Form Schedule D (Form 9 Schedule D (Form 9 Supplemental Financial Statements

SCHEDULE D
(Form 990)

OMB No. 1545-0047

Supplemental Financial Statements


Department of the Treasury
Internal Revenue Service



Open to Public
Inspection

Attach to Form 990.  See separate instructions.

Name of the organization

Part I

2009

Complete if the organization answered “Yes,” to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.

Employer identification number

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if
the organization answered “Yes” to Form 990, Part IV, line 6.
(a) Donor advised funds

(b) Funds and other accounts

1
2
3
4
5

Total number at end of year
Aggregate contributions to (during year)
Aggregate grants from (during year)
Aggregate value at end of year
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization’s property, subject to the organization’s exclusive legal control?

Yes

No

6

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other
purpose conferring impermissible private benefit?

Yes

No

Part II
1

2

Conservation Easements. Complete if the organization answered “Yes” to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).
Preservation of an historically important land area
Preservation of land for public use (e.g., recreation or pleasure)
Preservation of a certified historic structure
Protection of natural habitat
Preservation of open space
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation
easement on the last day of the tax year.
Held at the End of the Tax Year

a
b
c
d
3
4
5
6

Total number of conservation easements
Total acreage restricted by conservation easements
Number of conservation easements on a certified historic structure included in (a)
Number of conservation easements included in (c) acquired after 8/17/06

2a
2b
2c
2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year 
Number of states where property subject to conservation easement is located 
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of
violations, and enforcement of the conservation easements it holds?
Yes
No
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year


7

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year


8
9

$

Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)?
No
Yes
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered “Yes” to Form 990, Part IV, line 8.

1a If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of

art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,

historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:

$
(i) Revenues included in Form 990, Part VIII, line 1

$
(ii) Assets included in Form 990, Part X
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:

$
a Revenues included in Form 990, Part VIII, line 1

$
b Assets included in Form 990, Part X

2

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2009

Page 2
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Schedule D (Form 990) 2009

Part III

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its
collection items (check all that apply):

3

a
Public exhibition
d
Loan or exchange programs
e
b
Other
Scholarly research
c
Preservation for future generations
4 Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in

Part XIV.
During the year, did the organization solicit or receive donations of art, historical treasures, or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?

5

Part IV

Yes

No

Escrow and Custodial Arrangements. Complete if the organization answered “Yes” to Form 990, Part
IV, line 9, or reported an amount on Form 990, Part X, line 21.

1a Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not

included on Form 990, Part X?

Yes

No

Yes

No

b If “Yes,” explain the arrangement in Part XIV and complete the following table:
Amount
c
d
e
f
2a
b

1c

Beginning balance
Additions during the year
Distributions during the year
Ending balance
Did the organization include an amount on Form 990, Part X, line 21?
If “Yes,” explain the arrangement in Part XIV.

Part V

1d
1e
1f

Endowment Funds. Complete if the organization answered “Yes” to Form 990, Part IV, line 10.
(a) Current year

(b) Prior year

(c) Two years back

(d) Three years back

(e) Four years back

1a Beginning of year balance
b Contributions
c Net investment earnings, gains,

and losses
d Grants or scholarships
e Other expenditures for facilities

and programs
f Administrative expenses
g End of year balance

Provide the estimated percentage of the year end balance held as:
%
Board designated or quasi-endowment 
Permanent endowment 
%
%
Term endowment 
3a Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:
(i) unrelated organizations
(ii) related organizations
b If “Yes” to 3a(ii), are the related organizations listed as required on Schedule R?
4 Describe in Part XIV the intended uses of the organization’s endowment funds.
2
a
b
c

Part VI

Yes

No

3a(i)
3a(ii)
3b

Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment

(a) Cost or other basis
(investment)

(b) Cost or other
basis (other)

1a Land
b Buildings
c Leasehold improvements
d Equipment
e Other
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)

(c) Accumulated
depreciation

(d) Book value



Schedule D (Form 990) 2009

Schedule D (Form 990) 2009

Part VII

Page

3

Investments—Other Securities. See Form 990, Part X, line 12.

(a) Description of security or category
(including name of security)

(b) Book value

(c) Method of valuation:
Cost or end-of-year market value

Financial derivatives
Closely-held equity interests
Other

Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.) 

Part VIII

Investments—Program Related. See Form 990, Part X, line 13.

(a) Description of investment type

Total. (Column (b) must equal Form 990, Part X, col. (B) line 13.)

Part IX

(b) Book value

(c) Method of valuation:
Cost or end-of-year market value



Other Assets. See Form 990, Part X, line 15.
(a) Description



Total. (Column (b) must equal Form 990, Part X, col. (B) line 15.)

Part X

(b) Book value

Other Liabilities. See Form 990, Part X, line 25.

1.
(a) Description of liability
Federal income taxes

Total. (Column (b) must equal Form 990, Part X, col. (B) line 25.)

(b) Amount



2. FIN 48 Footnote. In Part XIV, provide the text of the footnote to the organization’s financial statements that reports the
organization’s liability for uncertain tax positions under FIN 48.
Schedule D (Form 990) 2009

Page

Schedule D (Form 990) 2009

Part XI
1
2
3
4
5
6
7
8
9
10

Total revenue (Form 990, Part VIII, column (A), line 12)
Total expenses (Form 990, Part IX, column (A), line 25)
Excess or (deficit) for the year. Subtract line 2 from line 1
Net unrealized gains (losses) on investments
Donated services and use of facilities
Investment expenses
Prior period adjustments
Other (Describe in Part XIV.)
Total adjustments (net). Add lines 4 through 8
Excess or (deficit) for the year per audited financial statements. Combine lines 3 and 9

Part XII
1
2
a
b
c
d
e
3
4

a
b
c
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.)
1
2
a
b
c
d
e
3
4
a
b
c
5

1

2e
3

4c
5

Reconciliation of Expenses per Audited Financial Statements With Expenses per Return

Total expenses and losses per audited financial statements
Amounts included on line 1 but not on Form 990, Part IX, line 25:
Donated services and use of facilities
Prior year adjustments
Other losses
Other (Describe in Part XIV.)
Add lines 2a through 2d
Subtract line 2e from line 1
Amounts included on Form 990, Part IX, line 25, but not on line 1:
Investment expenses not included on Form 990, Part VIII, line 7b
Other (Describe in Part XIV.)
Add lines 4a and 4b
Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I,

Part XIV

1
2
3
4
5
6
7
8
9
10

Reconciliation of Revenue per Audited Financial Statements With Revenue per Return

Total revenue, gains, and other support per audited financial statements
Amounts included on line 1 but not on Form 990, Part VIII, line 12:
2a
Net unrealized gains on investments
2b
Donated services and use of facilities
2c
Recoveries of prior year grants
2d
Other (Describe in Part XIV.)
Add lines 2a through 2d
Subtract line 2e from line 1
Amounts included on Form 990, Part VIII, line 12, but not on line 1:
4a
Investment expenses not included on Form 990, Part VIII, line 7b
4b
Other (Describe in Part XIV.)
Add lines 4a and 4b

Part XIII

4

Reconciliation of Change in Net Assets from Form 990 to Audited Financial Statements

1
2a
2b
2c
2d
2e
3
4a
4b
line 18.)

4c
5

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part IV, lines 1b
and 2b; Part V, line 4; Part X, line 2; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete
this part to provide any additional information.

Schedule D (Form 990) 2009

Schedule D (Form 990) 2009

Part XIV

Page

5

Supplemental Information (continued)

Schedule D (Form 990) 2009