Year 2004 - Foundation Center

advertisement
Return of Private Foundation
Form 99b-Pr
Department of the Treasury
Raven ue Service
I
OMB No 1545-0052
aiion may be able to use a copy of this return to satisfy state reporting requirements.
For calendar year 2004, or tax year bepinnin
. and ending
Use the IRS
label .
Otherwise,
print
Note : The organ,,
or Section 4947(a)(1) Nonexempt Charitable Trust
Treated as a Private Foundation
FOUNDATION
Number and street (or P O box number if mail is not delivered to street address)
Room/suite
or type P .O . BOX 221432
See Specific
City or town, state, and ZIP code
Instructions
I Fair market value of all assets at end of year
(from Part 11, co/ (c), line 16)
(831) 624-8917
0 1 . Foreign organizations, check here
2, Foreign organizations meeting the 85% test,
check here and attach computation
Accounting method: M Cash
0 Accrual
E] Other (Specify)
6 2 7 5 914 . (Part 1, column (d) must be on cash bass.)
Analysis
of
Revenue
and Expenses
Part I 01,e
(a) Revenue and
(b) Net investment
or
J
total amounts in columns rot, (c), and (d) may got
necessarily equal the amounts in column (a))
r
3
4)
IrWi
b
1
Contributions, gifts, grants, etc., received
Q
Check 10- EFO ifthefoundation isnotrequired toattach Sch B
Interest on savings and temporary
3
77-0438710
B Telephone number
(, If exemption application is pending, check here
H Check type of organization:
LXJ Section 501(c)(3) exempt private foundation
0 Section 4947(a)(1) nonexempt charitable trust = Other taxable private foundation
N
4
Address change
E:] Name change
A Employer identification number
Name of organization
B ERKSHIRE
200
expenses per books
E If private foundation status was terminated
under section 507(b)(1)(A), check here 10
F If the foundation is m a 60-month termination
under section 507 ( b )( 1 13 ), check here
0
income
(d) Disbursements
for charitable purposes
(cash basis only)
(C) Adjusted flat
income
N /A
136 .
cash investments
4 Dividends and interest from securities
5a Gross rents
Statement 2
b Net rental income or (doss)
Net gain or (loss) from sale of assets not on
s8 line 10
S tatement I
372,771 .
Gross sales price for all
b assets on line 6a
7
Capital gain net income (from Part IV, line 2)
8
Net short-term capital gain
00.
,
2,603 .
9 Income modifications
Gross sales less returns
103 and allowances
b Less Cost of goods sold
c Gross profit or (loss)
Other income
Total Add lines 1 through 11
11
12
14 Other employee salaries and wages
y 15 Pension plans, employee benefits
y 16a Legal fees
b Accounting fees
c Other professional fees
Stmt
> 17 Interest
18 Taxes
Stmt
19 Depreciation and depletion
~ 20 Occupancy
~ 21 Travel, conferences, and meetings
~ 22 Prin
0) 23 Othe expens~~,r~IV~~
t
24 Tota op az mp and administrative
o
0.
Compensation of officers, directors, trustees, etc
13
expe
25 Cont tfEti
Aid ~ ~ t% o
Ml~l~
26 Total xp
Addle es24 n
27
Subtr
grants paid
DC
C
e
-o->
C Adjusted net income (it negative, enter -o-)
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LHA
400
,
000 .
406 233 .
enter
-162 , 726
400
737 .
,
000 .
402 413 .
.
For Privacy Act and Paperwork Reduction Act Notice, see the instructions .
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8.
755 .
5
a Excess of revenue over expenses and disbursements
b Net investment income (if negative,
725 .
725 .
4
~
ert~eq
V
.I
3
372 , 002 . [
N /A
1
2004 .04000 BERKSHIRE FOUNDATION
~
Form 990-PF (2004)
04245001
"
Form 990-F1F (2004) ~
BERKSHIRE FOUNDATION
Attached schedules andamounts inihedescripdon
Balance SlleetS column
should be for end -ot-yearamounis only
Part II
Cash - non-interest-bearing
Savings and temporary cash investments
Accounts receivable
Less: allowance for doubtful accounts
4 Pledges receivable
Less : allowance for doubtful accounts 00,
5 Grants receivable
6 Receivables due from officers, directors, trustees, and other
disqualified persons
7 Other notes and loans receivable
Less : allowance for doubtful accounts 00,
8 Inventories for sale or use
d
N 9 Prepaid expenses and deferred charges
a 10a Investments - U.S . and state government obligations
b Investments - corporate stock
Stmt
c Investments - corporate bonds
11 Investments -land,bwldings,andequipment basis
01
Less accumulated depreciation
17 , 391 .
50 , 950 .
26 , 157 .
8 , 858 .
26 , 157 .
8 , 858 .
2 , 426 , 250 .
2 , 296 , 850 .
6 , 240 , 899 .
2 , 494 , 591 .
2
6 , 275 , 914 .
1
2
3
12
13
14
15
is
17
18
19
20
21
J 22
23
m
24
25
26
Y! 27
28
a 29
Z4) 30
31
Investments - mortgage loans
Investments - other
Land, buildings, and equipment: basis "
Hess accumulated depreciation
Stmt 7 .
Other assets (describe "
2
3
4
5
6
6
5 , 461 .
5,461 .
)
Total assets to be com p leted b all tigers
Accounts payable and accrued expenses
Grants payable
Deferred revenue
Loans from officers, directors, trustees, and other disqualified persons
Mortgages and other notes payable
Other liabilities (describe )o.
3 31
8 65 .
)
Total liabilities add lines 17 throu g h 22
Organizations that follow SFAS 117, check here
and complete lines 24 through 26 and lines 30 and 31
Unrestricted
Temporarily restricted
Permanently restricted
Organizations that do not follow SFAS 117, check here
and complete lines 27 through 31 .
Capital stock, trust principal, or current funds
Paid-in or capital surplus, or land, bldg ., and equipment fund
Retained earnings, accumulated income, endowment, or other funds
Total net assets or fund balances
2,494,591 .
2 , 494 , 591 .
0
0
2,331,865
2 , 331 , 865
Total liabilities and net assets/fund balances
2 , 494 , 591 .
2 , 331 , 8651
Part III
1
Page 2
77-0438710
End of year
(b) Book Value
(C) Fair Market Value
Beginning of year
(g) Book Value
0 .
0.
0.
0 .
.
.
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 end-of-year figure reported on prior year's return)
Enter amount from Part I, line 27a
Other increases not included in line 2 (itemize) "
Add lines 1, 2, and 3
Decreases not included in line 2 (itemize) "
Total net assets or fund balances at end of year (line 4 minus line 5) - Part II, column (b), line 30
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.
.
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2004 .04000
Z
BERKSHIRE
1
2
3
4
5
6
FOUNDATION
2 , 494 , 591 .
-162 , 726 .
0 .
2 3 31 , 865 .
0 .
2 331 , 865 .
Form 990-PF (2004)
04245001
Form 990-P'F (2004)
IV I Capital Gains and Losses for Tax on Investment Income
(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 .)
SHS BERKSHIRE HATHAWAY
(e) Gross sales price
(f) Depreciation allowed
(or allowable)
3
(b 1 How acquin
P - Purchase
D - Donation
(g) Cost or other basis
plus expense of sale
(d) Date sold
(mo ., day, yr.)
I
(h) Gam or (loss)
(e) plus (f) minus (g)
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(k) Excess of col . (i)
(1) Adjusted basis
(i) F .M .V, as of 12/31/69
as of 12/31/69
over col. (1), if any
(I) Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col. (h))
372 .603 .
If gain, also enter in Part I, line 7
~ If (loss), enter -0- in Part I, line 7
2 Capital gain
9 net income or C net capital loss) .
(c Date acquired
~mo ., day, yr.)
2
72 .603 .
3 Net short-term capital gam or (loss) as defined in sections 1222(5) and (6) :
If gam, also enter in Part I, line 8, column (c).
If (loss), enter -0- in Part I, line 8
Part V I C+IUaIliIC8t1011 Under ,eCtl0n 494U(e) TOE Keaucea It ax on Net investment income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)
If section 4940(d)(2) applies, leave this part blank.
Was the organization liable for the section 4942 tax on the distributable amount of any year m the base period?
If "Yes;" the organization does not qualify 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 peraod years
Calendar ear or tax ear be g innin g in
((c)
Adjusted qualifying
distributions
Net value of noncharitable-use assets
Zoos
2002
349 , 217 .
348,125 .
5 , 529 , 406 .
5 .714 .770 .
0 Yes [2:1 No
Distribution ratio
(col . (b) divided by col . (c))
.0631563
.0609167
4
2 Total of line 1, column (d)
3 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
4 Enter the net value of noncharitable-use assets for 2004 from Part X, line 5
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
402,413 .
S Enter qualifying distributions from Part XII, line 4
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 .
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2004 .04000 BERKSHIRE FOUNDATION
Form 990-PF (2004)
04245001
Form 990-FIF (2004) ~
BERKSHIRE FOUNDATION
Page 4
77-0438710
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948 - see instructions)
Part VI
1a Exempt operating foundations described in section 4940(4)(2), check here 1 0 and enter "N/A" on line 1 .
Date of ruling letter:
(attach copy of ruling letter if necessary-see instructions)
b Domestic organizations that meet the section 4940(e) requirements in Part V, check here 1 Ef] and enter 1%
of Part 1, line 27b
c All other domestic organizations enter 2% of line 27b . Exempt foreign organizations enter 4% of Part I, line 12, col . (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
3 Add lines 1 and 2
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
5 Tax based on investment income . Subtract line 4 from line 3 . If zero or less, enter -06 Credits/Payments :
a 2004 estimated tax payments and 2003 overpayment credited to 2004
6a
3 , 000 .
b Exempt foreign organizations - tax withheld at source
6b
c Tax paid with application for extension of time to file (Form 8868)
6c
d Backup withholding erroneously withheld
6d
7 Total credits and payments . Add lines 6a through 6d
8 Enter any penalty for underpayment of estimated tax. Check here 0 if Form 2220 is attached
9 Tax due . If the total of lines 5 and 8 is more than line 7, enter amount owed
1
10 Overpayment . If line 7 is more than the total of lines 5 and 8, enter the amount overpaid
"
11 Enter the amount of line 10 to be: Credited to 2005 estimated tax
Refunded
Part VII-A
Statements Regarding Activities
1
3 , 720 .
2
3
4
5
0
3 , 720
0
3 720
7
8
9
10
11
3 , 000 .
is During the tax year, did the organization attempt to influence any national, state, or local legislation or did it participate or intervene in
any political campaign
b Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see instructions for definition)
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials published or
distributed by the organization 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:
(1) On the organization . t $
0 . (2) On organization managers. t $
0 .
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 m any activities that have not previously been reported to the IRS
If "Yes, " attach a detailed description of the activities
3 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
4a Did the organization have unrelated business gross income of $1,000 or more during the years
b If "Yes," has it filed a tax return on Form 990-T for this years
N/A
5 Was there a liquidation, termination, dissolution, or substantial contraction during the years
If "Yes, " attach the statement required by General Instruction T.
6 Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either :
~ By language in the governing instrument, or
~ By state legislation that effectively amends the governing instrument so that no mandatory directions that conflict with the state law
remain in the governing instrument?
7 Did the organization have at least $5,000 in assets at any time during the year?
If "Yes," complete Part fl, col. (c), and Part XV
8a Enter the states to which the foundation reports or with which it is registered (see instructions)
CALIFORNIA
b If the answer is "Yes" to line 7, has the organization furnished a copy of Form 990-PF to the Attorney General (or designate)
of each state as required by General Instruction G7 If "No," attach explanation
9 Is the organization claiming status as a private operating foundation within the meaning of section 4942(j)(3) or 4942(j)(5) for calendar
year 2004 or the taxable year beginning in 2004 (see instructions for Part XIV)9 If "Yes," complete Part XIV
10 Did any persons become substantial contributors during the tax years If "Yes," attach a schedule listing their names and addresses
11 Did the organization comply with the public inspection requirements for its annual returns and exemption applications
Web site address 1
N/A
12 The books are in care of " ROBERTA BUFFETT BIALEK
Located at " P . 0 . BOX 221432, CARMEL, CALIFORNIA
13 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
oi3oaos
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.
.
.
.
720 .
Yes No
1a
1b
X
X
is
X
2
X
3
4a
4b
5
X
X
X
6
7
X
X
8b
X
9
10
~ 11 I X
X
X
Telephone no. " ( 8 31 ) -624-8917
ZIP+4 19 3 9 2 2
10- 1
4
2004 .04000 BERKSHIRE FOUNDATION
13
"0
N/A
Form 990-PF (2004)
04245001
Form 990-PF (2004) ~
Part VII-B
BERKSHIRE FOUNDATION
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
1a During the year did the organization (either directly or indirectly) :
(1) Engage m the sale or exchange, or leasing of property with a disqualified person?
(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
(3) Furnish goods, services, or facilities to (or accept them from) a disqualified persons
(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
(5) Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)?
b
c
2
a
Page s
77-0438710
Yes
NO
F-1 Yes M No
D Yes M No
0 Yes M No
D Yes FXI No
E] Yes
(6) Agree to pay money or property to a government officials (Exception Check "No"
if the organization agreed to make a grant to or to employ the official for a period after
termination of government service, if terminating within 90 days.)
D Yes
If any answer is "Yes" to 1a(1)-(6), did any of the acts fad to qualify under the exceptions described m Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance (see page 20 of the instructions)?
Organizations relying on a current notice regarding disaster assistance check here
Did the organization engage m a prior year in any of the acts described in 1a, other than excepted acts, that were not corrected
before the first day of the tax year beginning in 2004
Taxes on failure to distribute income (section 4942) (does not apply for years the organization was a private operating foundation
defined in section 4942(j)(3) or 4942(j)(5)) :
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
M No
Ell No
N/A
1D
1b
is
before 2004?
D Yes Ef] No
If "Yes," list the years 1
b Are there any years 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 year's undistributed incomes (If applying section 4942(a)(2) to all years listed, answer "No" and attach
statement-see instructions .)
N/A
c If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here .
X
2b
3a Did the organization hold more than a 2% direct or indirect interest in any business enterprise at any time
during the years
E] Yes Eil No
b If "Yes," did it have excess business holdings in 2004 as a result of (1) any purchase by the organization or disqualified persons after
May 26, 1969 ; (2) the lapse of the 5-year period (or longer period approved 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 penod9 (Use Schedule C,
Form 4720, to determine if the organization had excess business holdings in 2004.)
N/A
4a Did the organization invest during the year any amount m a manner that would jeopardize its charitable purposes?
b Did the organization make any investment m a prior year (but after December 31, 1969) that could jeopardize its charitable purpose that
had not been removed from jeopardy before the first day of the tax year beginning in 2004?
5a During the year did the organization pay or incur any amount to:
0 Yes EY] No
(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))9
(2) Influence the outcome of any specific public election (see section 4955); or to carry on, directly or indirectly,
any voter registration drive?
D Yes DO No
D Yes [f] 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
509(a)(1), (2), or (3), or section 4940(d)(2)7
D Yes M No
(5) Provide for any purpose other than religious, charitable, scientific, literary, or educational purposes, or for
the prevention of cruelty to children or animals?
E] Yes Ef] No
b If any answer is "Yes" to 5a(1)-(5), did any of the transactions fail to qualify under the exceptions described in Regulations
section 53 .4945 or in a current notice regarding disaster assistance (see instructions)
N/A
Organizations relying on a current notice regarding disaster assistance check here
1D
c If the answer is "Yes" to question 5a(4), does the organization claim exemption from the tax because it maintained
expenditure responsibility for the grant?
N/A
D Yes D No
If "Yes, " attach the statement required by Regulations section 53 .4945-5(d)
6a Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on
D Yes L11 No
a personal benefit contract?
b Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract's
If you answered "Yes" to 6b, also file Form 8870
3b
4a
X
4b
X
6b
X
Form 990-PF (2004)
423541
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5
2004 .04000 BERKSHIRE FOUNDATION
04245001
BERKSHIRE FOUNDATION
77-0438710
Information
About
Officers,
Directors,
Trustees,
Foundation
Managers,
Highly
Part VIII
0
Paid Employees, and Contractors
1
List all officers, directors, trustees, foundation managers and their compensation .
(b) Title, and average
hours per week devoted
(a) Name and address
to position
ROBERTA BUFFETT BIALEK
PRESIDENT
(c) Compensation
(If not paid,
enter -0-
(dlconcribunonsio
emp sndedefefrtedplans
compensation
Page s
(e) Ex p ense
account, other
allowances
P .O . BOX 221432
ECRETARY/
O
S.
IRECTOR
IRECTOR
2 Compensation of five highest-paid employees (other than those
(a) Name and address of each employee paid more than $50,000
ad on line 1) . If no
(b) Title and average
hours per week
devoted to position
Total number of other employees paid over $50,000
3 Five highest-paid independent contractors for professional services. If none, enter "NONE ."
(a) Name and address of each person paid more than $50,000
~.
enter "NONE."
(c) Compensation
Tvue of service
, ..
!ons
., .
(e) Ex p ense
account, other
allowances
(c) Compensation
Total number of others receiving over $50,000 for professional services
Part IX-A Summary of Direct Charitable Activities
List the foundation's four 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 .
1
Expenses
N/A
2
3
4
01-03-05
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2004 .04000
6
BERKSHIRE FOUNDATION
Form 990-PF (2004)
04245001
Form 990-PF (2004),
77-0438710
BERKSHIRE FOUNDATION
Page ?
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 .
A
1
Amount
0
All other program-related investments . See instructions.
3
Total . Add lines 1 through 3
Part X
Minimum Investment Return (All domestic foundations must complete this part Foreign foundations, see instructions .)
Fair market value of assets not used (or held for use) directly m carrying out charitable, etc., purposes:
is
Average monthly fair market value of securities
1b
Average of monthly cash balances
is
Fair market value of all other assets
id
Total (add lines 1a, b, and c)
Reduction claimed for blockage or other factors reported on lines 1a and
0 .
1c (attach detailed explanation)
1e
2
2 Acquisition indebtedness applicable to line 1 assets
3
3 Subtract line 2 from line 1d
4
4 Cash deemed held for charitable activities . Enter 1 1/2% of line 3 (for greater amount, see instructions)
5
5 Net value of noncharitable-use assets . Subtract line 4 from line 3 . Enter here and on Part V, line 4
~6
6 Minimum investment return . Enter 5% of line 5
DiStt'Ibutable Amount (see instructions) (Section 4942(j)(3) and (1)(5) private operating foundations and certain
Part XI
foreign organizations check here 1 0 and do not complete this part.)
1
a
b
c
d
e
81,586 .
477,514 .
0.
477,514 .
97,163 .
380,351 .
1
Minimum investment return from Part X, line 6
Tax
on investment income for 2004 from Part VI, line 5
2a
2a
Income
tax
for
2004
.
(This
does
not
include
the
tax
from
Part
VI
.)
2b
b
Add
lines
2a
and
2b
c
3 Distnbutable amount before adjustments. Subtract line 2c from line 1
4 Recoveries of amounts treated as qualifying distributions
5 Add lines 3 and 4
6 Deduction from distributable amount (see instructions)
7 Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1
Part XII Qualifying Distributions see instructions)
1
Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes :
a Expenses, contributions, gifts, etc . - total from Part I, column (d), line 26
b Program-related investments - total from Part IX-13
2 Amounts paid to acquire assets used (or held for use) directly m carrying out charitable, etc ., purposes
3 Amounts set aside for specific charitable projects that satisfy the :
a Suitability test (prior IRS approval required)
b Cash distribution test (attach the required schedule)
4 Qualifying distributions . Add lines 1a through 3b . Enter here and on Part V, line S, and Part XIII, line 4
5 Organizations that qualify under section 4940(e) for the reduced rate of tax on net investment
income . Enter 1% of Part I, line 27b
~
6 Adjusted qualifying distributions . Subtract line 5 from line 4
whether
the
The
amount
on
line
6
will
be
used
in
Part
V,
column
(b),
in
subsequent
years
when
calculating
Note :
4940(e) reduction of tax m those years.
1a
1b
2
3a
3b
4
402 , 413 .
0 .
402 , 413 .
3 , 720 .
5
6 ~
398,693 .
foundation qualifies for the section
Form 990-PF (2004)
423561
01-03-OS
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2004 .04000 BERKSHIRE FOUNDATION
04245001
Form 990-PF (2004),
Part XIII
77-0438710
BERKSHIRE FOUNDATION
Undistributed Income see instructions)
(a)
Corpus
1
Distnbutable amount
for 2004 from Part XI, line 7
2
Undistributed income, if any, as of the end of 2003
I
(b)
Years prior to 2003
(c)
2003
0 .
0.
3 Excess distributions carryover, if any, to 2004 :
a From 1999
35 , 443 .
c From 2001
d From 2002
e From 2003
f Total of lines 3a through e
1 459 .
68 , 260 .
78 , 723 .
885 .
4 Qualifying distributions for 2004 from
Part XI I, pine 4: t $
402 , 413 .
a Applied to 2003, but not more than line 2a
0.
b Applied to undistributed income of prior
years (Election required - see instructions)
c Treated as distributions out of corpus
(Election required - see instructions)
d Applied to 2004 distnbutable amount
e Remaining amount distributed out of corpus
5
(d)
2004
315 298 .
a Enter amount for 2003 only
p Total for prior years:
b From 2000
Page 8
0.
315 298 .
0.
Excess distributions carryover applied to 2004
(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 :
1,000 .
$ Corpus Add lines 3f, 4c, and 4e 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(a) 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 mstr .
f 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)
S Excess distributions carryover from 1999
not applied on line 5 or line 7
Excess distributions carryover to 2005
Subtract lines 7 and 8 from line 6a
10 Analysis of line 9 :
a Excess from 2000
b Excess from 2001
1 , 459
c Excess from 2002
68 , 260
d Excess from 2003
78 , 723
e Excess from 2004
87 , 115
0.
0.
0.
0.
0.
0.
443 .
9
.
.
.
.
Form 990-PF (2004)
423571
01-03-OS
12120210 603056 0424500
O
2004 .04000 BERKSHIRE FOUNDATION
04245001
Form 990-PF
Part XIV
1 a If 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 is a p rivate operatin foundation described in
Tax year
2 a Enter the lesser of the adjusted net
(a) 2004
(b) 2003
income from Part I or the minimum
b
c
d
e
3
a
77-0
(see instructions and Part VII-A,
00.
Prior 3 years
(c) 2002
Page 9
or
(d) 2001
(e) Total
investment return from Part X for
each year listed
85% of line 2a
qualifying distributions from Part XI 1,
line 4 for each year listed
Amounts included in line 2c not
used directly for active conduct of
exempt activities
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 4942(j)(3)(B)(i)
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
512(a)(5)), or royalties)
(2) Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(ui)
(3) Largest amount of support from
an exempt organization
f41 Gross investment income
Part XV
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 :
a List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation before the close of any tax
year (but only if they have contributed more than $5,000) . (See section 507(d)(2).)
ROBERTA BUFFETT BIALEK
b List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the ownership of a partnership or
other entity) of which the foundation has a 10% or greater interest.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc ., Programs :
Check here " [XI 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 in which applications should be submitted and information and materials they should include :
c Any submission deadlines:
d Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other factors :
423581/01-03-OS
12120210 603056 0424500
9
2004 .04000 BERKSHIRE FOUNDATION
Form 990-PF (2004)
04245001
Form 990-PF (2004),
BERKSHIRE FOUNDATION
Part XV
Supplementary Information (continued)
3 Grants and Contributions Paid During the Year or Approved for Future Payment
If recipient is an individual,
Recipient
Foundation
show any relationship to
status of
any foundation manager
Name and address (home or business)
recipient
or substantial contributor
a Paid during the year
CARMEL UNIFIED SCHOOL
DISTRICT
CENTER FOR REPRODUCTIVE
LAW AND POLICY
INTERIM,
INC .
MONTEREY SYMPHONY
PACIFIC REPERTORY THEATRE
RISE PROGRAM AT CSUMB
SAN FRANCISCO OPERA
77-0438710
Purpose of grant or
contribution
Page 10
Amount
HILTON BIALEK
BIOLOGICAL
SCIENCES
PROJECT
50,000 .
PUBLIC
CHARITY
ENER.AL
OPERATING
SUPPORT
25,000 .
PUBLIC
HARITY
G ENERAL
PER .ATING
SUPPORT
25,000 .
PUBLIC
CHARITY
GENERAL
OPERATING
SUPPORT
25,000 .
PUBLIC
HARITY
GENERAL
OPERATING
SUPPORT
25,000 .
PUBLIC
CHARITY
GENERAL
OPERATING
SUPPORT
150,000 .
PUBLIC
HARITY
OKTOR FAUST
PROJECT
100,000 .
PUBLIC
CHARITY
Total
" 3a
b Approved for future payment
None
Total
" 3b 1
15560315 603056 0424500
0,
Form 990-PF (2004)
423801/01-03-OS
2004 .05002 BERKSHIRE FOUNDATION
04245001
Form 990-PF (2004)'
Part XVI-A
BERKSHIRE FOUNDATION
77-0438710
Page 1 1
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
1 Program service revenue :
a
b
c
d
e
f
p Fees and contracts from government agencies
2 Membership dues and assessments
3 Interest on savings and temporary cash
txauded o secuon oiz oijor oia
UiuCiaiGU uusuross n1Uuina
(a)
Business
code
(b)
Amount
E~~~_
S'o"
code
Related or exempt
function income
(d)
Amount
investments
4 Dividends and interest from securities
14
136 .
than inventory
9 Net income or (loss) from special events
18
243 , 371 .
5 Net rental income or (loss) from real estate :
a Debt-financed property
b Not debt-financed property
6 Net rental income or (loss) from personal
property
7 Other investment income
8 Gain or (loss) from sales of assets other
10 Gross profit or (loss) from sales of inventory
11 Other revenue:
a
b
c
d
e
12 subtotal. Add columns (b), (d), and (e)
13 Total . Add line 12, columns (b), (d), and (e)
(See worksheet in line 13 instructions to verify calculations .)
Part XVI-B
0 .1
243,507 .
13
0.
243,507 .
Relationship of Activities to the Accomplishment of Exempt Purposes
oi3oaos
12120210 603056 0424500
11
2004 .04000 BERKSHIRE FOUNDATION
Form 990-PF (2004)
04245001
A Form 990-pF (2004) '
77-0438710
BERKSHIRE FOUNDATION
Part XVII
Information Regarding Transfers To and Transactions and Relationships With Noncharitable
Exempt Organizations
1
Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) of
the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
a Transfers from the reporting organization to a noncharitable exempt organization of:
(1) Cash
(2) Other assets
b Other transactions :
(1) Sales of assets to a nonchantable exempt organization
(2) Purchases of assets from a nonchantable exempt organization
Page 12
Yes
X
X
La (2 )
1b 1
1b 2
1b 3
(3) Rental of facilities, equipment, or other assets
1b 4
(4) Reimbursement arrangements
1b 5
(5) Loans or loan guarantees
1b 6
(6) Performance of services or membership or fundraising solicitations
1c
c Sharing of facilities, equipment, mailing lists, other assets, or paid employees
d If the answer to any of the above is "Yes," complete the following schedule . Column (b) should always show the fair market value of the goods, other assets,
or services given by the reporting organization . If the organization received less than fair 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 501(c)(3)) or m section 527
~ Yes
b If "Yes ." complete the following schedule .
Name of organization
(b) Type of organization
(c) Description of relationship
I
I
Under penalties of penury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct,
and complete Declaration of preparer (other than taxpayer or fiduciary) is based on all information of which preparer has any knowledge
d
d
o
y
n
Preparer's '
signature
Firm's name (or yours
if self-employed),
H
address,andZIPCOde 1r
NSON ROTTER GREEN CP
O BOX 4056
423821
01-03-05
12120210 603056 0424500
2004 .04000
NO
X
X
X
X
X
X
X
X
No
2004 DEPRECIATION AND AMORTIZATION REPORT
Form 990-PF Page 1
Asset
No
Description
1 ORGANIZATIONAL COSTS
* Total 990-PF Pg 1
epr & Amort
428102
io-os-oa
Date
Acquired
110696
Method
Life
60M
990-PF
Line
No
43
Unadjusted
Cost Or Basis
Bus %
Excl
Reduction In
Basis
5,461 .
5,461 .
(D) ~ Asset disposed
13
0.
Basis For
Depreciation
Accumulated
Depreciation
5,461 .
5,461 .
5,461 .
5,461 .
Current
Sec 179
Amount Of
Depreciation
0.
0.
* ITC, Section 179, Salvage, Bonus, Commercial Revitalization Deduction
0.
-BERKSHIRE FOUNDATION
I
77-0438710
Gain or
Form 990-PF
(Loss)
from Sale of Assets
Statement
1
(a)
Description of Property
Manner
Acquired
Date
Acquired
Date Sold
4 SHS BERKSHIRE HATHAWAY
Donated
11/06/96
04/26/04
(b)
Gross
Sales Price
(d)
Expense of
(c)
Value at
Time of Acq .
Sale
129,400 .
372,771 .
(e)
(f)
Deprec .
0 .
Gain or Loss
0.
243,371 .
0.
Capital Gains Dividends from Part IV
Total to Form 990-PF,
Form 990-PF
Part I,
243,371 .
line 6a
Interest on Savings and Temporary Cash Investments
Statement
Amount
Source
136 .
WELLS FARGO BANK
Total to Form 990-PF,
Part I,
Form 990-PF
line
3,
136 .
Column A
Statement
Accounting Fees
(a)
Expenses
Per Books
Description
ACCOUNTING
To Form 990-PF,
2
Pg 1,
In 16b
12120210 603056 0424500
(b)
Net Investment Income
(c)
Adjusted
Net Income
3
(d)
Charitable
Purposes
1,450 .
725 .
725 .
1,450 .
725 .
725 .
14
Statement s) 1, 2, 3
2004 .04000 BERKSHIRE FOUNDATION
04245001
77-0438710
.-BERKSHIRE FOUNDATION
I
Form 990-PF
(a)
Expenses
Per Books
Description
To Form 990-PF,
Pg 1,
3,028 .
0.
0 .
(a)
Expenses
Per Books
Statement
(b)
Net Investment Income
1,755 .
12 .
1,688 .
0.
Statement
Book Value
Description
BERKSHIRE HATHAWAY INC
Part II,
line 10b
Cost or
Other Basis
Description
ORGANIZATIONAL COSTS
Part
12120210 603056 0424500
II,
In 14
6
Fair Market
Value
2,296,850 .
6,240,899 .
2,296,850 .
6,240,899 .
Depreciation of Assets Not Held for Investment
Total To Fm 990-PF,
Purposes
1,676 .
12 .
Corporate Stock
Total to Form 990-PF,
(d)
Charitable
(c)
Adjusted
Net Income
0.
12 .
0.
In 23
Form 990-PF
5
1,676 .
24 .
55 .
INSURANCE
MISCELLANEOUS
FILING FEES
To Form 990-PF, Pg 1,
(d)
Charitable
Purposes
0 .
0 .
Other Expenses
Form 990-PF
Form 990-PF
(c)
Adjusted
Net Income
0.
0.
In 18
Description
~
(b)
Net Investment Income
4
28 .
3,000 .
2003 IRS BALANCE DUE
2004 IRS ESTIMATES
~
Statement
Taxes
Accumulated
Depreciation
Statement
7
Book Value
5,461 .
5,461 .
0.
5,461 .
5,461 .
0.
15
Statement s)
2004 .04000 BERKSHIRE FOUNDATION
4, 5, 6, 7
04245001
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