2013-05-09T04:39:04-00:00 2012-12-31 Foundation Source One Hollow Lane Suite 212 Lake Success NY 11042 990PF 2012-01-01 201266221 The Black Dog Private Foundation Inc BLAC 8008391754 Foundation Source 501 Silverside Rd Wilmington DE 198091377 David L Mahoney 2013-05-09 true Jeffrey D Haskell 8008391754 2013-05-09 2012 2016-02-24 21:20:13Z X 1406708 X 624297 35 35 10544 10544 15933 645658 415661 650809 426240 1491 1491 5084 9240 9240 15815 1491 9240 291000 291000 306815 1491 300240 343994 424749 416870 458394 458394 758778 1061248 948314 1175648 1519642 1406708 0 X 1175648 1519642 1175648 1519642 1175648 1519642 1175648 343994 1519642 1519642 Publicly-traded Securities 645658 629725 415661 415661 415661 false 231712 1233128 000.187906 342124 1038849 000.329330 177416 1031959 000.171922 276288 1024723 000.269622 130267 889070 000.146521 001.105301 000.221060 1051338 232409 4247 236656 300240 X 4247 4247 4247 2800 2800 2800 X 1447 false false false false false false true true true true false false false false true Foundation Source 8008391754 501 Silverside Road Suite 123 Wilmington DE 198091377 false false false false false false false false false false false false false false false false false false false Winnifred Ellis Foundation Source 501 Silverside Rd Wilmington DE 19809 001.00 0 David L Mahoney Foundation Source 501 Silverside Rd Wilmington DE 19809 001.00 0 785531 281817 0 1067348 1067348 16010 1051338 52567 52567 4247 4247 48320 48320 48320 300240 300240 4247 295993 48320 92925 236126 126030 292696 173671 921448 300240 48320 251920 1173368 0 92925 1080443 236126 126030 292696 173671 251920 David L Mahoney Winnifred Ellis X BOSTON COLLEGE TRUSTEES 140 COMMONWEALTH AVE CHESTNUT HILL MA 02467 N/A 509a1 Mahoney Family Scholarship Fund 10000 DREW SCHOOL 2901 CALIFORNIA ST SAN FRANCISCO CA 94115 N/A 509a1 Drew Annual Fund 12000 DREW SCHOOL 2901 CALIFORNIA ST SAN FRANCISCO CA 94115 N/A 509a1 New Roots Capital Campaign 20000 KQED INC 2601 MARIPOSA ST SAN FRANCISCO CA 94110 N/A 509a1 General Unrestricted 25000 LIVE OAK A LEARNING CENTER FOR CHILDREN 1555 MARIPOSA ST SAN FRANCISCO CA 94107 N/A 509a1 40th Anniversary Campaign 100000 MA MUSEUM OF CONTEMPORARY ART FDN 1040 MASS MOCA WAY NORTH ADAMS MA 01247 N/A 509a1 General Unrestricted 1000 MERCY CORPS 45 SW ANKENY ST PORTLAND OR 97204 N/A 509a1 Board Matching Grant Fund 30000 NARAL PRO-CHOICE AMERICA FOUNDATION 111 PINE ST SAN FRANCISCO CA 94111 N/A 509a1 General Unrestricted 5000 OUTWARD BOUND INC 21 OLD MAIN ST FISHKILL NY 12524 N/A 509a1 Outward Bound Bay Area Program 30000 PLANNED PARENTHOOD SHASTA PACIFIC 2185 PACHECO ST CONCORD CA 94520 N/A 509a2 General Unrestricted 2500 SAN FRANCISCO MUSEUM OF MODERN ART 151 3RD ST SAN FRANCISCO CA 94103 N/A 509a1 2012-13 Photo Accessions Committee Fund 7500 SAN FRANCISCO MUSEUM OF MODERN ART 151 3RD ST SAN FRANCISCO CA 94103 N/A 509a1 FY12 Trustee Unrestricted Support and FY12 Photo Accessions 32500 TEACH FOR AMERICA BAY AREA 101 MONTGOMERY ST 5TH FL SAN FRANCISCO CA 94105 N/A 509a1 Sponsor A Teacher Campaign 10000 UNIVERSITY OF COLORADO FOUNDATION 4740 WALNUT ST BOULDER CO 80301 N/A 509a1 College of Arts and Sciences Fund 2000 UNIVERSITY OF COLORADO FOUNDATION 4740 WALNUT ST BOULDER CO 80301 N/A 509a1 College of Arts and Sciences, Deans Annual Fund 2500 YOUNG MENS CHRISTIAN ASSOCIATION OF SAN FRANCISCO 50 CALIFORNIA ST STE 650 SAN FRANCISCO CA 94111 N/A 509a2 General Unrestricted 1000 291000 14 35 14 10544 18 15933 26512 26512 false false false false false false false false false false X X 1 David L Mahoney & Winnifred C Ellis 1998 Family TR David L Mahoney 121 Jordan Ave San Francisco CA 94118 624297 X 0 DFA TAX MANAGED U.S. SMALL CAP PORTFOLIO DFTSX, 8298 sh. 212512 2012-12-24 0 T. ROWE PRICE EMERGING MARKETS STOCK FUND PRMSX, 5930.791 sh. 197792 2012-12-24 0 JDS UNIPHASE CORP JDSU, 822 sh. 10481 2012-12-12 0 MERCK CO INC. MRK, 753 sh. 34077 2012-12-12 0 SHORETEL, INC. SHOR, 350 sh. 1605 2012-12-12 0 TIME WARNER CABLE INC TWC, 13 sh. 1226 2012-12-12 0 TIME WARNER INC. TWX, 54 sh. 2567 2012-12-12 0 ANCESTRY.COM INC ACOM, 303 sh. 9628 2012-12-03 0 PANDORA MEDIA INC. P, 740 sh. 7944 2012-09-27 0 EQUINIX, INC. EQIX, 48 sh. 9458 2012-09-05 0 EQUINIX, INC. EQIX, 58 sh. 9383 2012-07-23 0 AMYLIN PHARMACEUTICALS INC AMLN, 5000 sh. 127625 2012-05-03 Publicly-traded Securities 645658 629725 15933 397 shares of BERKSHIRE HATHAWAY INC. CLASS B 34615 35611 491 shares of COHEN STEERS INSTITUTIONAL REALTY SHS INC 19500 20668 75000 shares of CORCEPT THERAPEUTICS INC. 315376 107250 7460 shares of DFA EMERGING MARKETS CORE EQ PRTFL MUTUAL FUND 125725 152182 2173 shares of DFA INTERNATIONAL SMALL CAP VALUE PORTFOLIO 43332 34726 2157 shares of DFA INTERNATIONAL SMALL CO PORTFOLIO 39328 34357 3816 shares of DFA INTERNATIONAL VALUE PORTFOLIO 58000 63341 3015 shares of DFA U.S. LARGE CAP VALUE PORTFOLIO 55000 69045 1157 shares of DFA U.S. MICRO CAP PORTFOLIO 15405 16897 1495 shares of DFA U.S. SMALL CAP PORTFOLIO 30725 33880 2378 shares of DFA U.S. SMALL CAP VALUE PORTFOLIO 61173 62324 868 shares of GOLDMAN SACHS PREASSIGNED 39734 41638 546 shares of ISHARES SP 500 INDEX FD 75718 78154 509 shares of SPDR DJ WILSHIRE INT 18895 21047 568 shares of SPDR SP 500 ETF TRUST 53059 80889 995 shares of VANGUARD FTSE ALL-WORLD EX-US ETF 26663 45521 1690 shares of VANGUARD TOTAL INTERNATIONAL STOCK INDEX SIGNAL 49000 50784 This statement is submitted to report the distribution of certain assets during the above-referenced year. The distributions resulted in a substantial contraction of assets. The following information is submitted in accordance with Treasury Regulation Section 1.6043-3a1 and the Form 990-PF instructions During the taxable year ending December 31, 2012, The Black Dog Private Foundation Inc. the Foundation made distributions from assets from sources other than current income. Collectively, the distributions in excess of current income totaled 291,000. This amount represents over 25 of the Foundations net assets of 1,138,956 as measured by fair market value at the beginning of the Foundations taxable year ending December 31, 2012. Although the Foundation technically experienced a substantial contraction, it will continue in existence and has no plans for dissolution. The Foundation made distributions of cash to the grantees listed in the attachment to Part XV, Line 3a each such grant was made solely for the charitable purpose specified therein. Administrative Fees 9215 9215 State or Local Filing Fees 25 25 Investment Management Services 1491 1491 Estimated Tax for 2012 2800 IRS Excise Tax Payment with 1st ext 990-PF 2284