Return of Private Foundatio1 or Section 4947(a)(1) Nonexempt Charital Treated as a Private Foundation rom990-PF apr he Ty [efile GRAPHIC print DO NOT PROCESS [As Filed Data — | DLN: 9349122608233] n ble Trust Me No 1545-0052 2012 Open to Public een For calendar year 2012, or tax year beginning 01-01-2012 _, and ending 12-31-2012 Tame of Toondator Ta a GT A RIT G Check all that apply [Tnital return T initial return of a former public charity Final return Tamended return Fraddress change [name change HCheck type of organization’ Section $04(c)(3) exempt private foundation section 4947(2)(1) nonexempt chantable trust_T Other taxable pnvate foundation, TFawrmarket value ofall assets at end | 3Accounting methoa F cash PT Accrual TF epToyer anna haber Telephone manber (a msnocons) ( 2) 223-9000 IFexerptionappieation pening, check here & [= 4. Foren omnaations, check here or 2. Foran nanztons masini 8% sy of year (from Part II, col. (c), T other (specify) _ See earner atraicn oe line 16s 18,030 (are, calurn (4) musi be on cash bass.) See cee Sn een Ie ‘Analysis of Revenue and Expenses (7% | (a) noun ane () Dabararerts Sunnah eavena rarapenese ™ | crecm oe | wingman | eorgant | eee eee Ee i ites 3 |b cross sates pce fra assets on tne 6a ©] a Net short-term capital gain . Fe leat et Se eee eae & ce Leoni tees (eter senecue). | ‘ : & | 38 toro aac std (oe meteor) o a 7 z St pee cia es aa > z & | 22 Printing and publications Z [23 otherexpenses (attach schedule)... . . 1B Toas9 7 3 |24 Total operating and administrative expenses. a Pe ea ae 84,702 ° ° © | 25 contributions, gits, grants paid. . . . - . - | 72,150] 72190 Se = : a ¢ aa eee ees oe totes wee (care ete a) z Engoeniceetngme cea) a reForm 990-PF (2012) Page 2 EDEST) tela snoces Ried etcne ged sneons ne decay an [egg oar Tara a Sa tacentt yeaa ony tee ramitons ) [er bek whe — | Toy Bok aie [far Ra a a 2. Savings andtemporary cash mvestments |. ss ss ss =) 7 3 Accounts recevable > Lees allowance for doubt accounts 4 Pledges recervable Less allowance for doubitul accounts P Soe Receivables due from ofiers directors trustees, and ather dsqulited persons (attach schedule) (seepage 15 ofthe a 7 Other notes and loans recewable(etach schedule) sg| Tess alowonce or dutta accounts 1 ee 3B) 9 Prepaidexpenses and deferedcharges. ss 10a Investments—U S and state government blgstions (attach schedule) bb Investiments—corporate stock (attach schedule) Tm Te Ta € Investments—corporate bonds (atach schedule)... ss. 11 _Investments—Iand,buldings, ane equipment basis Less accumulated depreciation (attach schedule) 12 Investments—mortgage leans vv ee ee 13. Investments—other(attach schedule) | a 7 3 14 Land, buldings, and equipment basis B Less accumulated depreciation (etach scheaule) 15. other assets (describe > 16 Total assets tbe completed by al flers—re8 the instructions Also, see page 1, em) 30.04 wer go10 17 Accounts payable and accrued expensee ss vs a cnn ee waa waar Sis cee B| 20 Loans trom oficers, directors, trustees, and other disqualified persons B|_a1_moroaes and otnernotes payable (attach schedule). S22 other habiities (describe ) 2 Total tablites (244 ines 17 throwgh22). ss ss oraz Foundations that Follow SFAS 147, check here and complete ines 24 though 26 and lines 30 and 31. Sl 24 unvestneted 0,98 -s00 cs mand 2 0 ee G20 Permanentiyrestncted | Foundations that do not follow SEAS 337, check here Pe [- | and complete tines 27 through 33. "| 27 Copel stock, trust pnneipal oreurrent funds... ese 2] 28 Paxen or coptal surplus, orang, bldg, and equpment fund B29 Retained earings, accumulates income, endowment, r ether funds | 30° Totet net assets or fund balances (see page 17 ofthe conn rer 73 -s00 ‘31 Total iablities and nat assete/tund balances (see page 17 of iimctea tee sass wer ‘Analysis of Changes in Net Assets or Fund Balances 7 Total net assets or find balances at beginning ofyear-Parei column (a), ne 30 (must agree vith end-ot-year igure reported on pnoryeareretum) eee ee ee ee LD 707752 2 Cmte ee 172,814 3 Other mcreases not nuded in ne 2 (itemize) 3 @ . ots la 360,566 5 Decreases not ncluded nine 2 itemize) 5 o 6 ___Totanet assets orfund balances at end of year (ine 4 minus ine S)—Pan i, calumn (wine 20__| 6 360,566 Form 990-PF (2012)Form 990-PF (2012) Capital Gains and Losses for Tax on Investment Income Page 3 (2) List and descnbe the kind{s) of property sold (e.g, realestate, Co) How Beauedl (e) Date acquired] (a) Date sole story nck narehouse, oF common stock, 200 #he MLC Co) Prpurchase [me dey. ye) | (me day, ve) Ta Disponiton of Oreomboy, LLC partnership share ? woste20 | Air oro tb Disposition of Mormon Soy OF Brosdway LLC partnership share P 2005-10-27 | 20121215 4 ieee ar (Depreciation stowed | (a) Cost orcther base i) Gan ar osay (orallonabe) lus expense of sie ce) ptus (bmnus @) 17 anor 5,000 75000 ‘Complete only for sasets shovnng gain in column (R) and owned by the foundation on 12/31/69 (Gains (Col (h) gain minus eNvas nine @ Adusted basis (hd Excess of cl (i) col (x), but not less than -0-) or (DE MY as 0f 12/31) 3s of 12/31/69, over col (), any, Losses (from col th) 2 =Tno7a . 5,000 rl Tf gain also enterin Part tine 7 2 Capital gain net ncome or (net capital loss) loss), enter-0-inPariine? F | ee 3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6) 1 gain, also enter in Part, ine 8, column (c) (see instructions) If (loss), enter -0 } inParttjiines fe ‘i : Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income (For optional use by domestic private foundations subject tothe section 4940(e) tax on net investment income ) If section 4940(4)(2) applies, leave this part blank Was the foundation able forthe section 4942 tax on the distnbutable amount of any year i the base period? I ves F No 1f"¥es," the foundation does not qualify under section 4940(e) Do not complete this part 11 Enter the appropriate amount in each column for each year, see page 18 ofthe instructions before making any entries ase pend Jor lens ©) ©, Datne beeemotrearscotnder | paused quativng dstnbunons | Net vate of nontmableuseassts rte Zon 375,070 325385 0 514003 2008 37,542 3,256,150, 0011530, 2008 207,920 3,308,540 0062843) 2 Totalofline t,columm()- 2 ee ee eee L2 0730120 3 Average distnbution ratio forthe S-year base period—divide the total on line 2 By §, oF by the number of years the foundation has been im existence ifiess than 5 years. 3 0.146024 4 Enterthe net value of nonchaniteble-use assets for 2012 ftom Part X line 5. 4 94,359 5S Multiply une 4 by tine 3 ee s azaie 5 Enteri9% of net investment income (1% of Part I,line 276). ss ee LO a 7 Addtines 5 and. z 12,319 8 Enterqualifying distributions fom Part XILjline4. - 2 2 ee es LB 72350 fine 8 1s equal to or greater then line 7, check the box in Pert VI, line 1b, and complete that part using @ ite taxrate See the Part Viimetructions Form 990-PF (2012)Form 990-PF (2012) Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4848—see page 18 of the instructions) Page a Exp opratgfounfatons deed scion 44082), eck ae [= ar ent W/ one 1 ase fing oreetemnaon eter (attach copy of letter f necessary-s0e bb Domestic foundations that meet the section 4940(e) requirements in Part V, check 1 1 Ae Pcincnie Te Matter domed tandotonsetter 2 of te 278 Erempt oe ngpnzatons ete 4% of aL, ne 12, () 22a under secon S11 (mest secon 4547()() tts an taablefounfation only ter en 0-) 2 ° Sst is 1 {4 Siite Awe) tax (dames sen 4479) 5) stand acai oudtns ey Oe ero) 4 @ 5 Tax based on vestment Income, Subtract ine 4 from ine 3 Ifzerooriess,enter-0-. . . . . [5 z 6 Credits/Payments ‘2 2012 estimated tax payments and 2031 overpayment credited to 2012 | 6a bb Exempt foreign organcations-tax withheld atsource .. . . . . Deb € Tex ped with application for extension of me to fle (Form 8868) e Backup mthholdng erroneously withheld... «De 7 Total credits and payments Addlines 68 throughéd. «6 2 ew ee ° 28 Enter any penalty fr underpayment of estimated tax Check here [- Form 2220 is attached 9 Tax due. Ifthe total of lines $ and 81s more than line 7, enter amount owed... z 10° Overpayment. fine 7 s more than the total oflines § and, enter the amount overpaid... ® | 30 11. Enlerthe amount te 1010 be Credited to 2043 ested tx Refunded [an Statements Regarding Activities 18 Dunng the tax year, did the foundation attempt to influence any national, state, or local Tegislaton or id Yes | ne se participate or intervene many political campaign? ia No bb idst spend more than $100 dunng the year (either directy or indirectly) for pokicl purposes (see page 19 of Cia iatrictons ex aintony oh ch a | lan No “te answer ts "es" to Aa oF 1B, attach a detaled description ofthe activites and copes of any materials published ar distributed By the faundation in connection with the activites. € Didthe foundation fle Form 1420-POL 0F8Nis YER"? sv 1 No 4. Enter the amount (fany) of tax on political expenditures (section 4955) imposed during the year (3) On the foundation ® § ©. (2) Onfoundation managers ° Enter the remmbursement (any) pard by the foundation during the year for political expenditure tax mpesed an foundation managers $ ° 2 Has the foundation engaged in any actwtes that have not previously Deen ceportedtotheIRS? 6... 42 No 1 "Yee, tiach a detaled desertion ofthe activites 3 Has the foundation made any changes, not previously reperted tothe 18S, nits governing instrument, articles af incorporation or bylaws, or other similarinstruments? If "Ye,"attach a conformed copy of the changes... | 3 No 44a_bid the foundation have unrelated business gross income of $1,000 or more dunng the year?. .. . ss = | ae No bUVes,rhas a Med atx return on Form 99O-TIOFEN VERT? sw [aw 5 Was there alquidation, termination, disolutin, or substantial contraction dunng the year? 2. . DS Ne 1 Ves, “atach the stavement required by General Instricton T 6 Are:the requirements of section 508(e) (relating to sections 4941 through 4945) satisfies either By lnguage nthe governing mstrument, or ‘© By state legislation that effectively amends the governing mstrument zo that no mandatory directions that confict wth the state lwremainmthe governing instrument? «os ee ee LO [Ye 7 ote funtion have tas 4,00 acts a any te dna the yea? "es compee Pa co (), nd Po 7 [ves ‘Enter the states to which the foundation reports or wth which i registered (eee instructions) moa bb ifthe anawerse "Yea" to ine 7, has the foundation fumished a copy of Form 990-PF tothe Attomey Genera (or designate) of each state as required by General Instruction G? No," atach explanation a» | ves 9 Is the foundation claiming status as 2 private operating foundation thin the meaning of section 4942(X3) 0 4942(XS) for calendar year 2012 or the taxable year beginning in 2012 (see inetructions for Part XIV)? 1"¥ee,“compet Part XIV ee No 1004 any persons become susan contrbits dng he ax yea? I "es" aah acheter ase acess 10 Ne Form 990-PF (2012)2 4 1s 16 Form 990-PF (2012) Page S ‘Statements Regarding Activites (continued) {anytime dang the yee, ed the foundation recy or recy, om a Conaied anne wan he meaning of section s1200YL3) T°Ves, attach schedule (oeemmstuctons vv ee ess se ee [aa] | We Did ne undation make istbuton to donor esses fund over which the foundation ora lsqulnes person had Seon p vines vets tae sane Coen rene Didene ouncaton comply wth he pubic imapectonrequrements forts annunretuma and exempwenappheavon? [ax [Yen website aaress BAVA ‘he books oven coe of PStan liane Tastee Telephone ro ®{503)223-9000 Located at Pits fet enue 620 ond 2iP4a 97202 Secon 4947) nonexemt charable trust fing Form 990-PF in iu of Form 041 —Check here > and enter the amount of tax-exempt interest received or accrued during the year, >» [of At ony te dunn calendar yeor20%2 the foundation have en nterestn or signature or other authonty over a bank secuntes orothe Srancialsecountinaereign coum? vv swvr seers tens + (REDD N See nstractins for exceptions and fing requrements fr Form TOF 90-222 1f*¥es",enterthe name ofthe ereion county Statements Regarding Activities for Which Form 4720 May Be Required ile Form 47201 any item's checked inthe "Yes" alr, nts on exception apple ac During the year did the foundation (ether arecty or nae) (2) enone the sale or exchange, or levsing ot property wh 8 isqaies person? Tyee F no {@) Borrow money rom lend money to, or thermse extend ere to (or aecept rom) ee ee (2) Furman goods, series racist or accept them om) isqaited perzon? ves F no (4) Pay compensation, oF aya remburse the expenses ofa eiquatines person? F Yee no {Gy Trenster any ncome or assets toa squalid person (orm any otter avaiable forthe benet or use ofe equaled person? vee F no (6) ree to pay money or property toa government ofa? (Exception. Check Ne" tthe oundation agreed to make gant to orto employ the ofa fr 2 period ater termination of goverment serie, terminating wth 90s) ves F no Itany answers “Yes"to 10(1 (6) i amy afte ats fi to qeify uncerthe exceptions desenbe n Regulations section 53 4943(@)3 rma curent notice regarding disaster assistance (seepage 20 ofthe nstuctons) = [aw |_| We Did he ouncation engage ma por year many ofthe acts desenbed in 1a other than excepted acs USEtn oee ame enti omceryercominm nos er [a |e line Taxes on flr to estnbute come eecion 4942) (doesnot app fryers the foundation ma 2 private peratingoundeion dened in secuon 49420X3) 0 49420N59) Atte end oftaxyeor 2012, cd the foundation have any undstnbuted income (ines ede, are HiI1)wortax yeorts)begnnmngtetere 20127 eves eet ree eo ¥en Ne iter cbetthe years 20, 20, 20, 20 Are tere ony yeos sted n Ze or wich te foundation nt aplvng the proisions af section 4942 (aK2) (rteung to correct valuation of assets) the Years unastnbutedncome? (i aplyng section 4942(0}2) tual eur ted, aawer Wo" and each statement~see instructors} » Tike provisions of section 4942(02) are being apleg to amy ofthe yers listed in 2, ht the years here eee Did ns oundation hold more thn a2 avec orndectmerestm any business entergnse at owiieca ee Trives, dia ithave excess business holdings n 2012 2s est of) any purchase bythe unaation or dsquaiied persons aRer May 26, 1968, (2) the lose othe 5-year peed (or longer pened approved by the Commissioner under secbon 4943(¢K?))todiapes atholngstequred by gi or bequest or (3) the lapse or the 10-25, or20-yer fst phase heding pened? (Use Snel Farm 4720, to determine (eee ee ee | Didehe wundation vest dunng he year any amount ma mannerthet wuld eoperze ns chancablepuneses? — [an | [Ww Dd the oundation make any investment in pror yer (outer December 31, 1965) that could eoperdze ts hortbie purpose tet had not ben removed om jeopardy before the st coy ofthe tax yeorbegnmingin20:27 [aw |__| We Form 990-PF (2012)Form 990-PF (2012) 6 [PMRWEY statements Regarding Activities for Which Form 4720 May Be Required (continued) ‘Se During the year did the foundation pay or incur any amount to (2) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? T ves F No (2) Influence the outcome of any specific pubic election (see section 4955), orto carry on, directly or indirectly, any voterregistration dnve?. 2. vv ve ee ee we es Pes NO (3) Provide 8 grant to an individual for trevel, study, of other similar purposes? T ves F No (4) Provide a grant to an organization other than a charitable, etc , organization described sn section 509(a)(t, (2), oF (3), or Section 4940(4)(2)? (see instructions)... . . . . » [Yes No (5) Provide for any purpose other then religious, chantable,seientie, literary, or ‘educational purposes, or for the prevention of cruelty to children oranimals?. . . . . . « (Yes F No bb Ifany answer's "Yes" to 5a(1)-(5), did any ofthe transactions fil to qualify under the exceptions described in Regulations section 53 4945 or ma current notice regarding disaster assistance (see instructions)?» 6 + + « Organizations relying on a current notice regarding disaster assistance check here. - . . s 2 7 > E € Ifthe answers "Yes" to question 5a(4), does the foundation claim exemption from the tox because if maintained expenditure responsibility forthe grant”... vs wee es YOR No 1F Yes," atach the statement required by Regulations section 53.4945-5(d). {62 Did the foundation, curing the year, receive any funds, directly or indirectly, to pay premiums on « personal benefit contract? ves F Ne 1b Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? « IF Yes" to 6b, file Form 8870 7a At any time dunng the tax year, was the foundation a party tea prohibited tax shelter transaction? 7 Yes No bb_Ityes, did the foundation receive any oroceeds or have any net income attnbutable to the transaction?” Information About Officers, Directors, Trustees, Foundation Managers, Highly Pal and Contractors I List all officers directors, trustees, Foundation managers and their Compensation (see instructions) 3 oo No » Employees, {By ile, andaversge] —() Compensation] —(@) Conmostons ©] ciosma socom (ay name and cares ous perwosi”” | to planter | employes tenent suns | ()EtPente secount, devoas ta patton 3 and deed Samper an Tease Enron waa00 | c 1800 SW First Avenue Suite 620 ee Sarton JeoTasee Ta09 7 a 1800 SW First Avenue Suite 620 eee portant on 97201 Bond Jeeta q q 3 “425 8th Street 1143, jo. 50 Wartnaton De 20008 2 Compenstion of fv highs gad employes (other than thes ndded on ne Ise stration) none, fer NORE (sana and ates otaach ampoyan | PTH andeverne | | COsnavoabaneht| (a) Exsenen acco paid more than $50,000 7 et plans and deferred ‘other allowances none Test number fiber anployees pol oar S50 A00Ga ner ig ace aren a Form 990-PF (2012)Form 990-PF (2012) Page Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees, EEMEE and contractors (continued) ‘3 Five highest-paid independent contractors for professional services (see instructions). If none, enter “NONE” (@) Name and adaress of each person paid more than $50,000 (b) Type of service (© compensation ‘Total number of others receiving over $50,000 for professional seruces! ‘Summary of Direct Charitable Activities ‘ithe Fontana for Inge area cantabescies dnp Whee year Tae rovant asa] oMTan Aah He The MET 1 Expenses [EEHEEERY Summary of Program-Related Investments (see mstuchons) Descbe the Sue gest pogram-reted vestments made by the foundation dung the tax year on bnes 1 a> mount 1 Aether program-related investments See page 24 of the instructions 3 Total Adgines J through3. ° Form 990-PF (2012)Form 990-PF (2012) Page 8 Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions 7 Fairmarke value of assets rot used (or eld for ure) avec in carving ov chante, ee purposes Average monthly far market value of secuntes is ° b Average ofmonthly cashbaloncess oe ee ee ee Lat S57 € Fairmarkat vale ofall otherasests (see natrictons)- vw ee ee ee [ae 34,072 4 Total (add ines 10,080 eh ee ee ee ee Lae 35,644 © Reduction claimed fr blockoge oratherfetors reported on lines 19 and Le(atach denied explanation. we ee ee es Lael 2 Acquistion ndebtesness applicable to ine 1 assets ° S ieee ashe 4° Cash deemed held for chartable activities Enteri 12% oflie 3 (for greater amount, see instructions) 4 20s 5 Net value of nonchartable-ise assets. Subtract ine & from hne 3 Enter here and on Par V, line 4 5 34.355 6 _Minimuminvestment retum. EniarSti fine... ss... ......... [oe aat8 ae certain foreign organizations check here ® [and do not complete this part.) sutable Amount (see instructions) (Section 49424)(3) and )(5) private operating Foundations and TL Minimum investment return fomParX,line6. 2 2 vrs te ee ete ee LE aie 2a Taxon investment income for 2012 from Part VI,lineS. . . . . «| 2a 1b Income tax for 2012 (This does not include the tox from Part Vi)... [2b © Addlines 20and.20. ee | Re a 3 Distnbutable amount before adjustments Subtractline 2efomlinet. - se ee ee ee ee LS aaa? 4. Recovenes of amounts treated as qualifying distributions. 4 3 S Addiines 32nd4. 0 ve 5 4237 6 Deduction from distributable amount (seeimstructions)- ee ee ee ee LS 3 7 Distributable amount as adjusted Subtract line 6 from line 5 Enter here and on Par XIII, iva ee eae z Qualifying Distributions (see instructions) 4 Amounts pard (including administrative expenses) to accomplish charitable, ete , purposes 8 Expenses, contributions, gifts, ete —total from Part, column (d),lne 26... es ee ee | te 250 1b Program-related investments—total rom PartIX-Be ee ee ee ee ee ee [a 3 2 Amounts paid to acquire assets used (or held for use) directly in carrying out chantable, ete , ue eal 3 Amounts set aside for specific chantable proyects that satisfy the Suitability test (prior 18S approval required). 38 b Cash distribution test (attach the required schedule. © 2 2 ee ee ee Le 4 Qualifying distributions, Add lines 12 through 36 Enter here and on Part V, line 8, and Part XIII, ime # [4 EFETT) '5 Foundations that qualify under section 4840(e) fr the reduced rate of tax on net investment income Enter 1% of Part I, line 27b (see instructions)... ee ee ee ee LB a 6 Adjusted qualifying distributions. Subtractline Sfromline4. 2 2 2 6 7aas [Note: The amount on line 6 wll De used in Part V, column (b),n subsequent years when calculating whether the foundation qualifies for the section 4940(e) reduction of tax in those years Form 990-PF (2012)Form 990-PF (2012) Undistributed Income (see structions) Page 9 Distbutable amount for 202.2 from Pare XI, line 7 Undistnbuted income, ifany, a8 of the end of 2012 Enter amount for 2011 only. . = + + Total for prior years 20__, 20__, 20. @ corpus ) Years prorte 2011 ©), 2011 @ 2012 Excess distributions carryover, any, to 2012 Fram/snng setae 202,50 Fom2008. . 1... ECE From2009. 5 2 1. Feom2011. . 1 1. ss Ta Total of lines 3a throughe. vv se Qualifying distributions for 2012 trom Part XII, ines § 72,150 ‘Applied to 2011, but not more than line 23 [Applied to undistributed income of prior years (Election required—see mstructions). es > Treated a8 distnbutions out of corpus (Election required-seemstructions). wes = Applied to 2012 aistnbutable amount... = Remaining amount distributed out of corpus Excess distributions carryover applied to 2012 (fan amount pears in column (4), the {Same amount must be show in calurin(3).) Enter the net total of each column as indicated below: Corpus Add lines 31,4¢, and 4e Subtract ine 5 Prior years’ undistnbuted income Subtract line 46 fom line 20 Enter the amount of prior years’ undistnbutes tncome for which a notice of deficiency has. been issued, oron which the section 494 2(a) taxhas been previously assessed... ss ‘Subtract line 6¢ from line 6b Taxable amount Undistnbuted income for 2011. Subtract line 43 from line 22, Taxable amount—see instructions se ee et ee Undistnbuted income for 2032 Subtract lines 44-and 5 from line L This amount must bedistnbuted in 20137 vv ve ee ss Amounts treated as distributions out of corpus to satisfy requirements imposed by Section 170(b)(1)(F) or 494 2(g)(3) (see Instructions) see te ee ee Excess distributions carryover from 2007 not applied online 5 or line 7 {see structions). « Excess distributions carryover to 2013. ‘Subtract lines 7 and 8 from line 69 Analysis of line 9 Excess from 2008. 26.54 Excess from 2009. | Excess from 2010. | | Excess from 2011...» Tees Excess from 2012. 1.) 67.05 Form 990-PF (2012)Form 990-PF (2012) Page 10 Private Operating Foundations (see instruchons and Part VIA, queston 9) foundation andthe ruling eectve for 2012, enter the date ofthe rua. ‘Check box to indicate whether the organization 1s a pnvate operating foundation descnbed in section [_4942)(3) or [_49420N5) . 2a Enter the lesser of the adusted net Tax year ror 3 years ‘neame from Part [or the minimum 2) Total en @2012 wit (2010 2008 tnvestment retum from Part X for each year listed. b 85% of ine 23 - . : © Quatiyngatroutons rom Pre, ling 4 for each year listed . 4 Arounts hed ae 2 not wed ety {orscnve conductor exempt acts © Qualiying distnbutions made directly for active conduct of exempt actwities Subtract line 24 from line 26 3. Complete 3a, b, orc for the ‘alternative tect relied upon 8 “Assets” alternative test—enter (2) Value ofall assets (2) Value of assets qualifying under section 4942GK3 XOX) b “Endowment” alternative test— enter 2/3 ‘of minimum investment return shown in Part x, ine 6 for each year listed, © “Support” alternative test—enter (2) Total support other than gross snvestment mcome (interest, ividends, rents, payments fon securities loans (section 512(@5)) or royalties). (2) Support trom general pubic and 5 or more exempt frgametions 8a provided in Section 49420)3)(8 Xie (3) Largest amount of suppor from an exempt organization (4) Gross investment income ‘Supplementary Information (Complete this part only if the organization had $5,000 or more in assets at any time during the year—see instructions.) 1 Taformation Regarding Foundation Managers: ‘2 Listany managers ofthe foundation who have contributed more than 2% ofthe total contributions received by the foundation Before the close of any tax year (but only ifthey have contnbuted more than $5,000) (See section 507 (4}2) } B Lst ony managers ofthe foundation who own 10% or more of he stock of 8 corporation (ar an equally large portion of he ‘ovmership ofa partnership or ather entity) of which the foundation has 2 10% or greater interest 2 —Tnformation Regarding Contribution, Grant, Gift, Loan, Scholars ete, Programs: check here BI ifthe foundation only makes contributions to preselected chantable organizations and does not accept unsolicited requests for funds Ifthe foundation makes giRs, grants, etc (see instructions) to individuals or organizations under other conditions, complete items 2a,b,¢, nd d 2 The name, address, and telephone number or e-mail of the person to whom applications should be addressed Terry Bean 12800 SW First Avenue Suite 620 Portiand,OR 97201 (503) 223-9000 'b The form in which applications should be submitted and information and matenals they should melude © Any submission deadlines None Any restrictions or imitations on awards, such as by geagraphicel areas, chantable feds, kinds of institutions, or other factors ‘See statement & Form 990-PF (2012)Form 990-PF (2012) Page 14 Supplementary Information (continued) 3 Grants and Contributions Paid During the Year or Approved for Future Payment ‘Show any relationship te Purpose of grantor ‘any foundation manager bcs ‘contribution eee: Mame and adress (home ar bueinese) | otoundaton manage’ | fecovent 3 fed durg tre year See Additonal Data Table Total > Taio © Aeroved fears pai Total > a Form 990-PF (2012)Form 990-PF (2012) ‘Analysis of Income-Producing Activities: Page 12 Enter gross amounts unless otherwise indicated Unrelated business income ecu by section 512, 5153, or SLA (e) lated or exempt function meome © © _ 1 Program service revenue pusiness code] Amount | exclusion code | Amount | nay SESsng » ‘ ‘ {9 Fees and contracts from government agencies. 2 Membership dues and assessments. 3 neret on savin and terporary cash nvestrints 105 44 Dividends and interest from secunties. '5 Net rental income or (loss) fom real estate 1 Debt-financed property. b Not debt-hnanced property 6 Net renal mame oF (ss) rm persona propery 7 Other investment income. : {8 cam or (oss fom sles of asets other than ventory Tam {9 Net ncome or (loss) from spacial events 10 Gross profit or (loss) from sales of inventory. 11 Other revenue a b 4 42 Subtotal Add columns (B), (@) ond (e)- 33 Total Ad line 12, columns (b), (4), and (2). (See worksheet in line 13 instructions to venfy calculations Relationship of Acti Line No. | instructions ) Te 562 w [All assets of the foundation are invested pursuant to the (rust agreement under which the Foundation wae cr lo state law Allincome 1s avaiable for the foundation's grant- making activities ‘The foundation's anly activity is grant-making jes to the Accomplishment of Exempt Purposes Explain below how each activity for which income is reported n column (e) of Part XVI-A contributed mportantly fo the accomplishment ofthe foundation's exempt purposes (ether than by providing funds for such purposes) (See ted and pursuant Form 990-PF (2012)Form 990-PF (2012) Page 13 Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations 1 ba the owanaaton dvecty or ndecty ergoge m any ofthe folonig with any ster oganaation desea wn secon Yes | No. 501(€) of the Coe (other than secton 501()(3)organzatons) or m section 527, ela to pola oangations? 2 Transfers from the reporting foundation to @ noncharttable exempt organization af (2) Cash. 1a¢3)| ves (2) Other assets. aca No bb Other transactions (2) Sales of assets to 8 noncharitable exempt organization. + [abc No. (2) Purchases of assets from a nonchantable exempt organization. {a0} No (3) Rental of facilities, equipment, or other assets. 03) No (4) Reimbursement arrangements 264) Ne (5) Loans or loan guarantees. 65) cS (6) Performance of services or membership or fundraising solicitations. 66) No «Sharing of facilites, equipment, mailing lists, other assets, or paid employees. te No 4 Ifthe answer to any of the above 5 "Yes," complete the following schedule Column (b) should alvays show the fair market value ofthe goods, other assets, or services given by the reporting foundation Ifthe foundation received less than fair market value ‘many transaction of sharing arrangement, show in column (d) the value of the goods, other assets, or services received (2) ne No | (6) Amount volved_| () Nome of ronchartable exempt owaneaton |__ (a) Descrgton of tansfers, transactions, and shang srmangements satay 250]Multnomsh County Democratic Party [Donation to Celsi Award Celebration ‘2a Is the foundation directly or indirectly aflated with, or related to, one or more tax-exempt organizations descnbed in section 501(c) ofthe Code (other than section 501 (€)(3}) or in section 527°. Pres Fro bb If"¥es," complete the following schedule te) Name of omsnzaton (1 Type of omeneston (e) descpton of retort ‘Sign | based on allintormation of which preparer has any knowledge Under penalties of penury, | declare that! have examined this return, including accompanying schedules and statements, end to the best of my knowledge and Bele, it's true, correct, and complete Declaration of preparer (other than taxpayer or duciary) 1s Here| is epigine os ae Signature ofoficeror truslee Date Tae PontrType preparers name | Prepare's Signature a a check sete poszie201 empioves >I Paid = Preparet] cimename > FORDMAN GOODFELLOWLLP Fina EIN 95-1208398 Use Only TISSE Second ve [Firms eaaress > ——Husbore, on 971224036 Phone ne (503) 648-6651 Form 990-PF (2012)Form 990PF Part XV Line 3 - Grants and Contributions Paid During the Year or Approved for Future Payment Recipient Tfrecipient san Foundation Purpose of grant or ‘Amount ‘individual, status of ‘contribution Name end address (home or | showanyrelationshipto | recipient Pee) ‘ny foundation manager or substantial contributor ‘= Pad uring the yeor [ACLU Foundation of Oregon PO Box Public chanty | To provide funding to support, 5,500 40585 promote, and defend cist, Portiand, OR 97240 Niberties ‘ids Lifecycle 1035 Market St Publi chanty |To help rise awareness and 100 Suite 400 knowledge about HIV/AIDS SanFranciseo,CA 94103 among participants, donors, and the general public Broadway Carestquity Fights AIDS Publi chanty | To fund essential services for 100 165 West 6th Street 1300 people with AIDS and other Cascade Aids Project 208 SW Fith Publi chanty |To provide funds for research 200 Ave ste 800 and healthcare Portiang OR 972042714 ‘Duck Athletic Fund 2727 Leo Herne Public chanty [To help ofset the expenses of 1,200 Parkway student-athlete scholarships Eugene,OR 97401 Equity Foundation 221 NW 2nd Publi chanty | To fund projects to benefit the 36,350 Avenue Suite 208, LGBT community HRC Foundation 1640 Rhode Island Publi chanty [To fund projects for the 8,750 braw benef ofthe LGBT Washington,DC 200363278 community Lesbian Gay Bisexual & Transgender Publi chanty | To reise nds for HIV/Aids 250 Community Center 208 West 13th related programs and st seriees NewYork NY 10012, Massachusetts General Hospital 55 public chanty | To fund medical research 1,000 Frat Street Boston,MA 02114 Multnomah County Democratic Party 502(eN4) | To provide funding for Celst, 250 Celsi Celebration 3127 NE 67th taxcexempt | Celebration annual award Avenue dinner Portiand, OR 97213 ‘Network for Good 7920 Norfolk Ave Public chanty | To provide funding to faciitate 100 Sue 520, non-profit fundraising Bethesda, MD 20814 ‘Our House of Poriand 2727 SE Publi chanty | To provide funding for 500 Alder st healthcare, housing and other Portiand, OR 97214 services low-income people hnvng with HIV /A105 Pacific NW Hospice Foundation Publi chanty | To provide funding for 2,600 6663 SW Beaverton-Hilledale Huy organization granting last 63 wishes to hospice patients Portiang, OR 97225 Planned Parenthood 3727 NE MLK Public chanty |To provide neeced 750 areive reproductive healthcare Portland, OR 97212 availability ‘San Bernadino Community Service Public chanty [To fund community 500 Center 560 North Arrowhead Avenue assistance programs forthe Ger communityDuring the Year or Approved for Future Payment Form 990PF Part XV Line 3 - Grants and Contributions Pai Recipient Tf recipient ig an individual, | Foundation Purpose of grant oF ‘Amount showany relationship to | status of ‘contribution ome ond edarevs (home orbusmesay| anv foundation manager | recipient eee business) | of eubstantial contributor ‘2 Pad uring the year {UO Foundetion 1720 € 13th Ave Public charity | To help und scholarships for 12,000 Suite 420 LGer students Eugene, OR 974032253 Total > 30 72,150[efile GRAPHIC print DO NOT PROCESS [As Filed Data — | TY 2012 Investments Corporate Stock Schedule Name: Charles M Holmes Foundation EIN: 94-3331085 Name of Stock End of Year Book Value End of Year Fair Market Value Balvo Inc 18,000 18,000[efile GRAPHIC print DO NOT PROCESS [As Filed Data — | TY 2012 Investments - Other Schedule Name: EIN: Charles M Holmes Foundation 94-3331085, Category/ Item Listed at Cost or Book Value End of Year Fair FMV Market Value Dreamboy LLC AT COST 0 Mormon Boy Off Broadway LLC aT COST 0[As Filed Data — J TY 2012 Other Expenses Schedule Name: Charles M Holmes Foundation EIN: 94-3331085 Description Revenue and Expenses] Net Investment | Adjusted Net Income | _ Disbursements for per Books. Income Charitable Purposes Consulting fees 447 ° ° Insurance 1277 ° ° Postage 18 ° ° Bank eee 480 ° 2 ins 467 ° ° Meals & Entertainment 4385 ° ° Dues & subsenptions 125 ° °[efile GRAPHIC print DO NOT PROCESS [As Filed Data — | DLN: 9349122600823: TY 2012 Taxes Schedule Name: Charles M Holmes Foundation EIN: 94-3331085 Category ‘Amount | Net Investment | Adjusted Net [Disbursements for Income Income Charitable Purposes US Treasury 8 ° ° California Franchise Tax Board 75 ° °