21
Form 990 Return of Organization Exempt From Income Tax Under section 507(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung oepanmeni of one Treasury benefit trust or private foundation) infemni a~oiia saM n I " The organization may have to use a copy of this return to satisfy slate reporting requirements A For the 201 Cre« n a~qe ~aa~m ~tiro . wine ~mqe ~wbi mwn O FIN~~ "lun /~me~d<E r ~oo~nen oem~~y N CATHOLIC D Employer identification number 16-1549436 E Telephone number /iLCWn1Yp ~n.a Cas, nccniai Name of organization 008163 City or town stale a country, and ZIP + 4 IWICH . NY 13815 dons and I are not applicable to section 527 organizations a) Is this a group return for alfiliaies7 F-l Yea O Na 0) If'Yes'enternumber olaffiliates Ile i) Are all affiliates included? EN .- . D No (IT 'NO' atuith a list See instructionsT d) Is this a seoarale raWm 1190 oy an ~~ ~~ oraamzaemm~eebvaarouonilino7l IYes I tilNo ~ Section 501(c)(7) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A (Form 990 a 990-EZ) ac wan site " N / A 1 ~`J organization type (checkonly one)Is, X 501(c)10 3 ) " (msenno ) 4947(a)(t)or 527 Q Check hem 1 if the organizations gross receipts am normally not more than 525000 The i organization need not rile a return with the IRS but if the organizatsm received a Form, 990 Package 21' in the mail it should flea return without financial data Some stales require a complete return pi Gross receipts Add lines 61b 8b 9b and 10b to line 12 le 51, 8 17 I Enter 4-digit GEN M Check Is, LX to attach Sch B 1 if the organization is not required Foam 990 990 EZ or 990-PF) Revenue Ex enses and Chan ges in Net Assets or Fund Balances ( See p age 17 of the instructic 1 Contributions, gifts, grants and similar amounts received a Direct public support 1 a 19 , 062 b Indirect public support 1 b t Government contributions (grants) , , , , , , 1 t d Total ( .do lines la mrouBh IC) Iwsn S nonmsn S ) 1 d 1 9 , 062 2 Program service revenue including government fees and contracts (from Part VII, line 93) 2 3 Membership dues and assessments . . , , , , , , , 3 4 Interest on savings and temporary cash investments STMT 1 . . . , , 4 288 5 Dividends and interest from securities STMT, 2 5 6 , 498 6 a Gross rents , , , , , , 6a b Less rental expenses 6b t Net rental income or (loss) (subtract line 6b front line 6a) 6c m 7 Other investment income (describe ~ 7 c > 8 a Gross amount from sales of assets other (A) Securities (B) Other than inventory , 25 , 969 Ba ,~ b Less cost or other basis and sales expenses , 29,894 8 b c Gain or (loss) (attach schedule) -3,925 . so E d Net gam or (lass) (combine line 8c columns (A) and (B)) , 8d -3,925 9 Special events and activities (attach schedule) a Gross revenue (not including $ of contributions reported on line 1a) , , 9a CTn b Less direct expenses other khan fundraising expenses , , 9b . . ~O c Net income or (loss) from special events (subtract line 9b from line 9a) 9c 10a Gross sales of inventory, less returns and allowances Da l O b Less cost of goods sold , , , , , on c Gross profit or (loss) from sales of inventory (attach schedule) (subtract line 10b from line 10a) toc 11 Other revenue (from Part VII line 703) 11 12 Total revenue add lines 1d 2 3 4 5 6c 7 8d 9c 10c and 11 12 21 , 923 1 3 Program services (from line 44 column (B)) , , , , , 1 3 5 ,875 ~p ~~'om line 44, column (C)) 14 1 .012 a 1 5 WAirS~g (7ArtFMie 44, ' lumn (D)) 1 5 16 Payments to affiliates ( schedule) 16 e d iG2 76 and 44 column A 17 6,887 1 Excess or (deficit) (or t 1 a r (subtract line 17 from line 12) 18 15,036 m ,^~ 19 ce at beginning of year (from line 73, column (A)) 19 1$6 , 693 20 Wasset or fund balances (attach explanation) 20 d 21 Net assets or fund balances al end of ear combine lines 18 19 and 20 21 201 , 729 JSA For Paperwork Reduction Act Notice, see the separate instructions Fo"990 (zooa) 7E 1010 1 000 PT2657 564M 08/18/2003 09 51 21 008163 2 S PI .... C us. IRS D label or print or hay See p Number and street (or P O box if mail is not delivered to street address) I Room/suite

PI C CATHOLIC us. IRS D O FIN~~stbartsnorwichny.com/Documents/Financials/Bequests/... · Form 990 Return of Organization Exempt From Income Tax Under section 507(c), 527, or 4947(a)(1)

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Page 1: PI C CATHOLIC us. IRS D O FIN~~stbartsnorwichny.com/Documents/Financials/Bequests/... · Form 990 Return of Organization Exempt From Income Tax Under section 507(c), 527, or 4947(a)(1)

Form 990 Return of Organization Exempt From Income Tax Under section 507(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung

oepanmeni of one Treasury benefit trust or private foundation) infemni a~oiia saM n I " The organization may have to use a copy of this return to satisfy slate reporting requirements

A For the 201 Cre« n a~qe

~aa~m ~tiro . wine ~mqe

~wbi mwn

O FIN~~"lun

/~me~d<E

r ~oo~nen oem~~y

N

CATHOLIC D Employer identification number 16-1549436

E Telephone number

/iLCWn1Yp ~n.a

Cas, nccniai

Name of organization 008163

City or town stale a country, and ZIP + 4 IWICH . NY 13815 dons

and I are not applicable to section 527 organizations

a) Is this a group return for alfiliaies7 F-l Yea O Na

0) If'Yes'enternumber olaffiliates Ile

i) Are all affiliates included? EN.-. D No (IT 'NO' atuith a list See instructionsT

d) Is this a seoarale raWm 1190 oy an ~~ ~~ oraamzaemm~eebvaarouonilino7l IYes I tilNo

~ Section 501(c)(7) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A (Form 990 a 990-EZ)

ac wan site "N / A

1 ~`J organization type (checkonly one)Is, X 501(c)10 3 ) " (msenno ) 4947(a)(t)or 527

Q Check hem 1 if the organizations gross receipts am normally not more than 525000 The

i

organization need not rile a return with the IRS but if the organizatsm received a Form, 990 Package 21' in the mail it should flea return without financial data Some stales require a complete return

pi Gross receipts Add lines 61b 8b 9b and 10b to line 12 le 51, 817

I Enter 4-digit GEN

M Check Is, LX to attach Sch B 1

if the organization is not required

Foam 990 990 EZ or 990-PF)

Revenue Ex enses and Changes in Net Assets or Fund Balances (See page 17 of the instructic 1 Contributions, gifts, grants and similar amounts received a Direct public support 1 a 19 , 062 b Indirect public support 1 b t Government contributions (grants) , , , , , , 1 t

d Total ( .do lines la mrouBh IC) Iwsn S nonmsn S ) 1 d 1 9 , 062 2 Program service revenue including government fees and contracts (from Part VII, line 93) 2

3 Membership dues and assessments . .

, , , , , , , 3 4 Interest on savings and temporary cash investments STMT 1 . . . , , 4 288

5 Dividends and interest from securities STMT, 2 5 6 , 498 6 a Gross rents , , , , , , 6a b Less rental expenses 6b t Net rental income or (loss) (subtract line 6b front line 6a) 6c

m 7 Other investment income (describe ~ 7 c > 8 a Gross amount from sales of assets other (A) Securities (B) Other

than inventory , 25 , 969 Ba ,~ b Less cost or other basis and sales expenses , 29,894 8 b

c Gain or (loss) (attach schedule) -3,925 . so E d Net gam or (lass) (combine line 8c columns (A) and (B)) , 8d -3,925

9 Special events and activities (attach schedule) a Gross revenue (not including $ of

contributions reported on line 1a) , , 9a

CTn b Less direct expenses other khan fundraising expenses , , 9b . . ~O c Net income or (loss) from special events (subtract line 9b from line 9a) 9c

10a Gross sales of inventory, less returns and allowances Da l O b Less cost of goods sold , , , , , on c Gross profit or (loss) from sales of inventory (attach schedule) (subtract line 10b from line 10a) toc

11 Other revenue (from Part VII line 703) 11 12 Total revenue add lines 1d 2 3 4 5 6c 7 8d 9c 10c and 11 12 21 , 923 1 3 Program services (from line 44 column (B)) , , , , , 1 3 5 ,875

~p ~~'om line 44, column (C)) 14 1 .012 a 1 5 WAirS~g (7ArtFMie 44, ' lumn (D)) 1 5

16 Payments to affiliates ( schedule) 16 e d iG2 76 and 44 column A 17 6,887

1 Excess or (deficit) (or t 1a r (subtract line 17 from line 12) 18 15,036 m ,^~ 19 ce at beginning of year (from line 73, column (A)) 19 1$6 , 693

20 Wasset or fund balances (attach explanation) 20 d

21 Net assets or fund balances al end of ear combine lines 18 19 and 20 21 201 , 729

JSA For Paperwork Reduction Act Notice, see the separate instructions Fo"990 (zooa) 7E 1010 1 000

PT2657 564M 08/18/2003 09 51 21 008163 2 S

PI .... C

us. IRS D

label or

print or

hay See p

Number and street (or P O box if mail is not delivered to street address) I Room/suite

Page 2: PI C CATHOLIC us. IRS D O FIN~~stbartsnorwichny.com/Documents/Financials/Bequests/... · Form 990 Return of Organization Exempt From Income Tax Under section 507(c), 527, or 4947(a)(1)

Statement of Program Service Accomplishments (See page 24 of the instructions ) What is the organizations primary exempt purpose? " STMT 5 Program Service

Expenses All organizations must describe their exempt purpose achievements in a clear and concise manner Stale the number (Required lor5oi(c)(a)ane of clients served, publications issued, etc Discuss achievements that are not measurable (Section 507(c)(3) and (4) (^ ) orps and 4947(aK7 ) organizations and 4947(a)(7 ) nonexempt charitable trusts must also enter the amount of grants and allocations to others ) trusts but optional for

others

a 1/3 INC USED FOR STUDENT SCHOLARSHIPS, NEEDS OF THE POOR OR ST PAUL'S CEMETERY AND 213 FOR CONDUCT, MAINTENANCE, -----------------------

CHARITABLE ACTIVITIES DONOR PROMOTION DEVELOPMENT/SUPPORT OF Grants and allocations $ 5,875 ) 5,875

b IS ENGAGED --------------------------------------------------------------------------- ---------------------------------------------------------------------------

(Grants and allocations $ c

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

Grants and allocations $ d

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

--------------------------------------- - Grants and allocations $ ---------------- e Other program services (attach schedule) (Grants and allocations $

JSA 2E1020 1 000 Form 990 (2002)

3 - PT2657 564M 08/18/2003 09 51 21 008163

16-1549436 Form 990 (2002) Page 2

Statemen t of Allorgan izaiions must complate column (A) Columns (B) (C) and(D)arerequired forsection 507(c)(7)and(<)organizations Functional Expenses and section a9a7(a)(7) nonexempt charitable trusts but optional for others (See page 21 otthe instructions )

Do not include amounts reported on line 6b . 8b

gb Job, or 16 of Parf I

(q) Tmal (B) Program (C) Management (D) Fundi34mg serves and ene2l

22 Grants and allocations (attach schedule) ,cas� s 5,815 no� ,,,� s , 22 5,875 5,875

29 Specific assistance to indinduals (attach schedule) 23

24 Benefits paid to or for members (a"wh schedule) 24 25 Compensation of officers, directors, etc 25 777 777 26 Other salaries and wages , 26 27 Pension plan contributions 27 28 Other employee benefits 28 29 Payroll taxes , , , 29 70 Professional fundraising fees 30 37 Accounting fees 37 185 185 32 Legal fees 32 33 Supplies , , , 33 34 Telephone , , 34 35 Postage and shipping , , , , 35 36 Occupancy , , , 36 37 Equipment rental and maintenance 37 98 Printing and publications , , , , , 38 39 Travel 39 40 Conferences, conventions and meetings 40 41 Interest , 47 42 Depreciation depletion etc (attach sUcedule) 42 43 Omerevensesnolcoe~Mabmepiem2e)S TMT 4 43a 50 50

b 3b

c 43c d 3d g 3e

44 Tout functional expenses (add lines 121nroupn 43)

mace mn'i roiinesii~is°lumns (19)-(D), carry 44 6,887 5,875 1,012

Joint Costs Check " d you are following SOP 98-2 Are any point casts from a combined educational campaign and fundraising solicitation reported in (8) Program services) " Yes No If 'Yes,' enter (I) the aggregate amount of these point costs $ " (t0 the amount allocated to Program services $

Page 3: PI C CATHOLIC us. IRS D O FIN~~stbartsnorwichny.com/Documents/Financials/Bequests/... · Form 990 Return of Organization Exempt From Income Tax Under section 507(c), 527, or 4947(a)(1)

16-1549436 3 Forth 990 (2002)

(B) End of year

4,931

196,798

L

201,729

201,729

201,729 201,729

(A) Beginning of year

48a Pledges receivable 48a b Less allowance for doubtful accounts 48b

49 Grants receivable , 50 Recervables from officers, directors, trustees, and key employees

(attach schedule) 51a Other notes and loans receivable (attach

schedule) , 51a b Less allowance for doubtful accounts 1 511b

52 Inventories for sale or use 53 P d d d f- d h

63 64a 64b 65

66

67 68 69

186,693 70 71

Form 990 is available for public inspection and, for same people, serves as the primary or sole source of information about a particular organization How the public perceives an organization in such cases may be determined by the information presented on its return Therefore, please make sure the return is complete and accurate and fully describes, in Part III, the organization's programs and accomplishments

JS/ 2E 1030 I 000

PT2657 564M 08/18/2003 09 51 21 008163 4 -

Note Where required, attached schedules and amounts within the description

45 Cash - noninterest-beanng . . . 46 Savings and temporary cash investments

47a Accounts receivable b Less allowance for doubtful accounts

repai expenses an e ne c arges . . 54 Investments - securities (attach schedule) , " X Cost [I F MV SSa Investments - land, buildings, and

equipment basis , 55a b Less accumulated depreciation (attach

schedule) , , , , , , , 55b 56 Investments - other (attach schedule) 57a Land, buildings, and equipment basis 57a b Less accumulated depreciation (attach

schedule) , 57b 58 Other assets (describe Do

oy i otai asseu aao ones vo tnrou n oo must e uai une 14 ) 60 Accounts payable and accrued expenses , , 67 Grants payable , , , , , , , , , 62 Deferred revenue . . . . . . .

m 69 Loans from officers, directors, trustees, and key employees (attach _- schedule) � , , , , , � � � � � � � m 64a Tax-exempt bond liabilities (attach schedule) , , , , , . , , , . J b Mortgages and other notes payable (attach schedule) , _ ,

65 Other liabilities (describe " )

66 Total liabilities add lines 60 through 65 Organizations that follow SFAS 117, check here " and complete lines

67 through 69 and lines 73 and 74 m 67 Unrestricted , , , , , , , , , c 68 Temporarily restricted

69 Permanently restricted . . . . . . .

v Organizations that do not follow SFAS 177, check here ll~ F2 and complete lines 70 through 74

0 70 Capital stock, trust principal, or current funds , , , , , , , , , , , , , n 77 Paid-in or capital surplus, or land, building, and equipment fund , , e 72 Retained earnings, endowment, accumulated income, or other funds , , , Q 73 Total net assets or fund balances (add lines 67 through 69 or lines

70 through 72, column (A) must equal line 19, column (B) must equal line 21)

SSc

Page 4: PI C CATHOLIC us. IRS D O FIN~~stbartsnorwichny.com/Documents/Financials/Bequests/... · Form 990 Return of Organization Exempt From Income Tax Under section 507(c), 527, or 4947(a)(1)

Form 990 4 ecom inanc per

Add amounts on lines (t) through (4) c c Line a minus line b

d Amounts included on line 17, Form 990 but not on line a

(1) Investment expenses not included on line 6b Farm 990 f

(2) Other (specify)

c Line a minus line b , , , , , , , d Amounts included on line 12,

Form 990 but not on line a (1) Investment expenses

not included on line 6b, Form 990 $

(2) Other (specify)

S S Add amounts on lines (1) and (2) , " d Add amounts on lines (7) and (2) , " d

e Total revenue per line 12, Form 990 e Total expenses per line 17, Forth 990 plus line d) " e (line c plus line d) ~ " I e e List of Officers, Directors, Trustees, and Key Employees (List each one even if not compensated, see page 26 of

75 Did any officer director trustee, or key employee receive aggregate compensation of more than $100,000 from your organization and all related organizations of which more than $10 000 was provided by the related organizations? " 0 Yes EANo If 'Yes' attach schedule-see page 26 of the instructions

Form`!NU (2002)

5 - JSR 2E1040 1 000

PT2657 564M 08/18/2003 11 48 47 008163

16-1549436

a Total revenue, gains, and other support per audited financial statements

b Amounts included on line a but not on line 12, Form 990

(1) Net unrealized gains

on investments , f

(2) Donated services

and use of faalilies f (3) Recoveries of prior

year grants , S

(4) Other (specify)

Add amounts on lines (1) through (4)

a Total expenses and losses per audited financial statements

b Amounts included on line a but not an line 17, Form 990

(1) Donated sernces and use of facilities S

(2) Prior year adjustments reported on line 20, Form 990 f

(3) Losses reported on line 20, Form 990 S

(4) Other (specify)

Page 5: PI C CATHOLIC us. IRS D O FIN~~stbartsnorwichny.com/Documents/Financials/Bequests/... · Form 990 Return of Organization Exempt From Income Tax Under section 507(c), 527, or 4947(a)(1)

16-1

PT2657 564M 08/18/2003 09 51 21 008163 6 -

n 76 Did tie organization engage in any activity not previously reported to the IRS If "Yes," attach a detailed description of each activity , 76 X 77 Were any changes made in the organizing or governing documents but nor reported to the IRS? 77 X

If 'Yes,' attach a conformed copy of the changes 78a Did the organization have unrelated business gross income of $1,000 or more during the year covered by this returns , , 78a X

b If "Yes," has it filed a lax return on Form 990 "7 for this year? 78b NO 79 Was there a liquidation, dissolution, termination, or substantial contraction during the years If 'Yes.* attach a statement 79 X 80a Is the organization related (other than by association with a statewide or nationwide organization) through common

membership, governing bodies, trustees, officers, etc to any other exempt or nonexempt organizations . . . 80a K

b If 'Yes; enter the name of the organizauon"

and check whether it is exempt or nonexempt 81 a Enter direct or indirect political expenditures See line 81 instructions I 81 a I b Did the organization file Form 1120-POL for this year? . . 81b X

82a Did the organization receive donated services or the use of materials equipment, or facilities at no charge or at substantially less than lair rental value? , , , , , 82a X

b If 'Yes; you may indicate the value of these items here Do not include this amount as revenue in Part I a as an expense in Part II (See instructions in Part III ) , , 82b N/A

83a Did the organization comply with the public inspection requirements for returns and exemption applications? 83a X b Did the organization comply with tie disclosure requirements relating to quid pro quo contributions? 83b X

84a Did the organization solicit any contributions or gifts that were not tax deductible? , , 84a K b If "Yes," did the organization include with every solicitation an express statement than such contributions

or gifts were not tax deductible? , , , , 84b N A 85 501(c)(4),(5), w (6) organizations a Were substantially all dues nondeductible by members . . . BSa X

b Did the organization make only in-house lobbying expenditures of $2 000 a less . . BSb X If 'Yes' was answered to either BSa or BSb, do not complete 85c through 85h below unless the organization received a waiver far proxy tax owed for the prior year

c Dues, assessments, and similar amounts from members BSc N / A d Section 162(e) lobbying and political expenditures , BSd N / A e Aggregate nondeductible amount of section 6033(e)(1 )(A) dues notices 85e N/A f Taxable amount of lobbying and political expenditures (line 85d less BSe) . . . . . . . . . . BST N/A g Does the organization elect to pay the section 6033(e) lax on the amount on line 851 , , , , , , B5 X h I I section 6033(e)(1 )(A) dues notices were sent, does the organization agree to add the amount m line 85f to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following lax years 85h X

86 501(c)(7) oigs Enter a Initiation fees and capital contributions included on line 12 86a " " N / A b Gross receipts, included on line 12, for public use of dub facilities 86b N / A

87 501(c)(12) ags Enter a Gross income from members or shareholders , , 87a N/A b Gross income from other sources (Do not net amounts due a paid to other sources against amounts due a received from them ) , , . 87b N/A

88 Al any time during the year, did the organization own a 50°h or greater interest in a taxable corporation or partnership, or an entity disregarded as separate from she organization under Regulations sections 301 7701-2 and 301 7701-37 If "Yes," complete Part IX 88 X

B9a 501(c)(3) organizations Enter Amount of tax imposed on the organization during the year under section 4911 " N / A , section 4912 " N / A , section 4955 " N / A

b 501(c)(3) and 501(c)(4) orgs Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior years If -Yes,' attach a statement explaining each transaction 891a X

c Enter Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958 N I A

d Enter Amount of lax on line 89c, above, reimbursed by the organization . . . " N / A 90a Lisp the states with which a copy of this return is fled 1, N EW YORK

b Number of employees employed in the pay period that includes March 12, 2002 (See instructions) 90b ~ 91 rneoooksareioraieoi t NBT BANK, NA Telephone no t " (607)337-6193

Locaceoatj~ NORWICH, NY ZIP *a " 13815 92 Section 4947(x)(1) nonexempt charitable hosts filing Fam 990 m lieu o/ Form 1041 -Check here 0.1

and enter the amount of tax-exempt interest received or accrued during the tax year " 1 92 1 N / A

Foam 990 (2002)

JSA 7E IOaI 1 000

Page 6: PI C CATHOLIC us. IRS D O FIN~~stbartsnorwichny.com/Documents/Financials/Bequests/... · Form 990 Return of Organization Exempt From Income Tax Under section 507(c), 527, or 4947(a)(1)

(E) Relayed or

exempt function

Note Enter gross amounts unless ofheiwise Unrelated business income Excluded b section 512 513 or 51 indicated (A) B SC)

eus~ness Amount Excusion Ato) ont

93 Program service revenue code code

a

b

e

d

e

f Medicare/Medicaid payments

g Fees and contracts from government agencies 94 Membership dues and assessments .

95 interfti on savings and 1 4 28E

96 Dividends and interest from securities 14 6 , 49E

97 Net rental income a (loss) from real estate

a debt-financed property . . . .

b not debt-financed property

98 Nairental incomealiasslfrompersmaipiapery

99 Other investment income . . . . . .

100 Gainorposslfmn sales dassets anamanmeniuy 18 -3,925 " 101 Net income or (loss) from special events

102 Gross profit or (loss) from sales of inventory

103 Other revenue a

b

t

a

a

104 Subtotal (add columns (B) (D), and (E)) 2,861

105 Total (add line 104, columns (B) (D), and (E)) Note Line 105 Dlus line id. Part 1, should equal the amount on line 12, Part 1

Line No I Explain how each acumly for which income is reported in column (E) of Part VII contributed importantly to the accomplishment

(a) (C) (D) (E( aerce~~aeea I Nature of activities I Total income I Enda-rear ~on~enio imn.Mi aSSe s

address and EIN of

Information Regarding Transfers Associated with Personal Benefit Contracts See page 33 of the instructions (a) Did the organization, during the year, receive any funds directly or indirectly to pay premiums on a personal benefit contract ? Yes X No (b) Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contracts ~ Yes X No

Note I( 'Yes' Lo (b), file Form BB70 and Form 4720 (see instructions) Under

..n Ii.; of oeriurv I declare that I have examined this return in[IuCina armmoanHno schedules and statements and to the best of my knoxledae

any on

2111050 1 000 PT2657 564M 08/18/2003 09 51 21 008163 7 -

16-1549436

Please Sign I Signature olofficer Here ' ,H 1Na r.

Type or print name and We

Preparels ' Paid sienature PrCPerBf'S Firm sname (oryours U58 Only d seilcmployed) '-

address and ZIP " 4

e

Check if RA.¢r555NIXPTINsIBGQn~ Ins, W)

Poona no 1

Forth 990 (2002)

Page 7: PI C CATHOLIC us. IRS D O FIN~~stbartsnorwichny.com/Documents/Financials/Bequests/... · Form 990 Return of Organization Exempt From Income Tax Under section 507(c), 527, or 4947(a)(1)

OMB No 1545-0047 Organization Exempt Under Section 501(c)(3) (Except Private Foundation) and Section SOto), 5010, 501(k),

501(n), or Section 4947(a)(1) Nonexempt Charitable Trust Supplementary Information-(See separate instructions )

ST be completed by the above organizations and attached to their Form 990 or S

SCHEDULE A (Form 990 or 990-EZ)

Department of the Treasury Internal Revenue Service

2 002 Name o(theorganization ST PAUL'S ROMAN CATHOLIC CHURCH ENDOWMENT FUN tmwq'er iaemnicauonnum

D 008163 I 16-1549436 {ma/ Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees

(See page 1 of the instructions List each one If there are none, enter "None ") (a) Name and address of each employee paid more (b) Title and average (d) Contributions W (e) E-Vense

fours per reek (~) Compensation employee benefit plans 8 account and other khan $50 000 ne~~ien .~ ..~~n~~~

Total number of other employees paid over $50 000 " I NONE

Compensation of the Five Highest Paid Indepen (See page 2 of the instructions List each one (whethe

(a) Name and address of each Independent contractor paid more than $50 000

NONE

individuals or firms) If there are none, enter "None

(b) Type of sernce (c) compensation

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

Total number of others receiving over $50,000 for professional services " NONE For Paperwork Reduction Act Notice, see the Instructions !or Forth 990 and Form 99o-EZ JSA 2E1210 1 000

PT2657 564M 08/18/2003 09 51 21 008163

Schedule A (Forth 990 or 990-EZ) 2007

8 -

NONE

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

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

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

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

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

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

Page 8: PI C CATHOLIC us. IRS D O FIN~~stbartsnorwichny.com/Documents/Financials/Bequests/... · Form 990 Return of Organization Exempt From Income Tax Under section 507(c), 527, or 4947(a)(1)

1 During the year, has the organization attempted to influence national state, or local legislation, including any attempt to influence public opinion on a legislative matter or re(erendum'+ If "Yes; enter the tout expenses paid or incurred in connection with the lobbying activities " $ (Must equal amounts on line 38, Part VI-A, or line i a Part VI-B ) 1 X Organizations that made an election under section 501(h) by filing Form 5768 must complete Part VI-A Other organizations checking Yes,' must complete Part VI-B AND attach a statement giving a detailed description of the lobbying activities

2 During the year has the organization, either directly or indirectly, engaged in any of the following acts with any substantial contributors, trustees, directors officers creators, key employees, or members of their families, or with any taxable organization with which any such person is affiliated as an officer, director, trustee, majority owner, or principal benefiaary? (if the answer to any question is "Yes," attach a detailed statement explaining the transactions )

a Sale, exchange, or leasing of property , , , , , , , , , , , 7a X

X b Lending of money or other extension of credit

c Furnishing of goods services, or facilities? . . . , , , , , , , 2c X

d Payment of compensation (or payment or reimbursement of expenses it more than $7,000) . 2d

x e Transfer of any part of its income a assets? , ,

1 Does the organization make grants for scholarships fellowships, student loans etc ? (See Note below ) 3 X d Do you have a section 403(b) annuity plan for your employees 4 K

Note Attach a statement to explain how (he organization determines that individuals or organizations receiving grants . STMT 8

T PAUL'S ROMAN CATHOLIC CHURCH

Schedule n (Form 990 or 990.EZ) 2002 i 000

PT2657 564M 08/18/2003 09 51 21 008163 9 -

16-1549436 Schedule A (Form 990 or 990 EZ) 2002 Page 2

Reason for Non-Private Foundation Status (See pages 3 through 5 of the instructions )

The or anization is not a private foundation because it is (Please check only ONE applicable box) 5 A church convention of churches, or association of churches Section 170(b)(7)(A)(i) 6 A school Section 170(b)(1 )(A)(n) (Also complete Pan V ) 7 A hospital or a cooperative hospital service organization Section 170(b)(1)(A)(ni) 8 A Federal, slate, or local government or governmental unit Section 170(b)(1)(A)(v) 9 ~ A medical research organization operated in conjunction with a hospital Section 170(b)(1)(A)(m) Enter the hospital's name, city,

and state Ill 10 ~ An organization operated for the benefit of a college or university owned or operated by a governmental unit Section 170(b)(1)(A)(rv)

(Also complete the Support Schedule in Part IV-A ) 7 7 a F_1 An organization that normally receives a substantial part of its support from a governmental unit or from the general public

Section 770(b)(1 )(A)(vi) (Also complete the Support Schedule in Part IV-A )

17 b B A community trust Section 170(b)(1)(A)(vi) (Also complete the Support Schedule in Part IV-A ) 12 An organization that normally receives (1) more than 33 1/3°/. of its support from contributions, membership fees, and grass

receipts from activities related to its charitable, etc , functions - subject to certain exceptions, and (2) no more than 37 1/3".i of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975 See section 509(a)(2) (Also complete the Support Schedule in Part IV-A )

7 3 X

An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizahms described in (1) lines 5 through 12 above, or (2) section 501(c)(4) (5), or (6), if they meet the test of section 509(a)(2) (See

(a) Name(s) of supported organization(s) (b) Line number

from above

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Schedule a (For. sso or 990-EZ zaoz 16-1549436 ~J Support Schedule (Complete only if you checked a box online 10, 11, or 12 ) Use cash method of acc6QrT&nVPL7C ABLE

Calendar year (or fiscal year beginning In)

15 Gifts grants and contributions received (Do

19 Net income from unrelated business

activities not included in line 18

20 Tax revenues levied for the organization's

benefit and either paid to it or expended on its behalf

21 The value of services or facilities furnished to

the organization by a governmental unit

without charge Do not include the value of

sernces or facilities generally furnished to the

public without charge 22 Other income Attach a schedule Do not

include gain or (loss) from sale of capital assets

23 Total of lines 15 through 22

24 Line 23 minus line 17 .

25 Enter 1% of line 23

26 Organizations described on lines 10 a 11 a Enter 2% of amount in column (e), line 24 NOT APPL I.C

b Prepare a list for your records to show the name of and amount contributed by each person (other than a

governmental unit or publicly supported organization) whose total gifts for 1998 through 2001 exceeded the

amount shown in line 26a Do not file this list with your return Enter the total of all these excess amounts

c Total support for section 509(a)(1) test Enter line 24 column (e) , , 1

A Add Amounts from column (e) for lines 18 19 22 26b

e Public support (line 26c minus line 26d total) , , , , , , , , 10.

27 Organizations described on line 12 a For amounts included in lines 15, 76, and 17 that were received from a "disqualified person," prepare a list for your records to show the name of, and total amounts received in each year from, each 'disqualified person' Do not file this list with your return Enter the sum of such amounts la each year

(2001) _________12000 ___________________ (1999) ___ NOT APPLICABLE-(1s98) ______________ b For any amount included in line 17 that was received from each person (other than "disqualified persons'), prepare a list for your records to

show the name of. and amount received (or each year, that was more than the larger of (1) the amount on line 25 for the year or (2) $5000 (Include in the list organizations described in lines 5 through 11, as well as individuals ) Do not file this list with your return After computing the difference between the amount received and she larger amount described in (1) or (2), enter the sum of these differences (the excess amounts) for each year (2001)

--------------- (2000)

------------------- (1999)

------------------- (1998)---------------

c Add Amounts from column (e) for lines 1 5 16 17 20 21

d Add Line 27a total and line 27b total e Public support (line 27c total minus line 27d total) 1 Total support for section 509(a)(2) lest Enter amount from line 23, column (e) " I 271 g Public support percentage (line 27e (numerator) divided by line 271 (denominator)) . . .

PT2657 564M 08/18/2003 09 51 21 008163 10 -

17 Gross receipts from admissions merchandise sold or seances performed or furnishing of facilities in any activity that is related to the

18 Gross income from interest dividends, amounts received from payments on securities loans (section 512(a)(5)), rents royalties, and unrelated business taxable income (less section 517 taxes) from businesses acquired

28 Unusual Grants For an organization described in line 10 11 or 12 than received any unusual grants during 1998 through 2001 prepare a list fox your records to show, for each year, the name of the contributor the date and amount of the grant, and a brief

i i o00

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I( you answered "No" to any of the above, please explain (If you need more space, attach a separate statement )

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

33 Does the organization discriminate by race in any way with respect to

d Scholarships or other financial assistance

PT2657 564M 08/18/2003 09 51 21 008163 11 -

16-1549436

Schedule n(FOrmssoor ssoEZ) zooz NOT APPLICABLE pages Private School Questionnaire (See page 7 of the instructions ) (To be completed ONLY by schools that checked the box on line 6 in Part IV)

29 Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, Yes No other governing instrument, or in a resolution of its governing body 29

30 Does the organization include a statement of its racially nondiscriminatory policy toward students in all its brochures, catalogues, and other written communications with the public dealing with student admissions, programs, and scholarships 30

31 Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media during the period of solicitation (or students, or during the registration period if it has no solicitation program, in a way that makes the policy known to all parts of the general community it serves , , , , , , , 71 If "Yes," please describe, d "No," please explain (If you need more space, attach a separate statement )

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

32 Does the organization maintain the following a Records indicating the racial composition of the student body, faculty, and administrative staffs 32a b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory

basis 32b c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing

with student admissions, programs, and scholarships . . 32c d Copies of all material used by the organization or on its behalf to solicit contributions? , , , , , , , . . , . . , 32d

a Students' rights or privileges? , , , , ,

b Admissions policies?

c Employment of faculty or administrative staff

e Educational policies?

If Use of facilities?

g Athletic programs

h Other extracurricular activities?

If you answered "Yes" to any of the above, please explain (If you need more space, attach a separate statement )

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

34a Does the organization receive any financial aid or assistance from a governmental agency , , , , , , ,

b Has the organizations right to such aid ever been revoked or suspended If you answered "Yes" to either 34a or b, please explain using an attached statement

35 Does the organization certify that it has complied with the applicable requirements of sections 4 Ot Through 4 OS of Rev Proc 75-50, 1975-2 C B 587, covering racial nondiscrimination If "No," attach an explanation 35

7EtP7o t 000 Schedule A (Form 990 or 990-EZ) 3003

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Schedule A Form 990 or 990-EZ 2002 16-1549436 Page 5

aihd Lobbying Expenditures by Electing Public Charities (See page 9 of the instructions ) (To be completed ONLY by an eligible organization that filed Form 5768) NOT APPL I CABLE

Check " a N d the organization belongs to an affiliated group Check " b d you checked "a" and "limited control" provisions aoolv

Limits on Lobbying Expenditures

(The term "expenditures" means amounts paid or incurred )

36 Total lobbying expenditures to influence public opinion (grassroots lobbying) 77 Total lobbying expenditures to influence a legislative body (direct lobbying) 38 Total lobbying expenditures (add lines 36 and 37) 39 Other exempt purpose expenditures , 40 Total exempt purpose expenditures (add lines 38 and 39) 41 Lobbying nontaxable amount Enter the amount from the following table-

If the amount on line 40 is - The lobbying nontaxable amount is - Not over $500 000 20% of the amount on line <0 Over $500 000 but not over $1 000 000 , , , $100 000 plus 15% of the excess over E500 000 Over $1 000 000 but not over $1 500 000 3175 000 plus 10% of the excess over 51 000 000 Over $1 500 000 Out not over f 17 000 000 , 5225 000 plus SYe of the excess over $1 500 000 Over $17 000 000 $1 000 000

42 Grassroots nontaxable amount (enter 25% of line 41) . 43 Subtract line 42 from line 36 Enter -0- if line 42 is more than line 36 44 Subtract line 41 from line 38 Enter -0- it line 41 is more than line 38

aged group To be completed totals for ALL electing

organizations

43

Lobbying Expenditures During 4-Year Averaging Period

(c) I (d) (e) 001 2000 1999 Tota

Grassroots lobbying

PT2657 564M 08/18/2003 09 51 21 008163 12 -

41

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below

Calendar year (or fiscal (a) ear beginning m " 200 Lobbying nontaxable

Lobbying ceiling amount

Grassroots nontaxable

Grassroots ceiling amount

Lobbying Activity by Nonelecting Public Charities NOT APPLICABLE For reporting only b organizations that did not com plete Part VI-A ) See page 11 of the instructions

During the year did the organization attempt to influence national, state or local legislation, including any attempt to influence public opinion on a legislative matter a referendum, through the use of

Yes NO Amount

a Volunteers K b Paid staff or management (Include compensation in expenses reported on lines c through h ) X c Media advertisements X

d Mailings to members, legislators, or the public X e Publications, or published or broadcast statements X f Grants to other organizations for lobbying purposes X g Direct contact with legislators, their staffs, government officials, or a legislative body . X h Rallies demonstrations, seminars, conventions, speeches, lectures, or any other means K i Total lobbying expenditures (Add lines c through h )

If "Yes" to any of the above, also attach a statement giving a detailed description of the lobbying actiwlies JSA Schedule A (Forth 990 or 990EZ) 202 7E 12<0 1 000

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16-1 Nonchantable

Exempt Organizations (See page 12 of the instructions ) 51 Did the reporting organization directly or indirectly engage in any of the following with any other organization described in section

501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations? a Transfers from the reporting organization to a noncharitable exempt organization of YesTW

(i) Cash . . . 114!L ) (u) Other assets

b Other transactions (i) Sales or exchanges of assets with a noncharitable exempt organization b(i) (u) Purchases of assets from a noncharrtable exempt organization

(III) Rental of facilities, equipment, or other assets , , (iv) Reimbursement arrangements (v) Loans or loan guarantees

(vi) Performance of services or membership or fundraising solicitations c Sharing of facilities, equipment, mailing lists, other assets, or paid employees d If the answer to any of the above is "Yes," complete the following schedule Column (b) should always shoe the fair market value of the

goods other assets or services given by the reporting organization If the organization received less than fair market value in any

52a 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 5271 , , , 11~ E] Yes O No

PT2657 564M 08/18/2003 09 51 21 008163 13

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PT2657 564M 08/18/2003 09 51 21 008 163 1 4 -

ST PAUL S ROMAN CATHOLIC CHURCH ENDOWMENT FUN 16-1549436

FORM 990 PART I - INTEREST ON SAVINGS AND TEMPORARY CASH INVESTMENTS

DESCRIPTION AMOUNT ----------- ------

SVGS/TEMP INT 288 ------------

TOTAL 288

STATEMENT 1

XD57B 2000

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TOTAL

%D570 2000 PT2657 564M 08/18/2003 09 51 21 15 - 008163

ST PAUL S ROMAN CATHOLIC CHURCH ENDOWMENT FUN

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

DESCRIPTION

DIV/INT SECURITIES

16-15 4 9 4 36

AMOUNT

6 498 ------------

6 498

STATEMENT 2

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ST PAUL'S ROMAN CATHOLIC CHURCH ENDOWMENT FUN i6-1549436

FORM 990, PART II - GRANTS AND ALLOCATIONS PAID DURING THE YEAR

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR AND

RECIPIENT NAME AND ADDRESS FOUNDATION STATUS OF RECIPIENT PURPOSE OF GRANT DR CONTRIBUTION AMOUNT

GRANTS PAID

ST PAUL'S CATHOLIC CHURCH NONE RESTRICTED PURPOSES 5,815 AiTN REV DOUGLAS CUNNINGHAM 30 PLEASANT STREET EXEMPT NORWICH, NV 13815

------------ TOTAL CONTRIBUTIONS PAID 5,875

xosn xooo - Pi2657 5641 0811812003 09 51 21 008163 16 STATEMENT 3

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16-1549436

xDS77 2000

- PT2657 564M 08/18/2003 09 51 21 17 STATEMENT 4 008 163

ST PAUL S ROMAN CATHOLIC CHURCH ENDOWMENT FUN

FORM 990 PART II - OTHER EXPENSES

DESCRIPTION

NVS FILING FEE

TOTALS

MANAGEMENT

ANO GENERAL

50

50

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PT2657 564M 08/18/2003 09 51 21 008 163 18 -

ST PAUL'S ROMAN CATHOLIC CHURCH ENDOWMENT FUN 16-1549436

FORM 990, PART III - ORGANIZATION S PRIMARY EXEMPT PURPOSE ----------------------------------------------------------

INCOME USED TO SUPPORT ST PAUL S CATHOLIC CHURCH

STATEMENT 5

xos7e z o00

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ST PAUL S ROMAN CATHOLIC CHURCH ENDOWMENT FUN 16-1549436

xos77 Y aoo - PT2657 564M 08/18/2003 10 02 32 008 163 19 STATEMENT 6

FORM 990 PART V - LIST OF OFFICERS, DIRECTORS AND TRUSTEES -------------

TITLE AND TIME

NAME AND ADDRESS DEVOTED TO POSITION COMPENSATION ---------------- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

NBT BANK NA CORPORATE TRUSTEE 777

52 SOUTH BROAD STREET 1 HR WEEK

NORWICH NV 13815

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

GRAND TOTALS 7l7 -------------

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xosre z 000 PT2657 564M 08/18/2003 1 t 48 47 008163 20

ST PAUL S ROMAN CATHOLIC CHURCH ENDOWMENT FUN 16-1549436

SCHEDULE A PART III - EXPLANATION FOR LINE 4

ST PAUL S ROMAN CATH CHURCH QUALIFIES FOR EXEMPTION UNDER 501(C)(3)

STATEMENT 7

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Jsr. sFaa7o i 000

E PT2657 564M 08/18/2003 11 48 47 008163 21 STATEMENT

ST PAUL S ROMAN CATHOLIC CHURCH ENDOWMENT FUN 16-1549436

Schedule D Detail of Long-term Capital Gains and Losses

Date Date Gross Sales Cost or Other Long-term

Description Acq uired Sold Price Basis Gain/Loss

APITAL GAINS (LOSSES) FROM SECURITIES

1 AGERE SYSTEMS INC CL A 05/07/1998 07/19/2002 2 23 -21 0779 AGERE SYSTEMS INC CL A 05/07/1998 08/05/2002 2 -2

26 nGERE SYSTEMS INC Cl B 05/07/1998 07/25/2002 49 596 -5a7 4563 AGERE SYSTEMS INC CL 8 05/07/1998 08/05/2002 1 10 -9

19 AGILENT TECHNOLOGIES INC COM 05/28/1998 02/27/2003 248 723 -d75 8 AVAVA INC COM 05/07/1998 06/17/2002 43 792 -1a9 25000 FEDERAL NATL MTG ASSN 5 50

11-15-06 04/23/2001 05/75/2002 25 000 24 875 125 100 LUCENT TECHNOLOGIES INC COM 05/07/1998 07/19/2002 208 2 825 -2 617 1 SMUCKER J M CO COM 05/07/1998 07/26/2002 33 32 1 8 TRAVELERS PPTV CAS CORP CL A 04/23/2001 09/03/2002 115 177 -62 6409 TRAVELERS PPTV CAS CORP CL A Od/23/2001 09/06/2002 9 14 -5

17 TRAVELERS PPTV CAS CORP NEW CL B 04/23/2001 09/03/2002 251 407 -156 7531 TRAVELERS PPTY CAS CORP NEW CL B Od/23/2001 09/06/2002 10 18 -8

TOTAL CAPITAL GAINS (LOSSES) FROM SECURITI E S 25 969 29 894 -3 925

Totals 25 969 29 894 -3 925

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Augest 18, 1003

10 10 . 22 AM NBT BANK, N

SANDRA COLTON Account. 23 00 8/63 OCS ST PAUL'S ROMAN CATHOLIC CHURCH ENDOWMENT FUND Includes

Report Date

Time Prepared

Requested By

Account Holdings as of 04/30/2003 Cusip No Security Name Shares / Pa Investment Unit Pnce Market Value Price Date

060505104 BANK OF AMERICA CORP 1000000 6,99500 7405 7,40500 04/30/2003

149123101 CATERPILLAR INC 750000 422000 5260 3,94500 04/30/2003

172967101 CITIGROUP INC 2000000 905871 3925 7,85000 04/30/2003

302316702 EXXON MOBIL CORP 1000000 3,88500 3520 3,52000 04/30/2003

302571104 FPL GROUP INC 1000000 5,84250 6087 6,08700 04/30/2003

3133MXM82 FHLB 3 00 040207 10,000 0000 10,000 00 100 1913 10,019 13 04/302003

3134A2UJ5 FFILM 5 125 101508 25 000 0000 25,000 00 1095218 27,380 45 04/30/2003

313586109 FANNIE MAE 750000 4,45438 7239 5,42925 04/30/2003

31359MLH4 FNMA 4 375 101506 25,000 0000 24,769 50 106 595 26,648 75 04/30/2003

3136FOKM3 FNMA 6 00 051611 25 000 0000 25,000 00 107 823 26,955 75 04/30/2003

3136F2RT7 FNMA 4 00 111407 10 000 0000 10,000 00 101 1982 10,119 82 04/30/2003

31428P103 FED US GOVT 2-5 !l47 4295530 5,00000 11 67 5,01288 04/30/2003

369604103 GENERAL ELECTRIC CO 2500000 6,664 75 2945 7,36250 04/30/2003

428236103 HEWLETT-PACKARD CO 1000000 2,57124 1630 1,63000 04/30/2003

459200101 INTL BUS MACHINES 1000000 11,226 00 84 90 8,49000 04/30/2003

478160104 JOHNSON 8 JOHNSON 150 0000 525781 5636 8,45400 04/30/2003

594918104 MICROSOFT CORP 3000000 10,957 38 2556 7,66800 04/30/2003

713448108 PEPSICO INC 1000000 3,88875 4328 4,32800 04/30/2003

717081103 PFIZER INC 2000000 7,29400 3075 6,15000 04/30/2003

742718109 PROCTER 8 GAMBLE CO 50 0000 4,05488 8985 4,49250 04/30/2003

743884801 FEDFUND P 4,930 7600 4,93076 1 00 4,93076 04/30/2003

92343V704 VERIZON COMMS 1000000 4,59375 3738 3,73800 04/30/2003

931142103 WALMART STORES INC 100 0000 6,06500 5632 5,63200 04/30/2003

Total Securities 102,460 3170 201,729 41 203,248 79 Income Cash 000 000 Principal Cash 000 000

Account Total 207,729 41 203,248 79

Page 1