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55 Return of Private Foundation Form 99Q-PF . …...Return of Private Foundation or Pectior...

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Return of Private Foundation or Pectior 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation abon may be able to use a copy of this rntum to satisfy state mportmg 2qunements 2001 Depatmmt of Me Treaacy Internal Revenue Ssvre Note The Use the IRS Name of organization A Employer iden6heaLOn number label HE 100 PERCENT CHARITY INC . Otherwise, O RU S LL FRYE 04-3332128 print Nwibe awe svaei (a P o tox number i1 their is not emneea to sheet sootiness) Rooh~sint~sinta 8 Telephone number orrype 4 LONGFELLOW PLACE # 3805 ( 617 ) 227-5937 See SDecdic Instructions City ortown,state,andZIPcode C ue .~o+~~ma~~~~+~a~a~a~«xnae BOSTON , MA 02114 D 1 Foreign organiutions,check here H Check type of organization LXJ Section 501(c)(3) exempt private foundation 2 `u°°°na na ai~cr~ ~v°vi~5% test =Section 4947(a)(1) nonexempt charitable trust 0 Other wo61e private foundation E II private foundation status eras terminated I Fair market value of all assets at end of year Accounting method W Cash L-J Accrual under section 507(b)(1)(A) . check here No- (from Part //, col (c), line 16) = Other (specify) F If the foundation is in a O-month termination 0 (Part 1. column (d) must be on cash basis ) under section 507(b)(1)(8), check here Iii 1~$ .1i I Part I Analysis of Revenue and Expenses (a) Revenue and (d) Disbursements (The total of amounts in columns (b), expenses per (b) Net investment (e) Adjusted net for charitable (c),and(d)maynotnecessantyequal equal books income income purposes the amounts in column a) ) (cash basis only) 1 Contributions, gifts, grants, etc, received enx4 ljll~ [y] if the foundation is nod required to amcn Scn B 2 Distributions horn split interest trusts 9 Ifasn'nve sv ~ ia~~~~~P~ry 570 . $70 . S70 .STATEMENT 1 O~J 4 Dividends and interest from securities 5a Gross rents 00 b Met rmtWmmme a poa) 1 ...~ Net pmn v rose) fan Sale of assets not on N 6d line to b Cross sort . Ws . fa all assets on line 9a d d ] Capital ocn net incvne (horn Part N line 2) 0 . 0 cc B Net short term capital gain W 9 Income modifications ' l02 GrovuluiessreWma y aria albwmrxs b Less Cast of goods sold c Gross profit or (loss) 11 Other income 12 Total Addlines llMOUgh11 570 . 570 . 570 . 13 Companeanon of chines directors, wsieea am 0 . 0 . 0 . 0 . 11 Other employee salaries and wages 15 Pension plans, employee benefits N t6a Legal lees b Accounting fee R~CEiVED x, e Other professi al es > V Interest ~ NOV 13 2002 S 18 Taxes C~ 19 Depreciauonan de GDEt~ , U~ ~E 20 Occupancy a 21 Travel, conferences, and meetings a 22 Printing and publications I ~ 23 Other expenses STMT 2 1 , 091 . 0 . 0 . 0 . n 24 Total operating and admmistrahve n expenses Add lines 73 through 23 1 , 091 . 0 . 0 . 0 . 0 25 Contributions, gifts, grants paid 14 , 031 . 14 , 031 . 26 Total expenses and disbursements Add lines 24 and 25 15 , 122 . 0 . 0 . 14 , 031 . 27 Subtract line 26 from line 12 A 5 52 a Encasa of rw mue w> eapensea and EisEUrsunenia <14 hNetinvestment income ofnwn .aenta-0~ ~ ~ 570 . e Adjusted net income (if nsuoinn, ents, -o 570 . a i5 : oz LHA For Paperwork Reduction Act Notice, see the instructions Form 990 PF (2001 /J 1 h 1-c , +V ~~ /55 Form 99Q-PF . OMB No
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Page 1: 55 Return of Private Foundation Form 99Q-PF . …...Return of Private Foundation or Pectior 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation abon may be able

Return of Private Foundation or Pectior 4947(a)(1) Nonexempt Charitable Trust

Treated as a Private Foundation abon may be able to use a copy of this rntum to satisfy state mportmg 2qunements

2001 Depatmmt of Me Treaacy Internal Revenue Ssvre Note The

Use the IRS Name of organization A Employer iden6heaLOn number label HE 100 PERCENT CHARITY INC .

Otherwise, O RU S LL FRYE 04-3332128 print Nwibe awe svaei (a P o tox number i1 their is not emneea to sheet sootiness) Rooh~sint~sinta 8 Telephone number

orrype 4 LONGFELLOW PLACE # 3805 ( 617 ) 227-5937 See SDecdic Instructions City ortown,state,andZIPcode C ue.~o+~~ma~~~~+~a~a~a~«xnae

BOSTON , MA 02114 D 1 Foreign organiutions,check here H Check type of organization LXJ Section 501(c)(3) exempt private foundation 2 `u°°°na na ai~cr~ ~v°vi~5% test

=Section 4947(a)(1) nonexempt charitable trust 0 Other wo61e private foundation E II private foundation status eras terminated I Fair market value of all assets at end of year Accounting method W Cash L-J Accrual under section 507(b)(1)(A) . check here No- (from Part //, col (c), line 16) = Other (specify) F If the foundation is in a O-month termination

0 (Part 1. column (d) must be on cash basis ) under section 507(b)(1)(8), check here Iii 1~$ .1i I Part I Analysis of Revenue and Expenses (a) Revenue and (d) Disbursements

(The total of amounts in columns (b), expenses per (b) Net investment (e) Adjusted net for charitable (c),and(d)maynotnecessantyequal equal books income income purposes the amounts in column a) ) (cash basis only)

1 Contributions, gifts, grants, etc, received enx4 ljll~ [y] if the foundation is nod required to amcn Scn B

2 Distributions horn split interest trusts 9 Ifasn'nvesv ~ia~~~~~P~ry 570 . $70 . S70 .STATEMENT 1

O~J 4 Dividends and interest from securities 5a Gross rents 00 b Met rmtWmmme a poa) 1 ...~

Net pmn v rose) fan Sale of assets not on N 6d line to

b Cross sort . Ws. fa all assets on line 9a d

d ] Capital ocn net incvne (horn Part N line 2) 0 .

0 cc B Net short term capital gain

W 9 Income modifications ' l02 GrovuluiessreWma

y aria albwmrxs

b Less Cast of goods sold

c Gross profit or (loss) 11 Other income 12 Total Addlines llMOUgh11 570 . 570 . 570 . 13 Companeanon of chines directors, wsieea am 0 . 0 . 0 . 0 .

11 Other employee salaries and wages 15 Pension plans, employee benefits

N t6a Legal lees b Accounting fee R~CEiVED

�x, e Other professi al es > V Interest ~ NOV 13 2002 S 18 Taxes C~

19 Depreciauonan de GDEt~ , U~ ~E 20 Occupancy a 21 Travel, conferences, and meetings a

22 Printing and publications I ~ 23 Other expenses STMT 2 1 , 091 . 0 . 0 . 0 . n 24 Total operating and admmistrahve n expenses Add lines 73 through 23 1 , 091 . 0 . 0 . 0 . 0 25 Contributions, gifts, grants paid 14 , 031 . 14 , 031 .

26 Total expenses and disbursements Add lines 24 and 25 15 , 122 . 0 . 0 . 14 , 031 .

27 Subtract line 26 from line 12 A

5 52 a Encasa of rw mue w> eapensea and EisEUrsunenia <14

hNetinvestment income ofnwn.aenta-0~ ~ ~ 570 . e Adjusted net income (if nsuoinn, ents, -o 570 .

a i5: oz LHA For Paperwork Reduction Act Notice, see the instructions Form 990 PF (2001 /J 1 h 1-c ,

+V ~~

/55 Form 99Q-PF . OMB No

Page 2: 55 Return of Private Foundation Form 99Q-PF . …...Return of Private Foundation or Pectior 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation abon may be able

CHARITY INC . 1 2

Value (E) Book Value (c) Fair Market Value

1 , 277 .

L , 056 .

x,333 . 0 . 0 .

Organizations that follow SFAS 117, check here " U and complete lines 24 through 26 and lines 30 and 31

N °' 24 Unrestricted U

.2 25 Temporarily restricted co 26 Permanently restricted C Organizations that do not follow SFAS 117 . check here

and complete lines 27 through 37 0 H 27 Capital stock, trust principal, or current funds ,°'n 28 Paid-in or capital surplus, or land, bldg, and equipment fund m a 29 Retained earnings, accumulated income, endowment, or other funds °' 30 Total net assets or fund balances z

Analysis of Changes in Net Assets or Fund Balances

From 990-PF (2001)

123511 of 24 OZ

2

Part II ,Balance Sheets Attached schedules ane+mounuinmedescription column should be far enOClyrhamounts puts,

1 Cash - non-interest-bearing 2 Savings and temporary cash investments 3 Accounts receivable

Less allowance for doubtful accounts 4 Pledges receivable 10,

less allowance for doubtful accounts 5 Grants receivable 6 Receivables due from officers, directors, trustees, and other

disqualified persons Other notes inAloans iaeqGle

Less allowance for doubtful accounts y 8 Inventories for sale or use d 9 Prepaid expenses and deterred charges N

10a Investments - U S and state government obligations

b Investments-corporate stock e Investments-corporate bonds

1 Innitmenb land 0uY0inOS+nEequipment Eavs

Los artumeGteGGe0rttu0on

12 Investments - mortgage loans 13 Investments - other 14 Land, bwldings, and equipment hosts

Less accumulated 0t0ill

15 Other assets (describe

77 Accounts payable and accrued expenses 18 Grants payable 19 Deferred revenue d

20 Lawns Rom oHims dvectws vustees and oma aisQUalified p>sans

m 21 Mortgages and other notes payable

J 22 Other liabilities (describe " STATEMENT 3 )

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)

2 Enter amount from Part I, line 27a 3 Other increases not included in line 2 (itemize) t 4 Add lines 1, 2, and 3 5 Decreases not included in line 2 (itemize) 6 Total net assets or fund balances at end of year (line 4 minus line 5) - Part II, color

Page 3: 55 Return of Private Foundation Form 99Q-PF . …...Return of Private Foundation or Pectior 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation abon may be able

THE 100 PERCENT CHARITY INC . 990-PF

" Ca(2o01 C O RU SELL FRYE 04-3332

R IV pital Gams and Losses for Tax on Investment Income

(a) List and describe the kind(s) of property sold (e 8 . peal estate, (b1 How acquired (c) Date acquired 2-story brick warehouse, or common stock, 200 shs MLC Co ) P - Purchase (mo , day, yr ) D - Donation

NONE

(e) Gross sales price I (1) Depreciation allowed I (p) Cast or other basis I (h) Gain or (lass) (or allowable) plus expense of sale (e) plus (f) minus (p)

(d) Date sold (ma , day, yr )

omplete only for assets showing gain in column (h) and owned by the foundation on 12/31/69

i 12!31/69 (l) Adjusted basis (k) Excess of col (q 1 F M V as of as of 12131/69 over col (1), if any

(I) Gains (Col (h) gain minus Cal (k), but not less than-0-)or

Losses (from col (h))

3

2 Capital gain net income or (net capital loss) If gain, also enter in Part I, line 7

g ( 1 t II (loss), enter -0- in Part I, line 7

3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6) II gain, also enter in Part I, line 8, column (c) If (loss) . enter -0- in Part I, line 8

I Part V I Qualification under section aV4u1[e) for r+eaucea i ax on Net investment income (For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income ~

II section 4940(4)(2) applies, leave this part blank

Was the organization liable for the section 4942 tax on the distriDulable amount of any year in the base periods 0 Yes [M] No If 'Yes .'the organization does not quality under section 4940(e) Do not complete this part 1 Enter the appropriate amount in each column for each year, see instructions before making any entries

Base Deraod years 'bn (~) Distribution ratio raionnar voa, ((If tax VPBf hP0100100101 Ad justed q ualifying distributions Net value of nonchantable-use assets lcol !61 divided by cot fru

2 Total of line 1, column (d) 3 Average distribution ratio for the 5 year base period - divide the total on line 2 by 5, or by the number of years

the foundation has been in existence if less than 5 years

4 Enter the net value of nonchantable-use assets for 2041 ham Part X, line 5

5 Multiply line 4 byline 3

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

7 Add lines 5 an0 6

8 Enter qualifying distributions from Part XII, line 4

II line 8 is equal to or greater than line 7, check the box in Part VI, line 7b, and complete that part using a 1 % tax rate See the Part VI instructions

Fmn 990-PF (zooi) 177527 01-74-02

Page 4: 55 Return of Private Foundation Form 99Q-PF . …...Return of Private Foundation or Pectior 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation abon may be able

Farm 990-PF Part on

check here 1 I-I and enter 'N/A' on line 1 f a Exempt operating foundations described in section

c Tax paid with application for extension of time to file (Form 8868) I 6 d Backup withholding erroneously withheld

7 Total credits and payments Add lines 6a through 6d B Enter any penalty far underpayment of estimated lax Check here 0 d Farm 2220 is attached 9 Tax due If the total of lines 5 and B is mare than line 7, enter amount owed

10 Overpayment If line 7 is more than the total of lines 5 and 8, enter the amount overpaid 11 Enter the amount of line 10 to be Credited to 2002 estimated tax ja~ Part

Web site address

Located at " 4 LONGFELLOW PLACE, STE . 3805, BOSTON . MA ZIP .4 .02114 13 Section 4941(a)(1) nonexempt charitable trusts tiling Form 990-PF in lieu of Form 1041- Check here No- EJ

and enter the amount of tax-exempt interest received or accrued during the Veal 0-1 13 1 N/A 133571 o, a.az c~ 990-PF agog

INC .

Date of ruling letter (attach copy of ruling letter if necessary-see Instructions) b Domestic organizations that meet the section 4940(e) requirements in Part V, check here 1 M and enter tYo

of Part I, line 21b s All other domestic organizations enter 2% of line 27b Exempt foreign organizations enter 4% of Part I, line 12, cot (b)

2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable loundauons only Others enter -0-) 3 Add lines 1 and 2 4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and table foundations only Others enter -0-) 5 Tax based on investment income Subtract line 4 from line 3 If zero or less, enter -0- 6 Credits/Payments a 2001 estimated tax payments and 2000 overpayment credited to 2001 6a b Exempt foreign organizations - tax withheld at source 6b

or

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 $700 during the year (either directly or indirectly) for political purposes (see instructions for definition)? 11 the answer is 'Yes' to 1 a or 1b, attach a detailed description o/ the activities and copies of any materials published or distributed by the organization m connection with the actrvrties

c Did the organization file Form 1120-POL for this year? d Enter the amount (d any) of tax on political expenditures (section 4955) imposed during the year

(t) On the organization 1 5 0 . (2J On organization managers " S e Enter the reimbursement (d any) paid by the organization during the year for political expenditure tax imposed on organization

managers " $ 0 . 2 Has the organization engaged in any activities that have not previously been reported to the IRS

II 'Yes,' attach a detailed descnption of the activities 3 Has the organization made any changes, not previously reported to the IRS, in its governing instrument, articles of incorporation, or

bylaws, or other similar instruments If 'Yes,' attach a conformed copy of the changes 4a Did the organization have unrelated business gross income of $1,000 or more during the yeah 0 H Yes; has it tiled a tax return on Foam 990-T for this years N / A

S Was there a liquidation, termination, dissolution, or substantial contraction during the yeah 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 eflectrvey amends the governing instrument so that no mandatory directions that conflict with the state law remain in the governing instrument?

7 Did the organization have at least $5,000 in assets at any time during the year If 'Yes,' complete Part ll, cot (c), and Part XV

Be Enter the states to which the foundation reports or with which it is registered (see instructions) MASSACHUSETTS

b If the answer is 'Yes' to line 1, has the organization furnished a copy of Form 990-PF to the Attorney General (or designate) of each state a5 required by General Instruction GO If *No,' attach explanation

9 Is the organization claiming status as a private operating foundation within the meaning of section 4942(j)(3) or 4942(j)(5) for calendar year 2001 or the taxable year beginning in 2007 (see instructions for Part %1V)? It 'Yes,' complete Part XIV

10 Did any persons become substantial contributors during the tax years If 'Yes,' attach a schedule listing their names and addresses

11 Did the organization campy with the public inspection requirements for its annual returns and exemption application? N/A

12 The books are in care of 1 RUS SEL H . FRYE Telephone no 1

Page 5: 55 Return of Private Foundation Form 99Q-PF . …...Return of Private Foundation or Pectior 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation abon may be able

Farm

a disqualified person (3) Furnish goods, services, or facilities to (or accept them ham) 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) =Yes 130 No

b did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? 11 you answered 'Yes' to 6b, also ale Form 8870

w,~, 990-PF Rao,)

insa i 0 f xs-0z

D Yes M No

Yes ~ No D Yes ~ No D Yes ~ No

(6) Agree to pay money or property to a government official? (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, d terminating within 90 days ) =1 Yes [11 No

b It any answer is 'Yes'to 1a(1)-(6), did any of the acts fail to quaky under the exceptions described in Regulations section 53 4941(d)-3 or in a current nonce regarding disaster assistance (see gape 19 of the instructions)? N/A 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 1a, 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))

s At the end of tax year 2007, did the organization have any undistributed income (lines 6d and tie, Part XIII) for tax year(s) beginning before 2001 D Yea If] No It 'Yes,' list the yens 10-

b Are there any years listed in 2a for which the organization is not applying the provisions of section 4942(a)(2) (relating to incorrect valuation of assets) to the year's undistributed incomes (If applying section 4942(a)(2) to all years listed, answer 'Nor and attach statement - see instructions ) N/A

e II 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 year9 0 Yes [13 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) tie lapse of the 5-year period (or longer period approved by the Commissioner under section 4993(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 organrzahon had excess business holdings m 2001) N/A

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 otter 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 20017

5a During the year did the organization pay or incur any amount to t) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? 0 Yes W No

(2) Influence the outcome of any specific public election (see section 4955), or to carry on, directly or mduecly, any voter registration drrve9 ~ Yea ERI No

(3) Provide a grant to an individual for travel, study, or other similar purposes ~ Yea ETO 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)? 0 Yea EKI No (5) Provide for any purpose other than religious, charitable, scientific, literary, or educational purposes, or for

the prevention of cruelty to children or animals 0 Yes n No b II any answer is 'Yes' to Sa(1)-(5), did any of the transactions fail to quality under the exceptions described in Regulations

section 53 4945 or in a current notice regarding disaster assistance (see instructions)? NIA Organizations relying on a current notice regarding disaster assistance check here op. ED

c II the answer is Yes' to question Sa(4), does the organization claim exemption from the tax because it maintained expenditure responsibility for the gratin N/A ~ Yes D No If 'Yes,' attach the statement required by Regulations section 53 4945-5(d)

6a Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contracY9 1::1 Yes M No

THE 100 PERCENT CHARITY INC .

File Form 4720 N any item is checked in the 'Yes' column, unless an exception applies 1a During the year did the organization (either directly or indirectly)

(1) Engage 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 it from)

Page 6: 55 Return of Private Foundation Form 99Q-PF . …...Return of Private Foundation or Pectior 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation abon may be able

100 PERCENT CHARITY INC . RUSSELL FRYE

About Officers, Directors, Trustees, F Farm 990 PF(2

Part VIII

7 List all oN

2 Compensation of live highest-paid employees (other loan tl

(a) Name and address of each employee paid more than $50,000

on line 1) IT none, enter "NONE Title and average lours per week _ (c) Compensation

3 Five highest-paid independent contractors for professional services If none, enter "NONE (a) Name and address of each person paid more than $50,000 of service

cm� 990-PF (xooq

6

(a) Name and address (b) Title, and average (c) G

hours per week devoted (II to position e

RES/TREAS/DI .

DI

List the lounda6ori s four largest direct charitable actmties during the fax year Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc

t N/A

2

3

4

-3332128 Pages aid Employees,

b

Expenses

Page 7: 55 Return of Private Foundation Form 99Q-PF . …...Return of Private Foundation or Pectior 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation abon may be able

Total Add hoes 1 through 3 Pa. I

Part X Minimum Investment Return (All domestic foundations must complete this part Foreign foundations, see instructions )

1 Fair market value of assets not used (or held for use) directly in carrying out charitable, etc , purposes a Average monthly lair market value of securities b Average of monthly cash balances c Fart market value of all other assets d Total (add lines 1a, b, and c) e Reduction claimed for blockage or other factors reported on lines 1a and

1c (attach detailed explanation) 1e 2 Acquisition indebtedness applicable to line 1 assets 3 Subtract line 2 from line 1d 4 Cash deemed held for charitable activities Enter 1 12y of line 3 (for greater amount, see instructions) 5 Net value of noncharinble-use assets Subtract line 4 from line 3 Enter here and on Part V, line 4 6 Minimum investment return Enter 5% of line 5

7

THE 100 PERCENT CHARITY INC . Form 990-PF(2007) C/O RUSSELL FRYE 04-3332128 Page 7 Part IX-B Summary of Program-Related Investments

Describe the two largest oroaram-related investments made by fee Inundation during the tax year on lines 1 and 2

1

2

All other program related investments See instructions 3

Pa1t XI DiStnbutabl0 Amount (see instructions) (Section 4942(1)(3) and (1)(5) private operating foundations and certain foreign organizations check here 1 and do not complete this part)

-1 Minimum investment return from Part X, line 6 1 Q , 2a Tax on investment income for 2001 from Part VI, line 5 2a 6 . h Income tax tar 2001 (This does not include the tax from Part VI ) 2b e Add lines 2a and 2b 2e 6 .

3 Distribulable amount before adjustments Subtract line 2c from line 7 3 0 . 4a Recoveries of amounts treated as qualifying distributions 4, 0 . b Income distributions from section 4947(a)(2) trusts 4D 0 . e Add lines 4a and 4b 4e 0 .

5 Add lines 3 and 4c s 0 . 5 Deduction from distrihutable amount (see instructions) ~ 6-~ 0 . 7 Distrihuhble amount as adjusted Subtract line 6 from line 5 Enter here and on Part XIII, line 1 7

Part XII Qualifying Distnbutions see instructions)

1 Amounts paid (including administrative expenses) to accomplish charitable, etc , purposes a Expenses, contributions, gifts, etc - total from Part I, column (d), line 26 1a 14 , 0 31 . b Program-related investments Total from Past IX-B 7b 0 .

2 Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc , purposes 2 3 Amounts set aside for specific charitable projects that satisfy the a Suitability test (prior IRS approval required) 3a b Cash distribution test (attach the required schedule) 3b

4 Qualifying distributions Add lines 1a through 3b Enter here and on Part V, line 8, and Part XIII, line 4 4 141 , 031 . 31 . 5 Organizations that quaky under section 4940(e) far the reduced rate of lax on net investment

income Enter 1% of Part I, line 27b 5 ( , 6 Adjusted qualifying distributions Subtract tine 5 from fine 4 ~ 6 l 14 . 025 .

Note The amount online 6 will be used m Part V, column (b), m subsequent years when calculating whether the foundation qualifies for the section 4940(e) reduction of tax m those years

Fom, 990-PF Roo,)

123581 of-za-02

Page 8: 55 Return of Private Foundation Form 99Q-PF . …...Return of Private Foundation or Pectior 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation abon may be able

8

T PERCENT CHARITY INC .

Form 990-PF (2001) CM MRSELL FRYE 04-3332128 Page e

Undistiributed Income (see instmctions)

(a) (b) (c) (d) Corpus Years prior to 2000 2000 2001

1 Distributable amount for 2001 from Part X1, line 7 0 .

2 U.d.StnWied hi~ne. it My M of the end of 2000 a Enter amount for 2000 only 0 . b ToW for mor years 19 -,19 .19 0 .

3 Exotoo, ifliAnbutions ~Vff if my to 2WI a From 1996 b From 1997 c From 1998 d From 1999 e From 2000 I Total of lines 3a through a 0 .

4 Oualitying distributions for 2001 from PartXl1,lrne4 N~S 14,031 .

a Applied to 2000, but not More than line 2a 0 . b Applied to undistributed income of prior years (Election required - see instructions) 0 .

c Treated as distributions out of corpus (Election required - see instructions) 0 .

d Applied to 2001 distributable amount 0 . a Remaining amount distributed out of corpus 14,031 .

5 Exc~ distributiont; can-ywer ii,,Phed to 2W1 0 . 0 . of en mno,,,ni V~3 in Wtumn (cr~ the ~e arnweit muet oe m,ni,n in miumn ( .i)

6 Enter the net total of each column as indicated below-

a cono,.,3 Md lin" 31 ~, and fe SubtrW ine 5 14,031 . b Prior years' undistributed income Subtract line 41b from line 2b 0 .

c Enter the amount of prior years' undistributed income for which a notice of deficiency has been issued, or on which the section 4942(a) tax has been previously assessed 0 .

d Subtract line 6c from line 6b Taxable amount - see instructions 0 .

e Undistributed income for 2000 Subtract line 4a from line 2a. Taxable amount - see insor 0

t Undistributed income tar 2001 Subtract lines 4d and 5 from line 1 This amount must be distributed in 2002 0

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

8 Excess distributions carryover from 1996 not applied on line 5 or line 7 0

9 Excess distributions carryover to 2002 Subtract lines 7 and 8 from line 6a 1 4 0 3 1

10 Analysis of line 9 a Excess from 1997 b Excess from 1998 c Excess from 1999 d Excess from 2000 a Excess from 2001 14,03

Foon 990-PF (2001)

123571 0

1 -24-()2

Page 9: 55 Return of Private Foundation Form 99Q-PF . …...Return of Private Foundation or Pectior 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation abon may be able

CHARITY INC . see instwchons and Part VII A

10. 1 ction EJ 4942(j)(3) or El 42 (5) Prior 3 years

(c) 1999 (d) 1998 (e) Total

organization had $5,000 or more in assets

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

b Check box to indicate whether the organization is a orrvale operating foundation describe 2 a Enter the lesser of the adjusted net I Tax year I

2000 income from Part I or the minimum (a) 2001 investment return from Part X for each year listed

b 85% of line 2a j: Qualifying distributions from Part XII,

line 4 for each year listed it Amounts included in line 2c not used directly for active conduct of exempt activities

e Qualifying distributions Made directly [or 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)(8)(i) b *Endowmenr alternahve test -

Enter 213 of minimum investment return shown in Part X, line 6 for each year listed

c 'Supporr 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 Ili

(3) Largest amount of supp rt from an exempt organization

d Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, of other factors CHARITABLE, EDUCATIONAL, RELIGIOUS, SCIENTIFIC OR LITERARY PURPOSES .

F~990-PF f2wil 123MIMI-2. 02

at any time during the year-see page 26 of the instructions .) I 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) )

b List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.

2 Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc, Programs- Check here ll~ = it the organization only makes contributions to preselecled charitable organizations and does not accept unsolicited requests for funds It the organization makes gifts, grants, etc (see instructions) to individuals or organizations under other Conditions, complete items 2a, lb, c, and If

a The name, address, and telephone number of the person to whom applications should be addressed RUSSEL H . FRYE, 4 LONGFELLOW PLACE, #3805, BOSTON, MA 02114 (617) 227-5937

b The form in which applications should be submitted and information and materials they should include LETTER OR SUBSCRIPTION CARD, EXPLANATORY LETTER, BROCHURE/PAMPHLET

c Any submission deadlines

Page 10: 55 Return of Private Foundation Form 99Q-PF . …...Return of Private Foundation or Pectior 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation abon may be able

NONE

3b 1 0 . F. 990-PF r2w i) 123WIMI 244)2

10

TH 188

PERCENT CHARITY INC . Form 990-PF (2001) C, 6 R SELL FRYE 04-3332128 Page 10

IPartXV1 Supplementary Information (continued) 3 Grants and Conbibutions Paid During the Year or Approved for Future Payment

Recipient It recipient is an individual, show any relationship to Foundation Purpose of grant or

Name and address (home or business) any foundation manager status of contribution Amount or substantial contributor recipient

a Paid dunng the year

EYEBEAM ATELIER, 45 MAIN NON-PROFITDONATE TO STREET, BROOKLYN, NY 11201 DRGANIZATIMOVING IMAGE

N [DIVISION

IM ION

ONE VROJATCT 10,000 .

AMERICAN RED CROSS OF OTHER ASSIST FAMILIES MASSACHUSETTS BAY, 285 PUBLIC OF VICTIMS OF COLUMBUS AVE, BOSTON, MA ONE CHARITY 9/11/01 TRAGEDI 3,000 .

BOSTON SYNAGOGUE, 55 ELIGIOUS DONATION TO MARTHA ROAD, BOSTON, MA, RGANIZATISUPPORT 02114 N SYNAGOGUE

ONE JACTIVITIES 1,031 .

It Approved for future payment

Page 11: 55 Return of Private Foundation Form 99Q-PF . …...Return of Private Foundation or Pectior 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation abon may be able

Line No Explain below how each activity for which income is reporled in column (e) of Part XVI-A contributed importantly to the accomplishment of V I the organu2non s exempt purposes (other than by providing funds for such purposes)

11 F. 990-PF (zooi)

THE 100 PERCENT CHARITY INC. Form 990-PF (20011 CIO RUSSELL FRYE 04-3332128 page I I Analysis of income, Producing Activities

Enter gross amounts unless otherwise indicated umeiaieu uubillusb liluume I Ezclu~ bV Wt~ 512 513 ~ S14 I (e)

(a) (b) EU- (it) Related or exempt Business Amount 1 Program service revenue code C~* Amount function income

a It c I d e f it Fees and contracts from government agencies

2 Membership dues and assessments 3 Interest on savings and temporary cash

investments 570 . 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 8 Gain or (loss) from Sales of assets other than inventory

9 Net income or (loss) from special events 10 Gross profit or (loss) from sales of inventory 11 Other revenue

a b c it e

12 Subtotal Add columns (b), (d), and (e) 0 . 0 .1 570 . 13 Total Add line 12, columns (b), (d), and (e) ll~ 13 570 . (See worksheet in line 13 instructions to verity calculations F..P__a_r_t_X_V_1B_~ Relationship of Activities to the Accomplishment of Exempt Purposes

Page 12: 55 Return of Private Foundation Form 99Q-PF . …...Return of Private Foundation or Pectior 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation abon may be able

CHARITY INC .

(4) Reimbursement arrangements 11 (5) Loans or loan guarantees ; 5i

(6) Performance of Services or membership or fundrarsing solicitations 1b 6 Sharing of facilities, equipment, mailing lists, other assets, or paid employees 91C If the answer to any of the above is "Yes,' complete the following schedule Column (b) should always show the fair market value of the goods, other assets, or services given by the reporting organization If the Organization received less than fair market value in any transaction or sharing arrangement, show in column 1d) the value of the goods, other assets, or services received

of transfers, transactions, and Line no .[ (b) Amount involved I (c) Name of nonchantable exempt organization

= Yes [K) No

of

123521 01 2"2

Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?

a Transfers from the reporting organization to a norchantable exempt organization of-(1) Cash (2) Other assets

b Other Transactions (1) sales of assets to a noncharitable exempt organization (2) Purchases of assets from a noncharilable exempt organization (3) Rental of facilities, equipment, or other assets

2a Is the organization directly or indirectly alliliated 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?

u.a. ei-ta,beew ma)1 ih~e totaimmici th. Fitt. ~ndudlng accom,pamymg achadul" Md Matements Md to the best of my ~WIWW Wd better IF 16 "a ~ftt wal complete Oecl pay. ba~l on all intcirmatt. of tch V W has arty ~WW

Signature ofolficer or truste Da

Preparer's >

J5 -E Signature

We 'L 0 CE

0. a 0 Him 3 nime (OF YOUM SCHNEIDER, SCHNEAIDER& A Z =) dsefflrrrpilyed~ 35 BRAINTREE HILL OFFICE OL

IdUmS ad Zlittode MV A TXTMV WW M A I) ') 1 0 A

Page 13: 55 Return of Private Foundation Form 99Q-PF . …...Return of Private Foundation or Pectior 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation abon may be able

THE 100 PERCENT CHARITY INC . C/O RUSSELL 04-3332128

FORM 990-PF INTEREST ON SAVINGS AND TEMPORARY CASH INVESTMENTS STATEMENT I

AMOUNT

TOTAL TO FORM 990-PF, PART 1, LINE 3, COLUMN A

STATEMENT 2

(C) ADJUSTED

NET INCOME

0 . 0 .

0 .

(A) (B) EXPENSES NET INVEST-PER BOOKS MENT INCOME

1,056 . 0 . 35 . 0 .

1,091 . 0 .

AMORTIZATION MASS ANNUAL REPORT

TO FORM 990-PF, PG 1, LN 23 0 .

FORM 990-PF OTHER LIABILITIES STATEMENT 3

AMOUNT

STATEMENT(S) 1, 2, 3 13

SOURCE

FLEET BANK

FORM 990-PF

DESCRIPTION

OTHER EXPENSES

570 .

570 .

(D) CHARITABLE PURPOSES

0 . 0 .

DESCRIPTION

DUE TO FRYE PRODUCTIONS, INC

TOTAL TO FORM 990-PF, PART II, LINE 22, COLUMN B

0 .

0 .

Page 14: 55 Return of Private Foundation Form 99Q-PF . …...Return of Private Foundation or Pectior 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation abon may be able

0161J3 No IU~0142

2001 Underpayment of Estimated Tax by Corporations

IN- See separate instructions lll~ Attach to the contoration's tax return FC)RM qqf)-P

Depwtmmt of ffio Tra~ nt~ R~mue S.

Name

THE 100 PERCENT CHARITY INC .

Note In most cases, the corporation does not need to file Form 2220 (See Part I below for exceptions ) The IRS will figure any penalty owed and bill the corporation it the corporation does not need to file Form 2220, it may still use it to figure the penalty Enter the amount from line 36 on the estimated tax penalty line of the

boxes below that apply to the corporation It (tie Form 2220,

I L_J The corporation is using the annualized income installment method 2 E::] The corporation is using the adjusted seasonal installment method 3 [D The corporation is a 'large corporation* figuring its first required installment based on the prior year's tax. Note The corporation also must file Form 2220 if it has a suspended research credit allowed for the current year (see the instructions for line 4) or it is an

Sa Personal holding company tax (Schedule PH (Form 1120), line 26) included on line 4 5a b Look-back interest included on line 4 under section 460(b)(2) for completed long-term

contracts or of section 167(g) for property depreciated under the income forecast method 5b

c Credit for Federal tax paid on fuels (see instructions) Set d Total Add lines 5a through 5c 6 Subtract line 5d from line 4 If the result is less than S500, do not complete Or file this form The corporation does

not owe the penalty 7 Enter the tax shown on the Corporation's 2000 income tax return Caution See instructions before completing

this line

10 Required installments If the box on line 1 and/or line 2 above is checked, enter the amounts from Schedule A, line 40 If the box on line 3 (but not 1 or 2) is checked, see instructions for the amounts to enter If none of these boxes are checked, enter 25% of line 8 above in each column

11 Estimated tax paid or credited for each period (see instructions) For column (a) only, enter the amount from line 11 on line 15 Complete lines 12 through 18 of one column before going to the next column

12 Enter amount, if any, from line 18 of the preceding column

13 Add lines I I and 12 14 Add amounts on lines 16 and 17 of the preceding

column 15 Subtract line 14 from line 13 It zero or less, enter -0- 16 lt the amount on line 15 is zero, subtract line 13 from

line 14 Otherwise, enter -0- 17 Underpayment It line 15 is less than or equal to line

10, subtract line 15 from line 10 Then go to line 12 of the next column Otherwise, go to line 18

18 Overpayment It line 10 is less than line 15

Complete Part III on pace 2 to floure the penalty If there are no entries on line 17, no penalty is owed 11280, 02-01-02 JWA For Paperwork Reduction Act Notice, see separate instructions 13 .1 Form 2220 (200 1)

Form 2220

Employer identification number

4 Total tax (see instructions)

8 Enter the smaller of line 6 of line 7 it the corporation must 9 Installment due dates Enter in columns (a) through (d)

the 151h day of the 4th (Form 990-PF liters Use 5th month), Sth, 9th, and 12th months of the corporation's tax year Exception Enter October 1, 2001, instead of September 15, 2001 111.

Page 15: 55 Return of Private Foundation Form 99Q-PF . …...Return of Private Foundation or Pectior 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation abon may be able

FORM 990-PF T76 100 PERCENT CHARITY INC . Form 2220 (2001)

C RUSSELL FRYE 04-3332128 - Page 2

1~ Fig'unng the Penalty -

19 Enter the date of payment or the 15th day of the 3rd month after the close of the tax year, whichever is earlier (see instructions) (Form 990-PF and Form 990-T filers Use 5th month instead of 3rd month )

20 Number of days from due date of installment on line 9 to the date shown on line 19

36 Penalty Add columns (a) through (d), of line 35 Enter the total here and on Form 1120, line 33, Form 1120-A, line

* For underpayments paid after March 31, 2002 For lines 28, 30, 32, and 34, use the penalty interest rate for each calendar quarter, which the IRS will determine during the first month in the preceding quarter These fates are published quarterly in an IRS News Release and in a revenue ruling in the Internal Revenue Bulletin To obtain this information on the Internet access the IRS Web Site at wwrv irs gov You can also call 1-800-829-1040 to get interest rate information

JWA Form 2= 2001

".2502 02-0 1 ~02 13 .2

21

22 [email protected] .Ntrrnb. .fd . . on lin*2 c8% 3M

23 Numinite of d3OW line 20 aflw W0,21)(11 and belme 1/1/2W2

24 Llnd~.Ment . line 17 c Nunib~ fd~y. .n lima 2 X7% 365

25 Nu.~.1d~. .I~.2O .R.lV31/2WI .d~.Vl~M2

26 Jnd~aymennw line 17 x Numb& ofdayaon line 2 x&!1i6 3M

27 NuMbWot~y3wline2OOw=1/2W2wdbafma7/lnW2

28 .-A

29 ftmbwof~y3m~0620 .n~~2002 .dbot~.iWI/2M2

30 Und~~~toni,n6l7~NU,b~ .f"y.~[fne2 X`ek 385

31 Num~ofdaysmi~aZO~ag/W~002wdbafmal/lrW3

32 und~ayrnenl w line 17 it N.rnber W dW. n line 3 X M

33 Niiinbow f d.y . . line 20 ilfl~ 1~ InW2 end bilfm. VIW003

34 Llnd~enlwlinvwxlilum~of~i,mline3 X'lik 385

35 Add lines 22, 24, 26, 28, 30, 32, and 34

Page 16: 55 Return of Private Foundation Form 99Q-PF . …...Return of Private Foundation or Pectior 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation abon may be able

Form 886b (December 2000) Dep,irtmert of the Trca~ I .Whel S..

Application.for Extension of Time To File an Exempt Organization Return I OMB No 15451709

for each return File a

Note Form 990-T corporations requesting an automatic 6-month extension - check this box and complete Part J only All other corporations (including Fonri 990-C liters) must use Fomr; 7004 to request an extension of time to file income tax returns Partnerships, REMICs and trusts must use Form 8736 to request an extension of time to hle Form 1065, 1066 or 1041

File by the d .. d.t . W filM, Y., ' .t .'ri S. ins~ct*ns

Number street and room or suite no If a P 0 box see instructions

City town or post office, state, and ZIP code For a foreign address, see instructions

Reduction Act Notice, see instruction Form 8868 (12 2000) SOITIBER, SM':00 & ASSOCIATM PIL' 35 Braintree Hill Off ice Park Braintree . Massachusetts, 02184 ,fed. Id. # 04-3102588

123831 07 1801

" If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box it. ER] " if you are filing for an Additional (not automatic) 3-Month Extension, complete only Part 11 (on page 2 of this form) Note Do not complete Part 11 unless you have already been granted an automatic 3-month extension on a previously filed Form 8M

FP-art I j Automatic 3-Month Extension of Time - Only submit original (no copies needed)

Type or print

Name of Exempt Organization THE 100 PERCENT CHARITY INC .

Employer identification number

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

Form 990 ID Form 990 T (corporation) EA Form 4720 Form 99GBL Form 990 T (sec 401 (a) or 408(a) trust) = Form .5227 Form 990-EZ Form 990-T ("st other than above) E::] Form 6069

Ef] Form 990 PF Form 1041 A = Form 8870

0 If the organization does not have an office or place of business in the United States Check this box 1~ 1=1 0 If this is for a Group Return, enter the organization s four digit Group Exemption Number (GEN) _ If this is for the whole group check this box. 110- = lf .t,s for part of the group check this box ill, = and attach a list with the names and EINs of all members the extension will cover

1 1 request an automatic 3 month (6 month for 990-T corporation) extension of time until AUGUST 15, 2002 to file the exempt organization return for the organization named above The extension is for the organization s return for 10- calendar year 2 0 0 1 or 10, tax year beginning and ending

2 It this tax year is for less than 12 months check reason Initial return Final return Change in accounting period

3a If this application is for Form 990 BL, 990kPF, 990 T . 4720 or 60159 enter the tentative tax less any nonrefundable credits See instructions

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 if required deposit with FTD coupon or if required, by using EFTPS (Electronic Federal Tax Payment System) See instructions

Signature and Verification

Under penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, andpoinplete, and that I am authorized to prepare this form

LHA For

Page 17: 55 Return of Private Foundation Form 99Q-PF . …...Return of Private Foundation or Pectior 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation abon may be able

By Date Director

Type Number and street (include suite, room . or apt no) Or a P 0 box number 3r print 35 BRAINTREE HILL OFFICE PARK

~23= City or town . Province or state, and country (including postal Or ZIP code)

7 1"l BRAINTREE, MA 02184 Form 8868 (12-2000)

Form 88158 (1 2-2Q00J . Page 2 0 If you we filing for an Additional (not automatic) 3-Month Extension, complete only Part 11 and check this box M Note Only complete Part 11 if you have already been granted an automatic 3-month extension on a previously filed Form 8868. 0 If you are filina for an Automatic 3-Month Extension, complete only Part I (on page 1)

I Na;eof Exempt Organization Employer identification number

Typo or H

00 PERCENT CHARITY INC . print /0 RUSSELL FRYE 04-3332128 File by the For IRS use only "t~d Num~ber,sueet. anod room or suite no If a P 0 box, see instructions

[4 LON

FELL LACE # 3805 't a nl,.g the rrtu~ see City, town or post office, state, and ZIP code For a foreign address, see instructions instmcdons kjOSTON, MA 02114 Check type of return to be filed (File a separate application for each returr

ED Form 990 LD Form 990 EZ EJ Form 990 T (sec 401 (a) or 408(a) trust) EJ Form 1041 A = Form 5227 =1 Form 8870 = Form 990 Ell- a] Form 990 PF E3Fomn 990 T (trust other than above) Ej Form 4720 = Form 6069

STOP: Do not complete Part 11 if you were not already granted an automatic 3-month extension on a Previously filed Form 8868

" If the organization does not have m office or place of business in the United States, check this box 10. " If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEM ~ If this is for the whole group, check this box llll~ = If it is for part of the group, check this box lll~ [=1 and attach a list with the names and EINs of all members the extension is for

I request w additional 3-rnonth extension of time until NOVEMBER 15, 2002

For calendar year 2 0 0 1 , or other tax year beginning and ending If this tax yew is for less than 12 months, check reatson Initial return Final return Change in accounting Period State in detail why you need the extension ADDTIONAL TIME IS REQUIRED TO PREPARE A COMPLETE AND ACCURATE RETURN

8a - If this application is for Form 990-BL, 990-PF. 990 T, 4720, or 6069, enter the tentative tax. less my nonrefundable credits See instructions $ 0 .

b If this appl=lion is for Form 990 PF, 990-T. 4720, or 6069, enter my refundable credits md e,stimated tax payments made Include my prior yew overpayment allowed as a credit and my mount paid previously with Form 8868 0 .

c Balance Due Subtract line 8b from line Be Include your payment win this form, or, if required, deposit with Fi-D coupon or, if required, by using EFI-PS (Electronic Federal Tax Payment System) See instructions $ 0 .

Signature and Verification Under penalties of perjury, I declare that I nave examined this to". including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, an plete, a d that I am authorized to prepare this to"

Signature 10, rag~c Tc~". Title lo- CPA Date lll~ 4~1&2- Notice to Applicant - To Be Completed by the IRS

F-1 we have approved this application Please attach this form to the organization's return STIME11IMSCIMETUR ASSUME, PT, We have not approved this application However. we have granted a 1 0-clay grace period from the later of4pat

. 6% () I

, Ile date of the organization's return (including my prior extensions) This grace period is considered to be Nvigr ; a et

ho T Ions othervvise required 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 grmt your request for an extension of time to file We we not grariting the 1 0-clay grace period We cannot consider this application because it was filed after the due date of the return for which art extension was requested Other

Alternate Mailing Address - Enter the address if you want the copy of this application for an additional 3 month extension returned to an address different than the one entered above

Name ER, SCHNEIDER & ASSOC ., P .C .


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