' FILED PURSUANT TO NOTICE 2004-35 Return of Private Foundation OMB No 1545-0052 Form 990-PF or Section 4947(a)(1) Nonexempt Charitable Trust ^O Department of the Treasury Treated as a Private Foundation Internal Revenue Service Note. The foundation may be able to use a copy of this return to satisfy state reporting requirements. For calendar year 2012 or tax year beginning , and ending Name of foundation A Employer identification number BELZ FOUNDATION 62-6046715 Number and street (or P O box number if mail is not delivered to street address ) Room/suite B Telephone number 100 PEABODY PLACE, SUITE 1400 (901) 767-4780 City or town, state, and ZIP code C If exemption application is pending , check here ► MEMPHIS, TN 38103 G Check all that apply: L_J Initial return Initial return of a former public charity D 1. Foreign organizations , check here Final return Amended return 2. Foreign organizations meeting the 85% test, Add ress chan ge Name c hange 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 = Section 4947(a)(1) nonexempt charitable trust = Other taxable private foundation under section 507(b)(1)(A), check here Fair market value X I of all assets at end of year J Accounting method: Cash L_J Accrual F If the foundation is in a 60-month termination (from Part 11, col (c), line 16) = Other (specify) under section 507(b)(1)(B), check here ► s 2 4 , 9 0 5 , 5 0 4 . (Part 1, column (d) must be on cash basis ) Analysis of Revenue and Expenses Part I ( 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 purposes necessarily equal the amounts in column (a)) expenses per books income income (cash basis only) 1 Contributions, gifts, grants , etc , received 1,502,800 . N/A 2 Check ► = if the foundation is not required to attach Sch e and temporary 3 cashnvestmentss 291,640. 291,640 . S TATEMENT 1 4 Dividends and interest from securities 367,835. 367,835. S TATEMENT 2 5a Gross rents 384,950. 384,950. S TATEMENT 3 b Net rental income or (loss ) 116,818 . S TATEMENT 6a Net gain or (loss) from sale of assets not on line 10 1 1 4,4 93. 7 Gross sales price for all b assets on line 6a 2,398,539. 7 Capital gain net income (from Part N , line d 2) 1 14 , 493. cc 8 Net short-term capital gain 9 Income modifications Gross sa ate 1Da and olio ances b Less C t of gook c Gross roll or (loss) 11 Otheri e ^nV 2,573. 2,573. STATEMENT 5 2^t3 12 Total dd Ines 1 `t(roug 1 '{ 2,664,291. 1,161,491. 13 Compe sation o ffic rs irec o 0. 0. 0. 14 Other mplor e ge T T 15 Pension pans, emp y 16a Legal fees a b Accounting fees W c Other professional fees > 17 Interest 97,235. 0. 0 . m. 18 Taxes STMT 6 110,797. 74,928. 0. A 19 Depreciation and depletion 88,016. 88,016. 'E 20 Occupancy 4 21 Travel, conferences, and meetings 22 Printing and publications 23 Other expenses STMT 7 242,810. 242,189. 0. io 24 Total operating and administrative CL expenses . Add lines 13 through 23 538,858. 405,133. 0. 0 25 Contributions , gifts, grants paid 1, 321,244. 1,321,2 4 4. 26 Total expenses and disbursements. Add lines 24 and 25 1,860,102. 405,133. 1,321,244. 27 Subtract line 26 from line 12 a Excess of revenue over expenses and disbursements 804,189 . b Net investment income (if negative, enter -0-) 756,358. c Adjusted net income (if negative, enter -0-) N / A 12-05-12 LHA For Paperwork Reduction Act Notice, see instructions . Form 990-PF (2012) Form 990-PF (2012) BELZ FOUNDATION 62-6046715 Pane 2 Attached schedules and amounts in thedescnption Beginning of year End of year Pa rt II Balance Sheets column should belorend of -year amounts only (a) Book Value (b) Book Value ( c) Fair Market Value 1 Cash - non-interest-bearing 1 ,177,969. 1,113,005. 1,113,005. 2 Savings and temporary cash investments 383,67 6. 625,830. 625,830. 3 Accounts receivable ► <23,496. > Less: allowance for doubtful accounts ► 241,182. <23,496. <23,496. 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 ► 4,498,615. Less: allowance for doubtful accounts ► 0. 5,034,923. 4,498,615. 4,498,615. 8 Inventories for sale or use 9 Prepaid expenses and deferred charges a 10a Investments - U.S. and state government obligations b Investments - corporate stock STMT 8 12,940,793. 13,011,967. 13,820,305. c Investments - corporate bonds STMT 9 1,700,500. 1,650 ,500. 1,650,500. 11 Investments - land, buildings , and equipment basis ► 3, 871,551. Less accumulated depreciation STMT 10 ► 725,553. 3,234,014. 3,145,998. 3,145,998. 12 Investments - mortgage loans 13 Investments - other 14 Land, buildings, and equipment: basis ► Less accumulated depreciation ► 15 Other assets (describe ► STATEMENT 11 ) 86,170. 74,747. 74,747. 16 Total assets to be completed b all filers 24,799,227. 24,097,166. 24,905,504. 17 Accounts payable and accrued expenses 4 5,357. 39,107 . 18 Grants payable u) 19 Deferred revenue 20 Loans from officers , directors , trustees , and other disqualified persons 2 21 Mortgages and other notes payable 6 ,500,000. 5,000,000. J 22 Other liabilities (describe Op. STATEMENT 12 ) 103,125. 0 3 , 12 5 . 23 Total liabilities (add lines 17 through 22 ) 6, 648,482. 5,142,232. Foundations that follow SFAS 117, check here ► and complete lines 24 through 26 and lines 30 and 31. 24 Unrestricted rma 25 Temporarily restricted to 26 Permanently restricted Foundations that do not follow SFAS 117 , check here ► LL ii^ and complete lines 27 through 31. y 27 Capital stock, trust principal, or current funds 0. 0. 28 Paid -in or capital surplus, or land, bldg ., and equipment fund 0. 0. a 29 Retained earnings, accumulated income, endowment, or other funds 18,150,745. 18,954,934. Z 30 Total net assets or fund balances 18 ,150,745. 18,954,934 ] 31 Total liabilities and net assets/fund balances 24,799,227. 24,097,166 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) 18,150,745. 2 Enter amount from Part I, line 27a 3 Other increases not included in line 2 (itemize) ► 4 Add lines 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, column line 30 1 V , J .J i, J J• Form 990-PF (2012) 223511 12-05-12 Form 990-PF (2012) BELZ FOUNDATION 62-6046715 Page 3 Part IV Capita Gains an EEsses for Tax on I nvestment I ncome (a) List and describe the kind(s) of property sold (e.g., real estate, ow acquire (c) Date acquired (d) Date sold Purchas e d 2-story brick warehouse; or common stock, 200 shs. MLC Co.) D - Donation (mo., day, yr.) (mo., day, yr.) 1a PUBLICLY TRADED SECURITIES P b STATE OF ISRAEL 3RD JUBILEE ISSUE P 1 1/ 01/02 1 01 12 c STATE OF ISRAEL 6TH JUBILEE ISSUE BOND P 06/22/09 0 6/22/12 d STATE OF ISRAEL 6 TH JUBILEE ISSUE BOND P 1 2 / 01 / 09 1 1 2 / 01 / 12 e or other (h) Gain or (loss) (e) Gross sales price (f) Depreciation allowed (g) Cost basis (or allowable) plus expense of sale (e) plus (f) minus (g) a 2,0 8,539. 1,934,0 4 6. 1 1 4 ,493. b 50,000. 50,000. 0. c 250,000. 250,000. 0. d 50,000. 50,000. 0. 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 cal (k), but not less than -0-) or Losses (from col. (h)) (i) F.M.V. as of 12/31/69 as of 12/31/69 over col. (I), if any a 114,493. b 0. C 0• d 0. 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 2 114,493. 3 Net short-term capital gain or (lass) 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 Part V Qualification Under section 494O(e) for Heaucea f ax on Net investment income (For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income ) If section 4940(d)(2) applies, leave this part blank. Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period? Yes OX No If "Yes, the foundation does not qualify under section 4940 (e).