rate or deducting lease expense, complete only 24a, 24b, columns (a)
through (c) of Section A, all of Section B, and Section C if applicable.
Section A - Depreciation and Other Information (Caution: See the instructions for limits for passenger automobiles.)
24a Do you have evidence to support the business/investment use claimed? ! Yes ! No 24b If "Yes," is the evidence written?! Yes! No
(b)
(c)
(i)
(e)
(f)
(g)
(h)
(a)
(d)
Basis for depreciation
Date
Business/
Elected
Recovery
Depreciation
Type of property
Method/
Cost
or
(business/investment
placed in
investment
section 179
period
deduction
(list vehicles first )
Convention
other basis
use only)
use percentage
service
cost
25 Special allowance for qualified Gulf Opportunity Zone property placed in service during the tax year and
used more than 50% in a qualified business use!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
26 Property used more than 50% in a qualified business use:
%
%
%
27 Property used 50% or less in a qualified business use:
!
!
!
!
!
!
25
!
!
!
!
!
!
%
S/L %
S/L %
S/L 28
28 Add amounts in column (h), lines 25 through 27. Enter here and on line 21, page 1 ~~~~~~~~~~~~
29 Add amounts in column (i), line 26. Enter here and on line 7, page 1 !!!!!!!!!!!!!!!!!!!!!!!!!!!
Section B - Information on Use of Vehicles
29
Complete this section for vehicles used by a sole proprietor, partner, or other "more than 5% owner," or related person.
If you provided vehicles to your employees, first answer the questions in Section C to see if you meet an exception to completing this section for
those vehicles.
(a)
(b)
(c)
(d)
(e)
(f)
30 Total business/investment miles driven during the
Vehicle
Vehicle
Vehicle
Vehicle
Vehicle
Vehicle
year (do not include commuting miles) ~~~~~~
31 Total commuting miles driven during the year ~
32 Total other personal (noncommuting) miles
driven~~~~~~~~~~~~~~~~~~~~~
33 Total miles driven during the year.
Add lines 30 through 32~~~~~~~~~~~~
34 Was the vehicle available for personal use
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
during off-duty hours? ~~~~~~~~~~~~
35 Was the vehicle used primarily by a more
than 5% owner or related person? ~~~~~~
36 Is another vehicle available for personal
use? !!!!!!!!!!!!!!!!!!!!!
Section C - Questions for Employers Who Provide Vehicles for Use by Their Employees
Answer these questions to determine if you meet an exception to completing Section B for vehicles used by employees who are not more than 5%
owners or related persons.
37 Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting, by your
Yes
employees?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
38 Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your
employees? See the instructions for vehicles used by corporate officers, directors, or 1% or more owners ~~~~~~~~~~~~
39 Do you treat all use of vehicles by employees as personal use? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
40 Do you provide more than five vehicles to your employees, obtain information from your employees about
the use of the vehicles, and retain the information received? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
41 Do you meet the requirements concerning qualified automobile demonstration use? ~~~~~~~~~~~~~~~~~~~~~~~
Note: If your answer to 37, 38, 39, 40, or 41 is "Yes," do not complete Section B for the covered vehicles.
Part VI Amortization
(a)
(b)
(c)
(d)
(e)
(f)
Description of costs
Date amortization
begins
Amortizable
amount
Code
section
Amortization
period or percentage
No
Amortization
for this year
42 Amortization of costs that begins during your 2007 tax year:
! !
! !
43 Amortization of costs that began before your 2007 tax year ~~~~~~~~~~~~~~~~~~~~~~~~~~
44 Total. Add amounts in column (f). See the instructions for where to report !!!!!!!!!!!!!!!!!!!
716252/11-03-07
10541111 798408 6042.FDN01
43
44
Form 4562 (2007)
45
39-1916960
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
}}}}}}}}}}
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 4562
PART III - NONRESIDENTIAL REAL PROPERTY
STATEMENT 13
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
(A)
DESCRIPTION OF PROPERTY
}}}}}}}}}}}}}}}}}}}}}}}
LEASEHOLD IMPROVEMENTS
DESIGN & MISC LEASEHOLD COSTS
BAMBOO FLOORING
MARMOLEUM FLOORING
(B)
MO/YR
}}}}}
10/07
10/07
10/07
10/07
TOTAL TO FORM 4562, PART III, LINE 19I
10541111 798408 6042.FDN01
(C)
BASIS
}}}}}}}}}}}
159,246.
25,685.
15,024.
4,477.
}}}}}}}}}}}
204,432.
~~~~~~~~~~~
(D)
(G)
PERIOD
DEDUCTION
}}}}}}}} }}}}}}}}}}}
39.0 YRS
851.
39.0 YRS
137.
39.0 YRS
80.
39.0 YRS
24.
}}}}}}}}}}}
1,092.
~~~~~~~~~~~
46
STATEMENT(S) 13
Form 8868 (Rev. 4-2008)
Page 2
X
|!
" If you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part II and check this box ~~~~~~~~~~
Note. Only complete Part II if you have already been granted an automatic 3-month extension on a previously filed Form 8868.
" If you are filing for an Automatic 3-Month Extension, complete only Part I (on page 1).
Part II
Type or
print
File by the
extended
due date for
filing the
return. See
instructions.
Additional (Not Automatic) 3-Month Extension of Time. You must file original and one copy.
Name of Exempt Organization
Employer identification number
39-1916960
Number, street, and room or suite no. If a P.O. box, see instructions.
For IRS use only
City, town or post office, state, and ZIP code. For a foreign address, see instructions.
SEATTLE, WA
98107
Check type of return to be filed (File a separate application for each return):
! Form 990
! Form 990-EZ ! Form 990-T (sec. 401(a) or 408(a) trust)
X Form 990-PF ! Form 990-T (trust other than above)
! Form 990-BL !
!
!
Form 1041-A
Form 4720
!
!
Form 5227
Form 6069
!
Form 8870
STOP! Do not complete Part II if you were not already granted an automatic 3-month extension on a previously filed Form 8868.
" The books are in the care of | ERIK M. HANISCH, PRESIDENT
Telephone No. | (206) 783-5554
FAX No. |
" If the organization does not have an office or place of business in the United States, check this box~~~~~~~~~~~~~~~~ | !
" If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN)
. If this is for the whole group, check this
box | ! . If it is for part of the group, check this box | ! and attach a list with the names and EINs of all members the extension is for.
NOVEMBER 15, 2008.
4
I request an additional 3-month extension of time until
2007
5
For calendar year
, or other tax year beginning
, and ending
.
6
If this tax year is for less than 12 months, check reason: ! Initial return
! Final return
! Change in accounting period
7
State in detail why you need the extension
WAITING FOR INFORMATION FROM PASS-THRU INVESTMENTS.
8a
b
c
If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any
nonrefundable credits. See instructions.
If this application is for Form 990-PF, 990-T, 4720, or 6069, enter any refundable credits and estimated
tax payments made. Include any prior year overpayment allowed as a credit and any amount paid
previously with Form 8868.
Balance Due. Subtract line 8b from line 8a. Include your payment with this form, or, if required, deposit
with FTD coupon or, if required, by using EFTPS (Electronic Federal Tax Payment System). See instructions.
Signature and Verification
8a
$
13,424.
8b
$
21,503.
8c
$
0.
Under penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct, and complete, and that I am authorized to prepare this form.
Signature |
Title |
PRESIDENT
Date |
Form 8868 (Rev. 4-2008)
723832
04-16-08
10541111 798408 6042.FDN01
47

2007 Form 990PF - Quixote Foundation

Transcription

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