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0MB No 1545-0052
Return of Private Foundation
Form990-PF or Section 4947(a)(1) Nonexempt Charitable Trust
Departmentof theTreasury
Treated as a Private Foundation
Note. The foundation may be able to use a copy of this return to satisfy state reporting requirements
2011
InternalRevenue Service
For calendar year 2011, or tax year beginning 01-01-2011 , and ending 12-31-2011
G Check all that apply r In1t1al return r In1t1al return of a former public charity r Final return
Name of foundation
A mended r return r Address change r Name change A Employer identification number
FRED C & MARYR KOCH FOUNDATIONINC
48-6113560
% HEATHERLOVE
B Telephone number (see page 10 of the instructions)
Number and street (or PO box number 1fmail 1snot delivered to street address) Room/suite
PO BOX2256
(316) 828-8286
''
City or town, state, and ZIP code C If exemption application 1spending, check here ~
WICHITA, KS 672012256
D 1. Foreign organizations, check here ~
H Check type of organ1zat1on P"Section 501(c)(3) exempt private foundation 2. Foreign organizations meeting the 85% test,
'
~
r Section 494 7(a)(l) nonexempt charitable trust r Other taxable private foundation
check here and attach computation
I Fair market value of all assets at end J Accounting method r Cash P"Accrual E If private foundation status was terminated
'
under section 507( b)( l)(A), check here ~
of year (from Part II, col. (c),
!me 16)..,.$ 30,320,124
r Other (specify)
- F If the foundation 1sin a 60-month temnmat1on
(Part I, column (d) must be on cash basis.)
'
under section 507(bH1HBl, check here ~
Sa Gross rents
9 Income mod1f1cat1ons
~ 1,722 1,722
.!::'
23 Other expenses (attach schedule)
-..,
,:::; 24 Total operating and administrative expenses.
'-
t
0
Add lines 13 through 23 55,042 16,797 0 21,543
26 Total expenses and disbursements. Add Imes 24 and 25 2,039,836 16,797 0 2,006,337
4 Pledges receivable,..
Less allowance for doubtful accounts,..
5 Grants receivable
6 Receivables due from officers, directors, trustees, and other
d1squal1f1ed persons (attach schedule) (see page 15 of the
1nstruct1ons).
7 Other notes and loans receivable (attach schedule),..
18 Grants payable
,fl
19 Deferred revenue
4'
-e 20 Loans from officers, directors, trustees, and other d1squal1f1ed persons
.3 Mortgages and other notes payable (attach schedule)
,:::; 21
.::i 22 Other l1ab1l1t1es (describe,.. )
1 Total net assets or fund balances at beg1nn1ng of year-Part II, column (a), line 30 (must agree
with end-of-year figure reported on prior year's return) 1 30,953,406
2 Enter amount from Part I, line 27a 2 -533,147
3 Other increases not included 1n line 2 (1tem1ze),.. 3
4 Add lines 1, 2, and 3 4 30,420,259
5 Decreases not included 1n line 2 (1tem1ze),.. 5
6 Total net assets or fund balances at end of year (line 4 minus line 5 )-Part II, column (b), line 30. 6 30,420,259
Form 990-PF (2011)
Form 9 9 O- P F ( 2 O 11 ) Page 3
l:F-Till"t Capita Gams an d Losses f or Tax on Investment Income
(b) How acquired
(a) List and describe the k1nd(s) of property sold (e g, real estate, (c) Date acquired (d) Date sold
P-Purchase
2-story brick warehouse, or common stock, 200 shs M LC Co) (mo, day, yr) (mo, day, yr)
D-Donat1on
la ZAZOVE ASSOCIATES, LLC p
d
e
(f) Deprec1at1on allowed (g) Cost or other basis (h) Gain or (loss)
(e) Gross sales price
(or allowable) plus expense of sale (e) plus (f) minus (g)
a 1,036,414 977,000 59,414
b 157,355 154,961 2,394
C
d
e
Complete only for assets showing gain 1n column (h) and owned by the foundation on 12/31/69 (I) Gains (Col (h) gain minus
(j) AdJusted basis (k) Excess of col (1) col (k), but not less than -0-) or
(i) FM V asof12/31/69 Losses (from col (h))
asof12/31/69 over col (J), 1f any
a 59,414
b 2,394
C
d
e
2 Capital gain net income or (net capital loss) { If gain, also enter 1n Part I, line 7
If (loss), enter -0- 1n Part I, line 7 } 2 61,808
3 Net short-term capital gain or (loss) as defined 1n sections 1222(5) and (6)
Was the foundation liable for the section 4942 tax on the distributable amount of any year 1n the base period7 I Yes P- No
If"Yes," the foundation does not qualify under section 4940(e) Do not complete this part
1 Enter the appropriate amount 1n each column for each year, see page 18 of the 1nstruct1ons before making any entries
(a) (d)
(b) (c)
Base period years Calendar Net value of nonchantable-use assets D1stnbut1onratio
Adjusted qualifying d1stnbut1ons
year (or tax year beginning in) (col (b) d1v1dedby col (c))
2010 1,954,001 31,460,360 0 06211
2009 1,508,261 30,901,951 0 048808
2008 1,637,628 33,807,502 0 04844
2007 1,627,052 35,306,398 0 046084
2006 1,589,777 33,772,998 0 047072
4 Enter the net value ofnoncharitable-use assets for 2011 from Part X, line 5. 4 31,454,310
2 Tax under section 511 (domestic section 4947(a)(l) trusts and taxable foundations only Others enter -0-) 2
3 Add lines 1 and 2. 3 12,139
4 Subtitle A (income) tax (domestic section 4947(a)(l) trusts and taxable foundations only Others enter -0-) 4
5 Tax based on investment income. Subtract line 4 from line 3 If zero or less, enter -0-. 5 12,139
6 Credits/Payments
a 2011 estimated tax payments and 2010 overpayment credited to 2011 6a 17,962
b Exempt foreign organ1zat1ons-tax withheld at source 6b
c Tax paid with appl1cat1on for extension oft1me to file (Form 8868) 6c
d Backup w1thhold1ng erroneously withheld. 6d
7 Total credits and payments Add lines 6a through 6d. 7 17,962
s Enter any penalty for underpayment of estimated tax Check here 1 1f Form 2220 1s attached 8
9 Tax due. If the total ofl1nes 5 and 8 1s more than line 7, enter amount owed.
,... 9
10 Overpayment. If line 7 1s more than the total of lines 5 and 8, enter the amount overpaid. ,... 10 5,823
11 Enter the amount of line 10 to be Credited to 2012 estimated tax,... 5,823 I Refunded,... 11
Part VII-A Statements Regarding Act1v1t1es
la During the tax year, did the foundation attempt to influence any national, state, or local leg1slat1on or did Yes No
1t part1c1pate or intervene 1n any pol1t1cal campa1gn7 la No
b Did 1t spend more than $100 during the year (either directly or 1nd1rectly) for pol1t1cal purposes (see page 19 of
the 1nstruct1ons for def1n1t1on)7 lb No
If the answer 1s "Yes" to 1a or 1b, attach a detailed descnptJOn of the act1v1t1es and copies of any matenals
published or d1stnbuted by the foundatJOn 1n connection with the act1v1t1es.
c D 1d the foundation file Form 1120-POL for this yea r7. le No
d Enter the amount (1fany) of tax on pol1t1cal expenditures (section 4955) imposed during the year
(1) On the foundation ,... $ ________ (2) On foundation managers ,... $ _______ _
e Enter the reimbursement (1f any) paid by the foundation during the year for pol1t1cal expenditure tax imposed
on foundation managers ,... $ _______ _
2 Has the foundation engaged 1n any act1v1t1es that have not previously been reported to the IRS7 2 No
If "Yes," attach a detailed descnpt1on of the act1v1t1es.
3 Has the foundation made any changes, not previously reported to the IRS, 1n its governing instrument, articles
of 1ncorporat1on, or bylaws, or other s1m1lar 1nstruments7 If "Yes," attach a conformed copy of the changes 3 No
4a Did the foundation have unrelated business gross income of$1,000 or more during the year7. 4a No
b If "Yes," has 1t f1led a tax return on Form 990-T for this yea r7. 4b
5 Was there a l1qu1dat1on, term1nat1on, d1ssolut1on, or substantial contraction during the year7 5 No
If "Yes," attach the statement required by General Instruct/On T.
6 Are the requirements of section 508(e) (relating to sections 4941 through 4945) sat1sf1ed either
By language 1n the governing instrument, or
By state leg1slat1on that effectively amends the governing instrument so that no mandatory d1rect1ons
that conflict with the state law remain 1n the governing instrument? 6 Yes
7 D1dthe foundation have at least $5,000 in assets at any time during the year7 If "Yes," complete Part II, col (c), and Part XV 7 Yes
Sa Enter the states to which the foundation reports orw1th which 1t 1s registered (see page 19 of the
1nstruct1ons) ,..._K_s
_________________________________________ _
b If the answer 1s "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G7 If "No," attach explanation. Sb Yes
9 Is the foundation cla1m1ng status as a private operating foundation w1th1n the meaning of section 4942(J)(3)
or 4 9 4 2 (J)(5) for calendar year 2 O 11 or the taxable year beg1nn1 ng In 2 O 11 (see I nstruct1ons for Pa rt XIV on
page 2 7 )7 If "Yes," complete Part XIV 9 No
10 D1dany persons become substantial contributors during the tax year7 If "Yes," attach a schedule /Jstmg their names and addresses 10 No
Form 990-PF (2011)
Form 9 9 O- P F ( 2 O 11 ) Page 5
l:F-Till'd9~1
Statements Regarding Activities (continued)
11 At any time during the year, did the foundation, directly or 1nd1rectly, own a controlled entity w1th1n the
meaning of section 512(b)(13)7 If"Yes," attach schedule (see page 20 of the 1nstruct1ons). 11 No
12 Did the foundation acquire a direct or 1nd1rect interest 1n any applicable insurance contract before August 17, 20087 12 No
13 Did the foundation comply with the public 1nspect1on requirements for its annual returns and exemption appl1cat1on7 13 Yes
Website address t,,www fmkfoundat1on org
15 Section 494 7(a)(l) nonexempt charitable trusts f1l1ng Form 990-PF 1n lieu of Form 1041-Check here.
and enter the amount of tax-exempt interest received or accrued during the year. t,, 15
16 At any time during calendar year 2011, did the foundation have an interest 1n or a signature or other authority over IYes I No
a bank, securities, or other f1nanc1al account 1n a foreign country?. 16 I I No
See the 1nstruct1ons for exceptions and f1l1ng requirements for Form TD F 90-22 1 If "Yes", enter the name of the
foreign country t,,
Statements Regarding Act1v1t1es for Which Form 4720 May Be Require d
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies. Yes No
la During the year did the foundation (either directly or 1nd1rectly)
(1) Engage 1n the sale or exchange, or leasing of property with a d1squal1f1ed person? I Yes F No
(2) Borrow money from, lend money to, or otherwise extend credit to (or accept 1t from)
a d1squal1f1ed person?. I Yes F No
(3) Furnish goods, services, or fac1l1t1es to (or accept them from) a d1squal1f1ed person? F Yes I No
(4) Pay compensation to, or pay or reimburse the expenses of, a d1squal1f1ed person? F Yes I No
(5) Transfer any income or assets to a d1squal1f1ed person (or make any of either available
for the benefit or use of a d1squal1f1ed person)?. I Yes F No
(6) Agree to pay money or property to a government off1c1al7 (Exception. Check "No"
1f the foundation agreed to make a grant to or to employ the off1c1al for a period
after term1nat1on of government service, 1f term1nat1ng w1th1n 90 days ). 1 Yes F No
b If any answer 1s "Yes" to la(l )-(6 ), did any of the acts fail to qualify under the exceptions described 1n Regulations
section 53 4941(d)-3 or 1n a current notice regarding disaster assistance (see page 20 of the 1nstruct1ons)7. lb No
O rgan1zat1ons relying on a current notice regarding disaster assistance check here.
c Did the foundation engage 1n a prior year 1n any of the acts described 1n 1 a, other than excepted acts,
that were not corrected before the first day of the tax year beg1nn1ng 1n 20117. le No
2 Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined 1n section 4942(J)(3) or4942(J)(5))
a At the end of tax year 2011, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beg1nn1ng before 20117. I Yes F No
If"Yes," 11st the years t,, 20 __ , 20 __ , 20 __ , 20 __
b Are there any years listed 1n 2a forwh1ch the foundation 1s not applying the prov1s1ons of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year's undistributed 1ncome7 (If applying section 4942(a)(2)
to all years listed, answer "No" and attach statement-see page 20 of the 1nstruct1ons). 2b
c If the prov1s1ons of section 4942(a)(2) are being applied to any of the years listed 1n 2a, 11st the years here
t,, 20 __ , 20 __ , 20 __ , 20 __
3a Did the foundation hold more than a 2% direct or 1nd1rect interest 1n any business
enterprise at any time during the year7. 1 Yes F No
b If "Yes," did 1t have excess business holdings 1n 2011 as a result of (1) any purchase by the foundation
or d1squal1f1ed 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 10-, 15-, or 2 0-yea r f1rst phase hold1 ng period7 (Use Schedule C, Form 4720, to determme
If the foundation had excess busmess holdmgs m 2011.). 3b
4a Did the foundation invest during the year any amount 1n a manner that would Jeopardize its charitable purposes? 4a No
b Did the foundation make any investment 1n a prior year (but after December 31, 1969) that could Jeopardize its
charitable purpose that had not been removed from Jeopardy before the first day of the tax year beg1nn1ng 1n 20117 4b No
Form 990-PF (2011)
Form 9 9 O- P F ( 2 O 11 ) Page 6
l:F-Till'dl!l:I
Statements Regarding Activities for Which Form 4720 May Be Required (continued)
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))7 1 Yes [7 No
(2) Influence the outcome of any spec1f1c public election (see section 4955), orto carry
on, directly or 1nd1rectly, any voter reg1strat1on drive 7. 1 Yes [7 No
(3) Provide a grant to an 1nd1v1dual for travel, study, or other s1m1lar purposes? P- Yes 1 No
(4) Provide a grant to an organ1zat1on other than a charitable, etc, organ1zat1on described
1n section 5 O9 (a )(1 ), (2 ), or (3 ), or section 4 9 4 O (d )(2 )7 (see page 2 2 of the 1nstruct1ons ). P- Yes 1 No
(5) Provide for any purpose other than rel1g1ous, charitable, sc1ent1f1c, literary, or
educational purposes, or for the prevention of cruelty to children or animals 7. .1 Yes [7 No
b If any answer 1s "Yes" to 5a(l )-(5 ), did any of the transactions fail to qualify under the exceptions described 1n
Regulations section 53 4945 or 1n a current notice regarding disaster assistance (see page 22 of the 1nstruct1ons)7 Sb No
C
O rgan1zat1ons relying on a current
If the answer 1s "Yes" to question
notice regarding disaster
5a(4 ), does the foundation
assistance
claim exemption
check here.
from the
_,,.'
tax because 1t ma1nta1ned expenditure respons1b1l1ty for the grant?. P- Yes I No
If "Yes," attach the statement required by Regulations sectJOn 53.4945-S(d).
6a Did the foundation, during the year, receive any funds, directly or 1nd1rectly, to pay
premiums on a personal benefit contract?. 1 Yes P- No
b Did the foundation, during the year, pay premiums, directly or 1nd1rectly, on a personal benefit contract?. 6b No
If "Yes" to 6b, file Form 8870.
7a At any time during the tax year, was the foundation a party to a proh1b1ted tax shelter transact1on7 I Yes P- No
b If yes, did the foundation receive any proceeds or have any net income attributable to the transact1on7. 7b
~-,."l'!'!'P.
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
lifliia,.IU and Contractors
1 List all officers, directors, trustees, foundation managers and their compensation (see page 22 of the instructions).
(b) Title, and average (c) Compensation (d) Contributions to
(e) Expense account,
(a) Name and address hours per week (If not paid, enter employee benefit plans
other allowances
devoted to pos1t1on -0-) and deferred compensation
See Add1t1onal Data Table
2 Compensation of five highest-paid employees (other than those included on line 1-see page 23 of the instructions).
If none, enter "NONE."
(d) Contributions to
(b) Title, and average
(a) Name and address of each employee employee benefit (e) Expense account,
hours per week (c) Compensation
paid more than $50,000 plans and deferred other allowances
devoted to pos1t1on
compensation
Total number of others rece1v1ng over $50,000 for professional services. ... 0
10 Analysis ofl1ne 9
a Excess from 2 OO7.
b Excess from 2008. 0
C Excess from 2009. 0
d Excess from 2010. 0
e Excess from 2 O 11. 0
Form 990-PF (2011)
Form 9 9 O- P F ( 2 O 11 ) Page 10
M:ifli:u*M Private 0 Foundations see a e 27 of the instructions and Part VII-A uest1on 9
la If the foundation has received a ruling or determ1nat1on letter that 1t 1s a private operating
foundation, and the ruling 1s effective for 2011, enter the date of the ruling. ...-~-----------------
b Check box to 1nd1cate whether the organ1zat1on IS a private operating foundation described In section r 4942(J)(3) or r 4942(J)(5)
2a Enter the lesser of the adJusted net Tax year Prior 3 years
income from Part I or the m1n1mum (e) Total
(a)2011 (b) 2010 (c) 2009 (d) 2008
investment return from Part X for each
year listed.
b 85% ofl1ne 2a.
C Q ual1fy1ng d1stribut1ons from Part XII,
line 4 for each year listed.
d Amounts included in line 2c not used directly
for active conduct of exempt act1v1t1es.
e Q ual1fy1ng d1stribut1ons made directly
for active conduct of exempt act1v1t1es
Subtract line 2d from line 2c.
3 Complete 3a, b, or c for the
alternative test relied upon
a "Assets" alternative test-enter
(1) Value of all assets
(2) Value of assets qual1fy1ng
under section 4942(J)(3 )(B)(1)
b "Endowment" alternative test- enter 2/3
of m1n1mum investment return shown 1n
Part X, line 6 for each year listed.
C "Support" alternative test-enter
(1) Total support other than gross
investment income (interest,
d1v1dends, rents, payments
on securities loans (section
512(a)(5)), or royalties).
(2) Support from general public
and 5 or more exempt
organ1zat1ons as provided 1n
section 4942(J)(3)(B)(111).
(3) Largest amount of support
from an exempt organ1zat1on
(4) Gross investment income
I :r-Tili
:t'fJ Supplementary Information (Complete this part only if the organization had $5,000 or more in
assets at any time during the year-see page 27 of the instructions.)
1 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))
NONE
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 ... r1fthe foundation only makes contributions to preselected charitable organ1zat1ons and does not accept
unsol1c1ted requests for funds If the foundation makes gifts, grants, etc (see page 28 of the 1nstruct1ons) to 1nd1v1duals ororgan1zat1ons
under other cond1t1ons, complete items 2a, b, c, and d
a The name, address, and telephone number of the person to whom appl1cat1ons should be addressed
FRED MARY KOCH FDN GRANT ADM
PO BOX 2256
WICHITA,KS 67201
(316) 828-6083
b The form 1n which appl1cat1ons should be submitted and 1nformat1on and materials they should include
NONE
c Any subm1ss1on deadlines
NONE
d Any restrictions or l1m1tat1ons on awards, such as by geographical areas, charitable fields, kinds of 1nst1tut1ons, or other
factors
NEW SCHOLARSHIPS LIMITED TO DEPENDENTS OF FULL-TIME EMPLOYEES OF KOCH INDUSTRIES, INC AND ITS
SUBSIDIARIES GRANTS GENERALLY LIMITED TO TAX-EXEMPT PUBLIC CHARITIES IN KANSAS
Form 990-PF (2011)
Form 9 9 O- P F ( 2 O 11 ) Page 11
1:)ffii:tfJ
Supplementary Information (continued)
3 Grants and Contributions Paid During the Year or Approved for Future Payment
If rec1p1ent 1s an 1nd1v1dual,
Rec1p1ent Foundation
show any relat1onsh1p to Purpose of grant or
status of A mount
any foundation manager contribution
Name and address (home or business) rec1p1ent
or substantial contributor
a Paid dunng the year
See Add1t1onal Data Table
Total. ....3b
Form 990-PF (2011)
Form 9 9 O - P F ( 2 O 11 ) Page 12
I :F-Til ;i"~!lit~J Ana IYSIS 0 f Income-Pro d ucmg Act1v1t1es
Enter gross amounts unless otherwise 1nd1cated Unrelated business income Excluded by section 512, 513, or 514 (e)
Related or exempt
function income
(a) (b) (c) (d)
(See page 28 of
1 Program service revenue Business code A mount Exclusion code A mount
the 1nstruct1ons )
a
b
C
d
e
f
g Fees and contracts from government agencies
2 Membership dues and assessments.
3 Interest on savings and temporary cash investments 14 268
4 D1v1dends and interest from securities. 14 1,168,613
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.
8 Gain or ( loss) from sales of assets other than inventory 18 61,808
9 Net income or (loss) from special events
10 Gross profit or (loss) from sales of inventory.
11 Other revenue a
b
C
d
e
12 Subtotal Add columns (b), (d), and (e). 1,230,689
13 Total. Add line 12, columns (b), (d), and (e). . 13 ________ ___;;1;;.,.;;;;.2..;;..3...;;.0.,_6'-8;;..;;_9
(See worksheet 1n line 13 1nstruct1ons on page 28 to verify calculations )
Part XVI-B Relationshi of Activities to the Aecom lishment of Exem t Pur oses
..
Line No.
Explain below how each act1v1ty for which income
the accomplishment of the organ1zat1on's exempt
page 28 of the 1nstruct1ons)
1s reported 1n column (e) of Part XVI-A contributed importantly
purposes (other than by prov1d1ng funds for such purposes) (See
to
(a) Line No (b) Amount involved (c) Name of nonchantable exempt organ1zat1on (d) Description of transfers, transactions, and sharing arrangements
2a Is the foundation directly or 1nd1rectly aff1l1ated with, or related to, one or more tax-exempt organ1zat1ons
described 1n section 5 O 1 (c) of the Code (other than section 5 O 1 (c )(3 )) or 1n section 5 2 7 7. .I Yes
b If"Yes," complete the following schedule
(a) Name of organ1zat1on (b) Type of organ1zat1on (c) Description of relat1onsh1p
Under penalties of perJury, I declare that I have examined this return, 1nclud1ng accompanying schedules and statements, and to
the best of my knowledge and belief, 1t 1s true, correct, and complete Declaration of preparer (other than taxpayer or f1duc1ary) 1s
based on all 1nformat1on ofwh1ch preparer has any knowledge
i 2012-11-15
~ ~
****** ******
Signature of officer or trustee Date Title
Date PTIN
~
-:l) Check 1f self-
:::c
C
Preparer's ~ ELIZABETH S HOGAN employed ~r
::r.:, Signature
ii) >,
'":..-
v.i -fC
.::.:,i::o Firm's name ~ BKD LLP Firm's EIN ~
i::f:::.,t,
t ,j) 1551 N WATERFRONT PKWY STE 300
Cl.:i
Firm's address ~ WICHITA, KS 672066601 Phone no (316) 265-2811
May the IRS discuss this return with the preparer shown above7 See 1nstruct1ons ...P-Yes I No
r 527 pol1t1calorganization
General Rule-
P" For an organization f1l1ngForm 990, 990-EZ, or 990-Ff" that received, during the year, $5,000 or more ( 1nmoney or
property) from any one contributor Complete Parts I and II
Special Rules
1
1 For a section 501 ( c )(3) organization f1l1ngForm 990 or 990-EZ, that met the 33 /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 (1) Form 990, Part VIII, line 1h, or (11)Form 990-EZ, line 1 Complete Parts I and II
1 For a section 501 ( c )(7), ( 8), or ( 10) organization f1l1ngForm 990, or 990-EZ, that received from any one contributor,
during the year, aggregate contributions of more than $1,000 for use exclus1vely for rel1g1ous,charitable,
sc1ent1f1c,literary, or educational purposes, or the prevention of cruelty to children or animals Complete Parts I, II, and
Ill
1 For a section 501 ( c )(7), ( 8), or ( 10) organization f1l1ngForm 990, or 990-EZ, that received from any one contributor,
during the year, contributions for use exclus1vely for rel1g1ous,charitable, etc , purposes, but these contributions did
not aggregate to more than $1,000 If this box 1schecked, enter here the total contributions that were received during
the year for an exclus1vely rel1g1ous,charitable, etc, purpose Do not complete any of the parts unless the General Rule
applies to this organization because 1treceived nonexclus1vely rel1g1ous,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-Ff"), but 1tmust answer "No" on Part IV, line 2 of its Form 990, or check the box 1nthe heading of its
Form 990-EZ, or on line 2 of its Form 990-Ff", to certify that 1tdoes not meet the f1l1ngrequirements of Schedule B ( Form 990,
990-EZ, or 990-Ff")
For Paperwork Reduction Pct Notice, see the Instructions Cat No 30613X Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
for Form 990, 990-EZ, or 990-PF
Schedule B (Form 990, 990-EZ, or 990-PF) (2011) Page _1_ of _1_ of Part I
Name of organization Employer identification number
FRED C & MARY R KOCH FOUNDATION INC
48-6113560
-- 1 Person p
KOCH INDUSTRIES
PO BOX 2256
INC
Payroll r
$ 226,000 Noncash r
WICHITA, KS 672012256 (Complete Part II 1f there 1s
a noncash contribution )
-- Person r
Payroll r
$ Noncash r
(Complete Part II 1f there 1s
a noncash contribution )
-- Person r
Payroll r
$ Noncash r
(Complete Part II 1f there 1s
a noncash contribution )
-- Person r
Payroll r
$ Noncash r
(Complete Part II 1f there 1s
a noncash contribution )
-- Person r
Payroll r
$ Noncash r
(Complete Part II 1f there 1s
a noncash contribution )
-- Person r
Payroll r
$ Noncash r
(Complete Part II 1f there 1s
a noncash contribution )
--
--
--
--
--
--
--
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
--
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
--
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
--
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
Software ID:
Software Version:
EIN: 48-6113560
Name: FRED C & MARY R KOCH FOUNDATION INC
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KANSAS 255 N 2010-01-22 111,000 GENERAL OPERATING SUPPORT FOR 10,775 NO JULY 11, 2011 THE GRANTOR HAS NO REASON TO DOUBT THE ACCURACY
CULTURAL ROOSEVELT EDUCATIONAL FOUNDATION - GRANTS OR RELJABIUTY OF THE REPORT FROM THE GRANTEE,
TRUST WICHITA, KS FOR YOUNG VISUAL & PERFORMING THEREFORE, NO INDEPENDENT VERIFICATION OF THE
67208 ARTISTS REPORTS WERE MADE
KANSAS 255 N 2011-01-18 148,000 GENERAL OPERATING SUPPORT FOR 141,862 NO JULY 11, 2011 THE GRANTOR HAS NO REASON TO DOUBT THE ACCURACY
CULTURAL ROOSEVELT EDUCATIONAL FOUNDATION - GRANTS OR RELJABIUTY OF THE REPORT FROM THE GRANTEE,
TRUST WICHITA, KS FOR YOUNG VISUAL & PERFORMING THEREFORE, NO INDEPENDENT VERIFICATION OF THE
67208 ARTISTS REPORTS WERE MADE
lefile GRAPHIC print - DO NOT PROCESS I As Filed Data - I DLN:934913200191121
BANK FEES 44 44
CORPORATE FILING FEES 89 89
lefile GRAPHIC print - DO NOT PROCESS I As Filed Data - I DLN:934913200191121