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Form 990-PF (2016)
Part XIII
Undistributed Income (see instructions)
Page 9
1 Distributable amount for 2016 from
2 Undistnbuted income, if any, as
a Enter amount for 2015 only
b Total for prior years
20— ,
3 Excess distributions carryover, if
• From 2011
b From 2012
c From 2013
d From 2014
e From 2015
f Total of lines 3a through e
4 Qualifying distributions for 2016
XII, line 4 ► $
Part XI, line 7
of the end of 2016
20— , 20-
any, to 2016
(a)
Corpus
(b)
Years pnor to 2015
(c)
2015
(d)
2016
477,501
122,434
rom Part
875,160
122,434
a Applied to 2015, but not more than
b Applied to undistnbuted income
(Election required—see instructions).
c Treated as distributions out of corpus
required—see instructions).
.
d Applied to 2016 distributable amount.
e Remaining amount distributed out
5 Excess distributions carryover applied
(If an amount appears in column
same amount must be shown
6 Enter the net total of each column
indicated below:
a Corpus Add lines 3f, 4c, and 4*
b Prior years' undistributed income
line 4b from line 2b .
. . .
o Enter the amount of prior years'
income for which a notice of deficiency
been issued, or on which the section
tax has been previously assessed.
d Subtract line 6c from line 6b Taxable
—see instructions .
.
. . .
e Undistributed income for 2015 Subtract
4a from line 2a Taxable amount
instructions .
.
.
.
. .
.
.
.
.
.
.
.
f Undistributed income for 2016 Subtract
lines 4d and 5 from line 1 This amount
be distributed in 2017 .
.
.
.
7 Amounts treated as distnbutions
corpus to satisfy requirements imposed
section 170(b)(1)(F) or 4942(g)(3)
be required - see instructions) .
8 Excess distributions carryover from
applied on line 5 or line 7 (see instructions)
9 Excess distributions carryover
Subtract lines 7 and 8 from line
10 Analysis of line 9
a Excess from 2012. .
.
.
b Excess from 2013. .
.
.
c Excess from 2014. .
.
.
d Excess from 2015. .
. .
e Excess from 2016. .
.
.
line 2a
of pnor years
. .
. .
(Election
.
.
.
.
.
.
.
.
.
.
of corpus
to 2016
(d), the
in column (a) )
as
Subtract line 5
Subtract
.
.
.
.
.
.
undistnbuted
has
4942(a)
.
.
. . .
amount
.
.
.
.
.
.
line
—see
must
.
out of
by
(Election may
.
.
.
. . .
2011 not
.
.
.
to 2017.
6a
0
.17 1 5C1
275,21S
tit,,225
o
275,225
275,225
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
Forrn 990-PF 2016)
DB-SDNY-0051752
S0NY_GM_00 197936
EFTA01362365