LUTSEY FAMILY FOUNDATION INC: Form 990PF, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- LUTSEY FAMILY FOUNDATION INC (EIN 39-1657029)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-02
- IRS object ID
- 202313069349100836
- 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
- Schedule B
- Accounting Fees Schedule
- Investments Corp Stock Schedule
- Investments Other Schedule2
- Other Assets Schedule
- Other Decreases Schedule
- Other Expenses Schedule
- Other Income Schedule2
- Other Increases Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-02T13:06:43-05:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 200794302 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MBE CPAS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 224700 ZINNIA DRIVE | AddressLine1Txt |
| City | WAUSAU | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54401 | 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 | 391657029 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LUTSEY FAMILY FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LUTS | BusinessNameControlTxt |
| Phone | 9203399823 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6177 KIEHNAU ROAD | AddressLine1Txt |
| City | EGG HARBOR | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54209 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | THOMAS LUTSEY | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 9203399823 | PhoneNum |
| Signature | 2023-11-01 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | THOMAS | PersonFirstNm |
| Person Last | LUTSEY | 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 | CHRIS IVERSON CPA | PreparerPersonNm |
| PTIN | P01293838 | PTIN |
| Phone | 7153554401 | PhoneNum |
| Preparation | 2023-11-01 | 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 | $5,946,772 | FMVAssetsEOYAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rcvd Rev And Expnss | $5,000 | ContriRcvdRevAndExpnssAmt |
| Interest On Sav Rev And Expnss | $1,226 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $1,226 | InterestOnSavNetInvstIncmAmt |
| Dividends Rev And Expnss | $61,626 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $61,626 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $340,537 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $3,531,333 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $340,537 | CapGainNetIncmNetInvstIncmAmt |
| Other Income Rev And Expnss | $112 | OtherIncomeRevAndExpnssAmt |
| Other Income Net Invst Incm | $112 | OtherIncomeNetInvstIncmAmt |
| Other Income Adj Net Incm | $0 | OtherIncomeAdjNetIncmAmt |
| Total Rev And Expnss | $408,501 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $403,501 | 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 | $6,005 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $6,005 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $0 | AccountingFeesAdjNetIncmAmt |
| Accounting Fees Chrtbl Prps | $6,005 | AccountingFeesChrtblPrpsAmt |
| Interest Rev And Expnss | $127 | InterestRevAndExpnssAmt |
| Interest Net Invst Incm | $127 | InterestNetInvstIncmAmt |
| Interest Adj Net Incm | $0 | InterestAdjNetIncmAmt |
| Interest Dsbrs Chrtbl | $0 | InterestDsbrsChrtblAmt |
| Taxes Rev And Expnss | $15,506 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $15,506 | TaxesNetInvstIncmAmt |
| Taxes Adj Net Incm | $0 | TaxesAdjNetIncmAmt |
| Taxes Dsbrs Chrtbl | $15,506 | TaxesDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $6,672 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $6,672 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Adj Net Incm | $0 | OtherExpensesAdjNetIncmAmt |
| Other Expenses Dsbrs Chrtbl | $6,672 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $28,310 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $28,310 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $0 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $28,183 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $287,555 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $287,555 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $315,865 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $28,310 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $0 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $315,738 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $92,636 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $375,191 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $5,238 | CashBOYAmt |
| Cash EOY | $2,408 | CashEOYAmt |
| Cash EOYFMV | $2,408 | CashEOYFMVAmt |
| Sav And Temp Cash Invst BOY | $150,081 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $316,801 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $316,801 | SavAndTempCashInvstEOYFMVAmt |
| US Government Obligations BOY | $84,658 | USGovernmentObligationsBOYAmt |
| US Government Obligations EOY | $0 | USGovernmentObligationsEOYAmt |
| US Govt Obligations EOYFMV | $0 | USGovtObligationsEOYFMVAmt |
| Corporate Stock BOY | $5,385,529 | CorporateStockBOYAmt |
| Corporate Stock EOY | $4,010,361 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $4,010,361 | CorporateStockEOYFMVAmt |
| Corporate Bonds BOY | $40,267 | CorporateBondsBOYAmt |
| Corporate Bonds EOY | $0 | CorporateBondsEOYAmt |
| Corporate Bonds EOYFMV | $0 | CorporateBondsEOYFMVAmt |
| Other Investments BOY | $1,948,349 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $2,655,349 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $1,585,990 | OtherInvestmentsEOYFMVAmt |
| Other Assets BOY | $2,731 | OtherAssetsBOYAmt |
| Other Assets EOY | $31,212 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $31,212 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $7,616,853 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,016,131 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $5,946,772 | TotalAssetsEOYFMVAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
| No Donor Rstr Net Assests BOY | $7,616,853 | NoDonorRstrNetAssestsBOYAmt |
| No Donor Rstr Net Assests EOY | $7,016,131 | NoDonorRstrNetAssestsEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $7,616,853 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $7,016,131 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $7,616,853 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $7,016,131 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $7,616,853 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $92,636 | ExcessRevenueOverExpensesAmt |
| Other Increases | $376,001 | OtherIncreasesAmt |
| Subtotal | $8,085,490 | SubtotalAmt |
| Other Decreases | $1,069,359 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $7,016,131 | 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 |
|---|---|---|---|---|---|---|---|
| MERRILL SHORT TERM COVERED | P | 2021-04-21 | 2022-02-07 | $205,573 | $238,345 | -$32,772 | -$32,772 |
| MERRILL LONG TERM COVERED | P | 2021-10-28 | 2022-12-23 | $1,626,760 | $1,571,700 | $55,060 | $55,060 |
| MERRILL SHORT TERM NONCOVERED | P | 2022-04-20 | 2022-04-20 | $561 | $561 | $0 | $0 |
| MERRILL LONG TERM COVERED | P | 2018-10-17 | 2022-06-23 | $1,063,785 | $791,559 | $272,226 | $272,226 |
| MERRILL LONG TERM NONCOVERED | P | 2010-06-02 | 2022-02-07 | $1,733 | $322 | $1,411 | $1,411 |
| MERRILL SHORT TERM COVERED | P | 2021-12-14 | 2022-05-26 | $27,330 | $25,843 | $1,487 | $1,487 |
| MERRILL LONG TERM COVERED | P | 2020-08-21 | 2022-01-25 | $249,312 | $186,527 | $62,785 | $62,785 |
| MERRILL SHORT TERM COVERED | P | 2021-06-16 | 2022-03-22 | $180,110 | $187,796 | -$7,686 | -$7,686 |
| MERRILL LONG TERM COVERED | P | 2019-12-03 | 2022-03-22 | $176,169 | $188,143 | -$11,974 | -$11,974 |
| P | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $340,537 | CapitalGainNetIncomeAmt |
| Net Short Term Capital Gain Loss | -$38,971 | NetShortTermCapitalGainLossAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $5,215 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $5,215 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $5,215 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $6,520 | 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 | $6,520 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $93 | EsPenaltyAmt |
| Overpayment | $1,212 | OverpaymentAmt |
| Applied To ES Tax | $1,212 | 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 | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (1) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (1) | AtLeast5000InAssetsInd |
| 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 | THOMAS LUTSEY | IndividualWithBooksNm |
| Phone | 9203399823 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6177 KIEHNAU RD | AddressLine1Txt |
| City | EGG HARBOR | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54209 | 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 | Yes (1) | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | 0 | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | 0 | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | 0 | PaymentToGovernmentOfficialInd |
| Acts Fail To Qlfy As Exceptions | 0 | ActsFailToQlfyAsExceptionsInd |
| 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 (6 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 |
|---|---|---|---|---|---|---|---|---|
| THOMAS J LUTSEY | ||||||||
| 6177 KEIHNAU RD | EGG HARBOR | WI | 54209 | PRESIDENT | 1.00 | $0 | $0 | $0 |
| SHARON L LUTSEY | ||||||||
| 6177 KEIHNAU RD | EGG HARBOR | WI | 54209 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| MATTHEW T LUTSEY | ||||||||
| 6177 KEIHNAU RD | EGG HARBOR | WI | 54209 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| JEFFREY K LUTSEY | ||||||||
| 6177 KEIHNAU RD | EGG HARBOR | WI | 54209 | DIRECTOR | 0.00 | $0 | $0 | $0 |
| NICHOLAS P LUTSEY | ||||||||
| 6177 KEIHNAU RD | EGG HARBOR | WI | 54209 | DIRECTOR | 0.00 | $0 | $0 | $0 |
| ANDREW J LUTSEY | ||||||||
| 6177 KEIHNAU RD | EGG HARBOR | WI | 54209 | DIRECTOR | 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 | $4,141,390 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $393,571 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $1,627,856 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $6,162,817 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $6,162,817 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $92,442 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $6,070,375 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $303,519 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $303,519 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $5,215 | TaxBasedOnInvestmentIncomeAmt |
| Income Tax | $10,099 | IncomeTaxAmt |
| Total Tax | $15,314 | TotalTaxAmt |
| Distributable Before Adj | $288,205 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $288,205 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $288,205 | DistributableAsAdjustedAmt |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $315,738 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $315,738 | QualifyingDistributionsAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $288,205 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $285,292 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Total Excess Distribution Cyov | $0 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $315,738 | QualifyingDistributionsAmt |
| Applied To Year1 | $285,292 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $30,446 | 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 | $257,759 | 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
Application Submission Info ApplicationSubmissionInfoGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Person | LUTSEY ENTERPRISES LLP ATTN MATT LU | RecipientPersonNm |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 22074 | AddressLine1Txt |
| City | GREEN BAY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54305 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Phone | 9203399823 | RecipientPhoneNum |
| Form And Info And Materials | NO STANDARD FORM OR APPLICATION PROCESS IS REQUIRED BY THE FOUNDATION. | FormAndInfoAndMaterialsTxt |
| Submission Deadlines | NONE | SubmissionDeadlinesTxt |
| Restrictions On Awards | NONE | RestrictionsOnAwardsTxt |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (30 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|
| BOYS & GIRLS CLUB OF DOOR COUNTY | |||||
| PO BOX 579 | STURGEON BAY | WI | 54235 | SUPPORT FOR ANNUAL OPERATIONS | $18,500 |
| CATHOLIC YOUTH EXPEDITIONS | |||||
| 3035 OBRIEN RD | BAILEYS HARBOR | WI | 54202 | TO FUND PROGRAMS THAT SUPPORT THE ORGANIZATION'S RELIGIOUS BELIEFS | $500 |
| CROSSROADS AT BIG CREEK | |||||
| PO BOX 608 | STURGEON BAY | WI | 54235 | 2021 BREAD PUDDING & BONFIRE SPONSORSHIP | $500 |
| DOOR COUNTY COMMUNITY FOUNDATION INC | |||||
| 222 NORTH THIRD AVENUE | STURGEON BAY | WI | 54235 | 10.2021 PLEDGE DONATION TO DOOR COUNTY COMMUNITY FOUNDATION (YEAR 1 OF 5 YEAR PLEDGE) | $35,100 |
| ENCOMPASS EARLY EDUCATION & CARE | |||||
| PO BOX 1627 | GREEN BAY | WI | 54305 | 2021 WEEKEND FOOD PROGRAM DONATION / ENCOMPASS | $5,000 |
| FEEDING AMERICA EASTERN WISCONSIN | |||||
| 1700 WEST FONDDULAC AVENUE | MILWAUKEE | WI | 53205 | 2021 DONATION TO THE FEEDING AMERICA NE WISCONSIN FARM LINK PROGRAM | $25,000 |
| GOLDEN HOUSE | |||||
| 1120 UNIVERSITY AVENUE | GREEN BAY | WI | 54302 | 2021 DONATION TO THE FEEDING AMERICA NE WISCONSIN FARM LINK PROGRAM | $100,000 |
| GREATER GREEN BAY COMMUNITY FDN INC | |||||
| 400 SOUTH WASHINGTON STREET | GREEN BAY | WI | 54301 | 2022 DONATION FOR THE THOMAS H. LUTSEY-WASEDA FARMS SCHOLARSHIP | $40,000 |
| LAKESHORE CAP INC | |||||
| PO BOX 791 | STURGEON BAY | WI | 54235 | TO SUPPORT HUNGER RELIEF | $1,000 |
| NOTRE DAME ACADEMY | |||||
| 610 MARYHILL DRIVE | GREEN BAY | WI | 54303 | 2021 NORTE DAME OF DEPERE DONATION / STUDENT SUPPORT FOR EDUCATION | $1,500 |
| SYBLE HOPP SCHOOL | |||||
| 755 SCHURING RD | DEPERE | WI | 54115 | YEAR 1 OF 2 YEAR PLEDGE FOR THE SYBLE HOPP CAPITAL CAMPAIGN | $5,000 |
| THE BELLIN HEALTH FOUNDATION | |||||
| PO BOX 23400 | GREEN BAY | WI | 54305 | BELLIN'S MATERNITY/NEONATAL INTENSIVE CARE UNIT (NICU) - 2021 CAPITAL CAMPAIGN DONATION | $25,000 |
| UNIVERSITY OF NEBRASKA FOUNDATION | |||||
| 1010 LINCOLN MALL | LINCOLN | NE | 68508 | UNIVERSITY OF NEBRASKA FOUNDATION - NANCY ARMITAGE PANCREAS CANCER STUDY | $100 |
| ADULT & TEEN CHALLENGE NORTHEASTERN WISCONSIN | |||||
| 1460 SHAWANO AVENUE | GREEN BAY | WI | 54301 | TO ASSIST TEENS & ADULTS IN GAINING FREEDOM FROM CHEMICAL ADDICTIONS AND OTHER LIFE CONTROLLING PROBLEMS BY ADDRESSING THEIR PHYSICAL, EMOTIONAL & SPIRITUAL NEEDS. | $2,000 |
| AMERICAN HEART ASSOCIATION | |||||
| 7272 GREENVILLE AVENUE | DALLAS | TX | 75231 | STROKE RESEARCH | $100 |
| AUTISM SOCIETY OF GREATER WISCONSIN | |||||
| 1477 KENWOOD DRIVE | MENASHA | WI | 54952 | CREATE CONNECTIONS, EMPOWERING EVERYONE IN THE AUTISM COMMUNITY WITH THE RESOURCES NEEDED TO LIVE FULLY | $1,000 |
| BOYS & GIRLS CLUB OF GREEN BAY | |||||
| 1451 UNIVERSITY AVENUE | GREEN BAY | WI | 54302 | ENGAGE AND MEET THE UNIQUE NEEDS OF GREATER GREEN BAY AREA YOUTH SO THEY MAY ACHIEVE ACADEMIC SUCCESS, DEMONSTRATE GOOD CHARAGTER AND CITIZENSHIP, AND LIVE A HEALTHY LIFESTYLE | $100 |
| CASA OF BROWN COUNTY | |||||
| 414 EAST WALNUT ST | GREEN BAY | WI | 54301 | PROVIDE A VOICE FOR ABUSED AND NEGLECTED CHILDREN WHO ARE UNDER THE LEGAL PROTECTION OF THE COURT SYSTEM. | $3,834 |
| DOOR CANCER | |||||
| PO BOX 423 | STURGEON BAY | WI | 54235 | ALLEVIATE SUFFERING THROUGH MENTARY AID FOR FAMILIES BATTLING THE FINANCIAL DRAIN OF CANCER DIAGNOSIS | $1,000 |
| DOOR COUNTY ECONOMIC DEVELOPMENT CORPORATION | |||||
| 185 EAST WALNUT ST | STURGEON BAY | WI | 54235 | HELP BUILD SUCCESSFUL BUSINESSES | $200 |
| DOOR COUNTY YMCA | |||||
| 1900 MICHIGAN ST | STURGEON BAY | WI | 54235 | ENGAGE AND CONNECT ALL PEOPLE IN PURSUIT OF WELL-BEING AND A VIBRANT, HEALTHY, AND WELCOMING COMMUNITY | $1,000 |
| FRIENDS OF STURGEON BAY SCHOOL | |||||
| 1230 MICHIGAN ST | STURGEON BAY | WI | 54235 | PROVIDE FRESH PRODUCE IN SCHOOL MENUE AND SALAD FOOD BOXES | $1,571 |
| GREATER CHICAGO FOOD DEPOSITORY | |||||
| 4100 WEST ANN LURIE PLACE | CHICAGO | IL | 60632 | DISTRIBUTE NUTRITIOUS FOOD TO A NETWORK OF FOOD PANTRIES, SOUP KITCHENS, AND SHELTERS TO FEED HUNGRY PEOPLE IN CHICAGO | $2,500 |
| GREATER GREEN BAY YMCA | |||||
| 235 JEFFERSON ST | GREEN BAY | WI | 54301 | PUT CHRISTIAN PRICIPLES INTO PRACTICE THROUGH PROGRAMS THAT BUILD HEALTHY SPIRIT, MIND, AND BODY FOR ALL | $5,500 |
| NEW COMMUNITY SHELTER | |||||
| 301 MATHER ST | GREEN BAY | WI | 54303 | EMERGENCY SHELTER IN BROWN COUNTY THAT SERVES HOMELESS ADULT MEN AND WOMEN. | $500 |
| NOTRE DAME OF DEPERE | |||||
| 137 SOUTH SUPERIOR ST | DEPERE | WI | 54115 | PROVIDES CATHOLIC EDUCATION THAT GUIDES EACH STUDENT TO CONFIDENTLY PURSUE THEIR ACADEMIC POTENTIAL, DEVELOP A STROM MORAL COMPASS, AND FORM A GROWING RELATIONSHIP WITH GOD | $4,200 |
| PBS WISCONSIN FRIENDS | |||||
| PO BOX 7929 | MADISON | WI | 53707 | 2022 DONATION AND WISCONSIN PROGRAMS FUND DRIVE | $300 |
| RIDGES SANCTUARY | |||||
| PO BOX 152 | BAILEYS HARBOR | WI | 54202 | FESTIVAL OF NATURE SPONSORSHIP | $2,500 |
| SAWYER BENEFIT | |||||
| 6177 KIEHNAU ROAD | EGG HARBOR | WI | 54209 | DONATIONS | $50 |
| UNITED METHODIST CHURCH OF STURGEON BAY | |||||
| 836 MICHIGAN ST | STURGEON BAY | WI | 54235 | DONATION | $4,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $287,555 | 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 | $1,226 | ExclusionAmt |
Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $61,626 | ExclusionAmt |
Other Investment Income OtherInvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $112 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $340,537 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $403,501 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $403,501 | 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 |
Schedule B IRS990ScheduleB
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| General Rule | Yes (X) | GeneralRuleInd |
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | 1 | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANNONYMOUS | BusinessNameLine1Txt |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6177 KIEHNAU ROAD | AddressLine1Txt |
| City | EGG HARBOR | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54209 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | $5,000 | TotalContributionsAmt |
| Person Contribution | Yes (X) | PersonContributionInd |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | ACCOUNTING | CategoryTxt |
| Amt | $6,005 | Amt |
| Net Investment Income | $6,005 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $6,005 | DisbursementsCharitablePrpsAmt |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp (3 entries)
| StockStockNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| ML #2176 CORE EQUITIES | $1,706,783 | $1,706,783 |
| ML #2017 PRIVATE EQUITIES | $1,423,459 | $1,423,459 |
| ML #2184 DIVIDEND GROWTH | $880,119 | $880,119 |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (11 entries)
| Category Or ItemCategoryOrItemTxt | Listed At Cost Or FMVListedAtCostOrFMVCd | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| ML #2278 BLACKSTONE ALTERNATIVES SOLUTION 2014 TRUST | AT COST | $262,500 | $69,789 |
| ML #2278 BREP EUROPE IV REAL ESTATE FUND | AT COST | $231,250 | $49,849 |
| ML #2278 CRESCENT VI MEZZANINE | AT COST | $279,750 | $38,892 |
| ML #2278 BLACKSTONE ALTERNATIVES SOLUTION IV FUND | AT COST | $306,250 | $289,065 |
| ML #2278 BLACKSTONE ALTERNATIVES SOLUTION V FUND | AT COST | $232,500 | $284,783 |
| GREEN BAY PACKER SUPER BOWL RING | AT COST | $20,000 | $20,000 |
| ML #2278 ACP POWER AND ENERGY REAL ASSET FUND | AT COST | $354,750 | $1,949 |
| ML #2278 LS REAL ESTATE RECOVERY IV TRUST | AT COST | $226,349 | $70,959 |
| ML #2278 BX STRATEGIC PARTNERS | AT COST | $72,000 | $83,450 |
| ML #2278 BLACKSTONE REAL ESTATE | AT COST | $335,000 | $342,993 |
| ML #2278 PARTNERS GROUP | AT COST | $335,000 | $334,261 |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp (2 entries)
| DescDesc | BOY Book ValueBOYBookValueAmt | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| PREPAID INCOME TAX | $2,731 | $1,212 | $1,212 |
| DIRECTOR/OFFICER RECEIVABLE | $0 | $30,000 | $30,000 |
Other Decreases Schedule OtherDecreasesSchedule
Other Decreases Detail OtherDecreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | UNREALIZED GAINS/LOSSES | Desc |
| Amt | $1,069,359 | Amt |
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 |
|---|---|---|---|---|
| BANK SERVICE CHARGES | $508 | $508 | $0 | $508 |
| OUTSIDE SERVICES | $6,164 | $6,164 | $0 | $6,164 |
Other Income Schedule2 OtherIncomeSchedule2
Other Income Detail OtherIncomeDetail (2 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt |
|---|---|---|---|
| MERRIL LYNCH CAP GAIN DISTRIBUTION | $91 | $91 | $0 |
| MERRIL LYNCH SEC 1250 GAIN | $21 | $21 | $0 |
Other Increases Schedule OtherIncreasesSchedule
Other Increases Detail OtherIncreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PRIOR PERIOD ADJUSTMENT | Desc |
| Amt | $376,001 | Amt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|---|
| FOREIGN TAX PAID | $2,710 | $2,710 | $0 | $2,710 |
| INCOME TAXES | $12,796 | $12,796 | $0 | $12,796 |
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