Documente Academic
Documente Profesional
Documente Cultură
Form
As Filed Data -
DLN: 93491314006080
OMB No 1545-0052
990 -PF
`
Department of the Treasury Internal Revenue Service
2009
Number and street (or P 0 box number if mail is not delivered to street address) 5200 BUFFINGTON ROAD
Room/ suite
C If exemption application is pending, check here D 1. Foreign organizations , check here 2. Foreign organizations meeting the 85% test, check here and attach computation E F If private foundation status was terminated un d er sec t ion 507 ( b )( 1 )( A ), c h ec k h ere If the foundation is in a 60 - month termination under section 507(b)(1)(B), check here (c) Adjusted net income
F F r-
Section 4947( a)(1) nonexempt charitable trust I Fair market value of all assets at end
ofyear (fromPartII,col.(c), line 16 ) x$ 60,832,283
3 Accounting method
^ I_ Other( specify ) MODIFIED ACCRUAL (Part I , column (d) must be on cash basis .) (a) Revenue and expenses per books 15,617,284
9,022 353,173
9,022 353,173
9,022 353,173
b cp
75 co 7 8
Net rental income or (loss) Net gain or (loss ) from sale of assets not on line 10
Gross sales price for all assets on line 6a 3,489,483
6a
b
-766,280
Capital gain net income ( from Part IV, line 2) Net short - term capital gain . . . . . .
9
10a
Income modifications
b c
11 12
Less
. .
. .
.
. . . . . 4,306,813 19,520,012 362,195 4,306,813 4,669,008
13
In 10 14 15 16a
0
4,804,641 232,414 41,161 0 1,150,200 47,465 11 ,963 3,654,440 184,949 29,198
b
W
. .
.
. .
. .
. . .
10,500 1,015
37,463 426,630
3 ,052 295
7,448 720
15,827 317,352
co
17 C5 18
15,153 4 ,416
21,637 109,277
19
51 20 21 rs 22 23 ss 24
2,540,407
92,903 199,500 403,848
738,298
9,349 40,756 108,016 46,882 2,118,064 83,554 158,744 295,832 6,435,385
8,553,450
Total operating and administrative expenses. Add lines 13 through 23 . . . . . . . 17,343,932 2,678,985 20,022,917 66,451 4,358,372 66,451 4,358,372 11,183,449 2,678,985 13,862,434
25 26 27
Contributions , gifts, grants paid . Total expenses and disbursements . Add lines 24 and 25 Subtract line 26 from line 12
a
b
-502,905
295,744
310,636
Form 990-PF (2009)
For Privacy Act and Paperwork Reduction Act Notice , see page 30 of the instructions .
Form 990-PF (2009) Attached schedules and amounts in the description column B a l ance Sh eets should be for end-of- year amounts only (See instructions 1 2 3 Cash-non - interest-bearing . . . . . . . . . . . . . . . . . . . Beginning of year ( a) B oo k V a l ue 337,125 21,731,595 End of year ( b ) B oo k V a l ue 327,243 18,171,868
Savings and temporary cash investments Accounts receivable Oil Less 35,087
584,411
35,087
35,087
5 6
Grants receivable
Receivables due from officers , directors , trustees , and other disqualified persons (attach schedule ) ( see page 15 of the instructions ) . . . . . . . . . . . . . . . . .
Other notes and loans receivable ( attach schedule) ^ Less allowance for doubtful accounts 111
. . . . . . . . . . . . . . . . . . . 20,083 23,507 17,559 81,158 17,559 81,158
8 9
10a b c 11
Investments - U S and state government obligations ( attach schedule) Investments - corporate stock ( attach schedule ) . Investments - corporate bonds (attach schedule ). Investments - land, buildings , and equipment
Less
. .
. .
. .
. . 12,000
12,000 Qg 12,000 12,000
basis 111
12 13
5,239,743 Qg
4,551,241
4,664,741
14
52,048,203
33,496,870 Qg 37,522,627 37,522,627
15 16
17 18 ^P 19
Deferred revenue
+ f-
20 21 22 23
Loans from officers, directors , trustees , and other disqualified persons Mortgages and other notes payable (attach schedule) Other liabilities ( describe 111111 Total liabilities ( add lines 17 through 22) . . . . . . . )
258,698 216,967
1,196,964
973,318
r_
U27
28
n 29
30
31
3
4
3
4 59,745,465
5
6
5
6 59,745,465
Form 990-PF (2009) Ca ital Gains and Losses for Tax on Investment Income
(b) How acquired (c) Date acquired P-Purchase mo , da y, r D-Donation ( y )
Page 3
(a) List and describe the kind ( s) of property sold (e g , real estate, 2-story brick warehouse, or common stock, 200 shs M LC Co )
la 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 (j) Adjusted basis as of 12/31/ 69 (k) Excess of col (i) over col ( j), if any
a b c d e
2 3
If gain, also enter in Part I, line 7 If (loss), enter -0- in Part I, line 7 2
-774,876
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 pages 13 and 17 of the instructions) If (loss ), enter -0- in Part I, line 8
-23,392
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? 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 page 18 of the instructions before making any entries
1 Yes
No
Base period years Calendar year (or tax year beginning in) 2008 2007 2006 2005 2004
(d) Distribution ratio (col (b) divided by col (c)) 0 486712 0 542285 0 711956 1 159018 1 814415
4 714386
Average distribution ratio for the 5-year base period-divide the total on line 2 by 5, or by the number of years the foundation has been in existence if less than 5 years
Enter the net value of noncharitable-use assets for 2009 from Part X, line 5. . . . .
3
4
0 942877
26,612,428
. 5 25,092,246
2,957
25,095,203
20,440,866
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 Part VI instructions on page 18
Page 4
U MMIF Excise Tax Based on Investment Income ( Section 4940 ( a), 4940 ( b), 4940(e), or 4948 - see page 18 of the instructions)
la Exempt operating foundations described in section 4940(d)(2), check here Oil F_ and enter "N/A" on line 1 Date of ruling or determination letter 1984-09-10 ( attach copy of letter if necessary-see 1 5,915
instructions)
b Domestic foundations that meet the section 4940(e) requirements in Part V, check
.
2
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 Others enter -0-) Add lines 1 and 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3 4
5,915
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 Credits/Payments 2009 estimated tax payments and 2008 overpayment credited to 2009 6a 6,000 If zero or less, enter -0- . . . . .
5,915
b
c
6b
6c 1,000
Tax paid with application for extension of time to file (Form 8868)
d
7 8
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6d
. . . . . . 7 8 7,000
9
10 11
Tax due . If the total of lines 5 and 8 is more than line 7, enter amount owed .
.
.
.
.
9
10 11 1,085 1,085
Overpayment . If line 7 is more than the total of lines 5 and 8, enter the amount overpaid . Enter the amount of line 10 to be Credited to 2010 estimated tax Or
Refunded '
Yes
No
No
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see page 19 of
lb
No
Yes "to la or 1b, attach a detailed description of the activities and copies of any materials
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year
111111 $
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?
No
of incorporation, or bylaws, or other similar instruments? If "Yes,"attach a conformed copy of the changes5 4a
b
. .
.
3 .
.
No Yes
Yes
Did the foundation have unrelated business gross income of $1,000 or more during the year?.
If "Yes," has it filed a tax return on Form 990 -T for this year? . . . . . . . . . . . .
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4a
4b
Was there a liquidation, termination, dissolution, or substantial contraction during the year? . If "Yes,"attach the statement required by General Instruction T.
No
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions that conflict with the state law remain in the governing instrument? . . . . . . . . . . . . . 6
7
Yes
Yes
Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col (c), and PartXV
8a
Enter the states to which the foundation reports or with which it is registered (see page 19 of the
instructions) ' GA
If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G? If "No,"attach explanation . 8b Yes
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 2009 or the taxable year beginning in 2009 (see instructions for Part XIV on page 27 )? If "Yes,"complete Part XIV . . . . . . . . . . . . . . . . . . . . . . . . 9 10 Yes No
10
Did any persons become substantial contributors during the tax year? if "Yes," attach a schedule listing their names and addresses
Form 990-PF (2009) Statements Re g ardin g Activities ( continued ) 11 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 12 13 (see page 20 of the instructions). . . . . . . 11 12 13 Yes
Page 5
No No
Did the foundation acquire a direct or indirect interest in any applicable insurance contract before August 17, 2008' Did the foundation comply with the public inspection requirements for its annual returns and exemption application? Website address Oil
14
' JA M ES B MCCABE
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 -Check here . and enter the amount of tax-exempt interest received or accrued during the year . . . . . . I
(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from) a disqualified person? . . . . . . . . . . . . . . . . . . . . . . . . . 1 Yes F No 1 Yes F No
F Yes 1 No
(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 the benefit or use of a disqualified person)? . . . . . . . . . . . . . . . . . 1 Yes F No
(6) Agree to pay money or property to a government official? (Exception . Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days ). . . . . . . . . 1 Yes F No
If any answer is "Yes" to la(1)-(6), did any of the acts fail to qualify under the exceptions described in Regulations
section 53 494 1(d)-3 or in a current notice regarding disaster assistance (see page 20 of the instructions)? . . . lb No
.. F
Did the foundation engage in a prior year in any of the acts described in la, other than excepted acts, that were not corrected before the first day of the tax year beginning in 2009 ' . . . . . . . . . . . . . 1c No
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private operating foundation defined in section 4942(j)(3) or 4942(j)(5))
At the end of tax year 2009, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2009' . If "Yes," list the years Oil 20 , 20 , 20 , . 20 . . . . . . . . . . . . . fl Yes F No
Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2) (relating to incorrect valuation of assets) to the year's undistributed income? (If applying section 4942(a)(2)
to all years listed, answer "No" and attach statement-see page 20 of the instructions ) .
c
2b
If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here 111' 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? . . . . . . . . . . . . . . . . . . . . . fl Yes F No
If "Yes," did it have excess business holdings in 2009 as a result of (1) any purchase by the foundation
or 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
3b 4a No
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes? 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 20097
4b
No
Form 990-PF ( 2009) Statements Re g ardin g Activities for Which Form 4720 Ma y Be Re q uired
5a 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 ? . . . . . . . . . . . . . . . 1 Yes 1 Yes F No F No 1 Yes F No
Page 6 continued
(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 509 (a)(1), (2), or ( 3), or section 4940( d)(2)'' (see page 22 of the 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 ?. b . . . . . . . .
(- Yes
F No
.1 Yes
F No
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 page 22 of the instructions)? Organizations relying on a current notice regarding disaster assistance check here . . . . . . . . F 5b
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 ?. . . . . . . . . . . . 1 Yes 1 No
6a
Did the foundation , during the year, receive any funds , directly or indirectly, to pay
premiums on a personal benefit contract? . . . . . . . . . . . . . . . . . . . . 1 Yes . . F No . 6b No
Did the foundation , during the year, pay premiums , directly or indirectly, on a personal benefit contract?. If "Yes "to 6b, file Form 8870.
7a b
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
1 Yes F No . . . 7b No
If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? .
Information About Officers , Directors , Trustees, Foundation Managers, Highly Paid Employees, and Contractors List all officers , directors , trustees , foundation managers and their compensation ( see page 22 of the instructions).
(b) Title, and average ( c) Compensation (d) Contributions to
other allowances
0
VICE P RE S 20 0
SEC /TRES 8 0
Compensation of five highest-paid employees (other than those included on line 1-see page 23 of the instructions). If none, enter "NONE."
(a) Name and address of each employee paid more than $ 50,000
ROBERT SKELTON PO BOX 490007 MT BERRY,GA 30149 SHAWN STOEVER PO BOX 80 MT BERRY,GA LARRY COX 9 BERRY COLLEGE MT BERRY,GA 30149 TERRY SHANK PO BOX 490007 MT BERRY,GA 30149 RICK ANTHO NY PO BOX 49007 MT BERRY,GA 30149
(c) Compensation
161,194
129,090
24,869
80,314
19,992
78,345
7,286
26
Page 7 Information About Officers , Directors, Trustees, Foundation Managers , Highly Paid Employees, and Contractors (continued)
( b) Type of service MARKETING CONSULTING ( c) Compensation 783,762
Five highest - paid independent contractors for professional services ( see page 23 of the instructions). If none , enter "NONE". (a) Name and address of each person paid more than $50,000
BRAND APART INC 575 WILLOW OAK WAY ROSWELL,GA 30076 EVERETT CONSTRUCTION INC 3665 OLD DALTON ROAD NE ROME,GA 30165 GAY CONSTRUCTION COMPANY PO BOX 2376 SMYRNA,GA 30081 SURBER BARBER CHOATE & HERTLEIN ARCHITEC 1776 PEACHTREE ST NW STE 700 SOUTH ATLANTA,GA 30309 WATTERS &ASSOCIATES LANDSCAPE 134 SILVER AVENUE RO M E, GA 30161
GENERAL CONTRACTING
187,192
GENERAL CONTRACTING
4,396,055
ARCHITECTS
497,977
LANDSCAPING
197,390
Form 990-PF (2009) Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,
Page 8
Fair market value of all other assets (see page 24 of the instructions). Total (add lines la, b, and c) . . . . . . . . . . . . . .
Reduction claimed for blockage or other factors reported on lines la and 1c (attach detailed explanation). . . . . . . .
. . .
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le
. . . . . . . . . . . . . . . . . . 2 3 0 27,017,693
2 3
Cash deemed held for charitable activities Enter 1 1/2% of line 3 (for greater amount, see page 25
of the instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 5 405,265 26,612,428 1,330,621
5 6
Net value of noncharitable-use assets . Subtract line 4 from line 3 Minimum investment return . Enter 5% of line 5 . . . . . . .
^6
Distributable Amount (see page 25 of the instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain forei g n or g anizations check here ok. F and do not com p lete t his art.
1 2a b Minimum investment return from Part X, line 6 . . . . . . . . . . . . . . . . . 2a 2b . . . . . . . . . 1 Tax on investment income for 2009 from Part VI, line 5. Income tax for 2009
c 3 4
5
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2c 3 4
5
Distributable amount before adjustments Subtract line 2c from line 1. Recoveries of amounts treated as qualifying distributions .
Add lines 3 and 4 . . . . . . . . . . . . . . .
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6 7
Distributable amount as adjusted Subtract line 6 from line 5 Enter here and on Part XIII,
line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc ,
purposes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 6,578,432
3
a
Amounts set aside for specific charitable projects that satisfy the
Suitability test (prior IRS approval required) . . . . . . . . . . . . . . . . . . . . 3a 0
b
4
3b
4
0
20,440,866
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 page 26 of the instructions). . . . . . . . . . . . . . . . . . . . . . . . . . 5 6 20,440,866
Adjusted qualifying distributions . Subtract line 5 from line 4 . the section 4940(e) reduction of tax in those years
Note : The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whet her the foundation qualifies for
Page 9
a e 26 of the instructions
(a)
Corpus
(b)
Years prior to 2008
(c)
2008
(d)
2009
2
a b 3 a b c d e
Excess distributions carryover, if any, to 2009 From 2004. From 2005. From 2006. From 2007. From 2008. . . . . . . . . . . . . . . . . . . . 0 0 0 0
f
4
0 0
.
0
0
0
(If an amount appears in column (d), the same amount must be shown in column (a).) Enter the net total of each column as indicated below:
Add lines 3f, 4c, and 4e Subtract line 5
a Corpus
b Prior years' undistributed income Subtract line 4b from line 2b . . . . . . . . . . . c Enter the amount of prior years' undistributed income for which a notice of deficiency has been issued, or on which the section 4942(a) tax has been previously assessed. . . . . . d Subtract line 6c from line 6b Taxable
amount-see page 27 of the instructions . . .
of the instructions . . . . . . . . . . . f Undistributed income for 2009 Subtract lines 4d and 5 from line 1 This amount must be distributed in 2010. . . . . . . . . . 7 Amounts treated as distributions out of
corpus to satisfy requirements imposed by section 170(b)(1)(F) or 4942(g)(3) (see page 27
of the instructions) .
8
Excess distributions carryover from 2004 not applied on line 5 or line 7 (see page 27 of the
instructions) .
9 10 a b c d e
. .
. .
. .
. .
. .
0
0 0 0
Page 10
Private O p eratin g Foundations ( see p a g e 27 of the instructions and Part VII -A q uestion 9 )
la If the foundation has received a ruling or d etermination letter that it is a private operating
foundation , and the ruling is effective for 2 009 , enter the date of the ruling .
b 2a
.
4942(j)(3) o r r
1984-09-10 4942(j)(5)
Check box to indicate whether the organiz ation is a private op erating foundation described in sectio n I' Enter the lesser of the adjusted net Tax year ( a) 2009 310,636 264,041 20,440,866 ( b) 2008 666,852 566,824 16,597,334 Prior 3 years (c) 2007 1,018,417 865,654 12,168,259
(e) Total
(d) 2006 523,213 444,731 10,389,218 2,519,118 2,141,250 59,595,677
c
d
Complete 3a, b, or c for the alternative test relied upon a "Assets " alternative test-enter
(1) (2) Value of all assets . . . . . 60,832,283 60,137,573 53,822,851 48,303,301 223,096,008 Value of assets qualifying under section 4942( j)(3)(B)(i)
"Endowment" alternative test- enter 2/3 of minimum investment return shown in Part X, line 6 for each year listed . . .
"Support " alternative test-enter (1) Total support other than gross
887,081
1,136,698
747,962
486,417
3,258,158
organizations as provided in
section 4942( j)(3)(B)(iii). (3) ( 4) Largest amount of support from an exempt organization Gross investment income
0 0
Supplementary information (Complete this part only if the organization had $5,000 or more in assets at any time during the year-see page 27 of the instructions.)
1 Information Regarding Foundation Managers:
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation before the close of any tax year (but only if they have contributed more than $5,000) ( See section 507(d)(2) )
S TRUETT CATHY
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
NA 2 Information Regarding Contribution, Grant , Gift, Loan, Scholarship, etc., Programs:
Check here F if the foundation only makes contributions to preselected charitable organizations and does not accept unsolicited requests for funds If the foundation makes gifts, grants, etc (see page 28 of the instructions) to individuals or organizations under other conditions, complete items 2a, b, c, and d
a The name, address, and telephone number of the person to whom applications should be addressed
b The form in which applications should be submitted and information and materials they should include
d Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other factors
Page 11
3 Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
Foundation
Name and address (home or business) a Paid during the year See Additional Data Table
status of recipient
Purpose of grant or
contribution
Amount
Total .
3a
2,678,985
Total .
3b
Page 12
1 Program service revenue a CAMP FEES b STATE FOSTER CARE c WILDERNESS FEES d RETREAT INCOME e MARRIAGE INCOME
f
g Fees and contracts from government agencies
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14 14 9,022 353,173
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16
6,273
9 Net income or (loss ) from special events 10 Gross profit or (loss ) from sales of inventory.
11 Other revenue b SALES INCOME a MISCELLANEOUS 23,524 91,410
C d e
12 Subtotal Add columns (b), (d), and (e). 13 Total . Add line 12, columns ( b), (d), and (e) . . . . . . . . . . . (See worksheet in line 13 instructions on page 2 8 to verify calc ulations ) 235,632 . . . . . . . . 13 -397,812 4,064,908 3,902,728
Page 13
Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exem p t Or g anizations
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? Yes No
Other assets .
b Other transactions
(1) Sales of assets to a noncharitable exempt organization . . . . . . . . . . . . . . . . . . . . lb(1) No
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. lb(2)
lb(3) lb(4) lb(5)
No
No No No
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.
lb(6)
lc
No
No
d If the answer to any of the above is "Yes," complete the following schedule Column (b) should always show the fair market value of the goods, other assets, or services given by the reporting foundation If the foundation received less than fair ma rket value in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services rece ived
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'x. b If"Yes, " complete the following schedule (a) Name of organization (b) Type of organization (c) Description of relationship . . . . . . . . . .f Yes I' No
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 based on all information of which preparer has any knowledge Signature of officer or trustee
Preparer's Signature
l efile
As Filed Data -
DLN: 93491314006080
OMB No 1545-0047
Schedule B
(Form 990 , 990-EZ,
or 990 -PF) Department of the Treasury
Internal Revenue Serice
Schedule of Contributors
Attach to Form 990, 990-EZ, or 990-PF.
2009
Organization type (check one) Filers of: Form 990 or 990-EZ Section: r 501(c)( ) (enter number) organization
r 4947( a)(1) nonexempt charitable trust not treated as a private foundation r 527 political organization Form 990-PF F 501(c)( 3) exempt private foundation r 4947 (a)(1) nonexempt charitable trust treated as a private foundation r 501(c)(3) taxable private foundation
Check if your organization is covered by the General Rule or a Special Rule. Note . Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule See instructions General RuleF For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or property) from any one contributor Complete Parts I and II Special Rules
fl For a section 501(c)(3) organization filing Form 990 or 990-EZ, that met the 331/3% support test of the regulations under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1 h, or (u) Form 990-EZ, line 1 Complete Parts I and II fl For a section 501(c)(7), ( 8), or (10 ) organization filing Form 990 , or 990-EZ, that received from any one contributor, during the year , aggregate contributions of more than $ 1,000 for use exclusively for religious , charitable, scientific , literary , or educational purposes , or the prevention of cruelty to children or animals Complete Parts I , II, and III fl For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor, during the year, contributions for use exclusively for religious, charitable, etc , purposes, but these contributions did not aggregate to more than $1,000 If this box is checked, enter here the total contributions that w ere 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 of $5,000 or more during the year . . . . . . . . . . . . . . . . . . . . . . . . . Ilk- $ 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 in the heading of its Form 990-EZ, or on line 2 of its Form 990-PF, 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 Cat No 30613X Schedule B (Form 990 , 990-EZ , or 990 - PF) (2009)
Schedule B (Form 990, 990-EZ, or 990-PF) (2009) Name of organization WINSHAPE FOUNDATION INC
Page
of
of Part I
Contributors (see Instructions) (a) No. (b) Name , address , and ZIP + 4
See Additional Data Table
Person
$
Payroll r Noncash r
(Complete Part II if there is a noncash contribution
(a) No.
Person
$
Payroll r Noncash r
(Complete Part II if there is a noncash contribution
(a) No.
Person
$
Payroll r Noncash r
(Complete Part II if there is a noncash contribution
(a) No.
Person
$
Payroll r Noncash r
(Complete Part II if there is a noncash contribution
(a) No.
Person
$
Payroll r Noncash r
(Complete Part II if there is a noncash contribution
(a) No.
Person
$
Payroll r Noncash r
(Complete Part II if there is a noncash contribution
Schedule B (Form 990, 990-EZ, or 990-PF) (2009) Name of organization WINSHAPE FOUNDATION INC
Page
of
of Part II
Noncash Property (see Instructions) (a) No. from Part I b ( ) Description of noncash property given
(c) FMV (or estimate) (see instructions)
d ( ) Date received
d ( ) Date received
d ( ) Date received
d ( ) Date received
d ( ) Date received
d ( ) Date received
Schedule B (Form 990, 990-EZ, or 990-PF) (2009) Name of organization WINSHAPE FOUNDATION INC
Page
of
of Part III
JIMM
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or ( 10) organizations aggregating more than $1 , 000 for the year . (Complete columns (a) through (e) and the following line entry) For organizations completing Part III, enter the total of exclusively religious, charitable, etc , contributions of $1,000 or less for the year (Enter this information once See instructions ) $ (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
Additional Data
Software ID: Software Version: EIN: Name : 58 -1595471 WINSHAPE FOUNDATION INC
1
CHICK-FIL-A INC 5200 BUFFINGTON RD
F r
Noncash r
(Complete Part II if there is
ATLANTA, GA
30349
a noncash contribution
2
S TRUETT CATHY 11169 TURNER RD
F r
Noncash r
(Complete Part II if there is
HAMPTON, GA
30228
a noncash contribution
3
DONALD CATHY 2989 LAKE PARK DRIVE
F r
Noncash r
(Complete Part II if there is
JONESBORO,GA
30281
a noncash contribution
4
METRO ATLANTA CHAMBER OF COMMERCE PO BOX 1740
Person Payroll $
30301
F r
416 ,724
Noncash r
(Complete Part II if there is
ATLANTA, GA
a noncash contribution
5
NATIONAL CHRISTIAN FOUNDATION 1100 JOHNSON FERRY RD NE SUITE 24
F r
Noncash r
(Complete Part II if there is
ATLANTA, GA
30342
a noncash contribution
6
OTHER 5200 BUFFINGTON ROAD
F r
Noncash r
(Complete Part II if there is
ATLANTA, GA
30349
a noncash contribution
(b)
Name , address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
7
CFA PROPERTIES INC SUITE 928 1105 NORTH MARKET STREET
F r
Noncash r
(Complete Part II if there is
WILMINGTON, DE
19801
a noncash contribution
8
DAN T CATHY 186 PEEPLES ROAD
Person Payroll $
30214
F r
22,632
Noncash r
(Complete Part II if there is
FAYETTEVILLE, GA
a noncash contribution
9
CARICO FARMS INC PO BOX 549
Person Payroll $
68355
F r
8,000
Noncash r
(Complete Part II if there is
FALLS CITY , NE
a noncash contribution
10
JOHN W WHITE III 411 SAWMILL ROAD
F r
Noncash r
(Complete Part II if there is
HAMPTON, GA
30228
a noncash contribution
F r
Noncash r
(Complete Part II if there is
LAKE CITY, GA
30260
a noncash contribution
Person
Payroll $ 10 , 000
Noncash r
(Complete Part II if there is
SEARCY, AK
72143
a noncash contribution
Additional Data
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns a - d
(a) List and describe the kind(s) of property sold (e g , real estate, 2-story brick warehouse, or common stock, 200 shs M LC Co (b) How acquired P-Purchase D-Donation P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P 2007-10-12 2008-05-07 2007-10-12 2007-10-12 2007-10-12 2006-01-04 2006-01-04 2008-01-15 2007-10-12 2007-10-12 2008-05-08 2008-08-19 (c) Date acquired (mo , day, yr (d) Date sold (mo , day, yr
REGIONS-FED HOME LOAN MTG REGIONS-FED NAT'L MTG ASSN REGIONS-INGERSOLL-RAND REGIONS-INGERSOL RAND REGIONS-MERRILL-LYNCH REGIONS-FED HOME LOAN MTG REGIONS-FED NAT'L MTG ASSN REGIONS-FIDELITY ADV DIV INT'L FUND REGIONS-OPPENHEIMER MAIN ST REGIONS-OPPENHEIMER MAIN ST REGIONS-RMK MID CAP GROWTH REGIONS-AT&T REGIONS-ABBOTT LABS REGIONS-AETNA INC REGIONS-ALLERGAN INC REGIONS-CVS/CAREMARK CORP REGIONS-CHEVRON REGIONS-CISCO REGIONS-DONNELLEY RR&SONS REGIONS-EMC CORP REGIONS-EMERSON ELECTRIC REGIONS-EXELON REGIONS-EXXON MOBILE REGIONS-GENENTECH INC REGIONS-GENERAL ELECTRIC REGIONS-GENERAL ELECTRIC REGIONS-INTEL CORP REGIONS-JOHNSON &JOHNSON REGIONS-LOWES COMPANIES REGIONS-MICROSOFT CORP
2009-01-15 2009-01-26 2009-01-30 2009-02-02 2009-02-04 2009-02-17 2009-02-25 2009-02-26 2009-02-26 2009-02-26 2009-02-26 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns e - h
(e) Gross sales price (f) Depreciation allowed (or allowable)
879 1,237 1,888 3,793 5,368 2,628 3,340 73,242 108,728 10,993 114,848 4,855 19,695 2,650 6,465 4,840 9,132 3,564 11,277 6,162 22,715 2,918 13,685 30,723 11,051 869 2,769 13,099 27,479 2,379
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns i 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 (j) Adjusted basis as of 12/31/69 ( k) Excess of col (i) over col (j), if any
-5 -4 -121 -147 -79 -7 -15 -82,204 -91,888 -10,427 -84,671 -275 5,400 -2,423 -4,235 -2,278 2,653 -722 -33,125 -6,988 -12,040 -1,829 4,211 2,244 -29,532 -2,266 -2,845 -33 -15,482 -1,870
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns a - d
(a) List and describe the kind(s) of property sold (e g , real estate, 2-story brick warehouse, or common stock, 200 shs M LC Co (b) How acquired P-Purchase D-Donation P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P 2008-03-11 2008-03-11 2008-12-10 2008-12-10 2008-03-11 2008-12-09 2008-03-11 2008-12-10 2008-03-11 2008-05-07 2008-05-07 2007-10-12 2007-10-12 2008-03-11 2005-11-02 2007-08-07 2006-08-22 2007-10-12 2007-10-12 2006-01-25 (c) Date acquired (mo , day, yr (d) Date sold (mo , day, yr
REGIONS-ORACLE CORP REGIONS-PEPSICO REGIONS-PROCTOR &GAMBLE REGIONS-QUALCOMM REGIONS-SYSCO CO RP REGIONS-TRAVELERS COMPANIES REGIONS-UNITED TECHNOLOGIES REGIONS-VERIZON COMM REGIONS-VULCAM MATERIALS REGIONS-VULCAM MATERIALS REGIONS-WALMART REGIONS-WALGREEN REGIONS-CREDIT SUISSE FB REGIONS-FED HOME LOAN MTG REGIONS-FED HOME LOAN MTG REGIONS-GENENTECH INC REGIONS-GENENTECH INC REGIONS-FED NAT'L MTG ASSN REGIONS-FED NAT'L MTG ASSN REGIONS-FED HOME LOAN MTG REGIONS-FED HOME LOAN MTG REGIONS-CREDIT SUISSE FB REGIONS-CREDIT SUISSE FB REGIONS-FED NAT'L MTG ASSN REGIONS-FED NAT'L MTG ASSN REGIONS-US TREAS REGIONS-US TREAS REGIONS-FED HOME LOAN MTG REGIONS-PROCTOR & GAMBLE REGIONS-FED HOME LOAN MTG
2007-10-12
2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-02-27 2009-03-03 2009-03-16 2009-03-16 2009-03-16 2009-03-16 2009-03-25 2009-03-25 2009-04-15 2009-04-15 2009-04-23 2009-04-23 2009-04-27 2009-04-27 2009-05-07 2009-05-07 2009-05-15 2009-05-15 2009-05-15
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns e - h
(e) Gross sales price (f) Depreciation allowed (or allowable ) ( g) Cost or other basis plus expense of sale
17,746 7,720 9,423 12,024 11,844 16,222 4,814 11,429 54,961 1,359 17,457 10,129 6,196 2,808 547 15,230 2,979 1,114 3,885 557 2,222 1,997 4,130 913 4,652 175,074 20,655 758 9,272 2,599 26 -84 -20 -13 -582 -203 -13 258 1
12,916 7,232 8,466 10,317 8,713 11,640 2,577 10,811 25,517 878 18,486 6,321 6,004 2,809 539 19,967 4,067 1,089 3,876 549 2,222 2,023 4,046 893 4,639 174,492 20,452 745 9,530 2,600
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns i 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 (j) Adjusted basis as of 12/31/69 (k) Excess of col (i) over col (j), if any
-4,830 -488 -957 -1,707 -3,131 -4,582 -2,237 -618 -29,444 -481 1,029 -3,808 -192 1 -8 4,737 1,088 -25 -9 -8
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns a - d
(a) List and describe the kind(s) of property sold (e g , real estate, 2-story brick warehouse, or common stock, 200 shs M LC Co (b) How acquired P-Purchase D-Donation P P P P P 2008-12-10 2008-03-11 2008-12-09 2008-03-11 2008-03-11 P P P P P P P P P P P P P P P P P P P P P P P P 2007-10-12 2007-10-12 2008-02-22 2007-10-12 2007-10-12 2008-01-15 2008-02-22 2008-05-07 2007-10-12 2008-09-04 2009-02-24 2008-09-03 2008-09-03 2009-02-24 2008-09-03 2008-09-03 2009-02-24 2008-09-03 2008-09-03 2007-10-12 2005-08-15 (c) Date acquired (mo , day, yr (d) Date sold (mo , day, yr
REGIONS-SHELL INT'L FIN REGIONS-FED NAT'L MTG ASSN REGIONS-FED NAT'L MTG ASSN REGIONS-DEERE JOHN CAPITAL REGIO NS-ALABAMA POWER CO REGIONS-DEERE JOHN CAPITAL REGIONS-MFS RESH INT'L FD REGIO NS-CO LGATE-PALMO LIVE CO REGIONS-HALLIBURTON REGIONS-EATON CORP REGIONS-BEST BUY REGIONS-DURDEN RESTAURANTS REGIONS-TIFFANY & CO REGIONS-THERMO FISHER SCIENTIFIC REGIONS-NORFOLD SOUTHERN CORP REGIONS-CITRIX SYSTEM INC REGIONS-CVS/CAREMARK CORP REGIONS-PEPSICO REGIONS-PROCTOR & GA M BLE REGIONS-SYSCO REGIONS-WALGREEN REGIONS-DEVON ENERGY CORP REGIONS-XTO ENERGY CORP REGIONS-GOLDMAN SACHS GROUP REGIONS-WELLS FARGO &CO REGIONS-JOHNSON &JOHNSON REGIONS-STRYKERCORP REGIONS-3M CO REGIONS-GENERAL DYNAMICS CORP REGIONS-EMC CORP
2009-05-20 2009-05-26 2009-05-26 2009-05-27 2009-05-27 2009-05-27 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns e - h
(e) Gross sales price ( f) Depreciation allowed (or allowable)
7,406 1,012 3,127 1,032 5,274 5,161 103,896 26,069 10,683 7,290 9,672 9,085 13,723 1,983 6,565 16,309 5,151 2,189 2,142 24,551 8,297 11,091 9,852 15,048 13,630 1,660 4,411 11,529 30,231 6,456
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns i 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 (j) Adjusted basis as of 12/31/69 (k) Excess of col (i) over col (j), if any
2 -22 -4 78 110 -17 -32,062 4,003 -8,577 -3,381 2,412 1,446 -6,401 81 -4,417 932 -1,571 -13 -596 -5,828 -2,222 -3,787 -3,896 -4,032 -5,964 -219 -3,726 -6,392 -11,486 -5,310
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns a - d
(a) List and describe the kind(s) of property sold (e g , real estate, 2-story brick warehouse, or common stock, 200 shs M LC Co (b) How acquired P-Purchase D-Donation P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P 2007-10-12 2005-07-14 2009-05-01 2008-12-10 2008-03-11 2008-12-10 2008-03-11 2009-06-05 2007-10-12 2008-02-22 2007-10-12 2007-10-12 2007-10-12 2007-08-09 2007-10-12 2007-10-12 2007-10-12 2007-10-12 2006-01-04 (c) Date acquired (mo , day, yr (d) Date sold (mo , day, yr
REGIONS-VERIZON COMM REGIONS-EXELON REGIONS-WALT DISNEY CO REGIONS-WALMART REGIONS-CHEVRON REGIONS-EXXON MOBILE REGIONS-SCHLUMBERGER LTD REGIONS-AMERICAN EXPRESS REGIONS-BANK OF NYMELLON REGIONS-JP MORGAN CHASE REGIONS-PRUDENTIAL FINANCIAL REGIONS-TRAVELERS COMPANIES REGIONS-ALLERGAN INC REGIONS-UNITED TECHNOLOGIES REGIONS-CISCO REGIONS-DELL INC REGIONS-INTEL CORP REGIONS-JUNIPER NETWORKS REGIONS-MICROSOFT CORP REGIONS-ORACLE CORP REGIONS-QUALCOMM REGIONS-AIR PRODUCTS &CHEMS REGIONS-AT&T REGIONS-US TREAS REGIONS-FED HOME LOAN MTG REGIONS-FED HOME LOAN MTG REGIONS-FED NAT'L MTG ASSN REGIONS-FED NAT'L MTG ASSN REGIONS-AETNA INC REGIONS-DOMINION RES INV VA
2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-05 2009-06-10 2009-06-15 2009-06-15 2009-06-25 2009-06-25 2009-07-07 2009-07-07
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns e - h
(e) Gross sales price ( f) Depreciation allowed (or allowable)
1,762 1,924 11,522 2,049 2,076 2,181 14,470 1,772 5,856 13,402 2,076 4,313 4,523 9,038 9,470 12,980 8,522 18,382 8,776 8,061 9,527 10,162 1,961 9,185 552 1,817 1,046 3,562 519 5,104
-23 -6 11 207
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns i 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 (j) Adjusted basis as of 12/31/69 (k) Excess of col (i) over col (j), if any
-43 -1,241 -4,796 162 219 561 -12,500 -2,634 -3,228 -3,595 -2,962 -1,094 -2,165 -3,800 899 -16,607 -5,004 -1,037 -3,364 -649 1,092 -4,472 35 -30 -8
-23 -6 11 207
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns a - d
(a) List and describe the kind(s) of property sold (e g , real estate, 2-story brick warehouse , or common stock, 200 shs M LC Co (b) How acquired P-Purchase D-Donation P P P P P P P P P P P P P P P P P P P P P P 2008-03-11 2008-12-10 2008-03-11 2009-05-07 P P P P P P P 2008-12-10 2008-03-11 2008-12-10 2008-03-11 2009-01-29 2008-06-20 2009-05-07 2008-03-11 2008-03-11 2009-05-07 2008-12-10 2008-12-10 2008-03-11 2008-12-10 2008-03-11 2008-12-10 2008-03-11 2008-03-11 2008-12-10 2008-03-11 (c) Date acquired (mo , day, yr (d) Date sold (mo , day, yr
REGIO NS-US TREAS REGIONS-AETNA INC REGIONS-DOMINION RES INV VA REGIONS-FED HOME LOAN MTG REGIONS-FED HOME LOAN MTG REGIONS-TARGET CORP REGIONS-FED NAT'L MTG ASSN REGIONS-FED NAT'L MTG ASSN REGIONS-WALT DISNEY CO REGIONS-FED HOME LOAN MTG REGIONS-FED NAT'L MTG ASSN REGIONS-FED NAT'L MTG ASSN REGIONS-FED HOME LOAN MTG REGIONS-HEWLETT-PACKARD CO REGIONS-CISCO SYSTEMS REGIONS-HEWLETT-PACKARD CO RGIONS-CISCO SYSTEMS REGIONS-FED HOME LOAN MTG REGIONS-WALMART REGIONS-WALMART REGIONS-FED NAT'L MTG ASSN REGIONS-FED NAT'L MTG ASSN REGIONS-US TREAS REGIONS-FED HOME LOAN MTG REGIONS-FED HOME LOAN MTG REGIONS-FED NAT'L MTG ASSN REGIONS-FED NAT'L MTG ASSN REGIONS-US TREAS REGIONS-US TREAS REGIONS-US TREAS
2009-05-01
2009-07-07 2009-07-07 2009-07-07 2009-07-15 2009-07-15 2009-07-23 2009-07-27 2009-07-27 2009-08-12 2009-08-17 2009-08-25 2009-08-25 2009-09-15 2009-09-11 2009-09-11 2009-09-11 2009-09-11 2009-09-15 2009-09-21 2009-09-21 2009-09-25 2009-09-25 2009-10-05 2009-10-15 2009-10-15 2009-10-26 2009-10-26 2009-10-27 2009-10-27 2009-11-02
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns e - h
(e) Gross sales price ( f) Depreciation allowed (or allowable)
3,056 20,197 5,104 607 2,595 8,212 803 2,543 9,464 308 698 2,416 305 5,318 4,428 5,318 5,535 974 5,293 5,293 621 1,288 28,067 363 1,449 463 1,848 4,143 5,179 7,594
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns i 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 (j) Adjusted basis as of 12/31/69 (k) Excess of col (i) over col (j), if any
-16 -22,018 110 -10 -1 331 -17 3 249 -6 -15 -5 -5 157 194 271 390
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns a - d
(a) List and describe the kind(s) of property sold (e g , real estate, 2-story brick warehouse , or common stock, 200 shs M LC Co (b) How acquired P-Purchase D-Donation P P P 2008-12-10 2008-03-11 P P P P P P P P P P P P P P P P P P P P P P P P P P 2007-05-17 2008-11-21 2007-05-14 2007-05-14 2009-01-15 2008-11-21 2009-05-20 2007-05-14 2007-05-14 2007-05-14 2008-03-11 2008-03-11 2008-03-11 2008-04-02 2008-03-11 2008-03-11 2009-04-27 2008-12-16 2008-03-11 (c) Date acquired (mo , day, yr (d) Date sold (mo , day, yr
REGIONS-US TREAS REGIONS-US TREAS REGIONS-FED HOME LOAN MTG REGIONS-FED HOME LOAN MTG REGIONS-FED NAT'L MTG ASSN REGIONS-FED NAT'L MTG ASSN REGIONS-US TREAS REGIONS-JP MORGAN CHASE REGIONS-JOHN DEERE CAPITAL REGIONS-US TREAS REGIONS-MORGAN STANLEY REGIONS-TRAVELERS COMPANIES REGIONS-WACHOVIA CORP REGIONS-ORACLE CORP REGIONS-VERIZON COMM REGIONS-TN VALLEY AUTH REGIONS-FED HOME LOAN MTG REGIONS-FED HOME LOAN MTG REGIONS-FED NAT'L MTG ASSN REGIONS-FED NAT'L MTG ASSN FIDELITY-PIMCO TOTAL RETURN FIDELITY-VANGUARD BOND INDEX FIDELITY-HARBOR CAPITAL APPREC FIDELITY-ARTIO INT'L EQUITY FIDELITY-EDGEWOOD GROWTH FIDELITY-VANGUARD BOND INDEX FIDELITY-PIMCO INV GR FIDELITY-MSIF INC GLOBAL FIDELITY-PIMCO TOTAL RETURN FIDELITY-LAUDUS ROSENBERG
2009-11-02 2009-11-09 2009-11-16 2009-11-16 2009-11-25 2009-11-25 2009-12-11 2009-12-14 2009-12-14 2009-12-14 2009-12-14 2009-12-14 2009-12-14 2009-12-14 2009-12-14 2009-12-14 2009-12-14 2009-12-15 2009-12-28 2009-12-28 2009-01-15 2009-01-15 2009-01-15 2009-05-20 2009-05-20 2009-05-20 2009-09-01 2009-09-01 2009-09-01 2009-09-01
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns e - h
(e) Gross sales price (f) Depreciation allowed (or allowable) (g) Cost or other basis plus expense of sale
10,360 28,981 327 1,616 929 1,779 38,783 993 4,101 2,300 1,009 1,869 1,937 1,000 1,013 4,527 9,361 1,644 294 2,434 117,257 18,388 102,588 101,947 14,336 111,817 27,737 50,232 50,170 180,016
10,849 28,489 321 1,617 903 1,777 38,221 1,118 4,148 2,205 1,038 2,152 2,098 1,095 1,089 4,520 9,973 1,638 275 2,421 116,554 19,294 66,884 62,594 17,014 116,604 29,814 27,164 52,334 101,569
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns i 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 (j) Adjusted basis as of 12 / 31/69 (k) Excess of col (i) over col (j), if any
489 -492 -6 1 -26 -2 -562 125 47 -95 29 283 161 95 76 -7 612 -6 -19 -13 -703 906 -35,704 -39,353 2,678 4,787 2,077 -23,068 2,164 -78,447
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns a - d
(a) List and describe the kind(s) of property sold (e g , real estate, 2-story brick warehouse, or common stock, 200 shs M LC Co (b) How acquired P-Purchase D-Donation P P P P P P P P P P P P 2006-06-20 2006-06-21 2006-06-27 2007-05-14 (c) Date acquired (mo , day, yr (d) Date sold (mo , day, yr
FIDELITY-LAUDUS ROSENERG FIDELITY-LAUDUS ROSENBERG FIDELITY-LAUDUS ROSENBERG FIDELITY-AMERICAN EUROPACIFIC FIDELITY-VANGUARD BOND INDEX FIDELITY-ARTIO INT'L EQUITY FIDELITY-VANGUARD BOND INDEX FIDELITY-MSIF INC GLOBAL FIDELITY-MSIF INC GLOBAL FIDELITY-US TREAS FIDE LITY-HSBC FIN FIDELITY-FEDERAL FARM CR BANKS
2009-09-01 2009-09-01 2009-09-01 2009-09-01 2009-09-01 2009-09-01 2009-11-24 2009-11-24 2009-11-24 2009-02-17 2009-06-15 2009-09-22
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns e - h
(e) Gross sales price (f) Depreciation allowed (or allowable)
8,733 814 791 15,634 102,245 42,554 351 28,720 44,213 300,000 300,000 300,000
Form 990PF Part IV - Capital Gains and Losses for Tax on Investment Income - Columns i 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 (j) Adjusted basis as of 12/31/69 (k) Excess of col (i) over col (j), if any
-4,240 108 105 -7,016 5,799 -19,971 -10 -12,549 15,699 4,875 2,427 1,059
Form 990PF Part XV Line 3 - Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient If recipient is an individual, Foundation Purpose of grant or Amount
status of recipient
contribution
N/A
N/A
GENERAL CONTRIBUTION
371,763
N/A
N/A
GENERAL CONTRIBUTION
480,000
N/A
N/A
GENERAL CONTRIBUTION
994,199
N/A
N/A
GENERAL CONTRIBUTION
240,000
N/A
N/A
GENERAL CONTRIBUTION
7,500
N/A
N/A
SCHOLARSHIPS
401,657
N/A
N/A
GENERAL CONTRIBUTION
50,000
N /A
N/A
GENERAL CONTRIBUTION
1,600
N/A
N/A
GENERAL CONTRIBUTION
31,500
N/A
N/A
GENERAL CONTRIBUTION
5,000
N/A
N/A
GENERAL CONTRIBUTION
1,000
N/A
N/A
GENERAL CONTRIBUTION
1,000
N/A
N/A
GENERAL CONTRIBUTION
12,500
N /A
N/A
GENERAL CONTRIBUTION
30,000
N/A
N/A
GENERAL CONTRIBUTION
19,166
.'
3a
2,678,985
Form 990PF Part XV Line 3 - Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient If recipient is an individual, Foundation Purpose of grant or Amount
status of recipient
contribution
N/A
N/A
GENERAL CONTRIBUTION
24,100
N/A
N/A
GENERAL CONTRIBUTION
8,000
3a
2,678,985
l efile
Form
As Filed Data -
DLN: 93491314006080
OMB No 1545-0184
4797
2009
Sales or Exchanges of Property Used in a Trade or Business and Involuntary Conversions From Other Than Casualty or Theft-Most Property Held More Than 1 Year (see instructions) (b) Date
2 (a) Description of property acquired (mo , day, yr (c) Date sold (mo , day, yr
(e) Depreciation
(d) Gross sales price allowed or allowable since acquisition
( g) Gain or (loss) Subtract (f) from the sum of (d) and (e)
3 4 5 6 7
. . . . . .
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
. .
3 4 5 . 6 7 8,596
Section 1231 gain from installment sales from Form 6252, line 26 or 37 Section 1231 gain or (loss) from like-kind exchanges from Form 8824 Gain, if any, from line 32, from other than casualty or theft Combine lines 2 through 6 . . .
Enter the gain or (loss) here and on the appropriate line as follows
Partnerships ( except electing large partnerships) and S corporations . Report the gain or (loss) following the instructions for Form 1065, Schedule K, line 10, or Form 1120S, Schedule K, line 9 Skip lines 8, 9, 11, and 12 below Individuals, partners, S corporation shareholders , and all others . If line 7 is zero or a loss, enter the amount from line 7 on line 11 below and skip lines 8 and 9 If line 7 is a gain and you did not have any prior year section 1231 losses, or they were recaptured in an earlier year, enter the gain from line 7 as a long-term capital gain on the Schedule D filed with your return and skip lines 8, 9, 11, and 12 below 8 9 Nonrecaptured net section 1231 losses from prior years (see instructions) Subtract line 8 from line 7 If zero or less, enter -0If line 9 is zero, enter the gain from line 7 on line 12 8
below If line 9 is more than zero, enter the amount from line 8 on line 12 below and enter the gain from line 9 as a long-term capital gain on the Schedule D filed with your return (see instructions ) ONST9 Ordinar y Gains and Losses ( see instructions ) 10 Ordinary gains and losses not included on lines 11 through 16 (include property held 1 year or less)
11 12 13 14 15 16 17 18
Loss, if any, from line 7 Gain, if any, from line 7, or amount from line 8, if applicable Gain, if any, from line 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11 12 13 14 15 16 17
Ordinary gain from installment sales from Form 6252, line 25 or 36 Ordinary gain or (loss) from like-kind exchanges from Form 8824 Combine lines 10 through 16 . . . . . . . . . .
For all except individual returns, enter the amount from line 17 on the appropriate line of your return and skip lines a and b below For individual returns, complete lines a and b below If the loss on line 11 includes a loss from Form 4684, line 39, column (b)(ii), enter that part of the loss here Enter the part of the loss from income-producing property on Schedule A (Form 1040), line 28, and the part of the loss from property used as an employee on Schedule A (Form 1040), line 23 Identify as from "Form 4797, line 18a " See instructions . . . . . . . . . . . . . . . . . . . . Redetermine the gain or (loss) on line 17 excluding the loss, if any, on line 18a Enter here and on Form 1040, line 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cat No 130861
18a
Form 4797 (2009) Gain From Disposition of Property Under Sections 1245 , 1250 , 1252 , 1254 , and 1255
Page 2
(see instructions)
19 A B C D
These columns relate to the properties on lines l9Athrough19D Property A Property B Property C Property D
20 21
Gross sales price ( Note : See line 1 before completing Cost or other basis plus expense of sale .
20 21
22
23 24 25
22
23 24
a b
26
Depreciation allowed or allowable from line 22 Enter the smaller of line 24 or 25a . . . .
25a 25b
If section 1250 property : If straight line depreciation was used, enter -0- on line 26g, except for a corporation subject to section 291 Additional depreciation after 1975 (see instructions) 26a
b c
d e f g 27
Additional depreciation after 1969 and before 1976 Enter the smaller of line 26c or 26d .
Sections 291 amount (corporations only) Add lines 26b, 26e, and 26f . . .
did not dispose of farmland or if this form is being completed for a partnership (other than an
electing large partnership)
a
b
27a
27b
c 28
27c
Intangible drilling and development costs, expenditures for development of mines and other natural deposits, mining exploration costs, and
depletion (see instructions) 28a
b
29
28b
a
b
Summar y of Part III Gains . Com p lete p ro p erty columns A throu g h D throu g h line 29b before 30
31 32
oln 30
to line 30.
Total gains for all properties Add property columns A through D, line 24
Add property columns A through D, lines 25b, 26g, 27c, 28b, and 29b Enter here and on line 13 Subtract line 31 from line 30 Enter the portion from casualty or theft on Form 4684, line 37 portion from other than casualty or theft on Form 4797, line 6 Enter the
Recapture Amounts Under Sections 179 and 280F(b)(2) When Business Use Drops to 50 % or Less (see instructions)
(a) Section 179 33 34 35 Section 179 expense deduction or depreciation allowable in prior years Recomputed depreciation (see instructions) Recapture amount Subtract line 34 from line 33 See the instructions for where to report . . 3 34 35 Form 4797 (2009) ( b) Section 280F(b)(2)
Additional Data
Software ID: Software Version: EIN: Name : 58 -1595471 WINSHAPE FOUNDATION INC
Form 4797, Part I, Line 2 - Sales or Exchanges of Property Used in a Trade or Business and Involuntary Conversions From Other Than Casualty or Theft - Most Property Held More Than 1 Year:
(a) Description of property (b) Date acquired (mo., day , yr.) 12- 31- 2001 10- 31- 1994 09- 30- 1995 01- 31- 2001 03- 31- 2000 09- 01- 1994 01- 31- 2006 ( c) Date sold (mo., day, yr .) ( d) Gross sales price (e) Depreciation allowed or allowable since acquisition (f) Cost or other basis, plus improvements and expense of sale 1,000 21,416 23,972 27,089 22,103 9,599 697 (g) Gain or (loss) for entire year. Subtract (f) from the sum of (d) and (e) 250 2,000 2,000 500 500 3,744 -398
1988 FORD ECONOLINE 1994 FORD ECONOLINE 1995 FORD CLUBWAGON 2000 FORD E350 VAN 1999 FORD E350 VAN WOODBURY FURNITURE RAMON GANN WASHER
As Filed Data -
DLN: 93491314006080
6,000
1,744
4,256
As Filed Data -
DLN: 93491314006080
Note : To capture the full content of this document, please select landscape mode (11" x 8 .5") when printing.
As Filed Data -
DLN: 93491314006080
Depreciation Schedule
WINSHAPE FOUNDATION, INC 58-1595471 FORM 990-PF 01/01/09 - 12/31/09 PART I, LINE 19,/PART II, LINE 14 ACQUISITION PRIOR DEPCR TOTAL CLASS VALUE TOTAL ACCUM THIS RUN ACCUM DEPCR ----- ----------- ----------- -------- ------------- AUTOS 1,669,900 1,203,193 175,052 1,378,245 BUILDINGS 3,988,774 1,004,436 99,525 1,103,961 EQUIPMENT 2,517,878 1,171,321 262,481 1,433,802 FURNITURE & FIX 3,839,914 2,675,539 382,552 3,058,091 LAND IMPROVEMENTS 178,071 140,945 11,200 152,145 LEASEHOLD 37,988,126 5,552,053 1,571,138 7,123,191 OFFICE EQUIP 537,154 364,491 38,462 402,953 GRAND TOTALS 50, 719, 818 12,111, 978 2,540,408 14,652,386 LESS DISP 146,376 126,811 NET TOTALS 50,573,442 10,084,736 2,075,098 14,525,575 DEPREC ASSETS 50,573,442 NON DEPRECIABLE BLDG 235,000 LAND 1,080,461 COLLECTOR AUTOS 85,250 HORSES 8,500 FILM 6,770 CONSTRUCTION IN PROGRESS 58,779 LESS ACCUM DEP (14,525,575) NET FIXED ASSETS 37,522,627 WinShape Foundation, Inc is the sole member of WinShape Homes, LLC The financial information for WinShape Homes, LLC is included in the 990PF return for WinShape Foundation, Inc and there is no separate filing for WinShape Homes, LLC
As Filed Data -
DLN: 93491314006080
As Filed Data -
DLN: 93491314006080
SECURITIES
ENDOWMENT FUNDS
6,025
4,545,216
6,090
4,658,651
As Filed Data -
DLN: 93491314006080
As Filed Data -
DLN: 93491314006080
TROUTMAN SANDERS THE BALDWIN LAW FIRM, LLC ADORNO &YOSS LLP THE CUMMING LAW FIRM SIMMS SHOWERS, LLP WOMBLE CARLYLE SANDRIDGE & RIC BUNDREN LAW FIRM, PLLC
1,500
436
1,064
As Filed Data -
DLN: 93491314006080
BANK CHARGES BAD DEBT EXPENSE CABLE TV CAMP STORE CANTEEN CASE WORKERS CHILDREN ALLOWANCES CLOTHING CONTRACT LABOR EQUIPT RENTAL FOOD GAS GIFT SHOP ITEMS GUEST ROOM SUPPLIES HEALTHCARE HONORARIA HYGIENE INSURANCE JANITORIAL KITCHEN SUPPLIES LAUNDRY LAWN CARE LINENS &TOWELS MISCELLANEOUS OFFICE SUPPLIES PEST CONTROL PHOTOGRAPHY PROGRAMMING RECREATION REGISTRATION FEES RELIEF HOUSEPARENTS REPAIRS & MAINTENANCE SCHOOL SUPPLIES SCHOOL TUITION SPECIAL ACTIVITIES SUMMER CAMP TELEPHONE TRASH UNIFORMS UTILITIES SHARED TUITION (CONNECT)
72,345 81 1,180 17,354 3,830 20,246 10,266 45,693 34,346 6,235 375,506 36,331 3,076 6,170 30,908 10,324 5,131 202,185 17,846 10,995 10,730 11,774 6,514 37,892 32,701 6,358 5,206 375,428 22,778 10,983 10,088 206,470 3,626 91,237 100,258 20,858 25,370 7,699 3,227 86,208 132,611
As Filed Data -
DLN: 93491314006080
CAMP FEE INCOME STATE FOSTER CARE FUNDS WILDERNESS FEES RETREAT FEES MISCELLANEOUS INCOME SALES INCOME RENTAL INCOME UNRELATED BUSINESS INCOME MARRIAGE PROGRAM FEE INCOME
As Filed Data -
DLN: 93491314006080
As Filed Data -
DLN: 93491314006080
As Filed Data -
DLN: 93491314006080