COMMUNITY HEALTH FOUNDATION OF WARREN AND HENDERSON COUNTIES: Form 990PF, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTH FOUNDATION OF WARREN AND HENDERSON COUNTIES (EIN 20-8070870)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-07-26
- IRS object ID
- 202402089349100805
- Schema version
- 2023v5.1
- 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
- Other Assets Schedule
- Other Decreases Schedule
- Other Expenses Schedule
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-07-26T10:40:32-07:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 363794537 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Timmer And Associates CPA PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4480 - 48th Avenue Ct Suite 3 | AddressLine1Txt |
| City | Rock Island | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61201 | 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 | 208070870 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH FOUNDATION OF WARREN & | BusinessNameLine1Txt |
| Business Name Line2 | HENDERSON COUNTIES | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 3097349333 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 EAST BROADWAY | AddressLine1Txt |
| City | MONMOUTH | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61462 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DOROTHY RICKETTS | PersonNm |
| Person Title | Secretary | PersonTitleTxt |
| Signature | 2024-07-26 | 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 | ANDREA WILLIS CPA | PreparerPersonNm |
| PTIN | P00533697 | PTIN |
| Phone | 5633239407 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2024-08-08 14:25:15Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $17,832,465 | FMVAssetsEOYAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Interest On Sav Rev And Expnss | $853 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $853 | InterestOnSavNetInvstIncmAmt |
| Interest On Savings Adj Net Incm | $853 | InterestOnSavingsAdjNetIncmAmt |
| Dividends Rev And Expnss | $313,327 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $313,327 | DividendsNetInvstIncmAmt |
| Dividends Adj Net Incm | $313,327 | DividendsAdjNetIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $145,818 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $5,432,966 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $145,818 | CapGainNetIncmNetInvstIncmAmt |
| Net ST Capital Gain Adj Net Incm | $78,131 | NetSTCapitalGainAdjNetIncmAmt |
| Total Rev And Expnss | $459,998 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $459,998 | TotalNetInvstIncmAmt |
| Total Adj Net Incm | $392,311 | TotalAdjNetIncmAmt |
| Accounting Fees Rev And Expnss | $2,175 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $2,175 | AccountingFeesNetInvstIncmAmt |
| Other Prof Fees Rev And Expnss | $50,000 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $50,000 | OtherProfFeesNetInvstIncmAmt |
| Taxes Rev And Expnss | $9,581 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $9,581 | TaxesNetInvstIncmAmt |
| Other Expenses Rev And Expnss | $2,368 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $2,368 | OtherExpensesNetInvstIncmAmt |
| Tot Opr Expenses Rev And Expnss | $64,124 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $64,124 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $0 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $850,000 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $850,000 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $914,124 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $64,124 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $850,000 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$454,126 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $395,874 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $392,311 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sav And Temp Cash Invst BOY | $151,441 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $492,386 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $492,386 | SavAndTempCashInvstEOYFMVAmt |
| Other Assets BOY | $16,115,659 | OtherAssetsBOYAmt |
| Other Assets EOY | $15,314,674 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $17,340,079 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $16,267,100 | TotalAssetsBOYAmt |
| Total Assets EOY | $15,807,060 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $17,832,465 | TotalAssetsEOYFMVAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
| No Donor Rstr Net Assests BOY | $16,267,100 | NoDonorRstrNetAssestsBOYAmt |
| No Donor Rstr Net Assests EOY | $15,807,060 | NoDonorRstrNetAssestsEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $16,267,100 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $15,807,060 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $16,267,100 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $15,807,060 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $16,267,100 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$454,126 | ExcessRevenueOverExpensesAmt |
| Subtotal | $15,812,974 | SubtotalAmt |
| Other Decreases | $5,914 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $15,807,060 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (41 entries)
| PropertyPropertyDesc | How AcquiredHowAcquiredCd | AcquiredAcquiredDt | SoldSoldDt | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt |
|---|---|---|---|---|---|---|---|
| 480 SH ISHARES MSCI EAF MIN VOL | P | 2022-12-14 | 2023-04-27 | $33,624 | $30,998 | $2,626 | $2,626 |
| 4490 SH ISHARES MSCI EAF MIN VOL | P | 2022-12-14 | 2023-08-14 | $305,497 | $289,964 | $15,533 | $15,533 |
| 900 SH ISHARES MSCI EAF MIN VOL | P | 2023-10-10 | $64,655 | $59,891 | $4,764 | $4,764 | |
| 840 SH ISHARES MSCI EAF MIN VOL | P | 2022-09-29 | 2023-10-31 | $59,161 | $55,899 | $3,262 | $3,262 |
| 3160 SH ISHARES MSCI USA MOMNTUM | P | 2023-10-10 | $437,877 | $465,108 | -$27,231 | -$27,231 | |
| 570 SH ISHARES S&P MID CAP 400 | P | 2022-09-29 | 2023-08-14 | $43,403 | $35,847 | $7,556 | $7,556 |
| 280 SH ISHARES 1-3 YEAR TREASRY | P | 2022-09-29 | 2023-04-27 | $23,051 | $22,761 | $290 | $290 |
| 2990 SH ISHARES 1-3 YEAR TREASRY | P | 2023-10-10 | $241,799 | $243,057 | -$1,258 | -$1,258 | |
| 432 SH ISHARES 7-10 YEAR | P | 2022-07-06 | 2023-04-27 | $43,173 | $44,405 | -$1,232 | -$1,232 |
| 480 SH ISHARES 7-10 YEAR | P | 2023-10-10 | $43,495 | $49,339 | -$5,844 | -$5,844 | |
| 1646.894 SH AMERICAN FUNDS EUROPACIFIC | P | 2023-01-01 | 2023-02-08 | $88,000 | $72,512 | $15,488 | $15,488 |
| 2359.027 SH AMERICAN FUNDS EUROPACIFIC | P | 2022-09-29 | 2023-04-26 | $127,000 | $103,866 | $23,134 | $23,134 |
| 1823.541 SH AMERICAN FUNDS EUROPACIFIC | P | 2022-09-29 | 2023-10-30 | $90,000 | $81,300 | $8,700 | $8,700 |
| 2740.78 SH DOUBLELINE CORE FIXED INC | P | 2023-02-07 | 2023-04-26 | $26,000 | $25,844 | $156 | $156 |
| 4339.479 SH FIDEITY EMERGING MARKET | P | 2022-07-06 | 2023-10-30 | $40,000 | $42,654 | -$2,654 | -$2,654 |
| 3508.222 SH FIDELITY INTERNATIONAL INC | P | 2022-09-29 | 2023-04-26 | $160,000 | $129,667 | $30,333 | $30,333 |
| 2854.662 SH FIDELITY INTERNATIONAL INC | P | 2022-09-29 | 2023-10-27 | $120,000 | $106,994 | $13,006 | $13,006 |
| 2572.381 SH FIDELITY US BOND INDEX | P | 2023-02-07 | 2023-04-26 | $27,000 | $27,430 | -$430 | -$430 |
| 4095.78 SH FIDELITY US BOND INDEX | P | 2022-07-06 | 2023-10-06 | $40,000 | $43,523 | -$3,523 | -$3,523 |
| 1075.667 SH GMO QUALITY I | P | 2022-12-14 | 2023-04-26 | $27,000 | $26,839 | $161 | $161 |
| 1124.391 SH GMO QUALITY I | P | 2023-02-07 | 2023-10-06 | $30,000 | $28,059 | $1,941 | $1,941 |
| 765.494 SH GMO QUALITY I | P | 2023-02-07 | 2023-10-30 | $20,000 | $19,103 | $897 | $897 |
| 939.878 SH GMO RESOURCES I | P | 2023-08-10 | 2023-10-30 | $20,000 | $22,830 | -$2,830 | -$2,830 |
| 251.221 SH GRANDEUR PEAK INTERNATIONAL | P | 2022-12-21 | 2023-02-08 | $887 | $867 | $20 | $20 |
| 1293.283 SH GUGGENHEIM TOTAL RETURN | P | 2022-04-06 | 2023-04-26 | $31,000 | $32,673 | -$1,673 | -$1,673 |
| 1931.669 SH JPMORGAN LARGE CAP GROWTH | P | 2023-02-07 | 2023-08-11 | $106,000 | $94,170 | $11,830 | $11,830 |
| 286.271 LONGLEAF PARTNERS SMALL CAP | P | 2022-12-29 | 2023-02-07 | $6,670 | $7,266 | -$596 | -$596 |
| 3169.307 SH PIMCO INCOME INSTL | P | 2022-09-29 | 2023-10-06 | $32,000 | $32,813 | -$813 | -$813 |
| 8917.708 PRINCIPAL DIVERSIFIED RE | P | 2022-11-01 | 2023-02-08 | $101,149 | $108,397 | -$7,248 | -$7,248 |
| 2822.201 SH SCHWAB FUNDAMENTAL US LA | P | 2021-04-05 | 2023-10-30 | $60,000 | $60,661 | -$661 | -$661 |
| 350.828 SH SCHWAB TOTAL STOCK MARKET | P | 2022-07-06 | 2023-02-08 | $25,000 | $22,824 | $2,176 | $2,176 |
| 1651.935 SH SCHWAB TOTAL STOCK MARKET | P | 2022-07-06 | 2023-04-26 | $114,000 | $107,469 | $6,531 | $6,531 |
| 2753.376 SH SCHWAB TOTAL STOCK MARKET | P | 2022-07-06 | 2023-08-11 | $210,000 | $179,125 | $30,875 | $30,875 |
| 2342.889 SH SCHWAB TOTAL STOCK MARKET | P | 2022-07-06 | 2023-10-06 | $170,000 | $152,420 | $17,580 | $17,580 |
| 1571.796 SH SCHWAB TOTAL STOCK MARKET | P | 2022-07-06 | 2023-10-30 | $180,000 | $167,312 | $12,688 | $12,688 |
| 629.75 SH WILLIAM BLAIR SMALL-MID | P | 2022-12-15 | 2023-02-08 | $18,262 | $16,898 | $1,364 | $1,364 |
| 116872.665 SH GRANDEUR PEAK INTERNATIONAL | P | 2020-01-01 | 2023-02-07 | $412,551 | $403,546 | $9,005 | $9,005 |
| 23956.512 SH LONGLEAF PARTNERS SMALL CAP | P | 2020-01-01 | 2023-02-07 | $558,177 | $608,088 | -$49,911 | -$49,911 |
| 61792.369 SH PRINCIPAL DIVERSIFIED RE | P | 2020-01-01 | 2023-02-07 | $700,725 | $750,936 | -$50,211 | -$50,211 |
| 19147.543 SH WILLIAM BLAIR SMALL-MID | P | 2020-01-01 | 2023-02-07 | $555,269 | $513,793 | $41,476 | $41,476 |
| Capital Gain Dividends | $40,541 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $145,818 | CapitalGainNetIncomeAmt |
| Net Short Term Capital Gain Loss | $78,131 | NetShortTermCapitalGainLossAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $5,503 | InvestmentIncomeExciseTaxAmt |
| Subtotal | $5,503 | SubtotalAmt |
| Tax Based On Investment Income | $5,503 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $15,000 | EstimatedPlusOvpmtIncmTxAmt |
| Total Payments And Credits | $15,000 | TotalPaymentsAndCreditsAmt |
| Overpayment | $9,497 | OverpaymentAmt |
| Applied To ES Tax | $9,497 | 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 |
| 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 | DOROTHY RICKETTS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3097342330 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 E BROADWAY | AddressLine1Txt |
| City | MONMOUTH | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61462 | 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 |
| 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 (13 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt |
|---|---|---|---|---|---|---|
| DOROTHY RICKETTS | ||||||
| 202 NORTH G STREET | MONMOUTH | IL | 61462 | CHAIR | 0.00 | $0 |
| GARY HEATON | ||||||
| 715 NORTH 9TH STREET | MONMOUTH | IL | 61462 | Secretary | 0.00 | $0 |
| MICHAEL CONNELL | ||||||
| 1150 WARREN SCHOOL RD | MONMOUTH | IL | 61462 | VICE CHAIR | 0.00 | $0 |
| DR JAMES BATTENDURG | ||||||
| 2028 62ND ST | MONMOUTH | IL | 61462 | Director | 0.00 | $0 |
| DON GLADFELTER | ||||||
| 3610 AVIAN CT | MILAN | IL | 61264 | Director | 0.00 | $0 |
| SPUD RILEY | ||||||
| 1361 EAST BROADWAY | MONMOUTH | IL | 61462 | Director | 0.00 | $0 |
| CAROL SHAW | ||||||
| 1008 HWY 116 | ROSEVILLE | IL | 61462 | Director | 0.00 | $0 |
| JON FERGUSON | ||||||
| 17 FAIRWAY DRIVE | MONMOUTH | IL | 61462 | Director | 0.00 | $0 |
| LYNNE HAASE | ||||||
| RRI BOX 112 | BIGGSVILLE | IL | 61418 | Director | 0.00 | $0 |
| MARIA GODINA | ||||||
| 2176 US HWY 67 | MONMOUTH | IL | 61462 | Director | 0.00 | $0 |
| BRANDON OUELLETTE | ||||||
| 525 NORTH 11TH ST | MONMOUTH | IL | 61462 | Director | 0.00 | $0 |
| RACHEL KUNKLE | ||||||
| 1174 230TH AVE | GERLAW | IL | 61435 | Director | 0.00 | $0 |
| LISA DEKEZEL | ||||||
| 1000 W HARLEM AVE | MONMOUTH | IL | 61462 | EX-OFFICIO | 0.00 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Hghst Pd Empl Or NONE | NONE | CompOfHghstPdEmplOrNONETxt |
| Comp Of Hghst Pd Cntrct Or NONE | NONE | CompOfHghstPdCntrctOrNONETxt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $17,911,224 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $295,393 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $18,206,617 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Adjusted Total FMV Of Unused Ast | $18,206,617 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $273,099 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $17,933,518 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $896,676 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $896,676 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $5,503 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $5,503 | TotalTaxAmt |
| Distributable Before Adj | $891,173 | DistributableBeforeAdjAmt |
| Distributable Before Ded | $891,173 | DistributableBeforeDedAmt |
| Distributable As Adjusted | $891,173 | DistributableAsAdjustedAmt |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $850,000 | ExpensesAndContributionsAmt |
| Qualifying Distributions | $850,000 | QualifyingDistributionsAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $891,173 | DistributableAsAdjustedAmt |
| Excess Distribution Cyov Yr4 | $163,146 | ExcessDistributionCyovYr4Amt |
| Excess Distribution Cyov Yr3 | $88,275 | ExcessDistributionCyovYr3Amt |
| Excess Distribution Cyov Yr1 | $58,459 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $309,880 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $850,000 | QualifyingDistributionsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $850,000 | AppliedToCurrentYearAmt |
| Excess Distri Cyov App CY Corpus | $41,173 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $41,173 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $268,707 | TotalCorpusAmt |
| Undistributed Income CY | $0 | UndistributedIncomeCYAmt |
| Excess Distri Cyov To Next Yr | $268,707 | ExcessDistriCyovToNextYrAmt |
| Excess From Year4 | $121,973 | ExcessFromYear4Amt |
| Excess From Year3 | $88,275 | ExcessFromYear3Amt |
| Excess From Year1 | $58,459 | ExcessFromYear1Amt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Application Submission Info ApplicationSubmissionInfoGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Person | DOROTHY RICKETTS | RecipientPersonNm |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 EAST BROADWAY | AddressLine1Txt |
| City | MONMOUTH | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61462 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Person | OSF HEALTHCARE SYSTEMS FD | RecipientPersonNm |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 WESGT HARLEM AVENUE | AddressLine1Txt |
| City | MONMOUTH | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61462 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Relationship | NONE | RecipientRelationshipTxt |
| Recipient Foundation Status | NONPROFIT | RecipientFoundationStatusTxt |
| Grant Or Contribution Purpose | EXPANSION | GrantOrContributionPurposeTxt |
| Amt | $850,000 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $850,000 | TotalGrantOrContriPdDurYrAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $853 | ExclusionAmt |
Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $313,327 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Related Or Exempt Function Incm | $145,818 | RelatedOrExemptFunctionIncmAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | $314,180 | ExclusionAmt |
| Related Or Exempt Function Incm | $145,818 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $459,998 | 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 | TAX RETURN | CategoryTxt |
| Amt | $2,175 | Amt |
| Net Investment Income | $2,175 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp (16 entries)
| DescDesc | BOY Book ValueBOYBookValueAmt | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| AMERICAN FUNDS EURO | $1,394,867 | $1,270,215 | |
| CHARLES SCHWAB INVESTMENTS | $17,250,425 | ||
| CHARLES SCHWAB MM | $89,654 | ||
| DOUBLELINE CORE FIXED INC | $833,579 | ||
| FIDELITY EMERGING MKT | $614,207 | $587,195 | |
| FIDELITY INTERNATIONAL | $1,255,191 | $1,344,332 | |
| FIDELITY US BONDS | $758,951 | $749,588 | |
| GMO QUALITY I | $324,109 | ||
| GMO RESOURCES I | $325,579 | ||
| GUGGENHEIM | $1,068,556 | $1,432,269 | |
| ISHARES | $3,173,515 | $2,346,118 | |
| JPMORGAN LARGE CAP | $820,055 | ||
| PIMCO INCOME | $333,715 | $407,010 | |
| PIMCO LOW DURATION | $302,633 | ||
| SCHWAB FUNDAMENTAL | $981,867 | $1,111,035 | |
| SCHWAB TOTAL STOCK MARKET | $4,030,610 | $3,460,957 |
Other Decreases Schedule OtherDecreasesSchedule
Other Decreases Detail OtherDecreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | estimated tax payments | Desc |
| Amt | $5,914 | Amt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (4 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt |
|---|---|---|
| INSURANCE | $2,104 | $2,104 |
| Licenses & Fees | $25 | $25 |
| Postage | $47 | $47 |
| website | $192 | $192 |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | INVESTMENT FEES | CategoryTxt |
| Amt | $50,000 | Amt |
| Net Investment Income | $50,000 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | foreign taxess | CategoryTxt |
| Amt | $9,581 | Amt |
| Net Investment Income | $9,581 | NetInvestmentIncomeAmt |
Comments