R & M CLARK FAMILY FOUNDATION: Form 990PF, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- R & M CLARK FAMILY FOUNDATION (EIN 86-0778653)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-05-11
- IRS object ID
- 202331319349103583
- 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 Corp Stock Schedule
- Legal Fees Schedule
- Other Assets Schedule
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-11T15:31:07-05:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390859910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7098 E COCHISE RD STE 100 | AddressLine1Txt |
| City | SCOTTSDALE | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85253 | 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 | 860778653 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | R & M CLARK FAMILY FOUNDATION | BusinessNameLine1Txt |
| Business Name Line2 | C/O CAROLE LEE RANDALL | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | R&MC | BusinessNameControlTxt |
| Phone | 4804831170 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5565 W 70TH STREET | AddressLine1Txt |
| City | EDINA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55439 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CAROLE LEE RANDALL | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 4804831170 | PhoneNum |
| Signature | 2023-05-04 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | CAROLE | PersonFirstNm |
| Person Last | LEE RANDALL | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CHUCK J INDERIEDEN CPA | PreparerPersonNm |
| PTIN | P00038206 | PTIN |
| Phone | 4804831170 | PhoneNum |
| Preparation | 2023-05-04 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | 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 | $4,929,020 | FMVAssetsEOYAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Dividends Rev And Expnss | $94,520 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $94,520 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $2,212,266 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $6,542,760 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $2,212,266 | CapGainNetIncmNetInvstIncmAmt |
| Total Rev And Expnss | $2,306,786 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $2,306,786 | TotalNetInvstIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $0 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $0 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $0 | CompOfcrDirTrstDsbrsChrtblAmt |
| Legal Fees Rev And Expnss | $683 | LegalFeesRevAndExpnssAmt |
| Legal Fees Net Invst Incm | $342 | LegalFeesNetInvstIncmAmt |
| Legal Fees Dsbrs Chrtbl | $341 | LegalFeesDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $3,800 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $1,900 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Chrtbl Prps | $1,900 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Rev And Expnss | $15,666 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $15,666 | OtherProfFeesNetInvstIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $0 | OtherProfFeesDsbrsChrtblAmt |
| Taxes Rev And Expnss | $14,922 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $6,493 | TaxesNetInvstIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $35,071 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $24,401 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $2,241 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $315,000 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $315,000 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $350,071 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $24,401 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $317,241 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $1,956,715 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $2,282,385 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sav And Temp Cash Invst BOY | $195,705 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $30,991 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $30,991 | SavAndTempCashInvstEOYFMVAmt |
| US Government Obligations BOY | $268,297 | USGovernmentObligationsBOYAmt |
| US Government Obligations EOY | $0 | USGovernmentObligationsEOYAmt |
| US Govt Obligations EOYFMV | $0 | USGovtObligationsEOYFMVAmt |
| Corporate Stock BOY | $2,381,585 | CorporateStockBOYAmt |
| Corporate Stock EOY | $4,650,488 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $4,181,193 | CorporateStockEOYFMVAmt |
| Corporate Bonds BOY | $357,145 | CorporateBondsBOYAmt |
| Corporate Bonds EOY | $756,319 | CorporateBondsEOYAmt |
| Corporate Bonds EOYFMV | $709,716 | CorporateBondsEOYFMVAmt |
| Other Investments BOY | $285,470 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $0 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $0 | OtherInvestmentsEOYFMVAmt |
| Other Assets BOY | $1 | OtherAssetsBOYAmt |
| Other Assets EOY | $7,120 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $7,120 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $3,488,203 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,444,918 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $4,929,020 | 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 | $3,488,203 | RetainedEarningBOYAmt |
| Retained Earning EOY | $5,444,918 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $3,488,203 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $5,444,918 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $3,488,203 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $5,444,918 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $3,488,203 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $1,956,715 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $5,444,918 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $5,444,918 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (2 entries)
| PropertyPropertyDesc | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt | How AcquiredHowAcquiredCd |
|---|---|---|---|---|---|
| PUBLICLY TRADED SECURITIES | $6,404,217 | $4,330,494 | $2,073,723 | $2,073,723 | |
| CAPITAL GAINS DIVIDENDS | $138,543 | $138,543 | $138,543 | P |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $2,212,266 | CapitalGainNetIncomeAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $31,725 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $31,725 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $31,725 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $6,000 | 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 | $6,000 | TotalPaymentsAndCreditsAmt |
| Form2220 Attached | Yes (X) | Form2220AttachedInd |
| Es Penalty | $0 | EsPenaltyAmt |
| Tax Due | $25,725 | TaxDueAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | 0 | LegislativePoliticalActyInd |
| More Than100 Spent | 0 | MoreThan100SpentInd |
| Form1120 POL Filed | 0 | Form1120POLFiledInd |
| Section4955 Organization Tax | $0 | Section4955OrganizationTaxAmt |
| Section4955 Managers Tax | $0 | Section4955ManagersTaxAmt |
| Tax Reimbursed | $0 | TaxReimbursedAmt |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | 0 | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (1) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (1) | AtLeast5000InAssetsInd |
| Org Report Or Register State | AZ | 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 | NA | WebsiteAddressTxt |
| Individual With Books | BAKER TILLY US LLP | IndividualWithBooksNm |
| Phone | 4804831170 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7098 E COCHISE ROAD SUITE 100 | AddressLine1Txt |
| City | SCOTTSDALE | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85253 | 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 (3 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 |
|---|---|---|---|---|---|---|---|---|
| CAROLE LEE RANDALL | ||||||||
| 5565 W 70TH STREET | EDINA | MN | 55439 | PRESIDENT/DIRECTOR | 0.00 | $0 | $0 | $0 |
| THOMAS E CLARK | ||||||||
| 404 W BROADWAY | GRANVILLE | OH | 43023 | VICE PRESIDENT/DIRECTOR | 0.00 | $0 | $0 | $0 |
| JAMES W CLARK | ||||||||
| 30 E 33RD AVE 5397 | EUGENE | OR | 97405 | SECRETARY/TREASURER/DIRECT | 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 | $5,422,101 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $54,635 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $5,476,736 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $5,476,736 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $82,151 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $5,394,585 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $269,729 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $269,729 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $31,725 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $31,725 | TotalTaxAmt |
| Distributable Before Adj | $238,004 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $238,004 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $238,004 | DistributableAsAdjustedAmt |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $317,241 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $317,241 | QualifyingDistributionsAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $238,004 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $154,280 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Total Excess Distribution Cyov | $0 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $317,241 | QualifyingDistributionsAmt |
| Applied To Year1 | $154,280 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $162,961 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $0 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $0 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $0 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $0 | TotalCorpusAmt |
| Prior Year Undistributed Incm | $0 | PriorYearUndistributedIncmAmt |
| Prior Year Deficiency Or Tax | $0 | PriorYearDeficiencyOrTaxAmt |
| Taxable1 | $0 | Taxable1Amt |
| Taxable2 | $0 | Taxable2Amt |
| Undistributed Income CY | $75,043 | UndistributedIncomeCYAmt |
| Corpus Distri170b1 E Or4942g3 | $0 | CorpusDistri170b1EOr4942g3Amt |
| Excess Distri Cyov From Yr5 | $0 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $0 | ExcessDistriCyovToNextYrAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (59 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| ALEE SHRINERS | |||||||
| 100 EISENBERG DR | SAVANNAH | GA | 31406 | NONE | 501(C)(3) | GENERAL FUND | $1,500 |
| ALZHEIMER'S ASSOCIATION | |||||||
| 1000 WILLAGILLESPIE RD SUITE 100 | EUGENE | OR | 97401 | NONE | 501(C)(3) | GENERAL FUND | $4,250 |
| ALZHEIMER'S ASSOCIATION | |||||||
| 7900 WEST 68TH STREET SUITE 100 | MINNEAPOLIS | MN | 55439 | NONE | 501(C)(3) | GENERAL FUND | $20,000 |
| AMERICA RED CROSS SW OREGON CHAPTER) | |||||||
| 440 BROADWAY | EUGENE | OR | 97401 | NONE | 501(C)(3) | GENERAL FUND | $6,375 |
| ANGEL HAIR FOUNDATION | |||||||
| PO BOX 2727 | EUGENE | OR | 97402 | NONE | 501(C)(3) | GENERAL FUND | $2,125 |
| BAGS OF LOVE | |||||||
| 710 COMMERCIAL STREET | EUGENE | OR | 97402 | NONE | 501(C)(3) | GENERAL FUND | $1,700 |
| BEACON INTERFAITH | |||||||
| 2610 UNIVERSITY AVENUE W SUITE 100 | ST PAUL | MN | 55114 | NONE | 501(C)(3) | GENERAL FUND | $3,000 |
| BIG BROTHERSBIG SISTERS | |||||||
| 62 WEST LOCUST STREET | NEWARK | OH | 43055 | NONE | 501(C)(3) | GENERAL FUND | $42,000 |
| BOYS & GIRLS CLUBS OF EMERALD VALLEY | |||||||
| 1545 W 22ND AVE | EUGENE | OR | 97405 | NONE | 501(C)(3) | GENERAL FUND | $5,000 |
| BRIDGEWAY HOUSE | |||||||
| 37770 UPPER CAMP CREEK ROAD | SPRINGFIELD | OR | 97478 | NONE | 501(C)(3) | GENERAL FUND | $3,400 |
| BRIDGING | |||||||
| 201 W 87TH ST | BLOOMINGTON | MN | 55420 | NONE | 501(C)(3) | GENERAL FUND | $7,000 |
| CAMP TWIN LAKES | |||||||
| 1100 SPRING STEET SUITE 406 | ATLANTA | GA | 30309 | NONE | 501(C)(3) | GENERAL FUND | $1,000 |
| COURAGEOUS KIDS | |||||||
| 677 EAST 12TH AVENUE SUITE N180 | EUGENE | OR | 97401 | NONE | 501(C)(3) | GENERAL FUND | $5,000 |
| DEPAUW UNIVERSITY | |||||||
| 300 E SEMINARY STREET | GREENCASTLE | IN | 46135 | NONE | 501(C)(3) | GENERAL FUND | $10,000 |
| DIAPER BANK OF NORTH CAROLINA | |||||||
| 1311 E CLUB BLVD | DURHAM | NC | 27704 | NONE | 501(C)(3) | GENERAL FUND | $5,000 |
| DRURY UNIVERSITY | |||||||
| 900 NORTH BENTON AVENUE | SPRINGFIELD | MO | 65802 | NONE | 501(C)(3) | GENERAL FUND | $10,000 |
| EASTERN LOCAL SCHOOL DISTRICT | |||||||
| 50008 STATE ROUTE 681 | REEDSVILLE | OH | 45772 | NONE | 501(C)(3) | GENERAL FUND | $9,500 |
| EUGENE MISSION | |||||||
| 1542 W 1ST AVENUE | EUGENE | OR | 97402 | NONG | 501(C)(3) | GENERAL FUND | $7,500 |
| FIRST PLACE FAMILY CENTER | |||||||
| 1995 AMAZON PARKWAY | EUGENE | OR | 97405 | NONE | 501(C)(3) | GENERAL FUND | $4,250 |
| FOOD FOR LANE COUNTY | |||||||
| 770 BAILEY HILL ROAD | EUGENE | OR | 97402 | NONE | 501(C)(3) | GENERAL FUND | $5,000 |
| FT MCALLISTER FISHING CLUB - BIKES FOR TOTS PROGRAM | |||||||
| PO BOX 1133 | RICHMOND HILL | GA | 31324 | NONE | 501(C)(3) | GENERAL FUND | $2,000 |
| GARY SINISE FOUNDATION | |||||||
| PO BOX 368 | WOODLAND HILLS | CA | 91365 | NONE | 501(C)(3) | GENERAL FUND | $7,500 |
| GIVING VOICE | |||||||
| 4627 BRUCE AVE | MINNEAPOLIS | MN | 55424 | NONE | 501(C)(3) | GENERAL FUND | $7,000 |
| GLOBAL EMPOWERMENT MISSION | |||||||
| 1850 NW 84TH AVE SUITE 100 | DORAL | FL | 33126 | NONE | 501(C)(3) | GENERAL FUND | $500 |
| GUILD INCORPORATED | |||||||
| 130 SOUTH WABASHA ST SUITE 90 | ST PAUL | MN | 55107 | NONE | 501(C)(3) | GENERAL FUND | $4,000 |
| HABITAT FOR HUMANITY OF BULLOCK COUNTY | |||||||
| 201 JOHNSON ST PO BOX 1253 | STATESBORO | GA | 30459 | NONE | 501(C)(3) | GENERAL FUND | $1,275 |
| HOPE & SAFETY ALLIANCE | |||||||
| 1577 PEARL ST 200 | EUGENE | OR | 97401 | NONE | 501(C)(3) | GENERAL FUND | $4,250 |
| HOPE ACADEMY | |||||||
| 7618 E UNIVERSITY DRIVE | MESA | AZ | 85207 | NONE | 501(C)(3) | GENERAL FUND | $1,000 |
| HUMANE SOCIETY - CAPITOL AREA | |||||||
| 3015 ASCIOTO DARBY ROAD | HILLIARD | OH | 43026 | NONE | 501(C)(3) | GENERAL FUND | $1,000 |
| IMAGINE AND INSPIRE | |||||||
| 3011 BROADWAY STREET | BOULDER | CO | 80304 | NONE | 501(C)(3) | GENERAL FUND | $5,000 |
| KIDS FIRST CENTER | |||||||
| 2675 MLK JR BLVD | EUGENE | OR | 97401 | NONE | 501(C)(3) | GENERAL FUND | $5,000 |
| LANE COUNTY SENIOR & DISABILITY SVCS | |||||||
| 1015 WILLAMETTE ST | EUGENE | OR | 97401 | NONE | 501(C)(3) | GENERAL FUND | $2,125 |
| LICKING COUNTY HUMANE SOCIETY | |||||||
| 825 THORNWOOD DR SW | HEATH | OH | 43056 | NONE | 501(C)(3) | GENERAL FUND | $3,500 |
| LIVING WELL DISABILITY SERVICES | |||||||
| 1168 NORTHLAND DR | MENDOTA HEIGHTS | MN | 55120 | NONE | 501(C)(3) | GENERAL FUND | $15,000 |
| LOOKING GLASS COMMUNITY SERVICES | |||||||
| 1790 W 11TH AVE SUITE 200 | EUGENE | OR | 97402 | NONE | 501(C)(3) | GENERAL FUND | $1,475 |
| MACPHIL CENTER FOR MUSIC | |||||||
| 501 S 2ND STREET | MINNEAPOLIS | MN | 55401 | NONE | 501(C)(3) | GENERAL FUND | $2,000 |
| MAINE PAWS FOR VETERANS | |||||||
| 675 OLD PORTLAND ROAD | BRUNSWICK | ME | 04011 | NONE | 501(C)(3) | GENERAL FUND | $4,000 |
| MCKENZIE RIVER TRUST | |||||||
| 120 SHELTON MCMURPHEY BLVD STE 270 | EUGENE | OR | 97401 | NONE | 501(C)(3) | GENERAL FUND | $2,500 |
| MEETINGHOUSE CHURCH | |||||||
| 6200 COLONIAL WAY | EDINA | OR | 55436 | NONE | 501(C)(3) | GENERAL FUND | $12,000 |
| MESH | |||||||
| 740 E 17TH ST | MINNEAPOLIS | MN | 55404 | NONE | 501(C)(3) | GENERAL FUND | $2,000 |
| MINNEAPOLIS YOUNG LIFE | |||||||
| PO BOX 390546 | MINNEAPOLIS | MN | 55439 | NONE | 501(C)(3) | GENERAL FUND | $8,000 |
| NICU - RIVERBEND PEACEHEALTH | |||||||
| 123 INTERNATIONAL WAY | SPRINGFIELD | OR | 97477 | NONE | 501(C)(3) | GENERAL FUND | $1,500 |
| OPHELIA'S PLACE | |||||||
| 1577 PEARL ST 100 | EUGENE | OR | 97401 | NONE | 501(C)(3) | GENERAL FUND | $2,550 |
| PARENTING NOW | |||||||
| 86 CENTENNIAL LOOP | EUGENE | OR | 97401 | NONE | 501(C)(3) | GENERAL FUND | $5,000 |
| PORT WASHINGTON MEDICAL CLINIC | |||||||
| 1290 NORTH CO HIGHWAY 395 | SANTA ROSA BEACH | FL | 32459 | NONE | 501(C)(3) | GENERAL FUND | $2,500 |
| RELIEF NURSERY | |||||||
| 1720 W 25TH AVE | EUGENE | OR | 97405 | NONE | 501(C)(3) | GENERAL FUND | $5,000 |
| SALVATION ARMY | |||||||
| 2707 E VAN BUREN STREET | PHOENIX | AZ | 85008 | NONE | 501(C)(3) | GENERAL FUND | $7,500 |
| SCHOOL GARDEN PROJECT OF LANE COUNTY | |||||||
| PO BOX 30072 | EUGENE | OR | 97403 | NONE | 501(C)(3) | GENERAL FUND | $5,000 |
| SHELTERCARE | |||||||
| 499 W 4TH AVENUE | EUGENE | OR | 97401 | NONE | 501(C)(3) | GENERAL FUND | $4,250 |
| SOUTHDALE YMCA | |||||||
| 7355 YORK AVE SOUTH | EDINA | MN | 55435 | NONE | 501(C)(3) | GENERAL FUND | $9,000 |
| ST VINCENT DE PAUL - EGAN WARMING CENTER | |||||||
| PO BOX 24608 | EUGENE | OR | 97402 | NONE | 501(C)(3) | GENERAL FUND | $850 |
| THE NATURE SCHOOL | |||||||
| 78D RICKER AVE | SANTA ROSA BEACH | FL | 32459 | NONE | 501(C)(3) | GENERAL FUND | $5,000 |
| TRAVIS MILLS FOUNDATION | |||||||
| 89 WATER STREET | HALLOWELL | ME | 04347 | NONE | 501(C)(3) | GENERAL FUND | $4,500 |
| TUNNELS TO TOWERS | |||||||
| 2361 HYLAN BOULEVARD | STATEN ISLAND | NY | 10306 | NONE | 501(C)(3) | GENERAL FUND | $8,500 |
| UNITED WAY | |||||||
| 1515 E OSBORN ROAD | PHOENIX | AZ | 85014 | NONE | 501(C)(3) | GENERAL FUND | $2,125 |
| WALTON VERONA SCHOOLS | |||||||
| 30 SCHOOL ROAD | WALTON | KY | 41094 | NONE | 501(C)(3) | GENERAL FUND | $1,500 |
| WATER | |||||||
| PO BOX 5026 | HAGERSTOWN | MD | 21741 | NONE | 501(C)(3) | GENERAL FUND | $500 |
| WORLD VISION | |||||||
| 4325 UPTON AVE S | MINNEAPOLIS | MN | 55410 | NONE | 501(C)(3) | GENERAL FUND | $3,000 |
| YOUTH FRONTIERS | |||||||
| 5215 EDINA INDUSTRIAL BLVD 400 | MINNEAPOLIS | MN | 55439 | NONE | 501(C)(3) | GENERAL FUND | $2,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $315,000 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $94,520 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $2,212,266 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $2,306,786 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $2,306,786 | 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 | BAKER TILLY US, LLP | CategoryTxt |
| Amt | $3,800 | Amt |
| Net Investment Income | $1,900 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $1,900 | DisbursementsCharitablePrpsAmt |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corporate Bonds InvestmentsCorporateBondsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond | SECURITIES HELD AT US BANK | BondNm |
| EOY Book Value | $756,319 | EOYBookValueAmt |
| EOYFMV | $709,716 | EOYFMVAmt |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Stock | SECURITIES HELD AT US BANK | StockNm |
| EOY Book Value | $4,650,488 | EOYBookValueAmt |
| EOYFMV | $4,181,193 | EOYFMVAmt |
Legal Fees Schedule LegalFeesSchedule
Legal Fees LegalFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | LEGAL FEES | CategoryTxt |
| Legal Fees | $683 | LegalFeesAmt |
| Net Investment Income | $342 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $341 | DisbursementsCharitablePrpsAmt |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DIVIDENDS AND SALES RECEIVABLE | Desc |
| BOY Book Value | $1 | BOYBookValueAmt |
| EOY Book Value | $7,120 | EOYBookValueAmt |
| EOYFMV | $7,120 | EOYFMVAmt |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| ABBOT DOWNING MANAGEMENT FEES | $12,249 | $12,249 | $0 |
| OTHER FEES | $3,417 | $3,417 | $0 |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| FOREIGN TAXES | $6,493 | $6,493 | $0 |
| FEDERAL EXCISE TAXES | $8,429 | $0 | $0 |
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