charles koch foundation 480918408 2005 02a51f19searchable
TRANSCRIPT
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 1/34
' Return of Private Foundation
[E~'fENS~
~J
Form990 PF or Section 4947(a)(1) Nonexempt Charitable Trust ~@OS
Departmentt lhe ,easury Treated as a Private Foundation Q
Internal evenueervice Note: The or amzat,on ma tJe'ableto use a of this return to sat,s state re wrements
For calendar year 2005, or tax year beginning __ , 2005, and ending
G Check all that aoolv
I I
mt1al return I IFinal return
I I
Amended return
I I
Address change I IName change
Use the IRS
label.
Name of organization
CHARLES
G.
KOCH CHARITABLE FOUNDATION
A
Employer1denbficationnumber
48-0918408
Otherwise, Number and street (or PO box number 1fma1l1snot delivered to street address)
Room/suite
B
Telephone number see page
10
of
the mstructJons)
rint
or
type.
SeeSpecific P.O. BOX 2256
Instructions. City or town, state, and ZIP code
WICHITA KS 67201-2256
H Check type of organization
lxJ
Section 501(c~ exempt private foundation
n
Section 4947(al(1) nonexemot charitable trust
I I
Other taxable onvate foundation
(316) 828-5552
C
If
exemptionppllcatlons tj
ending,heck ere . • . • . . .....-
0 1. Fore1gnrganizat1ons,heck ere
2
Foreign rganizat1onseetinghe
85o/oest, heck ere ndattach
computat100
• • • • • . • •
E If
private
foundat1a statuswas terminated
D
I Fair market value of all assets at erd
J
Accounting method
LJ
Cash
LxJ
ccrual undersection o?(b)(i)(Al.heck ere
of year (from Part II, col (c), /me D Other (specify) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ F
16) $ 7 6 o12 • 9 3 4 • (Part I, colurm (d) must be on cash basis)
•~••Analysis of Revenue and Expenses
(The total of amounts m columns (b), (c), and
(d) may not necessan/y equal the amounts m
column (a) (see page 11 of the mstruct,ons) )
1
2
Contnbut1ono1fts.rants, tc rece1wdattach chedule)
Ch k ..._ if the foundation1snot required o
ec .....-
attachSch B
(a) Revenue and
expenses per
books
30,020 760.
(bl Net investment
income
3 Interest on savingsand temporary ash nvestments 2 61, 6 71 • 2 61 6 71 •
4 D1v1dendsand interest from secunt1es . • . . 401 7 4 2 • 4 0 1 7 4 2 •
If the foundation IS In a 60-month terminationn
under ection 07(b)(1)(8),heck ere •
(c) AdJusted net
income
(d) Disbursements
for charitable
purposes
(cash basis onlv)
5 a Gross rents . . . • • . • • • • • • • • • . • [- _____ .f_2_14]3l.,.+-____ 12~4[;3L_J.-------JC==:::;;~~~~~~~==+-
REC
~,vr2:a
Net rental incomeor (loss) - 3. 5 8 7
·r-----:-:-:---:-::--::-t---------r---t-,= ;; =; ::~; ;;:===~~f--
6 a Net gam or (loss) from sale of assetsnot on line 10 - 8 4 , 4 7 6 .
(.)
CII
::I
c:
CII
>
CII
a:::
b Gross salespnce or all
assets on ine 6a 15 , 8 3 0, 218 •
7 Capital gain net income (from Part IV, line 2) •
8 Net short-term capital gain
9 Income mod1f1cat1ons • • · • · • ·
.....
.
- -
In
\ \\UV,
, 11 l.UUOJ
'
/)
.
-.
_ ,: ;;
OliU ~N. U
1
O
a Gioss sales ess returns
I
and allowances • • • •
1---------+---------+-----------+----------+----------
b Less Costof goodssold •
l~-------+---------+-----------+----------t---------
UI
c Gross profit or (loss) (attach schedule)
11 Other income (attach schedule) • • •
12 Total. Add Imes 1 throuah 11 • • • .
13 Compensationof officers,directors, rustees,etc
14
:J:15
Other employee salaries and wages • • •
Pension plans, employee benefits . • • .
Legal fees (attach schedule) • • • T -17' •
Accounting fees (attach scheduleJS.T.M;r'.
c:
[ 16a
in b
CII
>
.::;
17,996.
STMT 1
663.656.
17.996.
261 295.
L
843.
NONE
35 541.
5. 720.
NONE 26,537.
35.465.
360.110.
17
18
rsJZ.
19
-
20
{;'II
"C
21
a
22
183.198.
5.575.
23
26,279.
·-
.
'll
24
t
5
26
27
Subtract line 26 from hne 12
)
a Excess of revenue over expenses and disbursements
• .
t---~~~~~~~t----------+---------+--------
b Net investment income (1f negative, enter -0-)
c Adjusted net income (1f neaallve, enter -0-) ••
620 513.
For Privacy Act and Paperwork Reduction Act Notice, see the instructions.
* *
STMT 5
16733H K932 11/15/2006 14:39:08 V05-8 85646
17.996.
Form
990-PF
(200
3
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 2/34
---
Form 990-PF120051 48-0918408
Page
2
:: :Tillllalance Sheets
Attached schedules nd amounts n the
Beammna of vear
End of vear
descriptioncolumnshouldbe or
lal Book Value
lbl Book Value
lcl Fair Marl<etValuend-of-vear mountsonlv See nstructJons
1
Cash - non-mterest-beanng .
..
2
'Savings and temporary cash investments •
16
649 731. 30.995.569.
30
995 569.
3
Accounts receivable .... ________________ 8 6 L007.
Less
allowance for doubtful accounts ....
47.697.
86.007.
86.007.
-------------
4
Pledges receivable
....
------------------------
Less
allowance for doubtful accounts ....
-------------
5
Grants receivable
..
6
Receivables due from officers, directors, trustees, and other
d1squahf1ed ersons (attach schedule) seepage 15
of
the 1nstruct1ons)
7
Other notes and loans receivable (attach schedule) .... _____
less allowance for doubtful accounts "'
-------------
ll
8
Inventories for sale or use
..
...
9
Prepaid expenses and deferred charges . 30,544. 2 438.
2.438.
ll
ll
1 O
a
Investments US and stategovernment bhgabonsattach chedule)*~ NONE
12.500.000.
12
566.775.
<
b Investments - corporate stock (attach schedule) •
c
Investments - corporate bonds (attach schedule)
11
Investments land, buildings,
and equipment basis
.... ________ 3L377L694.
Less accumulated eprec1abon...
(attachschedule) - - - - - - - - - - - - - - - - - - -
3.377.694. 3.377.694. 5.070.000.
12
Investments - mortgage loans
13
Investments - other (attach schedule) .
. STMT. .8.
26.449.078. 25 471.589. 26.937.145.
14
Land.buildings, nd
....
quipment basis
Less accumulated eprec1at1on...
(attachschedule) - - - - - - - - - - - - - - - - - - - -
15
Other assets (descnbe
.... _____________ STMT_9_)
355
000.
355 000.
355.000.
16
Total assets (to be completed by all filers - see page
16
of
the instructions Also see oaae
1
1temll
46 909
744.
72
788 297. 76.012.934.
17
Accounts payable and accrued expenses
52 353. 84.016.
18
Grants payable
. .
..
1 185 000.
25.000.
ll
19
Deferred revenue
a
..
20
Loans rom officers, directors,rustees, nd otherd1squahfiedersons
21
Mortgages and other notes payable (attach schedule) .
. .
:J 22
Other hab1ht1esdescnbe
....------------------)
23
Total liabilities ladd Imes
17
throuah 221 · 1
237
353. 109 016.
Organizations that follow SFAS
117
check here"'
lx.J
and complete lines 24 through
26
and lines
30
and
31.
ll
45 672 391. 72.679 281.
24
Unrestricted •
. .
; 25
Temporarily restncted
..
26
Permanently restncted • •
..
"tl
Organizations that do not follow SFAS
117
:
....
:::I
check here and complete lines
27
through
31.
..
c5 7
Capital stock, trust principal, or current funds •
28
a
Paid-in or capitalsurplus, r and,bldg and equipmentund
..
::l
29
Retainedearnings, accumulatedncome, ndowment, r other unds •
30
Total net assets or fund balances (see page
17
of the
a
z
instructions) •
.. . .
45 672 391. 72.679.281.
31
Total liabilities and net assets/fund balances (see page 17 of
the instructions) ·
. . . .
46 909
744 • 72,788 297.
@
nalysis of Changes in Net Assets or Fund Balances
1 Total net assets or fund balances at beginning of year - Part II, column (a), line 30 (must agree with
end-of-year figure reported on prior year's return) .
1
45. 672, 391.
2
Enter amount from Part I, line 27a
..
2 27,006,890.
3
Other increases not included 1n ine 2 (1tem1ze) "'-------------------------------------
3
4
Add lines 1, 2, and 3
..
4
72 679.281.
5
Decreases not included in line 2 (1tem1ze) '-- ______________________ ----------------
5
6
Total net assets or fund balances at end of ~ear (line 4 minus line 5) - Part II column {b}. line 30 .
..
6
72
679
281.
**STMT 7
Form990-PF (200
JSA
SE 1420 1 000
16733H K932 11/15/2006 14:39:08 V05-8
85646
4
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 3/34
Form 990-PF (2005)
48-0918408
Page
3
·~1-·ll-
apital Gains and Losses for Tax on Investment Income
(a) List and describe the kmd(s) of propertysold (e g , real estate,
(b) How
(c) Date
~d) Date sold
cquired
acquired
P-Purttlase
mo, day, yr)
2-story brick warehouse. or commonstock, 200 shs MLC Co)
0-Donation
(mo , day, yr)
1a
SEE PART
IV
SCHEDULE
b
c
d
e
(e) Gross sales price
(f)
Depreciation allowed
(g) Cost or other basis
(h) Gain or (loss)
(or allowable) plus expenseof sale (e) plus f) minus (g)
a
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(I) Gains (Col (h) gain minus
(i)F M.V as of 12/31/69
U)AdJustedbasis
(kl Excess
of
col 1)
col (k), but not less than -0-) or
as of 12/31/69 over col ~). ,f any
Losses from col (h})
a
b
c
d
e
2
Capital gain net income or (net capital loss)
{
If gain, also enter in Part I, line 7
}
....
If (loss). enter -0- 1nPart I, line 7 2
-84,477.
3
Net short-term capital gain or (loss) as defined 1nsections 1222(5) an::I 6)
If gain, also enter in Part I, line 8, column (c) (see pages 13 and 17 of the 1nstruct1ons)
}
If (loss), enter -0- 1nPart I, line 8 ..............................
...
3
1:r.1••·- Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income)
If section 4940(d)(2) applies, leave this part blank
Was the organization liable for the section 4942 tax on the distributable amount of any year 1n he base perod?. . . .
D
Yes~ No
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 page 18 of the instructions before making any entries
(a)
(b) (c)
(d)
Base penod years Calendar year
D1stnbut1on ratio
(or tax year beginning in)
AdJusted qualifying d1stnbut1ons
Net value of nonchantable-use assets
(col (bl divided by col (cl)
2004
2.985.334. 33.959
784.
0.08790792073
2003
3.283.430. 25.930.498.
0.12662425535
2002
3.313
808. 28. 571 232.
0 .11598407797
2001
4 296 259.
27.673
813.
0.15524636956
2000
5.028
478.
33.847 015.
0.14856488822
2
Total of line 1, column (d)
. . . . . . . . . .
. . .
.
. . . . . .
. .
. .
. .
. .
.
.
. . . . .
..
2
0.63432751183
3
Average d1stribut1on ratio for the 5-year base period - d1v1de he total on line 2 by 5, or by
the number of years the foundation has been in existence 1f ess than 5 years
. . . . . . . ..
3
0.12686550237
4
Enter the net value of noncharitable-use assets for 2005 from Part X, line 5
4
47.843.504.
..........
5 Multiply line 4 by line 3
5
6
069.690.
. . . . . . . . . . . . . . . . . . . ...................
6
Enter 1% of net investment income (1% of Part I, hne 27b)
...................
6
6
205.
7 Add Imes 5 and 6 7
6
075 895.
.................
8 Enter qualifying d1stribut1ons from Part XII, line 4.
8 4 64 6
986.
If line 8 1s equal to or greater than line 7, check the box 1n Part VI, hne 1b, and complete that part using a 1% tax rate See the Part VI instructions on page 18
1 000
Form
990-PF
(2005
56733H K932 11/15/2006 14:39:08 V05-8 85646
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 4/34
JSA
Form 990-PF (2005) 4 8-0 918 4 0 8 Page 4
• II Excise Tax Based on Investment Income (Section 4940(a), 49401b , 4940(e), or 4948 - see paQe 18 of the instructions)
Date of ruling letter: _________ (attach copy of ruling letter if necessary- see instructions) .
1 a Exempt opf raMg foundabons descnbed in secbon 4940(d)(2), check here .....
LJ
and enter "N/A" on line 1 . }
b Domestic orgamzat1ons that meet the section 4940(e) requirements in Part V, check 1 12 41 O
here ..,.. D and enter 1 % of Part I, line 27b • • . . . • • • • • • • • • . • . . . . . . . • . . .•.•
c All other domestic orgamzabons enter 2% of line 27b Exempt foreign organizations enter 4% of Part I, hne 12. col (b)
2 Tax under section 511 (domestic section 494 7(a)(1) trusts and taxable foundations only Others enter -0-)
3 Add Imes 1 and 2
4
5
6
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only Others enter -0-)
Tax based on investment income. Subtract line 4 from line 3 If zero or less, enter
-O
Cred1ts/Payments
a 2005 estimated tax payments and 2004 overpayment credited to 2005
b Exempt foreign orgamzat1ons - tax withheld at source • • • • • .
Sa 14 848.
Sb NONE
c Tax paid with application for extension of time to file (Form 8868).
Sc
NONE
d Backup withholding erroneously withheld • • • . • • • • • • . .
6d
2
3
4
5
7
8
7
8
9
Total credits and payments Add Imes 6a through 6d . • • • . ••. - . • • .•••
Enter any penalty for underpayment of estimated tax Check here D 1f Form 2220 1s attached
Tax due. If the total of Imes 5 and 8 1s more than line 7, enter amount owed •••••
..... 9
12 410.
NON
12 410.
14.848.
1o Overpayment If line 7 1s more than the total of Imes 5 and 8, enter the amount overpaid ..,..,__1_0-+______ 2_~,4_3
11 Enter the amount of line 10 to be Credited to 2006 estimated tax..,.. 2 4 38. Refunded..... 11
• • Statements ReQardinQ Activities
Yes No
a During the tax year, did the orgamzat1on attempt to influence any national, state, or local leg1slat1on r did
11part1c1pateor intervene in any political campaign? • • . • • • • • • • • • • • • • • • • • • . ••.•
b Did 11 pend more than $100 during the year (either directly or indirectly) for poht1calpurposes (see page
19 of the instructions for definition)? • • • • • • . • • • • • • • • • • • • • • • • • • • • • • • . . .
• . . . • . . . . . . l---'1-"a'--+---1---"x'
• . . . . . . . _ . t-'-1""-b-+----1-=x'-
If the answer is Yes to 1a or 1b, attach a detailed description of the activities and ccp1es of any matenals
publtshed or
d1stnbuted by the organization m connection with the act1vtt1es
c Did the orgamzat1on file Form 1120-POL for this year? ••..••••••• .........•
d Enter the amount (1f any) of tax on political expenditures (section 4955) imposed dunng the year
. . . • • • • • . • • • • • • ,__1_c-+---+-~x'-
(1) On the organization ..... (2) On orgarnzabon managers .....
__________ _
e Enter the reimbursement (1f any) paid by the orgamzat1on during the year for poht1calexpenditure tax imposed
on orgamzat1on managers ..,.. $ _________ _
2 Has the orgamzat1on engaged in any act1v1t1eshat have not preV1ously een reported to the IRS? • • • . . •
If "Yes," attach a detailed descnpt1on of the acttv1ttes
3 Has the orgamzat1on made any changes, not previously reported to the IRS, in its governing instrument, articles
of mcorporat1on, 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 dunng the year?
b If "Yes," has 11iled a tax return on Form 990-T for this year? •...•........••
s Was there a liqu1dat1on, ermination, d1ssolullon, or substantial contraction dunng the year? ..
If "Yes," attach the statement requ,red 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 leg1slat1on hat effectively amends the governing instrument so that no mandatory d1rect1ons
that conflict with the state law remain in the governing instrument? • • • • • • • . • • • • • • . • . . . . . • • . . •
7
Did the orgamzat1on have at least $5,000 in assets at any time dunng the year? lf Yes, complete Part II, col (c), and Part XV
Sa Enter the states to which the foundation reports or with which 111s egistered (see page 19 of the
instructions) ..,.. DC, KS, __________________________ ------------- _____ -----------------
b If the answer 1s "Yes" to line
7,
has the orgamzat1on urnished a copy of Form 990-PF to the Attorney
2 x
3 x
4a x
4b N/A
5
x
6
x
7
x
x
eneral (or designate) of each state as required by
General Instruction
G? If
No, attach explanation
•...•
Sb
......... ,-.....c
9 Is the organization claiming status as a private operating foundation w1th1n he meaning of section 4942(])(3)
or 4942(])(5) for calendar year 2005 or the taxable year beginning in 2005 (see 1nstruct1ons or Part XIV on
page 26)? If "Yes," complete Part XIV . . . . • • • • . • . • • • • • • • • • • • • • • • • • . . • • • . •
1 0 Did any persons become substantial contributors dunng the tax year? If Yes,· at tach a schedule hstmg the,r names and addresses
11 Did the orgamzat1on comply with the public inspection requirements for its annual returns and exemption apphcat1on? ...
9
10
11
x
x
x
Web site address ..... ----WWW. CGKFOUNDATION. ORG -------------------------------------------------
12
The books are in care of ..,.. _ VONDA HOLLIMAN ----------------------- Telephone no ..,.. _ J 3161828-5552 ______
13
Located at ..... 4111 _E. _37TH_ST. _N. _vHCHITA_,_ KS ----------------- ZIP+4 ..... 67220 ________________
0
ection 4947(a)(1) nonexempt charitable trusts fihng Form 990-PF in lieu of Form 1041 • Check here ••....... N/A ....... ..,..
and enter the amount of tax-exempt interest received or accrued dunng the year . . . . . . . . . . • • ..,.. 13 I
Form 990-PF (2005
5E1440 1 000
16733H K932 11/15/2006 14:39:08 VOS-8 85646 6
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 5/34
Form 990-PF
2005)
48-0918408
·~··••.m11:•tatements Regarding Activities for Which Form 4720 May Be Required
File For:'jl'l 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)
(1i Engage in 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 1t rom)
a disqualified person? . . . . . . . . . . • • • . • • • . • . . . • . . . . . . .
(3) Furnish goods, services, or fac11it1eso (or accept them from) a disqualified person?
(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ..
(5) Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)? • • • • • • • • • • • • • • • • • • . .
(6)
Agree to pay money or property to a government official? (Exception. Check No
0Yes
~
Yes
Yes
Yes
DYes
Ci]
No
§
No
No
No
Ci]
No
1f he organization agreed to make a grant to or to employ the official for a period
after termination of government service, 1f erminating within 90 days ) . . . • . . . • • • • • • D Yes
Ci]
No
b
If any answer 1s
'Yes
to 1a(l )-(6), did any of the acts fail to qualify under the exceptions descnbed 1nRegulations
section 53 4941 (d)-3 or in a current notice regarding disaster assistance (see page 20 of the instructions)?. ·. ·.: ·
o· ·
Organizations relying on a current notice regarding disaster assistance check here . . . . . . • • . •
c Did the organization engage in a prior year in any of the acts descnbed 1n1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2005? . . . . . • • • • • • • • •
2 Taxes on failure to distribute income (section 4942) (does not apply for years the organization was a private
operating
foundation defined in section 4942(1)(3) or 4942(1)(5))
a At the end of tax year 2005, did the organization have any undistributed income (Imes 6d D
and 6e, Part XIII) for tax year(s) beginning before 2005? • • • • • • . • • • • • • • • • • • • • • • Yes
lf Yes, listtheyears ---------- ·--------- ·--------- ·---------
b Are there any years listed in 2a for which the organization 1snot applying the prov1s1onsof section 4942(a)(2)
(relating to incorrect valuation of assets) to the year's und1stnbuted ncome? (If applying section 4942(a)(2)
to all years listed, answer No and attach statement - see page 20 of the instructions) . . • • • • • • •
c If the prov1s1onsof section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here
----------
·--------- ·--------- ·---------
3a Did the organization hold more than a 2% direct or indirect interest in any business D
enterprise at any time dunng the year? . • • • . • • . • • . • • • • • • . • • • • • • • • . . . . • Yes
b If ''Yes, did 1t have excess business holdings in 2005 as a result of (1) any purchase by the organization
or d1squahf1edpersons after May 26, 1969, (2) the lapse of the 5-year period (or longer penod approved
by the Comm1ss1onerunder section 4943(c)(7)) to dispose of holdings acquired by gift or bequest, or (3)
the lapse of the 10-, 15-, or 20-year first phase holding period?
(Use Schedule
C,
Form 4720, to determine
if the organization had excess business hddings in 2005) . . . . . . . . . • . . . . . • • • • • • . .
Ci]
No
Ci]
No
4a Did the organization invest during the year any amount in a manner that would Jeopardize ts charitable purposes? • • • . .
b Did the organization make any investment in a prior year (but after December 31, 1969) that could Jeopardize ts chantable
purpose that had not been removed from Jeopardy before the first day of the tax year beginning 1n2005? • • • •
Sa During the year did the organization pay or incur any amount to
(1) Carry on propaganda, or otherwise attempt to influence leg1slat1onsection 4945(e))?
(2) Influence the outcome of any spec1f1cpublic election (see section 4955), or to carry
on, directly or indirectly, any voter reg1strat1on nve? ••••••••••••••.•
(3) Provide a grant to an md1v1dualor travel, study, or other similar purposes? • • • . .
(4) Provide a grant to an organization other than a charitable, etc, organization descnbed
in section 509(a)(1), (2), or (3), or section 4940(d)(2)? ...............•
0Yes
0Yes
0Yes
Ci]
Yes
Ci]
No
~No
0No
(5) Provide for any purpose other than rehg1ous,chantable, sc1ent1fic,iterary, or
educational purposes, or for the prevention of cruelty to children or animals? • • . . • . • • • • D Yes
Ci]
No
b If any answer 1s 'Yes to 5a(1 -(5), did any of the transactions fail to qualify under the exceptions descnbed 1n
Page5
Yes No
1b
x
1c
x
2b
NIA
3b
NIA
4a
x
4b
x
Regulations section 53 4945 or in a current notice regarding disaster assistance (see page 20 of the instructions)? • · · · · · · 5 b X
Organizations relying on a current notice regarding disaster assistance check here • . . . . • • • • • • • • • D
c If the answer 1s Yes to question 5a(4), does the organization claim exemption from the
tax because 1t maintained expenditure respons1b11ityor the grant?
?lj:F; .S.Tf,.TF;t1E.N'.['.O. . • .
CiJes D No
If Yes, attach the statement requ,red by Regulations sect1ex1 3 4945-5(d)
Sa Did the organ1zat1on,during the year, receive any funds, directly or indirectly, to pay
premiums on a personal benefit contract? . . . . • . • . . . . . . . . • . . . . . . • • • • • • • D Yes
b Did the organization, during the year, pay premiums, directly or 1nd1rectly, n a personal benefit contract? .•••
If you answered ''Yes to 6b, also file Form 8870
1 000
16733H K932 11/15/2006 14:39:08 V05-8
85646
Ci]
No
Sb
x
Form 990-PF 2005)
7
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 6/34
Form 990-PF (2005)
48-0918408
Page 6
i:ifil'1hi Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
---·-··- .ind Contractors
1
List all officers, directors, trustees, foundation managers and their compensation (see page
21
of the instructions).
(a) Name and address
(b) Title, and average
(c) Compensation
(d) Contnbu~ons to
(e) Expense account,
hours per week
(If not paid, enter employee benefit plans
other allowances
devoted to oos1t1on
-0-1
and deferred comoensa~on
SEE ATTACHMENT C ------------------- _
261. 295. NONE NONE
--------------------------------------
--------------------------------------
--------------------------------------
2 Compensation of five highest-paid employees (other than those included on line
1 -
see page
21
of the instructions).
If none, enter "NONE."
(a) Name and address of each employee paid more than $50,000
NONE
(b) Title and average
hours per week
devoted to posrt1on
(c) Compensation
(d) Contnbut1ons to
employee benefit
plans and deferred
com pensat1on
(e) Expense account,
other allowances
Total number of other employees paid over
50,000 .......................................
I
NONE
3 Five highest-paid independent contractors for professional services - (see page
21
of the instructions). If none, enter
"NONE."
(a) Name and address of each person paid more than $50,000 (b) Type of seMce
(c) Compensation
KOCH INDUSTRIES~_INC. ______________________________ _
P.O. BOX 2256 WICHITA, KS 67201 MANAGEMENT ERVICES 263.151.
-----------------------------------------------------
-----------------------------------------------------
-----------------------------------------------------
-----------------------------------------------------
Total number of others rece1v1ngover
50,000
for professional services ....................... ...... I
NONE
•ifil f4iummary of Direct Charitable Activities
List the foundation's four largest direct charitable act1VJt1esunng the tax year Include relevant sta Jst1cal nfonnallon such as the number
of organ1zat1ons and other benefic1anes served, conferences convened, research papers produced, etc
1_DURING_2005L_THE_FOUNDATION_CONDUCTED AN EDUCATIONAL ____________________ _
_ CONFERENCE_FOCUSING_ON_PHILANTHROPIC GIVING.------------------------------
2
3
4
16733H K932 11/15/2006 14:39:08 V05-8 85646
Expenses
145.831.
Form
990-PF
(2005)
8
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 7/34
48-0918408
-=•
Summary of Program-Related Investments (see page 22 of the instructions)
Describe the two largest program-related investments made by the foundation dunng the tax year on hnes 1 and 2
All other program-related investments See page 22 of the ,nstructrons
Add Imes 1 through 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Minimum Investment Return All domestic foundations must complete this part. Foreign foundations,
see page 22 of the instructions )
Fair market value of assets not used (or held for use) directly 1n arrying out charitable, etc.
purposes
a
Average monthly fair market value of secunt1es
1a
............
b
Average of monthly cash balances_ ...................
1b
c
Fair market value of all other assets (see page 23 of the 1nstruct1ons)
1c
d
Total (add lines 1a, b, ard c) ........................
1d
e Reduction claimed for blockage or other factors reported on lines 1a ard
1c ( attach detailed explanation) . . . . . . . . . . . . . . . . . . . . .
I
1 e
I
Acqu1s1t1onndebtedness applicable to line 1 assets
2
. . . ...................
Subtract line 2 from line 1d 3
.........................................
Cash deemed held for charitable actMt1es Enter 1
112
of line 3 (for greater amount, see page 23
of the instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .....
4
Net value of noncharitable-use assets. Subtract line 4 from line 3 Enter here and on Part V, line 4
5
..
Minimum investment return. Enter 5 of line 5 ..............................
6
Distributable Amount (see page
23
of the instructions) (Section 4942{])(3) and (J)(5) private operatng
~n
oundations and certain foreign organizations check here
and do not complete this part)
Minimum investment return from Part X, line 6 . . . . .............
. . . .
.
. . . ......
1
Tax on investment income for 2005 from Part VI, line 5
. . . . . . . .
I 2a I
12.410 .
b
Income tax for 2005
(This does not include the tax from Part VI) ...
I
2b
I
c Add Imes 2a and 2b 2c
.
. . . . . . . . . . . . . . . . . . . . . . . . . . . .
.
.
. .............
Distributable amount before adjustments Subtract line 2c from line 1
. . . . . .
. .
. .
.
. . . .
3
Recoveries of amounts treated as qualifying d1Stribut1ons
........................
4
Add Imes 3 and 4
5
..............................................
Deduction from distributable amount (see page 24 of the instructions) ..................
6
Distributable amount as adjusted Subtract line 6 from line 5 Enter here ard on Part XIII,
line 1
.....................................................
7
ualifying Distributions (see page
24
of the instructions)
Amounts paid (including adm1nistrat1ve xpenses) to accomplish charitable, etc. purposes
a
Expenses, contributions, gifts, etc - total from Part I, column (d), line 26 ...........
1a
b Program-related investments - total from Part IX-8
1b
.......................
Amounts paid to acquire assets used (or held for use) directly 1ncarrying out charitable, etc.
purposes ...............................
2
.
. .
. . . . . . . . . . . .
.....
Amounts set
aside for spec1f1c haritable projects that satJSfyhe
a Su1tab11ityest (prior IRS approval required) 3a
............................ . . . .
b Cash d1stribut1onest (attach the required sct'edule) 3b
.......................
Qualifying distributions.Add Imes
1
a through
3b
Enter here andon Part
V,
hne
8,
and PartXIII, hne
.. . . . .
4
Organizations that qualify under section 4940(e) for the reduced rate of tax on net investment
income Enter 1 of Part I, line 27b (see page 24 of the 1nstruct1ons)
5
. . . . . . . ..
Adjusted qualifying distributions. Subtract line 5 from line 4
6
. . . .
. . . . . ... ..
Page
Amount
36,404.363.
7.097.722.
5
070.000.
48 572.085.
NON
48 572.085.
728
581.
47
843.504.
2 392.175.
2.392
175.
12 410.
2.379 765
2.379 765.
2.379 765.
4 646 986.
NON
NON
NON
NON
4
646.986.
NIA
4
646.986.
Note:
The amount on f,ne 6 will be used ,n Part V, colurm b), ,n subsequent years vhen ca/cu/at,ng w,ether the foundation
quaflfles for the section 4940 e) reduction of tax ,n those years
Form 990-PF (200
1 000
16733H K932 11/15/2006 14:39:08 V05-8
85646
9
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 8/34
Form 990-PF (2005)
48-0918408
1: ffll3jj1ndistributed Income (see page 24 of the instructions)
(a)
(b)
(c)
1
Distributable amount for 2005 from Part XI,
Corpus
Years pnor to 2004
2004
line 7
. . . . .
.
. .
.
. . . .
.......
2
Und,stnbuted income, 1f any, as of the end of 2004
a
Enter amount for 2004 only
.........
b
Total for pnor years
2003
3
Excess distnbut1ons carryover, 1f any, to 2005
a
From 2000 3.380.679.
b
From 2001
2.919
590.
c
From 2002
1.893.383.
d
From 2003
1. 991 823.
e
From 2004
1.297.997.
f
Total of Imes 3a through e
. . .........
4 Qualifying d1stnbut1ons for 2005 from Part
XII, hne4
4,646,986_
a
Applied to 2004, but not more than line 2a • • .
b
Applied to und1stnbuted income of pnor years
(Election required - see page 25 of the mstruct,ons)
..
c Treated as d1stnbut1ons out of corpus (Election
required - see page 25 of the instructions)
d
Applied to 2005 d1stnbutable amount. • . • • •
e
Remaining amount d1stnbuted out of corpus
..
5
Excess d1stnbut1ons carryover applied to 2005
If an amount appears m column d), the
same amount must be shown m column a))
6
Enter the net total of each column as
indicated below:
a
Corpus Add Imes 3f, 4c, and 4e Subtract line 5
b
Pnor years und1stnbuted income Subtract
line 4b from line 2b
..............
c
Enter the amount of pnor years und1stnbuted
income for which a notice of def1c1ency has
been issued, or on which the section 4942(a)
tax has been previously assessed • • • . . . . .
d
Subtract
line 6c from
line
6b Taxable
amount - see page 25 of the instructions
....
e
Und,stnbuted
income for 2004
Subtract line
4a from line
2a
Taxable
amount -
see
page
25 of the instructions
...............
f
Und1stnbuted
income for 2005 Subtract
Imes 4d and 5 from line 1 This amount must
be d1stnbuted 1n 2006
.............
7 Amounts treated
as
d1stnbut1ons
out of
corpus
to satisfy requirements imposed by
section 170(b)(1 )(E) or 4942(g)(3) (see page
25 of the instructions) . • . • • . • • • • • ••
8 Excess d1stnbullons carryover from 2000 not
applied on line 5 or line 7 (see page 25 of
the instructions) . . . . . • . • . • . . • • ••
9
Excess distributions carryover to 2006.
Subtract Imes 7 and 8 from hne 6a
......
0
Analysis of line 9
a
Excess from 2001
2 919.590.
b
Excess from 2002
1 893.383.
c
Excess from 2003
1. 991. 823.
d
Excess from 2004
1
297.997.
e
Excess from 2005
2.267.221.
JSA
5E14801000
11 483 472.
2.267.221.
13
750
693.
3.380
679.
10.370.014.
16733H K932 11/15/2006 14:39:08 V05-8
85646
NONE
NONE
NONE
Page 8
(d)
2005
2 379 765.
NONE
NONE
2.379.765.
NONE
Form
990-PF
(2005
10
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 9/34
.
Form 990-PF (2005)
48-0918408
Page9
-~ ..... ~41111. •
Private Operating Foundations (see page 26 of the 1nstruct1ons nd Part VII-A, question 9)
NOT
APPLICABL
1a If the fouf\dat1on has received a ruling or determination letter that 11 sa pnvate operating
foundation, and the ruling 1seffective for 2005, enter the date of the ruling
-
.
b
Check box to indicate whether the orgamzat1on 1s a private operating foundation described in section
I
4942(J)(3) or
I
I
4942(J)(5)
2a
Enter the lesser of
the
Tax year
Prior 3 years
(e) Total
adJusted net income from
(a) 2005 (b) 2004 (c) 2003 (d) 2002
Part
I
or the
minimum
investment return from Part
X
for each year hsted •
b
85% of line 2a
c
Qualifying d1stnbut1onsrom Part
XII, line 4 for each year listed
d
Amounts induded 1nme 2c not
used directly for act,w conduct
of exempt act1\aUes
e
Qualifying
d1stnbuUons made
directly for active conduct of
exempt
act1V1tles
Subtract
line 2d from line 2c.
3
Complete 3a. b, or c for the
alternat,w test relied upon
a
Assets• altemauve est - enter
(1)
Value of all assets
..
( 2)
Value of assets qualifying
under section
49420)(3)(8)(1).
b
Endowment alternative test-
enter 2/3 of m,n,mum ,nwst-
ment return shown in Part
X.
line 6 for each year listed
c
Support• allemauve test - enter
(1)
Total support other than
gross
investment income
(interest, d1\adends, rents.
payments on secunues
loans
(seelion 512(a)(5)),
or royalues)
..
(2)
Support
from general
public and
5
or more
exempt organizations as
prov,ded in secuon 4942
OX3)(B)(111)
(3)
Largest amount
of sup-
port from an exempt
erg an 1zat100
14
Gross investment ncome •
•:.r.
1.1111119_... ~-
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% of the total contributions received by the foundatio
before the close of any tax year (but only 1f hey have contributed more than $5,000) (See secton 507(d)(2))
CHARLES G. KOCH
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of t
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
NONE
2 Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here~
D
1f the organization only makes contributions to preselected charitable organizations and does not acce
unsolicited requests for funds If the organization makes gifts, grants, etc (see page26 of the instructions) to 1nd1v1duals
organizations under other cond1t1ons, omplete items 2a, b, c, ard d
a
The name, address, and telephone number of the person to whom apphcat1ons hould be addressed
SEE STATEMENT
11
b
The form in which applications should be submitted and information and materials they should include
SEE STATEMENT
12
c Any subm1ss1on eadlines
NONE
d Any restrictions or llm1tat1ons on awards, such as by geographical areas, charitable fields, kinds of 1nst1tut1ons, r oth
factors
SEE ATTACHMENTD
JSA
SE 1490 1 000
16733H K932 11/15/2006 14:39:08 V05-8
85646
Fonm
990-PF
(2005)
11
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 10/34
Form 990-PF 2005) 4 8-0 918 4 08 Page
10
1@f: fj Supplementary Information continued)
3 Grants and Contributions Paid During the Year or Approved for Future Payment
Rec1p1ent
If ree1p1ent S an indMdUal,
Foundauon
Purpose of grant orhow any relat,onsh1po
status of
Amount
Name and address tome or business)
any foundat,onmanager
rec,p,ent
contnbuuon
or substantial contnbutor
a
Paid dunng the year
SEE
ATTACHMENT E 3 785 950.
Total .
..,..3a
3.785.950.
b
pproved for future payrrent
SEE ATTACHMENT E 25 000.
Total .
....
3b
25
000.
Form
990-PF
2005)
000
16733H K932 11/15/2006 14:39:08 V05-8 85646 2
---------
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 11/34
Form 990-PF (2005)
l::r.,~-.,•Jil f•W
Analysis of Income-Producing Activities
Enter gross amounts unless otherw1se ndicated Unrelated business income
.
(a)
Business
1 Program service revenue
code
a PROG. REL. INVSTMT
b
c
d
e
f
g
Fees and contracts from government agencies
2 Membership dues and assessments . • • • •
3 Interest on savings and temporary cash investments
4 D1v1dends nd interest from secunt1es
...
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 than inventory
9 Net income or (loss) from speoal events ••
1 O
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 hne
12,
columns (b), (d), and (e) •.....•.•••••
(See worksheet in line
13
instructions on page 27 to venfy calculations )
(b)
Amount
48-0918408
Excluded b1
section
512, 513,
or
514
(c)
d)
ExcluJ1on
co e
Amount
14 261 671.
14 401,742.
16
-3,587.
18
-84 4 76.
575.350.
l::r.,~•A•JI
:•
Relationship of Activities to the Accomplishment of Exempt Purposes
Page 1
(e)
Related or exempt
function income
~ee page
26
of
t e instructions )
17.996.
17
996.
Line No.
Explain below how each act1v1ty or which income 1s reported in column (e) of Part XVI-A contributed importantly t
the accomplishment of the organization s exempt purposes (other than by providing funds for such purposes)
(Se
...
page
27
of the instructions )
lA INCOME FROM LOAN MADE FOR PURPOSE OF PRODUCING AN
EDUCATIONAL IMAX FILM
Fenn 990-PF (20
1492 1 000
16733H K932 11/15/2006 14:39:08 V05-8
85646
13
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 12/34
SA
2005 4 8 - 0 91 8 4 0 8 Page 1 2
Information Regarding Transfers To and Transactions and Relationships With Noncharitable
Ex
O
mpt
raanizat1ons
1 Did the organization directly or indirectly engage in any of the following with any other organization descnbed in section
Yes
No
50'1 c) of the Code (other than section 501 (c)(3) organizations) or in section 527, relating to polil1calorganizations?
a Transfers from the reporting organization to a nonchantable exempt organization of
(1)
Cash .
1a(1l
x
(2) Other assets
..
1al21
x
b
Other transactions
(1)
Sales of assets to a noncharitable exempt organization
1bl11
x
(2)
Purchases of assets from a nonchantable exempt organization
1b(2)
x
(3)
Rental of facilities, equipment, or other assets
1b(31
x
(4) Reimbursement arrangements .
1b(4)
x
(5)
Loans or loan guarantees
1bl51
x
(6)
Performance of services or membership or fundra1sing sohc1tat1ons
1b(61
x
c
Sharing of fac11it1es, quipment, mailing hsts, other assets, or paid employees
1c
x
d If the answer to any of the above 1s '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) the value of the goods, other assets, or services
received
(a) Line no
(b) Amount involved (c) Name of nonchantable exempt organization
(d) Description of transfers. transactions, and shanng arrangements
NIA NIA
2 a 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 527? ••••••••••••••••.. 0 Yes [iJ No
b
I f
I h I
Yes, complete the o lowinQsc edu e
(a) Name of organization
(b) Type of organization (c) Description of relabonsh1p
Under penalties of periury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge an
belief, 1t 1s rue, correct, and complete Declaration of preparer (other than taxpayer or fiduciary) 1sbased on all information of which preparer has any knowledge
o ~~
I
lf-15-o
Trt:.fJ..S..rJ.t:.er
Q)
Signature of officer or trustee Date
Title
...
Q)
Date
Preparer's SSN or PTIN
:::c
Check1f
O
f;.ljfa
(See Signature on page 28
c:
-~ 2'
Preparer's
~ ~J\ . .An.
self-employed
of the instrucbons)
~
Cl)
:E c5
ignature
P00248403
g:
F1rm'snameforyours1~ P
EIN
44-0160260
a::::,
self-employed), address, 1551 N WATERFRONT
PKWY, STE 300
and ZIP code
WICHITA. KS
67206-6601
Phone no
316-265-2811
Form 990 PF (2005
E1493 1 000
16733H K932 11/15/2006 14:39:08 V05-8 85646
14
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 13/34
Schedule
(Form 990, 990-EZ,
or 990-PF)
Schedule of Contributors
OMB No 1545-0047
Department of the Treasury
Internal Revenue Service
Supplementary Information for
line 1 of Form 990, 990-EZ, and 990-PF (see instructions)
~© 5
Name of organization Employer identification number
CHARLES G KOCH CHARITABLE FOUNDATION
Organization type (check one)
Filers of:
Form 990 or 990-EZ
Form 990-PF
48-0918408
Section:
D 501 (c)( ) (enter number) organization
D 4947(a)(1) nonexempt charitable trust not treated as a private foundation
D 527 pol1t1calorganrzat1on
CiJ
01 (c)(3) exempt private foundation
D
4947(a)(1) nonexempt charitable trust treated as a private foundation
D
501 (c)(3) taxable private foundation
Check 1fyour organization 1scovered by the General Rule or a Special Rule. (Note: Only a section 501 c) 7), 8), or 10)
organization can check boxes for both the General Rule and a Special Rule
-
see instructions)
General Rule -
CiJor organrzat1ons iling Form 990, 990-EZ, or 990-PF that received, during the year, 5,000 or more (1nmoney or
property) from any one contributor (Complete Parts I and II )
Special Rules -
D
For a section 501(c)(3) organization filing Form 990, or Form 990-EZ, that met the 33 1/3% support test under Reguat1ons
sections 1 509(a)-3/1 170A-9(e) and received from any one contributor, during the year, a contribution of the greater of
5,000 or 2% of the amount on line 1 of these forms (Complete Parts I and II)
D For a section 501(c)(7), (8), or (10) organrzat1on iling Form 990, or Form 990-EZ, that received from any one contributor,
during the year, aggregate contributions or bequests of more than 1,000 for use exclusively for religious, charitable,
sc1ent1f1c,iterary, or educational purposes, or the prevention of cruelty to children or animals (Complete Parts I, II, and Ill)
D
For a section 501(c)(7), (8), or (10) organization filing Form 990, or Form 990-EZ, that received from any one contributor,
during the year, some contributions for use exclusively for religious, charitable, etc. purposes, but these contributions did
not aggregate to more than 1,000 (If this box 1schecked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc . purpose Do not complete any of the Parts unless the General Rule
applies to this organ1zat1onbecause it received nonexclus1vely eligious, charitable, etc . contributions of 5,000 or more
during the year) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..,. _______ _
Caution: Organizations that are not covered by the General Rule and/or the Special Rules do not file Schedule B Fon1J90,
990-EZ, or 990-PF), but they must check the box m the headmg of thetr Form 990, Form 990-EZ, or on /me 2 of their Form
990-PF, to certify that they do not meet the filmg requirerrents of Schedule B Form 990, 990-EZ, or 990-PF)
For Paperwork Reduction Act Notice, see the Instructions
for Fonn 990, Fonn 990-EZ, and Fonn 990-PF.
Schedule B (Fonn 990, 990-EZ, or 990-PF) (200
JSA
5E1251 1 000
16733H K932 11/15/2006 14:39:08 V05-8
85646
16
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 14/34
Schedule B Form 990, ~EZ. or ~PF) 2005)
Page of of Part
Name of organi~tion
CHARLES G. KOCH CHARITABLE FOUNDATION
Employer identification number
Utf i
ontributors See Specific Instructions )
a)
No.
__ 1_
a)
No.
---
a)
No.
---
a)
No.
---
a)
No.
---
a)
No.
---
JSA
5E12531000
CHARLES
4111 E.
WICHITA.
b)
Name, address, and ZIP + 4
G.
KOCH
37TH STREET N.
KS 67220
b)
Name, address, and ZIP+ 4
b)
Name, address, and ZIP + 4
b)
Name, address, and ZIP+ 4
b)
Name, address, and ZIP + 4
b)
Name, address, and ZIP+ 4
16733H K932 11/15/2006 14:39:08 V05-8
85646
48-0918408
c) d)
Aggregate contributions Type of contribution
Person
§
ayroll
30 020 760.
Noncash
Complete Part II 1f here IS
a noncash contribution )
c)
d)
Aggregate contributions Type of contribution
Person
§
ayroll
Noncash
Complete Part II 1f here IS
a noncash contribution )
c) d)
Aggregate contributions Type of contribution
Person
§
ayroll
Noncash
Complete Part II 1f here IS
a noncash contribution )
c) d)
Aggregate contributions Type of contribution
Person
§
ayroll
Noncash
Complete Part II 1f here 1s
a noncash contribution )
c) d)
Aggregate contributions Type of contribution
Person
§
ayroll
Noncash
Complete Part II 1f here 1s
a noncash contribution )
c)
d)
Aggregate contributions
Type of contribution
Person
§
ayroll
Noncash
Complete Part II 1f here IS
a noncash contribution )
Schedule B Form 990, 990-EZ, or 990-PF) 200
17
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 15/34
CHARLES G. KOCH CHARITABLE FOUNDATION
EIN 48-0918408
ATTACHMENT TO FORM 990-PF TO REPORT
EXPENDITURE RESPONSIBILITY GRANT
For the Year Ended 12/31/05
Sc:
ATIACHMEN
Expenditure Responsibility Statement for the Year 2005
to IRC Regulation section 53 4945-5(d)(2), the CHARLES G. KOCH CHARITABLE FOUNDATION
(i)
Name & Address
of Grantee:
11)
Date and Amount
of Grant:
111)Purpose of Grant·
Kansas Cultural Trust
255
N.
Roosevelt
Wichita, KS 67208
September 13, 2004
27,553 balance of grant funds remaining from original 35,000 grant
received on September 13, 2004
General operating support for the Kansas Cultural Trust, an educational foundation which
provides grants to young visual and performing artists to allow them to take advantage of
key opportunities arising early in their careers.
Amounts expended. Report received from the Kansas Cultural Trust shows the following expenditures:
(v) Diversions:
(v1) Date of Reports·
(vi) Verification:
27,553 of the remaining September 2004 grant was spent for providing enabling grants to
artists and for professional fees
To the knowledge of this granter foundation, no funds have been diverted to any
activity other than the activity for which the grant was originally made.
On April 24, 2006, the Kansas Cultural Trust submitted a full and complete report of its
expenditures of the September 2004 operating support grant
The granter has no reason to doubt the accuracy or reliability of the report from
the grantee; therefore, no independent verification of the reports were made
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 16/34
CHARLES G. KOCH CHARITABLE FOUNDATION
EIN 48-0918408
ATTACHMENT TO FORM 990-PF TO REPORT
EXPENDITURE RESPONSIBILITY GRANT
For the Year Ended 12/31/05
ART VII-B Question on Line Sc:
ATIACHMENTB
Expenditure Responsibility Statement for the Year 2005
Pursuant to IRC Regulation section 53.4945-5(d){2), the CHARLES G KOCH CHARITABLE FOUNDATION
provides the following information:
(1)
Name & Address
of Grantee:
11)
Date and Amount
of Grant
(iii)
Purpose of Grant·
(1v)
Amounts expended:
(v) Diversions.
(v1) Date of Reports.
(v1) Verification:
The Phillips Foundation
One Massachusetts Avenue, NW, Suite 620
Washington, DC 20001
June 20, 2005 37,500
Support for the
Journalism Fellowship Program run by the Phillips Foundation
Report received from The Phillips Foundation shows the following expenditures:
31, 176 of the June, 2005 grant was spent directly for providing grants through
their Journalism Fellowship Program
To the knowledge of this granter foundation, no funds have been diverted to any
activity other than the activity for which the grant was originally made.
On July 5, 2006, The Phillips Foundation submitted a full and complete
report of its expenditures of the June 2005 grant
The granter has no reason to doubt the accuracy or rehab1hty f the report from
the grantee, therefore, no independent verification of the reports were made
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 17/34
CHARLES G. KOCH CHARITABLE FOUNDATION
EIN 48-0918408
SCHEDULE OF INFORMATION FOR 2005 FORM 990 PF
PART VIII, Line 1 - Officers, Directors,Trustees, Managers, Etc.
b) Title, and average d) Contributions
hours per week to employee
{a} Name and Address devoted to ~osition I
c} ComQensation
benefit ~lans
Richard Fink
President
I
Director 0
0
655 15th Street, NW, Suite 445
1 hour per week average
Washington, DC 20005
Kelly Young
Vice President 0 0
655 15th Street, NW, Suite 445 111105o
7171 5
Washington, DC 20005 5 hours per week average
Kevin L. Gentry
Vice President 0
0
655 15th Street, NW, Suite 445 10 hours per week average
Washington, DC 20005
Logan Moore
Secretary 0
0
655 15th Street, NW, Suite 445
10/12/05 to 12131105
Washington, DC 20005
29 hours per week average
Mark Humphrey
Secretary 0 0
PO Box2256
111105o 10/12/05
Wichita, KS 67201
Less than 1 hour per week
Vonda Holliman
Treasurer 0 0
PO Box 2256
1Ohours per week average
Wichita, KS 67201
Charles G. Koch Director 0 0
P.O Box 2256
Less than 1 hour per week
Wichita, KS 67201
Elizabeth B. Koch
Director 0 0
P 0 Box 2256
Less than 1 hour per week
Wichita, KS 67201
Elizabeth Robinson Koch Director 0
0
P.O Box 2256
Less than 1 hour per week
Wichita, KS 67201
Charles Chase Koch
Director 0 0
P 0 Box 2256
Less than 1 hour per week
Wichita, KS 67201
Koch lndustnes, Inc
Not Applicable 232,605
0
PO Box 2256
Payment for management
Wichita, KS 67201 services of officers above)
Koch Business Holding, LLC Not Applicable 28,690
0
P.O Box 2256
Payment for management
Wichita, KS 67201 services of officers above)
TOTAL
261,295 0
ATTACHMENT C
e) Expense
account, other
allowances
0
0
0
0
0
0
0
0
0
0
0
0
0
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 18/34
CHARLES G. KOCH CHARITABLE FOUNDATION
EIN 48-0918408
SCHEDULE OF INFORMATION FOR 2005 FORM 990 PF
PART XV LINE 20 INFORMATION REGARDING GRANTS - LIMITATIONS ON AWARDS ATTACHMENT D
The foundation primarily supports research and education programs that analyze the impact of free soc1et1es, n
particular how they advance the well-being of mankind. Building on this knowledge, the Charles G. Koch Charitable
Foundation fosters the partnership of scientists and practitioners in order to integrate theory and practice.
By doing so, the Foundation strives to develop market-based tools that enable individuals, institutions and societies
to strive and prosper.
Grants from the Foundation are restricted to charitable organizations as defined in section 501 (c)(3) of the Internal
Revenue Code. The Charles G. Koch Charitable Foundation does not make grants to ind1v1duals
Charles G. Koch Charitable Foundation focuses on a select number of programs where it believes it is best positioned to support
positive social change. The Foundation encourages organizations seeking support to first familiarize themselves with those domains
by examining the Foundation s Areas of Interest In addition, the Foundation places several limitations on the requests it considers·
1. The Foundation primarily makes grants to Section 501 (c)(3) public charities. The Charles G. Koch Charitable Foundation
does not support for-profit corporations or individuals.
2. The Foundation discourages grant proposals for capital construction, debt reduction, or general fundraising drives or
events. The Foundation does not make grants intended to support lobbying activities or candidates for political office. The
Foundation rarely funds endowments.
Organizations seeking grants from the Foundation and which meet the aforementioned criteria should submit a short letter (no more
than three pages) outlining their request. The letter should clearly and succinctly state:
1. Prospective grantee s mission and goals;
2. Specific project for which support is being sought,
3 Amount of funding requested;
4 Name, title, address, telephone number, and e-mail address of the primary contact person; and,
5 Current annual budget or audited financial statements
If applicable, please also include a list of other support (e.g , funding, in-kind contributions) secured for the project. Because the
Foundation only supports Section 501 (c)(3) public charities, 1talso reqwres that you submit verification from the IRS that your
organization 1sexempt from federal income tax as a Section 501 (c)(3) organization and is classified as a public charity under Section
509(a) of the Internal Revenue Code The Foundation kindly requests that no materials beyond what are described above be
included Please send all required materials to
Other Contact Information
Phone· 202-393-2354
Fax 202-393-2355
email @ cgkfoundat1on com
Grant
Administrator
Charles G. Koch Charitable Foundation
655 15th Street NW, Suite 475
Washington, DC 20005
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 19/34
CHARLES G. KOCH CHARITABLE FOUNDATION
EIN 48-0918408
SCHEDULE OF INFORMATION FOR 2005 FORM 990 PF
Part XV Line 3a b - Grants and Contributions Paid During the Year or Approved for Future Payment
If reap,ent ,s an individual.
Foundation
Rec1p1ent
show any relabonsh,p to
status of
Purpose of grant
any foundabon manager
rec1p1ent
or contribution
Name and address (home or business)
or substanbal contnbutor
a
Paid during the year·
Acton Business School
Public
General Operating Support
Austin, TX
The Acton Institute
Public
General Operating Support
Grand Rapids, Ml
Alliance for School Choice
Public
General Operating Support
Phoenix, AZ
8111 f Rights Institute
Public
General Operating Support
Arlington, VA
Center for Excellence in Education
Public
Educational and Research
Vienna, VA Programs
Environmental Literacy Council
Public
General Operating Support
Washington, DC
The Federalist Society
Public
General Operating Support
Washington, DC
Milton Rose D Friedman Foundation
Public
General Operating Support
San Francisco, CA
Fund for American Studies
Public
General Operating Support
Washington, DC
George Mason University Foundation
Public
Educational and Research
Fairfax, VA
Programs
Goldwater Institute
Public
Educallonal Programs
Phoenix, AZ
Independence Institute
Pub he
General Operating Support
Golden, CO
lnt'I Foundation for Research 1n Experimental Economics
Pub he
General Operating Support
Arlington, VA
Mackinac Center for Public Polley
Public
General Operating Support
Midland, Ml
Mercatus Center
Pub he
General Operating Support
Arlington, VA
Educational Programs
Pacific Research Institute
Public
General Operating Support
San Francisco, CA
Philanthropy Roundtable
Public General Operating Support
Washington, DC
The Phillips Foundation
Private
General Operating Support
Washington. DC
San Jose State University Foundation
Public
General Operating Support
San Jose, CA
Sm1thson1an lnst1tut1on
Pub he
General Operating Support
Cambridge, MA
Texas Public Polley Foundation
Public
Educational Programs
Austin, TX
Youth Entrepreneurs of Kansas
Public
General Operating Support
Wichita, KS
of 2
ATTACHMENT
Amount
100,0
25,0
10,0
300,0
5,0
50,0
75,0
15,0
30,0
1, 102,5
43,6
56,6
380,0
10,0
800,0
215,0
90,0
25,0
37,5
25,0
55,0
35,6
300,0
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 20/34
CHARLES G. KOCH CHARITABLE FOUNDATION
EIN 48-0918408
SCHEDULE OF INFORMATION FOR 2005 FORM 990 PF
Part XV, Line la b - Grants and Contributions Paid During the Year or Approved for Future Payment
If reap,enl ,s an 1nd1vidual, Foundation
Rec1p1ent show any relabonsh1p 0 status of Purpose of grant
any foundabon manager rec1p1ent or contnbut1on
Name and address (home or business)
or subslanbal conlnbutor
a Paid dunno the vear:
TOTAL GRANTS PAID TO ORGANIZATIONS
b Approved for future payment
San Jose State University Foundation Pubhe General Operating Support
San Jose, CA
TOTAL GRANTS APPROVED FOR FUTURE PAYMENT
2 of2
ATIACHMENTE
Amount
3,785,95
25,0
25,0
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 21/34
G. KOCH CHARITABLE FOUNDATION
FORM 990PF PART I - OTHER INCOME
DESCRIPTION
INTEREST FROM PROGRAM-RELATED INVESTMENT
TOTALS
16733H K932 11/15/2006 14:39:08 V05-8
48-0918408
REVENUE
AND
EXPENSES
PER BOOKS
17 996.
17 996.
85646 18
ADJUSTED
NET
INCOME
17 996.
17 996.
STATEMENT 1
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 22/34
G. KOCH CHARITABLE FOUNDATION
FORM 990PF PART I - LEGAL FEES
ESCRIPTION
TOTALS
REVENUE
AND
EXPENSES
PER BOOKS
1 843.
38 269.
40 112.
16733H K932 11/15/2006 14:39:08 V05-8 85646
48-0918408
NET
INVESTMENT
INCOME
1 843.
1 843.
19
ADJUSTED
NET
INCOME
NONE
CHARITABLE
PURPOSES
35 541.
35 541.
STATEMENT 2
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 23/34
G. KOCH CHARITABLE FOUNDATION
ORM 990PF PART I - ACCOUNTING FEES
ESCRIPTION
ACCTG SERVICES FEES
TOTALS
REVENUE
AND
EXPENSES
PER BOOKS
26 541.
5 720.
4 783.
37 044.
16733H K932 11/15/2006 14:39:08 V05-8 85646
48-0918408
NET
INVESTMENT
INCOME
5 720.
5 720.
20
ADJUSTED
NET
INCOME
NONE
CHARITABLE
PURPOSES
23 129.
3 408.
26 537.
STATEMENT 3
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 24/34
G. KOCH CHARITABLE FOUNDATION
990PF PART I - OTHER PROFESSIONAL FEES
ADMINISTRATION FEES
PROFESSIONAL FEES
TOTALS
REVENUE
AND
EXPENSES
PER BOOKS
118 201.
30 763.
263 151.
3 715.
2 300.
545.
418 675.
16733H K932 11/15/2006 14:39:08 V05-8 85646
48-0918408
NET
INVESTMENT
INCOME
987.
30 763.
3 715.
35 465.
21
CHARITABLE
PURPOSES
122 012.
235 553.
2 000.
545.
360 110.
STATEMENT 4
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 25/34
G. KOCH CHARITABLE FOUNDATION
RM 990PF PART I - TAXES
EXCISE TAX
TOTALS
REVENUE
AND
EXPENSES
PER BOOKS
12 410.
115.
12 525.
16733H K932 11/15/2006 14:39:08 V05-8 85646
48-0918408
NET
INVESTMENT
INCOME
115.
115.
22 STATEMENT 5
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 26/34
CHARLES G. KOCH CHARITABLE FOUNDATION
FORM 990PF, PART I - OTHER EXPENSES
DESCRIPTION
INSURANCE
POSTAGE DELIVERY
TOTALS
REVENUE
AND
EXPENSES
PER BOOKS
7,230.
4,271.
328.
3,558.
6,222.
3,630.
39.
25,278.
16733H K932 11/15/2006 14:39:08 VOS-8 85646
48-0918408
23
CHARITABLE
PURPOSES
7,230.
3,856.
328.
5,184.
5,984.
3,658.
39.
26,279.
STATEMENT 6
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 27/34
G. KOCH CHARITABLE FOUNDATION
FORM 990PF, PART II - U.S. AND STATE OBLIGATIONS
ESCRIPTION
EDERAL HOME LOAN STATE BNDS
US OBLIGATIONS TOTAL
16733H K932 11/15/2006 14:39:08 V05-8 85646
48-0918408
ENDING
BOOK VALUE
12,500,000.
12,500,000.
24
ENDING
FMV
12,566,775.
12,566,775.
STATEMENT 7
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 28/34
G. KOCH CHARITABLE FOUNDATION
FORM 990PF PART II - OTHER INVESTMENTS
---
------------------------------
DESCRIPTION
CONVERTIBLE BONDS
ABSOLUTE FUND
SENIOR BANK/LOAN STRGY
TOTALS
16733H K932 11/15/2006 14:39:08 V05-8 85646
48-0918408
ENDING
BOOK VALUE
5 000 000.
5 471 589.
5 000 000.
5 000 000.
5 000 000.
25 471 589.
25
ENDING
FMV
5 768 046.
5 375 653.
5 555 303.
5 154 503.
5 083 640.
26 937 145.
STATEMENT 8
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 29/34
G. KOCH CHARITABLE FOUNDATION
M 990PF, PART II - OTHER ASSETS
ES RECEIVABLE - PROGRAM
RELATED INVESTMENTS
TOTALS
167338 K932 11/15/2006 14:39:08 V05-8 85646
48-0918408
ENDING
BOOK VALUE
355,000.
355,000.
26
ENDING
FMV
355,000.
355,000.
STATEMENT 9
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 30/34
'
CHARLES G. KOCH CHARITABLE FOUNDATION
48-0918408
FORM '990PF, PART VII-B, LINE SC - EXPENDITURE RESPONSBILITY STATEMENT
GRANTEE'S NAME:
GRANTEE'S ADDRESS:
CITY, STATE ZIP:
GRANT DATE:
GRANT AMOUNT:
GRANT PURPOS~:
AMOUNT EXPENDED:
ANY DIVERSION?
DATES OF REPORTS:
VERIFICATION DATE:
SEE ATTACHMENTS A B
NO
RESULTS OF VERIFICATION:
16733H K932 11/15/2006 14:39:08 V05-8
STATEMENT 10
85646 27
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 31/34
f
CHARLES G. KOCH CHARITABLE FOUNDATION
FORM 990PF PART XV - NAME ADDRESS AND PHONE FOR APPLICATIONS
----==========================================================
G~ANT
ADMINISTRATOR
CHARLES KOCH CHARITABLE FOUNDATION
655 15TH ST. NW SUITE 475
WASHINGTON DC 20005
202-393-2354
16733H K932 11/15/2006 14:39:08 V05-8
85646
48-0918408
STATEMENT 11
28
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 32/34
CHARLES G. KOCH CHARITABLE FOUNDATION
48-0918408
990PF PART XV - FORM AND CONTENTS OF SUBMITTED APPLICATIONS
-----=========================-=============================
LETTER EXPLAINING PROJECT AND AMOUNT REQUESTED PLUS A COPY OF IRS
DETERMINATION LETTER SHOWING EXEMPTION.
STATEMENT 12
16733H K932 11/15/2006 14:39:08 V05-8
85646 29
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 33/34
FORM 990 PF PART IV
CAPITAL GAINS AND LOSSES FOR TAX ON INVESTMENT INCOME
p
Kind of Property
Descnpt1on
or
Date
Date sold
D
acquired
Gross sale I
Deprec1at1on
Cost or
I
FMV
I
AdJ basis
I
Excess of Gain
price less
allowed/
other
as of as of
FMVover or
exnenses of sale
allowable
h,,c,c
1?n11nq 1?n11nq
ad1 basis
loss)
ZAZOVE ASSOCIATES,
LLC FUND
IE
VAR
VAR
PROPERTY TYPE: SECURITIES
1,980,978. 1,747,725.
233,253.
GOLDMANSACHS SHORT DURATION
FUND
p
VAR
VAR
PROPERTY TYPE: SECURITIES
11149240. 11466970.
-317,730.
CORPORATE BONDS
p
VAR
VAR
PROPERTY TYPE:
SECURITIES
~,700,000. 2,700,000.
TOTAL GAIN LOSS) ............................................... . -84,477.
JSA
5E1730 1 000
167338 K932 11/15/2006 14:39:08 V05-8
85646
15
7/21/2019 Charles Koch Foundation 480918408 2005 02A51F19Searchable
http://slidepdf.com/reader/full/charles-koch-foundation-480918408-2005-02a51f19searchable 34/34
Form 8868 (Rev 12-2004)
• If you are f1hng or an Additional (not automatic) 3-Month Extension, complete only Part II and check this box ....... .
Note: O~ly complete Part II if you have already been granted an automatic 3-month extension on a previously filed Form 8868.
• If ou are film for an Automatic 3-Month Extension, com lete onl Part
I
on a e 1 .
Additional not automatic 3-Month Extension of Time - Must File Original and One Co
Type or
Name of Exempt Organization
CHARLES G KOCH CHARITABLE FOUNDATION
r:· -
·-~~' , ,-j
:..'¥~
Employer Identification number
48-0918408
Number, street, and room or suite no. If a P.O. box, see nstructions
PO BOX 2256
For RS use only
Filaby he
extended
due date or
filing he
return See
Instructions
City, town or post office, state, and ZIP
code.
For a foreign address,see nstructions
f
~:;~·--
~r
'
:.,}·
,,~~-.;;-~~-
-"
WICHITA KANSAS 67201 _ :.-L. , i: l'
,_ ,_::_._ .,, •
Check type of return to be filed (File a se
X Form 990
Form 990-BL
Form 990-EZ
arate application for each return):
Form 990-T(sec. 401(a) or 408(a) trust)
Form 990-T (trust other than above)
Form 1041-A
Form 990-PF Form 4720
§
orm 5227
Form 6069
Form 8870
STOP: Do not complete Part
II
If you were not already granted an automatic 3-month extension on a previously filed Form
8868.
• The books are in the care of .,._ __ V_O_N_D_A_H_O_L_L_I_MA_N____________________ _
Telephone No . .,._ (316) 828-5552 FAX No .,._
• If the organization does not have an office or place of business in the United States, check this box. . . . . . . . . . . . . . . . .,._D
• If this 1s or a Group Return, enter the o~nization's four digit Group Exemption Number (GE.ill-, If this 1s
for the whole group, check this box .,._ LJ. If it is for part of the group, check this box .,._ LJand attach a list with the
names and EINs of all members the extension is for.
4 I request an additional 3-month extension of time until _N_O_V_E_M_B_E_R_ 1_5-'-,2_0_0_6________ _
5 For calendar year 2005 , or other tax year beginning ~1ng
6 If this tax year 1s or less than 12 months, check reason: LJ nitial return LJFinal return --.-LJ-,--c-h_a_n_g_e_rn_a_c_co_u_neriod
7 State 1ndetail why you need the extension --------------------------------
THE TAXPAYER REQUESTS ADDITIONAL TIME IN ORDER TO GATHER THE NECESSARY INFORMATION
FOR A COMPLETE AND ACCURATE RETURN.
Ba If
this appl1cat1on 1s for Form 990-BL, 990-PF, 990-T, 4 720, or 6069, enter the tentative tax, less any
nonrefundable credits See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
-'- ______ _
b If this application 1s or 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 8868 ...........................................
-'-- ______ _
c
Balance Due. Subtract line 8b from line Ba Include your payment with this form, or, 1f required, deposit
with FTD coupon or, 1f required, by using EFTPS (Electronic Federal Tax Payment System) See
instructions ....................................................
Signature and Verification
Under penalties f par1ury, declare hat I haveexamined his form, Includingaccompanyingchedules nd statements, nd to the best oJ my knowledge nd belie
11 s rue, correct,and complete, nd hat amauthorizedo preparehis orm,
Date.,._fJ} {/o (o
Notice Applicant - To Be Completed
by
the IRS
ID)
We have approved his application. Please attach this form to the organization's eturn
(
0 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 du
date of the organization's return (including any prior extensions). This grace period is considered to be a valid extension of time for election
otherwise required to be made on a timely return. Please attach this form to the organization's eturn.
O We have not approved this application. After considering the reasons stated in item 7, we cannot grant your request for an extension of lim
to file We are not granting a 10-daygrace period
B
Director
We cannot consider this application because it was filed after the extended due date of the return for which an extensionwas requested
Other
Date
Alternate Mailing Address - Enter the address if you want the copy of
this application for an a(Ji~L3-month extension
returned to an address different than the one entered above t:N,
Name
BKD, LLP
VV£o