Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Form
990-PF
Do not enter social security numbers on this form as it may be made public.
Internal Revenue Service
~~Information about Form 990-PF and its separate instructions is at www.irs.gov/form990pf.
For calendar year 2014 or tax year beginning
, and ending
Department of the Treasury
Name of foundation
26-0344869
Number and street (or P.O. box number if mail is not delivered to street address)
Room/suite
336-497-1854
City or town, state or province, country, and ZIP or foreign postal code
NC _
27403
GREENSBORO
G Check all that apply:
I-I
Initial return
Final return
Address change
IL,
amounts in columns (b), (c), and (d) may not necessarily equal
the amounts in column (a) (see instructions).)
2a)
>
a)
Et
u)
m
co
?<W
a)
>
..i=
sL
715
E
-0
ott
=
cc
ia)
c
...c
279,416
Contributions, gifts, grants, etc., received (attach schedule)
if the foundation is not required to attach Sch. B
Check ~~
3
4
5a
b
6a
b
13
14
15
16a
b
c
17
18
19
STMT 1
~~
~~
-1
i
~~
~~
137,332
(d) Disbursements
for charitable
purposes
(cash basis only)
137,332
777,253
777,441
8,443
STMT 2
STMT 3
STMT 4
24
1,194,001
101,476
165,725
27,022
914,773
145,775
101,476
165,725
27,022
10,263
10,263
13,803
7,863
15,898
86,905
86,905
15,898
STMT 5
STMT 6
134,741
45,900
45,900
88,009
45,900
45,900
'45,900
45,900
495,298
461,036
956,334
25
26
27
563,696
461,036
1,024,732
169,269
868,873
99,875
Form
~~ -
4,249,073
137,332
Occupancy
Travel, conferences, and meetings
a
b
Gross rents
Net rental income or (loss)
20
21
22
23
ivi
L.
a)
expenses per
books
1
2
7
8
9
10a
b
c
11
12
Name change
2014
Open to Public Inspection
990-P F (2014)
Balance Sheets
Part II
1
2
3
4
5
6
cr,
9,107,303
8,444,023
50, 000
50 , 000
50 , 000
57,342
39,272
STMT 7
SEE STATEMENT 8
)
20,734
4,756
18,070
50 , 000
18 ,070
50,000
9,324,404
8 , 744 f 251
8,744,252
56,255
56,255
53, 671
9,268,149
8,690,580
~~ SEE
~~
II
20
21
22
23
coo
Zi
cf)
a)
(.)
as
5
m
c
c
a.
)
a
u)
5
Z
~~
Grants payable
Deferred revenue
Loans from officers, directors, trustees, and other disqualified persons
Mortgages and other notes payable (attach schedule)
Other liabilities (describe
Total liabilities (add lines 17 through 22)
Foundations that follow SFAS 117, check here
and complete lines 24 through 26 and lines 30 and 31.
~~
~~ liE
53, 671
Unrestricted
Temporarily restricted
Permanently restricted
Foundations that do not follow SFAS 117, check here
and complete lines 27 through 31.
27
28
9,268,149
8,690,580
9,324,404
8,744,251
Part III
1
SEE STATEMENT 9
24
25
26
29
30
31
ct
10'
llot
12
13
14
u)
w
50 , 000
17
18
19
WRK
b
c
11
15
16
182 ,159
182 ,158
8,444,023
~~
~~
8
9
10a
<
7
to
,n
Analysis
of
Chanaes
in
Net Assets
or
~~ _
Fund Balances
Total net assets or fund balances at beginning of year Part II, column (a), line 30 (must agree with
~~
~~
SEE STATEMENT 10
9,268,149
169,269
1
2
3
4
5
6
9,437,418
746,838
8,690,580
Form
DAA
End of year
141, 611
ti.
Cash non-interest-bearing
Savings and temporary cash investments
Accounts receivable
Less: allowance for doubtful accounts
Pledges receivable
Less: allowance for doubtful accounts
Grants receivable
~~
~~
Page
Beginning of year
990-PF (2014)
Part IV
Page
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)
1a
b
c
d
e
26-0344869
SEE WORKSHEET
a
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(i) F.M.V. as of 12/31/69
a
b
c
d
e
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0- in
2 Capital gain net income or (net capital loss)
Part I, line 8
Part V
777,441
8,443
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 in the base period?
Yes Xi No
If "Yes," the foundation does not qualify under section 4940(e). Do not complete this part.
1 Enter the appropriate amount in each column for each year; see the instructions before making any entries.
(a)
(b)
Adjusted qualifying distributions
2013
2012
2011
2010
2009
(d)
Distribution ratio
(col. (b) divided by col. (c))
(c)
Net value of noncharitable-use assets
1,164,465
575,906
381,194
292,380
251,092
8,744,189
7,615,871
6,689,761
356,981
402,139
0.133170
0.075619
0.056982
0.819035
0.624391
1.709197
0.341839
4 Enter the net value of noncharitable-use assets for 2014 from Part X, line 5
8 I 922 f 490
3, 050,055
8,689
3 I 058 f 744
8
Enter qualifying distributions from Part XII, line 4
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1 b, and complete that part using a 1% tax rate. See the
956,334
Part VI instructions.
Form
DAA
990-PF (2014)
Part VII-A
la
b
17 377
All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4 % of
Part I, line 12, col. (b).
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only.
thers enter -0-)
Add lines 1 and 2
Subtitle A (income) tax (domestic section 4947(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 -0Credits/Payments:
2014 estimated tax payments and 2013 overpayment credited to 2014
6a
Exempt foreign organizations tax withheld at source
6b
Tax paid with application for extension of time to file (Form 8868)
6c
Backup withholding erroneously withheld
6d
TAX PAID W/ O.R.
Total credits and payments. Add lines 6a through 6d
X if Form 2220 is a ttached
Enter any penalty for underpayment of estimated tax. Check here
Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed
Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpai d
Enter the amount of line 10 to be: Credited to 2015 estimated tax ~~
Page 4
3
4
5
17,377
7
8
9
10
17,415
38
17,377
8,720
8,695
Refunded
~~
~~
~~
11
Statements RegardingActivities
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did it
participate or intervene in any political campaign?
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see
la
No
X
lb
1c
Yes
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers. ~~ $
Has the foundation engaged in any activities that have not previously been reported to the IRS?
incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes
4a Did the foundation have unrelated business gross income of $1,000 or more during the year?
b If "Yes," has it filed a tax return on Form 990-T for this year?
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
5
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:
6
7
8a
N/A
4a
4b
5
6
7
X
X
8b
NC
b If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney General
9
10
(or designate) of each state as required by General Instruction G? If "No," attach explanation
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3) or
4942(j)(5) for calendar year 2014 or the taxable year beginning in 2014 (see instructions for Part XIV)? If "Yes,"
10
Form
DAA
990-PF (2014)
Part VII-A
11
12
13
14
Page
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule (see instructions)
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified
person had advisory privileges? If "Yes," attach statement (see instructions)
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
Website address ~~ WWW F4DC . ORG
The books are in care of ~~ MARNIE THOMPSON
Telephone no. ~~
NC
12
13
336-497-1854
27403
ZIP+4 ~~
~ I
11
15
At any time during calendar year 2014, did the foundation have an interest in or a signature or other authority
over a bank, securities, or other financial account in a foreign country?
Yes
No
16
See the instructions for exceptions and filing requirements for FinCEN Form 114, (formerly TD F 90-22.1). If
"Yes," enter the name of the foreign country ~~
Part VII-B
la
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies
During the year did the foundation (either directly or indirectly):
(1) Engage in the sale or exchange, or leasing of property with a disqualified person?
(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from) a
disqualified person?
(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
(5) Transfer any income or assets to a disqualified person (or make any of either available for
Yes
Yes
No
Yes
Yes
Yes
No
No
No
Yes
Yes
No
No
No
1b
N/A
were not corrected before the first day of the tax year beginning in 2014?
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
1c
Yes
IX
No
(relating to incorrect valuation of assets) to the year's undistributed income? (If applying section 4942(a)(2) to
N/A
all years listed, answer "No" and attach statement see instructions.)
c If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
, 20
, 20
, 20
~ 20
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 it have excess business holdings in 2014 as a result of (1) any purchase by the foundation or
Yes
2b
No
disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved by the
Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3) the lapse of
the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine if the
foundation had excess business holdings in 2014.)
4a Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
b Did the foundation make any investment in 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 beginning in 2014?
N/A
3b
4a
4b
Form
DAA
990-PF (2014)
Part VII-B
5a
6a
26-0344869
During the year did the foundation pay or incur any amount to:
(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
(2) Influence the outcome of any specific public election (see section 4955); or to carry on,
directly or indirectly, any voter registration drive?
(3) Provide a grant to an individual for travel, study, or other similar purposes?
(4) Provide a grant to an organization other than a charitable, etc., organization described in
section 4945(d)(4)(A)? (see instructions)
(5) Provide for any purpose other than religious, charitable, scientific, literary, or educational
purposes, or for the prevention of cruelty to children or animals?
If any answer is "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)?
Organizations relying on a current notice regarding disaster assistance check here
If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the tax
because it maintained expenditure responsibility for the grant?
If "Yes," attach the statement required by Regulations section 53.4945-5(d).
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums
7a
b
Part VIII
Page
Statements Regarding Activities for Which Form 4720 May Be Required continued
Yes
X No
Yes
Yes
No
X No
X Yes
No
Yes
No
IX Yes
No
Yes
X No
Yes
5b
6b
No
N/A 7b
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1 List all officers, directors, trustees, foundation managers and their compensation (see instructions).
(b) Title, and average
hours per week
devoted to position
GREENSBORO
MARN I E THOMPSON
620 SOUTH ELM STREET STE 355
ED WHITFIELD
NC 27406
GREENSBORO
NC
27406
COMNGNG DIR
40.00
C0MNGNG DIR
40.00
(c) Compensation
(d) Contributions to
employee benefit
plans and deferred
compensation
51,928
49,548
2 Compensation of five highest-paid employees (other than those included on line 1 see instructions). If none, enter
"NONE."
(a) Name and address of each employee paid more than $50,000
(c) Compensation
(d) Contributions to
employee benefit
plans and deferred
compensation
NONE
DAA
0
990-PF (2014)
Part VIII
3
Page
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors (continued)
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
(c) Compensation
NONE
Part IX-A
List the foundation's four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of
organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
Part IX-B
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
N/A
DAA
990-PF
(2014)
Page 8
Part X
1
a
b
c
d
e
2
3
4
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 1 a, b, and c)
Reduction claimed for blockage or other factors reported on lines la and
lc (attach detailed explanation)
1e
Acquisition indebtedness applicable to line 1 assets
Subtract line 2 from line 1d
Cash deemed held for charitable activities. Enter 11/2% of line 3 (for greater amount, see
Part XI
8 , 907 , 842
1b
lc
ld
150,523
9 , 058 , 365
4
5
6
135,875
8 , 922 , 490
446,125
1
2a
2b
2c
5
6
7
line 1
a Expenses, contributions, gifts, etc. total from Part I, column (d), line 26
b Program-related investments total from Part IX-B
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
2
la
1b
purposes
Amounts set aside for specific charitable projects that satisfy the:
3
a Suitability test (prior IRS approval required)
b Cash distribution test (attach the required schedule)
Qualifying distributions. Add lines la through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment income.
5
365
Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations
and certain foreign organizations check here ~~ X and do not complete this p art.
Part XII
0
9 , 058 ,
instructions)
Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
Minimum investment return. Enter 5% of line 5
la
956,334
3a
3b
956,334
0
956,334
5
6
DAA
990-PF (2014)
Part XIII
1
26-0344869
Page
instructions)
(a)
(b)
(c)
(d)
Corpus
2013
2014
line 7
Undistributed income, if any, as of the end of 2014:
a Enter amount for 2013 only
, 20
b Total for prior years: 20
, 20
3
Excess distributions carryover, if any, to 2014:
2
a From 2009
b From 2010
c From 2011
d From 2012
e From 2013
f Total of lines 3a through e
4
Qualifying distributions for 2014 from Part XII,
956,334
line 4: $
a Applied to 2013, but not more than line 2a
b Applied to undistributed income of prior years
(Election required see instructions)
Treated as distributions out of corpus (Election
required see instructions)
d Applied to 2014 distributable amount
e Remaining amount distributed out of corp US
Excess distributions carryover applied to 2014
5
(If an amount appears in column (d), the same
amount must be shown in column (a).)
Enter the net total of each column as
6
indicated below:
a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
956,334
956,334
DAA
Part XIV
Page
1a If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2014, enter the date of the ruling
X 4942(j)(3) or
b Check box to indicate whether the foundation is a private operating foundation described in section
Tax year
Prior 3 years
2a Enter the lesser of the adjusted net
(02w4
(02ou
income from Part I or the minimum
lE02m1
0))2013
investment return from Part X for
each year listed
b 85% of line 2a
c Qualifying distributions from Part XII,
line 4 for each year listed
d Amounts included in line 2c not used directly
for active conduct of exempt activities
e Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
3
N/A
4942(j)(5)
le) Total
99,875
84,894
116,302
98,857
82,035
69,730
57,166
48,591
355,378
302,072
956,334
1,164,465
575,906
381,194
3,077,899
455,259
728,924
226,096
193,658
1,603,937
501,075
435,541
349,810
187,536
1,473,962
297,417
291,473
253,863
222,992
1,065,745
Part XV
1
10
Supplementary Information (Complete this part only if the foundation had $5,000 or more in assets at
any time during the year - see instructions.)
N/A
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.
N/A
2
a The name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
SEE STATEMENT 11
c Any submission deadlines:
SEE STATEMENT 12
d Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
SEE STATEMENT 13
DAA
Form
990-PF (2014)
26-0344869
Page 11
Part XV
Supplementary Information (continued)
3 Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
Name and address (home or business)
a
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
SEE ATTACHED
SEE ATTACHED
SEE ATTACHED NC
Total
Approved for future payment
27609
SEE ATTACHED
~~
3a
~~
3b
461,036
461,036
N/A
Total
DAA
Form
990-PF (2014)
figgoh.ghiimom09 4 1H1
m8------88888888g8888888e8g88888888888888888.-88
Part X
_VI-A
Page 12
(c)
Exclusion
code
(b)
Amount
le)
Related or exempt
function income
(See instructions.)
(d)
Amount
a
b
d
e
g Fees and contracts from government agencies
M embership dues and assessments
In terest on savings and temporary cash investments
2
3
4
5
137,332
Part XVI-B
Line No.
V
777,253
914,585
914,585
13
N/A
Form
DM
990-PF (2014)
Part XVII
Page 13
Exempt Organizations
Yes
1 Did the organization directly or indirectly engage in any of the following with any other organization described
in section 501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political
organizations?
a Transfers from the reporting foundation to a noncharitable exempt organization of:
(1) Cash
(2) Other assets
1a(1)
1a(2)
b Other transactions:
(1) Sales of assets to a noncharitable exempt organization
(2) Purchases of assets from a noncharitable exempt organization
(3) Rental of facilities, equipment, or other assets
1b(1)
1 b(2)
1 b(3)
No
1 b(4)
1 b(5)
1 b(6)
1c
N/A
2a Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527?
Yes L/_; No
N/A
Sign
Here
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,
correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
May the IRS discuss this return
with the preparer shown below
(see instructions)?
Paid
CHUCK AVERRE, CPA
Prepar r
Use Only
Firm's name
~~
Firm's address
lo.
Yes
I No
PRESIDENT
Date
Title
Preparer's signature
Date
Check
if
self-employed
07/25/16
P00280366
Firm's EIN Ilo 56-2119415
919-848-4100
Phone no.
PTIN
Form
990-PF (2ola)
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
~ Attach to Form 990, Form 990-EZ, or Form 990-PF.
~ Information about Schedule B (Form 990, 990-EZ, 990-PF) and its instructions is at www.irs.gov/form990.
2014
26-0344869
Section:
501(c)(
Jt. For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000
or more (in money or property) from any one contributor. Complete Parts I and II. See instructions for determining a
contributor's total contributions.
Special Rules
For an organization described in section 501(c)(3) 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)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line
13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1)
$5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1 h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.
For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one
contributor, during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific,
literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.
For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one
contributor, during the year, contributions exclusively for religious, charitable, etc., purposes, but no such
contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received
during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the
General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions
totaling $5,000 or more during the year
~~ $
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer "No" on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on its
Form 990-PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions for Form 990, 990-EZ, or 990-PF.
DAA
PAGE 1 OF 1
(a)
No.
Name of organization
Part I
Page
26-0344869
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(c)
Total contributions
(b)
Name, address, and ZIP + 4
(d)
Type of contribution
IX
Person
279,416
Payroll
Noncash
(Complete Part II for
noncash contributions.)
(a)
No.
(c)
Total contributions
(b)
Name, address, and ZIP + 4
(d)
Type of contribution
Person
Payroll
Noncash
___
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Fi--'
Payroll
Noncash
(c)
Total contributions
(b)
Name, address, and ZIP + 4
(d)
Type of contribution
Person
Payroll
L_
_J
Noncash
_1
(Complete Part II for
noncash contributions.)
(a)
No.
(c)
(b)
Name, address, and ZIP + 4
Total contributions
(d)
Type of contribution
1
Person
Payroll
Noncash
(Complete Part II for
noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
(d)
Total contributions
Type of contribution
,-Person
I__
Payroll
Noncash
(Complete Part II for
noncash contributions.)
7/25/2016 5:26 PM
7/25/2016 5:26 PM
Whom
Sold
Description
Date
Acquired
Date
Sold
1/01/14 $
10/19/07
WESTERN DIGITAL 250 GB MYBOOK PRO
1/01/14
10/19/07
ADOBE CS3 DESIGN PREM
1/01/14
10/19/07
MS WINDOWS XP
1/01/14
10/19/07
500 GB EXTERNAL DRIVE
2/01/08 1/01/14
LINKSYS NAS200 NETWRK STORAGE SYSTEM
2/23/08
1/01/14
1 COMPAC PRESARIO LAPTOPS
2/01/08 1/01/14
BH 500 COPIER
6/02/08 1/01/14
TELEPHONE
4/26/08
1/01/14
REFURB COMPAQ LAPTOP
8/31/11 1/01/14
REFURB COMPAQ LAPTOP #2
8/31/11 1/01/14
ADOBE UPGRADE
3/05/12
1/01/14
ROCKET GENIUS SOFTWARE
4/05/12
1/01/14
PROGRAM FOR MAC
6/14/12
1/01/14
PHP RUNNER FOR MFD DATABASE
3/06/13 1/01/14
How
Received
Sale
Price
PURCHASE
$
PURCHASE
PURCHASE
PURCHASE
PURCHASE
PURCHASE
PURCHASE
PURCHASE
PURCHASE
PURCHASE
PURCHASE
PURCHASE
PURCHASE
PURCHASE
PURCHASE
Depreciation
Expense
Cost
4,664 $
Net
Gain / Loss
4,664 $
171
171
1,896
1,896
298
298
145
145
241
241
1,065
1,065
9,599
9,599
53
53
225
225
225
225
72
58
-14
199
158
-41
135
103
-32
279
178
-101
7/25/2016 5:26 PM
Statements
Whom
Sold
Description
Date
Acquired
How
Received
Sale
Price
Date
Sold
TOTAL
19,267 $
0 $
Net
Gain / Loss
Depreciation
Expense
Cost
-188
19,079 $
0 $
$
$
10,263
10,263
$
$
Charitable
Purpose
Adjusted
Net
Net
Investment
Total
$
$
10,263
10,263
$
$
Net
Investment
Total
INDIRECT TAXES/LICENSES
TOTAL
$
$
13,803
13,803
$
$
Charitable
Purpose
Adjusted
Net
0
$
$
$
$
Description
Cost
Prior Year
Basis
Depreciation
4,664 200DB
171 200DB
Method
Life
5 $
Current Year
Depreciation
Net Investment
Income
$
Adjusted Net
Income
$
1-4
7/25/2016 5:26 PM
Statements
10/19/07
1,896
MS WINDOWS XP
10/19/07
298
GOTHAM ROUNDED MAC LICENSE (2)
1/05/08
576
QUICKBOOKS PRO MAC; OFFICE
4/09/08
101
QBOOKS 2010 MAC UPDATE
7/03/10
25
CS4 UPGRADE FOR MAC
9/29/10
136
MACBOOK AIR
8/02/11
1,947
Method
Life
7 $
102 $
11
5
5
5
5
5
5
7
1,896
298
576
101
25
136
1,947 200DB
Adjusted Net
Income
Net Investment
Income
Current Year
Depreciation
7/25/2016 5:26 PM
Statements
Method
Adjusted Net
Income
Net Investment
Income
Current Year
Depreciation
Life
200DB
5 $
200DB
200DB
200DB
198
200DB
34
3
3
3
200DB
17
200DB
17
200DB
13
200DB
40
200DB
20
200DB
200DB
200DB
14
200DB
399
7/25/2016 5:26 PM
Federal Statements
26-0344869
FYE: 12/31/2014
Date
Acquired
MICROWAVE
35 $
3/12/12 $
MINI REFRIGERATOR
100
3/12/12
PORTABLE HARD DRIVES (3)
326
6/12/12
2 MACBOOK AIRS
7,441
2/07/13
MAC MINI 2.3 SERVER
1,322
9/11/13
QUICKBOOKS
294
2/21/13
PHP RUNNER FOR MFD DATABASE
279
3/06/13
ADOBE CREATIVE SUITE 6
150
3/12/13
RR# 247 VIDEO CAMERA
344
4/10/13
CANON 5255 COPIER
12/30/13
9,547
Method
24 200DB
7 $
69 200DB
226 200DB
28
5,023 200DB
967
760 200DB
225
192
49
178
96
25
202 200DB
41
5,012 200DB
1,814
200DB
393
200DB
838
200DB
1,118
200DB
986
200DB
477
TABLET COMPUTER
2/04/14
655
MACBOOK AIR
1,396
6/18/14
CANON ZOOM LENS
8/21/14
1,956
CANON EOS 6D
8/21/14
1,725
BESCOR STUDIO LIGHT KIT
8/21/14
834
Adjusted Net
Income
Net Investment
Income
Current Year
Depreciation
Life
7/25/2016 5:26 PM
Statements
Date
Basis
Acquired
TOTAL
Prior Year
Depreciation
58,884 $
Life
Method
0$
7,863 $
41,526
Income
Income
Depreciation
Acquired
START UP COSTS
TOTAL
6/05/07 $
Cost
Basis
17,726 $
17,726 $
Prior Year
Amortization Life
7,780
7,780
15 $
Amortization
1,182 $
1,182 $
COGS
Income
Income
$
0$
4-5
7/25/2016 5:26 PM
Statements
EXPENSES
OUTSIDE CONTRACTOR SERVICES
INVESTING & BANKING FEES
DUES/SUBSCRIPTIONS
EVENT FOOD & SUPPLIES
OFFICE SUPPLIES
INSURANCE
WEB & INTERNET
BUSINESS MEALS
TELEPHONE
COMPUTER EXPENSE
BOOKS, SUBSCRIPTIONS
PAYROLL PROCESSING
VOLUNTEER APPRECIATION
DEVELOPMENT
POSTAGE, MAILING SERVICE
CREDIT CARD FEES
TOTAL
$
52,661
45,900
10,405
2,676
4,156
3,702
3,489
2,369
1,311
1,896
1,194
1,658
655
1,050
398
39
133,559
Charitable
Purpose
Adjusted
Net
Net
Investment
Total
Description
$
52,661
45,900
45,900
45,900
45,900
10,755
2,676
4,156
3,702
3,489
2,369
1,311
1,896
1,194
1,658
655
1,050
398
39
88,009
Statement 7 - Form 990-PF, Part II, Line 14 - Land, Building, and Equipment
Description
FURNISHINGS
OFFICE EQUIPMENT
COMPUTER EQUIPMENT
SOFTWARE
START UP COSTS
TOTAL
Beginning
Net Book
620
6,266
3,557
345
9,946
20,734
End
Cost / Basis
2,814
$
19,920
15,600
1,282
17,726
57,342
End Accumulated
Depreciation
2,440
14,027
12,643
1,200
8,962
39,272
Net
FMV
374
5,892
2,957
82
8,765
18,070
6-7
7/25/2016 5:26 PM
Beginning
of Year
Description
DUE FROM RCC
TOTAL
4,756
4,756
$
$
End of
Year
$
$
Fair Market
Value
50,000
50,000
$
$
50,000
50,000
Beginning
of Year
Description
DEPOSITS - SPONSORSHIPS
CREDIT CARD BALANCE
LOAN - COMMUNITY FOUNDATION
TOTAL
$
$
End of
Year
3,308
2,947
50,000
56,255
2,313
1,358
50,000
53,671
$
$
Description
UNREALIZED LOSS ON INVESTMENTS
TOTAL
Amount
$
$
746,838
746,838
Statement 11 - Form 990-PF, Part XV, Line 2b - Application Format and Required Contents
Description
GRANT APPLICANTS MUST COMPLETE THE GRANT APPLICATION
AVAILABLE ONLINE AT WWW.F4DC.ORG .
Statement 12 - Form 990-PF, Part XV, Line 2c - Submission Deadlines
Description
F4DC ACCEPTS GRANT APPLICATIONS ON A ROLLING BASIS.
INTERESTED PARTIES SHOULD CONSULT WWW.F4DC.ORG TO LEARN
MORE ABOUT OUR GRANT GUIDELINES.
Statement 13 - Form 990-PF, Part XV, Line 2d - Award Restrictions or Limitations
Description
F4DC CONCENTRATES ITS GRANTMAKING IN THE SOUTHEASTERN US,
WITH PARTICULAR INTEREST IN THE NORTH CAROLINA PIEDMONT.
OUR FOCUS IS ON PROJECTS AND PROGRAMS THAT NURTURE
GRASSROOTS DEMOCRACY. GRANTEES MUST SIGN A GRANT
AGREEMENT FORM STATING THAT THE GRANT WILL BE USED FOR THE
PURPOSE INTENDED. OTHER GUIDELINES ARE LAID OUT IN A
DOWNLOADABLE DOCUMENT TITLED "MATCHING GRANT
INFORMATION PACKET" AT WWW.F4DC.ORG .
8-13
Form
4562
2014
OMB No 1545-0172
(99)
Attachment
Sequence No.
79
Identifying number
26-0344869
INDIRECT DEPRECIATION
Election To Expense Certain Property Under Section 179
Note: If you have any listed property, complete Part V before you complete Part I.
Part I
500,000
Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less, enter -0-. If married filing separately, see instructions
(a) Description of property
2,000,000
7
8
2
3
4
5
8
9
10
11
12
Special De p reciation Allowance and Other De p reciation ( Do not include listed properh .) (See instructions.
Part II
14
Special depreciation allowance for qualified property (other than listed property) placed in service
during the tax year (see instructions)
Property subject to section 168(0(1) election
14
15
3,283
15
16
16
74
17
3,977
Part Ill
17
MACRS deductions for assets placed in service in tax years beginning before 2014
18
If you are electing to group any assets placed in service during the tax year into one or more general asset accounts, check here
~ n
Section BAssets Placed in Service During 2014 Tax Year Using the General Depreciation System
19a
b
c
3-year property
5-year property
7-year property
d
e
f
10-year property
15-year property
20-year property
25-year property
Residential rental
property
h
i
Nonresidential real
property
1,025
2,258
(d) Recovery
period
(e) Convention
5.0
7.0
HY
HY
25 yrs.
27.5 yrs.
MM
S/L
S/L
27.5 yrs.
39 yrs.
MM
MM
S/L
S/L
Class life
b 12-year
c 40-year
12 yrs.
40 yrs.
MM
23
For assets shown above and placed in service during the current year, enter the
DAA
200DB
200DB
205
324
S/L
S/L
S/L
22
21
MM
S/L
Section CAssets Placed in Service During 2014 Tax Year Using the Alternative Depreciation System
20a
Part IV
(f) Method
21
7 863
22
23
Form
4562 (2014)
26-0344869
Page
Part V
Note: For any vehicle for which you are using the standard mileage rate or deducting lease expense, complete only 24a,
24b, columns (a) through (c) of Section A, all of Section B and Section C if applicable.
Section ADepreciation and Other Information (Caution: See the instructions for limits for passenger automobiles.)
24a
Type of property
(list vehicles first)
25
26
(a)
Listed Property (Include automobiles, certain other vehicles, certain aircraft, certain computers, and property
used for entertainment, recreation, or amusement.)
(b)
Date placed
in service
(c)
Business/
investment use
percentage
Yes
I No
(e)
Basis for depreciation
(business/investment
use only)
(d)
Cost or other basis
T Yes
No
(f)
(g)
(h)
(i)
Recovery
period
Method/
Convention
Depreciation
deduction
Special depreciation allowance for qualified isted property placed in service during
the tax year and used more than 50% in a qualified business use (see instructions)
Property used more than 50% in a qualified business use:
cost
25
OA
27
28
29
S/L-
S/L28
Add amounts in column (h), lines 25 through 27. Enter here and on line 21, page 1
Add amounts in column (i), line 26. Enter here and on line 7, page 1
1 29
31
32
33
34
35
36
lines 30 through 32
Was the vehicle available for personal
use during off-duty hours?
Was the vehicle used primarily by a more
than 5% owner or related person?
Is another vehicle available for personal use?
Vehicle 1
Yes
No
Vehicle 2
Yes
No
Vehicle 3
Yes
Vehicle 4
No
Yes
(fl
Vehicle 6
Vehicle 5
No
Yes
No
Yes
No
Yes
No
Section CQuestions for Employers Who Provide Vehicles for Use by Their Employees
Answer these questions to determine if you meet an exception to completing Section B for vehicles used by employees who are not
more than 5% owners or related persons (see instructions).
37
Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting, by
38
your employees?
Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your
employees? See the instructions for vehicles used by corporate officers, directors, or 1% or more owners
39
40
41
Part VI
ization
(a)
Description of costs
(b)
Date amortization
begins
(c)
(d)
Amortizable amount
Code section
42
Amortization of costs that begins during your 2014 tax year (see instructions):
43
44
DAA
(e)
Amortization
period or
percentage
(r)
Amortization for this year
1 182
1 182
43
44
Form
4562 (2014)