Return of Private Foundation. or Section 4947(a)(1) Trust Treated as Private Foundation

Transcription

1 W9HWDO /5/ : PM Form Rturn of Privt Fountion 99-PF or Stion 97()() Trust Trt s Privt Fountion 6 Dprtmnt of th Trsury Do not ntr soil surity numrs on this form s it my m puli. Intrnl Rvnu Srvi Informtion out Form 99-PF n its sprt instrutions is t For lnr yr 6 or tx yr ginning, n ning G Nm of fountion Howr Fmily Fountion, In. /o Slly Thoms Numr n strt (or P.O. ox numr if mil is not livr to strt rss) 65 W. Mrion Av., # City or town, stt or provin, ountry, n ZIP or forign postl o Punt Gor FL 95 Chk ll tht pply: H Chk typ of orgniztion: Stion 5()() xmpt privt fountion Stion 97()() nonxmpt hritl trust Othr txl privt fountion I Fir mrkt vlu of ll ssts t J Aounting mtho: Csh Arul n of yr (from Prt II, ol. (), Othr (spify) lin 6) $ 6,77 (Prt I, olumn () must on sh sis.) Anlysis of Rvnu n Expnss (Th totl of () Rvnu n Rvnu Oprting n Aministrtiv Expnss Prt I Initil rturn Finl rturn Arss hng mounts in olumns (), (), n () my not nssrily qul th mounts in olumn () (s instrutions).) Contriutions, gifts, grnts, t., riv (tth shul). Chk if th fountion is not rquir to tth Sh. B Intrst on svings n tmporry sh invstmnts Divins n intrst from suritis Gross rnts Nt rntl inom or (loss) Nt gin or (loss) from sl of ssts not on lin Gross sls pri for ll ssts on lin 6 Cpitl gin nt inom (from Prt IV, lin ) Nt short-trm pitl gin Inom moifitions Gross sls lss rturns n llowns Lss: Cost of goos sol Gross profit or (loss) (tth shul) Othr inom (tth shul) Totl. A lins through Compnstion of offirs, irtors, trusts, t.... Othr mploy slris n wgs Pnsion plns, mploy nfits Lgl fs (tth shul) Aounting fs (tth shul) Othr profssionl fs (tth shul) Intrst Txs (tth shul) (s instrutions) Dprition (tth shul) n pltion Oupny Trvl, onfrns, n mtings Printing n pulitions Othr xpnss (tt. sh.) Totl oprting n ministrtiv xpnss. A lins through Contriutions, gifts, grnts pi Totl xpnss n isursmnts. A lins n 5 7 Sutrt lin 6 from lin : Exss of rvnu ovr xpnss n isursmnts Nt invstmnt inom (if ngtiv, ntr --)..... Ajust nt inom (if ngtiv, ntr --) For Pprwork Rution At Noti, s instrutions. Room/suit Initil rturn of formr puli hrity Amn rturn Nm hng xpnss pr ooks 5,6 Stmt -,55 Stmt 5 5,9 Stmt,5 Stmt, Stmt 5 5,6,7 7,6 -,76 A B C Employr intifition numr **-*** Tlphon numr (s instrutions) OMB No Opn to Puli Insption If xmption pplition is pning, hk hr.... D. Forign orgniztions, hk hr Forign orgniztions mting th 5% tst, hk hr n tth omputtion.. E If privt fountion sttus ws trmint unr stion 57()()(A), hk hr F If th fountion is in 6-month trmintion unr stion 57()()(B), hk hr () Disursmnts () Nt invstmnt () Ajust nt for hritl inom inom purposs (sh sis only) 5,6 5 5,7,5, 5,6 5,6 5,6 5 5,7,5, 5,6 5,6,7,7

2 W9HWDO /5/ : PM Assts Prt II Howr Fmily Fountion, In. **-***9 Bln Shts Csh non-intrst-ring Svings n tmporry sh invstmnts Aounts rivl Lss: llown for outful ounts Plgs rivl Lss: llown for outful ounts Grnts rivl Rivls u from offirs, irtors, trusts, n othr isqulifi prsons (tth shul) (s instrutions) Othr nots n lons rivl (tt. shul) Lss: llown for outful ounts Invntoris for sl or us Prpi xpnss n frr hrgs Invstmnts U.S. n stt govrnmnt oligtions (tth shul) Invstmnts orport stok (tth shul) Invstmnts orport ons (tth shul) Invstmnts ln, uilings, n quipmnt: sis Bginning of yr En of yr Atth shuls n mounts in th sription olumn shoul for n-of-yr mounts only. (S instrutions.) () Book Vlu () Book Vlu () Fir Mrkt Vlu 6,77,65 Pg,65 Lss: umult prition (tth sh.) Invstmnts mortgg lons Invstmnts othr (tth shul) Ln, uilings, n quipmnt: sis S Sttmnt 6 76,7 9,5 7,5 Liilitis Nt Assts or Fun Blns 5 6 Othr ssts (sri Totl ssts (to omplt y ll filrs s th ) instrutions. Also, s pg, itm l) Aounts pyl n ru xpnss Grnts pyl Dfrr rvnu Lons from offirs, irtors, trusts, n othr isqulifi prsons..... Mortggs n othr nots pyl (tth shul) Othr liilitis (sri ) Totl liilitis ( lins 7 through ) Fountions tht follow SFAS 7, hk hr n omplt lins through 6 n lins n Prt III Lss: umult prition (tth sh.) Unrstrit Tmporrily rstrit Prmnntly rstrit Fountions tht o not follow SFAS 7, hk hr n omplt lins 7 through. Cpitl stok, trust prinipl, or urrnt funs Pi-in or pitl surplus, or ln, lg., n quipmnt fun Rtin rnings, umult inom, nowmnt, or othr funs Totl nt ssts or fun lns (s instrutions) Totl liilitis n nt ssts/fun lns (s instrutions) Anlysis of Chngs in Nt Assts or Fun Blns,6 Totl nt ssts or fun lns t ginning of yr Prt II, olumn (), lin (must gr with n-of-yr figur rport on prior yr's rturn) Entr mount from Prt I, lin 7 Othr inrss not inlu in lin (itmiz) A lins,, n Drss not inlu in lin (itmiz) Totl nt ssts or fun lns t n of yr (lin minus lin 5) Prt II, olumn (), lin ,6,6,6 9,69 9,69 9,69 9,69 6,77,6 -,76 9,7 S Sttmnt 7,5 9,69

3 W9HWDO /5/ : PM Prt IV Cpitl Gins n Losss for Tx on Invstmnt Inom Morgn Stnly () Gross sls pri (i) F.M.V. s of //69 () Bs prio yrs Clnr yr (or tx yr ginning in) () List n sri th kin(s) of proprty sol (.g., rl stt, -story rik wrhous; or ommon stok, shs. MLC Co.) () How quir P Purhs D Dontion () Dt quir (mo., y, yr.) (f) Dprition llow (g) Cost or othr sis (h) Gin or (loss) (or llowl) plus xpns of sl () plus (f) minus (g) Complt only for ssts showing gin in olumn (h) n own y th fountion on //69 () Dt sol (mo., y, yr.) (l) Gins (Col. (h) gin minus (j) Ajust sis (k) Exss of ol. (i) ol. (k), ut not lss thn --) or s of //69 ovr ol. (j), if ny Losss (from ol. (h)) Cpitl gin nt inom or (nt pitl loss) If gin, lso ntr in Prt I, lin 7 If (loss), ntr -- in Prt I, lin 7 Nt short-trm pitl gin or (loss) s fin in stions (5) n (6): If gin, lso ntr in Prt I, lin, olumn () (s instrutions). If (loss), ntr -- in Prt I, lin Prt V Qulifition Unr Stion 9() for Ru Tx on Nt Invstmnt Inom (For optionl us y omsti privt fountions sujt to th stion 9() tx on nt invstmnt inom.) If stion 9()() pplis, lv this prt lnk. Ws th fountion lil for th stion 9 tx on th istriutl mount of ny yr in th s prio? Ys No If Ys, th fountion os not qulify unr stion 9(). Do not omplt this prt. Entr th pproprit mount in h olumn for h yr; s th instrutions for mking ny ntris. 5 Howr Fmily Fountion, In. **-***9 () Ajust qulifying istriutions () Nt vlu of nonhritl-us ssts Totl of lin, olumn ()... Avrg istriution rtio for th 5-yr s prio ivi th totl on lin y 5, or y th numr of yrs th fountion hs n in xistn if lss thn 5 yrs Entr th nt vlu of nonhritl-us ssts for 6 from Prt, lin Multiply lin y lin Entr % of nt invstmnt inom (% of Prt I, lin 7) A lins 5 n Entr qulifying istriutions from Prt II, lin If lin is qul to or grtr thn lin 7, hk th ox in Prt VI, lin, n omplt tht prt using % tx rt. S th Prt VI instrutions. () Distriution rtio (ol. () ivi y ol. ()) Pg, 95,9.6 9, 9,6.,5 56,7.99,7, ,7 9, ,75,99,99,7

4 W9HWDO /5/ : PM Exis Tx Bs on Invstmnt Inom (Stion 9(), 9(), 9(), or 9 s instrutions) Exmpt oprting fountions sri in stion 9()(), hk hr n ntr on lin. Dt of ruling or trmintion lttr: (tth opy of lttr if nssry s instrutions) Domsti fountions tht mt th stion 9() rquirmnts in Prt V, hk hr n ntr % of Prt I, lin All othr omsti fountions ntr % of lin 7. Exmpt forign orgniztions ntr % of Prt I, lin, ol. (). Tx unr stion 5 (omsti stion 97()() trusts n txl fountions only. Othrs ntr --) A lins n Sutitl A (inom) tx (omsti stion 97()() trusts n txl fountions only. Othrs ntr --) Tx s on invstmnt inom. Sutrt lin from lin. If zro or lss, ntr Crits/Pymnts: 6 stimt tx pymnts n 5 ovrpymnt rit to Exmpt forign orgniztions tx withhl t sour Tx pi with pplition for xtnsion of tim to fil (Form 6) Bkup withholing rronously withhl Totl rits n pymnts. A lins 6 through Entr ny pnlty for unrpymnt of stimt tx. Chk hr if Form is tth Tx u. If th totl of lins 5 n is mor thn lin 7, ntr mount ow Ovrpymnt. If lin 7 is mor thn th totl of lins 5 n, ntr th mount ovrpi Entr th mount of lin to : Crit to 7 stimt tx Rfun During th tx yr, i th fountion ttmpt to influn ny ntionl, stt, or lol lgisltion or i it Ys No prtiipt or intrvn in ny politil mpign? Di it spn mor thn $ uring th yr (ithr irtly or inirtly) for politil purposs (s Instrutions for th finition)? If th nswr is Ys to or, tth til sription of th tivitis n opis of ny mtrils pulish or istriut y th fountion in onntion with th tivitis. Di th fountion fil Form -POL for this yr? Entr th mount (if ny) of tx on politil xpniturs (stion 955) impos uring th yr: () On th fountion. $ () On fountion mngrs. $ Entr th rimursmnt (if ny) pi y th fountion uring th yr for politil xpnitur tx impos on fountion mngrs. $ Hs th fountion ngg in ny tivitis tht hv not prviously n rport to th IRS? If Ys, tth til sription of th tivitis. Hs th fountion m ny hngs, not prviously rport to th IRS, in its govrning instrumnt, rtils of inorportion, or ylws, or othr similr instrumnts? If Ys, tth onform opy of th hngs Di th fountion hv unrlt usinss gross inom of $, or mor uring th yr? If Ys, hs it fil tx rturn on Form 99-T for this yr? Ws thr liquition, trmintion, issolution, or sustntil ontrtion uring th yr? If Ys, tth th sttmnt rquir y Gnrl Instrution T. 6 Ar th rquirmnts of stion 5() (rlting to stions 9 through 95) stisfi ithr: By lngug in th govrning instrumnt, or By stt lgisltion tht fftivly mns th govrning instrumnt so tht no mntory irtions tht onflit with th stt lw rmin in th govrning instrumnt? Di th fountion hv t lst $5, in ssts t ny tim uring th yr? If Ys, omplt Prt II, ol. (), n Prt V. 7 Entr th stts to whih th fountion rports or with whih it is rgistr (s instrutions) 9 Prt VI Prt VII-A Howr Fmily Fountion, In. **-***9 Sttmnts Rgring Ativitis NY If th nswr is Ys to lin 7, hs th fountion furnish opy of Form 99-PF to th Attorny Gnrl (or signt) of h stt s rquir y Gnrl Instrution G? If No, tth xplntion Is th fountion liming sttus s privt oprting fountion within th mning of stion 9(j)() or 9(j)(5) for lnr yr 6 or th txl yr ginning in 6 (s instrutions for Prt IV)? If Ys, omplt Prt IV Di ny prsons om sustntil ontriutors uring th tx yr? If Ys, tth shul listing thir nms n rsss Pg 7

5 W9HWDO /5/ : PM Prt VII-A Howr Fmily Fountion, In. **-***9 Sttmnts Rgring Ativitis (ontinu) Pg 5 Ys No At ny tim uring th yr, i th fountion, irtly or inirtly, own ontroll ntity within th mning of stion 5()()? If Ys, tth shul (s instrutions) Di th fountion mk istriution to onor vis fun ovr whih th fountion or isqulifi prson h visory privilgs? If Ys, tth sttmnt (s instrutions) Di th fountion omply with th puli insption rquirmnts for its nnul rturns n xmption pplition? Wsit rss. Th ooks r in r of.. Slly C Thoms Tlphon no W. Mrion Av. # Lot t Punt Gor FL ZIP Stion 97()() nonxmpt hritl trusts filing Form 99-PF in liu of Form Chk hr n ntr th mount of tx-xmpt intrst riv or ru uring th yr At ny tim uring lnr yr 6, i th fountion hv n intrst in or signtur or othr uthority Ys No ovr nk, suritis, or othr finnil ount in forign ountry? S th instrutions for xptions n filing rquirmnts for FinCEN Form. If "Ys," ntr th nm of th forign ountry Prt VII-B Sttmnts Rgring Ativitis for Whih Form 7 My B Rquir Fil Form 7 if ny itm is hk in th Ys olumn, unlss n xption pplis. Ys No During th yr i th fountion (ithr irtly or inirtly): () Engg in th sl or xhng, or lsing of proprty with isqulifi prson? Ys No () Borrow mony from, ln mony to, or othrwis xtn rit to (or pt it from) isqulifi prson? Ys No () Furnish goos, srvis, or filitis to (or pt thm from) isqulifi prson? Ys No () Py ompnstion to, or py or rimurs th xpnss of, isqulifi prson? Ys No (5) Trnsfr ny inom or ssts to isqulifi prson (or mk ny of ithr vill for th nfit or us of isqulifi prson)? Ys No (6) Agr to py mony or proprty to govrnmnt offiil? (Exption. Chk No if th fountion gr to mk grnt to or to mploy th offiil for prio ftr trmintion of govrnmnt srvi, if trminting within 9 ys.) Ys No If ny nswr is Ys to () (6), i ny of th ts fil to qulify unr th xptions sri in Rgultions stion 5.9()- or in urrnt noti rgring isstr ssistn (s instrutions)? Orgniztions rlying on urrnt noti rgring isstr ssistn hk hr Di th fountion ngg in prior yr in ny of th ts sri in, othr thn xpt ts, tht wr not orrt for th first y of th tx yr ginning in 6? Txs on filur to istriut inom (stion 9) (os not pply for yrs th fountion ws privt oprting fountion fin in stion 9(j)() or 9(j)(5)): At th n of tx yr 6, i th fountion hv ny unistriut inom (lins 6 n 6, Prt III) for tx yr(s) ginning for 6? Ys No If Ys, list th yrs.....,.....,.....,..... Ar thr ny yrs list in for whih th fountion is not pplying th provisions of stion 9()() (rlting to inorrt vlution of ssts) to th yr's unistriut inom? (If pplying stion 9()() to ll yrs list, nswr No n tth sttmnt s instrutions.) If th provisions of stion 9()() r ing ppli to ny of th yrs list in, list th yrs hr......,.....,......,..... Di th fountion hol mor thn % irt or inirt intrst in ny usinss ntrpris t ny tim uring th yr? Ys No If Ys, i it hv xss usinss holings in 6 s rsult of () ny purhs y th fountion or isqulifi prsons ftr My 6, 969; () th lps of th 5-yr prio (or longr prio pprov y th Commissionr unr stion 9()(7)) to ispos of holings quir y gift or qust; or () th lps of th -, 5-, or -yr first phs holing prio? (Us Shul C, Form 7, to trmin if th fountion h xss usinss holings in 6.) Di th fountion invst uring th yr ny mount in mnnr tht woul jopriz its hritl purposs? Di th fountion mk ny invstmnt in prior yr (ut ftr Dmr, 969) tht oul jopriz its hritl purpos tht h not n rmov from jopry for th first y of th tx yr ginning in 6?

6 W9HWDO /5/ : PM 5 During th yr i th fountion py or inur ny mount to: () Crry on propgn, or othrwis ttmpt to influn lgisltion (stion 95())? Ys No () Influn th outom of ny spifi puli ltion (s stion 955); or to rry on, irtly or inirtly, ny votr rgistrtion riv? Ys No () Provi grnt to n iniviul for trvl, stuy, or othr similr purposs? Ys No () Provi grnt to n orgniztion othr thn hritl, t., orgniztion sri in stion 95()()(A)? (s instrutions) Ys No (5) Provi for ny purpos othr thn rligious, hritl, sintifi, litrry, or utionl purposs, or for th prvntion of rulty to hilrn or nimls? Ys No If ny nswr is Ys to 5() (5), i ny of th trnstions fil to qulify unr th xptions sri in Rgultions stion 5.95 or in urrnt noti rgring isstr ssistn (s instrutions)? Orgniztions rlying on urrnt noti rgring isstr ssistn hk hr If th nswr is Ys to qustion 5(), os th fountion lim xmption from th tx us it mintin xpnitur rsponsiility for th grnt? Ys No If Ys, tth th sttmnt rquir y Rgultions stion (). 6 Di th fountion, uring th yr, riv ny funs, irtly or inirtly, to py prmiums on prsonl nfit ontrt? Ys No Di th fountion, uring th yr, py prmiums, irtly or inirtly, on prsonl nfit ontrt? If Ys to 6, fil Form 7. 7 At ny tim uring th tx yr, ws th fountion prty to prohiit tx shltr trnstion? Ys No If Ys, i th fountion riv ny pros or hv ny nt inom ttriutl to th trnstion? Prt VII-B Prt VIII Howr Fmily Fountion, In. **-***9 Sttmnts Rgring Ativitis for Whih Form 7 My B Rquir (ontinu) Informtion Aout Offirs, Dirtors, Trusts, Fountion Mngrs, Highly Pi Employs, n Contrtors List ll offirs, irtors, trusts, fountion mngrs n thir ompnstion (s instrutions). () Nm n rss () Titl, n vrg hours pr wk vot to position () Compnstion (If not pi, ntr --) () Contriutions to mploy nfit plns n frr ompnstion Pg 6 () Expns ount, othr llowns Slly C. Thoms Punt Gor Prsint 65 W. Mrion Av. # FL 95. Brknrig M. Thoms Punt Gor Dirtor 65 W. Mrion Av. # FL 95. To L. Thoms Punt Gor Trs/S/Di /o Slly Thoms FL 95. NONE Compnstion of fiv highst-pi mploys (othr thn thos inlu on lin s instrutions). If non, ntr NONE. () Nm n rss of h mploy pi mor thn $5, () Titl, n vrg hours pr wk vot to position () Compnstion () Contriutions to mploy nfit plns n frr ompnstion () Expns ount, othr llowns Totl numr of othr mploys pi ovr $5,

7 W9HWDO /5/ : PM Howr Fmily Fountion, In. **-***9 Prt VIII Informtion Aout Offirs, Dirtors, Trusts, Fountion Mngrs, Highly Pi Employs, n Contrtors (ontinu) Fiv highst-pi inpnnt ontrtors for profssionl srvis (s instrutions). If non, ntr NONE. NONE () Nm n rss of h prson pi mor thn $5, () Typ of srvi () Compnstion Pg Totl numr of othrs riving ovr $5, for profssionl srvis Prt I-A Summry of Dirt Chritl Ativitis List th fountion's four lrgst irt hritl tivitis uring th tx yr. Inlu rlvnt sttistil informtion suh s th numr of orgniztions n othr nfiiris srv, onfrns onvn, rsrh pprs prou, t. Expnss Prt I-B Summry of Progrm-Rlt Invstmnts (s instrutions) Dsri th two lrgst progrm-rlt invstmnts m y th fountion uring th tx yr on lins n. Amount All othr progrm-rlt invstmnts. S instrutions. Totl. A lins through

8 W9HWDO /5/ : PM Prt Minimum Invstmnt Rturn (All omsti fountions must omplt this prt. Forign fountions, s instrutions.) Fir mrkt vlu of ssts not us (or hl for us) irtly in rrying out hritl, t., purposs: Avrg monthly fir mrkt vlu of suritis Avrg of monthly sh lns Fir mrkt vlu of ll othr ssts (s instrutions) Totl ( lins,, n ) Rution lim for lokg or othr ftors rport on lins n (tth til xplntion) Aquisition intnss pplil to lin ssts Sutrt lin from lin.. Csh m hl for hritl tivitis. Entr ½% of lin (for grtr mount, s instrutions) Nt vlu of nonhritl-us ssts. Sutrt lin from lin. Entr hr n on Prt V, lin Minimum invstmnt rturn. Entr 5% of lin Prt I Distriutl Amount (s instrutions) (Stion 9(j)() n (j)(5) privt oprting fountions n rtin forign orgniztions hk hr n o not omplt this prt.) Minimum invstmnt rturn from Prt, lin Tx on invstmnt inom for 6 from Prt VI, lin Inom tx for 6. (This os not inlu th tx from Prt VI.) A lins n Distriutl mount for justmnts. Sutrt lin from lin Rovris of mounts trt s qulifying istriutions A lins n Dution from istriutl mount (s instrutions) Distriutl mount s just. Sutrt lin 6 from lin 5. Entr hr n on Prt III, lin Prt II Howr Fmily Fountion, In. **-***9 Qulifying Distriutions (s instrutions) Pg 9,,5,7,7,77 9,75 5, 5, 5, 5, 5, Amounts pi (inluing ministrtiv xpnss) to omplish hritl, t., purposs: Expnss, ontriutions, gifts, t. totl from Prt I, olumn (), lin Progrm-rlt invstmnts totl from Prt I-B Amounts pi to quir ssts us (or hl for us) irtly in rrying out hritl, t., purposs Amounts st si for spifi hritl projts tht stisfy th: Suitility tst (prior IRS pprovl rquir) Csh istriution tst (tth th rquir shul) Qulifying istriutions. A lins through. Entr hr n on Prt V, lin, n Prt III, lin Fountions tht qulify unr stion 9() for th ru rt of tx on nt invstmnt inom. Entr % of Prt I, lin 7 (s instrutions) Ajust qulifying istriutions. Sutrt lin 5 from lin Not: Th mount on lin 6 will us in Prt V, olumn (), in susqunt yrs whn lulting whthr th fountion qulifis for th stion 9() rution of tx in thos yrs.,7,7,7

9 W9HWDO /5/ : PM Prt III 5 Unistriut Inom (s instrutions) 6 Entr th nt totl of h olumn s init low: 7 f Howr Fmily Fountion, In. **-***9 Distriutl mount for 6 from Prt I, lin Unistriut inom, if ny, s of th n of 6: Entr mount for 5 only Totl for prior yrs:,, Exss istriutions rryovr, if ny, to 6: From From From From From f Totl of lins through Qulifying istriutions for 6 from Prt II,,7 9,5,,5 9, lin : $ Appli to 5, ut not mor thn lin Appli to unistriut inom of prior yrs (Eltion rquir s instrutions) Trt s istriutions out of orpus (Eltion rquir s instrutions) Appli to 6 istriutl mount Rmining mount istriut out of orpus Exss istriutions rryovr ppli to (If n mount pprs in olumn (), th sm mount must shown in olumn ().) Corpus. A lins f,, n. Sutrt lin Prior yrs' unistriut inom. Sutrt lin from lin Entr th mount of prior yrs' unistriut inom for whih noti of fiiny hs n issu, or on whih th stion 9() tx hs n prviously ssss Sutrt lin 6 from lin 6. Txl mount s instrutions Unistriut inom for 5. Sutrt lin from lin. Txl mount s instrutions Unistriut inom for 6. Sutrt lins n 5 from lin. This mount must istriut in Amounts trt s istriutions out of orpus to stisfy rquirmnts impos y stion 7()()(F) or 9(g)() (Eltion my () () () () Corpus Yrs prior to 5 5 6,55 Pg 9 5,,7,7,7 7,77 rquir s instrutions) Exss istriutions rryovr from not ppli on lin 5 or lin 7 (s instrutions) Exss istriutions rryovr to 7. Sutrt lins 7 n from lin Anlysis of lin 9: Exss from Exss from Exss from Exss from Exss from ,,5 9, 5,7,5

10 W9HWDO /5/ : PM Prt IV Privt Oprting Fountions (s instrutions n Prt VII-A, qustion 9) () () () () () () Prt V () Totl Supplmntry Informtion (Complt this prt only if th fountion h $5, or mor in ssts t ny tim uring th yr s instrutions.) Informtion Rgring Fountion Mngrs: List ny mngrs of th fountion who hv ontriut mor thn % of th totl ontriutions riv y th fountion for th los of ny tx yr (ut only if thy hv ontriut mor thn $5,). (S stion 57()().) Informtion Rgring Contriution, Grnt, Gift, Lon, Sholrship, t., Progrms: Chk hr if th fountion only mks ontriutions to prslt hritl orgniztions n os not pt unsoliit rqusts for funs. If th fountion mks gifts, grnts, t. (s instrutions) to iniviuls or orgniztions unr othr onitions, omplt itms,,, n. Th nm, rss, n tlphon numr or -mil rss of th prson to whom pplitions shoul rss: If th fountion hs riv ruling or trmintion lttr tht it is privt oprting fountion, n th ruling is fftiv for 6, ntr th t of th ruling Chk ox to init whthr th fountion is privt oprting fountion sri in stion 9(j)() or 9(j)(5) Entr th lssr of th just nt inom from Prt I or th minimum invstmnt rturn from Prt for h yr list % of lin Qulifying istriutions from Prt II, lin for h yr list Amounts inlu in lin not us irtly Tx yr () 6 () 5 Prior yrs () () for tiv onut of xmpt tivitis.... Qulifying istriutions m irtly for tiv onut of xmpt tivitis. Sutrt lin from lin Complt,, or for th ltrntiv tst rli upon: Assts ltrntiv tst ntr: Vlu of ll ssts Vlu of ssts qulifying unr stion 9(j)()(B)(i) Enowmnt ltrntiv tst ntr / of minimum invstmnt rturn shown in Prt, lin 6 for h yr list... Support ltrntiv tst ntr: Totl support othr thn gross invstmnt inom (intrst, ivins, rnts, pymnts on suritis lons (stion 5()(5)), or royltis) Support from gnrl puli n 5 or mor xmpt orgniztions s provi in stion 9(j)()(B)(iii) Lrgst mount of support from n xmpt orgniztion Gross invstmnt inom List ny mngrs of th fountion who own % or mor of th stok of orportion (or n qully lrg portion of th ownrship of prtnrship or othr ntity) of whih th fountion hs % or grtr intrst. Th form in whih pplitions shoul sumitt n informtion n mtrils thy shoul inlu: Any sumission lins: Howr Fmily Fountion, In. **-***9 Slly Thoms W. Mrion Av., # Punt Gor FL 95 Any rstritions or limittions on wrs, suh s y gogrphil rs, hritl fils, kins of institutions, or othr ftors: Pg

11 W9HWDO /5/ : PM Howr Fmily Fountion, In. **-***9 Prt V Supplmntry Informtion (ontinu) Grnts n Contriutions Pi During th Yr or Approv for Futur Pymnt Ripint Nm n rss (hom or usinss) Pi uring th yr S Sttmnt If ripint is n iniviul, Fountion show ny rltionship to Purpos of grnt or sttus of ny fountion mngr ontriution ripint or sustntil ontriutor Amount Pg,7 Totl Approv for futur pymnt,7 Totl

12 W9HWDO /5/ : PM Howr Fmily Fountion, In. **-***9 Prt VI-A Prt VI-B Anlysis of Inom-Prouing Ativitis Entr gross mounts unlss othrwis init. Progrm srvi rvnu: f g Fs n ontrts from govrnmnt gnis Mmrship us n ssssmnts Intrst on svings n tmporry sh invstmnts Divins n intrst from suritis Nt rntl inom or (loss) from rl stt: Dt-finn proprty Not t-finn proprty Nt rntl inom or (loss) from prsonl proprty Othr invstmnt inom Gin or (loss) from sls of ssts othr thn invntory..... Nt inom or (loss) from spil vnts Gross profit or (loss) from sls of invntory Othr rvnu: Sutotl. A olumns (), (), n () Totl. A lin, olumns (), (), n () (S worksht in lin instrutions to vrify lultions.) Lin No. Unrlt usinss inom Exlu y stion 5, 5, or 5 () () () () Businss o Amount Exlusion Amount o Rltionship of Ativitis to th Aomplishmnt of Exmpt Purposs Explin low how h tivity for whih inom is rport in olumn () of Prt VI-A ontriut importntly to th omplishmnt of th fountion s xmpt purposs (othr thn y proviing funs for suh purposs). (S instrutions.) Pg () Rlt or xmpt funtion inom (S instrutions.) 5,6 5-5,9 5,9

13 W9HWDO /5/ : PM Prt VII Informtion Rgring Trnsfrs To n Trnstions n Rltionships With Nonhritl Exmpt Orgniztions Di th orgniztion irtly or inirtly ngg in ny of th following with ny othr orgniztion sri Ys No in stion 5() of th Co (othr thn stion 5()() orgniztions) or in stion 57, rlting to politil orgniztions? Trnsfrs from th rporting fountion to nonhritl xmpt orgniztion of: () Csh () () Othr ssts () Othr trnstions: () Sls of ssts to nonhritl xmpt orgniztion () () Purhss of ssts from nonhritl xmpt orgniztion () () Rntl of filitis, quipmnt, or othr ssts () () Rimursmnt rrngmnts () (5) Lons or lon gurnts (5) (6) Prformn of srvis or mmrship or funrising soliittions (6) Shring of filitis, quipmnt, miling lists, othr ssts, or pi mploys If th nswr to ny of th ov is Ys, omplt th following shul. Column () shoul lwys show th fir mrkt vlu of th goos, othr ssts, or srvis givn y th rporting fountion. If th fountion riv lss thn fir mrkt vlu in ny trnstion or shring rrngmnt, show in olumn () th vlu of th goos, othr ssts, or srvis riv. Howr Fmily Fountion, In. **-***9 () Lin no. () Amount involv () Nm of nonhritl xmpt orgniztion () Dsription of trnsfrs, trnstions, n shring rrngmnts Pg Is th fountion irtly or inirtly ffilit with, or rlt to, on or mor tx-xmpt orgniztions sri in stion 5() of th Co (othr thn stion 5()()) or in stion 57? Ys No If Ys, omplt th following shul. () Nm of orgniztion () Typ of orgniztion () Dsription of rltionship Sign Hr Unr pnltis of prjury, I lr tht I hv xmin this rturn, inluing ompnying shuls n sttmnts, n to th st of my knowlg n lif, it is tru, orrt, n omplt. Dlrtion of prprr (othr thn txpyr) is s on ll informtion of whih prprr hs ny knowlg. My th IRS isuss this rturn Signtur of offir or trust Dt Titl Prsint with th prprr shown low (s instrutions)? Ys No Pi Prprr Us Only Print/Typ prprr's nm Prprr's signtur Joshu P LPn CPA Joshu P LPn CPA /5/ Firm's nm Firm's rss Dt Chk if slf-mploy S&G LLP PTIN ********* 9 Fortun Blv St Firm's EIN **-***7 Milfor, MA Phon no