HASELWOOD FAMILY FOUNDATION: Form 990PF, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- HASELWOOD FAMILY FOUNDATION (EIN 46-3278630)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-11-14
- IRS object ID
- 202423199349100107
- 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
- Schedule B
- Accounting Fees Schedule
- Investments Corp Bonds Schedule
- Investments Corp Stock Schedule
- Investments Other Schedule2
- Other Expenses Schedule
- Other Liabilities Schedule
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-11-14T00:53:17+00:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 440160260 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Forvis Mazars LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 901 East Cary Street Suite 1000 | AddressLine1Txt |
| City | Richmond | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23219 | 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 | 463278630 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Haselwood Family Foundation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HASE | BusinessNameControlTxt |
| Phone | 3604056208 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 4999 | AddressLine1Txt |
| City | BREMERTON | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98312 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Eric J Wiler | PersonNm |
| Person Title | Director | PersonTitleTxt |
| Phone | 3604056208 | PhoneNum |
| Signature | 2024-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LaKrisha Castleberry | PreparerPersonNm |
| PTIN | P01677333 | PTIN |
| Phone | 8042827636 | PhoneNum |
| Preparation | 2024-11-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2024-10-15 13:58:12Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $764,012 | FMVAssetsEOYAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rcvd Rev And Expnss | $230,892 | ContriRcvdRevAndExpnssAmt |
| Dividends Rev And Expnss | $19,761 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $19,251 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | -$1,023 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $156,889 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $0 | CapGainNetIncmNetInvstIncmAmt |
| Gross Sales Less Ret And Allwnc | $0 | GrossSalesLessRetAndAllwncAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
| Gross Profit Rev And Expnss | $0 | GrossProfitRevAndExpnssAmt |
| Other Income Rev And Expnss | $0 | OtherIncomeRevAndExpnssAmt |
| Other Income Net Invst Incm | $0 | OtherIncomeNetInvstIncmAmt |
| Other Income Adj Net Incm | $0 | OtherIncomeAdjNetIncmAmt |
| Total Rev And Expnss | $249,630 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $19,251 | TotalNetInvstIncmAmt |
| Total Adj Net Incm | $0 | TotalAdjNetIncmAmt |
| Legal Fees Rev And Expnss | $0 | LegalFeesRevAndExpnssAmt |
| Legal Fees Net Invst Incm | $0 | LegalFeesNetInvstIncmAmt |
| Legal Fees Adj Net Incm | $0 | LegalFeesAdjNetIncmAmt |
| Legal Fees Dsbrs Chrtbl | $0 | LegalFeesDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $2,835 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $1,418 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $0 | AccountingFeesAdjNetIncmAmt |
| Accounting Fees Chrtbl Prps | $1,417 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Rev And Expnss | $2,081 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $2,081 | OtherProfFeesNetInvstIncmAmt |
| Other Prof Fees Adj Net Incm | $0 | OtherProfFeesAdjNetIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $0 | OtherProfFeesDsbrsChrtblAmt |
| Taxes Rev And Expnss | $508 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $329 | TaxesNetInvstIncmAmt |
| Taxes Adj Net Incm | $0 | TaxesAdjNetIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Deprec And Dpltn Rev And Expnss | $0 | DeprecAndDpltnRevAndExpnssAmt |
| Deprec And Dpltn Net Invst Incm | $0 | DeprecAndDpltnNetInvstIncmAmt |
| Deprec And Dpltn Adj Net Incm | $0 | DeprecAndDpltnAdjNetIncmAmt |
| Printing And Pub Rev And Expnss | $380 | PrintingAndPubRevAndExpnssAmt |
| Other Expenses Rev And Expnss | $34,257 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $0 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Adj Net Incm | $0 | OtherExpensesAdjNetIncmAmt |
| Other Expenses Dsbrs Chrtbl | $0 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $40,061 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $3,828 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $0 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $1,417 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $67,654 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $67,654 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $107,715 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $3,828 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $0 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $69,071 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $141,915 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $15,423 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $31,698 | CashBOYAmt |
| Cash EOY | $28,545 | CashEOYAmt |
| Cash EOYFMV | $28,545 | CashEOYFMVAmt |
| Acct Rcvbl BOY | $0 | AcctRcvblBOYAmt |
| Acct Rcvbl EOY | $0 | AcctRcvblEOYAmt |
| Acct Rcvbl EOYFMV | $0 | AcctRcvblEOYFMVAmt |
| Pledges Rcvbl EOY | $0 | PledgesRcvblEOYAmt |
| Pledges Rcvbl EOYFMV | $0 | PledgesRcvblEOYFMVAmt |
| Rcvbl From Officers BOY | $0 | RcvblFromOfficersBOYAmt |
| Rcvbl From Officers EOY | $0 | RcvblFromOfficersEOYAmt |
| Rcvbl From Officers EOYFMV | $0 | RcvblFromOfficersEOYFMVAmt |
| Other Nts And Loans Rcvbl | $0 | OtherNtsAndLoansRcvblAmt |
| Other Rcvbl Allwnc Dbtfl Acct | $0 | OtherRcvblAllwncDbtflAcctAmt |
| Other Nts And Loans Rcvbl BOY | $0 | OtherNtsAndLoansRcvblBOYAmt |
| Other Nts And Loans Rcvbl EOY | $0 | OtherNtsAndLoansRcvblEOYAmt |
| Other Nts And Loans Rcvbl EOYFMV | $0 | OtherNtsAndLoansRcvblEOYFMVAmt |
| US Government Obligations BOY | $0 | USGovernmentObligationsBOYAmt |
| US Government Obligations EOY | $0 | USGovernmentObligationsEOYAmt |
| US Govt Obligations EOYFMV | $0 | USGovtObligationsEOYFMVAmt |
| Corporate Stock BOY | $100,413 | CorporateStockBOYAmt |
| Corporate Stock EOY | $115,549 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $120,724 | CorporateStockEOYFMVAmt |
| Corporate Bonds BOY | $206,905 | CorporateBondsBOYAmt |
| Corporate Bonds EOY | $282,364 | CorporateBondsEOYAmt |
| Corporate Bonds EOYFMV | $281,511 | CorporateBondsEOYFMVAmt |
| Invst Land Cost Or Other Basis | $0 | InvstLandCostOrOtherBasisAmt |
| Invst Land Accum Depreciation | $0 | InvstLandAccumDepreciationAmt |
| Land Bldg Investments BOY | $0 | LandBldgInvestmentsBOYAmt |
| Land Bldg Investments EOYFMV | $0 | LandBldgInvestmentsEOYFMVAmt |
| Other Investments BOY | $234,739 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $290,949 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $333,232 | OtherInvestmentsEOYFMVAmt |
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
| Land BOY | $0 | LandBOYAmt |
| Land EOYFMV | $0 | LandEOYFMVAmt |
| Other Assets BOY | $0 | OtherAssetsBOYAmt |
| Other Assets EOY | $0 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $0 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $573,755 | TotalAssetsBOYAmt |
| Total Assets EOY | $717,407 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $764,012 | TotalAssetsEOYFMVAmt |
| Loans From Officers BOY | $0 | LoansFromOfficersBOYAmt |
| Loans From Officers EOY | $0 | LoansFromOfficersEOYAmt |
| Mortgages And Notes Payable BOY | $0 | MortgagesAndNotesPayableBOYAmt |
| Mortgages And Notes Payable EOY | $0 | MortgagesAndNotesPayableEOYAmt |
| Other Liabilities BOY | $1,148 | OtherLiabilitiesBOYAmt |
| Other Liabilities EOY | $2,885 | OtherLiabilitiesEOYAmt |
| Total Liabilities BOY | $1,148 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,885 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
| Retained Earning BOY | $572,607 | RetainedEarningBOYAmt |
| Retained Earning EOY | $714,522 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $572,607 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $714,522 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $573,755 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $717,407 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $572,607 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $141,915 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $714,522 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $714,522 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (3 entries)
| PropertyPropertyDesc | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Excess FMV Over Adjusted BssExcessFMVOverAdjustedBssAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt |
|---|---|---|---|---|---|
| FIDELITY INVESTMENTS #5271 ST | $37,231 | $36,910 | $321 | $0 | $321 |
| FIDELITY INVESTMENTS #5271 LT | $115,730 | $121,002 | -$5,272 | $0 | -$5,272 |
| Capital Gains Dividends | $3,928 | $3,928 | $0 | $3,928 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | -$1,023 | CapitalGainNetIncomeAmt |
| Net Short Term Capital Gain Loss | $0 | NetShortTermCapitalGainLossAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $214 | InvestmentIncomeExciseTaxAmt |
| Subtotal | $214 | SubtotalAmt |
| Tax Based On Investment Income | $214 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $0 | EstimatedPlusOvpmtIncmTxAmt |
| Total Payments And Credits | $0 | TotalPaymentsAndCreditsAmt |
| Form2220 Attached | Yes (X) | Form2220AttachedInd |
| Es Penalty | $9 | EsPenaltyAmt |
| Tax Due | $223 | TaxDueAmt |
| 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 |
| Section4955 Organization Tax | $0 | Section4955OrganizationTaxAmt |
| Section4955 Managers Tax | $0 | Section4955ManagersTaxAmt |
| Tax Reimbursed | $0 | TaxReimbursedAmt |
| 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 | WA | 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 | ERIC J WILER | IndividualWithBooksNm |
| Phone | 3604056208 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 4999 | AddressLine1Txt |
| City | BREMERTON | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98312 | 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 |
| 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 (2 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 |
|---|---|---|---|---|---|---|---|---|
| Eric J Wiler | ||||||||
| PO BOX 4999 | BREMERTON | WA | 98312 | Director | 0.100 | $0 | $0 | $0 |
| Joanne Haselwood | ||||||||
| PO BOX 4999 | BREMERTON | WA | 98312 | Director | 0.100 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Employee Paid Over50k | 0 | OtherEmployeePaidOver50kCnt |
| Contractor Paid Over50k | 0 | ContractorPaidOver50kCnt |
Sum Of Program Related Invst SumOfProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $596,440 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $52,056 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $648,496 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Adjusted Total FMV Of Unused Ast | $648,496 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $9,727 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $638,769 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $31,938 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $31,938 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $214 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $214 | TotalTaxAmt |
| Distributable Before Adj | $31,724 | DistributableBeforeAdjAmt |
| Distributable Before Ded | $31,724 | DistributableBeforeDedAmt |
| Distributable As Adjusted | $31,724 | DistributableAsAdjustedAmt |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $69,071 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Set Aside Cash Distri Test | $0 | SetAsideCashDistriTestAmt |
| Qualifying Distributions | $69,071 | QualifyingDistributionsAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $31,724 | DistributableAsAdjustedAmt |
| Excess Distribution Cyov Yr5 | $5,411 | ExcessDistributionCyovYr5Amt |
| Excess Distribution Cyov Yr3 | $32,083 | ExcessDistributionCyovYr3Amt |
| Excess Distribution Cyov Yr1 | $39,282 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $76,776 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $69,071 | QualifyingDistributionsAmt |
| Applied To Year1 | $0 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $31,724 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $37,347 | RemainingDistriFromCorpusAmt |
| Excess Distribution Cyov App CY | $0 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $114,123 | TotalCorpusAmt |
| Prior Year Undistributed Incm | $0 | PriorYearUndistributedIncmAmt |
| Taxable1 | $0 | Taxable1Amt |
| Taxable2 | $0 | Taxable2Amt |
| Undistributed Income CY | $0 | UndistributedIncomeCYAmt |
| Corpus Distri170b1 E Or4942g3 | $0 | CorpusDistri170b1EOr4942g3Amt |
| Excess Distri Cyov From Yr5 | $5,411 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $108,712 | ExcessDistriCyovToNextYrAmt |
| Excess From Year4 | $0 | ExcessFromYear4Amt |
| Excess From Year3 | $32,083 | ExcessFromYear3Amt |
| Excess From Year2 | $0 | ExcessFromYear2Amt |
| Excess From Year1 | $39,282 | ExcessFromYear1Amt |
| Excess From Current Year | $37,347 | ExcessFromCurrentYearAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (13 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| Admiral Theatre Foundation | |||||||
| 515 Pacific Ave | Bremerton | WA | 98337 | None | PC | Financial Support | $5,000 |
| Archdiocese of Seattle | |||||||
| 710 9th Ave | Seattle | WA | 98104 | None | PC | Financial Support | $2,500 |
| Central Kitsap Food Bank | |||||||
| 3537 NM Anderson Hill Rd | Silverdale | WA | 98383 | None | PC | Financial Support | $1,250 |
| Fishline Foodbank | |||||||
| 19705 Viking Ave NW | Poulsbo | WA | 98370 | None | PC | Financial Support | $3,000 |
| Fred Hutchinson Cancer Center | |||||||
| 1100 Fairview Ave N | Seattle | WA | 98109 | None | PC | Financial Support | $25,995 |
| Haselwood YMCA | |||||||
| 3909 NW Randall Way | Silverdale | WA | 98383 | None | PC | Financial Support | $14,071 |
| Kitsap Regional Library Foundation | |||||||
| 1301 Slyvan Way | Bremerton | WA | 98310 | None | PC | Financial Support | $2,500 |
| Mike's Rides for Lives Inc | |||||||
| 2309 Cherish PI SW | Port Orchard | WA | 983667801 | None | PC | Financial Support | $6,180 |
| Natrona County YMCA | |||||||
| 1611 Casper Mountain Rd | Casper | WY | 82601 | None | PC | Financial Support | $408 |
| Olympic College Foundation | |||||||
| 1600 Chester Ave Bldg 5 | Bremerton | WA | 98337 | None | PC | Financial Support | $1,250 |
| Seattle Children's Hospital- Silverdale Guild | |||||||
| 9800 Levin Rd NW Ste 204 | Silverdale | WA | 98383 | None | PC | Financial Support | $500 |
| Sunny Jack Events LLC | |||||||
| PO Box 2352 | Silverdale | WA | 98383 | None | NC | Financial Support | $2,500 |
| The Mike Tice Foundation | |||||||
| 4075 Abernathy Forest Pl | Belfair | WA | 891414335 | None | PC | Financial Support | $2,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $67,654 | 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) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | 14 | ExclusionCd |
| Exclusion | $19,761 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | 18 | ExclusionCd |
| Exclusion | -$1,023 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $18,738 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $18,738 | 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 |
Schedule B IRS990ScheduleB
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| General Rule | Yes (X) | GeneralRuleInd |
Contributor Information ContributorInformationGrp (10 entries)
| ContributorContributorNum | Address Line1ContributorUSAddress/AddressLine1Txt | CityContributorUSAddress/CityNm | State AbbreviationContributorUSAddress/StateAbbreviationCd | ZIPContributorUSAddress/ZIPCd | Total ContributionsTotalContributionsAmt | Person ContributionPersonContributionInd |
|---|---|---|---|---|---|---|
| Caltex | ||||||
| 1 | 7455 Natural Bridge Caverns Rd | Schertz | TX | 78154 | $5,500 | Yes (X) |
| Canopy World | ||||||
| 2 | 5000 Auto Center Way | Bremerton | WA | 98312 | $5,850 | Yes (X) |
| Cox Automotive | ||||||
| 3 | 6205 Peachtree Dunwoody Rd | Atlanta | GA | 30328 | $13,433 | Yes (X) |
| Eric Wiler | ||||||
| 4 | 3995 Erlands Point Dr | Bremerton | WA | 98312 | $11,750 | Yes (X) |
| Golf Planner Pro | ||||||
| 5 | 9889 Gate Parkway N 301 | Jacksonville | FL | 32246 | $55,432 | Yes (X) |
| Haselwood Autogroup | ||||||
| 6 | 1100 Oyster Bay Ave S | Bremerton | WA | 98312 | $48,736 | Yes (X) |
| Rawls Group | ||||||
| 7 | 1710 W Colonial Dr | Orlando | FL | 32804 | $5,000 | Yes (X) |
| Sameday Auto Scratch & Dent Repair | ||||||
| 8 | 2145 Caton Way SW | Olympia | WA | 98502 | $7,600 | Yes (X) |
| Snider Energy Co | ||||||
| 9 | 5517 W Valley Hwy Bldg C | Sumner | WA | 98390 | $30,000 | Yes (X) |
| US Bank | ||||||
| 10 | 2020 6th St | Bremerton | WA | 98337 | $5,500 | Yes (X) |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | Accounting Fees | CategoryTxt |
| Amt | $2,835 | Amt |
| Net Investment Income | $1,418 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $1,417 | DisbursementsCharitablePrpsAmt |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corporate Bonds InvestmentsCorporateBondsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond | Bonds | BondNm |
| EOY Book Value | $282,364 | EOYBookValueAmt |
| EOYFMV | $281,511 | EOYFMVAmt |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Stock | Stocks | StockNm |
| EOY Book Value | $115,549 | EOYBookValueAmt |
| EOYFMV | $120,724 | EOYFMVAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (3 entries)
| Category Or ItemCategoryOrItemTxt | Listed At Cost Or FMVListedAtCostOrFMVCd | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| Mutual Funds | AT COST | $201,884 | $228,943 |
| Other | AT COST | $5,392 | $5,662 |
| ETP Securities | AT COST | $83,673 | $98,627 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (5 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt |
|---|---|
| Bank Fees | $5 |
| Dues & Subscriptions | $382 |
| Golf Tournament | $32,123 |
| Website Expense | $247 |
| Reimbursement | $1,500 |
Other Liabilities Schedule OtherLiabilitiesSchedule
Other Liabilities Detail OtherLiabilitiesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Transaction in Transit | Desc |
| BOY Book Value | $1,148 | BOYBookValueAmt |
| EOY Book Value | $2,885 | EOYBookValueAmt |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | Advisor Fees | CategoryTxt |
| Amt | $2,081 | Amt |
| Net Investment Income | $2,081 | NetInvestmentIncomeAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt |
|---|---|---|
| Foreign Taxes | $329 | $329 |
| Excise Tax | $179 |
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