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Fan 99DPFRm1:4 Page3

Capital Gains and Losses for Tax on kivesbnent IncomeW List and the o oa q seed (e g . ^e ^aame.2-skey b i c wwdwusw_ or cwmomn sWck. 200 sh& arc co.)

4 HM acqde°P-PUmd^se kt 0,0, acqfaW

thy.44 oame scan(n d3r rra

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h r-A^ 4 ^I of SaL. i3 a.l^^^l i3PkM 0) ffims r91

b -

c -

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ody for assets showMgm n cohmn (F^) and owned by the 1 1/69A r PL(

A FMAV- as o612l3UA9 A°nsbad basisas of 12!31169

Alonwr ccL ®, ff wW

COL f, bast root Eels than -0-) orLosses (rmm at Qi1)

ab

cd

e2

Capital gain not i oconnor (not capital1

If gain, also enter in Pat 1, line 7If (loss),enta-G- anPart 1 , iie7 } 2

3 Net shortterm capital gain or (loss) as defined n sections 1222(5) and (6rIf gain, also enter in Part I, line 8, eohmn (c) (see instructions)- If (loss). enter -0- in i

partl, fne8 - - - - - - - - - - - - - - - - - - - - - - - J 3

D

• Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income(Far optional use by domestic private iandations subject to the section 4940(a) tax an net investment neon)

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

Was the fou on liable for the section 4942 tax on the d butable amount of any year in the base period? ® Yes [] NoIf `Yes,- the foundation does not qualify under section 4940(e). Do not complete this pat

1 Enter the appropriate amount in each column for each year; see the instructions before making any enlries-

BassraS

19

pa

aofact

a(=L 1b) &A&d bI c& J*

2011

20102M

20M2007

2 Tonal of line 1, coksm (d) - - - - - - - - - - - - - - - - - - - - - 23 Average dshtKil n 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 - - - - - - 3

4 Enter the net value of nonchantable-im assets for 2012 from Part X, 6ne 5 - - - - - 4

5 Multiply fine 4 by line 3 . . . . . . . . . . . . . . . . . . . . . . . 5

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

7 Addlines 5and6 - - - - - - - - - - - - - - - - - - - - - - - - 7

8 Enter qualifying distributions from PartXII, fine 4 - - - - - - - - - - - - - - - 8If fine 8 is equal to or geater than line 7, check the box in Part VI, fine 1 b, and complete thud part using a 1% tax rate. See thePart VI nstructions_

Fa m990-PF pmt)

Fc in 990-WPM2) Paqe4Excise Tax Based on Irneshnent Income (Section 4940(a). 4940(b). 4940(e). or 4948-see

la Exe npt aperabrg f iidalyans -l-M-d ' - 4940(d)^, checkhere and enter QUA' an One 1.o^ y ad lettei-z 3 v ^ra ^ r- : onsl

b• Domestic foundations that meet the 4940(e) reipi rnents in Part V. check 1 - - --here lo- q and ender 1 % of Part 1, line 27b . . . . . . . . . . . . . . . . .

c AN other domestic fandabor^s enter 2% of line 27b.. Exempt foreign a tions enter 4% ofPart 1, line 12, col- (b). - -- -

2 Tax under 9e^on 511 (domestic section 4947(aXl) trusts and taxable fdmdations only. Others enter -0-) 23 Add lines 1 and 2 - - - - - - - - - - - - - - - - - - - - - - - - - - 34 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others entei -G-) 45 Tax based on i veshnent i cones Subtract k* 4 from line 3. U zero or less, enter -G- - - - 56 t ts/Payrnanls:

a 2012 estimated tax payments and 2011 overpayment credited to 2012 6ab Exempt foreign orgy abons-tax withheld at source libc Tax paid with application for extension of time to tie (Form 8868) . 6cd Backup with holding erroneously withheld - - - - - - - - lid

7 Total credits and payments. Add lines 6a throw lid . . . . . . . . . . . . . . ..7 - - -

8 Enter any penalty for underpayment of estimated tax Check here q if Farm 2220 is attached 89 Tax due. if the total of lies 5 and 8 is more than line 7, enter anwud awwed - - - - - - ► 910 Overpayment If lie 7 is mane than the total of fins 5 and 8, enter the amount overpaid - . ► 1011 Bider the amotnt of fie 10 do ba Icedb213 es01 1 txc► I Refuided ► 11

la Dung the tax yea, did the foundation attempt to II J811ce any national, state. or local legislation or did it yes Noparticipate or intervene in any political campaign? . . . . . . . . . . . . . . . . . . . 1a

b Did it spend more than $100 ding the year (either dredly or iideedly) for political purposes (See6nhnictians for the defrrition)? . . . . . . . . . . . . . . . . . . . . . . . . . . 1 bIf the answer is 'Yes' to 1a or 14 attach a defaiied desc*don of the aides and copies of any materialspuNNied or distributed by the foundation in connecfan with the activit es.

c Did the foundation file For.. 1128-POL for this yeah - - - - - - - - - - - - - - - - - isd Enter the amount (if any) of tax on political expendil (section 4955) imposed during the year-

(1) On the r«saa ,. ► S D M On foundation ► S De Enter the rein4ssemerrt (if any) paid by th undalon during the year for political expendittme tax imposed

on foundation manages ► S

2 Has the foundation engaged in any activities chat Fine not previously been reported to the IRS? . . 2if 'Yes' attach a detailed desaiptkn of the activities.

3 Has the foundation made any lunges, not previously reported to the IRS, in its governing kisburnent, A P, ofncorporation, our bylaws, or other sirdar instruments? If 'Yes,' auadh a canfamed copy of the changes . . 3

4a Did the foundation have unrelated busj ss gross income of $1 ,000 or more during the year? - - - - 4ab IF 'Yes,' has it fled a tax return on For.. 990-T for this yeah . . . . . . . . . . . . . . . . 4b5 Was there a tic}ridation, termination, dssoluton, or substantial contraction during the yea" . . . . . 5

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 art, or• By state legislation that effectively amends the governing nsininent so that no mandatory drecfions thatconflict with the state law rernan in the governing nStrunent? - - - - - - - - - - - - - - - 6

7 Did the tasdation have at best $5,000 in assets & any tme duig the year? If 'Yes,' ram 1e Part p, oaL (qjand PartXV 783 Ender the states to which 1t Gabon reports or with which it is revered (see nsbuc ions) ►

b If the answer is 'Yes' to fine 7, Fm finished a copy of Form 990-PF to the Attorney General(or designate) of each state as requied by General Insin ic6nn G? if "1b,' attach ejgftiat,n . . . . . 8b

9 Is the foundation duaimig status as a private operating foundation within the meaning of section 4942Q(3) or4942M for calendar year 2012 or the taxable year beginning in 2012 (see instructions for Part)IV)? if "Yes,'corriplete PartXN - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 9

10 Did any persons become sIstantial conbtxd s during the tae year? If 'Yes,' attach a sdedode fsft thewnames and addresses - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 10

Farm 99D-Pb-

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Fans®O-PPM Page7information About Oflioers, Dbecbors, Trustees, Fowidadon Mana9em Paid EPA.and Conhaclows (continued)

3 . Fire hiiest-pad independent oontrac^ors for pnofe^ional services (see iit caction* If none, ewer 'PNOIlEN Ptsne and ad*ew of each pecan pedd nowOm $50.Q®o a Type of seevuoe (ciCan

Total comber of others receivwg over $50,000 for professional services - - - - - - - - - - - - ►

Summery of Died Charitable Activities

last the tame •sv largest aaect a®o^a ie aces deg the fa yew- frock de ieaemo4 std iftnmdim somre as On nWnber ofand aim saved, oa6aaoes convened ..1iasfixed. elr-

e the two kegest pffografftidah3d ws nmde by the 6oamo om wog the talc year cs Ewes 1 and 22 Amourd

2

Mad= pnxjra Steed ieo reins See iabucaos

3

TolaL Add fins 1 ltrot4 3 - - - - - - - - - -

Form 990-PF pmt)

Fan 990-W PM3) Page8man 1rwesbnent Return (All domestic foundations must complete this part Foreign foundations,see insbuctions.)

1 Fair market value of assets not used (or held for use) dnedly in carrying out chaitable, ems.

. purposema Average monthly fa market value of securities . . . . . . . . . . . . . . . . . la

b Average of monthly cash balances . . . . . . . . . . . . . . . . . . . . . ib

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

d Told (add fines la. b, and c) . . . . . . . . . . . . . . . . . . . . . . . 1de Reduction claimed for blockage or other factors reported an fines la and

1 c (attach dertatled explariation) . . . . . . . . . . . . . . . 1e

2 Acquisition indebtedness apps 1e to fine 1 assets - - - - - - - - - - - - - - - - 2

3 Subtract fine 2 from Ire i d - - - - - - - - - - - - - - - - - - - - - - 34 Cash deemed held for charitable activities Enter 1 '/2 % of line 3 (far eater anoint, see

instructions) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 45 Net ot imicimmlable-um assets. Subtract fine 4 from lie 3. Enter here and on Part V. fine 4 56 min investment rehen Enter 5% of lIne 5 - - - - - - - - - - - - - - - 6

Disirftlable Amount (see instructions) (Section 4942(D(3) and 0(5) Pie operating foundationsand certain foreign organizations check here ► q and do not complete this part.)

1 Mntrsn Investment rein from Part)(, line 6 - . . - - . - - - - - - - - - 1

2a Tax an investment income for 2013 from Part VI, line 5 - - - - - 2a

b Income tax for 2013. (His does not include the tax from Part VI-) - - - 2b

c Add fines 2aand 2b . . . . . . . . . . . . . . 2c

3 Disputable arrant before a*zftnerls- Subtract lie 2c from fine 1 - - - - - - - - - - 34 Recoveries of amounts treated as quarifyiig distributions - - - - - - - - - - - - - 4

5 Add lines 3 and 4 - - - - - - - - - - - - - - - - - - - - - - - - - - - 5

6 Deduction from distributable amount (see ions) - - - - - - - - - - - - - - 67 Db ulable amount as ar* steel Subtract lie 6 from line 5. Enter here and on Part X10,

fe^e1 . . . . . . . - - - - - - - - - - - - - - - - - - - - - - - 7

Quaffyng D-UIudon (see instructions)

I Amounts paid Cffx*m ng adm&fshdtire expenses) to accomplish charitable, ems, purposes:

a Expenses, contributions, gifts. ec.-total from Part I, column (d), fine 26 - - - - - - - - 13 / 2"7 Db Progam-related -total from Part D(-B - - - - - - - - - - - - - - - 1b

2 Amounts paid to acquire assets used (or held for use) directly n cany*g out charitable, etc.,

purposes - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2

3 Amounts set aside for specific A aitaWe projects that satisfy the:

a Suitability test (prior IRS approval required) - - - - - - - - - - - - - - - - - - - 3a

b Cash distribution test (attach the neq Aced schedode) - - - - - - - - - - - - - - - 354 Quaifyiig dtrIru6ons. Add fins la through 3b. Enter here and on Part V. fine 8. and Part )ait, line 4 4 75 Foundations that quality under section 4940(e) for the reduced rate of tic an net n meat i come.

Enter 1% of Part I, fie 27b (see instructions) . . . . . . . . . . . . . . . . . . 5

6 A*esUed quaifyig d u6ons. Subtract fine 5 from fie 4 - - - 6 2 Q

Mole. The amount on fne 6 wa be used in Part V. column (b), in subsequent yeas when calculating whedw the foundationqualifies for the section 4940(e) reduction of tax in those years-

Farm 99QPF pot3)

.Ab

Ila

Is

Ia

Ron (2M3)Private Operating Foundations (see instructions and Part VII-A, question 9)

la If the foundation has received a n or determnalion leer that it is a private operating ^-

faadation, and the nfirg is effective for 2013, enter the date of the ndrg . . . . . . ► G

b Check box to ndcate whether the foundation is a private operating foundation deso bed in section

2a Enter the lesser of the adusted net Tax year Prior 3 yearsincome from Pat I or the ninimYn

44 2M3 2D72 M 2a11neacti

,neat m4burn from Part x fory 0

b 85%offine 2a . . . . . . .

c Qualifying l otions from Part X11,

IM 4 for each year fisted . . . Z

d /l mmffft mdWgd n lime 2r rout used ►for active coi duct ofaaF l a ouloes . .

e Q aliif*g d buttons made dkeciyfor active corWW of exempt aambmS1dtrad Fine 2d tom We 2c . - -

3 Complete 3a, b, or c for the

alternative test relied upore

a Assets' alternative test-ewer.(1) Value of all assets . . . . .

0 Value of assets firing under

section 4942QM .

b 'Endowment' alWmabve test er 2kof nvnam iiveshment rehin shown inPart X. ie 6 for each yew Isted . . .

C -support alternative test-enter:

(1) TOW support other than goss-investment income (ate ,dividends. rents, payments onsecurities bares (section512(a)(5)), or royalties) - - - -

Support from gaimalland 5 or inoi exempt

argaa bali , as provided in9erIion 4942( (6 . . . .

(3) Largest amount of support from

an exempt amja bation . . .

z

Page 10

/30Mal 49420(3) or[] 4942)

"2MO"Tow

19 /D

02

1 0 9 O 1 0 1 D 1 _0

Goss bwesmment income .Stipnlemenlary kiformation (Complete this part only if the foundation had X000 or more in assets atairy time du*ig the year-see iosbuctions.)

1 bdimma6on Regard g Fw.dadin Managersa List manages, of the foundation who have contributed more than 2% of the total contributions received by the fanda6on

before 4ta dose ofd iy yje ifithey have contributed mom than $5,000)- (See section 507(4)(2) )

b List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of theownership of apawpr other entity) of which the foundation has a 10% or eater Merest

2 bdonnation Regan &g duttrbutiom (rant. CM Loan. StholarshiP6 ems. Pro9am

Check here ► q if the foundation only makes contribution to preselected charitable organizations and does not acceptunsolicited requests for funds. If the fandation makes gifts, p *2, etc- (see iratructions) to individuals or organizations widerother conditions, complete items 2a, b, c, and d-

a The name, address, and telephone number or e-mail address of the person to whom app&cabons should be addnesse t

b The form in which applications should be submitted andinformation and mates they should include:

c Anywondead ies

d Any restrictions or 6nitations an awards, such as by geographical areas. charitable fields. Bids of ns54itions, or otherfact

From 990-PF pm

F,oFmggD-IRm2 Page Ii

s- bdumiation (continued)3 Grmft and Con Ambons Paid Durig the Year or Approved for Future Payment

Recipknt uF^o j. i1 6a^: w4 r-oom^a^ansmany reE^°°ese'^ °°

sus -Papose of cam.t or

Moaamie

Name and address (home or business)cumbufon

a Paid ckmM the year ! L^

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Total - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3a

b Approved for fudoe payrnent

Total - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - D 3bir 990-PF pm2)

^WN ^OfOW VQI NAWN +,

A ae Q^^^ 4 ae^ o+

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I

Fm99W )1 X13Mormation Regarding Transfers To and Transactions and Relationsf ilp s With Noncharitable6cmpt Organaatior s

1 Did the organization dredhr or ndrecthr engage in any of the following with any other orgarwmbon described Yes No

• in section 501(c) of the Code (other than section 501(c)(3) aeons) or in section 527, relating do politicalorgannb-

a Transfers from the repordg foundation to a noncharitable exempt organization of

(1) Cash - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - lap)(2) Other assets - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - iaM

b Other tray ctiars

(1) Sales of assets to a noncharitable exempt organasbon . . . . . . . . . . . . . . . 1b(1 -

0 Purchases of assets from a noncharitable exempt organization . . . . . . . . . . . . lb(2)

Rental of facihties, equipment, or other assets . . . . . . . . . . . . . . . . . 1b(3)

(4) Rekdxxsemerd arrangements . . . . . . . . . . . . . . . . . . . . . . . . 1b(4)(S) Loans or loan guarantees . . . . . . . . . . . . . . . . . . . . . . . . . .(q Performance of services or membership or findraising solicitations . . . . . . . . . . . . i

c Sig of facF6es, eq ipment, muffing Isis, other assets, or paid employees . . . . . . . . - 1c

d it the answer to any of the above is 'Yes." complete the following schedule. Cokrrn (b) shoWd always show the fak marketvalue of the goods, other assets, or services given by the reporting foundation. IF the foundation received less than fat marketvalue in any transaction or dunV arranger rt, show in column (d) the value of the goods, other assets, or services received.

-6 H 6- 11-

10id MOM

Paidire p qi Slm Pu * u

pithe Only

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2a Is the foindation &ectly or iv recty affiliated wi h, or related to, one or more tax-exempt organ¢adionsdesrnIbed in section 501(c) of the Code (other than section 501(c)(3)) or in section 527? . . . . . . . q Yes No

b IF `Yes,- complete the following schedule-

14 Hawn c NTree iion W De of mr

Schedule BWarm 890, 99QEZ.agOO-M

Schedule of ComMbubors oOM IMM ,sAS a7

► anaaI toRgg , Fee.. 9e0-E7, or Fan. eeaPF. 2012

No a orne

Or wiiGon hype (dredc on

Rers of Section

Form 990 or 990-EZ q 501(c)( ) (enter rRmber) organ¢alion

q 4947(a)(1) nonexempt charitable- trust not treed as a private foundation

q 527 political organ¢ation

Form 990-PF[YAW

(c)(3) exempt private foundation

q 4947(a)(1) nonexempt charitable trust treated as a private foundation

q 501(c)(3) taxable private foundation

Check if your organization s covered by the General Rule or a Special Rule.

Male Only a section 501(cX7), (8), or (10) organization can check boxes for both the General Fie and a Special Rule. Seeinstructions

General Fkde

For an a alion filing Form 990, 990-EZ, or 990-PF that received, dung the year. $5,000 or more (n money orproperty) from any one contributor. Complete Paris I and II.

q For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33'/3 % support test of the regulationsunder sections 509(a)(1) and 170(bX1)(A)(vi) and received from any one contributor, during the year, a contribution ofthe greater of (1) $5,000 or0 2% of the amount on (I) Form 990, Part VIII, fine 1 h, or (u) Form 990-EZ, One 1.Complete Parts I and II.

q Fora section 501(c)(7), (8), or (10) organization ling Form 990 or 990-EZ that received from anyone contributor,airing the year, total contributions of more than $1,000 for use exr mivery for religious, c1 ilable, scientific, literary,or educational purposes, or the prevention of cruelty to deldren or animals. Complete Parts I, II, and M.

q For a section 501(c)(7), (8), or (10) orlon fang Form 990 or 990-EZ that received from any one contrixitor,during the year contrixilions for use exdtmrely for religious, chariitable, ems, purposes, but these contributions didnot total to more than $1,000.11 this box is checked, ender here the total contributions that were received during theyear for an exc arvely religious, charitable, etc., purpose. Do not complete any of the parts taxless the General Ruleapplies to this organization because it received nonexclusivdy religious, charitable, etc., contributions of $5,000 ormore fang the yew - - - - - - - - - - - - - - - - - - - - - - - - Do- S

Caihon. An organization that is not covered by the General Fade and/or the Special Was does not tae Schedule B (Form 990,990-EZ, or 990-PF), but it must answer `No' on Part IV, line 2 of its Form 990, or check the box on fne H of its Form 990-EZ or anPart I, line 2 of its Form 990-PF, to certify that it does not meet the fling re piiements of Schedule B (Form 990,99G-E7- or 990-PF).

Far Paperu=kwa- Act I ,aio see the l - - for Form 99O, QQ9go-PF CL rdo. 3E 61 S.J & &. B form 994 9904EZ. Q94"1M21

Sd-dL1e B Fam 9®0.990-EZ. -990 P9 (2012) Page21lsne of arga ___

Contrbubors (see mshuctions)_ Use duplicate copies of Part I if additional space is needed-

Ma Nance address and ZIP + 4 Total rdri u6ons (Type of contrfludion

^,qvj ^° G-f `o r-nr

LS

Part 11 if there is(Completea noncash oontriulioR)

NO. Name, address, aid ZIP + 4 Told ntrubou (Type of oontraution

v personPapvl

r"npk!be Part 11 if #we isa.xxx:adi ax tr on.)

Na Nam address, and ZP-t 4 Total conbudons (Type of oontniu6on

3 r /I rs^ne( Pelso

n /I . (^(Completea ^

u were isa narrash oorrtribubm)

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Type of contrftdion

ItD 6 l O K s

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(* e T „yy^ S^7 T

(Compkftsh Part 11' ff isanonenorrash oon>rxjUan)

Na Na^P address, andZ + 4 Total oantriiutions Type of conbibu6on

l ug "(^ 0 L Pierson

ker ns, Cl io g^-Z 11 if#me isa norxsasfi oontrbuti

m)or^

Na Na e, adtkess, and ZIP+ 4 Total coatrtutions Type of contribution

Person q

$

qPay"AlNoncash q

(Complete part 11 if Uwe isa noncash ccnnawfimy

Sdhedde 8 Farm 9900. 9043F, Q99DPi, PDf21

Sdoed me B (Eason S 99 -EZ. Q990-M R)1 Page3mm of org ___

Noncash Property (see msbiuctions). Use duplicate copies of Part 11 if additional space is needed.

(a) DALfim.Pot I

Cb)oesaiplion of nonc h property Sven

(C)FRW (or pl;li(see kmoucdon4

ICQDate received

^/1U1^ rM /I^ rw " $Ape, lY C^

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Desc. lipbon ofnom property

(C)(see imstruclMon4

(CODate received

11 L9 / -4

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Part IDenaiption of noncash property 9

ca(

ISM bwbuCffOrw4Date reoeima

s

hor.Part I

(b)oes«ion of property

(C)

((or estirnate)babucoonO

ICQDate received

s

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a1D . of n r.: R, Popel ty

(cF (or estillMV (Ccreceived

s

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