FURP.ORG / PUBLIC DATA EXPLORER

SEMLER FAMILY FOUNDATION INC: Form 990PF, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
SEMLER FAMILY FOUNDATION INC (EIN 20-3523866)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-05-12
IRS object ID
202301329349102130
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)
Return2023-05-12T11:12:54-05:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN201717681PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CBIZ SOMERSETBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13925 RIVER CROSSING PKWY STE 100AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46240ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN203523866EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE SEMLER FAMILY FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSEMLBusinessNameControlTxt
Phone3179971615PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line17920 BEAUMONT GREEN WEST DRAddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP462501651ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJERRY SEMLERPersonNm
Person TitleOFFICERPersonTitleTxt
Phone3179971615PhoneNum
Signature2023-05-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJERRYPersonFirstNm
Person LastSEMLERPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSUSIE M KEATON CPAPreparerPersonNm
PTINP00765420PTIN
Phone3174722200PhoneNum
Preparation2023-05-11PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
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$1,892,606FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Schedule B Not RequiredYes (X)ScheduleBNotRequiredInd
Interest On Sav Rev And Expnss$3,035InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$3,035InterestOnSavNetInvstIncmAmt
Dividends Rev And Expnss$35,197DividendsRevAndExpnssAmt
Dividends Net Invst Incm$35,197DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss$116,055NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$903,582GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$116,055CapGainNetIncmNetInvstIncmAmt
Total Rev And Expnss$154,287TotalRevAndExpnssAmt
Total Net Invst Incm$154,287TotalNetInvstIncmAmt
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$2,600AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm$2,600AccountingFeesNetInvstIncmAmt
Accounting Fees Chrtbl Prps$0AccountingFeesChrtblPrpsAmt
Other Prof Fees Rev And Expnss$19,896OtherProfFeesRevAndExpnssAmt
Other Prof Fees Net Invst Incm$19,896OtherProfFeesNetInvstIncmAmt
Other Prof Fees Dsbrs Chrtbl$0OtherProfFeesDsbrsChrtblAmt
Taxes Rev And Expnss$3,209TaxesRevAndExpnssAmt
Taxes Net Invst Incm$502TaxesNetInvstIncmAmt
Taxes Dsbrs Chrtbl$0TaxesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$25,705TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$22,998TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$0TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$132,650ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$132,650ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$158,355TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$22,998TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$132,650TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses-$4,068ExcessRevenueOverExpensesAmt
Net Investment Income$131,289NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Cash BOY$17,411CashBOYAmt
Cash EOY$13,557CashEOYAmt
Cash EOYFMV$13,557CashEOYFMVAmt
Sav And Temp Cash Invst BOY$54,085SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$81,921SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$81,921SavAndTempCashInvstEOYFMVAmt
US Government Obligations BOY$0USGovernmentObligationsBOYAmt
US Government Obligations EOY$64,513USGovernmentObligationsEOYAmt
US Govt Obligations EOYFMV$63,259USGovtObligationsEOYFMVAmt
Corporate Stock BOY$454,280CorporateStockBOYAmt
Corporate Stock EOY$439,622CorporateStockEOYAmt
Corporate Stock EOYFMV$603,147CorporateStockEOYFMVAmt
Corporate Bonds BOY$306,962CorporateBondsBOYAmt
Corporate Bonds EOY$187,923CorporateBondsEOYAmt
Corporate Bonds EOYFMV$183,948CorporateBondsEOYFMVAmt
Other Investments BOY$877,866OtherInvestmentsBOYAmt
Other Investments EOY$918,645OtherInvestmentsEOYAmt
Other Investments EOYFMV$946,274OtherInvestmentsEOYFMVAmt
Other Assets BOY$898OtherAssetsBOYAmt
Other Assets EOY$500OtherAssetsEOYAmt
Other Assets EOYFMV$500OtherAssetsEOYFMVAmt
Total Assets BOY$1,711,502TotalAssetsBOYAmt
Total Assets EOY$1,706,681TotalAssetsEOYAmt
Total Assets EOYFMV$1,892,606TotalAssetsEOYFMVAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind
Capital Stock BOY$1,642,061CapitalStockBOYAmt
Capital Stock EOY$1,642,061CapitalStockEOYAmt
Additional Paid In Capital BOY$0AdditionalPaidInCapitalBOYAmt
Additional Paid In Capital EOY$0AdditionalPaidInCapitalEOYAmt
Retained Earning BOY$69,441RetainedEarningBOYAmt
Retained Earning EOY$64,620RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY$1,711,502TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$1,706,681TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$1,711,502TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$1,706,681TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$1,711,502TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses-$4,068ExcessRevenueOverExpensesAmt
Other Increases$41OtherIncreasesAmt
Subtotal$1,707,475SubtotalAmt
Other Decreases$794OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY$1,706,681TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (5 entries)

PropertyPropertyDescHow AcquiredHowAcquiredCdAcquiredAcquiredDtSoldSoldDtGross Sales PriceGrossSalesPriceAmtCost Or Other BasisCostOrOtherBasisAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmt
FIDELITY 3003P2021-11-212022-12-02$58,037$83,423-$25,386-$25,386
FIDELITY 3003P2021-03-082022-07-18$132,351$126,029$6,322$6,322
FIDELITY 2997P2022-04-112022-12-13$65,708$69,328-$3,620-$3,620
FIDELITY 2997P2018-05-252022-12-21$634,324$508,747$125,577$125,577
CAPITAL GAINS DIVIDENDSP$13,162$13,162$13,162
FieldValueIRS element (for citing)
Capital Gain Net Income$116,055CapitalGainNetIncomeAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$1,825InvestmentIncomeExciseTaxAmt
Tax Under Section511$0TaxUnderSection511Amt
Subtotal$1,825SubtotalAmt
Subtitle A Tax$0SubtitleATaxAmt
Tax Based On Investment Income$1,825TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$1,880EstimatedPlusOvpmtIncmTxAmt
Exempt Frgn Org Tax Wthld At Srce$0ExemptFrgnOrgTaxWthldAtSrceAmt
Extsn Request Income Tax Paid$0ExtsnRequestIncomeTaxPaidAmt
Backup Withholding Withheld$0BackupWithholdingWithheldAmt
Total Payments And Credits$1,880TotalPaymentsAndCreditsAmt
Es Penalty$0EsPenaltyAmt
Overpayment$55OverpaymentAmt
Applied To ES Tax$55AppliedToESTaxAmt
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 StateINOrgReportOrRegisterStateCd
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
Individual With BooksJERRY SEMLERIndividualWithBooksNm
Phone3179971615PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line17920 BEAUMONT GREEN WEST DRAddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46250ZIPCd
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 (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
JERRY D SEMLER
7920 BEAUMONT GREEN WEST DRINDIANAPOLISIN46250PRESIDENT1.00$0$0$0
ROSEMARY R SEMLER
7920 BEAUMONT GREEN WEST DRINDIANAPOLISIN46250VICE-PRESIDENT1.00$0$0$0
MICHAEL R SEMLER
7920 BEAUMONT GREEN WEST DRINDIANAPOLISIN46250TREASURER1.00$0$0$0
KIMBERLY D HAMILTON
7920 BEAUMONT GREEN WEST DRINDIANAPOLISIN46250SECRETARY1.00$0$0$0
MARY D DODSON
7920 BEAUMONT GREEN WEST DRINDIANAPOLISIN46250DIRECTOR1.00$0$0$0
JOHN R SEMLER
7920 BEAUMONT GREEN WEST DRINDIANAPOLISIN46250DIRECTOR1.00$0$0$0
KRISTIN D TERRELL
7920 BEAUMONT GREEN WEST DRINDIANAPOLISIN46250DIRECTOR1.00$0$0$0
JEFFREY R SEMLER
7920 BEAUMONT GREEN WEST DRINDIANAPOLISIN46250DIRECTOR1.00$0$0$0
SALLY D BUTLER
7920 BEAUMONT GREEN WEST DRINDIANAPOLISIN46250DIRECTOR1.00$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

Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp

FieldValueIRS element (for citing)
Description1CONTRIBUTIONS TO VARIOUS PUBLIC CHARITIES TO CARRY OUT CHARITABLE GOALS. SEE LIST OF CHARITIES ATTACHED TO TAX RETURN.Description1Txt
Expenses1$0Expenses1Amt

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$1,973,450AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$29,905AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$2,003,355TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$2,003,355AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$30,050CashDeemedCharitableAmt
Net Vl Noncharitable Assets$1,973,305NetVlNoncharitableAssetsAmt
Minimum Investment Return$98,665MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$98,665MinimumInvestmentReturnAmt
Tax Based On Investment Income$1,825TaxBasedOnInvestmentIncomeAmt
Total Tax$1,825TotalTaxAmt
Distributable Before Adj$96,840DistributableBeforeAdjAmt
Recoveries Qualfied Distri$0RecoveriesQualfiedDistriAmt
Distributable Before Ded$96,840DistributableBeforeDedAmt
Deduction From Distributable$0DeductionFromDistributableAmt
Distributable As Adjusted$96,840DistributableAsAdjustedAmt

PF Qualifying Distributions PFQualifyingDistributionsGrp

FieldValueIRS element (for citing)
Expenses And Contributions$132,650ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Qualifying Distributions$132,650QualifyingDistributionsAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$96,840DistributableAsAdjustedAmt
Undistributed Income PY$0UndistributedIncomePYAmt
Total For Prior Years$0TotalForPriorYearsAmt
Excess Distribution Cyov Yr5$5,924ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr3$31,917ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2$36,053ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1$19,869ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov$93,763TotalExcessDistributionCyovAmt
Qualifying Distributions$132,650QualifyingDistributionsAmt
Applied To Year1$0AppliedToYear1Amt
Applied To Prior Years$0AppliedToPriorYearsAmt
Treated As Distri From Corpus$0TreatedAsDistriFromCorpusAmt
Applied To Current Year$96,840AppliedToCurrentYearAmt
Remaining Distri From Corpus$35,810RemainingDistriFromCorpusAmt
Excess Distri Cyov App CY Corpus$0ExcessDistriCyovAppCYCorpusAmt
Excess Distribution Cyov App CY$0ExcessDistributionCyovAppCYAmt
Total Corpus$129,573TotalCorpusAmt
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$5,924ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$123,649ExcessDistriCyovToNextYrAmt
Excess From Year3$31,917ExcessFromYear3Amt
Excess From Year2$36,053ExcessFromYear2Amt
Excess From Year1$19,869ExcessFromYear1Amt
Excess From Current Year$35,810ExcessFromCurrentYearAmt

Supplementary Information SupplementaryInformationGrp

Application Submission Info ApplicationSubmissionInfoGrp

FieldValueIRS element (for citing)
Recipient PersonJERRY D SEMLERRecipientPersonNm

Recipient US Address RecipientUSAddress

FieldValueIRS element (for citing)
Address Line17920 BEAUMONT GREEN WEST DRAddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46250ZIPCd
FieldValueIRS element (for citing)
Recipient Phone3172851615RecipientPhoneNum
Form And Info And MaterialsSUBMIT LETTER DESCRIBING NEED FOR AND PURPOSE OF REQUESTED CONTRIBUTION.FormAndInfoAndMaterialsTxt
Submission DeadlinesN/ASubmissionDeadlinesTxt
Restrictions On AwardsN/ARestrictionsOnAwardsTxt

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (42 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
500 FESTIVAL FOUNDATION
21 VIRGINIA AVEINDIANAPOLISIN46204NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$11,000
ARCHDIOCESE OF INDIANAPOLIS
PO BOX 6043INDIANAPOLISIN46206NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$1,000
CONNOR PRAIRIE
13400 ALLISONVILLE RDFISHERSIN46038NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$10,000
CROSSROADS OF AMERICA COUNCIL
7125 FALL CREEK RDINDIANAPOLISIN46256NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$300
CULVER BOYS & GIRLS CLUB
401 SCHOOL STCULVERIN46511NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$1,000
GLEANERS FOOD BANK
3737 WALDEMERE AVEINDIANAPOLISIN46241NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$1,500
INDIANA HISTORICAL SOCIETY
450 W OHIO STINDIANAPOLISIN46202NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$12,000
INDIANAPOLIS SYMPHONY ORCHESTRA
45 MONUMENT CIRCLEINDIANAPOLISIN46204NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$1,000
JUVENILE DIABETES RESEARCH FOUNDATION-GRANT
225 S EAST ST SUITE 280INDIANAPOLISIN46202NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$100
KATE'S KART
10376 LEO RD STE AFT WAYNEIN46825NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$200
LAKE MAX ENVIROMENTAL FUND
116 N MAIN STCULVERIN46511NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$750
LAKE MAXINKUCKEE ASSOCIATION
116 N MAIN STCULVERIN46511NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT (FIREWORKS)$1,000
MARIAN UNIVERSITY
3200 COLD SPRING RDINDIANAPOLISIN46222NO RELATIONPUBLIC CHARITYDAVISON PROJECT/GALA/HELPING HANDS$6,500
MDRT
3258 W TOUHY AVEPARK RIDGEIL60068NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$5,000
MERCIFUL HELP CENTER-GRANT
1045 W 146TH ST SUITE ACARMELIN46032NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$600
NATIONAL EATING DISORDERS ASSOCIATION
1500 BROADWAY STE 1101NEW YORKNY10036NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$100
PROVIDENCE CRISTO REY HIGH SCHOOL-GRANT
75 N BELLEVUE AVEINDIANAPOLISIN46222NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$400
PURDUE UNIVERSITY FOUNDATION
610 PURDUE MALLWEST LAFAYETTEIN47907NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$10,000
RILEY CHILDRENS FOUNDATION
30 S MERIDIAN ST STE 200INDIANAPOLISIN46204NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$5,200
SEEDS OF HOPE
1425 MICKLEY AVEINDIANAPOLISIN46241NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$600
ST MEINRAD
200 HILL DRST MEINREDIN47577NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$6,000
UNITED CATHOLIC APPEAL (ARCH OF INDIANAPOLIS)
PO BOX 6043INDIANAPOLISIN46206NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$15,000
INDIANA REPERTORY THEATRE
140 W WASHINGTON STINDIANAPOLISIN46204NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$13,000
HOOSIER ART SALON
212 W 10TH STINDIANAPOLISIN46202NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$3,500
ANTIQUARIAN HISTORICAL SOCIETY
106 S MAIN STCULVERIN46511NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$2,000
ATO FOUNDATION (GA ROSS FUND)
333 ALABAMA STINDIANAPOLISIN46204NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$5,000
BOYSCOUTS CROSSROADS OF AMERICA GOV LUNCH
7125 FALL CREEK RDINDIANAPOLISIN46256NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$5,000
CHRISTEL HOUSE
55 NORTH TIBBS AVEINDIANAPOLISIN46222NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$1,000
O'CONNOR HOUSE
45 N VILLAGE DRCARMELIN46032NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$100
BOYS & GIRLS CLUB OF TIPPECANOE CO
1529 N 10TH STLAFAYETTEIN47906NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$100
HEAR INDIANA
4740 KINGSWAY DR SUITE 33INDIANAPOLISIN46205NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$100
HUMANE SOCIETY OF INDIANAPOLIS
7929 MICHIGAN RDINDIANAPOLISIN46268NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$100
INDIANA GOLF FOUNDATION
PO BOX 26159INDIANAPOLISIN46226NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$100
K9 FOR WARRIORS
114 CAMP K9 RDPONTE VERDAFL32081NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$100
LAUREN HANAWALT SCHOLARSHIP FUND
6501 SUNNYSIDE RDINDIANAPOLISIN46256NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$100
LIAM & REECE KELLY FOUNDATION
15048 GLENMOORE CIRCARMELIN46032NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$100
RETREIVING INDEPENDENCE
2400 CLIFTON AVENASHVILLEIN37209NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$100
IMPACT INTERNATIONAL
3832 BROADWAY BLVDPLANTATIONFL33382NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$1,000
LITTLE SISTERS OF THE POOR
2345 W 86TH STINDIANAPOLISIN46260NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$1,000
INDIANAPOLIS ZOO
1200 WEST WASHINGTON STINDIANAPOLISIN46222NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$5,000
LMEC
PO BOX 187CULVERIN46511NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$1,000
ST MARY'S CATHOLIC CHURCH
311 N NEW JERSEY STINDIANAPOLISIN46204NO RELATIONPUBLIC CHARITYPROGRAM SUPPORT$5,000
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$132,650TotalGrantOrContriPdDurYrAmt
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$3,035ExclusionAmt

Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$35,197ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion$116,055ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$0UnrelatedBusinessTaxblIncmAmt
Exclusion$154,287ExclusionAmt
Related Or Exempt Function Incm$0RelatedOrExemptFunctionIncmAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$154,287TotalIncomeProducingActyAmt

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

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryACCOUNTING FEESCategoryTxt
Amt$2,600Amt
Net Investment Income$2,600NetInvestmentIncomeAmt
Disbursements Charitable Prps$0DisbursementsCharitablePrpsAmt

Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule

Investments Corporate Bonds InvestmentsCorporateBondsGrp (7 entries)

BondBondNmEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
ALLSPRING SHORT TERM HIGH YIELD BD INST$20,105$19,280
CARILLON REAMS UNCONSTRAINED BOND I$36,169$38,116
JACKSON ST UNIV EDL BLDG CORP MISS REV$24,070$24,502
JPMORGAN MORTGAGE BACKED SEC CLASS I$35,721$31,650
MAINSTAY MACKAY CONVERTIBLE CL I$21,644$23,631
NEW HAMPSHIRE ST GO CAP IMPT BDS$11,615$12,046
STONE RIDGE HIGH YLD REINSRNCE RSK PREM I$38,599$34,723

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp (47 entries)

StockStockNmEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
ADOBE SYSTEMS INCORPORATED COM$11,454$10,432
ALPHABET INC CAP STK CL C$9,880$15,971
AMAZON.COM INC$15,988$8,400
AMERICAN EXPRESS CO COM USD0.20$5,328$11,968
AMERICAN INTERNATIONAL GROUP$11,723$15,051
APPLE INC COM USD 0.00001$7,394$24,037
BERKSHIRE HATHAWAY INC COM USD 0.0033$11,388$15,754
BORG WARNER INC COM USD 0.01$10,389$12,115
BROADCOM INC COM$12,699$12,860
BROADRIDGE FINANCIAL SOLUTION INC$9,491$10,865
CATERPILLAR INC COM$6,099$6,229
CHARTER COMMUNICATIONS INC$7,849$8,138
CHEVRON CORP NEW COM$11,846$19,744
CORTEVA INC COM$7,301$15,106
COSTCO WHOLESALE CORP$9,820$8,674
CVS HEALTH CORPORATION COM$9,971$13,885
DOMINION ENERGY INC COM$6,503$6,009
EDISON INTERNATIONAL$5,943$6,807
EXXON MOBIL CORP$14,967$22,942
FIFTH THIRD BANCORP$8,425$11,188
FREEPORT-MCMORAN INC COM USD0.10$11,559$12,578
GLOBAL PAYMENTS INC$6,464$5,562
HONEYWELL INTERNATIONAL INC$6,578$15,001
HOSTESS BRANDS INC CL A$12,211$16,583
IQVIA HLDGS INC COM$4,128$10,245
JOHNSON CONTROLS INTERNATIONAL PLC$7,006$12,352
KLA CORP$9,526$9,426
KRAFT HEINZ CO COM$7,404$11,155
LOWES COMPANIES$7,908$7,970
MCKESSON CORP$5,466$18,756
MERCK & CO. INC COM$9,918$19,194
MICROSOFT CORP$21,031$27,100
PALO ALTO NETWORKS$6,108$5,721
PURDENTIAL FINANCIAL INC$11,012$11,736
QUALCOMM INC$9,960$17,480
RAYTHEON TECHNOLOGIES$7,281$13,120
SCHLUMBERGER LIMITED COM USD 0.01$6,161$21,544
SCHWAB CHARLES CORP$8,880$11,573
TJX COMPANIES INC$10,515$14,885
TMOBILE INC$10,502$10,780
UNITED HEALTH GROUP INC$7,180$15,735
VANGUARD COMMODITY STRATEGY FD ADMIRAL$16,797$15,191
VERIZON COMMUNICATIONS INC$9,481$7,446
VISA INC$9,722$9,765
WALT DISNEY CO$5,970$5,300
WELLS FARGO CO NEW COM$8,232$10,446
ZIMMER BIOMET HOLDINGS INC COM$8,164$10,328

Investments Govt Obligations Sch InvestmentsGovtObligationsSch

FieldValueIRS element (for citing)
US Govt Obligations Book Vl EOY$64,513USGovtObligationsBookVlEOYAmt
US Govt Obligations EOYFMV$63,259USGovtObligationsEOYFMVAmt
State Local Sec Book Vl EOY$0StateLocalSecBookVlEOYAmt
State Local Sec EOYFMV$0StateLocalSecEOYFMVAmt

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOtherGrp (16 entries)

Category Or ItemCategoryOrItemTxtListed At Cost Or FMVListedAtCostOrFMVCdBook ValueBookValueAmtEOYFMVEOYFMVAmt
BLACKROCK SYSTEMATIC MULTI-STRATEGY INSTLAT COST$39,094$37,097
CALAMOS MARKET NEUTRAL INCOME CL IAT COST$35,717$37,894
DIAMOND HILL LONG/SHRT FUND CL IAT COST$17,928$19,214
FEDERATED HERMES INTL EQ CL ISAT COST$51,926$49,684
FIDELITY ADVISOR REAL ESTATE INCOME ZAT COST$39,288$36,248
FIDELITY INTERNATL INDEX FUNDAT COST$129,650$123,170
FIDELITY TOTAL INTL INDEX FUNDAT COST$114,098$113,350
ISHARES CORE S&P SMALL-CAP EAT COST$93,362$90,854
ISHARES S&P 500 GROWTH ETFAT COST$122,495$138,316
ISHARES S&P MIDCAP 400 INDEX FUNDAT COST$28,620$36,284
ISHARES TR ISHS 1-5YR INVSAT COST$61,583$56,994
ISHARES TR ISHS 5-10YR INVSAT COST$32,316$29,676
JANUS HENDERSON ENTERPRISESAT COST$61,490$60,746
JP MORGAN MID CAP VALUE FUND CLASS LAT COST$12,018$12,254
PZENA EMERGING MKTSAT COST$35,042$33,984
SPDR SERIES TRUST S&P 600 SMCP VALAT COST$44,018$70,509

Other Assets Schedule OtherAssetsSchedule

Other Assets Schedule OtherAssetsScheduleGrp

FieldValueIRS element (for citing)
DescACCRUED INTERESTDesc
BOY Book Value$898BOYBookValueAmt
EOY Book Value$500EOYBookValueAmt
EOYFMV$500EOYFMVAmt

Other Decreases Schedule OtherDecreasesSchedule

Other Decreases Detail OtherDecreasesDetail

FieldValueIRS element (for citing)
DescADJUSTMENTDesc
Amt$794Amt

Other Increases Schedule OtherIncreasesSchedule

Other Increases Detail OtherIncreasesDetail

FieldValueIRS element (for citing)
DescNONDIVIDEND DISTRIBUTIONSDesc
Amt$41Amt

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees Detail OtherProfessionalFeesDetail

FieldValueIRS element (for citing)
CategoryFIDELITY FEESCategoryTxt
Amt$19,896Amt
Net Investment Income$19,896NetInvestmentIncomeAmt
Disbursements Charitable Prps$0DisbursementsCharitablePrpsAmt

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (2 entries)

CategoryCategoryTxtAmtAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
FOREIGN TAX$502$502$0
INVESTMENT TAX$2,707$0$0