JACK N & ADDIE D AVERITT FOUNDATION INC: Form 990PF, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- JACK N & ADDIE D AVERITT FOUNDATION INC (EIN 58-2093653)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-05-16
- IRS object ID
- 202221369349100722
- Schema version
- 2021v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990-PF
- Accounting Fees Schedule
- Investments Corp Bonds Schedule
- Investments Corp Stock Schedule
- Investments Other Schedule2
- Other Assets Schedule
- Other Expenses Schedule
- Other Income Schedule2
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-16T07:33:40-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 581137570 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DABBS HICKMAN HILL & CANNON LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 319 S MAIN ST | AddressLine1Txt |
| City | STATESBORO | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 304580716 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 582093653 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JACK N & ADDIE D AVERITT | BusinessNameLine1Txt |
| Business Name Line2 | FOUNDATION INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | JACK | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 568 | AddressLine1Txt |
| City | STATESBORO | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 304590568 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KATHY BRADLEY | PersonNm |
| Person Title | CHAIR | PersonTitleTxt |
| Phone | 9124899226 | PhoneNum |
| Signature | 2022-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | KATHY | PersonFirstNm |
| Person Last | BRADLEY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WILLIAM R HICKMAN JR | PreparerPersonNm |
| PTIN | P00744476 | PTIN |
| Phone | 9127646951 | PhoneNum |
| Preparation | 2022-05-16 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $3,953,651 | 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 |
| Interest On Sav Rev And Expnss | $3,551 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $3,551 | InterestOnSavNetInvstIncmAmt |
| Dividends Rev And Expnss | $53,075 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $53,075 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $194,963 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $525,689 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $194,963 | CapGainNetIncmNetInvstIncmAmt |
| Other Income Rev And Expnss | $81 | OtherIncomeRevAndExpnssAmt |
| Other Income Net Invst Incm | $81 | OtherIncomeNetInvstIncmAmt |
| Total Rev And Expnss | $251,670 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $251,670 | TotalNetInvstIncmAmt |
| Accounting Fees Rev And Expnss | $3,664 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $1,832 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Chrtbl Prps | $1,832 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Rev And Expnss | $39,030 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $11,709 | OtherProfFeesNetInvstIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $27,321 | OtherProfFeesDsbrsChrtblAmt |
| Taxes Rev And Expnss | $6,748 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $2,810 | TaxesNetInvstIncmAmt |
| Taxes Dsbrs Chrtbl | $3,938 | TaxesDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $37,965 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Dsbrs Chrtbl | $37,792 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $87,407 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $16,351 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $70,883 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $207,600 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $207,600 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $295,007 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $16,351 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $278,483 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$43,337 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $235,319 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sav And Temp Cash Invst BOY | $105,611 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $203,145 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $203,145 | SavAndTempCashInvstEOYFMVAmt |
| Corporate Stock BOY | $1,288,213 | CorporateStockBOYAmt |
| Corporate Stock EOY | $1,223,167 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $2,391,929 | CorporateStockEOYFMVAmt |
| Corporate Bonds BOY | $681,285 | CorporateBondsBOYAmt |
| Corporate Bonds EOY | $605,593 | CorporateBondsEOYAmt |
| Corporate Bonds EOYFMV | $666,698 | CorporateBondsEOYFMVAmt |
| Other Investments BOY | $1,303,086 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $1,302,917 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $691,879 | OtherInvestmentsEOYFMVAmt |
| Other Assets BOY | $2,178 | OtherAssetsBOYAmt |
| Other Assets EOY | $2,214 | OtherAssetsEOYAmt |
| Total Assets BOY | $3,380,373 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,337,036 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $3,953,651 | TotalAssetsEOYFMVAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
| Capital Stock BOY | $114,666 | CapitalStockBOYAmt |
| Capital Stock EOY | $114,666 | CapitalStockEOYAmt |
| Additional Paid In Capital BOY | $3,640,399 | AdditionalPaidInCapitalBOYAmt |
| Additional Paid In Capital EOY | $3,640,399 | AdditionalPaidInCapitalEOYAmt |
| Retained Earning BOY | -$374,692 | RetainedEarningBOYAmt |
| Retained Earning EOY | -$418,029 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $3,380,373 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $3,337,036 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $3,380,373 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $3,337,036 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $3,380,373 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$43,337 | ExcessRevenueOverExpensesAmt |
| Subtotal | $3,337,036 | SubtotalAmt |
| Tot Net Ast Or Fund Balances EOY | $3,337,036 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (2 entries)
| PropertyPropertyDesc | How AcquiredHowAcquiredCd | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt |
|---|---|---|---|---|---|
| SEE ATTACHED - SYNOVUS | P | $444,229 | $321,168 | $123,061 | $123,061 |
| SEE ATTACHED - SYNOVUS | P | $6,540 | $9,558 | -$3,018 | -$3,018 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $194,963 | CapitalGainNetIncomeAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $3,271 | InvestmentIncomeExciseTaxAmt |
| Subtotal | $3,271 | SubtotalAmt |
| Tax Based On Investment Income | $3,271 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $1,000 | EstimatedPlusOvpmtIncmTxAmt |
| Total Payments And Credits | $1,000 | TotalPaymentsAndCreditsAmt |
| Form2220 Attached | Yes (X) | Form2220AttachedInd |
| Es Penalty | $1 | EsPenaltyAmt |
| Tax Due | $2,272 | TaxDueAmt |
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 | GA | 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 | JASON BUSH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9122353722 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7402 HODGSON MEMORIAL DRIVE 110 | AddressLine1Txt |
| City | SAVANNAH | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31406 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | false | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | false | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | false | PaymentToGovernmentOfficialInd |
| 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 (9 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 |
|---|---|---|---|---|---|---|---|---|
| KATHY BRADLEY | ||||||||
| PO BOX 568 | STATESBORO | GA | 30459 | CHAIR | 000.00 | $0 | $0 | $0 |
| JANE JACKSON HIGHSMITH | ||||||||
| PO BOX 568 | STATESBORO | GA | 30459 | SECRETARY | 000.00 | $0 | $0 | $0 |
| ALBERT BURKE | ||||||||
| PO BOX 568 | STATESBORO | GA | 30459 | TREASURER | 000.00 | $0 | $0 | $0 |
| AUBREY HIGHSMITH | ||||||||
| PO BOX 568 | STATESBORO | GA | 30459 | DIRECTOR | 000.00 | $0 | $0 | $0 |
| BRADLEY W HOLMES | ||||||||
| PO BOX 568 | STATESBORO | GA | 30459 | DIRECTOR | 000.00 | $0 | $0 | $0 |
| FRANK FORTUNE | ||||||||
| PO BOX 568 | STATESBORO | GA | 30459 | DIRECTOR | 000.00 | $0 | $0 | $0 |
| MELISSA AVERITT POTTER | ||||||||
| PO BOX 568 | STATESBORO | GA | 30459 | DIRECTOR | 000.00 | $0 | $0 | $0 |
| JESSICA RUSHING | ||||||||
| PO BOX 568 | STATESBORO | GA | 30458 | DIRECTOR | 000.00 | $0 | $0 | $0 |
| ELIZABETH ORMSBEE | ||||||||
| PO BOX 568 | STATESBORO | GA | 30458 | DIRECTOR | 000.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Hghst Pd Empl Or NONE | NONE | CompOfHghstPdEmplOrNONETxt |
| Comp Of Hghst Pd Cntrct Or NONE | NONE | CompOfHghstPdCntrctOrNONETxt |
Sum Of Program Related Invst SumOfProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | N/A | Description1Txt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $3,025,777 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $92,016 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $2,464 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $3,120,257 | TotalFMVOfUnusedAssetsAmt |
| Adjusted Total FMV Of Unused Ast | $3,120,257 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $46,804 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $3,073,453 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $153,673 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $153,673 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $3,271 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $3,271 | TotalTaxAmt |
| Distributable Before Adj | $150,402 | DistributableBeforeAdjAmt |
| Distributable Before Ded | $150,402 | DistributableBeforeDedAmt |
| Distributable As Adjusted | $150,402 | DistributableAsAdjustedAmt |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $278,483 | ExpensesAndContributionsAmt |
| Qualifying Distributions | $278,483 | QualifyingDistributionsAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $150,402 | DistributableAsAdjustedAmt |
| Excess Distribution Cyov Yr5 | $70,600 | ExcessDistributionCyovYr5Amt |
| Excess Distribution Cyov Yr3 | $233,546 | ExcessDistributionCyovYr3Amt |
| Excess Distribution Cyov Yr1 | $102,834 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $406,980 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $278,483 | QualifyingDistributionsAmt |
| Applied To Current Year | $150,402 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $128,081 | RemainingDistriFromCorpusAmt |
| Total Corpus | $535,061 | TotalCorpusAmt |
| Undistributed Income CY | $0 | UndistributedIncomeCYAmt |
| Excess Distri Cyov From Yr5 | $70,600 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $464,461 | ExcessDistriCyovToNextYrAmt |
| Excess From Year3 | $233,546 | ExcessFromYear3Amt |
| Excess From Year1 | $102,834 | ExcessFromYear1Amt |
| Excess From Current Year | $128,081 | ExcessFromCurrentYearAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (3 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt | Recipient RelationshipRecipientRelationshipTxt |
|---|---|---|---|---|---|---|---|
| GSU FOUNDATION INC | |||||||
| 1332 SOUTHERN DRIVE | STATESBORO | GA | 30460 | 501C3 | EDUCATION - SCHOLARSHIPS | $131,000 | |
| BULLOCH COUNTY HISTORICAL SOCIETY | |||||||
| PO BOX 42 | STATESBORO | GA | 30459 | 501C3 | HISTORIC PRESERVATION | $76,500 | |
| BULLOCH ACADEMY | |||||||
| 873 WESTSIDE RD | STATESBORO | GA | 30458 | PC | EDUCATION | $100 | NONE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $207,600 | TotalGrantOrContriPdDurYrAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $3,551 | ExclusionAmt |
Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $53,075 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $194,963 | ExclusionAmt |
Other Revenue Described OtherRevenueDescribedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CLASS ACTION PROCEEDS | Desc |
| Exclusion | 18 | ExclusionCd |
| Exclusion | $81 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | $251,670 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $251,670 | TotalIncomeProducingActyAmt |
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 | ACCOUNTING FEES | CategoryTxt |
| Amt | $3,664 | Amt |
| Net Investment Income | $1,832 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $1,832 | DisbursementsCharitablePrpsAmt |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corporate Bonds InvestmentsCorporateBondsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond | CORPORATE BONDS | BondNm |
| EOY Book Value | $605,593 | EOYBookValueAmt |
| EOYFMV | $666,698 | EOYFMVAmt |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Stock | CORPORATE STOCK | StockNm |
| EOY Book Value | $1,223,167 | EOYBookValueAmt |
| EOYFMV | $2,391,929 | EOYFMVAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (6 entries)
| Category Or ItemCategoryOrItemTxt | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| RESIDENCE | $636,380 | $329,000 |
| CONTENTS OF RESIDENCE | $621,918 | $360,986 |
| JEWELRY | $16,776 | |
| PERSONAL EFFECTS | $1,000 | |
| LANDSCAPING PROJECT | $24,950 | |
| ACCRUALS | $1,893 | $1,893 |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENT INCOME IN TRANSIT | Desc |
| BOY Book Value | $2,178 | BOYBookValueAmt |
| EOY Book Value | $2,214 | EOYBookValueAmt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (3 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|
| EXPENSES | ||
| INSURANCE | $12,820 | $12,820 |
| PROPERTY MAINTENANCE, & UTILI | $25,145 | $24,972 |
Other Income Schedule2 OtherIncomeSchedule2
Other Income Detail OtherIncomeDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CLASS ACTION PROCEEDS | Desc |
| Revenue And Expenses Per Books | $81 | RevenueAndExpensesPerBooksAmt |
| Net Investment Income | $81 | NetInvestmentIncomeAmt |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| INVESTMENT MANAGEMENT | $11,709 | $11,709 | |
| TRUSTEE FEES | $27,321 | $27,321 |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (3 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| FOREIGN TAXES | $810 | $810 | |
| REAL ESTATE TAX | $3,938 | $3,938 | |
| OTHER TAXES | $2,000 | $2,000 |
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