BETA

GOSTOMSKI FOUNDATION: Form 990PF, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
GOSTOMSKI FOUNDATION (EIN 46-6976292)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-14
IRS object ID
202233189349102073
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)
Return2022-11-14T09:23:48-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FRIEDMAN & HUEY ASSOC LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11313 WEST 175TH STREETAddressLine1Txt
CityHOMEWOODCityNm
State AbbreviationILStateAbbreviationCd
ZIP60430ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN466976292EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE GOSTOMSKI FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% RYAN WIRTZInCareOfNm
Business Name ControlGOSTBusinessNameControlTxt
Phone7087996800PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O FH LLP 1313 W 175TH STAddressLine1Txt
CityHOMEWOODCityNm
State AbbreviationILStateAbbreviationCd
ZIP60430ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN STAABPersonNm
Person TitleTRUSTEEPersonTitleTxt
Phone7087996800PhoneNum
Signature2022-11-01SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJOHNPersonFirstNm
Person LastSTAABPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRYAN WIRTZPreparerPersonNm
PTINP01623867PTIN
Phone7087996800PhoneNum
Preparation2022-11-04PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
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$21,345,007FMVAssetsEOYAmt
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$7,014InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$7,014InterestOnSavNetInvstIncmAmt
Dividends Rev And Expnss$804,774DividendsRevAndExpnssAmt
Dividends Net Invst Incm$804,774DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss$492,468NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$1,029,579GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$492,468CapGainNetIncmNetInvstIncmAmt
Other Income Rev And Expnss$75,033OtherIncomeRevAndExpnssAmt
Other Income Net Invst Incm-$128,088OtherIncomeNetInvstIncmAmt
Total Rev And Expnss$1,379,289TotalRevAndExpnssAmt
Total Net Invst Incm$1,176,168TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$0CompOfcrDirTrstRevAndExpnssAmt
Other Prof Fees Rev And Expnss$103,885OtherProfFeesRevAndExpnssAmt
Other Prof Fees Net Invst Incm$103,885OtherProfFeesNetInvstIncmAmt
Taxes Rev And Expnss$104,645TaxesRevAndExpnssAmt
Taxes Net Invst Incm$1,214TaxesNetInvstIncmAmt
Other Expenses Rev And Expnss$255,758OtherExpensesRevAndExpnssAmt
Other Expenses Net Invst Incm$229,865OtherExpensesNetInvstIncmAmt
Other Expenses Dsbrs Chrtbl$195OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$464,288TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$334,964TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$195TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$465,586ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$465,586ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$929,874TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$334,964TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$465,781TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses$449,415ExcessRevenueOverExpensesAmt
Net Investment Income$841,204NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Cash BOY$503,872CashBOYAmt
Cash EOY$126,490CashEOYAmt
Cash EOYFMV$126,490CashEOYFMVAmt
Sav And Temp Cash Invst BOY$2,817,283SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$968,190SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$971,223SavAndTempCashInvstEOYFMVAmt
Corporate Stock BOY$441,863CorporateStockBOYAmt
Corporate Stock EOY$0CorporateStockEOYAmt
Corporate Stock EOYFMV$0CorporateStockEOYFMVAmt
Other Investments BOY$14,453,564OtherInvestmentsBOYAmt
Other Investments EOY$17,653,275OtherInvestmentsEOYAmt
Other Investments EOYFMV$20,166,554OtherInvestmentsEOYFMVAmt
Other Assets BOY$540OtherAssetsBOYAmt
Other Assets EOY$80,740OtherAssetsEOYAmt
Other Assets EOYFMV$80,740OtherAssetsEOYFMVAmt
Total Assets BOY$18,217,122TotalAssetsBOYAmt
Total Assets EOY$18,828,695TotalAssetsEOYAmt
Total Assets EOYFMV$21,345,007TotalAssetsEOYFMVAmt
Other Liabilities BOY$199,031OtherLiabilitiesBOYAmt
Other Liabilities EOY$265,809OtherLiabilitiesEOYAmt
Total Liabilities BOY$199,031TotalLiabilitiesBOYAmt
Total Liabilities EOY$265,809TotalLiabilitiesEOYAmt
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind
Retained Earning BOY$18,018,091RetainedEarningBOYAmt
Retained Earning EOY$18,562,886RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY$18,018,091TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$18,562,886TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$18,217,122TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$18,828,695TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$18,018,091TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses$449,415ExcessRevenueOverExpensesAmt
Other Increases$95,380OtherIncreasesAmt
Subtotal$18,562,886SubtotalAmt
Tot Net Ast Or Fund Balances EOY$18,562,886TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (10 entries)

PropertyPropertyDescHow AcquiredHowAcquiredCdGross Sales PriceGrossSalesPriceAmtCost Or Other BasisCostOrOtherBasisAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmt
PUBLICLY TRADED SECURITIESP$48,850$45,856$2,994$2,994
PUBLICLY TRADED SECURITIESP$466,856$249,715$217,141$217,141
PUBLICLY TRADED SECURITIESP$100,569$87,938$12,631$12,631
PUBLICLY TRADED SECURITIESP$336,576$153,602$182,974$182,974
GAIN ON DISPOSITION OF PARTNERSHIP INTERESTP$13,235$13,235$13,235
CAPITAL GAIN DIVIDENDSP$65
CAPITAL GAIN DIVIDENDSP$65
CAPITAL GAIN DIVIDENDSP$65
CAPITAL GAIN DIVIDENDSP$65
CAPITAL GAIN DIVIDENDSP$65
FieldValueIRS element (for citing)
Capital Gain Net Income$492,468CapitalGainNetIncomeAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$11,693InvestmentIncomeExciseTaxAmt
Subtotal$11,693SubtotalAmt
Tax Based On Investment Income$11,693TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$49,436EstimatedPlusOvpmtIncmTxAmt
Exempt Frgn Org Tax Wthld At Srce$0ExemptFrgnOrgTaxWthldAtSrceAmt
Total Payments And Credits$49,436TotalPaymentsAndCreditsAmt
Form2220 AttachedYes (X)Form2220AttachedInd
Es Penalty$0EsPenaltyAmt
Overpayment$37,743OverpaymentAmt
Applied To ES Tax$37,743AppliedToESTaxAmt

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 StateILOrgReportOrRegisterStateCd
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 AddressN/AWebsiteAddressTxt

Persons With Books Name PersonsWithBooksName

FieldValueIRS element (for citing)
Business Name Line1RYAN WIRTZBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7087996800PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line1C/O FH ASSOC 1313 W 175TH STAddressLine1Txt
CityHOMEWOODCityNm
State AbbreviationILStateAbbreviationCd
ZIP60430ZIPCd
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 PrsnYes (true)PayCompDisqualifiedPrsnInd
Transfer Ast Disqualified PrsnfalseTransferAstDisqualifiedPrsnInd
Payment To Government OfficialfalsePaymentToGovernmentOfficialInd
Acts Fail To Qlfy As ExceptionsfalseActsFailToQlfyAsExceptionsInd
Uncorrected Prior ActsfalseUncorrectedPriorActsInd
Undistributed Income PYfalseUndistributedIncomePYInd
Business HoldingsfalseBusinessHoldingsInd
Jeopardy InvestmentsfalseJeopardyInvestmentsInd
Uncorrected PY Jeopardy InvstfalseUncorrectedPYJeopardyInvstInd
Influence LegislationfalseInfluenceLegislationInd
Influence ElectionfalseInfluenceElectionInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Noncharitable PurposefalseNoncharitablePurposeInd
Transactions Fail To Qlfy As ExcfalseTransactionsFailToQlfyAsExcInd
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 (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
MICHAEL M GOSTOMSKI
C/O FH ASSOC LLP 1313 W 175TH STHOMEWOODIL60430TRUSTEE0$0$0$0
JOHN STAAB
18W140 BUTTERFIELD RD STE 1110OAKBROOK TERRACEIL60181CO-TRUSTEE0$0$0$0
CHRISTOPHER HUGHES
18W140 BUTTERFIELD RD STE 1110OAKBROOK TERRACEIL60181CO-TRUSTEE0$0$0$0
ADAM DAMEROW
525 W MONROE STCHICAGOIL60661CO-TRUSTEE0$0$0$0

Compensation Of Hghst Pd Cntrct CompensationOfHghstPdCntrctGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CYPRESS MANAGEMENT LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line118W140 BUTTERFIELD ROAD STE 1110AddressLine1Txt
CityOAKBROOK TERRACECityNm
State AbbreviationILStateAbbreviationCd
ZIP60181ZIPCd
FieldValueIRS element (for citing)
Service TypeINVESTMENT SERVICESServiceTypeTxt
Compensation$101,500CompensationAmt
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$20,806,437AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$175,647AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$20,982,084TotalFMVOfUnusedAssetsAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$20,982,084AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$314,731CashDeemedCharitableAmt
Net Vl Noncharitable Assets$20,667,353NetVlNoncharitableAssetsAmt
Minimum Investment Return$1,033,368MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$1,033,368MinimumInvestmentReturnAmt
Tax Based On Investment Income$11,693TaxBasedOnInvestmentIncomeAmt
Total Tax$11,693TotalTaxAmt
Distributable Before Adj$1,021,675DistributableBeforeAdjAmt
Distributable Before Ded$1,021,675DistributableBeforeDedAmt
Distributable As Adjusted$1,021,675DistributableAsAdjustedAmt

PF Qualifying Distributions PFQualifyingDistributionsGrp

FieldValueIRS element (for citing)
Expenses And Contributions$465,781ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Charitable Assets Acquis Paid$0CharitableAssetsAcquisPaidAmt
Set Aside Suitability Test$0SetAsideSuitabilityTestAmt
Set Aside Cash Distri Test$0SetAsideCashDistriTestAmt
Qualifying Distributions$465,781QualifyingDistributionsAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$1,021,675DistributableAsAdjustedAmt
Undistributed Income PY$0UndistributedIncomePYAmt
Prior Year12019PriorYear1Yr
Prior Year22018PriorYear2Yr
Prior Year32017PriorYear3Yr
Total For Prior Years$0TotalForPriorYearsAmt
Excess Distribution Cyov Yr5$148,867ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr4$678,185ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr2$674,122ExcessDistributionCyovYr2Amt
Total Excess Distribution Cyov$1,501,174TotalExcessDistributionCyovAmt
Qualifying Distributions$465,781QualifyingDistributionsAmt
Applied To Year1$0AppliedToYear1Amt
Applied To Current Year$465,781AppliedToCurrentYearAmt
Remaining Distri From Corpus$0RemainingDistriFromCorpusAmt
Excess Distri Cyov App CY Corpus$555,894ExcessDistriCyovAppCYCorpusAmt
Excess Distribution Cyov App CY$555,894ExcessDistributionCyovAppCYAmt
Total Corpus$945,280TotalCorpusAmt
Prior Year Undistributed Incm$0PriorYearUndistributedIncmAmt
Taxable1$0Taxable1Amt
Taxable2$0Taxable2Amt
Undistributed Income CY$0UndistributedIncomeCYAmt
Excess Distri Cyov To Next Yr$945,280ExcessDistriCyovToNextYrAmt
Excess From Year4$271,158ExcessFromYear4Amt
Excess From Year2$674,122ExcessFromYear2Amt
FieldValueIRS element (for citing)
Private Operating FoundationsPrivateOperatingFoundationsGrp

Supplementary Information SupplementaryInformationGrp

FieldValueIRS element (for citing)
Contributing ManagerMICHAEL M GOSTOMSKIContributingManagerNm
Shareholder ManagerNONEShareholderManagerNm
Only Contri To PreselectedYes (X)OnlyContriToPreselectedInd

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (21 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
ST MARY'S UNIVERSITY OF MINNESOTA
700 TERRACE HEIGHTSWINONAMN55987NONEPCGENERAL$24,500
FAMILY AND CHILDREN CENTER
1707 MAIN STREETLA CROSSEWI54601NONEPCGENERAL$20,000
FRANCISCAN FRIARS
1289 LAFOND AVENUEST PAULMN55104NONEPCGENERAL$35,000
MINNESOTA MARINE ART MUSEUM
800 RIVERVIEW DRIVEWINONAMN55987NONEPCGENERAL$15,000
DE LASALLE HIGH SCHOOL
1 DE LASALLE DRIVEMINNEAPOLISMN55401NONEPCGENERAL$68,500
EAGLE BLUFF ENVIRONMENTAL LEARNING CENTER
28097 GOODVIEW DRLANESBOROMN55949NONEPCGENERAL$15,000
GRACE PLACE
66 E 2ND STWINONAMN55987NONEPCGENERAL$15,000
LUNDSTRUM PERFORMING ARTS
1617 2ND STMINNEAPOLISMN55411NONEPCGENERAL$10,000
WINONA VOLUNTEER SERVICE
402 E 2ND STWINONAMN55987NONEPCGENERAL$10,000
BENILDE - ST MARGARET'S
2501 MN-100ST LOUIS PARKMN55416NONEPCGENERAL$10,000
CATHOLIC CHARITIES OF SOUTHERN MINNESOTA
111 MARKET STREET SUITE 2 PO BOXWINONAMN55987NONEPCGENERAL$25,000
CHRISTIAN BROTHERS OF THE MIDWEST
7650 S COUNTY LINE ROAD SUITE BBURR RIDGEIL60527NONEPCGENERAL$25,000
MERCY HOME FOR BOYS & GIRLS
1140 W JACKSON BLVDCHICAGOIL60607NONEPCGENERAL$10,000
MORRIE MILLER ATHLETIC FOUNDATION
580 E FRONT STWINONAMN55987NONEPCGENERAL$12,500
OSCAR MIKE FOUNDATION
21003 RIVER ROADMARENGOIL60152NONEPCGENERAL$5,000
SOLDIER STRONG
1127 HIGH RIDGE ROAD 124STAMFORDCT06905NONEPCGENERAL$5,000
ST CLEMENT CHURCH
642 W DEMING PLACECHICAGOIL60614NONEPCGENERAL$25,000
WISLIM FOUNDATION
18W140 BUTTERFIELD RD STE 1110OAKBROOK TERRACEIL60181NONEPCGENERAL$100,000
GOOD SHEPHERD CATHOLIC SCHOOL
145 JERSEY AVENUESOUTH GOLDEN VALLEYMN55426NONEPCGENERAL$5,000
JAMAL CLARKE - SCHOLARSHIP
410 S 3RD STREETRIVER FALLSWI54022NONEIGENERAL$16,734
ST JOHN PAUL SCHOOL
580 E FRONT STREETWINONAMN55987NONEPCGENERAL$13,352
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$465,586TotalGrantOrContriPdDurYrAmt

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$7,014ExclusionAmt

Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$804,774ExclusionAmt
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$492,468ExclusionAmt
FieldValueIRS element (for citing)
Net Income Loss From Special EvtNetIncomeLossFromSpecialEvtGrp
Gross Profit Loss Sls Of InvntryGrossProfitLossSlsOfInvntryGrp

Other Revenue Described OtherRevenueDescribedGrp (2 entries)

DescDescExclusionExclusionCdExclusionExclusionAmtUnrelated Business Taxbl IncmUnrelatedBusinessTaxblIncmAmt
OTHER INCOME01-$9,336
LESS AMOUNTS REPORTED ON 990T$84,369

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$84,369UnrelatedBusinessTaxblIncmAmt
Exclusion$1,294,920ExclusionAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$1,379,289TotalIncomeProducingActyAmt

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 Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp (2 entries)

StockStockNmEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
UBS A/C 14618 - EQUITIES$0$0
UBS A/C 16116 - EQUITIES$0$0

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOtherGrp (27 entries)

Category Or ItemCategoryOrItemTxtListed At Cost Or FMVListedAtCostOrFMVCdBook ValueBookValueAmtEOYFMVEOYFMVAmt
UBS A/C 14615-KKK ENERGY INCAT COST$403,205$403,206
UBS A/C 14615-SPECL CR OPPORTAT COST$75,847$75,847
BRIGHTWATER HOLDINGS SERIES DAT COST$142,661$142,661
CHG-IR LLCAT COST$0$0
CHG-MF LLCAT COST$275,485$275,485
CHG-COINVESTMENT LLCAT COST$688,521$688,521
CHG-BLACKBIRD LLCAT COST$641,290$641,290
CHG-GRANARY LLCAT COST$104,868$104,868
CHG-NEWBERRY LLCAT COST$66,977$66,977
HKI BRIGHTSOURCE LLCAT COST$179,701$179,701
CHG - COINVESTMENT II LLCAT COST$1,511,977$1,511,977
CHG - OET LLCAT COST$2,093,528$2,093,528
CHG - SG LLCAT COST$2,661,682$5,174,960
CHG - SN LLCAT COST$1,989,753$1,989,753
CHG - CREDIT LLCAT COST$902,218$902,218
CHG - MF II LLCAT COST$103,326$103,326
CHG - CASTILIAN LLCAT COST$519,365$519,365
CHG - CM LLCAT COST$2,508,466$2,508,466
CHG - COINVESTMENT III LLCAT COST$957,748$957,748
CHG - GC LLCAT COST$567,194$567,194
CHG - LF I LLCAT COST$327,044$327,044
CHG - BLACKBIRD II LLCAT COST$719,971$719,971
CHG - PEARLMARK LLCAT COST$102,646$102,646
HKI HG CO-INVESTMENTAT COST$1,685$1,685
WINONA CO-OPAT COST$10,000$10,000
CHG-BIGAT COST$39,514$39,514
CHG-COINVESTMENT IV LLC$58,603$58,603

Other Assets Schedule OtherAssetsSchedule

Other Assets Schedule OtherAssetsScheduleGrp (2 entries)

DescDescBOY Book ValueBOYBookValueAmtEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
DIVIDEND RECEIVABLE$540$240$240
DUE FROM CHG OET$0$80,500$80,500

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (3 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
OTHER PSHP INVSTMENT EXPENSES$229,945$229,865$80
NONDEDUCTIBLE EXPENSES$25,698
FILING FEES$115$115

Other Income Schedule2 OtherIncomeSchedule2

Other Income Detail OtherIncomeDetail (5 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtNet Investment IncomeNetInvestmentIncomeAmt
FEDERAL TAX REFUND$81
LESS AMOUNT REPORTED ON 990-T-$84,369
TAX EXEMPT INCOME$92,116
PARTNERSHIP INCOME/LOSS-$17,164-$17,164
DEPLETION EXPENSE FROM PSHIP-$26,555

Other Increases Schedule OtherIncreasesSchedule

Other Increases Detail OtherIncreasesDetail

FieldValueIRS element (for citing)
DescPRIOR PERIOD RECONCILATIONDesc
Amt$95,380Amt

Other Liabilities Schedule OtherLiabilitiesSchedule

Other Liabilities Detail OtherLiabilitiesDetail (4 entries)

DescDescBOY Book ValueBOYBookValueAmtEOY Book ValueEOYBookValueAmt
LOCUPLETO II - AI, LLC$103,651$95,048
CAPITAL CONTRIBUTION PAYABLE -$45,380$0
OTHER PAYABLE$50,000$0
CHG-IR LLC$0$170,761

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees Detail OtherProfessionalFeesDetail

FieldValueIRS element (for citing)
CategoryINVESTMENT ADVISORY FEECategoryTxt
Amt$103,885Amt
Net Investment Income$103,885NetInvestmentIncomeAmt

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (3 entries)

CategoryCategoryTxtAmtAmtNet Investment IncomeNetInvestmentIncomeAmt
FOREIGN TAXES$43$43
FEDERAL TAXES$98,381
STATE TAXES$6,221$1,171

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