ARTHUR C CHAFEE TR 1013002786: Form 990PF, tax year 2022
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- Organization
- ARTHUR C CHAFEE TR 1013002786 (EIN 56-6089459)
- Tax period
- 2022-10-01 to 2023-09-30
- Filed
- 2024-02-07
- IRS object ID
- 202400389349100640
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990-PF
- Accounting Fees Schedule
- Investments Other Schedule2
- Other Decreases Schedule
- Other Expenses Schedule
- Other Income Schedule2
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-02-07T19:00:15-06:00 | ReturnTs |
| Tax Period End | 2023-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 920460586 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PWC US TAX LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 301 GRANT STREET 45TH FLOOR | AddressLine1Txt |
| City | PITTSBURGH | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 15219 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2022-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 566089459 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ARTHUR C CHAFFEE TRUST | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHAF | BusinessNameControlTxt |
| Phone | 8887304933 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6325 S RAINBOW BLVD STE 300 | AddressLine1Txt |
| City | LAS VEGAS | CityNm |
| State Abbreviation | NV | StateAbbreviationCd |
| ZIP | 89118 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | - | PersonNm |
| Person Title | TRUSTEE | PersonTitleTxt |
| Phone | 8887304933 | PhoneNum |
| Signature | 2023-12-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (true) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LAURA B STROBEL | PreparerPersonNm |
| PTIN | P01271955 | PTIN |
| Phone | 4123556000 | PhoneNum |
| Preparation | 2023-12-11 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | TrustedCustomerGrp |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization4947a1 Trtd PF | Yes (X) | Organization4947a1TrtdPFInd |
| FMV Assets EOY | $3,802,360 | FMVAssetsEOYAmt |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Dividends Rev And Expnss | $120,344 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $120,344 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | -$45,562 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $672,220 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $0 | CapGainNetIncmNetInvstIncmAmt |
| Net ST Capital Gain Adj Net Incm | $0 | NetSTCapitalGainAdjNetIncmAmt |
| Other Income Rev And Expnss | $6,941 | OtherIncomeRevAndExpnssAmt |
| Total Rev And Expnss | $81,723 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $120,344 | TotalNetInvstIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $46,654 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $41,988 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $4,665 | CompOfcrDirTrstDsbrsChrtblAmt |
| Oth Empl Slrs Wgs Net Invst Incm | $0 | OthEmplSlrsWgsNetInvstIncmAmt |
| Oth Empl Slrs Wgs Adj Net Incm | $0 | OthEmplSlrsWgsAdjNetIncmAmt |
| Oth Empl Slrs Wgs Dsbrs Chrtbl | $0 | OthEmplSlrsWgsDsbrsChrtblAmt |
| Pension Empl Bnft Net Invst Incm | $0 | PensionEmplBnftNetInvstIncmAmt |
| Pension Empl Bnft Adj Net Incm | $0 | PensionEmplBnftAdjNetIncmAmt |
| Legal Fees Dsbrs Chrtbl | $0 | LegalFeesDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $1,150 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $0 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $0 | AccountingFeesAdjNetIncmAmt |
| Accounting Fees Chrtbl Prps | $1,150 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Dsbrs Chrtbl | $0 | OtherProfFeesDsbrsChrtblAmt |
| Interest Dsbrs Chrtbl | $0 | InterestDsbrsChrtblAmt |
| Taxes Rev And Expnss | $376 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $376 | TaxesNetInvstIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Deprec And Dpltn Rev And Expnss | $0 | DeprecAndDpltnRevAndExpnssAmt |
| Deprec And Dpltn Net Invst Incm | $0 | DeprecAndDpltnNetInvstIncmAmt |
| Trav Conf Meeting Net Invst Incm | $0 | TravConfMeetingNetInvstIncmAmt |
| Trav Conf Meeting Adj Net Incm | $0 | TravConfMeetingAdjNetIncmAmt |
| Printing And Pub Net Invst Incm | $0 | PrintingAndPubNetInvstIncmAmt |
| Printing And Pub Adj Net Incm | $0 | PrintingAndPubAdjNetIncmAmt |
| Other Expenses Rev And Expnss | $20 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Dsbrs Chrtbl | $20 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $48,200 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $42,364 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $0 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $5,835 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $220,000 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $220,000 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $268,200 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $42,364 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $0 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $225,835 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$186,477 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $77,980 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sav And Temp Cash Invst BOY | $141,398 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $58,735 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $58,735 | SavAndTempCashInvstEOYFMVAmt |
| Acct Rcvbl EOY | $0 | AcctRcvblEOYAmt |
| Acct Rcvbl EOYFMV | $0 | AcctRcvblEOYFMVAmt |
| Other Rcvbl Allwnc Dbtfl Acct | $0 | OtherRcvblAllwncDbtflAcctAmt |
| Other Investments BOY | $3,905,317 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $3,796,511 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $3,743,625 | OtherInvestmentsEOYFMVAmt |
| Total Assets BOY | $4,046,715 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,855,246 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $3,802,360 | TotalAssetsEOYFMVAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
| Capital Stock BOY | $4,046,715 | CapitalStockBOYAmt |
| Capital Stock EOY | $3,855,246 | CapitalStockEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $4,046,715 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $3,855,246 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $4,046,715 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $3,855,246 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $4,046,715 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$186,477 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $3,860,238 | SubtotalAmt |
| Other Decreases | $4,992 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $3,855,246 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (25 entries)
| PropertyPropertyDesc | AcquiredAcquiredDt | SoldSoldDt | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt |
|---|---|---|---|---|---|---|
| 317. GOLDMAN SACHS ACTIVEBETA INT ETF | 2021-07-28 | 2023-01-24 | $9,758 | $11,119 | -$1,361 | -$1,361 |
| 35. GOLDMAN ACTIVEBETA US LC ETF | 2022-04-22 | 2023-01-24 | $2,774 | $3,014 | -$240 | -$240 |
| 65. ISHARES CORE S&P TOTAL U.S. ETF | 2022-04-22 | 2023-01-24 | $5,781 | $6,293 | -$512 | -$512 |
| 193. ISHARES CORE U.S. AGGREGATE ETF | 2023-01-24 | $19,264 | $21,294 | -$2,030 | -$2,030 | |
| 14. ISHARES RUSSELL 2000 ETF | 2018-01-24 | 2023-01-24 | $2,611 | $2,233 | $378 | $378 |
| 142. ISHARES JP MORGAN USD EMERGING | 2021-01-25 | 2023-01-24 | $12,512 | $16,214 | -$3,702 | -$3,702 |
| 150. ISHARES CORE MSCI EMERGING ETF | 2019-08-06 | 2023-01-24 | $7,710 | $7,130 | $580 | $580 |
| 145. ISHARES CORE TOTAL BOND ETF | 2021-01-25 | 2023-01-24 | $6,705 | $7,884 | -$1,179 | -$1,179 |
| 76. VANGUARD DIVIDEND APPRECIATION | 2022-04-22 | 2023-01-24 | $11,727 | $12,175 | -$448 | -$448 |
| 100. VANGUARD MIDCAP VIPER | 2022-04-22 | 2023-01-24 | $21,526 | $23,026 | -$1,500 | -$1,500 |
| 165. GOLDMAN ACTIVEBETA US LC ETF | 2021-10-20 | 2023-05-11 | $13,423 | $14,956 | -$1,533 | -$1,533 |
| 308. ISHARES CORE S&P TOTAL U.S. ETF | 2022-04-22 | 2023-05-11 | $27,872 | $29,821 | -$1,949 | -$1,949 |
| 425. ISHARES RUSSELL 2000 ETF | 2023-05-11 | $73,542 | $67,529 | $6,013 | $6,013 | |
| 31. VANGUARD DIVIDEND APPRECIATION | 2022-04-22 | 2023-05-11 | $4,801 | $4,966 | -$165 | -$165 |
| 1430. VANGUARD MIDCAP VIPER | 2023-05-11 | $293,391 | $312,535 | -$19,144 | -$19,144 | |
| 93. GOLDMAN ACTIVEBETA US LC ETF | 2021-10-20 | 2023-05-23 | $7,605 | $8,430 | -$825 | -$825 |
| 251. ISHARES CORE S&P TOTAL U.S. ETF | 2023-05-23 | $22,918 | $23,500 | -$582 | -$582 | |
| 15. VANGUARD DIVIDEND APPRECIATION | 2022-04-22 | 2023-05-23 | $2,315 | $2,403 | -$88 | -$88 |
| 32. VANGUARD MIDCAP VIPER | 2021-01-25 | 2023-05-23 | $6,588 | $6,832 | -$244 | -$244 |
| 125. GOLDMAN ACTIVEBETA US LC ETF | 2021-10-20 | 2023-08-08 | $10,998 | $11,330 | -$332 | -$332 |
| 5129. INVESCO OPTIMUM YIELD DIVERSIF ETF | 2022-08-09 | 2023-08-08 | $74,008 | $88,180 | -$14,172 | -$14,172 |
| 608. INVESCO OPTIMUM YIELD DIVERSIF ETF | 2022-04-22 | 2023-08-08 | $8,773 | $11,332 | -$2,559 | -$2,559 |
| 80. ISHARES CORE U.S. AGGREGATE ETF | 2022-08-09 | 2023-08-08 | $7,755 | $8,237 | -$482 | -$482 |
| 27. VANGUARD DIVIDEND APPRECIATION | 2022-04-22 | 2023-08-08 | $4,391 | $4,325 | $66 | $66 |
| 61. VANGUARD MIDCAP VIPER | 2021-01-25 | 2023-08-08 | $13,472 | $13,024 | $448 | $448 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | -$45,562 | CapitalGainNetIncomeAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $1,084 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $1,084 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $1,084 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $840 | EstimatedPlusOvpmtIncmTxAmt |
| Exempt Frgn Org Tax Wthld At Srce | $0 | ExemptFrgnOrgTaxWthldAtSrceAmt |
| Extsn Request Income Tax Paid | $0 | ExtsnRequestIncomeTaxPaidAmt |
| Total Payments And Credits | $840 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Tax Due | $244 | TaxDueAmt |
| Applied To ES Tax | $0 | AppliedToESTaxAmt |
| Refund | $0 | RefundAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | false | LegislativePoliticalActyInd |
| More Than100 Spent | false | MoreThan100SpentInd |
| Form1120 POL Filed | false | Form1120POLFiledInd |
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | false | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (true) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (true) | AtLeast5000InAssetsInd |
| Org Report Or Register State | NC | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (true) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | false | PrivateOperatingFoundationInd |
| New Substantial Contributors | false | NewSubstantialContributorsInd |
| Own Controlled Entity | false | OwnControlledEntityInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (true) | ComplyWithPublicInspRqrInd |
| Website Address | N/A | WebsiteAddressTxt |
Persons With Books Name PersonsWithBooksName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLS FARGO BANK NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8003523705 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 N MAIN ST FL 5D4001-052 | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| NECT Filing In Lieu OF Form1041 | Yes (X) | NECTFilingInLieuOFForm1041Ind |
| Foreign Accounts Question | false | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | false | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | false | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | false | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | Yes (true) | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | false | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | false | PaymentToGovernmentOfficialInd |
| Acts Fail To Qlfy As Exceptions | false | ActsFailToQlfyAsExceptionsInd |
| Uncorrected Prior Acts | false | UncorrectedPriorActsInd |
| Undistributed Income PY | false | UndistributedIncomePYInd |
| Business Holdings | false | BusinessHoldingsInd |
| Jeopardy Investments | false | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | false | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | false | InfluenceLegislationInd |
| Influence Election | false | InfluenceElectionInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Noncharitable Purpose | false | NoncharitablePurposeInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | WELLS FARGO BANK N A | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 N Main St FL 5D4001-052 | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Title | TRUSTEE | TitleTxt |
| Average Hrs Per Wk Devoted To Pos | 1 | AverageHrsPerWkDevotedToPosRt |
| Compensation | $46,654 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Hghst Pd Empl Or NONE | NONE | CompOfHghstPdEmplOrNONETxt |
| Other Employee Paid Over50k | 0 | OtherEmployeePaidOver50kCnt |
| Comp Of Hghst Pd Cntrct Or NONE | NONE | CompOfHghstPdCntrctOrNONETxt |
| Contractor Paid Over50k | 0 | ContractorPaidOver50kCnt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Summary Of Direct Chrtbl Acty | SummaryOfDirectChrtblActyGrp | |
| Sum Of Program Related Invst | SumOfProgramRelatedInvstGrp |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $3,828,102 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $117,127 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $3,945,229 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $3,945,229 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $59,178 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $3,886,051 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $194,303 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $194,303 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $1,084 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $1,084 | TotalTaxAmt |
| Distributable Before Adj | $193,219 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $193,219 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $193,219 | DistributableAsAdjustedAmt |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $225,835 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Charitable Assets Acquis Paid | $0 | CharitableAssetsAcquisPaidAmt |
| Set Aside Suitability Test | $0 | SetAsideSuitabilityTestAmt |
| Set Aside Cash Distri Test | $0 | SetAsideCashDistriTestAmt |
| Qualifying Distributions | $225,835 | QualifyingDistributionsAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $193,219 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $206,513 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr5 | $0 | ExcessDistributionCyovYr5Amt |
| Excess Distribution Cyov Yr4 | $0 | ExcessDistributionCyovYr4Amt |
| Excess Distribution Cyov Yr3 | $0 | ExcessDistributionCyovYr3Amt |
| Excess Distribution Cyov Yr2 | $0 | ExcessDistributionCyovYr2Amt |
| Excess Distribution Cyov Yr1 | $0 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $0 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $225,835 | QualifyingDistributionsAmt |
| Applied To Year1 | $206,513 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $19,322 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $0 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $0 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $0 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $0 | TotalCorpusAmt |
| Prior Year Undistributed Incm | $0 | PriorYearUndistributedIncmAmt |
| Prior Year Deficiency Or Tax | $0 | PriorYearDeficiencyOrTaxAmt |
| Taxable1 | $0 | Taxable1Amt |
| Taxable2 | $0 | Taxable2Amt |
| Undistributed Income CY | $173,897 | UndistributedIncomeCYAmt |
| Corpus Distri170b1 E Or4942g3 | $0 | CorpusDistri170b1EOr4942g3Amt |
| Excess Distri Cyov From Yr5 | $0 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $0 | ExcessDistriCyovToNextYrAmt |
| Excess From Year4 | $0 | ExcessFromYear4Amt |
| Excess From Year3 | $0 | ExcessFromYear3Amt |
| Excess From Year2 | $0 | ExcessFromYear2Amt |
| Excess From Year1 | $0 | ExcessFromYear1Amt |
| Excess From Current Year | $0 | ExcessFromCurrentYearAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributing Manager | NONE | ContributingManagerNm |
| Shareholder Manager | NONE | ShareholderManagerNm |
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE RIDGE HEALTHCARE HOSPITALS INC | BusinessNameLine1Txt |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2201 SOUTH STERLING STREET | AddressLine1Txt |
| City | MORGANTON | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28655 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Relationship | NONE | RecipientRelationshipTxt |
| Recipient Foundation Status | PC | RecipientFoundationStatusTxt |
| Grant Or Contribution Purpose | GENERAL OPERATING | GrantOrContributionPurposeTxt |
| Amt | $220,000 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $220,000 | TotalGrantOrContriPdDurYrAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fees Contracts From Govt Ag | FeesContractsFromGovtAgGrp | |
| Membership Dues And Assmnt | MembershipDuesAndAssmntGrp | |
| Int On Sav And Temp Cash Invst | IntOnSavAndTempCashInvstGrp |
Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $120,344 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Rntl Incm Re Debt Fincd Prop | NetRntlIncmReDebtFincdPropGrp | |
| Net Rntl Incm Re Not Debt Fincd Prop | NetRntlIncmReNotDebtFincdProp | |
| Net Rental Income Personal Prop | NetRentalIncomePersonalPropGrp | |
| Other Investment Income | OtherInvestmentIncomeGrp |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | -$45,562 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Income Loss From Special Evt | NetIncomeLossFromSpecialEvtGrp | |
| Gross Profit Loss Sls Of Invntry | GrossProfitLossSlsOfInvntryGrp |
Other Revenue Described OtherRevenueDescribedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | FEDERAL TAX REFUND | Desc |
| Exclusion | 1 | ExclusionCd |
| Exclusion | $6,941 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | $81,723 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $81,723 | TotalIncomeProducingActyAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Rln Of Acty To Accom Of Exmpt Prps | RlnOfActyToAccomOfExmptPrpsGrp |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | false | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | false | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | false | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | false | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | false | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | false | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | false | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | false | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | false | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | false | RelationshipsNonchrtblEOInd |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | TAX PREPARATION FEE (NON-ALLOC | CategoryTxt |
| Amt | $1,150 | Amt |
| Disbursements Charitable Prps | $1,150 | DisbursementsCharitablePrpsAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (45 entries)
| Category Or ItemCategoryOrItemTxt | Listed At Cost Or FMVListedAtCostOrFMVCd | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| 921937819 VANGUARD INTERMEDIAT | |||
| 46090F100 INVESCO OPTIMUM YIEL | AT COST | $95,515 | $81,104 |
| 464287705 ISHARES S&P MID-CAP | |||
| 922042858 VANGUARD FTSE EMERGI | |||
| 921943858 VANGUARD FTSE DEVELO | |||
| 81369Y100 AMEX MATERIALS SPDR | |||
| 315920702 FID ADV EMER MKTS IN | |||
| 81369Y308 CONSUMER STAPLES SEC | |||
| 464287655 ISHARES RUSSELL 2000 | |||
| 464287606 ISHARES S&P MID-CAP | |||
| 81369Y407 AMEX CONSUMER DISCR | |||
| 77958B402 T ROWE PRICE INST FL | |||
| 81369Y803 AMEX TECHNOLOGY SELE | |||
| 87234N765 TCW EMRG MKTS INCM-I | |||
| 921937827 VANGUARD BD INDEX FD | |||
| 78463X863 SPDR DJ WILSHIRE INT | |||
| 779919307 T ROWE PR REAL ESTAT | |||
| 81369Y605 AMEX FINANCIAL SELEC | |||
| 81369Y209 HEALTH CARE SELECT S | |||
| 81369Y860 REAL ESTATE SELECT S | |||
| 4812C0803 JPMORGAN HIGH YIELD | |||
| 46434G103 ISHARES CORE MSCI EM | AT COST | $76,342 | $76,382 |
| 81369Y506 AMEX ENERGY SELECT S | |||
| 81369Y704 AMEX INDUSTRIAL SPDR | |||
| 464287226 ISHARES CORE U.S. AG | AT COST | $778,242 | $696,460 |
| 81369Y852 COMM SERV SELECT SEC | |||
| 464287150 ISHARES CORE S&P TOT | AT COST | $647,109 | $833,205 |
| 31641Q755 FIDELITY NEW MRKTS I | |||
| 803431410 JAMES ALPHA GL REAL | |||
| 921908844 VANGUARD DIVIDEND AP | AT COST | $206,039 | $227,321 |
| 922908629 VANGUARD MIDCAP VIPE | AT COST | $306,268 | $335,266 |
| 46432F339 ISHARES EDGE MSCI US | |||
| 74256W626 PRINCIPAL HIGH YIELD | |||
| 464287804 ISHARES CORE S&P SMA | |||
| 46434V613 ISHARES CORE TOTAL B | AT COST | $280,054 | $232,476 |
| 74440Y884 PGIM HIGH YIELD-Q 10 | AT COST | $142,012 | $116,122 |
| 381430503 GOLDMAN ACTIVEBETA U | AT COST | $308,395 | $304,576 |
| 464287598 ISHARES RUSSELL 1000 | |||
| 464288281 ISHARES JP MORGAN US | AT COST | $306,601 | $227,178 |
| 381430107 GOLDMAN SACHS ACTIVE | AT COST | $127,943 | $114,294 |
| 722005667 PIMCO COMMODITY REAL | |||
| 33739H101 FIRST TRUST GLOBAL T | AT COST | $78,754 | $79,128 |
| 46432F842 ISHARES CORE MSCI EA | AT COST | $240,922 | $227,477 |
| 72201R833 PIMCO ENHANCED SHORT | AT COST | $117,102 | $118,065 |
| 921937793 VANGUARD LONG-TERM B | AT COST | $85,213 | $74,571 |
Other Decreases Schedule OtherDecreasesSchedule
Other Decreases Detail OtherDecreasesDetail (2 entries)
| DescDesc | AmtAmt |
|---|---|
| MUTUAL FUND TIMING ADJ | $4,989 |
| ROUNDING | $3 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (2 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| FILING FEE/STATE TAX | $10 | $0 | $10 |
| FILING FEE/STATE TAX | $10 | $0 | $10 |
Other Income Schedule2 OtherIncomeSchedule2
Other Income Detail OtherIncomeDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | FEDERAL TAX REFUND | Desc |
| Revenue And Expenses Per Books | $6,941 | RevenueAndExpensesPerBooksAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| FOREIGN TAXES | $305 | $305 | $0 |
| FOREIGN TAXES ON NONQUALIFIED | $71 | $71 | $0 |
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