HARRY AND THELMA SURRENA MEMORIAL FUND: Form 990PF, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: HARRY AND THELMA SURRENA MEMORIAL FUND (EIN 23-7435554)
Tax period: 2011-11-01 to 2012-10-31
Filed: 2012-12-14
IRS object ID: 201213499349100601
Schema version: 2011v1.2
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
Accounting Fees Schedule
Compensation Explanation
Investments Corp Bonds Schedule
Investments Corp Stock Schedule
Investments Govt Obligations Sch
Other Assets Schedule
Other Liabilities Schedule
Other Professional Fees Schedule
Taxes Schedule

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-12-14T10:17:54-06:00	Timestamp
Tax Period End Date	2012-10-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	PRADERE MOHATT & RINALDO LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 603	AddressLine1
City	SHERIDAN	City
State	WY	State
ZIP Code	828010603	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990PF	ReturnType
Tax Period Begin Date	2011-11-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	237435554	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	HARRY & THELMA SURRENA MEMORIAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	HARR	NameControl
Phone	3076726494	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	P O BOX 603	AddressLine1
City	SHERIDAN	City
State	WY	State
ZIP Code	82801	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	JOHN M PRADERE	Name
Title	TRUSTEE	Title
Phone	3076726494	Phone
Date Signed	2012-12-15	DateSigned

Preparer Preparer

Field	Value	IRS element (for citing)
Name	MICHAEL B JOHNSON	Name
Phone	3076726494	Phone
Date Prepared	2012-12-14	DatePrepared
Self Employed	X	SelfEmployed

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990-PF IRS990PF

Field	Value	IRS element (for citing)
Exempt PF	X	ExemptPF
FMV Assets EOY	4923426	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	33737	InterestOnSavingsRevAndExpnss
Interest On Savings Net Invst Incm	32174	InterestOnSavingsNetInvstIncm
Dividends Rev And Expnss	112826	DividendsRevAndExpnss
Dividends Net Invst Incm	112826	DividendsNetInvstIncm
Net Gain Sale Assets Rev And Expnss	155662	NetGainSaleAssetsRevAndExpnss
Gross Sales Price	1191861	GrossSalesPrice
Capital Gain Net Incm Net Invst Incm	155662	CapitalGainNetIncmNetInvstIncm
Total Revenue And Expenses	302225	TotalRevenueAndExpenses
Total Net Investment Income	300662	TotalNetInvestmentIncome
Comp Ofcr Dir Trst Rev And Expnss	25437	CompOfcrDirTrstRevAndExpnss
Comp Ofcr Dir Trst Net Invst Incm	12719	CompOfcrDirTrstNetInvstIncm
Comp Ofcr Dir Trst Dsbrs Chrtbl Prps	12718	CompOfcrDirTrstDsbrsChrtblPrps
Accounting Fees Rev And Expnss	2000	AccountingFeesRevAndExpnss
Accounting Fees Net Invst Incm	1500	AccountingFeesNetInvstIncm
Accounting Fees Dsbrs Chrtbl Prps	500	AccountingFeesDsbrsChrtblPrps
Other Prof Fees Rev And Expnss	12000	OtherProfFeesRevAndExpnss
Other Prof Fees Net Invst Incm	12000	OtherProfFeesNetInvstIncm
Taxes Rev And Expnss	4913	TaxesRevAndExpnss
Taxes Net Invst Incm	1208	TaxesNetInvstIncm
Taxes Dsbrs Chrtbl Prps	973	TaxesDsbrsChrtblPrps
Tot Opr Expenses Rev And Expnss	44350	TotOprExpensesRevAndExpnss
Tot Opr Expenses Net Invst Incm	27427	TotOprExpensesNetInvstIncm
Tot Opr Expenses Dsbrs Chrtbl Prps	14191	TotOprExpensesDsbrsChrtblPrps
Contri Gifts Paid Rev And Expnss	233500	ContriGiftsPaidRevAndExpnss
Contri Gifts Paid Dsbrs Chrtbl Prps	233500	ContriGiftsPaidDsbrsChrtblPrps
Total Expenses Rev And Expnss	277850	TotalExpensesRevAndExpnss
Total Expenses Net Invst Incm	27427	TotalExpensesNetInvstIncm
Total Expenses Dsbrs Chrtbl Prps	247691	TotalExpensesDsbrsChrtblPrps
Excess Of Revenue Over Expenses	24375	ExcessOfRevenueOverExpenses
Net Investment Income	273235	NetInvestmentIncome

Balance Sheets BalanceSheets

Field	Value	IRS element (for citing)
Savings And Temp Cash Invst BOY	70494	SavingsAndTempCashInvstBOY
Savings And Temp Cash Invst EOY	77828	SavingsAndTempCashInvstEOY
Savings And Temp Cash Invst EOYFMV	77828	SavingsAndTempCashInvstEOYFMV
Investments Govt Oblig BOY	387933	InvestmentsGovtObligBOY
Investments Govt Oblig EOY	360168	InvestmentsGovtObligEOY
Investments Govt Oblig EOYFMV	379552	InvestmentsGovtObligEOYFMV
Investments Corp Stock BOY	2455252	InvestmentsCorpStockBOY
Investments Corp Stock EOY	2794416	InvestmentsCorpStockEOY
Investments Corp Stock EOYFMV	3473825	InvestmentsCorpStockEOYFMV
Investments Corp Bonds BOY	1206624	InvestmentsCorpBondsBOY
Investments Corp Bonds EOY	912289	InvestmentsCorpBondsEOY
Investments Corp Bonds EOYFMV	969239	InvestmentsCorpBondsEOYFMV
Other Assets BOY	22993	OtherAssetsBOY
Other Assets EOY	22982	OtherAssetsEOY
Other Assets EOYFMV	22982	OtherAssetsEOYFMV
Total Assets BOY	4143296	TotalAssetsBOY
Total Assets EOY	4167683	TotalAssetsEOY
Total Assets EOYFMV	4923426	TotalAssetsEOYFMV
Other Liabilities EOY	12	OtherLiabilitiesEOY
Total Liabilities EOY	12	TotalLiabilitiesEOY
Org That Do Not Follow SFAS117	X	OrgThatDoNotFollowSFAS117
Capital Stock BOY	2443594	CapitalStockBOY
Capital Stock EOY	2443594	CapitalStockEOY
Retained Earnings BOY	1699702	RetainedEarningsBOY
Retained Earnings EOY	1724077	RetainedEarningsEOY
Total Net Assets BOY	4143296	TotalNetAssetsBOY
Total Net Assets EOY	4167671	TotalNetAssetsEOY
Total Liabilities Net Assets BOY	4143296	TotalLiabilitiesNetAssetsBOY
Total Liabilities Net Assets EOY	4167683	TotalLiabilitiesNetAssetsEOY

Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances

Field	Value	IRS element (for citing)
Total Net Assets Fund Balances BOY	4143296	TotalNetAssetsFundBalancesBOY
Excess Of Revenue Over Expenses	24375	ExcessOfRevenueOverExpenses
Subtotal	4167671	Subtotal
Total Net Assets Fund Balances EOY	4167671	TotalNetAssetsFundBalancesEOY

Capital Gains And Losses CapitalGainsAndLosses

Capital Gains And Losses Info CapitalGainsAndLossesInfo (61 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
ABBOTT LABORATORIES	P	2010-02-12	2012-05-25	18738	16116	2622	2622
COSTCO WHOLESALE CORPORATION	P	2009-10-22	2011-11-23	10064	7267	2797	2797
GNMA POOL 2009-61 5.500%	P	2010-06-08	2012-05-20	204	223	-19	-19
PEABODY ENERGY CORPORATION	P	2010-03-12	2012-03-05	6271	9764	-3493	-3493
WASHINGTON MUTUAL BANKRUPTCY PROCEED	P	2006-07-18	2012-09-26	2870		2870	2870
ABBOTT LABORATORIES	P	2010-03-12	2012-05-25	18738	16214	2524	2524
COSTCO WHOLESALE CORPORATION	P	2009-10-22	2012-08-03	15618	9360	6258	6258
GNMA POOL 2009-61 5.500%	P	2010-06-08	2012-06-20	205	224	-19	-19
PEABODY ENERGY CORPORATION	P	2010-05-14	2012-03-05	6271	8301	-2030	-2030
ABBOTT LABORATORIES	P	2010-10-26	2012-05-25	12492	10515	1977	1977
DISNEY WALT CO HOLDINGS	P	2009-01-15	2012-07-05	16858	7015	9843	9843
GNMA POOL 2009-61 5.500%	P	2010-06-08	2012-07-20	206	225	-19	-19
PEABODY ENERGY CORPORATION	P	2010-06-02	2012-03-05	6271	7764	-1493	-1493
ABBOTT LABORATORIES	P	2011-04-06	2012-05-25	4247	3449	798	798
EXXON MOBIL CORPORATION	P	1983-06-24	2011-11-23	11259	649	10610	10610
GNMA POOL 2009-61 5.500%	P	2010-06-08	2012-08-20	207	226	-19	-19
PHILLIPS 66	P	2002-01-08	2012-05-09	11030	4783	6247	6247
AIR PRODUCTS & CHEMICALS	P	2009-09-17	2012-02-28	27296	23795	3501	3501
FED HOME LOAN BANK NOTES 1.250%	P	2012-05-23	2012-08-03	50000	50000
GNMA POOL 2009-61 5.500%	P	2010-06-08	2012-09-20	208	227	-19	-19
TARGET CORPORATION	P	2004-04-19	2012-08-03	19324	13621	5703	5703
AIR PRODUCTS & CHEMICALS	P	2010-10-26	2012-02-28	9099	8568	531	531
FED HOME LOAN BANK NOTES 3.125%	P	2011-08-18	2012-02-23	20625	20623	2	2
GNMA POOL 2009-61 5.500%	P	2010-06-08	2012-10-20	209	228	-19	-19
TIFFANY & CO	P	2011-12-23	2012-07-05	21694	25780	-4086	-4086
APPLE COMPUTER INC	P	2009-10-05	2012-03-22	12638	3923	8715	8715
FED HOME LOAN BANK NOTES STR 1.250%	P	2012-04-17	2012-06-28	50000	50000
GOOGLE INC	P	2012-03-22	2012-10-01	31828	27231	4597	4597
VANGUARD GNMA FUND 36	P	2007-12-20	2011-11-23	59000	54922	4078	4078
BARCLAYS BANK PLC STR 5.000%	P	2010-06-14	2012-06-29	100000	100000
GENERAL ELECTRIC CAPITAL CORP 5.000%	P	2007-12-20	2012-04-10	100000	102344	-2344	-2344
GOOGLE INC	P	2010-06-09	2012-10-01	37890	24208	13682	13682
VANGUARD SHORT-TERM INVESTMENT GRADE	P	2004-03-11	2012-10-17	30000	30000
BB&T CORPORATION 3.850%	P	2010-05-12	2012-07-27	50000	52250	-2250	-2250
GENERAL MOTORS CO	P	2007-12-31	2011-11-04	155		155	155
GOOGLE INC	P	2010-08-06	2012-10-01	18945	12495	6450	6450
VERIZON COMMUNICATIONS	P	2011-11-23	2012-05-04	10075	8896	1179	1179
CATERPILLAR INC	P	2010-02-12	2012-02-08	11391	5576	5815	5815
GNMA POOL 2009-61 5.500%	P	2010-06-08	2011-11-20	199	217	-18	-18
INTEL CORPORATION	P	1993-06-28	2012-09-13	28316	4284	24032	24032
VERIZON COMMUNICATIONS	P	2010-12-07	2012-05-04	40298	33110	7188	7188
CITIGROUP INC	P	2011-01-06	2011-11-23	8207	17428	-9221	-9221
GNMA POOL 2009-61 5.500%	P	2010-06-08	2011-12-20	200	218	-18	-18
JOHNSON & JOHNSON	P	1996-07-30	2012-09-13	41362	14318	27044	27044
WASHINGTON MUTUAL DEFAULTED 4.00%	P	2006-07-18	2012-03-23	111624	96741	14883	14883
CITIGROUP INC	P	2010-04-09	2011-11-23	5862	11450	-5588	-5588
GNMA POOL 2009-61 5.500%	P	2010-06-08	2012-01-20	200	219	-19	-19
JOHNSON & JOHNSON	P	2011-05-23	2012-09-13	20681	19716	965	965
WASTE MANAGEMENT INC	P	2011-11-04	2012-09-27	8020	7894	126	126
CITIGROUP INC	P	2010-05-13	2011-11-23	14069	24900	-10831	-10831
GNMA POOL 2009-61 5.500%	P	2010-06-08	2012-02-20	201	220	-19	-19
PEABODY ENERGY CORPORATION	P	2011-10-25	2012-03-05	9406	12023	-2617	-2617
WASTE MANAGEMENT INC	P	2011-11-23	2012-09-27	8020	7652	368	368
CITIGROUP INC	P	2010-06-02	2011-11-23	2345	3970	-1625	-1625
GNMA POOL 2009-61 5.500%	P	2010-06-08	2012-03-20	202	221	-19	-19
PEABODY ENERGY CORPORATION	P	2011-11-23	2012-03-05	4703	5039	-336	-336
WASTE MANAGEMENT INC	P	2011-08-26	2012-09-27	25663	26095	-432	-432
CONOCOPHILLIPS	P	2002-01-08	2012-08-17	40118	16097	24021	24021
GNMA POOL 2009-61 5.500%	P	2010-06-08	2012-04-20	203	222	-19	-19
PEABODY ENERGY CORPORATION	P	2010-02-12	2012-03-05	12542	17383	-4841	-4841
GENERAL MOTORS LITIGATION PROCCEDS	P	2009-11-23	2012-04-06	23		23	23

Field	Value	IRS element (for citing)
Capital Gain Net Income	155662	CapitalGainNetIncome
Net Short Term Capital Gain Or Loss	-9988	NetShortTermCapitalGainOrLoss

Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax

Field	Value	IRS element (for citing)
Liable For4942 Tax	false	LiableFor4942Tax
Qualifying Distributions Year1	234756	QualifyingDistributionsYear1
Noncharitable Assets Year1	4609464	NoncharitableAssetsYear1
Distribution Ratio Year1	0.050929	DistributionRatioYear1
Qualifying Distributions Year2	207821	QualifyingDistributionsYear2
Noncharitable Assets Year2	4402615	NoncharitableAssetsYear2
Distribution Ratio Year2	0.047204	DistributionRatioYear2
Qualifying Distributions Year3	186524	QualifyingDistributionsYear3
Noncharitable Assets Year3	3996482	NoncharitableAssetsYear3
Distribution Ratio Year3	0.046672	DistributionRatioYear3
Qualifying Distributions Year4	176828	QualifyingDistributionsYear4
Noncharitable Assets Year4	5058764	NoncharitableAssetsYear4
Distribution Ratio Year4	0.034955	DistributionRatioYear4
Qualifying Distributions Year5	269988	QualifyingDistributionsYear5
Noncharitable Assets Year5	5384174	NoncharitableAssetsYear5
Distribution Ratio Year5	0.050145	DistributionRatioYear5
Total Distribution Ratio	0.229905	TotalDistributionRatio
Average Distribution Ratio	0.045981	AverageDistributionRatio
Net Noncharitable Assets	4807448	NetNoncharitableAssets
Adjusted Noncharitable Assets	221051	AdjustedNoncharitableAssets
One Percent Net Investment Income	2732	OnePercentNetInvestmentIncome
Adj Nonchrtbl Assets And One	223783	AdjNonchrtblAssetsAndOnePct
Qualifying Distributions	247691	QualifyingDistributions

Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm

Field	Value	IRS element (for citing)
Domestic Org Meeting Sect4940e	X	DomesticOrgMeetingSect4940e
Investment Income Excise Tax	2732	InvestmentIncomeExciseTax
Subtotal	2732	Subtotal
Tax Based On Investment Income	2732	TaxBasedOnInvestmentIncome
Est Tax Payments And Overpayment	2720	EstTaxPaymentsAndOverpayment
Total Credits And Payments	2720	TotalCreditsAndPayments
Tax Due	12	TaxDue
Amount Credited To Next Year	0	AmountCreditedToNextYear

Statements Regarding Activities StatementsRegardingActivities

Field	Value	IRS element (for citing)
Legislative Political Activities	false	LegislativePoliticalActivities
More Than100 Spent	false	MoreThan100Spent
Form1120 POL Filed	false	Form1120POLFiled
Activities Not Prev Reported	false	ActivitiesNotPrevReported
Changes To Articles Or Bylaws	false	ChangesToArticlesOrBylaws
Unrelated Bus Income Over1000	false	UnrelatedBusIncomeOver1000
Termination Etc	false	TerminationEtc
Requirements Of Sect508e	true	RequirementsOfSect508e
At Least5000 In Assets	true	AtLeast5000InAssets
States Filed With	WY	StatesFiledWith
Form990 PF Filed With AG	true	Form990PFFiledWithAG
Private Operating Foundation	false	PrivateOperatingFoundation
New Substantial Contributors	false	NewSubstantialContributors
Interest In Controlled Entity	false	InterestInControlledEntity
Applicable Insurance Contract	false	ApplicableInsuranceContract
Comply With Public Inspection Rqr	true	ComplyWithPublicInspectionRqr
Website Address	N/A	WebsiteAddress

Books In Care Of Business Name BooksInCareOfBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	PRADERE MOHATT RINALDO	BusinessNameLine1

Field	Value	IRS element (for citing)
Books In Care Of Phone Number	3076726494	BooksInCareOfPhoneNumber

Books In Care Of US Address BooksInCareOfUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 603	AddressLine1
City	SHERIDAN	City
State	WY	State
ZIP Code	82801	ZIPCode

Statements Regarding Acty4720 StatementsRegardingActy4720

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

Ofcr Dir Trustees Key Employee Info OfcrDirTrusteesKeyEmployeeInfo

Ofcr Dir Trustees Or Key Employee OfcrDirTrusteesOrKeyEmployee (2 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
RALPH C ROBINSON
PO BOX 27	BUFFALO	WY	82834	TRUSTEE	2.00	12719	0	0
JOHN PRADERE
PO BOX 603	SHERIDAN	WY	82801	TRUSTEE	2.00	12718	0	0

Field	Value	IRS element (for citing)
Comp Of Highest Paid Empl NONE	NONE	CompOfHighestPaidEmplNONE
Comp Of Hghst Paid Cntrct NONE	NONE	CompOfHghstPaidCntrctNONE

Sum Of Program Related Investments SumOfProgramRelatedInvestments

Field	Value	IRS element (for citing)
Description1	N/A	Description1

Minimum Investment Return MinimumInvestmentReturn

Field	Value	IRS element (for citing)
Avg Monthly FMV Of Securities	4726592	AvgMonthlyFMVOfSecurities
Avg Monthly Cash Balances	131084	AvgMonthlyCashBalances
FMV All Other Noncharitable Assets	22982	FMVAllOtherNoncharitableAssets
Total FMV Of Unused Assets	4880658	TotalFMVOfUnusedAssets
Adj Total FMV Of Unused Assets	4880658	AdjTotalFMVOfUnusedAssets
Cash Deemed Charitable	73210	CashDeemedCharitable
Net Noncharitable Assets	4807448	NetNoncharitableAssets
Minimum Investment Return	240372	MinimumInvestmentReturn

Distributable DistributableAmount

Field	Value	IRS element (for citing)
Minimum Investment Return	240372	MinimumInvestmentReturn
Tax Based On Investment Income	2732	TaxBasedOnInvestmentIncome
Total Tax	2732	TotalTax
Distributable Amount Before Adj	237640	DistributableAmountBeforeAdj
Distributable Amount Before Ded	237640	DistributableAmountBeforeDed
Distributable Amount As Adjusted	237640	DistributableAmountAsAdjusted

Qualifying Distributions QualifyingDistributions

Field	Value	IRS element (for citing)
Expenses And Contributions	247691	ExpensesAndContributions
Qualifying Distributions	247691	QualifyingDistributions
One Pct Sect4940e Org Net Invst Incm	2732	OnePctSect4940eOrgNetInvstIncm
Adj Qualifying Distributions	244959	AdjQualifyingDistributions

Undistributed Income UndistributedIncome

Field	Value	IRS element (for citing)
Distributable Amount As Adjusted	237640	DistributableAmountAsAdjusted
Undistributed Income Prior Year	71231	UndistributedIncomePriorYear
Qualifying Distributions	247691	QualifyingDistributions
Applied To Year1	71231	AppliedToYear1
Applied To Current Year	176460	AppliedToCurrentYear
Undistributed Income CY	61180	UndistributedIncomeCY

Supplementary Information SupplementaryInformation

Appication Submission Info AppicationSubmissionInfo

Field	Value	IRS element (for citing)
Recipient Name	SURRENA MEMORIAL FUND	RecipientName

Recipient US Address RecipientUSAddress

Field	Value	IRS element (for citing)
Address Line1	BOX 27	AddressLine1
City	BUFFALO	City
State	WY	State
ZIP Code	82834	ZIPCode

Field	Value	IRS element (for citing)
Recipient Phone Number	3076845574	RecipientPhoneNumber
Form And Info And Materials	WRITTEN APPLICATION	FormAndInfoAndMaterials
Submission Deadlines	NONE	SubmissionDeadlines
Restrictions On Awards	CHARITABLE, RELIGIOUS, SCIENTIFIC, & EDUCATIONAL PURPOSES IN THE U.S.	RestrictionsOnAwards

Grant Or Contri Paid During Year GrantOrContriPaidDuringYear (22 entries)

Address Line1RecipientUSAddress/AddressLine1	CityRecipientUSAddress/City	StateRecipientUSAddress/State	ZIP CodeRecipientUSAddress/ZIPCode	Recipient RelationshipRecipientRelationship	Recipient Foundation StatusRecipientFoundationStatus	Purpose Of Grant Or ContributionPurposeOfGrantOrContribution	AmountAmount	Business Name Line2RecipientBusinessName/BusinessNameLine2
CHILDREN'S CENTER - BUFFA
151 KLONDIKE	BUFFALO	WY	82834	NONE	501C3	GENERAL OPERATIONS	$45,000
CHILDREN'S CENTER
863 HIGHLAND AVE	SHERIDAN	WY	82801	NONE	501C3	GENERAL OPERATIONS	$30,000
GENESIS FOUNDATION
444 CRESCENT DR	SHERIDAN	WY	82801	NONE	501C3	GENERAL OPERATIONS	$25,000
HABITAT FOR HUMANITY OF
PO BOX 6196	SHERIDAN	WY	82801	NONE	501C3	GENERAL OPERATIONS	$10,000	THE EASTERN BIGHORNS INC
JOHNSON COUNTY LIBRARY
171 N ADAMS	BUFFALO	WY	82834	NONE	501C3	GENERAL OPERATIONS	$10,000	FOUNDATION
SENIOR CITIZENS COUNCIL
211 SMITH STREET	SHERIDAN	WY	82801	NONE	501C3	GENERAL OPERATIONS	$5,000
METHODIST CHURCH
132 N ADAMS AVE	BUFFALO	WY	82834	NONE	501C3	GENERAL OPERATIONS	$5,000	OF BUFFALO WYOMING
METHODIST CHURCH
215 W WORKS	SHERIDAN	WY	82801	NONE	501C3	GENERAL OPERATIONS	$5,000	OF SHERIDAN WYOMING
MOUNTAIN PLAINS HERITAGE
PO BOX 27	BUFFALO	WY	82834	NONE	501C3	GENERAL OPERATIONS	$3,000
SHERIDAN COUNTY LIBRARY
335 W ALGER	SHERIDAN	WY	82801	NONE	501C3	GENERAL OPERATIONS	$5,000	FOUNDATION INC
SHERIDAN COLLEGE
3059 COFFEEN AVE	SHERIDAN	WY	82801	NONE	501C3	GENERAL OPERATIONS	$10,000	FOUNDATION
STORY BRANCH LIBRARY
PO BOX 188	STORY	WY	82842	NONE	501C3	GENERAL OPERATIONS	$5,000
STORY COMMUNITY CHURCH
PO BOX 415	STORY	WY	82842	NONE	501C3	GENERAL OPERATIONS	$5,000
VOLUNTEERS OF AMERICA OF
PO BOX 6291	SHERIDAN	WY	82801	NONE	501C3	HOMELESS SHELTER	$5,000	WYOMING AND MONTANA
JOHNSON COUNTY YMCA
101 SOUTH KLONDIKE	BUFFALO	WY	82834	NONE	501C3	GENERAL OPERATIONS	$20,000
SHERIDAN COUNTY YMCA
417 NORTH JEFFERSON	SHERIDAN	WY	82801	NONE	501C3	GENERAL OPERATIONS	$20,000
SCOTTISH RITE CHILDHOOD
8 RIVERBEND COURT	SHERIDAN	WY	82801	NONE	501C3	GENERAL OPERATIONS	$5,000	LANGUAGE CLINIC C/O TOM NEIGHBORS
BREAD OF LIFE
PO BOX 909	BUFFALO	WY	82834	NONE	501C3	GENERAL OPERATIONS	$5,000
BUFFALO SENIOR CENTER
671 W FETTERMAN	BUFFALO	WY	82834	NONE	501C3	GENERAL OPERATIONS	$500
CLEARMONT COMMUNITY LIBRA
PO BOX 26	CLEARMONT	WY	82835	NONE	501C3	GENERAL OPERATIONS	$5,000
TONGUE RIVER BRANCH
PO BOX 909	RANCHESTER	WY	82839	NONE	501C3	GENERAL OPERATIONS	$5,000	LIBRARY
TONGUE RIVER CHILD'S
84 DAYTON STREET	RANCHESTER	WY	82839	NONE	501C3	GENERAL OPERATIONS	$5,000	PLACE

Field	Value	IRS element (for citing)
Tot Grant Or Contri Paid During Year	233500	TotGrantOrContriPaidDuringYear

Analysis Income Producing Acty AnalysisIncomeProducingActy

Int On Savings And Temp Cash Invst IntOnSavingsAndTempCashInvst

Field	Value	IRS element (for citing)
Exclusion Code	14	ExclusionCode
Exclusion	$33,737	ExclusionAmount

Dividends And Int From Sec Part VII DividendsAndIntFromSecPartVII

Field	Value	IRS element (for citing)
Exclusion Code	14	ExclusionCode
Exclusion	$112,826	ExclusionAmount

Gain Sales Assets Oth Than Invntry GainSalesAssetsOthThanInvntry

Field	Value	IRS element (for citing)
Exclusion Code	18	ExclusionCode
Exclusion	$155,662	ExclusionAmount

Subtotals Part XVIA SubtotalsPartXVIA

Field	Value	IRS element (for citing)
Exclusion	$302,225	ExclusionAmount

Field	Value	IRS element (for citing)
Total Part XVIA	302225	TotalPartXVIA

Trnsfr Tr Rln With Noncharitable EO TrnsfrTrRlnWithNoncharitableEO

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

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees AccountingFees

Field	Value	IRS element (for citing)
Category	ACCOUNTING FEES	Category
Amount	$2,000	Amount
Net Investment Income	1500	NetInvestmentIncome
Disbursements Charitable Prps	500	DisbursementsCharitablePrps

Compensation Explanation CompensationExplanation

Compensation Compensation (2 entries)

RALPH C ROBINSON
JOHN PRADERE

Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule

Investments Corp Bonds InvestmentsCorpBonds (18 entries)

Name Of BondNameOfBond	EOY Book ValueEOYBookValue	EOYFMVEOYFMV
BARCLAYS BANK PLC
BB&T CORPORATION
BLACKROCK INC	50000	59347
CSX CORP 6.25%	50920	61566
DODGE & COX INCOME FUND	75000	79045
GENERAL ELECTRIC CAP 5.1%	100000	111085
GENERAL ELECTRIC CAPITAL 5.0%
LILLY ELI & CO	26963	29429
MORGAN STANLEY STR	24000	25927
OPPENHEIMER INTERNATIONAL BOND FUND	73000	72982
PRUDENTIAL FINANCIAL INC 5.75%	100000	99999
ROYAL BANK OF SCOTLAND PLC 3.40%	25280	25452
TEMPLETON GLOBAL BOND FUND	76000	75233
US BANCORP	15725	15847
VANGUARD HIGH YIELD CORPORATE PORT	125000	136115
VANGUARD INTERMEDIATE-TERM INVEST	98000	104733
VANGUARD SHORT TERM CORP FUND	72401	72479
WASHINGTON MUTUAL INC

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corp Stock InvestmentsCorpStock (74 entries)

Name Of StockNameOfStock	EOY Book ValueEOYBookValue	EOYFMVEOYFMV
GENERAL ELECTRIC CAPITAL CORP	49987	50277
PUBLIC STORAGE 6.50% PFD	25000	28270
TENN VALLEY AUTH 6/1/28	49980	53155
ABBOTT LABORATORIES	6694	8646
AIR PRODUCTS & CHEMICALS
AMGEN INC	53284	77841
APACHE CORPORATION	43804	40532
APPLE COMPUTER INC	52793	121445
BAKER HUGHES INC	66625	60856
BB&T CORPORATION	35117	32685
BERKSHIRE HATHAWAY INC - CL B	46352	51810
BOEING CO	42930	52830
CATERPILLAR INC	50699	60385
CHEVRON CORP	32432	79925
CISCO SYSTEMS	60417	41148
CITIGROUP INC
COCA COLA COMPANY	32015	37180
CONOCOPHILLIPS
CONSOLIDATED EDISON INC	16915	36228
COSTCO WHOLESALE CORPORATION	23705	40750
DEERE & COMPANY	59013	64080
DISNEY WALT CO HOLDINGS	36314	56537
DU PONT E I DE NEMOURS & COMPANY	49615	46746
EMC CORPORATION	32330	43956
EMERSON ELECTRIC CO	32434	48430
EXELON CORPORATION	76664	69950
EXXON MOBIL CORP	16499	91170
FLUOR CORPORATION	45724	39095
FORD MOTOR COMPANY	70325	82606
GENERAL ELECTRIC CO	50559	63180
GENERAL MILLS	21057	40080
GILEAD SCIENCES INC.	35513	47023
GOOGLE INC
HUNTINGTON BANCSHARES INC	33055	35173
ILLINOIS TOOL WORKS INC	24598	27599
INTEL CORP	42095	41962
INTERNATIONAL BUSINESS MACHINES CORP	65091	80730
JOHNSON & JOHNSON
JOHNSON CONTROLS INC	42641	32188
J.P. MORGAN CHASE & CO	124552	127124
KRAFT FOODS INC	16513	22730
MCDONALDS CORPORATION	67935	80984
MCKESSON CORPORATION	58560	62144
MDU RESOURCES GROUP	27086	39114
MERCK & CO INC	44834	54756
MICROSOFT CORPORATION	41449	39956
MONDELEZ INTERNATIONAL INC	30547	39825
NEXTERA ENERGY INC	54412	70060
NORTHERN TRUST CORPORATION	54945	47800
ORACLE CORPORATION	44415	62160
PEABODY ENERGY CORPORATION
PEPSICO	24613	55392
PFIZER INC	3983	52227
PHILIP MORRIS INTERNATIONAL	45035	61992
PROCTOR & GAMBLE CO	37000	55392
QUALCOMM INC	37584	58610
SCHLUMBERGER LIMITED	45606	46933
SOUTHERN CO	6839	46840
TARGET CORP	39071	53486
UNITEDHEALTH GROUP INC	66056	69888
VERIZON COMMUNICATIONS
WASTE MANAGEMENT INC
BHP BILLITON LIMITED ADR	35212	35370
TEVA PHARMACEUTICAL INDUSTRIES LIMIT	62804	44462
OPPENHEIMER MAIN ST SMALL CAP	40000	44746
T ROWE PRICE MID CAP FUND	50000	57327
T ROWE PRICE MID CAP VALUE FUND	50000	57226
AMERICAN EUROPACIFIC GROWTH FUND	73447	82510
HARBOR INTERNATIONAL FUND	58089	81497
EATON VANCE TAX-MANAGED EMERGING	55000	54314
VANGUARD EMERGIN MARKETS ETF	26553	24897
HARBOR COMMODITY REAL RETURN STRATEG	50000	49716
GENERAL MOTORS CO WARRANTS EXP 07/10		6087
GENERAL MOTORS CO WARRANTS EXP 07/10		3792

Investments Govt Obligations Sch InvestmentsGovtObligationsSch

Field	Value	IRS element (for citing)
US Govt Securities EOY Book Value	309649	USGovtSecuritiesEOYBookValue
US Govt Securities EOYFMV	326968	USGovtSecuritiesEOYFMV
State Local Securities EOY Book Val	50519	StateLocalSecuritiesEOYBookVal
State Local Securities EOYFMV	52584	StateLocalSecuritiesEOYFMV

Other Assets Schedule OtherAssetsSchedule

Other Assets OtherAssets (2 entries)

DescriptionDescription	BOY Book ValueBOYBookValue	EOY Book ValueEOYBookValue	EOYFMVEOYFMV
MINERAL RIGHTS	22982	22982	22982
PREPAID FEDERAL EXCISE TAX	11

Other Liabilities Schedule OtherLiabilitiesSchedule

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	FEDERAL TAXES PAYABLE	Description
EOY Book Value	12	EOYBookValue

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees OtherProfessionalFees

Field	Value	IRS element (for citing)
Category	INVESTMENT MANAGEMENT FEES	Category
Amount	$12,000	Amount
Net Investment Income	12000	NetInvestmentIncome

Taxes Schedule TaxesSchedule

Taxes Taxes (3 entries)

CategoryCategory	AmountAmount	Net Investment IncomeNetInvestmentIncome	Disbursements Charitable PrpsDisbursementsCharitablePrps
PAYROLL TAXES	$1,946	973	973
2011 990-PF EXCISE TAXES	$2,732
FOREIGN TAXES	$235	235