990-PF Return of Private Foundation990s.foundationcenter.org/990pf_pdf_archive/866/... · Fr L Form 990-PF Return of Private Foundation orSection 4947(aXl)NonexemptCharitable Trust

FrL

Form 990 - PF Return of Private Foundationor Section 4947(aXl) Nonexempt Charitable Trust

Treated as a Private Foundation

OMB No 1545-0052

2009Department of the TreasuryInternal Revenue Service Note : The foundation may be able to use a copy of this return to satisfy state reporting requirements

For calendar year 2009 , or tax year beginning , 2009, and ending

G Check all that apply : Initial return Initial Return of a former public charity Final return

Amended return Address change Name change

Use theA Employer Identification number

IRS label . WESTERN STATES LAND RELIANCE TRUST 86-6307810Otherwise , PO BOX 70165 B Telephone number (see the instructions)

aptp EUGENE , OR 97401 541 - 367-1641See Specific C If exemption application is pending, check hereInstructions.

D 1 Foreign organizations , check here

H Check type of organization : Section 501 (c)(3 exempt private foundation 2 Foreign organizations meeting the 85% test, check

Section 4947 (a)( 1 ) nonexem p t charitable trust X Other taxable p rivate foundation

qhere and attach computation 0.

Fair market value of all assets at end of year J Accounting method : M Cash Accrual E If private foundation status was terminatedunder section 507(b)(1)(A), check here

(from Part J), column (c), hne 16) Other ( s ecif ) - - - - - - - - - - - - -p y F If the foundation is in a 60 - month termination$ (Part 1, column (d) must be on cash basis under section 507 ( b)(1)(B), check here la- F^

Ana lysis o f Revenue an d (a) Revenue and (b) Net investment (c) Adjusted net (d) DisbursementsExpenses (The total of amounts in expenses per books income income for charitablecolumns (b), (c), and (d) may not neces - purposessarily equal the amounts in column (a) (cash basis only)(see the instructions)1 Contributions, gifts, grants , etc, received (aft sch) ss#f##f£#£££f!##s£ ##££`t£`s####£`t^££!i !: /f't## s££.!E't####£ #`sisss££#£# f s£## #r £'t£ £#££,f£ E

2 Ck FRI if the foundn is not req to aft Sch B „f,» , /,,, sf/,,, ff'/,'f,'.#J# »f„ f'/'s'fss „/,^/f,## ^ss ##£#^ss'fs„».,#££#f»I„»» »„

3 Interest on savings and temporary £ 5%f?;fr/ff{f^^`'s;fssscash investments {s!f/fiir,

4 Dividends and interest from securities %,ff ' # N#£ 's £,./f££#£#

5a Gross rents fs#s`£##;%s';#f## 's#

ental income f ss# "ss sf r# £{"#fs1`£f f , #'fiss c, # , s i,£# sf»„

s, s ff' f» ssssf „M ff s, 11 ££ ##r££

,^

y frs ££s »£f£ f fff»»»f£ f£ f #f u/: ££££££`

REr

s) fro sale of assets not on line 10 - 12,831 . f#'''.`•%f£f#f`^£f,##£f£f. '£s£!;{,tf£f£f£ff##f£t##{f£ ££ff, {f 'f££;ffi`,f',#fJf`.f###£ #%f£ff»»,»„

-- e Mr allassets on 3 , 991 . f,iss sss ss",xsssj , ,•s"' fffffs

ff:s ifs ,`,: f' ssF£££££, ff{,#s'/.ffsfs sssss»,,,N,,,, »,»»,,,,,,fsf sf

,`,^fs'f£'ff,sf ss ,ff ffl,f}y, ' ,f'fs£f:fsff£ff# f,'ff££f£ #£ f,:Gff,,:r»ff's•,fff, ' .s### ;l/ £#£"£f£f£# #fff

•Ij^g^ t^pp^ n e me (from Part IV , line 2) .s£^ ff%fff££f^S',^ff ££^ff'»»», ££'`f`f#'',^,f,f#fff£ £#f££#££z££££f£tss„ si#,»,,, „»f £s

.

`fkff ::%.'̀ ff#£'#f f»,ffr,'%s£#£»» ,,, , , r„f,f"

`8 `N ^SfibYt erm capital gain s£ {%fsf£?s ;{/`,, s,fi.`'s#sf£%s i£s£ssf'f ?f ?# £ %%%%f^£ #,"'%/fffrf',1`,%t

V 9 Income m I ations ;;£iiN{! sss''%!££ ss tiz#s{ #s`ss'£ £s; { sss £s: ssss}sue ;%s s's's:

,+ `

f£; {xss £ii }{i •i's%£ f'

e^f,£.f£', ,%f' `,f;f,f,#ff

7##%{%::i fs„{/ .,ff„ff£ s.'S£f », »t„ irisff sff s/ '

£fffffHl%f#fff.fl,,, f„f,,,,,,,s„f,

„f„ /,.ff ss f'

£ffs;+ff,s#f fff„££ #f#££#£££,f £i%#£££' £££ %G #£sf ££##£s

£#^ffsffff£ fff£££sf, ,,S ';„#f7•£##sfi,,,»,

#£#s#r` s#££f£ . £'#Ilow

oods sold

s£„ ,,,f!i£££#£s£

s,:,,,r,,,,,,, ,ft•ff££f'',''f £.'f./,„ ' ;ES'`>' ,. /, ,,fsssssss:sfssf,» »•»

y/,£ £,',^^s£

» s ssssf:f!/f# J£ffsf„f,f£££## .,f. {£3 #'f.:/l,££fffff:»»,sffssfss,,,{„ „ff,»f, , ,»,,,»,

#r s :f,# N

ss f"f',## #£%',`t „f,f£f£f£f,#f££#f##,,.»,#£££Y,,,,f f»»,,,,,,,^„^ „f »,», ,,,,»»,,,

fssf:ss f i

:fi: `sfs s'##J###ftf,,,f,:f,,,,.s%£f£,t ff „f,,,,,,,,.tsl,»» ...fsssssfsssssssfff' » »»„ »„f»»

c Gross profit/(loss ) ( att sch ) fr»sfffsssss'ffff, „rs ss>;££#££###£ sssssssftss __^»»,», ;s»y ,,,,,,N, f

%%i#f#s£;ss£"s£#sf#ff#£;^ :, 'ss%z f

11 Other income (attach schedule)_

s£s.'',#### ##y£ cfa#^^£

SEE STATEMENT 2 64 , 554 . f''''#`'ff„`h##N`'###£{ '

12 Total . Add lines 1 through 11 -248 , 277 . 0. 0 . '£££r£££ ~f##£####£££"`££££ s££%^£#f£z

13 Compensation of officers , directors , trustees, etc

14 Other employee salaries and wages

15 Pension plans , employee benefits

A 16a Legal fees (attach schedule) SEE ST 3 10 , 450.M b Accounting fees (attach sch ) SEE ST 4 16 , 900.

c Other prof fees (attach sch) SEE ST 5 9 , 218.20" S 17 Interest 5 , 745.

T 18 Taxes ( attach sdxdulexsee untr) SEE STM 6 200.aA A 19 Depreciation (attach £ffysfffsssff# ;

sch) and depletion . 27, 615. £C-n v 20 Occupancy 808.

E 21 Travel, conferences , and meetings 24 , 089.X 22 Printing and publications 739.

D p 23 Other expenses (attach schedule)

NSEE STATEMENT 7 76,637.

E 24 Total operating and administratives expenses. Add lines 13 through 23 172,401.

25 Contributions, gifts, grants paid PART XV 790 1 My 790.26 Total expenses and disbursements.

_

Add lines 24 and 25 173 , 191. 0 . 0. 790.27 Subtract line 26 from line 1 2 • sss^ f fss s'ffrsss#££f^£"££sf# ,, , ,^ s ,»<»,»»„»,»»s»»,G'r,^^sssss^,»»»

's££££££££^;f,####ssss££££'"# sssxx£s# `s, sf't^#^s,,;;,`ss's's#fiss"##ss is{ ssss, i#„ss

s,'ffs sss ss sff,ssssssss'££££^ £#, „f»»»,,,,,,,,»»»,»,,,s,»`f^s'^,fssss''^xr fftssssssr?££####£#s sN.,,;,;,rfs,,,,,,.s

ff x » s»»,^,» ,srf s , s , mm"#£f#f is s'# ^'• s

f ' „s£ssi s#f s £i#a Excess of revenue over expenses ,fff fsffssssxffxs fssss^xss„sx,4:``'^^'. s4f„ ```»r„ifs:` fff

,/ "s ?ifs ..s„f,"f„fss" ff sr.#JvfSand disbursements - 421,468 .++ ,##### ££%fff» N f fsNf,,,»f ,N f»„ f .££ f#fff#££ffff£N##x £#%:£ff f£,ffff. £f'»,f,., ^,,,»,»,ff,,, A f„»

b Net Investment Income (i f negative , enter -0•) ri£ ££££ N H ms£j£££i£#££ £## %f#%##` ££££#£r s #£{£ s£ ", ###sz##£sr sf # # z::sfs#ss !i $

{

C Adjusted net Income (i f negative , enter -0-) £££;££f£sfff+N £££; sf#s#£sss »' s "„#f» 'Mm sf '##£#£»„r. , fx

£ss s#sfffs „f„»,'f'f

ff •N'Nf s£s s £ 0 .

£sfsf s sF f f£ffXyss # s,

BAA For Privacy Act and Paperwork Reduction Act Notice, see the instructions. TEEA0504L ovovia Form -PF (2009)

2

Form 990-PF (2009) WESTERN STATES LAND RELIANCE TRUST 86-6307810 Pace 2Attached schedules and amounts in the description

l'' B ShK5 ,Beginning of year End o f year

eets column should be for end-of-year amounts onlya ance(See instructions ) (a) Book Value (b) Book Value (c) Fair Market Value

1 Cash - non-Interest-bearing 9 , 772. 801.

2 Savings and temporary cash investments 10. 10.

3 Accounts receivable ►----------

Less• allowance for doubtful accounts ►- - - - - - - - - -4 Pledges receivable ►

,,, •xsf ,,,,, , ,;`ss;irs Af`ssxr;xf;;;•,':ffsff z;,f

% ff ^,r,fsfs^ frf•r,xsssr,,,,,, „

• / i- - - - - - - ,,, ,,.,, is,,,,, s, ,,, ,:xxxfaf r,fffx s^ f ,..,,,,, r rir i ri r, f„f

Less: allowance for doubtful accounts ►----------

5 Grants receivable

6 Receivables due from officers , directors, trustees, and otherdisqualified persons (attach schedule ) ( see the instructions)

7 Other notes and loans receivable (attach sch) 01 r/•s''s :î!`si;;i#s` ;sl'i`sf 'tff,%•"s%'si%ss!f'si f;^^ri:is

S Less: allowance for doubtful accounts 01 15,071.

S----------

8 Inventories for sale or use

ET 9 Prepaid expenses and deferred charges

S 10a Investments - U.S. and state governmentobligations (attach schedule)

b Investments - corporate stock (attach schedule)

c Investments - corporate bonds (attach schedule)

11 Investments -land, buildings, and ;.i's's.'s.:s;/.::r• !::.f.? ?::f'ixGrifff s {sssx.....s fxssas:;i's sii,xsxxf f r rfrxx%,,,,f s' f

f' s`ss'tif%.f.,;.%.r .,,,,,,,A„f.,,.fxs.... .}f ri #,,,,,,,, „ ,,,rf

equipment basis ►- - - - - - - - - -,s, ., ssxss'sii'sfs„x'ss;sssx........ ,,xs' „^,^,,.r}.c..r•„s,,^••`•

f „xfx r Gr/i %', .fs.,ssf NNsf'ls's'tfs#'s sxf's`srci,x•cisf,.^s.cx,.,.

Less: accumulated depreciation(attach schedule) ►

----------12 Investments - mortgage loans

13 Investments - other (attach schedule)

__14 Land, buildings, and equipment basis 0, - - 6 ,45 6 ,63 5 .•fr,xxs•.xs••sx,fsss• xxffsxx

SS:fsff fff;fff^`'.xff:fr{/,s'.f•ssssf,5;,,;;;:.::::::,:::::rr:^G,.:.:•vsffxxxfsssxxsxxxxsssxsfssfxfffffffff' r fff'rffff'J,x'J,,.:::::'/^?f;;::f:,:::.:::.yx•

xs^fffffff•ss•s, x•sxfxf•,;•sfrr{"ff,•ffff;/.;{;i ff'`,s, fffsf%•Sf{,:{.f:%:.::y::fs:./:f:r::{

Less accumulated depreciation(attach schedule ) SEE STMT 8 ► 21 9 ,92 3 . 6, 580, 479. 6,236,712._ _ _

15 Other assets (describe ► SEE STATEMENT 9 ) 1,275. 975.----------------16 Total assets (to be completed-by all filers --

see instructions Also, see page 1, item I 6, 606, 607. 6,238 , 498. 0.L 17 Accounts payable and accrued expenses f "`' f';fxiffsssfr^

A18 Grants pay

able xssffsf.ffis;#sfss•sf'fs%%{szs?#y;`si's;^:%?#s„fs^s's`t4's's'

B 19 Deferred revenue f frxf ^ffsf'si's's'zs ;

L20 Loans from officers, directors, trustees , & other dis q ualified persons ST 10 98 807. 199 058.

f xx

if{ffffffffSff:;;'1.'fr}f N+;'`',,•r,Sf,

I 21 Mortgages and other notes payable (attach schedule ) STMT 11 88 , 765. 59,388. ............ r s # •sffsx .r 22 Other liabilities (describe ► SEE STATEMENT 12 ) 738.81 64 223.

. . ., ,

S 23 Total liabilities (add lines 17 through 22) 269 310. 322 669. " J %, , ?y s { fFoundations that follow SFAS 117, check here X ,{sf;;fs s• x»„srr,,x,^x.r f/ f sx' Momi"and complete lines 24 through 26 and lines 30 and 31 . sfff xfiirf% fx" s sx y

^s;.fsfff^,;^'S '̂ `' ^

N F 24 Unrestricted 6,337,297 . .5,915,829:yS,^^•,f` •̂ ^îYr•,r55

j/E U,,.... ,, xf r^fzsxr sfss ssr

' `' '"T N 25 Temporarily restricted ,rr,,fff}x s. Nfs xxf f:,?issfssf

D 26 Permanently restricted 'Z {%?%s{ i$ f %%AS B Foundations that do not follow SFAS 117, check here ► E

s fsf:sts^s%••,f;; fs fsf %! #? j; fand complete lines 27 through 31. xfj`fr' ,,, Gtr 'xx xr

%i :;fXNNrE L

T A 27 Capital stock, trust principal, or current fundsr , cr/r;'sf'si

^• , ^ ip 'rrS N or land and eq ui pment fund28 Paid-in or cap ital surp lus buildin g

f^, x^{̂ ; ^ N y^ {^yy.7"'xfiz??....-•; ff"kfff § r

`.... "'s' x s, ,, %si rsss . ;•, ss# s f s

sf'f; '' % ' ! ff# • {r0 E accumulated income, endowment, or other funds29 Retained earnin g s,

$;% %s; ...- cf fs ..' rrsssss

ii '' i:':# M%{'s "r if 4R S 30 Total net assets or fund balances (see the instructions) 6, 337, 297. 5, 915, 829. ss f s st rrsP,,fxfxfff;,ffff;,..,'.lt;ff^;fffff•

31 Total liabilities and net assets/fund balances sff#`s^ffif$fffzf ` f" ' `

see the instructions) 6,606,607 . .6,238,498..'ff f f fx

fffxfx;f„sf;;;!IH011-1- ,1 Analysis of Chan ges 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 withend-of-year figure reported on prior year's return) 1 6 f 337 , 297.

2 Enter amount from Part I, line 27a . . 2 -421 , 468.

3 Other increases not included in line 2 ( itemize ) ► 3__________________________

4 Add lines l , 2, and 3 4 5 , 915 , 829.5 Decreases not included in line 2 ( itemize) ►

-5

-----------------------------6 Total net assets or fund balances at end of year (line 4 minus line - Part II, column (b) , line 30 6 5 , 915, 829.

BAA TEEA03o2L 07r01 Form 990-PF (2009)

Form 990-PF (2009) WESTERN STATES LAND RELIANCE TRUST 86-6307810 Page 3

MEW-WO Capital Gains and Losses for Tax on Investment I ncome(a) List and describe the kind (s) of property sold (e . g., real estate,

2-story brick warehouse; or common stock , 200 shares MLC Company)(b) How acquired

P - PurchaseD - Donation

(c) Date acquired(month , day, year)

(d) Date sold(month, day, year)

l a N/Ab

c

d

e

(e) Gross sales price (f) Depreciation allowed(or allowable )

(g) Cost or other basisplus expense of sale

(h) Gain or (loss)(e) plus (f) minus (g)

a

b

c

d

e

Comp lete only for assets showin g gain in column (h) and owned by the foundation on 12/31/69 ( I) Gains (Column (h)(i) Fair Market Value

as of 12131/69(jj) Adjusted basisas of 12/31/69

(k) Excess of column ( i)over column Q), if any

gain minus column ( k), but not lessthan - 0-) or Losses (from column (h))

a

b

c

d

e

2 Capital gain net income or (net capital loss). Elf gain, also enter in Part I, line 7If (loss), enter - 0- in Part I, line 7 2

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) (see the instructions). If (loss), enter -0-in Part I, line 8 3

Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.) N/A

If section 4940(d)(2) applies, leave this part blank.

Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period? ElYes No

If 'Yes,' the foundation does not qualify under section 4940 (e) Do not complete this part.

1 Enter the aoorooriate amount in each column for each year : see the instructions before making any entries

(a)Base period years

Calendar year (or tax yearbeginning in)

(b)Adjusted qualifying distributions

(c)Net value of

noncharitable-use assets

(d)Distribution ratio

(column (b) divided by column (c))

2008

2007

2006

2005

2004

2 Total of line 1, column (d) 2

3 Average distribution ratio for the 5-year base period - divide the total on line 2 by 5, or by thenumber of years the foundation has been in existence if less than 5 years 3

4 Enter the net value of nonchantable-use assets for 2009 from Part X, line 5 4

5 Multiply line 4 by line 3 5

6 Enter 1 % of net investment income (1 % of Part I, line 27b) 6

7 Add lines 5 and 6 .. .. 7

8 Enter qualifying distributions from Part XII, line 4 8

If line 8 is equal to or greater than line 7, check the box in Part VI, line 1 b, and complete that part using a 1 % tax rate . See thePart VI instructions.

BAA Form 990-PF (2009)

TEEA0303L 07/06/09


ON Excise Tax Based on Investment Income (Section 4940(a) , 4940(b), 4940(e), or 4948 - see the instructions

1 a Exempt operating foundations described in section 4940(d)(2), check here and enter 'N/A: on line 1

Date of ruling or determination letter: _ _ _ _ _ _ _ (attach copy of letter if necessary - see instr.)

b Domestic foundations that meet the section 4940(e) requirements in Part V, 1 0.

check here and enter I% of Part I, line 27b ^^^^%^f^f^/j^'•,^^

c All other domestic foundations enter 2% of line 27b Exempt foreig n organizations enter 4% of Part I, line 12, column (b)

2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable %'%%^foundations only. Others enter -0-) 2 0.

3 Add lines 1 and 2 3 0.

4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only Others enter -0-) 4 0.

5 Tax based on investment income . Subtract line 4 from line 3. If zero or less, enter -0- 5 0.

6 Credits/Payments: ^zffigggmlg̀ %iifi

a 2009 estimated tax pmts and 2008 overpayment credited to 2009 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 0.

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 . 0. 9 0.

10 Overpayment . If line 7 is more than the total of lines 5 and 8, enter the amount overpaid 01 10

11 Enter the amount of line 10 to be Credited to 2010 estimated tax Refunded ► 11

„4 - Statements Reaardina Activities

1 a During the tax year, did the foundation attempt to influence any national, state, or local legislation or did itparticipate or intervene in any political campaign?

b Did it spend more than $100 during the year (either directly or indirectly) for political purposes(see the instructions for definition)?

If the answer is 'Yes' to 7a or 1b, attach a detailed description of the activities and copies of any materials publishedor 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:

(1) On the foundation No. $ 0. (2) On foundation managers N. $

e Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed on

foundation managers M. $ 0.

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, articlesof 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?

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 conflictwith 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 11, column (c), and PartXV

8a Enter the states to which the foundation reports or with which it is registered (see the instructions)

OR

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 ) of each state as required by General Instruction G? If No,'attach explanation

9 Is the foundation claiming status as a private operating foundation within the meaning of section 49420)(3) or 49420)(5)for calendar year 2009 or the taxable year beginning in 2009 (see instructions for Part XIV)? If 'Yes,' complete Part XIV

10 Did any persons become substantial contributors during the tax year ? If 'Yes,' attach a schedule listing their names

BAA

2 1 I X

3 X4a X

4b N VA5 X

s ; zNz#i'..'s psi ss,

6 X7 X

8b1 X

9 1 I X

Form 990-PF (2009)

111119,11 Yes No

1a X

1b X

1c X

0 F1 T", 7erg

TEEA0304L 07106/09

Form 990=PF (2009) WESTERN STATES LAND RELIANCE TRUST 86-6307810 Page 5

Statements Reg arding Activities ContinuedEWA'

11 At any time during the year, did the foundation, directly or indirectly, own a controlled entitywithin the meaning of section 512(b)(13)? If 'Yes', attach schedule (see instructions) 11 X

12 Did the foundation acquire a direct or indirect interest in any applicable insurance contract beforeAugust 17, 2008? 12 X

13 Did the foundation comply with the public inspection requirements for its annual returns and exemption application? 13 X

Website address N/A

14 The books are in care of ► DIXSON PROFESSIONAL CORP. _ _ _ _ _ _ _ _ _ Telephone no. ► 541 _484 =1195--------------------

_2_67_7__WI_L_L_AK_E_N_ZI_E__RD__S_TE__1_AL EUG_E_N_EL OR______ ZIP+4 _9_74_0_1____IT15 Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 - Check here N./A EF

and enter the amount of tax-exem pt interest received or accrued durin g the year 15 N/A

ar ' Statements Reg arding Activities for Which Fonn 4720 May Be Required

File Form 4720 if any item is checked in the 'Yes' column , unless an exception applies . Yes No

1 a 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? LIYes No 00 , O

(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)a-«"`disqualified person? Yes X No j,,

Furnish goods, services, or facilities to (or accept them from) a disqualified person? Yes X No `

(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person Yes X No fr;i

(5) Transfer any income or assets to a disqualified person (or make any of either availablefor the benefit or use of a disqualified person)? EYes XNNo%171

{ zf:(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 termination ''s %``s#'si;-• :??fof government service, if terminating within 90 days.) LIYes []No

-Z g_

b If any answer is 'Yes' to la(1)-(6), did any of the acts fail to qualify under the exceptions described in %%% = f }Regulations section 53.4941(d)-3 or in a current notice regarding disaster assistance (see the instructions)? 1 b N A

Organizations relying on a current notice regarding disaster assistance check here

c Did the foundation engage in a prior year in any of the acts described in 1 a, other than excepted acts,that were not corrected before the first day of the tax year beginning in 2009? 1C X

2 Taxes on failure to distribute income (section 4942) (does not app ly for years the foundation was a „%

private operating foundation defined in section 49420)(3) or 49420)(5 %%

a At the end of tax year 2009, did the foundation have any undistributed income (lines 6d f %%f£fand 6e, Part XI I I) for tax year(s) beginning before 2009. LI Yes No gfflg

If 'Yes,' list the years 20 , 20 , 20 , 20 s# 's%'''s ;s;;f*

b Are there any years listed in 2a for which the foundation is not app lyin g the provisions of section 4942 (a)(2)Y Y sJSf's' sss^'s#s #^^r`ss^(relating to incorrect valuation of assets) to the year's undistributed income? (If applying section 4942(a)(2) toall years listed, answer 'No' and attach statement - see the instructions) 2b N A

#'sst;:ssc If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.

20 20 20 20

3a Did the foundation hold more than a 2% direct or indirect interest in any business '"""" •s•'`; `'s``s`senterprise at any time during the year? Yes No

b If 'Yes,' did it have excess business holdings in 2009 as a result of (1) any purchase by the foundationor disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved s#Ns# l --'- frby 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, Form 4720, todetermine if the foundation had excess business holdings in 2009) 3b N A

4a Did the foundation invest during the year any amount in a manner that would jeopardize itscharitable purposes' 4a X

b Did the foundation make any investment in a prior year (but after December 31, 1969) that couldjeopardize its charitable purpose that had not been removed from jeopardy before the first day of -N` i::: ": s'y' =•

the tax year beginnin g in 2009? 4b X


TEEA0305L 07/06/09

Form 990=PF (2009) WESTERN STATES LAND RELIANCE TRUST 86-6307810 Page 6,:^ Statements Regarding Activities for Which Form 4720 May Be Req uired (continued)5a During the year did the foundation pay or incur any amount to: ss"ssss' /iii %s,

/X .(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? Yes No /;j

p/ f(2) Influence the outcome of any specific public election (see section 4955); or to carry ^, is^ssi ^s^fon, directly or indirectly, any voter registration drive? ... B Yes IX No

,%%,si(3) Provide a grant to an individual for travel, study, or other similar purposes? Yes No ! i%

(4) Provide a grant to an organization other than a charitable, etc, organization described s•%ifss r , rs','in section 509 (a)( 1 ). (2), or (3), or section 4940(^(2)• (see instructions) [ Yes No f'r'r '•%^ %

sniff f^'s i %(5) Provide for any purpose other than religious, charitable, scientific, literary, or Vs,•s,

educational purposes, or for the prevention of cruelty to children or animals? [ Yes No ^^fss ,'s{%i s

b If any answer is 'Yes' to 5a(1)-(5), did any of the transactions fail to q uali fy under the exceptions " jssr "`mss'

described in Regulations section 53.4945 or in a current notice regarding disaster assistance(see instructions)? 5b N A

disaster assistance check hereOrganizations relying on a current notice regarding %'s,`î%% ',110, r.^fr j

c If the answer is 'Yes' to question 5a(4), does the foundation claim exemption from thetax because it maintained expenditure responsibility for the grant? NJA [Yes 11 No

ZVZZ

#%^s,s"s !s mvI,^;;/srs^^ s%r,^ ^^;ssss

If 'Yes , ' attach the statement required by Regulations section 53 4945-5(d) sssss''ss% s ri`

s r ys%6a Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums

l b f t t t? [ Y X] N

%£ îs% sssss%^ss pi s'' s,} Eon a persona ene i con rac es o ,

b Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? 6b X

If 'Yes' to 6b, file Form 8870sr/ors .is 1 {

' ,{ f

7a At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction? []Yes XjNo

b If as, did the foundation receive any proceeds or have any net income attributable to the transaction? 7b NVAt !;: I n formation About Officers , D irectors , Tru es , Foundation Managers ,

and Contractors1 I it all nffirnrc dirnrtnre tntctaac fnundatinn manannrc and their rmmnancatinn (cep inctnurtinncl

(b) Title and average (c) Compensation (d) Contributions to (e) Expense account,

(a) Name and address hours per week (If not paid , enter -0-) employee benefit other allowancesdevoted to position plans and deferred

com pensation

-DANIEL DESLER _ _ _ _ _ _ _ _ _ _ _ _ _ TRUSTEE 0. 0. 0.401 MAIN STREET 40.00SWEET HOME , OR 97386DENNIS CUNNING------------------

- -TRUSTEE 0. 0. 0.

5133 NORTH CENTRAL AVE STE 10 2 0.50PHOENIX , AZ 85012BILL DWYER---------------------- TRUSTEE 0. 0. 0.5558 THURSTON ROAD 0.50SPRINGFIELD, OR 97478

-------------------------

2 Compensation of five highest-paid emolovees (other than those included on line 1- see instructions). If none. enter 'NONE.'

(a) Name and address of each employeepaid more than $50,000

(b) Title and averagehours per week

devoted to position

(c) Compensation (d) Contributions toemployee benefitplans and deferred

compensation

(e) Expense account,other allowances

NONE ---------------

------------------------

------------------------

------------------------

------------------------

Total number of other employees paid over $50,000 0BAA MEAM011 V/ g Form 990-PF (2009)

Form 990-PF (2009) WESTERN STATES LAND RELIANCE TRUST 86-6307810 Page 7Information About Officers , Directors, Trustees, Foundation Managers , Highly Paid Employees,and Contractors (continued)

3 Five highest-Paid independent contractors for professional services - (see instructions). If none,enter 'NONE.

(a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation

NONE--------------------------------------

--------------------------------------

--------------------------------------

--------------------------------------

--------------------------------------

Total number of others receivin g over $50,000 for professional services 0

,r^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 I Expensesorganizations and other beneficiaries served, conferences convened, research papers produced, etc.

1 N/A------------------------------------------------------

2------------------------------------------------------

3------------------------------------------------------

4------------------------------------------------------

------------------------------------------------------

Summary of Program -Related Investments (see instructions)

Describe the two larg est pro gram - related investments made by the foundation during the tax year on lines 1 and 2 Amount

1 N/A------------------------------------------------------------------------------------------------------------

2------------------------------------------------------

------------------------------------------------------

All other program-related investments. See instructions.

3------------------------------------------------------------------------------------------------------------

Total . Add lines 1 through 3 0.


TEEA0307L 07/06/09

Form 990-PF (2009) WESTERN STATES LAND RELIANCE TRUST 86-6307810 Paqe 8

W/NeWMA5 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:a Average monthly fair market value of securities 1 a

b Average of monthly cash balances 1 b

c Fair market value of all other assets (see instructions) 1 c

d Total (add lines la, b, and c) 1 d 0.

e Reduction claimed for blockage or other factors reported on lines 1a and 1c

(attach detailed explanation) 1 e

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 0.

6 Minimum investment return . Enter 5% of line 5 6 0.

Distributable Amount (see instructions) (Section 49420)(3) and (j)(5) private operating foundationsWWIand certain forei g n organizations check here and do not com p lete this art.

1 Minimum investment return from Part X, line 6 1

2a Tax on investment income for 2009 from Part VI, line 5 2a

b Income tax for 2009. (This does not include the tax from Part VI.) 216 1

c Add lines 2a and 2b 2c

3 Distributable amount before adjustments. Subtract line 2c from line 1 3

4 Recoveries of amounts treated as qualifying distributions 4

5 Add lines 3 and 4 5

6 Deduction from distributable amount (see instructions) 6

7 Distributable amount as adj usted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 7 0.

Qualifying Distributions (see instructions)

1 Amounts paid (including administrative expenses) to accomplish charitable, etc, purposesa Expenses, contributions, gifts, etc - total from Part I, column (d), line 26 1 a 790.

b Program-related investments - total from Part IX-B 1 b

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)

s !{3a

b Cash distribution test (attach the required schedule) 3b

4 Qualifying distributions . Add lines la through 3b. Enter here and on Part V, line 8, and Part XIII, line 4 4 790.

5 Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment income.Enter 1% of Part I, line 27b (see instructions) 5

6 Adjusted qualifying distributions . Subtract line 5 from line 4 6 790.

Note : The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whethqualifies for the section 4940(e) reduction of tax in those years.

er the foundation


TEEA0308L 07/06/09


Undistributed Income (see instructions)

1 Distributable amount for 2009 from Part Xl,line 7

2 Undistributed income, if any, as of the end of 2009.

a Enter amount for 2008 only

b Total for prior years . 20_, 20 _, 20

3 Excess distributions carryover , if any, to 2009-

a From 2004

b From 2005

c From 2006

d From 2007 2,850.

e From 2008

f Total of lines 3a through e.

4 Qualifying distributions for 2009 from Part

XII, line 4: 11 $ 790.

a Applied to 2008, 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 2009 distributable amount

e Remaining amount distributed out of corpus

5 Excess distributions carryover applied to 2008(If an amount appears in column (d), thesame amount must be shown in column (a) )

6 Enter the net total of each column asindicated below:

a Corpus Add lines 3f, 4c, and 4e. Subtract line 5

b Prior years' undistributed income. Subtractline 4b from line 2b

c Enter the amount of prior years' undistribut-ed income for which a notice of deficiencyhas been issued, or on which the section4942(a) tax has been previously assessed

d Subtract line 6c from line 6b. Taxableamount - see instructions

e Undistributed income for 2008. Subtract line 4a fromline 2a Taxable amount - see instructions

f Undistributed income for 2009. Subtract lines4d and 5 from line 1. This amount must bedistributed in 201Q

7 Amounts treated as distributions out ofcorpus to satisfy requirements imposedby section 170(b)(1)(F) or 4942(g)(3)(see instructions)

8 Excess distributions carryover from 2004 notapplied on line 5 or line 7 (see instructions)

9 Excess distributions carryover to 2010.Subtract lines 7 and 8 from line 6a

10 Analysis of line 9:

a Excess from 2005

b Excess from 2006

c Excess from 2007 2 , 850.

d Excess from 2008

e Excess from 2009 790.

BAA

(a) b (c) (d

Corpus Years prior to 2008 2008 2009

0.

0.0.

2,850.

0.

0.

790.0.

0.

0.

3,640.

0.

0.

0.

0.

0.

0.

0.

3.640.

Form 990-PF (2009)

TEEA0309L 07/06/09

Form 990-PF (2009) WESTERN STATES LAND RELIANCE TRUST 86-6307810 Page 10Private Operating Foundations (see instructions and Part VII-A q uestion 9) N/A

1 a If the foundation has received a ruling or determination letter that it is a private operating foundation, and the rulingis effective for 2009, enter the date of the ruling 10.

b Check box to indicate whether the foundation is a private operating foundation described in section 4942) or 49420)(5)

2a Enter the lesser of the adjusted net Tax year Prior 3 yearsincome from Part I or the minimum (a) 2009 (b) 2008 (c) 2007 (d) 2006 (e) Totalinvestment return from Part X foreach year listed

b 85% of line 2a

c Qualifying distributions from Part XII,line 4 for each year listed

d Amounts included in line 2c not used directlyfor active conduct of exempt activities

e Qualifying distributions made directlyfor active conduct of exempt activities.Subtract line 2d from line 2c

3 Complete 3a, b, or c for thealternative test relied upon:

a 'Assets' alternative test - enter:

(1) Value of all assets

(2) Value of assets qualifying undersection 49420)(3)(6)0

b 'Endowment ' alternative test - enter 2/3 ofminimum investment return shown in Part X,line 6 for each year listed

c 'Support' alternative test - enter:

(1) Total support other than grossinvestment income (interest,dividends, rents, paymentson securities loans (section512(a)(5)), or royalties)

(2) Support from general public and 5 ormore exempt organizations as providedin section 49420)( 3)(B)(iii)

(3) Largest amount of support froman exempt organization

(4) Gross investment income

Supplementary Information (Complete this part only if the organization had $5, 000 or more inassets at any time during the year - see instructions.)

1 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 theclose of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2) )

NONE

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 ofa 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:

Check here ► F] if the foundation only makes contributions to preselected charitable organizations and does not accept unsolicited

requests for funds. If the foundation makes gifts, grants, etc, (see instructions) to individuals or organizations under other conditions,complete items 2a, b, c, and d.

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:

BAA TEEAMIou 07/D6/D9 Form 990-PF (2009)

Form 990-PF (2009) WESTERN STATES LAND RELIANCE TRUST 86-6307810 Page 11{- -..... _ Supplementary Information (continued)

3 Grants and Contributions Paid Durina the Year or Aoeroved for Future Payment

RecipientIf recipient is an individual ,show any relationship to Foundation Purpose of grant or

any foundation manager or status of contribution Amountrecipient

Name and address (home or business) substantial contributor

a Paid during the year

SWEET HOME RODEO NONE SUPPORT 40.4001 LONG STREETSWEET HOME, OR 97386

THE OREGON JAMBOREE NONE SUPPORT 750.PO BOX 430SWEET HOME, OR 97386

Total 3a 790.

b Approved for future payment

Total . 3bl

BAA TEEA0501L 07m6M9 Form 990-PF (2009)

Form '990-PF (2009) WESTERN STATES LAND RELIANCE TRUST 86-6307810 Page 12

;' fF "' Analysis of Income -Producing Activities

Enter

1

a

I:

C

C

C

f

c

2

3

4

5

a

b

6

7

8

9

10

11

a

b

c

d

e

12

gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514

rogram service revenue :

(a)Businesscode

(b)Amount

(c)Exclu -sioncode

(d)Amount

(e)Related or exemptfunction income

see the instructions)

Fees and contracts from government agencies

Membership dues and assessments

Interest on savings and temporary cash investments 15

Dividends and interest from securities

Net rental income or (loss) from real estate :

Debt-financed property

i ` F"; r F%%••• ^Y •••,,,,,i,^{l{f,•,• f :f{'s's'tFS:s't 'ssFFF;s'ssiss:?sssFs's/'s""" } {fFFfr^FFF,sFxffsff'si`siFFfFFF^•r.Fff;F{FF/.F'ssf 'sFS•••••„/},,,,,,,^^•

i sssf"rfsr'sF iiif FFS'si s sr.••••!/{}•••••••••• }}f••••,• •,•F•,,,,,,,,,,^,,,,,,,,FFFFf,,,,,,,,,^„ 'F 's's'sfF'sf:: ii ,//s/!:...... ..i'FiFFFf!i^;;f^^sFFFFF^Fff :ffz/•:

28 , 629.Not debt-financed property

Net rental income or (loss) from personal property

Other investment income

Gain or ( loss) from sales of assets other than inventory - 312, 831.

Net income or (loss) from special events.

Gross profit or (loss) from sales of inventory

Other revenue : :FY;;;;F,F„^^__

: ,.5, F.FF.Ff•f ffS^Sf, f::FF'{//f S;.%„•F,,, ,FffiFFFF, , „ ••l,fF^„ffSf „ F :ffff ,•,f• Sfff f,S;",.,.,Ff S.f;,,,,,,,,,,,,,,,, "{,,,^{ ^^^'f S^:^F:; { :Sil'OS'S`,:'{},;:F^;;F {:Jl ,'FF. S,,, ^,.F,,,S,., „F

Subtotal. Add columns (b), (d), and (e) {s%%`sz%%%% -284, 202.

13 Total . Add line 12, columns (b), (d), and (e) 13 -284,202.

(See worksheet in the instructions for line 13 to verify calculations )

Relationship of Activities to the Accomplishment of Exempt Purposes

Line No . Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to thet accomplishment of the foundation's exempt purposes (other than by providing funds for such purposes) (See the instructions )

97A RENTAL OF FACILITY PRESERVES THE FACILITY AS WELL AS THE LAND. IN ADDITION TO

PROVIDING RENTAL INCOME, IT ALSO PROVIDES ACTIVITY THAT DETERS VANDALISM.

BAA TEEA0502L 07106ro9 Form 990-PF (2009)

Form 990-PF 2009 WESTERN STATES LAND RELIANCE TRUST 86-6307810 Page 13

E' Information Regarding Transfers To and Transactions and Relationships With NoncharitableExempt Organizations

Yes NoDid the organization directly or indirectly engage in any of the following with any other organizationdescribed in section 501 (c) of the Code (other than section 501(c)(3) organizations) or in section 527, { ;fj -f;,,• ^ ,

ll t t ?l^

organiza ionsre ating to po icai

a Transfers from the reporting foundation to a noncharitable exempt organization of:

(1) Cash 1 a X

(2) Other assets la X

b Other transactionsM-0

(1) Sales of assets to a noncharitable exempt organization 1 b A

(2) Purchases of assets from a noncharitable exempt organization 1 b X

(3) Rental of facilities, equipment, or other assets 1 b X

(4) Reimbursement arrangements 1 b (4) X

(5) Loans or loan guarantees .. 1 b (5) X

(6) Performance of services or membership or fundraising solicitations 1 b (6) X

c Sharing of facilities, equipment, mailing lists, other assets, or paid employees 1 c X

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

(a) Name of or anization b T e of or anization c Descrl tlon of relationshl

N/A

Under penaitie erjury I declare th h e examined this r m , including accomp - - stn e, an tax ayer or fi uciary) is based oncomplete la bon of p

S Do-W

G Sig re of officer or

N

or

'1

NE Paid

Preparerssignature Y 04R Pre-

EM

Firm ' s name (or DIXSON PROFESSIONAL CORPORAe

UOnOnly yyourpsioyself 0' 2677 WILLAKENZIE ROAD, SUITaddress and,ZIP code EUGENE, OR 97401

BAA

2a Is the foundation directly or indirectly affiliated with , or related to, one or more tax-exempt organizationsdescribed in section 501 (c) of the Code (other than section 501(c)(3)) or in section 527? []Yes XM No

b If 'Yes ,' com p lete the following schedule.

2009 FEDERAL STATEMENTS PAGE 1

WESTERN STATES LAND RELIANCE TRUST 86-6307810

STATEMENT1FORM 990 -PF, PART I, LINE 6ANET GAIN (LOSS) FROM NONINVENTORY SALES PER BOOKSASSETS NOT INCLUDED IN PART IV

DESCRIPTION: ITEMS SCRAPPED, STOLEN OR DISPOSEDDATE ACQUIRED: 9/08/2002HOW ACQUIRED: PURCHASEDATE SOLD: 12/31/2009TO WHOM SOLD:GROSS SALES PRICE: 3,991.COST OR OTHER BASIS: 320,069.BASIS METHOD: COSTDEPRECIATION: 3,247.

GAIN (LOSS) -312,831.

TOTAL -312,83-17

STATEMENT 2FORM 990-PF , PART I , LINE 11OTHER INCOME

(A) (B) NET (C)REVENUE INVESTMENT ADJUSTED

PER BOOKS INCOME NET INCOME

RENTAL INCOME - NONINVESTMENT PROPERTY $ 64,554.TOTAL 4. 0.$ 0.

STATEMENT 3FORM 990-PF, PART I , LINE 16ALEGAL FEES

(A) (B) NET (C) (D)EXPENSES INVESTMENT ADJUSTED CHARITABLEPER BOOKS INCOME NET INCOME PURPOSES

LEGAL FEES $ 10 , 450.TOTAL 10, 0.

STATEMENT 4FORM 990-PF, PART I , LINE 16BACCOUNTING FEES


ACCOUNTING $ 16 900.TOTAL 1 6', 90r



STATEMENT 5FORM 990-PF, PART I, LINE 16COTHER PROFESSIONAL FEES


OUTSIDE LABOR $ 5,751.PROFESSIONAL FEES 3 , 467.

TOTAL 9,218. 0. 0. 0.

STATEMENT 6FORM 990-PF , PART I, LINE 18TAXES


STATE $ 200.TOTAL 200. 0. 0. 0.

STATEMENT 7FORM 990 -PF, PART I , LINE 23OTHER EXPENSES


AMORTIZATION $ 300. N/ABANK CHARGES 1,454.CLEAN UP COSTS (DEQ AND FIRE) 16,764.DUES & SUBSCRIPTIONS 559.EQUIPMENT RENTAL & REPAIRS 3,144.GIFTS 14.INSURANCE 8,315.LICENSES & PERMITS 1,954.LOSS ON BAD DEBT 15,071.MAINTENANCE 705.MISCELLANEOUS 500.OFFICE SUPPLIES 3,569.POSTAGE & DELIVERY 249.RECORDING FEES 1,163.RENTAL EXPENSES 10,890.SMALL TOOLS 110.SUPPLIES 2,546.TELEPHONE 5,525.UTILITIES 3 805.

TOTAL 76,6 3 7 . 0.



STATEMENT 8FORM 990 -PF, PART II , LINE 14LAND , BUILDINGS , AND EQUIPMENT

ACCUM. BOOK FAIR MARKETCATEGORY BASIS DEPREC. VALUE VALUE

FURNITURE AND FIXTURES $ 2,741. $ 1,668. $ 1,073. $ 0.MACHINERY AND EQUIPMENT 14,427. 7,048. 7,379. 0.BUILDINGS 991,976. 198,826. 793,150. 0.IMPROVEMENTS 29,078. 8,209. 20,869. 0.LAND 5,121,750. 5,121,750. 0.MISCELLANEOUS 296 663.

TOTAL4 172.

219 92292 491.

'712T--;---2360.

, , .

STATEMENT 9FORM 990-PF , PART II , LINE 15OTHER ASSETS

FAIR MARKETBOOK VALUE VALUE

NET INTANGIBLE ASSETS $ 975.TOTAL 975. 0.

STATEMENT 10FORM 990-PF, PART II, LINE 20LOANS FROM OFFICERS , DIRECTORS, TRUSTEES , AND KEY EMPLOYEES

BALANCE DUE

LENDER'S NAME: DANIEL DESLERLENDER'S TITLE: DIRECTORDATE OF NOTE:MATURITY DATE:REPAYMENT TERMS:INTEREST RATE:SECURITY PROVIDED:PURPOSE OF LOAN: OPERATING EXPENSESDESC. OF CONSIDERATION:FMV OF CONSIDERATION: 0.ORIGINAL AMOUNT: 0.BALANCE DUE: $ 199,058.

TOTAL 199, 8.

STATEMENT 11FORM 990 -PF, PART II, LINE 21MORTGAGES AND OTHER NOTES PAYABLE

MORTGAGES PAYABLE BALANCE DUE

FOOD INDUSTRIES CREDIT UNION $ 13,386.WASHINGTON MUTUAL

GAGES PAYABLE16 , 002.29 388TOTAL MORT , .

2009 FEDERAL STATEMENTS

WESTERN STATES LAND RELIANCE TRUST

STATEMENT 11 (CONTINUED)FORM 990-PF, PART II, LINE 21MORTGAGES AND OTHER NOTES PAYABLE

OTHER NOTES PAYABLE

LENDER'S NAME:RELATIONSHIP OF LENDER:DATE OF NOTE:MATURITY DATE:REPAYMENT TERMS:INTEREST RATE:SECURITY PROVIDED:PURPOSE OF LOAN:DESC. OF CONSIDERATION:FMV OF CONSIDERATION:ORIGINAL AMOUNT:BALANCE DUE:

JOLI G ROOTNONE4/10/2008

DEMAND12.00%

OPERATING EXPENSES

0.30,000.

PAGE 41

86-63078101

BALANCE DUE

$ 30,000.

TOTAL OTHER NOTES PAYABLE 30,000.

TOTAL MORTGAGES AND OTHER NOTES PAYABLE $ 59,388.

STATEMENT 12FORM 990-PF, PART II, LINE 22OTHER LIABILITIES

CREDIT CARD PAYABLELOAN FROM DEVELOPMENT BY DESIGNTENANT DEPOSITS HELDROUNDING

$ 2,142.37,080.25,000.

1.

TOTAL 64,2T3-.

• Form 5868 (Rev 4-2008) Page 2

• If you are filing for an Additional (Not Automatic) 3-Month Extension , complete only Part II and check this box . ► q

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).

Additional (Not Automatic) 3-Month Extension of Time. You must file ori g inal and one copy .

Type or Name of Exempt Organization Employer identification number

print WESTERN STATES LAND RELIANCE TRUST 86 : 6307810

File by the Number, street, and room or suite no If a P O. box, see instructions For IRS use onlyextendeddue date for PO BOX 70165filing the City, town or post office, state, and ZIP code. For a foreign address, see instructions.return Seeinstructions EUGENE . OR 97401

Check type of return to be filed (File a separate application for each return):q Form 990 0 Form 990-PF q Form 1041-A q Form 6069

q Form 990-BL q Form 990-T (sec. 401(a) or 408(a) trust) q Form 4720 q Form 8870q Form 990-EZ q Form 990-T (trust other than above) q Form 5227

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 ► _DIXSON PROFESSIONAL CORPORATION.

Telephone No. ► (. 541 ) 484-1195 _ _ _ _ _ _ FAX No. 0- (...541 ) 484-1165------------------

• If the organization does not have an office or place of business in the United States, check this box . . . . . . ► q

• If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN) . If this isfor the whole group, check this box ...... ► q . If it is for part of the group, check this box...... ► q and attach alist with the names and EINs of all members the extension is for.

4 I request an additional 3-month extension of time until ............. NOVEMBER 15 , 20 . 09---------------5 For calendar year . ?008 , or other tax year beginning ......................... . 20....., and ending ........................... 20.--_-.

6 If this tax year is for less than 12 months, check reason: q Initial return q Final return q Change in accounting period

7 State in detail why you need the extension WE NEED ADDITIONAL TIME TO GATHER INFORMATION AND ASCERTAIN

THAT ALL ACCOUNTS ARE ACCURATE BEFORE FILING.- - -----------------------------------------------------------------••-•-----........-----------------------------.-.........----------•--......-.

8a 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. 0.00

b If this application is for Form 990-PF, 990-T, 4720, or 6069, enter any refundable credits andestimated tax payments made. Include any prior year overpayment allowed as a credit and anyamount paid previously with Form 8868. 8b $ 0.00

c Balance Due. Subtract line 8b from line 8a. Include your payment with this form, or, if required, depositwith FTD coupon or, if required, by usinq EFTPS (Electronic Federal Tax Payment System). See Instructions . 8c $ 0.00

Signature and VerificationUnder 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 ► EXEC DIRECTOR Date ►

Form 8868 (Rev 4-2008)

For, 8868 Application for Extension of Time To File an(Rev April 2008) Exempt Organization Return OMB No 1545-1709

Department of the TreasuryInternal Revenue Service ► File a separate application for each return.

• If you are filing for an Automatic 3-Month Extension , complete only Part I and check this box . . . . . . . ► q

• If you are filing for an Additional (Not Automatic) 3-Month Extension , complete only Part II (on page 2 of this form).Do not complete Part 11 unless you have alread y been g ranted an automatic 3-month extension on a previousl y filed Form 8868.

Automatic 3-Month Extension of Time. Only submit original (no copies needed).

A corporation required to file Form 990-T and requesting an automatic 6-month extension-check this box and completePart I only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ► q

All other corporations (including 1120-C filers), partnerships, REMICs, and trusts must use Form 7004 to request an extension oftime to file income tax returns.

Electronic Filing (e-file). Generally, you can electronically file Form 8868 if you want a 3-month automatic extension of time to fileone of the returns noted below (6 months for a corporation required to file Form 990-T). However, you cannot file Form 8868electronically if (1) you want the additional (not automatic) 3-month extension or (2) you file Forms 990-BL, 6069, or 8870, groupreturns, or a composite or consolidated Form 990-T. Instead, you must submit the fully completed and signed page 2 (Part II) of Form8868. For more details on the electronic filing of this form, visit www.irs.gov/efile and click on e-file for Charities & Nonprofits.

Type or Name of Exempt Organization Employer identification number

print

File by the Number, street, and room or suite no If a P O. box, see instructionsdue date forfiling yourreturn Seeinstructions City, town or post office, state, and ZIP code. For a foreign address, see instructions.

Check type of return to be filed (file a separate application for each return):

q Form 990 q Form 990-T (corporation) q Form 4720

q Form 990-BL q Form 990-T (sec. 401(a) or 408(a) trust) q Form 5227

q Form 990-EZ q Form 990-T (trust other than above) q Form 6069

0 Form 990-PF q Form 1041-A q Form 8870

• The books are in the care of ► ----------------------------------------------------------------------------------------------

Telephone No. ► ( ---------- ) ------------------------------ FAX No. ► ^ .......... .)

If the organization does not have an office or place of business in the United States , check this box . . . . . . ► q

• If this is for a Group Return , enter the organization ' s four digit Group Exemption Number (GEN) . If this isfor the whole group , check this box ...... ► q . If it is for part of the group , check this box ...... ► q and attacha list with the names and EINs of all members the extension will cover.

I request an automatic 3-month (6 months for a corporation required to file Form 990-T) extension of timeuntil ....................... . 20....., to file the exempt organization return for the organization named above. The extension isfor the organization's return for:► q calendar year 20--------or

► q tax year beginning ------------------------------------- 20------ , and ending--------------------------------------, 20........

2 If this tax year is for less than 12 months, check reason: q Initial return q Final return q Change in accounting period

3a If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax,less any nonrefundable credits. See instructions.

If this application is for Form 990-PF or 990-T, enter any refundable credits and estimated taxpayments made. Include any prior year overpayment allowed as a credit.

c Balance Due. Subtract line 3b from line 3a . Include your payment with this form, or, if required,deposit with FTD coupon or, if required, by using EFTPS (Electronic Federal Tax PaymentSystem). See Instructions.

Caution . If you are going to make an electronic fund withdrawal with this Form 8868, see Form 8453-EO and Form 8879-EOfor payment instructions.

For Privacy Act and Paperwork Reduction Act Notice , see Instructions . Cat No 27916D Form 8868 (Rev 4-2008)

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Documents

990-PF Return of Private Foundation990s.foundationcenter.org/990pf_pdf_archive/866/... · Fr L Form 990-PF Return of Private Foundation orSection 4947(aXl)NonexemptCharitable Trust