pfhof enshrinees assistance foundation 2005

8/8/2019 Pfhof Enshrinees Assistance Foundation 2005

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S h o r t Form

Form 990-EZ Return o f O r g a n i z a t i o n Exempt From Income TaxUnder s e c t i o n 5 0 1 ( c ) , 5 2 7 , o r 4 9 4 7 ( a X l ) of t h e In t e rna l Revenue Code

( e x c e p t b l a c k l u n g b e n ef i t t ru s t o r p r i v a te f o u nd a t io n )

For organizations w i t h gross r e c e i p t s l e s s t h a n $100,000 an d t o t a l assets l e s s

D e p a r t m e n t o f t h e T r e a s u r yt h a n $250,000 a t th e end of t he y ea r.

I n t e r n a l R e v e n u e S e r v i c e The o r g a n i z a t i o n may have t o use a copy o f t h i s r e t u r n to s a t i s f y s t at e r e p or t in g requirements

OM B No 1 5 4 5 . 1 1 5 0

2005

A For t h e 2 0 0 5 c a l e nd ar y e a r , or t a x y e a r b e g i n n i n g , 2 0 0 5 , and

B Check i f a p p l i c a b l e CPlease

Add r e s s cha n g eus e IR S PFHOF E N SHR I N EE S AS S IS T AN C E FOUN DATION

Name change label or 2121 GEOR GE HALAS DR IVE N Wdnt orI n i t i a l return t y p e . CAN TON , OH 44708F i na l r e tu r n

ee

S p e c i f i cAmended return I n s t r u c .

Section 5 0 1 ( c ) ( 3 ) organizations and4947(a) ( 1 ) n o n e x e m p t c h a r i t a b le tr u s t sm u s t attach a compl eted Schedu l e A (F or m 990 or 990-EZ

D Employer Iden t i fica t i o n n u m be r34-1962043

E Telephone number330-456-8207F Group E x e m p t i o n

Number

G Accou nt in g me t ho d: [j Cash X AccrualOther ( s o e c l f v )

H Che ck I i f t h e o r g an i z at i o n i s not

I Web s i t e : N/A r e q u i r e d to a a }t a ch Schedule B (Form 9 9 0 ,J O r g a n i z a t i o n t y p e ( c h e c k o n ly on e ) - X 5 0 1 ( c ) ( 3 ) ( i n s e r t n o . ) 4 9 4 7 ( a ) ( 1 ) o r 5 2 7 990 EZ, or 990 P F ) .K Ch eck I f t h e organization' s gross r e c e i p t s a r e normally no t more t h a n $25,000. The o r g a n i z a t i o n n e e d n o t f i l e a r e t u r n w i t h th e I RS ;

but i f th e o r g a n i z a t i o n chooses to f i l e a r e t u r n , be sure to f i l e a complete r e t u r n . Some s ta te s r eq ui re a complete r e t u r n .L Add l i n e s 5 b , 6 b , an d 7 b , to l i n e 9 to determine gross r e c e i p t s ; i f $100,000 o r more, f i l e Form 990

I n s t e a d o f Form 990-EZ $ 12,173.Raft Revenue . Expenses - and Chances in Net Assets or Fund Balances (See I n s t r u c t i o ns )

1 C o n t r i b u t i o n s , g i f t s , g r a n t s , and s i m i l a r amounts received . . . . 1 12,1 73.

2 Program s e r v i c e revenue i n c l u d i n g government f e e s an d c ontra c t s 2

3 Me mbe rs hi p d u es a nd a s se s s me n t s 3

4 Investment i n come 4

5a Gross am ou n t f ro m s a l e o f assets o t h e r than i n v e n t o r y 5a

b L es s : c os t or other b a s i s an d s a l e s expenses . . . . . . . . . . . . . . . 5b

R c G a i n o r ( l o s s ) fr o m sa le o f a s s e t s o t h e r t h a n i n v e n t o r y ( l i n e 5 a l e s s l in e 5 b ) ( a t t a c h s c h e d u l e ) . . . Sc

v 6 S p e c ia l events an d a ct i vi t i es ( a t t a c h schedule). I f a ny a mo u nt i s from g am i n g , check here

N a Gross revenue ( n o t i n c l u d i n g $ of c o n t r i b u t i o n s

E r e p o r t e d on l i n e 1 ) . . . . . 6a

b L e s s . d i r e c t expenses oth e r than f u n d r a i s i n g expenses . . . . . . . . . . . . . 6b

c Ne t income o r ( l os s ) from s p e c i a l events an d a ct i vi t i es ( l i n e 6a l e s s l i n e 6 b ) . . . . . . 6c

7a Gross s a l e s of i nv e nt or y, l e s s r e t u r n s an d allowances . . . . . . . 7a

b L es s: c os t o f goods s o l d . . . . . . . . . . . 7b

c Gross p r o f i t o r ( l os s ) from s a l e s of i n v e n t o r y (li n e 7a l e s s l i n e 7 b ) . . . . 7c

8 O t h e r r e v e n u e ( d e s c r i b e ) 8

9 T o t a l revenue (add l i n e s 1 , 2 , 3 , 4 , 5 c , 6 c , 7 c , an d 8 ) 9 12,1 73.10 Grants an d s i m i l a r amounts p a i d ( a t t a c h schedule) . . . 1 0 5,112.

E 1 1 B e n e f i t s p ai d t o o r f or members . . . . . . . . .. . 1 1

x 12 S a l a r i e s , o t h e r compensation, and employee b e n e f i t s . . . 12

E 13 P r of e ss i on al f e e s an d oth e r payments to independent c o n t r a c t o r s . . 13

s 14 Occupancy, r en t , u t i l i t i e s , a n d m ai n t e n a nc e . . 14

ES

15 P r in ti ng , p u b l i c a t i o n s , postage, an d shipping . . . . 1 5

1 6 O t h e r e x p e n s e s ( d e s c r i b e SEE STATEMENT 1 ) 1 6 6,299.17' oa ugh16 17 11,411.18 Exce ear ( I e 9 l e s s line 1 7 ) . . 18 762.

N s

T

E

19 N t a s s e t s or fund balances g i n n i n g o f year ( f r o m l i n e 2 7 , column ( A ) ) (mu s t a gr ee w i t h end-of-yearr e r t e 4 o i l a r ' r n)1 1 9 1 14, 471 .T 20 e r n a e t s nd b ht t 0

s

a ances ( a ac ex p an a ion) 2

2 1 N d o f year (combine l in e s 1 8 t h r o u g h 2 0 ) 2 1 115, 233.

( d# j , . . . . . EWI 1 kbtjAT7otal a s s e t s o n l i n e 2 5 , column ( B ) ar e $ 2 5 0 , 0 0 0 or m o r e , f i l e Form 9 9 0 i n s t e a d o f Form 9 9 0 - E Z .I "---' ` I - ' PA n s t r u c t i o n s )

22 Cash, s a v i n g s , an d investments

23 Land a n d b u i l d ing s .

2 4 O t h e r a s s e t s ( d e s c r i b e SEE STATEMENT 2

25 T ot al a s se t s . .

26 T o t a l l i a b i l i t i e s ( d e s c r i b e SEE STATEMENT 327 Ne t a s s e t s or fund balances ( l i n e 27 o f column ( B ) m u s t aaree w i t h l i n e 2 1 )

BAA F o r P r i v a c y A c t and Paperwork R e d u c ti on A c t N o t i c e , s e e t he s e p ar a te i n s t r u c t i o n s

B e g i n n i n g o f y e a r ( B ) En d o f y e a r105,885. 2 2 111,549.

117,221. 2 5 116,806.

2,750. 2 6 1,573.114,471. 2 7 115,233.T E E A 0 8 0 3 L 0 2 / 0 1 / 0 6 Form 9 9 0 - E Z ( 2 0 0 5 )


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[Paid 1 1 Statement of Program Service Accomplishments (See I n s t r u c t i o n s ) ExpensesW h a t i s t h e o r g a n i z a t i o n ' s p r i m a r y e x e m p t p u r p o s e ? SEE STATEMENT 4 (Required f o r 5 0 1 ( c ) ( 3 )Describe what wa s achieved i n c a r r y i n g o u t t h e o r g a n i z a t i o n ' s exempt purposes. I n a c l e a r an d concise manner,

an d ( 4 ) o r g a n i z a t i o n s and

d e s c r i b e t h e services p r o v i d e d , t h e number o f persons b e n e f i t e d , o r o t h e r r e l e v a n t i n f o r m a t i o n f o r each 4 9 4 7 ( a ) ( 1 ) t r u s t s ; o p t i o n a l

oroaram t i t l e . f o r o t h e r s . )

28 -------------------------------------------------------------------------------------------------------------------------------------------------------Grants $ I f t h i s amount i n c l u d e s f o r e i g n r a n t s , check here 28 a

29

( G r a n t s $ - - - - - - - - - --) I f t h i s amount i n c l u d e s f o r e i gn g r an t s , check here- - - - - - - - -0 - - 29a30

-----------------------------------------------------------------------------------------------------Grants $ f t h i s amount i n c l u d e s f o r e g n g r a n t s , check here 30a

3 1 Other program s e r v i c e s ( a t t a c h schedule)

( G r a n t s $ I f t h i s amount i n c l u d e s f o r e i g n g r a n t s , check here . . . 3 1 a

32 T o t a l program s e r v i c e expenses ( a d d l i n e s 28a through 3 1 a . . 32

v a l t I V LIS T O T UMCerS u l r e c t o r s 1 r u s t e e s , ana ry e tm i o ee5 ( L i s t eac h one e ve n i f n o t compensated. Se e I n s t r u c t i o n s . )( A ) Name and address ( B ) T i t l e a nd a ve rage hoursp e r w e e k devoted

t o p o s i t i o n

( C ) Compensation I fnot p a i d , enter-0 - . )

( D ) C o n t r i b u t i o n s t o

e m p l o y e e b e n e f i t p l a n s a n d

d e f e r r e d c o m p e n s a t i o n

( E ) Expense account

and o t h e r allowances

------------------------------------------SEE STATEMENT 5 0 . 0 . 0 .--------------------------------------------------------------------------------------------------------------------------------

r a T 1 F other Information ( N o t e t h e a t t achment r e q u i r e m e n t i n t h e i n s t r u c t i o n s ) SEE STATEMENT 6 Yes No3 3 D i d t h e o r ga n iz at i o n engage i n a n y a c t i v i t y n o t p r e vi o u sl y r e p o r t e d t o t h e I R S ? I f ' Y e s , ' a t t a c h a d e t ai l e d d e s cr i p t i o n

o f each a c t i v i t y . . . . . . 33 X34 W e r e a n y c h a n g e s m a d e t o t h e o r g a n i z i n g o r g o v e r n i n g d o c u m e n t s b u t n o t r e p o r t e d t o t h e I R S ? I f Y e s , ' a t t a c h a c o n f o r m e d c o p y o f t h e c h a n g e s . . . 34 X35 I f t h e o r g a n i z a t i o n h a d i n c om e f r o m b us i ne s s a c t i v i t i e s , s u c h a s t h o s e r e p or t ed o n l i n e s 2 , 6 , a n d 7 ( a m o n g o t h e r s ) , b ut n ot r ep o r t e d o n F o r m 9 9 0 - T , a t t a c h

a s t a t e m e n t e x p l a i n i n g y o u r r e as o n f o r n o t r e p o r t i n g t h e i n c o m e o n F o r m 990 -T .

a D i d t h e o r g a n i z a t i o n h a ve u n r e l a t e d b u s i n e s s g r o s s i n c o m e o f $ 1 , 0 0 0 o r m o r e o r 6 0 3 3 ( e ) n o t i ce , r e p o r t i n g , a n d p r o x y t a x r e q u i r e m e n ts ? . 35a Xb I f ' Y e s , ' has i t f i l e d a t ax r e t u r n on Form 990 - T f o r t h i s year ? 3 5b N A

36 W a s t h e r e a l i q u i d a t i o n , d i s s o l u t i o n , t e r m i n a t i o n , o r s u b s t a n t i a l c o n t r a c t i o n d u r i n g t h e y e a r ? ( I f Y e s , ' a t t a s t m n t . ) . . 36 X37a E n t e r a m o u n t o f p o l i t ic a l e x p e n d i t u r e s , d i r e c t o r i n d i r e c t , a s d e s c r i b ed i n t h e i n s t r u c t i o n s . 3 7a 0.

b D i d t h e o r g a n i z a t i o n f i l e Form 1120-POL f or t hi s year? . . 37b

38a D i d t h e o r g a n i z a t i o n borrow f r o m , o r make any loans t o , any o f f i c eany such loans made i n a p r i o r year and s t i l l unpaid a t t h e s t a r t o f

b i t Y e s , ' a t t a c h t h e s ch s p e c i f i e d i n t h e I n 3 8 i n s t r u c t i o n s a n d e n t e r t h e a m o u n t m v o l y

39 5 01 ( c )( 7 ) o r g a n i za t i o n s E n t e r :

a I n i t i a t i o n fees an d c a p i t a l c o n t r i b u t i o n s i n c l u d e d on l i n e 9

b G r os s r e c e i p t s , i n c l u d e d on l i n e 9 , f o r p u b l i c use o f c l u b f a c i l i t i e s

4 0 a 5 01 ( c )( 3 ) o r g an i z at i o n s Enter amount o f t a x imposed on t h e o r g a r

s e c t i o n 4911 0 . ; s e c t i o n 4912

b 5 0 1 ( c ) ( 3 ) a n d ( 4 ) o r g a n i z a t i o n s . D i d t h e o r g a n i z a t i o n e n g a g e i n a n y s e c t i o n 4 9 5 8 e x c e

e x c e s s b e n e f i t t r a n s a c t i o n f r o m a p n o r y e ar ? I f ' Y e s , ' a t t a c h a n e x p l a n a t i o n .

c Enter amount o f t a x imposed on o r g a n i z a t i o n managers o r d i s q u a l

s e c t i o n s 4912, 4 9 5 5 , an d 4958

d En t e r amount o f t ax on l i n e 40c reimbursed by t h e o r ga n iz at i on .

BAA T E E 0 8 1


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Form 9 9 0 - E Z 2 0 0 5 PFHOF ENSHRINEES ASSISTANCE FOUNDATION 34-1962043 Page 3P;d . Other Inform ation ( N o t e t h e a t t ac h m e nt r e q ui r e m e n t i n t h e i n s tr u ct i on s ) ( C o n t i n u e d )4 1 ' L i s t t h e s t a t e s w i t h w h i c h a c o p y o f t h i s r e t u r n i s f i l e d NONE4 2 a T h e b o o k s a r e i n c a r e o f - LEE DICOLA T e l e p h o n e n o 330-456-8207

L o c a t e d a t 2121 GEORGE HALAS DRIVE NW, CANTON, OH, ZIP +4 44708bA t any t i m e d u r i n g the calendar y e a r , d i d t h e o r g a n i z a t i o n ha ve a n i n t e r e s t i n o r a s i gn at ur e o r o t h e r a u t h o r i t y over a

Ye s No

f i n a n c i a l account i n a f o r e i g n country (such as a bank a c c o u n t , s e c u r i t i e s account, o r o t h e r f i n a n c i a l account)? 4 2b Xl i o -

I f ' Y e s , ' e nt e r t he na m e o f t h e f o r e i g n c o u n t r y :

Se e t h e in s t ruc t i o n s f o r e x c e p t i o n s and f i l i n g r e q u i r e m e n t s f o r Form TD F 9 0 - 2 2 . 1 .

c At any t im e d ur in g the calendar y e a r , d i d t h e o r ga n iz a ti o n maintain an o f f i c e o u t s i d e o f t h e U.S.? 4 2c XI f ' Y e s , ' e nt er t he name o f t h e f o r e i g n c o u n t r y : b l .

4 3 S ec tio n 4 94 7( a) (1) nonexempt charitable t r u s t s f i l i n g Form 990-EZ f n l i e u of Form 1041- Check here N/Aa nd enter the amou o ax-exempt interest received r c r u e d during t h e tax ye a r 43 N/A

U n d e r p e b e of r y u I d e c l a t h a t I h e x i n e c l u d i c or n a ny i n g s ch ed ul es n d s ta te me nt s a n d t o t he b es t of m y k n ow l e dg e a nd b e l i e f , i t i st r u e _ c o r e c c e D bon o r e p s th e f f i c e r )

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+ s n s anZ P

CANTON, OH 44702 Phone no (330) 452-9788

BAA T E E A 0 8 1 2 L 0 2 / 0 6 / 0 6 Form 9 9 0 - E Z ( 2 005 )


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5/11

Schedule A ( F o r m 9 9 0 o r 9 9 0 - E Z ' 2005 PFHOF ENSHRINEES ASSISTANCE FOUNDATION 34-1962043 Page 2P rt [ f [ Statements About A c t i v i t i e s ( Se e i n s t r u c t i o n s . ) Y e s No

1 During t h e y ea r , has the o r g a n i z a t i o n attempted t o i n f l u e n c e n a t i o n a l , s ta te , o r l oca l l eg is la t io n, i n c ludi n g an y attempt

t o i n f l u e n c e p u b l i c opinion an a l e g i s l a t i v e matter o r referendum? I f ' Y e s , ' e nt er t h e t o t a l expenses paid

o r i nc ur re d i n c o n n e c t i o n w i t h t h e l o b b y i n g a c t i v i t i e sD o -

$ N/A(Must e q u a l amounts on l i n e 3 8 , P a r t V I- A , o r l ine i o f P a r t VI-B) 1 XOrganizations t h a t made an e l e c t i o n under s ec t i on 5 01 ( h) by f i l i n g For m 5 768 m us t complete P a r t V I - A . Othero r g a n i z a t i o n s checking ' Y e s ' must complete Part VI-B AND a t t a c h a statement g i v i n g a d e t a il e d d e sc r ip t i o n o f t h el o b b y i n g a c t i v i t i e s .

2 During t h e y ea r, has the o r g a n i z a t i o n , e i t h e r d i r e c t l y o r i n d i r e c t l y , engaged i n an y o f t h e f o l l o w i n g a c t s w i t h an y

s u b s t a n t i a l c o n t r i b u t o r s , t r u s t e e s , d i r e c t o r s , o f f i c e r s , c r e a t o r s , ke y employees, o r members o f t h ei r f a mi l ie s , o r w i t h an y

t a x a b l e o r g a n i z a t i o n w i t h which an y such person i s a f f i l i a t e d as an o f f i c e r , d i r e c t o r , t r u s t e e , m a j o r i t y owner, o r p r in ci pa l

b e n e f i c i a r y ? ( I f t h e answer t o an y question i s ' Y e s , ' a t t a c h a d e t a i l e d statement e xp l a in in g t h e t r a n s a c t i o n s )

a S a l e , exchange, o r l e a s i n g of p r o p e r t y ? 2 a Xb Lending o f m o n ey o r other e x t e n s i o n o f c r e d i t ? . . . . . . 2b Xc Furnishing of goods, s e r v i c e s , o r f a c i l i t i e s ? . . 2 c Xd P aym en t of compensation (o r payment o r reimburseme nt o f expenses i f more than $1,000)? 2 d Xe Transfer of any p a r t o f i t s income o r assets? . . . . 2 e X

3a Do you m a k e g r a n t s f o r s c h o l a r s h i p s , f e l l o w s h i p s , student l oa ns , e t c? ( I f ' Y e s , ' a t t a c h ane x p l a n a t i o n of h ow you determine t h a t r e c i p i e n t s q u a l i f y t o r e c e i v e payments.). 3a X

b Do you have a s ec t io n 4 03 ( b) a n nu i t y p l a n f o r your employees? . . . . 3b Xc During t h e y ea r, d i d the o rg an iz at i on r ec ei ve a c o n t r i b u t i o n o f q u al i fi e d r ea l p r o p e r t y i n t e r e s t under s e c t i o n 1 7 0 ( h ) ? 3c X

4a D id you m a i n t a i n any separate account f or p a r t i c i p a t i n g donors where donors have t h e r ig ht t o p r ov id e a d vi ce

on t h e use o r d i s t r i b u t i o n o f funds? 4a Xb Do you p r o v i d e c r e d i t c o u n s e l i n g , debt management, c r e d i t r e p a i r , o r d e b t n eg ot i a t io n s e rv i ce s ? 4b X

Pa # L V Reason f o r Non - P r i v a t e Foundation S t a t u s ( s e e i n s t r u c t i o n s . )

T h e o r g a n i z a t i o n i s n o t a p r i v a t e f o u n d a t i o n because i t i s : (Please check o n l y ONE a p p l i c a b l e b o x . )5 A c h u r c h , convention o f churches , o r a s s o c ia t i o n o f churches . S e c t i o n 1 7 0 ( b ) ( 1 ) ( A ) ( i ) .

6 A s c h o o l . S e c t i o n 1 7 0 ( b ) ( 1 ) ( A ) ( i ) . ( A l s o complete Part V . )

7 A h o s pi t al o r a cooperative h o s p i t a l s e rv ic e o r ga n iz a t i on . S e c t i o n 1 7 0 ( b ) ( 1 ) ( A ) ( i i i ) .8 A F e d e r a l , s t a t e , or l o c a l government o r governmental u n i t . S ec t io n 1 70 ( b ) ( 1 ) ( A ) ( v ) .9 A m e d i c a l research o r g a n i z a t i o n operated i n c o n j u n c t i o n w i t h a h o s p i t a l . Section 1 7 0 ( b ) ( 1 ) ( A ) ( u i ) . Enter the h o s p i t a l ' s name, c i t y ,

an d s t a t e b -I

10 An o r g a n i z a t i o n operated fo r t h e b en ef i t o f a c ol le ge o r u n iv e rs i t y owned o r operated by a governmental u n i t . Section 1 7 0 ( b ) ( 1 ) ( A ) ( i v ) .

( A l s o complete the S u ppor t S c h e d u l e i n P a r t I V - A . )

1 1 a nn o r g a n i z a t i o n t h a t normally receives a s u b s t a nt i a l p a r t o f i t s sup p o r t from a governmental u ni t o r from t h e g e n e r a l p u b l i c .S ec t io n 1 7 0 ( b ) ( 1 ) ( A ) ( w ) . ( A l s o complete t h e S u p por t S c h e du l e i n P a r t I V - A . )

1 1 bDcommunity t r u s t . S e c t i o n 1 7 0 ( b ) ( 1 ) ( A ) ( v i ) . ( A l s o complete t h e Support Schedule i n P a r t I V - A . )12 An o r g a n i z a t i o n t h a t normally r e c e i v e s : ( 1 ) more than 33 - 113% o f i t s suppo r t f rom con t r i b u t i o n s , membership f e e s , an d gross r e c e i p t s

from a c t i v i t i e s r e l a t e d t o i t s c h a r i t a b l e , e t c , f u n c t i o n s - s u b j e c t t o c e r t a i n excepti ons , and ( 2 ) no more than 3 3 - 1 1 3% o f i t s supportfrom gross investment i ncom e and unrelated business t a x a b l e income ( l e s s s e c t i o n 5 1 1 t a x ) from businesses acquired by t h eo r g a n i z a t i o n a f t e r June 3 0 , 1 9 7 5 . S e e s e c t i o n 509 ( a ) ( 2 ) . ( A l s o complete t h e S u p p o r t Schedule i n P a r t I V - A . )

13 Jn o r g a n i z a t i o n t h a t i s n o t con t r o l l e d by an y d i s q u a l i f i e d persons ( o t h e r t h an foundation managers) an d supports o r g a n i z a t i o n sd e s c r i b e d

i n . ( 1)l i n e s 5 t h rough 1 2 above ; o r ( 2 ) s e c t i o n 5 0 1 ( c ) ( 4 ) , ( 5 ) , o r ( 6 ) , i f they m e et t h e t es t o f s e c t i o n 509(a ) ( 2 ) . C h e c k t h e

box t h a t describes t h e t y p e o f supporting o r g a n i z a t i o n : ' nyp e 1 (Type 2 (Type 3Provide t h e f o ll o w in g i nf o r ma t i o n about t h e supported o r g a n i z a t i o n s . ( S e e i n s t r u c t i o n s . )

( a ) Name ( s ) o f supported o r g a n i z a t i o n ( s ) ( b ) L i n e numberfrom above

N A TI O N A L F O O T B A L L MUSEUM , INC - PR O FO O TB AL L HO F 1 1 A

14 nn o r g a n i z a t i o n organized and operated t o t e s t fo r p u b li c s af et y . Section 5 0 9 ( a ) ( 4 ) . (See i n s t r u c t i o n s . )BAA TEEA0402L 0 8 1 0 9 / 0 5 Schedule A (F o r m 9 9 0 o r Form 9 9 0 - E Z) 2005


6/11

Schedule A (Form 99 0 o r 990-EZ) 2005 PFHOF ENSHRINEES ASSISTANCE FOUNDATIO 34-1962043 Page 3PartWA Support Schedule (Complete o n l y i f you checked a box on l i n e 1 0 , 1 1 , o r 1 2 . ) Use cash method of accounting.Note : Yo u may use t h e worksheet i n t h e i n s tr u c t io n s f o r c o n v e r t i n g from t h e a c c r u a l t o t h e cash method o f accountingCalendar year ( or f i s c a l year ( a ) ( b ) ( c ) ( d ) ( e )

beginning i n ) 2004 2003 2002 2001 T o t a l15 G i f t s , g r a n t s , and c o n t r i b u t i o n s

r e c e i v e d . (Do n o t i n c l u d e

u n u s u a l g ran ts . See l i n e 2 8 . ) N /A

16 Membership f e e s received

17 G r o s s r e c e i p t s f r o m a d m i s s i o n s ,

m e r c h a n d i s e s o l d o r s e r v i c e s p e r f o r m e d ,

o r f u r n i s h i n g o f f a c i l i t i e s i n a ny a c t i v i t y

t h a t i s r e l a t e d t o t h e o r g a n i z a t i o n ' s

c h a r i t a b l e , e t c , p u r p o s e

18 G r o s s i nc o me f r o m i n t e r e s t , d i v i d e n d s ,

a m o u n t s r e c e i v e d f r o m p a y m e n t s o n

s e c u r i t i e s l o a n s ( s e c t i o n 5 1 2 ( a ) ( 5 ) ) ,

r e n t s , r o y a l t i e s , a nd u n r e l a t e d b u s i n e s s

t a x a b l e i n c o m e ( l e s s s e c t i o n 5 1 1 t a x e s )

f r o m b u s i n es s e s a c q u i r ed b y t h e o r g a n -

i z a t i o n a f t e r J u n e 3 0 , 1 9 7 5

19 N e t i nc o m e f r o m u n r e l a t e d b u s i n e s s

a c t i v i t ie s n o t i n c l u d e d i n l i n e 1 8

20 Tax revenues l e v i e d f o r t h e

o r g a n i za t i o n 's b e ne f i t and

e it he r p a i d to i t o r expended

on i t s b e h a l f

2 1 The v a l u e o f s e r v i c e s o r

f a c i l i t i e s f u r n i s h e d to t h e

o r g a n i z a ti o n by a governmental

u n i t w i t h o u t c h a r g e . Do n o t

i n c l u d e t h e value o f s e r v i c e s o r

f a c i l i t i e s g e ne r a ll y f u r n i s he d t o

t h e p ub l i c w i t h o u t charge

22 Other income. Attach a

s c h e d u l e . D o n o t i n c l u d e

g a i n o r ( l o s s ) from s a l e o f

c a p i t a l assets

23 T o t a l of l i n e s 1 5 through 22

24 L i n e 23 minus l i n e 1 7

25 Enter I% o f l in e 23

2 6 Organizati ons described on l i ne s 1 0 or 1 1 : a Enter 2% o f amount i n column ( e ) , l in e 24 N/A 26 ab P r e p a r e a l i s t f o r y o u r r e c o r d s t o s h o w t h e n a m e o f a nd a m o u n t c o n t r i b u t e d b y e ac h p e rs on ( o t h e r t h a n a gove r n me nt al u n i t o r p u b l i c l y

s u p p o r t e d o r g a n i z a t i o n ) w h o s e t o t a l g if ts f o r 2 0 0 1 t h r o u g h 2 0 0 4 e x ce e de d t h e a m o u nt s h ow n i n l i n e 2 6 a D o no t f i l e t h i s l i s t w i t h y o u r

r e t u r n . E n t e r t h e t o t a l o f a l l t h e s e e x c e s s a m o u n t s . . . . . . . . . . 26 bc T o t a l support f o r s e c t i o n 5 0 9 ( a) ( 1 ) t e s t : Enter l in e 2 4 , column ( e ) 26 cd Add: Amounts from column ( e ) f o r l i ne s : 18 19

2 2 26 b 26d

e P u b li c support ( l i n e 26c minus l in e 26 d t o t a l ) . . . . 26 ef P u b l i c support percentage ( l ine 26 e (numerator) divided by line 26c denominator) ) 26f %

2 7 O r g a ni za t i o n s d es c r i b ed on l i n e 1 2 : N/Aa For amounts i n c l u d e d i n line s 1 5 , 1 6 , and 1 7 t h a t were received from a ' d i s q u a l i f i e d p e r s o n , ' prepare a l i s t f o r your r e c o r d s t o show t h ename o f , an d t o t a l amounts received i n each year f r o m , each ' di s q ua li f i ed p e r s o n . ' Do not f i l e t h i s l i s t with your r e t u r n . E n t e r t h e sum o fsuch amounts f o r each y e a r :

( 2 0 0 4 ) ------------ (2003)------------ (2002)------------ ( 2 0 0 1 ) --------bFor any amount i n c l u d e d i n l i n e 1 7 t h a t was received from each person ( o t h e r t h a n ' d i s q u a l i f i e d p e r s o n s ' ) , prepare a l i s t f o r y o u r records

t o show t h e name o f , and amount r e c e i v e d f o r each y e a r , t h a t was more t h an t h e l ar ge r o f ( 1 ) t h e amount on l i n e 25 f o r t h e y e a r o r ( 2 )$ 5 , 0 0 0 . ( I n c l u d e i n t h e l i s t o r g a n i z a t i o n s described i n l i n e s 5 through 1 1 b , as well a s i n d i v i d u a l s . ) Do not f i l e t h i s l i s t w i t h your r e t u r n .A f t e r computing t h e d i f f er e nc e between t h e amount received an d t h e l a r g e r amount described i n ( 1 ) o r ( 2 ) , e n t e r t h e su m o f t h e s ed i f f e r e n c e s ( t h e excess amounts) f o r each y e a r :

( 2 0 0 4 ) ------------ (2003)------------ (2002)------------ ( 2 0 0 1 ) --------c Add: Amounts from column ( e ) f o r l i n e s : 15 1 6

1 7 20 2 1 27 c

d Add. L i n e 27 a t o t a l an d l in e 27 b t o t a l 27 d

e P u b li c support ( l i n e 27c t o t a l minus l in e 27 d t o t a l ) . 27 ef T o t a l support f o r s e ct i o n 5 09 ( a ) ( 2 ) t e s t : Enter amount from l in e 2 3 , column ( e ) . 27 fg P u b l i c support percentage ( line 27 e ( numerator ) divided by l in e 2 7 f ( denominator ) ) 27 %h Investment income percentage ( l ine 18 , column ( e) (numerator) divided by l i n e 2 7 1 (denominator)) 27 h %

28 Un usual Gran ts : For an o r g a n i z a t i o n described i n l i ne 1 0, 1 1 , o r 1 2 t h a t r e c e i v e d any unusual g r a n t s d u r i n g 2001 through 2 0 0 4 , prepare a

l i s t f o r your records t o show, f o r each y e ar , t he name o f t h e c o n t r i b u t o r , t h e d a t e and amount o f t he g r a n t an d a b r i e f d e s c r i p t i o n o f t h en a t u r e o f t h e g r a n t . Do not f i l e t h i s l i s t w i t h your r e t u r n . Do n o t i n c l u d e these g r a n t s i n l in e 1 5 . N/ABAA T E E A D 4 0 3 L 0 2 / 0 3 / 0 6 Schedule A (Form 990 o r 990-EZ) 2005


7/11

S c h e d u l e A ( F o r m 9 9 0 o r 9 9 0 - E Z ) 2 0 0 5 PFHOF ENSHRINEES ASSISTANCE FOUNDA T 34-1962043 P a g e 4Ptl P r i v a t e School Questionnaire ( S e e i n s t r u c t i o n s . )( T o b e completed ONLY b y s c h o o l s t h a t checked t h e box on l i n e 6 i n P a r t I V ) N/A

Yes No

29 Does t he o r g a ni za t io n have a r a c i a l l y n o n d i s c r i m i n a t o r y p o l i c y toward students by statement i n i t s c h a r t e r , bylaws,

o t h e r governing in s t r ument , o r i n a r e s o l u t i o n o f i t s governing body? .

3 0 Does t h e o r g a n i z a t i o n i n c l u d e a statement o f i t s r aci al ly nondiscriminatory p o l i c y toward students i n a l l i t s brochures,

catalogues , an d o t h e r w r i t t en communications w i t h t h e p ub li c d e a l i n g w i t h s t u d e n t admissions , programs,

an d s c h o l a r s h i p s ?

31 Ha s t h e o r g a n iz a ti o n p u b l i c i z e d i t s r a c i a l l y n o n d i s c r i m i n a t o r y p o l i c y t h rough newspaper o r broadcast media d u r i n g

t h e p e r i o d o f s o l ic i ta t io n f o r students , o r d u r i n g t h e r e g is tr a ti o n p e r i o d i f i t has no s o li ci t ati o n program, i n a w a y t h a t

m a k e s t h e p ol ic y known to a l l pa r t s o f t h e g e n e r a l community i t serves?.

I f ' Y e s , ' please describe ; i f ' N o , ' please e x p l a i n . ( I f you n ee d m or e space, a t t ach a separate s t a t e m e n t . )

---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------3 2 Does t h e o r g a n i z a t i o n maintain t h e f o l l o w i n g :

a Records i n d i c a t i n g t h e r a c i a l composition o f t h e s t u d e n t body, f a c u l t y , an d adminis t r a t i v e s t a f f ?

b Records documenting t h a t scholarships an d o t h e r f i n a n c i a l assistance a r e awarded on a r aci al ly

n o n d i s c r i m i n a t o r y basis?

c Co p i es o f a l l catalogues , brochures , announcements, and o t h e r w r i t t en communications t o t h e p ub l ic d e a l i n g

w i t h s t u d e n t admissions , programs , an d s c h o l a r s h i p s ? . . . . . .

d Copies o f a l l m a t e r i a l used by t h e o r g a n i z a t i o n o r on i t s b e h a l f to s o l i c i t con t r i b u t i o n s ?

I f you answered ' N o ' t o an y o f t h e above, please e x p l a i n . ( I f you need more space, a t t ach a separate s t a t e m e n t . )

----------------------------------------------------------------------------------------------------------------33 Does t h e o r g a n i z a t i o n d i s c r i m i n a t e by race i n an y w a y w i t h respect t o :

a S t u d e n t s ' r i g h t s or p r i v i l e g e s ?

b Admiss ions p o l i c i e s ?

c Employment o f f ac u l ty o r a d m i n i s t r a t i v e s t a f f ? . .

d Scholarships o r o t he r f in an ci al assistance?

e E d u c a t i o n a l p o l i c i e s ?

I Use o f f a c i l i t i e s ?

g A th l et ic programs? . . . . . .

h Other e x t r a c u r r i c u l a r a c t i v i t i e s ?

I f you answered ' Y e s ' t o an y o f t h e above , please e x p l a i n . ( I f y ou n ee d m or e space, a t t ach a separate s t a t e m e n t . )

------------------------------------------------------------------------------------------------------------------------------------------------------------------------34a Does t h e o r g a ni za t io n receive an y f i n a n c i a l a i d o r a s s i s t a n c e f r om a governmental agency?

b Ha s t h e o r g an iz a ti o n s r i g h t t o such a i d e v e r been revoked o r suspended?

I f you answered Y e s ' t o e i t h e r 34a o r b , please e x p l a i n u s i n g an a t t ached statement.

35 Does t h e o r g a ni za t io n ce r t i f y t h a t i t has complied w i t h t h e a p p l i c a bl e requirements o f

s e c t i o n s 4 . 0 1 through 4 05 o f Rev Proc 75.50 , 1 9 7 5 - 2 C . B . 5 8 7 , covering r aci aln o n d i s c r i m i n a t i o n ? I f ' N o , ' a t t ach an e x p l a n a t i o n .

BAA TEEA0404L 08/08/05

2 9

3 0

3 1

32a

32b

32c

32d

33a

33b

33c

33d

33e

33f

33g

33h

34a

34

1 3 5

S c h e d u l e A ( F o r m 9 9 0 o r


8/11

S c h e d u l e A ( F o r m 9 9 0 o r 9 9 0 - E Z ) 2005 PFHOF ENSHRINEES ASSISTANCE FOUNDATI 34-1962043 Page 5Pa WA Lobbying Expenditures by Electing Public Charities ( S e e i n s t r u ct i o n s . )

( T o be completed ONLY by a n e l i g i b l e o r g a n i z a t i o n t h a t f i l e d Form 5768) N/A-- fl, 4 1 , . ,---+-iein.,,,e f ^ t e r , ffa hn+o- r r, i in chpr-k h I if vn i checked a' anri 'limited control ' provisions aooly.L i m i t s on Lobbying E x p e n d i t u r e s A f f i l i a t e d group To be completed

he term ' e x p e n d i t u r e s ' means amounts p a i d o r i n c ur r e d. )( Tt o t a l s f or ALL

organizations

e l e c t i n g

t i o n s

36 T o t a l l o b b y i n g expenditures t o i n f l u e n c e p u b l i c o p i n i o n ( g r a s s r o ot s l o b b yi n g ) 36

37 T o t a l l o b b y i n g expenditures t o i n f lu en c e a l e g i s l a t i v e body ( d i r e c t l o b b y i n g ) . 37

38 T o t a l l o b b y i n g expenditures (add l i n e s 36 and 3 7 ) 38

39 Other exempt purpose expenditures 39

40 T o t a l exempt purpose expenditures (add l i n e s 3 8 and 3 9 ) 40

4 1 Lobbying nontaxable amount. Enter t h e amount from t h e f o l l o w i n g t a b l e -I f t h e amount on l i n e 40 i s - The lobbying nontaxable amount i s -N o t o v e r $ 5 0 0 , 0 0 0 . 2 0 % o f t h e amount o n l i n e 4 0

O v e r $ 500, 000 b u t n o t o v e r $ 1 , 000, 000 $ 1 0 0 , 0 0 0 p l u s 15 % o f t h e e x c e s s o v e r $ 5 0 0 , 0 0 0

O v e r $ 1 , 0 0 0 , 0 0 0 b u t n o t o v e r $ 1 , 5 0 0 , 0 0 0 $ 1 7 5 , 0 0 0 p l u s 1 0 % o f t h e e x c e s s o v e r $ 1 , 0 0 0 , 0 0 0 4 1

O v e r $ 1 , 5 0 0 , 0 0 0 b u t n o t o v e r $ 1 7 , 000, 000 $ 2 2 5 , 0 0 0 p l u s 5 % o f t h e e x c e s s o v e r $ 1 , 5 0 0 , 0 0 0

Over $17,000,000 $1,000,000... . .

42 Grassroots nontaxable amount ( e n t e r 25% o f l i n e 4 1 ) 4243 S u b t r a c t l i n e 42 from l i n e 3 6 . Enter - 0 - i f l i n e 42 i s more than l i n e 36 43

44 S u b t r a c t l i n e 4 1 from l i n e 3 8 . Enter - 0 - i f l i n e 4 1 i s more t h a n l i n e38 44

C a ut i o n : I f t h e r e i s an amount on e i t h e r l i n e 4 3 o r li n e 4 4, you must f i l e F or m 4 7 20

4 -Year Averaging Period Under Se c t ion 501(h)

(Some organizations t h a t made a s ec ti o n 5 0 1 ( h ) e l e ct i o n do n o t have t o complete a l l o f t h e f i v e columns below.See t h e i n s t r uc t i on s f or l in es 45 through 5 0 . )

Lobbying Expenditures Dur i ng 4 -Year Averaging Pe r i od

Calendar year ( a ) ( b ) ( c ) ( d ) (e )

( o r f i s c a l year 2005 2004 2003 2002 T o t a l

beginning i n )

45 Lobbying nontaxable

amount

46 L o b b y i n g c e i l i n g a m o u n t

( 1 5 0 / o o f l i n e 4 5 ( e ) )

47 T o t a l l o b b y i n g

e x p en d i t u r e s

48 Grassroots n o n -

t a x a b l e amount

49 G r a s s r o o t s c e i l i n g a m o u n t

( 1 5 0 % o f l i n e 4 8 ( e ) )

50 Grassroots l o b b y i n g

e x p en d i t u r e sP-Bobbying A c t i v i t y by Nonelecting Public C h a r i t i e s( F o r r e p o r t i n g o n l y by organizations t h a t d i d n o t complete P ar t V I- A ) (See i n s t r u c t i o n s . ) N/A

During t h e y e a r, d i d t h e o r g a n i z at i o n attempt t o i n f l u e n c e n a t i o n a l , s t a t e o r l o ca l l eg i s la t i o n , i n c l u d i n g any

attempt t o i n f l ue n ce p u b l i c o p i n i o n on a l e g i s l a t i v e matter o r referendum, through t h e use o f :Y es No Amount

a V ol un t e er s .

b Paid s t a f f o r manageme nt ( I n c l u d e compensation i n expenses r e p o r t e d on l i n e s c through h . ) . .

c Media advertisements

d M a i l i n g s t o members, l e g i s l a t o r s , o r t h e p u b l i c . .

e P u b l i c at i o n s , or published o r broadcast statements . . . .

f Grants t o o t h e r o r g a n i z at i o n s f o r l o b b y i n g purposes

g D i r e c t c o n t a c t w i t h l eg i s la t or s , t he ir s t a f f s , governme nt o f f i c i a l s , o r a l e g i s l a t i v e body

h R a l l i e s , demonstrations, seminars, conventions, speeches, l ec t ur es , o r any o t h e r means . .

i T o t a l l o b b y i n g expenditures (add l i n e s c through h . ) .

I f ' Y e s ' t o any o f t h e above, a l s o a t t ac h a statement g i v i n g a d e t a i l e d d e s c r i p t i o n o f t h e l o b b y i n g a ct i v i t i e s .

BAA S c h e d u l e A ( F o r m 9 9 0 o r 9 9 0 - E Z ) 2 0 0 5

TEEA0 40 5L 08/08/05


9/11

S c h e d u l e A ( F o r m 9 9 0 o r 9 9 0 - E Z ) 2 0 0 5 PFHOF ENSHRINEES ASSISTANCE FOUNDAT 34-1962043 P a g e 6

P a r t V I I Information Regarding Transfers To a n d Transactions and Relatio nships Wi t h Noncharitable

Exempt O r g a n i z a t i o n s ( S e e i n s t r u c t i o n s )

5 1 Did t h e r e p o r t i n g o r g a n i z a t i o n d i r e c t l y o r i n d i r e c t l y engage i n any o f t h e f o l l o w i n g w i t h any o t h e r o r g a n i z a t i o n described i n s ec ti o n 5 0 1 (c )

o f t h e Code ( o t h e r than s e c t i o n 5 0 1 ( c ) ( 3 ) o r g a n i z a t i o n s ) o r i n s e c t i o n 5 2 7 , r e la ti ng t o p o l i t i c a l o r g a n i z a t i o n s ?

a Transfers from t h e r e p o r t i n g o r g a n i z a t i o n to a noncharitable exempt o r g a n i z a t i o n o f : Ye s No(i)Cash . . 5 1 a ( I ) X

( i i ) O t h e r a s s e t s . . . . . . . . a i i Xb Other t r a n s a c t i o n s .

( i ) S a l e s o r exchanges o f assets w i t h a noncharitable exempt o r g a n i z a t i o n . b ( I ) X(ii)Purchases o f assets from a noncharitable exempt o r g a n i z a t i o n b i i X( i ii ) Re n ta l o f f a c i l i t i e s , equipment, o r o t h e r assets . . b i i i X(iv)Reimbursement arrangements b ( i v ) X(v)Loans o r l o a n guarantees. . . . . b ( v ) X(vi)Performance o f s e r v i c e s o r membership o r f u n d r a i s i n g s o l i c i t a t i o n s . . . . b v i ) X

c Sharing o f f a c i l i t i e s , equipment, m a i l i n g l i s t s , o t he r a ss et s, o r p a i d employees . . . c Xd I f t h e answer t o an y o f t h e above i s ' Y e s , ' complete t h e f o l l o w i n g s c h e d u l e . Column ( b) should always s h o w t h e f a i r market v a l u e o f

t h e goods, o t h e r a s s e t s , o r s e r v i c e s g i v e n by t h e r e p o r t i n o r g a n i z a t i o n . I f t h e o r g a n i z a t i o n received l e s s than f a i r market v a l u e i n

any t r a n s a c t i o n o r sharing arrangement, s h o w i n column d t h e v a l u e o f t h e goods, o t he r a ss et s, o r s e r v i c e s r e c ei v e d:

( a ) ( b ) ( c ) ( d )

L i n e n o . Amount i n v o l v e d Name o f n o n c h a r i t a b l e exempt o r g a n i z a t i o n D e s c r i p t i o n o f t r a n s f e r s , t r a n s a c t i o n s , a n d s h a r i n g a r r a n g e m e n t s

N/

52 a I s t h e o r g an i za t io n d i r e c t l y o r i nd i re c tl y a f f il ia te d w i t h , o r r e l a t e d t o , one o r more tax-exempt organizations

described i n s e c t i o n 501 ( c ) o f t h e Code ( o t h e r th an s e c t i o n 5 0 1 ( c ) ( 3 ) ) o r i n s e c t i o n 527? F] Ye s XM No

TEEA0406L 0 8 / 0 8 / 0 5

BAA S c h e d u l e A ( F o r m 9 9 0 o r 9 9 0 - E Z ) 2005


10/11

2005, FEDERAL STATEMENTS PAGE 1PFHOF ENSHRINEES ASSISTANCE FOUNDATION 3 4 - 1962043

STATEMENT 1FORM 990 -EZ , PART I , LINE 16OTHER EXPENSESAMORTIZATION $ 4,732.INSURANCE 1,017.

TAXES/FEES 550.

TOTAL 6,299.

STATEMENT 2FORM 9 9 0 - E Z , PART I I , LINE 24OTHER ASSETS

BEGINNING ENDING

ACCOUNTS RECEIVABLE . . . $ 1,380. $ 0 .NET INTANGIBLE ASSETS 9,464. 4,732.PREPAID E XPE NS ES AN D DEFERRED CHARGES 492. 525.

TOTAL 11,336. 5,257.

STATEMENT 3FORM 990-EZ , PART I I , LINE 26TOTAL LIABILITIESBEGINNING ENDING

ACCOUNTS PAYABLE A ND AC CRUE D EXPENSES.. . . . . . $ 2 7 5 0 . , $ 1 573.

TOTAL 2,750. 73.

STATEMENT 4FORM 990-EZ , PART I I IORGANIZATION ' S PRIMARY EXEMPT PURPOSETHE PFHOF ENSHRINEES ASSISTANCE FOUNDATION IS AN ORGANIZATI ON DEDICATED TOPROVIDING FINANCIAL ASSISTANCE TO, OR FOR THE BENEF IT OF, POOR, NEEDY ORDISTRESSED INDIVIDUALS WHO ARE ENSHRINED IN THE PRO FOOTBALL HALL OF FAME; AND/ORTHEIR POOR, NEEDY OR DISTRESSED FAMILY MEMBERS.

STATEMENT 5FORM 990-EZ , PART I VLIST OF OFFICERS , DIRECTORS , TRUSTEES , AND KEY EMPLOYEES

TITLE AND CONTRI- EXPENSE

AVERAGE HOURS COMPEN- BUTION TO ACCOUNT/NAME A ND ADDRES S PER WEEK DEVOTED SATION EBP & DC OTHER

JOHN MUHLBACH, JR PRESIDENT & DIR $ 0 . $ 0 . $ 0 .224 LINCOLN WAY E 0MASSILLON, OH 44 6 4 6


11/11

2005' FEDERAL STATEMENTS PAGE 2PFHOF ENSHRINEES ASSISTANCE FOUNDATION 34-1962043

STATEMENT 5 (CONTINUED)FORM 990-EZ, PART I VLIST OF OFFICERS , DI R E CT OR S , T R US T E E S , AND KEY EMPLOYEES

T I T L E AND CONT RI - EXPENS E

AVERAGE HOURS COMPE N- BUTI ON T O ACCOUNT/

NAME AND ADDRESS PE R WE EK DE VOT E D S AT I ON E BP & DC OTHERDONALD JAKEWAY VICE PRES & DI R $ 0 . $ 0 . $ 0 .

30 0 MADISON AVE, S U I T E 270 0

TOLE DO, OH 43604

DAVID ROBINS ON SECRET ARY & DI R 0 . 0 . 0 .

406 S ROSE BLVD 0

AKRON, OH 44320

ROGER BE T T I S TREASURER & DI R 0 . 0 . 0 .

7084 ALLI ANCE RD 0

MALVERN, OH 44644

K S ( B U D ) ADAMS, JR DIRECTOR 0 . 0 . 0 .

4400 POST OAK PKWY, S U I T E 2800 0

HOUST ON, T X 77027

L AMAR HU NT DIRECTOR 0 . 0 . 0 .

1601 E L M ST, SUITE 4000 0

DALL AS, T X 7 5 2 0 1

GAL E S AYE RS DIRECTOR 0 . 0 . 0 .

1313 R I T CH I E CT , S U I T E 40 7 0

CHICAGO, IL 60 610

TOTAL 0 . $ 0 . 0 .

STATEMENT 6FORM 990-EZ, PART VREGARDING TRANSFERS ASSOCIATED WITH PERSONAL BENEFIT CONTRACTS(A ) DI D T HE OR GANI Z AT I ON, D UR I NG THE YEAR, R E C E IVE ANY FUNDS, DIRECTLY OR

I NDI RE CT LY, T O PAY PR E MI U MS ON A PERS ONAL BENEFIT CONTRACT? NO

(B) DI D T HE OR GANI Z A T I ON , DURING T HE YEAR, P AY PR E MI U MS , D I R E C T L Y OR

I NDI RE CT L Y, ON A PERS ONAL BE NE FI T C ONT R AC T ? NO

pfhof enshrinees assistance foundation 2005

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