MOZAIK PHILANTHROPY INC: Form 990PF, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
MOZAIK PHILANTHROPY INC (EIN 20-8104037)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-14
IRS object ID
202223189349106777
Schema version
2021v4.2
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 ReturnHeader

FieldValueIRS element (for citing)
Return2022-11-14T20:33:08-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Foundation SourceBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13333 New Hyde Park Rd Ste 406AddressLine1Txt
CityNew Hyde ParkCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11042ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN208104037EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Mozaik Philanthropy IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% Foundation SourceInCareOfNm
Business Name ControlNEDABusinessNameControlTxt
Phone8008391754PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1Foundation Source 501 Silverside RdAddressLine1Txt
CityWilmingtonCityNm
State AbbreviationDEStateAbbreviationCd
ZIP198091377ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDARLA MASHOUFPersonNm
Person TitleTREASURERPersonTitleTxt
Phone8008391754PhoneNum
Signature2022-11-07SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstDARLAPersonFirstNm
Person LastMASHOUFPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJeffrey D HaskellPreparerPersonNm
PTINP01345770PTIN
Phone8008391754PhoneNum
Preparation2022-11-03PreparationDt

Additional Filer Information AdditionalFilerInformation

FieldValueIRS element (for citing)
Trusted CustomerTrustedCustomerGrp
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$9,646,925FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$0ContriRcvdRevAndExpnssAmt
Schedule B Not RequiredYes (X)ScheduleBNotRequiredInd
Interest On Sav Rev And Expnss$4,338InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$4,338InterestOnSavNetInvstIncmAmt
Dividends Rev And Expnss$156,216DividendsRevAndExpnssAmt
Dividends Net Invst Incm$156,216DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss$94,245NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$4,253,436GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$94,245CapGainNetIncmNetInvstIncmAmt
Other Income Rev And Expnss$22,466OtherIncomeRevAndExpnssAmt
Other Income Net Invst Incm$9,778OtherIncomeNetInvstIncmAmt
Total Rev And Expnss$277,265TotalRevAndExpnssAmt
Total Net Invst Incm$264,577TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$54,167CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl$54,167CompOfcrDirTrstDsbrsChrtblAmt
Oth Empl Slrs Wgs Rev And Expnss$170,000OthEmplSlrsWgsRevAndExpnssAmt
Oth Empl Slrs Wgs Dsbrs Chrtbl$170,000OthEmplSlrsWgsDsbrsChrtblAmt
Pension Empl Bnft Rev And Expnss$17,527PensionEmplBnftRevAndExpnssAmt
Pension Empl Bnft Dsbrs Chrtbl$17,527PensionEmplBnftDsbrsChrtblAmt
Other Prof Fees Rev And Expnss$52,236OtherProfFeesRevAndExpnssAmt
Other Prof Fees Net Invst Incm$11,328OtherProfFeesNetInvstIncmAmt
Other Prof Fees Dsbrs Chrtbl$40,308OtherProfFeesDsbrsChrtblAmt
Taxes Rev And Expnss$8,240TaxesRevAndExpnssAmt
Trav Conf Meeting Rev And Expnss$800TravConfMeetingRevAndExpnssAmt
Trav Conf Meeting Dsbrs Chrtbl$800TravConfMeetingDsbrsChrtblAmt
Printing And Pub Rev And Expnss$3,459PrintingAndPubRevAndExpnssAmt
Printing And Pub Dsbrs Chrtbl$3,459PrintingAndPubDsbrsChrtblAmt
Other Expenses Rev And Expnss$60,654OtherExpensesRevAndExpnssAmt
Other Expenses Net Invst Incm$690OtherExpensesNetInvstIncmAmt
Other Expenses Dsbrs Chrtbl$59,961OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$367,083TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$12,018TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$346,222TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$195,125ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$195,125ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$562,208TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$12,018TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$541,347TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses-$284,943ExcessRevenueOverExpensesAmt
Net Investment Income$252,559NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Sav And Temp Cash Invst BOY$1,214,755SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$1,126,301SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$1,126,301SavAndTempCashInvstEOYFMVAmt
Acct Rcvbl$6,193AcctRcvblAmt
Acct Rcvbl BOY$7,196AcctRcvblBOYAmt
Acct Rcvbl EOY$6,193AcctRcvblEOYAmt
Acct Rcvbl EOYFMV$6,193AcctRcvblEOYFMVAmt
US Government Obligations BOY$2,523,581USGovernmentObligationsBOYAmt
US Government Obligations EOY$2,181,987USGovernmentObligationsEOYAmt
US Govt Obligations EOYFMV$2,143,615USGovtObligationsEOYFMVAmt
Corporate Stock BOY$581,515CorporateStockBOYAmt
Corporate Stock EOY$615,081CorporateStockEOYAmt
Corporate Stock EOYFMV$580,044CorporateStockEOYFMVAmt
Corporate Bonds BOY$2,020,928CorporateBondsBOYAmt
Corporate Bonds EOY$2,444,038CorporateBondsEOYAmt
Corporate Bonds EOYFMV$2,423,379CorporateBondsEOYFMVAmt
Other Investments BOY$2,715,333OtherInvestmentsBOYAmt
Other Investments EOY$2,404,765OtherInvestmentsEOYAmt
Other Investments EOYFMV$3,367,393OtherInvestmentsEOYFMVAmt
Total Assets BOY$9,063,308TotalAssetsBOYAmt
Total Assets EOY$8,778,365TotalAssetsEOYAmt
Total Assets EOYFMV$9,646,925TotalAssetsEOYFMVAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind
Retained Earning BOY$9,063,308RetainedEarningBOYAmt
Retained Earning EOY$8,778,365RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY$9,063,308TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$8,778,365TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$9,063,308TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$8,778,365TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$9,063,308TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses-$284,943ExcessRevenueOverExpensesAmt
Subtotal$8,778,365SubtotalAmt
Tot Net Ast Or Fund Balances EOY$8,778,365TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (3 entries)

PropertyPropertyDescGross Sales PriceGrossSalesPriceAmtCost Or Other BasisCostOrOtherBasisAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmt
Publicly-traded Securities$4,253,436$4,139,082$114,354$114,354
Passthrough K1 Capital Gain/(Loss)-$19,106
CAM FARMINGDALE LLC - HOLDBACK ADJ-$1,003
FieldValueIRS element (for citing)
Capital Gain Net Income$94,245CapitalGainNetIncomeAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$3,511InvestmentIncomeExciseTaxAmt
Subtotal$3,511SubtotalAmt
Tax Based On Investment Income$3,511TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$11,380EstimatedPlusOvpmtIncmTxAmt
Exempt Frgn Org Tax Wthld At Srce$0ExemptFrgnOrgTaxWthldAtSrceAmt
Total Payments And Credits$11,380TotalPaymentsAndCreditsAmt
Form2220 AttachedYes (X)Form2220AttachedInd
Es Penalty$0EsPenaltyAmt
Overpayment$7,869OverpaymentAmt
Applied To ES Tax$3,600AppliedToESTaxAmt
Refund$4,269RefundAmt

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 LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Organization Dissolved EtcfalseOrganizationDissolvedEtcInd
Section508e Rqr SatisfiedYes (true)Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (true)AtLeast5000InAssetsInd
Org Report Or Register StateCAOrgReportOrRegisterStateCd
Org Report Or Register StateDEOrgReportOrRegisterStateCd
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

Persons With Books Name PersonsWithBooksName

FieldValueIRS element (for citing)
Business Name Line1Foundation SourceBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8008391754PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line1501 Silverside Road Suite 123AddressLine1Txt
CityWilmingtonCityNm
State AbbreviationDEStateAbbreviationCd
ZIP198091377ZIPCd
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
Uncorrected Prior ActsfalseUncorrectedPriorActsInd
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 (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
Daria Mashouf
Foundation Source 501 Silverside RdWilmingtonDE198091377Treas3.0$54,167$0$0
Neda Nobari
Foundation Source 501 Silverside RdWilmingtonDE198091377Pres, Dir, Sec15.0$0$0$0

Compensation Highest Paid Empl CompensationHighestPaidEmplGrp

FieldValueIRS element (for citing)
PersonMs Keely H BadgerPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1501 SILVERSIDE RDAddressLine1Txt
CityWILMINGTONCityNm
State AbbreviationDEStateAbbreviationCd
ZIP19809ZIPCd
FieldValueIRS element (for citing)
TitleExecutive DirectorTitleTxt
Average Hrs Per Wk Devoted To Pos40.0AverageHrsPerWkDevotedToPosRt
Compensation$170,000CompensationAmt
FieldValueIRS element (for citing)
Summary Of Direct Chrtbl ActySummaryOfDirectChrtblActyGrp
Sum Of Program Related InvstSumOfProgramRelatedInvstGrp

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$5,302,724AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$1,064,267AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$3,373,586FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$9,740,577TotalFMVOfUnusedAssetsAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$9,740,577AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$146,109CashDeemedCharitableAmt
Net Vl Noncharitable Assets$9,594,468NetVlNoncharitableAssetsAmt
Minimum Investment Return$479,723MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$479,723MinimumInvestmentReturnAmt
Tax Based On Investment Income$3,511TaxBasedOnInvestmentIncomeAmt
Total Tax$3,511TotalTaxAmt
Distributable Before Adj$476,212DistributableBeforeAdjAmt
Distributable Before Ded$476,212DistributableBeforeDedAmt
Distributable As Adjusted$476,212DistributableAsAdjustedAmt

PF Qualifying Distributions PFQualifyingDistributionsGrp

FieldValueIRS element (for citing)
Expenses And Contributions$541,347ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Charitable Assets Acquis Paid$0CharitableAssetsAcquisPaidAmt
Set Aside Suitability Test$0SetAsideSuitabilityTestAmt
Set Aside Cash Distri Test$0SetAsideCashDistriTestAmt
Qualifying Distributions$541,347QualifyingDistributionsAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$476,212DistributableAsAdjustedAmt
Prior Year12019PriorYear1Yr
Prior Year22018PriorYear2Yr
Prior Year32017PriorYear3Yr
Excess Distribution Cyov Yr5$380,060ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr4$469,704ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr2$414,209ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1$149,131ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov$1,413,104TotalExcessDistributionCyovAmt
Qualifying Distributions$541,347QualifyingDistributionsAmt
Applied To Current Year$476,212AppliedToCurrentYearAmt
Remaining Distri From Corpus$65,135RemainingDistriFromCorpusAmt
Total Corpus$1,478,239TotalCorpusAmt
Undistributed Income CY$0UndistributedIncomeCYAmt
Excess Distri Cyov From Yr5$380,060ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$1,098,179ExcessDistriCyovToNextYrAmt
Excess From Year4$469,704ExcessFromYear4Amt
Excess From Year2$414,209ExcessFromYear2Amt
Excess From Year1$149,131ExcessFromYear1Amt
Excess From Current Year$65,135ExcessFromCurrentYearAmt
FieldValueIRS element (for citing)
Private Operating FoundationsPrivateOperatingFoundationsGrp

Supplementary Information SupplementaryInformationGrp

FieldValueIRS element (for citing)
Contributing ManagerNeda NobariContributingManagerNm
Only Contri To PreselectedYes (X)OnlyContriToPreselectedInd

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (87 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmtAddress Line1RecipientForeignAddress/AddressLine1TxtCityRecipientForeignAddress/CityNmProvince Or StateRecipientForeignAddress/ProvinceOrStateNmCountryRecipientForeignAddress/CountryCdForeign PostalRecipientForeignAddress/ForeignPostalCd
ALMA BACKYARD FARM
453 N ALMA AVELOS ANGELESCA90063N/APCGeneral & Unrestricted$10,000
CINEMA WITHOUT BORDERS FOUNDATION
734 N KENWOOD STBURBANKCA91505N/APCGeneral & Unrestricted$20,000
COMMON COUNSEL FOUNDATION
1624 FRANKLIN ST STE 1022OAKLANDCA94612N/APCKindle Project Afghanistan Fund$5,000
FILM FORUM INC
209 W HOUSTON STNEW YORKNY10014N/APCCOUP 53" Production Cost$20,000
FOR-SITE FOUNDATION
2 MARINA BLVD BDLG C STE 255SAN FRANCISCOCA94123N/APCGeneral & Unrestricted$2,000
LOCAL ARTISTS BERKELEY
6117 SAN PABLO AVEOAKLANDCA94608N/APCGeneral & Unrestricted$10,000
ORLANDO MUSEUM OF ART INC
2416 N MILLS AVEORLANDOFL32803N/APCA Boundless Drop to a Boundless Ocean exhibition$10,000
SELF-HELP GRAPHICS AND ARTS INC
1300 E 1ST STLOS ANGELESCA90033N/APCGeneral & Unrestricted$3,000
SIMA STUDIOS
551 NORWICH DRWEST HOLLYWOODCA90048N/APCNEW ECONOMY Flow Fund Support$4,375
THE CRANE INSTITUTE OF SUSTAINABILITY INC
13 ELM ST STE 1MANCHESTERMA01944N/APCIntentional Endowment Network$750
WOMEN FOR AFGHAN WOMEN INC
15824 73RD AVEFRESH MEADOWSNY11366N/APCGeneral & Unrestricted$5,000
F Bifulco
1780 N Main Street Unit BLos AngelesCA90031noneIARTIST RELIEF AWARD$2,000
J Garcia
6615 Easton StreetLos AngelesCA90022NONEIARTIST RELIEF AWARD$2,000
D Harrison
6431 Chelwynde AvePhiladelphiaPA19142NONEIARTIST RELIEF AWARD$2,000
M Jaffe
PO Box 702BridgehamptonNY11932noneIARTIST RELIEF AWARD$2,000
A Parkey
2842 Merced DriveDes MoinesIA50310noneIARTIST RELIEF AWARD$2,000
J Garcia
6615 Easton StreetLos AngelesCA90022noneIARTIST RELIEF AWARD$5,000
C Edwards
142 Iron Hill WayCollegevillePA19426noneIARTIST RELIEF AWARD$2,000
J T Moore
906 Magnolia DriveHuntsvilleAL35816noneIARTIST RELIEF AWARD$2,000
A Smith
115757 Moorpark StreetStudio CityCA91602noneIARTIST RELIEF AWARD$2,000
K Hailey
10240 S 2nd AveInglewoodCA90303noneIARTIST RELIEF AWARD$5,000
J Ivacic
5644 N Natoma AveChicagoIL60631noneIARTIST RELIEF AWARD$1,000
J Packer
1614 Belle DriveAnnapolisMD21401noneIARTIST RELIEF AWARD$1,000
I Peretz
21630 Medina Estate DriveWoodland HillsCA91364noneIARTIST RELIEF AWARD$1,000
G Rahimi
1440 Veteran AveLos AngelesCA90024noneIARTIST RELIEF AWARD$1,000
D Bates
224A North Louise StreetGlendaleCA91206noneIARTIST RELIEF AWARD$2,000
D Adamo
888 West Lambert RoadLa HabraCA90631noneIARTIST RELIEF AWARD$1,000
D Dowding
3816 Medford StLos AngelesCA90063noneIARTIST RELIEF AWARD$1,000
O Rorsunska
303 Elmshire DrLancasterPA17603noneIARTIST RELIEF AWARD$1,000
I Matchett
1480 Bewick StDetroitMI48214noneIARTIST RELIEF AWARD$2,000
A Roberts
5830 Pimlico RdBaltimoreMD21209noneIARTIST RELIEF AWARD$1,000
C Lee
2150 Reservoir StreetLos AngelesCA90026noneIARTIST RELIEF AWARD$1,000
C Sims
140 Wynter CourtAthensGA30601noneIARTIST RELIEF AWARD$2,000
B Culverhouse
7286 LaCabreah DriveBrownsburgIN46112noneIARTIST RELIEF AWARD$1,000
E Mann
5049 Collis AveSouth PasadenaCA91030noneIARTIST RELIEF AWARD$2,000
B Mark
341 10th StreetBrooklynNY11215noneIARTIST RELIEF AWARD$1,000
B Goeller
PO Box 401118San FranciscoCA941401118noneIARTIST RELIEF AWARD$1,000
B Fine
285 8th StreetJersey CityNJ07203noneIARTIST RELIEF AWARD$1,000
B Hack
3125 Oak Meadow DriveFlower MoundTX75028noneIARTIST RELIEF AWARD$1,000
A Manalo
1269 Oak StreetSan FranciscoCA94117noneIARTIST RELIEF AWARD$2,000
L Muller
2737 Chadwick CircleLos AngelesCA90032noneIARTIST RELIEF AWARD$2,000
M Heintze
1250 Long Beach AvenueLos AngelesCA90021noneIARTIST RELIEF AWARD$1,000
M Pagoaga
2971 Finch StreetLos AngelesCA90039noneIARTIST RELIEF AWARD$2,000
M Weston
1800 Constellation DriveColorado SpringsCO80905noneIARTIST RELIEF AWARD$1,000
S Kowsik
54 Esparito PlaceFremontCA94539noneIARTIST RELIEF AWARD$1,000
S Thompson
27 S 4th AveCoatesvillePA19320noneIARTIST RELIEF AWARD$1,000
M Essa
4443 Clarissa AveLos AngelesCA90027noneIARTIST RELIEF AWARD$1,000
J Park
16343 Valley Ranch RdSanta ClaritaCA91387noneIARTIST RELIEF AWARD$1,000
S Meskill
1916 Mathews AveRedondo BeachCA90278noneIARTIST RELIEF AWARD$1,000
A Le
1739 7th Street NWWashingtonDC20001noneIARTIST RELIEF AWARD$1,000
D Walker
5540 North 27th StreetMilwaukeeWI53209noneIARTIST RELIEF AWARD$1,000
C Valle
2100 North Main StLos AngelesCA90031noneIARTIST RELIEF AWARD$1,000
Z Zemet
3403 Fletcher DriveLos AngelesCA90065noneIARTIST RELIEF AWARD$1,000
B Iverson
noneIARTIST RELIEF AWARD$1,0001 ROAD 283NEW MAADICAIROEG11431
A Soria
639 S Spring StLos AngelesCA90014noneIARTIST RELIEF AWARD$1,000
V Broersma
550 Orange AveLong BeachCA90802noneIARTIST RELIEF AWARD$1,000
A Haines-Stiles
347 Andersen RoadMilfordNJ08848noneIARTIST RELIEF AWARD$1,000
K Robertson
5646 Aldama StreetLos AngelesCA90042noneIARTIST RELIEF AWARD$2,000
J Wiant
3613 Pecan CirBedfordTX76021noneIARTIST RELIEF AWARD$1,000
S Filippucci
1074 Hope StreetStamfordCT06907noneIARTIST RELIEF AWARD$1,000
B Mune
2304 Summit Pointe Way NEAtlantaGA30329noneIARTIST RELIEF AWARD$1,000
S Alcala
5625 Anada CtSalidaCA95368noneIARTIST RELIEF AWARD$1,000
K Kelm
426 Curtain Hill LaneCottage GroveOR97424noneIARTIST RELIEF AWARD$1,000
J Garrett
243 8th AvenueSan FranciscoCA94118noneIARTIST RELIEF AWARD$1,000
W Bongiorno
118 Valley Force CirElyriaOH44035noneIARTIST RELIEF AWARD$1,000
J Jimenez
1200 West AvenueMiami BeachFL33139noneIARTIST RELIEF AWARD$2,000
J Fleurant
218 Superior PlWest Palm BeachFL33409noneIARTIST RELIEF AWARD$2,000
A Belizaire
66 Marine StreetMassapequaNY11758noneIARTIST RELIEF AWARD$1,000
B Valian
26645 Altamont RdLos Altos HillsCA94022noneIARTIST RELIEF AWARD$1,000
Y Leung
1529 5th AvenueLos AngelesCA90019noneIARTIST RELIEF AWARD$1,000
G Gossens
22 Kitty CtKimberlyWI54136noneIARTIST RELIEF AWARD$1,000
M Nouri
1811 Filbert StreetSan FranciscoCA94123noneIARTIST RELIEF AWARD$2,000
J Moore
PO Box 17711HuntsvilleAL35811noneIARTIST RELIEF AWARD$1,000
S Queen
1358 N Grant AveColumbusOH43201noneIARTIST RELIEF AWARD$1,000
J Park
16343 Valley Ranch RdSanta ClaritaCA91387noneIARTIST RELIEF AWARD$1,000
L Gallant
49 Fenno StCambridgeMA02138noneIARTIST RELIEF AWARD$2,000
I Jimenez
7548 Bloomington AvenueBurbankCA91504noneIARTIST RELIEF AWARD$2,000
E Delaney
6319 Deveron DrCharlotteNC28211noneIARTIST RELIEF AWARD$1,000
J Fleurant
218 Superior PlWest Palm BeachFL33409noneIARTIST RELIEF AWARD$1,000
S Queen
1358 N Grant AveColumbusOH43201noneIARTIST RELIEF AWARD$1,000
S Enos
2867 Park StreetHonoluluHI96817noneIARTIST RELIEF AWARD$1,000
K Robertson
5646 Aldama StreetLos AngelesCA90042noneIARTIST RELIEF AWARD$1,000
G Rahimi
1440 Veteran AveLos AngelesCA90024noneIARTIST RELIEF AWARD$1,000
J Wiant
235 W Boundary StSavannahGA31401noneIARTIST RELIEF AWARD$1,000
J Wu
10 River RoadNew YorkNY10044noneIARTIST RELIEF AWARD$1,000
L Gallant
49 Fenno StCambridgeMA02138noneIARTIST RELIEF AWARD$1,000
J Roff
1522 Villanova DriveAustinTX78757noneIARTIST RELIEF AWARD$1,000
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$195,125TotalGrantOrContriPdDurYrAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

FieldValueIRS element (for citing)
Fees Contracts From Govt AgFeesContractsFromGovtAgGrp
Membership Dues And AssmntMembershipDuesAndAssmntGrp

Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$4,338ExclusionAmt

Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$156,216ExclusionAmt
FieldValueIRS element (for citing)
Net Rntl Incm Re Debt Fincd PropNetRntlIncmReDebtFincdPropGrp
Net Rntl Incm Re Not Debt Fincd PropNetRntlIncmReNotDebtFincdProp
Net Rental Income Personal PropNetRentalIncomePersonalPropGrp
Other Investment IncomeOtherInvestmentIncomeGrp

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion$94,245ExclusionAmt
FieldValueIRS element (for citing)
Net Income Loss From Special EvtNetIncomeLossFromSpecialEvtGrp
Gross Profit Loss Sls Of InvntryGrossProfitLossSlsOfInvntryGrp

Other Revenue Described OtherRevenueDescribedGrp

FieldValueIRS element (for citing)
DescK-1 Inc/LossDesc
Business525990BusinessCd
Unrelated Business Taxbl Incm$12,688UnrelatedBusinessTaxblIncmAmt
Exclusion14ExclusionCd
Exclusion$9,778ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$12,688UnrelatedBusinessTaxblIncmAmt
Exclusion$264,577ExclusionAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$277,265TotalIncomeProducingActyAmt

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

Depreciation Schedule DepreciationSchedule

Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule

Investments Corporate Bonds InvestmentsCorporateBondsGrp (21 entries)

BondBondNmEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
AMERICAN EXPRESS - 3.400% - 02$103,150$102,886
AMERICAN HONDA FIN CORP - 2.04$130,128$130,211
AMERICAN TOWER CORP BOND - 4.0$104,189$112,403
AT&T INC - 4.300% - 02/15/2030$149,449$140,816
BANK OF MONTREAL - 2.500% - 06$121,212$118,616
BK OF AMERICA CORP SER - 3.593$121,496$118,391
CITIGROUP INC BND - 3.300% - 0$100,653$106,251
COCA COLA CO NOTE CALL - 1.375$93,872$94,320
CVS CAREMARK CORP NOTE - 4.300$95,828$93,210
DUKE ENERGY CORP - 3.400% - 06$113,630$106,020
GENERAL MLS INC - 4.000% - 04/$131,435$130,997
GOLDMAN SACHS GROUP - 4.250% -$116,273$119,961
JEFFERIES GROUP LLC - 4.850% -$123,812$119,103
KLA-TENCOR SR GLBL NT - 4.650%$104,583$108,435
MORGAN STANLEY NOTE - 1.869% -$126,524$129,318
ORACLE CORP NOTE CALL MAKE WHO$98,114$95,710
PROLOGIS - 2.125% - 04/15/2027$134,436$132,210
SUNOCO LOGISTICS PARTNERS - 5.$105,355$102,544
UNITEDHEALTH GROUP INC - 3.850$103,210$100,386
VERIZON COMMUNICATIONS - 3.376$139,297$133,018
WELLS FARGO CO MTN BE - 3.450%$127,392$128,573

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp

FieldValueIRS element (for citing)
StockCNI FIXED INCOME OPP FD CL NStockNm
EOY Book Value$615,081EOYBookValueAmt
EOYFMV$580,044EOYFMVAmt

Investments Govt Obligations Sch InvestmentsGovtObligationsSch

FieldValueIRS element (for citing)
US Govt Obligations Book Vl EOY$2,181,987USGovtObligationsBookVlEOYAmt
US Govt Obligations EOYFMV$2,143,615USGovtObligationsEOYFMVAmt

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOtherGrp (6 entries)

Category Or ItemCategoryOrItemTxtBook ValueBookValueAmtEOYFMVEOYFMVAmt
CAM CAPITAL 374 LLC$779,163$990,210
CAM MANAGEMENT 418 LLC$355,493$493,264
CAM MANAGEMENT 421 LLC$349,945$484,301
GOLUB CAPITAL PARTNERS INTERNA$236,776$450,000
HERSHISER INCOME FUND II, LP$43,599$41,504
KAISER INDUSTRIAL LLC$639,789$908,114

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (8 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmtNet Investment IncomeNetInvestmentIncomeAmt
Administrative Fees$38,153$38,153
Indemnification Insurance$1,131$1,131
K-1 Exp CAM MANAGEMENT 421 LLC$3
K-1 Exp HERSHISER INCOME FUND$690$690
ADVERTISING & SOCIAL MEDIA$9,335$9,335
Postage/Delivery Service$3,399$3,399
State or Local Filing Fees$130$130
Website Hosting/Support$7,813$7,813

Other Income Schedule2 OtherIncomeSchedule2

Other Income Detail OtherIncomeDetail (4 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtNet Investment IncomeNetInvestmentIncomeAmt
K-1 Inc/Loss CAM CAPITAL 374 LLC$27,761$27,761
K-1 Inc/Loss CAM MANAGEMENT 418 LLC-$22,303-$22,303
K-1 Inc/Loss CAM MANAGEMENT 421 LLC$4,352$937
K-1 Inc/Loss KAISER INDUSTRIAL LLC$12,656$3,383

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees Detail OtherProfessionalFeesDetail (3 entries)

CategoryCategoryTxtAmtAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
Investment Management Services$11,328$11,328
Philanthropic Consulting Srvcs$5,000$5,000
Website Development$35,908$35,308

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (2 entries)

CategoryCategoryTxtAmtAmt
990-PF Estimated Tax for 2021$6,700
990-PF Extension for 2020$1,540

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.