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I A Form_wOm PF rkpartment of the Treasury Internal Revenue Service Ret urn of P_r-ivate_Foundation-- or Section 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation Note. The foundation may be able to use a copy of this return to satisfy state reporting re For calendar year 2010, or tax year beginning , and ending G Check all that apply: 0 Initial return initial return of a former public charity 0 Final return 0 Amended return Address change 0 Name change Name of foundation A Employer identification number GALKIN PRIVATE FOUNDATION 05-0494243 Number and street (or P 0 box number if mail is not delivered to street address) Room/sui te B Telephone number 155 BROOKSIDE AVENUE 401-828-0 300 City or town, state, and ZIP code C If exemption application is pending, check here WEST WARWICK , RI 0 2893 0 1. Foreign organizations, check here H Check typ e of or g anization: ®Sectlon 501(c)(3) exempt private foundation 2. Foreign organizations meeting the 85% test, check here and attach computation Section 4947 ( a )( 1 ) nonexem p t charitable trust Other taxable p rivate foundation E If rivate foundation status was terminated I Fair market value of all assets at end of year J Accounting method: ® Cash Accrual p under section 507(b)(1)(A), check here (from Part 11, col. (C), line 16) Other (specify) F If the foundation is in a 60-month termination 1 8 11 12 2 . (Part 1, column (d) must be on cash basis) under section 507 ( b )( 1 ) B ) , check here Part I Analysis of Revenue and Expenses (a) Revenue and (b ) Net investment (c) Adjusted net (d) Disbursements (The total of amounts in columns (b), (o), and (d) may not necessarily equal the amounts in column (a)) expenses per books income income for charitable purposes (cash basis only) 1 Contributions, gifts, grants, etc., received 426 , 335 . N / A 2 Check Ill- a it the foundation is not required to attach Sch e 3 Interest on savings and temporary cash investments 4 Dividends and interest from securities 33 , 601. 33 , 601. S tatement 1 5a Gross rents b Net rental income or (loss) 6a Net gain or (loss) from sale of assets not on line 10 72 , 145 . 7 Gross sales price for all b assets on line Oa 100,317. N y Capital gain net income (from Part IV, line 2) 72 , 145 . cc 8 Net short-term capital gain 9 Income modifications Gross sales less returns 1 t)a and allowances b Less Cost of goods sold c Gross profit or (loss) 11 Other income 12 Total . Add lines 1 throw h 11 532 , 081. 105 , 746. 0 ^ 13 Compensation of officers, directors, trustees, etc 0. 0. p V 0. 14 Other employee salaries and wages ti 15 Pension plans, employee benefits t fn N l f 1 L ega ees 6a Q b Accounting fees Stmt 2 7 , 000. 0. 0. W c Other professional fees 17 Interest T 18 Taxes 19 Depreciation and depletion E 20 Occupancy 4 21 Travel, conferences, and meetings C 2 Printing and publications Other expenses Stmt 3 2 , 373. 0. 0. M Total operating and administrative as expenses . Add lines 13 through 23 9 , 373. 0. 0. o 21 Contributions, gifts, grants paid 188 , 034. 188 , 034. 98 Total expenses and disbursements. ?` Add lines 24 and 25 197 , 407. 0. 188 , 034. t^ Subtract line 26 from line 12: Excess of revenue over expenses and disbursements 334 , 674 . Net investment income (if negative. enter -0- ) 105 , 746. Adjusted net income ( if negative , enter-0- N/A u2 0U-) LHA For Paperwork Reduction Act Notice, see the instructions. 1 08200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION No J5450052 ____-.____------ 2010 Form 990-PF (2010) 05-049 . 4
23

Form wOmPF Return ofP r-ivate Foundation-- 2010990s.foundationcenter.org/990pf_pdf_archive/050/050494243/050494243...I A Form_wOmPF rkpartment of theTreasury Internal RevenueService

Aug 19, 2019

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Page 1: Form wOmPF Return ofP r-ivate Foundation-- 2010990s.foundationcenter.org/990pf_pdf_archive/050/050494243/050494243...I A Form_wOmPF rkpartment of theTreasury Internal RevenueService

I A

Form_wOmPF

rkpartment of the TreasuryInternal Revenue Service

Return of P_r-ivate_Foundation--or Section 4947(a)(1) Nonexempt Charitable Trust

Treated as a Private FoundationNote. The foundation may be able to use a copy of this return to satisfy state reporting re

For calendar year 2010, or tax year beginning , and ending

G Check all that apply: 0 Initial return initial return of a former public charity 0 Final return

0 Amended return Address change 0 Name change

Name of foundation A Employer identification number

GALKIN PRIVATE FOUNDATION 05-0494243Number and street (or P 0 box number if mail is not delivered to street address) Room/sui te B Telephone number

155 BROOKSIDE AVENUE 401-828-0 300City or town, state, and ZIP code C If exemption application is pending, check here

WEST WARWICK , RI 0 2 8 9 3 0 1. Foreign organizations, check here

H Check typ e of or g anization: ®Sectlon 501(c)(3) exempt private foundation 2. Foreign organizations meeting the 85% test,check here and attach computation

Section 4947 ( a )( 1 ) nonexem p t charitable trust Other taxable p rivate foundation E If rivate foundation status was terminatedI Fair market value of all assets at end of year J Accounting method: ® Cash Accrual

punder section 507(b)(1)(A), check here

(from Part 11, col. (C), line 16) Other (specify) F If the foundation is in a 60-month termination1 8 11 12 2 . (Part 1, column (d) must be on cash basis) under section 507 ( b )( 1 ) B ) , check here

Part I Analysis of Revenue and Expenses (a) Revenue and (b ) Net investment (c) Adjusted net (d) Disbursements(The total of amounts in columns (b), (o), and (d) may notnecessarily equal the amounts in column (a)) expenses per books income income for charitable purposes

(cash basis only)

1 Contributions, gifts, grants, etc., received 426 , 335 . N /A2 Check Ill-a it the foundation is not required to attach Sch e

3 Interest on savings and temporarycash investments

4 Dividends and interest from securities 33 , 601. 33 , 601. S tatement 15a Gross rents

b Net rental income or (loss)

6a Net gain or (loss) from sale of assets not on line 10 72 , 145 .

7 Gross sales price for allb assets on line Oa 100,317.

N y Capital gain net income (from Part IV, line 2) 72 , 145 .

cc 8 Net short-term capital gain

9 Income modificationsGross sales less returns

1 t)a and allowances

b Less Cost of goods sold

c Gross profit or (loss)

11 Other income

12 Total . Add lines 1 throw h 11 532 , 081. 105 , 746. 0̂13 Compensation of officers, directors, trustees, etc 0. 0. p V 0.

14 Other employee salaries and wages ti

15 Pension plans, employee benefits t fnN

l f1 L ega ees6a

Q b Accounting fees Stmt 2 7 , 000. 0. 0.W c Other professional fees

17 Interest

T 18 Taxes

19 Depreciation and depletion

E 20 Occupancy

4 21 Travel, conferences, and meetings

C 2 Printing and publications

Other expenses Stmt 3 2 , 373. 0. 0.

M Total operating and administrative

as expenses . Add lines 13 through 23 9 , 373. 0. 0.

o 21 Contributions, gifts, grants paid 188 , 034. 188 , 034.98 Total expenses and disbursements.

?` Add lines 24 and 25 197 , 407. 0. 188 , 034.t^ Subtract line 26 from line 12:

Excess of revenue over expenses and disbursements 334 , 674 .

Net investment income (if negative. enter -0- ) 105 , 746.Adjusted net income (if negative , enter-0- N/A

u20U-) LHA For Paperwork Reduction Act Notice, see the instructions.

108200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION

No J5450052 ____-.____------

2010

Form 990-PF (2010)

05-049 . 4

Page 2: Form wOmPF Return ofP r-ivate Foundation-- 2010990s.foundationcenter.org/990pf_pdf_archive/050/050494243/050494243...I A Form_wOmPF rkpartment of theTreasury Internal RevenueService

Form 90,0-PF (2010) GALKIN PRIVATE FOUNDA

Part 11 Balance Sheets A ttached schedules and amounts in the descriptioncolumn should be for end -o f-year amounts only

1 Cash - non-interest-bearing

2 Savings and temporary cash investments

3 Accounts receivable ►Less: allowance for doubtful accounts ►

4 Pledges receivable ►Less: allowance for doubtful accounts ►

5 Grants receivable

6 Receivables due from officers, directors, trustees, and other

disqualified persons

7 Other notes and loans receivable ►

Less: allowance for doubtful accounts ►

8 Inventories for sale or use

9 Prepaid expenses and deferred charges

10a Investments - U.S. and state government obligations

b Investments - corporate stock Stmt 4

c Investments - corporate bonds Stint 5

11 Investments - land,buddings , andequipment basis ►

Less accumulated depreciation ►

12 Investments - mortgage loans

13 Investments - other Stint 6

14 Land, buildings, and equipment basis ►Less accumulated depreciation ►

15 Other assets (describe ►

17 Accounts payable and accrued expenses

18 Grants payable

19 Deferred revenue

20 Loans from officers, directors , trustees, and other disqualified persons

21 Mortgages and other notes payable

22 Other liabilities (describe ►

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

24 Unrestricted

25 Temporarily restricted

m 26 Permanently restricted

r-Foundations that do not follow SFAS 117, check here ► Ell

LL and complete lines 27 through 31.

° 27 Capital stock, trust principal, or current funds

28 NO-in or capital surplus, or land, bldg, and equipment fundfJla 29 Retained earnings, accumulated income, endowment, or other funds

z 30 Total net assets or fund balances

Beginning of year

(a) Book Value

81,369.

52,847.

0.

2- - -

(b) Book Value

166,974.

53,671.

57,575.

r0.1 0.1

663,223.1 831,551.1

End of

131 Total liabilities and net assetstfund balances 663,223.1 831,551

Part III 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 prior year's return)

2 Enter amount from Part I, 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) ► UNREALIZED GAIN ON CONTRIBUTION

6 Total net assets or fund balances at end of year ( line 4 minus line 5 - Part II column ( b ), line 30

02351112-07-10

334, 674.0.

997, 897.166, 346.831, 551.

Form 990-PF (2010)

(c) Fair Market Value

166 974.

-F -

1,508, 588.44, 957.

90, 603.

05-049412

08200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION

Page 3: Form wOmPF Return ofP r-ivate Foundation-- 2010990s.foundationcenter.org/990pf_pdf_archive/050/050494243/050494243...I A Form_wOmPF rkpartment of theTreasury Internal RevenueService

Form 990-PF (201 0)_ _ _ GALKIN_ PRIVATE_FOUNDATION 05-0494243 Page 3Part IV Capital Gains and Losses for Tax on Investment Income

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

(b How acquiredPurchase

D Donation

(c Date acquired(mo., day, yr.)

(d) Date sold(mo., day, yr.)

to

b See Attached Statementc

d

e

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

(g) Cost or other basisplus expense of sale

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

a

b

c

d

e 100 , 317. 1 1 28 , 172. 72 , 145.Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (I) Gains (Col. (h) gain minus

(i) F.M.V. as of 12/31/69(j) Adjusted basisas of 12/31/69

(k) Excess of col. (i)over col. (j), if any

col. (k), but not less than -0-) orLosses (from col. (h))

a

b

c

d

e 72 , 145.

2 Capital gain net income or (net capital loss)If gain, also enter in Part I, line 7If (loss), enter -0- in Part I, line 7 2 72 , 145.

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

If gain, also enter in Part I, line 8, column (c).

If loss enter -0- in Part I line 8 3 N /APart V Qualification Under Section 4940 (e) for Reduced Tax on Net Investment Income

(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)

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

Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period? 0 Yes ® No

If "Yes; the foundation does not qualify under section 4940(e). Do not complete this part.

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

Base p e riod yearsCalendar year ( or tax year beginning in ) (b)qualifying distributions (c)Net value of noncharitable-use assets

Distributdion ratio(col. (b) divided by col. (c))

2009 271 280. 1 , 334 , 377. .2033012008 229 250. 1 , 712 , 321. .1338832007 232 696. 1 , 906 , 325. .1220652006 208 467. 1 , 507 , 366. .1382992005 263 210. 1 , 303 , 385. .201943

2 Total of line 1, column (d) •799491

3 Average distribution ratio for the 5-year base period - divide the total on line 2 by 5,

the foundation has been in existence if less than 5 years

or by the number of years

3 . 159898

4 Enter the net value of noncharitable- use assets for 2010 from Part X, line 5 4 1 , 704 , 304.

5 Multiply line 4 by line 3 5 272 , 515.

6 Enter 1 % of net investment income (1% of Part I, line 27b) 6 1 , 057.

7 Add lines 5 and 6 7 273 , 572.

8 Enter qualifying distributions from Part XI I, line 4 8 188 , 034.

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

023521 12-07-10

308200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION

Form 990-PF (2010)

05-04941

Page 4: Form wOmPF Return ofP r-ivate Foundation-- 2010990s.foundationcenter.org/990pf_pdf_archive/050/050494243/050494243...I A Form_wOmPF rkpartment of theTreasury Internal RevenueService

_ Form 990_PF (20'10) GALKIN PRIVATE FOUNDATION 05-0494243 Page 4PartVI Excise Tax Based on Investmenflncome (Section-4940(a),-4940(b), 4940(e),- or- 4948---see-instructions)__

,1a Exempt operating foundations described in section 4940(d)(2), check here ► EA and enter 'N/A' on line 1.

Date of ruling or determination letter: ( attach copy of letter if necessary- see instructions)

b Domestic foundations that meet the section 4940(e) requirements in Part V, check here ► and enter 1% 1 2 , 115.of Part I, line 27b

c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b).

2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0.

3 Add lines 1 and 2 3 2 , 115.

4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0.

5 Tax based on investment income . Subtract line 4 from line 3. If zero or less, enter -0- 5 2 115.6 Credits/Payments:

a 2010 estimated tax payments and 2009 overpayment credited to 2010 6a 3 , 739 .

b Exempt foreign organizations - tax withheld at source 6b

c Tax paid with application for extension of time to file (Form 8868) 6c

d Backup withholding erroneously withheld 6d

7 Total credits and payments. Add lines 6a through 6d 7 3 , 739.

8 Enter any penalty for underpayment of estimated tax. Check here 0 if Form 2220 is attached 8

9 Tax due . If the total of lines 5 and 8 is more than line 7, enter amount owed ► 9

10 Overpayment . If line 7 is more than the total of lines 5 and 8, enter the amount overpaid ► 10 1 , 624.11 Enter the amount of line 10 to be: Credited to 2011 estimated tax 1110, 1 6 2 4 . Refunded Poo, 11 0.

Part VII-A Statements Regarding Activities

la During the tax year, did the foundation attempt to influence any national, state, or local legislation or did it participate or intervene in Yes No

any political campaign? la X

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

If the answer is "Yes" to la or 1b, attach a detailed description of the activities and copies of any matenals published or

distributed by the foundation in connection with the activities

c Did the foundation file Form 1120-POL for this year? 1c X

d Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:

(1) On the foundation. ► $ 0. (2) On foundation managers. ' $ 0.

e Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed on foundation

managers. ► $ 0.

2 Has the foundation engaged in any activities that have not previously been reported to the IRS? 2 X

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

3 Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles of incorporation, or

bylaws, or other similar instruments9 If "Yes,' attach a conformed copy of the changes 3 X

4a Did the foundation have unrelated business gross income of $1,000 or more during the year? 4a X

b If "Yes," has it filed a tax return on Form 990-T for this year? N/A 4b

5 Was there a liquidation, termination, dissolution, or substantial contraction during the year? 5 X

If "Yes, " attach the statement required by General Instruction T

6 Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:

• By language in the governing instrument, or

• By state legislation that effectively amends the governing instrument so that no mandatory directions that conflict with the state law

remain in the governing instrument? 6 X

7 Diu' the foundation have at least $5,000 in assets at any time during the year? 7 X

If 'Yes,' complete Part ll, col. (c), and Part XV.

8a Enter the states to which the foundation reports or with which it is registered (see instructions) ►

b If the answer is 'Yes' to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney General (or designate)

of each state as required by General Instruction G? If "No,' attach explanation 8b X

9 Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3) or 4942(l)(5) for calendar

year 2010 or the taxable year beginning in 2010 (see instructions for Part XIV)? If "Yes," complete Part XIV 9 X

0 Did any persons become substantial contributors durino the tax year? if "Yes." attach a schedule listinq their names and addresses 10 X

Form 990-PF (2010)

02353112-07-10

408200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION 05-04941

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Form 99,0-PF (2010) GALKIN PRIVATE_FOIJNDATI ON 05=0 49 4-2 43 PagfPart VII-A Statements Regarding Activities (continued)

11 At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the meaning of

section 512(b)(13)? If 'Yes,' attach schedule (see instructions) 11 X

12 Did the foundation acquire a direct or indirect interest in any applicable insurance contract before

August 17, 2008? 12 X

13 Did the foundation comply with the public inspection requirements for its annual returns and exemption application? 13 X

Website address ► N/A

14 The books are in care of ► ROBERT T. GALKIN Teleph one no. ► 4 01 - 8 2 8 - 0 3 0 0Located at ► 15 5 BROOKSIDE AVENUE , WEST WARWICK , RI ZIP+4 ►0 2 8 9 3

15 Section 4947 ( a)(1) nonexempt charitable trusts filing Form 990 - PF in lieu of Form 1041 - Check here ►0and enter the amount of tax-exempt interest received or accrued during the year ► 15 N/A

16 At any time during calendar year 2010 , did the foundation have an interest in or a signature or other authority over a bank, Yes No

securities, or other financial account in a foreign country? 16 X

See page 20 of the instructions for exceptions and filing requirements for Form TO F 90-22.1. If 'Yes; enter the name of

the forei n countrylo-Part VII - B Statements Regarding Activities for Which Form 4720 May Be Required

File Form 4720 if any item is checked in the "Yes" column, unless an exception applies. Yes No

la During the year did the foundation ( either directly or indirectly):

(1) Engage in the sale or exchange , or leasing of property with a disqualified person? 0 Yes ® 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 ? I--] Yes ® No

(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? Yes ® No

(5) Transfer any income or assets to a disqualified person ( or make any of either available

for the benefit or use of a disqualified person )? Yes ® No

(6) Agree to pay money or property to a government official'? (Exception . Check 'No*

if the foundation agreed to make a grant to or to employ the official for a period after

termination of government service, if terminating within 90 days. ) =Yes ® No

b If any answer is "Yes" to la(1)-(6), did any of the acts fail to qualify under the exceptions described in Regulations

section 53.4941 ( d)-3 or in a current notice regarding disaster assistance ( see page 22 of the instructions)? N/A

Organizations relying on a current notice regarding disaster assistance check here ►0c Did the foundation engage in a prior year in any of the acts described in la, other than excepted acts, that were not corrected

before the first day of the tax year beginning in 2010'

Taxes on failure to distribute income ( section 4942) (does not apply for years the foundation was a private operating foundation

defined in section 4942 ( l)(3) or 4942 ( l)(5)):

a At the end of tax year 2010, did the foundation have any undistributed income ( lines 6d and 6e, Part XIII) for tax year(s) beginning

before 2010? E Yes ® No

If 'Yes," list the years ►b Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2) (relating to incorrect

valuation of assets) to the year's undistributed income? (If applying section 4942(a)(2) to all years listed, answer 'No' and attach

statement - see instructions.) N/A

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

3.- Did the foundation hold myc than a 2% direct or indirect interest in any business enterprise of ally lone

during the year? Yes ® No

b If "Yes; did it have excess business holdings in 2010 as a result of (1) any purchase by the foundation or disqualified persons after

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 (3) the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C,

Form 4720, to determine if the foundation had excess business holdings in 2010) N/A

4a Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?

b Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its charitable purpose that

02354112-07-10

508200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION

is

2b

Form 990-PF (2010)

05-04941

Page 6: Form wOmPF Return ofP r-ivate Foundation-- 2010990s.foundationcenter.org/990pf_pdf_archive/050/050494243/050494243...I A Form_wOmPF rkpartment of theTreasury Internal RevenueService

VII-B I' Statements05-04

5a During the year did the foundation 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 ); or to carry on , directly or indirectly,

any voter registration drive? E]Yes ® No

(3) Provide a grant to an individual for travel , study, or other similar purposes ? Yes ® 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? 0 Yes ® No

b If any answer is Yes to 5a(1)-(5 ), did any of the transactions fail to qualify under the exceptions described in Regulations

section 53.4945 or in a current notice regarding disaster assistance ( see instructions)? N/A

Organizations relying on a current notice regarding disaster assistance check here ►0c If the answer is 'Yes ' to question 5a(4), does the foundation claim exemption from the tax because it maintained

expenditure responsibility for the grant? N/A =Yes 0 No

If "Yes," attach the statement required by Regulations section 53 4945-5(d).

6a Did the foundation , during the year , receive any funds, directly or indirectly, to pay premiums on

a personal benefit contract? 0 Yes ® No

b Did the foundation , during the year , pay premiums , directly or indirectly, on a personal benefit contract?

If "Yes' to 6b, file Form 8870.

7a At any time during the tax year , was the foundation a party to a prohibited tax shelter transaction2 Yes ® No

b If "Yes, did the foundation receive any proceeds or have any net income attributable to the transaction? N/A

Part VIII Information About Officers , Directors , Trustees , Foundation Managers , HighlyPaid Employees, and Contractors

I I it -II nffirprc directnrs _ trustees - foundation manaaers and their compensation.

5b

6b I I X

(a) Name and address(b) Title, and average

hours per week devotedto position

(c) Compensation( If not paid,enter -0

(dl Contribuoonsto

emp anddeferredplans

compensaboo

(e)Expenseaccount otherallowances

ROBERT T. GALKIN RESIDENT110 ELSIE STREET , CRANSTON , RI 02910

0.00 0. 0. 0.WARREN B. GALKIN TREASURER29 SAGE DRIVE , WARWICK , RI 02886

0.00 0. 0. 0.STEVEN ROSENBAUM SECRETARY30 EXCHANGE TERRACE , PROVIDENCE , RI 0

0.00 0. 0. 0.

7 r`mmnananfinn of five hinhect-naid emnlnvees fnther than those included on line 11. If none- enter "NONE."

(a) Name and address of each employee paid more than $50,000(b) Title, and average

hours per weekdevoted to position

(c) Compensation(d) Contnbubons to

emp anddeferedinscompensation

(e) Expenseaccount, otherallowances

NONE

Total number of other employees paid over $50,000 ► 1 0Form 990-PF (2010)

02355112-07-10

608200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION 05-04941

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Form 990-PF (20'10) GALKIN PRIVATE FOUNDATION -0.5=

Part VIII Information About Officers, Directors, Trustees, Foundation Managers, Highly0 Paid Employees, and Contractors (continued)

3 Five highest -paid independent contractors for professional services . If none , enter "NONE."

(a) Name and address of 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 ► 0

Part IX-A Summary of Direct Charitable Activities

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

1 N/A

0.2

3

4

Part IX- B I Summary of Program - Related InvestmentsDescribe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount

1

2

All other program-related investments. See instructions.

3 N/A

0.Total. Add lines 1 through 3 ► 0.

Forrn990-PF (2010)

02356112-07-10

708200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION 05-04941

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Form 9190-PF (2C1

Part X 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 monthly fair market value of securities la 1 , 541 , 367.b Average of monthly cash balances lb 188 , 891.

c Fair market value of all other assets 1c

d Total (add lines 1a, b, and c) Id 1 730 , 258.

e Reduction claimed for blockage or other factors reported on lines la and

1c (attach detailed explanation) le 0.

2 Acquisition indebtedness applicable to line 1 assets 2 0.

3 Subtract line 2 from line 1d 3 1 , 730 , 2- 58.

4 Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see instructions) 4 25 , 954.5 Net value of noncharitable-use assets Subtract line 4 from line 3. Enter here and on Part V, line 4 5 1 , 704 , 304.

6 Minimum investment return . Enter 5% of line 5 6 85,215.

Part XIDistributable Amount (see instructions) (Section 4942(l)(3) and (1)(5) private operating foundations and certain

foreign organizations check here ► 0 and do not complete this part.)

1 Minimum investment return from Part X, line 6 1 85 , 215.2a

b

c

Tax on investment income for 2010 from Part VI, line 5 2a

Income tax for 2010. (This does not include the tax from Part VI.) 2b

Add lines 2a and 2b

2 , 115.

2c 2 , 115 .3 Distributable amount before adjustments. Subtract line 2c from line 1 3 83 , 100 .

4 Recoveries of amounts treated as qualifying distributions 4 0 .

5 Add lines 3 and 4 5 83 , 100.

6 Deduction from distributable amount (see instructions) 6 0 .

7 Distributable amount as ad j usted. Subtract line 6 from line 5. Enter here and on Part XIII , line 1 7 83 , 100 .

Part XII Qualifying Distributions (see instructions)

1 Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:

a Expenses, contributions, gifts, etc. - total from Part I, column (d), line 26 la 188 , 034.b Program-related investments - total from Part IX-B 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 Suitability test (prior IRS approval required) 3a

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

4 Qualifying distributions . Add lines la through 3b. Enter here and on Part V, line 8, and Part XIII, line 4 4 188 , 034.

5 Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment

income. Enter 1% of Part I, line 27b 5 0.

6 Adjusted qualifying distributions . Subtract line 5 from line 4 6 188 , 034.

Note . The amount on line 6 will be used in 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 (2010)

02357112-07-10

808200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION 05-04941

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Form 990-PF (20'10) GALKIN PRIVATE FOUNDATION- - - - - - 0 5 - 0 4-9 4-2 -4-3- -Page 9-

Part XIII Undistributed Income (see instructions)

(a) (b) (c) (d)Corpus Years prior to 2009 2009 2010

1 Distributable amount for 2010 from Part XI,

line? 83 , 100.2 Undistributed income, if any , as of the end of 2010

a Enter amount for 2009 only 0.

b Total for prior years:

0.3 Excess distributions ca rryover, if any, to 2010:

a From 2005 200 , 710.b From 2006 139 , 059.c From 2007 143 , 405.dFrom2008 146 , 348.eFrom2009 206 507.f Total of lines 3a throu gh e 836 , 029.

4 Qualifying distributions for 2010 from

Part Xll,line 4:0, $ 188 034.

a Applied to 2009, but not more than line 2a 0.

b Applied to undistributed income of prior

years (Election required - see instructions) 0.

c Treated as distributions out of corpus

(Election required - see instructions) 0.

d Applied to 2010 distributable amount 83 , 100.

e Remaining amount distributed out of corpus 104 , 934.5 Excess distributions carryover applied to 2010 0. 0.

(if an amount appears in column (d), the same amount

must be shown in column (a) )

6 Enter the net total of each column asindicated below:

a corpus Add lines 3f, 4c, and 4e Subtract line 5 940 , 963.b Prior years' undistributed income. Subtract

line 4b from line 2b 0.

c Enter the amount of prior years'undistributed income for which a notice ofdeficiency has been issued, or on whichthe section 4942(a) tax has been previouslyassessed 0 .

d Subtract line 6c from line 6b. Taxable

amount - see instructions 0 .e Undistributed income for 2009. Subtract line

4a from line 2a. Taxable amount - see instr. 0

f Undistributed income for 2010. Subtract

lines 4d and 5 from line 1. This amount must

be distributed in 2011 0

7 Amounts treated as distributions out of

corpus to satisfy requirements imposed by

section 170(b)(1)(F) or 4942(g)(3) 0

8 Excess distributions carryover from 2005

not applied on line 5 or line 7 200 , 710.

9 Excess distributions carryover to 2011.

Subtract lines 7 and 8 from line 6a 740 , 253.10 Analysis of line 9:

a Excess from 2006 139 , 059.b Excess from 2007 143 , 405.

c Excess from 2008 146 , 348.d Excess from 2009 206 , 507.

e Excess from 2010 104 , 934.Form 990-PF (2010)

02358112-07-10

908200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION- 05-04941

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Form 990-PF 2010Part XIV Private Foundations (see instructions and Part VII-A, question 9)

1 a If the foundation has received a ruling or determination letter that it is a private operating

foundation, and the ruling is effective for 2010, enter the date of the ruling ►b Check box to indicate whether the foundation is a private operating foundation described in section

2 a Enter the lesser of the adjusted net

income from Part I or the minimum

investment return from Part X for

each year listed

b 85% of line 2a

c Qualifying distributions from Part XII,

line 4 for each year listed

d Amounts included in line 2c not

used directly for active conduct of

exempt activities

e Qualifying distributions made directly

for active conduct of exempt activities.

Subtract line 2d from line 2cComplete 3a, b, or c for thealternative test relied upon:

a "Assets" alternative test - enter:(1) Value of all assets

(2) Value of assets qualifyingunder section 4942(I)(3)(B)(i)

b "Endowment' alternative test - enter2/3 of minimum investment returnshown in Part X, line 6 for each yearlisted

c "Support" alternative test - enter:

(1) Total support other than grossinvestment income (interest,dividends, rents, payments onsecurities loans (section512(a)(5)), or royalties)

(2) Support from general publicand 5 or more exemptorganizations as provided insection 4942(I)(3)(B)(uQ

(3) Largest amount of support from

an exempt organization

( 4 ) Gross investment income

Part XV Supplementary Information (Completep pat any time during the year-see the instructions.)

1 Information Regarding Foundation Managers:

a List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation before the close of any taxyear (but only if they have contributed more than $5,000). (See section 507(d)(2).)

See Statement 7b List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the ownership of a partnership or

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

None

2 Information Regarding Contribution , Grant , Gift, Loan , Scholarship , etc., Programs:Check here 10, ® if the foundation only makes contributions to preselected charitable organizations and does not accept unsolicited requests for funds. Ifthe foundation 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:N/A

b The form in which applications should be submitted and information and materials they should include:

c Any submission deadlines:

d Any restrictions or limitations on awards, such as by geographical areas , charitable fields, kinds of institutions, or other factors:N/A

023601 12-07-10

1008200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION

4942 (j)( 3 ) or U 4942(1)(5)Tax year Prior 3 years

(a) 2010 (b) 2009 (c) 2008 (d) 2007 (e) Total

rmation Com lete this art only if the foundation had $5.000 or more in assets

Form 990-PF (2010)

05-04941

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Form 990-PF(2010)

Information

3 Grants and Contributions Paid Durina the Year or Anoroved for Future Payment

Recipient If recipient is an individual,show any relationship to Foundation Purpose of grant or

Name and address (home or business) any foundation manager status ofi

contribution Amount

or substantial contributor recip ent

a Paid dunng the year

See Statement 8Total ► 3a 188 , 034.

b Approved for future payment

None

Total ► 3b 1 0.023611 12-07-10 Form 990-PF (2010)

1108200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION 05-04941

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.Form 990-PF(2010) GALKIN PRIVATE FOUNDATION 05-0494243 Page 12

Part XVI -A Analysis of Income-Producing Activities

Enter

1 Pr o

a

b

c

d

e

f

9

2 Me

3 Int

my

4 Div

5 NeNet

a

b

6 NeNet

pro

7 Ot

8 Gal

tha

9 Net

10 Gr

11 0th

a

b

C

d

e

12 Subtotal. Add columns (b), (d), and (e) 0. 105 , 746. 1 0.

13 Total . Add line 12, columns (b), (d), and (e) 13 105,746.

(See worksheet in line 13 instructions to verify calculations.)

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

ross amounts unless otherwise indicated Unrelat ed business income Exclu ded by ion 512, 513, or 514 (e).

gram service revenue:

(a)Businesscode

(b)Amount

EXcu_

ode

(d)Amount

Related or exempt

function income

Fees and contracts from government agencies

mbership dues and assessments

rest on savings and temporary cash

estments

idends and interest from securities 14 33 , 601.rental income or (loss) from real estate:

Debt-financed property

Not debt-financed property

rental income or (loss) from personal

perty

er investment income

n or (loss) from sales of assets other

n inventory 18 72 , 145.income or (loss) from special events

ss profit or (loss) from sales of inventory

er revenue:

Add columns (b) , (d), and (e) 0 . 10 5 7 4 6 .

g

B

h

o

0 .

1208200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION 05-04941

0230 ;o Form 990-PF (2010)

Page 13: Form wOmPF Return ofP r-ivate Foundation-- 2010990s.foundationcenter.org/990pf_pdf_archive/050/050494243/050494243...I A Form_wOmPF rkpartment of theTreasury Internal RevenueService

Form990-PF 2010 GALKIN PRIVATE FOUNDATION 05=049-4243-Pa a-13PartXVII Information Regarding Transfers To and Transactions and Relationships With Noncharitable

Exempt Organizations

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

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

a Transfers from the reporting foundation to a noncharitable exempt organization of.

(1) Cash la ( l ) X

(2) Other assets la ( 2 ) X

b Other transactions:

(1) Sales of assets to a noncharitable exempt organization lb ( l ) X

(2) Purchases of assets from a noncharitable exempt organization lb ( 2 )1 X

(3) Rental of facilities, equipment, or other assets lb ( 3 ) X

(4) Reimbursement arrangements 1b ( 4 ) X

(5) Loans or loan guarantees lb (5 ) X

(6) Performance of services or membership or fundraising solicitations lb ( 6 ) X

c Sharing of facilities, equipment, mailing lists, other assets, or paid employees 1c X

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, ot

or services given by the reporting foundation. If the foundation received less than fair market value in any transaction or sharing arrangement, sh

her ass

ow in

ets,

(a) Name of organization (b) Type of organization (c) Description of relationship

N/A

Under penalti of perjury , I declare that I have examined this return , including accompanying schedules and statements , and to the best of my knowledge and belief, it is true , correct,and comple anIno reparer h h axpay or fiduciary) is based on all information of which preparer has any knowledge

Sign

Here

Signature of officer or truste

Print/Type preparer's name Prep is s gngtur

Paid K^d kenneth^ d4)

Preparer Firm's name ► ANDSAGER, BARTLETT & PIUse Only ONE CATAMORE BLVD.

Firm's address ► EAST PROVIDENCE, RI 0 2

02382203-04-11

08200506 352006 05-0494243 2010.03050

2a Is the foundation 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 ® No

h If "Yes' cmmnlete the fnllowlna schedule-

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Schedule_B(Form 990, 990-EZ,or 990-PF)

Department of the TreasuryInternal Revenue Service

Name of the organization

Organization type (check one):

Filers of: Section:

edule-of-Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Form 990 or 990-EZ Q 501(c)( ) (enter number) organization

0 4947(a)(1) nonexempt charitable trust not treated as a private foundation

0 527 political organization

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

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

OMB No 1545-0047

2010Employer identification number

/lI_fAQd7AZ

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

® For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or property) from any one

contributor. Complete Parts I and II

Special Rules

0 For a section 501 (c)(3) organization filing Form 990 or 990-EZ that met the 33 1 /3% support test of the regulations under sections

509(a)(1) and 170(b)(1)(A)(vi ), and received from any one contributor, during the year , a contribution of the greater of (1) $5 ,000 or (2) 2%

of the amount on () Form 990 , Part VIII , line 1 h or ( ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)( 7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor, during the year,

aggregate contributions 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 Ill.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor, during the year,

contributions for use exclusively for religious, chartable, etc., purposes, but these contributions did not aggregate to more than $1,000

If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc ,

purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively

religious, chartable, etc, contributions of $5,000 or more during the year. ► $

Caution . An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990, 990-EZ, or 990-PF),

but it must answer "No" on Part IV, line 2 of its Form 990, or check the box on line H of Its Form 990-EZ, or on line 2 of its Form 990-PF, to certify

that it does not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).

LHA For Paperwork Reduction Act Notice , see the Instructions for Form 990 , 990-EZ, or 990-PF. Schedule B (Form 990, 990 - EZ, or 990- PF) (2010)

023451 12-23-10

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-Schedule B (Form 990, 991

Name of organization

Part I Contributors (see instructions)

of Part I

Employer identification number

(a)

No.

(b)

Name, address , and ZIP + 4

(c)

Aggregate contributions

(d)

Type of contribution

1 NATCO HOME FASHIONS Person If]

155 BROOKS I DE AVENUE $ 150,000.

Payroll 0Noncash 0

WEST WARWICK, RI 0 2 8 9 3

(Complete Part II if there

is a noncash contribution )

(a)

No.

(b)

Name, address , and ZIP + 4

(c)

Aggregate contributions

(d)

Type of contribution

2 WARREN B. GALKIN Person

29 SAGE DRIVE $ 276,335.Payroll

Noncash Ef]

WARWICK, RI 0 2 8 8 6

(Complete Part II if there

is a noncash contribution.)

(a)

No.

(b)

Name, address , and ZIP + 4

(c)

Aggregate contributions

(d)

Type of contribution

Person

$

Payroll

Noncash

(Complete Part II if there

is a noncash contribution.)

(a)

No.

(b)

Name, address, and ZIP + 4

(c)

Aggregate contributions

(d)

Type of contribution

Person

$

Payroll

Noncash 0

(Complete Part II if there

is a noncash contribution )

(a)

No.

(b)

Name, address, and ZIP + 4

(c)

Aggregate contributions

(d)

Type of contribution

Person 0

$

Payroll 0

Noncash

(Complete Part II if there

is a noncash contribution )

(a)

No.

(b)

Name, address, and ZIP + 4

(c)

Aggregate contributions

(d)

Type of contribution

Person 0

$

Payroll Q

Noncash Q

(Complete Part II if there

is a noncash contribution.)

nggasa 19_0 q-1n Schedule B (Form 990. 990-EZ. or 990 -PF) (2010)

1508200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION 05-04941

Page 16: Form wOmPF Return ofP r-ivate Foundation-- 2010990s.foundationcenter.org/990pf_pdf_archive/050/050494243/050494243...I A Form_wOmPF rkpartment of theTreasury Internal RevenueService

Schedule B (Form 990, 990 -EZ,-o?

Name of organization

N

of Part II

Employer identification number

T

Part II Noncash Property (see instructions)

(a)No.

from

Part I

(b)Description of noncash property given

(c)

FMV (or estimate)

(see instructions)

(d)Date received

See Statement 92

$ 276,335. Various

(a)No.

from

Part 1

(b)Description of noncash property given

(c)

FMV (or estimate)

(see instructions )

(d)Date received

(a)No.

from

PartDescription of noncash property given

(c)

FM (or estimate)(seee instructions )

(Date received

(a)

PartDescription of noncash property given

(c)

FMV (or(see

or estimate)

(see instructions)

(d)Date received

(a)No.

from

Part

(b)Description of noncash property given

(c)

FMV (or estimate)

(see instructions)

(d)Date received

(a)No.

from

Part I

(b)Description of noncash property given

(c)

FMV (or estimate)

(see instructions)

(d)Date received

023453 12-23-10 Schedule B (Form 990 . 990-EZ . or 990 - PFI(2010)

1608200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION 05-04941

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- - -Schedule a (Form 990,-990-EZ,-or 990-PFD (2010)- Page of Of Part III

Name of organization Employer identification number

GALKIN PRIVATE FOUNDATION 05-0494243Part III Exclusively religious, charitable , etc., individual contributions to section 501(c)(7), (8), or (10) organizations aggregating

more than $1,000 for the year . Complete columns (a) through (e) and the following line entry. For organizations completingPart III, enter the total of exclusively religious, charitable, etc , contributions ofC1 Win nr Inca fnr tha vanr (Fntar this infnrmr Linn nnna Ran rnctn int nnc) R

(a) No.fromPart I

(b) Purpose of gift (c) Use of gift (d) Description of how gift is held

(e) Transfer of gift

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

(a) No.fromPart I

(b) Purpose of gift (c) Use of gift (d) Description of how gift is held

(e) Transfer of gift

Transferee's name , address , and ZIP + 4 Relationshi p of transferor to transferee

(a) No.fromPart I

(b) Purpose of gift (c) Use of gift (d) Description of how gift is held

(e) Transfer of gift

Transferee's name , address, and ZIP + 4 Relationshi p of transferor to transferee

(a) No.fromPart I

(b) Purpose of gift (c) Use of gift (d) Description of how gift is held

(e) Transfer of gift

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

023454 12-23-10 Schedule B (Form 990 , 990-EZ , or 990-PF) (2010)

1708200506 352006 05 - 0494243 2010.03050 GALKIN PRIVATE FOUNDATION 05-04941

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Continuation for 990-PF, Part IVGALKIN PRIVATE FOUNDATION 05-0494243 Page 1 of 1-Part, IV- 1-Capital - Gains - and-Losses -for-Tax on-Investment - Income

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

( b How acquired

0 - Donation

( c) Date acquired(mo., day, yr.)

( d) Date sold(mo., day, yr.)

la 43 SHARES LOWES P Various 03/11/10b 229 SHARES LOWES P Various 04/21/10c 728 SHARES LOWES P Various 05 / 03/10d 81 SHARES EXXON P Various 05/03 / 10e 185 SHARES EXXON P Various 07/27/10f203 SHARES EXXON P Various 09/30/10g 219 SHARES EXXON P Various 11/16 / 10h 284 SH PRUDHOE BAY P Various 11/04/10

k

m

n

0

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

( g) Cost or other basisplus expense of sale

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

a 1 , 029. 160. 869.b 6 , 023. 850. 5 , 173.c 19 , 575. 2 , 701. 16 , 874.d 5 , 566. 191. 5 , 375.e 11 , 006. 437. 10 , 569.f 12 , 549. 479 . 12 , 070.

15 , 023. 517 . 14 , 506.h 29 , 546. 22 , 837. 6 , 709.

k

m

n

0Complete only for assets showing gain in column (h) and owned by the foundation on 12/31 /69 (I) Losses (from col. (h))

(i) F.M.V. as of 12/31/69(j) Adjusted basisas of 12/31/69

(k) Excess of col. (i)over col. (1), if any

Gains ( excess of col. (h) gain over col. (k),but not less than'-0- )

a 869.b 5 , 173.c 16 , 874.d 5 , 375.e 10 , 569.f 12 , 070.

14 , 506.h 6 , 709.

k

m

n

0

If gain, also enter in Part I, line 72 Capital gain net income or (net capital loss) t If (loss) enter'-0= in Part I line 7 } 2 72 , 145.,,

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

02359105-01-10

1808200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION 05-04941

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GALKIN PRIVATE FOUNDATION 05-0494243

Form 990-PF Dividends and Interest from Securities Statement 1

Capital Gains Column (A)Source Gross Amount Dividends Amount

RELIANCE TRUST 6,200. 0. 6,200.UBS FINANCIAL 27,401. 0. 27,401.

Total to Fm 990-PF, Part I, In 4 33,601. 0. 33,601.

Form 990-PF Accounting Fees Statement 2

Description

(a) (b) (c) (d)Expenses Net Invest- Adjusted CharitablePer Books ment Income Net Income Purposes

7,000. 0. 0.PROFESSIONAL FEES

To Form 990-PF, Pg 1, In 16b 7,000. 0. 0.

Form 990-PF Other Expenses Statement 3

(a) (b) (c) (d)Expenses Net Invest- Adjusted Charitable

Description Per Books ment Income Net Income Purposes

FILING FEES 70. 0. 0.TRUSTEE FEES 300. 0. 0.BANK FEES 2,003. 0. 0.

To Form 990-PF, Pg 1, In 23 2,373. 0. 0.

Form 990-PF Corporate Stock Statement 4

Description

WELLS FARGO & COSIMON DEBARTOLO GROUP, INC.GENERAL ELECTRIC CORP.JOHNSON & JOHNSONHOME DEPOTINTERNATIONAL BUSINESS MACHINE

Book Value

18,468.9,665.

31,866.25,104.7,406.

18,955.

Fair MarketValue

37,188.31,041.46,493.

103,104.35,060.29,352.

19 Statement(s) 1, 2, 3, 408200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION 05-04941

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GALKIN PRIVATE FOUNDATION 05-0494243

VITESSE SEMICONDUCTOR 1,331. 84.BANK OF NY 4,280. 17,093.EMC CORP MASS 2,635. 12,595.ENERGY CONVERSION 31,828. 15,125.BLACK HILLS CORP 9,072. 9,000.LOWES COMPANIES INC. 6,893. 50,160.HEWLETT PACKARD 759. 77,885.CHEVRON 15,897. 41,063.ISHARES MSCI 15,572. 42,878.IBM 10,122. 58,704.LILLY ELI 3,046. 5,081.BANK OF AMERICA 24,974. 40,581.PROCTOR & GAMBLE 1,358. 9,392.LOWES COMPANIES INC. 883. 5,969.PROCTOR & GAMBLE 11,449. 32,165.TJX COS INC. 3,094. 22,195.I SHARES TRUST 26,813. 31,235.CYTEC INDUSTRIES 389. 4457.,SCHLUMBERGER LTD 2,549. 76 ,570.BERKSHIRE HATHAWAY INC 55,668. 48,066.GENERAL DYNAMICS CORP 17,863. 14,192.MONSANTO CO 2,456. 34,820.VERIZON COMMUNICATIONS INC 34,348. 35,780.WALMART STORES 23,180. 21,572.DR PEPPER SNAPPLE 1,031. 16,877.DUKE ENERGY HOLDING 18,470. 17,810.FRONTIER OIL 2,309. 30,617.GENZYME CORP. 18,717. 86,223.HEWLETT PACKARD 215. 21976.,PROCTOR & GAMBLE 1,030. 51 ,464.FRONTIER COMMUNICATIONS 2,318. 2,335.BLACK HILLS CORP 5,782. 6,000.ROYCE VALUE TRUST 46,408. 43,824.BP PLC 8,206. 13,251.CLEAN ENERGY FUELS 9,852. 30,794.FRONTIER OIL 1,310. 17,380.AMGEN 8,342. 53,912.COLGATE PALMOLIVE 315. 13,100.EXXON MOBIL 1,356. 25,958.LOWES COMPANIES INC. 0. 0.HEWLETT PACKARD 396. 40,542.JOHNSON & JOHNSON 9,351. 47,625.

Total to Form 990-PF, Part II, line 10b 553,331. 1,508,588.

20 Statement(s) 408200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION 05-04941

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GALKIN PRIVATE FOUNDATION 0 5-0494243

Form 990-PF Corporate Bonds Statement 5

Fair MarketDescription Book Value Value

MUTUAL FUNDS 53,671. 44,957.

Total to Form 990-PF, Part II, line 10c 53,671. 44,957.

Form 990-PF Other Investments Statement 6

Description

PRUDHOE BAY ROYALTY

Total to Form 990-PF, Part II, line 13

Form 990-PF

ValuationMethod Book Value

COST 57,575.

57,575.

Part XV - Line laList of Foundation Managers

Fair MarketValue

90,603.

90,603.

Statement 7

Name of Manager

ROBERT T. GALKINWARREN B. GALKIN

21 Statement(s) 5, 6, 708200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION 05-04941

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GALKIN PRIVATE FOUNDATION 0 5 -049424 3

Form 990-PF Grants and Contributions Statement 8Paid During the Year

Recipient Name and Address

BOYS & GIRLS CLUB OF WARWICKWARWICK, RI42 FREDERICK ST WARWICK, RI02888

BROWN UNIVERSITY PROVIDENCE, RI45 PROSPECT ST PROVIDENCE, RI02906

COMMUNITY PREP SCHOOLPROVIDENCE, RI126 SOMERSET ST PROVIDENCE, RI02907

MISCELLANEOUS ORGANIZATIONSVARIOUS

RI FOUNDATIONONE UNION STATION PROVIDENCE,RI 02903

Recipient Relationship Recipientand Purpose of Grant Status

NONE N/ATO SUPPORT CLUB

Amniini-

V V V .

NONE N/A 12,000.TO SUPPORT UNIVERSITY

NONE N/ATO SUPPORT PREP SCHOOL

22,880.

NONE N/A 15,554.TO SUPPORT LOCALORGANIZATIONS

NONE N/A 10,000.TO SUPPORT FOUNDATION

UNITED WAY OF RHODE ISLAND NONEPROVIDENCE, RI TO SUPPORT UNITED WAY50 VALLEY STREET PROVIDENCE, RI02903

USS SARATOGA FOUNDATION NONE496 EDDY STREET PROVIDENCE, RI TO SUPPORT02903 ORGANIZATION

FUNDRAISING EFFORTS

Total to Form 990-PF, Part XV, line 3a

N/A 35,000.

N/A 92,000.

188,034.

22 Statement(s) 808200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION 05-04941

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GALKIN PRIVATE FOUNDATION 05-0494243

Schedule B Statement 9

MARKETABLE SECURITIES

VARIOUS STOCKS

23 Statement(s) 908200506 352006 05-0494243 2010.03050 GALKIN PRIVATE FOUNDATION 05-04941