Return of Private Foundation or Section 4947(a)(7) Nonexempt Charitable Trust '010

Treated as a Private Foundation Depanmeni of the Treasury

and ending For calendar year 2001 or tax year beginning

G Check all that apply ~ Initial return ~ Final return

Use the Name of organization IRS label GRAND CIRCLE FOUNDATION, INC Otherwise, Number and street (or P O bo+numpel .f mul is hot Eelrvere0 b street address)

print or 347 CONGRESS STREET

Amended return UAAdress change U Name change A Employer identification number

04-3175434 RooMsuile I B Telephone number (see page 10 0l the instr )

type City or tam (BOSTON

State ZIP + 4 MA 02210

H Check organization ~X Section 501(c)(3) exempt private foundation

11 Section 4947(x)(1) nonexempt charitable trust F~ Other taxable private foundation

I Fair market value of all assets at J Accounting method end of year (from Part II, column O Cash M Accrual (c), tine 16) Other (specify)

9,17 77~ under section 507(D)(1)/B) check here 0

(c) Adjusted I (d) Disbursements net (or charitable purposes

0 0 2,006,745

0 2006.745

Form 990.PF (2001)

l

a Excess of revenue over expenses and disbursements

b Net investment income (d negative, ester ~) c Adj usted net income (d negative . enter ~)

For Paperwork Reduction Act Notice, see the instructions (Flirt)

Form 990-PF

C it exemption application is pending check here

1 Foreign organaabons check here

1 Foreign orpamzauons meeting the 85% test check

E II prm+ro foundation status was terminated under

section 507(b)(1)(A) check hero

F II the foundation is In a 50-monM termination

Part I Analysis of Revenue and Expenses (a) Revenue and (b) Net (The total of amounts in columns (b) (c), and (d) may expenses per I investment

i c;ontriouuons, gins, grants, etc , received Check Flit p,efoundation isrclreqwaGmattach Sdi B

2 Distributions from split-interest trusts 3 Interest on savings and temporary cash investments 4 Dividends and interest from securities

R 5a Gross rents e b (Net rental income or (loss) V 68 Net gain or (loss) from sale of assets not on line 10 e b G S P for assets on 6a n 7 Capital gain net income (from Part IV line 2) u 8 Net short-term capital gain e 9 Income modifications

10a Gross sales less returns ~- b Less COGS c Gross profit or (loss) (attach schedule)

11 Other income (attach schedule) 12 Total Add lines 1 through 11 13 Compensation of officers, directors, trustees, etc 14 Other employee salaries and wages 15 Pension plans, employee benefits 16a Legal fees (attach schedule)

b Accounting fees (attach schedule) c Other professional fees

17 Interest 78 Taxes (attach schedule) 19 Deprecation and depletion 20 Occupancy 21 Travel, conferences, and meetings 22 Printing and publications 23 Other expenses (attach schedule) 24 Total operating and administrative

expenses Add lines 13 through 23 25 Contributions, gifts, grants paid 26 Total expenses and disbursements

1 .182

INC

1 Cash - non-interest bearing 1,025,496 1,036,315 1,036 315 2 Savings and temporary cash investments 3 Accounts receivable y~~~~~~~~~~~~~/N

Less allowance (or doubtful accounts 0 4 Pledges receivable

Less allowance for doubtful accounts 0 5 Grants receivable 6 Receivables due from officers, directors, trustees,

and other disqualified persons (attach schedule) (see page 15 of the instructions) 42,380 611,458 611,458

A 7 Other notes and loans receivable 911011100101000115 s Less allovrance for doubtful accounts 0 s 8 Inventories for sale or use e 9 Prepaid expenses and deferred charges t 10a Investments - U S and state government obligations s b Investments - corporate stock (attach schedule)

c Investments - corporate bonds (attach schedule) 11 Investment land bwlEings and eqmpment basis

Less accumulated depreciation 0 12 Investments - mortgage loans 13 Investments - other (attach schedule) 14 Land, buildings, and equipment basis

Less accumulated depreciation 0 15 Other assets (describe ) 16 Total assets (to be completed by all filers-see

page 16 of the instructions Also see page 1, item I 1,067,876 1,647,773 1,647,773 17 Accounts payable and accrued expenses 18 Grants payable

Lia- 79 Deferred revenue bill- 20 Loans from oKCers directors trustees and other disqualified persons ties 21 Mortgages and other notes payable (attach schedule)

22 Other liabilities (describe )

23 Total liabilities add lines 17 through 22 0 0 ~~

Organizations that follow SFAS 117 D check here and complete lines 24 through 26

N and lines 30 and 31 e 24 Unrestricted i t 25 Temporarily restricted

26 Permanently restricted A Organizations that do not follow SFAS 117, 0 s check here and complete lines 27 through 31 s 27 Capital stock, trust principal, or current funds C 28 Paid-in or capital surplus or land bldg , and equipment lurid T 29 Relamedearnings accumulated income,endovrtnent,orother funds 1,067,876 1,647 s 30 Total net assets or fund balances (see page 17

of the instructions) 1,067,876 1,647,773 j 31 Total liabilities and net assets/fund balances

see page 17 of the instructions 1,067,876 1,647,773

Part III Analysis of Changes in Net Assets or Fund Balances

1 Total net assets or fund balances at beginning of year - Part II, column (a), line 30 1 1,067,876 (must agree with end-of-year figure reported on prior years return)

2 Enter amount from Part I, line 27a 2 579,897 3 Other increases not included in line 2 (itemize) 3 4 Add lines 1, 2, and 3 4 1,647,773 5 Decreases not included in line 2 (itemize) 5 6 Total net assets or fund balances at end of ear line 4 minus line 5 " Part II column b line 30 6 1,647 773

Form 990.PF (2001)

II Balance Sheets Attached schedules and amounts in the

(a) List and describe the kinds) of property sold (e g real estate, 2-story brick warehouse Date acquired I (d) Date sold

e

a b c d e

a b

(I) Gains (Col (h) gain minus cal (k) but not less than -0-) (k) Excess of col (i) (Q F M V as of 12!31/69 0) Adjusted basis

0

0

Was the organization liable for the section 4942 tax on the distributable amount of any year in the base period? Yes 91 No If "Yes," the organization does not qualify under section 4940(e) Do not complete this part

1 Enter the a ro rule amount in each column for each ear , see page 18 of the instructions before making an entries (a) Base period years Calendar (b) (c) (d) Distribution ratio

1

1 764

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

4 Enter the net value of noncharitable-use assets for 2001 fro

5 Multiply line 4 by line 3

6 Enter 1% of net investment income (1% of Part I, line 27b)

7 Add lines 5 and 6

8 Enter qualifying distributions from Part XII, line 4 If line 8 is equal to or greater than line 7, check the box in Pa c.. .. ~w ., o . . .~ vi . .. . .~ .. . . .~ . .. .. . . .._ _, . .._ , o

1000790

(e) Gross sales price (f) Depreciation allowed

(b) How acquired P - Purchase n _ n~nat.~~ ~~

(g) Cost or other basis (h) Gain or (loss)

0

0 0

e I I II gain, also enter in Part I line 7

2 Capital gain net income or (net capital loss) If (loss) enter -0- in Part I line 7 3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6)

If gain, also enter in Part I, line 8, column (c) (see pages 13 and 17 of the

(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

se Tax Based on Investment

Exempt operating foundations described in section 4940(d)(2) check here and [_]enter 'NIA a on line 1 Dale of ruling letter (amcn coot/ of ruling letter ii neceuary)

b Domestic organizations that meet the section 4940(e) requirements in Part V, check here and enter 1°.6 of Part I, line 27b

C All other domestic organizations enter 2% of line 27b Exempt foreign organizations enter 4% of Part I line 12 cot (b) Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only Others enter -0-) Add lines 1 and 2 Subtitle A (income) lax (domestic section a947(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-0-Credits/Payments

a 2001 estimated tax payments and 2000 overpayment credited to 2001 6a 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

Total credits and payments Add lines 6a through 6d Enter any PENALTY for underpayment of estimated tax Check here if Form 2220 Flis attached TAX DUE If the total of lines 5 and 8 is more than line 7 . enter AMOUNT OWED

1

487

4CI

8 9 1 0 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

Part VII-A

71 Is Me aiBan2auon claiming status as a private operating foundation within the meaning of section aBa70)(3) or d8d10)(5) for calendar year 2001 or

the taxable year beginning in 2001 (see instructors for Part %1V on page 75)'+ If 'Yes' complete Pan XIV

Did 10 any persons become substantial contributors Aunng the lea year? It 'Yes' attach a schedule listing their names and addresses 11 Did the organ¢ation comply with the public inspection requirements for its annual returns and exemption application? 11 X

Web site address 12 The books are in care of LARRY FOX Telephone no 617-350-7500

Located at GCF, 347 CONGRESS ST, BOSTON, MA ZIP+4 02210 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 1 13 IN/A Form 99OPF (2001)

1a 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 page 19 of the instructions for definition) It the answer is "Yes' to 1 a 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 organ¢ation S 0 (2) On organization managers $ 0 e Enter the reimbursement (if any) paid by the organization during the year for political expenditure

tax imposed on organization managers S 0 2 Has the organization engaged in any activities that have not previously been reported to the IRS

If "Yes," attach a detailed description of the activities 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 grass income of $1,000 or more during the year b It "Yes," has it filed a tax return on Form 990-T for this year

5 Was there a liquidation, termination, dissolution, or substantial contraction during the year 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 $S 000 in assets al arty time during Ire year? If 'Yes' complete Part II, column (c) and Pan 7N

Ba Enter the states to which the foundation reports or with which it is registered (see page 19 of the instructions) MASSACHUSETTS

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 G? If "No," attach explanation

GRAND CIRCLE FOUNDATION . INC

X

4b

6a Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contracts Yes OX No

b Did the organization, during the year pay premiums, directly or indirectly, on a personal benefit contract? K / A. If wu answered "Yes to fih also file Form 111170

Statements File Form 4720 ii any item is checked in the "Yes" column, unless an exception applies

7a During the year did the organization (either directly or indirectly) (1) Engage in the sale or exchange or leasing of property with a disqualified person? a Yes 0 No (2) Borrow money from, lend money to, or otherwise extend credit to (or accept

it from) a disqualified persons Yes 0 No

(3) Furnish goods, services or facilities to (or accept them from) a disqualified persons E] Yes E No

(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified persons E] Yes EXI No (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) 0 Yes ED No (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 0ves X No

b If any answer is "Yes" to 1a(1) - (6), did ANY of the acts fail to qualify under the exceptions described in Regulations section 53 4941(d)-3 or in a current notice regarding disaster assistance (see page 19 of the instructions) Organizations relying on a current notice regarding disaster assistance check here

c Did the organization engage in a prior year in any of the acts described in la, other than excepted acts, that were not corrected before the first day of the tax year beginning in 2001 ?

2 Taxes on failure to distribute income (section 4942) (does not apply for years the organization was a private operating foundation defined in section 4942(j)(3) or 4942(j)(5))

a At the end of tax year 2001, did the organization have any undistributed income (lines 6d and 6e, Part XIII) for tax year(s) beginning before 2001 Yes Ex_JNo If "Yes," list the years ,

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 years undistributed incomes (II applying section 4942(a)(2) to all years listed ansvrer "No and attach statement-see page 19 of the instructions )

c If the provisions of section 4942(a)(2) are being applied to ANY of the years listed in 2a, list the years here

3a Did the organization hold more than a 2% direct or indirect interest in any business enterprise at any time during the year? F]res OX No

b If "Yes," did it have excess business holdings in 2001 as a result of (1) any purchase by the organization or disqualified persons after May 26, 1969, (2) the lapse of the 5-year period (or longer period approved 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 periods (Use Schedule C, Form 4720, to determine if the organization had excess business holdings in 2001 )

4a Did the organization invest during the year any amount in a manner that would jeopardize its charitable purposes? b Did the organization make any investment in a 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 200V

Sa During the year did the organization pay or incur any amount to (1) Carry on propaganda, or othervnse attempt to influence legislation (section 4945(e))? E]Yes FX No (2) Influence the outcome of any specific public election (see section 4955), or

to carry on, directly or indirectly, any voter registration drives Fl Yes OX No (3) Provide a grant to an individual for travel, study, or other similar purposes Yes 0 No (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)? F]ves F X1 (5) Provide for any purpose other than religious, charitable, scientific, literary, or

educational purposes, or for the prevention of cruelty to children or animals F~ Yes OX 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 page 20 of the instructions) Organizations relying on a current notice regarding disaster assistance check here

c If the answer is "Yes" to question Sa(4), does the organization claim exemption from the tax because it maintained expenditure responsibility for the grants []Yes 0 No If "Yes ;" attach the statement required by Regulations section 53 4945-5(d)

No

3b 4a

2 Compensation of five highest-paid employees bother than those included on line 1 - see page 21

(a) Name and address of each employee (e) Tine and average (d) Contributions to paid more than $50 000 pours per sex (c) Compensation employee benefit plans

Total number of other employees paid over $50,000 3 Five highest-paid independent contractors for professional services - (see page 21 of the

instructions) If none, enter "NONE "

Total number of others recervino over $50.000 for

Expenses

1 N/A

2

3

4

Form 990-PF (2001) GRAND CIRCLE FOUNDATION INC 04-3175434 Page 6 Part VIII Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid

Employees, and Contractors 1 List all officers, directors, trustees, foundation managers and their compensation see page 20 of the instructions

(b) Title and average (c) Compensation (d) Contributions m (e) Expense (a) Name and address hours per week (If not paid enter employee benefn plans account, other

NONE

NONE

Part IX-A Summary of Direct Charitable Activities

Lisp the foundations four largest direct charitable activities during the tax year Include relevant statistical information such as the number of

(e) Expense account other

(All domestic foundations must complete this part Foreign foundations see

purposes Average monthly fair market value of securities Average of monthly cash balances Fair market value of all other assets (see page 22 of the instructions)

amount, see page 23 of the instructions) Net value of noncharitable-use assets Subtract line 4 from line 3 Enter here and on Part V, line 4 521 .530

IStflbutable Amount see page 23 of the instructions) (Section 4942Q)(3) and Q)(5) private operating foundations and certain foreign organizations check here Fland do not complete this part )

Minimum investment return from Part X, line 6 a Tax on investment income for 2001 from Part VI, line 5 2a b Income tax for 2001 (This does not include the tax from Part VI ) 2b c Add lines 2a and 2b

Distributable amount before adjustments Subtract line 2c from line 1 a Recoveries of amounts treated as qualifying distributions 4a b Income distributions from section 4947(a)(2) trusts 4b c Add lines 4a and 4b Add lines 3 and 4c Deduction from distributable amount (see page 23 of the instructions) Distributable amount as adjusted Subtract line 6 from line 5 Enter here and on Part XIII . line 1 25,590

2,006,745 0

2,006,745

0

Part XII Qualifying Distributions (see page 23 of the instructions) Amounts paid (including administrative expenses) to accomplish charitable, etc , purposes Expenses, contributions, gifts, etc -total from Part I, column (d), line 26 Program-related investments - Total from Part IX-B Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc , purposes Amounts set aside for specific charitable projects that satisfy the Suitability test (prior IRS approval required) Cash distribution test (attach the required schedule) Qualifying distributions Add lines 1 a through 3b Enter here and on Part V, line 8, and Part XIII line 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 instructions) Adjusted qualifying distributions Subtract line 5 from line 4

qualifies for the section 4940(e) reduction of tax in those years Form 99OPF (2001)

Form 990-PF(2001) GRAND CIRCLE FOUNDATION, INC 04-3175434 Page 7

Part IX-B Summary of Program-Related Investments see page 21 of the instructions)

All other program-related investments See page 22 of the instructions 3 N/A

1 th

Fair market value of assets not used (or held for use) directly in carrying out charitable, etc ,

Total (add lines 1a, b, and c) Reduction claimed for blockage or other factors reported on lines 1a and 1c (attach detailed explanation) 1e Acquisition indebtedness applicable to line 1 assets Subtract line 2 from line 1d Cash deemed held for charitable activities Enter 1 1 /2% of line 3 (for greater

NOTE The amount on line 6 volt be used in Part V column (b) in subsequent years when calculating whether the foundation

Forth 990-PF(2001)

Form 990.PF(2001) GRAND CIRCLE FOUNDATION, INC 04-3175434 Page e

Part XIII Undistributed Income (see page 24 of the instructions)

(a) (b) (c) (d) 1 Distributable amount for 2001 from Part XI, Corpus nears nor to 2000 2000 2001

line 7 25,590 2 Undistributed income, d any as of the end 012000 a Enter amount for 2000 only MINE am INOWN b Total for poor years ,s- ,s- ,s-

3 Excess distributions carryover d any, to 2007 j a From 1996 256 183 b From 1997 766,333 / c From 1998 1,635,422 d From 1999 549 e From 2000 2,794,393 f Total of lines 3a through e 7,380,880

4 Qualifying distributions for 2001 from

l a Applied to 2000, but not more than hn~e 2a 45

b years (Election undistr ibuted

required - see instructions c Treated as distributions out of corpus ~//~~//

(Election required - see instructions) d Applied to 2001 distributable amount 25 590 e Remaining amount distributed out of corpus 1,981,155 i

5 Excess distributions carryover applied l0 2001 0 (If an amount appears in column (d), the same j///VM, amount must be shown in column (a) )

6 Enter the net total of each column indicated

c Add 3f, below

* Corpus y and 4e Subtract line 5 / 9,362,035 i mill i hill

b Pne 4b faom und

li el2bbuted income Subtract

MINE O

c Enter the amount of prior years' undistributed % ~ ,~'

been issued l or on which the section 942(a) tax has been previousl y assessed

d Subtract line 6c from line 6b Taxable amount - see instructions

O

e from line 2adTaxable amount

Subtract line 4a O

income for 2001 Subtract lines 4d

t

Undistribu ted

` Zpp2

O and 5 from line 1 This amount must be distributed in 2002 0

7 Amounts treated as distributions out of corpus to satisfy requirements imposed by section 0" 0 170(b)(1)(E) or 4942(8)(3)

instructions) e S or line 7 (see page 25901 the

256,183 9 Excess distributions carryover to 2002

Subtract lines 7 and B from line 6a 9 105,852 io Analysis of line s a Excess from 1997 766,333 b Excess from 1998 1,635,422 c Excess from 1999 1,928,54

113 1 .981

9

e Excess from 2001 ~155 /

If the foundation has received a ruling or determination letter that it is a private operating foundation and the ruling is effective for 2001, enter the date of the ruling

49420)(3) or E149420)(5) b Check box to indicate whether the organization is a private operating foundation described in section 2a Enter the lesser of the adjusted net

income from Part I or the minimum investment return from Part X for each year listed

b BS% of line 2a c Qualifying distributions from Part XII,

line 4 for each year listed d Amounts included in line 2c not used

directly for active conduct of exempt activities

e qualifying distributions made directly for active conduct of exempt activities Subtract line 2d from line 2c

3 Complete 3a, b, or c for the alternative test relied upon

a "Assets" alternative 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

s part only if the organization had $5,000 or - see oaae 26 of the instructions .) more in assets at anv time during the

Form 990.PF (2001)

Form 990-PF (2001) GRAND CIRCLE FOUNDATION INC 04-3175434 Page 9

2000

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) )

NONE 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

NONE 2 Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc , Programs

Check here 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 page 26 of the 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 SEE ATTACHED ~SyqT FC-

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

Form 99o-PF (2007) GRAND CIRCLE FOUNDATION, INC 04-3175434 Pace 70 Part XV Supplementary Information (continued)

Form 990.PF (2001 )

(e) Related or exempt

Enter gross amounts unless otherwise indicated

1 Program service revenue a b c d e f g Fees and contracts from

government agencies 2 Membership dues and

assessments Inbred on sannps and temporary

cash mvesvnents

4 Dividends and interest from securities

5 Net rental income or (loss) from real estate

a Debt-financed property b Not debt-financed property

6 Net rental income or (loss) from personal property

7 Other investment income Gain or (loss) from sales of assets other than invmmry

9 Net income or (loss) from special events

10 Gross profit or (loss) from sales of inventory

(C) I (d)

24 14

71 Other revenue (a) TIC 01 9,535 b c d e [' ~//

33,9041 12 Subtotal Add cois (b) (d) and (e) OV~~~~~%~~~~1~1~~ 13 Total Add line 12, columns (b), (d), and (e) 13 33,904

(See vrorksheet in line 13 instructions on pace 26 to verify calculations )

Farm

Form 996PF (2001) GRAND CIRCLE FOUNDATION, INC 04-3175434 Page 12 Part XVII Information Regarding Transfers To and Transactions and Relationships

1 Did the organization directly or indirectly engage in any of the following with any other organization ~~%/ Yes No 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

X

(1) Sales of assets to a noncharitable exempt organization 1 (2) Purchases of assets from a noncharitable exempt organization 1 (3) Rental of facilities, equipment, or other assets 1 (4) Reimbursement arrangements 1 (5) Loans or loan guarantees 1 (6) Performance of services or membership or fundraising solicitations 1 Sharing of facilities, equipment, mailing lists, other assets or paid employees 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,

described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527? Lj Yes [A No

Form 990-PF(2001)

(1) Cash (2) Other assets Other Transactions

Under penalties of perjury I declare teal I have examined iris return including accompanying scneEUles and statements and to the best of my ~erloe and EeLef rt is True coned and complete Declaration of 0repamr (aNer Man taxpayer or fiduciary) is Eased on all mlormaGOn of wfi¢n preparer has any knowledge

Sign Here ToSfPe

Date ICheck d sell- - 1Preparers SSN or PTIN Paid

Preparei s F~~s came ~o~ io~R Use InunemoloveEl address

GRAND CIRCLE FOUNDATION, INC 04-3175434

STATEMENT 1

-----------------------------

AMOUNT

5,695

1,037,270

1, 275,650

238,560

2,557 .175

GRAND CIRCLE TRAVEL 347 CONGRESS STREET BOSTON, MA 02210

LEWIS FAMILY 347 CONGRESS STREET BOSTON, MA 02210

OVERSEAS ADVENTURE 347 CONGRESS STREET BOSTON, MA TRAVEL 02210

TOTAL INCLUDED ON LINE 1 COLUMN (a)

FORM 990-PF OTHER INCOME STATEMENT 2

3,000 TOTAL TO FORM 990-PF, PART I, LINE 16b, COLUMN (a)

FORM 990-PF CASH CONTRIBUTIONS OF $5,000 OR MORE INCLUDED ON PART I, LINE 1

CONTRIBUTOR'S NAME CONTRIBUTORS ADDRESS

PASSAGERS 8 FRIENDS

DESCRIPTION

TICKET SALES

TOTAL TO FORM 990-PF, PART I, LINE 11 COLUMN (a)

FORM 990-PF ACCOUNTING FEES

DESCRIPTION

TAX PREPARATION FEE FOR THE YEAR 2000

AMOUNT

9,535

9,535

STATEMENT 3

3,000

GRAND CIRCLE FOUNDATION . INC 04-3175434

DESCRIPTION

STATEMENT 6

FORM 990-PF TAXES STATEMENT 4

COMMONWEALTH OF MASSACHUSETTS INTERNAL REVENUE SERVICE

TOTAL TO FORM 990-PF, PART I, LINE 18, COLUMN (a)

FORM 990-PF OTHER EXPENSES

DESCRIPTION

ADMINISTRATIVE EXPENSES

TOTAL TO FORM 990-PF, PART I, LINE 23, COLUMN (a)

FORM 990-PF OTHER FUNDS

(a) (b) DESCRIPTION Beginning End of

of Year Year ENDOWMENT FUND 1,067,876 1,647,773

TOTAL TO FORM 990-PF, PART II, LINE 29 1,067,876 1,647,773

250 669

919

STATEMENT5

518

518

Name Address Relationship Status Purpose Amount

Gache Gache School ($3,500) None School General 3,500 South Africa Victoria Fall Primary School ($2,500) None School Building Fund 2,500 Victoria Falls, Tanzania Little Brothers Friends of the Elderly None Public General 25,000 One Chandler St, Boston, Ma 02116 City on a Hill Charter School None Public General 9,000 320 Huntington Ave , Boston, Ma 02115 Kinder-Und Jugenzentrum der Kath None School General 500 Winterstr 35, Munch, Germany Mass Governers Com on Physical None Public General 12,000 1 Ashburton Place, Boston, Ma 02108 Little Brothers Friends of the Elderly None Public General 3,250 One Chandler St , Boston, Ma 02116 Lhasa Jatson Chumig Welfare School None School General 500 Lhasa, China Amen Cares None Public General 5,000 161 Cherry St, New Caanan, Ct 06840 Christmas in April None Public General 20,000 249 River St , Mattapan, MA 02126 Westbrook College / Parker Pavillion None School Budding Fund 1,000 Westbrook College, Portland, Me 04103 WGBH Ralph Lowell Society None Public General 1,400 125 Western Ave, Boston, MA 02134 Amen Cares None Public General 10,000 161 Cherry St, New Caanan, Ct 06840 Tarahumara Children's Hospital None Public General 15,000 330 Crystal St, New Orleans La 70124 World Monuments Fund None Public General 50,000 95 Madison Ave, M', NY 10016 Oasis de la Ninez None Public General 15,000 Calle "El Oasis" 90 Col Minmar, Guadalajara, Mexico Northern Tentory Dept Arts & Museui None Public General 34,518 Australia West End House None Public Building Fund 5,000 105 Allston St , Allston, MA 02134 The Fund of Commonwealth Ave None Public General 200 Boston, Ma Cultural Heritage LTD None Public General 10,500 P O Box 647, Arusha, Tanzania Thompson Island Education Center None Public General 25,000 P O Box 127, Boston, Ma 02127 Artist for Humanities None Public General 25,000 288-300 A Sty ,Boston, Ma 02110 Aids Acton Committee None Public General 35,000 131 claredon St , Boston, Ma 02215 Facing History and Ourselves None Public General 10,000 16 hurd Rd, Brookline, Ma 02445 NF Inc - Mass Bay Area None Public General 10,000 9 Bedford St , Burlington, Ma 01803 The Childrens Museum None Public General 74,000

sSTRT E NkF,~ T I GRAND CIRCLE FOUNDATION, INC 04-3175434 CONTRIBUTIONS For the Year Ended 12/31/2001 Form 990-PF, Part XV - Grants & contributions Paid, Line 3

STAB ~ ~~~ . 1 O. 300 Congress St , Boston, MA 02210 Anti Defamation Plan None Public General 100,000 126 High St , Boston, MA 02210 Massachusetts Assoc for the Blind None Public General 1,000 200 Ivy Street, Brookline, Ma 02446 St Elizabeth Medical Center None Public General 3,000 736 Cambridge St, Boston, Ma 02135 HPC / Best Buddies None Public General 1,000 132 Adams St Newton, Ma 02458 MABL Boston Indians None Public General 1,000 175 - 0 Centre St, Quincy, Ma 02169 Temple Shir Tikvah None Church Building Fund 39,677 P O Box 373, Winchester, Ma 01890 Bran Tumor Society None Public General 500 124 Watertown St , Watertown, MA 024'72 Make a Wish Foundation None Public General 10,000 295 devonshire St , Boston, Ma 02210 Neurofibromatosis Inc None Public General 50.000 9 Bedford St , Burlington, Ma 01803 Roxbury Preparation Charter School None School General 5,000 120 Fisher Ave , Roxbury, MA 02120 Ells Mendel Elementary School None School General 5.000 164 School St, Roxbury, Ma 02119 Match up None Public General 5,000 140 Clarendon St, Boston, Ma 02216 Boston City Lights None Public General 4,000 1154 Washington St, Boston, Ma 02218 Rogerson Communities None Public General 5,000 One Florence St , Boston, Ma 02131 City on the Hill, Inc None School General 20,000 320 Huntington Ave , Boston, Ma 02115 Boston Sparks Association None Public Budding Fund 10,000 344 Congress St , Boston, MA 02210 The Rivers School None School General 20,000 333 Winter St, Weston, Ma 02493 AIDS Project Rhode Island None Public General 500 303 Allens Ave, Providence, RI 02905 National Multiple Sclerosis Society None Public General 1,000 733 Third Ave, NY, Ny 10017 Bran Tumor Society None Public General 1,900 124 Water-town St , Watertown, MA 02472 Brain Tumor Society None Public General 500 124 Watertown St , Watertown, MA 02472 Kensington Congregational Church None Church General 5,000 Kensington, NH 03833 Thompson Island Outward Bound None School General 100,000 P O Box 127, Boston, Ma 02127 Babson College None School Building Fund 600,000 Babson Parks, Ma 02457 Coping Center for People w/ HIV / Ax None Public General 50 PO Box 50349, Gaborore, Bots«ana Lhasa Jatson Chumig Welfare School None School General 200 Lhasa, China Amazon Medical Project Inc None Public General 5,000 106 Brodhead St , Mazomanie, WI 53560 Big Sister Association of Boston None Public General 44,000 161 Massachusetts Ave , Boston, Ma 02115

Save the Harbor / Save the Bay None Public General 10,000 59 Temple St , Boston, Ma 02111 Coastal Stars Youth Hockey League None Public General 1,000 P O Box 699, Marshfield, Ma 02050 Beth Israel / Deaconess Medical Cntr None Public General 5,000 330 Brookline Ave , Boston, Ma 02215 C G Jung Institute - Boston None Public General 1,000 P O Box 650178, W Newton, Ma 02465 Oxford University 100 Shahili Duct None School General 1,030 Oxford, England Arusha Guide School None School General 7,484 Arusha, Tanzania Putt for Parkinsons None Public Building Fund 2,000 4 David Henry Gardner Lane, Southboro, Ma 01772 The Jimmy Fund None Public General 500 10 Brookline Place West, Brookline, Ma 02445 Dana Farber None Public General 1,000 44 Binney St , Boston, MA 02115 The Jimmy Fund None Public General 500 10 Brookline Place West, Brookline, Ma 02445 Boston Partners in Education None Public General 5,000 44 Farnsworth Street, Boston, Ma 02210 Asian Task Force Against Domestic Vi None Public General 5,000 P O Box 120108, Boston, Ma 02112 Jewish Community Housing None Public General 4,620 30 Wallingford Rd, Brighton, Ma 02135 Generation Inc None Public General 5,000 59 Temple Place, Boston, Ma 02111 Memory Ride Inc (Alzheimer' s) None Public General 500 P O Box 412, Cataumet, Ma 02534 Floating Hospital (or Children Hone Public General 250 One Medical Center Place, Boston, Ma 02118 Boston Sparks Association None Public General 300 344 Congress St , Boston, MA 02210 West End House Camp None Public Scholarships 16,250 105 Allston St , Allston, MA 02134 New York Police & Fire Widow's & Children's Benefit Fund None Public General 25,000 P O Box 3713 Grand Central Station, NY, Ny 10163 Lincoln/Sudbury Metro Scholarship None School Scholarships 5,000 309 Lincoln Rd, Sudbury, Ma 01776 Make a Wish Foundation None Public General 5,000 295 devonshire St , Boston, Ma 02210 Ed Lewes Foundation (West End Hous None Public Building Fund 327,223 105 Allston St , Allston, MA 02134 Squash Busters None Public General 10,000 Astor Station Box 230027, Boston, Ma 02123 The Food Project None Public General 7,500 P O Box 705, Lincoln, Ma 01773 Southboro Education Center None School General 1,000 Southboro, Ma Ed Lewes Foundation (West End Hous None Public Building Fund 1,000 105 Allston St , Allston, MA 02134 Aids Acton Committee None Pubic General 1,000 131 claredon St , Boston, Ma 02215 New York Police Ss Fire Widow's 8s Children's Benefit Fund None Public General 1,000

Total 2,006,745

P O Box 3713 Grand Central Station, NY, Ny 10 163 San Ra(ael de Chachagua Elementary None School Building Fund 5,000 San Jose, Costa Rica Himalayan Trust None School Teacher Training F 50,000 278A Remuera Rd , Auckland, NZ Beth Israel Deaconess Medical Ctr None Public General 5,000 330 Brookline Ave , Boston, Ma 02215 Boston Family Shelter None Public General 40,000 656 Massachuetts Ave , Boston, Ma 02110 Ed Lewis Foundation (West End Hous None Public General 4,768 105 Allston St , Allston, MA 02134 Big Sister Association of Boston None Public General 10,625 161 Massachusetts Ave , Boston, Ma 02115

Directors

-0- -0- -0- Alan E Lewes Director Grand Circle Travel, Inc f{-) ilJr< <l ; c 347 Congress Street Boston, MA 02210

Fiartiel R Lewes Director Grand Circle Travel . Inc - A 347 Congress Street Boston, MA 02210

Lisa Furtado Director Grand Circle Associate Representative AA,(W Grand Circle Travel 347 Congress Street Boston, MA 02210

r, .... . Fl1R4AOI1 97 Vi SYIh

Grand Circle Foundation

Form 990-PF

-O,ASL n-q2V)Lisl

of Officers, Directors, Honorary Directors

Name and Address Title Compensabon Contributions to Avg/Hrs/Week Emp Benefit

Officers Alan E Lewes President and Treasurer -0- -0- 400 Beacon Street 1 hourhveek BOSIOn . MA

Richard Goldman Clerk -0- -0- 47 Baughn Avenue n-, tic (1,(r Newton, MA

Expense Acoounl

-4-

-0-

-0- -0- -0-

-0- -0- -0-

Susan L Ruddy Honorary Director -0- -0- 'a

Nalrure Conservancy ' I j

016 West 5th Avenue

Style 550 Anchorage. AK 99501

FORANG4o7 XL5Wh

Grand Circle Foundation Form 990-PF

s; A . ~t,,3T a List of Officers, Directors, Honorary Directors

Name and Address Title Compensation Conlnbutans to Expense AvgIHrsfWeek Emp Benefit Account

Honorary Directors Nancy Anderson Honorary Director -0- -0- -0-Lincoln Fllene Center A-) Aje(, 1 1

06dlord, MA 02155

Rodngo Carazu Honorary Duecl« ~ -0- -0- -0-

Fnends d the University la Peace A , /l/, ~~I'i (CKjdad Colon

Mora, Costa Rica

Selatiallin Erdremgil Honorary Director -0- -0- -0-

Efus Muxesi $e1CUk Izmir. 1 urkey

Sir Edmund Hillary Honorary Director -0- -0- -0-

Himalayan Trust ,q c, ~J~~c~t~c~ '8 A Remuera Road

Paw-Wand 5 New Zealand

Robert Multur Honorary Director -0- -0- -0

University la Peau: f{5 1,~~~i d, " cl P O Box 138 Gudacf Colon Costa Rica

Page 3 FORAfDGP 97 XL 5 yn

Grand Circle Foundation Form 990 - PF

s.TA. ~~mE~.cr 3

List of Officers, Directors, Honorary Directors

Name and Address Title Compensation ConlnbuUOns to Expense Avg/Hrs/Week Emp Benefit Account

Roe S Speck Honorary Director -O- -0- -0-Monteverde Conservation League A " , A/,,-, 1 ~( I Apartado 10165 .1000 San Jose, Costa Rica '

Pedro TavarQS Honorary Director -0- -0- -0- Alde&a SOS Children's Village, Portugal A5 A,'e ; de, I Rue Jose Dias Coleho 040 1300 Lisbon Portugal

Bradford Washburn Honorary Directs -0- -0- -(Y

Museum of Science A, /U~, eclrCl Silence Park Boston, MA 02 114

Barbara Washburn Honorary Director 0- -0- -0-

Museum of Science l1-, U,',cl Science Park Boston, MA 02114

Robert Wuder Honorary Director -0- -0- PinnadeLTD /~5 /1,~.'2C~c'c~ 347 Congress Street Boston, MA 02210

.1997 Giving Guideline U:ieCI ~-r, ~Z ~,ZDUO q s "e 1 I T

347 Congress Street Boston, MA 02210 (617) 346-6842

(617) 346-6840 (fax)

fin, uig+nit+iwn icai~.ng a Giant Circle grant will be capcUCd go provide a summary

How to Apply : C - if your orguutjuon hL a specific plogjarn that meets these guidelines, please complete the followgrig steps

5 In a Lonuscly wnucn two page piuposal plisse waver the fctlowmg questions

" Who aic your

" What do you witni to do' " How wail you do 0 " Who will it help,

How much vvill if cost, - flow will we luiaw you have done u?

Slcr, 2 _

Include wish your propoc+l the following " a Lsung of your bond of directors " tusid agency budget " annual report (if available) " evidence of the organization's laut-exempt status

Do nor ciccid she two poet limn or tend additional mHCna4 for they wdI not be reviewed

S~

gn otigmal and five topics of your proposal should be submnltd to Mu1N Prybylo Dirwor Grand Circle Foundation )4) Congress Street Boson, MA 02210

Ihopusils may also be delivered through any Grand Cu le associate

funJing decisions are made three times a year m May August and November Deadlines lui plopos+ls age April JO1h, July J1, and October )1

The Grand Circle Foundation

Community Services Crank Program

Giving Back

t

We an a gro++p who recognize that global clnsenship it central to the success of the company Wt will commit time people and funding to support our local community and environment in the service of creating a beast world joy our cusromerr and atsocuures to travel and discover

" Grind Circle Foundation does not fund individuals political orgamlruons aJ,uiiung dinner-table sponsorship or religious organizations

Dear Friena(

7hmA you Jol your interest art the community services grant progrmn of the Grid Gale Foundation Giving 6act to our communusu u an importmd belief ojGrand Circle Corporation We make Jmmulal contributions through the Grand Circle Foundation, which supports tananailtlu through global and community grants . charitable donations and community service

What follows an our gwdrJbw jot community service grants We believe thin people arc a canmunhy i grcarut resource and will consider projedr that recognize the wisdom of all ages and those that encourage I!felong discovery

We an interested in creative approaches and developing parourshipt that will help us give boot to our community We welcome ynt+r proposals

Grand Circle Corporation Community Servicu Team

m6sim Statement

Areas We Support:

" Elder Involvement and Education

Older adulii have built communities, ruled famdiet and coninbuted to succeeding generations m many wsys We invite proposals that FCAP the benefit, or lifetime experiences and thu involve dden u integral pans of their community We are pan¢ululy interested m projects that duller myth% of aging and instead promote cicat., carve, advcmurow aging We also beLcve in lifelong learning and will fund projects that recognize the student, and teacher. In all of um Elders are a *vibrant community resource and Grind Circle will mppon projatt that improve she community through their involvement

" Youth Education and Discovery

Young people challenge commuruua to do their best for the next generation We inviii: projeus which me dedicated to unprovuig the flmurc toy children and youth paniculaily those who are a-uit We are interested m projeai that apand horuoni for young people and build con6da,ce in that chum ud fume Proj«u Ow improve global literacy and promote global uUZrntlup will be even strong consideration

General Guidelines:

" Grants Are one year m duration and range m amount from SS00 ~ $2,300

" Gnnb ate awarded to orginwUau m the Greater Boston area

" The Foundation supports only non-profit orguuuuoni holding an active 501(c)(11i slain under the IRS Code

" We do nor fund general operating expenses or administrative cola

" Grand Circle Corporation wdeoma diversity m an iffimuuve way by providing equAl opportunity without regud to ram creed . Color, gender, secual orientation national ongm, or physical ability We expect orgwuuom we (end to men our corporate Affirmative Action and Equal Employrnem Opponunny guidelines in their hiring .,,i m Ihoee they serve

Application for Extension of Time To File an � 8868 Exempt Organization Return

IDecembet2000) OMB NO 15aS1709 ocmriiieni of mp ncasusy File a separate application for each return Inlcindl Revenue Serve

II you are filing for an Automatic 3 Month Extension complete only Part I and check this box II you are tiling for an Additional tnol automatic) 3 Month Extension complete only Part II (on page 2 of this form)

Note Do not complete Part II unless you have already been gaoled an automatic 3 month extension on a previously tiled Form 8868 Part I Automatic 3-Month Extension of Time- Only submit original (no copies needed) Note form 590 7 corporations requesting an automatic 6 month ealension-check this box and complete Part I only

all other corporations (including Form 990 C filers) must use Form 7004 to request an erlension of [,me m hle income (ax returns Partneahis REMICS and trusts must use Form 8736 m request an extension o! time to 61e Form 1065 1066 or 1041 Type or Name of Exempt Organization Employer identification number print GRAND CIRCLE FOUNDATION INC 04-3175434 F de ny ine Plumber street and loom or suite no II a P O boa see inslmclions r,,e date for 347 CONGRESS STREET tiling your iriwn Sec City town or post office slate and ZIP code For a foreign address see instructions

on,

BOSTON, MA 02210

3a If this application is (or Form 990-BL 990 PF 990-T, 4720 or 6069 enter the tentative tax, less any nonrefundable credits See instructions 487

b If this application is for Form 990-PF or 990-T, enter any refundable credits and estimated tax payments made Include any prior year overpayment allowed as a credit

c Balance Due Subtract line 3b from line 3a Include your payment with this form, or d required, deposit with FTD coupon or if required by using EFTPS (Electronic Federal Tax Payment System) See instructions 487

Signature and Verification Under penalties of perjury 1 declare that I have examined [his form including accompanying schedules and statements and to the best of my knowledge and belie)

complete and that I am aulhonzed to prepare this loam d slue coned T

sq.aiwe rule VP Planning 8 Taxation Date S - (o -0;- For Paperwork Reduction Act Notice see Instruction prtnf Form 8868 (12-2000)

Check type of return to be tiled (file a separate application for each return)

Form 990 OForm 990-T (corporation) Form 4720 Form 990 BL Form 990-T (sec 401(a) or 408(a) trust) Form 5227

F]Fonn 990 EZ Form 990-T (trust other than above) Form 6069 ~X Form 990 PF Form 1041-A Form 8870

II the organization does not have an office of place of business in the United Sales check this box If this is for a Group Return enter the organization s lour digit Group Exemption Number (GE N) I( this is

for the whole group check this box 1:1 If it is for part of the group check this box and attach a list with the names and EINS of all members the extension will cover t I request an automatic 3-month (6-month for 990-T corporation) extension of lime until 8/15/2002

to file the exempt organization return for the organization named above The extension is for the organization s return for Mcalendar year 2001

tax year beginning -and ending

2 If this tax year is for less than 12 months check reason 0 Initial return Final return [-]Change m accounting period

By Duector Date Alternate Mailing Address- Enter the address if you want the copy of this application for an additional 3 month extension

Name DARLENE D JARVIS C/O GRAND APPROVED

Type or Number and street (include style room or apt no ) Or a P O box number print 1347 CONGRESS STREET

City or town province or state and country (including postal or ZIP code) ASTON . MA 02210

Form 8868 ( -u00) Page 2

II you are filing for an Additional (not automatic) 3 Month Extension complete only Part II and check [his box Fx_1 Note Only complete Part II it you have already been granted an automatic Jrnonih extension on a previously filed Form 8868

11 you are filing for an Automatic 3-Month Extension complete only Part I (on page 1)

Part II Additional not automatic 1-Month Extension of Time-Must File On anal and One Co Type or Name of Exempt Organization

011 ,

~~ ~~~ ~~~ Employer idenhfrahon number pant GRAND CIRCLE FOUNDATION, INC i 04-3575434 v.e e, iM Number street and room or style no it a P O box see instructions j j//~ For IRS use only `"°"`° 347 CONGRESS STREET i/,/

City town of post olhce stale and ZIP code For a foreign address see instructions BOSTON MA 02210

Check type of return to he tiled (File a separate application for each return)

Form 990 F]Form 990 EZ O Form 990-T (sec 401(a) or 408(a) trust) ~ Form 1041 A Q Form 5227 ~ Form 8870

::]Fo rm 99o-BL E Form 990-PF Form 990-T (trust other than above) For. 4 X ~ Form 6069

STOP Do not complete Part 11 if you were not already granted an automatic 3irronth extension on a previously filed Form 8868

If the organization does not have an office or place of business in the United Stales check this box U If this is for a Group Return enter the organization s four digit Group Exemption Number (GEN) II this is

for the whole group check this box [:] If it is for part of the group check this box and attach a list with the names and EINS of all members tie extension is for 4 I request an additional 3-month extension of lime until 11/15/2002 5 For calendar year 10c I , or other tax year beginning an lending 6 If this tax year is for less than 12 months check reason Initial return Final return Change in accounting period 7 State in detail why you need the extension ADDITIONAL TIME IS NEEDED IN ORDER TO GATHER THE INFORMATION NECESSARY TO FILE AN ACCURATE AND CORRECT LAX RETURN

8a If this application is for Form 990-BL, 990-PF 990-T 4720 or 6069 enter the tentative tax less any nonrefundable credits See instructions

b If this application is for Form 990-PF 990-T 4720, or 6069 enter any refundable credits and estimated tax payments made Include any prior year overpayment allowed as a credit and any amount paid previously with Form 8868

c Balance Due Subtract line Sb from line 8a Include your payment with this form, or, if required deposit with FTD coupon or d required by using EFTPS (Electronic Federal Tax Payment System) See instructions 0

Signature and Verification Under penalties of penury I dxlaie that 1 have examined this loam including accompanying schedules and statements and to the best of my knowledge and belie

it is true cone a d complete and̀ that I am authorized to prepare this loan

Signature - Tine VP Planning & Taxation Date Nonce to Applicant-To Be Completed by the IRS

We have approved this application Please attach this form to the organization's return

We have not approved this application However we have granted a 10-day grace period from the later of the date shown below or the due date of the organization s return (including any prior extensions) This grace period is considered to be a valid extension of time for elections otherwise requires to be made on a timely return Please attach this form to the organization s return

We have not approved this application After considering the reasons stated in item 7 we cannot grant your request for an extension of time to file We are not granting a 10-day grace period

We cannot consider this application because it was filed after the due date of the return for which an extension eras requested

Other