04///rLo.gL / o,1L 0

Form 990-PF Return of Private Foundationor Section 4947(ax1) Nonexempt Charitable Trust

Treated as a Private Foundationp•paitn•nt of the Treasury Note: The organuatlon may be able to use a copy of this return to satisfy stateInt.m.r aw.nw s•nnn reporting requirements.

0MB No. 1545-00552

2003For calendar year 2004 or tax yew baglnninq . 2003. and ending0 Check all that apply: IXI Initial return Final return Amended return Address chanoe Name chance

use the A Ebp•ysrld o. smnb•r

IRSIahL CHRISTEN ELIZABETH CLEMENT 20 - 0122620' FOUNDATION , INC. B Telephone number (sae instructions)

Jtpe, 11100 MEAD RD. #300 225 -298-3532BATON ROUGE , LA 70816 C If exemption application is pending, check here 0. X

D 1 Foreign organizations , check here . ........ ►H Check type of organization Section 501 (c)(3 exempt private foundation 2Foreign organizations meeting the 85% test, check

Section 4947 a 1 nonexempt charitable trust Other taxable private foundationq

here and attach computation .... .. ... 10air market va ue a asse at en o year(from Part 11 column c line 16)

Accounting method : M Cash Accrual qEIfndr

> foundationda^status was terminated110.o (bXIXA) check here, ,

Other (spec ify)q, ....

$ (Part ! column d must be on cash baseF If the foundation is in a 60-month termination

under section 507 b 1 B check heres :€s Analysis of Revenue and

808 a Inamountsttotal o

ofEX (Th

Expn

(a) Revenue and (b) Net investment (c) Adjusted net (d) Disbursementsexpenses per books income Income for charitable

ns b, ta not s -colum and d ayc,a

ur osessarily equal the amounts in column a)

p p(cash basis only)is

see instructions

1 contri butions, 9ft. Cmts, etc, received (.ttecfl) 205,-000. ''JE S{,f ^,i E<i,'•••r<` i'•^.Oi\i+"J •,'i,n, ,..i,$,,,; xr^i^aY ,'h „cii.. y,£ x`i,^vk + +,.+ ,J, nf„ ,# p.n •.i { Sfvi E , i'#;''S}.., i', r^,.Y,

CkW q If the found I! adr•q toatt SthB

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17 i€ L f5'#t '£ff 3 #iff ^#£f •>f,^#`li`, 2*i2} a#i#f^€f •`oi£;${tt <'€if>4t iv .<'+"'

2 Distributions from split - interest trusts .. , ... M11 y;S Interest on savings and temporary

" > °cash Investments.... .. .......... n ; > >,y`•4 Dividends and interest from securities .... ;zz^.'};>i> >•; ` f# sr,`5a Gross rents ................ ...... ,

rbout rental (^^^Income or (toss)

£Y" z, ;cJ$vw Y :rJi7f9'E'Sti`,J;}.1%

aL„r:,,s3> S ::nkx._=Jr)£Y%`+fS .c, . ky Yt'$.W <%,L v}v,

. > x $,,.x <) , . <,,n. r)+L4'----- .SQ-> <.'';3f`

a tr#°", rF#$^Ty, S^•Y2•,£ J ,y t +$.t .$`

6aNot gainl(bss)from sale of assets not on un. 10 =<nR 9` )£f" tYC>4rfYSFCt C S#N%WSSY} itYi`{p rLin4 Y'# nz{EfirtfpS#CAP•<' i£ J2

r

R b Grose sales r si for a ll•ss•la on hne 6a

oYalrr ,• Y,z i;i#r;3%#ntaf3E^$,^cf:$,E,3, iii##3 's"si¢,'J' :too ,,,, o o-

J. $

%;£';EOtr,^>"o}bi

V 7 Capital gain net mcon» (from Part IV , fine 2) ..

E 8 Net short -term capital gain. .. .... su^£ £:x# °."f °,•sfsr: J fzy11' # £ # $,:s$f .;.?N 9 Income modifications . #itLx:;4;x#>: #'£#:;#,'3<# ,•r>$.s:€:fi^^L:

g 104 Gross sales less }af€, ;t f tsj:£^ :J fast'`z.+,E +s•;4fj.^. tt<>J#s f;t, '`^`##<:<;:>£t£t£,'£t"` s.;J

s £ ^:f;t;., :;£> ;'

< i f<z ;` i'^i j ,, :, r,•

" '}returns and ,,M1;, fiy,,,^„ftx,f<,,,>a° ^%^Y `:i' # i ^ i #f

n, ,fn .jic:£#. i'£,, ,. r,n„£#;:'^fr #^,:i# : %

i, , ^yr ,•E•^ ati

"'J:"` '''x ' f ^^t

,J E,i,fi:.. : ;::off ii" cr,f '%'%^^^;'f ^• ` '

allawanEr ....,•E . , .< ,£:oYo# : .rn£'•,t,t•.,w„nt

r,.E .£.,,:i^i ,:>'.t,t}ts 's<• .+rtsi

f# r '><}'Jisf $J•>^fz,>f#$;' :,

: rc : [.4 ,t•iii•r roCi CY OJ J•,,,,£,,

b Less : Cost ofd ld

Rb •,i,{ ,`„^ ,^a$; •'t t %'"r.>i>£:.^^,k t.:£ Y,:,Zol+, tssLr.i,4 „ t,x t}S,U>r ,.;Ji .

#n,S; . ,,. ; GS r,;^£;t ;#• , :, ,.£,.f ,.y`s J•..s .,'g,, J ,,. S.L,.,J.. , , £3 iL

r'

',<4e£„`^L,'v„£ i ^^•kr #,. Yor#„)#,.o, ,, i;n„•i J ,,^,,,,,s•

. , r + +,'i SiSwtnv ,} 5" JA' ' #+"JL ;, a. p.:`"• ^,k,L ., ,

'gco s so „f >i, n,R„i,+"n,+..r 9s .s0 >s^,

J, <., r•:,,+, >J >>#:?# i,if •v;i i;<f•f#f'!JS>•,#>L^€; S' y£S£ £, /f J, ,. ^,;.

^#<1 •

c Gross profit/(loss ) (aft sch) ........ .... f;:; xi°",.>; %;>' ; ^,`••` ,',,`' : "r :..i

11 Other income (attach schedule ) `,$>

ii°i; fE #<# s12 Total . Add lines 1 through 11 205 000. -77 ;t'13 Compensation of officers . drachms, rruslea, etc14 Other employee salaries and wages .........

D15 Pension plans, employee benefits... .

m 16a Legal fees (attach schedule) . .. .........M b Accounting fees (attach sch) ............ .

r C Other prof fees (attach sch) ...............y 17 Interest ............. . ... . ..A 18 Taxes (attach schedule)................T 19 Depreciation (attach schedule) and depletion .

o v 28 Occupancy .... .. ..... .. .....21 Travel, conferences , and meetings

A eN

22 Printing and publications...

e23 Other expenses (attach schedule)

N See Statement 1 50. 50.E 24 Total operating and ad W.s sxpsnses. Add lines 13 through 23. . 50. 50.

25 Contributions ifts rant Part XVid 61 725 :#s ; # ;i#,'°<k `J'•r}'>:' 4 #, g , g s pa . . . , , £,i , s ,:<,< t 61,725,26 Total expanses and disbursements.

Add lines 24 and 25 ................ 61 4 775. 0. 0. 61,775.Subtract line 26 from line 12: `#£#e$+f£f.,,.,,f:, , , rrLff

,• „n

n fn£ , ,h, ^ . , y^ ^: ^%+, ,,52<' i ^0i d'

:. ^, n, .,J,n• ,,^ti.`$^aExcess of revenue am expanses;

ti•^r ', i,s yi':2fi3;: it: s # #

'

t s i. >

£x•,e %o r;,r i,frr•:3:$fif£# ::^# $'^ ' ^

r.i#t.£,iii^#.''•<% :£"£anddlsburuments........ ...... 143 , 225 .

, t ,::';# >+v,.

, „ s:ts£t cf^^£sts#s#,'i"A `. ,"

£^: ,;^i:£i ; :,,.'i,;; ;,:f„ :<';L•btMttrwsOMalbcaaMof n•p.tfw,enter 4 •y.. rfrx f#>•,o'#G.c:,u#%'>^'r

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$5;^,, ,yp^:.,.,', r xt ' `

C A4valled ad Ifacod. O f negative enter .0.) ;;rte,. %,,, n.>> r.C+J^$,s,'t E3 • rrr>, ,p

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,. i", # fs Q >22 Jx SV__ L,£`£, ____}

BAA For Paperwork Reduction Act Nodes, ses the Insbuctlons. TEEA05U oar1 an>3 Form 990-PF (2003)

Fnrrn Oe.PF t7nnai CHRISTEN ELIZAAP.TH CT.FMrMT qn-ni ip9rgirl D- -3

Atfid)ad schaduks and amounts in ew desenphonf' l':< B etsl Sh

Beginnin g of year End of yearumn, t co or andafyear amounts only.a eance

(a) Book Value (b) Book Value (c) Fair Market Value

1 Cash - non-interest-bearing ............................... 143 , 225.2 Savings and temporary cash investments ....................

3 Accounts receivable.. 's^2^ SS ,^nc)AYbi.J#.w. Y%#^:'•.

Less: allowance for doubtful accounts-•- ••' ----

4 Pledges receivable ....... .... itti wX,3 ,v.v, .

X}ySr8ql°s>); rsa£v E ; t;}

t'i Pi 5 SkOrt+^<,tJtw%JS )i,it^

"ta"liib' 3i{ E3E)3E,£/£r ta' ,t i <

:^`'^t^# # .^s is +`•a:2:i.+.3txxa x, i3• {Z'•)....

---------, ,, , ,{ i

'Ta Lr r YJ`f r+ )f#4} 33 a3A<a,w•Sv,.v.r%4,.LS LS,r,F+,..v ^ w ,„•}4,.v v ,6 wn<gt'r..Yi X<tE E,

Less: allowance for doubtful accounts

------5 Grants receivable ................... ---

6 Receivables due from officers , directors, trustees , and otherdisqualified persons ( attach schedule ) (see instructions ) ....... .........

7 Other notes and loans receivable (attach sch).y .3+•aa.tt•^.t .t.. ( .,,.y 2 ,r,.

E k'Fa„ : E: 4 ( `, ,

s.,,a. «t va<<E{^)°' s' >+x#°:^. ,t E r3,: t t

) ^<:;'.}sY$wn> a e.s° ;>::'1.3'$ifrA"'Z.. r.s )s>,^ox»>{v„A ..-.......

Less: allowance for doubtful accounts '__ _ _ _ _ _ _

s 8 Inventories for sale or use ........ . .. . ............

tt 9 Prepaid expenses and deferred charges.....................

s 100 Investments - U.S. and state governmentobligations (attach schedule) ..............................

b Investments - corporate stock (attach schedule ) ......................

c Investments - corporate bonds (attach schedule ) ........ .. .........

11 Investments - land 1 buildings i and^• ^)la YY •'^ ,g•a++ >.t

£ € y :..' =$.{ E^w..t•$<rs,x+ a <,.E> ar>.. >.:>'fE <i Ex>°' <•E t t tJ<i,^E, i)K < ^EY^o <stY

^f fl:d,#f:E^ S{Z t`K:3 {s333Y+,^1 :;y ^,rr #i E>cFt.^3l% vatequipment basis €k^#>{wg a, . u,{, ^ s € s^

rtEI s -0'F1r E ; aifi ^

+^ . +<>; #<' t>r +.^ '^ ^' % i j..........• ---------- >.,+a..a.c Y,sia is {t {a k „o{s. { t^: c F,2{crl £: 4c3r 3r£# ; + t", 6ri •, .iai r %:£5.

Less: accumulated depreciation(attach schedule).......... w

12 Investments - mortgage loans ........................... .

13 Investments - other (attach schedule) . ... . .. ..........

14 Land, buildings, and equipment: basis ----------•ay^tvywi t[Sr{a{ t -0R },

'E t ).f,4 EM+E Ew+EI,tI;,s;%.E•$£<t•Y+.^E:,t:t<, s<:>)•+ >$+ 2a\)^$ S3Y ri+i `f'^t,,. c. w. :'Yp•(^i''sisl•ir{ast>,^-?aa#{aw^ al,^

•vqY,, ., 4,i^Ev3"v'l+v{ i {

) $n+)^^.a:..;a:.v:.:.^^IS,^^,;';^w3•;#Less: accumulated depreciation(attach schedule) ............. .. .....

--------'IS Other assets (describe la-_ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ )16 Total assab (to be completed by all filers -

see instructions. Also , see page 1 , item I ...... 0. 143 225. 0.L 17 Accounts payable and accrued expenses ................... v<:ir# •>t < F^g^'+,}, .;

a 18 Grants payable ...................... .. .. ..........

b 19 Deferred revenue ........................................ ..........µ)' ^{ E ^; '^ {20 Loans from officers, directors, trustees, & other disqualified persons .......t °

21 Mortgages and other notes parable (attach schedule)....................t

22 Other liabtlEties (describe .

J

. #':

23 Total lIabllitIes add lines 17 throw•

0 . +^O thatfolbrrSFA5117 chaclrhaea }{

S

..;+^ier{%-0at^ry• a SY•naYa,y S

. .....i S.t Si 'tf3S%0 E•oomplab lines 24 thraigFr 26 and lines 30 and 31 .

y^y ^)y>. Y ^.i O<$^Jf i,O^a) , { • a,D., s ; v, ^ .+ ^

N F 24 Unr t t d 143 225rices e .......... .. ............................. , . s s•It n

u 25 Temporarily restricted ................. .. ....... .......€;^fr; s<{; w.€' :>

fd 26 Permanently restrIcted .

s B Organizations that do not follow SFAS 117, check ham.d 27 th h 31l te lia en roug .comp e nes

t a 27 Capital stock, trust principal, or current funds . ............9 n 28 Paid-in or capital surplus , or land, building, and equipment fund.

c 29 Retained earnings, accumulated income, endowment or other funds ....... , a` tr s 30 Total not asisats or fund balances (see instructions) .. 0. 1 143 225 . 11"1-11 11`s`'

31 Total liablirdes and notasssmNund balances ;#;; #f£;v: > #<:(see instructions 0. 1 143 225

Iatil", Analysis of Changes in Net Assets or Fund Balances

1 Total net assets or fund balances at beginning of year - Part II, column (a), line 30 (must agree withend-of-year figure reported on prior year's return) ............... .

2 Enter amount from Part I, line 27a .. .. .. . . .. .. ......... .. .................... 2 143 , 225.9 Other increases not included in line 2 ( itemize) . . . _____________________ 3

4 Add lines 1, 2 , and 3 ..... ................ ... . .. . .. . . . .. ..... .. ...... .. ........ 4 143 225.8 Decreases not included in line 2 ( itemize) .. .. . - - - - - - --- --- - - - - - - - - - --- _ 5

-

_ _ _

6 Total net assets or fund balances at end of year ine 4 minus line - Part 11 , column line 30...... .... 6 143 , 225.BAA MEMO& oa1`1 sa3 Form 990-PF (2003)

Forrn 990-PF 200CHRISTEN ELIZABETH CLEMENT 20-0122620 Page 3Capital Gains and Losses for Tax on nvesbnent Income

(a) List and describe the kind(s) of property sold (e . g., real estate,2-story brick warehouse ; or common stock, 200 shares MLC Company)

Haw .cwmedP - PurchaseD - Don.bon

(c) late acwired(month, day, year)

Dat• sold(month, d.y, year)

is N/Ab

cd•

(9) Gross sales price (f) Depreciation allowed(or allowable)

(g) Cost or other basisplus expense of sale

(h) Gain or (loss)(e) plus (f) minus (g)

b

cd

•

Com plete only for assets showi gain in column (h) and owned by the foundation on 12/31169 (1) Gans (Column (h)(I) Fair Market Value

as of 12/311690 Adjusted basisas of 12/31/69

(IQ Excess of column ()over column 0), if any

gain minus column (k), but not lessthan -0-) or buss (from column (h))

ab

e

d

•

2 Capital gain net income or (net capital loss). If gain, also enter in Part I, line 7It (loss), enter -0- in Part I, line 7 2

3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):

If gain , also enter In Part I, line 8, column (c) (see instructions). If (loss), enter -D-in Part ! line 8 ........... . .. ........... .... . . . ........ ..... . .. 3

Doff M.N Qualiflcation 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.) N/A

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

Was the organization liable for the section 4942 tax on the distributable amount of any year in the base penod? .. ........ []Yes F]No

If 'Yes ,' the organization does not qualify under section 4940 (e). Do not complete this part.

1 Enter the appropriate amount in each column for each year; see instructions before making any entries.

Base period yearsCalendar year (or tax year

beginning in)

Adjusted qualifying distributions Net value ofnoncharitable-use assets

Distribution ratio(column (b) divided by column (c))

2002

2001

2000

1999

1998

2 Total of line 1, column (d).. . ................... ... ......... .. ... ........ ... . ....... 2

3 Average distribution ratio for the 5-year base period - divide the total on line 2 by 5, or by thenumber of years the foundation has been In existence if less than 5 years .. .. .......... ......... 8

4 Enter the net value of nonchantable-use assets for 2003 from Part X, line 5 .. .. .. ..... .. ..... 4

5 Multiply line 4 by line 3 ..................... .................... ........ .... ..... ........ 4

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

7 Add lines 5 and 6............ . ........... .......... .. . . . .. ... . .... .. ...... 7

8 Enter qualifying distributions from Part XII, line 4 ....... .................. ..... .. .. . .. ... 8

If line 8 is equal to or greater than line 7, check the box in Part VI, line lb, and complete that part using a 1 % tax rate. See thePart VI instructions.

BAA Form 990-PF (2003)

1EEA03031 08113107

'orrn 990-PF 3 CHRISTEN ELIZABETH CLEMENT 20-0122620 Page 4a n-Ma Ex se Tax Based on Investment Income maction a or4948 - see Instructlons

1 a Exempt operating foundations described in section 4940(dx2), check here ...... ► and enter N/A' on line 1. ^" <^^; - -; «r,•' ' _

Date of ruling letter: _ _ _ _ _ _ _ .(attach copy of rullnq Iattar If necessary - aaa Insbvctions)b Domestic organizations that meet the section 4940(e) requirements in Part V, 1 0.check here. ► 0 and enter I% of Part I, line 27b ................... ................... .... . #' •` i z `> ;° k,: "`• s `k';

c All other domestic organizations enter 2%of line 27b. Exempt foreign organizations enter 4% of Part[, line 12, column(b) .....2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0- ) .... 2 0.8 Add lines 1 and 2 .. ... .... . . .. ... ........................ ..... ........................ . 3 0.4 Subtitle A (income) tax (domestic section 4947(a)(1) busts and taxable foundations only. Others enter -0-).... 4 0.5 Tax based on Investment Income. Subtract line 4 from line 3. If zero or less, enter .0...... ..... ... .... 5 0.6 Credits/Payments: ^:€ a; '^«> :' '< ::3:' {

` 1k` "a: #f'Rfzcx;a 2003 estimated tax pmts and 2002 overpayment credited to 2003 . .......................... 6a`"}" ,)S

b Exempt foreign organizations - tax withheld at source .. . ................... 6b• t?(;>

c Tax paid with application for extension of time to file (Form 8868)............ • . 6c : €sdBackup withholding erroneously withheld....................... ............ 6d

7 Total credits and payments. Add lines 6a through 6d.. • .......... ....... .. .. .................. 7 0.8 Enter any penalty for underpayment of estimated tax. Check here [] if Form 2220 is attached ............ 89 Tax due If the total of lines 5 and 8 is more than line 7, enter arrow t owed .................. .. .. ................. ► 9

10 0wrpayaroet. ff line 7 is more than the total of lines 5 and 8, enter the araomd overpaId .............. ........... ...... ► 1011 Enter the amount on line 10 to be: Cradbd to 2001 setloatad fu....... ► Refunded ..... ► 11

1 a During the tax year, did the organization attempt to Influence any national state or local legislation or did it &' Yes No, ,participate or Intervene in any political campaign?......................... ...... . . .... ........ . . . . . . . 1 a X

b Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see instructions for definition)? .... ........... . . 1 b X

If the answer is 'Yes ' to Is or 1bi, attach a detailed description of the activities and copies of any materials published ;;;<; r•••• <<;:or distributed by the organization in connection with the activities . ;;;;?` ;•; } } r;••` <,

c Did the organization file Form 1120-POL for this year?............................................. ..... . ....... 1e Xd Enter the amount (if any) of tax on political expenditures (section 4955) Imposed during the year : ;:;::

(1) On the organization .... ► $ 0. (2) On organization managers . ► $ 0.• Enter the reimbursement ( if any) paid by the organization during the year for political expenditure tax Imposed on s; g ;>#^ Yorganization managers ..... 10, $ 0. : ' ;-A ^s, sj^

2 Has the organization engaged in any activities that have not previously been reported to the IRS? ....... . ............. 2 XIf 'Yes,' attach a detailed description of the activities . };4

-4

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

$, ,

of incorporation , or bylaws , or other similar Instruments ? If Yes,' attach a conformed copy of the changes .... . ... S X4a Did the organization have unrelated business gross income of $1,000 or more during the year? ... . 4a Xb It 'Yes ,' has it filed a tax return on Form 990-T for this year? ..................... . .... ................ . .. .. 4b N A

5 Was there a liquidation , termination, dissolution , or substantial contraction during the year? ... ... • ...... ................... . .. .... 5 XIf 'Yes,' attach the statement required by General Instruction T. >^ ^, ;,>; •`• :.f=

6 Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either : )<s>;s $'>r s4 ' 's• By language in the governing instrument or =

•. ;:x^ • i<:`-`:.

v'^^^y , . 4Y ,ii

• By state legislation that effectively amends the governing instrument so that no mandatory directions that conflictwith the state law remain in the governing instrument? ... . . .. .. .... ..... .. . . ............. ... 6 X

7 Did the organization have at least $5,000 in assets at any time during the year? If Yes,' camplele Part fl, column (C). and Part XV ...... ............ 7 X8a Enter the states to which the foundation reports or with which it is registered (see instructions).. ► :;> v___

Louisiana _______________ _____ __________------------ :y :ry

---b If the answer is'Yes ' to line 7, has the organization furnished a copy of Form 990-PF to the Attorney Genera l

'(or designate) of each state as required by General Instruction G? If Nq attach arplenatron ... .. . . . .. ............... ........... . 8b X

9 Is the organ ization claiming status as a private operating foundation within the meaning of section 4942(!x3) or 4942(/x5) for calendar year 2003 orthe taxable year beginning in 2003 (see instructions for Part XIV)? If 'Yes,' complete PartXIV ........ 9 X

10 Did any persons become substantial contributors during the tax year?.... .......... .. 10 XIf Yes,' attach a schedule listing their names and addresses.

11 Did the organization comply with the public Inspection requirements for its annual returns and exemption application? ... 11jWebsite address .................. ......... ► N/A____________________________

12 The books are in care of ► _MICHAEL _PITT_SLocated at 1,

_ _________ ____ Telephone no. ► 225298 _350811100 MEAD RD STE 300 BATOI-T ROIIGE1 -LA ZIP +4 ► 70816-- ---- --- -- --- --- - -----13 Section 4947(a)(1) nonexempt chantable trusts filing Form 990 -PF in lieu of Form 1041 - Check here .................... N/A .. ►

and enter the amount of tax - exempt interest received or accrued during the year . . 13 1 N/ABAA Form 990-PF (2003)

TEEAW04L o8R5103

20 5

File Form 472D If any Item Is chocked In tlt.'Yos' column, unless an oonptlon applies. :`i< Yes No

1 a During the year did the organization (either directly or Indirectly):

Cl) Engage In the sale or exchange, or leasing of property with a disqualified person?.............. Yes No #?;f Ix` : 2

' ` "(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from) a <r>>

a?s?° ` ":#.

disqualified person? .... ....... .. .. ........................ ..... .. .. ........ ...... Yes X No c> }f<<;;

(3) Furnish goods , services , or facilities to (or accept them from) a disqualified person? .... ....... Yes X No

(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person! ......... .. Yes X No -''

(5) Transfer any income or assets to a disqualified person (or make any of either availablefor the benefit or use of a disqualified person)? ................ . .... ElYos :lh;, ,

(6) Agree to pay money or property to a government official? (Exception . Check 'No' If theorganization agreed to make a grant to or to employ the official for a period after terminationof government service if terminating within 90 days ) [JYes No, . . ................ ......................

b If any answer is 'Yes ' to la(1)-(6), did any of the acts fail to q ualify under the exceptions described in :<s:^:Regulations section 53 .4941(d)• 3 or In a current notice regarding disaster assistance (see Instructions)? ......... ... . . 1 b N A

Organizations relying on a current notice regarding disaster assistance check here ................... ... . W %s;•.

;F;='s::S •,

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

, Y„2

:•sCy.nk

that were not corrected before the first day of the tax year beginning in 2003? .................................. ... . 1 c X

2 Taxes on failure to distribute income (section 4942) (does not apply for years the organization was arivate o eratin foundation defined in section 4942 ) 3 4942 M?

•°^ •` ••`r` .(^,)p gp (J ( ) or Q)

a At the end of tax year 2003 , did the organization have any undistributed income (lines 6dand 6e Part XIII ) for tax year(s) beginning before 2003? []Yes No

^^ £:S...

''". .

%, ............. . . .. .. . .........

If 'Yes ,' list the years 01 20 20 20 19

.

^

_- OK ^Yr< }s r

b Are there any years listed in 2a for which the organization is not applying the provisions of section 4942(a)(2)(relating to incorrect valuation of assets) to the year ' s undistributed income? (If applying section 4942(a)(2) to :z:. .,, » •`:all years listed , answer ' No' and attach statement - see instructions .) ............................ . .. . ....... 2b N A

c If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here .

► 20_ 20 20 19Sc Did the organization hold more than a 2% direct or Indirect interest in any business

enterprise at any time during the year? .. .. ....................................... .. . ..... [J Yes a No

b If 'Yes, ' did it have excess business holdings in 2003 as a result of (1) any purchase by the organizationor disqualified persons after May 26, 1969,(^ the lapse of the 5-year period (or longer period approved

;3•`•• "> :°::s"

b the Commissioner under section 4943 c)(ny ( {_ h) to di spose of holden s acquired by g ft or be est; or(8) the la se of the 10 15- or 20 ear firs ase ho l din ri U h 4720d? S d l C F t a` `

., ^,,;"• - >-

;s,>a >p , , y p g pe o ( se c e u e , orm , o

determine if the organization had excess business holdings in 2003.) . ..... .. ...................... ....... .. . . Sb,N

• •A

4a Did the organization Invest during the year any amount in a manner that would jeopardize itscharitable purposes?........... ....... ...... ... ..... . .......... .. .. ....... . . ..... 4o X

b Did the organization make any investment in a prior year (but after December 31, 1969) that couldj eopardize its charitable purpose that had not been removed from jeopardy before the first day of

` 4X

the tax year beginning in 2003? ................ . . ................................. .. . .............. b

5a During the year did the organization pay or Incur any amount to : ; y21 <ir;t

(1) Carry on propaganda , or otherwise attempt to influence legislation (section 4945(e))?............ Yes 21 No < s4s 4`€ %s f

(2) Influence the outcome of any specific public election (see section 4955); or to carry •<<•s; ;<r;•° =-^=;:on, directly or indirectly, any voter registration drive? ........ .. .. ............. e Yes X No

(3) Provide a grant to an individual for travel, study, or other similar purposes?.... ..... .. Yes X No

(4) Provide a grant to an organization other than a charitable , etc, organization describedin section 509(a)(1), (2), or (3), or section 4940 (d)(2)? .... . . .. . ........... ........ [J Yes No

-;V;

(5) Provide for any purpose other than religious , charitable , scientific, literary , oreducational purposes , or for the prevention of cruelty to children or animals?......... . . ... El Yes XM No

' ''

^-b If any answer is Yes to 50(1)•(5), did any of the transactions fail to qualify under the exceptions °= r>: ^#; ;'•described in Re lations section 53.4945 or in a current notice regarding disaster assistance

'

E'-

(see instructions) ..... .... ..... ........... .. . ... . ....... 5b N AOrganizations relying on a current notice regarding disaster assistance check here . '°,2`

'

c If the answer is 'Yes' to question 5a(4), does the organization claim exemption from thetax because it maintained expenditure responsibility for the rant? N/A []Yes No

4N!!r

; {

, •^

r• "g .. .. ...... . 4 2;rEiy

ryIf 'Yes, ' attach the statement required by Regulations section 534945-5(d). 59SYip

^••

f£ i^•i, it$

.' E

{̂ Fl}•,6a Did the organization , during the year , receive any funds , directly or indirectly, to pay premiums

on a personal benefit contract ? . ... .......

Yes RENOs•x^^ 2

;̀3+'?

% ••b Did the organization , during the year , pay premiums , directly or indirectly , on a personal benefit contract?. .. .. 6b X

Ifyou answered 'Yes' to 6b, also file Form 8870. x "`" -'`

BM l o3os> oansro3 Form 990-PF (2003)

Form 990.PF CHRISTEN ELIZABETH CLEMENT 20-0122620 Page 6-P IV,a" Informati on About cers, Directors , Trustees , Foundation Managers, Highly Paid Employees,

and Contractors

1 List all officers. directors, truistass . foundation manag.rs and flair carnpsnsation (sae instructions):

(a) Name and address

(b) Title and averagehours per week

devoted to position

(c) Compensationof not paid, enter -0-)

(d) Contributions toemployee benefitplans and deferredcompensation

(e) Expense account,other allowances

-----------------------See Statement 2 0. 0. 0.

------------------------

------------------------

2 Comoansatton of five hisest.pald emplotnas (other than those Included on line 1- sea Instructions). If none, enter 74ONE.'

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

(b) Title and averagehours per week

devoted to position

(c) Compensation (d) Contributions toemployee benefitplans and deferred

compensation

(a) Expense account,other allowances

None------------------------

------------------------

------------------------

------------------------

-------------------------

Total number of other employees paid over $50000.

3 Fhn hltdsest-pald Indeaandsnt contractors for professional servloss - (see Instructlons). If none, enter 'ONE.'

(a) Name and address of each person paid more than $50 ,000 Type of service (c) Compensation

None-------------------------------------

-------------------------------------

-------------------------------------

-------------------------------------

Total number of others recelvin over $50,000 for professional services..

KW= A Summary of Direct Charitable Activities

List the foundation's four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of I Expensesorganizations and other beneficiaries served, conferences convened, research papers produced, etc.

2------------------------------------------------------

------------------------------------------------------

S------------------------------------------------------

4

------------------------------------------------------

BAA TEFAM06L oansma

Form 990.PF (2003) CHRISTEN ELIZABETH CLEMENT 20-0122620 Page 7

F 'r ; Summary of Program-Related Inveatintents (see instructions)

Describe the two largest program -related investments made by the foundation during the tax year on lines 1 and 2. Amount

1 NLA--------------------------------------------------------------------------------------------------------

2------------------------------------------------------------------------------------------------------------

All other program-related investments. See instructions.

3------------------------------------------------------------------------------------------------------------

Total. Add lines 1 throu gh 3 ........... .. .... .. .. . .. .......... ..... .. .. .. ..... . ... . .. ....... 0.1 0.

^Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)

1 Fair market value of assets not used (or held for use) directly in carrying out chartable, etc, purposes:a Average monthly fair market value of securities . ................. .. ...... .... . ... ......... 12

bAverage of monthly cash balances . .. .. .......... .. ...... . .... .... .. .... ...... 1 b 24 , 000.c Fair market value of all other assets (see instructions) . .. ..... ................. .... . . .. .. 1 c

dTotal (add lines la , b and c) ....... . . ... ........................ . .. . ............... .... 1d 24 , 000.• Reduction claimed for blockage or other factors reported on lines 1a and 1c

(attach detailed explanation) . .. ...................................... 1s 0.

2 Acquisition indebtedness applicable to line 1 assets .................... ........ ... . ............... 2 0.3 Subtract line 2 from line I d 24 , 000.4 Cash deemed held for charitable activities. Enter 1-1/2% of line 3 (for greater amount, see instructions). . . 4 360.5 Not value of noncharitableouse assets. Subtract line 4 from line 3. Enter here and on Part V, line 4.. .. ... 5 23 , 640.6 Minimum inv sbnent nrium. Enter 5% of line 5 6 1 182.......... ..... .. .. . . ........ .......

Disthibutabie Amount (see instructions) (Section 49420)(3) and 0)(5) private operating foundations and certain

foreign organizations check here nand do not complete this Dart.!1 Minimum investment return from Part X, line 6 ........ . . . .. .. . ................. .. ........ 1 1 , 182.2a Tax on investment income for 2003 from Part VI, line 5 .. ......... . .. ..... 2a

b Income tax for 2003. (This does not include the tax from Part VI.) ..... ....... 2b

c Add lines 2a and 2b .. .............. .. ........................................... ................ 2c3 Distributable amount before adjustments. Subtract line 2c from line I ...................... .... .. . .. 3 1 , 182.4a Recoveries of amounts treated as qualifying distributions ..................... 4ab Income distributions from section 4947(a)(2) trusts........ ... 4bc Add lines 4a and 4h ................... ..... .. ........... .. . 4c

5 Add lines 3 and 4c ...... ..................... .. . . ............ ..... ............ 5 1 , 182.6 Deduction from distributable amount (see Instructions) ............. ...... ........................ .... 67 Dlsbl butabla amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ............. 7 1.182.

rFWM Qualifying Distributions (see instructions)

1 Amounts paid (including administrative expenses) to accomplish charitable, etc, purposes:a Expenses, contributions, gifts, etc - total from Part I, column (d), line 26 . . .. . .. .. ................. 1a 61 , 775.b Program-related investments - Total from Part IX•B ............................ .. . . .. . ........ 1 b

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

3 Amounts set aside for specific charitable projects that satisfy the:a Suitability test (prior IRS approval required) ... .. .. .................................................. 3ab Cash distribution test (attach the required schedule) . ...................... . ........... .. .. . .. . 3b

4 QuaUfyfng dMrfbutlons . Add lines la through 3b. Enter here and on Part V, line 8, and Part XI II, line 4.., 4 61 , 775.

5 Organizations that qualify under section 4840(e) for the reduced rate of tax on net investment income.Enter 1% of Part I, line 27b (see instructions) ...................................... . ..... . . .... S

6 Adjusted qualifying dlstrfbutlons. Subtract line 5 from line 4 ............. .. .... .. . .... ........... 6 61 775 .

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

BAA Form 990.PF (2003)

TEEA0307L pan sr02

Form 990-PF (2003) CHRISTEN ELIZABETH CLEMENT 20-0122620 Page 8

QI Undlsblbuted Income (see instructions)

Corpus Years prior to 2002 2062

1 Distributable amount for 2003 from Part XI , 3F5F# '^Eor#3e:

line 7 .............. .................... ryvn ,}:i3'<#co#5#c"53"t#'%iE

2 Undistributed income, if any, as of the end of 2002 r #f$3Yffi?fi#'•>r €> < EhiMl Y£.; }'So}tl orryM1 Fla

a Enter amount for 2002 only .................y

(< € r;<=<t<€Fo>^);zja>

b Total for prior years : 20_,20 , 19_{}r3Y 4i {J2r F`Y '2'^y i. ) , ♦,:<>}a*k+<'zl^>a ,x€vssn3^ r

3 Excess distr i butions carryover if any, t02003 : s%''%x: E+^^^xt r^;ca#ShfEIUS % Aa.2],2a i

1}A, f

a From 1998 ......t r r r ,

bf ::;.E iE ,if•##a ax ^•}x^;i„Y<Yt,;r3E, E;s^f^cQ ^},a€a,u3o rz ..4..a.f

J` ;bFrom 1999 ..........

f'h̀ 'k

a F Via;' £fi: z#a ;#zsc From 2000 ...........

d From 2001 .........

r4, n n n+ ,3xsY,Y is o (•st^•,y,ai3+ } Ya<3ii^£'ry r^3

°'v '^ S^ '^2,,,J,x

srs^JO# s-s From 2002 ........... ; ; i^€{€t3x's?;:}.;:a

I Total of lines 3a through is . . .. ...... . .... 0 .

4 Qualifying distributions for 2003 from Part n 1: I f C+,t

XII, line 4 : 11, $ 61,775 . Ft^;€^.<;:f`f^# r^^^{ fJ } >E

a Applied to 2002 , but not more than line 2a ...•

,4 7< ;r:}t :3s

bApplied to undistributed Income of prior years0.iXry[

^h^h13T^}x<i(Election requ ired - see instructions) ....... z:t:I: •:£: yaf i'•

c Treated as distributions out of corpus(Election required - see Instructions)........ 0.

d Applied to 2003 distributable amount .... 'i-n3}i,+S. n,ryva 2

• Remaining amount distributed out of corpus 60 , 593.5 Excess distributions carryover applied to 2003 . , . , ... . 0.

(if an amount appears In column (d), the <3=j£^ r+j5 n ,4 kxi£ £' ;'Yry #" "same amount must be shown in column (a))

#(

3'lE4RJ><S[YR fit f.^y^5 jf}at Y^y)t

+t)45E 4,n w2 wf ,Y. ,t #£S <y, <>; S

{^ 1 -1

^6 Enter On net^W of each CVIAas`{Yj`v%ty'

i'l^+7,}>S S£S{Sii

4i ;f LL<f^3^KE 5•J1)+EY 3-^iX

Indtcated below:a ODrpus , Add lines 3f, 4c, and 4e . Subtract line 5. . 60 , 593.

bPr£or ears ' undistributed Income. Subtractline from line 2b ..... ....... .. ..

+^ryY »^r} ^ktv(SS#4»j'tCflisO^

szsxf %54 f'+rk.?` S ,SY E ,_ ^•F^r£.{n:^ R

c Enter the amount of prior years ' undistnbut•J^ •f

i 3fy #) #f s E^ $ed income for which a notice of deficiency f g, s[a >t% ztzl

> a £has been issued , or on which the section tk,i, E y., Ef,'„<,,;4942(a) tax has been previously assessed .. :(=er«<a€ < >°.€>i

d Subtract line 6c from line 6b. Taxableamount - see Instructions............ .. "J^ xt 5

• Undistributed income for 20 Z Subtract line 4a fromline 2a . Taxable amount - see instructions .........

[Y >? a? ,.} yk°# £ k E ^"xa" 3 EsJ>.

f Undistrlbuted Income for 2003 . Subtract lines 5 <t$M :;3h#,5#4d and 5 from line 1. This amount must be C;; £x #:'},K k=>< n F

€yN >distributed In 2004 ............ .. .. ..... ^ {

7 Amounts treated as distributions out ofcorpus to satisfy requirements Imposedb sect on 170(b) 1 E) o 4942 3y i ( )( r (8)( )(see instructions) ...... . . . ............... 0 .

8 Excess distributions carryover from 1998 notapplied on line 5 or line 7 (see instructions) .. 0.

9 Exass distributions canyovK to 2004.Subtract lines 7 and 8 from line 6a .......... 60 9 593.

10 Analysis of line 9 :

a Excess from 1999 ... :3'$<;;:a'3#<;>-3;;°3 ?E=

b Excess from 2000 ...'f?3k33i€t=Y¢.;'.En;nL',•.F•?X'Ev$J

fj 5`:

C Excess from 2001..^ 3 S +Yfi a+• .f i>•kS`

dExcess from 2002 ...^j f}J b S , S^

+<rkak,^##"{,'%S Yob"+pEar^

#s Excess from 2003 60, 593 . "€3` "

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TEEao3oeL oansras

Form 990 PF (2003)

ELIZABETH CLEMENT 20Private v raan Foundations see instructions and Part VII-A , question 9) N/A

1 a If the foundation has received a ruling or determination letter that it Is a private operating foundation, and the rulingis effective for 2003, enter the date of the ruling . ................ ............................ ..... ........

b Check box to indicate whether the organization is a private o eratin foundation described In section 4942 or 49422a Enter the lesser of the adjusted net Tax year Prior 3 years

income from Part I or the minimum a 2003 2002 c 2001 2000 a Totalinvestment return from Part X foreach year listed ................. .....

b 85% of line 2a .......................

c Qualifying distributions from Part XII,line 4 for each year listed ........ ...

d Amounts included in line 2c not used directlyfor active conduct of exempt activities, ..........

• Qualifying distributions made directlyfor active conduct of exempt activities.Subtract line 2d from line 2c ...........

3 Complete 3a, b, or c for thealternative test relied upon:

a 'Assets' alternative test - enter:

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

(2) Value of assets qualifying undersection 4942 (i . .............

b'Endowment' alternative test - Enter 2/3 ofminimum investment return shown in Part X,line 6 for each year listed............ .. ....

c'Support! alternative test - enter:

(1) Total support other than grossinvestment income (interest,dividends, rents, paymentson securities loans (section512(a)(5)), or royalties) .... .......

(2) Support from general public and 5 ormore exempt organ izations as providedin section 4941(1 3(B in) ..............

(3) Largest amount of support froman exempt organization ........ ..

1 Information Regaring Foundation Manpws:this part only If the

a List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation before theclose of any tax year (but only If they have contributed more than $5,000). (See section 507(d)(2).)None

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 ofa partnership or other entity) of which the foundation has a 10% or greater interest.

None

2 hrfamdlon Regarding Con atbuton, Grant, Gift, Loan, Scholarship , etc, Programs:Check here ► 11 if the organization only makes contributions to preselected charitable organizations and does not accept unsolicitedrequests for funds. If the organization makes gifts, grants, etc, (see Instructions) to individuals or organizations under other conditions,complete items 2a, b, c, and d.

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

Misty Purdom, fax numbe 225-295-9624

b The form in which applications should be submitted and information and materials they should include:See attached application.

c Any submission deadlines:

Two weeks needed from application time for processing.d Any restrictions or limitations on awards, such as by geographical areas , charitable fields, kinds of institutions, or other factors:Only 501(c)(3) organizations allowed.

SAA TEEAosoa. 0811 sroa Form 990-PF (2003)

'Form 99a-PF (2003) CHRISTEN ELIZABETH CLEMENT 20-0122620 Page 10:"PO x; Supplementary Information (continued)3 Grants and Conbibutlons Paid Durlna tha Year or A rwad for Futw Parmnst

RecipientIf recipient is an individual,show a relatiny onship to

any foundation manager or

Foundationstatus Purpose of grant or

t lb tl mounti recipient n r u onco

Name and address (home or business) substantial contr butor

a Paid during the year

AMEDISYS DONATION 2,725.

AMERICAN HEART ASSOC DONATION 10,000.

CARDIOVASCULAR RESEARCH DONATION 10,000.

CATHOLIC COMMUNITY SERVICES DONATION 1,000.

COVENANT HOUSE DONATION 2,000.

GIVE KIDS THE WORLD DONATION 2,000.

GREATER BR FOOD BANK DONATION 5,000.

JW CARMICHAEL ENDOWED PROF DONATION 5,000.

JR. ACHIEVEMENT OF GBR DONATION 5,000.

LA ARS & SCIENCE MUSEUM DONATION 3,500.

METROCENTER HEALTHCARE FOUNDAT DONATION 2,000.

ST. ELIZABETH FOUNDATION DONATION 10,000.

ST. JUDE RESEARCH HOSPITAL DONATION 2,500.

LEUKEMIA & LYMPHOMA FOUNDATION DONATION 1,000.

Taw . • ► 8a 61 , 725.b Approved for future payment

Total ► SblBAA A031a i2n0ro3 Form 990-PF (2003)

Form 99Q-PF (2003) CHRISTEN ELIZABETH CLEMENT 20-0122620 Page 11

Analysis of income-Producing Activities

Enter gross amounts unless otherwise Indicated.

1 Program service revenue:

b

C

d

e

f

g Fees and contracts from government agencies... .

2 Membership dues and assessments ....... .. ..

3 Interest on savings and temporary cash investments ........

4 Dividends and interest from securities.......... .

5 Net rental income or (loss) from real estate,

s Debt-financed property ............. .... ....

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

6 Not 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

Unrelated business income Excluded by section 51 513, or 514

() (b) (c) (d) N)Business Amount Exclu. Amount Related or exemptcode Sion function income

code (see Instructinnsl

c

d

12 Subtotal, Add columns (b), (d), and (e) 2• •i^Y

13 Tolai. Add line 12, columns (b), (d), and (e) ............ ..................... .... .. .... .. . .. 13 0.(See worksheet in the instructions for line 13 to verity calculations.)

P`' ' =x Relationship of Activities to the Accomplishment of Exempt Purposes

am TEEAOSO11. osn SW Form 990-PF (2003)

'Form 9 O.PF CHRISTEN ELIZABETH CLEMENT 20-0122620 Pag e 12Information Regarding Transfers To and Transactions and Relationships With Noncharitable

No1 Did the organization directly or Indirectly engage In any of the following with any other organization

described in section 501 (c) of the Code (other tthan section 501(c)(3) organizations) or in section 527,relating to political organizations?

a Transfers from the reporting organization to a nonchantable exempt organization of:

(1) Cash .................... .. .... .. ........................................ ......... .. . .........

(2) Other assets .......... ..... . .... .................... .. ............... ..... .. . .. ...........

b Other transactions:

(1) Sales of assets to a noncharitable exempt organization .................. .................... . ...........

( Purchases of assets from a noncharitabie exempt organization ....... .............. ..... .. . . .... ....

(5) Rental of facilities, equipment, or other assets .................... .... ........ .............. ...........

(4) Reimbursement arrangements ....................................... ......................... .........

(5) Loans or loan guarantees ....... ................ ................ ............................. ... ....

(6) Performance of services or membership or fundraising solicitations ............................ ... . .......

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

d It the answer to any of the above is 'Yes,' complete the following schedule . Column (b) should always show the fair market value ofthe goods, other assets, or services given by the reporting organization. If the organization received less than fair market value in

(a) Line no. 1 (b) Amount involved 1 (C) Name of noncharitable exempt organization 1 (d) Description of transfers, transactions, and sharino arrangements

2a Is the organization directly or indirectly affiliated with , or related to, one or more tax-exempt organizationsdescribed in section 501 (c) of the Code (other than section 501(c)(3)) or in section 527? ........... .... ............ [] Yes No

h If 'Vac ' nmmniAta thA fnllmmAnn o hail da

Name of organization (b) Type of organization (c) Description of relationshi

N/A

U-W pendbea of pwwry I declare tat I hays mmined this rsf^nn . inelud nq aorcmpargvq adj. d a and slatemsnh, and b fie bat of my edge and tale}, it is ho, enact, andeomplate Dsdaradon o^ praparar (otlNr ems taxpayer or Aducis y) is bawd on all information of whieh preparer has any knowladgo.

s ►or Mat"Signature, of officer

Paid *'t"` ►E

Pro-Wes Firm 's name (or

a it adf a ►yours

pOnly MW6d

coda

BAA

Schedule B0bB No 1545-0047

(FormorM 99047,iWF) Schedule of Contributors

o.pao,,.nt of m. Tnausy SL;i&, Information for 2003tnt.m.1 K.wnw s.n^« lIne 1 of Form 880, 990 EZ and 890-PF (see Instructions)

^io1 0' CHRISTEN ELIZABETH CLEMENT E rI'"ekdoinumberFOUNDATION , INC. 1 20-0122620

Organization type (check one):Filers of: Swdon:Form 990 or 990-EZ 501(c)(_) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF X 501 (c)(3) exempt private foundation4947(a)(1) nonexempt charitable trust treated as a private foundation

501 (c)(3) taxable private foundation

Check if your organization Is covered by the General Rule or a Special Rule. (Note: Only a section 507(c)(7), (8), or (10) organization cancheck box(es) for both the General Rule and a Special Rule - see instructions.)

General Rule -For organizations filing Form 990, 990-EZ, or 990•PF that received, during the year, $5,000 or more (in money or property) from any onecontributor. (Complete Parts I and II.)

Special Rules -

F] For a section 501(c)(3) organization filing Form 990, or Form 990-EZ, that met the 33-1/3% support test of the regulations under sections509(a)(1)l170(b)(1)(A)(v) and received from any one contributor, during the year, a contribution of the greater of $5,000 or 2% of theamount on line 1 of these forms. (Complete Parts I and II.)

E]For a section 501(c)(7), (8), or (10) organization filing Form 990, or Form 990-EZ, that received from any one contributor, during the year,aggregate contributions or bequests of more than $1,000 for use exclusively for religious, chantable, scientific, literary, or educationalpurposes, or the prevention of cruelty to children or animals. (Complete Parts I, 11, and III.)

0For a section 501(c)(7), (8), or (10) organization filing Form 990, or Form 990-EZ, that received from any one contributor, during the year,some contributions for use exclusively for religious, charitable, etc, purposes, but these contributions did not aggregate to more than$1,000. (If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable,etc, purpose. Do not complete any of the Parts unless the General Rule applies to this organization because it received nonexclusivelyreligious, charitable, etc, contributions of $5,000 or more during the year.) ..................... . ....... ... ' $

Caution: Organizations that are not covered by the General Rule andlor the Spe^cial Rules do not file Schedule B (Form 990, 990-EZ or990-PF) but they mustcheck the box In the heading of their Form 990, Form 990-EZ, or on line 1 of their Form 990-PF, to certify that they donot meet the filing requirements of Schedule B (Form 990, 990-E2 or 990-PF)

BAA For Paperwork Reduction Act Notice see the Insbvcllonsfor Fonn 990 and Form 990-EL

Schedule B (Form 990, 990-EZ, or 990-PF) (2003)

TEEAO7OIL 12110/)3

B (Form 990 . 990-EZ. 990-PF) (2003 ) Pace 1 to 1 of

20-012

Contributors (See Specific Instructions,)

(a) (b) (c) (d)Number Name, address, and ZIP +4 Aggregate

contributionsType of contribution

1 LARRY R_ GRAHAM _______________________ Person XPayroll

5233 HAGERSTOWN DR. ______________________ $ 51000 Nonwh

(Complete Part II if thereBATON ROUGE,_ LA 70817_ is a noncash contribudon.

(a) (b) (C) (d)Number Name, address, and EP + 4 A9 . Type of contribution

2 AMEDISYS----------- ------------------ Person XPayroll

11100 MEAD RD. STE. 300 ______________ $_ ____200L000_ Noncash

(Complete Part II if thereBATON-ROUGE,- LA------ 70816 -- - - - - - - - - - - - _ _ _ _ _ _ _ is a noncash contribution.)

(a) (b) (c) (d0Number Nam., address, and MP + 4 A9 t Type of contributionbUti

co

----------- -------------------------PersonPayroll

----------- ------------------------- $- --------- Noncash

(Complete Part I I if there

-----------__

-----------------------is a noncash contribution.)

(a) (b) (c) (d)Number Name, address, and ZIP +4 Aggregate Type of contribution

contributions

------------------------------------PersonPayroll

------------------------------------ $---------- Noncash

(Complete Part II if there____________________________________ is a noncash contnbuton.)

(a) (b) (c) (d)Number Name, address, and aP + 4 A te Type of contribution

------------------------------------Person

Payroll$ Noncash

(Complete Part II it there____________________________________ Is anoncashcontribution.)

(a) (b) (c) (d)Number Name, address, and aP + 4 Aggregate Type of contribution

contributions

----------- -------------------------PersonPayroll

$ Noncash

(Complete Part II if there________________________________ is a noncash contribution.)

BAA TEEAO7aa 08/13/ Schedule B (Form 990 , 990-EZ, 990-PF) (2003)

5cheaule tl roan Yyu `WJ-t.L or JJu-rr QIUJ rage 1 to t oT 1

ohm* of of wbmum Ar IduMwea0 ameba

EL

Noncash Property (see specific instructions.)

f r(d)

1ofrrolm Description of noncash property given (o )s^ Data eivedrs(see

1

n

-

N/A --------------------------------------------------------------------------------------------------------------------------- - - - - - - -- - - - -- --- -- - - - - - - - - - - - - - - - - - - - - ----------- --------

a reNo from Description of nonc ah properly Shen FMVfo stlmate rivedData receivedP(WWI tstrucons)

-----------------------------------------------------------------------------------

----------------------------------------$

i ti fD ce t iW

i(d)

No from p on oescr non proper y g ven mateM

(or est Date rr.ccelved

-------------------------------------------- --------------------------------------

----------------------------------------

---------------------------------------- - --------- -------

.r ti f n hD i it % dom1P f on o no asescr p proper y g ven M(o ^ ) Date receive

-

------------------------------------------

------------------------------------------

-------------------------------------------------------------------------------- ---------- -------

ar

(C)(moNo. from Description of noncash property given FMV(oresftmate Data ved

Part I (see nstructlons

--------------------------------------------------- ------ --- ------ ------------ ------------------------------------------------------------------------------------- $---------- --------

t .fif f caD i ti h i FM or } d(ceP rom nonon o sescr p property g ven V o( estimaate) Date elveitesM

------------------------------------------

-- -- ----- -- -- ---------- ------------- -------

--------------------------------------- $---------- --------

BAA Schedule B (Form 990.990-EL or 990-PF) (2003)

TEEAO703L 08/13103

Nis of etgawase.of Part

ftoupr 1O o5&afo. omnf.r

Exclus/ve/y religious , charitable, etc, Individual contributions to section 501(c)(7), (8), or (10)organizations aggregating more than $1 ,000 for the year (Complete cols (a) through (e) and the following line entry.)

For organizations completing Part III, enter total of exclusively religious, charitable, etc,contributions of $1AOOorlsss for the year. (Enter this information once - see instructions.) ....... S N/A

^a)No. from'Part

(b)

Purpose of gift

(C)

Uss of gift

(d)

Description of how gift Is held

-

N/A----------------------------------------

-----------------------------------------

-------------------------------------------

(e)Transfer of gift

Transferee's nuns, address, and ZIP +4 Relationship of transferor to transferee

---------------------------------------------------------------------

----------------------------------

-------------------------------------------------------

---------------------------

(a)NPR

I

)Purpose of gift

(c)Use of gift Desatptlon of how gift is held

-----------------------------------------

-------------------

-----------------------------------------

--------------------

-------------------------------------------

---------------------

(e)Transfer of gift

Transform 's name, address, and aP +4 Relationship of transferor to transferss

-------------------------------------------------------------------------------------------------------

----------------------------------------------------------------------------------

a)No. from

-Part I

(b)Purpose of gift

cUse of gift

(CODescription of how gift Is hold

-----------------------------------------

-------------------

-----------------------------------------

--------------------

-------------------------------------------

---------------------

(s)Transfer of gift

Transferee 's name, address, and ZIP + 4 Relationship of transferor to transfers.

-----------------------------------

--------------------------------------------------------------------

----------------------------

------------------------------------------------------

(a)No. frornPart

)Purpose of gift

(o)Use of gift

(d)Description of how gift Is held

----------------------

---------------------

-------------------

---------------------

---------------------

--------------------

----------------------

----------------------

---------------------

(a)Transfer of gift

Transfersa's name, address, and ZIP + 4 RelatIorwhlp of transferor to transferee

---------------------------------------------------------------------------------------------------------

------------------------------------------------------------------------------------

BM Schedule B (Form 990, 990-EZ, or 990-PF) (A03)TEEAd704I. 08/13103

2003 Federal StatementsCHRISTEN ELIZABETH CLEMENT

FOUNDATION, INC.

Page 1

20-01

Statement 1Form 990-PF, Part I, Line 23Other Expenses

(a) (b) Net (c) (d)Expenses Investment Adjusted Charitableper Books Income Net Income Purposes

MISC .. ........................ . ........ . 50. $ 50.Total 4 50. 0. 50.

Statement 2Form 990-PF, Part VIII, Line 1List of Officers, Directors , Trustees, and Key Employees

Title and Contri- ExpenseAverage Hours Compen- bution to Account/

Name and Address Per Week Devoted sation EBP & DC Other

MARK R. PHILLIPS Secretary $ 0. $ 0. $ 0.8658 QUARTERS LAKE RD. NoneBATON ROUGE, LA 70809

PHILIP G. CAIRE Treasurer 0. 0. 0.8658 QUARTERS LAKE RD. NoneBATON ROUGE, LA 70809

LARRY R. GRAHAM President 0. 0. 0.11100 MEAD RD., STE. 300 NoneBATON ROUGE, LA 70816

Total