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

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CALIFORNIA PHYSICIANS' SERVICE FDN (DBA 94-2822302 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 990-PF EXPENDITURE RESPONSIBILITY STATEMENT STATEMENT 14 PART VII-B, LINE 5C }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} GRANTEE'S NAME }}}}}}}}}}}}}} SEE ATTACHMENT E, PAGES 1 THROUGH 11 GRANTEE'S ADDRESS }}}}}}}}}}}}}}}}} SEE ATTACHMENT E GRANT AMOUNT DATE OF GRANT AMOUNT EXPENDED }}}}}}}}}}}}}} }}}}}}}}}}}}} }}}}}}}}}}}}}}} PURPOSE OF GRANT }}}}}}}}}}}}}}}} SEE ATTACHMENT E DATES OF REPORTS BY GRANTEE }}}}}}}}}}}}}}}}}}}}}}}}}}} SEE ATTACHMENT E 23 STATEMENT(S) 14 09011109 794095 155930.0 2009.04050 CALIFORNIA PHYSICIANS' SERV 15593001
CALIFORNIA PHYSICIANS' SERVICE FDN (DBA 94-2822302 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 990-PF ELECTION UNDER REGULATIONS SECTION STATEMENT 15 53.4942(A)-3(D)(2) TO TREAT EXCESS QUALIFYING DISTRIBUTIONS AS DISTRIBUTIONS OUT OF CORPUS }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} ELECTION UNDER REGULATIONS SECTION 53.4942(A)-3(D)(2), THE FOUNDATION HEREBY ELECTS TO TREAT CURRENT YEAR QUALIFYING DISTRIBUTIONS OUT OF CORPUS. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 24 STATEMENT(S) 15 09011109 794095 155930.0 2009.04050 CALIFORNIA PHYSICIANS' SERV 15593001
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November 9, 2010 California Physici
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TAX RETURN FILING INSTRUCTIONS FORM
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Form 990-PF (2009) Assets Liabiliti
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Form 990-PF (2009) Part VI CALIFORN
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Form 990-PF (2009) Part VII-B CALIF
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Form 990-PF (2009) Part X CALIFORNI
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CALIFORNIA PHYSICIANS' SERVICE FDN
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Form 990-PF (2009) Part XVI-A Enter
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Schedule B (Form 990, 990-EZ, or 99
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Form Department of the Treasury Int
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Form 8868 (Rev. 4-2009) ¥ If you a
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Blue Shield of California Foundatio
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California Physicians' Service Fdn
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Form 990P- Part IX-A Summary of Dir
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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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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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FORM 990-PF Form 2220 (2009) Part I
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IRS Form 990-PF for 2009 - Blue Shield of California Foundation

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