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Barbara and Barrie Seid Foundation 363342443 2010 077d83fesearchable
Barbara and Barrie Seid Foundation 363342443 2010 077d83fesearchable
I As
G Check
all that
DLN:934912230075511
OMB
or Section
4947(a)(1)
Nonexempt
Charitable
Treated as a Private Foundation
Trust
year
2010,
or tax year
r
r
apply
beginning
r
r
In1t1al return
A mended
Name of foundation
BARBARAAND BARRE SEID FOUNDATION
return
01-01-2010
In1t1al return
Address
, and ending
of a former
public
change
Name
1545-0052
12-31-2010
charity
No
2010
Note. The foundation may be able to use a copy of this return to satisfy state reporting requirements
InternalRevenueService
For calendar
Form990-PF
Department
of the Treasury
Filed Data -
Final
return
change
A Employer identification
number
36-3342443
Number and street (or PO box number 1f mail 1snot delivered to street address)
1111 W 35TH STREET
Room/suite
(773) 869-1111
H Check
type
Section
P"Section
oforgan1zat1on
4947(a)(1)
nonexempt
I Fair market
l:F.Till
;
:r;
~
Ci::
$
,fl
!::
J Accounting
at end
of Revenue
and Expenses
(The
Interest
D1v1dends
Sa
Gross
p- 1fthe
Net rental
income
cash
from sale
of assets
(from
capital
Part IV,
Less
Cost
Gross
profit
of goods
168
526,238
Other
income
12
Total.
Add lines
13
Compensation
14
Other
15
Pension
16a
Legal
Accounting
Other
schedule)
schedule)
1 through
526,406
11
of officers,
directors,
salaries
and wages
plans,
(attach
(attach
employee
fees
sold
or (loss)
11
employee
(attach
trustees,
(attach
professional
fees
Deprec1at1on
-:::::: 20
Occupancy
-:::::: 21
Travel,
(attach
conferences,
,:::;
22
Printing
!::'
23
Other
24
Total operating
schedule).
(attach
',!;!
',!;!
1,550
',!;!
4,125
',!;!
6,260
6,260
6,260
12, 741
6,260
6,260
6,260
6,260
806
schedule)
schedule)
and depletion
and meetings
and publ1cat1ons
expenses
(attach
schedule)
and administrative
A d d I Ines 1 3 through
expenses.
23
paid.
2,040,672
26
2,053,413
27
Subtract
25
526,406
benefits
schedule).
fees
869,304
etc
168
526,238
gain
18
168
526,238
mod 1f1cat1ons
17
:.....
( d) D1sbursements
for charitable
purposes
( cash basis only)
342,898
:.....
.....
,:::;
line 2)
t.-:
!::
not on line 10
...:r
19
Accrual
be on cash basis.)
investments
Interest
from securities.
p
,:::;
i::
foundation
''
'
'
'
or (loss)
Net short-term
>
rents
Income
)(
and temporary
and interest
Li.J
$
P"Cash
on savings
Capital
private
Other (specify)
(Part I, column (d) must
Check ....
foundation
taxable
method
6a
private
Other
10a
,fl
exempt
trust
b
$
Analysis
501(c)(3)
charitable
Contributions,
gifts,
grants
line 26 from
Excess of revenue
Net investment
Adjusted
2,040,672
2,040,672
line 12
over expenses
Reduction
and disbursements
enter
enter
-1,527,007
863,044
-0-)
520, 146
-0-)
Cat
No
11289X
Form
990-PF
(2010)
Form 990-PF
l:F.TilllBalance
Sheets
1
2
Savings
Accounts
Less
and temporary
cash
investments
1,401,833
676,517
676,517
185,000
185,000
185,000
821,455
821,455
1,682,972
1,682,972
receivable,...
allowance
Pledges
Less
Beginning of year
(a) Book Value
Cash-non-interest-bearing.
Page 2
End of year
(b) Book Value
(c) Fair Market Value
(2010)
for doubtful
accounts,...
allowance
Grants
Receivables
for doubtful
accounts,...
receivable
due from officers,
d1squal1f1ed persons
directors,
(attach
trustees,
schedule)
and other
1nstruct1ons).
7
'-""
m
8
'-""
'-""
notes
and loans
Less
allowance
Inventories
-e
schedule),...
accounts,...
S and state
charges
government
obl1gat1ons
Investments-corporate
stock
(attach
schedule)
Investments-corporate
bonds
(attach
schedule).
Investments-land,
buildings,
accumulated
Investments-mortgage
13
Investments-other
14
Land, buildings,
Less
accumulated
15
Other
assets
16
17
Accounts
(attach
(attach
1,280,248
schedule)
bas 1s ,...
deprec1at1on
Also,
(attach
schedule),...
Deferred
20
)
by all filers-see
the
2,867,081
payable
Grants
and accrued
expenses
payable
revenue
,:::; 21
Mortgages
.::i
22
Other
23
Total liabilities
directors,
and other
notes
trustees,
payable
and other
(attach
d1squal1f1ed persons
schedule)
l1ab1l1t1es (describe,...
Foundations
(add lines
that
and complete
follow
17 through
22)
,...
lines 24 through
4' 24
u
Unrestricted
,:::; 25
Temporarily
,:::;
Permanently
restricted
Foundations
that
::::!
u..
:.....
0
,fl
4)
,fl
,fl
ci
restricted
do not follow
and complete
lines 27 through
27
Capital
trust
28
Pa1d-1n or capital
stock,
principal,
surplus,
earnings,
,...p-
or land, bldg,
29
Retained
30
4)
'
,fl
ca 26
!:::
accumulated
income,
funds
and equipment
endowment,
31
Total liabilities
Analysis
Total
of Changes
net assets
with end-of-year
Enter
amount
balances
or other
increases
Other
Add lines
Decreases
Total
2,867,081
1,682,972
2,867,081
1,682,972
funds
(see page 17 of
or fund balances
figure
1,682,972
fflOI
2,867,081
fund
1nstruct1ons).
schedule),...
(describe,...
18
schedule)
loans
and equipment
19
(attach
bas 1s ,...
and equipment
deprec1at1on
12
.3
(attach
1nstruct1ons
4'
for doubtful
Investments-Li
Less
,fl
receivable
9
10a
11
Other
reported
at beg1nn1ng of year-Part
on prior year's
II,
column
agree
return)
1n line 2 (1tem1ze),...
net assets
2,867,081
-1,527,007
342,898
1, 2, and 3
not included
1,682,97
1n line 2 (1tem1ze),...
or fund balances
1,682,97
line 5)-Part
II,
column
(b), line 30
6
Form
990-PF
(2010)
Form 990-PF
(2010)
.:r.........
Page
Capital
2-story
140000
la
(mo,
day, yr)
2009-03-18
2010-12-23
5 875%
2008-10-28
2010-12-23
CO 8 7%
2008-11-18
2010-12-23
2002-12-31
2010-12-31
PWR CO 6 375%
200000
GE CAP CORP
200000
INTL
170565
UNITSPVPTL
PAPER
APPALACHIAN
SEP UNSECURED
A PART
Income
NOTES
e
(e) Gross
sales
(f)
price
Deprec1at1on allowed
(or allowable)
135,800
111,169
24 ,6 31
201,800
146,086
55,714
242,500
150,512
91,988
170,565
170,565
e
Complete
gain 1n column
showing
by the foundation
(i) F M V as of 12/31/69
on 12/31/69
24 ,6 31
55,714
91,988
170,565
Capital
Net short-term
or (net capital
gain or (loss)
as defined
..
rnn
Quahf1cat1on
Under Section
(For optional
use by domestic
private
If section
4940(d)(2)
amount
to the section
342,898
and (6)
Income
income)
(b)
Adjusted qualifying d1stnbut1ons
1222(5)
part blank
1n each column
(a)
subJect
1n sections
4940(e)
foundations
leave this
applies,
loss)
before
making
P-
Yes
No
any entries
(d)
D1stnbut1onratio
(col ( b) d 1v1dedby col (c))
(c)
Net value of nonchantable-use assets
2009
1,691,878
3,510,650
0 481927
2008
1,728,964
5,092,708
0 339498
2007
2,128,874
3,425,110
0 621549
2006
5,029,778
6,370,136
0 789587
2005
3,102,332
6,391,234
0 485404
Average d1stribut1on
the number of years
Multiply
Enter
Add lines
Enter
(d).
assets
for 2010
line 4 by line 3.
1% of net investment
income
(1%
line 4.
2717965
0 543593
2,332,391
1,267,871
5 and 6.
qual1fy1ng d1stribut1ons
line lb,
and complete
that
8,630
1,276,501
2,040,67
part using
a 1% tax rate
Form
See
990-PF
(2010)
Form 990-PF
(2010)
Page
:r.,..,.,,. Excise
la
Income
(Section
or determ1nat1on
4940(a),
letter
(attach
4940(b),
4940(e),
or 4948
copy of letter
if necessary-see
Domestic
All other domestic foundations enter 2% of line 27b Exempt foreign organizations enter 4% of Part I, line 12, col (b)
here,...
foundations
p-and
that
enter
Add lines
Credits/Payments
estimated
tax payments
foreign
and 2009
organ1zat1ons-tax
w1thhold1ng
Total
credits
Enter
any penalty
for extension
erroneously
and payments
credited
of estimated
or intervene
Did 1t spend
tax
Check
of lines
or d1stnbuted
D 1d the foundation
attempt
during
amount
by the foundation
on foundation
,... $ ---------
managers
Was there
engaged
descnpt1on
or other
have unrelated
By state
10
Refunded,...
11
state,
or local
leg1slat1on
leg1slat1on
that conflict
4955)
during
not previously
business
required
gross
d1ssolut1on,
during
been reported
to the IRS?
instrument,
income
of $1,000
or more during
instrument,
the foundation
the governing
1n the governing
10
reports
the year?.
contraction
during
No
No
4a
No
as required
as a private
year 2010
No
the year?
4 941
through
instrument
so that
no mandatory
d1rect1ons
instrument?
or with which
T.
1s "Yes"to
cla1m1ng status
No
4b
or substantial
If the answer
for calendar
le
articles
year?.
,..._IL
____________________________________________
Is the foundation
No
or
amends
law remain
1nstruct1ons)
or 4942(J)(5)
lb
(or designate)
No
tax imposed
Sa
to which
la
the year
,... $ _______
reported
that effectively
imposed
managers
on Form990-Tforth1s
1n the governing
No
(see page 19 of
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
General
Yes
or did
3,368
(section
,...
s1m1lar instruments?
a l1qu1dat1on, term1nat1on,
overpaid.
of the act1v1t1es.
8
9
the amount
or 1nd1rectly)
(2) 0 n foundation
If"Yes,"has
1s attached
year?.
of 1ncorporat1on,
2220
3,368
descnpt1on
in connection
for this
,... $
4a
owed
any national,
directly
p- 1f Form
here
5 and 8, enter
to influence
11,999
for def1n1t1on)?
6,300
Activities
6c
the 1nstruct1ons
8,630
5,699
11
1t part1c1pate
6d
8,630
-0-.
6d.
6b
6a through
Regarding
enter
6a
withheld.
for underpayment
Statements
to 2010
at source
oft1me
Add lines
of lines
overpayment
withheld
Overpayment.
During
10
Part VII-A
8,630
income. Subtract
Exempt
la
2010
Backup
1n Part V, check
1 and 2.
requirements
4940(e)
furnished
by General
operating
or the taxable
1t 1s registered
Yes
Yes
Sb
Yes
foundation
to the Attorney
of section
(see 1nstruct1ons
4942(J)(3)
on
Part XIV
Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule /Jstmg their names and addresses
10
Form
990-PF
No
No
(2010)
Part VII-A
11
Statements
Atanyt1m
e during
of section
meaning
Regarding
512(b)(13)?
If"Yes,"
acquire
a direct
13
D 1d the fo undat1on
comply
14
The books
16
STARK
Section
494 7(a)(1)
the amount
At any time
during
calendar
a bank, securities,
or other
trusts
ReqardinQ
During
( 1) Engage
(2) Borrow
money
from,
or accrued
August
and exemption
appl1cat1on?
1n or a signature
(6) Agree
or other
1fthe foundation
agreed
1 If "Yes",
after term1nat1on
If any answer
section
credit
them from)
to (or accept
relying
on a current
engage
Taxes
on failure
operating
If "Yes,"
to incorrect
.... 20 __
3a
If"Yes,"d1d
valuation
answer
20 __
at any time
of the 10-,
if the foundation
4942(a)(2)
,
(does
No
I
I
I
Yes
No
Yes
F
F
F
Yes
No
Yes
No
Yes
No
No
available
"No"
).
assistance
assistance
described
1n Regulations
described
1n la,
not apply
lb
here.
other
for years
than excepted
acts,
the foundation
le
No
2b
No
was a private
or 4942(J)(5))
have any undistributed
income
(lines
6d
2010?.
20 __
to the year's
Yes
No
20 __
1s not applying
the foundation
during
1t have excess
by the Comm1ss1oner
4a
20 __
of assets)
20 __
Yes
undistributed
statement-see
the prov1s1ons
income?
of section
(If applying
4942(a)(2)
section
4942(a)(2)
listed
here
20
hold more than a 2 % d I rect or ind I rect I nte rest In any bus 1nes s
or d1squal1f1ed persons
the lapse
disaster
disaster
4942)
4942(J)(3)
1n 2a forwh1ch
of section
D 1d the foundation
enterprise
listed,
If the prov1s1ons
beg1nn1ng before
.... 20 __
listed
regarding
No
1t from)
Check
w1th1n 90 days
fall to qualify
regarding
(section
1n section
any years
to all years
the first
income
defined
Are there
(relating
before
notice
the
to distribute
foundation
1f term1nat1ng
notice
enter
No
Yes
off1c1al? (Exception.
or 1n a current
over
Mav Be Required
to or to employ
service,
to la(l)-(6),
53 4941(d)-3
O rgan1zat1ons
of government
1s "Yes"
'
,..
applies.
extend
to a government
to make a grant
828-9600
or ind I rectly)
to a d1squal1f1ed person
or property
Yes
15
authority
to pay money
13
16
to, or otherwise
or assets
No
------------
any income
No
12
....60611
. ....
the year.
(4) Pay c ompe ns at1on to, or pay or re I mburs e the ex pens es of, a d 1squa I 1f1ed person?
(5) Transfer
no .... (312)
11
here
a d1squal1f1ed person?.
17, 2008?
Telephone
during
country?
lend money
returns
before
DAVI
have an interest
1n a foreign
(e 1the r d 1rectly
contract
la
insurance
GOLDGEHN
f1nanc1al account
Statements
requirements
received
Part VII
w1th1n the
ARONBERG
interest
year 2010,
entity
ZIP+4
charitable
of tax-exempt
own a controlled
1n any applicable
1nspect1on
and enter
or 1nd1rectly,
schedule
or 1nd1rect interest
Located
nonexempt
directly
attach
12
15
(continued)
Activities
after
holdings
4943(c)(7))
or 2 0-yea r first
charitable
that
as a result
to dispose
phase
holdings
purpose
during
1n 2010
of(l)
under section
15-,
the year?.
business
of holdings
period
acquired
Yes
No
by the foundation
(or longer
period
approved
by gift or bequest,
or (3)
in 2010.).
3b
1n a manner
any purchase
from Jeopardy
its charitable
December
before
the first
31, 1969)
4a
purposes?
No
its
4b
990-PF
No
(2010)
Part VII-B
Sa
During
Statements
(1) Carry
on propaganda,
(2) Influence
a grant
to an organ1zat1on
509(a)(1),
section
If the answer
1s "Yes"
tax because
1t ma1nta1ned
premiums
during
on a personal
notice
5a(4),
expenditure
the year,
benefit
during
(section
(see section
or other
May Be Required
4955),
etc,
I
I
Yes
Yes
p- No
p- No
Yes
p- No
Yes
or to carry
notice
regarding
described
sc1ent1f1c, literary,
or
or animals?.
fall to qualify
regarding
disaster
disaster
assistance
assistance
check
organ1zat1on
to children
claim
exemption
described
pay premiums,
.Jrr-'
Yes
No
Yes
f7
No
53.4945-S(d).
d 1rectly
directly
Sb
from the
or ind I rectly,
to pay
contract?.
the year,
p- No
1n
p- No
Yes
of cruelty
(continued)
4945(e))?
s1m1lar purposes?
4940(d)(2)?
by Regulations
required
4720
drive?.
rel1g1ous, charitable,
or 1n a current
to question
election
on a current
than
5a(1)-(5),
53 4945
relying
leg1slat1on
study,
1s "Yes"to
Regulations
other
purposes,
O rgan1zat1ons
to influence
than a charitable,
If any answer
other
Form
to
reg1strat1on
a grant
educational
any voter
for Which
any amount
or 1nd1rectly,
(4) Provide
(5) Provide
6a
attempt
(3) Provide
1n section
Activities
pay or incur
or otherwise
the outcome
on, directly
Regarding
or 1nd1rectly,
on a personal
benefit
6b
contract?.
No
7a
any proceeds
Information
About
and Contractors
l:ffil9111
1
during
directors,
Officers,
trustees,
and their
Foundation
compensation
Managers,
f7
Yes
No
7b
Highly
Paid Employees,
(c) Compensation
(If not paid, enter
-0-)
and average
per week
to pos1t1on
transaction?
to the transaction?
(d) Contributions
to
employee
benefit plans
and deferred compensation
PRES/TREAS
1 00
SECY
0 10
DIRECTOR
1 00
60609
JOAN FRONTCZAK
1111W35THST
CHICAGO,IL
managers
Trustees,
attributable
60609
BARBARALANDIS-SEID
1111W35THST
CHICAGO,IL
Directors,
foundation
(b) Title,
hours
devoted
a party
60609
Compensation
of five highest-paid
If none, enter "NONE."
employees
(other
(b) Title,
hours
devoted
than
those
and average
per week
to pos1t1on
included
on line 1-see
(c) Compensation
NONE
Total
number
of other
employees
pa 1d over$
5 0 ,0 0 0.
,,..
0
Form
990-PF
(2010)
Form 990-PF
(2010)
I Vi il'I ! I W
3
Five highest-paid
(a) Name
Page
Information
About Officers,
and Contractors
(continued)
independent
and address
of each
contractors
person
Directors,
for professional
Trustees,
Foundation
Managers,
(b) Type
$50,000
of service
(c) Compensation
NONE
Total number
of others
iihilf!#.;I
rece1v1ng
Summary
over $50,000
for professional
of Direct Charitable
....
services.
Activities
List the foundation's four largest direct charitable act1v1t1esduring the tax year Include relevant stat1st1calinformation such as the number of
organizations and other benef1c1ariesserved, conferences convened, research papers produced, etc
Expenses
:.r.,..--==-: Summary
of Program-Related
Investments
investments made by the foundation during the tax year on Imes 1 and 2
A mount
A II other
program-related
investments
1 through
3.
.... I
Form
990-PF
(2010)
Form 990-PF
liifli!i
1
(2010)
Page
Minimum Investment
Return (All domestic foundations
see paqe 24 of the instructions.)
Fair market
value
of assets
1n carrying
etc,
purposes
a
Average
monthly
Average
of monthly
fair market
value
Fair market
value
Reduction
claimed
for blockage
le
detailed
explanation).
(attach
Acqu1s1t1on
Subtract
Cash deemed
of securities.
cash balances.
of all other
la,
assets
or other factors
reported
on lines
I le I
applicable
to line 1 assets.
act1v1t1es
Enter
1 1/2%
ofl1ne
3 (for greater
amount,
see page 25
investment
Subtract
assets.
Enter
return.
5% of line 5.
Tax on investment
income
Income
Recoveries
of amounts
Add lines
Deduction
Distributable
for 2010
I 2a I
I 2b I
line 5.
116,620
8,630
before adJustments
treated
Subtract
8,630
107 ,990
as qual1fy1ng d1stribut1ons.
3 and 4.
from distributable
amount
as adJusted
amount
Subtract
107 ,990
line 1.
107 ,990
Qualifying
A mounts
Distributions
Expenses,
Program-related
contributions,
A mounts
gifts,
investments-total
paid to acquire
expenses)
etc -total
assets
to accomplish
charitable,
etc,
purposes
la
1n carrying
out charitable,
2,040,67
etc,
2
A mounts
Su1tab1l1ty test
Cash d1stribut1on
Qualifying
Foundations
Adjusted
income
2,040,67
lb
purposes.
3
116,620
2c
Distributable
2,332,391
return
3 5 ,519
Distributable
Amount (see page 25 of the instructions) (Section 4942(J)(3) and (J)(5) private operating
foundations and certain fore1qn orqarnzat1ons check here,...
and do not complete this part.)
M1n1mum investment
l:ffll30
2,367,910
2a
0
2,367,910
la and
984,277
ld
of the 1nstruct1ons).
l:ff.lS:a
1,383,633
lb
le
b, and c).
indebtedness
la
IRS approval
test
(attach
distributions.
Enter
that qualify
proJects
the required
Add lines
that satisfy
the
required).
3a
schedule).
la through
under section
4940(e)
3b
Enter
3b
line 4
qualifying
distributions.
Subtract
(b), 1n subsequent
8,630
2,032,042
years
when calculating
whether
the foundation
Form
qual1f1es for
990-PF
(2010)
Undistributed
Part XIII
Income
Distributable
Undistributed
income,
1fany,
Enter
amount
for 2009
only.
Total
Excess
From 2005.
amount
20
__, __,
(d)
2010
107,990
20
20
--
1f any, to 2010
2, 789, 797
From 2006.
5,033,916
From 2007.
2, 128,874
From 2008.
1,480,856
From 2009.
1,521,632
Total of lines
(c)
2009
carryover,
3a through
(b)
prior to 2009
for 2010
d1stribut1ons
Years
12,955,075
e.
XII, line 4
..... $
2,040,672
a A ppl1ed to 2009,
b A ppl1ed to undistributed
(Election
required-see
line 2a
c Treated as d1stribut1ons
out of corpus (Election
required-see
page 26 of the 1nstruct1ons).
d Applied
to 2010
distributable
distributed
e Rema1n1ng amount
Excess
d1stribut1ons
107,990
amount.
1,932,682
out of corpus
carryover
applied
to 2010
a Corpus
Add lines
of each column as
3f, 4c, and 4e
income
Subtract
line 5
14,887, 757
Subtract
Undistributed
income for 2010
lines 4d and 5 from line 1 This
1n 2011
be distributed
Subtract
amount must
9
10
a
Excess d1stribut1ons
carryover
from 2005 not
applied on line 5 or line 7 (see page 27 of the
1nstruct1ons).
Excess distributions
carryover to 2011.
lines 7 and 8 from line 6a.
Subtract
A nalys1s
2, 789, 797
12,097,960
of line 9
E x c es s from 2 0 0 6
5,033,916
E x c es s from 2 0 0 7
2, 128,874
E x c es s from 2 0 0 8
1,480,856
E x c es s from 2 0 0 9
1,521,632
E x c es s from 2 0 1 0
1,932,682
Form
990-PF
(2010)
Foundations
Part XIV
la
foundation,
b Check
2a
the organ1zat1on
operating
...-~------------------
foundation
described
85%
Q ual1fy1ng d1stribut1ons
made directly
for active conduct of exempt act1v1t1es
line 2d from line 2c
Subtract
In section
4942(J)(3)
or
P ri or 3 ye a rs
(a) 2010
ofl1ne
IS a private
uest1on 9
operating
Tax year
(b) 2009
4942(J)(5)
(e) Total
(c) 2008
(d) 2007
2a.
Complete
3a, b, or c for the
alternative
test relied upon
"Assets"
alternative
test-enter
(1)
Value
(2)
of all assets
"Endowment"
alternative
testenter
of m1n1mum investment
return shown
Part X, line 6 for each year listed.
"Support"
alternative
2/3
1n
test-enter
(1)
(2)
Support from
and 5 or more
organ1zat1ons
section 4942
(3)
Largest amount
from an exempt
(4)
Gross
I :r.Tili
'.t'
1
see
If the foundation
general public
exempt
as provided 1n
(J)(3 )(8)(111).
of support
organ1zat1on
investment
income
Supplementary
Information
(Complete
assets at any time during the year-see
had $5,000
or more in
Information
contributions
received
by the foundation
(See section 507 (d)(2))
NONE
of the foundation
of a partnership
or other
large portion
of the
NONE
Information
Regarding
Contribution,
etc., Programs:
.,_p
Check here
1fthe foundation
only makes contributions
to preselected
charitable
organ1zat1ons and does not accept
unsol1c1ted requests for funds If the foundation
makes gifts, grants, etc (see page 28 of the 1nstruct1ons)
to 1nd1v1duals or organ1zat1ons
under other cond1t1ons, complete
items 2a, b, c, and d
and telephone
appl1cat1ons
number
should
of the person
be submitted
c Any subm1ss1on
deadlines
d Any restrictions
or l1m1tat1ons on awards,
such
to whom appl1cat1ons
and 1nformat1on
as by geographical
should
and materials
areas,
charitable
be addressed
they
should
fields,
include
kinds
of 1nst1tut1ons,
or other
facto rs
Form
990-PF
(2010)
Form 990-PF
Page
11
2,040,67
2,040,67
(2010)
ffii:W Supplementary
3 Grants
Information
(continued)
and Contributions
Paid During the Year or Approved
Rec1p1ent
Paid dunng
(home or business)
If rec1p1ent 1s an 1nd1v1dual,
show any relat1onsh1p to
any foundation
manager
or substantial
contributor
PUBLIC
Purpose of grant or
contribution
A mount
UN RESTRICTED
.....3a
Total.
Total.
Foundation
stat us of
rec1p1ent
Payment
the year
SEE ATTACHED
SCHEDULE
VARIO US
VA RIO US, IL 60609
b Approved
for Future
for future
payment
.....3b
Form
990-PF
(2010)
Part XVI-A
Enter
gross
Analysis
am ounts
1 Program
of Income-Producing
unless
ser vice
otherwise
1nd1cated
Activities
Unrelated
(a)
Business
revenue
business
income
(b)
code
(c)
A mount
(e)
Related or exempt
function income
(See page 28 of
the 1nstruct1ons
)
Exclusion
code
(d)
A mount
a
b
c
d
e
f
g Fees and contracts
2 Members
from government
agencies
526,238
f1na nc ed property.
7 Other1nves
tment
9 Net income
10 Gross
or (loss)
prof1 tor
11 Otherreven
b ___
c ___
d ___
e ___
12 Subtotal
13
income.
342,898
ue
from special
from sales
events
of inventory.
A dd columns
869,304
. 13 __________
Part XVI-B
..
Line No.
3,4,8
Relationshi
of Activities
FOUNDATION
IS A PASSIVE
calculations
to the Aecom
8_6_9~,3_0_4
lishment
of Exem
1s reported 1n column
purposes
(other than
t Pur oses
INVESTOR
Form
990-PF
(2010)
Form 990-PF
(2010)
l:hii!WI
1
13
Page
Information
Regarding Transfers To and Transactions
Noncharitable
Exempt Organizations
and Relationships
With
Did the organization directly or indirectly engage in any of the following with any other organ1zat1ondescribed in section
Yes
No
SOl(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
a Transfers
foundation
to a noncharitable
exempt
organ1zat1on
of
(1)
Cash.
1a(1)
No
(2)
0 ther assets.
1a(2)
No
b Other
transactions
1b(1)
No
1b(2)
No
1b(3)
No
1b(4)
No
lb(S)
No
1b(6)
No
le
No
(1)
Sales
(2)
Purchases
(3)
Rental
(4)
Reimbursement
(5)
Loans
of assets
offac1l1t1es,
exempt
from a noncharitable
equipment,
or other
organ1zat1on.
exempt
organ1zat1on.
assets.
arrangements.
or loan guarantees.
(6) Performance
c Sharing
to a noncharitable
of assets
of services
offac1l1t1es,
or membership
equipment,
or fundra1s1ng
ma1l1ng lists,
other
sol1c1tat1ons.
assets,
or paid employees.
d If the answer to any of the above 1s "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
show 1n column (d) the value of the goods, other assets, or services
received
1n any transaction
or sharing arrangement,
(a) Line No
2a Is the foundation
described
b If"Yes,"
d 1rectly
1n section
complete
or ind I rectly
SOl(c)
the following
than section
501(c)(3))
or 1n section
orga n1zat1ons
i 2011-08-11
******
of officer
or trustee
Date
:::c
c
::r.:,
v.i
schedules
and statements,
and to
(other than taxpayer
or f1duc1ary) 1s
******
Title
Date
-:l)
ii)
'":..-
>,
-fC
.::.:,i::o
i::f:::.
t ,t,
o.:i
P re pa re r' s
Signature
Firm's
name
DAVID
1fself-
employed
HAFFT
~r
2011-08-11
~
address
PTIN
Check
,j)
Firm's
Yes
schedule
Signature
.I
5277.
VILLAGE
LINCOLNSHIRE,
Firm's
EIN~
Phone
no
600693086
(847)
Form
913-8006
990-PF
(2010)
lefile
GRAPHIC
- DO NOT PROCESS
TY 2010 Accounting
EIN:
Filed
DLN:934912230075511
Data -
Fees Schedule
Name:
Category
I As
Amount
Net Investment
Income
1,550
Adjusted Net
Income
Disbursements
Charitable
Purposes
for
lefile
GRAPHIC
I As
- DO NOT PROCESS
TY 2010 Investments
Bonds Schedule
Filed
DLN:934912230075511
Data -
Corporate
Name:
EIN:
Name of Bond
212 sh LDSS, INC
SEP/SUNFLOWER CORP UNSECURED PARTICIPATION NOTES
lefile
I As Filed
DLN:934912230075511
Data -
36-3342443
Amount
DAVIS
REPRESENTATION
Net Investment
Income
611
195
Adjusted Net
Income
Disbursements for
Charitable
Purposes
lefile
I As Filed
DLN:934912230075511
Data -
EIN: 36-3342443
Description
INVESTMENT
FEES
6,260
Net Investment
Income
Adjusted
6,260
Net Income
6,260
Disbursements
for
Charitable
Purposes
lefile
GRAPHIC
- DO NOT PROCESS
I As
Filed
Data -
DLN:934912230075511
Schedule
Name:
EIN: 36-3342443
Description
Amount
342,898
lefile
GRAPHIC
- DO NOT PROCESS
I As
Filed
DLN:934912230075511
Data -
FRANCHISE
FEDERAL
TAX
TAXES
Amount
Net Investment
Income
25
4,100
Adjusted Net
Income
Disbursements
Charitable
Purposes
for
--dcJ(O
201 O contnbut1ons
DATE
ORGANIZATION
LOCATION
.Chicago, lll1no1s
__
Emet Synagogue
8/2/2_010_!l~s_he
5/27/201 O
Avon
Walk
for
Breast
Cancer
[ch_ic~~~-ill1no1s
--9/1/2010 Blessed Sacrament Youth Center
!Chicago, lll1no1s
12/13/201 O Boy Scouts of America
!Chicago, lll1no1s
ICh1cago, lll1no1s
10/19/2010 Catholic Relief Services
12/21/2010, Center for Enriched Living
Riverwood, lll1no1s
1/12/2010.Charnber Opera Chicago
Chicago, Illinois
Chic:;_ago
Academy for the Arts
12/21/2010 __
Chicago, Illinois
12/21/2010 Chicago Child Care Society
___
_t:;hicago,Illinois
12/12/2010 Chicago Clg of the Prfmng A_rt_s(f3sylt) Chicago, lfhno1s
Chicago, Illinois
3/29/2010 Chicago Opera The~\~~
12/21/2010 Chica~o_:5hakespeare Theatre
4/16/2001 _Chicago Symphony Orchestra
12/13/201 O Chinese Fine Arts Society
1/8/2010 Church of the Three Crosses
12/10/2010 CIVICOrchestra of Chicago
5/3/2010 Classical Symphony
11/22/2010 Community Actron Centers ProJect
1/11/2010 Covenant House
12/12/201 O, DePaul University
2/3/2010 Elgin Opera
12/21/2010'.Emergency Fund
12/12/2010 Ensemble Espanol
12/21/2010 Executive Serv~9e Corps
2/15/2010 Fa1rvote
--- - - ------10/1/2010 Illinois Holocaust Museum
12/12/2010, Immaculate Conceptio~ Church
12/13/201 OI Jewish Federation of No America
12/13/2010 Jewish United Fund of Metro Chgo
3/12/201 D I LBRSS
8/18/2010 Light Opera Works
7/9/2010 Lincoln Central Assoc1at1on
12/21/2010 Lincoln Park Zoo
12/21/2010, Lyrrc Opera_ClfChicago
1/8/2010.Mercy Home for Boys & G_1rls
12/21/2010. Metropolitan Opera
12/21/2010, Morehouse College
8/18/201 Northbrook ~ymphony Orchestra
2/19/2010 Old Town Trrangle Assn
12/10/201 O Piano Forte Fdtn
7/2/201 O Salvation Army
6/11/201 O Santa Fe Opera
10/28/201 OI SCT Productions
q_
-.-0--r:-Jl{ _
Ch1caE_~_
Illinois
Chicago, Illinois
,Chicago, lllmo1s
IChicago, lllmo1s
Chicago, Illinois
Chicago, Illinois
Los Angeles, CA
Ch1c.:igo, Illinois
Chicago, lfhno1s
Elgin, lll1no1s
Chicago, Illinois
.Chicago, lll1nms
,Chicago, 111'.no_is
iTakorna Park, MD
1- ---;Skokie, Illinois
lch1cago, lll1no1s
'New York, NY
Chicago, Illinois
Chicago, Illinois
Evanston, llhno1s
Chicago, lllino!~ _
__
<::_~~~ago,
llhno1s
Chicago, lllmo1s
j Chicago, lll1no1s
'New York, NY
Atlanta, GA
Northbrook, IL
_Chicago, lllino1s
Chicago, llhno1s
Chicago, Illinois
Santa Fe, NM
~C~1cago, lll1no1s
Milwaukee, WI
I
JC~(C~~Cl,_
lllinms
Chicago, Illinois
!Chicago_, lll1no1s
New York, NY
Chicago, lllmo1s
Velarde, NM
Elmhurst, IL
Glenn Ellyn, IL
Chicago, Jllmo1s
Chicago, Illinois
AMOUNT
$1,000 00
$500 00
$2,000.00
$5,000.00
$1,000 00
$5,000 00
$780,000 OD
$20,000_00
$7,500 00
$10,000 00
$65,172 10
$50,000_00
$10,000 OD
$1,000 00
$5,000 00
$40,000 00
$5,000 00
$200,000 00
$3,700 00
$5,000.00
$13,000.00
$10,000 00
$1,000 00
$5,000 00
$9,000 00
$10,000.00
$3,000 00
S 100,000 00
$100,000 OD
$500 00
$115,000.00
S1DO00
$10,000_00
$25,000.00
$4,000_00
$10,000_00
$5,000_00
$40,000_00
$500_00
$1,000 00
$10,000 00
$25,000.00
$25,000 00
$28,000 DO
$10,000 00
$2,000 00
$200,000.00
$1,200 DD
$50,000 DO
$2,500 DO
$1,000 DO
$1,000 OD
$2,500.00
$3,500 DO
$2,040,672 1D
FORM~B~eF~
--