990:PF Return of Private Foundation990s.foundationcenter.org/990pf_pdf_archive/386/... · 1 i3...

Form 990:PF Return of Private Foundation OMB No 1545-0052

or Section 4947(a)(1) Nonexempt Charitable Trust

2009Department of the Treasury Treated as a Private FoundationInternal Revenue Service Note. The foundation may be able to use a copy of this return to satisfy state reporting requirements

For calendar year 2009 , or tax year beginning NOV 1, 2009 , and ending OCT 31 , 2010

G Check all that apply 0 Initial return initial return of a former public charity El Final return

® Amended return El Address change 0 Name change

Use the IRS Name of foundation A Employer identification number

label.Otherwise , HAROLD AND GRACE UPJOHN FOUNDATION 38-6052963

print Number and street (or P O box number if mail is not delivered to street address) Room/suite B Telephone numberortype . 136 E. MICHIGAN AVE., 9TH FLOOR, STE B ( 269 ) 344-2818

See SpecificCity or town , state , and ZIP code C If exemption application is pending , check here

Instructions .ALAMAZOO MI 4 9 0 0 7 D 1- Foreign organizations, check here ►0

H Check of organization X Section 501 c 3 exempt private foundationtype ()() p2. Foreign organizations meeting the 85% test,

check here and attach computation

El Section 4947 ( a )( 1 ) nonexem pt charitable trust 0 Other taxable p rivate foundation rivate foundation status was terminatedE IfI Fair market value of all assets at end of year J Accounting method 0 Cash 0 Accrual

punder section 507(b)(1)(A), check here

(from Part ll, col. (c), line 16) El Other (specify) F If the foundation is in a 60-month termination► $ 15 , 779 , 156 . (Part 1, column (d) must be on cash basis.) under section 507 ( b )( 1 8 check here ►0Part I Analysis of Revenue and Expenses (a) Revenue and (b) Net investment (c) Adjusted net (d) Disbursements

(The total of amounts in columns ( b), (c), and (d) may not

necessanly equal the amounts in column (a)) expenses per books income income for chantable purposes(cash basis only)

1 Contributions, gifts, grants, etc , received 4,941,667 . N/A

2 Check ►Q if the foundation is not required to attach Sch B

emosand temporary

3 (cash st on msavin

381 . 381. TAT MEN,l. 1

4 Dividends and interest from securities 200,604 . 200, 365. STATEMENT 2

5a Gross rents

b Net rental income or (loss)

6a Net gain or (loss) from sate of assets not on line 10 439r646. :Gross sales puce for all

2 2 1 5 7 3 8.b assets on line 6a , ,

y 7 Capital gain net income (from Part IV, line 2) 439,646.8 Net short-term capital gain

9 Income modificationsGross sales less returns

10a and allowances

b Less Cos

"

51r(

F119ttrer in (.?C&M

52 Total. Add lines 1 t u 5 5 8 2 2 9 8. 6 4 0 3 9 2.

1 d^ tom, rustees, etci 3 rk,r°n *n?af 9,000. 6,000. 3,000.

14 Other employee sv gessalI

15 Pension plans. a bene s

y 6 0 0 0STMT 316a'egel fee 6 0 0. . .

b Accounting fees STMT 4 9,450. 1,889. 7,560.CLW c Other professional fees STMT 5 69, 120. 69,091. 0.

17 Interest

2 18 Taxes STMT 6 11,584. 811. 0.

19 Depreciation and depletion

20 Occupancy

a 21 Travel, conferences, and meetings 495. 0 .

.

5

22 Punting and publications

23 Other expenses STMT 7 7 2 3 7. 0. 7.

24 Total operating and administrative

o expenses Add lines 13 through 23 107,486. 78,391. 18,292.,0 25 Contributions, gifts, grants paid 681 , 415. 681 , 415.

26 Total expenses and disbursements.

Add lines 24 and 25 788 901. 78 , 391. 699 707.

27 Subtract line 26 from line 12

a Excess of revenue over expenses and disbursements 4, 793,397.

b Net investment income (if negative, enter -0-) 562,001.c Adjusted net income ofnegati ve, enter -o- N/A

cwt

92350102-02-10 LHA For Privacy Act and Paperwork Reduction Act Notice , see the instructions . Form 990-PF (2009)

A

Form 990-PF ( 2009) HAROLD AND GRACE UPJOHN FOUNDATION 38-6052963 Paae2

Balance Sheets Atfachedschedules andamounts inthedescnpbon Beginning of year End of yearcolumn should beforend-o1-yearamounts only (a) Book Value (b) Book Value ( c) Fair Market Value

1 Cash - non -Interest-bearing

2 Savings and temporary cash investments 1,441,799. 571,873. 571,873.3 Accounts receivable ►

Less allowance for doubtful accounts ►4 Pledges receivable ►

Less allowance for doubtful accounts ►5 Grants receivable

6 Receivables due from officers , directors, trustees , and other

disqualified persons

7 Other notes and loans receivable ►

Less allowance for doubtful accounts ►8 Inventories for sale or use

9 Prepaid expenses and deferred charges

10a Investments - U S and state government obligations STMT 8 100,000. 100,000. 100,000.

b Investments - corporate stock STMT 9 2, 935, 607. 5, 238, 403. 9, 364, 546.c Investments - corporate bonds STMT 10 401f791. 100,00 0 . 100f000.

11 investments - land, buildings , and equipment basis ►

Less accumulated depreciation ►

12 Investments - mortgage loans STMT 11 302,950. 291,789. 291,789.

13 Investments - other STMT 12 1, 643, 840. 5, 317, 319. 5, 350, 948.

14 Land , buildings, and equipment basis ►Less . accumulated depreciation ►

15 Other assets ( describe ►

16 Total assets (to be completed by all filers ) 6 , 825 , 987. 1 1 619 3 8 4. 15f779 156.

17 Accounts payable and accrued expenses

18 Grants payable

to 19 Deferred revenue

20 Loans from officers , directors, trustees , and other disqualified persons

21 Mortgages and other notes payable

J 22 Other liabilities ( describe ►

23 Total liabilities ( add lines 17 throu g h 22 ) 0. 0.

Foundations that follow SFAS 117, check here ► 0and complete lines 24 through 26 and lines 30 and 31.

24 Unrestricted 6, 8 2 5, 9 8 7. 1 1, 619 , 3 8 4.

a 25 Temporarily restricted

m 26 Permanently restricted

3 Foundations that do not follow SFAS 117 , check here ► 0LL and complete lines 27 through 31.

° 27 Capital stock, trust principal, or current funds

28 Paid-in or capital surplus , or land , bldg , and equipment fund

< 29 Retained earnings , accumulated income , endowment , or other funds

Z 30 Total net assets or fund balances 6,825,987. 1 1, 619 , 3 8 4 .

31 Total liabilities and net assets fund balances 6 , 82 5 9 8 7 . 11 f 619 , 384. .

PartLtd 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

(must agree with end-of-year figure reported on prior year ' s return ) 1 6,825,987 .

2 Enter amount from Part I , line 27a 2 4,793,397 .

3 Other increases not included in line 2 (itemize) ► 3 0 .

4 Add lines 1, 2 , and 3 - 4 11,619,384 .5 Decreases not included in line 2 ( itemize) ► 5 0

6 Total net assets or fund balances at end of year ( line 4 minus line 5 - Part II column ( b ), line 30 6 11 , 619 ; 384

Form 990-PF (2009)92351102-02-10

Form 990-PF (2009) HAROLD AND GRACE UPJOHN FOUNDATION 3 8 -6 0 5 2 9 6 3 Page 3Part i:Y 'Capital Gains and Losses for Tax on Investment Income

' (a) List and describe the kind(s) of property sold (e g , real estate,2-sto brick warehouse, or common stock, 200 shs MLC Cory )

(b How acquired- Purchase

D - Donation

(c) Date acquired(mo , day, yr)

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

1a

b SEE ATTACHED STATEMENTS

c

d

e

(e) Gross sales price (f) Depreciation allowed(or allowable)

(g) Cost or other basisplus expense of sale

(h) Gain or (loss)(e) plus (f) minus (g)

a

b

c

de 2,215,738. 1,776,092. 439,646.

Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (I) Gains (Col (h) gain minus

(i) F M V as of 12/31/69(j) Adjusted basisas of 12/31/69

(k) Excess of col (i)over col (t), if any

col (k), but not less than -0-) orLosses (from col (h))

a

b

c

de 439,646.

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

If (loss), enter -0- in Part I, line 7 2 4 3 9 6 4 6 .r

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)

If loss enter-0-in Part I line 8 3 N/A

I Part V I Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income

(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income )

If section 4940(d)(2) applies, leave this part blank

Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base periods 0 Yes ^ No

If "Yes " the foundation does not qualify under section 4940(e) Do not complete this part

1 Enter the appropriate amount in each column for each year, see instructions before making any entries

(a)ar ( rt x y years

Calendar ear or tax ear be mmn in

(b)Adjusted quali m distributionsg

(c)Net value of nonchantable -use assets

(d)Di) div dedn ratio(col (b) divided by col (c))

2008 485,186. 9,333,280. .0519852007 663,541. 11,745,484. .056493

2006 714,074. 12,980,041. .055013

2005 721,185. 12,701,845. .056778

2004 598 435. 12 623 340. .047407

2 Total of line 1, column (d) 2 . 2 6 7 6 7 6

3 Average distribution ratio for the 5-year base period - divide the total on line 2 by 5,

the foundation has been in existence if less than 5 years

or by the number of years

3 . 0 5 3 5 35

4 Enter the net value of nonchantable - use assets for 2009 from Part X , line 5 4 12 , 6 5 8 , 6 4 8 .

5 Multiply line 4 by line 3 5 6 7 7, 6 81 .

6 Enter 1 % of net investment income (1 % of Part I, line 27b) 6 5 6 2 0 .

7 Add lines 5 and 6 7 6 8 3, 3 01 .

8 Enter qualifying distributions from Part XII , line 4 8 6 9 9, 7 0 7.

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

923521 02-o2-10 Form 990-PF (2009)

Form 990-PF ( 2009 ) HAROLD AND GRACE UPJOHN FOUNDATION 38-6052963 Page 4

Part V1 'Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948 - see instructions)

1 a Exempt operating foundations described in section 4940(d)(2), check here ► LJ and enter "N/A" on line 1

Date of ruling or determination letter ( attach copy of letter if necessary -see instructions)

b Domestic foundations that meet the section 4940(e) requirements in Part V, check here ► OX and enter 1 % 1 5,620.

of Part I, line 27b

c All other domestic foundations enter 2% of line 27b Exempt foreign organizations enter 4% of Part I, line 12, col (b)

2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only Others enter -0-) 2 0

3 Add lines 1 and 2 3 5,620.

4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only Others enter -0-) 4 0

5 Tax based on investment income . Subtract line 4 from line 3 If zero or less, enter -0- 5 5,620.

6 Credits/Payments

a 2009 estimated tax payments and 2008 overpayment credited to 2009 6a 5,005.

b Exempt foreign organizations - tax withheld at source 6b

c Tax paid with application for extension of time to file (Form 8868) 6c

d Backup withholding erroneously withheld 6d

7 Total credits and payments Add lines 6a through 6d 7 5,005.

8 Enter any penalty for underpayment of estimated tax Check here if Form 2220 is attached 8

9 Tax due . If the total of lines 5 and 8 is more than line 7, enter amount owed ► 9 615.

10 Overpayment . If line 7 is more than the total of lines 5 and 8, enter the amount overpaid ► 10

11 Enter the amount of line 10 to be Credited to 2010 estimated tax ► Refunded ► 11

Part VI1-A Statements Regarding Activities

did the foundation attempt to influence any national, state, or local legislation or did it participate or intervene in1 a During the tax year Yes No,

any political campaign" 1 a X

b Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see instructions for definition) 1 b X

If the answer is "Yes" to 1 a or 1 b, attach a detailed description of the activities and copies of any materials published or

distnbuted by the foundation in connection with the activities.

c Did the foundation file Form 1120-POL for this years 1 c X

d Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year

(1) On the foundation ► $ 0. (2) On foundation managers ► $ 0

e Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed on foundation

managers ► $ 0

2 Has the foundation engaged in any activities that have not previously been reported to the IRS" 2 X

If "Yes," attach a detailed description of the activities.

3 Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles of incorporation, or

" attach a conformed copy of the changes _or other similar instruments" If "Yesbylaws 3 X,,

4a Did the foundation have unrelated business gross income of $1,000 or more during the year? 4a X

" has it filed a tax return on Form 990-T for this year? N/Ab If 'Yes 4b,

or substantial contraction during the year"dissolutiontermination5 Was there a liquidation 5 X,,,

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" 6 X

000 in assets at any time during the years7 Did the foundation have at least $5 7 X,

If "Yes," complete Part fl, co!. (c), and Part XV.

8a Enter the states to which the foundation reports or with which it is registered (see instructions) ►MI

b If the answer is "Yes'to line 7, has the foundation 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 8b X

9 Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3) or 4942(1)(5) for calendar

year 2009 or the taxable year beginning in 2009 (see instructions for Part XIV)" If "Yes," complete Part XIV 9 X

10 Did an y persons become substantial contributors dunn the tax year? if 'Yes . ' attach a schedule listin g their names and addresses STMT J. 3 10 XForm 990-PF (2009)

92353102-02-10

Form 990-PF ( 2009 ) HAROLD AND GRACE UPJOHN FOUNDATION 38-6052 963 Pag e 5

Part VU-A Statements Regarding Activities (continued)

11 At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the meaning of

section 512 (b)(13)') If 'Yes,* attach schedule (see instructions) 11 X

12 Did the foundation acquire a direct or indirect interest in any applicable insurance contract before

August 17 , 2008 12 X

13 Did the foundation comply with the public inspection requirements for its annual returns and exemption applications 13 X

Website address ► N/A

14 The books are in care of ► FLOYD PARKS Telephone no ► (269 ) 344-2818

Locatedat ► 136 E. MICHIGAN AVE 9TH FLOOR STE B, KALAMAZOO, M ZIP+4 ►4900715 Section 4947 (a)(1) nonexempt charitable trusts filing Form 990 - PF in lieu of Form 1041 - Check here ► El

and enter the amount of tax-exem pt interest received or accrued durin g the year ► 15 N/A

Part VI I -B Statements Regarding Activities for Which Form 4720 May Be Required

File Form 4720 if any item is checked in the "Yes" column , unless an exception applies. Yes No

1 a During the year did the foundation ( either directly or indirectly)

( 1) Engage in the sale or exchange , or leasing of property with a disqualified persons El Yes EXI No

(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)

a disqualified person? El Yes 0 No

(3) Furnish goods , services , or facilities to ( or accept them from) a disqualified person? 0 Yes No

(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified persons 0 Yes El 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 No

(6) Agree to pay money or property to a government official? ( Exception . Check "No"

if the foundation agreed to make a grant to or to employ the official fora period after

termination of government service , if terminating within 90 days ) 0 Yes No

b If any answer is "Yes " to la(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 20 of the instructions)? lb X

Organizations relying on a current notice regarding disaster assistance check here ►

c Did the foundation 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 2009') 1 c X

2 Taxes on failure to distribute income ( section 4942 ) (does not apply for years the foundation was a private operating foundation

defined in section 4942 (1)(3) or 4942 (j)(5))

a At the end of tax year 2009 , did the foundation have any undistributed income (lines 6d and 6e, Part XIII ) for tax year(s) beginning

before 2009') El Yes 0 No

If "Yes," list the years ►b Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2) (relating to incorrect

valuation of assets) to the year ' s undistributed income') (If applying section 4942 ( a)(2) to all years listed, answer "No' and attach

statement - see instructions ) N/A 2b

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 foundation hold more than a 2% direct or indirect interest in any business enterprise at any time

during the year? 0 Yes 0 No

b If "Yes , did it have excess business holdings in 2009 as a result of (1) any purchase by the foundation 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 period') (Use Schedule C,

to determine if the foundation had excess business holdings in 2009) N/AForm 4720 3b,

4a Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes') 4a X

b Did the foundation make any investment in a prior year ( but after December 31, 1969) that could jeopardize its charitable purpose that

hadi not hen remnvari from iennardv before the first day of the tax year beainnino in 2009' 4b

Form 990-PF (2009)

92354102-02-10

Form 990-PF 2009 HAROLD AND GRACE UPJOHN FOUNDATION 38-6052963 Pa g e 6Part VII-B Statements Regarding Activities for Which Form 4720 May Be Required (continued)

5a During the year did the foundation pay or incur any amount to

(1) Carry on propaganda , or otherwise attempt to influence legislation ( section 4945 (e))? Yes No

(2) Influence the outcome of any specific public election ( see section 4955), or to carry on , directly or indirectly,

any voter registration drive? Yes E1 No

(3) Provide a grant to an individual for travel , study, or other similar purposes? Yes EXI 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)? Yes 0 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? Yes 0 No

b If any answer is "Yes" to 5a ( 1)-(5), did any of the transactions fail to qualify under the exceptions described in Regulations

section 53 4945 or in a current notice regarding disaster assistance ( see instructions ) ? N/A 5b

Organizations relying on a current notice regarding disaster assistance check here pop.

c If the answer is "Yes " to question 5a(4), does the foundation claim exemption from the tax because it maintained

expenditure responsibility for the grant' _ N/A Yes No

If "Yes," attach the statement required by Regulations section 53. 4945-5(d).

6a Did the foundation , during the year , receive any funds , directly or indirectly, to pay premiums on

a personal benefit contract? Yes No

b Did the foundation , during the year , pay premiums , directly or indirectly , on a personal benefit contracts 6b X

If "Yes" to 6b, file Form 8870

7a At any time during the tax year , was the foundation a party to a prohibited tax shelter transaction? Yes No

b if yes , did the foundation receive an y p roceeds or have an y net income attributable to the transaction? N/A 7b

part Vf-Information About Officers , Directors , Trustees, Foundation Managers, HighlyPaid Employees, and Contractors

1 List all officers . directors . trustees . foundation managers and their compensation.

(a) Name and address(b) Title, and avera g e

per week devotedhoursto position

(c) Compensation(If not paid ,enter -0

(d) Contnbubons toemplayee ie^ft laps

compensabo

(e) Exp enseaccount, otherallowances

SEE STATEMENT 14 9,000. 0. 0.

0 /^.....n ncnfinn of fiuu hinhact- nnie1 amnlnvoac Inther than those inellltletl on line l l- IT none- enter "NUNt.-

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

hours p er weekdevoted to position

(c) Compensation(d)Conmbutonstoemp oyes benefit laps

anddele,,,compensation

(e) Exp enseaccoun t , otherallowances

NONE

Total number of other employees paid over $50,000 1110. I UForm 990-PF (2009)

92355102-02-10

Form 990-PF (2009) HAROLD AND GRACE UPJOHN FOUNDATION 38-6052963 Page 7

PittV

III ' Information About Officers , Directors , Trustees, Foundation Managers , HighlyPaid Employees , and Contractors (continued)

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 (b) Type of service (c) Compensation

NONE

Total number of others receivin over $50 ,000 for p rofessional services pol- 0

Part IX-A Summary of Direct Charitable Activities

List the foundation ' s four largest direct charitable activities during the tax year Include relevant statistical information such as thenumber of organizations and other beneficiaries served, conferences convened , research papers produced, etc

Expenses

1 N/A

2

3

4

Part IX-8 Summary of Proaram- Related InvestmentsDescribe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2 Amount

1 N/A

2

All other program-related investments See instructions

3

Total. Add lines 1 through 3 0Form 990-PF (2009)

92356102-02-10

Form 990-PF ( 2009 ) HAROLD AND GRACE UPJOHN FOUNDATION 3 8-6052963 Page 8

Part ^f 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 fair market value of securities 1 a 11,347,225.b Average of monthly cash balances 1 b 1,504,194.c Fair market value of all other assets 1 c

d Total ( add lines la, b, and c ) Id 12,851,419.

e Reduction claimed for blockage or other factors reported on lines 1 a and

1c (attach detailed explanation) le 0.

2 Acquisition indebtedness applicable to line 1 assets 2 0

3 Subtract line 2 from line 1d 3 12,851,419 .

4 Cash deemed held for charitable activities Enter 1 1/2% of line 3 (for greater amount , see instructions ) 4 192 , 771 .

5 Net value of noncharitable -use assets . Subtract line 4 from line 3 Enter here and on Part V , line 4 5 12, 6 5 8 , 6 4 8 .

6 Minimum investment return . Enter 5% of line 5 6 632 , 932 .eRXI Distributable Amount (see instructions) ( Section 4942(j)(3) and (1)(5) private operating foundations and certain

foreign organizations check here ► 0 and do not complete this part )

1 Minimum investment return from Part X , line 6 1 632, 932 .

2a Tax on investment income for 2009 from Part VI, line 5 2a 5,620.

b Income tax for 2009 (This does not include the tax from Part VI) 2b

c Add lines 2a and 2b 2c 5 620 .

3 Distributable amount before adjustments Subtract line 2c from line 1 3 627, 312 .

4 Recoveries of amounts treated as qualifying distributions 4 0

5 Add lines 3and4 5 627, 312 .

6 Deduction from distributable amount (see instructions) 6 0 -

7 Distributable amount as ad i usted Subtract line 6 from line 5 Enter here and on Part XIII line 1 7 627 , 312 .

Part Xli Qualifying Distributions (see instructions)

1 Amounts paid (including administrative expenses) to accomplish charitable, etc , purposes

a Expenses, contributions , gifts, etc - total from Part I , column ( d), line 26 l a 699,707.b Program- related investments - total from Part IX-B lb 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 la through 3b Enter here and on Part V, line 8, and Part XIII, line 4 4 699,707.

5 Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment

income Enter 1% of Part I , line 27b 5 5 , 620.6 Adjusted qualifying distributions . Subtract line 5 from line 4 6 694,087.

Note. The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation

4940 (e) reduction of tax in those years

qualifie s for the section

Form 990-PF (2009)

92357102-02-10

Form 990-PF (2009 ) HAROLD AND GRACE UPJOHN FOUNDATION 38-6052963 Page 9

Part XLIt Undistributed Income (see instructions)

( a) (b) (c)Corpus Years prior to 2008 2008

1 Distributable amount for 2009 from Part XI,

line 7

2 Undistnbuted income, if any , as of the end of 2009

a Enter amount for 2008 only

b Total for prior years

3 Excess distributions carryover, if any, to 2009

a From 2004

b From 2005 93,9 20 .

c From 2006 74,566 .

d From 2007 83, 781 .

eFrom2008 25 , 299 .

f Total of lines 3a through e4 Qualifying distributions for 2009 from

Part Xll, line 699,707.

a Applied to 2008, but not more than line 2a

b Applied to undistributed income of prior

years (Election required - see instructions)

c Treated as distributions out of corpus

(Election required - see instructions)

d Applied to 2009 distributable amount

e Remaining amount distributed out of corpus

5 Excess distributions carryover applied to 2009(if an amount appears in column (d), the same amount

must be shown in column (a) )

6 Enter the net total of each column asindicated below:

a Corpus Add lines 3t, 4c, and 4e Subtract line 5

b Prior years' undistributed income Subtract

line 4b from line 2b

c Enter the amount of prior years'undistributed income for which a notice ofdeficiency has been issued, or on whichthe section 4942(a) tax has been previouslyassessed

d Subtract line 6c from line 6b Taxable

amount - see instructions

e Undistributed income for 2008 Subtract line

4a from line 2a Taxable amount - see instr

t Undistributed income for 2009 Subtract

lines 4d and 5 from line 1 This amount must

be distributed in 2010

7 Amounts treated as distributions out of

corpus to satisfy requirements imposed by

section 170(b)(1)(F) or 4942(g)(3)

8 Excess distributions carryover from 2004

not applied on line 5 or line 7

9 Excess distributions carryover to 2010.

Subtract lines 7 and 8 from line 6a

10 Analysis of line 9

a Excess from 2005 93,920.

b Excess from 2006 74,566.

c Excess from 2007 83,781.

d Excess from 2008 25,299 .

P Fvt ecs from 700q 72,395.

(d)2009

627,312.

0.

277,566.

0.

0.

0.

0.

62-/,312.

1 72,395.10. 1 0

.

349,961.

0.

0.

0.

0.

0.

349,961.

0.-

0.

Form 990-PF (2009)92358102-02-10

Form 990-PF (2009 ) HAROLD AND GRACE UPJOHN FOUNDATIONFoundations (see instructions and Part VII-A, c

38-6052963 Page10N/A

4942 (1)(3) or 0 4942(j)(5)

1 a it the foundation has received a ruling or determination letter that it is a private operating

foundation, and the ruling is effective for 2009, enter the date of the ruling 11111.

b Check box to indicate whether the foundation is a private operating foundation described in section

2 a Enter the lesser of the adjusted net

income from Part I or the minimum

investment return from Part X for

each year listed

b 85% 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 2cComplete 3a, b, or c for thealternative test relied upon

a "Assets' alternative test - enter(1) Value of all assets

(2) Value of assets qualifyingunder section 4942(1)(3)(B)(i)

b 'Endowment' alternative test - enter2/3 of minimum investment returnshown in Part X, line 6 for each yearlisted

c "Support" alternative test - enter

(1) Total support other than grossinvestment income (interest,dividends, rents, payments onsecurities loans (section512(a)(5)), or royalties)

(2) Support from general publicand 5 or more exemptorganizations as provided insection 4942(j)(3)(B)(iii)

(3) Largest amount of support from

an exempt organization

( 4 ) Gross investment income

Part XV Supplementary Information (Complete this part only if the foundation had $5,000 or more in assetsat any time during the year-see the instructions.)

1 Information Regarding Foundation Managers:

a List any managers of the foundation who have contributed more than 2% of the total contributions received by the 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 0 if the foundation only makes contributions to preselected charitable organizations and does not accept unsolicited requests for funds If

the foundation makes gifts , grants , etc (see instructions ) to individuals or o rg anizatio n s u n de r other conditions , compl ete items 2a, b, c, a n d d

a The name , address , and telephone number of the person to whom applications should be addressed

MR. FLOYD L. PARKS, HAROLD AND GRACE UPJOHN FOUNDATION, (269)344-2818

136 E. MICHIGAN AVE 9TH FLOOR STE B, KALAMAZOO, MI 49007

b The form in which applications should be submitted and information and matenals they should include

GRANT APPLICATION AVAILABLE AT ADDRESS LISTED IN ITEM 2A

c Any submission deadlinesNONE

d Any restrictions or limitations on awards , such as by geographical areas , chantable fields , kinds of institutions , or other factors

BOARD REVIEWS GRANT APPLICATIONS

Tax year Prior 3 years

(a) 2009 ( b) 2008 (c) 2007 ( d) 2006 ( e) Total

923601 02-02-10 Form 990-PF (2009)

Form 990-PF (2009 ) HAROLD AND GRACE UPJOHN FOUNDATION 38-6052963 PInformation

3 Grants and Contributions Paid During the Year or Approved for Future Payment

Recipient If 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

SEE STATEMENT 15Total NO- 3a 681 , 415.

b Approved for future payment

NONE

Total NO- 3b 1 0 .

923611 02-02-10 Form 990-PF (2009)

Form 990-PF ( 2009 ) HAROLD AND GRACE UPJOHN FOUNDATION 38-6052963 Page12

Pact XVI-A Analysis of Income-Producing Activities

Enter gross amounts unless otherwise indicated Unrelate d business income Excluded by section 512 , 513, or 514 (e)

1 Program service revenue

(a)Businesscode

(b)Amount

Exc „_

5ioncode

(d)Amount

Related or exempt

function income

a

b

c

d

e

f

g Fees and contracts from government agencies

2 Membership dues and assessments

3 Interest on savings and temporary cash

investments 14 381.

4 Dividends and interest from securities 14 200, 604.5 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 18 439,646.

9 Net income or (loss ) from special events

10 Gross profit or ( loss) from sales of inventory

11 Other revenue

a

b

c

d

e

12 Subtotal Add columns ( b), (d), and (e) 0 . 640 , 631. 0.

13 Total. Add line 12, columns ( b), (d), and ( e) 13 6 40,631.

(See worksheet in line 13 instructions to venfy calculations

Part XVI-8 Relationship of Activities to the Accomplishment of Exempt Purposes

Form990-PF 2009 HAROLD AND GRACE UPJOHN FOUNDATION 38-6052963 Pag e 13Part XVII Information Regarding Transfers To and Transactions and Relationships With Noncharitable

Exempt Organizations

Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) of Yes No

the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations

Transfers from the reporting foundation to a nonchantable exempt organization of

(1) Cash 1a (l ) X

(2) Other assets 1a ( 2 ) X

Other transactions

(1) Sales of assets to a nonchantable exempt organization 1b ( l ) X

(2) Purchases of assets from a noncharitable exempt organization _ 1b (2) X

(3) Rental of facilities, equipment, or other assets 1 b (3 ) X

(4) Reimbursement arrangements 1b ( 4 ) X

(5) Loans or loan guarantees 1 b ( 5 ) X

(6) Performance of services or membership or fundraising solicitations 1 b ( 6 ) X

Sharing of facilities, equipment, mailing lists, other assets, or paid employees 1 c X

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 foundation If the foundation received less than fair market value in any transaction or sharing arrangement, show in

(a) Name of organization (b) Type of organization (c) Description of relationship

N/A

Under penalties of perjury, I declare that I have exams this return, including accompanying schedules and statements, and to the best of my knowledge and belief , it is true, correct,

ne,

la ton of reparer Cher ant er or fiduciary) is based on all information of which preparer has any knowledgeand completD

Signature of o cer o ru ee

CPreparers

N signature

CL o,0 Rrmsnarm(oryou PLANTE & MO , PLLCa0 750 TRADE CENTRE WAY,:3 ifsaf-enwloyed),

address, and ZIP code PORTAGE MI 4 9 0 0 2'

2a Is the foundation directly or indirectly affiliated with , or related to , one or more tax-exempt organizations described

in section 501 (c) of the Code ( otherthan section 501(c)(3)) or in section 5279 Q Yes ® No

b If 'Yes.' complete the followlna schedule

Schedule B(Form 990, 990-EZ,or 990-PF)

Department of the Treasury

Schedule of Contributors► Attach to Form 990, 990-EZ, or 990-PF. 2009

Name of the organization I Employer identification number

HAROLD AND GRACE UPJOHN FOUNDATION 1 38-6052963

Organization type (check one):

Filers of: Section:

Form 990 or 990-EZ 0 501 (c)( ) (enter number) organization

El 4947(a)(1) nonexempt charitable trust not treated as a private foundation

0 527 political organization

Form 990-PF 0 501 (c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.

Note. Only a section 501 (c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990 , 990-EZ , or 990 - PF that received , during the year , $5,000 or more (in money or property) from any one

contributor . Complete Parts I and II.

Special Rules

0 For a section 501 (c)(3) organization filing Form 990 or 990-EZ that met the 33 1/3% support test of the regulations under sections

509(a)( 1) and 170 (b)(1)(A)(vi), and received from any one contributor , during the year, a contribution of the greater of (1) $5 ,000 or (2) 2%

of the amount on (i) Form 990 , Part VIII, line 1 h or (i) Form 990- EZ, line 1. Complete Parts I and II.

For a section 501 (c )(7), (8), or ( 10) organization filing Form 990 or 990 -EZ that received from any one contributor , during the year,

aggregate contributions of more than $1,000 for use exclusively for religious , charitable , scientific , literary , or educational purposes, or

the prevention of cruelty to children or animals . Complete Parts I, II, and III.

For a section 501(c)( 7), (8), or ( 10) organization filing Form 990 or 990 - EZ that received from any one contributor , during the year,

contributions for use exclusively for religious , charitable , etc , purposes , but these contributions did not aggregate to more than $1,000.

If this box is checked , enter here the total contnbutions that were received during the year for an exclusively religious , charitable, etc.,

purpose . Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively

religious , charitable , etc., contributions of $5,000 or more during the year ► $

Caution . An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990, 990-EZ, or 990-PF),

but it must answer "No' on Part IV, line 2 of its Form 990, or check the box on line H of its Form 990-EZ, or on line 2 of its Form 990-PF, to certify

that it does not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).

LHA For Privacy Act and Paperwork Reduction Act Notice , see the Instructions

for Form 990, 990-EZ , or 990-PF.

Schedule B (Form 990, 990-EZ, or 990 -PF) (2009)

OMB No 1 545-0047

923451 02-01-10

Schedule B (Form 990, 99

Name of organization

1 of 1 of Part I

Employer identification number

HAROLD AND GRACE UPJOHN FOUNDATION 38-6052963

Part I Contributors (see instructions)

(a)

No.

(b)

Name, address, and ZIP + 4

(c)

Aggregate contributions

(d)

Type of contribution

1 MARY U MEADER IRREVOCABLE TRUST Person OX

136 EAST MICHIGAN AVE, 9TH FLOOR STE $ 4,941,667.Payroll fl

Noncash 0

KALAMAZOO, MI 4 9 0 0 7(Complete Part II if thereIs a noncash contnbutlon.)

(a)

No.

(b)


(c)


(d)


Person

$

Payroll

Noncash

(Complete Part II If there

is a noncash contribution.)

(a)

No.

(b)

Name, address , and ZIP + 4

(c)


(d)


Person

$

Payroll

Noncash

(Complete Part II if there


(a)

No.

(b)


(c)


(d)


Person

$

Payroll

Noncash



(a)

No.

(b)

Name , address, and ZIP + 4

(c)


(d)


Person

$

Payroll

Noncash

(Complete Part II If there


(a)

No.

(b)

Name , address, and ZIP + 4

(c)


(d)


Person

$

Payroll

Noncash



91452 09-o,-1 0 Schedule B (Form 990 . 990-EZ, or 990-PF) (20091


Name of organization

HAROLD AND GRACE UPJOHN FOUNDATION

Page of of Part II

Employer Identification number

38-6052963

Part II Noncash Property (see instructions)

(a)No.

from

Part I

(b)Description of noncash property given

(c)

FMV (or estimate)

(see instructions)

(d)Date received

(a)No.

from

Part I


(c)

FMV (or estimate)

(see instructions)

(d)Date received

(a)No.

from

Part I

(b)

Description of noncash property given

(c)

FMV (or estimate)

(see instructions)

(d)Date received

(a)No.

from

Part I


(c)

FMV (or estimate)

(see instructions)

(d)Date received

(a)No.

from

Part I


(c)

FMV (or estimate)

(see instructions)

(d)Date received

(a)

ffrom

Part IDescription of noncash property given

(c)

FMV (or estimate)

(see instructions)Date received

923453 02-01-10 Schedule B (Form 990, 990-EZ, or 990-PF) (2009)


Name of orgarfization


of Part III

Employer identification number

38-6052963p+af'[ FEE cxcwsivery religious, cnantaoie , etc., monnouai coninouuons to section out tcltit, to), or t1uf organizations aggregating

more than $1,000 for the year . Complete columns (a) through (e) and the following line entry. For organizations completingPart III, enter the total of exclusively religious, charitable, etc., contributions of$1.000 or less for the year. (Enter this information once. See Instructlons.l ► $

(a) No.fromPart l

(b) Purpose of gift (c) Use of gift (d) Description of how gift is held

(e) Transfer of gift

Transferee's name , address , and ZIP + 4 Relationshi p of transferor to transferee

(a) No.fromPart l



Transferee's name, address , and ZIP + 4 Relationship of transferor to transferee

(a) No.fromPart I



Transferee's name , address , and ZIP + 4 Relationshi p of transferor to transferee

(a) No.fromPart I



Transferee's name, address , and ZIP + 4 Relationshi p of transferor to transferee

923454 02-01-10 Schedule 8 (Form 990, 990-EZ, or 990 - PF) (2009)

CONTINUATION FOR 990-PF, PART IVHAROLD AND GRACE UPJOHN FOUNDATION 38-6052 963 PAGE 1 OF 2Part Capital Gains and Losses for Tax on Investment Income

(a) List and describe the kind(s) of property sold, e g , real estate,2-story brick warehouse , or common stock , 200 shs MLC Co

(b How acquired- Purchase

D - Donation

(c Date acquired(mo , day , yr )

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

1a ADOBE SYSTEMS INC 4000 SHS P 04/21/10 10/22/10bADOBE SYSTEMS INC 3000 SHS P 06/03/10 10/22/10cPFIZER INC 7092 SHS P 10/15/09 09/29/10d VCA ANTECH INC 4000 SHS P 06/14/10 10/22/10e BP PLC SPONSORED ADR 5293.67 SHS P 05/25/76 09/29/10f BP PLC SPONSORED ADR 0.33 SHS P 08/06/99 09/2 9/10BROADWAY BK CHICAGO IL 4.500% 08/15/11 950 P 08/08/08 04/29/10

hCINTAS CORP 3000 SHS P 07/11/03 06/1 4/10i GUARANTEE BK DENVER CO 3.600% 11/12/09 950 P 05/06/08 11/1 2/09I & J LC TAXABLE VR NT .805% 12/01/24 100 P 08/30/06 05/06/10

k INTEL CORP 9600 SHS P 12/27/90 11/20/09I INTEL CORP 6400 SHS P 04/13/94 11/20/09mINTERNATIONAL LEASE FIN CORP 5.000% 04/15/10 100 P 10/30/07 04/15/10nLEHMAN BROS BK WILMINGTON 4.400% 03/23/10 950 P 03/17/05 03/23/10oMERRILL LYNCH & CO MTN 4.750% 11/20/09 100 P 03/17/05 11/20/09

(e) Gross sales price (t) Depreciation allowed(or allowable )

( g) Cost or other basisplus expense of sale

( h) Gain or (loss)( e) plus (f) minus (g)

a 111,638. 140,080. -28,442.b 83,729. 98,784. -15,055.c 123,115. 125,245. -2,130.

d 80,959. 109,112. -28,153.

e 210,843. 23,820. 187,023.f 13. 30. -17.

95,000. 95,000. 0.

h 75,602. 107,850. -32,248.95,000. 95,000. 0.100,000. 100,000. 0.

k 183,163. 11,250. 171,913.122,109. 25,450. 96,659.

m 100,000. 100,546. -546.

n 95,000. 95,000. 0.o 100,000. 1 1 101,245. -1,245.

Complete only for assets showing gain in column ( h) and owned by t he foundation on 12/31 /69 (I) Losses (from col (h))

(1) F M V as of 12/31/69(t) Adjusted basisas of 12/31/69

( k) Excess of col (i)over col ( I), if any

Gains ( excess of col ( h) gain over col (k),but not less than "-o-')

a -28,442.b -15,055.c -2,130.d -28, 153.e 187,023.f -17.

0.h -32,248.

0.0.

k 171,913.96,659.

m -546.n 0.o -1,245.

2 Capital ain net income or net capital lossf f (lain , also enter in Part I, line 7

g ( ) l If loss)

line 7enter'-0-"in Part I2

,,

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)If (loss), enter'-0- in Part I , line 8 3

92359104-24-09

CONTINUATION FOR 990-PF, PART IVHAROLD AND GRACE UPJOHN FOUNDATION 38-6052963 PAGE 2 OF 2

Part IV I Capital Gains and Losses for Tax on Investment Income

(a) List and describe the kind ( s) of property sold, e g , real estate ,2-story brick warehouse , or common stock , 200 shs MLC Co

( b How acquired

D - Dontaon

(c) Date acquired(mo , day, yr )

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

la MOODYS CORP 2000 SHS P 04/07/95 06/28/10bMOODY S CORP 2000 SHS P 01/09/97 06/28/10cPATTERSON COMPANIES INC 4800 SHS P 12/12/02 12/28/09dSTATE STREET CORP 1300 SHS P 11/30/07 10/22/10eSTONEGATE BANK FL 4.400% 09/16/10 9500 P 09/08/05 09/16/10

f STRYKER CORP 2000 SHS P 03/25/96 12/28/09VCA ANTECH INC 3800 SHS P 07/22/08 10/22/10

hWHEATLAND BK NAPERVILLE IL 4.050% 12/20/10 950 P 06/12/08 04/29/10i SECURITIES LITIGATION P

k

I

m

n

0

(e) Gross sales price ( f) Depreciation allowed(or allowable)

(g) Cost or other basisplus expense of sale

( h) Gain or (loss)(e) plus ( f) minus (g)

a 42,722. 13,899. 28,823.b 42,722. 16,769. 25,953.c 132,379. 101,105. 31,274.

d 52,389. 104,871. -52,482.e 95,000. 95,000. 0.

f 102,085. 12,280. 89,805.

76,911. 108,756. -31,845.h 95,000. 95,000. 0.

359. 359.

k

m

n

0Complete only for assets showing gain in column ( h) and owned by the foundation on 12/31 /69 (I) Losses (from col (h))

(I) F M V as of 12 /31/69(j) Adjusted basisas of 12 /31/69

( k) Excess of col (i)over col ( j), if any

Gains ( excess of col. (h) gain over col (k),but not less than '-0-')

a 28,823.b 25,953.c 31,274.d -52,482.e 0.f 89,805.

-31,845.h 0.

359.

k

m

n

0

f2 Capital gain net income or ( net capital loss )

If ain, also enter in Part I, line 7line 7 )enter'-Vin Part Il If ?loss ) 2 439,646.,,

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)If (loss), enter'-0- in Part I , line 8 3 N/A

92359104-24-09


FORM 990-PF INTEREST ON SAVINGS AND TEMPORARY CASH INVESTMENTS STATEMENT 1

SOURCE AMOUNT

NORTHERN DIVERSIFIED ASSET FUND 381.

TOTAL TO FORM 990-PF, PART I, LINE 3, COLUMN A 381.

FORM 990-PF DIVIDENDS AND INTEREST FROM SECURITIES STATEMENT 2

SOURCE

INTEREST AND DIVIDENDSTAX-EXEMPT INTEREST

TOTAL TO FM 990-PF, PART I, LN 4

CAPITAL GAINSGROSS AMOUNT DIVIDENDS

200,365. 0.239. 0.

COLUMN (A)AMOUNT

200,365.239.

200,604. 0. 200,604.

FORM 990-PF LEGAL FEES STATEMENT 3

DESCRIPTION

LEGAL FEES

TO FM 990-PF, PG 1, LN 16A

(D)CHARITABLEPURPOSES

600. 600. 0.

600. 600. 0.

FORM 990-PF ACCOUNTING FEES STATEMENT 4

DESCRIPTION

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


(C)ADJUSTED

NET INCOME

(C) (D)ADJUSTED CHARITABLE

NET INCOME PURPOSES

ACCOUNTING FEES - PLANTE &MORAN, PLLCACCOUNTING FEES - RELATEDTO TAX EXEMPT INCOME

TO FORM 990-PF, PG 1, LN 16B

9,449 . 1,889 . 7,560.

1. 0. 0.

9,450. 1,889 . 7,560.

STATEMENT(S) 1, 2, 3, 4


(C)ADJUSTED

NET INCOME

FORM 990-PF OTHER PROFESSIONAL FEES STATEMENT 5

DESCRIPTION

ASSET CUSTODIAL FEES -GREENLEAF TRUSTASSET CUSTODIAL FEES -GREENLEAF TRUST TAX EXEMPTASSET MANAGEMENT FEES -ARCADIA INVESTMENTMANAGEMENTASSET MANAGEMENT FEES -ARCADIA INVESTMENTMANAGEMENT - TAX EXEMPT

TO FORM 990-PF, PG 1, LN 16C

38-6052963

(D)

CHARITABLE

PURPOSES

33,211. 33,211. 0.

14. 0. 0.

35,880. 35,880. 0.

15. 0. 0.

69,120. 69,091. 0.

FORM 990-PF TAXES STATEMENT 6

DESCRIPTION

FEDERAL EXCISE TAXFOREIGN TAXES

TO FORM 990-PF, PG 1, LN 18



10,773. 0.811. 811.

11,584. 811.

(C)ADJUSTEDNET INCOME

(D)

CHARITABLE

PURPOSES

0.0.

0.

FORM 990-PF OTHER EXPENSES STATEMENT 7

DESCRIPTION

TELEPHONEMICHIGAN ANNUAL REPORT FEECLERICALCOUNCIL OF MICHIGANFOUNDATIONSOTHER EXPENSES

TO FORM 990-PF, PG 1, LN 23

(A) (B) (C) (D)EXPENSES NET INVEST- ADJUSTED CHARITABLEPER BOOKS MENT INCOME NET INCOME PURPOSES

464. 0. 464.20. 0. 20.

4,332. 0. 4,332.

2,300. 0. 2,300.121. 0. 121.

7,237. 0. 7,237.

STATEMENT(S) 5, 6, 7


FORM 990-PF U.S. AND STATE/CITY GOVERNMENT OBLIGATIONS STATEMENT 8

U.S. OTHER FAIR MARKETDESCRIPTION GOV'T GOV'T BOOK VALUE VALUE

PORTLAND OREGON UTGO VR .227% X06/01/2019 100,000. 100,000.

TOTAL U.S. GOVERNMENT OBLIGATIONS

TOTAL STATE AND MUNICIPAL GOVERNMENT OBLIGATIONS 100,000. 100,000.

TOTAL TO FORM 990-PF, PART II, LINE 10A 100,000. 100,000.

FORM 990-PF CORPORATE STOCK STATEMENT 9

FAIR MARKET

DESCRIPTION BOOK VALUE VALUE

ABBOTT LABS 107,534. 184,752.

ACCENTURE PLC SHS CL A NEW 207,456. 232,492.

AFFILIATED MANAGERS GROUP INC 254,042. 299,635.

AFLAC INC 324,079. 380,052.

ALLERGAN INC 230,429. 289,640.

APPLE INC 153,718. 180,588.

BECTON DICKINSON & COMPANY 141,280. 151,040.

CARMAX 107,200. 309,900.

CISCO SYS INC 237,537. 235,458.

CORE LABORATORIES NV ADR 155,655. 171,094.

ECOLAB INC 136,524. 147,960.

EXPEDITORS INTL WASHINGTON 187,019. 493,600.

EXXON MOBIL CORP 17,930. 438,834.

FASTENAL CO 75,264. 247,104.

GENERAL ELECTRIC CO 22,023. 216,270.

GILEAD SCIENCES INC 217,823. 206,284.

ILLINOIS TOOL WORKS INC 142,248. 219,264.

INTERCONTINENTALEXCHANGE INC 248,921. 241,227.

INTUIT INC 191,332. 302,274.

JACOBS ENGINEERING GROUP INC 126,660. 231,660.

JOS A BANK CLOTHIERS INC 125,654. 327,000.

LIFE TECHNOLOGIES CORPORATION 244,579. 250,900.

O REILLY AUTOMOTIVE INC 105,280. 468,000.

OMNICOM GROUP INC 168,546. 228,592.

ORACLE CORP 203,838. 273,234.PEPSICO INC 28,172. 391,800.RITCHIE BROTHERS AUCTIONEERS INC ADR 140,665. 152,496.

STARBUCKS CORP 141,516. 388,416.

STATE STREET CORP 58,567. 62,640.

STRYKER CORP 36,842. 296,940.

STATEMENT(S) 8, 9


SYMANTEC CORPSYSCO• CORPTEVA PHARMACEUTICAL INDS LTD ADRWALGREEN CO

TOTAL TO FORM 990-PF, PART II, LINE 10B

96,587.101,078.369,717.132,688.

5,238,403.

38-6052963

323,800.353,520.363,160.304,920.

9,364,546.

FORM 990-PF CORPORATE BONDS STATEMENT 10

FAIR MARKETDESCRIPTION BOOK VALUE VALUE

GARMONG NEWSPAPER DEV FLTG .737% 0 9/01/16 100,000. 100,000.

TOTAL TO FORM 990-PF, PART II, LINE 10C 100,000. 100,000.

FORM 990-PF MORTGAGE LOANS STATEMENT 11

FAIR MARKETDESCRIPTION BOOK VALUE VALUE

DENNIS/ANNE NELSON NOTE 4.000% 12/15/16 31,773. 31,773.ERIC/MICHAEL ULBRICH MTGE 4.000% 06/20/32 120,500. 120,500.ULBRICH/GILBERT NOTE 4.000% 07/20/34 139,516. 139,516.

TOTAL TO FORM 990-PF, PART II, LINE 12 291,789. 291,789.

FORM 990-PF OTHER INVESTMENTS STATEMENT 12

DESCRIPTION

AMERICAN EXPRESS CENTURION BK1.700% 12/09/11ATLANTA BUSINESS BANK GA CTF4.100% 05/02/12BANK OF AMERICA.450% 07/21/11BANK OF INDIA NY NY.550% 07/13/11BANK OF INDIA NY NY .600%05/11/11BANKERS BK DENVER CO.750% 07/26/11BANNER BK WALLA WALLA WA1.100% 12/28/12

VALUATION FAIR MARKETMETHOD BOOK VALUE VALUE

COST95,000. 96,019.

COST95,000. 99,440.

COST95,000. 94,966.

COST95,000. 95,032.

COST100,000. 100,051.

COST100,000. 100,182.

COST95,000. 95,744.

STATEMENT(S) 9, 10, 11, 12


BARCLAYS HANK DE 2.350% COST08/20'12 200,000. 204,300.BYRON CENTER MI BANK COST4.400% 12/12/12 95,000. 101,073.CHOICE FINL GROUP COST1.000% 06/28/12 95,000. 94,924.COASTAL BK & TR FL COST2.200% 12/04/12 95,000. 96,751.COLUMBUS BK & TRUST GA COST2.100% 10/30/13 100,000. 101,743.DISCOVER BK GREENWOOD DEL COST1.650% 12/09/11 100,000. 101,018.ENERBANK USA COST.400% 07/15/11 95,000. 94,934.ENTERPRISE BK CLAYTON MO COST3.900% 11/16/10 95,000. 95,111.FIRST NAT BK EAGLE RIVER COST1.100% 12/17/12 95,000. 95,764.FIRST NATIONAL BK OLATHE KS COST4.400% 02/22/11 101,870. 100,162.FLAGSTAR BK FSB COST2.500% 11/27/12 94,000. 96,315.FOUR OAKS BK NC COST1.400% 08/30/12 100,000. 100,864.GE CAP FINL INC COST2.550% 08/13/13 200,000. 205,873.GE MONEY BANK COST1.750% 07/09/13 95,000. 95,802.

GE MONEY BANK 2.050% COST07/09/14 95,000. 95,579.GE MONEY BANK 2.050% COST07/16/14 95,000. 95,794.

GE MONEY BANK DRAPER UT COST1.250% 04/30/12 100,000. 100,589.

GE MONEY BANK UT .600% COST12/03/10 95,000. 95,039.

HINSDALE BK & TR CO 1.400% COST07/22/13 95,000. 95,933.

ISHARES TR MSCI EAFE INDEX FUND COST 979,172. 957,768.

JEFFERSON BK DALLAS TX COST3.500% 12/17/10 100,977. 99,359.

LAKE FOREST BANK & TRUST COST1.400% 07/22/13 95,000. 95,908.LUANA SAVINGS BK COST1.000% 11/15/12 95,000. 95,682.MID-WISCONSIN BK COST4.100% 12/06/11 95,000. 98,493.MORRIS BK DUBLIN GA 2.400% COST12/16/13 95,000. 97,341.PLAINS CAPITAL BK TX COST.800% 11/07/11 100,000. 100,136.PLANTERS FIRST BK CORDELE GA COST4.000% 11/07/11 95,000. 98,187.PROVIDENT BANK BALTIMORE MD COST4.688% 08/15/11 95,000. 98,048.

STATEMENT(S) 12


STATE BK COUNTRYSIDE IL2.100% 12/09/13VANGUARD EMERGING MARKETS ETFWILMINGTON TRUST CO2.000% 07/16/14WILMINGTON TRUST CO .600%07/21/11WORTHINGTON FED BK AL1.300% 11/02/12

TOTAL TO FORM 990-PF, PART II, LINE 13

38-6052963

COST100,000. 101,700.

COST 461,300. 468,700.COST

95,000. 95,557.COST

95,000. 95,067.COST

100,000. 100,000.

5,317,319. 5,350,948.

FORM 990-PF LIST OF SUBSTANTIAL CONTRIBUTORS STATEMENT 13PART VII-A, LINE 10

NAME OF CONTRIBUTOR

MARY U MEADER IRREVOCABLE TRUST

ADDRESS

136 EAST MICHIGAN AVENUEKALAMAZOO, MI 49007

STATEMENT(S) 12, 13


FORM 990-PF PART VIII - LIST OF OFFICERS, DIRECTORS STATEMENT 14TRUSTEES AND FOUNDATION MANAGERS

TITLE ANDNAME AND ADDRESS AVRG HRS/WK

CHRISTOPHER T. HAENICKE ASST SEC/TREAS136 E. MICHIGAN AVE., 9TH FLOOR,STE. B 2.00KALAMAZOO, MI 49007

JANET J. DEAL-KOESTNER TRUSTEE136 E. MICHIGAN AVE., 9TH FLOOR,STE. B 2.00KALAMAZOO, MI 49007

FLOYD L. PARKS SEC/TREAS136 E. MICHIGAN AVE., 9TH FLOOR,STE. B 15.00KALAMAZOO, MI 49007

FLORENCE U. OROSZ VICE PRESIDENT

136 E. MICHIGAN AVE., 9TH FLOOR,STE. B 2.00

KALAMAZOO, MI 49007

TIMOTHY LIGHT PRESIDENT

136 E. MICHIGAN AVE., 9TH FLOOR,STE. B 2.00

KALAMAZOO, MI 49007

RANDELL W. EBERTS TRUSTEE

136 E. MICHIGAN AVE., 9TH FLOOR,STE. B 2.00KALAMAZOO, MI 49007

TOTALS INCLUDED ON 990-PF, PAGE 6, PART VIII

EMPLOYEECOMPEN- BEN PLAN EXPENSESATION CONTRIB ACCOUNT

0. 0. 0.

0. 0. 0.

9,000. 0. 0.

0. 0. 0.

0. 0. 0.

0. 0. 0.

9,000. 0. 0.

STATEMENT(S) 14


FORM 990-PF GRANTS AND CONTRIBUTIONS STATEMENT 15PAID DURING THE YEAR

RECIPIENT RELATIONSHIP RECIPIENTRECIPIENT NAME AND ADDRESS AND PURPOSE OF GRANT STATUS

PUBLIC MEDIA NETWORK 509(A)(1)359 S. KALAMAZOO MALL, 3RD FLOOR KALAMAZOO STORIES &KALAMAZOO, MI 49007 170(B)(1)(

GRYPHON PLACE1104 S. WESTNEDGE KALAMAZOO, MI KALAMAZOO COUNTY49008 SUICIDE PREVENTION

PLAN

MICHIGAN YOUTH ARTS FESTIVAL988 S . ADAMS, STE 207BIRMINGHAM, MI 48009

CITY OF PORTAGE320 LIBRARY LANE PORTAGE, MI49024

2010 ARTS FESTIVAL AT

WMU

SHAKESPEARE IN THE

PARK

ARTS COUNCIL OF GREATERKALAMAZOO THRIVING THROUGH THE

359 S BURDICK ST KALAMAZOO, MI ARTS WORKSHOP SERIES

49007

BACH FESTIVAL SOCIETY OFKALAMAZOO, INC.1140 ACADEMY ST KALAMAZOO, MI

49006

DISABILITY RESOURCE CENTER OF SW

MI517 E CROSSTOWN PARKWAYKALAMAZOO, MI 49001

RENAISSANCE ENTERPRISES COMPANY901 LAY BLVD KALAMAZOO, MI49001

PROGRAMMING SUPPORT

INDEPENDENTLIVING/LIFE MANAGEMENTPROGRAM

2010-2011 MUSIC ANDARTS PROGRAMS

AMOUNT

2,SUU.

509(A)(1) 3,000.

170(B)(1)(

509(A)(1) 3,000.

170(B)(1)(

509(A)(1) 3,300.

170(B)(1)(

509(A)(1) 3,500.

170(B)(1)(

509(A)(1) 4,000.

170(B)(1)(

509(A)(1) 4,000.

170(B)(1)(

509(A)(2) 4,000.

STATEMENT(S) 15


LIFE MINISTRY7162 W H AVE KALAMAZOO, MI49009

EYESAIAH 58 PROJECT

BLACK ARTS & CULTURAL CENTERPO BOX 3505 KALAMAZOO, MI 49003 YOUTH DEVELOPMENT

PROGRAM

BALLET ARTS ENSEMBLE, INC.2018 RAMBLING RD KALAMAZOO, MI49008

FAIR HOUSING CENTER SOUTHWESTMICHIGAN410 E MICHIGAN AVE KALAMAZOO,MI 49007

JULIUS & ESTHER STULBERGCOMPETITION INC359 S BURDICK ST STE 14KALAMAZOO, MI 49007

KALAMAZOO JUNIOR SYMPHONYSOCIETY359 S BURDICK ST STE 100KALAMAZOO, MI 49007

NEW YEAR'S FEST OF KALAMAZOO,INC.346 W MICHIGAN AVE KALAMAZOO,MI 49007

"THE 12 DANCINGPRINCESSES" VENUEEXPENSES

MATCH TO RECEIVE

3-YEAR $825,000 HUD

GRANT

2011 STULBERG STRINGCOMPETITION MASTERCLASSES

COMPREHENSIVE STRINGORCHESTRAL TRAININGPROGRAM

NEW YEAR'S FEST 2010

38-6052963

509(A)(1) 4,000.

170(B)(1)(

509(A)(1) 4,000.

170(B)(1)(

509(A)(1) 5,000.

170(B)(1)(

509(A)(1) 5,000.

170(B)(1)(

509(A)(1) 5,000.

170(B)(1)(

509(A)( 1) 5,000.

170(B)(1)(

509(A)(1) 5,000.

170(B)(1)(

COMSTOCK COMMUNITY CENTER, INC. 509(A)(1)6330 KING HIGHWAY KALAMAZOO, MI EDUCATION EQUIPMENT &49048 FOR COMMUNITY LEARNING 170(B)(1)(

CENTER

BARRY COUNTY COMMUNITYFOUNDATION629 W STATE STREET, STE 201HASTINGS, MI 49058

OAKWOOD NEIGHBORHOOD ASSOCIATION3320 LAIRD AVE KALAMAZOO, MI49008

509(A)(1)MIDWEST MINIATURES &MUSEUM 170(B)(1)(

509(A)(1)AFTER-SCHOOL TUTORING &FOR "AT RISK" YOUTH 170(B)(1)(

5,000.

5,000.

5,500.

STATEMENT(S) 15


MICHIGAN BLIND ATHLETICASSOCIATION222 N. KALAMAZOO MALLKALAMAZOO, MI 49007

KALAMAZOO COLLECTIVE HOUSING302 W WALNUT KALAMAZOO, MI49007

FONTANA CHAMBER ARTS359 S BURDICK ST STE 200KALAMAZOO, MI 49007

KALAMAZOO JUNIOR GIRLSORGANIZATION1114 W PATERSON KALAMAZOO, MI49007

BUILDING BLOCKS OF KALAMAZOO1822 WEST MILHAM AVENUEPORTAGE, MI 49024

COMMUNITY AIDS RESOURCE &EDUCATION629 PIONEER STREETMI 49008

KALAMAZOO COMMUNITFDN125 W EXCHANGE PL49007

PROGRAM SUPPORT

PURCHASE ANDRENOVATION OF 6APARTMENTS AND 1SINGLE-FAMILY HOME

2010-11 EDUCATIONALOUTREACH PROJECTS

OPERATING SUPPORT

2011 SPRING BUILDINGPROGRAM

HIV TESTING,KALAMAZOO, COUNSELING AND

REFERRAL

IES IN SCHOOLSCHILDREN 'S DEFENSE

KALAMAZOO, MI FUND FREEDOM SCHOOLPROGRAM

KALAMAZOO COUNTY POVERTYRECUTION INITIATIVE OPERATING SUPPORT1903 W MICHIGAN AVE KALAMAZOO,MI 49008

KALAMAZOO COUNTY PARKS & RECPO BOX 50467 KALAMAZOO, MI49005

RED TENT1918 STEARNS AVE KALAMAZOO, MI49008

KALAMAZOO RIVER VALLEYTRAILWAY

SUNLIGHT PEERLEADERSHIP PROGRAM

38-6052963

509(A)(1)

170(B)(1)

509(A)(2)

509(A)(1)

170(B)(1)

509(A)(1)

170(B)(1)(

6,000.

6,000.

8,000.

8,000.

509(A)(1) 9,000.

170(B)(1)(

509(A)(1) 10,000.

170(B)(1)(

509(A)(1) 10,000.

170(B)(1)(

509(A)(1)

170(B)(1)(

10,000.

509(A)(3)

509(A)(1)

170(B)(1)(

10,000.

10,000.

STATEMENT(S) 15


MICHIGAN 'FESTIVAL OF SACREDMUSIC. 2010-11 "OFF-YEAR"PO BOX 50566 KALAMAZOO, MI EVENTS AND 201149005 FESTIVAL

COMMUNITY HOMEWORKS603 ELM ST KALAMAZOO, MI 49007 EMERGENCY HOME REPAIR

SERVICES

IRVING S GILMORE INT'L KEYBOARDFESTIVAL359 S BURDICK ST STE 101KALAMAZOO, MI 49007

JOBS FOR MICHIGAN'S GRADUATESINC300 S WESTNEDGE AVE KALAMAZOO,MI 49007

GREATER KALAMAZOO UNITED WAY709 S WESTNEDGE KALAMAZOO, MI49007

FAMILY & CHILDREN SERVICES INC1714 EASTMAN MIDLAND, MI 48640

KAIROS DWELLING2945 GULL RD KALAMAZOO, MI49048

YWCA OF KALAMAZOO353 E MICHIGAN AVE KALAMAZOO,MI 49007

HERITAGE COMMUNITY OF KALAMAZOO2400 PORTAGE ST KALAMAZOO, MI49001

PIANO LABS PROGRAM

38-6052963

509(A)(2) 10,000.

509(A)(1) 10,000.

170(B)(1)(

509(A)(1) 15,000.

170(B)(1)(

509(A)(1) 15,000.MASTER PLANNING TOWARD &DOWNTOWN DEVELOPMENT 170(B)(1)(

KALAMAZOO COUNTY READY4S PRE-PILOT PHASE

"HANDLE WITH CARE"FUND

2011 OPERATIONALEXPENSES

509(A)(1) 15,000.

170(B)(1)(

509(A)(1) 15,000.

170(B)(1)(

509(A)(1) 20,000.

170(B)(1)(

CHILD CARE ANDEDUCATION ATCHILDREN'S CENTER

DEMENTIA & ALZHEIMER'SCENTER AT DIRECTOR'SHALL

SW MI COUNCIL BOY SCOUTS OFAMERICA ROTA-KIWAN SCOUT1035 MAPLE STREET KALAMAZOO, MI RESERVATION49008

509(A)(2)

509(A)(2)

509(A)(1)

170(B)(1)

20,000.

20,000.

21,000.

STATEMENT(S) 15


KALAMAZOO*SYMPHONY ORCHESTRA359 S•BURDICK ST STE 100KALAMAZOO, MI 49007

CONSTANCE BROWN HEARING-SPEECHCENTER1634 GULL RD KALAMAZOO, MI49048

HOUSING RESOURCES, INC.345 N BURDICK ST KALAMAZOO, MI49007

KALAMAZOO COMMUNITY FOUNDATION151 SOUTH ROSE STREET STE 332KALAMAZOO, MI 49007

WESTERN MICHIGAN UNIVERSITYFOUNDATION1903 W MICHIGAN AVE KALAMAZOO,MI 49008

KALAMAZOO CENTER FOR COMMUNITYAND YOUTH350 E MICHIGAN AVE, STE 415KALAMAZOO, MI 49007

DRUG TREATMENT COURT FDNPO BOX 50587 KALAMAZOO, MI49005

PLANNED PARENTHOOD OF SOUTH

CENTRAL MI

4201 W MICHIGAN AVE KALAMAZOO,MI 49006

KALAMAZOO NATURE CENTER INC7000 N WESTNEDGE AVE KALAMAZOO,MI 49009

EDUCATION ANDCOMMUNITY PROGRAMS

38-6052963

509(A)( 1) 22,500.

170(B)(1)(

509(A)(1) 25,000.ADULT HEARING SERVICES &ASSISTANCE FUND 170(B)(1)(

OPERATING SUPPORT509(A)(1) 25,000.

170(B)(1)(

LIFELINE INITIATIVEPARTNERSHIP PROJECT

509(A)(1)

170(B)(1)

25,000.

509(A)(1)SEITA SCHOLARS PROGRAM &OPERATIONS 170(B)(1)(

CAPACITY

BUILDING/CAMPAIGN

START

PARISH CONFERENCE 7500AND STAFF TRAINING17500

SEXUALLY TRANSMITTEDINFECTIONS PROGRAM

CAMP PROGRAM, ART BARN

KALAMAZOO VALLEY HABITAT FORHUMANITY 2010-2011 BUILDING

525 E KALAMAZOO AVE KALAMAZOO, PROGRAMMI 49007

25,000.

509(A)(1) 25,000.

170(B)(1)(

509(A)(1) 25,000.

170(B)(1)(

509(A)(2) 25,000.

509(A)(2) 25,115.

509(A)(1)

170(B)(1)

28,000.

STATEMENT(S) 15


MINISTRY WITH COMMUNITY, INC. 509(A)(1) 30,000.440 N'CHURCH ST KALAMAZOO, MI MEALS PROGRAM &49007 170(B)(1)(

FRIENDSHIP HOUSE1829 S BURDICK ST KALAMAZOO, MI CHRISTIAN RESOURCE49001 CENTER EMERGENCY

RELIEF FUND

KALAMAZOO LOAVES & FISHES, INC.913 E ALCOTT ST KALAMAZOO, MI "BUILD-NOURISH-SUSTAIN49001 FACILITIES CAMPAGIN

TOTAL TO FORM 990-PF, PART XV, LINE 3A

509(A)(1) 30,000.

170(B)(1)(

509(A)(1) 47,000.

170(B)(1)(

681,415.

STATEMENT(S) 15


GENERAL EXPLANATION STATEMENT 16FORM AND LINE REFERENCES

FORM/LINE IDENTIFIER

990-PF AMENDED RETURN

GENERAL EXPLANATION STATEMENT 17

PART I, LINES 6A AND B:

THE REMOVAL OF TWO (2) WASH SALES FROM THE AMOUNT PREVIOUSLY REPORTED.

THE SALES OF ISHARES TRUST MSCI EAFE INDEX FUND RESULTED IN PROCEEDS OF

$137,350 AND A NET LOSS OF $61,490. THESE AMOUNTS WERE REMOVED FROM

THE LINES NOTED ABOVE.

PART II, LINES 13 AND 24:

THE COST BASIS OF THE ASSET WAS INCREASED BY $61,490 TO REFLECT THE

DISALLOWED WASH SALES. ADDITIONALLY, NET ASSETS WAS ADJUSTED FOR THE

SAME AMOUNT.

STATEMENT (S) 16, 17

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