efile Public Visual Render
Submission Date - 2016-05-16
TIN: 55-0754353
Form
990-PF
Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
Do not enter social security numbers on this form as it may be made public.
Information about Form 990-PF and its instructions is at
www.irs.gov/form990pf
.
OMB No. 1545-0052
20
15
Open to Public Inspection
For calendar year 2015, or tax year beginning
01-01-2015
, and ending
12-31-2015
Name of foundation
OAKLAND FOUNDATION INC
Number and street (or P.O. box number if mail is not delivered to street address)
PO BOX 491
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
STOWE
,
VT
05672
A Employer identification number
55-0754353
B
Telephone number (see instructions)
(802) 253-5115
C
If exemption application is pending, check here
G
Check all that apply:
Initial return
Initial return of a former public charity
Final return
Amended return
Address change
Name change
D 1.
Foreign organizations, check here .............
2.
Foreign organizations meeting the 85%
test, check here and attach computation ...
E
If private foundation status was terminated
under section 507(b)(1)(A), 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
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here .......
I
Fair market value of all assets at end
of year
(from Part II, col. (c),
line 16)
$
4,068,288
J
Accounting method:
Cash
Accrual
Other (specify)
(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)
1
Contributions, gifts, grants, etc., received (attach schedule)
2
Check
Sch. B
.............
3
Interest on savings and temporary cash investments
31
31
31
4
Dividends and interest from securities
...
155,339
152,239
155,339
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
97,286
b
Gross sales price for all assets on line 6a
594,035
7
Capital gain net income (from Part IV, line 2)
...
97,286
8
Net short-term capital gain
.........
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
........
252,656
249,556
155,370
13
Compensation of officers, directors, trustees, etc.
27,500
3,000
24,500
14
Other employee salaries and wages
......
1,750
1,750
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
2,600
2,600
c
Other professional fees (attach schedule)
....
16,725
16,725
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
5,081
230
2,033
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
1,752
1,752
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
55,408
19,955
32,635
25
Contributions, gifts, grants paid
.......
173,012
173,012
26
Total expenses and disbursements.
Add lines 24 and 25
228,420
19,955
205,647
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
24,236
b
Net investment income
(if negative, enter -0-)
229,601
c
Adjusted net income
(if negative, enter -0-)
...
155,370
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2015)
Form 990-PF (2015)
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
.............
13,247
10,610
10,610
2
Savings and temporary cash investments
.........
38,276
19,254
19,254
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 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)
50,000
50,000
50,204
b
Investmentscorporate stock (attach schedule)
.......
2,129,195
2,174,874
3,418,765
c
Investmentscorporate bonds (attach schedule)
.......
552,742
552,958
569,455
11
Investmentsland, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investmentsmortgage loans
.............
13
Investmentsother (attach schedule)
..........
14
Land, buildings, and equipment: basis
16,428
Less: accumulated depreciation (attach schedule)
16,428
15
Other assets (describe
)
16
Total assets
(to be completed by all filerssee the
instructions. Also, see page 1, item I)
2,783,460
2,807,696
4,068,288
17
Accounts payable and accrued expenses
..........
1,071
1,071
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)
.........
1,071
1,071
Foundations that follow SFAS 117, check here
and complete lines 24 through 26 and lines 30 and 31.
24
Unrestricted
..................
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
2,782,389
2,806,625
30
Total net assets or fund balances
(see instructions)
.....
2,782,389
2,806,625
31
Total liabilities and net assets/fund balances
(see instructions)
.
2,783,460
2,807,696
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
2,782,389
2
Enter amount from Part I, line 27a
.....................
2
24,236
3
Other increases not included in line 2 (itemize)
3
4
Add lines 1, 2, and 3
..........................
4
2,806,625
5
Decreases not included in line 2 (itemize)
5
6
Total net assets or fund balances at end of year (line 4 minus line 5)Part II, column (b), line 30
.
6
2,806,625
Form
990-PF
(2015)
Form 990-PF (2015)
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
CALAMOS CONVERTIBLE FUND CL1
P
2009-05-27
2015-01-20
b
AT&T INC COMMON
P
2009-06-01
2015-12-15
c
ILLINOIS TOOL WORKS INC COMMON
P
2011-02-25
2015-01-20
d
AT&T INC COMMON
P
2010-10-06
2015-12-15
e
RIDGEWORTH SEIX HIGH YIELD
P
2009-05-27
2015-04-17
AT&T INC COMMON
P
2011-02-25
2015-12-15
ROYCE TOTAL RETURN FUND
P
2009-10-09
2015-04-17
TEMPLETON GLOBAL BOND FUND
P
2013-08-27
2015-04-17
AFLAC INC COMMON
P
2014-06-30
2015-09-30
PFIZER INC COMMON
P
2008-02-11
2015-12-15
PFIZER INC COMMON
P
2011-02-25
2015-12-15
PFIZER INC COMMON
P
2011-11-28
2015-12-15
JOHNSON & JOHNSON COM
P
2000-02-10
2015-12-15
JOHNSON & JOHNSON COM
P
2011-11-28
2015-12-15
ITC HOLDINGS CORP
P
2011-02-25
2015-12-15
ALTRIA GROUP INC COMMON STK
P
2009-06-03
2015-12-15
ALTRIA GROUP INC COMMON
P
2010-10-06
2015-12-15
ALTRIA GROUP INC
P
2011-02-25
2015-12-15
(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
109,962
107,250
2,712
b
2,074
1,514
560
c
99,519
57,047
42,472
d
1,078
914
164
e
105,269
100,004
5,265
1,854
1,534
320
70,192
50,007
20,185
98,646
100,007
-1,361
53,850
57,621
-3,771
3,625
2,479
1,146
4,258
2,477
1,781
2,114
1,238
876
7,516
2,867
4,649
2,505
1,502
1,003
4,980
2,968
2,012
9,507
2,814
6,693
3,971
1,689
2,282
6,519
2,817
3,702
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
2,712
b
560
c
42,472
d
164
e
5,265
320
20,185
-1,361
-3,771
1,146
1,781
876
4,649
1,003
2,012
6,693
2,282
3,702
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
97,286
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
...................
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?
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 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))
2014
202,644
4,292,819
0.047205
2013
196,630
4,142,707
0.047464
2012
179,120
3,906,469
0.045852
2011
179,790
3,811,930
0.047165
2010
153,793
3,524,952
0.043630
2
Total
of line 1, column (d)
.....................
2
0.231316
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
0.046263
4
Enter the net value of noncharitable-use assets for 2015 from Part X, line 5
.....
4
4,094,678
5
Multiply line 4 by line 3
......................
5
189,432
6
Enter 1% of net investment income (1% of Part I, line 27b)
...........
6
2,296
7
Add lines 5 and 6
........................
7
191,728
8
Enter qualifying distributions from Part XII, line 4
.............
8
205,647
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
(2015)
Form 990-PF (2015)
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
2,296
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
2,296
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
2,296
6
Credits/Payments:
a
2015 estimated tax payments and 2014 overpayment credited to 2015
6a
2,400
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
2,400
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
104
11
Enter the amount of line 10 to be:
Credited to 2015 estimated tax
104
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 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
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)
WV
,
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
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 2015 or the taxable year beginning in 2015 (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
(2015)
Form 990-PF (2015)
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 address
N/A
14
The books are in care of
MRS KATHERINE COPPOCK
Telephone no.
(802) 253-4550
Located at
808 BARROWS ROAD
STOWE
VT
ZIP+4
05672
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 2015, did the foundation have an interest in or a signature or other authority over
Yes
No
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
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 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 2015?
.............
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 2015, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2015?
.............
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 instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the 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 2015 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 2015.)
..................
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 2015?
4b
No
Form
990-PF
(2015)
Form 990-PF (2015)
Page
6
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
(Continued)
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 4945(d)(4)(A)? (see 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 instructions)?
......
5b
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
Form
990-PF
(2015)
Form 990-PF (2015)
Page
7
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
KATHERINE L COPPOCK
PRESIDENT
16.00
14,000
0
0
808 BARROWS RD
STOWE
,
VT
05672
JOHN S LUTZ
VICE-PRES
8.00
10,000
0
0
1109 7TH STREET
PARKERSBURG
,
WV
26101
ATHEY LUTZ
SECRETARY
6.00
3,500
0
0
1043 CORTLAND RD
DAVIS
,
WV
26260
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
...................
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
.............
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
N/A
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
Form
990-PF
(2015)
Form 990-PF (2015)
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
4,113,747
b
Average of monthly cash balances
.......................
1b
43,286
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
4,157,033
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation)
.............
1e
2
Acquisition indebtedness applicable to line 1 assets
..................
2
3
Subtract line 2 from line 1d
.........................
3
4,157,033
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
62,355
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
4,094,678
6
Minimum investment return.
Enter 5% of line 5
..................
6
204,734
Part XI
Distributable Amount
(see 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
204,734
2a
Tax on investment income for 2015 from Part VI, line 5
......
2a
2,296
b
Income tax for 2015. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
2,296
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
202,438
4
Recoveries of amounts treated as qualifying distributions
................
4
5
Add lines 3 and 4
............................
5
202,438
6
Deduction from distributable amount (see instructions)
.................
6
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1
...
7
202,438
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
205,647
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
205,647
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
2,296
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
203,351
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
(2015)
Form 990-PF (2015)
Page
9
Part XIII
Undistributed Income
(see instructions)
(a)
Corpus
(b)
Years prior to 2014
(c)
2014
(d)
2015
1
Distributable amount for 2015 from Part XI, line 7
202,438
2
Undistributed income, if any, as of the end of 2015:
a
Enter amount for 2014 only
.......
41,539
b
Total for prior years:
20
,
20
,
20
3
Excess distributions carryover, if any, to 2015:
a
From 2010
......
b
From 2011
......
c
From 2012
......
d
From 2013
......
e
From 2014
......
f
Total
of lines 3a through e
........
4
Qualifying distributions for 2015 from Part
XII, line 4:
$
205,647
a
Applied to 2014, but not more than line 2a
41,539
b
Applied to undistributed income of prior years
(Election requiredsee instructions)
.....
c
Treated as distributions out of corpus (Election
requiredsee instructions)
........
d
Applied to 2015 distributable amount
.....
164,108
e
Remaining amount distributed out of corpus
5
Excess distributions carryover applied to 2015.
(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
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 amount
see instructions
...........
e
Undistributed income for 2014. Subtract line
4a from line 2a. Taxable amountsee
instructions
.............
f
Undistributed income for 2016. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2015
..........
38,330
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)
.......
8
Excess distributions carryover from 2010 not
applied on line 5 or line 7 (see instructions)
...
9
Excess distributions carryover to 2016.
Subtract lines 7 and 8 from line 6a
......
10
Analysis of line 9:
a
Excess from 2011
....
b
Excess from 2012
....
c
Excess from 2013
....
d
Excess from 2014
....
e
Excess from 2015
....
Form
990-PF
(2015)
Form 990-PF (2015)
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 2015, 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)
2015
(b)
2014
(c)
2013
(d)
2012
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.)
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 instructions) to individuals or organizations under
other conditions, complete items 2a, b, c, and d.
a
The name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
KATHERINE COPPOCK
808 BARROWS RD
STOWE
,
VT
05672
(802) 253-4550
b
The form in which applications should be submitted and information and materials they should include:
SEE ATTACHED GUIDELINES
c
Any submission deadlines:
NONE
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
NONE
Form
990-PF
(2015)
Form 990-PF (2015)
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)
a
Paid during the year
ALPINE HERITAGE PRESERVATION
264 EAST AVENUE
THOMAS
,
WV
26292
PC
RESTORE COTTRILL'S OPERA HOUSE
4,000
ALTZHEIMERS ASSOCIATION
300 CORNERSTONE DRIVE
WILLISTON
,
VT
05495
PC
SUPPORT WALK TO END ALTZHEIMERS
1,000
ARTS BUS PROJECT
67 MAIN STREET
RANDOLPH
,
VT
05060
PC
EXPLORING THE ARTS PROGRAM
2,500
ARTSBRIDGE
935 MARKET STREET
PARKERSBURG
,
WV
26101
PC
ARTS FESTIVAL FOR DISABLED STUDENTS
2,000
AURORA PROJECT
PO BOX 14
AURORA
,
WV
26705
PC
SUPPORT BARN DANCE FUND RAISER
770
BLACKWATER MINISTERIAL ASSOCIATION
737 WILLIAM AVENUE
DAVIS
,
WV
26260
PC
SUPPORT FOOD BANK
5,000
BOYS AND GIRLS CLUB OF BURLINGTON
52 OAK STREET
BURLINGTON
,
VT
05401
PC
UPGRADE OR REPLACE COMPUTER TECHNOLO
4,500
CHALLENGED ATHLETES AT TIMBERLINE
8203 FLAG RUN
DAVIS
,
WV
26260
PC
PURCHASE ADAPTIVE SKI EQUIPMENT
6,000
CHILDREN'S LITERACY FOUNDATION
1536 LOOMIS HILL ROAD
WATERBURY CENTER
,
VT
05677
PC
COBLEIGH PUBLIC LIBRARY AT-RISK CHIL
3,000
CIRCUS SMIRKUS
1 CIRCUS ROAD
GREENSBORO
,
VT
05841
PC
CENTER RING SHOWCASE OF FEM LEADERSH
1,000
COLONY HISTORICAL THEATRE ASSOCIATI
222 PUTNAM STREET
MARIETTA
,
OH
45750
PC
PURCHASE ACOUSTICAL CEILING PANELS
2,500
COMMUNITY HEALTH CENTER OF BURLINGT
179 PEARL STREET
BURLINGTON
,
VT
05401
PC
PURCHASE ELECTROCARDIOGRAM
2,500
CRAFTSBURY PUBLIC LIBRARY
12 CHURCH LANE
CRAFTSBURY COMMON
,
VT
05827
PC
CREDENZA FOR OFFICE EQUIPMENT
1,590
CROSS VERMONT TRAIL ASSOCIATION
PO BOX 116
MONTPELIER
,
VT
05601
PC
CONSTRUCT 3 TRAIL BRIDGES
2,000
DUKE LEMUR CENTER
3705 ERWIN ROAD
DURHAM
,
NC
27705
PC
GENERAL SUPPORT
1,000
EAST WOOD FIRE DEPARTMENT
PO BOX 6
DAVISVILLE
,
WV
26142
PC
PURCHASE PHILLIPS HEADSTART FRX DEFI
4,194
FLYNN CENTER FOR THE PERFORMING ART
153 MAIN STREET
BURLINGTON
,
VT
05401
PC
DANCE AND LANGUAGE FOR NON-ENGLISH S
2,000
GLOBAL CAMPUS FOUNDATION
43 S MAIN STREET
RANDOLPH
,
VT
05060
PC
PURCHASE TABLETS FOR EDUCATIONAL PRO
3,500
GREEN MOUNTAIN CLUB
4711 WATERBURY-STOWE ROAD
WATERBURY CENTER
,
VT
05677
PC
BRIDGES FOR SHORT TRAIL OUTDOOR EDUC
2,500
GREEN MOUNTAIN PERFORMING ARTS
37 COMMERCIAL DRIVE
WATERBURY
,
VT
05676
PC
EXPAND FARM TO BALLET PARTNERSHIP
2,058
HELEN DAY ART CENTER
90 POND STREET
STOWE
,
VT
05672
PC
SUPPORT MATCHING GRANT
200
HELEN DAY ART CENTER
90 POND STREET
STOWE
,
VT
05672
PC
SUPPORT EMERGING ARTISTS EXHIBIT
1,000
HIGH ROCKS EDUCATIONAL CORPORATION
HIGHWAY COUNTY 64
HILLSBORO
,
WV
24946
PC
SUMMER CAMP HEALTHY LIVING & WELLNES
4,000
HOME SHARE NOW
115 NORTH MAIN STREET
BARRE
,
VT
05641
PC
SUPPORT PRO BONO CONFLICT PROGRAM
3,000
HUNGER FREE VERMONT
38 EASTWOOD DRIVE
SOUTH BURLINGTON
,
VT
05403
PC
INAUGURATE HUNGER COUNCIL
1,000
LAKE CHAMPLAIN MARITIME MUSEUM
4472 BASIN HARBOR ROAD
VERGENNES
,
VT
05491
PC
PURCHASE ROV REMOTELY OPERATED VEHIC
2,500
LAMOILLE FAMILY CENTER
480 CADY FALLS ROAD
MORRISVILLE
,
VT
05661
PC
SUPPORT PARENT EDUCATION PROGRAM
3,500
MAD RIVER PATH ASSOCIATION
4061 MAIN STREET
WAITSFIELD VT
,
VT
05673
PC
CONSTRUCT ALL YEAR RECREATION PATH
1,200
MARSHALL COUNTY HISTORIC SOCIETY
PO BOX 267
MOUNDSVILLE
,
WV
26041
PC
PURCHASE ARCHIVAL SUPPLIES
1,500
MID-OHIO VALLEY MULTI CULTURAL FEST
PO BOX 2050
PARKERSBURG
,
WV
26102
PC
WV MUSIC HALL OF FAME EXHIBIT
1,900
MID-OHIO VALLEY SYMPHONY SOCIETY
PO BOX 5511
VIENNA
,
WV
26105
PC
PROVIDE COST OF CONCERT RENTAL SPACE
3,000
MOUNTAIN LAUREL LEARNING COOPERATIV
PO BOX 26260
DAVIS
,
WV
26260
PC
GENERAL SUPPORT
1,000
NEW HISTORIC THOMAS
PO BOX 116
THOMAS
,
WV
26292
PC
CONSTRUCT ADA MULT- USE TRAIL
4,500
NEW YORK CITY BALLET
20 LINCOLN CENTER PLAZA
NEW YORK
,
NY
10023
PC
GENERAL SUPPORT
1,000
NORTH COUNTRY ANIMAL LEAGUE
3524 LAPORTE ROAD
MORRISVILLE
,
VT
05661
PC
PURCHASE COMPUTERS
1,000
NORTH PARKERSBURG BAPTIST CHURCH
3109 EMERSON AVE
PARKERSBURG
,
WV
26104
PC
MATERNITY SHELTER FOR HOMELESS WOMEN
3,500
OIL AND GAS MUSEUM
119 3RD STREET
PARKERSBURG
,
WV
26101
PC
SUPPORT MATCHING GRANT
5,000
OIL AND GAS MUSEUM
119 3RD STREET
PARKERSBURG
,
WV
26101
PC
HENDERSON HALL HEATING SYSTEM
5,000
PLANNED PARENTHOOD OF NEW ENGLAND
128 LAKESIDE AVE STE 301
BURLINGTON
,
VT
05401
PC
HYDE PARK SLIDING SCALE FEE PROJECT
5,000
RESOURCE
266 PINE STREET
BURLINGTON
,
VT
05401
PC
PROVIDE PURCHASE VOUCHERS FOR LOW IN
3,000
RIVER ARTS
72 PLEASANT STREET
MORRISVILLE
,
VT
05661
PC
SUPPORT SUMMER YOUTH PROGRAM
3,000
RIVER CITIES SYMPHONY ORCHESTRA
PO BOX 477
PARKERSBURG
,
WV
26102
PC
PROMOTE CONCERTS AND MUSIC EDUCATION
3,500
SALVATION ARMY BURLINGTON
64 MAIN STREET
BURLINGTON
,
VT
05401
PC
SUPPORT EMERGENCY NEEDS PROGRAM AND
3,000
SHADER-CROFT SCHOOL
5 PEROTTA PLACE
BURLINGTON
,
VT
05401
PC
SUPPORT SUMMER LEARNING PROGRAM
2,000
SHELBURNE FARMS
1611 HARBOR ROAD
SHELBURNE
,
VT
05482
PC
FORMAL GARDEN RESTORATION PROJECT
5,000
SPECTRUM YOUTH AND FAMILY SERVICES
19 CHURCH STREET
BURLINGTON
,
VT
05401
PC
SUPPORT MULTI-CULTURAL YOUTH PROGRAM
3,000
ST FRANCIS XAVIER CHURCH
532 MARKET STREET
PARKERSBURG
,
WV
26101
PC
GENERAL SUPPORT
5,000
STERN CENTER FOR LANGUAGE & LEARNIN
183 TALCOTT ROAD
WILLISTON
,
VT
05495
PC
UPGRADE COMPUTERS
2,600
STOWE HISTORICAL SOCIETY
PO BOX 730
STOWE
,
VT
05672
PC
SUPPORT STOWE SPEAKS ORAL PROJECT
1,000
STOWE LAND TRUST
699 SOUTH MAIN STREET
STOWE
,
VT
05672
PC
PRESERVE KAISER FARM
5,000
TRUST FOR PUBLIC LAND
3 SHIPMAN PLACE
MONTPELIER
,
VT
05602
PC
DOWSVILLE HEADWATERS CONSERVATION PR
1,000
TUCKER COMMUNITY FOUNDATION
100 EDUCATION LANE
DAVIS
,
WV
26260
PC
CHILDREN'S CLIMBING BOULDER
5,000
TUCKER COUNTY HIGH SCHOOL
RT1 BOX 153
HAMBLETON
,
WV
26269
PC
2015 COLLEGE SCHOLARSHIP
1,500
TUCKER COUNTY VETERANS ASSOCIATION
737 WILLIAM AVENUE
DAVIS
,
WV
26260
PC
ERECT VETERANS MEMORIAL
500
VERMONT ADAPTIVE SKI AND SPORTS
73 ALPINE DRIVE
KILLINGTON
,
VT
05751
PC
PURCHASE STANDUP WATERBOARDS
3,500
VERMONT CENTER OF ECOSTUDIES
PO BOX 420
NORWICH
,
VT
05055
PC
STRATEGIC PLANNING FOR ECOCENTER
3,500
VERMONT COUNCIL ON RURAL DEVELOPMEN
43 STATE STREET
MONTPELIER
,
VT
05601
PC
SUPPORT VERMONT CLIMATE CHANGE ECONO
2,000
VERMONT PBS
204 ETHAN ALLEN AVENUE
COLCHESTER
,
VT
05446
PC
SUPPORT NEW TV AND ONLINE JAZZ SERIE
1,000
VERMONT STUDIO CENTER
80 PEARL STREET
JOHNSON
,
VT
05656
PC
MONTH RESIDENCY FOR WV ARTIST
4,500
VERMONT WORKS FOR WOMEN
32A MALLETTS BAY AVE
WINOOSKI
,
VT
05404
PC
SUPPORT SCHOLARSHIPS FOR ROSIE'S GIR
2,500
VSA VERMONT
20 WEST CANAL STREET
WINOOSKI
,
VT
05404
PC
START WITH THE ARTS EARLY LITERACY
2,500
WEST VIRGINIA BOTANIC GARDEN
1079 TYRONE ROAD
MORGANTOWN
,
WV
26508
PC
LIGHTING FOR NEW EDUCATION CENTER
5,000
WOOD COUNTY HABITAT FOR HUMANITY
615 ELDER STREET
PARKERSBURG
,
WV
26101
PC
MOVE RESTORE TO VIENNA
2,000
Total
.................................
3a
173,012
b
Approved for future payment
Total
.................................
3b
Form
990-PF
(2015)
Form 990-PF (2015)
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.)
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
...........
14
31
4
Dividends and interest from securities
....
14
155,339
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
............
18
97,286
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)
..
252,656
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
252,656
(See worksheet in line 13 instructions 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 foundations exempt purposes (other than by providing funds for such purposes). (See
instructions.)
Form
990-PF
(2015)
Form 990-PF (2015)
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?
...........
Yes
No
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.
2016-05-06
May the IRS discuss this return
with the preparer shown below
(see instr.)?
Yes
No
Signature of officer or trustee
Date
Title
Paid Preparer Use Only
Print/Type preparer's name
MAC LICHTERMAN CPA
Preparer's Signature
Date
2016-05-16
Check if self-
employed
PTIN
P00575378
Firm's name
TENNEY & ASSOCIATES LLC CPA'S
Firm's EIN
31-1624928
Firm's address
1101 ROSEMAR ROAD SUITE B
PARKERSBURG
,
WV
26105
Phone no.
(304) 428-9711
Form
990-PF
(2015)
Additional Data
Software ID:
Software Version:
Form 990PF - Special Condition Description:
Special Condition Description