David H Koch Charitable Foundation 480926946 2010 07b84bc6

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Form990-PF EXTENSION GRANTED Return of Private Foundation OMB No 1545-0052 Department orthe Treasury Internal Revenue SeMCe or Section 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation Note. The foundation ma be able to use a co of this return to satis state re ~©10 For calendar year 2010 or tax year begmn ng , 2010, and ending , 20 G Check all that apply: H Initial return Amended return LJ Initial return of a former public charity LJ Final return n Address change n Name change Name of foundation A Employer identification number DAVID H. KOCH CHARITABLE FOUNDATION 48-0926946 Number and street (or PO box number If ma1l 1s not delivered to street address) Room/suite B Telephone number (see page 10 orthe instructions) 4111 E. 37TH ST. N. City or town, state, and ZIP code WICHITA, KS 67220-3203 H Check type of organization: Section 501 (cl@.) exempt private foundation n Section 4947(a)(1) nonexemot chantable trust I I Other taxable private foundation (316) 828-8286 C II exemplron applJCatlon Is pending, check here • • • • • • D 1 Foreign organizations, check here 2 Foreign organizations meehng the 85% tes~ check here and attach computabon • • • • • • • • E II private roundabon status was tenmnaled D I Fair market value of all assets at end J Accounting method.LJ Cash Accrual under sectJon 507(bJ(IJ(Al, check here of year (from Part II, col. (c), /me O Other (specify) _____ ------- __________ F QI :::, c QI > G) . 16) $ 7 5, 5 91, 8 8 6. (Part I. column (d) must be on cash basis.) Analysis of Revenue and Expenses (The total of amounts ,n columns (b), (c), and (d) (a) Revenue and (b) Net investment may not necessanly equal the amounts m expenses per income column (a) (see page 11 of the mstruct,ons).) books 1 Conlnbutlon~s, grants, etc , rece111ed (attach schedule) 0 2 Ch k X 1f the foundabon 1s not requiredto ec attachSch B • • • • • • • • • 3 Interest on savings and temporary cashinvestments 4 D1v1dends and interest from secunltes 1,113 1,113. Sa Gross rents • • • • • • . • . . • . . • • • • b Net rental income or (loss) 6a Net gain or (loss) from saleof assets noton line 10 b Gross salesprice for all assetson line6a 7 If the foundal1on IS In 3 60-month temunatJon n under section 507(b)(1)(B), check here. (c) AdJusted net income (d) Disbursements for charitable purposes (cash basis onlvl ATCH 1 0:: Capital gain net income (from Part IV, line 2) • - 8 Net short-term capital gain - c::> C'J QC) > C) :z: Q w 9 Income modifications • • 1 O a Gross saleslessreturns I and allowances • • • • • b Less Costof goods sold • I c Gross profit or (loss) (attach schedule) 11 Other income (attach schedule) ••• 12 Total. Add Imes 1 throuah 11 . • . . 1,113 1, 113. 13 Compensation of officers, directors, trustees, etc Z 111 1 4 Other employee salaries and wages Z 5l 15 Pension plans, employee benefits • • •• (3 [ 16a Legal fees (attach schedulaj_ ••••• CJ) W,c c-AccQUpting-fees,liattacti sche~)ATCH 2 2 1, 711 0 . 0 • 19, 8 0 0 K t- .I r "l C I J ,~u'j . . . . . Other ~rofes~onaLfees-(atta 1 uredule). *: . 1-------3_,_4_3_1-+ _____ 2_,_2_5_8--1.1----------+------l-, _1_3_4 17\~t .......... -~· ..... . 18 :l{xes (,ai@;~ ~Ju1eWJe\•page\1e,f~the Instructions) E 1 9 1,Q~prec1at1on (attach schedu!_!l(%Jddepletion. 20 Occf~i~l.1FN UT·· · · · · · · · 1--------+-------+--------+------- 't:I 21 TraveJ~.sg.nferenc~an<l-meetlng 1-----------+----------+---------+---------- c ... ca 22 Pnntmg and publications ••••• f 23 Other expenses (attach schedule) ~1C:H. ~. 1------1_, _5_1_0-+--------+---------+------1_,_0_3_3 24 G) a. O 25 26 Total operating and administrative expenses. Add Imes 13 through 23 • • • • • • • • • • 1----,--..,....,,.2--=6_,--:6:-5:-2=---+-----2-'_2_5_8--1.1----------0-.+---.....,.....----=-2=-=-l-' --=9--:6:-=-7 Contnbullons, gifts, grants paid • • • •••• ___ 2_,_6_5_0_, _0_0_0-+--------+----------+---1_2_,_6_5_0_, _O_O_O Total exoenses and dl1bursements Add Imes 24 and25 2, 67 6, 652 2, 2 58 • 0 • 12, 671, 9 67 27 Subtract line 26 from hne 12 a Excess of revenue over expenses and disbursements • • -2,675,539 b Net investment income (if negative, enter -0-) 1----------t----------O_.t----------t---------- c Adiusted net income (1f negative, enter -0-). . {) For Paperwork Reduction Act Notice, see page 30 of the instructions. * ATCH 3 JSA Form 990-PF (2010) l \ OE 14101000 14352G K932 11/14/2011 3:21:24 PM V 10-8.2 85652 \

description

David H Koch Charitable Foundation 2010 990 form (Searchable PDF)

Transcript of David H Koch Charitable Foundation 480926946 2010 07b84bc6

Form990-PF EXTENSION GRANTED

Return of Private Foundation OMB No 1545-0052

Department or the Treasury Internal Revenue SeMCe

or Section 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation

Note. The foundation ma be able to use a co of this return to satis state re ~©10 For calendar year 2010 or tax year begmn ng , 2010, and ending , 20

G Check all that apply: H Initial return

Amended return

LJ Initial return of a former public charity LJ Final return n Address change n Name change

Name of foundation A Employer identification number

DAVID H. KOCH CHARITABLE FOUNDATION 48-0926946

Number and street (or PO box number If ma1l 1s not delivered to street address) Room/suite B Telephone number (see page 10 or the instructions)

4111 E. 37TH ST. N. City or town, state, and ZIP code

WICHITA, KS 67220-3203

H Check type of organization: ~ Section 501 (cl@.) exempt private foundation n Section 4947(a)(1) nonexemot chantable trust I I Other taxable private foundation

(316) 828-8286 C II exemplron applJCatlon Is

pending, check here • • • • • • D 1 Foreign organizations, check here

2 Foreign organizations meehng the 85% tes~ check here and attach computabon • • • • • • • •

E II private roundabon status was tenmnaled D I Fair market value of all assets at end J Accounting method.LJ Cash ~ Accrual under sectJon 507(bJ(IJ(Al, check here • ~

of year (from Part II, col. (c), /me O Other (specify) _____ ------- __________ F

QI :::, c QI > G)

. 16) ~ $ 7 5, 5 91, 8 8 6. (Part I. column (d) must be on cash basis.)

Analysis of Revenue and Expenses (The total of amounts ,n columns (b), (c), and (d) (a) Revenue and (b) Net investment may not necessanly equal the amounts m expenses per income column (a) (see page 11 of the mstruct,ons).) books

1 Conlnbutlon~s, grants, etc , rece111ed (attach schedule) • 0

2 Ch k ~ X 1f the foundabon 1s not required to

ec attach Sch B • • • • • • • • •

3 Interest on savings and temporary cash investments

4 D1v1dends and interest from secunltes 1,113 1,113.

Sa Gross rents • • • • • • . • . . • . . • • • •

b Net rental income or (loss)

6a Net gain or (loss) from sale of assets not on line 10 b Gross sales price for all

assets on line 6a 7

If the foundal1on IS In 3 60-month temunatJon n under section 507(b)(1)(B), check here . ~

(c) AdJusted net income

(d) Disbursements for charitable

purposes (cash basis onlvl

ATCH 1

0:: Capital gain net income (from Part IV, line 2) • - 8 Net short-term capital gain -c::>

C'J

QC)

~

> C)

:z: Q w

9 Income modifications • • 1 O a Gross sales less returns I

and allowances • • • • • b Less Cost of goods sold • I c Gross profit or (loss) (attach schedule)

11 Other income (attach schedule) •••

12 Total. Add Imes 1 throuah 11 . • . . 1,113 1, 113.

13 Compensation of officers, directors, trustees, etc

Z 111

1 4 Other employee salaries and wages

Z 5l 15 Pension plans, employee benefits • • ••

(3 [ 16a Legal fees (attach schedulaj_ ••••• CJ) W,c c-AccQUpting-fees,liattacti sche~)ATCH 2 2 1, 711 0 . 0 • 19, 8 0 0

K t- .I r "l C I J ,~u'j . . . . . ~ Other ~rofes~onaLfees-(atta 1uredule). *: . 1-------3_,_4_3_1-+ _____ 2_,_2_5_8--1.1----------+------l-, _1_3_4

~ 17\~t .......... -~· ..... . ~ 18 :l{xes (,ai@;~ ~Ju1eWJe\•page\1e,f~the Instructions)

E 1 9 1,Q~prec1at1on (attach schedu!_!l(%Jd depletion.

~ 20 Occf~i~l.1FN • UT· · · · · · · · · 1--------+-------+--------+-------'t:I 21 TraveJ~.sg.nferenc~an<l-meetlng • 1-----------+----------+---------+----------c ... ca 22 Pnntmg and publications •••••

f 23 Other expenses (attach schedule) ~1C:H. ~. 1------1_, _5_1_0-+--------+---------+------1_,_0_3_3

~ 24 G) a. O 25

26

Total operating and administrative expenses.

Add Imes 13 through 23 • • • • • • • • • • 1----,--..,....,,.2--=6_,--:6:-5:-2=---+-----2-'_2_5_8--1.1----------0-.+---.....,.....----=-2=-=-l-' --=9--:6:-=-7

Contnbullons, gifts, grants paid • • • •••• ___ 2_, _6_5_0_, _0_0_0-+--------+----------+---1_2_,_6_5_0_, _O_O_O Total exoenses and dl1bursements Add Imes 24 and 25 2, 67 6, 652 2, 2 58 • 0 • 12, 671, 9 67

27 Subtract line 26 from hne 12

a Excess of revenue over expenses and disbursements • • -2,675,539

b Net investment income (if negative, enter -0-) 1----------t----------O_.t----------t----------c Adiusted net income (1f negative, enter -0-). . {)

For Paperwork Reduction Act Notice, see page 30 of the instructions. * ATCH 3 JSA Form 990-PF (2010) l ~ \ OE

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Form 990-PF (2010) 48-0926946 Page 2

111111 Attached schedules and amounts in the Beginning of year End of year

Balance Sheets description column should be for end-of-year amounts only (See instrucbons) (a) Book Value (b) Book Value (c) Fair Market Value

1 Cash - non-mterest-beanng • . . .. 5,224. 4,007. 4,007

2 Scl'vmgs and temporary cash investments • .. . . 20,259,741. 10,587,846. 10,587,846

3 Accounts receivable ~ ______ --------- ________ . Less allowance for doubtful accounts ~

4 Pledges receivable ~ 65,000,000. ------------------------

Less allowance for doubtful accounts ~ 75,000,000. 65,000,000. 65,000,000 -------------

5 Grants receivable .. . . . . . .... 6 Receivables due from officers, directors, trustees, and other

disqualified persons (attach schedule) (see page 15 of the instructions)

7 Other notes and loans receivable (attach schedule) ~ _____

Less· allowance for doubtful accounts ~ -------------Ill 8 lnventones for sale or use . . . . ... -GI 9 Prepaid expenses and deferred charges • .l\'l'.CI:J . ~ 33. 33. 33 Ill Ill

10 a cc Investments - US and state government obhgabons (attach schedule).

b Investments - corporate stock (attach schedule) ••

c Investments - corporate bonds (attach schedule). .. . . 11 Investments - land, buildings, ~ and equipment basis ------------------Less accumulated deprec1abon ~

(attach schedule) - - - - - - - - - - - _______ -12 Investments - mortgage loans .. 13 Investments - other (attach schedule) • • • • . • • . • . • •• 14 Land, bu1ld1ngs, and ~

equipment basis ------------------Less accumulated deprec1abon ~ (attach schedule) - -- ________ -- _______

15 Other assets (descnbe ~ ____________________ )

16 Total assets (to be completed by all filers - see the instructions Also, see page 1, item I) . 95,264,998. 75,591,886. 75,591,886

17 Accounts payable and accrued expenses 3,200. 5,627.

18 Grants payable 85,000,000. 75,000,000.

Ill 19 Deferred revenue GI .. ~ 20 Loans from officers, directors, trustees, and other disqualified persons

:g 21 Mortgages and other notes payable (attach schedule) • ::::i 22 Other hab1ht1es (descnbe ~ ___________________ )

23 Total liabilities (add Imes 17 through 22) • .. 85,003,200. 75,005,627.

Foundations that follow SFAS 117, check here ~~ and complete lines 24 through 26 and lines 30 and 31.

Ill 10,261,798. 586,259. t 24 Unrestricted • . . c 25 Temporarily restncted ca . . . . .... . . iii co 26 Permanently restncted • .. . .. "C Foundations that do not follow SFAS 117, c ~o ::,

check here and complete lines 27 through 31. LL.

0 27 Capital stock, trust principal, or current funds .

!! 28 Paid-in or capital surplus, or land, bldg , and equipment fund GI .. l: 29 Retained earnings, accumulated income, endowment, or other funds .

~ 30 Total net assets or fund balances (see page 17 of the GI 10,261,798. 586,259. z instructions) • . . . . . . ...

31 Total liab1hbes and net assets/fund balances (see page 1 7

of the instructions) •• . . . . . . . . 95,264,998. 75,591,886.

•• ,u1111111m Analysis of Chanaes in Net Assets or Fund Balances 1 Total net assets or fund balances at begrnnrng of year - Part II, column (a), lrne 30 (must agree with

end-of-year figure reported on pnor year's return) • 1 10,261,798

2 Enter amount from Part I, lrne 27a 2 -2,675,539 . . .. 3 Other rncreases not rncluded rn lrne 2 (itemize) ~ 3 -------------------------------------4 Add Imes 1, 2, and 3 ..... . . 4 7,586,259 . . . .. . . . ... 5 Decreases not included rn lrne 2 (itemize)~ ATTACHMENT 6 5 7,000,000

6 Total net assets or fund balances at end of vear Clrne 4 mrnus lrne 51 - Part II column Cb). lrne 30 • 6 586, 259

Form 990-PF (2010)

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Form 990-PF (2010) 48-0926946 Page 3 1:1:Pililf- Capital Gains and Losses for Tax on Investment Income

(a) List and describe the kmd(s) of property sold (e g , real estate, (DJ How (c) Date ld) Date sold acquired acquired P-Purchase mo., day, yr) 2-story brick warehouse; or common stock, 200 shs. MLC Co.) D-Donation (mo , day, yr )

1a

b .

c d

e

(e) Gross sales pnce (f) Deprec1at1on allowed (g) Cost or other basis (h) Gain or (loss) (or allowable) plus expense of sale (e) plus (f) minus (g)

a

b

c d

e Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (I) Gains (Col (h) gain minus

(ii FM V as of 12/31/69 (j) AdJusted basis (kl Excess of col (1) col (k}, but not less than -0-) or as of 12/31/69 over col (J), 1f any Losses (from col (h))

a

b c d

e

2 Capital gain net income or (net capital loss) { If gain, also enter m Part I, hne 7 } If (loss), enter -0- m Part I, hne 7 2

3 Net short-term capital gain or (loss) as defined m sections 1222(5) and (6) If gain, also enter m Part I, hne 8, column (c) (see pages 13 and 17 of the instructions) } If (loss), enter -0- 1n Part I, hne 8 ........................•....•. .. 3

1:1:r.i••- Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income (For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)

If section 4940(d)(2) applies, leave this part blank.

Was the foundation liable for the section 4942 tax on the distributable amount of any year 1n the base penod? If "Yes," the foundation does not qualify under section 4940(e) Do not complete this part.

Oves[K)No

1 Enter the appropriate amount m each column for each year; see page 18 of the instructions before making any entries.

2 3

4

5

6

7

8

(a) (b) (c) (d) Base penod years D1stnbut1on ratio

Calendar year (or tax year beginning ,n) Adjusted qualifying d1stnbubons Net value of nonchantable-use assets (col (b) dMded by col (c))

2009 11,973. 1,087,431. 0.011010

2008 18,657,783. 1,531,990. 12.178789

2007 10,106. 3,737,419. 0.002704

2006 4,350,615. 982,416. 4.428485

2005 11, 518. 218,181. 0.052791

Total of line 1, column (d) 2 16.673779 ..................................... Average distribution ratio for the 5-year base period - d1v1de the total on line 2 by 5, or by the

number of years the foundation has been m existence 1f less than 5 years 3 3.334756 ..........

Enter the net value of noncharitable-use assets for 2010 from Part X, hne 5 4 9,541,525. ..........

Multiply line 4 by line 3 5 31,818,658. ................... . . . . . . . . . . . . . . . . . . .

Enter 1 % of net investment income (1 % of Part I, hne 27b). 6 0. ...................

Add Imes 5 and 6 7 31,818,658. . . . . . . . . . . . . . . . . . ........................

Enter qualifying d1stribut1ons from Part XII, hne 4. 8 12,671,967. ........................ If line 8 is equal to or greater than hne 7, check the box in Part VI, hne 1b, and complete that part using a 1% tax rate. See the Part VI instructions on page 1 8

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• Form 990-PF(2010) 48-0926946 Page 4

Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948 - see page 18 of the Instructions)

Date of ruling or deterrmnabon letter ____________ (attach copy of ruling letter If neceasary • see Instructions)

b Dome'St1c foundations that meet the section 4940(e) requirements in Part V, check 1 0 ·

1 a Exempt operabng foundabons descnbed in secbon 4940(d)(2), check here Ill>- LJ and enter "NIA" on line 1 ••• }

here Ill>-0 and enter 1 % of Part I, hne 27b • • • • • • • • . • • • • • • • • • • • • • • • • • • • •

2

3

4

5

6

c All other domestic foundations enter 2% of line 27b Exempt foreign organizations enter 4% of

Part I, line 12, col (b)

Tax under section 511 (domestic section 494 7(a)(1) trusts and taxable foundations only Others enter -0-)

Add Imes 1 and 2

Subtitle A (income) tax (domestic section 494 7(a)(1) trusts and taxable foundations only Others enter -0-)

Tax based on investment income. Subtract line 4 from hne 3 If zero or less, enter -O­

Cred1ts/Payments

a 2010 es II mated tax payments and 2009 overpayment credited to 2010.

b Exempt foreign organizations-tax withheld at source • • . . • • .

c Tax paid with application for extension of lime to file (Form 8868).

d Backup withholding erroneously withheld • • • • • • • . . • . •

6a

6b

6c

6d

7 Total credits and payments. Add Imes 6a through 6d • • • • • • • . . ..•••••••••••

8 Enter any penalty for underpayment of estimated tax Check here O if Form 2220 1s attached

9 Tax due. If the total of Imes 5 and 8 is more than hne 7, enter amount owed ••••••

2

3

4

5

33. 0. 0.

7

8

.... 9

0. 0. 0.

33.

1 o Overpaymenl If line 7 1s more than the total of lines 5 and 8, enter the amount overpaid 111>-_1_0 __________ 3_3_. 11 Enter the amount of hne 10 to be Credited to 2011 estimated tax Ill>- "33: Refunded 111>-11

•~ ...... u"•• Statements Regarding Activities

1 a During the tax year, did the foundation attempt to influence any national, state, or local leg1slat1on or did 1t Yes No x part1c1pate or intervene in any political campaign? . • • . • . • • • • • • • • • • . • • • • • • • • • • • • • • • ta • • • • • • l--'-"--+----1--

b Did 1t spend more than $100 during the year (either directly or 1nd1rectly) for political purposes (see page 19

of the instructions for definition)? • • • • • • • • • • • • • • • • . • • • • • • . • . ..••...•.•.••• If the answer is "Yes· to fa or 1b, attach a detailed descnpt1on of the act1v1t1es and copies of any matenals

published or d1stnbuted by the foundation m connection with the activities

. . . . . . 1---'-t=b-+-----1-x-

x c Did the foundation file Form 1120-POL for this year? . . • • • • . • . . •••••••••••

d Enter the amount (1f any) of tax on political expenditures (section 4955) imposed dunng the year

tc • • • • • • • • • • • • • • . l--'...;:;_+----1--

(1) On the foundabon Ill>-$ (2) On foundation managers Ill>-$ __________ _

e Enter the reimbursement (1f any) paid by the foundation during the year for political expenditure tax imposed

on foundation managers. Ill>-$ ___________ _

2 Has the foundation engaged in any act1v1t1es that have not preVJously been reported to the IRS? •••••••••••

If "Yes,• attach a detailed descnpt1on of the act1v1t1es

3 Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles of

mcorporat1on, or bylaws, or other s1m1lar instruments? If "Yes,• attach a conformed copy of the changes ••••••••

4a Did the foundation have unrelated business gross income of $1,000 or more dunng the year?

b If "Yes," has 1t filed a tax return on Form 990-T for this year? •••••••••••••••

5 Was there a hqu1dat1on, termination, d1ssolut1on, or substantial contraction dunng the year? •

ff "Yes,• attach the statement requ,red by General Instruction T

6 Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either·

• By language in the governing instrument, or

• By state leg1slat1on that effectively amends the governing instrument so that no mandatory d1rect1ons that

conflict with the state law remain in the governing instrument? . • . • • • • • • • • • • • • • • . • • • . . • • • • • • •

7 Did the foundation have at least $5,000 in assets at any time dunng the year? ff "Yes,• complete Part II, col (c), and Part XV

Ba Enter the states to which the foundation reports or with which 1t is registered (see page 19 of the

2 x

3 x

4a x

4b

5 x

6 x 7 x

instructions) Ill>-KS' _____________________________ ------------------------_----------b If the answer 1s "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney General

(or designate) of each state as required by General Instruction G? If "No,• attach explanation •••••••••••••••••• i---B~b---t_x_-+---

9 Is the foundation claiming status as a private operating foundation within the meaning of section 4942{])(3) or

4942{])(5) for calendar year 2010 or the taxable year beginning in 2010 (see instructions for Part XIV on page

27)? If "Yes,• complete Part XIV • • • • • • • . • . • • . • . • . • . • • . • • . • . . . • • • • • • • • • • • • • • • • . i--=9--+---+-X-

10 Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule //sting the,r

names and addresses • • • • . . • • • . • • . • . . • . • . . . . . . . • . . . . . . . . • • • • • • . . • . . . . . • • .

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10 x Form 990-PF (2010)

11

12

At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the

meaning of section 512(b)(13)? If "Yes," attach schedule (see page 20 of the instructions) ••.•

Did tne foundation acquire a direct or indirect interest in any apphcable insurance contract before

11 x

x August 17, 2008?. • • • . • • • • • • • • • • • • . • • • . • • • • • • • • • • • . • • • • • • • • • • • • • • • J--'-1=2-+--+--

13 'Did the foundation comply with the public inspection requirements for its annual returns and exemption apphcatJon? • 13 X Website address ~ ____ NONE ___________________________________________________________________ _

14 The books are in care of ~-1::!~~'!:.1::!~~-~~~~ ----------------------- Telephone no. ~ _____ ~~~-=-~~~-=-~~~§ _____ _ 15

Located at ~5'111_ E._ 37TH ST._ N. WICHITA, KS---------------------- ZIP+ 4 ~ 67220-3203 ____

8 Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF 1n lieu of Form 1041 - Check here • • • • • • • • • • • • • • • • • • ~

and enter the amount of tax-exempt interest received or accrued dunng the year • . • . • • • • • • • • • • • • • • ~ 1~1_5_~1----~--

16 At any time during calendar year 2010, did the foundation have an interest in or a signature or other authority

over a bank, secuntJes, or other financial account in a foreign country? • • • • •

See page 20 of the instructions for exceptions and filing requirements for Form TD F 90-22 1 If "Yes," enter

the name of the foreian countrv ~

1:.1rn&•J1!!1:• Statements RegardinQ Activities for Which Form 4720 Mav Be Required

File Form 4720 if any item is checked in the "Yes" column, unless an exception applies. 1 a During the year did the foundation (either directly or indirectly)

DYes ~No

2

(1) Engage in the sale or exchange, or leasing of property with a d1squahfied person? •..

(2) Borrow money from, lend money to, or otherwise extend credit to (or accept 1t from) a

disqualified person? • • • • . . . • • • • • • • • • . . • • • • • • • • • . . • •

(3) Furnish goods, services, or fac1ht1es to (or accept them from) a d1squahfied person? ••

(4) Pay compensation to, or pay or reimburse the expenses of, a d1squahfied person? ••.

(5) Transfer any income or assets to a d1squahfied person (or make any of either available for

the benefit or use of a d1squahfied person)?. • • • • • • ••.••••••••.••••

~

Yes

Yes

Yes

0Yes

~

No

No

No

~No

(6) Agree to pay money or property to a government official? (Exception. Check "No" 1f the

foundation agreed to make a grant to or to employ the official for a period after

termination of government service, 1f terminating within 90 days ) • • • • • . • . • • . . • • . • D Yes ~ No

b If any answer 1s "Yes· to 1a(1)-(6), did any of the acts fail to quahfy under the exceptions described in Regulations

section 53 4941 (d)-3 or in a current notice regarding disaster assistance (see page 22 of th.e .in.stru. c_t,o. n.s)? .• •. -~ • o· · · · · Organizations relying on a current notice regarding disaster assistance check here • • . •

c Did the foundation engage in a prior year in any of the acts described in 1 a, other than excepted acts, that

were not corrected before the first day of the tax year beginning in 201 O? • . . • . • • • • . •

Taxes on failure to distribute income (section 4942) (does not apply for years the

operating foundation defined in section 4942(])(3) or 4942(])(5))

foundation was a private

a At the end of tax year 2010, did the foundation have any undistributed income (lines 6d and

6e, Part XIII) for tax year(s) beginning before 2010?. • • • • • • • • • • • • • • • • • . • .•• 0Yes ~No If "Yes," hst the years ~ __________ , _________ , ________ , _______ _

b Are there any years hsted in 2a for which the foundation 1s not applying the prov1s1ons of section 4942(a)(2)

(relating to incorrect valuation of assets) to the year's undistributed income? (If applying section 4942(a)(2) to

all years hsted, answer "No" and attach statement -see page 22 of the instructions ) •••...•••••

c If the prov1s1ons of section 4942(a)(2) are being apphed to any of the years hsted in 2a, hst the years here

~ ---------- ·--------- ·-------- ·--------3a Did the foundation hold more than a 2% direct or indirect interest in any business enterpnse

at any time during the year? • • • • . • . . • • • • • • . • • • • • • • • • • . • • • • • • • • • • D Yes ~ No

b If "Yes," did 1t have excess business holdings in 2010 as a result of (1) any purchase by the foundation or

disqualified persons after May 26, 1969, (2) the lapse of the 5-year period (or longer period approved by the

Comm1ss1oner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3) the lapse of

the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine if the

16

1b

1c

2b

Yes No x

Yes No

x

x

foundation had excess business holdings in 2010.) . . . . . . . • . • . . . . . . . . . . . . . . . . . . . . . . . . . . . l---'3-"b'-1---1---

4a Did the foundation invest during the year any amount in a manner that would 1eopard12e its chantable purposes? •••••.• b Did the foundation make any investment in a prior year (but after December 31, 1969) that could Jeopardize its

charitable ouroose that had not been removed from 1eooardv before the first dav of the tax vear bea1nnina in 2010? .

JSA

OE1450 1 000 14352G K932 11/14/2011 3:21:24 PM V 10-8.2 85652

4a x

4b x Form 990-PF (2010)

Form 990-PF (2010) 48-0926946 Page 6

l::.F.To!a.'jll!I:• Statements Regarding Activities for Which Form 4720 May Be Required (continued)

Sa During the year drd the foundation pay or incur any amount to (1) Carry on propaganda, or otherwise attempt to influence leg1slat1on (section 4945(e))?

(2) Influence the outcome of any specific pubhc electron (see section 4955), or to carry on,

directly or indirectly, any voter registration dnve? • • • _ _ • • • • • • • • • • • • • • _ _ • • •

·(3) Provide a grant to an ind1v1dual for travel, study, or other s1m1lar purposes? ••••••• _ ••••

(4) Provide a grant to an organrzatron other than a charitable, etc, organrzatron described in

section 509(a)(1 ), (2), or (3), or section 4940(d)(2)? (see page 22 of the instructions) •• _

0Yes

0Yes

0Yes

0Yes

[BNo

(BNo

~No

(5) Provide for any purpose other than rehgrous, chantable, sc1ent1fic, hterary, or educational

purposes, or for the prevention of cruelty to children or animals?. • • • • • • • • • • • • • • • • D Yes [B No

b If any answer rs "Yes" to 5a(1 )-(5), drd any of the transactions fall to qualify under the exceptions described in

Regulations section 53 4945 or in a current notice regarding disaster assistance (see page 22 of the instructions)? ••••••• 1-5-'--b"--+---+--­

Organrzations relying on a current notice regarding disaster assistance check here • • • • • • • • • • • • • • • ~ D c If the answer rs "Yes" to question 5a(4), does the foundation claim exemption from the tax

because rt maintained expenditure respons1b1hty for the grant? • • • • • • • • • • • • • •

If "Yes,• attach the statement requ,red by Regulations section 53 4945-5(d)

0Yes 0No

6a Drd the foundation, during the year, receive any funds, directly or indirectly, lo pay premiums on a personal benefit contract?. _ •• _ ••• _ • • • ___ • . • • • • • • • • • • • • • •••• _ D Yes [B No

6b x b Drd the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? • . •••

If "Yes· to 6b, file Form 8870 . . . . . . . t---+---+----

7 a At any time during the tax year, was the foundation a party to a proh1b1ted tax shelter transaction? • • D Yes [BNo

b If "Yes," drd the foundation receive any proceeds or have any net income attnbutable to the transaction? •••••••••• _ 7b ·~····~11• Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees, and Contractors

1 List all officers, directors, trustees, foundation managers and their compensation (see page 22 of the instructions)-(b) Title, and average (cl Compensation (d) Contnbutions to (e) Expense account,

(a) Name and address hours per week (If not pai,d, enter employee benefit plans other allowances devoted to nos11ton .0-1 and deferred comnensatJon

ATTACHMENT 7 -0- -0- -0-

2 Compensation of five highest-paid employees (other than those included on line 1 - see page 23 of the instructions). If none, enter "NONE."

(a) Name and address of each employee paid more than $50,000

NONE

Total number of other employees paid over $50,000 __

JSA OE 1460 1 000

(b) Title, and average hours per week

devoted to pos1t1on

14352G K932 11/14/2011 3:21:24 PM V 10-8.2

(c) Compensallon

85652

(d) Contributions to employee benefit

plans and deferred comoensat1on

(e) Expense account, other allowances

___ .~I NONE

Form 990-PF (2010)

Form 990-PF (2010) 48-0 92694 6 Page 7 1@IW1i Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,

and Contractors (continued)

3 Five highest-paid independent contractors for professional services (see page 23 of the instructions). If none, enter "NONE." (a) Name and address of each person paid more than $50,000 (b) Type of service

NONE

Total number of others rece1v1ng over $50,000 for professional serv1ces ......••.............. ~

•ifli@-j Summary of Direct Charitable Activities

List the foundation's four largest direct charitable achv1bes dunng the tax year Include relevant stat1st1cal mformahon such as the number of organizations and other benefic1anes served, conferences convened, research papers produced, etc

N/A

2

3

4

·~··-··..,,=• Summarv of Pro~ram-Related Investments (see page 24 of the instructions) Describe the two largest program-related investments made by the foundation dunng the tax year on Imes 1 and 2

NONE

2

All other program-related investments See page 24 of the instructions

3 NONE

Total. Add Imes 1 throuQh 3 • . • . . . • . . • . . . . . . . . • . . • • . . . . . . • . . . . . . . . . . . . . . . . ~

JSA

OE 1465 1 000

14352G K932 11/14/2011 3:21:24 PM V 10-8.2 85652

(c) Compensabon

NONE

Expenses

Amount

NONE

Form 990-PF (2010)

Form 990-PF (2010) 48-092 694 6

14ffifj Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see page 24 of the instructions.)

1 Fair market value of assets not used (or held for use) directly in carrying out charitable, etc., purposes·

a Averc1ge monthly fair market value of secunbes. 1a ............ b Average of monthly cash balances ........ 1b ............ c Fair market value of all other assets (see page 25 of the instructions) . 1c

d Total (add Imes 1 a, b, and c) ....................... 1d

e Reduction claimed for blockage or other factors reported on Imes 1a and

1 c (attach detailed explanation) . . . . . . . . . . . . . . . . . . . . . I 1 e I 2 Acquisition indebtedness applicable to line 1 assets 2 . . . . . . . . . . .................. 3 Subtract line 2 from line 1 d 3 . . . . . . . . . . . . . . . . . . . . . . . .................. 4 Cash deemed held for charitable activities. Enter 1 1 /2 % of line 3 (for greater amount, see page 25 of

the instructions) 4 .............................................. 5 Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, hne 4 5

6 Minimum investment return. Enter 5% of hne 5 ............................ 6

•:.,:,n···· Distributable Amount (see page 25 of the instructions) (Section 4942(])(3) and (J)(5) pnvate operating foundations and certain foreign organizations check here ~ and do not complete this part.)

1 Minimum investment return from Part X, line 6 ............ . 2a Tax on investment income for 2010 from Part VI, line 5 . . . . . . ,__2_a __________ o---<.

b Income tax for 2010 (This does not include the tax from Part VI.). . . ~2_b~------------i c Add Imes 2a and 2b

3 Distributable amount before adJustments. Subtract line 2c from hne 1

4 Recoveries of amounts treated as qualifying d1stnbutions ........................ . 5 Add lines 3 and 4

j:fflji!Jjl Qualifying Distributions (see page 25 of the instructions)

1 Amounts paid (including adm1nistrat1ve expenses) to accomplish chantable, etc., purposes: a Expenses, contributions, gifts, etc - total from Part I, column (d), line 26 ........... ...... b Program-related investments - total from Part IX-8 . . . . . . . . . . . . . . . . . . . . . . . ......

2 Amounts paid to acquire assets used (or held for use) directly m carrying out charitable, etc.,

purposes ............................... . . . . . . . . . . . . . . . . . . . . 3 Amounts set aside for specific charitable projects that satisfy the·

a Su1tab11ity test (prior IRS approval required) .......................... b Cash d1stribut1on test (attach the required schedule) .....................

4 Qualifying distributions. Add Imes 1 a through 3b Enter here and on Part V, hne 8, and Part XIII, hne 4

5 Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment income. Enter 1% of Part I, line 27b (see page 26 of the instructions) .

6 Adjusted qualifying distributions. Subtract line 5 from line 4 .......................

1

2c 3 4 5

6

7

1a 1b

2

3a 3b 4

5

6

Page 8

9,686,827. 0.

9,686,827.

0. 9,686,827.

145,302. 9,541,525.

477,076.

477,076.

0. 477,076.

477,076.

477,076.

12, 671, 967. 0.

0.

0. 0.

12,671,967.

N/A 12,671,967.

Note: The amount on line 6 will be used m Part V, column (b), m subsequent years when calculating whether the foundation qualifies for the section 4940(e) reduction of tax m those years.

Form 990-PF (2010)

JSA

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..

Form 990-PF (2010) 48-0926946 Page 9 ·~~oi .. '1111• Undistributed Income (see page 26 of the instructions)

(a) (b) (c) (d)

1 Distributable amount for 2010 from Part XI, Corpus Years pnor to 2009 2009 2010

hne 7 ..................... 477,076_

2 Und1stnbuted income, 1f any, as of the end of 2010

a Enter amount for 2009 only .......... b Total for pnor years 2 0 ~. 2 0 ~. 2 0 ~

3 Excess d1stribut1ons carryover, 1f any, to 201 O

a From 2005

b From 2006 4,123,446.

c From 2007

d From 2008 18,582,189.

e From 2009

f Total of Imes 3a through e 22,705,635. ........... 4 Qualifying d1stnbut1ons for 201 O from Part XII.

lme 4 .... $ 12,671,967 .

a Applied to 2009, but not more than line 2a .••

b Applied to und1stnbuted income of prior years (Election required - see page 26 of the instructions) ......

c Treated as d1stnbut1ons out of corpus (Election required - see page 26 of the instructions) .•

d Applied to 2010 d1stnbutable amount 477,076. ..... e Remaining amount d1stnbuted out of corpus 12,194,891. ..

5 Excess d1stnbut1ons carryover applied to 2010 . (If an amount appears m column (d), the same amount must be shown m column (a) )

6 Enter the net total of each column as indicated below:

a Corpus Add lines 3f, 4c, and 4e Subtract line 5 34,900,526.

b Pnor years' und1stnbuted income Subtract line 4b from line 2b . . . . . . . . . .....

c Enter the amount of pnor years' undistributed income for which a notice of def1c1ency has been issued. or on which the section 4942(a) tax has been previously assessed • • • • • • . • • • • •

d Subtract line 6c from lme 6b Taxable amount - see page 27 of the 1nstruct1ons ....

e Undistributed income for 2009 Subtract line 4a from line 2a. Taxable amount - see page 27 of the instructions .............

f Und1stnbuted income for 2010 Subtract Imes 4d and 5 from line 1 This amount must be d1stnbuted m 2011 0. ...............

7 Amounts treated as d1stnbut1ons out of corpus to satisfy requirements imposed by sec lion 170(b)(1)(F) or 4942(g)(3) (see page 27 of the instructions) • . . . . . . • • •••••••••

8 Excess d1stnbut1ons carryover from 2005 not applied on line 5 or line 7 (see page 27 of the instructions) • . • • • • • • • ••••• . . . .

9 Excess distributions carryover to 2011.

Subtract Imes 7 and 8 from line 6a 34,900,526. ....... 10 Analysis of line 9

a Excess from 2006 4,123,446.

b Excess from 2007

c Excess from 2008 18,582,189.

d Excess from 2009 e Excess from 2010 12, 194, 891.

Form 990-PF (2010)

JSA

OE 1480 1 000

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• Form 990-PF (2010) 48-0926946 Page 10

E l::.mi•.~m• Private Operating Foundations see page 27 of the instructions and Part VII-A, question 9) NOT APPLICABL

1a If the foundation has received a ruling or determination letter that 11 1s a private operating I foundation, and the ruling is effective for 2010, enter the date of the ruling • • • • • • • • • • • • • ~

b Check box to indicate whether the foundation 1s a private operating foundation descnbed 1n section I I 4942(])(3) or I I 4942u)cs)

2a Enter the lesser of the ad-Tax year Prior 3 years

(e) Total Justed net income from Part (a) 2010 (b) 2009 (c) 2008 (d) 2007

I or the minimum investment return from Part X for each year listed ..

b 85% of line 2a ..... c Qualifying d,stnbutlons from Part

XII, line 4 for each year listed

d Amounts included in line 2c not used directly for actr,e conduct of exempt activities • • • • •

e Qualifying d1stnbullons made directly for actr,e conduct of exempt activllJes Sublracl line 2d from 1,ne 2c ......

3 Complete 3a, b, or c for lhe alternallVe test relied upon

a "Assets• alternallVe test - enter

(1) Value of all assets ... (2) Value of assets qualifying

under section 49420)(3)(8)(1). • • • •

b "Endowmenr alternallVe Jest-

enter 2/3 of minimum invest-

ment return shown m Part X,

line 6 for each year listed .. c ·supporr alternallVe test - enter

( 1) Total support olher than gross investment income (interest dMdends rents payments on secunttes loans (secllon 512(a)(5)), orroyalbes). • • • • •

(2) Support from general public and 5 or more exempt orgamzatJons as provided in secllon 4942 0)(3)(B)(ui) • • • • • •

(3) Largest amount of sup-port from an exempt organtzaUOn .....

(4) Gross investment income •

•!so111•: .. ,. Supple'!'entary Information (Complete this pa~ only _if the foundation had $5,000 or more in assets at any time during the year - see page 28 of the instructions.)

1 Information Regarding Foundation Managers: a List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation

before the close of any tax year {but only if they have contributed more than $5,000). {See section 507{d){2).)

DAVID H. KOCH

b List any managers of the foundation who own 10% or more of the stock of a corporation {or an equally large portion of the ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.

N/A 2 Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:

Check here~ [TI 1f the foundation only makes contributions to preselected charitable organizations and does not accept unsolicited requests for funds. If the foundation makes gifts, grants, etc. {see page 28 of the instructions) to ind1v1duals or organizations under other cond1t1ons, complete items 2a, b, c, and d.

a The name, address, and telephone number of the person to whom applications should be addressed: N/A

b The form in which applications should be submitted and information and materials they should include:

N/A

c Any submission deadlines.

N/A

d Any restrictions or hm1tabons on awards, such as by geographical areas, charitable fields, kinds of inst1tut1ons, or other factors·

JSA OE1490 1 000

N/A

14352G K932 11/14/2011 3:21:24 PM V 10-8.2 Form 990-PF (2010)

85652

Form990-PF(2010) 48-0926946 1:,ft#Q!J Supplementary Information (continued)

Page 11

3 Grants and Contributions Paid During the Year or Approved for Future Payment Rec1p1ent If rec1p,ent IS an 1ndMdual, Foundation Purpose of want or show any relabonsh1p to status of Amount

Name and address (home or business) any foundabon manager rec1p1ent contnbu ion

or substantial contnbutor

a Paid during the year

ATTACHMENT 8

Total ~ 3a 12,650,000. b Approved for future payment

Total ~ 3b NONE Form 990-PF (2010)

JSA OE1491 1 000

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Form 990-PF (2010)

1::r.P-:&fJJlt'•W Analysis of Income-Producing Activities Enter gross amounts unless otherwise 1nd1cated Unrelated business income

(a)

1 Program seMce revenue Busu,ess code

a

b

c

d

e

f

g Fees and contracts from government agencies

2 Membership dues and assessments ..... 3 Interest on saVJngs and temporary cash investments

4 D1v1dends and interest from secunt1es . . .. 5 Net rental income or (loss) from real estate

a Debt-financed property . • • • ..••

b Not debt-financed property • • . . • •

6 Net rental income or (loss) from personal property

7 Other investment income ......... 8 Gain or (loss) from sales of assets other than inventory

9 Net income or (loss) from special events .. 10 Gross profit or (loss) from sales of inventory.

11 Other revenue: a b

c

d

e

12 Subtotal Add columns (b), (d), and (e) .•••

13 Total. Add hne 12, columns (b), (d), and (e). • • • ••••••••• (See worksheet in hne 13 instructions on page 29 to venfy calculations )

(b) Amount

48-0926946

Excluded b, section 512 513 or 514

(c) (d) ExclUSIOO code Amount

14 1, 113-

1,113.

13

·~·:,,.41 =• Relationship of Activities to the Accomplishment of Exempt Purposes

Page 12

(e) Related or exempt funcllon income ~ee page 28 of

e mstruclJons )

1,113.

Line No. Explain below how each activity for which income 1s reported in column (e) of Part XVI-A contributed importantly to the

... accomplishment of the foundation's exempt purposes (other than by providing funds for such purposes) (See page 29 of the instructions.)

NOT APPLICABLE

'

Form 990-PF (2010) JSA OE 1492 1 000

14352G K932 11/14/2011 3:21:24 PM V 10-8.2 85652

• Form990-PF(2010) 48-0926946 Page 13

hiffli!\M• Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations

Did the organization directly or indirectly engage in any of the following with any other organization described

1n section 501(c) of the Code (other than section 501(c)(3) orgamzallons) or in section 527, relating to political

organizations?

a 'rransfers from the reporting foundation to a nonchantable exempt organization of.

(1) Cash

(2) Other assets

b Other transactions

(1) Sales of assets to a noncharitable exempt organization

(2) Purchases of assets from a nonchantable exempt organization

(3) Rental of fac11illes, equipment, or other assets

(4) Reimbursement arrangements •

(5) Loans or loan guarantees

(6) Performance of services or membership or fundra1smg sohc1tat1ons

c Sharing of fac11it1es, equipment, mailing lists, other assets, or paid employees

Yes No

1al1l x 1a(2l x

1 b(1 l x 1bl2l x 1b(3l x 1bl4l x 1b(51 x 1b(6) x

1c x d If the answer to any of the above 1s "Yes," complete the following schedule Column (b) should always

value of the goods, other assets, or services given by the reporting foundation If the foundation received

show the fair market

less than fair market

value in anv transaction or shanna arranaement show in column !dl the value of the aoods other assets or services received (a) Line no (b) Amount involved (c) Name of nonchantable exempt organization (d) Description of transfers, transac~ons, and shanng arrangements

N/A N/A

-

2a Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations

described in section 501 (c) of the Code (other than section 501 (c)(3)) or in section 527?. • • • • • . . . . . . . . . . . . . D Yes [Jg No

b If "Yes • comolete the followina schedule (a) Name of organization (b) Type of organization (c) Description of relat1onsh1p

Under penal~es of periury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and

Sign behef, 1t 1s true, correct, and complete Declaration of preparer (other than taxpayer or fiduciary) 1s based on all information of which preparer has any knowledge

Here ~~~ I 1/-J'i_-ll ~ Tc.e '1.fJ,l.C. er' ~ Signature of officer or trustee Date Title

PrinVType preparer's name ~Preparer's signature Date PTIN

Paid Check01f P00051392 lf/11frh1( f ~t( f e,J.4-~ ~f I f, __ {d~1 d!1 .1,1, ,j,

I tf /1 self-employed Preparer

Firm's name ~ BKD, LLP Finn's EIN ~ 44-0160260 Use Only

JSA

OE1493 1 000

Firm's address ~ 15 51 N WATERFRONT

WICHITA, KS

PKWY, STE

14352G K932 11/14/2011 3:21:24 PM V 10-8.2

300

67206-6601 Phone no 316-265-2811

Form 990-PF (2010)

85652

Fonn 8868 (Rev 1-2011)

• If you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part II and check this box Note. Only complete Part II 1f you have already been granted an automatic 3-month extension on a previously filed Form 8868 • If you are filino for an Automatic 3-Month Extension complete only Part I I on oaoe 1) l::F.Ti•i• Additional (Not Automatic) 3-Month Extension of Time. Only file the original (no copies needed). Type or Name of exempt organization I Employer identification number

print DAVID H. KOCH CHARITABLE FOUNDATION· 48-0926946 Fiie by the extended due date for fihng your return See instructions

Number, street, and room or suite no If a P 0. box, see 1nstruct1ons

4111 E. 37TH ST. N. City, town or post office, state, and ZIP code. For a foreign address, see instructions

WICHITA, KS 67220-3203

Enter the Return code for the return that this application is for (file a separate application for each return) ............ [QlD

Application Return Application Return Is For Code Is For Code

Form 990 01 Form 990-BL 02 Form 1041-A 08 Form 990-EZ 03 Form 4720 09 Form 990-PF 04 Form 5227 10 Form 990-T (sec 401 (a) or 408(a) trust) 05 Form 6069 11 Form 990-T (trust other than above) 06 Form 8870 12 STOPI Do not complete Part II if you were not already granted an automatic 3-month extension on a previously filed Form 8868.

• The books are in the care of ..,_ HEATHER LOVE -------------------------------Te I e phone No ..,_ 316 828-8286 FAX No ..,_ ------------- .............. o • If the organization does not have an office or place of business in the United States, check this box

• If this 1s for a Group Return, enter the organization's four d1g1t Group Exemption Number (GEN) for the whole group, check this box ..•.•• ..,_ D . If 1t 1s for part of the group, check this box list with the names and EINs of all members the extension 1s for

If this IS

..,_ D and attach a

4 I request an add1t1onal 3-month extension of time until -----------=1=1~/=1-'----5 ,20.11.._ 5 For calendar year 2010 , or other tax year beginning 6 If the tax year entered in line 5 1s for less than 12 months, check reason

D Change in accounting period 7 State 1n detail why you need the extension

, 20 , and endin,...;!.9...,......,. _______ , 20 D Initial return LJ Final return

ADDITIONAL TIME IS REQUIRED TO ACCUMULATE THE INFORMATION NECESSARY TO FILE A COMPLETE AND ACCURATE RETURN.

Sa If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any 0.

:

nonrefundable credits See instructions $ :+'-------

b If this application 1s for Form 990-PF, 990-T, 4720, or 6069, enter any refundable credits and estimated tax payments made Include any prior year overpayment allowed as a credit and any . amount paid previously with Form 8868 Sb $ 0.

c Balance Due. Subtract line 8b from line 8a Include your payment with this form, if required, by using EFTPS (Electronic Federal Tax Payment System) See instructions Sc $ 0.

Signature and Verification Under penal!Jes of pef]ury, I declare that I have examined this fonn, rncludrng accompanying schedules and statements, and to the best of my knowledge and behef, rt rs true, correct, and complete, and that I am authonzed to prepare this fonn

Signature ....

JSA

OF80553000

14352G K932 8/9/2011

Trtte ....

10:25:10 AM V 10-7.2

Date ....

Fonn 8868 (Rev 1-2011)

85652

DAVID H. KOCH CHARITABLE FOUNDATION

FORM 990PF, PART I - DIVIDENDS AND INTEREST FROM SECURITIES

DESCRIPTION

GOLDMAN SACHS DEUTSCHE BANK

TOTAL

14352G K932 11/14/2011 3:21:24 PM V 10-8.2

REVENUE AND

EXPENSES PER BOOKS

85652

20. 1,093.

1L113.

48-0926946

ATTACHMENT 1 .

NET INVESTMENT

INCOME

20. 1,093.

1L113.

ATTACHMENT 1

DAVID H. KOCH CHARITABLE FOUNDATION

FORM 990PF, PART I - ACCOUNTING FEES

DESCRIPTION

ACCOUNTING

TOTALS

REVENUE AND

EXPENSES PER BOOKS

21,711.

21L711.

14352G K932 11/14/2011 3:21:24 PM V 10-8.2

NET INVESTMENT

INCOME

85652

0.

48-0926946

ATTACHMENT 2

ADJUSTED NET

INCOME

0.

CHARITABLE PURPOSES

19,800.

19L800.

ATTACHMENT 2

DAVID H. KOCH CHARITABLE FOUNDATION

FORM 990PF, PART I - OTHER PROFESSIONAL FEES

DESCRIPTION

GRANT ADMINISTRATION FEES FILING FEES INVESTMENT ADMINISTRATION FEES

TOTALS

REVENUE AND

EXPENSES PER BOOKS

1,084. 89.

2,258.

3L431.

14352G K932 11/14/2011 3:21:24 PM V 10-8.2

NET INVESTMENT

INCOME

2,258.

2L258.

85652

48-0926946

ATTACHMENT 3 .

CHARITABLE PURPOSES

1,045. 89.

1L134.

ATTACHMENT 3

Ii,

DAVID H. KOCH CHARITABLE FOUNDATION

FORM 990PF, PART I - OTHER EXPENSES

DESCRIPTION INSURANCE BANK FEES SUPPLIES

TOTALS

REVENUE AND

EXPENSES PER BOOKS

913. 120. 477.

1L510.

14352G K932 11/14/2011 3:21:24 PM V 10-8.2 85652

48-0926946

ATTACHMENT 4

CHARITABLE PURPOSES

913. 120.

1L033.

ATTACHMENT 4

"

DAVID H. KOCH CHARITABLE FOUNDATION

FORM 990PF, PART II - PREPAID EXPENSES AND DEFERRED CHARGES

DESCRIPTION

PREPAID EXPENSES

TOTALS

14352G K932 11/14/2011 3:21:24 PM V 10-8.2 85652

ENDING BOOK VALUE

ATTACHMENT 5

33.

33.

ENDING FMV

48-0926946 "

33.

33.

ATTACHMENT 5

·- ... ~AVID H. KOCH CHARITABLE FOUNDATION 48-0926946

ATTACHMENT 6

FORM 990PF, PART III - OTHER DECREASES IN NET WORTH OR FUND BALANCES

DESCRIPTION

CHANGE IN DONOR INTENT - RECLASS FROM CONTRIBUTIONS TO PLEDGE RECEIVABLE

TOTAL

14352G K932 11/14/2011 3:21:24 PM V 10-8.2

AMOUNT

7,000,000.

7,000,000.

ATTACHMENT 6 85652

DAVID H. KOCH CHARITABLE FOUNDATION

FORM 990PF, PART VIII - LIST OF OFFICERS, DIRECTORS, AND TRUSTEES

NAME AND ADDRESS

DAVID H KOCH 667 MADISON AVE NEW YORK, NY 10021

RUTHE WILLIAMS PO BOX 2256 WICHITA, KS 67201

VONDA HOLLIMAN PO BOX 2256 WICHITA, KS 67201

TITLE AND AVERAGE HOURS PER WEEK DEVOTED TO POSITION

PRESIDENT/DIRECTOR 1. 00

SECRETARY 1. 00

TREASURER 1. 00

GRAND TOTALS

14352G K932 11/14/2011 3:21:24 PM V 10-8.2 85652

48-0926946 I.

ATTACHMENT 7

ATTACHMENT 7

DAVID H, KOCH CHARITABLE FOUNDATION

FORM 990Pf. PART XV - GRANTS AND CONTRrn1!DONS~el,ID QW>.ING THE~ YEAR

RECIPIENT NAME AND ADDRESS

BALLET THEATRE FOUNDATION, INC

890 BROADWAY

NEW YORK, NY 10003

EDUCATIONAL BROADCASTING CORP

450 W. 33RD STREET

NEW YORK, NY 10001

NATIONAL CHAMBER FOUNDATION

1615 H STREET NW

WASHINGTON, DC 20062-2000

CITY CENTER OF MUSIC & DRAMA, INC.

70 LINCOLN CENTER PLAZA

NEW YORK, NY 10023

14352G K932 11/14/2011 3:21:24 PM

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR

AND

FOUNDATION STATUS OF RECIPIENT

N/A

PUBLIC

N/A

PUBLIC

N/A

PUBLIC

N/A

PUBLIC

V 10-8.2 85652

48-0926946

ATTACHMENT 8

PURPOSE OF GRANT OR CONTRIBUTION

NUTCRACKER PERFORMANCE

WNET-CHANNEL 13

CAMPAIGN FOR FREE ENTERPRISE

RENOVATION OF NEW YORK STATE THEATER BUILDING

(2010 PAYMENT OF 2008 ACCRUED GRANT)

TOTAL CONTRIBUTIONS PAID

ATTACHMENT 8

... ,, ~

(

AMOUNT

2,500,000.

50,000

100,000.

10,000,000.

12.650,000