Return of Private Foundation
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-' { I ti Return of Private Foundation OMB No 1545-0052 Form 990 -PF or Section 4947(a)(1) Nonexempt Charitable Trust 20 Department of the Treasury Treated as a Private Foundation Internal Revenue Service Note. The foundation may be able to use a copy of this return to satisfy state reporting requirements. For calendar year 2012 or tax year beginning , and ending Name of foundation _ A Employer identification number MARK AND ANNA RUTH HASTEN FAMILY FOUNDATION, INC. 35-1998923 Number and street (or P O box number if mail is not delivered to street address) Roo m/swte B Telephone number 3901 W. 86TH STREET 70 317-872-9901 City or town, state, and ZIP code C If exemption is pending, check here ► INDIANAPOLIS, IN 46268 G Check all that apply Initial return L_J Initial return of a former public charity D 1. Foreign organizations, check here Final return Amended return 2. Foreign organizations meeting the 85% test, Address chang e Name change check here and attach computation X H Check type of organization: Section 501(c)(3) exempt private foundation E If private foundation status was terminated Section 4947(a)(1) nonexempt charitable trust 0 Other taxable private foundation under section 507(b)(1)(A), check here Fair market value X I of all assets at end of year J Accounting method: Cash L_J Accrual F If the foundation is in a 60-month termination (from Part ll, col (c), line 16) = Other (specify) under section 507(b)(1)(B), check here ► $ 5 , 8 8 5 , 4 5 0 . (Part I, column (d) must be on cash basis.) Part 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 for chantable purposes necessanly equal the amounts in column (a)) expenses per books income income (cash basis only) 1 Contributions, gifts, grants, etc., received 110 , 0 0 0 2 Check ► if the foundation is not required to attach Sch B and temporary 3 cash investments 36,719. 36, 719. 36, 719 . TATEMENT 1 4 Dividends and interest from securities 20,013. 20, 013. 20, 013. TATEMENT 2 5a Gross rents b Net rental income or (loss) 6a Net gain or (loss) from sale of assets not on line 10 74 ,611. C b Gross sales price for all assets on line 6a 2 , 414 , 723. d 7 Capital gain net income (from Part IV, line 2) 74 ,611. 8 Net short-term ca Ital N/A 9 Income mod s retu rrr - CE yED Gross sales less recur 10a and allowances b Less Cost of goo solder c Gross profit oa oss)N( Z 11 Other Income 9,915. 9,915. 9 , 915. TATEMENT 3 12 Total. Addilnes1 251,258. 141,258. 66,647. 13 Compensabo b of ff, t es, e 51,762. 0. 0. 0. 14 Other employee salaries and wages 15 Pension plans, employee benefits 3 y 16a Legal fees is b Accounting fees STMT 4 9,595. 0. 0. 0. 3 W c Other professional fees 17 Interest 18 Taxes STMT 5 59. 0. 0. 0. 19 Depreciation and depletion 20 Occupancy -^r 21 Travel, conferences, and meetings 22 Printing and publications 23 Other expenses STMT 6 4 15 . 19,545. 0. 0. 16 24 Total operating and administrative a expenses . Add lines 13 through 23 106,031. 19,545. 0. 0. 0 25 Contributions, gilts, grants paid 801,358. 801,358. 26 Total expenses and disbursements. Add lines 24 and 25 907,389. 19,545. 0. 801,358. 27 Subtract line 26 from line 12: - a Excess of revenue over expenses and disbursements <656, 131. b Net investment income (if negative, enter -o-) 121 , 713 . c Adjusted net income (if negative, enter -o-) 66 , 647. 1 IJU YYlIVII. 1 FUIIII is ,J rr (cv if] 10581031 137329 HASTEN,M-PF 2012.04030 MARK AND ANNA RUTH HASTEN F HASTEN11 f^ MARK AND ANNA RUTH HASTEN FAMILY For'm990-PF 2012 FOUNDATION, INC. 35-1998923 Page2 Attached schedules and amounts in the description Beginning of year End of year Part II Balance Sheets column should beforend -ol-year amounts only ( a) Book Value ( b) Book Value ( c) Fair Market Value 1 Cash - non-interest-bearing 2 Savings and temporary cash investments 105,371. 190,645. 190,645. 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 b Investments - corporate stock STMT 7 - 346,640. 346,640. 186,340. c Investments - corporate bonds 11 Investments - land, buildings, and equipment basis ► a _ S Less accumulated depremauon ► 12 Investments - mortgage loans 13 Investments - other STMT 8 5,756,282. 4,988,807. 5,346,685. 14 Land, buildings , and equipment : basis ► - E Less accumulated depremabon ► 15 Other assets (describe ► STATEMENT 9 ) 121,780. 161,780. 161,780. 16 Total assets to be completed by all filers 6,330,073. 5,687,872. 5, 885,450. 17 Accounts payable and accrued expenses 13,930. 18 Grants payable u) 19 Deferred revenue 20 Loans from officers , directors , trustees , and other disqualified persons 21 Mortgages and other notes payable 22 Other liabilities (describe ► ) 23 Total liabilities (add lines 17 through 22 ) 0. 13,930. Foundations that follow SFAS 117 , check here - ► and complete lines 24 through 26 and lines 30 and 31. 24 Unrestricted m 25 Temporarily restricted m 26 Permanently restricted Foundations that do not follow SFAS 117 , check here ► OR 3LL and complete lines 27 through 31. 0 27 Capital stock, trust principal, or current funds 443,951. 443,951. y 28 Paid- in or capital surplus, or land, bldg ., and equipment fund 0. 0. a 29 Retained earnings, accumulated income, endowment, or other funds 5, 886,122. 5, 229,991. Z 30 Total net assets or fund balances 6 , 330,073. 5, 673,942. 1 31 Total liabilities and net assets/fund balances 6, 330,073. 5, 687,872. Part III Analysis of Changes in Net Assets or Fund Balances 1 Total net assets or fund balances at beginning of year - Part II, column (a), line 30 (must agree with end-of-year figure reported on prior year's return) 6,330,073. 2 Enter amount from Part I, line 27a <656,131. > 3 Other increases not included in line 2 (itemize) ► U. 4 Add lines 1, 2, and 3 5,673,942. 5 Decreases not included in line 2 (itemize) ► 0. 6 Total net assets or fund balances at end of year (line 4 minus line 5) - Part II, column (b), line 30 5,673,942. Form 990-PF (2012) 223511 12-05-12 2 10581031 137329 HASTEN,M-PF 2012.04030 MARK AND ANNA RUTH HASTEN F HASTEN11 MARK AND ANNA RUTH HASTEN FAMILY Form 990-PF (2012) FOUNDATION, INC. 35-1998923 Page 3 Part IV Capital Gains and Losses for Tax on I nvestment Income (a) List and describe the kind (s) of property sold (e.g., real estate, How acquire (c) Date acquired (d) Date sold - Purchase ( 2-story brick warehouse; or common stock, 200 shs. MLC Co.) D - Donation mo., day, yr. ) (mo., day, yr.) la b SEE ATTACHED STATEMENT C d e - (e) Gross sales price (f) Depreciation allowed ( g) Cost or other basis (h) Gain or (loss) (or allowable) plus expense of sale (e) plus (f) minus (g) a b c d e 2,414,723. 1 1 2,340,112. 74,611. Complete only for assets showing gain in column ( h) and owned by the foundation on 12/31/69 (I) Gains (Col- (h) gain minus Adjusted col. ( less or (j) basis (k) Excess of col. (i) -^) (i) F.M.V as of 12/31/69 as of 12/31/69 over col. (j), if any k), but (from col. a b c d e 74,611. If gain, also enter in Part I, line 7 2 Capital gain net income or ( net capital loss) If (loss), enter -0- in Part I, line 7 2 74,611. 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 13 ,647 . I r-arr .v j % Udlilleauon u n uer aeciuon '+Zrufe) Tor neuucea i ax on net investment income (For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.) If section 4940(d)(2) applies, leave this part blank. Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period 0 Yes ^X No If "Yes." the foundation does not aualifv under section 4940(e). Do not complete this fart. 1 Enter the appropriate amount in each column for each year; see the instructions before making any entries. (a ) Base period years (c) Distribution ratio Calendar year ( or tax year beginning in ) Adjusted qualifying(bri distributions Net value of noncharitable -use assets (col. (b) divided by col. (c)) 2011 905,528 . 4,189,052. .216165 2010 1,910,528. 7,303,9 7. .2 6 1575 2009 3,426,228. 8,182,279. .418738 2008 2,257,429. 9,792,199. .230533 2007 7,650,657.