t
1
t
Return of Private Foundation
.~ Form"990-PF
or Section 4947(a)(1) Nonexempt Charitable Trust
Treated as a Private Foundation
Department of the Treasury
internal Revenue Somico
Employee Identllicollon number
Name of organization
otherwise, S UE NAN FIND ROD CUTSINGCR FOUNDATION
print
Numoer and apaet (or P.O, box number if moil Is not delivered to street address)
P40woulto
or typo . 1900 ST JAMES PLACE SUITE 150
Sao Spoctllc
Instructions . City or town , state, and ZIP code
HOUSTON , TX
77056
expenses per books
Chock hero and ott~n
E If private foundation status was terminated
under section 507(b)(1)(A), check here , . .t
F If the foundation Is In a 60-month termination
under section 507 b 1 B , check here . . .
interest
nna temporary
a Dividends and Interest from securities. ......,.. .. .
5a Gross rents ...... .. .. . .... .. .. .. ... ..... .. .. ..... .. ... .. .
U
W
O
b Nat rental income or pops)
Not aln.. or
.....gone)
.. .. ....
horn. ....
halo.. o.. .......
naoote.....
not...
on
m
Ba line ~o
7
C
z
y
N
.. . ... .. . ... .. .. .. ~
2,681,000 .
Groan sales price for all
It waste an line as . . . . . .
7 Capitol pain not Income (from Port N, line 2)
°~
8
Net short-term capital gain
9 Income modifications . .
Groan oaar lara rotumo
100 and nuowanooa .. . . . .. .. . .
b Lane: Coot of goods cold
. ... ....... .. ..... ... ... .. .
Compensation of ol0aoro, directors, trustees. ate ,
14
Pension plans, employee benefits
S TMT 4
It Acc o unting fees
R 47- into rest .
t_VVE!6sional fees
'
~ 18 Taxes . .. ' .. .. .. .. ... .
..
V
D ENT,
Pla.1111ITano pu
%TMh
M
' ' ' *-
, . . TMT ,5. ,.
'France
and meetings
ications
..
expenses . Add lines 13 through 23
Contributions, gifts, grants paid
, ..
Total expenses and disbursements .
.. ... ..
a Excps of revenue over exPenap and alaDUraunents
b Net Investment Income of nroawa enter -0-)
c Adjusted net Income Pfneenwa e+w-a1
O1-OJ-OS
~s~~001111%
MUM
M
.-PE:
1 1 9
V
3 1 8 .
.^'r
;r~%!
~Q
<1 , 278 .
192 , 995 .
<1 , 278 .
192 , 995 .
0 .
0
3,173 .
1,586 .
0
3 , 534 .
0.
54 .
27 .
0 .
613 .
0 .
10 .
0 .
x
LHA
-
-----
.. . . . . . . .
Add lines 24 and 25 ,
7 ubtract fine 26 rom line ~ 2
423501
.,-.. ~ ,
, . . . . X 23 Other expenses
, STMT , 6
~` 24 Total operating and administrative
25
26
f.`~.3. " .k.~~~~t#~>5
, ,
":
119
, 318 . ~>~.,~
:sk,
.. .. .... ... .. ... . .. . ... .. . ....
, .
92*20ffin a ~ pletfon M
20 Occupant:
.!,?7. . . . . . . . . . .
. .. .. .. . .
a
' ~o-k~
72 , 484 .
2 , 471 .
. . .,
18a Legal fees . . .. . . . . . . . . . . . .. . . . . . . . .. . . . . . . . . .. . . .. . . . . . . . . . . .
r
(cash basin only)
Other employee salaries and wages , . . ., . . . . . . . .,
15
N
Income
..
11 Other Income .,. .,. ., ...,... . .. ... ., .., ...,.. .. .
12 Total. Add lines i through > > . .....,. .... . ... .,. .
1$
~ 7 2 484 .
2 , 471 .
. . . . . . . . .. . . . . . . . . . . . . . . . . . . .
c Gross profit or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
A
(d) Olaburuamonta
for charitable purposes
(C) Adjusted not
Income
Contributions, gifts, grants, etc., received , . . . ., .
Check 1 OIt the foundation is not mqIdmA t0 iw Sth. B
0
N
O
713-785-1777
D 1 . Foreign organizations . chock here . . "
the 86% loll,
2 . Foreign organizations meoting
aomputntlon , . . . . , . .1 L-I
(Part 1, column (~ must be on cash basis.)
"$
2 , 959 , 02 4 . (Pad
arty ; Analysis of Revenue and Expenses
(a) Revenue and
(b) Net Investment
(ihe tomb of amounts in columns ft (e), and (d) may not
necessarily equal the amounts In Column (o) .)
3 1-1644919
B Telephone number
If exemption application Is pending, CMoCk nor .
H Chock type of organization :
Section 501(0)(3) exempt private foundation
Section 4947(a) ( 1 )
charitable trust
Other taxable private foundation
I Fair market value of alt assets at end of year J Accounting method : LYJ Cash
I-1 Accrual
(from Port 11, col. (c), line 16)
0 Other (specify)
1
2004
Note : The organ atlon may be able to use a copy of this return to sotlsly state repor
an
or tax year bepinnin
For calendar year 200
Use the IRS
label .
OMB No . 19aS-00!S2
.
6 , 761 .
145 , 210 .
1
151 . 971 .
1 , 613 .
41 , 02
:
r<
Y +
~y ~ %;% >r r>>~~'~1~~~,
3
f ; f; ;,
191
t%';' .. ` %~
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions .
382
r ~r/r
i/ f r
N/A
1W 1/1~
145 , 210 .
I, XV,
Form 990-PF (2004)
31-1644919
Form 990-PF(2004)
Part
SUE NAN AND ROD CUTSINGER FOUNDATION
Beginning o1 year
Balance Sheets "~°°""`~'~'""°"'~""t~°°°`~°d°"
ca'°""s"°w°oefma'°'°aycu""ou"°
e Book Value
i Cash - non-interest-bearing ... ..... .. .. .. ..... ..... . . ..... ... .... .. .. .. . ., ., ... .
2
3
Savings and temporary cash investments
Accounts receivable 01
Less . allowance for doubtful accounts t
Pledges receivable 10,
4
., . . ., . ., . . . . ., ., . . .,
2
334 , 925 .
b Book Value
Page 2
End of ear
(c Fair Market Value
2 , 589 , 276 .
I
2 , 593 , 064 .
s~
r
-tvy
Lass : allowance for doubtful accounts ~
Grants receivable , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
RoCOlvdblos due from officers, directors, trustees, and other
disqualified persons . . . . . . . . . . . . . . . ., . . . . . . . . . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
S
6
7
OO+u not= and ulna iatlqOto . . . . . . . . . . . . . . . . . . . . . . . .
~.w~..~. ., r: .~ix..w..~..k .,.".~t:x.. s:...x~.yy..:z::,:~..4. ..W..,... .., . . ...
Loss : allowance for doubtful accounts 10,
0 Inventories for safe or use . ,.., .., .. . . . ., . , . . . ., . ,..,
d
9 Prepaid expenses and deferred charges 10a Investments - U .S . and state government obligations . . . , .
I
I
b investments -corporate stuck . ., , STMT .7 ,
557 , 433 . 1
c Investments - corporate bonds . . . . . . . . . , , . , 11 imam+ens - land. buildings, ono ewIDrt+ent basis . . . . . .
Less uamuUOeo dt0mdadon
I
14
.. .. .... .. ... ..... . .. ..
17
18
g
19
20
21
22
2 , 933 , 382 .
2 , 959 , 024 .
I
Investments - other ,
Land, buildings, and equipment: basis "
;:
LcS:iceumulam0depreciation . . . . . . .. .. . . . . . . . . . . . . .1
15
365- 1 9-6-0--
Man
12 Investments - mortgage loans ..., ., . , . ,. 13
344 106 .
Other assets (describe 1
i
1
I
358 .
Accounts payable and accrued expenses . , . . ., . . ., . . . . . . ., ., .,
Grants payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
~~Hi}+y`
y~
ti
Deferred revenue . .. . . . .. . . . . .. . . . . . . . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Loans from omcoro, alratoro, truntous, and olnor dlnqumlfloa parsons
. - i
. ., ., ., . . .
Mortgages and other notes payable , . , . , . ., ., . . ., . . . . . . ., . ., . .
Other liabilities (describe "
7;~{ , }'i
1
i
)
23
~,
19
m
a
Y
°'
°'
Total liabilities ( add lines 17 thr0u h 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Organi :otlons that to 11ow SFAS 117, check hero
01.0
and complete lines 24 through 26 and lines 30 and 31 .
24 Unrestricted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ZS Temporarily restricted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
26 Permanently restricted . . . . . . ., . . ., ., . ., . . . . ., ., ., ., ., . ., ., . . ., , . ., . .
Organizations that do not follow SFAS 117, Check here
1
and complete lines 27 through 31 .
27 Capital stock, trust principal, or current funds , . , 28 Paid-in or capital surplus, or land, bldg ., and equipment fund . .
29 Retained earnings, accumulated Income, endowment, or other funds
30 Total net assets or fund balances , .
0.
2 , 892 , 358 .
2,892,358 .
0.
2 , 933 , 382 .
2,933,382 .
31 Total liabilities and net assets lung bounces
2 , 892 , 358 . 1
2 , 933 , 382 ..
0 .
~r<
<Pa"rt<III:% Analysis of Changes in Net Assets or Fund Balances
1
2
3
4
5
6
Total net assets or fund balances at beginning of year- Part II, column (a), line 30
(must agree with end-of-year figure reported on prior years return)
Enter amount from Part I, line 27a
.,
, , ..
Other increases not included in line 2 (itemize)
Add lines t, 2, and 3
Decreases not included in line 2 (itemize) 1111Total net assets or fund balances at end of year (line 4 minus line 5) - Part II, column (b), line 30
423511
O7-O3-DS
2,892,358 .
41,024 .
0 .
2,933,382 .
0 .
2,933,382 .
Form 990-PF (2004)
r
Form 990-PF 2004
SUE NAN AND ROD CUTSINGEF
Part IV
Capital Gains and Losses for Tax on investmer
(a) List and describe the kind(s) of property sold (e .g ., real estate,
2-story brick warehouse ; Or common stock, 200 Shs . MLC C0 .)
OUNDATION
come
31-1644919
(D' How acqu
P - Purcha ;
acquired
(c~mo.t dayqyr
Page 3
(,mo~ day, Yrd.)
SEE ATTACH
(e) Gross sales price
,. .
omplete only for assets shows
(q Depreciation allowed
(or allowable)
I
(h) Gain or (loss)
(u) plus (Q minus (0)
(p) Cost or other basis
plus expense of aato
1]
(I) Gains (Col (h) gain minus
In column (h and owned by the foundation on 12/31/69
(1) Adjusted basis
as of 12/31/69
(I) F M.v as of t2/31/69
Col (k), but not less than -0-) or
Losses (from col . (h))
(k) Excess of col (I)
over coi (1), It any
e
119
~ It gain,;also enter In Part I, line 7 1, .
If (loss , enter -0- In Part I, line 7 1
2 Capital gain net Income or (net capital loss).
3 Net short-term capital gain or (loss) as defined In sections X222(5) and (6) :
If pain, also enter In Part I, line 8, column (c) .
2
. .. .. .. . . . .
318 .
119 , 318 .
If (loss), enter -0- In Part I, line 8 ... .. ... .. .. .. ..... ... ..... .. . ... . .... . .... .. .. ... ... ... ....... .. ... . . .. .. .
3
>ParttV= ; Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
N/A
(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 organization liable for the section 4942 lax on the dlstrlbulable amount of any year In the base period? . . . . . . . . ., ., ., . ., ., . . . . . . . , O Yes CE No
It 'Yes .'the organization does not quality under section 4940(e) . Do not complete this part .
1
Enter the appropriate amount In each column for each year; see Instructions before making any entries.
Base period year s
Calendar ear or tax ear be g innin g in )
Adjusted quali fy(distributions
ing
145
110
6,
2,
3,
2003
2002
zoos
2000
1999
2
3
214 .
749 .
000 .
000 .
000 . 1
Net value of noncho)ritable-use assets
2 , 890 ,
2 , 951 ,
2 , 060 ,
116
61
429
552
458
920
442
Distribution ratio
cot, b divided b cot, c
.
.
.
.
.
.0502396
.0375223
.0029120
.0171057
.0488265
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 In existence If less than 5 years , . . ,
2
.1566061
3
.0313212
4
Enter the net value of nonchantable-use assets for 2004 from Part X, line 5
4
2 , 934 , 654 .
5
Multiply line 4 by line 3 , . , . . , . . . , . . . . . . . .
6 Enter 1% 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
.. . .
.
,. ,
. ,
,
. .
.
.
s
91
917 .
s
1
914 .
7
93
831 .
g
145
210 .
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
4z3sz,/o,-o3-as
Form 990-PF (2004)
Form 990-PF(2004)
SUE NAN AND ROD CUTSINGER FOUNDATION
31-1644919
Pa g e 4
Excise Tax Based on Investment Income Section 4940 ( a), 4940 (b ) , 4940 ( e or 4948 - see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here " LLJ and enter 'N/A' on line 1 .
Date of ruling letter.
(attach copy of ruling letter II necessary-see Instructions)
' - `T
b Domestic organizations that meet the section 4940(e) requirements In Part V, check here " IM and enter 196
, .^1 ` n `~~~~1~ . 9 .14 .,
otPart l,line 27b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
-. ~
- c
c All other domestic organizations enter 2% of line 27b . Exempt foreign organizations enter 496 of Part I, line 12, cot . (b)
2 Tax under section 511 (domestic section 4947(a)(1) butts and taxable foundations only . Others enter -0-) ,
2
0.
3 Add lines 1 and 2 . . . . . . . . . . . . . . . . . . . . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .-- . . . . . . . . . . . . . . . . . . . .
1 4 914 .
9l_
Subtitle A (income) tax (domestic section 4947(a)(t ) trusts and taxable foundations only . Others onlor -0-) , . . , .,
0.
4
8 Tax based on Investment Income . Subtract line 41rom line 3 . It zero or lean, onto-0- . 1 , 914 .
8
..
..
8 Crecllto/Puymont
s
0 2004 estimated tax payments and 2003 overpayment credited to 2004 , , , . 1 j 892 .
68
b Exompt foreign organizations " tax withheld at source , . . . ., . . , . 611
c Tax paid with application for extension of time to file (Form 8868) . . . , . , . . ., . . ., . . . ,
8c
;0` .
d Backup withholding erroneously withheld
,
, , , , ,
Bd
7 Total credits and payments . Add lines 6a through 6d
1 892 .
7
8 Enter any penalty for underpayment of estimated tax . Check here ~ N Form 2220 Is attached ,
11 .
8
9 Tax due . It the total of lines 5 and 8 is more than line 7, enter amount owed , , , SEE. STATEMENT 8
33 .
9
10 Overpayment . If Tine 7 IS more than the total of lines 5 and 8, enter the amount overpaid
. .,
, "
10
11 Enter the amount of line 10 to be: Credited to 2005 estimated tax "
,Refunded "
11
kPaWV11W.
Statements Regarding Activities
1 a During the tax year, did the organization attempt to influence any national, state, or local legislation or did it participate or Intervene In
C, Yes No
Part VI
any political campaign? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b Old it spend more than $100 during the year (either directly or Indirectly) for political purposes (See instructions for definition)? , . 11 the answer Is "Yes" to 1 a or 1 b, attach a detailed descriP tfon of the activities and cop ies of any materials published or
distributed b the o rganization In connection with the activities.
c Did the organization file Form 1120-POL for this year? . . ., . . . . . . , ., . , ., ., . . . . , ., . . . ., . , ., ., ., ., .
., ., . , . . .
,.
d Enter the amount if any) of tax on political expenditures (section 4955) Imposed during the year :
0 . (2) On organization managers . " a
0 .
(i) On the organization . " a
e Enter the reimbursement (If any) paid by the organization during the year for political expenditure tax Imposed on organization
managers . " $
0 .
2 Has the organization engaged In any activities that have not previously been reported to the IRS? , ., . ., . . . . . . ., . , .
11 "Yes," attach o detailed doscrlptlon of tho activities.
3
da
b
5
8
7
8a
b
9
10
11
12
13
Has the org anization made any chang es, not previously re p orted to the IRS, In Its g overnin g Instrument, articles of Incor p oration, or
bylaws, or other similar Instruments? 11 "Yes," attach a conformed copy of the changes , . . . . . , . . . . . . . . . . . . . . . . ., ., . , . . ., ., . . . . . .,
Old the organization hove 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? . . . . . . ., ., . . . . . ., . . , ., . . ., . ., ., . . ., ., . . N/A . . .
Was there a liquidation, termination, dissolution, or substantial contraction dining the year? ., ., ., , . , . , . ., . , . ., . . ., . . . . . , . . . . . . . . . . . . . . . . .
11 "Yes," attach the statomont roqulred by General Instruction T.
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either
" By language In the governing Instrument, or
" By stale legislation that effectively amends the governing Instrument so that no mandatory directions that conflict with the state law
remain in the governing instrument? , , ., . . . . . . . , .
. ,
. . , , ., . . . . , . , . , . .
. . . . . . . ., ., .
Did the organization have at least $5,000 in assets at any time during the year?
11 "Yes," complete Part fl, cal. (c), and Pert XV.
Enter the states to which the foundation reports or with which it Is registered (see Instructions)
TEXAS
If the answer is 'Yes' to line 7, has the organization furnished a copy of Form 990-PF to the Attorney General (or designate)
each state as required by General Instruction G? I/ "No," attach explanation , , . , , . . . . . , . . , ,
,
Is the organization claiming9 status as a private operating9 foundation within the meaning9 of section 4942(1)(3) or 4942(j)(5) for calendar
year 2004 or the taxable year beginning in 2004 (see Instructions for Part XIV)? If "Yes," complete Part XIV
Did any persons become substantial contributors during the tax yeast it -Yes.- attach o schedule listing their name3 and oaaresses
Did the organization comply with the public inspection requirements for its annual returns and exemption application?
Web site address " N/A
The books are in care of " ROD CUTS INGER
Locatedat t 1900 ST . JAMES PLACE,
STE 150,
HOUSTON,
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
o~-o~~-'as
TX
yz
1b
"~~ fr ~`
~`ay
}'
1c
K
~s,
t`;~
2
X
3
X
X
4a
4b
8
8
7
X
X
X
~"
{~("~. +r '''
``r .
` (`
:f.'?:<w~
,%~?
'~~~
X
¢of
8b
~s, 3 F
- 511 '` ,~
X
9
10
X
11
X
Telephone no " 713-7 85-17 7 7
ziP+4 X77056
10-1
13 ~
N/A
10-0
Form 990-PF (2004)
Forrri990-1)1` (2004)
Part VII-B
SUE
NAN
AND
ROD CUTSINGER
FOUNDATION
Pages
31-1644919
Statements Regarding Activities for Which Form 4720 May Be Re quired
File Form 4720 if any itom is shocked in the "Yes" column, unless on exception applies.
Yes
to During the year did the organization (eltherdirectly or Indirectly) :
(1 ) Engage in the sale or exchange, or leasing of property with a disqualified person?
., . ., . . . . , ., . , . . . . ., 0 Yes [XI No
(2) Borrow money from, lend money to, or otherwise extend credit to (or accept It from)
a disqualified person?
"
.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . ~ Yes MI No
~--~
., ., . . , . , ., . , . . , ~ Yoe CKI No
(3) Furnish goods, services, or facilities to (or accept them from) n disqualified person?
(4) Pay compensation to, or ply or reimburoo the expenses of, o dlsqualitled poison?
for the benefit or use of a disqualified person)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
=, , r, . .; ` ,
r {
~ "~`°~ `' `'"' '~ °`
No
(8) Agree to guy money or property to a government officlal? (Exception, Check 'No*
x
It the organization agreed to make a grant to or to employ the official for o period after
termination of government service, It terminating within 90 days .)
.' °'
. .~ `
= Y83 CM NO
(6) Trancbr any income or assets to a disqualified person (or make any of either available
No
- u=' r.'~`. ',
. . , . , . , . . . , ., . , (~ Yes [~ No
b It any answer Is 'Yes' to 1a(1)-(6), did any of the acts tall to quality under the exceptions described In Regulations
section 53 .4941(d)-3 or In o current notice regarding disaster assistance (see page 20 of the Instructions)? , , , , , , Organizations relying on a current notice regarding disaster assistance check here
,
.i
, N,~A ,
1b
.
.s 1 c
~w
,
-----
,
c Did the organization engage In a prior year In any of the acts described In 1a, other than excepted acts,
act's*, that were not corrected
2
before the first day of the tax year beginning In 2004? , , . . .
, ,
,
, , . , . , . , Taxes on failure to distribute Income (section 4942) (does not apply for years the organization was a private operating foundation
X
E `;Y':
} .;
defined In section 49420)(3) or 49420)(5)) :
~"~
a At the end of tax year 2004, did the organization have any undistributed Income (lines 6d and 6e, Part XIII) for tax year(s) beginning
before 2004?
11 'Yes,' list the years " .' . .,~ . . . . .. . . .. . . . ., . . ., . .
. . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . .. . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . 0 Yes ~ No
.
~YY ~'`{ ~~
:~` t`'R~
b Are there any Y ears listed In 2a for which the organization Is not applying the provisions of section 4942 (a)( 2) (relating to Incorrect
,'
valuation of assets) to the yam's undistributed Income? (It applying Section 4942(4)(2) to all years listed, answer'No' and attach
statement see instructions .)
.. . . . . . .. . . . . . . . . . . . . .. . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .
.
. . . . ..
. . . . ... . . .
c If the provisions of section 4942(a)(2) are being applied to any of the years listed In 2a, list the years here .
. .
. . . . . . . . . . . NBA . .
1
3a Did the organization hold more than a 296 direct or Indirect Interest In any business enterprise at any time
during the year? . . . . . . . .. . . . .. . . . .. .. . . . . . . . .. . . . . . .. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 Yes EENo
b It 'Yes,* did ft have excess business holdings fn 2004 as a result of (1) any purchase by the organization or disqualified persons attar
2b
a"
~`
r
`^`
~7 :r
,'
.. .
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
;_'~~; ^$~ `:
Form 4720, to dotormlno !J the orgnnlzatlon had excess business holdings fn 2004 .) N,~ A
9b
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,
4a Did the organization Invest during the year any amount In a manner that would jeopardize Its charitable purposes? . . . . . . . , ., . ., . .,
4a
...
b Did the organization make any Investment In o 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 20047 . ., ., . . . . . , . . . . . ., ., , . . . ., . . . . ., . . . ., . . . . . .
5a During the year did the organization pay or Incur any amount to :
w
}` ,
X
X
4b
~;~;;
(1 ) Carry on propaganda, or otherwise attempt to Influence legislation (section 4945(e))1.. . ., . . . ., ., . . , , . . ., ., ., 0 Yes CK No
#
(2) Influence the outcome of any specific public election (see section 4955); or to carry on, directly or Indirectly,
any voter registration drivel . . ., . , . .. . . . . ., .
. . ..
, . . . ., .,
0 Yes C11 No
(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
(2), or (3), or section 4940(d)(2)7
(5) Provide for any purpose other than religious, charitable, scientific, literary, or educational purposes, or for
the prevention of cruelty to children or animals?
. 0 Yes [E No
~ Yes ~ No
cj " ' {; .J
Yes FX1 No
f +~V~
b If any answer is 'Yes' to Sa(1)-(5), did any of the transactions fall to qualify under the exceptions described In Regulations
section 53 4945 or in a current notice regarding disaster assistance (see instructions)?
Organizations relying on a current notice regarding disaster assistance check here
f
..
>, .f ~ ,"r
N/A
Sb
,
f
c If the answer is 'Yes'to question Sa(4), does the organization claim exemption from the tax because it maintained
expenditure responsibility for the grant?
N/A
0 Yes ~ No
If "Yes," attach the statement required by Regulations section 53.4945-5(~.
b Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contracts
If you answered "Yes" to 6b, also file Form 8870.
,,
k. . ., f . .
r+~~~'"` ~~` '` "`'x
f?`~"
6a Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract?
<509(4)1,
Yes
. 6b '
y%r1
~
X
Form 990-PF (2004)
429541
of-os-os
.
~Pa-rt ~VIII
1
SUE NAN AND ROD CUTSINGER FOUNDATION
31-1644919
Officers,
Information About
Directors, Trustees, Foundation Managers, Highly
Paid Employees, and Contractors
List all officers, directors, trustees, foundation managers and their compensation .
(b) Title, and average
hours per week devoted
(a) Name and address
to position
RESIDENT
ROD CUTSINGER
5483 TILBURY
HOUSTON, TEXAS
SUE NAN CUTSIN
5483 TILBURY
HOUSTON, TEXAS
Y
(c) Compensation
(II not pall,
enter -0-
co~omubomro
~,d ...~.....P
""'"'d'o~
Oy~00d~ofll lill4
Page s
~a) Expense
account, other
allowances
0.
0.
0.
o.
o.
o.
2 Com p ensation of five hi g hest- paid em p loyees ( other than those Included on line 1 ) . If none, enter "NONE ."
(b) Title and average
(o) Name and address of each employee paid more than $50,000
hours per week
(c) Compensation
devoted to p osition
Ezp ense
unt, other
THE FOUNDATION HAS NO EMPLOYEES
Total number of other employees paid over $50,000 ,
3 Five highost-gold independent contractors for professional services. If none, enter "NONE ."
(o) Name and address of each person paid more than $50,000
THE FOUNDATION PAYS NO ONE
S50,000 OR MORE
Total number of others receivin g over $50.000 for professional services . ... . .... ., . , ., .. ., .. . . . ..
'`sPart-WA'f Summary of Direct Charitable Activities
(c) Compensation
of service
.. . .. ..
List the foundation's tour largest direct charitable activities during the tax year Include relevant statistical Information such as the
number of organizations and other beneficiaries served, conferences convened, research papers produced, etc
10.
Expenses
iNOT APPLICABLE
2
3
4
of-o3-os
Form 990-PF (2004)
Form990-PF(2004)
SUE NAN AND ROD CUTSINGER FOUNDATION
31-1644919
Page 7
Part IX-B Summary of Program-Related Investments
Describe the two largest program-related Investments made by the foundation during the tax year on lines 1 and 2.
SNOT APPLICABLE
Amount
2
All other program-rotated Investments . Seo instructions .
9
Total . Add Iinos 1 through 3
, 1 1
0 .
;paTt X~, Minimum Investment Return (All domestic foundations must complete this part . Foreign foundations, see Instructions .)
t
Fair market value o1 assets not used (or held for use) directly In carrying out charitable, etc ., purposes .
Average monthly fair market value of securities , ,
,
. . ..
Average of monthly cash balances ., . , , , .
, ,
, ,
Fair market value of all other assets . . , . . , , ,
Total (add lines 1a . b . and c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. .. . . . .. .. .. .
. . . . .. .. . ..
Reduction claimed (or blockage or other factors reported on lines 1a and
. , ~ 1e
0.
1c (attach detailed explanation) , , . . , , . . 2 Acquisition Indebtedness applicable to line 1 assets , . , , , . ,
3 Subtract line 2 from line td . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
..
a Cash deemed held for charitable activities . Enter 1 1/296 of line 3 (for greater amount, see instructions) . . . , . .
5 Net value of noncharltable-use assets . Subtract line 4 from line 3 . Enter here and on Part V, line 4
8 Minimum Investment return . Enter 596 of line 5 . . . . . . . . . .
. . .. . .. .....
DIStrlbutable Amount (see instructions) (Section 4942(j)(3) and (1)(5) private operating foundations and certain
Part;Xl7
foreign organizations check here "
and do not complete this part )
e
b
c
d
e
1
2a
b
c
3
4
S
8
7
Minimum Investment return from PAR X, line 6 . . ., . ., . ., . . . , , ,
t
Tax on Investment Income for 2004 from Pail VI, line 5
1 914 . WIN
2a
Income tax for 2004, (This does not include the tax from Part VI .) ,
2b
Add lines 2a and 2b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2c
Oistributable amount before adjustments . Subtract line 2c from line 1 , , ,
, , , , ,
3
Recoveries of amounts treated as quallying distributions . . . . . . . . . . . . . . . . . . ., . ., . . , , , , , , , 4
Add lines 3 and 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Deduction from dlstributabte amount (see instructions) , . , ., . ., . . . ., . . . . . . ., ., . . .
, . . B
Dlstrlbutable amount as adjusted . Subtract line 6 from line 5 . Enter here and on Part XIII, line 1 , . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,
628,145 .
2,351,199 .
2,979,344 .
0
2,979,344
44,690
2,934,654
146,733
.
.
.
.
.
146,733 .
1,914
144,819
0
144,819
0
144,819
.
.
.
.
.
.
~Pa'rt~Xll~ Qualifying Distributions (see Instructions)
1
Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes
y;~~f~;
;w~
a Expenses, contributions, gigs, etc . - total from Part I, column (d), line 26
145,210 .
a
.. . . . .. .
b Program-related investments - total from Part IX-8 , . .
. ,
1b
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc , purposes
02
2
3 Amounts set aside for specific charitable projects that satisfy the
f<~
a Suitability test (prior IRS approval required) .
. ..
3a
b Cash distribution test (attach the required schedule) .
3h
4 Qualifying distributions . Add lines 1a through 3b. Enter here and on Part V, line 8, and Part Xtll, line 4 ,
14 5 , 210 .
4
S Organizations that quality under section 4940(e) for the reduced rate of tax on net Investment
income Enter 1% of Part 1, line 27b
1 , 914 .
5
6 Adjusted qualifying distributions . Subtract line 5 from line 4
8
143 , 296 .
Note : The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies lei the section
4940(e) reduction of tax in those years.
Form 990-PF (200a)
423561
01-03-05
Form990-PF(2004)
Part XI11
SUE NAN AND ROD CUTSINGER FOUNDATION
31-1644919
Undistributed Income (see Instructions)
(a)
Corpus
1
Dlstributable amount
for 2004 from Part XI, line 7
Z
Undistributed income . If any, an of No and of 2003:
(b)
Years prior to 2003
(c)
2003
(d)
2004
-
a Enter amount for 2003 only .. ..... ... . . .. .. . . .. .
"
b Total for prior years:
-
:s,:
..... ........ .14 .1.
144 , 819 .
.
.129 .
~~r.~+..r»+.~ ... . .r...r,~»~ .. . .....-
3 Excess dlstribullons corryavor, It any, to 2004 :
a From 1999
b From 2000
d From 2002
e from 2003
4
5
;-
., . ..,
I Total of lines 3a through e , 0 .
Qualltylng distributions for 2004 from
~< ~ ~'` c. tom"
r. >. ~
Part XII, line 4 . " g
145 , 210 .~~~
a Applied to 2003, but not more than floe 2a ,
b Applied to undistributed Income of prior
years (Election required -see Instructions) ., .
c Treated as distributions out of corpus
(Election required - see Instructions) . . , . ,
0 .
d Applied to 2004 dfslr(buWble amount ., . e Remaining amount distributed out of corpus
0 .
Exeosn dlntrlbutlonc eartyovor applied to 2004
(If on on-punt opPeara In CpturtVl (d), w0 come ortl0unl
>."
must be nnown in eowmn (a,)
141 .129 .
0.
4
~~ ?;
0 .
g
Indicated below :
;f
. .
a COrpuO Add line!) 3f. 4c. and 4o, Subtract line 5 . . . . . .
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(x) tax has been previously
assessed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d Subtract line 6c from line 6b . Taxable
amount-see Instructions e Undistributed income for 2003 . Subtract line
4a from line 2a . Taxable amount - see instr ,
1 Undistributed income for 2004 . Subtract
lines 4d and 5 from line 1 . This amount must
be distributed In 2005
, ,
7 Amounts treated as distributions out of
corpus to satisfy requirements Imposed by
section 170(b)(1)(E) or 4942(8)(3) , . . ., .
8 Excess distributions carryover from 1999
not applied on line 5 or line 7 . . ,
9 Excess distributions carryover to 2005 .
Subtract hoes 7 and 8 from line 6a
10 Analysis of line 9 .
a Excess from 2000
bExcess from 200t
c Excess from 2002
d Excess from 2003
a Excess from 2004
,081 .
0 .
,~,
+.~
B Enter the net total of each column as
423571
01m-05
Page e
0 .
. .~s .>,
.
'
V
~~ sr
0.
`r zyf
v
A
r{:
Y
9
' ~'{~s ' ~gY~rr ?~
~4
~ r it
~~
140,738 .
.
r4
. yf
Y
r
r+
M
F7
S
S'1"
!;~'f!~~'~
3'f }~j ~i/~
:Ck
y~f f
IRS
yyy,,,, 1 {;'T .ill. NIP,
`~JJJ
' }FFFf y
.$~,/
,'~
~ f~~~
rf ., .
0
rr~
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v ~f
0.
r
+asr~~
~Z
sf
.,c~1.1 .. .
..,1. fi
ri f.
J.>
;" flr~jl~~f`;"
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G :
. .Jic
/~J1
~/
l gs~/~/'//r ~r i%
V&-";/~ "
'~J»x~r;~,'x
r~r~
~
Form 990-PF (2004)
Form990-PF ( 2004 )
SUE NAN AND ROD CUTSINGER FOUNDATION
Part XIV Private Operating Foundations (see instructions and Part villa, question 9)
1 a it the foundation has received a ruling or determination letter that it Is a private operating
foundation, and the ruling is effective for 2004, enter the date of the ruling b Check box to indicate whether the organization (s a p rivate opera Un foundation described In section . . . . . . . .
2 a Enter the lesser of the adjusted net
lax ear
Prior 3 ears
(a)2004
(b) 2003
(c) 2002
Income from Part I or the minimum
investment return from Part X for
each year listed . , . . . b 85S5 of line 2a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c Qualllyinq distributions from PAR XII,
line 41or each year listed . . ,
d Amounts Included In line 2c not
used directly for active conduct of
exempt activities . o Qualifying distributions made directly
for active conduct of exempt activities .
Subtract line 2d from line 2c . . . .,
3 Complete 3a, b, or c for the
alternative test relied upon :
a 'Assets' alternative lest - enter :
(1) Value of all assets ., . . . . . . . . . . ., . .
31-1644919
N/A
4942 ( e )( 3 ) or
4942(1)(5)
(0) 2001
-
-
Page 9
(e) Total
--
(2) value of assets qualifying
under section 4942(j)(3)(8)(1) ,
b 'Endowment' alternative test - enter
2/3 of minimum Investment return
shown In Part X, line 6 for each year
listed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c 'Support' alternative test - enter:
(1) Total support other than gross
Investment Income (Interest,
dividends, rents, payments on
securities loans (section
St2(a)(5)), or royalties) ,
(2) Support from general public
and 5 or more exempt
organizations as provided In
section 4942(p(3)(8)(ili) ,
(3) Largest amount of support from
an exempt organization ,Part XT/, 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 .)
1
Information Regarding Foundation Managers :
a List any managers of the foundation who have contributed more than 2°Yo of the total contributions received by the foundation before the close of any tax
year (but only I1 they have contributed more than $5,000) . (See section 507(d)(2) )
SEE STATEMENT 10
b List any managers of the foundation who own 10% or more of the stock o1 a corporation (or an equally large portion of the ownership of a partnership or
other entity) of which the foundation has a 1090 or greater Interest
NONE
2
Information Regarding Contribution, Grant, Gin, Loan, Scholarship, etc ., Programs:
Check here 10, EX7 if the organization only makes contributions to preselected charitable organizations and does not accept unsolicited requests for funds If
the organization makes gifts, grants, etc . (see 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 m 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, charitable fields, kinds of institutions, or other factors
42358,A1-03-05
Form 990-PF (2004
423601/01-03-05
Form 990-PF (200a)
Form 990-PF(2004)
Part XVI-A
SUE NAN AND ROD CUTSINGER FOUNDATION
31-1644919
pane 11
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise Indicated.
1 Program service revenue :
a
b
C
d
unroia n uusIllnss maome
(a)
Business
code
EAemaaa
EW' .
W°"
Codo
M
Amount
0
1
p Foas and contracts from govornmont agonctes 2 Momboiship dues and assessments ,
3 Interact on savings and temporary Cash
Investments .. .. ... . .. ... .. . .. .. .... .. ..... ... . .... .. .. ... ... .. ....... .
4 Dividends and Interest tram securities, . . . . . ,
V No t rental I ncome or (loss) f rom rea l estate :
a Debt-financed property , . , . . . , . , ., b Not debt-financed property , . . . . , . B Net rental income or (loss) from personal
14
~
14
ooeoon 9iz air or a1a
(d)
Amount
Related or exempt
function Income
72 , 484 .
2
471
~{i'
.r " kKF*r~'i~"w'
7
property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7 Other Investment income
8 Gain or (loss) from sales of assets other
<1 , 278 .>
119 , 318 .
than Inventory .. . . ... . .. .. . .... .. .. ...... .. ..... .. .. ... ... ....... .
9 Net income or (loss) from special events ., . ., ., ., . .
10 Gross profit or (loss) from sales of Inventory, ., . . ., . . , .,
11 Other revenue :
a
b
t
d
e
12 Subtotal. Add columns (b), (d), and (e) .. .. ., . .., ..... .. .
.
.~~ . :~7 4 ~ 9 5 5
.~.<$0
13 Total . Add line 12, columns (b), (d), and (e) ., . . . . , ., . ., . . . , ., . . . . , ., . . . .
(See worksheet in line 13 Instructions to verity calculations .)
i Part "XVI-B;
423611
01-03-05
13
118 , 0 4 0
192,995 .
Relationship of Activities to the Accomplishment of Exempt Purposes
Form 990-PF (2004)
Form990-PF(200a)
SUE NAN AND ROD CUTSINGER FOUNDATION
31-1644919
Pa g e t2
Part XVII
Information Regarding Transfers To and Transactions and Relationships With Noncharitable
Exem pt Organizations
1
Did the organization directly or Indirectly engage (n any of the following with any other organization described In section 501(c) of
Yes NO
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 noncharitable exempt organization of :
}t
(1) Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180 )
X
(2) Other assets . . . . . . . . . . . . . . . . . . . . . . . . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . ., . . . . . . 10 2
b Other transactions :
., .' , .,
X
(1) Salop of ocsots to a noncnaiita0le exempt organ(tatlon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., . . . . . . . , . . . 1b 1
(2) Purchases of ascots from n nonCharltable exempt organization , . 1 b 2
K
(3) Rontai of facilities, equipment, or other assets . . , . . , . ., .,
1b 3
K
X
(4) Reimbursement arrOng9mBntE . . . . . . . . . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . .. . ..
1b 4
(S) loans or loan guarantees . . . . . . . . . . . . . . . . . . . . . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . 1b 8
X
(8) Performance of services or membership or fundraising solicitations . . . . ., . . ., ., , , , , , , , , . , . , , ., . . . . . . , ., t NO)
K
c Sharing of facilities, equipment, moiling lists, other assets, or paid employees . . . ., . . . . . . , . , . ., . . . ., . , , ,
1c
. . . , , ., . . . .
d If the answer to any o1 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 . It the organization received less than lair market value In any transaction or sharing arrangement, show In
2a Is the organization 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 SOt(c)(3)) or In section 527? . ... .. ... .., .. ., . .. .. ... . .. .. . . . ., . .., . .., .. .. .., .., .. . . . . , .. ..., .
pe at of
NBA
(a) Name of organization
Under ponolt
and complat
d
.21
(lon , f prep
1 Signature of officer or trustee
N
Preparer's'
signature
N F1m+ sn~ e(« yours
HENRY,
-HESS
&
ON,
a M ifsu~e~+oior~m
a
. ' 19 0 0 ST . JAMES PLACE,
aa"as Inoz~~oae HOUSTON TEXAS 77056
423621
01-09-05
Description of
ro that I have examined this return. Including accompanying schedules and ntatmnonta, and to tie beat of my knowledge and ballot. It la true, carted
tr (other 4Gnn tnicpoym or fiduciary) Is based on all Inlortnn tlon of whim prepwm has any knowlodpa
or/uy,
0
= Yes
CK No
CONTINUATION FOR 990-PF,
PAGE
31-1644919
SUE NAN AND ROD CUTSINGER FOUNDATION
Pert IV
Ca p ital Gains and Losses for Tax on Investment Income
(b How acquired (c Date acquired
P - Purchase
rchase
~mo ., day, yr .)
D - Donation
(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 .
~a 2000 ALLTEL CORP
b7000 ALLTEL CORP CORP UNITS
c 10000 BRISTOL-MYERS S Q UIBB CO
t 3700 LOEWS CORP CAROLINA CRP
3000 NORTHERN BORDER PARTNERS
n 11400 ONEOK INC NEW CORP UNIT
5000 SBC COMMUNICATIONS INC
10000 SYSCO CORP
103
362
235
111
190
105
120
373
122
321
131
245
257
a
n
c
d
e
t
n
1
k
1
m
n
0
378
752
085
959
321
061
124
401
175
483
661
725
875
.
.
.
.
.
.
.
.
.
.
.
.
.
P
P
P
(f) Depreciation allowed
(or allowable)
(p) Cost or other basis
plus expense of sale
101
354
232
105
190
92 ,
112
337
122
300
130
235
246
(I) F.M .v . as of 12/31/69
ay 0112/31/69
I
(k) Excess of col . (I)
over col . (p, It any
VARIOUS VARIOUS
O1 07 04 ARYOUS
VARIOUS 627 1-9VARIOUS VARIOUS
02 /-18 / 04027 25/04
10 15 0410/29/04
VARIOUS VARIOUS
08 / 26 0304/14/04
08 / 26 / 03017 147o
4
VARIOUS VARIOUS
(h) Gain or (loss)
(e) plus (f) minus (g)
320 .
910 .
510 .
399 .
220 .
377 .
512 .
805 .
020 .
010 .
275 .
843 .
481 .
Complete only for assets showing gain In column (h) and owned by the foundation on 12/31/69
(1) Adjusted basis
10/25/0410/29/04
03/22/0409/07/04
02 / 18 / 0402/20/04
P
n VARIANCE
(e) Gross sales price
P
P
P
P
1250000 GOLDMAN SRCHS BONDS
m250000 MORGAN STANLEY BONDS
0
03/15/0404/23/04
P
P
P
P
k 4000 WALGREEN CO
I
(d) Date sold
(mo ., day, yr .)
P
P
d4300 CENTURYTEL INC
e 3000 DOMINION RES INC VA COM
PART IV
1
1 OF
2 , 058
7 , 842
2 , 575
6 , 560
101
12 , 684
7 , 612
35 , 596
155
21 , 473
1 , 386
9 , 882
11 , 394
.
.
.
.
.
.
.
.
.
.
.
.
.
(I) Losses (from col . (h))
Gains (excess of col (h) gain over col . (k),
but not less than *-0-*)
s. r vrv "
7,842 .
2,575 .
6,560 .
101 .
12,684 .
7,612 .
35,596 .
h
i
155 .
21,473 .
1,386 .
9,882 .
11,394 .
0 .
n
l
sin, also enter m Part I, line 7 1
1 :If loss), enter'-0= in Part I, line 7 1
2
Capital 9 sin net Income or ( net capital loss 1
3
Net short-term capital gain or (loss) as defined in sections 1222(5) and (6)
It pain, also enter in Part I, line 8, column (c)
If (loss, enter'-0= in Part I, line 8
423591
05-01 -04
119,318 .
N/A
SUE NAN AND ROD CUTSINGER FOUNDATION
FORM 990-PF
31-1644919
INTEREST ON SAVINGS AND TEMPORARY CASH INVESTMENTS
AMOUNT
SOURCE
3,641
38,751
3,970
26,042
80
HARRIS DIRECT
HARRIS DIRECT - OYn
JP MORGAN
MORGAN STANLEY
NORTHERN BORDERS PARTNERS LP
TOTAL TO FORM 990-PF,
,FORM 990-PF
PART I,
LINE
STATEMENT
TOTAL TO FM 990-PF,
PART I,
LN 4
2,471 .
0.
2,471 .
2,471 .
0 .
2,471 .
STATEMENT
OTHER INCOME
FORM 990-PF
2
COLUMN (A)
AMOUNT
CAPITAL GAINS
DIVIDENDS
GROSS AMOUNT
HARRIS DIRECT
.
.
.
.
"
72,484 .
3, COLUMN A
DIVIDENDS AND INTEREST FROM SECURITIES
SOURCE
3
AMOUNT
DESCRIPTION
<1,278 "
NORTHERN BORDERS PARTNERS LP
TOTAL TO FORM 990-PF,
PART I,
FORM 990-PF
LINE
<1,278 .>
11, COLUMN A
(A)
EXPENSES
PER BOOKS
ACCOUNTING FEES
PG
1,
LN
16B
4
STATEMENT
ACCOUNTING FEES
DESCRIPTION
TO FORM 990-PF,
1
STATEMENT
(B)
NET INVESTMENT INCOME
(C)
ADJUSTED
NET INCOME
(D)
CHARITABLE
PURPOSES
3,173 .
1,586 .
0 "
3,173 .
1,586 .
0 .
STATEMENT S)
1,
2,
3,
4
SUE NAN AND ROD CUTSINGER FOUNDATION
.
TAXES
FORM 990-PF
(A)
EXPENSES
PER BOOKS
DESCRIPTION
INCOME TAXES
TO FORM 990-PF,
PG 1,
LN 18
FORM 990-PF
(B)
NET INVESTMENT INCOME
(C)
ADJUSTED
NET INCOME
PG
1,
LN 23
FORM 990-PF
0.
3,534 .
0.
0.
(B)
NET INVESTMENT INCOME
(C)
ADJUSTED
NET INCOME
27 .
0 .
54 .
27 .
0.
BOND INVESTMENTS
TAX DUE FROM FORM 990-PF,
UNDERPAYMENT PENALTY
LATE PAYMENT INTEREST
(D)
CHARITABLE
PURPOSES
54 .
LINE lOB
INTEREST AND PENALTIES
7
STATEMENT
BOOK VALUE
FORM 990-PF
6
STATEMENT
CORPORATE STOCK
PART II,
(D)
CHARITABLE
PURPOSES
0.
DESCRIPTION
TOTAL TO FORM 990-PF,
5
3,534 .
(A)
EXPENSES
PER BOOKS
BANK SERVICE CHARGES
STOCK &
STATEMENT
OTHER EXPENSES
DESCRIPTION
TO FORM 990-PF,
31-1644919
FAIR MARKET
VALUE
344,106 .
365,960 .
344,106 .
365,960 .
STATEMENT
8
22 .
11 .
PART VI
1 .
34 .
TOTAL AMOUNT DUE
STATEMENT S)
5,
6,
7,
8
SUE .NAN AND ROD CUTSINGER FOUNDATION
LATE PAYMENT INTEREST
FORM 990-PF
DESCRIPTION
DATE
TAX DUE
INTEREST RATE CHANGE
DATE FILED
TOTAL LATE
31-1644919
BALANCE
AMOUNT
05/15/05
09/30/05
11/15/05
STATEMENT
22 .
0 .
RATE
22 .
23 .
23 .
.0600
.0700
9
DAYS
INTEREST
138
46
1 .
1.
PAYMENT INTEREST
FORM 990-PF
PART XV - LINE 1A
LIST OF FOUNDATION MANAGERS
STATEMENT
10
STATEMENT
11
"NAME OF MANAGER
ROD CUTSINGER
SUE NAN CUTSINGER
FORM 990-PF
GRANTS AND CONTRIBUTIONS
PAID DURING THE YEAR
RECIPIENT NAME AND ADDRESS
RECIPIENT
STATUS
PURPOSE OF GRANT
RECIPIENT
RELATIONSHP
AMOUNT
501(C)(3)
GENERAL SUPPORT
NONE
2,500 .
501(C)(3)
GENERAL SUPPORT
NONE
1,000 .
AMERICAN CANCER SOCIETY,
HOUSTON TX
501(C)(3)
GENERAL SUPPORT
NONE
AMERICAN DIABETES
ASSOCIATION, HOUSTON TX
501(C)(3)
GENERAL SUPPORT
NONE
AMERICAN HEART ASSOCIATION,
HOUSTON TX
501(C)(3)
GENERAL SUPPORT
NONE
HOUSTON 501(C)(3)
GENERAL SUPPORT
NONE
ACLJ,
HOUSTON TX
A D PLAYERS,
HOUSTON TX
AMERICAN RED CROSS,
TX
CAMPUS CRUSADE FOR CHRIST,
HOUSTON TX
501(C)(3)
GENERAL SUPPORT
NONE
CARE NET,
501(C)(3)
GENERAL SUPPORT
NONE
HOUSTON TX
STATEMENT S)
250 .
100 .
10,000 .
1,000 .
6,000 .
1,000 .
9,
10,
11
.
31-1644919
SUE NAN AND ROD CUTSINGER FOUNDATION
CHANNEL 8,
501(C)(3)
GENERAL SUPPORT
NONE
1,000 .
HOUSTON TX 501(C)(3)
GENERAL SUPPORT
NONE
2,500 .
HOUSTON TX
CHILD ADVOCATES,
CHRIST EVANGELICAL
PRESBYTERIAN, HOUSTON TX
501(C)(3)
GENERAL SUPPORT
NONE
CHRISTIAN EMBASSY,
TX
501(C)(3)
GENERAL SUPPORT
NONE
501(C)(3)
GENERAL SUPPORT
NONE
3,360 .
501(C)(3)
GENERAL SUPPORT
NONE
2,500 .
501(C)(3)
GENERAL SUPPORT
NONE
HOUSTON 501(C)(3)
GENERAL SUPPORT
NONE
COMPASSION,
HOUSTON
HOUSTON TX
COVENANT HOUSE,
HOUSTON TX
DALLAS LIFE FOUNDATION,
DALLAS TX
''DE PELCHIN SOCIETY,
'TX
2,500 .
1,000 .
5,000 .
2,400 .
EPISCOPAL HIGH SCHOOL,
HOUSTON TX
501(C)(3)
GENERAL SUPPORT
NONE
GOOD SAMARITAN FOUNDATION,
HOUSTON TX
501(C)(3)
GENERAL SUPPORT
NONE
HABITAT FOR HUMANITY,
HOUSTON TX
501(C)(3)
GENERAL SUPPORT
NONE
HOLLY HALL,
501(C)(3)
GENERAL SUPPORT
NONE
500 .
HOUSTON TX 501(C)(3)
GENERAL SUPPORT
NONE
1,000 .
501(C)(3)
GENERAL SUPPORT
NONE
5,000 .
RANDALL ENDOWED SCHOLARSHIP 501(C)(3)
FUND, HOUSTON TX
GENERAL SUPPORT
NONE
RIVER OAKS BAPTIST SCHOOL,
HOUSTON TX
501(C)(3)
GENERAL SUPPORT
NONE
RONALD MCDONALD HOUSE,
HOUSTON TX
501(C)(3)
GENERAL SUPPORT
NONE
SECOND BAPTIST CHURCH,
HOUSTON TX
501(C)(3)
GENERAL SUPPORT
NONE
SIRE,
501(C)(3)
GENERAL SUPPORT
NONE
501(C)(3)
GENERAL SUPPORT
NONE
HOUSTON TX
OPERATION SMILE,
PEARL BALL,
HOUSTON TX
HOUSTON TX
SOUTHERN METHODIST
UNIVERSITY, DALLAS TX
1,000 .
5,000 .
1,000 .
10,000 .
15,000 .
1,000 .
2,500 .
1,000 .
1,000 .
STATEMENT S)
11
31-1644919
SUE NAN AND ROD CUTSINGER FOUNDATION
ST . JOHN THE DEVINE,
HOUSTON TX
501(C)(3)
GENERAL SUPPORT
NONE
ST . MARTIN'S CHURCH,
HOUSTON TX
501(C)(3)
GENERAL SUPPORT
NONE
THE 100 CLUB,
501(C)(3)
GENERAL SUPPORT
NONE
501(C)(3)
GENERAL SUPPORT
NONE
501(C)(3)
GENERAL SUPPORT
NONE
5,000 .
501(C)(3)
GENERAL SUPPORT
NONE
2,000 .
HOUSTON TX
THE SENIORS PLACE,
TX
TIRR,
HOUSTON
HOUSTON TX
YOUNG LIFE,
HOUSTON TX
`TOTAL TO FORM 990-PF,
PART XV,
LINE 3A
46,000 .
5,000 .
100 .
1,000 .
145,210 .
STATEMENT S)
1 1
Form 2220
Dcpartmant of the Trvwuy
t see separate Instructions .
2~~4
FORM 9 9 0 -PF
" Attach to the corporation's tax return .
Internal Revenue Service
Name
OMB No. "°'"°'°2
Underpayment of Estimated Tax by Corporations
SUE NAN AND ROD CUTSINGER FOUNDATION
I
Employer Identification number
31-1644919
Note : In most cases, the corporation is not required to file Form 2220 . (see Part I below for exceptions) because the IRS will figure any penalty owed and bill the
corporation . Even it Form 2220 Is not required, the corporation may still use It to figure the penalty . In such a case, enter the amount from page 2, line 38 on
the estimated tax emit line 01 the cor p oration's income tax return but do not attach Form 2220 .
;paKI-'k
Reasons for Filin~ - Check the boxes below that apply. It any bozos are Chocked, anti line 8, below, Is E500 or more, the corporation must
file Form 2220, even if il d-oes not owe a penalty .
1
2
0 The corporation Is using the adjusted seasonal Installment method .
E3 The corporation too using tho onnualitod Income Installment method .
3_F-1 7The Corporation Is a'larpo corporation' flouring Its first rogulred Installment based on the ardor Moor's tax .
4 Total tax (see Instructions) .. .. .. .. . ..... ... .. .... . ... .. ... .. .... . .. ... ... . . . .. ... . . .. . .. . . . . . .. .. .. .. .. .. ...
. .. .
.. . . ... .. .. ... .. .. .. . . . . .
I 4
1 , y 14 .
I
5 a Personal holding company lax (Schedule PH (Form 1120), line 26) Included on line 4
b Look-back Interest Included on line 4 under section 460(b)(2) toy completed long-term
contracts or of section 167(8) for depreciation under the income forecast method
c Credit for Federal tax paid on fuels (see Instructions) , , . . , ,
,
I 5c I
d Total . Add lines Sa through SC . ., . . , . , . , ,
, , ,
6 Subtract line Sd from line 4 . It the result is less than $500, do not complete or file this form The corporation does
not owe the penalty
.. . ..... .. .. ... .. ... ... .. ..... ... . ... .. .. ..... ... ... .. .. . . .. . ... ... .. .. .. .. .. . .. .. .. . .
. ...... . . . . . . . .
7 Enter the tax shown on the corporation's 2003 Income tax return Caution . II the tax Is zero
or the tax year was for less than 12 months, skip this line and enter the amount from line 8 an line 8 , , , , . , .
8
Enter the smatter of line 6 or line 7 . If the cOrooratian I5 required to sklo line 7 . enter the amount from line 6
9
Installment due dates. encainool (W
lhf0ug A (a) the ism (Say of mo 4th Form
990-PF liters : Use au, Month). am, ein,
05/15/04
end 1ztnmooof the comoroiio~~otoxyonr 9
Exception . Ironoor y our lnetnumont
06/15/04
, ,
1 .914 .
1,892 .
. . . .. .. .. . . .. .
09/15/04
1
B
10/01/04
1, 892 .
1
12/15/04
duo dG107 10 Soot 10, 2004, 000 the
Instructions
10
Required Installments . a Wo ow on
line 1 and/or Ilno 2 above III checked onto
the amounm from BohaOUlo
line ~~~ If
loo boa on In J (but not 1 or ~ 10 OhoCk00,
itcoo Instructions for Ih0 ORqYI1lD l0 af1I01.
none of th*5O
2 311 of in 8 above In~aoph Column
11
column (a) only, enter the amount
from line tt on line 15 12
Complete hoes 12 through 18 0l
one column before going to the
next column .
Enter amount, if any, from line 18
of the preceding column 13 add lines 11 and 12 ... .. . . .,
14
Add amounts on lines 16 and 17
17
12
13 .
'
+' ;.~`
` "~,~k
~vM, :0W1
zero or less, enter -0-
15
523 .
if the amount on line 1s la zero, ouotroct
-0Underpayment n nee is is icon than
18
[ina ,o Then go to line iz of me next
~~
or equal to line 10, subtract [Ina 15 tram
Overpayment if line 10 ,,as, than
,In a 7 S, aubtfnct
70 f9
romline 1
Then go to lineclime
12 of the next column
4121,
oi~o3-os
.1WA
378 .
95 .
473 .
1 , 369 .
.{. rr" : '
~ ' ~:~ ;` <~
L
line 13 horn line 14 Otherwise, enter
473 .
523 .
;
14
column Otherwise. go W fine is
18
~~
of the preceding column
15 Subtract line 14 from line 13 . If
18
473 .
.°,". .'°,' i o
Estimated tax paid or credited for
each period (see instructions) . For
18
,tp,
.y
,y,,,~
50 .
50 .
50 .
0 .
423 .
1 , 369 .
423 .
801 .
896 .
0 .
0 .
473 .
423
.
80 1 .
378 .
95.
5 0 .1
Go to Part III on pace 2 to figure the penalty Do not go to Part III II there are no entries on line 17 - no penalty is owed .
For Paperwork Reduction Act Notice, see separate Instructions .
~
ry
'
Form 2220 (2004)
b
1
FORM 990-PF
Forin2220(200a)
PaR 111
19
SUE NAN AND ROD CUTSINGER FOUNDATION
31-1644919
Pace 2
Figuring the Penalty
Enter the onto of payment or the tbtn day
of the 3rd month attar Me Uooo of the tart
ear, whlchwm to aartia (coo Inulrupilonn;
Form 990- PF and Form 990-T
1188 : U00 5th month inistuad of 3rd
month,)
. . . . . . . . . . .. . .. .. . .. ... ..
2o
NumDar of aeyo from due dote of Inntsll"
mqnt on In 0 to !ho dato chOwn On Ilnb 10
21
Numpur of day* on line 20 otter
4/16/d004 and bolow 7lll2ppA
ZZ
UnAOrpGymonl on line 17 x
Number of pnvn an line 21 x 5%
]00
23
Number of clayo an lima 20 after
WO/2004 one tatoro tNi/200a
24
Underpayment on line 17 x
Number of days on line 23 x 4%
use
25
Numocr of daya on line 20 after
BrJ02004 and UOfOra 1/12009
26
Underpayment on line 17 x
Number of days on line 29 x 9%
368
27
Number of days on line 20 after
12l312004 end before 012009
28
Underpayment on line 17 x
29
Number of dove an line 2 X5%
365
Number of anyn on line 20 attar
9/J1l1008 and before 7/1/2003
30
Underpayment on iIno 17 x
31
32
Numbor of earn on Ilnn 2A X *%
365
Numbm of tJnyn on line 20 attar
8/J02003 and before 70/1200
. .. .. .
. .. .. .
, , , . .,
SEEI ATTACHED WORKSHEET
... .. .
. .. .. .
Underpayment on line 17 x
Number ofdnyoonline .71 1t'13
yes
Number of aoyn on lima TO chat
33 Moaoos Ono before +nnooo
34
Underpayment am line 17 x
35
Number of COya on Ilno 3.1 x '1t
385
Number of day* on line ZO attar
t2/J1R009anobefore 2/t8r1008
36
Underpayment on line 17 x
Numbor of aoyn on line 35 A '%
789
37
., . ,
.. ....
Add line* 22 24, 26, 26, 30, 92, 34, & 38
38 Penalty . Add columns (a) through (e), of line 37 . Enter the total here and on Form 1120, line 33, Form 1120-A, line 29 :
" For underpayments paid after March 31, 2005 : For lines 30, 32, 34, and 36, use the penalty interest rate for each calendar quarter, which the IRS
will determine during the first month in the preceding quarter . These rates are published quarterly in an IRS News Release and in a revenue ruling in
the Internal Revenue Bulletin 70 obtain this information on the Internet, access the IRS websde at www Irs .gov . You can also call 1-800-829-1040
to get interest rate information .
JWA
412802
01 ~2a-05
11 .
Form 2?20 (2004)
[1
FORM 990-PF
UNDERPAYMENT OF ESTIMATED TAX WORKSHEET
Names)
Identifying Number
SUE NAN AND ROD CUTSINGER FOUNDATION
(A)
(B)
*Date
Amount
(C)
Adjusted
Balance Due
(D)
Number Days
Balance Due
31-1644919
~77
/
1
(E)
Daily
Penalty Rate
(F)
Ponolty
o
05/15/09
473 .
473 .
05/15/09
<523 .
<50 .
06/15/04
473 .
423 .
15
.000136612
1.
06/30/04
0.
423 .
77
.000109290
4 .
09/15/04
378 .
801 .
15
.000109290
1.
09/30/04
0.
801 .
1
.000136612
10/01/04
95 .
896 .
38
.000136612
11/08/04
<1 , 369 . >
<473 .
12/15/04
473 .
0.
12/31/04
0.
0.
90
.000136986
03/31/05
0.
0.
45
.000164384
Penalty Due (Sum of Column F) .
Date of estimated tax payment, withholding
credit date or installment due date
412517
OSO1-Oa
5.
11
.
" .
.
8868
(Rev. December 2004)
Application for Extension of Time To File an
Exempt Organization Return
Form
Department of lha Treasury
IntomN Revenue Service
OMB No .
1sas~,7o9
" File a separate application for each return .
t
" If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box ,
, ,
, , . . . ., .
. ,.
. .
" If you are filing for an Additional (not automatic) 3-Month Extension, complete only Port II (on page 2 of this form) .
Do not complete Part II unless you hove already been granted an automatic 3-month extension on a previously filed Form 8868 .
Pa'rt~D
Automatic 3-Month Extension of Time - Only submit original (no copies hooded)
Form 990-T corporations requesting an automatic 6-month extension ~ check this box and complete Pert I only
, , .,
.
, ,
. .. .
All othor corporations (including Form 990-C Marc) must use Form 7004 to roquost on oxtonslon of limo to Illo income tax
roturns. Partnorshlps, REMICs, and trusts must use Form 8 736 to roquost an oxtonslon of limo to No Form 1065, 1066, or 1041 .
Electronic Filing (o-fllo) . Form 8888 can be fllod oloctronlcally If you want o 3-month automatic oxtonolon of limo to Alo ono of the returns noted
below (8 months for corporoto Form 990~T (flora) . However, you cannot file It oloctronlcAlly If you wont the additional (not automatic) 3-month
extension, Instead you moot submit the fully completed signed pogo 2 (Part II) of Form 8888 . For morn details on the electronic filing of this form .
visit www.Irs.gov/ef`i/0 .
Typo or
I
print
File oy the
due auto for
filing your
rotum Sae
Innwctlona .
Employer Identification number
Name of Exempt Organization
31-1644919
SUE NAN AND ROD CUTSINGER FOUNDATION
Number, street, and room or suite no . If a P .O . box, see Instructions
1900 ST JAMES PLACE SUITE 150
City, town or post office, state, and ZIP code . For a foreign address, see instructions .
HOUSTON, TX
77056
Check type of return to be flled(flle A separate application for each return) :
Form
Form
Form
Form
990
990~81990~EZ
990~PF
0 Form
0 Form
~ Form
~ Form
990~T (corporation)
990~T (sec . 401(x) or 408(ra) trust)
990~T (trust other than above)
1041~A
0
0
0
~
Form
Form
Form
Form
4720
5227
6069
8870
" The books are In the care of " ROD CUTS INGER
Telephone No . " 713-7 8 5-1777
FAX No .
If the organization does not have an office or place of business In the United States, check this box , , . . ., . . ., . ., . . . . . . . . . . . . . . .
If this Is for a Group Return, enter the organization's (our digit Group Exemption Number (GEN)
. If this Is for the whole group, check this
1
box
= . If It Is for port of the group, chock this box " 0 and attach a list with the names and EINa of all members the extension will cover .
1
1 request an automatic 3-month (8 " montho for n Form 990-T corporation) extension of time until
AUGUST
15,
to file the exempt organlzntlon return for the organization named above. The extension Is for the organization's return for:
" CX1 calendar your 2 0 0 4 or
t = tax year beginning
2 00 5
, and ending
2
Ii this tax year is for less than 12 months, check reason :
3a
Ii this application Is for Form 990-BL. 990~PF, 990~T, 4720, or 6069, enter the tentative tax, less any
nonrefundable credits . See Instructions ,
. . ,
..
. . , , , ..
..
,.
= Initial return
= Final return
~ Change in accounting period
b
If this application Is for Form 990~PF or 990~T, enter any refundable credits and estimated
tax pay ments made . Include any prior year overpayment allowed as a credit
c
Balance Due . Subtract line 3b from line 3a Include your payment with this form, or, if required, deposit with FTD
coupon or, if required, by using EFTPS (Electronic Federal Tax Payment System) . See instructions
$
1 , 892 .
1 , 892
$
0
Caution . If you are going to make an electronic fund withdrawal with this Form 8868, see Form 8453~E0 and Form 8879-EO for payment instructions .
LHA
423931
01-i0-05
For Privacy Act and Paperwork Reduction Act Notice, see instructions .
Form 8888 (Rev 12-2004)
r5
Z
~
Paae 2
Form 8868(Rev.12-2004)
0 If you are filing for an Additional (not automatic) 3-Month Extension, complete only Pert II and check this box
Note : Only complete Part II If you have already been granted an automatic 3-month extension on a previously filed Form 8868 .
If you are filin g for an Automatic 3-Month Extension, complete only Port I (on page 1) .
Additional not automatic 3-Month Extension of Time - Must filo Original and One Co p y.
Part 11
Name of Exempt
Typo or
print.
Pilo by ISO
Q ,aate
Organization
Employer identification number
31-1644919
SUE NAN AND ROD CUTS INCyER FOUNDATION
For IRS uau only
Number, otreot, and room or suite no . If a P .O . box, see Instructions .
aucaacaror 1900
RIIev plq .
o
150
ST JAMS PLACE SUITE
City, town or post offlco, otAto, and ZIP codo . For o foreign od9rooa . coo Inotructlona .
°""""°""' HOUSTON,
TX
77056
Chock typo of return to be filed (Fllo a ooparato application for oath rotum) :
Form 990
0 Form 990" EZ
C:3 Form 990~T (ooc 4101 (n) or a08(o) trust)
Form 990-SL
MI Form 990~PF
= Form 990~T (trust othor than abovo)
C= Form 5227
= Form 6069
(~ Form 104 t ~A
[] Form 4720
~ Form 8870
STOP : Do not complete Port II If you worn not already granted an automatic 3-month extension on o previously filed Form 8888 .
" The books are In the care of " ROD CUTS INGER
TelephoneNo . 1 7 1 3-785-1777
FAX No
" If the organization does not have an office or place of business in the United States, check this box ,
,.
..
I( this Is for a Group Return, enter the organization's (our digit Group Exemption Number (GEN)
If this is for the whole group, check this
box " = If It is for part of the group check this box 1 = and attach a list with the names and EINs of all members the extension Is for . a
I request an additional 3-month extension of time until
NOVEMBER 15, 2005
5
For calendar year 2 0 0 4 , or other tax year beginning
and ending
8
If this tax year is for less than 12 months, check reason :
L] Initial return
[J Final return
Change in accounting period
7
State In detail why you need the extension
INFORMATION NEEDED TO FILE A TRUE AND ACCURATE TAX RETURN HAS NOT BEEN
ADDITIONAL TIME IS HEREBY REQUESTED .
RECEIVED AS OF THE DATE OF FILING .
8a
If this application is for Form 990-BL, 990~PF, 990~T, 4720, or 6069, enter the tentative tax, less any
nonrefundable credits . See Instructions ,
b
If this application Is for Form 990~PF, 990~T, 4720, or 6069, enter any refundable credits and estimated
tax payments made . Include any prior year overpayment allowed as a credit and any amount paid
previously with Form 8888
c
1
S
Balance Duo . Subtract line 8b from Ilno 8a . Include your payment with this form, or, if required, deposit with FTD
coupon or If required, by using EFfPS (Electronic Federal Tax Payment System) See Instructions
Signature and Verification
. 1, 892
S
892
0.
.. $
Under penalties of perjury, I declare that I have examined this term, Including accompanying schedules and statements, anti to the best at my knowledge and belief .
it Is true, correct, and complete, and that I am authorised to prepare this form .
SI nature t
n~l(,G
..
Noti ,
Tills t CPA
to Applicant - To Be Completed by the IRS
Date "
.' /J
U 3-
We have approved this appllcatlon . Please attach this form to the organization's return .
We have not approved this application . However, we have granted a 10-day grace period from the later of the date shown below or the due
date of the organization's return (Including any prior extensions) . This grace period is considered to be a valid extension of time (or elections
otherwise required to be made on a timely return Please attach this form to the organization's return
0 We have not approved this application After considering the reasons stated in item 7, we cannot grant your request for an extension of time to
file We are not granting a 10-day grace period .
We cannot consider this application because it was filed after the extended due date of the return for which an extension was requested
0 Other
By .
Director
Oats
Alternate Mailing Address - Enter the address if you want the copy of this application for an additional 3 month extension returned to an address
different than the on e entered above.
Name
TVPe
HENRY,
HESS & C ANON,
PC
EXTENSION APPROVED
Number and street (include suite, room, or apt. no .) or a P O. box number
or print
~ 1900
o?~goo5
I
ST .
JAMES PLACE,
SUITE 150
City or town, province or state, and country (including postal or ZIP code)
HOUSTON, TEXAS 77056
SUBMISSION
.