EFTA Document EFTA01372333

Form 990-PF (2015) Page 6 Part VII -B Statements Regarding Activities for Which Form 4720 May Be Required (Continued) 5a During the year did the foundation pay or incur any amount to (1) Carry on propaganda, or othermse attempt to influence legislation (section 4945(e))' F Yes P No (2) I nfluence the outcome of any specific public election (see section 4955), or to carry on, directly or indirectly, any voter registration drive, F Yes Pi No (3) Provide a grant to an individual for travel, study, or other similar purposes, r Yes WI No (4) Provide a grant to an organization other than a charitable, etc , organization described in section 41945(d)(4)(R )2 (see instructions) F Yes Ri 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> F Yes Pi No b if any answer is 'Yes' to 5a(1)-(5), did anyof the transactions fail to qualify under the exceptions described in Regulations section 53 4945 or in a current notice regarding disaster assistance (see instructions)' Organizations relying on a current notice regarding disaster assistance check here r C 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, 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) F Yes P No F Yes 1.7 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 transactions F Yes 71. No b 5b No 6b No If yes, did the foundation receive any proceeds or nave any net income attributable to the transaction) . . . . 7b No Part VIII Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees, and Contractors 1 List all officers, directors, trustees, foundation managers and their compensation (see instructions). (a) Name and address Title, and average hours per week (b) devoted to position (c) Compensation(lf not paid, enter -0-) (d) Contributions to employee benefit plans and deferred compensation Expense account, (e) other allowances RICHARD KAHN President 1 00 0 DARREN K INDYKE Treasurer 1 00 ERIKA A KELLERHALS Secretary 1 00 2 Compensation of five highest-paid employees (other than those Included on line 1—see Instructions). If none, enter "NONE.- (a) Name and address of each employee paid more than $50,000 Title, and average hours per week (b) devoted to position (c) Compensation Contributions to employee benefit plans and deferred (d) compensation Expense account, (a) other allowances NONE Total number of other employees paid over $50,000 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL Form 990-PF (2015) DB-SDNY-0066022 SDNY_GM_00212206 EFTA01372333