DOUGLAS C AND LYNN M ROBERTS FAMILY FOUNDATION: Form 990PF, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- DOUGLAS C AND LYNN M ROBERTS FAMILY FOUNDATION (EIN 37-6421756)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-05-12
- IRS object ID
- 202341329349100429
- 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
- All Oth Prog Rltd Investments Sch
- Investments Corp Bonds Schedule
- Investments Corp Stock Schedule
- Investments Govt Obligations Sch
- Investments Other Schedule2
- Other Expenses Schedule
- Other Income Schedule2
- Other Increases Schedule
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-12T15:03:03-05:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 134008324 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRICEWATERHOUSECOOPERS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 NORTH WACKER DR | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 606062807 | 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 | 376421756 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOUGLAS C & LYNN M ROBERTS | BusinessNameLine1Txt |
| Business Name Line2 | FAMILY FOUNDATION | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DOUG | BusinessNameControlTxt |
| Phone | 8158952921 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 218 | AddressLine1Txt |
| City | SYCAMORE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 601780218 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DOUGLAS C ROBERTS | PersonNm |
| Person Title | GRANTOR | PersonTitleTxt |
| Phone | 8158952921 | PhoneNum |
| Signature | 2023-05-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DOUGLAS | PersonFirstNm |
| Person Last | ROBERTS | 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 | SHERYL EIGHNER | PreparerPersonNm |
| PTIN | P00965775 | PTIN |
| Phone | 3122982000 | PhoneNum |
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 | $4,381,145 | 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 | $58,259 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $58,259 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $159,091 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $354,140 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $159,091 | CapGainNetIncmNetInvstIncmAmt |
| Other Income Rev And Expnss | $1,358 | OtherIncomeRevAndExpnssAmt |
| Other Income Net Invst Incm | $1,358 | OtherIncomeNetInvstIncmAmt |
| Other Income Adj Net Incm | $0 | OtherIncomeAdjNetIncmAmt |
| Total Rev And Expnss | $218,708 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $218,708 | 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 | $4,250 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $4,250 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $0 | AccountingFeesAdjNetIncmAmt |
| Accounting Fees Chrtbl Prps | $0 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Rev And Expnss | $12,805 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $12,805 | OtherProfFeesNetInvstIncmAmt |
| Other Prof Fees Adj Net Incm | $0 | OtherProfFeesAdjNetIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $0 | OtherProfFeesDsbrsChrtblAmt |
| Taxes Rev And Expnss | $20,631 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $2,795 | TaxesNetInvstIncmAmt |
| Taxes Adj Net Incm | $0 | TaxesAdjNetIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $46 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $31 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Adj Net Incm | $0 | OtherExpensesAdjNetIncmAmt |
| Other Expenses Dsbrs Chrtbl | $0 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $37,732 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $19,881 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $0 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $0 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $275,449 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $275,449 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $313,181 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $19,881 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $0 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $275,449 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$94,473 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $198,827 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $176,993 | CashBOYAmt |
| Cash EOY | $70,846 | CashEOYAmt |
| Cash EOYFMV | $70,846 | CashEOYFMVAmt |
| US Government Obligations BOY | $557,022 | USGovernmentObligationsBOYAmt |
| US Government Obligations EOY | $573,379 | USGovernmentObligationsEOYAmt |
| US Govt Obligations EOYFMV | $489,464 | USGovtObligationsEOYFMVAmt |
| Corporate Stock BOY | $3,048,337 | CorporateStockBOYAmt |
| Corporate Stock EOY | $3,004,974 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $3,409,986 | CorporateStockEOYFMVAmt |
| Corporate Bonds BOY | $281,831 | CorporateBondsBOYAmt |
| Corporate Bonds EOY | $295,170 | CorporateBondsEOYAmt |
| Corporate Bonds EOYFMV | $276,845 | CorporateBondsEOYFMVAmt |
| Other Investments BOY | $156,593 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $184,377 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $134,004 | OtherInvestmentsEOYFMVAmt |
| Total Assets BOY | $4,220,776 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,128,746 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $4,381,145 | 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 | $4,220,776 | RetainedEarningBOYAmt |
| Retained Earning EOY | $4,128,746 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $4,220,776 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $4,128,746 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $4,220,776 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $4,128,746 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $4,220,776 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$94,473 | ExcessRevenueOverExpensesAmt |
| Other Increases | $2,443 | OtherIncreasesAmt |
| Subtotal | $4,128,746 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $4,128,746 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (6 entries)
| PropertyPropertyDesc | How AcquiredHowAcquiredCd | AcquiredAcquiredDt | SoldSoldDt | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt |
|---|---|---|---|---|---|---|---|
| 431 SHS OF MFO LITMAN GREGORY FDS TR PARTNERSELECT INTERNATIONAL | P | 2021-12-21 | 2022-08-15 | $6,903 | $8,101 | -$1,198 | -$1,198 |
| 807 SHS OF MFO VANGUARD FENWAY FDS PRIMECAP | P | 2021-12-20 | 2022-08-15 | $25,000 | $25,945 | -$945 | -$945 |
| 434 SHS OF MFO SEQUOIA FD INC | P | 2022-01-01 | 2022-08-16 | $62,415 | $80,412 | -$17,997 | -$17,997 |
| 5815 SHS OF MFO LITMAN GREGORY FDS TR RTNERSELECT INTERNATIONAL | P | 2021-01-01 | 2022-08-15 | $93,097 | $64,138 | $28,959 | $28,959 |
| 87 SHS OF MFO SEQUOIA FD | P | 2021-01-01 | 2022-08-16 | $12,573 | $16,453 | -$3,880 | -$3,880 |
| CAPITAL GAINS DIVIDENDS | P | $154,152 | $154,152 | $154,152 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $159,091 | CapitalGainNetIncomeAmt |
| Net Short Term Capital Gain Loss | -$20,140 | NetShortTermCapitalGainLossAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $2,764 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $2,764 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $2,764 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $12,000 | 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 | $12,000 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Overpayment | $9,236 | OverpaymentAmt |
| Applied To ES Tax | $9,236 | 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 | IL | 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 | DOUGLAS C ROBERTS | IndividualWithBooksNm |
| Phone | 8158952921 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 218 | AddressLine1Txt |
| City | SYCAMORE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 601780218 | 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 (2 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 |
|---|---|---|---|---|---|---|---|---|
| DOUGLAS C ROBERTS | ||||||||
| PO BOX 218 | SYCAMORE | IL | 601780218 | GRANTOR/TRUSTEE | 0.00 | $0 | $0 | $0 |
| LYNN M ROBERTS | ||||||||
| PO BOX 218 | SYCAMORE | IL | 601780218 | CHARITABLE CONSULTANT | 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) |
|---|---|---|
| Description1 | NONE | Description1Txt |
| Expenses1 | $0 | Expenses1Amt |
| All Other Program Rltd Invst Tot | $0 | AllOtherProgramRltdInvstTotAmt |
| Total | $0 | TotalAmt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $4,718,690 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $117,913 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $4,836,603 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $4,836,603 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $72,549 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $4,764,054 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $238,203 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $238,203 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $2,764 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $2,764 | TotalTaxAmt |
| Distributable Before Adj | $235,439 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $235,439 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $235,439 | DistributableAsAdjustedAmt |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $275,449 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $275,449 | QualifyingDistributionsAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $235,439 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $275,346 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Total Excess Distribution Cyov | $0 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $275,449 | QualifyingDistributionsAmt |
| Applied To Year1 | $275,346 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $103 | 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 | $235,336 | 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 (10 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|
| BOCA GRANDE HEALTH CLINIC FOUNDATION | ||||||
| 280 PARK AVE | BOCA GRANDE | FL | 33921 | NONE | TO FURTHER THE MISSION OF THE DONEE | $1,000 |
| CASA DEKALB COUNTY | ||||||
| 407 WEST STATE STREET 6 | SYCAMORE | IL | 60178 | NONE | TO FURTHER THE MISSION OF THE DONEE | $1,000 |
| CHARLOTTE COMMUNITY FOUNDATION INC | ||||||
| 227 SULLIVAN ST | PUNTA GORDA | FL | 33950 | NONE | TO FURTHER THE MISSION OF THE DONEE | $15,000 |
| COLLABORATORY | ||||||
| 18283 HARVARD BLVD | GARDENA | CA | 90248 | NONE | TO FURTHER THE MISSION OF THE DONEE | $15,000 |
| DEKALB COUNTY COMMUNITY FOUNDATION | ||||||
| 475 DEKALB AVE | SYCAMORE | IL | 60178 | NONE | TO FURTHER THE MISSION OF THE DONEE | $13,900 |
| DEKALB COUNTY HISTORY CENTER | ||||||
| 1730 N MAIN ST | SYCAMORE | IL | 60178 | NONE | TO FURTHER THE MISSION OF THE DONEE | $55,249 |
| KISHWAUKEE FAMILY YMCA | ||||||
| 2500 BETHANY RD | SYCAMORE | IL | 60178 | NONE | TO FURTHER THE MISSION OF THE DONEE | $10,000 |
| NORTHERN ILLINOIS FOOD BANK | ||||||
| 273 DEARBORN COURT | GENEVA | IL | 60134 | NONE | TO FURTHER THE MISSION OF THE DONEE | $5,000 |
| NORTHWESTERN MEMORIAL FOUNDATION | ||||||
| 251 E HURON ST | CHICAGO | IL | 60611 | NONE | TO FURTHER THE MISSION OF THE DONEE | $100,000 |
| OPPORTUNITY HOUSE | ||||||
| 357 N CALIFORNIA ST | SYCAMORE | IL | 60178 | NONE | TO FURTHER THE MISSION OF THE DONEE | $59,300 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $275,449 | 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 | $58,259 | ExclusionAmt |
Other Investment Income OtherInvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $1,358 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $159,091 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $218,708 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $218,708 | TotalIncomeProducingActyAmt |
Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp
Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Line Number | 1 | LineNumberTxt |
| Relationship Statement | N/A | RelationshipStatementTxt |
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 | PRICEWATERHOUSECOOPERS LLP | CategoryTxt |
| Amt | $4,250 | Amt |
| Net Investment Income | $4,250 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
All Oth Prog Rltd Investments Sch AllOthProgRltdInvestmentsSch
All Other Program Related Invst AllOtherProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NONE | Desc |
| Amt | $0 | Amt |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corporate Bonds InvestmentsCorporateBondsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond | CORPORATE BONDS | BondNm |
| EOY Book Value | $295,170 | EOYBookValueAmt |
| EOYFMV | $276,845 | EOYFMVAmt |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Stock | CORPORATE STOCK | StockNm |
| EOY Book Value | $3,004,974 | EOYBookValueAmt |
| EOYFMV | $3,409,986 | EOYFMVAmt |
Investments Govt Obligations Sch InvestmentsGovtObligationsSch
| Field | Value | IRS element (for citing) |
|---|---|---|
| US Govt Obligations Book Vl EOY | $573,379 | USGovtObligationsBookVlEOYAmt |
| US Govt Obligations EOYFMV | $489,464 | USGovtObligationsEOYFMVAmt |
| State Local Sec Book Vl EOY | $0 | StateLocalSecBookVlEOYAmt |
| State Local Sec EOYFMV | $0 | StateLocalSecEOYFMVAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category Or Item | INVESTMENTS - REAL ESTATE | CategoryOrItemTxt |
| Listed At Cost Or FMV | AT COST | ListedAtCostOrFMVCd |
| Book Value | $184,377 | BookValueAmt |
| EOYFMV | $134,004 | EOYFMVAmt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (2 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|---|
| IL CHARITY BUREAU REPORT FEE | $15 | $0 | $0 | $0 |
| OLD NATIONAL BANK SERVICE CHARGES | $31 | $31 | $0 | $0 |
Other Income Schedule2 OtherIncomeSchedule2
Other Income Detail OtherIncomeDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NORTHERN TRUST - OTHER INCOME | Desc |
| Revenue And Expenses Per Books | $1,358 | RevenueAndExpensesPerBooksAmt |
| Net Investment Income | $1,358 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
Other Increases Schedule OtherIncreasesSchedule
Other Increases Detail OtherIncreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCREASES/DECREASES | Desc |
| Amt | $2,443 | Amt |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | NORTHERN TRUST | CategoryTxt |
| Amt | $12,805 | Amt |
| Net Investment Income | $12,805 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (3 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|---|
| 2022 FEDERAL ES PAYMENTS | $12,000 | $0 | $0 | $0 |
| FOREIGN TAXES | $2,795 | $2,795 | $0 | $0 |
| 2021 BALANCE | $5,836 | $0 | $0 | $0 |
Comments