ARTHUR C CHAFEE TR 1013002786: Form 990PF, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- ARTHUR C CHAFEE TR 1013002786 (EIN 56-6089459)
- Tax period
- 2020-10-01 to 2021-09-30
- Filed
- 2022-02-10
- IRS object ID
- 202200419349101200
- Schema version
- 2020v4.1
- 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 Other Schedule2
- Other Decreases Schedule
- Other Expenses Schedule
- Other Increases Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-02-10T09:00:15-06:00 | ReturnTs |
| Tax Period End | 2021-09-30 | 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 | 301 GRANT STREET 45TH FLOOR | AddressLine1Txt |
| City | PITTSBURGH | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 15219 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2020-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 566089459 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ARTHUR C CHAFFEE TRUST | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHAF | BusinessNameControlTxt |
| Phone | 8887304933 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6325 S RAINBOW BLVD STE 300 | AddressLine1Txt |
| City | LAS VEGAS | CityNm |
| State Abbreviation | NV | StateAbbreviationCd |
| ZIP | 89118 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | - | PersonNm |
| Person Title | TRUSTEE | PersonTitleTxt |
| Phone | 8887304933 | PhoneNum |
| Signature | 2021-12-22 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOSEPH J CASTRIANO | PreparerPersonNm |
| PTIN | P01251603 | PTIN |
| Phone | 4123556000 | PhoneNum |
| Preparation | 2021-12-22 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | TrustedCustomerGrp |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization4947a1 Trtd PF | Yes (X) | Organization4947a1TrtdPFInd |
| FMV Assets EOY | $4,685,159 | FMVAssetsEOYAmt |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Dividends Rev And Expnss | $110,222 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $110,222 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $558,322 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $3,869,127 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $558,322 | CapGainNetIncmNetInvstIncmAmt |
| Net ST Capital Gain Adj Net Incm | $0 | NetSTCapitalGainAdjNetIncmAmt |
| Total Rev And Expnss | $668,544 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $668,544 | TotalNetInvstIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $53,187 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $47,868 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $5,319 | CompOfcrDirTrstDsbrsChrtblAmt |
| Oth Empl Slrs Wgs Net Invst Incm | $0 | OthEmplSlrsWgsNetInvstIncmAmt |
| Oth Empl Slrs Wgs Adj Net Incm | $0 | OthEmplSlrsWgsAdjNetIncmAmt |
| Oth Empl Slrs Wgs Dsbrs Chrtbl | $0 | OthEmplSlrsWgsDsbrsChrtblAmt |
| Pension Empl Bnft Net Invst Incm | $0 | PensionEmplBnftNetInvstIncmAmt |
| Pension Empl Bnft Adj Net Incm | $0 | PensionEmplBnftAdjNetIncmAmt |
| Legal Fees Dsbrs Chrtbl | $0 | LegalFeesDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $1,056 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $0 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $0 | AccountingFeesAdjNetIncmAmt |
| Accounting Fees Chrtbl Prps | $1,056 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Dsbrs Chrtbl | $0 | OtherProfFeesDsbrsChrtblAmt |
| Interest Dsbrs Chrtbl | $0 | InterestDsbrsChrtblAmt |
| Taxes Rev And Expnss | $8,615 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $760 | TaxesNetInvstIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Deprec And Dpltn Rev And Expnss | $0 | DeprecAndDpltnRevAndExpnssAmt |
| Deprec And Dpltn Net Invst Incm | $0 | DeprecAndDpltnNetInvstIncmAmt |
| Trav Conf Meeting Net Invst Incm | $0 | TravConfMeetingNetInvstIncmAmt |
| Trav Conf Meeting Adj Net Incm | $0 | TravConfMeetingAdjNetIncmAmt |
| Printing And Pub Net Invst Incm | $0 | PrintingAndPubNetInvstIncmAmt |
| Printing And Pub Adj Net Incm | $0 | PrintingAndPubAdjNetIncmAmt |
| Other Expenses Rev And Expnss | $20 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Dsbrs Chrtbl | $20 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $62,878 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $48,628 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $0 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $6,395 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $195,000 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $195,000 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $257,878 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $48,628 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $0 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $201,395 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $410,666 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $619,916 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $1,157 | CashBOYAmt |
| Sav And Temp Cash Invst BOY | $52,243 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $100,520 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $100,520 | SavAndTempCashInvstEOYFMVAmt |
| Acct Rcvbl EOY | $0 | AcctRcvblEOYAmt |
| Acct Rcvbl EOYFMV | $0 | AcctRcvblEOYFMVAmt |
| Other Rcvbl Allwnc Dbtfl Acct | $0 | OtherRcvblAllwncDbtflAcctAmt |
| Other Investments BOY | $3,763,796 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $4,127,554 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $4,584,639 | OtherInvestmentsEOYFMVAmt |
| Total Assets BOY | $3,817,196 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,228,074 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $4,685,159 | TotalAssetsEOYFMVAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
| Capital Stock BOY | $3,817,196 | CapitalStockBOYAmt |
| Capital Stock EOY | $4,228,074 | CapitalStockEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $3,817,196 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $4,228,074 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $3,817,196 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $4,228,074 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $3,817,196 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $410,666 | ExcessRevenueOverExpensesAmt |
| Other Increases | $214 | OtherIncreasesAmt |
| Subtotal | $4,228,076 | SubtotalAmt |
| Other Decreases | $2 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $4,228,074 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (80 entries)
| PropertyPropertyDesc | SoldSoldDt | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt | AcquiredAcquiredDt | How AcquiredHowAcquiredCd |
|---|---|---|---|---|---|---|---|
| 5491.536 FIDELITY NEW MRKTS INC-Z #3323 | 2021-01-25 | $81,769 | $81,367 | $402 | $402 | ||
| 523. ISHARES CORE S&P TOTAL U.S. ETF | 2021-01-25 | $46,567 | $35,149 | $11,418 | $11,418 | 2019-09-26 | |
| 2907. ISHARES CORE U.S. AGGREGATE ETF | 2021-01-25 | $341,500 | $327,721 | $13,779 | $13,779 | ||
| 57. ISHARES CORE U.S. AGGREGATE ETF | 2021-01-25 | $6,696 | $6,509 | $187 | $187 | 2020-02-13 | |
| 1788. ISHARES S&P MID-CAP 400 GROWTH | 2021-01-25 | $138,166 | $83,841 | $54,325 | $54,325 | 2017-01-26 | |
| 399. ISHARES RUSSELL 2000 ETF | 2021-01-25 | $85,321 | $63,630 | $21,691 | $21,691 | 2018-01-24 | |
| 1282. ISHARES S&P MID-CAP 400 VALUE | 2021-01-25 | $116,490 | $95,347 | $21,143 | $21,143 | 2017-01-26 | |
| 16802. PRINCIPAL HIGH YIELD-R6 #4264 | 2021-01-25 | $121,646 | $119,126 | $2,520 | $2,520 | 2019-10-09 | |
| 847.819 PRINCIPAL HIGH YIELD-R6 #4264 | 2021-01-25 | $6,138 | $6,096 | $42 | $42 | 2020-02-14 | |
| 4304.404 JAMES ALPHA GL REAL EST-I | 2021-01-25 | $74,552 | $85,615 | -$11,063 | -$11,063 | 2020-02-14 | |
| 1097. HEALTH CARE SELECT SECTOR | 2021-01-25 | $129,377 | $76,044 | $53,333 | $53,333 | 2017-01-26 | |
| 1004. CONSUMER STAPLES SECTOR SPDR TR | 2021-01-25 | $65,924 | $53,503 | $12,421 | $12,421 | ||
| 41. AMEX INDUSTRIAL SPDR | 2021-01-25 | $3,599 | $3,486 | $113 | $113 | 2020-02-13 | |
| 1453. AMEX INDUSTRIAL SPDR | 2021-01-25 | $127,558 | $94,816 | $32,742 | $32,742 | ||
| 547. AMEX TECHNOLOGY SELECT SPDR | 2021-01-25 | $73,094 | $27,684 | $45,410 | $45,410 | 2017-01-26 | |
| 19155.658 TCW EMRG MKTS INCM-I 4721 | 2021-01-25 | $161,099 | $153,414 | $7,685 | $7,685 | ||
| 491.145 TCW EMRG MKTS INCM-I 4721 | 2021-01-25 | $4,131 | $4,248 | -$117 | -$117 | 2020-02-14 | |
| 3799. VANGUARD INTERMEDIATE TERM B | 2021-01-25 | $350,619 | $315,334 | $35,285 | $35,285 | ||
| 6716. VANGUARD FTSE DEVELOPED ETF | 2021-01-25 | $325,340 | $257,328 | $68,012 | $68,012 | ||
| 153. VANGUARD FTSE DEVELOPED ETF | 2021-01-25 | $7,412 | $6,732 | $680 | $680 | 2020-02-13 | |
| 1957. VANGUARD FTSE EMERGING MARKETS ETF | 2021-01-25 | $105,670 | $74,470 | $31,200 | $31,200 | 2017-01-26 | |
| 4239. GOLDMAN SACHS ACTIVEBETA INT ETF | 2021-02-11 | $140,203 | $138,534 | $1,669 | $1,669 | 2021-01-25 | |
| 2052. ISHARES EDGE MSCI MIN VOL US ETF | 2021-02-11 | $139,246 | $139,803 | -$557 | -$557 | 2021-01-25 | |
| 2380. ISHARES MSCI USA QUALITY FAC ETF | 2021-02-11 | $284,088 | $252,146 | $31,942 | $31,942 | ||
| 1046. AMEX TECHNOLOGY SELECT SPDR | 2021-02-11 | $144,158 | $52,938 | $91,220 | $91,220 | 2017-01-26 | |
| 531. VANGUARD MIDCAP VIPER | 2021-02-11 | $117,773 | $113,372 | $4,401 | $4,401 | 2021-01-25 | |
| 501. PIMCO COMMODITY REAL RET STRAT-I45 | 2021-02-12 | $3,236 | $3,081 | $155 | $155 | 2021-01-26 | |
| 111. ISHARES CORE S&P TOTAL U.S. ETF | 2021-03-29 | $10,138 | $10,158 | -$20 | -$20 | 2021-02-11 | |
| 34075. PGIM HIGH YIELD-Q 1067 | 2021-03-29 | $187,753 | $188,776 | -$1,023 | -$1,023 | 2021-01-26 | |
| 105. VANGUARD DIVIDEND APPRECIATION | 2021-03-29 | $15,496 | $14,827 | $669 | $669 | 2021-01-25 | |
| 46. VANGUARD MIDCAP VIPER | 2021-03-29 | $10,185 | $9,821 | $364 | $364 | 2021-01-25 | |
| 336. ISHARES CORE S&P TOTAL U.S. ETF | 2021-06-08 | $32,783 | $30,747 | $2,036 | $2,036 | 2021-02-11 | |
| 87. VANGUARD MIDCAP VIPER | 2021-06-08 | $20,548 | $18,575 | $1,973 | $1,973 | 2021-01-25 | |
| 160. GOLDMAN ACTIVEBETA US LC ETF | 2021-07-28 | $14,133 | $12,708 | $1,425 | $1,425 | 2021-02-11 | |
| 315. ISHARES CORE S&P TOTAL U.S. ETF | 2021-07-28 | $31,685 | $28,826 | $2,859 | $2,859 | 2021-02-11 | |
| 38. ISHARES CORE U.S. AGGREGATE ETF | 2021-07-28 | $4,417 | $4,443 | -$26 | -$26 | 2021-02-11 | |
| 1081. ISHARES CORE U.S. AGGREGATE ETF | 2021-07-28 | $125,644 | $120,114 | $5,530 | $5,530 | ||
| 383. ISHARES RUSSELL 2000 ETF | 2021-07-28 | $84,078 | $86,882 | -$2,804 | -$2,804 | 2021-02-11 | |
| 105. VANGUARD DIVIDEND APPRECIATION | 2021-07-28 | $16,666 | $13,672 | $2,994 | $2,994 | 2020-02-13 | |
| 468. VANGUARD MIDCAP VIPER | 2021-07-28 | $111,705 | $99,922 | $11,783 | $11,783 | 2021-01-25 | |
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P | |||||
| CAPITAL GAIN DIVIDENDS | $2,524 | P |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $558,322 | CapitalGainNetIncomeAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $8,617 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $8,617 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $8,617 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $4,856 | EstimatedPlusOvpmtIncmTxAmt |
| Exempt Frgn Org Tax Wthld At Srce | $0 | ExemptFrgnOrgTaxWthldAtSrceAmt |
| Extsn Request Income Tax Paid | $0 | ExtsnRequestIncomeTaxPaidAmt |
| Total Payments And Credits | $4,856 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Tax Due | $3,761 | TaxDueAmt |
| Applied To ES Tax | $0 | AppliedToESTaxAmt |
| Refund | $0 | RefundAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | false | LegislativePoliticalActyInd |
| More Than100 Spent | false | MoreThan100SpentInd |
| Form1120 POL Filed | false | Form1120POLFiledInd |
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | false | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (true) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (true) | AtLeast5000InAssetsInd |
| Org Report Or Register State | NC | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (true) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | false | PrivateOperatingFoundationInd |
| New Substantial Contributors | false | NewSubstantialContributorsInd |
| Own Controlled Entity | false | OwnControlledEntityInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (true) | ComplyWithPublicInspRqrInd |
| Website Address | N/A | WebsiteAddressTxt |
Persons With Books Name PersonsWithBooksName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLS FARGO BANK NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8887304933 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 N MAIN ST MAC D4001-117 | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| NECT Filing In Lieu OF Form1041 | Yes (X) | NECTFilingInLieuOFForm1041Ind |
| Foreign Accounts Question | false | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | false | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | false | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | false | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | Yes (true) | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | false | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | false | PaymentToGovernmentOfficialInd |
| Acts Fail To Qlfy As Exceptions | false | ActsFailToQlfyAsExceptionsInd |
| Uncorrected Prior Acts | false | UncorrectedPriorActsInd |
| Undistributed Income PY | false | UndistributedIncomePYInd |
| Business Holdings | false | BusinessHoldingsInd |
| Jeopardy Investments | false | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | false | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | false | InfluenceLegislationInd |
| Influence Election | false | InfluenceElectionInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Noncharitable Purpose | false | NoncharitablePurposeInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | WELLS FARGO BANK N A | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 N MAIN ST MAC D4001-117 | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Title | TRUSTEE | TitleTxt |
| Average Hrs Per Wk Devoted To Pos | 1 | AverageHrsPerWkDevotedToPosRt |
| Compensation | $53,187 | CompensationAmt |
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Summary Of Direct Chrtbl Acty | SummaryOfDirectChrtblActyGrp | |
| Sum Of Program Related Invst | SumOfProgramRelatedInvstGrp |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $4,514,572 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $101,074 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $4,615,646 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $4,615,646 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $69,235 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $4,546,411 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $227,321 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $227,321 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $8,617 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $8,617 | TotalTaxAmt |
| Distributable Before Adj | $218,704 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $218,704 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $218,704 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $201,395 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Charitable Assets Acquis Paid | $0 | CharitableAssetsAcquisPaidAmt |
| Set Aside Suitability Test | $0 | SetAsideSuitabilityTestAmt |
| Set Aside Cash Distri Test | $0 | SetAsideCashDistriTestAmt |
| Qualifying Distributions | $201,395 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $0 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $201,395 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $218,704 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $193,831 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr5 | $0 | ExcessDistributionCyovYr5Amt |
| Excess Distribution Cyov Yr4 | $0 | ExcessDistributionCyovYr4Amt |
| Excess Distribution Cyov Yr3 | $0 | ExcessDistributionCyovYr3Amt |
| Excess Distribution Cyov Yr2 | $0 | ExcessDistributionCyovYr2Amt |
| Excess Distribution Cyov Yr1 | $0 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $0 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $201,395 | QualifyingDistributionsAmt |
| Applied To Year1 | $193,831 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $7,564 | 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 | $211,140 | UndistributedIncomeCYAmt |
| Corpus Distri170b1 E Or4942g3 | $0 | CorpusDistri170b1EOr4942g3Amt |
| Excess Distri Cyov From Yr5 | $0 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $0 | ExcessDistriCyovToNextYrAmt |
| Excess From Year4 | $0 | ExcessFromYear4Amt |
| Excess From Year3 | $0 | ExcessFromYear3Amt |
| Excess From Year2 | $0 | ExcessFromYear2Amt |
| Excess From Year1 | $0 | ExcessFromYear1Amt |
| Excess From Current Year | $0 | ExcessFromCurrentYearAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributing Manager | NONE | ContributingManagerNm |
| Shareholder Manager | NONE | ShareholderManagerNm |
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE RIDGE HEALTHCARE HOSPITALS INC | BusinessNameLine1Txt |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2201 SOUTH STERLING STREET | AddressLine1Txt |
| City | MORGANTON | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28655 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Relationship | NONE | RecipientRelationshipTxt |
| Recipient Foundation Status | PC | RecipientFoundationStatusTxt |
| Grant Or Contribution Purpose | GENERAL OPERATING | GrantOrContributionPurposeTxt |
| Amt | $195,000 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $195,000 | TotalGrantOrContriPdDurYrAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fees Contracts From Govt Ag | FeesContractsFromGovtAgGrp | |
| Membership Dues And Assmnt | MembershipDuesAndAssmntGrp | |
| Int On Sav And Temp Cash Invst | IntOnSavAndTempCashInvstGrp |
Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $110,222 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Rntl Incm Re Debt Fincd Prop | NetRntlIncmReDebtFincdPropGrp | |
| Net Rntl Incm Re Not Debt Fincd Prop | NetRntlIncmReNotDebtFincdProp | |
| Net Rental Income Personal Prop | NetRentalIncomePersonalPropGrp | |
| Other Investment Incm Part VII | OtherInvestmentIncmPartVIIGrp |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $558,322 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Income Loss From Special Evt | NetIncomeLossFromSpecialEvtGrp | |
| Gross Profit Loss Sls Of Invntry | GrossProfitLossSlsOfInvntryGrp |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | $668,544 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $668,544 | TotalIncomeProducingActyAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Rln Of Acty To Accom Of Exmpt Prps | RlnOfActyToAccomOfExmptPrpsGrp |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | false | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | false | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | false | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | false | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | false | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | false | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | false | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | false | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | false | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | false | RelationshipsNonchrtblEOInd |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | TAX PREPARATION FEE (NON-ALLOC | CategoryTxt |
| Amt | $1,056 | Amt |
| Disbursements Charitable Prps | $1,056 | DisbursementsCharitablePrpsAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (41 entries)
| Category Or ItemCategoryOrItemTxt | Listed At Cost Or FMVListedAtCostOrFMVCd | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| 921937819 VANGUARD INTERMEDIAT | |||
| 46090F100 INVESCO OPTIMUM YIEL | |||
| 464287705 ISHARES S&P MID-CAP | |||
| 922042858 VANGUARD FTSE EMERGI | |||
| 921943858 VANGUARD FTSE DEVELO | |||
| 81369Y100 AMEX MATERIALS SPDR | |||
| 315920702 FID ADV EMER MKTS IN | |||
| 81369Y308 CONSUMER STAPLES SEC | |||
| 464287655 ISHARES RUSSELL 2000 | AT COST | $250,376 | $283,719 |
| 464287606 ISHARES S&P MID-CAP | |||
| 81369Y407 AMEX CONSUMER DISCR | |||
| 77958B402 T ROWE PRICE INST FL | |||
| 81369Y803 AMEX TECHNOLOGY SELE | |||
| 87234N765 TCW EMRG MKTS INCM-I | |||
| 921937827 VANGUARD BD INDEX FD | |||
| 78463X863 SPDR DJ WILSHIRE INT | |||
| 779919307 T ROWE PR REAL ESTAT | |||
| 81369Y605 AMEX FINANCIAL SELEC | |||
| 81369Y209 HEALTH CARE SELECT S | |||
| 81369Y860 REAL ESTATE SELECT S | |||
| 4812C0803 JPMORGAN HIGH YIELD | |||
| 46434G103 ISHARES CORE MSCI EM | AT COST | $516,319 | $558,681 |
| 81369Y506 AMEX ENERGY SELECT S | |||
| 81369Y704 AMEX INDUSTRIAL SPDR | |||
| 464287226 ISHARES CORE U.S. AG | AT COST | $312,011 | $329,562 |
| 81369Y852 COMM SERV SELECT SEC | |||
| 464287150 ISHARES TRS & P 1500 | AT COST | $656,573 | $880,796 |
| 31641Q755 FIDELITY NEW MRKTS I | |||
| 803431410 JAMES ALPHA GL REAL | |||
| 921908844 VANGUARD DIVIDEND AP | AT COST | $287,259 | $321,178 |
| 922908629 VANGUARD MIDCAP VIPE | AT COST | $596,977 | $706,492 |
| 46432F339 ISHARES EDGE MSCI US | |||
| 74256W626 PRINCIPAL HIGH YIELD | |||
| 464287804 ISHARES CORE S&P SMA | AT COST | $93,152 | $93,139 |
| 46434V613 ISHARES CORE TOTAL B | AT COST | $240,588 | $235,640 |
| 74440Y884 PGIM HIGH YIELD-Q 10 | AT COST | $377,996 | $380,891 |
| 381430503 GOLDMAN ACTIVEBETA U | AT COST | $127,798 | $138,422 |
| 464287598 ISHARES RUSSELL 1000 | AT COST | $190,242 | $186,873 |
| 464288281 ISHARES JP MORGAN US | AT COST | $289,988 | $279,883 |
| 381430107 GOLDMAN SACHS ACTIVE | AT COST | $94,807 | $92,362 |
| 722005667 PIMCO COMMODITY REAL | AT COST | $93,468 | $97,001 |
Other Decreases Schedule OtherDecreasesSchedule
Other Decreases Detail OtherDecreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ROUNDING | Desc |
| Amt | $2 | Amt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (2 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| FILING FEE/STATE TAX | $10 | $0 | $10 |
| FILING FEE/STATE TAX | $10 | $0 | $10 |
Other Increases Schedule OtherIncreasesSchedule
Other Increases Detail OtherIncreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MUTUAL FUND TIMING ADJ | Desc |
| Amt | $214 | Amt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (5 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| FOREIGN TAXES | $259 | $259 | $0 |
| FEDERAL TAX PAYMENT - PRIOR YE | $2,999 | $0 | $0 |
| FEDERAL ESTIMATES - PRINCIPAL | $4,856 | $0 | $0 |
| FOREIGN TAXES ON QUALIFIED FOR | $217 | $217 | $0 |
| FOREIGN TAXES ON NONQUALIFIED | $284 | $284 | $0 |
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