SAMUELSON CHARITABLE FOUNDATION INC: Form 990PF, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- SAMUELSON CHARITABLE FOUNDATION INC (EIN 95-4594473)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-14
- IRS object ID
- 202233189349100948
- 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
- Form 990-PF
- Schedule B
- Accounting Fees Schedule
- Investments Other Schedule2
- Other Assets Schedule
- Other Expenses Schedule
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-14T10:22:37-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 201484966 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SKINNER FOUCH & OLSON LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 38 DISCOVERY SUITE 250 | AddressLine1Txt |
| City | IRVINE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92618 | 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 | 954594473 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAMUELSON CHARITABLE FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SAMU | BusinessNameControlTxt |
| Phone | 8185000155 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5000 EDENHURST AVENUE | AddressLine1Txt |
| City | LOS ANGELES | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90039 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | REID G SAMUELSON | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 8185000155 | PhoneNum |
| Signature | 2022-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | REID | PersonFirstNm |
| Person Last | SAMUELSON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 000000000 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LISA R ANNAN | PreparerPersonNm |
| PTIN | P00543409 | PTIN |
| Phone | 9492601430 | 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 | 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 | $3,144,024 | 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 | $512,000 | ContriRcvdRevAndExpnssAmt |
| Dividends Rev And Expnss | $4,597 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $4,597 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $27,009 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $286,892 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $27,009 | CapGainNetIncmNetInvstIncmAmt |
| Total Rev And Expnss | $543,606 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $31,606 | 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 | $9,580 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $9,580 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Chrtbl Prps | $0 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Rev And Expnss | $12,138 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $12,138 | OtherProfFeesNetInvstIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $0 | OtherProfFeesDsbrsChrtblAmt |
| Taxes Rev And Expnss | $1,000 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $0 | TaxesNetInvstIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $58 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $0 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Dsbrs Chrtbl | $25 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $22,776 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $21,718 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $25 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $109,400 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $109,400 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $132,176 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $21,718 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $109,425 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $411,430 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $9,888 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Investments BOY | $1,964,966 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $2,391,660 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $3,144,024 | OtherInvestmentsEOYFMVAmt |
| Other Assets BOY | $15,264 | OtherAssetsBOYAmt |
| Other Assets EOY | $0 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $0 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $1,980,230 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,391,660 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $3,144,024 | 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 | $1,980,230 | RetainedEarningBOYAmt |
| Retained Earning EOY | $2,391,660 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $1,980,230 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $2,391,660 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $1,980,230 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $2,391,660 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $1,980,230 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $411,430 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $2,391,660 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $2,391,660 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (3 entries)
| PropertyPropertyDesc | How AcquiredHowAcquiredCd | AcquiredAcquiredDt | SoldSoldDt | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt |
|---|---|---|---|---|---|---|---|
| D.A. DAVIDSON | P | 2020-01-10 | 2021-03-01 | $250,000 | $249,140 | $860 | $860 |
| HIGHLAND INVESTMENT TRUST | P | $22,747 | $10,743 | $12,004 | $12,004 | ||
| CAPITAL GAINS DIVIDENDS | P | $14,145 | $14,145 | $14,145 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $27,009 | CapitalGainNetIncomeAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $137 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $137 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $137 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $123 | EstimatedPlusOvpmtIncmTxAmt |
| Exempt Frgn Org Tax Wthld At Srce | $0 | ExemptFrgnOrgTaxWthldAtSrceAmt |
| Extsn Request Income Tax Paid | $1,500 | ExtsnRequestIncomeTaxPaidAmt |
| Backup Withholding Withheld | $0 | BackupWithholdingWithheldAmt |
| Total Payments And Credits | $1,623 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Overpayment | $1,486 | OverpaymentAmt |
| Applied To ES Tax | $1,486 | 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 | CA | 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 | REID G SAMUELSON | IndividualWithBooksNm |
| Phone | 8185000155 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5000 EDENHURST AVENUE | AddressLine1Txt |
| City | LOS ANGELES | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90039 | 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 (3 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 |
|---|---|---|---|---|---|---|---|---|
| JACK D SAMUELSON | ||||||||
| 5000 EDENHURST AVENUE | LOS ANGELES | CA | 90039 | CHIEF EXECUTIVE OFFICER | 0.00 | $0 | $0 | $0 |
| REID G SAMUELSON | ||||||||
| 5000 EDENHURST AVENUE | LOS ANGELES | CA | 90039 | CHIEF FINANCIAL OFFICER | 0.00 | $0 | $0 | $0 |
| DORIS C SAMUELSON | ||||||||
| 5000 EDENHURST AVENUE | LOS ANGELES | CA | 90039 | SECRETARY | 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 |
| Comp Of Hghst Pd Cntrct Or NONE | NONE | CompOfHghstPdCntrctOrNONETxt |
| 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 | $1,445,598 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $1,495,104 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $2,940,702 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $2,940,702 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $44,111 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $2,896,591 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $144,830 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $144,830 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $137 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $137 | TotalTaxAmt |
| Distributable Before Adj | $144,693 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $144,693 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $144,693 | DistributableAsAdjustedAmt |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $109,425 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $109,425 | QualifyingDistributionsAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $144,693 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $0 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr5 | $26,892 | ExcessDistributionCyovYr5Amt |
| Total Excess Distribution Cyov | $26,892 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $109,425 | QualifyingDistributionsAmt |
| Applied To Year1 | $0 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $109,425 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $0 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $26,892 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $26,892 | 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 | $8,376 | 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) |
|---|---|---|
| Contributing Manager | JACK D SAMUELSON | ContributingManagerNm |
| Contributing Manager | REID G SAMUELSON | ContributingManagerNm |
| Contributing Manager | DORIS C SAMUELSON | ContributingManagerNm |
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (20 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| ARLINGTON GARDEN IN PASADENA | |||||||
| PO BOX 50617 | PASADENA | CA | 91105 | NONE | PC | GENERAL PROGRAM SUPPORT | $1,500 |
| BEACON HOUSING INC | |||||||
| 5000 EDENHURST AVENUE | LOS ANGELES | CA | 90039 | NONE | PC | GENERAL PROGRAM SUPPORT | $36,000 |
| BRIDGES | |||||||
| 466 FOOTHILL BLVD SUITE 320 | LA CANADA | CA | 91011 | NONE | PC | GENERAL PROGRAM SUPPORT | $8,500 |
| CHRIST LUTHERAN CHURCH | |||||||
| 25816 TOURNAMENT ROAD | SANTA CLARITA | CA | 91355 | NONE | PC | GENERAL PROGRAM SUPPORT | $3,000 |
| CHRIST THE SERVANT LUTHERAN CHURCH | |||||||
| 506 VIA APPIA WAY | LOUISVILLE | CO | 80027 | NONE | PC | GENERAL PROGRAM SUPPORT | $1,500 |
| COMMUNITY LIFE CHURCH | |||||||
| 4441 LA CRESCENTA AVE | LA CRESCENTA | CA | 91214 | NONE | PC | GENERAL PROGRAM SUPPORT | $3,000 |
| CONNECT2MINISTRIES | |||||||
| 2635 BRINDLE COURT | SIMI VALLEY | CA | 93063 | NONE | PC | GENERAL PROGRAM SUPPORT | $1,500 |
| DOOR OF HOPE | |||||||
| PO BOX 90455 | PASADENA | CA | 91109 | NONE | PC | GENERAL PROGRAM SUPPORT | $10,000 |
| FIRESIDE ELEMENTARY SCHOOL | |||||||
| 845 W DAHLIA STREET | LOUISVILLE | CO | 80027 | NONE | PC | GENERAL PROGRAM SUPPORT | $1,000 |
| FULLER SEMINARY | |||||||
| 385 E COLORADO BLVD S-250 | PASADENA | CA | 91101 | NONE | PC | GENERAL PROGRAM SUPPORT | $10,000 |
| HOLLYWOOD CHURCH OF CHRIST | |||||||
| 600 N ROSSMORE AVENUE | LOS ANGELES | CA | 90004 | NONE | PC | GENERAL PROGRAM SUPPORT | $3,000 |
| LA CANADA PRESBYTERIAN CHURCH | |||||||
| 626 FOOTHILL BLVD | LA CANADA | CA | 91011 | NONE | PC | GENERAL PROGRAM SUPPORT | $3,000 |
| MOUNT HERMON | |||||||
| PO BOX 413 | MOUNT HERMON | CA | 95041 | NONE | PC | GENERAL PROGRAM SUPPORT | $10,000 |
| NEW HOPE LUTHERAN CHURCH | |||||||
| 29295 AGOURA ROAD | AGOURA HILLS | CA | 91301 | NONE | PC | GENERAL PROGRAM SUPPORT | $3,000 |
| PAT TILLMAN FOUNDATION | |||||||
| 400 E TYLER MALL | TEMPE | AZ | 85281 | NONE | PC | GENERAL PROGRAM SUPPORT | $1,000 |
| ROSE DRIVE FRIENDS CHURCH | |||||||
| 4221 ROSE DRIVE | YORBA LINDA | CA | 92886 | NONE | PC | GENERAL PROGRAM SUPPORT | $3,000 |
| SAN DIEGUITO UNITED METHODIST CHURCH | |||||||
| 170 CALLE MAGDALENA | ENCINITAS | CA | 92024 | NONE | PC | GENERAL PROGRAM SUPPORT | $1,500 |
| SHEPHERD CHURCH | |||||||
| 19700 RINALDI STREET | PORTER RANCH | CA | 91326 | NONE | PC | GENERAL PROGRAM SUPPORT | $2,400 |
| THE MOVEMENT CHURCH | |||||||
| 1609 CAPALINA ROAD | SAN MARCOS | CA | 92069 | NONE | PC | GENERAL PROGRAM SUPPORT | $1,500 |
| CRESCENTA CANADA FAMILY YMCA | |||||||
| 1936 FOOTHILL BLVD | LA CANADA | CA | 91011 | NONE | PC | GENERAL PROGRAM SUPPORT | $5,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $109,400 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $4,597 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $27,009 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $31,606 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $31,606 | 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 (3 entries)
| ContributorContributorNum | Address Line1ContributorUSAddress/AddressLine1Txt | CityContributorUSAddress/CityNm | State AbbreviationContributorUSAddress/StateAbbreviationCd | ZIPContributorUSAddress/ZIPCd | Total ContributionsTotalContributionsAmt | Person ContributionPersonContributionInd |
|---|---|---|---|---|---|---|
| JACK D SAMUELSON | ||||||
| 1 | 5000 EDENHURST AVENUE | LOS ANGELES | CA | 90039 | $162,000 | Yes (X) |
| REID G SAMUELSON | ||||||
| 2 | 5000 EDENHURST AVENUE | LOS ANGELES | CA | 90039 | $105,000 | Yes (X) |
| DORIS C SAMUELSON | ||||||
| 3 | 5000 EDENHURST AVENUE | LOS ANGELES | CA | 90039 | $245,000 | Yes (X) |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | ACCOUNTING | CategoryTxt |
| Amt | $9,580 | Amt |
| Net Investment Income | $9,580 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (2 entries)
| Category Or ItemCategoryOrItemTxt | Listed At Cost Or FMVListedAtCostOrFMVCd | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| CASH EQUIVALENTS | FMV | $1,762,664 | $1,791,349 |
| HIGHLAND INVESTMENT TRUST | FMV | $628,996 | $1,352,675 |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RECEIVABLE FROM H. JAMES SCHAFER | Desc |
| BOY Book Value | $15,264 | BOYBookValueAmt |
| EOY Book Value | $0 | EOYBookValueAmt |
| EOYFMV | $0 | EOYFMVAmt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (2 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| FILING FEES | $25 | $0 | $25 |
| OTHER EXPENSE | $33 | $0 | $0 |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | FROM HIGHLAND INVESTMENT TRUST | CategoryTxt |
| Amt | $12,138 | Amt |
| Net Investment Income | $12,138 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | FEDERAL TAX | CategoryTxt |
| Amt | $1,000 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |