2011-05-13T08:33:51-05:00 2010-12-31 HAYNES STRAND AND COMPANY PLLC PO BOX 10949 GREENSBORO NC 27404 990PF 2010-01-01 561116935 THE JACK LEVIN FOUNDATION INC JACK 3362990900 10 POSTBRIDGE COURT GREENSBORO NC 274077890 JACK LEVIN 3362990900 2011-05-10 1 JOHNNY C WOOD CPA 3362863204 2011-05-10 2010 2016-02-24 21:20:13Z X 1000064 X X 10 10 16287 16287 47447 310820 47447 63744 63744 0 0 0 3120 0 3120 5184 5184 0 583 339 0 8887 5523 3120 27492 27492 36379 5523 30612 27365 58221 384 7772 7772 9102 9532 9532 1541 1297 1297 871500 891291 981463 882527 909892 1000064 0 0 X 0 0 0 0 882527 909892 882527 909892 882527 909892 882527 27365 0 909892 0 909892 PUBLICLY TRADED SECURITIES P 308549 263373 45176 45176 CAPITAL GAINS DIVIDENDS P 2271 2271 2271 47447 0 9702 741210 0.013089 12464 891313 0.013984 42774 1043972 0.040972 55111 612035 0.090046 72036 533515 0.135022 0.293113 0.058623 894374 52431 582 53013 30612 1164 0 1164 0 1164 1297 1297 133 133 0 0 0 0 0 0 0 0 0 0 0 1 1 NC 1 0 0 0 0 1 N/A JACK LEVIN 3362990900 10 POSTBRIDGE COURT GREENSBORO NC 27407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 JACK LEVIN 10 POSTBRIDGE COURT GREENSBORO NC 274077890 1.00 0 0 0 JANIS L FIELDS 1006 BRIDGEWATER DRIVE GREENSBORO NC 27410 1.00 0 0 0 KAREN L ANSEL 1823 BEARHOLLOW ROAD GREENSBORO NC 27410 1.00 0 0 0 LINDA L HYSON 2705 ROSCREA COURT TALLAHASSEE FL 32309 1.00 0 0 0 NONE 0 NONE 0 0 893941 12664 1389 907994 0 0 907994 13620 894374 44719 44719 1164 1164 43555 0 43555 0 43555 30612 0 30612 0 30612 43555 0 0 47077 25377 72454 30612 0 0 0 30612 0 12943 12943 59511 0 0 0 0 0 0 34134 25377 25377 JACK LEVIN X AMYOTROPHIC LATERAL SCLEROSIS (ALS) ASSOCIATION PO BOX 8178 PUEBLO CO 81008 N/A PUBLIC CHARITY UNRESTRICTED 35 AMERICAN CANCER SOCIETY PO BOX 41912 RALEIGH NC 27629 N/A PUBLIC CHARITY UNRESTRICTED 25 AMERICAN DIABETES ASSOCIATION PO BOX 7023 MERRIFIELD VA 22116 N/A PUBLIC CHARITY UNRESTRICTED 25 AMERICAN FRIENDS OF ALYN HOSPITAL INC 51 EAST 42ND STREET STE 308 NEW YORK NY 10017 N/A PUBLIC CHARITY UNRESTRICTED 100 AMERICAN FRIENDS OF MAGEN DAVID PO BOX 3098 NEW YORK NY 10117 N/A PUBLIC CHARITY UNRESTRICTED 25 AMERICAN HEART ASSOCIATION INC PO BOX 78851 PHOENIX AZ 85062 N/A PUBLIC CHARITY UNRESTRICTED 50 AMERICAN KIDNEY FUND INC PO BOX 1837 MERRIFIELD VA 22116 N/A PUBLIC CHARITY UNRESTRICTED 25 AMERICAN PARKINSON DISEASE ASSOCIATION 135 PARKINSON AVENUE STATON ISLAND NY 10305 N/A PUBLIC CHARITY UNRESTRICTED 25 AMERICAN RED CROSS PO BOX 14710 GREENSBORO NC 27415 N/A PUBLIC CHARITY UNRESTRICTED 25 ANTI-DEFAMATION LEAGUE PO BOX 96226 WASHINGTON DC 20090 N/A PUBLIC CHARITY UNRESTRICTED 25 ARTHRITIS FOUNDATION PO BOX 96280 WASHINGTON DC 20077 N/A PUBLIC CHARITY UNRESTRICTED 25 BETH DAVID SYNAGOGUE 804 WINVIEW DRIVE GREENSBORO NC 27410 N/A PUBLIC CHARITY UNRESTRICTED 1804 B'NAI BRITH INTERNATIONAL PO BOX 96729 WASHINGTON DC 20090 N/A PUBLIC CHARITY UNRESTRICTED 103 B'NAI BRITH YOUTH ORGANIZATION (BBYO INC) PO BOX 19006 WASHINGTON DC 20036 N/A PUBLIC CHARITY UNRESTRICTED 200 B'NAI SHALOM DAY SCHOOL 804 WINVIEW DRIVE GREENSBORO NC 27410 N/A PUBLIC CHARITY UNRESTRICTED 2300 CONSUMER REPORTS FOUNDATION PO BOX 96552 WASHINGTON DC 20090 N/A PUBLIC CHARITY UNRESTRICTED 30 CYSTIC FIBROSIS FOUNDATION PO BOX 96305 WASHINGTON DC 20090 N/A PUBLIC CHARITY UNRESTRICTED 25 DAYSTAY HBC INC 135 CANDLER SCHOOL ROAD CANDLER NC 28715 N/A PUBLIC CHARITY UNRESTRICTED 100 DENTAL FOUNDATION OF NORTH CAROLINA UNC SCHOOL OF DENTISTRY CAMPUS BOX 7451 CHAPEL HILL NC 27599 N/A PUBLIC CHARITY UNRESTRICTED 3000 EAST CHATHAM BASEBALL INC 375 PITTSBORO ELEMENTARY SCH RD PITTSBORO NC 27312 N/A PUBLIC CHARITY UNRESTRICTED 300 EASTER SEAL SOCIETY PO BOX 28239 RALEIGH NC 27611 N/A PUBLIC CHARITY UNRESTRICTED 100 EPILEPSY FOUNDATION PO BOX 96546 WASHINGTON DC 20077 N/A PUBLIC CHARITY UNRESTRICTED 100 FREEDOM ALLIANCE PO BOX 97242 WASHINGTON DC 20090 N/A PUBLIC CHARITY UNRESTRICTED 125 FRIENDS OF THE SMITHSONIAN PO BOX 9016 PITTSFIELD MA 01202 N/A PUBLIC CHARITY UNRESTRICTED 60 GEORGIA TECH FOUNDATION 190 NORTH AVENUE NW ATLANTA GA 303139806 N/A PUBLIC CHARITY UNRESTRICTED 1000 GETTYSBURG FOUNDATION PO BOX 3997 GETTYSBURG PA 17325 N/A PUBLIC CHARITY UNRESTRICTED 50 GREENSBORO JEWISH FEDERATION 5509-C WEST FRIENDLY AVENUE GREENSBORO NC 274104211 N/A PUBLIC CHARITY UNRESTRICTED 10000 GREENSBORO URBAN MINISTRIES 305 WEST LEE STREET GREENSBORO NC 27406 N/A PUBLIC CHARITY UNRESTRICTED 100 HOMINY BAPTIST CHURCH 135 CANDLER SCHOOL ROAD CANDLER NC 287158309 N/A PUBLIC CHARITY UNRESTRICTED 500 HOSPICE & PALLIATIVE CARE OF GREENSBORO 2500 SUMMIT AVENUE GREENSBORO NC 27405 N/A PUBLIC CHARITY UNRESTRICTED 200 JEWISH NATIONAL FUND PO BOX 800 ROCKVILLE CENTRE NY 11571 N/A PUBLIC CHARITY UNRESTRICTED 200 KELLY CARTER BENEFIT GOLF TOURNAMENT 423 HARVEY TEAGUE ROAD WINSTONSALEM NC 27107 N/A PUBLIC CHARITY UNRESTRICTED 100 LEUKEMIA & LYMPHOMA SOCIETY INC PO BOX 9031 PITTSFIELD MA 01202 N/A PUBLIC CHARITY UNRESTRICTED 25 LUPUS FOUNDATION OF AMERICA PO BOX 630147 BALTIMORE MD 21263 N/A PUBLIC CHARITY UNRESTRICTED 25 MACCABI USA SPORTS FOR ISRAEL PO BOX 96462 WASHINGTON DC 20090 N/A PUBLIC CHARITY UNRESTRICTED 25 MACULAR DEGENERATION RESEARCH PO BOX 1952 CLARKSBURG MD 20871 N/A PUBLIC CHARITY UNRESTRICTED 25 MARCH OF DIMES PO BOX 2547 DECATUR IL 62525 N/A PUBLIC CHARITY UNRESTRICTED 25 MEDICAL FOUNDATION OF NORTH CAROLINA 880 MLK JR BLVD CAMPUS BOX 7565 CHAPEL HILL NC 275142600 N/A PUBLIC CHARITY UNRESTRICTED 500 METROPOLITAN MUSEUM OF MODERN ART 1000 FIFTH AVENUE NEW YORK NY 10130 N/A PUBLIC CHARITY UNRESTRICTED 60 NC ZOO SOCIETY 4403 ZOO PARKWAY ASHEBORO NC 27205 N/A PUBLIC CHARITY UNRESTRICTED 45 NATIONAL MULTIPLE SCLEROSIS SOCIETY PO BOX 958 GREENSBORO NC 27402 N/A PUBLIC CHARITY UNRESTRICTED 1000 NATIONAL OSTEOPOROSIS FOUNDATION 1150 17TH STREET NW SUITE 850 WASHINGTON DC 20036 N/A PUBLIC CHARITY UNRESTRICTED 25 NATIONAL PARK FOUNDATION PO BOX 17394 BALTIMORE MD 21298 N/A PUBLIC CHARITY UNRESTRICTED 25 PARALYZED VETERANS OF AMERICA 7 MILL BROOK ROAD WILTON NH 03086 N/A PUBLIC CHARITY UNRESTRICTED 25 PEDIATRIC BRAIN TUMOR FOUNDATION 302 RIDGEFIELD COURT ASHEVILLE NC 28806 N/A PUBLIC CHARITY UNRESTRICTED 25 PROSTATE CANCER FOUNDATION PO BOX 7015 ALBERT LEA MN 56007 N/A PUBLIC CHARITY UNRESTRICTED 50 RAMAH DAROM 6400 POWERS FERRY ROAD STE 215 ATLANTA GA 30339 N/A PUBLIC CHARITY UNRESTRICTED 100 SALVATION ARMY PO BOX 5363 GREENSBORO NC 27435 N/A PUBLIC CHARITY UNRESTRICTED 30 SENIOR SERVICES INC 2895 SHOREFAIR DRIVE WINSTONSALEM NC 27199 N/A PUBLIC CHARITY UNRESTRICTED 100 SILK HOPE RURITAN CLUB 4221 SILK HOPE ROAD SILER CITY NC 27344 N/A PUBLIC CHARITY UNRESTRICTED 100 SIMON WIESENTHAL CENTER 1399 SOUTH ROXBURY DRIVE STE 100 LOS ANGELES CA 90035 N/A PUBLIC CHARITY UNRESTRICTED 25 SMILE TRAIN INC PO BOX 96231 WASHINGTON DC 20090 N/A PUBLIC CHARITY UNRESTRICTED 25 SPECIAL OLYMPICS NORTH CAROLINA INC PO BOX 27728 RALEIGH NC 27611 N/A PUBLIC CHARITY UNRESTRICTED 25 ST JUDE CHILDREN'S RESEARCH HOSPITAL PO BOX 50 MEMPHIS TN 38101 N/A PUBLIC CHARITY UNRESTRICTED 100 TALLAHASSEE JEWISH FEDERATION PO BOX 14825 TALLAHASSEE FL 32317 N/A PUBLIC CHARITY UNRESTRICTED 100 TEMPLE EMANUEL 1129 JEFFERSON ROAD GREENSBORO NC 27410 N/A PUBLIC CHARITY UNRESTRICTED 1025 THE DISCOVERY FUND (MOREHEAD-CAIN FOUNDATION) PO BOX 690 CHAPEL HILL NC 275140690 N/A PUBLIC CHARITY UNRESTRICTED 500 UNITED STATES HOLOCAUST MEMORIAL MUSEUM PO BOX 90988 WASHINGTON DC 20090 N/A PUBLIC CHARITY UNRESTRICTED 25 UNITED STATES OLYMPIC COMMITTEE PO BOX 7010 ALBERT LEA MN 56007 N/A PUBLIC CHARITY UNRESTRICTED 25 VETERANS OF FOREIGN WARS OF THE UNITED STATES PO BOX 8911 TOPEKA KS 66608 N/A PUBLIC CHARITY UNRESTRICTED 25 WAKE FOREST FUND 1834 WAKE FOREST ROAD WINSTONSALEM NC 27106 N/A PUBLIC CHARITY UNRESTRICTED 1000 WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER MEDICAL CENTER DRIVE WINSTONSALEM NC 27157 N/A PUBLIC CHARITY UNRESTRICTED 1500 WINSTON-SALEM HADASSAH 3545 SUMMERFIELD LANE WINSTONSALEM NC 27106 N/A PUBLIC CHARITY UNRESTRICTED 100 WORLD JEWISH CONGRESS FOUNDATION PO BOX 90400 WASHINGTON DC 20090 N/A PUBLIC CHARITY UNRESTRICTED 25 27492 0 14 10 14 16287 18 47447 0 63744 0 63744 0 0 0 0 0 0 0 0 0 0 ACCOUNTING FEES 3120 0 3120 ARTIO INTL EQUITY FD CL I 64465 49098 BRANDYWINE BLUE FUND 67849 82417 FRANKLIN VALUE INVS TR SMALL CAP VALUE FD 31355 41000 GABELLI EQUITY SMALL CAP GROWTH FD 27629 30368 HARBOR CAPITAL APPRECIATION FD INSTL CL 67837 73782 JANUS INVT FD FLEXIBLE BD FD CL I 76577 74297 LAZARD EMERGING MKTS PORT INSTL 62417 67383 LEGG MASON NAVIGATOR VALUE TR 58692 38552 MFS SER TR VALUE FD CL W 67897 74197 NEUBERGER & BERMAN SMALL CAP GROWTH FD 33479 41831 OAKMARK INTL FD HARRIS ASSOC INVT TR CL I 49814 69430 OPPENHEIMER INTL GROWTH FD CL Y 56141 69905 PIMCO PAC INVT MGMT TOTAL RETURN FD 35806 36893 PIMCO PAC INVT COMMODITY REAL RETURN STRAT FD 26568 29076 RS INVT TR VALUE FD 33542 40574 T ROWE PRICE MID CAP GROWTH FD 24669 30529 T ROWE PRICE REAL EST FD 14479 19858 TCW RELATIVE VALUE LRG CAP FD CL I 64877 81781 WILLIAM BLAIR SMALL CAP GROWTH FD CL I 27198 30492 INVESTMENT MANAGEMENT FEES 5184 5184 0 FEDERAL FORM 990-PF, 2009 244 0 0 FOREIGN TAX WITHHELD 339 339 0