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Form 990-PF Return of Private Foundation

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Form 990-PF Return of Private Foundation OMB No 1545-OX2 Form 990-PF Return of Private Foundation or Section 4947(a)(1) Nonexempt Charitable Trust n Treated as a Private Foundation 200 Node The organization may be able to use a copy of this return to satisfy state reporting requirements 2 For calendar year 2002, or tai year beginning , and ending G Check all that a E:1 initial return 0 Final return LA Amended return 0 Address than e 0 Name clan e Use the IRS Name of organization A Employer Identification number label Otherwise, HE ANNE HENDRICKS BASS FOUNDATION 13-7117629 print Number enUstreet (orPO Dwnumb>Il noel isnot aarvensnmstreet aearess) amw"uim B Telephone number orqpe 1801 DEEPDALE DRIVE 817-735-1863 See Specific town, ZIP Instructions City or state, and code C u am,Pem~~vl~~t~~ t" amaina ~~ nM " 0 FORT WORTH TX 76107-3517 D 1 Foreign orpaniutions,check here mi-0 2 ~~IWn ~l~x~oo^unpNe65%tcS ~ H Check type of organization XSection501(c)(3)exemptprrvatefoundatian mpubeon Section 4947(a)(1) nonerempl charrta0le trust = Other taxable private foundation E If private foundation status was terminated I Fair market value of all assets at end of year J Accounting method OX Cash Ej Accrual under section 507(b)(t)(A), check here (/turn Part ll, cot (c), line 16) 0 Other (specify) F If the foundation is in a 60-month termination 10.$ 3 8 3 7 918 . (Pert I, column (d) must be on cash basis) under section 507 b 1 B check here 0- EJ I Analysis of Revenue and Expenses (a) Revenue and (h) Net (0) oiswrs~d (fTe mm of ertnunb In mlumnf (b) (b. ~4 (~ ~' not investment (c) Adjusted net br fJ~anfaple u n,otes,dy,qu m ,uni m,u ,(,)) expenses Derbooks income income (fin bolao only)`P°'° 1 Contributions, gifts, grants, etc , received N/A °' Cnsk 1 a M pq Iwnmlm k nolrtpdRU briGCi $mB 2 Distributions from splrtintarest trusts ~ ` O interest on strivings end tcnporery 0 3 a, 29 . 29 . STATEMENT 1 `" 4 Dividends and interest from securities 12,104 . 12 , 104 . STATEMENT 2 c 5a Gross rents b (Net W I.or (losil Not n or rose) from rise of steserts not on 6a lin. ro 0 . b G. sides pri. for Wi assons on line 68 92,732 . M 7 CVitril gain net noorre (ftm Pont N line 2) 0 . C-) 8 Not short-term capital gain Lu 9 Income modifications 10a G . sides 1. raturn . sold t 11 Olh ~ WlC~I.rICII y 12 rotGin BOAto dunestthmu 12 , 133 . 12 , 133 . 13 Co tlo AL-ii, ea 0 0 . 0 . 0 . 14 Ot ~a pioyee saunas and wap~s <q 15 Pe MW c l6a Le b Accounting fees c Other professional fees i 17 Interest m ie taxes STMT 3 <1,339 . 0 . 0 . 19 Depreciation and depletion E 20 Occupancy c a 21 Travel, conferences, and meetings m 22 Printing and publications c 23 Other expenses STMT 4 3 1 2 . 3 1 2 . 0 . m 26 Total operating and administrative n expenses Add lines 13 through 23 < 1 , 027 . > 312 . 0 . 0 25 Contributions, grtts, grants paid 339 , 228 . 3-3-9 , 22-8 . 26 Total expenses and disbursements nddlines 2aand25 338,201 . 312 . 339 228 . 27 Subtract line 26 from line 12 I`r {} 2Eamaolrevmuewnupmasanadlsbursmtenn I ' <326 , 0 68 .~ } 6 Net investment income (if nw.wa, me* 01 i l , 82 1 . ,Gjusteanetlncome[initgawaenter -o-) F ~ I '- I N/A k - - . ' n LHA For Paperwork Reduction Act Notice, see the Instructions Form 990-PF (2002 " / l 1 f' Form 99o-PF(2002) THE ANNE HENDRICKS BASS FOUNDATION 13-7117629 Page 2 Beginning alyear Endolyear ~f Balance Sheets "'"°""°n°"dC2*°`" °"°°"M (a) Book Value (G) Book Value (c) Fair market Value t Cash -nonintereshueanng 23,111 . 42 1` 672 . 42 672 . 2 Savings andtemporary cash investments 908,456 . 656,470 . 656,470 . 3 accounts receivable 10- 638 . less allowance tordoubtful accounts " 1 , 548 . 638 . 638 . 0 Pledges receivable 1 , ~ a _ a a a ~ y Less allowance for doubtful accounts 5 Gents receivable B Recenables due from officers, directors, trustees, and other disqualified persons 7 omrnatsmamrs~ame " m , N. .. Less allowance for doubtful accounts 1 B Inventories for sale or use H 9 Prepaid expenses and deferred charges a 10a Investments -U S and state qovemment obligations D Investments " corporate stock s Investments - corporate bonds 11 k~s-waeuoaO& NOewm~ msh 1 t8amennamR~em 1 12 Investments - mortgage loans 13 Investments -other STMT 5 2 , 922 , 528 . 2 1` 829f795 . 3,138 , 138, ld Land, buildings, and equipment basis 1 l8avaAatrlQwsinm 1 15 Other assets (describe is Total assets tonecompleted o all siers 3 , 855 , 643 . 3 529 575 . 3 , 837 , 918 . 17 Accounts payable and accrued expenses 18 Grants payable m 19 Deferred revenue , 20 Loan, hom om~ aimcmrs, wstew, end ome abquNinm pmaona , m 21 Mortgages and other notes payable 22 Other liabilities (describe " ) ' 23 Total liabilities add lines 17 through 22) 0 . 0 . Organizations that follow SFAS 117, check here 1 0 N and complete lines 24 through 26 and lines 30 and 31 $ 24 Unrestricted m 25 Temporarily restricted 10 m 26 Permanency restricted Organizations teal do not follow SFAS 117, cheek here 1 4 and complete lines 27 through 31 27 Capital stock,trust vnnapai,orcurrent funds 5 , 076,250 . 5 076 250 . 28 Paid-in or capital surplus, or land, bldg , and equipment fund 0 . 0 . a 29 Retained earninps,accumulated income,endowment,orother funds <1 220 607 . <1 , 546 , 675 . Z 30 Total netassets orfund balances 3 , 855,643 . 3r529 1` 575 . Iii Total liabilities ananetaasetaAunabalances 3,855,643 . 3,529,575 . ~` ~~~ 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 years return) ,855,643 . 2 Enter amount from Part I, line 27a <326,068 .> 3 Other increases not included in line 2 (itemize) 01 0 Add lines 1, 2, and 3 5 Decreases not included in line 2 (itemize) 111* 6 Total net assets or fund balances at end of year (line 4 minus line 5) - Part II, total zzasn F. 990-PF aom1 of-zsm 2 Form 990-PF(2002) THE ANNE HENDRICKS BASS FOUNDAT Part IV Capital Gams and Losses for Tax on Investment Income (a) tut and describe the kind(s) of properly sold (e q , real estate, (cl Date acquired (it) Date sold 2-story brick warehouse, or common stock, 200 shs MLC Co ) mo , day, yr ) (mo,day,yr) P (e) Gross sales price (f) Depreciation allowed (g) Cost or other basis (h) Gam or (loss) (or allowable) plus expense of sale (e) plus (f) minus (g) assets column (h) and owned foundation on 12(d1B9 (I) Gains (Col (h) gain minus (1) Adjusted basis (k) excess of coi (i) cot (k), but not less than -0-) or (I) FMV as o117ld1/69 as al 72I37/69 over cot (1), it any posses (from coi (n)) { It ain, also enter in Part I, line 7 l 2 Capital pain net income or (net capital loss) Itloss), enter -0- in Part I, line 7 1 0 . 3 Net short-term capital pain or (loss) as delved in sections 1222(5) and (6) If gain, also enter in Part 1, line 8, column (c) N/A I Pmt Y I Qualification Under Section 4940(e) for Reduced Tax on Net Inve (For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income ) It section 4940(d)(2) applies, leave this part blank Was the orpanizaGan liable for the section 4942 tax on the distnbutable amount of any year in the base period? FX1 Yes ONO It 'Yes,' the organization does not quality under section 4940(e) Do not complete this pall 1 Enter the appropriate amount in each column for each year, see instructions before making any entries a Base penod years Distnbudon ratio Calendar vear (or tax vear beainnina in) Adjusted qualifying distributions Net value of noncha'ntable-use assets (cot (6) dmded by cot (c)1 2 Total of line 1, column (0) 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 A less than 5 years 0 Enter the net value of nonchairtable-use assets for 2002 from Part X, line 5 5 Multiply line 4 byline 3 6 Enter 1% of net investment income (1% of Part I, line 27b) 7 Add lines 5 and 6 B Enter qualifying distributions tram Part %1I, line 4 It 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 aasxvoi-23m vain 990-PF Q~n 3 Form 990-PF(20021 THE ANNE HENDRICKS ION 13-71176 on Investment Income d. 4940(b). 4940(e). or 4948 - see in: 1 a Exempt operating foundations described in section 4940(4)(2), check here " U and enter 'WA, an line 1 Date of ruling letter (attach copy of ruling letter it necessary-sea Instructions) h Domestic organizations that meet the section 4940(e) requirements in Part V, check here " 0 and enter 1% of Part I, line 27D c All other domestic organizations enter 2% of line 27b Exempt foreign organizations enter 4% of Part I, line 12, cot (b) 2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations on y Others enter-0-) 3 Add lines 1 and 2 4 SuDtRle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only Others enter -0-) 5 Tai based on Investment income Subtract line 4 from line 3 It zero or less, enter-0- 6 Credds/Payments a 2002 estimated lax payments and 2001 overpayment credited to 2002 6a 1,520 D Exempt foreign organizations -tax withheld at source 6b c Tax paid with application for extension of time to file (Form 8868) tic d Backup withholding erroneously withheld ~ 6d 7 Total credits and payments Ado lines 6a through 6d 1,520 .
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