Document EmBJ422boDRwRBzyryGOgjRxn

990Forni Department of the Treasury Internal Revenue Service Return of Organization Exempt From Income Tax Under section 5 0 1 (c ) (except black lung benefit trust or private foundation) of the Internal Revenue Code or section 4 9 4 7 (a )(1 ) trust Note: You may be required to use a copy of this return to satisfy state reporting requirements. See instruction D. 1188QMS No. 1S4S-0047 Usa 1RS label. Other wise, please print or type. Name of organization t S\ Address (number aod street) _ f in & >x 55V / City or town, state, and ZIP code P n n re .T O A AJ J . K. .* J , A Employer identification number (see instruction L) 3 3T b c J n 2 T ? d / \ . ia 3 3 /V 7 < 9 B State registration number (fee instruction } 0J5Y 3 C Section 4947(a)(1) trusts filing this form in lieu of Form 1041. check here 0 (see instruction CIO) D Check type of organtiation--Exempt under section ]^ 5 0 1 (c ) ( ^ | ) (Insert number), OR section 4947(a)(1) trust Check here if application for E Accounting method:'SiCash Q Accrual 0 Other (specify) exemption is pending a a q F Is this a group return (see instruction J) filed for affiliates?......................0 Yes jS^No If " Yes, ' enter the number of affiliates for. which this return is file d ____ Is this a separate return filed by a group a ffilia te ? ................................ 0 Yes 'Q No G If "Yes" to either, give four-digit group exemption number (GEN) H 0 Check here if your gross receipts are normally not more than $25.000 (see instruction B ll) . You do not have to file a completed return with 1RS but should file a return without financial data if you were mailed a Form 990 Package (see instruction A). Some states may require a completed return. I 0 Check here if gross receipts are normally more than $25,000 and line 12 is $25,000 or less. Complete Parts I (except lines 13-15), III, IV, VI, and VII and only the indicated items in Parts II apd V (see instruction I), If line 12 is more than $25,000, complete the entire return.____________________ 501(c)(3) organizations and 49 47(a)(1) trusts must also complete and attach Schedule A (Form 990). (See instructions.) Part I S tatem ent of Support, Revenue, and Expenses and C hanges in Fund Balances These columns are optional-- set instructions 1 Contributions, gifts, grants, and similar amounts received: a Direct public s u p p o r t ........................................ b Indirect public s u p p o r t ........................................ c Government g r a n t s .............................................. d Total (add lines la through lc ) (attach schedule-- see instructions). 2 Program service revenue (from Part IV, line f ) .................................. 3 Membership dues and assessm ents.................................................... 4 Interest on savings and temporary cash investments....................... 5 Dividends and interest from securities . . . 6 a Gross rents............................................................... a b Minus: rental expenses........................................ c> c Net rental income (loss)........................................ 7 Other investment income (Describi os Securities 8 a Gross am ount from sale of assets other than inventory . b Minus: cost or other basis and sales expenses . . . CO c Gain (loss) (attach schedule) Other ; \ \ 9 Special fundraising events and activities (attach schedule-- see instructions) a Gross revenue (not including $ ________ of contributions reported on line l a ) . . . b Minus: direct expen ses.................................. c Net income (line 9a minus line 9b) . . . 1 0 a Gross sales minus returns and allowances . b Minus: cost of goods sold (attach schedule) c Gross profit ( l o s s ) .............................' . . 11 Other revenue (from Part IV, line g) 12 Total revenue (add lines Id , 2 . 3 . 4 , 5 , 6c, 7 , 8c, 9c, 10c, and i 1) 13 Program services (from line 44 , column (B )) (see instructions) Lc0QXU). 14 15 16 Management and general (from line 4 4 , column (C)) (see instructions) Fundraising (from line 44 , column (D)) (see instructions) . Payments to affiliates (attach schedule-- see instructions) 17 Total expenses (add tines 16 and 4 4 , column (A)) ---a y 18 C C 19 3 20 Excess (deficit) for the year (subtract line 17 from line 12) . . Fund balances or net worth at beginning of year (from line 74, column (A)) Other changes in fund balances or net worth (attach explanation) 21 Fund balances or net worth at end of year (add lines 18. 19, and 20) For Paperwork Reduction Act Notice, see page 1 of the Instructions. c a o b a s , (1988) Jf 'Form 99 0(19 88) Part S tatem ent of Functional Expenses All organizations must complete column (A). Columns (B), (C), and (D) are required for most sections 501(cX3) and (cX4) organizations and 4947(aXl) trusts but optional for others. (See instructions.) Do not include amounts reported on lines 6b, 8b, 9b, 10b, or 16 of Part I. (A) Total (B) Program services (C) Management and general 22 Grants and allocations (attach schedule). . . 2 3 Specific assistance to in d ivid u als....................... 2 4 Benefits paid to or for members............................. 25 Compensation of officers, directors, etc. . . . 2 6 Other salaries and w ages........................................ 2 7 Pension plan c o n trib u tio n s .................................. 2 8 Other employee b e n e fits ........................................ 2 9 Payroll ta x e s .................................. ..... 3 0 Professional fundraising f e e s ............................ 3 1 Accounting fe e s ......................................................... 3 2 Legal fees ............................. . . . . . . . 3 3 S u p p lie s ..................................................................... 3 4 T e l e p h o n e ............................................................... 3 5 Postage and s h ip p in g ....................... ..... 3 6 Occupancy ............................................................... 3 7 Equipment rental and maintenance . . . . 3 8 Printing and publications . . . . . . . 3 9 Travel fiH D rr& ^ fr\fts r^ e *C r. . . . 4 0 Conferences, conventions, and meetings . . 4 1 Interest ..................................................................... 4 2 Depreciation, depletion, etc. (attach schedule). 4 3 Other expenses (itemize): a ...................................... ?t (n fr/A 5. I S O 21 23231 M JS L s is o l.S lC o S 2J- a& , 11 Page 2 4 4 Total functional expenses (add lines 22 through 43) Organisationscompletingcolumns 8-D, carrythesetotals to lines 13*15. Partili S ta te m e n t of P ro g ram S ervices R endered lO S .H Id ios,w*> List each program service title on lines a through J; f i r each, identify the service output(s) or produces), and report the quantity provided. Enter the total expenses attributable to each program service and the amount of grants and allocations included in that total. (See instructions for Part 111.) Expenses (Optional for some organizations-- see instructions) STVyj. 0.S.rlJT.L-:..Co.0. 0l.T> 6r... SSJZll.1 fe.-S.. .Jtr............................ (Grants and allocations $ OSTM'i') _______________ ____________________________________________________ (Grants and allocations $______________) c .................... d .................... __________________________________________________ (Grants and allocations $_____________ ) ___________________________________ ________________________________ (Grants and allocations"$ ________ )________________ e Other program service activities (attach schedule) .................................. (Grants and allocations $______________ )_________________ f Total (add lines a through e) (should equal line 4 4 . column ( B ) ) ............................................................................................ IOS ^ j 000523 Form 990(1988) Program Service R evenue and O ther R evenue (State nature.) e Program service revenue Page 3 Other revenue a F e s fro m government agencies .............................................................................................................................j b ^ P oh Llc a Jr. t.o. n . . _ S a . / S . .. .................. c ...................................................................... / r , ter? /. O d ............................................................................... e .................................................................. : ........................................................................................................ .. f Total oroeram service revenue (enter here and on line 2 ) ........................................................................... X Ibi W///M//i//iff ft Total other ____ revenue -- -- (enter ^-- here and on --- line i__ 1 1- ) .a....._....._._._._._._._._._.._._._._._._._._._._._._.._._._._._._._._._._._._._._._._._._._._..:_._._._._.._._._._._._._._..l..._._.._._._._._._._._._._._.._._...j._._._._._._._._._._.._ . . x------ `i .*Q -- Q=-- ~Q----,- PartV line *2 or Column (B) of line 59 is more than $25,000,-complete the entire balance sheet. If line 12, Part I, and B a la n ce o n e e is Column (B) of line 59 are $25,000 or less, you may complete only lines 59.66,74, and 75. See instructions. Note: Columns (C) and (D) are optional. Columns (A) and (B) must be completed to the extent applicable. Where required, attached schedules should be for end-of-year amounts only. (A) Beginning of year (B) Total End of year (C) Unrestricted/ Expendable (D) Restricted/ Nonexpendable Assets 4 5 Cash-- noninterest-bearing . . . . . 4 6 Savings and temporary cash investments 4 7 Accounts receivable _______________ minus allowance for doubtful accounts 4 8 Pledges receivable minus allowance for doubtful accounts 4 9 Grants re c e iv a b le .................................. 5 0 Receivables due from officers, directors, trustees, and key employees (attach s c h e d u l e ) .......................................................... 51 Other notes and loans receivable _______________________ minus allowance for doubtful accounts _________________ . 5 2 Inventories Tor sale or u s e ............................................................... 5 3 Prepaid expenses and deferred c h a rg e s ......................................... 5 4 Investments-- securities (attach s c h e d u le )................................... 5 5 Investments--land, buildings, and equipment: basis ______________ minus accumulated depreciation ___________ (attach schedule) 5 6 Investments-- other (attach s c h e d u le ) ......................................... 5 7 Land, buildings, and equipment: basis - minus accumula'ed depreciation ______vS'j 1 1 fo (attach schedule) . 5 8 Other assets ___________ !______________________________ . 5 9 Total assets (add lines 4 5 through 5 8 ) ......................................... Liabilities 6 0 Accounts payable and accrued expenses......................................... 6 1 Grants p a y a b le ...................................................................................... 6 2 Support and revenue designated for future periods (attach schedule) . 6 3 Loans from officers, directors, trustees, and key,employees (attach schedule) p T F .^ d 5 . . . . 6 4 Mortgages and other notes-payable (attach schedule) . . . 6 5 Other liabilities 'R A -'jro L t ,, _____________ 6 6 Total liabilities fadd lines 6 0 through 6 5 ) ........................................ Fund Balances or N et W orth Organizations that use fund accounting, check here Q and complete lines 67 through 70 and lines 74 and 75. 6 7 a Current unrestricted f u n d ........................................ * . . . b Current restricted fund . .......................................................... 6 8 Land, buildings, and equipment f u n d ................................... 6 9 Endowment f u n d .......................................................................... 7 0 Other funds (Describe ______________________________ ) Organizations that do not use fund accounting, check here D and complete lines 71 through 75. 7 1 Capital stock or trust p rin c ip a l.............................................. 7 2 Paid-in or capital su rp lus......................................................... 7 3 Retained earnings or accumulated in c o m e ....................... 7 4 Total fund balances or net worth (see instructions) . . 75 Total liabilities and fund balances/net worth (see instructions) 1 o? ? / 5 ~ 3 7V iI O , b i t ll.tb lO . /V . U S O Q S 'L 'L O Q_ (d ! m 5 .7 3 -7 n s <oiA\ 9 n o mForm 990( 1988) Page 4 Part VI List of O ffice rs. D ire cto rs, and T rustees (List each one w hether com pensated or not. See in stru ctio n s.) (A) Name and address (B) Title and average hours per week (C) Compensation (if not paid, (0) Contributions to employee (E) Expense account and other devoted to position enter zero) benefit plans allowances . K & T f t M i n e . . . r o o . o T A 3 . o e : . ........................ . . P . T s . . { V o n X A 6 . 0 . 6 . ........................................ P k -e s S ec. (W J 5r i 3 / n ? > " - -- -- . . ( i o . b e & T . . . t M - f c L S .............................................. V , P ry ? c P frA - . . Y A . . . . A S T . M A M ................................................. J 'r e c t E PhA -- S ee $ T A T 5 M e ~ fi> T ..............p - o Part VII O th e r In fo rm a tio n 3 ______ : ________ L Yes I No 76 Has the organization engaged in any activities not previously reported to the Internal Revenue S e r v ic e ? ........................... If " Yes," attach a detailed description of the activities. 77 Have any changes been made in the organizing or governing documents, but not reported to 1 R S ? ...................................... If " Yes." attach a conformed copy of the changes. 78 I f the organization had income from business activities, such as those reported on lines 2, 9, and 10 (among others), but NOT reported on Form 990-T, attach a statement explaining your reason for not reporting the income on Form 9 9 0 - T. a Did the organization have unrelated business gross income of $ 1,000 or more during the year covered by this return? b If " Yes," have you filed a tax return on Form 990-T, Exempt Organization Business Income Tax Return, for this year? 79 Was there a liquidation, dissolution, termination, or substantial contraction during the year? (See instructions.) . . If " Yes." attach a statement as described in the instructions. . 80 Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc., to any other exempt or nonexempt organization? (See instructions.). . If " Yes." enter the name of the organization ................................................................................................................................ .................................................................................................. and check whether it is exempt OR nonexempt. 81 a Enter amount of political expenditures, direct or indirect, as described in the instructions . . !________________ Q . b Did you file Form 1120-POL. U.S. Income Tax Return for Certain Political Organizations, for this year? 82 Did your organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially less than fair rental value?..................... v.................................................................................................................... If " Yes," you may indicate the value of these items here. Do not include this amount as support in Part I or as an expense in Part II. See instructions for reporting in Part I I I ................................ |____________________ 83 Section 501(c)(5) or (6) organizations.-- Did the organization spend any amounts in attempts to influence public opinion about legislative matters or referendums? (See instructions and Regulations section 1 .1 6 2 - 2 0 (c ).)...................... If " Yes," enter the total amount spent for this p u r p o s e ...................................................................... 84 Section 501(c)(7) organizations.-- Enter: a Initiation fees and capital contributions included on line 12. b Gross receipts, included in line 12, for public use of club facilities (See in s tru c tio n s .)...................... c Does the club's governing instrument or any written policy statement provide for discrimination against any person because of race, color, or religion? (See in s tru c tio n s .)................................................................................................................ 85 Section 501(c)(12) organizations.-- Enter amount of: a Gross income received from members or s h a r e h o ld e r s ................................................................ b Gross income received from other sources (do not net amounts due or paid to other sources against amounts due or received from t h e m ) ................................................................................ 86 Public interest law firms.-- Attach information described in the instructions. 8 7 List the states with which a copy of this return is filed .............................................................................................................. 88 During this tax year did you maintain any part of your accounting/tax records on a computerized s y s t e m ? ...................... 8 9 The books are in care of .............................................................................. Telephone no. ............................................ Located at .......... 90 Section 4947(a)(1) trusts filing Form 9 90 in lieu o f Form 1041.--'Enter the amount of tax-exempt interest received or accrued during the tax year........................................................................................................... Please Sign Here Paid Preparer's Use Only Under penalties of penury. I declare that I have examined this return, including accompanying schedules and statements, and to the Best of my knowledge and belief, it is true, correct, and complete Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge kY Signature of officer VPreparer's Wsignature Firm's name (or w yours, if self-employed) m and address y - TAX PAY z H * L O P Y r Title MLG8GS, GALUSK'M, S0SSSR & COMPANY'" * QCheck if seK-empioyed UhKiiht Kbo OrtOR 1 |j\!PO! M HIGHWAY ii. j . OSSI 7 r.u .Zip cod# ----------------------i saz D90 2 7 5 8Form. Application for Extension of Time To File (Rev. October 1988) ,, Fiduciary and Certain Other Returns Department of the Treasury Internal Revenue Service File a separate application for each return. Please type or Name p rin t File the original and , h (L O t\fA < L t\T fr \j'^ K L S kZACbCA one copy by Number and street (or P.O. Box number if mail is not delivered to street address) the due date for filing your ?o J^Y / re tu rn . (See Cijyoeiown. state, and ZIP code Instructions on back.) 'r c u r ite -r o ^ Mu . OMBNo. 1545-0148 Expires: 10-31-90 Employer identification number Farm ers' cooperative associations filing Form 990-C , corporate exem pt organizations filing Form 9 9 0-T , funds filing Form 1 1 2 0 -N D , political or exem pt organizations filing Form 1120-P O L, or S corporations filing Form 1 1 2 0 S , use Form 7 0 0 4 . Partnerships filing Form 1 0 6 5 and trusts filing either Form 1041 or Form 1 0 4 1 S , use Form 8 7 3 6 . 1 An extension of tim e until . . . . f W . W . 'i . T ............ ........................................................ ............. is requested in which to file (check only one): Form 706GS (D) Form 990-BL D Form990-T(trust other than above) Form 1066 D Form 4 7 2 0 D Form8612 Form 706GS (T) Form 990-PF Form 1041 (estate) Form 1120-ND (4951 taxes) Form 5227 Form8613 p^fForm 990 Form990-T (401(a) or 408(a) trust) Form 1041-A Form3520-A Form 6069 Form8725 If organization does not have an office or place of business in the United States, check this box . ................................ ^ 2 For calendar year 1 9 .......... or other tax year beginning and e n d i n g . . . 3 0 3 Has an extension of tim e to file been previously granted for this tax year? . . . v . . . . . . ____ _ . Yes JETNo 4 State in detail why you need the extension. . .................... .L k -E U x .. j f o - . Z+ 4 ................................................................................................................................................................. 5a If this form is for Form 706GS(D), 706GS(T), 990-BL, 990-PF, 990-T, 1041 (estate), 1066, 1120-ND, 4720, 6069, 8612, 8613, or 8 725, e nterthe tentative tax. See the in s tru c tio n s ................................................................ $ b If this form is for Form 990-PF, 990-T, or 1041 (estate), enter any refundable credits and estimated tax payments made. Include any prior year overpayment allowed as a credit. See the in s t r u c t io n s ........................... $ c Balance due (subtract line 5b from line 5a). Include your payment with this form, or deposit w ith FTD Coupon if required. See the in s tru c tio n s ........................................................................................................................................... $ Caution: Interest will be charged on any tax not paid by the regular due date o f the returns filed on forms listed above until the tax is paid. Signature and V erification Under penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements, and to thebest of my knowledge and belief, it is true, correct, and complete; and that I am authorized to prepare this form. Signature Date File original and one copy, IRS will show below w hether or not your application Is approved and will return the copy.________________ N o tice to A p p lican t-- To Be C o m pleted by IRS We HAVE approved your application. (Please attach this form to your return.) We HAVE NOT approved your application. (Please attach this form to your return.) However, because of your reasonsstated above, we have granted a 10-day grace period from the date shown below or due date of your return, whichever is later. This 10-day grace period is considered to be a valid extension of time for purposes of elections otherwise required to be made on tim ely filed returns. We HAVE NOT approved your application. After considering your reasons stated above, we cannot grant your request for an extension of time to file. (We are not granting the 10-day grace period.) We cannot consider your application because it was filed after the due date of your return. Other Director Date ______ By: If th e copy o f th is fo rm is to be re tu rn e d to an address o th e r th a n th a t sh o w n above, please e n te r th e a d d re ss w h e re th e copy should be sent. Please Type or P rint M llG R O M . GALUSWN. M S N E R & W M lPAN Y CERTIFIED PUBLIC ACCOUNTANTS, P.u nnnc t Mni M HIGHWAY Number and street (or P.O. Box num bent^iaii pdress) City or town, state, and ZIP code h* ' * 97-7258638 _____________________________ U U U jru b For P aperw ork R eduction A ct N otice, see back of form . Form 2 7 5 8 (Rev. 10 88) STATEMENT: 1 NAME : FEIN: F.Y.E . : ENVIRONMENTAL RESEARCH FOUNDATION 22-2331477 11-30.8? ' PAGE: LINE: 42 - DEPRECIATION DESCRIPTION DATE ACQUIRED VARIOUS COMPUTER BGOKSELVES COMPUTER COMPUTER COMPUTER COMPUTER TELEPHONE EQUIPMENT EQUIPMENT COMPUTER COMPUTER COMPUTER COMPUTER COMPUTER COMPUTER COMPUTER F U R N fie F I X F U R N fi F I X FURN & FIX F U R N fi F I X VARIOUS 2-86. 11.86 4.87 6-87 11.S3 11.38 12.18.88 1.3.89 1.15.89 12.3.88 12.28.88 12.28.88 1.5.89 2.6.89 2.24.89 5.31.89 1.2.89 12.10.33 1.2.89' 1.3.89 TOTALS BAS IS $8,389 2 *2 2 2 223 830 311 822 326 322 226 254 373 777 412 568 2,685 399 189 230 36 36 177 ACCUM D E P R 'N METHOD LIFE $300 ACRS 5YRS 1,283 ACRS 5YRS 130 ACRS 5YRS 4 58 MACRS 5YRS 162 MACRS 5YRS 164 MACRS 5YRS 65 MACRS 5YRS MACRS 7YRS MACRS 7YRS MACRS 7YRS MACRS 5YRS MACRS 5YRS MACRS 5YRS MACRS 5YRS MACRS 5YRS MACRS 5YRS MACRS 5YRS MACRS 5YRS r MACRS 5YRS MACRS 5YRS MACRS 5YRS $20,407 $3,067 CURRENT D E P R *N $0 466 47 169 60 263 104 56 32 36 75 155 32 2B4 537 200 38 46 17 7 35 $2,709 000527 STATEMENT NAME: FEIN: F. Y. E- : PAGE: LINE: P ENVIRONMENTAL RESEARCH FOUNDATION -331479 11-30.S3 43b - OTHER EXPENSES PERSONNEL INSURANCE COMPUTER EXPENSE BOOKS AND JOURNALS MEMBERSHIPS OFFICE EXPENSE ADVERTISING A U :0 =.X P E N S E 4 1 S 73 3 1,04E 7, 4 7 . 0 0 460 3-513 `I 453 = O p ^ iC S i 000S28 8 STATEMENT : , NAME : FEIN: F . Y . E. : PAGE: PART : ENVIRONMENTAL RESEARCH FOUNDATION 22-2331479 1 1 - 3 0 -S 9 4 VI - LIST OF DIR E C T O R S NAME ED BEGLEY*, JR DEBBIE KELLER WINFRED BENCHLY TIME DEVOTED PART PART PART CQMPENSATION 0 0 0 CONTRIBUTION 0 0 0 EXPENSE ACCOUNT 0 0 0 000529 SCHEDULEA Organization Exempt Under 501(c)(3) 0M B No. 1545 0047 ^ o rm 990) Department of the Treasury Internal Revenue Service (Except Private Foundation), 50 1(e ), 5 0 1 (0 . 50 1(k ), or Section 4 9 4 7 (a )(1 ) Trust Supplementary Information Attach to Form 990. 88 Employer identification number -------f--o----r--t----M-----g------------ ----------------- -- T -z J fT T T T I C o m p e n s a tio n o f th e F iv e H ig h e s t P aid E m p lo y e e s O th e r T h a n O ffic e rs ., D ire c to rs , an d T ru s te e s a a e n A aiili/ i va /* !/>( \ /I a m a U m a m IX U ________ _______ ___ _______ _______ a _ -- " b. I _ " N Name and address of employees paid more than S30.000 Title and average hours per week devoted to position Compensation Contributions to employee benefit plans Expense account and other allowances ..................................... Total number of other employees paid over $ 3 0 .0 0 0 ................................................................ A / o rsf Partii C o m p en sa tio n of th e Five H ig hest Paid Persons for P rofessional Services (S e e s p e c ific in s tru c tio n s .) (List each one. If there are none, enter " None.") Name and address of persons paid more than S30.000 Type o? service Compensation Total number of others receiving over $30,000 for professional se rvice s........................................... Partili S ta te m e n ts A bout A ctivities 1 During the year, have you attempted to influence national, state, or local legislation, including any attem pt to influence public opinion on a legislative matter or re fe re n d u m ? ........................................................................................... If "Y e s," enter the total expenses paid or incurred in connection with the legislative activities $ ________________ Complete Part VI of this form for organizations that made an election under section 501(h) on Form 5768 or other statement. For other organizations checking "Y e s," attach a statement giving a detailed description of the legislative activities and a classified schedule of the expenses paid or incurred. 2 During the year, have you, either directly or indirectly, engaged in any of the following acts with a trustee, director, principal officer, or creator of your organization, or any taxable organization or corporation with which such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary: a Sale, exchange, or leasing of p r o p e r t y ? ................................................................................................................................ b Lending of money or other extension of credit? . ........................................................................................................... c Furnishing of goods, services, or f a c ilit ie s ? ...........................................* ............................................................................ d Payment of compensation (or payment or reimbursement of expenses if more than $ 1 , 0 0 0 ) ? ................................ e Transfer of any part of your income or a s s e t s ? ...................................................................................................................... If the answer to any question is "Y e s." attach a detailed statement explaining the transactions. 3 Do you make grants for scholarships, fellowships, student loans, e t c . ? ........................................................... . . . 14 Attach a statement explaining how you determine that individuals or organizations receiving disbursements from you in furtherance of your charitable programs qualify to receive payments. (See specific instructions.) For Paperw ork R eduction A ct N otice, see page 1 of the instru ctio n s to Form 990. Schedule A (Form 99 0) 1988 000530 t Schedule A (Forni 990) 1988 2Page ^|23333 R e a s o n fo r N o n -P r iv a te F o u n d a tio n S ta tu s (S e e in s tru c tio n s fo r d e fin itio n s .)__________________________________ The organization is not a private foundation because it is (check applicable box; please check only ONE box): 5 EH 1 A church, convention of churches, or association of churches. Section 1 7 0 (b X lX A )(i). , EH6 2 A school. Section 17O (bXl)(AX`0- (Also complete Part V, page 3.) EH7 3 A hospital or a cooperative hospital service organization. Section 170(b)( 1XA)(i0- EH8 4 A Federal, state, or local government or governmental unit. Section 170(b)(l)(A )(v). EH9 5 A medical research organization operated in conjunction with a hospital. Section 170(b)(l)(A )(iii). Enter name, city, and state of hospital .................................................................................................................................................................................................................... 10 6 An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section 170 (b X lX A )(iv)- (Also complete Support Schedule.) a 0 7 An organization that normally receives a substantial part of its support from a governmental unit or from the general public. Section 170(bX l)(A X vi). (Also complete Support Schedule.) 12 8 An organization that normally receives: (a) no more than 1 /3 of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975, and (b) more than 1 /3 of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc., functions-- subject to certain exceptions. See section 509(a)(2). ( Also complete Support Schedule.) EH13 9 An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations described in (1) boxes 5 through 12 above or (2) section 501(c)(4), (5), or (6) if they meet the test of section 509(aX2). See __________section 509(aX3).____________________________________________________________________________________ __________ Provide the following inform ation about the supported organizations. (See instructions for Part IV, box 13.)______ _ (a) Name of supported organizations (b ) Box number from above 14 An organization organized and operated to test for public safety. Section 509(a)(4). (See specific instructions.) Support Schedule (Com plete only if you checked box 10, 11, or 12 above.) Use cash method of accounting. Calendar year (or fiscal year beginning in) (a) 1987 (b) 1986 (C) 1985 (d) 1984 (*) Total 15 Gifts, grants, and contributions received. (Do not include unusual grants. See line 28.) . . 16 Membership fees received . . . . 5 9 ,3 ? H s .liZ 3 /,S O O nooo / 1 3 3 , (n > 0 17 Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is not a business unrelated to the organization's charitable, etc., purpose ................................................ .3 % Mob -- -- /O .g o X 18 Gross income from interest, dividends, amounts received from payments on securities loans (section 512(aX5)), rents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organization after June 30,1975 . . . . 19 Net income from unrelated business activities not included in line 18 . . 30 Ill -- Hi H 20 Tax revenues levied for your benefit and either paid to you or expended on your behalf . . . 21 The value of services or facilities furnished to you by a governmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charge . . . % 22 Other income. Attach schedule. Do not in clude gain (or loss) from sale of capital assets 23 Total of lines 15 through 22 47, 24 Line 23 minus line 17 3 9 ,y> V - 25 Enter 1% of line 23 _______3 ? ^ 26 Organizations described in box 10 or 11: 9 7- ) V6, 0 /5 " V 60 21. ( t i l H , <>7 3 !b / 1 .onO / "7 f OCO nn a Enter 2% of amount in column (e). line 2 4 ................................................................................................................ b Attach a list (not open to public inspection) showing the name of and amount contributed by each person (other than a governmental unit or publicly supported organization) whose total gifts for 1984 through 1987 exceeded the amount shown in 26a. Enter the sum of all excess amounts h e r e ...................................................... (Continued on page 3) 1 /VV.94C , /3 4 ,o ? 4 I0fe.on4 COObJJ. Schedule A (Form 990 ) 1988 3Page S upport S chedule (continued) (C o m p lete only if you checked box 10, 11, or 12 on page 2.) i r p r27 Organizations described in box 12, page 2: Attach a list for amounts shown on lines 15, 16. and 17, showing the name of, and total amounts received in each year from, each "disqualified person," and enter the sum of such amounts for each year: ( 1 9 8 7 ) ........................................ (1 9 8 6 )...................... (1985) .............................. ( 1 9 8 4 ) b Attach a list showing, for 1984 through 1987, the name and amount included in line 17 for each person (other than "disqualified persons" ) from whom the organization received more, during that year, than the larger of: the amount on line 25 for the year or $5,000. Include organizations described in boxes 5 through 11 as well as individuals. Enter the sum of these excess amounts for each year: (1987)______________________(1986)_____________________ (1985)______________________(1984)_______________________ 28 For an organization described in box 10, 11, or 12, page 2, th a t received any unusual grants during.1984 through 1987, attach a list (not open to public inspection) for each year showing the name of the contributor, the date and amount of the grant, and a brief description of the nature of the grant. Do not include these grants in line 15 above. (See specific instructions.) P rivate School Q uestionnaire (T o be c o m p le te d O N L Y by schools th a t ch ecked box 6 in P a rt IV ) Yes No (1) (2) 2 9 Do you have a racially nondiscriminatory policy toward students by statement in your charter, bylaws, other governing instrument, or in a resolution of your governing b o d y ? ...................................................................................... 29 3 0 Do you include a statement of your racially nondiscriminatory policy toward students in all your brochures, catalogues, and other written communications with the public dealing with student admissions, programs, and s c h o la rs h ip s ? ........................................................................................................................................................................... 30 31 Have you publicized your racially nondiscriminatory policy by newspaper or broadcast media during the period of solicitation for students, or during the registration period if you have no solicitation program, in a way that makes the policy known to all part; of the general community you serve? ...................................................................... 31 If " Yes," please describe: if "N o ," please explain. (If you need more space, attach a separate statement.) 32 Do you maintain the following: a Records indicating the racial composition of the student body, faculty, and administrative s t a f f ? ........................... P 32a P b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory b a s i s ? ..................................... . ................................................................................. 32b c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student admissions programs and scholarships? ........................................................................... d Copies of all material used by you or on your behalf tq solicit c o n tr ib u tio n s ? ................................................................ If you answered " N o " to any of the above, please explain. (If you need more space, attach a separate statement.) .............................................. 32c 32d ! 33 Do you discriminate by race in any way with respect to: a Students' rights or privileges? . . . ... ................................................................................ b Admissions policies? . . . . . ... ...................................................................................... c Employment of faculty or administrative staff? . . . ...................................................................................... d Scholarships or other financial assistance? (See instructions.)........................................................................................... e Educational policies? . ................................................................................................................ f Use of facilities? g Athletic programs? ........................................................... .......................... h Other extracurricular activities? .......................................... ' ................................................................................. 33a 33b 33c 33d 33e 33f 33g 33h If you answered "Y es" to any of the above, please explain. (If you need more space, attach a separate statement.) I 34a Do you receive any financial aid nr assistance from a governmental a g e n c y ? ................................................................ b Has your right to such aid ever heer) revnked nr s u s p e n d e d ? ........................................................................................... If you answered "Yes' to either 34a or b. please explain using an attached separate statement. 34a 34b mm 35 Do you certify that you have complied with the applicable requirements of sections 4.01 through 4.05 of Rev. Proc. 75- 50, 1975-2 C.B. 587, covering racial nondiscrimination? If "N o ." attach an explanation. (See instructions for Part V.) 35 000532 m . G Schedule A (forni 990) 1988 Part VI Lobbying Expenditures by Public Charities (see instructions) (To be completed ONLY by an eligible organization that filed Form 5 7 6 8 ) Check here a Check here b I If the organization belongs to an affiliated group (see instructions). I If you checked a and "limited control" provisions apply (see instructions). Limits on Lobbying Expenses Page 4 To be completed for ALL electing organizations c 3 6 Total (grassroots) lobbying expenses to influence public o p i n io n .......................................................... 3 7 Total lobbying expenses to influence a legislative b o d y ........................................................................... 3 8 Total lobbying expenses (add lines 36 and 3 7 ) ...................................................................................... 3 9 Other exempt purpose expenses (see Part VI in s tru c tio n s )..................................................................... 4 0 Total exempt purpose expenses (add lines 38 and 39) (see instructions).............................................. 4 L Lobbying nontaxable amount. Enter the smaller of $ 1 ,0 0 0 ,0 0 0 or the amount determined under the following table-- If the amount on line 4 0 1's-- . The lobbying nontaxable amount Is-- Not over $500,000 .............................................. 20% of the amount on line 40............................. Over $500,000 but not over $1,000,000 . . . $100,000 plus 15% of the excess over $500,000 . Over $1,000,000 but not over $1,500,000 . . . $175,000 plus 10% of the excess over $1,000,000 Over $1,500,000............................. ..... $225,000 plus 5% of the excess over $1,500,000 4 2 Grassroots nontaxable amount (enter 25 % of line 4 1 ) .................................................... (Complete lines 43 and 44. File Form 4720 if either line 36 exceeds line 42 or line 38 exceeds line 41 4 3 Excess of line 36 over line 4 2 ..........................................................' .................................... 4 4 Excess of line 3 8 over line 41 4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 5 0 1 (h ) election do not have to complete all of the five columns below. See the instructions for lines 4 5 - 5 0 for details.) c \ 000533 ^ P Q c hIJute A (Form 990) 1988 Page 5 P a rt VU In fo rm atio n R egarding Transfers, T ran sactio ns, and R elationships W ith O ther O rganizations See instructions on reverse side. ________________ 5 1 Did the organization directly or indirectly engage in any of th e following with any other organization described in section 5 0 1 (c ) of the Code (other than section 5 0 1 (c X 3 ) organizations) or in section 5 2 7 , relating to political organizations? a Transfers of: (i) C a s h ....................................................................................................................................................................................................... (ii) Other a s s e t s ......................................................................................................................,................................................................ b Transactions: (i) Sales of a s s e t s .................................................................................. .................................................................................................... (ii) Purchases of assets.................................................................................................................................................................................. (iii) Rental of facilities or e q u ip m e n t......................................................................................................................................................... (v) Reimbursement arrangem ents............................................................................................................................................................. (v) Loans or loan guarantees............................................................................................................................... m. . . . . . . (vi) Performance of services or membership or fundraising s o lic ita tio n s ................................................................................. .... c Sharing of facilities, equipment, mailing lists or other assets, or paid employees ....................................................................... d If ` Yes'* to any of the above; complete the following schedule. The "Amount involved" column below should always indicate the value of the goods, other assets, or services given. In addition, if the organization received less than fair market value in any transaction or sharing arrangement, the column should include the value of the goods, other assets, or services received. Line no. Amount involved Name of noncharitable organization Description of transfers, transactions, and sharing arrangements - - c 5 2 a Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt organizations described in section 50 1(c ) of the Code (other than section 5 0 1 (c )(3 ) organizations) or in section 5 2 7 ? ......................................... Yes b If "Yes," complete the following schedule. `- Name of organization Type of organization Description of relationship No 000534 STATEMENT: NAME: FEIN: F.Y.E PAGE PART LINE 1 ENVIRONMENTAL RESEARCH FOUNDATION 22-2331479 11.30.S9 IV '. . 26b NAME: GERALDINE DODGE FOUNDATION FUND FOR NJ CS MOTT FOUNDATION BELDGN FOUNDATION MARY REYNOLDS BABOOK FOUNDATION ANNE ROBERTS LEVINSON FOUNDATION VICTORIA FOUNDATION TOTALS TOTAL 35,000 22,000 18,000 17,500 15,000 10,000 5,000 5,000 EXCESS 32,318 19,318 15,318 14,818 12,318 7,313 2,318 2,318 127,500 106,044 000535