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Farm990_PF Return of Private Foundation OMB No 1545-0052
or Section 4947(a)(1) Nonexempt Charitable Trust �O®�Treated as a Private Foundation
Depa rt ment of the TreasuryInternal Revenue serv ice Note : The organization may be able to use a copy of this return to satisfy state reporting requirements
For calendar year 2005 , or tax year beginning , 2005 , and ending , 20
G Check all that apply: ❑ Initial return ❑ Final return ❑ Amended return ❑ Address change ❑ Name change
0ZZ
O
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Use the IRS Name of organization _ A Employer identification number
label. [ s�-r "v a�l0N o Al 'c 3 S . (a D 8 2 C 8Otherwise , Number and street (or P 0 box number if mail is not delivered to street addr ss) Room/suite B Telephone number (see page 10 of the instructions)
printa/4 i Ale5 AlQ 7 ir+ (.i/n) /1 61 - 77
or type u, VS MSS.See Specific City or town, state , and ZIP code If exemption application is pending , check here ► ❑CInstructions . N N0. N�l zt N Z- L Q '� J ( 19 O 1. Foreign organizations , check here . . ► ❑
H Check type of organization: JX Section 501 (c)(3) exempt private foundation 2. Foreign organizations meeting the 85% test,t t ► ❑h k h h❑ Section 4947(a)(1) nonexempt charitable trust ❑ Other taxable private foundation compu ion .ere and attac aecc
I Fair market value of all assets at end J Accounting method: I'M Cash El Accrual E If private foundation status was terminatedunder section 507(b)(1)(A), check here . ► ❑
of year (from Part ll, col (c), ❑ Other (specify) ............................ F If the foundation is in a 60-month termination❑line 16) ► $ 79 01-7.01 (Part 1, column (d) must be on cash basis .) under section 507(b)( 1)(B), check here . ►
Analysis of Revenue and Expenses (Me total ofamounts in columns (b), (c), and (d) may not necessa ri ly equal
(a) Revenue andexpenses per (b) Net investment (c) Adjusted net
(d) Disbursementsfor charitable
the amounts in column (a) (see page 11 of the instructions)) books income income purposes(cash basis only)
received (attach schedule)grants etc1 Contributions gifts Zzy 3 1. -1-1/, , ,,uired to attach Sch B2 Check ► ❑ if the foundation is not re .q
3 Interest on savings and temporary cash investments4 Dividends and interest from securities . . . 'fZ 2-Z2-. 4-2- ZZZ 9
5a Gross rents . . . . . . . . . . . .b Net rental income or (loss)
6a Net gain or (loss) from sale of assets not on line 10b Gross sales price for all assets on line 6a
y line 2)7 Capital gain net income (from Part IVCc
,8 Net short-term capital gain
7. . . . . . .
9 Income modifications . . . . . .10a Gross sales less returns and allowances
b Less: Cost of goods sold .c Gross profit or (loss) (attach schedule) . . .
11 Other income (attach schedule) . . . .12 Total . Add lines 1 through 11 ZZY Ste, ZzZ . 4Z z2't• Z
u directors trustees etc.13 Compensation of officers , , ,14 Other employee salaries and wages0
d. . . .
15 Pension plans employee benefitsW
.,16a Legal fee attach_sr hedule .
b Accountin fees 19a P, 100.00 DO • o o DO cc -too •dyam- c Other pro ss o ees a ac sc e ),
17 Interesty
.uctlons)18 Taxes (atta ed (Yeea I lki
19 Depreciati ( tionOG EK UT20 Occupanc .
. 21 Travel coio
, . . .22 Printing and publications S.S 7 S S 9.67. . .23 Other expenses (attach schedule) "K ��e s P!I. 93 94 -73 04. 93 6-4 _Y
24 Total operating and administrative expenses.Add lines 13 through 23 . . . . . . . .
25 Contributions gifts grants paid 194 g0 , , . . . .1 r26 Total expenses and disbursements . Add lines 24 and 25 9 7 3a. 2-6 • (v D 0 `I 0 ) 30.289
27 Subtract line 26 from line 12:a Excess of revenue over expenses and disbursements a Z 3.68b Net investment income (if negative, enter -0-)c Adjusted net income (if negative, enter -0-)
For P rivacy Act and Paperwork Reduction Act Notice, see the instructions . Cat No 11289X
9Form 990-PF (2005)
Form 990-PF (20051 • Page 2
Attached schedules and amounts in the description column Beg inn i ng of year End of yearBalance Sheets should be for end-of-year amounts only (See instructions .) V l b B lk V ir Ma rket VF l. (a) Book uea ) oo ue( a a(c) a ue
1 Cash-non-interest -bearing ' 3 0 92.0? �1 o y Z .01. . . . . . . . . . .2 Savings and temporary cash investments . . . . . .3 Accounts receivable ► sr r :1 �-------------------•----•---------------•--
Less: allowance for doubtful accounts ► ..-..__•.-•-._.__....4 Pled es receivable ► .--•------------•-••-•---------•-----------•g
Less : allowance for doubtful accounts to ...... .. ..... .. . .....5 Grants receivable . . . . . . . . . . . . . .
6 Receivables due from officers , directors, trustees, and otherdisqualified persons (attach schedule) (see page 15 of theinstructions ) . . . . . . . . . . . . . . . .
7 Other notes and loans receivable (attach schedule ) ► ________________Less : allowance for doubtful accounts ►
ai.............................
8 Inventories for sale or use . . . . . . . . . . . .9 Prepaid expenses and deferred charges . . . . . . .
and state government obligations (attach schedule)10a Investments-U S. .b Investments-corporate stock (attach schedule) . . . .c Investments-corporate bonds (attach schedule) .
11 Investments-land buildings and equipment : basis 10 _ _______ _ _ ____xx „
u-��`� - .��:: _ _�^�__ �_,, • , T` .•-:-•�'x,,
Less : accumulated depreciation ( attach schedule ) ► ..................12 Investments-mortgage loans . . . . . . . . . .13 Investments-other (attach schedule) . . . . .. .14 Land buildings , and equipment : basis ►___________________________
"' Y4 _
,Less- accumulated depreciation ( attach schedule ) ► ..................
15 Other assets (describe ► ........................................16 Total assets (to be completed by all filers-see page 16 of
the instructions . Also, see page 1, item I) .5-/ 66 8. 3 ') 5 0 f 2 •O 9 ' 9 c 4 L • o O
17 Accounts payable and accrued expenses . . . . . .18 Grants payable
d 19 Deferred revenue . . . . . . . . . . . . . .20 Loans from officers and other disqualified personsdirectors , trustees ,,21 Mortgages and other notes payable (attach schedule)
J 22 Other liab il ities (describe ►__________________________________•--) . .
23 Total liabilities (add lines 17 through 22). .Organizations that follow SFAS 117, check here ► ❑and complete lines 24 through 26 and lines 30 and 31.
c 24 Unrestricted . . . . . .. . . . . 51 b . 3 79 oqz. . . . .25 Temporarily restricted .. . . . . . . . . . . .26 Permanently restricted . .
-'
C. . . . . . . . . .
Organizations that do not follow SFAS 117 , check here ► ❑3U. and complete lines 27 through 31.
p 27 Capital stock trust principal or current funds . . ., , . .O 28 Paid - in or capital surplus bldg. and equipment fundor land-Wy
, , ,or other funds29 Retained earnings accumulated income endowment
Q,, ,
30 Total net assets or fund balances (see page 17 of theG 0791'9instructions ) . . . . . . . . . . . . . . . S g� � z •
Z 31 Total liabilities and net assets/fund balances (see page 17 of'the instructions) - - 0
• 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 withend-of-year figure reported on prior year's return) . . . . . . . . . . . . . . . . . .
2 Enter amount from Part I, line 27a . .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. .
C .3
Zr
910 13-. 0 77-Form 990-PF (2005)
Form 990-PF (2005) C r ( w o.v O . N lN c. r G o4 2. (DB Page 3Capital Gains and Losses for Tax on Investment Income
• (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)
(b) How acquiredP-PurchaseD--Donation
(c) Date acquired(mo., day, yr)
(d) Date sold(mo., day, yr)
1abcd
(e) Gross sales price (f) Depreciation allowed(or allowable)
(g) Cost or other basisplus expense of sale
(h) Gain or (loss)(el plus (Q minus (n)
abcdeComplete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 m Gains (Col (h) gain minus
(I) F.M.V as of 12/31/69 U) Adjusted basisas of 12/31/69
(k) Excess of col (i)over col 0), if any
.col (k), but not less than -0-) or
Losses (from col.(h))
abcde
2 Capital gain net income or (net capital loss) {If 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 pages 13 and 17 of 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.)
If section 4940(d)(2) applies, leave this part blank.
Was the organization liable for the section 4942 tax on the distributable amount of any year in the base period? ❑ Yes ❑ NoIf "Yes," the organization does not qualify under section 4940(e). Do not complete this part.
1 Enter the appropriate amount in each column for each year; see page 18 of the instructions before making any entries.
(a)Base period years
Calendar year (or tax year beginning in) Adjusted qualifying distributions Net value of nonchantable-use assets Distribution ratio(col. (b) divided by col (c))
20042003200220012000
. . . . . . .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
the number of years the foundation has been in existence if less than 5 years . . . . 3
4 Enter the net value of noncharitable-use assets for 2005 from Part X line 5. . . 4, . .
5 Multiply line 4 by line 3 . 5. . .. . . . . . . . . . . . . . . . . . .
line 27b)6 Enter 1 % of net investment income (1 % of Part I 6, . . . . . . . . . . .
7 Add lines 5 and 6 7. . . . . . . . . . . . . . . . . . . . . . . . .
8 Enter qualifying distributions from Part XII line 4 . . . . . . . . . . . . 8If 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. Seethe Part VI instructions on page 18.
Form 990-PF (2005)
Form 990-PF (2005) ` Page 4
FEMIM Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948-see page 18 of the instructions)is Exempt operating foundations described in section 4940(d)(2), check here ► ❑ and enter "N/A" on line 1.
Date of ruling letter_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (a ttach copy of ruling letter if necessary-see instructions)checkanizations that meet the section 4940(e) requirements in Part Vb Domestic or 1 b d D,g
here ► ❑ and enter 1 % of Part I, line 27b . . . . . . . . . . . . .c All other domestic organizations enter 2% of line 27b Exempt foreign organizations enter 4% of Part I, line 12, col (b) -_ J
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 23 Add lines 1 and 2 . . . . . . 3 0 G. . .. . . . . . . . . . . . . . . . . .4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4.
enter -0-5 Tax based on investment income . Subtract line 4 from line 3. If zero or less 5 C� 40, . .6 Credits/Payments:a 2005 estimated tax payments and 2004 overpayment credited to 2005 6ab Exempt foreign organizations-tax withheld at source . . . . 6bc Tax paid with application for extension of time to file (Form 8868) 6c
6dd Backup withholding erroneously withheld .. . . . . .7 Total credits and payments. Add lines 6a through 6d . . . . . . . . . . . . . 7 00. .8 Enter any penalty for underpayment of estimated tax. Check here ❑ if Form 2220 is attached. 89 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed . . . . . ► 9 O _
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid. . . ► 1011 Enter the amount of line 10 to be: Credited to 2006 estimated tax ► Refunded ► 11
. Statements Regarding Activities1a During the tax year did the organization attempt to influence any national state or local legislation or did Yes No, , ,
it participate or inte rvene in any political campaign? . . . . . . . . . . . . . . . . . . 1ab Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see page
19 of the instructions for definition)? . . . . . . . . . . . . . . . . . . . . . . . 11bIf the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materialspublished or distributed by the organization in connection with the activities.
c Did the organization file Form 1120-POL for this year? . . . . . . . . . . . . . . . 1 cd Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the organization . ► $ (2) On organization managers. ► $ Ie Enter the reimbursement ( if any) paid by the organization during the year for political expenditure tax imposed
on organization managers. ► $2 Has the organization engaged in any activities that have not previously been reported to the IRS? 2
If "Yes," attach a detailed description of the activities.3 Has the organization made any changes , not previously repo rted to the IRS , in its governing instrument , a rt icles --- - -
of incorporation , or bylaws , or other sim il ar instruments? If "Yes," attach a conformed copy of the changes 34a Did the organization have unrelated business gross income of $1 000 or more during the year9 4a, .b If "Yes ," has it f il ed a tax return on Form 990-T for this year? . . . . . . . . , . . N f Xi 41b
5 Was there a liquidation , termination , dissolution , or substantial contraction during the year?. . . . . 5If "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? 6. . . . . . . . . . . .7 Did the organization have at least $5,000 in assets at any time during the year? If " Yes," complete Part 11, col. (c), and Part XV. 78a Enter the states to which the foundation report s or with which it is registered (see page 19 of the
instructions ) ►.---•--••--•------------------•-•--...---•-•--••--------•---•--•----.-.-.--------•--•--•---•-------------b If the answer is "Yes" to line 7, has the organization 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 81b.,9 Is the organization claiming status as a private operating foundation within the meaning of section 49420)(3)
or 49420)(5) for calendar year 2005 or the taxable year beginning in 2005 (see instructions for Part XIV on -- -page 26)? If "Yes," complete Part XIV . . . . . . . . . . . . . . . . . . . . . . . 9
10 Did any persons become substantial contributors during the tax year? If "Yes,"a ttach a schedule listing their names and addresses. 1011 Did the organization comply with the public inspection requirements for its annual returns and exemption application? 11
W b it ►dd ! /Ae s resse a _ A ----- ------------------------ ----------------------------------------------------------------------12 The books are in care of ► _ Z! v1->±S... Ce_N-NeI------------------- ----------- Telephone no. ► ,3)- ---
Located at ► -v.4q ..CtY1.5&rN7 _,Stki1�_?-00..-�N �'Sr. �-.- ZIP+4 10, (,?•'�a 3
-7-�((j
13 Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041-Check here . . . . . ► ❑and enter the amount of tax-exempt interest received or accrued during the year . . . . ► 113 I
Form 990-PF (2005)
12 �p �� 1 5 f-� aN N / ~ /✓ ly 14N 1 ILL, 3 o 2 6 B Page 5Form 990-PF (2005)
10,001Wstatements Regarding Activitlps for Which Form 4720 May Be Requiredunless an exception applies.item Is checked in the "Yes" column• File Form 4720 if an Yes No,y
la During the year did the organization (either directly or indirectly): �" • -(1) Engage in the sale or exchange, or leasing of property with a disqualified person? ❑ Yes ANo
(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from) '`a disqualified person? . . . . . . . . . . . . . . . . . . . . . ❑ Yes M No
(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? El Yes R No(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? El Yes C� No
(5) Transfer any income or assets to a disqualified person (or make any of either availablefor the vonef;t or use of a %disquaiifivi pa rs-oii) i . . . . . . . . . . . . LJ Yes No
(6) Agree to pay money or property to a government official? (Exception . Check "No"if the organization agreed to make a grant to or to employ the official for a period ' - .after termination of government service, if terminating within 90 days.) . . . . ❑ Yes B No
ulatioitions described in Relif nd r the exceil tf th t f1 1 did"" 5gpo qua y u ee ac s aH6), any ob If any answer is Yes to a(biv4941(d)-3 or in a current notice regarding disaster assistance (see page 20 of the instructions)?section 53 1..
Organizations relying on a current notice regarding disaster assistance check here . . . . . ► ❑c Did the organization engage in a prior year in any of the acts described in 1a, other than excepted acts, 11
that were not corrected before the first day of the tax year beginning in 2005? is. . . . . . . . .
2 Taxes on failure to distribute income (section 4942) (does not apply for years the organization was a privateoperating foundation defined in section 4942(j)(3) or 49420)(5)):
a At the end of tax year 2005, did the organization have any undistributed income (lines 6dand 6e, Part XIII) for tax year(s) beginning before 2005? . . . . . . . . . . . ❑ Yes NoIf "Yes," list the years ► 20..... , 20..... , 20..... , 20 .....
b Are there any years listed in 2a for which the organization 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) -
.answer "No" and attach statement-see page 20 of the instructions.)to all years listed 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. ;� • ;► 20 ..-- , 20 .... , 20 ---- , 20 -----
3a Did the organization hold more than a 2% direct or indirect interest in any businessenterprise at any time during the year? . . . . . . . . . . . . . . . . ❑ Yes No
b If "Yes," did it have excess business holdings in 2005 as a result of (1) any purchase by the organizationor disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approvedby the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
to dete i eForm 4720i d? (U e Schedule Cfi t h h ldih f th 10 15 20l ,ng per ,rs p o o s-, or -year aset e apse o e -,�
-IVif the organization had excess business holdings in 2005 ) 3b. . . . . . . . . . . . . . .
4a Did the organization invest during the year any amount in a manner that would jeopardize its charitable purposes? 4a
ardize its charitablet after December 31 1969) that could jeot i rb Did th i ti k i t i b-
por yea ( u ,e organ za on ma e any nves men n a prpurpose that had not been removed from jeopardy before the first day of the tax year beginning in 2005? 4b. . . .
5a During the year did the organization pay or Incur any amount to:(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ❑ Yes No(2) Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive? . . . . . . . . . . ❑ Yes No(3) Provide a grant to an individual for travel, study, or other similar purposes?. . . ❑ Yes ® No(4) Provide a grant to an organization other than a charitable, etc., organization described
in section 509(a)(1), (2), or (3), or section 4940(d)(2)? . . . . . . . . . . ❑ Yes M No(5) Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals? . . ❑ Yes J No _ - --, -tions described inualif under the exceti n f il tdid f th tb If i "Y " t 5 1 5 y p){ any o e ransac o s a o qany answer es o a( ),s
4945 or in a current notice regarding disaster assistance (see page 20 of the instructions)?Regulations section 53 5b.Organizations relying on a current notice regarding disaster assistance check here. . . . . ► ❑ •
q_ ec If the answer is "Yes" to question 5a(4), does the organization claim exemption fr m'ftax because it maintained expenditure responsibility for the grant? . .v',� ❑ Yes ❑ No
If "Yes," a ttach the statement required by Regulations section 53.4945-5(d).
6a Did the organization, during the year, receive any funds, directly or indirectly, to paypremiums on a personal benefit contract? . . . . . . . . . . . . . . . ❑ Yes A No
directly or indirectly, on a personal benefit contract?during the year pay premiumsb Did the organization 6b, ,,If you answered "Yes" to 6b, also file Form 8870. " -
Form 990-PF (2005)
Form 990-PF (2005) Page 6
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,and Contractors
I List all officers , directors , trustees, foundation managers and their compensation (see page 21 of the instructions).
(a) Name and address(b) Title, and average
hours per weekdevoted to position
(c) Compensation(If not paid , enter
-0-)
(d) Cont ri butions toemployee benefit plans
and deferred compensation
(e) Expense account,other allowances
Co.INNe_ r -----------------Q.5%O&Frt
LIP
•1 a f�IL 0 `- - b - G •--
�� tlpStc /Terms
2 Compensation of five highest-paid employees (other than those included on line 1-see page 21 of the instructions).If none, enter "NONE."
(a) Name and address of each employee paid more than $50,000(b) Title and average
hours per weekdevoted to position
(c) Compensation(d) Contributions toemployee benefitplans and deferred
compensation
(e) Expense account,other allowances
oNe
------------------------------------------------------------------
------------------------------------------------------------------
-------------------------------------------------•----------------
Total number of other employees paid over $50,000. ► 13 Five highest -paid independent contractors for professional services-(see page 21 of the instructions ). If none, enter
"NONE."(a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
NoN e-
Total number of others receiving over $50,000 for professional services . . ►
Summary of Direct Charitable Activities
List the foundation ' s four largest direct charitable activities du ring the tax year Include relevant statistical information such as the numberof organizations and other beneficiaries served , conferences convened , research papers produced, etc. Expenses
1 eN!veK �'e�.Ec tica�fi.pn% Fti° OVq�ho6� ��"'� q - S z-------------------------------------------------------------------------------•--------------------------•----------------- 2 , 7sy, 76
2Pr...p!_?.. ¢ !�B� Ryf,� ow_er� -See ...............
2t6 ob.33 Fp --"- Cre .'t. A110_v -FU-p--t7.N ............AG---~ :52 � S Q- - ---•----
---------------------------------------------------------------------------------------------------------------------------- 2,3 (Sl,Z4 ---pkp al-� t -S2�S w�E
-----------------------------------------------------------------------------------------------------•---------------------- ) J 0001 (lioForm 990-PF (2005)
Form 990-PF (2005) /2 -3 1- o3 (J1 y)5 4- , y tl N Q& A CA,' o 4 K rCiimmnr,# of Drnnrcam_Rehtorl Inumotmantc ( a nano 99
r1,-. 3S=(,oinctn irtinnsl
L K z 6 61 Page 7
Describe the two largest program -related investments made by the foundation during the tax year on lines 1 and 2 Amount
1 -0OV/-1 ----------------------------------------•----------------------------------•-----•-----•----•-•------•-•--------
2 •---------------------------------------------------------------------------------------•-------------•--••-----------•------
All other program -related Investments . See page 22 of the instructions
Total . Add lines 1 through 3 . . . • ►Minimum Investment Return (All domestic foundations must complete this part. Foreign tounoations,see page 22 of the 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 . . . . . . . . . . . . . . . . . is - o -b Average of monthly cash balances . . . . . . . . . . . . . . . . . . . . . lb
c Fair market value of all other assets (see page 23 of the instructions) . . . . . . . . . is
d Total (add lines 1 a b and c) id,, .e Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation) . . . . . . . . . . . . le _2 Acquisition indebtedness applicable to line 1 assets . . . . . . . . . . . . . . . 23 Subtract line 2 from line l d 3 (o /.$ 7. 61(
4 Cash deemed held for charitable activities. Enter 1'/z% of line 3 (for greater amount, see page 236 ` 3(3of the instructions) M.,,-4 1v D15fr� 6v.ttoN 4 °t .
5 Net value of noncha ritable -use assets . Subtract line 4 from line 3. Enter here and on Part V, line 4 5 L(/ 9 (0 It. S6 Minimum investment return . Enter 5% of line 5 6 2. 3 z2
Distributable Amount (see page 23 of the instructions) (Section 49420)(3) and 0)(5) private operatingfoundations and certain foreign organizations check here ► ❑ and do not complete this part . )
1 Minimum investment return from Part X, line 6 . . . . . . . . . . . . ? 2 3 . 2i
2a Tax on investment income for 2005 from Part VI, line 5 . . . . . . 2ab Income tax for 2005. (This does not include the tax from Part VI.) . . 2bc Add lines 2a and 2b . . . . . . . . . . . . . . . . . . . . . . . . 2c
3 Distributable amount before adjustments. Subtract line 2c from line 1 . . . . . . . . . 3 23 . Z--4 Recoveries of amounts treated as qualifying distributions . . . . . . . . . . . . . 45 Add lines 3 and 4 . . . . . . . . . . . . . . . . . . . . . . . . . . 5 3 8,z_z -
6 Deduction from distributable amount (see page 24 of the instructions) . . . . . . . . . 67 Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII,
line 1 7 2_39 f!. Zz
Qualifying Distributions (see page 24 of the instructions)
1 Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:a Expenses, contributions, gifts, etc.-total from Part I, column (d), line 26 . . . . . . . . 1a I9? 13o.z8b Program-related investments-total from Part IX- B . . . . . . . . . . . . . . . ib
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
4 and Part XIII line 4line 8Enter here and on Part VAdd lines la through 3bQualifying distri butions 4 3 0 • a9, ., ,..5 Organizations that qualify under section 4940(e) for the reduced rate of tax on net investment
income. Enter 1 % of Part I, line 27b (see page 24 of the instructions) . . . . . . . . . 56 Adjusted qualifying distributions . Subtract line 5 from line 4 . . . . . . . . . . . 6 30.28
Note : The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundationqualifies for the section 4940(e) reduction of tax in those years .
Form 990-PF (2005)
Form 990-PF (2005) • Page 8
Undistributed Income (see page 24 of the instructions)
(a) (b) (c) (d)1 Distributable amount for 2005 from Part XI, Corpus Years pnor to 2004 2004 2005
line 7 . zz2 Undistributed income, if any, as of the end of 2004:a Enter amount for 2004 only . . . . . 0,00b Total for prior years: 20 ,20 ,20
3 Excess distributions carryover, if any, to 2005:a From 2000 . . . . . 30 5'1.4b From 2001 4
��c From 2002. . . . . D 3d From 2003. . . . . i-' .3 RAYe From 2004 . . . . . O 7f Total of lines 3a through e. . . . . 6S't� 7 �p , 0 ti. ;
4 Qualifying distributions for 2005 from PartXII, line 4: ► $ (9 q 3 D, 24
a Applied to 2004, but not more than line 2ab Applied to undistributed income of prior years
(Election required-see page 25 of the instructions) D • C'c Treated as distributions out of corpus (Election
required-see page 25 of the instructions)d Applied to 2005 distributable amount • Zl�-e Remaining amount distributed out of corpus
5 Excess distributions carryover applied to 2005(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 qwa' 9'b Prior years' undistributed income. Subtract
line 4b from line 2b . . . . . . . =�"c Enter the amount of prior years' undistributed jf
income for which a notice of deficiency hasbeen issued, or on which the section 4942(a)
(tax has been previously assessed . . . . �'`•= `d Subtract line 6c from line 6b. Taxable
amount-see page 25 of the instructions .e Undistributed income for 2004. Subtract line
4a from line 2a. Taxable amount-see page25 of the instructions . . . . . . . " 1 V4
f Undistributed income for 2005. Subtractlines 4d and 5 from line 1. This amount must - vbe distributed in 2006 . . . . . . .
7 Amounts treated as distributions out ofcorpus to satisfy requirements imposed by +.{Ri `section 170(b)(1)(E) or 4942(g)(3) (see page .. ; s25 of the instructions) . . . . . .
8 Excess distributions carryover from 2000 notapplied on line 5 or line 7 (see page 25 ofthe instructions) . . . . . . . . . 8'13 o 15-7 .9
9 Excess distributions carryover to 2006.ZIO-Subtract lines 7 and 8 from line 6a
10 Analysis of line 9:a Excess from 2001 . . 67 1 .'t S'b Excess from 2002 . , 802- Fc Excess from 2003 . .d Excess from 2004 1• °`-'-
`e Excess from 2005 o e' -F ; ' + a�+> wForm 990-PF (2005)
Form 990-PF (2005) / Z -3)-OS- hl 5 /• , r0 K+A/d hOw O 1N / ,1 I(/[ - ^- rO D 2,g 8 Page 9
Private Operating Foundations (see page 26 of the instruction and Part VII -A, question 9)
'1a If the foundation has received a ruling or determination letter that it is a private operatingfoundation , and the ruling is effective for 2005, enter the date of the ruling . . . . ►
b Check box to indicate whether the organization is a private operating foundation described in section ❑ 49426)(3) or ❑ 49420)(5)
2a Enter the lesser of the adjusted net Tax year Prior 3 years (e) Totalincome from Part I or the minimum (a) 2005 (b) 2004 (c) 2003 (d) 2002investment return from Part X for eachyear listed . . . . . . . .
b 85% of line 2a . . . . . .
c Qualifying distributions from Pa rt XII,line 4 for eacn year iisied . . . .
d Amounts included in line 2c not used direct lyfor 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
under section 49420)(3)(B)(i)b "Endowment" alternative test-enter %
of minimum investment return shown inPart 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 publicand 5 or more exemptorganizations as provided insection 4942(I)(3)(B)(ni) . .
(3) Largest amount of supportfrom an 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 page 26 of the 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 the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
N f6b List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of theor74
hip of a partnership or other entity) of which the foundation has a 10% or greater interest.
2 Information Regarding Contribution, Grant, Gift, Loan , Scholarship, etc., Programs:
Check here ► ❑ if the organization only makes contributions to preselected charitable organizations and does not acceptunsolicited requests for funds. If the organization makes gifts, grants, etc. (see page 26 of the instructions) to individuals ororganizations under other conditions, complete items 2a, b, c, and d.
a The name , address, and telephone number of th�e .pa�on to whom applications should be addressed:
Q C�►�s'�-ia- g' �1-�roR1 o-� JNd"(4rvc,,, ZAc.gq 4r ,fie�s 4n,uc� rv ,Sti,�c zn A . 2 NIC l, 25y `I6�4 1 - LI3/c?
b The form in which applications should be submitted and information and materials they should include:
Plr 2 s c- r , 6 0 CO 4)4Jl c, -r i nN rc"'r�G/ &A r Q r f 4
c Any submission deadlines:
t1d Any restrictions or limitations on awards , such as by geographical areas , charitable fields, kinds of institutions , or other
factors: J-a �Q.J SC-40 �O "q4 (0 Z g0s"Se /,!4 7Ps C h � Is 7`'
Form 990-PF (2005)
Form 990-PF (2005) Page 10
F7.91M. Supplementary Information (continued)3 Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient If recipient is an individual,show any relationship to Foundation
st t s f Purpose of grant or Am tName and address (home or business)
any foundation manageror substantial contributor
a u orecipient contribution oun
a Paid during the year
5.e L s4 &/- -
Total . ► 3a B& 6b Approved for future payment
Total ► 3bl D . d QForm 990-PF (2005)
Form 990-PF (2005) -4 -3) -O ,S Y f a u �kN / o o - _LAr I rNC 3 - L D 9 62.6 5Page 11
Analysis of Income-Producing ActivitiesEnter gross amounts unless otherwise indicated. Unrelated business income Excluded by secti on 512, 513, or 514 (e)
Program service revenue:
(a)Business code
(b)Amount
(c)Exclusion code
(d)Amount
Related or exemptfunction income(See page 26 ofthe instructions)
abcdeIfg Fees and contracts from government agencies
2 Membership dues and assessments . . . .3 Interest on savings and temporary cash investments4 Dividends and interest from securities . . .5 Net rental income or (loss) from real estate:
a Debt-financed property . . . . . . .b Not debt-financed property . . . . . .
6 Net rental income or (loss) from personal property7 Other investment income . . . . . . . .8 Gain or (loss) from sales of assets other than inventory9 Net income or (loss) from special events . . .
10 Gross profit or (loss) from sales of inventory11 Other revenue: a
bcde
12 Subtotal. Add columns (b) (d) and (e) Z ' y2, . . .,13 Total. Add line 12, columns (b), (d), and (e) .(See worksheet in line 13 instructions on page 27 to
- Relationship of Activities to the
. .verify calculatiAccomplish
ons)ment of Exempt Purpose
13 2
s A IT
2 z
Line No.VExplain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly tothe accomplishment of the organization's exempt purposes (other than by providing funds for such purposes). (Seepage 27 of the instructions.)
Form 990-PF (2005)
Form 990-PF (2005) Page 12
Information Regarding Transfers To and Transactions and Relationships With Noncharitable
I Did the organization directly or indirectly engage in any of the following with any other organization described in section Yes No
501(c) of the Code (other than section 501(c)(3 ) organizations ) or in section 527, relating to political organizations?a Transfers from the reporting organization to a noncharitable exempt organizationof:�'
(1) Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a 1
(2) Other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a(2
b Other transactions:(1) Sales of assets to a noncharitable exempt organization . . . . . . . . . . . . . . . . 1b 1)
(2) Purchases of assets from a noncharitable exempt organization . . . . . . . . . . . . . 1b(2)(3) Rental of facilities , equipment , or other assets . . . . . . . . . . . . . . . . . . lb(3)(4) Reimbursement arrangements . . . . . . . . . . . . . . . . . . . . . . . . 1b(4)(5) Loans or loan guarantees . . . . . . . . . . . . . . . . . . . . . . . . . . 1b 5)(6) Performance of services or membership or fundraising solicitations . . . . . . . . . . . . 1b(6) 1C
c Sharing of facilities , equipment , mail ing lists, other assets , or paid employees . . . . . . . . . 1cd 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 repo rting organization . If the organization received less than fairmarket value in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets , or servicesreceived.
(a) Name of organization (b) Type of organization (c) Description of relationship
Under penal ' s of perju ry , I declare that I have examined this return, including accompanying schedules and statements , an to the best of my knowledge andbelief, it is e , correct , and complete . Declaration of preparer (other than
S,gnature f offic r or trustee
i�V) ' �-MO Preparers
. y signatureo,a Firm 's name (or yours if r7- ,
self-employed), address,'and ZIP code 1
2a Is the organization 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 , No
b If "Yes," complete the following schedule.
List of Deposits35 6 0 y 6' �O 8 Christian Foundation of IN, Inc.
2005
IDeposit Date Name Check # Amount01/19/05 Guy & Etta Faye Hudson Trust 2830 $100.0001/19/05 Larry Reagan 5977 $1000001/19/05 National Christian Foundation-Valinet Charity Fund 73125 $5,000 0001/19/05 Terry Heath 7943 $1,000.0001/19/05 Lawrence Sievers 8467 $1000001/19/05 Chad Davis 9089 $1,000.0002/09/05 Ali Kahn 1340 $50 0002/09/05 Ronald Morris 1467 $100 0002/09/05 nivigipn of rnrnArgtnno inr icinac rnrp 21069 $500.00
02/09/05 Shelley Haffner 226 $30.0002/09/05 Dennis Oberg 2424 $100.0002/09/05 Craig Baute 2442 $100.0002/09/05 William Potter 2505 $100.0002/09/05 Gerald Powell 2625 $300.0002/09/05 David Humphries 2832 $25.0002/09/05 Douglas Witter 2930 $1,000.0002/09/05 Denis Schinderle 2941 $100 0002/09/05 James Stanley, Jr. 3407 $50 0002/09/05 Joseph Bauer 3846 $50.0002/09/05 Robert Jordan 5248 $50 0002/09/05 David Parish 5738 $100.0002/09/05 Steven Wenning 8794 $1,000.0002/09/05 Brian McCall 9666 $25 0002/11/05 Douglas Dye 888 $200.0002/11/05 Steven Martin 1007 $500.0002/11/05 Jeffrey Hopper 1155 $25.0002/11/05 Thomas Bewsey 1366 $50.0002/11/05 Richard Curtis 2369 $500 0002/11/05 Jeff Unruh 2940 $75 0002/11/05 Brian Dougherty 3429 $3000002/11/05 Jon Huskins 3488 $50.0002/11/05 Helen Gardner 3690 $25.0002/11/05 Chris Raisovich 5569 $1000002/11/05 Mervin Minks 6425 $100.0002/11/05 David Roseberry 7469 $4000002/11/05 R Douglas Fenton 1802 $300.0002/16/05 Freidrich Ress 5093 $500.0002/16/05 Barry Maier 1005 $20.0002/16/05 Michael Shea 1039 $10,000.0002/16/05 Mark Lewis, DDS 12878 $1,000 0002/16/05 Michael Stevens 1396 $1000002/16/05 Michael Zoilar 1482 $1,000.0002/16/05 Brian Totton 1637 $100 0002/16/05 Kurt Paige 1701 $900.0002/16/05 Charles Ryerson 2088 $50.0002/16/05 John Price 22118 $1,000.0002/16/05 Robert Burger 2499 $250 0002/16/05 Nathan Gross 2637 $100.0002/16/05 Thomas Heniff 3136 $100 0002/16/05 Chad Kelley 3404 $1500002/16/05 Johnathan Moran 3440 $1,000 0002/16/05 Richard Smith 3492 $200.0002/16/05 Donald Fisher 3575 $500.0002/16/05 David Nakata 3678 $500.0002/16/05 J Michael Chapel 4493 $1000002/16/05 Russell Homes 4530 $350.0002/16/05 Bradley Johns 5317 $100.0002/16/05 Timothy Willoughby 5438 $1,000.00
,�j,Ou.IQ1
�� 60 &24 a List of DepositsCh ri stian Foundation of IN, Inc.
2005
02/16/05 John King 5538 $50.0002/16/05 Donald Raffel 5657 $500002/16/05 Michael Campbell 5937 $50.0002/16/05 Donald Fisher 7052 $50.0002/16/05 Brian Ba iley 8770 $200.0002/16/05 Edward Sung 895 $200.0002/16/05 James Disney 9021 $50 0002/16/05 E ric Slack 953 $300 0003/08/05 Indy Church Inc 1147 $300.0003/08/05 Richard Ferguson 1157 $5nn_nn03/08/05 JWA Sports , LLC 1160 $2 , 500.0003/08/05 David Oles 1172 $1,500 0003/08/05 H ilda Cullom 1262 $500.0003/08/05 Peggy Bechtle 1272 $25.0003/08/05 Carol Stoops 1277 $1 , 000.0003/08/05 Marilyn Mueda 1490 $500.0003/08/05 Georgette F. Joyce Trust 1554 $1,000.0003/08/05 Jennifer Cecil 1701 $100.0003/08/05 Steven Herr 1836 $100.0003/08/05 Richard Blum 1991 $1,000 0003/08/05 Jason Siciliano 2096 $100.0003/08/05 Dewitt Lane , LLC 2514 $10 , 000.0003/08/05 James Croner 2681 $100.0003/08/05 John Warren 3178 $1,000.0003/08/05 Charles Breece 3938 $100.0003/08/05 Redmond International LTD 4208 $300.0003/08/05 Steve Norris 4904 $200.0003/08/05 Clay Barnes 5534 $500.0003/08/05 John King 5579 $50.0003/08/05 James Watt 8234 $50.0003/08/05 Ronald Chambers 8333 $100.0003/08/05 Edward Sung 869 $200.0003/08/05 Edward Sung 914 $200.0003/08/05 JK Wieder 9674 $60.0003/08/05 JK Wieder 9687 $50.0003/08/05 Nathan Sa rtell 1033 $300.0004/15/05 Kristiana Buddee 1156 $40.0004/15/05 Peggy Bechtle 1284 $25 0004/15/05 Michael Stevens 1422 $ 100.0004/15/05 Michael Stevens 1465 $50.0004/15/05 Gregory Langford 1947 $92.0004/15/05 Compassion Ministries Hea rt of The Word 265 $2,000 0004/15/05 William Rambo Jr 284 $100.0004/15/05 Kevin Mink 2902 $200.0004/15/05 Donald Fisher 3617 $500.0004/15/05 Ulf Ester-Bode 3631 $100.0004/15/05 James Watt 3743 $25 0004/15/05 Jasmine Lee 404 $200 0004/15/05 Brian Humphrey 4199 $100.0004/15/05 Donald Mercer 4649 $90.0004/15/05 Lake Couthy Athletic Officials Association 471 $3650004/15/05 John King 5616 $50.0004/15/05 Patricia Reilly 6155 $100.0004/15/05 J. Brumfield 7399 $560.0004/15/05 Elizabeth Jones 7490 $200.0004/15/05 Edward Sung 936 $200.0004/15/05 Heritage Christian School 9981 $1 , 942.2305/17/05 R. Gregory Albers 1120 $1 , 000.0005/17/05 William Dull 1175 $1,000.00
Pon
List of Deposits'4 P 6- Christian Foundation of IN. Inc
2005
05/17/05 Marilyn Mueda 1516 $1,000 0005/17/05 Paula Mueda 1576 $100.0005/17/05 Charles Kurtz 1798 $500005/17/05 David Finley 1944 $500.0005/17/05 Robert Burns 2188 $1000005/17/05 Lawrence Thoune 253 $100.0005/17/05 Robert Burger 2583 $150.0005/17/05 George Whittaker 2719 $1000005/17/05 Donald Fisher 3661 $500.0005/17/05 Donald Fisher 3714 $500.0005/17/05 Patrick Jarrett 3802 $350 0005/17/05 Jeffrey Stillinger 3947 $100.0005/17/05 James Hawke 4178 $5,000 0005/17/05 Jasmine Lee 428 $500.0005/17/05 Kevin Regnier 4450 $300.0005/17/05 Heath Benson 4542 $50 0005/17/05 Timothy Roesler 6689 $200 0005/17/05 Mark Grant 6799 $1,000 0005/17/05 Richard Belanger 7042 $100 0005/17/05 National Christian Foundation-Wilson Family Foundation 79465 $4,000.0005/24/05 Chad Kelley 3452 $64.0005/24/05 Charles Morgan FND 1150 $5,000.0005/24/05 Peggy Bechtle 1298 $25.0005/24/05 Michael Stevens 1486 $1000005/24105 Ernie Oar 1513 $2,000 0005/24/05 James Snodgrass 1640 $500.0005/24/05 Lake Couthy Athletic Officials Association 500 $195.0005/24/05 Edward Sung 963 $200 0005/24/05 Chris Doehring 969 $200.0006/10/05 Peggy Bechtle 1313 $25.0006/10/05 Sigma Pi Fraternity 2033 $1,000.0006/10/05 Mark Abernathy 2301 $4.8406/10/05 Brian Dougherty 3481 $500.0006/10/05 Donald Fisher 3749 $500.0006/10/05 Jack Nikcevich 3883 $100.0006/10/05 John King 5699 $50.0006/10/05 Carol Stoops 6658 $400.0006/10/05 National Christian Foundation-Gregory G. Enas Charitable Fund 80231 $1,500.0006/10/05 Donald Nester 837 $300.0006/10/05 Edward Sung 986 $200.0006/10/05 Peggy Bechtle 1325 $250006/30/05 Bradford Osborne 1418 $2500006/30/05 Michael Stevens 1543 $50.0006/30/05 Paula Mueda 1651 $100.0006/30/05 John Price 22235 $250.0006/30/05 Edwin Brown 2425 $500.0006/30/05 Ellen Stancil 3243 $50 0006/30/05 Charles Davis 4340 $100 0006/30/05 Jerry Clough 5739 $50.0006/30/05 R.E. Van Duesen 7222 $200.0006/30/05 Douglas King 8103 $1500006/30/05 Lawrence Sievers 8559 $50 0007/08/05 United Hope Foundation, Inc. of IN 1021 $595.0007/08/05 Larry Smith 1853 $55.0007/08/05 Donald Fisher 3829 $500.0007/08/05 Dale Crabtree 3965 $200.0007/08/05 Paul Estridge Jr. 7065 $26,200 0007/08/05 Edward Sung 999 $200 0007/25/05 Blake Jackson 1309 $1,000 00
5c4a4 (e IP 3 �1 8
�r y gL68 List of DepositsChristian Foundation of IN , Inc
2005
07/25/05 Go Jon Go 1312 $150.0007/25/05 Hea rtland Collegiate Athletic Conference 1660 $2,700.0007/25/05 Donald Mercer 4737 $78.0007/25/05 Larry Reagan 6119 $1000007/25/05 Colfax Center Church 936 $323.4208/05/05 Barry Sharp 1925 $6,0000008/05/05 Paul Vallina 2243 $100 0008/31 /05 Edward Sung 1025 $200.0008/31 /05 Peggy Bechtle 1343 $50.0008/31/05 Paula Mueda 1738 $100 0008/31 /05 James Watt 3815 S500008/31 /05 Christ Evange li cal Free Church 515 $120.0008/31 /05 John King 5834 $50.0008/31 /05 National Christian Foundation-Ga ry & Linda Allen Fund 83887 $2,500 0008/31/05 Peter Burke 924 $500.0009/19/05 Edward Sung 1047 $200.0009/19/05 David Wey 1070 $300.0009/19/05 Michael Stevens 1594 $1000009/19/05 Michael Stevens 1619 $50.0009/19/05 Barry Sharp 1949 $5,000 0009/19/05 D. Ruth Stark 360 $200.0009/19/05 Norman Mindrebo 4374 $350.0009/19/05 Edward Soots 7378 $ 1,375 0009/19/05 National Christian Foundation -Valinet Charity Fund 85394 $2,500.0009/19/05 Michael Drippe 8780 $5000009/19/05 Peggy Bechtle $50.0009/28/05 Karin Lilj estrand 1009 $30 0009/28/05 Steven Bennett 10170 $50 0009/28/05 Joseph Leavell 1117 $500009/28/05 Carol Butler 1125 $350009/28/05 Sharron Atkins 1184 $200.0009/28/05 Richard Carey 12267 $250009/28/05 AdverMotions 1326 $25.0009/28/05 Academy Allergy, Asthma & Sinus , PC 1406 $25 0009/28/05 Valda Burgis 1425 $30.0009/28/05 J. David Resley 1457 $250.0009/28/05 Frank Chaten 1528 $100 0009/28/05 Clista Lovell 1560 $1,200 0009/28/05 Steve Arnold 1580 $20.0009/28/05 Joshua Campbell 1695 $50.0009/28/05 Daniel Wil son 1772 $5000009/28/05 Colonial Hills Baptist Church 20398 $1000009/28/05 James Eaton 2054 $100.0009/28/05 Schneider & Company , Inc. 20716 $100.0009/28/05 Gregg Mantock 2207 $20 0009/28/05 John Price 22325 $100 0009/28/05 Cynthia Germain 270 $30 0009/28/05 Jack Hogan 2863 $1500009/28/05 Herbe rt Gaunt 3030 $25 0009/28/05 Terry Snider 3075 $50.0009/28/05 Pat ri ck McKee 3093 $50 0009/28/05 Phillip Mosabaugh 4009 $1000009/28/05 Delmar Bu rtner 4024 $100.0009/28/05 John Baker 4070 $50 0009/28/05 Clifton McFarland 4146 $100.0009/28/05 John Jordan 4311 $100.0009/28/05 David Nief 4362 $25.0009/28/05 William Powell 4399 $25.0009/28/05 Wayne Smith 5553 $50 00
3 S- 6 D gZ� £�List of Deposits
Christian Foundation of IN , Inc.2005
09/28/05 Gregory Davis 5844 $50.0009/28/05 Jeffrey Furlin 5995 $200.0009/28/05 Paul Cox 6019 $100.0009/28/05 Newell 0. Pugh , Jr. MD 6351 $50.0009/28/05 L J Bucket 6664 $100.0009/28/05 Zeller Construction Co., Inc. 6705 $50 0009/28/05 Daniel Skaggs 7739 $100.0009/28/05 Philip Woodbury 7965 $25.0009/28/05 Dawn Ayers 802 $40.0009/28/05 Timothy Brent 8115 $50.0009/28/05 Jennifer Rundle 9095 $25 0009/28/05 Roland Inskeep 9749 $1000010/03105 Brian Flickinger 1008 $250010/03/05 Randall Nederho 10584 $850 0010/03/05 Greenwood Foot Clinic - Mark Lazar 11441 $100.0010/03/05 Heritage Christian School 12282 $1000010/03/05 William Howell 1231 $100010/03/05 Kara Ford 1307 $500010/03/05 Carmel High School 13336 $50.0010/03/05 Covenant Christian School 13426 $50.0010/03/05 Paul Wilson 1397 $1000010/03/05 Jessee Rush 14585 $25.0010/03/05 Berdean Suprenant 1739 $100.0010/03/05 Haffley , Taylor & Company , LLC 1746 $150.0010/03/05 Jennifer Thomas 1889 $ 150.0010/03/05 Richard Krampe 2046 $25.0010/03/05 Cu rt is Dicken 2054 $50 0010/03/05 Tammy Goodyear 2082 $30 0010/03/05 JHC Foundation 2281 $1 , 000.0010/03/05 Bill Blankenbaker 2416 $250010/03/05 Michael Alley 2812 $100.0010/03/05 Jeff Holcomb 3084 $25.0010/03/05 Stephen Freeman 3098 $5000010/03/05 Alvis Robe rtson , Jr. 3208 $500010/03/05 John Sweeney 3289 $20 0010/03/05 Charles Goodwin 3621 $25.0010/03/05 Kevin Arnold 3785 $25 0010/03/05 Hamilton Hea rt, Inc 3832 $2500010/03/05 Wil liam Sahm Jr. 4257 $100.0010/03/05 Gary Trauter 4272 $500010/03/05 William Spidle 4719 $500010/03/05 P. A . Begala 5386 $30.0010/03/05 Robert Shocklee 5517 $25.0010/03/05 Wil liam Wiechman 5891 $100.0010/03/05 Brian Cooley 6005 $25.0010/03/05 Michael Logar 6451 $30.0010/03/05 W . P. Power 6571 $50.0010/03/05 Jeffrey Ginther 6640 $1000010/03/05 Eugene Barc 6719 $30.0010/03/05 Harold Francis 7412 $25.0010/03/05 Greg Bamrick 7467 $400010/03/05 Dwight Williams 7684 $100.0010/03/05 Joe Forgey , DDS 7711 $1000010/03/05 John Acton 7712 $450.0010/03/05 Timothy Johnston 7820 $250.0010/03/05 National Christian Foundation -Gary & Linda Allen Charitable Fund 86376 $500.0010/03/05 Pat Welch 8749 $500010/03/05 Scott Lockha rt 90656 $15.0010/03/05 Shepherd Insurance & Financial Se rvices , Inc. 9320 $100.00
d.X. 1PVJ�e g
3 S- 60 4 g'- 6 S List of DepositsChristian Foundation of IN, Inc.
2005
10/03/05 Jeffrey Brunett 9404 $50.0010/03/05 Robe rt King 111 9810 $50.0010/03/05 Jeffrey West 9889 $30 0010/10/05 C David Garman 840 $40.0010/10/05 Kelly Brown 1 $100010/10/05 Markland Enterprises , Inc. 1059 $4500010/10/05 Benjamin Cloyd 1282 $25.0010/10/05 Blue River Valley High School 15309 $500010/10/05 Cathedral Trustees , Inc. 16260 $50.0010/10/05 Michael Stevens '1999 Ginn nn10/10/05 Naraine 1726 $500010/10/05 Gregory Bosler 1922 $2000010/10/05 Janice Brown 2150 $25.0010/10/05 Richard Rust 2281 $100.0010/10/05 Brett Miller 2297 $100.0010/10/05 Myron Dickerson 2371 $50 0010/10/05 Kendall Bush 2382 $100.0010/10/05 R Terry Heath 2768 $50.0010/10/05 Christina Carter 2848 $100 0010/10/05 Christian Medical & Dental Society 2929 $50.0010/10/05 Beverly Engebretsen 2948 $25 0010/10/05 Guy & Etta Faye Hudson Trust 2967 $100.0010/10/05 Terry Porter 2987 $50.0010/10/05 David Wilson 3033 $500.0010/10/05 Bishop Chatard High School 30901 $50.0010/10/05 Larry Sweany 3501 $50.0010/10/05 Carmel Raquet Club , Inc 37475 $100.0010/10/05 Wil liam Caskey 3896 $ 100.0010/10/05 Teri Lambe rt 3959 $50.0010/10/05 Bernie M il ler 4258 $50.0010/10/05 Anthony Wil liams 4314 $450 0010/10/05 Thomas Ewald 4392 $25.0010/10/05 Heritage Christian School 4432 $100.0010/10/05 Thomas Berry 4668 $ 100.0010/10/05 Jon Sheffer 4751 $100.0010/10/05 Walter Gray 5044 $20.0010/10/05 Billy Shepherd 5380 $100.0010/10/05 John King 5864 $50 0010/10/05 Denise Barc 590 $25 0010/10/05 Hoosier Foot & Ankle , LLC 6528 $100 0010/10/05 Gregory Otey 6606 $50.0010/10/05 Hamilton Orthopedics & Sports Medicine , PC-Thomas Cittadine 6764 $100.0010/10/05 James Reed 6886 $450.0010/10/05 Michael Smart 7894 $50.0010/10/05 Chad Davis 9511 $1000010/10/05 Ronald Lyon 9528 $50 0010/10/05 Albert Lee , MD 9662 $2 , 000.0010/14/05 Bobbi Conner 101 $ 1,000.0010/14/05 David Josephson 11286 $100.0010/14/05 Bethel College 115404 $500.0010/14/05 R Adomatis 1168 $500.0010/14/05 Heritage Christian School 12412 $1000010/14/05 E Lennis Utterback 1378 $25.0010/14/05 Susanne Wible-Richards 1648 $25.0010/14/05 Jonathan Altman 1995 $50.0010/14/05 Judith Barnes 1999 $25.0010/14/05 Allen Moore 2522 $1000010/14/05 George Kish 2535 $10 0010/14/05 American Health Network of IN 3141237 $100.00
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b• ibList of Deposits
3S6, f r Christian Foundation of IN, Inc2005
10/14/05 James Lockhart Jr. 3293 $50 0010/14/05 Robert Sand 481 $50 0010/14/05 Frank E. Casper 4922 $25.0010/14/05 Samuel Heiser 5558 $100 0010/14/05 R Shane Muir 5628 $50.0010/14/05 William Haehl 5687 $30 0010/14/05 Jon Stroh 6051 $50.0010/14/05 Thomas Abernathy 6368 $100 0010/14/05 Robert Stevens 6808 $25.0010/14/05 Gretchen Geyer 681 $20.0010/14/05 New Hope Orthopedics & Sports Medicine PC 7268 $1,000 0010/14/05 Linda Hillman 7948 $50 0010/20/05 Inez Stoltzfus 1034 $1,100.0010/20/05 Edward Sung 1070 $200 0010/20/05 Thomas Russell 11443 $1000010/20/05 Thomas Jones 2035 $50.0010/20/05 Jennifer Young 2069 $50.0010/20/05 Thomas Remender 216 $100.0010/20/05 Roberta Horan 3013 $50.0010/20/05 Margie Debruyn 367 $25 0010/20/05 Brian Bosma 4109 $100 0010/20/05 Brent Burke 5011 $500010/20/05 M Alen Bechtel 5935 $50 0010/20/05 Teri Burton 760 $100 0010/20/05 Riverview Hospital 18555 $150.0010/20/05 Roger Sickle 1102 $50.0010/20/05 Gwen O'Donnell 1 $38.0010/26/05 Nagan, Arregui & Davis MD'S, Inc 1150 $100.0010/26/05 M J Reed 1680 $5,000.0010/26/05 Robert Meyer 2260 $100.0010/26/05 David Wilson 2456 $50.0010/26/05 Justin Burtner 381 $100.0010/26/05 Robert Milleville 4196 $25.0010/26/05 James Schneider 6618 $350010/26/05 Timothy Whisman 8934 $50.0010/31/05 Mark Novotony 1076 $250.0010/31/05 East Columbus Christian Church 128 $200.0010/31/05 East Columbus Christian Church 14863 $20.0010/31/05 Michael Stevens 1693 $100 0010/31/05 Melissa Kramer 1866 $500010/31/05 Vincent Cook 4010 $100010/31/05 Donald Stanton 4124 $200010/31/05 John King 5895 $50.0010/31/05 R. Daniel Hockett 9234 $100.0011/10/05 Heritage Christian School 12694 $1,217.0511/10/05 Merrill Lynch- Shannon Ginn 125 $300.0011/10/05 East Columbus Christian 14872 $20.0011/10/05 Amber Scannell 2010 $100.0011/10/05 John Rosich 2046 $250011/10/05 Dr. David Kristoff 22050 $1,000 0011/10/05 Willard Hensley 2457 $50.0011/10/05 Dennis Adomatis 3895 $200.0011/10/05 Richard Risinger 5221 $1000011/10/05 Mark Ambre 5564 $1000011/10/05 Bruce Gilham 5773 $1000011/10/05 D Clay Scott 9686 $4,850.0011/17/05 Edward Sung 1086 $2000011/17/05 Marilyn Mueda 1591 $100.0011/17/05 Joseph Clayton 1775 $100.00
y_ b v 8 iG List of DepositsChristian Foundation of IN , Inc.
2005
11/17/05 Gyspyfrog 2091 $500011/17/05 David Watt 2929 $150.0011/17/05 Herbe rt Feldmann 3213 $25.0011/17/05 Stephen Etter 4346 $20.0011/17/05 Connersville Senior High School 65389 $30.0011/25/05 Rosemary Schaefer 1481 $10.0011/25/05 Robe rt Smitson 2077 $ 1,000 0011/25/05 David Henthorn 3929 $500.0011/25/05 David Henthorn 3930 $500.0011/25/05 George Clark 5071 $200 0012/05/05 Dr . Stanley 1403 $2,000.0012/05/05 East Columbus Christian Church 14906 $20 0012105/05 Michael Stevens 1720 $1000012/05/05 Donald Smith 1981 $20.0012/05/05 John Price 22373 $2,500 0012/05/05 Richard Taylor 2848 $2500012/05/05 Guy & Etta Faye Hudson Trust 2999 $50.0012/05/05 Joseph Hession 3827 $ 100.0012/05/05 Linda Fisher 3910 $ 1,500.0012/05/05 Linda Fisher 3911 $1 , 500.0012/05/05 Patrick Jarrett 4056 $550.0012/05/05 Jennifer Grant 4703 $250012/05/05 Steve Norris 5083 $100.0012/05/05 W Todd Southard 8595 $1000012/19/05 Sandra Wire 628 $3000012/19/05 JTC Foundation 1010 $500.0012/19/05 Kimberly E Davis Trust 1093 $1,000 0012/19/05 Edward Sung 1108 $2000012/19/05 Ernie Oar 131 $1 , 500.0012/19/05 East Columbus Ch ri stian Church 14934 $20.0012/19/05 East Columbus Christian Church 14937 $100012/19/05 JHC Foundation 2285 $1,200 0012/19/05 Charles Lofton 2435 $50.0012/19/05 T . David Wesner 3905 $250012/19/05 John King 5937 $50.0012/19/05 Steve Znachko 6236 $5,000 0012/19/05 Cornerstone Companies , Inc 6865 $2 , 500.0012/19/05 Alan Naas 7724 $5000012/19/05 David Garrison 8010 $5,000 0012/19/05 National Christian Foundation -Wil son Family Foundation 89731 $500.0012/19/05 National Christian Foundation - Valinet Charity Fund 90066 $2,500.0012/19/05 Blaising Inc 9109 $2,500 0012/19/05 Thomas Jarrett 9166 $9000012/19/05 Albe rt C. Lee , MD 9859 $1,300 0012/30/05 Anthony Stremiecki 1029 $30 0012/30/05 Todd Hu fford 1657 $ 1,200 0012/30/05 Eric Turner 2181 $ 100.0012/30/05 Bill Fanning 2732 $100.0012/30/05 Lawrence Higgins 4033 $200.0012/30/05 John Poehler 5011 $500012/30/05 Eldon Hoyt 5449 $100.0012/30/05 John King 5972 $500012/30/05 Robert Haskin 823 $500 00
Total $224 ,374.54Anonymous Cash Donations $557 00
Final Total $224,931.54
s��u�a T
Oharitable C tnbutionsCAridian Foundation of IN. Inc.
2015Naune Adc ess Purpose Of Grant AmountHeritage Christian School 6401 E. Mh St., hidiampot . IN TilSon $7,222.00
Medical Expense &Bevei1y maple 202 Center St_, Eii¢abelhtown. IN Hosehotd Expense $350.00Richard Harvey 125 Webster, Chestedb ld, IN Vehicle Expense $507.15Abdo KIr g 2341 Cayner Ave, Indianapolis, IN Household Expense $400.00May Dourarnacos 1305 S. Park Ave.. Lot # 05, AEexan& a. IN Health Insurance $5D1.66TrM Harrison 616 W. Main SL. Chesterfield. IN Funeral Expense $800.00James Snith 343 Lansdowne Rd., Indkanapalis, IN Household Expense $1,000.00Terri Andersom 6500 Whitehorn Court #ZA. Indanepolis, IN Hotsehold Expense $500.00James Snith 343 Lansdowne Rd., Indianapolis, IN Medb=al Expense $1,000.00Tanury Abernathy 825 Rarilko Dr.. Anderson, IN Mediica[ Expense $560.00Angi Bosick 2 E. Branch, Bmmnsburg , IN 46112 Household Expense $2,00000Leslie Ellis 7930 Ptacfng Rd., lndlaiapoflsr IN Household E*ense $750.00Tim WNW 5910 E. 91st St.. Indianapolis. IN Mortgage Expense $1,000.00Ter k Area Education Fund Nairmbl, Kenya Education Supplies $4,625.00Pokfw Dodge -F80 /t(&ry DD Kr4M 4e o s 4343 W. 38M St. Indianapolis. IN VeP ide Expense $6,632.50Richard Harvey / 125 Webster, C hesterftetd, N Insurance Expense $500.00Tdcla Harrison 618 W. Main St. Chesterfield. IN Funeral Expense $776.00Dian Long 109 Amber Dr., Anderson, IN 46012 Medical Expense $2,000-00Jeffvia= 44 Cambridge CL, Andaman. IN Househ id Appliance $516.00Clams Statey 5170 Oldleld Q., Carmel, IN General Need3 $200.00Larry Myers 7027 Lockwood Dr., Indianapolis, IN Dental Expense $420110Terri Anderson 6509'Miiiehom Court *7A, Indianapolis , IN Hou sehold Expense $500.00Tent Anderson 6509 hIlehom Court 7►ZA, Indianapolis , IN Household Expense $500J10Forum Credit Union - Ana Bostick 11313 USA Parkway, Ether, 04 46035 Household Expense $2,000.00Tenwek Area Education Furod Nairobl, Kenya Ed- albn Suppfes $7,15723Len Somers 8436 Harrison De., Indianapolis, IN Household Expense $2.000110Dan Ambrose 11228 Woodbury Gt., Cannel, IN Household Expense $2,000.00Toni Anderson 6500 Whilehom Court#ZA. Indianapolis. IN Household Expense $500.00Forum Cnadt Union - Angi Bostic 11313 USA Parkway, Fishers, IN 48035 Household Expense $2,000.00Tony Hinkle 9030 Shady Tree Ln., Indianapo li s. IN Vehicle Expense $1,500.00Stall Cooper 2916 Shemten SL, Anderson. IN Vehicle Insurance $500.00Kurt Lortz 5607 Columbus Ave., Anderson. IN Medical Expense $3,600.00Marie King 2341 Cayner Ave, Indianapolis, IN Household Expense $800.00Susanne Miller 5849 W SR 234 . Jamestown, IN Medical Expense $400.00Forum (edit Union - Anti Bos5ck 11313 USA Park way, Fishers . IN 46035 Household Expense $2.000.00
Jones Orthodontics, P.C - Paul HouckDave WaftDebbie birrithMares 1GnyTenwek Area Education FundPaanoerpo*je F13o .15S SIawerSSusanne MilerTerri AndersonForm Cre dit Union - Argi BostickDawn BragaraHoward BellamyBJ CarverMarie KirnDDan StroupForum Credit Union - Angi BostickAndrew HadForum Credit Union - Angi BostidsWUNam Carver Jr.Community Christian School - Samuel KuIpForum Credit Union - Angi BosiidcConner Instxanoe Agen , Inc.Nancy Jackson
Angi BostickOaks Academy - Lily RigbySharon CruseAyoola I ndapo-OgunleyeFarm Credit Union - Angl BostickDarren CashmanShane AndersonBilly BeltClair StaleySusan BensonLand BloomersKurt LnrtzElanie GrantMn Gustitushieg LambooyyErin PotoetSharon Racks
Z3 6 o L( 2-1--3Chafe a CantiIbuibons
Christian Foundation of IN, Inc.2005
11140 Oaklandun Rd.. Indianapolis. IN Dnntal Expense $110.004319 N. Olney Rd., Indianapolis. IN Household Expense $13,000.00343 Lansdowne Rd., Indianapolis, IN Missionary Trip $250-002341 Coy►nerAve, Indtanopolis , IN Household Expense $1.000-00Nairobi , Kenya Educa ffan Supplies $8,114.004343 W. 38th St, Indks taposs, IN Vehicle $M.064.345649 W SR 234. Jamest wn, IN Child Expense $595.008509 Whitahorn Court #ZA. Ind1anapotis. IN General Needs $500.0011313 USA Parkway, Fishers. IN 46035 Household Ecense $2,000.002536 Hideaway Dr., Indianapolis . IN Household Expense $2,000.004040 Eastern Ave-, Indianapolis, IN Household Expense $2,000.0013171 Sunrnorwood Ln, Flsh s, IN 46038 General Needs $500.002341 Coyner Ave, Indianapolis . IN Household Expense $450.007309 Totlenhann Dr., Indlanapotis, IN Household Expense $6.000.0011313 USA Parkway. Fishers. IN 46035 Household Expense $2,000.005338 Washingbn Blvd.. Indeanepolis , IN General Needs $3.055.0011313 USA Parkway. Fishers, I N 46035 Household Expense $2,000.0013171 Sunwnenvood Ln, Fishers, IN 48038 Household Expense $500.00900 Enos Rd.. Ridrnond , IN Tuition $1 ,375.0011313 USA Parkway, Fishes, IN 46035 Household Expense $2,000.00
��� 1�h�rh /�caaf �fSN<8445 Keystone Crossing. Al 200, Indfanapols. IN iov$1.17300 Oav3316 Maple Rd., Anderson, N Medical Expanse $5,000.00
Funeral Expense &2 E. Brandt. Brownsburg. IN 46112 Medical Expense $5,151.282301 North Park Ave., I anapols , IN Tultton $1,500.0011772 Boar atc In., Fishers , IN Bad Debt Reduction $2,700.007713 Knue Rd., Indianapolis , IPI Vehicle Expense $4,315.0011313 USA Parkway, Fishers . IN 46035 Ho hold Expense $2,000.007409 N. IGIL y Ave. Utility Expense $650.0010260 Tod House Way, Fishers, IN General Needs $500.003202 E 46th St.. Indianapolis . IN General Needs $500.005170 OkIfbeid CL, Carmel , IN General Needs $500-003600 W 961h SL, Indianapols , IN 46268 General Needs $350.003600 W 98th St., Indianapolis, IN 46268 General Needs $350.005607 Columbus Ave.., Anderson, IN General Needs $350.00421 Lexington Bld., Cannel, IN General Needs $350.003600 W 96th St., Indlenapotis` IN 46268 General Needs $350.005005 PlantatIon Dr.. Ind0napofs,14 General Needs $350.003600 +N 96th St., hndlnapoL% IN 46268 General Needs $300.003000 W 96th St.. Indianapois, IN 46268 General Needs $300.00
C4
Beth FettersAnn MoreJudy StaleyTenwek Area Edr ion FundAaron TaguePastors SaninaryHerila9e Christian School -La h RdmrdsBrenda KFn®ermonForum Or-edit Union - An 8oeickTens AndersonHeritage Christig► School - HeightJaares SmithJamY GoffGwen BondForum Credit Union - Any Bod ckJames Sm hKen CopleyAndrew HadShare AndersonBilly BellSusan BensonLani BloomersBeth FeltenElanle GrantAnn GustbusKurt LortzNarnet a McDonaldErin PoteetSharon RacksLode RegrrerJoni ScottGair StaleyJeanette TomeJudy StaleyAnn Moore
_3s-- 6o If tP zb 8Charitable Contribidions
Christian Foundation of IN. Inc.2005
3160 W 86th St. Indisnap 1is, IN 462683600 W 96th St, Indianapolis, IN 462683600 W 96th St. Indianapolis. IN 46268Nairobi, Kenya2358 W mhmoke Blvd.. Indianapolis. IN12928 Whilehaven Lane; Fishers, IN6901 E. 75th St. Indianapolis. IN13019 Wirgstem Ct., Fishers , IN11313 USA Parkway. Fishers. IN 460356549 Whilehom Court &7A, Indianapoft, IN6401 E. 75th St. Indianapolis, IN343 Lando me Rd., Indianapores, IN6ZT7 Commonwealth CL, Indianapolis. IN2192 Ro1k'iBHi1 Ct_ Cokinrbas, IN11313 USA Parkway, Fishers. IN 46035343 Lansdorne Rd., Indienaporra, IN12928 WhItehaven Lane. Fishers, IN5336 Weahington Blvd., Indus napols, IN10280 Tog House Way, Makers, IN3202 E. 48th St. Indianapolis. IN3600 W 96th St, Indianapolis, IN 482683600 W 96th St. Indianapolis. IN 462683600 W 961h 3L. Ind®napniL . IN 46268421 Lexington Sid., Camel. IN3600W 96th SL. Indianapol is, IN 46M685807 Columbus Ave., Anderson, IN3600 W 96th St. Indianapolis, IN 462683600 W 96th SL, Indianapolis, IN 462683600 W 96th St, Indianapolis . IN 462681116 frufWnpiie In., Zionsville, IN3640 W 96th 8L, Indianapolis, IN 462685170 Oldrield Ct_ Carmel, IN3600 W 96th SL, Indianapolis, IN 46268360D W 96th SL, Indianapolis, IN 462683600 W 96th SL. Indianapolis , IN 46268
General NeedsGeneral NeedsGeneral NeedsEducation SuppliesGeneral NeedsGeneral NeedsTtutimEducation E'enseHousehold ExpenseGeneral NeedsTuttbDnVehicle ExpenseVeNcie ExpenseHowehold ExpenseHousehold ExpenseAuto ExpenseTravel ElseGeneral NeedsGeneral NeedsGeneral NeedsGeneral NeedsGeneral NeedsGeneral NeedsGeneral NeedsGeneral NeedsGeneral NeedsGeneral NeedsGeneral NeedsGeneral NeedsGeneral NeedsGeneral NeedsGeneral NeedsGeneral NeedsGeneral NeedsGener i Needs
Total
$250.00$200.00$200.00
$5,863.47$1.200.00$2,400.00$3,99205$2,000-00$2.000.00SM000
$1,500.00$1,500.00$5 0.00$360.00
$2,000.00$500.00
$2,000.00$5,000.00$100.00$100.00$50.00
$100.00$50.00
$100.00$100.00$100.00$50.00
$100.00$100.00$50.00$5D.00
$100.00$50.00$,510.00$50.00
$196,885.68
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3 S-- 4? ,94 t� ab fr LIST OF SUBSTANTIAL CONTRIBUTORS1999-2005
Dr. Mark and Pamela Templeton10727 Seascape CourtT«.7:.. �...... ,.1:.. TAT A-InC4L1uia&1apJ11J , 111 tU .JU
Bobbi Conner5421 Whittier LaneIndianapolis , IN 46250
Jim Conner5431 Whittier LaneIndianapolis , IN 46250
Mr. David & Ellen Smitson13201 North Ditch RoadCarmel, IN 46032
Mr. Doug & Jayne Ann Wilson1031 Foxglove CircleCarmel, IN 46033
Mr. Ardie & Leann Bucher10122 North Cumberland RoadFishers, IN 46038
Mr. Mark Alt10120 Cumberland RoadFishers, IN 46038
Ms. Gayle Hitchcock7111 Eastwick LaneIndianapolis, IN 46256
Mr. Steve ZnachkoZnachko Family Foundation650 E. Carmel DriveSuite 360Carmel, IN 46032
Mr. & Mrs. Craig McGinnisThe Jack Jennings Foundation Trust8653 Moon Bay CircleIndianapolis, IN 46236
cti i- ,s+.4u �uwco4e/�,�.�rN41 M (/ ThC .3S 6G�Fsabd L�s� o�S�dsie.��,� Cowf.� ��tfot5 SC�e4a3
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Mr. & Mrs . Thomas Flynn13655 Smokey Ridge PlaceCarmel , IN 46033
Mr. Cecil Campbell6^035 Wlilow RoadIndianapolis , IN 46220
Mrs. Peggy MindreboMindrebo Living Trust5465 E. 1615` StreetNoblesville, IN 46060
Mr. & Mrs. Ronald K. Young11875 Durbin DriveCarmel, IN 46032
Mr. & Mrs. Chad J. DavisC/O National Christian Charitable Found.4435 Washington Blvd.Indianapolis, IN 46205
Mr. & Mrs. Gary Allen5744 East Fall Creek ParkwayIndianapolis, IN 46226
Mr. & Mrs. Steven C. ZnachkoJT Ten Wros4420 East 75`h StreetIndianapolis , IN 46250-2210
Mr. & Mrs. Robert W. Andersen4110 Cranbrook DriveIndianapolis , IN 46250
Mr. & Mrs. David Garrison8427 Goldfinch CircleIndianapolis , IN 46256
Mr. & Mrs. Steven ZnachkoThe Zacchaeus Foundation Inc.650 East Carmel Drive, Ste. 360Carmel, IN 46032-2867
Cl��is I-�G l;& oaf ur ��v�ia�C(, ZNC.
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Rk5 -BoaMr. & Mrs. Mark Alt10120 Cumberland RoadFishers, IN 46038
Mr. & Mrs. Mark Scales11204 Desert Glen Drive
n.' A Z1 YQl aJ11v1 J, 11\ TVVJV
Mr. John Miley3694 Doyt LaneCarmel, IN 46033
Mr. R. David SmitsonCapital Trust Company of Delaware3762 West Morris St.Indianapolis, IN 46242
Mr. & Mrs. Bryan Lacey8953 Admirals Bay DriveIndianapolis , IN 46236
Mr. Steven Kistler8923 William Penn CircleIndianapolis, IN 46256
The Mark Templeton Charitable FundNational Christian Foundation10727 Seascape CourtIndi anapolis , IN 46256
Mr. & Mrs. Stephen Valinet3641 Brumley WayCarmel, IN 46033
Mr. & Mrs. Bryan Lacey11601 Pebblepointe PassCarmel, IN 46033
Mr. & Mrs. Aaron Gick10829 Lakeshore Dr. W.Carmel, IN 46033
Bish & Frannie FoundationTrustee Valerie Cismoski - Flagler4165 Lake TerraceKalamazoo, MI 49008
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Application for Grant of Scholarship Funds From:The Christian Foundation of Indiana, Inc.
I Personal Data:
Name of Applicant Is this your first application for a scholarshipGrant from The Christian Foundation OfIndiana , Inc.?Yes No
Street Address If no, please provide the approximate dateof your previous application:
City, State, CountrySocial Security Number:
Date of Birth: Name of Employer and/or SponsoringMission Board or other Organization:
II Data Respecting Work:
A. Teacher: If you are a teacher or a missionary, provide a brief summary ofthe principal activities and purposes ofany school, mission board or otherorganization for which you work. How long have you been engaged insuch work?
B. Other than a teacher: Provide a summary of the Christian or charitablework, if any, in which you are engaged. How long have you been engagedin such work?
d•1 zG'3
C. Other than a teacher : Provide a history of your work experience, ifany, in the last 10 years, listing the name and address of each employer,your job responsibilities and wages?
D. All applicants : Identify any sources of funding available to you for themeeting of your financial needs to which you would otherwise put anygrant funds you might receive from the Foundation.
M. Use of Grant Funds
A. Describe how you would use any grant funds received from theFoundation.
B. Do you agree that if you receive a grant from the Foundation, youwill: a) complete and return the Grant Utilization Report (a copy ofwhich is attached hereto) to the Foundation; b) repay any part ofthe grant funds not used for the purposes for which the grant wasmade; c) maintain records of receipts and expenditures of the grantfunds and make your books and records available to theFoundation for inspection at reasonable times upon reasonablenotice; and d) use the funds only for the purposes described in ItemIII. A., above?
I declare that I have completed this application and the facts stated hereinare true, correct and complete.
Signature Date
To Be Completed By The Foundation:
(1) Denied by Board of Directors on
(2) Granted by Board of Directors on
(date)
(date)
Amount of Grant:
