LEWIS J AND CLELIA M SERVENTI FAMILY FOUNDATION: Form 990PF, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: LEWIS J AND CLELIA M SERVENTI FAMILY FOUNDATION (EIN 31-1585491)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-05-14
IRS object ID: 201341349349101654
Schema version: 2012v2.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990-PF
Distribution From Corpus Election
Gain Loss Sale Other Assets Sch
Investments Corp Stock Schedule
Other Expenses Schedule
Other Increases Schedule
Taxes Schedule

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-05-14T13:01:48-05:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	161468002	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CHIAMPOU TRAVIS BESAW & KERSHNER LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	45 BRYANT WOODS NORTH	AddressLine1
City	AMHERST	City
State	NY	State
ZIP Code	14228	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990PF	ReturnType
Tax Period Begin Date	2012-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	311585491	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	THE LEWIS J AND CLELIA M SERVENTI	BusinessNameLine1
Business Name Line2	FAMILY FOUNDATION	BusinessNameLine2

Field	Value	IRS element (for citing)
Name Control	LEWI	NameControl
Phone	5852375292	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 30	AddressLine1
City	PERRY	City
State	NY	State
ZIP Code	14530	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	ED RECHBERGER	Name
Title	VP/TREASURER	Title
Phone	5852372213	Phone
Date Signed	2013-05-07	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	CHERYL JANKOWSKI	Name
PTIN	P00540410	PTIN
Phone	7166302400	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990-PF IRS990PF

Field	Value	IRS element (for citing)
Address Change	X	AddressChange
Exempt PF	X	ExemptPF
FMV Assets EOY	2332616	FMVAssetsEOY
Method Of Accounting Cash	X	MethodOfAccountingCash

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

Field	Value	IRS element (for citing)
Not Required To Attach Schedule B	X	NotRequiredToAttachScheduleB
Interest On Savings Rev And Expnss	283	InterestOnSavingsRevAndExpnss
Interest On Savings Net Invst Incm	283	InterestOnSavingsNetInvstIncm
Dividends Rev And Expnss	60563	DividendsRevAndExpnss
Dividends Net Invst Incm	60563	DividendsNetInvstIncm
Net Gain Sale Assets Rev And Expnss	95132	NetGainSaleAssetsRevAndExpnss
Gross Sales Price	573223	GrossSalesPrice
Capital Gain Net Incm Net Invst Incm	102709	CapitalGainNetIncmNetInvstIncm
Total Revenue And Expenses	155978	TotalRevenueAndExpenses
Total Net Investment Income	163555	TotalNetInvestmentIncome
Comp Ofcr Dir Trst Rev And Expnss	0	CompOfcrDirTrstRevAndExpnss
Comp Ofcr Dir Trst Net Invst Incm	0	CompOfcrDirTrstNetInvstIncm
Comp Ofcr Dir Trst Dsbrs Chrtbl Prps	0	CompOfcrDirTrstDsbrsChrtblPrps
Taxes Rev And Expnss	577	TaxesRevAndExpnss
Taxes Net Invst Incm	327	TaxesNetInvstIncm
Taxes Dsbrs Chrtbl Prps	250	TaxesDsbrsChrtblPrps
Other Expenses Rev And Expnss	19029	OtherExpensesRevAndExpnss
Other Expenses Net Invst Incm	19029	OtherExpensesNetInvstIncm
Other Expenses Dsbrs Chrtbl Prps	0	OtherExpensesDsbrsChrtblPrps
Tot Opr Expenses Rev And Expnss	19606	TotOprExpensesRevAndExpnss
Tot Opr Expenses Net Invst Incm	19356	TotOprExpensesNetInvstIncm
Tot Opr Expenses Dsbrs Chrtbl Prps	250	TotOprExpensesDsbrsChrtblPrps
Contri Gifts Paid Rev And Expnss	125000	ContriGiftsPaidRevAndExpnss
Contri Gifts Paid Dsbrs Chrtbl Prps	125000	ContriGiftsPaidDsbrsChrtblPrps
Total Expenses Rev And Expnss	144606	TotalExpensesRevAndExpnss
Total Expenses Net Invst Incm	19356	TotalExpensesNetInvstIncm
Total Expenses Dsbrs Chrtbl Prps	125250	TotalExpensesDsbrsChrtblPrps
Excess Of Revenue Over Expenses	11372	ExcessOfRevenueOverExpenses
Net Investment Income	144199	NetInvestmentIncome

Balance Sheets BalanceSheets

Field	Value	IRS element (for citing)
Savings And Temp Cash Invst BOY	138237	SavingsAndTempCashInvstBOY
Savings And Temp Cash Invst EOY	49608	SavingsAndTempCashInvstEOY
Savings And Temp Cash Invst EOYFMV	49608	SavingsAndTempCashInvstEOYFMV
Investments Corp Stock BOY	2088918	InvestmentsCorpStockBOY
Investments Corp Stock EOY	2283008	InvestmentsCorpStockEOY
Investments Corp Stock EOYFMV	2283008	InvestmentsCorpStockEOYFMV
Total Assets BOY	2227155	TotalAssetsBOY
Total Assets EOY	2332616	TotalAssetsEOY
Total Assets EOYFMV	2332616	TotalAssetsEOYFMV
Total Liabilities BOY	0	TotalLiabilitiesBOY
Total Liabilities EOY	0	TotalLiabilitiesEOY
Org That Do Not Follow SFAS117	X	OrgThatDoNotFollowSFAS117
Capital Stock BOY	0	CapitalStockBOY
Capital Stock EOY	0	CapitalStockEOY
Paid In Or Capital Surplus BOY	0	PaidInOrCapitalSurplusBOY
Paid In Or Capital Surplus EOY	0	PaidInOrCapitalSurplusEOY
Retained Earnings BOY	2227155	RetainedEarningsBOY
Retained Earnings EOY	2332616	RetainedEarningsEOY
Total Net Assets BOY	2227155	TotalNetAssetsBOY
Total Net Assets EOY	2332616	TotalNetAssetsEOY
Total Liabilities Net Assets BOY	2227155	TotalLiabilitiesNetAssetsBOY
Total Liabilities Net Assets EOY	2332616	TotalLiabilitiesNetAssetsEOY

Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances

Field	Value	IRS element (for citing)
Total Net Assets Fund Balances BOY	2227155	TotalNetAssetsFundBalancesBOY
Excess Of Revenue Over Expenses	11372	ExcessOfRevenueOverExpenses
Other Increases	94089	OtherIncreases
Subtotal	2332616	Subtotal
Other Decreases	0	OtherDecreases
Total Net Assets Fund Balances EOY	2332616	TotalNetAssetsFundBalancesEOY

Capital Gains And Losses CapitalGainsAndLosses

Capital Gains And Losses Info CapitalGainsAndLossesInfo (42 entries)

Description Of AssetDescriptionOfAsset	How AcquiredHowAcquired	Date AcquiredDateAcquired	Date SoldDateSold	Gross Sales PriceGrossSalesPrice	Cost Or Other BasisCostOrOtherBasis	Gain Or LossGainOrLoss	Gains Minus Excess Or LossesGainsMinusExcessOrLosses
MOLINA HEALTHCARE INC	P	2011-05-03	2012-02-17	20541	15757	4784	4784
MOLINA HEALTHCARE INC	P	2011-05-24	2012-02-17	5482	3935	1547	1547
COL LARGE CAP GRWTH CL Z	P	2007-05-10	2012-02-03	219095	219370	-275	-275
COL LARGE CAP GRWTH CL Z	P	2010-06-18	2012-02-03	13	11	2	2
DISCOVER FINL SVCS	P	2010-02-05	2012-03-08	9084	3891	5193	5193
ISHARES MSCI JAPAN INDEX	P	2011-03-15	2012-03-08	5020	4920	100	100
ISHARES MSCI JAPAN INDEX	P	2011-03-17	2012-03-08	10040	10140	-100	-100
MCDONALDS CORP COM	P	2009-03-12	2012-03-08	7269	3884	3385	3385
MCDONALDS CORP COM	P	2009-06-10	2012-03-08	14538	8820	5718	5718
MCDONALDS CORP COM	P	2009-06-30	2012-03-08	19384	11608	7776	7776
SEAGATE TECH PLC SHS	P	2011-04-14	2012-02-29	10016	6405	3611	3611
SEAGATE TECH PLC SHS	P	2011-04-15	2012-02-29	7345	4775	2570	2570
COLMB VALUE & RESTRUCT Z	P	2008-04-01	2012-03-15	71471	77188	-5717	-5717
COLMS VALUE & RESTRUCT Z	P	2010-06-18	2012-03-15	23	19	4	4
PHILLIPS 66 SHS	P	2009-02-13	2012-06-15	4216	2656	1560	1560
PHILLIPS 66 SHS	P	2009-03-25	2012-06-15	843	458	385	385
PHILLIPS 66 SHS	P	2009-03-31	2012-06-15	843	457	386	386
PHILLIPS 66 SHS	P	2009-04-07	2012-06-15	1686	918	768	768
APPLE INC	P	2009-08-27	2012-08-23	31883	8036	23847	23847
APPLE INC	P	2009-09-01	2012-08-23	1328	333	995	995
COSTCO WHOLESALE CRP DEL	P	2010-05-25	2012-08-23	14209	8370	5839	5839
COSTCO WHOLESALE CRP DEL	P	2010-06-01	2012-08-23	4736	2921	1815	1815
ISHARES MSCI AUSTRALIA	P	2010-01-22	2012-08-07	2374	2240	134	134
ISHARES MSCI AUSTRALIA	P	2010-01-26	2012-08-07	4748	4416	332	332
ISHARES MSCI AUSTRALIA	P	2010-01-27	2012-08-07	2374	2179	195	195
ISHARES MSCI AUSTRALIA	P	2010-02-04	2012-08-07	4748	4118	630	630
ISHARES MSCI AUSTRALIA	P	2010-10-21	2012-08-07	5935	6015	-80	-80
ISHARES MSCI AUSTRALIA	P	2010-10-26	2012-08-07	2374	2462	-88	-88
HUNT J B TRANS SVCS INC	P	2010-07-16	2012-08-07	8260	5300	2960	2960
VODAFONE GROP PLC SP ADR	P	2010-05-20	2012-08-06	5952	3788	2164	2164
VODAFONE GROP PLC SP ADR	P	2010-05-21	2012-08-06	1488	946	542	542
COPA HOLDINGS S A CL A	P	2009-11-10	2012-11-20	9436	4732	4704	4704
COPA HOLDINGS S A CL A	P	2009-11-12	2012-11-20	9436	4748	4688	4688
COPA HOLDINGS S A CL A	P	2009-11-17	2012-11-20	9436	4948	4488	4488
COPA HOLDINGS S A CL A	P	2010-12-15	2012-11-20	7077	4255	2822	2822
AMER EXPRESS COMPANY	P	2010-04-16	2012-12-14	7088	5660	1428	1428
AMER EXPRESS COMPANY	P	2010-10-22	2012-12-14	8505	5871	2634	2634
AMER EXPRESS COMPANY	P	2011-07-28	2012-12-14	7088	6384	704	704
DISCOVER FINL SVCS	P	2010-02-09	2012-12-14	7906	2580	5326	5326
DISCOVER FINL SVCS	P	2011-01-13	2012-12-14	9882	5000	4882	4882
ENTERPRISE PRODUCTS PARTNERS K-1	P			25		25	25
CAPITAL GAINS DIVIDENDS	P			26		26	26

Field	Value	IRS element (for citing)
Capital Gain Net Income	102709	CapitalGainNetIncome

Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax

Field	Value	IRS element (for citing)
Liable For4942 Tax	0	LiableFor4942Tax
Qualifying Distributions Year1	172180	QualifyingDistributionsYear1
Noncharitable Assets Year1	2305163	NoncharitableAssetsYear1
Distribution Ratio Year1	0.074693	DistributionRatioYear1
Qualifying Distributions Year2	223633	QualifyingDistributionsYear2
Noncharitable Assets Year2	2137393	NoncharitableAssetsYear2
Distribution Ratio Year2	0.104629	DistributionRatioYear2
Qualifying Distributions Year3	159658	QualifyingDistributionsYear3
Noncharitable Assets Year3	1797658	NoncharitableAssetsYear3
Distribution Ratio Year3	0.088814	DistributionRatioYear3
Qualifying Distributions Year4	185390	QualifyingDistributionsYear4
Noncharitable Assets Year4	2350725	NoncharitableAssetsYear4
Distribution Ratio Year4	0.078865	DistributionRatioYear4
Qualifying Distributions Year5	153431	QualifyingDistributionsYear5
Noncharitable Assets Year5	2408423	NoncharitableAssetsYear5
Distribution Ratio Year5	0.063706	DistributionRatioYear5
Total Distribution Ratio	0.410707	TotalDistributionRatio
Average Distribution Ratio	0.082141	AverageDistributionRatio
Net Noncharitable Assets	2347312	NetNoncharitableAssets
Adjusted Noncharitable Assets	192811	AdjustedNoncharitableAssets
One Percent Net Investment Income	1442	OnePercentNetInvestmentIncome
Adj Nonchrtbl Assets And One	194253	AdjNonchrtblAssetsAndOnePct
Qualifying Distributions	125250	QualifyingDistributions

Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm

Field	Value	IRS element (for citing)
Investment Income Excise Tax	2884	InvestmentIncomeExciseTax
Tax Under Section511	0	TaxUnderSection511
Subtotal	2884	Subtotal
Subtitle A Tax	0	SubtitleATax
Tax Based On Investment Income	2884	TaxBasedOnInvestmentIncome
Est Tax Payments And Overpayment	1480	EstTaxPaymentsAndOverpayment
Total Credits And Payments	1480	TotalCreditsAndPayments
Tax Due	1404	TaxDue

Statements Regarding Activities StatementsRegardingActivities

Field	Value	IRS element (for citing)
Legislative Political Activities	0	LegislativePoliticalActivities
More Than100 Spent	0	MoreThan100Spent
Form1120 POL Filed	0	Form1120POLFiled
Sect4955 Tax On Organization	0	Sect4955TaxOnOrganization
Sect4955 Tax On Managers	0	Sect4955TaxOnManagers
Reimbursement Of Tax	0	ReimbursementOfTax
Activities Not Prev Reported	0	ActivitiesNotPrevReported
Changes To Articles Or Bylaws	0	ChangesToArticlesOrBylaws
Unrelated Bus Income Over1000	0	UnrelatedBusIncomeOver1000
Termination Etc	0	TerminationEtc
Requirements Of Sect508e	1	RequirementsOfSect508e
At Least5000 In Assets	1	AtLeast5000InAssets
States Filed With	NY	StatesFiledWith
Form990 PF Filed With AG	1	Form990PFFiledWithAG
Private Operating Foundation	0	PrivateOperatingFoundation
New Substantial Contributors	0	NewSubstantialContributors
Interest In Controlled Entity	0	InterestInControlledEntity
Applicable Insurance Contract	0	ApplicableInsuranceContract
Comply With Public Inspection Rqr	1	ComplyWithPublicInspectionRqr
Website Address	N/A	WebsiteAddress
Books In Care Of Person Name	LEWIS J SERVENTI	BooksInCareOfPersonName
Books In Care Of Phone Number	5852375292	BooksInCareOfPhoneNumber

Books In Care Of US Address BooksInCareOfUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 30	AddressLine1
City	PERRY	City
State	NY	State
ZIP Code	14530	ZIPCode

Field	Value	IRS element (for citing)
Foreign Bank	0	ForeignBank

Statements Regarding Acty4720 StatementsRegardingActy4720

Field	Value	IRS element (for citing)
Sale Or Exchange With Dsqfly Person	0	SaleOrExchangeWithDsqflyPerson
Borrow Or Lend With Dsqfly Person	0	BorrowOrLendWithDsqflyPerson
Furnished Goods With Dsqfly Person	0	FurnishedGoodsWithDsqflyPerson
Pay Compensation To Dsqfly Person	0	PayCompensationToDsqflyPerson
Transfer Assets To Dsqfly Person	0	TransferAssetsToDsqflyPerson
Payment To Government Offical	0	PaymentToGovernmentOffical
Uncorrected Prior Acts	0	UncorrectedPriorActs
Undistributed Income Prior Years	0	UndistributedIncomePriorYears
Business Holdings	0	BusinessHoldings
Jeopardy Investments	0	JeopardyInvestments
Uncorrected Jeopardy Investments	0	UncorrectedJeopardyInvestments
Influence Legislation	0	InfluenceLegislation
Influence Election	0	InfluenceElection
Grants To Individuals	0	GrantsToIndividuals
Grants To Organizations	0	GrantsToOrganizations
Noncharitable Purpose	0	NoncharitablePurpose
Rcv Funds To Pay Prsnl Bnft Contract	0	RcvFundsToPayPrsnlBnftContract
Pay Premiums Prsnl Bnft Contract	0	PayPremiumsPrsnlBnftContract
Prohibited Tax Shelter Transactn	0	ProhibitedTaxShelterTransactn

Ofcr Dir Trustees Key Employee Info OfcrDirTrusteesKeyEmployeeInfo

Ofcr Dir Trustees Or Key Employee OfcrDirTrusteesOrKeyEmployee (4 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	TitleTitle	Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition	CompensationCompensation	Contri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtc	Expense Account Other AllowancesExpenseAccountOtherAllowances
LEWIS J SERVENTI
PO BOX 30	PERRY	NY	14530	PRESIDENT	10.00	0	0	0
CLELIA M SERVENTI
PO BOX 30	PERRY	NY	14530	V. PRESIDENT	10.00	0	0	0
DEBRA SERVENTI JONES
PO BOX 30	PERRY	NY	14530	DIRECTOR	10.00	0	0	0
MARY MICHELE RECHBERGER
PO BOX 30	PERRY	NY	14530	DIRECTOR	10.00	0	0	0

Field	Value	IRS element (for citing)
Comp Of Highest Paid Empl NONE	NONE	CompOfHighestPaidEmplNONE
Tot Number Of Oth Empl Paid Over50k	0	TotNumberOfOthEmplPaidOver50k
Comp Of Hghst Paid Cntrct NONE	NONE	CompOfHghstPaidCntrctNONE
Tot Number Of Cntrct Paid Over50k	0	TotNumberOfCntrctPaidOver50k

Sum Of Program Related Investments SumOfProgramRelatedInvestments

Field	Value	IRS element (for citing)
Total	0	Total

Minimum Investment Return MinimumInvestmentReturn

Field	Value	IRS element (for citing)
Avg Monthly FMV Of Securities	2254050	AvgMonthlyFMVOfSecurities
Avg Monthly Cash Balances	129008	AvgMonthlyCashBalances
FMV All Other Noncharitable Assets	0	FMVAllOtherNoncharitableAssets
Total FMV Of Unused Assets	2383058	TotalFMVOfUnusedAssets
Reduction Claimed	0	ReductionClaimed
Acquisition Indebtedness	0	AcquisitionIndebtedness
Adj Total FMV Of Unused Assets	2383058	AdjTotalFMVOfUnusedAssets
Cash Deemed Charitable	35746	CashDeemedCharitable
Net Noncharitable Assets	2347312	NetNoncharitableAssets
Minimum Investment Return	117366	MinimumInvestmentReturn

Distributable DistributableAmount

Field	Value	IRS element (for citing)
Minimum Investment Return	117366	MinimumInvestmentReturn
Tax Based On Investment Income	2884	TaxBasedOnInvestmentIncome
Total Tax	2884	TotalTax
Distributable Amount Before Adj	114482	DistributableAmountBeforeAdj
Recoveries Qlfy Distributions	0	RecoveriesQlfyDistributions
Distributable Amount Before Ded	114482	DistributableAmountBeforeDed
Deduction Fr Distributable	$0	DeductionFrDistributableAmount
Distributable Amount As Adjusted	114482	DistributableAmountAsAdjusted

Qualifying Distributions QualifyingDistributions

Field	Value	IRS element (for citing)
Expenses And Contributions	125250	ExpensesAndContributions
Program Related Investments Total	0	ProgramRelatedInvestmentsTotal
Qualifying Distributions	125250	QualifyingDistributions
One Pct Sect4940e Org Net Invst Incm	0	OnePctSect4940eOrgNetInvstIncm
Adj Qualifying Distributions	125250	AdjQualifyingDistributions

Undistributed Income UndistributedIncome

Field	Value	IRS element (for citing)
Distributable Amount As Adjusted	114482	DistributableAmountAsAdjusted
Undistributed Income Prior Year	0	UndistributedIncomePriorYear
Total For Prior Years	0	TotalForPriorYears
Excess Distri Carryover Year2	196196	ExcessDistriCarryoverYear2
Excess Distri Carryover Year1	173640	ExcessDistriCarryoverYear1
Total Excess Distri Carryover	369836	TotalExcessDistriCarryover
Qualifying Distributions	125250	QualifyingDistributions
Applied To Year1	0	AppliedToYear1
Applied To Prior Years	0	AppliedToPriorYears
Treated As Distri From Corpus	125250	TreatedAsDistriFromCorpus
Applied To Current Year	0	AppliedToCurrentYear
Remaining Distri From Corpus	0	RemainingDistriFromCorpus
Excess Distri Cyov App CY Corpus	114482	ExcessDistriCyovAppCYCorpus
Excess Distri Cyov Applied CY	114482	ExcessDistriCyovAppliedCY
Total Corpus	380604	TotalCorpus
Prior Year Undistributed Income	0	PriorYearUndistributedIncome
Prior Year Deficiency Or Tax	0	PriorYearDeficiencyOrTax
Taxable Amount1	0	TaxableAmount1
Taxable Amount2	0	TaxableAmount2
Undistributed Income CY	0	UndistributedIncomeCY
Distri From Corpus170b1 E Or4942g3	0	DistriFromCorpus170b1EOr4942g3
Excess Distri Cyov From Year5	0	ExcessDistriCyovFromYear5
Excess Distri Cyov To Next Year	380604	ExcessDistriCyovToNextYear
Excess From Year2	81714	ExcessFromYear2
Excess From Year1	173640	ExcessFromYear1
Excess From Current Year	125250	ExcessFromCurrentYear

Supplementary Information SupplementaryInformation

Field	Value	IRS element (for citing)
Contributing Manager	LEWIS J SERVENTI	ContributingManager
Contributing Manager	DEBRA SERVENTI JONES	ContributingManager
Contributing Manager	MARY MICHELE RECHBERGER	ContributingManager
Only Contributes To Preselected	X	OnlyContributesToPreselected

Grant Or Contri Paid During Year GrantOrContriPaidDuringYear (9 entries)

Address Line1RecipientUSAddress/AddressLine1	CityRecipientUSAddress/City	StateRecipientUSAddress/State	ZIP CodeRecipientUSAddress/ZIPCode	Recipient RelationshipRecipientRelationship	Recipient Foundation StatusRecipientFoundationStatus	Purpose Of Grant Or ContributionPurposeOfGrantOrContribution	AmountAmount
GOLISANO CHILDREN'S HOSPITAL AT STRONG
300 EAST RIVER ROAD PO BOX 278996	ROCHESTER	NY	14627	N/A	EXEMPT	GENERAL FUNDS DONATION.	$25,000
MARTHA JEFFERSON HOSPITAL
459 LOCUST AVE	CHARLOTTESVILLE	VA	22902	N/A	EXEMPT	GENERAL FUNDS DONATION.	$20,000
MERCY FLIGHT
100 VILLA AVENUE	BUFFALO	NY	14225	N/A	EXEMPT	GENERAL FUNDS DONATION.	$1,000
PANCREATIC CANCER ACTION NETWORK
1500 ROSECRANS AVE SUITE 200	MANHATTAN BEACH	CA	90266	N/A	EXEMPT	GENERAL FUNDS DONATION.	$1,000
ROSWELL PARK CANCER INSTITUTE
PO BOX 631	BUFFALO	NY	14240	N/A	EXEMPT	GENERAL FUNDS DONATION.	$25,000
ST JUDES CHILDREN'S RESEARCH HOSPITAL
501 ST JUDE PLACE	MEMPHIS	TN	38105	N/A	EXEMPT	GENERAL FUNDS DONATION.	$15,000
THE SALVATION ARMY
46 BROAD STREET PO BOX 191	TONAWANDA	NY	14150	N/A	EXEMPT	GENERAL FUNDS DONATION.	$10,000
WESTERN NY PERFORMING ARTS CENTER
23 S MAIN ST	WARSAW	NY	14569	N/A	EXEMPT	GENERAL FUNDS CONTRIBUTION.	$3,000
WOMEN & CHILDREN'S HOSPITAL OF BUFFALO
219 BRYANT STREET	BUFFALO	NY	14222	N/A	EXEMPT	GENERAL FUNDS DONATION.	$25,000

Field	Value	IRS element (for citing)
Tot Grant Or Contri Paid During Year	125000	TotGrantOrContriPaidDuringYear
Tot Grant Or Contri Approved Future	0	TotGrantOrContriApprovedFuture

Analysis Income Producing Acty AnalysisIncomeProducingActy

Int On Savings And Temp Cash Invst IntOnSavingsAndTempCashInvst

Field	Value	IRS element (for citing)
Exclusion Code	14	ExclusionCode
Exclusion	$283	ExclusionAmount

Dividends And Int From Sec Part VII DividendsAndIntFromSecPartVII

Field	Value	IRS element (for citing)
Exclusion Code	14	ExclusionCode
Exclusion	$60,563	ExclusionAmount

Gain Sales Assets Oth Than Invntry GainSalesAssetsOthThanInvntry

Field	Value	IRS element (for citing)
Exclusion Code	18	ExclusionCode
Exclusion	$95,132	ExclusionAmount

Subtotals Part XVIA SubtotalsPartXVIA

Field	Value	IRS element (for citing)
Unrelated Business Income	$0	UnrelatedBusinessIncomeAmount
Exclusion	$155,978	ExclusionAmount
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Part XVIA	155978	TotalPartXVIA

Rln Of Acty To Accom Of Exempt Prps RlnOfActyToAccomOfExemptPrps

Rln Of Acty To Accom Of Exempt Prps RlnOfActyToAccomOfExemptPrps (3 entries)

Line NumberLineNumber	Relationship StatementRelationshipStatement
3	INTEREST FROM INVESTMENTS DONATED
4	DIVIDENDS FROM INVESTMENTS DONATED
8	GAIN/(LOSS) ON SALE OF INVESTMENTS DONATED

Trnsfr Tr Rln With Noncharitable EO TrnsfrTrRlnWithNoncharitableEO

Field	Value	IRS element (for citing)
Trnsfr Of Cash To Noncharitable EO	0	TrnsfrOfCashToNoncharitableEO
Trnsfr Oth Assets Noncharitable EO	0	TrnsfrOthAssetsNoncharitableEO
Sales Or Exchanges Of Assets	0	SalesOrExchangesOfAssets
Purchase Assets Noncharitable EO	0	PurchaseAssetsNoncharitableEO
Rental Of Facilities Etc	0	RentalOfFacilitiesEtc
Reimbursement Arrangements	0	ReimbursementArrangements
Loans Or Loan Guarantees	0	LoansOrLoanGuarantees
Performance Of Services Etc	0	PerformanceOfServicesEtc
Sharing Of Facilities Etc	0	SharingOfFacilitiesEtc
Relationships Noncharitable E Os	0	RelationshipsNoncharitableEOs

Distribution From Corpus Election DistributionFromCorpusElection

Field	Value	IRS element (for citing)
Election	PURSUANT TO IRC SEC. 4942(H)(2) AND REG. 53.4942(A)-3(D)(2) , THE ABOVE REFERENCED FOUNDATION HEREBY ELECTS TO TREAT CURRENT YEAR QUALIFYING DISTRIBUTIONS IN EXCESS OF THE IMMEDIATELY PRECEDING TAX YEAR'S UNDISTRIBUTED INCOME AS BEING MADE OUT OF CORPUS.	Election

Gain Loss Sale Other Assets Sch GainLossSaleOtherAssetsSch

Gain Loss Sale Other Asset GainLossSaleOtherAsset (3 entries)

NameName	How AcquiredHowAcquired	Total NetTotalNet
MARKWEST ENERGY PARTNERS, L.P.	PURCHASED	-3503
PLAINS ALL AMERICAN PIPELINE, L.P.	PURCHASED	-5
ENTERPRISE PRODUCTS	PURCHASED	-4069

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corp Stock InvestmentsCorpStock

Field	Value	IRS element (for citing)
Name Of Stock	COMMON STOCK	NameOfStock
EOY Book Value	2283008	EOYBookValue
EOYFMV	2283008	EOYFMV

Other Expenses Schedule OtherExpensesSchedule

Other Expenses OtherExpenses (2 entries)

DescriptionDescription	Revenue And Expenses Per BooksRevenueAndExpensesPerBooks	Net Investment IncomeNetInvestmentIncome	Disbursements Charitable PrpsDisbursementsCharitablePrps
MERRILL LYNCH AGENCY FEES	18999	18999	0
OTHER FEES	30	30	0

Other Increases Schedule OtherIncreasesSchedule

Other Increases OtherIncreases

Field	Value	IRS element (for citing)
Description	CHANGE IN VALUE OF INVESTMENTS	Description
Amount	$94,089	Amount

Taxes Schedule TaxesSchedule

Taxes Taxes (3 entries)

CategoryCategory	AmountAmount	Net Investment IncomeNetInvestmentIncome	Disbursements Charitable PrpsDisbursementsCharitablePrps
FOREIGN TAXES PAID	$323	323	0
PLAINS ALL AMERICAN PIPELINE, L.P. FOREIGN TAXES	$4	4	0
NYS REGISTRATION	$250	0	250

LEWIS J AND CLELIA M SERVENTI FAMILY FOUNDATION: Form 990PF, tax year 2012

Return header ReturnHeader

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Preparer Firm US Address PreparerFirmUSAddress

Filer Filer

Name Name

US Address USAddress

Officer Officer

Preparer Preparer

Form 990-PF IRS990PF

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

Balance Sheets BalanceSheets

Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances

Capital Gains And Losses CapitalGainsAndLosses

Capital Gains And Losses Info CapitalGainsAndLossesInfo (42 entries)

Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax

Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm

Statements Regarding Activities StatementsRegardingActivities

Books In Care Of US Address BooksInCareOfUSAddress

Statements Regarding Acty4720 StatementsRegardingActy4720

Ofcr Dir Trustees Key Employee Info OfcrDirTrusteesKeyEmployeeInfo

Ofcr Dir Trustees Or Key Employee OfcrDirTrusteesOrKeyEmployee (4 entries)

Sum Of Program Related Investments SumOfProgramRelatedInvestments

Minimum Investment Return MinimumInvestmentReturn

Distributable DistributableAmount

Qualifying Distributions QualifyingDistributions

Undistributed Income UndistributedIncome

Supplementary Information SupplementaryInformation

Grant Or Contri Paid During Year GrantOrContriPaidDuringYear (9 entries)

Analysis Income Producing Acty AnalysisIncomeProducingActy

Int On Savings And Temp Cash Invst IntOnSavingsAndTempCashInvst

Dividends And Int From Sec Part VII DividendsAndIntFromSecPartVII

Gain Sales Assets Oth Than Invntry GainSalesAssetsOthThanInvntry

Subtotals Part XVIA SubtotalsPartXVIA

Rln Of Acty To Accom Of Exempt Prps RlnOfActyToAccomOfExemptPrps

Rln Of Acty To Accom Of Exempt Prps RlnOfActyToAccomOfExemptPrps (3 entries)

Trnsfr Tr Rln With Noncharitable EO TrnsfrTrRlnWithNoncharitableEO

Distribution From Corpus Election DistributionFromCorpusElection

Gain Loss Sale Other Assets Sch GainLossSaleOtherAssetsSch

Gain Loss Sale Other Asset GainLossSaleOtherAsset (3 entries)

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corp Stock InvestmentsCorpStock

Other Expenses Schedule OtherExpensesSchedule

Other Expenses OtherExpenses (2 entries)

Other Increases Schedule OtherIncreasesSchedule

Other Increases OtherIncreases

Taxes Schedule TaxesSchedule

Taxes Taxes (3 entries)

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