990-PF
Form
Return of Private Foundation
or Section 49471a)(1) Nonexempt Charitable Trust
Treated as a Private Foundation
Oepanmen~ W the Treasury
internal Revenue Sen+ce
For calendar
Note The organization may be able to use a copy al this return to satisfy state reporting i
, 2001, and end
ear 2001, or tax ear be Innln
G Check all that aoolv
Use the IRS
label
Otherwise,
pant
Initial return
°v
Rm
Number and street (or P O box number if mail is not delivered to street address)
City or town
Instructions
H Check tYP e of
I
Section a947 a
C
RI 02940-6767
.,on
Section 501(~ c
1 nonezem t charitable trust
1
change
I
I Name chant
A Employer identification number
B Telephone number (see page 10 W
the instructions)
R exemption appltamn a
Oenaionp ChKkners
esxhIien«knk. .mamu
3 exempt P
private foundation
camoma+w~
Other taxable p rivate foundation
C1 Other (specify)
(Part l, column (d) must be on cash bests )
1
OMB No 1545 0052
,
(
Cash
, ~ Revenue and
expenses per
books
Accrual
_
(b) Net investment
income
.
. .
if prrvaa launaatbnmica wasrcrminne0
p
if the lounaaoan n n alPmanm tummamn
under ..=h sm(ex+Ke) Check Me,.
(c) Adjusted net
income
~
. 1D
E
under section 5o7(eM+)c"1 cnxk hero
~
~ L-1
3Foreign organizations mfoeunqNa
of year (from Part 11 L0l (L), line
1 , 922 , 800
I
D 1 Foreign orpanila0pn7 cne[k he'.
J Accounting method
JjUM Analysts of Revenue and Expenses
(the total of amounts m columns (b) (c) and
(d) may not necessenty equal the amounts in
_., .. .... ., i..o I --- ---- .n ..1 x._ . . .~ ... ...~_.1 .
C
VO'OVL4004
Room/suite
6767
Fair market value of all assets at end
16 .
Adds
state, and ZIP code
PROVIDENCE
organ'
i
X
Amended return
MUNSON W J-MUNSON FUND 18-3301316
ortype
s« Specific P 0 BOX
r
Final return
organization
C
"0
(d) Disbursements
for charitable
purposes
"__°
GontnCUwnaft grants ow ncervM (.mcn schedule) .
if the foundation is not required to
Check 1111~
attach Scn B
Z
Distributions from split-interest trusts
3
, ,
Interest on sanvngs and temporary cash investments
4
Dividends and interest from securities
5a
Gross rents
,
,
b (Net rental income or (loss)
)
6a
Net gain of (loss) from sale of assets not on line 10
e
Net short-term capital gain
b Grass sale pace for all
596
assets m line 6a
7
Capital gain net income (from Part IV line 2)
9
Income modifications
0 a Gmss sales less returns
and allowances
11
,
c WrpSSYYanoocpxuy(attac
scneauie) ,
Other income (attach s
le)
, ,
, , ,
73LOOMpAnsati6loFdllelrs (II~C{ors Wslees etc
c
d
ta
lO'~tF$rfe1mG~Fto ee'salYartE!'dhd gages
76
W6r~+sbA~p7a~
employee b nefRS
K 16a Legal fees (attach schedule) , ,
b Accounting lees (attach xheduIe)STMT ~ 4
d
A
c
17
Interest
e 18
V-4
is
cz
(,
M
Other professional fees (attach schedule)
Taxes (attach schedule) (sea page u moU)
19
Depreciation (attach schedule) and depletion
ZO
Occupancy
21
Travel, conferences, and meetings , , ,
22
, ,
Printing and publications
q 27
Other expenses (attach schedule) $TMT
`u 26
Total operating and administrative expenses
O
Add lines 73 through 23
, , , , , , , ,
25
Contributions, gifts, grants paid
26
Total rr.onm and abEen .m.nv Add lines
27
Subtract line 26 from line 12
e
~ ,
,
, ,
8,157
15 .280
4 and 25
E.aana o1 revenue ever expenses and disbursements
b Net investment income (it negative, enter-d)
JS"
tE 14+o a oao
23 .242
-4
_
For Paperwork Reduction Act Notice, see the instructions
G01070 M129 04/30/2002 09 28 21
18-3301316
Form 990-PF (200; ),
S
Ba lance
os-
Attached schedules and amounts in the
Sheets descr iption column should be far _._ ., .
1
Cash - non-interest-bearing
Z
Savings and temporary cash investments
3
Accounts receivable P-
z
Value
,
Less allowance for doubtful accounts
d
Pledges receivable
Less allowance for doubtful accounts
5
Grants receivable
RecervaCles due from officers, drtectors, trustees, and other
6
disqualified persons (attach schedule) (see page 15 of the instructions)
T
Other notes and loans receivable (attach schedule) 1
Less allowance (or doubtful accounts
8
Inventories for sale or use
9
Prepaid expenses and deferred charges
10 a
~~
12
Investments - U S end slate government obligations (attach schedule)
b
Investments - corporate stock (attach schedule) , ,
c
Investments - corporate bonds (attach schedule)
investments -land buildings
III
and equipment bans
Less accumulated depreciation W
(attach schedule)
Investments - mortgage loans
,
,
___________________
------------------, ,
15
Investments - other (attach schedule)
, , ,
Land buildings and
III ___________________
equipment basis
Less accumulated depreciation,
____________________
(attach schedule)
Other assets (describe
16
Total assets (to be completed by all filers - see page 16 0l
17
Accounts payable and accrued expenses
13
14
18
, , ,
, , ,
Grants payable
19
Deferred revenue
20
Loans from officers directors trustees and other disqualR~eO persons
21
Mortgages and other notes payable (attach schedule) ,
22
Other liabilities (descnbe 1
zs
-_- )
i oiai paomnes ( add ones i i mrou n zc
Organizations that follow SFAS 117, cheek here III- "
and complete lines 24 through 26 and tines 10 and 71
~ ]d
Unrestricted
~ ZS
Temporarily restricted
m 26
Permanently restricted
, , , ,
`o 27
Organizations that do not follow SFAS 117,
cheek here and complete lines 27 through 31
Capital stock trust principal or current funds
d 38
Paid-in or capital surplus or land bidg
.,~, Y 9
Retained earnings accumulated income endavrtnent or other lands
,'~
a 30
i
31
1 .570 .71
, ,
Total net assets or fund balances (see page 17 of the
instructions) , , , , , , , ,
1 , 524
and equipment kind
,
Total liabilities and net assetallund balances (see page 77 0l
the instructions)
,397
61,915
1,586,3 1 2
~
I
. ~
1,586 .312 )
1
Analysis of Changes in Net Assets or Fund Balances
1 Total net assets or fund balances at beginning of year- Part II, column (a), line 30
x
a
a
5
a
(must agree with end-of-year figure reported an prior year's return)
. . . . . . .
Enter amount from Part I, line 27a
Other increases not included in line 2 (itemize) " SEESTATEMENT 7
Add lines 1, 2, and 3
Decreases not included in line 2 (itemize) "
. . . . . . . .
, ,
, , , , ,
_ _ _ _ _ __
Total not assets or fiend halancns of end of year IOna d m,m,s Loa 51 - Part II column fhl hoe 30
JSA
115 1420 3 000
GQ1070 M129 04/30/2002 09 28 21
18-3301316
1
2
]
4
5
6
1 , 586 , 312
-47,738
32,141
1,570 , 715
1 . 570 . 715
Form 990-PF (zoai)
7
06-6024564
(c) Date
acqurteu
acquired
purchase
i n~ .,u~~l (mo , day yr j
(a) List and describe the kind(s) of property sold (e g ,real estate
2-story brick warehouse, or common stock, 200 shs MLC Co
SEE
a
b
c
d
e
PART
IV
J
(d) Dale solo
Imo , day yr )
SCHEDULE
(e) Gross roles price
0) F M V as of 12131/69
I
(f) Depreciation allowed
(or allowable)
(g) Cost or other basis
plus expense of sale
(h) Gain or (loss)
(e) plus (f) minus (g)
U) Adjusted bash
as of 12/31/69
(k) Excess of col (t)
over col Q) if any
(I) Gains (Col (h) gain minus
col (k) bud not less than -0-) or
Losses (from col (h))
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
} 2
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6)
If gain, also enter in Part 1, line 8, column (c) (see pages 13 and 17 of the instructions)
,j
If loss , enter -0- in Part I, line B
,
7
~ualrtication 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 )
2 Capital gain net income or (net capital loss)
{
68,433
If section 4940(d)(2) applies, leave this part blank
Was the organization liable for the section 4942 tax on the distributable amount of any year in the base period,
If' Yes," the organization does not quality under section 4940(e) Do not complete this part
1
a Yes F-A No
Enter the appropriate amount in each column for each year, see page 18 of the instructions before making any entries
Base pPnoG yUrs Calendar year
her tax veer eaunnvv, m~
I
(b)
Adjusted qualifying distributions
I
(~)
Net value al nonChamade-use assets
I
DislnDUlion ratio
' , ,n~ nom M . .~
1999
1998
JSA
z
J
Total of line t, column (d)
. . . . . .
. . . .
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 m existence R less than 5 years
, , , , , ,
1 3 ~
4
Enter we net value of nonchantable-use assets for 2001 from Part X, line 5 , , , ,
1 4 1
5
Multiply line 4 by line 3
6
Enter 1°h of net investment income (1% of Part I, line 27b)
7
Add lines 5 and 6
8
Enter qualifying distributions from Part XII, line 4
. . .
.
" "
~ ~
159 , 058
I B 1
If line 8 is equal to or greeter than line 7 check one box in P0n vi line tb and complete dial part using a 116 tax rate See the Pan VI instructions on page 18
1E 1430 3 00
, , , , ,
.
. . .
, , , , ,
.
G01070 M129 0413012002 09 28 21
, , , , , , , ,
.
.
. . . . ,
18-3301316
,
,
2
0 17464495030
0 03492899006
2 , 012 , 215
, ,
5
70,285
. . . . .
6
1 , 311
. . .
7
71,596
.
Form 990-PF (200t)
8
-
os-s
e Tax Based on Investment Income (Section d910(a), 49406), 4940(e), or 4948 - see page 18 of the
1a
Exempt operating foundations described in section 4960(d)(2), check here "
Date of ruling letter
U and enter "N/A" on line 1
_ _ _ _ _ _ _ -- (attach copy of ruling letter if necessary - see instructions)
b Domestic or anizations that meet The section 4940(e) requirements in Part V check
here "
and enter 1 °h of Part I, line 27b
c All other domestic organizations enter 2% of line 27b Exempt foreign organizations enter 4% of Part I, line 12, tot (b)
Z
.)
Tax under section 511 (domestic section 4947(a)(1) trusts and fixable foundations only Others enter-0
3
Add lines 1 and 2
4
Subtitle A (income) lax (domestic section 4947(a)(1) trusts and taxable foundations only Others enter-0
.)
Tax based on investment income Subtract line d from line 3 II zero or less enter -0
.
5
6
Credits/Payments
a 2001 estimated lax payments and 2000 overpayment credited to 2001
b Exempt foreign organizations - tax withheld a1 source
c Tax paid with application for extension of time to file (Form 8868)
7
d Backup withholding erroneously withheld , , , , ,
Total credits and payments Add lines 6a through 6d
6a
1, 892
6b
NOM
r6 c
NOW
I
6d
. . ,
9
70
Overpayment II line 7 is more than the total of lines 5 and 8, enter the amount overpaid
1 a
1,89
. . , . .
Enter any penalty for underpayment al estimated tax Check here ID if Form 2220 is attached
Tax due If the total of lines 5 and B Is more than line 7, enter amount owed
8
, , ,
during the lax year, did the organization attempt to influence any national, state, or local legrslation or did
it participate or intervene in any political campaign? , ,
Yes
, ,
b Did it spend more khan $100 during the year (either directly or indirectly) for political purposes (see page
19 of the instructions for definRion)'7
,
, , , , , ,
, , ,
1I the answer is 'Yes" to la or 1b, attach a detailed description o/ Me activities and copies of any materials
c
published or distributed by the organization m connection with the activities
Did the organization file Form 1120 " POl for this yea(
, ,
No
1a
, , ,
1b
, , , ,
, , , ,
7c
d Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year
(1) On [he organization " E
(2) On organization managers
"S
e Enter the reimbursement (if any) paid by the organization during the year (or political expenditure tax imposed
on organization managers
1 5
2
Has the organization engaged in any activities that have not previously been reported to the IRS?
, , , , , ,
7
Has the organization made any changes, not previously reported to the IRS, in ids governing instrument, articles
2
If 'Yes 'attach a detailed description o1 the activities
of incorporation, or bylaws, or other similar instruments? If "Yes 'attach a conformed copy o1 the changes , , , , ,
4 a Did the organization have unrelated business gross income of $1,000 or more during the yeaf7 , , ,
b
II 'Yes, has h filed a tax return on Form 990"7 for this year?
, , , ,
3
, , , , ,
, , , , ,
5
Was there a liquidation, termination dissolution, or substantial contraction during the year?
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either
4a
N
4b
A
5
If 'Yes "attach the statement required by General Instruction T
By language in the governing instrument or
"
7
e a
b
9
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, , ,
11
12
13
, ,
6
7
Enter the stales to which the foundation reports or with which it is registered (see page 19 0l the
instructions) 1o. CONNECT ICUT-
If the answer is 'Yes' to line 7, has the
.PF to the Attorney
---organization furnished a copy of Form 990
General (or designate) of each state as required by General Instruction G7 If 'No,' attach explanation
, ,
8b
Is the organization claiming status as a private operating foundation within the meaning of section 4962Q)(3)
or a9420)(5) tar calendar year 2001 or the taxable year beginning in 2007 (see instructions for Part %IV on
page 25)? If "Yes 'complete Part XlV ,
10
, , , , , , , , ,
Did the organization have at least $5,000 in assets at any time during the yeaf7 If 'Yes 'complete Part ll, co/ (c), and Part XV
, ,
, ,
, , , , ,
did any persons become substantial contributors during the tax year? It "Yes" attach a schedule listing their names and addresses
Did the organization comply with the public inspection requirements for its annual returns and exemption application?
9
K
10
11
Web site address
The books are in careol Is. FLEET _PCG----- Telephoneno " 401)276-7229 -- -- ------u80e
02I940 6767
Located
. ~ - --- ----------------TO
con 4sh,
Section
no ne xem pt
trustfiling
s
Form 1041.-Check here LP~a
-and
t
nblo
Eo~ accrued during the year
jy~
1E14404 000
II
Form 980-PF (2001)
G01070 M129 0400/9009 OR " 99 21
1A-330131R
9
I
5
Form 990-PF
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies
1 a
During the year did the organization (either directly or indirectly)
(1) Engage in the sale or exchange or leasing of property with a disqualified person')
(3) Borrow money (ram, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
. .
. . . .
" "
(3) Furnish goods, services, or facilities to (or accept them from) a disqualified persons
.
~ Yes
~ No
Yes
X No
Yes
No
K Yes
~ No
a Yes
~ No
o Yes
~ No
. ,
(a) Pay compensation lo, or pay or reimburse [he expenses of, a disqualified persons
(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)
. .
(6) Agree to pay money or property to a government official? (Exception Check "No
if the organization agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days )
b
. .
" " "
,
II any answer is 'Yes to 1x(1)-(6) did any of the acts fail to qualify under the exceptions described in Regulations
section 53 4941(4)-3 or in a current notice regarding disaster assistance (see page 19 of the instructions)
Organizations relying on a current notice regarding disaster assistance check here
c
2
. . .
~
Did the organization engage in a prior year in any of the acts described in 1a other than excepted acts,
. .
that were not corrected before the first day of the tax year beginning in 2001
for
years
the
organization
a private
(section
4942)
(does
not
apply
was
Taxes on failure to distribute income
x
~
L-I
~
. . .
operating foundation defined in section 69420)(3) or 49420(5))
a
At the end of tax year 2001 did the organization have any undistributed income (lines 6d
. . . .
. .
and 6e, Part XIII) for tax year(s) beginning before 20017
~ Yes
. .
~ No
If Yes, list the years 1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - -applying
the
provisions
of section 4942(x)(2)
Are
there
any
years
listed
in
2a
for
which
the
organization
is
not
b
(relating to incorrect valuation of assets) to the year's undistributed incomes (If applying section 4942(x)(2)
to all years listed, answer 'No' and attach statement - see page 19 of the instructions )
c
7a
A
. . .
II the provisions of section 4942(x)(2) are being applied to any of [he years listed in 2a, list the years here
1 __________ ._________
________
Did the organization hold more than a 2% direct or indirect interest in any business
enterprise at any time during the yea(!
, , , , , ,
, , ,
b If ' Yes," did it have excess business holdings in 2001 as a result of (1) any purchase by the organization
or disqualified persons after May 26, 1969, (2) the lapse of the 5-year period (or longer period approved
D Yes
E~ No
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 penod? (Use Schedule C Farm 4720 to determine
4a
b
5 a
if [he organization had excess business holdings m 20011
" "
" "
Did the organization invest during the year any amount in a manner that would jeopardize its charitable purposes
Did the organization 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 lax year beginning in 2001
During the year did the organization pay or incur any amount to
(1) Carry on propaganda, or otherwise attempt to influence legislation (section 49d5(e))? ,
a Yes
E~ No
Yes
x No
e Yes
LXJ No
0 Yes
E~ No
El Yes
E~ No
(Z) Influence the outcome of any specific public election (see section 4955) or to wiry
on, directly or indirectly, any voter registration drive?
, , ,
, , ,
(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(x)(1) (2), or (3), or action 4940(d)(2)?
(5) Provide for any purpose other than religious, charitable scientific, literary or
educational purposes, or (or the prevention of cruelty to children or animals
, , ,
X
b if any answer is "Ves'to 5x(1)-(5), did any of the transactions fail to quality under the exceptions described in
Regulations section 53 4945 or in a current notice regarding disaster assistance (see page 20 of the instructions)? "~
c
6 a
Organizations relying on a current notice regarding disaster assistance check here
II the answer is "Yes" to question Sa(4), does the organization claim exemption from the
, ,
tax because it maintained expenditure responsibility (or the grants
" " " " .
1
N,/A ~ Yes
~ No
Yes
a No
If 'Yes " attach the statement required 6y Regulations section 53 49455(d)
Did the organization, during the year, receive any funds, directly or indirectly, to pay
premiums on a personal benefit contract?
b Did the organization during the year, pay premiums, directly or indirectly on a personal benefit contract?
11 you answered 'Ves'to 66, also file Form 8870
x
, ,
Form990-PF (2001)
JSA
1E1450 ~ 000
GQ1070 M129 04/3012002 09 .28 21
18-3301316
10
-
Page 6
Form996PF(2007)
06-6024564
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
List all officers, directors, trustees, foundation managers and their compensation (see page 20 of the instructions)
7
o? I lie and average
(e) Name and address
hours per week
devoted to po5rt~on
I
---------------------------------
SEE STATEMENT 8
---------------------------------
(11 not pelA, enter
~~
22
I
eM^ I
er
~no
(e) Expense account
other allowances
-0-
----------------------------------
2
Compensation of flue highest-paid employees (other than those Included on line 1 - see page 21 of the Instructions)
Ii none, enter "NONE "
(a) Name and address of each employee paid more than $50 000
NONE
(E) Title and average
hours peg meek
devoted f0 Position
(c) Compensation
(E) contributions to
employee oenetrt piana
ano OvIarteE com0ennpon
(e) Expense account
other allowances
--------------------------------------------------------------------------------------------
Total number of other employees paid over $50,000
I
J
Five highest-paid Independent contractors for professional services - (see page 21 of the Instructions) Ii none, enter
"NONE "
a Name and address of each
NONE
arson
b T yp e of service
aid more than $50000
c Cam
---------------------------------------------------------------------------------------------------------------------------------------------------------Total number of others receiving over $50,000 for professional services
Summary of Direct Charitable Activities
Lisp tie foundation s lour largest direct charitable activates during the lax year Include relevant stalietubl information such as fife number
of organizations and other Dmefinanp served conferences convened research papers produced etc
1 --------------------------------NONE
2
---------------------------
---------------------------------
Exicenlift
-----------------------------------------------------------------------------------
7
---------------------------------------------------------------------------4
---------------------------------------------------------------------------Form 990-PF (2001)
JSA
~E14607000
GQ1070 M129 04130/2002 09 28 21
18-3301316
11
-
4
Amount
i
NONE
- - - - - - - - - - - - - - - - - - - -- - - - - - --- - - - --- - - - - - - - -- - --- - - -- - - - - --- - - - - - -- - - - - -- -- -
2
- - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - -- - - - - - - -- - - - - -- - - - - - - - ---- - - - -- --- - - - - All other program reiateo mveslmenl5 bee page ZZ or the instructions
s
NONE
---------------------------------------------------------------------------
Total Add lines 1 throu gh 3 , ,
Minimum Investment Retum (All domestic foundations must complete this part Fort
see page 22 of the instructions )
7
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc ,
a
b
c
d
e
2
J
4
5
6
purposes
Average monthly fair market value of secun0es , .
, ,
Average of monthly cash balances, ,
, , , , , ,
Fair market value of all other assets (see page 22 of the instructions)
Total (add lines 1 a, b, and c)
Reduction claimed for blockage or other factors reported on lines 1a and
1e
1c (attach detailed explanation)
Acquisition indebtedness applicable to line 1 assets
Subtract line 2 from fine 1 d
Cash deemed held for charitable activities Enter 1 1/2°h of line 3 (for greater amount, see page 23
of the instructions)
. ,
Net value of noneharltable-use assets ~Subtract cline 4 from line 3 Enter here and on Part V, line 4 ~
Minimum Investment return Enter s°h of line 5 , ,
1
1
1
1
a
b
c
d
2
7
NON
2,042,858
4
5
6
30,643
2,012,215
100,611
Distnbutable Amount (see page 23 of the instructions) (Section 4942Q)(3) and 0)(5) private
foundations and certain foreign organizations check here ~
and do not complete this par
7
2a
b
e
3
4a
b
c
5
e
7
Minimum investment return from Part K, line 6 .
. , , , ,
Za
Tax on investment income for 2001 from Part VI, line 5
1 , 311
2b
Income tax for 2001 (This does not include the tax from Part VI ) ,
Add lines 2a and 2b
Distnbuta6le amount before adjustments Subtract line 2c from line 1
4a
Recoveries of amounts treated as qualifying disfibuUOns
NON
section
,
,
,
.
,
.
4b
Income distributions from
4947(a)(2) trusts
Add lines 4a and 4b
Add lines 3 and 4c
. .
Deduction from distributable amount (see page 23 of the instructions)
Dlstrlbuta6le amount as adj usted Subtract line 6 from line 5 Enter here and on Part XIII line t
1,967,391
-4,270
79,737
2,042,858
100 .611
1
2c
7
NONE
4~
6
Qualifying Distnbutions (see page 23 of the instructions)
1
2
3
4
5
6
a
b
a
b
Amounts paid (including administrative expenses) to accomplish charitable, etc , purposes
Expenses, contributions, gifts, etc - total from Part I, column (d), line 26
, .
1a
Program-related investments - Total from Part IX-B
tb
Amounts paid to acquire assets used (or held for use) duectly in carrying out charitable, etc ,
purposes
2
Amounts set aside for specific charitable projects that satisfy the
Suitability test (prior IRS approval required)
. , , ,
. , , . , , , ,
3a
Cash distribution test (attach the required schedule) ,
Jb
Qualifying distributions Add lines t a through 3b Enter here and on Part V, line 8 and Part XIII, line 4
4
Organizations that quality under section 4940(e) far the reduced rate of tax on net investment
~
I
income Enter 1°.6 of Part 1, line 27b (see page 24 of the instructions)
Adjusted qualifying distributions Subtract line 5 from line 4
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 fax m those years
NONE
Form 990-PF (200t)
JSA
IEt470 4 000
601070 M129 04/3012002 09 28'21
18-3301316
12
06-6024564
Page 8
Form 990 PF (2001)
Undistributed Income (see page 24 of the instructions)
7
(a)
Corpus
Distributable amount for 2001 from Part XI,
(b)
Years prior to 2000
(q
2000
99,300
line 7
Unaisiribvrea income d arty as of the end of 2000
2
a
Enter amount for 2000 only
b Total for prior years
, , , , , , , ,
NON
1999
89,830
Excess distributions carryover, if any l0 2001
3
a
c
NON
From 1996
b From 7997
NON
, , , ,
NON
From 1998
NON
d From 1999
d
(d)
2001
NON
e
From 2000
I
Total of lines 3a through e
NON
Qualifying distributions (or 2001 from Part
159,058
x11 pine 4 1111,
a Applied to 2000, but not more than line 2a
89,830
b Applied to undistributed income of poor years
(Election required see page 24 0l the instructions) ,
c Treated as distributions out of corpus (Elation
required - see page 24 0( the instructions)
NON
NONE
69,228
d Applied to 2001 disiributable amount
e Remaining amount distributed out of corpus
5
Excess distributions carryover applied l0 2001
(N an amount appears in column (d) the
same amount must be shown m column (a) )
s
Enter the net total of each column as
Indicated below
a Corpus Add lines 3f, 4c, and 4e Subtract line s
NON
NON
NON
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
, , , ,
NON
NON
d Subtract line 6c (ram line 6b Taxable
amount - see page 25 of the instructions
Undistributed income far 2000 Subtract tine
4a from line 2a Taxable amount see page
35 of the instructions
1
7
8
9
NON
Undistributed income for 2001 Subtract
lines 4d and 5 from line i This amount must
be distributed in 2002
, , ,
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(E) or 4942(p)(3) (see page
25 of the instructions) , , ,
Excess distributions carryover from 1996
not applied on line 5 or line 7 (see page 25
of the instructions)
. .
Excess distributions carryover to 2002
Analysis of line 9
a
Excess from 7997 ,
NON
Excess from 1999
NON
b Excess from 1998 .
c
d Excess from 2000
e Excess from 2001
.
NON
NON
NON
Subtract lines 7 and e from line sa
10
30 , 072
NON
NON
Form 990-PF (2001
I EUBO 1 000
G01070 M129 04/30/2002 09 28 21
18-3301316
13
-
06-6024564
990 PF
1a
II the foundation has reserved a ruling or determination letter that it is a private operating
foundation . and the ruling is effective far 2001
b
Za
enter the date of the ruling
VII-A , q uestion 9
, , , , ,
descnbedin section
Check box to indicate wt
10.1
Enter the lesser W the
adjusted net income from
Part I or the minimum
investment return from Pan
( for each year listed . .
b
c
65% of line 2a
.
OuaiYymgamri0umnafrom PVrt
sll Ime a hr each Yeas LoUe
d
,
AmOUnIa mC1uEM n Me 2c not
used artrecW ror 11rnn conaun
of exempt
C
Qualifying E6[lIOOIAlqTi7 "
Eirecfly for eths, ford ." of
exempt activities Subtrad
ine ?d from fine 2c
0
Complete 7a o or c for tie
.Ipi test Failed upon
d
'P7flIYiliOlfl"IMtest -enter
0)
Valueol~~~aixb
(2) ValueWafaaOaual(ynp
under sei,tion
b
a
4943UII7HB101
'Eneowminrammriuntnt
Enter V3 of minimum
investment te{u1O Nm+11 h
Part A Ime9~0r irafAyear
",red
-SuPP.M .N.m.M.ond
enter
(1) Total support other man
gross investment ....
intearvid . dividends mile;
paymend on fecurrtin
loans (sactbn 512Ia)(51)
or roralnal
(2) support from general
putts and S o! mor,
exempt oiganizations
.Loon
73 provided, YI .
.s4xaMaXeHWI .
(3) Largest Mount of support
ham an exempt
organization
Supplementary Information (Complete this part only If the organization had $5,000 or more In
assets at any time during the year - see page 26 of the instructions
a
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 mare than $5,000) (See section 507(d)(2) )
NONE
b
Z
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
NONE
Information Re ardlng Contribution, Grant, Gift, Loan, Scholarship, ere , Programs
Check here
1
d the organization only makes contributions to preselected charitable organizations and does not accept unsolicited requests !or lands
If the organization makes gifts grants etc (see pale 26 of [he instructions) to individuals or organizations under other conditions, complete items 7a, 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
c
Any submission deadlines
d
Any restrictions or limitations on awards such as by geographical areas, chantable fields, vends of institutions, or other
SEE STATEMENT 9
APPLICATION FORM WITH SPECIFIC INFO ON FINANCIAL STATUS
OF APPLICANT
MAY 15 - JUNE 15
factors SEE STATEMENT
'E 1490 3 000
11
GQ1070 M129 04/30/2002 09 28 21
18-3301316
Fog 990-PF (2001)
14
-
os-
Form 990 PF rZp01)
Uffm Supplementary Infortnati
3
Grants and Contributions Paid D
Recipient
Name and address (home or business)
I me Tear or A
io
roves ror r
II recipient is an mdmdual
show any relationship to
any foundation manager
. . . .~ .. ... ._~ _.._ ._ . . . .... .
Faundahon
status of
reciprem
Purpose of grant or
conVibutan
Amount
a Paid dunngthe year
SEE STATEMENT 10
b Approved for future payment
NONE
Form 990-PF (20011
iEU917000
(301070 M129 04/3012002 09 28 21
18-3301316
15
-
Form 990-PF
06-6024564
Analysis of Income-Pro ucin
Enter gross amounts unless otherwise indicated
Unrela
(a)
Business
code
1 Program service revenue
11
At
°' '
`^y"(~l`
Exclusion
,~
' ~'
~
RRelated or exempt
(unction income
(See oaae 26 0(
a
b
c
d
e
f
g
Fees and contracts from government agencies
Z Membership dues and assessments
3 interest on savings and temporary cash investments
A Dividends and interest from securities
5 Net rental income or (loss) from real estate
a
Debt-financed property
b
Not debt-financed property
, , , ,
6 Net rental income or (toss) ham personal property
7 Other investment income
, ,
8 Gain or (loss) from sales of assets other than inventory
9 Net income or (loss) from special events
10 Gross profit or (loss) tram sales of inventory
11 Other revenue a
n
o
FEDERAL TAX REFUND
INTEREST ON REFUND
d
.
12 Subtotal Add columns (b), (d), and (e)
13 Total Add line 12 columns (b), (d), and (e)
, , ,
. .
. . .
.
10-13
119 .282
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No
Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
the accomplishment of the organizations exempt purposes (other than by providing funds for such purposes) (See
page 27 of the instructions )
Porn 990-PF (2001)
Jsn
e usz ~ o00
GQ1070 M129 04130/2002 09 .28 21
18-3301316
16
-
Information Regarding Transfers To
s
-5024564
hips With Noncha
Did the organization directly or indirectly engage in any of the following with any other organization described in section
1
501(c) of the Code (other than section 501(c)(3) organizations) or in section 527 relating to political organizations?
a Transfers from the reporting organization to a noncharRable exempt organization of
x
(1) Cash
(2) Other assets
,
, , , , ,
, ,
b Other Transactions
X
(1) Sales of assets to a noncharitable exempt organization
(2) Purchases of assets from a noncharRable exempt organization
(3) Rental of facilities equipment, or other assets
(d) Reimbursement arrangements , , , , , , , , , , , ,
, ,
, , ,
, , ,
(5) Loans or loan guarantees
(6) Performance of services or membership or fundraising solicitations
c
Sharing of facilities equipment, mailing lists, other assets, or paid employees
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 organization I( the organization received less than fair
market value in any transaction or sharing arrangement, show in column (d) the value of the goods other assets, or services
2 a
Is the organization directly or indirectly affiliated with, or relayed 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
Under penalties of penury
1 declare that I have examined this return including accompanying schedules and statements and to the best of my knowledge and belie) it is
true correct and complete Declaration of fLreparer (other than taxpayer or
N
d
c
a
y
,
V ~ 3~Cf~vV7-/ ~
Signature of officer or trustee
i = Preparefs
~ c
q `w O signature
'
Firms name (or y6A
if self-employed), address,
and ZIP code
JSA
tE1~977000
0 Yes EMNo
/
P
BOX -6767
PROVIDENCE R I
GQ1070 M129 04/30/2002 09 28 .21
FORM 990-PF - PART IV
CAPITAL GAINS AND LOSSES FOR TAX ON INVESTMENT INCOME
Kind of Property
Gross sale
price less
exp enses of sale
Deprecation
allowed/
9[IgWable
Description
FMV
as of
Cost or
other
basis
cess of
FMV over
ad basis
Ad) basis
as of
1 2/31/6Q
12131169
Date
acquired
Gain
or
(loss )
Date sold
TOTAL SHORT-TERM COMMON TRUST FUND AND
PARTNERSHIP, S CORPORATION, AND OTHER
ESTATES OR TRUST GAIN OR LOSS
TOTAL LONG-TERM CAPITAL GAIN DIVIDENDS
TOTAL LONG-TERM COMMON TRUST FUND AND
PARTNERSHIP, S CORPORATION, AND OTHER
ESTATES OR TRUST GAIN OR LOSS
143
10,158
SMITH INTERNATIONAL
PROPERTY TYPE
10,937
INC
SECURITIES
6,484
1,173
6,182
200
18,713
2,880 .
100
7,996
PROPERTY TYPE' SECURITIES
324
200
11,050
tEt
730 ,ooa
SECURITIES
PFIZER INC COM
07/07/2000
06/0611980
09/2712000
01/29/1958
01/27/1982
01/0912001
01112/2001
01126/2001
01/29/2001
0112912001
8,575
ALLTEL CORP
03/01/1999
SECURITIES
30.1070 M129 04/30/2002 09 28 21
01108/2001
7,672
225
11,816
07/07/2000
-926
PROPERTY TYPE . SECURITIES
200
01/05/2001
15,833
EXXON MOBIL CORP COM
PROPERTY TYPE
07/07/2000
86
INC CL A NEW COM
4,824
100
INC
SECURITIES
DVNEGY
18,981
302
INTERNATIONAL BUSINESS MACHS
PROPERTY TYPE
5,750
8,800
INC
SECURITIES
16 SMITH INTERNATIONAL
PROPERTY TYPE SECURITIES
1,087
PROPERTY TYPE
728
-779
91 . SMITH INTERNATIONAL
PROPERTY TYPE
6,710
02/08/2001
-766
18-3301316
18
-
FORM 990-PF - PART IV
CAPITAL GAINS AND LOSSES FOR TAX ON INVESTMENT INCOME
Kind of Property
Gross sale
price less
x enses of sale
Depreciation
allowed!
a l l owab l e
Cost or
other
FMV
as of
Add basis
as of
i
Excess of
FMV over
ad basis
aaqwre0
01/28/1985
6,126
09/28/2000
6,157
136 EDWARDS A G INC
PROPERTY TYPE SECURITIES
6,967
8,471
EXXON MOBIL CORP COM
PROPERTY TYPE
324 .
SECURITIES
01/29/1958
01127/1982
8,952
200 PFIZER INC COM
PROPERTY TYPE . SECURITIES
225
11/14/2000
6,842
154 EDWARDS A G INC
PROPERTY TYPE SECURITIES
7,795
01/29/2001
7,128
160 EDWARDS A G INC
PROPERTY TYPE SECURITIES
7,755
200 SCHLUMBERGER LTD '
PROPERTY TYPE SECURITIES
03101/1999
29 MOLEX INC CL A NON-VTG COM
PROPERTY TYPE SECURITIES
07/25/2000
1,088
122
2,675
5,368
165
3,652
SUN MICROSYSTEMS
PROPERTY TYPE
SECURITIES
SUN MICROSYSTEMS
PROPERTY TYPE' SECURITIES
7,259
e,730 ~ooa GQ1070 M129 04/3012002 09 28 21
18-3301316
02/08/2001
8,147
4,721
870
02/08/2001
-810
03109/1961
8,720
02/08/2001
5,445
100 GENERAL ELEC CO COM
PROPERTY TYPE SECURITIES
71
12,827
Date sold
Gain
or
loss
100 AMERICAN HOME PRODS CORP
PROPERTY TYPE SECURITIES
681 .
100
sn
Date
Description
02108/2001
4,650
0210812001
8,727 .
02/09/2001
-953
02112/2001
-627
02/15/2001
4,107 .
03/06/2001
-218
11113/2000
03/06/2001
-2,693
11/13/2000
03/06/2001
-3,607
19
-
FORM 990-PF - PART IV
CAPITAL GAINS AND LOSSES FOR TAX ON INVESTMENT INCOME
Kind of Property
Gross sale
price less
expenses of sale
Cost or
other
FMV
as of
2131169
Adl basis
as of
1 213 1 iAq
Excess of
FMV over
adi basis
Date
acquired
Gain
or
(loss)
19 MOLEX INC CL A NON-VTG COM
PROPERTY TYPE SECURITIES
113
07/25/2000
02/02/2001
2 .540
56 SIGMA ALDRICH CORP
PROPERTY TYPE SECURITIES
2,242
01/26/2001
5,551
225 CORNING INC COM
PROPERTY TYPE SECURITIES
12,605
07/25/2000
3,269
108 . MOLEX INC CL A NON-VT6 COM
PROPERTY TYPE SECURITIES
4,051
0/2512000
61
2 MOLEX INC CL A NON-VTO COM
PROPERTY TYPE SECURITIES
75
07/25/2000
1,325
44 MOLEX INC CL A NON-VTG COM
PROPERTY TYPE SECURITIES
1,650
425 EXXON MOBIL CORP COM
PROPERTY TYPE' SECURITIES
1 .375 .
01/29/1958
03/01/1999
4,563
100 MEDTRONIC INC
PROPERTY TYPE SECURITIES
3,548
07126/2000
2,835
98 MOLEX INC CL A NON-VTG COM
PROPERTY TYPE SECURITIES
3,659
01/05/2001
13,114
200 EMERSON ELECTRIC CO
PROPERTY TYPE SECURITIES
14,717
01/29/2001
14,919 .
250 HARTFORD FINL SVCS GROUP INC
PROPERTY TYPE SECURITIES
16,267
570 .
33,822
A
Depreciation
allowed/
jIllowable
Description
17301000 B01070 M129 04/30/2002 09 28 21
18-3301316
Date sold
03107/2001
-143
03/08/2001
298
03/23/2001
-7,054
03126/2001
-782
03J26/2001
-14
03/27/2001
-325
03/30/2001
32,447
03/30/2001
1,015
04/10/2001
-824
04/20/2001
-1,603 .
04/20/2001
-1 .348
20
-
FORM 990-PF - PART IV
CAPITAL GAINS AND LOSSES FOR TAX ON INVESTMENT INCOME
P
Date
Kind of Property
Grow sale
price less
emen5eS of sale
11,961
1,455
13,922
9,753
12,586 .
or
Description
eforeciation
allowed/
allmitle
FMV
as of
1 2L3 1 162
Cost or
Adl ba
as of
1 2131/6Q
FMV over
adi basis
250 BROCADE COMMUNICATIONS
PROPERTY TYPE SECURITIES
SYTEM
7,982
PROPERTY
25
1,069
AOL
TYPE
TIME WARNER
SECURITIES
INC COM
PRODS CORP
8,490
PROPERTY TYPE
225 .
8,284
100
UNITED TECHNOLOGIES CORP COM
PROPERTY TYPE
SECURITIES
858
6,238 .
100 AMERICAN HOME PRODS CORP
PROPERTY TYPE . SECURITIES
681
4,863,
100
GENERAL ELEC CO COM
PROPERTY TYPE
SECURITIES
71
4,259 .
I E 1730 1 000
G01070
COM
COM
SECURITIES
100
PFIZER INC COM
PROPERTY TYPE' SECURITIES
113
M129 04/30/2002
09 28
21
05/22/2001
05/22/2001
01/26/2001
06/0512001
1,810
01/28/1985
06/06/2001
11,224
4,890
INC
03/01/1999
1,187
100 . GENERAL ELEC CO
SECURITIES
PROPERTY TYPE
71
PFIZER
05/02/2001
3,979
09/0712000
175 KING PHARMACEUTICALS COM
PROPERTY TYPE . SECURITIES
7,943
200
03/23/2001
Date sold
386
375
ACE LTD COM
PROPERTY TYPE
SECURITIES
12,735
200 AMERICAN HOME
SECURITIES
PROPERTY TYPE
1,362
acquired
Gain
or
(loss)
18-3301316
03/09/1961
06/06/2001
4,819
01127/1982
06/06/2001
8,265
03/29/1983
06/06/2001
7,426
0112811986
06/0712001
5,557
03/09/1961
06/07/2001
4,792
01/27/1982
06/07/2001
4,146
21
FORM 990-PF - PART IV
CAPITAL GAINS AND LOSSES FOR TAX ON INVESTMENT INCOME
P
Date
Kind of Property
Gross sale
price less
expenses of
Depreciation
allowed/
allowable
Cost or
other
FMV
as of
Adl basis
of
I
Excess of
FMV over
adi basis
of
0
acquired
Gain
or
floss)
01/05/2001
20,267
225 . WELLPOINT HEALTH NETWORKS IN
PROPERTY TYPE SECURITIES
24,033
06/30/2000
10,397
206 EL PASO CORP COM
PROPERTY TYPE SECURITIES
10,616
02/02/2001
3,802
570 ADC TELECOMMUNICATIONS INC C
PROPERTY TYPE SECURITIES
16,099
02/02/2001
27
4 ADC TELECOMMUNICATIONS INC C
PROPERTY TYPE SECURITIES
57
350 WAL-MART STORES INC
PROPERTY TYPE SECURITIES
16,734
11/02/2000
301 ADC TELECOMMUNICATIONS INC C
PROPERTY TYPE SECURITIES
4,276
02102/2001
10/17/2000
17,409
434 . CVS CORP COM
PROPERTY TYPE SECURITIES
20,824
10/17/2000
639
16 CVS CORP COM
PROPERTY TYPE SECURITIES
717
11/14/2000
1,189
17 ST JUDE MED INC
PROPERTY TYPE . SECURITIES
967
11/14/2000
2,308
33 ST JUDE MED INC
PROPERTY TYPE SECURITIES
1,876
6666 KING PHARMACEUTICALS COM
PROPERTY TYPE SECURITIES
23
01/26/2001
17,344
1,973
28 .
A,
Description
710100
G01070 M129 040101200-2
09 28 21
19-2201216
Date sold
06/08/2001
-3,766
06/22/2001
-219
06/28/2001
-12,297
06128/2001
-30
06./28/2001
610
06/29/2001
-2,303
07/17/2001
-3,415
07/18/2001
-78
07/25/2001
222
07/26/2001
432
07/27/2001
5
99
-
FORM 990-PF - PART IV
CAPITAL GAINS AND LOSSES FOR TAX ON INVESTMENT INCOME
P
Date
Kind of Property
Gross sale
price less
exgenses of ~le
epreciation
,
Ilowed/
allowable
Description
Cost or
other
h,~,~
31
acquired
Cain
or
(loss)
06/29/2001
1,637
41 FEDERATED DEPT STORES INC DE
PROPERTY TYPE' SECURITIES
1,767
08/17/2000
7,163
175 DYNEGY INC CL A NEW COM
PROPERTY TYPE SECURITIES
3,772
08/17/2000
3,078
75 DYNEGY INC CL A NEW COM
PROPERTY TYPE SECURITIES
3,331
03/23/2001
2,795 .
200 TELLABS INC COM
PROPERTY TYPE SECURITIES
9,480
04/20/2001
10,059
175 HOUSEHOLD INTERNATIONAL COMM
PROPERTY TYPE SECURITIES
11,005
06/29/2001
11,787 .
359 FEDERATED DEPT STORES INC DE
PROPERTY TYPE SECURITIES
15,401
08/30/2000
8,982
475 GWEST COMMUNICATIONS INTL CO
PROPERTY TYPE SECURITIES
23,898
12/07/2000
1,907 .
150 AES CORP COM
PROPERTY TYPE SECURITIES
7,131 .
09/27/2000
2,543
200 AES CORP COM
PROPERTY TYPE SECURITIES
13,792
650 CONCORD EFS INC COM
PROPERTY TYPE SECURITIES
14,327
01126/2001
175 PEPSI BOTTLING GROUP COM
PROPERTY TYPE' SECURITIES
5,232 .
07/20/2000
17,191
8,197
""e"'es GQ1030 M129 04/3012002 09 28 21
18-3301316
Date sold
08/0812001
-130
08/17/2001
-609
08/17/2001
-253
08/17/2001
-6,685
09./04/2001
-946
09/0712001
-3,614
0910712001
-14,916
09/28/2001
-5,224
09/28/2001
-11,249
10/05/2001
2,864
10/05/2001
2,965
23
FORM 990-PF - PART IV
CAPITAL GAINS AND LOSSES FOR TAX ON INVESTMENT INCOME
Kind of Property
Gross sale
price less
if safe
Depreciation
allowed/
allowable
Description
Cost or
other
FMV
as of
I?Illlrq
I
Act basis
as of
I
Exci-s-s-of
FMV over
~~- basis
Date
acquired
Gain
or
(loss)
12/07/2000
2,493
43 MOIC INVT CORP W1 COM
PROPERTY TYPE SECURITIES
2 .734
02/08/2001
8,955
250 WASHINGTON MUT INC COM
PROPERTY TYPE SECURITIES
8,605
12/07/2000
575
10 IVIGIC INVT CORP WI COM
PROPERTY TYPE SECURITIES
636
12/0712000
2,531
44 MGIC INVT CORP WI COM
PROPERTY TYPE SECURITIES
2,797
07/09/2001
8,081
275 VERITAS SOFTWARE CO COM
PROPERTY TYPE SECURITIES
16,907
07/3012001
7,362
216 . PPL CORP COM
PROPERTY TYPE . SECURITIES
12,871
600 WASHINGTON MUT INC COM
PROPERTY TYPE SECURITIES
16,107
02/08/2001
09107/2001
9,660
284 PPL CORP COM
PROPERTY TYPE SECURITIES
12,489
09/28/2001
6,509
350 IVAX CORP
PROPERTY TYPE SECURITIES
7,674
12/07/2000
2,530
44 . MGIC INVT CORP W1 COM
PROPERTY TYPE . SECURITIES
2,797
12/07/2000
517
9 MGIC INVT CORP WI COM
PROPERTY TYPE SECURITIES
572
15,554
JSA
,
E I 710 1 000
1301070 M129 04/30/2002 09 28 21
18-3301316
Date sold
10/11/2001
-241
10/12/2001
360
10/15/2001
-61
10116/2001
-266 .
10/23/2001
-8,826
10/26/2001
-5,509
10/26/2001
-553
10/29/2001
-2,829
11/07/2001
-1,165
11113/2001
-267
11/14/2001
-55
24
-
FORM 990-PF - PART IV
CAPITAL GAINS AND LOSSES FOR TAX ON INVESTMENT INCOME
P
Date
Description
Kind of Property
Gross sale
price les
expenses olfs
Depreciation
allowed/
Cost or
other
has's
FMV
as of
120 1 169
Ad) bas s
as of
1
2131169
250 . BROAOCOM CORP CIL A COM
PROPERTY TYPE SECURITIES
11,991 .
08/02/2001
200 PEPSI BOTTLING GROUP COM
PROPERTY TYPE' SECURITIES
5,931
07/20/2000
200 MGIC INVT CORP WI COM
PROPERTY TYPE SECURITIES
11,107
01/18/2001
05114/2001
8,970
282 NABORS INDS INC COM
PROPERTY TYPE SECURITIES
15,791
05/14/2001
4,646
143 NABORS INDS INC COM
PROPERTY TYPE SECURITIES
7,165
05/30/2001
2,851
143 CENDANT CORP COM
PROPERTY TYPE SECURITIES
2,681
11,193
9,012
11,243
IE173D I WO
GQ1070 M129 04/30/2002 09 28 .21
Date sold
11/30/2001
-798
12/04/2001
3,081
12/07/2001
136
12/18/2001
-6,821
12/19/2001
-3,119
12/31/2001
170
---------68,433
TOTAL GAIN(LOSS)
JSA
Excess of
FMV over
adi basis
acquired
Gain
or
(loss)
18-3301316
25
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MUNSON W J-MUNSON FUND
FORM 990PF,
PART
III
18-3301316
06-6024564
- OTHER INCREASES IN NET WORTH OR FUND BALANCES
DESCRIPTION
-----------
AMOUNT
TAX TO BOOK ADJUSTMENT
TOTAL
32,141
---------32 .141
I
STATEMENT
ADS76 2 NO
OU1070 M129 04/30/2002 09 .28-21
18-3301316
32
7
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MUNSON W J-MUNSON FUND
FORM 99OPF,
18-3301316
06-6024564
PART XV - NAME, ADDRESS AND PHONE FOR APPLICATIONS
ALFRED MORENCY, CHAIRMAN, 71 SCOTT AVE . WATERTOWN,
PHONE 203-274-4288
CT 06795
STATEMENT
XDsTs 2000
GG1070 M129 04/30/2002 09 .28 21
18-3301316
34
9
ol INNIVIS
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-----------
9181088-91
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Capital Gains and Losses
SCHEDULE D
(Form 1041)
CMB No 1545-0092
2001
ll~ Attach to Form 1041 (or Form 5227) See the separate Instructions for
Deparment of the T,easury
Name of estate or twat
Employer identification number
FUND 18-
Note
[M
Short-Term Capital Gains and Losses - Assets Held One Year or Less
. . .. . ..
100 sh;,j7~:
c4ured
(c) Date sold
(0) Cost of other basis
to) Sales price
11) Gain or (Loss)
1
2
3
4
5
Short-term capital gain or (loss) from Forms 4684, 6252, 6781, and 8824
Net short-term gain or (loss) from partnerships, S corporations, and other
estates or trusts
1
Short-term capital loss carryover Enter the amount, if any, from line 9 of the
2000 Capital Loss Carryover Worksheet
Net short-term gain or (loss) Combine lines 1 through 4 in column (f) Enter
.
. . . .
here and on line 14 below
1=
6,710 .
3
4
ll~
5
-73,624
Long-Term Capital Gains and Losses - Assets Held More Than One Year
(a) Descripuon
(Emmple 100
M share.
0"'Ope'
I
- 1~ I7%
6
2
~ lin~"'
.qU',a7d
'e- I I li-OD day
e .0Y"d~
(d) Sales once
I
(a) Cost
(see orpage
other291basis
f) Gain or (Loss)
"(nl ldh lp~q r.ni (Pil
of (Loss)
4
7
a
9
10
11
12
13
Long-term capital gain or (loss) from Forms 2439, 4684, 6252, 6781, and 8824
Net long-term gain or (loss) from partnerships, S corporations, and other estates or trusts
Capital gain distributions
. . . . . .
Gain from Form 4797, Part 1
Long-term capital loss carryover Enter in both columns (f) and (9) the amount,
if any, from line 14 . of the 2000 Capital Loss Canyover Worksheet
Combine lines 6 through 11 in column (g)
Net long-term gain or (loss) Combine lines 6 through 11 in column (f) Enter
here and on line 15 below
- - - - la~
7
8
9
10
18,981
11
12
13
142 .057
'28% rate gain or loss includes all "collectibles gains and losses' (as defined on page 30 of the instructions) and up to 50% of
the eligible gain on qualified small business stock (see page 28 of the instructions)
= Summary of Parts I and 11
14
15
(1) Beneficiaries'
(see Daoe 30) 1
(2) Estate's
or trust's
I
(3) Total
Net short-term gain or (loss) (from line 5 above)
14
-/3,624
Net long-term gain or (loss)*
a 28% rate gain or (loss) (from line 12 above)
15a
b Unrecaptured section 1250 gain (see line 17 of the worksheet
on page 31)
15b
c Total for year (from line 13 above)
15C
142,057
16 Total net gain or (loss) Combine lines 14 and 15c
16
68,433
Note If line 16, column (3) is a net gain. enter the gain on Form 1041 line 4 If hnes 15c and 16, column (2) are net gains, go to Parr V and do
not complete Part IV it line 16, column (31, is a net lom;, complete Part IV and the Capitall-oss Carryover Vibrkshee4 as nacessarv
For paperwork Reduction Act Notice, see the Instructions for Form 1041
Schedule D (Form 1041) 2001
JSA
IF1210 2 NO
GQ1070 M129 04/30/2002 09 28 21
18-3301316
36
-
2
ScneOule 0 (Form 1041) 2001
a=
Capital Loss Limitation
Enter here and enter as a (loss) on Form 1041, line 4, the smaller of
a The loss on line 16, column (3) or
b $3,000 . .
1 .17
1
If the loss on fine 16 column (3) is more than S3 000, or if Form 1041 page 1, line 22 is a loss, complete the Capital Loss
Carryover Worksheet on page 32 of the instructions to determine your capital loss carryover
Tax Computation Using Maximum Capital Gains Rates (Complete this part only if both lines 15c and
16 in column (2) are gains, and Form 1041, line 22 is more than zero )
17
Note If line 15a column (2) or line 15b, column (2) is more than zero complete the worksheet on page 34 to figure the instructions
to figure the amount to enter on lines 20, 27, and 38 below and skip ail otherhnes below Otherwise go to line 18
18
18 Enter taxable income from Form 1041, line 22
19
19 Enter the smaller of line 15c or 16 in column (2)
20 If the estate or trust is filing Form 4952, enter
the amount from line 4e, othe~ise, enter -0- Ili20
21 Subtractline 20from line 19 If zero orless, enter-021
. . .
22 Subtract line 21 from line 18 If zero or less, enter -022
. .
23 Figure the tax on the amount on line 22 Use the 2001 Tax Rate Schedule on page 20 of the
instructions
. . .
. . .
24 Enter the smaller of the amount on line 18 or $1,800
24
. . . .
If line 24 is greater than line 22, go to line 25 Otherwise, skip lines 25
through 31 and go to line 32
25
26
27
28
29
30
31
Enter the amount from line 22
Subtract line 25 from line 24 If zero or less, enter -0- and go to line 32
Enter the estate's or trust's allocable portion of
I
I
qualified 5-year gain, if any, from line 7c of the
27
worksheet on page 33
Enter the smaller of line 26 or line 27 .
. . . . .
. . . . . .
Multiply line 28 by 8% ( 08)
Subtract line 28 from line 26
Multiply line 30 by 10% ( 10)
. . . . .
. . .
30
If the amounts on lines 21 and 26 are the same, skip lines 32 through 35 and go to line 36
32
33
34
35
Enter the smaller of line 1 B or line 21
. . .
Enter the amount, if any, from line 26 .
Subtract line 33 from line 32 . . . .
Multiply line 34 by 20% ( 20)
. . .
36
37
Add lines 23, 29, 31, and 35
. . . . . .
. . . . . . . .
Figure the tax on the amount on line IS Use the 2001 Tax Rate Schedule on page 20 of the
instructions
. .
. .
.
.
Tax on all taxabie income (including capital g al ns) Enter the s mailer of lin-e 36 or line' ii ~e~e'
and on line 1 a of Schedule G, Form `1041
. . . .
38
33
34
Schedule D (Form 1041) 2001
JSA
IF 1220 3 OM
GQ1070 M129 04/30/2002 09 28 21
18-3301316
37
-
MUNSON W J-MUNSON FUND 18-3301316
Schedule D Detail of Short-term Capital Gains and Losses
_
IF0971 1 000
06-6024564
J~
GC11070 M129 04130/2002 09 28 21
18-3301316
38
STATEMENT
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MUNSON W J-MUNSON FUND 18-3301316
06-6024564
FEDERAL CAPITAL GAIN DIVIDENDS
LONG-TERM CAPITAL GAIN DIVIDENDS
20% MAX RATE CAPITAL GAIN DIVIDENDS
GALAXY SMALL CAP VALUE FUND
TOTAL 20% MAX RATE CAPITAL GAIN DIVIDENDS
530
----------
TOTAL LONG-TERM CAPITAL GAIN DIVIDENDS
X0578 2000
G(11070 M129 04/30/2002 09-28 21
18-3301316
530
---------728
STATEMENT
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