• C7 Return of Private Foundation OMB N o 1 5 4 5-0052 Form 990-PF I or Section 4947(aX1) Trust Treated as Private Foundation Do not enter Social Security numbers on this form as it may be made public. Department of the Treasury ► 2013 Internal Revenue Service ► Information about Form 990-PF and its seuarate instructions is at www arc nnvlfnrm For calendar year 2013 or tax year beginning , and ending Name of foundation A Employer identification number
INTEL FOUNDATION 94-3092928 Number and street (or P O box number if mail is not delivered to street address ) Room/swte B Telephone number 5200 NE ELAM YOUNG PARKWAY ( 503) 696-8080
City or town, state or province , country, and ZIP or foreign postal code C If exemption application is pending , check here ► HILLSBORO , OR 97124 G Check all that apply: Initial return -LI initial return of a former public charity D 1. Foreign organizations, check here 10.= Final return Amended return 2. Foreign organizations meeting the 85% test, Address chan g e Name change check here and attach computation ► H Check type of organization : LXJ Section 501(c)(3 ) exempt private foundation E If private foundation status was terminated 0 Section 4947( a)(1) nonexempt charitable trust = Other taxable private foundation under section 507 (b)(1)(A), check here I Fair market value of all assets at end of year J Accounting method: LXJ Cash Accrual F If the foundation is in a 60-month termination (from ll, col. (c), line Other (specify) Part 16) 0 under section 507(b )(1)(B), check here ► 1, column ( must be on 31, 0 2 5 , 4 5 9 J (Part d) cash basis) Analysis Revenue and Expenses Part I of ( a) Revenue and (b ) Net investment (c) Adjusted net (d) Disbursements (The total of amounts in columns ( b), (c), and ( d) may not for charitable p urposesonly) necessarily equal the amounts in column ( a )) expenses per books income income (cash basis only) 1 Contributions , gifts, grants, etc., received 10,000,000 . N A 2 Check (the foundation is not required to attach Sch B and temporary 3 cashInvestments 16 6 , 0 51. 16 6 , 0 51 . S TATEMENT 2 4 Dividends and interest from securities 5a Gross rents
b Net rental income or (loss)
6a Net gain or (loss) from sale of assets not on line 10 256,483. S TATEMENT M b Gross sales price for all assets on line 6a 17 , 803 , 704. 7 Capital gain net income (from Part IV, line 2) 13,202,852. 8 Net short-term capltaLaam---
9 Incomemodlfl r^ ^^,,,,,,,,,,^^^CCC, ^^^ Gross sales less rZtOrr^T - 10a and allowan b Less Cp^ goods sold 1 4 1 01 c Gross ^ofl 01 11 Other i cg e 6 119 , 3 6 0 . 0. TATEMENT 12 Total . dd Ine thrattgtfl Ujd 11 I 10 , 541, 8 9 4. 13 , 3 6 8, 9 0 3. 13 Compen tioAatottioare , directors; truss;etc 0. 0. 0. 14 Other employee salaries and wages 15 Pension plans, employee benefits en 16a Legal fees b Accounting fees STMT 4 18,832 . 0. 18,832. 0. W c Other professional fees 17 Interest 18 Taxes STMT 5 210 , 000. 0. 0. Q 0 19 Depreciation and depletion a 20 Occupancy < 21 Travel, conferences , and meetings r- 22 Printing and publications O M 23 Other expenses STMT 6 187,166. 0 . 187,166. is 24 Total operating and administrative LI Q. expenses . Add lines 13 through 23 415 ,998. 0 . 205,998. 0 25 Contributions , gifts, grants paid 4 5, 122, 1 9 5. 5 , 122,195. 26 Total expenses and disbursements. Add lines 24 and 25 45,538 , 193. 0 . 45,328,193. )) 27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements - 34 ,996,299. b Net investment income (if negative, enter -0-) 13 , 3 8 , 9 0 3 . c Adjusted net income (if negative , enter -0-) N / A ^^^ lu-lu-141 LM/1 r ^^ r oyc^nu^n n^uuvu^u nm nvu^ , c,^ u.uu u^uvuo. , ..,,,, --- . • t-.,/ 1 14421003 099815 INTEL 2013.04030 INTEL FOUNDATION INTEL1 0 • Form 990-PF (2013) INTEL FOUNDATION 94-3092928 pane2 Beginning of year End of year Part 11 Balance Sheets Attached schedules and amounts in the description column should beforend-of-year amounts only (a) Book Value (b) Book Value (c) Fair Market Value 1 Cash - non-Interest-bearing 182,215. 1,09 4 ,707. 1 ,094,7 07. 2 Savings and temporary cash investments 38,767,050. 15, 4 23, O C-4. 15, 423, 0 6 4. 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 ► w 8 Inventories for sale or use y 9 Prepaid expenses and deferred charges a 10a Investments - U.S. and state government obligations b Investments - corporate stock c Investments - corporate bonds 11 Investments-land, buildings, and equipment basis ►
Less accumulated depreciation ► 12 Investments - mortgage loans 13 Investments - other STMT 7 27,072,493. 14,507,688. 14,507,688. 14 Land, buildings, and equipment basis ► Less accumulated depreciation ► 15 Other assets (describe ► 16 Total assets (to be completed by all filers - see the instructions. Also, see page 1, item 1 ) 66,021,758. 31,025,459. 31,025,459. 17 Accounts payable and accrued expenses 18 Grants payable u) 19 Deferred revenue
20 Loans from officers, directors, trustees, and other disqualified persons 2 21 Mortgages and other notes payable 22 Other liabilities (describe ►
23 Total liabilities (add lines 17 through 22 ) 0. 0. Foundations that follow SFAS 117, check here ► LXJ and complete lines 24 through 26 and lines 30 and 31. 24 Unrestricted 66,021,758. 31,025,459. 25 Temporarily restricted ca 26 Permanently restricted Foundations that do not follow SFAS 117, check here ► LL and complete lines 27 through 31. y 27 Capital stock, trust principal, or current funds y 28 Paid-in or capital surplus, or land, bldg., and equipment fund a 29 Retained earnings, accumulated income, endowment, or other funds Z 30 Total net assets or fund balances 66,021,758. 31, 025,T5-9.
31 Total liabilities and net assets/fund balances 66,021,758. 31, 025,459. 1 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) 66,021,758. 2 Enter amount from Part I, line 27a -34,99 6 ,29T.- 3 Other increases not included in line 2 (itemize) ► 0. 4 Add lines 1, 2, and 3 31,025,459. 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 31,025,459. Form 990-PF (2013) 323511 10-10-13 2 14421003 099815 INTEL 2013.04030 INTEL FOUNDATION INTEL1 • • Form 990-PF (2013) INTEL FOUNDATION 94-3092928 Page 3 Part IV Capital Gains and Losses for Tax on Investment Income How acquire (a) List and describe the kind(s) of property sold (e.g., real estate, (C) Date acquired (d) Date sold (mo., day, yr.) 2-story brick warehouse; or common stock, 200 shs. MLC Co.) D - Donton (mo., day, yr.) to GAIN LOSS ON INVESTMENTS D VARIOUS VARIOUS b 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 17,803,704. 4,600,8 52. 13,202,85 27 b c d e Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (I) Gains (Col. (h) gain minus (j) Adjusted basis (k) Excess of col. (Q col. (k), but not less than -0-) or Losses (from (i) F.M.V. as of 12/31/69 as of 12/31/69 over col. (j), if any col. (h)) a 13,202,852. b c d e 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 13,202,852. 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 uuallticatlon Under Section 494U(e) for Heduced 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 period? 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 the instructions before making any entries. (a ) Base periodtax years Di) dtributdio)nived rata Calendar year (orr tax year beginning in) Adjusted q uali fY(m 9 distributions Net value of noncharitable-use assets (col. (b) divided by col. (c)) 2012 45,454,613. 45,963,996. .988918 2011 43,274,083. 63,396,573. .68259 3 2010 40,859,916. 57,793,787. .706995 2009 40,441,258. 50,073,397. .807640 2008 36,469,208. 61,658,705. .591469
2 Total of line 1, column (d) 2 3 .777615 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 3 .755523
4 Enter the net value of noncharitable-use assets for 2013 from Part X, line 5 4 41,310,714.
5 Multiply line 4 by line 3 5 31,211 ,195.
6 Enter 1% of net investment income (1% of Part I, line 27b) 6 133,689.
7 Add lines 5 and 6 7 31, 344,884.
8 Enter qualifying distributions from Part XII, line 4 8 45, 328 ,193. If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1 % tax rate. See the Part VI instructions.
323521 10- 10-13 Form 990-PF (2013)
14421003 099815 INTEL 2013.04030 INTEL FOUNDATION INTEL1 • 0 Form 990-PF 2013 INTEL F OUNDATION 9 4-3092 928 Page 4 Part VI Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948 - see instructions la Exempt operating foundations described in section 4940(d)(2), check here ► 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 ► © and enter 1% 1 133,689. 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 3 133,689. 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- 5 133,689. 6 Credits/Payments: a 2013 estimated tax payments and 2012 overpayment credited to 2013 6a 144,529. b Exempt foreign organizations - tax withheld at source 6b c Tax paid with application for extension of time to file (Form 8868) 6c 35, 0 00. d Backup withholding erroneously withheld 6d 7 Total credits and payments. Add lines 6a through 6d 7 179 ,529. 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 10 Overpayment. 7 is than the lines If line more total of 5 and 8, enter the amount overpaid ► 10 45,840. 11 Enter the amount of line 10 to be: Credited to 2014 estimated tax ► 4 5 , 8 4 0 . Refunded 111,- 11 0. Part VII-A Statements Regarding Activities la During the tax year, did the foundation attempt to influence any national, state, or local legislation or did it participate or intervene in Yes No any political campaign? la X b Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see instructions for the definition)? 1b X If the answer is "Yes" to la or 1b, attach a detailed description of the activities and copies of any materials published or distributed by the foundation in connection with the activities c Did the foundation file Form 1120-POL for this year? is 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. III,- $ 0. e Enter the reimbursement (If any) paid by the foundation during the year for political expenditure tax imposed on foundation managers. Do- $ 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 bylaws, or other similar instruments? If "Yes, " attach a conformed copy of the changes 3 X 4a Did the foundation have unrelated business gross income of $1,000 or more during the year? 4a X b If "Yes," has it filed a tax return on Form 990 -T for this years N/A 4b 5 Was there a liquidation, termination, dissolution, or substantial contraction during the year? 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 7 Did the foundation have at least $5,000 in assets at any time during the year? If "Yes, " complete Part ll, col. (c), and Part XV 7 X
8a Enter the states to which the foundation reports or with which it is registered ( see instructions) ► OR 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(j)(5) for calendar year 2013 or the taxable year beginning in 2013 (see instructions for Part XIV)? If "Yes," complete Part XIV 9 X 10 Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listinq their names and addresses 10 X Form 990-PF (2013)
323531 10-10-13 4 14421003 099815 INTEL 2013.04030 INTEL FOUNDATION INTEL1 • 0 Form 990-PF (2013 ) INTEL FOUNDATION 94-3092928 Page 5 Part VII-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 make a distribution to a donor advised fund over which the foundation or a disqualified person had advisory privileges? If "Yes," attach statement (see instructions) 12 X 13 Did the foundation comply with the public inspection requirements for its annual returns and exemption application? 13 1 X Website address ► WWW. INTEL . COM 14 The books are in care of ► INTEL FOUNDATION Telephone no. 10, (503) 696-8080 Located at ► 5 2 0 0 NE ELAN YOUNG PARKWAY, HI LL SBORO , OR ZIP+4 712 4 15 Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 -Check here WT-F and enter the amount of tax-exempt interest received or accrued during the year ► 15 N/A 16 At any time during calendar year 2013, did the foundation have an interest in or a signature or other authority over a bank, Yes No securities, or other financial account in a foreign country? ^ 16 X See the instructions for exceptions and filing requirements for Form TD F 90-22.1. If "Yes,' enter the name of the foreign country ► Part VII- 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 la During the year did the foundation (either directly or indirectly): (1) Engage in the sale or exchange, or leasing of property with a disqualified person? Yes ® No (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from) a disqualified person? Yes No (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? Yes No (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? Yes ® 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)? 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.) Yes MX 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 instructions)? 1b X Organizations relying on a current notice regarding disaster assistance check here ► Q 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 2013? 1c 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(j)(3) or 4942(l)(5)): a At the end of tax year 2013, did the foundation have any undistributed income (lines 6d and 6e, Part XIII) for tax year(s) beginning before 2013? Yes ® 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? = Yes ® No b If 'Yes," did it have excess business holdings in 2013 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, Form 4720, to determine if the foundation had excess business holdings in 2013) N/A 3b 4a Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes? b Did the foundation make any investment in a prior year ( but after December 31, 1969) that could jeopardize its charitable purpose that had not been removed from jeopardy before the first day of the tax year beainnina in 2013? I4bI IX Form 990-PF (2013)
323541 10-10-13 5 14421003 099815 INTEL 2013.04030 INTEL FOUNDATION INTEL1 Form 990-PF (2013) INTEL FOtTION 0 94-3092928 Page6
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 No (3) Provide a grant to an individual for travel, study, or other similar purposes? Yes OX 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)? OX Yes = 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 OX No b If any answer is "Yes' to 5a(1)-(5), did any of the transactions fail to qualify under the exceptions described in Regulations section 53.4945 or in a current notice regarding disaster assistance (see instructions)? 5b X Organizations relying on a current notice regarding disaster assistance check here 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? 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 contract9 Yes No b Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? 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 any proceeds or have any net income attributable to the transaction? N/A 7b Part Information About Officers, Directors, Trustees, Foundation Managers , Highly Paid Employees , and Contractors 1 List all officers , directors, trustees , foundation managers and their compensation. (b) Title, and average (c) Compensation contributions to (e)Expense (a) Name and address hours per week devoted ( If not paid , empoyeebenefit plans account, other to position enter -0 ) compensation allowances
SEE STATEMENT 0. 0. 0.
z compensation of tive nianest-papa employees Cotner tnan tnose mctuaea on line it. it none, enter "NUNt." a average contribution o emp lags (a) Name and address of each employee paid more than $50,000 (b)hours week (c) Compensation deferred ns account, other devoted to position compensation allowances NONE
Total number of other employees paid over $50,000 IN. I U Form 990-PF (2013)
323551 10-10-13 6 14421003 099815 INTEL 2013.04030 INTEL FOUNDATION INTEL1 0 0 Form 990-PF 2013 INTEL FOUNDATION 94-3092928 Page 7 art Vill Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid 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 SCHOLARSHIP AMERICA - 1550 AMERICAN BLVD E., 155, MINNEAPOLIS, MN 55425 AGEMENT SERVICES 128,985. JK GROUP PROCESSING GRANTS P.O. BOX 7174, PRINCETON, NJ 085 4 3 D GIFTS 53,814.
Total number of others receiving over $50,000 for professional services ► 0 I rant IA-A I QurnnId[ UI vIIGCL I. IIantdLIC List the foundation's four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses N/A
2
3
4
I Part IX-1131 Summary of Program-Related Investments Describe 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 throu gh 3 0 Form 990-PF (2013)
323561 10-10-13 7 14421003 099815 INTEL 2013.04030 INTEL FOUNDATION INTEL1 0 9 Form990-PF 2013 INTEL FOUNDATION 94-3092928 Page8 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 fair market value of securities la 40,386,223. b Average of monthly cash balances lb 1, 553, 5 8 8 . c Fair market value of all other assets 1c d Total (add lines la, b, and c) id 41,939,811. e Reduction claimed for blockage or other factors reported on lines la 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 41 ,939,811 . 4 Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see instructions) 4 6 29,097 . 5 Net value of noncharitable -use assets . Subtract line 4 from line 3. Enter here and on Part V, line 4 5 41, 310 , 714 . 6 Minimum investment return . Enter 5% of line 5 6 2, 065 , 536 . Part XI Distributable Amount (see instructions) (Section 4942(1)(3) and (1)(5) private operating foundations and certain foreign organizations check here (po. E and do not complete this part.) 1 Minimum investment return from Part X, line 6 1 2, 065 , 536 . 2a Tax on investment income for 2013 from Part VI, line 5 2a 133,689. b Income tax for 2013. (This does not include the tax from Part VI.) 2b c Add lines 2a and 2b 2c 133 , 689 . 3 Distributable amount before adjustments. Subtract line 2c from line 1 3 1 , 931 , 847 . 4 Recoveries of amounts treated as qualifying distributions 4 118 , 860 . 5 Add lines 3 and 4 5 2, 050 , 707. 6 Deduction from distributable amount (see instructions) 6 0 . 7 Distributable amountas adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 7 2, 050 , 707 . art 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 la 45,328,193. 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 45,3287-9 -3. 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 5 133,689. 6 Adjusted qualifying distributions . Subtract line 5 from line 4 6 45, 194, 5 0 4. Note. The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for the section 4940(e) reduction of tax in those years. Form 990-PF (2013)
323571 10-10-13 8 14421003 099815 INTEL 2013.04030 INTEL FOUNDATION INTEL1 0 0
Form 990-PF (2013) INTEL FOUNDATION 94-3092928 Page 9 Part XIII Undistributed Income (see instructions)
(p) (b) (c) (d) Corpus Years prior to 2012 2012 2013 1 Distributable amount for 2013 from Part XI, line 7 2,050,707. 2 Undistributed income, if any , as of the end of 2013 a Enter amount for 2012 only 0. b Total for prior years: 0. 3 Excess distributions carryover, if any, to 2013: a From 2008 33 , 225 ,153. b From 2009 38,10 4,360. cFrom 2010 37,838,599. dFrom2011 0,494,755. eFrom 2012 43,228,982. f Total of lines 3a through e 192,891,849. 4 Qualifying distributions for 2013 from Part Xll,line4: 45, 328,193. a Applied to 2012, but not more than line 2a 0. bApplied to undistributed income of prior years (Election required - see instructions) 0. c Treated as distributions out of corpus (Election required - see instructions) 0. dApplied to 2013 distributable amount 2,050,707. e Remaining amount distributed out of corpus 4 3,277,486. 5 Excess distributions carryover applied to 2013 (If an amount appears in column ( d), the same amount 0. must be shown in column (a) ) 6 Enter the net total of each column as indicated below:
a Corpus Add lines 3f, 4c, and 4e Subtract line 5 236,169,335. bPrlor years' undistributed income. Subtract line 4b 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 2012. Subtract line 4a from line 2a. Taxable amount - see instr. 0. f Undistributed income for 2013. Subtract lines 4d and 5 from line 1. This amount must be distributed in 2014 0. 7 Amounts treated as distributions out of corpus to satisfy requirements imposed by section 170(b)(1)(F) or 4942(g)(3) 0. 8 Excess distributions carryover from 2008 not applied on line 5 or line 7 33,225,153. 9 Excess distributions carryover to 2014. Subtract lines 7 and 8 from line 6a 202,944,182. 10 Analysis of line 9: a Excess from 2009 3 8 ,10 4, 3 6 0. b Excess from 2010 37,838,599. c Excess from 2011 0, 19-T-7-5 5. d Excess from 2012 3, 2 2 8, 9 8 2. e Excess from 2013 .13,277,486.
323581 Form 990-PF (2013) 10-10-13 9 14421003 099815 INTEL 2013.04030 INTEL FOUNDATION INTEL1 0 •
Form 990-PF (2013) INTEL FOUNDATION 94-3092928 Page 10 Part XIV Private Operating-Foundations (see instructions and Part VII-A, question 9) N/A 1 a If the foundation has received a ruling or determination letter that it is a private operating foundation, and the ruling is effective for 2013, enter the date of the ruling ► b Check box to indicate whether the foundation is a private operating foundation described in section L_J 4942(1)(3) or L_J 4942(j)(5) 2 a Enter the lesser of the adjusted net Tax year Prior 3 years income from Part I or the minimum (e) Total 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 2c Complete 3a, b, or c for the alternative test relied upon: a "Assets" alternative test - enter: (1) Value of all assets (2) Value of assets qualifying under section 4942(j)(3)(B)(i) b "Endowment" alternative test - enter 2/3 of minimum investment return shown in Part X, line 6 for each year listed c "Support" alternative test - enter: (1) Total support other than gross investment income (interest, dividends, rents, payments on securities loans (section 512(a)(5)), or royalties) (2) Support from general public and 5 or more exempt organizations as provided in section 4942(I)(3)(B)(in) (3) Largest amount of support from an exempt organization (4) Gross investment income ( tart xv Supplementary mtormatlon tt;omplete tuts part only It the tounaatlon naa 4io,wu or more in assets at any time during the year-see 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, gra nts, etc. (see in structi o ns) to individuals or organizatio n s under other conditions, complete items 2a, b, c, and d. a The name, address, and telephone number or e-mail address of the person to whom applications should be addressed: PRESIDENT - INTEL FOUNDATION, 503-696-8080 5200 NE ELAM YOUNG PARKWAY, HILLSBORO, OR 97124-6497 b The form in which applications should be submitted and information and materials they should include: SEE APPLICATION GUIDELINES AT ATTACHMENT A c Any submission deadlines: EVALUATION MAY TAKE UP TO 3 MONTHS d Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other factors: SEE APPLICATION GUIDELINES AT ATTACHMENT A
323601 10-10-13 Form 990-PF (2013) 10 14421003 099815 INTEL 2013.04030 INTEL FOUNDATION INTEL1 • • Form 990-PF (2013) INTEL FOUNDATION 94-3092928
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 contribution Amount Name and address (home or business) any foundation manager status of or substantial contributor recipient a Paid during the year
SEE ATTACHMENT B 45 122,195.
Total 45 122 195. ► 3a b Approved for future payment
SEE ATTACHMENT C 62,037,499.
62 037,499. Total ► 3b ( Form 990-PF (2013) 323611 10-10-13 11 14421003 099815 INTEL 2013 . 04030 INTEL FOUNDATION INTEL1 0 0 Form 990-PF (2013) INTEL FOUNDATION 94-3092928 Page 12 Part XVI-A Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated. Unrelate d b usiness income Exclu ded by section 512, 513, or 514 (e) (a) (b) Exc u- (d) Related or exempt Business Amount 1 Program service revenue: code code5ion Amount 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 14 166,051. 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 18 256,483. 9 Net income or (loss) from special events 10 Gross profit or (loss) from sales of inventory 11 Other revenue: a GRANTS b REFUNDS RECOVERIES 01 118,8 0. c OTHER INCOME 01 500. d e 12 Subtotal. Add columns (b), (d), and (e) 0. 541,894. 0. 13 Total. Add line 12, columns (b), (d), and (e) 13 541,894. (See worksheet in line 13 instructions to verify calculations.) FP_ar_t_XV - Relationship of Activities to the Accomplishment of Exempt Purposes
10-10-13 runt aw-rr Icu w) 12 14421003 099815 INTEL 2013.04030 INTEL FOUNDATION INTEL1 9 0 Form 990-PF (2013) INTEL FOUNDATION 94-3092928 Page 13 Part 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? a Transfers from the reporting foundation to a noncharitable exempt organization of. (1) Cash la(l) (2) Other assets la(2) 1 I X b Other transactions: (1) Sales of assets to a noncharitable exempt organization lb(1) X (2) Purchases of assets from a noncharitable exempt organization lb(2) 1 I X (3) Rental of facilities, equipment, or other assets lb(3) 1 I X (4) Reimbursement arrangements lb(4) X (5) Loans or loan guarantees lb(5) X (6) Performance of services or membership or fundraising solicitations 1b(6) X Sharing of facilities, equipment, mailing lists, other assets, or paid employees 1c 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 column (d) the value of the goods, other assets, or services received.
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 (other than section 501(c)(3 )) or in section 527? Yes ® No b If "Yes; complete the following schedule. (a) Name of organization (b) Type of organization (c) Description of relationship N/A
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge m ay th e iscuss is and belief, it is true, correct, and co"e DecI lion of preparer (other than taxpayer) is based on all information of which preparer has any knowledge Sign return with the preparer Here Signature of officer or trustee Dat Prlnt/Type preparer's name Preparer's signature
Paid SHARON L. ZORBACH
14421003 0 0
Schedule B I Schedule of Contributors OMB No 1545-0047 (Form 990, 990-EZ, 11- Attach to Form 990, Form 990-EZ, or Form 990-PF. or 990- PF) Department of the Treasury Information about Schedule B (Form 990, 990-EZ, or 990- PF) and 2013 Internal Revenue Service its instructions is at lvww,,, onv/fnrm990 Name of the organization Employer identification number
INTEL FOUNDATION 94-3092928 Organization type (check one):
Filers of: Section:
Form 990 or 990-EZ 0 501 (c)( ) (enter number) organization
0 4947(a)(1) nonexempt charitable trust not treated as a private foundation
527 political organization
Form 990-PF 501 (c)(3) exempt private foundation
0 4947(a)(1) nonexempt chartable trust treated as a private foundation
0 501 (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
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)(vl) 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 (n) 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, total 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, chartable, etc., purposes, but these contributions did not total to more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more during the year 00. $
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 its Form 990-PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).
LHA For Paperwork Reduction Act Notice , see the Instructions for Form 990, 990-EZ, or 990-PF. Schedule B (Form 990 , 990-EZ, or 990-PF) (2013)
323451 10-24-13 0 • Schedule B (Form 990.990-EZ, or 2013) 2 Name of organization Employer identification number
INTEL FOUNDATION 94-3092928
Part I Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) (b) (c) (d) No. Name, address, and ZIP + 4 Total contributions Type of contribution
1 INTEL CORPORATION Person 0 Payroll 5350 NE ELAM YOUNG PARKWAY $ 10,000,000. Noncash (Complete Part II for HILLSBORO, OR 97124 noncash contributions.)
(a) (b) (c) (d) No. Name, address, and ZIP + 4 Total contributions Type of contribution
Person Payroll $ Noncash (Complete Part II for noncash contributions.)
(a) (b) (c) (d) No. Name , address, and ZIP + 4 Total contributions Type of contribution
Person Payroll $ Noncash fl (Complete Part II for noncash contributions)
(a) (b) (c) (d) No. Name, address, and ZIP + 4 Total contributions Type of contribution
Person Payroll $ Noncash (Complete Part II for noncash contributions.)
(a) (b) (c) (d) No. Name, address , and ZIP + 4 Total contributions Type of contribution
Person Payroll $ Noncash (Complete Part II for noncash contributions.)
(a) (b) (c) (d) No. Name, address , and ZIP + 4 Total contributions Type of contribution
Person Payroll $ Noncash 0 (Complete Part li for noncash contributions.) 323452 10-24-13 Schedule B (Form 990. 990-EZ. or 990 -PF)(2013) 15 14421003 099815 INTEL 2013.04030 INTEL FOUNDATION INTEL1 • 9 Schedule B (Form 990, 990-EZ, or 990-PF) (2013) Page 3 Name of organization Employer identification number
INTEL FOUNDATION 94-3092928
Part II Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) (c) FMV (or estimate) from Description of noncash property given Date received (see instructions) Part I
(a) (c)
FMV (or estimate) from Description of noncash property given Date received (see instructions) Part I
(a) (c) FMV (or estimate) from Description of noncash property given Date received (see instructions) Part I
(a) No. (c) FMV (or estimate) from Description of noncash property given Date received (see instructions) Part I
(a) (c) No. (b) FMV (or estimate) (d) from Description of noncash property given Date received (see instructions) Part I
No. (c) (b) FMV (or estimate) (d) from Description of noncash property given Date received (see instructions) Part I
323453 10-24-13 acneuuie tl irorm uuu , aau-CC, or aau-rr) (ZU ii, 16 14421003 099815 INTEL 2013.04030 INTEL FOUNDATION INTEL1 • 0 Schedule B (Form 990, 990-EZ, or 990-PF) (2013) 4 Name of organization oyer identification number
INTEL FOUNDATION 1 94-3092928 P a rt Exclu tvel re l igious chari ta bl e, e tc., indivi d ua l cont ributions to section II1(c^ , or organizations th a t o a more an , or e year. LEom'lete columns (a) through ( e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. )Enterthis information once) 00, $ l lsP dunhcata conies of Part I I I if adrirtinns l snare is needed (a) No. from (b) Purpose of gift (c) Use of gift (d) Description of how gift is held Part 1
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 Relationshi p of transferor to transferee
(a) No. from (b) Purpose of gift (c) Use of gift (d) Description of how gift is held Part I
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 Relationshi p of transferor to transferee
(a) No. from (b) Purpose of gift (c) Use of gift (d) Description of how gift is held Part I
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 Relationshi p of transferor to transferee
(a) No. from (b) Purpose of gift (c) Use of gift (d) Description of how gift is held Part I
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 Relationshi p of transferor to transferee
323454 10-24-13 Schedule B (Form 990, 990-EZ, or 990-PF) (2013) 17 14421003 099815 INTEL 2013 . 04030 INTEL FOUNDATION INTEL1 0 INTEL FOUNDATION 0 94-3092928
FORM 990-PF GAIN OR (LOSS) FROM SALE OF ASSETS STATEMENT 1
(A) MANNER DATE DESCRIPTION OF PROPERTY ACQUIRED ACQUIRED DATE SOLD
GAIN/(LOSS) ON INVESTMENTS DONATED VARIOUS VARIOUS
(B) (C) (D) (E) (F) GROSS VALUE AT EXPENSE OF SALES PRICE TIME OF ACQ. SALE DEPREC. GAIN OR LOSS
17,803,704. 17,547,221. 0. 0. 256,483.
CAPITAL GAINS DIVIDENDS FROM PART IV 0.
TOTAL TO FORM 990-PF, PART I, LINE 6A 256,483.
FORM 990-PF INTEREST ON SAVINGS AND TEMPORARY CASH INVESTMENTS STATEMENT 2
(A) (B) (C) REVENUE NET INVESTMENT ADJUSTED SOURCE PER BOOKS INCOME NET INCOME
INTEREST INCOME 166,051. 166,051.
TOTAL TO PART I, LINE 3 166,051. 166,051.
FORM 990-PF OTHER INCOME STATEMENT 3
(A) (B) (C) REVENUE NET INVEST- ADJUSTED DESCRIPTION PER BOOKS MENT INCOME NET INCOME
GRANTS REFUNDS/RECOVERIES 118,860. 0. OTHER INCOME 500. 0.
TOTAL TO FORM 990-PF, PART I, LINE 11 119,360. 0.
18 STATEMENT(S) 1, 2, 3 14421003 099815 INTEL 2013.04030 INTEL FOUNDATION INTELI INTEL FOUNDATION 0 0 94 -3092928
FORM 990-PF ACCOUNTING FEES STATEMENT 4
(A) (B) (C) (D) EXPENSES NET INVEST- ADJUSTED CHARITABLE DESCRIPTION PER BOOKS MENT INCOME NET INCOME PURPOSES
ACCOUNTING 18,832. 0. 18,832.
TO FORM 990-PF, PG 1, LN 16B 18,832. 0. 18,832.
FORM 990-PF TAXES STATEMENT 5
(A) (B) (C) (D) EXPENSES NET INVEST- ADJUSTED CHARITABLE DESCRIPTION PER BOOKS MENT INCOME NET INCOME PURPOSES
FEDERAL EXCISE TAX 210,000. 0. 0.
TO FORM 990-PF, PG 1, LN 18 210,000. 0. 0.
FORM 990-PF OTHER EXPENSES STATEMENT 6
(A) (B) (C) (D) EXPENSES NET INVEST- ADJUSTED CHARITABLE DESCRIPTION PER BOOKS MENT INCOME NET INCOME PURPOSES
ADMINISTRATIVE EXPENSES 185,797. 0. 185,797. FILING FEES 1,369. 0. 1,369.
TO FORM 990-PF, PG 1, LN 23 187,166. 0. 187,166.
FORM 990-PF OTHER INVESTMENTS STATEMENT 7
VALUATION FAIR MARKET DESCRIPTION METHOD BOOK VALUE VALUE
SHORT TERM FMV 14,507,688. 14,507,688. LONG TERM FMV 0. 0. STOCK CONTRIBUTIONS FMV 0. 0.
TOTAL TO FORM 990-PF, PART II, LINE 13 14,507,688. 14,507,688.
19 STATEMENT(S) 4, 5, 6, 7 14421003 099815 INTEL 2013.04030 INTEL FOUNDATION INTELI INTEL FOUNDATION • • 94-3092928
FORM 990-PF PART VIII - LIST OF OFFICERS, DIRECTORS STATEMENT 8 TRUSTEES AND FOUNDATION MANAGERS
EMPLOYEE TITLE AND COMPEN- BEN PLAN EXPENSE NAME AND ADDRESS AVRG HRS/WK SATION CONTRIB ACCOUNT
SHELLY ESQUE PRESIDENT 5000 W CHANDLER BLVD 5.00 0. 0. 0. CHANDLER, AZ 85226
RICHARD TAYLOR CHAIRMAN 2200 MISSION COLLEGE BLVD 1.00 0. 0. 0. SANTA CLARA, CA 95052
RAVI JACOB TREASURER 2200 MISSION COLLEGE BLVD 1.00 0. 0. 0. SANTA CLARA, CA 95052
JUSTIN RATTNER BOARD MEMBER 5200 NE ELAM YOUNG PARKWAY 1.00 0. 0. 0. HILLSBORO, OR 97124
SUZAN MILLER SECRETARY 2200 MISSION COLLEGE BLVD 1.00 0. 0. 0. SANTA CLARA, CA 95052
DEBORAH CONRAD BOARD MEMBER 2200 MISSION COLLEGE BLVD 1.00 0. 0. 0. SANTA CLARA, CA 95052
WENDY HAWKINS EXECUTIVE DIRECTOR 5200 NE ELAM YOUNG PARKWAY 50.00 0. 0. 0. HILLSBORO, OR 97124
ALLISON GOODMAN BOARD MEMBER 1900 PRAIRIE CITY ROAD 1.00 0. 0. 0. FOLSOM, CA 95630
TOTALS INCLUDED ON 990-PF, PAGE 6, PART VIII 0. 0. 0.
20 STATEMENT(S) 8 14421003 099815 INTEL 2013. 04030 INTEL FOUNDATION INTELI 0 0
Dear Grantseeker: Below are the questions that will be asked on the Foundation Grant Application. Please use this as a guide to gather all of the infonnation to complete the online application. These questions are subject to change during the year.
Preview Form
This is an example of the application questions with which you will be presented. It is recommended that you compose the answers to the paragraph questions in a word processing program and then cut and paste that text into the online application.
Contact Information
Instructions: (Text;*Salutation Please enter one of the following: Mr., Ms., (Text; 100 character maximum) Dr., Prof., Dean
*First Name Instructions: (Text• 40 character maximum) •
*Last Name Instructions: (Text; 40 character maximum)
*Contact Title Instructions: (Text, 255 character maximum) •
*Email Address Instructions: (Text; 100 character maximum) •
*Telephone Instructions: (Text; 30 character maximum)
Cell Phone Instructions: (Text, 100 character maximum) • Organization Information
• This field is not editable. If the organization *Legal Name name and address it not correct, email the Intel Foundation([email protected]) with the new address. For universities and colleges, a generic address is used.
Instructions: DBA Name • If your organization has a Doing Business As (Text; 100 character maximum) (DBA) name, please enter. *Address This field is not editable.
Address 2 This field is not editable.
Th,r f nldl nn* n l ta4 In -
ATTACHMENT A 0 •
i ------Instructions: I • If your organization is not in the United States, please select "(Not Applicable)".
Instructions: * ZIP Code / Postal Code • Non- US organization : If you do not have a (Text; 20 character maximum) Postal Code, enter 9999.
*Country (Single-Select List)
*Telephone (Text; 30 character maximum)
Website Address (Text; 100 character maximum)
*Mission Statement Instructions: i (Paragraph; 1000 character maximu m) • Project Information
*Project Title Instructions: (Text; 255 character maximum) •
*Project Start Date Instructions: (Date) • ------Instructions: *Project End Date • Please indicate the "End Date" in terms of this (Date) specific request for funding.
*Project Period ( in months ) Instructions: (Number; 2 digit maximum) •
Instructions: *Requested Cash Amount • Please enter the amount (in USD) you are (Currency; 20 character maximum) requesting for this project. ------Instructions: *Total Organization Budget • Report for current fiscal year only. (Currency; 12 character maximum) Character limit is 12.
Instructions: Ethnicity breakdown of those served by the • Please estimate/enter the percent to the project nearest whole number for each ethnic group (Percentage List) served by the project. Do not include the per • African American cent sign (%). • Asian/Pacific Islander • Caucasian Total must equal 100 percent. • Hispanic • Native American NOTE : Required for all US grants.
ATTACHMENT A •
Instructions: *Gender breakdown of those served by the • Please estimate/enter the percent to the project nearest whole number for each gender. Do not (Percentage List) include the per cent sign (%). • Female • Male Total must equal 100 percent.
*Age breakdown of those served by the Instructions: project • Please estimate/enter the percent to the (Percentage List) nearest whole number for each age group served • Pre-School by the project. Do not include the per cent sign • K-12 (%). • Higher Ed. • Adult Total must equal 100 percent.
*Location ( s) where Project is to be Instructions: conducted: • Please enter city and country. (User-Defined List)
*Request Date Instructions: (Date) •
Project Narrative
Instructions: *Project Description • How many people will be served by this (Paragraph; 750 character maximum) Project? What is the geographic reach of this Project-)
Instructions: *Description of Need • What are the issues this project will address (Paragraph; 2000 character rnaximum) What approach will be used? What research suggests that this project will succeed?
Instructions: *Project Goals and Objectives • Please describe the goals, objectives and (Paragraph; 2000 character maximum) expected outcomes of the project for which you seek funding.
Instructions: *Project Activities • What tasks and activities will be undertaken to (Paragraph; 2000 character maximum) achieve the program goals and objectives.
Instructions: *Project Evaluation • How will the progress and success of this (Paragraph; 2000 character maximum) Project be measured?
Instructions: *Sustainability • How will the project be sustained, scaled or (Paragraph; 2000 character maximum) transferred?
Instructions: Other Project Information • Provide relevant information about the Project (Paragraph; 2000 character maximum) that is not covered in responses above. Financial and Board Information
ATTACHMENT A • •
Instructions: • Please download the Project Budget Template provided.
• Right Click Project Budget Template to download the template. 1 *Itemized Project Budget • Select " Save Target As" to save the (File Upload; 1,524,288 byte limit) template to your computer. • Complete the template. • Click the "Upload File" link to the left and follow the directions to upload the file.
Instructions: * Sources of Contributions / Pledges and • Please provide any contributions/pledges Amount received for this program by other sources. (Paragraph; 1000 character maximum) Include Organization Name, Amount and if received or pledged.
Instructions: Please enter the name of each Board Member *Board of Directors • then click the "Add to List" button. (User-Defined List) If you need to remove a name, highlight it then click the "Remove from List" button.
* Chairman / Superintendent of your Instructions: organization • Please enter the name of the (Text; 500 character maximum) Chairman/Superintendent of your organization
Instructions: *Treasurer of your Organization • Please enter the name of the treasurer of your (Text; 500 character maximum) organization.
*Chief Executive Officer / Executive Instructions: Director • Please enter the name of the Chief Executive (Text; 500 character maximum) Officer / Executive Director of your organization.
Instructions: • Is any individual serving on the Board of *Intel Employee or Family Involvement Directors or serving otherwise in a fiduciary role (Yes/No) with your organization currently an employee of Intel Corporation or a member of the immediate family of an Intel employee?
Instructions: Intel Employee or Family Member • If you responded "Yes" to the previous Involvement question, please identify each person, the (Paragraph; 500 character maximum) relationship to Intel, and the role in your organization.
*Entity Type (Single-Select List) Instructions: • Non-profit organization • D. ,F,I Fnl-i f,,
ATTACHMENT A • •
• Other
If you selected "Other" as the Entity Type, Instructions: please explain. (Paragraph; 1000 character maximum)
Instructions: • If you selected "Non-profit organization" as the "Entity Type" and are a US 501(c)(3), please Government Tax Determination Letter upload your IRS 501(c)(3) determination letter. (File Upload; 1,524,288 byte limit) If you are not located in the US, please upload your local government letter verifying not-for- profit status."
If you selected "Public Entity" as the "Entity Type", please choose the state in which your organization is a political Instructions: subdivision of:
(No input required)
Political Subdivision of Instructions: (Single-Select List of US States)
Instructions: Payee Information • Enter the information below if the Organization Name and/or full address as shown in the "Organization Information " section differs (No input required) from the payee name and payee full address.
Instructions: Payable Name on Check • Please complete if the Payee name is different (Text; 25 character maximum) than the Organization Name
Explanation of different name on check Instructions: (Paragraph; 2000 character maximum)
Instructions: • Please enter the full mailing address for payment if any part of the full address is different Mailing Address for payment than the full address shown in the "Organization (Long Paragraph; 2000 character maximum) Information" section.
Full address includes : street address, city, state, ZIP code, and Country.
Certification and Authorization
*Intel Foundation 's Non-Discrimination Policy (Single-Select List) Instructions: • I verify the organization I represent complies • Organizations seeking financial support with Intel Foundation's non-discrimination policy from the Intel Foundation are asked to Tho nrn ,nwafinn T renroconf A - not rm-i ,
ATTACHMENT A • •
with Intel Foundation's non-discrimination policy offered without discrimination on the basis of race, color, religion, gender, national origin, ancestry, aqe, disability, medical condition, genetic information, veteran status, marital status, pregnancy, gender expression, gender identity, sexual orientation, or any other characteristic protected by federal, state or local law, regulation, or ordinance.
Educational institutions or non-profit organizations which offer gender-based programs or have services designed to address the needs of other targeted populations, may not, in and of themselves, be considered discriminatory and will be considered for funding.
Please choose the appropriate statement below in the drop-down box. Only one statement can be selected. For questions or concerns about this policy, please contact intel.foundation(&intel.com
Instructions: • By checking this box I certify:
*Certifying the application • The information in this application is (Checkbox List) correct. • I certify • I am authorized by the governing board of this organization to submit this grant application to Intel Foundation.
*Certifying Name Instructions: (Text; 500 character maximum)
Instructions: *Certifying Title • Please enter the title of the individual who is (Text, 500 character maximum) certifying this application.
Instructions: 'Certifying Email Address • Please enter the email address of the person (Text; 500 character maximum) certifying the application
*Certifying Date Instructions: (Date)
Need Sulipoi t?
ATTACHMENT A • 1 e l Ill-, ol 1' -,c • * Irademailks • Prnac.} • "Intel Coiporauon
ATTACHMENT A Intel Foundation • Page 2 of 6
Established by Intel in 1988, the Intel Foundation fosters educational opporlun,tws and quality of life improvements for communities worldwide By developing programs, exercising leadership, and providing, funding for grants, the Intel Foundation
Fuels innovation in science, technology, engineering, and math (STEM) rX Y
Empowers girls and women go. A Inspires underserved youth r+ ^ t) Engages with our communities
Through these efforts the Intel Foundation works to increase it opporlun ties for all-especially girls and underrepresented populations-in STEM education and related careers
Find out about our efforts in these areas below Read about our Board of Directors here You can also follow us on Twitter or in our CSR blogs,
Please note the Intel Foundation does not accept unsolicited grant requests
Fostering •6
•R^ ^5 .y^ "^ 3
Innovation in STEM Education Empowering Girls and Women Because science, technology, engineering, and math are foundational for a The Intel Foundation partners with industry, non-government thriving, innovative economy, the Intel Foundation rewards excellence, organizations, and others to remove gender-based hurdles for education promotes training, and encourages studies in STEM education. and technology and give girls and women more opportunity to participate in the global innovative economy. We recogn re outstanding original research protects globally through our science competitions The Intel Science Talent Search and the Intel As partof our social innovation focus, Intel partners with Ashoka International Science and Engineering Fair-the world's largest pre-college Changemakers to reward innovative digital technology solutions that science fair competition-both support the nonprofit organization Society for enable gels and women to live healthier, smarter, and more meaningful Science & the Public lives
To give children a chance to solve scientific problems in a fun way, we sponsor Intel Corporation is the founding strategic partner for the 10x10 global team-oriented robotics tournaments where contestants build robots from action campaign for girl's education which recently released the feature- Legos length movie Girl Rising
Our Educators Academy pros ides an online community for K-12 educators to Other programs we conduct include robotic competitions where we share innovative melhods and ideas for transforming the science classroom provide mentors for at[-girl teams, science competitions that are open to girls in regions throughout the word, and Intel Math which helps Entrepreneurial competitions like the Intel Global Challenge motivate young supplement mathematics training for teachers who in turn can help entrepreneurs to take their innovations out of the classroom and into the students build confidence in their math skills in the critical elementary business world years
Read stories about how these programs help to transform lives Find out more about Intel's programs for girls and women or read about how they are having an impact Innovative Cancer Test Garners Gordon E Moore Award It's the Journey Taking Flight Robotics Changing the World One Girl at a Time
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Inspiring
Underserved Youth Engaging with Our Communities By gearing programs toward youth in underserved communities, the Intel Every year, the Intel Foundation contributes millions of dollars toward Foundation provides opportunities for engaging with technology and learning community programs, disaster relief efforts, educctron grants, and more life skills for those who would not otherwise have such opportunities More than 40% of the company's employees are involved in the Intel The Intel Computer Clubhouse Network provides a place where youth use Involved Volunteer Program and logclhcr they donale thousands of computers and get help from mentor s to pursue a project they've dreamed up. hours to education, environments' programs, and other local community The result' Youth who are more involved in the Clubhouse report greater needs Through the Intel Involved Matching Grant Program. the Intel competency in problem-solving, collaboration, and use of technology tools Foundation gives schools and community organizations cash donations for every hour that employees volunteer. Scholarship programs, robohcs competitions, community grants, and other efforts from the Intel Foundation also provide opportunities for underserved Intel employees can apply for seed grants from the Intel Foundation to youth We collaborate with the National Consortium for Graduate Degrees for get their creative volunteer initiatives off the ground The Foundation Minorities in Engineering and Science on supporting graduate education for awards grants of up to $5000 to underwrite selected employee-initiated underrepresented minorities at the master's and PhD levels We also Support community service projects efforts by the Semiconductor Research Corporation which provide undergraduates with valuable research experience and mentoring Our approach to disaster relief focuses on communities in which we live and work, and includes both initial humanitarian relief and long-term Learn more about tnd'viduals whose lives these programs positively impact in restoration efforts This approach allows us to assess the effects of each these inspiring stories disaster and design recovery programs to achieve the greatest impact by leveraging Intel's technical expertise and competencies Undergraduates Learn Research is Relevant Get inspired by articles describing how the Intel Foundation engages Escaping Generational Poverty with our communities
Cloth Bag Entrepreneurs
Connecting Japanese Tsunami Refugees
Intel Foundation Highlights
Intel Foundation 25th Anniversary Report
Self-Driving Car Wins Top Prize at Intel ISEF
The Intel Foundation's 25th Anniversary report shares stories about real people whose lives we're touching and the tangible impact we're making
Read the stories
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lonut Alexandra Bud steanu , 19, of Romania , won the Gordon C Moore Award for using artif icial intethoence to crecte a viable model for a low-cost, self-driving car,
Read more about this amazing project
Videos
Barriers to Education:... Intel For Change Summit Patricia Mwove, Intel Intel ' She Will Connect Engineer Addressing the Internet gender gap by connecting women with
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Intel For Chance student Student ambassadors and teams Patricia Mwove tells how she Internet, each other, and new ambassadors identify barriers to discuss plans to explore local overcame educational hardship to (323)
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Related Content Inlet Foundation Board of Barriers to Education- Mindsets Related Topics Directors are Changing In 1989, Intel established the Intel Intel For Change student ambassadors Related Products Foundation to develop and fund identity barriers to education in India educational and charitable programs
For Summit Corporate Citizenship Inspires a New! Student ambassadors and teams Better Future discuss plans to explore local bar riers to fl education for girls Discover Intel's programs that improve education, inspire communities, and sustain the environment.
Conversations
Committing to Action Girls and STEM Disrupting Global Development by What Is Strategy? at CGI "Making" 55 days ago • Full Post 13 days ago • Full Post 32 days ago • Full Post
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P..,,.... a ,.n,w) mle n w .. rr J IN3 9232014 ,varbaim .....,.. w.,.u. _e.., 13 j I'-El 1 11 9132014 0 0 ADDITIONAL DETAIL FOR VOLUNTEER GRANTS INCLUDED IN FOUNDATION GRANTS SCHEDULE 921 2014 • • Intel Foundation Grants Payable at YE 2013 Clessdremon .q-.td Or,anvitan Info Scheduled A pproved ram name ST 10123119 China Foundation for Pove Alleviation 12/10/13 $33 679 00 CFPAantel Commune Development Plan ST 11799319 UNESCO International Institute for Educational Planning 12/13/13 $10000000 Planning for Imp roved Learning Outcomes P4L Portal Problemsolving research Community end ST 11532017 The Future Lab 1/172014 $6000000 Disaster communication m=a of pos t 3 11 / ST 11739065 M hn Sawa Seva Samb 01 01/14 $48200C) oven the uab of lives of waste -pi ckers ST 11779729 Shan g hai Munici pal Welfare Foundation for Disabled 01/01 114 E5 000 00 In"The Reader ST 3474394 Society for Science 8 the Public 01/15/14 5735000000 2008 - 2016 Intel STS - Foundation grant ST 6546747 United Wa y laceholder 01/15 / 14 $7 500 000 00 Placeholder for Foundation financials The Leadership and Assistance for Science Education Reform (LASER) Model A Systemic and Sustainable Approach for Achieving High Standards rn Science T 554824 mihsonian Insbtute/NSRC 2/151 14 10 000 00 Education ST 3474636 Society for Science & the Public 03/15114 54882 500 00 2010 - 2019 Intel ISEF - Foundation rant Business development services for promotion of poor ST 10200713 Ud ini 05/01 /14 $62 500 00 women as entre preneurs Problemsolving research protect Community and ST 11532017 The Future Lab 05/01/14 $4900000 Disaster communication in the a ge of post 3 11 ST 3474394 Socie ty for Science & the Public 07/15/14 $3 150 000 00 2008 - 2016 Intel STS - Foundation g rant ST 3.474636 Society for Science & the Public 09/15/ 14 $2 167 500 00 2010 - 2019 Intel ISEF - Foundation g rant ST 11732981 Aga Khan Foundation USA 12/01/14 &150 000 EDUCATING GIRLS IN THE SCIENCES IEGIS Total ST $19,524.999 Ctassdkatton re east rd Or mrabon Info Scheduled A pproved ram name LT 3474394 Society for Science & the Public 1/152015 $1 380 000 00 2008 -2016 Intel STS- Foundation g rant LT 3474636 Society for Science & the Public 3/152015 $5 057 500 00 2010 - 2019 Intel ISEF - Foundation rant LT 3474394 Society for Science 8 the Public 7/152015 $3 220 000 00 2008 - 2016 Intel STS - Foundation rant LT 3474636 Society for Science b the Public 91152015 $2 244 000 00 2010 - 2019 Intel ISEF - Foundation rant LT 3474394 Society for Science & the Public 1/1512016 5137000000 2008-2016 Intel STS - Foundation grant LT 3474636 Society for Science & the Public 3 /152016 $5 236 000 00 2010 - 2019 Intel ISEF - Foundation g rant LT 3474636 Society for Science & the Public 91 152016 S2 320 500 00 2010 - 2019 Intel ISEF - Foundation g rant LT 3474636 Society for Science & the Public 3/152017 55 414 500 00 2010 - 2019 Intel ISEF - Foundation rant LT 3474536 Society for Science & the Public 9/152017 $2 397 000 00 2010 - 2015 Intel ISEF - Foundation rant LT 3474636 Socie ty for Saence 8 the Public 3/152018 $5 593 000 00 2010 - 2019 Intel ISEF - Foundation rant LT 3474636 Society lot Science & the Public 91152018 S2481 000 00 2010 - 2019 Intel ISEF - Foundation rant LT 3474636 Society for Science 6 the Public 3/152019 S5 789 000 00 2010 - 2019 Intel ISEF - Foundation g rant The Leadership and Assistance for Science Education Reform (LASER) Model A Systemic and Sustainable Approach for Achieving High Standards in Science T 554824 mihsonien InsatuteMSRC /1512015 10 000 00 Education Total LT 42,512.500 ATTACHMENT C • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII- B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee : Habitat Kalkinma ve Yoneti^im Dernegi Ulus Mah . Okul Yolu Sok. No.13 Besiktas Istanbul 34340 Turkey 2. Request ID: 5454064 3. Date Paid in Current Tax Year: $0 4. Total Paid: $45,000 .00 paid on June 9, 2011 $45,000. 00 paid on December 22, 2011 ------$90,000.00 Total 5. Purpose of Grant: Enhancing Youth Technology Entrepreneurship Culture in Turkey 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - December 20, 2011 with remaining funds of $15,371.03 - September 18, 2012 with remaining funds of $25,600.00 - March 11, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Social Welfare Council of Fukushima Shichishanomiya 111 Fukushima City 960-8141 Japan 2. Request ID: 5510057 3. Date Paid in Current Tax Year: $0 4. Total Paid: $200,000.00 paid on September 19, 2011 $100,000.00 paid on August 23, 2012 $300,000.00 Total 5. Purpose of Grant: East Japan Disaster Relief Volunteer Center of Fukushima 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - August 31, 2012 with remaining funds of $0 - June 13, 2013 with remaining funds of $0 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Miyagi Prefectural Council of Social Welfare 1-2-3, Kamisugi, Aoba Ward Sendai, Miyagi 980-0014 Japan 2. Request ID: 5757491 3. Date Paid in Current Tax Year: $0 4. Total Paid: $200,000.00 paid on August 26, 2011 $100,000.00 paid on June 3, 2012 $300,000.00 Total 5. Purpose of Grant: Japan disaster relief 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - June 18, 2012 with remaining funds of $0 - August 20, 2013 with remaining funds of $0 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • C7 Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Teach for Japan B1 Tokyo-Kotsukaikan Building, 2-10-1 Yurakucho Chiyoda-Ku, Tokyo Japan 2. Request ID: 5836281 3. Date Paid in Current Tax Year: $0 4. Total Paid: $150,000.00 paid on October 20, 2011 $ 94,737.00 paid on April 27, 2012 $244,737. 00 Total 5. Purpose of Grant: Teach for Japan - Tohoku disaster relief project 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - March 31, 2012 with remaining funds of $106,944.00 - March 31, 2013 with remaining funds of $104,591.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Divya Jyoti Jagrati Sansthan(R) Plot No. 3, Pocket OCF, Pitampura Extn., Parwana Road, New Delhi 110034 India 2. Request ID: 6387372 3. Date Paid in Current Tax Year: $0 4. Total Paid: $4,875. 00 paid on December 19, 2011 $4,875.00 Total 5. Purpose of Grant: Antarkriti- To empower inner creativity and shape it to livelihood for underprivileged women. 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - January 3, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • E Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Fondation Tipa Tipa # 25 1 ere Av. du Travail Port-au-Prince Haiti 2. Request ID: 6514176 3. Date Paid in Current Tax Year: $74,850.00 paid on February 11, 2013 4. Total Paid: $75,000. 00 paid on March 8, 2012 $74,850 .00 paid on February 11, 2013 $149,850.00 Total 5. Purpose of Grant: LASYANS POU TIMOUN (Haiti) 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - January 16, 2013 with remaining funds of $11,130.00 - August 29, 2013 with remaining funds of $19,355.23 - October 14, 2013 with remaining funds of $18,956.39 7. Diversions: To the knowledge of the grantor , no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Fondation Etre Ayisyen 514, Autoroute de delmas Port-au-Prince HT6140 Haiti 2. Request ID: 6546454 3. Date Paid in Current Tax Year: $0 4. Total Paid: $75,000.00 paid on February 23, 2012 $74,074.00 paid on October 25, 2012 $149,074.00 Total 5. Purpose of Grant: Entrepreneurial Development Project 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - September 28, 2012 with remaining funds of $74,023.00 - January 8, 2013 with remaining funds of $39,460.94 - April 30, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: CRUSA Foundation Oficentro del Este, Edificio B. San Pedro, Montes de Oca San Pedro 12229-1000 Costa Rica 2. Request ID: 6568021 3. Date Paid in Current Tax Year: $0 4. Total Paid: $40,000.00 paid on February 21, 2012 $40,000.00 Total 5. Purpose of Grant: ISEF 2012 and affiliated fair support 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - November 28, 2012 with remaining funds of $24,500.00 - January 6, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII- B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Nizhni Novgorod Foundation for Support of Education and Research 603000 Nizhni Novgorod, st. B.Pokrovskaya, 37 Nizhni Novgorod 603950 Russian Federation 2. Request ID: 6925443 3. Date Paid in Current Tax Year: $0 4. Total Paid: $60,000.00 paid on June 27, 2012 $60,000.00 Total 5. Purpose of Grant: BIT biz plans contest and Global Track Initiative 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - December 28, 2012 with remaining funds of $7,784.40 - May 16, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor , no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D L • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B , Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: SRC Education Alliance P.O. Box 12053 Research Triangle Park, NC 27709 2. Request ID: 6933320 3. Date Paid in Current Tax Year: $0 4. Total Paid: $700,000.00 paid on May 10, 2012 $700,000.00 Total 5. Purpose of Grant: SRC Undergraduate Research Opportunities 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - March 11, 2013 with remaining funds of $0.00 - July 10, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D 1-1 • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII -B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee : A.N.P.AS. Associazione Nazionale Pubbliche Assistenze Via Pio Fedi, 46/48 Firenze 50142 Italy 2. Request ID : 7219546 3. Date Paid in Current Tax Year: $0 4. Total Paid: $4,000 .00 paid on November 13, 2012 $4,000.00 Total 5. Purpose of Grant: Rebuilding Resilience after the Earthquake 6. Reports : The grantee submitted full and complete reports of its expenditure as follows: - March 1, 2013 with remaining funds of $0.00 7. Diversions : To the knowledge of the grantor , no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification : The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D 0 0 Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: SRC Education Alliance P.O. Box 12053 Research Triangle Park, NC 27709 2. Request ID: 7281178 3. Date Paid in Current Tax Year: $0 4. Total Paid: $275,000.00 paid on September 26, 2012 $275,000.00 Total 5. Purpose of Grant: SRC Master/PhD Scholarship Program 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - October 24, 2012 with remaining funds of $138,064.00 - July 15, 2013 with remaining funds of $0.00 7. Diversions : To the knowledge of the grantor , no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Fundacion de Desarrollo Educacional y Tecnologico de La Araucania Montevideo 0830 Temuco 4811322 Chile 2. Request ID: 7316241 3. Date Paid in Current Tax Year: $0 4. Total Paid: $20,000.00 paid on August 29, 2012 $20,000.00 Total 5. Purpose of Grant: Strengthening the scientific approach and critical thinking in Mapuche students in La Araucania region (Phase II) 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - December 1, 2012 with remaining funds of $0.00 - February 15, 2013 with remaining funds of $0.00 7. Diversions : To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Social Welfare Corporation Iwate Social Welfare Council 8-1-3 Sambonyanagi Morioka, Iwate 020-0831 Japan 2. Request ID: 7499697 3. Date Paid in Current Tax Year: $150,000.00 paid on January 22, 2013 $100,000.00 paid on July 29, 2013 4. Total Paid: $150,000.00 paid on January 22, 2013 $100,000.00 paid on July 29, 2013 $250,000.00 Total 5. Purpose of Grant: Japan Stricken area support project Management of a disaster volunteer center 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - July 16, 2013 with remaining funds of $0 - March 7, 2014 with remaining funds of $0 7. Diversions : To the knowledge of the grantor , no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Shanghai Jiao Tong University Education Development Foundation 1954 , Huashan Road Shanghai 200030 China 2. Request ID: 7651781 3. Date Paid in Current Tax Year: $0 4. Total Paid: $20,000.00 paid on November 30, 2012 $20,000.00 Total 5. Purpose of Grant: national technology entrepreneurship curriculum workshop 6. Reports : The grantee submitted full and complete reports of its expenditure as follows: - January 28, 2013 with remaining funds of $0.00 7. Diversions : To the knowledge of the grantor , no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification : The grantor has no reason to doubt the accuracy or reliability of the report from the grantee ; therefore no independent verification of the report was made. ATTACHMENT D • L Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII- B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee : Children and Youth Science Center, China Association for Science and Technology Room 219 BLDG C , CAST Building, No.3 Fuxing Road Beijing 100863 China 2. Request ID: 7658711 3. Date Paid in Current Tax Year: $0 4. Total Paid: $46,000. 00 paid on November 30, 2012 $46,000.00 Total 5. Purpose of Grant: SODA program 2012-2013 in China 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - December 31, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Potential FZ LLC 2nd Floor, Block 17 Dubai United Arab Emirates 2. Request ID: 7708793 3. Date Paid in Current Tax Year: $0 4. Total Paid: $120,000.00 paid on December 7, 2012 $120,000.00 Total 5. Purpose of Grant: Intel Business Challenge Middle East and North Africa 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - July 20, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee : Junior Achievement USA Ma'ruf al- Rasafi Street No. 39, Shmeisani PO Box 941033 Amman, 11194, Jordan 2. Request ID: 7783817 3. Date Paid in Current Tax Year: $0 4. Total Paid: $24,000.00 paid on December 6, 2012 $24,000.00 Total 5. Purpose of Grant: Intel Youth Enterprise Program 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - March 27, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • E Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Shanghai Xingeng Philanthropy Service Center Room 206, Building 2 Shanghai 200127 China 2. Request ID: 7869827 3. Date Paid in Current Tax Year: $0 4. Total Paid: $5,000.00 paid on December 19, 2012 $5,000 .00 Total 5. Purpose of Grant: Seed hope for the disabled in Jiangchuan Sunshine Home 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - July 14, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D 0 0 Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Shanghai Science & Technology Service Center For Ageing 201-2F, No.70 Kui Lin Road Shanghai 200234 China 2. Request ID: 7879741 3. Date Paid in Current Tax Year: $0 4. Total Paid: $5,000.00 paid on December 21, 2012 $5,000.00 Total 5. Purpose of Grant: Connect and Enrich the life of Senior Citizens in local community 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - August 18, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B , Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Buddhist Tzu-Chi Merits Society Malaysia 316 Jalan Macalister Georgetown , Penang 10450 Malaysia 2. Request ID: 7894755 3. Date Paid in Current Tax Year: $0 4. Total Paid: $3,000. 00 paid on December 12, 2012 $3,000.00 Total 5. Purpose of Grant: Sungai Nibong Tzu Chi Recycling and Education Center 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - August 29 , 2013 with remaining funds of $0.00 7. Diversions : To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification : The grantor has no reason to doubt the accuracy or reliability of the report from the grantee ; therefore no independent verification of the report was made. ATTACHMENT D • E Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5( d)(2), the Intel Foundation provides the following information: 1. Grantee: Associacao do Laboratorio de Sistemas Integraveis Tecnologico Rua Paes Leme, 524 - cj. 95 e 96 Sao Paulo 05424-904 Brazil 2. Request ID: 8002957 3. Date Paid in Current Tax Year: $20,000.00 paid on February 15, 2013 4. Total Paid: $20,000.00 paid on February 15, 2013 $20,000.00 Total 5. Purpose of Grant: 11th FEBRACE Brazilian Fair of Science and Engineering 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - September 25, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Yaroslav Mudry International Foundation of Education BuIv. Likhachova 6A Kiev 01133 Ukraine 2. Request ID: 8129505 3. Date Paid in Current Tax Year: $30,000.00 paid on February 25, 2013 4. Total Paid: $30,000.00 paid on February 25, 2013 $30,000.00 Total 5. Purpose of Grant: Intel ISEF Administration and Development in Ukraine in 2013 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - December 25, 2013 with remaining funds of $0.00 7. Diversions : To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee ; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII -B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Associacao de Pais e Mestres da Fundacao liberatoi - Brazil Inconfidentes st, 395, Primavera Novo Hamburgo, RS, Brasil 93.340-140 Brazil 2. Request ID: 8129529 3. Date Paid in Current Tax Year: $20,000.00 paid on February 21, 2013 4. Total Paid: $20,000.00 paid on February 21, 2013 $20,000.00 Total 5. Purpose of Grant: To support Brazilian Students to participate in Intel/Isef, in Phoenix - 2013 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - September 23, 2013 with remaining funds of $0.00 7. Diversions : To the knowledge of the grantor , no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D Ol • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII- B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Parque Explora Carrera 52 No. 73-75 Medellin 9999 Colombia 2. Request ID: 8196463 3. Date Paid in Current Tax Year: $10,000.00 paid on March 1, 2013 4. Total Paid: $10,000 .00 paid on March 1, 2013 $10,000.00 Total 5. Purpose of Grant: Sponsorship of Feria de Ciencia, Tecnologia e Innovacion at ISEF 2013 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - June 17, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Argentina Ministry of Education Pizzurno 935 Ciudad Aut6noma de Buenos Aires 1020 Argentina 2. Request ID: 8202217 3. Date Paid in Current Tax Year: $10,000.00 paid on February 21, 2013 4. Total Paid: $10,000.00 paid on February 21, 2013 $10,000.00 Total 5. Purpose of Grant: Argentina's National Science & Technology Fairs 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - December 12, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Asociacion Empresarios por la Educacion Av. Reducto 1310, piso 5. Oficina 502 Miraflores Lima 9999 Peru 2. Request ID: 8228793 3. Date Paid in Current Tax Year: $0 4. Total Paid: $10,000.00 paid on March 6, 2013 $10,000.00 Total 5. Purpose of Grant: Intel ISEF 2013 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - December 13, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII- B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Ortadogu Teknopark Inc. ODTU Teknokent Ikizler Binasi ODTU Yerleskesi Ankara 06800 Turkey 2. Request ID: 8239757 3. Date Paid in Current Tax Year: $35,000.00 paid on March 8, 2013 4. Total Paid: $35,000.00 paid on March 8, 2013 $35,000.00 Total 5. Purpose of Grant: Intel Challenge Turkey 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - December 4, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D .7 Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Russian Further Vocational Education Development Foundation 51, Lyusinovskaya St. Moscow 115998 Russian Federation 2. Request ID: 8239773 3. Date Paid in Current Tax Year: $50,000.00 paid on February 27, 2013 $50,000.00 paid on April 4, 2013 4. Total Paid: $50,000.00 paid on February 27, 2013 $50,000.00 paid on April 4, 2013 $100,000.00 Total 5. Purpose of Grant: Intel ISEF Russian team 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - March 29, 2013 with remaining funds of $0 (from first payment) 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: High Tech Foundation (Fundacja Zaawansowanych Technologii) Fontany 12/1 Warsaw, Mazowieckie 01-885 Poland 2. Request ID: 8240061 3. Date Paid in Current Tax Year: $80,000.00 paid on March 4, 2013 $50,000.00 paid on May 17, 2013 4. Total Paid: $80,000.00 paid on March 4, 2013 $50,000.00 paid on May 17, 2013 $130,000.00 Total 5. Purpose of Grant: Intel Business Challenge Europe (European Finals) 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - April 25, 2013 with remaining funds of $77,519.00 - August 31, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Direccion Nacional de Ciencia y Tecnologia Ministerio de Educaci6n y Cultura Montevideo 11100 Uruguay 2. Request ID: 8245695 3. Date Paid in Current Tax Year: $10,000.00 paid on February 28, 2013 4. Total Paid: $10,000.00 paid on February 28, 2013 $10,000.00 Total 5. Purpose of Grant: Uruguay's National Fair Sponsorship 6. Reports : The grantee submitted full and complete reports of its expenditure as follows: - December 10, 2013 with remaining funds of $0.00 7. Diversions : To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification : The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D u Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: High Tech Foundation (Fundacja Zaawansowanych Technologii) Fontany 12/1 Warsaw, Mazowieckie 01-885 Poland 2. Request ID: 8289765 3. Date Paid in Current Tax Year: $40,000.00 paid on March 4, 2013 $35,000.00 paid on July 17, 2013 4. Total Paid: $40,000. 00 paid on March 4, 2013 $35,000.00 paid on July 17, 2013 ------$75,000.00 Total 5. Purpose of Grant: Intel Challenge Europe Submission/Selection 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - July 5, 2013 with remaining funds of $0.00 - October 31, 2013 with remaining funds of $0.00 7. Diversions : To the knowledge of the grantor , no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Tertius Tsentr realizatsii socialno-orientirovannyh proektov ANO 197 d.Kuznechikha Nizhny Novgorod, Novgorod 603136 Russian Federation 2. Request ID: 8396411 3. Date Paid in Current Tax Year: $43,000.00 paid on February 26, 2013 $15,000.00 paid on June 19, 2013 4. Total Paid: $43,000.00 paid on February 26, 2013 $15,000.00 paid on June 19, 2013 $58,000.00 Total 5. Purpose of Grant: STEM-centers 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - May 30, 2013 with remaining funds of $0.00 - December 31, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT 0 • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII -B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee : Impulsora de la Cultura y de las Arles, IAP Alvaro Obregon no. 500 Pte. Los Mochis, Sinaloa 81200 Mexico 2. Request ID: 8402403 3. Date Paid in Current Tax Year: $20,000. 00 paid on March 13, 2013 4. Total Paid: $20,000. 00 paid on March 13, 2013 $20,000.00 Total 5. Purpose of Grant: Mexican Science and Engineering Fair 6. Reports : The grantee submitted full and complete reports of its expenditure as follows: - December 5, 2013 with remaining funds of $675.61 7. Diversions : To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • 11 Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee : CRUSA Foundation Oficentro del Este, Edificio B. San Pedro, Montes de Oca San Pedro 12229-1000 Costa Rica 2. Request ID: 8414025 3. Date Paid in Current Tax Year: $40,000.00 paid on March 14, 2013 4. Total Paid: $40,000.00 paid on March 14, 2013 $40,000.00 Total 5. Purpose of Grant: ISEF participation and STEM 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - August 15, 2013 with remaining funds of $22,000.00 - December 23, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Maker Media, Inc 1005 Gravenstein Hwy North Sebastopol, CA 95472 2. Request ID: 8521633 3. Date Paid in Current Tax Year: $45,000.00 paid on March 14, 2013 4. Total Paid: $45,000.00 paid on March 14, 2013 $45,000.00 Total 5. Purpose of Grant: Education Day at Maker Faire Bay Area 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - June 10, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee : Potential FZ LLC 2nd Floor, Block 17 Dubai United Arab Emirates 2. Request ID: 8927221 3. Date Paid in Current Tax Year: $50,000.00 paid on May 10, 2013 4. Total Paid: $50,000.00 paid on May 10, 2013 $50,000.00 Total 5. Purpose of Grant: Intel Business Challenge Middle East and North Africa 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - July 20, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: MADAD Humanitarian Organization Public Union 50 M.Ibragimov St. Baku 1009 Azerbaijan 2. Request ID: 9037187 3. Date Paid in Current Tax Year: $10,000.00 paid on June 28, 2013 4. Total Paid: $10,000.00 paid on June 28, 2013 $10,000.00 Total 5. Purpose of Grant: Intel ISEF Continuation to enable STEM Development in Education in Azerbaijan in 2013 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - August 26, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Tsinghua University Education Foundation Tsinghua University Beijing 100084 China 2. Request ID: 9085999 3. Date Paid in Current Tax Year: $55,000.00 paid on April 26, 2013 4. Total Paid: $55,000.00 paid on April 26, 2013 $55,000.00 Total 5. Purpose of Grant: Intel - Tsinghua Technology Entrepreneurship Summer Camp program 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - August 31, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII- B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Nizhni Novgorod Foundation for Support of Education and Research 603000 Nizhni Novgorod, st. B.Pokrovskaya, 37 Nizhni Novgorod 603950 Russian Federation 2. Request ID: 9172043 3. Date Paid in Current Tax Year: $60,000.00 paid on June 5, 2013 4. Total Paid: $60,000.00 paid on June 5, 2013 $60,000.00 Total 5. Purpose of Grant: BIT business plans contest and Global Track Initiative 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - September 30, 2013 with remaining funds of $27,000.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D E L Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII- B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Tertius Tsentr realizatsii socialno-orientirovannyh proektov ANO 197 d.Kuznechikha Nizhny Novgorod, Novgorod 603136 Russian Federation 2. Request ID: 9221065 3. Date Paid in Current Tax Year: $50,000.00 paid on June 4, 2013 $52,000.00 paid on August 28, 2013 4. Total Paid: $50,000.00 paid on June 4, 2013 $52,000.00 paid on August 28, 2013 $102,000.00 Total 5. Purpose of Grant: RCIS Scientists of the Future Fair 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - August 14, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII- B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: British Council Korea 4F, Hungkuk Life Insurance Building, 226, Shinmunno 1-ga, Jongno-gu Seoul 110-786 Republic Of Korea 2. Request ID: 9233447 3. Date Paid in Current Tax Year: $20,000.00 paid on July 15, 2013 4. Total Paid: $20,000.00 paid on July 15, 2013 $20,000.00 Total 5. Purpose of Grant: Asia Youth Tech Entrepreneurship Camp 2013 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - October 15, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Shaanxi Western Development Foundation 1803, Block A, Shiji Yiyuan, Ke Ji Road Xi'an, Shaanxi 710075 China 2. Request ID: 9378037 3. Date Paid in Current Tax Year: $4,380.00 paid on July 9, 2013 4. Total Paid: $4,380.00 paid on July 9, 2013 $4,380.00 Total 5. Purpose of Grant: Innovation Classroom Band Team Building in rural primary school 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - November 29, 2013 with remaining funds of $4,380.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D 0 10 Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee : VbA-Selbstbestimmt Leben e.V. Westendstrasse 93 Munich 80339 Germany 2. Request ID: 9385467 3. Date Paid in Current Tax Year: $3,614.00 paid on September 18, 2013 4. Total Paid: $3,614. 00 paid on September 18, 2013 ------$3,614.00 Total 5. Purpose of Grant: Find your Voice 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - December 31, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee, therefore no independent verification of the report was made. ATTACHMENT D • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII- B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Scouting Ireland: 3rd Kildare (1st Celbridge) c/o 14 Hawthorn View Co Kildare Ireland 2. Request ID: 9397813 3. Date Paid in Current Tax Year: $5,000.00 paid on August 22, 2013 4. Total Paid: $5,000. 00 paid on August 22, 2013 $5,000.00 Total 5. Purpose of Grant: Community Centre Restoration of Disused property for community use 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - October 1, 2013 with remaining funds of $5,000.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII -B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: SK St. George 11000 Balik Pulau Penang 11000 Malaysia 2. Request ID: 9398681 3. Date Paid in Current Tax Year: $1,000.00 paid on June 25, 2013 4. Total Paid: $1,000.00 paid on June 25, 2013 $1,000.00 Total 5. Purpose of Grant: IIMSG - 1 PUPIL 1BOOK 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - November 11, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee, therefore no independent verification of the report was made. ATTACHMENT D Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Tsinghua University Education Foundation Tsinghua University Beijing 100084 China 2. Request ID: 9719221 3. Date Paid in Current Tax Year: $50,000.00 paid on August 8, 2013 4. Total Paid: $50,000.00 paid on August 8, 2013 $50,000.00 Total 5. Purpose of Grant : Sponsor 3 China Student teams to attend Intel Global Challenge at Berkeley program 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - November 30, 2013 with remaining funds of $0.00 7. Diversions : To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification : The grantor has no reason to doubt the accuracy or reliability of the report from the grantee ; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Children and Youth Science Center, China Association for Science and Technology Room 219 BLDG C, CAST Building, No.3 Fuxing Road Beijing 100863 China 2. Request ID: 9762007 3. Date Paid in Current Tax Year: $90,000.00 paid on September 6, 2013 4. Total Paid: $90,000. 00 paid on September 6, 2013 $90,000.00 Total 5. Purpose of Grant : 2013 CASTIC 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - December 31, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII- B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: YouNoodle Inc. 330 Townsend St, Suite 1 San Francisco, CA 94107 2. Request ID: 9943233 3. Date Paid in Current Tax Year: $150,000.00 paid on August 12, 2013 4. Total Paid: $150,000.00 paid on August 12, 2013 $150,000.00 Total 5. Purpose of Grant: Desafio Intel 2013-2014 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - December 30, 2013 with remaining funds of $75,000.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII- B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee : Pinnacle Business & Marketing Consulting, LLC 145 Mecca Street, Office 403 Amman 11183 Jordan 2. Request ID: 9944957 3. Date Paid in Current Tax Year: $110,000.00 paid on August 13, 2013 $100,000.00 paid on October 15, 2013 $40,000.00 paid on October 15, 2013 4. Total Paid: $110,000.00 paid on August 13, 2013 $100,000.00 paid on October 15, 2013 $40,000.00 paid on October 15, 2013 $250,000.00 Total 5. Purpose of Grant: Intel Science Competition Arab World, 2013 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - September 30, 2013 with remaining funds of $80,804.54 - December 29, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • E Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: China Foundation for Poverty Alleviation 5th Floor, South Building, No.36 Shuangyushu Xili, Haidian District Beijing 100086 China 2. Request ID: 10123119 3. Date Paid in Current Tax Year: $1,631,321.00 paid on September 16, 2013 4. Total Paid: $1,631,321.00 paid on September 16, 2013 $1,631,321.00 Total 5. Purpose of Grant : CFPA-Intel Community Development Plan 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - December 15, 2013 with remaining funds of $1 , 609,369.90 7. Diversions : To the knowledge of the grantor , no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification : The grantor has no reason to doubt the accuracy or reliability of the report from the grantee ; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: PSG-Science & Technology Entrepreneurial Park PSG College of Technology Coimbatore 641004 India 2. Request ID: 10169607 3. Date Paid in Current Tax Year: $30,000.00 paid on September 5, 2013 4. Total Paid: $30,000.00 paid on September 5, 2013 $30,000.00 Total 5. Purpose of Grant: Entrepreneurship Ecosystem Development Program 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - December 10, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D 0 0 Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII- B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Expo for Young Scientists P 0 Box 26045 Gauteng 1459 South Africa 2. Request ID: 10176249 3. Date Paid in Current Tax Year: $50,000.00 paid on August 27, 2013 4. Total Paid: $50,000.00 paid on August 27, 2013 $50,000.00 Total 5. Purpose of Grant: Intel Educator Academy 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - October 29, 2013 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee : Shanghai Jiao Tong University Foundation of America 1462 Voyager Dr. Tustin CA 92782-1724 2. Request ID: 11457351 3. Date Paid in Current Tax Year: $20,000.00 4. Total Paid: $20,000.00 paid on November 14, 2013 $20,000.00 Total 5. Purpose of Grant: Technology Entrepreneurship Faculty Training program 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - No reports were submitted within the year 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Phoenix Zoo Auxilliary 455 North Galvin Parkway Phoenix, AZ 85008 2. Request ID: Not applicable 3. Date Paid in Current Tax Year: $320.00 paid on April 10, 2013 4. Total Paid: $320.00 paid on April 10, 2013 $320.00 5. Purpose of Grant: Intel Involved Matching Grant Program 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - September 25, 2014 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D • • Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee : Hillsboro Schools Foundation 5193 NE Elam Young Pkwy, Suite A Hillsboro , OR 97124 2. Request ID : Not applicable 3. Date Paid in Current Tax Year: $930.00 paid on April 21, 2013 4. Total Paid: $930.00 paid on April 21, 2013 $930.00 Total 5. Purpose of Grant: Intel Involved Matching Grant Program 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - September 23, 2014 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D Intel Foundation EIN # 94-3092928 Attachment for Form 990PF Part VII-B, Question 5c on page 6 Expenditure Responsibility Statement For the year 2013 Pursuant to IRC Regulations 53.4945-5(d)(2), the Intel Foundation provides the following information: 1. Grantee: Hillsboro Schools Foundation 5193 NE Elam Young Pkwy, Suite A Hillsboro, OR 97124 2. Request ID: Not applicable 3. Date Paid in Current Tax Year: $388.00 paid on August 21, 2013 4. Total Paid: $388.00 paid on August 21, 2013 $388.00 paid on August 21, 2013 5. Purpose of Grant: Matching Gifts to Education 6. Reports: The grantee submitted full and complete reports of its expenditure as follows: - September 23, 2014 with remaining funds of $0.00 7. Diversions: To the knowledge of the grantor, no funds have been diverted to any activity other than the activity for which the grant was originally made. 8. Verification: The grantor has no reason to doubt the accuracy or reliability of the report from the grantee; therefore no independent verification of the report was made. ATTACHMENT D 0 0 Form 8868 I Application for Extension of Time To File an I (Rev. January 2014) Exem pt Org anization Return OMB No. 1545-1709 File a separate application for each return. Department of the Treasury I ► Internal Revenue Service ► Information about Form 8868 and its instructions is at www.irs gov/form8868 • If you are filing for an Automatic 3-Month Extension , complete only Part I and check this box ► Lxi • If you are filing for an Additional ( Not Automatic ) 3-Month Extension , complete only Part II (on page 2 of this form). Do not complete Partll unless you have already been granted an automatic 3-month extension on a previously filed Form 8868. Electronic filing (e-file) • You can electronically file Form 8868 if you need a 3-month automatic extension of time to file (6 months for a corporation required to file Form 990-T), or an additional (not automatic) 3-month extension of time. You can electronically file Form 8868 to request an extension of time to file any of the forms listed in Part I or Part II with the exception of Form 8870, Information Return for Transfers Associated With Certain Personal Benefit Contracts, which must be sent to the IRS in paper format (see instructions) For more details on the electronic filing of this form, visit www irs ov/efile and click on a-file for Charities & Nonprofits. Part I Automatic 3-Month Extension of Time. Only submit original (no copies needed). A corporation required to file Form 990-T and requesting an automatic 6-month extension - check this box and complete Part I only ► Q All other corporations (including 1120-C filers), partnerships, REMICs, and trusts must use Form 7004 to request an extension of time to file income tax returns. Enter filer' s identifyin g number Type or Name of exempt organization or other filer, see instructions. Employer identification number (EIN) or print INTEL FOUNDATION 94-3092928 File by the due date for Number, street, and room or suite no. If a P.O. box, see instructions. Social security number (SSN) filing your 5200 NE ELAM return See YOUNG PARKWAY instructions City, town or post office, state, and ZIP code. For a foreign address, see instructions. HILLSBORO, OR 97124 Enter the Return code for the return that this application is for (file a separate application for each return) 1 0 4 Application Return Application Return Is For Code Is For Code Form 990 or Form 990-EZ 01 Form 990-T (corporation ) 07 Form 990-BL 02 Form 1041-A 08 Form 4720 individua 03 Form 4720 (other than individual) 09 Form 990-PF 04 Form 5227 10 Form 990-T (sec. 401 a or 408(a) trust) 05 Form 6069 11 Form 990-T (trust other than above) 06 Form 8870 12 INTEL FOUNDATION NE The books are In the care of ► 5200 ELAM YOUNG PARKWAY - HILLSBORO, OR 97124 (503) 696-8080 Telephone No ► Fax No. ► • If the organization does not have an office or place of business in the United States, check this box ► U • 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 ► 0 If it is for part of the group , check this box ► 0 and attach a list with the names and EINs of all members the extension is for. 1 I request an automatic 3-month (6 months for a corporation required to file Form 990-T) extension of time until AUGUST 15, 2014 , to file the exempt organization return for the organization named above The extension is for the organization 's return for: O 13 ► ® calendar year 2 or ► = tax year beginning and ending 2 If the tax year entered in line 1 is for less than 12 months, check reason- Initial return Final return = Chan ge in accounting period 3a If this application is for Forms 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any nonrefundable credits. See instructions 3a $ 179,529. b If this application is for Forms 990-PF, 990-T, 4720, or 6069, enter any refundable credits and estimated tax payments made. Include any nor year overp ayment allowed as a credit 3b $ 144,529. c Balance due. Subtract line 3b from line 3a. Include your payment with this form, if required, by using EFTPS (Electronic Federal Tax Payment System) . See instructions. 3c $ 35,000 . Caution. If you are going to make an electronic funds withdrawal (direct debit) with this Form 8868, see Form 8453-EO and Form 8879-EO for payment instructions. LHA For Privacy Act and Paperwork Reduction Act Notice, see instructions . Form 8868 (Rev. 1-2014) 323841 12-31-13 1 04130423 099815 INTEL 2013 . 03040 INTEL FOUNDATION INTEL1 Form 8868 (Rev. 1.2014 Page 2 • If you are filing for an Additional ( Not Automatic ) 3-Month Extension, complete only Part II and check this box ► Note . Only complete Part II if you have already been granted an automatic 3-month extension on a previously filed Form 8868. • If you are filing for an Automatic 3-Month Extension, complete only Part I (on page 1) Part II Additional (Not Automatic) 3-Month Extension of Time. Only file the original (no copies needed). Type or Name of exempt organization or other filer, see instructions. Employer identification number (EIN) or print Filebythe INTEL FOUNDATION 94-3092928 due date for Number, street, and room or suite no. If a P.O. box, see instructions. Social security number (SSN) filing your return See 200 NE ELAM YOUNG PARKWAY instructions City, town or post office, state, and ZIP code. For a foreign address , see instructions. ILLSBORO, OR 97124 Enter the Return code for the return that this application is for (file a separate application for each return) FO-T-4-1 Application Return Application Return Is For Code Is For Code Form 990 or Form 990-EZ 01 Form 990-BL 02 Form 1041-A 08 Form 4720 (individual) 03 Form 4720 (other than individual) 09 Form 990-PF 04 Form 5227 10 Form 990-T (sec. 401 a or 408(a) trust) 05 Form 6069 11 Form 990-T (trust other than above) 06 Form 8870 12 STOP! Do not complete Part II if you were not already granted an automatic 3-month extension on a previously filed Form 8868. INTEL FOUNDATION 5 2 0 0 NE ELM YOUNG PARKWAY - HILLSBORO, OR 712 4 • The books are in the care of ► 9 Telephone No ► (503) 6 9 - 8 0 8 0 Fax No. 10o • If the organization does not have an office or place of business in the United States, check this box ► 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 00, = . If it is for part of the group, check this box 0, = and attach a list with the names and EINs of all members the extension is for 4 I request an additional 3-month extension of time until NOVEMBER 17, 2014 5 For calendar year 2 0 13 , or other tax year beginning , and ending 6 If the tax year entered in line 5 is for less than 12 months, check reason: Initial return Final return = Change in accounting period 7 State in detail why you need the extension ADDITIONAL TIME IS REQUIRED TO GATHER INFORMATION TO PREPARE A COMPLETE AND ACCURATE RETURN. Ba If this application is for Forms 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any nonrefundable credits. See Instructions. 179,529. b If this application is for Forms 990-PF, 990-T, 4720, or 6069, enter any refundable credits and estimated tax payments made. Include any prior year overpayment allowed as a credit and any amount paid with 179,529. c Balance due. Subtract line 8b from line 8a. Include your payment with this form, if required, by using EFTPS (Electronic Federal Tax Payment System) See instructions. 0. Signature and Verification must be completed for Part II only. 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,and complete, 4qd that I am authopged to prepare this form. 7/21/14 CPA Date ► Form 8868 (Rev. 1.2014) 323842 12-31-13 1 16510709 099815 INTEL 2013.04000 INTEL FOUNDATION INTEL1