Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletInformation about Form 990-PF and its instructions is at www.irs.gov/form990pf.
OMB No. 1545-0052
2014
Open to Public Inspection
For calendar year 2014, or tax year beginning 05-01-2014 , and ending 04-30-2015
Name of foundation
J KENT PERLEY AND BESSIE V PERLEY FUND

Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 477
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CONCORD, NH033020477
A Employer identification number

03-0276834
B Telephone number (see instructions)

(802) 860-5407
C bullet
G Check all that apply:

D 1. bullet
2. bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$1,015,320
J Accounting method:

(Part I, column (d) must be on cash basis.)
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 instructions).) (a) Revenue and
expenses per
books
(b) Net investment
income
(c) Adjusted net
income
(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)
2 Check bullet Sch. B .............
3 Interest on savings and temporary cash investments
4 Dividends and interest from securities... 22,378 22,378
5a Gross rents............
b Net rental income or (loss)
6a Net gain or (loss) from sale of assets not on line 10 49,871
b Gross sales price for all assets on line 6a 339,819
7 Capital gain net income (from Part IV, line 2)... 49,871
8 Net short-term capital gain......... 0
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........ 72,249 72,249
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 9,667 9,667
14 Other employee salaries and wages...... 0 0 0
15 Pension plans, employee benefits....... 0 0
16a Legal fees (attach schedule)......... 0
b Accounting fees (attach schedule)....... 725 725 0 0
c Other professional fees (attach schedule).... 0
17 Interest............... 0
18 Taxes (attach schedule) (see instructions)... 2,111 187 0
19 Depreciation (attach schedule) and depletion... 0 0
20 Occupancy..............
21 Travel, conferences, and meetings....... 0 0
22 Printing and publications.......... 0 0
23 Other expenses (attach schedule)....... 40 40
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 12,543 10,619 0 0
25 Contributions, gifts, grants paid....... 48,000 48,000
26 Total expenses and disbursements. Add lines 24 and 25 60,543 10,619 0 48,000
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 11,706
b Net investment income (if negative, enter -0-) 61,630
c Adjusted net income (if negative, enter -0-)... 0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2014)
Form 990-PF (2014)
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
Assets 1 Cashnon-interest-bearing.............
2 Savings and temporary cash investments......... 28,575 73,036 73,036
3 Accounts receivable bullet
Less: allowance for doubtful accounts bullet 0 0
4 Pledges receivable bullet
Less: allowance for doubtful accounts bullet
5 Grants receivable.................
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....
7 Other notes and loans receivable (attach schedule) bullet
Less: allowance for doubtful accounts bullet0
8 Inventories for sale or use..............
9 Prepaid expenses and deferred charges..........
10a InvestmentsU.S. and state government obligations (attach schedule)
b Investmentscorporate stock (attach schedule)....... 508,991 Click to see attachment409,312 496,347
c Investmentscorporate bonds (attach schedule)....... 383,453 Click to see attachment449,840 445,937
11 Investmentsland, buildings, and equipment: basis bullet
Less: accumulated depreciation (attach schedule) bullet
12 Investmentsmortgage loans.............
13 Investmentsother (attach schedule).......... 0
14 Land, buildings, and equipment: basis bullet
Less: accumulated depreciation (attach schedule) bullet
15 Other assets (describe bullet)
16 Total assets (to be completed by all filerssee the
instructions. Also, see page 1, item I) 921,019 932,188 1,015,320
Liabilities 17 Accounts payable and accrued expenses..........
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 bullet)
23 Total liabilities (add lines 17 through 22)......... 0
Net Assets or Fund Balances bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted..................
25 Temporarily restricted...............
26 Permanently restricted...............
bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds........ 921,019 932,188
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 instructions)..... 921,019 932,188
31 Total liabilities and net assets/fund balances (see instructions). 921,019 932,188
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
921,019
2
Enter amount from Part I, line 27a .....................
2
11,706
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
932,725
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
537
6
Total net assets or fund balances at end of year (line 4 minus line 5)Part II, column (b), line 30 .
6
932,188
Form 990-PF (2014)
Form 990-PF (2014)
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 20. ABBOTT LABS CO 2013-01-15 2014-05-01
b 10. AETNA U S HEALTHCARE INC 2013-12-03 2014-05-01
c 20. AGILENT TECHNOLOGIES INC COM 2013-12-03 2014-05-01
d 39.798 INVESCO INTERNATIONAL GROWTH FUND INSTITUTIONAL CLASS 2010-11-30 2014-05-01
e 10. AMERICAN EXPRESS CO 2009-05-19 2014-05-01
20. AMERICAN INTL GROUP INC COM NEW 2013-12-03 2014-05-01
10. AMERIPRISE FINANCIAL INC 2013-12-03 2014-05-01
10. APPLE COMPUTER, INC 2013-12-03 2014-05-01
30. APPLIED MATERIALS 2013-12-03 2014-05-01
10. BLACKROCK INC CL A 2013-12-03 2014-05-01
10. BOEING CO 2013-12-03 2014-05-01
10. CME GROUP INC 2013-12-03 2014-05-01
20. CVS CORP 2013-12-03 2014-05-01
10. CAMERON INTERNATIONAL CORP 2013-12-03 2014-05-01
10. CAPITAL ONE FINANCIAL CORP 2011-07-14 2014-05-01
30. CENTURYTEL INC COM 2013-12-03 2014-05-01
20. CITIGROUP INC. 2013-12-03 2014-05-01
10. CITRIX SYS INC COM 2014-01-22 2014-05-01
10. DANAHER CORP 2011-04-21 2014-05-01
10. DAVITA INC 2013-12-03 2014-05-01
10. DEVON ENERGY CORPORATIOIN NE COM 2013-12-03 2014-05-01
10. E I DUPONT DE NEMOURS INC 2013-12-03 2014-05-01
10. ECOLAB INC COM 2010-05-14 2014-05-01
10. EXXON MOBIL CORP COM 2010-06-24 2014-05-01
20.443 HARBOR INTERNATIONAL FUND 2010-11-30 2014-05-01
10. KOHL'S CORP 2013-12-03 2014-05-01
20. MARSH & MCLENNAN CORP 2013-12-03 2014-05-01
10. MCDONALDS CORP 2013-12-03 2014-05-01
30. MICROSOFT CORPORATION 2010-11-29 2014-05-01
20. MORGAN STANLEY GROUP INC. DEAN 2014-03-13 2014-05-01
10. NATIONAL-OILWELL INC 2013-12-03 2014-05-01
10. NORTHERN TRUST CORP 2014-01-23 2014-05-01
30. ORACLE CORPORATION 2012-09-13 2014-05-01
10. PEPSICO INCORPORATED 2013-12-03 2014-05-01
10. PRAXAIR INCORPORATED COMMON 2013-12-03 2014-05-01
10. ROCKWELL COLLINS INC COM 2013-12-03 2014-05-01
30. STAPLES INC 2013-12-03 2014-05-01
10. TJX COMPANIES INC. 2013-02-04 2014-05-01
20. TEXAS INSTRUMENTS 2013-12-03 2014-05-01
20. TIME WARNER INC 2013-12-03 2014-05-01
10. UNITEDHEALTH GROUP INC COM 2013-12-03 2014-05-01
20. WISCONSIN ENERGY CORP 2013-12-03 2014-05-01
10. DELPHI AUTOMOTIVE PLC 2013-12-03 2014-05-01
10. INGERSOLL-RAND PLC SHS 2013-12-03 2014-05-01
20. SEAGATE TECHNOLOGY PLC SHS 2014-02-03 2014-05-01
10. CHECK POINT SOFTWARE TECHNOLOGIES LTD 2011-07-14 2014-05-01
100. INTL GAME TECHNOLOGY 2013-12-03 2014-05-06
60. ELECTRONIC ARTS COM 2013-12-03 2014-05-07
70. ELECTRONIC ARTS COM 2013-12-03 2014-05-08
25. NOW INC 2013-12-03 2014-06-09
15. TIME INC 2013-12-03 2014-06-16
50. CAPITAL ONE FINANCIAL CORP 2011-07-14 2014-06-18
30. CAPITAL ONE FINANCIAL CORP 2013-06-21 2014-06-18
260. STAPLES INC 2013-12-03 2014-06-18
180.105 VANGUARD INFLTN PRTCTD SEC FD #5119 2010-11-30 2014-06-26
20. AETNA U S HEALTHCARE INC 2013-12-03 2014-06-30
2. VERITIV CORP 2013-12-03 2014-07-10
.676 VERITIV CORP 2013-12-03 2014-07-21
20. DAVITA INC 2013-12-03 2014-07-24
20. EXXON MOBIL CORP COM 2013-06-21 2014-07-25
30. DAVITA INC 2013-12-03 2014-08-01
30. AETNA U S HEALTHCARE INC 2013-12-03 2014-08-12
30. DELPHI AUTOMOTIVE PLC 2013-12-03 2014-08-27
30. DELPHI AUTOMOTIVE PLC 2013-12-03 2014-08-28
10. AETNA U S HEALTHCARE INC 2013-12-03 2014-10-15
20. TIME WARNER INC 2013-12-03 2014-10-16
50. AETNA U S HEALTHCARE INC 2013-12-03 2014-10-28
15. KEYSIGHT TECHNOLOGIES INC 2013-12-03 2014-11-24
60. KEYSIGHT TECHNOLOGIES INC 2013-08-16 2014-11-24
28. CALIFORNIA RESOURCES CORPORATION 2013-12-03 2015-01-13
4. CALIFORNIA RESOURCES CORPORATION 2014-07-25 2015-01-13
445.016 BUFFALO SMALL CAP FD #1444 2013-06-21 2015-01-22
602.79 HARTFORD MUT FDS INC MIDCAP FD CL Y FD# 229 2013-06-21 2015-01-22
674.263 PERKINS MID CAP VALUE FUND INSTITUTIONAL CLASS 2013-06-21 2015-01-22
662.958 ROYCE SPECIAL EQUITY FD #327 2013-06-21 2015-01-22
1811.828 VANGUARD INFLTN PRTCTD SEC FD #5119 2013-06-21 2015-01-22
20. AMERISOURCEBERGEN CORP 2014-06-13 2015-01-29
40. SMUCKER J M CO NEW 2013-12-03 2015-02-06
40. KOHL'S CORP 2013-12-03 2015-02-12
30. CVS CORP 2013-12-03 2015-02-19
10. APPLE COMPUTER, INC 2013-06-27 2015-02-20
50. NATIONAL-OILWELL INC 2013-12-03 2015-03-17
50. NATIONAL-OILWELL INC 2013-12-03 2015-03-18
50. CME GROUP INC 2013-12-03 2015-04-06
70. EXXON MOBIL CORP COM 2004-03-11 2015-04-08
40. ABBOTT LABS CO 2013-12-03 2015-04-09
30. ABBVIE INC 2013-12-03 2015-04-09
40. AGILENT TECHNOLOGIES INC COM 2013-12-03 2015-04-09
10. AMERICAN EXPRESS CO 2014-02-04 2015-04-09
40. AMERICAN INTL GROUP INC COM NEW 2013-12-03 2015-04-09
10. AMERISOURCEBERGEN CORP 2014-05-19 2015-04-09
10. AMERIPRISE FINANCIAL INC 2013-12-03 2015-04-09
20. ANADARKO PETROLEUM 2015-04-08 2015-04-09
30. APPLE COMPUTER, INC 2013-06-27 2015-04-09
90. APPLIED MATERIALS 2013-12-03 2015-04-09
20. BOEING CO 2013-12-03 2015-04-09
20. CIT GROUP INC COM NEW 2013-12-03 2015-04-09
10. CME GROUP INC 2013-12-03 2015-04-09
20. CVS CORP 2013-12-03 2015-04-09
20. CAMERON INTERNATIONAL CORP 2013-12-03 2015-04-09
50. CENTURYTEL INC COM 2013-12-03 2015-04-09
40. CITIGROUP INC. 2013-12-03 2015-04-09
20. CITIZENS FINANCIAL GROUP INC 2015-03-30 2015-04-09
30. CITRIX SYS INC COM 2014-01-23 2015-04-09
20. COLGATE PALMOLIVE CO 2012-04-12 2015-04-09
30. COMCAST CORP SPECIAL CL A 2013-12-03 2015-04-09
40. DANAHER CORP 2012-02-06 2015-04-09
20. DEVON ENERGY CORPORATIOIN NE COM 2013-12-03 2015-04-09
30. E I DUPONT DE NEMOURS INC 2013-12-03 2015-04-09
40. EVERSOURCE ENERGY 2013-12-03 2015-04-09
50. FIDELITY NATL INFORMATION SV 2013-12-03 2015-04-09
20. GENUINE PARTS CO 2013-12-03 2015-04-09
10. HOME DEPOT INC 2014-06-18 2015-04-09
50. INTERNATIONAL PAPER CO 2013-08-16 2015-04-09
10. KOHL'S CORP 2013-12-03 2015-04-09
10. LAS VEGAS SANDS CORP COM 2014-10-30 2015-04-09
40. MARSH & MCLENNAN CORP 2013-12-03 2015-04-09
20. MCDONALDS CORP 2013-12-03 2015-04-09
30. METLIFE INC 2014-06-17 2015-04-09
100. MICROSOFT CORPORATION 2013-12-03 2015-04-09
50. MORGAN STANLEY GROUP INC. DEAN 2014-03-13 2015-04-09
20. NORTHERN TRUST CORP 2014-01-23 2015-04-09
30. OCCIDENTAL PETROLEUM CO 2013-12-03 2015-04-09
70. ORACLE CORPORATION 2013-12-03 2015-04-09
20. PEPSICO INCORPORATED 2013-12-03 2015-04-09
20. PRAXAIR INCORPORATED COMMON 2013-12-03 2015-04-09
20. ROCKWELL COLLINS INC COM 2013-12-03 2015-04-09
30. SYNCHRONY FINANCIAL 2015-02-12 2015-04-09
40. TJX COMPANIES INC. 2013-12-03 2015-04-09
50. TEXAS INSTRUMENTS 2013-12-03 2015-04-09
20. TIME WARNER INC 2013-12-03 2015-04-09
20. UNITED TECHNOLOGIES 2013-12-03 2015-04-09
30. UNITEDHEALTH GROUP INC COM 2013-12-03 2015-04-09
40. VISA INC. - CL A 2013-12-03 2015-04-09
40. WISCONSIN ENERGY CORP 2013-12-03 2015-04-09
20. INGERSOLL-RAND PLC SHS 2013-12-03 2015-04-09
30. SEAGATE TECHNOLOGY PLC SHS 2013-12-03 2015-04-09
20. CHECK POINT SOFTWARE TECHNOLOGIES LTD 2011-07-14 2015-04-09
10. NIELSEN N V 2015-04-06 2015-04-09
20.901 INVESCO INTERNATIONAL GROWTH FUND INSTITUTIONAL CLASS 2010-11-30 2015-04-13
30. AMERISOURCEBERGEN CORP 2014-05-12 2015-04-20
CAPITAL GAIN DIVIDENDS P
(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 773 666 107
b 715 677 38
c 1,086 1,057 29
d 1,399 1,053 346
e 865 248 617
1,054 972 82
1,113 1,068 45
5,903 5,639 264
566 513 53
3,008 2,984 24
1,284 1,323 -39
703 808 -105
1,458 1,333 125
650 555 95
742 493 249
1,047 910 137
953 1,038 -85
593 611 -18
737 533 204
699 585 114
698 614 84
667 605 62
1,043 477 566
1,014 602 412
1,502 1,153 349
552 553 -1
984 949 35
1,009 963 46
1,199 761 438
621 628 -7
785 823 -38
599 619 -20
1,224 961 263
855 839 16
1,302 1,243 59
780 723 57
379 467 -88
582 455 127
904 856 48
1,337 1,307 30
748 737 11
978 824 154
669 569 100
599 560 39
1,011 1,018 -7
642 566 76
1,260 1,730 -470
1,984 1,300 684
2,373 1,517 856
804 832 -28
346 311 35
4,041 2,449 1,592
2,424 1,848 576
2,894 4,046 -1,152
4,811 4,732 79
1,626 1,354 272
73 68 5
26 22 4
1,440 1,171 269
2,061 1,322 739
2,132 1,756 376
2,262 2,030 232
2,087 1,708 379
2,078 1,708 370
728 677 51
1,500 1,255 245
3,846 3,384 462
492 438 54
1,970 1,555 415
115 230 -115
16 35 -19
13,822 12,035 1,787
17,421 14,116 3,305
13,499 14,963 -1,464
14,837 13,945 892
47,470 47,158 312
1,906 1,435 471
4,527 4,201 326
2,754 2,211 543
3,078 2,000 1,078
1,292 564 728
2,388 3,699 -1,311
2,376 3,699 -1,323
4,630 4,040 590
5,894 2,955 2,939
1,882 1,375 507
1,805 1,501 304
1,700 1,487 213
791 841 -50
2,252 1,944 308
1,135 693 442
1,249 1,068 181
1,785 1,723 62
3,784 1,692 2,092
2,014 1,540 474
3,062 2,645 417
910 1,002 -92
909 808 101
2,041 1,333 708
965 1,109 -144
1,792 1,517 275
2,082 2,077 5
500 487 13
1,935 1,823 112
1,399 789 610
1,773 1,419 354
3,420 2,126 1,294
1,299 1,227 72
2,159 1,813 346
1,998 1,636 362
3,407 2,540 867
1,859 1,657 202
1,147 800 347
2,728 2,364 364
775 553 222
595 617 -22
2,275 1,898 377
1,929 1,926 3
1,545 1,679 -134
4,148 3,830 318
1,832 1,571 261
1,421 1,239 182
2,337 2,730 -393
3,026 2,343 683
1,927 1,677 250
2,449 2,485 -36
1,945 1,446 499
901 1,018 -117
2,746 2,497 249
2,882 2,141 741
1,713 1,255 458
2,358 2,189 169
3,560 2,212 1,348
2,653 2,019 634
1,958 1,648 310
1,358 1,120 238
1,637 1,483 154
1,700 1,132 568
458 460 -2
730 553 177
3,397 1,998 1,399
10,055
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 107
b 38
c 29
d 346
e 617
82
45
264
53
24
-39
-105
125
95
249
137
-85
-18
204
114
84
62
566
412
349
-1
35
46
438
-7
-38
-20
263
16
59
57
-88
127
48
30
11
154
100
39
-7
76
-470
684
856
-28
35
1,592
576
-1,152
79
272
5
4
269
739
376
232
379
370
51
245
462
54
415
-115
-19
1,787
3,305
-1,464
892
312
471
326
543
1,078
728
-1,311
-1,323
590
2,939
507
304
213
-50
308
442
181
62
2,092
474
417
-92
101
708
-144
275
5
13
112
610
354
1,294
72
346
362
867
202
347
364
222
-22
377
3
-134
318
261
182
-393
683
250
-36
499
-117
249
741
458
169
1,348
634
310
238
154
568
-2
177
1,399
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
Bracket 2 49,871
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 ...................
Bracket 3
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?
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 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))
2013 87,119 965,702 0.090213
2012 39,307 965,304 0.04072
2011 49,988 943,259 0.052995
2010 47,371 930,064 0.050933
2009 42,541 877,247 0.048494
2
Total of line 1, column (d) .....................
20.283355
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
0.056671
4
Enter the net value of noncharitable-use assets for 2014 from Part X, line 5.....
4
973,059
5
Multiply line 4 by line 3......................
5
55,144
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
616
7
Add lines 5 and 6........................
7
55,760
8
Enter qualifying distributions from Part XII, line 4.............
8
48,000
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.
Form 990-PF (2014)
Form 990-PF (2014)
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 Bullet and enter N/A" on line 1. Bracket
Date of ruling or determination letter: (attach copy of letter if necessarysee instructions)
b 1 1,233
hereBulletand 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 0
3 Add lines 1 and 2........................... 3 1,233
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 1,233
6 Credits/Payments:
a 2014 estimated tax payments and 2013 overpayment credited to 2014 6a 1,372
b Exempt foreign organizationstax withheld at source...... 6b
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d
7 Total credits and payments. Add lines 6a through 6d.............. 7 1,372
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 139
11 Enter the amount of line 10 to be: Credited to 2015 estimated taxBullet139 RefundedBullet 11 0
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 $100 during the year (either directly or indirectly) for political purposes (see Instructions
for definition)?.................................
1b
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ (2) On foundation managers.bullet$
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$
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
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 instructions)
    bulletVT
    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
    Yes
    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 2014 or the taxable year beginning in 2014 (see instructions for Part XIV)?
    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
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 5
    Part VII-A
    Statements Regarding Activities (continued)
    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 instructions) .............
    11
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement (see instructions).................
    12
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
    Website addressbullet
    14
    The books are in care ofbulletTD Bank NA Telephone no.bullet (802) 860-5407

    Located atbullet111 MAIN STREETBURLINGTONVT ZIP+4bullet05401
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041.......bullet
    and enter the amount of tax-exempt interest received or accrued during the year ......bullet
    15
    16 At any time during calendar year 2014, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country?
    16 No
    See instructions for exceptions and filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR). If "Yes", enter the name of the foreign country bullet
    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?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?......................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (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)?...............
    (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.).......
    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 instructions)? ........
    1b
    No
    ........bullet
    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 2014?.............
    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 2014, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2014?.............
    If "Yes," list the years bullet20, 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 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.
    bullet20, 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?......................
    b
    If "Yes," did it have excess business holdings in 2014 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 2014.)..................
    3b
    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 2014?
    4b
    No
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 6
    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))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?.............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? (see instructions)................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?.....
    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 instructions)? ......
    5b
    .........bullet
    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?..........
    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?.....................
    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?
    b
    If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
    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 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
    TD Bank NA Trustee
    1
    9,667
    111 Main Street
    Burlington,VT05401
    2 Compensation of five highest-paid employees (other than those included on line 1see 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...................bullet 0
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 7
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    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
    Part IX-B
    Summary of Program-Related Investments (see 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 instructions.
    3
    Total. Add lines 1 through 3.........................bullet
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 8
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    950,406
    b
    Average of monthly cash balances.......................
    1b
    37,471
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    987,877
    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
    0
    3
    Subtract line 2 from line 1d.........................
    3
    987,877
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    14,818
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    973,059
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    48,653
    Part XI
    Distributable Amount
    1
    Minimum investment return from Part X, line 6....................
    1
    48,653
    2a
    Tax on investment income for 2014 from Part VI, line 5......
    2a
    1,233
    b
    Income tax for 2014. (This does not include the tax from Part VI.)...
    2b
    c
    Add lines 2a and 2b............................
    2c
    1,233
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    47,420
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    47,420
    6
    Deduction from distributable amount (see instructions).................
    6
    0
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
    47,420
    Part XII
    Qualifying Distributions (see 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
    48,000
    b
    Program-related investmentstotal from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
    0
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
    0
    b
    Cash distribution test (attach the required schedule) .................
    3b
    0
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    48,000
    5
    Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
    income. Enter 1% of Part I, line 27b (see instructions).................
    5
    0
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    48,000
    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 (2014)
    Form 990-PF (2014)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus
    (b)
    Years prior to 2013
    (c)
    2013
    (d)
    2014
    1 Distributable amount for 2014 from Part XI, line 7 47,420
    2 Undistributed income, if any, as of the end of 2014:
    a Enter amount for 2013 only....... 0
    b Total for prior years:2012, 20, 20 0
    3 Excess distributions carryover, if any, to 2014:
    a From 2009...... 0
    b From 2010...... 0
    c From 2011...... 0
    d From 2012...... 0
    e From 2013...... 518
    fTotal of lines 3a through e........ 518
    4Qualifying distributions for 2014 from Part
    XII, line 4: bullet$ 48,000
    a Applied to 2013, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election requiredsee instructions).....
    0
    c Treated as distributions out of corpus (Election
    requiredsee instructions)........
    0
    d Applied to 2014 distributable amount..... 47,420
    e Remaining amount distributed out of corpus 580
    5 Excess distributions carryover applied to 2014. 0 0
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 1,098
    b Prior years undistributed income. Subtract
    line 4b from line 2b ..........
    0
    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......
    0
    d Subtract line 6c from line 6b. Taxable amount
    see instructions ...........
    0
    e Undistributed income for 2013. Subtract line
    4a from line 2a. Taxable amountsee
    instructions .............
    0
    f Undistributed income for 2014. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2015 ..........
    0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......
    0
    8Excess distributions carryover from 2009 not
    applied on line 5 or line 7 (see instructions) ...
    0
    9Excess distributions carryover to 2015.
    Subtract lines 7 and 8 from line 6a ......
    1,098
    10 Analysis of line 9:
    a Excess from 2010.... 0
    b Excess from 2011.... 0
    c Excess from 2012.... 0
    d Excess from 2013.... 518
    e Excess from 2014.... 580
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 10
    Part XIV
    Private Operating Foundations (see 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 2014, enter the date of the ruling.......bullet
    b Check box to indicate whether the organization is a private operating foundation described in section or
    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) 2014 (b) 2013 (c) 2012 (d) 2011
    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 2/3
    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 instructions.)
    1Information Regarding Foundation Managers:
    aList 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).)
    NONE
    bList 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.
    NONE
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 11
    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)
    aPaid during the year
    BELLOWS FREE ACADEMY
    UNION HIGH SCHOOL DISTRICT #48
    28 CATHERINE STREET
    ST ALBANS,VT05478
    NONE SCHOOL MAINTENANCE OF ATHLETIC 48,000
    Total .................................bullet 3a 48,000
    bApproved for future payment
    Total .................................bullet 3b
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 12
    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 instructions.)
    1Program service revenue: (a)
    Business code
    (b)
    Amount
    (c)
    Exclusion code
    (d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees 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 22,378
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......
    bNot 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 ............
    18 49,871
    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).. 72,249
    13Total. Add line 12, columns (b), (d), and (e)..................
    1372,249
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow
    Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the foundations exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2014)
    Form 990-PF (2014)
    Page 13
    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 501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    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?...........
    b
    If "Yes," complete the following schedule.

    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    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.
    Bullet 2015-07-27 Bullet
    May the IRS discuss this return
    with the preparer shown below
    (see instr.)?
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    Firm's EIN SmallBullet
    Firm's address SmallBullet


    Phone no.
    Form 990-PF (2014)
    Additional Data


    Software ID:
    Software Version:


    Form 990PF - Special Condition Description:
    Special Condition Description