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Income m difi - Charity Blossom

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Form 990-PF (zoos) Page 3<br />

Part IV Capital Gains and Losses for Tax on Investment <strong>Income</strong><br />

IFTHOW ( ) Dale<br />

(a) List and describe the kind(s) of property sold (e g , real estate, acquired agqulred d) Date sold<br />

2-sie ry brick e war ouse,o n r mm n co si k, zoo o oc sns ivii.c ) co Pf*"""?" (mo . day. vr I gm" " day" Yr)<br />

VARIOUS VARIOUS<br />

(t) Depreciation allowed (9) C051 Of Other DHSIS<br />

(9) Gross sales price (or allowable) plus expense of sale<br />

Complete only for assets showing gain in column (Q) and owned by the foundation on 12/31/69<br />

(1) Adlusted basis (k) Excess of col (i)<br />

(I) F M V" as M12/31/69 as of 12/31/69 over col (1), if any<br />

(h) Gain or (loss)<br />

(e) plus (t) minus (g)<br />

6, OOO, 936<br />

(I) Gains (Col (h) gain minus<br />

col (k), but not less than -0-) or<br />

Losses (from col (h))<br />

6, 000, 936<br />

If gain, also enter in Part I, line 7<br />

2 Capital gain net income or (net capital loss)<br />

""""" ( lf(loss), enter-0- in Partl, line7 1 2 6,000, 936<br />

3 Net short-term<br />

(al<br />

capital gain or (loss) as defined in sections 1222(5) and<br />

ldl<br />

(6)<br />

If gain, (loss), also enter in -0- Part in I, line Part 8, I, column line (c) 8 . (see . . . pages . . . . 13 . and . . . 17 . . ofthe . . . instructions) . . . . . . . . I.<br />

. . . . . .. . 3 5 I 002 , 04 9<br />

Qualification Under Section 4940(e) for Reduced Tax on Net Investment <strong>Income</strong><br />

(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment <strong>Income</strong> )<br />

If section 4940(d)(2) applies, leave this part blank<br />

Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period? I I I I EI Yes lj No<br />

If "Yes,"<br />

Base<br />

the foundation does not<br />

enod (bi<br />

qualify under section 4940(e).<br />

ears (cl<br />

Do not complete<br />

Distrib<br />

this part<br />

t t<br />

1 Enter the appropriate amount in each column for each yearg see page 18 of the instructions before making any entries<br />

Calendar year (gi tax yogi beginning in) Adjusted qualifying distnbutions Net value of nonchantable-use assets (col (D) dlwlaggnbriggl (6))<br />

2008 16, 030, 518 90, 663, 271 0.1768<br />

2007 20,341,429 145,282,377 1400<br />

2006 15,944,830 111,057,608 1436<br />

2005 15, 195,349 95, 320, 642 1594<br />

2004 13, 264, 007 55, 883, 352 0.2374<br />

2 Total of line 1, column (d)<br />

3 Average distribution ratio for the 5-year base period - divide the total on line 2 by 5, or by the<br />

number of years the foundation has been in existence if less than 5 years ,<br />

4 Enter the net value of noncharitable-use assets for 2009 from Part X, line 5 I I I I I I I II I<br />

5 Multiply line 4 by line 3 I<br />

6 Enter 1% of net investment income (1% of Part I, line 27b)I<br />

7 Add lines5and6I I I I I<br />

. . . . - . . - - - - . . - . . -- ­<br />

. . . . . . . . . . . . . . . . .. .<br />

. . - . . . - - . . . . . - . - .. .<br />

0.8572<br />

0.1714<br />

94, 877, 078<br />

16, 261, 931<br />

84, 137<br />

16, 346, 068<br />

8 Enter qualifying distributions from Part XII, line 4 I I I I I I I I I I I I I I I I I I I I I I II I<br />

15, 630,769<br />

If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate See the<br />

Part VI instructions on page 18<br />

$224301 000 Form 990-PF (2009)

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