2018-05-10T08:06:47-05:00 2017-12-31 420714325 RSM US LLP 801 NICOLLET MALL SUITE 1100 MINNEAPOLIS MN 55402 990PF 2017-01-01 411873951 THE PATCH FOUNDATION PATC 6127817677 900 42ND AVE NE NO 317 COLUMBIA HEIGHTS MN 55421 CAROLYN SAMPLE PRESIDENT 6127817677 2018-05-07 1 TODD A JACKSON P00092672 6123324300 2018-05-07 2017 2022-09-23 18:48:47Z X 9709421 X X 426 426 211560 211560 96855 1155524 96855 8077 0 316918 308841 0 0 0 3255 2441 814 43 0 43 3298 2441 857 1174000 1174000 1177298 2441 1174857 -860380 306400 855638 686416 686416 330114 697625 697625 8784593 7725924 8325380 9970345 9109965 9709421 0 0 X 0 0 0 0 9970345 9109965 9970345 9109965 9970345 9109965 9970345 -860380 0 9109965 0 9109965 MEDTRONIC PLC 1155524 1058669 96855 96855 96855 0 1096420 10516420 0.104258 852325 10497691 0.081192 675925 8768762 0.077083 622900 7300472 0.085323 700875 6142529 0.114102 0.461958 0.092392 9662738 892760 3064 895824 1174857 X 3064 0 3064 0 3064 3500 0 0 3500 0 436 436 0 0 0 0 0 0 0 0 0 0 0 1 1 MN 1 0 0 0 0 1 N/A THE FOUNDATION 6127817677 900 42ND AVE NE NO 317 COLUMBIA HEIGHTS MN 55421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 CAROLYN SAMPLE 3201 RANKIN RD MINNEAPOLIS MN 55418 PRESIDENT 2.00 0 0 0 WILLIAM C PETERSON 6724 99TH AVE NORTH BROOKLYN PARK MN 55445 DIRECTOR 0.50 0 0 0 ERNEST LINDSTROM-LINDSTROM LAW OFFI 7600 PARKLAWN AVE STE 444 EDINA MN 55435 DIRECTOR 0.50 0 0 0 NONE 0 NONE 0 0 9337340 472546 0 9809886 0 0 9809886 147148 9662738 483137 483137 3064 3064 480073 0 480073 0 480073 1174857 0 1174857 3064 1171793 480073 0 0 397524 260938 251714 442236 577445 1929857 1174857 0 0 0 480073 694784 0 0 2624641 0 0 0 0 0 0 397524 2227117 260938 251714 442236 577445 694784 CAROLYN P SAMPLE 3201 RANKIN ROAD NE MINNEAPOLIS MN 55418 6127817677 SEE STATEMENT 7 SEE STATEMENT 7 SEE STATEMENT 7 AMERICAN HEART ASSOCIATION PO BOX 78851 PHOENIX AZ 85062 NONE PC PROGRAM SUPPORT 1000 AMERICAN LUNG ASSOCIATION PO BOX 7000 ALBERT LEA MN 56007 NONE PC PROGRAM SUPPORT 1000 ARC GREATER TWIN CITIES 2446 UNIVERSITY AVE W 110 ST PAUL MN 55114 NONE PC PROGRAM SUPPORT 10000 BANYAN COMMUNITY 2529 13TH AVE SO MINNEAPOLIS MN 55404 NONE PC EDUCATIONAL 5000 BETHEL UNIVERSITY 3900 BETHEL DR ST PAUL MN 55112 NONE PC PROGRAM SUPPORT 5000 CAMP KNUTSON 11169 WHITEFISH AVENUE CROSSLAKE MN 56442 NONE PC PROGRAM SUPPORT 5000 CARE PO BOX 1870 MERRIFIELD VA 22116 NONE PC PROGRAM SUPPORT 10000 CATHOLIC CHARITIES 1200 SECOND AVENUE SO MINNEAPOLIS MN 55403 NONE PC PROGRAM SUPPORT 5000 CHILDREN'S HOME SOCIETY 1605 EUSTIS STREET ST PAUL MN 55108 NONE PC PROGRAM SUPPORT 5000 COURAGE KENNY REHABILITATION INSTITUTE 3915 GOLDEN VALLEY RD MINNEAPOLIS MN 55422 NONE PC PROGRAM SUPPORT 20000 COVENANT KIDS CONGO 8303 W HIGGINS ROAD CHICAGO IL 60631 NONE PC RELIGIOUS 50000 COVENANT RETIREMENT COMMUNITIES OF MN 5800 ST CROIX AVENUE N GOLDEN VALLEY MN 55422 NONE PC RELIGIOUS 10000 COVENANT WORLD RELIEF 8303 W HIGGINS ROAD CHICAGO IL 60631 NONE PC PROGRAM SUPPORT 200000 CRISTO REY JESUIT HIGH SCHOOL 2924 4TH AVENUE SOUTH MINNEAPOLIS MN 55408 NONE PC EDUCATIONAL 7000 DOCTORS WITHOUT BORDERS PO BOX 5023 HAGERSTOWN MD 217415023 NONE PC PROGRAM SUPPORT 7000 DUNWOODY COLLEGE OF TECHNOLOGY 818 DUNWOODY BLVD MINNEAPOLIS MN 55403 NONE PC EDUCATIONAL 15000 EAST SIDE NEIGHBORHOOD SERVICES 1700 SECOND STREET NE MINNEAPOLIS MN 55413 NONE PC PROGRAM SUPPORT 3000 EVANGELICAL COVENANT CHURCH 8303 W HIGGINS ROAD CHICAGO IL 60631 NONE PC RELIGIOUS 175000 EXODUS LENDING CO HOLY TRINITY CHURCH 2730 E 31ST ST MINNEAPOLIS MN 55406 NONE PC PROGRAM SUPPORT 3000 FAMILY VALUES FOR LIFE 1280 ARCADE ST ST PAUL MN 55106 NONE PC PROGRAM SUPPORT 5000 FEED MY STARVING CHILDREN 401 93RD AVE NW COON RAPIDS MN 55433 NONE PC PROGRAM SUPPORT 30000 GREATER MINNEAPOLIS CRISIS NURSERY 4544 4TH AVE SOUTH MINNEAPOLIS MN 55419 NONE PC PROGRAM SUPPORT 5000 HABITAT FOR HUMANITY 3001 4TH ST SE MINNEAPOLIS MN 55414 NONE PC PROGRAM SUPPORT 15000 HENNEPIN TECHNICAL COLLEGE 9000 BROOKLYN BLVD BROOKLYN PARK MN 55445 NONE PC EDUCATIONAL 5000 HOMEWARD BOUND 12805 HIGHWAY 55 STE 400 PLYMOUTH MN 55441 NONE PC PROGRAM SUPPORT 10000 HOUSE OF CHARITY 510 SOUTH EIGHTH STREET MINNEAPOLIS MN 55404 NONE PC PROGRAM SUPPORT 15000 KIWANIS CLUB OF NE MINNEAPOLIS 1612 SECOND ST NE MINNEAPOLIS MN 554131138 NONE PC PROGRAM SUPPORT 1000 LOAVES AND FISHES 1121 JACKSON STREET NE STE 143 MINNEAPOLIS MN 55413 NONE PC PROGRAM SUPPORT 25000 MARCH OF DIMES PO BOX 8972 TOPEKA KS 66608 NONE PC PROGRAM SUPPORT 1000 METRO HOPE MINISTRIES 2739 CEDAR AVENUE SOUTH MINNEAPOLIS MN 55407 NONE PC PROGRAM SUPPORT 30000 MINNEAPOLIS HEART INSTITUTE FOUNDATION 920 EAST 28TH STREET 100 MINNEAPOLIS MN 55407 NONE PC PROGRAM SUPPORT 5000 MINNESOTA ADULT AND TEEN CHALLENGE 1619 PORTLANT AVENUE SOUTH MINNEAPOLIS MN 55404 NONE PC PROGRAM SUPPORT 25000 NEW LIFE IN CHRIST MINISTRY PO BOX 456 CLEARWATER MN 55320 NONE PC RELIGIOUS 2000 NORTH HENNEPIN COMMUNITY COLLEGE 7411 85TH AVENUE NORTH BROOKLYN PARK MN 55445 NONE PC EDUCATIONAL 5000 NORTHEAST SENIOR SERVICES 900 42ND AVE NE 317 COLUMBIA HEIGHTS MN 55421 NONE PC PROGRAM SUPPORT 3000 PEOPLE SERVING PEOPLE 614 SOUTH THIRD STREET MINNEAPOLIS MN 55415 NONE PC PROGRAM SUPPORT 25000 SALEM COVENANT CHURCH 2655 FIFTH STREET NW NEW BRIGHTON MN 55112 NONE PC RELIGIOUS 150000 SCIENCE WITH A MISSION 602 MASSAPOAG AVE SHARON MA 02067 NONE PC PROGRAM SUPPORT 7000 SECOND HARVEST HEARTLAND 1140 GERVAIS AVENUE ST PAUL MN 55109 NONE PC PROGRAM SUPPORT 40000 SHARING & CARING HANDS 425 NORTH SEVENTH ST MINNEAPOLIS MN 55405 NONE PC PROGRAM SUPPORT 7000 SIMPSON HOUSING SERVICES 2100 PILSBURY AVE SO MINNEAPOLIS MN 55404 NONE PC PROGRAM SUPPORT 20000 SUNSHINE ACRES CHILDREN'S HOME 3405 NORTH HIGLEY ROAD MESA AZ 85215 NONE PC PROGRAM SUPPORT 7000 THE GIDEONS INTERNATIONAL PO BOX 403810 ATLANTA GA 30384 NONE PC PROGRAM SUPPORT 5000 THE RICHFIELD SPARTAN FOUNDATION 6638 KNOX AVE S RICHFIELD MN 55423 NONE PC EDUCATIONAL 5000 THE SALVATION ARMY 2445 PRIOR AVENUE NORTH ROSEVILLE MN 55113 NONE PC RELIGIOUS 100000 TRINITY FIRST LUTHERAN SCHOOL 1115 19TH AVE SO MINNEAPOLIS MN 55404 NONE PC EDUCATIONAL 7000 TRUE FRIENDS 10509 108TH ST NW ANNANDALE MN 55302 NONE PC PROGRAM SUPPORT 10000 UNION GOSPEL MISSION 77 NINTH STREET E ST PAUL MN 55101 NONE PC RELIGIOUS 10000 UNIVERSITY OF MINNESOTA FOUNDATION 200 OAK STREET SE 500 MINNEAPOLIS MN 55455 NONE PC EDUCATIONAL 50000 URBAN HOMEWORKS 2015 EMERSON AVE N MINNEAPOLIS MN 55411 NONE PC PROGRAM SUPPORT 5000 WORLD VISION PO BOX 9716 FEDERAL WAY WA 980639716 NONE PC RELIGIOUS 7000 1174000 0 14 426 14 211560 18 96855 IRS REFUND 01 8077 0 316918 0 316918 0 0 0 0 0 0 0 0 0 0 ACCOUNTING FEES 3255 2441 814 MEDTRONIC STOCK 7561924 8075000 CHEVRON 164000 250380 STATE OF MN FILING FEE 25 0 25 MISCELLANEOUS EXPENSE 18 0 18 IRS REFUND 8077 8077