20
r ; 90- Form pF Return of Private Foundation or Section 4947(a)(1) Nonexempt Chantable Trust Treated as a Private Foundation LOOL Depain em of fin, Tremor IntmW Revenue Sernca NoG The of tax year bi y be able to use e copy of this return m satiny stele reporting requirements For calendar end Employer identification number J9-171V1 R°w"n'sift B Telephone number or type p VANIR & BUT See Specific Instructions City or town, sate, and ZIP coda 1G1017G0-/74V II eaeripoon application n pending cnerk here, 1 1 Foreign organizations, check here po. 0 2 For<i~ aQan¢aoom mnonp the e9% test, check h>a end attach wnpudwn 1 If private foundation status was terminated under section 507(b)(1)(A), check here DO, If the foundation is in a 60-month termination under section 507( b)( 1 )~ B), check here (e) Adjusted not (4) am,,,,e^K^b income is `""°°-° a°'°°"' line 12 Form 000-PF(2002) LHA For Paperwork Reduction Act Notice, see the instructions OMB No 751S0052 Use the IRS Name of organization label HE PATRICK J . do MARILYN W . 0'NEILL Omernae, FAMILY FOUNDATION print Nurtbr mid street IQ P O Eon nunES A mal o not deLve~E to Street oder .) H Check type of organ¢aLOn LX1 Section 501(c)(3) exempt private foundation 0 Section 4947(a)(1) nonexempt chanlable trust 0 Other taxable private foundation I Fair market value of all assets at end of year J Accounting method ELI Cash 0 Accrual (from Part 11, ml (c), line 76) 0 Other (speedy) $ 9 3 313 . (Part 1 . column (d) must on cash basis Part I Analysis of Revenue end Expense, (~) pevenue and (b) Net investment o ~iyn equal o w~i~~~m aj )(a) ~ ~t expenses expenses per books income 1 Contributions, gifts, grants, etc , received Chcdo-a ANsbunErtonnnotnqunlbvmch5eli B 2 Distributions tram sphlinlarest trusts Intent on aa,nnpa and 1ertpQay -" mvahrcnb 1 Dividends and interest from securities 5e Grass rents b Mat renal orcame a Cam) m Net goon a Los) from ale d emote not on o line io C b Cross sale> Pnu la all 13 ,7 35 . i axb on line 6a 0 Q 7 Capital gain net income (hvm Pal IV line i) B Net shah term capital gain 'T9 D Income modifications c 10! Gr°v~°i°vreWma ana N~owancea b Lea Cost d pooch sold v c Gross profit or (loss) 11 Other income 12 Total Add lines I throu gh 11 13 Corripanvoon at oMsen dnsim trustees arc C 11 Other employee salaries and wages 15 Pension plans, employee benefits ~p a pp??p 1Ea Legal fees b Accounting lees STMT 2 e Other professional fees > 17 Interest 10 Taxes °- 10 Depreciation and depletion c 9E 20 Occupancy a 21 Travel, conferences, and meetings 9 m 22 Printing and publications Yd Other expenses STMT 3 m 21 Total operating and administrative expenses Add lqtss3pruF- and Net inpti;F{n) tibbliie 6 ( van ,i -o )

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Page 1: Form Return of Private Foundation990s.foundationcenter.org/990pf_pdf_archive/341/... · r Form ;90- pF Return of Private Foundation or Section 4947(a)(1) Nonexempt Chantable Trust

r

;90- Form pF Return of Private Foundation or Section 4947(a)(1) Nonexempt Chantable Trust

Treated as a Private Foundation LOOL Depain em of fin, Tremor IntmW Revenue Sernca NoG The

of tax year bi y be able to use e copy of this return m satiny stele reporting requirements

For calendar end

Employer identification number

J9-171V1 R°w"n'sift B Telephone number

or type p VANIR & BUT See Specific Instructions City or town, sate, and ZIP coda

1G1017G0-/74V

II eaeripoon application n pending cnerk here, 1

1 Foreign organizations, check here po. 0 2 For<i~ aQan¢aoom mnonp the e9% test,

check h>a end attach wnpudwn 1

If private foundation status was terminated under section 507(b)(1)(A), check here DO,

If the foundation is in a 60-month termination under section 507(b)( 1 )~ B), check here

(e) Adjusted not (4) am,,,,e^K^b income is ̀ ""°°-° a°'°°"'

line 12

Form 000-PF(2002) LHA For Paperwork Reduction Act Notice, see the instructions

OMB No 751S0052

Use the IRS Name of organization

label HE PATRICK J . do MARILYN W . 0'NEILL Omernae, FAMILY FOUNDATION

print Nurtbr mid street IQ P O Eon nunES A mal o not deLve~E to Street oder.)

H Check type of organ¢aLOn LX1 Section 501(c)(3) exempt private foundation 0 Section 4947(a)(1) nonexempt chanlable trust 0 Other taxable private foundation

I Fair market value of all assets at end of year J Accounting method ELI Cash 0 Accrual (from Part 11, ml (c), line 76) 0 Other (speedy)

$ 9 3 313 . (Part 1. column (d) must 1» on cash basis Part I Analysis of Revenue end

Expense, (~) pevenue and (b) Net investment o

~iyn equal o w~i~~~m aj )(a) ~ ~t expenses expenses per books income

1 Contributions, gifts, grants, etc , received Chcdo-a ANsbunErtonnnotnqunlbvmch5eli B

2 Distributions tram sphlinlarest trusts Intent on aa,nnpa and 1ertpQay -" mvahrcnb

1 Dividends and interest from securities

5e Grass rents

b Mat renal orcame a Cam) m Net goon a Los) from ale d emote not on o a° line io C b Cross sale> Pnu la all

13 ,7 35 . i axb on line 6a 0 Q 7 Capital gain net income (hvm Pal IV line i)

B Net shah term capital gain

'T9 D Income modifications c 10! Gr°v~°i°vreWma ana N~owancea

b Lea Cost d pooch sold

v c Gross profit or (loss)

11 Other income 12 Total Add lines I through 11

13 Corripanvoon at oMsen dnsim trustees arc C 11 Other employee salaries and wages

15 Pension plans, employee benefits ~p a pp??p 1Ea Legal fees

b Accounting lees STMT 2 e Other professional fees

> 17 Interest

10 Taxes

°- 10 Depreciation and depletion c 9E 20 Occupancy

a 21 Travel, conferences, and meetings 9 m 22 Printing and publications

Yd Other expenses STMT 3

m 21 Total operating and administrative expenses Add lqtss3pruF-

and

Net inpti;F{n) tibbliie 6 ( van�,i -o )

Page 2: Form Return of Private Foundation990s.foundationcenter.org/990pf_pdf_archive/341/... · r Form ;90- pF Return of Private Foundation or Section 4947(a)(1) Nonexempt Chantable Trust

(o) Fair Marked Value 1 .465 .

91,848 .

Organizations that follow SFAS 117, cheek hen " U end complete lines 24 through 20 end lines 30 end 31 m

Ou 24 Unrestricted m 25 Temporarily restricted m CD 25 Permanently restricted

Organizations wet do not follow SFAS 117, check here end complete lines 27 through 31

m 27 Capital stock, trust principal, or current funds 28 Paid-in or capital surplus, or land, bldg , and equipment fund

u a 29 Retained earnings, accumulated income, endowment, or other funds 30 Total not assets or fund balances Z

From G90-PF Rooxl zzasn 01 zoos

" THE PATRICK J . & MARILYN W . O~NEILL Form 990-PF(2002) FAMILY FOUNDATION

Part II Be lance Sheets "m`°'°`°'°°1°"aMinor ~~maMoom~ Beginning o'

year wGm~eoulMb~naayaiwouobony /~~BookV2117e

1 Cash non-interest-bearing 2 Savings and temporary cash investments 3 Accounts receivable

Less allowance for doubtful accounts I Pledges receivable 11,

Less allowance for doubtful accounts 5 Grants receivable 0 Recervables due from officers, directors, trustees, and other

disqualified persons 7 OCinnoOnmObamiwvbY 1

Less allowance tot doubtful accounts m 8 Inventories for sale or use m 0 Prepaid expenses and deferred charges °m a 10e Investments - U S and state government o6ligaGons

b Investments -corporate stock STMT $ e Investments corporate bonds

71 in+smnmn had evions, and squipment band; Pa.

12 Investments - mortgage loans 13 Investments - other 14 Land, buildings, and equipment bass 110,

lm=umuhbdAiDradiaOOn

15 Other assets (describe

17 Accounts payable and accrued expenses 18 Grants payable

m 19 Deferred revenue 4" 20 LaaishomoliKma Evxmn trushea Win oNwEisqualdiadpeaona

0 21 Mortgages and other notes payable J 22 Other lubilihes (describe Is-

-191000R Pane 2

Part III Analysis of Changes in Net Assets or Fund Balances

1 Total net assets or fund balances at beginning of year - Pan II, column (a), line 30 (must agree with end-of-year figure reported an prior year's return)

2 Enter amount from Pan I, line 27a 3 Other increases not included in line 2 (itemize) I Add bass 1, 2, and 3 5 Decreases not included in line 2 (itemize) 10- SEE STATEMENT 4 0 Total net assets or fund balances at end al year (line 4 minus line 5) - Pan II, column (b), line 30

Page 3: Form Return of Private Foundation990s.foundationcenter.org/990pf_pdf_archive/341/... · r Form ;90- pF Return of Private Foundation or Section 4947(a)(1) Nonexempt Chantable Trust

a

(E) Date sold (mo,day, yr )

(h) Gain or (loss) (e) plus (f) minus (g)

e in column (h) and ovmed by the foundation an 12/d 1/69

(1) AdNSted basis (k) Excess of col (Q as of 12/d 1169 over col (1), A any

(I) Gains (Col (h) gain minus coi (k), but not less than -0 ) or

Losses (from col (h)) (i) F M V as of 1213 1/69

5 Mulbpty line 4 by line 3

e

7 Add lines 5 and 8

8 Enter qualifying distri6u4ons from Part Xil, line 4 1 0 1 14 , U U Z3 . If line 8 n equal to or greater than line 7, check the box in Part VI, tine 16, and complete that part using a 1°H fax rate See the Part VI instructions

773571A1 2103 Fvm 000-PF (2002)

" THE PATRICK J . & MARILYN W. 0'NBILL Form 990-Pf(20021 , FAMTT.Y F(1TTNi)ATTffN Part IV 1 l:apiL81 Valns anC Losses ror I ax on investment income

(e) List and describe the kind(s) of property sold (e g , real estate, 2-story brick xarehouse, or common stock, 200 shs MLC Co )

1e 185 SHS GENERAL ELECTRIC b 160 SHS MICROSOFT e d e

(e) Gross sales price IQ Depreciation allowed (p) Cost or other bass (or allov2ble) plus expense of sale

for asset

(c) Date acquired (ma , day, yr )

1 2 Capitol gain net income or (net capital loss)

If gain, also enter in Part I, line 7 t If (loss), enter -0- in Part I, line 7 I

3 Net short term capital gain or (loss) as defined in sections 1222(5) and (6) It gain, also enter m Part I, line B, column (c) If (loss). enter -0- in Part I . line B

YaR V I wauncation under section a9411.11(e) ror Heaucea i ax on net mve: (For optonal use by domestic private foundations subject to the section 4940(a) fax on net investment income )

II section 4940(d)(2) applies, leave this part blank

Was the organization liable for the section 4942 tax on the distri6utahle amount of any year in the base periods ~ Yes [k] No If'Yes,'the organization does not qualify under section 4940(e) Do not complete this part 1 Enter the appropriate amount in each column for each year, see instructions before making any entries

Base period years AdNSteC qualifying distribu~ons Net value of noncha) rifable-use assets DisVi6u6on ratio Calendar veer for tea veer beainninn in) (col (b) divided by col (c))

2 Total of line 1, column (d) 3 Average distribution ratio for the 5-year base period - divide the total on line 2 by 5, or by the number of years

the foundation has bean in existence A less than 5 years

Enter the net value of nonchariGhle use assets for 2002 from Part X, line 5

D Enter 1% of net investment income (1Y of Part I, line 27b)

Page 4: Form Return of Private Foundation990s.foundationcenter.org/990pf_pdf_archive/341/... · r Form ;90- pF Return of Private Foundation or Section 4947(a)(1) Nonexempt Chantable Trust

THE PATRICK J . & MARILYN W . O'NBILL

part VI txase I ax t3asecf on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948 - see 1s Exempt operating foundations described in section 4940(d)(2), check here 111,- L-J and enter T7/A' on line 1

Date of ruling letter (attach copy of ruling I1Cer it necessary-ses instructions) b Domestic organizations that meat the section 4940(x) requirements in Part V, check here No- ITO and enter 1% 1

of Part I, line 27b e All artier domestic organizations enter Y/o of tine 27b Exempt foreign organizations enter 4% of Part I, line 12, col (b) 2 Tax under section 511 (domestic section 4947(x)(1) trusts and taxable foundations only Others enter -0 ) 2 3 Add lines 1 and 2 3 I Subtitle A (income) tax (domestic section 4947(x)(1) trusts and taxable foundations only Others enter -0-) 5 Tax based on investment income Subtract line 4 from line 3 If zero or less, enter -0- 0 Credits/Payments a 2002 estimated tax payments and 2001 overpayment credited t0 2002 de b Exempt foreign organizations -tax withheld at source Eb e Tax paid with application for extension of hma to file (Farm 8868) Oe d Backup withholding erroneously withheld Ed

7 Total credits and payments Add lines 6a through 6d 8 Enter any penalty for underpayment of estimated fax Check here 0 if Form 2220 is attached 0 Tax due If the total of lines 5 and B is more than line 7, enter amount owed 10 Overpayment If line 7 is more than the total of lines 5 and 8, enter the amount overpaid 11 Enter the amount of line 10 to he Credited to 2003 estimated h: Is, Z 'J 2 ,I Refunded Do,

11 Did the organization comply with the public inspection requirements for its annual returns and exemption application? I 11 I X I Web site address * N/A

12 The books are in cue of No- DANIEL J . O'NEILL Telephone no " 216-321-3159 Located at " 2589 BERKSHIRE ROAD CLEVELAND HTS . . OH ZiP .4 X44106

13 Section 4947(x)(1) nonexempt charitable trusts filing Form 990 PF in lieu of Form 1011 " Check here Bl. ED and enter the amount of tax-exempt interest received or accrued during the year 0.1 13 N/A

of z~ F~ 090-PF Roan

Form 990 PF

1e During the fax year, did the organization attempt to influence any national, state, or local legislation or did n par4cipate or intervene in any political campaign? Is

b Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see instructions for definition)? tb If the answer is 'Yes' to 1a or 1D, attach e defected description o/ the activities end copies o/ any materials published or distributed by the organ¢efqn in connectan with the activities

e Did the organization file Form 1120 "POL for this year! 10 d Enter the amount (A any) of tax on political expenditures (section 4955) imposed during the year

(1) On the organization 1 $ 0 . (2) On organization managers ~ $ 0 . e Enter the reimbursement (if any) paid by the organization during the year for political expenditure tax imposed on organization

managers 1 $ 0 . 2 Has the organization engaged in any activities that have not previously been reported to the IRS?

11 "Yes,' attach a detailed description of the activities 3 Has the organization made any changes, nod previously reported to the IRS, in He governing instrument articles of incoiporabon, or

bylaws, or other similar instruments? 1/'Yes,"attach e conformed copy of the changes le Did the organization have unrelated business gross income of $1,000 or more during the year? b If Yes; has it tiled a tax return on Form 900-T for this year? N/A

5 Was there a liquidation, termination, dissolution, or substantial contraction during the yeah If 'Yes," attach the statement required by General Instruction T

0 Are the requirements of section 508(e) (relating to sections 4941 though 4945) satisfied either " By language in the governing instrument or " By state legislation that effectively amends the governing instrument so that no mandatory directions that conflict with the slate law

remain in the governing instrument's 7 Did the organization have at leash $5,000 in asset at any Mme during the year's

If "Yes, " oomplefe Pert 11, cot (c), end Pert XV 0e Enter the states to which the foundation reports or with which it is registered (see instructions)

b If the answer is Yes to line 7, has the organizaUon furnished a copy of Form 990-PF to the Attorney General (or designate) of each state as required by General Instruction G7 1/'No,' attach explanation

9 Is the organization claiming status as a private operating foundation within the meaning of section 4942(j)(3) or 4942(j)(5) for calendar year 2002 or the taxable year beginning in 2002 (see instructions far Part XIV)9 If 'Yes,' complete Part XIV

10 Did any persons become substantial contributors during the tax yeah n "ri amen a xn.dui . usnnp m .r ~ wa mareasas

Page 5: Form Return of Private Foundation990s.foundationcenter.org/990pf_pdf_archive/341/... · r Form ;90- pF Return of Private Foundation or Section 4947(a)(1) Nonexempt Chantable Trust

THE PATRICK J . & MARILYN W . O'NEILL

Yes Uj Na

Yes Uj No 0 Yes E~j No

Yes Uj Na

Yes [k) No

0 Yaa ~ No

N/A ~ ED

(d) Agree to pay money or property to a government oKcuh (Exceptron Check *No' d the organization agreed to make a grant to or to employ the official for a period after termination of government service, if terminating within 90 days

b II any answer is Yes' to 1a(1) (6), did any of the acts tail to quality under the excepbons described in Regulations section 5,7 4941(d)-3 or m a current notice regarding disaster assistance (sea page 19 of the instructions)? Organizations raying on a current notice regarding disaster assistance check here

zz~1, 01 zloa

Form 990-PF

File Form 4720 rt any item a checked in the 'Yes' column, unless an exception apples 1e During the year did the organization (either directly or indirectly)

(1) Engage m me sale or exchange, or leasing of property with a disqualified person? (2) Barrow money ham, lend money to, or otherwise extend credit to (or accept it from)

a disqualified person? (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? (1) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? (S) Transfer any income or assets to a disqualified person (or make any of either available

for the benefit or use of a disqualified person)

e Did the organization engage in a prior year in any of the acts described in 1a, other than excepted acts, that were not corrected before the first day of the tax year beginning in 2002?

2 Taxes on failure to distribute income (section 4942) (does not apply for years the organization was a private operating foundabon defined in section 4942(j)(3) or 4942(j)(5))

e At the end of tax year 2002, did the organization have any undistributed income (lines 6d and tie, Part XIII) for tax year(s) beginning before 20027 [::) Yes CKI No If Yes; list the years 1.

b Are there any years listed in 2a for which the organization is not applying the provisions of section 4942(a)(2) (relating to incorrect valuation of assets) to the year's undistributed income? (If applying section 4942(a)(2) to all years lined, answer 'No' and attach statement - see instructions ) N/A

e It the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here 1

3e Did the organization hold more than a 296 direct or indirect interest in any business enterprise at any Mme during the year? E] Yes I-VI No

b If "Yes, *did h have excess business holdings in 2002 as a result of (1) any purchase by the organization or disqualified persons alter May 26, 1969, (2) the lapse of the 5-year period (or longer period approved by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest, or (d) the lapse of the 10 , 15 , or 20 year first phase holding period? (Use Schedule C, Form 4720, to determine A the orgenwafion tied excess business holdings in 2002) N / A

as Did the organization invest during the year any amount in a manner that would jeopardize ft chanlahle purposes b Did the organization make any investment in a prior year (hut after December 31, 1989) that could jeopardize its charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 20027

Sa During the year did the organization pay or incur any amount to (7) Carry an propaganda, or otherwise attempt to influence legislation (section 4945(e))? I--] Yes ~ No (2) Influence the outcome of any specific public election (see section 4955), or to carry on, directly or indirectly,

any voter registration drive? Yes Ji No (3) Provide a grant to an individual for travel, study, or other similar purposes ~ Yep ETLI No (4) Provide a grant to an organization other than a charitable, eic , organization described in section

509(a)(1), (2), or (3), or section 4940(d)(2)? =Yep EjL-1 No (5) Provide for any purpose other than religious, charitable, scientific, literary, or educational purposes, or for

the prevention of cruelty to children or animals? = Yea FXI No b If any answer is Yes'to 5a(l) (5), did any of the transactions tail to quality under the exceptions described in Regulations

section 53 4945 or in a current notice regarding disaster assistance (sae instructions)? N/A Organizations raying on a current notice regarding disaster assistance check here 10

c If the answer is Yes' to question Sa(4), does the organization claim exemption from the tax because it maintained expenditure responsibility for the grant's N/A ~ Yap = No II 'Yes,' attach the statement required by Regulations section 53 4945-5(d)

Be Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit cantract9 ID Yes CjEl No

b Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? 11 you answered 'Yes' to 66, also file Form 8870

Finn 990-PF 1eooz)

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.J9-

Highly Page 6

Total number of other employees paid over $50,000 Five highest-paid independent contractors la professional services If none, enix "NONE °

(s) Name and address of each person paid more khan $50,000 of service

lisp the foundation's four largest direct charitable activities during the fax year Include relevant statistical information such as the number of organizabons and other beneficiaries served, conferences convened, research papers produced, etc

N/A

z

s

a

Fm� 980-PF Rooz>

THE PATRICK J . & MARILYN W . O'NEILL FAMILY FOUNDATION

Part VIII Info lion About Officers, Directors, Trustees, Foundation Paid Employees, and Contractors

7 List all officers, dvectors, trustees, foundation managers and then compensation (b) Tide, and average

(a) Name and address hours per week devote to oosioon

Title and (a) Name and address of each employee paid more than $50,000

(c) G III

(c) Compensation

(a)

(s)Expense account, other allowances

Expenses

Page 7: Form Return of Private Foundation990s.foundationcenter.org/990pf_pdf_archive/341/... · r Form ;90- pF Return of Private Foundation or Section 4947(a)(1) Nonexempt Chantable Trust

Part X Minimum Investment Return (All domestic foundations must complete this part Foreign foundations, see instructions )

1 Fair market value of assets not used (or held for use) directly in carrying out chantable, etc , purposes e Average monthly fair market value of securNes b Average of monthly cash balances c Fair market value of all other assets d Total (add lines 1a, b, and c) a Reduction claimed for blockage or other factors reported an lines 1a and

lc (attach detailed explanation) Is 2 Acquisition indebtedness applicable to line 1 assets 3 Subtract line 2 from line 1d 1 Cash deemed held for charitable activities Enter 1 1/2% of line 3 (for greater amount, see instructions) 5 Not value of nanchente6la-use assets Subtract line 4 from line 3 Enter here and on Part V, line 4 0 Minimum investment return Enter 5% al line 5

Part XII Qualifying Distnbutions (see instructions)

223x, of-zaoa

" THE PATRICK J . & MARILYN W . O'NEILL Form 99o-PF(20o2) , FAMILY FOUNDATION 34-1910008 Page?

Part IX-B ,Summary of Program-Related Investments

Describe the two largest program-retatad investments made 6y the foundation during the tax year on hoes 1 and 2 I Amount

2

All other program-related investments See instructions a

Total Add tines 1 through 3

Part XI Distnbutable Amount (see instructions) (Section 4942(j)(3) and (1)(5) private operating foundations and certain foreign organizations check here 1 and do not complete this part)

1 Minimum investment return from Pan X, line 6 1 2e Tax on investment income for 2002 from Part VI, line 5 2e 1 28 . b Income tax for 2002 (This does not include the tax from Part VI 2b e Add lines 2a and 2b 2c

3 Distributa6le amount before adjustments Subtract line 2c from line 1 3 Ia Recoveries of amounts treated as qualifying distributions 48 0 . b Income distributions from section 4947(a)(2) trusts Ib 0 . c Add lines 4a and 4b Io

y Add lines 3 and 9c I ~5 I 0 Deduction from Oistributable amount (sea instructors)

1 Amounts paid (including administrative expenses) to accomplish charitable, etc, purposes e Expenses, contributions, grits, etc total from Part 1, column (d), line 26 Is 14 . 008 . b Program-related investments -TOUI from Part IX-B 1b 0 .

2 Amounts paid to acquire assets used (or held for use) directly in carrying out charifabla, etc , purposes 2 3 Amounts set aside for specific chartahle projects that sabsty the e Suitability test (poor IRS approval required) 3a b Cash distribution test (attach the required schedule) 36

1 Qualifying distributions Add lines 1a through 3D Enter here and on Part V, line B, and Pan XIII, line 9 1 14 , 00 8 . 5 Organizations that quality under section 4940(e) for the reduced rate of fax on net investment

income Enter 1% of Part I, line 27b S 12 8 . D Adjusted qualifying diatribu6ans Subtract line 5 from fine 4 ( 0 ~ 13 . 88 0 .

Nato The amount on line 6 wig be used in Pert V, column (b), m subsequent years when calculating whether the foundation qualifies log the section 4940(e) reduction of tax in those yeav:s

F~ B90-PF (2oo2)

Page 8: Form Return of Private Foundation990s.foundationcenter.org/990pf_pdf_archive/341/... · r Form ;90- pF Return of Private Foundation or Section 4947(a)(1) Nonexempt Chantable Trust

" THE PATRICK J . & MARILYN W . 0'NEILL Form sso-aF(2oo2) _ FAMILY FOUNDATION 34-1910008 Page e

Part Xlll ,Undistributed Income (see instructions)

(e) (6) (e) (d) )rpus Years prior to 2001 2001 2002

2 unaisvmuted income n any as of Me and a zoo,

a Enter amount for 2001 only y Total for prior years

e eomue Add fares b .c end Ae Subtract line 5 b Prior years' undistributed income Subtract

line 46 from line 2b e Enter the amount of poor years' undistributed income for which a notice of deficiency has been issued, or on which the section 9942(a) fax has been previously assessed

d Subtract line tic from line 6h Taxable amount see instructions

e Undistributed income for 2001 Subtract line 4a from line 2a Taxable amount see tnstr

1 Undistributed income for 2002 Subtract lines 4d and 5 from line 1 this amount must be distributed in 2003

1 Amounts treated as distributions out of corpus to sahsy requirements imposed 6y section 170(b)( 1)(E) or 4942(g)(3)

d Excess distributions carryover from 1997 not applied on line 5 or line 7

0 Excess distributions carryover to 2003 Subtract lines 7 and 8 from line 6a

10 Analysis of line 9 a Excess from 1998 E Excess from 1999 e Excess from 2000 d Excess from 2001 13 , z ~ ~

Fomn 990-PF (2002) 223571 01 xw3

Datributa6le amount for 2002 ham Part %I, line 7

3 Excess distributions carryover, d any, to 2002' e From 1997 b From 1998 e From 1999 d From 2000 aFrom 2oo1 13 2004 1 Total 01 lines 3a through e

1 Qualifying distributions for 2002 from Part %1I, line 4 " $ 14,00 8 .

e Applied to 2001, but not more than line 2a b Applied to undistributed income of prior years (Election required see instructions)

e Treated as distributions out of corpus (Election required - see instructions)

d Applied to 2002 distributable amount e Remaining amount distributed out of corpus

5 Eswdistributions caryovvWpliedro2002 of an amount opPeaa in column (G) Me sane amount must be aliovn in column (a)

d Enter the not total of ir column as indicated below

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Farm

1 a II the foundation has received a ruling or determination letter that it is a private operating

Prior 3 years 2001 (e) 2000 (d) 1999 I (s) Total

(1) Total support other than gross investment income (interest, dividends, rents, payment on securities loans (section 512(a)(5)), or royalties)

(2) Support from general public and 5 or mare exempt organizations as provided in section 4942(j)(3)(B)(m)

(3) Largest amount of support from an exempt organization

d My restrictions or limitations on awards, such as by geographical areas, chantable fields, kinds al institutions, or other factors

F.990-PF (202) 723381A1 2103

THE PATRICK J . & MARILYN W . O'NEILL

instructions and Part VII

foundation, and the ruling is effective for 2002, enter the date of the ruling b Check box to indicate whether the oroanizaLOn is a private ooeraUna loom

2 a Enter the lesser of the adjusted not income from Part I or the minimum investment return from Part X for each year listed

6 B5°h al line 2a e Qualifying distributions from Part XII,

line 4 for each year listed d Amounts included in line 2c not used directly for acute conduct of exempt activities

@ Qualifying distributions made directly for acute conduct of exempt activities Subtract line 2d ham line 2c

3 Complete 3a, b, or c for the alternative test relied upon

e 'Asse6' alternaWe test - enter (1) Value of all assets

(2) Value of assets qualifying under section 4942(p(3)(8)(p

b 'Endovrtnenf alternative test - Enter 2(3 of minimum investment return shown in Part X, line 8 for each year listed

c Support alternative test enter

Part Supplementary Information (Complete this part only if the organization had $5,000 or more in assets at any time during the year-see page 25 of the instructions.)

7 Information Regarding Foundation Managers a List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation before the close of any fax

year (bud only A they have contributed more than $5,000) (See section 507(d)(2) )

b List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the ownership of a partnership or other entity) of which the foundation has a 10°,5 or greater interest

2 Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc, Programs Check here " E04 the organization anty makes contributions to preselected charifahle organizations and does not accept unsolicited requests for funds If the organization makes grits, grants, etc (sea instructions) to individuals or organizations under other conditions, complete items 2a, b, c, and d

a The name, address, and telephone number of the person to wham applications should be addressed

b The form in which applications should he submitted and information and materials they should include

e Any submission deadlines

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10

Purpose of grantor contribution

3e

Total 2711607N1 77-07 r.e90-aF a002,

THE PATRICK J . & MARILYN W . O'NSILL Form 990-PF(2oo2) FAMILY FOUNDATION Part XV Supplementary Information (continued) 3 Grants end Contributions Paid Dunnp the Veer a Approved for Future Payment

Recipient II recipient is an individual, show anyrelationship to Foundation

Name and address (home or business) any foundation manager status al arsubstanLalcontributor recipient

Paid dunng the yew

GILMOUR ACADEMY, 34001 PUBLIC CEDAR ROAD, GATES MILLS, RARITY OH 44040 /A

MARQUSTTB UNIVERSITY, 707 PUBLIC BUILDING 111, MILWAUKEE, RARITY WI 53201 /A

PLAYHOUSE SQUARE PUBLIC FOUNDATION, 1501 EUCLID RARITY AVENUE, CLEVELAND, OH 44115 /A

b Approved for future payment

NONE

Amount

6,000 .

2,500 .

2,500 .

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" THE PATRICK J . & MARILYN W . O'NEILL Form 990-PF(2002) . FAMILY FOUNDATION 34-1910008 Paaa11 Part XVI-A Analysis of Income-Producing Activities

~anicewn ertwaeao a~coonmz an 0v "

(b) (d) Relayed or exempt Amount ~~ Amount function income

e Debt-financed property b Not debt-financed property

0 Net rental income or (loss) from personal property

7 Other investment income B Gain or (lass) from sales of assets other

khan inventory 0 Net income or (loss) from special events 10 Grass profit or (loss) from sates of inventory 11 Other revenue

F~990-PF RoosJ

Enter gross amounts unless otherwise indicated

1 Program service revenue

p Fees and contracts from government agencies 2 Membership dues and assessments 3 Interest on savings and temporary cash

investments

1 Dividends and interest from securities 5 Not rental income or (loss) from real estate

12 Subtotal Add columns (b), (d), and (e) I I 0 .1 I 13,194 .1 0 . 13 Total Add line 12, columns (h), (d), and (e) 13 13 ,194 . (See worksheet in line 13 instructions to verity calculations

Part XVI-B Relationship of Activities to the Accomplishment of Exempt Purposes

Line No Explain below how each acWiy for which income is reported in column (e) of Part XVI A contributed importantly to the accomplishment of the organization's exempt purposes (other than by providing lands tar such purposes)

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" THE PATRICK J . & MARILYN W . O'NEILL Form 990-PF(2002) FAMILY FOUNDATION 4-191

2e Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt organizations described in section 501(c) of the Code (other than section 501(c)(3)) or in section 5277 0 Yes OX No

b II Yes; complete the following schedule (a) Name of organization (b) Type of organization (c) Description of relationship

N/A

Under penalhea of pa Babe Mat I luw ewnnad this rehun including acconpanyinp schedules and uahnenb and N Me best of rty knoWedpe and belie) it is true cmect aiy,nplete Eon ffi prma¢Ioipp~)q,y~~validuaay)obsedonalliManvOmoIWiichpreparhsanyknoricdge

////

or trustee

Ftmimme(oryoYn VL11Y1A O[ aV1Jl.n8n, LLt

nwe.mpcnai ,1406 WEST 6TH STREET -aaa~anazia~,a~ rT.uvuT.nun nu eeii'1 _11

223621 01 z~oa

Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) of Ye the Code (other than section 501(c)(J) organizations) or in section 527, relating to political organizations?

e Transfers from the reporting organization to a noncharnable exempt organization of, (1) Cash 1e 1 (2) Other assets 1a ( 2 )

6 Ocher Transactions (1) Sales of assets to a noncharnabte exempt organiuhon 16 1 (2) Purchases otassets from anonchariGhleexempt organization 1b2 (3) Rental of facilities, equipment, or other assets 16 3 (4) Reimbursement arrangements 1b t (5) Loans or loan guarantees 16 5 (0) Performance of services or membership or fundraising solicitations 16 6

c Sharing of facilities, equipment, mailing lists, other assets, or paid employees 1e d If the answer to any of the above is Yes; complete the following schedule Column (b) should always show the fair market value of the goods, other assets,

or services given by the reporting organization If the organization received less than fair market value in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or sernces received

Line no (b) Amount involved (e) Name of noncharita6la exempt organization (d) Description of transfers, transactions, and sharing arrange N/A

O 2 Preparer's

adre'

sign nadre

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Schedule B (Fwm 990, 990-EZ, a

990-PF) Dmahrcnt d the Treavey

Schedule of Contributors OMB NO 151'x0077

2002 Supplementary Information far line 1 01 Form 990, 990-EZ, and 990-pr (sae instructions)

Employer identification number Name of organization THE PATRICK J . & MARILYN W . O'NEILL

For e section 501(c)(/), (8), or (10) organization filing Forth 990, or Form 990 EZ, that received from anyone contributor, dunng the year, some contributions for use exclusively for religious, charitable. etc , purposes, but these contributions did not aggregate to more than $1,000 (If this box is checked, enter here the total contributions that were received during the year for en exclusively religious, charitable, etc , purpose Do not complete any of the Parts unless the General Rule applies to this organization because it received

1 nonexclusrvety, religious, charitable, etc , contributions of $5,000 or more during the year )

Caution Organizetuns that ere not covered 6y the General Rule end/or the Special Rules do not file Schedule B (Form 990, 990-EZ, or 990-PF), but they must check the box in the heading of their Form 990, Forth 990-EZ or on line f of their Form 990-PF, to certify that they do not inset the filing requirements of Schedule B (Form 990, 994EZ or 990.PF)

Sells dule B (Form 000, 990-EZ, or G00-PF) (2002)

u3.si 01 ss-w

Organization type (check one)

Filers of Section

Forth 990 or 990 EZ 0 501(c)( ) (enter numbed organization

0 4947(e)(1) nonexempt charitable trust not treated as e private foundation

0 527 political organization

Form 990 PF C~j 501(c)(3) exempt private foundation

4997(x)(1) nonexempt charitable trust treated as e private foundation

501(c)(3) taxable pnvate loundation

Check il your organization is covered by the General Rule or e Special Rule (Note Only a section 501(c)(7), (8), or (10) organization can check boz(es) for both the General Rule end e Special Rule-sae instructrons )

General Rule-

For organizations filing Form 990, 990 EZ, or 990 PF that received, during the year, $5,000 or more (in money or property) from any one contributor (Complete Parts I end II )

Special Rules-

For a section 501(c)(3) organization filing Form 990, or Form 990 EZ, that met the 33 1/3% support test of the regulations under L] sections 509(a)(t)/170(b)(1)(A)(h) end received from any one contributor, during the year, e contribution of the greeter of $5,000 or 2% of the amount on line 1 of these forms (Complete Parts I end II )

0 For e section 501(c)(7),(8), or (10) organization filing Form 990, or Form 990 EZ, that received from anyone contributor, during the year, aggregate contributions or bequests of more than $1,000 for use exclusively for religious, charitable, scientific, literary, or educational purposes, or the prevention of cruelty to children or animals (Complete Parts I, II, end III )

LHA For Paperwork Reduction Act Notice, see the Instructions for Form 890 and Form 990-EZ

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Name of organization THE PATRICK J . & MARILYN W . O'NBILL

Part I Contributors (See Specific Instructions )

(a) (b) (c) (d) No Name, address, end ZIP + 4 Aggregate contributions Type of contribution

1 DANIEL J . O'NBILL Person D Payroll

2589 BERKSHIRE RD S 8 .818 . Noncasn (Complete Pert II A there

CLEVELAND HTS . OHIO 44124 is e noncash contnbution )

(b) No Name, address, and DP + 4 Aggregate contributions Type of contribution

Person O Payroll F-1 Noncash 191

(Complete Pert II A there is e noncash contribution

2 MARILYN W . O'NBILL

20620 HRANTLEY RD $ 150 .366 .

SHARER HTS . OH 44122

let (b) 1c) No Name, address, end DP + 4 Aanrepate contributions

(d) of contribution

Person 71 Payroll

g Noncesh

(Complete Pert II il there is e rioncash contribution

(c) (d) Aggregate contributions Type of contribution

Person Payroll

g Noncseh

(Complete Pert 11 0 there is B noncash contribution )

(c) (d)

Aggregate contributions Type of contribution

Person

Payroll 0 g Noncash

(Complete Part II if there is e noncash contribution )

(c) (d) Aggregate contributions Type of contribution

Person D Payroll

g Honcash 0

(Complete Part II A there is e noncash contribution )

Schedule B (Farm 000, 990-E2, or 920-PF) (2002) m.sz 01 aam

pooo 1 to 1 a

Employer idenhfiaehon number

IBI I (b) No Name, address. end DP + 4

(e) (d) No Name, address, and ZIP +4

Lei I (b) No Name. address . end ZIP +4

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nUsa 01 zsoa Schedule 8 (Form 000, 090-EZ. or

ScheEUla B (Fam 990 990-E2 a 990-PF) (2007) Pam 1 b 1 0l Port 11 Nome of arpeni :ehon Employer identification number

THE PATRICK J . & MARILYN W . O'NEILL FAMILY FOUNDATION 34-1910008

Part II NOI1Ca5h Property (See Spastic Instructions )

e) No (b) fcl

from FMV (or estimate) from pesaiption of noncash property given is" instructions) Data starved Pert 1

160 SHARES MICROSOFT CORP . 1

$ 8 .818 . 06/25/02

lal No (b) FMV (or estimate) (d) from Description of noncash properly green

(see instructions) Date reserved Pert 1

3957 SHARES G E COMMON STOCK 2

S 150 .366 . 01/25/02

IBI

from pesaiption o1 noncash properly given FMV (or estimate)

Date reserved Part I (sea instructions)

S

(e)

(b) FMV (m estimate) (d) from Desaiption of noncash property given Dates rocorvW Part I (sae instructions)

(e)

from pesaiption of noncash property given FMV (or estimate)

Date reeansd see instructions)

No (°) FMV from Description o1 noncash property green

(or estimate) Date rdecerved

Part l (see instructions)

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'THE PATRICK J . & MARILYN W . O'NEILL FAMI 34-1910008

FORM 990-PF DIVIDENDS AND INTEREST FROM SECURITIES STATEMENT 1

0 .

0 .

FORM 990-PF ACCOUNTING FEES

(C) ADJUSTED

NET INCOME

(D) CHARITABLE PURPOSES

3,008 .

3,008 .

(A) (a) EXPENSES NET INVEST-PER BOORS MENT INCOME

3,008 . 0 .

3,008 . 0 .

DESCRIPTION

TAX PREPARATION

TO FORM 990-PF, PG 1, IN 16B

(A) (B) (C) (D) EXPENSES NET INVEST- ADJUSTED CHARITABLE

DESCRIPTION PER BOORS MBNT INCOME NET INCOME PURPOSES

RBYBANR AGENCY FEES 377 . 377 . O .

TO FORM 990-PF, PG 1, IN 23 377 . 377 . 0 .

FORM 990-PF OTHER DECREASES IN NET ASSETS OR FUND BALANCES

DESCRIPTION

ADJUST STOCK CONTRIBUTED TO DONOR'S BASIS

TOTAL TO FORM 990-PF, PART III, LINE 5

144,245 .

144,245 .

STATEMENT S) 1, 2, 3, 4

SOURCE

KEY HANK NATIONAL ASSOC

TOTAL TO FM 990-PF, PART I, IN 4

GROSS AMOUNT

2,080 .

2,080 .

CAPITAL GAINS DIVIDENDS

COLUMN (A) AMOUNT

2,080 .

2,080 .

STATEMENT 2

FORM 990-PF OTHER EXPENSES STATEMENT 3

STATEMENT 4

AMOUNT

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*THE PATRICK J . & MARILYN W . O'NBILL FAMI 34-1910008

FORM 990-PF CORPORATE STOCK STATEMENT 5

DESCRIPTION BOOR VALUE

3772 SHS GENERAL ELECTRIC 12,318 .

TOTAL TO FORM 990-PF, PART II, LINE lOB 12,318 .

FORM 990-PF PART VIII - LIST OF OFFICERS, DIRECTORS TRUSTEES AND FOUNDATION MANAGERS

STATEMENT 6

EMPLOYEE TITLE AND COMPEN- HEN PLAN EXPENSE

NAME AND ADDRESS AVRG HRS/WR SATION CONTRIB ACCOUNT

MARILYN W . O'NEILL PRESIDENT & TRUSTEE 20620 BRANTLBY ROAD NOMINAL 0 . 0 . 0 . SHARER HTS ., OH 44122

MICHAEL T . O'NEILL VICE PRES, TREAS & TRUSTEE 42 HASRELL DRIVE NOMINAL O . 0 . 0 .

0 .

0 .

0 .

0 .

0 . 0 .

0 . 0 .

TOTALS INCLUDED ON 990-PF, PAGE 6, PART VIII

STATEMENT(S) 5, 6

FAIR MARKET VALUE

91,848 .

91,848 .

BRATENAHL, OH 44108

DANIEL J . 0'NEILL SECRETARY & TRUSTEE 2589 BERKSHIRE ROAD NOMINAL CLEVELAND HTS ., OH 44106

HUGH M . O'NEILL III ADVISORY BOARD 30000 AURORA ROAD NOMINAL SOLON, OH 44139

ANNE B . O'DONNBLL ADVISORY BOARD 34589 CEDAR ROAD NOMINAL GATES MILLS, OH 44040

THOMAS C . VANIR ADVISORY HOARD 1406 WEST 6TH STREET - THIRD FLOOR NOMINAL CLEVELAND, OH 44113

0 . 0 .

0 . 0 .

0 . 0 . 0 .

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-THE PATRICK J . & MARILYN W . O'NEILL FAMI 34-1910008

STATEMENT(S) 7

FORM 990-PF PART XV - LINE 1A STATEMENT 7 LIST OF FOUNDATION MANAGERS

NAME OF MANAGER

MARILYN W . O'NBILL DANIEL J . 0'NSILL

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Application for Extension of Time To Exempt Organization Return

Form 8868 , (December 200) ppament d Ana Tremuy Intrnal R~venua Scv~ce

OMB No 1545-1709

M6catron for each return File a

" II you ere filing for en Automates 9-Month Extension, complete only Pert I end check this " II you ere tiling for an Additional (not automatic) 3-Month Extension, complete onlXY~~ Note Do not complete Pert II unless you have already been mom` granted an autome o(If

o} Time - Only submit onginel (no We ~~P`

Automatic

Note Form 980-7 corporations requesting en automatic 6-month extension - check this All other corporations Including Form 990-0 filers) must use Form 7004 to request en esf( returns Partnerships, REMICs end trusts must use Form 8736 to request an extension of

I}b'(o his income fef Form 1065, 1066, or 1091

zzwi 0w1 02

+`uy ii. ERI of this form)

oAa praviousty filed Form 8868

I only 10. D

Type a Name of Exempt Organization Employer identification number pool THE PATRICK J . Fc MARILYN W . O'NEILL

FAMILY FOUNDATION 34-1910008 Fits by Na a~ . eau ra Number, street, and room or suite no if e P O box, see instructions '°'rgY"' C/O VANIR & BUTSCHSR LLP 1406 WEST 6TH STREET NO . re~ S. ~ naMxnons City, town or post office, state, end ZIP code For e foreign address, see instructions

CLEVELAND OH 44113

Check type of return to be filed (file e separate application for each return)

0 Forth 990 0 Forth 990-7 (corporation) 0 Form 4 720 0 Forth 990 BL 0 Form 990-7 (sec 401(a) or 408(a) trust) ~ Forth 5227

Form 990 EZ 0 Form 990 T (trust other than above) 0 Form 6069

CTLI Form 990 PF O Form 1041 A D Forth 8870

II the organization does not have en office or place of business in the United States, check this box

" II this is for e Group Return, enter the organization's four digit Group Exemption Number (GEN) II this is for the whole group, check this box No- 0 If die for pert of the group, check [his box 1 0 and attach e list with the names and EINs of all members the extension will cover

7 I request en automatic 3-month (6-month, for 990-T corporation ) extension of time until AUGUST 15, 2003 to file the exempt organization return for the organization named above me extension is for the organization's return for "FX] calendar year 2002 or 10 tax year beginning , and ending

2 II this tax year is for less than 12 months, check reason 0 Initial return 0 Final return ~ Change in accounting period

9a If this application is for Form 99D BL, 990 PF, 990 T, 4720, or 6069, enter the tentative tax, less any nonrefundable credits See instructions $ 4 00 .

b It this application is for Form 990 PF or 990 T, enter any refundable credits end estimated tax payments made Include any poor year overpayment allowed as e credit

c Balance Due Subtract line 3b from line 3e Include your payment with this forth, or, it required, deposit with FTD coupon or, d required, by using EFTPS (Electronic Federal Tax Payment System) See instructions S 4 00 .

Signature and Verification

Under penalties of penury, I declare that I have examined this form, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete, and that I am authorized to prepare this form

Signature " LY-~G bA"Jql--iee 00, ATTORNEY Date " MAY 1 L ~ � j

LHA For Paperwork Reduction Act Notice, ses instruction Form 8868 ( 12-2000)

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ACKNOWLEDGMENT COPY

Signature and Venfication Under penalties of perjury, I declare that I have examined this form . including accompanying schedules and statements, and to the best of my knowledge and belief, it s true, corrett,~dpd complete, and that I am authorized to prepare this form

\ 1 . k T

Notice to Applicant - To Be Completed by the IRS 0 We have approved this application Please attach this forth to the organizations return D We have not approved this application However, we have granted a 10-day grace penod from the later of the date shown below or the due

date of the organization's return (including any poor extensions) This grace penod is considered to be a valid extension of time for elections otherwise required to be made on a timely return Please attach this form to the organization's return We have not approved this application After considenng the reasons stated in item 7, we cannot grant your request for an extension of time to file We are not granting the 10day grace penod We cannot consider this application because R was filed crier the due date of the return for which Gn extension was requested Other

BY Director Nternate Mailing Address - Enter we address A you went the copy of this application for an additional 3-rri pREPJSICN APPROVED different than the one entered above

3 r D'kY%a9.Xr W . Name

Type or print

Number and street Include suite, room, or apt no ) a a P O box number

LINDP :""=~ov~~-= . FIT D f ~7,F_CTOR :.~ .t.ua~ .:.u ~r' ~~_5.6v C -LER City or town, province or state, and country (including postal or ZIP code)

Form 8868 (12-2000)

0, If you aie filing for an Additional (not automatic) 3-Month Extension, complete only Part II and check this box 10. EE Note Only complete Part II it you have already been granted an automatic 3-month extension on a previously filed Form 8868. 0 If you are fill for an Automatic 3-Month Extension, complete only Part I (on page t) Part II Additional (not automatic) 3-Month Extension of Time - Must file Original and One Copy.

Name of Exempt Organization Employer identification number T~° pant HE PATR ICK J . & MARILYN W . O'NEILL

. .,r . . . - ..,. . . . ..._ ...~,... , . _ . . . ,. .. _ . . F.1. by M . Number, street, and room or suite no I( a P O box, see instructions For IRS use only °"" °"" '° O VANIR &: HUTSCHER LLP 1406 WEST 6TH STREE 41mp N~

S. ~ City, town or post office, state, and ZIP code For a foreign address, see instructions natruc~ms ~~. . .. . . . . .. - A A , , ,

Cheek type of return to be filed (File a separate application for each return) 0 Form 990 0 Form 99o-¢ 0 Form 990 7 (sec 401(a) w 408(a) trust) ~ Form 1047 A 0 Form 5227 C::] Form 8870

Form 990 BL EK] Form 99UPF 0 Form 990 T (trust other than above) 0 Form 4720 0 Forth 6069

STOP- Do not complete Part II if you were not already granted an automatic 3-month extension on a previously filed Form 81368.

" If the organization does not have an office or place of business in the United States, check this box " II this is for a Group Return, enter the organization's four digit Group Exemption Number (GEM Ii this is for the while group, check this box 1 C:D If it is for part of the group, cheek this box 1 [::] and attach a list with t~q names and EINS of all members the extension is for

4 I request an additional 3month extension of time until NOVEMBER 1-4 ? 2003 5 For calendar year 2 0 0 2 , or other tax year beginning ~ and ending 6 II this tax year i5 for less than 12 months, check reason ~ Initial return 0 Final return 0 Change in accounting penod 7 State in detail why you need the extension

NOT ALL OF THE INFORMATION NECESSARY FOR PROPER COMPLETION OF FORM 990-PF HAS BEEN RECEIVED .

8a If this application is for Form 990 BL, 990-PF, 990 T, 4720, or 6069, enter the tentative tax, less any nonrefundable credos See instructions $ 400 .

b If this application is for Form 990 PF, 990 T, 4720, or 6069 enter any refundable credits and estimated tax payments made Include any pnor year overpayment allowed as a credit and any amount paid previously with forth 8868 S 40 0 .

c Balance Due Subtract line Bb from fine 8a Include your payment with this form, or, R required, deposit with FrD coupon or, it required, by using EFfPS (Electronic Federal Tax Payment System) See instructions

Al!f; 2 s 2003 ' r