R Forn? 990-PF OMB No as a Private Foundation...

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R Forn? 990-PF Return of Private Foundation OMB No ,545 .o052 or Section 4947(ax1) Nonexempt Charitable Trust Treate d as a Private Foundation 2004 oePartment or we Treasury Note : The organization may be able to use a copy of this return to satisfy state Internal Revenue Service reporting requirements. For calendar ear 2004, or tax ear be g innin g Oct 1 , 2004, and endin g Se 30 2005 G Check all that aoolv~ I Initial return I I Final return ~ ~ Amended return Address change Name chan ge Use the ,4 Employer identification number IRS label . i 25-6201015 Otherwise, 582 ****AUTO**21I~L FOR ADC 150 B Telephone number (see instructions) optype . ARTHUR W PHILLIPS TRUST UW ~ ~ I (814) 676-2736 See Specific 0 BOX 316 Lf r~~-Z~~ Ro~~?R t~E P14 R C If exemption application is pending, check here 11. Instructions OIL CITY PA 16301-0316 B 24 S D 1 Foreign organizations, check here H Check type of organization : U Section 501(c)(3 exempt private foundation 2 Foreign organizations meeting the 85% test, check Section 4947 (a) (1 ) nonexempt charitable trust Other taxable private foundation here and attach computation I Fair market value of all assets at end of year J Accounting method : X Cash Accrual E If private foundation status was terminated (from Part 1l, column (c), line 16) U U under section 507(b)(1)(A), check here Other (specify) _ _ _ _ _ _ _ _ F If the foundation is in a 60-month termination ~ $ 14,599,129 . art 1, column (d must be on cash basis .) under section 501(bxl)(B), check here . . Part Analysis of Revenue and Expenses (The total of amounts in (a) Revenue and (b) Net investment (c) Adjusted net (d) Disbursements expenses per books income income for charitable columns (b), (c), and (d) may not neces- purposes sanly equal the amounts in column (a) (cash basis only) see instructions) .) Contributions, gifts, grants, etc, received (att sch) 2 Ck ~ ~ d the foundn is not req to aft Sch B 3 Interest on savings and temporary cash investments . . . . . . . . . . . . 1 , 157 . 1 , 157 . 4 Dividends and interest from securities . . . . . . . 453 , 943 . 453 , 943 . 5a Gross rents . . . . . . .. ........ b Net rental income t ~+ or loss) 19 := - ---,r- . r-~- _~ - ~~-rt' - ~ - _ - _ _ ~ " - - " ~` 6 a Net gam/(loss) from sale of assets riot on brie 10 . .` . -29 , 021 . b Gross sales price for au 50 , 021 . -- E assets on line 6a V 7 Capital gam net income (from Part IV, brie 2) . . 0 . 8 Net short-term capital gam _- 9 Income modifications . . . . . . . . a : ,t14 10a Gross sales less returns and allowances . -s b Less : Cost of goods sold c Gross profit/(loss) (aft sch) . ....... . . . . . . . - ;- 11 Other income (attach schedule) . . . .. . 2003 EXCISE TAX REFUND 5 , 187 . 12 Total . Add lines 1 through 11 . . 431,266 . 455, 100 . r' 13 Compensation of officers, directors, trustees, etc . 38 , 875 . 38 , 875 . loyee salaries and wages . . . . . . . . 14 , 836 . 14 , 836 . 5 Pe~DA ployee benefits . 6 Leg lees q~ .6a~Stmt 3 , 500 . 3 , 500 . Accounting fees (atta )'L- Zb Stmt 14 , 490 . 14 , 490 . o i c"0 t r I fe s (attach sch . 0 . . . . . . . . . ere Z B B g . ~ . . . . . . . . p 1 hedule) ine 18 Stmt . 12 , 323 . 323 . ~(a c ~ ~ and depletion , -' N y ZO OCC 21 Travel, confe d meetings 351 . 351 . 22 Printing and publications . . . . . 186 . 186 . o P 23 Other expenses (attach schedule) See Line 23 Stmt 2 , 188 . 2 188 . N 24 Total operatin g and administrative expenses. Add lines 13 through 23 .. . 86,749 . 56,865 . 17,884 . 25 Contributions, gifts, grants paid . . . . . . . . . . 717 , 722 . 717, 722 . 26 Total expenses and disbursements . Add lines 24 and 25 . . . . . . . . . . 804, 471 . 56 865 . 735 , 606 . 27 Subtract brie 26 from brie 12 : a Excess of revenue over expenses and disbursements . . . ........ -373 , 205 . b Net investment Income (if negative, enter ~o-) . '' - - 398 , 235, 1 7 - r'" ' + ` - C Adjusted net income (if negative, enter -0-) ,r .-'~~'- :',t' : BAA For Privacy Act and Paperwork Reduction Act Notice, see the ,instructions. , TEEa,o3oi oiiosios Form 990-PF (2004) I

Transcript of R Forn? 990-PF OMB No as a Private Foundation...

  • R

    Forn? 990-PF Return of Private Foundation OMB No ,545 .o052 or Section 4947(ax1) Nonexempt Charitable Trust Treated as a Private Foundation 2004

    oePartment or we Treasury Note : The organization may be able to use a copy of this return to satisfy state Internal Revenue Service reporting requirements. For calendar ear 2004, or tax ear beginning Oct 1 , 2004, and ending Se 30 2005 G Check all that aoolv~ I Initial return I I Final return ~ ~ Amended return Address change Name change Use the ,4

    Employer identification number

    IRS label . i 25-6201015 Otherwise, 582 ****AUTO**21I~L FOR ADC 150 B Telephone number (see instructions) optype . ARTHUR W PHILLIPS TRUST UW ~ ~ I (814) 676-2736

    See Specific 0 BOX 316 Lf r~~-Z~~ Ro~~?R t~E P14 R C If exemption application is pending, check here 11. Instructions OIL CITY PA 16301-0316 B 24 S D 1 Foreign organizations, check here

    H Check type of organization : U Section 501(c)(3 exempt private foundation 2 Foreign organizations meeting the 85% test, check Section 4947 (a)(1 ) nonexempt charitable trust Other taxable private foundation here and attach computation

    I Fair market value of all assets at end of year J Accounting method : X Cash Accrual E If private foundation status was terminated (from Part 1l, column (c), line 16) U U under section 507(b)(1)(A), check here Other (specify) _ _ _ _ _ _ _ _ F If the foundation is in a 60-month termination

    ~ $ 14,599,129 . art 1, column (d must be on cash basis .) under section 501(bxl)(B), check here . . Part Analysis of Revenue and

    Expenses (The total of amounts in (a) Revenue and (b) Net investment (c) Adjusted net (d) Disbursements

    expenses per books income income for charitable columns (b), (c), and (d) may not neces- purposes sanly equal the amounts in column (a) (cash basis only) see instructions) .) Contributions, gifts, grants, etc, received (att sch)

    2 Ck ~ ~ d the foundn is not req to aft Sch B 3 Interest on savings and temporary

    cash investments . . . . . . . . . . . . 1 , 157 . 1 , 157 . 4 Dividends and interest from securities . . . . . . . 453 , 943 . 453 , 943 . 5a Gross rents . . . . . . . . . . . . . . . . b Net rental income t ~+

    or loss) 19:=

    - ---,r- .�r-~- _~- ~~-rt' - ~ - _ - _ _ ~ " - - " ~`

    6 a Net gam/(loss) from sale of assets riot on brie 10 . .` . -29 , 021 . b Gross sales price for au 50 , 021 . -- E assets on line 6a

    V 7 Capital gam net income (from Part IV, brie 2) . . 0 .

    8 Net short-term capital gam _- 9 Income modifications . . . . . . . . a : ,t14 10a Gross sales less

    returns and allowances .

    -s b Less : Cost of goods sold

    c Gross profit/(loss) (aft sch) . . . . . . . . . . . . . . . - ;- 11 Other income (attach schedule) . . . . . .

    2003 EXCISE TAX REFUND 5 , 187 . 12 Total . Add lines 1 through 11 . . 431,266 . 455, 100 .

    r' 13 Compensation of officers, directors, trustees, etc . 38 , 875 . 38 , 875 . loyee salaries and wages . . . . . . .

    . 14 , 836 . 14 , 836 .

    5 Pe~DA ployee benefits . 6 Leg lees q~ .6a~Stmt 3 , 500 . 3 , 500 .

    Accounting fees (atta )'L- Zb Stmt 14 , 490 . 14 , 490 . o i c"0 t r I fe s (attach sch . 0 . . . . . . . . .

    ere Z B B g . ~ . . . . . . . . p 1 hedule) ine 18 Stmt . 12 , 323 . 323 .

    ~(a c ~ ~ and depletion , -' N y ZO OCC

    21 Travel, confe d meetings 351 . 351 . 22 Printing and publications . . . . . 186 . 186 .

    o P 23 Other expenses (attach schedule) See Line 23 Stmt 2 , 188 . 2 188 . N

    24 Total operating and administrative expenses. Add lines 13 through 23 . . . 86,749 . 56,865 . 17,884 .

    25 Contributions, gifts, grants paid . . . . . . . . . . 717 , 722 . 717, 722 . 26 Total expenses and disbursements .

    Add lines 24 and 25 . . . . . . . . . . 804, 471 . 56 865 . 735 , 606 . 27 Subtract brie 26 from brie 12 :

    a Excess of revenue over expenses and disbursements . . . . . . . . . . . -373 , 205 .

    b Net investment Income (if negative, enter ~o-) . '' - - 398 , 235, 17 - r'" ' +� ` - C Adjusted net income (if negative, enter -0-) ,r .-'~~'- :',t' :

    BAA For Privacy Act and Paperwork Reduction Act Notice, see the ,instructions. , TEEa,o3oi oiiosios Form 990-PF (2004)

    I

  • 25-6201015 Page Form 990-PF (2004) Dr . & Mrs . Arthur William Phillips Charitable Trust Attached schedules and amounts in the description Beginning of year

    Part II Balance Sheets column should be for end-of-year amounts only (See instructions ) (a) Book Value

    End of year " , Book Value (c) Fair market value

    1 Cash - non-interest-bearing 2 Savings and temporary cash investments 3 Accounts receivable

    Less : allowance for doubtful accounts 4 Pledges receivable No -_

    Less : allowance for doubtful accounts 5 Grants receivable 6 Recewables due from officers, directors, trustees, and other

    disqualified persons (attach schedule) (see instructions) . . . . . . . . . . . . . . . 7 Other notes and loans receivable (attach sch)

    Less : allowance for doubtful accounts s 8 Inventories for sale or use . .

    9 Prepaid expenses and deferred charges . s 10a Investments - U S and state government

    obligations (attach schedule) . L-l0a .Stmt b Investments - corporate stock (attach schedule) L-10b Stmt c Investments - corporate bonds (attach schedule) L-10c Stmt . . . . . .

    11 Investments - land, buildings, and equipment : basis . . . . . . . . . . . . . . ~ ' Less' accumulated depreciation (attach schedule)

    12 Investments - mortgage loans . . . . . . . . . . . . . . . . . . . . . 13 Investments - other (attach schedule) L-13 Stmt 14 Land, buildings, and equipment : basis

    Less' accumulated depreciation (attach schedule)

    15 Other assets (describe "` See Other Assets Stmt ) 16 Total assets (to be completed by all filers -

    see instructions . Also, see page 1, item I 17 Accounts payable and accrued expenses . . . 18 Grants payable a 19 Deferred revenue . . . . . . 20 Loans from officers, directors, trustees, & other disqualified persons

    I

    21 Mortgages and other notes payable (attach schedule) . . . . . . . . . . . . 22 Other liabilities (describe b )

    e 23 Total liabilities add lines 17 throu gh 22

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

    N F 24 Unrestricted . . . . . . . . . . . . . . e u t n 25 Temporarily restricted d 26 Permanently restricted . . . . . . . . . . . . . . . . . . . . . . . . .

    Organizations that do not follow SFAS 117, check here ~ X s a and complete lines 27 through 31 .

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

    29 Retained earnings, accumulated income, endowment, or other funds o e r s 30 Total net assets or fund balances (see instructions) . . . . . . . . . .

    31 Total liabilities and net assets/fund balances see instructions

    Part III Analysis of Changes in Net Assets or Fund Balance!

    2 , 883 . 7 f 592 . 7 , 592 .

    3 , 375 , 556 . 3 , 375 , 555 . 3 , 264 , 135 . 1 , 738 f 333 . 1 , 711 , 920 . 9 181 165 .

    165 630 . 113 002 . 105 254 .

    1 , 840 . 1 840 . 3 , 950 .

    7 , 619 , 984 . 1 7 , 246 , 942 . 1

    7,619 .984 . 7,246 .942 . . '

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

    2 Enter amount from Part I, line 27a . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Other increases not included in line 2 (itemize) 01 See Other Increases Stmt 4 Add lines 1, 2, and 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    5 Decreases not included in line 2 (itemize) 6 Total net assets or fund balances at end of year (line 4 minus line 5) - Part II, column (b), line 30 . . . . . . . . . .

    BAA TEEA0302 07129104

    7,619,984 . -373,205 . °' 163 .

    7,246 .942 .

    7,246,942 . Form 990-PF (2004)

    F

    2 335 742 . 2 , 037 , 033 . 2 , 037 , 033 .

    7 , 619 , 984 . 7,246,942 . 14 599 129 . v -,

    .~~`` -~ ,~+r:

    - ,, 7 , 61 5 261 . 7 , 237 , 510 .

  • Form X30-PF 2004 Dr . & Mrs . Arthur William Phillips Charitable Trust Part IV . Capital Gains and Losses for Tax on Investment Income

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

    1a 20000 SHS ENRON CORP b 50000 PV FORD MOTOR CO 7 .5% DUE 3/15/05 c 0 .451 SHS FIFTH THIRD BANCORP d e

    (b) How acquired (C) Date acquired (U) Date sold P - Purchase (month, day, year) (month, day, year) D - Donation

    P 01 / 01 / 79 12 / 29/04 P 11/05/03 03/15/05 P 11/11/96 01/04/05

    TEEA0303 07/29/04

    -6201015 Page 3

    (g) Cost or other basis (h) Gain or (loss) (e) Gross sales pace (f) Deprecation allowed (or allowable) plus expense of sale (e) plus (0 minus (g)

    a 0 . 26 , 406 . -26 , 406 .

    b 50 , 000 . 52 , 629 . -2 , 629 . C 21 . 7 . 14 .

    d

    e

    Complete only for assets showing gain m column h and owned b the foundation on 12/31/69 (I) Gains (Column (h) (i) Fair Market Value (j) Adjusted basis (k) Excess of column (i) gain minus column (k), but not less

    as of 12/31/69 as of 12131/69 over column 0), if any than -0-) or Losses (from column (h))

    a -26 , 406 . b -2 , 629 . c 14 . d e

    2 Capital gain net income or (net capital loss) If gain, also enter in Part I, line 7 If (loss), enter -0- m Part I, line 7 ~ 2 -29,021 . 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 -0- in Part I, line 8 J 3

    Part V ~ 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 organization liable for the section 4942 tax on the distributable amount of any year in the base period? 1-1 Yes RX 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 .

    a b c Base period years Adjusted qualifying distributions Net valu uao e of Distribution n ratio

    Calendar year (or tax year nonchantable-use assets beginning in) (column (b) divided by column (c))

    2003 597 735 . 13 409 325 . 0 .044576 2002 584 604 . 12 318 596 . 0 .047457 2001 602 720 . 11 680 094 . 0 .051602 2000 836 724 . 14 171 610 . 0 .059042 1999 707,503 . 16,303,524 . 0 .043396

    2 Total of line 1, column (d) . . . . . . . . . . . . . . . . . . . . . . . . . . 2 0 .246073

    3 Average distribution ratio for the 5-year base period - divide the total on line 2 by 5, or by the number of years the foundation has been m existence if less than 5 years . . . . . . . 3-I- 0 .049215

    4 Enter the net value of nonchantable-use assets for 2004 from Part X, line 5 . . . . . . . . . 4 14 , 380 , 142 .

    5 Multiply line 4 by line 3 . . . . . . . . . . . . . . . . . . . . . . 5 707 , 719 .

    6 Enter 1 % of net investment income (1 % of Part I, line 27b) . . . . . . . . . . . . . . . . . . . . . . . 6 3 , 982 .

    7 Add lines 5 and 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 ~ 711,701 .

    S Enter qualifying distributions from Part XII, line 4 . . . . . . . . . . . . . . . . . . . . . . . , . . 1 8 1 735,606 .

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

    BAA Form 990-PF (2004)

  • 25-6201015 Page 4 Form 990-PF (2004) Dr . & Mrs . Arthur William Phillips Charitable Trust or 4948 - see in 1 Excise Tax Based on Investment Income i -

    1 a Exempt operating foundations described in section 4940(d)(2), check here ~ ~ and enter 'N/A' on line 1 Date of ruling letter : (attach copy of ruling letter if necessary - see instructions)

    b Domestic organizations that meet the section 4940(e) requirements in Part V, check here and enter 1 % of Part I, line 27b

    c All other domestic organizations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, column (b) 2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only . Others enter -0-) 3 Add lines 1 and 2 . . . 4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only . Others enter -0-) . . . . 5 Tax based on investment income . Subtract line 4 from line 3 If zero or less, enter -0- 6 Credits/Payments . a 2004 estimated tax pmts and 2003 overpayment credited to 2004 6a 12 , 000 . b Exempt foreign organizations - tax withheld at source . . . . . . . . . . . . . . . . 6b c Tax paid with application for extension of time to file (Form 8868) . . . . . . . . . . . . 6c d Backup withholding erroneously withheld . . . . . . . . . . . . 6d

    7 Total credits and payments . Add lines 6a through 6d 8 Enter any penalty for underpayment of estimated tax . Check here F1 if Form 2220 is attached . . . . . . . . . . 9 Tax due . If the total of lines 5 and 8 is more than line 7, enter amount owed 10 Overpayment . If line 7 is more than the total of lines 5 and 8, enter the amount overpaid . . . . . . . . . . . . . . . . 11 Enter the amount on line 10 to be' Credited to 1005 estimated tax . ~ Refunded part VII-A Statements Regarding Activities

    1 ' 3,982 . l

    2 0 . 982 .

    5 3 , 982 . . .

    , .: , . 7 . 12,000 .

    8,018 . 8 .018 .

    TEEA0304 01/03/05

    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 la or 7b, attach a detailed description of the activities and copes of any materials published - , r or distributed by the organization m connection with the activities . ^ _ I .~ _w.

    c Did the organization file Form 1120-POL for this year? . . . . . . . . . . . . . . . . . . . . . . . 1 c X d Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year : `'

    (1) On the organization ~ $ (2) On organization managers ~ $ - , e Enter the reimbursement (if any) paid by the organization during the year for political expenditure tax imposed on -

    organization managers . . . . ~ $ 2 Has the organization engaged m any activities that have not previously been reported to the IRS 2 X

    If 'Yes,' attach a detailed description of the activities.

    3 Has the organization made any changes, not previously reported to the IRS, in its governing instrument, articles --~= --~- -- I of incorporation, or bylaws, or other similar instruments? If 'Yes,' attach a conformed copy of the changes 3 X

    4a Did the organization have unrelated business gross income of $1,000 or more during the year? . . 4a X b If 'Yes,' has it filed a tax return on Form 990-T for this year? . . . . . . . . . . . . . . . . . . 4b

    5 Was there a liquidation, termination, dissolution, or substantial contraction during the years 5 X If 'Yes,' attach the statement required 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 legislation that effectively amends the governing instrument so that no mandatory directions that conflict - -- ---with the state law remain in the governing instrument? . . . . . . . . . . . . . 6 ~X

    7 Did the organization have at least $5,000 in assets at anytime during the year? If Yes,'complefe Part 11, column (c), and Part XV 7 X 8a Enter the states to which the foundation reports or with which it is registered (see instructions) 10 -_

    PA -------------------------------------------------------- I b If the answer is 'Yes' to line 7, has the organization 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8b X

    9 Is the organization claiming status as a private operating foundation within the meaning of section 4942(j)(3) or 4942(j)(5) for calendar year 2004 or ~ - - -- -' the taxable year beginning in 2004 (see instructions for Part XIV)? If Yes,'complete Part XIV 9 X

    10 Did any persons become substantial contributors during the tax year? . . . . . . . . . . . . . . . . . . 10 X If '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? . . . . 11 X Web site address . . bl NBA

    12 The books are m care of " BERTA WINTERS ADMINISTRATIVE ASSISTANT Telephone no . - (814)_676=2736__ Located at 1, 229 ELM STREETL OIL CITY,PA ________-_____ ZIP +4 ~ 16301=0316 _ Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 - Check here . 13 and enter the amount of tax-exempt interest received or accrued during the year ~~ 13 I .

    BAA Form 990-PF (2004)

  • b If any answer is 'Yes' to 5a(1)-(5), did any of the transactions fad to qualify under the exceptions described in Regulations section 53.4945 or in a current notice regarding disaster assistance (see instructions)? . . . . . . Organizations relying on a current notice regarding disaster assistance check here . . . . . . . . . . . . . . . . . . . . . .

    c If the answer is 'Yes' to question 5a(4), does the organization claim exemption from the tax because it maintained expenditure responsibility for the grant? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes F] No If 'Yes,' attach the statement required by Regulations section 53.4945-5(d) .

    6a Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    . . . . . a Yes E] No

    b Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? . . . . . . . . . . . . . . . If you answered 'Yes' to 6b, also file Form 8870

    Form 990-PF (2004) lEEA0305 07/29/04 BAA

    '` Form 990-PF 2004) Dr . & Mrs . Arthur William Phillips Charitable Trust 25-6201015 Page 5

    Part .Vll-B . Statements Regarding Activities for Which Form 4720 Ma Be Required File Form 4720 if any item is checked in the 'Yes' column, unless an exception applies. - ' Yes No

    1 a During the year did the organization (either directly or indirectly): (1) Engage in the sale or exchange, or leasing of property with a disqualified person? . . . . . . . . . . . Yes No

    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from) a disqualified person? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes X No , .

    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? . . . . . . . . Yes X No r . .. , - (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? . . . . . . Yes No

    ,.. (5) Transfer any income or assets to a disqualified person (or make any of either available - ; .u . ,

    for the benefit or use of a disqualified person)? . . . . . . . . . . . . . Yes X~ No .t < <

    (6) Agree to pay money or property to a government official? (Exception . Check 'No' if the ~a_ ' '` r organization agreed to make a grant to or to employ the official for a period after termination of government service, if terminating within 90 days .) . . . . . .

    . . . . Yes Xa No . . , .,t ._ . -,

    b If any answer is 'Yes' to 1 a(1)-(6), did any of the acts fad to quaky under the exceptions described in I y j' r~% Regulations section 53.4941(d)-3 or in a current notice regarding disaster assistance (see instructions)? . . . . . . . . . . 1 b Organizations relying on a current notice regarding disaster assistance check here . . . . . . . . . . . . . . .

    c Did the organization engage m a prior year m any of the acts described m 1 a, other than excepted acts, . that were not corrected before the first day of the tax year beginning in 2004? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 c X

    2 Taxes on failure to distribute income (section 4942) (does not apply for years the organization was a vF .y ~` private operating foundation defined in section 49420(3) or 49420(5)):

    a At the end of tax year 2004, did the organization have any undistributed income (lines 6d and 6e, Part XIII) for tax year(s) beginning before 2004? . . . . . . . . . . . . . . . . . . . . Yes ~ No

    r If 'Yes,' list the years ~ 20_ _ , 20_ _ .20 _ _ , 20_

    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 all years listed, answer 'No' and attach statement - see instructions .) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2b

    c If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here . ....: X20 ,20 ,20 ,20

    3a Did the organization hold more than a 2% direct or indirect interest in any business ' enterprise at any time during the year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~ Yes ~ Na ' ,~ .~ ,

    b If 'Yes,' did it have excess business holdings in 2004 as a result of (1) any purchase by the organization _ or disqualified persons after May 26, 1969 ; (2) the lapse of the 5 -year period (or loner period approved by the Commissioner under section 4943(c)(1)) 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 organization had excess business holdings in 2004.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3b

    4a Did the organization invest during the year any amount in a manner that would jeopardize its ~= 1' ~ ~` ~ ' - charitable purposes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~ 4a ~ X

    b Did the organization make any investment in a prior year (but after December 31, 1969) that could jeopardize its charitable purpose that had not been removed from jeopardy before the first day of .~ . .~: . ~ ~ : . the tax year beginning in 2004? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4b X

    5a During the year did the organization pay or incur any amount to : l~r,(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? . . . . . . . . . . a Yes E] No

    (2) Influence the outcome of any specific public election (see section 4955) ; or to carry .~s ` on, directly or indirectly, any voter registration drive? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No ''

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

    (4) Provide a grant to an organization other than a charitable, etc, organization described " , m section 509(a)(1), (2), or (3), or section 4940(d)(2)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~ Yes ~ No . .=' :

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

  • 1 .

    Form 990-PF 2004 Dr . & Mrs . Arthur William Phillips Charitable Trust 25-6201015, Page 6 Part VIII Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees, '

    and Contractors 1 List all officers, directors . trustees . foundation managers and their compensation (see instructions).

    (b) Title and average I (c) Compensation (a) Name end address hours per week (I( not paid, enter -0-) devoted to position

    (d) Contributions to employee benefit plans and deferred compensation

    0 .

    0 .

    0 .1 0 actions). I( none, enter'NONE .' (c) Contributions to (e) Expense account, employee benefit other allowances plans and deferred

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

    Total number of others receiving over $50,000 for professional services ~~ None

    Part IX-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 Expenses organizations and other beneficiaries served, conferences convened, research papers produced, etc.

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

    0 . 2

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

    3

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

    4

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

    BAA TEEA0306 01/03/05 Form 990-PF (2004)

    ROBERT W . McFATE TRUSTEE 229 ELM ST . OIL CITY PA 16301 VARIES 17 , 500, WILLIAM E . BREENE TRUSTEE 111 OAK RD . OIL CITY PA 16301 VARIES 6 , 250 . EDITH GILMORE LETCHER TRUSTEE 213 EAST ROSE VALLEY RD, WALLINGFORD, PA 19086 VARIES 13 , 500a LARRY S . ADAMS TRUSTEE 55 CENTENNIAL DR FOXBURG, PA 16036 VARIES 1 , 125 . 2 Compensation of five highest-paid employees other than those included online 1- see in'

    (a) Name and address of each employee (b) Title and average (c) Compensation paid more than $50,000 hours per week

    ~ devoted to position

    NONE

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

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

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

    (e) Expense account, other allowances

    0 .

    Total number of other employees paid over $50,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~~ None 3 Five highest-paid independent contractors for professional services - see instructions ) . I( none enter'NONE .'

    a Name and address of each person aid more than $50,000 b Type of service c Compensation NONE

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

  • r Form 990-PF (2004) Dr . & Mrs . Arthur William Phillips Charitable Trust 25-6201015 Page 7

    Part IX-B Summary of Program-Related Investments see instructions) Describe the two largest program-related investments made by the foundation the tax year on lines 1 and 2 . 1 Amount

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

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

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

    None Total . Add lines 1 through 3

    Pdl't X ' M1111111Ut11 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 charitable, etc, purposes : a Average monthly fair market value of securities . . . . . . . . . . . . . . , . . , b Average of monthly cash balances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Fair market value of all other assets (see instructions) . . . . . . . . . . . . d Total (add lines 1a, b and c) . . . . . . . . . . . . . . . . . . . e Reduction claimed for blockage or other factors reported on lines 1 a and 1 c

    (attach detailed explanation) . . . . . . . . . . . . . . . ., . I 1el 2 Acquisition indebtedness applicable to line 1 assets . . . . . . . . . . . . . . . . . .

    1a 14 , 587 , 587 . . . 1b 7 , 592 .

    . . 1t 3 , 950 . 1d 14,599 .129 .

    2 0 .

    1EEA0307 01/14/05

    1 NONE

    2

    All other program-related investments . See instructions . 3

    3 Subtract line 2 from line 1d . . . . . . . . . . . . . . . . . . . . . . . 3 14 , 599 , 129 . 4 Cash deemed held for charitable activities . Enter 1-1/2% of line 3 (for greater amount, see instructions) . . . 4 218 , 987 . 5 Net value of noncharitable-use assets. Subtract line 4 from line 3 . Enter here and on Part V, line 4 . . . . . 5 14 1 380 , 142 . 6 Minimum investment return . Enter 5% of line 5 .

    . 6 719 , 007 .

    Pert XI ~ DI5t1'IbUtBble Amount (see instructions) . (Section 49420)(3) and 0)(5) private operating foundations and certain foreig n or ganizations check here ~ and do not coin lete this art .

    1 Minimum investment return from Part X, line 6 . . . . . . . . . . . . . . . . . . . 1 719 , 007 . 2a Tax on investment income for 2004 from Part VI, line 5 . . 2a 3 , 982 . b Income tax for 2004 . (This does not include the tax from Part VI ) . . . . . . 2b ' c Add lines 2a and 2b . . . . . . . . . . . . . . . . , . . , . . . . . . . 2c 3,982 .

    3 Distnbutable amount before adjustments . Subtract line 2c from line 1 . . . . . . . . . . . . . . . . . . 3 715 , 025 . 4 Recoveries of amounts treated as qualifying distributions . . . . . . . . . . . . . . . . . . 4 5 Add lines 3 and 4 . . . . . . . . . . . . . . . . . , . . . . . . . . 5 715 , 025 . 6 Deduction from distnbutable amount (see instructions) . . . . . . . . . . . 6 7 Distributable amount as ad j usted . Subtract line 6 from line 5 . Enter here and on Part XIII, line 1 7 715,025 .

    Part XII 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 . . . . . . . . . . . . . . . . . . . . 1 a 735 , 606 . b Program-related investments - total from Part IX-B . . . . . . . . . . . . . . 1 b 0 .

    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) . . . . . . . . . . . . . . 3a b Cash distribution test (attach the required schedule) . . . . . . . . 3 b

    4 Qualifying distributions . Add lines la through 3b . Enter here and on Part V, line 8, and Part XIII, line 4 . . . 4 735 , 606 .

    5 Organizations that qualify under section 4940(e) for the reduced rate of tax on net investment income . Enter 19'0 of Part I, line 27b (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 3 , 982 .

    6 Adjusted qualifying distributions. Subtract line 5 from line 4 . . . . . . . . . . . . . . . . , . . . . . ~ 6 ~ 731,624 .

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

    BAA Form 990-PF (2004)

  • Form 990-PF (2004) Dr . & Mrs . Arthur William Phillips Charitable Trust 25-6201015 I Page 8

    Part XIII Undistributed Income see instructions)

    a b c Corpus Years prior to 2003 2003

    1 Distnbutable amount for 2004 from Part XI, -line 7 . . .

    . _ , - -- 2 Undistributed income, if any, as of the end of 2003 : a Enter amount for 2003 only 0 .

    (d) 2004

    715,025 .

    y*_ . .

    b Total for prior years : 20-, 20-, 20-3 Excess distributions carryover, d any, to 2004 a From 1999 . . . . 0 b From 2000 0

    ;. ., . . .,

    c From 2001 . . . . . . . . . . 0 . . d From 2002 0

    064 e From 2003 . . . . . . . . 83 , 064 . " f Total of lines 3a through e . . . . . . . . ,83 064 . 1 ̀ ~1 "~~ '

    F;, . .Y ,J

    4 Qualifying distributions for 2004 from Part X11, line 4: 1" $ 735,606 .

    - " t ` r" " A

    a Applied to 2003, but not more than line 2a

    bApplied to undistributed income of prior years . (Election required - see instructions) . . . . . . . .

    c Treated as distributions out of corpus 41 -A" 1

    (Election required - see instructions) _ :-t A_ . :hb'~''.~, d Applied to 2004 distnbutable amount 631 , 961 . e Remaining amount distributed out of corpus 103 645 .

    5 Excess distributions carryover applied to 2004 . . 83 064 . -~~~'. ;- - '"~ 83 064 . (If an amount appears in column (d), the same amount must be shown in column (a) '",air=.re;' ' .,K_.os-u r?''"'t:,

    n 6 Enter the net total of each column as

    indicated below : a Corpus. Add lines 3f, 4c, and 4e Subtract line 5 103 645 . '

    b Prior years' undistributed income . Subtract line 4b from line 2b - ~ 0 .

    c Enter the amount of prior years' undistribut- =,-A ~ ed income for which a notice of deficiency has been issued, or on which the section 4942(a) tax has been previously assessed

    d Subtract line 6c from line 6b . Taxable amount - see instructions 0 .

    e Undistributed income for 2003 . Subtract line 4a from line 2a . Taxable amount - see instructions 0 .

    ( Undistributed income for 2004 Subtract lines 4d and 5 from line 1 . This amount must be distributed in 2005 . . . . . . . . . . . 0 .

    7 Amounts treated as distributions out of l corpus to satisfy requirements imposed -- - . - - y - t-,, by section 170(b)(1)(E) or 4942(8)(3) (see instructions) - - 't - I

    t, ;. . 8 Excess distributions carryover from 1999 not

    applied on line 5 or line 7 (see instructions) __ O .

    9 Excess distributions carryover to 2005 . Subtract lines 7 and 8 from line 6a . . . 103 , 645 .

    10 Analysis of line 9 : a Excess from 2000 . 0 ' .ft. b Excess from 2001 . . 0 . .~

    �, ' .

    c Excess from 2002 . 0 -- d Excess from 2003 0 ' ' 71'~ . { e Excess from 2004 103,645 .

    BAA Form 990-PF (2004)

    TEEA0308 07/29/04

  • r 25-6201015 Paae 9 liam Phi r

    N/A art XIV I Private operating Foundations (see instructions and Part VII-A, question 9) 1 a If the foundation has received a ruling or determination letter that it is a private operating foundation, and the ruling

    is effective for 2004, enter the date of the ruling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Check box to indicate whether the orgarnzation is a private operating foundation described in section 4942 (j)(3 ) or

    2a Enter the lesser of the adjusted net Tax ear Prior 3 ears income from Part I or the minimum 2004 b 2003 c 2002 2001 investment return from Part X for a each year listed . . . .

    b 85% of line 2a . . . . . . . . . c Qualifying distributions from Part XIf,

    line 4 for each year listed . . . . . . . d Amounts included in line 2c not used directly

    for active conduct of exempt activities . . . . . . e Qualifying distributions made directly for active conduct of exempt activities . Subtract line 2d from line 2c . . . . . .

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

    a 'Assets' alternative test - enter : (1) Value of all assets . . . . . . . . . . . . . . . . (2) Value of assets qualifying under

    section 4942Q)(3)(B)(i) . . . . . . . . . . b 'Endowment alternative test - Enter 2/3 of minimum investment return shown m Part X, line 6 for each year listed . . . . . . . . . . . . . . .

    c 'Support alternative test - enter : (1) Total support other than gross

    investment income (interest, dividends, rents, payments on securities loans (section 512(a)(5)), or royalties) . . . . .

    d Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other factors : PREFERENCE GIVEN TO NORTHWESTERN PENNSYLVANIA . ALSO PREFERRED ARE ORGANIZATIONS HAVING MEDICAL OR EDUCATIONAL PURPOSES .

    BAA TEEno3as o7izsioa Form 990-PF (2004)

    (2) Support from general public and 5 or more exempt organizations as provided m section 4942(Ix3xB#i) . . . . . . . .

    (3) Largest amount of support from an exempt organization . . . . . . . . .

    4 Gross investment income 31't X/ ~ Su pplementary Information complete this art onl y if the organization had E5,000 or more in assets at an time durin g the ear. 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) .) 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 of a partnership or other entity) of which the foundation has a 10% or greater interest . NONE

    2 Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc, Programs : Check here 11 a if the organization only makes contributions to preselected charitable organizations and does not accept unsolicited requests 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 : BERTA WINTERS, ADMINISTRATIVE ASSISTANT DR . & MRS . ARTHUR WILLIAM PHILLIPS CHARITABLE TRUST, P .O . BOX 316 OIL CITY PA 16301-0316 (814) 676-2736

    b The form in which applications should be submitted and information and materials they should include : NO SPECIFIC FORM REQUIRED . REQUESTS MUST BE SUBMITTED IN TRIPLICATE, & INCLUDE A BRIEF HISTORY OF THE ORGANIZATION, ANNUAL BUDGET, COPY OF IRS 501(C)3 TAX EXEMPTION CERTIFICATE .

    c Any submission deadlines : NONE

  • Form 990-PF (2004 Dr. & Mrs . Arthur William Phillip s Charitable Trust 25-6201015' Page 10 Part XV' Supplementary Information (continued)

    BAA TEEt+031o 07129104 Form 990-PF (2004)

  • r ,. rForm990-PF (2004) Dr . & Mrs . Arthur William Phillips Charitable Trust 25-6201015 Page 11

    Pan XVI-A Analysis of Income-Producing Activities

    a b c d e f g Fees and contracts from government agencies

    2 Membership dues and assessments 3 Interest on sarongs and temporary cash investments 4 Dividends and interest from securities 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 Gam 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 :

    181 -29 .021 .

    a b c d e

    12 Subtotal . Add columns (b), (d), and (e) 426,079 .1 13 Total . Add line 12, columns (b), (d), and (e) . . . . . . . . . 13 426,079 . (See worksheet m the instructions for line 13 to verify calculations )

    Part XVI-B Relationship of Activities to the Accomplishment of Exempt Purposes

    BAA TEEA0501 07129104 Form 990-PF (2004)

    Enter gross amounts unless otherwise indicated

    1 Program service revenue .

    Unrelated business income Excluded b section 512, 513, or 514 (a) (b) (c) (d) (e)

    Business Amount Exclu- Amount Related or exempt code sion function income

    code (see instructions)

    14 1 , 157 . 14 453 .943 .

  • 2a Is the organization 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a Yes Q No

    b If 'Yes .' complete the following schedule . of Name of orqarnzation

    and statements, and to she best of my knowledge and belief, it is true, correct, and

    S . ~ (/

  • DR. & MRS. ARTHUR WILLIAM PHILLIPS CHARITABLE TRUST P.O . Box 310

    229 ELM STREET

    OIL CITY, PENNSYLVANIA 18301

    TRUSTEES

    EDITH G. LETCHER

    ROBERT W. MCFATE TELEPHONE

    r~+aRY s. ADAMS December 14, 2005 (814) 070-2730

    Internal Revenue Service Ogden, UT 84201-0027

    Gentlemen :

    Enclosed is the Annual Return of Private Foundation, Form 990-PF, for the Dr . & Mrs . Arthur William Phillips Charitable Trust, 229 Elm Street, Oil City, PA, 16301, TIN #25-6201015 . This Return covers the 2004 tax year from October l, 2004 to September 30, 2005 . The tax as shown on the return has been paid, and a refund is due us in the amount of $8,018 .00 .

    Sincerely,

    Berta Winters Administrative Assistant

    lbw Enclosure

  • 02/01/05 George Junior Republic - Assist with Campus $ 25,000 .00 Fiber-Optic Infrastructure Project

    Box 1058, Grove City, PA 16127-5058

    02/01/05 Make-A-Wish Foundation - Fulfill the Wishes of Two $ 6,800 .00 Children from Venango and Clarion Counties

    555 Grant Street, Suite 425, Pittsburgh, PA 15219-4408

    02/01/05 Penn State Shenango - Assist with Campus Renovation $ 50,000 .00 Project

    147 Shenango Avenue, Sharon, PA 16146-1597

    02/01/05 St . Petersburg Volunteer Fire Company - Assist with $ 7,500 .00 Purchase of Used Fire Truck

    P .O . Box 81, St . Petersburg, PA 16054

    02/01/05 Special Olympics Pennsylvania - Underwrite Cost of $ 4,136 .00 Sending 11 Venango & Forest County Athletes to the 2005 Winter Games

    150 Pleasant Drive, Suite 104, Aliquippa, PA 15001

    02/01/05 Sugar Valley Lodge - Food Purchases for Residents $ 40,000 .00 with Inadequate Income

    323 Causeway Drive, Franklin, PA 16323

    02/01/05 Venango Museum of Art, Science & Industry - Assist $ 2,500 .00 with Project to Catalogue & Inventory Items in Collection

    274 Seneca Street, Oil City, PA 16301

    02/01/05 Keystone Tall Tree Girl Scout Council - Construct $ 18,000 .00 Gun Safety and Rifle Range at Singing Hills

    R .D . #7, Box 358, Kittanning, PA 16201-7404

    06/09/05 ABC Crisis Pregnancy Center - Renovations at New $ 1,000 .00 Location

    1243 Liberty Street, Suite 423, Franklin, PA 16323

    06/09/05 Association of Small Foundations - Annual Fund Drive $ 250 .00 to Support Education and Public Policy

    33 Wild Berry Lane, PO Box 117, Underhill, VT 05489

    06/09/05 Clarion University, Venango Campus - Assist with $ 80,000 .00 Construction of Third Student Apartment Building

    1801 West First Street, Oil City, PA 16301

    06/09/05 Community Services of Venango County - Assist with $ 7,500 .00 Building Improvements at 203 Center Street Site

    206 Seneca Street, Oil City, PA 16301

    06/09/05 DeBence Antique Music World - Purchase and Installation $ 4,000 .00 of New Cold Air Ducts at Museum

    1261 Liberty Street, Franklin, PA 16323 _,

    06/09/05 Oil City Presbyterian Home - Dining/Activity Room $ 21,000 .00 Renovations

    10 Vo-Tech Drive, Oil City, PA 16301

    ia-aa r111LIL11tJ ~.i1CliCiltfGLG 1RV~71 1V/ 1/ V 1V V7/ .7 V/ V 7

    i

    #25-6201015 PART XV - LINE 3A CHARITABLE GRANTS PAID

    02/01/05 Emlenton Area Ambulance Service - Assist with Relocation $ 10,000 .00 to Separate Quarters for Ambulance Crew --

    P .0 . Box 346, Emlenton, PA 16373

    02/01/05 Emlenton Volunteer Firemans Association - Assist with $ 35,000 .00 Purchase of a 2002 Spartan Heavy Rescue Truck

    Emlenton, PA 16373

  • DR . & MRS . ARTHUR WILLIAM PHILLIPS CHARITABLE TRUST - 10/1/04 TO 09/30/05

    #25-6201015 PART XV - LINE 3A con't CHARITABLE GRANTS PAID

    $ 3,600 .00

    $ 10,000 .00

    $ 6,000 .00

    $ 10,000 .00

    $ 30,000 .00

    $ 10,000 .00

    $ 750 .00

    $ 100,000 .00

    $ 4,686 .00

    $ 7,000 .00

    $ 15,500 .00

    $ 5,000 .00

    $ 2,500 .00

    $ 200,000 .00

    $ 717 .722 .00 TOTAL GRANTS PAID

    06/09/05 St . Elizabeth Center - Purchase Cargo Trailer for Use at Food Pantry

    c/o Terry Schmader, 620 Sawtown Road, Oil City, PA 16301

    06/09/05 St . Paul Homes - Assist with Purchase of Adaptive Computer System

    339 East Jamestown Road, Greenville, PA 16125

    06/09/05 Salvation Army - Oil City - Assist with Transportation Costs for Summer Youth Programs

    217 Sycamore Street, PO Box 282, Oil City, PA 16301

    06/09/05 University of Pittsburgh at Titusville - Purchase Equipment for Nursing Laboratory

    504 East Main Street, PO Box 287, Titusville, PA 16354

    06/09/05 Oil City Area YMCA - Assist with Feasibility Study and Pool Lighting Projects

    7 Petroleum Street, Oil City, PA 16301

    06/09/05 Venango County Humane Society - Assist with Construction of Dog Quarantine Kennels

    P .O . Box 1045, Oil City, PA 16301

    06/09/05 City of Oil City / Oil City Arts Council - Assist with Performance Costs for Oil Heritage Festival

    21 Seneca Street, Oil City, PA 16301

    06/09/05 Penn State Erie, The Behrend College - Matching Trustee Scholarship Endowment

    -5091 Station Road, Erie, PA 16563-G307

    09/20/05 Special Olympics Pennsylvania - Underwrite Costs of Sending 18 Athletes to 2006 Summer & Fall Games

    150 Pleasant Drive, Suite 104, Aliquippa, PA 15001

    09/20/05 United Negro College Fund - Annual Campaign P .O . Box 1789, Pittsburgh, PA 15230-1789

    09/20/05 Venango Catholic High School - Assist with Purchase of of a Small Bus

    1505 West First Street, Oil City, PA 16301

    09/20/05 Venango County Association for the Blind - Purchase Eye Screening Equipment, Educational Literature, Computer

    3035 State Rt . 257, P.O . Box 515, Seneca, PA 16346

    09/20/05 WQLN Public Broadcasting of Northwest PA - Renewal Grant to Support Performing Arts Programming

    8425 Peach Street, Erie, PA 16509-4788

    09/20/05 Clarion University of PA - Scholarship Endowment 1801 West First Street, Oil City, PA 16301

  • Copies of the orders of court are attached .

    Reminder Notes and Narratives

    Dr. & Mrs. Arthur William PhilliDS Charitable Trust 25-6201015

    Form 990-PF, p4: Line 3 Yes

    A petition was filed and approved by the Court to appoint a Successor Trustee due to the death of William J . McFate, Trustee who died on September 20, 2004. His successor is Robert W. McFate.

    A petition was filed and approved by the Court to appoint a Successor Trustee due to the death of William E . Breene, Trustee who died on March 16, 2005 . His successor is Larry S . Adams.

  • (-C~11 (all Ply i In the Court of Common Pleas of Venango County, Pennsylvania Orphans' Court Division R .D . No . 217 of 1974 O .C .D. No . 141 - 1980

    been originally named as a Trustee by thi.decedent .

    C0M0M=Tff OF PMSTL~ANIA

    UK TOMW

    C4ir~fikcl'ftom thlo/x~lcvTds of the Orphans' CoiKt of Comon Pleas of tlii, ILf6resixid, C06ty . Witness my hand . aid the seal of said Court this 17TH day of IqOVFMER,_ A. D. 2004

    CLM

    7

    IN THE JMATT33R OF TBE ESTATE OF

    ARTHUR WILLIAM PHILLIPS

    DECEUED.

    Q.Em OF

    NOW. this day of NOVeML 200_4 upon cotisider~

    ation of the within Petition for the Appointment of a SuceJessor =in

    Co-Trustee, Robert W. Mcrate is hereby appointed as a Co-Trustee

    of the Trust under the Last Will and Testament of Dr . Arthur

    William Phillips, )Mown as the Dr . and Mrs. Arthur William

    Phillips Charitable Trust, to serve without bond and in all

    respects and with all the authority and duties as though he had

  • Phillips, known as the Dr . and Mrs . Arthur William Phillips

    Charitable Trust, to serve without bond and in all respects and

    with all the authority and duties as though he had been origina-

    lly named as a Trustee by the decedent .

    7

    IN THE MATTER OF THE ESTATE OF In the Court of Common Pit2w of Venango County, Pennsylvania

    ARTHUR WILLIAM PHILLIPS Orphans' Court Division R .D . No . 217 of 1974

    DECEASED . O .C .D . No . 141 1980

    ORDER QF COURT 7'

    NOW, this day of 200,%' upon consider-

    ation of the within Petition for the Appointment of a Successor

    Co-Trustee, Larry S . Adams is hereby appointed as a Co-Trustee of

    the Trust under the Last Will and Testament of Dr . Arthur William

    C0bfNONWE11Z7'R OF

    Co" OF VEIVANco Cert tfted from

    § Court Z), the records of th of t e s on Of the C e Or W1 8 ore ta , Ourt of tness r - %,Ount Phansr this ly

    a y. Common Pleas 2

    1 S7, hand and the A. D . day Of seal of No said C t

    ERK 71

  • I Dr . & Mrs . Arthur William Phillips Charitable Trust 25-6201015 1

    Form 990-PF, Page 1, Part 1, Line 16a L-16a Stmt

    Line 16a - Legal Fees: Name of Provider Type of Service Provided I Amount Paid

    ROBERT W McFATE -JANNUAL RETAINER-2004 TAX YEAR_j 3,500 .

    Line 16b - Accounting Fees: Name of Provic I Type of Service Provided Amount Paid

    MELLON BANK -JANNUAL COMPENSATION-2004 TAX YEAR 1 14,490 .

    14,490 . Total

    Dr . & Mrs. Arthur William Phillips Charitable Trust 25-6201015 1

    Form 990-PF, Page 1, Part 1, Line 18 Line 18 Stmt

    Taxes : (see instructions) Rev/Exp Book Net Inv Inc Adi Net Inc Charitv Disb ESTIMATED EXCISE TAX PAYMENTS 12,000 . 2005 REAL ESTATE TAXES 18 . 18, BCE, INC . FOREIGN TAX 305 . 305 .

    323 . Total 12,323 .

    Other expenses : Rev/Exp Book Net Inv Inc Adi Net Inc Charity Disb ASSOC OF SMAIL FOUNDATIONS DUES 400 . 400 . TAX PREP SOFTWARE 107 . 107 . D & 0 LIABILITY INSURANCE 1,625 . 1,625 . FILING FEES FOR PETITIONS 56 . 56 .

    Total 2,188 . 2,188 .

    Total

    Form 990-PF, Page 1, Part 1, Line 16b L-16b Stmt

    3,500 .

    Form 990-PF, Page 1, Part 1, Line 23 Line 23 Stmt

  • End of Year Line 1 Oa - Investments - Book Fair Market

    US and State Government Obligations : Value I Value

    US TREASURY NOTES 3 .125% DUE 10/15/2008 1,986,015 . 1,939,380 . US TREASURY NOTES 5 .75* DUE 08/15/2010 1,117,578 . 1,066,520 . FEDERAL HOME LOAN BANK 5 .125% DUE 03/06/2006 531166 . 50,235 . FEDERAL HOME LOAN MTG 5 .75% DUE 03/15/2009 218,796 . 208,000 .

    3,375,555, 3,264,135 .

    Form 990-PF, Page 2, Part 11, Line 10b L-10b Stmt

    End of Year Line 10b - Investments - Corporate Stock: Book Fair Market

    I Value I Value

    43,630 . 315,413 . 54,880 .

    181,996 . 356,021 . 192,480 .

    1,122,807 . 333,075 . 139,820 . 123,200 . 19,276 . 92,960 . 3,856 .

    296,925 . 29,578 . 97,240 . 14,091 . 29,196 . 2,558 .

    214,080 . 30,000 . 86,038 .

    1,929,583 . 23,103 . 25,615 . 96,400 . 61,220 . 36,897 .

    581, 56 . 37,210 . 15,435 . 42,500 . 8,185 . 716 0 .

    120,630 . 116,040 . 223 206 . 82 698 .

    36,842 . 65, 368 L-34,710* 76,266 . 29,874s

    ill, 0010 77,790w 80,0006 5,388 .

    45,785 . 2,298 . 6,371s 5,484 .

    94,627 . 11,499 . 84,398 . 10,075 . 40,299 . 14, 188a 53,980 . 12,857 . 8,201 .

    55,307 . 11,630 . 11,166 . 52,689 . 27, 732L.. 3,901 .

    31, 869 2,388 1,077 .

    12,625 . 3, 175o 3,175 .

    60,115 . 46 875 . 26, 969 42,313

    AMERICAN ELECTRIC POWER - 1,099 SHS BANK OF AMERICA CORP - 7,492 SHS BCE INC - 2,000 SHS BELL SOUTH CORP - 6,920 SHS BP PLC - 5,025 SHS BRISTOL MYERS SQUIBB - 8,000 SHS CHEVRON CORP - 17,346 SHS CINERGY CORP - 7,500 SHS CONOCOPHILLIPS CO - 2,000 SHS CONSTELLATION ENERGY - 2,000 SHS CHEMTURA CORP - 1,552 SHS CSX CORP - 2,000 SHS DELPHI CORP - 1,397 SHS DOMINION RESOURCES INC VA NEW- 3,447 SHS DUKE ENERGY CORP - 1,014 SHS DUPONT EI DENEMOURS $4 .50 CUM PFD - 1,105 SHS EASTMAN CHEMICAL CO - 300 SHS EASTMAN KODAK CO - 1,200 SHS EL PASO CORP - 184 SHS ELI LILLY AND CO - 4,000 SHS EMCLAIRE FINANCIAL CORP - 1,000 SHS EXELON CORP - 1,610 SHS EXXON MOBIL CORP - 30,368 SHS FNB CORP - 1,337 SHS FIFTH THIRD BANCORP - 697 SHS GENERAL MILLS INC - 2,000 SHS GENERAL MOTORS CORP - 2,000 SHS MONSANTO CO NEW - 588 SHS NATIONAL CITY CORP - 17,400 SHS NATIONAL FUEL GAS CO - 1,088 SHS NORTHROP GRUMMAN CORP - 284 SHS NORTHWEST BANCORP INC PA - 2,000 SHS OHIO EDISON CO 4 .40% CUM PFD - 100 SHS PECO ENERGY $3 .80 PFD - 100 SHS PFIZER INC CORP - 4,831 SHS PNC FINANCIAL SERVICES - 2,000 SHS PPL CORP - 6,904 SHS PROGRESS ENERGY INC - 1,848 SHS

    IF Dr . & Mrs . Arthur William Phillips Charitable Trust 25-6201015 2 1.

    Form 990-PF, Page 2, Part 11, Line I Oa L-1 Oa Strnt

    Total

  • 25-6201015

    Continued Form 990-PF, Page 2, Part 11, Line I Ob L-1 Ob Stmt

    End of Year Line 1 Ob - Investments - Corporate Stock: Book Fair Market

    I Value I Value

    9,181,165 . 1,711,920 .

    Line 1 Oc - Investments - Corporate Bonds: Book Fair Market Value I Value

    GENERAL ELECTRIC CAP CORP 6 .8% DUE 11/01/2005 54,380 . 50,103 . BANKAMERICA CORP 5 .875% DUE 02/15/2009 27,403 . 25,921 . PHILLIPS PETROLEUM 8 .75* DUE 05/25/2010 31,219 . 29,230 .

    End of Year Book Fair Market Value I Value

    Line 13 - Investments - Other:

    GOLD COINS 1 1,840 .1 31950 .

    Total 1,840 . 3,950 .

    Form 990-PF, Page 2, Part 11, Line 15 Other Assets Stmt

    End of Year Book Fair Market Value I Value

    Line 15 - Other Assets :

    MELLON CASH MGMT RESERVE - Income Cash 101,895* 101,895 . MELLON CASH MGMT RESERVE - Principal Cash d 1, 935, 138 . 1,935,138 .

    Total 2,037,033 . 2,037,033 .

    Dr . & Mrs. Arthur William Phillips Charitable Trust

    PUBLIC SERVICE ENTERPRISE GROUP - 463 SHS QUESTAR CORP 10,000 SHS RAYTHEON CO 127 SHS SBC COMMUNICATIONS INC - 7,343 SHS SOUTH JERSEY INDUSTRIES INC - 2,400 SHS SOUTHERN CO - 2,400 SHS TXU CORP - 1,500 SHS UGI CORP NEW - 3,600 SHS VERIZON COMMUNICATIONS - 5,944 SHS WACHOVIA CORP - 5,000 SHS XCEL ENERGY INC - 2,208 SHS

    Total

    Form 990-PF, Page 2, Part 11, Line 10c L- 10c Strnt

    3,781 . 34,453 . 1,862 .

    69,616 . 26,417 . 25,046 . 67,238 . 24,316 .

    102,461 . 8,198 .

    48,225 .

    29,799 . 881,200 . 4,828 .

    176,012 . 69,936 . 85,824 .

    169,320 . 101,340 . 194,309 . 237,950 . 43,299 .

    End of Year

    Total

    Form 990-PF, Page 2, Part 11, Line 13 L-13 Strrit

    113,002 . 105,254 .

  • ADDITION TO PRINCIPAL - DYNEGY/ENRON CLASS ACTION PROCEEDS 162 .

    FRACTIONS OF CENTS 1 .

    Total 163 .

    Dr . & Mrs . Arthur William Phillips Charitable Trust 25-6201015

    Form 990-PF, Page 2, Part 111, Line 3 Other Increases Strnt