Bloomberg 2012

Annual Filing for Charitable Organizations
Form CHAR500
New York State Department of Law (Office of the Attorney General)

Charities Bureau - Registration Section
This form used for120 Broadway
Article 7-A, EPIL and dual filers
New Yo, NY 10271
(replaces forms CHAR 497,
MAD nmrwAD nnr,
http://www.charitiesnys.com
1. General Information
a. For the fiscal year beginning (mm/ddlyyyy) 01/
and
b. Check if applicable for NYS: c. Name of organization
Address change
Name changeTHE BLOOMBERG FAMILY FOUNDATION INC
Initial filing
Final filingNumber and street (or P.O. box if mail not delivered to street address) Room/suite
Amended filingC/O GELLER & CO, 909 THIRD AVE116 FL
NY registration pendingCity or town, state or country and ZIP + 4
2012
Open to Public
Inspection
d. Fed. employer ID no. (EIN)
20-5602483
e. NY State registration no.
40-57-41
f. Telephone number
212 205-0100
g. Email
N/A
2. Certification - Two Signatures Required
We certify under penalties of perjury that we reviewed this report, including all attachments, and to the best of our knowledge and belief, they are
true, correct and complete in accordance h hR laws of the State f N w York applicable to this report.
T
11112-11-3
i
b. Chief Financial Officer orTreas.
MICHAEL
Na m :
BLOOMBERG AUTH SIGNER
3. Annual Report Exemption Information
a. Article 7-A annual report exemption (Article 7-A registrants and dual registrants)
Check *
if total contributions from NY State (including residents, foundations, corporations, government agencies, etc.) did not exceed
$25,000 and the organization did not engage a professional fund raiser (PFR) or fund raising counsel (FRC) to solicit
contributions during this fiscal year.
NOTE: An organization may claim this exemption if no PFR or FRC was used and either: 1) it received an allocation from a
federated fund, United Way or incorporated community appeal and contributions from other sources did not exceed
$25,000 or 2) it received all or substantially all of its contributions from one government agency to which it submitted an
annual report similar to that required by Article 7-A.
b. EPTL annual report exemption (EPTL registrants and dual registrants)
Check *= if gross receipts did not exceed $25,000 and assets (market value) did not exceed $25,000 at anytime during this fiscal year.
For EPTL or Article 7-A registrants claiming the annual report exemption under the one law under which they are registered and for dual registrants claiming the annual
report exemptions under both laws, simply complete part 1 (General Information), part 2 (Certification) and part 3 (Annual Report Exemption Information) above.
QQ
not
submit a fee, Ug n complete the following schedules and do not submit any attachments to this form.
4. Article 7-A Schedules
If you did not check the Article 7-A annual report exemption above, complete the following for this fiscal year:
a. Did the organization use a professional fund raiser, fund raising counsel or commercial co-venturer for fund raising activity in NY State? . YesNo
* If "Yes", complete Schedule 4a.
b. Did the organization receive government contributions (grants)? YesNo
* If "Yes", complete Schedule 4b.
5. Fee Submitted: See last page for summary of fee requirements.
Indicate the filing fee(s) you are submitting along with this form:
a. Article 7-A filing fee
..........................................................................................$ Submit only one check or money order for the
b. EPTL filing fee ...................................................................................................
$
1,500.total fee, payable to "NYS Department of Law'
c. Total fee......................................................................................................... $1,500.
6. Attachments - For organizations that are not claiming annual report exemptions under both laws, see last page for required attachments 0, 0 0
I
268451
1 01-21-13 1019 CHAR500-2012
2
15141028 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA1
THE BLOOMBERG FAMILY JNDATION INC
5. Fee Instructions
The filing fee depends on the organizations Registration Type. For details on Registration Type and filing fees, see the Instructions for
Form CHAR500.
Organization's Registration Type Fee Instructions
Article 7-A
EPTL
Dual
a) Article 7-A filing fee
Calculate the Article 7-A filing fee using the table in part a below. The EPTL filing fee is $0.
Calculate the EPTL filing fee using the table in part b below. The Article 7-A filing fee is $0.
Calculate both the Article 7-A and EPTL filing fees using the tables in parts a and b below. Add the Article 7-A
and EPTL filing fees together to calculate the total fee. Submit a single check or money order for the total fee.
Total Support & Revenue Article 7-A
Fee lAny organization that contracted with or used the services of a professional fund raiser
more than $250,000$25
(PFR) or fund raising counsel (FRC) during the reporting period must pay an Article 7-A
up to $250,000 *
$10
filing fee of $25, regardless of total support and revenue.

b) EPTL filing fee
6. Attachments - Document Attachment Check-List
Check the boxes for the documents you are attaching.
For All Filers
Filing Fee
Single check or money order payable to "NYS Department of Law
Copies of Internal Revenue Service Forms
IRS Form 990
All required schedules (including
Schedule B)
LIII IRS Form 990-T
IRS Form 990-EZ
All required schedules (including
Schedule B)
IRS Form 990-T
IRS Form 990-PF
L1 All required schedules (including
Schedule B)
EIII IRS Form 990-T
Additional Article 7-A Document Attachment Requirement
Independent Accountant's Report
EDAudit Report (total support & revenue more than $250,000)
EDReview Report (total support & revenue $100,001 to $250,000)
No Accountant's Report Required
(total support & revenue not more than $100,000)
1019
4288481 01-21-13CHAR500 - 2012
3
1053 1111 73 7725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
Geller & Company
Via Certified Mail
August 8, 2013
Office of Attorney General
Charities Bureau Dept.
120 Broadway, 3rd Floor
New York, NY 10271
Re: The Bloomberg Family Foundation Inc.
E1N 20-5602483
2012 Char-500
NYS Reg. #40-57-41
Dear Sir/Madam:
We respectfully request an additional three months extension of time to file until November
15,
2013 for the above referenced foundation. A federal extension request for an additional
3-month extension of time was timely filed on Form 8868. The reason for the extension is
due to all information necessary to file a complete and accurate tax return is not yet
available.
Attached please find a copy of the Internal Revenue Service Form 8868 submitted by the
Bloomberg Family Foundation Inc.
Please contact us at (212) 583-6000 should you need additional information.
Sincerely,
Charles Pomo
Enclosures
FiIes\Content.Outlook\9186426N\CHAR500 2nd extension Ietter.docx
909 Third Avenue New York, NY 10022
212.583.6000 tel www.gellerco.com
Form 8868 (Rev. 1-2013)
Page
If you are filingfor an Additional (Not Automatic) 3-Month Extension, complete only Part If and check this b o x * *
Note. Only complete Part II if you have already been granted an automatic 3-month extension on a previously filed Form 8668.
If you are filingfor an Automatic 3-Month Extension, complete only Part I (on page 1).
Part IllAdditional (Not Automatic) 3 - Month Extension of Time. Only file the o riginal (no co pies needed).
Enter filer's ldentifvina number. see Instructions
Type or
print
File by the
due date for
filing your
return. See
instructio ns.
Name of exempt organization or other filer, see instructions
BLOOMBERG FAMILY FOUNDATION INC
Number, street, and room or suite no. If a P.O. box, see instructions.
/0 GELLER & CO, 909 THIRD AVE. NO. 16 FL
City, town or post office, state, and ZIPcode. For a foreign address, see instructions.
EW YORK, NY 10022
Employer identification number (EIN) or
20-56 02483
Social security number (SSN)
Enter the Return code for the return that this application is for (file a separate application for each return)
I
0
I
41
Application
Return
I
Application
Return
Is For
or Form 990EZ
02 I Form lO41-A
Form 4720 (ii
Form 990-PF
05
I
F o rm
6069
06 I Form 887O
08
11
12
STOP! Do not complete Part II if you were not already granted an automatic 3-month extension on a previously filed Form 8868.
DIANE GtJBELLI, C / O GELLER & CO LLC
The books are lnthe care of 909 THIRD AVENUE, 16TH FL - NEW YORK, NY 10022
TelephoneNo. 212-583-6000FAXNo. lo. 2l2583624l
If the organization does not have an office or place of business In the United States, check this box I JJ
If this is for a Group Return, enter the organizations four digit Group Exemption Number (GEN) ________ If this Is for the whole group, check this
box. If it is for part of the group, check this box 0, Ej 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 untilNOVEMBER 15, 2013.
5 For calendar year 2012 ,
or other tax year beginning , and ending
6 If the tax year entered In line 5 is for less than 12 months, check reason: L..J Initial return=Final return
Change in accountingperiod
7 State in detail why you need the extension
AN ADDITIONAL EXTENSION OF TIME IS REQUIRED TO FILE A COMPLETE AND
ACCURATE RETURN BECAUSE ALL INFORMATION IS NOT AVAILABLE.
8a If this application is for Form 990-13L, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any
nonrefundable credits. See instructions.
b If this application is for Form 990PF, 990-1, 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
Balance due. Subtract line 8b from line 8a. Include your payment with this form, if required, by using
EFTPS (Electronic Federal Tax
nd Verification must be completed for Part II only.
this form, includingaccompanyingschedules and statements, and to the best of
m y
to prepare this form.
TitleCPA
223842
01- 21- 13
Under penalties of perjury, I declare that I
it is true, correct, anji1te,
anI4hat I
4,612,153.
4,612,153.
0.
dgand belief,
18668 (Rev. 1.2013)
.
Castro, Susan
From:Castro, Susan
Sent:Monday, May 13, 2013 11:19 AM
To:
[email protected]
Cc:Porno, Charles; Jacaruso, James
Subject:
The Bloomberg Family Foundation, Inc., NYS Reg No.40-57-41, EIN# 20-5602483
Attachments:
FORM 8868 BFF 990-PF due 8.15.12.PDF
We respectfully request an extension of time to file the annual report for the year ended December 31, 2012 Form CHAR500 until
August 15, 2013 for The Bloomberg Family Foundation, Inc., because all information necessary to file a complete and accurate
return is not available.
We have also attached a copy of the 2012 Internal Revenue Service Form 8868, Application for Extension of Time to File an Exempt
Organization Return, submitted by The Bloomberg Family Foundation, Inc.
Susan Castro
Geller Family Office Services LLC
a suhsidhir of Geller & Cnmpanv LIE
909 Third Avenue - 16th Floor
New York, NY 10022
212.583.6062 Office
www.gellerfamilvofficeservices.com
I

0
Form
8868
(Rev. January 2013)
Department of the Treasury
Internal Revenue Service
Application for Extension of Time To File an
Exempt Organization Return
File a
for each return.

OMB No. 1545-1709
If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box EXI
If you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part II (on page 2 of this form).
Do not complete Part II unless
you have already been granted an automatic 3-month extension on a previously filed Form 8868.
Electronic filing
(e-fl/e) . You can electronically file Form 8868 if you need a 3-month automatic extension of time to file (6 months for a corporation
required to file Form 990-1), or an additional (not automatic) 3-month extension of time. You can electronically file Form 8868 to request an extension
of time to file any of the forms listed in Part I or Part II with the exception of Form 8870, Information Return for Transfers Associated With Certain
Personal Benefit Contracts, which must be sent to the IRS in paper format (see instructions). For more details on the electronic filing of this form,
visit wwvi'irs.gov/eflle and click on e-file for Charities & Nonprofits.
I
Part I
I
Automatic 3-Month Extension of Time.
Only submit original (no copies needed).
A corporation required to file Form 990-T and requesting an automatic 6-month extension - check this box and complete
Part lonly
All other corporations (including 1120-C fliers), partnerships, REM/Cs, and trusts must use Form 7004 to request an extension of time
to file income tax returns.
Type orName of exempt organization or other filer, see instructions.
print
THE BLOOMBERG FAMILY FOUNDATION INC
File by the
due date for Number, street, and room or suite no. If a P.O. box, see instructions.
filing your
GELLER & CO, 909 THIRD AVE, NO. 16 FL
return. See
instructions.
City, town or post office, state, and ZIP code. For a foreign address, see instructions.
NEW YORK, NY 10022
20-5602483
Enter the Return code for the return that this application is for (file a separate application for each return)
I
0
I
4
I
Application
Return Application
Return
Is For
Code Is For
Code
Form 990 or Form 990-EZ
01Form 990-T(l
07
Form 990-BL
02Form 1041-A
08
Form 4720 (individual)
03Form 4720
09
Form 990-PF
04 1 Form 5227
Form 990-T (sec. 401 (a) o
05Form 6069
Form 990-T (trust other than above)
I
06
I
Form 8870
I
12
DIANE GUBELLI, C/O GELLER & CO LLC
Thebooksareinthecareof 909 THIRD AVENUE, 16TH FL - NEW YORK, NY 10022
TelephoneNo* 2125836000
FAXNo." 2125836241
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 Exemption Number (GEN)
- If this is for the whole group, check this
boxEl. If it is for part of the group, check this box N o. El and attach a list with the names and EINs of all members the extension is for.
1I request an automatic 3-month (6 months for a corporation required to file Form 990-1) extension of time until
AUGUST 15, 2013
, to file the exempt organization return for the organization named above. The extension
is for the organization's return for:
p -EXI calendar year 2Ol2
or
E1 tax year beginning , and ending
2 If the tax year entered in line 1 is for less than 12 months, check reason: El Initial returnEl Final return
El Change in accounting period
3a
If this application is for Form 990-BL, 990-PF, 990-1, 4720, or 6069, enter the tentative tax, less any
refundable credits. See instructions.
$
2,900,515.
If this application is for Form 990-PF, 990-1, 4720, or 6069, enter any refundable credits and
estimated tax payments made. Include any prior year overpayment allowed as a credit.
I $ 3,112,153.
Balance due. Subtract line 3b from line 3a. Include your payment with this form, if required,
by using EFTPS (Electronic Federal Tax Payment System). See instructions.
I
3c
I $ 0
Caution. If you are going to make an electronic fund withdrawal with this Form 8868, see Form 8453-EQ and Form 8879-EQ for payment instructions.
LHA For Privacy Act and Paperwork Reduction Act Notice, see instructions.
Form 8868 (Rev. 1-2013)
223841
01-21-13
Return of Private Foundation
or Section4947(a)(1) Nonexempt Charitable Trust
Treatedas a Private Foundation
Note. The foundation may be able to use acopy of this return to satisfy state reporting n
ir beginning
. and endina
Form 990-PF
Department of theTreasury
For calendar year 2012 or tax
Name of foundation
2012
Employer identification number
INC
0-5602483
Number and street (or P.O. box number if mail isnot deliveredtostreet address)
Roomsuite
B Telephone number
C/a GELLER & CO, 909 THIRD AVE
16 FL212-205-0100
City ortown, state, and ZIP code
CIf exemptionapplicationispending, check here

13Check all that apply., U Initial return
UInitial return of former public charity
LI Final return
LI Amended return
LI Address change
El Name change
H Check type of organization:LIII Section 501(c)(3) exempt private foundation
L11 Section 4947(a)(1) nonexempt charitable trust LII] Other taxable private foundation
I Fair market value of all assets at end of yearJ Accounting method:
WCashEl Accrual
(front Part II, Col.(c), line 16)
El Other (specify)
4,242,746,954.
(Part!, column (d) must be on cash basis.)
Part I
(flie total of amounts in columns(c and (d) may not
exp enses per books
(b) Ne t
ne ce ssarily e qual the amounts In column (s^)
I Contributions, gifts, grants, etc., received .998,378,348.1
2
Check
El
n the fovndalion is not req uired to attach S ch. a
interest onsavi
ents
ngs
..
and t
'a
emporary
cshinvestm
..... .... . ............
...................__________
4Dividends and interest from securities
156,
347, 6
5a Gross rents
b Net rental income or foss)
62 Net gainor Voss) from saleof assets not on line 10
..Gross sales price for all
1 3# 300 , , 000. U
assets on line 6a
g
l
7Capital gain net income (from Part IV tine2)
8Net short-term capital gain
9Income modifications ....................................
.________
Grosssales less returns
lOa and allowances............
b Less: Cost of goods sold
o Gross profit or (loss)
11 Other income2, 1
-12 Total. Add lines 1 through 111 20
13 Compensation of officers, directors, trustees, etc1
14Other employee salaries and wages
15 Pension plans, employee benefits
l6a Legal feesSTMT 53
b Accounting feesSTMT s5
c Other professional feesS.'IMT
7
17 Interest
518
18 Taxes
S .TMT s2, 6
19 Depreciation and depletion
20 Occupancy
< 21 Travel, conferences, and meetings188 , 361.
22 Printing and publications.____________________
23Other expenses
S TMT ...
9
31, 845, 699.
24Total operating and administrative
CL
expenses. Add lines 13through 23
131 , 263 , 38
6
.41, 664, 753.
0
25 Contributions, gifts, grants paid
.
26Total expenses and disbursements.
-Add lines 24and 25172, 928, 139.
27 S ubtract line 26from line 12:
a Excess of revenue over expenses and disbursements 1.031.580.408.
b Net investment income ft negative, enter -0-)
-CAdjusted net income ft negative. enter -U-) ............ .
.
-05-12LHA For Paperwork Reduction Act Notice, see instructions.
1. Foreign organizations, check here
2. Foreign organizations meeting the85% test,
check hereandattach computation
If private foundation status was terminated
under section 507(b)(1)(A), check here ...El
lithe foundation is in a 60-month termination
under section 507(b)(1)(B), check here ..r..El
(c) Adjusted net
I (d) Disbursements
income
for
thar table purpos
3
LIP
705.711.
Form 990-PF (2012)
5, 122.
4.091.
5
97,100.49,275.
57,785.0.
3 7,403 .23 7,452.
12,000.0.
76,3 28.5,876,3 28.
50,077.477.707.
1
1053 1111 73 7725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
6.
1.28
S
A "
FA MILY
111 1 c h l t 2t f a o u n i t o l l t l ) l l o n
[part
i i I
Name Sheets
c o l u m n s h o u l d b e f o r * o l ' y e a r a m o u n t s o n l y .
1 Ca s h - n o n -i n t e r e s t -b e a r i n g.
2 Sa vi n gs a n d t e m po r a r y c a s h i n ve s t m e n t s
3 Ac c o u n t s r e c e i va b l e
Le s s : a l l o wa n c e f o r d o u b t f u l a c c o u n t s
4 Pl e d ge s r e c e i va b l e
Le s s : a l l o wa n c e f o r d o u b t f u l a c c o u n t s
5 Gr a n t s r e c e i va b l e
6 Re c e i va b l e s d u e f r o m o f f i c e r s , d i r e c t o r s , t r u s t e e s , a n d o t h e r
d i s qu a l i f i e d pe r s o n s
7Ot h e r n o t e s a n d l o a n s r e c e i va b l e
Le s s : a l l o wa n c e f o r d o u b t f u l a c c o u n t s 10,
8 I n ve n t o r i e s f o r s a l e o r u s e
9 Pr e pa i d e xpe n s e s a n d d e f e r r e d c h a r ge s
<b a I n ve s t m e n t s - U. S. a n d s t a t e go ve r n m e n t o b l i ga t i o n s STMT
b I n ve s t m e n t s - c o r po r a t e s t o c k
o I n ve s t m e n t s - c o r po r a t e b o n d s
11 I n ve s t m e n t s -l a n d , b u i l d i n gs , a n d e qu i pm e n t o a s i s
Le s s : a c c u m u l a t e d d e pn e c i a u s n .
12 I n ve s t m e n t s - m o r t ga ge l o a n s
13 I n ve s t m e n t s - o t h e r
12.
14 La n d , b u i l d i n gs , a n d e qu i pm e n t b a s i s
Le s s :a c c u m u i a t e d d e pr e c i a t i o n
15 Ot h e r a s s e t s (d e s c r i b e
S
TIQNINC
20-
I ' a i j2
B ek i n i n o o f y ear
E n d o f
( a B o o k Va l u e ( b ) B o o k Va l u e I
Fa i r Ma r ke t Va l u e
26.606
8,857.
9, 5 8,857.
17Ac c o u n t s pa y a b l e a n d a c c r u e d e xpe n s e s
18 Gr a n t s pa y a b l e
19 De f e r r e d r e ve n u e
20 Loans fromofficers, directors, trustees, andother disqualifiedpersons
21 Mo r t ga ge s a n d o t h e r n o t e s pa y a b l e
' 22 Ot h e r l i a b i l i t i e s (d e s c r i b e l i o .
Fo u n d a t i o n s t h a t f o l l o w SFAS 117, c h e c k h e r e LX]
U)
a n d c o m pl e t e l i n e s 24 t h r o u gh 26 a n d l i n e s 30 a n d 31.
a)
0
24 Un r e s t r i c t e d
C
25 Te m po r a r i l y r e s t r i c t e d (a
26 Pe r m a n e n t l y r e s t r i c t e d
Fo u n d a t i o n s t h a t d o n o t f o l l o w SFAS 117, c h e c k h e r e
C
U-
a n d c o m pl e t e l i n e s 27t h r o u gh 31.
I-
0
27Ca pi t a l s t o c k, t r u s t pr i n c i pa l , o r c u r r e n t f u n d s
a )
28 Pa i d -i n o r c a pi t a l s u r pl u s , o r l a n d , b l d g. , a n d e qu i pm e n t f u n d (I,
29 Re t a i n e d e a r n i n gs , a c c u m u l a t e d i n c o m e , e n d o wm e n t , o r o t h e r f u n d s
30 To t a l n e t a s s e t s o r f u n d b a l a n c e s
I
Part Ill
I
Analysis of Changes in Net Assets or Fund Balances
I To t a l n e t a s s e t s o r f u n d b a l a n c e s a t b e gi n n i n g o f y e a r - Pa r t I I , c o l u m n (a ), l i n e 30
(m u s t a gr e e wi t h e n d -o f -y e a r f i gu r e r e po r t e d o n pr i o r y e a r ' s r e t u r n )
2 En t e r a m o u n t f r o m Pa r t I , l i n e 27a
3 Ot h e r i n c r e a s e s n o t i n c l u d e d i n l i n e 2 (i t e m i ze )0o .
4 Ad d l i n e s l ,2, a n d 3
5 De c r e a s e s n o t i n c l u d e d i n l i n e 2 (i t e m i ze )
223511
Fo r m 990-PF (2012)
12-05-12
2
10531111 737725
B LOOMFAMFND 2012.04040 THE B LOOMB ERG FAMILY FOUNDA B LOOMFA2
(C) Date acquired(d) Date sold
(mo., day, yr.)
(mo., day, yr.)

3
I
Form 990-PF (2012)
THE BLOONBERGFAMILYFOUNDATION
art IV Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)
la
b SEE ATTACHED STATEMENT
C
d
0
(e) Gross sales price
(f) Depreciation allowed(g) Cost or other basis
(or allowable)plus expense of sale
(h) Gain or (loss)
(e) plus (f) minus (g)
13,300,000.1
113,300,000
omplete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(j) Adjusted basis(k) Excess of cot. (i)
(I) F.M.V. as of 12/31/69
as of 12/31/69over cal. (j), if any
155,2
(I) Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from cal. (h))
[
If gain, also enter in Part I, line 7
I
2 Capital gain net income or (net capital loss)
'j If (loss), enter -0- in Part I, line 7..................
J
...j
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).
I Part VI Quaiitication Under section 44U()tor ileciuceci lax 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 in the base period? ......... . fl Yes EE No
If "Yes,' the foundation does not q ualify 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.
(d) (a)
(b)(0)
Distribution ratio Base period years
Calendar year for tax year beolnnina j
Adjusted qualifying distributions
I
Net value of noncharitable-use assets
col. (b) divided b y col. (c)i
1
.040100
046 21
05104
.023970
071795
233124
046 6 25
354, 6 00 486 .
156 ,408 ,248.
1,6 82,137.
158,090,385.
131.96 9.097.
83,945,446 .1,6 44,449,325.

2008
31.6 90.900.1.322.117.206 .
2Total of line 1, column (d) .......................................................................................................................2
8 Average distribution ratio for the 5-year base period - divide the total on line 2 by 5, or by the number of years
the foundation has been In existence if less than 5 years ..................................................8
4 Enter the net value of noncharitable-use assets for 2012 from Part X, line 54
5Multiply line 4 by line 3....................................................................................................................................5
6 Enter 1% of net investment income (1% of Part I, line 27b) .6
7 Add lines 5 and 67
8 Enter qualifying distributions from Part XII, line 4.8
If line 8 is equal to or greater than line 7, check the box in Part VI, line ib, and complete that part using a 1% tax rate.
See the Part VI instructions.
223521 12-05-12Form 990-PF (2012)
3
10531111 737725 BLOOMFANFND 2012.04040 THE BLOOMBERG FAMILY FOtJNDA BLOOMFA2
O N
orni 990-PF
ax based on
1 a Exempt operating foundations described in section 4940(d)(2), check here L..J and enter ' N/A' on line 1.
Date of ruling or determination letter (attach copy of letter if necessary-see instructions)
b Domestic foundations that meet the section 4940(e) requirements in Part V, check here l o,and enter 1%
ofPart I, line 27b.....................................................................................................
c Al 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. O thers enter -0-)
3 Add lines l and 2
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. O thers enter -0-)
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0-
20-5602483
Pag e
or 4948- see instructions)
,364,274.
6
6 Credits/Payments:
a 2012 estimated tax payments and 2011 overpayment credited to 2012 .........................6a3,112,153
b Exempt foreign organizations - tax withheld at source .6b
o Tax paid with application for extension of time to file (Form 8868) .6c1,500,000
d Backup withholding erroneously withheld.6d
7Total credits and payments. Add lines 6a through 6d........................................................................
8 Enter any penalty for underpayment of estimated tax. Check here i:i it Form 2220 is attached
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed
10 O verpayment. It line 7 is more than the total of lines 5 and 8, enter the amount overpaid
la 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?
b Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see instructions for definition)? .............
If the answer is 'Yes' to la or ib, attach a detailed description of the activities and copies of any materials published or
distributed by the foundation in connection with the activities.
c Did the foundation file Form 1 120-PO L for this year? .....................................................................................................................
d Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) O n the foundation.
$0 . ( 2) O n foundation managers.
$0
e Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed on foundation
managers.
$
0
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.
3 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
4a Did the foundation have unrelated business gross income of $1,000 or more during the year?
b It 'Yes,' has it filed a tax return on Form 990-1 for this year?
5 Was there a liquidation, termination, dissolution, or substantial contraction during the year?
If 'Yes,' attach the statement required by General instruction T.
6 Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
'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?
7Did the foundation have at least $5,000 in assets at any time during the year?...............................................................................
If 'Yes,' complete Part II, col. (c), and Part Xt1
Ba Enter the states to which the foundation reports or with which it is registered (see instructions) 10,
D E , N Y
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
9 Is the foundation claiming status as a private operating foundation within the meaning of section
4942(0(3)
or 4942( j)(5) for calendar
year 2012 or the taxable year beginning in 2012 (see instructions for Part XIV)? If 'Yes,' complete Part XIV
Form 990-PF (2012)
4
4
223531
12-c5-12
4
10531111 737725 BLOOMFAMFN D 2012.04040 THE BLOOMBE RG FAMILY FOUN D A BLOON FA2
1 i
-560
Part VI-A
I
Statements Regarding Activities (continued) -
11 At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the meaning of
I 1
section 512(b)(13)? lf'Yes, attach schedule (see instructions)STATEMENT : L a STATEMENT
. 4 .
...... S. T. . .
. 5
I _ilx-
12 Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had advisory privileges?
ll'Yes,' attach statement (see instructions)
-x
13 Did the foundation comply with the public inspection requirements for its annual returns and exemption application?[.13
Website addressN/A
14 Thebooksarein care of O o . DIANE GUBELLI, C/OGELLER&COLLCTelephone no*212-583-6000
Locatedat909THIRD AVENUE, 16THFL, NEW YORK,
NYZIP+4 10022
15 Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PFin lieu of Form 1041 -Check here
and enter the amount of tax-exempt interest received or accrued during the year
L 15 I N/A -
16At any time during calendar year 2012, did the foundation have an interest in or a signature or other authority over a bank,
Yes No
securities, or other financial account in a foreign country?
L
16X
Seethe instructions for exceptions and tiling requirements for Form TOF90-22.1. If 'Yes,' enter the name of the foreign
4720
File Form 4720if any item is checked in the "Yes" column, unless an exception applies.
No
1 a 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?
EliYes E1 No
(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
.Yes I 1 No
(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
E1 Yes EJ No
(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
I 1 Yes El No
(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)?
El Yes E1 No
(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 90days.)
.Yes El No
b It any answer is "Yes' to la(1)-(6), did any of the acts fail to quality under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance (see instructions)?
lb
Organizations relying on a current notice regarding disaster assistance check here
. ci
o Did the foundation engage in a prior year in any of the acts described in la, other than excepted acts, that were not corrected
before the first day of the taxyear beginning in 2012?
ic
2 Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private operating foundation
defined in section 4942(j)(3) or 4942(j)(5)):
a At the end of taxyear 2012, did the foundation have any undistributed income (lines 6d and 6e, Part XIII) for taxyear(s) beginning
before 2012?
1 1 Yes I 1 No
If 'Yes,' list the years
b 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
statement -see instructions.)
NL.A
c If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
3a Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at any time
during the year?
E1 Yes El No
b lf'Yes,' did it have excess business holdings in 2012 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 2012.)
4a Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
b Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its charitable purpose that
Form 990-PF (2012)
22354 1
1 2-05-1 2
5
1 0531 1 1 1
737725 BLOOMFANFND 2012.04040THE BLOOMBERGFAMILY FOTJNDA BLOOMFA2
(a) Name and address
(b) Title, and averaoe(c) Cc
hours per week devdled
(if
to position
I e
(e) Expense
account, other
allowances
Form 990-PF (2012)
enter NONE.N
(C) Compensation
(e) Expense
account, other
allowances
n
C
-5602
for Which Form 4720May Be
5a 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))?
El Yes FI l No
(2) Influence the outcome of any specific public election (see section 4955); or to carry on, directly or indirectly,
any voter registration drive?
El Yes[] No
(3) Provide a grant to an individual for travel, study, or other similar purposes?
.Yes E1 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)?
.Yes LI 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?
El YesNo
b If any answer is Yes to 5a(1 )-(5), did any of the transactions fail to quality 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 01.0
c lithe answer is Yes to question 5a(4), does the foundation claim exemption from the tax because it
expenditure responsibility for the grant?
.E.EEME
[1 Yes El No
It "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?
El Yes [] No
b Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
If Yes" to 6b, tile Form 8870.
7a At any time during the tax year, was the foundation a party to a prohibited lax shelter transaction?
El Yes EiJ No
o ii-yes, aicc me tounuation receive any proceeds or have any net income attributable to the transaction?
Information About Officers, Directors, Trustees, Foundation Managers, Highly
I
Part VIII
I
Paid Employees, and Contractors
I List all
foundation managers and their

16
['p
2 pensatuon of
live highest-paid employees (other than those Included on line I
(b) Title, and
(a) Name and address of each employee paid more than $50,000hoursper
devoted to o
223551
12-05-12
6
Form S9O-PF(2012)THE BLOOMBERG FAMILY FOUNDATION INC20-5602483 Page
Information About Officers, Directors, Trustees, Foundation Managers, Highly
L!TaI.
Paid Employees, and Contractors (continued)
3 Five highest-paid independent contractors for professional services. If none, enter "NONE."
(a) Nameandaddressofeachpersonpaidmorethan$50,000(b) Typeofservice(c) Compensation
GELIER & COMPANY - 909 THIRD AVE., 16TH
1
FLOOR, NEW YORK, NY 10022IA.CCOt J NTING474,903.
WILLKIE FARR & GALLAGHER LLP
A
f A
Part IX-A I summary 0? LHrect charitable Activities
Listthefoundation'sfour largestdirectcharitableactivitiesduring thetax year. Includerelevantstatistical informationsuchasthe
number oforganizationsandother beneficiariesserved,conferencesconvened,researchpapersproduced,etc.
Expenses
N/A
2
3
4
I
Part IX-13
I Summary of Program-Related Investments
Describethetwo largestprogram-relatedinvestmentsmadeby thefoundationduring thetax year onlines1 and2. Amount
1N/A
2
All other program-relatedinvestments. Seeinstructions.
3
Form 990-PF ( 2012)
223561
12-05-12
7
10531111 737725 BLOOMFANFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
Form 99O-PF(2012)THE BLOONBERG FAMILY FOUNDATION INC20-5602483 Page
[irt X
I
Minimum Investment Return (All domestic foundations must completethis part. Foreign foundations, seeinstructions.)
1Fair market valueof assets not used (or held for use) directly in carryingout charitable, etc., purposes:
aAveragemonthly fair market valueof securities. . . . . . . . . . . . . . . . . . . .
b Averageof monthly cash balances
c Fair market valueof all other assets
dTotal (add lines la, b, and C). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
eReduction claimed for blockageor other factors reported on lines laand
is (attach detailed explanation). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
I
le I
0
2Acquisition indebtedness applicableto line1 assets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3Subtract line2 from lineid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4Cash deemed held for charitableactivities. Enter 11/2% of line3 (for greater amount, seeinstructions)
5Net valueof noncharitable-useassets. Subtract line4 from line3. Enter hereand on Part V, line4
rp
ad xi Distributable Amount seeinstructions) (Section 4942(D(3) and (j)(5) privateoperatingfoundations and certain
foreign organizations check here
f l
and do not completethis part)
1 Minimum investment return from Part X, line. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1167,730 , 024.
2aTax on investment incomefor 2012 from Part VI, line5 .2a3,364,274
b Incometax for 2012. (This does not includethetax from Part VI.).2b
c Add lines 2aand 2b.20 3,364,274.
3Distributableamount beforeadjustments. Subtract line2c from line1.3164,365,750
4Recoveries of amounts treated as qualifyingdistributions ..............................................................................j...
0
5Add lines 3 and 4. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5164,365,750.
6Deduction from distributableamount (seeinstructions).60
reand on Part XIII. line1 7Distributableamount as adiusted. Subtract line6 from line5. Enter he7164.365.750 -
Part XIIJ Qualifying Distributions (seeinstructions)
1Amounts paid (includingadministrativeexpenses) to accomplish charitable, etc., purposes:-
aExpenses, contributions, gifts, etc. - total from Part I, column (d), line26.la131,969,097.
b Program-related investments - total from Part IX-B.lii0
2Amounts paid to acquireassets used (or held for use) directly in carryingout charitable, etc., purposes.2
3Amounts set asidefor specific charitableprojects that satisfy the:
a Suitability test (prior IRS approval required)
bCash distribution test (attach therequired schedule) .......................................................................................
4Qualifyingdistributions. Add lines lathrough 3b. Enter hereand on Part V, line8, and Part XIII, line4 . . . . . . . . . . . . . . . . . . . . . 4131,969,097
5Foundations that qualify under section 4940(e) for thereduced rateof tax on net investment
income. Enter 1% of Part I, line27b
..1
0
6 Adjusted qualifyingdistributions. Subtract line5 from line4 .6131,969,097
Note. Theamount on line6 will beused in Part V, column (b), in subsequent years when calculatingwhether thefoundation qualifies for thesection
4940(e) reduction of tax in thoseyears.
Form 990-PF (2012)
4
4,6
223571
12-05-12
8
10531111 737725 BLOOMFAMFND 2012. 04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
1
0
r
Form 99O-PF(2012)THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Pae9
rt
ffJ
Undistributed Income (seeinstructions)
(a)(b)(c)
(d)
CorpusYears prior to2oll2011
2012
I Distributableamount for 2012 from Part Xl,
line7
2 Undslributed Income, any, as of the end of 2012:
aEnter amount for 2oll only
b Total for prior years:
[i
3 Excess distributions carryover, if any, to 2012:
aFrom 2007
b From 2008
c From 2009
d From 2OlO
eFrom 2011
f Total of lines 3athrough e
4 Qualifying distributions for 2012 from
PartXll, line4:$ 131 .969,097.
aApplied to 2011, but not morethan line2a
b Applied to undistributed incomeof prior
years (Election required - seeinstructions)
c Treated as distributions out of corpus
(Election required - seeinstructions)
d Applied to 2012 distributableamount
TION
eRemaining amount distributed out of corpus
5Excess distributions carryover applied to 2012
IM P
(If on amount appears in column
(4
the same amount
must be shown in column (a).)
6 Enter thenet total of each column as
indicated below:
aCorpus. Add lines 31, 40, and 4e. Subtract line 5
b Prior years undistributed income. Subtract
line4b from line2b
c Enter theamount of prior years
undistributed incomefor which anoticeof
deficiency has been issued, or on which
thesection 4942(a) tax has been previously
assessed
d Subtract line6c from line6b. Taxable
amount - seeinstructions
[iJ
eUndistributed incomefor 2011. Subtract line
4afrom line2a. Taxableamount - seeinstr.
f Undistributed incomefor 2012. Subtract
lines 4d and 5from line1. This amount must
bedistributed in 2013
7 Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3)
8 Excess distributions carryover from 2007
not applied on line5or line7
9Excess distributions carryover to 2013.
Subtract lines 7 and 8 from lineBa
10 Analysis of line9:
aExcess from 2008
b Excess from 2009
o Excess from 2010...
d Excess from 2011
223581
Form 990-PF (2012)

12-05-12
9
10531111 737725 BLOOMFAMFND 2012.04040 THE BLOONBERG FAMILY FOUNDA BLOOMFA2
Form 990-PF
?AMILY FOUNDATION INC
10
(see instructions and Part VU-A, question 9)
1 a lithe foundation has received a ruling or determination letter that it is private operating
foundation, and the ruling is effective for 2012, enter the date of the ruling
b Check box to indicate whether the foundation is a private operating foundation described in section
2 a Enter the lesser of the adjusted net
L
Tax yearPrior 3 year
Income from Part I or the minimum
(a) 2012(b) 2011(C) 2010
investment return from Part X for
each year listed
b 85% of line 2a
o Qualifying distributions from Part Xli,
line 4 for each year listed
d Amounts included in line 2c not
used directly for active conduct of
exempt activities
e Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
3Complete 3a, b, or c for the
alternative test relied upon:
a 'Assets' afternailve test - enter:
(1) Value of all assets
(2) Value of assets qualifying
under section 4942(j)(3)(13)(i)
b 'Endowment' alternative test - enter
2/3 of minimum investment return
shown in Part X, line 6 for each year
listed ..........................................
c Support' alternative test - enter
(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(j)(3)(8)(iil)
(3) L argest amount of support from
an exempt organization
or
(d)2009
I
(e)Total
I
Part XV
I Supplementary Information (Complete this part only if the foundation had $5,000 or more in assets
at any time during the year-see instructions.)
1 Information Regarding Foundation Managers:
a L ist 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).)
NONE
b L ist 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
NONE
2 Information Regarding Contribution, Grant, Gift, L oan, Scholarship, etc., Programs:
Check here
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 instructions) to individuals or organizations under other conditions, complete items 2a, b, c, and d.
a The name, address, and telephone number or e-mail of the person to whom applications should be addressed:
b The form in which applications should be submitted and information and materials they should include:
c Any submission deadlines:
d Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other factors:
223601 12-05-12
Form 990-PF (2012)

10
10531111 737725 BLOOMF.AMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
S
I
Y FOUNDATI
IV
I
Up.nJIIwIwIy uiiurtiiaiion (continued)-
nts and Contributions Paid During the Year or Approved for Future Payment
RecipientI f recipient is an individual,
show any relationship toFoundationPurpose of grant or
Name and address (home or business)
any foundation managerstatus ofcontributionAmount
or substantial contributorrecipient
11
a Paid during the year
AMERI CA ACHI EVES, I NC. - SEE STMT 10
13.769 GAI NSBOROUGH ROAD
POTOMAC, MD 20854
ASSOCI ATI ON FOR SAFE I NTERNATI ONAL
ROAD TRAVEL
11769 GAI NSBOROUGH ROAD
CHARI TY I SDUCATI ON REFORM
C CHARI TY TO PROMOTE ROAD SAFETY
LOW-MI DDLE I NCOME
0
CAMPAI GN FOR TOBACCO FREE KI DS
CHARI TY I TO REDUCE TOBACCO USE

1400 EYE STREET, NW SUI TE 1200
CDC FOUNDATI ON
TONEPUBLI C CHARI TY rOREDUCE TOBACCO USE
8800 AMBASSADOR ROW
DALLAS, TX75247
5.492.000
NATI ONAL FOUNDATI ON FOR THE CENTERSTONEPUBLI C CHARI TY rOREDUCE MATERNAL
FOR DI SEASE CONTROL & PREVENTI ON
DEATHS I N TANZANI A
8800 AMBASSADOR ROW
DALLAS, TX75247
630 865
TotalS E E . . . COT.LNtJATI ON ...
S H E F T . ( . S ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B o . 3 a 131.263386
b Approved for future payment
NATI ONAL FOUNDATI ON FOR THE CENTERS TONEPUBLI C CHARI TY rOREDUCE MATERNAL
DEATHS I N TANZANI A
8800 AMBASSADOR ROW
DALLAS, TX75247
678,180,
NATI ONAL FOUNDATI ON FOR THE CENTERSTONE
PUBLI C CHARI TY COLLABORATI ON WI TH
SATES FOUNDATI ON TO
8800 AMBASSADOR ROW
REDUCE TOBACCO USE
DALLAS, TX75247
476.910,
CI TY OF ATLANTAONE
LOCALI NNOVATI ON I N
OFFI CE OF THE MAYOR, 55 TRI NI TY
GOVERNMENTI TY GOVERNMENT
AVENUE S.W., SUI TE 2400 ATLANTA, GA
30303
467,000,
T o t a l S E E . . . CONTI NUATI ON ... S . H E E T . ( . S . . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 b 51661,679.
223611
Form 990P F (2012)
12-05-12
11
1053 1111 73 7725 B LOOMF AMF ND 2012. 04040
THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
) n
b22,

(e)
(d)Related or exempt
Amountfunction Income
(a)(b)
Business
Amount
code
S
S
W IV
Form99O-PF (2012)THE BLOOMBERG FAMILY FOUNDATION INC 205602483 Page 12
III!irtXVl-A Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
1 Program service revenue:
a
b
C
d
e
g Fees and contracts from government agencies
2 Membership dues and assessments
3 Interest on savings and temporary cash
investments............................................................
4 Dividends and interest from securities
5 Net rental income or (loss) from real estate:
a Debt-financed property
b Not debt-financed property
6 Net rental income or (loss) from personal
property...........................................................
7 Other investment income
8 Gain or (loss) from sales of assets other
than inventory
9 Net income or (loss) from special events ......
10 Gross profit or (loss) from sales of inventory
11 Other revenue:
a
b
C
d
145,122.
1447,504,091.1
3000 <1,644,608.443,796,786.
3000 1.119.815. 18155.237.277.
e
L
12 Subtotal. Add columns (b),(d), and (e) I <524,793.1>.1 206,543,276. 111,716.
13 Total. Add line 12, columns (b), (d), and (e) ...........................................................................13206,130 ,199.
(See worksheet in line 13 instructions to verify calculations.)
Part XVI-Bj Relationship of Activities to the Accomplishment of Exempt Purposes
12-05-12
ruruiu - r - r - t z u )
12
10531111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FO1JNDA BLOOMFA2
Form 99O-PF(2D12)
THE BLOOMEERG FAMILY FOUNDATION INC
20-5602483
Page 13
Part XVII
I 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 In section 501(c) of
- Yes N
the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
a Transfers from the reporting foundation to a noncharitable exempt organization of
(1) Cash
.i_(i)X
(2) Other assets
b Other transactions:
(1) Sales of assets to anoncharitable exempt organization.
i1ix
(2) Purchases of assets from a noncharitable exempt organization
. 1
- I
(3) Rental of facilities, equipment or other assets .._
(4) Reimbursement arrangements.
-
(5) Loans or loan guarantees.
-
(6) Performance of services or membership or fundraising solicitations
.i
o Sharing of facilities, equipment, mailing lists, other assets, or paid employees
.ji - x
d 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
a is me Tounoation aireciiy or Inalrectly atilliatee 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?
El YesDO No
Name of a
of organization
Description of
N/A
Under penalties of perjury, I declare that I have examined this return, Including accompanying schedules and statements and to the best of my knowledge
I May the IRS discuss thIil

Sign
and belief i
shown below (see nstr.)?
SIGNER
[ ]Yes E
IH ere
7taxpayer) is based on aS Infoimatlon ofowledga
return with the preparer
Iu
l No
Signature of officer ortustee______
DateTitle
Print/Type preparer's name
I
Preparer's signature
,I DateI Check r'-i if I PuN
Paid
CHARLES POMO
Preparer
Firm's name
GELLER & COMPANY LLC
Use Only
self- employed
Firm'sElN lo. 13-4149326
Firm's address 1
10. 909 THIRD AVENUE 16TH FLOOR
z,o'ouuu
Form 990-PF (2012)
223622
12-05-12
13
F A
Form
8868
(Rev. January 2013)
Dmrl,nent of the Treasury
internal Revenue Sevice
File a separate application for each return.
OMB No. 1545-1709
If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box
[J
If you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part Il (on page 2 of this form).
Do not complete Part// unless you have already been granted an automatic 3-month extension on a previously filed Form 8868.
Electronic filing
(e-file) . You can electronically file Form 8868 if you need a 3-month automatic extension of time to file (6 months for a corporation
visit www.irsgov/efile and click on e-file for Charities & Nonprofits.
I
Part I
I
Automatic 3-Month Extension of Time.
Only submit original (no copies needed).
A corporation required to file Form 990-T and requesting an automatic 6-month extension - check this box and complete
Part lonly
[]
All other corporations (including 1120-C fliers), partnerships, REM/Cs, and trusts must use Form 7004 to request an extension of time
Type or
Name of exempt organization or other filer, see instructions.

print
File by the
due date for
filing your
return. See
instructions.
C/O GELLER & CO, 909 THIRD AVE, NO. 16 FL
NEW YORK, NY 10022
20-5602483
Enter the Return code for the return that this application is for (file a separate application for each return) -T-1 4
Application
Return
I
Application
Return
Is For
Form 990 or Form 990-EZ
01Form 990-T
Form 990-BL
02Form 1041
08
03 Form 4720
04Form 5227
Form 990-T
05Form 6069
11
06Form 8870
12
.1. ,
...( '.JnJfl.IJJJJ.aJ.%.',J .UJJ'....
The booksarein the care of' 909 THIRD AVENUE, 16TH FL - NEW YORK, NY 10022
Telephone No. 2125836000
FAXNo- 2125836241
If this is for a Group Return, enter the organizations four digit Group Exemption Number (GEN) . If If this is for the whole group, check this
box Oo, [J - If it is for part of the group, check this box and attach a list with the names and ElNs of all members the extension is for.
1 I request an automatic 3-month (6 months for a corporation required to file Form 990-1) extension of time until
AUGUST 15, 2013
to file the exempt organization return for the organization named above. The extension
is for the organization's return for:
p-IXI calendar year 2Ol2 or
O o . El tax year beginning and ending
2 If the tax year entered in line 1 is for less than 12 months, check reason: Initial etumFinal return
Change in accounting period
35 If this application is for Form 990-BL, 990-PF, 990-1, 4720, or 6069, enter the tentative tax, less any
3a $
2,900,515.
b If this application is for Form 990-PF, 990-1,4720, or 6069, enter any refundable credits and
estimated tax payments made. Include any prior year overpayment allowed as a credit.
3,112,153.
C
Balance due. Subtract line 3b from line 3a. Include your payment with this form, if required,
by using EFTPS (Electronic Federal Tax Payment System). See instructions.
I
Sc
I $ 0
Caution. If you are going to make an electronic fund withdrawal with this Form 8868, see Form 8453-E0 and Form 8879-E0 for payment instructions.
LI-IA For Privacy Act and Paperwork Reduction Act Notice, see instructions.
Form 8868 (Rev. 1-2013)
223841
01-21-13
13560509 737725 BLOOMFAMFND 2012.03040 THE BLOO4BERG FAMILY FOUNDA BLOOMFA1
A
Form 8868 (Rev. 12013)

Page 2
If you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part II and check this box....................... 1110. L X J
Note. Only complete Part II if you have already been granted an automatic 3-month extension on a previously filed Form 8868.
If you are filing for an Automatic 3-Month Extension, complete only Part I (on page 1).
Part III Additional (Not Automatic) 3-Month Extension of Time.Only file the original (no copies needed).
Type or
print
Re by the
due date for
tiling your
relian See
IflSlnJCtIClle.
Name of exempt organization or other filer, see Instructions
BLOOMBERG FAMILY FOUNDATION INC
/0 GELLER & CO, 909 THIRD AVE. NO. 16 FL
EW YORK, NY 10022
Employer identification number (E1N) or
20-5602483
Enter the Return code for the return that this application is for (file a separate application for each return) .................................... [0141
STOP! Do not complete Part II if you were not already granted an automatic 3-month extension on a previously filed Form 8868.
DIANE GUBELLI, C/O GELLER & CO LLC
The books are in the care of 909 THIRD AVENUE, 16TH FL - NEW YORK, NY 10022
TelephoneNo.- 2125836000FAXNo.- 212-583-6241
if the organization does not have an office or place of business in the United States, check this box .............................................IX ]
If this is for a Group Return, enter the organization's four droup Exemption Number (GEN) ________ - If this is for the whole group, check this
4 I request an additional 3-month extension of time untilNOViNb1iK.L D, 4 Ui. i.
5 For calendar year 2 012 , or other tax year beginning and endin
8 If the tax year entered In line 5 is for less than 12 months, check reason:L .J Initial returnFinal return
EJ Change in accounting period
7 State in detail why you need the extension
AN ADDITIONAL EXTENSION OF TIME IS REQUIRED TO FILE A COMPLETE AND
ACCURATE RETURN BECAUSE ALL INFORMATION IS NOT AVAILABLE.
8a if this application is for Form 990-BL 990-PF, 990-1, 4720, or 6069, enter the tentative tax, less any
nonrefundablecredits. SeeInstructions. 8a 1 $ 4,612,153.
b If this application is for Form 990-PF, 990-1,4720, 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 $
4,612,153.
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.Sc $0.
Signature and Verification must be completed for Part II only.
Under penalties of perjury, I declare that I hav.eamined this form, Including accompanying schedules and statements, and to the best of my knowledgend belief,
It is true, correct, an ,tilete, p that I Mjt1thorlzejgprepare this form.
-7"-/
CPA
Date
(Rev. 1-2013)
22342
01-21-13
S

.
1TION FOR 990PF, PART IV
C
d
:apjtal Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold, e.g., real estate,
2-story brick warehouse; or common stock, 200 she. MLC Co.
Ki - WILLETT PRIVATE INVESTORS (
ATED BUSINESS GAIN REPORTED ON FO
Ki - WILLETT SELECT INVESTORS (T
0.000 UST .5% DUE 11/30/12
(c Date acquired (d) Date sold
(mo., day, yr.)(ma., da
y
, yr.)
8/1
(e) Gross sales price
(f) Depreciation allowed
(or allowable)
(g) Cost or other basis
plus expense of sale
n
U
U
(h) Gain or (loss)
(e) plus (1 ) minus (g)
516.
815.
576.
0.
e
f
n
0
Complete only for assets sh
(I) F.M.V. as of 1 2/31 /69
gain in column (h) and owned by the foundation on 1 21 31 /69
(j) Adjusted basis(k) Excess of col. (i)
as of 1 2/31 /69
1
over coL(j), if any
(I) Losses (from col. (h))
Gains (excess of col. (h) gain over col. (k),
but not less than '-0-')
6
If gain, also enter in Part I, line 7
I I
2 Capital gain net income or (net capital loss) ......(If (loss), enter'-O-" in Part I, line 7 ) ..................I 2155,237,277
3 Net short-term capital gain or (loss) as defined in sections 1 222(5) and (6):
}3N/A
If gain, also enter in Part I, line 8, column (c).
If (loss), enter '-0-' in Part I, line 8
223591
05-01 -1 2
14
Purpose of grant or
contribution
BORATION WITH
FOUNDATION TO
E TOBACCO USE
INNOVATION IN
GOVERNMENT
Amount
I
20-56024
I
Part XV
I
Supplementary Information
3 Grants and Contributions Paid During the Year (Continuation)
Recipient If recipient is an individual,
show any relationship to Foundation

any
flmbar
recipient or substantial
NATIONAL FOUNDATION FOR THE CENTERS TONE?UBLIC CHARITY
FOR DISEASE CONTROL & PREVENTION
8800 AMBASSADOR ROW
DALLAS, TX 75247
CITY OF ATLANTAlONEOCAL
OFFICE OF THE MAYOR S 55 TRINITY
OVERNMENT
AVENUE S.W.. SUITE 2400 ATLANTA GA
CITY OF CHICAGO
121 N LASALLE STREET. ROOM 507
CITY OF LOUISVILLE
527 WEST JEFFERSON STREET
CAMPAIGN FOR TOBACCO FREE KIDS
1400 EYE STREET, NW SUITE 1200
CITY OF MEMPHIS
125 N MAIN STREET 7TH FLOOR
EL PODER DEL CONSUMIDOR, A.C.
JUAREZ 67-4, COL. SANTA URSULA COAPA
C.P. 04650, MEXICO D.F.. MEXICO
EMBARQ - THE WRI CENTER FOR
SUSTAINABLE TRANSPORT
10 C STREET NE #800
WASHINGTON, DC 20002
ENVIRONMENTAL DEFENSE FUND
257 PARK AVENUE SOUTH, 17TH FL
NEW YORK, NY 10010
FUND FOR CITIES OF SERVICE, INC.
909 THIRD AVENUE. 16TH FL
FUND INNOVATION IN
lENTCITY GOVERNMENT
'UN]) INNOVATION IN
lENTCITY GOVERNMENT
CHARITY COLLABORATION WITH
GATES FOUNDATION TO
REDUCE TOBACCO USE
FUND INNOVATION IN
lENTCITY GOVERNMENT
F NONTO COMBAT OBESITY IN
MEXICO
CHARITY rO PROMOTE ROAD SAFETY
N LOW-MIDDLE INCOME
COUNTRIES
CHARITY 0 MINIMIZE THE IMPACT
HE EXTRACTION OF
NATURAL GAS HAS ON THE
ENVIRONMENT
CHARITY ROMOTE VOLUNTEERISM
N CITIES
223631
05-01-12
15
10531111 737725 BLOOMFANFND 2012.04040 THE BLOOMBERG FAMILY FOUDA BLOOMFA2
S
I
i
Recipient IF recipient is an individual,
show any relationship toFoundation
any foundation manager
status of
INSTITUTONACIONAL DE SALUDPUBLICATONE?OREIGN NON
UNIVERSIDAD# 655 COLONIASANTAMARIAXEMPT
AMUACATITLAN CP. 62100 CUERNAVACA
Purpose of grantor
contribution
Amount
COMBATOBESITY IN
5
INTERNATIONAL BANK FOR RECONSTRUCTION
ANDDEVELOPMENT
1818 HSTREET, NW
WASHINGTON. DC 20433
INTERNATIONAL FEDERATION OF THE RED
CROSS ANDREDCRESCENT SOCIETIES
17 CHEMIN DES CRETS, CH-1211
GENEVA, SWITZERLAND12
INTERNATIONAL ONION AGAINST
TUBERCULOSIS ANDLUNG DISEASE INC.
61 BROADWAY
NEWYORK, NY 10006
JOHN HOPKINS BLOOMBERG SCHOOL OF
PUBLICHEALTH
615 N. WOLFE STREET
BALTIMORE. MD 21205
PUBLICHEALTH
615 N. WOLFE STREET
BALTIMORE, MD21205
PUBLICHEALTH
615 N. WOLFE STREET
BALTIMORE, MD21205
LIVING CITIES
1040 AVENUE OF THE AMERICAS, 17TH
FLOOR NEWYORK, NY 10018-3703
MDRC
16 EAST 34THSTREET 19THFL
MDRC
16 EAST 34THSTREET 19THFL.
PROMOTEROADSAFETY
LOW-MIDDLEINCOME
PROMOTEROADSAFETY
LOW-MIDDLEINCOME
CHARCOUNTRIES
CHARITY TOCOMBAT OBESITY IN
CHARITY rOPROMOTE ROADSAFETY
IN LOW-MIDDLE INCOME
OUNTRIES
CHARITY rOREDUCE TOBACCOUSE
CHARITY DROWNING PREVENTION
CHARITY SUPPORTTHE
LEPLICATION OF
FINANCIALEMPOWERMENT
ENTERS IN CITIES
CROSS THE US
CHARITY rOIMPROVE OUTCOMES
OR BLACK ANDHISPANIC
YOUTH
CHARITY '0 IMPROVE OUTCOMES
OR BLACK ANDHISPANIC
223631
05-01-12
16
61 ^

I
o c
on

I
Rec ipientIf rec ipient is an individual,
sho w any relatio nship to Fo undatio nPurpo se o f grant o r
Name and address (ho me o r business)
any fo undatio n manager
status o fc o ntributio n
o r substantial c o ntributo rrec ipient
NEW YORK UNIVERSITY
ONE'UBLICCHARITY UPPORT INNOVATION IN
295 LAFAYETTE STREET, 2ND FLOOR
J.S, CITIES
NONPROFIT FINANCE FUND
CHARITY SUPPORT ART PROGRAMS

70 WEST 36THSTREET. 11TH FL
kIED TO ECONOMIC
THE PEW CHARITABLE TRUSTS
CHARITYREATE MARINE
901 E STREET, N.W.
PROTECTED AREAS
THE ASPEN INSTITUTE INC.
CHARITY 9UPPORT EDUCATION AND

ONE DUPONT CIRCLE NW SUITE 700
EMPLOYMENT OF AT-RISK
Amo unt
CITY OF NEW ORLEANS
1300 PERDIDO STREET, SUITE 2E04
NEW ORLEANS. LA70122
MAYOR'S FUND TO ADVANCE NEW YORK CITY
253 BROADWAY, 8THFLOOR
NEW YORK, NY 10007
253 BROADWAY, 8THFLOOR
NEW YORK, NY 10007
253 BROADWAY, 8TH FLOOR
NEW YORK, NY 10007
THE SIERRACLUBFOUNDATION
85 2ND STREET, 2ND FLOOR
SAN FRANCISCO, CA94105-3456
FUND INNOVATION IN
LENTCITY GOVERNMENT
CHARITY ro SUPPORT THE YOUNG
[EN'S INITIATIVE TO
IMPROVE OUTCOMES FOR
YOUTH(BEATING THE
DOS)
CHARITY rO SUPPORT THE YOUNG
LENS INITIATIVE TO
'CUTE (ARCHES)
CHARITY ro SUPPORT THE YOUNG
EN'S INITIATIVE TO
YOUTH(VIOLENCE INTER
FROG)
CHARITY ENCOURAGE THE USE OF
LEAN ENERGY AND THE
EDUCTION OF COAL
r i
THE WORLD HEALTHORGANIZATION
PROMOTE ROAD SAFETY

CH- 1211
LOW-MIDDLE INCOME
223631
05-01-12
17
10531111 737725 BLOQMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
S
RecipientIf recipient is an individual,
show any relationship toFoundation
status of
THE WORLD HEALTH ORGANIZATION
CH - 1211
GENEVA SWITZERLAND
WOMEN FOR WOMEN INTERNATIONAL
CHARITY
4455 CONNECTICUT AVENUE, NW, SUITE 200
WASHINGTON, DC 20008
S
20-5602483
Purpose of grant or
contributionAmount
OWNING PREVENTION
177
.EATE ECONOMIC
?PORTUNITY FOR WOMEN
POST-CONFLICT
WORLD LUNG FOUNDATION
CHARITY TO REDUCE MATERNAL

61 BROADWAY - 6TH FL
DEATHS IN TANZANIA
CHARITY fiOPROMOTE ROAD SAFETY

IN LOW-MIDDLE INCOME
CHARITY frOREDUCE TOBACCO USE

WORLD LUNG FOUNDATION - SEE STMT 10
CHARITY pOLLABORA'rIoN WITH

bATES FOUNDATION TO
EARMARKED GRANTS - SEE STATEMENT 10
223031
05-01-12
18
P C
n
3 Gran ts an d Con tribution s Approved for Future Paymen t (Con tin uation )
show any relationship toFoundationPurpose of grantor
status ofcontribution
CITY OF CHICAGONONE OCALFUND INNOVATION IN
121 N LASALLE STRE E T, ROOM 5074OVE RNME NT2ITY GOVE RNME NT
CHICAGO. IL 60602
CITY OF LOUISVILLE ONE LOCAL FUND INNOVATION IN
527 WE ST JE FFE RSON STRE E TGOVE RNME NTCITY GOVE RNME NT
LOUISVILLE , KY 40202
CITY OF ME MPHISNONE LOCAL FUND INNOVATION IN
125 N MAIN STRE E T, 7TH FLOORGOVE RNME NTCITY GOVE RNME NT
ME MPHIS, TN 38103
E NVIRONME NTAL DE FE NSE FUND90NE PUBLIC CHARITY TO MINIMIZE THE IMPACT
257 PARK AVE NUE SOUTH, 17TH FLrHE E XTRACTION OF
NE W YORK, NY 10010NATURAL GAS HAS ON THE
E NVIRONME NT
FUND FOR CITIE S OF SE RVICE , INC. 90NE PUBLIC CHARITY PROMOTE VOLUNTE E RISM
909 THIRD AVE NUE , 16TH FL IN CITIE S
NE W YORK, NY 10022
JOHN HOPKINS BLOOMBE RG SCHOOL OF NONE PUBLIC CHARITY DROWNING PRE VE NTION
PUBLIC HE ALTH
615 N. WOLFE STRE E T
BALTIMORE . ND 21205
LIVING CITIE SNONE PUBLIC CHARITY SUPPORT THE
1040 AVE NUE OF THE AME RICAS, 17THRE PLICATION OF
FLOOR NE W YORK, NY 10018-3703FINANCIAL E MPOWE RME NT
E NTE RS IN CITIE S
CROSS THE US
MAYOR'S FUND TO ADVANCE NE W YORK CITY NONE PUBLIC CHARITY 10 SUPPORT THE YOUNG
253 BROADWAY, 8TH FLOORE N'S INITIATIVE TO
NE W YORK, NY 10007IMPROVE OUTCOME S FOR
YOUTH (ARCHE S)
NDRCNONE PUBLIC CHARITY rO IMPROVE OUTCOME S
16 E AST 34TH STRE E T, 19TH FL FOR BLACK AND HISPANIC
NE W YORK, NY 10016 YOUTH
NDRCPUBLIC CHARITY TO IMPROVE OUTCOME S TONE
16 E AST 34TH STRE E T. 19TH FL OR BLACK AND HISPANIC
223635
05-01-12
19
10531111 737725 ELOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
Amount
0
0
S

.
3 Grants and Contributions Approved for Future Payment (Continuation)
show any relationship toFoundationPurpose of grant or
status ofcontribution
THE PEW CHARITABLE TRUSTSTONE'UBLIC CHARITYREATE MARINE
901 8 STREET, N.W.
^ROTECTED AREAS
THE ASPEN INSTITUTE INC.
CHARITY
EDUCATION AND
ONE DUPONT CIRCLE, NW, SUITE 700
NT OF AT-RISK
Amount
CITY OF NEW ORLEANS
INNOVATION IN
1300 PERDIDO STREET, SUITE 2EO4
GOVERNM ENT
NEW ORLEANS, LA 70122
THE SIERRA CLUB FOUNDATION
CHARITY
RAGE THE USE OF

852ND STREET, 2ND FLOOR
ENERGY AND THE

SAN FRANCISCO, CA 94105-3456
TION OF COAL
THE WORLD HEALTH ORGANIZATION
PREVENTION
CH - 1211
C CHARITY TO REDUCE MATERNAL

EATHS IN TANZANIA
CHARITY F
OLLABORATION
WITH
61 BROADWAY - GTE FL
2ATES FOUNDATION TO
EARMARKED GRANTS - SEE STATEMENT 10
223835
05-01-12
20
I

I
THE BLOOMBERG FAMILY PDATION INC
L A I

20-5602483
FORM 990-PF INTEREST ON SAVINGS AND TEMPORARY CASH INVESTMENTS STATEMENT 2
SOURCE
AMOUNT
BANK OF AMERICA AGERUP MATERNAL HEALTH ACCOUNT
203.
BANK OF AMERICA GATES FOUNDATION TOBACCO CONTROL
4,919.
TOTAL TO FORM 990-PF, PART I, LINE 3, COLUMN A
5,122.
FORM 990-PF
DIVIDENDS AND INTEREST FROM SECURITIES
STATEMENT 3
SOURCE
FROM K-i - WILLETT PRIVATE
INVESTORS (TAX EXEMPT) I ILC
INVESTORS (TAX EXEMPT) I LLC
FROM K-i - WILLETT SELECT
INVESTORS (TAX EXEMPT) I LP
FROM K-i - WILLETT SELECT
INVESTORS (TAX EXEMPT) I LP
US TRUST
UST BILLS
VANGUARD
VANGUARD AMORTIZATION
CAPITAL GAINS
GROSS AMOUNTDIVIDENDS
9,031,465.
0.
4,056,735.
0.
10,366,695.
0.
24,130,295.
0.
414.
0.
7,215.
0.
67,673.
0.
<44,685.>
0.
COLUMN (A)
AMOUNT
9,031,465.
4,056,735.
10,366,695.
24,130,295.
414.
7,215.
67,673.
<44,685.>
TOTAL TO FM 990-PF, PART I, LN 4 47,615,807.
0.
47,615,807.
FORM 990-PF
OTHER INCOME
STATEMENT 4
DESCRIPTION
INVESTORS (TAX EXEMPT) I LLC
UNRELATED BUSINESS TAXABLE LOSS
REPORTED ON FORM 990-T
FROM K-i - WILLETT SELECT INVESTORS
(TAX EXEMPT) I LP
UNRELATED BUSINESS TAXABLE INCOME
REPORTED ON FORM 990-T
(A)(B)
REVENUENET INVEST-
PER BOOKSMENT INCOME
646,582.646,582.
<2,007,762.>0.
3,150,204.
3,150,204.
363,154.
AF
(C)
ADJUSTED
NET INCOME
TOTAL TO FORM 990-PF, PART I, LINE 11 2,152,178.3,796,786.
21STATEMENT(S) 2, 3, 4
0
THE BLOOMBERG FAMILY P JATION INCC 20-5602483
FORM 990-PFLEGAL FEESSTATEMENT 5
( A)
( B)
( C) ( D )
EXPENSES NET INVEST-
AD JUSTED CHARITABLE
D ESCRIPTION
PER BOOKS MENT INCOME NET INCOMEPURPOSES

WILLKIE FARR & GALLAGHER
LLP
357,526.
0.
357,526.
OTHER LEGAL FEES
259.
0.
259.
TO FM 990-PF, PG 1, LN 16A357,785.0.357,785.
FORM 990-PFACCOUNTING FEESSTATEMENT 6
( A) ( B)
D ESCRIPTIONPER BOOKS MENT INCOME
GELLER & CO474,903.237,452.
MITCHELL & TITUS, LLP20,000.0.
KPMG, LLP40,000.0.
ERNST & YOUNG2,500.0.
TO FORM 990-PF, PG 1, LN 16B537,403.237,452.
( C) ( D )
AD JUSTED CHARITABLE
NET INCOMEPURPOSES
237,451.
0.
0.
0.
237,451.
FORM 990-PPOTHER PROFESSIONAL FEESSTATEMENT 7
( A) ( B) ( C)
( D )
EXPENSES NET INVEST-AD JUSTED
CHARITABLE
D ESCRIPTION
PER BOOKS MENT INCOME NET INCOME
PURPOSES
OTHER PROFESSIONAL FEES
12,000.0.
TO FORM 990-PF, PG 1, LN 16C
12,000.0.
22STATEMENT( S) 5, 6, 7
10531111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUND A BLOOMFA2
( A )
( B )
( C )
( D )
A D JUSTED
C HA RITA B LE
PER B OOKS MENT INC OME NET INC OME
PURPOSES
2,100,000.
0.
0.
16,800.
16,800.
460,907.
66,047.
6,278.
45.
460,907.
0.
19
o f
2,650,077.477,707.
0.
THE B LOOMB ERG FA MILY FD A TION INC
V 20-5602483
FORM 990PF
TA XES
STA TEMENT 8
D ESC RIPTION
FED ERA L EXC ISE TA X
FOREIGN TA X WITHHELD :FROM
Ki - WILLETT PRIVA TE
INVESTORS ( TA X EXEMPT) I
FOREIGN TA X WITHHELD :FROM
Ki - WILLETT SELEC T
INVESTORS ( TA X EXEMPT) I
UNRELA TED B USINESS TA X
UB T - INTEREST A ND
PENA LTIES
B A C KUP WITHHOLD ING
TO FORM 990PF, PG 1, LN 18
FORM 990PF
OTHER EXPENSES
STA TEMENT 9
( A )
EXPENSES
PER B OOKS
3,508.
1,406.
D ESC RIPTION
B A NK FEES
FILING FEES
INSURA NC E - PROFESSIONA L
LIA B ILITY
NOND ED UC TIB LE EXPENSES
OTHER D ED UC TIONS - FROM Ki
- WILLETT PRIVA TE INVESTORS
( TA X EXEMPT) I LLC
OTHER D ED UC TIONS - FROM Ki
- WILLETT SELEC T INVESTORS
( TA X EXEMPT) I LP
TO FORM 990PF, PG 1, LN 23
( B )
( C ) ( D )
NET INVEST-
A D JUSTED C HA RITA B LE
MENT INC OME NET INC OME
PURPOSES
1,754.
1,754.
0.
1,406.
116,080.
58,040.
37,664.
0.
14,046,604. 14,046,604.
ME
17,640,437.17,640,437.
0.
31,845,699.31,688,795.
61,200.
FOOTNOTES
STA TEMENT 10
PA RT VIII: LINE 1 C OLUMN ( B )
THE D IREC TORS WHO A RE LISTED A T .58 HOURS PER WEEK
SPEND A PPROXIMA TELY 30 HOURS PER YEA R ON FOUND A TION
RELA TED MA TTERS.
23STA TEMENT( S) 8, 9, 10
10531111 737725 B LOOMFA NFND 2012.04040 THE B LOOMB ERG FA MILY FOTJND A B LOOMFA 2
THE BLOOMBERG FAMILY FDATION INC
20-5602483
PART XIII - UNDISTRIBUTED INCOME, LINE 4C AND LINE 7
SECTION 4942(H)(2) ELECTION
AS TO THE TREATMENT OF QUALIFYING DISTRIBUTIONS
PURSUANT TO IRC SEC. 4942(H)(2) AND REG. 53.4942(A)-3(D)(2),
THE BLOOMBERG FAMILY FOUNDATION INC. HEREBY ELECTS TO TREAT
$6,752,845 OF TOTAL CURRENT YEAR QUALIFYING DISTRIBUTIONS IN
EXCESS OF THE IMMEDIATELY PRECEDING TAX YEAR'S UNDISTRIBUTED
INCOME AS BEING MADE OUT OF CORPUS.
SIGNED:
NAME AND TITLE: MICHAEL R. BLOOMBERG, AUTHORIZED SIGNER
24
STATEMENT(S) 10
I

I
THE BLOOMBERG FAMILY Ft6ATION INC
20-5602483
PART XV - SUPPLEMENTARY INFORMATION
LINE 3A - GRANTS AND CONTRIBUTIONS PAID DURING THE YEAR
THE FOLLOWING ORGANIZATIONS ARE SUB-GRANTEES OF AMERICA
ACHIEVES, INC.:
THOMAS B. FORDHAM INSTITUTE - IRC 501(C)(3) PUBLIC CHARITY
ANALYSIS OF METHODS TO IMPROVE HOW SCHOOL SYSTEMS SELECT
NEW PRINCIPALS
NEW LEADERS D/B/A NEW LEADERS FOR NEW SCHOOLS -
IRC 501(C)(3) PUBLIC CHARITY
(1) - STATE SUPERINTENDENTS FELLOWSHIP GRANTS
(2) - PRINCIPAL VIDEO TIED TO PRINCIPAL EVALUATIONS
(3) - SUPPORT DEVELOPMENT OF TOOL TO MEASURE AND IMPROVE
PERFORMANCE OF SITTING PRINCIPALS
THE EDUCATION TRUST - IRC 501(C) (3) PUBLIC CHARITY
IDENTIFYING MISSING DATA NEEDED TO EQUIP STATE AND LOCAL
POLl CYMAKERS
NEW SCHOOLS FUND - IRC 501(C)(3) PUBLIC CHARITY
SPONSOR SESSION ON INTERNATIONAL BENCHMARKING IN NATION'S
LEADING EDUCATION REFORM SUIT
THE ORGANISATION FOR ECONOMIC COOPERATION AND DEVELOPMENT
(OECD) - INTERNATIONAL ORGANIZATION DESIGNATED BY EXECUTIVE
ORDER UNDER 22 U.S.C. SECTION 288 (EX. ORD. NO. 10133, JUNE
27, 1950, 15 F.R. 4159)
DEVELOPMENT OF ADDITIONAL ANALYSES AND COMPLETION OF PUBLIC
REPORT
50,000.
602,000.
40,000.
50,000.
140,000.
25STATEMENT(S) 10
THE BLOOMBERG FAMILY ECDATION INC20-5602483
THE FOLLOWING ORGANIZATIONS ARE SUB-GRANTEES OF EDUCATION
CHAMPIONS FOR ALL, INC. D/B/A AMERICA ACHIEVES, INC.:
THE ORGANISATION FOR ECONOMIC COOPERATION AND DEVELOPMENT
(OECD.) - INTERNATIONAL ORGANIZATION DESIGNATED BY EXECUTIVE
ORDER UNDER 22 U.S.C. SECTION 288 (EX. ORD. NO. 10133, JUNE
27, 1950, 15 F.R. 4159)
SUPPORT THE DEVELOPMENT AND ADMINISTRATION OF THE PISA-BASED
TEST FOR SCHOOLS200,000.
ACHIEVE INC. - IRC 501(C)(3) PUBLIC CHARITY
SUPPORT A JANUARY 2012 CONVENING TO EXPLORE REQUESTS FROM
STATES FOR ASSISTANCE AROUND DEVELOPING TOOLS AND PROCESSES
FOR IDENTIFYING THE QUALITY OF INSTRUCTIONAL MATERIALS
ALIGNED TO THE COMMON CORE STATE STANDARDS
THE ASPEN INSTITUTE INC. - IRC 501(C)(3) PUBLIC CHARITY
SUPPORT WORK IN THE AREA OF SCHOOL LEADERSHIP
NEW LEADERS D/B/A NEW LEADERS FOR NEW SCHOOLS -
IRC 501(C)(3) PUBLIC CHARITY
(1) - SUPPORT EFFECTIVE PRACTICE INCENTIVE PROGRAM
(2) - SUPPORT THE STATE SERVICES PROJECT IN CONNECTICUT,
INDIANA AND TENNESSEE
(3) - SUPPORT WORK IN THE AREA OF SCHOOL LEADERSHIP
THIRD SECTOR NEW ENGLAND, INC. - IRC 501(C)(3) PUBLIC
CHARITY
SUPPORT KINDERGARTEN ENTRY ASSESSMENT WORK, INCLUDING
RESEARCH AND THE PLANNING OF CROSS-STATE CONVENINGS
50,000.
500,000.
850,000.
100,000.
26STATEMENT(S) 10
THE BLOOMBERG FAMILY FATION INC
20-5602483
THE FOLLOWING ORGANIZATIONS ARE SUB-GRANTEES OF THE WORLD
LUNG FOUNDATION:
INTERNATIONAL UNION AGAINST TUBERCULOSIS AND LUNG DISEASE
INC. - IRC 501(C)(3) PUBLIC CHARITY
SUPPORT ADMINISTRATION OF A PILOT COMPETITIVE GRANTS PROGRAM
FOCUSING ON ESTABLISHING SMOKE FREE ENVIRONMENTS
1,000,000.
27
STATEMENT(S) 10
THE BLOOMBERG FAMILY FATION INC
20-5602483
THE FOLLOWING ORGANIZATIONS ARE EARMARKED SUB-GRANTEES FROM
THE GATES FOUNDATION:
NATIONAL FOUNDATION FOR THE CENTERS FOR DISEASE CONTROL &
PREVENTION
TOTAL EARMARKED GRANTS PAID FROM THE GATES FOUNDATION
THE FOLLOWING ORGANIZATIONS ARE EARMARKED SUB-GRANTEES FOR
H&B AGERUP FOUNDATION:
PREVENTION
TOTAL EARMARKED GRANTS PAID FROM H&B AGERUP FOUNDATION
2,212,217.
6,291,000.
8,503,217.
163,070.
1,216,090.
1,379,160.
TOTAL EARMARKED GRANTS PAID
9,882,377.
28STATEMENT(S) 10
E
.
THE BLOOMBERO FAMILY PIWATIONINC
L A I

20-5602483
LINE 3B - GRANTS AND CONTRIBUTIONS APPROVED FOR FUTURE
PAYMENT
THE FOLLOWING ORGANIZATIONS ARE EARMARKED SUB-GRANTEES FROM
THE GATES FOUNDATION:
PREVENTION
TOTAL EARMARKED GRANTS APPROVED FROM THE GATES FOUNDATION
493,680.
2,000,000.
2,493,680.
THE FOLLOWING ORGANIZATIONS ARE EARMARKED SUB-GRANTEES FOR
PREVENTION
H&B AGERUP FOUNDATION:
PREVENTION
TOTAL EARMARKED GRANTS APPROVED FROM H&B AGERUP FOUNDATION
236,930.
1,929,388.
2,166,318.
TOTAL EARMARKED GRANTS APPROVED FOR FUTURE PAYMENT
4,659,998.
29STATEMENT(S) 10
10531111 737725BLOOMFAMFND 2012.04040THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
.
THE BLOONBERG FAMILY FDATION INC
PART I: LINE GACOLUMN(A) ANDLINE 6B
% - 4
20-5602483
GROSS SALES PRICE FOR ALL ASSETS ON LINE 6A AS REPORTED ON
LINE 6B OF $13,300,000 INCLUDES ONLY DIRECT SALES OF ASSETS
OWNED BY THE BLOOMBERG FAMILY FOUNDATION INC.NET
GAIN FROM
SALES ON ASSETS OF $156,357,092 AS REPORTED ON LINE GA
COLUMN (A) INCLUDES PASS THRU GAINS AS FOLLOWS:
WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC
WILLETT SELECT INVESTORS (TAX EXEMPT) I LP
TOTAL REPORTED ON LINE GA COLUMN (A)
SINCE THE PASS THRU ENTITIES DO NOT REPORT ALLOCABLE SALES
PROCEEDS, LINE 6B DOES NOT INCLUDE ANY ALLOCABLE SHARE OF
GROSS PROCEEDS FROM THE SALES THAT GENERATED FLOW THRU GAINS
REPORTED ON LINE 6A.
15,046,516.
141,310,576.
156,357,092.
30
STATEMENT(S) 10
DESCRIPTION
VANGUARD T-BILLS
U.S. OTHER
GOV'T GOV'T
X
FAIR MARKET
BOOK VALUE
VALUE
[ 'P
20-5602483
FORM 990-PF
U.S. AND STATE/CITY GOVERNMENT OBLIGATIONS
STATEMENT 11
TOTAL U. S. GOVERNMENT OBLIGATIONS
TOTAL STATE AND MUNICIPAL GOVERNMENT OBLIGATIONS
TOTAL TO FORM 990-PF, PART II, LINE 10A
0.
0.
FORM 990-PF
OTHER INVESTMENTS
STATEMENT 12
DESCRIPTION
VALUATION
METHODBOOK VALUE
FAIR MARKET
VALUE
WILLETT SELECT INVESTORS (TAX
EXEMPT) I LP
WILLETT PRIVATE INVESTORS (TAX
EXEMPT) I LLC
TOTAL TO FORM 990-PF, PART II, LINE 13
COST
3,157,127,509. 3,316,694,673.
COST
785,738,332.
876,463,424.
3,942,865,841. 4,193,158,097.
31
STATEMENT(s) 11, 12
.
THE BLOOMBERG FAMILY FWATION INC
20-5602483
FORM 990-?FTRANSFERS TO CONTROLLED ENTITIES
STATEMENT 13
PART Vu-A, LINE 11
NAME OF CONTROLLED ENTITY
WIL,LETT SELECT INVESTORS (TAX-EXEMPT) I LP
ADDRESS
C/O WILLETT ADVISORS LLC, 25 E 78TH STREET
NEW YORK, NY 10075
DESCRIPTION OF TRANSFER
CAPITAL CONTRIBUTIONS
EMPLOYER ID NO
26-1634308
AMOUNT
OF TRANSFER
991,919,351.
WILLETT PRIVATE INVESTORS (TAX-EXEMPT) I LLC
ADDRESS
NEW YORK, NY 10075
CAPITAL CONTRIBUTIONS
EMPLOYER ID NO
26-2359838
AMOUNT
OF TRANSFER
494,000,000.
32
STATEMENT(S) 13
I
is
THE BLOONBERGFAMILY FDATION INC
20-5602483
WILIJETT SELECT INVESTORS II LP
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
83-0501786
CAPITAL CONTRIBUTION THROUGH WILLETT SELECT INVESTORS (TAX-EXEMPT) I LP
AMOUNT
OF TRANSFER
324,941,009.
WILL,ETT PRIVATE INVESTORS (TAX-EXEMPT) II LP
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
98-0678785
CAPITAL CONTRIBUTION THROUGH WILLETT PRIVATE INVESTORS (TAX-EXEMPT) I LLC
AMOUNT
OF TRANSFER
108,501,207.
33
STATEMENT(S) 13
THE BLOOMBERG FAMILY F]DATION INC20-5602483
EMPLOYER ID NO
031612 INVESTMENT HOLDINGS LLC
80-0793225
ADDRESS
NEW YORK, NY 10075
CAPITAL CONTRIBUTION THROUGH WILLETT PRIVATE INVESTORS (TAX-EXEMPT) I, LLC
AMOUNT
OF TRANSFER
5,719,612.
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
80-0819344
CAPITAL CONTRIBUTION THROUGH WILLETT PRIVATE INVESTORS (TAX-EXEMPT) II LP
AMOUNT
OF TRANSFER
11,848,760.
34STATEMENT(S) 13
.
THE BLOOMBERGFAMILY FWTION INC
20-5602483
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
80-0841232
AMOUNT
OF TRANSFER
20,000 ,000.
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
46-0751709
AMOUNT
OF TRANSFER
22,000,000.
35STATEMENT(S) 13
10531111 737725 BLOOMFANFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOONFA2
I

I
THE BLOONBERG FAMILY FCDATION INC
20-5602483
ADDRESS
C/O WIrJLETT ADVISORS LLC, 25 E 78TH STREET
NEW YORK, NY 10075
EMPLOYER ID NO
46-0765422
AMOUNT
OF TRANSFER
9,900,000.
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
46-0775441
AMOUNT
OF TRANSFER
18,109,286.
36
STATEMENT(S) 13
.
THE BLOOMBERG FAMILY FIATIONINC
20-5602483
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
45-5507007
AMOUNT
OF TRANSFER
22,209,537.
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
46-1000457
AMOUNT
OF TRANSFER
13,431,649.
37STATEMENT(S) 13
20-5602483
EMPLOYER ID NO
46-1571879
ADDRESS
C/O WILLETT ADVISORS IJLC, 25 E 78TH STREET
NEW YORK, NY 10075
CAPITAL CONTRIBUTION THROUGH WIL1LETT PRIVATE INVESTORS (TAX-EXEMPT) I, LLC
AMOUNT
OF TRANSFER
15,000,000.
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
46-1030450
AMOUNT
OF TRANSFER
25,000,000.
38
STATEMENT(S) 13
10531111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOtJNDA BLOOMFA2
THE BLOOMBERG FAMILY FWATION INC
20-5602483
NAME OF CONTROLLEDENTITY
EMPLOYER ID NO
WILLETT (AIV) SELECT INVESTORS I LP
26-1633115
ADDRESS
C/O Wfl,LETT ADVISORS LLC, 25 E 78TH STREET
NEW YORK, NY 10075
CAPITAL CONTRIBUTION THROUGH WILLETT SELECT INVESTORS (TAX-EXEMPT) I, LP
AMOUNT
OF TRANSFER
91,127,451.
TOTAL AMOUNT OF TRANSFERS TO CONTROLLED ENTITIES
2,173,707,862.
39
STATEMENT(S) 13
V 20-5602483
FORM 990-PF
TRANSFERS FROM CONTROLLED ENTITIES
STATEMENT 14
PART Vu-A, LINE 11
WILLETT SELECT INVESTORS (TAX-EXEMPT) I LP
ADDRESS
NEW YORK, NY 10075
CAPITAL WITHDRAWALS
EMPLOYER ID NO
26-1634308
AMOUNT
OF TRANSFER
632,000 , 000.
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
80-0793225
CAPITAL WITHDRAWAL THROUGH WILLETT PRIVATE INVESTORS (TAX-EXEMPT) I, LLC
AMOUNT
OF TRANSFER
176,760.
40
STATEMENT(S) 14
THE BLOOMBERG FAMILYNDATION INC
20-5602483
EMPLOYER ID NO
26-1633115
ADDRESS
NEW YORK, NY 10075
CAPITAL WITHDRAWAL THROUGH WILLETT SELECT INVESTORS (TAX-EXEMPT) I, LP
AMOUNT
OF TRANSFER
226,918,161.
TOTAL AMOUNT OF TRANSFERS FROM CONTROLLED ENTITIES
859,094,921.
41
STATEMENT(S) 14
THE BLOOMBERG FAMILY PNDATION INC
20-5602483
FORM 990-PFLIST OF CONTROLLED ENTITIES
STATEMENT 15
PART Vu-A, LINE 11
ADDRESS
C/O WIL,LETT ADVISORS LLC, 25 E 78TH STREET
NEW YORK, NY 10075
EMPLOYER ID NO
26-1634308
WILIJETT PRIVATE INVESTORS (TAX-EXEMPT) I LLC
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
26-2359838
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
26-1634308
WILLETT SELECT INVESTORS II LP
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
83-0501786
42STATEMENT(S) 15
10531111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOtJI'IDA BLOOMFA2
4
THE BLOOMBERG FAMILY FDATI0N INC
20-5602483
WIL1IETT PRIVATE INVESTORS (TAX-EXEMPT) II LP
ADDRESS
C/a WILLETT ADVISORS LLC, 25 E 78TH STREET
NEW YORK, NY 10075
EMPLOYER ID NO
98-0678785
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
80-0793225
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
80-0793225
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
80-0819344
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
80-0841232
43
STATEMENT(S) 15
10531111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOTJNDA BLOOMFA2
THE BLOOMBERG FAMILY FNDATION INC C 20-5602483
EMPLOYER ID NO
46-0751709
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
46-0765422
ADDRESS
NEW YORK, NY 10075
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
45-3943441
EMPLOYER ID NO
46-0775441
ADDRESS
NEW YORK, NY 10075
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
45-4001606
44STATEMENT(S) 15
10531111 737725 BLOOMFANFND 2012.04040 THE BLOOMBERG FAMILY FOtINDA BLOOMFA2
.
THE BLOONBERG FAMILY k " ' ADATION INC
% A
20-5602483
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
45-5507007
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
46-1000457
ADDRESS
C/O WILLETT ADVISORS IjLC, 25 E 78TH STREET
NEW YORK, NY 10075
EMPLOYER ID NO
46-1571879
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
46-1030450
ADDRESS
NEW YORK, NY 10075
EMPLOYER ID NO
26-1633115
45
STATEMENT(S) 15
10531111 737725 BLOOMFANFND 2012.04040 THE BLOOMEERG FAMILY FOUNDA BLOOMFA2
TITLE AND
AVRG HRS/WK
CEO & DIRECTOR
5.00
DIRECTOR
0.58
DIRECTOR
0.58
DIRECTOR
0.58
DIRECTOR
0.58
DIRECTOR
0.58
0.0.
9,400.0.
9,400.0.
9,400.0.
0.0.
9,400.0.
EMPLOYEE
CONPEN- BEN PLAN EXPENSE
SATIONCONTRIB ACCOUNT
0.
0.
0.
0.
0.
0.
O
S
THE BLOOMBERG FAMILY FIIDATION INC
1 4

20-5602483
WILL,ETP (AIV) SELECT INVESTORS I LP
ADDRESS
C/O WII1LETT ADVISORS LLC, 25 E 78TH STREET
NEW YORK, NY 10075
EMPLOYER ID NO
26-1633115
FORM 990-PF
PART VIII - LIST OF OFFICERS, DIRECTORS
STATEMENT 16
TRUSTEES AND FOUNDATION MANAGERS
NAME AND ADDRESS
PATRICIA E. HARRIS
C/O GELLER & CO, 909 THIRD AVE.,
16TH FLOOR
NEW YORK, NY 10022
TENLEY ALBRIGHT
16TH FLOOR
NEW YORK, NY 10022
EMMA BLOOMBERG
16TH FLOOR
NEW YORK, NY 10022
GEORGINA BLOOMBERG
16TH FLOOR
NEW YORK, NY 10022
CORY A. BOOKER
16TH FLOOR
NEW YORK, NY 10022
DAVID L. BOREN
16TH FLOOR
NEW YORK, NY 10022
46STATEMENT(S) 15, 16
10531111 737725 BLOOMF.ANFND 2012.04040 THE BLOOMBERG FAMILY FOTJNDA BLOOMFA2
C
9,400.
9,400.
9,400.
9,400.
9,400.
9,400.
9,400.
18,500.
9,400.
0.
20-5602483
0.
0.
0.
0.
0.0.
0.
0.
0.0.
0.0.
0.
0.
0.0.
0.0.
0.0.
THE BLOOMBERG FAMILY 46DATI0N INC
JOHN ELLIS BUSH
DIRECTOR
16TH FLOOR
0.58
NEW YORK, NY 10022
ELAINE L. CHAODIRECTOR
16TH FLOOR
0.58
NEW YORK, NY 10022
KENNETH I. CHENAULT
DIRECTOR
C/O GELLER & CO. 909 THIRD AVE.,
16TH FLOOR
0.58
NEW YORK, NY 10022
D. RONALD DANIEL
DIRECTOR
16TH FLOOR
0.58
NEW YORK, NY 10022
MANuEL A. DIAZ
DIRECTOR
16TH FLOOR
0.58
NEW YORK, NY 10022
FIONA DRUCKENMILLER
DIRECTOR
16TH FLOOR
0.58
NEW YORK, NY 10022
WALTER ISAACSON
DIRECTOR
16TH FLOOR
0.58
NEW YORK, NY 10022
MAYA LIN
DIRECTOR
16TH FLOOR
0.58
NEW YORK, NY 10022
JOHN J. MACK
DIRECTOR
16TH FLOOR
0.58
NEW YORK, NY 10022
REVERAND JOSEPH M. MCSHANE
DIRECTOR
16TH FLOOR
0.58
NEW YORK, NY 10022
47
STATEMENT(S) 16
10531111 737725 BLOOMFANFND 2012.04040 THE BLOOMBERG FAMILY FOtINDA BLOOMFA2
THE BLOONBERG FAMILY P'1DATION INC
MICHAEL G. MULLENDIRECTOR
16TH FLOOR0.58
NEW YORK, NY 10022
SAM NUNN
DIRECTOR
C/O GELLER & CO. 909 THIRD AVE.,
16TH FLOOR0.58
NEW YORK, NY 10022
SAMUEL J. PALMISANO
DIRECTOR
16TH FLOOR
0.58
NEW YORK, NY 10022
HENRY MERRITT PAULSON, JR.DIRECTOR
16TH FLOOR
0.58
NEW YORK, NY 10022
ALFRED SOMMER
DIRECTOR
16TH FLOOR
0.58
NEW YORK, NY 10022
MARTIN SORRELL
DIRECTOR
16TH FLOOR
0.58
NEW YORK, NY 10022
ANNE TATLOCKDIRECTOR
16TH FLOOR
0.58
NEW YORK, NY 10022
TOTALS INCLUDED ON 990-PF, PAGE 6, PART VIII
20-5602483
9,400. 0.
0.
9,400.
0.
0.
9,400.
0.0.
9,400.
0.
0.
9,400.
0.
0.
9,400.
0.0.
9,400.
0.0.
197,100.0.0.
48
STATEMENT(S) 16
.
THE BLOOMBERG FAMILY F1DATIONINC
I
20-5602483
FORM 990-PF
EXPENDITURE RESPONSIBILITY STATEMENT
STATEMENT 17
PART Vu-B, LINE 5C
GRANTEE'S NAME
EL PODER DEL CONSUMIDOR, A.0
GRANTEE'S ADDRESS
JUAREZ 67-4, COL. SANTA URSULA COAPA
C.P. 04650, MEXICO, D.F., MEXICO
GRANT AMOUNT
DATE OF GRANT AMOUNT EXPENDED
950,000.06/21/12877,381.
PURPOSE OF GRANT
TO SUPPORT THE INITIATIVE TO COMBAT OBESITY IN MEXICO
DATES OF REPORTS BY GRANTEE
02/04/13, 07/16/13
ANY DIVERSION BY GRANTEE
NOT TO OUR KNOWLEDGE
RESULTS OF VERIFICATION
N/A
49
STATEMENT(S) 17
THE BLOOMBERG FAMILY
FtDATION INC
20-5602483
GRANTEE'S NAME
INSTITTJTO NACIONAL DE SALUD PUBLICA
GRANTEE'S ADDRESS
UNIVERSIDAD #655 COLONIA SANTA MARIA AHUACATITLAN
C.P. 62100, CUERNAVACA, MOR. , MEXICO
GRANT AMOUNT
DATE OF GRANT AMOUNT EXPENDED
350,750.07/11/12313,933.
PURPOSE OF GRANT
TO SUPPORT THE INITIATIVE TO COMBAT OBESITY IN MEXICO
DATES OF REPORTS BY GRANTEE
01/31/2013, 08/30/2013
ANY DIVERSION BY GRANTEE
NOT TO OUR KNOWLEDGE
RESULTS OF VERIFICATION
N/A
50
STATEMENT(S) 17
r
L
0 V
THE BLOOMBERG FAMILY FOUNDATION INC.
Action of Sole Member
in Lieu of a Meeting
I, Michael R. Bloomberg, the undersigned, being the sole Member of The
Bloomberg Family Foundation Inc., a Delaware non-stock, non-profit corporation (the
"Foundation"), do hereby state that the following actions were taken on this day pursuant to
Section 11 of Article II of the Third Amended Bylaws of the Foundation (as defmed herein) and
Section 228(b) of the General Corporation Law of the State of Delaware:
WHEREAS, by an instrument titled "Action of Sole Member in Lieu of a
Meeting" and dated March 31, 2010, Michael R. Bloomberg, as sole Member of the Foundation,
repealed the bylaws for the regulation of the affairs of the Foundation and replaced them with the
Amended and Restated Bylaws of the Foundation (the "Amended Bylaws"); and
Meeting" and dated May 10, 2010, Michael R. Bloomberg, as sole Member of the Foundation,
repealed the Amended Bylaws for the regulation of the affairs of the Foundation and replaced
them with the Second Amended and Restated Bylaws of the Foundation (the "Second Amended
Bylaws"); and
Meeting" and dated May 13, 2010, Michael R. Bloomberg, as sole Member of the Foundation,
repealed the Second Amended Bylaws for the regulation of the affairs of the Foundation and
replaced them with the Third Amended and Restated Bylaws of the Foundation (the "Third
Amended Bylaws"); and
Meeting" and dated September 28, 2011, Michael R. Bloomberg, as sole Member of the
Foundation, repealed the Third Amended Bylaws for the regulation of the affairs of the
Foundation and replaced them with the Fourth Amended and Restated Bylaws of the Foundation
(the "Fourth Amended Bylaws"); and
WHEREAS, Article X of the Fourth Amended Bylaws provides that the
Bylaws may be amended, altered or repealed by the written consent of all the Members without a
meeting; and
WHEREAS, Michael R. Bloomberg, as sole Member of the Foundation,
desires to repeal the Fourth Amended Bylaws and replace them with amended and restated bylaws,
entitled the "Fifth Amended and Restated Bylaws of The Bloomberg Family Foundation Inc."
and annexed hereto as Exhibit A (the "Fifth Amended Bylaws").
NOW, THEREFORE, BE IT
7449760.4
H
W
gel
1 9
RESOLVED, that the Fifth Amended Bylaws be and hereby are approved
and adopted as the bylaws of the Foundation, and, together with this Action of Sole Member in
Lieu of a Meeting, the certificate of incorporation and notice of filing thereof by the Delaware
Secretary of State, shall be inserted in the minute book of the Foundation.
IN WITNESS WHEREOF, the undersigned has subscribed this Action of Sole
Member in Lieu of a Meeting as of
5
, 2012.
w_'a...
Michael R. Bloober g, Sole MemberDate
7449 760.4 2
SO
EXHIBIT A
FIFTH AMENDED AND RESTATED BYLAWSO F
THE BLO O MBERG FAMILY FO UNDATIO N INC.
ARTICLE I
Office and Books
Section 1. Office The Bloomberg Family Foundation Inc. (the
"Foundation") shall have offices at such places, either within or without the State of Delaware,
as the Board of Directors (the "Board") may determine from time to time.
Section 2. Books and Records There shall be kept at the office of the
Foundation correct and complete books of account of the activities and transactions of the
Foundation including a minute book, which shall contain a copy of the Certificate of
Incorporation and all amendments thereto, a copy of these Bylaws and minutes of all meetings of
the Members, the Board and all committees of the Board.
ARTICLE II
Members
Section 1. a. Members The initial Member of the Foundation shall be
Michael R. Bloomberg (the "Initial Member"). The Initial Member shall have the power to
appoint such person or persons, as the Initial Member determines to be advisable, as additional
Member or Members. Upon the death of the Initial Member or the resignation of the Initial
Member at a time when there are no other Members then acting, (i) there shall be no Members of
the Foundation and (ii) no rights, powers, obligations or duties of the Members shall survive the
occurrence of any such event. Notwithstanding the foregoing, during any period in which (i) the
Initial Member is Incapacitated (as hereinafter defined) and (ii) there are no other Members of
the Foundation, for the purposes of these Bylaws, there shall be deemed to be no Members of the
Foundation for such period of Incapacity (as hereinafter defined).
b. The Initial Member shall be deemed to have an
"Incapacity" or to be "Incapacitated" for purposes of these Bylaws when (i) a valid court order
exists ruling the Initial Member to be legally unable to act on the Initial Member's own behalf or
appointing a guardian or conservator of the Initial Member's property to act on behalf of the
Initial Member, (ii) the Initial Member is unable to conduct business and financial affairs, which
inability shall be deemed to exist or to terminate when so certified in writing by two licensed
physicians then attending the person to whom such certification applies (neither of whom are
related by blood or marriage to any Member, Director or Officer at such time) or (iii) the Initial
Member has been missing for longer than 60 days and cannot be located with reasonable effort
or the Initial Member is being detained under duress where the Initial Member is unable
effectively and prudently to look after financial matters. Such Incapacity shall be deemed to
continue until such court order, certificates and/or circumstances have become inapplicable or
have been revoked; in such event, the Initial Member shall resume his role as the Initial Member
of the Foundation.
7449760.4
.
S
c. During any period in which there are no Members as
determined pursuant to subsection La of this Article, the Directors shall be the Members
pursuant to subsection 102(a)(4) of the General Corporation Law of the State of Delaware (the
"GCLD"). Said Directors shall not hold any of the rights, powers, obligations or duties
conferred to the Members pursuant to Article III, Article IV and Article X hereunder.
Section 2. Term Each Member shall serve until the earliest to occur of (i)
the resignation of such Member, (ii) the removal of such Member or (iii) the death of the Initial
Member.
Section 3. Removal Any Member appointed by the Initial Member may
be removed, with or without cause, by the Initial Member at a meeting of the Members or by
written consent of the Initial Member. The Initial Member may not be removed.
Section 4. Resignation Any Member may resign at any time. Such
resignation shall be made in writing or by electronic transmission and shall take effect at the time
specified therein, and if no time be specified, at the time of its receipt by the Chief
Administrative Officer. The acceptance of a resignation shall not be necessary to make it
effective, unless so specified therein. The Chief Administrative Officer shall present such notice
of resignation at the first meetings of the Members and Directors following its receipt.
Section 5. Annual Meeting The Members shall convene for an annual
meeting of the Members each year on such date and at such time and place, within or without the
State of Delaware, as shall be designated in the notices or waivers of notice relating to such
meeting for the purpose of the election of the initial Directors of the Foundation, as provided in
Section 4 of Article III hereunder, and/or the transaction of such other business as may come
before the Members.
Section 6. Special Meetings Special meetings of the Members for any
purpose may be held either within or without the State of Delaware and may, unless otherwise
prescribed by statute, be called at any time by the Board or by the Chief Executive Officer and
shall be called by the Chief Executive Officer or by the Chief Administrative Officer upon the
written demand of a majority of the Members, which demand shall be delivered to the Chief
Executive Officer or Chief Administrative Officer and shall specify the date and time of the
meeting, which shall not be less than sixty (60) days or more than ninety (90) days from the date
of said demand. Upon receiving any such written demand, the Chief Executive Officer or Chief
Administrative Officer shall give notice of the date, time and place of the special meeting to each
member in accordance with the provisions of Section 7 of this Article. No business other than
that specified in the notice of special meeting of the Members shall be transacted at such meeting
without the unanimous consent of all Members present at such meeting.
Section 7. Notice of Meetings Notice of the time and place of any
meeting of the Members, whether annual or special, shall be given to each Member entitled to
vote thereat, at least ten (10) days but not more than sixty (60) days before the day of the
meeting. Notice of any adjourned meeting need not be given except by announcement at the
meeting so adjourned, unless otherwise ordered in connection with such adjournment. Such
further notice, if any, shall be given as may be required by law.
7449760.4 4
Section 8. Quorum A majority of the Members shall be necessary to
constitute a quorum for the transaction of business. In the absence of a quorum, or when a
quorum is present, a meeting may be adjourned from time to time by a vote of the majority of the
Members present or represented by proxy, without notice other than announcement at the
meeting and without further notice to any absent Member. When a quorum is initially present, it
may not be broken by the subsequent withdrawal of any Members.
Section 9. Voting At every meeting of the Members, each Member shall
be entitled to one vote on all matters. All actions to be taken by vote of the Members shall be
authorized by a majority of the members present or represented by proxy at a meeting of the
Members, except as otherwise required by law. At all meetings of the Members, each Member
may vote either in person or by proxy. At all meetings of the Members where a Member is
participating by means of remote communication, said Member may submit his, her or its ballot
by electronic transmission.
Section 10. Proxies A Member may authorize another person or persons
to act for said Member by written proxy. No proxy shall be valid after the expiration of eleven
(11) months from the date thereof unless otherwise provided in the proxy. Every proxy shall be
revocable at the pleasure of the Member executing it. The authority of the holder of a proxy to
act shall not be revoked by the incompetence or death of the Member who executed the proxy
unless, before the authority is exercised, written notice of an adjudication of such incompetence
or of such death is received by the corporate Officer responsible for maintaining the list of
Members.
Section 11. Action Without a Meeting Any action required or permitted
to be taken at any annual or special meeting of the Members may be taken without a meeting,
without prior notice and without a vote, if a consent in writing or by electronic transmission,
setting forth the action so taken, shall be signed or transmitted, as the case may be, by the
Members having not less than the minimum number of votes that would be necessary to
authorize or take such action at a meeting at which all Members entitled to vote thereon were
present and voted and shall be delivered to the Foundation by delivery to its registered office in
the State of Delaware, its principal place of business, or an officer or agent of the Foundation
having custody of the book in which proceedings of meetings of Members are recorded. Prompt
notice of the taking of the corporate action without a meeting by less than unanimous written
consent shall be given to those Members who have not consented in writing.
Section 12. Meeting by Means of Telecommunications Any one or more
of the Members may participate in a meeting of the Members by means of a conference
telephone or similar telecommunications equipment allowing all persons participating in the
meeting to hear each other at the same time or by means of remote communication. Participation
by such means shall constitute presence in person at a meeting.
Section 13. Delegation of Duties to the Board The Members may, in
writing, authorize the Board to act in their place and stead with respect to any action required or
permitted to be taken by the Members of the Foundation pursuant to these Bylaws, and such
delegation to the Board may be revoked by the Members at any time.
7449760.4 5
1 1
ARTICLE III
Directors
Section 1 . Responsibilities The business and affairs of the Foundation
shall be managed under the direction of the Board, unless otherwise provided hereunder.
Section 2. Classification There shall be three (3) classes of Directors:
Class I, Class II and Class III (collectively, the "Directors").
Section 3. Number Anything contained herein to the contrary
notwithstanding, there shall always be at least sixteen (1 6) Directors of the Foundation and there
shall not be more than twenty-five (25) Directors of the Foundation. There shall always be at
least eight (8) Class II Directors and eight (8) Class III Directors.
Section 4. Election
a. Initial Class I Directors The initial Class I Directors (the
"Initial Class I Directors") shall be elected at the first annual meeting of the Members following
the adoption by the Foundation of the Third Amended and Restated Bylaws of the Foundation
(the "Initial Meeting") by a vote of the majority of the Members. There shall be no successors to
the Initial Class I Directors.
b. Initial Class II Directors The initial Class II Directors (the
"Initial Class II Directors") shall be elected at the Initial Meeting of the Members by a vote of
the majority of the Members.
c. Initial Class III Directors The initial Class ifi Directors
(the "Initial Class III Directors") shall be elected at the Initial Meeting of the Members by a vote
of the majority of the Members.
d. Successors to Initial Class II Directors The successors to
the Initial Class II Directors (each, a "Class II Director") shall be elected at the Annual Meeting
of the Board (as hereinafter defined) that is held upon the expiration of the term of the Initial
Class II Directors. The Directors currently serving in office (the "Current Directors") and the
outgoing Directors whose term expired as of the date of the Annual Meeting at issue (the
"Outgoing Directors") shall elect a Class II Director by majority vote. When selecting the Class
II Directors, the Current Directors and the Outgoing Directors shall first consider electing such
individuals designated by resolution of the Members, if any, but shall not be under any
obligation to elect such individuals.
e. Successors to Initial Class III Directors The successors to
the Initial Class III Directors (each, a "Class III Director") shall be elected at the Annual Meeting
of the Board that is held upon the expiration of the term of the Initial Class Ill Directors, The
Current Directors and the Outgoing Directors shall elect a Class III Director by majority vote.
When selecting the Class III Directors, the Current Directors and the Outgoing Directors shall
first consider electing some or all of the Initial Class II Directors, but shall not be under any
obligation to elect some or all of the Initial Class II Directors.
7449760.4
f. Successors to Class II Director A successor to a Class II
Director (other than an Initial Class II Director) shall be elected at the Annual Meeting of the
Board that is held upon the expiration of the term of such Class II Director. The Current
Directors and the Outgoing Directors shall elect the successor of a Class II Director by majority
vote. When selecting the successor of a Class II Director, the Current Directors and the
Outgoing Directors shall first consider electing former members of the Board, but shall not be
under any obligation to elect former members of the Board.
g. Successors to Class 111 Directors A successor to a Class III
Director (other than an Initial Class Ill Director) shall be elected at the Annual Meeting of the
Board that is held upon the expiration of the term of such Class III Director. The Current
Directors and the Outgoing Directors shall elect the successor of a Class III Director by majority
vote. When selecting the successor of a Class III Director, the Current Directors and the
Outgoing Directors shall first consider electing former members of the Board, but shall not be
under any obligation to elect former members of the Board.
Section 5. Term
a. Initial Class I Directors The term of an Initial Class I
Director shall commence at the election of said Initial Class I Director and shall expire on the
earliest to occur of the death, disqualification, resignation or removal of said Initial Class I
Director. The Initial Class I Directors shall not be subject to term limits hereunder.
b. Initial Class II Directors Except as provided in Section 8 of
this Article, the term of an Initial Class II Director shall commence at the election of said Initial
Class II Director and shall expire at the earlier to occur of (i) the Annual Meeting of the Board
held in the calendar year that is four (4) years after the calendar year in which said Initial Class II
Director was elected and (ii) at said Initial Class II Director's death, disqualification, resignation
or removal.
c. Initial Class III Directors Except as provided in Section 8
of this Article, the term of an Initial Class III Director shall commence at the election of said
Initial Class III Director and shall expire at the earlier to occur of (i) the Annual Meeting of the
Board held in the calendar year that is five (5) years after the calendar year in which said Initial
Class III Director was elected and (ii) at said Initial Class III Director's death, disqualification,
resignation or removal.
d. Class II Directors and Class III Directors Except as
provided in Section 8 of this Article, the term of a Class II Director and a Class III Director shall
commence at the election of such Director and shall expire at the earlier to occur of (i) the
Annual Meeting of the Board held in the calendar year that is two (2) years after the calendar
year in which said Director was elected and (ii) said Director's death, disqualification,
resignation or removal.
e. Directors Serving as Special Assets Committee Members
Notwithstanding the foregoing provisions of this Section and Section 8 of this Article, upon the
Trigger Date, as defined below, the term of any SAC Director, as defined below, shall expire on
the later to occur of (i) the expiration of such SAC Director's term as otherwise provided by the
7449760.47
.
S
t
provisions of this S ection 5 or S ection 8 of this Article, as the case may be, and (ii) the
completion of the duties and the obligations of the S AC Director, as determined by a majority
vote of the Directors other than the S AC Directors.The Board shall elect a Class II Director to
serve in addition to an S AC Director who is a Class II Director and a Class III Director to serve
in addition to an S AC Director who is a Class III Director, and said additional Class II Director
or Class III Director, as the case may be, shall be elected at the Annual Meeting held in the
calendar year in which said S AC Director's term would otherwise have expired as provided by
the provisions of this S ection 5 or S ection 8 of this Article, as the case may be, provided said
S AC Director is serving at such time.The term of said additional Class II Director or Class III
Director, as the case may be, shall be determined by the foregoing provisions of this S ection 5.
At the expiration of the term of an S AC Director, other than by death, resignation or removal, a
successor to said S AC Director shall not be elected by the Board.
i. For purposes of subsection e of this S ection 5, the term
"Trigger Date" shall mean the earlier to occur of (i) the date that is eighteen (18) months after the
time the Initial Member becomes Incapacitated, provided such Incapacity continued for the
duration of the eighteen (18) month period without interruption, and (ii) the death of the Initial
Member.
ii. For purposes of subsection e of this S ection 5, the term
S AC Director shall mean any Director of the Foundation who is serving on the Trigger Date as a
member of the S pecial Assets Committee or has been appointed after the Trigger Date to the
S pecial Assets Committee pursuant to S ection 16a of this Article.
f. Consecutive Terms Directors shall be eligible for re-
election but may not serve consecutive terms except as provided in S ection 8 of this Article;
provided, however, that any Director of the Foundation who is serving as a member of the
S pecial Assets Committee at the Trigger Date shall be eligible to serve for a consecutive term as
provided in paragraph e of this S ection 5.
S ection 6.Resi gnation Any Director acting hereunder may resign and be
discharged from office by delivery to the Directors of an instrument of resignation.S uch
instrument shall be made in writing, signed and acknowledged by such resigning Director, or by
electronic transmission.S uch instrument shall specify the date at which such resignation shall
take effect, which date shall be at least thirty (30) days after the delivery thereof; provided,
however, that such resignation may take effect in fewer than thirty (30) days after the delivery of
such instrument with the consent of a majority of the Directors.
S ection 7.Removal Any Director may be removed, with or without
cause, by a vote of a majority of the Members at an annual meeting of the Members, at any
special meeting of the Members called for that purpose or pursuant to S ection 11 of Article II
hereunder.If there are no Members, any Director may be removed, with or without cause, by a
vote of two-thirds of the Directors at an Annual Meeting of the Board, at any special meeting of
the Board called for that purpose or pursuant to S ection 13 of this Article; provided, however,
that the Directors shall not have the authority to remove an Initial Class I Director, and provided
further, however, that the Directors shall not have the power to remove, other than for cause, a
Director who is a member of the S pecial Assets Committee appointed by the Initial Member.
Any Director who has been removed pursuant to this section shall not act as or be designated to
7449760.4
act as a Director hereunder. Notwithstanding the foregoing, the Members may, by a vote of a
majority of the Members or by majority written consent, provide that an individual who has been
removed as Director shall be eligible for re-election.
Section 8. Newly Created Directorships and Vacancies Newly created
directorships and any vacancies in the Class II or Class III Directors of the Board occurring
during the term of a Class II or Class III Director, as the case may be, by reason of death,
resignation, disqualification, removal or for any other cause may be filled by vote of a majority
of the Directors. Any Initial Class II Director or Class II Director, as the case may be, so elected
by the Directors shall hold office until the election and qualification of a successor Class II
Director at the next succeeding Annual Meeting at which Class II Directors are elected, and any
Initial Class III Director or Class III Director, as the case may be, so elected by Directors shall
hold office until the election and qualification of a successor Class III Director at the next
succeeding Annual Meeting at which Class III Directors are elected. Notwithstanding the
provisions of subsection f of Section 5 of this Article, any individual elected hereunder to fill a
vacancy may be elected to serve as a successor Class II or Class III Director, as the case may be,
for the term immediately following the term for which such individual was elected to fill a
vacancy, and such election shall occur at the next succeeding Annual Meeting at which Class II
or Class III Directors, as the case may be, are elected.
Section 9. Re
gular Meetings The Board shall convene for an annual
meeting of the Directors (the "Annual Meeting") in the month of June of each year, or as
otherwise determined by the Board, on such date and at such time and place, within or without
the State of Delaware, as shall be designated in the notices or waivers of notice relating to such
meeting for the purpose of the election of Directors and Officers and the transaction of such
other business as may come before the Board. Other regular meetings may be held at such times
as may be determined from time to time by the Chairperson on such date and at such time and
place, within or without the State of Delaware, as shall be designated in the notices or waivers of
notice relating to such meeting for the purpose of the transaction of such business as may come
before the Board. Notice of the time and place of any regular meeting of the Board shall be
given to each Director entitled to vote thereat at least five (5) days before the day of the meeting.
Section 10. Special Meetings Special meetings of the Board may be
called by the Chairperson of the Board by giving notice to each Director entitled to vote thereat
at least two (2) days before the day of the meeting. On the written request of a majority of the
Directors, special meetings shall be called by the Chief Administrative Officer by giving notice
to each Director entitled to vote thereat at least five (5) days before the day of the meeting. In
each case, the person or persons calling the special meeting shall fix a reasonable time and place
for the meeting.
Section 11. Quorum A majority of the Directors shall be necessary to
constitute a quorum for the transaction of business. In the absence of a quorum, or when a
quorum is present, a meeting may be adjourned from time to time by a vote of the majority of the
Directors present, without notice other than announcement at the meeting and without further
notice to any absent Director. When a quorum is initially present, it may not be broken by the
subsequent withdrawal of any Directors.
7449760.4
9
. I
Section 12. Voting At every meeting of the Board, each Director shall be
entitled to one vote on all matters. All actions to be taken by vote of the Board shall be
authorized by a majority of the Directors present at any such meeting, except as may otherwise
be provided by law or these Bylaws.
Section 13. Action Without a Meeting Any action required or permitted
to be taken by the Board or any committee thereof may be taken without a meeting if all
members of the Board or the committee, as the case may be, consent thereto in writing or by
electronic transmission to the adoption of a resolution authorizing the action. Said resolution,
writing(s) and electronic transmission(s) shall be filed with the minutes of the proceedings of the
Board or committee, as the case may be.
Section 14. Meeting by Means of Telecommunications Any one or more
members of the Board or any committee thereof may participate in a meeting of the Board or
such committee by means of a conference telephone or similar communications equipment
allowing all persons participating in the meeting to hear each other at the same time.
Participation by such means shall constitute presence in person at a meeting.
Section 15. Chairperson
a. The Members, by majority consent, shall designate a
Chairperson of the Board. The Chairperson shall be selected from among the Directors. If the
Chairperson ceases for any reason to act as a Director or Chairperson, the Members by majority
consent, or if there are no Members, the Directors by majority consent, shall designate a
successor Chairperson. The Chairperson may be removed from his or her position as
Chairperson of the Board by a vote of two-thirds of the Members, or if there are no Members, by
a vote of two-thirds of the Directors,
b. The Chairperson of the Board shall preside at all meetings
of the Board at which the Chairperson is present. The Chairperson of the Board shall also do and
perform such other duties as may, from time to time, be assigned by the Directors.
Section 16. Committees
a. Standing Committees The Members shall have the power
to (i) establish such standing committees of the Board as the Members may deem desirable for
the furtherance of the objects and purposes of the Foundation, (ii) appoint the members of such
standing committees, (iii) delegate to such standing committees such powers as, in the discretion
of the Members and consistent with applicable law, are necessary or desirable, and (iv) change
the composition of any such standing committee at such times as the Members in their absolute
discretion determine to be necessary or desirable. If there are no Members, the Directors shall
have the power to (i) establish such standing committees of the Board as the Directors may deem
desirable for the furtherance of the objects and purposes of the Foundation, (ii) appoint the
members of such standing committees, (iii) delegate to such standing committees such powers
as, in the discretion of the Board and consistent with applicable law, are necessary or desirable,
and (iv) change the composition of any such standing committee at such times as the Board in its
absolute discretion determines to be necessary or desirable; provided, however, that at any time
after the Initial Member's death or Incapacity, (1) the Directors shall not have the power to
7449760.4
10
remove, other than for cause, a member of the Special Assets Committee appointed by the Initial
Member, and (2) the Directors shall have the power to appoint members of the Special Assets
Committee only to fill a vacancy occurring by reason of the death, resignation, removal for cause
or expiration of the term of a Director.
b. Additional Committees The Directors shall have the power
to (i) establish from time to time such additional committees of the Board as the Directors may
deem desirable for the furtherance of the objects and purposes of the Foundation, (ii) appoint the
members of such committees, (iii) delegate to such committees such powers as, in the discretion
of the Board and consistent with applicable law, are necessary or desirable, (iv) change the
composition of any such committee at such times as the Board in its absolute discretion
determines to be necessary or desirable, and (v) adjourn any such committee upon the
completion of its duties and obligations, as determined by the Directors.
c. The Initial Chief Executive Officer (as defined herein) shall
act as a member of any committee created hereunder. All additional committee members shall
be appointed from among the Directors. If a committee member ceases to act as Director or
Initial Chief Executive Officer, as the case may be, for any reason, such committee member shall
cease to serve on any committee to which such committee member was appointed. The Initial
Chief Executive Officer shall be the chairperson of each committee. Notwithstanding the
foregoing, the Initial Chief Executive Officer or the Chief Executive Officer, as the case may be,
shall not act as a member or be the chairperson of the Audit Committee.
d. At the Annual Meeting of the Board and at such times as
the Board directs, each committee shall provide a report of its actions and such actions shall be
subject to amendment by the Directors; provided, however, that any such amendment shall not
adversely affect the rights of any third party.
e. There shall be the following standing committees of the
Board and any such other standing committees as the Members or Directors, as the case may be,
shall establish from time to time:
i. Investment Committee The Investment Committee
shall assist the Board with overseeing the management of the Foundation's assets. The
Investment Committee shall be responsible for formulating the investment policies of the
Foundation, subject to the approval of the Board, and monitoring the management of the
Foundation's assets to ensure compliance with the Foundation's investment policies.
ii. Program Committee The Program Committee shall
assist the Board with developing and overseeing the program and grant-making policies of the
Foundation.
iii. Special Assets Committee The Special Assets
Committee shall assist the Board with managing certain assets of the Foundation.
iv. Audit Committee The Audit Committee shall assist the
Board with monitoring the Foundation's financial reporting and financial reporting processes.
The Audit Committee shall review the Foundation's policies, practices and compliance with
7449760.4 1 1
regulations concerning financial reporting, tax filings, accounting and conflicts of interest, and
oversee the Foundation's relationship with its outside auditor.
Section 17. Compensation
a. The Directors may be reimbursed for all of their direct
expenses, including but not limited to travel expenses, in serving the Foundation. Such
reimbursements shall be approved by the Chief Executive Officer, taking into consideration the
requirements of Section 4941 (d)(2)(E) and (G) of the Internal Revenue Code of 1986, as
amended (the "Code"), and the Treasury Regulations promulgated thereunder. If the Chief
Executive Officers is unable or unavailable to approve such reimbursements, the Members may
designate an individual or individuals to approve such reimbursements. Notwithstanding the
foregoing, no Director shall participate (in any capacity) in a vote on matters pertaining to such
Director's reimbursement.
b. The Directors may be reasonably compensated for personal
services that are reasonable and necessary to carry out the exempt purposes of the Foundation.
Such compensation shall be determined by a vote of the majority of the Members from time to
time, taking into consideration the requirements of Section 4941 (d)(2)(E) of the Code, and the
Treasury Regulations promulgated thereunder. Notwithstanding the foregoing, the compensation
of the Directors shall be fixed as of the date of death of the Initial Member (the "Final
Compensation Amount"); provided, however, that each year on January 1st, the Final
Compensation Amount shall be adjusted for inflation by multiplying the Final Compensation
Amount by the sum of one plus the percentage by which the CPI for the immediately preceding
December exceeds the CPI for December of the year prior to the Initial Member's date of death,
and such adjusted amount shall be rounded to the next lowest multiple of $100. Any reference
herein to the term "CPI" shall mean the Consumer Price Index for All Urban Consumers (US
City Average, All Items) as published by the Bureau of Labor Statistics (or the most comparable
successor index compiled by such agency or its successor). The compensation of the Directors
(other than reimbursements) may not be determined by a vote of the Directors.
Section 18. Rules and Regulations. The Board may from time to time
adopt such rules and regulations as it may deem advisable to carry out the affairs of the
Foundation.
ARTICLE IV
Officers
Section 1. Number There shall be a Chief Executive Officer and a Chief
Administrative Officer of the Foundation. Additional Officers of the Foundation may include a
Chief Investment Officer, a Chief Financial Officer and such other Officers or assistant Officers
as the Chief Executive Officer may from time to time determine. The initial Chief Executive
Officer (the "Initial Chief Executive Officer") shall be a Director. Any Officer other than the
Initial Chief Executive Officer may, but need not, be a Director or Member. Any two or more
offices may be held by the same person.
7449760.4 12
Section 2. Election of Officers
a. Election of Chief Executive Officer The Initial Chief
Executive Officer shall be elected at the annual meeting of the Members by a vote of the
majority of the Members. The successor to the Initial Chief Executive Officer and all future
successor Chief Executive Officers shall be elected at the annual meeting of the Members by a
vote of the majority of the Members, or if there are no Members, at the Annual Meeting of the
Board by a vote of the majority of the Directors. All references hereunder to the Chief Executive
Officer shall apply to the Initial Chief Executive Officer and all Successor Chief Executive
Officers.
b. Election of Other Officers The Chief Executive Officer (i)
shall appoint the Chief Administrative Officer and (ii) may appoint such additional Officers,
including a Chief Investment Officer, a Chief Financial Officer and such assistant Officers as the
Chief Executive Officer may determine from time to time.
Section 3. [rn The Initial Chief Executive Officer shall not be subject
to a term limit hereunder. Successor Chief Executive Officers shall serve for such term as a
majority of the Members shall determine from time to time, or if there are no Members, as a
majority of Directors shall determine from time to time. Chief Administrative Officers and such
other Officers or assistant Officers (as determined by the Chief Executive Officer) shall serve for
such term as the Chief Executive Officer shall determine from time to time.
Section 4. Chief Executive Officer
a. The Chief Executive Officer shall have general executive
charge management and control of the properties and operations of the Foundation in the
ordinary course of its business, with all such powers with respect to such properties and
operations as may be reasonably incident to such responsibilities. The Chief Executive Officer
shall preside at all meetings of the Board in the absence of the Chairperson of the Board. The
Chief Executive Officer shall keep the Board fully informed and shall consult with the Board
concerning the business of the Foundation. Notwithstanding the foregoing, the Chief Executive
Officer shall have such authority and perform such duties in the management of the Foundation
as are provided in these Bylaws or as may be determined by resolution of the Board, where such
resolution is not inconsistent with these Bylaws.
b. In addition to those powers conferred in the paragraph
above, the Initial Chief Executive Officer shall have the power to make and receive grants on
behalf of the Foundation. The Initial Chief Executive Officer may execute, make, verify,
acknowledge, deliver, file and record any and all certificates, instruments, agreements and
documents and take any and all other actions as may be necessary or desirable in the Initial Chief
Executive Officer's judgment in order to carry out the making and receiving of such grants.
Section 5. Chief Administrative Officer The Chief Administrative
Officer shall keep the minutes of meetings of the Board and Members, shall have the custody of
the seal of the Foundation, and shall affix the seal to documents when authorized to do so. The
Chief Administrative Officer shall perform all duties customary to the office of secretary and
7449760.4 13
such other duties as may be determined from time to time by resolution of the Board, where such
resolution is not inconsistent with these Bylaws.
Section 6. Chief Investment Officer If appointed pursuant to Section 2 of
this Article, the Chief Investment Officer shall (i) have the care and custody of the portfolio of
assets of the Foundation and shall manage and monitor such assets as is in the best interests of
the Foundation, (ii) consult with the Investment Committee as to the management of such assets,
and (iii) shall be responsible for such other duties as may be determined from time to time by
resolution of the Board, where such resolution is not inconsistent with these Bylaws.
Section 7. Chief Financial Officer If appointed pursuant to Section 2 of
this Article, the Chief Financial Officer shall be responsible for the financial planning and record
keeping of the Foundation and such other duties as may be determined from time to time by
resolution of the Board, where such resolution is not inconsistent with these Bylaws.
Section 8. Removal The Chief Executive Officer shall have the power to
remove subordinate Officers, agents and employees with or without cause. Notwithstanding the
foregoing, any Officer, agent or employee may be removed at anytime, with or without cause, by
vote of two-thirds of the Directors at an Annual Meeting of the Board or at a special meeting of
the Board called for that purpose.
Section 9. Vacancies
a. i.In the event any office (other than the Chief
Executive Office) of the Foundation (A) has been filled by the Chief Executive Officer pursuant
to Section 2 of this Article, and (B) subsequently becomes vacant by reason of death, resignation,
disqualification, removal or for any other cause, the Chief Executive Officer shall have the
power to appoint an individual to fill such vacancy, and the individual so elected shall hold
office and serve until the regular election and qualification of a successor.
ii. Notwithstanding the foregoing, if the office of the Chief
Administrative Officer becomes vacant and the Chief Executive Officer shall fail to appoint an
individual to fill such vacancy within sixty (60) days of the date on which the office became
vacant (or waives his or her power to appoint within the sixty (60) day period), or if there is no
Chief Executive Officer, a majority of the Members, or if there are no Members, a majority of
the Directors may elect an individual to fill such vacancy, and the individual so elected shall hold
office and serve until the regular election and qualification of a successor.
b. If the office of the Chief Executive Officer becomes vacant
by reason of death, resignation, disqualification, removal or for any other cause, a majority of the
Members, or if there are no Members, a majority of Directors, may elect an individual to fill such
vacancy, and the individual so elected shall hold office and serve until the regular election and
qualification of a successor.
Section 10. Compensation of Officers, Employees and Agents The
Officers, employees, agents and representatives of the Foundation may be reimbursed for all of
their direct expenses in serving the Foundation and, in addition, shall be reasonably compensated
for personal services that are reasonable and necessary to carry out the exempt purposes of the
7449760.4 14
I
I
HE
1 9
Foundation. Said reimbursements and compensation shall be approved by a majority of the
Members, or if there are no Members, by a majority of the Directors, taking into consideration
the requirements of Section 4941(d)(2)(E) and (G) of the Code, and the Treasury Regulations
promulgated thereunder. Said compensation shall be consistent with (i) the compensation
received by the Officers, employees, agents and representatives of other large national
foundations providing similar services, (ii) current compensation surveys compiled by
independent firms or (iii) actual written offers from similarly situated organizations.
Notwithstanding anything herein, no Officer shall participate (in any capacity) in a vote on
matters pertaining to his or her compensation or reimbursement,
ARTICLE V
Indemnification
Section 1. Non-derivative Action The Foundation may, to the fullest
extent now or hereafter permitted by law, indemnify any person made, or threatened to be made,
a party to any action or proceeding, whether civil, criminal, administrative or investigative (a
"proceeding"), by reason of the fact that he or she, or a person for whom he or she is the legal
representative, was a Director, Officer, employee, agent or representative of the Foundation, or is
or was serving at the request of the Foundation as a Director, Officer, employee, agent or
representative of another corporation or of a partnership, joint venture, trust, enterprise or non-
profit entity, including service with respect to employee benefit plans, against judgments, tines,
amounts paid in settlement and reasonable expenses, including attorneys' fees reasonably
incurred by such person, if such person acted in good faith for a purpose he or she believed to be
in, or in the case of service for any other corporation or any partnership, joint venture, trust,
enterprise, non-profit entity or employee benefit plan, not opposed to, the best interests of the
Foundation, and, with respect to a criminal action or proceeding, had no reasonable cause to
believe his or her conduct was unlawful. The termination of any action, suit or proceeding by
judgment, order, settlement, conviction, or upon a plea of nolo contendere or its equivalent, shall
not, of itself, create a presumption that the person did not act in good faith and in a manner that
the person reasonably believed to be in or not opposed to the best interests of the Foundation,
and, with respect to any criminal action or proceeding, had reasonable cause to believe that the
person's conduct was unlawful. The Foundation may indemnify a person in connection with a
proceeding (or part thereof) initiated by such person only if the commencement of such
proceeding (or the applicable part thereof) was authorized in advanced by the Board.
Section 2. Derivative Action The Foundation may, to the fullest extent
now or hereafter permitted by law, indemnify any person made, or threatened to be made, a party
to any suit, action or proceeding by or in the right of the Foundation to procure ajudgment in its
favor by reason of the fact that he or she, or a person for whom he or she is the legal
representative, was a Member, Director, Officer, employee, agent or representative of the
Foundation, or is or was serving at the request of the Foundation as a Director, Officer,
employee, agent or representative of another corporation or of a partnership, joint venture, trust,
enterprise or non-profit entity, including service with respect to employee benefit plans, against
expenses, including attorneys' fees, actually and reasonably incurred by the person in connection
with the defense or settlement of such action or suit if the person acted in good faith and in a
manner the person reasonably believed to be in or not opposed to the best interest of the
Foundation and except that no indemnification shall be made in respect of any claim, issue or
7449 760.4
15
matter as to which such person shall have been adjudged to be liable to the Foundation unless
and only to the extent that the Delaware Court of Chancery or the court in which such action or
suit was brought shall determine upon application that despite the adjudication of liability but in
view of all the circumstances of the case, such person is fairly and reasonably entitled to
indemnity for such expenses which the Delaware Court of Chancery or such other court shall
deem proper.
Section 3. Limitation The Foundation shall not indemnify anyone if
doing so would constitute an act of self-dealing within the meaning of Section 4941 of the Code,
or the Treasury Regulations promulgated thereunder.
ARTICLE VI
Contracts, Funds, Checks and Investments
Section 1. Cheeks, Notes and Contracts The Initial Chief Executive
Officer has the authority, in the name of and on behalf of the Foundation, to enter into any
contract or to execute and deliver any instrument, or to sign checks, drafts or other orders for the
payment of money or notes or other evidences of indebtedness, including establishing margin
accounts with securities firms. Notwithstanding the foregoing, the Board may authorize any
Officer or Officers, in the name of and on behalf of the Foundation, to enter into any contract or
to execute and deliver any instrument, or to sign checks, drafts or other orders for the payment of
money or notes or other evidences of indebtedness, including establishing margin accounts with
securities firms, and such authority may be general or confined to specific instances. Unless so
authorized by these Bylaws or the Board, no Officer shall have the power or authority to bind the
Foundation by any contract or engagement or to render it pecuniarily liable for any purpose or to
any amount, with any other institution or firm, corporation or individual.
Section 2. Depositories of Funds All funds of the Foundation not
otherwise employed shall be deposited from time to time to the credit of the Foundation in such
banks, trust companies or other depositories as the Board may select, or as may be selected by
any Officer or Officers of the Foundation to whom such power may from time to time be
delegated by the Board.
Section 3. Investments The funds of the Foundation may be retained part
in cash or may be invested and reinvested from time to time in such property, real, personal or
otherwise, including stocks, bonds or other securities, as the Board may deem desirable.
Section 4. Stock of Other Corporations Unless otherwise determined by
the Board, the Chief Executive Officer shall have full power and authority on behalf of the
Foundation to vote, either in person or by proxy, at any meetings of stockholders of any
corporation in which the Foundation may hold stock and at any such meeting may possess and
exercise any and all rights and powers incident to the ownership of such stock, which, as the
owner thereof, the Foundation may have possessed and exercised if present. The Board may
confer like powers upon any person or persons from time to time and may revoke any such
power as granted at its pleasure.
7449760.4 16
ARTICLE VII
Fiscal Year
The fiscal year of the Foundation ends on December 31st of each calendar
year.
ARTICLE VIII
Seal
The seal of the Foundation shall be circular in form and shall bear the
name of the Foundation and the year of its organization.
ARTICLE IX
Notices and Waivers
Section 1. Notice of Meetings
a. Whenever under the provisions of these Bylaws, the
Certificate of Incorporation or any statute, notice is required to be given to any Director or
Officer, it shall be given personally or by first-class mail, facsimile or electronic transmission, if
the Director or Officer has consented to receipt by such method, addressed to such Director or
Officer at such address as appears on the records of the Foundation or at such other address as
the Director or Officer may have filed with the Chief Administrative Officer for such purpose. If
mailed, such notice shall be deemed to have been given for such purpose when deposited in the
United States mail, with postage thereon prepaid, directed to the Director or Officer at his or her
address as it appears on the records of the Foundation or at such other address as he or she may
have filed with the Chief Administrative Officer for such purpose. If sent by facsimile or
electronic transmission, such notice shall be deemed to have been given for such purpose when
directed to the electronic mail address or facsimile number at which the Director or Officer has
consented to receive notice. Notice of a special meeting shall state the purpose for which it is
called and shall indicate that it is being issued by or at the direction of the person(s) calling the
meeting.
b. When a meeting is adjourned to another time or place, it
shall not be necessary to give any notice of the adjourned meeting if the time and place to which
the meeting is adjourned are announced at the meeting at which the adjournment is taken, and at
the adjourned meeting any business may be transacted that might have been transacted on the
original date of the meeting.
Section 2. Waivers of Notice Any Member, Director or Officer may at
any time (whether before or after the meeting or other event requiring notice) waive any notice
required to be given by law, the Certificate of Incorporation or these Bylaws. Notice of a
meeting need not be given to any Member, Director or Officer who submits a waiver signed or
given by telegraph, cable or electronic transmission, whether before or after the meeting. The
attendance of any Member, Director or Officer at a meeting, in person or by proxy, without
protesting the lack of notice prior to the conclusion of the meeting shall constitute a waiver of
notice by said person.
7449760.4 17
Section 3. Use of Electronic Transmission The Foundation is authorized
to use "electronic transmission" as defined in the GCLD to the full extent allowed by the GCLD
including, but not limited to, the purposes of notices (to the extent that the recipient of any such
notice has consented to receive such notice by electronic transmission), proxies, waivers,
resignations and any other purpose for which electronic transmissions are permitted by the
GCLD.
ARTICLE X
Amendments
These Bylaws may be amended, altered or repealed at any meeting of the
Members by a vote of a majority of all the Members, or they may be amended, altered or
repealed by the written consent of all the Members without a meeting. If there are no Members,
these Bylaws may be amended, altered or repealed at any meeting of the Board by a vote of two-
thirds of all the Directors, or they may be amended, altered or repealed by the written consent of
all the Directors without a meeting. Notwithstanding the foregoing, Sections 5 and 17 of Article
III and this Article X may not be amended by the Directors.
ARTICLE XI
Winding Down
If, for any reason, it shall be in the best interests of the Foundation to
dissolve, such dissolution shall occur pursuant to Section 276 of the GCLD and Article TENTH
of the Certificate of Incorporation. The net assets of the Foundation shall be distributed in
accordance with said Article TENTH.
7449760.4
18
L l
F.990-T
Exempt Organization Business Income Tax Return

lDapartment of the Treasury
(and proxy tax under section 6033(e))

calendar year 2012 or other tax year beginning ,and ending

ALi Check box if
Name of organization ( L...J Check box if name changed and see Instructions.)
I
address changed
B Exempt under section Print THE BLOOMBERG FAMILY FOUNDATION INC
EJ
501(c )( 3 )or Number, street, and room or suite no. If a P.O. box, see Instructions.
[:]408(e) []220(e) Type
GELLER &CO, 909THIRD AVE. NO. 16FL

0408AL1530(a)City or town, state, and ZIP code
E529(a)NEWYORK, NY 10022
C Book value of all assets I F Group exemption number (see instructions)
at end of year
6Check organization typeLX] 501(c) corporationL..J 501(c) trustL_i 401(a) trust
(Employees' trust, see
Instructions.)
20-5602483
Unrelated business activity c
(See Instructions)
23000
L_.J Other trust
3,992, 454,698.
H Describe the organization's primary unrelated business activity. j o. UBTI FROM FLOWTHROUGH ACTIVITY.
I During the tax year, was the corporation a subsidiary in an affiliated group or a parent-subsidiary controlled group? ........ 1 0. UYesLX] No
lf'Yes,' enter the name and Identifying number of the parent corporation.
J The books are in care of DIANE GUBELLI, C/O GELLER & CO LLCleleohone number 01, 212-583-6000
or business
1 a Gross receipts or sales
b Less returns and allowancesc Balance
10
2 Cost of goods sold (Schedule A, line 7)
3 Gross profit Subtract line 2 from line ic
4 a Capital gain net income (attach Schedule D)
b Net gain (loss) (Form 4797, Part II, line 17) (attach Form 4797)...............
o Capital loss deduction for trusts
5 Income (loss) from partnerships and S corporations (attach statement)
6Rent Income (Schedule C)
7 Unrelated debt-financed income (Schedule E)
8 Interest, annuities, royalties, and rents from controlled organizations (Sch. F),.,
9 Investment income of a section 501(c)(7), (9), or (17) organization
(Schedule G)
9
10 Exploited exempt activity income (Schedule I)
11 Advertising income (Schedule J)
12 Other income (see instructions; attach statement)
13Total. Combine lines 3through 12.........................................................
1
13 1<1,264,174.I >
Part Ill Deductions Not Taken Elsewhere (see instructions for limitations on deductions)
(except for contributions, deductions must be directly connected with the unrelated business income)
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
Compensation of officers, directors, and trustees (Schedule K)
Salaries and wages
Repairs and maintenance
Bad debts
Interest (attach statement)
Taxes and licenses
Charitable contributions (see instructions for limitation rules)
Depreciation (attach Form 4562) .21
Less depreciation claimed on Schedule Aand elsewhere on return.22a
Depletion
Contributions to deferred compensation plans
Employee benefit programs
Excessexempt expenses (Schedule I) ........................................................................................................................
Excess readership costs (Schedule J) ........................................................................................................................
Other deductions (attach statement) ...........................................................................................................................
Total deductions. Add lines 14 through 28
Unrelated business taxable income before net operating loss deduction. Subtract line 29 from line 13 . ...................................
Net operating loss deduction (limited to the amount on line 30)
SAE S.T.TE.ME
Unrelated business taxable income before specific deduction. Subtract line 31 from line 30...........................................
Specific deduction (generally $1,000, but see instructions for exceptions)
Unrelated business taxable Income. Subtract line 33 from line 32. If line 33 is greater than line 32, enter the smaller
of zero or line 32
223701
01-11-13
LI-IAFor Paperwork Reduction Act Notice, see instructions.
22b
.>
1,264,174.
Form 990-T (2012)
56
17171111 737725 BLOOMF.AMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDABLOOMFA2
I//J)i$
/ Oat
Preparer's signature
& COMPANY LLC
AUTHOR I ZED SIGNER the preparer shown below (see
Title
instructions)?[]
Ye s 0N
DateCheckif PTIN
self-employed
It

P00445956
Firm's EIN 01 , 1 . 3 -
L &
Fonnti904(2012)
THE BLOOMBERG FAMILY FOUNDAT
INC
20- 5602483 Page 2

35 Organizations taxable as corporations (see instructions for tax computation).
Controlledgroup members (sections 1561 and1563) check hereSee instructions and:
aEnter your share of the $50,000,$25,000, and$9,925,000taxable income brackets (in that order):
(1)
1$I
(2)
1$I
(8)
1$I
b Enter organization's share of (1) Additional 5% tax (not more than $11,750)
[ $I
(2) Additional 3% tax (not more than $100,000)
IsI
c Income tax on the amount on line 34
36 Trusts taxable at trust rates (see instructions for tax computation). Income tax on the amount on line 34 from:
Tax rate schedule orSchedule (Form1041)
37 Proxytax(see instructions)
38Alternative minimumtax.............................................................................................................................
39 Total. Addlines 37 and38 toline 35c or 36, whichever applies
Part IV I Tax and Payments
40aForeign tax credit (corporations attach Form1118; trusts attach Form1116)
T
.!.
b Other credits (see instructions)
I.
I; General business credit Attach Form3800.40c
If Credit for prior year minimumtax (attach Form8801 or 8827) .40d
e Total credits. Addlines 40athrough 40d
41 Subtract line 40e fromline 39
42 Other taxes. Check if from: Form4255Form-8611 c:i Form8697:1- F, Form8866 EJ Other (attach statement)
43 Total tax. Addlines 41 and42
44aPayments: A2011 overpayment creditedto2Ol2.44a225, 000.
b2012 estimatedtax payments ...................................................................................._________________
c Tax depositedwith Form8868 . ....44c
dForeign organizations: Tax paidor withheldat source (see instructions)
e Backup withholding (see instructions)
J44g
44e
Credit for small employer health insurance premiums (Attach Form8941)
g Other credits andpayments:Form2439
Form4136EJ Other ___________________ Total
45 Total payments. Addlines 44athrough 44g
46 Estimatedtax penalty(see instructions). Check if Form2220is attached
47 Tax due, if line 45 is less than the total of lines 43 and46, enter amount owed
48 Overpayment. If line 45 is larger than the total of lines 43 and46, enter amount overpaid
49 Enter the amount of line 48 you want Creditedto2013 estimatedtax 225 , 00 0
.1
Refunded
Part V
I Statements Regarding Certain Activities and Other Information (see instructions)
35c1
0.
36
451225. 000.
At anytime during the 2012 calendar year, didthe organization have an interest in or asignature or other authorityover afinancial account (bank,
securities, or other) in aforeign country? If 'Yes," the organization mayhave tofile FormTOF 90-22.1, Report of Foreign Bank andFinancial
Accounts. It 'Yes,' enter the name of the foreign countryhere 0, VARIOUS OUS
Duringthe tax year, did the organization receive a distribution from, or was It the Wanton 01, or translerar 10, it IoreIgl trust?
If Yes" see Instructions for other forms the organization may have to file. ..................................................................................................................
Enter the amount of tax-exempt interest receivedor accruedduring the tax year N o. $
iedule A - Cost of Goods Sold. Enter methodof inventoryvaluation bo. N/A
1 Inventoryat beginning of year 1 6 Inventoryat endof year .6
2 Purchases2 7 Cost of goods sold. Subtract line 6
3 Cost of labor3 fromline 5. Enter here andin Part I, line 27
4 aAdditional section 263A costs (att. statement)4a8 Dothe rules of section 263A (with respect to
b Other costs (attach statement).4b propertyproducedor acquiredfor resale) applyto
5 Total. Addlines 1 through 4b5
the organization
Under penalties of perjury, I declare that I have examined this return, Includingaccompanyingschedules and statements, and to the best of my knowledg
Sign
correct, and complete. Declaration of preparer (other than taxpayer) Is based on all Information of which preparer has any knowledge.
Here
Print/Type preparer's name
Paid
CHARLES POMO
Preparer
Use Only
Firms name ' GELL
Firm's address
no.21 2- 583 - 6000

223711 01-11-13
Form990- T (2012)
2
3
(es No
X
No
and belief, it Is true,
57
1 71 71 1 1 1 73 7725 BLOOMFANFND 201 2. 04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
[ A
R l
Form
8868
(Rev. January 2013)
internal Revenue Service
File a separate application for each return.
OMB No. 1545-1709
If you are filing for an Automatic 3-Month Extension, complete only Part land check this box
It you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part II (on page 2 of this form).
Do not complete Part // unless you have already been granted an automatic 3-month extension on a previously filed Form 8868.
Electronic filing
(e-file) . You can electronically file Form 8868 If you need a 3-month automatic extension of time to file (6 months for a corporation
visft wwwirs.gov/efile and click one-file for Chant/es & Nonprofits.
Automatic 3-M
of Time.
A corporation required to file Form 990T and requesting an automatic 6-month extension - check this box and complete
Part lonly
Ail other corpo,ations (including 1120-C filers), partnerships, REM/Cs,
and trusts must use Form 7004 to request an extension of time
Type or
print
File by the
due date for
filing your
return. See
instructions.
Name of exempt organization or other filer, see instructions.
C/O GELLER & CO, 909 THIRD AVE. NO. 16 FL
NEW YORK, NY 10022-
20- 5602483
Enter the Return cede for the return that this application is for (file a separate application for each return)
I
0
I 71
Application
Return Application
Return
Code Is For
Code
Form 990 or I
01Form 990-T(
Form 990-SL
02Form 1041-A
08
03Form 4720
09
Form 990-PF
04 1 Form 5227
Form 990-T (sec. 401(a) or 4
05Form 6069
11
Form 990-T (trust other than
06Form 8870
12
The books are in the care of 909
THIRD AVENUE, 16TH FL - NEW YORK, NY
10022
Tel ept- ioneNo.. 212583- 6000
FAXNo..- 2125836241
If this is for a Group Return, enter the organization's four digit Group Exemption Number (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 EIN5 of all members the extension is for.
1 I request an automatic 3-month (6 months for a corporation required to file Form 990-1) extension of time until
NOVEMBER 15, 2013
,to file the exempt organization return for the organization named above. The extension
is for the organization's return for
.I calendar year 2012 or
L] tax year beginning
, and ending
2 If the tax year entered in line 1 is for less than 12 months, check reason:
ED Initial returnEl Final return
[J Change in accounting period
3a
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.
3a
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. 3b
C
Balance due. Subtract line 3b from line 3a. Include your payment with this form, If required,
L i,
225,000.
by using EFTPS (Electronic Federal Tax Pa
y ment System). See Instructions.
I 3c
I $0
Caution. If you are going to make an electronic fund withdrawal with this Form 8868, see Form 8453
. E0 and Form 8879-EQ for payment instructions.
LI-IA For Privacy Act and Paperwork Reduction Act Notice, see instructions.
Form 8868 (Rev. 1-2013)
223841
01-21-13
13560509 737725 BLOOMFANFND
2012.03040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA1
1 9
)12)THE BLOOMBERG FAMILY
ION INC
20-5602483
P a u e 3
C - Rent Income (From Real Prop
1. Description of property
2. Rent received or accrued
From personal property (it the percentage of I
(b)
From real end personal property f the percentage
3 (a )
Deductions directly connected with the income in
rent for personal property is more then of rent for personal property exceeds 50% or it
columns 2(s) and 2(b) (attach statement)
10% but not more than 50%)
I
the rent is based on profit or Income)
Total
0
I
Total
(C) Tota l income. Add tota ls of columns 2(a ) a nd 2(b). Enter
here a nd on pa ge 1, Pa rt I, line 6, column (A)
Schedule E - Unrelated Debt-Financed Income
1. Description of debt-financed property
(b)Tota l deductions.
Enter here and on page 1,
0 . JPart l. line 6. column (B)0

ictions)
3 . Deductions directly connected with or allocable
2. Gross Income from
I
to debt-financed property
or allocable to debt-
I( a ) Straight line depreciationI(b) Other deductions
financed property
(attach statement)
I
(attach statement)
4, Amount of average acquisitIon5. Average adjusted basis6. Column 4 divided7. Gross Income8. Allocable deductions
debt on or allocable to debt-tinancedof or allocable toby column 5reportable (column(column 6 total of columns
property (attach statement)debt-financed property
2 x column 6)3(a) and 3(b))
(attach statement)
(1)
(2)
(3 )
(4)
Enter here and on page 1,Enter here and on page 1,
Part I, line 7, column (A).Part I, tee 7, column (B).

Tota ls ................................................................................. 0.0.
Tota l dividends-received deductions included in column 8 0
ichedule F - Interest, Annuities, Royalties, and Rents From Controlled Organizations (see instructions)
Exempt Controlled Orga niza tions
1. Name of controlled organization2.3 .4.5. Part of column 4 that is6. Deductions directly
Employer identificationNet unrelated IncomeTotal of specifiedIncluded In the controtlingconnected with Income
number(loss) (see Instructions)
I
payments madeorganization's gross Income in columns
ompt Controlled Orga niza tions
7.
Taxable Income8.
Net Unrelated income (loss)
9.
Total of specified payments10. Part of column 9 that is included11. Deductions directly connected
(see Instructions)madeIn the controlling organization's with Income in column 10

gross Income
Add columns 5 and 10.Add columns Sand it
Enter here and on page 1, Part I,Enter here and on page 1, Part I,
line 8, column (A).line 8, column (B).
Tota ls ..........................................................................................................................0. 0.
223721 01-11-13
Form 990.1(2012)
58
6. Expenses
attributable to
column 5
7. Excess exempt
expenses (column
6 minus column 5,
but not more than
column 4).
VV
Form990-T(2012) THE BL100MBERG FAMILY FOUNDATION INC 205602483
Page 4
Schedule G - Investment Income of a Section 501(c)(7),(9), or (17) Organization
(see instructions)
3. Deductions
1.
Description of Income2. Amount of income
I
directly connected
4. Set-asides
5.
Total et-asides
deductions
and S
-(attach statement) L _ ( A
statement)
1
- ( plus cot. 4)
rhere and onpage 1.
I, line 9, column (B).
0.
I Enterhere anti on page 1,
I Patti, toeS, column (A)
Totals .....................................................
0.j
Schedule I - Exploited Exempt Activity Income, Other Than Advertising Income
(see instructions)
2. Gross
I
. Expenses
4. Net income (toss)
directly connected
from unrelated trade or5. Gross Income
Description ofunrelated businessbusiness (column 2from activity that
Income from
with production
minus column 3). If ato not unrelated
I
exploded activityy
business income
gain, compute cots. 5business in
through 7.
come trade or business
of unrelated
(1)
Enter here and
on page 1,
Part II, line 26.
0.
Enter here and on
page 1, Part I,
tine 10, col. (A).
ota)s 0.
Schedule J - Advertising Income (see
Part I I Income From Periodicals Re
nter here and on
page 1, Part I,
line 10, cot. (B).
0.
on a
4. Advertising gain7. Excess readership
2. Gross
3. Director (loss) (cot. 2 minus5. Circulation6. Readershipcosts (column 6 minus
1. Name of periodical
advertising
advertising costscot. 3). Ifs gain, computeIncomecostscolumn 5, but not more
income
cots. 5 through 7.than column 4).
(2)
(3)
(4) J0 .Totals (cai' ryto Part II, line (5)) 0. 0.
I
Part II I Income From Periodicals Reported on a Separate Basis (For each periodical listed in Part II, fill in
columns 2 through 7 on a line-by-line basis.
4. Advertising gain I
II i . Excess readership
2. Gross
3. Director (loss) (Cot. 2 minus I
5. CirculuttonI
6. ReadershipI costs (columnS minus
1. Name of
advertisings
I
dvesiog costsccl. 3). if a gain, compute Iincomecoats
I column 5, but not more
income
cola. 5 through 7.
IiI
than column 4).
Totals from Part I
Part I) (lines 1-5)
dule K - Compensat
1. Name
, .
inter here and onEnter hare and on
page 1, Part I,page 1, Part
line it, cot. (A). line ii, cot. (B).
0.0.
istees (see Instructions)
3 Percent of
2. TItle
time denoted to
business
on page 1,
Pail II, tine 27.
0.
4. Compensation attributable
to unrelated business
Total. Enter here and on page 1, Part Ii, line 14
I
U
Form 990-T (2012)
223731
01-11-13
59
17171111 737725 BLOOMFAMFND 2012. 04040 THE BIJOOMBERG FAMILY FOUNDA BLOOMFA2
LOSS
REMAINING
0 .
334,434.
1,670 ,140 .
2,0 0 4,574.
AVAILABLE
THIS YEAR
0 .
334,434.
1,670 ,140 .
2,0 0 4,574.
TIRE BLOONBERG FAMILY (JNDATION INC
20 -560 2483
FORM 990 -TINCOME (LOSS) FROM PARTNERSHIPS STATEMENT 18
DESCRIPTION
AMOUNT
<2,0 0 7,762. >

WILiLETT SELECT INVESTORS (TAX EXEMPT) I LP
363,154.
TOTAL TO FORM 990 -T, PAGE 1, LINE 5
<1,644,60 8. >
FORM 990 -PNET OPERATING LOSS DEDUCTIONSTATEMENT 19
LOSS
PREVIOUSLY
TAX YEARLOSS SUSTAINED APPLIED
12/31/0 8186,525. 186,525.
12/31/0 9613,334. 278,90 0 .
12/31/10 1,670 ,140 . 0 .
NOli CARRYOVER AVAILABLE THIS YEAR
60 STATEMENT(S) 18, 19
17171111 737725 BLOOMFAMFND 20 12. 0 40 40 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
Attach to Form 1120, 1
1120-ND, 1120-13C, 1120-P
Information about Schedule D
SCHEDULE D
(Form 1120)
Name
Gains and Losses
120-F, 1120-FSC, 1120-H, 1120-IC-D
REIT1120-RIC, 1120-SF, or certain
0) and'its se p arate Instructions Is atwww.
OMB No. 1545-0123
l
ns 990-T.
I
iv/formlllO.
2012
I
Emp loyer identification number
THE
FAMILY FOUNDATI
0-5602483
I
Part I I snort- I erm capitai uains ana Losses - Assets iieia une Year or tess
omp iete Form 8949 before comp leting line 1
,d) PIOCendS (sales price)(e) Cost or other basis from(g) Adjustments to gain
or 3. This form may be easier to comp lete If youfrom Form(s) 8949, Part I,Form(s) 8949, Part I, or toss from Form(s) 8949,
round off cents to whole dollars.line 2, column (d)tine 2. column (e)Part I, line 2, column (g)
1 Short-term totals from all Forms 8949 with
boxA checked in Part I
boxBchecked in Part I
boxC checked in Part I
4 Short-term cap ital gain from installment sales from Form 6252, line 26 or 37
5 Short-term cap ital gain or (loss) from like-kind exchanges from Form 8824
6 Unused cap ital loss carryover (attach comp utation) .................................... ............... SEE STATEMENT 20
7 Net short-term cap ital gain or (loss). Combine lines 1 through 6 in column h
I Part II I Long
.
-Term Capital Gains and Losses - Assets Held More Than One Year
Comp lete Form 8949 bfore comp leting line
Id) Proceeds(sales price) (e) Cost or other basIs from(9)
Adjustments to gain
or 10. This form maybe easier to comp lete if Y OU from Form(s) 8949, Pert ii, Form(s) 8949, Part II,or loss from Form(s) 8949,
round off cents to whole dollars.line 4, column (d)-line 4, column (e)Part ii, line 4, column (g)
8 Long-term totals from all Forms 8949 with
boxA checked in Part II ................... ____________________________
9 Long-term totals from all Forms 8949 with
boxBcheckedinPart II ........................ ______________________
10 Long-term totals from all Forms 8949w,
boxC checked in Part II ................... ____________________________
11 Enter gain from Form 4797, line 7 or 9.-
12 Long-term cap ital gain from installment sales from Form 6252, line 26 or 37 .-
13 Long-term cap ital gain or (loss) from like-kind exchanges from Form 8824.-
14 Cap ital gain distributions
15 Net long-term cap ital gain or (loss). Combine lines 8through 14In column h ___________________________________________________________________-
Part Ill I Summary of Parts I and II -
16 Enter excess of net short-term cap ital gain (line 7) over net long-term cap ital loss (line 15)
17 Net cap ital gain. Enter excess of net long-term cap ital gain (line 15) over net short-term cap ital loss (line 7)
18 Add lines 16 and 17. Enter here and on Form 1120, p age 1, line 8, or the p rop er line on other returns
Note. If losses exceed gains, see Cap ital losses in the instructions.
Gain or doss). Subtract
in (e) from column (d) and
the result with column (g)
1,119,815.
Gain or doss). Subtract
n (e) from column (d) and
the result with column (g)
JWAFor Pap erworkReduction Act Notice, see the Instructions for Form 1120. Schedule D (Form 1120) (2012)
221052
01-03-13
61
17171111 737725 BLOONFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
E A
Sales and Other Dispositions of Capital A ssets
Information about Form 8949 and its separate instructions is at
www.irs.gov1form8949.
File with yourSchedule D to list your transactions for lines 1,2,3,8,9, and 10 of Schedule D.
OMB No. 1 5450074
2 0 1 2
Attachment
Sequence No.l 2A
8 9 4 9
Department of thaTreasury
Name(s) shown on return
Social security number or

(taxpayer identification no.
I
20-5602483
Most brokers Issue their own substitute statement Instead of using Form 1099. 8. They also may provide basis information (usually your cost) to you on the statement even If it is not reported to the IRS.
Before you check Box A B, or C below, determine whether you received any statement(s) and, If so, the transactions for which basis was reported to the IRS. Brokers are required to report basis to the
IRS for most stock you bought In 2011 or later.
Part I I Short-Term. Transactions Involving capital assets you held one year or less are short-term. For long-tern' transactions, see page 2.
You
must
check Box A, B,
or
C below. Check only one box. If more than one box applies for your short-term transactions, complete a separate Form
8949, page 1, for each applicable box. If you have more short-term transactions than will fit on this page for one or more of the boxes, complete as
many forms with the same box checked as you need.
E (A) Short-term transactions reported on Form(s) 1099-B showing basis was reported to the IRS
[XI (B) Short-term transactions reported on Form(s) 1099-8 showing basis was not reported to the IRS
(C) Short-term transactions not reported to you on Form 1099-B
(a)(b)(c)(d)(e}
Adjustment, if any, to gain or
(h) I
loss. If you enter an amount
Description of propertyDate acquired Date sold or
Proceeds
Cost or other in column (g\ enter a code in Gain or (loss).
(Example: 100 sh. XYZ Co.)(Mo., day, yr.)disposed
(sales price)
basis. See the column . ee instructions. Subtract column (e)
Note below andfrom column (d) and
(Mo., day, yr.)
see Column (e) in
(1)I(g) of
combine the result
the instructions Cede(s)
ijustment
with column (g)
FROM Ki - WILLET'] I
1,115 42O.
2 Totals. Add the amounts in columns (d), (e), (g) and (h) (subtrai
negative amounts). Enter each total here and include on your
Schedule D, line 1 (if Box A above is checked), line 2 (if Box B
is
1,119,815.
Note. If you checked Box A above but the basis reported to the IRS was incorrect, enter in column (e) the basis as reported to the IRS, and enter an
adjustment in column (a) to correct the basis. See Column (g) in the separate instructions for how to figure the amount of the adjustment.
223011 01-02-13 LHA For Paperwork Reduction Act Notice, see separate Instructions. Form 8949 (2012)
62
H 1 1 1

^ 1
Form
2220
Underpayment of Estimated Tax by Corporations
Attach to the corporation's tax return.FORM990-P
Information about Form 2220 and its se p arate instructions is atwww.lrs.aov/form222O.
OMBNo. 1545-0142
2012
Name
Employer identification number

20-5602483
Note: Generally, the corporation is not required to file Form 2220 (see Part II below for exceptions) because the IRS will figure any penalty owed and bill the
corporation. However, the corporation may still use Form 2220 to figure the penalty. If so, enter the amount from page 2, line 38 on the estimated tax
penalty line of the corporations income tax return, but do not attach Form 2220.
1 Total tax (see Instructions)...................................................................................................................
2 a Personal holding company tax (Schedule PH (Form 1 1 20), line 26) included on line 1
2a
b Look-back interest included on line 1 under section 460(b)(2) for completed long-term
contracts or section 1 67(g) for depreciation under the income forecast method
2b
o Credit for federal tax paid on fuels (see instructions) ............................................2c
I
d Total. Add lines 2a through 2c .....................................................................................................................2d
Subtract line 2d from line 1 . If the result is less than $500, do not complete or file this form. The corporation
does not owe the penalty........................................................................................................................................3
Enter the tax shown on the corporations 201 1 income tax return (see instructions). Caution: If the tax is zero
or the tax year was for less than 1 2 months, skip this line and enter the amountfrom line 3 on line 5 .4
5 Required annual payment. Enter the smaller of line 3 or line 4. If the corporation is required to skip line 4,
I
Part I I I Reasons for Filing . Check the boxes below that apply. If any boxes are checked, the corporation mustfile Form 2220
even if ft does not owe a penalty (see instructions).
6 L.....J The corporation is using the adjusted seasonal Installment method.
7 El The corporation is using the annualized income installment method.
8 LI J The corporation is large corporation figuring its first required installment based on the prior years tax.
9 Installment due dates. Enter in columns (a) through
(d) the 1 5th day of the 4th (Form 990-PF filers:
Use 5th month), 6th, 9th, and 1 2th months of the
corporation's tax year ................................................
1 0 Required installments, lithe box on line 6 and/or line 7
above is checked, enter the amounts from Sch A, line 38. If
the box on line 8 (but not 6 or 7) is checked, see instructions
for the amounts to enter. If none of these boxes are checked,
enter 25% of line 5 above in each column.
1 1 Estimated tax paid or credited for each period (see
instructions). For column (a) only, enter the amount
from line 1 1 on line 1 5
Complete lines 1 2 through 1 8 of one column before
going to the next column.
1 2 Enter amount, if any, from line 1 8 of the preceding column
1 3 Add lines 1 1 and 1 2
1 4 Add amounts on lines 1 6 and 1 7 of the preceding column
1 5 Subtract line 1 4 from line 1 3. If zero or less, enter -0-
1 6 If the amount on line 1 5 is zero, subtract line 1 3 from line
1 4. Otherwise, enter -0-
1 7 Underpayment. If line 1 5 Is less than or equal to line 1 0,
subtract line 1 5 from line 1 0. Then go to line 1 2 of the next
column. Otherwise, go to line 1 8 .................................
1 8 Overpayment. If line 1 0 is less than line 1 5, subtract line 1 0
from line 1 5. Then co to line 1 2 of the next column .........
Go to Part IV an page 2 to figure the penalty. Do not go to Part IV if there are no entries on line 1 7-no penalty is owed.
JWAFor Paperwork Reduction Act Notice, see separate instructions. Form 2220(201 2)
212501
12-11-12
1 1
1 2
1 3
1 4
1 5
1 6
1 7
1 8
62.1
17171111 737725 BLOOMFNFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
FORM 990-P
Form 2220 (2012)THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483
Page 2
I Part IV I Figuring the Penalty
19 Enter the date of payment or the 15th day of the 3rd month
after the close of the tax year, whichever is earlier (see
instructions). (Form 990-PF and Form 990-1 filers: Use 5th
month instead of 3rd month.).19
20 Number of days from duedateof installment online9 to the
dateshown on Onel9.................................................... 20
21 Number of days online20 after 4/15/2012 and before 7/1/2012 ......
22 Underpayment on line170 Number of days online21 x3%
366
23 Number of days online20 after 06/30/2012 and before10/1/2012 ..
24 Underpayment on line17 x Number of days on line23 x 3% 24
Mr
25 Number of days on line20 after 913012012 and before1/1/2013
I
25
26 Underpayment online170 Number of days online25x 3%
366
27 Number of days online20 after 12/31/2012 and before411/2013127
28Underpayment on One17 tc Number of days on line27 x 3%
3b5
29 Number of days online20 after 3/3lf2Ol3 and baforo7/1/2013
I
29
30 Underpayment on line17x Number of days online29 x %.30
3b5
31 Number of days online20 after 6/30/2ol3 and before10/0112013131
32 Underpayment online170 Number of days online31 x %.32
365
33 Number of days online20 after 9/30/2013 and before111/2014 ......
34 Underpayment on line17 x Number of days on line33x %
365
35 Number of days online20 after 12/31/2013 and before2/16/2014135
36 Underpayment online170 Number of days online35 x % ......... .36
365
37 Add lines 22. 24, 26, 28. 30, 32, 34, and 36
LZ
38Penalty. Add columns (a) through (d) of line 37. Enter the total here and on Form 1120; line 33;
or the comparable line for other income tax returns
0.
* Use the penalty interest rate for each calendar quarter, which the I RS will determine during the first month in the preceding quarter.
These rates are published quarterly in an I RS News Release and in a revenue ruling in the I nternal Revenue Bulletin. To obtain this
information on the I nternet, access the I RS website at wwwirs.gov
. You can also call 1-800-829-4933 to get interest rate I nformation.
JWA
Form 2220 (2012)
212802
12-11-12
62. 2
17171111 737725 BLOOMFAMFND 2012. 04040 THE ELOOMBERG FAMILY FO1JNDA BLOOMFA2
THE BLOOMBERG FAMILY W U N D A T I O N I N C
2 0 - 5 6 0 2 4 8 3
SCHEDULE DC A P I T A L LOSS CARRYOVERSTATEMENT 20
L O SS
O RI GI N A L
P REVI O U SL Y
L O SS
L O SS YEA R
L O SS SU ST A I N ED
A P P L I ED
REMA I N I N G
2 0 0 7
2 0 0 8
8 10 ,2 8 6
76 ,3 16
73 3 ,970
2 0 0 9
5 ,4 11
5 ,4 11
2 0 10
2 0 11
C A P I T A L L O SS C A RRYO VER T O C U RREN T T A XA BL E YEA R
73 9,3 8 1
6 3 ST A T EMEN T (S) 2 0
17171111 73 772 5 BL O O MFA N FN D 2 0 12 .0 4 0 4 0 T HE BL O O MBERG FA MI L Y FO U N D A BL O O MFA 2
S
S
N *
E f
Form
8 6 2 1 1
Information Return by a Shareholder of a Passive Foi
(Rev.December2Ol2)
Investment Company or Qualified Electing Fund
I
Inte,nai Revenue ServiceI nf ormation about Form 8621 and its se p arate instructions is at ,..... ;.... ;....o.',. -
OMB No. 1546-1002
Attachment-
Sequence No. 69
N ame of shareholder
N umber, street, and room or suite no. (I f a P.O. box, see instructions.)
C/O GELLER & CO. 909 THIRD AVE. NO. 16 FL
City or town, state, and ZI P code or country
NEW YORK, NY 10022
I dentif ying number (see instructions)
20-5602483
Shareholder tax year calendar year U 1 2
or other tax year beginning
Check type of shareholder f iling the return:L....J I ndividual LJ Corporation L.....J Partnership L......J S Corporation L......J N ongran
N ame of passive f oreign investment company (PFI C) or qualif ied electing f und (QE F)
E mployer identif ication number (if any)
ALPST.AR CLO 2 P.L.C.
Address (E nter number, street, city or town, and country.)
Ref erence I D number (see instructions)
5 HARBOURMASTER PLACE, INT'L FIN SVC CTR
DUBLIN 1 , IRELAND
Tax year of PFI C or QE F: calendar year
tax year beginning
ending
Part I Summary of Annual Information
Part I is reserved f or f uture use (see instructions).
Provide the f ollowing inf ormation with respect to all shares of the PFI C held by the shareholder:
1 Description of each class of shares held by the shareholder:
F Check if shares jointly owned with spouse.
2 Date shares acquired during the taxable year, if applicable:
3 N umber of shares held at the end of the taxable year:
4 Value of shares held at the end of the taxable year (check the appropriate box, I f applicable):
(a) LI I $0-50,000(b) E J $50,001-100,000(c) LI $100,001-150,000(d) LI $150,001-200,000
(e) I f more than $200000, list value:
5 Type of PFI C and amount of any excess distribution or gain treated as an excess distribution under section 1291, inclusion under section
1293, or inclusion or deduction under section 1296:
(a) LI Section 1291 $________________________
(b)Section 1293 (Qualif ied E lecting Fund) $________________________
(C)LI Section 1296 (Mark to Market) $________________________
or other
and
Part II Elections
(See instructions.)
A L.J E lection To Treat the PFI C as a QE F. 1,0 shareholder of a PFI C, elect to treat the PFI C as a QE F.
Complete lines 6a through 7c of Part II!.
BLI
E lection To E xtend Time For Payment of Tax. I , a shareholder of a QE F, elect to extend the time f or payment of tax on the undistributed earnings and prof its
of the QEF until this election is terminated. Completelines 8a through 9c of Part Ill to calculate the tax that may be deferred.
N ote: If any portion of line 6a or line 7a of Part
ill
is includible under section 951, you may 0f make this election. Also, see sections
1294(c) and 1294(0 and the related regulations for events that terminate this election.
C LI
E lection To Mark-to-Market PFI C Stock. I , a shareholder of a PFI C, elect to mark-to-market the PFI C stock that is marketable within the meaning of section
1296(e). Complete Part IV.
D LI
Deemed Sale E lection. I , a shareholder on the f irst day of a PFI Cs f irst tax year as a QE F, elect to recognize gain on the deemed sale of my interest in the
PFIC.Entergain or loss online 15f of Part V.
E LI
Deemed Dividend E lection. I , a shareholder on the f irst day of a PFI Cs f irst tax year as a QE F that is controlled f oreign corporation (CFC), elect to treat an
amount equal to my share of the post-1986 earnings and prof its of the CFC as an excess distribution.
Enter this amount on line 15e of Part V. If the
excess distribution is greater than zero, also complete line 16 of Part V.
F LI E lection To Recognize Gain on Deemed Sale of PFI C. I , a shareholder of a f ormer PFI C or a PFI C to which section 1297(d) applies, elect to treat as an excess
distribution the gain recognized on the deemed sale of my interest I n the PFI C on the last day of its last tax year as a PAC under section 1297(a).
Enter
gain on line 75f of Part V.
G E D
1.1297-3(a),
Dividend E lection With Respect to a Section 1297(e) PFI C. I , a shareholder of a section 1297(e) PFI C, within the meaning of Regulations section
1.1297.
3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFI C. My holding period I n the stock of the Section 1297(e)
PFI C includes the CFC qualif ication date, as def ined in Regulations section 1.1297-3(d).
Enter the excess distribution online 15e, Part V. If the excess
distribution is greater than zero, also complete line 16, Part V.
HE :1
elect
Dividend E lection With Respect to a Former PFI C. I , a shareholder of a f ormer PFI C, within the meaning of Regulations section 1.1298-3(a),
elect to make a deemed dividend election with respect to the f ormer PFI C. My holding period in the stock of the f ormer PFI C includes the termination date, as
defined in Regulations section 1.1298-3(d). Enter the excess distribution on line
15e, Part V. If the excess distribution is greater than zero, also
complete line 16, Part V.
01-2813I j-LA For Disclosure, Privacy Act, and Paperwork Reduction Act N otice, see separate instructions.
Form 8621 (Rev. 12-2012)
Ei

E A
Form 8621 (Rev. 12-2012)
Page 2
Part III Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines Ba through 7c. If you are making
Election B, also complete lines Ba through 9c. (See instructions.)
6 a Enter your pro rata share of the ordinary earnings of the QEF
I
68
I
Enter the portion of line Ba that is included in income under section 951 or that may be
excluded under section 1293(g)
I
6b
I
Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary Income ...................................................
7 a Enter your pro rata share of the total net capital gain of the QEF
I
7a
I
b Enter the portion of line 7a that is included In income under section 951 or that may be
I
lb
I
o Subtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule D
used for your income tax return. (See instructions.)
8 Add lines 6c and 7c ..........................................................................................................................................
b Enter the total amount of cash and the fair market value of other property distributed
or deemed distributed to you during the tax year of the QEF. (See instructions.)
._!!L.
Enter the portion of line 8a not already included in line 8c that Is attributable to shares
in the QEF that you disposed of, pledged, or otherwise transferred during the tax year Bc
d Add lines 8band Bc
e Subtract line 8d from line Ba, and enter the difference (if zero or less, enter amount in brackets)
Important:!!
line Be is greater than zero, and no portion of line 6a or 7a is includible in income under sec tion 951,
you may make Election B with respect to the amount online Be.
9 a Enter the total tax for the tax year (See Instructions.)
...2L
b Enter the total tax for the tax year determined without regard to the amount entered
on line 8e
9b
c Subtract line 9b from line 9a. This is the deferred tax, the time for payment of which Is extended by making
iecuun Is
......................................................................................................................................................
I
Part IVGain or (Loss) From Mark-to-Market Election (See
instructions.)-
lOa Enter the fair market value of your PFIC stock at the end of the tax year .........................................................................
.i!
b Enter your adjusted basis in the stock at the end of the tax year
c Subtract line lOb from line ba. If a gain, do not complete lines 11 and 12. Include this amount as ordinary income
on your tax return. If a loss, go to line 11 .
_j.
11 Enter any unreversed inclusions (as defined in section 1296(d)).
.J!
12 Enter the loss from line lOc, but only to the extent of unreversed inclusions on line 11. Include this amount as an ordinary
loss on your tax return
12
13 If you sold or otherwise disposed of any section 1296 stock (see instructions) during the tax year
a Enter the fair market value of the stock on the date of sale or disposition
b Enter the adjusted basis of the stock on the date of sale or disposition
.13b
c Subtract line 13b from line 13a. If a gain, do not complete line 14. Include this amount as ordinary income on your
tax return. If a loss, go to line 14
14a Enter any unreversed inclusions (as defined in section 1296(d))
b Enter the loss from line 13c, but only to the extent of unreversed inclusions on line 14a. Include this amount as an ordinary
loss on your tax return. If the loss on line 13c exceeds unreversed inclusions on line 14a, complete line 14c
.14b
c Enter the amount by which the loss on line 13c exceeds unreversed inclusions on line 14a. Include this amount on your tax
return according to the rules generally applicable for losses provided elsewhere in the Code and regulations
.
Note. See instructions in case of multiple dispositions.
Form 8621 (Rev. 12-2012)
6c
7c
8d
212612
01-29-13
L i
S
Form 8621 (Rev. 12-2012)
Page 3
Part V
Distributions From and Dispositions of Stock of a Section 1291 Fund(See
instructions.)
Complete aPart Vfor each excess distribution (see instructions).
15 a Enter your total distributions from the section 1291 fund during the current tax year with respect to the applicable stock. If the
holding period of the stock began in the current tax year, see instructions
b Enter the total distributions (reduced by the portions of such distributions that were excess distributions but not
Included In income under section 1291(a)(1)(13)) made by the fund with respect to the applicable stock for each of the 3 years
preceding the current tax year (or if shorter, the portion of the shareholders holding period before the current tax year)
o Divide line 15b by 3. (See instructions if the number of preceding tax years is less than 3.)
d Multiply line 15c by 125% (1.25)
e Subtract line 15d from line 15a. This amount, if more than zero, is the excess distribution with respect to the applicable stock.
If zero or less and you did not dispose of stock during the tax year, do not complete the rest of Part V. See instructions if you
received more than one distribution during the current tax year. Also, see instructions for rules for reporting a nonexcess
distribution on your income tax return
I Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund. If a gain,
complete line 16. If a loss, show it in brackets and do not complete line 16
16 a Attach a statement for each distribution and disposition. Show your holding period for each share of stock
or block of shares held. Allocate the excess distribution to each day in your holding period. Add all amounts
that are allocated to days in each tax year.
b Enter the total of the amounts determined In line 16a that are allocable to the current tax year and tax years
before the foreign corporation became a PFIC (pre-PFIC tax years). Enter these amounts on your income tax
return as other income
SEE STATEMENT 21
o Enter the aggregate increases in tax (before credits) for each tax year In your holding period
(other than the current tax year and pre-PFIC years). (See instructions.)
d Foreign tax credit. (See instructions.)
e Subtract line 16d from line 16c. Enter this amount on your income tax return as 'additional tax? (See instructions.)
Determine interest on each net increase in tax determined on line 16e using the rates and methods of section 6621.
15a1
39,421.
15e
39,421.
151
16b139,421.
- -
I..amount -----------------.--.- -----
Liner me ayyiojte OIIIUUIIL lit IllWISt H e r e . iee IDSUUCUOflS.) ....................................................................................
I
1611
Part VI
Status of Prior Year Section 1294 Elections and Termination of Section 1294 Elections
Complete a separate column for each outstanding election. Complete lines 25 and 26 only
if there Is partial termination of the section
1294 election.
17 Tax year of outstanding
election
18 Undistributed earnings to
which the election relates
19 Deferred tax
20 interest accrued on deferred
tax (tine 19) as of the filing date
21 Event terminating election
22 Earnings distributed or deemed
distributed during the tax year
23 Deferred tax due with this
return
24 Accrued interest due with
this return
25 Deferred tax outstanding after
Partial termination of election
26 Interest accrued after partial
termination of election ......
Form 8621 (Rev. 12-2012)
212613
01-29-13
1 9
Form
8 6 2 1 1
Information Return by a Shareholder of a Passive Foreig
lev.Dber2 a1 2 )
Depaument of theTreasury
tflte,n RevenueService Information about Form 8621 and Its separateInstructions Is at L V W W
i,nnvIf,,mR21
OMB No, 1 545.1 002
Attachment
SequenceNo.69
Nameof shareholder
Number, street and room orsuiteno.(If a P.O.box, seeinstructions.)
City ortown, state, and ZIP codeorcountry
NEW YORK, NY 10022
Check
thereturn:LJ Individual
Nameof passiveforeign investment company (PFIC) orqualified electing fund (QEF)
CORDATUS CLO I P.L.C.
Address (Enternumber, street, city ortown, and country.)
DUBLIN 1, IRELAND
i-'art ISummary of Annual Information
Part I is reserved forI
Providethefollowing information with respect to all shares of thePFIC held by theshareholder:
I Description of each class of shares held by theshareholder:
E l Check U shares Jointly owned with spouse.
2 Dateshares acquired during thetaxableyear, if applicable:
3 Numberof shares held at theend of thetaxableyear:
4 Valueof shares held at theend of thetaxableyear(check theappropriatebox, if applicable):
(a) il $0-50,000 (b) i::i $50,001 -1 00,000 (
c)
E l $1 00,001 -1 50,000
(e) If morethan $200,000, list value:
Identifying number(seeInstructions)
20-5602483
Shareholder tax year: calendar year2 0 1
2 or other tax year beginning
and ending
L_J S Corporation L .._J Non grantorTrust L.....J Estat
Employeridentification number(if any)
ReferenceIDnumber(seeinstructions)
Tax yearof PFIC orQEF: calendaryear
orother
tax yearbeginning
and
(d) E l $1 50,001 -200,000
5 Typeof PFIC and amount of any excess distribution orgain treated as an excess distribution undersection 1 29 1 , inclusion undersection
1 29 3, orinclusion ordeduction undersection 1 29 6:
(a) E l Section 1 29 1 $_______________________
(b) E l Section 1 29 3 (Qualified Electing Fund) $_________________________
(C) E l Section 1 29 6 (Mark to Market) $
Part II Elections (Seeinstructions.)
A L iElection To Treat thePFIC as a QEF.I, a shareholderof a PFIC, elect to treat thePFIC as a QEF.
Complete fines Ga through 7c of Part Ill.
B E l Election To Extend TimeForPayment of Tax.I, a shareholderof a QEF, elect to extend thetimeforpayment of tax on theundistributed earnings and profits
of theQEF until this election is terminated.
Complete lines Ba through 9c of Part Il/to calculate the tax that maybe deferred.
Note: If any portion of fine Ga or line 7a of Part Ill is includible under section 951, you may
0f make this election. Also, see sections
1294(c) and 1294(f) and the related regulations for events that terminate this election.
C E l
Election To Mark-to-Market PFIC Stock.I, a shareholderof a PFIC, elect to mark-to-market thePFIC stock that is marketablewithin themeaning of section
DE l Deemed SaleElection.I, a shareholderon thefirst day of a PFICs first tax yearas a QEF, elect to recognizegain on thedeemed saleof my interest in the
PFIC. Enter gain or loss on fine 15f of Part V.
E E l
Deemed Dividend Election.I, a shareholderon thefirst day of a PFIC's first tax yearas a QEF that is a controlled foreign corporation (CFC), elect to treat an
amount equal to my shareof thepost-1 9 86 earnings and profits of theCFO as an excess distribution.
Enter this amount on fine 15e of Part V. If the
F E l
Election To RecognizeGain on Deemed Saleof PFIC.I, a shareholderof a formerPFIC ora PFIC to which section 1 29 7(d) applies, elect to treat as an excess
distribution thegain recognized on thedeemed saleof my interest in thePFIC on thelast day of its last tax yearas a PFIC undersection 1 29 7(a). Enter
gain on fine 15f of Part V.
E l
Deemed Dividend Election With Respect to a Section 1 29 7(e) PFIC.I, a shareholderof a section 1 29 7(e) PFIC, within themeaning of Regulations section
G
1 .1 29 7-3(a), elect to makea deemed dividend election with respect to theSection 1 29 7(e) PFIC.My holding period in thestock of theSection 1 29 7(e)
PFIC includes theCFC qualification date, as defined in Regulations section 1 .1 29 7-3(d).
Enter the excess distribution on fine 15e, Part V. If the excess
distribution is greater than zero, also complete fine 16, Part V.
HE l
Deemed Dividend Election With Respect to a FormerPFIC.I, a shareholderof a formerPFIC, within themeaning of Regulations section 1 .1 29 8-3(a),
elect to makea deemed dividend election with respect to theformerPFIC.My holding period In thestock of theformerPFIC includes thetermination date, as
defined in Regulations section 1 .1 29 8-3(d).
Enterthe excess distribution on line 15e, Part V. If the excess distribution isgreaterthan zero, also
complete fine 16, Part V.
01 -29 -1 3 Li-IA ForDisclosure, Privacy Act, and Paperwork Reduction Act Notice, seeseparateinstructions.
Form 8621 (Rev.1 2-201 2)

Form 8621 (Rev. 122012)
Page 2
Part Ill Income From a Qualified Electing Fund (QEF).
All OF shareholders complete lines Ba through 7c. If you are making
Election B, also complete lines 8a through 9c. (See instructions.)
6 a Enter your pro rata share of the ordinary earnings of the aEF
I
6a
I
b Enter the portion of line 6a that is included in income under section 951 or that may be
I
6b
I
Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary income
...................................................
7 a Enter your pro rata share of the total net capital gain of the QEF.7a
I
Enter the portion of line 7a that Is included in income under section 951 or that may be
excluded under section 1293(g)[7b
CSubtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule D
used for your Income tax return. (See instructions.)
8 a Add lines 6c and 7c
..........................................................................................................................................
or deemed distributed to you during the tax year of the QEF. (See instructions.) .8b
c Enter the portion of line Ba not already included In line 8c that is attributable to shares
in the QEF that you disposed of, pledged, or otherwise transferred during the tax yearBc
d Add lines 8b and 8c
e Subtract line 8d from line Ba, and enter the difference (If zero or less, enter amount in brackets)
Important: If line 8e is greater than zero, and no portion of line Ga or 78 is includible In income under section 951,
you may make Election B with respect to the amount on line Be.ga
9 a Enter the total tax for the tax year (See instructions.)
on line Be
9b
c Subtract line 9b from line 9a. This Is the deterred tax, the time for payment of which is extended by making
or
ba Enter the fair market value of your PFIC stock at the end of the tax year
c Subtract line lOb from line lOa. If again, do not complete lines 11 and 12. Include this amount as ordinary income
on your tax return. If a loss, go to line 11
11 Enter any unreversed inclusions (as defined in section 1296(d))
13 It you sold or otherwise disposed of any section 1296 stock (see instructions) during the tax year
.13a
.13b
c Subtract line 13b from line 13a. It a gain, do not complete line 14. Include this amount as ordinary income on your
130
.
.i
.
Form 8621 (Rev. 12-2012)
6c
8d
212612
01-29-13
Form 8621 (Rev. 12-2012)
Page 3
Part VDistributions From and Dispositions of Stock of a Section 1291 Fund
(See instructions.)
Complete aspoarat, Part Vfor each excess distribution (see Instructions).
b Enter the total distributions (reduced by the portions 01 such distributions that were excess distributions but not
included in income under section 1291(a)(1)(8)) made by the fund with respect to the applicable stock for each of the 3 years
Divide line 15b by 3. (See instructions if the number of preceding tax years is less than 3.)
Subtract line 15d from line 15a. This amount, if more than zero, is the excess distribution with respect to the applicable stock.
Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund, If a gain,
b Enter the total of the amounts determined in line 16a that are allocable to the current tax year and tax years
SEE STATEMENT 22
c Enter the aggregate increases In tax (before credits) for each tax year in your holding period
e Subtract line 16d from line 16c. Enter this amount on your income tax return as 'additional tax.' (See instructions.)
I Determine interest on each net increase in tax determined on line 16e using the rates and methods of section 6621.
Enter the aooreoate amount of Interest here. (See instriir.tinnn'i
Part VI
Status of Prior Year Section 1294 Elections and Termination of Section
5
15b13,446.
1,431.
1511
1.
16c
Complete a separate column for each outstanding election. Complete fines 25 and 26 only if there is a partial termination of the section
1294 election.
election
19 Deterred tax
20 interest accrued on deferred
return
24Accrued interest due with
this return
partial termination of election
Form 8621 (Rev. 12-2012)
212613
01-29-13
1 7 A

^ 1 1
8 6 2 1 1
Information Return by a Shareholder of a Passive Foreign
(Rev. Decem 12)
I
Intetnat Revenue ServiceInformation about Form 8621 and its separate instructions is at
www irn nr,w1rnrmpp.1
OMB No. 1545-1002
Attachment
Sequence No. 69
Name of shareholder
Number, street, and room or suite no. (If a P.O. box, see instructions.)
C/O GELLER & CO. 909 THIRD AVE. NO. 16 FL
City or town, state, and ZIP code or country
NEWYORK, NY10022
Check type of shareholder filing the return:L.....J Individual
Name of passive foreign investment company (PFIC) or qualified electing fund (QEF)
CAIRN CLO I BV
Identifying number (see Instructions)
20-5602483
Shareholder tax year: calendar year4 U14
Employer identification number (if any)
Address (Enter number, street, city or town, and country.)
P.ARNASSUSTRN, LOCATELLIKADE1
1076 AZ AMSTERDAM, NETHERLANDS
of Annual
Reference ID number (see instructions)
Tax year of PFIC or QEF: calendar year
tax year beginning
for
or other
and
Provide the following information with respect to all shares of the PFIC held by the shareholder.
1 Description of each class of shares held by the shareholder
Check if shares jointly owned with spouse.
2 Date shares acquired during the taxable year, If applicable:
3 Number of shares held at the end of the taxable year:
4Value of shares held at the end of the taxable year (check the appropriate box, if applicable):
(a)$0-50,000(b)$50,001-100,000( C) $100,001-150,000
(e) If more than $200,000, list value:
(d)$150,001-200,000
5 Type of
PFIC and amount of any excess distribution or gain treated as an excess distribution under section 1291, inclusion under section
(a) EJ Section 1291
$_________________________
(b)Section 1293 (Qualified Electing Fund)
$_________________________
(c) LII] Section 1296 (Mark to Market) $
Part I I Elections (See instructions.)
A L.....] Election To Treat the PFIC as a DEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF.
Complete lines 6a through 7c of Part ill.
BLJ Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits
of the QEF until this election is terminated. Complete lines 8a through 9c of Part Ill to calculate the tax that may be deferred.
Note: If any portion of line 6a or line 7a of Part 1/1 is includible under section 951, you
maynot make this election. Also, see sections
1294(c) and 1294(l) and the related regulations for events that terminate this election.
C
Election To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-market the PFIC stock that is marketable within the meaning of section
1296(e). Complete Part /V.
DE1 Deemed Sale Election. I, a shareholder on the first day of a PFICs first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in the
PFIC. Enter gain or loss online 15f of Part V.
EDeemed Dividend Election. I, a shareholder on the first day of a PFIC's first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat an
amount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution.
FElection To Recognize Gain an Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excess
distribution the gain recognized on the deemed sale of my Interest in the PF1C on the last day of its last tax year as a PFIC under section 1297(a).
Enter
gain online 15f of Part V.
Deemed Dividend Election With Respect to a Section 1297(e) PFIC. I, a shareholder of a section 1297(e) PFIC, within the meaning of Regulations section
1.1297-3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period in the stock of the Section 1297(e)
PFIC includes the CFC qualification date, as defined in Regulations section 1.1297-3(d).
HLII
Deemed Dividend Election With Respect to a Former PFIC. I, a shareholder of a former PFIC, within the meaning of Regulations section 1.1298-3(a),
elect to make a deemed dividend election with respect to the former PFIC. My holding period In the stock of the former PFIC includes the termination date, as
defined in Regulations section 1.1298-3(d). Enter the excess distribution on
line 15e, Part V. If the excess distribution is greater than zero, also
01-29-13 LI-IA For Disclosure, Privacy Act, and Paperwork Reduction Mt Notice, see separate instructions.
Form 8621 (Rev. 12-2012)
t0
Form 8621 (Rev. 12-2012)
Page 2
All QEF shareholders complete lines 6a through 7c. If you are making
Election B, also complete lines Ba through 9c. (See instructions.)
I
6a
I -
b Enter the portion of line 6a that Is Included in Income under section 951 or that may be
I
6b
I
Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary income ...................................................
I
Ta
b Enter the portion of line 7a that is included In Income under section 951 or that may be
I
lb
I
CSubtract line lb from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule D
8 a Add lines 6c and 7c ..........................................................................................................................................
or deemed distributed to you during the tax year of the QEF. (See instructions.).8b
c Enter the portion of line Ba not already included in line Bc that is attributable to shares
in the QEF that you disposed of, pledged, or otherwise transferred during the tax year8c
e Subtract line Sd from line Be, and enter the difference (if zero or less, enter amount in brackets)
Important: If line Be
is greater than zero, and no portion of fine Ba or 7a is includible in income under section 951,
9 a Enter the total tax for the tax year (See Instructions.) .99
on line 8e
.9b
Subtract line 9b from line 9a. This is the deferred tax, the time for payment of which is extended by making
Election B
I IVGain or (Loss) From Mark-to-Market Election
(See instructions.'
iDa Enter the fair market value of your PFIC stock at the end of the tax year
iDa
lob
o Subtract line lOb from line lOa. If a gain, do not complete lines 11 and 12. Include this amount as ordinary income
100
11 11 Enter any unreversed inclusions (as defined in section 1296(d)) .
12 Enter the loss from line bc, but only to the extent of unreversed Inclusions on line 11. Include this amount as an ordinary
losson your tax return ......................................................................................................................................._________________________
13 If you sold or otherwise disposed of any section 1296 stock (see instructions) during the tax year:
.13a
b Enter the adjusted basis of the stock on the date of sale or disposition .
c Subtract line 13b from line 13a. If a gain, do not complete line 14. Include this amount as ordinary Income on your
.t3c
loss on your tax return. If the loss on line 13c exceeds unreversed Inclusions on line 14a, complete line 14c
.14b
.14c
Form 8621 (Rev. 12-2012)
8d
212612
01- 29- 13
Form 8621 (Rev. 12-2012)
Page 3
Part VDistributions From and Dispositions of Stock of a Section 1291 Fund(See
instructions.)
Complete a , 1 2 arat, .Part V for each excess distribution (see instructions).
holding period of the stock began In the current tax year, see instructions
Enter the total distributions (reduced by the portions of such distributions that were excess distributions but not
included in Income under section 1291(a)(1)(13)) made by the fund with respect to the applicable stock for each of the 3 years
preceding the current tax year (or if shorter, the portion of the shareholder's holding period before the current tax year)
Multiply line 15c by 125% (1.25)
received more than one distribution during the currenttax year. Also, see instructions for rules for reporting a nonexcess
Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund. If a gain,
SEE STATEMENT 23
Enter the aggregate increases in tax (before credits) for each tax year in your holding period
e Subtract line 16d from line 16c. Enter this amount on your income tax return as 'additional tax.' (See Instructions.)
4.. ..... III...' _4--II--
L uiwie UyIO-- yaLOOUUIII UI tIIW--
lO---1----
010. fee IHSUUCIIUflS.)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I
1 6 f
I
Part VI
Complete a separate column for each outstanding election. Complete lines 2 5 and 2 6 only if there is partial termination of the section
1 2 94 election.
election
20 Interest accrued on deferred
return
24 Accrued Interest due with
this return
Form 8621 (Rev. 12-2012)
152
2,780.
15b
2,403.
15e1
1 ,277.
16b
1 ,277.
16c
212613
01-29-13
8 6 2 1 1
(Rev.Decembe2012)
IInvestment Company or Qualified Electing Fund
Internal Revenue Service Information about Form 8621 and its se p arate instructions is at
OMB No. 1545-1002
Attachment
Sequence No. 69
Name of shareholder
THE BLOONBERG FAMILY FOUNDATION INC
Number, street, and room or suite no. (if a P.O. box, see instructions.)
Cityor town, state, and ZIP code or country
NEW YORK, NY 10022
Check type of shareholder filing the return:L.....J Individual L.J Corporation
CAIRN CLO II BV
Identifying number (see instructions)
20-5602483
Shareholder tax year. calendar year2 U1 4
or Other tax year beginning
and ending
L._J S Corporation Liii Nongrantor Trust L.....J Estat
Address (Enter number, street, city or town, and country.)Reference ID number (see instructions)
PARNASSUSTRN I LOCATELLIKADE 1
1076 AZ AMSTERDAM, NETHERLANDS
tax year beginning
ending
Part ISummary of Annual Information Part I is reserved for future use (see instructions).
Provide the following information with respect to all shares of the PFIC held by the shareholder:
2 Date shares acquired during the taxable year, If applicable:
3Number of shares held at the end of the taxable year:
4 Value of shares held at the end of the taxable year (check the appropriate box, if applicable):
(a) E$0-50,000(b)$50,001-100,000iiiii $100,001-150,000((I) c:ii $150,001-200,000
5 Type of PFIC and amount of any excess distribution or gain treated as an excess distribution under section 1291, inclusion under section
(a) Section 1291 $________________________
(b) LIII Section 1293(Qualified Electing Fund) $________________________
(C) Lii Section 1296 (Mark to Market) $________________________
or other
and
Part IIElections (See instructions.)
A L.....J Election To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete lines Ga through 7c of Part Ill.
B Lii Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits
of the QEF until this election is terminated. Complete lines 8a through 9c of Part lii to calculate the tax that maybe deferred.
Note: If any portion of line 6a or line 7a of Part Ill is includible under section 951, you
maynot
make this election. Also, see sections
C E Election To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-market the PFIC stock that is marketable within the meaning of section
D LIII Deemed Sale Election. I, a shareholder on the first day of a PFIC's first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in the
PFIC. Enter gain or loss on line 15f of Part V.
EDeemed Dividend Election. I, a shareholder on the first day of a PFICs first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat an
amount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount on line 15e of Part V. If the
F LJ Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excess
distribution the gain recognized on the deemed sale of my interest in the PFIC on the last day of its last tax year as a PFIC under section 1297(a). Enter
G
Deemed Dividend Election With Respect to a Section 1297(0) PFIC. I, a shareholder of a section 1297(e) PFIC, within the meaning of Regulations section
PF1C includes the CFC qualification date, as defined in Regulations section 1.1297-3(d). Enter the excess distribution online 15e, Part V. If the excess
H
defined in Regulations section 1.1298-3(d). Enter the excess distribution online 15e, Part V. If the excess distribution is greater than zero, also
01-29-13LI-IA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 8621 (Rev. 12-2012)
I S
U
Form 8621 (Rev. 12-2012)
Page 2
61 Enter your pro rata share of the ordinary earnings of the QEF
I
6a
I
b Enter the portion of line 6a that Is included in income under section 951 or that may be
I
6b
I
C
I
7a
I
b Enter the portion of line 7a that is included in Income under section 951 or that may be
I
lb
c Subtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule
8 Add lines 6c and 7c ..........................................................................................................................................
c Enter the portion of line 8a not already included in line 8c that Is attributable to shares
in the QEF that you disposed of, pledged, or otherwise transferred during the tax year
8c
d Add lines 8b and Bc
e Subtract line 8d from line 8a, and enter the difference (if zero or less, enter amount in brackets)
Important: If line Be is greater than zero, and no portion of line 6a or 7a is includible in income under section 951,
you may make Election B with respect to the amount on line Be.
9 a Enter the total tax for the tax year (See Instructions.) .9a
on line 8e
c Subtract line 9b from line 9a. This Is the deferred tax, the time for payment of which is extended by making
Election B
Part IVGain or (Loss) From Mark-ti
ctions
iDa Enter the fair market value of your PFICstock at the end of the tax year
c Subtract line lOb from line iDa. If a gain, do not complete lines 11 and 12. Include this amount as ordinary income
.ii.
12 Enter the loss from line lOc, but only to the extent of unreversed Inclusions on line 11. Include this amount as an ordinary
losson your tax return ........................................................................................................................................_______________________
13 II you sold or otherwise disposed of any section 1296 stock (see instructions) during the tax year
c Subtract line 13b from line 13a. If a gain, do not complete line 14. include this amount as ordinary income on your
14a Enter any unreversed Inclusions (as defined in section 1296(d))
loss on your tax return. If the loss on line 13c exceeds unreversed Inclusions on line 14a, complete line 14c
.14b
return according to the rules generally applicable for losses provided elsewhere in the Code and regulations.
Form 8621 (Rev. 12-2012)
6c
70
8d
212612
01-29-13
S
X
VDistributions From and Dispositions of Stock of a Section 1291 Fund (See

CompletePart Vfor each excess distribution (see instructions).
included in income under section 1291(a)(1)(B)) made by the fund with respect to the applicable stock for each of the 3 years
preceding the current tax year (or 9 shorter, the portion of the shareholders holding period before the current tax year)
e Subtract line 15d from line 15a. This amount, If more than zero, is the excess distribution with respect to the applicable stock.
distribution on your Income tax return
returnas other income

SEE STATEMENT 24
e Subtract line 16d from line 16c. Enter this amount on your income tax return as additional tax.' (See instructions.)
Enter the aggregate amount of Interest here. (See instructions.)....................................................................................
161
Part VI
Status of Prior Year Section 1294 Elections and Termination of Section 1294
1,858.
i..
1,156.
12.
578.
723.
1,135.
151
16b11.1
Complete a separate column for each outstanding election. Complete lines 25 and 26
only if there is partial termination of the section
1294 election.
17Tax year of outstanding
election
18Undistributed earnings to
distributed during the tax yew
return
this return
25 Deterred tax outstanding after
Form 8621 (Rev. 12-2012)
212613
01-29-13
E eA

E A r
8621 1
(Rar.Dbor2012)
Department of the TI reasury
I nternal Revenue Service111o. I nformation about Form 8621 and I ts separate I nstructions is at
wwrt, irc nr,r,/frrrmPROl
0M13 No. 1545-1002
Attachment
Sequence No. 69
Name of shareholder
Number, street and room or suite no. (I f a P.O. box, see instructions.)
NEW YORK, NY 10022
Check tvoe of shareholder fume the return:
Name of passive foreign investment company (PFI C) or qualified electing fund (QEF)
GILLESPIE CLO P.L.C.
I dentifying number (see instructions)
20-5602483
Shareholder tax year calendar year U I A or other tax year beginning
and ending
L_i S Corporation L......J Non grantor Trust L..J Estatt
DUBLIN 1, IRELAND
Reference I D number (see instructions)
Tax year of PFI C or QEF: calendar year
tax year beginning
or other
and
Provide the following I nformation with respect to all shares of the PFI C held by the shareholder
[J Check it shares jointly owned with spouse.
4 Value of shares held at the end of the taxable year (check the appropriate box, I t applicable):
(a) El $0-50,000 (b) EI $50,001-100,000 (C) El $100,001-150,000
(e) I f more than $200,000, list value:
(d) E::1$150,001-200,000
5 Type of PFI C and amount of any excess distribution or gain treated as an excess distribution under section 1291, inclusion under section
1293, or I nclusion or deduction under section 1296:
(a) El Section 1291 $________________________
(b) El Section 1293 (Qualified Electing Fund) $_________________________
(C) El Section 1296 (Mark to Market) $__________________________
Par t IIE lections (See instructions.)
ALi Election To Treat the PFI C as a QEF. I , a shareholder of a PFI C, elect to treat the PFI C as a QEF.
Complete lines 6a through 7c of Part Ill.
BEl Election To Extend Time For Payment of Tax. I , a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits
of the QEF until this election is terminated. Complete lines 8a through 9c of Part lii to calculate the tax that maybe deferred.
Note: If any portion of fine 6a or line 7a of Part li/is includible under section 951, you
C El Election To Mark-to-Market PFI C Stock. I , a shareholder of a PFI C, elect to mark-to-market the PFI C stock that is marketable within the meaning of section
D El Deemed Sale Election. I , a shareholder on the first day of a PFI C's first tax year as a QEF, elect to recognize gain on the deemed sale of my I nterest in the
PFIC. Enter gain or/oss on line 15f of Part V.
E El Deemed Dividend Election. I , a shareholder on the first day of a PFI Cs first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat an
Enter this amount on fine 15e of Part V. If the
excess distribution is greater than zero, also complete fine 16 of Part V.
F El
Election To Recognize Gain on Deemed Sale of PFI C. I , a shareholder of a former PFI C or a PFI C to which section 1297(d) applies, elect to treat as an excess
distribution the gain recognized on the deemed sale of my interest in the PFI C on the last day of I ts last tax year as a PFI C under section 1297(a).
Enter
G El
Deemed Dividend Election With Respect to a Section 1297(e) PFI C. I , a shareholder of a section 1297(e) PFI C, within the meaning of Regulations section
1.1297-3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFI C. My holding period in the stock of the Section 1297(e)
PFI C includes the CFC qualification date, as defined in Regulations section 1.1297-3(d).
H El
Deemed Dividend Election With Respect to a Former PFI C. I , a shareholder of a former PFI C, within the meaning of Regulations section 1.1298-3(a),
elect to make a deemed dividend election with respect to the former PFI C. My holding period in the stock of the former PFI C includes the termination date, as
defined in Regulations section 1.1298-3(d). Enter the excess distribution on fine 15e, Part V. If the excess distribution is greater than zero, also
01-29-13 LHA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.
Form 8621 (Rev. 12-2012)
SS
F o r m 8 6 2 1 ( R e v . 1 2 - 2 0 1 2 )
P a g e 2
P a rt Ill Income From a Qua lifie d Ele cting Fund ( QEF) .
Election B, also complete lines 8a through 9c. (See instructions.) -
I
6a
I
b Enter the portion of line 6a that Is included in Income under section 951 or that maybe
I
6b
I
7 a Enter your pro rata share of the total net capital gain of the QEF.7a
I
I
lb
I
c Subtract line 7b from line 7a. This amount is a net long- term capital gain. Enter this amount in Part II of the Schedule
8 a Add lines 6c and 7c ..........................................................................................................................................
Enter the portion of line 8a not already included in line 8c that is attributable to shares
in the QEF that you disposed of, pledged, or otherwise transferred during the tax year 8c
d Add lines 8b and 8c..
Important:
If line Be is greater than zero, and no portion of line 6a or 7a Is Includible in income under section 951,
on line 8e
9b
Election B
or
lOa Enter the fair market value of your PFICstock at the end of the tax year
.lOb
c Subtract line lOb from line lOa. If a gain, do not complete lines 11 and 12. Include this amount as ordinary income
..122
11 Enter any unreversed inclusions (as defined in section 1296(d)) .
12 Enter the loss from line lOc, but only to the extent of unreversed Inclusions on line 11. Include this amount as an ordinary
losson your tax return .......................................................................................................................................__________________________
.13a
.13b
tax return. If a loss, go to line 14.
.
.14o
Note. See Instructions in case of multiple dispositions.
Form 8621 (Rev. 12- 2012)
7c
8d
9c
212612
01-29-13
3
8 6 2 1
irt V
a Section 1291 Fund(See

Part Vfor each excess distribution
holding period of the stock began in the current tax year, see Instructions
c Divide line 15b by 3. (See instructions if the number of preceding tax years Is less than 3.)
If zero or less and you did not dispose of stock during the tax year, do notcomplete the rest of Part V. See instructions if you
Enter gain or toss from the disposition of stock of a section 1291 fund or farmer section 1291 fund. If a gain,
SEE STATEMENT 25
o Enter the aggregate increases in tax (before credits) for each tax year in your holding period
d Foreign tax credit (See instructions.)
e Subtract line 16d from line 16c. Enter this amount on your income tax return as"additional tax." (See Instructions.)
15b
2 ,732 .
16b12 ,73
aggregate--------------------,n
LIIWI 1110 dIIIUUIIL UI IIIW1OSL terre. (;66 instructions.)
I
16f
I
Part VI
Complete a separate column for each outstanding election. Complete lines 25 and 26 only if there is partial termination of the section
1294 election.
election
20 I nterest accrued on deferred
return
this return
Form 8621 (Rev. 12-2012)
212613
01-29-13
I
0
1 ^

1 9
Form
8621
(Rev. December 20 12)
Depastment of the Treasu,y
N a m e of sha re holde r
is a t
LMALir gr,v1fnrmRF21
Ide ntifying num be r (se e Instructions)
OMBNo. 1545-1002
Attachment
Sequence No. 69
THE BLOOMBERG FAMILY FOUNDATION INC 120-5602483
N um be r, stre e t, a nd room or suite no. (If a P.O. box, se e instructions.) Shareholder tax y.ac calendar year2 012
or other lax year beginning
C/0GELLER& CO, 909 THIRD AVE, NO. 16 FL
I
an d ening
City or town, sta te , a nd ZIP code or country
N EWYORK, N Y10022
Che ck
the
N a m e of pa ssive fore ign Inve stm e nt com pa ny (PFIC) or qua lifie d e le cting fund (QEF)
HARBOURMASTERCLO 10LTD.
Addre ss (Ente r num be r, stre e t, city or town, a nd country.)
PBN ASSUSTRN , LOCATELLIKADE1
1076 AZ AMSTERDAM, NETHERLANDS 1076 AZ
Em ploye r ide ntifica tion num be r (if a ny)
Re fe re nce IDnum be r (se e instructions)
Ta x ye a r of PFICor QEF: ca le nda r ye a r2012or othe r
ta x ye a r be ginning,a nd
Pa rt I is re se rve d for future use
Provide the following inform a tion with re spe ct to a ll sha re s of the PFIChe ld by the sha re holde r
1De scription of e a ch cla ss of sha re s he ld by the sha re holde r.
LJ Che ck it sha re s jointly owne d with spouse .
2Da te sha re s a cquire d during the ta xa ble ye a r, if a pplica ble :
3 N um be r of sha re s he ld a t the e nd of the ta xa ble ye a r
4 Va lue of sha re s he ld a t the e nd of the ta xa ble ye a r (che ck the a ppropria te box, if a pplica ble ):
(a ) i::i $050,000(b)$50,001-100,000(C)$100,001-150,000
(d)$150,001-200,000
(e ) If m ore tha n $200,000, list va lue :
5 Type of PFICa nd a m ount of a ny e xce ss distribution or ga in tre a te d a s a n e xce ss distribution unde r se ction 1291, inclusion unde r se ction
1293, or inclusion or de duction unde r se ction 1296:
(a )
Se ction 1291$________________________
(b)Se ction 1293 (Qua lifie d Ele cting Fund) $_________________________
(c)Se ction 1296 (Ma rk to Ma rke t) $__________________________
Pa rt If Ele ctions (Se e instructions.)
AL....J Ele ction To Tre a t the PFICa s a QEF. I, a sha re holde r of a PFIC, e le ct to tre a t the PFICa s a QEF. Complete fines 6a through 7c of Part Ill.
B EEl Ele ction To Exte nd Tim e For Pa ym e nt of Ta x. I, a sha re holde r of a QEF, e le ct to e xte nd the tim e for pa ym e nt of ta x on the undistribute d e a rnings a nd profits
of the QEF until this e le ction is te rm ina te d. Complete fines 8a through 9c of Part /// to calculate the tax that maybe deferred.
N ote : If any portion of fine 6a or fine 7a of Part Ill is includible under section 951, you
maynot
1294(c) and 1294(t) and the related regulations for events tha t terminate this e le ction.
C EJ Ele ction To Ma rk-to-Ma rke t PFICStock. I, a sha re holde r of a PFIC, e le ct to m a rk-to-m a rke t the PFICstock tha t is m a rke ta ble within the m e a ning of se ction
1296(e ). Complete Part IV.
DDe e m e d Sa le Ele ction. I, a sha re holde r on the first da y of a PFICs first ta x ye a r a s a QEF, e le ct to re cognize ga in on the de e m e d sa le of m y inte re st in the
E EE De e m e d Divide nd Ele ction. I, a sha re holde r on the first da y of a PFIC's first ta x ye a r a s a QEF tha t is controlle d fore ign corpora tion (CFC), e le ct to tre a t a n
a m ount e qua l to m y sha re of the post-1986 e a rnings a nd profits of the CFCa s a n e xce ss distribution. Ente r this amount on fine lSe of Part V. If the
F EE Ele ction To Re cognize Ga in on De e m e d Sa le of PFIC. I, a sha re holde r of a form e r PFICore PFICto which se ction 1297(d) a pplie s, e le ct to tre a t a s a n e xce ss
distribution the ga in re cognize d on the de e m e d sa le of m y inte re st in the PFICon the la st da y of its la st ta x ye a r a s a PFICunde r se ction 1297(a ). Ente r
G
De e m e d Divide nd Ele ction With Re spe ct to a Se ction 1297(0) PFIC. I, a sha re holde r of a se ction 1297(e ) PFIC, within the m e a ning of Re gula tions se ction
1.1297-3(a ), e le ct to m a ke a de e m e d divide nd e le ction with re spe ct to the Se ction 1297(e ) PFIC. My holding pe riod in the stock of the Se ction 1297(e )
PFICinclude s the CFCqua lifica tion da te , a s de fine d in Re gula tions se ction 1.1297-3(d). Enter the excess distribution online 15e, Part V. If the e xce ss
distribution is greater tha n zero, a lso complete line 16, Part V.
H
De e m e d Divide nd Ele ction With Re spe ct to a Form e r PFIC. I, a sha re holde r of a form e r PFIC, within the m e a ning of Re gula tions se ction 1.1298-3(a ),
e le ct to m a ke a de e m e d divide nd e le ction with re spe ct to the form e r PFIC. My holding pe riod In the stock of the form e r PFICinclude s the te rm ina tion da te , a s
de fine d in Re gula tions se ction 1.1298-3(d). Ente r the e xce ss distribution online 15e, Part V. If the excess distribution is gre a te r tha n zero, also
01-29-13 u40, For Disclosure , Priva cy Act, a nd Pa pe rwork Re duction Act N otice , se e se pa ra te Instructions. Form 8621(Re v. 12-2012)
E x
1 9 ,
Form 8621 (Rev. 12-2012)
Page 2
All QE F shareholders complete tines 6a through 7c. If you are making
E lection B, also complete lines Ba through 9c. (See instructions.)
6 a E nter your pro rata share of the ordinary earnings of the QE F.6a
I -
E nter the portion of line 6a that is included in income under section 951 or that may be
ex cluded under section 1293(g)
.6b
I
Subtract line 6b from line 6a. E nter this amount on your tax return as ordinary income ....................................................6c
7 a E nter your pro rata share of the total net capital gain of the QE F
I
la
b E nter the portion of line 7a that is included In Income under section 951 or that may be
ex cluded under section 1293(g)
I
lb
C
Subtract line 7b from line 7a. This amount is a net tong-term capital gain. E nter this amount in Part II of the Schedule D
used for your income tax return. (See instructions.) .,
8 Add lines 6c and 7c ...........................................................................................................................................Ba
b E nter the total amount of cash and the fair market value of other property distributed
or deemed distributed to you during the tax year of the QE F. (See instructions.) .8b
c E nter the portion of line 8a not already included in line Bc that is attributable to shares
in the QE F that you disposed of, pledged, or otherwise transferred during the tax year 80
8d
Important: if
line Be is greater than zero, and no portion of line Ga or 7a is includible in income under section 951,
9 a E nter the total tax for the tax year (See Instructions.).
b E nter the total tax for the tax year determined without regard to the amount entered
I
on line 8e
.9b
Subtract line 9b from tine 9a. This is the deferred tax , the time for payment of which Is ex tended by making
E lection B
9c
I IVGain or (Loss) From Mark-to-Market Election
(See instructions.)
lOa E nter the fair market value of your PFICstock at the end of the tax year
b E nter your adjusted basis in the stock at the end of the tax year
.lOb
11 E nter any unreversed inclusions (as defined in section 1296(d))
12 E nter the loss from line lOc, but only to the ex tent of unreversed Inclusions on line 11. Include this amount as an ordinary
a E nter the fair market value of the stock on the date of sale or disposition
b E nter the adjusted basis of the stock on the date of sate or disposition
14a E nter any unreversed Inclusions (as defined In section 1295(d))
14a
b E nter the loss from line 13c, but only to the ex tent of unreversed inclusions on line 14a. Include this amount as an ordinary
loss on your tax return. If the loss on line 13c ex ceeds unreversed inclusions on line 14a, complete line 14c
o E nter the amount by which the loss on line 13c ex ceeds unreversed inclusions on line 14a. Include this amount on your tax
.14c
Form 8621 (Rev. 12-2012)
212612
01-29-13
Form 8621 (Rev. 12-2012)
Page 3
Part VDistributions From and Dispositions of Stock of a Section 1291 Fund(See instructions.)
Complete aPan' V for each excess distribution (see instructions).
preceding the current tax year (or if shorter, the portion of the shareholder's holding period before the current tax year)
Subtract line 15d from line 15a. This amount, if more than zero, Is the excess distribution with respect to the applicable stock.
that are allocated to days In each tax year.
It Enter the total of the amounts determined in line 16a that are allocable to the current tax year and tax years
SEE STATEMENT 26
Enter the aggregate increases In tax (before credits) for each tax year in your holding period
e Subtract line 16d from line 16c. Enter this amount on your income tax return as "additional tax." (See instructions.)
Enter the aggregate amount of interest here. (See instructions.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15a1
1,154.
338.
150
169.
211.
943.
. i!.
3,070.
4,013.
16c
16d
16e
161
fl_. . . S. Illfls_s___ a!-a. . --
Li
.-. -- -
rd.RVIoiaius OT rrior rear ection i14Electio
ns and Termination of Section 1294Elections
Complete a separate column for each outstanding election. Complete lines
25and 26
1294 election.
election
distributed during the taxyear
return
this return
25 Deferred taxoutstanding after
terminstinn nf pler'. tinn
Form 8621 (Rev. 12-2012)
212613
01-29-13
1 4
Form
8621
I
Information Return by a Shareholder of a Passive Foreigni OMBNO.1 54 5.1 2
"'a
Oacomb"20121Investment Company or Qualified Electing Fund
lntcaal RenenueI
I nformation about Form8621 and its separate I nstructions I s at
;nv/fnR1
Sequence No. 69
Attachment
Name of shareholder

Number, street, and roomor suite no. (I f aP.O. box, see instructions.)
NEW YORK, NY 1 0022
Check tvDe of shareholder filino the return: L.....i I ndividual
20-56024 83
Shareholder tax year calendar arh U .t. h or other tax year beginning
and ending
Trust
Estate
Name of passive foreign I nvestment company (PFI C) or qualified electing fund (QEF)
MAC FUNDING II, LTD.
C/O MAPLES FINANCE LIMITED
P.O. BOX 1093GT, QUEENSGATE HOUSE, S. CHURCH
GEORGE TOWN, GRAND CAYMAN, CAYMAN ISLANDS
tax year beginning
or other
and
Provide the following information with respect to all shares of the PFI C held by the shareholder
I Description of each class of shares held by the shareholder.
El Check if shares jointly owned with spouse.
4 Value of shares held at the end of the taxable year (check the appropriate box, I f applicable):
(a) i::i $0-50,000 (b) [] $50,001 -1 00,000 (c) El $1 00,001 -1 50,000
(d) El $1 50,001 -200,000
5 Type of PFI C and amount of any excess distribution or gain treated as an excess distribution under section 1 291 , inclusion under section
1 293, or inclusion or deduction under section 1 296:
(a) El Section 1 291 $________________________
(b) El Section 1 293 (Qualified Electing Fund) $_________________________
(C) El Section 1 296 (Mark to Market) $_____________________
Part I I Elections (See instructions.)
A L..J Election To Treat the PFI C as aQEF. I , ashareholder of aPFI C, elect to treat the PFI C as aQEF. Complete lines 6a through 7c of Part III.
B El Election To Extend Time For Payment of Tax. I , ashareholder of aQEF, elect to extend the time for payment of tax on the undistributed earnings and profits
of the QEF until this election is terminated. Complete lines 8a through 9c of Part III to calculate the tax that may be deferred.
Note: If any portion of line 6a or line 7a of Part /I/is includible under section 951, you
maynot
C El Election To Mark-to-Market PFI C Stock. I , ashareholder of aPFI C, elect to mark-to-market the PFI C stock that I s marketable within the meaning of section
D El Deemed Sale Election. l,ashareholder on the first day of aPFI C's first tax year as aQEF, elect to recognize gain on the deemed sale of my interest in the
PFI C. Enter gain or loss on line 15f of Part V.
E El Deemed Dividend Election. l,ashareholder on the first day of aPFI Cs firsttax year as aQEF that is acontrolled foreign corporation (CFC), elect to treat an
amount equal to my share of the post-1 986 earnings and profits of the CFC as an excess distribution. Enter this amount on line 15e of Part V. If the
F El Election To Recognize Gain on Deemed Sale of PFI C. I , ashareholder of aformer PFI C or aPFI C to which section 1 297(d) applies, elect to treat as an excess
distribution the gain recognized on the deemed sale of my interest in the PFI C on the last day of its last tax year as aPFI C under section 1 297(a). Enter
G El
Deemed Dividend Election With Respect to aSection 1 297(e) PFI C. I , ashareholder of asection 1 297(e) PFI C, within the meaning of Regulations section
1 .1 297-3(a), elect to make adeemed dividend election with respect to the Section 1 297(e) PFI C. My holding period I n the stock of the Section 1 297(e)
PFI C includes the CFC qualification date, as defined I n Regulations section 1 .1 297-3(d). Enter the excess distribution on line 15e, Part V. If the excess
HEl
Deemed Dividend Election With Respect to aFormer PFI C. I , ashareholder of aformer PFI C, within the meaning of Regulations section 1 .1 298.3(a),
elect to make adeemed dividend election with respect to the former PFI C. My holding period in the stock of the former PFI C includes the termination date, as
I J-1 .A For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.Form8621 (Rev. 1 2-201 2)
Form 8621 (Rev. 12-2012)
Page 2
Part III Income From a Qualified Electing Fund (QEF).
All QEF shareholders complete lines Ba through 7c. If you are making
Election B, also complete lines 8a through 9c. (See instructions.) -
F
6a
I
I
6b
I
c Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary income
...................................................
I
7a
I
.7b
I
C
Subtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule 0
..........................................................................................................................................
CEnter the portion of line Ba not already included in line 8c that is attributable to shares
8c
Important
If line Be is greater than zero, and no portion of line 6a or 7a is Includible in income under section 951,
you may make Election B with respect to the amount on fine Be.
9 a Enter the total tax for the tax year (See instructions.) .9a
on line 8e
.9b
I
Subtract line 9b from line 9a. This is the deferred tax, the time for payment of which is extended by making
Election B
t IVGain or (Loss) From Mark-to-Market Election
(See instructions.)
10a Enter the fair market value of your PFICstock at the end of the tax year
...................................................
10b
12 Enter the loss from line iDe, but only to the extent of unreversed inclusions on line 11. Include this amount as an ordinary
losson your tax return.......................................................................................................................................12
.13a
.13b
c Subtract line 13b from line 13a. If a gain, do not complete line 14. include this amount as ordinary income on your
tax return, if a loss, go to line 14
.14a
b Enter the lass from line 13c, but only to the extent of unreversed inclusions on line 14a. Include this amount as an ordinary
loss on your tax return. if the loss on line 13c exceeds unreversed inclusions on line 14a, complete line 14c
.14b
c Enter the amount by which the loss online 13c exceeds unreversed Inclusions on line 14a. Include this amount on your tax
.14c
Form 8621 (Rev. 12-2012)
6c
70
8d
212612
01-29-13
^ 4

I s
For m 8621 ( Rev. 12- 2012)
Page- 3
Part VDistributions From and Dispositions of Stock of a Section 1291 Fund( See instr uctions.)
Complete a spparatp Part V f or each excess distribution ( see instructions).
15 a Enter your total distr ibutions fr om the section 1291 fund dur ing the cur r ent tax year with r espect to the applicable stock. If the
holding per iod of the stock began in the cur r ent tax year , see instr uctions
bEnter the total distr ibutions ( r educed by the por tions of such distr ibutions that wer e excess distr ibutions but not
included in income under section 1291( a) ( 1) ( B) ) made by the fund with r espect to the applicable stock for each of The 3 year s
pr eceding the cur r ent tax year ( or if shor ter , the por tion of the shar eholder s holding per iod befor e the cur r ent tax year )
Divide line 15bby 3. ( See instr uctions if the number of pr eceding tax year s Is less than 3.)
d Multiply line 15c by 125% ( 1.25)
e Subtr act line 15d fr om line 15a. This amount, if mor e than zer o, is the excess distr ibution with r espect to the applicable stock.
If zer o or less and you did not dispose of stock dur ing the tax year , do not complete the r est of Par t V. See instr uctions if you
r eceived mor e than one distr ibution dur ing the cur r ent tax year . Also, see instr uctions for r ules for r epor ting a nonexcess
distr ibution on your income tax r etur n
Enter gain or loss fr om the disposition of stock of a section 1291 fund or for mer section 1291 fund. If a gain,
complete line 16. If a loss, show it in br ackets and do not complete line 16
16 a Attach a statement for each distr ibution and disposition. Show your holding per iod for each shar e of stock
or block of shar es held. Allocate the excess distr ibution to each day in your holding per iod. Add all amounts
that ar e allocated to days in each tax year .
bEnter the total of the amounts deter mined in line 16a that ar e allocable to the cur r ent tax year and tax year s
befor e the for eign cor por ation became a PFIC ( pr e- PFlc tax year s) . Enter these amounts on your income tax
r etur n as other income SEE STATEMENT 27
c Enter the aggr egate incr eases in tax ( befor e cr edits) for each tax year in your holding per iod
( other than the cur r ent tax year and pr e- PFIC year s) . ( See instr uctions.)
d For eign tax cr edit. ( See instr uctions.)
e Subtr act line 16d fr om line 16c. Enter this amount on your income tax r etur n as 'additional tax.' ( See instr uctions.)
I Deter mine inter est on each net incr ease In tax deter mined on line 16e using the r ates and methods of section 6621.
15a
8.591.
15b1 4,463.
5,801.
151
16b( 5,801.
Enter the aggr egate amount of inter est her e. ( See instr uctions.) ....................................................................................
I
16f
I
Part VI Status of Prior Year Section 1294 Elections and Termination of Section 1294 Elections
Complete a separate column for each outstanding election. Complete fines 25 and 26 only if there Is partial termination of the section
1294 election.
17Tax year of outstanding
election
18 Undistr ibuted ear nings to
which the election r elates
19 Defer r ed tax
20I nterest accruedon defer r ed
tax (line 19) as of the filing date
21 Event ter minating election
22 Earnings distributedor deemed
distributeddaring the lax year
23 Defer r ed tax due with this
r etur n
24 Accr ued inter est due with
this r etur n
partial terminationof election
26 Inter est accr ued after par tial
For m 8621 ( Rev. 12- 2012)
212613
01-29-13
S
A
^ i
I
Form
R 1 2 1 1
InformationR eturn by aShareholder of aPassive Fot
(Rev. December 2012) Investment Company or Qualified Electing Fund
Information about Fe
is at www
ir.r gnv1frJrmR21
Name of shareholder

OMB No, 1545-1002
Attachment
Sequence No. 69
Number, street, and room or suite no. (if a P.O. box, see instructions.)
C /O GELLER&CO. 909 THIRD AVE, NO. 16 FL
NEW YORK, NY 10022
MACCAPITAL, LTD.
C/O MAPLES FINANCE LIMITED
P.O. BOX 109 3GT, QUEENSGATE HOUSE, S. CHURCH
GEORGETOWN, GRAND CAYMAN, CAYMAN ISLANDS
20-5602483
Shareholder tax year calendar year4 U 4 or other tax year beginning
and ending
Li S Corporation L_ J Nongrantor Trust Li Estati
Employer Identification number (if any)
Tax year of PFICor QEF: calendar yearA U 12 or other
tax year beginning,and
Of
Part I is reserved for future use

Provide the following information with respect to all shares of the PFICheld by the shareholder
1 Description of each class of shares held by the shareholder.
[2 Check U shares jointly owned with spouse.
(a) [2 $0-50,000 (b) [2 $50,001-100,000 (c) [I$10O,001-150,DOO
(d) [2$150,001-200,000
5 Type of PFICand amount of any excess distribution or gain treated as an excess distribution under section 1291, inclusion under section
(a)[2 Section 1291 $_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
(b)[2 Section 1293 (Qualified Electing Fund) $_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
(c)EJ Section 1296 (Mark to Market)
$
A L..J Election To Treat the PFICas a QEF. 1,0 shareholder of a PF1C, elect to treat the PFICas a QEF. Complete lines 6a through 7c of Part lii.
B [2 Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits
of the QEF until this election is terminated. Completefines 8a through 9c of Part Ill to calculate the tax that may be deferred.
maynot
1294(c) and 1294(t) and the related regulations for events that terminate this election.
C[2 Election To Mark-to-Market PFICStock. I, a shareholder of a PFIC, elect to mark-to-marketthe PFICstock that is marketable within the meaning of section
D2 Deemed Sale Election. I, a shareholder on the first day of a PFIC's first tax year as a OEF, elect to recognize gain on the deemed sale of my interest in the
E EJ Deemed Dividend Election. I, a shareholder on the first day of a PFIC's first tax year as a QEF that is controlled foreign corporation (CFC), elect to treat an
amount equal to my share of the post-1986 earnings and profits of the GFCas an excess distribution. Enter this amount on line 15e of Part V. If the
F 2 Election To Recognize Gain on Deemed Sale of PFIC. 1,0 shareholder of a former PF1Cor a PF1Cto which section 1297(d) applies, elect to treat as an excess
distribution the gain recognized on the deemed sale of my Interest in the PFICon the last day of its last tax year as a PFICunder section 1297(a). Enter
G[2
PFICincludes the CFCqualification date, as defined in Regulations section 1.1297-3(d). Enter the excess distribution on line 15e, Part V. If the excess
[2
Deemed Dividend Election With Respect to a Former PFIC. l,a shareholder of a former PFIC, within the meaning of Regulations section 1.1298-3(a),
'' elect to make a deemed dividend election with respect to the former PFIC. My holding period in the stock of the former PFICincludes the termination date, as
-29-13 U- lA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 8621 (Rev. 12-2012)
C
C
Form 8621 (Rev. 12-2012)
Page 2
Election B, a l s o complete lines 8 a through 9 c . (See instructions.)
I
- 6a
I
I
6b
I
Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary Income ...................................................
I
7a
I
Enter the portion of line 7a that Is Included In income under section 951 or that may be
.7b
I
c Subtract line 7b from line 7a. This amount is net long-term capital gain. Enter this amount in Part II of the ScheduleD
8 a Add lines 6c and 7c ..........................................................................................................................................
c Enter the portion of line Be not already Included in line Be that is attributable to shares
in the QEF that you disposed of, pledged, or otherwise transferred during the tax year80
d Add lines Sb and Sc..
e Subtract line 8d from line Be, and enter the difference (if zero or less, enter amount in brackets)
Important
If line Be is greater than zero, and no portion of line Ba or 7a is includible in income under section 951,
9 a Enter the total tax for the tax year (See instructions.) .
on line 8e
Election B
or (Loss) From Mark-to-Market Election
(See ins truc tio ns
lOa Enter the fair market value of your PFICstock at the end of the tax year
b Enter your adjusted basis in the stock at the end of the tax year .
.i9
c Subtract line lOb from line lOa. If a gain, do not complete lines 11 and 12. Include this amount as ordinary Income
11 Enter any unreversed inclusions (as defined In section 1296(d)) .
.1!
.13a
b Enter the adjusted basis of the stock on the date of sale or disposition.
.14b
.
Form 8621 (Rev. 12-2012)
7c
8d
9c
212612
01-29 -13
Form 8621 (Rev. 12-2012)
Page 3
Complete aPart Vfor each excess distribution (see instructions).
complete line 16. If a loss, show It in brackets and do not complete line 16 SEEM1T28
return as other incomeSEESTATEMENT29
c Enter the aggregate increases In tax (before credits) for each tax year in your holding period
(other than the current tax year and pre'PFIC years). (See instructions.)
Subtract line 16d from line 16c. Enter this amount on your Income tax return as 'additional tax.' (See instructions.)
15a187.0
15b144,092
15e152,388.
52.3
Enter the aggregate amount of Interest here. (See instructions.) .......................
............................................................. I
16f
Part VIStatus of Prior Year Section 1294 Elections and Termination of Section 1294 Elections
Complete a separate column for each outstanding election. Complete lines 25 and 26 only if there isa partial termination of the section
1294 election.
election
19 Deferred tax
return
this return
Form 8621 (Rev. 12-2012)
212613
01-29-13
8 6 2 1
Information about Form 8621 and its seoarate instructions Is at ,............
Name of shareholder
2 0-56 02 48 3
Shareholder tax yeac cal endar year 2 0 1 4
and ending
Number, street and room or suite no. (If a P.O. box, see instructions.)
C/O GELLER & CO, 90 9 THIRD AVE. NO. 16 FL
Sri
JI l 0No. 1 545-1 002
nt
nce No. 69
NEW YORK, NY 10022
Check type of shareholder filing the return: L...J Individual
MOSELLE CLO S.A.
.ALLE SCHEFFER 1
2520 LUXEMBOURG, LUXEMBOURG
r ar t usummar y Ot Annual Information
Par t I is reserved for I
Provide the following information with respect to all shares of the PFIC held by the shareholder
I Description of each class of shares held by the shareholder:
(a) fl 80-50,000(b) E$50,001-100,000(c)8100,001-150,000
or other
tax year beginning
and
(d)$150,001-200,000
5 Type of PFIC and amount of any excess distribution or gain treated as an excess distribution under Section 1291, inclusion under section
(a) EJ Section 1291 $_________________________
(b) Section 1293 (Qualified Electing Fund) $_________________________
(c) Section 1296 (Mark to Market) $__________________________
Par t H El ections (See instructions.)
A L..J Election To Treat the PRO as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF.
Complete lines 6a through 7c of Part III.
B
Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits
of the QEF until this election is terminated.
Complete fines Ba through 9c of Part Ill to calculate the tax that may be deferred.
Note: If any portion of fine 6a of-fine 7a of Part Ill is includible under section 951, you
C
0 EJ
Deemed Sale Election. I, a Shareholder on the first day of a PFICs first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in the
E
Deemed Dividend Election. I, a shareholder on the first day of a PFIC's first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat an
F ED
Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excess
distribution the gain recognized on the deemed sale of my interest in the PFIC on the last day of its last tax year as a PFIC under section 1297(a).
Enter
G
H
elect to make a deemed dividend election with respect to the former PFIC. My holding period in the stock of the former PFIC includes the termination date, as
defined In Regulations section 1.1298-3(d).
Enter the excess distribution on line 15e, Part V. If the excess distribution is greater than zero, also
Form 8621 (Rev. 12-2012)
S S
V 4 )
Form 8621 (Rev. 122012)
Page 2
All QEF shareholders complete lines 6a through lc. If you are making
Election 8, also complete lines 8a through 9c. (See instructions.)
I
6a
I -
I
6b
I
c Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary income ...................................................
I
7a
I
b Enter the portion of line 7a that Is included in Income under section 951 or that may be
I
lb
I
c Subtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule
8 a Add lines 6c and 7c ..........................................................................................................................................
c Enter the portion of line Be not already included In line 8c that Is attributable to shares
8c
e Subtract line 8d from line Be, and enter the difference (If zero or less, enter amount in brackets)
Important
If line 8e is greater than zero, and no portion of line Ga or 7a is includible in income under section 951,
you may make Section B with respect to the amount on line Be.
I ..2._
on line Be
L.!!I _
C
Subtract line 9b from line 9a. This is the deferred tax, the time for payment of which Is extended by making
Election B
Part IVGain or (Loss) From Mark-to-Market Election (See instruction
IN Enter the fair market value of your PFICstock at the end of the tax year
C
Subtract line lOb from line lOa. If a gain, do not complete lines 11 and 12. Include this amount as ordinary Income
12 Enter the loss from line 10c, but only to the extent of unreversed inclusions on line 11. Include this amount as an ordinary
13 If you sold or otherwise disposed of any section 1296 stock (see Instructions) during the tax year
.13b
c Subtract line 13b from line 13a. If a gain, do not complete line 14. Include this amount as ordinary Income on your
.14a
b Enter the loss from line 13c, but only to the extent of unreversed Inclusions on line 14a. Include this amount as an ordinary
.14b
c Enter the amount by which the loss online 13c exceeds unreversed inclusions on line 14a. Include this amount on your tax
...............
14c
Form 8621 (Rev. 12-2012)
70
8d
9c
212612
01-29-13
&
W ,
PA
Form 8621 (Rev. 12-2012)
Page 3
Part VDistributions From and Dispositions of Stock of a Section 1291 Fund (See instructions.)
Complete a
Renmte
Part V for each excess distribution (see instructions).
N
X
iri
Included in income under section 1291(a)(1)(B)) made by the fund with respect to the applicable stock for each of the 3 years
III Multiply line 15c by 125% (1.25)
return as other incomeSEE STATEMENT 30
a Enter the aggregate increases in tax (before credits) for each tax year in your holding period
(other than the current tax year and pre-PFIC years). (See instructions.) .......................................................................
If Foreign tax credit. (See instructions.)
Determine interest on each net increase In tax determined online 16e using the rates and methods of section 6621.
Enter the aggregate amount of interest here. i
50,684.
i_.
19,347.
i.
9,674.
T5d
Me38,591.
233,733.
16b272,324.
Part VIStatus of Prior Year Section 1294Elections and Termination of Section 1294Elections
1294 election.
election
19 Deferred tax
20Interest accrued on deferred
tax (line 19) as of the filing date
return
this return
Form 8621 (Rev. 12-2012)
212613
01.29.13
Form
8 6 2 1 1
Information Return by a Shareholder of a Passive Fot
(Rev.December 2012) I Investment Company or Qualified Electing Fund
Department of the Treasury I
I ntarnal Revenue Service I
I nformation about Form8621 and its separate instructions I s at
www inq nnv1fnrmqR9-t--
Name of shareholder
Number, street, and roomor suite no. (I f a P.O. box, see instructions.)
C/O GELLER & CO, 909 THIRD AVE, NO. 16 FL
NEW YORK, NY 10022
20-5602483_
Shareholder tax year calendar
and
EJ'
I 0MB No. 1545-1002
[Attachment
5equence No. 69
Name of passive foreign investment company (PFI C) or qualified electing fund (QEF)
AACP DEBT INVESTORS, L.P.
C/0 ASIA ALTERNATIVES MANAGEMENT
ONE MARITIME PLAZA, SUITE 1000
SAN FRANCISCO, CA 94111
Part I Summary of Annual Information Part I is reserved for I
Provide the following information with respect to all shares of the PFI C held by the shareholder
EJ Check if shares jointly owned with spouse.
3Number of shares held at the end of the taxable year:
4Value of shares held at the end of the taxable year (check the appropriate box, if applicable):
(a) i:J $0-50,000(b) EJ $50,001-100,000(c) EJ $100,001-150,000
Employer I dentification number (if any)
20-8920779
tax year beginning
endina
(d) El $150,001-200,000
or other
and
5Type of PFI C and amount of any excess distribution or gain treated as an excess distribution under section 1291, inclusion under section
1293, or I nclusion or deduction under section 1296:
(a) El Section 1291 $__________________________
(b) El Section 1293(Qualified Electing Fund) $___________________
(C) El Section 1296 (Mark to Market) $________________________
Part II Elections (See instructions)
A L..J Election To Treat the PFI C as a QEF. I , a shareholder of a PFI C, elect to treat the PFI C as a QEF. Complete lines 6a through 7c of Part Ill.
B El Election To Extend Time For Payment of Tax. I , a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits
of the QEF until this election is terminated. Complete lines Ba through 9c of Part Il/to calculate the tax that maybe deferred.
Note: If any portion of line 6a or line 7a of Part Il/is includible undersection 951, you
maynot
1294(c) and 1294(1) and the related regulations for events that terminate this election.
C El Election To Mark-to-Market PFI C Stock. I , a shareholder of a PFI C, elect to mark-to-market the PFI C stock that is marketable within the meaning of section
D El Deemed Sale Election. l.a shareholder on the first day of a PFI Cs first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in the
PF1C. Enter gain or loss on fine 15f of Part V.
E El Deemed Dividend Election. I , a shareholder on the first day of a PFI C's first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat an
amount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount on line 15e of Part V. If the
FEl Election To Recognize Gain on Deemed Sale of PFI D. I , a shareholder of a former PFI C or a PFI C to which section 1297(d) applies, elect to treat as an excess
distribution the gain recognized on the deemed sale of my interest in the PFI C on the last day of its last tax year as a PFI C under section 1297(a). Enter
G El
Deemed Dividend Election With Respect to a Section 1297(e) PFI C. I , a shareholder of a section 1297(e) PFI C, within the meaning of Regulations section
1.1297-3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFI C. My holding period in the stock of the Section 1297(e)
PFI C includes the CFC qualification date, as defined in Regulations section 1.1297-3(d). Enter the excess distribution on fine 15e, Part V. If the excess
H El
Deemed Dividend Election With Respect to a Former PFI C. I , a shareholder of a former PFI C, within the meaning of Regulations section 1.1298-3(a),
elect to make a deemed dividend election with respect to the former PFI C. My holding period in the stock of The former PFI C includes The termination date, as
01-2913 li-tA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form8821 (Rev. 12-2012)
Form 6621 (Rev. 12-2012)
Pace 2
All OF shareholders complete lines 6a through 7c. If you are making
6 a Enter your pro rats share of the ordinary earnings of the QEF
La
I -
I
6b
I
o Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary Income
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7 a Enter your pro rats share of the total net capital gain of the QEF
I
7a
I
I
lb
8 a Add lines 6c: and
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
o Enter the portion of line 8a not already Included in line 8c; that is attributable to shares
e Subtract line 8d from line 8a, and enter the difference (If zero or less, enter amount in brackets)
Important: If line Be is greater than zero, and no portion of line Ga or 7a is includible in income under section 951,
9 a Enter the total tax for the tax year (See instructions.).9a
online Be
I
9b
I
Subtract line 9b from line 9a. This Is the deferred tax, the time for payment of which is extended by making
Election B
90
Gain or
on
10a Enter the fair market value of your PFIC stock at the end of the tax year
lOa
Ii Enter your adjusted basis in the stock at the end of the tax year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -
10
C Subtract line lOb from line iDa. If a gain, do not complete lines 11 and 12. Include this amount as ordinary income
.100
Ii Enter any unreversed inclusions (as defined in section 1296(d)) .
13 It you sold or otherwise disposed of any section 1296 stock (see instructions) during the tax year:
.13b
C Subtract line 13b from line 13a. If a gain, do not complete line 14. Include this amount as ordinary income on your
..i
.14a
C
Enter the amount by which the loss on line 13c exceeds unreversed inclusions on line 14a. Include this amount on your tax
Form 8621 (Rev. 12-2012)
6c
70
8d
212612
01-29-13
Form 8621 (Rev. 12-2012)
P a g e 3
Part V
Distributions From and Dispositions of Stock of a Section 1291 Fund(See
instructions.)
Complete a
Part V f or each excess distribution (see instructions).
included in income under section 1291(a)(1)(13)) made by the fund with respect to the applicable stock for each of the 3 years
It Multiply line 15c by 125% (1.25)
If zero or less and you did not dispose of stock during the tax year, do notcomplete the rest of Part V. See instructions if you
complete line 16. If a loss, show ft in brackets and do not complete line 16
b Enter the total of the amounts determined In line 16a that are allocable to the current tax year and tax years
before the foreign corporation became a PFIC (pre .PFIC tax years). Enter these amounts on your income tax
SEE STATEMENT 31
o Enter the aggregate Increases In tax (before credits) for each tax year in your holding period
e Subtract line 16d from line 16c. Enter this amount on your income tax return as additional tax." (See instructions.)
Enter the aggregate amount of interest here. (See instructions.
15a
15b
15e
15f1225,511.
16b1225,511.
16c
IRE
Part VI
1294 election.
election
20 Inte re st a ccrue d on de fe rre d
distribute d during the ta x ye a r
return
this return
25 De fe rre d ta x outsta nding a fte r
pa rtia l te rmina tion of e le ction
Form 8621 (Rev. 12-2012)
212613
01-29.13
Ef
Fom
8 6 2 1 1
(Rev.Decembe2 01 2 )Investment Company or Qualified Electing Fund
Department of the Treasury,.
,.. ------
OMB No. 1545-1002
Attachment
Sequence No. 69
Name of shareholder
NEW YORK, NY 10022
Check type of shareholder filing the return:L_i Individual LXJ Corporation L..
AACP TAXEXEMPT INVESTORS FUND III, L.P
C/O ASIA ALTERNATIVES MANAGEMENT
20-5602483
Shareholder tax year. cajendan ye& U .1. h or Other tax year beginning
and ending
L.....J S Corporation L....J Nongrantor Trust
0 Estate
Tax year of PFIC or QEF: calendar year4 U .1.
Zor other
tax year beginning,and
Part I Summary of Annual Information Part I is reserved for future use (see instructions).
Provide the following information with respect to all shares of the PFIC held by the shareholder.
3 Number of shares held at the end of the taxable year
(a) El 80-50,000(b) i:i 850,001-100,000(c) El $100,001-150,000(d) El 8150,001-200,000
(a) EJ Section 1291 $________________________
(b) EIJ Section 1293 (Qualified Electing Fund) $_________________________
(c) El Section 1296 (Mark to Market) $
Part II Elections (See instructions.)
A L..J Election To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete lines 6a through 7c of Part Ill.
BEl Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits
of the QEF until this election is terminated. Complete lines Ba through 9c of Part Ill to calculate the tax that may be deferred.
maynof
C El Election To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-market the PFIC stock that is marketable within the meaning of section
D El Deemed Sale Election. I, a shareholder on the first day of a PFICs first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in the
E El Deemed Dividend Election. I, a shareholder on the first day of a PFICs first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat an
amount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount online 15e of Part V. If the
F El Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excess
G El
1.1297-3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period In the stock of the Section 1297(e)
PFIC includes the CFC qualification date, as defined In Regulations section 1.1297-3(d). Enter the excess distribution on line 15e, Part V. If the excess
HEl
11 - z2b91-11 3 LHA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate Instructions. Form 8621 (Rev. 12-2012)
V V
Form 8621 (Rev. 12-2012)
Page 2
Part Ill Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines 6a through it. If you are making
Election B, also complete lines Ba through 9. (See instructions.) -
I
6a
I
I
6b
7 a Enter your pro rats share of the total net capital gain of the QEF
I
7a
I
I
7b
o Subtract line 7b from line 7a. This amount Is a net long-term capital gain. Enter this amount in Part II of the Schedule D
8 a Add lines 6c and 7c ..........................................................................................................................................
o Enter the portion of line 8a not already included in line Sc that is attributable to shares
in the QEF that you disposed of, pledged, or otherwise transferred during the tax year8c
e Subtract line Sd from line 8a, and enter the difference (if zero or less, enter amount in brackets)
Important: if line 8e is greater than zero, and no portion of line Gaor 7ais includible in income under section 951,
you may make Election B with respect to the amount on line 8e.
9 a Enter the total tax for the tax year (See instructions.) .9a
on line 8e
I
9b
Subtract line 9b from line 9a. This Is the deferred tax, the time for payment of which Is extended by making
Election B
.................................................................................................................................
or
c Subtract line lOb from line 10a. If a gain, do not complete lines 11 and 12. Include this amount as ordinary income
a Enter the fair market value of the stock on the date of sale or disposition.13a
.13c
.14a
b Enter the loss from line 13c, but only to the extent of unreversed inclusions online 14a. Include this amount as an ordinary
c Enter the amount by which the loss on line 13c exceeds unreversed inclusions on line 14a. include this amount on your tax
Form 8621 (Rev. 12-2012)
60
8d
90
212812
01-29.13
Form 8621 (Rev. 12-2012)
Page 3
Part VDistributions From and Dispositions of Stock of a Section 1291 Fund (See instructions.)
Complete a _qp naratq Part Vfor each excess distribution (see instructions).
holding period of the stock began in the current tax year, see instructions.iSa -
Included in income under section 1291(a)(1)(13)) made by the fund with respect to the applicable stock for each of the 3 years
preceding the current tax year (or if shorter, the portion of the shareholders holding period before the current tax year) .15b
.
-
Divide line 15b by 3. (See Instructions if the number of preceding tax years is less than 3.)-
..j-
Subtract line 15d from line 15a. This amount if more than zero, is the excess distribution with respect to the applicable stock.
distribution on your income tax return.-
before the foreign corporation became a PFIC (pre-PF1C tax years). Enter these amounts on your income tax
return as other IncomeSEE STATEMENT 3216b -
c Enter the aggregate increases in tax (before credits) for each tax year in your holding period
.J.!!-
e Subtract line 16d from line 16c. Enter this amount on your income tax return as 'additional tax.' (See instructions.).
j.-
Enter the aggregate amount of interest here. (See Instructions.) .................................................................................... .16f-
3,431.
3.4
1294 election.
election
return
24Accrued interest due with
this return
Form 8621 (Rev. 12-2012)
212613
01-29-13
n

.
I

[ 1
Form
8 6 2 1 1
(Rev. December 2012)
IInvestment Company or Qualified Electing Fund
Internal Revenue se,vlceOo.
Information about Form 8621 and its separate Instructions is at y
h
Name of shareholder
OMB No. 1545-1002
Attachment
Sequence No. 69
1 20-5602483
Number, street, and room or suite no.(If a P.O.box, see Instructions.)
C/O GELLER & CO, 909 THIRD AVE. NO. 1 6 FL
NEW YORK, NY 10022
Shareholder tax year.
Of other tax Year beginning
and
Check type of shareholder filing the return: L......J Individual LJ Corporation L
Name of passive foreign investment company (PFIC) or qualified electing fund (DEE)
AACP TAXEXEMPT INVESTORS FUND II, L.P.
C/O ASIA ALTERNATIVES MANAGEMENT
98-061 5699
Tax year of PFICor QEF: calendar year
or other
tax year beginning
and
use
Provide the following information with respect to all shares of the PFICheld by the shareholder
(a) $0-50,000 (b) El $50,001 -1 00,000 (c) r: $1 00,001 -1 50,000
(d) El $1 50,001 -200,000
5 Type of PFICand amount of any excess distribution or gain treated as an excess distribution under section 1 291 , inclusion under section
1 293, or inclusion or deduction under section 1 296:
(a)
Section 1 291 $________________________
(b) E7 Section 1 293 (Qualified Electing Fund) $________________________
(c) ED Section 1 296 (Mark to Market) $________________________
Part II Elections (See instructions.)
A L.J Election To Treat the PFICas a QEF.I, a shareholder of a PFIC, elect to treat the PFICas a QEF.
B UJ
Election To Extend Time For Payment of Tax.I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits
of the DEE until this election is terminated.
Complete lines 8a through 9c of Part Il/to calculate the tax that maybe deferred.
Note: If any portion of line 6a or line 7a of Part Ill Is Includible undersection 951, you may 0 make this election. Also, see sections
1294(c) and 1294(l) and the related regulations for events that terminate this election.
C i::i
Election To Mark-to-Market PFICStock.I, a shareholder of a PFIC, elect to mark-to-market the PFICstock that is marketable within the meaning of section
1 296(e).Complete Part IV.
0 LJ
Deemed Sale Election.I, a shareholder on the first day of a PFICs first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in the
PFIC.Enter gain or loss online 15f of Part V.
E U
Deemed Dividend Election.I, a shareholder on the first day of a PFIC's first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat an
amount equal to my share of the post-1 986 earnings and profits of the CFCas an excess distribution.
F E11
Election To Recognize Gain on Deemed Sale of PFIC.I, a shareholder of a former PFICor a PFICto which section 1 297(d) applies, elect to treat as an excess
distribution the gain recognized on the deemed sale of my interest in the PFICon the last day of its last tax year as a PFICunder section 1 297(a).
Enter
Deemed Dividend Election With Respect to a Section 1 297(e) PFIC.I, a shareholder of a section 1 297(e) PFIC, within the meaning of Regulations section
G
1 .1 297-3(a), elect to make a deemed dividend election with respect to the Section 1 297(e) PFIC.My holding period in the stock of the Section 1 297(e)
PFICincludes the CFCqualification date, as defined in Regulations section 1 .1 297-3(d).
Enter the excess distribution on line 15e, Part V. If the excess
H
Deemed Dividend Election With Respect to a Former PFIC.I, a shareholder of a former PFIC, within the meaning of Regulations section 1 .1 298.3(a),
elect to make a deemed dividend election with respect to the former PFIC.My holding period in the stock of the former PFICincludes the termination date, as
defined in Regulations section 1 .1 298-3(d).
Enter the excess distribution on line 15e, Part V. If the excess distribution is greater than zero, also
01-29-13 LI-iA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.
Form 8621 (Rev.1 2-201 2)
U J

^ i *
Form 8621 (Rev. 12-2012)
Page 2
Part Ill Income From a Qualified Electing Fund (QE9. All QEF shareholders complete lines Ba through 7c. If you are making
Election B, also complete lines Ba through Bc. (See instructions.) -
I
6a
I
b Enter the portion of line Be that is included in income under section 951 or that may be
I
6b
I
o Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary Income ...................................................
7 a Enter your pro rata share of the total net capital gain of the CEF
I
ia
I
excluded under section 1293(g).
m
I
CSubtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount In Part II of the Schedule D
8 a Add lines 6c and 7c ..........................................................................................................................................
o Enter the portion of line Ba not already included in line Bc that is attributable to shares
Important: if line 8e is greater than zero, and no portion of line 6a or 7a Is includible in income under section 951,
you may make Section B with respect to the amount on line Be.
on line 8e.9b
c Subtract line 9b from line Ba. This Is the deferred tax, the time for payment of which is extended by making
or
lOa Enter the fair market value of your PFIC stock at the end of the tax year
12 Enter the loss from line 10c, but only to the extent of unreversed inclusions on line 11. Include this amount as an ordinary
13 It you sold or otherwise disposed of any section 1296 stock (see Instructions) during the tax year
return according to the rules generally applicable for losses provided elsewhere in the Code and regulations .
Note. See instructions in case of multiple disposi
t i
ons.
Form 8621 (Rev. 12-2012)
6c
7c
8d
I 9c
12
13a
212612
01-29-13
Form 8621 (Rev. 12-2012)
Page
(See instructions,)
C o m p l e t e aso p nrat e Part Vfo r e ach e xce ss dist ribut io n (see inst ruct io ns).
15 aEnter your total distributions from the section 1291 fund duringthe current tax year with respect to the applicable stock. If the
holdingperiod of the stock began in the current tax year, see Instructions
included In income under section 1291(a)(1)(13)) made by the fund with respect to the applicable stock for each of the 3 years
precedingthe current tax year (or if shorter, the portion of the shareholders holdingperiod before the current tax year)
Divide line 15b by 3. (See instructions if the number of precedingtax years Is less than 3.)
If zero or less and you did not dispose of stock duringthe tax year, do not complete the rest of Part V. See instructions if you
received more than one distribution duringthe current tax year. Also, see instructions for rules for reportinganonexcess
Enter gain or loss from the disposition of stock of asection 1291 fund or former section 1291 fund. If again,
complete line 16. If aloss, show it in brackets and do not complete line 16
16 aAttach astatement for each distribution and disposition. Show your holdingperiod for each share of stock
or block of shares held. Allocate the excess distribution to each day in your holdingperiod. Add all amounts
b Enter the total of the amounts determined in line 16athat are allocable to the current tax year and tax years
before the foreign corporation became aPFIC (pre .PFIC tax years). Enter these amounts on your income tax
SEE STATEMENT 33
c Enter the aggregate increases in tax (before credits) for each tax year in your holdingperiod
e Subtract line 16d from line 16c. Enter this amount on your income tax return as 'additional tax? (See instructions.)
Determine interest on each net increase in tax determined on line 16e usingthe rates and methods of section 6621.
Enter the aggregate amount of interest here. (See instructions.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15b
15e
15f18,852.
16b18,852.
1160
16f
Part VI
C o m p l e t e a se p arat e co l um n fo r e ach o ut st anding
e l e ct io n. C o m p l e t e l ine s 25 and 26 o nl y if t he re Is a p art ial t e rm inat io n o f t he se ct io n
1294 e l e ct io n.
election
21 Event terminatingelection
return
this return
Form 8621 (Rev. 12-2012)
212613
01-29-13
NA
Foev
8 6 2 1 1
Information Return by a Shareholder of a Passive Forei
(Rev.December2 Ol2 )
Depattment of the Treasury
Internal Revenue ServiceInformation about Form 8621 and its se
Name of shareholder
ns is at
OMB No. 1 5451 02
Attachment
Sequence No. 69
Number, street, and room or suite no. (If a P.O. ho; see instructions.)
C/O GELLER & CO. 909 THIRD AVE, NO. 16 FL
NEW YORK, NY 10022
of shareholder filino the
ALTOR FUND III (NO. 2) LP
20-5602483
Shareholder tax year. Calendar year UI Z or other tax year beginning
and ending
L.....J S Corporation L....J Nongrantor Trust L...J
Estatf
P.O. BOX 730, 11-15 SEATON PLACE
ST. HELIER, JERSEY JE JE4 OQH
Part ISummary of Annual Information
Part I is reserved for I
1 Description of each class of shares held by the shareholder.
98-0594714
Tax year of PFIC or aEF: calendar year
or other
lax year beginning
and
re use
(a) El $0-50,000(b) El $50,001-100,000(C) El $100,001-150,000(d) El $150,001-200,000
5 Type of
PFIC and amount of any excess distribution or gain treated as an excess distribution under section 1291, inclusion under section
(a) EJ Section 1291 $_________________________
(b) El Section 1293 (Qualified Electing Fund) $_________________________
(C) E11 Section 1296 (Mark to Market) $_________________________
A L.....J Election To Treat the PFIC as a QEF. l.a shareholder of a PFIC, elect to treat the PFIC as a QEF.
Complete lines Ga through 7c of Part Ill.
BEl
of the QEF until this election is terminated. Complete lines Ba through 9c of Part Ill to calculate the tax that maybe deferred.
C El
D El Deemed Sale Election. I, a shareholder on the first day of a PFICs first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in the
PFIC. Enter gain or loss online 15! of Part V.
F El Election To Recognize Gain on Deemed Sale of PFIC. l.a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excess
distribution the gain recognized on the deemed sale of my interest In the PFIC on the last day of its last tax year as a PFIC under section 1297(a).
Enter
G El
Deemed Dividend Election With Respect to a Section 1297(e) PFIC. I, a shareholder eta section 1297(e) PFIC, within the meaning of Regulations section
H El
defined In Regulations section 1.1298-3(d). Enter the excess distribution on line 15e, Part V. If the excess distribution is greater than zero, also
Form 8621 (Rev. 12-2012)
El
Form 8621 (Rev. 12-2012)
Page 2
I
6a
I
b Enter the portion of line Ga that is included in Income under section 951 or that may be
Leb
I
c Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary Income ...................................................
I
7a
I
7b
I
c Subtract line 7b from tine 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the ScheduleD
8 a Add lines Bc and 7c ..........................................................................................................................................
or deemed distributed to you during the tax year of the QEF. (See instructions.).._ ______________________
Enter the portion of line 8a not already Included in line 8c that is attributable to shares
8c
d Add lines 8b and 8c....
Important
If line 8e is greater than zero, and no portion of fine 6a or 7a is includible in income under section 951,
9 a Enter the total tax for the tax year (See Instructions.)
on line 8e
9b
c Subtract line 9b from line 9a. This is the deferred tax, the time for payment of which is extended by making
or
lOa Enter the fair market value of your PFIC stock at the end of the tax year
lOa
on your tax return. If a loss, go to line 11Joe
.i?..
o Enter the amount by which the loss on line 13c exceeds unreversed inclusions on line 14a. Include this amount on your tax
.j. 1
Form 8621 (Rev. 12-2012)
6c
7c
8d
212612
01-29-13
Form 8621 (Rev. 12-2012)
Page 3
(See instructions.)
Complete a spnarate Part Vfor each excess distribution
(see instructions).
included in Income under section 1291(a)(1)(B)) made by the fund with respect to the applicable stock for each of the 3 years
c Divide line 15b by 3. (See instructions if the number of preceding tax years Is less than 3.)
d Multiply line 15c by 1250/.(1.25)
SEE STATEMENT 34
o Enter the aggregate increases in tax (before credits) for each tax year in your holding period
Determine interest on each net Increase in tax determined on line 16e using the rates and methods of section 6621.
Enter the aggregate amount of interest here. (See instructions.)
rart vi
status of Prior Year Section 1294 Elections and Termination of Section 1294 Elections
Complete a separate column for each outstanding election. Complete lines
25 and 26 only if there is partial termination of the section
1294 election.
election
this return
Form 8621 (Rev. 12-2012)
15a
15e
31,020.
31.0
212613
01-29-13
2
: i
Form
8 6 2 1 1
Information Return by a Shareholder of a Passive Fo,
(Revecember2012)
In
Company or Qualified Electing Fund
Depalment of theTreasury
If.......4.... r..... enni....l...
OMBNo.1545-1002
Attachment
SequenceNo.69
Name of shareholder
Number, street, and room or sui te no. (If a P.O. box, see i nstructi ons.)
C/OGELLER & CO, 909 THIRD AVE. NO. 16 FL
Ci ty or town, state, and ZIP code or country
NEWYORK, NY 10022
Check type of shareholder flung the return: L....J Indi vi dual LJ Corporati on L...J Partnersl
Name of passi ve forei gn i nvestment company (PFIC) or quali fi ed electi ng fund (QEF)
ROCKWALL INVESTORS CORP.
C/O MAPLESFS LIMITED
Address (Enter number, street, ci ty or town, and country.)
P.O. BOX 1093, BOUNDARY HALL, CRICKET SQUARE
GRAND CAYMAN, KY1 1102, CAYMAN ISLANDS
Identi fyi ng number (see i nstructi ons)
20-5602483
Shareholder tax year: calendar year U .1. ,& orothertax yearbeginning
and endi ng
L.J S Corporati on L...J Nongrantor Trust L...J Estat
Employer Identi fi cati on number (i f any)
Reference ID number (see i nstructi ons)
or other
tax year begi nni ng
and
Summary of
Part I i s reserved for
re use
Provi de the followi ng i nformati on wi th respect to all shares of the PFIC held by the shareholder:
I Descri pti on of each class of shares held by the shareholder.
El Check i t shares joi ntly owned wi th spouse.
2 Date shares acqui red duri ng the taxable year, i f appli cable:
4 Value of shares held at the end of the taxable year (check the appropri ate box, i f appli cable):
(a) El $0-50,000(b) EJ $50,001-100,000(C) c: $100,001-150,000
(e) If more than $200,000, li st value:
(d) El $150,001-200,000
5Type of PFIC and amount of any excess di stri buti on or gai n treated as an excess di stri buti on under secti on 1291, i nclusi on under secti on
1293, or i nclusi on or deducti on under Secti on 1296:
(a) El Secti on 1291$________________________
(b) El Secti on 1293 (Quali fi ed Electi ng Fund) $_________________________
(c) El Secti on 1296 (Mark to Market) $
Part II Elections (See i nstructi ons.)
A L_..] Electi on To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete fines Ga through 7c of Part I/I.
B El Electi on To Extend Ti me For Payment of Tax. I, a shareholder of a QEF, elect to extend the ti me for payment of tax on the undi stri buted earni ngs and profi ts
of the QEF until this election is terminated. Complete lines 8a through 9c of Part Ill to calculate the tax that may be deferred.
Note: If any portion of fine Ga or line 7a of Part III is includible under section 951, you mayno t make this election. Also, see sections
C El Electi on To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-market the PFIC stock that i s marketable wi thi n the meani ng of secti on
D Ll Deemed Sale Electi on. I, a shareholder on the fi rst day of a PFICs fi rst tax year as a QEF, elect to recogni ze gai n on the deemed sale of my i nterest i n the
E El Deemed Di vi dend Electi on. I, a shareholder on the fi rst day of a PFICs fi rst tax year as a QEF that i s a controlled forei gn corporati on (CFC), elect to treat an
amount equal to my share of the post-1986 earni ngs and profi ts of the CFC as an excess di stri buti on. Enter this amount on fine 15e of Part V. If the
F El
Electi on To Recogni ze Gai n on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to whi ch secti on 1297(d) appli es, elect to treat as an excess
di stri buti on the gai n recogni zed on the deemed sale of my i nterest i n the PFIC on the last day of i ts last tax year as a PFIC under secti on 1297(a). Enter
G El
Deemed Di vi dend Electi on Wi th Respect to a Secti on 1297(e) PFIC. I, a shareholder of a secti on 1297(e) PFIC, wi thi n the meani ng of Regulati ons secti on
1.1297-3(a), elect to make a deemed di vi dend electi on wi th respect to the Secti on 1297(e) PFIC. My holdi ng peri od i n the stock of the Secti on 1297(e)
PFIC i ncludes the CFC quali fi cati on date, as defi ned i n Regulati ons secti on 1.1297-3(d). Enter the excess distribution on fine 15e, Part V. If the excess
H El
Deemed Di vi dend Electi on Wi th Respect to a Former PFIC. I, a shareholder of a former PFIC, wi thi n the meani ng of Regulati ons secti on 1.1298-3(a),
elect to make a deemed di vi dend electi on wi th respect to the former PFIC. My holdi ng peri od i n the stock of the former PFIC i ncludes the termi nati on date, as
defi ned i n Regulati ons secti on 1.1298-3(d). Enter the excess distribution on fine 15e, Part V. If the excess distribution is greater than zero, also
u-tA For Di sclosure, Pri vacy Act, and Paperwork Reducti on Act Noti ce, see separate i nstructi ons.Form 8621(Rev. 12-2012)
^ 0 1
Form 0621 (Rev. 122012)
Page 2
Part lii Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines 6a through 7c. It you are making
6 a Enter your pro rata share of the ordinary earnings 01 the OEF
I
6b
I
Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary income ....................................................6c
I
la
I
lb
I
Subtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule D
used for your Income tax return. (See Instructions.)
8 a Add lines 6c and 7c ...........................................................................................................................................8a
or deemed distributed to you during the tax year of the QEF. (See instructions.).__ ______________________
o Enter the portion of line 8a not already included in line Bc that Is attributable to shares
in the QEF that you disposed of, pledged, or otherwise transferred during the tax yearBc
8d
Important If line Be is greater than zero, and no portion of line 6a or 7a is includible in income under section 951,
9 a Enter the total tax for the tax year (See instructions.).9a
online8e.
o Subtract line 9b from line 9a. This Is the deferred tax, the time for payment of which is extended by making
ElectionB .............................................................................................
or
Subtract line lOb from line lOa. If a gain, do not complete lines 11 and 12. Include this amount as ordinary Income
12
13a
CSubtract line 13b from line 13a. If a gain, do not complete line 14. Include this amount as ordinary Income on your
b Enter the loss from line 13c, but only to the extent of unreversed Inclusions on line 14a. Include this amount as an ordinary
..1.
.14c
Form 8621 (Rev. 12-2012)
212612
O1-2913
O I
Form8621(Rev. 12-2012)
Page 3
Part VDistributions From and Dispositions of Stock of a Section 1291 Fund(See

instructions.)
Complete aPart Vfo,r each excess distribution (see instructions).
15 a Enteryourtotal distributions fromthe section 1291fund during the current tax yearwith respect tothe applicable stock. If the
b Enterthe total distributions (reduced by the portions of such distributions that were excess distributions but not
included in income undersection 1291(a)(1)(B)) made by the fund with respect tothe applicable stock foreach of the 3 years
preceding the current tax year(orif shorter, the portion of the shareholder's holding period before the current tax year)
Divide line 15b by 3. (See instructions it the numberof preceding tax years is less than 3.)
e Subtract line 15d fromline 15a. This amount, if more than zero, is the excess distribution with respect tothe applicable stock.
If zeroorless and you did not dispose of stock during the tax year, donot complete the rest of Part V. See instructions if you
received more than one distribution during the current tax year. Also, see instructions forrules forreporting a nonexcess
distribution on yourIncome tax return
Entergain orloss fromthe disposition of stock of a section 1291fund orformersection 1291fund. If a gain,
complete line 16. If a loss, show it in brackets and donot complete line 16
16a Attach a statement foreach distribution and disposition. Show yourholding period foreach share of stock
orblock of shares held. Allocate the excess distribution toeach day in yourholding period. Add all amounts
that are allocated todays in each tax year.
b Enterthe total of the amounts determined in line 16a that are allocable tothe current tax yearand tax years
before the foreign corporation became a PFIC (pre-PFIC tax years). Enterthese amounts on yourIncome tax
returnas otherincome
SEE STATEMENT 35
Enterthe aggregate increases in tax (before credits) foreach tax yearin yourholding period
(otherthan the current tax yearand pre-PFIC years). (See instructions.)
e Subtract line 16d fromline 16c. Enterthis amount on yourincome tax return as 'additional tax.' (See instructions.)
I Determine interest on each net increase in tax determined on line 16e using the rates and methods of section 6621.
Enterthe aggregate amount of interest here. (See instructions.)....................................................................................
VI
Complete a separate column for each outstanding election. Complete lines 25 and 26
1294 election.
17 Tax yearof outstanding
election
18Undistributed earnings to
this return
26Interest accrued afterpartial
termnstinn nf p.lp.r.tirtn
Form8621(Rev. 12-2012)
18,048.
15b
15e1
18,048.
151
16b118,048.
16c
212613
01-29-13
Name of shareholder
C/O GELIEJER & CO, 909 THIRD AVE. NO. 16FL
20-5602483
Shareholder tax year. calendar year2 014
and endlnq
N ' t
Form o
8621 I
Information Return by a Shareholder of a Passive F
Investment Company or Qualified Electing Fur
InternalRevenue ServiceInformation about Form 8621and its separate instructions is at
tyly wiryv1fr,'nR21
NEW YORK, NY 10022
Check tvoe of shareholder fume the return:
JI I 0MB No. 1545.1002
Attachment
Sequence No. 69
PARTNERS GROUP GLOBAL OPPORTUNITIES LIMITED
P.O. BOX 477, TUDOR HOUSE
ST. PETER PORT, GUERNSEY
Part I Summary of Annual I nformation Part I is reserved for I
1Description of each class of shares held by the shareholder
EJ Check if shares jointly owned with spouse.
(a) El $0-50,000(b)$50,001-100,000(C)$100,001-150,000
or other
tax year beginning
and
use
(d)$150,001-200,000
(a) LIJ Section 1291$__________________________
(b)USection 1293 (Qualified Electing Fund) $________________________
(c) USection 1296(Mark to Market) $
Part I I Elections (See inst ruct ions.)
A L....J Election To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF.
Complete lines 6a through 7c of Part ill.
B LJ
Completelines 8a Through 9c of Part /// to calculate the tax that maybe deferred.
Note: If any portion of line Ga or line 7a of Part
ill
is includible under section 951, you
C UElection To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-market the PFIC stock that is marketable within the meaning of section
0EXi
Deemed Sale Election. I, a shareholder on the first day of a PFICs first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in the
UDeemed Dividend Election. I, a shareholder on the first day of a PFIC's first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat an
amount equal to my share of the post-1986earnings and profits of the CFC as an excess distribution.
Enter this amount on line 15e of Part V. if the
F UElection To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excess
G
Deemed Dividend Election With Respect to a Section 1297(e) PFIC. l,a shareholder of a section 1297(e) PFIC, within the meaning of Regulations section
PFIC includes the CFC qualification date, as defined in Regulations section 1.1297-3(d). Enter the excess distribution on line 15e, Part V. If the excess
H
defined In Regulations section 1.1298-3(d).
Enter the excess distribution on line 15e, Part V. if the excess distribution is greater than zero, also
LHA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.
Form 8621(Rev. 12-2012)
0
0
Form 8621 (Rev. 12-2012)
Page 2
All QEF shareholders complete lines Ba through 7c. If you are making
I
6a
I
b Enter the portion of line 6a that is included in income under section 951 or that maybe
excluded under section 1293(g)L6b
I
Subtract line Sb from line Ba. Enter this amount on your taxreturn as ordinary income ..........................................
I
ia
I
excluded under section 1293(g)j7b
I
used for your income taxreturn. (See instructions.)
8 a Add lines 6c and 7c ..........................................................................................................................................
or deemed distributed to you during the taxyear of the QEF. (See instructions.) .8b
CEnter the portion of line Ba not already included in line Sc that is attributable to shares
in the QEF that you disposed of, pledged, or otherwise transferred during the taxyear 8c
d Add lines Sb and 8c
Important:
If line Be is greater than zero, and no portion of line 6a or 7a is Includible in income under section 951,
9a Enter the total taxfor the taxyear (See instructions.) .
te b Enter the total taxfor the taxyear determined without regard to the amount enred
on line Be
9b
C
Subtract line 9b from line 9a. This Is the deferred tax, the time for payment of which is extended by making
Election B
90
ain or
on
lOa Enter the fair market value of your PFICstock at the end of the taxyear
b Enter your adjusted basis in the stock at the end of the taxyear .
on your taxreturn. If a loss, go to line 11
loss on your taxreturn
13If you sold or otherwise disposed of any section 1296 stock (see instructions) during the taxyear
a Enter the fair market value of the stock on the date of sale or disposition.
o Subtract line 13b from line 13a. If a gain, do not complete line 14. Include this amount as ordinary income on your
taxreturn. If a loss, go to line 14
._14a
loss on your taxreturn. If the loss on line 13c exceeds unreversed inclusions on line 14a, complete line 14c
Form 8621 (Rev. 12-2012)
I 6c
70
212612
01-29-13
Form 8621 (Rev. 12-2012)
P a g e 3
P a rt VDistributions From a nd Dispositions of Stock of a Se ction 1291 Fund(Se e
instructions.)
Complete aPart V for each excessdistribution (see instructions).
15 a Enter your total distributionsfrom the section1291 fund during the current tax year with respect to the applicable stock. If the
holding period of the stock beganinthe current tax year, see Instructions
b Enter the total distributions(reduced by the portionsof such distributionsthat were excessdistributionsbut not
included Inincome under section1291(a)(1)(B)) made by the fund with respect to the applicable stock for each of the 3 years
preceding the current tax year (or if shorter, the portion01 the shareholdersholding period before the current tax year)
o Divide line 15b by 3. (See instructionsif the number of preceding tax yearsislessthan3.)
it Multiply line 15cby 125% (1.25)
e Subtract line 15d from line 15a. Thisamount, if more thanzero, isthe excessdistributionwith respect to the applicable stock.
If zero or lessand youdid not dispose of stock during the tax year, do not complete the rest of Part V. See instructionsif you
received more thanone distributionduring the current tax year. Also, see instructionsfor rulesfor reporting a nonexcess
distributiononyour income tax return
Enter gainor lossfrom the dispositionof stock of a section1291 fund or former section1291 fund, It a gain,
complete line 16. If a loss, show it inbracketsand do not complete line 16
16 a Attach a statement for each distributionand disposition. Show your holding period for each share of stock
or block of sharesheld. Allocate the excessdistributionto each day inyour holding period. Add all amounts
that are allocated to daysineach tax year.
b Enter the total of the amountsdetermined inline 16a that are allocable to the current tax year and tax years
before the foreigncorporationbecame a PFIC (pre-PFIC tax years). Enter these amountsonyour Income tax
returnasother income
SEE STATEMENT 36
Enter the aggregate Increasesintax (before credits) for each tax year inyour holding period
(other thanthe current tax year and pre-PFIC years). (See instructions.)
d Foreigntax credit. (See instructions.)
e Subtract line 16d from line 16c. Enter thisamount onyour income tax returnas'additional tax.' (See instructions.)
I Determine interest oneach net increase intax determined online 16e using the ratesand methodsof section6621.
1.--------
_____..._& -' Interest "ere.
__._- -------
CEnter 1110 oyjitgae OIIIUUIILUI IiIt
-
0101nero. l,ee tflSUUCIIOflS.)
I
IN
I
P a rt VI
Sta tus of P rior Ye a r Se ction 1294 Ele ctions a nd Te rmina tion of Se ction 1294 Ele ctions
Complete a
separate column for each outstanding election. Complete lines 25 and 26 only if there is partial termination of the section
1294 election.
election
18 Undistributed earningsto
which the electionrelates
20 Interest accrued ondeferred
distributed during the taxyear
return
thisreturn
25 Defamed taxoutstanding altar
partial terminationof election
Form 8621 (Rev. 12-2012)
15b
10,055.
10,055.
16C
212613
01-29.13
S
S
A .
Form
8 6 2 1
(Rev. December 2 01 2 )
Name of shareholder
and its separate instructions is
OMB No. 1 545. 1 002
Attachment
Sequence No. 6 9
120-56 02483
Number, street, and roomor suite no. (If a P.O. box, see instructions.)
C/O GELLER & CO, 9 09 THIRD AVE. NO. 16 FL
NEW YORK, NY 10022
Check tvoe of shareholder filino the return:
BROOKSIDE CAYMAN LTD.
Shareholder tax year calendar year4 U 1 2
and ending
L..J S Corporation L_J Nongrantor Trust L...J Estati
Part ISummary of Annual Information Part I is reserved for futi
3 Number of shares held atthe end of the taxable year:
(a) El $0-50,000(b) El $50,001-100,000(C) El $100,001-150,000
or other
tax year beginning
and
ending
(d) EJ $150,001-200,000
5Type of PFIC and amount of any excess distribution or gain treated as an excess distribution under section 1291, inclusion under section
(a) EJ Section 1291 $________________________
(b) EJ Section 1293 (Qualified Electing Fund) $________________________
(c) El Section 1296 (Mark to Market) $_________________________
Part IIElections (See instructions. )
A L. . . . . J Election To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF.
BEl Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits
Complete lines 8a through 9c of Part Ill to calculate the tax that may be deferred.
Note: If any portion of line 6a or line 7a of Part /// is Includible under section 951, you
C El Election To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-market the PFIG stock that is marketable within the meaning of section
D c:i
Deemed Sale Election. I, a shareholder on the first day of a PFICs first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in the
F El Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excess
distribution the gain recognized on the deemed sale of my interest in the PFIC on the last day of its last tax year as a PFIC under section 1297(a).
Enter
G El
PFIC Includes the CFC qualification date, as defined in Regulations section 1.1297-3(d).
Enter the excess distribution on line 15e, Part V. If the excess
El
defined In Regulations section 1.1298-3(d). Enter the excess distribution online 15e, Part V. If the excess distribution is greater than zero, also
01-29-13 u-i.. For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.
Form8621 (Rev. 12-2012)
Form 8621 (Rev. 12-2012)
Page 2
6a Enter your pro rata share of the ordinary earnings of the QEF.6a
I
I
6b
I
Subtract line Sb from line 6a. Enter this amount on your tax return as ordinary Income
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
60
7a Enter your pro rata share of the total net capital gain of the QEF
J
7a
I
b Enter the portion of line 7a that is included in income under section 951 or that maybe
I
7b
I
Subtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule D
..i
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . aa
c Enter the portion of line Ba not already included in line 8c that is attributable to shares
Important
If line Be is greater than zero, and no portion of line 6a or 7a Is includible in income under section 951,
you may make Election B with respect to the amount on fine Be.
ga
on line Be9b
CSubtract line 9b from line 9a. This is the deferred tax, the time for payment of which is extended by making
9c
or
12 Enter the loss from line bc, but only to the extent of unreversed inclusions on line 11. Include this amount as an ordinary
loss on your tax return. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
13a
14a Enter any unreversed inclusions (as defined in section 1296(d)).
.j. !
c Enter the amount by which the loss on line 13c exceeds unreversed Inclusions on line 14a. Include this amount on your tax
return according to the rules generally applicable for losses provided elsewhere in the Code and regulations.14c
Form 8621 (Rev. 12-2012)
212612
01-29-13
Al
Form 8 6 2 1 ( R e v . 1 2 - 2 0 1 2 )
Plane 3
Part VDistributions From and Dispositions of Stock of a Section 1291 Fund(See instructions. )
- Complete a
eoamte
Part Vfor each excess distribution (see instructions).
included In Income under section 1291(a)(1)(13)) made by the fund with respect to the applicable stock for each of the 3 years
it Multiply line 15c by 1259/6 (1.25)
It zero or less and you did not dispose of stock during the tax year, do not complete the rest of Part V. See instructions if you
complete line 16.11 a loss, show it in brackets and do not complete line 16
return as other income SEE STATEMENT 37
(other than the current tax year and pre-PFIC years). (See instructions.) ...........................................................
Enter the aooreaate amount of interest here. (See instructions.
15a
15b
15e
15f 1 1 0 ,32 3.
32 3.
VIStatus of Prior Year Section 1294 Elections and Termination of Section 1294 Elections
Complete a separate column for each outstanding election. Complete lines 25 and 26 only if there Is partial termination of the section
1294 election.
election
19 Deferred tax
20inte re st accrue d on de fe rre d
tax ( line 1 9) as of the Cling date
22 Earnings distribute d or de e me d
distribute d during the lax ye ar
return
this return
25 De fe rre d tax outstanding afte r
partial te rmination of e le ction
Form 8621 (Rev. 12-2012)
2 1 2 6 1 3
0 1 - 2 9- 1 3
I
.
E l
D i
Form
8 6 2 1 1
Information Return by a Sharehol der of a Passive Foi
(Rev, December IInvestment Company or Qual ified E l ecting Fund
D epartment of the Treasury
INo- Intemel Revenue Service 1 -_Information about Form 8621 and its separate instructions is at
mnvw i, nnv1fnrmR91
OMB No. 1545-1002
Attachment
Sequence No. 69
Name of shareholder
NEW YORK, NY 10022
Check Noe of shareholder filinothe return: 77Individual
TPGAXON PARTNERS (OFFSHORE), LTD.
20-5602483
Shareholder tax year: calendar year U 1A or other tax year begi nni ng
and endi ng
L..J S Corporation L......J Nongrantor Trust L.J Estat
or other
tax year beginning
and
Provide the following information with respect toall shares of the PFIC held by the shareholder:
EJ Check U shares jointly owned with spouse.
(a)$0-50,000(b)$50,001-100,000(C)$100,001-150,000
(a) It more than $200,000, list value:
(d)$150,001-200,000
(a)
Section 1291 $__________________________
(b) Section 1293 (Qualified Electing Fund) $____________________
(c) LIISection 1296 (Mark toMarket) $_________________________
Part H Elections (See instructions.)
A Li Election ToTreat the PFIC as a QEF. l.a shareholder of a PFIC, elect totreat the PFIC as a DEF. Complete lines 6a through 7c of Part Ill.
BLJ Election ToExtend Time For Payment of Tax. l.a shareholder of a QEF, elect toextend the time for payment of tax on the undistributed earnings and profits
of the QEF until this election is terminated. Complete fines Sa through 9c of Part Ill to calculate the tax that may be deferred.
Note: If any portion of fine 6a or line 7a of Part 1/1 is includible under section 951, you
maynot
C El Election ToMark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect tomark-to-market the PFIC stock that is marketable within the meaning of section
D EIi Deemed Sale Election. I, a shareholder on the first day of a PFIC's first tax year as a QEF, elect torecognize gain on the deemed sale of my interest in the
PFIC. Enter gain orloss on line 15f of Part V.
EDeemed Dividend Election. I, a shareholder on the first day of a PFICs first tax year as a QEF that is a controlled foreign corporation (CFC), elect totreat an
amount equal tomy share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount on line 15e of Part V. If the
excess distribution is greater than zero, alsocomplete line 16 of Part V.
FElection ToRecognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC towhich section 1297(d) applies, electtotreat as an excess
G
Deemed Dividend Election With Respect toa Section 1297(e) PFIC. I, a shareholder of a section 1297(e) PFIC, within the meaning of Regulations section
1.1297-3(a), elect tomake a deemed dividend election with respect tothe Section 1297(e) PFIC. My holding period in the stock of the Section 1297(e)
PFIC Includes the CFC qualification date, as defined in Regulations section 1.1297-3(d). Enter the excess distribution on line 15e, Part V. If the excess
H
Deemed Dividend Election With Respect toa Former PFIC. I, a shareholder of a former PFIC, within the meaning of Regulations section 1.1298-3(a),
elect tomake a deemed dividend election with respect tothe former PFIC. My holding period in the stock of the former PFIC includes the termination date, as
01-29-13 U-IA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 8621 (Rev. 12-2012)
Form 8621 (Rev. 12-2012)
Page 2
All QEF shareholders complete lines 6a through 7c. Ifyou are making
Election B, also complete lines 8a through Sc. (See instructions.)
6 a Enter your pro rata share of the ordinary earnings of the flEE.6a
I
I
6b
I
o Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary income
...................................................
I
7a
I
b Enter the portion of line 7a that is Included in income under section 951 or that may be
I
7b
I
c Subtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule D
..........................................................................................................................................
o Enter the portion of line 8a not already included In line Sc that is attributable to shares
in the flEE that you disposed of, pledged, or otherwise transferred during the tax year 8e
Important: If line Be is greater than zero, and no portion of line Ba or 7a is Includible in income under section 951,
9 a Enter the total tax for the tax year (See instructions.).99
on line 8e
I
Yb
I
Subtract line Yb from line 9a. This is the deferred tax, the time for payment of which is extended by making
Election B
rt IVGain or (Loss) From Mark-to-Market Election (See
instructions.
iDa Enter the fair market value of your PFIC stock at the end of the tax year
.!
.lot)
income o Subtract line lOb from line iDa. If a gain, do not complete lines 11 and 12. Include this amount as ordinary
..i
11 Enter any unreversed Inclusions (as defined in section 1296(d))
._ii_
losson your tax return ........................................................................................................................................
13 If you sold or otherwise disposed of any section 1296 stock (see instructions) during the tax year:
a Enter the fair market value of the stock on the date of sale or disposition.
b Enter the adjusted basis of the stock on the date of sale or disposition.
o Subtract line 13b from line 13a. If a gain, do not complete line 14. Include this amount as ordinary Income on your
.j..
.j.
Form 8621 (Rev. 12-2012)
6c
8d
212612
01-29-13
1 4
^ A
Form 8621 (Rev. 12-2012)
Page 3
-Complete aPart V f or each excess distribution (see instructions).
Included in income under section 1291(a)(1)(B)) made by the fund with respect to the applicable stock for each of the 3 years
Subtract line 15d from tine 15a. This amount, if more than zero, is the excess distribution with respect to the applicable stock.
03.286.>
that are allocated to days In each tax year.
return as other incomeSEE STATEMENT 38
<703.286.>
o Enter the aggregate Increases In tax (before credits) for each tax year in your holding period
e Subtract line 16d from line 16c. Enter this amount on your income tax return as additional tax? (See instructions.)
Enter the aggregate amount of interest here. (See instructions.)....................................................................................
1294 election.
election
19 Deterred tax
tax (tine 19) as of the filing date
return
this return
Form 8621 (Rev. 12-2012)
212613
01-29.13
I
T H E B L O O M B E R G F A M I L Y A U N D A T I O N I N C
20-5602483
FORM 8621DISTRIBUTIONS OF STOCK IN A SECTION 1291 FUND STATEMENT 21
12/16/10
12/31/12
PERIOD
461.
461.
0.
11/23/10
12/31/12
PERIOD
3,458.
3,458.
0.
04/22/10
12/31/12
PERIOD
34,580.
34,580.
0.
12/16/10
12/31/12
1. DATE STOCK PURCHASED
2. DATE STOCK DISPOSED OF OR DISTRIBUTED
3. EXCESS DISTRIBUTION ALLOCATED TO EACH DAY IN HOLDING
4. TOTAL ALLOCABLE TO EACH TAX YEAR IN HOLDING PERIOD
5. TOTAL ALLOCABLE TO THE CURRENT TAX YEAR AND
PRE-PFIC TAX YEARS, IF DIFFERENT
6. TOTAL TO LINE 16B (LINE 4 OR 5)
7. TAX. TOTAL TO LINE 16C
8. FOREIGN TAX CREDIT. TOTAL TO LINE 16D
9. NET TAX. TOTAL TO LINE 16E
10. INTEREST. TOTAL TO LINE 16F
3. EXCESS DISTRIBUTION ALLOCATED TO EACH DAY IN HOLDING PERIOD
922.
922.
[ ' p
115STATEMENT(S) 21
THE Bri0OMBERG FAMILY F JNDATION INC
1 9
20-5602483
FORM 8621 DISTRIBUTIONS OF STOCK IN A SECTION 1 29 1 FUND
STATEMENT
22
09/16/10
1 2/31 /1 2
7. TAX. TOTAL TO LINE 1 6C
1 ,431 .
1,431.
116
STATEMENT(S) 22
17171111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOONFA2
THE BLOOMBERG FAMILY F (JNDATION INC
20-5602483
FORM 8621
DISTRIBUTIONS OF STOCK IN A SECTION 1291 FUND
STATEMENT 23
I.DATE STOCK PURCHASED
09/16/10
2 DATE STOCK DISPOSED OF OR DISTRIBUTED
12/31/12
1,277.
1,277.
[ ' p
117
STATEMENT(S) 23
17171111 737725 BLOOMF.ANFND 2012.04040 THE BLOONBERG FAMILY FOTJNDA BLOOMFA2
THE BLOOMBERG FAMILY(JNDATION INC
20-5602483
FORM 8621DISTRIBUTIONS OF STOCK IN A SECTION 1291 FUND STATEMENT 24
1.. DATE STOCK PURCHASED09/16/10
2. DATE STOCK DISPOSED OF OR DISTRIBUTED12/31/12
1,135.
1,135.
118STATEMENT(S) 24
17171111 737725 BLOOMF.ANFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
THE BLOOMBERG FAMILY 1NDATION INC
20-5602483
FORM 8621
STATEMENT 25
DATE STOCK PURCHASED
11/23/10
DATE STOCK DISPOSED OF OR DISTRIBUTED
04/25/12
EXCESS DISTRIBUTION ALLOCATED TO EACH DAY IN HOLDING PERIOD
TOTAL ALLOCABLE TO EACH TAX YEAR IN HOLDING PERIOD
TOTAL ALLOCABLE TO THE CURRENT TAX YEAR AND
TOTAL TO LINE 16B (LINE 4 OR 5)
TAX. TOTAL TO LINE 16C
FOREIGN TAX CREDIT. TOTAL TO LINE 16D
NET TAX. TOTAL TO LINE 16E
INTEREST. TOTAL TO LINE 16F
DATE STOCK PURCHASED
11/23/10
DATE STOCK DISPOSED OF OR DISTRIBUTED
04/25/12
EXCESS DISTRIBUTION ALLOCATED TO EACH DAY IN HOLDING PERIOD
TOTAL ALLOCABLE TO EACH TAX YEAR IN HOLDING PERIOD
TOTAL ALLOCABLE TO THE CURRENT TAX YEAR AND
TOTAL TO LINE 16B (LINE 4 OR 5)
TAX. TOTAL TO LINE 16C
FOREIGN TAX CREDIT. TOTAL TO LINE 16D
NET TAX. TOTAL TO LINE 16E
INTEREST. TOTAL TO LINE 16F
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
1,205.
1,205.
0.
1,527.
1,527.
0.
119
STATEMENT(S) 25
THE BLOOMBERG FAMILY 1NDATION INC
20-5602483
FORM 8621DISTRIBUTIONS OF STOCK IN A SECTION 1291 FUNDSTATEMENT 26
10/15/10
11/06/12
PERIOD
3,070.
3,070.
0.
10/15/10
12/31/12
PERIOD
943.
943.
0.
120STATEMENT(S) 26
T H E B L O O M B E R G F A M I L Y A M D A T I O N I N C 20-5602483
FORM 8621DISTRIBUTIONS OF STOCK IN A SECTION 1291 FUNDS T A T E M E N T 2 7
D A T E S T O C K P U R C H A S E D 1 1 / 1 8 / 1 0
D A T E S T O C K D I S P O S E D O F O R D I S T R I B U T E D 1 2 / 3 1 / 1 2
E X C E S S D I S T R I B U T I O N A L L O C A T E D T O E A C H D A Y I N H O L D I N G P E R I O D
T O T A L A L L O C A B L E T O E A C H T A X Y E A R I N H O L D I N G P E R I O D
T O T A L A L L O C A B L E T O T H E C U R R E N T T A X Y E A R A N D
P R E - P F I C T A X Y E A R S , I F D I F F E R E N T
T O T A L T O L I N E 1 6 B ( L I N E 4 O R 5)
T A X . T O T A L T O L I N E 16C
F O R E I G N T A X C R E D I T . T O T A L T O L I N E 1 6 D
N E T T A X . T O T A L T O L I N E 1 6 E
I N T E R E S T . T O T A L T O L I N E 1 6 F
1.
2.
3.
4.
5.
6.
7 .
8 .
9.
1 0 .
5,801.
5 , 8 0 1 .
1 2 1 S T A T E M E N T ( S ) 2 7
1 7 1 7 1 1 1 1 7 3 7 7 2 5 B L O O M F A M F N D 2 0 1 2 . 0 4 0 4 0 T H E B L O O M B E R G F A M I L Y F O U N D A B L O O M F A 2
T H E B L O O M B E R G F A M I L Y A M A T I O N I N C
[ I ]
20-5602483
FORM 8621DISTRIBUTIONS/DISPOSITIONS OF SEC 1291 STOCK
STATEMENT 28
15A ENTER THE TOTAL DISTRIBUTIONS FROM THE PFIC DURING THE
CURRENT TAX YEAR. IF THE HOLDING PERIOD OF THE PFIC STOCK
BEGAN IN THE CURRENT TAX YEAR, THIS AMOUNT IS DIVIDEND
INCOME TO THE EXTENT THERE ARE ACCUMULATED EARNINGS AND
PROFITS
B ENTER THE TOTAL DISTRIBUTIONS (REDUCED BY THE PORTIONS OF
SUCH DISTRIBUTIONS THAT WERE EXCESS DISTRIBUTIONS BUT NOT
INCLUDED IN INCOME UNDER SECTION 1291(A)(1)(B)) MADE BY
THE COMPANY FOR EACH OF THE 3 YEARS PRECEEDING THE
CURRENT TAX YEAR (OR IF SHORTER, THE PORTION OF THE
SHAREHOLDER'S HOLDING PERIOD BEFORE THE CURRENT TAX YEAR)
C DIVIDE LINE 15B BY 3
D MULTIPLE LINE 15C BY 125%. ENTER THE LESSER OF LINE 15A
OR LINE 15D AS DIVIDEND INCOME ON YOUR INCOME TAX RETURN
E SUBTRACT LINE 15D FROM LINE 15A. THIS AMOUNT, IF MORE THAN
ZERO, IS THE TOTAL EXCESS DISTRIBUTION. IF ZERO OR LESS
AND YOU DID NOT DISPOSE OF STOCK DURING THE TAX YEAR, DO
NOT COMPLETE THE REST OF PART IV
F ENTER GAIN OR LOSS FROM THE DISPOSITION OF STOCK OF A
SECTION 1291 FUND OR A FORMER SECTION 1291 FUND. IF A
GAIN, COMPLETE LINE 16. IF A LOSS, SHOW IT IN BRACKETS
AND DO NOT COMPLETE LINE 16
15A ENTER THE TOTAL DISTRIBUTIONS FROM THE PFIC DURING THE
CURRENT TAX YEAR. IF THE HOLDING PERIOD OF THE PFIC STOCK
BEGAN IN THE CURRENT TAX YEAR, THIS AMOUNT IS DIVIDEND
INCOME TO THE EXTENT THERE ARE ACCUMULATED EARNINGS AND
PROFITS
B ENTER THE TOTAL DISTRIBUTIONS (REDUCED BY THE PORTIONS OF
SUCH DISTRIBUTIONS THAT WERE EXCESS DISTRIBUTIONS BUT NOT
INCLUDED IN INCOME UNDER SECTION 1291(A)(1)(B)) MADE BY
THE COMPANY FOR EACH OF THE 3 YEARS PRECEEDING THE
CURRENT TAX YEAR (OR IF SHORTER, THE PORTION OF THE
SHAREHOLDER'S HOLDING PERIOD BEFORE THE CURRENT TAX YEAR)
C DIVIDE LINE 15B BY 3
D MULTIPLE LINE 15C BY 125%. ENTER THE LESSER OF LINE 15A
OR LINE 15D AS DIVIDEND INCOME ON YOUR INCOME TAX RETURN
E SUBTRACT LINE 15D FROM LINE 15A. THIS AMOUNT, IF MORE THAN
ZERO, IS THE TOTAL EXCESS DISTRIBUTION. IF ZERO OR LESS
AND YOU DID NOT DISPOSE OF STOCK DURING THE TAX YEAR, DO
NOT COMPLETE THE REST OF PART IV
F ENTER GAIN OR LOSS FROM THE DISPOSITION OF STOCK OF A
SECTION 1291 FUND OR A FORMER SECTION 1291 FUND. IF A
GAIN, COMPLETE LINE 16. IF A LOSS, SHOW IT IN BRACKETS
AND DO NOT COMPLETE LINE 16
64,649.
32,751.
16,376.
20,470.
44,179.
22,385.
11,341.
11,341.
14,176.
8,209.
122
STATEMENT(S) 28
S
THE BLOOMBERG FAMILYNDATION INC
20-5602483
04/15/10
12/31/12
PERIOD
44,181.
44,181.
0.
02/24/11
12/31/12
PERIOD
8,207.
8,207.
0.
123STATEMENT(S) 29
T H E B L O O M B E R G F A M I L Y A U N D A T I O N I N C
I F - A
2 0 - 5 6 0 2 4 8 3
F ORM 8621D I S T R I B U T I O N S O F S T O C K I N A S E C T I O N 1 2 9 1 F U N D S T A T E M E N T 3 0
0 3 /2 6 /1 0
0 9 /1 2 /1 2
PE R I O D
1 9 ,6 1 9 .
1 9 ,6 1 9 .
0 .
0 3 /2 6 /1 0
0 9 /1 2 /1 2
PE R I O D
1 76 ,5 72 .
1 76 ,5 72 .
0 .
1 2 /1 1 /1 1
0 9 /1 2 /1 2
PE R I O D
3 7,5 4 2 .
3 7,5 4 2 .
0 .
0 3 /2 6 /1 0
1 2 /3 1 /1 2
PE R I O D
2 ,3 8 5 .
2 ,3 8 5 .
0 .
1 . D A T E S T O C K PU R C H A S E D
2 . D A T E S T O C K D I S PO S E D O F O R D I S T R I B U T E D
3 . E XC E S S D I S T R I B U T I O N A L L O C A T E D T O E A C H D A Y I N H O L D I N G
4 . T O T A L A L L O C A B L E T O E A C H T A X Y E A R I N H O L D I N G PE R I O D
5 . T O T A L A L L O C A B L E T O T H E C U R R E N T T A X Y E A R A N D
PR E - PF I C T A X Y E A R S , I F D I F F E R E N T
6 . T O T A L T O L I N E 1 6 B (L I N E 4 O R 5 )
7. T A X. T O T A L T O L I N E 1 6 C
8 . F O R E I G N T A X C R E D I T . T O T A L T O L I N E 1 6 D
9 . N E T T A X. T O T A L T O L I N E 1 6 E
1 0 . I N T E R E S T . T O T A L T O L I N E 1 6 F
1 2 4 S T A T E M E N T (S ) 3 0
1 71 71 1 1 1 73 772 5 B L O O M F A N F N D 2 0 1 2 .0 4 0 4 0 T H E B L O O M B E R G F A M I L Y F O U N D A B L O O M F A 2
D A T E S T O C K P U R C H A S E D
D A T E S T O C K D I S P O S E D O F O R D I S T R I B U T E D
T O T A L T O L I N E 1 6 B ( L I N E 4 O R 5 )
T A X . T O T A L T O L I N E 1 6 C
1 .
2.
3.
4 .
5 .
6 .
7.
8.
9.
10.
1.
2.
3.
4 .
5 .
6 .
7.
8.
9.
10.
114
T H E B L O O M B E R G F A M I L Y A U N D A T I O N I N C 20 - 5 6 0 24 83
0 3/ 26 / 1 0
1 2/ 31 / 1 2
21 , 4 6 2.
21 , 4 6 2.
0.
1 2/ 1 2/ 1 1
1 2/ 31 / 1 2
1 4 , 74 4 .
1 4 , 74 4 .
0 .
1 25 S T A T E M E N T ( S ) 30
1 71 71 1 1 1 737725 B L O O M F A M F N D 20 1 2. 0 4 0 4 0 T H E B L O O M B E R G F A M I L Y F O U N D A B L O O M F A 2
THE BLOOMBERG FAMILY FATION INC ND
20-5602483
FORE 8621DISTRIBUTIONS OF STOCK IN A SECTION 1291 FUND STATEMENT 31
07/01/10
07/31/12
80,866.
80,866.
0.
07/01/10
10/09/12
144 ,645.
144,645.
0.
PRE'-PFIC TAX YEARS, IF DIFFERENT
126STATEMENT(S) 31
T H E B L O O M B E R G F A M I L Y A N D A T I O N I N C
2 0 - 5 6 0 2 4 8 3
FORM 8621
D I S T R I B U T I O N S O F S T O C K I N A S E C T I O N 1 2 9 1 F U N D
S T A T E M E N T 3 2
E X C E S S D I S T R I B U T I O N A L L O C A T E D T O E A C H D A Y I N H O L D I N G
E X C E S S D I S T R I B U T I O N A L L O C A T E D T O E A C H D A Y I N H O L D I N G
1.
2 .
3 .
4 .
5 .
6 .
7.
8 .
9 .
1 0 .
1 .
2 .
3 .
4 .
5 .
6 .
7.
8 .
9 .
1 0 .
0 2 / 2 3 / 1 2
0 2 / 2 3 / 1 2
P E R I O D
4 9 .
4 9 .
0 .
0 2 / 2 3 / 1 2
0 5 / 1 8 / 1 2
P E R I O D
2 , 6 0 4 .
2 , 6 0 4 .
0 .
0 2 / 2 3 / 1 2
0 8 / 0 7/ 1 2
1 .
2 .
3 .
4 .
5 .
6 .
7.
8 .
9 .
1 0 .
778 .
778 .
0 .
1 2 7
S T A T E M E N T ( S ) 3 2
1 71 71 1 1 1 73 772 5 B L O O M F A M F N D 2 0 1 2 . 0 4 0 4 0 T H E B L O O M B E R G F A M I L Y F O U N D A B L O O M F A 2
THE BLOOMBERG FAMILY FNDATION INC
20-5602483
FORM 8621
STATEMENT 33
07/01/10
01/17/12
1,171.
1,171.
0.
07/01/10
07/24/12
7,681.
7,681.
0.
128
STATEMENT(S) 33
S

is
THE BLOOMBERG FAMILY &DATION INC
20-5602483
FORM 8621DISTRIBUTIONS OF STOCK IN A SECTION 1291 FUND
STATEMENT 34
04/01/09
03/13/12
<1,938.>
<1,938.>
0.
04/01/09
10/23/12
32,958.
32,958.
0.
129STATEMENT(S) 34
THE BLOOMBERG FAMILY &DATION INC- 20- 5602483
04/08/10
01/01/12
18,048.
18,048.
0.
PRE- PFIC TAX YEARS, IF DIFFERENT
130STATEMENT(S) 35
THE BLOOMBERG FAMILY 1tNDATION INC
20-5602483
FORM 8621DISTRIBUTIONS OF STOCK IN A SECTION 1291 FUND
STATEMENT 36
I. DATE STOCK PURCHASED
07/06/11
02/08/12
2,825.
2,825.
0.
07/06/11
05/10/12
2,611.
2,611.
0.
07/06/11
08/03/12
2,369.
2,369.
0.
07/06/11
11/01/12
2,250.
2,250.
0.
131
STATEMENT(s) 36
THE BLOOMBERG FAMILY (JNDATION INC
20-5602483
01/01/08
12/31/12
10,323.
10,323.
0.
132STATEMENT(S) 37
THE BLOOMBERG FAMILY (JNDATION INC
20-5602483
01/01/08
12/31/12
<703,286.>
<703,286.>
0.
133STATEMENT(S) 38
17171111 737725 BLIOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
E#
:z
Form
8886
Reportable Transaction Disclosure Statement

(Rev. March 2011)
A f t ach t o y ou r t ax ret u rn .
Depart men t of t he Treasu ry
S ee separat e i n st ru ct i on s.
Name(s) shown on ret u rn (i n di vi du als en t er last n ame, f i rst n ame, mi ddle i n i t i al)
OMB No. 1545-1800
A t t achmen t
S equ en ce No. 13 7
Iden t i f y i n g n u mber
20-5602483
Nu mber, st reet , an d roomor su i t e n o. I Ci t y or t own , st at e, an d ZIP code
C/O GELLER & CO, 909 THIRD AVE. NO. 16 NEW YORK, NY 10022
A If y ou are f i li n g more t han on e Form8886wi t h y ou r t ax ret u rn , sequ en t i ally n u mber each Form8886an d en t er t he st at emen t n u mber
f or t hi s Form8888...................................................... S t at emen t n u mber1 of 4
BEn t er t he f ormn u mber of t he t ax ret u rn t o whi ch t hi s f ormIs at t ached or relat ed .................................................................
00.
99 0 PF
En t er t he y ear of t he t ax ret u rn i den t i f i ed above2012
Is t hi s Form8886bei n g f i led wi t h an amen ded t ax ret u rn ? ................................................................................................ L..J YesLXJ No
CCheck t he box (es) t hat apply (see i n st ru ct i on s).L - - - J In i t i al y ear f i lerL...J Prot ect i ve di sclosu re
I Name of report able t ran sact i on
FOREIGN CURRENCY LOSS PURSUANT TO IRC SECTION 988
lb In i t i al y ear part i ci pat ed i n t ran sact i on
i c Report able t ran sact i on or t ax shelt er regi st rat i on n u mber

2009
2i den t i f y t he
t y pe
of report able t ran sact i on . Check all box es t hat apply (see i n st ru ct i on s).
a LJ Li st edcCon t ract u al prot ect i on e Ei J Tran sact i on of i n t erest
b EJ Con f i den t i ald EJ Loss
3 lf y ou checked box 2a or2e, en t ert he pu bli shed gu i dan ce n u mberf ort he li st ed t ran sact i on
ort ran sact i on of i n t erest
4En t er t he n u mber of 'same as or su bst an t i ally si mi lar t ran sact i on s report ed on t hi s f orm...............................................................
5If y ou part i ci pat ed i n t hi s report able t ran sact i on t hrou gh a part n ershi p, S corporat i on , t ru st , an d f orei gn en t i t y , check t he appli cable box es an d provi de t he
i n f ormat i on below f or t he en t i t y (s) (see i n st ru ct i on s). (A t t ach addi t i on al sheet s, If n ecessary .)
a Ty pe of en t i t y I mp- Part n ershi pTru st Part n ershi pTru st
S corporat i on Forei gn L1 S corporat i on Forei gn

b Name
SEE STATEMENT 39
c Employ er i den t i f i cat i on n u mber (EIN), i f kn own
d Dat e S chedu le K- i recei ved f romen t i t y (en t er
'n on e' i f S chedu le K- i n ot recei ved) ............
6
En t er below t he n ame an d address of each i n di vi du al or en t i t y t o whomy ou pai d a f ee wi t h regard t o t he t ran sact i on i f t hat i n di vi du al or en t i t y promot ed, soli ci t ed, or
recommen ded y ou r part i ci pat i on i n t he t ran sact i on , or provi ded t ax advi ce relat ed t o t he t ran sact i on . (A t t ach addi t i on al sheet s, i f n ecessary .)
a
Name
t
Iden t i f y i n g n u mber (i f kn own ) I Fees pai d
Nu mber, st reet , an d roomor su i t e n o.
Ci t y or t own , S t at e, an d ZIP code
b Name
Iden t i f y i n g n u mber (i f kn own ) I Fees pai d

Nu mber, st reet , an d roomor su i t e n o.
Ci t y or t own , S t at e, an d ZIP code
05- 01 212 LI- IA
For Paperwork Redu ct i on A ct Not i ce, see separat e In st ru ct i on s. Form8886(Rev. 3 - 2011)
135
17171111 737725 BLOOMFAMFND 2012.04040 THE BLOONBERG FAMILY FOTJNDA BLOOMFA2
T H E B L O O M B E R G F A M I L Y O M A T I O N I N C
A MA
U.
20-5602483
Forni8805 (Rev. 3-2011)
Page 2
7 Facts
a Identify the type of tax benefit generated by the transaction. Check all the boxes that apply (see instructions).
E l DeductionsLJ E xclusions from gross incomeLJ Absence of adjustments to basisTax Credits
E l Capital lossE l Nonrecognition of gainE l Deferral
LXI Ordinary lossE l Adjustments to basisE l Other
b Further describe the amount and nature of the expected tax treatment and expected tax benefits generated by the transaction for all affected years. Include facts of
each step of the transaction that relate to the expected tax benefits including the amount and nature of your investment. Include in your description your
participation in the transaction and all related transactions regardless of the year in which they were entered into. Also, include a description of any tax result
protection with respect to the transaction.
F O R E I G N C U R R E N C Y L O S S O F 6 7 , 5 6 5 T H R O U G H I N V E S T M E N T I N U N D E R L Y I N G
P A R T N E R S H I P P U R S U A N T T O I R C S E C T I O N 9 8 8 .
Identify all individuals and entities involved in the transaction that are tax-exempt, foreign, or related. Check the appropriate box(es) (see instructions). Include their
name(s), identifying number(s), address(es), and a brief description of their involvement For each foreign entity, identify its country of incorporation or existence. For
each individual or related entity, explain how the individual or entity Is related. Attach additional sheets, if necessary.
a Type of individual or entity:E :]Tax-exemptE l ForeignEJ Related
Name
Identifying number
Address
Description
b Type of individual or
Related
Name
Identifying number
Address
Description
4ib4
05-01-12
Form 8886 (Rev. 3-2011)
1 3 6
1 7 1 7 1 1 1 1 7 3 7 7 2 5 B L O O M F A N F N D 2 0 1 2 . 0 4 0 4 0 T H E B L O O M B E R G F A M I L Y F O U N D A B L O O M F A 2
A
I 7 A
8886
(Rev. March 2011)
Depalment of the Treasury
Attach to your tax return.
See separate instructions.
OMB No, 1545-1800
Attachment
Sequence No. 137
Identifying number
2 0 - 5 6 0 2 4 8 3
Name(s) shown on return (individuals enter last name, first name, middle initial)
T H E B L O O M B E R G F A M I L Y F O U N D A T I O N I N C
Number, street, and room or suite no.
R W
or town, state, and ZIP code
C /OGELLER&CO, 909THIRDAVE. NO. 16 Y O R K , N Y 1 0 0 2 2
AIf are filing more than one Form 8886with your tax return, sequentially number each Form 8886and enter the statement number
forthis Form 8886........Statement number2 of4
B Enter the form number of the tax return to which this form is attached or related 9 9 0 P F
Enter the year of the tax return identified above................................................................ 1 1 0.
2 0 1 2
Is this Form 8886being filed with an amended tax return? ................................................................................................ L..J YesLXJ No
CCheck the box(es) that apply (see instructions). L...J Initial year filerLI
Protective disclosure
I a Name of reportable transaction
F O R E I G N C U R R E N C Y L O S S P U R S U A N T T O I R C S E C T I O N 9 8 8
lb Initial year participated in transaction
2011
2 Identify the type of reportable transaction. Check all boxes that apply (see instructions).
a EJ ListedcContractual protectione i::ii Transaction of interest
b El Confidentiald EXI Loss
3 If you checked box 2a or2e, enter the published guidance number for the listed transaction
or transaction of interest...........
4 Enter the number of 'same as or substantially similar transactions reported on this form00.
5If you participated In this reportable transaction through a partnership, S corporation, trust, and foreign entity, check the applicable boxes and provide the
information below for the entity(s) (see instructions). (Attach additional sheets, If necessary.)
a Type of entity...El PartnershipEl TrustEl PartnershipEl Trust
El S corporation El Foreign El S corporation El Foreign
b Name
S E E S T A T E M E N T 4 0
c Employer identification number (EIN), if known
d Date Schedule K-i received from entity (enter
'none' if Schedule K-i not received)00.
6Enter below the name and address of each individual or entity to whom you paid a fee with regard to the transaction if that individual or entity promoted, solicited, or
recommended your participation In the transaction, or provided tax advice related to the transaction. (Attach additional sheets, if necessary.)
a NameIdentifying number (it known)Fees paid
$
City or town, State, and ZIP code
b Name
Identifying number (if known)

I
Fees paid
05-01-12 LI-IAFor Paperwork Reduction Act Notice, see separate instructions. Form 8886(Rev. 3-2011)
1 3 7
1 7 1 7 1 1 1 1 7 3 7 7 2 5 E L O O M F A N F N D 2 0 1 2 . 0 4 0 4 0 T H E B L O O N B E R G F A M I L Y F O U N D A B L O O M F A 2
ic Reportable transaction or tax shelter registration number
THE BLOOMBERG FAMILY JNDATION INC20-5602483
Form6886 (Rev. 3-2011)
Page 2
7 Facts
aIdentify the type of tax benefit generated by the transaction. Check all the boxes that apply (see instructions).
El DeductionsEJ Exclusions from gross incomeEl Absence of adjustments to basis1 1 1 1 1 Tax Credits
EJ Capital lossEl Nonrecognition of gainEl Deferral
lj Ordinary lossEl
Adjustments to basisEl Other
Further describe the amount and nature of the expected tax treatment and expected tax benefits generated by the transaction for all affected years. Include facts of
each step of the transaction that relate to the expected tax benefits includingthe amount and nature of your investment Include In your description your
participation in the transaction and all related transactions regardless of the year in which they were entered into. Also, include adescription of any tax result
FOREIGN CURRENCY LOSS OF 199,059 THROUGH INVESTMENT IN UNDERLYING
PARTNERSHIP PURSUANT TO IRC SECTION 988.
name(s), Identifyingnumber(s), address(es), and abrief description of their Involvement For each foreign entity, identity its country of incorporation or existence. For
each individual or related entity, explain how the individual or entity is related. Attach additional sheets, if necessary.
aType of individual or entityLJ Tax-exemptEl ForeignEJ Related
NameI
Identifyingnumber
Address
Description
Related
Name
Identifyingnumber
Address
Description
1u* 14
05-01-12
Form8886Pev.3.2011l
138
[All
8886
(Rev. March 2011)
Depaztnt of the Treasury
)0- Attach to your tax return.
See separate instructions.
OMB No. 1545.1800
Attachment
Sequence No. 137
Identifying number
FOUNDATION INC
20-5602483
I
City or town, state, and ZIP code
C / O GELLER & CO, 909 THIRD AVE. NO. 16 I I vTEW YORK, NY 10022
A Uyou are filing more than one Form 8886 with your tax return, sequentially number each Form 8886 and enter the statement number
for this Form 8886..........................................Statement number3 of4
B Enter the form number of the tax return to which this form is attached or related O N .
990 PF
Enter the year of the tax return identified above2012
Is this Form 8886 being filed with an amended tax return? ................................................................................................ =YesLXJ No
C Check the box(es) that apply (see instructions).LX] Initial year filerL.J Protective disclosure
la Name of reportable transaction

2012
2 Identify the
type
of reportable transaction. Check all boxes that apply (see instructions).
aListedo El Contractual protectione EJ Transaction of interest
EJ Confidentiald LJ Loss
3 If you checked box 2a or 2e, enter the published guidance number for the listed transaction
or transaction of interest.
4 Enter the number of 'same as or substantially similar transactions reported on this form. ................
5 If you participated in this reportable transaction through a partnership, S corporation, trust, and foreign entity, check the applicable boxes and provide the
information below for the entity(s) (see instructions). (Attach additional sheets, if necessary.)
a Type of entity ................El Partnership[J Trust[] Partnership[J Trust
Lii S cornorationEl Foreian[I I ] S corooration[ii] Foreian
bName
j o - WILLETT SELECT INVESTORS (TAXJEXEMPT) I LP
c Employer Identification number (EIN), if known
2 6-163 43 08
'none if Schedule K-i not received)
e-
1
09/15/2013
Enter below the name and address of each individual or entity to whom you paid a fee with regard to the transaction if that individual or entity promoted, solicited, or
recommended your participation in the transaction, or provided tax advice related to the transaction. (Attach additional sheets, if necessary.)
Name
I
I
Fees paid
b Name
Identifying number (if known) Fees paid

$
LI-IAFor Paperwork Reduction Act Notice, see separate instructions. Form 8886 (Rev. 3-2011)
139
17171111 737725 BLOOMFMFND 2012.04040 THE BL100MBERG FAMILY FOUNDA BLOOMFA2
6
a
THE BLOOMBERG FAMILY JNDATION INC 20-5602483
F= 8886 (Rev. 3-2011)
Page
7 Facts
LJ DeductionsExclusions from gross incomeAbsence of adjustments to basisEJ Tax Credits
Capital lossEJ Nonrecognition of gainDeferral
FYI Ordinary lossfl Adjustments to basisOther
b Further describe the amount and nature of the expected tax treatment and expected tax benefits generated by the transactIon for all affected years. Include facts of
each step of the transaction that relate to the expected tax benefits Including the amount and nature of your investment Include in your description your
participation in the transaction and all related transactions regardless of the year in which they were entered into. Also, include a description of any tax result
Identify afl individuals and entities involved in the transaction that are tax-exempt, foreign, or related. Check the appropriate box(es) (sea instructions). Include their
name(s), identifying number(s), address(es), and a brief description of their Involvement. For each foreign entity, identify its country of incorporation or existence. For
a Type of individual or entity: Tax-exemptForeign[IJ Related
Name
Identifying number
Address
Description
Related
Name
Identifying number
Address
Description
05-01-12
Form 8886ne. 3-2011)
140
8886
(Rev. March 2011)
.Attach to your tax return.
Oepatment of the T
See separate Instructions.

OMB No, 1545-1800
Attachment
Sequence No. 137
Identifying number
20-5602483
Number, street and room or suite no.
I
City or town, state, and ZIP code
C/O GELLIER & CO, 909 THIRD AVE. NO. 16 PEW YORK, NY 10022
A If you are filing more than one Form 8886 with your tax return, sequentially number each Form 8886 and enter the statement number
for this Form 8886 ...................................... Statement number 4 of 4
B Enter the form number of the tax return to which this form is attached or related 7777 j o . 990 PF
Enter the year of the tax return identified above
^*
2012
Is this Form 8886 being filed with an amended tax return? ................................................................................................ o. Li Yes
LXJ No
C Check the box(es) that apply (see instructions). LXJ Initial year filer L.J Protective disclosure
1 a Name of reportable transaction

2012
2 Identify the type of reportable transaction. Check all boxes that apply (see instructions).
a E1 Listed c Contractual protection e Transaction of interest
b
E l Confidential d EXI Loss
3 If you checked box 2a or 2e, enter the published guidance number for the listed transaction
or transaction of interest
00.
4 Enter the number of 'same as or substantially similar transactions reported on this form.
5 If you participated in this reportable transaction through a partnership, S corporation, trust, and foreign entity, check the applicable boxes and provide the
information below for the entity(s) (see instructions). (Attach additional sheets, if necessary.)
a Type of entity E l Partnership E l Trust
I
E l Partnership E l Trust
El S corporation El Foreign I E l S corporation E l Foreign
b Name
SEE STATEMENT 41
c Employer identification number (EIN), if known
none' If Schedule K-i not received) ............ .
Enter below the name and address of each individual or entity to whom you paid a fee with regard to the transaction if that individual or entity promoted, solicited, or
recommended your participation in the transaction, or provided tax advice related to the transaction. (Attach additional sheets, if necessary.)
Name
I
I
Fees paid
Name
Identifying number (if known) I Fees paid

LHA For Paperwork Reduction Act Notice, see separate instructions. Form 8806(Rey.3-2011)
141
I
I
I
r.JNDATION
INC20-5602483
Form 8886 (Rev. 3.2011)
Page 2
7 Facts
El DeductionsEl Exclusions from gross Income L1 Absence of adjustments to basisEl Tax Credits
El Capital lossc:i Nonrecognition of gainEl Deferral
IX ] Ordinary lossLJ Adjustments to basisEl Other
b Further describe the amount and nature of the expected tax treatment and expected tax benefits generated by the transaction for all affected years. Include facts of
each step of the transaction that relate to the expected tax benefits including the amount and nature of your investment. Include in your description your
participation in the transaction and all related transactions regardless of the year in which they were entered Into. Also, include a description of any tax result
name(s), identifying number(s), address(es), and a brief description of their involvement For each foreign entity, identity its country of incorporation or existence. For
a Type of individual or entityEl Tax-exemptEl ForeignEl Related
NameI
Identifying number
Address
Description
Related
Name
Identifying number
Address
Description
05-0 rue1-12
Form 8886 (Rev. 3-2011)
142
17171111 737725 BLOONFANFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
.
THE BLOOMBERO FAMILY NDATION INC
20-5602483
FORM 8886PARTICIPATED IN TRANSACTION THROUGHSTATEMENT 39
ANOTHER ENTITY
TRANSACTION NAME: FOREIGN CURRENCY LOSS PURSUANT TO IRC SECTION 988
TYPE OF ENTITYDATE K-i
NAME AND ElM OF OTHER ENTITYPARTNER S CORP TRUST FOREIGN RECEIVED
WILLETT PRIVATE INVESTORS (TAX EXEMPT)X09/15/2013
I LLC
26-2359838
THE VARDE FUND IX, LP
Ki

NONE
26-1594327
FORM 8886PARTICIPATED IN TRANSACTION THROUGHSTATEMENT 40
ANOTHER ENTITY
TYPE OF ENTITY
NAME AND EIN OF OTHER ENTITY PARTNER S CORP TRUST FOREIGN
WIL1LEPP SELECT INVESTORS (TAX EXEMPT) I X
LP
26-1634308
DATE K-i
RECEIVED
09/15/2013
BAtJPOST VALUE PARTNERS, LP -IV
Ki

NONE
26-2208448
143STATEMENT(S) 39, 40
THE BLOONBERG FAMILY FIFLTNDATION INC20-5602483
FORM 8886 PARTICIPATED IN TRANSACTION THROUGH STATEMENT 41
ANOTHER ENTITY
TYPE OF ENTITYDATE K-i
NAME AND EIN OF OTHER ENTITYPARTNER S CORP TRUST FOREIGN RECEIVED
WILLETT SELECT INVESTORS (TAX EXEMPT) I X09/15/2013
LP
20-5602483
WILLETT AIV SELECT INVESTORS I LP XNONE
26-1633115
144STATEMENT(S) 41
No. 1545-0026
Attachment
Sequence No.128
US
926
Internet Revenue Service
Part ILJ.S.Ti
Return by a U.S. Transferor of Property
to a Foreign Corporation
O N-Attach to your income tax return for the year of the transfer or distribution.
Name of transferor
Identifying number (see

20-5602483
If the transferor was a corporation, complete questions 1 a through 1 d.
a lithe transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 or
fewer domestic corporations?. Yes

No
It Did the transferor remain In existence after the transfer?......................................................................................... EJ YesEJ No
If not, list the controlling shareholder(s) and their Identifying number(s):
Controlling shareholder
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?[Iii YesLi No
If not, list the name and employer identification number (EIN) of the parent corporation:
Name of parent corporation
EIN of parent corporation
d Have basis adjustments under section 367(a)(5) been made?L...J Yes
No
2 If the transferor was a partner in a partnership that was the actual transferor (but is not treated as such under section 367), complete
questions 2a through 2d.
a Ust the name and EIN of the transferor's partnership:
Name of partnership
EIN of partnership
WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC126-2359838
b Did the partner pick up its pro rota share of gain on the transfer of partnership assets?
L&l YesLJNo
c Is the partner disposing of its entire Interest in the partnership?............................................. ID Yes1X 1 No
d Is the partner disposing of an interest in a limited partnership that is regularly traded on an established
Part II
I
Transferee Foreign Corpo
3 Name of transferee (foreign corporation)
4 Identifying number, if any

ALG HOLDINGS E.V.
5 Address (including country)
DE BOELELAAN 7
1083 HJ AMSTERDAM, NETHERLANDS
6 Country code of country of incorporation or organization
NL
7Foreign law characterization (see instructions)
CORPORATION
8Is the transferee forei g n corporation a controlled foreign corporation?..................................................................... Li YesLXJ No
LHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12.2011)
224531
05-01-12
145
[ k ]

L Z i r
Form926(Rev.12-2011)
THE BLOOMBERG FAMILY FOUNDATION INC 205602483
Paqe2
I
Part I l l
I
Information Regarding Transfer of Property (see instructions)
Type of
property
(a)(b)(c)(d)(e)
Date ofDescription ofFair market value on Cost or otherGain recognized on
transfer
I
property
I
dale of transfer
I
basis
I
transfer
Stock and
securities
Installment obligations,
account receivables or
similar property
Foreign currency or other
property denominated in
foreign currency
Inventory
Assets subject to
depreciation recapture
(see Temp. Regs. sec.
Tangible property used in
trade or business not listed
under another category
Intangible
property
Property to be leased
(as described in final
and temp. Regs. sec.
1.367(a)4(c
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a)4T(d))
Transfers of oil and gas
working interests (as
described in Temp.
Other property
Supplemental Information Required To Be Reported (see instructions):
Form 926 (Rev. 12-2011)
224532
05-01-12
146
Elf
1 A
20-5602483
9 Enter the transferor's interest in the foreign transferee corporation before and after the transfer
(a) Before %(b) After
10 Type of nonrecognition transaction (see instructions) SECTION 351 TRANSACTION
11 Indicate whether any transfer reported in Part III is subject to any of the following:
a Gain recognition under section 904(0(3)

El Yes[] No
b Gain recognition under section 904(f)(5)(F)

EJ Yes[I] No
c Recapture under section 1503(d)

EJ Yes
EM No
d Exchange gain under section 987 .
YesEJ No
12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation?
El Yes[] No
13 Indicate whether the transferor was required to recognize income under final and temporary Regulations sections
1.367(a)-4 through 1.367(a)-6 for any of the following:
a Tainted property
El YesIX] No
b Depreciation recapture
El Yes[] No
c Branch loss recapture
El Yes EXI No
d Any other Income recognition provision contained in the above-referenced regulations

El Yes[] No
14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)?
El YesEM No
15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section
1 .367(a)-i T(d)(5)(iii)?
El YesLJ No
b If the answer to line 15a is 'Yes," enter the amount of foreign goodwill or going concern value
transferred$
16 Was cash the only property transferred?

.YesEl No
17a Was intangible property (within the meaning of section 936h)(3)(B)) transferred as a result of the transaction?
El YesNo
b if 'Yes,' describe the nature of the rights to the intangible property that was transferred as a result of the
transaction:
Form 926 (Rev.12-2011)
224533
05-01-12
147
Form 9 2 6
Attach to your Income tax return for the year of the transfer or distribution.
Attathment
Sequence No. 12 8
Name of transferor
Identifying number
( s e e lflSbUCffOflS)
20-5602483
a If the transfer was a section 36 1(a) or (b) transfer, was the transferor controlled (under section 36 8(c)) by 5 or
fewer domestic corporations? ................................................................................................................................. LIIJ YesEJ No

b Did the transferor remain inexistence after the transfer?................................................................................ L1J Yes
No
If not, list the controlling shareholder(s) and their identifying number(s):
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was It the parent corporation? ......... L_J YesL..J No
d Have basis adjustments under section 36 7(a)(5) been made? 1_i Yes
No
2 If the transferor was a partner in a partnership that was the actual transferor (but Is not treated as such under section 36 7), complete
questions 2 a through 2 d.
Name of partnership
EINof partnership
WILLETT PRIVATE INVESTORS ( TAX EXEMPT) I LLCL26-2359838
b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LXJ YesU No
c Is the partner disposing of its entire interest in the partnership? 11 YesIXJ No

d Is the partner disposing of an interest in a limited partnership that is regularly traded on an established-
Part II
I
Transferee ForeignCorpo

BC LUXCO MIDCO SRL98-1085652
9A, RUE GABRIEL LIPPMANN
MUNSBACH, L-5365 LUXEMBOURG
LU
CORPORATION
8Is the transferee forei g n corporation a controlled foreign corporation? ..................................................................... Li YesLXJ No
LHA For Paperwork Reduction Act Notice, see separate Instructions. Form 9 2 6 (Rev. 12 -2 011)
224531
05-01-12
148
17171111 737725 BLOOMFMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
Form 926 (Rev. 12 2011) THE BLOOMBERG FAMILY FOUNDATION INC20-5602433
Page 2
I Part III I Information Regarding Transfer of Property
(see instructions)
(a)(b)(c)(d)
(e)
Type of
Date ofDescription ofFair market value onCost or otherGain recognized on
property
transfer
I propertydate of transfer basistransfer
casi,12/04/2012
155,741.
Stock and
securities
I nstallment obligations,
similar property
property denominated I n
foreign currency
I nventory
Assets subject to
1 .367(a).4T(b))
I ntangible
property
Property to be sold
(as described I n
Temp. Regs. sec.
1 .367(a)4T(d))
described I n Temp.
Other property
Supplemental Information Required To Be Reported
(see I nstructions):
224532
Form 926 (Rev. 12.2011)
05-01-12
149
THE BLOOMBERG FAMILY FOUNDATION INC20-5602483
9 Enter the transferor's Interest in the foreign transferee corporation before and after the transfer
11 Indicate whether any transfer reported in Part Ill is subject to any of the following:
a Gain recognition under section 904(t)(3) EJ Yes

No
b Gain recognition under section 904(t)(5)(F) ElYes
FX7 No
c Recapture under section 1503(d) El Yes MNo
d Exchange gain under section 987 0Yes[Z] No
12Did this transfer result from a change In the classification of the transferee to that of a foreign corporation? El Yes[J No
a Tainted property Lii] YesCJ No

b Depreciation recapture UYesIJl No
c Branch loss recapture........................................................................................................................... El Yes[XI No
d Any other income recognition provision contained in the above-referenced regulations El YesEIX I No
14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? ............ UYesEL No
1.367(a)-i T(d)(5)(iii)? El YesLXI No

b If the answer to line 15a is Yes," enter the amount of foreign goodwill or going concern value
transferred$
16 Was cash the only property transferred? [X I Yes El No
17 a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction?ED YesNo
b If Yes, describe the nature of the rights to the intangible property that was transferred as a result of the
transaction:
Form 926 (Rev. 12-2011)
22453
05-01-12
150
OMB No. 1545-0026
Attachment
Sequence No.
1 2 8
Name of transferor
Identifying number
(stelrtstrrjctjons)
1i
3
9 2 6
'Attach to your income tax return for the year of the transfer or distribution.
2 0-5602 48 3
If the transferor was a corporation, complete questions 1 a through 1d.
a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 or
fewer domestic corporations?.
Yes
No
b Did the transferor remain in existence after the transfer? .
Yes
No
If not, list the controlling shareholder(s) and their Identifying number(s)
Identifying number
C
If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?
Li YesL..J ii
d Have basis adjustments under section 367(a)(5) been made?

L.J Yes
No
2 If the transferor was a partner in a partnership that was the actual transferor(but is not treated as such under section 367), complete
Name of partnership
EIN of partnership
WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC1 2 6-2 3598 38
b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?
Lxi YesU No
C Is the partner disposing of its entire interest in the partnership?
.Yes[] No
securities market?
YesL] No
Part II
J
BRAVISSIMA
5 Address Cincluding country)
P.O. BOX 2 70, 8 51 04 SUNDSVALL
STOCKHOLM lAN, STOCKHOLM KOMUN, SWEDEN
6 Country code of country of Incorporation or organization
SW
CORPORATION
8Is the transferee foreign corporation a controlled forei g n corporation? .....................................................................
LJ YesLXJ No
LHA For Paperwork Reduction Act Notice, see separate Instructions.
Form 926 (Rev. 12-2011)
224531
05-01-12
1 51
1 71 71 1 1 1 73772 5 BLOOMFAMFND 2 01 2 .04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
Form 926(Rev.12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 205602483
Paq
I Part Ill J Information Regarding Transfer of Property
(see Instructions)
Type of
property
(a)(b)(c)(d)(e)
transferproperty
I
date of transfer -basis
I transfer
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
Intangible
property
1.367(a)-4(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a)-4T(d))
working Interests (as
described in Temp.
Other property
(see Instructions):
224532
Form 926 (Rev. 12-2011)
05-01-12
152
1 # 1
THE
FAMILY FOUNDATION INC
20-5602483
9 Enter the transferor's interest in the foreign transferee corporation before and after the transfer.
(a) Before %(b) After - %
10 Type of nonrecognition transaction (see Instructions) SECTION 351 TRANSACTION
11 Indicate whether any transfer reported In Part III is subject to any of the following:
a Gain recognition under section 904(t)(3)

El Yes[J No

E1 Yes[Xl No
c Recapture under section 1503(d)i:i

Yes[Xi No
Yes
No
12Did this transfer result from a change In the classification of the transferee to that of a foreign corporation?
El Yes[Xl No
13
Indicate whether the transferor was required to recognize income under final and temporary Regulations sections
1.367(a)4 through 1.367(a)-6 for any of the following:
a Tainted property
LI Yes [Xl No
i::i YesEE No
E l Yes [Xi No
d Any other income recognition provision contained in the above-referenced regulations

E l YesL X] No
14
Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)?
LI YesLJNo
1 .367(a)-i T(d)(5)(ii?
E l YesNo
b If the answer to line 15a is "Yes," enter the amount of foreign goodwill or going concern value
transferred$
LX] Yes E l No
17 a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction?
E l Yes[Xl No
b If 'Yes, describe the nature of the rights to the intangible property that was transferred as a result of the
transaction:
Form 926 (Rev. 12-2011)
224533
05-01-12
153
No. 1545-0026
Attachment
Sequence No.
1 2 8
JAJ
926
Department or the Treasury
10-Attach to your income tax return for the year of the transfer or distribution.
Name of transferor
Identifying
2 0-5602 48 3
If the transferor was a corporation, complete questions la through 1d.
Yes
No
b Did the transferor remain in existence afterthe transfer?
LJYes
No
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?
L..J YesL....J No

L.J Yes
No
2 If the transferor was a partner In a partnership that was the actual transferor (but is not treated as such under section 367), complete
a List the name and EIN of the transferor's partnership:
Name of partnership
EIN of partnership
WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 1 2 6-2 3598 38
LX] YesUNo
ElYes[X]No
No

GENPACT LIMITED
I
98 -0533350
CANON'S COURT, 2 2 VICTORIA STREET
HAMILTON, HM, BERMUDA
BD
7 Foreign law characterization (see instructions)
CORPORATION
8Is the transferee forei g
n corporation a controlled foreign corporation? .....................................................................
LJ Yes[Xi No
LHA For Paperwork Reduction Act Notice, see separate instructions.
Form 926 (Rev. 12-2011)
224531
05-01-12
1 54
C
Form 926(Rev.122011)
THE BLOOMBERG FAMILY FOUNDATION INC205602483
Page2
I
Part I I I
I
I nformation Regarding Transfer of Property (see instructions)
Type of
property
(a)(b)(c)(d)(e)
transferI orooertvI date of transferI basisI transfer
Stock and
securities
similar property
property denominated In
foreign currency
Inventory
Assets subject to
1 .367(a)4T(b))
Intangible
property
(as described In final
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a).4T(d))
described in Temp.
Recis. sec. 1.367(a)-4T((
Other property
Supplemental I nformation Required To Be Reported (see instructions):
224532
Form 926 (Rev. 12-2011)
05-01-12
155
12-2011) THE BLOOMBERG FAMILY FOUNDATION INC
20-5602483
3
9 Enter the transferor's interest in the foreign transferee corporation before and after the transfer:
10 Type of nonrecognition transaction (see instructions) 11o . SECTION 351 TRANSACTION
a Gain recognition under section 9O4(tX3)
E1] YesL X ] No
b Gain recognition under section 904(1)(5)(F)
El1 Yes
EM No
CRecapture under section 1503(d)
Eli YesL X] No
d Exchange gain under section 987
. Yes L X] No
El YesL XI No
1. 367(a)-4 through 1. 367(a)-6 for any of the following:
a Tainted property
El Yes L X] No
El Yes[] J No
CBranch loss recapture
El Yes IlIXI No
El YesL I No
El Yes
1 . 367(a)-i T(d)(5)(iii)?
El] Yes
b If the answer to line 15a is "Yes, enter the amount of foreign goodwill or going concern value
transferred 111o. $
11X] No
L XI No
[XI Yes El No
17a
Was Intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction?
El YesIM No
b If Yes," describe the nature of the rights to the intangible property that was transferred as a result of the
transaction:
Form 926 (Rev. 12-2011)
224533
05-01-12
156
17171111 737725 BLOOMF2MFND 2012.04040 THE BLOOMBERG FAMILY FOtJNDA BLOOMFA2
1 i
9 2 6
(Rev. December 201 1 )
IDepei rnent of the Treasury
1 0 , Attach to your i ncome tax return for the year of the transfer or di stri buti on.
Name of transferor
OMB No. 1 545-0026
Attachment
Sequence No.
1 2 8
Identi fyi ng number (see
i nshcgons)
2 0-5602 48 3
If the transferor was a corporati on, complete questi ons la through 1 d.
a If the transfer was a secti on 361 (a) or (b) transfer, was the transferor controlled (under secti on 368(c)) by 5 or
fewer domesti c corporati ons? ElYesE l No
b Di d the transferor remai n i nexi stence after the transfer? ..........................................................................................E J YesE l No
If not, li st the controlli ng shareholder(s) and thei r Identi fyi ng number(s):
Controlli ng shareholder
Identi fyi ng number

o If the transferor was a member of an affi li ated group fi li ng a consoli dated return, was i t the parent corporati on?L.....J YesL...J No
If not, li st the name and employer i denti fi cati on number (E IN) of the parent corporati on:
Name of parent corporati on
E IN of parent corporati on
d Have basi s adjustments under secti on 367(a)(5) been made? L . _ _ J Yes
No
2 If the transferor was a partner i n a partnershi p that was the actual transferor (but i s not treated as such under secti on 367), complete
questi ons 2a through 2d.
a Li st the name and E IN of the transferor's partnershi p:
Name of partnershi p
E IN of partnershi p
2 6-2 3598 38
b Di d the partner pi ckup i ts pro rata share of gai n on the transfer of partnershi p assets?
L XJ v_ L _ TNo
o Is the partner di sposi ng of i ts enti re i nterest In the partnershi p?
L:JvesLlNo
d Is the partner di sposi ng of an i nterest i n a li mi ted partnershi p that Is regularly traded on an establi shed
Part II
I
Transferee Foreign Corporation Information
3 Name of transferee (forei gn corporati on)
4 Identi fyi ng number, i f any

ACECO TI
5 Address (i ncludi ng country)
AV. DAS NACOES UNIDAS, LL633-1 2 .ANDAR, BROOKLIN NOVO
CEP 04578 -000, SAO PAULO - SP BRAZIL
6 Country code of country of i ncorporati on or organi zati on
BR
7Forei gn law characteri zati on (see i nstructi ons)
CORPORATION
8Is the transferee forei gn corporati on a controlled forei gn corporati on? ..................................................................... L iYesL X] No
LI-IA For Paperwork Reducti on Act Noti ce, see separate i nstructi ons. Form 826 (Rev. 1 2.201 1 )
224531
05.01 -1 2
1 57
Fomi926(Rev.12.2011)
Page2
I
Part Ill
I
(a)(b)(C)(d)(e)
Type of
property
transfer
I
propertydate of transfer basistransfer
03/27/20121 257,469.
Stock and
securities
similar property
foreign currency
I nventory
Assets subject to
1 .367(a)-4T(b))
I ntangible
property
1 .367(a)4(c))
Property to be sold
(as described in
Temp. Regs. sec.
described in Temp.
Reos. sec. 1 .367(al-4Tft
Other property
224532
Form 926 (Rev. 12-2011)
05-01-12
158
17171111 737725 BLOOMFNFND 2012.04040 THE BLOOMBERG FAMILY FOtThDA BLOOMFA2
E A
[A
20-5602483
8 Enter the transferor's Interest In the foreign transferee corporation before and after the transfer
10 Type of nonrecognition transaction (see instructions) SE CTION 351 TRANSACTION
11 Indicate whether any transfer reported In Part III is subject to any of the following:
a Gain recognition under section 904(f)(3) ................................................................................................................... YesL X ] No

b Gain recognition under section 904(f)(5)(F) .
YesL X ] No
c Recapture under section 1503(d) .
YesL X ] No
YesiJJ No
12 Did this transfer result from a change In the classification of the transferee to that of a foreign corporation?
E ] YesL X ] No
a Tainted property .
YesL X ] No
L J YesL X ] No
c Branch loss recapture .
YesL X J No
d Any other income recognition provision contained In the above-referenced regulations
U Yes1X I No
U YesL X ] No
15a
Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section
1 .367(a)-i T(d)(5)(ii?
U YesNo
transferred 10 , $

L X J YesU No
U YesL X ] No
b If "Yes," describe the nature of the rights to the intangible property that was transferred as a result of the
transaction:
Form 926 (Rev. 12-2011)
224533
05-01-12
159
17171111 737725
BIJOONFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOONFA2
1 4
I A l
Form 9 2 6
01, Attach to your income tax return for the year of the transfer or distribution.
Attachment
Sequence No.
1 2 8
Name of transferor
Identifying number
(senlnstiucttons)
20-5602483
If the transferor was a corporation, complete questions 1 a through id.
fewer domestic corporations?. Yes
No
b Did the transferor remain In existence after the transfer? . YesEll No
If not, list the controlling shareholder(s) and their identifying number(s)
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L......J YesL..J No
E1N of parent corporation

d Have basis adjustments under section 367(a)(5) been made"Li Yes
No
Name of partnership
EIN of partnership
WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838
b Did the partner pick up its pro rats share of gain on the transfer of partnership assets? LAJ YesL_J No
c Is the partner disposing of its entire Interest in the partnership? . YesIIJ No
securities market?YesEJ No
art II I Transferee Foreicin Corooration Information (see Instructions)

AXEL
I
AXEL-SPRINGER-STRABE 65
10888 BERLIN, GERMANY
GM
7 Foreign law characterization (see Instructions)
CORPORATION
8Is the transferee foreign corporation a controlled foreign corporation? ................................................ ..................... U YesLXJ No
LHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)
224531
05-01-12
160
Type of
property
Cash
Stock and
securities
ri Regarding Transfer of Property (see instructions)
(a)(b)(c)
Date ofDescription ofFair market value on
transferI orooertvI date of transfer
20-5602483
(d)(e)
Cost or otherGain recognized on
basis
I transfer
Instatment obligations,
similar property
foreign currency
Inventory
Assets subject to
1 .367(a)-4T(b))
Intangible
property
1 .367(a)-4(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a)4T(d))
described In Temp.
Regs. sec. 1 .367(a)-4T(
Other property
224532
Form 926 (Rev. 12.2011)
05-01-12
161
17171111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA ELOOMFA2
Form 926 (Rev. 12-2011) THE BIOOMBERG FAMILY FOUNDATION INC205602483
Page3
[Part IV J Additional Information Regarding Transfer of Property (see Instructions)
9 Enter the transferors interest in the foreign transferee corporation before and after the transfer
(a) Before %(b) After %
10Type of nonrecognition transaction (see instructions) SECTION 351 TRANSACTION
11 indicate whether any transfer reported In Part III is subject to any of the following:
a Gain recognition under section 904(f)(3). Yes[X] No

b Gain recognition under section 904(f)(5)(F) . YesIXJ No
c Recapture under section 1503(d) . Yes[X] No
d Exchange gain under section 987 . YesIXI No
12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? . YesEU No
1 367(a) .4through 1 367(a)-6 for any of the following:
aTainted property
....................................................................................................................................................
YesEE No
b Depreciation recapture .Yes[I] No
c Branch loss recapture .Yes IM No
d Any other income recognition provision contained in the above-referenced regulations . YesE2 No
14Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? EJ YesEXJ No
L367(a)-1T(d)(5)(iii)? . YesEJ No
b If the answer to line 15a is Yes, enter the amount of foreign goodwill or going concern value
transferred$
16 Was cash the only property transferred? .YesNo
17a Was intangible property (within the meaning of section 936(h)(3))) transferred as a result of the transaction? YesL3 No
b if Yes, describe the nature of the rights to the intangible property that was transferred as a result of the
transaction:
Form 926 (Rev. 12-2011)
224533
05-01-12
162
17171111737725ELOOMFNFND 2012.04040 THE BTJOOMBERG FAMILY FOUNDA BLOOMFA2
1 ^

E A
926

IDepatment ot the Treasury
Name of transferor-
OMB No. 1545-0026 -
Attachment
Sequence No.
Identifying number (s e
e tflSfrUCQflS)
20-5602483
fewer domestic corporations?.YesNo
b Did the transferor remain in existence after the transfer? .YesNo
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? L.J 'sU No
If not, list the name and employer identification number (EIN of the parent corporation:
E1N of parent corporation
d Have basis adjustments under section 367(a)(5) been made? ................................................................................. L_ _ J Yes
No
Name of partnership
EIN of partnership
WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC1 26-2359838
b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? UJ YesLi No
o Is the partner disposing of its entire interest in the partnership?
....... ... ............
.................. EJ YesLX] No
Part II
I
4 identifying number, if any

KIWI HOLDCO CAYCO, LTD (DBA FNZ)
1 TANFIELD
EDINBURGH, EH3 5DA, UNITED KINGDOM
UK
CORPORATION
8Is the transferee foreign corporation a controlled foreign corporation' ..................................................................... Li YesLXJ No
LHA For Paperwork Reduction Act Notice, see separate instructions Form 926 (Rev. 12-2011)
05-01-12
163
Awk
Form 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC205602483
Page 2
Part Ill Information Regarding Transfer of Property
(see instructions)
(a)(b)
(C)(d)
(e)
Type of
Date ofDescription ofFair market value on Cost or other
Gain recognized on
property
transferpropertydate of transfer basistransfer
Cash03/06/20121183.634.
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
(see Temp. Pegs. sec.
1 .367(a)4T(b))
Intangible
property
and temp. Rags. sec.
1.367(a)-4(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a).4T(d))
described in Temp.
Recis. sec. 1 .367(a)-4T(E
Other property
(see instructions):
224532
Form 926 (Rev. 12-2011)
05-01-12
164
17171111 737725 BLOOMFAMFND 2012.04040 THE
BLOOMBERG FAMILY FOUNDA BLOOMFA2
20-5602483
10 Type of nonrecognition transaction (see instructions) P o o , SECTION 351 TRANSACTION
11 Indicate whether any transfer reported in Part III Is subject to any of the following:
a Gain recognition under section 904(tX3)

El YesEXJ No
b Gain recognition under section 904(l(5)(F)

El Yes
EXI No

ElYes
No
YesLJ No
El YesL1 No
13 Indicate whether the transferor was required to recognize Income under final and temporary Regulations sections
aTainted property...................................................................................................................................................
QYes
No
El Yes LJ No
ElYes IJ No

ElYesEXJ No
ElYesEJ No
1.367(a)-1T(c)(5)(iii)?
ElYes[I No
b If the answer to line 15a is 'Yes,' enter the amount of foreign goodwill or going concern value
transferred 11o.$
16 Was cash the only property transferred?[]Yes

ElNo
17a Was intangible property (within the meaning of section 936(h)(3)(8)) transferred as a result of the transaction?
ElYes[XI No
b If 'Yes,' describe the nature of the rights to the intangible property that was transferred as a result of the
transaction:
Form 926 (Rev.12-2011)
224533
05-01-12
165
1 ^
I
as-
F. 926
Attachment
Sequence
No. 128
Name of transferor
Identifying number (see )flsc)

20-5602483
a if the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 or
fewer domestic corporations? ................................................................................................................................. [l YesEl No

b Did the transferor remain in existence after the transfer? ............ ................ ............................. ... El Yes[l No
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? L..J YesL_J No
if not, list the name and employer Identification number (EIN) of the parent corporation:
d Have basis adjustments under section 367(a)(5) been made? L.J Yes
No
a List the name and 8W of the transferors partnership:
Name of partnership
EIN of partnership
WILLETT PRIVATE INVESTORS (TAX EXEMPT) ILLC26-2359838
b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LXJ Yes1......J No
c Is the partner disposing of its entire interest in the partnership?.................................................... El Yes[IJ No
d Is the partner disposing of an Interest in a limited partnership that is regularly traded on an established
securities market?El Yes []No
Part II
I
Transferee Foreign Corporation Information (see instructions)
3Name of transferee (foreign corporation) 1 4 Identifying number, if any
FOURCEE INFRASTRUCTURE EQUIPMENTS PRIVATE LTD.
5Address (including country)
432, LAXMIMALL, LAXMIINDUSTRIAL ESTATE, NEW LINK ROAD, ANDHERI(w)
MUMBAI400053, INDIA
6 Country cede of country of Incorporation or organization
IN
CORPORATION
8Is the transferee forei gn corporation a controlled foreign corporation? ...................................................................... YesLXJ No
LHA For Paperwork Reduction Act Notice, see separate instructions.Form 926 (Rev. 12-2011)
224531
05-01-12
166
17171111 737725BLOOMFAMPND 2012.04040THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
THE BL100MBERG FAMILY FOUNDATION
20-5602483
ri Regarding Transfer of Property (see instructions)
Type of
property
(a)(b)(c)(d)(e)
transferI DrooertvI date of transferI basisI transfer
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
1 .367(a)4T(b))
Intangible
property
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a)-4T(d))
described in Temp.
Other property
224532
Form 926 (Rev. 12-2011)
05-01-12
167
17171111 737725 ELOOMFAMFND 2012.04040 THE BL100MBERG FAMILY FOUNDA BLOOMFA2
1 4 1 #
122011 THE
20-5602483
(a) Before % (b) After %
a Gain recognition under section 904(1)(3) .YesIX] No
b Gain recognition under section 904(I)(5)(F) E]YesLX] No
c Recapture under section 1503(d) El YesLXJ No
d Exchange gain under section 987 .YesE1 No
12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? [JYes[JNo
1367(a)-4 through 1.367(a)-6 for any of the following:
aTainted property.............................................................................................................................................Yes No
b Depreciation recapture El Yes[Xi No

c Branch loss recapture El YesI]JNo
d Any other income recognition provision contained in the above-referenced regulations[] Yes[XI No
14Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El YesiJJNo
ISa Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section
1.367(a)-1T(d)(5)(ill)? EJYesEXI No
transferred$
16 Was cash the only property transferred? LX] Yes El No
17 a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? E l YesIll No
transaction:
Form 926 (Rev.12-2011)
224533
05-01-12
168
17171111 737725 BLOOMFAMFND 2012.04040 THE BTJOOMBERG FAMILY FOUNDA BLOOMFA2
1 # 1
F.926
1 0 , Attach to your income tax return for the year of the transfer or distribution.
Attathrnent
Sequence No.
1 2 8
Name of transferor
Identifying number ( see

Instructions)
2 0-5602 48 3
a If the transfer was a section 361 ( a) or ( b) transfer, was the transferor controlled ( under section 368( c)) by 5 or
fewer domestic corporations?.Yes
No
b Did the transferor remain in existence after the transfer?.YesL1J No
If not, list the controlling shareholder( s) and their identifying number( s):
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was It the parent corporation?L...J YesL...J No
If riot, list the name and employer identification number ( EIN) of the parent corporation:

d Have basis adjustments under section 367( a)( 5) been made? ........................................
I ........................................
L_J Yes
No
2 If the transferor was a partner in a partnership that was the actual transferor ( but is not treated as such under section 367), complete
a Ust the name and ON of the transferor's partnership:
Name of partnership
EIN of partnership
WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC2 6-2 3598 38
b Did the partner pickup its pro rata share of gain on the transfer of partnership assets?L1 uJ YesL...J No
C Is the partner disposing of its entire interest in the partnership?............................................................................ [1] YesIM No
3 Name of transferee ( foreign corporation)

KLARNA
5 Address ( including country)
NORRA STATIONSGATAN 61
1 1 3 43 STOCKHOLM, SWEDEN
SW
7Foreign law characterization ( see instructions)
CORPORATION
BIs the transferee foreign corporation a controlled foreign corporation? .....................................................................L......J Yes[Xi No
LKA For PaperworkReduction Act Notice, see separate InstructionsForm 926 ( Rev. 1 2-20 1 1 )
0 5-0 1 -1 2
1 69
1 71 71 1 1 1 73772 5 BLOOMF.ANFND 2 01 2 .04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
[E*
Im 1 # 1
Form 926 (Rev. 12-2011)
Page 2
[Part Ill Information Regarding Transfer of Property (see instructions)
Type of
property
(a)(b)(c)(d)(e)
ransferI propertyI date of transfer I basisI transfer
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
1 .367(a)-4T(b))
Intangible
property
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a)-4T(d))
described in Temp.
Other property
224532
Form 926 (Rev. 12-2011)
05-01-12
170
17171111 737725 BLOONFAMFND 2012.04040 THE BLOOMBERG FAMILY FOtJNDA BLOOMFA2
20-5602453
11 indicate whether any transfer reported in Part lii is subject to any of the following:
El Yes[X] No

[JYes[I] No
Yes[J No
YesEll No
.YesiJ No
13 indicate whether the transferor was required to recognize income under final and temporary Regulations sections
a Tainted property
.Yes[] No
.Yes M No
CBranch loss recapture .
Yesi:xi No
.
Yes[J No
.YesEJ No
15a
1 .367(a)-i T(d)(5)(ii? .
YesLJ No
transferred" $

EJ YesNo
17a
Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction?
Yes[J No
b if"Yes," describe the nature of the rights to the intangible property that was transferred as a result of the
transaction:
Form 926 (Rev.12-2011)
224533
05-01-12
171
E#
Fcwm926
Interval Revenue Service
Return by a U.S Transferor of Property
Name of transferor
I
OMB No. 1545-0026
I Attachment
Sequence No.
1 2 8
Identifying number (setinthes)
2 0-5602 48 3
a If the transfer was a section 361(a) or ) transfer, was the transferor controlled (under section 368(c)) by 5 or
fewer domestic corporations?[]Yes

No
b Did the transferor remain in existence after the transfer?.Yes
No
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?U]Yes Li No
If not, list the name and employer identification number (EIND of the parent corporation:
d Have basis adjustments under section 367(a)(5) been made? . - L__J Yes

No
Name of partnership
EIN of partnership
b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?LZOJ Yes L_J No
c Is the partner disposing of its entire interest in the partnership?.YesNo
securitiesmarket"................................................................................................................................................. YesNo
Part I I 1 Transferee Foreign Corporation I nformation (see Instructions)
3 Name of transferee (foreign corporation) 1 4 Identifying number, if any
XIABUXIABU
P.O. BOX 2 68 1 , CRICKET SQUARE, HUTCHINS DRIVE
GRAND CAYMAN, KY1 -1 1 1 1 , CAYMAN ISLANDS
6 Country cede of country of incorporation or organization
CJ
CORPORATION
8Is the transferee foreign cor poration a controlled forei g n corporation.....................................................................Li Yes LXJ No
Li-lA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12.2011)
224531
05-01-12
1 72
AIN
t
Form 926 (Rev. 12-2011)
Paqe2_
I
Part III
I
Information Regarding Transfer of Property (see Instructions)
(a)(b)(c)(d)(e)
Type Of
property
transfer
I
property
I
date of transferbasis
I transfer
Cash
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
(see Temp. Flegs. sec.
Intangible
property
1 .367(a)-4(c))
Property to be sold
(as described In
Temp. Regs. sec.
1 .367(a)-4T(d))
described in Temp.
Reas. sec. 1 .367fa-4T(
Other property
224532
Form 926 (Rev. 12-2011)
05-01-12
173
17171111 737725 BLOOMFAMFND 2012.04040 THE BLOOM-BERG FAMILY FOUNDA ELOOMFA2
Form 926(Rev.122011)
Page3
[Part IV
I
Additional Information Regarding Transfer of Property (see instructions)
a Gain recognition under section 904(f(3)

E1 Yes[Xl No
b Gain recognition under section 904(0(5XF) El Yes[Xl No

c Recapture under section 1503(d) El Yes [Xl No
d Exchange gain under section 987 ElI Yes[XI No
El Yes[Xl No
a Tainted property El Yes[Xl No

b Depreciation recapture E l Yes [Xi No
c Branch loss recapture....................................................................................................................................... El YesFX1 No
d Any other income recognition provision contained in the above-referenced regulations E l YesL XI No
14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? E l Yes[IX] No
1 .367(a)-i T(d)(5)Qii)? .
Yes[XI No
b If the answer to line 1 5a is "Yes," enter the amount of foreign goodwill or going concern value
transferred$
16 Was cash the only property transferred? [Xl YesE l No
17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? E l YesL XII No
transaction:
Form 926 (Rev. 12-2011)
224533
05-01-12
174
1 i
Form 9 2 6
1 1 1 0 -Attach to your income tax return for the year of the transfer or distribution.
Name of transferor
010B No. 1545-0026
Attachment
Sequence No.
1 2 8
2 0-5602 48 3
fewer domestic corporations?........................................................................ E l YesE J No
b Did the transferor remain in existence after the transfer? E l YesE l No
Identifying number
C If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L...J YesL_J No
It not, list the name and employer Identification number (EIN) of the parent corporation:
d Have basis adjustments under section 367(a)(5) been made? .................................................................................L...i Yes
No
Name of partnership
EIN of partnership
WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC1 2 6-2 3598 38
b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LXJ YesL..J No
c Is the partner disposing of Its entire interest in the partnership? ............................................ E l YesNo
. rn.
Part U
I

MEDAFE PRTICIPACOES S.A., L,INX S.A. (DBA GRUPO LINX)
I
RUA AUREKIA, NO. 61 6, SALA 2
BAIRRO VILA ROMANA, SAO PAULO, BRAZIL
BR
CORPORATION
8Is the transferee foreign corporation a controlled foreign corporation ? .. .............................................. .....................L.....l YesLX] No
224531
05-01-12
1 75
1 71 71 1 1 1 73772 5 BLOOMFMFND 2 01 2 .04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
Form 926 (Rev. 12-2011)
Paq
I
Part Ill
I
Type of
property
(a)(b)Cc ) (d)(e)
transfer
I
property
I
date of transfer
I
basis
I
transfer
Stock and
securities
Instanient obligations,
similar property
foreign currency
Inventory
Assets subject to
1 .367(a)-4T(b))
Intangible
property
1 .367(a)4(c))
Property to be sold
(as described In
Temp. Regs. sec.
described in Temp.
Other property
Form 926 (Rev. 12-2011)
224532
05-01-12
176
()
THE BLOOMBERG FAMILY FOUNDATION INC -
20-5602483
9 Enter the transferor's interest In the foreign transferee corporation before and after the transfer:
a Gain recognition under section 904(f)(3)

El Yes[Xl No
El Yes[XI No
Yes[Xl No
El Yes iXl No
El Yes[Xl No
a Tainted property
El Yes [XI No
El Yes [XI No

El Yes[Xl No

El YesLXI No
El Yes[Xl No
15a
Did the transferor transfer foreign goodwill or going concern value as defined In Temporary Regulations section
1.367(a)-1T(d)(5)(11?
El Yes[XI No
b If the answer to line 15a is 'Yes, enter the amount of foreign goodwill or going concern value
transferred$

[Xl YesEl No
17 a Was Intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction?
El YesFT No
b If 'Yes, describe the nature of the rights to the intangible property that was transferred as a result of the
transaction:
Form 926 (Rev. 12-2011)
224533
05-01-12
177
Form 926
Attach to your income tax return for the year of the transfer or distribution.
Name of transferor
E A
r4102
B No . 15-05
achment
quence
No . 1 2 8
lentifying (ste
20-5602483
fewer domestic corporations?
b Did the transferor remain in existence after the transfer?
Yes
No
UYes
No
Identifying number
o If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?LJ
YesL__J No
If not, list the name and employer identification number (E IN) of the parent corporation:
E IN of parent corporation

L_J Yes
No
a List the name and E IN of the transferors partnership:
Name of partnership
E IN of partnership
WILLIETT PRIVATE INVESTORS (TAX EXEMPT) I LL,C 126-2359838
L X J YesUNo
UYesOTNo
securitiesmarket?
................................................................................................................................................
No
4Identifying number, if any

TENFtJ
2901BUILDING C, XINGJING COMMERCE CENTER
NO, 25JIAHE ROAD, XI. AMEN CHINA
CH
CORPORATION
8Is the transferee forei gn corp
oration a controlled foreign corporation? .......................... ........................................... L.J YesLxi No
Form 926 (Rev. 12-2011)
224531
05-01-12
178
17171111737725BLOOMF.AMFND 2012.04040THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
D 4 1

1 1 4 1
Form 926 (Rev. 12-2011)
Paqe
[Part Ill
I
Type of
property
(a)(b)(c)(d)(e)
transferI propertyI date of transferI basisI transfer
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
(see Temp. Regs. sac.
Intangible
property
1 .367(a).4(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a).4T(d))
described in Temp.
Other property
224532
Form 926 (Rev. 12.2011)
05-01-12
179
li
1 i
F.. 9 2 6
intenalRevenue Service
Intormation
Attachment
Sequence No.
1 2 8
Name of transferor
Identifying number is"

20-5602483
fewer domestic corporations?.YesEJ No
b Did the transferor remain in existence after the transfer? .Yes[]No
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? L_J YesLJ No
If not, list the name and employer identification number (EIN of the parent corporation:

d Have basis adjustments under section 367(a)(5) been made? L..JNo
Name of partnership
EIN of partnership
WIIJLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC
26-2359838
I J YesL.J No
o Is the partner disposing of its entire Interest in the partnership? ..............................................................................
ED YesLXNo

SUNART RETAIL GROUP
LEVEL 28, THREE PACIFIC PLACE
1 QUEEN'S ROAD EAST HONG KONG
HK
-CORPORATION
8Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... L.iYesLXJ No
224531
05-01 -1 2
1 81
1 71 71 1 1 1 737725 BLOOMFAMFND 201 2.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
Fomi926 (Rev. 122011) THE BLOOMBERG FAMILY FOUNDATION INC
20-5602483
Pacie
[Part III
I
Information Regarding Transfer of Property
(see instructions)
(a)(b)(c)(d)(e)
Type of
property
transferpropertydate of transferbasistransfer
Cash353,263.
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
1 .367(a).4T(b))
Intangible
property
Property to be sold
(as described in
Temp. Regs. sec.
described in Temp.
Reps. sec. 1 .367(al-4T(
Other property
(see instructions):
224532
Form 926 (Rev. 12-2011)
05-01-12
182
^ A
Part IV
I
Additional Information Regarding Transfer of Property
(see instructions)
9Enter the transferor's interest in the foreign transferee corporation before and after the transfer:
20-5602483
3
a Gain recognition under section 904(1)(3)

El Yes
No
El YesIll No

El Yes[Xi No
El Yes
EXI No
12
Did this transfer result from a change in the classification of the transferee to that of a foreign corporation?
El YesEl No
13
a Tainted property
El Yes [] No
El Yes [XI No
El YesNo
El YesI]JNo
14
El YesL]No
1.367(a)-1T(d)(5)(ii?
El YesIJJNo
b if the answer to line 15a is "Yes," enter the amount of foreign goodwill or going concern value
transferred 11o. $

[XI YesEl No
17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction?
El Yes[l No
transaction:
Form 926 (Rev. 12-2011)
224533
05-01-12
180
17171111 737725 BLOOMFAMFND 2012.04040 THE BLOONBERG FAMILY FOUNDA BIJOOMFA2
I i
N 4 1
THE BLOOMBERG FAMILY FOUN DATION IN C
20-56024 83
9 Enter the transferors interest in the foreign transferee corporation before and after the transfer.
10 Type of nonrecognition transaction (see Instructions) SECTION 351 TRAN SACTION
a Gain recognition under section 904(t)(3) .
Yes11 No
b Gain recognition under section 904(1)(5)(F) .
Yes{]J No
Yes[J No
YesLJ No
[11 Yes[It] No
13
YesEM No
.YesE]] No
YesNo
-
YesIJJ No
LIII Yes[J No
1 .367(a)-i T(d)(5)(iii)?
.YesNo
transferred$

LJ YesNo
17a
Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction?
YesEK No
transaction:
Form 926 (Rev. 12-2011)
224533
05-01-12
1 83
1 71 71 1 1 1 737725 BLOOMFAMFN D 201 2.04 04 0 THE ELOOMBERG FAMILY FOUN DA BLOOMFA2
E A
F. 9 2 6
Intemal Revenue Service
OMB No, 1545-002 6
Attachment
Sequence No.
1 2 8
Name of transferor
Identifying number ( see Ifl$U5)

THE BL300MBERG FAMILY FOUNDATION INC
2 0-5602 48 3
fewer domestic corporations?.Yes 0No
b Did the transferor remain in existence after the transfer? L] YesDNo
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L.....J Yes - L..J No

d Have basis adjustments under section 36 7(a)(5) been made?...................................................... L.J Yes
No
a LIst the name and EIN of the transferors partnership:
Name of partnership
EIN of partnership
2 6-2 3598 38
c Is the partner disposing of its entire interest in the partnership?
Information
LXJ Yes LJ No
EDYes LJNo
STUDIO MODERNA HOLDINGS B.V.
5 Address (Including country)
SM HEADQUARTERS, FERRUCCIO PELLI 1 3
6900 LUGANO, NETHERLANDS
NL
CORPORATION
8Is the transferee forei g n corporation a controlled forei g n corporation? ..................................................................... L..i YesLXJ No
LHA For Paperwork Reduction Act Notice, see separate instructions.Form 9 2 6 (Rev. 12 -2 011)
2 2 4531
05-01-12
1 8 4
1 71 71 1 1 1 73772 5 BLOOMFANFND 2 01 2 .04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
Fomi92641ev.12-2011) THE BLIOONBERG FAMILY FOUNDATION INC
205602483
Page2
I
Part Ill
I
(see instructions)
(a) (b)(c)(d) (e)
Type of
Date of Description of Fair market value on Cost or other
Gain recognized on
property -
- transfer property date of transfer basis
I transfer
Cash
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
1 .367(a)-4T(b))
Intangible
property
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a)-4T(d))
described in Temp.
Recis. sec. I .367(a4T(
Other property
(see Instructions):
224532
Form 926 (Rev. 12.2011)
05-01-12
185
17171111 737725 BLOOMF.MFND 2012.04040 THE BLOONBERG FAMILY FOUNDA BLOOMFA2
20-560248
(a) Before %(b) After%
11 Indicate whether any transfer reported in Part Ill Is subject to any of the following:
a Gain recognition under section 904(f){3) .
Yes
No
b Gain recognition under section 904(f)(5)(F).
YesEJ No
CRecapture under section 1503(d) .
YesEl] No
.Yes Eli No
.YesEE No
a Tainted property
E]YesEE No
.Yesliii No
o Branch loss recapture
.Yes1X1 No
.
YesCX] No
14
.YesEJ No
iSa
1 .367(a)-i T(d)(5)(iii)? .
Yes[IJ No
b If the answer to line 15a is "Yes,' enter the amount of foreign goodwill or going concern value
transferred$

CX] YesNo
17a
Was Intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction?
L]YesI]J No
b If "Yes, describe the nature of the rights to the intangible property that was transferred as a result of the
transaction:
Form 926 (Rev.12-2011)
224533
05-01-12
186
[ A ]
9 2 6
Internal Revenue SeMce
Name of transferor
OMB No. 1545-0026
Attachment
Sequence No.
1 2 8
Identifying
20-5602483
If the transferor was a corporation, complete questions 1 a through Id.
b Did the transferor remain in existence after the transfer? [:]YesE] No
Identifying number
O If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? L_J YesLJ No

d Have basis adjustments under section 367(a)(5) been made? L..J Yes
No
2 If the transferor was a partner in a partnership that was the actual transferor (but Is not treated as such under section 367), complete
Name of partnership
EIN of partnership
b Did the partner pickup its pro rata share of gain on the transfer of partnership assets?L.J YesL....J No
c Is the partner disposing of its entire Interest in the partnership? .Yes[XI No

PRIVALIA VENTA DIRECTA
I
CALLE LLULL, 113-119
BARCELONA, CATALONIA, 08005, SPAIN
5?
CORPORATION
8Is the transferee forei g n corporation a controlled foreign corporation? .................................................. ................... L.JYesLX] No
224531
05-01-12
187
Form 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC20-5602483
Paa
I
Part Ill
I
(see instructions)
(a)(b)(c)(d)
(e)
Type of
Date ofDescription ofFair market value onCost or other
Gain recognized on
property
Cash240.604.
Stock and
securities
Instament obligations,
similar property
foreign currency
Inventory
Assets subject to
Tangible property used In
Intangible
property
Property to be sold
(as described in
Temp. Regs. Sec.
1 .367(a)4T(d))
described in Temp.
Req s. sec. 1 .367(a4T(
Other property
(see instructions):
224532
Form 926 (Rev. 12-2011)
05-01-12
188
17171111 737725 BLOOMFFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
20-5602483
9 Enter the transferor's interest In the foreign transferee corporation before and after the transfer
11 Indicate whether any transfer reported In Part Ill is subject to any of the following:
a Gain recognition under section 904(1)(3) .
YesLJ No
.Yes
No

LI Yesi:i No
.YesEJ No
.Yes[]No
a Tainted property
.Yes IX] No
.Yes[I]No
YesEJ No
d Any other income recognition provision contained in the above-referenced regulations .
YesEJJ No
.YesIIJ No
1.367(a).1T(c(5)(iii)? .
YesLJ No
transferred
$
16Was cash the only property transferred?

EJ] YesNo
YesNo
b If 'Yes," describe the nature of the rights to the intangible property that was transferred as a result of the
transaction:
Form 926 (Rev.12-2011)
224533
05-01-12
189
17171111 737725 BLOONF.AMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
No.
Attachment
Sequence No.
1 2 8
Name of transferor
Identifying number
( see Instructions)
2 0-5602 48 3
Form 9 2 6
( Rev. December 2 011)
Intenrei Revenue Service
lithe transferor was a corporation, complete questions 1 a through 1d.
a If the transfer was a section 36 1( a) or ( b) transfer, was the transferor controlled ( under section 36 8( c) ) by 5 or

[11J Yes[1] No
b Did the transferor remain In existence after the transfer?[]

YesEI No
If not, list the controlling shareholder( s) and their identifying number( s) :
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L....J
YesL...J No
If not, list the name and employer identification number ( EIN) of the parent corporation:
d Have basis adjustments under section 36 7( a) ( 5) been made?

U Yes
No
2 If the transferor was a partner in a partnership that was the actual transferor ( but is not treated as such under section 36 7) , complete
Name of partnership
[IN of partnership
2 6-2 3598 38
b Did the partner pick up Its pro rata share of gain on the transfer of partnership assets?Lxi YesUNo
c Is the partner disposing of its entire Interest In the partnership?
[J Yes EXI No
securities market?
Yes[J No
Part II
I
Transferee Foreign Corporation Information ( see instructions)
1 4 Identifying number, if any
KASPERSKY LABS
MOSCOW, 1 2 3060, RUSSIA
RS
CORPORATION
8Is the transferee forei g n corporation a controlled foreign corporation? ..................................................................... L_J YesLXI No
Form 9 2 6 ( Rev. 12 -2 011)
2 2 4531
05-01-12
1 90
1 71 71 1 1 1 73772 5 BLOOMF.AMFND 2 01 2 .04040 THE BLOOMBERG FAMILY FOTJNDA BLOOMFA2
C
Form 926 (Rev. 12-2011)
Page
I
Part Ill
I
(a)(b)(C)(d)(e)
Type of
property
transfer
I
property
I
date of transferbasis
I transfer
Cash
'-2 1 I
Stock and
securities
sini!ar property
foreign currency
Inventory
Assets subject to
Intangible
property
1 .367(a)-4(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a).4T(d))
described in Temp.
Reos. sec. 1 .367(a)-4T(
Other property
224532
Form 926 (Rev. 12-2011)
05-01-12
191
ON INC
20-560248
9 Enter the transferor' s Interest in the foreign transferee corporation before and after the transfer:
10 Type of nonrecognition transaction (see instructions) D o . SECTION 351 TRANSACTION
a Gain recognition under section 904(f)(3) E l YestJJ No
b Gain recognition under section 904(f)(5)(F)[I]YesEX] No

c Recapture under section 1503(d) ...........................................................................................................................LJ YesXI No
d Exchange gain under section 987 E l Yes Ill No
12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation?U Yes[J No
a Tainted property[l Yes[1 No

b Depreciation recapture ................................................................................El Yes [I]No
cBranch loss recapture ......................................................................................................................................[l YesLXI]No
d Any other income recognition provision contained in the above-referenced regulations UI]Yes[XI] No
14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)?El YesIXJ No
1.367(a)-i T(d)(5)(iii)?i:i Yes[Xl No

b If the answer to line 1 5a is Yes, enter the amount of foreign goodwill or going concern value
transferred
$
16 Was cash the only property transferred? [IX] YesEl No
17a Was intangible property (within the meaning of section 936h)(3)(B)) transferred as a result of the transaction? -------- El Yes No
transaction:
Form 926 (Rev. 12-2011)
224533
05-01-12
192
2
9 26
Name of transferor
1 If the transferor was a corporation, complete questions 1 a through 1 d. --
a If the transfer was a section 361 (a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 or
It Did the transferor remain in existence after the transfer?
OMB No. 1545-0026
Attachment
Sequence No. i
Ientifylng number (see
jflS)
20-5602483
EJYes EINo
L:JYes EJNo
Identifying number
C If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L.....J YesL.JNo
d Have basis adjustments under section 367(a)(5) been made? L.JYes
No
Name of partnership
EIN of partnership
b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LI YesL..JNo
c Is the partner disposing of its entire interest In the partnership? . YesEJNo
PartII
I
Transferee ForeignCorpo

GRUPO DE INVERSIONES STJRib MERICA1A ESPANA, S.L.
CALLE AYALA, N66
28001 MADRID, SPAIN
SP
CORPORATION
8Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... L..i YesLxi No
224531
05-01-12
193
Form 926(Rev.12-2011) THE BLOOMBERG FAMILY FOUNDATION INC
20-5602483
PaQe2
P a r t I l l
I
(see instructions)
Type of
property
(a)(b)C c) (d)(e)
Gain recognized on
transfer
I
property
I
date of transfer
I
basis
I transfer
D
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
Intangible
property
1.367(a)-4(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a).4T(d))
described in Temp.
Other property
(see instructions):
224532
Form 926 (Rev. 12-2011)
05-01-12
194
00
a Gain recognition under section 904(fX3) .
Yes[IX] No
Yes
CX] No
C Recapture under section 1503(d)
.Yes CX] No
.Yes [IX] No
.Yes[ix] No
a Tainted property
.YesNo
.Yes
No

El Yes
No

L1 YesNo
14
LJYesNo
1.367(a)-1T(d)(5)(11?
E l Yes[X] No
b If the answer to line 1 5a is "Yes, enter the amount of foreign goodwill or going concern value
transferred$
LX] Yes E l No
17a
Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? E l Yesl]Il No
transaction:
Form 926 (Rev.12-2011)
224533
05-el-12
195
17171111 737725 ELOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
9 2 6
Name of transferor
0MB No. 1545-0026
Attachment
Sequence No.
1 2 8
Identifying number($teIflsbuttofl$)
2 0-5602 48 3
Yes
ED No
.Yes
No
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?-.
L..J YesL..J No

L_ _ i Yes
No
a List the name and EIN of the transferors partnership:
Name of partnership
EIN of partnership
WILLETT PRIVATE INVESTORS TAX EXEMPT) I LLC
2 6-2 3598 38
LXI YesUN0
c Is the partner disposing of its entire Interest in the partnership?
YesNo
EE

_______________________
INDTJSIND BANK
701 , SOrITARE CORPORATE BANK, ANDHERI (EAST)
MDNBAI 400093, INDIA
IN
CORPORATION
8Is the transferee foreign corporation a controlled foreign cor
p oration? ..................................................................... L_ J YesLxi No
Form 926 (Rev. 12-2011)
224531
05-01-12
1 96
1 71 71 1 1 1 73772 5 BLOOMFAMFND 2 01 2 .04040 THE BLOOMBERG FAMILY FOUNDA BLOONFA2
Form 926 (Rev. 12-2011)
Paqe2
I
Part I I I
I
(a)(b)(C)(d)(e)
Type of
property
Cash213,561.
Stock and
securities
smiler property
foreign currency
Inventory
Assets subject to
Intangible
property
1 .367(a)-4(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a).4T(d))
described in Temp.
Reas. sec. 1.367(a)-4T((
Other property
224532
Form 926 (Rev. 12.2011)
05-01-12
197
20-5602483
a Gain recognition under section 904(0(3) E l Yes[] No
b Gain recognition under section 904(t)(5)(F) EJ YesQXNo
CRecapture under section 1503(d) EJ Yes[Xl No

d Exchange gain under section 987 E l Yes [Xl No
12Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? E l YesDJ No
aTainted property............................................................................................................. E l Yes[XI No

b Depreciation recapture E l Yes E K No
c Branch loss recapture E l Yes l J No
d Any other income recognition provision contained In the above-referenced regulations E l Yes[J No
14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? E l YesI]J No
1 .367(a}-1T(d)(5)(iii)? E l Yes[J No
b If the answer to line 1 5a is AYes, enter the amount of foreign goodwill or going concern value
transferred$
16 Was cash the only property transferred? .YesE l No
17 a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? E l Yes[XI No
transaction:
Form 926 (Rev. 12-2011)
224523
05-01-12
198
17171111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOTJNDA BLOOMFA2
1 i
Form 9 2 6
(Rev. December 2 01 1 )
Depai tment of the Treasury
Internal Revenue Servi ce
1 0 , Aftach to your income tax return for the year of the transfer or distribution.
Name of transferor
OMB No. 1 545-002 6
Attachment
Sequence No.
1 2 8
Identifying number (meInsfruc)
2 0-5602 48 3
.Yes
No
b Did the transferor remain in existence after the transfer?.

Yes
E] No
Identifying number
C
L - - - J Yes L i No
If not, list the name and employer Identification number (EIN) of the parent corporation:
FIN of parent corporation

L i Yes L i No
Name of partnership
FIN of partnership
1 2 6-2 3598 38
L iJ YesU No
CIs the partner disposing of its entire interest in the partnership?.
Yes EX- 1 No
Part II
I

CITCO III LIMITED
5 Address (Including country)
8 9 NEXUS WAY, 2 ND FL, CAMANA BAY; P.O. BOX 31 1 06
GRAND CAYMAN KY1 -1 2 05, CAYMAN ISLANDS
C'].
CORPORATION
n corporation a controlled foreign corporation? .................................................. ....... ............ U Yes LXJ No
L HA For Paperwork Reduction Act Notice, see separate Instructions.
Form 926 (Rev. 1 2.20 1 1 )
2 2 4531
05-01 .1 2
1 99
1 71 71 1 1 1 73772 5 BLOOMFAMFND 2 01 2 .04040 THE BLOO4BERG FAMILY FOUNDA BLOOMFA2
Form 926 (Rev. 122011)
Page 2
L
Part III
I
(a)(b)(C) (d)(e)
Type of
property
Cash1 857.757.
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
(see Temp. Pegs. sec.
1 .367(a).4T(b))
Intangible
property
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a)-4T(d))
described in Temp.
Other property
224532
Form 926 (Rev. 12-2011)
05-01-12
200
1 71 71 1 1 1 737725 BLOOMFAMFND 201 2.04040 THE ELOOMBERG FAMILY FOUNDA BLOOMFA2
omi 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC
Part IV
I
(see instructions)
20-5602483
11 Indicate whether any transfer reported In Part III Is subject to any of the following:

EJYes1X1 No
.Yes
No
YesI JJNo
.Yes1X1 No
.Yes
EXI No
YesEJNo
b Depreciation recapture .
YesEE No
cBranch loss recapture
.......................................................................................................................................... QYesEKJNo
.Yes[I ]No
.Yes EU No
ISa
1 .367(a)-i T(d)(5)(ii? .
YeslJNo
b If the answer to line 15a Is "Yes," enter the amount of foreign goodwill or going concern value
transferred$
.YesNo
17a Was intangible property (within the meaning of section 936,)(3)(B)) transferred as a result of the transaction?
YesI JJNo
transaction:
Form 926 (Rev. 12-2011)
224533
05-01-12
201
l i _ 7 1 1 1 1 1 1
LA
9 2 6
Internet Revenue Servi ce
Attach to your i ncome tax return for the year of the transfer or di stri buti on.
Name of transferor
I
OMB No. 1 545.0026
Attathment
Sequence No.
.d
Identi fyi ng number (see scuons)
20-5602483
If the transferor was a corporati on, compl ete questi ons l a through 1 d.
a If the transfer was a secti on 361 (a) or (b) transfer, was the transferor control l ed (under secti on 368(c)) by 5 or
fewer domesti c corporati ons?
.Yes
EJ No
b Di d the transferor remai n i n exi stence after the transfer? .
YesEI ii No
If not, l i st the control l i ng sharehol der(s) and thei r i denti fyi ng number(s):
Control l i ng sharehol der
Identi fyi ng number

c If the transferor was a member of an affi l i ated group fi l i ng a consol i dated return, was i t the parent corporati on?
L..JYes=FN,
If not, l i st the name and empl oyer Identi fi cati on number (EIN) of the parent corporati on:
Name of parent corporati on
EIN of parent corporati on

d Have basi s adjustments under secti on 367 (a)(5) been made? .................................................................................
L.J Yes
No
2 If the transferor was a partner i n a partnershi p that was the actual transferor (but i s not treated as such under secti on 367 ), compl ete
questi ons 2a through 2d.
a Li st the name and EIN of the transferor's partnershi p:
Name of partnershi p
EIN of partnershi p
WILLETP PRIVATE INVESTORS (TAX EXEMPT) I LLC126-2359838
b Di d the partner pi ck up i ts pro rata share of gai n on the transfer of partnershi p assets?
LXJ YesL_J No
C Is the partner di sposi ng of i ts enti re i nterest In the partnershi p?
El Yes[X] No
d Is the partner di sposi ng of an i nterest i n a l i mi ted partnershi p that i s regul arl y traded on an establ i shed
Part H
I
3 Name of transferee (forei gn corporati on)
4 Identi fyi ng number, i f any

AEC HOLDINGS LTD.
5 Address (i ncl udi ng country)
303 SHIRLEY STREET
P.O. BOX N-492 NASSAU BAHAMAS
6 Country code of country of i ncorporati on or organi zati on
BF
7 Forei gn l aw characteri zati on (see i nstructi ons)
CORPORATION
8Is the transferee forei gn cor p
orati on a control l ed forei gn corporati on? ..................................................................... LX] YesLi No
LHA For Paperwork Reducti on Act Noti ce, see separate i nstructi ons.
Form 926 (Rev. 1 2-201 1 )
224531
05-01 -1 2
202
17171111 737725 BLOONFANFND 2012.04040 THE BLOOMBERG FAMILY FOtJNDA BLOOMFA2
Form 926(Rev.12.2011) THE BLOOMBERG FAMILY FOUNDATION INC 205602483
Paqe2
I
Part Ill
I
(see Instructions)
Type of
property
Stock and
securities
(a)(b)(C)(d)(e)
Gain recognized on
transferpropertydate of transfer
Ibasistransfer
23/2012111,471.
similar property
foreign currency
Inventory
Assets subject to
1 .367(a)-4T(b))
Intangible
property
1 .367(a).4(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a)4T(d))
described in Temp.
Other property
(see instructions):
224532
Form 826 (Rev. 12-2011)
05-01-12
203
17171111 737725 BLOOMFNFND 2012.04040 THE BLOONBERG FAMILY FOUNDA BLOOMFA2
1) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483
10Type of nonrecognition transaction (see Instructions) SECTION 351 TRANSACTION
a Gain recognition under section 904(f)(3) .
YesL] No
b Gain recognition under section 904(t)(5)(F).

Yes[I] No
YesLXI No
YesLX] No
.YesEXJ No
a Tainted property
.Yes [XI No
EJ YesLXI No
.Yes LXI No
.Yes[XI No
.YesLXI No
1 .367(a)-i T(c(5)(iii)?
ElYes[XI No
transferred$
.Yes El No
17 a Was Intangible property (within the meaning of section 936h)(3)(B)) transferred as a result of the transaction?
ElYes[Xl No
transaction:
Form 926 (Rev.12-2011)
224533
05-01-12
204
,.926
bo
-Attach to your Income tax return for the year of the transferor distribution.
Name of transferor
Hl
li
0MB No . 1545-0026
Attachment
Sequence
N o . 1 2 8
lentitying number (me
iflslructtons)
20-5602483
If the transferor was a corporation, complete questions la through 1d.
fewer domestic corporations?i:iii Yes
No
b Did the transferor remain In existence after the transfer?

[TI Yes
No
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was It the parent corporation?
L_J Yes UNo

L_.J Yes
No
a Ust the name and EIN of the transferors partnership:
Name of partnership
EIN of partnership
126-2359838
d is the partner disposing of an interest in a limited partnership that is regularly traded on an established
LXJ Yes ___=No
El Yes L] No
No
Part II
I
Transferee Foreign Corpc

PETRUS RESOURCES LTD.
2400, 240 4TH AVENUE SW
CALGARY ALBERTA T2P 1G1 CANADA
CA
CORPORATION
8
Is the transferee foreign corporation a controlled foreign corporation?...........................................
..........................L_J Yes LX] No
LF-{A For Paperwork Reduction Act Notice, see separate instructions.
Form 926 (Rev. 12-2011)
224531
05-01-12
205
Form 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483
Page2_
I Part III Information Regarding Transfer of Property (see instructions)
Type of
property
(a)(b)
(0)
(d)(e)
transferI propertyI date of transfer I basisI transfer
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
1 .367(a)-4T(b))
Intangible
property
11.367(a)-41(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a).4T(d))
described in Temp.
Reos. sec. 1.367(a)-4T6
Other property
224532
Form 926 (Rev. 12-2011)
05-01-12
206
Forrn926(Rev.12-2011) THE BLOOMBERG FAMILY FOUNDATION INC
205602483
Page3
I
Part IV
I
(see instructions)
(a) Before%(b) After
10 Type of nonrecognition transaction (see instructions) u. SECTION 351 TRANSACTION
.Yes
[] No
b Gain recognition under section 904(t)(5)(F).
Yes[X] No
.Yes1 X 1 No
d Exchange gain under section 987.
Yes[11 No
12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation?i:i
Yes(]1 No
a Tainted property.
YesL1 No
b Depreciation recapture.
Yes[XI No
c Branch loss recapture.
Yes[JNo
d Any other Income recognition provision contained In the above-referenced regulations .
YesEK No
LJYesiJJNo
1 .367(a)-i T(d)(5)(iii)?.
Yes[X I No
transferred$

EJYesE] No
YesMI No
transaction:
Form 926 (Rev. 12.2011)
224533
05-01-12
207
17171111 737725 BLOOMF.AMFND 2012.04040 THE BLOOMBERG FAMILY FOtJNDA BLOOMFA2
F.926
Oepadment of the Treasury
P a r t I U . S . T i
10 , Attach to your Income tax return for the year of the transfer or distribution.
0MB No. 1545-0026
Attachment
Sequence No.128
Identifying number (sea
fl5UCfDfls)
20-5602483
iniormation (see instructions)
Name of transferor
T HE BLOOMBERG FAMI LY FOU NDAT I ON I NC
EJYes
No
EJYesNo
Identifying number
C
L. . J Yes - L...J No

L_..JYes
No
Name of partnership
EIN of partnership
WI LLET T P RI VAT E I NVES T ORS (T AX EXEMP T ) I LLC
126-2359838
LXJ YesL..J No
.YesNo
', .-._ securities market?ffl


ALCHEMY P ART S (I RELAND) LI MI T ED
S ECOND FLOOR, BEAU X LANE HOU S E
MERCER S T REET LOWER, DU BLI N 2, I RELAND
El
-CORP ORAT I ON
8Is the transferee forei g n corporation a controlled foreign cor poration? .............................................................
........Lxi YesLi No
Form 926 (Rev. 12-2011)
224531
05-01-12
208
17171111 737725 BLOOMF. ANFND 2012. 04040 T HE BLOOMBERG FAMI LY FOU NDA BLOOMFA2
E A
E A
Form 926 (Rev. 12.2011) THE BLOOMBE RG FA MILY FOUNDA TION INC
20-5602483
Pacio2
I Part III I Information Regarding Transfer of Property (see instructions)
Type of
property
(a)(b)(c)(d)(e)
Gain recognized on
transfer
I
property
Idate of transfer IbasisItranfcr
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
1 .367(a)4T(b))
Intangible
property
Property to be sold
(as described in
Temp. Regs. sec.
I .367(a).4T(d))
described In Temp.
Other property
(see instructions):
224532
Form 926 (Rev. 12.2011)
05-01-12
209
E A
20-5602483
.Yes
[] No
b Gain recognition under section 904(t)(5)(F) .
YesE li No
Yes[JNo

E ]YesE li No
12
Did this transfer result from a change In the classification of the transferee to that of a foreign corporation?
.Yes[IX] No
a Tainted property
.Yes LX] No
YesLX] No
YesLXI No
YesLXI No
14
. YesLX] No
15a Did the transferor transfer foreign goodwill or going concern value as defined In Temporary Regulations section
1 .367(a)-i T(d)(5)(ii? .
YesLXI No
transferred$

LX]YesNo
L1Yes[XI No
transaction:
Form 926 (Rev. 12.207)
224533
05-01-12
210
17171111 737725 BLOOMF2MFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
1 4
Form 9 2 6
Name of transferor
i
OMB No, 1545-0026
I
tah cment
Se
At
quence No. 128
lenifyingnumber
(me Inst,us)
20-5602483
I If the transferor was a corporation, complete questions 1 a through 1 d. -
fewer domestic corporations? .................................................................................................................................. Yes

E1 No
b Did the transferor remain in existence after the transfer? ................................................................................. YesLJ No
If not, list the controllingshareholder(s) and their identifyingnumber(s):
Controllingshareholder
Identifyingnumber
c If the transferor was a member of an affiliated group filinga consolidated return, was It the parent corporation? ...... L.J YesL......J No
d Have basis adjustments under section 367(a)(5) been made? L.JYes
No
2 If the transferor was a partner in a partnership that was the actualtransferor (but is not treated as such under section 367), complete
Name of partnership
EIN of partnership
LXJ YesUNo
c Is the partner disposingof its entire interest in the partnership? ..............................................................................
EJ YesLXJ No
d Is the partner disposingof an Interest in a limited partnership that is regularly traded on an established
Part II
I
4 Identifyingnumber, if any
ORIVA AIRLEASE LTD.
5 Address (includingcountry)
2ND FLOOR BOOTERSTOWN HALL, BOOTERSTOWN AVE
BOOTERSTOWN, DUBLIN, IRELAND
El
CORPORATION
8Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... [Xi YesL..i No
LHA For Paperwork Reduction Act Notice, see separate Instructions. Form 926 (Rev. 12-2011)
224531
05-01-12
211
Fons926(Rev.12-2011) THE BLOOMBERG FAMILY FOUNDATION INC
205602483
Page
I
Part Ill
I
(see instructions)
(a)(b)(c)(d)
(e)
Type of
Gain recognized on
property
transferpropertydate of transfer basis
transfer
casi,
154,231.
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
Intangible
property
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a).4T(d))
described in Temp.
Other property
(see instructions):
224532
Form 926 (Rev. 12-2011)
05-01-12
212
1 # 1
26 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC
IV
I
(see instructions
20-5602483
.Yes
No
b Gain recognition under section 904((5)(F) .
YesLX] No
YesLXI No
YesLXI No
12 Did this transfer result from a change In the classification of the transferee to that of a foreign corporation?
E1 J YesLX] No
a Tainted property[]
YesLX] No
YesI XJ No
o Branch loss recapture
.Yes LX] No
YesLX] No
.Yes[XI No
16a
1 .367(a)-i T(d)(5)(iil)? .
YesLXI No
transferred$

LX] YesUNo
17a Was Intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction?
UI Yes[XI No
transaction:
Form 926 (Rev. 12-2011)
224533
05-01-12
213
17171111 737725 BLOONFFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOONFA2
OMB No. 1545.0026
Attachment
Sequence No.
1 2 8
INC
Name of transferor
THE BLOOMBERG FAMILY FOUNDATION
Identifying number( ins
s)
9 2 6
(Rev. Oecembe( 20 11)
2 0-5602 48 3

YesEl No

ElYes
El No
Identifying number
o if the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? .........
LJ YesUNo

L.J Yes
No
Name of partnership
EIN of partnership
WILLETT PRIVATE INVESTORS (TAX EXEMPT
-I LLC1 2 6-2 3598 38
c Is the partner disposing of Its entire interest In the partnership?
securities market?
LXI _ Yes U_ _ No'
El Yes EXI No

PUBLIC HOUSE TRUST
P.O. BOX 1 093, BOUNDARY HALL, CRICKET SQUARE
GRAND CAYMAN, KY1 -1 1 02 , CAYMAN ISLANDS
CJ
CORPORATION
8Is the transferee forei gn corporation a controlled foreign corporation? ..............................
....................................... LXJ YesL.J No
Form 926 (Rev. 12-2011)
224531
05-01-12
2 1 4
1 71 71 1 1 1 73772 5 BLOOMF.AMFND 2 01 2 .04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
Awk
Form 926(Rev.12-2011) THE BLOONBERG FAMILY FOUNDATION INC
20-5602483 Paqe2
I
Part Ill
I
(see Instructions)
(a)(b)(C)(d)
(e)
Type of
Gain recognized on
property
Cash
93.379.
Stock and
securities
Instailment obligations,
similar property
foreign currency
Inventory
Assets subject to
1 .367(a).4T(b))
Intangible
property
1 .367(a).4(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a)-4T(d))
described in Temp.
Other property
(see instructions):
224532
Form 926 (Rev. 12-2011)
05-01-12
215
17171111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOIJNDA BLOOMFA2
THE BT.iOOMBERG FAMILY FOUNDATION INC
20-5602483
Yes[X1No
b Gain recognition under section 904(0(5)(F) .Yes[] No
c Recapture under section 1503(d) ............................................................................................................................YesEll No

d Exchange gain under section 987 .YesLXI No
12 Did this transfer result from a change In the classification of the transferee to that of a foreign corporation? ..............Yes EiJ No
1 .367(a)-4 through 1.367(a)-6 for any of the following:
aTainted property...................................................................................................................................................Yes[] No
b Depreciation recapture .Yes[J No
c Branch loss recapture LJ YesE2 No
d Any other income recognition provision contained in the above-referenced regulations .YesIMNo
14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? .Yes
1 .367(a)-i T(d(5)(ll? .Yes
b If the answer to line 15a is Yes,' enter the amount of foreign goodwill or going concern value
transferred$
EJNO
JNo
16 Was cash the only property transferred? CX] YesLJ No
17 a Was intangible property (within the meaning of section 936(h)(3)(13)) transferred as a result of the transaction? Yes1XI No
b It Yes," describe the nature of the rights to the intangible property that was transferred as a result of the
transaction:
Form 926 (Rev.12-2011)
224533
05-01-12
216
[A
Form 9 2 6
ev. December 2 011)
10, Attech to your income tax return for the year of the transfer or distribution.
Name of transferor
OMB No. 1545-002 6
Attachment
re
Sequence No.1
8
Identifying number(MSbUC)
20-5602483
lithe transferor was a corporation, complete questions la through id.
fewer domestic corporations?Yes
E] No
b Did the transferor remain in existence after the transfer? .YesNo
Identifying number
c lithe transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L......J YesL.J No
d Have basis adjustments under section 36 7(a5) been made? LiYes
No
Name of partnership
EIN of partnership
WIL1LETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838
LAJ YesUNo
C Is the partner disposing of its entire interest in the partnership?....................................................................
DYesEXJNo
L1 No
Part II I Transferee Foreign Corpc

INVICTA CARD SERVICES HOLDINGS SARL
6C, RUE GABRIEL LIPPMANN
MUNSBACH, L-5365, LUXEMBOURG
LU
-CORPORATION
8Is the transferee forei gn corporation a controlled forei g n corporation? ..................................................................... LXJ YesL..J No
LHA For Paperwork Reduction Act Notice, see separate instructions. Form 9 2 6 (Rev. 12 -2 011)
2 2 4531
05-01-12
217
t
Form 926 (Rev. 12-2011)
Pao
I
Part I l l I Information Regarding Transfer of Property (see instructions)
(a)(b)(c)(d)(e)
Type of
property
Cash1 503.556.
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
1 .367(a).4T(b))
Intangible
property
1 .367(a)-4(c))
Property to be sold
(as described In
Temp. Regs. sec.
1 .367(a)-4T(d))
described in Temp.
Regs. sec. 1 .367(a)-4T(E
Other property
224532
Form 926 (Rev. 12-2011)
05-01-12
21 8
1 71 71 1 1 1 737725 BLOOMFAMFND 201 2.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
12 . 2011) THE BLOOMBERG FAMILY FOUNDATION INC
20-5602483
Paae3
.
Yes[X] No
YesIJJ No
YesJ No
. Yes[] No
. Yes
No
13 indicate whether the transferor was required to recognize income under final and temporary Regulations sections
1. 367(a)-4 through 1. 367(a)-6 for any of the following:
Yes[Xl No
YesIJ No
YesEJ No
.
Yes
MNo
. Yes
EXI No
1. 367(a)-i T(d)(5)(iii)? .
YesXI No
b If the answer to line 1 5a Is "Yes,' enter the amount of foreign goodwill or going concern value
transferred 10- $
[XI YesNo
17 a Was intangible property (within the meaning of section 936h)(3)(B)) transferred as a result of the transaction?
. YesEXJ No
transaction:
Form 926 (Rev. 12. 2011)
224533
05-01-12
219
2
9 26
Depelinent of the Treasury
Name of transferor
OMB No. 1545-0026
IAttachment
Sequence N.. 1 2 8
Identifying number (see jns)
2 0-5602 48 3
a If The transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 or
fewer domestic corporations? . Yes
No
b Did the transferor remain in existence after the transfer? .......................................................................................... EJ YesE1 No
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? L..J YesL...J No

d Have basis adjustments under section 367(a)(5) been made? ............................................................................... L..J Yes
No
Name of partnership
EIN of partnership
WILLETT PRIVATE INVESTORS (Tax EXEMPT) I LLC1 2 6-2 3598 38
M YesLJNO
EIJ YesI1 No

TRENDYOL DSM GRUP D1NISMANHK
ILETISIM VE SATIS TIC. A. S., AYAZAGA ME. KEMERBURGAZ CD
AYAZAGA/SISLI, TURKEY
TU
CORPORATION
8Is the transferee foreign corporation a controlled foreign corporation? .......................... ........................................... Lxi YesLi No
LI-LA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)
224531
05-01-12
2 2 0
1 71 71 1 1 1 73772 5 BLOOMFAMFND 2 01 2 .04040 THE ELOOMBERG FAMILY FOUNDA BLOOMFA2
Form 926(Rev.12.2011)
Paqe2
I
Part III
I
(a)(b) (c)(d)(e)
Type of
property
transferI propertyI date of transfer basisI transfer
Cash
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
Tangible property used In
Intangible
property
1 .367(a)-4(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a)-4T(d))
described in Temp.
Reqs. sec. 1 .367(a)4T(
Other property
224532
Form 926(Rev. 12-2011)
05-01-12
221
H E
20-560248
a Gain recognition under section

9 04( 0( 3)
..................................................................................................................[ 1] Yes
LX] No
b Gain recognition under section 904(f)(5)(F)[]
YesFRI No
.Yes LXI No
YesLXI No
.Yes[IX] No
1.367(a). 4through 1.367(a) . 6 for any of the following:
a Tainted property
.Yes E XI No
b Depreciation r e c a p t u r e
[II] YesLX] No
YesLXI No
d Any other income recognition provision contained In the above-referenced regulations .
YesLX] No
14Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)?
.YesLXI No
1.367(a)-1T(d)(5)(iii)?
E lYesNo
b If the answer to line 15a is Yes, enter the amount of foreign goodwill or going concern value
transferred P o p . $
LX] YesE l No
E lYesLX] No
b If"Yes," describe the nature of the rights to the intangible property that was transferred as a result of the
transaction:
Form 926 (Rev. 12.2011)
224533
05-01-12
222
H A
E A
F.. 926
Depeilment of the Treasury
on
Name of transferor
OMB No. 1545-0026
A ttachment
Sequence No.
128 28
Identifying number( jfl$hUCUOflS)
20-5602483
a if the transfer was a section 361( a) or ) transfer, was the transferor controlled ( under section 368( c) ) by 5 or
Yes
No
b Did the transferor remain inexistence after the transfer? .
Yes
No
Identifying number
- - L.J YesL...J No
d Have basis adjustments under section 367( a) ( 5) been made?

U Yes
No
2 If the transferor was a partner in a partnership that was the actual transferor ( but is not treated as such under section 367) , complete
Name of partnership
EIN of partnership
I
26-2359838
LXI YesL.J No
o Is the partner disposing of Its entire interest in the partnership?
.YesNo
d Is the partner disposing of an interest in a limited partnership that Is regularly traded on an established
securities market?
El Yes[]No

PEPSCA PTY LTD
5 Address Qncluding country)
19 AILSA STREET, BOX HILL
VICTORIA, 3128, AUSTRALIA
AS
7 Foreign law characterization ( see instructions)
CORPORATION
n corporation a controlled foreign corporation? ..................................................................... LXI YesLi No
LI- IA For Paperwork Reduction Act Notice, see separate instructions.
Form 926 ( Rev. 12- 2011)
224531
05-01-12
223
1 i

E A
Form 926 (Rev. 122011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483
Pa
I
Part Ill
I
(see instructions)
Type of
property
(a)(b)(c)(d)
(e)
Date ofDescription ofFair market value onCost orotherGain recognizedon
transfer
I
propertydate of transferbasisI transfer
Stock and
securities
simar property
property denominatedin
foreign currency
Inventory
Assets subject to
Tangible property usedin
Intangible
property
(as describedin final
andtemp. Regs. sec.
Property to be sold
(as describedin
Temp. Regs. sec.
1 .367(a).4T(d))
Transfers of oil andgas
describedin Temp.
Other property
(see instructions):
224532
Form 926 (Rev. 12-2011)
05-01-12
224
17171111 737725 BLOOMFFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
H]
12-2011) THE BLOOMBERG FAMILY FOUNDATION INC
20-5602483

E1 Yes[lJ No

Li Yes
No
E l Yes[] No
E l Yes [11 No
12
Did this transfer result from a change in the classification of the transferee to that of a foreign corperation?
E l YesLJ No
a Tainted property
El Yes [I] No
El] Yes[J No

EJ YesDJ No

El Yes[]] No
El YesLJ No
15a
1 .367(a)-i T(d)(5)(iii)?
El YesIXI No
transferred$

.YesEl No
El YesEM No
transaction:
Form 926 (Rev. 12-2011)
224533
05-01-12
225
17171111 737725 BLOOMF.AMFND 2012.04040 THE ELOOMBERG FAMILY FOUNDA ELOOMFA2
Form 926
111 -Attach to your income tax return for the year of the transfer or distribution.
Name of transferor
1i
LJ
OMB No. 1545-0026
Attachment
Sequence No. 1 2 8
Instructions)
20-5602483
1 If the transferor was a corporation, complete questions la through 1d.
Yesc:i No
YesEJ No
Identifying number
o If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L.....l
YesL......J No

L.JNo
Name of partnership
EIN of partnership
LJ YesL.....i No
c Is the partner disposing of its entire interest in the partnership? .
YesM No
securitiesmarket?
.................................................................................................................................................
YesEU No
art II I
Transferee Forei gn Corporation Information (see instructions

NEW TOPCO PTY LIMITED
254-294 WELLINGTON ROAD
MULGRAVE VIC, 3170, AUSTRALIA
AS
CORPORATION
8
Is the transferee foreign corporation a controlled foreign corporation? .....................................................................
Lxi YesL....J No
Form 926 (Rev. 12-2011)
224531
05-01-12
226
17171111 737725
BLOOMFAMFND 2 01 2 .04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
5 - 31

1 9
Form 926 (Rev. 12-2011) THE BLOONBERG FAMILY FOUNDATION INC 205602483
Pa
I Part Ill I Information Regarding Transfer of Property
(see instructions)
Type of
property
Stock and
securities
(a)(b)(C) (d(e)
I basistransfer
01/2012675,907.
similar property
foreign currency
I nventory
Assets subject to
I ntangible
property
1.367(a)-4(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a)-4T(d))
described in Temp.
Other property
224532
Form 826 (Rev. 12.2011)
05-01-12
227
17171111
737725 BLOOMFAMFND 2012.04040 THE BLOONBERG FAMILY FOUNDA BLOONFA2
orrn 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC
Part IV I Additional Information Regarding Transfer of Property
(see instructions)
20-5602483

EJ YesEIJ No
b Gain recognition under section 904(1)(5)(F) -
Yes[X] No
c Recapture under section 1503(d) -
YesEJ No
d Exchange gain under section 987 -
YesIJJ No
YesMNo
a Tainted property
-YesIll No
b Depreciation recapture -
Yes[xi] No
CBranch loss recapture -
YesEJ No
YesNo
Yes1 1 X1 No
'15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section
1 .367(a).1T(d)(5)(ii? -
YesLJ No
transferred ' $

EX J YesNo
17a
Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? YesNo
transaction:
Form 926 (Rev. 12-2011)
224533
05-01-12
228
926
Name of transferor
I
OMB No. 1545-0026
Attachment
Sequence No. 1 2 8
I dentifying number(CCI fl SCffO fl S)
2 0-5602 48 3
I f the transferor was a corporation, compl ete questions 1 a through 1 d.
a I f the transfer was a section 361(a) or (b) transfer, was the transferor control l ed (under section 368(c)) by 5 or

E]Yes
No
Yes
No
I f not, l ist the control l ing sharehol der(s) and their identifying number(s):
Control l ing sharehol der
I dentifying number
c I f the transferor was a member of an affil iated group fil ing a consol idated return, was it the parent corporation?
L..J YesL....J No
I f not, l ist the name and empl oyer identification number (EI N) of the parent corporation:
EI N of parent corporation

L.J Yes
No
2 I f the transferor was a partner in a partnership that was the actual transferor (but is not treated as such under section 367), compl ete
a List the name and EI N of the transferor's partnership:
Name of partnership
EI N of partnership
1 2 6-2 3598 38
LXJ YesL..J No
c I s the partner disposing of its entire I nterest I n the partnership?.
YesI1No
d is the partner disposing of an interest in a l imited partnership that is regul arl y traded on an establ ished
securities market?Yes
No
Part II
I
(see I nstructions)
14 identifying number, I f any
PACIFIC INDUSTRIAL SERVICES PTY LTD
I
5 Address (incl uding country)
LEVEL 31 , 1 2 6-1 30 PHILLIP STREET
SYDNEY NSW 2 000, AUSTRALIA
6 Country code of country of I ncorporation or organization
AS
7 Foreign l aw characterization (see instructions)
CORPORATION
8
I s the transferee foreign corporation a control l ed foreign corporation? .....................................................................
LXJ YesL......J No
LI -I A For Paperwork Reduction Act Notice, see separate instructions
Form 926 (Rev. 12-2011)
224531
05-01-12
2 2 9
1 71 71 1 1 1 73772 5 BLOOMF.ANFND 2 01 2 .04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
CC
Fomi926(Rev.12-2011)
P1qe2
I
Part I ll
I
(a) (b) (c) (d) (e)

Type of
Date of Description of Fair market value on Cost or other Gain recognized on
property
transfer
I property I date of transfer basis I transfer
Cash
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
Intangible
property
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a)-4T(d))
described in Temp.
Reos. sec. 1.367(a)-46
Other property
224532
Form 926 (Rev. 12.2011)
05-01-12
230
20-5602483

EjYes
No
Yes[X] No
.Yes[] No
Yes
EXI No
.Yes
MI No
a Tainted property
.Yes [XI No
.Yes [Xi No
YesEXI No
.Yes M1 No
LI YesIJJ No
1 .367(a)-i T(d)(5)(ii? .
YesLJ No
transferred$

II]YesNo
.Yes[J No
transaction:
Form 926 (Rev.12-2011)
224533
05-01-12
231
Is
F. 9 2 6
Intern1 Revenue Service
Name of transferor
THE BIJOOMBERG FAMILY FOUNDATION INC
OMB No. 1545-0026
I
Attachment
Sequence No.
1 2 8
Identifying number (see jAsu$)
2 0-5602 48 3
fewer domestic corporations? ................................................................................................................................. LJ YesEl No
b Did the transferor remain in existence after the transfer? ...........................................................................................Yes

No
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was It the parent corporation?L...J YesL..J No
d Have basis adjustments under section 367(a)(5) been made? U Yes
No
Name of partnership
EIN of partnership
WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 2 6-2 3598 38
b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?LJJ YesL......J No
C Is the partner disposing of its entire interest in the partnership?................... L1 YesEXI No
d Is the partner disposing of an Interest in a limited partnership that is regularly traded on an established-
PartII
I
Transferee ForeignComa

PACIFIC INDUSTRIAL SERVICES 2 PTY LTD
LEVEL 31, 126-130 PHILLIP STREET
SYDNEY NSW 2000, AUSTRALIA
AS
CORPORATION
8Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... Lxi YesLJ No
LHA For Paperwork Reduction Act Notice, see separate Instructions.Form 926 (Rev. 12-2011)
224531
05-01-12
2 32
1 71 71 1 1 1 73772 5 BLOOMF.AMFND 2 01 2 .04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
A ;
Form 926 (Rev. 12 .2011) THE BLOOMBERG FAMILY FOUNDATION INC
20-5602483
Page 2
I
P a r t III
I
(see instructions)
Type of
property
(a)(b)(C)(d)(e)
Gain recognized on
transfer
IpropertyIdate of transfer IbasisItrarisfAr
Stock and
securities
Instalment obligations,
similar property
foreign currency
Inventory
Assets subject to
I .367(a)-4T(b))
Intangible
property
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a).4T(d))
described in Temp.
Req s. sec. 1 .367(a-4T(E
Other property
(see instructions):
224532
Form 926 (Rev. 12-2011)
05-01-12
233
^ A ]
20-5602483
9
Enter the transferor's interest in the foreign transferee corporation before and after the transfer
10 Type of nonrecognition transaction (see instructions) SECTION 351TRANSACTION
11
indicate whether any transfer reported in Part ill is subject to any of the following:

El YesLX] No
b Gain recognition under section 904(t)(5)(F)
El Yes
LX] No
El
Yes MNo
El Yes LJ No
12
El YesLXJ No
13Indicate whether the transferor was required to recognize income under final and temporary Regulations sections
1.367(a)-4through 1.367(a)-6for any of the following:
a Tainted property
El Yes [] No
L1J YesLX] No
C Branch loss recapture
El YesEE No
El YesEENo
El YesLX] No
15a Did the transferor transfer foreign goodwill or going concern
as defined in Temporary Regulations section
1.367(a)-i T(d)(5)(iii)?
El YesLX] No
b If the answer to line 15a is Yes,' enter the amount of foreign goodwill or going concern value
transferred$
LX] Yes El No
.YesLX] No
transaction:
Form 926(Rev. 12-2011)
224533
05-01-12
234
Fcrm9 2 6
Name of transferor
OMB No . 1545.0026
I
Attachment
Seqen uce
No.128
Instructions)
20-5602483
a if the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by S or
fewer domestic corporations?. YesED No
b Did the transferor remain in existence after the transfer? [JYes
No
Identifying number
c if the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L.J YesL.J No
If not, list the name and employer identification number (E1N) of the parent corporation:

d Have basis adjustments under section 367(a)(5) been made? Li Yes
No
Name of partnership
EIN of partnership
b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? ........................................ I I YesLJNo
YesXlNo
ci Is the partner disposing of an interest in a limited partnership that is regularly traded on an established
-
PartII
I
Transferee ForeignCorporation

TB HOLDINGS LTD CIE SCS 198-1069703
P. O. BOX 309, UGLND HOUSE
GRAND CAYMAN, KY1-1104, CAYMAN ISLANDS
CJ
CORPORATION
8Is the transferee foreign corporation a controlled foreign corporation? ........ ............................................................. L..JYesLXJ No
224531
05-01-12
235
Form 926(Rev.12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 205602483
Pa
I
Part Ill
I
( s e e i n s t r u c t i o n s )
Type of
property
Stock and
securities
(a)(b)(c)(d)
(e)
Gain recognized on
I basistransfer
20/20121,596,953.
sin-afar property
foreign currency
I nventory
Assets subject to
I ntangible
property
1 .367(a)-4(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a).4T(d))
described in Temp.
Reas. sec. 1 .367(a-4T(E
Other property
(see instructions):
224532
Form 926 (Rev. 12.2011)
05-el-12
236
TION INC
20-5602483
3
9 Enter the transferor's Interest in the foreign transferee corporation before and after the transfer:
10 Type of nonrecognition transaction (see Instructions) 0 0 . SECTION 351 TRANSACTION
a Gain recognition under section 904(t)(3).
YesEli No
b Gain recognition under section 904(l)(5)(F) .
Yes
LX] No
YesLX] No
. Yes LX] No
E] YesLX] No
1. 367(a)-4Through 1. 367(a)-6 for any of the following:
a Tainted property
. Yes LX] No
YesLX] No
. Yes LX] No
. YesEX:i No
. Yes
t367(a). 1T(d)(5)(iii)?
. Yes
transferred$
LX]No
LX]No
LX] YesNo
17
a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction?
iII] Yes 12 No
transaction:
Form 926 (Rev. 12-2011)
224533
05-01-12
237
17171111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOTINDA BLOOMFA2
OMB No. 1545-0025
Attachment
Sequence No.
1 2 8
[J
F. 9 2 6
Name of transferor
Identifying number ( see

20-5602483
a If the transfer was a section 361( a) or ( b) transfer, was the transferor controlled ( under section 368( c)) by 5 or
fewer domestic corporations?.Yes
No
b Did the transferor remain in existence after the transfer? . Yes
No
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L.J YesU No
If not, list the name and employer Identification number ( EIN) of the parent corporation:

d Have basis adjustments under section 367( a)( 5) been made? L..J Yes
No
2 If the transferor was a partner in a partnership that was the actual transferor ( but is not treated as such under section 367), complete
Name of partnership
EIN of partnership
b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LIaJ YesUJ No
c Is the partner disposing of its entire interest in the partnership? .YesEXI No
d Is the partner disposing of an Interest In a limited partnership that is regularly traded on an established-
Part II
I
4 Identifying number, If any

Al CAPITAL (I) CORPORATION
P.O. BOX 309, UGL.AND HOUSE
GRAND CAYMAN KY1 1104, CAYMAN ISLANDS
CJ
7 Foreign law characterization ( see instructions)
CORPORATION
8Is the transferee forei g n corporation a controlled forei g n corporation? .....................................................................L......J YesLxi No
LHA For Paperwork Reduction Act Notice, see separate Instructions. Form 926 ( Rev. 12.2011)
224531
05-01-12
238
CC
Form 926(Rev.12-2011)
Paa
I
Part III
I
(a) (b) (c)(d)(e)

Type of
property
transfer
I
property date of transfer basis transfer
C'mqh 1 1 .265.487.
Stock and
securities
similar property
foreign currency
I nventory
Assets subject to
1.367(a).4T(b))
I ntangible
property
1.367(a)-4(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a)-4T(d))
described in Temp.
Other property
224532
Form 926 (Rev. 12-2011)
05-01-12
239
1 71 71 1 1 1 737725 BLOOMFAMFND 201 2.04040 THE BLOOMBERG FAMILY FOUDA BLOOMFA2
LA
E #
THE BLOOMBE RG FAMILY FOUNDATION INC
20-5602483
9 Enter the transferors interest In the foreign transferee corporation before and after the transfer:
a Gain recognition under section 904(0(3) .

YesU1 No
U Yes[I] No

U YesIX J No

U Yest: No
U YesEJ No
a Tainted property
U Yes [ X ] No
U Yes
1X J No

EJ YesLJ No
d Any other Income recognition provision contained in the above-referenced regulations

U YesEJ No
U Yes
No
15a
1 .367(a)-i T(d)(5)(iii)? .
YesEI No
transferred$

L1 YesU No
U YesEJ J No
transaction:
Form 926 (Rev.12-2011)
224533
05-01-12
240
Fc m926
(Rev. Dec ember 2011)
Internal Revenue Servic e
0 1 , Attach to your Income tax return for the year of the transfer or distribution.
Name of transferor
El f
=0 26
2 8
Identifying number
( see
jflth.,JcOofls)
2 0-5602 48 3
If the transferor was a corporation, complete questions la through id. - -
fewer domestic corporations?...........................................................................................................................
If not, list the controlling shareholder( s) and their Identifying number( s):
LJYes EJNO
lYes ED No
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? UI YesL..J No

d Have basis adjustments under section 367( a)( 5) been made? L..J Yes
No
2If the transferor was a partner In a partnership that was the actual transferor ( but is not treated as such under section 367), complete
Name of partnership
EINof partnership
WILLETT PRIVATE INVESTORS (TAX EXEMPT) I rJLC 12 6-2 3598 38
b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LJ YesQ No
c Is the partner disposing of Its entire Interest in the partnership? El Yes[Xl No
securities market?El Yes [Xl No
Part II I Transferee Foreign Corporation Information ( see instructions)
3 Name of transferee ( foreign corporation) 1 4 Identifying number, if any
AIC COMPANY LTD.
I
98 -1034941
WALKERS CORPORATE SVCS LTD., WALKER HOUSE, 8 7 MARY STREET, GEORGE TOWN
GRAND CAYMAN, KY1-9005, CAYMAN ISLANDS
6Country code of country of incorporation or organization
Cl J.
CORPORATION
8Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... L_J YesLX.J No
LHA For Paperwork Reduction Act Notice, see separate instructions. Form 926( Rev. 12-20 11)
224531
0 5.0 1.12
2 41
17171111 73772 5 BLOOMFAMFND 2 012 .04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
Form Y2G(Rev.12-2011) THE BIiOOMBERG FAMILY FOUNDATION INC205602483
Paqe2
I
Part III
I
(see instructions)
(a)(b)(c)(d)
(e)
Type of
Gain recognized on
property
transferpropertydate of transferbasis
I transfer
Cash
L1,o3o,72.I
27,5
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
1 .367(a)4T(b))
Intangible
property
1.367(a)-4(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a)-4T(d))
described in Temp.
Other property
(see instructions):
224532
Form 926 (Rev. 12-2011)
05-01-12
242
1 # 1
20-5602483
(a) Before %(b) After -
a Gain recognition under section 904((3)

EJ Yes[J No
YesIJJ No

L]Yes[]No
E l Yes [] No
E l Yes[ J No
13
1.367(a)- 4 through 1.367(a)- 6 for any of the following:
a Tainted preperty
E l Yes [X]No
E l Yes L] No
E l Yes [X]No
d Any other income recognition provision contained in the above- referenced regulations
E l Yes
No
E l YesE1 No
15a Did The transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section
1.367(a)- 1T(d)(5)(iiD?
E l YesEJJ No
transferred$

E l Yes[J No
E l Yes[J No
transaction:
Form 926 (Rev.12- 2011)
22453
05- 01- 12
243
Name of transferor
Identifying numberii551
I S
1 4
926
1 1 0 - to your income tax return for the year of the transfer or distribution.
Attachment
Sequence No.
1 2 8
20-5602483
If the transferor was a corporation, complete questions lathrough ld.
E l Yes E l No
E l YesNo
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L......J
YesL..J No

L_J Yes
No
Name of partnership
EIN of partnership
WILL,ETT PRIVATE INVESTORS (TAX EXEMPT) I LLC
26-2359838
c Is the partner disposing of its entire interest In the partnership?
Part II
I
WYes UNo
E l Yes [JNo
LANTIQ HOLDCO S.ARL
412 F, ROUTE D'ESCH
L-1 030, LUXEMBOURG
LU
CORPORATION
8Is the transferee forei gn corporation a controlled forei gn corporation? ..................................................................... L.J YesLXJ No
Form 926 (Rev. 12-2011)
224531
05-01-12
244
17171111737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
Form926(Rev.12-2011) THE BLOOMBERG FAMILY FOUNDATION INC
205602483
Page2
I
Part Ill
I
(see instructions)
Type of
pmperty
(a)(b)(c)(d)(e)-
transfer
I
propertydate of transfer
I
basistransfer
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
1 .367(a)-4T(b))
Intangible
property
1.367(a)-4(c))
Property to be sold
(as described in
Temp. Regs. sec.
described in Temp.
Reos. sec. 1.367(64T((
Other property
(see instructions):
224532
Form 926 (Rev. 12-2011)
05-01-12
245
17171111 737725
BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
[ A ]
20-5602483
3
9 Enter the transferor's Interest In the foreign transferee corporation before and after the transfer:

LJYes
No
b Gain recognition under section 904(l)(5)(F).
Yes
No

E l YesIX] No
YesLK] No
E l Yes
Ell No
a Tainted property
E l Yes [] No
E l Yes[]] No
E l Yes EXI No

E l YesIJ No
E l YesiJ No
15a
1 .367(a)-i T(d)(5)(iii)?
E l YesMNo
b If the answer to line 1 5a is "Yes, enter the amount of foreign goodwill or going concern value
transferred$

.1XI YesE l No
E l Yes[K] No
transaction:
Form 926 (Rev.12-2011)
224533
05-01-12
246
17171111 737725 BLOOMFANFND 2012.04040 THE BLOONBERG FAMILY FOUNDA ELOOMFA2
Form9 2 6
internal Revenue SaMoa
1 0 , Attach to your income tax return for the year of the transfer or distribution.
Name of transferor
^ t l

1 7 A
OMB No. 1545-002 6
Attachment
Sequen ce iio.
12 8
Identifying number
(s eeI ns hJ c (Ons )
20-5602483

[E Yes
No
.Yes
ED No
Identifying number
o If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L...J Yes
L....IJ
If not, list the name and employer identification number (EItJ) of the parent corporation:

Li Yes
No
Name of partnership
EIN of partnership
I
26-2359838
LJ YesLi No
.YesFX7 No
securities market?
Yea[]Nn
Par t II
I
Tr ans f er ee Foreign Corpo
3 Name of transferee (f o r ei g n co r p o r ati o n)
4 Identi f yi ng number , i f any

GGC PUBLIC EQUITIES OPPORTUNITIES BLOCKER CORP. LTD.
1 98-0572956
WALKERS SPV LIMITED, WALKER HOUSE, 87 MARY STREET
GEORGE TOWN, GRAND CAYMAN KY1-9 002, CAYMAN ISLANDS
6 Country code of country of Inco r p o r ati o n o r o r g ani z ati o n
CtJ
CORPORATION
8
Is the transferee foreign corporation a controlled foreign corporation? .....................................................................
Li YesLxi No
LI-IA For Paperwork Reduction Act Notice, see separate instructions.
Form 926 (Rev . 1 2-20 1 1 )
2 2 4531
05-01-12
247
17171111 737725 BLOOMFAMFND 2012.04040 THE
BLOOMBERG FAMILY FOUNDA BLOOMFA2
Form 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC
20-5602483
Paae
(a)(b)(c)(d)(e)
Type of
property
Cash
1653,573.
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
1 .367(a)-4T(b))
Intangible
property
1 .367(a)4(c))
Property to be sold
(as described in
Temp. Regs. sec.
described in Temp.
Rep s. sec. 1 .367(a.4T(E
Other property
(see instructions):
224532
Form 926 (Rev. 12-2011)
05-01-12
248
17171111 737725 BLOOMFAMFND 2012.04040
THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
AJ
20-5602483
9 Enter the transferors interest in the foreign transferee corporation before and after the transfer:

E] Yes[]1 No
b Gain recognition under section 904(0(5)(F)

Eli YesC X ] No
YesLX I No
YesLX I No
12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? .YesLX ] No
13Indicate whether the transferor was required to recognize Income under final and temporary Regulations sections
a Tainted property
.Yes LX ] No
.YesNo
.YesNo

Eli YesEIJ No
.YesLJ No
1.367(a)-1T(d)(5)(iii)?
.YesNo
transferred 10.
$

C X ] YesEli] No
17 a Was Intangible property (within the meaning of section 936h)(3)(B)) transferred as a result of the transaction? .YesLX II No
transaction:
Form 926 (Rev.12.2011)
224533
05-01-12
249
51 .
Form926
Intemul Revenue Service
p-Attach to your income tax return for the year of the transfer or distribution.
Name of transferor
OMB No. 1545-0026
I
Attachment
Sequence No.128
I dentifying number (see
20-5602483
I f the transferor was a corporation, complete questions 1 a through 1 d.
a I f the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 or
fewer domestic corporations?............................................................................................................................ YesEl No
b Did the transferor remain in existence after the transfer? E l YesE l No
I f not, list the controlling shareholder(s) and their identifying number(s):
I dentifying number
c I f the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?- L _ _ J YesL _ J No
I f not, list the name and employer identification number (EI N) of the parent corporation:
d Have basis adjustments under section 367(a)(5) been made? L _ J Yes
No
2 I t the transferor was a partner I n a partnership that was the actual transferor (but is not treated as such under section 367), complete
a L ist the name and EI N of the transferor's partnership:
Name of partnership
EINof partnership
b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? L ZJ YesL .J No
c I s the partner disposing of I ts entire interest in the partnership? E l Yes[]No

d I s the partner disposing of an I nterest I na limited partnership that is regularly traded on an established
securitiesmarket?-------------- --- --------- - ----------- ---- --------- --- --------- - ----------------- - -------- -------------- ------- -------- ---- -------- ---- -------- -[J YesL ] No
Part II
I
4 I dentifying number, I f any

INFOR LUX BOND COMP ANY
412 F, ROUTE DtESCH
L-1030, LUXEMBOURG
LU
CORPORATION
8I s the transferee foreign corporation a controlled foreign corporation? ..................................................................... L i YesL xi No
L HA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)
224531
05-01-12
250
17171111737725BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
E A
Fom926(Rev.12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483
Pa
I
Part III
I
(see instructions)
(a)(b)(c)(d)(e)
Type of
Gain recognized on
property
transfer
Cash948784.
Stock and
securities
similar property
foreign currency
I nventory
Assets subject to
I .367(a).4T(b))
I ntangible
property
Property to be sold
(as described in
Temp. Regs. sec.
working I nterests (as
described in Temp.
Rens. sec. 1 .367(a-4T(E
Other property
(see instructions):
224532
Form 926 (Rev. 12-2011)
05-01-12
251
17171111 737725 BLOOMFPJffFND 2012.04040 THE BLIOOMBERG FAMILY FOUNDA BLOOMFA2
THE BLOONBERG FAMILY FOUNDATION INC
20-5602483
9 Enter the transferors interest in the foreign transferee corporation before and after the transfer:
a Gain recognition under section 904(f)(3)[]

Yes [Xl No

E l Yes [XI No
E l Yes EKN.

E l Yes
E E No
12 Did this transfer resuft from a change in the classification of the transferee to that of a foreign corporation?
E l Yes [JNo
13indicate whether the transferor was required to recognize income under final and temporary Regulations sections
1.367(a)-4through 1.367(a)-6 for any of the following:
a Tainted property
E l YesNo
E l YesE Xi l No
E l Yes [JNo

E l YesE JNo
E l YesLJNo
1.367(a)-1T(d)(5)(ii?
E l Yes[JNo
b If the answer to line 15a Is "Yes, enter the amount of foreign goodwill or going concern value
transferred$

E l No
E l Yes[X] No
b If "Yes, describe the nature of the rights to the intangible property that was transferred as a result of the
transaction:
Form 926 (Rev. 12-2011)
224533
05-01-12
252
926
Name of transferor
OMB No. 1545-0026
Attachment
Sequence No . 1 2 8
Identifying number (at
IISIJ1}CtIOflS)
20-5602483
If the transferor was a corporation, complete questions I a through 1d.
YesEl No

El Yes
E l No
Identifying number
c if the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L......J
YesL...J No

L.J Yes
No
Name of partnership
EIN of partnership
I
26-2359838
securitiesmarket?
................................................................................................................................................
Part II
I
see Instructions)
LJ Yes U No
El Yes [Xi No
Name 01 transferee (foreign corporation)
1 4 Identifying number, if any
WILLETT PRIVATE INVESTORS TAX EXEMPT II LP
98-0678785
C/O WILLETT ADVISORS LLC, WALKER HOUSE,
87 MARY STREET
GEORGE TOWN, GRAND CAYMAN KY1-9002, CAYMAN ISLANDS
CJ
CORPORATION
8Is the transferee foreign corporation a controlled foreign corporation' ? ..................................................................... Lxi YesL..J No
Form 926 (Rev. 12.2011)
224531
05-01-12
253
H 4
E A
Form 926(Rev.12.2011) THE BL100NBERG FAMILY FOUNDATION INC 20-56024 83
Pa
Part III
I
(see instructions)
(a)(b)(c)(d)(e)
Type of
Gain recognized on
property
transfer
Cash- 108,501,207.
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
1 .367(a).4T(b))
Intangible
property
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a).4T(d))
described in Temp.
Reris. sec. 1.367(a)- 4T((
Other property
(see instructions):
224532
Form 926 (Rev. 12- 2011)
05- 01- 12
254
17171111 737725 BIOOMFAMFND 2012.04 04 0 THE BLOONBERG FAMILY FOTJNDA BLOOMFA2
orm 926 (Rev. 12 .2011) THE BLOOMBERG FAMILY FOUNDATION INC
Part IV I Additional Information Regarding Transfer of Property
(see instructions
10Type of nonrecognition transaction (see instructions) I0, SECTION 351 TRANSACTION
20-5602483
Yes[K] No

El Yes[] No

El YesM No
El Yes [K] No
EJ YesIJJ No
a Tainted property
El Yes
No
El Yes [K] No

El YesNo

El YesLJ No
El YesEX I No
1.367(a)-1T(d)(5)(iil)?
El YesEX I No
b if the answerto line iSa Is 'Yes, ' enter the amount of foreign goodwill or going concern value
transferred$
[K] Yes El No
17a Was intangible property (within the meaning of section 936(h)(3)(13)) transferred as a result of the transaction?
El Yes[J No
transaction:
Form 926 (Rev. 12-2011)
224533
o5-el-12
255
LA

F A
F arm926
0 1, A ttach to your income tax return for the year of the transfer or distribution.
A ttachment
Sequence No. 1 2 8
Name of transferor
Identifying number ( see IflabucOofls)

2 0-5602 48 3
fewer domestic corporations? .................................................................................................................................
0 YesU No
b Did the transferor remain in existence after the transfer? ............................ .......................... U YesU No
Identifying number
o If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?t._i YesL....J No
d Have basis adjustments under section 367( a)( 5) been made?L.....JYes
No
2 If the transferor was a partner in a partnership that was the actual transferor ( but Is not treated as such under section 367), complete
Name of partnership
EIN of partnership
b Did the partner pick up its pro rate share of gain on the transfer of partnership assets? LISJYesL..JNo
c Is the partner disposing of its entire Interest in the partnership? U YesNo


MOSAIC ENERGY LTD.
5 A ddress ( including country)
2 02 -6TH AVENUE, SUITE 8 00
CALGARY ALBERTA, CA T2 P 2 R9, CANADA
CA
7F oreign law characterization ( see instructions)
CORPORATION
8Is the transferee foreign corporation a controlled forei g n corporation? ................................................... ..................L...l YesLxi No
LHA F or Paperwork Reduction A ct Notice, see separate Instructions. F orm926 ( Rev. 12-20 11)
224531
0 5-0 1-12
2 56
L E

L i J
Form 926 (Rev. 12-2011)
Page 2
I
Part ifi Information Regarding Transfer of Property (see instructions)
Type of
property
Stock and
securities
(a)(b)(c)(d)
(e)
Gain recognized on
I basis
transfer
25,195,160.
similar property
foreign currency
I nventory
Assets subject to
1 .367(a)4T(b))
I ntangible
property
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a).4T(d)
described in Temp.
Rens. sec. 1 .367(a)-4T(E
Other property
(see instructions):
224532
Form 926 (Rev. 12.2011)
O5O1-12
257
17171111 737725 BLOOMF.NFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
20-5602483
9 Enter the transferor's Interest In the foreign transferee corporation before and after the transfer:
10 Type of nonrecognition transaction (see instructions) p o p . SECTION 351 TRANSACTION
Yes[ J No
b Gain recognition under section 904(f)(5)(F)[]Yes

[]No
Yes111 No
YesEXI No
12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation?[]
Yes[JNo
a Tainted property
.Yes(]]No
.Yes MI No

E]Yes[] No
.
Yes1XI No
.YesEXI No
15a
1.367(a)-1T(d)(5)(ii? .
Yes[ J No
transferred$

No
YesLJNo
b if 'Yes," describe the nature of the rights to the intangible property that was transferred as a result of the
transaction:
Form 926 (Rev.12-2011)
224533
05-01-12
258
17171111 737725 BLOOMF. AMFND 2012. 04040 THE BLOOMBERG FAMILY FOUNDA BL100MFA2
,.926
Depelinent of the Treasury
Return by a U.S Transferor of Property
Name of transferor
D E
1 # 1
OMB No. 1545.0026
Attachment
Sequence No.
128
Identifying number (see ins, , uceonsi
20-5602483
If the transferor was a corporation, complete questions 1 a throug h 1d.
E1 Yes
No
ElYes
ON.
Identifying number
c If the transferor was a member of an affiliated g roup filing a consolidated return, was it the parent corporation?L.....J
YesL..J No
If not, list the name and employer identification number (El) of the parent corporation:

Liy
No
questions 2a throug h 2d.
Name of partnership
EIN of partnership
WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LL,C
126-2359838
b Did the partner pick up its pro rata share of g ain on the transfer of partnership assets?
LJ YesL....J No
El Yes[I] No
d Is the partner disposing of an interest in a limited partnership that is reg ularly traded on an established
securities market?
El Yes [li No
PartII
I
3 Name of transferee (foreig n corporation)
AACP DEBT INVESTORS, L.P.
CIO ASIA ALTERNATIVES MANAGEMENT,
6 Country code of country of incorporation or org anization
20-8920779
7 Foreig n law characterization (see instructions)
CORPORATION
B
Is the transferee foreig n corporation a controlled foreig n corporation? ..................................................................... L_ _ J YesLxiNo
Form 926 (Rev. 12-2011)
224531
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259
Form 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC205602483
Pape2
I
Part III
I
(see instructions)
(a)(b)(c)(d)
(e)
Type of
Date ofDescription ofFair market value on Cost or other
Gain recognized on
property
transferpropertydate of transfer basis
transfer
Cash317.311.
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
Intangible
property
and temp. Regs. Sec.
1.367(a)-4(c))
Property to be sold
(as described In
Temp. Regs. sec.
1 .367(a)-4T(d))
described In Temp.
Other property
(see instructions):
224532
Form 926 (Rev. 12-2011)
05-01-12
260
20-5602483
.Yes[I] No
.Yes
ill No
.YesLX] No
YesIIJ No
.Yes[J No
a Tainted property
EJ YesLX] No
YesEXI No
Yes
No
YesLX] No
14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? Yes
EE No
15a
1.367(a)-1T(d)(5)(iiO? .
Yes[IJ No
b If the answer to line 15a Is "Yes, enter the amount of foreign goodwill or going concern value
transferred$
16 Was cash the only property transferred?[]

Yes[IJ No
YesLX] No
transaction:
Form 926 (Rev.12-2011)
224533
05-01-12
261
17171111 737725 BLOOMFAMFND
2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
Form 926
Department of the Trees unj
10- Attach to your Income tax return for the year of the transfer or distribution.
Attachment
Sequence No.
1 2 8
Name of transferor
Identifying number ( see instructions)

2 0-5602 48 3
If the transferor was a corporation, complete questions 1 a throug h 1d.
a If the transfer was a section 361( a) or ( b) transfer, was the transferor controlled ( under section 368( c) ) by 5 or
fewer domestic corporations?.YesNo
b Did the transferor remain in existence after the transfer? .Yes
No
Identifying number
c If the transferor was a member of an affiliated g roup filing a consolidated return, was it the parent corporation?L....J YesL..J No
d Have basis adjustments under section 367( a) ( 5) been made? ................................................................................. L_.J Yes
No
2 If the transferor was a partner in a partnership that was the actual transferor ( but is not treated as such under section 367) , complete
questions 2a throug h 2d.
Name of partnership
EIN of partnership
WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 2 6-2 3598 38
b Did the partner pickup its pro rata share of g ain on the transfer of partnership assets?LASJ YesL.J No
o Is the partner disposing of its entire interest in the partnership? .YesEK No
d Is the partner disposing of an interest in a limited partnership that Is reg ularly traded on an established
securitiesmarket?.................................................................................................................................................Yes EXI No
3 Name of transferee ( foreig n corporation)

AACP TAX EXEMPT INVESTORS II, L.P.
98 -061 5699
C/O ASIA ALTERNATIVES MANAGEMENT, ONE MARITIME PLAZA, SUITE 1 000
SAN FRANCISCO, CA 941 1 1
6 Country code of country of incorporation or org anization
7Foreig n law characterization ( see instructions)
CORPORATION
8Is the transferee forei g n corporation a controlled forei g n corporation? ..................................................................... L..J YesLXJ No
LHA For PaperworkReduction Act Notice, see separate instructions. Form 926 ( Rev. 12.2011)
224531
05-01-12
2 62
1 71 71 1 1 1 73772 5 BLOOMFANFND 2 01 2 .04040 THE BLOOMBERG FAMILY FOIJNDA BLOOMFA2
Form 926 (Rev. 12-20111 THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483
Page 2
I
Part III
I
(a)(b)(c)(d)(e)
Type Of
Property
Cash1,476,693.
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
Intangible
property
1 .367(a)4(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a)-4T(d))
described in Temp.
Recis. sec. 1 .367(a)-4T(E
Other property
224532
Form 926 (Rev. 12-2011)
05O1-12
263
17171111 737725 BLOOMFMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOONFA2
20T5602483
11 indicate whether any transfer reported in Part HI is subject to any of the following:
a Gain recognition under section 904(t)(3) .
Yes[XII No
b Gain recognition under section 904(t)(5)(F) .
Yes[1 No
Yes1X1No
.Yes CE No
.YesEXII No
1.367(a) .4 through 1.367(a)-6 for any of the following:
Yes[JNo
EIJYesDJNo
.Yes EK No
d Any other income recognition provision contained in the above-referenced re
gulations
1111] Yes[JNo
.Yes
1.367(a)-1 T(d)(5)(iii)?
.Yes
transferred$
EJNo
IM No
.YesNo
.YesLJNo
transaction:
Form 926 (Rev.12.2011)
224533
05-01-12
264
17171111 737725 BLOOMFNFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOONFA2
Fcm926
"Attach to your income tax return for the year of the transfer or distribution.
Name of transferor
1 2

^ Il i
OMB No. 1545-0026
Attachment
Sequence No. 128
ientifying number
I nstrucioss)
20-5602483
I f the transferor was a corporation, complete questions 1 a through id.
a I f the transfer was a section 361 (a) or(b) transfer, was the transferor controlled (under section 368(c) ) by 5 or
b Did the transferor remain in existence after the transfer? ...........................................................................................Yes El No

I f not, list the controlling shareholder(s) and their I dentifying number(s) :
I dentifying number
c I f the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? Li YesL......JNo
I f not, list the name and employer I dentification number (EI NQ of the parent corporation:
d Have basis adjustments under section 367(a) (5) been made? Li Yes
No
2 I f the transferor was a partner I n a partnership that was the actual transferor (but is not treated as such under section 367) , complete
a Ust the name and EI N of the transferor's partnership:
Name of partnership
EI N of partnership
b Did the partner pickup its pro rata share of gain on the transfer of partnership assets? ............................................ [Xi YesLJ No
c I s the partner disposing of I ts entire interest I n the partnership? ..................................Yes[I ) No
d I s the partner disposing of an interest in a limited partnership that is regularly traded on an established
4 I dentifying number, if any

ALTOR FUND III (NO. 2) LP j 98-0594714
P.O. BOX 730, 11-15 SEATON PLACE
ST. HELIER, JE4 OQH, JERSEY
JE
CORPORATION
8I s the transferee forei g n corporation a controlled foreign corporation? ..................................................................... Li YesLXI No
LHA For Paperwork Reduction Act Notice, see separate I nstructions. Form 926 (Rev. 12.2011)
224531
05-01-12
265
1 V 0
Form 926(Rev.12-2011)
Paqe2
(Part III (Information Regarding Transfer of Property (see instructions)
(a) (b) (C) (d) (e)
Type of
property
transfer
I
property date of transfer basis
I transfer
849.229.
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
Intangible
property
1.367(a)-4(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a).4T(d))
described in Temp.
Reos. sec. 1 .367(aI-4T(E
Other property
224532
Form 926 (Rev. 12-2011)
05-01-12
266
17171111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA ELOOMFA2
P1
926 (Rev. 122011) THE BLOOMBERG FAMILY FOUNDATION INC
IV I Additional Information Regarding Transfer of Property
(see instructions)
20-5602483
Yes[1 No
Yes[K) No
YesEU No
Yes[K) No
.YesLJ No
Yes[IX] No
Yes[K] No
.YesNo

EIJ Yes[K) No
EJ YesW No
1.367(a).1T(d)(5)(ili)? .
YesNo
transferred$

LX] YesLIIIJ No
[1 YesLX] No
transaction:
Form 926 (Rev. 12-2011)
224533
05-01-12
267
Form 926
Internal Revenue Service'Attach to your income tax return for the year of the transfer or distribution.
I Part I I U.S. Transferor Information (see instructions)
Name of transferor
I OMB No. 15450026
I
Attachment
Sequence No.
128
I dentifying number (see jnssi
20-5602483
I f the transferor was a corporation, complete questions 1 a through 1 d.
a I f the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 or
fewer domestic corporations? El Yes E l No
b Did the transferor remain in existence after the transfer? .................................................................................. El YesE l No
I f not, list the controlling shareholder(s) and their identifying number(s):
I dentifying number
c I f the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? 1_i YesL_J No
I f not, list the name and employer identification number (EI N) of the parent corporation:
d Have basis adjustments under section 367(a)(5) been made? L..J yes
No
2 I f the transferor was a partner in a partnership that was the actual transferor (but I s not treated as such under section 367), complete
a List the name and EI N of the transferor's partnership:
Name of partnership
EI N of partnership
b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LXJ YesL...J No
c I s the partner disposing of its entire interest in the partnership? El YesLX] No
d I s the partner disposing of an interest I n a limited partnership that is regularly traded on an established
securities market?El Yes [I ] No
Part II
I
J
4 I dentifying number, if any
AACP TAX EXEMPT INVESTORS III, L.P.
I
5 Address (I ncluding country)
C/O ASIA ALTERNATIVES MANAGEMENT, ONE MARITIME PLAZA, SUITE 1000
6 Country code of country of I ncorporation or organization
CORPORATION
8I s the transferee foreign corporation a controlled foreign corporation? ......................................... ............................L..J YesLXJ No
224531
O5O112
268
t 0
Form 926 (Rev. 12 . 2011)
THE BIOOMBERG FAMILY FOUNDATION INC 20-5602483
Page 2
I
Part III
I
( see i n s t ru c t i on s )
Type of
propert y
(a)(b)(c )(d)(e)
Dat e ofDes c ri pt i on ofFai r market valu e on Cos t or ot her Gai n rec ogn i zed on
t ran s fer
I
propert y
I
dat e of t ran s fer
I
bas i s
I t ran s fer
St oc k an d
s ec u ri t i es
In s t allmen t obli gat i on s ,
ac c ou n t rec ei vables or
s i mi lar propert y
Forei gn c u rren c y or ot her
propert y den omi n at ed In
forei gn c u rren c y
In ven t ory
As s et s s u bjec t t o
deprec i at i on rec apt u re
(s ee Temp. Regs . s ec .
1 .367(a)4T(b))
Tan gi ble propert y u s ed i n
t rade or bu s i n es s n ot li s t ed
u n der an ot her c at egory
In t an gi ble
propert y
Propert y t o be leas ed
(as des c ri bed In fi n al
an d t emp. Regs . s ec .
1.367(a)-4(c 3
Propert y t o be s old
(as des c ri bed i n
Temp. Regs . s ec .
1 .367(a)-4T(d))
Tran s fers of oi l an d gas
worki n g i n t eres t s (as
des c ri bed i n Temp.
Ot her propert y
Supplemental Information Required To Be Reported (s ee In s t ru c t i on s ):
224532
Form 926 (Rev. 12-2011)
05-01-12
269
17171111 737725 BLOOMFFND 2012.04040 THE BL100NBERG FAMILY FOUNDA BL100MFA2
L A I
Form 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 205602483
Paqe3
I
Part IV
I
11 Indicate whether any transfer reported In Part III Is subject to any of the following:
a Gain recognition under section 904(f)(3) El] YesE] No

b Gain recognition under section 904(0(5)(F) ED Yes[J No
c Recapture under section 1503(d) El Yes[]No

d Exchange gain under section 987 El Yes EZ No
12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? El] Yes[l No
a Tainted property El] Yes [Xl No
b Depreciation recapture El YesIXJ No
c Branch loss recapture El YesI ll No
dAny other Income recognition provision contained in the above-referenced regulations El Yes[]]No
14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El YesEll No
1.367(a)-1 T(d)(5)(i)? E:JYesL X I I No

b If the answer to line 15a Is Yes," enter the amount of foreign goodwill or going concern value
transferred
$
16 Was cash the only property transferred? I J] YesEl No
17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? El Yes[XI No
b If "Yes, describe the nature of the rights to the Intangible property that was transferred as a result of the
transaction:
Form 926 (Rev. 12-2011)
224533
05-01-12
270
Form 9 2 6
Depeanent of the Treasury
on
Name of transferor
01AB No. 1545.0026
ttachment
Sequ
A
ence
No.128
20-5602483
1 if the transferor was a corporation, complete questions la through 1 d.
fewer domestic corporations? E l Yes E l No
b Did the transferor remain in existence after the transfer? ..........................................................................................[l YesEJ No
Identifying number
o if the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L.....J YesL.1 No
If not, list the name and employer identification number (E 1N) of the parent corporation:
d Have basis adjustments under section 367(a)(5) been made? L.J Yes
No
2 if the transferor was a partner in a partnership that was the actual transferor (but is not treated as such under section 367), complete
a Ust the name and E 1N of the transferor's partnership:
Name of partnership
EIN of partnership
WILLET SELECT INVESTORS (TAX EXEMPT) I LP 126-1634308
b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? ............................................. LXJ Yes
=No
c is the partner disposing of Its entire interest in the partnership? .................
........................... E l YesNo
securitiesmarket?- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - El Yes[]No
Part II
I

CULLIGAN HOLDINGS SARL
15, RUE EDWARD STEICHEN, 4TH FLOOR
L-2440, LUXEMBOURG
LU
CORPORATION
8is the transferee foreign corporation a controlled forei g n corporation? ..................................................................... [Xi YesL.J No
LHA For Paperwork Reduction Act Notice, see separate Instructions. Form 926 (Rev. 12- 2011)
224531
05- 01- 12
271
Form 926(Rev.12.2011)
THE BLiOOMBERG FAMILY FOUNDATION INC205602483
Paqe2
I
Part III
I
(a)(b)(c)(d)(e)
Type of
property
transfer
I
property
I
date of transfer basis
I transfer
Cash
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
Intangible
property
1.367(a)-4(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a)-4T(d))
described in Temp.
Other property
Supplemental Information Required To Be Reported (see Instructions):
224532
Form 926 (Rev. 12-2011)
05-01-12
272
17171111 737725 BLOOMFAMFND 2012.04040 THE BLIOOMBERG FAMILY FOUNDA BLOOMFA2
20-5602483
9 Enter the transferor's interest in the foreign transferee corporation before and after the transfer-

El Yes[] No
b Gain recognition under section 904(l)(5)(F)

El Yes[] No
o Recapture under section 1503(d) .
Yes[X]No
El Yes [J No
El YesLJ No
a Tainted property
El Yes E2 No
El Yes E2 No

EIJ YesEJNo

El YesLJ No
El YesEX I No
1 .367(a)-i T(d)(5)(iii)?
El YesEJNo
transferred 10. $

E]YesEl No
17 a Was intangible property (within the meaning of section 936(h)(3)(6)) transferred as a result of the transaction?
El YesIJJNo
b If "Yes,' describe the nature of the rights to the intangible property that was transferred as a result of the
transaction:
Form 926 (Rev.12-2011)
224523
05-01-12
273
17171111 737725 BLOOMFFND 2012.04040 THE ELOOMBERG FAMILY FOUNDA BLOOMFA2
No. 1545.0026
Attachment
Sequence No. 128
n
Name of transferor
THE BL100MBERG FAMILY FOUNDATION INC
Identifying number (see jnscions)
20-5602483
^ Z
F. 926
It the transferor was a corporation, complete questions 1 a through 1 d.
If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 or
.Yesc:i No
EJ YesEJ No
Identifying number
C
.. L.J YesL.....J No

L.J Yes
No
Name of partnership
EIN of partnership
WILLET SELECT INVESTORS (TAX EXEMPT) I LP 1 26-1634308
LXI Yes
17 No
CIs the partner disposing of its entire interest in the partnership?

LJ YesE]J No
d Is the partner disposing of an interest in a limited partnership that Is regularly traded on an established
securities market?17 u....lvi

A86-B INST SARL
I
98-1070579
41 AVENUE DE LA GARE
L-1611, LUXEMBOURG
LU
-CORP ORATI ON
8
Is the transferee foreign corporation a controlled foreign corporation? ............................ ..........................................
LXI YesL...J No
Form 926 (Rev. 12-2011)
224531
05-01-12
274
C
Form 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483
Page 2
Part III Information Regarding Transfer of Property (see instructions)
(a)(b)(c)(d)(e)-
Type of
property
transfer
I
propertydate of transferbasistransfer
Cash09/20/20121 142,552.
Stock and
securities
I nstalment obligations,
similar property
foreign currency
I nventory
Assets subject to
1 .367(a).4T(b))
I ntangible
property
1.367(a)-4(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a)-4T(d))
described I n Temp.
Reos. sec. 1 .367(al-4T(
Other property
224532
Form 926 (Rev. 12-2011)
05-01-12
275
,
Form 926(Rev.122O11)
Paqe3
I
Part IV
I
9 Enter the transferor's Interest in the foreign transferee corporation before and after the transfer:
a Gain recognition under sebtion 904(t)(3) .YesNo
b Gain recognition under section 904(fX5)(F) ............................................................................................................. Yes[XI No
c Recapture under section 1503(d) .Yes No
d Exchange gain under section 987 .YesL1 No
12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? .Yes EJ No
a Tainted property .Yes [XI No
b Depreciation recapture .Yes[XI No
c Branch loss recapture .Yes IJ No
d Any other Income recognition provision contained in the above-referenced regulations ........................................ YesEJ No
14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? .Yes EX] No
1.367(a).1T(d)(5)(iii)?........................................................................................................................................ YesEJ No
b If the answer to line 15a is "Yes, " enter the amount of foreign goodwill or going concern value
transferred$
17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? Yes !JJ No
b If 'Yes, " describe the nature of the rights to the intangible property that was transferred as a result of the
transaction:
Form 926 (Rev. 12.2011)
224533
05-01-12
276
17171111 737725 BLOOMFAMFND 2012.04040 THE BL100MBERG FAMILY FOUNDA BLOOMFA2
Name of transferor
number
( S e e i n s t r u c l i o r t s )
R at
1 1 1
F. 926
00, Attach to your Income tax return for the year of the transfer or distribution.
Attachment
Sequence Ne.
1 2 8
2 0-5602 48 3
1 If the transferor was a corporation, complete questions 1 a through 1 d.-
fewer domestic corporations?.YesLJ No
b Did the transferor remain in existence after the transfer?... YesE] No
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? L._JYesLJ No
d Have basis adjustments under section 367(a)(5) been made? L_.JYes
No
Name of partnership
EIN of partnership
WILLET S ELECT INVES TORS ( TAX EXEMPT) I LP2 6-1 634308
b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? L1J YesL_J No
c Is the partner disposing of its entire interest in the partnership?.Yes[]] No
securities market?LI Yes[] No
Part II
I
3 Name of transferee (foreign corporation)j 4 Identifying number, if any
BDS 3TES ARL
41AVENUE DE LA GARE
L-1 61 1 , LUXEMBOURG
LU
CORPORATION
8Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... LXJYesLi No
LFIA
431
For Paperwork R eduction Act Notice, see separate instructions. Form 926 (R ev. 12-2011)
05-01-12
2 77
1 71 71 1 1 1 73772 5 BLOOMFAMFND 2 01 2 .04040 THE BLOOMBERG FAMILY FOt JNDA BLOOMFA2
Am
s o
0
Form926 (Rev. 12-2011)
Page 2
(a) (b) (c) (d) (e)

TYPO of
property
transfer property date of transfer basis transfer
04/04/20121 594881.
Stock and
securities
Instalment obligations,
similar property
foreign currency
Inventory
Assets subject to
1 .367(a)4T(b))
Intangible
property
1 .367(a)4(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a).4T(d))
described in Temp.
Reas. sec. 1.367(a)-4T((
Other property
Form 926 (Rev. 12-2011)
224532
05-01-12
278
Ek
Form 926(Rev. 12-20111 THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483
P1ge3
I
Part IV
I
10Type of nonrecognition transaction (see Instructions) SECTION 351 TRANSACTION
a Gain recognition under section 904( 0( 3) ................................................................................................................... Yes[Xli No

b Gain recognition under section 904(f)(5)(F) Eli Yes[Xli No
c Recapture under section 1503(d) .YesEU No
d Exchange gain under section 987 .Yes [Xli No
12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? .YesEll No
1.367(a) .4 through 1.367(a)-6 for any of the following:
a Tainted property .Yes[XI No
b Depreciation recapture .YesLXI No
c Branch loss recapture .Yes MN.
d Any other income recognition provision contained in the above-referenced regulations .Yes[Xli No
14Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? Eli Yes[Xli No
1 .367(a).1T(d)(5)(iii)? .YesLXI No
b If the answer to line 15a is 'Yes," enter the amount of foreign goodwill or going concern value
transferred$
17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? YesNo
transaction:
Form 926 (Rev, 12-2011)
224533
05-01-12
279
L2A
F.,. 9 2 6
Intemol Revenue Service
Aftach to your income tax return for the year of the transfer or distribution.
INC
I
OMB No. 1545-0026
I
Attachment
Sequence No.
128
Identifying numberi5j0051
20-5602483
Name of transferor
THE BLOOMBERG FAMILY FOUNDATION
lithe transferor was a corporation, complete questions 1 a through 1d.
fewer domestic corporations? LJYesETJNo

b Did the transferor remain in existence after the transfer? L]YesNo
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was It the parent corporation? L_.J YesLI No

d Have basis adjustments under section 367(a)(5) been made? ................................................................... LI Yes
No
Name of partnership
EIN of partnership
WILLET SELECT INVESTORS (TAX EXEMPT) I LP 126-1634308
LXJYesLi No
El Yes[XI No
Part If
I

PTOLEMY III LP198-0592851
P0 BOX 309, UGLAND HOUSE, SOUTH CHURCH STREET
CJ
CORPORATION
8Is the transferee foreign corporation a controlled forei gn corporation? ..................................................................... LXJ YesL.JNo
224531
05-01-12
280
17171111 737725 BLOOMFANPND 2012.04040 THE BLOOMBERG FAMILY FOTJNDA BLOOMFA2
Form 926(Rev.12-2O11
THE BIJOOMBERG FAMILY FOUNDATION INC20-5602483
Page 2
I
Part Ill
I
(a)(b)(c)(d)(e)
Type of
property
Cash06/29/2012256,011.
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
1 .367(a).4T(b))
Intangible
property
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a)4T(d))
described In Temp.
Other property
Supplemental Information Required To Be Reported (see Instructions):
Form 926 (Rev. 12.2011)
224532
05-01-12
281
17171111 737725 BLOOMFNFND 2012.04040 THE BLOOMBERG FAMILY FOtJNDA BLOOMFA2
E A

I
Form 926(Rev.12-2011)
Page3
I
Part IV
I
10 Type of nonrecognition transaction (see instructions) l o . SECTION 351 TRANSACTION
a Gain recognition under section 904(0(3) El Yest: No

El Yes[1 No
c Recapture under section 1503(d) LJ YesM No
d Exchange gain under section 987 EI YesM No
12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? El Yes[X] No
a Tainted property El Yes[J No

b Depreciation recapture El Yesl]] No
CBranch loss recapture LJ YesiJ No
d Any other income recognition provision contained in the above-referenced regulations El YesEE No
14Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El YesIJJ No
iSa Did the transferor transfer foreign goodwill or going concern value as defined In Temporary Regulations section
1.367(a)-1T(d)(5)(iii)?
El YesEJ No
b If the answer to line 15a Is "Yes,' enter the amount of foreign goodwill or going concern value
transferred$
16 Was cash the only property transferred? .YesEl No
17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? El Yes(]J No
transaction:
Form 926 (Rev. 12-2011)
224533
05-01-12
282
4
,.926
Name of transferor
0M13 No. 1545-0026
Attachment
Sequence No.128
Instructions)
20-5602483

LI YesEl No

EI Yesi:jNo
Identifying number
L..J YesL_J No

d Have basis adjustments under section 367(a)(5) been made? .................................................................................
Li Yes
No
Name of partnership
EIN of partnership
WILLET SELECT INVESTORS (TAX EXEMPT) I LP
26-1634308
LX J YesE:: -No
CIs the partner disposing of its entire interest in the partnership?

El Yes[]No
securities market?
El Yes EX I No
4Identifying number, if any

STUDIO BOULOGNE SARL
198-0688441
20 RUE DE LE POSTE
L-2346, LUXEMBOURG
LU
CORPORATION
8Is the transferee foreign corporation a controlled foreig n corporation? ..................................................................... LX.] YesLJ No
Form 926 (Rev. 12-2011)
224531
05-01-12
283
Form926 (Rev. 12 .2011) THE BLOOMBERG FAMILY FOUNDATION INC
20-5602483
Pa
I
Part Ill Information Regarding Transfer of Property
(see instructions)
(a)(b)(c)(d)
(e)
Type of
property
transfer
Cash
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
1 .367(a).4T(b))
Intangible
property
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a)4T(d))
described in Temp.
Reqs. sec. 1 .367(a)4T(E
Other property
(see instructions):
224532
Form 926 (Rev. 12-2011)
05-01.12
284
17171111 737725 BLOOMFMFND 2012.04040 THE BL,00MBERG FAMILY FOTJNDA BLOOMFA2
2
20-5602483
.Yes
No
b Gain recognition under section 904(0(5)(F) .
YesIX] No
Yes
EJ No
YesEXI No
12Did this transfer result from a change in the classification of the transferee to that of a foreign corporation?
.YesE1 No
1.367(a)-4through 1.367(a)-6for any of the following:
a Tainted property
[I] Yes[X] No
YesIZI No
YesEJ No
d Any other income recognition provision contained In the above-referenced regulations .
YesL1 No
14
.Yes
EXI No
1.367(a)-1T(d)(5)(ii?ci:i
YesEJ No
b if the answer to line 15a is "Yes," enter the amount of foreign goodwill or going concern value
transferred$
16Was cash the only property transferred?
.YesNo
17 a Was intangible property (within the meaning of section 936( h)(3)(B)) transferred as a result of the transaction?
EJYesEX] No
transaction:
Form 926(Rev.12-2011)
224533
a5-el-12
285
1717111]. 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
E A
Farm 926
Intumal Revenue Service
A ttach to your income tax return for the year of the transfer or distribution.
Name of transferor
I
OMB No. 1545-0026
I
A ttachment
Sequence No.
1 2 8
Identifying number(SCfjflSbflS)
2 0-5602 48 3
1 If the transferor was a corporation, complete questions la through 1 d. -
fewer domestic corporations?. Yes El No
b Did the transferor remain in existence after the transfer? EJYes [11] No
Identifying number
o If the transferor was a member of an affiliated group filing a consolidated return, was It the parent corporation? L_J Yes L..J No
If not, list the name and employer identification number (E IN) of the parent corporation:
d Have basis adjustments under section 367(a)(5) been made? ................................................................................. L_J Yes

No
a List the name and E 1N of the transferor's partnership:
Name of partnership
E IN of partnership
WILLET SELECT INVESTORS (TAX EXEMPT) I LP 2 6-1 634308
b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LX] Yes LJ No
c is the partner disposing of its entire interest in the partnership?.YesMNo
WILLETT SELECT INVESTORS II LP
5 A ddress (including country)
C/O WILLETT ADVISORS LLC, 2 5 EAST 78 TH ST
NEW YORK, NY 1 0075
8 3-0501 78 6
CORPORATION
8is the transferee forei g n corporation a controlled forei g n corporation? ..................................................................... LX] Yes L..J No
LHA For Paperwork Reduction A ct Notice, see separate instructions. Form 926 (Rev. 12-2011)
05-01-12
2 8 6
1 71 71 1 1 1 73772 5 BLOONFAMFND 2 01 2 .04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
t
Form 926 (Rev. 12-2011)
Page 2
I
Part III
I
(a)(b)(c)(d)(e)
Type of
property
transfer
I
propertydate of transfer basistransfer
324.941.009.
Stock and
securities
similar property
foreign currency
I nventory
Assets subject to
I ntangible
property
(as described I n final
1 .367(a-4(c))
Property to be sold
(as described in
Temp. Regs. sec.
1 .367(a)-4T(d))
described I n Temp.
Other property
224532
Form 926 (Rev. 12-2011)
05-01-12
287
17171111 737725 BLOONF.ANFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA ELOOMFA2
[ j J
THE
20-5602483
10Type of nonrecognition transaction (see instructions) Op. SECTION 351 TRANSACTION
11 Indicate whether any transfer reported in Part III is subj ect to any of the following:

El Yes[ ]No

El Yes
[J No

El YesLJJ No
El Yes
EE No
12
El YesEI No
a Tainted property
E] Yes[X1 No
El Yes[Ix] No
El Yes [Xl No

El YesIIJ No
El Yesl]J No
15 a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section
1 .367(a)-i T(c)(5)(j i)V.................................................................................... El YesEM No

transferred$

.YesEl No
El Yes[J No
transaction:
Form 926 (Rev. 12711)
224533
05-01-12
288
LA
Form 9 2 6
Interna' Revenue Service
1 1 0-Attach to your income tax return for the year of the transfer or distribution.
on
Name of transferor
OMB No. 1545-002 6
I
Attachment
Sequence No. 12 8
Identifying number (See
20-5602483
fewer domestic corporations? ............................................................................................................ E l YesEl No
b Did the transferor remain In existence after the transfer? ............................................................................ E l YesEl No
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? L._i Yes L-No,
d Have basis adjustments under section 36 7(a)(5) been made? L_JYes
No
2 If the transferor was a partner in a partnership that was the actual transferor (but is not treated as such under section 36 7), complete
a List the name and EIN of the transferor' s partnership:
Name of partnership
EIN of partnership
WILLET SELECT INVESTORS (TAX EXEMPT) I LP126-1634308
LJYesLJNo
E l YesLX] No
Part II J Transferee Foreign Corporation Inform

BVP-IV CAYMAN A LIMITED
5 Address Cincluding country)
P.O. BOX 309, tJ GLAND HOUSE, SOUTH CHURCH ST
CJ
CORPORATION
8Is the transferee forei gn corporation a controlled foreign corporation? ..................................................................... Lxi YesLJNo
LHA For Paperwork Reduction Act Notice, see separate Instructions. Form 9 2 6 (Rev. 12 .2 011)
289
Form 926 (Rev. 12-2011)
Pa
I Part Ill I Information Regarding Transfer of Property (see instructions)
(a)(b)(c)(d)(e)
Type of
property
Cash
.I
Stock and
securities
similar property
foreign currency
Inventory
Assets subject to
1 .367(a)4T(b))
Intangible
property
1.367(a)-4(c))
Property to be sold
(as described In
Temp. Regs. sec.
1 .367(a)-4T(d))
described in Temp.
Reas. sec. 1 .367(a)4T(
Other property
Form 926 (Rev. 12-2011)
224532
05-01-12
290
17171111 737725 BLOOMF.ANFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2
I &
THE BL100MBERG FAMILY FOUNDATI INC
20-5602483
11 I ndicate whether any transfer reported in Part I I I is subject to any of the following:

YesEJ No

L1 YesEJ No

[J Yes[I] No

El Yes[X] No
12Did this transfer result from a change in the classification of the transferee to that of a foreign corporation?
El YesiJJ No
13 I ndicate whether the transferor was required to recognize income under final and temporary Regulations sections
a Tainted property
El Yes []No
El Yes [Cl No
El Yes EJ No

El YesE]] No
EI Yes
1.367(a).1T(d)(5)(iii)?[l
Yes
b I f the answer to tine 15a I s Yes," enter the amount of foreign goodwill or going concern value
transferred$
IX J No
EX I No
El Yes EJ No
17 a Was intangible property (within the meaning of section 936(h)(3)(13)) transferred as a result of the transaction?
El YeslX 1 No
b I f Yes," describe the nature of the rights to the I ntangible property that was transferred as a result of the
transaction:
Form 926 (Rev.12-2011)
224533
05-01-12
291
Awl
THE BLOOMBERG FAMILY F UNDATION INC
20-5602483
FORM 926
PART III - INFORMATION REGARDING
STATEMENT 42
TRANSFER OF PROPERTY
CASH
( A)
( C)
DATE OF
FAIR MARKET VALUE

TRANSFER
ON DATE OF TRANSFER
12/07/2011
149,478.
107,991.
257,469.
FORM 926
PART III - INFORMATION REGARDING STATEMENT 43
CASH
( A)
( C)
DATE OF
FAIR MARKET VALUE

TRANSFER
ON DATE OF TRANSFER
06/20/2012
691,210.
07/18/2012
25,016.
07/20/2012
4,800.
721,026.
FORM 926
PART III - INFORMATION REGARDINGSTATEMENT 44
CASH
( A)
( C)
DATE OF
FAIR MARKET VALUE

TRANSFER
ON DATE OF TRANSFER
01/04/2012
1,139,533.
08/17/2012
36,434.
1,175,967.
17171111 737725 BLOOMFAMFND
292STATEMENT( S) 42, 43, 44
2012.04040 THE BLOONBERG FAMILY FOUNDA BLOOMFA2
COPY OF WITHIN PAPER
RECEIVED
NOV 2 2 2013
OFFICE OF THE ATTORNEY G EN
CHARITIES BUREAU

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What is the purpose of the annual filing form?

What is the purpose of the annual filing form?

What information is required to be submitted in the annual filing?

What information is required to be submitted in the annual filing?

Annual Filing for Charitable Organizations

New York State Department of Law (Office of the Attorney General)

filing fee of $25, regardless of total support and revenue.

for each return.

CIf exemptionapplicationispending, check here

3 7,403 .23 7,452.

76,3 28.5,876,3 28.

(mo., day, yr.)

83,945,446 .1,6 44,449,325.

foundation managers and their

Form 990-PF (2012)

?AMILY FOUNDATION INC

Form 990-PF (2012)

CHARI TY I TO REDUCE TOBACCO USE

I May the IRS discuss thIil

Name of exempt organization or other filer, see instructions.

Employer identification number (EIN) or

Form 8868 (Rev. 12013)

Name and address (home or business)

CHARITY SUPPORT ART PROGRAMS

CHARITY 9UPPORT EDUCATION AND

PROMOTE ROAD SAFETY

CHARITY TO REDUCE MATERNAL

CHARITY fiOPROMOTE ROAD SAFETY

CHARITY frOREDUCE TOBACCO USE

CHARITY pOLLABORA'rIoN WITH

RAGE THE USE OF

ENERGY AND THE

C CHARITY TO REDUCE MATERNAL

PER BOOKS MENT INCOME NET INCOMEPURPOSES

PER BOOKS MENT INCOME NET INCOME

Exempt Organization Business Income Tax Return

(and proxy tax under section 6033(e))

calendar year 2012 or other tax year beginning ,and ending

GELLER &CO, 909THIRD AVE. NO. 16FL

20- 5602483 Page 2

no.21 2- 583 - 6000

. If this is for the whole group, check this

0 . JPart l. line 6. column (B)0

Part I, line 7, column (A).Part I, tee 7, column (B).

(see Instructions)madeIn the controlling organization's with Income in column 10

Add columns 5 and 10.Add columns Sand it

<2,0 0 7,762. >

Social security number or

combine the result

the instructions Cede(s)

Employer identification number

C A P I T A L L O SS C A RRYO VER T O C U RREN T T A XA BL E YEA R

Form 8621 (Rev.1 2-201 2)

VDistributions From and Dispositions of Stock of a Section 1291 Fund (See

returnas other income

a Section 1291 Fund(See

I dentifying number (see instructions)

Identifying number (see instructions)

Part I is reserved for future use