SAM MILLER FOUNDATION: Form 990PF, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- SAM MILLER FOUNDATION (EIN 41-6035570)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-05-03
- IRS object ID
- 202321239349100807
- 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
- Form 990-PF
- Accounting Fees Schedule
- Investments Corp Bonds Schedule
- Investments Govt Obligations Sch
- Other Assets Schedule
- Other Expenses Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-03T09:37:36-05:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 203294646 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BOMBERG HANSON & ASSOCIATES LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9800 SHELARD PARKWAY SUITE 208 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55441 | 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 | 416035570 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAM MILLER FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SAMM | BusinessNameControlTxt |
| Phone | 6123392651 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | POBOX 581398 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55458 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DEBORAH RICH | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 6123392651 | PhoneNum |
| Signature | 2023-04-27 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DEBORAH | PersonFirstNm |
| Person Last | RICH | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JAMES D BOMBERG CPA | PreparerPersonNm |
| PTIN | P00003325 | PTIN |
| Phone | 7632770303 | PhoneNum |
| Preparation | 2023-04-27 | PreparationDt |
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 | $942,538 | FMVAssetsEOYAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Interest On Sav Rev And Expnss | $5,472 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $5,472 | InterestOnSavNetInvstIncmAmt |
| Dividends Rev And Expnss | $18,199 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $18,199 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $33,514 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $100,230 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $33,514 | CapGainNetIncmNetInvstIncmAmt |
| Total Rev And Expnss | $57,185 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $57,185 | TotalNetInvstIncmAmt |
| Total Adj Net Incm | $0 | TotalAdjNetIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $0 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $0 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Adj Net Incm | $0 | CompOfcrDirTrstAdjNetIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $0 | CompOfcrDirTrstDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $3,600 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $0 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $0 | AccountingFeesAdjNetIncmAmt |
| Accounting Fees Chrtbl Prps | $0 | AccountingFeesChrtblPrpsAmt |
| Taxes Rev And Expnss | $2,242 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $0 | TaxesNetInvstIncmAmt |
| Taxes Adj Net Incm | $0 | TaxesAdjNetIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $7,265 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $6,504 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Adj Net Incm | $0 | OtherExpensesAdjNetIncmAmt |
| Other Expenses Dsbrs Chrtbl | $0 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $13,107 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $6,504 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $0 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $0 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $45,586 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $45,586 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $58,693 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $6,504 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $0 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $45,586 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$1,508 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $50,681 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sav And Temp Cash Invst BOY | $7,894 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $8,477 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $8,477 | SavAndTempCashInvstEOYFMVAmt |
| US Government Obligations BOY | $121,130 | USGovernmentObligationsBOYAmt |
| US Government Obligations EOY | $96,518 | USGovernmentObligationsEOYAmt |
| US Govt Obligations EOYFMV | $87,680 | USGovtObligationsEOYFMVAmt |
| Corporate Bonds BOY | $143,000 | CorporateBondsBOYAmt |
| Corporate Bonds EOY | $143,000 | CorporateBondsEOYAmt |
| Corporate Bonds EOYFMV | $143,000 | CorporateBondsEOYFMVAmt |
| Other Assets BOY | $632,802 | OtherAssetsBOYAmt |
| Other Assets EOY | $655,323 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $703,381 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $904,826 | TotalAssetsBOYAmt |
| Total Assets EOY | $903,318 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $942,538 | TotalAssetsEOYFMVAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
| Capital Stock BOY | $0 | CapitalStockBOYAmt |
| Capital Stock EOY | $0 | CapitalStockEOYAmt |
| Additional Paid In Capital BOY | $0 | AdditionalPaidInCapitalBOYAmt |
| Additional Paid In Capital EOY | $0 | AdditionalPaidInCapitalEOYAmt |
| Retained Earning BOY | $904,826 | RetainedEarningBOYAmt |
| Retained Earning EOY | $903,318 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $904,826 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $903,318 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $904,826 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $903,318 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $904,826 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$1,508 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $903,318 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $903,318 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (10 entries)
| PropertyPropertyDesc | How AcquiredHowAcquiredCd | AcquiredAcquiredDt | SoldSoldDt | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt |
|---|---|---|---|---|---|---|---|
| AMER FUNDS AMEIRCAN MUTUAL FUND CLASS F2 | P | 2021-03-23 | 2022-10-03 | $6,161 | $5,908 | $253 | $253 |
| FIRST EAGLE OVERSEAS FUND CLASS I | P | 2013-01-18 | 2022-10-03 | $461 | $461 | $0 | $0 |
| FIRST EAGLE GLOBAL INCOME BUILDER FUND CLASS I | P | 2017-08-10 | 2022-10-03 | $794 | $794 | $0 | $0 |
| THE HARTFORD FLOATING RATE FUND CLASS I | P | 2012-09-28 | 2022-05-16 | $3,690 | $4,029 | -$339 | -$339 |
| HARTFORD BALANCED INCOME FUND CLASS I | P | 2019-01-22 | 2022-10-03 | $3,230 | $3,095 | $135 | $135 |
| MAIRS BALANCED FUND CLASS INVESTOR | P | 2013-01-18 | 2022-10-03 | $13,943 | $10,537 | $3,406 | $3,406 |
| MAIRS GROWTH FUND CLASS INVESTOR | P | 2015-12-16 | 2022-10-03 | $395 | $360 | $35 | $35 |
| AMER FUNDS AMEIRCAN MUTUAL FUND CLASS F2 | P | 2021-03-23 | 2022-10-03 | $4,221 | $4,330 | -$109 | -$109 |
| THE HARTFORD FLOATING RATE FUND CLASS I | P | 2010-08-30 | 2022-12-20 | $34,325 | $37,202 | -$2,877 | -$2,877 |
| CAPITAL GAINS DIVIDENDS | P | $33,010 | $33,010 | $33,010 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $33,514 | CapitalGainNetIncomeAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $704 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $704 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $704 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $1,600 | 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 | $1,600 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Overpayment | $896 | OverpaymentAmt |
| Applied To ES Tax | $896 | AppliedToESTaxAmt |
| Refund | $0 | RefundAmt |
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 | MN | 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 | DEBORAH RICH | IndividualWithBooksNm |
| Phone | 6123392651 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 581398 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55458 | 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 |
|---|---|---|---|---|---|---|---|---|
| DEBORAH RICH | ||||||||
| 752 WISCONSIN AVENUE NORTH | GOLDEN VALLEY | MN | 55427 | PRESIDENT | 2.00 | $0 | $0 | $0 |
| EVE MILLER | ||||||||
| 110 LOUISIANA AVE N | GOLDEN VALLEY | MN | 55427 | VICE PRESIDENT | 2.00 | $0 | $0 | $0 |
| HINDY FRISHMAN | ||||||||
| 2506 LYNN AVE S | ST LOUIS PARK | MN | 55416 | SECRETARY | 0.00 | $0 | $0 | $0 |
| CRAIG KUPRITZ | ||||||||
| 300 LOUISIANA AVENUE NORTH | GOLDEN VALLEY | MN | 55427 | TREASURER | 0.00 | $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 | $855,113 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $7,661 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $862,774 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $862,774 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $12,942 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $849,832 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $42,492 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $42,492 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $704 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $704 | TotalTaxAmt |
| Distributable Before Adj | $41,788 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $41,788 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $41,788 | DistributableAsAdjustedAmt |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $45,586 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $45,586 | QualifyingDistributionsAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $41,788 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $0 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr2 | $1,225 | ExcessDistributionCyovYr2Amt |
| Excess Distribution Cyov Yr1 | $431 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $1,656 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $45,586 | QualifyingDistributionsAmt |
| Applied To Year1 | $0 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $41,788 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $3,798 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $0 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $0 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $5,454 | 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 | $0 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $5,454 | ExcessDistriCyovToNextYrAmt |
| Excess From Year2 | $1,225 | ExcessFromYear2Amt |
| Excess From Year1 | $431 | ExcessFromYear1Amt |
| Excess From Current Year | $3,798 | ExcessFromCurrentYearAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (68 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| ALEPH-BET ORGANIZATION | |||||||
| PO BOX 8 LOMBARDY ST | NEWARK | NJ | 07102 | NONE | PUBLIC CHARITY | GENERAL | $180 |
| ALZHEIMERS ASSOCIATION | |||||||
| 2631 12TH AVE S SUITE A | FARGO | ND | 58103 | NONE | PUBLIC CHARITY | GENERAL | $160 |
| AMERICAN DIABETES ASSOCIATION | |||||||
| PO BOX 7017 | MERRIFIELD | VA | 22116 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| AMERICAN HEART ASSOCIATION | |||||||
| PO BOX 78851 | PHOENIX | AZ | 85062 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| AMERICAN JEWISH WORLD SERVICES | |||||||
| PO BOX 568 | ETNA | NH | 03750 | NONE | PUBLIC CHARITY | GENERAL | $250 |
| ADATH JESHURUN SYNAGOGUE | |||||||
| 10500 HILLSIDE LN | MINNETONKA | MN | 55305 | NONE | PUBLIC CHARITY | GENERAL | $180 |
| AMERICAN SOCIETY FOR YAD VASHEM | |||||||
| PO BOX 170305 | MILWAUKEE | WI | 53217 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| ANIMAL HUMANE SOCIETY | |||||||
| 845 MEADOW LANE N | GOLDEN VALLEY | MN | 55422 | NONE | PUBLIC CHARITY | GENERAL | $250 |
| ASHE SHOLOM BNAI ISRAEL SYNAGOGUE | |||||||
| 540 W MELROSE | CHICAGO | IL | 60657 | NONE | PUBLIC CHARITY | GENERAL | $243 |
| AUTISM SPEAKS | |||||||
| 1060 STATE RD | PRINCETON | NJ | 08540 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| BAIS YAAKOV GIRLS SCHOOL | |||||||
| 4221 SUNSET BLVD | ST LOUIS PARK | MN | 55416 | NONE | PUBLIC CHARITY | GENERAL | $250 |
| BAIS YISROEL SYNAGOGUE | |||||||
| 4221 SUNSET BLVD | ST LOUIS PARK | MN | 55416 | NONE | PUBLIC CHARITY | GENERAL | $500 |
| BETH EL SYNAGOGUE | |||||||
| 5225 BERRY ST | ST LOUIS PARK | MN | 55416 | NONE | PUBLIC CHARITY | GENERAL | $180 |
| CHABAD OF ALABAMA | |||||||
| 3040 OVERTON RD | BIRMINGHAM | AL | 35223 | NONE | PUBLIC CHARITY | GENERAL | $6,000 |
| CHABAD OF CHARLOTTE | |||||||
| 2060 EUCLID AVE | CHARLOTTE | NC | 28203 | NONE | PUBLIC CHARITY | GENERAL | $180 |
| CHILDREN'S HOME SOCIETY | |||||||
| 1605 EUSTIS SOCIETY | ST PAUL | MN | 55108 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| CLEAN WATER ACTION | |||||||
| 330 2ND AVE S 420 | MINNEAPOLIS | MN | 55401 | NONE | PUBLIC CHARITY | GENERAL | $50 |
| CONGREGATION DARCHEI NOAM | |||||||
| 2950 JOPPA AVE S | ST LOUIS PARK | MN | 55416 | NONE | PUBLIC CHARITY | GENERAL | $15,360 |
| DOCTORS WITHOUT BORDERS | |||||||
| PO BOX 5022 | HAGERSTOWN | MD | 21741 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| DAVIS PHINNEY FOUNDATION | |||||||
| 357 S MCCASLIN | LOUISVILLE | CO | 80027 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| ESCHEL | |||||||
| 115 E 23RD SY | NEW YORK | NY | 10010 | NONE | PUBLIC CHARITY | GENERAL | $186 |
| GUTHRIE THEATER FOUNDATION | |||||||
| 818 SOUTH 2ND STREET | MINNEAPOLIS | MN | 55415 | NONE | PUBLIC CHARITY | GENERAL | $1,000 |
| HABITAT FOR HUMANITY | |||||||
| 322 W LAMAR ST | AMERICUS | GA | 31709 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| HADASSAH WORLD ZIONIS ORG | |||||||
| 40 WALL STREET | NEW YORK | NY | 10005 | NONE | PUBLIC CHARITY | GENERAL | $250 |
| HIAS | |||||||
| PO BOX 976077 | WASHINGTON | DC | 20090 | NONE | PUBLIC CHARITY | GENERAL | $500 |
| HATZOLAH | |||||||
| 518 PARK AVE | BROOKLYN | NY | 11204 | NONE | PUBLIC CHARITY | GENERAL | $1,000 |
| HEILICHER MPLS JEWISH DAY SCHOOL | |||||||
| 4330 CEDAR LAKE ROAD | ST LOUIS PARK | MN | 55416 | NONE | PUBLIC CHARITY | GENERAL | $2,500 |
| JQY | |||||||
| 1460 BROADWAY | NEW YORK | NY | 10036 | NONE | PUBLIC CHARITY | GENERAL | $180 |
| JDC | |||||||
| 220 E 42ND ST 400 | NEW YORK | NY | 10017 | NONE | PUBLIC CHARITY | GENERAL | $500 |
| IDFISRAEL DEFENSE FORCE | |||||||
| 4224 | NEW YORK | NY | 10163 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| KENESSETH ISRAEL SYNAGOGUE | |||||||
| 4330 W 28TH ST | ST LOUIS PARK | MN | 55416 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| LEUKEMIALYMPHOMA SOCIETY | |||||||
| PO BOX 8900 | WASHINGTON | DC | 20090 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| LIVING WELL DISABILITIES | |||||||
| 1168 NORTHLABD DR | MENDOTA HEIGHTS | MN | 55120 | NONE | PUBLIC CHARITY | GENERAL | $200 |
| MESORAH DC | |||||||
| 10717 MEADOWHALL RD | SILVER SPRING | MD | 20901 | NONE | PUBLIC CHARITY | GENERAL | $216 |
| MARCH OF DIMES | |||||||
| 1275 MAMARONECK AVE | WHITE PLAINS | NY | 10605 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| MATAN | |||||||
| PO BOX 40 | NEW YORK | NY | 10970 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| MINNEAPOLIS JEWISH COMMUNITY CENTER | |||||||
| 4330 CEDAR LAKE ROAD | MINNEAPOLIS | MN | 55416 | NONE | PUBLIC CHARITY | GENERAL | $36 |
| MEMORIAL SLOAN KETTERING | |||||||
| PO BOX 5028 | HOGERSTOWN | MD | 21741 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| MINNEAPOLIS JEWISH FEDERATION | |||||||
| 111 CHESHIRE LANE SUITE 50 | MINNETONKA | MN | 55305 | NONE | PUBLIC CHARITY | GENERAL | $2,500 |
| MINNESOTA FOUNDATION OF ACLU | |||||||
| 125 BROAD STREET | NEW YORK | NY | 10004 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| MN PUBLIC RADIO | |||||||
| PO BOX 860294 | MINNEAPOLIS | MN | 55486 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| MOISHE HOUSE ORG | |||||||
| 441 SAXONY RD 2 | ENCINITA | CA | 92024 | NONE | PUBLIC CHARITY | GENERAL | $110 |
| NATIONAL COUNCIL OF JEWISH WOMAN | |||||||
| 13100 WAYZATTA BLVD 160 | MINNETONKA | MN | 55305 | NONE | PUBLIC CHARITY | GENERAL | $250 |
| NATIONAL YIDDISH BOOK CENTER | |||||||
| 1021 W AMHERST | AMHERST | MA | 01002 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| NE MILES JEWISH DAY SCHOOL | |||||||
| 4000 MONTCLAIR RD | BIRMINGHAM | AL | 35213 | NONE | PUBLIC CHARITY | GENERAL | $3,100 |
| NORTHSIDE ACHIEVEMENT | |||||||
| 2123 W BROADWAY AVE 100 | MINNEAPOLIS | MN | 55411 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| ST JUDES | |||||||
| 262 DANNY THOMAS PLACE | MEMPHIS | TN | 38105 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| ORTHODOX UNION WOMANS INITIATIVE | |||||||
| 11 BROADWAY | NEW YORK | NY | 10004 | NONE | PUBLIC CHARITY | GENERAL | $250 |
| PARKINSONS FOUNDATION | |||||||
| PO BOX 6003 | ALBERTA LEA | MN | 56007 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| PLANNED PARENTHOOD | |||||||
| 671 VANDALLA ST | ST PAUL | MN | 55114 | NONE | PUBLIC CHARITY | GENERAL | $250 |
| PROCHOICE MN | |||||||
| 222 N 2ND ST | MINNEAPOLIS | MN | 55401 | NONE | PUBLIC CHARITY | GENERAL | $107 |
| STEP SLP | |||||||
| 6812 W LAKE STREET | ST LOUIS PARK | MN | 55426 | NONE | PUBLIC CHARITY | GENERAL | $186 |
| SHALVA | |||||||
| 315 5TH AVE | NEW YORK | NY | 10016 | NONE | PUBLIC CHARITY | GENERAL | $180 |
| SHARSHERET | |||||||
| 1086 TEANECK RD | TEANECK | NJ | 07666 | NONE | PUBLIC CHARITY | GENERAL | $371 |
| SPCA | |||||||
| PO BOX 8682 | NEW YORK | NY | 10001 | NONE | PUBLIC CHARITY | GENERAL | $200 |
| SUMMITT INSTITUTE ( PEF ISRAEL ENDOWMWNT FUNDS) | |||||||
| 630 3RD AVE 15TH | NEW YORK | NY | 10017 | NONE | PUBLIC CHARITY | GENERAL | $1,500 |
| ST JOSEPHS INDIAN SCHOOL | |||||||
| PO BOX 326 | CHAMBERLAIN | SD | 57326 | NONE | PUBLIC CHARITY | GENERAL | $50 |
| SUSAN G KOMEN | |||||||
| 13770 NOEL RD | DALLAS | TX | 75380 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| SINAI SCHOOLS | |||||||
| 240 FRESH COURT | PARAMUS | NJ | 07652 | NONE | PUBLIC CHARITY | GENERAL | $500 |
| TEMPLE ISRAEL MINNEAPOLIS | |||||||
| 2323 FREEMONT AVE S | MINNEAPOLIS | MN | 55405 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| TEMPLE OF AARON | |||||||
| 616 S MISSISSIPPI RIVER BLVD | ST PAUL | MN | 55116 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| ALTENU SYNAGOGUE | |||||||
| 24 W 57TH ST | NEW YORK | NY | 10019 | NONE | PUBLIC CHARITY | GENERAL | $1,000 |
| THAREINU | |||||||
| 78 BUCHANAN LANE | SPRING VALLEY | NY | 10977 | NONE | PUBLIC CHARITY | GENERAL | $1,200 |
| TORAH IN MOTION | |||||||
| 46 GLENWOOD DR E | BERGENFIELD | NJ | 07621 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| FEEDING AMERICA | |||||||
| 161 N CLARK | CHICAGO | IL | 60601 | NONE | PUBLIC CHARITY | GENERAL | $250 |
| UNICEF | |||||||
| 125 MAIDEN LANE | NEW YORK | NY | 10038 | NONE | PUBLIC CHARITY | GENERAL | $100 |
| YACHAD | |||||||
| 11 BROADWAY 13TH FLOOR | NEW YORK | NY | 10004 | NONE | PUBLIC CHARITY | GENERAL | $360 |
| GLOBAL VILLAGE CONNECT | |||||||
| 5536 LORING LANE | GOLDEN VALLEY | MN | 55422 | NONE | PUBLIC CHARITY | GENERAL | $371 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $45,586 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $5,472 | ExclusionAmt |
Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $18,199 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $33,514 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $57,185 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $57,185 | 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 | BOOKKEEPING | CategoryTxt |
| Amt | $3,600 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corporate Bonds InvestmentsCorporateBondsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond | ISRAEL BONDS | BondNm |
| EOY Book Value | $143,000 | EOYBookValueAmt |
| EOYFMV | $143,000 | EOYFMVAmt |
Investments Govt Obligations Sch InvestmentsGovtObligationsSch
| Field | Value | IRS element (for citing) |
|---|---|---|
| US Govt Obligations Book Vl EOY | $0 | USGovtObligationsBookVlEOYAmt |
| US Govt Obligations EOYFMV | $0 | USGovtObligationsEOYFMVAmt |
| State Local Sec Book Vl EOY | $96,518 | StateLocalSecBookVlEOYAmt |
| State Local Sec EOYFMV | $87,680 | StateLocalSecEOYFMVAmt |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp (2 entries)
| DescDesc | BOY Book ValueBOYBookValueAmt | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| EXCISE TAX REFUND RECEIVABLE(PAYABLE) | $443 | $0 | $0 |
| UBS EQUITES | $632,359 | $655,323 | $703,381 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (4 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|---|
| UBS FEE | $6,329 | $6,329 | $0 | $0 |
| UBS MANAGEMENT FEES | $175 | $175 | $0 | $0 |
| MN SECRETARY OF STATE | $50 | $0 | $0 | $0 |
| MISCELLANEOUS | $711 | $0 | $0 | $0 |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | EXCISE TAX | CategoryTxt |
| Amt | $2,242 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
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