PFEFFERKORN FOUNDATION INC 6392-1025876301: Form 990PF, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- PFEFFERKORN FOUNDATION INC 6392-1025876301 (EIN 20-3275894)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-02-21
- IRS object ID
- 202240529349100314
- Schema version
- 2020v4.2
- 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
- Applied To Prior Year Election
- Investments Corp Bonds Schedule
- Investments Corp Stock Schedule
- Investments Other Schedule2
- Other Expenses Schedule
- Other Income Schedule2
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-02-21T13:33:37-06:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 560892557 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LEVIN SPINNETT & COMPANY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1025 WEST FIRST STREET | AddressLine1Txt |
| City | WINSTONSALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 271013683 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 203275894 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PFEFFERKORN FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PFEF | BusinessNameControlTxt |
| Phone | 8003523705 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4625 COUNTRY CLUB ROAD | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27104 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RICHARD G PFEFFERKORN | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 3364142775 | PhoneNum |
| Signature | 2022-02-21 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | RICHARD | PersonFirstNm |
| Person Last | PFEFFERKORN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | HUGH L MCLENDON | PreparerPersonNm |
| PTIN | P00148465 | PTIN |
| Phone | 3367254279 | 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 | 2020 | 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 | $6,618,065 | 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 | $297,075 | ContriRcvdRevAndExpnssAmt |
| Interest On Sav Rev And Expnss | $66 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $66 | InterestOnSavNetInvstIncmAmt |
| Dividends Rev And Expnss | $139,021 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $139,021 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $148,928 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $1,372,484 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $148,928 | CapGainNetIncmNetInvstIncmAmt |
| Other Income Rev And Expnss | $252 | OtherIncomeRevAndExpnssAmt |
| Other Income Net Invst Incm | $252 | OtherIncomeNetInvstIncmAmt |
| Total Rev And Expnss | $585,342 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $288,267 | TotalNetInvstIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $0 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $0 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $0 | CompOfcrDirTrstDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $2,482 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $0 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Chrtbl Prps | $0 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Rev And Expnss | $35,626 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $35,626 | OtherProfFeesNetInvstIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $0 | OtherProfFeesDsbrsChrtblAmt |
| Taxes Rev And Expnss | $24,689 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $627 | TaxesNetInvstIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $56 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $56 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Dsbrs Chrtbl | $0 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $62,853 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $36,309 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $0 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $309,000 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $309,000 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $371,853 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $36,309 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $309,000 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $213,489 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $251,958 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $1,267 | CashBOYAmt |
| Sav And Temp Cash Invst BOY | $159,464 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $207,795 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $207,795 | SavAndTempCashInvstEOYFMVAmt |
| Corporate Stock BOY | $3,108,350 | CorporateStockBOYAmt |
| Corporate Stock EOY | $3,084,053 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $4,384,466 | CorporateStockEOYFMVAmt |
| Corporate Bonds BOY | $1,487,211 | CorporateBondsBOYAmt |
| Corporate Bonds EOY | $1,678,417 | CorporateBondsEOYAmt |
| Corporate Bonds EOYFMV | $1,706,520 | CorporateBondsEOYFMVAmt |
| Other Investments BOY | $305,043 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $304,559 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $319,284 | OtherInvestmentsEOYFMVAmt |
| Total Assets BOY | $5,061,335 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,274,824 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $6,618,065 | 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 | $5,061,335 | RetainedEarningBOYAmt |
| Retained Earning EOY | $5,274,824 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $5,061,335 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $5,274,824 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $5,061,335 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $5,274,824 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $5,061,335 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $213,489 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $5,274,824 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $5,274,824 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (3 entries)
| PropertyPropertyDesc | How AcquiredHowAcquiredCd | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt |
|---|---|---|---|---|---|
| PUBLICLY TRADED SECURITIES | P | $1,315,666 | $1,222,862 | $92,804 | $92,804 |
| GPB HOLDINGS LP | P | $694 | -$694 | -$694 | |
| CAPITAL GAINS DIVIDENDS | P | $56,818 | $56,818 | $56,818 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $148,928 | CapitalGainNetIncomeAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $3,502 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $3,502 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $3,502 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $3,983 | 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 | $3,983 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $4 | EsPenaltyAmt |
| Overpayment | $477 | OverpaymentAmt |
| Applied To ES Tax | $477 | 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 | NC | 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 | WELLS FARGO BANK | IndividualWithBooksNm |
| Phone | 8003523705 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 WEST FOURTH STREET | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27101 | 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 |
|---|---|---|---|---|---|---|---|---|
| SUSAN D PFEFFERKORN | ||||||||
| 1 WEST FOURTH STREET | WINSTON SALEM | NC | 27101 | DIRECTOR | 0.00 | $0 | $0 | $0 |
| RICHARD G PFEFFERKORN | ||||||||
| 1 WEST FOURTH STREET | WINSTON SALEM | NC | 27101 | 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 |
Compensation Of Hghst Pd Cntrct CompensationOfHghstPdCntrctGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLS FARGO BANK | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 WEST FOURTH STREET | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Service Type | INVESTMENT MANAGEMENT AND CUSTODIAN | ServiceTypeTxt |
| Compensation | $35,626 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contractor Paid Over50k | 0 | ContractorPaidOver50kCnt |
Sum Of Program Related Invst SumOfProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $5,868,790 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $307,056 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $6,175,846 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $6,175,846 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $92,638 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $6,083,208 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $304,160 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $304,160 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $3,502 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $3,502 | TotalTaxAmt |
| Distributable Before Adj | $300,658 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $300,658 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $300,658 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $309,000 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $309,000 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $0 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $309,000 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $300,658 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $261,355 | UndistributedIncomePYAmt |
| Prior Year1 | 2018 | PriorYear1Yr |
| Total For Prior Years | $33,281 | TotalForPriorYearsAmt |
| Total Excess Distribution Cyov | $0 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $309,000 | QualifyingDistributionsAmt |
| Applied To Year1 | $261,355 | AppliedToYear1Amt |
| Applied To Prior Years | $33,281 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $14,364 | 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 | $286,294 | 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 (28 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| ARBOR ACRES | |||||||
| 1240 ARBOR ROAD | WINSTON SALEM | NC | 27104 | NONE | PC | GENERAL SUPPORT | $13,000 |
| BOOKMARKS | |||||||
| 251 N SPRUCE STREET | WINSTON SALEM | NC | 27101 | NONE | PC | PROGRAM SUPPORT | $5,000 |
| CANCER SERVICES | |||||||
| 3175 MAPLEWOOD AVENUE | WINSTON SALEM | NC | 27103 | NONE | PC | PROGRAM SUPPORT | $5,000 |
| CENTENARY UNITED METHODIST CHURCH | |||||||
| 646 W FIFTH STREET | WINSTON SALEM | NC | 27101 | NONE | PC | GENERAL SUPPORT | $2,000 |
| CROSBY SCHOLARS | |||||||
| 2100 UNIVERSITY PARKWAY | WINSTON SALEM | NC | 27105 | NONE | PC | PROGRAM SUPPORT | $10,000 |
| EXCHANGE CLUB | |||||||
| 500 NORTHWEST BOULEVARD | WINSTON SALEM | NC | 27105 | NONE | PC | GENERAL SUPPORT | $40,000 |
| FORSYTH COUNTRY DAY SCHOOL | |||||||
| 5501 SHALLOWFORD ROAD | LEWISVILLE | NC | 27023 | NONE | PC | GENERAL SUPPORT | $4,000 |
| FORSYTH MEDICAL CENTER FOUNDATION | |||||||
| 1701 S HAWTHORNE ROAD | WINSTON SALEM | NC | 27103 | NONE | PC | GENERAL SUPPORT | $10,000 |
| HABITAT FOR HUMANITY | |||||||
| 1023 W 14TH STREET | WINSTON SALEM | NC | 27105 | NONE | PC | PROGRAM SUPPORT | $6,500 |
| HISTORIC FLAT ROCK | |||||||
| PO BOX 295 | FLAT ROCK | NC | 28731 | NONE | PC | GENERAL SUPPORT | $3,500 |
| HOSPICE & PALLIATIVE CARECENTER | |||||||
| 101 HOSPICE LANE | WINSTON SALEM | NC | 27103 | NONE | PC | PROGRAM SUPPORT | $13,000 |
| HOSPITAL HOSPITALITY HOUSE | |||||||
| 1970 BALDWIN LANE | WINSTON SALEM | NC | 27103 | NONE | PC | PROGRAM SUPPORT | $5,000 |
| JUNIOR LEAGUE OF WINSTON SALEM | |||||||
| 390 S LIBERTY STREET | WINSTON SALEM | NC | 27101 | NONE | PC | GENERAL SUPPORT | $1,000 |
| MUSEUM OF EARLY SOUTHERN DECORATIVE ARTS | |||||||
| 924 S MAIN STREET | WINSTON SALEM | NC | 27101 | NONE | PC | PROGRAM SUPPORT | $1,000 |
| OLD SALEM | |||||||
| 600 S MAIN STREET | WINSTON SALEM | NC | 27101 | NONE | PC | GENERAL SUPPORT | $1,000 |
| PIEDMONT LAND CONSERVANCY | |||||||
| PO BOX 4025 | GREENSBORO | NC | 27404 | NONE | PC | GENERAL SUPPORT | $5,000 |
| PROTESTANT EPISCOPAL HIGH SCHOOL | |||||||
| 1200 NORTH QUAKER LANE | ALEXANDRIA | VA | 22302 | NONE | PC | GENRAL SUPPORT | $55,000 |
| SENIOR SERVICES | |||||||
| 2895 SHOREFAIR DRIVE | WINSTON SALEM | NC | 27105 | NONE | PC | PROGRAM SUPPORT | $5,000 |
| ST CATHERINES SCHOOL FOUNDATION | |||||||
| 6001 GROVE AVENUE | RICHMOND | VA | 23226 | NONE | PC | GENERAL SUPPORT | $75,000 |
| SUMMIT SCHOOL | |||||||
| 2100 REYNOLDS ROAD | WINSTON SALEM | NC | 27106 | NONE | PC | GENERAL SUPPORT | $8,000 |
| UNC CHAPEL HILL | |||||||
| PO BOX 309 | CHAPEL HILL | NC | 27514 | NONE | PC | GENERAL SUPPORT | $2,000 |
| WAKE FOREST UNIVERSITY | |||||||
| 1834 WAKE FOREST ROAD | WINSTON SALEM | NC | 27109 | NONE | PC | GENERAL SUPPORT | $1,000 |
| WINSTON SALEM INDUSTRIES FOR THE BLIND | |||||||
| 7730 NORTH POINT DRIVE | WINSTON SALEM | NC | 27106 | NONE | PC | GENERAL SUPPORT | $6,000 |
| YMCA OF NORTHWEST NC | |||||||
| 301 N MAIN STREET | WINSTON SALEM | NC | 27101 | NONE | PC | GENERAL SUPPORT | $3,000 |
| SECOND HARVEST FOOD BANK NWNC | |||||||
| 3655 REED STREET | WINSTON SALEM | NC | 27107 | NONE | PC | GENERAL SUPPORT | $10,000 |
| SALVATION ARMY | |||||||
| 1225 N TRADE STREET | WINSTON SALEM | NC | 27101 | NONE | PC | GENERAL SUPPORT | $8,000 |
| FORSYTH TECHNICAL COMMUNITY COLLEGE | |||||||
| 2100 SILAS CREEK PARKWAY | WINSTON SALEM | NC | 27103 | NONE | PC | GENERAL SUPPORT | $10,000 |
| SHEPHERD'S CENTER | |||||||
| 1700 EBERT STREET | WINSTON SALEM | NC | 27103 | NONE | PC | GENERAL SUPPORT | $1,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $309,000 | 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 | $66 | ExclusionAmt |
Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $139,021 | ExclusionAmt |
Other Investment Incm Part VII OtherInvestmentIncmPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 01 | ExclusionCd |
| Exclusion | $252 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 01 | ExclusionCd |
| Exclusion | $148,928 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $288,267 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $288,267 | 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 | L GORDON PFEFFERKORN JR ADMINISTRATIVE TRUST | BusinessNameLine1Txt |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | C/O WELLS FARGO BANK | AddressLine1Txt |
| City | AUSTIN | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78735 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | $297,075 | TotalContributionsAmt |
| Person Contribution | Yes (X) | PersonContributionInd |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | ACCOUNTING | CategoryTxt |
| Amt | $2,482 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Applied To Prior Year Election AppliedToPriorYearElection
| Field | Value | IRS element (for citing) |
|---|---|---|
| Election | SECTION 4942(H)(2) ELECTION AS TO TREATMENT OF QUALIFYING DISTRIBUTIONSPURSUANT TO IRC SEC 4942(H)(2), THE FOUNDATION HEREBY ELECTS TO TREAT CURRENT YEAR QUALIFYING DISTRIBUTIONS IN EXCESS OF THE IMMEDIATELY PRECEDING TAX YEAR'S UNDISTRIBUTED INCOME AS BEING MADE OUT OF THE UNDISTRIBUTED INCOME OF THE TAX YEAR ENDING IN 2018 IN THE AMOUNT OF $33,281. | ElectionDesc |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corporate Bonds InvestmentsCorporateBondsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond | SCHEDULE ATTACHED | BondNm |
| EOY Book Value | $1,678,417 | EOYBookValueAmt |
| EOYFMV | $1,706,520 | EOYFMVAmt |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Stock | SCHEDULE ATTACHED | StockNm |
| EOY Book Value | $3,084,053 | EOYBookValueAmt |
| EOYFMV | $4,384,466 | EOYFMVAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category Or Item | SCHEDULE ATTACHED | CategoryOrItemTxt |
| Listed At Cost Or FMV | AT COST | ListedAtCostOrFMVCd |
| Book Value | $304,559 | BookValueAmt |
| EOYFMV | $319,284 | EOYFMVAmt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (2 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| GPB HOLDINGS LP | $43 | $43 | $0 |
| ADR FEES | $13 | $13 | $0 |
Other Income Schedule2 OtherIncomeSchedule2
Other Income Detail OtherIncomeDetail (3 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt |
|---|---|---|---|
| BELVEDERE LIMITED PARTNERHSIP | $600 | $600 | $600 |
| GPB HOLDINGS LP | -$355 | -$355 | -$355 |
| MISCELLANEOUS | $7 | $7 | $7 |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | INVESTMENT MANAGEMENT AND CUSTODIAN | CategoryTxt |
| Amt | $35,626 | Amt |
| Net Investment Income | $35,626 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (3 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| FOREIGN TAXES WITHHELD | $627 | $627 | $0 |
| FEDERAL TAX PAYMENTS | $19,687 | $0 | $0 |
| FEDERAL TAX ESTIMATES | $4,375 | $0 | $0 |
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