Return of Private Foundation or Section 4947(a)(1) Nonexempt Charitable Trust

Treated as a Private Foundation nhnn inmi Ho n6/n In unn o nnno nI IF~e iulur~ "w ~nbnA~ ..b~.~ ~.~~w .~.. ~~. ..~~~~~~

OMB NO 15,15-0052 For � 990-PF DripNmenl of Me Treasuy Internet Rs+enw Ssvka 2001 Note me

or tax rear Gi

1s co ° e- �L~~~44ASIl~Q 2 , 889 . 2,889 . 0 . 14 Olh re a0~wages-~ 15 Pen ion planeA~A1~6c~en fi T V~av~ 78a Leg

a hAccounting fees STMT 2 700 . 0 . 700 . '~j c Other professional tees °> 17 Interest L tB taxes STMT 3 450 . 450 . 0 .

19 Depreciation and depletion 9 20 Occupancy a 21 Travel, conferences, and meetings

F2~ c 22 Printing and publications CY% cc 23 Other expenses STMT 4 208 . 0 . 208 .

24 Total operating and administrative $ expense: Add lines 13 through 23 9 247 . 3 , 339 . 908 .

�~ X 25 Contributions . pelts, grants paid 10 8 2 8 . ' ~ - 10 828 . ~`Cn~' 26 Total expenses and disbursements ~1 Addlines 2aana25 15 , 075 . . ,3 339 . ' ' 11 , 736 .

27 Subtract line 26 from line 12 ~f

1 10 . L Ex- aa of m~ua avs expenses and EbOUnamnb ~L� ̂ 'd

e NetInvestment Income pf n.a.wa«.w a) 9 626 . oAdjusted netIncome pin.v.waenter -a) - N/A[^

f i1 oz-ox I.HA For Paperwork Reduction Act Notice, see the Instructions [Form B90-PF (2007) 1

13170506 790883 51591 9001 .05030 ANNTF M_ f'(1(lT(CFV TRTTCT dfRdA 5155'l 1

Use the IRS Name of organization A Employer Identification number label AN NIE M . COOKSEY TRUST #846

Otherwise, /O VIRGINIA COMMONWEALTH TRUST COMPANY 54-6280321 print Numberenastreet (orPObaanumWIlemIllanotaNNereOtostrselWartaa) RooMaulta 8 Telephone number

On type ,p, BOX 1717 540/825-9110 Sae Specific Instructions City or town, slate, and ZIP coda Cu,.ernouon .pPnmnon i .pending ~«k he. "0

ULPEPER VA 22701 D 1 Foreign orpanizations,check here t ~ H Check type of organization M aniuUOn X Section 501 (c )( 3 ) exempt private foundation 2 FoRion or,asiz.uons treating m, 85% iaL ~

cnaknenenaeturnmmPUteoan Section 4947(a)(1) nonexempt charitable trust ~ Other taxable private foundation E If pnvale foundation status was terminated

I Fair market value of all assets al end o1 year J Accounting method OX Cash El Accrual under section 507(b)(1)(A), clack here "0 (from Part ll, cot (c), line 16) 0 Other (specify)

$ 2 8 4 10 0 . (Part I, column F If the foundation is in a 60-month termination

" (c) must be on cash basis) under section 507 (b )( 1 8 ) . check here Is= part I Analysis of Revenue and Expanses (a) Revenue and (E) Disbursements

(the total o! amounts in columns (6) expenses per (h) Net investment (c) Adjusted net for charitable (c), and (~ may not necessanty equal books income income purposes the amounts in column ( N/A (cash basis only)

1 Contnbutions,gifts,qranis,etc,received Check "O IIIIalanmomsins rtyYeam&Wli$qi 8

2 Distributions from split-interest trusts Interest on turning, end temporvy

3 cash Invesmrnd 4 Dividends and interest from securities 11 , 114 . 11,114 . STATEMENT I Sa Grass rents b (Net "W inoone, or goes)

Be N~palnor(lofalftmsets alusebnoton ~1 , 851 . O --- o cross; ". pd. lo, WI 3 , 301 . 0 axbonline 6!

7 Cel W pdn not Inwms (horn Part N line T) `1,8 5 1 . '

B Net short-term capital pain 9 Income modifications

lOB Gnuaalelsareturns end N~awancw

h ..da-- - , , ' .. ..

s cr sproftR~EI 11 Olh t infamf~-~ 12 TatlJlbdlineslthrnunh7l ~5~3i 12 .965_ 17_9F,5

ANNIE M . COOKSEY TRUST #846

17 Accounts payable and accrued expenses 18 Grams payable 19 Deferred revenue

- 20 Loenakomollan director trustee enCOMerdIaQUelifieGpenana A 21 Mortgages and other notes payable J 22 Other liabilities (Aescnbe " )

r

Orpanlzatloni that follow SFAS 117, cheek here 1 U ` and complete lines 24 through 26 and lines 30 and 31

24 Unrestricted nC 25 Temporarily restricted M 26 Permanently restricted

Organizations that do not follow SFAS 117, check here 1 and template lines 27through 31

t°~ 27 Capital stock, trust principal . or current funds 208 , 828 . 206 , 718 . i 28 Paid-in or capital surplus, or land, bldg , and equipment fund 0 . 0 . 29 Retained earnings, accumulated income endowment, or other funds 0 . 0 . 30 Total netassets orfund balances 208 828 . 206 718 .

^ 31 Total liabilities endnetassets /fu nd balancas 208 828 . 206 , 718 .

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 years return)

2 Enter amount from Part I, line 27a 3 Other increases not Included in fine 2 (itemize) 4 Add lines 1, 2, and 3 5 Decreases not included in line 2 (itemize) 0, 6 Total net assets or fund balances at end of year cline 4 minus line 5) - Part 1 1, column

<2,110 . > 0 .

103311 of-xa.ot

13120506 790883 51553 2

2001 .05030 ANNIE M . COOKSEY TRUST #846 51553 1

Form 990-PF(2007) C/O VIRGINIA COMMONWE Balance Sheets "°°'°°0"°°"°'"°""a'"°""°°n*'°' NuimNalaDelum6oFpvimWnsorgy

1 Cash - non -into rest-boa ring 2 Savings and temporary cash investments 3 Accounts receivable 1

Less allowance for doubtful accounts 111-4 Pledges receivable llll~

Less allowance for doubtful accounts 111i 5 Grants receivable 6 flecerva6les due from officers, directors, trustees, and other

disqualified persons 7 OT>natszn0lmrsmv,A70k

Less allowance fordoubtful accounts

8 Inventories for sale or use

9 Prepaid expenses and deferred charges 10a Investments- U S and state government obligations

b Investments " corporate stock c Investments " corporate bonds

11 in xrnms wiaeunaiqsmaewlo~t ours

l= mrtWeOQ9tadaOm 1

12 Investments - mortgage loans 13 Investments-other STMT 5 14 Land, buildings, and equipment basis ~

l= nvmAea0[v~em

15 Other assets (describe

'H TRUST COMPANY 54-6280321 Page 2 Beginning of year End of ear (a) Book Value (b) Book Value (c) Fair Market Value

3 024 . 2 351 . 2 , 35-1 . . .� , .,. ,. . ,. c :, .. . . ,

205 804 . 204,367 . 281,749 .

208 .828 . 206,718 . 284 .100 .

F- 990-PF (2ro+)

3

(a) List and describe the kind(s) al property sold (e p , real estate, 2- story brick warehouse, o r common stock, 200 shs MLC Co )

J UNITS COMMON TRUST FUND A )MMON TRUST FUND A GAIN/LOSS ALLOCATION )MMON TRUST FUND B GAIN/LOSS ALLOCATION

(e) Gross sales Dnce (0 Deprecation allowed (p) Cost or other basis (or allowable) plus expense of sale

omplete only for assets showing gain in column (h) and owned by the foundation on 12/3189

(I) F M V a5 of 12/31/69 (1) Adl uSteU ba5i5 (k) Excess

Of c01 (I) as of 12/31/69 over cal (1),d any

1,85

2112152

0422430

80,993 .

11,870 .

96 .

11 .966 . 7 Add lines 5 and 6

B Enter qualifying distributions from Part XII, line 4 11,736 .

If line B is equal to or greater than line 7, chock the box In Part VI, line 1b, and complete that part using a 1% tax ate See the Part VI Instructions

123521 Fog 990-PF Room

m-x4m 3

13120506 790883 51553 2001 .05030 ANNIE M . COOKSEY TRUST #846 51553 1

ANNIE M . COOKSEY TRUST #846 Form 990-PFf20011 C/O VIRGINIA COMMONWEALTH TRUST COMPANY

2 Capital gain net income or (net capital loss) ~ If p ain, also enter in Part I, line 7 1 If (loss), enter-0- in Part I, line 7 l

3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6) If pain, also enter in Part I, line 8, column (c) If (loss), enter-0-in Part I, line 8

[ raft Y 1 VU811iIC8il0n UOUer SBCiIOfI 4`JqUtC) TOE 1S6011CeO 187( Oft IVBi InV65ZTBfli IA(

(For optional use by domestic private foundations subject to the section 4940(a) lax on net Investment income )

It section 4940(4)(2) applies, leave this part blank

Was the organization liable for the section 4942 tax on the distn6ulable amount of any year in the base penod9 If Yes,' the organization does not quality under section 4940(e) Do not complete this part 1 Enter the appropriate amount in each column for each year, see Instructions before making any entries

(1111 IN Base penod years Adjusted rainnaar ~nar In, tar vaar naninninn ini qualifying distributions Net value of nonchantable-use assets

2 Total of line t, column (6) 3 Average distribution ratio for the 5-year base penod -GrviOe the total on line 2 by 5, or by the number of years

the foundation has been in existence If less than 5 years

4 Enter the net value of nonchantaDle-use assets for 2001 from Part X, line 5

5 Multiply line 4 byline 3

6 Enter 7% of net investment income (1% of Part I, line 27b)

54-6280321

(c Date acquired I (d) Date sold ~mo .dey,yr) (ma,day,yr)

(h) Gain or (loss) (e) plus (t) minus (q)

(1) Gains (Col (n) gain minus cot (k), but not less khan -0-) or

Losses (iromcol (h))

0 Yes M No

ANNIE M . COOKSEY TRUST #846 54-6280321 Paoe4

or 4948 - see instructions F"-

i 'f93 .

z 0 . 3 193 . 4 5 193 .

ran vi ucise a ax nasea on investment income taecnon 4aqutal, naauilo), 4a4ui 1! Exempt operating foundations described In section 4940(E)(2), check here 1 and enter 'WA' on line 1

Date of ruling letter (attach copy of ruling letter If necessary-see Instructions) D Domestic organizations that meet the section 4940(e) requirements In Part V, check here 1 0 and enter 1 % of Part I, line 27D

c All other domestic organizations enter 2°/, of line 27b Exempt foreign organizations enter 4% of Part I, line 72, col (b) 2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only Others enter -0-) 3 Ado lines 1 and 2 d Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only Others enter -0-) 5 Tea based on Investment Income Subtract line 4 from line 3 If zero or less, enter-0- 8 Credits/Payments a 2001 estimated tax payments and 2000 overpayment credited to 2001 6a D Exempt foreign organizations -tax withheld at source 6b c Tax paid with application for extension of time to file (Form 8868) 6c d Backup withholding erroneously withheld 6d 7 Total credits and payments Add lines 6a through 6d B 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 1, enter amount owed 10 Overpayment If line 7 is more than the total of lines 5 and 8, enter the amount overpaid

1 a During the tax year, did the organization attempt to influence any national, state, or local legislation or did it participate or Intervene in Yes No any political campaign? to X

h Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see instructions for definition) 16 X N the answer /s 'Yes' to 1 a or 76, attach a detailed description of the activities and copies of any materials published or distributed by the orgen¢atron in connection with the activities

c Did the orqaniratlon file Farm 1120-POL for this years 1s ~ X d Enter the amount (d any) of tax on political expend flures (section 4955) imposed du nnp the year

(t) On the organization " $ 0 " (2) On organization managers " $ 0 . e Enter the reimbursement (if any) paid by the organization during the year for political expenditure tax imposed on organization

managers " a 0 . 2 Has the organization engaged in any activities that have not previously been reported to the IRS 2 , X

If 'Yes,' attach a deleted description of the activities 3 Has the organization made any changes, not previously reported to the IRS, in its governing instrument, articles of Incorporation, or

bylaws, or other similar insiruments'> If 'Yes,* attach e conformed copy o/ the changes 3 ` V X <a Did the organization have unrelated business grass income of $1,000 or more during the years 4a X D If Yes; has d filed a tax return on Form 990-i for this years N/A 4p

5 WasNerealiqw0atian,termination,dissolutian,arsubsWntialcontractiondurlnptheyear9 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 stale law

remain in the governing instrument? ~ 8 `X 7 did the organization have at least $5,000 In assets at any time during the year? 7 X

If 'Yes,' complete Pert ll, cot (c), end Pert XV 8a Enter the states to which the foundation reports or with which it is registered (see instructions) VIRGINIA

6 It the answer is 'Yes' to line 7, has the organization furnished a copy of Form 990-PF to the Aqamey General (or designate) of each state as required by General Instruction G7 If "No,' attach explanation ' Bb X }

9 Is the organization claiming status as a private operating foundation within the meaning of section 4942(l)(3) or 4942(j)(5) for calendar ' ` year 2001 or the taxable year beginning in 2001 (see instructions for Park XIV)? I/ 'Yes,' complete Pert XIV "`9~ � ` `X

10 Did any persons become substantial contributors during the tax years 10 X If 'Yes,' attach a schedule listing thalrnames end addresses

11 Did the organization comply with the public Inspection requirements for its annual retains and exemption applicalian9 71 X Web srteaddress " N/A

12 ihebooks aremcareot " VIRGINIA COMMONWEALTH TRUST COMPANY Telephone no "540/825-9110 Locatedat " P .0 . BOX 1717, CULPEPER, VA . Zipw "22701

13 Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Farm 1001 - Check here " 0 and enter the amount of tax-exempt interest received or accrued during the Year " 1 13 1 N/A

of zSi~ F��, 990-PF Room 4

13120506 790RR3 51553 2001_05030 ANN7R M_ COOKGRV TRfIRT #R4(, 5155' 7

Farm

ANNIE M . COOKSEY TRUST #846 Form 990-PF 54-6280321 Pape5

File Form 4720 if any item Is checked in the °Yes' column, unless an exception applies 1a During the year did the organization (either directly or Indirectly)

(1) Engage in the sale or exchange, or leasing of property with a disQualdie0 persons ~ yes D No (2) Borrow money from, lend money to, or otherwise extent credit to (or accept h from)

a disqualified parsons 0 Yea 0 No (3) Furnish goods, services, or facilities to (or accept them from) a disqualified persons 0 Yes M No (C) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? EJ Yes EXI 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)? Yes [71 No (6) Agree to pay money or property to a government official? (Exception Chock 'No*

ii the organization agreed to make a grant to or to employ the official for a period after termination of government service, it terminating within 90 days ) E] Yes M No

h If any answer is 'Yes' to 1a(1)-(6), did any of the acts tail to quality under the exceptions described in Regulations section 53 4941(G)-3 or in a current notice regarding disaster assistance (see page 19 of the instructions)? Organizations relying on a current notice regarding disaster assistance check here

e Did the organization engage in a prior year in any o1 the acts described in 1a, other than excepted acts, that were not corrected baton the first day of the lax year beginning in 20019

2 Taxes on failure to distribute Income (section 4942) (does not apply for years the organization was a private operating foundation defined in section 4942(j)(3) or 4942(j)(5))

a At the end of G: year 2001, did the organization have any undistributed income (lines 6d and 6e, Pan %11I) for tax year(s) beginning before 2001 Yes 0 Na If'Yes; list the years

6 Are there any years listed in 2a for which tie organization is not applying the provisions of section 4942(a)(2) (relating to incorrect valuation of assets) to the year's undistributed incomes (If applying section 4942(a)(2) to all years listed, answer "No' and attach statement-see instructions ) N/A

o If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list tie years here

3a Did tie organization hole more than a 2 % direct or indirect interest in any business enterprise at any time during theyear? EJ Yes M Na

6 If'Yes; did it have excess business holdings in 2001 as a result of (1) any purchase by the organization or disqualified persons otter May 26, 1969, (2) the lapse of tie 5-year penod (or longer period approved by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired 6y 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 organization had excess business holdings in 2001) N/A

4a Did the organization invest during the year any amount in a manner that would jeopardize its charitable purposes h Did the organization make any investment in a prior year (but otter December 31, 1969) that could jeopardize its charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 20019

5a During the year did the organization pay or incur any amount to (t) Carry on propaganda . or otherwise attempt to influence legislation (section 4945(e))? D yes ~X No (2) Influence the outcome of any specific public election (see section 4955) or to carry on . directly or indirectly,

any voter registration drive? 0 Yes ~ No (3) Provide a grant to an individual for travel, study, or other similar purposes 0 Yes EXI No (4) Provide a grant to an organization other than a charitable, etc , organization described In section

509(a)(1), (2), or (3), or section 4940(d)(2)? ~ Yes D No (5) Provide tar any purpose other than religious, charitable, scientific, literary, or educational purposes, or for

the prevention of cruelty to children or animals 0 Yea 0 No 6 It any answer is 'Yes'to Sa(1 )-(5), did any of the transactions fail to quality under the exceptions described in Regulations

section 53 4945 or in a current notice reporting disaster assistance (see instructions)7 N/A Organizations relying on a current notice regarding disaster assistance check here 10

C If the answer is 'Yes' to question 5a(4), does the organization claim exemption from the tax because 9 maintained expenditure responsibility fortheprant? N/A DYe:ONo If 'Yes,' attach the statement required by Regulations section 53 4945-5(d)

6a Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? Yes M No

D Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contact If you answered 'Yes' to 66 . also file Form 8870

.B6 , X.

Form 990-PF Rope

5 13120506 790883 51553 2001 .05030 ANNIE M . COOKSEY TRUST #846 51553 1

16

~1 c

3h ~` 4a X

4h X

izssn of z1-az

ANNIE M . COOKSEY TRUST #846 Form 990-PF(21

Pmt VIII

280321 Page e Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,

3 Five highest-paid independent contractors for professional services If none, enter "NONE " (a) Name and address of each person paid more than E50,000 (61 Tvoe of service (c) Compensation

61 -5 u2 Fog 080-PF poor) 6

13120506 790883 51553 2001 .05030 ANNIE M . COOKSEY TRUST #846 51553 1

List the foundation's tour largest direct chantabla activities during the tax year Include relevant statistical information such as the I Expenses number of organizations and other beneficianes served, conferences convened, research papers produced, etc THE TRUST MAKES GRANTS ONLY TO AMISSVILLE BAPTIST CHURCH AND DOES NOT CARRY ON ANY CHARITABLE ACTIVITIES DIRECTLY .

2

3

4

1 Minimum investment return from Part X, line 6 2a Tax on investment income for 2001 from Part VI, line 5 2a b Income tax for 2001 (This does not include the lax from Part VI ) 2b t Add lines 2a and 26 3 Distnbutable amount before adjustments Subtract line 2c from line 1 4 a Racovenas of amounts treated as qualifying distributions 4a b Income distributions from section 4947(a)(2) trusts 4h c Add lines 4a and 4b

Add lines 3 and 4c 5 Deduction from dislnbulable amount (see instructions) 7 DlctributaGle amount as adjusted Subtract line 61rom line 5 Enter here and on Pad XIII, line 1

Part X11 Qualifying Distributions (see instructions)

1 Amounts paid (including administrative expenses) to accomplish chantable, etc , purposes . a Expenses, contributions, gifts, etc -total from Part I, column (d), line 26 12 11 , 736

D Program-relaledinvestments -Total from Part IX-B 16 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 protects that satisfy the a Suitability test (poor IRS approval required) 3a h Cash distribution test (attach tie required schedule) 3D

d Qualifying distributions Add lines 1a through 3b Enter here and on Part V, line 8, and Part %11I, line 4 4 11 , 736 . 5 Organizations that quality under section 4940(e) for the reduced rate of tax on net investment

income Enter 1% of Part I, line 27G 5 0 . 6 Adjusted qualifying distributions Subtract line 5 from line 4 ~ B ~ 11, T36 .

Note The amount online 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualities (or the section 4940(e) reduction of tar in those veers

Fog 990-PF Rroi)

7 13120506 790883 51553 2001 .05030 ANNIE M . COOKSEY TRUST #846 51553 1

ANNIE M . COOKSEY TRUST #846 Form 990-PF(200i) C/O VIRGINIA COMMONWEALTH TRUST COMPANY 54-6280321 Page 7

dart IX-8 Summary of Program-Related Investments

Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2 Amount i N/A

2

All other program-related investments See instructions 3

Total Add lines 1 through 3

Part X 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 6 Average of monthly cash balances 16 c Fair market value of all other assets 1 t 0 Total (add lines la, b, and c) 1 d e Reduction claimed for blockage or other factors reported an lines 1a and

1c(attaChdetailed Bxplana6on) 1B 0 " , 2 Acquisition indebtedness applicable to line 1 assets 2 3 Subtract line 2 from line Id -3 4 Cash deemed held for charitable activities Enter 1 1/2% of line 3 (for greater amount, see instructions) 4 5 Net value of nonchanta6le-use assets Subtract line 41rom line 3 Enter here and an Part V, line 4 5

3R ~, Dlstrlbutable Amount (see instructions) (Section 4942(j)(3) and (1)(5) private operating foundations and certain

foreign organizations check here " F-1 and do not complete this part )

123561 of x4-0x

ANNIE M . COOKSEY TRUST #846 Form 990-PF(2001) C/O VIRGINIA COMMONWEALTH TRUST COMPANY 54-6280321 Page e

PeR Xll) Undistributed Income (see Instructions)

dal Idl M (it) Corpus Years prior (o 2000 2000 2001

7 Distnbulable amount for2007from Part A line 7 13 857 .

2 undistributedlnGOrtq If Ny, uolmeenao17a0o

aEnter amount for2000only ,5 478 . bTotal brpHoryeve 19 ,19 ,1J 0 .

FlcufOIaNbuMOm unyws, ilmy b2001

a From 1996 b From 1997 c From 1998 A From 1999 e From 2000 I Total of lines 3a through e 0 .

4 Qualifying distributions for 2001 from ` Part x11, line 4 " S 11 , 736 .

a Applied to 2000, but not more than line 2a 5 478 . h Applied to undistributed income of poor " - , years (Election required - see instructions) 0 .

0 . ' 6 , 258 .

0 . 0 . 0 .

.. .. ..� , .. _ O,~

0 .

O .

0 .

o .-

0 . ,

0 .

a :6 .f

Form 990-PF Root)

127571 01 :am

13120506 790883 51553 8

2001 .05030 ANNIE M_ COORSRY TR[1ST #R46 5155"3 1

c Treated as distributions out of corpus (Election required -see instructions)

UAppIieO to 2001 distnbutabla amount e Remaining amount distributed out of corpus

S Ertmi EIaMbutlona mrryws fpplleC W 7001 if N /ROYlI/ OPPGlR III WIIIRN id) UI" tY1M 6'iV VIII

must C! 7110W11 III COIYIM (if)

B Enter the oat total of each column as Indicated below

2 Corpus Md lines 3f Jc, end Ce Subtract line 5

h Prior years' undistributed income Subtract line 0 from line 2b

c Enter the amount of poor years' undistributed income tar which a notice of deficiency has been issued, or an which the section 4942(a) tax has been previously assessed

d Subtract line 6c from line 6b Taxable amount-see instructions

a Undistributed income for 2000 Subtract line 4a from line 2a Taxable amount- sea Instr

1 Undistributed Income for 2001 Subtract lines 40 and 5 from line 1 This amount must be distributed in 2002

7 Amounts treated as distributions out of corpus to satisfy requirements Imposed by section 170(b)(1)(E) or 4942(8)(3)

B Excess distributions carryover from 1996 not applied on line 5 or line 7

9 Excess distributions carryover to 2002 Subtract lines 7 and 8 from line 6a

10 Analysis of line 9 a Excess from 1997 b Excess from 1998 c Excess from 7999 d Excess from 2000

(e) Total

each year listed c 'SupporC alternative test - enter

(1) Total support other than gross investment income (mteiest, dividends, rents, payments on securities loans (section 512(a)(5)), or royalties)

(2) Support from general publIc and 5 or more exempt organizations as provided in section 4942(I)(3)(B)(w)

(3) Largest amount of support from an exempt organization

d Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of Institutions, or other factors

Form990-PF (2ooi) 51557 1

123587N1-24-C2

ANNIE M . COOKSEY TRUST #846

instructions end Pert VII A,

1 a If tie foundation has received a ruling or determination letter that it Is a finvale operating foundation, and the ruling is effective for 2001, enter the date of the ruling

b Check box to Indicate whether the orp2 a Enter the [asset at the adjusted not

income from Part I or the minimum investment return from Part X for each year listed

b BSw of line 2a c Qualifying distributions from Part %1I,

line 4 for each year listed 0 Amounts included in line 2c nod used directly for active conduct of exempt activities

e Qualifying distributions made directly for active conduct of exempt activities Subtract line 2d from line 2c

3 Complete 3a, b, or c for the alternative test relied upon

a 'Assets' alternative test - enter (7) Value at all assets (2) Value of assets qualifying

under section 4942(i)(3)(B)(i) 6 'Endowment' alternative test-

Enter 2/3 0l minimum investment return shown in Part X, line 6 for

I Part XY' l Supplementary Information (Complete this part only if the organization had $5,000 or more in assets at any time during the year-see page 26 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 tax year (but only A they have contributed more than E5,000) (See section 5070)(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 or

other entity) of which the foundation has a 10% or greater interest

NONE 2 Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc , Programs

Check here 1 D it the organization only makes coninbutlans to preselected chantahle organizations and does net accept unsolicited requests for funds It the organization makes gifts, grants, etc (see instructions) to inGlwduals or organizations under other conditions, complete hems 2a, b, c, and d

a The name, address, and telephone number of the person to whom applications should be addressed

O The form m which applications should be submitted and information and materials they should Include

c My submission deadlines

ANNIE M . COOKSEY TRUST #846

Total 11- 3a 10 828 . b Approved for future payment

NONE

Total 1110- 3b 0 . iz3soiAi-sum Fo .m 990-PF Root)

10 13120506 7908R3 51553 2001 .05030 ANNIE M . COOKSEY TRUST #846 51553 1

Form 990-PF

3 Grants and Contributions Paid During the Year or Approved for Future Payment Recipient It 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 Amount

orsubstantial contributor recipient

a Perd during the year

AMISSVILLE ISSVILLE,BVATI2200zURCH

; /A CHURCH (GENERAL SUPPOR'I~ 10,828 . AM

1 1 Fwm B90-PF Rroi) 06 7908A3 51991 2007_05030 ANNTR M . CnnKSRV TRiIRT lEAdf; 51551 1 13

ANNIE M . COOKSEY TRUST #846 Form 990-PF(200t) C/O VIRGINIA COMMONWEALTH TRUST COMPANY 54-6280321 Page 11 Pert~XV1-A Analysis of Income-Producing Activities

Enter gross amounts unless otherwise indicated unreiacea ousiness income E.n~ase .~-uonsis sia o.si4 (e) (a) (6) d' � (p) Related orexempt Business Amount a", Amount function income 1 Program service revenue code

a 0 c a

i I I I I q Fees and contracts from government agencies

2 Membership dues and assessments 3 Interest on savings and temporary cash

investments e Dividends and Interest from securities 14 11,114 . 5 Net rental income or (loss) tram real estate

a Debt-financed property b Not debt-financed property

6 Net rental income or (lass) from personal property

7 Other investment income 8 Gain or (loss) from sales of assets other

than inventory 14 1,851 . 9 Net income or (loss) from special events 10 Grass profit or (loss) from sales of inventory 11 Other revenue

8

6

t d

e P

12 Subtotal Add columns (D), (0), and (e) I 0 . 12,965 . 0 . 13 Total Add line 12, columns (b), (d), and (e) 10.13 12,965 . Lee worksheet m line 13 Instructions to verity calculations )

Part XVI-B Relationship of Activities to the Accomplishment of Exempt Purposes

Line No I Explain below how each activity for which income is reported in column (e) of Pad XVI-A contributed importantly to the accomplishment of ~ the orqaniza6on's exempt purposes (other than by Drovidinp funds for such ourooses)

ANNIE M . COOKSEY TRUST #846 Forth

Did tie organization directly or Indvecly engage in any of the following with any other organization described in section 501(c) of ~ Yes NC the Coda (other than section 501(c)(3) organizations) or In section 527, relating to political orpanlzations9

a Transfers from the reporting organization to a nonchanlabie exempt organization of (1) Cash 1110 11 ~ X

1a2 X (2) Other assets 6 Other Transactions

(1) Sales of assets to a noncharilable exempt organization 1b 1 X (2) Purchases of assets from a nonchardable exempt organization MIN X (3) Rental of facilities, equipment, or other assets 1 D 3 (4) Reimbursement arrangements 1 b ( 4 ) (5) Loans or loan guarantees 1b (5 ) (6) Performance of services or membership or fundraising solicitations 1b ( 6 ) X

c Sharing of faalRies, equipment, matting fists, other assets, or paid employees tc D It the answer to any of the above is Yes; complete the following schedule Column (h) should always show the fair market value of the goods, other assets,

or services given by the reporting organization If the organization received less khan fair market value in any transaction or sharing arrangement, show in

2a Is tie organization directly or indirectly affiliated with, or related to, one or more tax-exempt organizations described in section 507(c) of the Code (other than section 501(c)(3)) or in section 527? ED Yes M No

,z=, 01 z4m

of oraaniution I IC) Tvoe of oroanfza6on I W Description of

under panNtief of par/ury, I UrJVa Diet 1 have wMneO ISIS Slum Including accompanying Schedules end sG[emenb end Io Na Mat of rty hnowiedpe end bdlef, it 1 . bu% correct, end complete DadvsHan of p (oNm Ilien fogey or IOU ery) Is OnaE on en InbrmeUOn of which prepertr has my 4no'MaCpa

lrAls...~nw*~/T.F¢Gm ~.~~~ac ,

d PF Signature of officer or MOW x � PreDarers ' m u c signature a gol ,ir����,a���� YOUNT, DE & BARBOUR, a~ uvnaow,~a, ,1100 SUNSET LANE, SUITE

.m~sr,azw~ CULPEPER, VIRGINIA 2270

ANNIE M . COOKSEY TRUST #846 C/O VIRGINIA 54-6280321

FORM 990-PF ACCOUNTING FEES STATEMENT 2

(C) ADJUSTED NET INCOME

EXPENSES NET INVEST-PER BOOKS MENT INCOME

700 . 0 .

700 . 0 .

DESCRIPTION

YOUNT, HYDE 6 BARBOUR, P .C .

TO FORM 990-PF, PG 1, LN 16B 700 .

FORM 990-PF TAXES STATEMENT 3

(C) ADJUSTED NET INCOME

(A) (H) EXPENSES NET INVEST-PER BOOKS MENT INCOME

450 . 450 .

450 . 450 .

FEDERAL EXCISE TAX

TO FORM 990-PF, PG 1, LN 18 0 .

FORM 990-PF OTHER EXPENSES STATEMENT 4

(C) ADJUSTED NET INCOME

EXPENSES NET INVEST-PER BOOKS MENT INCOME

208 . 0 .

208 . 0 .

(D) CHARITABLE PURPOSES

208 .

208 .

13 STATEMENT S) 1, 2, 3, 4 2001 .05030 ANNIE M . COOKSEY TRUST #896 51553 1 13120506 790883 51553

FORM 990-PF DIVIDENDS AND INTEREST FROM SECURITIES STATEMENT 1

CAPITAL GAINS COLUMN (A) SOURCE GROSS AMOUNT DIVIDENDS AMOUNT

COMMON TRUST FUND "A" 2,497 . 0 . 2,497 . COMMON TRUST FUND "B" 8,453 . 0 . 8,453 . TEMPORARY INVESTMENT FUND 164 . 0 . 169 .

TOTAL TO FM 990-PF, PART I, LN 4 11,114 . 0 . 11,114 .

(D) CHARITABLE PURPOSES

700 .

DESCRIPTION

(D) CHARITABLE PURPOSES

0 .

DESCRIPTION

COURT FEES

TO FORM 990-PF, PG 1, LN 23

ANNIE M . COOKSEY TRUST #846 C/O VIRGINIA 54-6280321

FORM 990-PF OTHER INVESTMENTS STATEMENT 5

FAIR MARKET VALUE

132,270 . 149,479 .

281,749 .

DESCRIPTION

COMMON TRUST FUND "A" UNITS COMMON TRUST FUND "B" UNITS

TOTAL TO FORM 990-PF, PART II, LINE 13

BOOK VALUE

62,986 . 141,381 .

204,367 .

14 STATEMENT S) 5 13120506 790883 51551 2001 .05030 ANNIE M . COOKSEY TRUST #846 51553 1