1b11b!'JYl lU/162UUL 11LYM
990-PE
Form
Return of Private Foundation
Department of the Tieasurv
Note The organization ma
Internal Revenue Service
For calendar ear 2007 or tax ear be innin
G Check all That a pp ly
Initial return
Name of organization
Use the IRS
Otherwise,
pant
or type
See Spenfic
Instructions
H
e
be able to use a co
~1
O1
Final return
of flux return to sails
and endin
7
31
Address chan c e
Name than e
A Employer identification number
EDUCATION
FOUNDATION
Number and snaet far P O pox number a man is not delivered m street address)
P .O .
BOX 4808 CARRIER PARKWAY
City or town, sate and ZIP code
SYRACUSE
<Io
Roordsuite
R . ~ufm G
NY 13221
Check type of organization
Section 501(c)(3 exempt private foundation
Section 4947 a 1 nonexemp t charitable Wst
Other taxable nvate foundation
Fair market value of all assets at
J Accounting method
~ Cash U Accrual
I
end of year (from Part II, cot (c),
line 16 110-$
515 315
Part 1
e
CI n
6
Sa
b
6a
b
7
Z u
~e
8
9
V
103
b
c
77
12
A 73
d
m 14
I 15
16a
P S
b
'~
books
70 0l the inslr
Gross sales price for ell assets
on line 6a
d x 23
24
25
s 26
27
a
b
c
D
Telephone number (see page 10 0l ma instructions)
315-432 -6323
If exemption application is pending, check here
1
Foreign organizations, check here
2
Foreign org meeting the &576
IonI
1 ,
test check hem aneattach computation
if private foundation status was terminates
under section 507(b)(t)(q), check here
u the foundation a in a so-monLn termination
under section so7(b)(i)(9), check nave
F
(o)
(~ b ) Net Investment
Income
Adjusted
income
(a)
not
Disbursements
for charitable
purposes
Cash basis onl y)
"
9 364
Interest on savings and temporary cash Investments
Dividends and interest from securities
Gross rents
(Nat rental income or (loss)
)
Net gain or (loss) from sale of assets not on line 10
C
16-1153992
'
Distributions from split-interest trusts
9 , 364 .
`
""
-
Capital gain net me (from Part IV, line 2)-
Net short-term capital gain
Income modifications
Gross sales less returns and allowances
Less Cost of goods sold
Gross profit or (loss) (aft schedule)
Other Income (attach schedule)
iota Add lines 1 throu gh 11
Compensation of officers, directors, trustees. etc
Other employee salaries and wages
Pension plans, employee benefits
Legal fees (attach schedule)
AccounLn
hedule)
STMT
he~p~~~in~feesI sch )
C
_DkFk~~ 01
a a ~f1
18
Texas
~~~1( en.
~ sch
"1 ) 7t s~ ~ 1
he lnstr >
ciBAioH(3tt'~Ch
)
~
I ~q
y~p~r "
pleLOn
n v
Oceupan
~g e
1
,ro~"nc~,iand m e~ngs
V ~a E
2
ca ons
Pe
n
e
Revenue end
expenses per
Check 1 W If the foundation is not required to art Sth B
3
R
B
see
(a)
Contributions, gifts grants, etc , ieceNed (attach schedule)
2
j
total of amount In cot (b), (c) 8 (d) may not necessanly
B
E
a Other (specify)
Part I column d must be on cash basis
Analysis of Revenue and Expenses (The
e q ual the amounts in column a
1
02
lvnended velum
2001
req uirements
stale re onln
CRIER 6 HRYANT DISTRIBUTORS'
label
OMB No 154s.0052
or Section 4947(a)(1) Nonexempt Charitable Trust
Treated as a Private Foundation
Other expenses (attach schedule)
9 , 364
9 364
1
2
1 , 030
150
150
STMT 3
598
STMT 4
4 , 219
STMT
Total operating and administrative expenses
Add lines 13 through 23
Contributions . gifts, grants paid
5 , 997
Total ex ensee and disbursements Add lines 24 and 25
37 , 500
43 , 497
Excess of revenue over expenses and disbursements
-34 133
Subtract line 26 horn line 12
Net Investment Income (d negative, enter -0-)
Ad j usted net Income if negative, enter -0-
0
'
`
4 , 119
150
' " '
150
o' 9 , 214 "
,
0
0
4 , 119
37,500
41 , 619
lot ~Sa"z iunaaw< i ze rm
i
F3rF~ll -"~
I
t
2
3
4
5
6
A
7
e6
t
8
9
S
10a
b
c
Schedules and amounts In the description column
Balance Sheets Ached
should be for and-of year amounts only (See instructions )
Cash-non-interest-beanng
Savings and temporary cash investments
Accounts receivable 1
Less allowance for doubtful accounts
1
Pledges receivable 1
Less allowance for doubtful accounts
1
Grants receivable
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see page 15 of we
Accounts payable and accrued expenses
18
b
19
Deferred revenue
20
Loans from officers, directors, trustees . and other disqualified persons
I
s
A
s
s
23
Total liabilities add lines 17 fhrou h 22
Temporarily restricted
Permanency restricted
28
B
29
e
n
c
30
2
3
4
5
1
and complete lines 27 through 31
Capital stock. trust principal, or current funds
Paid-in or capital surplus, or land, bldg , and equipment find
Retained eamlngs, accumulated income, endowment, or other funds
Total net assets or fund balances (see page 17 of the
instructions)
37
Total liabilities and net assets/fund balances (see page 17 of
,;, Part 111;'
1
515
1
Organizations that do not follow SFAS 117, check here
27
Fair market
Unrestricted
26
d
fc )
)
and complete lines 24 through 26 and lines 30 and 31
25
F
a
1
Organizations that follow SFAS 117, check here
r
2
515 , 313
Mortgages and other notes payable (att sch )
Other liabilities (describe
24
Book Value
Grants payable
22
N
a
t
2
545 , 446
End of ear
b
4
a
i
Book Value
Investments-corporate stock (attach schedule)
17
27
a
Investments-1.1 5 one sure povamment obligations (an schedule)
75
16
12
13
74
Beg inning of ear
instructions)
Other notes 8 loans receivable
1
Less allowance (or doubtful accounts
10,
Invenlones for sale or use
Prepaid expenses and deferred charges
Investments-corporate bonds (attach schedule)
Investments-land, buildings, 8 equipment basis 1
Less accumulated depreciation 1
Investments-mortgage loans
Investments-other (attach schedule)
Land, buildings, and equipment basis
1
Less accumulated depreciation 111,
Other assets (describe
1
)
Total assets (to be completed by all filers-see page 16 of
11
1 $z_
Analysis of Changes in Net Assets or Fund Balances
Total net assets or fund balances at beginning of year-Part II, column (a), line 30 (must agree with
endaf-year figure reported an prior year's return)
Enter amount from Part I, line 27a
Other increases not included in line 2 (itemize)
III
Add lines 1, 2, and 3
Degreases riot included in line 2 (itemize)
11
Farm you-rr (zoo1
lO7lS.fY7C lU/7pINU[ 1 CC rM
0-11737yZ
and
(a ~ List and describe the kind(s) of propsrty sold (a g real estate
'2-story brick warehouse, or common stock, 200 shs MLC CO )
(b) Mow acquired
P-Purchase
Paa
(1)( Date qwred
mo , day,
ac yr )
(d) Dale sold
(mo , day yr )
C
d
e
(e) Gross sales pots
(n
Depreciation allowed
(9) Cost or other basis
(h) Gain or (loss)
(k) Excess of fAl (I)
cot (k) but not less than -0-) or
a
b
t
d
e
Complete only for assets
(I)
F M V as of 12131169
Q)
Adjusted bests
(I)
Gains (Cal (h) gain minus
a
b
c
If gain, also enter in Part I, line 7
If (loss), enter-0- in Part I, line 7
3 Net short-te,m capital gain m (loss) as defined in sections 1222(5) and (6)
2 Capital gain net income or (net capital loss)
I( gain, also enter in Part I, line 8, column (c) (see pages 13 and 17 of the instructions)
If [loss) . enter -0- m Part L hoe A
(For optional use by domestic private foundations subbed 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 tax on the distributable amount of any year in we base period?
If 'Yes' the organization does not qualify under section 4940(e) Do not complete this part
(b)
Adjusted qualifying dlstnbullone
I
Yes
No
1cl
Net value of noncharlteble-use assets
2000
2 Total of line 1, column (d)
3 Average disNbuhon ratio for the 5-year base penoddivide the total on line 2 by 5, or by
the number of years the foundation has been in existence if less than 5 years
4 Enter the net value of nonchantable-use assets for 2001 from Part X, line 5
5
4
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
I
47
8
~
41,619
ono
Enter qualifying distnbuhons from Part XII, tine 4
1 8
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% fax rate See
the Part VI instructions on page 18
Fpm, 990-PF zooi)
.0l ~JJrit lUlidNVL7 L[YM
Page 4
to
b
Exempt operating foundations described in section 4940(d)(2), check here
Dale of ruling letter
C
3
4
5
6
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only Others enter-0
.)
Add lines 1 and 2
Subtitle A (income) tax (domestic section 4947(a)(1) busts and taxable foundations only Others enter -0-)
Tax based on Investment income Subtract line 4 from line 3 If zero or less, enter -0Credits/Payments
b
Exempt foreign organizations-tax withheld at source
d
Backup withholding erroneously withheld
6a
6b
Tax paid with application for extension of time m file (Form 8868)
tic
6d
7
Total credits and payments Add lines 6a through 6d
9
Tax due If the total of lines 5 and 8 is more than line 7, enter amount owed
10
71
1a
b
c
d
a
2
3
4a
b
5
6
7
Its
b
9
10
11
12
73
ore
, 189
All other domestic organizations enter 2% of line 276 Exempt foreign o%an¢84ons enter 4°l. of Pan l, Ilne 12 . cat (CJ
2001 estimated tax payments and 2000 overpayment credited to 2001
B
j
i a and enter 1 % of Part I, line 27b
a
c
" U and enter'N/A' on line 1
(attach copy of ruling letter If necessary see instructions)
Domestic organizations that meet the section 4940(e) requirements in Part V, check
here
2
ons)
Enter any penalty (or underpayment of estimated fax Check here
Q d Form 2220 is attached
Overpayment If line 7 is more wan the total of lines 5 and 8, enter we amount overpaid
Enter we amount of line 10 to be Credited to 2002 estimated tax
"
1
~
Refunded
During the tax year, did we organization attempt to influence any national, stale, or local legislation or did
it participate or intervene in any political campaign?
Did It spend more than $100 during the year (either directly or indirectly) for political purposes (see page
19 of the instructions for definilion))
If the answer is "Yes' to 1 a or 7 b, attach a detailed description of the activities and copies of any materials
published or distributed by the organization in connection with the activities
Did the organization file Form 1120-POL tar this year?
Enter the amount (it any) of tax on political expenditures (section 4955) imposed during the year
(1) On the organization 1
$
$
(2)
On organization managers "
the
political
Enter
reimbursement (d any) paid by we organization during the year for
expenditure tax imposed
on organization managers 1
$
Has the organization engaged in any activities that have not previously been reported to the IRS?
If 'Yes .' attach a detailed description of the activities
Has the organization made any changes, not previously reported to the IRS, in its governing instrument. articles
of incorporation, or bylaws, or other similar Instruments? If "Yes,' attach a conformed copy of the changes
Did the organization have unrelated business gross income of $1,000 or more during the yeao
If 'Yes .' has it filed a lax return on Form 990-T for this yea(?
Was were a liquidation, termination, dissolution, or substantial contraction during the year?
If "Yes," attach the statement required by General Instruction T
Me the requirements of section 508(e) (relating to sections 4941 Through 4945) satisfied either
By language in the governing instrument or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain In the governing instrument?
Did the organization have et least $5,000 In assets et any time during the year? II Yes ; complete Pert it, cot (c), and Pert %V
Enter the states to which the foundation reports or with which it is registered (see page 19 of the
instructions) 11NY
If the answer is 'Yes' to line 7, has the organization famished a copy of Form 990
.PF to the Attorney General
(or designate) of each state as required by General Instruction G? If 'No,' att explanation
Is we organvaGOn claming status as a private operating foundation within the meaning of section 49420(3)
or 4942Q)(5) for calendar year 2001 or the taxable year beginning in 2001 (see msWctions for Part XIV on
page 25)? If "Yes .' complete Part XIV
Did any persons become substantial mnmbutors during the tat year? If 'Yes' sit a sch listing then names d addr
Did we org comply with the public inspection requirements for its annual returns 8 exemption application)
Web site address 10The books are in care of
1 RICHARD JC
Telephone no
Located at 1 P .O . BOX 4808 CARRIER PKWY SYRACUSE, NYZIP + 4 1
Section 4947(ax1) nonexempt charitable trusts filing Forth 990
.PF in lieu of Forth 1041 -Check here
TOT
1
No
X
~X
X
2"
N/A
3
as
Alb
~X
X
5
X
6X
7
X
Bb
X
f
" 315-432-6323
13221
.-
D
Form 990-0F (2001)
1b11~!`J`!1 lU/lb/NUL 1 LL vM
File Form 4720 if any Item is checked in the "Yes' column, unless an exception applies
During the year did the organization (either directly or indirectly)
(1) Engage in the sale o " exchange, or leasing of property with a disqualified persons
O Yes
(2) Barrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified persons
Yes
(3) Furnish goods, services, or facilities to (or accept them from) a disqualified persons
Yes
(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified persons
~ Yes
(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)
~ Yes
(6) Agree to pay money or property to a government officials ( Exception Check 'No"
d we organization agreed to make a grant to or to employ the official far a period
after termination of government service, it terminating within 90 days )
~ Yes
b It any answer is "Yes" to 1a(1)-(6), did any of the acts fail to quaky under the exceptions described in Regulations
section 53 4941(d}3 or in a current nonce regarding disaster assistance (see page 19 of the instructions)?
Organizations relying on a current notice regarding disaster assistance check here
1
c Did the organization engage in a poor year in any of the acts described in 1a, other then excepted acts,
that were not corrected before the first day of the tax year beginning in 2001
2
Taxes on failure to distribute income (section 4942) (does not apply for years we organization was a private
operating foundation defined in section 49420(3) or 49420(5))
a Al we end of tax year 2001, did the organization have any undistributed income (lines 6d
and tie, Part XIII) for tax years) beginning before 20017
Q Yes
If 'Yes,* list we years
" 20
, 19
, 19
, 19
b Are there any years listed in 2a for which we organization is not applying we provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the years undistributed incomes (If applying section 4942(a)(2)
to all years fisted, answer "No" and attach statement-see page 19 of the 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
1 20
, 19
, 19
, 19
3a Did the organization hold more than a 2% direct or indirect interest in any business
enterprise at any lime during the yea(
~ Yes
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 we 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest, or (3)
the lapse of the 10
., 15-, or 20-year first phase holding period? (Use Schedule C, Farm 4720, to determine
if the organization had excess business holdings in 2001 )
Did we organization invest during the year any amount in a manner that would jeopardize its charitable purposes
b Did the organization make any investment in a poor year (but after December 31, 1969) that could jeopardize its charitable
purpose that had not been removed from jeopardy before the first day of we tax year beginning in 20017
5a During the year did we organization pay or Incur any amount to
(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))7
El Yes
(2) Influence the outcome of any specific public election (see section 4955), or to carry
on, directly or indirectly . any voter registration drive'
Yes
(3) Provide a grant to an individual for travel . study, or other similar purposes?
8 Yes
(4) Provide a grant to an organization other than a charitable, etc , organization described
in section 509(a)(1), (2), or (3), or section 4940(d)(2)?
Yes
(5) Provide for any purpose other than religious, charitable, scientific . literary . or
educational purposes, or (or the prevention of cruelty to children or animals?
~ Yes
b If any answer is 'Yes" to Sa(1 )-(5), did any of the transactions fail to qualify under the exceptions described in
Regulations section 53 4945 or in a current notice regarding disaster assistance (see page 20 of the inslrucLOns)?
Organizations relying on a current notice regarding disaster assistance check here
1
e If the answer is "Yes" to question Sa(4), does the organization clam exemption from the
lax bemuse it maintained expenditure responsibility for the grant?
N/A O Yes
If 'Yes,' attach the statement required by Regulations section 53 49455(d)
6a Did the organization, during the year, receive any funds, directly or indirectly, to pay
premiums on a personal benefit contract?
~ Yes
b Did the organization, during the year pay premiums, directly or indirectly, on a personal benefit contract?
- If you answered -Yes' to 6b also file Forth 8870
Yes
1a
DM
No
~ No
No
No
~ No
`
`
~ No
~
No
N/A
1b
7c ,
~ No
N/A
~
2b
No
N/A
3b
4a
4b
R
No
~
No
No
..
No
~ No
N/A
El
Sb
No
~ No
"
t'66 ,
~X
I
" ~ ~` 1
Fog 990-PF (zooi)
+
1b17b,7Y`JL 7U/tb(NUL 1 LC PM
Form 9so-aF(z0oi)
CARRIER 6 BRYANT DISTRIBUTORS'
16-1153992
information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
PartVIII ,;
and Contractors
1
Page s
Li3t all officers, directors . trustees foundation mana gers and their com pe nsation ( see pa g e 20 of the instructions
(b) Title and average
hours per week
devateG ro pasNOn
(a) Name and address
SEE STATEMENT 5
2
(cCompensation
(III ot paid, enter
-0-)
(d) ContnE to
plansand~
Oef¢rted
(e) Expense account
other allowances
Compensation of five highest-paid employees (other than those Included online 1-see page 21 of the Instructions)
(a) Name and address of each employee paid more than $50,000
Title and average
hours erweek
EevoleE Po posiGOn
(b)
I
(c)
Compensation
I
(d) Contnbulions to
employeebenefl
O~ns and delerted
compensation
(e)
Ex penseaccount,
other allowances
NONE
rtal number of other employees paid over $50,000
3 Five highest-paid Independent contractors for professional services{see page 27 of the Instructions) If none, enter
'NONE"
(a) Name and address o! each person paid more than $50,000
(b) Type of service
NONE
Part IX-A .,
Summary of Direct Charitable Activities
List the foundation's lour largest direct chaAtable ecWiEes during the tax year Include relevant statistical Information such as the number
SEE STATEMENT
Expenses
6
z
3
4
DA?,
Form 990-PF (2001)
1O17JJ`J`JL lU/1b/NU[ 7 [C YM
of Praaram-Related Investments
N/A
z
All other Ore9ram-related investments See page 22 0l the insinicilons
3
fowl Add lines 1 through 3
Part X ~
Minimum Investment Return (All domestic foundations must complete this part Fori
see gape 22 of the instructions )
1
Fair market value of assets not used (or held for use) directly in carrying out charitable. etc ,
purposes
a Average monthly fair market value of securities
foundations,
b
c
d
Average of monthly cash balances
Fair market value of all other assets (see page 22 of we insWchons)
Total (add lines 1a, b, and c)
e Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation)
~ 1e
2
Acquisition indebtedness applicable to line 1 assets
3
Subtract line 2 from line 1d
4
Cash deemed held for charitable activities Enter 1 1/2% of line 3 (for greater amount, sea page 23
of the instructions)
5
Net value of nonchantable-use assets Subtract line 4 from line 3 Enter here and on Part V, line 4
6
Minimum investment return Enter 5%, of line 5
DIStrlbutable Amount (see page 23 of the instructions) (SecUOn 49420(3) and 0)(5) private operating
F Pa[t Xf ~
foundations and certain fore ig n org anizations check here
1
and do not com p lete this art
1
Minimum investment retain ham Part X, line 6
7
2a Tax on investment income for 2001 from Part VI, line 5
2a
184 .
b Income tax !or 2001 (this does not include we fax from Part VI )
2b
c Add lines 2a and 2b
2c
3
Distnbutable amount before adjustments Subtract line 2c from line 1
3
4a Recoveries of amounts treated as qualifying distributions
4a
b Income distributions from section 4947(a)(2) trusts
4b
c Add lines 4a and 4b
4c
s
add lines 3 and ac
5
6
Deduction from distnbutable amount (see page 23 of the instructions)
6
7
Distributable amount as adjusted Subtract line 6 from line 5 Enter here and on Part XIII,
~
line 1
~ Part Xfl
1
a
b
2
3
a
b
4
5
6
can
7
7 .7
25,579
25
184
395
I 7
25 , 395
I
25 , 395
Qualifying Distributions (see page 23 of the instructions)
Amounts paid (including administrative expenses) to accomplish charitable . etc , purposes
Expenses, contnbuhons, gifts, etc-total from Part I, column (d), line 26
ProgramKelated investments-Total from Part IX-B
'toy
1D
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc ,
purposes
2
Amounts set aside for specific charitable projects that satisfy the
Suitability lest (poor IRS approval required)
,Ja~
Cash distribution test (attach the required schedule)
3b
Qualifying distributions Add lines 1a through 3b Enter here and on Part V, line 8, and Part XIII, line 4
4
Organizations that qualify under section 4940(e) for we reduced rate of fax on net investrnent
income Enter 1 % of Part I, line 27b (see page 24 of the instructions)
5
Adjusted qualifying distributions Subtract tine 5 from tine 4
6 ~
Note The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether we foundation
qualifies for the section 4940(e) reduction of tax in those years
41 , 619
41 1 6-1-9
0
41,619
Form 980-PF (zoo,)
ionbarieiunaewc i <erm
Form 990
.PF(2oo7)
, Part Mill,
CARRIER 6 BRYANT DISTRIBUTORS'
16-1153992
Undistributed Income (see page 24 of the instructions)
(a)
1
2
PaoeC
(d)
(c)
Years prior l0 2000
Dislnbutable amount for 2001 from Part XI,
7000
line 7
Undistributed income, if any, as of the end of 2000
a Enter amount for 2000 only
b Total (or poor years
19
. 19- . 19
3
Excess distributions carryover, if any, to 2001
a From 1996
b From 1997
c From 1998
d From 1999
e From 2000
f Total of lines 3a through e
4
Qualifying distributions for 2001 from Part
x1 I, pine 4 10$
106 , 632
41 , 619
a Applied to 2000, but not more wan line 2a
b Applied to undistributed income of poor years
(Election required-see page 24 of the instructions)
c Treated as distributions out of corpus (Election
required-see page 24 of the instructions)
d Applied to 2001 distnbutable amount
e Remaining amount distributed out of corpus
5
Excess distributions carryover applied to 2001
(If an amount appears in column (d), the
same amount must be shown in column (a) )
6
Enter the net total of each column as
indicated below
a Corpus Add lines 3t, 4c, and 4e Subtract line 5
b Prior years undistributed income Subtract
line 4b from line 2b
c Enter the amount of poor years undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
fax has been previously assessed
d Subtract line tic from line 6b Taxable
amount-see page 25 of the instructions
e Undistributed income for 2000 Subtract line
4a from line 2a Taxable amount-see page
25 of the instructions
f Undistributed income for 2001 Subtract
lines 4d and 5 from line 1 This amount must
be distributed in 2002
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(E) or 4942(8)(3) (see page
25 of the instructions)
8
Excess distributions carryover from 1996
not applied on line 5 or line 7 (see page 25
of the Instructions)
9
Excess distributions carryover to 2002
Subtract lines 7 and 8 from line 6a
10
Analysis of line 9
a Excess from 1997
b Excess from 1998
c Excess from 7999
d Excess from 2000
e Excess from 2001
Con
. . 122 , 256
12,930 .
r
109 326
.i
. F.
w`
"y
7 b17 SS'J'Jl 70/1 FYNU[ 1 11 PM
1a
b
2a
6
c
d
e
3
a
b
c
If the foundation has received a ruling or determination letter that it is a Private operating
foundation, and the ruling is effective for 2001, enter the date of the ruling
Check box ;o indicate whether the org[
descnbedin
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for
each year listed
85% of line 2a
Qualifying distributions from Part XII,
line 4 for each year listed
Amounts included In Ilne 2c not used directly
for active conduct of exempt acbWtles
Qualifying distributions made directly
for active conduct of exempt activities; Subtract line 2d from line 2c
Complete 3a, b, or c for the
alternative test relied upon
'Assets' alternative test-enter
(1 ) Value of all assets
(2) Value of assets qualifying under
section 49420(3)(8)(1)
"Endowment' alternative test-Enter
2/3 of min investment return shown
in Part X, line 6 for each year listed
"Support' alternative test-enter
(1) Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
(2) Support from general public
and 5 or more exempt
organizations as provided In
section 49420)(3)(B)(ni)
(3) Largest amount of support from
an exempt organization
Part XV 1
a
b
2
a
b
1
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.)
Information Regarding Foundation Managers
List any managers of the foundation who have contributed more than 29'0 of the total contributions received by the foundation
before the close of any tax year (but only if they have conlnbuted more than $5,000) (See section 507(d)(2) )
Ust any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of we
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, ele, Programs
Check here " 0 if the organization only makes coninbuhons to preselected charitable organizations and does not accept
unsolicited requests far funds If the organization makes gifts, grants, etc (see page 26 of we instructions) to individuals or
organizations under other condiUons complete items 2a, b c and d
The name, address and telephone number of the person to whom applications should be addressed
MACLIN RICHARDSON - DIRECTOR OF SCHOLARSHIP SERVICES
P .O . BOX 770728
LAKEWOOD, OH
44107
(440)892-4272
The form in which applications should be submitted and information and malenals they should include
SEE STMT 7
c
My submission deadlines
d
My restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other factors
SEE STMT 9
DAA
Form 990-PF (2001)
lbll~`J`JL 1U/16MUL 1 !t NM
Fom,99o-FF(zoo7)
CARRIER 6 BRYANT DISTRIBUTORS'
16-1153!
Part X1F
Supplementary Information (continued)
3 Grants and Contributions Paid Dunn the Year or A pp roved for Future Pa ment
Recipient
a
Name and address home or business
Paid during the year
SEE ATTACHED SCHEDULE
If recipient Is en individual,
snow any
relal~onship to
any foundation mansger
or substantial conlnDulor
Foundation
status o!
recipient
Purpose o! grant or
contribution
Amount
NONE
I N/A
COLLEGE
37,500
I NONE
I N/A
COLLEGE
37,500
c2ooi/2oo2 : $1,500 EACH)
b
Approved for future payment
SEE ATTACHED SCHEDULE
c2ooz/loos : $1,500 EACH)
Form
DM
(2001 )
ioiuJyyZ iunnauu2 i ~ I'M
11
TRI
Enter 9f055 amounts unless otherwise indicated
1
2
3
4
5
6
7
8
9
10
11
Program service revenue
a
Unrelated business income
(p)
Amount
Business
wee
I
Excluded b
(e)
Related or exempt
function income
Sae page 26 0l
the Instructions
(e)
Amount
xc usw
toes
L
sec 512 $13 or 51
1
I
d
e
f
g Fees and contracts from government agencies
Membership dues and assessments
Interest on savings and temporary cash investments
Dividends and interest from securities
Net rental income or (loss) from real estate
a Debt-financed property
b Not debt-financed property
Net rental income or (loss) horn personal property
Other investment income
Gain or (loss) /mm sales of assets other than inventory
Net Income or (loss) from special events
Gross profit or (loss) from sales of inventory
a
Other revenue
b
c
d
-
72 Subtotal Add columns (b), (d), and (e)
13 Total Add line 12, columns (b), (d), and (e)
Line No
onn
~~
01 _,~
01~
13
Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
the accomplishment of we organization's exempt purposes (other than by providing funds for such purposes) (See
Fog 990-PF (zoo+)
161153'92 10/762002 122 PM
Form990-PF(2o0t)
CARRIER 6 BRYANT DISTRIBUTORS'
16-1153992
?art XVII
Information Regarding Transfers To and Transactions and Relationships With Nonchantable
Exem p t Or g anizations
1
Did the organization directly or indirectly engage in any of the following with any other organization described in section
507(c) of we Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
Transfers from the reporting organization to a nonchantable exempt organization of
(1) Cash
(2) Other assets
Other Transac6ons
(1) Sales of assets to a nonchantable exempt organization
(2) Purchases of assets from a nonchantable exempt organization
(3) Rental of facilities, equipment, or other assets
(4) Reimbursement arrangements
(5) Loans or loan guarantees
(6) Performance of services or membership or fundraising solicitations
Sharing of facilities, equipment, mailing lists, other assets, or paid employees
I( 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 If the organization received less than fair
market value in any transaction or sharing arrangement, show in column (d) we value of the goods, other assets, or services
a
b
c
d
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 501(c)(3)) or in section 5277
b If 'Yes," com p lete the following schedule
a Name of org anization
b Typ e of organization
C
N/A
Under penaWes of perjury, I declare that I have examined this return Including aca
belief It is tryrSVacl, 9nC wryqlqro-Qeclarabon of preparer (other than taxpayer
5
I
9
n
H
e
r
e
DAA
U
e
a O
d r ^
e
a
s y
areparers
sinature
Finn s name (or yours d
seu-employed) address, ~
ann na ~Ma
]
..
ROSS,
PAULR
Page 12
,
Ycs
la(l )
la (2 )
X
X
1^
X
X
X
X
X
1b
1b
1b
1b
7b
2
3
4
5
lb(6 )
1c
El Yes 0
Descd hon of relahonshl
No
X
No
7o110driL 1V/10(LVUt 7< A YM
Form
2220
FORM 990-PF
Underpayment of Estimated Tax by Corporations
1 See separate instructions
1 Attach to the corp oration's tax return
Department oftie Treasury
incernai Revenue Service
Name
Note
CARRIER 6 BRYANT DISTRIBUTORS'
OMB No 1545-0
200
1
Employeridentification number
EDUCATION FOUNDATION
X16-1153992
In most roses, the corporation does not need to file Form 2220 (See Part I below (or exceptions ) The IRS will figure any penalty
owed and bill the corporation I( the corporation does not need to file Form 2220, it may still use it to figure the penalty Enter the
amount from line 36 on the estimated tax penalty line of the corporations income tax return, but do not attach Forth 2220
Reasons for Filing . Check the boxes below that apply to the corporation If any bones are checked, the
Part I ,
corporation must file Forth 2220, even if it does not owe the penalty If the box on line 1 or line 2 applies,
1
I / The corporation is using the annualized income installment method
2
~ The corporation Is using the adjusted seasonal installment method
3
The corporation is a 'large corporation" figuring its first required installment based on the prior years tax
Note
The corporation also must file Forth 2220 ii it has a suspended research credit allowed (or the current year (see the instructions for
line 4) or it is an Indirectly affected taxpayer (see instructions)
4
Total tax (see instructions)
5a
Personal holding company tax (Schedule PH (Forth 1120), line 26) included on line 4
b
4
Sa
Look-back interest included on tine 4 under section 460(0)(2) for completed long-term
contracts or aechon 167(8) for depreciation under the Income forecast method
c
d
6
7
8
9
Sc
Credit for Federal tax paid on fuels (see msWchons)
Total Add lines Sa through Sc
Subtract line Sd from line 4 If the result is less wan $500, do not complete or file this forth The corporation
does not owe the penalty
Enter the tax shown on the corporation's 2000 (name tax return Caution See instructions before completing
this line
Enter the smaller of line 6 or line 7 If the corporation
Installment duedates Enter lncol (a) - (d) the 15th
184
d
day of the 4111 Form 99"F tilers Use 5th month),
6th, 9w, and 12N months of the cord tax year
Exception Enter October 1, 2001, instead of
10
September 15 2001
1
Required Installments II the box on line 1 and/or line
9
above Is checked, enter the amounts horn Sch A line
<0 If the boa on In 3 (but not 1 or 2) I5 checked sae
Instructors for the amt to enter II none of these
11
boxes are checked, enter 25% of In 8 above in each cot
10
0
Estimated tax paid or credited for each period (see
Instructions) For column (e) only, enter the amount
horn line 11 on line 15
71
Complete lines 72 through 18 of ore column befo
going to the next column
12
Enter amount, II any, horn In 18 of the preceding cot
12
13
Add lines 11 and 12
13
14
15
16
17
Add amounts on Mee 16 b 17 0l the preceding column
Subtract line 14 from line 13 If zem or less, enter 4)It the amount on Me 151s zero, subtract line 13 from
too 14 Otherwise, enter -0 .
is
0
16
Underpayment If line 15 is less than or actual to line 1 ,
subtract [me 15 horn line 10 Then go to line 12 of the
1B
74
next column Otherwise, go to line 78
77
Overpayment If line 10 Is less than line 15, subtract
Complete Part III on page 2 to figure the penalty If there are no entnes on line 17, no penalty is owed
For Paperwork Reduction Act Notice, see separate Instructions
DM
Form 2220 (2001)
161153992 CARRIER 8 BRYANT DISTRIBUTORS'
Federal Statements
16-1153992
FYE 7/31/2002
10/16/2002 1 22 PM
Statement 1 - Form 990-PF. Part 1, Line 16b -Accounting Fees
Description
2000 FORM 990-PF
$
TOTAL
$
Total
1, 030
1,030
Net
$
Investment
0
$
Adjusted
$
Charitable
Purpose
Net
$
0
$
0
Statement 2 - Form 990-PF, Part I. Line 16c - Other Professional Fees
Description
MERRILL LYNCH ANNUAL FEE
TOTAL
$
Total
$
Net
Adjusted
150
Investment
150
$
$
150
$
$
150
Charitable
Purpose
Net
0
$
0
Statement 3 - Form 990-PF. Part I, Line 18 - Taxes
2000 990-PF
Description
TOTAL
$
Total
$
598
$
598
$
Net
Investment
$
0
Adjusted
Net
$
$
0
Charitable
Purpose
$
0
Statement 4 - Form 990-PF, Part I, Line 23 - Other Expenses
Description
EXPENSES
S
NEW YORK STATE FEE
ADMINISTRATIVE FEES
TOTAL
Total
Net
Investment
S
S
Charitable
Purpose
Adjusted
Net
S
100
4,119
$
4,219
4,119
$
0
$
0
$
4,119
1-4
161153992 CARRIER & BRYANT DISTRIBUTORS'
Federal Statements
16-1153992
FYE 7/31/2002
10/16/2002 1 22 PM
Statement 5 - Form 990-PF, Part VIII, Line 1 - Officers, Directors, Foundation Managers
Name
L B . MINGLEDORFF
KELLY ROMANO
ROBERT MADDEN
FRANK NISONGER
JOHN STAPLES
DORAL ATKINS
FRANK J .
RAU,
JOSEPH WILSON
JR .
Address
Title
Average
Hours
Compensation
NORCROSS, GA
PRES ./DIRECT 2 - 4
SYRACUSE, NY
SECRET/DIREC 2 - 4
LUBBOCK, TX
TREAS/DIRECT 2 - 4
SACRAMENTO, CA
DIRECTOR
2 - 4
CITY OF INDUSTRY,
2 - 4
DIRECTOR
IRONDALE, AL
2 - 4
DIRECTOR
MOBILE, AL
2 - 4
DIRECTOR
IRVING, TX
2 - 4
DIRECTOR
-Q
Benefits
Expenses
--O-
CA-(3 -0- 0-0-
Statement 6 - Form 990-PF. Part IX-A. Line 1 - Summary of Direct Charitable Activities
PAYMENT OF SCHOLARSHIPS TO 2001-2002 ACADEMIC YEAR
RECIPIENTS ($37,500), AND RELATED ADMINISTRATIVE FEES
($4,119) ASSOCIATED WITH SELECTION OF 25 SCHOLARSHIP
RECIPIENTS ;
DETERMINATION OF SCHOLARSHIPS FOR 2002-2003 ACADEMIC YEAR
RECIPIENTS ($37,500), AND RELATED ADMINISTRATIVE FEES
ASSOCIATED WITH SELECTION OF 25 SCHOLARSHIP RECIPIENTS
($3,350), (PAYMENTS OF THESE SCHOLARSHIPS AND FEES WERE
MADE AFTER THE END OF THE CURRENT FISCAL YEAR) .
5-6
161153992 CARRIER & BRYANT DISTRIBUTORS'
Federal Statements
16-1153992
10/16/2002 1 22 PM
FYE 713112002
Statement 7 - Form 990-PF. Part XV, Line 2b - Application Format and Required Contents
SEE ATTACHED APPLICATION FORM
Statement 8 - Form 990-PF. Part XV, Line 2c - Submission Deadlines
MAY 31 FOR ACADEMIC YEAR BEGINNING IN THE FALL
Statement 9 - Form 990-PF, Part XV, Line 2d - Award Restrictions or Limitations
4 YEAR ACCREDITED COLLEGE OR UNIVERSITY FOR UNDERGRADUATE
DEGREE ONLY, APPLICANT'S MUST HE DEPENDENTS OF EMPLOYEES
IN THE HVAC INDUSTRY
7-9
C-
7/31joU
'7q0 - Fr-
Y~-q~ 7fe~, 3
;t
P4
WILLIAM A. BLEES EDUCATIONAL FOUNDATION, INC.
Written Action of Directors
WHEREAS, the Board of Directors of the William A Blees Educational
Foundation, Inc., a New York Not-for-Profit corporation (the "Corporation") desire to amend
and restate the By-laws of the Corporation
WHEREAS, the Board of Directors of the Corporation desire to appoint new
directors and officers .
WHEREAS, the Board of Directors of the Corporation desire to appoint certain
Honorary Directors
WHEREAS, The Board of Directors of the Corporation desire to change the name
of the Corporation to "Carver & Bryant Distributors' Education Foundation in Memory of Willis
Carver, Inc."
WHEREAS, the Corporation made attempts to locate Donald Stetil and Anthony
Jokerst but was unable to locate an address to use for the purpose of giving notice.
WHEREAS, the whereabouts of Donald Stehl and Anthony Jokerst are unknown
WHEREAS, Warren W. Farr, Sr . is deceased .
WHEREAS, the undersigned directors of the Corporation, being all of the
directors thereof, do consent to the taking of the following action m lieu of a meeting of the
Board of Directors, and do adopt the following resolutions by written action pursuant to
Section 405 of the Not-for-Profit Corporation Law of the State of New York'
RESOLVED, that L. B Mingledorff is hereby appointed as
President, effective immediately, and shall serve as such until his
successor shall have been duly elected or appointed and qualified,
or as otherwise provided in the By-laws of the Corporation, and it
is further
RESOLVED, that Kelly Romano is hereby appointed as
Secretary, effective immediately, and shall serve as such until her
successor shall have been duly elected or appointed and qualified,
or as otherwise provided m the By-laws of the Corporation, and it
is further
RESOLVED, that Robert Madden is hereby appointed as
Treasurer, effective immediately, and shall serve as such until his
successor shall have been duly elected or appointed and qualified,
or as otherwise provided in the By-laws of the Corporation ; and it
is further
RESOLVED, that the Amended and Restated By-Laws
attached hereto as Exhibit A, are hereby adopted as the By-Laws of
the Corporation; and it is further
RESOLVED, that the number of directorships is set at eight
(8) and the following persons are hereby appointed as the directors
of the Corporation until their successors are appointed and
qualified
Term
1 year S~c~rrP M E: NTo, C A
1 year S1~2ACAA sE, NY
2 year L .~aao~-~ Tn
2 year
2 year ZizoN'DP~, AL
3 year ~,/orzc~oss, GA .
3 year Moa~~e,
3 year ~RV~ N ~
)<
Name
Frank Nisonger
Kelly Romano
Robert Madden
John Staples
Doral Atlans
L. B . Mmgledorff
Frank J . Raue, Jr.
Joseph Wilson
(,ITy o~s.~~USmY, C,~
and it is further
RESOLVED, that the name of the Corporation is hereby
changed to "Carver & Bryan Distributors' Education Foundation
m Memory of Willis Carver, Inc ." pursuant to the Certificate of
Amendment attached hereto as Exhibit B, and the officers of the
Corporation and their agents are hereby authorized to take any
actions necessary to effectuate such change, including filing the
attached Certificate of Amendment with the New York Department
of State, and it is further
65038901
III
-2-
RESOLVED, ?hat the following persons arc hereby
appointed as Honorary Directors of the CorporationGeorge Saunders, Jr
Warren Farr, Jr
M D Mitchella
E. C Hunt
Robert Kesterton
and it is further
RESOLVED, that the Corporation accepts the resignations
the
of
following directors .
Henn E Bonvin
Robert Taylor
Warren W. Farr, Jr
James C Van Landingham
Howard Goldstein
Michael J. Ward
Robert Ratcliffe
Robert Kesterton
M. D. Mitchella
Michael Clevy
and it is further
George S. Saunders, Jr
RESOLVED, that the Corporation removes the following
directors for cause:
Donald J Stehle
Warren W Farr, Sr
Anthony B Jokerst
Dated .
, 2002.
Doral Atkins
Frank J. Raue, Jr
John Staples
65038901
--,
CERTIFICATE OF AMENDMENT
OF THE
CERTIFICATE OF INCORPORATION
OF
WILLIAM A. GLEES EDUCATIONAL FOUNDATION, INC.
Under Section 803 of the Nolfor-Profit Corporation Law
Filer :
ewa+a.ai
CERTIFICATE OF AMENDMENT
OF
CERTIFICATE OF INCORPORATION
OF
WILLIAM A. BLEES EDUCATIONAL FOUNDATION, INC .
Under Section 803 of !he Not-for-Profit Corporation Law
The undersigned, being the President end Secretary of WILLIAM A. BLESS
EDUCATIONAL FOUNDATION, INC. do hereby state:
'°
1
The name of the corporation is WILLIAM A. BLESS EDUCATIONAL
FOUNDATION, INC.
The date of filing the Certificate of Incorporation in the office of the
2
Secretary of State of New York is December 19, 1979 and the Certificate of Incorporation was
filed under Section 402 of the Not-for-Profit Corporation Law
3.
She Corporation is a Corporation as defined in Section 102(a)(5) of the
Not-for-Profit Corporation Law; the Corporation is a Type B corporation under Section 201 of
the Nat-for-Profit Corporation Law
4.
The Certificate of Incorporation of WILLIAM A. BLEE3
EDUCATIONAL FOUNDATION, INC . is hereby amended to effect a change m the name of the
Corporation . Article I of the Certificate of Incorporation is hereby amended to read as follows.
ARTICLE I
The name of the corporation is Carver & Hryant Distributors' Education
Foundation In. Memory Of Willis Carver, Inc.
5.
The Certificate of Incorporation of WILLIAM A. BLESS
EDUCATIONAL FOUNDATION, INC . is hereby amended to effect a change in the address to
which the Secretary of State shall mail copies of any process against the Corporation served
upon the Secretary of State . Article IX is hereby amended to read u follows:
ARTICLE IX
The Secretary of State is designated as the agent of the Corporation upon whom
process against it may ix served and the post office address to which the
Secretary of State shall mail a copy of any process against it served upon the
Secretary of State is: Kelly Romano, Cagier Corporation, P.O Box 4808,
Syracuse, New York 13221
aaaaa 01
6
This Amendment to the Certificate of Incorporation of WILLIAM A
HLEES EDUCATIONAL FOUNDATION, INC . was authorized by the Unanimous Written
Consent of the Members of the Board of Directors of the Corporation, dated Much 20, 2002 .
The Corporation has no members
7
The Secretary of State is designated as the agent of the Corporation upon
whom process against it may be served and the post office address to which the Secretary of
State shall mail a copy of any process against it served upon the Secretary of State is. Kelly
Romano, Carver Corporation, P.O. Box 4808, Syracuse, New York 13221
IN WITNESS WHEREOF, the undeisi
acknowledged this Certificate this ~ day of
have made and subscribed and
2002.
==
.'`~~~`~~'~~~=
1
\J
.
MingledorfF
L.B
President
Kelly o
Secretary
STATE OF GEORGIA
)
COUNTY OF Gwn~-
ss.:
On M u--t 7
. 2002, L.H . Mingledorff, being duly sworn, deposes and
says he is President of W~II .LIAM A. HLEES EDUCATIONAL FOUNDATION, INC, the
Corporation described in the foregoing Certificate of Amendmait; that the Corporation does not
have any members; and that the Board of Directors of the Corporation, by unanimous written
consent, dated Match 20, 2002, authorized the deponent to execute and file the foregoing
Certificate .
.o&
N
STATE OF NEW YORK
COUNTY OF
nn c
J
)
,.
Notary Pu
Pu6CC. Gwnnolt Camly~ Georpb
6Vuos JON 3o. :ax
ss..
On
of,
, 2002, Kelly Romano being duly sworn, deposes and says
she is Secretary
WILL AM A. HLEES EDUCATIONAL FOUNDATION, INC, the
Corporation described m the foregoing Certificate of Amendment; that the Corporation does not
have any members ; and that the Board of Directors of the Corporation, by unanimous written
consent, dated March 20, 2002, authorized th e deponent to execute and file the foregoing
Certificate .
Notary Public
TANI L MUTTON
K%WV AM I4Stub of
CIOllflGdh1G67dlYOnCO
L~ C~etttl?~On ~
1
Uc*
7EA
09D660 01 01l!51!001
f
C.
~ 2~ : u,
t
-
i
j
-i
I
ar,4,T . ~ ~-I
.3~?1 .~Qo:;;~
r
".
Y
t
CZUESTIONNAIRE
; BIOGRAPHICAL
.
I
The following questions are designed to gather information about your background, interests and plans
Your answers to these questions will be used only in connection with your application far the Carner & Bryant
Distributors' Education Foundation Scholarship
PLEASE TYPE OR PRINT, USING BLACK INK.
APPLICATIONS MUST BE RECEIVED BY MAY 31 .
I
A. APPLICANT
NAME IN FULL LAST
FIRST
MIDDLE
ADDRESS
CITY
(AREA CODE) PHONE
STATE
ZIP
DOB
AGE
STATE
ZIP
CHECK ONE Male F
Female 0
U S CITIZENSHIP Yes Q
No
B . EDUCATION
NAME OF HIGH SCHOOL
STREET ADDRESS
CITY
In what year will you graduate
2 . List all schools you have attended during the last four years, beginning with the one you attended most recently
NAME OF SCHOOL
DATES ATTENDED
LOCATION
i 3 List any advanced or special program courses or summer courses you have taken Begin with the most recent
course or program.
i
COURSE/PROGRAM
NAME OF SCHOOL
LOCATION
DATES ATTENDED
HOURS PER WEEK
C . COLLEGE CHOICE AND OBJECTIVE
1 What college or university do you plan to attend?
NAME OF INSTITUTION
CITY
I 2 Will you be a resident 0
j 3 Have you been accepted
STATE
or a commuter 0
Yes 0
No
4. What is your degree objective? (example : B.S , B.A , M S , M.A., PH D )
Other (specify)
5 What course of study (mayor) would you like to follow in college? (You may list more than one or answer "undecided")
Whys
6 Have you decided on your future occupation?
Yes 0
No n
If yes, specify
D. ACTIVITIES
1 . List school-related activities in which you have participated Please also include any honorary awards
ACTIVITY
DATES OF PARTICIPATION
OFFICES HELD
SPECIAL AWARDS OR HONORS
2 List sport(s) in which you participated
SPORT
DATES OF
PARTICIPATION
NUMBER OF
VARSITY LETTERS
EVENT OR
POSITION
SPECIALAWARDS
OR HONORS
3 List community or volunteer activities in which you have participated (such as hospital volunteer work, church
work, drug hot lines, and outreach programs)
ACTIVITY
NAME OF AGENCY OR ORGANIZATION
DATES OF PARTICIPATION
SPECIAL AWARDS
I
4 Please describe one of your favorite experiences from the activities you have listed in Section D
E . EMPLOYMENT
Starting with the most recent, list any part-time or full-time jobs you have held.
EMPLOYER
ADDRESS
JOB DESCRIPTION
DATES EMPLOYED
HOURS PER WEEK
F. READING
I
1 What books and articles have you read within the last six months
ASSIGNMENTS
2 Which book or article did you find interestmgl Whys
PERSONAL READING
G . TECHNOLOGY
As a member of a family involved in the HVAC industry, you probably see ways in which HVAC technology
makes our lives better Willis Carrier invented au-conditioning in 1902. Please describe another 20th
Century technology that improved the way we live .
H . YOUR FAMILY
1 Which of your parents is an employee of an HVAC Dealer/Contractor
At which location does he/she work
;2
'i
LOCAL CARRIER OR BRYANT DISTRIBUTOR NAME
ADDRESS
CITY
STATE
3. Father's full name
Occupation
4. Mother's full name:
Occupation:
5 Guardian who supports you if other than father or mother:
NAME
RELATIONSHIP TO YOU
ZIP
I . ABOUT YOU
1 Please describe why you feel you would be an appropriate recipient of this scholarship
2 Please describe what you would like to have accomplished 10 years from now.
J. SUBMITTING APPLICATION
----- - - -- - --- --- - --------- - --- ----- --------------------
J
Review all questions to be sure you have answered them completely.
Mail this application, your high school transcript (include SAT/ACT scores and class rank), and your college
transcript (if applicable) to: SCHOLARSHIP SERVICES CO.
R0. BOX 770728
LAKEWOOD, OH 44107
Please list your hometown newspaper and its address for use in a press release if you are an award winner
0 Yes, I authorize you to release information to:
NEWSPAPER NAME
ADDRESS
CITY
STATE
ZIP
No, I do not wish to have the information released
I verify that all information is accurate and true to the best of my knowledge .
STUDENT SIGNATURE
I
DATE
;:FPL1CA7lONS MUST BE RECEIVED BY MAY 31 . APPLICATIONS RECEIVED AFTER THIS DATE WILL NOT B E CONS IDERED.
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L Name Student
Bergman
Blau
Blessing
Churchill
Clark
Craig
Davis
Evanco,
Gaelhals
Grossheider
Hartman
Hxhsrhld
Holcombe
Royce
141ganfl
Wile
Leaman
Libwda
Mlrhalek
Neitrke
i Peavy
Sweazay
Vauk
Whaley
Wills
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Flrst Name Student
Gregory
Ryan
Matthew
Sara
William
Cheryl
Stephanie
Eric
Jessica
Abby
Nicholas
Katherine
Kaeey
John
Shannon
Elizabeth
JAI
Melissa
Dorothy
Sarah
Aaron
Melanie
Bryan
Jonathan
Alron
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Address
1566 Sandy Pass
145 Linden Avenue
812 Baulell Dr
1700 Hermitage Or
235 N ButleAleld Rd
2602 Sleepy Hollow Or
33640 Chipper Or
2881 OW US 40 NW
1865 Shaman Ave p218
3772 St Hwy N
805 Overhl0 Dr
2628 Chesapeake
8 Woodbend CI
13 Atlantis Blvd
165 Marion Ponta Or
5561 Mountain Springs Ct
1891 Windy HMI RA
222 Derby Trek Or
9 S 541 Charles Ct
34&1 Little York Read
2876 W Albatross Rd
10 Spenry Ln
2572 HuOpfna Rd
426 WhaleY Rd
2009 Dogwood Ct
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State Zip
60047
Lake Zurich
IL
Befleville
NJ
07109
Grand Blanc
MI
48439
New Lenax
IL
66451
LICertyvilie
IL
60648
PeaAanO
TX
77581
MI
49W0
Colon
43140
London
OH
Evanstnn
IL
60201
Advance
MO
63730
N Veraalllee
PA
15137
Northbrook
IL
60062
Maul6ln
SC
29682
TurJcertnn
W
08087
Belews Croak
27009
NC
Gahenna
OH
43230
Lancaster
PA
17602
77679
Sugar land
TX
Downers Grove IL
60516
Dayton
OH
1511
~
FL
33825
Avon Park
Lansing
NY
14882
Sherman
T%
75092 ,
Conngtnn
TN
38019
Grand Prairie
TX
75050 ,
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