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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-(3052 990-PF Return of Private Foundation Form br SPctipn 4947(a)(1) Nonexempt Charitable Tr;dit ?"~ Department of the 7raIIwry Treated as a Private Foundation ~ internee Rrvaiue5ts"nu Note The iinaatron may be able to use a copy of this return to satisfy state reporting rei 2001 For calendar year 2001, or tax yeu bi and Use Ne IRS Name of organization Employer identification number label Otherwise, OCH FOUNDATION INC . »-ioo» print Numb> and street (a P O box numbs it mail ~a not aelrvsW to atrwt address) R°°r^,i=1'" B Telephone number orype 2830 NW 41ST STREET SUITE H \J7G/J/J-/Y71 See Specific or town, state, and ZIP code if exemption apPliptim is pandinp rlheA hoe 1 instructions City AINESVILLE FL 32606-6667 1 Foreign organizations, check here 10 'j Fusion opanizatimamaetinpNeES%test, , H Check type of organization [I] Section 501(c)(3) exempt private foundation cnerx hue and a¢a~ wmoubtion If private foundation status was terminated I Fair market value of all assets at end of year J Accounting method LXJ Cash L_J Accrual under section 507(b)(1)(A), check here "0 (from Part 11, col (c), line 76) [] Other (specify) If the foundation is in a 60-month termination- $ 13 0 7 9 9 , 6 0 0 . (Part 1" column (d) must be on cash basis Part I Analysis at Revenue and ense~ (d) Di (a) Revenue and Net investment (c) Adjusted net (fhe total of amounts mExp columns (bJ, expenses per (b) for (`), and (d) may not necessarily equal books income income o 1 Contributions, gifts, grants, etc , received ChM Ms. F-1 I the intention n oaf rtauire0 to two kA B 2 Distributions horn split-interest trusts imsas, o ., and isnvaaY 3 coon, invesimema 4 Dividends and interest from securities Sa Gross rents b Met rental income a pons) Nel pain a (loss) hornsale ofavers notm p 6~ line 10 b c~°u"°'°"`°'"°" 0 assess on fin. sa 38,105,159 . O ] Capital pan net income (horn Put iv line 3) 8 Net short-term capital gain 9 Income moddicallons ! '07 GoW SaIM leaf rotuma mid Nlawancm b Less cost .1 oooaaWa c Gross profit or (loss) 11 Other income 12 Total Add lines I through 11 13 GomDehxswnoior.caa avecivs trustee etc 14 Other employee salaries and wages ,c~..,. 15 Pension plans, employee benefits 16a Legal lees STMT 3 b Accounting lees 4 O STMT g33 c Other professional fees i 11 Interest 18 Taxes STMT 5 19 Depreciation and depletion 20 Occupancy 21 Travel, conferences, and meetings 22 Printing andpublications Im 23 Other expenses STMT 6 23 investment income (if negative enter -o-) 81 ,2-4 oz LHA For Paperwork Reduction Act Notice, see the instructions Form 990-PF (2001) \!\ 1 "" +mnono -7aqdfl7 5(117d4 2001 .06010 KOCH FOUNDATION, INC . 501744_1 Form 990-PF120011 Rflf`H Fllttamnm7llN . TNC_ 5Q- 2 Avunea¢Aeauleslnaamounts lnmeaexniaon oeqmnmquiyeer Partll Balance Sheets commnlnomaeelorenao~y~~~maunn,on (a)Book V31u¢ 61 Book Fair Market Value 1 Cash-non-interest-bearing 2 Savings and temporary cash investments 3 Accounts receivable Less allowance for doubtful accounts 4 Pledges receivable ll~ Less allowance for doubtful accounts 5 Grants receivable 6 Recervables due from officers, directors, trustees, and other disqualified persons 7 Omunotes aaloans car+eie Less allowance for doubtful accounts 10, y B Inventories for sale or use y 9 Prepaid expenses and deferred charges 10g Investments-US and state government obligations STMT 7 e Investments-corporate stock STMT 8 c Investments - corporate bonds 11 inrestmenn soon buildings add tQUIPMIAL 3114 Las auumWteEaeorsitoan 1 12 Investments - mortgage loans 13 Investments - other 14 Land, buildings, and equipment basis " 28 3 . 65 less laumulaea oeorecuoan 282 .60 15 Other assets (describe 17 Accounts payable and accrued expenses 18 Grants payable 0 19 Deferred revenue 20 Loans from olficss dvstva Wsiwa end aths EiequyAed persons m 21 Mortgages and other notes payable J 22 Other liabilities (describe 0. Organizations that follow SFAS 111,check here b~ L.XI end complete lines 24 through 26 end lines 30 end 37 $ 24 Unrestricted 25 Temporary restricted t0 M 26 Permanently restricted 0 Organizations that do not follow SFAS 117, check here F-1 end complete lines 27 through 31 27 Capital stock, trust principal, or current funds Y°, 28 Paid-in or capital surplus, or land, bldg , and equipment fund 29 Retained earnings, accumulated income, endowment, or other funds z 30 Total net assets or fund balances part ~~~ 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) 2 Enter amount [Tom Part I, line 27a 3 Other increases not included in line 2 (itemize) 4 Add fines 1, 2, and 3 5 Decreases not included in line 2 (itemize) 6 Total net assets or fund balances at end of year (line 4 minus line 5) - Part II, colw From 990-PF (zoot) 127511 O~-N-OZ 2 14180809 789407 501744 2001 .06010 KOCH FOUNDATION, INC . 501744_1 Iv Capital Gains and Losses for Tax on investment income (e) List and describe the 6d(s) of property salfle 0 . re21 estate, ate acquired (d) Date sold 2-story brick warehouse, or common stack, 200 shs MLC Co ) " W10 I (mo , day, yr ) EE ATTACHED STATEMENT EE ATTACHED STATEMENT (e) Gross sales price (f) Depreciation allowed (p) Cost or other basis (h) Gain or (loss) (or allowable) plus expense of sale (e) plus (p minus (p) 'amplete only for assets showing gain m column (h) and owned by the foundation on 17fd1/69 (I) Gams (Col (h) pain minus cot (k), but not less than -0-) or (l) Adjusted basis (k) Excess of cal (i) ( i) F M V as of 1731/69 as 0112/31/69 over cot (1),d any Losses (from cot (h)) n Part 2 Capital pain net income or (net capital loss) ~ IIloss), ente~l0-iin Part ll,lline 7 3 Net short-term capital pain or (loss) as defined in sections 1222(5) and (6) If pain, also enter in Part I, line 8, column (c) If floss). enter -0- in Part I . line 8 rart v I uuauncanon under section aaau(ei for Keaucea i ax on net mve (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 organization liable for the section 4942 tax on the dislributable amount of any year in the base period Yes [Y] No in each column for each year, see instructions before malting any envies (b) (C) ratio ,n~nn Adjusted qualifying distributions Net value of nancharitable-use assets v cot 2 Total of line 1, column (d) 3 Average distribution ratio for the 5-year base period - divide the total on line 2 by 5, or 6y the number of years the foundation has been in existence it less than 5 years 4 Enter the net value of noncharrtable-use assets far 2001 from Part K, line 5 5 Mulhpty line 4 6y line 3 6 Enter 1%. of net investment income (1%, of Part I, line 27b) 1 Ado lines 5 and 6 8 Enter qualifying distributions from Part XII, line 4 II line B 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 vain 990-PF (2wi) 17]577 Ot N-02 3 14180809 789407 501744 2001 .06010 KOCH FOUNDATION, INC 501744_1 Part VI I txase i ax tsaseu on investment income (Section 4w4up), 4`J4U(D), asao(e), or is Exempt operating foundations described in section 4940(d)(2), check Here 10 and enter 'N/A' on line 1 Date of ruling letter (attach copy of ruling letter if necessary-see instructions) b Domestic organizations that meet the section 4940(e) requirements in Part V, check here " Eil and enter 1°/, of Part I, line 27b c All other domestic organizations enter 2°/, of line 27b Exempt foreign organizations enter 4% of Part I, line 12, coL (b) 2 Tax under secbon 511 (domestic section 4947(a)(1) trusts and taxable foundations only Others enter -0-) 3 Add lines 1 and 2 4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only Others enter -0-) 5 Tax based on investment income Subtract line 41rom line 3 II zero or less, enter -0- 6 CrednsRaymenls a 2001 estimated tax payments and 2000 overpayment credited to 2001 tie 64 . 235 b Exempt foreign organizations - tax withheld al 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 Add lines 6a through 6d 8 Enter any penalty for underpayment of estimated tax Check here [_ if Form 2220 is attached 9 Tax due If the total of lines 5 and B is more than line 7, enter amount owed 10 Overpayment II line 7 is more than the total of lines 5 and 8, enter the amount overpaid 11 Enter the amount of line 10 to be Credited a 2002 estimated tax Iii, ~ Refunded Is, f a During the fax year, did the organization attempt N influence any national, state, or local legislation or did it participate or intervene in No any political campaign? b Did it spend more than $100 during the year (either directly or indirectly) far political purposes (See instructions for definition)? II the answer is 'Yes' to 1 a w 1b, attach a detailed description o! the activities and copes o! any materials published or distributed by the organization m connection with the actrvrties c Did the organization file Form 1120-POl for this year d Enter the amount (it any) of tax on political expenditures (section 4955) imposed during the year (1) On the organization 1 $ 0 .
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