01e999b5 - Foundation Center990s.foundationcenter.org/990pf_pdf_archive/311/311721314/311721314_200412_990PF.pdfr Form 990-PF Department Of the TrOagjry tntomN RovFnuo Sonko Note:

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Form 990-PF Department Of the TrOagjry tntomN RovFnuo Sonko Note : The

For calendaryear 2004, or tax year till

return of Private Foundation or Section 4947(a)(1) Nonexempt Charitable Trust

Treated as a Private Foundation ation may be able to use e copy of this return to sa tisfy state repor

OMB No 154 5 .0052

2004 and end

G Chock all at i U Initial return U Final return -_j Amended return

Use the IRS Name of organization

label .

A Employee Identification number

Otherwise, xH5 FOUNDATION 31-1721314 print Number anti dtroW (0r P .O . UOX number II mall Is not delivm9d t0 Wool UdCrCaO) IipordPUllo 8 Telephone number

or typo . 700 E . DUBLIN G12ANVILLE RD SUTTE 01

I 614-898-7700 boo SpoclBc Instructions . cIty or town, stale, and ZIP code

OLUMBUS OH 43231 H Check typo of organization : Section 501(c)(3) exempt private foundation CJ Section 4947(x)(1) nonexempt charitable trust 0 Other taxable private foundation

I Fair market value o1 all assets at end of year J Accounting method [X] Cash (~ Accrual (from Port 11, cot (c), line 16) [::] Other (specify) " $ 16 2 3 8 3 4 0 . (Pert 1, column (d) must be on cash basis)

" ; Analysts of Revenue and Expenses (a) Revenue and (b) Net investment (Tno tow of amounts In columns (b), (d. and (d) may not necessarily equal the amounts In column (o) .) expenses per books income

Contnbutions,gitts,grants,etc,received , . . . 1, 000 000 ~~`

2 Chock " 0 If moiammua+is not maiw to marnsa~e ~.~'~~`?;"~`~` .~ ^~w ~ .,~"~`k~-,~ ;;' W 3 ',°h;~�°, ,',m °"°,'«"P°'~,' 12 515 . 12 515 . men . . . d Dividends and interest from securities . . . . . . . . , . 66 , 270 . 66,270 .- 5a Gross rents , . . . ., . . . . , .

. . . . . . _,

b Nat rental Income or (low) , v MON"01t ~ ~A~ 3~~` Nat r -amts in In or peen) hem onto o not on , 867 951 . ]A, ~W

2 Gross sales price for Oil 3 112 5 3 8 ' ' ~ ~~ ~ d b assets an line so . . . . r r E:5 ~~ti~s~`:l~~n~~~

m 7 Capitol gain not Income (hem Port N, Ilno 2) � , � . 867 4` 951 . °c 8 Net short-term capital gain

ldJ 9 Income modifications . . . . , . . . . . . . . . Gross

108 and calI

allow-. cos . . . . .na ratum0

. . . . . 4 . . ~

s,FIRM-MI-EM A'~t^

b era

. . . . . . 42 M1110 MINIM

(/J 11 r0~111 r income . . . . .'. . . . . . . . ., .� ., .� ~~ . . . . . . . . . . . 97 , 165 . 0 i2 I e o 1 ., v . . . . . . . . � ., . 2 043 901 . 9 13 co Pa+aauon o~ omeo~n, , ote. , � 0 14 Other ee-seleF+ec.and~ �� , �� 15 Pens ~~eb r efits . . . . . .

~ t6a ~ega~fees �� , . . , � , �� ,MT..4 . . 16 , 855 . b Accounting tees ., , ., � ., STMT. 5 3 , 544 .

W c Other professional fees , � , � , � , � 17 Interest . . .

LO 18 Taxes STMT 6. 5,152 . ~u? 19 Depreciation and depletion

20 Occupancy a 21 Travel, conferences, and meetings v ~ 22 Pnntmg and publications ~ 23 Other expenses ~ 24 Total operating and administrative n expenses Add lines 13 through 23 25 , 551 .

25 Contributions . grits . grants paid 801, 700 ._ 26 Total expenses and disbursements

Add lines 24 and 25 827 f 251 . 27 Subtract line 26 from line 12 ; ;

a Excess of revenue a« expenses and disbursements 1 ~ 216, 65 0

6 Net Investment income (it negative, enter -0-) t Adjusted net income of negative. enter -o-)

LHA For Privacy Act and Paperwork Reduction An Notice, see the Instructions 423501 01 -03-05

1 , 772 .

1 , 772 . .

4,964 . N/A

ni ~~R4 i ,oennA n,r- 1) 0 o ~nnn nsn-rn ruc PnrrrlnnmTnrt

6 . 0 .

0 . 1,772 .

0 .

It tuanptlon application In pending. Chock nwo � ,1 U D i . Foreign organizations, check hero 10, 2. Forolpn organizations mooting the 85% test,

Chock here find [1IlaCh computation . . . ~--1

E II private foundation status was terminated under section 507(b)(1)(A), check here , ~ 0

F M the foundation is m a 60-month termination under section 507 (b )( 1 B ) , check here

(t) Adjusted net (d) oisournomcnm income for charitable purposes

(cash basis only)

0 . 1,772 .

0 . v h

1,772 . 801,700 .

803,472 .

Form 990-PF (2o0a)

Form 990-PF(2004) IHS FOUNDATI .,J

~°`~`~ j4 Balance Sheets ""m""°'"°'"""z "°"°~'°'°°°" cdunn amid to for awa xar imams obr

1 Cash - non-interest-bearing � �� 2 Savings and temporary cash investments 9 Accounts receivable 110,

Less . allowance toy doubtful accounts t 4 Pledges receivable 1

less : allowance for doubtful accounts ~ S Grants receivable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Recoivables due from officers, directors, trustees, and other

disqualified persons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., . . . . . . . . . . 7 ONOi n01Ct &nOIWro mzMOb . . . . . . . . . . .

. . . .

11110.

Less : allowance for doubtful accounts ~ 8 Inventories for sale or use , . .� . , ., . . . . . .,

G1 9 Prepaid expenses and deterred charges � . � , ., . , �

d 10a Investments - U S and state government obligations � , , b investments - corporate stock . � , . .STMT 8 c Investments-corporate bonds . , . .

11 hn~ - tina eWidrW, am eqWO=c auk , . .

lzm eaaeoreeheon . . . . . . . . . . . . .

12 Investments -mortgage loans , � , � � � � � , � , � 13 Investments-other .�� . . . . . . . .STMT . 9 14 Land, buildings, and equipment: basis 10'

Lasaoamumt00oDnic48ai . . . . . . . . . . . . . . . . .1

15 Other assets (describe 10,

77 7 77 7 77 A o.. ...7

Beginning of year End of year (a) Book Value (b) Book Value (c) Fair Market Value

1 , 357,913 . 2 499 045 . 2 ,499045 .

14 121,084 . 14,089,829 . 13,632,522 .

~s~ ~~ ~~~ti ~t ~j~ vt s ti h s~

5'k .awK ~tv.~". F. .. `t " . % . : v"$. .L.vkww . " . ::.' .r "

0 . 106 773 . 10~6p Y773 . {~~\QS~.yQ~};f,n\C

MR,

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t~ ~ v~ 70.\ ~ : N% : 211~ k»k~t\~N , ~'S`3

1

16 Total assets to be comp leted b all tilers . . . . . . . . . . . . . . . . . . . . . . 17 Accounts payable and accrued expenses ., . . . � , . . . . . . . . . . . . 18 Grants payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Deferred revenue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 keens hem olflcan, diroetorn. Vuatop, and other OIcquNllloO poroono �� ,

21 Mortgages and other notes payable

22 Other liabilities (describe " )

29 Total IIabIINies add lines 17 throu g h 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . Organizations that follow SFAS 117, check here 1 U and template lines 24 through 26 and lines 30 and 31 .

24 Unrestricted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Temporarily restricted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12 26 Permanently restricted , . . . . . . . . . . . . . . Organizations that do not follow SFAS 117, check here ~ 0 and complete lines 27 through 31 .

0 .1 0 .

SN ; ~~,!",y~,

0 . 16 , 695,647 . ",}~ ~ °~~h{ ` 16,695,647 .

16,695,647 . t :

27 Capital stock, trust principal, or current funds 0 y 28 Paid-in or capital surplus, or land, bldg , and equipment fund 0

29 Retained earnings, accumulated income, endowment, or other funds . 15 , 4 78 , 997 . °' 30 Total net assets or fund balances 15,478,997 . z . .

31 Total liabilities and net assets and balances 15 , 478 , 997 .

Analysis of Changes in Net Assets or Fund Balances

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

2 Enter amount from Part 1, line 27a 3 Other increases not included in line 2 (itemize) 4 Add lines 1, 2, and 3 5 Decreases not included in line 2 (itemize) 10, 6 Total net assets or fund balances at end of year (line 4 minus line 5) - Part II, column (b), line 30

15,478,997 . 1,216,650 .

0 . 16,695,647 .

0 .

423511 o1-0o-0s 2

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15,478,997 .1 16,695,647 .1 16,238,340 .

16,695,647 . Form 99o-PF (2ooa)

3

a

(h) Gain or (loss) (o) plus (t) minus (g) (o) Gross sales price I (1) Doprociotion allowed I III) Cost or other basis

(Or OIIOwab10) plus expense 01 sale

c

2 Total of line 1, column (d) 2 .5436333

3 Average distribution ratio for the 5-year base period -deride the total on line 2 by 5, or by the number of years the foundation has been in existence rf less than 5 years 3 .1087267

4 Enter the net value of nonchaMable-use assets for 2004 from Part X, line 5 4 13, 594, 4 17 .

5 Multiply line 4 by line 3 5 1 , 478,076 .

6 Enter 1 % of net investment income (1% of Pad I, line 27b) 6 9 , 4 50 .

7 Addlines Sands 7 1,487,526 .

8 Enter qualifying distributions from Pan XII, line 4 8 803,472 .

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

Form 990-PF (2004) a23szvo,-oa-os 3

C-)'71 1 Art -70AAAA Al r,')00 1nnn nsn-7n TUC PnirNTnnmrnu ~15~R9 1

f

Form 990-PF(2004) IHS FOUNDAT-rN ,ParttN Capital Gains and Losses for Tax on Investment Income

(a) List and describe the kind(s) 01 property sold (e .g ., real estate, (b) R 2-story brick warehouse ; or common stock, 200 sns . MLC Co .) p .

18 b SEE ATTACHED STATEMENTS

31-1721314

(c Date acquired (d) Date sold ~mo ., day, yr ) I (mo , day, yr .)

3 , 112,538 . 1 2,244,587 . 867,951 . Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (I) Gains (Col (h) gain minus

2/31/69 I (l) Adjusted basis I (k) Excess of cot (i) I cot (LO Losses (from cot ~h~-0-) or

(I) F M V as of 1 as of 12/31/69 over cot Q), rt any

2 Capital gain net income or net capital loss). l h Cain,; Iso enter in Pad I, line 7 1 2 867,951 . 9 ( 1 h loss , enter -0- in Pad I, line 7 ~

3 Net short-term capital gain or (loss) as defined In sections 1222(5) and (6) If gain, also enter in Part I, Ilne 8, column (c) . If (loss), enter -0- in Part I, line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 N/A

1#?arttV;'fl 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 o1 any year in the base period? � �� 1~ Yes FX7 No If 'Yes,'the organization does not quaky 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 Base period years Adjusted qualifying 'distributions Net value of nonchatritable-use assets

Distribution ratio Calendar ear or tax ear be Innin in ~ cot (b divided by cot ( c ))

2003 471 780 . 11 287,185 . .0417978 2002 202 506 . 7 , 389 , 980 . .0274028 200 659,119 . 7 , 871 , 788 . .0837318 2000 91,444 . 3 , 840 , 493 . .0238105 1999 209 654 . 571 435 . .3668904

a

t Form 990-PF(200a) IHS FOUNDAT.L .,N Part>VI ; Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 49401

1a Exempt opera(inp foundations described in section 4940(d)(2), check here " and enter 'WA' on line 1 Date o1 ruling letter (attach copy of ruling letter II necessary-see Instructions)

b Domestic organizations that meet the section 4940(e) requirements in Pal V, check here " ~ and enter 1 Yo

of Pert I, line 27b C All other domestic organizations enter 296 of line 27b . Exempt foreign organizations enter 4% of Part I, line 12, c0l (b) 2 lax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only . Others enter -0-), �� 9 Add lines 1 and 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Subtitle A (income) tax (domestic section a9a7(o)(1) trusts and taxable foundations only . Others enter -0-) 6 Tax based on Investment Income . Subtract line 4 from line 3 . If zoo oi loss . enter -0- � . . , , � � B Credits/Payments : a 2004 estimated tax payments and 2003 overpayment credited to 2004 8a b Exempt foreign organizations -tax withhold at source �� , �� 511 c Tax paid with application for extension o1 lime to file (Form 8868) 6c 20 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 [K] A 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

s 18899 .

;;`~ ti. .~, . 249 . 00 .

i ~ 24,249 . a 38 .

00. s 00. io 5,312 .

11 0 . 11 Enter the amount of line 10 to be : Credited to 2005 estimated tai " 5 , 312 .1 Refunded ~PitirtkVlVkd Statements Regarding Activities

423531 of -m-os Form 990-PF (2004) 4

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f

31-1721314 Page 4 or 4948 - see instnrctions)

i ~ ~18,899 . ~

2 ,' 0 . 18,899 .

1 a During the tax year, did the organization attempt to influence any national, state, or local legislation or did d participate or intervene m YeS No any political campaign? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b Did it spend more than $100 during the year (either directly or Indirectly) for political purposes (see instructions for definition)? 1 b 1/ the snswerls 'Yes' to 18 or 1b, attach e detailed description of the activities end copies of any matensls published or ~ ~~ `à'` distributed by the organization in connection with the scNvlUes.

c Did the organization file Form 1120-POL for this year? �� , . ., 1c d Enter the amount (n any) of tax on political expenditures (section 4955) Imposed during the year

(1) On the organization . " $ 0 . (2) On organization managers " $ D " e Enter the reimbursement (if any) paid by the organization during the year for political expenditure tax imposed on organization

managers " $ 0 . ~`' 2 Has the organization engaged In any activities that have not previously been reported to the IRS? 2 X

If 'Yes,' attach s detailed descrrpNon of the activities. ~~'`t~} 9 Has the organization made any changes, not previously reported to the IRS, In Its governing Instrument, articles of incorporation, or

bylaws, or other similar Instruments? 11 'Yes,' attach a conformed copy of the changes . . . . . . . . . , . . 3 K 4a Did the organization have unrelated business gross Income of $1,000 or more during the year? , �� , 4a K

b It 'Yes,* has R filed a lax return on Form 990-T for this year? � �� . �� . . ., , . . . . , . , . . , . . . , . 4b X

6 Was there a liquidation, termination, dissolution, or substantial contraction during the year? ., ., , 5 I/ 'Yes, ° attach the statement required by General Instruction T. fe

8 Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either* n~ : 2~` tF., . ir " By language in the governing instrument, or :, � ,~ ~,; >fi � {

" 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 any time during the yeah 7

N "Yes,' complete Part fl, cot. (c), and Part XV. 8a Enter the states to which the foundation reports or with which d is registered (see instructions)

OHIO b It 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 G9 11 'No, ° attach explanation 8b K

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 m 2004 (see instructions for Part XIV)*? II 'Yes,' complete Part XIV 9 10 Did any persons become substantial contributors during the tax years If -Yes .' anon a schedule listing their names and addresses 10

11 Did the organization comply with the public inspection requirements for its annual returns and exemption applications 11 X

Web site address " N /A 12 The books are m care of 00- KEN NEAL Telephone no lo- 614-898-7700

Locatedat " 2700 E . DUBLIN GRANVILLE RD, SUITE 01, COLUMBUS, zIP+4 .43231 13 Section 4947(a)(1) nonexempt charitable trusts fling Form 990-PF m lieu of Form 1041 - Check here " 0

and enter the amount of tax-exempt interest received or accrued dunna the veer 10-1 13 ~ N/A

r

Form 990-PF(2004) IHS FOUNDATi ..N 31-1721314 Page 5 Part VII-,B Statements Regarding Activities for Which Form 4720 May Be Required

File Form 47,20 if any item is checked in the "Yes" column, unless an exception applies. 1 a During the year did the organization (either directly or indirectly) :

(1) Engage in the sale or exchange, or leasing o1 properly with a disqualified person? , ~ Yes [X1 No

(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)

a disqualified person? . . . � , � , � , , (~ Yes (.~] No (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? Yes [?~ No (e) Pay compensation to, or pay or reimburse the expenses o1, a disqualified poison? ,_ , .�� , �� , ~ Yes CK No (5) Transfer any Income or assets to a disqualified person (or make any of either available

for the benefit or use of d disqualified person)? ., . ., . �� , ., .� , . . ., . � .�� . � , � �� Yes ~~ No (8) Agree to pay money or property to a government official? (Exception . Check 'NO' "

N the organization agreed to make o grant to or to employ the official toy a period after termination of government servlce .11terminating within 90 days .) �� , � � , . � , , . . . . . Yes rXI No

b If any answer is 'Yes'to ta(1)-(6), did any of the acts 1aI1 to quality under the exceptions described in Regulations section 53 4941 (d)-3 or in a current notice regarding disaster assistance (see page 20 of the instructions)? N/A Organizations retying on a current notice regarding disaster assistance check here

c Did the organization engage in a prior year in any o1 the acts described in la, other than excepted acts, that were not corrected before the fast day of the tax year beginning In 2004?, �� , �� , �

2 Taxes on failure to distribute Income (section 4942) (does not apply for years the organization was a private operating foundation defined in section 4942(j)(3) or 4942(j)(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 [K] No If Yes,' list the years 10,

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 Incomes (Ii applying section 4942(a)(2) to all years fisted, answer 'No* and attach statement-see instructions .) � . , �� , �� , � �� , , �� . NBA

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

3a Did the organization hold more than a 2% direct or indirect interest In any business enterprise at any time during the year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 Yes 0 No

b If 'Yes ; did ft have excess business holdings In 2004 as a result of (1) any purchase by the organization or disqualified persons crier May 26, 1969, (2) the lapse of the 5-year period (or longer period approved by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest ; or (9) the lapse 01 the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine 11 the organization had excess business holdings !n 2004)

4a Did the organization Invest during the year any amount In a manner that would jeopardize its charitable purposes? , � , � b Old the organization make any Investment In a prior year (but crier December 31, 1969) that could jeopardize ifs charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2004? � , � , � � , ., .

5a During the year did the organization pay or Incur any amount to : . (1) Carry on propaganda, or otherwise attempt to Influence legislation (section 4945(e))? , � , ,_ . 0 Yes ~ No (2) Influence the outcome of any specific public election (see section 4955), orto carry on, directly or indirectly,

any voter registration drive? �� , . . 0 Yes 0 No (3) Provide a grant to an Individual for travel, study, or other similar purposes . ~ Yes 0 No (4) Provide a grant to an organization other than a charitable, etc ., organization described in 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 [--1 Yes [K] No b n any answer is 'Yes'to Sa(1)-(5), did airy of the transactions fad to quality under the exceptions described in Regulations

section 53 4945 or m a current notice regarding disaster assistance (see mstrudions)9 Organizations relying on a current nonce regarding disaster assistance check here

c If the answer is Yes'to question Sa(4), does the organization claim exemption from the tax because d maintained expenditure responsibdrtyforthegrant9 NBA DYes ONo 1/ 'Yes,' attach the statement required by Regulations section 53 4945-5(co

6a Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contracts _ E Yes ~ No

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

6b I

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9b X 4a X

4b X

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Forte 990-PF (2ooa)

IHS FOUNDAT ' `d 31-1721314

~Part:Vll pa d Employees, a dCont~a~Ctors ors, Trustees, Foundation Managers, Highly Page s

1 List all officers, directors, trustees, foundation managers and their compensation .

(o) Name and address (b) Title . and avers g e (c) Compensation crv~ounas ~o (a) Expense

hours p er week devoted (If not paid, `"° �roaccount, other to position enter -0-) 1 cmowr4uon allowances

0 .1 0 .1 0 . SEE STATEMENT 10

o°~01-03-05 Form 990-PF (2004) 6

c"1 -� ,nn -7 0 A nnn n,r, 1 0 o ')nnn nsn'7n ruc FnrrrTnnmrnrT (115'i R4 1

2 Compensation o1 five highest-paid employees (other than those included on line 1) . If none, enter "NONE." (b) Title and average ~a~~ow~~o (e) Expense

(a) Name and address of each employee paid more than $50,000 hours per week (c) Compensation `"° °'°` °`"~~"~°`6 account, other devoted to position c'o~mou~`sado~ allowances

NONE

Total number of other employees paid over $50,000 �� , �� . � . � , . . ., ., . . . . . ., ., . � . . , . . . . , , , , " ~ C 3 Five highest-paid independent contractors for professional services . If none, enter "NONE."

(a) Name and address o1 each person paid more than $50,000 ~ (b) Type of service ~ (c) Compensation

NONE

Total number of others receivin g over $50,000 for p rofessional services dart U(.A Summary of Direct Charitable Activities

List the foundation's four largest direct charRabte activities dunng the tax year Include relevant statistical information such as the Expenses number of organizations and other beneficiaries served, conferences convened, research papers produced, etc

tN/A

2

3

4

Form 990-PF (2004) I H S FOUNDAT i .,iJ

Part;iX=B' Summary of Program-Related Investments

31-1721314 Page

Describe the two largest program-related investments made by the foundation di N/A

the tax near on lines 1 and 2 Amount

2

All other program-ieiated investments . Sea instructions . 9

Total. Add lines 1 through 3

?P61'~$XW` Minimum Investment Return (All domestic foundations must complete this part Foreign foundations, see instructions .)

1 Fair market value of assets not used (or held for use) directly in carrying out charitable, etc , purposes a Average mouthy fair market value of securities . . . b Average of mouthy cash balances � .� , , c Fair market value of all other assets �� , � , , � , , � , _ d Total (add lines 1a, b, and c) . . . . . . . . . . . . . . . . . . . . . . e Reduction clamed for blockage or other factors reported on lines 1a and

1c (attach detailed explanation) �� _ �� , ., , � 1e 2 Acquisition indebtedness applicable to line 1 assets � ., �� , 3 Subtract line 2 from line~ld ., . . ., . . . . . . ., . . . . . . . . . . . . . . . . . . . . ., . . . . . . . . . ., . . 4 Cash deemed held for charitable activities . Enter 1 1/296 of line 3 (for greater amount, see instructions) 5 Net value of noncharitable-use assets . Subtract line 41rom line 3. Enter here and on Part V, line 4 6 Minimum Investment return . Enter 596 of line 5 �� , , . � � ,

0 .

423561 Ol-Q3-05

7 1 I n A ^7 0 A A A A A 1 C 1 O (1 ') A /l A /1 C A '7 (1 TUC L`nT TILT TNT T T /'1T7 niqlQO i

12,477,896 . 1,296,704 .

26,839 . 13,801,439 .

0 . 13,801,439 .

207,022 . 13,594,417 .

679,721 .

'P%r't"kXI Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain 1 j foreign organizations check here " 0 and do not complete this part )

Minimum investment return from Part X, line 6 . . . . . . . . . . . . . . . . . . . . ., . . . . , . . . . . . . 6 79 , 721 . 28 Tax on investment Income for 2004 from Part VI, line 5 �� . . . � , . . . . . ., , , 2a 18 899 b income tax for 2004 (This does not Include the tax'rom Pad VI .) � �� , , � , 2b 1 8 2 2 3 c Add lines 2a and 2b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2c 37 , 122 .

9 Distributable amount before adjustments . Subtract line 2c from line 1. 9 642 , 599 . 4 Recoveries of amounts treated as qualifying distributions , . . .� . , . � . , . . . . , 4 0 . s Add lines 3 and 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . s 642 , 599 . 6 Deduction from distributable amount (see instructions) . � ., . . . . . . . . � , 6 0 . 7 Distributable amount as adjusted . Subtract line 61rom line 5. Enter here and on Part XIII, line 1 7 642 , 599 .

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 803,472 .

b Program-related investments -total from Pad IX-8 1b 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 SuAabdrty test (prior IRS approval required) , 3a b Cash distribution test (attach the required schedule) 3b

4 Qualifying distributions . Add lines to through 3b Enter here and on Part V, line 8, and Part XIII, line 4 4 8 0 3 ,472 .

5 Organizations that qualify under section 4940(e) for the reduced rate of tax on net investment income Enter 1% of Part 1, fine 27b 5 0 .

6 Adjusted qualifying distributions . Subtract line 5 from line 4 ~6 I 803,472 .

Note : The amount on line 6 writ be used m Part V, column (b), in subsequent years when calculating whether the foundation qualifies for the section

4940(e) reduction of tax in those years Form 990-PF (2ooa)

1

Farm 990-FF (2004) I HS FOUNDAZ _ .rN 31-1721314 Page e

`PaWXlII'~ Undistributed Income (see instructions)

lal I Ibl 1c1 I Idl " Corpus Years prior to 2003 2003 2004

;7K~, Q1

O

642,599 .

3 Excess distributions carryovoi, h any, to 2004 ; a From 1999 181 , 856 . b From 2000 9 , 918 . cFrom 2001 � ,~~ 269,952 . d From 2002 e From 2003 I Total of lines 3a through e

4 Oualtfying distributions toy 2004 from Part Xll,line 4 t$ 803,472 .

a Applied to 2003, but not more than line 2a . . . b Applied to undistributed Income of prior years (Election required -see instructions)

c Treated as distributions out of corpus (Election required -see instructions)

d Applied to 2004 distributable amount e Remaining amount distributed out of corpus

5 Fxo=s distributions carryover cppitad to 2004 Of nn ortqunt appears In column (d), No oartq amount must be shown In column ().)

6 Enter the not total a1 each column as Indicated below :

8 Corpus . Add Ilnos 3f, 4c, ono 40. Subtract Ilno 6 ��

b Prior years' undistributed Income . Subtract

line 4b from line 2b �� ,

e Enter the amount of prior years' undistributed income for which a notice o1 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 � � , , .� , � , ., ,

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

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

0 .

0 .

7 Amounts treated as distributions out of a> corpus to satisfy requirements imposed by section 170(b)(1)(E) or 4942(8)(3)

08 Excess distributions carryover from 1999 not applied on pine 5 or pine 7 181,856 .

9 Excess distributions carryover l0 2005 +4 ' Subtract lines 7 and 8 from line 6a 4 40,7 4 3 .

».i , > . � 10 Analysis of line 9

a Excess from 2000 9,918 . b Excess from 200 269,952 . t Excess from 2002 d Excess from 2003 e Excess from 2004 160,873 . 1

423571 01-Q;l-OS

C 7 7 1 1 A!1 '7 O A nAA A 1 C 7 0 0

8 7 /1 /1 A Il qIl '7 (1 T U C L'!1 f TTT 11 T rP T (1TT nislRO 1

1 Distribulable amount for 2000 from Pert X1, line 7 � �� , �

2 UrWiDtrlbutvtJ InCOmo, if arty . w 01 Iho and 0f 2003

n Enter amount for 2003 only , . ., _ �� , � , , b Total for prior years'

461 726V. y ~~Y4 \ '~ f~`<a

s ~ti sk" } " ,S"

0 .

160,873 .

:X ̀k~

"

``,`2.~'Ct `~~.L`Y~~ ~a~sb't\`t`5,' yi . ~,~3' ~s .<` ~yp'~"~ , .tt~'~,',~ . ;~,`` y . .~\'~Y,~wc

kS>`!,~N: 'sv gs +f ,P 'v

s : k r ~ : sv ~~ \ ~ \ aZs Z.F~

kx:a~ks`tb`s.t "~\`^ ~~ ~ as s"~"L~s`"~kY'8 t wc~`n'q ~,~'vS`, ~\~~ ti. '\ 7Y . s ̀ ~ v ~ys :~kn.`. .̀~ :~ b.,

% \;:k... k ; 'sw.`. ~ `~i \` ̀ ~ : ' :<,\ysr.YY .

ti 4r ,` ~ ̀~ (~3~~ \S~F~ ~~Sk VF\W i } Ss ` V +~~ s J+'s V~:i-'~ ~ ~,

.

~p~ 3 ~~~ s~y ~ t

tih~~Kv ~ _y`~ ~~ {L~S.Y\\ \~i~ \\sC\Y~vh t'~' Vki` s~:,}

J.- nn

0 .

~` 114 r~ ml " s4 ~ #( 3~

v + {J Y r t ,

f

Form 990-PF (2004)

Form 990-PF (2004) IHS FOIJNDAZ'_ aN 31-1721314 Page 9 N/A Part`XtVd Private Operating Foundations (see instructions and Part VII-A, question 9)

1 a I1 the foundaliDn has received a ruling or determination letter that it is a private operating

foundation . and the ruling is effective for 2004, enter the date 011h9 puling

b Check'box to indicate whether the organization is a p rivate o pera tin foundation describE 2 a Enter the lesser of the adjusted net Tax ear

income from Pad I or the minimum (a) 2004 (b) 2003

investment return from Part X for each year listed �� , ��

b 859 of lino 2a �� . �� , . � , ., ., . � . �� t OunIHying distributions fi0m Past XII,

line 4 for each year listed �� ,

d Amounts included in line 2c not

used directly for active conduct of exempt activities . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

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

a 'Assets' artematroe test - enter : (1) Value of all assets , . ., . . . . . . � . � . . .

(2) Value of assets qualifying under section 4942(j)(3)(B)(I)

b 'Endowment alternative test - enter 2/3 of minimum investment return shown in Part X, line 6 for each year listed � , � ,

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

Investment Income (Interest, dividends, rents, payments on securities loans (section St2(a)(5)), or royalties) �� ,

(2) Support from general public and 5 or more exempt organizations as provided In section 4942(i)(3)(8)(111) �� ,

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

din section 4942(j )(3) or ~ 4942 j )(5) Prior 3 years

(o) Total (c) 2002 (d) 200

azasavo,m-05 Form 990-PF (2004) 9

nn -,O .nnA n,~1) 0 n ')nnA nrn7n TWO VnrTKTnrmrnNl n19; 1 RQ 1

JPWXN; Supplementary Information (Complete this part only if the organization had $5,000 or more in assets at any time during the year-see page 26 of the instructions .)

1 Information Regarding Foundation Managers: a List any managers of the foundation who have contributed more than 290 of the total contributions received by the foundation before the close of any tax

year (but only rt they have contributed more than $5,000) (See section 507(d)(2) )

SEE STATEMENT 11 b List any managers of the foundation who own 1096 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 1 0 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 SEE ATTACHED STATEMENT

b The form m which applications should be submitted and information and materials they should include SEE ATTACHED STATEMENT

c Any submission deadlines SEE ATTACHED STATEMENT

d Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other factors SEE ATTACHED STATEMENT

Form 990-PF (2004) 10

r ~ ̂r ~ ~ n n ^r n w n n w n i c '~ A A '1 A /1 A Il C A 7 (1 T tJ C L'llT MT 11 T T T /1r7 (1 1 5 Z i2 Q 1

o,~.acci.os Form 990-PF (2004) 11

C '1 Î 1 1 ^ n Î A A A A A /1 1 C ') 0 A 7 n A A 0 S I) '7 A T U C L' /l T M711 T T T (PTT ni~,)AO 1

Form990-PF(2004) INS FO[JNDAT~ .,N 31-1721314 Page 11 Part,-XYtxA', Analysis of Income-Producing Activities

Enter gross amounts unless otherwise indicated unreiaieo ousiness income F&-xu~a«damnonopt s13 ots+a (8) (b) Fl_ (d) Related or exempt Business Amount °i°" Amount function income 1 Program service revenue code ooao

a b t d 0 I p Pees and contracts from government agencies

2 Membership dues and assessments �� . . � . . � , � , � ., ., 3 Interest on savings and temporary cash

Investments . . ., . ., ., . . . . . . . ., . ., .� . . . � ., . .� , . . . . . 14 12 515 . . 4 Dividends and interest from securities . . . ., � , . , . . . 14 66 , 270

5 Net rental Income or (loss) from real estate . ;,~ a Debt-financed properly . . , b Not debt4inanced property

8 Net rental income or (loss) from personal property . . . . . . . . . . . . . . . . . . . . . .

7 Other Investment income . , . . . . . . , 5 23000 97 , 165 . 0 . 0 . 8 Gain or (loss) from sales of assets other

than inventory . . . . . . . . . ., . . . . . . 18 867 , 951 . 9 Net income or (loss) from special events 10 Gross profit or (loss) from sales of inventory . . 11 Other revenue

8

b c d e

12 Subtotal Add columns (b), (d), and (e) . . . .� , . . . . . . . . . . . . . . . . . 97 , 165 . 946 , 736 . 0 . 13 Total . Add line 12, columns (b), (d), and (e) �� .�� , 13 1,0431f9_01, (See worksheet in line 13 instructions to verify calculations .)

MV~I; Ql Relationship of Activities to the Accomplishment of Exempt Purposes

Line No . I Explain below how each activity for which income is reported in column (e) of Pad XVI-A contributed importantly to the accomplishment o1 the organization's exempt purposes (other than by providing funds for such purposes)

azasx, o,-as-os

cn -7 1 1 nn -r0 A nnA nic7on n nnA nlZ n'7 0 t

Form990-PF(200a) IHS FOUNDAT~--,N 31-1721314 Page 12 Part XVII'. Information Regarding Transfers To and Transactions and Relationships With Noncharitable

Exempt Organizations

1 Did the organization directly or Indirectly engage in any of the following with any other organization described in section 501(c) 01 Yes No

the Code (other khan section 501(c)(3) organizations) or in section 527, relaying to political organizations?

a Transfers from the reporting organization to a nOnCharilable exempt organization of

(1) Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a 1 X

(2) Other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1! 2 X . .

b Other transactions :

(1) Sales o1 assets to a nonchnritoblo exempt organization � , �� , � � , � , }C

(2) Purchases of assets troin a nOnChUrllOblO exempt organization �� , , 1 b 2

(3) Rental of facilities, equipment, or other assets .� . . ., .�� .�. .�., ., .�. � , � , �� , , �� . , .� � , � , � , �

. . . ��

� � . 1b 3 X

(4) Reimbursement arrangements . ., .�� . � . . ., � � � , � � , � , � � , 1b (4) X

(S) Loans or town guarantees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1b 6 K

(B) Performance of services or membership or tundralslng solicitations . � � ., � , 1 b 6

c Sharing o1 facilities, equipment, mailing lists . other assets, or paid employees 1 c

d If the answer to any of the above Is 'Yes,* complete the following schedule Column (b) should always show 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 transaction or sharing arrangement, show in

column (d) the value of the goods, other assets, or services received

(a) Line no (b) Amount Involved (c) Name of noncharttable exempt organization (d) Description of transfers, transactions, and sharing arrangements

N/A

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? . . , . . . . . . . . 0 Yes 00 No

b If 'Yes ' complete the followin g schedule . (a) Name of organization (b) Type of organization (c) Description of relationship

N/A

Under end comp et~

perl arah yh o

ecleto that I~ N ejbMn~O this flduuday)

Iaudbiecoo~Parolschedulp end statements, end to the best of rty knowledge and belief, it is true . correct

9~ R61'

11 i v

' Sig ure of office r t ee Date Preparers , , C

signature & GO F B, a a~ Finns namecaywrs SALTZ, SHAMI 9 4

(D 0 it ioto '300 SPRUCE ST ., S ~E 250 a miess.and z~cam COLUMBUS . OH 4 321

Schedule B (Form 990, 990-EZ, or

990-PF) OcPoftmo+t of tno Trca :iuy Miami iiavmuv Smvlco

Name of olganization

Schedule of Contributors OMB No. 1 y15 .OOd 7

2004 Supplementary Information for line t of Form 990, 990-EZ, and 990-PF (see instructions)

31-1721314 IHS FOUNDATION

Caution : Organizations that are not covered by the General Rule and/or the Special Rules do not file Schedule 8 (Form 990, 990-EZ, or 990-P~, but they must check the box in the heading of their Form 990, Form 990-Q, or on line 2 of their Form 990-PF, to certify that they do not meet the filing requirements of Schedule 8 (Form 990, 990-EZ or 990-Ph7 .

423451 11-24-04

13 c -$ -r, 1 nn -r o w nn w n, c won n nnn nC n'7 n TUC Vnrrn,n rmrnrT nis1ao 1

Employer identification number

Organization typo (check one) :

Fi1aro 01 : Section :

Form 990 or 990-EZ = SOi (c)( ) (outer numboO organization

4947(p)(1) nonexempt chprhAble trust not troAteU n3 a private foundation

527 political organization

Form 990-PF OT 501(c)(3) exempt private foundation

0 49470(1) nonexempt charitable trust treated as a private foundation

0 501(c)(3) taxable private foundation

Check if your organization Is covered by the General Rule or a Special Rule. (Note : Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule-see Instructions.)

General Rule-

OX For organizations filing Form 990, 990~EZ, or 990~PF that received, during the yetis, $5.000 or more (n money or property) from anyone contributor . (Complete Paris I And II .)

Special Rules-

For a section 501(c)(3) organization filing Form 990, or Form 990~FZ, that met the 33 1/3% support test of the regulations under sections 509(a)(1)/170(b)(1)(A)(vQ and received from any one contributor, during the year, a contribution of the greater of $5.000 or 2% of the amount on line 1 of these forms . (Complete Paris I and II .)

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

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

LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990, Form 990-EZ, and Form 990-PF.

Schedule B (Form 990, 990-E2, or 990-PF) (2004)

Scnafulo B (Form 990. 99D-E?- a 991

Name of organization

IHS FOUNDATION

Pogo I of Z of Port i

Employer Identification number

31-1721314

LPal~ ' Contributors (See Specific Instructions)

lo! (b) 1c! Id) No . Name, address, and ZIP + 4 Aggregate contributions Typo of contribution

7 . GEORGE ANTHONY SKESTOS Person M Payroll

933 CITY PARK AVENUE $ 1., 000, 000 . Noncosh (Complete Port II it thorn

COLUMBUS, OH 43206 is A noncash contribution )

(o) (b) (c) (d) No . Name, address, end ZIP + 4 Aggregate contributions ] Typo 01 contribution

Person 0 Payroll 0 Noncesh 0

(Complete Part II rf there is a noncash contribution )

M (d)

Aggregate contributions Type of contribution (b)

No . Name, address, and ZIP + 4

Person Payroll 0

Noncash 0

(Complete Part II H there is a noncash contribution .)

Icl (d) contributions Type of contribution

Person Payroll Noncash

(Complete Part II H there Is a noncash contribution .)

(a) (b) No. Name, address, and ZIP + 4

(b) M (d) No. Name, address, and ZIP + 4 Aggregate contributions Type of contribution

Person 0 Payroll 0 Noncash 0

(Complete Part II d there is a noncash contnbution )

(a) (b) 1c1 (d) No . Name, address, and ZIP + 4 Aggregate contributions Type of contribution

Person O Payroll Noncash

(Complete Part II d there is a noncash contnbution )

423452 >> .24-04 Schedule B (Form 990, 990-EZ, or 990-PF) (2004) 14

r- '7 1 1 A 0 ,o,,nnA n,~10 O 1nnn 09;n-7n Tuc Fnrnanamrnrt (115'~R9 1

CONTINUATION FOR 990-PF, PART IV ZHS FOUNDATION 31-172131 PAGE 1 OF 2 PaM1V, cap ital Gains and Losses for Tai on Inr..iment Income

(a) List and describe the kind(s) 01 property sold, e .g ., real estate, (b How acquired (c 1 Date acquired (d) Date sold 2-story brick warehouse, or common stock, 200 shs MLC Co ~' - Purchase (mo ., day, yr .) (mo, day, yr .) D - Donation

la COMMSCOPE INC P 11/24/0006/28/04 b COMMSCOPE INC P 11/27/0006/28/04 c COMMSCOPE INC P 11/28/0006/28/04 d COMMSCOPE INC P 08/22/0009/09/04 e COMMSCOPE INC p 12/26/0009/09/04 I COMMSCOPE INC P 127267666-97-69/04 g INGRAM MICRO P 12/26/0008/04/04 n INGRAM MICRO P 12/2610008/04/04 I INGRAM MICRO P 12 72 1/0009 17 04 INGRAM MICRO P 12 21 0009 20 04

k LUCENT TECHNOLOGIES P 11/22/0011/15/04 i USG CORP P 617-22 7-6110/26/04 m USG CORP P 01 / 22 / 0110/26/04 n USG CORP P 12/11/0011/03/04 o USG CORP P 12711 7 66-117-6-3F04

(e) Gross sales price (Q Depreciation allowed I (p) Cost or other basis I (h) Gam or (loss) (or allowable) plus expense of sale (e) plus (f) minus (g)

10,492 . 7,992 .

25,989 . <3,537 . > 16,956 . 21,196 . 6,525 .

65,271 . 42,854 . 48,325 .

<48,159 . > 98 .

19,719 . 41,994 . 42,303 .

(I) Losses (from col (h)) Gams (excess of col (h) gain over col (k),

but not less than'-0= )

87 , 754 . 90,254 .

170,504 . 24 , 327 . 66 , 202 . 82 , 752 . 22 , 102 .

221 002 . 103 872 . 117,132 . 67 , 903 . 2 , 227 .

443 225 . 90 , 250 . 89 , 941 .

in column (h) and owned by the foundation on 12/31/69 (p Adjusted basis (k) Excess o1 col (I) as of 12/31/69 over col (p, if any

I k 19,744 . i 2,325 . m 462,944 . n 132,244 . 0 132,244 .

Complete only for assets showy

(I) F M.V as of 12/31/69

10,492 . 7,992 .

25,989 . <3,537 . > 16,956 . 21,196 . 6,525 .

65,271 . 42,854 . 48,325 .

<48,159 . > 98 .

f

h

19,719 . 41,994 . 42,303 .

IS � ,no -roA nnn nisi ao 1nnn nsn7n ruc FnrrrlnnmTnN niSIRq I

a 98,246 . b 98,246 . c 196,493 . d 20,790 . e 83,158 . r 103,948 .

28,627 . n 286,273 . t 146,726 .

165 457

n

2 Capital gain net income or net capital loss) If ?loss), am,Iso enter m Part I, line 7 1

1 ~ H enter'-0= m Part I, line 7 1

3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6) If gam, also enter in Part I, line 8, column (c) n (loss), enter *-0-* m Part I, line 8 3

423591 OS01-04

t 9 h

f

k

I

m

n

(g) Cost or other basis plus expense of sale

300,484 . 178,002 . 86,654 .

(q Depreciation allowed (or allowable)

Complete only for assets

(I) F M V as of 12/31169

In column (h) and owned by the foundation on 12/3/69

Adjusted basis (k) Excess of cot (i) as of 12/31/69 over cot (j), if any

2 Capital am net income or net capital loss I n ain, also enter m Part I, line 7 1 1 ,moss), enter'-0= m Part I, line 7 1

3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6) If gam, also enter in Part I, line 8, column (c) n (loss), enter'-0= in Pad I, line 8

423591 oso,-oa

2

16 r ̂ f -i 1i n n ^r cf An n A n 1 C -) o n 7 n I1 A AS 0-71`) TUC! L1rNTM7n7%rVTn'K7 nir%zR4 i

CONTINUATION FOR 990-PF, PART IV ,Z HS FOUNDATION 31-172131 PAGE 2 OF 2 Part N Capital Gains and Lasses for Tax on Invo,tmeM Income

a) list and describe the kind (s) o1 sold, e real estate, (b1 How acquired (cDate acquired d Date sold p ro perty 9~~ p - Purchase 2-story brick warehouse ; or common stock . 200 shs MLC Co 0 - Donation mo , day, yr.) Imo., day, yr .)

la USG CORP P 02 22/0111 04/04 b USG' CORP ~ P 03/12 /0111/05/04 c USG CORP ~P 105/31/01 112 / 29 / 04

t 9 h I 1 k I R

n

f

9 h

I n n

(e) Gross sales price

419,913 . 308,652 . 406,508 .

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

119,429 . 130,650 . 319,854 .

(1) posses (from cot (h)) Gains (excess of cot . (h) gain over coy (k),

but not less than *-0-')

119,429 . 130,650 . 319,854 .

867,951 .

N/A

IIIS Foundation EIN : 31-1721314 2004 Dorm 990-PF Park XV Lines 2a-d

2d . Restrictions and limitations based upon available funds. Preference given to charitable & religious organizations, education and educational institutions, health and medical research, aid to need persons and scholarships for worthy students ; all of which arc exempt under Section 501(e)(3).

2a . II-IS Foundation Attn : "I'crric Rico 2700 E. Dublin-Granvillc Rd, Suite 01 Columbus, Ol-f 43231

2b . Letter of request with the following : Verification of exempt status under Section 501(c)(3) of the Intcmal Revenue Code Description of charitable need and cause Requested amount

2c. No deadline, submissions accepted and reviewed as received

'ORM 990-PF DIVIDENDS AND INTEREST FROM SECURITIES STATEMENT 2

0 .

0 .

:OLUMBUS TITLE COMPANY LLC

'OTAL TO FORM 930-PF, PART I, LINE 11, COLUMN A

(D) CHARITABLE PURPOSES

0 .

0 .

(C) ADJUSTED NET INCOME

EXPENSES NET INVEST-PER BOOKS MENT INCOME

16,855 . 0 .

16,855 . 0 .

17 STATEMENT S) 1, 2, 3, 4 innA nqn7n Tuc FnrrrmamTnN n1c;iR9 1 s~'7iino '7oAnnA ni q iQo

IHS FOUNDATION 31-1721314

'ORM 990-PF . INTEREST ON SAVINGS AND TEMPORARY CASH INVESTMENTS STATEMENT 1

;OURCE AMOUNT

NTEREST - HNB MONEY MARKET 1,555 . NTEREST - SN MONEY MARKET 10,215 . NTEREST - SSB MONEY MARKET 745 .

'OTAL TO FORM 990-PF, PART I, LINE 3, COLUMN A 12,515 .

:OURCE GROSS AMOUNT

;ALOMON SMITH BARNEY 66,270 .

'OTAL TO FM 990-PF, PART I, LN 4 66,270 .

'ORM 990-PF ETHER INCOME

DESCRIPTION

CAPITAL GAINS DIVIDENDS

'ORM 990-PF

DESCRIPTION

LEGAL FEES

'O FM 990-PF, PG 1, LN 16A

LEGAL FEES

COLUMN (A) AMOUNT

66,270 .

66,270 .

STATEMENT 3

AMOUNT

97,165 .

97,165 .

STATEMENT 4

31-1721314 IHS FOUNDATION

'ORM 990-PF ACCOUNTING FEES STATEMENT 5

EXPENSES NET INVEST-PER BOOKS MENT INCOME

200 . 0 . 4,952 . 0 .

5,152 . a .

0 . 0 .

0 . 'O FORM 990-PF, PG 1, LN 18

.'OLUMBUS TITLE COMPANY LLC (EIN # 20-1266046)

'HE ACTIVITY HAS BEEN REPORTED ON FORM 990-T

V 18 STATEMENT S) 5, 6, 7

nn won nn n n, r,goo Innn nsn7n Tuc Vnrrnmamrnnt !11 ~, ~R4 1

DESCRIPTION

ACCOUNTING FEES

'O FORM 990-PF, PG 1, LN 16B

'ORM 990-PF

>ESCRIPTION

;TATE 'EDERAL

(B) EXPENSES NET INVEST-PER HOOKS MENT INCOME

3,544 . 1,772 .

3,544 . 1,772 .

TAXES

(C) (D) ADJUSTED CHARITABLE NET INCOME PURPOSES

1,772 .

1,772 .

STATEMENT 6

(C) (D) ADJUSTED CHARITABLE NET INCOME PURPOSES

FOOTNOTES STATEMENT 7

'ART VII-A, QUESTION 2 - NEW ACTIVITIES PREVIOUSLY TOT REPORTED TO THE INTERNAL REVENUE SERVICE :

'HS FOUNDATION PURCHASED INTEREST IN THE FOLLOWING LIMITED LIABILITY COMPANY :


'ORM 990-PF, CORPORATE STOCK STATEMENT 8

DESCRIPTION

'ARIOUS STOCKS

'OTAL TO FORM 990-PF, PART II, LINE lOB

BOOK VALUE

14,089,829 .

14,089,829 .

'ORM 990-PF OTHER INVESTMENTS

DESCRIPTION BOOK VALUE

'OLUMBUS TITLE COMPANY LLC 106,773 .

'OTAL TO FORM 990-PF, PART II, LINE 13 106,773 .

'ORM 990-PF PART VIII - LIST OF OFFICERS, DIRECTORS TRUSTEES AND FOUNDATION MANAGERS

STATEMENT 10

19 STATEMENT S) 8, 9, 10 r~'7 1 nom '7 0 Ann,, n~r, '3 00 innn nqnin Tuc VnrnKTnamTnN f115ift9 1

FAIR MARKET VALUE

13,632,522 .

13,632,522 .

STATEMENT 9

FAIR MARKET VALUE

106,773 .

106,773 .

EMPLOYEE TITLE AND COMPEN- BEN PLAN EXPENSE

LAME AND ADDRESS AVRG HRS/WK SATION CONTRIB ACCOUNT

GEORGE ARTHUR SKESTOS PRESIDENT 700 E . DUBLIN GRANVILLE RD, SUITE 0 . 1 0 . 0 . 0 . 'OLUMBUS, OHIO 43231

'ERRIE L . RICE SECRETARY/TREASURER 700 E . DUBLIN GRANVILLE RD, SUITE 0 . 1 0 . 0 . 0 . 'QZUMBUS, OHIO 43231

:TEPIiANIE K . SKESTOS TRUSTEE 700 E . DUBLIN GRANVILLE RD, SUITE 0 . 1 0 . 0 . 0 . OLUMBUS, OHIO 43231

.LEXANDRA SRESTOS HOLMES TRUSTEE 700 E . DUBLIN GRANVILLE RD, SUITE 0 . 1 0 . 0 . 0 . OLUMBUS, OHIO 43231

'OTALS INCLUDED ON 990-PF, PAGE 6, PART VIII

STATEMENT 11 PART XV - LINE IA LIST OF FOUNDATION MANAGERS

ME OF MANAGER

:EORGE ARTHUR SKESTOS :TEPHANIE K . SKESTOS .LEXANDRA SRESTOS HOLMES :EORGE ANTHONY SKESTOS JASON J . SKESTOS

RECIPIENT RECIPIENT .ECIPIENT NAME AND ADDRESS STATUS PURPOSE OF GRANT RELATIONSHP AMOUNT

.LPHA PREGNANCY COUNSELING, PUBLIC 691 KERSDALE PLACE, GROVE CHARITY ITY, OH 43123

.MERICAN CANCER SOCIETY, PUBLIC 709 WEST JETTON AVENUE, CHARITY 'AMPA, FL 33629

ILLY GRAHAM EVANGELISTIC PUBLIC .SSOCIATION, 1 BILLY GRAHAM CHARITY 'ARKWAY, CHARLOTTE, NC

ARE, 151 ELLIS STREET NE, PUBLIC .TLANTA, GA 30303-2440 CHARITY

'00D FOR THE POOR, 550 SW PUBLIC 2TH AVENUE, DEERFIELD CHARITY EACH, FL 33442

GENERAL PURPOSE NONE FUNDS

7,500 .


2,000 .


10,000 .

GENERAL PURPOSE NONE FUNDS 5,000 .


6,000 .

20 STATEMENT S) 10, 11, 12 r 1 ~r 1 In n ^7 n A A ^1 r 1 A A n A l1 A n C n '7 A T U f` LlI'1 f T'kT T T T T /lAT !1 1 S Z o0 1

IHS FOUNDATION

EORGE ANTHONY SKESTOS TRUSTEE 700 E . DUBLIN GRANVILLE RD, SUITE 0 . 1 OLUMBUS, OHIO 43231

ASON J . SKESTOS TRUSTEE 700 E . DUBLIN GR.ANVILLE RD, SUITE 0 . 1 'OLUMBUS, OHIO 43231

'ORM 990-PF

31-1721314

0 . 0 . 0 .

0 . 0 . 0 .

0 . 0 . 0 .

'ORM 990-PF GRANTS AND CONTRIBUTIONS STATEMENT 12 PAID DURING THE YEAR

2ADTKLIN PARK CONSERVATORY, PUBLIC GENERAL PURPOSE NONE 777 EAST BROAD STREET, CHARITY FUNDS )LUMBUS, OH 43203 5,000 .

JIDE DOG FOUNDATION , 371 PUBLIC GENERAL PURPOSE NONE SST JERICHO TURNPIKE, CHARITY FUNDS KITHTOWN, NY 11787 2,000 .

EARTBEAT INTERNATIONAL, PUBLIC GENERAL PURPOSE NONE 55 E . DUBLIN-GRANVILLE CHARITY FUNDS J ., STE 440, COLUMBUS, OH 20,000 .

MMES CANCER HOSPITAL, P .O . PUBLIC GENERAL PURPOSE NONE DX 710811, COLUMBUS, OH CHARITY FUNDS 3271 510,000 .

ILL NECK FOUNDATION, P .O . PUBLIC GENERAL PURPOSE NONE )X 100, MILL NECK, NY CHARITY FUNDS 1765 3,000 .

JLTIPLE SCLEROSIS SOCIETY, PUBLIC GENERAL PURPOSE NONE i1G LAKEVIEW PLAZA BLVD ., CHARITY FUNDS 3RTHINGTON, OH 43085 200 .

I%RKINSON'S FOUNDATION, 710 PUBLIC GENERAL PURPOSE NONE EST 168TH STREET, NEW CHARITY FUNDS 3RK, NY 10032 2,500 .

REGNANCY DECISION HEALTH PUBLIC GENERAL PURPOSE NONE ENTERS, 665 E . CHARITY FUNDS JBLIN-GRANVILLE RD ., 20,000 .

VMARITAN'S PURSE, P .O . BOX PUBLIC GENERAL PURPOSE NONE 700, BOONE, NC 28607 CHARITY FUNDS 25,000 .

iE SALVATION ARMY, 340 E . PUBLIC GENERAL PURPOSE NONE JLTON STREET, COLUMBUS, OH CHARITY FUNDS 13215 10,000 .

ON THE ROOF, 300 WEST PUBLIC GENERAL PURPOSE NONE 7TH AVE ., SUITE 519, CHARITY FUNDS )LiJMBUS, OH 43210 6,000 .

;LS KINGDOM WORKERS, 2401 PUBLIC GENERAL PURPOSE NONE IRTH MAYFAIR RD, SUITE CHARITY FUNDS )4, WAUWATOSA, WI 53226 25,000 .

BLS LUTHERAN FOR LIFE, PUBLIC GENERAL PURPOSE NONE X49 N . MAYFAIR RD ., SUITE CHARITY FUNDS )9, MILWAUKEE, WI 53222 5,000 .

TEAT RIDGE MINISTRY, ONE PUBLIC GENERAL PURPOSE NONE LERCE PLACE, SUITE 250E, CHARITY FUNDS rASCA, IL 60143-2634 2,500 .

21 STATEMENT S) 12 -n"l in .. -+nAnn A n, c,on nnnn nsn7n TWO VnrrKmrmrnrT niSZQq


OTAL TO FORM 990-PF, PART XV, LINE 3A 801,700 .

22 STATEMENT S) 12 r ~1 î ~ ~ l~ A ^7 f1 A I1 AA AlC 7 O !1 7 nA A /1 /1 '7 /1 7U0 LV11 TAT T1 T T TlIAT X11 RZ R Q 1


EED THE CHILDREN, P .O . BOX PUBLIC GENERAL PURPOSE NONE 6, OKLAHOMA CITY, OK CHARITY FUNDS 3101-0036 5,000 .

AITH MISSION, DEPT . PUBLIC GENERAL PURPOSE NONE -1313, P .O . BOX 18045, CHARITY FUNDS OLUMBUS, OH 43218 10,500 .

NOUGHTS FAITH UKRAINE, 900 PUBLIC GENERAL PURPOSE NONE ARKET STREET, OREGON, WI CHARITY FUNDS 3575 25,000 .

ÌSCONSIN LUTHERAN CHAPEL, PUBLIC GENERAL PURPOSE NONE 20 W . GILMAN STREET, CHARITY FUNDS ADISON, WI 53703 5,000 .

BUCKEYE RANCH, 5665 HOOVER PUBLIC GENERAL PURPOSE NONE OAD, GROVE CITY, OH 43123 CHARITY FUNDS 2,500 .

T . PAUL'S EVANGELICAL PUBLIC GENERAL PURPOSE NONE HURCH, 326 STEWART STREET, CHARITY FUNDS OLUMBUS, OH 43206 20,000 .

NIVERSITY LUTHERAN CHAPEL, PUBLIC GENERAL PURPOSE NONE 511 WHENAW AVENUE, ANN CHARITY FUNDS RBOR, MI 48104-3122 5,000 .

APITAL AREA HUMANE PUBLIC GENERAL PURPOSE NONE OCIETY, 3015 SCIOTO-DARBY CHARITY FUNDS XECUTIVE COURT, HILLIARD, 5,000 .

. . FERRARI LECTURESHIP, PUBLIC GENERAL PURPOSE NONE .O . BOX 710811, COLUMBUS, CHARITY FUNDS H 43271 25,000 .

MERICAN UNITED 4 LIFE, 310 PUBLIC GENERAL PURPOSE NONE . PEORIA STREET, SUITE CHARITY FUNDS 00, CHICAGO, IL 60607- 2,500 .

RAILLE BIBLE FOR BLIND PUBLIC GENERAL PURPOSE NONE HILDREN, P .O . BOX 7481, CHARITY FUNDS ALETHORPE, MD 21227-0481 2,000 .

ARCH OF DIMES, P .O . BOX PUBLIC GENERAL PURPOSE NONE 547, DECATUR, IL CHARITY FUNDS 2525-2547 1,500 .

RT INSTITUTE CHICAGO, 111 PUBLIC GENERAL PURPOSE NONE . MICHIGAN AVENUE, CHARITY FUNDS HICAGO, IL 60603 26,000 .

Form Oepw1ment of the Treasury Internal Rovanu0 Savbo

Name

OMB No . 1545-0142 Underpayment of Estimated Tax by Corporations " See separate Instructions .

eN..w 11 . . u.. -_.....u . . .. .- #... ...~ . . . .. L1r1DLA non -DV 2004 Employer identification number

31-1721314 ZHS FOUNDATION Note : In most cases, the corporation is not required to file Form 2220 . (see Part I below for exceptions) because the IRS will figure any penalty owed and bill the

corporation . Even i1 form 2220 is not required, the corporation may still use It to figure the penalty . In such a case, enter the amount from page 2, tine 38 on the estimated tax penalty line of the corp oration's income tax return but do not attach Form 2220 . ;~~, Reasons for Filing - Check the boxes below that apply . It any boxes are checked, and line 6, below, Is E500 or more, the corporation must

rile Form 2220, even ft It does not owo a penalty .

1 0 The corporation IS using the adjusted seasonal Instnllmont method . 2 0 The Corporation Is using the annualized Income Inst3limort method .

9 Installment due dates . Enter In cot (a) through (~ the 15th day of the 4th (Form

~9di~v,f�,~oru,ooo~omuo ow~y~. 9 05/15/04 06/15/04 09/15/04 10/01/04 12/15/04 Exception . it ono of your Installment duo dates la Sept 16, 2004, am the Instructions .

10 Required Installments . if the box an line 1 and/or line 2 above la enoekod, ant the amounts from Schedule l, line 3 . II the box on In 3 (but not 1 or 2) 1a ehxko0, am Instructions for the amounts to onto.

zs9iorinao~novboins calm f+o~owk ' .°.~.' .'°.` 10 1 , 058 . 1 , 057 . 846 . 212 . 1 , 057 . 11 Estimated tax paid or credited for

each period (see instructions). For column (a) only. enter the amount ~ ~ 297 . 3 , 952 . from line 11 on line 15 �� , . Complete lines 12 through 18 of

5, 0 no column before going to the next

column .

12 Enter amount, d any, from line 18 ~A } rhs`~~~;i ~ %w

of the preceding column . 12 13 Add lines 11 and 12 13 3 , 952 .

14 Add amounts on lines 16 and 17 of the preceding column 14 761 . 1 , 818 . 21664 . 2 , 876 .

15 Subtract line 14 from line 13 If zero orless,enter -0- 15 297 . 0 . 0 . 0 . 1,076 . . , . . . .

;,t~. e 1 6 If the amount on line 15 is zero, subtract

761 . 1 , 818 . 2 , 664 . line 13 from line 14 Otherwise, enter -0- 16 s~ +~s+c ~ 7r~< � ~ "o `

17 Underpayment . a use is Is less ma� or equal W Tine 10. subtract line 15 from line ,o Then go co line , 2 0f ma next

17 761 . 1 057 . 846 . 212 . column Otherwise, go to line 1B

18 Overpayment if line 10 is less than line 15, subtract line 10 from line 15 Then W line 72 of me next column 18

Go to Part III on pane 21o haute the penalty Do not go to PaA III If there are no entries online 17 - no penalty is owed . 412801 JWA For Paperwork Reduction Act Notice, see separate instructions . Form 2220 (2004)

24 A , r- 1 ten ,oA nnn n, r, '1o o ~0 nn n9;n'7n ruc PnrrunamTnu (11 S~R4 1

~Raitklu Figuring the Unde a ment a Total tax (see Instructions) . . � , . . ., . . . � , . ., . . � . . ., . . � . ., . . . . , . , . . . , , . . . . , . � . . . ~0 18 , 899 .

\~ s\

5 a Personal holding company tax (Schedule PH (Form 1120), line 26) included on line 4 Sa {" ... b Look-back Interest included on line 4 under section 460(b)(2) for completed long-term ~~`w<r contracts or of section 167(8) for depreciation under the Income forecast method 5b 4k` .~t

c Credit for Federal tax paid on fuels (see Instructions) . . , . . 5c w;y~� ' d Total . Add lines Sa through SC . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . 5d

B Subtract line 5d from line 4 . n the result Is less than $500, do not complete or file this form The corporation does not owe the penalty . . . . . . . . . . . . . . . . . . . . . . . . . . 6 18 , 899 .

7 Enter the tax shown on the corporation's 2003 Income tax return . Caution : It the tax Is zero or the tax year was for less than 12 months, skip this line and enter the amount from line 6 online 8 i 4 , 230 .

8 Enter the smaller of line 6 or line 7 . If the co rporation is req uired to ski line 7 enter the amount from line 6 8 4 , 230 .

FORM 990-PF Form 2220(2004) IHS FOUNDATION 31-1721314 Page 2

'`,PartÌII~ Figuring the Penalty

Number at days on line 20 after 21 4/t g/1ppA end before 7/1/Z004 ��

22 Underpayment on line 17 x

Number of clays on line 21 x 5% . . . . .

Number

3116

of days on line 20 ohm 29 8/J0200a and before tOnrz004 ��


Number of clays on line 23 x 4% . . . . . . 366

Number of days on line 20 after 25 9/302004 end before 1/1,2005 . . . . . .


Number of days on line 25 x 5% . . . . 366

Number of days an Ilno 20 after 27 12/31rzaoa and before anrzoos . . . . 28 underpoymaic on line 17 x

Number of days on line 27 X 5% . . . . . 369

Number of days on Ilne 20 after 29 ~iaoos ena oerone 7n2aos . . . 30 Underpayment on dine 17 x

Number of Cayn on Tine Z9 x*% � �

ass Number of days on line 20 after

31 8/do/=ODs and before 1on2o0s . . . . . .

32 Underpayment on flna 17 x

Number of days on line 31 x 363

Number of cloys on line 20 after 93 er3ortaos and before inaooe . . . . . . 34 Underpayment on line 17 x

Number of days an line 33 x *% . . . . . . ass

Number of days on line 20 after 95 12/d12009 and before 2/188008 . . . . . .


Number of days on line 35 x 3115

ZS

26

SEEI ATTACHED WIORKSHEET 27

4128(1Q 01-24-OS

25 � n rl ,oA A A ,, n, C; ') 0 o ~nnn nrn7n Tuc Fnrrunn,TTnN O1 53A9 1

19 Enter the solo of payment or the 15tn day of the 3rd month after the cJosa of the tax

1Fo~mh990 P F andiForm 990 Tt~ Ilprs : use sin month instead of 3rd month 1 . . . . . . . . . . . . . . . .

Number of days from duo date of Install- 20 moot on in 9 to the oato anown on ono lo

37 Add lines 22, 24, 26, 28, 30, 32, 34, 8 38 97

38 Penalty . Add columns (a) through (e), of line 37. Enter the total here and on Form 1120, line 33, Form 1120-A, fine 29,

or the comparable line for other Income tax returns 38 3 8 .

" For underpayments paid after March 31, 2005 : For lines 30, 32, 34, and 36, use the penalty interest rate for each calendar quarter, which the IRS will determine during the first month m the preceding quarter These rates are published quarterly in an IRS News Release and in a revenue rating in the Internal Revenue Bulletin To obtain this Information on the Internet, access the IRS websde at www.irs gov. You can also call 1-800-829-1040 to get inte rest rat e information

JWA Form 2220 (2004)

412511 OSOI-04

26 r, 1 no ,oAnnn n, 9; -1 Aca Anna ng;0'7n ruc FnrrNnATTnN 015389 1

FORM 990-PF UNDERPAYMENT OF ESTIMATED TAX WORK4. .EET

Name(s) Identifying Number

IHS FOUNDATION 31-1721314 (A) (B) (C) (0) (E) (F)

Adjusted Number Days Daily *Date Amount Balance Due Balance Due Penalty Rate Penalty

.r

W, "~~s~ "y~.\v \\~: A~ ~

'w

~t:,

05/15/04 1 , 058 . 1 , 058 .

05/15/04 <200 . 858 .

05/15/04 <97 . 761 . 31 .000136612 3 .

06/15/04 1 , 057 . 1 , 818 . 15 .000136612 4 .

06/30/04 0 . 1 , 818 . 77 .000109290 15 .

09/15/04 846 . 2 , 664 . 15 .000109290 4 .

09/30/04 0 . 2 , 664 . 1 .000136612

10/01/04 212 . 2 , 876 . 30 .000136612 12 .

10/31/04 <2 , 872 . > 4 . 45 .000136612

12/15/04 1 , 057 . 1 , 061 .

12/15/04 <1 , 080 . > <19 .

12/31/04 0 . <19 . 90 .000136986

03/31/05 0 . <19 . 45 .000164384

Penalty Due (Sum of Column F) 38 .

" Date of estimated tax payment, withholding credit date or installment due date

<Application for Extension of Time To File an Exempt Organization Return

Form gggg (Rev . December 2004) DcpnArnont of u+aTroxury Internal ployanuo Service

OMB No . 15451709

0- File a for each return .

Electronic Filing (o-file). Form 8868 can 4o filed electronically I( you want n 3-month automatic extension of limo to file ono of the roturns noted below (6 months for corporate Form 990~T filers) . However, you cannot file It electronically If you want the additional (not automatic) 3-month extension, Instead you must submit the fully completed signed page 2 (Part II) of Form 8868 For more details on the electronic filing of this form, visit www.lrs.gov/e/ile .

IHS FOUNDATION Number, street, and room or suite no . If a P O. box, see instructions . 750 NORTHLAWN DRIVE

31-1721314 File by the due dote for filing your return Sao Instructions City, town or post office, state, and ZIP code . For a foreign address, see instructions

COLUMBUS, OH 43214

Caution . If you are going to make an electronic fund withdrawal with this Form 8868, see Form 8453~E0 and Form 8879-EO for payment instructions

LHA For Privacy Act and Paperwork Reduction Act Notice, see instructions. Form 8868 (Rev 12-2004)

9ALTZ, St-;AMi8 b (30LpFA;M MAC, Certified Public qooouirnw,,U 300 Sprvoe St , Ste 250 " Cole . pH 4321,5 -1411795 427837

01 lees

" If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box �� , , , . � . . . , . , " If you are filing for an Additional (not automatic) 3-Month Extension, complete only Port II (on page 2 of this form) . Do not complete Pan II unless you have already been granted an automatic 3-month extension on a previously filed Form 8868 .

RPa I Automatic 3-Month Extension of Time - only submit original ono coploa needed)

Form 990-T corporations requoatlng an automatic 6-month extension ~ chock this box and complete Part I only �� , .�� , � " 0

All other corporotlons (including Form 990-C Illors) must use Form )004 to roquost an extension of time to No income tax rotums. Partnerships, REMICs, and busts must use Form 8736 to roquost an extension of time to 1110 Form 1065, 1066, or 1041

Typo or

print

Name of Exempt Organization Employer identification number

Check type of return to be filed (file a separate application for each return) :

Form 990 0 Form 990~T (corporation) = Form 4720 0 Form 990-BL ~ Form 990~T (sec 401(a) or 408(a) trust) = Form 5227

Form 990~EZ ~ Form 990~T (trust other than above) 0 Form 6069 Form 990-PF ~ Form 1041~A 0 Form 8870

" The books are in the care of " KEN NEAL Telepnone No . " 614-451-9999 FAX No 1110-

" the organization does not have an office or place of business in the United States, check this box ., �� , , , , � , � � If this is for a Group Return, enter the organization's four digit Group Exemption Number (GETS . Ii this is for the whole group, check this

box " = . If h Is for part of the group, check this box " = and attach a list with the names and EINs of all members the extension will cover.

1 I request en automatic 3-month (6-months for a Form 090-T corporation) extension of time until AUGUST 15, 2 005 to file the exempt organization return for the organization named above . The extension Is for the organization's return for : " EK calendar year 2 0 0 4 or " =1 tax year beginning , and ending

2 If this tax year Is for less than 12 months, check reason : 0 Initial return 0 Final return F-IChange in accounting period

3a If this application Is for Form 990-BL. 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any nonrefundable credits . See Instructions . . . . . , . $ 24,249 .

b If this application Is for Form 990-PF or 990~T, enter any refundable credits and estimated tax payments made . Include any prior year overpayment allowed as a credit _ ., $ 4,249 .

c Balance Due . Subtract line 3b from line 3a Include your payment with this form, or, if required, deposit with FAD coupon or, d required, by using EFTPS (Electronic Federal Tax Payment System) See instructions $ 20,000 .

By Director Date

Altercate Mailing Address - Enter the address A you want the copy of this application for an additional 3-month ext different than the one entered above

AUG 2 3 Name SALTZ, S HAMIS & GOLDFARB, INC .

, FIELD DIRECTOR, SUBMISSION PROCESSING, OGDEPa

Type I Number and street (include surte, room, or apt. no.) or a P.O. box number or print ~ 300 SPRUCE ST ., SUITE 250

City or town, province or state, and country (including postal or ZIP code) COLUMBUS, OH 43215

Form 8868 (Rev 12-2004)

form 4868 (Rev . 12-2004) Page 2

~ H you are filing for an Ae "lion-Nil (not automatic) 3-Month Extension, complete only Part 11 and check this box ., . � . . � � 1 Note : Only complete Partf II if you have already been granted an automatic 3-month extension on a previously filed Form 8868 . 0 Fi ou tue filing for an Automatic 3-Month Extension, complete only Part 1 on page 1 ) . ! P~iitslC Additional not automatic 3-Month Extension of Time - Must file Original and One Copy .

Typo or Name of Exempt Organization ~ Employer identification number

print . YHS FOUNDATION 31-177.1.31 nic by "to

Number, street . and room or suito no . If a P.O. box, see Instructions . For IRS use only 700 E . DUBLIN GR.ANVILLE RD SUITE 01 nlr,y as ~ ...._._ ~.._ .. City, town or post office, stato . and ZIP code . For n foreign address. sec instruction,

°`~°' OLUMBUS OH 43231 z~`\t~ �~w Check typo of return to be filed (File o Geparafo application for oath return)- ED Forth 990 CD Form 990~Q 0 Form 990~T (sec . 401(0) or 408(n) trust) CDForm 1041 ~A 0 Form 5227 0 Form 8870

Form 990-BL CK Form 990~PF CD Forth 990~T (trust other than above) CD Form 4720 El Form 6069

STOP: Do not complete Part II if you were not already granted an automatic 3-month extension on a previously filed Form 8868 .

" The books are In the care of " KEN NEAL Telephone No . " 614-898-72 0 0 FAX No . Ii the organization does not have an office or place of badness in the United States, check this box . . . . . . . . . . , . . If this Is for a Group Return, enter the organlzatlon's four digit Group Exemption Number (GEN) . K this is for the whole group, check this

box " [] . If ft Is for part of the group, check this box " 0 and attach a list with the names and EINs of ell members the extension is for . a I request an additional 3inontn extension of time until NOVEMBER 15, 2005 .. 5 For calendar year 2 0 0 4 , or other tax year beginning and ending

0 Final return 0 Change fn accounting period 6 If this tax year is for less than 12 months, cheek reason : 0 Initial return 7 State to detail why you need the extension

THE INFORMATION NEEDED TO PREPARE A COMPLETE AND ACCURATE RETURN IS NOT YET AVAILABLE

8a If this application is for Form 990-BL, 99o-PF, 99aT, 4720, or 6069, enter the tentative tax, less any nonrefundable credits. See instructions �� , . .��, .�� , .�� . �, �� , , � , , . . . $ 18,899 .

b If this application is for Form 990~PF, 990-T, 4720, w 6069, enter any refundable credits and estimated tax payments made . Include any prior year overpayment allowed as a credit and any amount paid previously with Form 8868 . . . � , ., . . . . ., �. . � , $ 24,249 .

c Balance Due. Subtract line 8b from line 8a. Include your payment with this forth, or, H required, deposit with FTD coupon or, if required, by using EFTPS (Electronic Federal Tax Payment system). See Instructions $

Signature and Verification

Under penalties of perjury, I declare that I have examined this forth, Including axompanyinmUtqclplegHARtatemer)§Laa&pAge?~&f my knowledge and belief, i it is true, corr t, ti d corn ete, a that 1 am thorizedto repare this term . ~(~ Public Accountanta

pnioe St. . Ste. 250 - Cole IB ' " SI nature " Title " 3D0

v Notice i0 Applicant - To Bc Con. S,:.IStOd V, kshw- !F[%

We have approved this application . Please attach this forth to the organization's return .

We have not approved this application . However, we have granted a 10-day grace paned from the later of the date shown below or the due date of the organization's return (including any prior extensions) . This grace period is considered to be a valid extension of time for elections otherwise required to be made on a timely return . Please attach this forth to the organization's return .

0 We have not approved this application . After considering the reasons stated in darn 7, we cannot grant your request for an extension of time to file. We are not granting a 10-day grace period. We cannot consider this application because it was filed after the extended due date of the return for which an extension was requested

Other

01e999b5 - Foundation Center990s.foundationcenter.org/990pf_pdf_archive/311/311721314/311721314_200412_990PF.pdfr Form 990-PF Department Of the TrOagjry tntomN RovFnuo Sonko Note:

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