BETA

PATCH FOUNDATION: Form 990PF, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
PATCH FOUNDATION (EIN 41-1873951)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-04-12
IRS object ID
202311029349100516
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-04-12T14:56:34-05:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN420714325PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1RSM US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1227 WEST FIRST STREET SUITE 700AddressLine1Txt
CityDULUTHCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55802ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN411873951EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE PATCH FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPATCBusinessNameControlTxt
Phone6127817677PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13201 RANKIN ROADAddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55418ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCAROLYN SAMPLEPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone6127817677PhoneNum
Signature2023-04-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstCAROLYNPersonFirstNm
Person LastSAMPLEPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJULIE BOYERPreparerPersonNm
PTINP01278549PTIN
Phone2187275025PhoneNum
Preparation2023-04-10PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$5,724,702FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$20,000ContriRcvdRevAndExpnssAmt
Interest On Sav Rev And Expnss$953InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$953InterestOnSavNetInvstIncmAmt
Dividends Rev And Expnss$185,340DividendsRevAndExpnssAmt
Dividends Net Invst Incm$185,340DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss$48,034NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$804,749GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$48,034CapGainNetIncmNetInvstIncmAmt
Total Rev And Expnss$254,327TotalRevAndExpnssAmt
Total Net Invst Incm$234,327TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$0CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$0CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl$0CompOfcrDirTrstDsbrsChrtblAmt
Accounting Fees Rev And Expnss$2,625AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm$1,312AccountingFeesNetInvstIncmAmt
Accounting Fees Chrtbl Prps$1,313AccountingFeesChrtblPrpsAmt
Taxes Rev And Expnss$5,329TaxesRevAndExpnssAmt
Taxes Net Invst Incm$0TaxesNetInvstIncmAmt
Taxes Dsbrs Chrtbl$0TaxesDsbrsChrtblAmt
Other Expenses Rev And Expnss$25OtherExpensesRevAndExpnssAmt
Other Expenses Net Invst Incm$0OtherExpensesNetInvstIncmAmt
Other Expenses Dsbrs Chrtbl$25OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$7,979TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$1,312TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$1,338TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$1,100,000ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$1,100,000ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$1,107,979TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$1,312TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$1,101,338TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses-$853,652ExcessRevenueOverExpensesAmt
Net Investment Income$233,015NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Cash BOY$615,758CashBOYAmt
Cash EOY$727,779CashEOYAmt
Cash EOYFMV$727,779CashEOYFMVAmt
Sav And Temp Cash Invst BOY$650,021SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$441,063SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$441,063SavAndTempCashInvstEOYFMVAmt
Corporate Stock BOY$5,003,631CorporateStockBOYAmt
Corporate Stock EOY$4,246,916CorporateStockEOYAmt
Corporate Stock EOYFMV$4,555,860CorporateStockEOYFMVAmt
Total Assets BOY$6,269,410TotalAssetsBOYAmt
Total Assets EOY$5,415,758TotalAssetsEOYAmt
Total Assets EOYFMV$5,724,702TotalAssetsEOYFMVAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind
Capital Stock BOY$0CapitalStockBOYAmt
Capital Stock EOY$0CapitalStockEOYAmt
Additional Paid In Capital BOY$0AdditionalPaidInCapitalBOYAmt
Additional Paid In Capital EOY$0AdditionalPaidInCapitalEOYAmt
Retained Earning BOY$6,269,410RetainedEarningBOYAmt
Retained Earning EOY$5,415,758RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY$6,269,410TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$5,415,758TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$6,269,410TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$5,415,758TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$6,269,410TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses-$853,652ExcessRevenueOverExpensesAmt
Other Increases$0OtherIncreasesAmt
Subtotal$5,415,758SubtotalAmt
Other Decreases$0OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY$5,415,758TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp

FieldValueIRS element (for citing)
PropertyPUBLICLY TRADED SECURITIESPropertyDesc
How AcquiredPHowAcquiredCd
Gross Sales Price$804,749GrossSalesPriceAmt
Cost Or Other Basis$756,715CostOrOtherBasisAmt
Gain Or Loss$48,034GainOrLossAmt
Gains Minus Excess Or Losses$48,034GainsMinusExcessOrLossesAmt
FieldValueIRS element (for citing)
Capital Gain Net Income$48,034CapitalGainNetIncomeAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$3,239InvestmentIncomeExciseTaxAmt
Tax Under Section511$0TaxUnderSection511Amt
Subtotal$3,239SubtotalAmt
Subtitle A Tax$0SubtitleATaxAmt
Tax Based On Investment Income$3,239TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$6,560EstimatedPlusOvpmtIncmTxAmt
Exempt Frgn Org Tax Wthld At Srce$0ExemptFrgnOrgTaxWthldAtSrceAmt
Extsn Request Income Tax Paid$0ExtsnRequestIncomeTaxPaidAmt
Backup Withholding Withheld$0BackupWithholdingWithheldAmt
Total Payments And Credits$6,560TotalPaymentsAndCreditsAmt
Es Penalty$0EsPenaltyAmt
Overpayment$3,321OverpaymentAmt
Applied To ES Tax$3,321AppliedToESTaxAmt
Refund$0RefundAmt

Statements Regarding Acty StatementsRegardingActyGrp

FieldValueIRS element (for citing)
Legislative Political Acty0LegislativePoliticalActyInd
More Than100 Spent0MoreThan100SpentInd
Form1120 POL Filed0Form1120POLFiledInd
Section4955 Organization Tax$0Section4955OrganizationTaxAmt
Section4955 Managers Tax$0Section4955ManagersTaxAmt
Tax Reimbursed$0TaxReimbursedAmt
Activities Not Previously Rpt0ActivitiesNotPreviouslyRptInd
Changes To Articles Or Bylaws0ChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Organization Dissolved Etc0OrganizationDissolvedEtcInd
Section508e Rqr SatisfiedYes (1)Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (1)AtLeast5000InAssetsInd
Org Report Or Register StateMNOrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (1)Form990PFFiledWithAttyGenInd
Private Operating Foundation0PrivateOperatingFoundationInd
New Substantial Contributors0NewSubstantialContributorsInd
Own Controlled Entity0OwnControlledEntityInd
Donor Advised Fund0DonorAdvisedFundInd
Comply With Public Insp RqrYes (1)ComplyWithPublicInspRqrInd
Website AddressN/AWebsiteAddressTxt

Persons With Books Name PersonsWithBooksName

FieldValueIRS element (for citing)
Business Name Line1THE FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6127817677PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line13201 RANKIN ROADAddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55418ZIPCd
FieldValueIRS element (for citing)
Foreign Accounts Question0ForeignAccountsQuestionInd

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

FieldValueIRS element (for citing)
Sale Or Exch Disqualified Prsn0SaleOrExchDisqualifiedPrsnInd
Brrw Or Lend Disqualified Prsn0BrrwOrLendDisqualifiedPrsnInd
Furn Goods Disqualified Prsn0FurnGoodsDisqualifiedPrsnInd
Pay Comp Disqualified Prsn0PayCompDisqualifiedPrsnInd
Transfer Ast Disqualified Prsn0TransferAstDisqualifiedPrsnInd
Payment To Government Official0PaymentToGovernmentOfficialInd
Uncorrected Prior Acts0UncorrectedPriorActsInd
Undistributed Income PY0UndistributedIncomePYInd
Business Holdings0BusinessHoldingsInd
Jeopardy Investments0JeopardyInvestmentsInd
Uncorrected PY Jeopardy Invst0UncorrectedPYJeopardyInvstInd
Influence Legislation0InfluenceLegislationInd
Influence Election0InfluenceElectionInd
Grants To Individuals0GrantsToIndividualsInd
Grants To Organizations0GrantsToOrganizationsInd
Noncharitable Purpose0NoncharitablePurposeInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
CAROLYN SAMPLE
3201 RANKIN RDMINNEAPOLISMN55418PRESIDENT2.00$0$0$0
WILLIAM C PETERSON THRU 0422
6724 99TH AVE NORTHBROOKLYN PARKMN55445DIRECTOR0.50$0$0$0
ERNEST LINDSTROM-LINDSTROM LAW OFFI
7600 PARKLAWN AVE STE 444EDINAMN55435DIRECTOR0.50$0$0$0
RONALD K DRAPER
861 OAKGREEN AVE PL NSTILLWATERMN55082DIRECTOR0.50$0$0$0
FieldValueIRS element (for citing)
Comp Of Hghst Pd Empl Or NONENONECompOfHghstPdEmplOrNONETxt
Other Employee Paid Over50k0OtherEmployeePaidOver50kCnt
Comp Of Hghst Pd Cntrct Or NONENONECompOfHghstPdCntrctOrNONETxt
Contractor Paid Over50k0ContractorPaidOver50kCnt

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$6,223,707AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$472,137AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$6,695,844TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$6,695,844AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$100,438CashDeemedCharitableAmt
Net Vl Noncharitable Assets$6,595,406NetVlNoncharitableAssetsAmt
Minimum Investment Return$329,770MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$329,770MinimumInvestmentReturnAmt
Tax Based On Investment Income$3,239TaxBasedOnInvestmentIncomeAmt
Total Tax$3,239TotalTaxAmt
Distributable Before Adj$326,531DistributableBeforeAdjAmt
Recoveries Qualfied Distri$0RecoveriesQualfiedDistriAmt
Distributable Before Ded$326,531DistributableBeforeDedAmt
Deduction From Distributable$0DeductionFromDistributableAmt
Distributable As Adjusted$326,531DistributableAsAdjustedAmt

PF Qualifying Distributions PFQualifyingDistributionsGrp

FieldValueIRS element (for citing)
Expenses And Contributions$1,101,338ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Qualifying Distributions$1,101,338QualifyingDistributionsAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$326,531DistributableAsAdjustedAmt
Undistributed Income PY$0UndistributedIncomePYAmt
Total For Prior Years$0TotalForPriorYearsAmt
Excess Distribution Cyov Yr5$694,784ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr4$683,682ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr3$792,999ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2$728,182ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1$653,599ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov$3,553,246TotalExcessDistributionCyovAmt
Qualifying Distributions$1,101,338QualifyingDistributionsAmt
Applied To Year1$0AppliedToYear1Amt
Applied To Prior Years$0AppliedToPriorYearsAmt
Treated As Distri From Corpus$0TreatedAsDistriFromCorpusAmt
Applied To Current Year$326,531AppliedToCurrentYearAmt
Remaining Distri From Corpus$774,807RemainingDistriFromCorpusAmt
Excess Distri Cyov App CY Corpus$0ExcessDistriCyovAppCYCorpusAmt
Excess Distribution Cyov App CY$0ExcessDistributionCyovAppCYAmt
Total Corpus$4,328,053TotalCorpusAmt
Prior Year Undistributed Incm$0PriorYearUndistributedIncmAmt
Prior Year Deficiency Or Tax$0PriorYearDeficiencyOrTaxAmt
Taxable1$0Taxable1Amt
Taxable2$0Taxable2Amt
Undistributed Income CY$0UndistributedIncomeCYAmt
Corpus Distri170b1 E Or4942g3$0CorpusDistri170b1EOr4942g3Amt
Excess Distri Cyov From Yr5$694,784ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$3,633,269ExcessDistriCyovToNextYrAmt
Excess From Year4$683,682ExcessFromYear4Amt
Excess From Year3$792,999ExcessFromYear3Amt
Excess From Year2$728,182ExcessFromYear2Amt
Excess From Year1$653,599ExcessFromYear1Amt
Excess From Current Year$774,807ExcessFromCurrentYearAmt

Supplementary Information SupplementaryInformationGrp

FieldValueIRS element (for citing)
Contributing ManagerCAROLYN SAMPLEContributingManagerNm

Application Submission Info ApplicationSubmissionInfoGrp

FieldValueIRS element (for citing)
Recipient PersonCAROLYN P SAMPLERecipientPersonNm

Recipient US Address RecipientUSAddress

FieldValueIRS element (for citing)
Address Line13201 RANKIN ROAD NEAddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55418ZIPCd
FieldValueIRS element (for citing)
Recipient Phone6127817677RecipientPhoneNum
Form And Info And MaterialsORGANIZATIONS APPLYING SHOULD PROVIDE INFORMATION SIMILAR TO THAT SET FORTH BELOW: 1. ORGANIZATION NAME AND ADDRESS. 2. STATE IN WHICH APPLICANT IS ORGANIZED AS A NONPROFIT ENTITY. IF NOT SO ORGANIZED, EXPLAIN. 3. ATTACH ANY RULING OR DETERMINATION LETTER FROM INTERNAL REVENUE SERVICE ABOUT EXEMPT STATUS OR PRIVATE FOUNDATION STATUS. 4. COPY OF APPLICANT'S PROPOSED BUDGET AND PURPOSE OF ORGANIZATION. 5. IS APPLICANT CONTROLLED BY, RELATED TO, CONNECT WITH, OR SPONSORED BY ANOTHER ORGANIZATION? IF YES, IDENTIFY PARENT ENTITY. 6. SHOW AMOUNT REQUESTED AND HOW IT WILL BE USED. 7. SIGNED BY AUTHORIZED PERSON.FormAndInfoAndMaterialsTxt
Submission DeadlinesNONESubmissionDeadlinesTxt
Restrictions On AwardsIN AWARDING GRANTS, THE FOUNDATION GIVES PREFERENCE TO MINNESOTA CHARITABLE ORGANIZATIONS. MEDICAL FOUNDATIONS, EDUCATION AND THE ARTS RECEIVE PRIME CONSIDERATION. GRANTS ARE NORMALLY RESTRICTED TO $1,000 OR LESS. APPLICANTS ARE USUALLY NOTIFIED WITHIN TWO MONTHS THAT THEIR APPLICATION HAS BEEN APPROVED OR REJECTED, OR THAT ADDITIONAL INFORMATION IS NEEDED. FOUNDATION DOES NOT PROVIDE APPLICATION FORMS.RestrictionsOnAwardsTxt

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (44 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
AGATE HOUSING & SERVICES
2309 NICOLLET AVEMINNEAPOLISMN55404NONEPCPROGRAM SUPPORT$20,000
ALASKA CHRISTIAN COLLEGE
35109 ROYAL PLACESOLDNOTNAAK99669NONEPCEDUCATIONAL$7,000
BANYAN COMMUNITY
2529 13TH AVE SOMINNEAPOLISMN55404NONEPCEDUCATIONAL$5,000
BETHEL UNIVERSITY
3900 BETHEL DRST PAULMN55112NONEPCEDUCATIONAL$5,000
CAMP KNUTSON
11148 MANHATTAN PT BLVDCROSSLAKEMN56442NONEPCRELIGIOUS$5,000
CATHOLIC CHARITIES
1007 E 14TH STMINNEAPOLISMN554041314NONEPCRELIGIOUS$5,000
COURAGE KENNY REHABILITATION INSTITUTE
3915 GOLDEN VALLEY RDMINNEAPOLISMN55422NONEPCHEALTH$20,000
COVENANT WORLD RELIEF
PO BOX 773420CHICAGOIL60677NONEPCRELIGIOUS$150,000
CRISTO REY JESUIT HIGH SCHOOL
2924 4TH AVENUE SOUTHMINNEAPOLISMN55408NONEPCEDUCATIONAL$5,000
CROSS SERVICES
12915 WEINAND CIRCLEROGERSMN55374NONEPCPROGRAM SUPPORT$3,000
DUNWOODY COLLEGE OF TECHNOLOGY
818 DUNWOODY BLVDMINNEAPOLISMN55403NONEPCEDUCATIONAL$15,000
EVANGELICAL COVENANT CHURCH
PO BOX 773420CHICAGOIL60677NONEPCRELIGIOUS$200,000
EXODUS FINANCIAL SERVICES
2380 WYCLIFF ST SUITE B-100ST PAULMN55114NONEPCPROGRAM SUPPORT$5,000
FAMILY VALUES FOR LIFE
1280 ARCADE STST PAULMN55106NONEPCPROGRAM SUPPORT$7,000
FEED MY STARVING CHILDREN
401 93RD AVE NWCOON RAPIDSMN54433NONEPCRELIGIOUS$30,000
GREATER MINNEAPOLIS CRISIS NURSERY
4544 4TH AVE SOUTHMINNEAPOLISMN55419NONEPCPROGRAM SUPPORT$5,000
HABITAT FOR HUMANITY
1954 UNIVERSITY AVE WST PAULMN55104NONEPCPROGRAM SUPPORT$15,000
HENNEPIN TECHNICAL COLLEGE
9000 BROOKLYN BLVDBROOKLYN PARKMN55445NONEPCEDUCATIONAL$5,000
HOMEWARD BOUND
12805 HIGHWAY 55 STE 400PLYMOUTHMN55441NONEPCHEALTH$10,000
HOPE ACADEMY
2300 CHICAGO AVEMINNEAPOLISMN55404NONEPCEDUCATIONAL$5,000
HOPE DENTAL CLINIC
800 MINNEHAHA AVENUE EAST 465ST PAULMN55106NONEPCPROGRAM SUPPORT$3,000
KIWANIS CLUB OF NE MPLS
729 MARSHALL ST NEMINNEAPOLISMN55413NONEPCPROGRAM SUPPORT$1,000
LOAVES AND FISHES
721 KASOTA AVE SEMINNEAPOLISMN55414NONEPCRELIGIOUS$25,000
METRO HOPE MINISTRIES
2739 CEDAR AVENUE SOUTHMINNEAPOLISMN55407NONEPCPROGRAM SUPPORT$30,000
MINNESOTA ADULT AND TEEN CHALLENGE
740 E 24TH STMINNEAPOLISMN55404NONEPCPROGRAM SUPPORT$25,000
NEW LIFE IN CHRIST MINISTRY
PO BOX 456CLEARWATERMN55320NONEPCRELIGIOUS$3,000
PEOPLE SERVING PEOPLE
614 SOUTH THIRD STREETMINNEAPOLISMN55415NONEPCPROGRAM SUPPORT$25,000
SALEM COVENANT CHURCH
2655 FIFTH STREET NWNEW BRIGHTONMN55112NONEPCRELIGIOUS$150,000
SCIENCE WITH A MISSION
602 MASSAPOAG AVESHARONMA02067NONEPCPROGRAM SUPPORT$10,000
SECOND HARVEST HEARTLAND
7101 WINNETKA AVE NBROOKLYN PARKMN55428NONEPCPROGRAM SUPPORT$50,000
SHARING & CARING HANDS
425 NORTH SEVENTH STMINNEAPOLISMN55405NONEPCPROGRAM SUPPORT$7,000
SIMPSON HOUSING SERVICES
160 GLENWOOD AVEMINNEAPOLISMN55405NONEPCPROGRAM SUPPORT$25,000
SPARTAN FOUNDATION INC
7229 CLINTON AVENUERICHFIELDMN55423NONEPCEDUCATIONAL$7,000
SUNSHINE ACRES CHILDREN'S HOME
3405 NORTH HIGLEY ROADMESAAZ85215NONEPCPROGRAM SUPPORT$7,000
THE ARC MINNESOTA
2446 UNIVERSITY AVE W 110ST PAULMN55114NONEPCPROGRAM SUPPORT$10,000
THE GIDEONS INTERNATIONAL
PO BOX 403810ATLANTAGA30384NONEPCRELIGIOUS$5,000
THE SALVATION ARMY
2445 PRIOR AVENUE NORTHROSEVILLEMN55113NONEPCRELIGIOUS$100,000
THRESHOLD TO NEW LIFE
10031 SARATOGA WAYMAPLE GROVEMN55369NONEPCPROGRAM SUPPORT$5,000
TRINITY FIRST LUTHERAN SCHOOL
1115 19TH AVE SOMINNEAPOLISMN55404NONEPCEDUCATIONAL$10,000
TRUE FRIENDS
10509 108TH ST NWANNANDALEMN55302NONEPCPROGRAM SUPPORT$10,000
UNION GOSPEL MISSION
376 WESTERN AVE NST PAULMN55103NONEPCPROGRAM SUPPORT$10,000
UNIVERSITY OF MINNESOTA FOUNDATION
200 OAK STREET SE 500MINNEAPOLISMN55455NONEPCEDUCATIONAL$50,000
UNIVERSITY OF NORTHWESTERN
3003 SNELLING AVE NST PAULMN55113NONEPCEDUCATIONAL$5,000
URBAN HOMEWORKS
PO BOX 11267MINNEAPOLISMN55411NONEPCPROGRAM SUPPORT$5,000
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$1,100,000TotalGrantOrContriPdDurYrAmt
Total Grant Or Contri Apprv Fut$0TotalGrantOrContriApprvFutAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$953ExclusionAmt

Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$185,340ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion$48,034ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$0UnrelatedBusinessTaxblIncmAmt
Exclusion$234,327ExclusionAmt
Related Or Exempt Function Incm$0RelatedOrExemptFunctionIncmAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$234,327TotalIncomeProducingActyAmt

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

FieldValueIRS element (for citing)
Trnsfr Of Cash To Nonchrtbl EO0TrnsfrOfCashToNonchrtblEOInd
Trnsfr Other Asset Nonchrtbl EO0TrnsfrOtherAssetNonchrtblEOInd
Sales Or Exchanges Of Assets0SalesOrExchangesOfAssetsInd
Purchase Of Assets Nonchrtbl EO0PurchaseOfAssetsNonchrtblEOInd
Rental Of Facilities Oth Assets0RentalOfFacilitiesOthAssetsInd
Reimbursement Arrangements0ReimbursementArrangementsInd
Loans Or Loan Guarantees0LoansOrLoanGuaranteesInd
Performance Of Services Etc0PerformanceOfServicesEtcInd
Sharing Of Facilities Etc0SharingOfFacilitiesEtcInd
Relationships Nonchrtbl EO0RelationshipsNonchrtblEOInd

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 Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1CAROLYN P SAMPLEBusinessNameLine1Txt

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line13201 RANKIN ROADAddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55418ZIPCd
FieldValueIRS element (for citing)
Total Contributions$20,000TotalContributionsAmt
Person ContributionYes (X)PersonContributionInd

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryACCOUNTING FEESCategoryTxt
Amt$2,625Amt
Net Investment Income$1,312NetInvestmentIncomeAmt
Disbursements Charitable Prps$1,313DisbursementsCharitablePrpsAmt

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp (2 entries)

StockStockNmEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
MEDTRONIC STOCK$4,082,916$4,196,880
CHEVRON$164,000$358,980

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp

FieldValueIRS element (for citing)
DescSTATE OF MN FILING FEEDesc
Revenue And Expenses Per Books$25RevenueAndExpensesPerBooksAmt
Net Investment Income$0NetInvestmentIncomeAmt
Disbursements Charitable Prps$25DisbursementsCharitablePrpsAmt

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail

FieldValueIRS element (for citing)
Category2022 ESTIMATED EXCISE TAXCategoryTxt
Amt$5,329Amt
Net Investment Income$0NetInvestmentIncomeAmt
Disbursements Charitable Prps$0DisbursementsCharitablePrpsAmt

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