Sample Form 990-Pf - Return Of Private Foundation - 2015 Page 8
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138
Form 990-PF (2015)
Page
Part X
Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,
see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a Average monthly fair market value of securities
1a
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b Average of monthly cash balances
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1b
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c Fair market value of all other assets (see instructions)
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1c
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d Total (add lines 1a, b, and c)
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e Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation) .
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1e
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2
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Acquisition indebtedness applicable to line 1 assets .
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3
Subtract line 2 from line 1d .
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3
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Cash deemed held for charitable activities. Enter 1
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% of line 3 (for greater amount, see
1
2
instructions) .
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4
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5
Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
5
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6
Minimum investment return. Enter 5% of line 5 .
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0
Part XI
Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations
and certain foreign organizations check here
and do not complete this part.)
▶
1
Minimum investment return from Part X, line 6 .
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1
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2a Tax on investment income for 2015 from Part VI, line 5 .
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2a
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b Income tax for 2015. (This does not include the tax from Part VI.)
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c Add lines 2a and 2b
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2c
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3
Distributable amount before adjustments. Subtract line 2c from line 1 .
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3
0
4
4
Recoveries of amounts treated as qualifying distributions .
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5
5
Add lines 3 and 4 .
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6
Deduction from distributable amount (see instructions) .
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6
0
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Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII,
line 1
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0
Part XII
Qualifying Distributions (see instructions)
1
Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
a Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 .
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1a
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b Program-related investments—total from Part IX-B .
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1b
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2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes .
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2
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Amounts set aside for specific charitable projects that satisfy the:
a Suitability test (prior IRS approval required) .
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3a
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b Cash distribution test (attach the required schedule) .
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Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
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5
Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment income.
Enter 1% of Part I, line 27b (see instructions)
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5
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6
Adjusted qualifying distributions. Subtract line 5 from line 4
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6
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Note. The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation
qualifies for the section 4940(e) reduction of tax in those years.
990-PF
Form
(2015)
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