EXTENSION

GRANTED

Return of Private Foundation

990-PF

Fonn

~@13

or Section 4947(a)(1) Trust Treated as Private Foundation

... Do not enter Social

Departmentof theTreasury

... Information

Internal Revenue Service

about

Security

numbers

on this form as it may be made public.

Form 990-PF and its separate instructions

For calendar year 2013 or tax vear beainnina JANUARY 1

is at www.irs.gov/form990pf.

MARCH 31

, 2013, and endina

, 20 13

A Employer identification number

Name of foundation

CLAUDE R. LAMBE CHARITABLE FOUNDATION

48-0935563

Number and street (or PO box number 1fma1l1snot delivered to street address)

P.O.

OMBNo 1545-0052

Room/suite

B Telephone number (see instructions)

BOX 2256

(316)

828-6847

City or town. state or province, country, and ZIP or foreign postal code
If exemptionapplicationis
...
pending,checkhere

WICHITA,

KS 67201-2256
_

Initial return
Initial return of a former public charity
D 1. Foreign organizat1ons.check here
2. Foreign organizations meeting the
Final return
~ Amended return
85% test.checkhereand attach
Address chance
Name chance
computation

H Check type of organization I XI Section 501 (ccr9 exempt private foundation
~
E If private foundationstatuswasterrmnated ~
Section 4947(a)(1) nonexempt charitable trust
Other taxable onvate foundation
under sectionsO?(b)(
1)(A), checkhere .... ~
I Fair market value of all assets at
J Accounting methodLJ
Cash
Accrual
F If the foundation 1sin a 60~onlh termination
under section507(b)(1)(8),
checkhere ...
end of year (from Part II, col (c), /me
Other (specrfy) _____________________
_
16) ... $
2, 8 2 9 . 0 0 (Part I, column (d) must be on cash basis)

G Check all that apply:

Analysis of Revenue and Expenses (The

(a) Revenue and

expenses per
books

total of amounts m columns (b), (c), and (d)

may not necessar,ly equal the amounts m
column (a) (see instructions) J

1
2
3

Contnbut1on~s, grants,etc , received(attachschedule)

Ch k ... ~ 1fthe foundation 1snot required to
ec
attach Sch B
Interest on saVJngsand temporary cash investments

D1v1dends and interest from securities

b Net rental income or (loss)-------CD 6a Net gam or (loss) from sale of assets not on line
~
b Gross sales pnce for all
assets on hne 6a
CD
il; 7 Cap~lgrunn~1nwmeCTromPartl~l1M2).
Net short-term

(b) Net investment

income

f----------1-----------+----------+---------752.00
752.00

'-----------t---------l----l1--A[i5).!fc:'.Gs-tirr'11il:;:s-ll-1
I

10

f----------1-----------+--~~~~lf-_

capital gain

9
Income mod1f1cat1ons
10 a Gross sales less returns
and allowances
b Less Cost of goods sold

(d) Disbursements
for charitable
purposes
( cash basis onlv)

(c) AdJusted net

income

l---------+--------~----ti=~~~~~t==::::::;::,==::::::,=r::n:c::,;1----

5 a Gross rents

a::

n\~f/c.JTEc:bnh-d---

~uv,...._.__..-()

U\l.~--

-r-

r- n

"' "

:::ic:....~1::::..

""

"

1
1
__
__~.u_4&_u_~_.u

~-~~i,~~~--

====
-===f,,====d0C

UGu!j'\!J, u~

1---------+---------1----------+----------+---------

c Gross profit or (loss) (attach schedule)

u,

Other income (attach schedule)

12

Total. Add Imes 1 throuoh

13

Compensation of officers, directors, trustees, etc

14

Other employee

15

Pension plans, employee benefits

CD

1,512.00
2,264.00

11

!>C 16a

..
..
CD

-~

fees (attach schedule)

c Other professional

fees (attach schedule).

~ 17

Interest

.!!! 18
c

Taxes (attach schedule) (see1nstruct1ons)

Occupancy

e1e

20

Travel, conferences,

- 23
~ 24

Other expenses

(attach schedule)

Total operating

and administrative

A~l1n~13~rough23

7.00

t----------1-----------+----------l---------~

~ 21
ca 22

7.00

Depre~atlon(attachschedule)andde~etlon.

Printing

752.00

salaries and wages

Legal fees (attach schedule)

b Accounting

11

and meetings

and publications

769.00

769.00

expenses.

1--~~~-7~7_6_._0_0~~~~~~-7_._0~0~~~~~~~~~~~~~7_6_9~-0~0-

26

Contnbutlons,
gdts,grantspa~

~~2~,_2~9~9~,_5~9~3_._0~0~~-----~-~--------~~2~,~2~9~6~,_7~7~1~.~0~0Totatexpensesand disbursementsAdd Imes 24 and 25

2 , 300 , 3 69 . 00
7 . 00
2 , 2 97 ,

27

Subtract

25

540 . 00

line 26 from hne 12

a Excessof revenueover expensesand disbursements

b N~inve~me~~come(dneg~.eM~~~
c Adiusted net income (1f neaat1ve, enter -0-).
JSA For Paperwork
Reduction Act Notice, see instructions.
3E1410 1 000

t--_2...c,_2_9_8-',_1_0_5_.
_0_0---11----------+----------+--------f----------1-------7-4_5_._0_0-+----------+--------~
Fann

990-PF(2013) /

-~

J~

Page 2

Form 990-PF (2013)

1@jj1 Balance

Sheets

Attached schedulesand amounts m the

Beginning of year
description column should be for end-of-yeari------------t----------.....---------amounts only (See instructions)
(a) Book Value

Savings and temporary cash investments

Accounts receivable ~ ______________________
Less allowance for doubtful accounts ~ _____________
Pledges receivable ~ ______________
----------

i------------t----------;----------

Less allowance for doubtful accounts ~ _____________

Grants receivable

i------------t----------;----------

5
6

(b) Book Value

(c) Fair Market Value

2 , 2 95 , 304 . 00

Cash - non-interest-beanng

1
2

End of year

Receivables due from officers, directors,

trustees, and other

d1squahf1ed persons (attach schedule) (see 1nstruct1ons)

Other notes and loans receivable (attach schedule)

Cl)

GI
Cl)
Cl)

c(

____

Less allowance for doubtful accounts ~ ____________

-;-----------+----------+----------

8 lnventones for sale or use

9 Prepaid expenses and deferred charges
10 a Investments - US and state governmentobligations(attach schedule).

3,580.00

2,829.00

2,829.00

2,829.00

2,829.00

b Investments - corporate stock (attach schedule)

11

12
13
14

15
16

c Investments - corporate bonds (attach schedule).

Investments- land, buildings,
~
and equipment basis
____________
-----_
Less accumulateddeprec1at1on
~
(attach schedule)
- - - - - - - - - - - - - - - - - - - -t-----------+----------+---------lnvestments - mortgage loans
Investments - other (attach schedule)
~

Land, buildings,and
equipment basis
_
Less accumulateddeprec1at1on
~
(attach schedule)
- - - - - - - - - - - - - - - - - - - -;-----------+----------+---------Other assets (describe ~ ____________________
) i------------t-----------t---------Total assets (to be completed by all filers - see the
instructions Also, see page 1, item I)
2 298,884.00

17

18
GI 19
E 20
:c
Ill 21
:i
22
Cl)

23
Cl)

779.00

Accounts payable and accrued expenses

2,822.00

Grants payable
Deferred revenue
Loans from officers, directors,trustees,and other disqualifiedpersons
Mortgages and other notes payable (attach schedule)
Other hab1ht1es(describe ~ ATCH _

5 _____________

) 1-----------+-------7_._0_0--1
779.00

Total liabilities (add Imes 17 through 22)

GI

g 24
Ill

Unrestricted

iii 25
IXl 26

Permanently restricted

c
::,
u..

...
0

Foundations that do not follow SFAS 117,

check here and complete lines 27 through 31 .

-3l

en 27
28
~ 29

Capital stock, trust principal, or current funds

ai 30

Total net assets or fund balances (see instructions).

Total
liabilities
and net
assets/fund
balances

Z 31

2,298,105.00

Temporarily restricted

"Cl

2,829.00

Foundations that follow SFAS 117, check here. ~~

and complete lines 24 through 26 and lines 30 and 31.

~o

Paid-in or capitalsurplus, or land, bldg , and equipmentfund

Retained earnings, accumulatedincome,endowment,or other funds

instructions)
~ ,.... 11

2,298,105.00
(see

2, 2 9 8, 8 8 4 . 0 0

2,829.00

Analysis of Changes in Net Assets or Fund Balances

1 Total net assets or fund balances at beginning of year - Part II, column (a), hne 30 (must agree with
end-of-year figure reported on prior year's return).
2 Enter amount from Part I, hne 27a
3 Other increases not included in hne 2 (1tem1ze)~-----------------------------------4 Add lines 1, 2, and 3
5 Decreases not included in hne 2 (1tem1ze)~----------------------------------------1--5-+--------6 Total net assets or fund balances at end of year (hne 4 minus hne 5) - Part II, column (b), hne 30 .

1
2

2,298,105.00
-2,298,105.00

i--3-+--------4
i----;----------

6
Form

JSA

3E1420 1 000

990-PF (2013)

Form 990-PF (2013)

!6:R-

Page

Capital Gains and Losses for Tax on Investment Income

\DJ HOW

(a) List and describe the kind(s) of property sold (e g, real estate,

acquired
P-Purchase
D - Donaloon

2-story brick warehouse, or common stock, 200 shs MLC Co )

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

(d) Date sold

(mo, day, yr)

1a
b

c
d
e
(g) Cost or other basis
plus expense of sale

(f) Deprec1at1on allowed

(or allowable)

(e) Gross sales price

{h) Gain or (loss)

(e) plus (f) minus (g)

a
b

c
d

e
Comolete onlv for assets showing gain in column (h) and owned bv the foundation on 12/31/69
(i) F M V as of 12/31 /69

0) AdJusted basis
as of 12/31 /69

(I) Gains (Col (h) gain minus

col (k), but not less than -0-) or
Losses (from col (h))

(k) Excess of col (1)

over col (J), 1fany

a
b
c
d

e
If gain, also enter in Part I, line 7 }
{
If (loss), enter -0- 1nPart I, hne 7
i--2-i------------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) (see instructions) If (loss), enter -0- in }
Part I, hne 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3

2 Capital gain net income or (net capital loss)

~ --

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 1nthe 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 the instructions before making any entries
(a)
Base penod years
Calendar year (or tax year begonnongon)

(b)
AdJusted qualifying d1stnbut1ons

2
3

3,382,261.00
5,068,581.00
6,651,320.00
8,782,857.00
11,492,427.00

. . . . . . . . .............................

Enter the net value of noncharitable-use

Multiply line 4 by line 3

Enter 1% of net investment income (1 % of Part I, hne 27b).

Add lines 5 and 6

Enter qualifying d1stribut1ons from Part XII, line 4.

If line 8 1s equal to or greater than line 7, check the box
Part VI instructions

..........

0.3441

..........

604,120.00

...................

207,854.00

...................

. . . . . . . . . . . . . . . . . . . . . ....................
....

JSA

0.6614
0.2376
0.2968
0.3109
0.2137
1.7204

assets for 2013 from Part X, hne 5

...................

[KJ No

Total of line 1, column (d)

Average d1stribut1on ratio for the 5-year base period - d1v1dethe total on line 2 by 5, or by the
number of years the foundation has been in eXlstence If less than 5 years

Yes

(d)
D1stnbut1on ratm
(col (b) divided by col (c))

(c)
Net value of nonchantable-use assets

2,236,897.00
1,204,226.00
1,973,852.00
2,730,340.00
2,456,244.00

2012
2011
2010
2009
2008

7.00
207,861.00

....................
in

2,297,540.00
8
Part VI, line 1b, and complete that part using a 1% tax rate See the
Form 990-PF(2013)

3E1430 1 000
-------

Page

For~ 990-PF (2013)

::.F.na
1a

Excise Tax Based on Investment

Exempt operating foundations descnbed in section 4940(d)(2), check here

Date of ruling or determination letter _______________

b Domestic foundations
here ....

LJ

....

and enter "N/A" on hne 1

(attach copy of letter if necessary see instructions)

that meet the section 4940( e) requirements

CRJ
and enter

Income (Section 4940(a), 4940(b), 4940(e), or 4948 - see instructions)

in Part V, check

7 00

1% of Part I, hne 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)

3
4

Add lines 1 and 2.

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 hne 3 If zero or less, enter -O-

Cred1ts/Payments
a 2013 estimated tax payments and 2012 overpayment credited to 2013.

6a

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 w1thhold1ng erroneously withheld

6d

Total credits and payments

8
9

Enter any penalty for underpayment of estimated tax. Check here

1O
11

Statements

8
9

....

Overpayment. If hne 7 is more than the total of lines 5 and 8, enter the amount overpaid
Enter the amount of hne 10 to be Credited to 2014 estimated tax ....

:a.

. . l---'1'----1------2-','-8-2_9 ___
o_o_

1f Form 2220 1s attached

Tax due. If the total of Imes 5 and 8 1s more than hne 7, enter amount owed

7.00

2,829.00

Add Imes 6a through 6d

7.00

2,822.00
2,822.00

.... 10
.... 11

Refunded

Regarding Activities

1 a During the tax year, did the foundation

Yes

attempt to influence any national, state, or local legislation or did 1t part1c1pate

No

or intervene in any political campaign?

b Did 1t spend more than $100 during the year ( either directly or indirectly) for political purposes (see Instructions for the

1a

def1nit1on)?
If the answer is 'Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials pubhshed or

1b

1c

or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes

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

4a

d1stnbuted by the foundation m connection with the acllv1t1es

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

d Enter the amount (1f any) of tax on political expenditures (section 4955) imposed during the year
(1) On the foundation .... $
(2) On foundation managers .... $ __________
e Enter the reimbursement

(1f any) paid by the foundation

during

the year for political

expenditure

tax imposed on

foundation managers .... $ -------------Has the foundation engaged in any activ1t1es that have not previously been reported to the IRS?.

If "Yes," attach a detailed description of the act1v11/es

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

4b

b If "Yes," has 1tfiled a tax return on Form 990 T for this year?

Was there a liqu1dat1on, termination, d1ssolut1on, or substantial contraction during the year?

If 'Yes," attach the statement reqwred by General Instruction T.

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

By language in the governing instrument, or

By state leg1slat1on that effectively
7

amends the governing

instrument

so that no mandatory directions that conflict

with the state law remain in the governing instrument?

Did the foundation have at least $5,000 in assets at any time during the year? If 'Yes," complete Part II, col (c), and Part XV

x
x

Sb

Ba Enter the states to which the foundation reports or with which 1t 1sregistered (see instructions)

....

KS, VA---------------------------------------------------------------------b If the answer 1s '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.
9

Is the foundation

claiming

status as a private

operating

foundation

. . . . . . . . . . . . . .

within

the meaning

of section

4942(J)(3) or

4942(J)(5) for calendar year 2013 or the taxable year beginning in 2013 (see instructions for Part XIV)? If 'Yes," complete

Part XIV . ......................................

10

Did any persons become substantial contributors

addresses . ....

during the tax year? If 'Yes," attach a schedule fisting their names and
10
Form

JSA

3E1440 1 000

x
x
990-PF (2013)

Page 5

Fori-n990-PF (2013)

~-..1ll"f~
Statements

11

At

time

any

the

during

(continued)

Regarding Activities
year,

did

foundation,

the

directly

indirectly,

or

own

12

Did

the

make

foundation

a d1stribut1on

a donor

to

advised

over

fund

controlled

within

entity

which

the

foundation

or

.......................

person had advisory privileges? If 'Yes," attach statement (see instructions)

Did the foundation

14

Website address .... _NI A _____________

----------------------------------------------------------The books are 1ncare of .... KARA_ WORTHINGTON _____ -------__________
Telephone no .... 316-82

16

12
13

for its annual returns and exemption application?

E.

37TH

STREET

NORTH WICHITA,

LJ

....

At

authority

any time

during

calendar

year 2013,

did

the foundation

have an interest

in or a signature

or other

See the instructions for

the foreign country ..,.

~-~11"1:
Statements

exceptions

and

Regarding

filing

requirements

Yes

Activities

TD F 90-22 1

Form

If 'Yes,"

enter

the

name

for Which Form 4720 May Be Required

Yes

1 a During the year did the foundation ( either directly or 1nd1rectly)

(1) Engage in the sale or exchange, or leasing of property with a d1squahf1edperson?

money from,

lend money

to, or otherwise

extend

credit

to (or accept

to, or pay or reimburse the expenses of, a d1squahf1edperson?

Yes

Yes

CKJ
No

Yes

CKJ
No

Yes

the benefit or use of a d1squahfied person)?.

foundation

agreed

to

make

to a government

a grant

to

or to

termination of government service, 1f terminating

official?
employ

(Exception.
official

the

within 90 days).

for

period

after

under the exceptions

described

section 53 4941 (d)-3 or in a current notice regarding disaster assistance (see instructions)?
engage

in a prior

year

in any

of the

acts

No

described

1a, other

in

in Regulations

.... d

Orgamzat1ons relying on a current notice regarding disaster assistance check here

c Did the foundation

No

Check "No" 1f the

b If any answer 1s 'Yes" to 1a(1)-(6), did any of the acts fail to qualify

No

Yes

(5) Transfer any income or assets to a d1squahf1ed person (or make any of either available for
(6) Agree to pay money or property

than

excepted

acts,

on

failure

to

distribute

income

(section

4942)

(does

not

apply

for

years

the

foundation

was

1b

1c

that

were not corrected before the first day of the tax year beginning in 2013?
Taxes

No

00 No

0Yes

11 from)

disqualified person?
(3) Furnish goods, services, or fac1ht1esto (or accept them from) a d1squahfied person?
(4) Pay compensation

of

File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.

(2) Borrow

No

16

for

_
_

1........,1"'5'----'-I--~--~--

and enter the amount of tax-exempt interest received or accrued during the year
over a bank, securities, or other financial account in a foreign country?.

x
x

8-67 68 ______
KS--------------ZIP+4 .... _ 67220_________
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF 1n heu of Form 1041 - Check here ......................
.... 4111

Located at

15

requirements

11

a d1squalif1ed

13

comply with the public inspection

the

. . . . . . . . ........

meaning of section 512(b)(13)? If 'Yes," attach schedule (see instructions)

a private

operating foundation defined in section 4942(J)(3) or 4942(1)(5))

a At the end of tax year 2013, did the foundation

have any undistributed

6e, PartXlll)fortaxyear(s)begmmngbefore2013?,
lf"Yes,"hsttheyears
b Are

there

(relating

..,. __________

any years listed

to

incorrect

, _________

in 2a for which

valuation

of

income (Imes 6d and

Yes

CKJ
No

prov1s1ons of section

4942(a)(2)

assets)

the

to

, ________
foundation

the

year's

--------

1s not

applying

undistributed

the

income?

(If

applying

section

4942(a)(2)

to

all years listed, answer "No" and attach statement - see instructions ) i---=2=b-+---II--c If the prov1s1ons of section 4942(a)(2) are being applied to any of the years listed in 2a, hst the years here
,
,
,

....___________________ ________________

3a Did the foundation

hold more than a 2% direct

or indirect

interest

in any business enterpnse

at any time during the year?

b If 'Yes,"

did

11 have excess

d1squalif1ed persons
Comm1ss1oner under
the

10-,

15-,

or

after

business

May 26,

section
20-year

holdings

1969,

4943(c)(7))
first

phase

(2)
to

in

2013

the

lapse of the

dispose

holding

as a result

of holdings
penod?

of (1)

5-year period
acquired

(Use

Schedule

any

(or longer

by gift
C,

purchase

period

or bequest,

Form

4 720,

Yes

by the

approved

or (3) the

to

No

foundation

determine

lapse of
tf

foundation had excess business holdings m 2013 ) . . . . .

4a Did the foundation
b Did the foundation
charitable

invest during the year any amount in a manner that would Jeopardize its charitable purposes?
make any investment

in a prior

year (but

after

December

31,

1969)

that

or

by the

the
,__3_b
____

4a

4b

could Jeopardize its

ouroose that had not been removed from 1eooardv before the first dav of the tax vear beainmna

in 2013?

Form 990-PF(2013)

JSA
3E1450 2 000

Form 990-PF (2013)

Page

Statements

Re arding Activities

continued

for Which Form 4720 Ma Be Required

Sa 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))?
(2) Influence the outcome

of any specific

public

election

(see section

4955),

directly or indirectly, any voter reg1strat1ondnve?

(3) Provide a grant to an ind1v1dual for travel, study, or other s1m1larpurposes?.
(4) Provide a grant to an organization

other than a charitable,

than

religious,

charitable,

[Kl

0Yes

[I]No

0Yes

[I]No

0Yes

0No

No

in

or educational

[Kl

No

described

in

Yes

If any answer 1s "Yes" to 5a(1)-(5), did any of the transactions fall to qualify under the exceptions
Regulations section 53 4945 or in a current notice regarding disaster assistance (see 1nstruct1ons)?
Organizations

described

sc1ent1fic, literary,

purposes, or for the prevention of cruelty to children or animals?.

b

etc , organization

section 509(a)(1 ), (2), or (3), or section 4940(d)(2)? (see instructions)

(5) Provide for any purpose other

0Yes

or to carry on,

Sb

relying on a current notice regarding disaster assistance check here

If the answer 1s "Yes" to question

5a(4), does the foundation

because 1t maintained expenditure respons1b1htyfor the grant?

claim exemption

from the tax

Yes

No

Yes

[Kl

No

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

&a

Did the foundation,

during the year. receive any funds, directly

on a personal benefit contract?.

or indirectly,

to pay premiums

b Did the foundation, during the year, pay premiums, directly or 1nd1rectly,on a personal benefit contract?

If "Yes" to 6b, file Form 8870

7 a At any time during the tax year, was the foundation a party to a proh1b1tedtax shelter transaction?
b If "Yes," did the foundation receive an

roceeds or have an net income attributable to the transaction?

6b
Yes

[Kl

No

7b

Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1

List all officers,

directors,

trustees,

foundation

managers and their compensation

(b) Title, and average
hours per week
devoted to oos1t1on

(a) Name and address

(see instructions).

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

-------------------------------------

0.00

ATCH 6

(d) Contributions to
employee benefit plans
and deferred compensation

(e) Expense account,

other allowances

0.00

0.00

------------------------------------------------------------------------------------------------------------2

Compensation
"NONE."

of five

highest-paid

employees

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

(other

than

those

(b) Title, and average

hours per week
devoted to pos1t1on

included

on line 1 - see instructions).

(c) Compensation

(d) Contributions to
employee benefit
plans and deferred
compensation

If none, enter

(e) Expense account,

other allowances

NONE

Total number of other emolovees paid over $50,000

..............................

~
Form

JSA

3E1460 1 000

990-PF

(2013)

Form 990-PF (2013)

Page

@110Information

About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,

and Contractors (continued)

Five highest-paid independent contractors for professional services (see instructions). 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 rece1vino over $50,000 for professional services ......................

itilf!IA Summary

of Direct Charitable Activities

List the foundation's four largest direct charitable act1v1t1esdunng the tax year Include relevant stat1st1cal information such as the number of
organizations and other benefic1anes served, conferences convened, research papers produced, etc

Expenses

NONE----------------------------------------------------------------------

;I

Summary of Program-Related Investments (see instructions)

Describe the two largest program-related

Amount

investments made by the foundation dunng the tax year on Imes 1 and 2

NONE

---------------------------------------------------------------------------

All other program-related investments See 1nstruct1ons

3 NONE

---------------------------------------------------------------------------

Total. Add lines 1 through 3 ............................................

~
Form

JSA

3E1465 1 000

990-PF (2013)

Page

Form 990-PF (2013)

1QMQ Minimum

Investment
see 1nstruct1ons.)

Fair market value of assets not used (or held for use) directly
purposes:
a Average monthly fair market value of securities
b Average of monthly cash balances. . . . . . . .
c Fair market value of all other assets (see instructions).

m carrying out charitable, etc.,

1a
1b
1c
1d

d Total (add Imes 1a, b, and c) .....................

e Reduction claimed for blockage or other factors reported on Imes 1a and
'--1_e_._
_________
1c (attach detailed explanation) ..................
Acqu1s1t1onindebtedness applicable to line 1 assets
Subtract line 2 from line 1d
Cash deemed held for charitable act1v1t1es. Enter 1 1/2 % of line 3 (for greater amount, see

2
3
4

130,252.00
483,068.00
613,320.00

__J

.............

2
3

613,320.00

4
5
6
Distributable Amount (see instructions) (Section 4942(.J)(3) and (j)(5) private operating foundations
and certain foreign organizations check here ~
and do not complete this part)

instructions). . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .
Net value of noncharitable-use assets. Subtract line 4 from line 3 Enter here and on Part V, hne 4
Minimum investment return. Enter 5% of hne 5

Minimum investment return from Part X, line 6 ...........

Return (All domestic foundations must complete this part. Foreign foundations,

.
2a
7.00
.
2b
b Income tax for 2013 (This does not include the tax from Part VI ) ..
c Add Imes 2a and 2b
Distributable amount before adjustments Subtract line 2c from line 1.
3
Recoveries of amounts treated as qualifying d1stnbut1ons
4
Add Imes 3 and 4
5
.
.
. .
Deduction from distributable amount (see instructions). . . .
6
Distributable amount as adjusted. Subtract lme 6 from line 5. Enter here and on Part XIII,
7
line 1. . . . . . . . . . . . . . . . . . . . . . . . . . .
. ...................

9 200.00
604,120.00
7,428.00

7,428.00

2 a Tax on investment income for 2013 from Part VI, hne 5 .....

Afflf3ii
Qualifying
1
a
b

2
3
a
b

4
5

7.00
7,421.00

4
5
6

7,421.00

7,421.00

Distributions (see instructions)

Amounts paid (including adm1nistrat1ve expenses) to accomplish charitable, etc. purposes

Expenses, contributions, gifts, etc - total from Part I, column (d), hne 26 ..
Program-related investments - total from Part IX-B
Amounts paid to acquire assets used (or held for use) directly m carrying out charitable, etc .

..... . . . . . ....
..............
. . . . . . . . . . ...
. .... . . . . . . . . . . . . . .
. . . . . . . . . . . . . ...........

1a
1b

2
purposes ......
Amounts set aside for spec1f1ccharitable projects that satisfy the
3a
Su1tab11itytest (prior IRS approval required). . . . . . . . . . . . .
3b
Cash d1stribut1on test (attach the required schedule) .......
4
Qualifying distributions. Add Imes 1a through 3b Enter here and on Part V, hne 8, and Part XIII, hne4
Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment income
5
Enter 1% of Part I, line 27b (see instructions) ........
6
Adjusted qualifying distributions. Subtract line 5 from line 4 ........
Note. The amount on line 6 will be used in Part V, column (b), m subsequent years when calculating
qualifies for the section 4940(e) reduction of tax m those years

2,297,540.00

...............
...............

..

2c
3

........

......

2,297,540.00
7.00
2,297,533.00
whether

the foundation

Form

JSA
3E1470 1 000

---

--------

-----~

990-PF

(2013)

..

p age

Form 990-PF (2013)

Undistributed

for 2013

Distributable

Und1stnbutedincome, 1f any, as of the end of 2013

line 7

amount

from

Part XI,

(a)
Corpus

.....................

(b)
Years prior to 2012

(c)
2012

(d)
2013

7,421.00

..........

a Enter amount for 2012 only

b Total for pnor years

Income (see instructions)

20___ll_ ,20---1...Q_
,2Q_Q2._

Excess d1stribut1ons carryover, 1f any, to 2013

1,896,993.00
2,293,087.00
1,645,368.00
953,000.00
2,074,790.00

a From 2008
b From 2009

From2010

From 2011

e From 2012
f

Total of Imes 3a through e

Qualifying

line 4

...........

8,863,238.00

d1stribut1ons for 2013 from Part XII,

.....$

2,297,540.00

a Applied to 2012, but not more than line 2a

b Applied to undistributed income of prior years
(Election required - see instructions)

c Treated as distributions out of corpus (Election

required - see instructions)

d Applied to 2013 distributable

amount

.....

7,421.00

..

Remaining amount distributed out of corpus

Excess d1stribut1ons carryover applied to 2013
(If an amount appears ,n column (d), the same
amount must be shown ,n column (a))

Enter the net total

indicated below:

of each column

2,290,119.00

as

a Corpus Add lines 3f, 4c, and 4e Subtract line 5

11,153,357.00

Subtract
income
b Prior years' undistributed
line 4b from line 2b
c Enter the amount of prior years' undistributed
income for which a notice of def1c1ency has
been issued, or on which the section 4942(a)
tax has been previously assessed

...............

.......

Taxable
line 6b
line 6c from
d Subtract
amount - see instructions
e Undistributed income for 2012 Subtract line
Taxable amount
see
4a from line 2a
instructions

.. . . . . . . . . . .
........
..........

Undistributed income for 2013 Subtract Imes

4d and 5 from line 1 This amount must be
distributed in 2014

..............

Amounts treated as distributions out of corpus

to satisfy requirements imposed by section
170(b)(1 )(F) or 4942(9)(3) (see instructions)

Excess d1stribut1ons carryover from 2008 not

applied on line 5 or line 7 (see instructions)

Excess

..

distributions

carryover

Subtract Imes 7 and 8 from line 6a

Analysis of line 9
a Excess from 2009

to

1,896,993.00

2014.

... . . . .

9,256,364.00

10

b Excess from 2010

Excess from 2011

d Excess from 2012

e Excess from 2013

2,293,087.00
1,645,368.00
953,000.00
2,074,790.00
2,274,360.00
Form 990-PF(2013)

JSA

3E14801000

~=l

Page

Form 990-PF (2013)

10

Private Operating Foundations ( see instructions and Part VII-A, question 9'

1 a If the

foundation

foundation,

has received

a ruling

or determination

letter

that

1t 1s a private

b Check box to indicate whether the foundation

(a) 2013

Justed net income from Part

I or the minimum investment
return from Part X for each
year listed

..,..

1s a private operating foundation described m section

Tax year

2a Enter the lesser of the ad-

operating

and the ruling 1s effective for 2013, enter the date of the ruling

I I

4942(J)(3) or

I I

Prior 3 years
(b)2012

(c) 2011

4942())(5)

(e) Total
(d)2010

b 85% of line 2a
C Qualifying

d1stnbut,ons from Part

XII, Ima 4 for each year listed

Amounts included m line 2c not

used directly for active conduct
of exempt act1v1t1es

Qualifying
d1stnbut1ons made
directly for active conduct of
exempt act1V1t1es Subtract line
2d from line 2c

Complete 3a, b, or c for the

alternative test rahed upon

a Assets"
(1)
(2)

alternative test - enter

Value of all assets

Value of assets qualifying
under section
4942())(3)(8)(1).

b "Endowment"

test-

alternative

enter 213 of minimum

invest-

ment return shown en Part

X.

line 6 for each year listed

C "Support"

altemat,ve test - enter

(1)

Total support other than

gross investment income
(interest. d1V1dends, rents,
on secunt1es
payments
loans (section 512(a)(5)),
or royalties).

(2)

Support
from
general
public and 5 or more
exempt organ1zat1ons as
provided m section 4942
(J)(3)(B)(m)

(3)

Largest amount
from
port
an
organ1zat1on.

of supexempt

(4) Gross investment income.

1::r., :.....
1

Supple'!'entary_ Information (Coi:nplete ~his part only if the foundation

at any time during the year - see instructions.)

had $5,000

or more in assets

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 tax year (but only 1fthey have contributed more than $5,000) (See section 507(d)(2))

N/A
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
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest

N/A
2

Information

Regarding

Contribution,

Grant, Gift, Loan, Scholarship, etc., Programs:

Check here..,.. [fil 1f 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 instructions) to ind1v1duals or organizations under
other cond1t1ons,complete items 2a, b, c, and d
a The name, address. and telephone number or e-mail address of the person to whom apphcat1onsshould be addressed
b The form in which applications should be submitted and information and materials they should include:

c Any subm1ss1on deadlines

d Any restrictions
factors:
JSA
3E1490 1 000

or hm1tat1ons on awards, such as by geographical

areas, charitable fields, kinds of institutions,

or other

Fonm 990-PF (2013)

Form 990-PF (2013)

Page

1:fffiJfJSupplementary
3

11

Information (continued)
Grants and Contributions Paid Durina the Year or Ancroved for Future Pavment

Rec1p1ent
Name and address (home or business)
a Paid during the year

If rec1p1ent1san ind1vtdual,
show any relat1onsh1pto
any foundation manager
or substantial contnbutor

Foundation
status of
rec1p1ent

Purpose of grant or
contribution

Amount

ATCH 7

Total

Ja

Jb

2,296,771.00

b Approved for future payment

ATCH 8

Total

2,822.00
Form 990-PF (2013)

JSA
3E1491 1 000

..

Page 12

Form 990-PF (2013)

Analysis of Income-Producing Activities

[!Bl

Enter gross amounts unless otherwise 1nd1cated

1 Program service revenue

Unrelated business income

Excluded by section 512, 513, or 514

(a)

(b)

(c)

(d)

Business code

Amount

Exclusion code

Amount

(e)
Related or exempt
function income
<See instructions )

c
d
e

Fees and contracts from government agencies

2 Membership dues and assessments

.....

3 Interest on savingsand temporarycash investments

4 D1v1dends and interest from secunt1es

14

752.00

.. . .

5 Net rental income or (loss) from real estate

Debt-financed

Not debt-financed

property
property

6 Net rental income or (loss) from personalproperty

7 Other investment income

.........

8 Gain or (loss) from sales of assetsother than inventory

9 Net income or (loss) from speaal events

..

10 Gross profit or (loss) from sales of inventory.

INCOME
11 Other revenue a OTHER

01

1,512.00

c
d
e
12 Subtotal

Add columns (b), (d), and (e)

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

(See worksheet in line 13 instructions to venfy calculations)

::.:

..--=

Line No.

...

JSA

3E1492 1 000

2,264.00
13

2,264.00

Relationship of Activities to the Accomplishment of Exempt Purposes

Explain below how each act1v1ty for which income 1s reported in column (e) of Part XVI-A contributed importantly to the
accomplishment of the foundation's exempt purposes (other than by providing funds for such purposes). (See instructions )

Form 990-PF (2013)

Form 990-PF (2013)

Mdii
1

c
d

Page

13

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
No
Yes
in section 501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political
organizations?
Transfers from the reporting foundation to a noncharitable exempt organization of
(1) Cash
x
1af1l
(2) Other assets
1a{2l
x
Other transactions
(1) Sales of assets to a noncharitable exempt organization
1b{1l
x
x
1b(2)
(2) Purchases of assets from a noncharitable exempt organization .
(3) Rental of fac11it1es,equipment, or other assets
1b{3l
x
(4) Reimbursement arrangements
x
1b(4l
x
(5) Loans or loan guarantees
1bf5l
x
(6) Performance of services or membership or fundra1smg sohc1tat1ons
1b{6l
Sharing of fac1ht1es,equipment, mailing lists, other assets, or paid employees .
x
1c
If the answer to any of the above 1s ''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) Line no

(c) Name of nonchantable exempt organization

(b) Amount 1n110lved

(d) Description of transfers, transactions, and shanng arrangements

N/A

N/A

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? . . . . . . . . . . . .
b If "Yes" com lete the follow1n schedule
(b) Type of organization

(a) Name of organization

Yes

No

(c) Description of relat1onsh1p

re that I have examined this return. including accompanying schedules and statements, and to the best of my knowledge and belief, 1t 1s true,
preparer (other than taxpayer) 1sbased on all information of which preparer has any knowledge

Sign
Here
Paid
Preparer
Use Only

~Jfp1WJU

May
with

Title

(see mstrucbons)?

Date

the
the

IRS discuss this

preparer shown

PnnUType preparers name

Check

ELIZABETH

self-employed

Firm's name
Firm's address

S. HOGAN
~ BKD,
LLP
~ 1551
N. WATERFRONT
WICHITA,
KS
67206

Firm's EIN

PARKWAY,

SUITE

3E1493 1 000

Yes

1f PTIN

POO2 7 3 2 4 8
4 4 - 0 1 602 60

300
Phone no

3 1 6 - 2 6 5 - 2 8 11
Form

JSA

return
below

990-PF

(2013)

CLAUDE R. LAMBE CHARITABLE FOUNDATION

FORM 990PF

48-0935563

- GENERAL EXPLANATION ATTACHMENT

FINAL DISTRIBUTION

OF ASSETS

IN MARCH OF 2013,
THE ORGANIZATION WAS TERMINATED, AND A FINAL
DISTRIBUTION OF ASSETS WAS MADE.
A FINAL DISTRIBUTION OF ASSETS WAS MADE ON MARCH 22, 2013 WHEN ALL
REMAINING ASSETS WERE TRANSFERRED TO THE FIDELITY INVESTMENTS CHARITABLE
GIFT FUND, A PUBLIC CHARITY UNDER 509 (A) (1).
FIDELITY INVESTMENTS CHARITABLE GIFT
P.O. BOX 770001
CINCINNATI, OH 45277-0053

FUND

A WIRE TRANSFER OF $2,296,771.16

WAS MADE TO THE FIDELITY INVESTMENTS
CHARITABLE GIFT FUND. THIS TRANSFER HAD A FAIR MARKET VALUE OF
$2,296,771.16
AND WAS A COMPLETE DISTRIBUTION OF ALL REMAINING ASSETS,
WITH THE EXCEPTION OF AN OVERPAYMENT OF PRIOR YEAR TAXES.
ANY AMOUNTS
ULTIMATELY REFUND WILL BE TRANSFERRED TO THE SAME FIDELITY INVESTMENTS
CHARITABLE GIFT FUND.
THE ORGANIZATION HAS CEASED TO EXIST AND HAS TERMINATED ITS PRIVATE
FOUNDATION STATUS UNDER SECTION 507(B) (1) (A) BY TRANSFERRING ALL
REMAINING ASSETS TO A PUBLIC CHARITY.

8992FT

K932

1/21/2014

11:35:05

AM V 12-7.12

85651

PAGE_J__4
__

CLAUDE R. LAMBE CHARITABLE FOUNDATION

ACTION BY THE SOLE TRUSTEE
The undersigned, being the sole trustee (the "Trustee") of the Claude R. Lambe Charitable
Foundation (the "Trust"), created under the laws of the State of Kansas by that ce1iain Charitable
Trust Agreement, dated February 19, 1982, as amended (the "Trust Agreement"}, does hereby
consent in writing to the adoption of, and does hereby adopt, in lieu of a meeting, the following
resolutions:
WHEREAS, the Trustee has the power under A1iicle XII of the Trust Agreement, to
te1111inatethe Trust at any time and distribute its assets to qualified recipients; and
WHEREAS, the Trustee desires to dissolve the Trust;
RESOLVED, that the Trust, by its duly authorized representative(s), immediately upon
the adoption of this resolution, shall proceed to liquidate and distribute all of the
remaining assets of the Trust to a donor-advised fund within Fidelity Charitable Gift Fund,
an organization described in Section 501(c)(3) of the Internal Revenue Cude, as more
particularly described as follows:
JPMorgan Chase Bank
New York, NY
ABA Number: 021000021
For credit to: National Financial Services LLC
For Benefit of: Fidelity Charitable Gift Fund, 297-000442

RESOLVED FURTHER, that the Trust shall take any and all actions required to dissolve
under Kansas law;
RESOLVED FURTHER, that the appropriate personnel of the Trust are hereby
authorized and directed, on behalf of the Trust, to take such actions as may be
necessary and proper to carry out the intent and purpose of the foregoing resolutions;
RESOLVED FURTHER, that
Trust by appropriate personnel
with the authority hereinabove
adopted as actions of the Trust,

all known actions previously taken on behalf of the

in connection with the foregoing resolutions, consistent
granted, are hereby ratified, approved, confirmed, and
and the Trust shall hereafter be bound by such actions.

Once signed, any reproduction of this consent made by reliable means (e.g., photocopy,
facsimile) is considered an original. This written consent shall be filed with the minutes of the
proceedings of the Trustees and shall have the same force and effect as a vote of the sole Trustee.

In witness whereof, the undersigned has caused this written consent action to be
executed effective ns of January~. 2013.

By:
Date:
/. ,_73 - / 3
Name: Charles G. Koch
TRUSTl1:R, CLAUDE R. LAMBE
CHAIUTAHLJi:FOUNDATION

CLAUDE R. LAMBE CHARITABLE FOUNDATION

48-0935563

ATTACHMENT 1
FORM 990PF,

PART I - OTHER INCOME

REVENUE
AND
EXPENSES
PER BOOKS
1,512.

DESCRIPTION
MISCELLANEOUS

1 512.

TOTALS

8992FT

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AM V 12-7.12

85651

48-0935.563

CLAUDE R. LAMBE CHARITABLE FOUNDATION

11
I

ATTACHMENT 2
i

FORM 990PF,

PART I - TAXES

REVENUE
AND
EXPENSES
PER BOOKS

I
DESCRIPTION
ACCRUED TAXES
TOTALS

8992FT

K932

1/21/2014

11:35:05

AM V 12-7.12

NET
INVESTMENT
INCOME
7.

7.

L_

L_

85651

ATTACHMENT 2
PAGE 16

CLAUDER. LAMBECHARITABLE FOUNDATION

48-0935?63

'
I

ATTACHMENT 3

I
FORM 990PF,

'I

PART I - OTHER EXPENSES

REVENUE
AND
EXPENSES
PER BOOKS
751.
18.

DESCRIPTION
INSURANCE
BANK FEES
TOTALS

l6..9.....

CHARITABLE
PURPOSES
751.
18.

1-6..9...

I'

8 9 92 FT K9 3 2

1 I 21 I 2 0 14

11 : 3 5 : 0 5 AM V 12 - 7 . 12

85651

ATTACHMENT3
PAGE 17

CLAUDER. LAMBECHARITABLEFOUNDATION

48-0935!J63

ATTACHMENT 4
FORM 990PF,

PART II

- PREPAID EXPENSES AND DEFERRED CHARGES

Ii
DESCRIPTION

ENDING
BOOK VALUE

EXCISE TAX

2,829.

2,829.

2 r 829.

2.829.

TOTALS

ENDING
FMV

, I
I

: i

8992FT K932

1/21/2014

11: 35: 05 AM V 12-7 .12

85651

ATTACHMENT4
PAGE 18

CLAUDE R. LAMBE CHARITABLE FOUNDATION

48-0935563
ATTACHMENT5

FORM 990PF,

PART II

- OTHER LIABILITIES

ENDING
BOOK VALUE

DESCRIPTION

ACCRUED TAXES

7.

TOTALS

8992FT

K932

1/21/2014

11:35:05

AM V 12-7.12

7.

85651

CLAUDER. LAMBECHARITABLE FOUNDATION

FORM_990PF, PART VIII

48-0935963

- LIST OF OFFICERS, DIRECTORS, AND TRUSTEE~

TITLE AND AVERAGEHOURS PER

WEEK DEVOTEDTO POSITION

NAMEAND ADDRESS

ATTACHMENT6

COMPENSATION

CONTRIBUTIONS
TO EMPLOYEE
BENEFIT PLANS

EXPENSE ACCT
AND OTHER
ALLOWANCES

11

RICHARD H FINK
1515 N. COURTHOUSERD, SUITE 200
ARLINGTON, VA 22201

PRESIDENT/DIRECTOR
1. 00

LOGANMOORE
1515 N. COURTHOUSERD, SUITE 200
ARLINGTON, VA 22201

SECRETARY

HEATHERLOVE
P.O. BOX 2256
WICHITA, KS 67201

TREASURER

CHARLES G KOCH
P.O. BOX 2256
WICHITA, KS 67201

DIRECTOR
.25

ELIZABETH B KOCH
P.O. BOX 2256
WICHITA, KS 67201

DIRECTOR
.25

CHARLESC KOCH
P.O. BOX 2256
WICHITA, KS 67201

DIRECTOR
.25

1. 00

1. 00

GRANDTOTALS

8992FT K932

1/21/2014
------

11: 35: 05 AM V 12-7 .12

-

----

---

85651

ATTACHMENT6
PAGE 20

CLAUDER

FORM 990PF

LAMBECHARITABLE FOUNDATION

48-0935563

PPRT XV - GRANTS AND CONTRTRJTTTONS PAID DIIRING THE' YJ:"AR

ATTACHMENT 7

RELATIONSHIP TO SUBSTANTIALCONTRIBUTOR
AND
RECIPIENT NAMEAND ADDRESS

FIDELITY INVESTMENTSCHARITABLEGIFT FUND

P O

PURPOSE OF GRANTOR CONTRIBUTION

FOUNDATIONSTATUS OF RECIPIENT

AMOUNT

GENERALSUPPORT

PUBLIC

2,296,771

BOX 770001

CINCINNATI, OH 45277-0053

TOTAL CONTRIBUTIONS PAID

2 296 771

ATTACHMENT
7
8992FT K932

1/21/2014

11 35 05 AM

V 12-7

12

85651

PAGE 21

CLAUDER

48-0935563

LAMBECHARITABLEFOUNDATION

..

ii
FORM

990P'F

PP.RT

XV

CONTRIETJTTONS

P.PPRO\TFD

FOR

E"'IITJJRF' PP.YMFNT

ATTfil:HME.NT__

RELATIONSHIP TO SUBSTANTIALCONTRIBUTOR
11

AND

RECIPIENT NAMEAND ADDRESS

FIDELITY INVESTMENTSCHARITABLEGIFT FUND

AMOUNT

PURPOSEOF GRANT_
OR CONTRIBUTION

FOUNDATION
STATUS OF RECIPIENT

2,822

GENERALSUPPORT

PUBLIC

P O BOX 770001
CINCINNATI, OH 45277-0053

TOTAL CONTRIBUTIONSAPPROVED

2-R22

ATTACHMENT
8
8992FT K932

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85651

PAGE 22

Form 8868 (Rev. 1-2013)

Page

If you are filing for an Addltlonal (Not Automatic) 3-Month Extension, complete only Part II and check this box
Note. Only complete Part II if you have already been granted an automatic 3-month extension on a previously filed Form 8868.
If ou are filin for an Automatic 3-Month Extension com lete onl Part I on a e 1 .

Additional

Not Automatic

.,..

liJ

3-Month Extension of Time. Onl file the or" inal no co ies needed .
Employer Identification number (EIN) or

Name of exempt organization or other filer, see instructions.

Type or

print

CLAUDE R. LAMBE CHARITABLE FOUNDATION

File by the
due dalll for
filing your
retum. See
Instructions

48-0935563

Number, street, and room or suite no. If a P.O. box, see instructions.
P.O.
BOX 2256
City, town or post office, state. and ZIP code.

WICHITA,

Social sea.irtty number (SSN)

For a forei!11address, see Instructions.

KS 67201-2256

Enter the Return code for the return that this a

Application
Is For
Form 990 or Form 990-EZ
Form 990-BL
Form 4720 individua
Form 990-PF
Form 990-T sec. 401 a

lication for each return

Return
Code
01
02
03
04
05
06
STOPI Do not complete Part II if you were not already granted an
The books are in the care of .... THE ORGANIZATION

............

4
Return
Code

Form 1041-A
08
Form 4720
09
Form 5227
10
Form 6069
11
Form 8870
12
automatic 3-month extension on a previously flied Form 8868

------------------------------

Te Ie phone No.....
316
828-6768
FAX No..... ------------ If the organization does not have an office or place of business in the United States, check this box .,..
If this is for a Group Return, enter the organization's four digit Group E>eemptionNumber (GEN)
. If this is
for the whole group, check this box
.,..
If it is for part of the group, check this box
.,..
and attach a
list with the names and EINs of all members the extension is for.
4
I request an additional 3-month extension of time until
o2 I 1 7 , 20 ..l!._
5 For calendar year ___
or other tax year beginning
01/01 , 20 13 , and endi.']l.,
03/31 , 20..!2_
6
If the tax year entered in line 5 is for less than 12 months, ct,eck reason:
Initial return ii] Final return
Change in accounting period
7 State in detail why you need the extension ADDITIONAL TIME IS REQUIRED TO ACCUMULATETHE

D .

INFORMATION NECESSARY TO FILE A COMPLETE AND ACCURATE RETURN.

If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any
nonrefundable credits. See instructions.
8a $
b If this application is for Form 990-PF, 990-T, 4720, or 6069, enter any refundable credits and
estimated tax payments made. Include any prior year overpayment allowed as a credit and any .
amount paid previously with Form 8868.
8b $
c Balance Due. Subtract line 8b from line Ba. Include your payment with this form, if required, by using EFTPS
(Electronic Federal Tax Payment System). See instructions.
8c $

8a

,:

2,829.
0

Signature and Verification must be completed for Part II only.

Under penalties of perjury, I declant that I haw examined this form, lndudlng accompanying schedules and statements, and to the best of my knowledge and belief,
it Is true, correct, and complete, and that I am authorized to prepare this form.

Form 8868 (Rev. 1-2013)

JSA
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