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KATALINA AND MICHAEL SIMON FOUNDATION: Form 990PF, tax year 2021

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Organization
KATALINA AND MICHAEL SIMON FOUNDATION (EIN 85-1620436)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-09-15
IRS object ID
202222589349101302
Schema version
2021v4.2
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 ReturnHeader

FieldValueIRS element (for citing)
Return2022-09-15T14:54:10-05:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FOUNDATION SOURCEBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1ONE HOLLOW LN STE 212AddressLine1Txt
CityLAKE SUCCESSCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11042ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN851620436EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1The Katalina and Michael Simon FoundationBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% Foundation SourceInCareOfNm
Business Name ControlKATABusinessNameControlTxt
Phone8008391754PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1Foundation Source 501 Silverside RdAddressLine1Txt
CityWilmingtonCityNm
State AbbreviationDEStateAbbreviationCd
ZIP198091377ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHAEL SIMONPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone8008391754PhoneNum
Signature2022-08-10SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMICHAELPersonFirstNm
Person LastSIMONPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJeffrey D HaskellPreparerPersonNm
PTINP01345770PTIN
Phone8008391754PhoneNum

Additional Filer Information AdditionalFilerInformation

FieldValueIRS element (for citing)
Trusted CustomerTrustedCustomerGrp
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$2,900,781FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$1,021,271ContriRcvdRevAndExpnssAmt
Interest On Sav Rev And Expnss$249InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$249InterestOnSavNetInvstIncmAmt
Cap Gain Net Incm Net Invst Incm$0CapGainNetIncmNetInvstIncmAmt
Total Rev And Expnss$1,021,520TotalRevAndExpnssAmt
Total Net Invst Incm$249TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$0CompOfcrDirTrstRevAndExpnssAmt
Taxes Rev And Expnss$30,173TaxesRevAndExpnssAmt
Other Expenses Rev And Expnss$13,387OtherExpensesRevAndExpnssAmt
Other Expenses Dsbrs Chrtbl$13,387OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$43,560TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$0TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$13,387TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$200,000ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$200,000ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$243,560TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$0TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$213,387TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses$777,960ExcessRevenueOverExpensesAmt
Net Investment Income$249NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Sav And Temp Cash Invst BOY$2,143,790SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$1,900,479SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$1,900,479SavAndTempCashInvstEOYFMVAmt
Corporate Stock EOY$1,021,271CorporateStockEOYAmt
Corporate Stock EOYFMV$1,000,302CorporateStockEOYFMVAmt
Total Assets BOY$2,143,790TotalAssetsBOYAmt
Total Assets EOY$2,921,750TotalAssetsEOYAmt
Total Assets EOYFMV$2,900,781TotalAssetsEOYFMVAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind
Retained Earning BOY$2,143,790RetainedEarningBOYAmt
Retained Earning EOY$2,921,750RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY$2,143,790TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$2,921,750TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$2,143,790TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$2,921,750TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$2,143,790TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses$777,960ExcessRevenueOverExpensesAmt
Subtotal$2,921,750SubtotalAmt
Tot Net Ast Or Fund Balances EOY$2,921,750TotNetAstOrFundBalancesEOYAmt
FieldValueIRS element (for citing)
Cap Gains Loss Tx Invst Incm DetailCapGainsLossTxInvstIncmDetail

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$3InvestmentIncomeExciseTaxAmt
Subtotal$3SubtotalAmt
Tax Based On Investment Income$3TaxBasedOnInvestmentIncomeAmt
Exempt Frgn Org Tax Wthld At Srce$0ExemptFrgnOrgTaxWthldAtSrceAmt
Extsn Request Income Tax Paid$100ExtsnRequestIncomeTaxPaidAmt
Total Payments And Credits$100TotalPaymentsAndCreditsAmt
Overpayment$97OverpaymentAmt
Applied To ES Tax$97AppliedToESTaxAmt

Statements Regarding Acty StatementsRegardingActyGrp

FieldValueIRS element (for citing)
Legislative Political ActyfalseLegislativePoliticalActyInd
More Than100 SpentfalseMoreThan100SpentInd
Form1120 POL FiledfalseForm1120POLFiledInd
Activities Not Previously RptfalseActivitiesNotPreviouslyRptInd
Changes To Articles Or BylawsfalseChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Organization Dissolved EtcfalseOrganizationDissolvedEtcInd
Section508e Rqr SatisfiedYes (true)Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (true)AtLeast5000InAssetsInd
Org Report Or Register StateDEOrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (true)Form990PFFiledWithAttyGenInd
Private Operating FoundationfalsePrivateOperatingFoundationInd
New Substantial ContributorsYes (true)NewSubstantialContributorsInd
Own Controlled EntityfalseOwnControlledEntityInd
Donor Advised FundfalseDonorAdvisedFundInd
Comply With Public Insp RqrYes (true)ComplyWithPublicInspRqrInd
Website AddressN/AWebsiteAddressTxt

Persons With Books Name PersonsWithBooksName

FieldValueIRS element (for citing)
Business Name Line1Foundation SourceBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8008391754PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line1501 Silverside Road Suite 123AddressLine1Txt
CityWilmingtonCityNm
State AbbreviationDEStateAbbreviationCd
ZIP198091377ZIPCd
FieldValueIRS element (for citing)
Foreign Accounts QuestionfalseForeignAccountsQuestionInd

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

FieldValueIRS element (for citing)
Sale Or Exch Disqualified PrsnfalseSaleOrExchDisqualifiedPrsnInd
Brrw Or Lend Disqualified PrsnfalseBrrwOrLendDisqualifiedPrsnInd
Furn Goods Disqualified PrsnfalseFurnGoodsDisqualifiedPrsnInd
Pay Comp Disqualified PrsnfalsePayCompDisqualifiedPrsnInd
Transfer Ast Disqualified PrsnfalseTransferAstDisqualifiedPrsnInd
Payment To Government OfficialfalsePaymentToGovernmentOfficialInd
Uncorrected Prior ActsfalseUncorrectedPriorActsInd
Undistributed Income PYfalseUndistributedIncomePYInd
Business HoldingsfalseBusinessHoldingsInd
Jeopardy InvestmentsfalseJeopardyInvestmentsInd
Uncorrected PY Jeopardy InvstfalseUncorrectedPYJeopardyInvstInd
Influence LegislationfalseInfluenceLegislationInd
Influence ElectionfalseInfluenceElectionInd
Grants To IndividualsfalseGrantsToIndividualsInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Noncharitable PurposefalseNoncharitablePurposeInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonMichael SimonPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1Foundation Source 501 Silverside RdAddressLine1Txt
CityWilmingtonCityNm
State AbbreviationDEStateAbbreviationCd
ZIP198091377ZIPCd
FieldValueIRS element (for citing)
TitleDir, Pres, Sec, TreasTitleTxt
Average Hrs Per Wk Devoted To Pos1.0AverageHrsPerWkDevotedToPosRt
Compensation$0CompensationAmt
Employee Benefit Program$0EmployeeBenefitProgramAmt
Expense Account Other Allwnc$0ExpenseAccountOtherAllwncAmt
FieldValueIRS element (for citing)
Summary Of Direct Chrtbl ActySummaryOfDirectChrtblActyGrp
Sum Of Program Related InvstSumOfProgramRelatedInvstGrp

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$83,359AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$1,954,401AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$2,037,760TotalFMVOfUnusedAssetsAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$2,037,760AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$30,566CashDeemedCharitableAmt
Net Vl Noncharitable Assets$2,007,194NetVlNoncharitableAssetsAmt
Minimum Investment Return$100,360MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$100,360MinimumInvestmentReturnAmt
Tax Based On Investment Income$3TaxBasedOnInvestmentIncomeAmt
Total Tax$3TotalTaxAmt
Distributable Before Adj$100,357DistributableBeforeAdjAmt
Distributable Before Ded$100,357DistributableBeforeDedAmt
Distributable As Adjusted$100,357DistributableAsAdjustedAmt

PF Qualifying Distributions PFQualifyingDistributionsGrp

FieldValueIRS element (for citing)
Expenses And Contributions$213,387ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Charitable Assets Acquis Paid$0CharitableAssetsAcquisPaidAmt
Set Aside Suitability Test$0SetAsideSuitabilityTestAmt
Set Aside Cash Distri Test$0SetAsideCashDistriTestAmt
Qualifying Distributions$213,387QualifyingDistributionsAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$100,357DistributableAsAdjustedAmt
Prior Year12019PriorYear1Yr
Prior Year22018PriorYear2Yr
Prior Year32017PriorYear3Yr
Excess Distribution Cyov Yr1$2,164ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov$2,164TotalExcessDistributionCyovAmt
Qualifying Distributions$213,387QualifyingDistributionsAmt
Applied To Current Year$100,357AppliedToCurrentYearAmt
Remaining Distri From Corpus$113,030RemainingDistriFromCorpusAmt
Total Corpus$115,194TotalCorpusAmt
Undistributed Income CY$0UndistributedIncomeCYAmt
Excess Distri Cyov To Next Yr$115,194ExcessDistriCyovToNextYrAmt
Excess From Year1$2,164ExcessFromYear1Amt
Excess From Current Year$113,030ExcessFromCurrentYearAmt
FieldValueIRS element (for citing)
Private Operating FoundationsPrivateOperatingFoundationsGrp

Supplementary Information SupplementaryInformationGrp

FieldValueIRS element (for citing)
Contributing ManagerMichael SimonContributingManagerNm
Only Contri To PreselectedYes (X)OnlyContriToPreselectedInd

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1CARROLL SCHOOL CORPBusinessNameLine1Txt

Recipient US Address RecipientUSAddress

FieldValueIRS element (for citing)
Address Line125 BAKER BRIDGE RDAddressLine1Txt
CityLINCOLNCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01773ZIPCd
FieldValueIRS element (for citing)
Recipient RelationshipN/ARecipientRelationshipTxt
Recipient Foundation StatusPCRecipientFoundationStatusTxt
Grant Or Contribution PurposeCarroll, Steve Wilkens Fund, and Annual FundGrantOrContributionPurposeTxt
Amt$200,000Amt
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$200,000TotalGrantOrContriPdDurYrAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

FieldValueIRS element (for citing)
Fees Contracts From Govt AgFeesContractsFromGovtAgGrp
Membership Dues And AssmntMembershipDuesAndAssmntGrp

Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$249ExclusionAmt
FieldValueIRS element (for citing)
Dividends And Interest From Sec DtlDividendsAndInterestFromSecDtl
Net Rntl Incm Re Debt Fincd PropNetRntlIncmReDebtFincdPropGrp
Net Rntl Incm Re Not Debt Fincd PropNetRntlIncmReNotDebtFincdProp
Net Rental Income Personal PropNetRentalIncomePersonalPropGrp
Other Investment IncomeOtherInvestmentIncomeGrp
Gain Sales Ast Oth Than InvntryGainSalesAstOthThanInvntryGrp
Net Income Loss From Special EvtNetIncomeLossFromSpecialEvtGrp
Gross Profit Loss Sls Of InvntryGrossProfitLossSlsOfInvntryGrp

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Exclusion$249ExclusionAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$249TotalIncomeProducingActyAmt

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

FieldValueIRS element (for citing)
Trnsfr Of Cash To Nonchrtbl EOfalseTrnsfrOfCashToNonchrtblEOInd
Trnsfr Other Asset Nonchrtbl EOfalseTrnsfrOtherAssetNonchrtblEOInd
Sales Or Exchanges Of AssetsfalseSalesOrExchangesOfAssetsInd
Purchase Of Assets Nonchrtbl EOfalsePurchaseOfAssetsNonchrtblEOInd
Rental Of Facilities Oth AssetsfalseRentalOfFacilitiesOthAssetsInd
Reimbursement ArrangementsfalseReimbursementArrangementsInd
Loans Or Loan GuaranteesfalseLoansOrLoanGuaranteesInd
Performance Of Services EtcfalsePerformanceOfServicesEtcInd
Sharing Of Facilities EtcfalseSharingOfFacilitiesEtcInd
Relationships Nonchrtbl EOfalseRelationshipsNonchrtblEOInd

Schedule B IRS990ScheduleB

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
General RuleYes (X)GeneralRuleInd

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
Contributor1ContributorNum
Contributor PersonSimon MichaelContributorPersonNm

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line136 Everett AvenueAddressLine1Txt
CityWinchesterCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01890ZIPCd
FieldValueIRS element (for citing)
Total Contributions$1,021,271TotalContributionsAmt
Noncash ContributionYes (X)NoncashContributionInd

Non Cash Property Contribution NonCashPropertyContributionGrp

FieldValueIRS element (for citing)
Contributor1ContributorNum
Noncash PropertyAMAZON COM AMZN, 300 sh.NoncashPropertyDesc
Fair Market Value$1,021,271FairMarketValueAmt
Received2021-12-03ReceivedDt

Depreciation Schedule DepreciationSchedule

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp

FieldValueIRS element (for citing)
StockAMAZON COMStockNm
EOY Book Value$1,021,271EOYBookValueAmt
EOYFMV$1,000,302EOYFMVAmt

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (3 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
Administrative Fees$13,337$13,337
Postage/Delivery Service$25$25
State or Local Filing Fees$25$25

Substantial Contributors Sch SubstantialContributorsSch

Substantial Contributor Detail SubstantialContributorDetail

FieldValueIRS element (for citing)
PersonSimon KatalinaPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line136 Everett AvenueAddressLine1Txt
CityWinchesterCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01890ZIPCd

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (2 entries)

CategoryCategoryTxtAmtAmt
990-PF Estimated Tax for 2020$29,900
990-PF Excise Tax for 2020$273

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