MARVIN P VERHULST FOUNDATION INC: Form 990PF, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- MARVIN P VERHULST FOUNDATION INC (EIN 33-0998350)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-03-09
- IRS object ID
- 202430699349100608
- Schema version
- 2023v4.0
- 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
- All Oth Prog Rltd Investments Sch
- Gain Loss Sale Other Assets Sch
- Investments Corp Stock Schedule
- Investments Govt Obligations Sch
- Investments Other Schedule2
- Other Decreases Schedule
- Other Expenses Schedule
- Other Increases Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-03-09T14:33:19-08:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RANDALL S GROBE CPA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3404 CIRCLE CLOSE | AddressLine1Txt |
| City | MADISON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53705 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2023-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 330998350 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARVIN P VERHULST FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MARV | BusinessNameControlTxt |
| Phone | 5613716563 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 104 MUIRFIELD DRIVE | AddressLine1Txt |
| City | PONTE VEDRA BEACH | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32082 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARY S BURBACH | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 5613716563 | PhoneNum |
| Signature | 2024-02-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MARY | PersonFirstNm |
| Person Last | BURBACH | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
| 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 | RANDALL GROBE | PreparerPersonNm |
| PTIN | P01211811 | PTIN |
| Phone | 6082176115 | PhoneNum |
| Preparation | 2024-03-09 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Federated Assurance Level | FAL1 | FederatedAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $4,835,004 | FMVAssetsEOYAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Dividends Rev And Expnss | $135,152 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $135,152 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $46,012 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $1,577,520 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $46,012 | CapGainNetIncmNetInvstIncmAmt |
| Gross Profit Rev And Expnss | $0 | GrossProfitRevAndExpnssAmt |
| Other Income Rev And Expnss | $0 | OtherIncomeRevAndExpnssAmt |
| Total Rev And Expnss | $181,164 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $181,164 | TotalNetInvstIncmAmt |
| Legal Fees Rev And Expnss | $0 | LegalFeesRevAndExpnssAmt |
| Accounting Fees Rev And Expnss | $2,500 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $1,250 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Chrtbl Prps | $1,250 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Rev And Expnss | $0 | OtherProfFeesRevAndExpnssAmt |
| Taxes Rev And Expnss | $5,410 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $1,465 | TaxesNetInvstIncmAmt |
| Deprec And Dpltn Rev And Expnss | $0 | DeprecAndDpltnRevAndExpnssAmt |
| Other Expenses Rev And Expnss | $25,577 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $25,577 | OtherExpensesNetInvstIncmAmt |
| Tot Opr Expenses Rev And Expnss | $33,487 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $28,292 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $1,250 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $237,000 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $237,000 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $270,487 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $28,292 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $238,250 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$89,323 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $152,872 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $39,289 | CashBOYAmt |
| Cash EOY | $1,824 | CashEOYAmt |
| Cash EOYFMV | $1,824 | CashEOYFMVAmt |
| Sav And Temp Cash Invst EOY | $109,349 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $109,349 | SavAndTempCashInvstEOYFMVAmt |
| Rcvbl From Officers EOY | $0 | RcvblFromOfficersEOYAmt |
| Other Nts And Loans Rcvbl EOY | $0 | OtherNtsAndLoansRcvblEOYAmt |
| US Government Obligations BOY | $221,645 | USGovernmentObligationsBOYAmt |
| US Government Obligations EOY | $967,521 | USGovernmentObligationsEOYAmt |
| US Govt Obligations EOYFMV | $970,767 | USGovtObligationsEOYFMVAmt |
| Corporate Stock BOY | $8,953 | CorporateStockBOYAmt |
| Corporate Stock EOY | $8,953 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $132,520 | CorporateStockEOYFMVAmt |
| Land Bldg Investments EOY | $0 | LandBldgInvestmentsEOYAmt |
| Other Investments BOY | $3,511,181 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $2,605,117 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $3,620,544 | OtherInvestmentsEOYFMVAmt |
| Land EOY | $0 | LandEOYAmt |
| Other Assets BOY | $0 | OtherAssetsBOYAmt |
| Other Assets EOY | $0 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $0 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $3,781,068 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,692,764 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $4,835,004 | TotalAssetsEOYFMVAmt |
| Loans From Officers EOY | $0 | LoansFromOfficersEOYAmt |
| Mortgages And Notes Payable EOY | $0 | MortgagesAndNotesPayableEOYAmt |
| Other Liabilities BOY | $0 | OtherLiabilitiesBOYAmt |
| Other Liabilities EOY | $0 | OtherLiabilitiesEOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
| Retained Earning BOY | $3,781,068 | RetainedEarningBOYAmt |
| Retained Earning EOY | $3,692,764 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $3,781,068 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $3,692,764 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $3,781,068 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $3,692,764 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $3,781,068 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$89,323 | ExcessRevenueOverExpensesAmt |
| Other Increases | $1,858 | OtherIncreasesAmt |
| Subtotal | $3,693,603 | SubtotalAmt |
| Other Decreases | $839 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $3,692,764 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Property | PUBLICLY TRADED SECURITIES | PropertyDesc |
| How Acquired | P | HowAcquiredCd |
| Acquired | 2022-12-30 | AcquiredDt |
| Sold | 2023-12-31 | SoldDt |
| Gross Sales Price | $1,577,520 | GrossSalesPriceAmt |
| Depreciation | $0 | DepreciationAmt |
| Cost Or Other Basis | $1,531,508 | CostOrOtherBasisAmt |
| Gain Or Loss | $46,012 | GainOrLossAmt |
| FMV As Of123169 | $0 | FMVAsOf123169Amt |
| Adjusted Basis As Of123169 | $0 | AdjustedBasisAsOf123169Amt |
| Excess FMV Over Adjusted Bss | $0 | ExcessFMVOverAdjustedBssAmt |
| Gains Minus Excess Or Losses | $46,012 | GainsMinusExcessOrLossesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $46,012 | CapitalGainNetIncomeAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $2,125 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $2,125 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $2,125 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $3,945 | EstimatedPlusOvpmtIncmTxAmt |
| Total Payments And Credits | $3,945 | TotalPaymentsAndCreditsAmt |
| Original Return Overpayment | -$3,945 | OriginalReturnOverpaymentAmt |
| Overpayment | $1,820 | OverpaymentAmt |
| Applied To ES Tax | $1,820 | AppliedToESTaxAmt |
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 | WI | 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 |
| Individual With Books | PATRICIA DORFMAN | IndividualWithBooksNm |
| Phone | 5613716563 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 104 MUIRFIELD DR | AddressLine1Txt |
| City | PONTE VEDRA BEACH | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32082 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | false | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | false | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | false | PaymentToGovernmentOfficialInd |
| Uncorrected Prior Acts | false | UncorrectedPriorActsInd |
| Undistributed Income PY | false | UndistributedIncomePYInd |
| Undistr Incm Sect4942a2 Not App | false | UndistrIncmSect4942a2NotAppInd |
| 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 (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|---|---|---|---|
| MARY S BURBACH | ||||||||
| 250 BIRNAM OAK DR UNIT L308 | PONTE VEDRA BEACH | FL | 32082 | PRESIDENT | 1.00 | $0 | $0 | $0 |
| KENNETH M BURBACH | ||||||||
| 250 BIRHAM OAK DR UNIT L308 | PONTE VEDRA BEACH | FL | 32082 | SECRETARY | 1.00 | $0 | $0 | $0 |
| PATRICIA DORFMAN | ||||||||
| 104 MUIRFIELD DRIVE | PONTE VEDRA BEACH | FL | 32082 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| BRIAN BURBACH | ||||||||
| 507 5TH ST | HUDSON | WI | 54016 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| SARAH BRUCH | ||||||||
| 507 5TH ST | HUDSON | WI | 54016 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| ROBERT DORFMAN | ||||||||
| 104 MUIRFIELD DR | PONTE VEDRA BEACH | FL | 32082 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| 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 |
Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | N/A | Description1Txt |
| Expenses1 | $0 | Expenses1Amt |
Sum Of Program Related Invst SumOfProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | NONE | Description1Txt |
| Expenses1 | $0 | Expenses1Amt |
| All Other Program Rltd Invst Tot | $0 | AllOtherProgramRltdInvstTotAmt |
| Total | $0 | TotalAmt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $4,643,964 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $60,288 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $4,704,252 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Adjusted Total FMV Of Unused Ast | $4,704,252 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $70,564 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $4,633,688 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $231,684 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $231,684 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $2,125 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $2,125 | TotalTaxAmt |
| Distributable Before Adj | $229,559 | DistributableBeforeAdjAmt |
| Distributable Before Ded | $229,559 | DistributableBeforeDedAmt |
| Distributable As Adjusted | $229,559 | DistributableAsAdjustedAmt |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $238,250 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $238,250 | QualifyingDistributionsAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $229,559 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $220,657 | UndistributedIncomePYAmt |
| Qualifying Distributions | $238,250 | QualifyingDistributionsAmt |
| Applied To Year1 | $220,657 | AppliedToYear1Amt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Remaining Distri From Corpus | $17,593 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $17,593 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $17,593 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $0 | TotalCorpusAmt |
| Prior Year Undistributed Incm | $0 | PriorYearUndistributedIncmAmt |
| Taxable1 | $0 | Taxable1Amt |
| Taxable2 | $0 | Taxable2Amt |
| Undistributed Income CY | $211,966 | UndistributedIncomeCYAmt |
| 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 |
Application Submission Info ApplicationSubmissionInfoGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Person | MARY S BURBACH | RecipientPersonNm |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 104 MUIRFIELD DRIVE | AddressLine1Txt |
| City | PONTE VEDRA BEACH | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32082 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Info And Materials | N/A | FormAndInfoAndMaterialsTxt |
| Submission Deadlines | N/A | SubmissionDeadlinesTxt |
| Restrictions On Awards | N/A | RestrictionsOnAwardsTxt |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (14 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|
| NORTH HUDSON ELEMENTARY SCHOOL | ||||||
| 510 LEMON ST NORTH | HUDSON | WI | 54016 | GOVT | PROGRAM SUPPORT | $13,000 |
| RONALD MCDONALD HOUSE | ||||||
| ONE KROC DRIVE | OAK BROOK | IL | 60523 | PC | PROGRAM SUPPORT | $20,000 |
| HUDSON BLUE LINE CLUB | ||||||
| 1820 HANLEY ROAD | HUDSON | WI | 54016 | PC | PROGRAM SUPPORT | $13,000 |
| HUDSON CHAMBER OF COMMERCE | ||||||
| 219 2ND ST | HUDSON | WI | 54016 | PC | PROGRAM SUPPORT | $3,000 |
| SALVATION ARMY - HAWAII | ||||||
| 2950 MANOA ROAD | HONOLULU | HI | 96822 | PC | PROGRAM SUPPORT | $80,000 |
| CYCLE PROJECT | ||||||
| 625 WOODLAKE ROAD | KOHLER | WI | 53044 | PC | PROGRAM SUPPORT | $2,000 |
| CARE NET PREGNANCY CENTER | ||||||
| 44180 RIVERSIDE PARKWAY | LANSDOWNE | VA | 20176 | PC | PROGRAM SUPPORT | $10,000 |
| CLEVELAND CLINIC FOUNDATION | ||||||
| 6770 MAYFIELD RD 426 | CLEVELAND | OH | 44124 | PC | PROGRAM SUPPORT | $10,000 |
| WOMEN'S BUSINESS DEVELOPMENT | ||||||
| 8 S MICHIGAN AVE 4TH FLOOR | CHICAGO | IL | 60603 | PC | PROGRAM SUPPORT | $6,000 |
| CAMP SANDSTONE | ||||||
| 54165 AUDUBON DR | SANDSTONE | MN | 55072 | PC | PROGRAM SUPPORT | $5,000 |
| SUSTAIN HUDSON | ||||||
| 413 BROOKWOOD DRIVE | HUDSON | WI | 54016 | PC | PROGRAM SUPPORT | $5,000 |
| VOLUNTEERS IN MEDICINE | ||||||
| 3728 PHILIPS HWY STE 34 | JACKSONVILLE | FL | 32207 | PC | PROGRAM SUPPORT | $20,000 |
| VICARS LANDING FOUNDATION | ||||||
| 1000 VICARS LANDING WAY | PONTE VEDRA BEACH | FL | 32082 | PC | PROGRAM SUPPORT | $25,000 |
| MAKING EVERYDAY COUNT | ||||||
| 501 S FLAGLWER DR | WEST PALM BEACH | FL | 33401 | PC | PROGRAM SUPPORT | $25,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $237,000 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $135,152 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $46,012 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | $181,164 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $181,164 | TotalIncomeProducingActyAmt |
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 | RANDALL GROBE, CPA TAX PREPARATION | CategoryTxt |
| Amt | $2,500 | Amt |
| Net Investment Income | $1,250 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $1,250 | DisbursementsCharitablePrpsAmt |
All Oth Prog Rltd Investments Sch AllOthProgRltdInvestmentsSch
All Other Program Related Invst AllOtherProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NONE | Desc |
| Amt | $0 | Amt |
Gain Loss Sale Other Assets Sch GainLossSaleOtherAssetsSch
Gain Loss Sale Other Asset GainLossSaleOtherAssetGrp (2 entries)
| AssetAssetDesc | Gross Sales PriceGrossSalesPriceAmt | BasisBasisAmt | Total NetTotalNetAmt |
|---|---|---|---|
| PUBLICLY TRADED STOCKS | $1,526,503 | $1,531,508 | -$5,005 |
| CAPITAL GAIN DISTRIBUTIONS | $51,017 | $51,017 |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp (2 entries)
| StockStockNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| ABBOTT LABORATORIES | $4,295 | $55,035 |
| ABBVIE, INC. | $4,658 | $77,485 |
Investments Govt Obligations Sch InvestmentsGovtObligationsSch
| Field | Value | IRS element (for citing) |
|---|---|---|
| US Govt Obligations Book Vl EOY | $967,521 | USGovtObligationsBookVlEOYAmt |
| US Govt Obligations EOYFMV | $970,767 | USGovtObligationsEOYFMVAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (18 entries)
| Category Or ItemCategoryOrItemTxt | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| SMALL CAP WORLD FUND | $42,582 | $113,127 |
| DFA EMERGING MARKETS | $84,487 | $105,761 |
| DFA INT'L CORE EQUITY | $107,893 | $143,233 |
| DFA INT'L LARGE CAP GROWTH | $100,000 | $143,705 |
| DODGE & COX INT'L STOCK FD | $58,651 | $92,800 |
| DFA US CORE EQUITY | $426,485 | $756,353 |
| FIDELITY ADVISOR NEW INSIGHTS FD | $26,683 | $45,619 |
| FUNDAMENTAL INVESTORS | $185,745 | $342,230 |
| GROWTH FUND OF AMERICA | $34,951 | $99,433 |
| PRIME CAP ODYSSEY STOCK FD | $82,164 | $109,594 |
| WASHINGTON MUTUAL INVESTORS FD | $229,739 | $361,272 |
| FIDELITY ADV STK SELECTOR MID CAP FD | $56,978 | $122,917 |
| DIMENSIONAL US SMALL CAP ETF | $27,611 | $54,420 |
| BLACKROCK STRATEGIC INCOME OPTIONS PORT | $118,677 | $114,151 |
| ATISAN PARTNERS HIGH INCOME FD ADVISOR SHS | $103,954 | $114,062 |
| AMERICAN STRATEGIC BOND FD | $135,564 | $113,582 |
| DODGE & COX INCOME FD | $682,953 | $686,149 |
| VANGUARD LONG TERM INV GRADE FD | $100,000 | $102,136 |
Other Decreases Schedule OtherDecreasesSchedule
Other Decreases Detail OtherDecreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PRIOR PERIOD ADJUSTMENT | Desc |
| Amt | $839 | Amt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INV PROGRAM FEES | Desc |
| Revenue And Expenses Per Books | $25,577 | RevenueAndExpensesPerBooksAmt |
| Net Investment Income | $25,577 | NetInvestmentIncomeAmt |
Other Increases Schedule OtherIncreasesSchedule
Other Increases Detail OtherIncreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NON-DIVIDEND DISTRIBUTIONS | Desc |
| Amt | $1,858 | Amt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt |
|---|---|---|
| FOREIGN TAXES | $1,465 | $1,465 |
| FEDERAL INCOME TAXES | $3,945 |
Comments