BRUCE AND TAMMY WERNER FOUNDATION: Form 990PF, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- BRUCE AND TAMMY WERNER FOUNDATION (EIN 36-4235915)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-03-10
- IRS object ID
- 202330699349101203
- Schema version
- 2022v4.1
- 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
- Investments Corp Bonds Schedule
- Investments Corp Stock Schedule
- Investments Govt Obligations Sch
- Investments Other Schedule2
- Other Increases Schedule
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-03-10T12:45:24-06:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 341667340 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PACKER THOMAS | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6601 WESTFORD PLACE SUITE 101 | AddressLine1Txt |
| City | CANFIELD | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44406 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 364235915 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRUCE D AND TAMMY H WERNER FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BRUC | BusinessNameControlTxt |
| Phone | 8479102025 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 NORTHAMPTON | AddressLine1Txt |
| City | LINCOLNSHIRE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60069 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRUCE D WERNER | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 8479102025 | PhoneNum |
| Signature | 2023-02-20 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | BRUCE | PersonFirstNm |
| Person Last | WERNER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOSEPH GABRIEL | PreparerPersonNm |
| PTIN | P00595382 | PTIN |
| Phone | 3305339777 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $210,648 | 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 |
| Dividends Rev And Expnss | $5,844 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $5,844 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | -$238 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $74,620 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $0 | CapGainNetIncmNetInvstIncmAmt |
| Total Rev And Expnss | $5,606 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $5,844 | TotalNetInvstIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $0 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $0 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $0 | CompOfcrDirTrstDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $1,375 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $688 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Chrtbl Prps | $687 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Rev And Expnss | $1,067 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $1,067 | OtherProfFeesNetInvstIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $0 | OtherProfFeesDsbrsChrtblAmt |
| Taxes Rev And Expnss | $456 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $0 | TaxesNetInvstIncmAmt |
| Taxes Dsbrs Chrtbl | $128 | TaxesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $2,898 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $1,755 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $815 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $20,820 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $20,820 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $23,718 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $1,755 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $21,635 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$18,112 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $4,089 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sav And Temp Cash Invst BOY | $31,332 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $10,324 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $10,324 | SavAndTempCashInvstEOYFMVAmt |
| US Government Obligations BOY | $0 | USGovernmentObligationsBOYAmt |
| US Government Obligations EOY | $20,539 | USGovernmentObligationsEOYAmt |
| US Govt Obligations EOYFMV | $20,645 | USGovtObligationsEOYFMVAmt |
| Corporate Stock BOY | $93,817 | CorporateStockBOYAmt |
| Corporate Stock EOY | $92,336 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $95,239 | CorporateStockEOYFMVAmt |
| Corporate Bonds BOY | $53,160 | CorporateBondsBOYAmt |
| Corporate Bonds EOY | $44,751 | CorporateBondsEOYAmt |
| Corporate Bonds EOYFMV | $40,591 | CorporateBondsEOYFMVAmt |
| Other Investments BOY | $51,825 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $45,872 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $43,849 | OtherInvestmentsEOYFMVAmt |
| Total Assets BOY | $230,134 | TotalAssetsBOYAmt |
| Total Assets EOY | $213,822 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $210,648 | TotalAssetsEOYFMVAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
| Capital Stock BOY | $230,134 | CapitalStockBOYAmt |
| Capital Stock EOY | $213,822 | CapitalStockEOYAmt |
| Additional Paid In Capital BOY | $0 | AdditionalPaidInCapitalBOYAmt |
| Additional Paid In Capital EOY | $0 | AdditionalPaidInCapitalEOYAmt |
| Retained Earning BOY | $0 | RetainedEarningBOYAmt |
| Retained Earning EOY | $0 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $230,134 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $213,822 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $230,134 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $213,822 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $230,134 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$18,112 | ExcessRevenueOverExpensesAmt |
| Other Increases | $1,800 | OtherIncreasesAmt |
| Subtotal | $213,822 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $213,822 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (3 entries)
| PropertyPropertyDesc | How AcquiredHowAcquiredCd | AcquiredAcquiredDt | SoldSoldDt | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt |
|---|---|---|---|---|---|---|---|
| NET SHORT-TERM GAIN (PUBLICLY TRADED SECURITIES) | P | 2022-06-30 | 2022-12-31 | $26,936 | $28,967 | -$2,031 | -$2,031 |
| NET LONG-TERM GAIN (PUBLICLY TRADED SECURITIES) | P | 2021-01-01 | 2022-12-31 | $47,116 | $45,891 | $1,225 | $1,225 |
| CAPITAL GAINS DIVIDENDS | P | $568 | $568 | $568 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | -$238 | CapitalGainNetIncomeAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $57 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $57 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $57 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $0 | EstimatedPlusOvpmtIncmTxAmt |
| Exempt Frgn Org Tax Wthld At Srce | $0 | ExemptFrgnOrgTaxWthldAtSrceAmt |
| Extsn Request Income Tax Paid | $0 | ExtsnRequestIncomeTaxPaidAmt |
| Backup Withholding Withheld | $0 | BackupWithholdingWithheldAmt |
| Total Payments And Credits | $0 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Tax Due | $57 | TaxDueAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | 0 | LegislativePoliticalActyInd |
| More Than100 Spent | 0 | MoreThan100SpentInd |
| Form1120 POL Filed | 0 | Form1120POLFiledInd |
| Section4955 Organization Tax | $0 | Section4955OrganizationTaxAmt |
| Section4955 Managers Tax | $0 | Section4955ManagersTaxAmt |
| Tax Reimbursed | $0 | TaxReimbursedAmt |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | 0 | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (1) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (1) | AtLeast5000InAssetsInd |
| Org Report Or Register State | IL | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (1) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | 0 | PrivateOperatingFoundationInd |
| New Substantial Contributors | 0 | NewSubstantialContributorsInd |
| Own Controlled Entity | 0 | OwnControlledEntityInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (1) | ComplyWithPublicInspRqrInd |
| Website Address | N/A | WebsiteAddressTxt |
| Individual With Books | BRUCE D WERNER | IndividualWithBooksNm |
| Phone | 8479102025 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 NORTHAMPTON | AddressLine1Txt |
| City | LINCOLNSHIRE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60069 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Accounts Question | 0 | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | 0 | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | 0 | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | 0 | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | 0 | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | 0 | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | 0 | PaymentToGovernmentOfficialInd |
| Uncorrected Prior Acts | 0 | UncorrectedPriorActsInd |
| Undistributed Income PY | 0 | UndistributedIncomePYInd |
| Business Holdings | 0 | BusinessHoldingsInd |
| Jeopardy Investments | 0 | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | 0 | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | 0 | InfluenceLegislationInd |
| Influence Election | 0 | InfluenceElectionInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Noncharitable Purpose | 0 | NoncharitablePurposeInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (4 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 |
|---|---|---|---|---|---|---|---|---|
| BRUCE D WERNER | ||||||||
| 210 NORTHAMPTON | LINCOLNSHIRE | IL | 60069 | PRESIDENT | 2.00 | $0 | $0 | $0 |
| AMY WERNER | ||||||||
| 1851 BASSETT ST UNIT 310 | DENVER | CO | 80202 | VICE PRESIDENT | 2.00 | $0 | $0 | $0 |
| HILLARY WERNER | ||||||||
| 1409 N MAPLEWOOD AVE 1 | CHICAGO | IL | 60622 | VICE PRESIDENT | 2.00 | $0 | $0 | $0 |
| ELISE WERNER FROST | ||||||||
| 1001 SAXONY DRIVE | HIGHLAND PARK | IL | 60035 | ASSISTANT VICE PRESIDENT | 2.00 | $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 |
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 | $216,381 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $11,971 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $228,352 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $228,352 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $3,425 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $224,927 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $11,246 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $11,246 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $57 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $57 | TotalTaxAmt |
| Distributable Before Adj | $11,189 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $11,189 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $11,189 | DistributableAsAdjustedAmt |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $21,635 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $21,635 | QualifyingDistributionsAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $11,189 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $0 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr5 | $3,943 | ExcessDistributionCyovYr5Amt |
| Excess Distribution Cyov Yr4 | $3,956 | ExcessDistributionCyovYr4Amt |
| Excess Distribution Cyov Yr3 | $3,260 | ExcessDistributionCyovYr3Amt |
| Excess Distribution Cyov Yr2 | $3,879 | ExcessDistributionCyovYr2Amt |
| Excess Distribution Cyov Yr1 | $3,672 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $18,710 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $21,635 | QualifyingDistributionsAmt |
| Applied To Year1 | $0 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $11,189 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $10,446 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $0 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $0 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $29,156 | TotalCorpusAmt |
| Prior Year Undistributed Incm | $0 | PriorYearUndistributedIncmAmt |
| Prior Year Deficiency Or Tax | $0 | PriorYearDeficiencyOrTaxAmt |
| Taxable1 | $0 | Taxable1Amt |
| Taxable2 | $0 | Taxable2Amt |
| Undistributed Income CY | $0 | UndistributedIncomeCYAmt |
| Corpus Distri170b1 E Or4942g3 | $0 | CorpusDistri170b1EOr4942g3Amt |
| Excess Distri Cyov From Yr5 | $3,943 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $25,213 | ExcessDistriCyovToNextYrAmt |
| Excess From Year4 | $3,956 | ExcessFromYear4Amt |
| Excess From Year3 | $3,260 | ExcessFromYear3Amt |
| Excess From Year2 | $3,879 | ExcessFromYear2Amt |
| Excess From Year1 | $3,672 | ExcessFromYear1Amt |
| Excess From Current Year | $10,446 | ExcessFromCurrentYearAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (22 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| ALLIANCE FOR GREAT LAKES | |||||||
| 150 N MICHIGAN AVE | CHICAGO | IL | 60601 | N/A | PC | GENERAL SUPPORT | $250 |
| BIRTHRIGHT ISRAEL | |||||||
| P O BOX 21615 | NEW YORK | NY | 10087 | N/A | PC | GENERAL SUPPORT | $360 |
| CARNEGIE MELLON UNIVERSITY MECHANICAL ENGINEERING | |||||||
| 5000 FORBES AVE | PITTSBURGH | PA | 15213 | N/A | PC | GENERAL SUPPORT | $180 |
| FRIENDS OF IDF | |||||||
| P O BOX 4224 | NEW YORK | NY | 10163 | N/A | PC | GENERAL SUPPORT | $180 |
| HILLEL | |||||||
| 629 FOSTER ST | EVANSTON | IL | 60201 | N/A | PC | GENERAL SUPPORT | $1,000 |
| ILLINOIS HOLOCAUST MUSEUM | |||||||
| 9603 WOODS DR | SKOKIE | IL | 60077 | N/A | PC | GENERAL SUPPORT | $500 |
| JEWISH UNITED FUND | |||||||
| 30 S WELLS ST | CHICAGO | IL | 60606 | N/A | PC | GENERAL SUPPORT | $5,600 |
| MAGEN DAVID ADOM | |||||||
| 30100 CHAGRIN BLVD 150 | PEPPER PIKE | OH | 44124 | N/A | PC | GENERAL SUPPORT | $360 |
| MIT SLOAN SCHOOL OF MANAGEMENT | |||||||
| 100 MAIN ST | CAMBRIDGE | MA | 02142 | N/A | PC | GENERAL SUPPORT | $180 |
| NORTHSHORE HEALTH SYSTEM | |||||||
| 2650 RIDGE AVE | EVANSTON | IL | 60201 | N/A | PC | GENERAL SUPPORT | $1,800 |
| PLANNED PARENTHOOD | |||||||
| 1200 N LASALLE ST | CHICAGO | IL | 60610 | N/A | PC | GENERAL SUPPORT | $200 |
| RIMLAND SERVICES FOR AUTISTIC CITIZENS | |||||||
| 1265 HARTREY AVE | EVANSTON | IL | 60202 | N/A | PC | GENERAL SUPPORT | $200 |
| SPERTUS INSTITUTE | |||||||
| 610 S MICHIGAN AVE | CHICAGO | IL | 60605 | N/A | PC | GENERAL SUPPORT | $1,800 |
| STAND WITH US | |||||||
| P O BOX 341069 | LOS ANGELES | CA | 90034 | N/A | PC | GENERAL SUPPORT | $1,000 |
| STANFORD ENGINEERING | |||||||
| 450 SERRA MALL | STANFORD | CA | 94305 | N/A | PC | GENERAL SUPPORT | $180 |
| TEMPLE BETH EL | |||||||
| 3610 DUNDEE RD | NORTHBROOK | IL | 60062 | N/A | PC | GENERAL SUPPORT | $250 |
| THE ARK | |||||||
| 6450 N CALIFORNIA AVE | CHICAGO | IL | 60645 | N/A | PC | GENERAL SUPPORT | $3,600 |
| US HOLOCAUST MUSEUM | |||||||
| 100 RAUL WALLENBERG PL SW | WASHINGTON | DC | 20024 | N/A | PC | GENERAL SUPPORT | $180 |
| WFMT-FINE ARTS RADIO | |||||||
| 5400 N ST LOUIS AVE | CHICAGO | IL | 60625 | N/A | PC | GENERAL SUPPORT | $100 |
| SCOPE MIDWEST | |||||||
| PO BOX 5450 | ASTORIA | NY | 11105 | N/A | PC | GENERAL SUPPORT | $100 |
| FUENTE LATINA | |||||||
| 7300 BISCAYNE BLVD STE 200 | MIAMI | FL | 33138 | N/A | PC | GENERAL SUPPORT | $1,800 |
| HIGHLAND PARK COMMUNITY FOUNDATION | |||||||
| 508 CENTRAL AVE | HIGHLAND PARK | IL | 60035 | N/A | PC | GENERAL SUPPORT | $1,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $20,820 | 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 | $5,844 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | -$238 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $5,606 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $5,606 | TotalIncomeProducingActyAmt |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | 0 | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | 0 | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | 0 | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | 0 | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | 0 | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | 0 | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | 0 | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | 0 | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | 0 | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | 0 | RelationshipsNonchrtblEOInd |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | PACKER THOMAS TAX PREPARATION | CategoryTxt |
| Amt | $1,375 | Amt |
| Net Investment Income | $688 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $687 | DisbursementsCharitablePrpsAmt |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corporate Bonds InvestmentsCorporateBondsGrp (3 entries)
| BondBondNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| 2,118.759 SHS DOUBLELINE CORE FIXED INCOME | $22,709 | $19,471 |
| 752.283 SHS RIVER CANYON TOTAL RET BOND | $8,042 | $7,493 |
| 1,306.542 SHS CLIFFWATER CORP LENDING | $14,000 | $13,627 |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp (5 entries)
| StockStockNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| 1,306.609 SHS TOUCHSTONE SANDS CAPITAL | $16,906 | $12,426 |
| 3,734.136 SHS AQUARIUS INTL FUND | $36,652 | $35,549 |
| 1,272.216 SHS FIDELITY LARGE CAP VALUE INDEX | $17,256 | $18,829 |
| 93.239 SHS FIDELITY 500 INDEX | $7,770 | $12,412 |
| 1,139.595 SHS ALTAIR SMALLER COMPANIES FUND | $13,752 | $16,023 |
Investments Govt Obligations Sch InvestmentsGovtObligationsSch
| Field | Value | IRS element (for citing) |
|---|---|---|
| US Govt Obligations Book Vl EOY | $20,539 | USGovtObligationsBookVlEOYAmt |
| US Govt Obligations EOYFMV | $20,645 | USGovtObligationsEOYFMVAmt |
| State Local Sec Book Vl EOY | $0 | StateLocalSecBookVlEOYAmt |
| State Local Sec EOYFMV | $0 | StateLocalSecEOYFMVAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (4 entries)
| Category Or ItemCategoryOrItemTxt | Listed At Cost Or FMVListedAtCostOrFMVCd | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| 25,000 ISRAEL DUE 12/01/22 | AT COST | $25,000 | $25,000 |
| 12 SHS TR RUSSELL 2000 ETF | AT COST | $1,835 | $2,092 |
| 861.989 SHS FIDELITY INTL REAL ESTATE | AT COST | $10,471 | $8,611 |
| 503.452 SHS TIAA-CREF REAL ESTATE SEC | AT COST | $8,566 | $8,146 |
Other Increases Schedule OtherIncreasesSchedule
Other Increases Detail OtherIncreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CREDIT BACK UNCASHED CHECK #320 | Desc |
| Amt | $1,800 | Amt |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | INVESTMENT MANAGEMENT FEES | CategoryTxt |
| Amt | $1,067 | Amt |
| Net Investment Income | $1,067 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (3 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| ILLINOIS ANNUAL REPORT FILING FEE | $115 | $0 | $115 |
| ILLINOIS SECRETARY OF STATE | $13 | $0 | $13 |
| 2021 EXCISE TAX BALANCE DUE | $328 | $0 | $0 |
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