form 990-pf return of private foundation or section 4947(a...
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Form 990-PF Return of Private Foundation OMB No 1545-0052
or Section 4947(a)(1) Nonexempt Charitable Trust
2006Depatyhent of the Treasury Treated as a Private FoundationInternal Revenue Service Note The foundation may be able to use a copy of this return to satisfy state reporting requirements
For calendar year 2006 , or tax year beginning , and ending
r: !.hark all that annly F__ I Initial return F-1 Final return Amended return [1 Address chance [1 Name chance
Use the IRS Name of foundation A Employer identification number
labelOtherwise , HE GOERGEN FOUNDATION, INC. 06-1180035
print Number and street (or P O box number if mail is not delivered to street address) Roomfsuite B Telephone numberortype /O THOMAS E. FINN, PC, 35 MASON STREE 203-661-7760
See SpecificInstructions
City or town, state, and ZIP code C If exemption application is pending , check here ►
REENWICH, CT 06830 D 1. Foreign organizations , check here ►H Check a of organization X Section 501 c 3 exempt private foundationtype ()()
2 Fore i gn organizations meeting the 85% test,check here and attach computation
0 Section 4947(a)(1) nonexempt charitable trust 0 Other taxable private foundationrivate foundation status was terminatedE If
I Fair market value of all assets at end of year J Accounting method 0 Cash 0 Accrualp
under section 507(b)(1)(A), check here
(from Part 11, col (c), line 16) = Other ( specify) F If the foundation is in a 60-month termination► $ 14 5 0 9 2 0 7 . (Part 1, column (d) must be on cash basis) under section 507 ( b )( 1 ) B ), check here ►0part Analysis of Revenue and Expenses ( a) Revenue and (b ) Net investment ( c) Adjusted net (d) Disbursements
(The total of amounts in columns ( b), (c), and (d) may notnecessarily equal the amounts in column (a) expenses per books income income for charitable purposes
(cash basis only)
1 Contributions , gifts, grants, etc , received NIA
2 Check ► F_X ] if the foundabon is not required to attach Sch B
3I n terestnvestment9s
and tempo rary 50,711. 50,711. STATEMENT 1
4 Dividends and interest from securities 178,137. 174,778. STATEMENT 2
5a Gross rents
b Net rental income or (loss)
6a Net gain or (loss ) from sale of assets not on line 10 711,245 .
cGross sales once for all 1 , 541 , 702.b assets on line 6a
y 7 Capital gain net income ( from Part IV, line 2) 711,245. 0
8 Net short -term capital gain
9 Income modificationsGross sales less returns
1 Oa and allowances
b Less Cost of goods sold
c Gross profit or (loss)
I 11 Other income 371,478. 371,478. STATEMENT 3
12 Total Add lines 1 through 11 1,311,571. 1,308,212.
13 Compensation of officers , directors , trustees , etc 0 • 0 • 0
14 Other employee salaries and wages
15 Pension plans, employee benefitsto
16a Legal fees
a b Accounting fees STMT 4 15,461. 0. 15,461.
W c Other professional fees STMT 5 108,977. 91,500. 17,477.
17 Interest 14,143. 6,071. 0.
18 Taxes STMT 6 19,990. 0. 0.
•0E 19 Depreciation and depletion
E 20 Occupancy
a 21 Travel, conferences , and meetings 2,726. 0 . 2,726.
r- 22 Printing and publications
m 23 Other expenses STMT 7 96,110. 84,438. 0.
24 Total operating and administrative
c. expenses . Add lines 13 through 23 257 , 407. 182 0 0 9. 35 , 664.
0 25 Contributions , gifts, grants paid 733, 852. 733,852.
26 Total expenses and disbursements.
Add lines 24 and 25 991,259. 182,009. 769 516.
27 Subtract line 26 from line 12
a Excess of revenue over expenses and disbursements 320,312 .
b Net investment income ( if negative , enter -0-) 1,126,203.
c Adjusted net income (if negative , enter -0-) N/A
LHA For Privacy Act and Paperwork Reduction Act Notice , see the instructions Form 990-PF (2006)62350101-29-07 b\k130-37.-U"
10421106 739634 7217 2006.07000 THE GOERGEN FOUNDATION, INC 7217 1
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Form 990-PF 1900fi1 THR GOERGFN FOUNDATION. TNC. 06-1180035 Pane2
A"fiedschedulesand amounts in the descnpbonI B l Sh t
Beginning of year End of year^ a ance ee sPart 11 column should beforend-of-year amounts only V( a) Book Value ( b) Book alue ( c) Fair Market Value
1 Cash - non-interest -beanng
2 Savings and tempora ry cash investments 1,800,025. 842,479. 842,479.3 Accounts receivable ► 500,233.
Less allowance for doubtful accounts ► 3,530. 500,233. 500,233.4 Pledges receivable ►
Less allowance for doubtful accounts ►5 Grants receivable
6 Receivables due from officers, directors , trustees , and other
disqualified persons
7 other notes and loans nxrmble ►
Less allowance for doubtful accounts ►8 Inventories for sale or use
9 Prepaid expenses and deferred charges
a 10a Investments - U S and state government obligations
b Investments - corporate stock STMT 9 1,062,630. 2,544,334. 4,918,577.c Investments - corporate bonds
11 investments - land buildings . and equipment basis ►
Less . accumulated depreciation
12 Investments - mortgage loans
13 Investments - other STMT 11 6,202,543. 6,142,209. 8,247,918.14 Land , buildings, and equipment basis ► 2 7 , 7 5 1 .
Less accumulated depreciation STMT 10110- 2 7 , 7 51 .15 Other assets ( describe ► ) 203,058. 0. 0.
16 Total assets to be com p leted b y all filers 9 271 , 786. 10 , 029 , 255. 14 , 509 , 207.17 Accounts payable and accrued expenses
18 Grants payable
u) 19 Deferred revenue
•`-' 20 Loans from officers , directors, trustees , and other disqualified persons
21 Mortgages and other notes payable
J 22 Other liabilities ( describe ►
23 Total liabilities (add lines 17 throu g h 22 ) 0. 0.
Foundations that follow SFAS 117 , check here ► 0and complete lines 24 through 26 and lines 30 and 31
N
24 Unrestricted
a 25 Temporarily restrictedTaM 26 Permanently restricted
Foundations that do not follow SFAS 117, check here ► LXLL and complete lines 27 through 310U, 27 Capital stock , trust principal , or current funds 0. 0.
28 Paid-fn or capital surplus, or land, bldg , and equipment fund 0. 0.
a 29 Retained earnings, accumulated income , endowment , or other funds 9,271,786. 10,029,255.
Z 30 Total net assets or fund balances 9 ,271,786. 10,029,255
131 Total liabilities and net assets and balances 9 , 271 , 786. 10 , 0 29 , 255
04Ill Analysis of Changes in Net Assets or Fund Balances
1 Total net assets or fund balances at beginning of year - Part II, column (a), line 30
(must agree with end-of-year figure reported on prior year's return)
2 Enter amount from Part I, line 27a
3 Other increases not included in line 2 (itemize) ►4 Add lines 1, 2, and 3
5 Decreases not included in line 2 (itemize) ►6 Total net assets or fund balances at end of year (line 4 minus line 51- Part II. column (bl. line 30
62351103-08-07
9,271,786.
SEE STATEMENT 8
320,312.437,157.
10,029,255.0.
10,029,255.Form 990-PF (2006)
410421106 739634 7217 2006.07000 THE GOERGEN FOUNDATION, INC 7217 1
Form 990-PF (2006) THE GOERGEN FOUNDATION , INC. 06-1180035 Page 3Part IV "Canital Gains and Losses for Tax on Investment Income
(a) List and describe the kind ( s) of property sold (e g , real estate ,2-story buck warehouse , or common stock , 200 shs MLC Co )
( b How acquired
D -PurchaseDonation
(c Date acquired(mo , day, yr )
( d) Date sold( mo , day, yr )
1a GABELLI 300697, PER SCH A ATTCH'D P VARIOUS VARIOUS
b AR SCHMEIDLER 1944, PER SCH B ATTCH'D P VARIOUS VARIOUS
c GOLDMAN CAPITAL 00141, PER SCH C ATTCH'D P VARIOUS VARIOUS
d GOLDMAN CAPITAL 00141, PER SCH C ATTCH'D P VARIOUS VARIOUS
e CAPITAL GAINS DIVIDENDS
(e) Gross sales puce ( f) Depreciation allowed(or allowable )
( g) Cost or other basisplus expense of sale
( h) Gain or (loss)(e) plus ( f) minus (g)
a 444,636. 413,003. 31,633.b 231,575. 220,627. 10,948.
c 100,756. 108,617. <7,861.:
d 124,266. 88,210. 36,056.e 640 ,469. 1 1 640,469.
Complete only for assets showing gain in column ( h) and owned by the foundation on 12/31 /69 (I) Gains ( Col (h) gain minus
(i) F M V as of 12/31/69(j) Adjusted basisas of 12 /31/69
(k) Excess of col (i)over col ( 1), if any col
th a n -0-)-) orcol (k),
bu tot
le ssLosse s (f rom
a 31,633.b 10,948.C <7,861.:d 36,056.e 640,469.
2If (loss) li ne
enter -0er -0-in
in PaPart
rt II ,Capital gain net income or (net capital loss ) f loss
als oli n e
77I
2 711,245.
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)If (loss), enter -0 - in Part I, line 8 3 N/A
I Part v 1 uuatttication Under Section 494U(e) for Reduced 1 ax 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? 0 Yes [X No
If'Yes," the foundation does not qualify under section 4940(e) Do not complete this part1 Enter the aooroonate amount in each column for each year . see instructions before makino any entries
Base period yearsCalendar year or tax year be g innin g in Adjusted qualifying distributions Net value of noncha)ntable use assets
Distribution ratio(col (b) divided by col (c))
2005 720,285. 12,933,866. .0556902004 435,921. 12,275,592. .0355112003 694,846. 11,926,479. .0582612002 1,825,536. 11,992,518. .1522232001 1 , 211 , 426 . 13 318 746. .090956
2 Total of line 1, column (d) 2 . 3 9 2 6 4 1
3 Average distribution ratio for the 5-year base period - divide
the foundation has been in existence if less than 5 years
the total on line 2 by 5, or by the number of years
3 . 0 7 8 5 2 8
4 Enter the net value of nonchantable - use assets for 2006 from Part X , line 5 4 13,783,758.
5 Multiply line 4 by line 3 5 1,082,411.
6 Enter 1% of net investment income ( 1 % of Part I, line 27b) 6 11 , 262.
7 Addlines5and6 7 1,093,673.
B Enter qualifying distributions from Part XII , line 4 8 769,516.
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rateSee the Part VI instructions
623521/01-29-07 Form 990-PF (2006)5
10421106 739634 7217 2006.07000 THE GOERGEN FOUNDATION , INC 7217 1
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Form990 -PF(2006) THE GOERGEN FOUNDATION , INC. 06-1180035 Page4
Part VI I ' Excise Tax Based on Investment Income (Section 4940(a), 4940 (b), 4940(e), or 4948 - see instructions)
1 a Exempt operating foundations described in section 4940(d)(2), check here ► and enter'N/A' on line 1
Date of ruling letter ( attach copy of ruling letter if necessary-see instructions)
b Domestic foundations that meet the section 4940(e) requirements in Part V, check here ► and enter 1% 1 22,524.
of Part I, line 27b
c All other domestic foundations enter 2% of line 27b Exempt foreign organizations enter 4% of Part I, line 12, col (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only Others enter -0-) 2 0.
3 Add lines 1 and 2 3 22,524.
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only Others enter -0-) 4 0.
5 Tax based on investment income . Subtract line 4 from line 3 If zero or less, enter -0- 5 22,524.
6 Credits/Payments
a 2006 estimated tax payments and 2005 overpayment credited to 2006 6a
b Exempt foreign organizations - tax withheld at source 6b
c Tax paid with application for extension of time to file (Form 8868) 6c 35,000.
d Backup withholding erroneously withheld 6d
7 Total credits and payments Add lines 6a through 6d 7 35,000.
8 Enter any penalty for underpayment of estimated tax Check here 0 If Form 2220 is attached 8 1,337.
9 Tax due If the total of lines 5 and 8 is more than line 7, enter amount owed ► 9
10 Overpayment . If line 7 is more than the total of lines 5 and 8, enter the amount overpaid ► 10 1 1,139.
11 Enter the amount of line 10 to be Credited to 2007 estimated tax ► 11 13 9 . 1 Refunded ► 11 0.
Part Vu -14 Statements Regarding Activities1 a During the tax year, did the foundation attempt to influence any national, state, or local legislation or did it participate or intervene in Yes No
any political campaign? l a X
b Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see instructions for definition)? lb X
If the answer is "Yes" to 1 a or 1 b, attach a detailed descnption 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 1120-POL for this year? 1 c X
d Enter the amount (If any) of tax on political expenditures (section 4955) imposed during the year
(1) On the foundation ► $ 0. (2) On 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? 2 X
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 3 X
4a Did the foundation have unrelated business gross income of $1,000 or more during the year' 4a X
b If'Yes " has it filed a tax return on Form 990-T for this year? 4b X
5 Was there a liquidation, termination, dissolution, or substantial contraction during the year? 5 X
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 la w
remain in the governing instrument? 6 X
7 Did the foundation have at least $5,000 in assets at any time during the year? 7 X
If "Yes, " complete Part ll, col (c), and Part XV
Ba Enter the states to which the foundation reports or with which it is registered (see instructions) ►CT
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 8b X
9 Is the foundation claiming status as a private operating foundation within the meaning of section 4942(I)(3) or 4942(1)(5) for calend ar
year 2006 or the taxable year beginning in 2006 (see instructions for Part XIV)' If "Yes," complete Part XIV 9 X
10 Did an y p ersons become substantial contributors durin g the tax year? It "Yes' attach a schedule listin g their names and addresses 10 X
Form 990-PF (2006)
62353101-29-07
610421106 739634 7217 2006.07000 THE GOERGEN FOUNDATION, INC 7217 1
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Form 990- PF (2006 ) THE GOERGEN FOUNDAT ION, INC. 06-1180035 Page5
Part VII-A Statements Regarding Activities Continued
11a At any time during the year, did the foundation , directly or indirectly , own a controlled entity within the meaning of section 512(b)(13)'
If 'Yes, attach schedule ( see instructions) 11a X
b If 'Yes, did the foundation have a binding written contract in effect on August 17 , 2006, covering the interest, rents , royalties, and
annuities described in the attachment for line 1la' N/A 11b
12 Did the foundation acquire a direct or indirect interest in any applicable insurance contract? 12 X
13 Did the foundation comply with the public inspection requirements for its annual returns and exemption application? 13 X
Web site address ► N/A
14 The books are in care of ► THOMAS E. FINN, P.C. Telephone no ► 203-661-7760I-ocatedat ► 35 MASON STREET, GREENWICH, CT ZIP+4 ►06830
15 Section 4947 ( a)(1) nonexempt charitable trusts filing Form 990 - PF in lieu of Form 1041 - Check here ►=and enter the amount of tax -exem pt interest received or accrued durin g the vear ► 15 N/A
Part VU-B Statements Regarding Activities for Which Form 4720 May Be RequiredFile Form 4720 if any item is checked in the "Yes" column , unless an exception applies . Yes 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' Yes EXI No
(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person' 0 Yes FXI No
(3) Furnish goods , services, or facilities to (or accept them from ) a disqualified person? 0 Yes LI No
(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? Yes 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 0 No
(6) Agree to pay money or property to a government officials (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 90 days ) 0 Yes No
b If any answer is Yes to 1a(1)-(6), did any of the acts fail to qualify under the exceptions described in Regulations
section 53 4941 ( d)-3 or in a current notice regarding disaster assistance ( see page 22 of the instructions ) ' N/A 1 b
Organizations relying on a current notice regarding disaster assistance check here ►c 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 tax year beginning in 20069 1 c X
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 tax year 2006, did the foundation have any undistributed income (lines 6d and 6e , Part XIII ) for tax year ( s) beginning
before 2006' Yes 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 ) N/A 2b
c If the provisions of section 4942 ( a)(2) are being applied to any of the years listed in 2a, list the years here
110.
3a Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at any time
during the year? Yes MX No
b If 'Yes ' did it have excess business holdings in 2006 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 2006) N/A 3b
4a Did the foundation invest during the year any amount in a manner that would j eopardize its charitable purposes? 4a X
b Did the foundation make any investment in a prior year ( but after December 31, 1969 ) that could jeopardize its charitable purpose that
62354101-29-07
4b I XForm 990-PF (2006)
710421106 739634 7217 2006 . 07000 THE GOERGEN FOUNDATION , INC 7217 1
THE GOERGEN FOUNDATION , INC. 06-1180035 Pag e 6Part VII- 13 Statements Regarding Activities for Which Form 4720 May Be Required Continued
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))'7 Yes No
(2) Influence the outcome of any specific public election ( see section 4955 ), or to carry on, directly or indirectly,
any voter registration dnve7 L Yes 0 No
(3) Provide a grant to an individual for travel , study, or other similar purposes? ED Yes OX 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)7 = Yes 0 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? 0 Yes EXI No
b If any answer is 'Yes' to 5a(1)-(5), did any of the transactions fail to qualify under the exceptions described in Regula tions
section 53 4945 or in a current notice regarding disaster assistance (see Instructions ) ' N/A 5b
Organizations relying on a current notice regarding disaster assistance check here 0
c If the answer is 'Yes' to question 5a(4), does the foundation claim exemption from the tax because it maintained
expenditure responsibility for the grant? N/A Yes No
If "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? 0 Yes 0 No
b Did the foundation , during the year , pay premiums , directly or indirectly, on a personal benefit contract? 6b X
If you answered " Yes" to 6b, also file Form 8870
7a At any time during the tax year , was the foundation a party to a prohibited tax shelter transaction? El Yes 0 No
b If yes , did the foundation receive an y p roceeds or have an y net income attributable to the transaction? N/A 7b
Part VIII Information About Officers, Directors , Trustees, Foundation Managers , HighlyPaid Employees , and Contractors
1 List all officers. directors. trustees. foundation managers and their compensation.
a) Name and address(a)(b) Title, and avera g e
per week devotedto position
(c) Compensation
(If not p aidenter -0 -)
(d)Contnbubonstoetoyeebenefi tans
andauaon
comp
(e) Exp enseaccount, otherallowances
ROBERT B. GOERGEN RESIDENT / T RUSTEEKHAKUM WOOD ROAD,
GREENWICH, CT 06831 0.00 0. 0. 0.PAMELA M. GOERGEN SEC/TREAS / T RUSTEEKHAKUM WOOD ROAD,
GREENWICH, CT 06831 0.00 0. 0. 0.ROBERT B. GOERGEN JR .P./TRUSTEE
129 GRAND STREET, APT R3
NEW YORK, NY 10013 0.00 0. 0. 0.
TODD A. GOERGEN .P./TRUSTEE
30 SUTTON PLACE, APT 2ANEW YORK , NY 10022 0.00 0. 0. 0.2 comoensation of five mahest-oaid emorovees (other than those included on line 1 ). it none. enter "NUNt."
(a) Name and address of each employee paid more than $50 , 000(b) Title and average
hours per weekdevoted to position
(c) Compensation(d)Contnbubonsto
^;^ee
^b^^tianscompensation
( e) Expenseaccount, otherallowances
NONE
Total number of other employees paid over $50,000 U
Form 990-PF (2006)
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10421106 739634 72178
2006.07000 THE GOERGEN FOUNDATION, INC 7217 1
Form 990-PF (2006) THE GOERGEN FOUNDATION, INC. 06-1180035 Pagel
part Vtll 1Information About Officers, Directors, Trustees, Foundation Managers , HighlyPaid Employees, and Contractors Continued
3 Five highest - paid independent contractors for professional services. If none, enter " NONE."
(a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
ROPART INVESTMENTS LLC
1 EAST WEAVER STREET, GREENWICH, CT 06831 CONSULTING 108,977.
Total number of others receiving over $50,000 for professional services ► 0
I Part IX-A I Summary of Direct Charitable Activities
List the foundation ' s four largest direct charitable activities during the tax year Include relevant statistical information such as thenumber of organizations and other beneficiaries served , conferences convened , research papers produced, etc Expenses
1 N/A
2
3
4
I Pan !A-b 1 Summarv of Prnnram-RplatPd Invpstmpnts
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2 Amount
1 N/A
2
All other program- related investments See instructions
3
Total . Add lines 1 through 3 ► 0.
Form 990-PF (2006)
62356101-29-07
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10421106 739634 7217 2006.07000 THE GOERGEN FOUNDATION, INC 7217 1
Form 990-PF (2006) THE GOERGEN FOUNDATION, INC. 06-1180035 Page8
Pmt K Minimum Investment Return (All domestic foundations must complete this part Foreign foundations, see instructions)
1 Fair market value of assets not used ( or held for use) directly in carrying out charitable , etc , purposes
a Average monthly fair market value of securities la 3,963,819.
b Average of monthly cash balances 11 b 1,315,040 .
c Fair market value of all other assets 1 c 8, 714 , 804 .
d Total ( add lines 1 a, b, and c) 1 d 13, 993 , 663 .
e Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation ) le 206,743.
2 Acquisition indebtedness applicable to line 1 assets 2 0 .
3 Subtract line 2 from line 1 d 13,993 , 663 .4 Cash deemed held for charitable activities Enter 1 1/2% of line 3 (for greater amount , see instructions ) 4 209 , 905 .
5 Net value of noncharitable -use assets Subtract line 4 from line 3 Enter here and on Part V, line 4 5 13, 783 , 758 .
6 Minimum investment return Enter 5% of line 5 6 689 , 188 .x Distributable Amount (see instructions) (Section 4942(l)(3) and (I)(5) private operating foundations and certainart
foreign organizations check here ► 0 and do not complete this part )
1 Minimum investment return from Part X, line 6 1 689,188.
2a Tax on investment income for 2006 from Part VI, line 5 2a 22,524.
b Income tax for 2006 (This does not include the tax from Part VI) 2b 3,764.
c Add lines 2a and 2b 2c 26 , 288 .
3 Distributable amount before adjustments Subtract line 2c from line 1 3 6 6 2 , 9 0 0
4 Recoveries of amounts treated as qualifying distributions 4 0 .
5 Add lines 3 and 4 5 662,900 .6 Deduction from distributable amount (see instructions) 6 0 .
7 Distributable amount as adjusted Subtract line 6 from line 5 Enter here and on Part XIII, line 1 7 6 6 2 , 9 0 0 .
Part X11 Qualifying Distributions (see instructions)
1 Amounts paid (including administrative expenses) to accomplish charitable, etc , purposes
a Expenses, contributions, gifts, etc - total from Part I, column (d), line 26 1 a 769,516.
b Program-related investments - total from Part IX-B 1b 0
2 Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc , purposes 2
3 Amounts set aside for specific charitable projects that satisfy the
a Suitability test (prior IRS approval required) 3a
b Cash distribution test (attach the required schedule) 3b
4 Qualifying distributions Add lines 1 a through 3b Enter here and on Part V, line 8, and Part XIII, line 4 4 769,516.
5 Foundations that qualrfy under section 4940(e) for the reduced rate of tax on net investment
income Enter 1% of Part I, line 27b 5 0.
6 Adjusted qualifying distributions Subtract line 5 from line 4 6 769,516.Note The amount on line 6 will be used in Part V, column (b), In subsequent years when calculating whether the
4940(e) reduction of tax in those years
foundation qualifies for the section
Form 990-PF (2006)
62357101-29-07
1010421106 739634 7217 2006.07000 THE GOERGEN FOUNDATION, INC 7217 1
• Form 990-PF (2006) THE GOERGEN FOUNDATION, INC. 06-1180035 Page9
Part X111 Undistributed Income (see instructions)
1 Distributable amount for 2006 from Part XI,
line 7
2 Undistributed income , if any, as of the end of 2005
a Enter amount for 2005 only
b Total for prior years
3 Excess distributions carryover, if any, to 2006
aFrom 2001 549,305.
bFrom2002 1,229, 554 .
c From 2003 105, 965 .
d From 2004
e From 2005 102 , 128 .
f Total of lines 3a through e
4 Qualifying distributions for 2006 from
Part Xll, line 4 ► $ 769, 516.
a Applied to 2005, but not more than line 2a
b Applied to undistributed income of prior
years ( Election required - see instructions)
c Treated as distributions out of corpus
(Election required - see instructions)
d Applied to 2006 distributable amount
e Remaining amount distributed out of corpus
5 Excess distributions carryover applied to 2006Qf an amount appears in column (d), the same amount
must be shown in column (a) )
6 Enter the net total of each column asindicated below
a Corpus Add lines 3f, 4c , and 4e Subtract line 5
b Prior years ' undistributed income Subtract
line 4b from line 2b
c Enter the amount of prior years'undistributed income for which a notice ofdeficiency has been issued , or on whichthe section 4942 ( a) tax has been previouslyassessed
d Subtract line 6c from line 6b Taxable
amount - see instructions
e Undistributed income for 2005 Subtract line
4a from line 2a Taxable amount - see instr
f Undistributed income for 2006 Subtract
lines 4d and 5 from line 1 This amount must
be distributed in 2007
7 Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170( b)(1)(E) or 4942(g)(3)
8 Excess distributions carryover from 2001
not applied on line 5 or line 7
9 Excess distributions carryover to 2007.
Subtract lines 7 and 8 from line 6a
10 Analysis of line 9
a Excess from 2002 1,229,554.
b Excess from 2003 105,965.
c Excess from 2004
d Excess from 2005 102,128.
e Excess from 2006 106,616.
(a) (b) (c) (d)Corpus Years prior to 2005 2005 2006
662,900.
0.
0.
1,986,952.
0.
0.
0.662,900.
106,616.0. 0.
2,093,568.
0.
0.
0.
0.
0.
0.
549,305.
1,544,263.
Form 990-PF (2006)62358101-29-07
1110421106 739634 7217 2006.07000 THE GOERGEN FOUNDATION, INC 7217 1
Form 990-PF ( 2006) THE GOERGEN FOUNDATION, INC.
Part XJV' Private Operating Foundations (see instructions and Part VII-A, question 9)
1 a If the foundation has received a ruling or determination letter that it is a pnvate operating
foundation, and the ruling is effective for 2006, enter the date of the ruling Bib.
b Check box to indicate whether the foundation is a p rivate o p eratin g foundation described in section
2 a Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for
each year listed
b 85% of line 2a
c Qualifying distributions from Part XII,
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 2c3 Complete 3a, b, or c for the
alternative test relied upona 'Assets' alternative test - enter
(1) Value of all assets
(2) Value of assets qualifyingunder section 4942(I)(3)(B)(i)
b 'Endowment' alternative test - enter2/3 of minimum investment returnshown in Part X, line 6 for each yearlisted
c 'Support" alternative test - enter
(1) Total support other than grossinvestment income (interest,dividends, rents, payments onsecurities loans (section512(a)(5)), or royalties)
(2) Support from general publicand 5 or more exemptorganizations as provided insection 4942(I)(3)(B)(ui)
(3) Largest amount of support from
an exempt organization
( 4 ) Gross investment income
Part XV Supplementary Info
06-1180035 Page10N/A
494210131 or I 149421015/
Tax year Prior 3 years
(a) 2006 (b) 2005 (c) 2004 (d) 2003 ( e) Total
rmation (Complete this part only if the foundation had $5,000 or more in assetsat any time during the year-see page 28 of the instructions.)
1 Information Regarding Foundation Managers:
a List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation before the close of any taxyear (but only if they have contributed more than $5,000) (See section 507(d)(2) )
NONE
b List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the ownership of a partnership orother entity) of which the foundation has a 10% or greater interest
NONE
2 Information Regarding Contribution , Grant , Gift, Loan, Scholarship , etc., Programs:
Check here 01 L1 if the foundation only makes contributions to preselected charitable organizations and does not accept unsolicited requests for funds Ifthe 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 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
623601/01-29-07 Form 990-PF (2006)
10421106 739634 721712
2006 . 07000 THE GOERGEN FOUNDATION , INC 7217 1
Form 990-PF (2006 ) THE GOERGEN FOUNDATION, INC. 06-1180035 Page11Part XV ' Supplementary Information (continued)
3 grants and Contributions Paid During the Year or Approved for Future Payment
Recipient If recipient is an individual,show any relationship to Foundation Purpose of grant or
Name and address (home or business) any foundation manager status of contribution Amountor substantial contributor recipient
a Paid during the year
SUPPORT OF
SEE ATTACHED SCHEDULE ONE PUBLIC ORGANIZATION 733,852.
Total ► 3a 733 852.b Approved for future payment
NONE
Total ► 3b I 0.623611 /01-29 -07 Form 990-PF (2006)
1310421106 739634 7217 2006.07000 THE GOERGEN FOUNDATION, INC 7217
Form 990-PF (2006) THE GOERGEN FOUNDATION, INC. 06-1180035 Page 12
Part XVI A Analysis of Income - Producing Activities
Enter
1 Pro
a
b
C
d
e
f
92 Me
3 Int
inv
4 Div
5 Net
ba
6 Net
p
7 0t
8 Gal
tha
9 Net
10 Gr
11 0th
a
b
c
d
e
12 Su
ross amounts unless otherwise indicated Unrelat ed business income Excluded b section 512 513 or 514 (e)
gram service revenue
(a)Businesscode
(b)Amount
ESJ„_see
( d)Amount
Related or exemptfunction income
Fees and contracts from government agencies
mbership dues and assessments
Brest on savings and temporary cashestments 14 5 0 , 711 .idends and interest from securities 14 17 8 , 13 7 .rental income or (loss ) from real estate
Debt-financed property
Not debt-financed property
rental income or (loss ) from personal
perty
er investment income 14 3 71 , 4 7 8 .
n or (loss ) from sales of assets othern inventory 18 711, 2 4 5 .income or (loss ) from special events
ss profit or ( loss) from sales of inventory
er revenue
btotal Add columns ( b), (d), and (e) 0 . 1, 311, 5 71 .
g
t
t
o
h
o
0 .
13 Total Add line 12, columns (b), (d), and (e) 13 1,31T-,571.
(See worksheet in line 13 instructions to verify calculations
P XVE»B Relationship of Activities to the Accomplishment of Exempt Purposes
1410421106 739634 7217 2006.07000 THE GOERGEN FOUNDATION, INC 7217 1
7 Form 990-PF (2006)01-29-0
Form 990-PF (2006) THE GOERGEN FOUNDATION, INC. 06-1180035 Pag e 13Part XVII - 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 Nit
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 la ( l ) X
(2) Other assets 1a 2 X
b Other transactions
(1) Sales of assets to a nonchantable exempt organization 1 b ( l ) X
(2) Purchases of assets from a nonchantable exempt organization 1 b ( 2 ) X
(3) Rental of facilities, equipment, or other assets 1 b ( 3 )1 X
(4) Reimbursement arrangements 1b ( 4 ) X
(5) Loans or loan guarantees 1b (5 ) X
(6) Performance of services or membership or fundraising solicitations 1b ( 6 )
Sharing of facilities, equipment, mailing lists, other assets, or paid employees 1 c X
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) Name of organization (b) Type of organization ( c) Description of relationship
N/A
Under penalties of pe u re that I ve examined this return , including accompanying schedu196 and st ements , and to the best of my knowledge and belief , it is true, correct,
and complete Dec o of r than taxpayer or fiduciary) is based on all information of ich pr arer has any knowledge
/ I4)
V
Slgnat re of fc r trustee
Preparer's21
'signature
THOMAS'a p, Firm sname (oryours
a j it sett-employed ), klli,35 MASONaddress andZiPcode GREENWICH,'
62362201-29-07
10421106 739634 7217
2a Is the foundation directly or indirectly affiliated with, or related to , one or more tax-exempt organizations described
in section 501 ( c) of the Code ( other than section 501 (c)(3 )) or in section 5279 Yes ® No
b If 'Yes , ' comp lete the followin g schedule
WE'GOERGEN FOUNDATION, INC. 06-1180035
FORM 990-T INCOME (LOSS) FROM PARTNERSHIPS STATEMENT 12
DESCRIPTION
SCOTTWOODLINN ENERGY LLCKAYNE ANDERSON CAPITAL INCOME PARTNERSTRIANA FUND IX
TOTAL TO FORM 990-T, PAGE 1, LINE 5
AMOUNT
15,933.499.
<1,997.><47.>
14,388.
49 STATEMENT(S) 1210421106 739634 7217 2006.07000 THE GOERGEN FOUNDATION, INC 7217 1
ZL Gabelli & Company, Inc.
THE GOERGEN FOUNDATION
Realized Gain/Loss Detail for Year
Sub / Branch / Rep / Account No
170 / GA / M03D / 77300697
Realized Gain/Loss33.527
Page 15 of 15
Amended Date: 3/16/07
Short TermDescription Quantity Original Pnce Date Acquired Close Date Proceeds Cost/Adlusted Cost GaIn/Loss
AFCO APPLI ED FI LMS CHG 1,500 0000 28.3700 06/13/06 07/10/06 42,750.00 42,620 00 130.00AZTAR CORP CHG 500.0000 30.8480 11/04/05 08/24/06 26,025.50 15,449.00 10,576.50CHIRON CORP CHG 1,000.0000 44.2041 11/04/05 04/26/06 48,000 00 44,269 10 3,730.90DREYERS GRAND ICE CREXXXHLDGS INC CL A CALLABLEPUTTABLE COM 500 0000 82.3382 11/04/05 01/17/06 41 550 00 41 234 10 315.90GROUPE DANONESPONSORED ADR 500 0000 20.6161 11/30/05 08/02/06 14,15656 10333 05 3 823 51KERR-MC GEE CORPORATICHG 500.0000 69.4201 06/30/06 08/11/06 35,250.00 34,730.05 519.95LA QUINTA PRPTY PAIRECHGCOM 2,000.0000 10.8924 11/10/05 01/25/06 22 500 00 21 884 80 615.20NEXTEL P ARTNERS INC CHG 2,000.0000 28.0745 02/14/06 06/28/06 57,000.00 56,214.00 786.00OCEANEERING INTL INC 300.0000 50.4888 11/28/05 05/05/06 21,794.36 15,161.64 6,63272ROLLS-ROYCE GROUP PLCXXXCL B 107,600 0000 0.0000 07/13/06 07/17/06 197.91 0.00 0.00SCIENTIFIC ATLANTA INCHG 1,000.0000 42.1420 11/28/05 02/27/06 43 000.00 42 192.00 808 00SIEBEL SYS INC CHG 3 000 0000 10.3949 11/04/05 02/07/06 31,980.00 31,249.70 730.30TRIBUNE CO NEW XXX 500.0000 32 5300 11/03/05 07/05/06 16,250.00 16,290.00 -40.00WESTERN GAS RESOURCESCHGINC 500 0000 59.7599 06/29/06 08/23/06 30,500.00 29,899.95 600.05ZIMMER HOLDINGS INC 200 0000 57.3390 07/10/06 09/15/06 13,681.57 11,475 80 2,205 77Tota l - Short Term $444,635 .90 $413,003.19 31, 4.80
YT313079 001418 079084848313 NNNNN NNNNN NNNNNN 000008
A.R. Schmeidler & Co., Inc.
REALIZED GAINS AND LOSSESThe Goergen Foundation Inc.
1944From 01 -01 -06 Through 12-31 -06
Open Close CostDate Date Quantity Securlt) Ba sis
01.24-06 04-06-06 0 49 Tronox Inc 9 18
01-24-06 04-12-06 1,500 00 Linn Energy LLC 31,945 0501-24-06 05-09-06 6000 Tronox Inc 1,1200905-12-06 05-24-06 061 Hugoton Roya lty Trust 17 24
01.11.06 06-08-06 200 00 Apache Corp 14,268 50
01-19-06 06-08-06 20000 Marathon Oil Corp 14,418 0001-24-06 07-11-06 60000 Kerr McGee Corp 30,326 73
01-19-06 09-20-06 300 00 Marathon Oil Corp 21,627 0001-24-06 11-20-06 500 00 Foundation Coal Holdings 22,89000
Inc
01-25-06 11-20-06 200 00 Foundation Coal Holdings 8,82900
,'Inc11-20-06 11-21-06 1.000 00 Enterprise Products Partners 28,386 00
LP07-28-06 11-28-06 20000 Phelps Dodge Corp 16,171 9007-28-06 12-21-06 200 00 Phelps Dodge Corp 16,171 90
05-12-06 12-27-06 59 00 Hugoton Royalty Trust 1,6699906-05-06 12-27-06 141 00 Hugoton Royalty Trust 4,146 9506-15-06 ' 12-27-06 300.00 1-lugoton Royalty Trust ('^ v Z 8,62900
TOTAL GAINSTOTAL LOSSES
220,626 53
Gain Or Loss
Proceeds Short Term Long Term
8 37 -0 8128,324 82 -3,620 23
955 96 -164 1318 14 0.90
11,807 75 -2,460 75
14,305 96 -112 0441,698 71 11,371 98
21,374.69 -252 31
17,514 46 -5,375 54
7,005.78 -1,82322
28,268 13 -117 87
24,212.69 8,040 7923,656.25 7,484 351,465 95 -204 04
3,503 37 -643.58
7,45399 -1,175 01
26,898 02 0 00-15,94953 000
231,575.02 10 ,948.49 0.00
TOTAL REALIZED GAIN/LOSS 10,94849
Jefferies S'Jetferies & Company. Inc
REALIZED GAINS AND LOSSESTHE GOERGEN FOUNDATION INC
743-00141From 01-01-06 Through 12-31-06
Gabs Or LouOpen Close Unit cost We
Date_ Dale Quantity Symbol Security Coat Bazb Me Proceeds Short Term Loeb Term
COMMON STOCK06.19-06 10-11-06 4.019 FM Pad Tecb lac 12.59 50 ,60905 17 .28 69,437.86 18,828.81
06-19-06 10-12.06 981 PmK FbelTech be 12 .39 12 .353 19 17 Z5 16,917.60 4,56441
62,962 24 86,35546 23,393.22 0.00
02-04-05 10-16-06 10,000 HPOL Hutis k9cracfl a Inc 5 .17 31.711-27 6.19 61.873 .08 10,161.81
02-08-05 03-22.06 5,000 HYC Hypavvm Corp 4.34 21,678.08 8 81 44.053.63 22,375.55
1028-04 04- 10.06 1,500 IIG I®ergeat Inc 9.88 14.82099 12. 23 18,339- 18 3,518.20
01-11-06 12-04-06 10,000 NEST Neater Ice New 4.57 45,655.00 1.44 19,399.55 -31.255.45
196.82738 225,02090 -7 . 962-23 36,05536
1U[ALGA NS 23,393.22 36.05556TOTAL LOS,SES -31.255.45 OA0
19482448" 12.9,02090 -7,gdl.23 36ASS
TOTAL RR.ar MM GAIN/LOSS 28.193.33
'Itu report Is ftV informational pwpoms only and has boos prepared to seas[ you is the mviow of your socount. If you note any d pmcxa, please contact your Account E ccutive innaedLatcly Tau mfamumcaa is act meanI
to be mtied on for tu, accounting. regal or other purpWes. The 1ltfotmatlon a befLeved to be from reliable sources, but we make an topetaentatbcn as fo its aCCatacy m cc npkteoea crappropriateness for campaiaon.
89
Report run at 11 :33:41 AM on W ay. January 03, 2007
mcnmWNC9M
NmW
mr
mcn
M0-u
0
to
m
THE GOERGEN FOUNDATION
TIN it 06-1180035
2006 FORM 990-PF, PART X
LINE le. REDUCTION CLAIMED FOR BLOCKAGE AND OTHER FACTORS
THE FOUNDATION HELD 108,735 SHARES OF BLYTH INDUSTRIES ON 1/1/06 AND 89,487
SHARES AT 12/31/06 WHICH REPRESENTS APPROXIMATELY 1% OF TOTAL OUTSTANDING SHARES
SINCE THE STOCK IS NOT HEAVILY TRADED ON THE NEW YORK STOCK EXCHANGE, A BLOCK THIS SIZE
COULD ONLY BE LIQUIDATED AT A SUBSTANTIAL DISCOUNT A 10'/ DISCOUNT, AS ALLOWED BY IRC
SECTION 4942, HAS BEEN USED
THE CALCULATION IS AS FOLLOWS 1/1/06 12/31 /06 AVERAGE FMV
TOTAL BLYTH SHARES OUTSTANDING 108,735 89,487
SECTION 144 SHARES 0 0
NET SHARES OUTSTANDING 108,735 89,487
FAIR MARKET VALUE 2,277,998 1, 856,855 2,067,427
SECTION 4942 10% DISCOUNT 206,743
THE GOERGEN FOUNDATION, INC.Charitable Contributions
For the Period From January 1, 2006 to December 31, 2006
Date Reference Journal Transaction Description Transaction Amount
1/8/06 4192 CDJ Boy Scouts - Greenwich Counsel - Invoice: 01.04 06 500.001/8/06 4193 CDJ Brunswick Annual Fund - Invoice: 01.04.06 2,500.001/8/06 4194 CDJ Children's Day School - Invoice: 01.04.06 500001/8/06 4195 CDJ Greenwich Library - Invoice: 01.06.06 1,000 001/8/06 4196 CDJ The Greenwich Roundtable - Invoice: 01.04.06 2,000.001/8/06 4197 CDJ Historical Society of Greenwic - Invoice: 01.04.06 15,000.001/8/06 4198 CDJ Port Chester Carver Center, In - Invoice: 01.04.06 1,000001/17/06 4199 CDJ East Side House Settlement - Invoice: 01.07.06 1,200.001/31/06 JPM013106 GENJ Record charitable contribution of 1,513 shares of Blyth Stock to the YWCA of Greenwich 33,013.661/31/06 JPM013106 GENJ Record charitable contribution of 2,127 shares of Blyth Stock to the Smithsonian Hirshhorn Museum 43,837.472/7/06 4201 CDJ The New York Public Library - Invoice: 02.07.06 1,000002/28/06 JPM022806 GENJ Record charitable donation of 4,400 shares of Blyth stock to Boys and Girls Club of Greenwich 99,528.002/28/06 JPM022806 GENJ Record charitable donation of 4,463 shares of Blyth stock to Greenwich Hospital 100,953.062128/06 JPM022806 GENJ Record charitable donation of 4,423 shares of Blyth stock to Greenwich Family YMCA 100,048.263/20/06 4203 CDJ Reach Prep • Invoice: 03.20.06 1,000.003/31/06 JPM 033106 GENJ Record charitable donation of 2,322 Blyth shares @ $21.54/share to The Children's Educational 50,015.884/6/06 4204 CDJ YWCA Greenwich - Invoice. 04.07 06 4,000.004/11/06 4205 CDJ YMCA of Greenwich - Invoice: 04.11.06 2,500.004/12/06 4206 CDJ Drawing Center - Invoice: 04.12.06 2,000.004/12/06 4207 CDJ Museum of the City of New York - Invoice: 0412.06 250004/17/06 4208 CDJ Avon Theatre Film Center - Invoice: 04.06.06 1,000.004/17106 4209 CDJ Bruce Museum of Arts and Sclen - Invoice: 04.06.06 500.004/17/06 4210 CDJ Cato Institute - Invoice: 04.06.06 1,000.004/17/06 4211 CDJ Drawing Center - Invoice: 04 06.06 2,000.004/17/06 4213 CDJ Group for the South Fork - Invoice- 04.06.06 500.004/17/06 4214 CDJ Hospice of Palm Beach County - Invoice: 04.06.06 100.004/17/06 4215 CDJ Museum of Modern Art - Invoice. 04.06.06 1,000004/17/06 4216 CDJ NYU Medical Center - Invoice: 04.06.06 100 004/17/06 4217 CDJ National Ctr for Learning Disa - Invoice: 04.06.06 500.004/17/06 4218 CDJ Partnership for Kids - Invoice, 04 06.06 1,000.004/17/06 4219 CDJ SoundWaters - Invoice, 04.06.06 100.004/17/06 4220 CDJ Southampton Hospital Foundatio - Invoice: 04.06 06 500.004/17/06 4221 CDJ YWCA Greenwich - Invoice: 04.06.06 500.004/17/06 4222 CDJ Yankee Institute for Public Po - Invoice: 04.06.06 250.004/26/06 4229 CDJ Bruce Museum of Arts and Scien - Invoice: 04.18.06 1,500.004/26/06 4230 CDJ Children's Day School - Invoice, 04 18.06 100 004/26/06 4231 CDJ Common Good - Invoice: 04.18.06 1,000 004/26/06 4238 CDJ Institute for Justice - Invoice: 04.18.06 500.004/26/06 4255 CDJ Malta House of Good Counsel - Invoice: 04.24 06 1,000.004/26/06 4256 CDJ The Wharton Fund - Invoice: 04.24.06 1,000.004/26/06 4223 CDJ African Wildlife Foundation - Invoice: 04.18 06 25.004/26/06 4224 CDJ American Humane Society - Invoice: 04 18 06 25004/26/06 4225 CDJ The American Society Preventio - Invoice. 04 18.06 50.00
10/10/2007 at 12 45 PMPage 1
THE GOERGEN FOUNDATION, INC.
Charitable Contributions
For the Period From January 1, 2006 to December 31, 2006
Date Reference Journal Transaction Description Transaction Amount
4/26106 4226 CDJ Angeles National Forest - Invoice: 04 18.06 50.00
4/26/06 4227 CDJ Animal Legal Defense Fund - Invoice: 04 18.06 25.00
4/26106 4228 CDJ Bide A Wee Home Association - Invoice: 04.18.06 25.00
4/26/06 4232 CDJ Defenders of Wildlife - Invoice- 04.18 06 200.00
4/26/06 4233 CDJ Farm Sanctuary - Invoice: 04.18.06 30.00
4/26106 4234 CDJ Greenwich Academy - Invoice: 04.18.06 500.00
4/26/06 4235 CDJ THe Humane Society Internation - Invoice: 04.18.06 2500
4126/06 4236 CDJ The Humane Society of the Unit - Invoice: 04.18.06 100.00
4126/06 4237 CDJ IFAW Orphan Animal Rescue - Invoice: 04.18.06 50.00
4/26/06 4239 CDJ Lifesavers, Inc - Invoice: 04.18.06 25.00
4/26106 4240 CDJ National Wildlife Foundation - Invoice: 04.18.06 25.00
4/26/06 4241 CDJ Noah's Lost Ark - Invoice: 04.18.06 37.00
4/26/06 4242 CDJ Northwestern University - Invoice: 04.18.06 250.00
4126/06 4243 CDJ Partnership for Kids - Invoice: 04.18.06 100.00
4/26106 4244 CDJ People for the Ethical Treatme - Invoice: 04 18.06 50.00
4/26/06 4245 CDJ Pet Adoption Fund - Invoice: 04.18.06 2500
4/26/06 4247 CDJ Sierra Club - Invoice: 04.18.06 50.00
4/26/06 4249 CDJ Tiger Creek - Invoice: 04 18.06 35.00
4/26/06 4250 CDJ World Society for the Protects - Invoice: 04.18.06 100.00
4/26/06 4251 CDJ World Wildlife Fund - Invoice: 04.18.06 25.00
4/26/06 4252 CDJ IFAW Orphan Animal Rescue - Invoice: 04.18 06a 100.00
4/26/06 4253 CDJ IFAW Orphan Animal Rescue - Invoice: 04.18.06c 50.00
5/2/06 4257 CDJ Bruce Museum of Arts and Scien - Invoice: 05.02.06 3,000.00
5/2/06 4258 CDJ YMCA of Greenwich - Invoice, 05 02 06 1,000.00
5/11/06 4260 CDJ American Red Cross - Invoice: 05.1006 500.00
5/23/06 4261 CDJ ICI Independent Curators Inter- Invoice. 05.22 06 375.00
5/24/06 4263 CDJ Sisters of St. Francis of Assi - Invoice: 05.24 06 15.00
5/31/06 4265 CDJ Caramoor - Invoice: 05.31.06 2,500.00
6/8/06 4266 CDJ Bruce Museum of Arts and Scien - Invoice: 06.06.06 4,00000
6/8/06 4267 CDJ East End Hospice - Invoice. 06.06 06 100.00
6/8/06 4269 CDJ University of Rochester - Invoice: 06.06.06 28,000.00
6/8/06 4270 CDJ Leukemia & Lymphoma Society - Invoice: 06.06 06 250.00
6/20/06 4271 CDJ Alison Gertz Foundation for - Invoice: 06.20.06 600.00
6/23/06 4272 CDJ Breast Cancer Alliance - Invoice. 06.23 06 20,000.00
6/23/06 4273 CDJ United Way of Greenwich - Invoice: 06.23 06 10,000.00
6/27/06 4274 CDJ Buckley School - Invoice: 06.27.06 2,500.00
6/27106 4275 CDJ Help Funding Inc. - Invoice: 06 27.06 1,500.00
7/7/06 4277 CDJ Family Counseling Service - Invoice, 07 07 06 500.00
7/7/06 4280 CDJ Friends of the Forum - Invoice: 06.22.06 1,000.00
7/7/06 4282 CDJ Whitney Museum of American Art - Invoice: 06.01 06 100.00
7/7/06 4279 CDJ International Fund for Animal - Invoice: 06.21.06 25.00
7/12/06 4283 CDJ Global Leadership Foundation - Invoice 07 11 06 10,000 00
7/25/06 4284 CDJ Alliance for Cancer Gene There - Invoice: 07 25 06 2,00000
10/10/2007 at 12 45 PM Page 2
THE GOERGEN FOUNDATION, INC.
Charitable Contributions
For the Period From January 1, 2006 to December 31, 2006
Date Reference Journal Transaction Description Transaction Amount
7/25/06 4285 CDJ Classroom, Inc. - Invoice: 07.18.06 1,000.00
7/25/06 4286 CDJ Institute for Justice - Invoice: 07.18.06 1,000.00
7/25/06 4287 CDJ Peconic Bay Medical Center - Invoice- 07.18.06 500.00
7/25/06 4288 CDJ Quogue Fire Department - Invoice. 07.18.06 100 00
7/25/06 4289 CDJ Quogue Junior Theater Troupe - Invoice: 07.19 06 100.00
7/25/06 4291 CDJ The Gale for Greenwich Hospita - Invoice: 07.25 06 3,000.00
7/25/06 4292 CDJ YMCA of Greenwich - Invoice: 07.25.06 500.00
7/26/06 4293 CDJ Greenwich Hospital - Invoice: 06.06 2,000.00
7/26/06 4294 CDJ University of Rochester - Invoice: 06.30.06 50,000.00
7/27/06 4295 CDJ New York Philharmonic - Invoice. 07.27.06 2,50000
8/1/06 4297 CDJ University of Rochester - Invoice: 08.01 06 14,000.00
8/15/06 WT 081806 CDJ National Gallery of Art - Invoice: 02.07.06 15,000.00
9/1/06 4298 CDJ Bruce Museum of Arts and Scien - Invoice: 08.25 06 2,500.00
9/1/06 4299 CDJ Good Counsel - Invoice: 09.01.06 50000
9/1106 4300 CDJ Kenmore West Alumni Foundation - Invoice: 08.25.06 200.00
9/1/06 4301 CDJ National Theatre Workshop - Invoice- 09 01 06 100.00
9/15/06 4302 CDJ Atlas Economic Research Founds - Invoice: 09.13.06 2,00000
9/15/06 4303 CDJ Cato Institute - Invoice: 09.15.06 25,000.00
9/15/06 4304 CDJ Memorial Sloan-Kettering Cance - Invoice. 091306 50000
9/15/06 4305 CDJ Pathways, Inc. - Invoice: 09.13.06 800.00
9/18/06 4308 CDJ The Inner-City Foundation - Invoice: 09.18.06 1,00000
9/18/06 4309 CDJ Waterside School - Invoice: 09.18.06 4,000.00
9/20/06 4310 CDJ The Battery Conservancy - Invoice- 09 20.06 250.00
9/20/06 4311 CDJ Center for Chamber Music, Inc. - Invoice- 09 20 06 350.00
9/20/06 4312 CDJ Historical Society of Greenwic - Invoice- 09 20 06 5,000.00
9/26/06 4314 CDJ Quogue Library - Invoice: 09.22.06 1,000.00
9/26/06 4313 CDJ The Fund for Park Avenue - Invoice: 09.22.06 100.00
9/29/06 4185V CDJ Room to Grow - Invoice: 12.20.05 (500.00)
9/29/06 4081V CDJ Revlon Run/Walk - Invoice: Mar.22.05 (10000)
10/2/06 4315 CDJ Audubon Greenwich - Invoice: 10.02.06 200.00
1012/06 4316 CDJ Lincoln Center Theater - Invoice: 10.02.06 2,000.00
10/2/06 4317 CDJ Women's Sports Foundation - Invoice 10 02 06 1,250.00
10/19/06 4318 CDJ Bruce Museum of Arts and Scien - Invoice 10 18 06 1,500.00
10/23/06 4321 CDJ ICI Independent Curators Inter - Invoice: 10.16.06 1,500 00
10/23/06 4322 CDJ ICI Independent Curators Inter - Invoice: 10 16 06a 1,000.00
10/31/06 4323 CDJ Doris Day Animal League - Invoice: 10.20 06 20.00
10/31/06 4324 CDJ East Side House Settlement - Invoice- 10 20 06 1,000.00
10/31/06 4326 CDJ Jane Goodall Institute - Invoice: 10.20 06 25000
10/31/06 4327 CDJ Noah's Lost Ark - Invoice: 10.23.06 74.00
10/31/06 4328 CDJ Northwestern University - Invoice: 10.20.06 250.00
10/31/06 4330 CDJ The Gorilla Foundation- Invoice: 10.2306 10000
10/31/06 4331 CDJ YMCA of Greenwich - Invoice: 10.31.06 2,50000
11/14/06 4333 CDJ Boy Scouts - Greenwich Counsel - Invoice. 11 09.2006 1,000.00
10/10/2007 at 12 45 PM Page 3
THE GOERGEN FOUNDATION, INC.
Charitable Contributions
For the Period From January 1, 2006 to December 31, 2006
Date Reference Journal Transaction Description Transaction Amount
11/14/06 4334 CDJ Cancer Research - Invoice: 11.07.06 500.00
11/14/06 4335 CDJ Drawing Center - Invoice: 10.12.06 35000
11/21/06 4336 CDJ Drawing Center - Invoice: 11.21.06 200.00
11/21/06 4337 CDJ MS Clinic - Invoice: 11 21 06 100.00
12/4/06 4339 CDJ Hospice of Palm Beach County - Invoice: 12.04.06 50000
12/4/06 4340 CDJ Miami Art Museum - Invoice: 12.04.06 50000
12/4/06 4341 CDJ Mission of Kindness Children's - Invoice: 12.04.06 500.00
12/4/06 4342 CDJ University of Rochester - Invoice: 12.04.06 14,000.00
12/19/06 4344 CDJ Sanctuary for Families - Invoice: 12.20.06 500.00
12/19/06 4346 CDJ University of Richmond - Men's - Invoice. 12.18 06 2,500.00
12/22106 4347 CDJ Bomb Magazine - Invoice. 12.21.06 12000
12122106 4348 CDJ Global Partnership for Afgahan - Invoice: 12.21 06 1,500.00
12/22/06 4349 CDJ Greenwich Arts Council - Invoice: 12.21.06 100.00
12/22/06 4350 CDJ Group for the South Fork - Invoice. 12.21 06 100.00
12/22/06 4352 CDJ Robin Hood - Invoice: 12.21.06 1,000.00
12/22106 4351 CDJ Independent Curators Internet! - Invoice: 12.21 06 250.00
12/22/06 4353 CDJ TEAK Fellowship - Invoice 12 21.06 150.00
Charitable Contributions-2006 733,852.33
10/10/2007 at 12 45 PM Page 4
2006 DEPRECIATION AND AMORTIZATION REPORT
FORM 990-PF PAGE 1 990-PF
AssetNo Description
DateAcquired Method Life
Cn
V
LUneNo
UnadjustedCost Or Basis
Bus%
Excl
Section 179Expense
Reduction InBasis
Basis ForDepreciation
BeginningAccumulatedDepreciation
CurrentSec 179Expense
Current YearDeduction
EndingAccumulatedDepreciation
1 OFFICE FURNITURE 05/15/97 SL 7.00 H *1 1 6 24,954. 24,954. 24,954. 0. 24,954.
2 D8W COMPt R 08/31/90 SS. 5.00 6 2,797. 2,797. 2,797. 0. 2,797.
* TOTAL 990-PF PG 1 DEPR 27,751. 27,751. 27,751. 0. 27,751.
62811112-05-06 (D) - Asset disposed • ITC, Salvage, Bonus, Commercial Revitalization Deduction, GO Zone
16
• THE'GOERGEN FOUNDATION, INC. 06-1180035
FORM 9.90-PF INTEREST ON SAVINGS AND TEMPORARY CASH INVESTMENTS STATEMENT 1
SOURCE AMOUNT
AR SCHMEIDLER 1,130.
FIRST RESERVE FUND IX 7,088.J P MORGAN Q73373 41,059.PER BOOKS 1,416.TRIANA FUND IX 18.
TOTAL TO FORM 990-PF, PART I, LINE 3, COLUMN A 50,711.
FORM 990-PF DIVIDENDS AND INTEREST FROM SECURITIES STATEMENT 2
CAPITAL GAINS COLUMN (A)
SOURCE GROSS AMOUNT DIVIDENDS AMOUNT
ALTERNATIVE INVESTMENT INST LP 174,905. 148,912. 25,993.
AR SCHMEIDLER 3,930. 0. 3,930.FIRST RESERVE FUND IX LP 281,256. 276,307. 4,949.FIRST RESERVE FUND VII LP <6,703.> <6,737.> 34.FOUNDATION COAL HOLDINGS 242. 0. 242.
FR IX OFFSHORE 67,695. 67,695. 0.GABELLI 00697 18,537. 0. 18,537.GOLDMAN CAPITAL 4,215. 0. 4,215.HKW CAPITAL PARTNERS II, LP 70,522. 63,474. 7,048.HUGOTON ROYALTY TRUST 1. 0. 1.J P MORGAN Q73373 58,311. 2,342. 55,969.KAYNE ANDERSON 6,545. 2,114. 4,431.LINN ENERGY 4. 0. 4.MCKEE DRIVE ASSOC 292. 0. 292.MIDMARK EQUITY 9,354. 8,848. 506.NEUBERGER BERMAN 00141 16. 0. 16.PERMIAN BASIN ROYALTY TRUST 6. 0. 6.RII WORLD TIMBERFUND LLC 21,496. 0. 21,496.SCOTTWOOD 105,367. 74,899. 30,468.TRIANA FUND IX 2,615. 2,615. 0.
TOTAL TO FM 990-PF, PART I, LN 4 818,606. 640,469. 178,137.
17 STATEMENT(S) 1, 210421106 739634 7217 2006.07000 THE GOERGEN FOUNDATION, INC 7217 1
'• THE'GOERGEN FOUNDATION, INC. 06-1180035
FORM 9,90-PF OTHER INCOME STATEMENT 3
DESCRIPTION
ALTERNATIVE INVESTMENT INST LPMIDMARK EQUITY PARTNERS
MCKEE DRIVE ASSOCIATESSCOTTWOOD PARTNERS
KAYNE ANDERSON CAPITALCALLIDUS CLO
TRIANA FUND IX
GS GAMMA INVESTMENTS LTD-PFIC
HUGOTON ROYALTY TRUST
LINN ENERGYPERMIAN BASIN ROYALTY TRUST
AR SCHMEIDLER
TOTAL TO FORM 990-PF, PART I, LINE 11 371,478. 371,478.
FORM 990-PF ACCOUNTING FEES STATEMENT 4
DESCRIPTION
TAX PREPARATION FEES
(A) (B)
EXPENSES NET INVEST-
PER BOOKS MENT INCOME
15,461.
TO FORM 990-PF, PG 1, LN 16B 15,461.
(C) (D)
ADJUSTED CHARITABLENET INCOME PURPOSES
0.
0.
FORM 990-PF OTHER PROFESSIONAL FEES STATEMENT 5
DESCRIPTION
MANAGER FEESCONSULTING FEESADMIN FEE- RI LLC
(A)EXPENSES
PER BOOKS
0.91,500.17,477.
TO FORM 990-PF, PG 1, LN 16C 108,977.
(B)
NET INVEST-
MENT INCOME
0.91,500.
0.
91,500.
(C)ADJUSTED
NET INCOME
15,461.
15,461.
(D)
CHARITABLEPURPOSES
(A) (B) (C)REVENUE NET INVEST- ADJUSTED
PER BOOKS MENT INCOME NET INCOME
49,637. 49,637.<60,272.> <60,272.><2,554.> <2,554.>
<903.> <903.><2,026.> <2,026.>
282,905. 282,905.<47.> <47.>
96,200. 96,200.482. 482.499. 499.
2,815. 2,815.4,742. 4,742.
0.0.
17,477.
17,477.
18 STATEMENT(S) 3, 4, 510421106 739634 7217 2006.07000 THE GOERGEN FOUNDATION, INC 7217 1
• THE'GOERGEN FOUNDATION, INC. 06-1180035
FORM 990-PF TAXES STATEMENT 6
(A) (B) (C) (D)EXPENSES NET INVEST- ADJUSTED CHARITABLE
DESCRIPTION PER BOOKS MENT INCOME NET INCOME PURPOSES
FOREIGN TAX 343. 0. 0.EXCISE TAX 19,647. 0. 0.
TO FORM 990-PF, PG 1, LN 18 19,990. 0. 0.
FORM 990-PF OTHER EXPENSES STATEMENT 7
(A) (B) (C) (D)
EXPENSES NET INVEST- ADJUSTED CHARITABLEDESCRIPTION PER BOOKS MENT INCOME NET INCOME PURPOSES
MISCELLANEOUS ADMINISTRATIVE
EXPENSES 484. 0. 0.INVESTMENT EXP 24,893. 24,893. 0.PORTFOLIO DEDUCTIONS -VARIOUS PARTNERSHIPS 59,545. 59,545. 0.CHARITABLE CONTRIBUTIONS 2. 0. 0.OTHER FEES 11,186. 0. 0.
TO FORM 990-PF, PG 1, LN 23 96,110. 84,438. 0.
FORM 990-PF OTHER INCREASES IN NET ASSETS OR FUND BALANCES STATEMENT 8
DESCRIPTION
BASIS ADJUSTMENT ON PROPERTY DONATED TO CHARITIESOTHER ADJUSTMENT
TOTAL TO FORM 990-PF, PART III, LINE 3
AMOUNT
426,747.
10,410.
437,157.
19 STATEMENT(S) 6, 7, 810421106 739634 7217 2006 . 07000 THE GOERGEN FOUNDATION , INC 7217 1
THE GOERGEN FOUNDATION, INC. 06-1180035
FORM 990-PF CORPORATE STOCK STATEMENT 9
FAIR MARKET
DESCRIPTION BOOK VALUE VALUE
89,487 SHS BLYTH INDUSTRIES 1,217. 1,856,855.JPMORGAN EQUITIES 559,815. 725,067.GABELLI 1,036,180. 1,226,829.GOLDMAN 473,363. 611,120.AR SCHMEIDLER 473,759. 498,706.
TOTAL TO FORM 990-PF, PART II, LINE 10B 2,544,334. 4,918,577.
FORM 990-PF DEPRECIATION OF ASSETS NOT HELD FOR INVESTMENT STATEMENT 10
COST OR ACCUMULATEDDESCRIPTION OTHER BASIS DEPRECIATION BOOK VALUE
OFFICE FURNITURE 24,954. 24,954. 0.
DELL COMPUTER 2,797. 2,797. 0.
TOTAL TO FM 990-PF, PART II, LN 14 27,751. 27,751. 0.
FORM 990-PF OTHER INVESTMENTS STATEMENT 11
FAIR MARKET
DESCRIPTION BOOK VALUE VALUE
ALTERNATIVE INVESTMENTS LP 1,314,035. 2,110,299.
1ST RESERVE VII LP 87,722. 105,000.
RII WORLD TIMBERFUND, LLC 553,896. 1,133,588.PROTEIN SCIENCES CONV PROM 100,000. 100,000.MIDMARK EQUITY PARTNERS II LP 70,315. 190,925.
HKW CAPITAL PARTNERS II 517,009. 641,901.
FIRST RESERVE FUND IX,LP 131,667. 305,741.
MCKEE DRIVE ASSOCIATES 42,656. 43,088.
CALLIDUS CLO 1,329,413. 1,329,413.SCOTTWOOD PARTNERS, L.P. 685,160. 802,807.KAYNE ANDERSON CAPITAL 156,654. 224,140.
GS GAMMA INVESTMENTS 1,149,421. 1,256,755.FR IX OFFSHORE LP 4,261. 4,261.
TRIANA IX 0. 0.
TOTAL TO FORM 990-PF, PART II, LINE 13 6,142,209. 8,247,918.
20 STATEMENT(S) 9, 10, 1110421106 739634 7217 2006.07000 THE GOERGEN FOUNDATION, INC 7217 1
Form 926 Return by a U.S. Transferor of Property(Rev December to a Foreign CorporationDepartfient of th e TreasuryInternal Revenue Service ► Attach to your income tax return .
OMB No 15450026
AttachmentSequence No 128
Part 1 U.S. Transferor Information (see instructions)Name of transferor
THE GOERGEN FOUNDATION, INC.
Identifying number (seeinsmchos)
06-1180035
1 If the transferor was a corporation, complete questions 1 a, 1 b, and 1 c
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?
b Did the transferor remain in existence after the transfer"
If not, list the controlling shareholder(s) and their identifying number(s)
El Yes EXI No
^X Yes No
Controlling shareholder Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation9
If not, list the name and employer identification number (EIN) of the parent corporation:
LX Yes No
Name of parent corporation EIN of parent corporation
2 If the transferor was a partner in a partnership that was the actual transferor (but is not treated as such under section 367), list the name and
EIN of the transferor's partnership
Name of partnership EIN of partnership
Part 11 Transferee Foreign Corporation Information (see instructions)3 Name of transferee (foreign corporation )
SEE ATTACHED LIST
4 Identifying number, if any
5 Address (including country)
6 Country of incorporation or organization
7 Foreign law characterization (see instructions)
8 Is the transferee foreign corporation a controlled foreign corporation'? E:J Yes 0 No
LHA For Paperwork Reduction Act Notice, see instructions . Form 926 (Rev 12-2005)
62453112-28-06
5310421106 739634 7217 2006.07000 THE GOERGEN FOUNDATION, INC 7217 1
2
Part In Information Regarding Transfer of Property (see instructions9 Date of transfer 10 Type of nonrecognition transaction (see instructions)
11 Description of property transferred-
12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? II Yes IAI No
13 Was the transferor required to recognize income under Temporary Regulations sections 1.367 (a)•4T through
1 367(a)-6T (e g , for tainted property , depreciation recapture, branch loss recapture , etc )? ED Yes 0 No
14a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction ? E:1 Yes 0 No
b If yes, describe the nature of the rights to the intangible property that was transferred in the transfer
62453212-28-06
5410421106 739634 7217 2006.07000 THE GOERGEN FOUNDATION, INC 7217 1
Alternative Investments Institutional, L.P The Goergen Foundation IncSCHEDULE K-1 SUPPORTING SCHEDULE - FORM 926
RETURN BY A U.S. TRANSFEROR OF PROPERTY TO A FOREIGN CORPORATION
Pursuant to Internal Revenue Code Section 60386 and related regulations, a partnership's contribution of property or cash to a foreign corporation is
deemed to be made by its underlying partners As a result, each partner has a potential filing requirement for such contributions (Form 926). Please
consult your tax advisor regarding this filing requirement Form 926 must be filed If cash In excess of $100,000 Is transferred to a foreign corporation, or
if the transferor owns at least 10% of the foreign corporation after the transfer. The form must be filed with the US transferor's annual Federal Income
tax return for the year that Includes the date of transfer. Partners that have participated in these investments either directly or indirectly through other
Investment entitles should aggregate the amount of their Investment when completing Form 926
Your applicable percentage of the below cash contributions to foreign corporations
during 2006 : .6600%
DATE OF
TRANSFER AMOUNT
Absolute Return (Cayman), Ltd. March 1, 2006 5,000.000
International Fund Services ( Ireland) Limited July 1. 2006 5,000.000
Third Floor, Bishop 's Square
Redmond's HillDublin 2, Ireland
EIN: N/A
The Canyon Value Realization Fund (Cayman), Ltd. January 1, 2006 4,000,000
clo Fords Fund Services (Cayman) LimitedGrand Pavillion Commercial Centre
802 West Bay Road
Grand Cayman BWI, Cayman IslandsEIN. WA
Cyrus Opportunities Fund II, Ltd. February 1, 2006 3,500,000
do GlobeOp Financial Services September 1, 2006 5,000,000
Walker House
Mary Street
P.O. Box 10201 APO
George Town, Grand Cayman
Cayman Islands
EIN N/A
Magnetar Capital Fund, Ltd. March 1, 2006 4,000,000
c/a Citco Fund Services (Cayman Islands) LtmIledWindward I, 2nd Floor
West Bay RoadP.O Box 31106
Grand Cayman, KY1-1205
Cayman Islands
EIN: WA
Polygon Global Opportunities Fund August 1, 2006 3,000,000
10 Duke of York Square September 1, 2006 7,000,000
London SW3 4LY
EIN: N/A
Scottwood Fund, Ltd. September 1, 2006 3,000,000
do Bank of New York Alternative Investment Services, Ltd.
129 Front Street
4th FloorHamilton HM 12, Bermuda
EIN: N/A
SCP Overseas Fund, Ltd. January 1, 2006 2,000,000
c/o Bank of Bermuda6 Front Street, Hamilton HM 11
P O. Box HM 1020, Hamilton HM DX
Alternative Investments Institutional, L.P The Goergen Foundation IncSCHEDULE K-1 SUPPORTING SCHEDULE - FORM 928
RETURN BY A U.S. TRANSFEROR OF PROPERTY TO A FOREIGN CORPORATION
Your applicable percentage of the below cash contributions to foreign corporations
during 2006:
DATE OFTRANSFER
Seasons Core Fund, Ltd
do Citco Fund Services (Cayman Islands) Limited
Windward I, 2nd Floor
Regatta Office Park
West Bay Road
P O. Box 31106Grand Cayman, KYI-1205Cayman IslandsEIN: N/A
April 1, 2006
May 1, 2006
Seligman Tech Spectrum Fund
do PFPC International, Ltd.
Riverside Two
Sir John Rogerson's Quay
Grand Canal Dock
Dublin 2
Ireland
EIN. WA
Shepherd Investments International, Ltd
clo SEI Investment Global Fund Services Ltd.Styne House, Upper Hatch StreetDublin 2, Ireland
EIN• WA
Tiedemann Japan QP, Ltd.
HSBC House
Harcourt Ctr, Harcourt St.
Dublin 2, Ireland
EIN: 98-0445191
December 1, 2006
January 1, 2006
May 1, 2006
May 1, 2006
.6600%
AMOUNT
9,000,000
10,000,000
2,000,000
6,000.000
12,000,000
4,000,000
Westfield Life Sciences Fund (Cayman), Inc. May 1, 2006 6,000,000
do Admiral Administration Ltd
Admiral Financial Center, 5th Floor
90 Fort Street, Box 32021 SMB
Grand Cayman, Cayman Islands
EIN: N/A
Form 8271(Rev December 2005)
investor Reporting of Tax shelter Kegistration Number.Attach to your tax return . OMB No 1545-0881
Department of the Treasury
Internet Revenue Seiv x ► If you received this form from a partnership , S corporation, or trust , see the instructions .AttachmentSequence No 71
Investors name(s) shown on return
SCOTTWOOD PARTNERS , LP
Investor's identifying number
01-0548708
Investor's tax year ended
12/31/2006
(a) Tax Shelter Name) Taxmber 11 te Registration
t(Nu
( c )
1 IDNEQK PARTNERS , LP 93271000031 93-112 0 8732
3
4
5
6
7
8
9
10
What's NewAfter October 22, 2004, tax shelterregistration numbers are no longerbeing issued. The American JobsCreation Act of 2004 amendedsection 6111 to replace the taxshelter registration requirement witha new disclosure requirement formaterial advisors who providematerial aid, assistance, or advicewith respect to any reportabletransaction, For more information,see Notice 2004-80, 2004-50 I.R.B.963. However, Form 8271 must befiled for any year you claim or reportincome or a deduction, loss, credit,or other tax benefit from aregistration-required tax shelter.
General Instructions
Section references are to theInternal Revenue Code.
Purpose of Form
Use Form 8271 to report the taxshelter registration number the IRSassigns to certain tax sheltersrequired to be registered undersection 6111 ("registration-requiredtax shelters") and to report the nameidentifying number of the taxshelter. This information must bereported even if the particularinterest is producing net income forthe filer of Form 8271. Useadditional forms to report more than10 tax shelter registration numbers.
Note : A tax shelter registrationnumber does not indicate that the taxshelter or its claimed tax benefitshave been reviewed, examined, orapproved by the IRS.
Who Must FileAny person claiming or reporting anydeduction, loss, credit, or other taxbenefit, or reporting any income onany tax return from an interestpurchased or otherwise acquired ina registration-required tax sheltermust file Form 8271. If the interest ispurchased or otherwise acquired bya pass-through entity, both thepass-through entity and its partners,shareholders, or beneficiaries mustfile Form 8271.
A pass-through entity that is theregistration-required tax shelter doesnot have to prepare Form 8271 andgive copies to its partners,shareholders , or beneficiaries unlessthe pass-through entity itself hasinvested in a registration -requiredtax shelter.
Note : Even if you have an interest ina registration-required tax shelter,you do not have to file Form 8271 ifyou did not claim or report anydeduction, loss, credit, or other taxbenefit, or report any income onyour tax return from an interest inthe registration-required tax shelter.This could occur, for example, if fora particular year you are unable to
claim any portion of a loss becauseof the passive activity losslimitations, and that loss is the onlytax item reported to you from theshelter.
Filing Form 8271Attach Form 8271 to any return onwhich a deduction, loss, credit, orother tax benefit is claimed orreported, or any income reported,from an interest in aregistration-required tax shelter.These returns include applicationsfor tentative refunds (Form 1045and 1139) and amended returns(Form 1040X and 1120X).
Furnishing Copies of Form8271 to InvestorsA pass-through entity that hasinvested in a registration-requiredtax shelter must furnish copies of itsForm 8271 to its partners,shareholders, or beneficiaries.
However, in the case where (a) thepass-through entity acquired at least;50% interest in one tax year in aregistered tax shelter (and in which ithad not held an interest in a prioryear), and (b) the investment wouldnot meet the definition of a taxshelter immediately following theacquisition if it had been offered forsale at that time, the pass-throughentity need not distribute copies ofForm 8271 to its investors. Thepass-through entity alone is requiredto prepare Form 8271 and include itwith the entity tax return.
For Paperwork Reduction Act Notice , see page 2 Form 8271 (Rev 12-2005)
JSA6X5400 1 000
82967H K355 V06-4.3
Form 8271(Rev December 2005 )
Investor Reporting of Tax Shelter Registration Number► Attach to your tax return .
0MB No 1545-0881
Department of the Treasury
internal Paveme service ► If you received this form from a partnership , S corporation, or trust , see the Instructions.Attachment
Sequence No 71
Investor's name( s) shown on return
PARTNER # 132
GOERGEN FOUNDATION
Investors Identifying number
06-1180035
Investor's tax year ended
12/31/2006
Shelter Name(a ) Tax( b) Tax Shelter RegistrationNumber ( 11 digit number)
( c) Tax ShelterIdentifying Number
1 ATLAS PIPELINE PARTNERS LP 99344000008 23-3011077
2 DORCHESTER MINERALS LP 02305000012 81-0551518
3 ALLIANCE RESOURCE PARTNERS LP 99225000019 73-1564280
4 BUCKEYE PARTNERS LP 86280000273 23-2432497
5 NBRIDGE ENERGY PARTNERS LP 92008000124 39-1715850
6 ENERGY TRANSFER PARTNERS LP 96234000014 73-1493906
7 ENTERPRISE PRODUCTS PARTNERS LP 99061000007 76-0568219
8 ERRELLGAS PARTNERS LP 94201000010 43-1698480
9 GENESIS ENERGY LP 97043000153 76-0513049
10 ENTERPRISE GP HOLDINGS LP MA0500946 13-4297064
What's NewAfter October 22, 2004, tax shelterregistration numbers are no longerbeing issued. The American JobsCreation Act of 2004 amendedsection 6111 to replace the taxshelter registration requirement witha new disclosure requirement formaterial advisors who providematerial aid, assistance, or advicewith respect to any reportabletransaction, For more information,see Notice 2004-80, 2004-50 I R B.963. However, Form 8271 must befiled for any year you claim or reportincome or a deduction, loss, credit,or other tax benefit from aregistration-required tax shelter
General Instructions
Section references are to theInternal Revenue Code.
Purpose of FormUse Form 8271 to report the taxshelter registration number the IRSassigns to certain tax sheltersrequired to be registered undersection 6111 ("registration-requiredtax shelters") and to report the nameidentifying number of the taxshelter. This information must bereported even if the particularinterest is producing net income forthe filer of Form 8271. Useadditional forms to report more than10 tax shelter registration numbers.
For Paperwork Reduction Act Notice, see page 2
JSA6X5400 1 000
Note : A tax shelter registrationnumber does not indicate that the taxshelter or its claimed tax benefitshave been reviewed, examined, orapproved by the IRS.
Who Must FileAny person claiming or reporting anydeduction, loss, credit, or other taxbenefit, or reporting any income onany tax return from an interestpurchased or otherwise acquired ina registration-required tax sheltermust file Form 8271. If the interest ispurchased or otherwise acquired bya pass-through entity, both thepass-through entity and its partners,shareholders, or beneficiaries mustfile Form 8271.
A pass-through entity that is theregistration-required tax shelter doesnot have to prepare Form 8271 andgive copies to its partners,shareholders, or beneficiaries unlessthe pass-through entity itself hasinvested in a registration-requiredtax shelter.
Note : Even if you have an interest ina registration-required tax shelter,you do not have to file Form 8271 ifyou did not claim or report anydeduction, loss, credit, or other taxbenefit, or report any income onyour tax return from an interest inthe registration-required tax shelter.This could occur, for example, if fora particular year you are unable to
claim any portion of a loss becauseof the passive activity losslimitations, and that loss is the onlytax item reported to you from theshelter.
Filing Form 8271Attach Form 8271 to any return onwhich a deduction, loss, credit, orother tax benefit is claimed orreported, or any income reported,from an interest in aregistration-required tax shelter.These returns include applicationsfor tentative refunds (Form 1045and 1139) and amended returns(Form 1040X and 1120X).
Furnishing Copies of Form8271 to InvestorsA pass-through entity that hasinvested in a registration-requiredtax shelter must furnish copies of itsForm 8271 to its partners,shareholders, or beneficianes.
However, in the case where (a) thepass-through entity acquired at least a50% interest in one tax year in aregistered tax shelter (and in which ithad not held an interest in a pnoryear), and (b) the investment wouldnot meet the definition of a taxshelter immediately following theacquisition if it had been offered forsale at that time, the pass-throughentity need not distribute copies ofForm 8271 to its investors. Thepass-through entity alone is requiredto prepare Form 8271 and include itwith the entity tax return.
Form 8271 (Rev 12-2005)
55687A 551R V06-5.4 QP-4861
Form 8271( Rev December 2005 )
Investor Reporting of Tax Shelter Registration Number► Attach to your tax return .
OMB No 1545-0881
Department of the Treasury
intemai Raverue Service ► If you received this form from a partnership , S corporation , or trust , see the instructions .Attachment
Sequence No 71
Investor's name ( s) shown on return Investor's identifying number Investors tax year ended
Shelter Name(a) Tax(b) Tax Shelter RegistrationNumber ( 11 digit number)
( c) Tax ShelterIdentifying Number
ALERO LP 00294000008 74-2956831
2 ANEB PIPE LINE PARTNERS LP 93230000163 75-2287571
3 ROSSTEX ENERGY LP 02337000008 16-16166054 INDER MORGAN ENERGY PARTNERS LP 92289000496 76-0380342
5 RKWEST ENERGY PARTNERS LP 02184000024 27-0005456
8 RTIN MIDSTREAM PARTNERS LP 02318000009 05-0527861
7 ATURAL RESOURCE PARTNERS LP 02247000042 35-2164875
8 INERGY LP 01204000001 43-1918951
9 -SEA TRANSPORTATION PARTNERS LP 04006000034 20-0194477
10 ORTHERN BORDER PARTNERS LP 93271000031 93-1120873
What's NewAfter October 22, 2004, tax shelterregistration numbers are no longerbeing issued. The American JobsCreation Act of 2004 amendedsection 6111 to replace the taxshelter registration requirement witha new disclosure requirement formaterial advisors who providematerial aid, assistance, or advicewith respect to any reportabletransaction, For more information,see Notice 2004-80, 2004-50 I.R B.963 However, Form 8271 must befiled for any year you claim or reportincome or a deduction, loss, credit,or other tax benefit from aregistration-required tax shelter.
General Instructions
Section references are to theInternal Revenue Code.
Purpose of Form
Use Form 8271 to report the taxshelter registration number the IRSassigns to certain tax sheltersrequired to be registered undersection 6111 ('registration-requiredtax shelters") and to report the nameidentifying number of the taxshelter. This information must bereported even if the particularinterest is producing net income forthe filer of Form 8271 Useadditional forms to report more than10 tax shelter registration numbers.
For Paperwork Reduction Act Notice , see page 2
JSA6X5400 1 000
Note : A tax shelter registrationnumber does not indicate that the taxshelter or its claimed tax benefitshave been reviewed, examined, orapproved by the IRS.
Who Must FileAny person claiming or reporting anydeduction, loss, credit, or other taxbenefit, or reporting any income onany tax return from an interestpurchased or otherwise acquired ina registration-required tax sheltermust file Form 8271. If the interest ispurchased or otherwise acquired bya pass-through entity, both thepass-through entity and its partners,shareholders, or beneficiaries mustfile Form 8271.
A pass-through entity that is theregistration-required tax shelter doesnot have to prepare Form 8271 andgive copies to its partners,shareholders, or beneficiaries unlessthe pass-through entity itself hasInvested in a registration-requiredtax shelter
Note : Even if you have an interest ina registration-required tax shelter,you do not have to file Form 8271 ifyou did not claim or report anydeduction, loss, credit, or other taxbenefit, or report any income onyour tax return from an interest inthe registration-required tax shelterThis could occur, for example, if fora particular year you are unable to
claim any portion of a loss becauseof the passive activity losslimitations, and that loss is the onlytax item reported to you from theshelter.
Filing Form 8271Attach Form 8271 to any return onwhich a deduction, loss, credit, orother tax benefit is claimed orreported, or any income reported,from an interest in aregistration-required tax shelter.These returns include applicationsfor tentative refunds (Form 1045and 1139) and amended returns(Form 1040X and 1120X).
Furnishing Copies of Form8271 to InvestorsA pass-through entity that hasinvested in a registration-requiredtax shelter must furnish copies of itsForm 8271 to its partners,shareholders, or beneficianes
However, in the case where (a) thepass-through entity acquired at least a50% interest in one tax year in aregistered tax shelter (and in which ithad not held an interest in a pnoryear), and (b) the investment wouldnot meet the definition of a taxshelter immediately following theacquisition if it had been offered forsale at that time, the pass-throughentity need not distribute copies ofForm 8271 to its investors Thepass-through entity alone is requiredto prepare Form 8271 and include itwith the entity tax return.
Form 8271 (Rev 12-2005)
55687A 551R V06-5.4 QP-4861
Form 8271( Rev December 2005 )
Investor Reporting of Tax Shelter Registration Number. Attach to your tax return. OMB No 1545-0881
Deperanent or the Treasury
internal Reveme SeMc ► If you received this form from a partnership, S corporation , or trust , see the Instructions.Attachment
Sequence No 71
Investor's name ( s) shown on return Investors Identifying number Investors tax year ended
Tax Shelter Name(a)( b) Tax Shelter RegistrationNumber ( 11 digit number )
( c) Tax ShelterIdentifying Number
1 PACIFIC ENERGY PARTNERS LP 02212000004 68-04905802 PLAINS ALL AMERICAN PIPELINE LP 99061000009 76-05821503 PENN VIRGINIA RESOURCE PARTNERS LP 01309000001 23-30875174 STAR GAS PARTNERS LP 96026000016 06-14377935 SUBURBAN PROPANE PARTNERS LP 96080000050 22-3410353s SUNOCO LOGISTICS PARTNERS LP 02042000005 23-30968397 C PIPELINE LP 99140000010 52-21354488 EPPCO PARTNERS LP 90036000017 76-02910589 TERRA NITROGEN COMPANY LP 92017000010 73-138968410 HOLLY ENERGY PARTNERS LP 04208000029 20-0833098
What's NewAfter October 22, 2004, tax shelterregistration numbers are no longerbeing issued. The American JobsCreation Act of 2004 amendedsection 6111 to replace the taxshelter registration requirement witha new disclosure requirement formaterial advisors who providematerial aid, assistance, or advicewith respect to any reportabletransaction, For more information,see Notice 2004-80, 2004-50 I.R.B.963. However, Form 8271 must befiled for any year you claim or reportincome or a deduction, loss, credit,or other tax benefit from aregistration-required tax shelter
General Instructions
Section references are to theInternal Revenue Code.
Purpose of Form
Use Form 8271 to report the taxshelter registration number the IRSassigns to certain tax sheltersrequired to be registered undersection 6111 ("registration-requiredtax shelters") and to report the nameidentifying number of the taxshelter. This information must bereported even if the particularinterest is producing net income forthe filer of Form 8271. Useadditional forms to report more than10 tax shelter registration numbers.
For Paperwork Reduction Act Notice, see page 2
JSA6X5400 1 000
Note : A tax shelter registrationnumber does not indicate that the taxshelter or its claimed tax benefitshave been reviewed, examined, orapproved by the IRS.
Who Must FileAny person claiming or reporting anydeduction, loss, credit, or other taxbenefit, or reporting any income onany tax return from an interestpurchased or otherwise acquired ina registration-required tax sheltermust file Form 8271. If the interest ispurchased or otherwise acquired bya pass-through entity, both thepass-through entity and its partners,shareholders, or beneficiaries mustfile Form 8271.
A pass-through entity that is theregistration-required tax shelter doesnot have to prepare Form 8271 andgive copies to its partners,shareholders, or beneficiaries unlessthe pass-through entity itself hasinvested in a registration-requiredtax shelter.
Note : Even if you have an interest ina registration-required tax shelter,you do not have to file Form 8271 ifyou did not claim or report anydeduction, loss, credit, or other taxbenefit, or report any income onyour tax return from an interest inthe registration-required tax shelter.This could occur, for example, if fora particular year you are unable to
claim any portion of a loss becauseof the passive activity losslimitations, and that loss is the onlytax item reported to you from theshelter.
Filing Form 8271Attach Form 8271 to any return onwhich a deduction, loss, credit, orother tax benefit is claimed orreported, or any income reported,from an interest in aregistration-required tax shelterThese returns include applicationsfor tentative refunds (Form 1045and 1139) and amended returns(Form 1040X and 1120X).
Furnishing Copies of Form8271 to InvestorsA pass-through entity that hasinvested in a registration-requiredtax shelter must furnish copies of itsForm 8271 to its partners,shareholders, or beneficiaries.
However, in the case where (a) thepass-through entity acquired at least a50% interest in one tax year in aregistered tax shelter (and in which ithad not held an interest in a prioryear), and (b) the investment wouldnot meet the definition of a taxshelter immediately following theacquisition if it had been offered forsale at that time, the pass-throughentity need not distribute copies ofForm 8271 to its investors. Thepass-through entity alone is requiredto prepare Form 8271 and include itwith the entity tax return.
Form t$Z11 (Rev 12-2005)
55687A 551R V06-5.4 QP-4861
Form 8271(Bev December 2005)
Investor Reporting of Tax Shelter Registration Number'Attach to your tax return .
OMB No 1545-0881
Department of the Treasury
internal Revenue Service ► If you received this form from a partnership , S corporation , or trust , see the instructions .AttachmentSequence No 71
Investors name ( s) shown on return investor's identifying number Investor's tax year ended
Tax Shelter Name(a)( b) Tax Shelter RegistrationNumber ( 11 digit number )
(c) Tax ShelterIdentifying Number
1 MAGELLAN MIDSTREAM PARTNERS LP 01036000014 73-15990532 NEOK PARTNERS LP 93271000031 93-11208733
4
5
6
7
8
9
10
What's NewAfter October 22, 2004, tax shelterregistration numbers are no longerbeing issued. The American JobsCreation Act of 2004 amendedsection 6111 to replace the taxshelter registration requirement witha new disclosure requirement formaterial advisors who providematerial aid, assistance, or advicewith respect to any reportabletransaction, For more information,see Notice 2004-80, 2004-50 I.R B.963. However, Form 8271 must befiled for any year you claim or reportincome or a deduction, loss, credit,or other tax benefit from aregistration-required tax shelter.
General Instructions
Section references are to theInternal Revenue Code
Purpose of FormUse Form 8271 to report the taxshelter registration number the IRSassigns to certain tax sheltersrequired to be registered undersection 6111 ("registration-requiredtax shelters") and to report the nameidentifying number of the taxshelter. This information must bereported even if the particularinterest is producing net income forthe filer of Form 8271. Useadditional forms to report more than10 tax shelter registration numbers.
For Paperwork Reduction Act Notice, see page 2
JSA6X5400 1 000
Note : A tax shelter registrationnumber does not indicate that the taxshelter or its claimed tax benefitshave been reviewed, examined, orapproved by the IRS.
Who Must FileAny person claiming or reporting anydeduction, loss, credit, or other taxbenefit, or reporting any income onany tax return from an interestpurchased or otherwise acquired ina registration-required tax sheltermust file Form 8271. If the interest ispurchased or otherwise acquired bya pass-through entity, both thepass-through entity and its partners,shareholders, or beneficiaries mustfile Form 8271.
A pass-through entity that is theregistration-required tax shelter doesnot have to prepare Form 8271 andgive copies to its partners,shareholders, or beneficiaries unlessthe pass-through entity itself hasinvested in a registration-requiredtax shelter.
Note : Even if you have an interest ina registration-required tax shelter,you do not have to file Form 8271 ifyou did not claim or report anydeduction, loss, credit, or other taxbenefit, or report any income onyour tax return from an interest inthe registration-required tax shelter.This could occur, for example, if fora particular year you are unable to
claim any portion of a loss becauseof the passive activity losslimitations, and that loss is the onlytax item reported to you from theshelter.
Filing Form 8271Attach Form 8271 to any return onwhich a deduction, loss, credit, orother tax benefit is claimed orreported, or any income reported,from an interest in aregistration-required tax shelter.These returns include applicationsfor tentative refunds (Form 1045and 1139) and amended returns(Form 1040X and 1120X).
Furnishing Copies of Form8271 to InvestorsA pass-through entity that hasinvested in a registration-requiredtax shelter must furnish copies of itsForm 8271 to its partners,shareholders, or beneficiaries.
However, in the case where (a) thepass-through entity acquired at least a50% interest in one tax year in aregistered tax shelter (and in which ithad not held an interest in a prioryear), and (b) the investment wouldnot meet the definition of a taxshelter immediately following theacquisition if it had been offered forsale at that time, the pass-throughentity need not distribute copies ofForm 8271 to its investors. Thepass-through entity alone is requiredto prepare Form 8271 and include itwith the entity tax return.
Form 8271 (Rev 12-2005)
55687A 551R V06-5.4 QP-4861
Fomi 8621 I Return by a Shareholder of a Passive Foreign(Rev December 2004 ) Investment Company or Qualified Electing FundDepartment of the Treasury
Name of shareholder
THE GOERGEN FOUNDATION, INC.
OMB No 1545-1002
Attachment
Seauence No 69
Identifying number (see page 2 of instructions)
06-1180035
Number , street , and room or suite no ( If a P 0 box , see page 2 of instructions ) I Shareholder tax year calendar year2 0 0 6 or other tax year beginning
C/O THOMAS E. FINN, PC, 35 MASON STREET andend,na
City or town, state, and ZIP code or countryGREENWICH, CT 06830
Check ty pe of shareholder film the return Individual X Corporation Partnershi p S Corporation Non rantor Trust Estate
Name of passive foreign investment company (PFIC) or qualified electing fund ( QEF) Employer identification number ( if any)
COATUE OFFSHORE FUND LTD
C/O GOLDMAN SACHS (CAYMAN) TRUST LTD
Address ( Enter number , street , city or town, and country ) Tax year of company or fund calendar year or otherPO BOX 896, HARBOUR CENTRE 2ND FLOOR tax year beginning JUL 1 2005 andGEORGETOWN, GRAND CAYMAN, CAYMAN ISL BWI ending JUN 30 2006
Part 1 Elections (See instructions )A OX Election To Treat the PFIC as a QEF I , a shareholder of a PFIC, elect to treat the PFIC as a QEF Complete lines la through 2c of Part 11.
B 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 10f of Part IV.
C 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-1986 earnings and profits of the CFC as an excess distribution Enter this amount on line 10e of Part IV
D 0 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 3a through 4c of Part /l to calculate the tax that may be deferred
Note If any portion of line la or line 2a of Part ll is includible under section 551 or 951, you may not make this election Also, see sections
1294(c) and 1294(f and the related regulations for events that terminate this election
E 0 Election To Recognize Gain on Deemed Sale of PFIC . I, a shareholder of a former PFIC or a PFIC to which section 1279(e) applies, elect to treat
as an excess distribution the gain recognized on the deemed sale of my interest in the PFIC, or, if I qualify, my share of the PFIC's post-1986 earnings
and profits deemed distributed, on the last day of its last tax year as a PFIC under section 1297(a) Enter gain on line 10f of Part IV
F 0 Election to Mark-to-Market PFIC Stock . 1, 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 l/I
Part 11 Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines la through 2c If you are makingElection D, also complete lines 3a through 4c (See page 5 of instructions )
1 a Enter your pro rata share of the ordinary earnings of the QEF la 1,815.
b Enter the portion of line la that is included in income under
section 551 or 951 or that may be excluded under section 1293(g) lb 1,815.
c Subtract line 1 b from line la Enter this amount on your tax return as dividend income 1 c 0
2 a Enter your pro rata share of the total net capital gain of the QEF 2a 2 8,814.
b Enter the portion of line 2a that is included in income under
section 551 or 951 or that may be excluded under section 1293(g) 2b 28 , 814.
c Subtract line 2b from line 2a 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 2c 0.
3 a Add lines 1c and 2c 3a
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 3b
c Enter the portion of line 3a not already included in line 3b that is
attributable to shares in the QEF that you disposed of, pledged,
or otherwise transferred during the tax year 3c
d Add lines 3b and 3c 3d
e Subtract line 3d from line 3a, and enter the difference (if zero or less, enter amount in brackets) 3e
Important* If line 3e Is greater than zero, and no portion of line 1a or 2a is Includible in income
under section 551 or 951, you may make Election D with respect to the amount on line 3e
4 a Enter the total tax for the tax year (See instructions ) 4a
b Enter the total tax for the tax year determined without regard to
the amount entered on line 3e 4b
c Subtract line 4b from line 4a This is the deferred tax, the time for payment of which is
extended by makin g Election D. See instructions 4c
LHA For Paperwork Reduction Act Notice , see page 7 of separate instructions Form 8621 (Rev 12-2004)61261105-01-06
Forth 8621 (Rev 12-2004) Page 2
Part 111 ' Gain or (Loss) From Mark-to-Market Election (See page 5 of instructions)5 Enter the fair market value of your PFIC stock at the end of the tax year 5
6 Enter your adjusted basis in the stock at the end of the tax year 6
7 Excess Subtract line 6 from line 5 If a gain, stop here. Include this amount as ordinary income
on your tax return If a loss, go to line 8 7
8 Enter any unreversed inclusions (as defined in section 1296(d)) See instructions 8
9 Enter the smaller of line 7 or line 8 Include this amount as an ordma loss on our tax return 9
Part IV Distributions From and Disposition of Stock of a Section 1291 Fund (See page 6 of instructions.)Complete a separate Part IV for each excess distribution (see instructions)
10 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 10a
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 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) 10b
c Divide line 10b by 3 (See instructions if the number of preceding tax years is less than 3 10c
d Multiply line 10c by 125% ( 1 25) 10d
e Subtract line 10d from line 10a 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 IV See instructions it 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 10e
f Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund If a gain,
complete line 11 If a loss, show it in brackets and do not complete line 11 101
11 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 1 la 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 11b
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 11c
d Foreign tax credit (See instructions ) 11d
e Subtract line 1ld from line 11c Enter this amount on your income tax return as "additional tax" (See instructions 11e
f Determine interest on each net increase in tax determined on line Ile using the rates and methods of section 6621
Enter the a gg reg ate amount of interest here See instructions 11f
Part V Status of Prior Year Section 1294 Elections and Termination of Section 1294 ElectionsComplete a separate column for each outstanding election Complete lines 9 and 10 only if there is a partial ter mination of the section 1294 election
iv v vi1 Tax year of outstanding
election
2 Undistributed earnings to
which the election relates
3 Deferred tax
4 Intent accrued on deferred
tax (line 3) as of the filing date
5 Event terminating election
6 Earnings distributed or deemed
distributed during the tax year
7 Deferred tax due with this
return
8 Accrued interest due with
this return
9 Deferred tax outstanding after
partial termination of election
10 Interest accrued after partial
termination of election
Form 8621 (Rev 12-2004)61261205-01-06
Form 8621 Return by a Shareholder of a Passive Foreign(Rev December2004) Investment Company or Qualified Electing FundDepartment of the TreasuryInternal Revenue Service 10, See separate instructions.
OMB No 1545-1002
Attachment
Sequence No 69
Name of shareholder I Identifying number (see page 2 of instructions)
THE GOERGEN FOUNDATION, INC. 106-1180035Number, street, and room or suite no (If a P 0 box, see page 2 of instructions ) I Shareholder tax year calendar year2 0 0 6 or other tax year beginning
C/O THOMAS E. FINN, PC, 35 MASON STREET nn,lend,nn
City or town, state, and ZIP code or countryGREENWICH, CT 06830
Check type of shareholder filin g the return Individual X Corporation Partnership S Corporation Non g rantor Trust 0 Estate
Name of passive foreign investment company (PFIC) or qualified electing fund (QEF ) Employer identification number (it any)
COBALT OFFSHORE FUND LTDC/O HEMISPHERE MGT ( BVI ) LTDAddress ( Enter number , street , city or town, and country ) Tax year of company or fund calendar year 2006 or otherPO BOX 3460 BISON COURT tax year beginning and
COLUMBUS CENTER, ROADTOWN, TORTOLA. BVI enrftnn
Part I Elections ( See Instructions )A OX Election To Treat the PFIC as a QEF . I, a shareholder of a PFIC , elect to treat the PFIC as a QEF Complete lines la through 2c of Part 11
B 0 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 10f of Part IV
c 0 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-1986 earnings and profits of the CFC as an excess distribution Enter this amount on line 10e of Part IV.
D 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 3a through 4c of Part ll to calculate the tax that may be deferred
Note If any portion of line la or line 2a of Part Il is includible under section 551 or 951, you may not make this election Also, see sections
1294(c) and 1294(1) and the related regulations for events that terminate this election
E 0 Election To Recognize Gain on Deemed Sale of PFIC . I, a shareholder of a former PFIC or a PFIC to which section 1279 ( e) applies, elect to treat
as an excess distribution the gain recognized on the deemed sale of my interest in the PFIC, or, if I qualify, my share of the PFIC' s post - 1986 earnings
and profits deemed distributed , on the last day of its last tax year as a PFIC under section 1297(a) Enter gain on line 10f of Part IV
F 0 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 111
Part II Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines la through 2c If you are makingElection D , also complete lines 3a through 4c (See page 5 of instructions )
1 a Enter your pro rata share of the ordinary earnings of the QEF 1 a 11,657.b Enter the portion of line la that is included in income under
section 551 or 951 or that may be excluded under section 1293(g) 1b 11,657.
c Subtract line 1 b from line la Enter this amount on your tax return as dividend income 11C 0.
2 a Enter your pro rata share of the total net capital gain of the QEF 2a 10,667.
b Enter the portion of line 2a that is included in income under
section 551 or 951 or that may be excluded under section 1293(g) 2b 10 , 667.
c Subtract line 2b from line 2a 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 2c 0.
3 a Add lines 1c and 2c 3a
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 3b
c Enter the portion of line 3a not already included in line 3b that is
attributable to shares in the QEF that you disposed of, pledged,
or otherwise transferred during the tax year 3c
d Add lines 3b and 3c 3d
e Subtract line 3d from line 3a, and enter the difference (If zero or less, enter amount in brackets) 3e
Important, If line 3e is greater than zero, and no portion of line la or 2a is includible in Income
under section 551 or 951, you may make Election D with respect to the amount on line 3e
4 a Enter the total tax for the tax year (See instructions ) 4a
b Enter the total tax for the tax year determined without regard to
the amount entered on line 3e 4b
c Subtract line 4b from line 4a This is the deferred tax, the time for payment of which is
extended by makin g Election D See instructions 4c
LHA For Paperwork Reduction Act Notice , see page 7 of separate instructions . Form 8621 (Rev 12-2004)61261105-01-06
Form 8621 (Rev 12- 2004) Page L
Part 111 ' Gain or (Loss) From Mark-to-Market Election (See page 5 of instructions)
5 Enter the fair market value of your PFIC stock at the end of the tax year
6 Enter your adjusted basis in the stock at the end of the tax year
7 Excess Subtract line 6 from line 5 If a gain, stop here Include this amount as ordinary income
on your tax return If a loss, go to line 8
8 Enter any unreversed inclusions (as defined in section 1296(d)) See Instructions
Part IV Distributions From and Disposition of Stock of a Section 1291 Fund (See page 6 of instructions)Complete a separate Part IV for each excess distnbution (see instructions)
10 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 10a
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 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) 10b
c Divide line 10b by 3 (See instructions if the number of preceding tax years is less than 3) 10c
d Multiply line 10c by 125% (1 25) 10d
e Subtract line 10d from line 10a This amount, it 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 IV See instructions it 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 10e
f Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund If a gain,
complete line 11 If a loss, show it in brackets and do not complete line 11 1 Of
11 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 1 la 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 11b
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 11C
d Foreign tax credit (See instructions ) 11d
11 ee Subtract line 11d from line 1 lc Enter this amount on your income tax return as "additional tax" (See instructions
f Determine interest on each net increase in tax determined on line 11e using the rates and methods of section 6621
Enter the aggregate amount of interest here (See Instructions) 11f
Part V Status of Prior Year Section 1294 Elections and Termination of Section 1294 ElectionsComplete a separate column for each outstanding election Complete lines 9 and 10 only it there is a partial termination of the section 1294 election
i ii iii ( iv ) v vi
1 Tax year of outstanding
election
2 Undistributed earnings to
which the election relates
3 Deferred tax
4 Interest accrued on deferred
tax (line 3) as of the filing date
5 Event terminating election
6 Earnings distributed or deemed
distnbuted during the tax year
7 Deferred tax due with this
return
8 Accrued interest due with
this return
9 Deferred tax outstanding after
partial termination of election
10 Interest accrued after partial
termination of election
Form 8621 (Rev 12-2004)61261205-01-06
Form 8621
(Rev December 2004)Department of the TreasuryInternal Revenue Service
Name of shareholder
Return by a Shareholder of a Passive ForeignInvestment Company or Qualified Electing Fund
► See separate instructions.
THE GOERGEN FOUNDATION, INC.
OMB No 1545-1002
AttachmentSequence No 69
Identifying number (see page 2 of instructions)
06-1180035Number, street, and room or suite no (If a P 0 box, see page 2 of instructions ) I Shareholder tax year calendar year2 0 0 6 or other tax year beginning
C/O THOMAS E. FINN, PC, 35 MASON STREET
City or town, state, and ZIP code or countryGREENWICH, CT 06830
Check ty pe of shareholder filin g the return Individual X Corporation Partnership S Corp oration Non rantor Trust Estate
Name of passive foreign investment company ( PFIC) or qualified electing fund ( QEF) Employer identification number (If any)
DORSET ENERGY FUND
Address ( Enter number, street , city or town , and country ) Tax year of company or fund calendar year 2006 or other73 FRONT STREET tax year beginning and
HAMILTON HM12 BERMUDA ending
Part I Elections (See Instructions
A 0 Election To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF Complete lines la through 2c of Part ll
B 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 10f of Part IV
C 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-1986 earnings and profits of the CFC as an excess distribution Enter this amount on line 10e of Part IV
D 0 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 3a through 4c of Part ll to calculate the tax that may be deferred
Note' If any portion of line la or line 2a of Part ll is includible under section 551 or 951, you may not make this election Also, see sections
1294(c) and 1294(f) and the related regulations for events that terminate this election
E 0 Election To Recognize Gain on Deemed Sale of PFIC . I, a shareholder of a former PFIC or a PFIC to which section 1279(e) applies, elect to treat
as an excess distribution the gain recognized on the deemed sale of my interest in the PFIC, or, if I qualify, my share of the PFIC's post-1986 earnings
and profits deemed distributed, on the last day of its last tax year as a PFIC under section 1297(a) Enter gain on line 10f of Part IV
F 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 111
Part 11 Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines 1a through 2c If you are makingElection D, also complete lines 3a through 4c (See page 5 of instructions )
1 a Enter your pro rata share of the ordinary earnings of the QEF la 572...........
b Enter the portion of line la that is included in income under
section 551 or 951 or that may be excluded under section 1293(g) 1b 572.
c Subtract line lb from line la Enter this amount on your tax return as dividend income 1c 0.
2 a Enter your pro rata share of the total net capital gain of the QEF 2a 11 , 689.
b Enter the portion of line 2a that is included in income under
section 551 or 951 or that may be excluded under section 1293(g) 2b 11 689.
c Subtract line 2b from line 2a 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 2c 0.
3 a Add lines 1c and 2c 3a
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 3b
c Enter the portion of line 3a not already included in line 3b that is
attributable to shares in the QEF that you disposed of, pledged,
or otherwise transferred during the tax year 3c
d Add lines 3b and 3c 3d
e Subtract line 3d from line 3a, and enter the difference (if zero or less, enter amount in brackets) 3e
Important If line 3e Is greater than zero, and no portion of line la or 2a is includible In income
under section 551 or 951, you may make Election D with respect to the amount on line 3e
4 a Enter the total tax for the tax year (See Instructions) 4a
b Enter the total tax for the tax year determined without regard to
the amount entered on line 3e 4b
c Subtract line 4b from line 4a This is the deferred tax, the time for payment of which is
extended by makin g Election D See instructions 4c
LHA For Paperwork Reduction Act Notice , see page 7 of separate instructions . Form 8621 (Rev 12-2004)61261105-01-06
Form 8621 (Rev 12-2004) Page 2
Part Ill ' Gain or (Loss) From Mark-to-Market Election (See page 5 of instructions)
5 Enter the fair market value of your PFIC stock at the end of the tax year 5
6 Enter your adjusted basis in the stock at the end of the tax year 6
7 Excess. Subtract line 6 from line 5 If a gain, stop here. Include this amount as ordinary income
on your tax return If a loss, go to line 8 7
8 Enter any unreversed inclusions (as defined in section 1296(d)) See instructions 8
9 Enter the smaller of line 7 or line 8 Include this amount as an ordina ry loss on your tax return 9
Part IV Distributions From and Disposition of Stock of a Section 1291 Fund (See page 6 of instructions.)Complete a separate Part IV for each excess distnbution (see instructions)
10 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 10a
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)(8)) 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) 10b
c Divide line 10b by 3 (See instructions if the number of preceding tax years is less than 3) 10c
d Multiply line 10c by 125% (1 25) 10d
e Subtract line 10d from line 10a 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 IV See instructions it 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 lice
f Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund If a gain,
complete line 11 If a loss, show it in brackets and do not complete line 11 10f
11 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 11 a 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 11b
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 11 c
d Foreign tax credit (See Instructions) 11d
e Subtract line 1ld from line 11 c Enter this amount on your income tax return as "additional tax" (See instructions 11e
f Determine interest on each net increase in tax determined on line 11 a using the rates and methods of section 6621
Enter the a gg re g ate amount of interest here ( See instructions 111
Part V Status of Prior Year Section 1294 Elections and Termination of Section 1294 ElectionsComplete a separate column for each outstanding election Complete lines 9 and 10 only if there is a partial termination of the section 1294 election
i li III iv v vi
1 Tax year of outstanding
election
2 Undistributed earnings to
which the election relates
3 Deferred tax
4 Interest accrued on deferred
tax (line 3 ) as of the filing date
5 Event terminating election
6 Earnings distributed or deemed
distributed during the tax year
7 Deferred tax due with this
return
8 Accrued interest due with
this return
9 Deferred tax outstanding after
partial termination of election
10 Interest accrued after partial
termination of election
Form 8621 (Rev 12-2004)61261205-01-06
Form 8621
(Rev December 2004)Department of the TreasuryInternal Revenue Service
Name of shareholder
Return by a Shareholder of a Passive ForeignInvestment Company or Qualified Electing Fund
► See separate instructions
OMB No 1545-1002
AttachmentSequence No 69
Identifying number (see page 2 of instructions)
THE GOERGEN FOUNDATION, INC. 06-1180035
Number , street , and room or suite no (If a P 0 box, see page 2 of instructions Shareholder tax year calendar year2 0 0 6 or other tax year beginning
C/O THOMAS E. FINN, PC, 35 MASON STREET and endin
City or town, state, and ZIP code or countryGREENWICH, CT 06830
Check ty pe of shareholder filin g the return Individual X Corporation Partnership S Corp oration Non g rantor Trust Estate
Name of passive foreign investment company (PFIC) or qualified electing fund ( QEF) Employer identification number (If any)
FORUM ABSOLUTE RETURN FUND LTD
C/O CITIGROUP FUND SERVICES ( BERMUDA ) LTDAddress ( Enter number , street , city or town, and country ) Tax year of company or fund calendar year 2 0 0 6 or other
WASHINGTON MALL 1, THIRD FLOOR, 22 CHURCH ST tax year beginning and
HAMILTON HM11, BERMUDA ending
Part I Elections ( See Instructions )A OX Election To Treat the PFIC as a QEF . I. a shareholder of a PFIC, elect to treat the PFIC as a QEF Complete lines la through 2c of Part ll
B 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 10f of Part IV.
c 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- 1986 earnings and profits of the CFC as an excess distribution Enter this amount on line 10e of Part IV
D 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 3a through 4c of Part ll to calculate the tax that may be deferred
Note If any portion of line la or line 2a of Part 11 is includible under section 551 or 951, you may not make this election Also, see sections
1294(c) and 1294(f and the related regulations for events that terminate this election
E Election To Recognize Gain on Deemed Sale of PFIC I, a shareholder of a former PFIC or a PFIC to which section 1279(e) applies, elect to treat
as an excess distribution the gain recognized on the deemed sale of my interest in the PFIC, or, it I quality , my share of the PFIC's post-1986 earnings
and profits deemed distributed , on the last day of its last tax year as a PFIC under section 1297(a) Enter gain on line 10f of Part IV.
F 0 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 Ill
Part 11 Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines 1a through 2c If you are makingElection D, also complete lines 3a through 4c (See page 5 of instructions )
1 a Enter your pro rata share of the ordinary earnings of the QEF la
b Enter the portion of line la that is included in income under
section 551 or 951 or that may be excluded under section 1293(g) 1 b
c Subtract line 1b from line 1a Enter this amount on your tax return as dividend income 1c
2 a Enter your pro rata share of the total net capital gain of the QEF 2a 4,598.
b Enter the portion of line 2a that is included in income under
section 551 or 951 or that may be excluded under section 1293(g ) 2b 4 , 598.
c Subtract line 2b from line 2a 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) 2c 0.
3 a Add lines 1c and 2c 3a
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 3b
c Enter the portion of line 3a not already included in line 3b that is
attributable to shares in the QEF that you disposed of, pledged,
or otherwise transferred during the tax year 3c
d Add lines 3b and 3c 3d
e Subtract line 3d from line 3a, and enter the difference (if zero or less , enter amount in brackets) 3e
Important* If line 3e is greater than zero, and no portion of line la or 2a is includible in income
under section 551 or 951, you may make Election D with respect to the amount on line 3e
4 a Enter the total tax for the tax year ( See instructions ) 4a
b Enter the total tax for the tax year determined without regard to
the amount entered on line 3e 4b
c Subtract line 4b from line 4a This is the deferred tax, the time for payment of which is
extended by makin g Election D See instructions 4c
LHA For Paperwork Reduction Act Notice , see page 7 of separate instructions Form 8621 ( Rev 12-2004)61261105-01-06
Form 8621 (Rev 12-2004) Page Z
Part Ill ' Gain or (Loss) From Mark-to-Market Election (See page 5 of instructions)
5 Enter the fair market value of your PFIC stock at the end of the tax year
6 Enter your adjusted basis in the stock at the end of the tax year
7 Excess Subtract line 6 from line 5 If a gain, stop here . Include this amount as ordinary income
on your tax return If a loss, go to line 8
8 Enter any unreversed inclusions (as defined in section 1296(d)) See Instructions
Part IV Distributions From and Disposition of Stock of a Section 1291 Fund (See page 6 of instructions.)Complete a separate Part IV for each excess distribution (see instructions)
10 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 distnbutions (reduced by the portions of such distributions that were excess distnbutions but not
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 it shorter, the portion of the shareholder's holding period before the current tax year)
c Divide line 10b by 3 (See instructions rf the number of preceding tax years is less than 3 )
d Multiply line 10c by 125% (1 25)
e Subtract line 10d from line 10a 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 IV See instructions if you
received more than one distnbution dunng the current tax year Also, see instructions for rules for reporting a nonexcess
dlstnbution on your income tax return
t Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund If a gain,
complete line 11 If a loss, show it in brackets and do not complete line 11
11 a Attach a statement for each distnbution 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 11 a 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
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
d Foreign tax credit (See instructions )
e Subtract line 1ld from line 11c Enter this amount on your income tax return as 'additional tax' (See instructions
f Determine interest on each net increase in tax determined on line Ile using the rates and methods of section 6621
amount of interest here (See Instructions
Part V Status of Prior Year Section 1294 Elections and Termination of Section 1294 ElectionsComplete a separate column for each outstanding election Complete lines 9 and 10 only it there is a partial termination of the section 1294 election
( iv ) v vi
1 Tax year of outstanding
election
2 Undistributed earnings to
which the election relates
3 Deferred tax
4 Interest accrued on deferred
tax Qine 3) as of the filing date
5 Event terminating election
6 Earnings distributed or deemed
distributed during the tax year
7 Deferred tax due with this
return
8 Accrued interest due with
this return
9 Deferred tax outstanding after
partial termination of election
10 Interest accrued after partial
termination of election
Form 8621 (Rev 12-2004)61261205-01-06
• ,
• Form 8621
(Rev December 2004)Department of the TreasuryInternal Revenue Service
Name of shareholder
Return by a Shareholder of a Passive ForeignInvestment Company or Qualified Electing Fund
OMB No 1545-1002
AttachmentSeauence No 69
Identifying number (see page 2 of instructions)
THE GOERGEN FOUNDATION, INC. 06-1180035Number, street, and room or suite no (If a P 0 box, see page 2 of instructions ) I Shareholder tax year calendar year2 0 0 6 or other tax year beginning
C/O THOMAS E. FINN, PC, 35 MASON STREET andend,no
City or town, state, and ZIP code or countryGREENWICH, CT 06830
Check type of shareholder filin g the return Individual X Corporation Partnership S Corporation 0 Non rantor Trust Estate
Name of passive foreign investment company (PFIC) or qualified electing fund (QEF) Employer identification number ( if any)
LIBERTY SQUARE OFFSHORE PARTNERS LTD
PO BOX 30362 SMB, 2ND FLOOR
Address ( Enter number , street , city or town, and country ) Tax year of company or fund calendar year 2006 or otherGENESIS BUILDING, GEORGETOWN tax year beginning andGRAND CAYMAN , CAYMAN ISLANDS BWI endmo
Part I Elections (See Instructions )
A Election To Treat the PFIC as a QEF . I, a shareholder of a PFIC, elect to treat the PFIC as a QEF Complete lines la through 2c of Part ll
B 0 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 10f of Part IV
c 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-1986 earnings and profits of the CFC as an excess distribution Enter this amount on line 10e of Part IV
D 0 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 3a through 4c of Part /l to calculate the tax that may be deferred.
Note: If any portion of line la or line 2a of Part ll is includible under section 551 or 951, you may not make this election Also, see sections
1294(c) and 1294(t) and the related regulations for events that terminate this election
E 0 Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1279(e) applies, elect to treat
as an excess distribution the gain recognized on the deemed sale of my interest in the PFIC, or, if I quality, my share of the PFIC's post-1986 earnings
and profits deemed distnbuted, on the last day of its last tax year as a PFIC under section 1297(a) Enter gain on line 10f of Part IV.
F 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 1296(e) Complete Part 111
Part II Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines la through 2c If you are makingElection D, also complete lines 3a through 4c (See page 5 of instructions )
1 a Enter your pro rata share of the ordinary earnings of the QEF 1 a
b Enter the portion of line 1 a that is included in income under
section 551 or 951 or that may be excluded under section 1293(g) 1 b
c Subtract line 1b from line la Enter this amount on your tax return as dividend income
2 a Enter your pro rata share of the total net capital gain of the QEF 2a
b Enter the portion of line 2a that is included in income under
section 551 or 951 or that may be excluded under section 1293(g) 2b
c Subtract line 2b from line 2a This amount is a net long-term capital gain Enter this amount
in Part 11 of the Schedule D used for your income tax return (See instructions
3 a Add lines 1c and 2c
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 3b
c Enter the portion of line 3a not already included in line 3b that is
attnbutable to shares in the QEF that you disposed of, pledged,
or otherwise transferred during the tax year 3c
d Add lines 3b and 3c
e Subtract line 3d from line 3a, and enter the difference (if zero or less, enter amount in brackets)
Important - If line 3e is greater than zero, and no portion of line la or 2a Is includible in income
under section 551 or 951, you may make Election D with respect to the amount on line 3e
4 a Enter the total tax for the tax year (See instructions ) 4a
b Enter the total tax for the tax year determined without regard to
the amount entered on line 3e 4b
c Subtract line 4b from line 4a This is the deferred tax, the time for payment of which is
15,069.
15,069.
LHA For Paperwork Reduction Act Notice , see page 7 of separate instructions.61261105-o1-06
0.
Form 8621 (Rev 12-2004)
Form 8621 (Rev 12-2004) Page 2
Part 111 ' Gain or (Loss) From Mark-to-Market Election (See page 5 of instructions)
5 Enter the fair market value of your PFIG stock at the end of the tax year 5
6 Enter your adjusted basis in the stock at the end of the tax year 6
7 Excess Subtract line 6 from line 5 If a gain, stop here. Include this amount as ordinary income
on your tax return If a loss, go to line 8 7
8 Enter any unreversed inclusions (as defined in section 1296(d)) See instructions 8
9 Enter the smaller of line 7 or line 8 Include this amount as an ordina ry loss on y our tax return 9
Part IV Distributions From and Disposition of Stock of a Section 1291 Fund (See page 6 of instructions.)Complete a separate Part IV for each excess distribution (see instructions).
10 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 10a
b Enter the total distributions (reduced by the portions of such distributions that were excess distnbutions but not
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 if shorter, the portion of the shareholder's holding period before the current tax year) 10b
c Divide line 10b by 3 (See Instructions If the number of preceding tax years is less than 3) 10c
d Multiply line 10c by 125% (1 25) 10d
e Subtract line 10d from line 10a 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 IV 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
f Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund If a gain,
complete line 11 If a loss, show it in brackets and do not complete line 11 1 Of
11 a Attach a statement for each distribution and disposition Show your holding penod 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 1 la 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 11b
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 11c
d Foreign tax credit (See Instructions) 11 d
e Subtract line 1 ld from line 11 c Enter this amount on your income tax return as *additional tax' (See instructions 11 e
f Determine interest on each net increase in tax determined on line 11e using the rates and methods of section 6621
Enter the aggregate amount of interest here (See Instructions ) 11 f
Part V Status of Prior Year Section 1294 Elections and Termination of Section 1294 ElectionsComplete a separate column for each outstanding election Complete lines 9 and 10 only if there is a partial termination of the section 1294 election
i ( ii ) ( iii ) Iv v vl
1 Tax year of outstanding
election
2 Undistributed earnings to
which the election relates
3 Deferred tax
4 Interest accrued on deferred
tax (line 3) as of the filing date
5 Event terminating election
6 Earnings distributed or deemed
distributed during the tax year
7 Deferred tax due with this
return
8 Accrued interest due with
this return
9 Deferred tax outstanding after
partial termination of election
10 Interest accrued after partial
termination of election
Form 8621 (Rev 12-2004)61261205-01-06
Forrn 8621
(Rev December 2004)Department of the TreasuryInternal Revenue Service
Name of shareholder
Return by a Shareholder of a Passive ForeignInvestment Company or Qualified Electing Fund
► See senarate instructionsAttachmentSequence No 69
Identifying number (see page 2 of instructions)
THE GOERGEN FOUNDATION, INC. 06-1180035Number, street, and room or suite no (If a P 0 box, see page 2 of instructions ) I Shareholder tax year calendar year2 0 0 6 or other tax year beg i nning
C/O THOMAS E. FINN, PC, 35 MASON STREET andend,no
OMB No 1545-1002
City or town, state, and ZIP code or countryGREENWICH, CT 06830
Check type of shareholder film the return E^j Individual X Corporation Partnership S Corporation Non g rantor Trust Estate
Name of passive foreign investment company (PFIC) or qualified electing fund (QEF ) Employer identification number ( if any)
MATTERHORN OFFSHORE FUND LTD
C/O C IITCI FUND SERVICES (CURACAO) LTDAddress ( Enter number , street , city or town, and country ) Tax year of company or fund calendar year 2 0 0 6 or otherKAYA FLAMBOYAN 9, PO BOX 4774 tax year beginning and
WILLEMSTED CURACAO NETHERLAND ANTILLES ending
Part I Elections (See Instructions )A LX Election To Treat the PFIC as a QEF . I, a shareholder of a PFIC, elect to treat the PFIC as a QEF Complete lines la through 2c of Part ll.
B 0 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 10f of Part IV.
C 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-1986 earnings and profits of the CFC as an excess distribution Enter this amount on line 10e of Part IV.
D 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 3a through 4c of Part 11 to calculate the tax that may be deferred.
Note: If any portion of line la or line 2a of Part ll is includible under section 551 or 951, you may not make this election Also, see sections
1294(c) and 1294(f and the related regulations for events that terminate this election
E 0 Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1279(e) applies, elect to treat
as an excess distribution the gain recognized on the deemed sale of my interest in the PFIC, or, if I qualify, my share of the PFIC's post-1986 earnings
and profits deemed distributed, on the last day of its last tax year as a PFIC under section 1297(a) Enter gain on line 10f of Part IV.
F 0 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 111
Part 11 Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines la through 2c If you are making
Election D, also complete lines 3a through 4c (See page 5 of instructions )
1 a Enter your pro rata share of the ordinary earnings of the QEF la 2,176.
b Enter the portion of line la that is included in income under
section 551 or 951 or that may be excluded under section 1293(g) 1b 2,176.
c Subtract line 1 b from line la Enter this amount on your tax return as dividend income 1 c 0.
2 a Enter your pro rata share of the total net capital gain of the QEF 2a 6,713.
b Enter the portion of line 2a that is included in income under
section 551 or 951 or that may be excluded under section 1293(g) 2b 6 , 713.c Subtract line 2b from line 2a 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 2c 0
3 a Add lines 1c and 2c 3a
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 3b
c Enter the portion of line 3a not already included in line 3b that is
attributable to shares in the QEF that you disposed of, pledged,
or otherwise transferred during the tax year 3c
d Add lines 3b and 3c 3d
e Subtract line 3d from line 3a, and enter the difference (if zero or less, enter amount in brackets) 3e
Important . If line 3e is greater than zero, and no portion of line la or 2a is includible in income
under section 551 or 951, you may make Election D with respect to the amount on line 3e
4 a Enter the total tax for the tax year (See instructions ) 4a
b Enter the total tax for the tax year determined without regard to
the amount entered on line 3e 4b
c Subtract line 4b from line 4a This is the deferred tax, the time for payment of which is
extended by making Election D. See instructions 4c
LHA For Paperwork Reduction Act Notice , see page 7 of separate instructions . Form 8621 (Rev 12-2004)61261105-o1-a6
Form 8621
Part III ' Gain or (Loss) From Mark-to-Market Election (see page 5 of instructions)
5 Enter the fair market value of your PFIC stock at the end of the tax year
6 Enter your adjusted basis in the stock at the end of the tax year
7 Excess . Subtract line 6 from line 5 If a gain, stop here. Include this amount as ordinary income
on your tax return If a loss, go to line 8
8 Enter any unreversed inclusions (as defined in section 1296(d)) See Instructions
9 Enter the smaller of line 7 or line 8 Include this amount as an ordinary loss on your tax return 1 9 1
Part IV Distributions From and Disposition of Stock of a Section 1291 Fund (See page 6 of instructions.)Complete a separate Part IV for each excess distribution (see rnstnJctfons)
10 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)(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 portion of the shareholder's holding period before the current tax year)
c Divide line 10b by 3 (See instructions it the number of preceding tax years is less than 3 )
d Multiply line 10c by 125% (1 25)
e Subtract line 10d from line 10a 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 IV See instructions it 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
f Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund If a gain,
complete line 11 If a loss, show it in brackets and do not complete line 11
11 a Attach a statement for each distribution and disposition Show your holding penod for each share of stock
or block of shares held Allocate the excess distribution to each day in your holding penod Add all amounts
that are allocated to days in each tax year
b Enter the total of the amounts determined in line 1 la 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
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
d Foreign tax credit (See instructions )
e Subtract line 1ld from line 11c Enter this amount on your income tax return as 'additional tax' (See instructions
f Determine interest on each net increase in tax determined on line 1 le using the rates and methods of section 6621
Enter the aggregate amount of interest here (See Instructions) 111f
Part V Status of Prior Year Section 1294 Elections and Termination of Section 1294 ElectionsComplete a separate column for each outstanding election Complete lines 9 and 10 only if there is a partial termination of the section 1294 election
it ill ( iv ) v ( vi )
1 Tax year of outstanding
election
2 Undistributed earnings to
which the election relates
3 Deferred tax
4 Interest accrued on deferred
tax (line 3) as of the filing date
5 Event terminating election
6 Earnings distributed or deemed
distributed during the tax year
7 Deferred tax due with this
return
8 Accrued interest due with
this return
9 Deferred tax outstanding after
partial termination of election
10 Interest accrued after partial
termination of election
Form 8621 (Rev 12-2004)61261205-01-06
Form 8621
(Rev December 2004)Department of the TreasuryInternal t3evenue Service
Name of shareholder
Return by a Shareholder of a Passive ForeignInvestment Company or Qualified Electing Fund
OMB No 1545-1002
AttachmentSequence No 69
Identifying number (see page 2 of instructions)
THE GOERGEN FOUNDATION, INC. 06-1180035
Number, street, and room or suite no (If a P 0 box, see page 2 of instructions Shareholder tax year calendar year2 0 0 6 or other tax year beginning
C/O THOMAS E. FINN, PC, 35 MASON STREET and ending
City or town, state, and ZIP code or countryGREENWICH, CT 06830
Check typ e of shareholder filin g the return Individual X Corporation Partnership S Corporation Non rantor Trust Estate
Name of passive foreign investment company (PFIC) or qualified electing fund ( QEF) Employer identification number ( it any)
SELIGMAN TECH SPECTRUM FD
C/O PFPC INTERNATIONAL LTD
Address ( Enter number , street , city or town, and country ) Tax year of company or fund calendar year 2 0 0 6 or otherRVERSIDE 2, SIR JOHN ROGERSON'S QUAY tax year beginning andGRAND CANAL DOCK DUBLIN 2, IRELAND endin g
Part I Elections (See Instructions )A 0 Election To Treat the PFIC as a QEF I, a shareholder of a PFIC , elect to treat the PFIC as a QEF Complete lines la through 2c of Part 11
B 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 10f of Part IV
C 0 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 - 1986 earnings and profits of the CFC as an excess distribution Enter this amount on line 10e of Part IV
D 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 3a through 4c of Part ll to calculate the tax that may be deferred
Note: If any portion of line la or line 2a of Part ll is includible under section 551 or 951, you may not make this election . Also, see sections
1294(c) and 1294(1) and the related regulations for events that terminate this election
E Election To Recognize Gain on Deemed Sale of PFIC . I, a shareholder of a former PFIC or a PFIC to which section 1279 ( e) applies, elect to treat
as an excess distribution the gain recognized on the deemed sale of my interest in the PFIC, or, a I qualify, my share of the PFIC ' s post - 1986 earnings
and profits deemed distributed , on the last day of its last tax year as a PFIC under section 1297(a) Enter gain on line 10f of Part IV
F 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 111
Part 11 Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines la through 2c If you are makingElection 0 , also complete lines 3a through 4c (See page 5 of instructions )
1 a Enter your pro rata share of the ordinary earnings of the QEF
b Enter the portion of line 1 a that is included in income under
section 551 or 951 or that may be excluded under section 1293(g)
c Subtract line 1b from line la Enter this amount on your tax return as dividend income
2 a Enter your pro rata share of the total net capital gain of the QEF
b Enter the portion of line 2a that is included in income under
section 551 or 951 or that may be excluded under section 1293(g)
c Subtract line 2b from line 2a 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 )
3 a Add lines 1c and 2c
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
c Enter the portion of line 3a not already included in line 3b that is
attributable to shares in the QEF that you disposed of, pledged,
or otherwise transferred during the tax year 3c
d Add lines 3b and 3c
e Subtract line 3d from line 3a, and enter the difference ( If zero or less, enter amount in brackets)
Important If line 3e is greater than zero, and no portion of line la or 2a is includible in income
under section 551 or 951, you may make Election D with respect to the amount on line 3e
4 a Enter the total tax for the tax year (See instructions )
b Enter the total tax for the tax year determined without regard to
the amount entered on line 3e 14b
c Subtract line 4b from line 4a This is the deferred tax, the time for payment of which is
extended by making Election D. See instructions
142.
142.1c
31.
31.
2c
3a
3d
LHA For Paperwork Reduction Act Notice , see page 7 of separate instructions61261105-01-06
0.
0.
Form 8621 (Rev 12-2004)
Form 8621 (Rev 12-2004) Page 2
Part III - Gain or (Loss) From Mark-to-Market Election (See page 5 of instructions)
5 Eoter the fair market value of your PFIC stock at the end of the tax year 5
6 Enter your adjusted basis in the stock at the end of the tax year 6
7 Excess Subtract line 6 from line 5 If a gain, stop here. Include this amount as ordinary income
on your tax return If a loss, go to line 8 7
8 Enter any unreversed inclusions (as defined in section 1296(d)) See instructions 8
9 Enter the smaller of line 7 or line 8 Include this amount as an ordina ry loss on y our tax return 9
Part IV Distributions From and Disposition of Stock of a Section 1291 Fund (See page 6 of instructions.)Complete a separate Part IV for each excess distribution (see instructions)
10 a Enter your total distributions from the section 1291 fund during the current tax year with respect to the applicable stock If the
holding penod of the stock began in the current tax year, see instructions 10a
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 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) 10b
c Divide line 10b by 3 (See instructions it the number of preceding tax years is less than 3 10c
d Multiply line 10c by 125% (1 25) 10d
e Subtract line 10d from line 10a 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 IV See instructions it 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 10e
f Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund If a gain,
complete line 11 If a loss, show it in brackets and do not complete line 11 1011
11 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 1 la 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 11b
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 11 c
d Foreign tax credit (See Instructions) 11d
e Subtract line 11d from line 11c Enter this amount on your income tax return as 'additional tax' (See instructions 11e
f Determine interest on each net increase in tax determined on line 11 a using the rates and methods of section 6621
Enter the agg reg ate amount of interest here See instructions 1111
Part V Status of Prior Year Section 1294 Elections and Termination of Section 1294 ElectionsComplete a separate column for each outstanding election Complete lines 9 and 10 only if there is a partial termination of the section 1294 election
i ( iv ) v vl1 Tax year of outstanding
election
2 Undistributed earnings to
which the election relates
3 Deferred tax
4 Interest accrued on deferred
tax (line 3) as of the filing date
5 Event terminating election
6 Earnings distributed or deemed
distributed during the tax year
7 Deferred tax due with this
return
8 Accrued interest due with
this return
9 Deferred tax outstanding after
partial termination of election
10 Interest accrued after partial
termination of election
Form 8621 (Rev 12-2004)61261205-01-06
Form 8621 I Return by a Shareholder of a Passive Foreign(Rev December 2004) Investment Company or Qualified Electing FundDepartment of the Treasury -
Name of shareholder
OMB No 1545-1002
AttachmentSequence No 69
Identifying number (see page 2 of instructions)
THE GOERGEN FOUNDATION, INC. 06-1180035Number , street , and room or suite no (If a P 0 box , see page 2 of instructions Shareholder tax year calendar year2 0 0 6 or other tax year beginning
C/O THOMAS E. FINN, PC, 35 MASON STREET and end ing
City or town , state, and ZIP code or countryGREENWICH, CT 06830
Check type of shareholder film the return Individual X Corporation Partnership S Corporation Non g rantor Trust Estate
Name of passive foreign investment company ( PFIC) or qualified electing fund ( QEF) Employer identification number ( if any)
SPRING POINT OPPORTUNITY OFFSHORE FDC/O BISYS HEDGE FFD SERVICES ( CAYMAN ) LTDAddress ( Enter number , street , city or town , and country ) Tax year of company or fund calendar year 2006 or other3RD FLOOR, HARBOUR CENTRE PO BOX 3 0 3 6 2 SMB tax year beginning andCAYMAN ISLANDS, BWI endin g
Part 1 Elections (See instructions
A Election To Treat the PFIC as a QEF . I, a shareholder of a PFIC , elect to treat the PFIC as a QEF Complete lines la through 2c of Part /l
B 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 10f of Part IV
C 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-1986 earnings and profits of the CFC as an excess distribution Enter this amount on line 10e of Part IV
D E:1 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 3a through 4c of Part 11 to calculate the tax that may be deferred
Note: If any portion of line la or line 2a of Part 11 is includible under section 551 or 951, you may not make this election. Also, see sections
1294(c) and 1294(1) and the related regulations for events that terminate this election
E O Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1279(e) applies, elect to treat
as an excess distribution the gain recognized on the deemed sale of my interest in the PFIC, or, if I qualify, my share of the PFIC's post-1986 earnings
and profits deemed distributed, on the last day of its last tax year as a PFIC under section 1297(a) Enter gain on line 10f of Part IV
F 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 Ill.
Part 11 Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines la through 2c If you are makingElection D, also complete lines 3a through 4c (See page 5 of instructions )
1 a Enter your pro rata share of the ordinary earnings of the QEF
b Enter the portion of line 1a that is included in income under
section 551 or 951 or that may be excluded under section 1293(g)
c Subtract line lb from line la Enter this amount on your tax return as dividend income
2 a Enter your pro rata share of the total net capital gain of the QEF
b Enter the portion of line 2a that is included in income under
section 551 or 951 or that may be excluded under section 1293(g)
c Subtract line 2b from line 2a 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 )
3 a Add lines 1c and 2c
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
c Enter the portion of line 3a not already included in line 3b that is
attributable to shares in the QEF that you disposed of, pledged,
or otherwise transferred during the tax year 3c
d Add lines 3b and 3c
e Subtract line 3d from line 3a, and enter the difference ( if zero or less , enter amount in brackets)
Important : If line 3e is greater than zero, and no portion of line la or 2a is includible in income
under section 551 or 951, you may make Election D with respect to the amount on line 3e
4 a Enter the total tax for the tax year (See instructions )
b Enter the total tax for the tax year determined without regard to
the amount entered on line 3e 4b
Subtract line 4b from line 4a This is the deferred tax , the time for payment of which is
ions
1,106.
1,106.
812.
812.
LHA For Paperwork Reduction Act Notice , see page 7 of separate instructions61261105-01-06
1c 0.
2c 0.3a
3d
3e
4c
Form 8621 (Rev 12-2004)
.e
Form 8621 (Rev 12 - 2004) Page 2
Part 111 ' Gain or (Loss) From Mark-to-Market Election ( See page 5 of instructions)
5 Enter the fair market value of your PFIC stock at the end of the tax year 5
6 Enter your adjusted basis in the stock at the end of the tax year 6
7 Excess Subtract line 6 from line 5 If a gain, stop here Include this amount as ordinary income
on your tax return If a loss , go to line 8 7
8 Enter any unreversed inclusions ( as defined in section 1296(d)) See instructions 8
9 Enter the smaller of line 7 or line 8 Include this amount as an ordina loss on y our tax return 9
Part IV Distributions From and Disposition of Stock of a Section 1291 Fund (See page 6 of instructions.)Complete a separate Part IV for each excess distribution (see instructions)
10 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 10a
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 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 penod before the current tax year) 10b
c Divide line 10b by 3 (See Instructions If the number of preceding tax years is less than 3) 10c
d Multiply line 10c by 125% ( 1 25) 10d
e Subtract line 10d from line 10a 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 IV See instructions if you
received more than one distribution dunng the current tax year Also , see instructions for rules for reporting a nonexcess
distribution on your income tax return
f Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund If a gain,
complete line 11 If a loss, show it in brackets and do not complete line 11
11 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 1 la 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
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 )
d Foreign tax credit (See instructions )
e Subtract line 11d from line 11 c Enter this amount on your income tax return as 'additional tax' (See instructions
f Determine interest on each net increase in tax determined on line 11e using the rates and methods of section 6621
Enter the aggregate amount of interest here (See Instructions
Part V Status of Prior Year Section 1294 Elections and Termination of Section 1294 ElectionsComplete a separate column for each outstanding election Complete lines 9 and 10 only if there is a partial termination of the section 1294 election
11 0 fi of iv v of1 Tax year of outstanding
election
2 Undistributed earnings to
which the election relates
3 Deferred tax
4 Interest accrued on deferred
tax Qine 3) as of the filing date
5 Event terminating election
6 Earnings distributed or deemed
distributed during the tax year
7 Deferred tax due with this
return
8 Accrued interest due with
this return
9 Deferred tax outstanding after
partial termination of election
10 Interest accrued after partial
termination of election
Form 8621 (Rev 12-2004)61261205-01-06
ad
Form 8621 I Return by a Shareholder of a Passive Foreign(Rev December 2904) Investment Company or Qualified Electing FundDepartment of the Treasury -
Name of shareholder
THE GOERGEN FOUNDATION, INC.
Attachment
Sequence No 69
Identifying number (see page 2 of instructions)
06-1180035Number, street, and room or suite no (If a P 0 box, see page 2 of instructions) I Shareholder tax year calendar year2 0 0 6 or other tax year beginning
C/O THOMAS E. FINN, PC, 35 MASON STREET andendma
OMB No 1545-1002
City or town, state, and ZIP code or countryGREENWICH, CT 06830
Check ty pe of shareholder filin g the return Individual X Corporation Partnership S Corporation Non rantor Trust Estate
Name of passive foreign investment company (PFIC) or qualified electing fund (QEF) Employer identification number ( if any)
TIEDEMANN JAPAN QP LTDC/O MORGAN STANLEY FUND SERVICES LTDAddress (Enter number, street, city or town, and country ) Tax year of company or fund calendar year 2006 or otherCLARENDON HOUSE, 2 CCHURCH ST tax year beginning andHAMILTON HM DX BERNUDA endin g
Part I Elections (See instructions )A WX Election To Treat the PFIC as a QEF I, a shareholder of a PFIC, elect to treat the PFIC as a QEF Complete lines la through 2c of Part ll.
B Deemed Sale Election 1 , 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 10f of Part IV
C 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-1986 earnings and profits of the CFC as an excess distribution Enter this amount on line 10e of Part /V.
D 0 Election To Extend Time For Payment of Tax 1, 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 3a through 4c of Part /l to calculate the tax that may be deferred
Note: If any portion of line la or line 2a of Part 11 is includible under section 551 or 951, you may not make this election Also, see sections
1294(c) and 1294(1) and the related regulations for events that terminate this election
E 0 Election To Recognize Gain on Deemed Sale of PFIC . I, a shareholder of a former PFIC or a PFIC to which section 1279(e) applies, elect to treat
as an excess distribution the gain recognized on the deemed sale of my interest in the PFIC, or, if I quality, my share of the PFIC's post-1986 earnings
and profits deemed distributed, on the last day of its last tax year as a PFIC under section 1297(a) Enter gain on line 1Of of Part IV
F 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 III.
Part 11 Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines la through 2c If you are makingElection D, also complete lines 3a through 4c (See page 5 of instructions )
1 a Enter your pro rata share of the ordinary earnings of the QEF la
b Enter the portion of line la that is included in income under
section 551 or 951 or that may be excluded under section 1293(g) lb
c Subtract line lb from line 1a Enter this amount on your tax return as dividend income 1c
2 a Enter your pro rata share of the total net capital gain of the QEF 2a 1,457.
b Enter the portion of line 2a that is included in income under
section 551 or 951 or that may be excluded under section 1293(g) 2b 1 , 457.
c Subtract line 2b from line 2a 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) 2c 0
3 a Add lines 1c and 2c 3a
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 3b
c Enter the portion of line 3a not already included in line 3b that is
attributable to shares in the QEF that you disposed of, pledged,
or otherwise transferred during the tax year 3c
d Add lines 3b and 3c 3d
e Subtract line 3d from line 3a, and enter the difference (if zero or less, enter amount in brackets) 3e
Important- If line 3e is greater than zero, and no portion of line la or 2a is includible in income
under section 551 or 951, you may make Election D with respect to the amount on line 3e
4 a Enter the total tax for the tax year (See instructions ) 4a
b Enter the total tax for the tax year determined without regard to
the amount entered on line 3e 4b
c Subtract line 4b from line 4a This is the deferred tax , the time for payment of which is
extended by makin g Election D See instructions 4c
LHA For Paperwork Reduction Act Notice , see page 7 of separate instructions Form 8621 (Rev 12-2004)61261105-01-06
aForm 8621 (Rev 12-2004) Page 2
Part 111 • Gain or (Loss) From Mark-to-Market Election (See page 5 of instructions)
5 Egter the fair market value of your PFIC stock at the end of the tax year 5
6 Enter your adjusted basis in the stock at the end of the tax year 5
7 Excess. Subtract line 6 from line 5 If a gain, stop here. Include this amount as ordinary income
on your tax return If a loss, go to line 8 7
8 Enter any unreversed inclusions (as defined in section 1296(d)) See instructions 8
9 Enter the smaller of line 7 or line 8 Include this amount as an ordina ry loss on y our tax return 9
Part IV Distributions From and Disposition of Stock of a Section 1291 Fund (See page 6 of instructions.)Complete a separate Part IV for each excess distribution (see instructions)
10 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 10a
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 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) 10b
c Divide line 1 Ob by 3 (See instructions if the number of preceding tax years is less than 3) 10c
d Multiply line 10c by 125% (1 25) 10d
e Subtract line 10d from line 10a 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 IV 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
f Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund If a gain,
complete line 11 If a loss, show it in brackets and do not complete line 11
11 a Attach a statement for each distribution and disposition Show your holding penod 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 1 la 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
c Enter the aggregate increases in tax (before credits) for each tax year in your holding penod
(other than the current tax year and pre-PFIC years) (See instructions )
d Foreign tax credit (See instructions )
e Subtract line 11d from line 11c Enter this amount on your income tax return as *additional tax' (See instructions
f Determine interest on each net increase in tax determined on line 11 a using the rates and methods of section 6621
ate amount of interest here (See instructions
Part V Status of Prior Year Section 1294 Elections and Termination of Section 1294 ElectionsComplete a separate column for each outstanding election Complete lines 9 and 10 only if there is a partial termination of the section 1294 election
iii Iv v vi1 Tax year of outstanding
election
2 Undistributed earnings to
which the election relates
3 Deferred tax
4 Interest accrued on deferred
tax Qine 3) as of the filing date
5 Event terminating election
6 Earnings distnbuted or deemed
distnbuted during the tax year
7 Deferred tax due with this
return
8 Accrued interest due with
this return
9 Deferred tax outstanding after
partial termination of election
10 Interest accrued after partial
termination of election
Form 8621 (Rev 12-2004)612612o5-ol-o6
aw
Form 8621
(Rev December 2004)
Department of the Treasury
Internal Revenue Service
Name of shareholder
Return by a Shareholder of a Passive ForeignInvestment Company or Qualified Electing Fund
► See separate instructions
THE GOERGEN FOUNDATION, INC.
OMB No 1545-1002
Attachment
Sequence No 69
Identifying number (see page 2 of instructions)
06-1180035Number , street , and room or suite no (If a P 0 box, see page 2 of instructions ) I Shareholder tax year calendar year2 0 0 6 or other tax year beginning
C/O THOMAS E. FINN, PC, 35 MASON STREET andendin4City or town, state , and ZIP code or countryGREENWICH, CT 06830
Check type of shareholder filing the return U Individual U Corporation L__J Partnership U S Corporation U Nongrantor Trust 0 Estate
Name of passive foreign investment company ( PFIC) or qualified electing fund ( QEF) Employer identification number ( if any)THIRD POINT OFFSHORE LTDC/O INTERNATIONAL FUND SERVICES (IRELAND) LT
Address ( Enter number , street , city or town, and country ) Tax year of company or fund calendar year 2006 or otherBISHOP'S SQUARE, THIRD FLOOR, REDMOND'S HILL tax year beginning andDUBLIN 2, IRELAND endin g
Pall I Elections ( See instructions
A [K] Election To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF Complete lines la through 2c of Part ll
B 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 10f of Part IV.
C 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-1986 earnings and profits of the CFC as an excess distribution Enter this amount on line 10e of Part IV
D 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 3a through 4c of Part ll to calculate the tax that may be deferred
Note If any portion of line la or line 2a of Part ll is includible under section 551 or 951, you may not make this election Also, see sections
1294(c) and 1294(f) and the related regulations for events that terminate this election
E Election To Recognize Gain on Deemed Sale of PFIC . I, a shareholder of a former PFIC or a PFIC to which section 1279(e) applies, elect to treat
as an excess distribution the gain recognized on the deemed sale of my interest in the PFIC, or, if I qualify, my share of the PFIC's post-1986 earnings
and profits deemed distributed, on the last day of its last tax year as a PFIC under section 1297(a) Enter gain on line 10f of Pan: IV.
F O 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 Ill.
Part 11 Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines la through 2c If you are makingElection D, also complete lines 3a through 4c (See page 5 of instructions )
1 a Enter your pro rata share of the ordinary earnings of the QEF la
b Enter the portion of line 1a that is included in income under
section 551 or 951 or that may be excluded under section 1293(g) 1 b
c Subtract line 1b from line la Enter this amount on your tax return as dividend income 1c
2 a Enter your pro rata share of the total net capital gain of the QEF 2a 6,147.
b Enter the portion of line 2a that is included in income under
section 551 or 951 or that may be excluded under section 1293(g) 2b 6 , 147.
c Subtract line 2b from line 2a 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 2c 0.
3 a Add lines 1c and 2c 3a
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 3b
c Enter the portion of line 3a not already included in line 3b that is
attributable to shares in the QEF that you disposed of, pledged,
or otherwise transferred during the tax year 3c
d Add lines 3b and 3c 3d
e Subtract line 3d from line 3a, and enter the difference (If zero or less, enter amount in brackets) 3e
Important If line 3e is greater than zero, and no portion of line la or 2a is includible in income
under section 551 or 951, you may make Election D with respect to the amount on line 3e
4 a Enter the total tax for the tax year (See instructions ) 4a
b Enter the total tax for the tax year determined without regard to
the amount entered on line 3e 4b
c Subtract line 4b from line 4a This is the deferred tax , the time for payment of which is
extended b y making Election D. See instructions 4c
LHA For Paperwork Reduction Act Notice , see page 7 of separate instructions Form 8621 (Rev 12-2004)61261105-01-06
rForm 8621 (Rev 12-2004) Page 2
Part ill • Gain or (Loss) From Mark-to-Market Election (Seepage 5 of instructions)5 Enter the fair market value of your PFIC stock at the end of the tax year 5
6 Enter your adjusted basis in the stock at the end of the tax year 6
7 Excess Subtract line 6 from line 5 If a gain, stop here. Include this amount as ordinary income
on your tax return If a loss, go to line 8 7
8 Enter any unreversed inclusions (as defined in section 1296(d)) See instructions 8
9 Enter the smaller of line 7 or line 8 Include this amount as an ordina ry loss on our tax return 9
Part IV Distributions From and Disposition of Stock of a Section 1291 Fund (See page 6 of instructions.)Complete a separate Part IV for each excess distribution (see instructions)
10 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 10a
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 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 penod before the current tax year) 10b
c Divide line 10b by 3 (See instructions if the number of preceding tax years is less than 3) 10c
d Multiply line 10c by 125% (1 25) 10d
e Subtract line 10d from line 10a 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 IV 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 108
f Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund If a gain,
complete line 11 If a loss, show it in brackets and do not complete line 11 10f
11 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 11 a 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 11b
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 11 c
d Foreign tax credit (See Instructions) 11d
e Subtract line 1ld from line 11c Enter this amount on your income tax return as "additional tax' (See instructions Ill e
f Determine interest on each net increase in tax determined on line 1 le using the rates and methods of section 6621
Enter the agg re g ate amount of interest here See instructions 11 f
Part V Status of Prior Year Section 1294 Elections and Termination of Section 1294 ElectionsComplete a separate column for each outstanding election Complete lines 9 and 10 only if there is a partial termination of the section 1294 election
i fl ui Iv v vi
1 Tax year of outstanding
election
2 Undistributed earnings to
which the election relates
3 Deferred tax
4 Interest accrued on deferred
tax (line 3 ) as of the filing date
5 Event terminating election
6 Earnings distributed or deemed
distributed during the tax year
7 Deferred tax due with this
return
8 Accrued interest due with
this return
9 Deferred tax outstanding after
partial termination of election
10 Interest accrued after partial
termination of election
Form 8621 (Rev 12-2004)61261205-01-06
Forrn 8621
(Rev December 2g04)Department of the TreasuryInternal Revenue Service
Name of shareholder
Return by a Shareholder of a Passive Foreign OMB No 1545-11002
Investment Company or Qualified Electing Fund Attachment10, See seoarate instructions . Sequence No 69
Identifying number (see page 2 of instructions)
THE GOERGEN FOUNDATION, INC. 06-1180035
Number , street , and room or suite no ( If a P 0 box , see page 2 of instructions Shareholder tax year calendar year2 0 0 6 or other tax year beginning
C/O THOMAS E. FINN, PC, 35 MASON STREET and endin
City or town, state , and ZIP code or countryGREENWICH, CT 06830
Check ty pe of shareholder filin g the return Individual X Corporation Partnership S Corporation Non rantor Trust Estate
Name of passive foreign investment company ( PFIC) or qualified electing fund ( QEF) Employer identification number ( if any)
ANDOR TECHNOLOGY OFFSHORE FUNDC/O MORGAN STANLEY FUND SERVICESAddress ( Enter number , street , city or town, and country ) Tax year of company or fund calendar year 2 0 0 6 or other
CLARENDON HOUSE, 2 CHURCH STREET tax year beginning and
HAMILTOM HMDX, BERMUDA endin g
Part I Elections (See instructions )A Election To Treat the PFIC as a QEF . I, a shareholder of a PFIC, elect to treat the PFIC as a QEF Complete lines la through 2c of Part ll
B fl 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 10f of Part IV.
C 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-1986 earnings and profits of the CFC as an excess distribution Enter this amount on line 10e of Part IV
D 0 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 3a through 4c of Part ll to calculate the tax that may be deferred
Note. If any portion of line 1 a or line 2a of Part // is includible under section 551 or 951, you may not make this election Also, see sections
1294(c) and 1294(1) and the related regulations for events that terminate this election
E Election To Recognize Gain on Deemed Sale of PFIC I, a shareholder of a former PFIC or a PFIC to which section 1279 (e) applies , elect to treat
as an excess distribution the gain recognized on the deemed sale of my interest in the PFIC , or, if I qualify, my share of the PFIC' s post - 1986 earnings
and profits deemed distributed , on the last day of its last tax year as a PFIC under section 1297 ( a) Enter gain on line 10f of Part /V.
F 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 Ill
Part 11 Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines la through 2c If you are makingElection D , also complete lines 3a through 4c (See page 5 of instructions )
1 a Enter your pro rata share of the ordinary earnings of the QEF la
b Enter the portion of line 1 a that is included in income under
section 551 or 951 or that may be excluded under section 1293(g) 1b
c Subtract line lb from line la Enter this amount on your tax return as dividend income 1c
2 a Enter your pro rata share of the total net capital gain of the QEF 2a
b Enter the portion of line 2a that is included in income under
section 551 or 951 or that may be excluded under section 1293(g) 2b
c Subtract line 2b from line 2a 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 2c
3 a Add lines 1c and 2c 3a
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 3b
c Enter the portion of line 3a not already included in line 3b that is
attributable to shares in the QEF that you disposed of, pledged,
or otherwise transferred during the tax year 3c
d Add lines 3b and 3c 3d
e Subtract line 3d from line 3a , and enter the difference (If zero or less, enter amount in brackets) 3e
Important If line 3e is greater than zero, and no portion of line la or2a is Includible in income
under section 551 or 951, you may make Election D with respect to the amount on line 3e
4 a Enter the total tax for the tax year (See Instructions) 4a
b Enter the total tax for the tax year determined without regard to
the amount entered on line 3e 4b
c Subtract line 4b from line 4a This is the deferred tax , the time for payment of which is
extended by makin g Election D See instructions 4c
LHA For Paperwork Reduction Act Notice , see page 7 of separate instructions Form 8621 (Rev 12-2004)61261105.01-06
Forth 8621 (Rev 12-2004) Page 2
Part 111 • Gain or (Loss) From Mark-to-Market Election (See page 5 of instructions )5 Epter the fair market value of your PFIC stock at the end of the tax year 5
6 Enter your adjusted basis in the stock at the end of the tax year 6
7 Excess Subtract line 6 from line 5 It a gain, stop here. Include this amount as ordinary income
on your tax return If a loss, go to line 8 7
8 Enter any unreversed inclusions (as defined in section 1296(d)) See instructions 8
9 Enter the smaller of line 7 or line 8 Include this amount as an ordina ry loss on your tax return 9
Part IV Distributions From and Disposition of Stock of a Section 1291 Fund (See page 6 of instructions.)Complete a separate Part IV for each excess distribution (see instructions)
10 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 10a
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 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) 10b
c Divide line 10b by 3 (See instructions if the number of preceding tax years is less than 3) 10c
d Multiply line 10c by 125% (1 25) 10111
e Subtract line 10d from line 10a 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 IV 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 10e
f Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund If a gain,
complete line 11 If a loss, show it in brackets and do not complete line 11 10f 28 f 9 8 7
11 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 1 la 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 13 11b 28,987.
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 11 c
d Foreign tax credit (See Instructions) lid
e Subtract line 1 ld from line 11c Enter this amount on your income tax return as 'additional tax' (See instructions 11110
f Determine interest on each net increase in tax determined on line 11 e using the rates and methods of section 6621
Enter the a gg reg ate amount of interest here See instructions 111111
Part V Status of Prior Year Section 1294 Elections and Termination of Section 1294 ElectionsComplete a separate column for each outstanding election Complete lines 9 and 10 only if there is a partial termination of the section 1294 election
i u Iii iv v ( vi )1 Tax year of outstanding
election
2 Undistributed earnings to
which the election relates
3 Deferred tax
4 Intent accrued on deferred
tax (line 3 ) as of the filing date
5 Event terminating election
6 Earnings distributed or deemed
distributed during the tax year
7 Deferred tax due with this
return
8 Accrued interest due with
this return
9 Deferred tax outstanding after
partial termination of election
10 Interest accrued after partial
termination of election
Form 8621 (Rev 12-2004)61261205-01-06
Form 8621
(Rev December 2004)Department of the TreasuryInternal Revenue Service
Name of shareholder
Return by a Shareholder of a Passive ForeignInvestment Company or Qualified Electing Fund
► See separate instructions.
OMB No 1545-1002
Attachment
Identifying number (see page 2 of instructions)
THE GOERGEN FOUNDATION, INC. 06-1180035Number , street , and room or suite no (If a P 0 box, see page 2 of instructions Shareholder tax year calendar year2 0 0 6 or other tax year beg i nning
C/O THOMAS E. FINN, PC, 35 MASON STREET and endin g
City or town, state, and ZIP code or country
GREENWICH, CT 06830Check ty pe of shareholder filin g the return Individual X Corporation Partnership S Corporation Nong rantor Trust Estate
Name of passive foreign investment company (PFIC) or qualified electing fund ( QEF) Employer identification number ( if any)
WHITNEY NEW JAPAN INVESTORS LTD
Address ( Enter number, street, city or town , and country ) Tax year of company or fund calendar year 2 0 0 6 or other177 BROAD STREET SUITE 502 tax year beginning andSTAMFORD, CT 06901 ending
Part I Elections ( See InstructionsA El Election To Treat the PFIC as a QEF . I, a shareholder of a PFIC, elect to treat the PFIC as a QEF Complete lines la through 2c of Part ll
B El 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 10f of Part IV.
C El 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 - 1986 earnings and profits of the CFC as an excess distribution Enter this amount on line 10e of Part IV.
D 0 Election To Extend Time For Payment of Tax . 1, 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 3a through 4c of Part ll to calculate the tax that may be deferred.
Note If any portion of line 1 a or line 2a of Part ll is includible under section 551 or 951 , you may not make this election Also, see sections
1294(c) and 1294(f) and the related regulations for events that terminate this election.
E 0 Election To Recognize Gain on Deemed Sale of PFIC I, a shareholder of a former PFIC or a PFIC to which section 1279 ( e) applies , elect to treat
as an excess distribution the gain recognized on the deemed sale of my interest in the PFIC, or, if I qualify, my share of the PFIC's post-1986 earnings
and profits deemed distributed , on the last day of its last tax year as a PFIC under section 1297(a) Enter gain on line 10f of Part IV.
F 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 1296(e ) Complete Part///
Part II Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines la through 2c If you are makingElection D , also complete lines 3a through 4c (See page 5 of instructions )
1 a Enter your pro rata share of the ordinary earnings of the QEF 1a
b Enter the portion of line la that is included in income under
section 551 or 951 or that may be excluded under section 1293(g) 1 b
c Subtract line lb from line la Enter this amount on your tax return as dividend income
2 a Enter your pro rata share of the total net capital gain of the QEF
L2
b Enter the portion of line 2a that is included in income under
section 551 or 951 or that may be excluded under section 1293(g)
c Subtract line 2b from line 2a 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 )
3 a Add lines 1c and 2c
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) 3b
c Enter the portion of line 3a not already included in line 3b that is
attributable to shares in the QEF that you disposed of, pledged,
or otherwise transferred during the tax year 3c
d Add lines 3b and 3c
e Subtract line 3d from line 3a, and enter the difference (if zero or less , enter amount in brackets)
Important If line 3e is greater than zero, and no portion of line la or 2a is includible in income
under section 551 or 951, you may make Election D with respect to the amount on line 3e
4 a Enter the total tax for the tax year (See instructions ) 4a
b Enter the total tax for the tax year determined without regard to
the amount entered on line 3e 4b
c Subtract line 4b from line 4a This is the deferred tax , the time for payment of which is
LHA For Paperwork Reduction Act Notice , see page 7 of separate instructions61261105-01-06
Form 8621 (Rev 12-2004)
M?; 9Form 8621 (Rev 12-2004) Page 2
Part III • Gain or (Loss) From Mark-to-Market Election (See page 5 of instructions)5 Enter the fair market value of your PFIC stock at the end of the tax year 5
6 Enter your adjusted basis in the stock at the end of the tax year 6
7 Excess Subtract line 6 from line 5 If a gain, stop here. Include this amount as ordinary income
on your tax return If a loss, go to line 8 7
8 Enter any unreversed inclusions (as defined in section 1296(d)) See instructions 8
9 Enter the smaller of line 7 or line 8 Include this amount as an ordina ry loss on your tax return 9
Part IV Distributions From and Disposition of Stock of a Section 1291 Fund (See page 6 of instructions)Complete a separate Part IV for each excess distribution (see Instructions)
10 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 10a
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 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 penod before the current tax year) 10b
c Divide line 1 Ob by 3 (See instructions if the number of preceding tax years is less than 3) 10c
d Multiply line 10c by 125% ( 1 25) 10d
e Subtract line 10d from line 10a This amount , it 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 IV 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 10e
t Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund If a gain,
complete line 11 If a loss, show it in brackets and do not complete line 11 1011 21 7 17
11 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 1 la 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 11b
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 11 c
d Foreign tax credit ( See Instructions) 11d
e Subtract line 1 ld from line 11c Enter this amount on your income tax return as 'additional tax' (See instructions 11le
f Determine interest on each net increase in tax determined on line 1 le using the rates and methods of section 6621
Enter the agg re g ate amount of interest here See instructions 11 f
Part V Status of Prior Year Section 1294 Elections and Termination of Section 1294 ElectionsComplete a separate column for each outstanding election Complete lines 9 and 10 only if there is a partial termination of the section 1294 election
ii iii ( iv ) v vi1 Tax year of outstanding
election
2 Undistributed earnings to
which the election relates
3 Deferred tax
4 Interest accrued on deferred
tax (line 3 ) as of the filing date
5 Event terminating election
6 Earnings distributed or deemed
distributed during the tax year
7 Deferred tax due with this
return
8 Accrued interest due with
this return
9 Deferred tax outstanding after
partial termination of election
10 Interest accrued after partial
termination of election
Form 8621 (Rev 12-2004)61261205-o1-06
E` GOERGEN FOUNDATION, INC. 06-1180035
FORM 8621 DISTRIBUTIONS OF STOCK IN A SECTION 1291 FUND STATEMENT 13
1. DATE STOCK PURCHASED
2. DATE STOCK DISPOSED OF OR DISTRIBUTED
3. EXCESS DISTRIBUTION ALLOCATED TO EACH DAY IN HOLDING PERIOD4. TOTAL ALLOCABLE TO EACH TAX YEAR IN HOLDING PERIOD5. TOTAL ALLOCABLE TO THE CURRENT TAX YEAR AND
PRE-PFIC TAX YEARS, IF DIFFERENT 28,987.
6. TOTAL TO LINE 11B (LINE 4 OR 5) 28,987.7. TAX. TOTAL TO LINE 11C
8. FOREIGN TAX CREDIT. TOTAL TO LINE 11D
9. NET TAX. TOTAL TO LINE 11E 0.10. INTEREST. TOTAL TO LINE 11F
50 STATEMENT(S) 1310421106 739634 7217 2006. 07000 THE GOERGEN FOUNDATION , INC 7217 _1
p.1 .
Form 8868(Aev December 2006)
Department of the Treasury
Internal Revenue Serwm
OMB No 1545-1709
• If you are filing for an Automatic 3-Month Extension , complete only Part I and check this box ►• If you are filing for an Additional (not automatic) 3-Month Extension , complete only Part li (on page 2 of this form)
Do not complete Part 11 unless you have already been granted an automatic 3-month extension on a previously filed Form 8868.
Part l Automatic 3-Month Extension of Time. Only submit original (no copies needed).
Section 501 (c)(3) corporations required to file Form 990-T and requesting an automatic 6-month extension - check this box
and complete Part I only ► 0
All other corporations (including 1120-C filers), partnerships, REMICs, and trusts must use Form 7004 to request an extension of time
to file income tax returns.
Electronic Filing (e-file). Generally , you can electronically file Form 8868 if you want a 3-month automatic extension of lime to file one of the returns
noted below (6 months for section 501 (c)(3) corporations required to file Form 990-T) However , you cannot file Form 8868 electronically If (1) you want
the additional (not automatic) 3-month extension or (2) you file Forms 990- BL, 6069 , or 8870 , group returns , or a composite or consolidated Form
990-T . Instead, you must submit the fully completed and signed page 2 (Part II ) of Form 8868 . For more details on the electronic filing of this form,visit www irs. oov/efile and click on a-file for Chanties & Nonprofits
Type or I Name of Exempt Organization I Employer identification number
File by the
due date for
filing your
return See
Instructions
THE GOERGEN FOUNDATION, INC.
Number , street , and room or suite no . If a P.O. box, see instructions.
C/O THOMAS E. FINN, PC, 35 MASON STREET
City, town or post office, state, and ZIP code . For a foreign address , see instructions.
GREENWICH, CT 06830
Check type of return to be filed (file a separate application for each return):
Form 990 Form 990-T (corporation) Form 4720
0 Form 990-BL Form 990-T (sec 401(a) or 408(a) trust ) Form 5227
O Form 990-EZ Form 990-T (trust other than above) Form 6069
0 Form 990-PF 0 Form 1041-A Form 8870
• The books are In the care of ► THOMAS E. F INN, P.C.
Telephone No ► 203-661-7760 FAX No ►• If the organization does not have an office or place of business in the United States , check this box ► El
• 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 ► 0 . If it is for part of the group , check this box ► El and attach a list with the names and EINs of all members the extension will cover.
I I request an automatic 3-month (6-months for a section 501(c)(3) corporation required to file Form 990-T) extension of time until
AUGUST 15, 200 7 , to file the exempt organization return for the organization named above The extension
is for the organization 's return for.
►L calendar year 2 0 0 6 or► El tax year beginning , and ending
2 If this tax year is for less than 12 months , check reason : 0 Initial return El Final return El 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 instruction s 3a $ 35,000.
b If this application is for Form 990-PF or 990-T, enter any refundable credits and estimated
tax payments made. Include any prior year overpayment allowed as a credit. 3b $ 0 .
c Balance Due. Subtract line 3b from line 3a. Include your payment with this form, or, If required,
deposit with FTD coupon or, if required, by using EFTPS (Electronic Federal Tax Payment System)
See Instructions 3c $ 35,000.
Caution. If you are going to make an electronic fund withdrawal with this Form 8868, see Form 8453-EO and Form 8879-EO for payment instructions.
LHA For Privacy Act and Paperwork Reduction Act Notice , see instructions . Form 8868 (Rev 12-2006)
Application for Extension of Time To File anExempt Organization Return
► File a separate application for each return.
06-1180035
62383102-07-07
et ^' r
Form 8868 (Rev 4-2007) Page 2
• If you are filing for an Additional (not automatic ) 3-Month Extension , complete only Part II and check this box ► LX
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 11 Additional (not automatic) 3-Month Extension of Time. You must file original and one copy.
Type orName of Exempt Organization Employer identification number
printHE GOERGEN FOUNDATION, INC. 06-1180035
File by the
extended Number, street, and room or suite no. If a P.O. box, see instructions For IRS use onlytluedatefor 2 /O THOMAS E. FINN, PC, 35 MASON STREETfiling thereturn see City, town or post office, state, and ZIP code For a foreign address, see instructions.instructions
GREENWICH, CT 06830
Check type of return to be filed (File a separate application for each return)
0 Form 990 0 Form 990-EZ EDForm 990-T (sec. 401(a) or 408(a) trust) Form 1041-A 0 Form 5227 Form 8870
= Form 990-BL 0 Form 990-PF 0 Form 990-T (trust other than above) Form 4720 Form 6069
STOP! Do not complete Part ll if you were not already granted an automatic 3-month extension on a previously filed Form 8868.
• The books are in the care of ► THOMAS E. FINN, P.C.
Telephone No. ► 203-661-7760 FAX No. ►• If the organization does not have an office or place of business in the United States , check this box ►• If this is for a Group Return , enter the organization 's four digit Group 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 and attach a list with the names and EINs of all members the extension is for.
4 I request an additional 3-month extension of time until NOVEMBER 15, 2007 .
5 For calendar year 2 0 0 6 , or other tax year beginning , and ending
6 If this tax year is for less than 12 months, check reason = Initial return Final return Change in accounting period
7 State in detail why you need the extension
INFORMATION NECESSARY TO COMPLETE THE RETURN HAS NOT BEEN RECEIVED FROMTHIRD PARTIES.
8a If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any
nonrefundable credit s. See instructions.
b If this application is for Form 990-PF, 990-T, 4720, or 6069 , enter any refundable credits and estimated
tax payments made Include any prior year overpayment allowed as a credit and any amount paid
35.000.
35,000.c Balance Due. Subtract line 8b from line 8a Include your payment with this form, or, if required, deposit
with FTD coupon or, if required, by using EFTPS (Electronic Federal Tax Payment System). See instructions 8c $ 0.
Signature and VerificationUnder penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements, and to the best of my knowledge and belief,it is true, correct, and complete, and that I am authorized to prepare this form
Signature ► Title ► CPA Date ►Notice to Applicant . (To Be Completed by the IRS)
We have approved this application Please attach this form to the organization's return.We have not approved this application. However, we have granted a 10-day grace period from the later of the date shown below or the due
date of the organization's return (including any prior extensions). This grace penod is considered to be a valid extension of time for elections
otherwise required to be made on a timely return Please attach this form to the organization's return
We have not approved this application. After considering the reasons stated in item 7, we cannot grant your request for an extension of time to
file We are not granting a 10-day grace period.
0 We cannot consider this application because it was filed after the extended due date of the return for which an extension was requested.
0 Other
ByDirector Date
Alternate Mailing Address . Enter the address if you want the copy of this application for an additional 3-month extension returned to an addressdifferent than the one entered above.
Name
THOMAS E. FINN P. C.Type or Number and street (include suite , room , or apt. no.) or a P . O. box numberprint 35 MASON STREET
City or town , province or state , and country (including postal or ZIP code)
iosoo7 GREENWICH , CT 06830
Form 8868 (Rev 4-2007)
5210421106 739634 7217 2006.07000 THE GOERGEN FOUNDATION, INC 7217 1