EFTA01378847.pdf

Form 990-PF (2015) Page 4 Part VI Exdse Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see page 18 of the instructions) la Exempt operating foundations described in section 4940(d)(2), check here ► r and enter "N/A" on line 1 Date of ruling or determination letter (attach copy of letter if necessary—see instructions) b Domestic foundations that meet the section 4940(e) requirements in Part V, check 1 87 here ► rand enter 1% of Part I, Irne 27b 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 87 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- 5 137 6 C redits/Payments a 2015 estimated tax payments and 2014 overpayment credited to 2015 6a b Exempt foreign organizations —tax withheld at source 6b Tax paid with application for extension of time to file (Form 8$68). . . 6c 200 d Backup withholding erroneously withheld 6d Total credits and payments Add lines 6a through 6d 7 200 8 Enter any penalty for underpayment of estimated tax Check here r if Form 22201 attached 8 9 Tax due.l f the total of lines 5 and 8 is more than line 7, enter amount owed ► 9 10 Overpayment.l f line 7 is more than the total of lines 5 and 8, enter the amount overpaid. . . ► 10 113 11 Enter the amount of line 10 to be credited to 2015 estimated tax ► 113 Refunded ► 11 Part VII -A Statements Regarding Activities la 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? la No b Did it spend more than 5100 during the year (either directly or indirectly) for political purposes (see Instructions for definition)? lb No If the answer is "Yes" to la or lb, 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? Sc No d Enter the amount Of 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 desorption o✓ 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 attach a conformed copy of the changes 3 No 4a Did the foundation have unrelated business gross income of 51,000 or more during the year? 4a No b If 'Yes,' has it filed a tax return on Form 990-1for this year? 4b No 5 Was there a liquidation, termination, dissolution, or substantial contraction during the year? 5 No If "Yes," attach the statement required by General Instruction T 6 Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either • By language in the governing instrument, or • By state legislation that effectively amends the governing instrument so that no mandatory directions that conflict with the state law remain in the governing instrument? 6 Yes 7 Did the foundation have at least $5,000 in assets at any time during the yearn, 'Yes/complete Pan II, col (c), and Pan XV 7 Yes 8a Enter the states to which the foundation reports or with which it is registered (see instructions) ►NY 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 49420)(3) or 49420)(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 ea t 10 Yes Foul 990-PF (2015) CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0076112 CONFIDENTIAL SDNY_GM_00222296 EFTA01378847