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EXTENSION

GRANTED

Return of Private Foundation

OMB No 1545-0052

or Section

4947(a)(1) Nonexempt Charitable Trust


Treated as a Private Foundation
Department of the Treasury
Note. The foundation ma be able to use a co of this return to sat1s state re
Internal Revenue S"""ce
2011 , an d en d"mg
F or ca Ien'd"ar year 2011 or tax year b ecimmnci
'
Name of foundation

Form990-PF

CHARLES KOCB FOUNDATION


Number and street (or P o box number rf mall

~11
'
A Employer idenbfication

48-0918408
Room/suite

1s not delivered to street address)

B Telephone number (see instructions)

(316)

828-8286

BOX 2256
P.O.
City or town, state, and ZIP code
c
WICHITA,

--

Initial return

,....__Final return
H Check type of orgamzat1on
I

~ Section 501(cM

(b},

may not necessanly equal the amounts ,n


column (a) (see mstruct,ons) )

~
<>"=

Contrlbu~onus.
C
k ~
hec

Interest on savings and temporary cash investments

;;::::>Cl)

Net gain or (loss) from sale of assets not on hne 10


Gross sales pnce for all
52,662,668.
assets on hne Sa

Capital gain net income (from Part IV. line 2)

a a::

~:~~

Gross
and al

2,545,112.

13

Compensation

19,384.

..
....

c Other professional fees (attach schedule) .

>

-...

ATCH 1

of officers, directors, trustees, etc

Pension plans, employee benefits

360.
6,100,217.

6,145,668.

1,1

3,495,632.

3,495,632

696,080.

696,

22,393.

;2.
~ 16a Legal fees (attach schedule) J\'.I'~J-i.
>< b Accounting fees (attach scheduleJA:c:8.3.
w
Cl)

g;

. .

Other employee salaries and wages

Cl)

2,545,112.

.,<410Jj,
1 ~ 7012 9
u~

Othe inco1.l\GO!t~1uleUT
Total. Add 1/A

,,,
,,,
15
c:

138,623.

7:

1,681,810.

080

22,393
2,601.

142,697

331,816.

1,365,526

Interest .............

17

!!? 18

92,590.
3,462,155.

less returns

owa ces

11
12
14

c:

(d) Disbursements
for charitable
purposes
leash basis onlvl

(c) AdJusted net


income

C\I

RI

II the loundat1on 1sin a 60-month tem,1nat1on


under section 507(b)(1)(B),check here ~

;:-::B.~
fc~Vf2
[J :
I

c Gros J1d::
fit or (loss) (attach schedule

.;::

D
D

Net rental income or (loss)

.,~.
r

9
1O a

vJJ

If private foundation status was terminated

under sectJon507(b)(1)(A).check here ~

Sa Gross rents . . . . . . . . .

C) c:
Cl)

~o
~o
~o

26,427.
92,590.

Sa
b

7'

L_29
Accrual

(b) Net investment


income

3,462,155.

0
C\l
Cl)
:::=,.::I

LJ Cash

(a) Revenue and


expenses per
books

grants etc received(attach schedule)


1f the foundation 1s not required to
attach Sch B

D1v1dendsand interest from securities

c::l)

c--..,

D Other (specify)---------------------(Part I, column (d) must be on cash basis)

~TI
Analysis of Revenue and Expenses (The
total of amounts
columns
(c). and (d)
,n

method

1 Foreign organizations.check here

..........

Name change

Other taxable private foundation

J Accounting

value of all assets at end

of year (from Part II, col (c), /me


214,087,257.
16) ~ $

2 Foreign organizations meet.mgthe


85% test. check here and attach
computation

exempt private foundation

Section 4947(a)(1) nonexempt charitable trust

Fair market

Initial return of a former public charity


Am ended return

Address change

.. . . . .. .

II exemption apphcat1on1s
pending, check here

KS 67201-2256

G Check all that apply

20

number

Taxes (attach schedule) (see 1nstruc~ons)

*.

136,108.

19

Deprec1at1on(attach schedule) and depletion.

274,429.

20

73.

20,720

Occupancy ..........

870,711.

870,

21
c:
RI 22

Travel, conferences. and meetings .

506,413.

506,733

c: 23

Cl

Other expenses (attach schedule) ~.'l'.C!1. ~

Total operating and administrative expenses.

"O
c(
"O

Printing and publications

.;::

24

QI

c..
0

Add lines 13 through 23

.....
..........

114,779.

114,779

539,330.

539,330

8,476,308.

25
26

Contributions. gifts. grants paid . . . ...

15,990,525.

Total exoenses and disbursements Add Imes 24 and 25

24,466,833.

27

Subtract line 26 from line 12

Excess of revenue over expenses and disbursements

334,490.

7,774,601
13,160,919

334,490.

20,935,520

-18,321,165.
5,765,727.

b Net investment income (1f negative, enter -0-)


c Adiusted net income (1f neoat1ve.enter -0-) .
For Paperwork Reduction Act Notice, see instructions.
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'torm

990-PF (2011)
PAGE

48-0918408
CHARLES KOCH FOUNDATION
Page 2
Attached schedulesand amountsin the
Beginning of year
End of year
descnpt1oncolumn shouldbe tor end-of-year1---''--'-""'-----',<....:.'--'--':..:::...--J---------=....c..::.....:;~=-=-------amounts only (See instruc:tJons)
(a) Book Value
(b) Book Value
(c) Fair Market Value

Form 990-PF (2011)

ilfiii

Balance Sheets

..

Cash -,non-interest-beanng

2
3

Savings and temporary cash investments

1--~~~~7~7~~8~4~2~.+-~~~-6_7_6_:_,_2_5~9--+-~~~~~6~7~6~,~2~5....::...9
_6_5_5--'''--4_6_1_.-+-----8-'-,
_6_5_5--'''--4_6_1

1---1_1_2_;_,_1_3_2-'-,
_1_8_6_-+---8-'-,

Accounts receivable ~ _____ ----------8 7, 889.


Less: allowance for doubtful accounts ~ _____________

Pledges receivable ~ ______

Grants receivable

1-----2_2_3-'-,

Less: allowance for doubtful accounts ~ _____________


6

_5_3_1_.
1-------8_7--'--,

_8_8_9_.-+______

8_7-'-,
8_8_9

------------------

1------------+-----------+---------

Receivables due from officers, directors, trustees. and other


d1squahf1ed persons (attach schedule) (see instructions)

Other notes and loans receivable (attach schedule)

____

Less allowance for doubtful accounts ~ _____________

-g:
II)

Inventories for sale or use

8
9

1----------l----------+---------

Prepaid expenses and deferred charges

113,397.

68,384.

113, 397

10 a Investments - U S and state governmentobhgallons(attachschedule).


b Investments - corporate stock (attach schedule)

11

12
13
14

15
16

c Investments - corporate bonds (attach schedule)


Investments- land, buildings,
~
3 377 694
_______ '
'

and equipment basis


Less accumulateddepreciation ~
3,377,694.
3,377,694.
(attach schedule)
- - - - - - - - - - - - - - - - - - - 1------'-----'-----+-----'----'----+-----'-----''--Investments - mortgage loans

203,038,442.
117,935,513.
~'.1;~ Ej
Investments - other (attach schedule)
Land.buddings.and
~
1
020
219
equipment basis
_________
.!. ___ !,. ___
:.._
Less accumulateddepreciation~
614 9 8 8
405,231.
1,042,504.
(attach schedule)
- - - - - - - - - - - - - - - '....- - - :.._1------'-------'------+---------'----+--------''--Other assets (describe ~ ____________________
) l----------+----------+--------Total assets (to be completed by all filers - see the
instructions Also. see page 1, item I)
234,857,654.
216,354,373.

17
18
: 19
20

Grants payable
Deferred revenue

;g

Loans from officers, directors,trustees.and otherdisqualifiedpersons

'.g21

Mortgages and other notes payable (attach schedule) .

::i 22

Other hab1l1t1es(describe ~ ___________________

23

Total liabilities (add Imes 17 through 22)

2,455,694
201,693,326

ATCH 9
405,231

214,087,257

18,746.
2,863,946.

29,937.
3,034,871.

Accounts payable and accrued expenses

ATCH 7

) 1------------+-----------.

3,064,808.

~w

2,882,692.

Foundations that follow SFAS 117, check here


and complete lines 24 through 26 and lines 30 and 31.
1/)

24

; 25

26

,:,

c:
:,

u.

o 27

Unrestricted .

Temporarily restricted
Permanently restricted

231,792,846.

213,471,681.

231,792,846.

213,471,681.

234, 857, 654.

216,354,373.

Foundations that do not follow SFAS 117,


check here and complete lines 27 through 31.

Capital stock. trust principal. or current funds .


Paid-in or capitalsurplus,or land, bldg . and equipmentfund
Retained earnings, accumulatedincome,endowment.or otherfunds
Total net assets or fund balances (see instructions)
Total
liabilities
and net assets/fund
balances
instructions).

(see

~o:~um Analysis of Changes in Net Assets or Fund Balances


1 Total net assets or fund balances at beginning of year - Part II, column (a), line 30 (must agree with
end-of-year figure reported on prior year's return) .
2 Enter amount from Part I, line 27a ..
3
4
5
6

Other increases not included in line 2 (itemize)~------------------------------------Add Imes 1, 2, and 3


. . . . .
. . .
. .
. . . . . . ..
Decreases not included in line 2 (itemize)~
Total net assets or fund balances at end of vear (line 4 minus line 5) - Part II, column lb), line 30 .

1
2
3
4
5
6

231,792,846
-18,321,165
213,471,681
213,471,681
Fonn 990-PF (2011)

JSA
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85646

PAGE 2

CHARLES KOCH FOUNDATION

48-0918408

Form 990-PF (2011)

f>age

:.:~l-.

Capital Gains and Losses for Tax on Investment Income

1a

101 How

(a) List and describe the kmd(s) of propertysold (e g , real estate,


2-story bnck warehouse,or commonstock, 200 shs MLC Co)
SEE PART IV SCHEDULE

acquired

P-ase

D-Donat,on

ld)
Date sold
mo, day, yr)

(c) Date
acquired
(mo , day, yr )

b
c
d

e
(g) Cost or other basis

(f) Deprec1at1on
allowed

(e) Gross sales pnce

(or allowable)

(h) Gain or (loss)


(e) plus (f) minus (g)

plus expenseof sale

a
b
c
d

e
Comolete onlv for assets showma aa1nm column (h\ and owned bv the foundation on 12/31169
U) Adjusted basis
(k) Excessof col (1)
(i) FM V as of 12/31/69
as of 12/31/69
over col (J), 1fany

(I) Gains (Col (h) gain minus


col (k), but not less than -0-) or
Losses(from col (h))

a
b
c
d

e
If gam, also enter m Part I, line 7
If (loss), enter -0- 1nPart I, line 7
3 Net short-term capital gam or (loss) as defined m sections 1222(5) and (6)
If gain, also enter m Part I, line 8, column (c) (see instructions) If (loss), enter -0Part I, line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2 Capital gam net income or (net capital loss)

2,545,112.

in}

:.:-

Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income

(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income)
If section 4940(d)(2) applies, leave this part blank

Was the foundation liable for the section 4942 tax on the distributable amount of any year 1nthe base period?
If "Yes," the foundation does not qualify under section 4940(e) Do not complete this part

Oves~

No

1 E nter t he appropriate amount m eac h co Iumn f or eac h year, see t he 1nstruct1onsbfe ore ma k m~ any entries
(a)
Base penod years
Calendar year (or tax year beginning 1n)

(b)
AdJusted quahfymg d1stnbut1ons

18,901,264.
19,551,962.
15,476,965.
10,080,287.
8,276,208.

2010
2009
2008
2007
2006

2
3

203,468,683.
155,141,798.
170,704,588.
127,673,989.
76,656,070.

.....................................

Total of line 1, column (d)


Average d1stribut1on ratio for the 5-year base period - d1v1dethe total on line 2 by 5, or by the
number of years the foundation has been m existence 1fless than 5 years

Enter the net value of noncharitable-use

Multiply lme 4 by hne 3

Enter 1% of net investment income (1% of Part I, line 27b).

Add Imes 5 and 6

Enter quahfymg d1stribut1ons from Part XII, line 4 .


If line 8 1s equal to or greater than line 7, check the box
Part VI instructions

0.496504

..........

0.099301

..........

215,815,197.

. .. ........ . . . . ... .

21,430,665.

...................

. . . . . . . . . . . . . . . . . . . . . . .. .

..................

0. 092895
0.126026
0.090665
0.078953
0 .107965

assets for 2011 from Part X, line 5

...................

(d)
D1stnbut1on ralJo
(col (bl d1V1dedby col (c))

(c)
Net value of nonchantable-use assets

........................

inPart VI, hne 1b, and complete

JSA

57,657.
21,488,322.

20,955,082.
8
that part using a 1% tax rate. See the
Form

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990-PF

(2011)

PAGE 3

CHARLES

Form 990-PF (2011)

1a

KOCH FOUNDATION

48-0918408

Exempt operating foundatJons descnbed m sectJon 4940(d)(2), check here


Date of rulr:,g or determm111Jonletter _______________

LJ

and enter "N/A" on lrne 1

(attach copy of letter if necessary see instructions)

b Domestic foundations that meet the section 4940(e) requirements in Part V, check
here

Page 4

Excise Tax Based on Investment Income {Section 4940{a), 4940{b), 4940{e), or 4948 - see instructions)

1::.,rna,a

1--1-'-+------1_1_5....:,_3_1_5_._

and enter 1% of Part I, line 27b . . . . .

c All other domestic foundations enter 2% of line 27b Exempt foreign organizations enter 4% of
Part I, line 12, col {b)
2

Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only Others enter -0-)

3
4

Add Imes 1 and 2 . . .


Subtltle A (income) tax (domestic section 494 7(a)(1) trusts and taxable foundations only Others enter -0-)

Tax based on investment income. Subtract line 4 from line 3 If zero or less, enter -O-

Cred1ts/Payments:
a 2011 estimated tax payments and 201 O overpayment credited to 2011

6a

b Exempt foreign organizations - tax withheld at source

6b

c Tax paid with appltcat1on for extension of time to file (Form 8868).

6c

ll5,315.

4
5

ll5,315.

150,834.

150,834.

6d

d Backup withholding erroneously withheld


7
Total credits and payments Add Imes 6a through 6d

8
Enter any penalty for underpayment of estimated tax. Check here
1f Form 2220 ,s attached
~
9
Tax due. If the total of Imes 5 and 8 1smore than line 7, enter amount owed
Overpayment If ltne 7 1s more than the total of Imes 5 and 8, enter the amount overpaid . .
~ 1---'1_,0'--+
_______
Enter the amount of line 10 to be Credited to 2012 estimated tax ~
3 5, 519 . Refunded ~ 11

9
1o
11

1::.,rn

Statements

3_5....:,_5_1_9_.

Regardina Activities

1 a During the tax year, did the foundation attempt to influence any national, state, or local leg1slat1onor d&d 1t part1c1pate

Yes

No

or intervene 1n any poltt1calcampaign? . . . . . 1--1~ac.....+---+--Xb Did ,t spend more than $100 during the year (either directly or indirectly) for political purposes (see page 19 of the
1b
instructions for definition)? . . . . .

If the answer is "Yes" to 1a or 1b, attach a detailed descnpt1on of the activities and copies of any matenals publtshed or

d1stnbuted by the foundation in connection with the act1v,t1es


c Did the foundation file Form 1120-POL for this year?
d Enter the amount (1f any) of tax on political expenditures (section 4955) imposed during the year
(1) On the foundation ~ $
(2) On foundatJon managers ~ $ __________
e Enter the reimbursement (1f any) paid by the foundation
_
on foundation managers ~ $ ___________

during

the year for political

If "Yes, attach

x
x

expenditure tax imposed

a detailed descnpt1on of the acttv1ttes

Has the foundation

Has the foundation engaged in any act1v1t1esthat have not previously been reported to the IRS?

1c

made any changes. not previously reported to the IRS, 1n its governing instrument, articles of

mcorporat,on, or bylaws, or other s1m1larinstruments? If "Yes," attach a conformed copy of the changes
Did the foundation have unrelated business gross income of $1,000 or more dunng the year?.

4a

b If "Yes," has ,t filed a tax return on Form 990-T for this year? .....
5
Was there a liqu1datlon, termination, d1ssolut1on,or substantial contraction during the year?

4b

4a

If "Yes," attach the statement required by General Instruction T

Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either
By language 1nthe governing instrument, or
By state leg1slat1on that

effectively

amends the governing

instrument

so that

no mandatory

d1rect1ons that

conflict with the state law remain in the governing instrument?


Did the foundation have at least $5,000 1n assets at any time during the year? If "Yes, complete Part II, col (c), and Part XV

8 a Enter the states to which the foundation reports or with which ,t 1sregistered (see instructions)
DC,KS,VA,

b If the answer 1s "Yes" to hne 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 . . . . . . . . . . . i--=-S~b-+-_x
__
9

Is the foundation

claiming

status as a private operating foundation

within

the meaning of section 4942(])(3)

or

4942(])(5) for calendar year 2011 or the taxable year beginning in 2011 (see instructions for Part XIV)? If "Yes, complete
1O

Part XIV ..

Did any persons become substantial contributors during the tax year? If "Yes, attach a schedule listing their names
and addresses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1o
Form

990-PF

(2011)

JSA

1E1440 1 000

16733H

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ll:

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85646

PAGE

CHARLES

Form 990-PF (2011)

Statements
~---
11
12

At

any time

during

KOCH FOUNDATION

year, did

foundation,

the

directly

or

indirectly,

own

entity

a controlled

meaning ef section 512(b)(13)? If 'Yes," attach schedule (see instructions)

. . . . . . . ..................

make a d1stribut1on to a donor adVISed fund


per'son had adVlsory prMleges? If 'Yes," attach statement (see instructions)

....................

Did the foundation

over which

the foundation

within

the
11

12

or a d1squal1f1ed

x
the public inspection requirements for its annual returns and exemption apphcat1on? .
13
~12~~~~~<2.~1:!.~<2.~~'!'.~<21:!.:.<2~~-------------------------------------------

Did the foundation comply with

14

Website address ~ ___ -~.:.


The books are m care of ~ HEATHER

LOVE -----------------------

Located at ~4111_E._37TH_ST.

_N.

WICHITA,

Telephone no ~ _____

KS-----------------------

ZIP+4

( 316)

828-8286

~ 67220 ________

Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF m lieu of Form 1041 Check here .
and enter the amount of tax-exempt interest received or accrued during the year . . .

16

Page

Regarding Activities (continued)


the

13

15

48-0918408

I 15 I

~LJ

Yes

At any time during calendar year 2011, d1d the foundation have an interest m or a signature or other authority
over a bank, securities, or other financial account m a foreign country?

____ _
_

No

16

See the mstruct1ons for exceptions and f1hng requirements for Form TD F 90-22 1 If 'Yes," enter the name of
the fore1an countrv

~'" ..~!!=Statements

Re9ardin9 Activities

File Form 4720 if any item is checked

for Which Form 4720 May Be Required

in the "Yes"

column,

unless an exception

Yes

applies.

No

1 a During the year did the foundation (either directly or indirectly)


( 1) Engage m the sale or exchange, or leasing of property with a d1squahfiedperson?

[iJ

0Yes

(2) Borrow money from, lend money to, or otherwise extend credit to {or accept 11 from) a
d1squal1fiedperson? . . . . .
(3) Furnish goods, services, or fac1ht1esto {or accept them from) a d1squahfiedperson?

~v

(4) Pay compensation to, or pay or reimburse the expenses of, a d1squahfiedperson?

..
Yes
Yes

(5) Transfer any income or assets to a d1squalif1ed person (or make any of either available for

~
No
No

[iJ

0Yes

the benefit or use of a disqualified person)?.


Check "No" 1f the

No

No

(6) Agree to pay money or property to a government official? {Exception.

foundation

agreed to make a grant

to or to employ the official

termination of government selVlce, 1fterminating w1th1n90 days).

for a period after

. . 0

Yes

liJ No

b If any answer 1s ''Yes" to 1a(1)-{6), did any of the acts fail to qualify under the exceptions described m Regulations
section 53 4941 (d)-3 or m a current notice regarding disaster assistance (see mstruct1ons)?
Orgamzat1ons relying on a current notice regarding disaster assistance check here .
c Did the foundation

1c

engage m a prior year m any of the acts described m 1a, other than excepted acts, that

were not corrected before the first day of the tax year beg1nn1ng1n2011? .
2

1b

Taxes on failure to distribute

income (section 4942)

(does not apply for years the foundation

was a private

operating foundation defined m section 4942{J)(3) or 4942(J)(5))


a At the end of tax year 2011, d1d the foundation have any undistributed income (hnes 6d and
6e, Part XIII) for tax year(s) beginning before 2011?. 0
, _________
, ________
, _______
_
If "Yes," hsttheyears ~ ---------b Are there any years listed m 2a for which the foundation

Yes

liJ No

1s not applying the prov1s1ons of section 4942(a)(2)

{relating to incorrect valuation of assets) to the year's undistributed

income? {If applying section 4942{a)(2)

to

all years listed, answer "No" and attach statement see mstruct1ons) . . . . . . ....

2b

c If the prov1s1onsof section 4942(a)(2) are being applied to any of the years listed m 2a. hst the years here

~----------

---------

--------

--------

3a Did the foundation hold more than a 2% direct or indirect interest in any business enterprise
at any time during the year?
b If 'Yes," did 11 have excess business holdings m 2011

liJ

0
Yes
No
as a result of (1) any purchase by the foundation or

d1squahf1ed persons after May 26, 1969, (2) the lapse of the 5-year period (or longer period approved by the
Comm1ss1oner under section 4943(c)(7))

to dispose of holdings acquired by gift or bequest. or (3) the lapse of

the

holding

10-,

15-, or

20-year

first

phase

period? (Use Schedule

C, Form 4720,

to

determine

,r

the

foundation had excess business holdings m 2011 ) . . . . . . . . . . . . . . . . . . . . . . .


4a Did the foundation invest during the year any amount 1n a manner that would Jeopardizeits charitable purposes?

i--=3~bc..+---t-4a

b Did the foundation make any investment in a prior year (but after December 31, 1969) that could Jeopardize its
charitable ouroose that had not been removed from 1eooardv before the first dav of the tax vear beamnma m 2011?

x
4b
990-PF (2011)

Form

JSA

1E14501

000

16733H

K932

11/11/2012

11: 02: 44

PM

V 11-6

.1

85646

PAGE

CHARLES KOCH FOUNDATION


48-0918408
Statements Regarding Activities for Which Form 4720 May Be Required (contmued)

Form 990-PF (2011)

::r.,~a..tll!!!:

Page

Sa During the year did the foundation pay or incur any amount to
(1) Carry-on propaganda, or otherwise attempt to influence leg1slat1on(section 4945(e))?
(2) Influence the outcome

of any specific public election (see section 4955),

~No

other than a charitable, etc,

~No

orgamzat1on described in

section 509(a)(1), (2), or (3), or section 4940(d)(2)? (see mstruct1ons) .


(5) Provide for any purpose other than

Yes

0No

Yes

rehg1ous, charitable, sc1ent1fic, literary, or educational

purposes, or for the prevention of cruelty to children or animals?. . . . 0


b

~No

::EJ~::

'directly or indirectly, any voter reg1strat1ondrive? .


(3) Provide a grant to an ind1v1dualfor travel, study, or other s1m1larpurposes?
(4) Provide a grant to an organization

0Yes

or to carry on,

No

If any answer 1s "Yes" to 5a(1)-(5), did any of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance (see instructions)? .

Sb

6b
I---+---+---

Organizations relying on a current notice regarding disaster assistance check here ..,_0

c If the answer 1s ''Yes" to question 5a(4), does the foundation claim exemption from the tax
because 11maintained expenditure respons1b1htyfor the grant?

)_0. . . . ~

bl'l'bC~ENl'.

Yes

No

Yes

No

If "Yes, attach the statement required by Regulations section 53 4945-S(d)


6a

Did the foundation,

during the year, receive any funds, directly or indirectly, to pay premiums

on a personal benefit contract?. . 0


b Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?

.......

If "Yes to 6b, file Form 8870


7 a At any time during the tax year, was the foundation a party to a proh1b1tedtax shelter transaction? 0

Yes
~No
b If "Yes," did the foundation receive any proceeds or have any net income attributable to the transaction? .

7b

:.J:TiiiaJ111Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1

List all officers,

directors,

trustees,

foundation

manaQers and their compensation


(b) Title, and average
hours per week
devoted to oos1t1on

(a) Name and address

(see instructions).

~'}>
Compensation
not paid, enter

(d) Contributionsto
employeebenefitplans

-0-1

and deferred comnensat1on

------------------------------------ATTACHMENT 11
-------------------------------------

(e) Expense account.


other allowances

------------------------------------------------------------------------2

Compensation
"NONE."

of five

highest-paid

employees

(other

than

those

(b) Title, and average


hours per week
devoted to pos1t1on

(a) N11me and address of each employee paid more than $50,000

ATTACHMENT 12

included

on line 1 - see instructions).

(c) Compensation

640,366.

Total number of other employees paid over $50 000

..

(d) Contributions to
employee benefit
plans and deferred
com pensat1on

25,349.

If none, enter

(e) Expense account,


other allowances

6,480

..... 1

12

Form 990-PF (2011)

JSA
1E1460 1 000

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85646

PAGE 6

CHARLES KOCH FOUNDATION

48-0918408

Form 990-PF (2011)

Page

1@11111
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,

~nd Contractors (contmued)

Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE."
(a) Name and address of each person paid more than $50,000

KOCH INDUSTRIES INC.


WICHITA, KS 67201
FPl STRATEGIES
--------------------------------------------------------ALEXANDRIA, VA 22201

(b) Type of seMce

ACCTG/FINANCE SRVC

132,750.

PROF. CONSULT. SVCS

70,000.

Total number of others rece1v1nqover $50,000 for professional services ..................

ifiifd

(c) Compensatton

Summary of Direct Charitable Activities

Lrst the foundation's four largest direct chantable act1v1t1esdunng the tax year lndude relevant stat1sttcal rnformat1on such as the number of
organ1zatrons and other benefic1anes served, conferences convened, research papers produced, etc

KOCH ASSOCIATES PROGRAM: SEE GENERAL EXPLANATION ATTACHMENT

KOCH INTERNSHIP PROGRAM: SEE GENERAL EXPLANATION ATTACHMENT

E)cpenses

2,048,905.

682,752.
3 LIBERTY@

WORK PROGRAM: SEE GENERAL EXPLANATION ATTACHMENT


320,514.

l::r.TH ..

= Summary of Program-Related Investments (see instructions)

Describe the two largest program-related

Amount

investments made by the foundation dunng the tax year on lrnes 1 and 2

NONE

All other program-related investments See instructions

NONE

Total. Add lines 1 throuah 3 ..................................

Fann

990-PF (2011)

JSA
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16733H

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85646

PAGE 7

CHARLES KOCH FOUNDATION

48-0918408

1ifid
1
a
b
c
d

2
3

Minimum Investment Return {All domestic foundations must complete this part. Foreign foundations,
see instructions.)

Fair market value of assets not used (or held for use) directly in carrying out charitable, etc,
purposes
Average monthly fair market value of securities
Average of monthly cash balances.
Fair market value of all other assets (see instructions)
Total (add lines 1a, b, and c)
Reduction claimed for blockage or other factors reported on lines 1a and
1e
1c (attach detailed explanation) ............................
Acqu1s1t1onindebtedness applicable to line 1 assets
Subtract lme 2 from hne 1d
....
.
Cash deemed held for charitable act1v1t1es Enter 1 112 % of line 3 (for greater amount, see
instructions).
.. .. ..
..
.. . .. ..
.. .. .. .. .. ..
Net value of noncharitable-use assets. Subtract line 4 from line 3 Enter here and on Part V, lme 4
Minimum investment return. Enter 5% of line 5
.....
.

..

167,462,872.
48,991,074.
2,647,777.
219,101,723.

..
.. .

2
3

219,101,723

...........

3,286,526
215,815,197.
10,790,760.

. ..

..

... . . ....... .. .

5
6

1a
1b
1c
1d

...

. . . . . . . .. . .

. . . . ..
..
.

. ..

. .

......

l:r.1

Distributable
foundations

1
2a
b
c
3
4

and certain foreign organizations check here ~

..

...

..

a
b
2

..

....

..

iffEiiiQualifying
1

D and do not complete this part)


1
. ..
115,315.
i ~~ i

Minimum investment return from Part X, hne 6.


Tax on investment income for 2011 from Part VI, line 5
I 2b I
Income tax for 2011 (This does not include the tax from Part VI )
Add Imes 2a and 2b
Distributable amount before adjustments Subtract hne 2c from line 1 .
Recoveries of amounts treated as quahfymg d1stribut1ons
Add Imes 3 and 4
.. .....
Deduction from distributable amount (see instructions)
..
Distributable amount as adJusted Subtract line 6 from line 5 Enter here and on Part XIII,
line 1

. . . ..

.....
. ..

a
b

4
5

...

...

.. . .
. . . . . . . ...

.. ..

. ..

..

..

115,315.
10,675,445.

..

..

2c
3

10,790,760.

5
6

10,675,445.

10,675,445.

1a
1b

20,935,520.

Distributions {see instructions)

Amounts paid (including admm1strat1veexpenses) to accomplish charitable, etc, purposes


Expenses, contributions, gifts, etc - total from Part I, column (d), line 26 ...
.......
Program-related investments - total from Part IX-8 ...........
.......
Amounts paid to acquire assets used (or held for use) directly m carrying out charitable, etc.

..... ..

5
6

Amount {see instructions) (Section 4942(])(3) and (J)(5) private operating

...

5
6
7

Page

Form 990-PF (2011)

.....

19,562.
purposes .......................
..
.. .. . . . .
. 2
Amounts set aside for specific charitable projects that satisfy the
Su1tab1htytest (prior IRS approval required) ................................
3a
..
3b
Cash d1stribut1on test (attach the required schedule) ......................................
Qualifying distributions. Add Imes 1a through 3b Enter here and on PartV, hne8, and PartXIII. hne4
4
20,955,082.
..
Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment income
5
0
Enter 1% of Part I, hne 27b (see 1nstruct1ons)....
...........
..
6
20,955,082.
Adjusted qualifying distributions. Subtract hne 5 from hne 4 ............
Note. The amount on line 6 will be used m Part V, column (b), m subsequent years when calculating whether the foundation
qualifies for the section 4940(e) reduction of tax m those years

...
.....
. ...

...

Form

990-PF

(2011)

JSA
1E1470 1 ODO

16733H

K932

11/11/2012

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PAGE 8

CHARLES KOCH FOUNDATION

48-0918408
Page

Form 990-PF (2011)

:s;n-,m

Undistributed

(b)
Years prior to 2010

(a)

Distributable

line 7

Corpus

(c)

(d)
2011

2010

10,675,445.

income, 1f any, as of the end of 2011

a Enter amount for 2010 only

b Total for pnor years

from Part XI,

amount for 2011

.........................

Und,stnbuted

Income (see instructions)

................
2 0...Q.2_

2 Q__Q2._,20~.

Excess d1stribut1ons carryover, 1f any, to 2011


4,479,130.
a From 2006
3,779,603.
b From 2007
7,054,261.
c From 2008

d From 2009

11,912,574.

e From 2010

8,931,145.

...........

Total of Imes 3a through e

36,156,713.

Qualifying distributions for 2011 from Part XII,


20,955,082.
lme4 ~ $

a Applied to 2010, but not more than line 2a

b Applied to undistributed income of prior years


(Election required - see instructions).
c

Treated as d1stribut1ons out of corpus (Election


required - see instructions) .

d Applied to 2011 distributable amount

......

e Remaining amount distributed out of corpus

10,675,445.

..

10,279,637.

Excess d1stribut1ons carryover applied to 2011


(If an amount appears m column (d), the same
amount must be shown m column (a))
Enter the net total of each column as
indicated below:

5
6

a Corpus Add lines 3f, 4c, and 4e Subtract line 5

46,436,350.

Prior years' undistributed income Subtract


line 4b from line 2b
..
c Enter the amount of prior years' undistributed
income for which a notice of def1c1encyhas been
issued, or on which the section 4942(a) tax has
been previously assessed
b

...

..........

. . . . . .....

Taxable
line 6c from line 6b
d Subtract
amount - see instructions
..
e Undistributed income for 201 O Subtract line
4a from hne 2a Taxable amount - see
instructions

. . . . . . .....

......................

Undistributed income for 2011 Subtract hnes


4d and 5 from line 1 This amount must be
distributed m 2012

...............

Amounts treated as distributions out of corpus


to satisfy requirements imposed by section
170(b)(1 )(F) or 4942(9)(3) (see instructions)

Excess d1stribut1ons carryover from 2006 not


applied on hne 5 or line 7 (see instructions)

..

Excess distributions
carryover
Subtract Imes 7 and 8 from hne 6a

10 Analysis of hne 9
a Excess from 2007

to

4,479,130.

2012.

. . . .....

41,957,220.

3,779,603.

b Excess from 2008

7,054,261.

Excess from 2009

11,912,574.

Excess from 2010

8,931,145.

e Excess from 2011

10,279,637.
Form

990-PF (2011 J

JSA
1E1480 1 000

16733H

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PAGE 9

'

CHARLES KOCH FOUNDATION


Private Operating Foundations see 1nstruct1onsand Part VII-A, question 9)

Page 10
48-0918408
NOT APPLICABL E

Form sd'o-PF (2011)

"'-:----

If the foundation has received a ruling or determination letter that 11 is a private operating
foundation, and the ruling 1seffective for 2011, enter the date of the ruling . . . . . ~
b Check box to indicate whether the foundation 1sa private operating foundationdescribed1nsection
Tax year
Prior 3 years

1a

2a

Enter the lesser of the adJusted net income from Part


I or the minimum investment
return from Part X for each
year listed

(a) 2011

(b) 2010

(c) 2009

I
I I

4942(1)(3) or

I I

4942(1)(5)

(e) Total
(d) 2008

85% of hne 2a

Qualifying d1stnbubonsfrom Part

Amounts induded in line 2c not


used directly for actNe conduct

XII, Iin e 4 for each year listed

of exempt act1V1bes

Qualifying d1stnbut.Jons made


directly for actNe conduct of
exempt act1vitJes Subtract IUle
2d from line 2c
Complete 3a, b, or c for the
alternabw test relied upon

Assets" altematNe test - enter

(1) Value of all assets


(2) Value of assets qualifying
under section

49420)(3)(8)(1).
"Endowment" alternative

test-

enter 2/3 of minimum invest


ment return shown in Part X.
line 6 for each year listed

"Support" altemabw test - enter

(1) Total support other than


gross investment income
(interest, dl\lldends, rents
payments on secunt.Jes
loans (section 512(a)(5)),
or royalties)
(2) Support from general
public and 5 or more
exempt organizations as
provided in section 4942
OX3)(B)(m)
(3) Largest amount of supan exempt
port from
organ 1zat1on

.
1

4)

Gross investment income

Supplementary Information (Complete


.
.this part only if the foundation
at any time durmg the year - see mstruct1ons.)

had $5,000

or more in assets

Information Regarding Foundation Managers:


a List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only 1fthey have contributed more than $5,000) (See section 507(d)(2))

CHARLES G. KOCH
b List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest

NONE
2

Information

Regarding Contribution,

Grant, Gift, Loan, Scholarship, etc., Programs:

Check here~
1f the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds If the foundation makes gifts, grants, etc (see instructions) to ind1v1duals or organizations under
other cond1t1ons, complete ,terns 2a, b, c, and d
a The name, address, and telephone number of the person to whom apphcat,ons should be addressed.

ATTACHMENT 13
b The form in which apphcat,ons should be submitted and information and materials they should include

ATTACHMENT 14
c Any subm 1ss1ondeadlines

NONE
d Any restrictions
factors

or hm 1tat1ons on awards, such as by geographical

areas, charitable fields, kinds of inst1tut1ons, or other

ATTACHMENT 15
JSA

Form

1E1490 1 000

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85646

990-PF

(2011)

PAGE 10

CHARLES KOCH FOUNDATION

48-0918408

Form 990-PF (2011)

Page

Uffftl+JSupplementary
3

11

Information (continued)
"d Durina the y ear or A,oorove d f or Future p ayment
Grants .and Contributions p a1

Rec1p1ent
Name and address (home or business)
a Paid dunng the year

If rec1p1ent
1san indMdual,

to
show any reta1Jonsh1p
any founda!Jonmanager
or substanllal contnbutor

Foundation
status of
rec1p1ent

Purpose of grant or
contnbut,on

Amount

ATTACHMENT 16

Total

..

..

..

3a

..

..

..~

3b

16,145,918.

b Approved for future payment

ATTACHMENT 17

Total

1,019,606.
Fonn

990-PF

(2011)

JSA
1E1491 1 000

16733H

K932

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85646

PAGE 11

CHARLES

KOCH

FOUNDATION

48-0918408

Form 990-PF (2011)

Page

12

l!r!1II Analysis of Income-Producing Activities

Enter gross amounts unless otherwise 1nd1cated

Unrelated business income


(b)
Amount

(a)
Businesscode

1 Program service revenue

Excluded by section 512, 513, or 514


(c)
Exclusion code

(d)
Amount

(e)
Related or exempt
function income
/See 1nstruct1ons)

a
b

c
d

e
f

Fees and contrae1s from government agencies

2 Membership dues and assessments

.....
14

3 Interest on savings and temporary cash investments


4 D1v1dendsand interest from securities

. . ..

92,590.

14

3,462,155.

18

2, 545,

5 Net rental income or (loss) from real estate

a Debt-financed property
b Not debt-financed property
6 Net rental income or (loss) from personal property
7 Other investment income

.........

18

8 Gain or (loss) from sales of assets other than inventory


9 Net income or (loss) from special events

112.

19,384.

..

10 Gross profit or (loss) from sales of inventory.


11 Other revenue a
b

c
d
e

6,119,241.

12 Subtotal Add columns (b), (d), and (e)


13 Total. Add line 12, columns (b), (d), and (e)
(See worksheet in line 13 instructions to verify calculations)
:.:

1.11.fa

Line No.

...

= Relationship

13

6, 119,

241.

of Activities to the Accomplishment of Exempt Purposes

Explain below how each act1v1ty for which income 1s reported in column (e) of Part XVI-A contributed importantly to the
accomplishment of the foundation's exempt purposes (other than by prov1d1ngfunds for such purposes) (See 1nstruct1ons)

JSA
1E1492 1 000

16733H

Form

K932

11/11/2012

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PM

11-6

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85646

990-PF
PAGE

(2011)

12

Form990-PF(2011)

1@ti9i1 lnfonnation

CHARLES

KOCH FOUNDATION

48-0918408

Re_gar~ing Transfers To and Transactions


Exempt Organizations

Page

13

and Relationships With Noncharitable

Did the organization directly or indirectly engage m any of the following with any other organization described
Yes
No
m section 501(c) of the Code (other than section 501(c)(3) organizations) or m section 527, relating to political
organizations?
Transfers from the reporting foundation to a noncharitable exempt organization of
x
1al1l
(1) Cash
. .
.
x
1a(2l
(2) Other assets . . .
. . . ..........
.
Other transactions
x
1b(1l
( 1) Sales of assets to a noncharitable exempt organization
x
1 bl2l
(2) Purchases of assets from a noncharrtable exempt organization .
x
1b(3l
(3) Rental of fac11it1es,equipment, or other assets .
x
1bl4l
(4) Reimbursement arrangements
. .
. .
x
1 b(5l
(5) Loans or loan guarantees
. . . .
. . . . . .
. .
x
(6) Performance of services or membership or fundra1s1ngsolic1tat1ons
1bl6l
x
Sharing of fac11it1es,equipment, mailing lists, other assets, or paid employees .
1c
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 m any transaction or sharing arrangement, show m column (d) the value of the goods, other assets, or services received

c
d

(a) Lme no

(b) Amount tn\/Olved

(c) Name of nonchantable exempt organization

(d) Description of transfers, transactions. and shanng arrangements

N/A

N/A

2a Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
described m section 501 (c) of the Code (other than section 501 (c)(3)) or m section 527? . . . . . . . . . . . .
b If "Yes" com lete the followm schedule
{a) Name of organization

Yes[!]

No

{c) Descnpt1on of relat1onsh1p

examined this return. ondud1ng accompanying schedules and statements. and to the best of my knowledge and belief. 1t 1s true.
than taxpayer) 1sbased on all onformat1onof which preparer has any knowledge

Sign
Here

(b) Type of organization

May
with

~~--,F-,l::::;,"H,'~..L-1,..-,(,,..<-='f->'~.,.-.:........::=-~--'--'-'--'-=--L-=--+-Sign

Paid
Preparer
Use Only

the IRS discuss this


the preparer shown

~ Yes

(see 1nstruct1ons)?

PrinUType preparer's name

Check

LIZABETH

self-employed

S.

HOGAN
Firm's name
.... BKD, LLP
Firm's address .... 1551
N WATERFRONT
WICHITA,
KS

If

return
below

PTIN

PO O2 7 3 2 4 8

Firm's EIN .... 44 -0160260

PKWY, STE

300
67206-6601

Phone no

316- 265-2811
Form 990-PF

(2011)

JSA
1E1493 2 000

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85646

PAGE 13

Schedule of Contributors

Schedule B
(Form 990, 990:EZ,
or 990-PF)

OMB No 1545-0047

~11

Attach to Form 990, Form 990-EZ, or Form 990-PF.

Department of the Treasury


Internal R!venue SeMce

Name of the organization

Employer identification number

CHARLES KOCH FOUNDATION


48-0918408

Organization type (check one)


Filers of:

Section:

Form 990 or 990-EZ

Form 990-PF

D
D
D

4947(a)(1) nonexempt charitable trust not treated as a private foundation

501(c)(3) exempt private foundation

D
D

501cc>C

) (enter number) organization

527 political organization

4947(a)(1) nonexempt charitable trust treated as a private foundation


501 (c)(3) taxable private foundation

Check 1fyour organization 1scovered by the General Rule or a Special Rule.


Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule See
instructions
General Rule

CK]For an organization

filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (1nmoney or
property) from any one contributor Complete Parts I and II

Special Rules

D
D

For a section 501 (c)(3) organrzat1on filing Form 990 or 990-EZ that met the 33 1/3 % support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(v1) and received from any one contributor, during the year, a contribution of
the greater of (1) $5,000 or (2) 2% of the amount on (r) Form 990, Part VIII, line 1h, or (11)Form 990-EZ, line 1
Complete Parts I and II
For a section 501(c)(7), (8), or (10) organization frling Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclus,vely for religious, charitable, sc1entrfrc,literary,
or educational purposes, or the prevention of cruelty to children or anrmals Complete Parts I, II, and Ill
For a sectron 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that recerved from any one contributor,
during the year, contributions for use exclus,vely for religious, charitable, etc , purposes, but these contributions drd
not total to more than $1,000 If this box rs checked, enter here the total contributions that were received during the
year for an exc/us,ve/y religrous, charitable, etc , purpose Do not complete any of the parts unless the General Rule
applies to thrs organization because rt received nonexclus1vely religious, charitable, etc , contributions of $5,000 or
more during the year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~ $ ---------

Caution. An organization that 1snot covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but rt must answer "No" on Part IV, line 2, of rts Form 990, or check the box on line Hof rts Form 990-EZ or on
Part I, line 2, of its Form 990-PF, to certrfy that rt does not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF)
For Paperwork

Reduction Act Nobce, see the Instructions for Form 990, 990-EZ, or 990-PF.

Schedule

B (Form 990, 990-EZ, or 990-PF) (2011)

JSA
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85646

PAGE 15

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)


Name of organization

CHARLES

Page2

KOCH FOUNDATION

Employer idenbficabon

number

48-0918408

Ul!flii.
Contributors

(see instructions) Use duplicate copies of Part I 1fadditional space is needed.


(b)
Name, address, and ZIP + 4

(a)
No.

- -

(c)
Total contributions

CHARLES G. KOCH
-1 - -----------------------------------------4111

E.

37TH

STREET

$ _________

N.

-----------------------------------------WICHITA,

26, 427.

(b)
Name, address, and ZIP + 4

- - - -

(c)
Total contributions

-----------------------------------------$ ________________

------------------------------------------

(b)
Name, address, and ZIP + 4

- - - -

(c)
Total contributions

-----------------------------------------$ ________________

------------------------------------------

(b)
Name, address, and ZIP + 4

- - - -

(c)
Total contributions

-----------------------------------------$ ________________

------------------------------------------

--

(b)
Name, address, and ZIP + 4

(c)
Total contributions

-----------------------------------------$ ________________

------------------------------------------

(d)
Type of contribution
Person
Payroll
Noncash

(d)
Type of contribution
Person
Payroll
Noncash

(d)
Type of contribution
Person
Payroll
Noncash

(Complete Part II 1fthere rs


a noncash contnbutron )

-----------------------------------------(a)
No.

Person
Payroll
Noncash

(Complete Part II 1fthere rs


a noncash contrrbutron )

-----------------------------------------(a)
No.

(d)
Type of contribution

(Complete Part II rf there 1s


a noncash contribution )

-----------------------------------------(a)
No.

(Complete Part II 1fthere 1s


a noncash contnbutron )

-----------------------------------------(a)
No.

Person
Payroll
Noncash

(Complete Part II 1fthere rs


a noncash contribution )

KS

67220
-----------------------------------------(a)
No.

(d)
Type of contribution

(b)
Name, address, and ZIP + 4

(c)
Total contributions

- - - -----------------------------------------$ ________________

------------------------------------------

(d)
Type of contribution
Person
Payroll
Noncash

(Complete Part II 1fthere 1s


a noncash contrrbutron )

-----------------------------------------Schedule

JSA

B (Form 990, 990-EZ, or 990-PF) (2011)

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PAGE 16

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Name of organization

CHARLES

Page

Employer identification number

KOCH FOUNDATION

48-0918408

ifHII

Noncash Property (see instructions). Use duplicate copies of Part II 1fadd1t1onalspace 1sneeded

(a) No.
from
Part I

(b)
Description

of noncash property given

(c)
FMV (or estimate)
(see instructions)

(d)
Date received

(c)
FMV (or estimate)
(see instructions)

(d)
Date received

(c)
FMV (or estimate)
(see instructions)

(d)
Date received

(c)
FMV (or estimate)
(see instructions)

(d)
Date received

(c)
FMV (or estimate)
(see instructions)

(d)
Date received

(c)
FMV (or estimate)
(see instructions)

(d)
Date received

---

$
(a) No.
from
Part I

(b)
Description

of noncash property given

---

$
(a) No.
from
Part I

(b)
Description

of noncash property given

---

$
(a) No.
from
Part I

(b)
Description

of noncash property given

---

$
(a) No.
from
Part I

(b)
Description

of noncash property given

---

$
(a) No.

(b)

from
Part I

Description

of noncash property given

---

$
JSA

Schedule

B (Form 990, 990-EZ, or 990-PF) (2011)

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PAGE 17

Schedut'e B (Form 990, 990-EZ, or 990-PF) (2011)

Name of organization

CHARLES

Page 4

Employer identification number

KOCH FOUNDATION

48-0918408

_;.AA;I_
Exc:/usive/yreligious,

charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations


that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry
For organizations completing Part Ill, enter the total of exclusively religious, charitable, etc ,
contributions of $1,000 or less for the year (Enter this information once See instructions.) ..,.$
-------f dd 11ona
t
I space 1snee d e d
se d up 1catecopies o f Pa rt Ill 1a

{~) No.
from
Part I

(c) Use of gift

(b) Purpose of gift

(d) Description

of how gift is held

---

(e) Transfer of gift


Transferee's

(a) No.
from
Part I

name, address, and ZIP + 4

Relationship

(c) Use of gift

(b) Purpose of gift

of transferor to transferee

(d) Description

of how gift is held

--(e) Transfer of gift


Transferee's

(a) No.
from
Part I

name, address, and ZIP+ 4

(b) Purpose of gift

Relationship

(c) Use of gift

of transferor to transferee

(d) Description

of how gift is held

--(e) Transfer of gift


Transferee's

(a) No.
from
Part I

name, address, and ZIP+ 4

(b) Purpose of gift

Relationship

(c) Use of gift

of transferor to transferee

(d) Description

of how gift is held

--(e) Transfer of grft


Transferee's

name, address, and ZIP+ 4

Relationship

of transferor to transferee

Schedule

JSA

B (Fonn 990, 990-EZ, or 990-PF) (2011)

1E1255 1 000

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PAGE 18

CHARLES KOCH FOUNDATION

FORM 990PF

48-0918408

- GENERAL EXPLANATION ATTACHMENT

SUMMARYOF DIRECT CHARITABLE ACTIVITIES


FORM 990-PF,
PART IX-A
KOCH ASSOCIATES PROGRAM:
DURING 2011 THE CHARLES KOCH FOUNDATION SPONSORED MORE THAN 80
INDIVIDUALS TO PARTICIPATE IN THE KOCH ASSOCIATE PROGRAM. 25 WASHINGTON,
D.C. AREA CHARITABLE ORGANIZATIONS WERE PARTNERS IN THE PROGRAM.
THE KOCH ASSOCIATE PROGRAMWAS ESTABLISHED TO IDENTIFY UP-AND-COMING
LEADERS AND ENTREPRENEURS INTERESTED IN LIBERTY AND HELP THEM DEVELOP THE
KNOWLEDGE, SKILLS, AND EXPERIENCE NECESSARY FOR CAREERS IN THE NONPROFIT
SECTOR, INCLUDING CAREERS WITH MARKET-ORIENTED THINK TANKS, POLICY
INSTITUTES, AND OTHER EDUCATIONAL INSTITUTIONS.
FOR MORE INFORMATION ON THIS PROGRAM, PLEASE VISIT
WEBSITE AT:
WWW.CHARLESKOCHFOUNDATION.ORG
KOCH INTERSHIP

THE FOUNDATION'S

PROGRAM:

DURING 2011 THE CHARLES KOCH FOUNDATION SPONSORED MORE THAN 113
INDIVIDUALS TO PARTICIPATE IN THE KOCH INTERNSHIP PROGRAM.
THE CHARLES KOCH FOUNDATION INTERNSHIP PROGRAMWAS ESTABLISHED TO DEVELOP
THE NEXT GENERATION OF LIBERTY-MINDED LEADERS, EDUCATORS, AND
ENTREPRENEURS. OVER THE COURSE OF THE PROGRAM, INTERNS ENGAGE IN RESEARCH
AND EDUCATIONAL ACTIVITIES WHILE LEARNING AND APPLYING MARKET-BASED
MANAGEMENT
FOR MORE INFORMATION ON THIS PROGRAM, PLEASE VISIT
WEBSITE AT:
WWW.CHARLESKOCHFOUNDATION.ORG
LIBERTY@

THE FOUNDATION'S

WORK PROGRAM:

DURING 2011 THE CHARLES KOCH FOUNDATION SPONSORED MORE THAN 42


INDIVIDUALS TO PARTICIPATE IN THE KOCH ASSOCIATE PROGRAM. 32 CHARITABLE
ORGANIZATIONS OUTSIDE OF THE WASHINGTON D.C. AREA WERE PARTNERS IN THE
PROGRAM.
THE LIBERTY@ WORK PROGRAMWAS ESTABLISHED TO IDENTIFY UP-AND-COMING
LEADERS AND ENTREPRENEURS INTERESTED IN LIBERTY AND HELP THEM DEVELOP THE
KNOWLEDGE, SKILLS, AND EXPERIENCE NECESSARY FOR CAREERS IN THE NONPROFIT
SECTOR, INCLUDING CAREERS WITH MARKET-ORIENTED THINK TANKS, POLICY

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PAGE 19

CHARLES KOCH FOUNDATION

FORM 990PF

INSTITUTES,
D.C. AREA.

48-0918408

- GENERAL EXPLANATION ATTACHMENT

AND OTHER EDUCATIONAL INSTITUTIONS

OUTSIDE THE WASHINGTON

FOR MORE INFORMATION ON THIS PROGRAM, PLEASE VISIT


WEBSITE AT:
WWW.CHARLESKOCHFOUNDATION.ORG

16733H

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THE FOUNDATION'S

85646

PAGE 20

CHARLES KOCH FOUNDATION

48-0918408

ATTACHMENT 1
FORM 990PF,

PART I - OTHER INCOME


REVENUE
AND

EXPENSES
PER BOOKS

DESCRIPTION
OTHER INCOME - LAND RENT
OTHER INCOME - MISCELLANEOUS
GAIN/LOSS ON DISPOSAL OF ASSETS

360.
19,000.
24.
TOTALS

16733H

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19.384.

85646

NET
INVESTMENT
INCOME
360.

360.

ATTACHMENT1
PAGE 21

48-0918408

CHARLES KOCH FOUNDATION

ATTACHMENT 2
FORM 990PF,

PART I - LEGAL FEES


REVENUE
NET
INVESTMENT
INCOME

AND

EXPENSES
PER BOOKS

DESCRIPTION
LEGAL SERVICES
TOTALS

16733H

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ADJUSTED
NET
INCOME

CHARITABLE
PURPOSES

22,393.

22,393.

22.393.

22. 393~

85646

ATTACHMENT2
PAGE 22

CHARLES KOCH FOUNDATION

48-0918408

ATTACHMENT 3
FORM 990PF,

PART I - ACCOUNTING FEES


REVENUE
AND
EXPENSES
PER BOOKS

DESCRIPTION
ACCOUNTING FEES
INVESTMENT ACCTG SERVICES FEES
TOTALS

16733H

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11:02:44

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NET
INVESTMENT
INCOME

136,022.
2,601.

2,601.

138,623.

2 601.

ADJUSTED
NET
INCOME

CHARITABLE
PURPOSES
142,697.

85646

142.697.

ATTACHMENT3
PAGE 23

CHARLES KOCH FOUNDATION

48-0918408

ATTACHMENT 4
FORM 990PF,

PART I - OTHER PROFESSIONAL FEES


REVENUE
AND
EXPENSES
PER BOOKS

DESCRIPTION
PROFESSIONAL CONSULTING FEES
INVESTMENT MANAGEMENTFEES
LAND MAINTENANCE FEES
WEBSITE FEES
CORPORATE FILING FEES
OTHER PROFESSIONAL FEES
RECRUITING FEES
TEMPORARY HELP
ADVERTISING FEES
SPEAKER FEES
ON-LINE SERVICE FEES
EQUIPMENT/MAINTENANCE
KAP PARTICIPATION FEES
L@W PARTICIPATION FEES
TOTALS

16733H

K932

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NET
INVESTMENT
INCOME

294,196.
330,308.
1,508.
10,901.
163.
111,949.
21,692.
41,953.
75,172.
14,750.
40,994.
21,896.
545,078.
171,250.
1. 681. 810.

85646

CHARITABLE
PURPOSES
294,196.

330,308.
1,508.
10, 901.
163.
111,949.
21,692.
41,953.
75,172.
14,750.
40,994.
21,896.
560,610.
171,250.
331.816.

l_.

365. 526.

ATTACHMENT 4
PAGE 24

48-0918408

CHARLES KOCH FOUNDATION

ATTACHMENT 5
FORM 990PF,

PART I - TAXES
REVENUE
NET
INVESTMENT
INCOME

AND

EXPENSES
PER BOOKS

DESCRIPTION
FEDERAL EXCISE TAX
REAL ESTATE TAXES
VA BUSINESS PROPERTY TAX
TOTALS

16733H

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115,315.
73.
20,720.

73.

136.108.

73.

85646

CHARITABLE
PURPOSES

20,720.
20.720.

ATTACHMENT 5
PAGE 25

48-0918408

CHARLES KOCH FOUNDATION

=A=T=T=A=C=HM::::::::=:EN==r=6====
FORM 990PF,

PART I

- OTHER EXPENSES
REVENUE
AND
EXPENSES
PER BOOKS
37,996.
8,640.
1,052.
52,763.
15,848.
1,658.
3,149.
725.
368,455.
37,632.
7,025.
4,104.
283.

DESCRIPTION
INSURANCE
POSTAGE & DELIVERY
BANK FEES
SUPPLIES
TELEPHONE
MEMBERSHIP & DUES
AWARDS/INCENTIVES
GIFTS
GIFTS - IN-KIND
LICENSE FEES
ACCOUNTS RECEIVABLE WRITE-OFF
INTERNET
MISCELLANEOUS
TOTALS

16733H K932

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11: 02: 44 PM V 11-6 .1

539,330.

CHARITABLE
PURPOSES
37,996.
8,640.
1,052.
52,763.
15,848.
1,658.
3,149.
725.
368,455.
37,632.
7,025.
4,104.
283.
539.330.

85646

ATTACHMENT6
PAGE 26

CHARLES KOCH FOUNDATION

48-0918408

FORM 990-PF - PART IV


CAPITAL GAINS AND LOSSES FOR TAX ON INVESTMENT
INCOME
p
Gross sale
pnce less
exoenses of sale

Deprec1at1on
allowed/
~un

bi

Description

Kind of Property

... ~hlo

Cost or
other
h~~~

FMV
as of
1'>l'H'"n

AdJ basis
as of
1?/'H/i;n

Ir

Excess of
FMVover
ad basis

Date
acquired
Gain
or
/loss'

ZAZOVE ASSOCIATES, LLC


PROPERTY TYPE: SECURITIES
994,248.

P VARIOUS

P VARIOUS

2,020,548.

ZAZOVE ASSOCIATES, LLC


PROPERTY TYPE: SECURITIES
1,845,833.

P VARIOUS

8,964,429.

ACIS CLO
PROPERTY TYPE: SECURITIES
8,791,432.

P VARIOUS

1,308,000.

ACIS CLO
PROPERTY TYPE: SECURITIES
1,610,000.

P VARIOUS

27459154.

PIMCO
PROPERTY TYPE: SECURITIES
26569477.

P VARIOUS

11607222.

PILOT TRAVEL CENTERS


PROPERTY TYPE: SECURITIES
10000000.

P VARIOUS

331,278.

EATON VANCE
PROPERTY TYPE: SECURITIES
306,566.

972,037.

Date sold

VARIOUS

-22, 211.
VARIOUS

174,715.
VARIOUS

172,997.
VARIOUS

-302,000.
VARIOUS

889,677.
VARIOUS

1,607,222.
VARIOUS

24, 712.

2,545,112.

TOTAL GAIN (LOSS)

JSA

1E1730 1 000

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85646

PAGE 14

48-0918408

CHARLES KOCH FOUNDATION

INVESTMENTS - Tl\ND

BTTIIDTNGS FOUIPMENT

ACCUMULATEDDEPRECIATION DETAIL

FIXED ASSET DETAIL

ASSET DESCRIPTION

UNIMPROVED LAND

METHOD/

BEGINNING

CLASS

BALANCE

TOTALS

ADDITIONS

DISPOSALS

ENDING

BEGINNING

BALANCE

BALANCE

3,377,694

3,377,694

3 377

3 372

694

ATTACHMENT7

ENDING
ADDITIONS

DISPOSALS

BALANCE

694

ATTACHMENT7
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PAGE 27

CHARLES KOCH FOUNDATION

48-0918408

ATTACHMENT 8
FORM 990PF,

PART II

- OTHER INVESTMENTS
ENDING
BOOK VALUE

DESCRIPTION
ZAZOVE FUND
EATON VANCE FUND
EXCELSIOR ABSOLUTE FUND
ELLIOT INTERNATIONAL FUND
HIGHLAND COMMINGLEDFUND
MPAM FUND
PILOT TRAVEL CENTERS
PIMCO FUND
WEBER STEPHEN PRODUCTS
WINTON FUTURES FUND
ACIS
TOTALS

16733H

K932

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85646

ENDING
FMV

7,122,377.

7,378,753.

16,627.
49,689,725.
10,000,000.
35,000,000.

48,563.
49,918,819.
12,106,819.
34,621,681.

25,666,667.
25,000,000.
50,543,046.

26,000,000.
26,158,101.
45,460,590.

203.038.442.

201.693.326.

ATTACHMENT8
PAGE 28

48-0918408

CHARLES KOCH FOUNDATION

TaND

RTJTTDTNGS FOUIPMENT NOT HEID FOP INVESTMENT


ATTACHMENT

FIXED ASSET DETAIL

METHOD/
ASSET DESCRIPTION

CLASS

OFFICE EQUIPMENT

SL

LEASEHOLD IMPROVE

SL

LEASEHOLD IMPROVE

SL

TOTALS

ACCUMULATEDDEPRECIATION DETAIL

ENDING

BEGINNING
BALANCE

ADDITIONS

DISPOSALS

BALANCE

16,630

2,932

1 000

652

BEGINNING
BALANCE

613,038.

020

214

DISPOSALS

BALANCE

194,641.

l, 440

807,679.

272

2,932

ENDING
ADDITIONS

1,440

16,630

1,000,652.

1,000,652

c;_

272.

aos...:lSl

ATTACHMENT9
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PAGE 29

CHARLES KOCH FOUNDATION

48-0918408

ATTACHMENT10
FORM 990PF,

PART VII-B,

LINE SC-EXPENDITURE RESPONSIBILITY

STATEMENT

MARKET-BASED MANAGEMENTINSTITUTE
GRANTEE'S NAME:
4111 E 37TH STREET N
GRANTEE'S ADDRESS:
WICHITA, KS 67220
CITY, STATE & ZIP:
GRANT DATE:
04/21/2011
GRANT AMOUNT:
185,000.
GRANT PURPOSE:
GENERAL OPERATING SUPPORT
AMOUNT EXPENDED:
185,000.
ANY DIVERSION?
NO
DATES OF REPORTS:
08/24/2012
FULL AND COMPLETE REPORT OF ALL EXPENDITURES
VERIFICATION DATE:
RESULTS OF VERIFICATION:
THE GRANTOR HAS NO REASON TO DOUBT THE ACCURACY OR RELIABILITY OF THE
REPORT FROM THE GRANTEE; THEREFORE, NO INDEPENDENT VERIFICATION OF
THE REPORTS WERE MADE.
GRANTEE'S NAME:
THE PHILLIPS FOUNDATION
GRANTEE'S ADDRESS:
ONE MASSACHUSSETS AVENUE, NW SUITE 620
CITY, STATE & ZIP:
WASHINGTON, DC 20001
GRANT DATE:
05/19/2011
GRANT AMOUNT:
30,000.
GRANT PURPOSE:
SUPPORT FELLOWSHIP PROGRAM
AMOUNT EXPENDED:
30,000.
ANY DIVERSION?
NO
DATES OF REPORTS:
12/28/2011
FULL REPORT OF ALL GRANT EXPENDITURES
VERIFICATION DATE:
RESULTS OF VERIFICATION:
THE GRANTOR HAS NO REASON TO DOUBT THE ACCURACY OR RELIABILITY OF THE
REPORT FROM THE GRANTEE; THEREFORE, NO INDEPENDENT VERIFICATION OF
THE REPORTS WERE MADE.

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PAGE 30

CHARLES KOCH FOUNDATION


FORM 990PF,

PART VIII

48-0918408

- LIST OF OFFICERS, DIRECTORS, AND TRUSTEES

TITLE AND AVERAGEHOURS PER


WEEKDEVOTEDTO POSITION

NAMEAND ADDRESS

ATTACHMENT11

COMPENSATION

CONTRIBUTIONS
TO EMPLOYEE
BENEFIT PLANS

EXPENSE ACCT
AND OTHER
ALLOWANCES

CHARLES CHASE KOCH


P.O. BOX 2256
WICHITA, KS 67201-2256

DIRECTOR
.25

ELIZABETH ROBINSON KOCH


P.O. BOX 2256
WICHITA, KS 6 72 0 1 - 2 2 5 6

DIRECTOR
.25

ELIZABETH B KOCH
P.O. BOX 2256
WICHITA, KS 6 72 0 1 - 2 2 5 6

DIRECTOR
.25

CHARLES G KOCH
P.O. BOX 2256
WICHITA, KS 67201-2256

DIRECTOR/ CHAIRMAN
.25

VONDAHOLLIMAN
P.O. BOX 2256
WICHITA, KS 67201-2256

TREASURER
1. 00

JOY RAUM
1515 N. COURTHOUSERD, SUITE 200
ARLINGTON, VA 22201

ASSISTANT SECRETARY
.25

16 7 3 3H K9 3 2

11 / 11 / 2 0 12

11 : 0 2 : 4 4 PM V 11 - 6 . 1

85646

ATTACHMENT11
PAGE 31

CHARLES KOCH FOUNDATION


FORM 990PF,

PART VIII

48-0918408

- LIST OF OFFICERS,

DIRECTORS, AND TRUSTEES

TITLE AND AVERAGE HOURS PER


WEEK DEVOTED TO POSITION

NAME AND ADDRESS

ATTACHMENT11

COMPENSATION

CONTRIBUTIONS
TO EMPLOYEE
BENEFIT PLANS

(CONT'D)

EXPENSE ACCT
AND OTHER
ALLOWANCES

BRIAN MENKES
1515 N. COURTHOUSERD, SUITE 200
ARLINGTON, VA 22201

SECRETARY
1. 00

KEVIN L GENTRY
1515 N. COURTHOUSERD, SUITE 200
ARLINGTON, VA 22201

VICE PRESIDENT
1. 00

RICHARD H FINK
1515 N. COURTHOUSE RD, SUITE 200
ARLINGTON, VA 22201

PRESIDENT/DIRECTOR
1. 00

GRAND TOTALS

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ATTACHMENT11
PAGE 32

CHARLES KOCH FOUNDATION

990PF,

PART VIII

48-0918408

- COMPENSATION OF THE FIVE HIGHEST PAID EMPLOYEES


ATTACHMENT 12 .
TITLE AND AVERAGE
HOURS PER WEEK
DEVOTED TO POSITION

NAME AND ADDRESS

COMPENSATION

CONTRIBUTIONS EXPENSE ACCT


TO EMPLOYEE AND OTHER
BENEFIT PLANS ALLOWANCES

LOGAN MOORE
1515 N. COURTHOUSE RD, STE 200
ARLINGTON, VA 22201

DIR OF OPERATIONS
40.00

135,000.

4,780.

1,200.

RYAN STOWERS
1515 N. COURTHOUSE RD, STE 200
ARLINGTON, VA 22201

PGM DIR HIGHER EDUC


40.00

185,000.

10,830.

1,440.

ARIANNE MASSEY
1515 N. COURTHOUSE RD, STE 200
ARLINGTON, VA 22201

PGM DIR TALENT/HR


40.00

130,000.

2,519.

1,200.

KRISTEN SHORT
1515 N. COURTHOUSE RD, STE 200
ARLINGTON, VA 22201

SR DEVELOP ASSOCIATE
40.00

DAN JORJANI
1515 N. COURTHOUSE RD, STE 200
ARLINGTON, VA 22201

PGM OFFICER RESEARCH


40.00
TOTAL COMPENSATION

16733H

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85646

89,866.

100,500.

640 366__.
I

1,440.

7,220.

1,200.

25.349.

6.480.

ATTACHMENT 12
PAGE 33

CHARLES KOCH FOUNDATION

48-0918408

ATTACHMENT13

FORM 990PF,

PART XV - NAME, ADDRESS AND PHONE FOR APPLICATIONS

CHARLES KOCH FOUNDATION


1515 N. COURTHOUSE ROAD, SUITE 200
ARLINGTON, VA 22201
703-875-1600

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PAGE 34

CHARLES KOCH FOUNDATION

48-0918408

ATTACHMENT 14

990PF,

PART XV - FORM AND CONTENTS OF SUBMITTED APPLICATIONS

ORGANIZATIONS SEEKING GRANTS FROM THE FOUNDATION AND WHICH MEET THE
CRITERIA LISTED IN ATTACHMENT 15 SHOULD SUBMIT A SHORT LETTER (NO MORE
THAN THREE PAGES) OUTLINING THEIR REQUEST. THE LETTER SHOULD CLEARLY
AND SUCCINCTLY STATE:
1. PROSPECTIVE GRANTEE'S MISSION AND GOALS;
2. SPECIFIC PROJECT FOR WHICH SUPPORT IS BEING SOUGHT;
3. AMOUNT OF FUNDING REQUESTED;
4. NAME, TITLE, ADDRESS, TELEPHONE NUMBER, AND EMAIL ADDRESS OF THE
PRIMARY CONTACT PERSON; AND,
5. CURRENT ANNUAL BUDGET OR AUDITED FINANCIAL STATEMENTS
IF APPLICABLE, PLEASE ALSO INCLUDE A LIST OF OTHER SUPPORT
(E.G.,
FUNDING, IN-KIND CONTRIBUTIONS) SECURED FOR THE PROJECT.
BECAUSE THE FOUNDATION GENERALLY ONLY SUPPORTS SECTION 501(C) (3)
PUBLIC CHARITIES, IT ALSO REQUIRES THAT YOU SUBMIT VERIFICATION FROM
THE IRS THAT YOUR ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX AS A
SECTION 501(C) (3) ORGANIZATION AND IS CLASSIFIED AS A PUBLIC CHARITY
UNDER SECTION 509(A) OF THE INTERNAL REVENUE CODE. THE FOUNDATION
KINDLY REQUESTS THAT NO MATERIALS BEYOND WHAT ARE DESCRIBED ABOVE BE
INCLUDED.

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CHARLES KOCH FOUNDATION

48-0918408

ATTACHMENT15

990PF,

PART XV - RESTRICTIONS

OR LIMITATIONS ON AWARDS

THE FOUNDATION PRIMARILY SUPPORTS RESEARCH AND EDUCATION PROGRAMSTHAT


ANALYZE THE IMPACT OF FREE SOCIETIES,
IN PARTICULAR HOW THEY ADVANCE
THE WELL-BEING OF MANKIND. BUILDING ON THIS KNOWLEDGE, THE CHARLES
KOCH FOUNDATION FOSTERS THE PARTNERSHIP OF SCIENTISTS AND
PRACTITIONERS IN ORDER TO INTEGRATE THEORY AND PRACTICE.
BY DOING SO,
THE FOUNDATION STRIVES TO DEVELOP MARKET-BASED TOOLS THAT ENABLE
INDIVIDUALS, INSTITUTIONS AND SOCIETIES TO PROSPER. THE CHARLES KOCH
FOUNDATION FOCUSES ON A SELECT NUMBER OF PROGRAMSWHERE IT BELIEVES IT
IS BEST POSITIONED TO SUPPORT POSITIVE SOCIAL CHANGE. THE FOUNDATION
ENCOURAGES ORGANIZATIONS SEEKING SUPPORT TO FIRST FAMILIARIZE
THEMSELVES WITH THOSE DOMAINS BY EXAMINING THE FOUNDATION'S AREAS OF
INTEREST.
IN ADDITION, THE FOUNDATION PLACES SEVERAL LIMITATIONS ON
THE REQUESTS IT CONSIDERS.
1. THE FOUNDATION PRIMARILY MAKES GRANTS TO SECTION 50l(C) (3) PUBLIC
CHARITIES. THE CHARLES KOCH FOUNDATION DOES NOT SUPPORT FOR-PROFIT
CORPORATIONS OR INDIVIDUALS.
2. THE FOUNDATION DISCOURAGES GRANT PROPOSALS FOR CAPITAL
CONSTRUCTION, DEBT REDUCTION, OR GENERAL FUNDRAISING DRIVES OR
EVENTS. THE FOUNDATION DOES NOT MAKE GRANTS TO SUPPORT LOBBYING
ACTIVITIES OR CANDIDATES FOR PUBLIC OFFICE. THE FOUNDATION RARELY
FUNDS ENDOWMENTS.

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CHARLES KOCH FOUNDATION

FORM 990PP

48-0918408

PART XV - GRANTS AND CONTRTBTTTTONS PAID OTTRINGTHE YEAR


AT.TACl!MENT___

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND

RECIPIENT

NAME AND ADDRESS

PURPOSE OF GRANT OR CONTRIBUTION

FOUNDATION STATUS OF RECIPIENT

BILL OF RIGHTS INSTITUTE

NONE

200 N GLEBE ROAD

PUBLIC

AMOUNT

EDUCATIONAL PROGRAMS

350,000

EDUCATIONAL PROGRAMS

250,000

EDUCATIONAL PROGRAMS

250,000.

EDUCATIONAL PROGRAMS

250,000

EDUCATIONAL PROGRAMS

101,000

EDUCATIONAL PROGRAMS

240,000.

SUITE 200
ARLINGTON, VA 22203

CLEMSON UNIVERSITY

NONE

DEPARTMENT OF ECONOMICS

PUBLIC

201 SIKES

HALL - BOX 345123

CLEMSON, SC 29634-1301

FLORIDA STATE UNIVERSITY

NONE

FOUNDATION

113 COLLEGIATE LOOP

PUBLIC

PO BOX 3062160
TALLAHASSEE, FL 32306-2160

NONE

JACK MILLER CENTER


111 PRESIDENTIAL
PHILADELPHIA,

BLVD.,

PUBLIC

#146

PA 19004

SOUTHERN METHODIST UNIVERSITY

NONE

PO BOX 750333

PUBLIC

SUITE

901

DALLAS, TX 75275-0333

TROY UNIVERSITY FOUNDATION

NONE

211 WRIGHT HALL

PUBLIC

TROY, AL 36082

ATTACHMENT 16
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CHARLES KOCH FOUNDATION

FORM 990PF

PART

XV -

48-0918408

GRANTS

AND CONTRTBTITIONS

PAID

DIIRING

THE YEAR

ATTACHMENT

l 6

(CONT I D}

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

NAME AND ADDRESS

FOUNDATION STATUS OF RECIPIENT

UNIVERSITY OF ARIZONA FOUNDATION

NONE

1111

PUBLIC

NORTH CHERRY AVENUE

PURPOSE OF GRANT OR CONTRIBUTION

AMOUNT

EDUCATIONAL PROGRAMS

200,000

EDUCATIONAL PROGRAMS

125,000

EDUCATIONAL PROGRAMS

200,000

EDUCATIONAL PROGRAMS

35,000

TUCSON, AZ 85721

UTAH STATE UNIVERSITY


1420

NONE

FOUNDATION

OLD MAIN HILL

PUBLIC

PO BOX 210109
LOGAN, UT 84322-1420

WEST VIRGINIA

UNIVERSITY

NONE

FOUNDATION

1 WATERFRONT PLACE 7TH FLOOR

PUBLIC

MORGANTOWN,WV 26507-1650

SALVATION ARMY

NONE

615 SLATERS LANE

PUBLIC

PO BOX 1650
ALEXANDRIA, VA 22313

THE PHILLIPS

FOUNDATION

ONE MASSACHUSETTS AVE.,

NONE

NW

EDUCATIONAL PROGRAMS

4,600.

EDUCATIONAL PROGRAMS

5,000.

PRIVATE

WASHINGTON, DC 20001

YMCA OF WICHITA KANSAS

NONE

3330

PUBLIC

WOODLAWN

SUITE 620
WICHITA,

KS 67220-2202

ATTACHME!JT 16
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Pl,GE 38

48-0918408

CHARLES KOCH FOUNDATION

EORM._______9_9QPF
PART XV - GRANTS AND CONTRIBUTIONS

PAID DTTRTNGTHE YEAR

ATTA.CH.MENT
16 (tONT'D)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND

GEORGEMASONUNIVERSITY FOUNDATION

NONE

4400 UNIVERSITY DRIVE

PUBLIC

AMOUNT

PURPOSE OF GRANT OR CONTRIBUTION

FOUNDATIONSTATUS OF RECIPIENT

RECIPIENT NAMEAND ADDRESS

EDUCATIONALPROGRAMS

4,157,548

EDUCATIONALPROGRAMS

3,671,

FAIRFAX, VA 22030

INSTITUTE FOR HUMANESTUDIES

NONE

3301 N FAIRFAX DR

PUBLIC

500

ARLINGTON, VA 22201

ACADEMYON CAPITALISM AND LIMITED GOV FON

NONE

528 E GREEN ST,

PUBLIC

SUITE 202

EDUCATIONALPROGRAMS

80,000.

EDUCATIONALPROGRAMS

123,765

SUITE 440
CHAMPAIGN, IL 61820

FLORIDA STATE UNIVERSITY

NONE

211 WESTCOTTBUILDING

PUBLIC

TALLAHASSEE, FL 32306-1470

GEORGE WASHINGTONUNIVERSITY

NONE

805 21ST STREET NW

PUBLIC

RESEARCH

4,500

WASHINGTON,DC 20052

NEW YORK UNIVERSITY

NONE

19 W 4TH STREET

PUBLIC

EDUCATIONALPROGRAMS

35,500.

SUITE 612
NEW YORK, NY 10012

ATTACHMENT16
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PAGE 39

48-0918408

CHARLES KOCH FOlJNDATION

FORM 990PF

PnRT XV - GRANTS AND CONTRTBTTTTONS PAID DTTRING THE YEAR

ATTACHMENT
16 (CONT'D)
RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR
AND
RECIPIENT

FOlJNDATION STATUS OF RECIPIENT

NAME AND ADDRESS

SUFFOLK UNIVERSITY

NONE

8 ASHBURTON PLACE

PUBLIC

PURPOSE OF GRANT OR CONTRIBUTION

AMOUNT

EDUCATIONAL PROGRAMS

91,692

EDUCATIONAL PROGRAMS

100,000.

EDUCATIONAL PROGRAMS

72,100

EDUCATIONAL PROGRAMS

185,000.

SUITE 200
BOSTON, MS 02108-2770

UNIVERSITY OF NORTH CAROLINA - CHAPEL HILL

NONE

103 SOUTH BUILDING,

PUBLIC

CHAPEL HILL,

WEST VIRGINIA

CB 9100

NC 27599

UNIVERSITY

NONE

FOlJNDATION

PUBLIC

1 WATERFRONT PLACE 7TH FLOOR


MORGANTOWN,WV 26507-1650

MARKET-BASED MANAGEMENTINSTITUTE

NONE

4111

PRIVATE

EAST 37TH STREET NORTH

PO BOX 1650
WICHITA,

KS 67226

AMERICAN COUNCIL OF TRUSTEES AND ALUMNI

NONE

1 726 M STREET NW

PUBLIC

GENERAL OPERATING SUPPORT

25,000.

GENERAL OPERATING SUPPORT

50,000.

WASHINGTON, DC 20036-4525

DONORS TRUST

NONE

109 NORTH HENRY ST

PUBLIC

SUITE 802
ALEXANDRIA, VA 22314

ATTACHMENT 16
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PAGE 40

48-0918408

CHARLES KOCH FOUNDATION

FORM 990PF

DART

XV

GRANTS

AND CONTPJBIJTIONS

PAID

DIIRING THE

YEP.R

ATTACHMENT16

(CONT'D)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

FOUNDATION FOR INDIVIDUAL RIGHTS IN EDUCATION

NONE

601 WALNUT STREET

PUBLIC

PHILADELPHIA,

SUITE

AMOUNT

GENERAL OPERATING SUPPORT

75,000.

GENERAL OPERATING SUPPORT

25,000

PA 19106

PHILANTHROPY ROUNDTABLE
1150

PURPOSE OF GRANT OR CONTRIBUTION

FOUNDATION STATUS OF RECIPIENT

NAME AND ADDRESS

NONE

- 17TH ST NW

PUBLIC

510

WASHINGTON, DC 20036

GEORGIA PUBLIC POLICY FOUNDATION

NONE

6100

PUBLIC

SUITE

LAKE FORREST DR

RESEARCH

l,750

RESEARCH

2,000.

503

ATLANTA, GA 30328

PACIFIC

RESEARCH INSTITUTE

NONE

ONE EMBARCADEROCENTER
SUITE

PUBLIC

110

SAN FRANCISCO,

CA 94111

UTAH STATE UNIVERSITY

NONE

1400

PUBLIC

SUITE

OLD MAIN HILL

RESEARCH

35,000

EDUCATIONAL PROGRAMS

50,000

350

LOGAN, UT 84322-1400

ACTON INSTITUTE

NONE

161 OTTAWA AVENUE NW

PUBLIC

GRAND RAPIDS,

MI 49503-2718

ATTACHME~'T 16
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PAGE 41

48-0918408

CHARLES KOCH FOUNDATION

FORM 990PF

PART

XV -

GPP.NTS

AND CONTPIBIITIONS

PAID

DIJRING

THE YEAR

~JENT

16

(CONT'D)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

PURPOSE OF GRANT OR CONTRIBUTION

FOUNDATION STATUS OF RECIPIENT

NAME AND ADDRESS

HEARTLAND INSTITUTE

NONE

19 S

PUBLIC

LASALLE

AMOUNT

25,000.

RESEARCH

SUITE 301
CHICAGO, IL 60603

GEORGE MASON UNIVERSITY


4400

NONE

FOUNDATION

FAIRFAX,

250,000.

EDUCATIONAL PROGRAMS

30,000

EDUCATIONAL PROGRAMS

5,583

VA 22030

TEXAS PUBLIC POLICY FOUNDATION

NONE

900 CONGRESS AVE

PUBLIC

AUSTIN,

EDUCATIONAL PROGRAMS

PUBLIC

UNIVERSITY DRIVE

TX 78701

NONE

COMMONWEALTH
FOUNDATION
225 STATE STREET,

SUITE

PUBLIC

302

STUITE 400
HARRISBURG, PA 17101

AMERICAN ENTERPRISE
1150

200,000

GENERAL OPERATING SUPPORT

NONE

INSTITUTE

SEVENTEENTH ST

PUBLIC

NW

WASHINGTON, DC 20036

BERNARD CENTER

NONE

10120

PUBLIC

CHAPEL ROAD

25,000.

GENERAL OPERATING SUPPORT

POTOMAC, MD 20854

ATTACHMENT 16
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PAGE 42

48-0918408

CHARLES KOCH FOUNDATION

FORM 990PF

PART XV - GRANTS AND CONTRIBTJTIONS PAID DTJRING THE YEAR


rmcH.t!IBNT

J6

(CONT I D}

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

FOUNDATION STATUS OF RECIPIENT

NAME AND ADDRESS

NONE

CAPITAL RESEARCH CENTER


l6TH STREET NW

1513

PURPOSE OF GRANT OR CONTRIBUTION

AMOUNT

GENERAL OPERATING SUPPORT

10,000.

EDUCATIONAL PROGRAMS

25,000

EDUCATIONAL PROGRAMS

10,000.

PUBLIC

WASHINGTON, DC 20036-1480

THE PHILLIPS

NONE

FOUNDATION

ONE MASSACHUSETTS AVE

PRIVATE

NW

WASHINGTON, DC 20001

AMERICAN SPECTATOR FOUNDATION

NONE

1611

PUBLIC

N. KENT ST

SUITE

620

ARLINGTON, VA 22209

AMERICA'S

SUITE

EDUCATIONAL PROGRAMS

NONE

FUTURE FOUNDATION

L STREET NW

1899

700

PUBLIC

901

WASHINGTON, DC 20036

BLUEGRASS INSTITUTE
400

SUITE

NONE

FOR PUBLIC POLICY SOLUTIONS

EDUCATIONAL PROGRAMS

5,200

EDUCATIONAL PROGRAMS

25,000

PUBLIC

MAIN STREET
1200

BOWLING GREEN, KY 42102

DONORS TRUST

NONE

109 NORTH HENRY ST

PUBLIC

SUITE 306
ALEXANDRIA, VA 22314

ATTACHMENT 16
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PAGE 43

CHARLES KOCH FOUNDATION

FORM 990PF

48-0918408

PP.RT XV - GRANTS

AND CONTRIBTCTTONS PAID

OTJRING THE YEAR


~

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

NAME AND ADDRESS

FOUNDATION STATUS OF RECIPIENT

LIBERTY ON THE ROCKS

NONE

13952

PUBLIC

DENVER WEST PKWY

PURPOSE OF GRANT OR CONTRIBUTION

AMOUNT

EDUCATIONAL PROGRAMS

300.

SUITE 510
GOLDEN, CO 80401

NETWORKOF ENLIGHTENED WOMEN


6501

NONE

GENERAL OPERATING SUPPORT

3,000

GENERAL OPERATING SUPPORT

25,000.

GENERAL OPERATING SUPPORT

15,000.

PUBLIC

DEAN ROAD

STE 400
INDIANAPOLIS,

IN 46220

STUDENTS FOR LIBERTY

NONE

PO BOX 17321

PUBLIC

ARLINGTON, VA 22216

THE FUND FOR AMERICAN STUDIES


1706

NEW HAMPSHIRE AVE,

NONE

NW

PUBLIC

WASHINGTON, DC 20009

ALEXANDER HAMILTON INSTITUTE

NONE

21 WEST PARK

PUBLIC

CLINTON,

EDUCATIONAL PROGRAMS

9,000.

EDUCATIONAL PROGRAMS

8,000

NY 13323

ALMA COLLEGE

NONE

614 W SUPERIOR ST

PUBLIC

ALMA, MI 48801

ATTACHMENT 16
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PAGE 44

48-0918408

CHARLES KOCH FOUNDATION

FORM 990PF

PART

XV

GRANTS

AND CONTPIBTITTONS

PAID

DURING

THE YEAR

16
ATTACHMENT

(CONTD)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

NAME AND ADDRESS

FOUNDATION STATUS OF RECIPIENT

ARKANSAS TECH UNIVERSITY

NONE

1509

PUBLIC

NORTH BOULDER AVE

RUSSELLVILLE,,

AK 72801

AZUSA PACIFIC

UNIVERSITY

PURPOSE OF GRANT OR CONTRIBUTION

NONE

AMOUNT

EDUCATIONAL PROGRAMS

12,500

EDUCATIONAL PROGRAMS

23,500

EDUCATIONAL PROGRAMS

5,000

EDUCATIONAL PROGRAMS

32,000.

EDUCATIONAL PROGRAMS

15,000

PUBLIC

901 E. ALOSTA AVE.


AZUSA, CA 91702-7000

BARTON COLLEGE

NONE

PO BOX 5000

PUBLIC

WILSON, NC 27893

BELOIT COLLEGE

NONE

700 COLLEGE STREET

PUBLIC

BELOIT,

WI 53511

BERRY COLLEGE

NONE

PO BOX 495024

PUBLIC

MOUNT BERRY, GA 30149-5024

BETHEL COLLEGE

NONE

1001

PUBLIC

BETHEL CIRCLE

EDUCATIONAL PROGRAMS

9,600.

#3010
MISHAWAKA, IN 46545

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PAGE 45

48-0918408

CHARLES KOCH FOtJNDATION

FORM 990PF

PART XV - GRANTS AND CONTPTBTTTTONS PAID DUPING THE YEa.P


rmc.H..t!IENT

l 6

(CONT D)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

FOUNDATION STATUS OF RECIPIENT

NAME AND ADDRESS

BOISE STATE UNIVERSITY FOtJNDATION

NONE

2225

PUBLIC

UNIVERSITY DRIVE

BOISE,

ID

PURPOSE OF GRANT OR CONTRIBUTION

AMOUNT

EDUCATIONAL PROGRAMS

7,470

EDUCATIONAL PROGRAMS

37,500

83706

BROWN UNIVERSITY

NONE

71 GEORGE ST

PUBLIC

PROVIDENCE, RI 02912-1000

BUENA VISTA UNIVERSITY

NONE

610 W

PUBLIC

FOURTH STREET

EDUCATIONAL PROGRAMS

1,000.

EDUCATIONAL PROGRAMS

7,000.

STORM LAKE, IA 50588

CALIFORNIA STATE UNIVERSITY EAST BAY FOUNDATION

NONE

25976

PUBLIC

CARLOS BEE BLVD

HAYWARD, CA 94542

CAMPBELL UNIVERSITY

NONE

PO BOX 218

PUBLIC

EDUCATIONAL PROGRAMS

16,093

EDUCATIONAL PROGRAMS

5,850

BUIES CREEK, NC 27506

CARNEGIE MELLON UNIVERSITY

NONE

5000

PUBLIC

FORBES AVENUE

SUITE 440
PITTSBURGH,

PA 15213-3890

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PAGE 46

48-0918408

CHARLES KOCH FOUNDATION

FORM 990PF

PART X\I - GRANTS AND CONTRIBUTIONS

PAID DURING THE YEAR


~

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

PURPOSE OF GRANT OR CONTRIBUTION

FOUNDATION STATUS OF RECIPIENT

NAME AND ADDRESS

CARTHAGE COLLEGE

NONE

2001

PUBLIC

ALFORD PARK DRIVE

AMOUNT

EDUCATIONAL PROGRAMS

6,500.

#146
KENOSHA, WI 53140

NONE

CHAPMANUNIVERSITY
l

EDUCATIONAL PROGRAMS

24,000

EDUCATIONAL PROGRAMS

10,000

PUBLIC

UNIVERSITY DRIVE

ORANGE, CA 92866

CHARLESTON SOUTHERN UNIVERSITY

NONE

9200

PUBLIC

UNIVERSITY BOULEVARD

CHARLESTON, SC 29406

CHRISTENDOM COLLEGE

NONE

134 CHRISTENDOM DR

PUBLIC

EDUCATIONAL PROGRAMS

5,100.

EDUCATIONAL PROGRAMS

8,000

EDUCATIONAL PROGRAMS

14,000

FRONT ROYAL, VA 22630

NONE

CHRISTOPHER NEWPORT UNIVERSITY


l

PUBLIC

AVENUE OF THE ARTS

NEWPORT NEWS, VA 23606-2998

CLAREMONT MCKENNACOLLEGE

NONE

500 E

PUBLIC

9TH ST.

CLAREMONT, CA 91711-6400

ATTACHMEl-.'T16
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PAGE 47

48-0918408

CHARLES KOCH FOUNDATION

FORM 990PF

DART XV -

GRANTS

AND CONTRIBIITIONS

PAID

DIJRING

THE YEAR

.AT.T.A.Clil1ENTJ 6

(CONT D)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
PURPOSE OF GRANT OR CONTRIBUTION

FOUNDATIONSTATUS OF RECIPIENT

RECIPIENT NAMEAND ADDRESS

COASTAL CAROLINA UNIVERSITY

NONE

119 CHANTICLEER DRIVE, EAST

PUBLIC

AMOUNT

EDUCATIONALPROGRAMS

15,000.

RETURN OF UNUSEDGRANT FUNDS

-1,041.

EDUCATIONALPROGRAMS

36, 731

EDUCATIONALPROGRAMS

7,500

EDUCATIONALPROGRAMS

15,000.

EDUCATIONALPROGRAMS

8,172

CONWAY,SC 29526

COLGATEUNIVERSITY

NONE

13 OAK DRIVE

PUBLIC

WALL 213
HAMILTON, NY 13346

COLLEGE OF CHARLESTONFOUNDATION

NONE

66 GEORGE STREET

PUBLIC

301 JAMES B COLGATEHALL


CHARLESTON, SC 29424

COLLEGE OF WILLIAM AND MARY

NONE

PO BOX 8795

PUBLIC

WILLIAMSBURG, VA 23187

DARTMOUTH
COLLEGE

NONE

DEPARTMENTOF ECONOMICS

PUBLIC

HANOVER, NH 03755

DELAWARESTATE UNIVERSITY

NONE

1200 NORTH DUPONT HIGHWAY

PUBLIC

6106 ROCKEFELLERHALL
DOVER, DE 19901-2277

ATTACHMENT16
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PAGE 48

48-0918408

CHARLES KOCH FOUNDATION

PP.RT XV - GRANTS llND CONTRIBUTIONS

FORM 990PF

PP.ID DURING THE YEAR


Al:T.A.CHl!IENT

J6

('CONT 1 0)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

PURPOSE OF GRANT OR CONTRIBUTION

FOUNDATION STATUS OF RECIPIENT

NAME AND ADDRESS

DELTA STATE UNIVERSITY

NONE

1003 W SUNFLOWER ROAD

PUBLIC

AMOUNT

EDUCATIONAL PROGRAMS

8,000

EDUCATIONAL PROGRAMS

16,281.

EDUCATIONAL PROGRAMS

25,000

EDUCATIONAL PROGRAMS

7,000

EDUCATIONAL PROGRAMS

26,000.

EDUCATIONAL PROGRAMS

10, 892

SUITE 900
CLEVELAND, MS 38733

DUKE UNIVERSITY

NONE

81 BEVERLY DRIVE

PUBLIC

DURHAM, NC 27707

DUQUESNE UNIVERSITY

NONE

600

PUBLIC

FORBES AVENUE

PITTSBURGH,

PA 15282

FAYETTEVILLE STATE UNIVERSITY

NONE

1200 MURCHISON RD.,

PUBLIC

FAYETTEVILLE,

SBE SUITE 230

NC 28301-4298

NONE

FLORIDA GULF COAST UNIVERSITY


10501

PUBLIC

FGCU BOULEVARD, SOUTH

FORT MYERS, FL 33965

NONE

GEORGE FOX UNIVERSITY


414 N

PUBLIC

MERIDIAN STREET

NEWBERG, OR 97132

ATTACHME~'T 16
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PAGE 49

48-0918408

CHARLES KOCH FOUNDATION

FORM 990PF

PART X\1

GRANTS P.ND CONTRIB[TTIONS

PP,ID DTTPING THE YEAR


~!ENT

16

(CONT'D)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND

RECIPIENT

FOUNDATION STATUS OF RECIPIENT

NAME AND ADDRESS

GEORGE WASHINGTON UNIVERSITY

NONE

805 21ST STREET NW

PUBLIC

PURPOSE OF GRANT OR CONTRIBUTION

AMOUNT

EDUCATIONAL PROGRAMS

86,120

EDUCATIONAL PROGRAMS

14,000

EDUCATIONAL PROGRAMS

8,830

EDUCATIONAL PROGRAMS

6,000.

WASHINGTON, DC 20052

GEORGETOWNUNIVERSITY

NONE

37TH ANDO STREET NW

PUBLIC

SUITE 612
WASHINGTON, DC 20057

GEORGIA COLLEGE & STATE UNIVERSITY

NONE

231 W HANCOCKST

PUBLIC

MILLEDGEVILLE,

GA 31061

GEORGIA STATE UNIVERSITY FOUNDATION

NONE

ONE PARK PLACE SOUTH

PUBLIC

CAMPUS BOX 20
ATLANTA, GA 30302

GEORGIA TECH RESEARCH CORPORATION

NONE

PO BOX 100117

PUBLIC

EDUCATIONAL PROGRAMS

15,000

EDUCATIONAL PROGRAMS

38,100.

SUITE 549
ATLANTA, GA 30384

GROVE CITY COLLEGE

NONE

100 CAMPUS DRIVE #3010

PUBLIC

GROVE CITY,

PA 16127

ATTACHMENT 16
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PAGE 50

48-0918408

CHARLES KOCH FOUNDATION

FORM 990PF

PART XV - GRANTS AND CONTRIBUTIONS

PAID DURING THE YF?tiP


A'.r:I:A.CHNENT J 6

f CONT' 0)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

PURPOSE OF GRANT OR CONTRIBUTION

FOUNDATION STATUS OF RECIPIENT

NAME AND ADDRESS

HAMPDEN-SYDNEY COLLEGE

NONE

CENTER FOR THE STUDY OF POLITICAL

PUBLIC

ECONOMY

AMOUNT

EDUCATIONAL PROGRAMS

35,000

HAMPDEN SYDNEY, VA 23943

HANOVER COLLEGE

NONE

484

PUBLIC

BALL DRIVE

5,000.

EDUCATIONAL PROGRAMS

1 COLLEGE ROAD
HANOVER, IN 47243

HILLSDALE COLLEGE

NONE

33 E

PUBLIC

COLLEGE STREET

HILLSDALE,

EDUCATIONAL PROGRAMS

23,423

EDUCATIONAL PROGRAMS

20,000

EDUCATIONAL PROGRAMS

19,000.

EDUCATIONAL PROGRAMS

9,000

MI 49242

JAMES MADISON INSTITUTE

NONE

PO BOX 37460

PUBLIC

TALLAHASSEE, FL 32315

JAMES MADISON UNIVERSITY

NONE

800 S

PUBLIC

MAIN ST

HARRISONBURG, VA 22807

JOHNS HOPKINS UNIVERSITY

NONE

100

PUBLIC

INTERNATIONAL DRIVE

BALTIMORE,

MD

21202

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48-0918408

CHARLES KOCH FOUNDATION

PART XU - GRANTS AND CONTRTBIITTONSPAID OIIRTNGTHE YEAR

FORM 990PF

AllACHHBNT

16

(CONT

D)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

NAME AND ADDRESS

LA SIERRA UNIVERSITY

NONE

4500

PUBLIC

RIVERWALK PKWY

RIVERSIDE,

AMOUNT

EDUCATIONAL PROGRAMS

10,000.

EDUCATIONAL PROGRAMS

7,500

EDUCATIONAL PROGRAMS

11,500

EDUCATIONAL PROGRAMS

25,000

EDUCATIONAL PROGRAMS

25,000

CA 92515

LAKE FOREST COLLEGE

NONE

555 N

PUBLIC

SHERIDAN ROAD

LAKE FOREST,

LINFIELD

PURPOSE OF GRANT OR CONTRIBUTION

FOUNDATION STATUS OF RECIPIENT

IL 60045

NONE

COLLEGE

PUBLIC

900 SE BAKER ST
MCMINNVILLE, OR 97128-6894

LOYOLA UNIVERSITY NEW ORLEANS

NONE

6363

PUBLIC

ST,

CHARLES AVENUE

NEW ORLEANS, LA 70118

MASSACHUSETTS INSTITUTE

NONE

OF TECHNOLOGY

PUBLIC

77 MASSACHUSETTS AVE
CAMBRIDGE, MS 02139

MASSACHUSETTS INSTITUTE

EDUCATIONAL PROGRAMS

NONE

OF TECHNOLOGY

-4 92.

PUBLIC

77 MASSACHUSETTS AVE
CAMBRIDGE, MS 02139

ATTACHMENT 16
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48-0918408

CHARLES KOCH FOUNDATION

FORM 990PF

PART

X\1

GRAbITS P.ND CONTRIBrtTIONS PAID DTTRINGTHE YEAR

AT.TA.C.lil?IENTl 6

(CONT' 0)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

MCKENDREE UNVIERSITY

NONE

701 COLLEGE ROAD

PUBLIC

SUITE

PURPOSE OF GRANT OR CONTRIBUTION

FOUNDATION STATUS OF RECIPIENT

NAME AND ADDRESS

AMOUNT

EDUCATIONAL PROGRAMS

7,000

EDUCATIONAL PROGRAMS

4,500

EDUCATIONAL PROGRAMS

15,500.

EDUCATIONAL PROGRAMS

15,000.

EDUCATIONAL PROGRAMS

8,000.

EDUCATIONAL PROGRAMS

4,000

503

LEBANON, IL 62254

MCNEESE STATE UNIVERSITY

NONE

PO BOX 90780

PUBLIC

SUITE

620

LAKE CHARLES, LA 70609-0780

METROPOLITAN STATE COLLEGE DENVER FOUNDATION

NONE

1512

PUBLIC

LARIHER STREET,

SUITE

900

DENVER, CO 80217-8424

MICHIGAN STATE UNIVERSITY

NONE

304 SOUTH CASE HALL

PUBLIC

CAMPUS BOX 14
EAST LANSING, MI 48825

MIDDLE TENNESSEE STATE UNIVERSITY

FOUNDATION

NONE
PUBLIC

WOOD-STEGALL CENTER
MURFREESBORO, TN 37132

MIDWESTERN STATE UNIVERSITY


3410

NONE

FOUNDATION

PUBLIC

TAFT BLVD

BOX 109
WICHITA FALLS,

TX 76308

ATTACHMENT 16
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48-0918408

CHARLES KOCH FOUNDATION

FORM 990PF

PART

Y\I

GRANTS

AND CONTRTBIITTONS

PAID

DURING

THE

YEAR

~JENT

16

(CONT'D)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

PURPOSE OF GRANT OR CONTRIBUTION

FOUNDATION STATUS OF RECIPIENT

NAME AND ADDRESS

MILLIGAN COLLEGE

NONE

PO BOX 500

PUBLIC

AMOUNT

EDUCATIONAL PROGRAMS

5,800

EDUCATIONAL PROGRAMS

-2,729.

EDUCATIONAL PROGRAMS

10,000.

EDUCATIONAL PROGRAMS

4,200.

EDUCATIONAL PROGRAMS

9,000.

MILLIGAN COLLEGE, TN 37682

MONTCLAIR STATE UNIVERSITY


l

NONE

FOUNDATION

PUBLIC

NORMAL AVENUE

MONTCLAIR, NJ 07043

NATIONAL UNIVERSITY

NONE

11255

PUBLIC

NORTH TORREY PINES RD

LA JOLLA,

CA 92037

NICHOLLS STATE UNIVERSITY

NONE

PICCIOLA

PUBLIC

HALL

THIBODAUX, LA 70310

NORTH CAROLINA STATE UNIVERSITY

NONE

A HOLLADAY HALL

PUBLIC

PO BOX 2001
RALEIGH,

NC 27695-7001

NORTHWESTERN UNIVERSITY

NONE

375

PUBLIC

CHICAGO AVE

EDUCATIONAL PROGRAMS

750.

CAMPUS BOX 7001


CHICAGO, IL 60611

ATTACHMENT 16
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CHARLES KOCH FOUNDATION

48-0918408

PART XV - GRANTS AND CONTRTBDTIONS PATO DURING THE YEAR

FORM 99QPF

Am.Cfil1ENT

J6

(CONT D)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

NORTHWOODUNIVERSITY
4000

PURPOSE OF GRANT OR CONTRIBUTION

FOUNDATION STATUS OF RECIPIENT

NAME AND ADDRESS

NONE

- FLORIDA

WHITING DRIVE

AMOUNT

EDUCATIONAL PROGRAMS

6,000

EDUCATIONAL PROGRAMS

14,000.

EDUCATIONAL PROGRAMS

36, 4 00

EDUCATIONAL PROGRAMS

8,000

EDUCATIONAL PROGRAMS

14,500

PUBLIC

MIDLAND, MI 48640

OHIO UNIVERSITY FOUNDATION

NONE

P 0.

PUBLIC

BOX 869

ATHENS, OH 45701

OKLAHOMASTATE UNIVERSITY
400 S

FOUNDATION

NONE

MONROE ST

STILLWATER,

PUBLIC

OK 74074

PATRICK HENRY COLLEGE

NONE

10 PATRICK HENRY CIRCLE

PUBLIC

PURCELLVILLE,

VA 20132

PENNSYLVANIA STATE UNIVERSITY

- ERIE

NONE

BLACK SCHOOL OF BUSINESS


ERIE,

PUBLIC

PA 16563

PRESBYTERIAN COLLEGE

NONE

503 BROAD STREET

PUBLIC

5151

EDUCATIONAL PROGRAMS

2, 043

JORDAN ROAD

CLINTON,

SC 29325

ATTACHMENT 16
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48-0918408

CHARLES KOCH FOUNDATION

..EORlL.9..9.0PF PART X\I - GRANTS AND CONTRIBTTTIONSPAID DTJRINGTHE YEAR


Amefil1ENT

16

(CONT'D)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

PURPOSE OF GRANT OR CONTRIBUTION

FOUNDATION STATUS OF RECIPIENT

NAME AND ADDRESS

PROVIDENCE COLLEGE

NONE

1 CUNNINGHAMSQUARE

PUBLIC

AMOUNT

EDUCATIONAL PROGRAMS

8,400

EDUCATIONAL PROGRAMS

9,000.

PROVIDENCE, RI 02918

RANDOLPH-MACONCOLLEGE

NONE

PO BOX SOOS

PUBLIC

ASHLAND, VA 23005

REGENT UNIVERSITY

NONE

REGENT UNIVERSITY DRIVE

PUBLIC

EDUCATIONAL PROGRAMS

10,000

EDUCATIONAL PROGRAMS

15,000.

EDUCATIONAL PROGRAMS

5,500.

EDUCATIONAL PROGRAMS

11,700.

60 GARDEN STREET
VIRGINIA

BEACH, VA 23464-9800

RHODES COLLEGE

NONE

2000

PUBLIC

N. PARKWAY

ADM 142
MEMPHIS, TN 38112

ROBERT MORRIS UNIVERSITY

NONE

6001

PUBLIC

UNIVERSITY BOULEVARD

MOON TOWNSHIP, PA 15108-1189

ROCKFORD COLLEGE

NONE

SOSO EAST STATE STREET

PUBLIC

ROCKFORD, IL 61108

ATTACHMENT 16
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CHARLES KOCH FOUNDATION

FORM 990PF

48-0918408

PART XV - GRANTS AND CONTRIBUTIONS

PllID

DURING THE YEAR


A~1ENT

16

[CONT'D)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND

RECIPIENT

NAME AND ADDRESS

FOUNDATION STATUS OF RECIPIENT

ROOSEVELT UNIVERSITY

NONE

430 S

PUBLIC

MICHIGAN AVENUE

PURPOSE OF GRANT OR CONTRIBUTION

AMOUNT

EDUCATIONAL PROGRAMS

8,400

EDUCATIONAL PROGRAMS

15,000

CHICAGO, IL 60605

RYAN FOUNDATION

NONE

SOS BROWER ROAD

PUBLIC

WAYNE, PA 19087

SAGINAW VALLEY STATE UNIVERSITY

NONE

7400

PUBLIC

BAY RD,

BROWN 342

EDUCATIONAL PROGRAMS

3,650.

UNIVERSITY CENTER, MI 48710

SALISBURY UNIVERSITY

NONE

PO BOX 2655

PUBLIC

SALISBURY,

MD

EDUCATIONAL PROGRAMS

12,000

EDUCATIONAL PROGRAMS

5,500

EDUCATIONAL PROGRAMS

S,000

21802-2655

SAN DIEGO STATE UNIVERSITY RESEARCH FOUNDATION

NONE

5250

PUBLIC

CAMPANILE DRIVE

SAN DIEGO, CA 92182

SARAH LAWRENCECOLLEGE

NONE

l MEAD WAY

PUBLIC

BRONXVILLE, NY 10708

ATTACHMENT 16
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48-0918408

CHARLES KOCH FOUNDATION

mRM______9_9QPF
PART XV~

GRrt.NTS AND CONTRIBUTIONS PAID DIJPTNG THE YEAR


ATl:A.Cl::U!1ENT
J6

(CONT I D)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
PURPOSE OF GRANT OR CONTRIBUTION

FOUNDATIONSTATUS OF RECIPIENT

RECIPIENT NAMEAND ADDRESS

SETON HALL UNIVERSITY

NONE

400 SOUTH ORANGEAVENUE

PUBLIC

AMOUNT

EDUCATIONALPROGRAMS

10,780

EDUCATIONALPROGRAMS

4,200

EDUCATIONALPROGRAMS

7,500.

EDUCATIONALPROGRAMS

17,000.

EDUCATIONALPROGRAMS

9,200.

EDUCATIONALPROGRAMS

5,400

SOUTH ORANGE, NJ 07079

SKIDMORE COLLEGE

NONE

815 NORTH BROADWAY

PUBLIC

SARATOGASPRINGS, NY 12866

SOUTHEAST IDAHO RESEARCH INSTITUTE

NONE

310 N. 2ND EAST

PUBLIC

REXBURG, ID 83440

SOUTHERNILLINOIS UNIVERSITY - CARBONDALE

NONE

WOODYHALL 8-204,

PUBLIC

MC 4703

SUITE 113
CARBONDALE,IL 62901-4703

SOUTHERNUTAH UNIVERSITY

NONE

351 WEST UNIVERSITY BOULEVARD

PUBLIC

SUITE 1500
CEDAR CITY, UT 84720

ST

NONE

AMBROSEUNIVERSITY

PUBLIC

518 W LOCUST STREET


DAVENPORT, IA 52803

ATTACHMENT16
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Pl'.GE 58

CHARLES KOCH FOUNDATION

FORM 990PF

48-0918408

PART XV - GRPrNTS AND CONTRIBIITIONS

PAID OIIRTNG THE YEn,R


A:CTACHMENT 1 6

(CONT I D)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
FOUNDATION STATUS OF RECIPIENT

RECIPIE~_T~~AME AND ADDRESS

ST.

CLOUD STATE UNIVERSITY FOUNDATION

NONE

ST
3001

8000

6,000.

EDUCATIONAL PROGRAMS

7,000

EDUCATIONAL PROGRAMS

29,562.

EDUCATIONAL PROGRAMS

14, 000

EDUCATIONAL PROGRAMS

7,500

EDUCATIONAL PROGRAMS

7,000

56301-4498

NONE

EDWARDSUNIVERSITY

AUSTIN,

ST.

MN

EDUCATIONAL PROGRAMS

PUBLIC

720 4TH AVENUE SOUTH


SAINT CLOUD,

AMOUNT

PURPOSE OF GRANT OR CONTRIBUTION

CONGRESS AVE

PUBLIC

TX 78704

JOHN'S

NONE

UNIVERSITY

PUBLIC

UTOPIA PARKWAY

QUEENS, NY 114 3 9

ST

LAWRENCEUNIVERSITY

NONE

23 ROMODADRIVE

PUBLIC

CANTON, NY 13617

STATE UNIVERSITY OF NEW YORK - PLATTSBURGH

NONE

P.O.

PUBLIC

BOX 9

ALBANY, NY 12201

STEPHEN F. AUSTIN STATE UNIVERSITY

NONE

BOX 13004,

PUBLIC

SFA STATION

NACOGDOCHES, TX 75962-3004

ATTACHMENT 16
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48-0918408

CHARLES KOCH FOUNDATION

PhRT XV - GRANTS AND CONTRIBTTTTONS PAID DTTRING THE YEAR

FORM 990PF

ATTACHMENT16

(CONT'D)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

FOUNDATION STATUS OF RECIPIENT

NAME AND ADDRESS

SUFFOLK UNIVERSITY

NONE

8 ASHBURTON PLACE

PUBLIC

PURPOSE OF GRANT OR CONTRIBUTION

AMOUNT

EDUCATIONAL PROGRAMS

19,000

EDUCATIONAL PROGRAMS

9,000

BOSTON, MS 02108-2770

TEXAS A&M UNIVERSITY

NONE

217 JOHN J

PUBLIC

KOLDUS BUILDING

COLLEGE STATION,

TX 77843

TEXAS STATE UNIVERSITY

NONE

601 UNIVERSITY DRIVE

PUBLIC

RETURN OF UNUSED GRANT FUNDS

-954.

SAN MARCOS, TX 78666

THE COLLEGE OF NEW JERSEY

NONE

P O

PUBLIC

BOX 7718

EDUCATIONAL PROGRAMS

11,900.

EWING, NJ 08628

THE RESEARCH FOUNDATION

NONE

35 STATE STREET

PUBLIC

RETURN OF UNUSED GRANT FUNDS

-219.

ALBANY, NY 12207-2826

TOWER FOUNDATION OF SAN JOSE STATE

NONE

UNIVERSITY

PUBLIC

SAN JOSE,

EDUCATIONAL PROGRAMS

25,000

CA 95192

ATTACHMENT 16
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PJI.GE 60

48-0918408

CHARLES KOCH FOUNDATION

FORM 990PF

PART XV

GRhNTS AND CONTRIBIITIONS PAID DURING THE YEAR


ArnCH11BNT

16

(CONT'D)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND

RECIPIENT

TRINITY

11, 200

EDUCATIONAL PROGRAMS

NONE

COLLEGE

AMOUNT

PURPOSE OF GRANT OR CONTRIBUTION

FOUNDATION STATUS OF RECIPIENT

NAME AND ADDRESS

PUBLIC

300 SUMMIT STREET


ONE WASHINGTON SQUARE
HARTFORD, CT 06106

TRINITY

NONE

UNIVERSITY

1 TRINITY

EDUCATIONAL PROGRAMS

a.coo.

EDUCATIONAL PROGRAMS

9,000.

EDUCATIONAL PROGRAMS

9,500.

PUBLIC

PL.

SAN ANTONIO, TX 78212

UCLA FOUNDATION

NONE

10920

PUBLIC

WILSHIRE BOULEVARD

LOS ANGELES, CA 90024

UNIVERSITY OF AKRON

NONE

302 BUCHTEL COMMONS

PUBLIC

SUITE

900

AKRON, OH 44325

UNIVERSITY OF ALABAMA - HUNTSVILLE

NONE

301 SPARKMAN DR

PUBLIC

RETURN OF UNUSED GRANT FUNDS

-26.

THE UNIVERSITY OF AKRON


HUNTSVILLE,

AL 35899

UNIVERSITY OF ALABAMA - HUNTSVILLE

NONE

301 SPARKMAN DR

PUBLIC

HUNTSVILLE,

7,000

EDUCATIONAL PROGRAMS

AL 35899

ATTACHMENT 16
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PAGE 61

~------~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

CHARLES KOCH FOUNDATION

FORM 990PF

PPiRT XV -

48-0918408

GRANTS

AND CONTRIBIITIONS

PAID

DURING

THE YEAR

A:CTACHMENT16

(CONT'D)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

FOUNDATION STATUS OF RECIPIENT

NAME AND ADDRESS

UNIVERSITY OF ALABAMAAT BIRMINGHAM

NONE

1400

BOX 70

PUBLIC

FAIRBANKS

NONE

UNIVERSITY BLVD,

PURPOSE OF GRANT OR CONTRIBUTION

AMOUNT

EDUCATIONAL PROGRAMS

4, 874.

BIRMINGHAM, AL 352941150

UNIVERSITY OF ALASKA

EDUCATIONAL PROGRAMS

14,800

RETURN OF UNUSED GRANT FUNDS

-3,826.

EDUCATIONAL PROGRAMS

15,000.

PUBLIC

505 SOUTH CHANDALARDRIVE


FAIRBANKS, AL 99775

UNIVERSITY OF ARKANSAS FOUNDATION

NONE

535 RESEARCH CENTER BLVD

PUBLIC

P.0

BOX 757500

FAYETTEVILLE,

AR 72701

UNIVERSITY OF ARKANSAS-LITTLE
2801

NONE

ROCK

PUBLIC

SOUTH UNIVERSITY AVE

STE 120
LITTLE ROCK, AR 722041099

UNIVERSITY OF CALIFORNIA

NONE

ONE SHIELDS AVENUE

PUBLIC

DAVIS,

RETURN OF UNUSED GRANT FUNDS

439.

CA 95616

UNIVERSITY OF CENTRAL ARKANSAS FOUNDATION

NONE

UCR BOX 4986

PUBLIC

EDUCATIONAL PROGRAMS

10,200

CONWAY, AR 72035-4986

ATTACHMENT 16
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PAGE 62

CHARLES KOCH FOUNDATION

FORM 990DF

PART

X\I

48-0918408

GRANTS

AND CONTRIBIITIONS

PAID

DIIPTNG

THE

VEr..R

~
RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR
AND
RECIPIENT

NAME AND ADDRESS

FOUNDATION STATUS OF RECIPIENT

UNIVERSITY OF COLORADO FOUNDATION

NONE

CORPORATE FOUNDATION RELATIONS

PUBLIC

PURPOSE OF GRANT OR CONTRIBUTION

AMOUNT

EDUCATIONAL PROGRAMS

12,000

EDUCATIONAL PROGRAMS

26,000

EDUCATIONAL PROGRAMS

15,500.

EDUCATIONAL PROGRAMS

10,000

BOULDER, CO 80302

UNIVERSITY OF DALLAS

NONE

1845

E.

PUBLIC

1305

UNIVERSITY AVENUE

IRVING,

NORTHGATE OR.

TX 75062

UNIVERSITY OF DAYTON

NONE

300 COLLEGE PARK

PUBLIC

DAYTON, OH 45469

UNIVERSITY OF HOUSTON

NONE

4 3 8 l HARVEST LN

PUBLIC

HOUSTON, TX 77204-3011

UNIVERSITY OF MAINE - ORONO

NONE

5703

PUBLIC

ALUMNI HALL

EDUCATIONAL PROGRAMS

3,200.

EDUCATIONAL PROGRAMS

7,400.

PORTLAND, ME 04469

UNIVERSITY OF MARYLAND - BALTIMORE COUNTY

NONE

1000

PUBLIC

HILLTOP CIRCLE

SUITE 200
BALTIMORE, MD 21250

ATTACHMENT 16
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PAGE 63

48-0918408

CHARLES KOCH FOUNDATION

FORM 990PF

PART XV - GRANTS AND CONTRTBTTTTONS PAID DUPING THE YEAR

ATTACHMENT
16 (CONT'D)
RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR
AND
RECIPIENT

NAME AND ADDRESS

FOUNDATION STATUS OF RECIPIENT

UNIVERSITY OF MEMPHIS

NONE

341 ADMINISTRATION BUILDING

PUBLIC

319

PURPOSE OF GRANT OR CONTRIBUTION

AMOUNT

EDUCATIONAL PROGRAMS

5,900

EDUCATIONAL PROGRAMS

7,000

EDUCATIONAL PROGRAMS

7,000

EDUCATIONAL PROGRAMS

34,500

EDUCATIONAL PROGRAMS

10,000

EDUCATIONAL PROGRAMS

7,000

PUBLIC POLICY BLDG

MEMPHIS, TN 38152

UNIVERSITY OF MICHIGAN

NONE

611 TAPPAN ST

PUBLIC

ANN ARBOR, MI 48109-1003

UNIVERSITY OF MISSISSIPPI

NONE

PO BOX 1848

PUBLIC

UNIVERSITY,

MS 38677

UNIVERSITY OF MISSOURI
904 VIRGINIA

NONE

- COLUMBIA

PUBLIC

AVE

COLUMBIA, MO 65201

UNIVERSITY OF NEBRASKA - OMAHA

NONE

6001

PUBLIC

DODGE STREET

OMAHA, NE 68182

UNIVERSITY OF NORTH ALABAMA FOUNDATION

NONE

ONE HARRISON PLAZA

PUBLIC

FLORENCE, AL 35632

ATTACHMENT 16
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PAGE 64

CHARLES KOCH FOUNDATION

48-0918408

PPrRT XV - GRANTS AND CONTl2TBTJTIONSPAID DURING THE YEAR

FORM 990PF

AT.TAC.HMENT J 6

(CONT' 0)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

FOUNDATION STATUS OF RECIPIENT

NAME AND ADDRESS

UNIVERSITY OF NORTH CAROLINA

GREENSBORO

NONE

PO BOX 26170

AMOUNT

PURPOSE OF GRANT OR CONTRIBUTION

EDUCATIONAL PROGRAMS

7,500.

EDUCATIONAL PROGRAMS

14,000.

EDUCATIONAL PROGRAMS

10,303

EDUCATIONAL PROGRAMS

2,500

EDUCATIONAL PROGRAMS

8,000

EDUCATIONAL PROGRAMS

9,000

PUBLIC

GREENSBORO, NC 27402-6170

UNIVERSITY OF RICHMOND

NONE

G - 17 MARYLANDHALL

PUBLIC

UNIV OF RICHMOND, VA 23173

UNIVERSITY OF SAN DIEGO

NONE

5998

PUBLIC

ALCALA PARK

SAN DIEGO, CA 92110

UNIVERSITY OF SOUTH FLORIDA FOUNDATION

NONE

4202

PUBLIC

FOWLER AVENUE, ALClOO

TAMPA, FL 33620

UNIVERSITY OF TEXAS - ARLINGTON


701 S

NONE

NEDDERMANDRIVE

PUBLIC

ARLINGTON, TX 76019

UNIVERSITY OF TEXAS - AUSTIN

NONE

1 UNIVERSITY STATION

PUBLIC

AUSTIN,

TX 78712

ATTACHMEh'T 16
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PAGE 65

48-0918408

CHARLES KOCH FOUNDATION

EOR.M._______9_0PF
PART XV

GRANTS AND CONTRTBIITTONS PAID DORING THE YEAR

ATTACHMENT16

(CONT'D)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

PURPOSE OF GRANT OR CONTRIBUTION

FOUNDATION STATUS OF RECIPIENT

NAME AND ADDRESS

UNIVERSITY OF TEXAS - SAN ANTONIO

NONE

ONE UTSA CIRCLE

PUBLIC

AMOUNT

EDUCATIONAL PROGRAMS

11, 500

EDUCATIONAL PROGRAMS

5,000.

SAN ANTONIO, TX 78249

UNIVERSITY OF TULSA

NONE

800 SOUTH TUCKER DRIVE

PUBLIC

TULSA, OK 74104

UNIVERSITY OF VIRGINIA

NONE

C/0

PUBLIC

UVA OFFICE OF SPONSORED PROGRAMS

CHARLOTTESVILLE,

EDUCATIONAL PROGRAMS

23,000

EDUCATIONAL PROGRAMS

6,000

EDUCATIONAL PROGRAMS

12,500.

RETURN OF UNUSED GRANT FUNDS

-1, 418

VA 22904

UNIVERSITY OF VIRGINIA'S

NONE

COLLEGE AT WISE

PUBLIC

ONE COLLEGE AVENUE


PO BOX 400195
WISE,

VA 24293

NONE

UNIVERSITY OF WEST FLORIDA FOUNDATION


11000

PUBLIC

UNIVERSITY PARKWAY

PENSACOLA, FL 32514

UNIVERSITY OF WISCONSIN FOUNDATION - EAU CLAIRE

NONE

105 GARFIELD AVENUE

PUBLIC

EAU CLAIRE,

WI 54702-5000

ATTACHMENT 16
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PAGE 66

CHARLES KOCH FOUNDATION

FORM 990PF

PflRT

XV -

48-0918408

GRANTS

AND CONTRIBIITIONS

PJ1ID DTTRING THR YFAR

Al:CACHMENT16

(CONT'D)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

NAME AND ADDRESS

FOUNDATION STATUS OF RECIPIENT

UNIVERSITY OF WISCONSIN FOUNDATION

NONE

1848 UNIVERSITY AVENUE

PUBLIC

PURPOSE OF GRANT OR CONTRIBUTION

AMOUNT

EDUCATIONAL PROGRAMS

7,000

EDUCATIONAL PROGRAMS

10,000

EDUCATIONAL PROGRAMS

45,000

EDUCATIONAL PROGRAMS

6,000

EDUCATIONAL PROGRAMS

3,000

EDUCATIONAL PROGRAMS

6,300.

MADISON, WI 53726

UNLV FOUNDATION

NONE

4505

PUBLIC

MARYLANDPKWY

LAS VEGAS, NV 89154

UTAH STATE UNIVERSITY

NONE

1400 OLD MAIN HILL

PUBLIC

PO BOX 451006
LOGAN, UT 84322-1400

WASHINGTONUNIVERSITY - ST

LOUIS

NONE

ONE BROOKINGS DRIVE


ST

LOUIS,

PUBLIC

MO 63130

WEBBER INTERNATIONAL UNIVERSITY

NONE

1201

PUBLIC

SCENIC HWY

BABSON PARK, FL 33827

WESLEYAN COLLEGE

NONE

4760

PUBLIC

FORSYTH ROAD

MACON, GA 31210

ATTACHMENT16
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48-0918408

CHARLES KOCH FOUNDATION

FORM

990PP

PART

XV

GRANTS

AND

CONTRTBIITTONS

PAID

DTTRTNG THE

..

YFb.R

ATTACHMENT)6

(CQNT1 D)

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
RECIPIENT

NAME AND ADDRESS

FOUNDATION STATUS OF RECIPIENT

WEST TEXAS A&M UNIVERSITY

NONE

2501

PUBLIC

4TH AVENUE

PURPOSE OF GRANT OR CONTRIBUTION

EDUCATIONAL PROGRAMS

2,000

CANYON, TX 79016

WEST VIRGINIA

UNIVERSITY

NONE

FOUNDATION

EDUCATIONAL PROGRAMS

ll,000

EDUCATIONAL PROGRAMS

12,000.

EDUCATIONAL PROGRAMS

ll,

EDUCATIONAL PROGRAMS

14,100.

EDUCATIONAL PROGRAMS

3,000.

PUBLIC

l WATERFRONT PLACE 7TH FLOOR


MORGANTOWN,WV 26507-1650

WESTERN CAROLINA UNIVERSITY

NONE

AFIE DEPARTMENT, FO

PUBLIC

121

PO BOX 1650
CULLOWHEE, NC 28723

WESTERN KENTUCKY UNIVERSITY RESEARCH FOUNDATION

NONE

1906

PUBLIC

COLLEGE HEIGHTS BLVD

700

COLLEGE OF BUSINESS
BOWLING GREEN, KY 42101

WESTERN MICHIGAN UNIVERSITY

NONE

1903

PUBLIC

W MICHIGAN AVE

KALI\MI\ZOO, MI 49008-5330

WESTMONT COLLEGE

NONE

955 LA PAZ ROAD

PUBLIC

5307

FRIEDMANN HALL

SANTA BARBARA, CA 93108

ATTACHMENT 16
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FORM 990PF

..

48-0918408

CHARLES KOCH FOUNDATION

PART XV - GRANTS AND CONTRIBUTIONS

PAID DURING THE YEAR

ATIAC..HMENT
16 (CONT'D)
RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR
AND
RECIPIENT

FOUNDATION STATUS OF RECIPIENT

NAME AND ADDRESS

WHEATONCOLLEGE

NONE

501 COLLEGE AVE

PUBLIC

PURPOSE OF GRANT OR CONTRIBUTION

AMOUNT

EDUCATIONAL PROGRAMS

7,300

EDUCATIONAL PROGRAMS

7,500.

WHEATON, IL 60187-5593

NONE

WISCONSIN LUTHERAN COLLEGE


8800

W, BLUEMOUNDRD.

PUBLIC

MILWAUKEE, WI 53226

CHARLES KOCH INSTITUTE

RELATED PARTY

1515

PRIVATE

N COURTHOUSE ROAD

EDUCATIONAL PROGRAMS

2,800,000.

ARLINGTON, VA 22201

1770

BURRANDST,

150,000

GENERAL OPERATING SUPPORT

NONE

FRASER INSTITUTE

PUBLIC

4TH FLOOR V6J 3G7

VANCOUVER
BRITISH

COLUMBIA

CANADA

855 SHERBROOKE ST.

8,000

EDUCATIONAL PROGRAMS

NONE

MCGILL UNIVERSITY

PUBLIC

W H3A 2T7

MONTREAL
QUEBE
CANADA

TOTAL CONTRIBUTIONS PAID

16

ATTACHMENT 16
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PAGE 69

]45

918

48-0918408

CHARLES KOCH FOUNDATION

FORM

990PF

PP.RT XV

CONTRTBIITTONS

ll.PPRO\IED

FOP

FIITTTRF

PAYMENT

AITACflME:l,IT____l_1

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR


AND
FOUNDATION STATUS OF RECIPIENT

RECIPIE_N'I'_N~E~~ADDRESS

FLORIDA STATE UNIVERSITY

NONE

211 WESTCOTT BUILDING

PUBLIC

PURPOSE OF GRANT OR CONTRIBUTION

PHD STUDENT FELLOWSHIPS

230,355

TALLAHASSEE, FL 32306-1470

NEW YORK UNIVERSITY

NONE

19 W 4TH STREET

PUBLIC

LEGAL FELLOWSHIP

35,500

PHD STUDENT FELLOWSHIPS

33, 751.

NEW YORK, NY 10012

SUFFOLK UNIVERSITY

NONE

8 ASHBURTON PLACE

PUBLIC

BOSTON, MA 02108-2770

TROY UNIVERSITY FOUNDATION

NONE

211 WRIGHT HALL

PUBLIC

MANUALH

JOHNSON CENTER FOR POLITICAL

ECONOMY

720,000

TROY, AL 36082

TOTAL CONTRIBUTIONS APPROVED

J 0]9

ATTACHMENT 17
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PAGE 70

606

SCHEDULED
(Form 1041)

OMB No 1545-0092

Capital Gains and Losses

Department of the Treasury


Internal Revenue Sennce

~11

..,.Attach to Form 1041, Form 5227, or Form 990-T. See the Instructions for
Schedule D (Form 1041) (also for Form 5227 or Form 990-T, if applicable).
Employer identification

Name of es~te or trust

CHARLES KOCH FOUNDATION

number

48-0918408

Note: Form 5227 filers need to complete only Parts I and II

Short-Term Capita! Gains and Losses -Assets Held One Year or Less

!!~!ol!I!!

(Example

(b) Date acquired


(mo , day, yr )

(a) Descnpt1on of property


100 shares 7% preferred of z: Co)

(c) Date sold


(mo , day, yr)

(d) Sales pnce

(e) Cost or other basis


(see instructions)

. ..

..

(f) Gain or (loss) for


the entire year
Subtract (e) from (d)

1a

..

b Enter the short-term gain or (loss), 1fany, from Schedule D-1, hne 1b

. ..

..

1b

..

Short-term capital gain or (loss) from Forms 4684, 6252, 6781, and 8824.

3
4

Net short-term gain or (loss) from partnerships, S corporations, and other estates or trusts
3
Short-term capital loss carryover Enter the amount, If any, from line 9 of the 2010 Capital Loss
4
Carryover Worksheet .
..
.
Net short-term gain or (loss). Combine lines 1a through 4 in column (f) Enter here and on hne 13,
..... 5
column (3) on the back.
. ..
..
. ..

.. ...

..

..

..

..

1:1:Tiiilll.

Long-Term

(Example

..

Capital Gains and Losses -Assets

(a) Descnpt1on of property


100 shares 7% preferred of"Z" Co)

..

1,758,008.

(b) Date acquired


(mo , day, yr)

1,758,008

Held More Than One Year


(c) Date sold
(mo , day, yr)

(d) Sales pnce

(e) Cost or other basis


(see 1nstruct1ons)

(f) Gain or (loss) for


the entire year
Subtract (e) from (d)

6a

b Enter the long-term gain or (loss), if any, from Schedule D-1, hne 6b.

..

.....

..

6b

Long-term capital gain or (loss) from Forms 2439, 4684, 6252, 6781, and 8824

..

. ..

Net long-term gain or (loss) from partnerships, S corporations, and other estates or trusts .

..

..

Capital gain d1stnbut1ons ...

10
11

.. . .

. ..

..

..

....

10
Gain from Form 4797, Part I .
.
Long-term capital loss carryover Enter the amount, 1f any, from hne 14 of the 2010 Capital Loss
11 (
Carryover Worksheet .
.
Net long-term gain or (loss). Combine lines 6a through 11 in column (f) Enter here and on hne 14a,
..... 12
column (3) on the back.
..

..

12

..

.... ..

..

Reduction Act Notice, see the Instructions

......

..

For Paperwork

787,104.

Schedule

for Form 1041.

787,104

D (Form 1041) 2011

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Page2
Summary
of Parts I and II
(1) Benefic1anes'
(2) Estate's
(3) Total
(see instr)
or trust's
Caution: Read the mstruct,ons before completing this part
1,758,008
.
13 Net short-term gain or (loss) ..
. ..
. . . 13
14 Net.long-term gain or (loss):
787,104.
14a
a Total for year
.. . . .......................
14b
b Unrecaptured section 1250 gain (see line 18 of the wrksht).
14c
a1n
c 28~~ rate l1....
2,545,112.
15 Total net gain or (loss). Combine Imes 13 and 14a ......
15
~
Note: If /me 15, column (3), is a net gam. enter the gam on Form 1041, /me 4 (or Form 990-T, Part I. /me 4a) If Imes 14a and 15, column (2), are net
gams, go to Part v;and do not complete Part IV If /me 15, column (3), is a net loss. complete Part IV and the capital Loss canyover Worlcsheet, as necessary

ScheduleD
l::F.Ti.111

(Form 1041) 2011

.... . .........

......

16

Capital Loss Limitation


Enter here and enter as a (loss) on Form 1041, hne 4 (or Form 990-T, Part I, line 4c. 1fa trust), the smaller of

a The loss on line 15. column (3) or b $3,000 ................................


':---'-1-=-6-'-'-.,....,-----,---=,--,,.,...,.-=--__
Note: If the loss on /me 15, column (3), is more than $3,000, or if Form 1041, page 1, /me 22 (or Form 990-T, line 34), is a loss, complete the capital Loss
Canyover Worlcsheet m the mstruct1ons to figure your capital loss carryover
Tax Computation
Using Maximum Capital Gains Rates
Form 1041 filers. Complete this part only 1f both Imes 14a and 15 m column (2) are gains, or an amount 1sentered m Part I or Part II and
there 1s an entry on Form 1041, line 2b(2), and Form 1041, line 22, 1smore than zero
Caution: Skip this part and complete the Schedule D Tax Worlcsheet m the instructions if
Either /me 14b, col (2) or line 14c, col (2) is more than zero, or
Both Form 1041, line 2b(1), and Form 4952, /me 4g are more than zero
Form 990-T trusts. Complete this part only 1f both Imes 14a and 15 are gains, or quahf1ed d1v1dendsare included in income m Part I
of Form 990-T, and Form 990-T, line 34, 1smore than zero Skip this part and complete the Schedule D Tax Worksheet m the instructions
1feither line 14b, col (2) or line 14c, col (2) 1smore than zero

1:ifttJ

17
18

19

20
21
22
23
24
25

Enter taxable income from Form 1041, hne 22 (or Form 990-T, hne 34) . . . i--:-17-'---1-----------l
Enter the smaller of line 14a or 15 in column (2)
but not less than zero. . . . . . . . . . . . ...
f---"1-"8-+-----------1
Enter the estate's or trust's quahf1ed d1v1dends
from Form 1 041, line 2b(2) (or enter the qualified
d1v1dends
included 1nincome in Part I of Form990-T) .. l--'1..;:9-+-----------1
Add Imes 18 and 19 ................
,__2-'-0_,_
_______
If the estate or trust 1sfiling Form 4952, enter the
amount from line 4g, otherwise. enter -0- . . ~ .__2_1_._
_______
Subtract line 21 from line 20 If zero or less, enter -0Subtract line 22 from line 17 If zero or less, enter -0Enter the smaller of the amount on hne 17 or $2,300
Is the amount on line 23 equal to or more than the amount on line 24?
Yes. Skip Imes 25 and 26, go to line 27 and check the "No" box.

__,
----1
22
23
...

~24~-----------l

No. Enter the amount from hne 23. . . . . . . . . . . . . . . . .


Subtract hne 25 from line 24
Are the amounts on Imes 22 and 26 the same?
Yes. Skop lones 27 thru 30; gotohne31
No. Enterthesmatlerof lone 17 or hne22

~2..::.5--1--------...J
26

28

Enter the amount from hne 26 (If hne 26 1sblank, enter -0-) ..........

t-=2~8--'-----------1

29
30
31

Subtract line 28 from line 27 ................................


.__29 _.__
_.
Multiply line 29 by 15% ( 15)
i-..::.-3~0-+-------............
Figure the tax on the amount on line 23 Use the 2011 Tax Rate Schedule for Estates and Trusts

26
27

O....CC.2-'-7_,__
_______

_ _______

(see the Schedule G 1nstruct1ons in the instructions for Form 1041) .....................
32
33
34

_.

i--::3....:1-+---------

Add Imes 30 and 31 ..............................................


i-=-3=-2+-------Figure the tax on the amount on line 17 Use the 2011 Tax Rate Schedule for Estates and Trusts
i--::3-=3-+--------(see the Schedule G instructions in the instructions for Form 1041) .....................
Tax on all taxable income. Enter the smaller of line 32 or line 33 here and on Form 1041, Schedule
G, line 1a (or Form 990-T line 36). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Schedule D (Form 1041) 2011

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72

Continuation Sheet for Schedule D


(Form 1041)

SCHEDULE 0-1
(Form 1041)
Department of the :treasury
Internal RevenueService

.... Attach

(b} Date

acquired
Imo dav. vr l

(c) Date sold


(mo, day, yr)

Employer identification number

48-0918408

CHARLES KOCH FOUNDATION


Short-Term Capital Gains and Losses -Assets Held One Year or Less
jaj Descripuon of property(Example
100 sh 7% preferredof "Z" Co )

~11

for Schedule D (Form 1041).


..,..See instructions
to Schedule D to list additional
transactions
for lines 1a and 6a.

Name of e:;tate or trust

OMB No 1545-0092

(d) Sales pnce

(e) Cost or other basis


(see 1nstruc!Jons)

(f) Gain or (loss)


Subtract (e) from (d)

1a

VARIOUS

VARIOUS

ACIS CLO

VARIOUS

VARIOUS

8,964,429.

8,791,432.

PILOT TRAVEL CENTERS

VARIOUS

VARIOUS

11,607,222.

10,000,000.

ZAZOVE ASSOCIATES,

1b Total.

LLC

972,037.

994,248.

Reduction Act Notice, see the Instructions

for Form 1041.

172,997.
1,607,222.

1,758,008.

Combine the amounts ,n column (f) Enter here and on Schedule D, hne 1b ...................

For Paperwork

-22,211.

Schedule

D-1 (Form 1041) 2011

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Schedule D-1 (Form 1041) 2011


Name of estate or trust as shown on Form 1041 Do not enter name and employer 1denbficatJonnumber If shown on the other side

~11

Page

Employer identification number

LonQ-Term Capital Gains and Losses -Assets Held More Than One Year
(~ Description of property (Example
100 sh 7% preferred of "Z" Co )

(b) Date
acquired
(mo dav. vr l

(c) Date sold


(mo day, yr)

(d) Sales pnce

(e) Cost or other basis


(see ,nstructJons)

(f) Gain or (loss)


Subtract (e) from (d)

6a

VARIOUS

VARIOUS

2,020,548.

1,845,833.

174,715.

VARIOUS

VARIOUS

1,308,000.

1,610,000.

-302,000.

PIM CO

VARIOUS

VARIOUS

27,459,154.

26,569,477.

889,677.

EATON VANCE

VARIOUS

VARIOUS

ZAZOVE P.SSOCIATES,

ACIS

LLC

CLO

331,278.

6b Total. Combine the amounts in column (f) Enter here and on Schedule D, hne 6b ...................

306,566.

24,712.

787,104.
Schedule D-1 (Form 1041) 2011

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'

2011

CHARLESKOCHFOIJNDATION

48-0918408

Description of Property

DEPRECIATION
Asset descriot1on
OFFICE EQUIPMENT

Date
UnadJusted
placed 1n
Cost
or basis
service
WAR

Bus
%

179 exp
reduction
in basis

Basis
Reduction

Beginning
Ending
Basis for
Accumulated Accumulated Medeorec1at1on deorec1at1on deorec1at1on lhnrl Conv
16 630

16 630

100 000

UNIMPROVED
LAND

05/13/1988 3 377 694

100 000

LEASEHOLD
IMPROVE

WAR

1 000 652

100 000

1 000 652

LEASEHOLD
IMPROVE

WAR

2 932 100 000

2 932

613 038.

Life

MA Current-year
ACR~ CRS
179
class class
exoense

Current-year
deorec1at1on

1 440 SL

1 440.

807 679 SL

194 641

272 SL

272

Less Retired Assets


Subtotals .

4 397 908

1 020 214

613 038

809 391

4 397 908

1 020 214

613 038

809 391.

'

Listed Property

196 353

Less Retired Assets


Subtotals
TOTALS

196 353

AMORTIZATION
Asset descriDt1on

Date
placed in
service

Cost
or
basis

Ending
Accumulated Accumulated
amort1zat1on amort1zat1on Code

Current-year
amort1zat1on

Life

TOTAi~

*Assets Retired
JSA
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PAGE75

Form 8868 (Rev 1-2012)

If you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part II and check this box_ ....
Note. Only complete Part II 1fyou have already been granted an automatic 3-month extension on a preVlously filed Form 8868
If ou are f11in for an Automatic 3-Month Extension, com lete onl Part I on a e 1

Additional

(Not Automatic)

3-Month Extension of Time. Only file the ong1nal (no copies needed)
Enter filer's identifying number, see instructions
Employer 1dent1f1cation
number(EIN) or

Name of exempt organization or other filer, see 1nstruct1ons

.,,..- nr-

Tuno

print

Fiie by the
due date for
filing your
return See
mstruct1ons

IXl

CHARLES G. KOCH CHARITABLE FOUNDATION


Number, street, and room or suite no If a PO box, see 1nstruct1ons

P.O. BOX 2256


City, town or post office, state, and ZIP code.For a foreign address,see instructions
WICHITA,

48-0918408
Social securitynumber(SSN)

KS 67201-2256

Enter the Return code for the return that this aoolicat1on 1sfor (file a separate aool1cat1onfor each return)
Application
Return
Application
Is For
Code
Is For

.............

I ol 4 J
Return
Code
x~
,.
' ~~

~llF~fllBli\-~''Mi},

Form 990
01
~:~:, ~
.~
.,~ y, ~!
. '
'
f:'iJ
Form 990-BL
02
Form 1041-A
08
01
Form 990-EZ
Form 4720
09
04
Form 5227
Form 990-PF
10
Form 6069
Form 990-T (sec 401 (a) or 408(a) trust)
05
11
Form 990-T (trust other than above)
06
Form 8870
12
STOP! Do not complete Part II if you were not already granted an automatic 3-month extension on a previously filed Form 8868.
__ L_O_V_E
_______________________
_
The books are 1nthe care of ~ _H_E_A_T_H_E_R
316
828-8286
FAX No ~ -------------Telephone No ~
If the organization does not have an office or place of business 1nthe United States, check this box
. .......
~
If this 1sfor a Group Return, enter the organization's four d1g1tGroup Exemption Number (GEN) -----~-If this 1s
for the whole group, check this box .....
~
If 1t1sfor part of the group, check this box. .
~
and attach a
list with the names and EINs of all members the extension 1sfor
11/15
. 20 12
4
I request an add1t1onal 3-month extension of time until
For calendar year 2 o 11 , or other tax year beginning
5
, 20
, and end1,Q9._,
. 20
Initial return ~LJ--.-F-1-na_l_r_e-tu_r_n
__ _
If the tax year entered in line 5 1sfor less than 12 months, check reason
6
Change in accounting period
TIME IS REQUIRED TO ACCUMULATE THE
State in detail why you need the extension ADDITIONAL
7
INFORMATION NECESSARY TO FILE A COMPLETE AND ACCURATE RETURN.

Sa

If this appl1cat1on 1s for Form 990-BL, 990-PF, 990-T, 4 720, or 6069, enter the tentative tax, less any
nonrefundable credits See instructions
Sa$
b If this application IS for Form 990-PF, 990-T, 4 720, or 6069, enter any refundable credits and ,
.,t._..,.,
estimated tax payments made Include any prior year overpayment allowed as a credit and any ~
amount paid previously with Form 8868
Sb$
c Balance Due. Subtract line 8b from line Ba Include your payment with this form, 1f required, by using EFTPS
(Electronic Federal Tax Payment System) See 1nstruct1ons
Sc$

"

Signature

Date~
Form

JSA

1 F8055 4 000

8/7 /2012

schedules and statements, and to the best of my knowledge and belief,

Title ~

Signature~

K932

and Verification must be completed for Part II only.

Under penalties of per1ury, I declare that I have examined this form, including accompanying
1t 1strue, correct, and complete, and that I am authonzed to prepare this form

16733H

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8868

(Rev 1-2012)

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