19
99o - Return of Organization Exempt From Income Tax Form Under sect Ion 601(c), 627, or 0907(e)(1) of the Interns l Revenue Code (except black loop oAw~w~iorm .r~...~y ~ benefit trust orprivate lounEatlon) m ,W A%~ ,ue senioe " The organization may have to use a copy of this return to satisfy state reporting requirements H end I ere not applicable to section 527 organizations Hoe)Isthis agroup return loraKllates9 DYes M No H(6) If Yes ; enter number ofaffiliates " H(e) Are all affiliates Included? N/A YesNo (17 -NO .- attach a list ) Hid) I5 this a separate return tiled by an or- M Check " U A the organization is not required to attach Sch B (Form 990 . 990-EZ . or 990-PFl 1 Contributions, pits, grants, and similar amounts received a Direct public support 1e 270 065 .'.: `H°~' b Indirect public support lb c Government contnbuuons(prants) 7c 39 078 . `, Q d Total (addlines iathrough 7c)(cash5 309,143 . noncashE ) id 309 143 . 2 Program service revenue Including government tees and contracts (from Part VII, line 93) Z 54 , 069 . 9 Membership dues and assessments 9 28 , 42 . N d Interest on savings and temporary cash Investments d 6 Dividends andInterest from securities 6 475 080 . =7 8 e Gross rents 8a h Less rental expenses 86 ,°~,,u°x o Net rental Income or (lass) (subtract line 6b from line 6a) ec 7 Other Investment Income (descnbe " 7 0 c 8 a Gross amount from sale of assets other A Securities B Other than Inventory 1 , 818 , 134 . ee U. m h Lass cosh or other basis and sales expenses 2 , 64 3 , 461 . Bb c Gain or(loss)(attachschedula) <825 327 . 8c d Net pain or (loss) (combine line Bc, columns (A) and (B)) STMT 1 ~ 8d <825, 327 . > . . 0 Special events and activities (attach schedule) a Gross revenue (not Including $ reported online la) bCU U go 264 394 . sc`= b Less dyed expenses other than Nndralsinp es 0 B6 2 32 2 2 9 . ~hs e NetIncome or(ioss) from speGaievents(sub ~ in~~m(~q~a~Q03 ~`EE STATEMENT 2 Be 32 , 165 . 10 a Gross sales of Inventory, less returns an0 olio an 10e D Less cost o1 goods sold OGD~~`~a " U 'r 10b e Gross profit or (loss) from sales of inventory ( Nro-70b tram line 10a) 4 70e 11 Other revenue (IromPart VII,line 103) 11 2-2- , 9-7 - 5 . 12 Total revenue add lines td 2 3 4 5 6c 7 8d 9c 10c and 11 12 95 , 947 . 13 Program services (from line 44, column (B)) 19 419 528 . jss 74 Management and general (from line 44, column (C)) 14 533 , 579 . 16 Fundraising (from line 44, column (D)) 16 1-2-5- , 472 . i 18 Payments to affiliates (attach schedule) 18 ~J 17 Total ex p enses add lines 16 and 44 column A 77 1 078 5 7 - 97 ~~ 18 Excess or (deficit) for the year (subtract line 77 from line 72) 18 <982 632 .> g 19 Nat assets or fund balances at beginning of year (from line 73, column (A)) 19 13 , 235 321 . 20 Other changes lnnetassets orfund balances (attachexpWnatlon) SEE STATEMENT 3 20 564 203 . 21 Net assets or fund balances at end of ear combine lines 18, 19, and 20 21 12 816 892 . oiia-aa LHA For Paperwork Reduction Act Notice, sae the separate Instructions Form BBO (2002) 1 ^ 11140513 742280 20016 2002 .05040 SALISBURY HOUSE FOUNDATION 20016 -1 A For the 2002 oelenAar y ear, or tea year period beginning and B Ch~ It C Name of organization ~Pflcable pl~ ." IRS : Addmo Is" 0 =9- pdnt o~ ALISBURY HOUSE FOUNDATION change lt~ Number and street (or P 0 box If mall Is not delivered to street address) InIuW s" E~].W. sp-cuic4025 TONAWANDA DRIVE N RnV INWo ~nWm tons City or (own, stale or country, and ZIP a 4 ES MOINES IA 50312 Onoaii~uon 0 Section 601(c)(3) organizations and a947(a)(1) nonexempt charitable fruits mutt attach a completed Schedule A (Form 990 or 990-EZ) J Organization type la4*wyarol " ~C 501(C)( .i )41111 Onwnm)U4947(a)(1)Or U62 K Check here " = If the organization's gross receipts are normally not more than E25,000 The organization need not file a return with the IRS, but it the organization received a Forth 990 Package In the mall, h should file a return without financial data Soma states require 8 complete return D Employer Identification number 42-1415581 Room/suite ETelephone number F A=nwrnmox u C . .h L&j Aocn;W

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Page 1: 99o - Return of Organization Exempt From Income Tax990s.foundationcenter.org/990_pdf_archive/421/...99o- Return of Organization Exempt From Income Tax Form Under sect Ion 601(c), 627,

99o - Return of Organization Exempt From Income Tax Form Under sect Ion 601(c), 627, or 0907(e)(1) of the Interns l Revenue Code (except black loop oAw~w~iorm.r~...~y ~ benefit trust orprivate lounEatlon) m�� ,W A%~�,ue senioe " The organization may have to use a copy of this return to satisfy state reporting requirements

H end I ere not applicable to section 527 organizations Hoe)Isthis agroup return loraKllates9 DYes M No H(6) If Yes; enter number ofaffiliates " H(e) Are all affiliates Included? N/A YesNo

(17 -NO .- attach a list ) Hid) I5 this a separate return tiled by an or-

M Check " U A the organization is not required to attach Sch B (Form 990 . 990-EZ . or 990-PFl

1 Contributions, pits, grants, and similar amounts received a Direct public support 1e 270 065 .'.: ̀H°~' b Indirect public support lb c Government contnbuuons(prants) 7c 39 078 . `,

Q d Total (addlines iathrough 7c)(cash5 309,143 . noncashE ) id 309 143 . 2 Program service revenue Including government tees and contracts (from Part VII, line 93) Z 54 , 069 . 9 Membership dues and assessments 9 28 , 42 .

N d Interest on savings and temporary cash Investments d 6 Dividends andInterest from securities 6 475 080 .

=7 8 e Gross rents 8a h Less rental expenses 86 ,°~,,u°x o Net rental Income or (lass) (subtract line 6b from line 6a) ec

7 Other Investment Income (descnbe " 7 0

c

8 a Gross amount from sale of assets other A Securities B Other than Inventory 1 , 818 , 134 . ee

U. m h Lass cosh or other basis and sales expenses 2 , 64 3 , 461 . Bb c Gain or(loss)(attachschedula) <825 327 . 8c d Net pain or (loss) (combine line Bc, columns (A) and (B)) STMT 1 ~ 8d <825, 327 . >

. . 0 Special events and activities (attach schedule) a Gross revenue (not Including $

reported online la) bCU U go 264 394 . sc`=

b Less dyed expenses other than Nndralsinp es 0 B6 2 32 2 2 9 . ~hs e NetIncome or(ioss) from speGaievents(sub ~ in~~m(~q~a~Q03 ~`EE STATEMENT 2 Be 32 , 165 .

10 a Gross sales of Inventory, less returns an0 olio an 10e D Less cost o1 goods sold OGD~~`~a " U 'r 10b e Gross profit or (loss) from sales of inventory ( Nro-70b tram line 10a) 4 70e

11 Other revenue (IromPart VII,line 103) 11 2-2- , 9-7-5 . 12 Total revenue add lines td 2 3 4 5 6c 7 8d 9c 10c and 11 12 95 , 947 . 13 Program services (from line 44, column (B)) 19 419 528 .

jss 74 Management and general (from line 44, column (C)) 14 533 , 579 . 16 Fundraising (from line 44, column (D)) 16 1-2-5- , 472 . i � 18 Payments to affiliates (attach schedule) 18 ~J 17 Total ex penses add lines 16 and 44 column A 77 1 078 5 7 -97 ~~ 18 Excess or (deficit) for the year (subtract line 77 from line 72) 18 <982 632 .>

g 19 Nat assets or fund balances at beginning of year (from line 73, column (A)) 19 13 , 235 321 . 20 Other changes lnnetassets orfund balances (attachexpWnatlon) SEE STATEMENT 3 20 564 203 . 21 Net assets or fund balances at end of ear combine lines 18, 19, and 20 21 12 816 892 .

oiia-aa LHA For Paperwork Reduction Act Notice, sae the separate Instructions Form BBO (2002) 1 ^

11140513 742280 20016 2002 .05040 SALISBURY HOUSE FOUNDATION 20016-1

A For the 2002 oelenAar y ear, or tea year period beginning and B Ch~ It C Name of organization

~Pflcable pl~ ." IRS

: Addmo Is" 0 =9- pdnt o~ ALISBURY HOUSE FOUNDATION change lt~ Number and street (or P 0 box If mall Is not delivered to street address) InIuW s"

E~].W. sp-cuic4025 TONAWANDA DRIVE N RnV INWo

~nWm tons City or (own, stale or country, and ZIP a 4 ES MOINES IA 50312

Onoaii~uon 0 Section 601(c)(3) organizations and a947(a)(1) nonexempt charitable fruits mutt attach a completed Schedule A (Form 990 or 990-EZ)

J Organization type la4*wyarol" ~C 501(C)( .i )41111 Onwnm)U4947(a)(1)Or U62 K Check here " = If the organization's gross receipts are normally not more than E25,000 The

organization need not file a return with the IRS, but it the organization received a Forth 990 Package In the mall, h should file a return without financial data Soma states require 8 complete return

D Employer Identification number

42-1415581 Room/suite ETelephone number

F A=nwrnmox u C..h L&j Aocn;W

Page 2: 99o - Return of Organization Exempt From Income Tax990s.foundationcenter.org/990_pdf_archive/421/...99o- Return of Organization Exempt From Income Tax Form Under sect Ion 601(c), 627,

22 Grants and allocations (attach schedule) m!1 f Ip11Qf11 f

29 Specific assistance to individuals (attach schedule) 21 Benefits paid to or for members (attach schedule) 25 Compensation of officers . directors, etc 28 Other salaries and wages 27 Pension plan contributions 28 Other employee benefits 29 Payroll taxes 90 Professional fundralslnp fees 31 Accounting toes 32 Legal fees 93 Supplies 34 Telephone 95 Postage and shipping 98 Occupancy 97 Equipment rental and maintenance 98 Printing and publications 99 Travel 10 Conferences, conventions, and meetings 61 Interest 02 Depreciation, depletion, etc (attach schedule) 49 Other expenses not covered above (itemize)

e b e a e SEE STATEMENT 4

Joint Costs Check " U If you are following SOP 9&2 Are any joint costs from a combined educational campaign and fundraising solicitation reported In (B) Program services? . 0 Yes EXI No It Yes; enter (I) the aggregate amount of these /pint costs $ , (II) the amount allocated to Program services S ,

2 2002 .05040 SALISBURY HOUSE FOUNDATION 200161 11140513 742280 20016

sAL statement of All

D Functional Expenses an.

HOUSE FOUNDATION Iratlons must complete column (A) Columns ~r aniratlons and section 4947(a )( 1 ) nanexen

(A) Total (B Propr servin

(u) are reQmrea ror season sui(c)(3) Page 2 trusts but optional for others

(C) Management (0) 0 and g eneral Fundralsln

Page 3: 99o - Return of Organization Exempt From Income Tax990s.foundationcenter.org/990_pdf_archive/421/...99o- Return of Organization Exempt From Income Tax Form Under sect Ion 601(c), 627,

Form 990(2002) SALISBURY HOUSE FOUNDATION 42-1415581 Page 9

Amt 1V ¢alancaSheets

Note Where required, attached schedules end amounts within the description column should be for end-of-year amounts only of year End of(B)year

47 a Accounts receivable 47e 161 , 306 . 6 Less allowance for doubtful accounts G76 159 742 . 47a

48 a Pledges receivable 4Ba y 114,, 341 . h Less allowance for doubtful accounts 48b 231 669 . 08c

49 Grants receivable 650 000 . 4g 50 Receivables from officers . directors, trustees,

and key employees 60 51 a Other notes and loans receivable 51a

b Less allowance for doubtful accounts 51b 51C

3 11140513 742280 20016 2002 .05040 SALISBURY HOUSE FOUNDATION 200161

45 Cash -non-InlerashDearlnq OB Savings and temporary cash investments

62 Inventories far sale or use 52 53 Prepaid expenses and deterred charges 61 , 421 . 69 49 , 202 . 54 Investments-securities " 0 Cost EJ FMV 64 55 a Investments - land, buildings, and

equipment basis 55e

b Less accumulated depreciation 55b 55' c 58 Investments - other 58 57a Land,bulldlnps,andequipment basis 57e 5 , 039 , 936 .

6 Less accumulated depreciation sib 161 249 . 3 , 947 , 953 . 57s~ 4 , 878 , 687 . 58 other assets (describe Do- ART COLLECTIONS ~ 3 , 494 , 130- 58 3 , 555 , 630 .

59 Total addle add lines 45 throw h 58 must equal line 74 18 392 , 110 . 69 18 132 , 612 . 80 Accounts payable anaaccrued expenses 142 , 510 . BO 307 505 . 61 Grants payable 51 82 Deterred revenue 14 , 279 . 82 8 215 . 83 Loans from officers, directors, trustees, and key employees 83

a 64 a Tax-exempt bond liabilities 8<e 6 Mortgages and other notes payable 81b

85 Other liabilities (oescdbe 10- BONDS PAYABLE ~ 5 , 000 , 000 . 85 5 , 000 , 000 .

66 Total liabilities add lines sotnrou nss 5 , 156 , 789 . ss 5 , 315 , 720 . Organizations that follow SFAS 117, check here " Wand complete lines 67 through

69 and lines 73 and 74 67 unrestricted 12 585 321 . ~87 12 , 816 , 892 .

A 88 Temporarily restricted 650 000 . BB 0 . 11 BB Permanently restricted! BB

Organizations that do not follow SFAS 117, check here 1 D and complete lines ` ~ssr 70 through 74 ° 70 Capital stock, trust principal, or current funds 70

71 Pa10-In or capital surplus, or land, building, and equipment fund 71 72 Retained earnings, endowment, accumulated Income, or other funds 72 73 Total net easel: or fund balances (add lines 67 through 69 or lines 70 through 72,

column (A) must equal line l9,column (B)must equal line 27) 13 235 321 . ~79 12 816 892 . 74 Total liabilities end net assets /fund balances (add lines 66 and 73) ~ 18,392,110 . 74 18 , 132 , 612 .

Form 990 is available for public Inspection and, for some people, serves as the primary or sole source of Information about a particular organisation How the Dublic perceives an organization In such cases may be determined by the Information presented on its return Therefore, please make sure the return Is complete and accurate and fully describes, In Part III, the organization's programs and accomplishments

n=i of-zsm

Page 4: 99o - Return of Organization Exempt From Income Tax990s.foundationcenter.org/990_pdf_archive/421/...99o- Return of Organization Exempt From Income Tax Form Under sect Ion 601(c), 627,

4 11140513 742280 20016 2002 .05040 SALISBURY HOUSE FOUNDATION 200161

rOIII17`JU ,W, OL11I10DVA1 RVVJG LVVL~V(f11VL " YL~lY1JJ01 rage O -A Reconciliation of Revenue per Audited - Ott Reconciliation of Expensespe r Audited

Financial Statements with Revenue per Financial Statements with Expenses per Return Return

e Total revenue,palns,andother support a Total expenses and losses per per audited financial statements " e ~571 512 . auditeOflnanclaistatements ~~989 941 .

6 Amounts Included online a but nolOn 6 Amounts Included on line a but not on '~ _,~ ̀"~ ; =° ' `~ `

line 12, Form 990 line 17, Form 990 ~ "~`> -,` ,<� ,~,Y

(1) Donated services (1) Net unrealized pains and use of lacllflYas

on investments S 564,203 . Y (2) Prloryearadjustments adjustments (2) Donated services reported on line 20, +~ .� '~ E ~

"- and use of facilities S ~ Form 990 S

(9) Recoveries of prior (9) Losses reported on year grants line 20, Forth 990

(4) Other (specify) (0) Other (specify) STMT 6 $ 232,229 . STMT 7 S 232,229. ,

Add amounts on lines (1) through (e) " b , 796 , 432 . Add amounts on lines (1) through (e) " b m " 232 , 229 " . c Line eminus line b " e <224 920 . c Line eminus line b " a 757 712 . 0 Amounts Included on line 72, Form d Amounts Included on line 17, Form ~f

990 but not on line a

(1) Investment expenses (1) Investment expenses

^°~ ~~.5 Y ~ ~ ~ibtC' a Loci 5 3'~6~rL8t not Included on ` ~ not Included on ~~ ` ' ;t ~; ~`~ ~s`" Une 66, Form 990 320 r 867 . °,` 'z" line 6o,Form 990 320 , 867 . Other (specify) '; a ~ pk W (2) Other (specify) K,` .",` "ti 9 <Fa`t`"yq~ t ~°G"~5

.9-0(~: f

nAdamounts onlines (1) and (2) " 'A' 320 , 867 . adCamounts onlines (1) and (2) " 0 320 867 . e Total revenue per line 12, Forth 990 a Total expenses per line 77, Form 990

tine e ws Ana d " e 95 , 947 .1 (the c tut line e " e 1 , 078 , 579 . ,Pelt Y List of Officers, Directors, Trustees, and Key Employees (L1St each one even n not compensates )

(B) Title and average hour C) Compensation (Ocw~mewon.ro (E) Expense (A) Name and address per week devoted to 'll not p I , enter Pi��°("a,~Mft account and

position d~ other allowances

---------------------------------

SEE STATEMENT 8 13-3 , 000 . 7 , 980 . 0 . --------------------------------- ---------------------------------

--------------------------------- ---------------------------------

--------------------------------- ---------------------------------

--------------------------------- ---------------------------------

--------------------------------- ---------------------------------

--------------------------------- ---------------------------------

--------------------------------- ---------------------------------

--------------------------------- ---------------------------------

75 Did any officer, director, trustee, or key employee receive aggregate compensation of more than E100,000 from your organization and all related organizations, of which more than $70,000 was provided by the related organizations? If Yes,' attach schedule P. E :] Yes [KNo Form 990 (20021

223031 01-22-03

Page 5: 99o - Return of Organization Exempt From Income Tax990s.foundationcenter.org/990_pdf_archive/421/...99o- Return of Organization Exempt From Income Tax Form Under sect Ion 601(c), 627,

42-141 Forth 990

and check whether K Is = exempt or = nonexempt 81 a Enter direct or Indirect political expenditures Sea line 81 Instructions ~ 81e ~ 0 .

6 Did the organization file Form 1120-POL for (hl5 yeah 82 a DIC the orqanlzalion receive donated services or the use of materials, equipment, or facllitles at no carpe or at substantially less than

fair rental value? b If Yes; you may indicate the value of these items sera Do not Include this amount as revenue In Pad I or as an

expense in Part II (See Instructions in Past III ) I B26 ~ N/A 83 a Did the organization comply with the public inspection requirements for returns and exemption applications?

D Did the organization comply with the disclosure requirements relating to quid pro quo contributions? BC a Old the organization solicit any contributions or pests that were not tax deductible?

b If 'Yes,' did the organization Include with every solicitation an express statement that such contributions or gifts were not tax deductible? N/A

BS 501(c)(4), (5), or (6) organizations a Were substantially all dues nondeductible by members N/A b Did the organization make only in-house lobbying expenditures of $2,000 or less? N/A

II Yes' was answered to either &5a or BSb, do not complete BSc through BSh below unless the organization received a wairver for proxy tax owed for the prior year

c Dues, assessments, and similar amounts from members 85C N/A d Section 162(e) lobbying and political expenditures BSd N/A B Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices go N/A 1 Taxable amount of lobbying and political expenditures (line 85d less 85e) 851 NBA p Does the organization elect 1o pay the section 6033(e) tax on the amount on line 850 NBA h It section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount on line 851 to its reasonable estimate of dues

allocable to nondeductible lobbying and political expenditures for tie following tax year? N/A 88 507(c)(7) organizations Enter a Initiation fees and capital contributions Included on line 12 88a N/A

6 Gross receipts, Included on line 12, for pu711c use of club facilities sob N/A 87 501(c)(72) organizations Enter a Gross income from members or shareholders B7e N/A

6 Gross Income from other sources (DO not net amounts due or paid to other sources against amounts due or received from them ) B7b N/A

BB /U any time dining the year, did the organization own a 50% or greater Interest In a taxable corporation or partnership, or an entity disregarded as separate tram the organization under Regulations sections 3017701-2 and 3017701-3? I1 Yes; complete Part IX

BB a 501(c)(3) organizations Enter Amount of tax Imposed on the organization during the year under section 4911 . 0 . , section 4912 . 0 . , section 4955 . 0 .

6 507(c)(3) end 501(c)(4) organizations Did the organization engage In any section 4958 excess benefit transaction during tie year or did It become aware of an excess benefit transaction from a prior year! If 'Yes : attach a statement explaining each transaction

e Enter Amount of tax imposed on the organization managers or disqualified persons donna the year under

~t,:c,. .~~Y <s,.

Located at 1 4025 TONAWANDA DRIVE, DES MOINES, IOWA ZIP+4 . 50312

0 N/A Form 290 (201

92 Section 4947(q)(1) nonaxamiot charitable trusts filing Form 9901n lieu of Form 1041-Check here

5 11140513 742280 20016 2002 .05040 SALISBURY HOUSE FOUNDATION 200161

78 Did the Orpaniza6bn engage In any activity not previously reported to the IRS? It Yes; attach a detailed description of each aqMy 77 Were any changes made In the organizing or governing documents but not reported to the IRS?

If 'Yes .' attach a conformed copy of the Changes 78 a Did the organization have unrelated business gross income of $7,000 or more during tie year covered by this return?

h II Yes,' has It filed a tax return on Form B90-T for this year? 79 Was there a liquidation, dissolution, termination, or substantial contraction during the year?

If Yes; attach a statement 80 a 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? 6 It-Yes :onter the name of the organization 1111~

78 X 77 X

- 78e ~ X 7Bb X 70 X

Boa X

�Bib ~X ~

B2e X

83e' X , 83b X BOa X

eao 658 BSb w m,Rs ,'gX22 3Rs

.,, tt «~a , � ,

t ~([T' 7 Fs~~9:

sections 4912, 4955, and 4958 . 0 . 0 Enter Amount o1 tax on line 89c, above, reimbursed by the organization to. 0 .

BO a List the states with which a copy of this return Is flied " NONE b Number of employees employed In the pay period that Includes March 12, 2002 ~ BOb 9

91 ineoaoksareincareot No- SALISBURY HOUSE FOUNDATION Telephone no " (515) 274-1777

Page 6: 99o - Return of Organization Exempt From Income Tax990s.foundationcenter.org/990_pdf_archive/421/...99o- Return of Organization Exempt From Income Tax Form Under sect Ion 601(c), 627,

42-1415581 Page e

in512513, or 511

Related or exempt Amount function income

Note Enter gross erriounts unless otherwise indicated e 93 Program service revenue e FACILITY USE FEES 6 C a e t Medicare/Medicaid payments p Fees and contracts from government agencies

94 Mambershlp dues and assessments 05 Interest on savings and temporary cash investments 08 DNldends and interest from securities 07 Not rental income or (loss) from real estate

e debt-financed property b not debt-financed property

98 Net rental income or (loss) from personal property 99 Other Investment Income 100 Gain or (loss) from sales of assets

other than Inventory 101 Nat Income or (loss) from special events 102 Gross profit or (loss) from sales of inventory 103 Other revenue

MERCHANDISE SALES 4`_ o MISCELLANEOUS c a e

101 Subtotal (add columns (B), (D), and (Q) 105 Total (add line 104, columns (B), (D), and (E)) Note Line 105 olus line Id. Pert 1 . should eauel the amount

Line No I Explain how each activity for which Income is reported in column (E) of Part VII contributed importantly to the accomplishment of the organization's exempt purposes (other than by providing funds for such purposes)

of I Nature of actNRles income

A

Paid PreDarefs' ` f '~J, signature '(�,~ /)' /~(/ f tar

Prepereri Fi������W MCGOWEN, HUR T, CLARK & UceOnty y,°�� ;;v1ar.m. '1601 WEST LAKES PARKWAY, 223161 wa~..., .na _»_ � LP ., WEST DES MOINES, IA 5026

11140513 742280 20016 2002 .05040

31

(B) Amount

<825,327 .

(e) Did tie organization, during the year, receive any funds, directly or InGlrecty, to (h) Did the organization, during the year, pay premiums, directly or Indirectly, on a I Note If 'Yes' to ( b ) , file Form 8870 end Form 4720 see Instructions

Please unaapmOtlwof pnjuy,IE~~ vutlneve uarNnwdNbmum Inducing~mp cortact, and aWbbls Dsdv,Um of (oM a Mvi olAOr) b bead on VI Inbrm

`S-~ Sign , l4r`-~~ 1 Here Slunatur Date

Page 7: 99o - Return of Organization Exempt From Income Tax990s.foundationcenter.org/990_pdf_archive/421/...99o- Return of Organization Exempt From Income Tax Form Under sect Ion 601(c), 627,

---------------------------------

ToUI number of other employees paid off Iz ~^' 0 " I 0

Compensation of the Five Highest Paid Independent Contractors for Professional Services

(6) Type a1 service (c) Compensation

--------------------------------------------

7 11140513 742280 20016 2002 .05040 SALISBURY HOUSE FOUNDATION 20016 1

SCHEDULE A Organization Exempt Under Section 501(c)(3) OMB NO tit}Op17

(Form 990 or 990-EZ) - (Except Private Foundation) end Section 601(e), 8011), 601(k), 60t(n),orSection e9e7(e)(1) NOnexemptCharitable Trust 'oo

Depntmentollhe Trmury Supplementary Information-(See separate Instructions.) mid aa.U.s.ma 1 MUST be completed by the above organizations and attached to their Form 990 or B90-EZ Name of the organization Employer Identification number

SALISBURY HOUSE FOUNDATION 42 1415581 Part 1 Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees

(Sao papa 1 of lie Instructions List each one I1 there are none, enter *None') e Name and address of each employee aid 6 Title and average hours contribution " to a Expense

per week devoted to (c) Compensation p,N~,~ a h,"�°"' account and otl mo re t han E50,000 position wmp~n~euon allowances

NONE

---------------------------------

---------------------------------

---------------------------------

(e) Name and address of each Independent contractor paid more than $50,000

NONE

--------------------------------------------

--------------------------------------------

--------------------------------------------

Totalnumberofothersrecelvlnpover $50,000 for professional services " I U ar3imAi.u.m LHA For Paperwork Reduction Act Notice . tae the Instructions tar Form 990 end Form 990-EZ rc ` x ( Schedule A(FOrm 980 or 990-EZ) 2002

Page 8: 99o - Return of Organization Exempt From Income Tax990s.foundationcenter.org/990_pdf_archive/421/...99o- Return of Organization Exempt From Income Tax Form Under sect Ion 601(c), 627,

-1415

F~aif 111 StateTents About Activities (See page 2 of the Instructions No

Organizations that made an election under section 501(h) by tiling Form 5768 must complete Part VI-A Other organizations checking Yes; must complete Part VI-B AND attach a statement giving a detailed description of the lobbying activities

2 During the year, has the organization, either directly or Indirectly. engaged In any o1 the following ads with any substantial contributors, ` °, trustees, directors, officers, creators, key employees, or members o1 their families, or with any taxable organization with which any such ' F person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary? Of the answer to any question Is 'Yes,' ` t attach a detailed statement explaining the transactions)

9 Does the organization make grants for scholarships . fellowships, student loans, etc 9 (See Note below ) d Do you have a sectlan 403(b) annuity plan for your emDlayaes9 Note Attach a statement to explain how the organization determines that individuals or organizations recelvlny grants or loans from !f In furtherance of Its charitable programs 'quality' to receive payments

. .yw o~3

5 of the Instructions

10 EJ M Orpanhallon operated for the benefd of a cottage or university owned or operated by a governmental unit Section 170(b)(1)(A)(Iv) (Also complete the Support Schedule In Part IV-A )

118 [XI An organization that normally receives a substantial pad of its support from a governmental unit or from the general public Section 170(b)(1)(A)(vi) (Also complete the Support Schedule In Part IV-A )

116 0 A communitytNSt Section 170(b)(1)(A)(vi) (Also complete the Support Schedule In Part IV-A 12 0 An organization that normally receives (1) more then 991/x% 01 its support from contributions, membership teas, and gross

receipts from activities related to its charitable, etc , functions - subjad to certain exceptions . and (2) no more than 33 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 See section 509(a)(2) (Also complete the Support Schedule In Pad IV-A )

13 0 An organization that is not controlled by any dl5qualAled persons (other than foundation managers) and supports organizations described In

Schedule A (Form BBO or 990-EZ) 2002

8 11140513 742280 20016 2002 .05040 SALISBURY HOUSE FOUNDATION 200161

Schedule A (Form 990 or

1 During tea year, has the organization attempted to Influence national, slate, or local legislation, IncIuGlnq any attempt to Influence public opinion on a legislative matter or referendum? II Yes; enter the total expenses paid or Incurred In connection with the lobbying activities 1 $ $ (Must equal amounts on line 38, Part VI-A, or line I of Part VI-B )

e Sale, exchange, or leasing of property?

D Lending of money or other extension of credit?

c Furnishing of goods, services, or facilities?

d Payment of compensation (or payment or relmCursement of expenses N more than $7,000)7

B Transfer of any part of its Income or assets

X

X

X

The organization Is not a private foundation because h Is (Please check only ONE applicable box ) 6 0 A church, convention a1 churches, or association of churches Section 170(D)(1)(A)(q B D A school section 170(b)(1)(A)(n) (Also complete Part V ) 7 ~ A hospital or a cooperative hospital service organization Section 170(b)(1)(A)(Iii) 8 0 A Federal, state, or local government or governmental unrt Section t70(b)(i)(A)(v) 0 0 A medical research orpantvtion operates In conjunction with 0 hospital Section 170(b)(1)(A)(lil) enter the hospital's name, city,

and state 10,

zxain of xx-a3

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Schedule n(FOrm990or990-EZ)2002 SALISBURY HOUSE FOUNDATION 42-1415581 Page 9 f Ad .iv=aj Support Schedule (Complete onIy H you checked a box on Ane 10, 11, w 12 ) Use cash method of seeounting .

Note ; You me usa the workshea(/n the Instructions !or convertln from the accrual to the cash method of eccountln Calendar year /arfiscal year be g

innin g in) " a 2001 6 2000 (a 1999 ( it) 199 a Total

15 race jDo not include unusual

rants Seeline 2s 737 784 . 830 871 . 861 701 . 3 , 908 , 173 . 6 338 529 . 18 Membershi p fees received 17 Gross receipts from admissions,

merchandise sold or services performed, or furnishing of facilities In any activity that Is related to the organization's cnaritabla,etc,purpose 320 099 . 281 864 . 183 598 . 186 594 . 972 155 .

18 Gross Income from Interest, dividends, amounts received from payments on securities loans (sec- tlon 512(a)(5)), rents, royattles, and unrelated business taxable Income (less section 511 taxes) from businesses acquired by the organization after June 3o,1975 648 433 . 647 f 881 . 402 571 . 77 , 445 . 1 , 776 , 330 .

79 Net Income from unrelated business activities not included In line 18 3 E 462 . 3 , 462 .

pp Tax revenues levi ed for the oruanlutlon's benefit and either paid to It or expended on its behalf

21 The value of services or facilities lumlshed to the organization by a governmental unit without carpe Do not include the value of services or facilities generally lumlsned to lie public without charge Other 22 Income Attach a schedule EE STATEME NT 10 saeotcaclneiasseisr(loss)from

irom 218 . 48,110 . 39 , 949 . B 497 . -96- , 774-,

29 Total oflines 15through 22 1 , 70-9 , 996, 1 f 808 , 726 . 1 , 4-8-7 f 819, 4 180 709 . 9 187 250. 24 Line 23minus line ll 1 , 389 f 897 . 1 , 526 , 862 . 1 , 304 , 221 . 3 , 994 , 115 . 81215,095 . 25 Enter t%otline 23 17 100 . 18 , 087 . 14 , 878 . 41 807 .~~ ~<�u° ~y"z~`t-~~'S 26 Organizations described on lines 10 or 11 a Enter 2% of amount In column (e), line 24 1 28a 164 302 . 0 Prepare a list for your records to show the name o1 and amount contributed by each parson (other than a governmental 's.%-;& -' " ~`t ~ °s gF~~t 77 r~;.. tz°~,~

unit or publicly supported organization ) whose total gifts for 1998 through 2007 exceeded the amount shown In line 26a Do not file tilt list with your return Enter the sum of all these excess amounts 1 ,286 , 461 , 428 .

C Total support for section 509(a)(1) test Enter tine 24, column (e) " 28a 8 215 095 . d AddAmounts from column (e)tarlines 78 1,776,330 . 19 3,462 . ,¢m

22 96f774 . 26o 461, 428 . " 2ea 2 , 337 , 994 . e Public support (line 26c minus line 260 total) 1 ~ 28e ~ 5,877, 101 . 1 Public support oeraentaae (line 269 (numerator) divided by line 26c (denominator)) 11i 211f 71 .5403%

27 Organizations described on line 12 a For amounts Included In lines 15, 16, and 77 that were received from a'Olsqualifled person,' prepare a list for your records to show the name at, and total amounts received In each year from, each 'disqualified person ' Do not file this list with your return Enter the sum of such amounts for each year N/A (2001) (2000) (1999) (1998)

b For any amount included In line 17 that was received from each person (other than 'disqualified persons, prepare a list for your records to show the name of, and amount received for each year, that was more than the larger o1 (7) the amount on line 25 for the year or (2) =5,000 (Include In the list organizations described In lines 5 through 11, as well as Individuals ) Do not file this list with your return After computing the difference between the amount received and the larger amount described In (1) or (?), enter the sum o1 these differences (the excess amounts) for each year N/A (2001 (2000) (1999) (1998)

e Add Amounts from column (e) for lines 15 16 17 20 21 " 27a N/A

d Add Line 27a total and line 27b total 110- 27d N/A e Public support (line 27c total minus line Y70 total) 1 270 N/A _,_ . . 1 Total support for section 509(a)(2) test Enter amount on line 23, column (e) 1 271 NBA p Public support percentage Pine 27e (numerator) divided by line 27f (denominator)) 111~ 27 N/A % h Investment income oereenteae (line 18, column (e) (numerator) divided by line 27f (denominator)) 11111- 27h N/A %

28 Unusual Grants : For an organization described In line 10, 11, or 12 that received any unusual grants during 1998 through 2001, prepare a list far Your, records to show, for each year, the name of the contributor, the date and amount o1 the grant, and a brief description of the nature of the gent Do not file this list with your return Do not include these pants In line 15

zzai:+ of-zxm NONE S� ,e , A (Form 990 W 990-Ez002

11140513 742280 20016 2002 .05040 SALISBURY HOUSE FOUNDATION 200161

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10 11140513 742280 20016 2002 .05040 SALISBURY HOUSE FOUNDATION 20016 1

Schedule A(FOrm990or990-EZ)2002 SALISBURY HOUSE FOUNDATION 42-1415581 Paqea ~Private School Questionnaire (See page 7 oime Instructions) N/A

o b6 completed ONLY b schools that checked the box on line 6 In Part

29 Does the organization have a racially nondiscriminatory policy toward students by statement In Its charter, bylaws . other qovemlnp Yes No

Instrument, or In a resolution of its governing body? 29 90 Does the organization include a statement of its racially nondiscriminatory policy toward students in all Its brochures, catalogues, ,

and other written communications with the public dealing with student admissions . programs, and scholarships? 30 31 Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media during the period o1 ',

solicitation for students, or dollop the registration period 1t R h25 AO solicitation program, IA a way that makes the policy known to all parts of the general community It serves? 91 It Yes,' please describe, 11 'No .' please explain (It you need more space, attach a separate statement )

"' q3 (Y '`

92 Does the organization maintain the following Y

a Records indicating the racial composition of the student body, faculty, and administrative statt9 '92e

h Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? 92b

c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student

admissions. programs, and scholarships? 32c I

d Copies of all material used by the organization or on its behalf to solicit contributions? 32d

I1 you answered 'No' to any of the above, please explain (If you need more space, attach a separate statement ) x ` . ¬

93 Does the organization discriminate by rata In any way with respect to

e Students' rights or privileges? 33a

6 Admissions policies? 93b

e Employment of faculty or administrative staM 33c

d Scholarships or other financial assistance? 33d

e Educational policies? Me

f Use of facilities? 33f

p Athletic programs? 93

h Other extracurricular activities? 33h

If you answered Yes'to any o1 the above, please explain (11 you need more space, attach a separate statement ) " °" °3 6~"i~~ aM;'I

.L IV 6£

.w~f 94 a Does the organization receive any financial old or assistance from a governmental agency? 34a

b Has the organization's night to such old ever been revoked or suspended? 94b

It you answered Yes'to either 34a or b, please explain using an attached statement 95 Does the organization certify that It has complied with the applicable requirements of sections 4 01 through 4 OS of Rev Prac 75-50,

7975-2 C B 587, covering racial nondiscrimination? 11 'No,' attach an explanation 95

Schedule A (Form 990 or 9B0-EZ) 2002

173171 01-22 03

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990or990-EZ)2oo2 SALISBURY HOUSE FOUNDATION Lobbying Expenditures by Electing Public Charities (See page 9 of the mstmcnons ) (To 6A comoleled ONLY by an elloi6te oraanhallon that filed Form 57681

(1) Affiliated group

totals

(b) To be completed for ALL electing organizations

38 Total lobbying expenditures to Influence public opinion (grassroots lobbying) 97 Total lobbying expenditures to Influence a legislative body (dived lobbying) 98 Total lobbying expenditures (add lines 36 and 37) 39 Other exempt purpose expenditures 40 Total exempt purpose expenditures (add lines 38 and 39) Ol Lobbying nontaxable amount Enter iheamount from thefollowing table -

II the amount on line 40 Is - The lobbying nontaxable amount Is -Not wv 5500 OW 20% of Me arnp..t on line 40 Ovs 1300,000 but not over f 1 000 000 1100,000 Plug 15% of Me vses, Me, {500,000

puvf1,000,000bulnolwwS1500000 $175 000 plus 10% of Me excess Wer, $1,0D0 ODD

Over j1,300,000butnotwerS17000,000 St2500Dplus 5% of Me excess over $1 500,0DO

P~1rf17000,000 {1,Opp,OpD

42 Grassroots nontaxable amount (enter 25% of line 41) 43 Subtract line 42 from line 36 Enter -0- K line 421s more than line 36 44 Subtract line 41 from line 38 Enter-0- n line 41 Is more than line 38

41

1-Year Averaging Period Under Seatlon 6010) (Some organizations that made a section 501(h) election do not have to complete all of the five catumns

below Seethe Instructions for lines 45 through 50 on gape 11 of the Instructions )

Lobbying Expenditures During 4-Year Averaging Period N/A

Calendar year (or (a) (b) 10 (d) (9) fiscal year beginning in) 1110, 2002 2001 2000 1999 Total 45 Lobbying nontaxable

amount 0 . 46 Lobbying telling amount =" 7 F ~ ~ a, " " < -~ yF "

150% of line 45 (o tl 47 Total lobbying

expenditures 0 . 08 Grassroots nontaxable

amount 0 . 49 Grassroots celliny amount

k . i9(` 150%o1line 48e 50 Grassroots lobbying

ex endflures 0 . Part VI-B Lobbying Activity by Nonelectinp Public Charities

(For reporting only by organizations that did not complete Part VI-A) (See page 11 01 the Instructions ) NBA During the year, did the organization attempt to Influence national, state or local legislation, Including any attempt to

yet No Amount Influence public opinion on a legislative matter or referendum, through the use of I Volunteers f h Paid staff or management (Include compensation In expanses reported on lines c through h C Media advertisements d Mailings to members, legislators, or the public a Publications, or published or broadcast statements 1 Grants to other organizations for lobbying purposes p Direct contact wRh laplslators, their sWHS, government officials, or a legislative body h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means I Total lobbying expenditures (Add Iinese through h ) 0 .

I1 Yes'to any of the above, also attach a statement giving a detailed description of the lobbying activities 22371 01-22-M Schedule A (Farm 990 or 990-E2) 2002

11 11140513 742280 20016 2002 .05040 SALISBURY HOUSE FOUNDATION 20016 1

Limits on Lobbying Expenditures

term 'expenditures' means amounts pald or Incurred

-1415581 - N/A

must file Form 4720

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Schedule a(FOrm990or990-ez)2002 SALISBURY HOUSE FOUNDATION 42-1415581 Page B 11 . Information Regarding Transfers To and Transactions and Relationships With Noncharitable

Exempt Organizations (See pant 12 of the Instructions ) 61 Did the reporting organization directly or indirectly engage In any a1 tie following with any other organization described In section

501(c) of the Code (other than section 501(c)(3) organizations) or in section 521, relating to political organizations? e Transfers from tie reporting organization to a noncharltabla exempt organization of Yes No

Ih) 10 (d) Line no Amount Involved Name a1 nanchanWble exempt organization Description of transfers, transactions, and arrangements

62 a Is the organization directly or Indlredy affiliated with, or related to, one or more fax-exempt organizations described In section 501(c) 01 the Coda (other than section 501(c)(3)) or In section 5277 111" 0 Yes No

b If Yes .' complete the tollowlna schedule N/A

(b) Type of organization

Schedule A (Form 090 or 9B0-EZ) 2002 12

2002 .05040 SALISBURY HOUSE FOUNDATION 20016 1 11140513 742280 20016

(q Cash (II) Other assets

D Other transactions (I) Sales or exchanges of assets With a noncharttable exempt organization (II) Purchases of assets from a noncharllaDle exempt organization

(III) Rental a1 facilities, equipment, or other assets IN) Reimbursement arrangements (v) Loans or loan guarantees (vi) Performance of services or membership or fundraising solicitations Sharing of facilities, equipment, mailing fists, other assets, or paid employees If the answer to any of the above is 'Yes .' complete the following schedule Column (6) should always show the fair market value of the goads, other assets, or services given by the reporting organization If tie organization received less than fair market value In any

or services received

61e(1) X Cpl X

b(l) X b i ll) X b(III) X 6(N) X 6(v) X h(vl) X e X

(a) Name of orq

(C) Description o1 relationship

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Form 8868 (December 2000) Dyvlnient ol N6 Treasury InIemN Rwsnue Servim

Application for Extension of Time To File an Exempt Organization Return I OMB No 1545 1709

10, FIFO 8 for each return

Note Form B90-T corporations requesting en automatic 6-month extension - check this box end complete Pert I only ED All other corporations Qncludlnp Form 990-C Tiers) must use Form 7004 to request an extension of time to file Income tax returns Partnerships, REMICs end busts must use Form 8 736 to request en extension of time to file Form 7065, 1066, or 1041 Type or Name of Exempt Organization Employer Identification number print

File by lbe due date for rang you, Mum 9w m.wcuom

Number, street, end room or suite no Ii e P O box, see Instructions 4025 TONAWANDA DRIVE City, town or post office, state, end ZIP code For e foreign address, sea Instructions

23 11160423 742280 20016 2002 .05040 SALISBURY HOUSE FOUNDATION 200161

" I/ you ere filing for an Automatic 3-Month Extension, complete only Part I and check INS box 11 00 " H you are filing for an Additional (not automatic) 3-Month Extension, complete only Part II (on gape 2 of this form) Note Do not complete Part II unless you have already been granted en automatic 3-month extension on a previously tiled Form 8888

Pan 1' Automatic 3-Month Extension of Time - Only submit original (no copies needed

Cheek type of return to be flied (file a separate application for each return)

EKI Form 980 0 Form 890~T (corporation) ~ Form 4720 0 Form 980-BL ~ Form 990~T (sec 401(e) or 408(e) trust) ~ Form 5227

Form B90-EZ ~ Forth BBO T (trust other then above) ~ Form 8069 0 Form 990 PF ~ Form 1041 A 0 Form 8870

" Ii the organization does not have en office or piece of business In the Untied States, aback this box " II this Is (or a Group Return, enter the organization's four digit Group Exemption Number (GEFfj II this la (or the whole group, check this box " 0 Ii k Is for part o1 the group, cheek this box " = end attach a list with the names and Me o1 ell members the extension will cover

7 I request en automatic 3-month (6-month . for 680-T corporation) extension of time until AUGUST 15, 2003 to Ille the exempt orpantratbn return for the organization named above The extension Is for the organization's return for " ~ calendar year 2 0 0 2 or " ~ tax year beginning , end ending

2 II this tax year Is for less than 12 months, check reason F-1 Initial return 0 Final return 0 Change In accounting period

3a If this application Is for Form 990-8L, 990 PF, 990~T, 4720, or 6068, enter the tentative tax, less any nonrefundable credits See Instructions

b N this application Is for Forth B90~PF or 990~T, enter any refundable credits end estimated tax payments made Include any prior year overpayment allowed as a credit

c Balance Due . Subtract line 3b from fine 3a Include your payment with this forth, w, H required, deposit with FTD coupon or, K required, by using EFTPS (Electronic Federal Tax Payment System) See Instructions $ N/A

Signature and Verification

Under penalties of per/ury, I Declare that I have examined this forth, Including accompanying schedules and statements, and to the best o1 my knowledge and ballet, M IS true, comet d complete, and that I am authorized prepare this forth

Sionature " 11 ~ wVi\ ~~ ~ Title " ( ,1 / ' Date " LHA For Paperwork Reduction Act Notice, see Instruction Form 8888 (12-2000)

2231131 ao-oi-oz

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TOTAL 77,361 83,888 - 161,249

SALISBURY HOUSE FOUNDATION 42-1415581

FORM 990 DEPRECIATION SCHEDULE

COST BEGINNING ENDING BALANCE ADDITIONS REDUCTIONS BALANCE

LAND 143,850 - - 143,850 BUILDINGS 3,839,898 1,011,015 - 4,850,913 EQUIPMENT 41,566 3,607 - 45,173

TOTAL 4,025,314 1,014,622 - 5,039,936

ACCUMULATED DEPRECIATION BEGINNING ENDING BALANCE ADDITIONS REDUCTIONS BALANCE

LAND - - _ _ BUILDINGS 56,351 74,405 - 130,756 EQUIPMENT 21,010 9,483 - 30,493

Page 15: 99o - Return of Organization Exempt From Income Tax990s.foundationcenter.org/990_pdf_archive/421/...99o- Return of Organization Exempt From Income Tax Form Under sect Ion 601(c), 627,

SALISBURY HOUSE FOUNDATION 42-1415581

FORM 990 " GAIN (LOSS) FROM PUBLICLY TRADED SECURITIES STATEMENT 1

1,470,257 . 2,255,429 . 0 .

47,877 . 80,722 . 0 .

300,000 . 307,310 . 0 .

1,818,134 . 2,643,461 . 0 .

<7,310 .>

<825,327 .> TO FORM 990, PART I, LINE B

GROSS CONTRIBUT . GROSS DIRECT NET DESCRIPTION OF EVENT RECEIPTS INCLUDED REVENUE EXPENSES INCOME

SALISBURY FAIRE - RENAISSANCE FESTIVAL 264,394 . 264,394 . 232229 . 32,165 .

TO FM 990, PART I, LINE 9 264,394 . 264,394 . 232229 . 32,165 .

FORM 990 OTHER CHANGES IN NET ASSETS OR FUND BALANCES STATEMENT 3

DESCRIPTION

UNREALIZED GAIN/LOSS ON INVESTMENTS

TOTAL TO FORM 990, PART I, LINE 20

AMOUNT

564,203 .

564,203 .

16 STATEMENT S) 1, 2, 3 11140513 742280 20016 2002 .05040 SALISBURY HOUSE FOUNDATION 200161

DESCRIPTION

WELLS FARGO EQUITY FUND WELLS FARGO INTERN'L FUND WELLS FARGO FIXED INCOME

GROSS COST OR EXPENSE SALES PRICE OTHER BASIS OF SALE

NET GAIN OR (LOSS)

<785,172 .>

<32,845 .>

FORM 990 SPECIAL EVENTS AND ACTIVITIES STATEMENT 2

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42-141581 SALISBURY HOUSE FOUNDATION

FORM 990 ' OTHER EXPENSES STATEMENT 4

RENT 1,555 . 1,555 . TOUR GUIDE 8,360 . 8,360 . SOUVENIRS 12,523 . 11,237 . 1,286 . ADVERTISING 12,409 . DUES AND SUBSCRIPTIONS 4,050 . 4,050 . OTHER 9,818 . 6,926 . 2,892 . SECURITY EXPENSE 14,269 . 14,269 . D & O INSURANCE 2,920 . 2,920 . PROPERTY INSURANCE 42,090 . 33,672 . 8,418 . INVESTMENT FEES 20,867 . 20,867 . UTILITIES 32,738 . 26,190 . 6,548 . CONSULTING FEES 6,590 . 435 . 6,155 .

17 STATEMENT S) 4, 5, 6 11140513 742280 20016 2002 .05040 SALISBURY HOUSE FOUNDATION 20016 1

(A) (B) (C) PROGRAM MANAGEMENT

DESCRIPTION TOTAL SERVICES AND GENERAL

(D)

FUNDRAISING

12,409 .

TOTAL TO FM 990, LN 43 168,189 . 102,644 . 46,981 . 18,564 .

FORM 990 STATEMENT OF ORGANIZATION'S PRIMARY EXEMPT PURPOSE STATEMENT 5 PART III

EXPLANATION

TO PRESERVE AND MAINTAIN THE SALISBURY HOUSE, A HISTORIC MANSION ON THE NATIONAL REGISTER OF HISTORIC PLACES, AND TO CONVERT TO A FULL-TIME MUSEUM .

FORM 990 OTHER REVENUE NOT INCLUDED ON FORM 990 STATEMENT 6

DESCRIPTION AMOUNT

SPECIAL EVENT EXPENSES 232,229 .

TOTAL TO FORM 990, PART IV-A 232,229 .

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SALISBURY HOUSE FOUNDATION 42-1415581

FORM 990 OTHER EXPENSES NOT INCLUDED ON FORM 990 STATEMENT 7

DESCRIPTION

SPECIAL EVENT EXPENSES

TOTAL TO FORM 990, PART IV-H

AMOUNT

232,229 .

232,229 .

18 STATEMENT S) 7, 8 11140513 742280 20016 2002 .05040 SALISBURY HOUSE FOUNDATION 200161

FORM 990 PART V - LIST OF OFFICERS, DIRECTORS, STATEMENT 8 TRUSTEES AND KEY EMPLOYEES

EMPLOYEE TITLE AND COMPEN- BEN PLAN EXPENSE

NAME AND ADDRESS AVRG HRS/WK SATION CONTRIB ACCOUNT

SCOTT BRUNSHEEN EXECUTIVE DIRECTOR 40 HR 79,000 . 4,740 . 0 .

DES MOINES, IA

ANN PROSS ASSOCIATE DIRECTOR 40 HR 54,000 . 3,240 . 0 .

DES MOINES, IA

BRUCE KELLEY CHAIRMAN 2 0 . 0 . 0 .

DES MOINES, IA

BOB HOUSER CHAIRMAN EMERITUS 2 0 . 0 . 0 .

DES MOINES, IA

ED HANSELL VICE CHAIRMAN 2 0 . 0 . 0 .

DES MOINES, IA

FRED HASKINS TREASURER 2 0 . 0 . 0 .

DES MOINES, IA

MARTHA SMITH SECRETARY 2 0 . 0 . 0 .

DES MOINES, IA

CHRIS HENSLEY DIRECTOR 2 0 . 0 . 0 .

DES MOINES, IA

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19 STATEMENT S) 8 11140513 742280 20016 2002 .05040 SALISBURY HOUSE FOUNDATION 200161

' SALISBURY HOUSE FOUNDATION 42-1415581

BILL PRITCHARD DIRECTOR 2 0 . 0 . 0 .

DES MOINES, IA

TOM BERNAU DIRECTOR 2 0 . 0 . 0 .

WEST DES MOINES, IA

KEN BONUS DIRECTOR 2 0 . 0 . 0 .

DES MOINES, IA

JACQUIE BREWER DIRECTOR 2 0 . 0 . 0 .

DES MOINES, IA

LYNDA CHASE DIRECTOR 2 0 . 0 . 0 .

DES MOINES, IA

BETTY EHLERT DIRECTOR 2 0 . 0 . 0 .

DES MOINES, IA

JEFF HUNTER DIRECTOR 2 0 . 0 . 0 .

DES MOINES, IA

TOM JUCKETTE DIRECTOR 2 0 . 0 . 0 .

CLIVE, IA

KENT MAUCK DIRECTOR 2 0 . 0 . 0 .

DES MOINES, IA

ELVIN MCDONALD DIRECTOR 2 0 . 0 . 0 .

WEST DES MOINES, IA

PAUL MEGINNIS DIRECTOR 2 0 . 0 . 0 .

DES MOINES, IA

ADDISON PARKER DIRECTOR 2 0 . 0 . 0 .

DES MOINES, IA

JACK PORTER DIRECTOR 2 0 . 0 . 0 .

DES MOINES, IA

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42-141581

0 .

0 .

0 .

0 .

0 .

0 .

DES MOINES, IA

JIM VICKERY

DES MOINES, IA

JIM WINDSOR

DES MOINES, IA

MICHAEL WOLNERMAN

URBANDALE, IA

0 . 0 .

0 . 0 . DIRECTOR 2

SCHEDULE A OTHER INCOME STATEMENT 10

1999 AMOUNT

39,949 .

39,949 .

1998 AMOUNT

8,497 .

8,497 .

2001 AMOUNT

218 .

218 . 48,110 .

20 STATEMENT S) B, 9, 10 2002 .05040 SALISBURY HOUSE FOUNDATION 200161 11140513 742280 20016

SAI;ISBURY HOUSE FOUNDATION

SARAH ROY

DES MOINES, IA

JAMS RUAN

DES MOINES, IA

JOE SMITH

DIRECTOR 2

DIRECTOR 2

DIRECTOR 2

DIRECTOR 2

DIRECTOR 2

0 . 0 .

0 . 0 .

0 . 0 .

0 . 0 .

TOTALS INCLUDED ON FORM 990, PART V 133,000 . 7,980 . 0 .

FORM 990 PART VIII - RELATIONSHIP OF ACTIVITIES TO STATEMENT 9 ACCOMPLISHMENT OF EXEMPT PURPOSES

LINE EXPLANATION OF RELATIONSHIP OF ACTIVITIES

93 FACILITY USE FEES PROVIDE IMPORTANT ONGOING REVENUE TO SUPPORT THE DAY TO DAY ACTIVITIES AT THE MUSEUM, AND TO INCREASE THE PUBLIC AWARENESS OF THE MUSEUM AS A CULTURAL TREASURE FOR THE STATE OF IOWA .

101 SPECIAL EVENTS SERVE TO INCREASE PUBLIC AWARENESS OF SALISBURY HOUSE AND TO PROMOTE THE FACILITY AS AN OUTSTANDING MUSEUM .

94 MEMBERSHIP SUPPORT THE ONGOING EDUCATIONAL NATURE OF THE MUSEUM .

DESCRIPTION

MISCELLANEOUS

TOTAL TO SCHEDULE A, LINE 22

2000 AMOUNT

48,110 .