J H & T A Forsyth Trust 1002070 Fbo, Forsyth Dental Infirmary Children in Providence, Rhode Island (RI)

J H & T A Forsyth Trust 1002070 Fbo, Forsyth Dental Infirmary Children
Employer Identification Number (EIN)	046007905
Name of Organization	J H & T A Forsyth Trust 1002070 Fbo
Secondary Name	Forsyth Dental Infirmary Children
In Care of Name	Kirkpatrick & Lockhart Llp
Address	PO BOX 1802, Providence, RI 02901-1802
Subsection	Charitable Organization
Ruling Date	02/2001
Deductibility	Contributions are deductible
Foundation	Organizations operated solely for the benefit of and in conjunction with organizations described in 10 through 16 above
Organization	Trust
Tax Period	09/2012
Assets	$10,000,000 to $49,999,999
Income	$10,000,000 to $49,999,999
Filing Requirement	990 (all other) or 990EZ return
Asset Amount	$19,848,509
Amount of Income	$10,177,008
Form 990 Revenue Amount	$626,525
National Taxonomy of Exempt Entities (NTEE)	Health - General and Rehabilitative: Single Organization Support

Non-representatives - add comments:

Amount of income in 2012: $10,177,008

This organization:	$10,177,008
Other organizations performing similar types of work:	$6,088,020

Assets in 2012: $19,848,509

This organization:	$19,848,509
Other organizations performing similar types of work:	$26,323,448

Expenses in 2012: $1,630,113

J H & T A Forsyth Trust 1002070 Fbo, Forsyth Dental Infirmary Children:	$1,630,113
Other organizations performing similar types of work:	$1,941,347

Income to expenses ratio in 2012: 6.2

J H & T A Forsyth Trust 1002070 Fbo, Forsyth Dental Infirmary Children:	6.2
Other organizations performing similar types of work:	2.7

Expenses allocated to program services in 2002: 94.7%

This organization:	94.7%
Other organizations performing similar types of work:	84.3%

Grants share in income in 2012: 0.0%

This organization:	0.0%
Other organizations performing similar types of work:	18.7%

Financial snapshot ($)

Revenue for 2012

Functional expenses for 2012

Statements Regarding Other IRS Filings and Tax Compliance (for 2012)
Did the organization have unrelated business gross income of $1,000 or more during the year?	No
Initiation fees and capital contributions	$0
Gross receipts for public use of club facilities	$0
Gross income from members or shareholders	$0
Gross income from other sources	$0

Statement of Revenue (for 2012)
Total revenue	$626,525
Contributions, Gifts, Grants and Other Similar Amounts	$0
Program Service Revenue	$0
Other Revenue
Investment income (including dividends, interest, and other similar amounts)	$299,662
Income from investment of tax-exempt bond proceeds	$0
Royalties	$0
Net rental income	$0
Net gain from sales of assets other than inventory	$326,863
Gross amount from sales of assets other than inventory (Securities / Other)	$9,877,346 / $0
Less: cost or other basis and sales expenses (Securities / Other)	$9,550,483 / $0
Gain or (loss) (Securities / Other)	$326,863 / $0
Net income from fundraising events	$0
Net income from gaming activities	$0
Net income from sales of inventory	$0
Miscellaneous Revenue	$0

Statement of Functional Expenses (for 2012)
Total functional expenses	$1,630,113
Compensation of current officers, directors, trustees, and key employees	$90,393
Other salaries and wages	$0
Payroll taxes	$0
Professional fundraising services	$0
Other	$1,539,720

Balance Sheet (for 2012)
Total assets	$19,848,509
Total liabilities	$0
Total net assets or fund balances	$19,848,509
Retained earnings, endowment, accumulated income, or other funds	$0

Reason for Public Charity Status (for 2012)
The organization is not a private foundation because it is:	An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2)

	2000	2001	2002
Revenue, Expenses, and Changes in Net Assets or Fund Balances
Total revenue	$426,125	$-841,005	$1,077,496
Contributions, gifts, grants, and similar amounts received	$0	$0	$0
Contributions to donor advised funds
Direct public support	$0	$0	$0
Indirect public support	$0	$0	$0
Government contributions (grants)	$0	$0	$0
Program service revenue including government fees and contracts	$0	$0	$0
Membership dues and assessments	$0	$0	$0
Interest on savings and temporary cash investments	$165,798	$70,253	$47,279
Dividends and interest from securities	$1,199,281	$1,258,625	$1,141,014
Net rental income or (loss)	$0	$0	$0
Gross rents	$0	$0	$0
Less: rental expenses	$0	$0	$0
Other investment income	$0	$0	$0
Gain or (loss) from sales of assets other than inventory	$-1,124,114	$-2,169,883	$-110,797
Gross amount from sales of assets other than inventory	$33,260,868	$44,302,251	$31,492,566
Less: cost or other basis and sales expenses	$34,384,982	$46,472,134	$31,603,363
Net income or (loss) from special events and activities	$0	$0	$0
Gross revenue	$0	$0	$0
Less: direct expenses other than fundraising expenses	$0	$0	$0
Gross profit or (loss) from sales of inventory	$0	$0	$0
Gross sales of inventory, less returns and allowances	$0	$0	$0
Less: cost of goods sold	$0	$0	$0
Other revenue	$185,160	$0	$0
Total expenses	$3,319,669	$3,287,693	$2,993,284
Program services	$3,097,593	$3,099,985	$2,835,217
Management and general	$222,076	$187,708	$158,067
Fundraising	$0	$0	$0
Payments to affiliates	$0	$0	$0
Net assets or fund balances at end of year	$38,096,402	$33,613,833	$31,698,045
Excess or (deficit) for the year	$-2,893,544	$-4,128,698	$-1,915,788
Net assets or fund balances at beginning of year	$40,989,946	$38,096,402	$33,613,833
Other changes in net assets or fund balances	$0	$-353,871	$0

	Total	Program services	Management and general	Fundraising
Statement of Functional Expenses (for 2002)
Total functional expenses	$2,993,284	$2,835,217	$158,067	$0
Grants paid from donor advised funds
Other grants and allocations		$2,835,217
Specific assistance to individuals		$0
Benefits paid to or for members		$0
Compensation of current officers, directors, key employees, etc.	$156,966	$0	$156,966	$0
Compensation of former officers, directors, key employees, etc.
Compensation and other distributions, not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B)
Salaries and wages of employees not included above	$0	$0	$0	$0
Pension plan contributions not included above	$0	$0	$0	$0
Employee benefits not included above	$0	$0	$0	$0
Payroll taxes	$0	$0	$0	$0
Professional fundraising fees	$0	$0	$0	$0
Accounting fees	$0	$0	$0	$0
Legal fees	$0	$0	$0	$0
Supplies	$0	$0	$0	$0
Telephone	$0	$0	$0	$0
Postage and shipping	$0	$0	$0	$0
Occupancy	$0	$0	$0	$0
Equipment rental and maintenance	$0	$0	$0	$0
Printing and publications	$0	$0	$0	$0
Travel	$0	$0	$0	$0
Conferences, conventions, and meetings	$0	$0	$0	$0
Interest	$0	$0	$0	$0
Depreciation, depletion, etc.	$0	$0	$0	$0
Other expenses not covered above	$1,101	$0	$1,101	$0

	2000	2001	2002
Balance Sheets
Total assets	$38,096,402	$33,613,833	$31,698,045
Cash - non-interest-bearing	$0	$0	$12,193
Savings and temporary cash investments	$3,447,917	$4,172,137	$63,463
Accounts receivable less allowance for doubtful accounts	$0	$0	$0
Pledges receivable less allowance for doubtful accounts	$0	$0	$0
Grants receivable	$0	$0	$0
Receivables from current and former officers, directors, trustees, and key employees	$0	$0	$0
Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B)
Other notes and loans receivable less allowance for doubtful accounts	$2,777,500	$0	$0
Inventories for sale or use	$0	$0	$0
Prepaid expenses and deferred charges	$0	$0	$0
Investments - publicly-traded securities
Investments - other securities	$31,870,985	$29,441,696	$31,622,389
Investments - land, buildings, and equipment less accumulated depreciation	$0	$0	$0
Investments - other	$0	$0	$0
Land, buildings, and equipment less accumulated depreciation	$0	$0	$0
Other assets, including program-related investments	$0	$0	$0
Total liabilities	$0	$0	$0
Accounts payable and accrued expenses	$0	$0	$0
Grants payable	$0	$0	$0
Deferred revenue	$0	$0	$0
Loans from officers, directors, trustees, and key employees	$0	$0	$0
Tax-exempt bond liabilities	$0	$0	$0
Mortgages and other notes payable	$0	$0	$0
Other liabilities	$0	$0	$0
Total liabilities and net assets/fund balances	$38,096,402	$33,613,833	$31,698,045
Total net assets or fund balances	$38,096,402	$33,613,833	$31,698,045

	2000	2001	2002
Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
Total revenue	$0	$0	$0
Total revenue, gains, and other support per audited financial statements	$0	$0	$0
Other expenses	$0	$0	$0
Net unrealized gains on investments	$0	$0	$0
Donated services and use of facilities	$0	$0	$0
Recoveries of prior year grants	$0	$0	$0
Other	$0	$0	$0
Other revenue	$0	$0	$0
Investment expenses	$0	$0	$0
Other	$0	$0	$0

	2000	2001	2002
Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
Total expenses	$0	$0	$0
Total expenses and losses per audited financial statements	$0	$0	$0
Other revenue	$0	$0	$0
Donated services and use of facilities	$0	$0	$0
Prior year adjustments	$0	$0	$0
Losses	$0	$0	$0
Other	$0	$0	$0
Other expenses	$0	$0	$0
Investment expenses	$0	$0	$0
Other	$0	$0	$0

Current Officers, Directors, Trustees, and Key Employees

Total number of officers, directors, and trustees permitted to vote on organization business at board meetings	0
Are any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, related to each other through family or business relationships?
Do any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, receive compensation from any other organizations, whether tax exempt or taxable, that are related to the organization?
Does the organization have a written conflict of interest policy?

Other Information
Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return, and has it filed a tax return on Form 990-T for this year?	No
Was there a liquidation, dissolution, termination, or substantial contraction during the year?	No
Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc., to any other exempt or nonexempt organization?	No
Direct and indirect political expenditures	$0
Did the organization file Form 1120-POL for this year?	No
Were substantially all dues nondeductible by members?
Did the organization make only in-house lobbying expenditures of $2,000 or less?
Dues, assessments, and similar amounts from members	$0
Section 162(e) lobbying and political expenditures	$0
Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices	$0
Taxable amount of lobbying and political expenditures	$0
Does the organization elect to pay the section 6033(e) tax on the amount above?
If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount above to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year?
Initiation fees and capital contributions	$0
Gross receipts for public use of club facilities	$0
At any time during the year, did the organization, directly or indirectly, own a controlled entity within the meaning of section 512(b)(13)?
Amount of tax imposed on the organization during the year under: section 4911	$0
Amount of tax imposed on the organization during the year under: section 4912	$0
Amount of tax imposed on the organization during the year under: section 4955	$0
Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year?	No
Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958	$0
Amount of tax above, reimbursed by the organization	$0
At any time during the tax year, was the organization a party to a prohibited tax shelter transaction?
Did the organization acquire a direct or indirect interest in any applicable insurance contract?
Did the supporting organization, or a fund maintained by a sponsoring organization, have excess business holdings at any time during the year?
Number of employees employed in the pay period that includes March 12, 2006	0

	Unrelated business income		Excluded by section 512, 513, or 514		Related or exempt function income
Analysis of Income-Producing Activities (for 2002)
	Business code	Amount	Exclusion code	Amount	Related or exempt function income
Total		$0		$1,077,496	$0
Program service revenue
Program service revenue 1	000000	$0	00	$0	$0
Program service revenue 2	000000	$0	00	$0	$0
Program service revenue 3	000000	$0	00	$0	$0
Program service revenue 4	000000	$0	00	$0	$0
Program service revenue 5	000000	$0	00	$0	$0
Medicare/Medicaid payments	000000	$0	00	$0	$0
Fees and contracts from government agencies	000000	$0	00	$0	$0
Membership dues and assessments	000000	$0	00	$0	$0
Interest on savings and temporary cash investments	000000	$0	Dividends, interest, payments with respect to securities loans, annuities, income from notional principal contracts, loan commitment fees, and other substantially similar income from ordinary and routine investments excluded by section 512(b)(1)	$47,279	$0
Dividends and interest from securities	000000	$0	Dividends, interest, payments with respect to securities loans, annuities, income from notional principal contracts, loan commitment fees, and other substantially similar income from ordinary and routine investments excluded by section 512(b)(1)	$1,141,014	$0
Net rental income or (loss) from real estate
debt-financed property	000000	$0	00	$0	$0
not debt-financed property	000000	$0	00	$0	$0
Net rental income or (loss) from personal property	000000	$0	00	$0	$0
Other investment income	000000	$0	00	$0	$0
Gain or (loss) from sales of assets other than inventory	000000	$0	Gain (or loss, to the extent allowed) from the sale of investments and other non-inventory property and from certain property acquired from financial institutions that are in conservatorship or receivership (sections 512(b)(5) and 512(b)(16)(A))	$-110,797	$0
Net income or (loss) from special events	000000	$0	00	$0	$0
Gross profit or (loss) from sales of inventory	000000	$0	00	$0	$0
Other revenue	000000	$0	00	$0	$0

EIN of corporation, partnership, or disregarded entity	Percentage of ownership interest	Total income	End-of-year assets
Information Regarding Taxable Subsidiaries and Disregarded Entities (for 2002)
	0%	$0	$0
	0%	$0	$0
	0%	$0	$0
	0%	$0	$0

Compensation	Contributions to employee benefit plans & deferred compensation	Expense account and other allowances
Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees (for 2002)
$0	$0	$0
$0	$0	$0
$0	$0	$0
$0	$0	$0
$0	$0	$0

Total number of other employees paid over $50,000	0

Total number of other employees paid over $50,000

Statements About Activities (for 2002)
Expenses paid or incurred in connection with the lobbying activities	$0
Did the organization receive or hold an easement for conservation purposes, including easements to preserve open space, the environment, historic land areas or historic structures?
Did the organization provide credit counseling, debt management, credit repair, or debt negotiation services?
Did the organization maintain any donor advised funds?
Did the organization make any taxable distributions under section 4966?
Did the organization make a distribution to a donor, donor advisor, or related person?
The total number of donor advised funds owned at the end of the tax year
The aggregate value of assets held in all donor advised funds owned at the end of the tax year
The total number of separate funds or accounts owned at the end of the tax year (excluding donor advised funds included above) where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts
The aggregate value of assets held in all funds or accounts included above at the end of the tax year

Reason for Non-Private Foundation Status
The organization is not a private foundation because it is	Not controlled by disqualified persons/supports non private foundation

	1999	2000	2001
Support Schedule
Total	$0	$0	$0
Gifts, grants, and contributions received	$0	$0	$0
Membership fees received	$0	$0	$0
Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is related to the organization's charitable, etc., purpose	$0	$0	$0
Gross income from interest, dividends, amounts received from payments on securities loans (section 512(a)(5)), rents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organization after June 30, 1975	$0	$0	$0
Net income from unrelated business activities not included above	$0	$0	$0
Tax revenues levied for the organization's benefit and either paid to it or expended on its behalf	$0	$0	$0
The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charge	$0	$0	$0
Other income	$0	$0	$0

Lobbying Expenditures by Electing Public Charities (for 2002)
Total exempt purpose expenditures	$0
Total lobbying expenditures	$0
Total lobbying expenditures to influence public opinion (grassroots lobbying)	$0
Total lobbying expenditures to influence a legislative body (direct lobbying)	$0
Other exempt purpose expenditures	$0
Lobbying nontaxable amount	$0
Grassroots nontaxable amount	$0

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Id	Name	Address	State	Established	Total Income
Organizations performing similar types of work
1	Miriam Hospital Foundation	167 Point Street, Providence, RI 02903-4771	RI	1995-04	$349,060,011
2	Rhode Island Hospital Foundation	167 Point Street, Providence, RI 02903-4771	RI	1994-05	$321,146,723
3	Women & Infants Corporation	101 Dudley St, Providence, RI 02905-2401	RI	1988-10	$17,270,155
4	J H & T A Forsyth Trust 1002070 Fbo, Forsyth Dental Infirmary Children	PO BOX 1802, Providence, RI 02901-1802	RI	2001-02	$10,177,008
5	Trust U/W Mary Alice Fitch 2-3576	PO BOX 1802, Providence, RI 02901-1802	RI	1973-07	$4,265,524
6	Ruth Charlton Mitchell Masson Fund For Charlton Memorial Hospital Inc, Charlton Earl P Et Al Ttee	PO BOX 1802, Providence, RI 02901-1802	RI	1997-08	$4,244,286
7	Caroline H Fabens Trust Uw 2-6308	PO BOX 1802, Providence, RI 02901-1802	RI	1972-10	$1,708,434
8	St Marys Rochester Methodist Hospital	PO BOX 1802, Providence, RI 02901-1802	RI	1997-10	$824,853
9	Eugene & Margaret M Blackford Memor Ial Fund A	PO BOX 1802, Providence, RI 02901-1802	RI	1984-04	$609,889
10	Caresource Management Group Co	230 N Main St, Dayton, OH 45402-1263	OH	2003-06	$387,634,367
11	Yakima Valley Memorial Hospital Charitable Foundation	2701 Tieton Dr, Yakima, WA 98902-3759	WA	1978-09	$4,387,844
12	Southeastern Regional Medical Center Foundation	PO BOX 1408, Lumberton, NC 28359-1408	NC	1999-09	$1,084,933
13	St Tammany Hospital Guild Inc	1202 S Tyler St, Covington, LA 70433-2330	LA	1999-11	$186,485
14	Trump Group-Green Foundation	4000 W Island Blvd Ph 2, Aventura, FL 33160-2540	FL	2002-10	$42
15	Bellevue Hospital Association	1400 West Main Street, Bellevue, OH 44811-9088	OH	2003-08	$0
16	Circus To Save Lives Inc	1103 Grand Prix Dr, St Charles, MO 63303-6313	MO	2008-01	$0
17	Hertzler Halstead Hospital Auxiliary Inc	710 Pine St, Halstead, KS 67056-2422	KS	2001-03	$0
18	Lourdes Campus Fund	2300 Watkins Lake Rd, Waterford, MI 48328-1439	MI	1946-03	$0
19	Man Area Health Care Incorporated	26 1/2 Main Ave, Logan, WV 25601-3331	WV	2003-03	$0
20	Providing Every American Child Education And Well Being Organizat, P E A C E And Well Being Organizati	PO BOX 150716, Austin, TX 78715-0716	TX	2001-03	$0

Number of organizations performing similar types of work

Alaska	1
Alabama	5
Arkansas	5
Arizona	2
California	36
Colorado	8
Connecticut	10
District of Columbia	2
Delaware	1
Florida	18
Georgia	5
Hawaii	3
Iowa	10
Idaho	2
Illinois	25
Indiana	10
Kansas	5
Kentucky	4
Louisiana	9
Massachusetts	13
Maryland	18
Maine	6
Michigan	12
Minnesota	7

Missouri	13
Mississippi	3
North Carolina	15
North Dakota	1
Nebraska	5
New Hampshire	1
New Jersey	14
New Mexico	2
Nevada	1
New York	27
Ohio	37
Oklahoma	3
Oregon	2
Pennsylvania	30
Rhode Island	9
South Carolina	3
South Dakota	2
Tennessee	5
Texas	22
Virginia	18
Washington	9
Wisconsin	6
West Virginia	5

Total

450

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