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SAM F WELLER FAMILY FOUNDATION: Form 990PF, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
SAM F WELLER FAMILY FOUNDATION (EIN 47-1887384)
Tax period
2021-07-01 to 2022-06-30
Filed
2022-11-01
IRS object ID
202203059349101505
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 ReturnHeader

FieldValueIRS element (for citing)
Return2022-11-01T17:29:30-04:00ReturnTs
Tax Period End2022-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN460434947PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ELO PROF LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 249AddressLine1Txt
CityMITCHELLCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57301ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2021-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN471887384EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SAM F WELLER FAMILY FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSAMFBusinessNameControlTxt
Phone6059967717PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 249AddressLine1Txt
CityMITCHELLCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57301ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDAVID G OLSONPersonNm
Person TitleDIRECTORPersonTitleTxt
Phone6059967717PhoneNum
Signature2022-10-26SignatureDt

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstDAVIDPersonFirstNm
Person LastOLSONPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJAMIE A ELDEEN CPAPreparerPersonNm
PTINP00736101PTIN
Phone6059967717PhoneNum
Preparation2022-10-25PreparationDt
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$3,255,433FMVAssetsEOYAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$150,000ContriRcvdRevAndExpnssAmt
Interest On Sav Rev And Expnss$81InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$81InterestOnSavNetInvstIncmAmt
Dividends Rev And Expnss$5,202DividendsRevAndExpnssAmt
Dividends Net Invst Incm$5,202DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss$177,602NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$310,217GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$177,602CapGainNetIncmNetInvstIncmAmt
Total Rev And Expnss$332,885TotalRevAndExpnssAmt
Total Net Invst Incm$182,885TotalNetInvstIncmAmt
Accounting Fees Rev And Expnss$2,231AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm$1,116AccountingFeesNetInvstIncmAmt
Accounting Fees Chrtbl Prps$1,115AccountingFeesChrtblPrpsAmt
Other Prof Fees Rev And Expnss$10,194OtherProfFeesRevAndExpnssAmt
Other Prof Fees Net Invst Incm$8,194OtherProfFeesNetInvstIncmAmt
Other Prof Fees Dsbrs Chrtbl$2,000OtherProfFeesDsbrsChrtblAmt
Taxes Rev And Expnss$423TaxesRevAndExpnssAmt
Taxes Dsbrs Chrtbl$423TaxesDsbrsChrtblAmt
Printing And Pub Rev And Expnss$450PrintingAndPubRevAndExpnssAmt
Printing And Pub Dsbrs Chrtbl$450PrintingAndPubDsbrsChrtblAmt
Other Expenses Rev And Expnss$986OtherExpensesRevAndExpnssAmt
Other Expenses Dsbrs Chrtbl$986OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$14,284TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$9,310TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$4,974TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$154,500ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$154,500ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$168,784TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$9,310TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$159,474TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses$164,101ExcessRevenueOverExpensesAmt
Net Investment Income$173,575NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Cash BOY$93,752CashBOYAmt
Cash EOY$283,241CashEOYAmt
Cash EOYFMV$283,241CashEOYFMVAmt
Sav And Temp Cash Invst BOY$9,242SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$74,111SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$74,111SavAndTempCashInvstEOYFMVAmt
Corporate Stock BOY$759,332CorporateStockBOYAmt
Corporate Stock EOY$422,715CorporateStockEOYAmt
Corporate Stock EOYFMV$422,715CorporateStockEOYFMVAmt
Other Investments BOY$2,900,318OtherInvestmentsBOYAmt
Other Investments EOY$2,475,366OtherInvestmentsEOYAmt
Other Investments EOYFMV$2,475,366OtherInvestmentsEOYFMVAmt
Total Assets BOY$3,762,644TotalAssetsBOYAmt
Total Assets EOY$3,255,433TotalAssetsEOYAmt
Total Assets EOYFMV$3,255,433TotalAssetsEOYFMVAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind
No Donor Rstr Net Assests BOY$3,762,644NoDonorRstrNetAssestsBOYAmt
No Donor Rstr Net Assests EOY$3,255,433NoDonorRstrNetAssestsEOYAmt
Tot Net Ast Or Fund Balances BOY$3,762,644TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$3,255,433TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$3,762,644TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$3,255,433TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$3,762,644TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses$164,101ExcessRevenueOverExpensesAmt
Subtotal$3,926,745SubtotalAmt
Other Decreases$671,312OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY$3,255,433TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (2 entries)

PropertyPropertyDescHow AcquiredHowAcquiredCdGross Sales PriceGrossSalesPriceAmtCost Or Other BasisCostOrOtherBasisAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmt
CHARLES SCHWAB 1372P$1,357$1,633-$276-$276
CHARLES SCHWAB 1372P$308,860$130,982$177,878$177,878
FieldValueIRS element (for citing)
Capital Gain Net Income$177,602CapitalGainNetIncomeAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$2,413InvestmentIncomeExciseTaxAmt
Subtotal$2,413SubtotalAmt
Tax Based On Investment Income$2,413TaxBasedOnInvestmentIncomeAmt
Form2220 AttachedYes (X)Form2220AttachedInd
Es Penalty$13EsPenaltyAmt
Tax Due$2,426TaxDueAmt

Statements Regarding Acty StatementsRegardingActyGrp

FieldValueIRS element (for citing)
Legislative Political ActyfalseLegislativePoliticalActyInd
More Than100 SpentfalseMoreThan100SpentInd
Form1120 POL FiledfalseForm1120POLFiledInd
Activities Not Previously RptfalseActivitiesNotPreviouslyRptInd
Changes To Articles Or BylawsfalseChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Organization Dissolved EtcfalseOrganizationDissolvedEtcInd
Section508e Rqr SatisfiedYes (true)Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (true)AtLeast5000InAssetsInd
Org Report Or Register StateSDOrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (true)Form990PFFiledWithAttyGenInd
Private Operating FoundationfalsePrivateOperatingFoundationInd
New Substantial ContributorsfalseNewSubstantialContributorsInd
Own Controlled EntityfalseOwnControlledEntityInd
Donor Advised FundfalseDonorAdvisedFundInd
Comply With Public Insp RqrYes (true)ComplyWithPublicInspRqrInd
Website AddressWWW.SFWFF.ORGWebsiteAddressTxt
Individual With BooksJAMIE A ELDEENIndividualWithBooksNm
Phone6059967717PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line11820 N SANBORN BLVDAddressLine1Txt
CityMITCHELLCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57301ZIPCd
FieldValueIRS element (for citing)
Foreign Accounts QuestionfalseForeignAccountsQuestionInd

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

FieldValueIRS element (for citing)
Sale Or Exch Disqualified PrsnfalseSaleOrExchDisqualifiedPrsnInd
Brrw Or Lend Disqualified PrsnfalseBrrwOrLendDisqualifiedPrsnInd
Furn Goods Disqualified PrsnfalseFurnGoodsDisqualifiedPrsnInd
Pay Comp Disqualified PrsnfalsePayCompDisqualifiedPrsnInd
Transfer Ast Disqualified PrsnfalseTransferAstDisqualifiedPrsnInd
Payment To Government OfficialfalsePaymentToGovernmentOfficialInd
Undistributed Income PYfalseUndistributedIncomePYInd
Business HoldingsfalseBusinessHoldingsInd
Jeopardy InvestmentsfalseJeopardyInvestmentsInd
Uncorrected PY Jeopardy InvstfalseUncorrectedPYJeopardyInvstInd
Influence LegislationfalseInfluenceLegislationInd
Influence ElectionfalseInfluenceElectionInd
Grants To IndividualsfalseGrantsToIndividualsInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Noncharitable PurposefalseNoncharitablePurposeInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
DAVID G OLSON
1410 S MINNESOTAMITCHELLSD57301DIRECTOR000.00$0$0$0
TONA ROZUM
87 S HARMON DRIVEMITCHELLSD57301DIRECTOR000.00$0$0$0
KEN TRACY
614 S ANDERSON STMITCHELLSD57301DIRECTOR000.00$0$0$0
DAVID BROOKS
PO BOX 87LETCHERSD57359DIRECTOR000.00$0$0$0
TRUDY MORGAN
1421 MITCHELL BLVDMITCHELLSD57301DIRECTOR000.00$0$0$0
FieldValueIRS element (for citing)
Comp Of Hghst Pd Empl Or NONENONECompOfHghstPdEmplOrNONETxt
Comp Of Hghst Pd Cntrct Or NONENONECompOfHghstPdCntrctOrNONETxt

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

FieldValueIRS element (for citing)
Description1N/ADescription1Txt

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$676,780AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$236,154AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$2,740,009FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$3,652,943TotalFMVOfUnusedAssetsAmt
Adjusted Total FMV Of Unused Ast$3,652,943AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$54,794CashDeemedCharitableAmt
Net Vl Noncharitable Assets$3,598,149NetVlNoncharitableAssetsAmt
Minimum Investment Return$179,907MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$179,907MinimumInvestmentReturnAmt
Tax Based On Investment Income$2,413TaxBasedOnInvestmentIncomeAmt
Total Tax$2,413TotalTaxAmt
Distributable Before Adj$177,494DistributableBeforeAdjAmt
Distributable Before Ded$177,494DistributableBeforeDedAmt
Distributable As Adjusted$177,494DistributableAsAdjustedAmt

PF Qualifying Distributions PFQualifyingDistributionsGrp

FieldValueIRS element (for citing)
Expenses And Contributions$159,474ExpensesAndContributionsAmt
Qualifying Distributions$159,474QualifyingDistributionsAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$177,494DistributableAsAdjustedAmt
Undistributed Income PY$104,652UndistributedIncomePYAmt
Qualifying Distributions$159,474QualifyingDistributionsAmt
Applied To Year1$104,652AppliedToYear1Amt
Applied To Current Year$54,822AppliedToCurrentYearAmt
Undistributed Income CY$122,672UndistributedIncomeCYAmt

Supplementary Information SupplementaryInformationGrp

Application Submission Info ApplicationSubmissionInfoGrp

FieldValueIRS element (for citing)
Recipient PersonDAVID G OLSONRecipientPersonNm

Recipient US Address RecipientUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 249AddressLine1Txt
CityMITCHELLCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57301ZIPCd
FieldValueIRS element (for citing)
Recipient Phone6059967717RecipientPhoneNum
Recipient Email AddressDAVE.OLSON@ELOCPA.COMRecipientEmailAddressTxt
Form And Info And MaterialsGRANT APPLICATION SUMMARY NAME OF ORGANIZATION______________________________________________ ____ DATE ORGANIZED_______________ ADDRESS___________________________________________________ _______ WEBSITE__________________________ CONTACT NAME____________________________________ CONTACT PHONE S___________________________________ CONTACT EMAIL ADDRESS____________________________________________ DATE SUBMITTED______________ AGENCY OBJECTIVE/PURPOSE: (DESCRIBE IN COMPLETE DETAIL) __________________________________________________________ __________________________________________________________ ________ TARGET POPULATION SERVED: (AGE, GENDER, SPECIAL INTEREST, ETC.) __________________________________________________________ __________________________________________________________ ________ TYPE OF FUNDING (CIRCLE) PROGRAM EQUIPMENT SPECIAL PURPOSE DESCRIPTION OF EXPENDITURE FOR WHICH FUNDING IS REQUESTED: __________________________________________________________ _________________________FormAndInfoAndMaterialsTxt
Submission DeadlinesN/ASubmissionDeadlinesTxt
Restrictions On AwardsN/ARestrictionsOnAwardsTxt

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (13 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmtAddress Line2RecipientUSAddress/AddressLine2Txt
ABBOTT HOUSE
909 CT MERRILL STMITCHELLSD57301NONE501C3PROGRAM SUPPORT$25,000
AVERA QUEEN OF PEACE
525 N FOSTER STMITCHELLSD57301NONE501C3PURCHASE FOOD FOR DAACE NUTRITION ED$500
DAKOTA WESLEYAN UNIVERSITY
1200 W UNIVERSITY AVEMITCHELLSD57301NONE501C3FUND SCHOLARSHIP FUND$18,000
JUNIOR ACHIEVEMENT
1000 N WEST AVESIOUX FALLSSD57104NONE501C3PROVIDE CLASSROOM PROGRAM MATERIALS$4,000SUITE 110
LOVE FEAST OF MITCHELL
40245 248TH STREETMITCHELLSD57301NONE501C3PROGRAM SUPPORT$3,000
MITCHELL AREA COMMUNITY THEATRE
700 N MAINMITCHELLSD57301NONE501C3FIRE EXTINGUISHERS, STAIRCARE REPAIR$2,500PO BOX 1181
MITCHELL AREA GARDEN CLUB
221 N DUFFMITCHELLSD57301NONE501C3PROGRAM SUPPORT$2,000
MITCHELL LIONS FOUNDATION
PO BOX 575MITCHELLSD57301NONE501C3PROGRAM SUPPORT$2,000
MITCHELL PREHISTORIC INDIAN VILLAGE
3200 INDIAN VILLAGE RDMITCHELLSD57301NONE501C3MUSEUM ENTRANCE FEES$5,000PO BOX 621
MITCHELL SCHOOL DISTRICT
821 N CAPITAL STMITCHELLSD57301NONEGOVTMUSICAL INSTRUMENTS$27,500
ST MARY'S EPISCOPAL CHURCH
214 W 3RD AVEMITCHELLSD57301NONE501C3WINDOWS AND INSULATION$35,000
MITCHELL KIWANIS CLUB
PO BOX 131MITCHELLSD57301NONE501C3ALL INCLUSIVE PLAYGROUND$15,000
MITCHELL PICKLEBALL ASSOCIATION
617 E 13TH AVEMITCHELLSD57301NONE501C3PICKLEBALL COURTS$15,000
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$154,500TotalGrantOrContriPdDurYrAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$81ExclusionAmt

Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$5,202ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion$177,602ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Exclusion$182,885ExclusionAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$182,885TotalIncomeProducingActyAmt

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

FieldValueIRS element (for citing)
Trnsfr Of Cash To Nonchrtbl EOfalseTrnsfrOfCashToNonchrtblEOInd
Trnsfr Other Asset Nonchrtbl EOfalseTrnsfrOtherAssetNonchrtblEOInd
Sales Or Exchanges Of AssetsfalseSalesOrExchangesOfAssetsInd
Purchase Of Assets Nonchrtbl EOfalsePurchaseOfAssetsNonchrtblEOInd
Rental Of Facilities Oth AssetsfalseRentalOfFacilitiesOthAssetsInd
Reimbursement ArrangementsfalseReimbursementArrangementsInd
Loans Or Loan GuaranteesfalseLoansOrLoanGuaranteesInd
Performance Of Services EtcfalsePerformanceOfServicesEtcInd
Sharing Of Facilities EtcfalseSharingOfFacilitiesEtcInd
Relationships Nonchrtbl EOfalseRelationshipsNonchrtblEOInd

Schedule B IRS990ScheduleB

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
General RuleYes (X)GeneralRuleInd

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
Contributor1ContributorNum
Contributor PersonRICHARD WELLERContributorPersonNm

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line124020 TWIN SPRINGS ROADAddressLine1Txt
CityRAPID CITYCityNm
State AbbreviationSDStateAbbreviationCd
ZIP577026546ZIPCd
FieldValueIRS element (for citing)
Total Contributions$150,000TotalContributionsAmt
Person ContributionYes (X)PersonContributionInd

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryINDIRECT ACCOUNTING FEESCategoryTxt
Amt$2,231Amt
Net Investment Income$1,116NetInvestmentIncomeAmt
Disbursements Charitable Prps$1,115DisbursementsCharitablePrpsAmt

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp

FieldValueIRS element (for citing)
StockCORPORATE EQUITIESStockNm
EOY Book Value$422,715EOYBookValueAmt
EOYFMV$422,715EOYFMVAmt

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOtherGrp (3 entries)

Category Or ItemCategoryOrItemTxtListed At Cost Or FMVListedAtCostOrFMVCdBook ValueBookValueAmtEOYFMVEOYFMVAmt
VARIABLE ANNUITY - 7804FMV$1,387,915$1,387,915
VARIABLE ANNUITY - 1491FMV$516,660$516,660
VARIABLE ANNUITY - 0059FMV$570,791$570,791

Other Decreases Schedule OtherDecreasesSchedule

Other Decreases Detail OtherDecreasesDetail

FieldValueIRS element (for citing)
DescUNREALIZED LOSS ON INVESTMENTSDesc
Amt$671,312Amt

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (4 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
EXPENSES
WEBSITE DEVELOPMENT$552$552
FILING FEES$117$117
SUPPLIES$317$317

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees Detail OtherProfessionalFeesDetail (2 entries)

CategoryCategoryTxtAmtAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
INVESTMENT FEES & CHARGES$8,194$8,194
OTHER PROFESSIONAL FEES$2,000$2,000

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail

FieldValueIRS element (for citing)
CategoryEXCISE TAXESCategoryTxt
Amt$423Amt
Disbursements Charitable Prps$423DisbursementsCharitablePrpsAmt

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