Form 990-PF (2016) Part VI Page 4 Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions) la Exempt operating foundations described in section 4940(d)(2), check here ► 0 and enter "N/A" on line 1 Date of ruling or determination letter (attach copy of letter if necessary-see instructions) b Domestic foundations that meet the section 4940(e) requirements in Part V, check here IP 0 and enter 1% 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(8)(1) trusts and taxable foundations only Others enter -0-) 3 Add lines 1 and 2 4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only Others enter -0-) • Tax based on investment income. Subtract line 4 from line 3 If zero or less, enter -0- 6 Credits/Payments a 2016 estimated tax payments and 2015 overpayment credited to 2016 6a b Exempt foreign organizations—tax withheld at source 6b 6c 6d 113 2,684 3 4 5 2,684 2,684 c Tax paid with application for extension of time to file (Form 8868) . . d Backup withholding erroneously withheld 7 Total credits and payments Add lines 6a through 64 8 Enter any penalty for underpayment of estimated tax Check here 0 if Form 2220 is attached 9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed ► 10 11 Part VII-A Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid. ► !Refunded ► Enter the amount of line 10 to be credited to 2017 estimated tax IP la 7 113 8 9 10 11 2,571 Statements Regarding Activities During the tax year, did the foundation attempt to influence any national, state, or local legislation or did it participate or intervene in any political campaign, b Did it spend more than 5100 during the year (either directly or indirectly) for political