Form 990-Pf - Return Of Private Foundation - 2012 Page 12
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1312
Form 990-PF (2012)
Page
Part XVI-A
Analysis of Income-Producing Activities
Unrelated business income
Excluded by section 512, 513, or 514
Enter gross amounts unless otherwise indicated.
(e)
Related or exempt
(a)
(b)
(c)
(d)
function income
Business code
Amount
Exclusion code
Amount
(See instructions.)
1 Program service revenue:
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
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
9 Net income or (loss) from special events .
.
.
10 Gross profit or (loss) from sales of inventory .
.
11 Other revenue: a
b
c
d
e
12 Subtotal. Add columns (b), (d), and (e) .
.
.
.
13 Total. Add line 12, columns (b), (d), and (e)
.
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13
(See worksheet in line 13 instructions to verify calculations.)
Part XVI-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to the
accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See instructions.)
▼
990-PF
Form
(2012)
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