2013-02-08T11:04:56-06:00 2012-06-30 135381590 BDO USA LLP 7101 WISCONSIN AVE SUITE 800 BETHESDA MD 208144827 990 2011-07-01 522204473 THE GOLDEN LEAF INC GOLD 2524427474 301 N WINSTEAD AVE ROCKY MOUNT NC 27804 DANIEL J GERLACH 2524427474 2013-02-08 1 MICHAEL SORRELLS CPA P00001737 3016544900 2011 2016-02-25 16:41:14Z DANIEL J GERLACH 301 N WINSTEAD AVE ROCKY MOUNT NC 27804 300495700 0 X WWW.GOLDENLEAF.ORG X 1999 NC SEE PART III, LINE 1 15 15 14 0 -1083463 -1083463 69128105 70489443 0 0 33741594 22755994 8686 6569 102878385 93252006 43092615 44742093 0 0 1559635 1600924 0 0 0 3035458 20780662 47687708 67123679 55190677 26128327 793585382 793382903 92950403 84625928 700634979 708756975 X GOLDEN LEAF'S MISSION IS TO PROMOTE THE SOCIAL WELFARE OF NORTH CAROLINA'S CITIZENS AND TO RECEIVE AND DISTRIBUTE FUNDS FOR ECONOMIC IMPACT ASSISTANCE TO ECONOMICALLY AFFECTED OR TOBACCO-DEPENDENT REGIONS OF NORTH CAROLINA. 0 0 45790656 44742093 THE PRIMARY PURPOSE FOR WHICH THIS CORPORATION WAS FORMED IS TO PROMOTE THE SOCIAL WELFARE AND LESSEN THE BURDENS OF GOVERNMENT BY RECEIVING AND DISTRIBUTING FUNDS TO BE USED TO PROVIDE ECONOMIC IMPACT ASSISTANCE TO ECONOMICALLY AFFECTED OR TOBACCO-DEPENDENT REGIONS OF NORTH CAROLINA IN ACCORDANCE WITH THE CONSENT DECREE AND FINAL JUDGMENT IN STATE OF NORTH CAROLINA V. PHILIP MORRIS INCORPORATED, ET AL., 98 CVS 14377.ACTIVITIES IN WHICH THE CORPORATION MAY ENGAGE IN THE STATE OF NORTH CAROLINA INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING:1. EDUCATION ASSISTANCE - PROVISION OF FUNDS FOR EDUCATIONAL PROGRAMS FOR TOBACCO FARMERS AND OTHER WORKERS IMPACTED OR PROJECTED TO BE IMPACTED BY A DECLINE IN DEMAND FOR AND/OR PRODUCTION OF TOBACCO OR TOBACCO PRODUCTS. (CONTINUED ON SCHEDULE O)2. JOB TRAINING AND EMPLOYMENT ASSISTANCE - PROVISION OF LOANS AND GRANTS, TO BE USED FOR JOB TRAINING AND OTHER EMPLOYMENT-RELATED PROGRAMS, TO ORGANIZATIONS ASSISTING TOBACCO FARMERS AND OTHER WORKERS DEPENDENT ON TOBACCO FARMING, PRODUCTION AND SALES TO TRANSITION TO OTHER SOURCES OF INCOME.3. SCIENTIFIC RESEARCH - PROVISION OF FUNDING FOR SCIENTIFIC RESEARCH TO DEVELOP NEW USES FOR TOBACCO OR FOR THE DEVELOPMENT OF ALTERNATIVE CASH CROPS.4. ECONOMIC HARDSHIP ASSISTANCE - PROVISION OF DIRECT GRANTS, LOANS AND OTHER ASSISTANCE PROGRAMS TO ALLEVIATE ECONOMIC HARDSHIP, POVERTY OR NEED EXPERIENCED BY TOBACCO FARMERS, QUOTA OWNERS, THEIR FAMILIES AND OTHERS AS A RESULT OF DECLINE IN QUOTA AND/OR PRODUCTION OF TOBACCO OR TOBACCO PRODUCTS.5. PUBLIC WORKS AND INDUSTRIAL RECRUITMENT - PROVISION OF GRANTS AND LOANS TO LOCAL GOVERNMENTS FOR UPGRADING UTILITIES, TRANSPORTATION, AND OTHER PUBLIC SERVICE INFRASTRUCTURE TO ATTRACT NEW BUSINESSES OR FOR MORE GENERAL ECONOMIC DEVELOPMENT PURPOSES.6. HEALTH AND HUMAN SERVICES - PROVISION OF FUNDING FOR IMPROVED HEALTH CARE AND OTHER SOCIAL SERVICES NEEDED TO MAINTAIN THE STABILITY OF TOBACCO-DEPENDENT COMMUNITIES.7. COMMUNITY ASSISTANCE - PROVISION OF DIRECT GRANTS AND LOANS TO ECONOMICALLY DEPRESSED AND DETERIORATING TOBACCO-DEPENDENT COMMUNITIES, TO BE USED EXCLUSIVELY FOR PUBLIC PURPOSES. 45790656 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 21 0 1 14 1 1 1 1 EI 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X BETH EDMONDSON 2524427474 301 N WINSTEAD AVE ROCKY MOUNT NC 27804 MICHAEL A ALMOND 3.00 X 832 0 0 WADE BARBER 3.00 X X 1248 0 0 DALE C BONE 3.00 X 1356 0 0 PAUL BROOKS 3.00 X 1248 0 0 J THOMAS BUNN 3.00 X 0 0 0 WILLIAM CLARKE VICE CHAIR 15.00 X X 1248 0 0 S LAWRENCE DAVENPORT 3.00 X X 624 0 0 BILLY RAY HALL 3.00 X 1352 0 0 JAMES H JOHNSON JR 3.00 X 416 0 0 YVONNE J JOHNSON 3.00 X 624 0 0 LACY R JOYNER 3.00 X 1248 0 0 J ARTHUR POPE 3.00 X 0 0 0 EDGAR M ROACH 15.00 X X 1248 0 0 JOHNATHAN RHYNE 3.00 X 0 0 0 DAVID T STEPHENSON 3.00 X 104 0 0 THOMAS F TAFT SR 3.00 X 1040 0 0 DANIEL J GERLACH 40.00 X 187412 0 34183 MARK A SORRELLS 40.00 X 155228 0 31149 PETER J CERA 40.00 X 134387 0 28815 PATRICIA CABE-CANTRELL 40.00 X 104889 0 23750 EDWARD P LORD 40.00 X 104139 0 25679 BETH A EDMONDSON 30.00 X 87332 0 21495 785975 0 165071 5 0 1 0 FRIESS ASSOCIATES 3711 KENNETT PIKE GREENVILLE DE 19807 INVESTMENT MANAGEMENT 400971 ARTISAN PARTNERS 5 CONCOURSE PARKWAY SUITE 2120 ATLANTA GA 30328 INVESTMENT MANAGEMENT 360728 SILCHESTER INTERNATIONAL INVESTORS 780 THIRD AVENUE 42ND FLOOR NEW YORK NY 10017 INVESTMENT MANAGEMENT 349281 PRIME BUCHHOLZ & ASSOCIATES INC 25 CHESTNUT STREET PORTSMOUTH NH 03801 INVESTMENT CONSULTING 243887 DRZ 250 PARK AVE SOUTH SUITE 250 WINTER PARK FL 32789 INVESTMENT MANAGEMENT 234729 10 70489443 70489443 7804907 -1083463 8888370 222194781 207243694 14951087 14951087 14951087 OTHER INCOME 900099 6569 6569 6569 93252006 6569 -1083463 23839457 44742093 44742093 979772 528312 451460 402427 311518 90909 40539 31564 8975 94388 65608 28780 83798 53683 30115 184937 184937 55873 55873 2474111 2474111 19426 19126 300 7728 7728 35967 35967 36157 36157 58022 58022 43580 38543 5037 209 209 20842 20842 PAYMENT TO STATE OF NC 17563760 17563760 MSA ENFORCEMENT 218720 218720 BOARD OF DIRECTORS EXPE 41115 41115 CAPITAL OUTLAYS 11088 11088 9127 9127 67123679 45790656 21333023 0 492750 445273 1223 1927 84651 84348 372430292 358916894 420576466 433934461 793585382 793382903 166298 120371 92784105 84505557 92950403 84625928 X 0 0 0 0 700634979 708756975 700634979 708756975 793585382 793382903 X 26128327 -18006331 X X 0 1 1 X 0 X 79976781 87593455 73179244 69128105 70489443 380367028 79976781 87593455 73179244 69128105 70489443 380367028 380367028 8075031 6455370 5237547 8247547 8888370 36903865 -47772 -576622 -705680 87492 -1083463 -2326045 54236 50554 5040 8686 6569 125085 415069933 0.91640 0.91490 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 1243 0 0 1243 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THESE EXPENSES REPRESENT SALARY AND BENEFIT COSTS FOR OUR PRESIDENT'S TIME SPENT LOBBYING MEMBERS OF THE NC GENERAL ASSEMBLY RELATED TO STATE BUDGET BILLS AFFECTING GOLDEN LEAF FUNDING AND EDUCATING LEGISLATORS ABOUT THE FOUNDATION AND ITS WORK. 0 AG REALTY FUND VII (TE), L.P. 7789987 F ARCHSTONE OFFSHORE FUND, LTD. 19943283 F AURORA VENTURES IV & V 6780819 F AXIOM INTL EQUITY FUND II 23096134 F BEACON CAPITAL STRATEGIC PTRS V & VI 5352942 F SWIFTCURRENT OFFSHORE, LTD. 16612453 F CANTILLON GLOBAL VALUE FUND 22607905 F CARLYLE VENTURE PARTNERS II, LP 2213775 F CAROUSEL CAPITAL PARTNERS III, L.P. 3089484 F COLONY INVESTORS VIII, L.P. 2013484 F DIVERSIFIED PARTNERS OFFSHORE FUND II, L.P. 2267653 F DENHAM COMMODITY PARTNERS FUND V LP 3576188 F ENCAP ENERGY CAPITAL FUND VII, L.P. 5884463 F FARALLON CAPITAL INSTITUTIONAL PARTNERS, L.P. 15128228 F HATTERAS VENTURE PARTNERS II, L.P. 11005143 F HIGHLINE CAPITAL INTERNATIONAL, LTD. 18775428 F KING STREET CAPITAL, LTD. 13229832 F LEXINGTON CAPITAL PTRS V & LCPVI-A (OFFSHORE) 9493159 F LONE CASCADE, L.P. 16776902 F LONE DRAGON PINE, L.P. 2137305 F MATLIN PATTERSON GLOBAL OPPORTUNITIES PTRS III, L.P. 3580532 F OZ OVERSEAS FUND II, LTD. 18091150 F Q-BLK PRIVATE CAPITAL II, (PARALLEL), L.P. 8614477 F SHEPHERD INVESTMENTS INTERNATIONAL, LTD. 8841947 F SHERIDAN PRODUCTION PARTNERS 1-B & 11 9983000 F SILCHESTER INTL VALUE EQUITY TRUST 41508454 F SILVERPOINT CAPITAL OFFSHORE FUND, LTD. 1023596 F SYNERGY LIFE SCIENCE PARTNERS, LP 2430290 F REALTY ASSOCIATES FUND VIII & IX 14224594 F TACONIC OPPORTUNITY OFFSHORE FUND, LTD 10529108 F THOMAS H LEE EQUITY FUND VI, L.P. 4683648 F VARDE FUND IX & X 16812754 F WARBURG PINCUS X 14552006 F WELLINGTON ARCHIPELAGO 28123089 F WELLINGTON BAY POND 22778988 F WELLINGTON CTF COMMODITIES II 20382261 F 433934461 93252006 67123679 26128327 -31010685 13004354 -18006331 8121996 60850673 -31010685 -31010685 91861358 2474111 -1083463 1390648 93252006 52728677 0 52728677 2474111 11920891 14395002 67123679 PART XI, LINE 8 - OTHER ADJUSTMENTS: PASS-THROUGH UBI LOSS FROM K-1S 1,083,463. RESCISSIONS AND RETURNS OF GRANTS 11,920,891. TOTAL TO SCHEDULE D, PART XI, LINE 8: 13,004,354. PART XII, LINE 4B - OTHER ADJUSTMENTS: PASS-THROUGH UBI LOSS FROM K-1S -1,083,463. PART XIII, LINE 4B - OTHER ADJUSTMENTS: RESCISSIONS AND RETURNS OF GRANTS 11,920,891. NORTH AMERICA 0 0 INVESTMENTS 28123089 NORTH AMERICA 0 0 INVESTMENTS 22778988 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 18775428 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 13229832 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 8841947 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 19943283 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 16612453 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 2267653 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 9493159 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 18091150 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 1023597 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 10529108 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 INVESTMENTS 22607905 0 0 0 0 0 0 130572673 61744919 192317592 1 0 0 1 1 0 1 ALLEGHANY MEMORIAL HOSPITAL 233 DOCTORS STREET PO BOX 9 SPARTA NC 28675 560525657 501(C)(3) 200000 CAPITAL EQUIPMENT IMPROVEMENT PLAN APPALACHIAN STATE UNIVERSITY 287 RIVERS ST BOONE NC 28608 561176030 EDUCATION TAX EXEMPT 80000 A SUSTAINABLE QA PROGRAM FOR THE NC GRAPE AND WINE INDUSTRY ASHE COUNTY JOB DEVELOPMENT INC (ACJD) 150 GOVERNMENT CIRCLE SUITE 2500 JEFFERSON NC 286408967 561993665 501(C)(3) 175000 ACJD RENOVATION/UPFIT OF OLD LEVITON MANUFACTURING FACILITY BARTON COLLEGE PO BOX 5000 WILSON NC 278937000 560529933 501(C)(3) 375000 THE HEARNE-BARTON PARTNERSHIP SCHOOL BATH HIGH SCHOOL PRESERVATION (BHSP) PO BOX 149 BATH NC 27808 300311916 501(C)(3) 250000 BATH AREA RETIREE INITIATIVE BEAUFORT COUNTY COMMUNITY COLLEGE PO BOX 1069 5337 HWY 264 EAST WASHINGTON NC 27889 560894923 EDUCATION TAX EXEMPT 1000000 ENHANCING & EXPANDING THE BCCC ALLIED HEALTH AND NURSING PROGRAMS BENSON AREA MEDICAL CENTER INC PO BOX 399 3333 NC HWY 242 N BENSON NC 27504 561181412 501(C)(3) 69165 POSITIONING TO MEET THE NEED - 2014 BENT CREEK INSTITUTE INC 100 FREDERICK LAW OLMSTED WAY ASHEVILLE NC 288069315 264768737 501(C)(3) 100000 U.S. BOTANICAL SAFETY LABORATORY BERTIE COUNTY SCHOOLS PO BOX 10 222 COUNTY FARM ROAD WINDSOR NC 27983 566000110 EDUCATION TAX EXEMPT 750000 WORLD WISE (W2) BLADEN'S BLOOMIN' AGRI-INDUSTRIAL INC 218-A AVIATION PARKWAY ELIZABETHTOWN NC 28337 460502334 501(C)(3) 160000 PROJECT HEALTHCARE BRUNSWICK COUNTY 45 COURTHOUSE DRIVE NE PO BOX 249 BOLIVIA NC 28422 560000278 GOV'T ENTITY 859933 PROJECT ROAD RUNNER: WATER, SEWER & NATURAL GAS INFRASTRUCTURE CALDWELL MEMORIAL HOSPITAL FOUNDATION INC PO BOX 1890 321 MULBERRY ST LENOIR NC 286451890 581935514 501(C)(3) 100000 MCCREARY CANCER CENTER CAMPBELL UNIVERSITY PO BOX 3539 BUIES CREEK NC 27506 560529940 EDUCATION TAX EXEMPT 2000000 CAMPBELL UNIVERSITY SCHOOL OF OSTEOPATHIC MEDICINE CAROLINA FARM STEWARDSHIP ASSOCIATION PO BOX 448 PITTSBORO NC 27312 240040340 501(C)(3) 40000 EXPANDING LOCAL FOOD MARKETING WITH SOCIAL MEDIA TOOLS CAROLINAS GATEWAY PARTNERSHIP 427 FALLS ROAD ROCKY MOUNT NC 27804 561931327 501(C)(3) 65000 KINGSBORO SELECT SITE PROGRAM CENTER FOR CREATIVE LEADERSHIP ONE LEADERSHIP PLACE PO BOX 26300 GREENSBORO NC 274386300 237079591 GOV'T ENTITY 1375997 GOLDEN LEAF SCHOLARS LEADERSHIP PROGRAM CENTER FOR CREATIVE LEADERSHIP ONE LEADERSHIP PL PO BOX 26300 GREENSBORO NC 274386300 237079591 GOV'T ENTITY 1274414 GOLDEN LEAF SCHOLARS LEADERSHIP PROGRAM (GLSLP) CENTER FOR ECONOMIC EMPOWERMENT & DEVELOPMENT 230 HAY STREET PO BOX 2384 FAYETTEVILLE NC 28301 581873977 501(C)(3) 250000 MICROENTERPRISE DEVELOPMENT PROGRAM CITY OF ASHEVILLE PO BOX 7148 ASHEVILLE NC 288027148 566000224 GOV'T ENTITY 300000 INFRASTRUCTURE IMPR REQUIRED FOR SECURING A MAJOR NEW EMPLOYER CITY OF KINSTON PO DRAWER 339 207 E KING STREET KINSTON NC 285020339 566001259 GOV'T ENTITY 1250000 PROJECT NORMAN CLEVELAND VOCATIONAL INDUSTRIES 650 NORTH POST ROAD SHELBY NC 28150 561448881 501(C)(3) 60787 CARE (CVA ACTIVELY RECYCLING ELECTRONICS) COLLEGE OF THE ALBEMARLE 1208 NORTH ROAD ST PO BOX 2327 ELIZABETH CITY NC 279062327 566024012 EDUCATION TAX EXEMPT 200000 GRANT TO COMPLETE THE REG AVIATION & TECH TRAINING CTR (EQUIP) CRAVEN COMMUNITY COLLEGE FOUNDATION 800 COLLEGE COURT NEW BERN NC 28562 591718436 501(C)(3) 147476 ROBOTICS AND WELDING CUMBERLAND COUNTY GOVERNMENT PO BOX 1829 FAYETTEVILLE NC 283011829 566000291 GOV'T ENTITY 469218 SEWER EXT TO VANDER FIRE DEPT, VANDER PARK & MORTY PRIDE MEATS CUMBERLAND COUNTY PUBLIC LIBRARY & INFORMATION CENTER 300 MAIDEN LANE FAYETTEVILLE NC 283015000 566000291 GOV'T ENTITY 61640 WORKFORCE DEV @ YOUR LIBRARY: EXPANDING ACCESS, IMPRV POTENTIAL CUMBERLAND COUNTY SCHOOLS PO BOX 2357 2465 GILLESPIE ST FAYETTEVILLE NC 28302 566001015 EDUCATION TAX EXEMPT 300000 LEADING THE WAY TO STEM SUCCESS DAVIE COUNTY 123 SOUTH MAIN STREET MOCKSVILLE NC 270282424 566000295 GOV'T ENTITY 2500000 TOP DRAWERS DUPLIN GENERAL HOSPITAL PO BOX 278 KENANSVILLE NC 28349 566011594 501(C)(3) 200000 DUPLIN GENERAL HOSPITAL EMERGENCY AREA EXPANSION EAST CAROLINA HEALTH-BEAUFORT-INC DBA VIDANT BEAUFORT HOSPITAL 628 EAST 12TH ST WASHINGTON NC 278893409 452436270 501(C)(3) 550000 MARION L. SHEPARD CANCER CENTER EXPANSION PROJECT EAST CAROLINA UNIVERSITY 2906 GREENVILLE CNTR MAILSTOP 165 GREENVILLE NC 278584353 566000403 EDUCATION TAX EXEMPT 75000 MEETING INDUSTRY DEMAND FOR CERTIFIED LOGGING EQUIPMENT OPERATORS EAST CAROLINA UNIVERSITY 2906 GREENVILLE CNTR MAILSTOP 165 GREENVILLE NC 278584353 566000403 EDUCATION TAX EXEMPT 50000 SUMMER PROGRAM FOR FUTURE DOCTORS EDGECOMBE COUNTY PO BOX 10 201 ST ANDREW ST TARBORO NC 27886 566000298 GOV'T ENTITY 100000 EDGECOMBE GREEN ENERGY PROJECT FAYETTEVILLE TECHNICAL COMMUNITY COLLEGE PO BOX 35236 2201 HULL RD FAYETTEVILLE NC 28303 560791849 GOV'T ENTITY 463046 SERVING THE AVIATION IND NEEDS THROUGH TRANSITIONING VETERANS FIRST CHOICE COMMUNITY HEALTH CENTERS (FCCHC) 40 AUTUMN FERN TRAIL PO BOX 2768 LILLINGTON NC 27546 561205213 501(C)(3) 75000 INCREASING ACCESS TO CARE IN HARNETT COUNTY FORSYTH TECHNICAL COMMUNITY COLLEGE 2100 SILAS CREEK PARKWAY WINSTONSALEM NC 27103 560792614 EDUCATION TAX EXEMPT 447145 PROJECT DOGWOOD FRANKLIN-VANCE-WARREN OPPORTUNITY INC PO BOX 1453 180 S BECKFORD DR HENDERSON NC 27536 560861261 501(C)(3) 30000 WOMEN'S ECONOMIC EQUITY (WEE) PROJECT GASTON COUNTY ECONOMIC DEVELOPMENT COMMISSION PO BOX 1578 620 NORTH MAIN ST GASTONIA NC 28053 566000300 GOV'T ENTITY 250000 PROJECT LIFT GATES COUNTY PO BOX 148 200 COURT ST GATESVILLE NC 27938 566000301 GOV'T ENTITY 200000 U.S. HIGHWAY 158 ECONOMIC DEVELOPMENT WASTEWATER PROJECT GOLER COMMUNITY DEVELOPMENT CORPORATION 889 NORTH LIBERTY STREET WINSTONSALEM NC 27101 562118777 501(C)(3) 40000 PIEDMONT CONTRACTOR RESOURCE CENTER GRANVILLE COUNTY 141 WILLIAMSBORO ST PO BOX 906 OXFORD NC 27565 566000303 GOV'T ENTITY 200000 GRANVILLE COUNTY EXPO & CONVENTION CENTER WATERLINE EXTENSION GRANVILLE COUNTY 141 WILLIAMSBORO ST PO BOX 906 OXFORD NC 27565 566000303 GOV'T ENTITY 5500000 PROJECT GREEN GRANVILLE HEALTH SYSTEM 1010 COLLEGE STREET OXFORD NC 27565 560593547 GOV'T ENTITY 112000 GRANVILLE MEDICAL CENTER EMERGENCY DEPARTMENT EXPANSION HENDERSON COUNTY GOVERNMENT 1 HISTORIC COURTHOUSE SQUARE HENDERSONVILLE NC 28792 566000307 GOV'T ENTITY 750000 BIG FOREST HOKE COUNTY ADMIN BLDNG 227 N MAIN ST RAEFORD NC 28376 566001525 GOV'T ENTITY 379500 PHASE 1A - SEWER - FIRST HEALTH & HOKE HEALTH SERVICES JOHNSTON MEMORIAL HOSPITAL FOUNDATION PO BOX 1376 SMITHFIELD NC 27577 561831806 501(C)(3) 100000 EMERGENCY SERVICES EXPANSION AND RENOVATION PROJECT JONES COUNTY PO BOX 340 TRENTON NC 28585 566000312 GOV'T ENTITY 75000 SPRINKLER SYSTEM FOR THE JONES COUNTY BUSINESS CENTER JONES COUNTY HEALTH DEPARTMENT PO BOX 216 TRENTON NC 28585 566000312 GOV'T ENTITY 200000 ADULT HEALTH CLINIC JONES COUNTY PUBLIC SCHOOLS 320 WEST JONES STREET TRENTON NC 28585 566001056 EDUCATION TAX EXEMPT 750000 JONES SENIOR HIGH TECHNOLOGY ACCESSIBILITY AND UTILIZATION LENOIR COMMUNITY COLLEGE - JONES CAI PO BOX 188 231 HIGHWAY 58 S KINSTON NC 285020188 560753025 GOV'T ENTITY 580000 CAREER TECH ACADEMY - JONES MADISON COUNTY PUBLIC SCHOOLS 5738 US HIGHWAY 25/70 MARSHALL NC 28753 566001070 EDUCATION TAX EXEMPT 199793 MADISON COUNTY 1:1 INITIATIVE MARTIN COUNTY ECONOMIC DEVELOPMENT CORPORATION 415 EAST BOULEVARD WILLIAMSTON NC 27892 562042675 501(C)(3) 350000 MARCO COMPANY JOB CREATION PROJECT MAYLAND COMMUNITY COLLEGE PO BOX 547 SPRUCE PINE NC 287770547 560990134 501(C)(3) 100000 THE CAREER AND TECHNICAL CENTER MCDOWELL COUNTY 60 EAST COURT ST MARION NC 28752 566000318 GOV'T ENTITY 2140000 UNIVERSAL CAREER PATHWAYS SKILL CENTER MONTGOMERY COUNTY 102 EAST SPRING STREET TROY NC 27371 566000321 GOV'T ENTITY 498750 RAW WATER BANK STABILIZATION IMPROVEMENTS MONTGOMERY COUNTY COUNCIL ON AGING INC PO BOX 697 TROY NC 27371 561173830 501(C)(3) 70000 MONTGOMERY COUNTY AGRICULTURAL AND CIVIC CENTER KITCHEN INCUBATOR MOREHEAD MEMORIAL HOSPITAL 117 EAST KINGS HIGHWAY EDEN NC 27288 560591294 501(C)(3) 200000 URGENT MEDICAL CARE FOR WESTERN ROCKINGHAM COUNTY NORTH CAROLINA AGRICULTURAL FOUNDATION INC CAMPUS BOX 7645 RALEIGH NC 276957645 566049304 501(C)(3) 75000 A.S.P.I.R.E. - ACT SUPPLEMENTAL PREPARATION IN RURAL EDUCATION NORTH CAROLINA AGRICULTURAL FOUNDATION INC CAMPUS BOX 7645 RALEIGH NC 276957645 566049304 501(C)(3) 160000 (CALS) AGRICULTURAL LEADERSHIP DEVELOPMENT NC ASSOCIATION FOR DAIRY STABILIZATION AND GROWTH INC 5301 GLENWOOD AVENUE RALEIGH NC 27612 450594324 501(C)(3) 50000 NC DAIRY ADVANTAGE PROGRAM NORTH CAROLINA BIOTECHNOLOGY CENTER 15 TW ALEXANDER DRIVE PO BOX 13547 RESEARCH TRIANGLE PARK NC 277093547 561434024 501(C)(3) 150000 BIOTECHNOLOGY CROP COMMERCIALIZATION CENTER NORTH CAROLINA COASTAL LAND TRUST 131 RACINE DRIVE STE 101 WILMINGTON NC 28403 561791849 501(C)(3) 75000 PHASE 3, ENCROACHMENT PARTNERSHIP WITH THE US MARINE CORPS NORTH CAROLINA COMMUNITY COLLEGE SYSTEM 5016 MAIL SERVICE CENTER RALEIGH NC 276995016 561288079 EDUCATION TAX EXEMPT 750000 GOLDEN LEAF SCHOLARS PROGRAM - TWO-YEAR COLLEGES NC DEPT OF AGRICULTURE & CONSUMER SERVICES 1020 MAIL SERVICE CENTER RALEIGH NC 27699 566000732 GOV'T ENTITY 160000 COOLER EXPANSION FOR THE NCDA&CS SALISBURY WAREHOUSE NORTH CAROLINA GOVERNOR'S SCHOOL FOUNDATION 3000 BETHESDA PLACE STE 804 WINSTONSALEM NC 27103 581985906 501(C)(3) 175000 NORTH CAROLINA GOVERNOR'S SCHOOL, 2012 SESSION NORTH CAROLINA INDEPENDENT COLLEGES AND UNIVERSITIES 530 N BLOUNT STREET RALEIGH NC 27604 560775353 501(C)(3) 420000 NCICU GOLDEN LEAF FOUNDATION SCHOLARSHIP PROGRAM NORTH CAROLINA NEW SCHOOLS PROJECT INC 4600 MARRIOTT DR STE 510 RALEIGH NC 276123307 204031703 501(C)(3) 500000 INVESTING IN INNOVATION NORTH CAROLINA NEW SCHOOLS PROJECT INC 4600 MARRIOTT DR STE 510 RALEIGH NC 276123307 204031703 501(C)(3) 100000 TOWARD SUSTAINABILITY: SUPPORTING 1:1 PROJECTS ACROSS NC NORTH CAROLINA REAL ENTERPRISES INC 3739 NATIONAL DRIVE SUITE 110 RALEIGH NC 27612 561522978 501(C)(3) 100000 FROM ENTREPRENEURSHIP TO ENTERPRISES: A REAL PATHWAY N CAROLINA STATE EDUCATION ASSISTANCE AUTHORITY PO BOX 14103 10 TW ALEXANDER DR RESEARCH TRIANGLE PARK NC 277094103 900145439 501(C)(3) 1390000 GOLDEN LEAF SCHOLARS PROGRAM 2012-13 NORTH CAROLINA STATE UNIVERSITY CAMPUS BOX 7514 RALEIGH NC 276957626 566000756 EDUCATION TAX EXEMPT 55000 BREEDING PEST RESISTANCE INTO FRASER FIRS & ORN. HEMLOCKS: YR 2 NORTHAMPTON COUNTY PO BOX 808 JACKSON NC 27845 566000325 GOV'T ENTITY 200000 ENVIVA INFRASTRUCTURE PROJECT OLIVE HILL COMMUNITY ECONOMIC DEVELOPMENT CORPORATION INC PO BOX 4008 420 C WEST FLEMING DR MORGANTON NC 28680 311639629 501(C)(3) 60000 BURKE CENTER FOR ECONOMIC DEVELOPMENT PIEDMONT TRIAD AIRPORT AUTHORITY 1000 A TED JOHNSON PARKWAY GREENSBORO NC 27409 560668378 501(C)(3) 1000000 PROJECT ICING ROCKINGHAM COUNTY BUSINESS & TECHNOLOGY CENTER 240 CHEROKEE CAMP RD STE 2 REIDSVILLE NC 27320 566001527 GOV'T ENTITY 350000 BIZFUEL ROWAN JOBS INITIATIVE 204 E INNES STREET SALISBURY NC 28144 870713114 501(C)(3) 550000 PROJECT PROTEIN RURAL ADVANCEMENT FOUNDATION INTERNATIONAL-USA (RAFI-USA) PO BOX 640 PITTSBORO NC 27312 561704863 501(C)(3) 61000 TOWNSEND GROWERS FINANCIAL ADVOCACY RUTHERFORD COUNTY GOVERNMENT 289 NORTH MAIN STREET RUTHERFORDTON NC 28139 566000337 GOV'T ENTITY 262000 GEPPETTO DOOR LINE EXPANSION RUTHERFORD COUNTY SCHOOLS EDUCATION FOUNDATION INC 382 W MAIN ST FOREST CITY NC 28043 272771407 501(C)(3) 200000 GOING G.L.O.B.A.L. ST ANDREWS UNIVERSITY 1700 DOGWOOD MILE LAURINBURG NC 28352 560530240 501(C)(3) 1000000 ST. ANDREWS PRESBYTERIAN COLLEGE STECOAH VALLEY ARTS CRAFTS & EDUCATIONAL CENTER INC 121 SCHOOLHOUSE RD ROBBINSVILLE NC 287719628 561935344 501(C)(3) 55000 STECOAH ASSET-BASED TOURISM PROJECT STURGEON CITY OF JACKSONVILLE NC INCORPORATED PO BOX 1056 JACKSONVILLE NC 28541 562228246 501(C)(3) 146475 ADAPTIVE REUSE OF A FORMER WASTEWATER PLANT SURRY COUNTY 118 HAMBY ROAD SUITE 342 DOBSON NC 27017 566000341 GOV'T ENTITY 200000 MT. AIRY INTERSTATES DISTRICT WATER PROJECT SURRY COUNTY SCHOOLS 209 NORTH CRUTCHFIELD ST DOBSON NC 27017 566001117 EDUCATION TAX EXEMPT 150000 21ST CENTURY SCHOOLS TOWN OF BATH PO DRAWER 6A BATH NC 27808 561094242 GOV'T ENTITY 250000 TOWN OF BATH WASTEWATER IMPROVEMENT TOWN OF BISCOE PO BOX 1228 BISCOE NC 27209 566001180 GOV'T ENTITY 800000 SEWER FOR HEART OF NC MEGA SITE TOWN OF BURNSVILLE PO BOX 97 BURNSVILLE NC 28714 566001190 GOV'T ENTITY 1200000 EAST YANCEY/MICAVILLE WATER EXTENSION TOWN OF PILOT MOUNTAIN 124 WEST MAIN STREET BOX 1 PILOT MOUNTAIN NC 27041 566001308 GOV'T ENTITY 75000 PILOT CTR FOR LEARNING, EDUC, AND RETRAINING (CLEAR) - PHASE II TOWN OF STAR PO BOX 97 STAR NC 27356 566010163 GOV'T ENTITY 10000 STAR - CAROLINA GROWLER SEWER EXTENSION PROJECT TOWN OF TRENTON PO BOX 399 TRENTON NC 285850399 560884709 GOV'T ENTITY 200000 TRENTON SANITARY SEWER IMPROVEMENTS TOWN OF TROY 315 N MAIN ST TROY NC 27371 566001353 GOV'T ENTITY 620000 SUPPORT FOR EQUIPMENT LEASING PROJECT FOR WRIGHT FOODS UNIVERSITY OF NORTH CAROLINA - GENERAL ADMINISTRATION UNC CSLD 140 FRIDAY CENTER DR CHAPEL HILL NC 27515 566172047 EDUCATION TAX EXEMPT 825000 GOLDEN LEAF SCHOLARS PROGRAM, 2012-13 THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL KNAPP-SANDERS BLDNG CB 3330 CHAPEL HILL NC 275993330 566001393 GOV'T ENTITY 31172 GOLDEN LEAF CAI FRONT-END ASSESSMENTS III UNIVERSITY OF NORTH CAROLINA AT PEMBROKE FOUNDATION INC OFFICE FOR ADVANCEMENT PO BOX 1510 PEMBROKE NC 283721510 581592230 501(C)(3) 200000 UNCP ENTREPRENEURSHIP INCUBATOR VANCE COUNTY 122 YOUNG ST SUITE B HENDERSON NC 275365574 566000346 GOV'T ENTITY 28834 SATTERWHITE POINTE ROAD WATER PROJECT WASHINGTON COUNTY SCHOOLS 802 WASHINGTON STREET PLYMOUTH NC 27962 566001128 501(C)(3) 200000 NORTHEAST REGIONAL SCHOOL FOR BIOTECHNOLOGY AND AGRISCIENCE WEBSTER ENTERPRISES OF JACKSON COUNTY INC PO BOX 220 WEBSTER NC 28788 561208982 501(C)(3) 165000 WEI MANUFACTURING EXPANSION WILSON COMMUNITY COLLEGE PO BOX 4305 902 HERRING AVE WILSON NC 27893 566052568 EDUCATION TAX EXEMPT 135000 'READY FOR WORK' PROGRAM WILSON COUNTY GOVERNMENT PO BOX 1728 WILSON NC 278941728 566000351 GOV'T ENTITY 380000 FARMERS MARKET MULTIPURPOSE COMPLEX WILSON YOUTH UNITED INC 910 TARBORO STREET WILSON NC 27893 271604121 501(C)(3) 85000 MY SPOT PROGRAM WIRELESS RESEARCH CENTER OF NORTH CAROLINA 3331 HERITAGE TRADE DRIVE STE 101 WAKE FOREST NC 27587 273397703 501(C)(3) 962000 WIRELESS RESEARCH CENTER OF NORTH CAROLINA WNC REGIONAL ECON DEV COMM (DBA ADVANTAGE WEST ECON DEV GROUP) 134 WRIGHT BROTHERS WAY FLETCHER NC 28732 561871844 501(C)(3) 200000 REALIZING THE POTENTIAL OF THE WNC NATURAL PRODUCTS IND PHASE II WRMC HOSPITAL OPERATING CORPORATION PO BOX 609 NORTH WILKESBORO NC 28659 830343789 501(C)(3) 184000 CAPITAL CAMPAIGN TO ENHANCE EMERGENCY SERVICES YANCEY COUNTY SCHOOLS PO BOX 190 BURNSVILLE NC 287140190 566001138 GOV'T ENTITY 697748 1:1 LAPTOP INITIATIVE AND 21ST CENTURY CLASSROOMS 103 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: APPLICANTS THAT RECEIVE AWARDS FROM THE BOARD ARE REQUIRED TO SIGN A GRANTEE ACKNOWLEDGEMENT & AGREEMENT, WHICH STATES GUIDELINES AND CONDITIONS FOR A GRANT. GRANTEES MUST ALSO ATTEND A GRANTS MANAGEMENT SESSION. THE GRANTEE ACKNOWLEDGEMENT & AGREEMENT MAY CONTAIN CONDITIONS THAT MUST BE SATISFIED BEFORE FUNDS WILL BE RELEASED. THESE CONDITIONS, ALONG WITH REQUIREMENTS FOR INTERIM AND FINAL REPORTS, ARE ENTERED IN A DATABASE. ONCE THE FOUNDATION RECEIVES THE SIGNED GRANTEE ACKNOWLEDGEMENT & AGREEMENT, EVIDENCE THAT PRECONDITIONS HAVE BEEN MET, AND A WRITTEN REQUEST FOR PAYMENT, THE APPLICANT IS ELIGIBLE TO RECIEVE AN INITIAL DISBURSEMENT OF UP TO 80% OF THE GRANT AWARD. A SUM EQUAL TO 20% OF THE TOTAL AMOUNT OF THE GRANT IS RETAINED BY THE FOUNDATION UNTIL COMPLETION OF THE GRANTEE'S OBLIGATIONS UNDER THE GRANT, INCLUDING THE SUBMISSION TO THE FOUNDATION OF A FINAL REPORT ON THE FUNDED PROJECT AND SATISFACTION OF ANY REMAINING CONDITIONS TO RELEASE OF FUNDS. GRANTEES MAY USE FUNDS ONLY FOR ITEMS IDENTIFIED IN THE PROJECT'S APPROVED BUDGET. SHOULD THE GRANTEE SEEK TO SPEND FUNDS ON AN ITEM NOT INCLUDED IN THE BUDGET OR IN AN AMOUNT IN EXCESS OF THE APPROVED BUDGET AMOUNT, THE GRANTEE MUST RECEIVE APPROVAL OF A BUDGET MODIFICATION. IN NO EVENT MAY A GRANTEE SPEND GOLDEN LEAF FUNDS IN EXCESS OF THE AMOUNT AWARDED BY THE GOLDEN LEAF BOARD. GRANTEES MUST SUBMIT INTERIM REPORTS IN SIX MONTH INCREMENTS BEGINNING SIX MONTHS AFTER THE AWARD DATE AND A FINAL REPORT WITHIN 60 DAYS AFTER COMPLETION OF THE PROJECT. THE REPORTS INCLUDE INFORMATION REGARDING THE WORK ACCOMPLISHED, COMPARED TO AN APPROVED SCOPE OF WORK, REPORTED OUTCOMES OF THE PROJECT, AND EXPENDITURE REPORTS WITH SUPPORTING DOCUMENTATION. X X X X 0 0 0 0 0 0 0 0 0 DANIEL J GERLACH 187232 0 0 0 180 0 19118 0 15065 0 221595 0 0 0 MARK A SORRELLS 154814 0 0 0 414 0 16080 0 15069 0 186377 0 0 0 PETER J CERA 134207 0 0 0 180 0 13750 0 15065 0 163202 0 0 0 FORM 990, PART VI, SECTION A, LINE 7A THE FOUNDATION IS GOVERNED BY A BOARD OF DIRECTORS COMPRISED OF FIFTEEN DIRECTORS. FIVE DIRECTORS ARE APPOINTED BY THE GOVERNOR OF THE STATE OF NORTH CAROLINA. FIVE DIRECTORS ARE APPOINTED BY THE PRESIDENT PRO TEMPORE OF THE NORTH CAROLINA SENATE. FIVE DIRECTORS ARE APPOINTED BY THE SPEAKER OF THE NORTH CAROLINA HOUSE OF REPRESENTATIVES. FORM 990, PART VI, SECTION A, LINE 7B THE FOUNDATION MAY NOT DISPOSE OF ASSETS PURSUANT TO THE PROVISIONS OF SECTION 55A-12-02 OF THE NORTH CAROLINA GENERAL STATUTES WITHOUT THE APPROVAL OF THE NORTH CAROLINA GENERAL ASSEMBLY. THE FOUNDATION MAY NOT AMEND ITS ARTICLES OF INCORPORATION WITHOUT THE APPROVAL OF THE NORTH CAROLINA GENERAL ASSEMBLY. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF FORM 990 WAS PROVIDED TO EACH MEMBER OF THE FOUNDATION'S BOARD OF DIRECTORS. THE AUDIT COMMITTEE OF THE BOARD REVIEWED THE FORM 990 AND RECOMMENDED APPROVAL TO THE FULL BOARD. THE BOARD OF DIRECTORS APPROVED THE FORM 990 PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C THE FOUNDATION'S BOARD OF DIRECTORS AND COMMITTEES MEET APPROXIMATELY SIX TIMES PER YEAR. AT EACH SUCH MEETING, OR GROUP OF MEETINGS, DIRECTORS ARE ASKED TO CONFIRM THEIR DISCLOSURES OR MAKE ANY NEW DISCLOSURES. WHEN A DIRECTOR DISCLOSES AN INTEREST IN A PROPOSED TRANSACTION, THE DIRECTOR DOES NOT PARTICIPATE IN THE DISCUSSION CONCERNING, OR THE VOTE UPON, THE PROPOSED TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15A NO CHANGES HAVE BEEN MADE TO THE PRESIDENT'S SALARY SINCE JUNE 2008. AT THAT TIME, THE PERSONNEL COMMITTEE OF THE BOARD OF DIRECTORS REVIEWED SALARY AND BENEFIT INFORMATION FOR POSITIONS COMPARABLE TO THE PRESIDENT AT OTHER NORTH CAROLINA FOUNDATIONS AND ENDOWMENTS AND NORTH CAROLINA STATE AGENCIES PRIOR TO MAKING A RECOMMENDATION TO THE BOARD REGARDING THE PRESIDENT'S SALARY AND BENEFITS. THE BOARD APPROVED THE SALARY AND BENEFITS OF THE PRESIDENT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE ON THE ORGANIZATION'S WEBSITE AND UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -31,010,685. PASS-THROUGH UBI LOSS FROM K-1S 1,083,463. RESCISSIONS AND RETURNS OF GRANTS 11,920,891. TOTAL TO FORM 990, PART XI, LINE 5: -18,006,331. OVERSIGHT OF AUDIT: FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.