EXTENSION ATTACHED Department of the Treasury Internal Revenue Service 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 retum to satisfy state reporting requirements MARCH 1 For calendar year 2009, or tax year beginning G Check all that apply: OMB No 1545-0052 Return of Private Foundation Form 990-PF El Initial return [:1 Amendedreturn 2O9 FEBRUARY 28 , 2009, and ending CI Initial return of a former public charity I: Address change E1 Name change ,2O 10 El Final return use the IRS Name of foundation A Employer identication number label. THE C.O.U.Q. FOUNDATION, INC. (FLORIDA SCIENCE FOUNDATION) 13-3996471 Otherwise, Number and street (or P 0 box number if mail is not delivered to street address) Room/suite B Telephone number (see page 10 of the instructions) o'?{'y'l':e_ CIO GEORGE v. DELSON ASSOCIATES, ass SECOND AVENUE 599 SPe_i Guy r town State and 2": Code C If exemption application is pending. check here F El 'n5t"uct'n5' NEW YORK, NY 10017 D 1. Foreign organizations. check here H Check type of organization: Section 501(c)(3) exempt Private foundation C] Section 4947(a)(1) nonexempt charitable trust C] Other taxable private foundation I Fair market value of all assets at J Accounting method: Cash CI Accrual end of year (from Part H! CO, (C)! D other (spemfy) line 16) D $ 33,475 (Part I, column (d) must be on cash basis ) Analysis of Revenue and Expenses (The total of (a) Revenue and I amounts in columns (b), (c), and (d) may not necessanly equal the amounts in column (a) (see page 11 of the instructional) 1 2 3 4 5a I b ' ' g 5 3 9: ED Contributions, gifts, grants, etc., received (attach schedule) Check D [3 if the foundation is not required to attach Sch. B Interest on savings and temporary cash investments Dividends and interest from securities Gross rents . . Net rental income or (loss) expgnsis per 5 2 Freisrg organatgrnshmeetingtthe 85% test. D E If Cnvaeo act feregnt n aionsauswas 3 ict computarminae D" t d n d 5e:,,on507;b)(1,(A,_ check he. 6 U elm F If the foundation is in a60-month tennination Under Section 507(b)(1l(B). Check here > I: (d) Disbursements "3, N";: 'L"n_3:tm9t 200.000 @O E i 5 DD M gfg Qt W fg5"_:;'g::'e (cash (33515 only) W *~*=-:..:i: ~42 @ %t* 6a b 7 8 9 Net gain or (loss) from sale of assets not on line 10 Gross sales price for all assets on line 6a Capital gain net income (from Part IV, line 2) Net short-term capital gain . Income modificati . . . . . 10a b c Gross sales less returns and Fqogag !\vI E D Less: Cost of goods St. lu . ,, Gross profit or (loss ttach schedule) . . ck/3 V wgwi. ." 12 11 Total. Add lines 1 gh 11 . 2. T . . . Other income (atta:I.$j:hedUId)I . S. 200,119 114 13 14 Compensation Other employeeofsac )E?\gustE?Te av )1 1 . . E. 42.308 42.308 767 9.203 767 9,203 3.237 3.237 g Z U, 3 i__Z J' Q g E. 15 "1 16a 0 b n c Pension plans, employee benefits . Legal fees (attach schedule) Accounting fees (attach schedule) Other professional fees (attach schedule) 2 E59 g .9. Interest . . . . . . . . . Taxes (attach schedule) (see page 14 of the instructions) 377 @ P 19 Depreciation (attach schedule) and depletion ST. 3 4,398 3 == 3 .5 E on -E. 20 21 22 23 24 Occupancy . . . . . . . . Travel, conferences, and meetings Printing and publications . . . . . . Other expenses (attach schedule) .31} 4. Total operating and administrative expenses. 40.385 17,129 40.385 17.129 24,826 24,826 142,253 137,355 17 18 . . g Add lines 13 through 23 . 8- 25 26 Contributions, gifts, grants paid . . . . . . Total expenses and disbursements. Add lines 24 and 25 125,000 267,253 Subtract line 26 from line 12: Excess of revenue over expenses and disbursements t a b c Net investment income (if negative, enter -0-) Adjusted net income (if negative, enter -0-) 27 . 5" 0 - 5 For Privacy Act and Paperwork Reduction Act Notice, see page 30 of the instructions. m . ~?,*z:2 0 ,7= PN 5 V .3Zi:3*E Cat No 11289X I k I 125,000 262,855 " E 1 '3 . '3 I Form 990-PF (2009) GI4 Form 990-PF (2009) Attached schedules and amounts in the descn tron column Balance Sheets should be for end-of-year amounts only. (See lStlUCtlOnS.] 1 2 3 Cashnon-interest-bearing Savings and temporary cash investments Accounts receivable D Less: allowance for doubtful accounts D 4 Pledges receivableD Less: allowance for doubtful accounts D Grants receivable . . . . . . 5 ' E In < *3 . . . . . . Other notes and loans recervable (attach schedule) D Less: allowance for doubtful accounts D 14 15 16 Land, buildings, and equipment: basis D 17.954 Less accumulated depreciation (attach schedule) D 6964 ST. 3 Other assets (describe D ) Total assets (to be completed by all fi erssee the instructions. Also, see page 1, item I) 9, -3 17 18 19 Accounts payable and accrued expenses Grants payable . Deferred revenue . . . . . . E 20 Loans from officers, directors, trustees, and other disqualified persons .3 21 22 Mortgages and other notes payable (attach schedule) . Other liabilities (describe D 23 Total liabilities (add lines 17 through 22) 3 2 24 Foundations that follow SFAS 1 17, check here . . D El and complete lines 24 through 26 and lines 30 and 31. Unrestricted T: In 25 26 Temporarily restricted Permanently restricted E E . . . . . W W M , , __ 1 i ' .% Inventories for sale or use . . . . . Prepaid expenses and deferred charges . . . . . . nvestmentsU.S. and state government obligations (attach schedule) lnvestmentscorporate stock (attach schedule) . lnvestmentscorporate bonds (attach schedule) lnvestments and, buildings, and equipment: basis D Less accumulated depreciation (attach schedule) D lnvestmentsmortgage loans . lnvestmentsother (attach schedule) . . . . 22,485 . 7 12 13 22,485 l Receivables due from officers, directors, trustees, and other disqualified persons (attach schedule) (see page 16 of the instructions) . . . . . . . . . . . 8 9 10a b c 11 Page 2 End Of Year (b) Book Value (c) Fair Market Value 85,219 6 0, B99 "'"Q 01' Yea! (a) Book Value .~ "" -Q __:_3 10.990 15.388 1oo,so7 33,475 " " . . . . . . ) . . . . . . E _ ,,,,,_,,3t,$5, , V $55. T @" S: . Foundations that do not follow SFAS 117, check here D [:1 and complete lines 27 through 31. '5 27 Capital stock, trust principal, or current funds . __i_ri 3 28 29 Paid-in or capital surplus, or land, b dg., and equipment fund Retained eamings, accumulated income, endowment, or other funds . . . . <0 "5, 2 30 ~ I } . 3 M ~ 0 100-007 33.475 K,f A .1: . Total net assets or fund balances (see page 17 of the (:1 H 3' instructions) . . . . . . . . . . . . . . . . 100.507 33.475 3 '~; 31 Total liabilities and net assets/fund balances (see page 17 17 ,{ of the instructions) . . . 100,607 33,475 3 I sfi. Analysis of Changes in Net Assets or Fund Balances 1 Total net assets or fund balances at beginning of yearPart ll, column (a), line 30 (must agree with end-of-year figure reported on prior year's return) 100,607 Enter amount from Part I, line 27a . . . . . (67,134) 2 Other increases not included in line 2 (itemize) D ROUNDING Add lines 1, 2, and 3 . Decreases not included in line 2 (itemize) D O')U'l-IDC IO Total net assets or fund balances at end of year (line 4 minus line 5)Part ll, column (b), line 30 . 33,475 O'U' -h(.i)N- 33,475 Form 990-PF (2009) Form 990-PF (2009) W Page 3 Capital Gains and Losses for Tax on Investment Income Ia) List and descnbe the kind(s) of property sold (e g , real estate. 2-story bnck warehouse, or common stock, 200 shs MLC Co) tbgaiiognggaugged D_Donat n (c) Date acquired (mo , day. yr) (d) Date sold (mo . day, yr) 1a b c d e e "e::,:e:.'.:*:::.7;', :..&::::;.:*::2:::: ,.l;.S::?,::.l::i,, a b c d e Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (i) F M v as of 12/31/59 ma:i;:"2jg:,;;'5 (I) Gams (Col 0,.) gal mmus ";VEr::T50)_f f::ED col (kliotigf-i:?ftrf J$:::fJrfa(r;)-)0-) or a b c d e 2 Capital gain net income or (net capital loss) { :;')a;S;3eern_t:_r ll: 5:: II! $215.; 3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6). } If (loss), enter -0- in . . . (c). (see . pages 13 and 17 of the Il"IStl'UCt OnS).} gain, also enter in Part Part I,I, line line 88, column 2 1 Z 3 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. [:1 Yes Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period? 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 page 18 of the instructions before making any entries. I) d (bl I6) B D t b (I t t Calendar ye:E'E"oE':2: ygzatgiglnnlng m) Adjusted qualifying distributions Net value of noncharitable-use assets (col (b')Sdr:vllcnbr:c'g (0)) 2008 220,541 89,044 2.476764 2007 1 8,671,736 13,057,835 1.429925 2006 1,186,000 22,142,808 0.053561 2005 1,255,795 22,630,448 0.055491 2004 936,665 20,159,106 0.046464 2 3 No Total of line 1, column (d) . . . . . . . . . . . . . . . . . . Average distribution ratio for the 5-year base perioddivide the total on line 2 by 5, or by the number of years the foundation has been in existence if less than 5 years 2 4.062205 3 0312441 4 Enter the net value of noncharitable-use assets for 2009 from Part X, line 5 4 63.869 5 Multiply line 4 by line 3 5 51.890 6 Enter 1% of net investment income (1% of Part I, line 27b) 6 0 7 Add lines 5 and 6 7 51.390 8 Enter qualifying distributions from Part XII, line 4 . . . . . 8 252.855 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 on page 18. Form 990-PF (2009) Form 990-PF (2009) 1a b c Page 4 Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 494-0(e), or 4948see pa e 18 of the instructions) Exempt operating foundations descnbed in section 4940(d)(2), check here D D and enter "N/A" on line 1. 1 Date of ruling or detemiinatlon letter: (attach copy of letter if necessarysee instructions) ,, Domestic foundations that meet the section 4940(e) requirements in Part V, check 1 0 hereb andenter1%ofPartl,line27b . . . . . . . . . . . . . . . . All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I. line 12, col. (b) Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) Add ines1and2 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- . G701-hCnl \) Credits/Payments: 2009 estimated tax payments and 2008 overpayment credited to 2009 Exempt foreign organizationstax withheld at source . . . . . 6a 6b 4.999 7 8 9 Tax paid with application for extension of time to file (Form 8868) . 6c Backup withholding erroneously withheld . . . . . . 6d Total credits and payments. Add lines 6a through 6d . . . . . . . . . . . Enter any penalty for underpayment of estimated tax. Check here El if Form 2220 is attached Tax due. If the total of lines 5 and 8 IS more than line 7, enter amount owed . . D 10 11 Overpayment. If line 7 IS more than the total of lines 5 and 8, enter the amount overpaid . . V Enter the amount of line 10 to be: Credited to 2010 estimated tax D 4,999] Refunded > 9.00!! 1a b U!-cnlfd P , E 5 i. g. H g V 3% 4.999 (OWN 4,999 _L_L -IO Statements Regarding Activities During the tax year, did the foundation attempt to influence any national, state, or local legislation or did it participate or intervene in any political campaign? . . . . . . . . . . . . . . . Yes 1a No ./ Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see page 19 of the instructions for definition)? . . . . . . . . . . . . . . . . . . . . . . . . If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials published or distributed by the foundation in connection with the activities. c d Did the foundation file Fonn 1120-POL for this year? . . . . . . . . . . Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year: (1) On the foundation. D $ (2) On foundation managers. D $ e Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed on foundation managers > $ 2 Has the foundation engaged in any activities that have not previously been reported to the IRS? If Yes, " attach a detailed description of the activities Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes . 3 4a b 5 6 Did the foundation have unrelated business gross income of $1,000 or more during the year? . If Yes, has it filed a tax return on Form 990-T for this year? _ . . . . . . . . Was there a liquidation, termination, dissolution, or substantial contraction during the year? If "Yes," attach the statement required by General Instruction T. Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either: 0 By language in the governing instrument, or 0 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? . . . . . . . . . . . . 7 8a Did the foundation have at least $5,000 in assets at any time dunng the year? if "Yes," complete Part ll, col. (C), and Part XV Enter the states to which the foundation reports or with which it is registered (see page 19 of the instructions) D New York 7 + 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 . . . . . ____ ab / ./ 9 Is the foundation claiming status as a private operating foundation within the meaning of section 4942( )(3) or 4942())(5) for calendar year 2009 or the taxable year beginning in 2009 (see instructions for Part XIV on page 27)? If Yes, " complete Part XIV . . . . . . . . . . . . . . . . . . . . . . . % 9 I 10 Did any persons become substantial contributors during the tax year? If Yes, attach a schedule listing their names and addresses . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 I Form 990-PF (2009) Form 990-PF (2009) Part VII-A Page5 Statements Regarding Activities (continued) 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 page 20 of the instructions) . . . 11 I 12 Did the foundation acquire a direct or indirect interest in any applicable insurance contract before August17,20087 . . . . . . . . . . . . . . . . . . 12 I 13 Did the foundation comply with the public inspection requirements for its annual returns and exemption application? 13 I Website address > 212-355-2404 The books are In care of P GEORGE V. DELSON ASSOCIATES Telephone no, D 11 14 Located at D 885 SECOND AVENUE, 26TH FLOOR, NEW YORK, NY 15 1a Z P+4 D 10017 Section 494'/(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 Check here. and enter the amount of tax-exempt interest received or accrued during the year . . . . D I 15 I 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. 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? El Yes No (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from) a disqualified person? . . . . . . . . . . . . . . . . . . Dyes No (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? . El Yes (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? [I Yes (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)? . . . . D Yes (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.) D Yes F El No Yes . :,ta-cV&#~39#;\35,9;.,-3; No No N0 No If any answer is "Yes" to 1a(1)(6), did any of the acts fail to qualify under the exceptions descnbed in Regulations section 53.4941 (d)-3 or in a current notice regarding disaster assistance (see page 20 of the instructions)? . Organizations relying on a current notice regarding disaster assistance check here > [I Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts, that were not corrected before the first day of the tax year beginning in 2009? . . . . . . . . . . . Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private operating foundation defined in section 4942(1)(3) or 4942(])(5)): At the end of tax year 2009, did the foundation have any undistributed income (lines 6d and I:IYes Be, Part XIII) for tax year(s) beginning before 2009? No If "Yes, list the years P 20_ , 20 : , 20 : , 20 _ 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 statementsee page 20 of the instructions.) . . 3a If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here. D 20_, 20_,20___,20___ Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at any time during the year? . D Yes No If "Yes," did it have excess business holdings in 2009 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 2009 ) Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes? Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its chantable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2009? 3b 4a 4b Form 990-PF (2009) Form 990-PF (2009) tatements Regarding Activities for Which Form 4720 May Be Required (continued) 5a b c 6a b 7a b During the year did the foundation pay or incur any amount to: (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(3))? D Yes (2) Influence the outcome of any specic public election (see section 4955); or to carry on, No ,' I i 32;: . directly or indirectly, any voter registration drive? . . . [1 yes Na ' (3) Provide a grant to an individual for travel. study, or other similar purposes? . Ci 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)? (see page 22 of the instructions) E] y._., no (5) Provide for any purpose other than religious. charitable, scientific. literary, or educational purposes, or for the prevention of cruetty to children or animals? . I:IYes No 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 page 22 of the instructions)? bl]-. Organizations relying on a current notice regarding disaster assistance check here 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? DYes BN0 3 _i.;.' @% , ';i_;E.:':E " ' , ' " it Yes, attach the statement required by Regulations section 53.49455(o'). Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? D Yes No Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benet contract? if "Yes" to 6b, le Form 8870. i:iYes No At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction? if es, did the foundation receive any proceeds or have any net income attributable to the transaction? . lnfomiation About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees, and Contractors 1 List all officers, directors, trustees, foundation managers and their compensation (see page 22 of the instructions). (3) Name and address MnT'i??:nd :i?erl?ge devoted to position ((I?n(i:)(:r:f:,i:ir:s:tn!tce': -0-) er:$lt(>";i.e'emb:nme[?irtf)l:ns ,_]:;i;,vfan?.}3"" and deferred compensation JEFFREY E. EPSTEIN 6100 RED HOOK QUARTERS, ST. THOMAS, USVI pREs DEN-r I2 0 0 O DARREN K. INDYKE 301 EAST 66TH STREET, NEW YORK. NY 10065 Vicg pRE3 DEN13 0 0 0 RICHARD KAHN 301 EAST 66TH STREET, NEW YORK. NY 10065 TREASURERIDIR 3 0 0 0 2 Compensation of five highest-paid employees (other than those included on line 1see page 23 of the instructions). if none, enter "NONE." (3) Name and address of each employee paid more than $50,000 lb) Title, and average darczugdpgrpvrgghm (c) Cornpensation M cnmbmbns ' pi:n: mdm toi:E;g_e;}?:sacc:ei;nt. compensation NONE Total number of other employees paid over $50,000 . F 0 Form 990PF (2009) Fomi 990-PF (2009) Page 7 Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees, and Contractors (continued) Five highest-paid independent contractors for professional services (see page 23 of the instructions). If none, enter NONE." (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation 3 NONE Total number of others receiving over $50,000 for professional services Part IXA . . . . . . . . . . . .> 0 Summary of Direct Charitable Activities l_ist the foundation's four largest direct charitable activities dunng the tax year Include relevant statistical infonriation such as the number of organizations and other beneciaries senred, conferences convened, research papers produced. etc Expenses 1 NONE Part IX-B Summary of Program-Related Investments (see page 24 of the instructions} Descnbe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2 1 NONE Amount All other program-related investments See page 24 of the instructions 3 Total.Addlines1through3. . . . . . . . . . . . . . . . . . . .> Form 990-PF (2009) Form 990-PF (2009) . W 1 Minimum Investment Fletum (All domestic foundations must complete this part. Foreign foundations, see page 24 of the instructions.) 2 3 Fair market value of assets not used (or held for use) directly in carrying out charitable, etc., purposes: Average monthly fair market value of securities Average of monthly cash balances . . . . . . Fair market value of all other assets (see page 24 of the instructions) Total (add lines 1a, b, and c) . . . . . . . . . . . . . Reduction claimed for blockage or other factors reported on lines 1a and 1c (attach detailed explanation). . . . . . . . . . I 1e Acquisition indebtedness applicable to line 1 assets . Subtract line 2 from line 1d . . . . . . . . . . . . . . . . . 4 Cash deemed held for charitable activities. Enter 1 /2 % of line 3 (for greater amount, see page 25 of 5 6 the instructions) . . . . . . . . . . . . . . . . . . . . . . . Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4 Minimum investment return. Enter 5% of line 5 . . . . . . . . . . . . . . a b c d e 1 Page 8 Part XI 1 2a 1 b c i, PXU 2K 1a 1b 1c 1d 53.852 10,990 64,842 2 3 64.842 4 5 6 973 63,869 3,193 Distributable Amount (see page 25 of the instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here > El and do not complete this part.) Minimum investment return from Part X, line 6 . Tax on investment income for 2009 from Part VI, line 5 . . Income tax for 2009. (This does not include the tax from Part VI.) Add ines2aand 2b . . . . . . . . . . . . . . . . . . 2a . . 2b . . . 3 4 5 Distributable amount before adjustments Subtract line 2c from line 1 Recoveries of amounts treated as qualifying distributions . Add lines3and4 . . . . . . . . . . . . . 6 7 Deduction from distributable amount (see page 25 of the instructions) . . . . . . . . Distributable amount as adjusted Subtract line 6 from line 5 Enter here and on Part Xlll, line 1 . 1 3.193 0 $5 ~__ 2c 3 4 5 0 3.193 3.193 6 7 3,193 Qualifying Distributions (see page 25 of the instructions) 3 j l 1 a b 2 3 a b 4 5 I 6 Amounts paid (including administrative expenses) to accomplish charitable, etc , purposes: Expenses, contributions, gifts, etc.tota from Part I, column (d), line 26 . Programrelated investmentstotal from Part lXB . . . . . . . . . . . . . Amounts paid to acquire assets used (or held for use) directly in carrying out charitable. etc., purposes . . . . . . . . _ 1a 1b 252,855 2 Amounts set aside for specific charitable projects that satisfy the: 4 Suitability test (prior IRS approval required) . 3a Cash distribution test (attach the required schedule) . . . . . . . . . . . . 3b Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4 4 Foundations that qualify under section 4940(9) for the reduced rate of tax on net investment income. Enter 1% of Part I, line 27b (see page 26 of the instructions) 5 262.855 0 Adjusted qualifying distributions. Subtract line 5 from line 4 6 262,855 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 (2009) Form 990-PF (2009) Page 9 Undistributed Income (see page 26 of the instructions) la) (bl Corpus Years prior to 2008 Distributable amount for 2009 from Part XI, Vivid- sisr \\. line 7 . . . . . . . $;'~*2 :e>s,:*i~ 0' Undistributed income, if any, as of the end of 2009 Enter amount for 2008 only . . Total for prior years 20__,20 ,20 Excess distributions carryover if any, to 2009' From 2004 From From From From "'DQ.OU'DI 2005 2006 2007 2008 139,200 1,237,003 18,027,104 216,091 19,519,393 gt Total of lines 3a through e . . . . . Qualifying distributions for 2009 from Part XII, line 4' > $ 262,855 Applied to 2008, but not more than line 2a Applied to undistributed income of prior years (Election requiredsee page 26 of the instructions) Treated as distributions out of corpus (Election requiredsee page 26 of the instructions) Applied to 2009 distributable amount Remaining amount distributed out of corpus Excess distributions carryover applied to 2009 (If an amount appears in column (d), the same amount must be shown in column (a).) Enter the net total of each column as indicated below: : 9,91% p] P= 259,562 Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 Prior years undistributed income. Subtract line 4b from line 2b Enter the amount of prior years undistributed income for which a notice of deficiency has been issued, or on which the section 4942(a) tax has been previously assessed Subtract line 6c from line 6b. Taxable amountsee page 27 of the instructions Undistributed income for 2008 Subtract line 4a from line 2a. Taxable amountsee page 27 of the instructions Undistributed income for 2009. Subtract lines 4d and 5 from line 1. This amount must be distributed in 2010 Amounts treated as distributions out of corpus to satisfy requirements imposed by section 170(b)(1)(F) or 4942(g)(3) (see page 27 of the instructions) . . . . . . . . Excess distributions carryover from 2004 not applied on line 5 or line 7 (see page 27 of the instructions) . . . . . . . . . . Excess distributions carryover to Subtract lines 7 and 8 from line 6a 10 Analysis of line 9: Excess from 2005 CDQOUHI Excess Excess Excess Excess from from from from 2006 2007 2008 2009 2010. 19,879,060 * 139,200 ,1 1.237.003 @e 10,027,104 ;' 216.091 259,662 .5:9A vy1 ~%,v;,". , ~. 2 7 Form 990-PF (2009) Form 990-PF (2009) Page 10 Part XIV Private Operating Foundations (see page 27 of the instructions and Part VII-A, question 9) 1a If the foundation has received a ruling or determination letter that it is a private operating foundation, and the ruling IS effective for 2009, enter the date of the mling . . . > b Check box to indicate whether the foundation is a private operating foundation described in section I] 4942(])(3) or :] 4942(])(5) 2a Enter thefrom lesser the the adjusted net Tax year Pnor3 years (eotal income Partof lor minimum investment return from Part X for M2009 M2008 M2007 "2006 each year listed . . . . 85% of line 2a . . . . Qualifying distributions from Part XII, line 4 for each year listed Amounts included in line 2c not used directly for active conduct of exempt activities . Qualifying distributions made directly for active conduct of exempt activities. Subtract line 2d from line 2c Complete 3a, b, or c for altemative test relied upon "Assets altemative testenter the (1) Value of all assets . . . . . (2) Value of assets qualifying under section 4942(j)(3)(B)(i) "Endowment" alternative testenter 2/3 of minimum investment return shown in Part X, line 6 for each year listed . Support alternative testenter. (1) Total support other than gross investment income (interest, dividends, rents, payments on securities loans (section 512(a)(5)), or royalties) . (2) Support from general public and 5 or more exempt organizations as provided in section 4942(])(3)(B)(l I) . (3) Largest amount of support from an exempt organization (4) Gross investment income . Supplementary Information (Complete this part only if the foundation had $5,000 or more in assets at any time during the yearsee page 28 of the instructions.) 1 Information Regarding Foundation Managers: List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).) JEFFREY E. EPSTEIN b List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the a ownership of a partnership or other entity) of which the foundation has a 10% or greater interest. Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs: Check here b if the foundation only makes contributions to preselected charitable organizations and does not accept unsolicited requests for funds. If the foundation makes gifts, grants, etc. (see page 28 of the instructions) to individuals or organizations under other conditions, complete items 2a, b, c, and d. The name, address, and telephone number of the person to whom applications should be addressed: The form in which applications should be submitted and information and materials they should include: Any submission deadlines: Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other factors: Form 990-PF (2009) Form 990-PF (2009) Page 1 1 Supp ementary Information (continued) 3 Grants and Contributions Paid During the Year or Approved for Future Payment - ' If recipient is an individual, Re''e Name and address (home OI business) ::3:;::z;:.t:::."::;*;;2 or substantial contributor Fia"t3i$?" 'e'p'e"t "':::':,::.:::'' Mr a Paid during the year STATEMENT 5 Total . . . P 3a 125,000 b Approved for future payment NONE Total D 3b Form 990-PF (2009) Form 990-PF (2009) Part XVI-A Page 12 Analysis of Income-Producin4g Activities Unrelated business income Enter gross amounts unless otherwise indicated. la) Business code 1 lb) Amount Excluded by section 512. 513, or 514 (cl Exclusion code Program service revenue. (11) Amount tel Related or exempt function income (See page 28 of the instructions.) CDQ.OU'I f g Fees and contracts from government agencies Membership dues and assessments . Interest on savings and temporary cash investments Dividends and interest from securities . (H-BUM Net rental income or (loss) from real estate: a Debtfinanced property b Not debt-financed property . . Net rental income or (loss) from personal property Other investment income . . . . . . 14 ac figs~"9=. Gx "3? f ~23 . :3 actsism it 3% 3 .>:;a (*3": Gain or (loss) from sales of assets other than inventory Net income or (loss) from special events Gross profit or (loss) from sales of inventory _ _L -IOCOQNICS Other revenue: a b c d e 3. :33 :9 Ma/ 12 Subtotal Add columns (b), (d), and (e) . 13 13 Total. Add line 12, columns (b), (d), and (e) worksheet in line 13 instructions on 28 to calculations. Relation of Activities to the ishment of Line No. mportantl to the n below how each activity for which income is reported in column_ (e) of Part XVI-A 9 of the V acctrom ins ruc ions lishment of the foundation's exempt purposes (other than by providing funds for such purposes). (See page NIA Form 990-PF (2009) Form 990-PF (2009) Page 13 Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations 1 : I l Did the organization directly or indirectly engage in any of the following with any other organization described in section 501 (c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political a b . , "$7 organizations? _ ,:) TE Transfers from the reporting foundation to a noncharitable exempt organization of: (1) Cash (2) Other assets Other transactions: (1) Sales of assets to a noncharitable exempt organization (2) Purchases of assets from a noncharitable exempt organization . (3) Rental of facilities, equipment, or other assets (4) Reimbursement arrangements . (5) Loans or loan guarantees . . . . . . . . . . p k "_ 0 tacl) I 1a(2) I ,,<;;;_:,{ j; 1b(1) -/ 1b(2) I 1b(3) J 1b(4) J 1b(5) I (6) Performance of services or membership or fundraising solicitations 1b(6) I Sharing of facilities, equipment, mailing lists, other assets, or paid employees . . . . . . . 1c I 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 foundation. If the foundation 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) l_ine no (b) Amount involved (c) Name of noncharitable exempt organization (d) Descnption of transfers, transactions, and sharing arrangements c d 2a b 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? . E] Yes If "Yes," complete the following schedule. (a) Name of organization (b) Type of organization (c) Descnption of relationship Under penalties of perjury, I e that belief, it is true. correct, co ple 2 G.) I 5, (0 l Signaturw officer or tngoff No examined this return, including accompanying schedules and statements, and to the best of my knowledge and ration of preparer (other than taxpayer or fiduciary) is based on all information of ich preparer has any knowledge I Date ///1/u I / Date I_in 7/ 92 c _ ZLj :3 mo Preparer s / I /4 ll ti. 3- 3 signature in F m' '5 nale (OF VOUFS if GEORGE V. DELSON ASSOCIATES self-employed). address, and ZIP code 885 SECOND AVENUE, NEW YORK, NY 10017 tle I/WI Preparer's identifying _ , Check if Signature on self-employed > CI number page 30 (see of the instructions) EIN P Phone no 13-2842281 212-355-2404 Form 990-PF (2009) Schedule B (Forn1 990, 990-F2, or 990-PF) Department of the Treasury lntemal Revenue Service OMB No 1545-0047 Schedule of Contributors p Attach to Fonn 990, 990-E2, or 990-PF. Name of the organization PE Employer identification number THE C.O.U.Q. FOUNDATION, INC. 13 : 3996471 Organization type (check one): Filers of: Section: Form 990 or 990-EZ El 501(c)( ) (enter number) organization El 4947(a)(1) nonexempt charitable trust not treated as a private foundation El 527 political organization Form 990-PF Z) 501(c)(3) exempt private foundation El 4947(a)(1) nonexempt charitable trust treated as a private foundation D 501(c)(3) taxable private foundation Check if your organrzation 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 El 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 ll Special Rules El For a section 501(c)(3) organization filing Form 990 or 990EZ that met the 33/3 % support test of the regulations under sections 509(a)(1) and 1T0(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 (i) Form 990, Part Vlll, line 1h or (ii) Form 990-EZ, line 1. Complete Parts I and II El 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, ll, and Ill. El 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, 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 it received nonexclusively religious, charitable, etc., contributions of $5,000 or more duringtheyear..........................>$ 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). For Pnvacy Act and Papeniirork Reduction Act Notice, see the Instructions for Form 990, 990-E2. or 990-PF. Cat No 30613)( Schedule B (Fomi 990, 990-E2, or 990-PF) (zoos) Schedule B (Form 990. 990EZ, or 990-PF) (2009) Page Name of organization THE C.O.U.Q. FOUNDATION, INC. E B) No. 1 of 1 of Partl Contributors (see instructions) (M Name, address, and ZIP + 4 id Aggregate contributions ENHANCEDEDUCAHON 6100 RED HOOK QUARTERS (M Name, address, and ZIP + 4 N) Type of contribution Person $ 200,000 El Payroll Noncash (Complete Part II it there is a noncash contnbution ) ST. THOMAS, US VI (m No. 1 Employer identification number 13 5 3996471 id Aggregate contributions M) Type of contribution Person D Payroll Noncash (Complete Part II if there is a noncash contribution) (a No. (M Name, address, and ZIP + 4 id Aggregate contributions M) Type of contribution Person D Payroll Noncash (Complete Part II if there is a noncash contribution.) (m No. (M Name, address, and ZIP + 4 (d Aggregate contributions M) Type of contribution Person El Payroll Noncash (Complete Part II if there IS a noncash contribution ) (a No. (M Name, address, and ZIP + 4 id Aggregate contributions i Type of contribution Person D Payroll Noncash (Complete Part II if there is a noncash contribution) (m No. (M Name, address, and ZIP + 4 id Aggregate contributions M) Type of contribution Person El Payroll Noncash (Complete Part II if there is a noncash contribution) Schedule B (Form 990, 990-EZ, or 990-PF) (2009) 13-3996471 THE C.O.U.Q. FOUNDATION FORM 990-PF YE 2/28/10 STATEMENT 1 Part 1, Line 11: Other Income Tax Refund STATEMENT 2 Part 1, Line 18: Taxes Payroll 3,237 STATEMENT 3 Part 1, Line 19; Part II, Line 14: Depreciation Furniture & Equipment 15,388 7 years Double Declining Balance Half-Year Convention 4,398 13-3 996471 TI-D3 C.O.U.Q. FOUNDATION FORM 990-PF YE 2/28/10 STATEMENT 4 Part 1, Line 23: Other Expenses Bank Charges $ 347 Office Expense 6,93 5 Payroll Fees 1,713 Repairs 320 Telephone Insurance 1 4,578 933 Total 24,826 STATEMENT 5 Part XV, Line 3: Grants and Contributions Paid During the Year Name Purpose Amount Stockholm School of Economics Scholarship $ 25,000 Bay Point School Unrestricted 25,000 Oona Agrigoraici Prior Achievement 15,000 Singularity Institute of Articial Intelligence Unrestricted 50,000 New York City First Unrestricted 10 000 Total 125,000