SAMUEL & LATANYA R JACKSON FOUNDATION: Form 990PF, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
SAMUEL & LATANYA R JACKSON FOUNDATION (EIN 95-4774091)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-05-02
IRS object ID
202301229349102330
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)
Return2023-05-02T18:01:47-05:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN261617223PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1LEVEL FOUR BUSINESS MANAGEMENT LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line111812 SAN VICENTE BLVD 4TH FLOORAddressLine1Txt
CityLOS ANGELESCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90049ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN954774091EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE SAMUEL AND LATANYA R JACKSONBusinessNameLine1Txt
Business Name Line2FOUNDATIONBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlSAMUBusinessNameControlTxt
Phone3109141600PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line111812 SAN VICENTE BLVD 4TH FLAddressLine1Txt
CityLOS ANGELESCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90049ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN RIGNEYPersonNm
Person TitleASST. SECRETARYPersonTitleTxt
Phone3109141600PhoneNum
Signature2023-05-01SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJOHNPersonFirstNm
Person LastRIGNEYPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonALLA NISSPreparerPersonNm
PTINP01084426PTIN
Phone3109141600PhoneNum
Preparation2023-05-01PreparationDt

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$879,052FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$100,000ContriRcvdRevAndExpnssAmt
Interest On Sav Rev And Expnss$236InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$236InterestOnSavNetInvstIncmAmt
Dividends Rev And Expnss$25,720DividendsRevAndExpnssAmt
Dividends Net Invst Incm$23,638DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss$2,413NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$15,872GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$2,413CapGainNetIncmNetInvstIncmAmt
Total Rev And Expnss$128,369TotalRevAndExpnssAmt
Total Net Invst Incm$26,287TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$0CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$0CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl$0CompOfcrDirTrstDsbrsChrtblAmt
Taxes Rev And Expnss$12,679TaxesRevAndExpnssAmt
Taxes Net Invst Incm$59TaxesNetInvstIncmAmt
Taxes Dsbrs Chrtbl$0TaxesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$12,679TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$59TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$0TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$358,119ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$358,119ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$370,798TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$59TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$358,119TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses-$242,429ExcessRevenueOverExpensesAmt
Net Investment Income$26,228NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Cash BOY$285,414CashBOYAmt
Cash EOY$22,503CashEOYAmt
Cash EOYFMV$22,503CashEOYFMVAmt
Other Investments BOY$833,541OtherInvestmentsBOYAmt
Other Investments EOY$854,061OtherInvestmentsEOYAmt
Other Investments EOYFMV$856,549OtherInvestmentsEOYFMVAmt
Other Assets BOY$118OtherAssetsBOYAmt
Other Assets EOY$0OtherAssetsEOYAmt
Other Assets EOYFMV$0OtherAssetsEOYFMVAmt
Total Assets BOY$1,119,073TotalAssetsBOYAmt
Total Assets EOY$876,564TotalAssetsEOYAmt
Total Assets EOYFMV$879,052TotalAssetsEOYFMVAmt
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$188,375AdditionalPaidInCapitalBOYAmt
Additional Paid In Capital EOY$188,375AdditionalPaidInCapitalEOYAmt
Retained Earning BOY$930,698RetainedEarningBOYAmt
Retained Earning EOY$688,189RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY$1,119,073TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$876,564TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$1,119,073TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$876,564TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$1,119,073TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses-$242,429ExcessRevenueOverExpensesAmt
Other Increases$0OtherIncreasesAmt
Subtotal$876,644SubtotalAmt
Other Decreases$80OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY$876,564TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (2 entries)

PropertyPropertyDescHow AcquiredHowAcquiredCdAcquiredAcquiredDtSoldSoldDtGross Sales PriceGrossSalesPriceAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmtCost Or Other BasisCostOrOtherBasisAmt
GOLDMAN SACHS #1488P2022-12-082022-12-31$4,095$4,095$4,095
GOLDMAN SACHS #14882021-10-072022-12-31$11,777-$1,682-$1,682$13,459
FieldValueIRS element (for citing)
Capital Gain Net Income$2,413CapitalGainNetIncomeAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$365InvestmentIncomeExciseTaxAmt
Tax Under Section511$0TaxUnderSection511Amt
Subtotal$365SubtotalAmt
Subtitle A Tax$0SubtitleATaxAmt
Tax Based On Investment Income$365TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$6,400EstimatedPlusOvpmtIncmTxAmt
Exempt Frgn Org Tax Wthld At Srce$0ExemptFrgnOrgTaxWthldAtSrceAmt
Extsn Request Income Tax Paid$0ExtsnRequestIncomeTaxPaidAmt
Backup Withholding Withheld$0BackupWithholdingWithheldAmt
Total Payments And Credits$6,400TotalPaymentsAndCreditsAmt
Es Penalty$0EsPenaltyAmt
Overpayment$6,035OverpaymentAmt
Applied To ES Tax$6,035AppliedToESTaxAmt
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 StateCAOrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (1)Form990PFFiledWithAttyGenInd
Private Operating Foundation0PrivateOperatingFoundationInd
New Substantial ContributorsYes (1)NewSubstantialContributorsInd
Own Controlled Entity0OwnControlledEntityInd
Donor Advised Fund0DonorAdvisedFundInd
Comply With Public Insp RqrYes (1)ComplyWithPublicInspRqrInd
Website AddressN/AWebsiteAddressTxt
Individual With BooksJOHN RIGNEYIndividualWithBooksNm
Phone3109141600PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line111812 SAN VICENTE BLVDAddressLine1Txt
CityLOS ANGELESCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90049ZIPCd
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 (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
SAMUEL JACKSON
11812 SAN VICENTE BLVD 4TH FLOORLOS ANGELESCA90049PRESIDENT0.00$0$0$0
LATANYA R JACKSON
11812 SAN VICENTE BLVD 4TH FLOORLOS ANGELESCA90049SECRETARY0.00$0$0$0
JOHN RIGNEY
11812 SAN VICENTE BLVD 4TH FLOORLOS ANGELESCA90049ASSISTANT SECRETARY0.00$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$894,886AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$270,963AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$1,165,849TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$1,165,849AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$17,488CashDeemedCharitableAmt
Net Vl Noncharitable Assets$1,148,361NetVlNoncharitableAssetsAmt
Minimum Investment Return$57,418MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$57,418MinimumInvestmentReturnAmt
Tax Based On Investment Income$365TaxBasedOnInvestmentIncomeAmt
Total Tax$365TotalTaxAmt
Distributable Before Adj$57,053DistributableBeforeAdjAmt
Recoveries Qualfied Distri$0RecoveriesQualfiedDistriAmt
Distributable Before Ded$57,053DistributableBeforeDedAmt
Deduction From Distributable$0DeductionFromDistributableAmt
Distributable As Adjusted$57,053DistributableAsAdjustedAmt

PF Qualifying Distributions PFQualifyingDistributionsGrp

FieldValueIRS element (for citing)
Expenses And Contributions$358,119ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Qualifying Distributions$358,119QualifyingDistributionsAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$57,053DistributableAsAdjustedAmt
Undistributed Income PY$0UndistributedIncomePYAmt
Total For Prior Years$0TotalForPriorYearsAmt
Excess Distribution Cyov Yr5$326,106ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr4$516,376ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr3$4,848ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2$251,130ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1$285,817ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov$1,384,277TotalExcessDistributionCyovAmt
Qualifying Distributions$358,119QualifyingDistributionsAmt
Applied To Year1$0AppliedToYear1Amt
Applied To Prior Years$0AppliedToPriorYearsAmt
Treated As Distri From Corpus$0TreatedAsDistriFromCorpusAmt
Applied To Current Year$57,053AppliedToCurrentYearAmt
Remaining Distri From Corpus$301,066RemainingDistriFromCorpusAmt
Excess Distri Cyov App CY Corpus$0ExcessDistriCyovAppCYCorpusAmt
Excess Distribution Cyov App CY$0ExcessDistributionCyovAppCYAmt
Total Corpus$1,685,343TotalCorpusAmt
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$326,106ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$1,359,237ExcessDistriCyovToNextYrAmt
Excess From Year4$516,376ExcessFromYear4Amt
Excess From Year3$4,848ExcessFromYear3Amt
Excess From Year2$251,130ExcessFromYear2Amt
Excess From Year1$285,817ExcessFromYear1Amt
Excess From Current Year$301,066ExcessFromCurrentYearAmt

Supplementary Information SupplementaryInformationGrp

FieldValueIRS element (for citing)
Contributing ManagerSAMUEL JACKSONContributingManagerNm
Contributing ManagerLATANYA R JACKSONContributingManagerNm
Only Contri To PreselectedYes (X)OnlyContriToPreselectedInd

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (6 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
AMERICAN INSTITUTE FOR STUTTERING
27 W 20TH ST STE 1203NEW YORKNY10011N/A501(C)(3)DONATION TO THE ORGANIZATION'S GENERAL FUND TO FURTHER ITS MISSIONS$10,000
AMERICAN THEATRE WING
PO BOX 36-20907NEW YORKNY10129N/A501(C)(3)DONATION TO THE ORGANIZATION'S GENERAL FUND TO FURTHER ITS MISSIONS$5,000
APOLLO THEATER
253 WEST 125TH STREETNEW YORKNY10027N/A501(C)(3)DONATION TO THE ORGANIZATION'S GENERAL FUND TO FURTHER ITS MISSIONS$15,000
NEW FEDERAL THEATRE
543 WEST 42ND STNEW YORKNY10036N/A501(C)(3)DONATION TO THE ORGANIZATION'S GENERAL FUND TO FURTHER ITS MISSIONS$20,000
SMITHSONIAN INSTITUTION
1000 JEFFERSON DRIVE SWWASHINGTONDC20560N/A501(C)(3)DONATION TO THE ORGANIZATION'S GENERAL FUND TO FURTHER ITS MISSIONS$258,119
THE LILLY AWARDS FOUNDATION INC
1501 BROADWAY STE 701NEW YORKNY10036N/A501(C)(3)DONATION TO THE ORGANIZATION'S GENERAL FUND TO FURTHER ITS MISSIONS$50,000
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$358,119TotalGrantOrContriPdDurYrAmt
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$236ExclusionAmt

Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$25,720ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion$2,413ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$0UnrelatedBusinessTaxblIncmAmt
Exclusion$28,369ExclusionAmt
Related Or Exempt Function Incm$0RelatedOrExemptFunctionIncmAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$28,369TotalIncomeProducingActyAmt

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 PersonSAMUEL AND LATANYA JACKSONContributorPersonNm

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line111812 SAN VICENTE BLVD 4TH FLOORAddressLine1Txt
CityLOS ANGELESCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90049ZIPCd
FieldValueIRS element (for citing)
Total Contributions$100,000TotalContributionsAmt
Person ContributionYes (X)PersonContributionInd

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOtherGrp

FieldValueIRS element (for citing)
Category Or ItemGOLDMAN SACHS BROKERAGE ACCOUNTCategoryOrItemTxt
Listed At Cost Or FMVAT COSTListedAtCostOrFMVCd
Book Value$854,061BookValueAmt
EOYFMV$856,549EOYFMVAmt

Other Assets Schedule OtherAssetsSchedule

Other Assets Schedule OtherAssetsScheduleGrp

FieldValueIRS element (for citing)
DescDIVIDENDS RECEIVABLEDesc
BOY Book Value$118BOYBookValueAmt

Other Decreases Schedule OtherDecreasesSchedule

Other Decreases Detail OtherDecreasesDetail

FieldValueIRS element (for citing)
DescNONDEDUCTIBLE EXPENSEDesc
Amt$80Amt

Substantial Contributors Sch SubstantialContributorsSch

Substantial Contributor Detail SubstantialContributorDetail (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCd
SAMUEL AND LATANYA JACKSON
11812 SAN VICENTE BLVD 4TH FLOORLOS ANGELESCA90049
LANGSTON EDWARDS
340 N REESE PLBURBANKCA91506

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (3 entries)

CategoryCategoryTxtAmtAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
REGISTRATION RENEWAL FEE$100$0$0
FEDERAL EXCISE TAX$12,520$0$0
FOREIGN TAXES$59$59$0

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