efile Public Visual Render
Submission Date - 2012-05-16
TIN: 31-1784246
Form
990-PF
Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Nonexempt Charitable Trust
Treated as a Private Foundation
Note.
The foundation may be able to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0052
20
11
For calendar year 2011, or tax year beginning
01-01-2011
, and ending
12-31-2011
G
Check all that apply:
Initial return
Initial return of a former public charity
Final return
Amended return
Address change
Name change
Name of foundation
HARRIS & FRANCES BLOCK FOUNDATION INC
CO BETSY CHODORKOFF
Number and street (or P.O. box number if mail is not delivered to street address)
491 ENNIS HILL ROAD
Room/suite
City or town, state, and ZIP code
MARSHFIELD
,
VT
05658
A Employer identification number
31-1784246
B
Telephone number (see page 10 of the instructions)
(802) 426-3806
C
If exemption application is pending, check here
D 1.
Foreign organizations, check here .
H
Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
2.
Foreign organizations meeting the 85% test,
check here and attach computation
I
Fair market value of all assets at end
of year
(from Part II, col. (c),
line 16)
$
6,282,491
J
Accounting method:
Cash
Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)
E
If private foundation status was terminated
under section 507(b)(1)(A), check here
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here
Part I
Analysis of Revenue and Expenses
(The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see page 11 of the instructions).)
(a)
Revenue and
expenses per
books
(b)
Net investment
income
(c)
Adjusted net
income
(d)
Disbursements
for charitable
purposes
(cash basis only)
1
Contributions, gifts, grants, etc., received (attach schedule)
994,149
2
Check
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
......
97,698
97,698
97,698
5a
Gross rents
..............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
183,560
b
Gross sales price for all assets on line 6a
1,616,742
7
Capital gain net income (from Part IV, line 2)
...
183,560
8
Net short-term capital gain
.........
23,601
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
........
1,275,407
281,258
121,299
13
Compensation of officers, directors, trustees, etc.
26,000
2,400
23,600
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
2,430
2,430
c
Other professional fees (attach schedule)
....
45,222
45,222
17
Interest
...............
18
Taxes (attach schedule) (see page 14 of the instructions)
9,335
219
1,836
19
Depreciation (attach schedule) and depletion
...
809
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
3,689
3,689
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
1,769
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
89,254
50,271
29,125
25
Contributions, gifts, grants paid
........
327,979
327,979
26
Total expenses and disbursements.
Add lines 24 and 25
417,233
50,271
357,104
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
858,174
b
Net investment income
(if negative, enter -0-)
230,987
c
Adjusted net income
(if negative, enter -0-)
...
121,299
For Privacy Act and Paperwork Reduction Act Notice, see page 30 of the instructions.
Cat. No. 11289X
Form
990-PF
(2011)
Form 990-PF (2011)
Page
2
Part II
Balance Sheets
Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year
End of year
(a)
Book Value
(b)
Book Value
(c)
Fair Market Value
1
Cashnon-interest-bearing
...............
2
Savings and temporary cash investments
..........
877,067
833,318
833,318
3
Accounts receivable
Less: allowance for doubtful accounts
4
Pledges receivable
Less: allowance for doubtful accounts
5
Grants receivable
.................
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see page 15 of the
instructions)
....................
7
Other notes and loans receivable (attach schedule)
Less: allowance for doubtful accounts
8
Inventories for sale or use
...............
9
Prepaid expenses and deferred charges
...........
10a
InvestmentsU.S. and state government obligations (attach schedule)
547,902
101,004
101,004
b
Investmentscorporate stock (attach schedule)
........
3,873,618
4,383,202
4,383,202
c
Investmentscorporate bonds (attach schedule)
........
171,033
260,825
260,825
11
Investmentsland, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investmentsmortgage loans
..............
13
Investmentsother (attach schedule)
...........
473,025
698,355
698,355
14
Land, buildings, and equipment: basis
3,402
Less: accumulated depreciation (attach schedule)
1,418
2,793
1,984
1,984
15
Other assets (describe
)
3,063
3,804
3,803
16
Total assets
(to be completed by all filerssee the
instructions. Also, see page 1, item I)
5,948,501
6,282,492
6,282,491
17
Accounts payable and accrued expenses
..........
1,196
18
Grants payable
...................
19
Deferred revenue
..................
20
Loans from officers, directors, trustees, and other disqualified persons
21
Mortgages and other notes payable (attach schedule)
......
22
Other liabilities (describe
)
23
Total liabilities
(add lines 17 through 22)
..........
1,196
Foundations that follow SFAS 117, check here
and complete lines 24 through 26 and lines 30 and 31.
24
Unrestricted
....................
5,948,501
6,281,296
25
Temporarily restricted
................
26
Permanently restricted
................
Foundations that do not follow SFAS 117, check here
and complete lines 27 through 31.
27
Capital stock, trust principal, or current funds
.........
28
Paid-in or capital surplus, or land, bldg., and equipment fund
29
Retained earnings, accumulated income, endowment, or other funds
30
Total net assets or fund balances
(see page 17 of the
instructions)
....................
5,948,501
6,281,296
31
Total liabilities and net assets/fund balances
(see page 17 of
the instructions)
..................
5,948,501
6,282,492
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of yearPart II, column (a), line 30 (must agree
with end-of-year figure reported on prior years return)
...............
1
5,948,501
2
Enter amount from Part I, line 27a
.....................
2
858,174
3
Other increases not included in line 2 (itemize)
3
4
Add lines 1, 2, and 3
..........................
4
6,806,675
5
Decreases not included in line 2 (itemize)
5
525,379
6
Total net assets or fund balances at end of year (line 4 minus line 5)Part II, column (b), line 30
.
6
6,281,296
Form
990-PF
(2011)
Form 990-PF (2011)
Page
3
Part IV
Capital 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 acquired
PPurchase
DDonation
(c)
Date acquired
(mo., day, yr.)
(d)
Date sold
(mo., day, yr.)
1 a
150000 FEDERAL FARM CREDIT BANKS CONS
P
2010-09-17
2011-04-27
b
2800 ECOLAB INC
P
2011-03-09
2011-12-12
c
100000 FEDERAL NATL MTG ASSN DEB CPN STRIP
P
2009-01-07
2011-11-15
d
200000 FEDERAL HOME LOAN BANKS
P
2011-05-16
2011-08-22
e
100000 FEDERAL NATL MTG ASSN
P
2010-08-16
2011-08-12
4800 WORTHINGTON INDUSTRIES INC
P
2006-02-03
2011-08-03
130000 CAPSTONE BANK TUSCALOOSA ALA
P
2009-07-21
2011-08-01
90000 INVESTORS COMMUNITY BANK WI
P
2009-05-12
2011-05-16
4100 PITNEY BOWES INC
P
2009-02-03
2011-05-10
200000 FEDERAL FARM CREDIT BANKS CONS
P
2010-12-27
2011-12-08
2600 AVON PRODUCTS INC
P
2006-02-03
2011-03-09
3500 BALDOR ELEC CO
P
2008-01-01
2011-02-24
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
150,000
149,918
82
b
154,464
133,565
20,899
c
100,000
93,204
6,796
d
200,000
200,519
-519
e
100,000
100,145
-145
96,339
65,134
31,205
130,000
130,000
90,000
90,000
101,961
122,440
-20,479
200,000
196,716
3,284
71,728
67,105
4,623
222,250
84,436
137,814
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-)
or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
Excess of col. (i)
over col. (j), if any
a
82
b
20,899
c
6,796
d
-519
e
-145
31,205
-20,479
3,284
4,623
137,814
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
183,560
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
23,601
Part V
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?
Yes
No
If Yes, the foundation does not qualify under section 4940(e). Do not complete this part.
1
Enter the appropriate amount in each column for each year; see page 18 of the instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in)
(b)
Adjusted qualifying distributions
(c)
Net value of noncharitable-use assets
(d)
Distribution ratio
(col. (b) divided by col. (c))
2010
281,254
5,080,472
0.05536
2009
251,726
3,791,509
0.06639
2008
161,855
2,565,572
0.06309
2007
136,319
1,541,016
0.08846
2006
89,731
1,030,721
0.08706
2
Total
of line 1, column (d)
......................
2
0.36036
3
Average distribution ratio for the 5-year base perioddivide 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
0.07207
4
Enter the net value of noncharitable-use assets for 2011 from Part X, line 5
.....
4
4,908,849
5
Multiply line 4 by line 3
.......................
5
353,786
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
2,310
7
Add lines 5 and 6
.........................
7
356,096
8
Enter qualifying distributions from Part XII, line 4
..............
8
357,104
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See
the Part VI instructions on page 18.
Form
990-PF
(2011)
Form 990-PF (2011)
Page
4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948see page 18 of the instructions)
1a
Exempt operating foundations described in section 4940(d)(2), check here
and enter N/A on line 1.
Date of ruling or determination letter:
(attach copy of letter if necessarysee instructions)
b
Domestic foundations that meet the section 4940(e) requirements in Part V, check
1
2,310
here
and enter 1% of Part I, line 27b
...................
c
All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
2
3
Add lines 1 and 2
............................
3
2,310
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-).
4
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
2,310
6
Credits/Payments:
a
2011 estimated tax payments and 2010 overpayment credited to 2011
6a
4,184
b
Exempt foreign organizationstax withheld at source
.......
6b
c
Tax paid with application for extension of time to file (Form 8868)
6c
d
Backup withholding erroneously withheld
...........
6d
7
Total credits and payments. Add lines 6a through 6d
..............
7
4,184
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
1,874
11
Enter the amount of line 10 to be:
Credited to 2012 estimated tax
1,874
Refunded
11
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see page 19 of
the instructions for definition)?
............................
1b
No
If the answer is Yes to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
(2)
On foundation managers.
$
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If Yes, attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If Yes, attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If Yes, has it filed a tax return on
Form 990-T
for this year?
...................
4b
No
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If Yes, attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
Yes
7
Did the foundation have at least $5,000 in assets at any time during the year?
If Yes, complete Part II, col. (c), and Part XV.
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see page 19 of the
instructions)
VT
b
If the answer is Yes to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G?
If No, attach explanation
.
8b
No
9
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
or 4942(j)(5) for calendar year 2011 or the taxable year beginning in 2011 (see instructions for Part XIV on
page 27)?
If Yes, complete Part XIV
..........................
9
No
10
Did any persons become substantial contributors during the tax year?
If Yes, attach a schedule listing their names and addresses.
10
No
11
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 page 20 of the instructions)
.......
11
No
12
Did the foundation acquire a direct or indirect interest in any applicable insurance contract before August 17, 2008?
12
No
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
www.blockfound.org
14
The books are in care of
BETSY CHODORKOFF
Telephone no.
(802) 426-3806
Located at
491 ENNIS HILL ROAD
MARSHFIELD
VT
ZIP+4
05658
15
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
......
15
16
At any time during calendar year 2011, did the foundation have an interest in or a signature or other authority over
a bank, securities, or other financial account in a foreign country?
.................
16
No
See page 20 of the instructions for exceptions and filing requirements for Form TD F 90-22.1. If "Yes", enter the name of the foreign country
Form
990-PF
(2011)
Form 990-PF (2011)
Page
5
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the Yes column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1)
Engage in the sale or exchange, or leasing of property with a disqualified person?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
.........................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
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
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
No
b
If any answer is Yes to 1a(1)(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance (see page 20 of the instructions)?
...
1b
No
Organizations relying on a current notice regarding disaster assistance check here
.........
c
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2011?
.............
1c
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2011, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2011?
...............
Yes
No
If Yes, list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the years undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer No and attach statementsee page 20 of the instructions.)
.........
2b
No
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 foundation hold more than a 2% direct or indirect interest in any business
enterprise at any time during the year?
.....................
Yes
No
b
If Yes, did it have excess business holdings in 2011 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 2011.)
....................
3b
No
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
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 2011?
4b
No
5a
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
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)? (see page 22 of the instructions)
...
Yes
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
No
b
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 page 22 of the instructions)?
5b
No
Organizations relying on a current notice regarding disaster assistance check here
.........
c
If the answer is Yes to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant?
............
Yes
No
If Yes, attach the statement required by Regulations section 53.49455(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay
premiums on a personal benefit contract?
....................
Yes
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
....
6b
No
If Yes to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
Yes
No
b
If yes, did the foundation receive any proceeds or have any net income attributable to the transaction?
....
7b
No
Form
990-PF
(2011)
Form 990-PF (2011)
Page
6
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1
List all officers, directors, trustees, foundation managers and their compensation (see page 22 of the instructions).
(a)
Name and address
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(If not paid, enter
-0-)
(d)
Contributions to
employee benefit plans
and deferred compensation
(e)
Expense account,
other allowances
DIANE MAURER SCHATZ
Secretary
1.00
1,000
2261 JASMINE STREET
DENVER
,
CO
80207
BETSY M CHODORKOFF
Treasurer
25.00
24,000
491 ENNIS HILL ROAD
MARSHFIELD
,
VT
05658
NANCY M SLUYS
Vice President
1.00
1,000
197 MINGLEWOOD ROAD
WESTFIELD
,
NC
27053
2
Compensation of five highest-paid employees (other than those included on line 1see page 23 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 week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
NONE
Total
number of other employees paid over $50,000
...................
3
Five highest-paid independent contractors for professional services (see page 23 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
NONE
Total
number of others receiving over $50,000 for professional services
.............
Part IX-A
Summary of Direct Charitable Activities
List the foundations 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
2
3
4
Form
990-PF
(2011)
Form 990-PF (2011)
Page
7
Part IX-B
Summary of Program-Related Investments
(see page 23 of the instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
2
All other program-related investments. See page 24 of the instructions.
3
Total.
Add lines 1 through 3
..........................
Part X
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations,
see page 24 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
...................
1a
4,128,410
b
Average of monthly cash balances
.......................
1b
855,193
c
Fair market value of all other assets (see page 24 of the instructions)
............
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
4,983,603
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation)
.............
1e
0
2
Acquisition indebtedness applicable to line 1 assets
..................
2
3
Subtract line 2 from line 1d
.........................
3
4,983,603
4
Cash deemed held for charitable activities. Enter 1 12% of line 3 (for greater amount, see page 25
of the instructions)
...........................
4
74,754
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
4,908,849
6
Minimum investment return.
Enter 5% of line 5
..................
6
245,442
Part XI
Distributable Amount
(see page 25 of the instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here
and do not complete this part.)
1
Minimum investment return from Part X, line 6
....................
1
245,442
2a
Tax on investment income for 2011 from Part VI, line 5
......
2a
2,310
b
Income tax for 2011. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
2,310
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
243,132
4
Recoveries of amounts treated as qualifying distributions
................
4
5
Add lines 3 and 4
............................
5
243,132
6
Deduction from distributable amount (see page 25 of the instructions)
...........
6
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII,
line 1
................................
7
243,132
Part XII
Qualifying Distributions
(see page 25 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
357,104
b
Program-related investmentstotal from Part IX-B
..................
1b
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
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
357,104
5
Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
income. Enter 1% of Part I, line 27b (see page 26 of the instructions)
............
5
2,310
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
354,794
Note:
The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
the section 4940(e) reduction of tax in those years.
Form
990-PF
(2011)
Form 990-PF (2011)
Page
8
Part XIII
Undistributed Income
(see page 26 of the instructions)
(a)
Corpus
(b)
Years prior to 2010
(c)
2010
(d)
2011
1
Distributable amount for 2011 from Part XI, line 7
243,132
2
Undistributed income, if any, as of the end of 2011:
a
Enter amount for 2010 only
.......
b
Total for prior years:
20
,
20
,
20
3
Excess distributions carryover, if any, to 2011:
a
From 2006
.......
38,404
b
From 2007
.......
61,724
c
From 2008
.......
34,502
d
From 2009
.......
63,239
e
From 2010
.......
31,412
f
Total
of lines 3a through e
.........
229,281
4
Qualifying distributions for 2011 from Part
XII, line 4:
$
357,104
a
Applied to 2010, but not more than line 2a
b
Applied to undistributed income of prior years
(Election requiredsee page 26 of the instructions)
c
Treated as distributions out of corpus (Election
requiredsee page 26 of the instructions)
...
0
d
Applied to 2011 distributable amount
.....
243,132
e
Remaining amount distributed out of corpus
113,972
5
Excess distributions carryover applied to 2011.
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
343,253
b
Prior years undistributed income. Subtract
line 4b from line 2b
...........
c
Enter the amount of prior years undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
d
Subtract line 6c from line 6b. Taxable
amountsee page 27 of the instructions
...
e
Undistributed income for 2010. Subtract line
4a from line 2a. Taxable amountsee page 27
of the instructions
...........
f
Undistributed income for 2011. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2011
..........
0
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (see page 27
of the instructions)
...........
8
Excess distributions carryover from 2006 not
applied on line 5 or line 7 (see page 27 of the
instructions)
.............
38,404
9
Excess distributions carryover to 2012.
Subtract lines 7 and 8 from line 6a
......
304,849
10
Analysis of line 9:
a
Excess from 2007
....
61,724
b
Excess from 2008
....
34,502
c
Excess from 2009
....
63,239
d
Excess from 2010
....
31,412
e
Excess from 2011
....
113,972
Form
990-PF
(2011)
Form 990-PF (2011)
Page
9
Part XIV
Private Operating Foundations
(see page 27 of the instructions and Part VII-A, question 9)
1a
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2011, enter the date of the ruling
.......
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2011
(b)
2010
(c)
2009
(d)
2008
b
85% of line 2a
.........
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
....
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
3
Complete 3a, b, or c for the
alternative test relied upon:
a
Assets alternative testenter:
(1)
Value of all assets
......
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
b
Endowment alternative test enter 23
of minimum investment return shown in
Part X, line 6 for each year listed
...
c
Support alternative testenter:
(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
Supplementary Information (Complete this part only if the organization had $5,000 or more in
assets at any time during the yearsee page 27 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).)
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.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. (see page 28 of the instructions) to individuals or organizations
under other conditions, complete items 2a, b, c, and d.
a
The name, address, and telephone number of the person to whom applications should be addressed:
HARRIS FRANCES BLOCK FOUNDATION
491 ENNIS HILL ROAD
MARSHFIELD
,
VT
05658
(802) 426-3806
b
The form in which applications should be submitted and information and materials they should include:
LETTERS OF INQUIRY SHOULD BE SUBMITTED VIA A TYPE-WRITTEN LETTER AND INCLUDE COMPLETE DETAILS.
c
Any submission deadlines:
ROLLING
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
HIGHEST PRIORITY CONSIDERATION IS GIVEN TO THE AREAS OF ECONOMIC JUSTICE, ENVIRONMENTAL PROTECTION, ARMS CONTROL, COMMUNITY DEVELOPMENT, AND HISTORIC PRESERVATION.
Form
990-PF
(2011)
Form 990-PF (2011)
Page
10
Part XV
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
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
BLUE RIDGE DISCOVERY CENTER
253 LITTLE BIG HORN LANE
INDEPENDENCE
,
VA
24348
NONE
501(C)
MAINTAIN AND RESTORE WOODLANDS ACROSS VIRGINIA
7,500
CLINCH COALITION
1097 OLD QUARRY DRIVE
NICKELSVILLE
,
VA
24271
NONE
501(C)
MAINTAIN AND RESTORE WOODLANDS ACROSS VIRGINIA
10,000
JAQUITH PUBLIC LIBRARY
THE OLD SCHOOLHOUSE COMMON
MARSHFIELD
,
VT
05658
NONE
501(C)
TO PROMOTE COMMUNITY AND THE ACCESSIBILITY OF INFORMATION AND IDEAS.
1,945
GEDAKINA
PO BOX 221
MILFORD
,
NH
03055
NONE
501(C)
TO STRENGTHEN THE CULTURAL KNOWLEDGE AND IDENTITY OF NATIVE AMERICANS.
5,000
CONNECTICUT AUDUBON SOCIETY
2325 BURR STREET
FAIRFIELD
,
CT
06824
NONE
501(C)
TO CONSERVE CONNECTICUT'S ENVIRONMENT THROUGH SCIENCE-BASED EDUCATION AND ADVOCACY.
10,000
CLEAN WATER FUND
1010 VERMONT AVENUE NW
WASHINGTON
,
DC
20005
NONE
501(C)
DEVELOP STRONG GRASSROOTS ENVIRONMENTAL LEADERSHIP FOCUSED ON CLEANER AND SAFER WATER.
10,000
RURAL VERMONT
15 BARRE STREET SUITE 2
MONTPELIER
,
VT
05602
NONE
501(C)
PROMOTE A SUSTAINABLE AGRICULTURAL FUTURE FOR VERMONT.
6,000
PLANNED PARENTHOOD
1055 COMMONWEALTH AVENUE
BOSTON
,
MA
02215
NONE
501(C)
ADVOCATE SEXUAL AND REPRODUCTIVE HEALTH CARE SERVICES AND INFORMATION.
30,000
VERMONT FOODBANK
33 PARKER ROAD
BARRE
,
VT
05641
NONE
501(C)
TO HELP VERMONTERS WHO NEED FOOD ASSISTANCE.
3,500
TWINFIELD UNION SCHOOL
106 NASMITH BROOK ROAD
PLAINFIELD
,
VT
05667
NONE
501(C)
FARM TO SCHOOL PROGRAM
7,534
ENVIRONMENT COLORADO
1536 WYNKOOP STREET
DENVER
,
CO
80202
NONE
501(C)
ENVIRONMNETAL ADVOCACY IN COLORADO.
10,000
UVM AND STATE AGRICULTURAL COLLEGE
85 SOUTH PROSPECT STREET
BURLINGTON
,
VT
05405
NONE
501(C)
YOUTH AGRICULTURE APPRENTICE PROGRAM
5,000
VERMONT WORKERS' CENTER
293 NORTH WINOOSKI AVENUE
BURLINGTON
,
VT
05401
NONE
501(C)
HEALTH CARE IS A HUMAN RIGHT CAMPAIGN
10,000
VERMONT SUSTAINABLE JOBS FUND
3 PITKIN COURT SUITE 301e
MONTPELIER
,
VT
05602
NONE
501(C)
TO STRENGTHEN VERMONT'S FOOD SYSTEM.
5,000
ECORI INC
111 HOPE STREET
PROVIDENCE
,
RI
02906
NONE
501(C)
PROMOTE THE IMPORTANCE OF ENVIRONMENTAL/SOCIAL JUSTICE NEWS.
5,000
COLORADO WILDLIFE FEDERATION
1410 GRANT STREET SUITE C-313
DENVER
,
CO
80203
NONE
501(C)
ADVOCATE FOR COLORADO WILDLIFE.
10,000
VERMONT LAW SCHOOL
PO BOX 96
SOUTH ROYALTON
,
VT
05068
NONE
501(C)
ENERGY ACTION NOW
10,000
HIGHFIELDS CENTER FOR COMPOSTING
PO BOX 503
HARDWICK
,
VT
05843
NONE
501(C)
COMMUNITY COMPOSTING SUPPORT AND RESEARCH
10,000
GREYSTON FOUNDATION INC
21 PARK AVENUE
YONKERS
,
NY
10703
NONE
501(C)
COMMUNITY SUPPORT
4,000
GLOBAL GREENGRANTS FUND
2840 WILDERNESS PLACE SUITE A
BOULDER
,
CO
80301
NONE
501(C)
RESPONSIBLE, ENVIRONMENTAL GRANTMAKING
10,000
VERMONT NATURAL RESOURCES COUNCIL
9 BAILEY AVE
MONTPELIER
,
VT
05602
NONE
501(C)
PROTECT NATURAL RESOURCES
15,000
ALLEHGENY FOUNDATION
301 GRANT STREET SUITE 3900
PITTSBURG
,
PA
15219
NONE
501(C)
junior appalacian musicians
10,000
VT PUBLIC INTEREST RESEARCH GROUP
141 MAIN ST STE 6
MONTPELIER
,
VT
05602
NONE
501(C)
SUPPORT PUBLIC INTEREST RESEARCH
10,000
VT COMMUNITY FOUNDATION
PO BOX 30
MIDDLEBURY
,
VT
05753
NONE
501(C)
VERMONT FARM DISASTER RELIEF FUND
10,000
RIVERLINK INC
170 LYMAN STREET
ASHEVILLE
,
NC
28801
NONE
501(C)
ECONOMIC AND ENVIRONMENTAL REVITALIZATION OF FRENCH BROAD RIVER
5,000
Citizens Awareness Network
PO Box 83
Shelburne Falls
,
MA
01370
None
501(c)
Use of sustainable, reliable and affordable energy generation
10,000
SEED COALITION
1303 SAN ANTONIO SUITE 100
AUSTIN
,
TX
78701
None
501(c)
ENERGY ISSUES
10,000
Toxic Free North Carolina
206 Newbern Place
Raleigh
,
NC
27601
None
501(c)
Fighting Pesticide Pollution
15,000
Global Justice Ecology Project Inc
Box 412
Hinesburg
,
VT
05461
None
501(c)
Environmental Advocacy
7,500
Food Works AT 2 RIVERS CENTER
64 Main Street
Montpelier
,
VT
05602
None
501(c)
Education re Sustainable Food Production
10,000
GREEN MOUNTAIN CLUB
4711 WATERBURY-STOWE ROAD
WATERBURY CENTER
,
VT
05677
None
501(c)
Support for community organizing effort for VERMONT
5,000
New England Grassroots Env Fu
PO Box 1057
MontpelieR
,
VT
05601
None
501(c)
Environmental issues
15,000
Dogwood Alliance
PO 7645
Asheville
,
NC
28802
None
501(c)
Protect southern forests
15,000
Toxics Action Center
29 Temple Place
Boston
,
MA
02111
None
501(c)
Support for community organizing effort regarding toxic waste in the local environment
10,000
Friends of Burlington Garden
33 Tracy Drive
Burlington
,
VT
05401
None
501(c)
Outreach Low Income Residents
10,000
Total
.................................
3a
327,979
b
Approved for future payment
Total
.................................
3b
Form
990-PF
(2011)
Form 990-PF (2011)
Page
11
Part XVI-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
Unrelated business income
Excluded by section 512, 513, or 514
(e)
Related or exempt
function income
(See page 28 of
the instructions.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
....
14
97,698
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 property
7
Other investment income
.....
8
Gain or (loss) from sales of assets other than inventory
183,560
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
..
11
Other revenue:
a
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
97,698
183,560
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
281,258
(See worksheet in line 13 instructions on page 28 to verify calculations.)
Part XVI-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
the accomplishment of the organizations exempt purposes (other than by providing funds for such purposes). (See
page 28 of the instructions.)
8& 11a
Income was used to give grants for the purposes outlined in statement 17.
Form
990-PF
(2011)
Form 990-PF (2011)
Page
12
Part XVII
Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
1
Did the organization directly or indirectly engage in any of the following with any other organization described in section
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 foundation to a noncharitable exempt organization of:
(1)
Cash
...................................
1a(1)
No
(2)
Other assets
.................................
1a(2)
No
b
Other transactions:
(1)
Sales of assets to a noncharitable exempt organization
....................
1b(1)
No
(2)
Purchases of assets from a noncharitable exempt organization
..................
1b(2)
No
(3)
Rental of facilities, equipment, or other assets
.......................
1b(3)
No
(4)
Reimbursement arrangements
...........................
1b(4)
No
(5)
Loans or loan guarantees
.............................
1b(5)
No
(6)
Performance of services or membership or fundraising solicitations
................
1b(6)
No
c
Sharing of facilities, equipment, mailing lists, other assets, or paid employees
..............
1c
No
d
If the answer to any of the above is Yes, complete the following schedule. Column
(b)
should always show the fair market value
of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
in any transaction or sharing arrangement, show in column
(d)
the value of the goods, other assets, or services received.
(a)
Line No.
(b)
Amount involved
(c)
Name of noncharitable exempt organization
(d)
Description of transfers, transactions, and sharing arrangements
2a
Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527?
...........
Yes
No
b
If Yes, complete the following schedule.
(a)
Name of organization
(b)
Type of organization
(c)
Description of relationship
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer or fiduciary) is based on all information of which preparer has any knowledge.
2012-05-15
Signature of officer or trustee
Date
Title
Preparer's Signature
E Lela McCaffrey CPA
Date
Check if self-
employed
PTIN
Firm's name
Firm's address
Fothergill Segale & Valley CPAs
143 Barre Street
Montpelier
,
VT
05602
Firm's EIN
Phone no.
(802) 223-6261
Form
990-PF
(2011)
Additional Data
Software ID:
11000144
Software Version:
2011v1.2
Form 990PF - Special Condition Description:
Special Condition Description