2014-05-13T11:43:09-05:00 2013-12-31 420714325 MCGLADREY LLP 801 NICOLLET MALL SUITE 1100 MINNEAPOLIS MN 55402 990PF 2013-01-01 411873951 THE PATCH FOUNDATION PATC 6127817677 3201 RANKIN ROAD MINNEAPOLIS MN 55418 CAROLYN SAMPLE PRESIDENT 6127817677 2014-05-12 1 TODD A JACKSON P00092672 6123324300 2013 2015-12-30 17:16:21Z X 8370146 X X 17 17 128594 119394 377257 995757 34557 505868 153968 0 0 0 1750 875 875 4575 0 0 25 0 25 6350 875 900 622000 622000 628350 875 622900 -122482 153093 39214 25861 25861 166356 675629 675629 255000 255000 258548 4349388 3730888 7410108 4809958 4687378 8370146 0 0 X 0 0 0 0 4809958 4687378 4809958 4687378 4809958 4687378 4809958 -122482 0 4687476 98 4687378 PUBLICLY TRADED SECURITIES 995757 961200 34557 34557 34557 0 700875 6142529 0.114102 516025 6563116 0.078625 420225 6583022 0.063835 353125 6380069 0.055348 959585 1974911 0.485888 0.797798 0.159560 7300472 1164863 1531 1166394 622900 3062 0 3062 0 3062 4000 4000 938 938 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 3201 RANKIN ROAD MINNEAPOLIS MN 55418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 WILLIAM C PETERSON 6724 99TH AVE NORTH BROOKLYN PARK MN 55445 DIRECTOR 0.50 0 0 0 CAROLYN SAMPLE 3201 RANKIN RD MINNEAPOLIS MN 55418 PRESIDENT 2.00 0 0 0 ERNEST LINDSTROM-LINDSTROM LAW OFFI 7600 PARKLAWN AVE STE 444 EDINA MI 55435 DIRECTOR 0.50 0 0 0 NONE 0 NONE 0 0 7215051 196596 0 7411647 0 0 7411647 111175 7300472 365024 365024 3062 3062 361962 0 361962 0 361962 622900 0 622900 0 622900 361962 0 0 862119 37229 93591 190767 397524 1581230 622900 0 0 0 361962 260938 0 0 1842168 0 0 0 0 0 0 862119 980049 37229 93591 190767 397524 260938 CAROLYN P SAMPLE 3201 RANKIN ROAD NE MINNEAPOLIS MN 55418 6127817677 SEE STATEMENT 7 SEE STATEMENT 7 SEE STATEMENT 7 AMERICAN HEART ASSOCIATION 4701 WEST 77TH STREET MINNEAPOLIS MN 55435 NONE PUBLIC CHARITY PROGRAM SUPPORT 1000 AMERICAN LUNG ASSOCIATION PO BOX 7000 ALBERT LEA MN 56007 NONE PUBLIC CHARITY PROGRAM SUPPORT 1000 ARC OF HENNEPIN COUNTY 106 NORTH CHESTNUT STREET CHASKA MN 55318 NONE PUBLIC CHARITY PROGRAM SUPPORT 5000 CAMP KNUTSON 11169 WHITE FISH AVENUE CROSSLAKE MN 56442 NONE PUBLIC CHARITY PROGRAM SUPPORT 5000 CARE 151 ELLIS STREET NE ATLANTA GA 30303 NONE PUBLIC CHARITY PROGRAM SUPPORT 5000 CATHOLIC CHARITIES 1200 SECOND AVENUE SO MINNEAPOLIS MN 55403 NONE PUBLIC CHARITY PROGRAM SUPPORT 5000 CHILDREN'S HOME SOCIETY 1605 EUSTIS STREET ST PAUL MN 55108 NONE PUBLIC CHARITY PROGRAM SUPPORT 3000 COVENANT RETIREMENT COMMUNITIES OF MN 5800 ST CROIX AVENUE N GOLDEN VALLEY MN 55422 NONE RELIGIOUS PROGRAM SUPPORT 5000 COVENANT WORLD RELIEF 5101 NORTH FRANCISCO AVENUE CHICAGO IL 60625 NONE PUBLIC CHARITY PROGRAM SUPPORT 100000 DUNWOODY COLLEGE OF TECHNOLOGY 818 DUNWOODY BLVD MINNEAPOLIS MN 55403 NONE EDUCATIONAL PROGRAM SUPPORT 5000 EAST SIDE NEIGHBORHOOD 1700 SECOND STREET NE MINNEAPOLIS MN 55413 NONE PUBLIC CHARITY PROGRAM SUPPORT 2000 EVANGELICAL COVENANT CHURCH 5101 NORTH FRANCISCO AVENUE CHICAGO IL 60625 NONE RELIGIOUS PROGRAM SUPPORT 100000 FEED MY STARVING CHILDREN 401 93RD AVE NW COON RAPIDS MN 55433 NONE PUBLIC CHARITY PROGRAM SUPPORT 10000 CAMPS OF COURANGE AND FRIENDSHIP 10509 108TH STREET NW ANNANDALE MN 55302 NONE PUBLIC CHARITY PROGRAM SUPPORT 10000 GREATER MINNEAPOLIS CRISIS NURSERY 5400 GLENWOOD AVE GOLDEN VALLEY MN 55422 NONE PUBLIC CHARITY PROGRAM SUPPORT 3000 HABITAT FOR HUMANITY 121 HABITAT STREET AMERICUS GA 31709 NONE PUBLIC CHARITY PROGRAM SUPPORT 5000 HOMEWARD BOUND 13895 INDUSTRIAL PARK BLVD 100 PLYMOUTH MN 55441 NONE PUBLIC CHARITY PROGRAM SUPPORT 8000 HOUSE OF CHARITY 510 SOUTH EIGHTH STREET MINNEAPOLIS MN 55404 NONE PUBLIC CHARITY PROGRAM SUPPORT 15000 KIWANIS CLUB OF NE MINNEAPOLIS C/O WALT SENTYRZ 1612 SECOND ST NE MINNEAPOLIS MN 554131138 NONE PUBLIC CHARITY PROGRAM SUPPORT 1000 LITTLE BROTHERS FRIENDS OF THE ELDERLY 1845 EAST LAKE STREET MINNEAPOLIS MN 55407 NONE PUBLIC CHARITY PROGRAM SUPPORT 15000 LITTLE SISTERS OF THE POOR 330 EXCHANGE STREET S ST PAUL MN 55102 NONE RELIGIOUS PROGRAM SUPPORT 3000 LOAVES AND FISHES 1917 LOGAN AVENUE SOUTH MINNEAPOLIS MN 55403 NONE PUBLIC CHARITY PROGRAM SUPPORT 7000 MARCH OF DIMES 1275 MAMARONECK AVENUE WHITE PLAINS NY 10605 NONE PUBLIC CHARITY PROGRAM SUPPORT 1000 METRO HOPE MINISTRIES 2739 CEDAR AVENUE SOUTH MINNEAPOLIS MN 55407 NONE PUBLIC CHARITY PROGRAM SUPPORT 20000 MINNEAPOLIS HEART INSTITUTE FOUNDATION 920 EAST 28TH STREET 100 MINNEAPOLIS MN 55407 NONE PUBLIC CHARITY PROGRAM SUPPORT 5000 MINNESOTA TEEN CHALLENGE 1619 PORTLANT AVENUE SOUTH MINNEAPOLIS MN 55404 NONE PUBLIC CHARITY PROGRAM SUPPORT 10000 NORTH HENNEPIN COMMUNITY COLLEGE 7411 85TH AVENUE NORTH BROOKLYN PARK MN 55445 NONE EDUCATIONAL PROGRAM SUPPORT 3000 NORTHEAST SENIOR SERVICES 2580 KENZIE TERRACE SUITE 2A ST ANTHONY MN 55418 NONE PUBLIC CHARITY PROGRAM SUPPORT 3000 PEOPLE SERVING PEOPLE 614 SOUTH THIRD STREET MINNEAPOLIS MN 55415 NONE PUBLIC CHARITY PROGRAM SUPPORT 15000 SALEM COVENANT CHURCH 2655 FIFTH STREET NW NEW BRIGHTON MN 55112 NONE RELIGIOUS PROGRAM SUPPORT 100000 SCIENCE WITH A MISSION 602 MASSAPOAG AVE SHARON MA 02067 NONE PUBLIC CHARITY PROGRAM SUPPORT 3000 SECOND HARVEST FOOD BANK 1140 GERVAIS AVENUE ST PAUL MN 55109 NONE PUBLIC CHARITY PROGRAM SUPPORT 15000 SHARING & CARING HANDS 525 NORTH 7TH STREET MINNEAPOLIS MN 554051523 NONE PUBLIC CHARITY PROGRAM SUPPORT 3000 SIMPSON HOUSING SERVICES 2740 FIRST AVENUE SOUTH MINNEAPOLIS MN 55408 NONE PUBLIC CHARITY PROGRAM SUPPORT 15000 SISTER KENNY FOUNDATION 800 EAST 28TH STREET MINNEAPOLIS MN 55407 NONE PUBLIC CHARITY PROGRAM SUPPORT 15000 SUNSHINE ACRES 3405 NORTH HIGLEY ROAD MESA AZ 85215 NONE PUBLIC CHARITY PROGRAM SUPPORT 5000 THE GIDEONS PO BOX 140800 NASHVILLE TN 37214 NONE PUBLIC CHARITY PROGRAM SUPPORT 3000 THE SALVATION ARMY 2445 PRIOR AVENUE NORTH ROSEVILLE MN 55113 NONE RELIGIOUS PROGRAM SUPPORT 50000 UNION GOSPEL MISSION 77 NINTH STREET E ST PAUL MN 55101 NONE RELIGIOUS PROGRAM SUPPORT 10000 UNIVERSITY OF MINNESOTA FOUNDATION 200 OAK STREET SE 500 MINNEAPOLIS MN 55455 NONE EDUCATIONAL PROGRAM SUPPORT 30000 THE RICHFIELD SPARTAN FOUNDATION 6638 KNOX AVE S RICHFIELD MN 55423 NONE EDUCATIONAL PROGRAM SUPPORT 2000 622000 0 14 17 14 128594 18 377257 0 505868 0 505868 0 0 0 0 0 0 0 0 0 0 ACCOUNTING FEES 1750 875 875 MEDTRONIC STOCK 3408938 6886800 3M 157950 273488 CHEVRON 164000 249820 0 0 255000 258548 BROKER BASIS ADJUSTMENTS - NO TAX EFFECT 98 STATE OF MN FILING FEE 25 0 25 FEDERAL EXCISE TAX PAID - 12/31/2012 575 0 0 ESTIMATED EXCISE TAX PAID - CURRENT YEAR 4000 0 0