IRS Form 990-PF for 2009 - Blue Shield of California Foundation

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Schedule B (Form 990, 990-EZ, or 990-PF) (2009) Page of of Part I Name of organization Employer identification number CALIFORNIA PHYSICIANS' SERVICE FDN (DBA BLUE SHIELD OF CALIFORNIA FDN) 94-2822302 1 1 Part I Contributors (see instructions) (a) No. (b) Name, address, and ZIP + 4 (c) Aggregate contributions (d) Type of contribution 1 CALIFORNIA PHYSICIANS' SERVICE Person Payroll Noncash (Complete Part II if there is a noncash contribution.) 50 BEALE STREET 24,864,623. X SAN FRANCISCO, CA 94105 $ (a) No. (b) Name, address, and ZIP + 4 (c) Aggregate contributions (d) Type of contribution $ Person Payroll Noncash (Complete Part II if there is a noncash contribution.) (a) No. (b) Name, address, and ZIP + 4 (c) Aggregate contributions (d) Type of contribution $ Person Payroll Noncash (Complete Part II if there is a noncash contribution.) (a) No. (b) Name, address, and ZIP + 4 (c) Aggregate contributions (d) Type of contribution $ Person Payroll Noncash (Complete Part II if there is a noncash contribution.) (a) No. (b) Name, address, and ZIP + 4 (c) Aggregate contributions (d) Type of contribution $ Person Payroll Noncash (Complete Part II if there is a noncash contribution.) (a) No. (b) Name, address, and ZIP + 4 (c) Aggregate contributions (d) Type of contribution 923452 02-01-10 $ Person Payroll Noncash (Complete Part II if there is a noncash contribution.) Schedule B (Form 990, 990-EZ, or 990-PF) (2009) 15 09011109 794095 155930.0 2009.04050 CALIFORNIA PHYSICIANS' SERV 15593001
Schedule B (Form 990, 990-EZ, or 990-PF) (2009) Page of of Part II Name of organization Employer identification number CALIFORNIA PHYSICIANS' SERVICE FDN (DBA BLUE SHIELD OF CALIFORNIA FDN) 94-2822302 1 1 Part II Noncash Property (see instructions) (a) No. from Part I 1 STOCK PORTFOLIO SEE ATTACHMENT C (b) Description of noncash property given (c) FMV (or estimate) (see instructions) (d) Date received $ 24,864,623. VARIOUS (a) No. from Part I (b) Description of noncash property given (c) FMV (or estimate) (see instructions) (d) Date received $ (a) No. from Part I (b) Description of noncash property given (c) FMV (or estimate) (see instructions) (d) Date received $ (a) No. from Part I (b) Description of noncash property given (c) FMV (or estimate) (see instructions) (d) Date received $ (a) No. from Part I (b) Description of noncash property given (c) FMV (or estimate) (see instructions) (d) Date received $ (a) No. from Part I (b) Description of noncash property given (c) FMV (or estimate) (see instructions) (d) Date received 923453 02-01-10 $ Schedule B (Form 990, 990-EZ, or 990-PF) (2009) 16 09011109 794095 155930.0 2009.04050 CALIFORNIA PHYSICIANS' SERV 15593001
Page 1 and 2: November 9, 2010 California Physici
Page 3 and 4: TAX RETURN FILING INSTRUCTIONS FORM
Page 5 and 6: Form 990-PF (2009) Assets Liabiliti
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Page 9 and 10: Form 990-PF (2009) Part VII-B CALIF
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TAX RETURN FILING INSTRUCTIONS CALI
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Form 990-PF (2009) 1a b c d e a b c
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CALIFORNIA PHYSICIANS' SERVICE FDN
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Form 990-PF (2009) 3 Five highest-p
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Form 990-PF (2009) CALIFORNIA PHYSI
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Form 990-PF (2009) Part XVII CALIFO
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Schedule B (Form 990, 990-EZ, or 99
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FORM 990-PF Form 2220 (2009) Part I
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Blue Shield of California Foundatio
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MAIL TO: Registry of Charitable Tru
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IRS Form 990-PF for 2009 - Blue Shield of California Foundation

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