Beruflich Dokumente
Kultur Dokumente
Form
990-PF
2013
u Do not enter Social Security numbers on this form as it may be made public.
26-0344869
Number and street (or P.O. box number if mail is not delivered to street address)
Room/suite
336-497-1854
City or town, state or province, country, and ZIP or foreign postal code
GREENSBORO
G Check all that apply:
NC 27403
Initial return
Final return
Address change
..
Revenue
amounts in columns (b), (c), and (d) may not necessarily equal
the amounts in column (a) (see instructions).)
1
2
3
4
5a
b
6a
b
7
8
9
10a
b
c
11
12
13
14
15
16a
b
c
17
18
19
20
21
22
23
24
713,248
319,255
157,429
income
157,429
income
purposes
(cash basis only)
157,429
319,255
Stmt 4
Stmt 5
expenses per
books
1,189,932
97,632
189,610
23,425
476,684
157,429
97,632
189,610
23,425
1,250
1,250
5,316
13,517
11,856
59,400
299
94,378
11,856
59,400
299
52,069
496,683
728,924
1,225,607
41,127
41,127
41,127
41,127
41,127
41,127
435,541
728,924
1,164,465
-35,675
435,557
116,302
Form
990-PF (2013)
Part II
1
2
3
4
5
6
Assets
7
8
9
10a
b
c
11
12
13
14
Balance Sheets
Cash non-interest-bearing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Savings and temporary cash investments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Accounts receivable u . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Less: allowance for doubtful accounts u . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Pledges receivable u . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Less: allowance for doubtful accounts u . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Grants receivable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see
instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Liabilities
Net Assets or Fund Balances
170,116
7,789,109
191,611
9,107,303
191,611
9,107,303
16,059
20,734
20,734
7,975,284
9,319,648
9,319,648
3,938
3,938
56,255
56,255
7,971,346
9,263,393
7,971,346
9,263,393
7,975,284
9,319,648
70,043
49,309
Stmt 6
17
18
19
20
21
22
23
24
25
26
Unrestricted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Temporarily restricted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Permanently restricted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Foundations that do not follow SFAS 117, check here . . . . . . . . . u
and complete lines 27 through 31.
27
28
29
30
31
Part III
1 Total net assets or fund balances at beginning of year Part II, column (a), line 30 (must agree with
end-of-year figure reported on prior year's return) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Enter amount from Part I, line 27a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3 Other increases not included in line 2 (itemize) uSee
. . . . . . . . Statement
. . . . . . . . . . . . . . . . . . . . . .8
...........................................
4 Add lines 1, 2, and 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 Decreases not included in line 2 (itemize) u . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Total net assets or fund balances at end of year (line 4 minus line 5) Part II, column (b), line 30 . . . . . . . . . . . . . . . . . . . . . .
1
2
3
4
5
6
7,971,346
-35,675
1,327,722
9,263,393
9,263,393
990-PF (2013)
Form
DAA
End of year
15
16
Page
Beginning of year
Part IV
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)
1a
b
c
d
e
Page
See Worksheet
a
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(j) Adjusted basis
as of 12/31/69
a
b
c
d
e
If gain, also enter in Part I, line 7
}
If (loss), enter -0- in Part I, line 7
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 instructions). If (loss), enter -0- in
}
Part I, line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Capital gain net income or (net capital loss) |
Part V
319,255
-10,116
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 foundation liable for the section 4942 tax on the distributable amount of any year in the base period?
If Yes, the foundation does not qualify under section 4940(e). Do not complete this part.
Yes
No
1 Enter the appropriate amount in each column for each year; see the instructions before making any entries.
(a)
Base period years
Calendar year (or tax year beginning in)
(b)
Adjusted qualifying distributions
575,906
381,194
292,380
251,092
146,520
2012
2011
2010
2009
2008
(d)
Distribution ratio
(col. (b) divided by col. (c))
(c)
Net value of noncharitable-use assets
7,615,871
6,689,761
356,981
402,139
215,076
0.075619
0.056982
0.819035
0.624391
0.681248
2.257275
0.451455
4 Enter the net value of noncharitable-use assets for 2013 from Part X, line 5
.......................................
8,744,189
...............................................................................................
3,947,608
.........................................................
4,356
3,951,964
1,164,465
Form
DAA
990-PF (2013)
Exempt operating foundations described in section 4940(d)(2), check here u and enter N/A on line 1.
Date of ruling or determination letter: . . . . . . . . . . . . . . . . . . (attach copy of letter if necessarysee instructions)
Domestic foundations that meet the section 4940(e) requirements in Part V, check
} 1
here u
and enter 1% of Part I, line 27b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of
Part I, line 12, col. (b).
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) . . . . . . .
2
Add lines 1 and 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) . . . . . .
4
Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . .
5
Credits/Payments:
2013 estimated tax payments and 2012 overpayment credited to 2013 . . . . . . . . . . .
6a
3,800
Exempt foreign organizations tax withheld at source . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6b
Tax paid with application for extension of time to file (Form 8868) . . . . . . . . . . . . . . . . .
6c
Backup withholding erroneously withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6d
Total credits and payments. Add lines 6a through 6d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
Enter any penalty for underpayment of estimated tax. Check hereX if Form 2220 is attached . . . . . . . . . . . . . . . . . . . . .
8
Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . u
9
Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid . . . . . . . . . . . . . . . . . . . u
10
Enter the amount of line 10 to be: Credited to 2014 estimated tax u
Refunded u
11
Part VII-A
1a
b
c
d
e
2
3
4a
b
5
6
Page
8,711
0
8,711
0
8,711
3,800
17
4,928
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did it
participate or intervene in any political campaign? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see
Instructions for the definition)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If the answer is Yes to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
Did the foundation file Form 1120-POL for this year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. u $
(2) On foundation managers. u $
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers. u $
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.
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles of
incorporation, or bylaws, or other similar instruments? If Yes, attach a conformed copy of the changes . . . . . . . . . . . . . . . . . . . . . . .
Did the foundation have unrelated business gross income of $1,000 or more during the year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If Yes, has it filed a tax return on Form 990-T for this year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N/A
......
Was there a liquidation, termination, dissolution, or substantial contraction during the year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If Yes, attach the statement required by General Instruction T.
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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Did the foundation have at least $5,000 in assets at any time during the year? If Yes, complete Part II, col. (c), and Part XV .
Enter the states to which the foundation reports or with which it is registered (see instructions) u
Yes
No
1a
1b
1c
3
4a
4b
5
X
X
7
8a
6
7
X
X
8b
NC
. .....................................................................................................................................
b
9
10
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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3) or
4942(j)(5) for calendar year 2013 or the taxable year beginning in 2013 (see instructions for Part XIV)? If Yes,
complete Part XIV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Did any persons become substantial contributors during the tax year? If Yes, attach a schedule listing their
names and addresses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
Form
DAA
990-PF (2013)
Part VII-A
11
12
13
14
Page
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If Yes, attach schedule (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
X
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified
X
person had advisory privileges? If Yes, attach statement (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
X
Did the foundation comply with the public inspection requirements for its annual returns and exemption application? . . . . . . . . . .
13
Website address u . www.f4dc.org
....................................................................................................................................
The books are in care of u . .MARNIE
Telephone no. u .336-275-1781
. . . . . . . . . . . . . . . THOMPSON
........................................................
.............................
Located at u GREENSBORO
ZIP+4 u . .27403
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .NC
..........
............................
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 Check here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . u
and enter the amount of tax-exempt interest received or accrued during the year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . u
15
At any time during calendar year 2013, did the foundation have an interest in or a signature or other authority
Yes No
X
over a bank, securities, or other financial account in a foreign country? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16
See the instructions for exceptions and filing requirements for Form TD F 90-22.1. If Yes, enter the name of
the foreign country u
Part VII-B
1a
c
2
a
c
3a
b
4a
b
File Form 4720 if any item is checked in the Yes column, unless an exception applies.
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? . . . . . . . . . . . . . . . . . . .
Yes
X No
(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from) a
disqualified person? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
X No
(3) 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? . . . . . . . . . . . . . . . . . . . X Yes
No
(5) Transfer any income or assets to a disqualified person (or make any of either available for
the benefit or use of a disqualified person)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
X No
(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 of government service, if terminating within 90 days.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
X No
If any answer is Yes to 1a(1)(6), did any of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance (see instructions)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Organizations relying on a current notice regarding disaster assistance check here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . u
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts, that
were not corrected before the first day of the tax year beginning in 2013? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N/A
......
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
At the end of tax year 2013, did the foundation have any undistributed income (lines 6d and
6e, Part XIII) for tax year(s) beginning before 2013? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
X No
If Yes, list the years u 20 . . . . . , 20 . . . . . , 20 . . . . . , 20 . . . . .
Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year's undistributed income? (If applying section 4942(a)(2) to
all years listed, answer No and attach statement see instructions.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N/A
......
If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
u 20 . . . . . , 20 . . . . . , 20 . . . . . . , 20 . . . . .
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise
at any time during the year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X Yes
No
If Yes, did it have excess business holdings in 2013 as a result of (1) any purchase by the foundation or
disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved by the
Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3) the lapse of
the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine if the
foundation had excess business holdings in 2013.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes? . . . . . . . . . . . . . .
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2013? . . . . . . . . . . .
Yes
1b
1c
2b
3b
4a
X
X
4b
Form
DAA
No
990-PF (2013)
Part VII-B
5a
6a
b
7a
b
During the year did the foundation pay or incur any amount to:
(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? . . . . . . . . . . . . . . .
Yes
X No
(2) Influence the outcome of any specific public election (see section 4955); or to carry on,
X No
directly or indirectly, any voter registration drive? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
X No
(3) Provide a grant to an individual for travel, study, or other similar purposes? . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
(4) Provide a grant to an organization other than a charitable, etc., organization described in
section 509(a)(1), (2), or (3), or section 4940(d)(2)? (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
X No
(5) Provide for any purpose other than religious, charitable, scientific, literary, or educational
X No
purposes, or for the prevention of cruelty to children or animals? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
If any answer is Yes to 5a(1)(5), did any of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance (see instructions)? . . . . . . . . . . . . . . . . . . . . . N/A
......
Organizations relying on a current notice regarding disaster assistance check here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . u
If the answer is Yes to question 5a(4), does the foundation claim exemption from the tax
because it maintained expenditure responsibility for the grant? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .N/A
Yes
No
.....
If Yes, attach the statement required by Regulations section 53.49455(d).
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums
on a personal benefit contract? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
X No
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? . . . . . . . . . . . . . . . . . . . . . . .
If Yes to 6b, file Form 8870.
X No
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction? . . . . . .
Yes
......
If Yes, did the foundation receive any proceeds or have any net income attributable to the transaction? . . . . . . . . . . . . . . . . N/A
Part VIII
Page
Statements Regarding Activities for Which Form 4720 May Be Required (continued)
5b
6b
7b
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1 List all officers, directors, trustees, foundation managers and their compensation (see instructions).
(b) Title, and average
(a) Name and address
(d) Contributions to
. . . . . . . . . . .THOMPSON
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GREENSBORO
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .CO-MNGNG
. . MARNIE
DIR
620 SOUTH ELM STREET STE 35
NC 27403
20.00
. ED
. . . . . WHITFIELD
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GREENSBORO
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .C0-MNGNG DIR
620 SOUTH ELM STREET STE 35
NC 27403
32.00
(c) Compensation
48,816
48,816
. ........................................................................................
. ........................................................................................
Compensation of five highest-paid employees (other than those included on line 1 see instructions). If none, enter
NONE.
(d) Contributions to
(c) Compensation
.......................................................................................
. . NONE
. ........................................................................................
. ........................................................................................
. ........................................................................................
. ........................................................................................
DAA
0
990-PF (2013)
Part VIII
3
Page
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors (continued)
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
(c) Compensation
NONE
. ....................................................................................................
. ....................................................................................................
. ....................................................................................................
. ....................................................................................................
. ....................................................................................................
Part IX-A
..........................................................
List the foundation's four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of
organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
. ...............................................................................................................................
. ...............................................................................................................................
1,164,465
2
. ...............................................................................................................................
. ...............................................................................................................................
. ...............................................................................................................................
. ...............................................................................................................................
. ...............................................................................................................................
. ...............................................................................................................................
Part IX-B
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
N/A
. ...............................................................................................................................
. ...............................................................................................................................
. ...............................................................................................................................
. ...............................................................................................................................
. ...............................................................................................................................
. ...............................................................................................................................
.................................................................................................
Form
DAA
990-PF (2013)
Part X
Page
Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,
see instructions.)
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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b Average of monthly cash balances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c Fair market value of all other assets (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d Total (add lines 1a, b, and c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
e Reduction claimed for blockage or other factors reported on lines 1a and
0
1c (attach detailed explanation) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
2
Acquisition indebtedness applicable to line 1 assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
Subtract line 2 from line 1d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
Cash deemed held for charitable activities. Enter 1% of line 3 (for greater amount, see
instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4 . . . . . . . . . . . .
6
Minimum investment return. Enter 5% of line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating
Part XI
foundations and certain foreign organizations check here u X and do not complete this part.)
1
Minimum investment return from Part X, line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2a Tax on investment income for 2013 from Part VI, line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2a
b Income tax for 2013. (This does not include the tax from Part VI.) . . . . . . . . . . . . . . . . .
2b
c Add lines 2a and 2b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
Distributable amount before adjustments. Subtract line 2c from line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
Recoveries of amounts treated as qualifying distributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
Add lines 3 and 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
Deduction from distributable amount (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII,
line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Part XII
1
a
b
2
3
a
b
4
5
6
1a
1b
1c
1d
8,792,823
84,526
0
8,877,349
2
3
0
8,877,349
4
5
6
133,160
8,744,189
437,209
2c
3
4
5
6
7
1,164,465
1,164,465
0
1,164,465
Form
DAA
990-PF (2013)
Part XIII
1
2
a
b
3
a
b
c
d
e
f
4
a
b
c
d
e
5
6
a
b
c
d
e
8
9
10
a
b
c
d
e
Page
(a)
(b)
(c)
(d)
Corpus
2012
2013
1,164,465
1,164,465
Form
DAA
990-PF (2013)
Part XIV
1a
b
2a
b
c
d
e
3
a
Page
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2013, enter the date of the ruling . . . . . . . . . . . . . . . . . . . . . . . . u
Check box to indicate whether the foundation is a private operating foundation described in section
X 4942(j)(3) or
Tax year
Prior 3 years
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for
each year listed . . . . . . . . . . . . . . . . . . . . .
85% of line 2a . . . . . . . . . . . . . . . . . . . . . . .
Qualifying distributions from Part XII,
line 4 for each year listed . . . . . . . . . . .
Amounts included in line 2c not used directly
for active conduct of exempt activities . . . .
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c . . . . . . . .
Complete 3a, b, or c for the
alternative test relied upon:
Assets alternative test enter:
(1) Value of all assets . . . . . . . . . . . . . . .
(2) Value of assets qualifying under
section 4942(j)(3)(B)(i) . . . . . . . . . .
Endowment alternative test enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed . . .
Support alternative test enter:
(1) Total support other than gross
investment income (interest,
dividends, rents, payments on
securities loans (section
512(a)(5)), or royalties) . . . . . . . . .
(2) Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii) . . . . . . . . .
(3) Largest amount of support from
an exempt organization . . . . . . . . .
(4) Gross investment income . . . . . . .
Part XV
1
a
10
(a) 2013
(b) 2012
(c) 2011
N/A
4942(j)(5)
(e) Total
(d) 2010
116,302
98,857
82,035
69,730
57,166
48,591
21
18
255,524
217,196
1,164,465
575,906
381,194
292,380
2,413,945
728,924
226,096
193,658
145,578
1,294,256
435,541
349,810
187,536
146,802
1,119,689
291,473
253,863
222,992
11,899
780,227
Supplementary Information (Complete this part only if the foundation had $5,000 or more in assets at
any time during the year see instructions.)
N/A
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
N/A
2
The form in which applications should be submitted and information and materials they should include:
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
See Statement 9
See Statement 10
See Statement 11
DAA
Form
990-PF (2013)
Page
11
Part XV
Supplementary Information (continued)
3 Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
Name and address (home or business)
a
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
SEE ATTACHED
SEE ATTACHED
SEE ATTACHED NC 27609
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
SEE ATTACHED
728,924
728,924
Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . u 3a
Approved for future payment
N/A
Total
DAA
...................................................................................................................
u 3b
Form
990-PF (2013)
Part XVI-A
Page
(b)
Amount
Exclusion
code
(d)
Amount
Part XVI-B
Line No.
12
157,429
319,255
476,684
476,684
13
N/A
Form
DAA
990-PF (2013)
Part XVII
1
c
d
Page
Did the organization directly or indirectly engage in any of the following with any other organization described
in section 501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political
organizations?
Transfers from the reporting foundation to a noncharitable exempt organization of:
(1) Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(2) Other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other transactions:
(1) Sales of assets to a noncharitable exempt organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(2) Purchases of assets from a noncharitable exempt organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(3) Rental of facilities, equipment, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(4) Reimbursement arrangements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(5) Loans or loan guarantees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(6) Performance of services or membership or fundraising solicitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sharing of facilities, equipment, mailing lists, other assets, or paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If the answer to any of the above is Yes, complete the following schedule. Column (b) should always show the fair market
value of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market
value in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
(a) Line no.
13
Yes
No
1a(1)
1a(2)
X
X
1b(1)
1b(2)
1b(3)
1b(4)
1b(5)
1b(6)
1c
X
X
X
X
X
X
X
N/A
2a Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b If Yes, complete the following schedule.
(a) Name of organization
Yes
No
N/A
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,
correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
May the IRS discuss this return
with the preparer shown below
(see instructions)?
Yes
Sign
Here
No
PRESIDENT
Signature of officer or trustee
Print/Type preparer's name
Paid
CHUCK AVERRE
Preparer
Firm's name
Hollingsworth
Use Only
Firm's address
Date
Title
Preparer's signature
Date
CHUCK AVERRE
Check
if
self-employed
08/12/14
PTIN
Firm's EIN
Phone no.
P00280366
56-2119415
919-848-4100
Form
DAA
990-PF (2013)
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
u Attach to Form 990, Form 990-EZ, or Form 990-PF.
u Information about Schedule B (Form 990, 990-EZ, 990-PF) and its instructions is at www.irs.gov/form990.
2013
26-0344869
Section:
501(c)(
For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.
Special Rules
For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 331/3 % support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi) and received from any one contributor, during the year, a contribution of
the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1.
Complete Parts I and II.
For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable, scientific, literary,
or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and III.
For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total to more than $1,000. If this box is checked, enter here the total contributions that were received during the
year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or
more during the year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$ ...........................
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file 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 line H of its Form 990-EZ or on its
Form 990-PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions for Form 990, 990-EZ, or 990-PF.
DAA
Page
Employer identification number
Name of organization
. ......
26-0344869
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
. ..........................................................................
(a)
No.
(b)
Name, address, and ZIP + 4
. ......
. ..........................................................................
............................................................................
713,248
...........................
(c)
Total contributions
...........................
. ..........................................................................
(a)
No.
(b)
Name, address, and ZIP + 4
. ......
............................................................................
............................................................................
(c)
Total contributions
...........................
............................................................................
(a)
No.
(b)
Name, address, and ZIP + 4
. ......
. ..........................................................................
............................................................................
(c)
Total contributions
...........................
. ..........................................................................
(a)
No.
(b)
Name, address, and ZIP + 4
. ......
. ..........................................................................
............................................................................
(c)
Total contributions
...........................
............................................................................
(a)
No.
(b)
Name, address, and ZIP + 4
. ......
. ..........................................................................
............................................................................
. ..........................................................................
(c)
Total contributions
...........................
(d)
Type of contribution
Person
X
Payroll
Noncash
(Complete Part II for
noncash contributions.)
(d)
Type of contribution
Person
Payroll
Noncash
(Complete Part II for
noncash contributions.)
(d)
Type of contribution
Person
Payroll
Noncash
(Complete Part II for
noncash contributions.)
(d)
Type of contribution
Person
Payroll
Noncash
(Complete Part II for
noncash contributions.)
(d)
Type of contribution
Person
Payroll
Noncash
(Complete Part II for
noncash contributions.)
(d)
Type of contribution
Person
Payroll
Noncash
(Complete Part II for
noncash contributions.)
990-PF
Form
2013
, and ending
26-0344869
(b)
List and describe the kind(s) of property sold, e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.
How acquired
P-Purchase
D-Donation
(f)
Depreciation allowed
(or allowable)
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
(g)
10,175
37,723
9,277
4,000
3,660
6,035
3,449
200,000
5,185
13,607
5,696
3,877
1,394
2,851
5,702
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
5,484
31,944
8,046
3,500
2,166
1,188
3,593
185,739
4,287
6,962
4,944
3,973
1,447
2,338
4,233
(c)
Date acquired
(mo., day, yr.)
02/18/09
04/12/11
05/31/11
04/12/11
10/12/10
01/04/07
02/21/13
04/12/11
05/14/10
01/04/07
02/15/11
03/05/12
06/12/12
01/04/07
05/05/10
(d)
Date sold
(mo., day, yr.)
03/12/13
06/03/13
06/03/13
06/20/13
03/12/13
03/12/13
03/12/13
06/03/13
03/12/13
03/12/13
03/12/13
03/12/13
03/12/13
03/12/13
03/12/13
(h)
Gain or (loss)
(e) plus (f) minus (g)
4,691
5,779
1,231
500
1,494
4,847
-144
14,261
898
6,645
752
-96
-53
513
1,469
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(i)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
4,691
5,779
1,231
500
1,494
4,847
-144
14,261
898
6,645
752
-96
-53
513
1,469
990-PF
Form
2013
, and ending
26-0344869
(b)
List and describe the kind(s) of property sold, e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.
How acquired
P-Purchase
D-Donation
(f)
Depreciation allowed
(or allowable)
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
(g)
13,640
5,173
16,526
1,098
11,447
3,041
11,614
1,468
7,106
9,723
6,133
70,618
117,930
854
117,301
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
6,378
1,779
7,047
935
8,756
1,423
6,364
978
6,996
7,094
5,058
72,161
120,026
865
118,020
(c)
Date acquired
(mo., day, yr.)
02/18/09
01/04/07
02/18/09
01/04/07
09/02/09
08/04/11
10/04/11
11/05/12
01/17/13
02/18/09
03/15/11
03/11/13
03/11/13
03/11/13
06/03/13
(d)
Date sold
(mo., day, yr.)
03/12/13
03/12/13
03/12/13
03/12/13
03/12/13
03/12/13
03/12/13
03/12/13
03/12/13
03/12/13
03/12/13
08/15/13
09/24/13
10/31/13
10/31/13
(h)
Gain or (loss)
(e) plus (f) minus (g)
7,262
3,394
9,479
163
2,691
1,618
5,250
490
110
2,629
1,075
-1,543
-2,096
-11
-719
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(i)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
7,262
3,394
9,479
163
2,691
1,618
5,250
490
110
2,629
1,075
-1,543
-2,096
-11
-719
990-PF
Form
2013
, and ending
26-0344869
(b)
List and describe the kind(s) of property sold, e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.
How acquired
P-Purchase
D-Donation
(f)
Depreciation allowed
(or allowable)
P
P
P
P
P
P
P
P
P
P
P
P
P
(g)
59,562
230,000
9,542
7,728
11,109
444,358
6,921
10,693
21,503
393,051
15,060
9,115
2,694
206,457
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
59,744
208,926
7,952
4,607
6,119
447,641
4,046
7,751
14,464
400,000
9,039
8,462
2,366
(c)
Date acquired
(mo., day, yr.)
03/15/13
04/12/11
03/18/11
08/26/10
02/11/09
03/01/12
07/22/09
01/23/12
09/08/10
11/26/12
12/24/08
04/30/12
06/12/12
(d)
Date sold
(mo., day, yr.)
12/11/13
06/03/13
03/12/13
03/12/13
03/12/13
06/20/13
03/12/13
03/12/13
03/12/13
03/08/13
03/12/13
03/12/13
03/12/13
(h)
Gain or (loss)
(e) plus (f) minus (g)
-182
21,074
1,590
3,121
4,990
-3,283
2,875
2,942
7,039
-6,949
6,021
653
328
206,457
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(i)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
-182
21,074
1,590
3,121
4,990
-3,283
2,875
2,942
7,039
-6,949
6,021
653
328
206,457
8/12/2014 11:26 AM
Statements
Net
Investment
Total
$
$
1,250
1,250
$
$
Adjusted
Net
0
$
$
Charitable
Purpose
0
$
$
1,250
1,250
Net
Investment
Total
$
$
5,316
5,316
$
$
Adjusted
Net
0
$
$
Charitable
Purpose
0
$
$
Description
Cost
Prior Year
Basis
Depreciation
Method
Life
Current Year
Depreciation
5 $
Net Investment
Income
$
Adjusted Net
Income
$
5
7
102
11
24
62
1-3
8/12/2014 11:26 AM
Statements
Description
Cost
Prior Year
Basis
Depreciation
Method
Life
Current Year
Depreciation
200DB
5 $
200DB
553
200DB
200DB
Net Investment
Income
14 $
Adjusted Net
Income
$
3
3
3
3
3
3
200DB
200DB
200DB
200DB
200DB
330
200DB
58
12
8/12/2014 11:26 AM
Statements
Description
Cost
Prior Year
Basis
Depreciation
Method
124
Life
Current Year
Depreciation
Net Investment
Income
3 $
34 $
22
114 200DB
25
114 200DB
25
86 200DB
18
257 200DB
55
133 200DB
29
57 200DB
12
57 200DB
12
98 200DB
21
2,607 200DB
559
20 200DB
57 200DB
12
186 200DB
40
200DB
5,023
200DB
760
192
81
Adjusted Net
Income
$
8/12/2014 11:26 AM
Statements
Date
Acquired
Method
Current Year
Depreciation
Life
3 $
Net Investment
Income
178 $
96
200DB
202
200DB
5,012
13,517 $
28,009
Adjusted Net
Income
$
0 $
Cost
Basis
Prior Year
Amortization
Life
Current Year
Amortization
Net Investment
Income
Adjusted Net
Income
COGS
START UP COSTS
6/05/07 $
$
Total
17,726 $
17,726 $
6,598
6,598
15 $
$
1,182 $
1,182 $
$
0 $
Net
Investment
Total
$
41,127
31,703
4,091
3,081
2,884
Adjusted
Net
$
41,127
Charitable
Purpose
$
41,127
31,703
4,091
3,081
2,884
3-5
8/12/2014 11:26 AM
Statements
Net
Investment
Total
2,546
1,845
1,662
1,652
1,319
535
362
303
56
30
93,196
Adjusted
Net
Charitable
Purpose
41,127
41,127
2,546
1,845
1,662
1,652
1,319
535
362
303
56
30
52,069
Statement 6 - Form 990-PF, Part II, Line 14 - Land, Building, and Equipment
Beginning
Net Book
Description
FURNISHINGS
OFFICE EQUIPMENT
COMPUTER EQUIPMENT
SOFTWARE
START UP COSTS
Total
916
2,782
1,076
157
11,128
16,059
End
Cost / Basis
$
2,814
25,057
20,285
4,161
17,726
70,043
End Accumulated
Depreciation
$
2,194
18,791
16,728
3,816
7,780
49,309
Net
FMV
$
617
6,266
3,561
344
9,946
20,734
5-6
8/12/2014 11:26 AM
Description
DEPOSITS - SPONSORSHIPS
CREDIT CARD BALANCE
LOAN - COMMUNITY FOUNDATION
Total
End of
Year
2,313
1,625
3,938
3,308
2,947
50,000
56,255
Amount
$
$
1,327,722
1,327,722
Statement 9 - Form 990-PF, Part XV, Line 2b - Application Format and Required Contents
Description
GRANT APPLICANTS MUST COMPLETE THE GRANT APPLICATION
AVAILABLE ONLINE AT WWW.F4DC.ORG.
7-11
Form
2220
Form 990-PF
Underpayment of Estimated Tax by Corporations
2013
Name
26-0344869
Note: Generally, the corporation is not required to file Form 2220 (see Part II below for exceptions) because the IRS will figure any penalty
owed and bill the corporation. However, the corporation may still use Form 2220 to figure the penalty. If so, enter the amount from page 2, line
38 on the estimated tax penalty line of the corporation's income tax return, but do not attach Form 2220.
Part I
2d
3
8,711
the tax year was for less than 12 months, skip this line and enter the amount from line 3 on line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3,797
Required annual payment. Enter the smaller of line 3 or line 4. If the corporation is required to skip line 4, enter
the amount from line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3,797
Part II
6
7
8
8,711
Reasons for FilingCheck the boxes below that apply. If any boxes are checked, the corporation must file
Form 2220 even if it does not owe a penalty (see instructions).
Part III
Installment due dates. Enter in column (a) through (d) the 15th
day of the 4th (Form 990-PF filers: Use 5th month), 6th, 9th,
and 12th months of the corporation's tax year . . . . . . . . . . . . . .
9
10 Required installments. If the box on line 6 and/or line 7 above
is checked, enter the amounts from Schedule A, line 38. If the
box on line 8 (but not 6 or 7) is checked, see instructions for the
amounts to enter. If none of these boxes are checked, enter 25%
of line 5 above in each column . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
11 Estimated tax paid or credited for each period (see instructions).
For column (a) only, enter the amount from line 11 on line 15
11
Complete lines 12 through 18 of one column before
going to the next column.
(a)
(b)
(c)
(d)
05/15/13
06/15/13
09/15/13
12/15/13
949
949
949
950
3,800
953
953
DAA
953
Form
2220 (2013)
Part IV
Page
(b)
(c)
(d)
See Worksheet
37 Add lines 22, 24, 26, 28, 30, 32, 34, and 36
......
21
22 $
36 $
37 $
23
24 $
25
26 $
27
28 $
29
30 $
31
32 $
33
34 $
35
38 Penalty. Add columns (a) through (d) of line 37. Enter the total here and on Form 1120, line 33; or the comparable
line for other income tax returns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
38 $
*Use the penalty interest rate for each calendar quarter, which the IRS will determine during the first month in the preceding quarter.
These rates are published quarterly in an IRS News Release and in a revenue ruling in the Internal Revenue Bulletin. To obtain this
information on the Internet, access the IRS website at www.irs.gov. You can also call 1-800-829-4933 to get interest rate
information.
17
Form
DAA
2220 (2013)
Form
2220
2013
, and ending
Name
26-0344869
2nd Quarter
05/15/13
949
06/15/13
949
3rd Quarter
4th Quarter
09/15/13
12/15/13
2nd Payment
3rd Payment
4th Payment
5th Payment
09/15/13
3,800
Qtr
From
To
Underpayment #Days Rate
Penalty
--- ---------- ---------- -------------- ----- ------- ------------1
5/15/13
9/15/13
949
123
3.00
10
2
6/15/13
9/15/13
949
92
3.00
7
--- ---------- ---------- -------------- ----- ------- ------------Total Penalty
17
============
Form
4562
2013
(99)
Attachment
Sequence No.
179
Identifying number
26-0344869
Indirect Depreciation
Part I
1
2
3
4
5
6
Part II
15
16
8
9
10
11
12
Special Depreciation Allowance and Other Depreciation (Do not include listed property.) (See instructions.)
Special depreciation allowance for qualified property (other than listed property) placed in service
during the tax year (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Property subject to section 168(f)(1) election . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other depreciation (including ACRS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Part III
2,000,000
7
Listed property. Enter the amount from line 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
8
Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
Tentative deduction. Enter the smaller of line 5 or line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10 Carryover of disallowed deduction from line 13 of your 2012 Form 4562 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11 Business income limitation. Enter the smaller of business income (not less than zero) or line 5 (see instructions)
12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 . . . . . . . . . . . . . . . . . . . . . . . . . . .
13 Carryover of disallowed deduction to 2014. Add lines 9 and 10, less line 12 . . . . . . . . .
13
Note: Do not use Part II or Part III below for listed property. Instead, use Part V.
14
500,000
1
2
3
4
5
14
15
16
9,688
17
1,984
174
17
18
MACRS deductions for assets placed in service in tax years beginning before 2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If you are electing to group any assets placed in service during the tax year into one or more general asset accounts, check here . . . . . . . .
Section BAssets Placed in Service During 2013 Tax Year Using the General Depreciation System
(a) Classification of property
19a
b
c
d
e
f
g
h
i
3-year property
5-year property
7-year property
10-year property
15-year property
20-year property
25-year property
Residential rental
property
9,156
172
(d) Recovery
period
5.0
7.0
25 yrs.
27.5 yrs.
27.5 yrs.
39 yrs.
(e) Convention
MQ
MQ
MM
MM
MM
(f) Method
200DB
200DB
1,641
30
S/L
S/L
12 yrs.
40 yrs.
MM
S/L
S/L
S/L
S/L
S/L
MM
S/L
Section CAssets Placed in Service During 2013 Tax Year Using the Alternative Depreciation System
Nonresidential real
property
Part IV
21
22
13,517
Form
4562 (2013)
Part V
Page
Listed Property (Include automobiles, certain other vehicles, certain computers, and property used for
entertainment, recreation, or amusement.)
Note: For any vehicle for which you are using the standard mileage rate or deducting lease expense, complete only 24a,
24b, columns (a) through (c) of Section A, all of Section B, and Section C if applicable.
Section ADepreciation and Other Information (Caution: See the instructions for limits for passenger automobiles.)
24a
Type of property
(list vehicles first)
25
26
Yes
(b)
Date placed
in service
(c)
Business/
investment use
percentage
No
Special depreciation allowance for qualified listed property placed in service during
the tax year and used more than 50% in a qualified business use (see instructions)
Property used more than 50% in a qualified business use:
Yes
(h)
Depreciation
deduction
(g)
Method/
Convention
(f)
Recovery
period
(e)
Basis for depreciation
(business/investment
use only)
(d)
No
(i)
25
..................
27
%
Property used 50% or less in a qualified business use:
S/L-
28
29
S/L%
Add amounts in column (h), lines 25 through 27. Enter here and on line 21, page 1 . . . . . . . . . . . . . . . . . .
28
Add amounts in column (i), line 26. Enter here and on line 7, page 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
29
(a)
Vehicle 1
Yes
No
(b)
Vehicle 2
Yes
No
(c)
Vehicle 3
Yes
No
(d)
Vehicle 4
Yes
No
(e)
Vehicle 5
Yes
No
(f)
Vehicle 6
Yes
No
Yes
No
Section CQuestions for Employers Who Provide Vehicles for Use by Their Employees
Answer these questions to determine if you meet an exception to completing Section B for vehicles used by employees who are not
more than 5% owners or related persons (see instructions).
37
38
39
40
41
Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting, by
your employees? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your
employees? See the instructions for vehicles used by corporate officers, directors, or 1% or more owners . . . . . . . . . . . . . . . . . . . . . . .
Do you treat all use of vehicles by employees as personal use? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Do you provide more than five vehicles to your employees, obtain information from your employees about the
use of the vehicles, and retain the information received? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Do you meet the requirements concerning qualified automobile demonstration use? (See instructions.) . . . . . . . . . . . . . . . . . . . . . . . . . .
Note: If your answer to 37, 38, 39, 40, or 41 is "Yes," do not complete Section B for the covered vehicles.
Part VI
Amortization
(a)
Description of costs
(b)
Date amortization
begins
(c)
Amortizable amount
(d)
Code section
(e)
Amortization
period or
percentage
42
Amortization of costs that begins during your 2013 tax year (see instructions):
43
44
DAA
(f)
Amortization for this year
1,182
1,182
43
44
Form
4562 (2013)
Form
990PF
, ending
Name
Other
Due / Refund
Taxes
Revenue
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
2013
Net investment
income
848,712
83,403
142,503
157,429
5,501
7,275
13,023
123,824
226,096
625,917
448,701
7,975,284
3,938
7,971,346
225,906
36,053
36,053
189,853
3,797
157,429
74,026
5,316
13,517
11,856
154,077
728,924
1,225,607
-35,675
74,026
176,752
319,255
1,189,932
97,632
189,610
23,425
1,250
Net investment
income
-135,464
319,255
142,503
1,074,618
92,000
137,942
19,156
1,100
Net investment
income
713,248
83,403
26-0344869
Differences
476,684
41,127
41,127
435,557
8,711
176,752
115,314
5,632
51,668
4,269
150
-185
6,242
-1,167
30,253
502,828
599,690
-484,376
250,778
5,074
5,074
245,704
4,914
3,797
2,300
8,711
3,800
4,914
1,500
2,300
1,497
3,800
4,911
1,500
3,414
19
1,516
17
4,928
-2
3,412
9,319,648
56,255
9,263,393
0
0
0
Form
990T
, ending
Name
26-0344869
Due/Refund
Expenses
Revenue
2012
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
1,000
-1,000
2013
1,000
-1,000
Differences
Grantee
Address
Purpose
Yes!
Magazine
Mortgage
Fraud
Detectives
(F4DC
is
fiscal
sponsor)
Farmworker
Association
of
Florida
Participatory
Budgeting
Project
Reading
Connections
Greensboro
PB
Project
(F4DC
is
fiscal
sponsor)
Face
to
Face
Food
for
Change
El
Kilombo
Intergalactico
Association
for
Cooperative
Education
New
Economics
Institute
US
Federation
of
Worker
Cooperatives
(NASCO
is
fiscal
sponsor)
Toolbox
for
Social
Education
(Ctr
for
Labor
and
Community
Research
is
fiscal
sponsor)
EDINA/GEO
National
Farmworker
Ministry
Interactive
Resource
Center
CoFed
(Inquiring
Systems,
Inc
is
fiscal
sponsor)
YWCA
Federation
of
Southern
Cooperatives
Student
Action
with
Farmworkers
Dollars
and
Sense
Slow
Money
NC
(Abundance
Foundation
is
fiscal
sponsor)
Planned
Paarenthood
UNCG
Sustainability
Committee
Federation
of
Southern
Cooperatives
Greensboro
PB
Project
(F4DC
is
fiscal
sponsor)
People's
Durham
Full
Circles
Foundation
RCC
music
Showcase
(F4DC
is
fiscal
sponsor)
EDINA/GEO
Southerners
on
New
Ground
Federation
of
Southern
Cooperatives
Neighborhood
Funders
Group
US
Federation
of
Worker
Cooperatives
(NASCO
is
fiscal
sponsor)
Witness
for
Peace
Claremont
Courts
Community
Organization
Cooperation
Jackson
(Community
Aid
&
Development
Corporation
is
Amount
Date
Awarded
$3,000.00
$5,000.00
1/10/13
1/16/13
$500.00
-$479.33
$250.00
$2,500.00
$200.00
$2,000.00
$1,864.15
$250.00
$100.00
$25,000.00
$500.00
$50.00
$7,500.00
1/24/13
2/27/13
3/14/13
3/14/13
3/14/13
3/17/13
4/1/13
4/3/13
5/1/13
5/15/13
6/11/13
6/11/13
6/19/13
$2,305.00
$1,493.00
$250.00
$407.00
$5,000.00
$3,365.14
$1,000.00
$5,000.00
$160.00
$5,000.00
$250.00
$250.00
$15,000.00
$2,135.00
$2,500.00
$250.00
$355.74
$1,007.00
$3,000.00
$1,275.00
$1,200.00
$5,000.00
$350.00
$500.00
$25,000.00
6/19/13
6/24/13
6/26/13
6/28/13
7/2/13
7/15/13
7/23/13
7/25/13
7/30/13
8/21/13
8/21/13
8/28/13
9/6/13
9/6/13
9/17/13
9/17/13
9/19/13
9/25/13
10/1/13
10/2/13
10/2/13
10/15/13
10/30/13
11/14/13
11/15/13
Grantee
Address
Purpose
Amount
$15,000.00
$15,000.00
$10,000.00
$15,000.00
$10,000.00
$10,000.00
$10,000.00
$50,000.00
$5,000.00
$10,000.00
$50,000.00
$3,565.00
$14,314.28
$5,000.00
$343,292.00
$32,464.63
$728,923.61
Date
Awarded
12/9/13
12/11/13
12/11/13
12/18/13
12/18/13
12/18/13
12/18/13
12/18/13
12/18/13
12/19/13
12/19/13
12/20/13
12/20/13
12/28/13
1/3/14
ongoing