RENAISSANCE FAMILY FOUNDATION INC: Form 990PF, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- RENAISSANCE FAMILY FOUNDATION INC (EIN 46-1376165)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-14
- IRS object ID
- 202243189349101229
- 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
- Investments Corp Stock Schedule
- Other Assets Schedule
- Other Expenses Schedule
- Other Increases Schedule
- Other Liabilities Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-14T08:37:04-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 MICHIGAN AVE STE 100 | AddressLine1Txt |
| City | EAST LANSING | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48823 | 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 | 461376165 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RENAISSANCE FAMILY FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | RENA | BusinessNameControlTxt |
| Phone | 5173496000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 S EAST ST | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46202 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JESSICA KENWORTHY | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 5173496000 | PhoneNum |
| Signature | 2022-11-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JESSICA | PersonFirstNm |
| Person Last | KENWORTHY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID LOWENTHAL CPA | PreparerPersonNm |
| PTIN | P00378651 | PTIN |
| Phone | 5173326200 | PhoneNum |
| Preparation | 2022-11-10 | PreparationDt |
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) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $2,147,124 | FMVAssetsEOYAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rcvd Rev And Expnss | $0 | ContriRcvdRevAndExpnssAmt |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Dividends Rev And Expnss | $35,329 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $35,329 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $44,564 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $326,648 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $44,564 | CapGainNetIncmNetInvstIncmAmt |
| Total Rev And Expnss | $79,893 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $79,893 | 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 |
| Interest Rev And Expnss | $4 | InterestRevAndExpnssAmt |
| Interest Net Invst Incm | $4 | InterestNetInvstIncmAmt |
| Interest Dsbrs Chrtbl | $0 | InterestDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $18,254 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $9,637 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Dsbrs Chrtbl | $8,617 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $18,258 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $9,641 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $8,617 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $0 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $0 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $18,258 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $9,641 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $8,617 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $61,635 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $70,252 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $35,081 | CashBOYAmt |
| Cash EOY | $22,256 | CashEOYAmt |
| Cash EOYFMV | $22,256 | CashEOYFMVAmt |
| Sav And Temp Cash Invst BOY | $22,124 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $17,834 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $17,834 | SavAndTempCashInvstEOYFMVAmt |
| Corporate Stock BOY | $1,789,857 | CorporateStockBOYAmt |
| Corporate Stock EOY | $2,107,017 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $2,107,017 | CorporateStockEOYFMVAmt |
| Other Assets BOY | $22 | OtherAssetsBOYAmt |
| Other Assets EOY | $17 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $17 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $1,847,084 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,147,124 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $2,147,124 | TotalAssetsEOYFMVAmt |
| Accounts Payable BOY | $500 | AccountsPayableBOYAmt |
| Other Liabilities BOY | $1,973 | OtherLiabilitiesBOYAmt |
| Other Liabilities EOY | $3,251 | OtherLiabilitiesEOYAmt |
| Total Liabilities BOY | $2,473 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,251 | TotalLiabilitiesEOYAmt |
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
| No Donor Rstr Net Assests BOY | $1,844,611 | NoDonorRstrNetAssestsBOYAmt |
| No Donor Rstr Net Assests EOY | $2,143,873 | NoDonorRstrNetAssestsEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $1,844,611 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $2,143,873 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $1,847,084 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $2,147,124 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $1,844,611 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $61,635 | ExcessRevenueOverExpensesAmt |
| Other Increases | $237,627 | OtherIncreasesAmt |
| Subtotal | $2,143,873 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $2,143,873 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Property | SALE OF STOCK | PropertyDesc |
| How Acquired | P | HowAcquiredCd |
| Acquired | 2021-03-10 | AcquiredDt |
| Sold | 2021-08-16 | SoldDt |
| Gross Sales Price | $326,648 | GrossSalesPriceAmt |
| Cost Or Other Basis | $282,084 | CostOrOtherBasisAmt |
| Gain Or Loss | $44,564 | GainOrLossAmt |
| Gains Minus Excess Or Losses | $44,564 | GainsMinusExcessOrLossesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $44,564 | CapitalGainNetIncomeAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $977 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $977 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $977 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $2,080 | EstimatedPlusOvpmtIncmTxAmt |
| Exempt Frgn Org Tax Wthld At Srce | $0 | ExemptFrgnOrgTaxWthldAtSrceAmt |
| Extsn Request Income Tax Paid | $0 | ExtsnRequestIncomeTaxPaidAmt |
| Backup Withholding Withheld | $0 | BackupWithholdingWithheldAmt |
| Total Payments And Credits | $2,080 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $9 | EsPenaltyAmt |
| Overpayment | $1,094 | OverpaymentAmt |
| Applied To ES Tax | $1,094 | 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 | IN | OrgReportOrRegisterStateCd |
| Org Report Or Register State | MI | 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 | JESSICA KENWORTHY | IndividualWithBooksNm |
| Phone | 5173496000 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 S EAST ST | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46202 | 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 (6 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 |
|---|---|---|---|---|---|---|---|---|
| ROBERT P MULLIGAN | ||||||||
| 225 S EAST ST | INDIANAPOLIS | IN | 46202 | PRESIDENT/CHAIRPERSON | 1.00 | $0 | $0 | $0 |
| JESSICA KENWORTHY | ||||||||
| 225 S EAST ST | INDIANAPOLIS | IN | 46202 | CFO/TREASURER | 1.00 | $0 | $0 | $0 |
| JORDAN G LEAMING | ||||||||
| 225 S EAST ST | INDIANAPOLIS | IN | 46202 | SECRETARY | 1.00 | $0 | $0 | $0 |
| CHRIS ADAMS | ||||||||
| 225 S EAST ST | INDIANAPOLIS | IN | 46202 | EXECUTIVE DIRECTOR | 4.00 | $0 | $0 | $0 |
| JEFFREY M KOLESAR | ||||||||
| 225 S EAST ST | INDIANAPOLIS | IN | 46202 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| YUEYING LAFLEUR | ||||||||
| 225 S EAST ST | INDIANAPOLIS | IN | 46202 | DIRECTOR | 1.00 | $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 |
Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | THE RENAISSANCE FAMILY FOUNDATION WILL FOCUS ITS PHILANTHROPIC EFFORTS ON SUPPORTING AND ENHANCING THE HEALTH AND WELL-BEING OF CHILDREN AND THEIR FAMILIES IN COMMUNITIES ACROSS THE COUNTRY WHERE RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA OPERATES. IN PARTICULAR, WE INTEND TO FOCUS OUR RESOURCES ON GROUPS AND ORGANIZATIONS THAT ARE DEDICATED TO PROMOTING HEALTHY FAMILIES AND ORAL HEALTH USING VARIOUS HEALTH, EDUCATION, AND LITERACY INITIATIVES. WE INTEND TO PARTNER WITH LIKE-MINDED ORGANIZATIONS TO LEVERAGE OUR RESOURCES AND BROADEN OUR SCOPE. | Description1Txt |
| Expenses1 | $0 | Expenses1Amt |
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 | $1,969,536 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $41,324 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $2,010,860 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $2,010,860 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $30,163 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $1,980,697 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $99,035 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $99,035 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $977 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $977 | TotalTaxAmt |
| Distributable Before Adj | $98,058 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $98,058 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $98,058 | DistributableAsAdjustedAmt |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $8,617 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $8,617 | QualifyingDistributionsAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $98,058 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $0 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr5 | $19,941 | ExcessDistributionCyovYr5Amt |
| Total Excess Distribution Cyov | $19,941 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $8,617 | QualifyingDistributionsAmt |
| Applied To Year1 | $0 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $8,617 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $0 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $19,941 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $19,941 | 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 | $69,500 | UndistributedIncomeCYAmt |
| Corpus Distri170b1 E Or4942g3 | $0 | CorpusDistri170b1EOr4942g3Amt |
| Excess Distri Cyov From Yr5 | $0 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $0 | ExcessDistriCyovToNextYrAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
| Total Grant Or Contri Pd Dur Yr | $0 | 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 | $35,329 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Related Or Exempt Function Incm | $44,564 | RelatedOrExemptFunctionIncmAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $35,329 | ExclusionAmt |
| Related Or Exempt Function Incm | $44,564 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $79,893 | TotalIncomeProducingActyAmt |
Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp
Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Line Number | 4 | LineNumberTxt |
| Relationship Statement | DIVIDENDS ON SHORT TERM INVESTMENTS | RelationshipStatementTxt |
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 | Yes (1) | RelationshipsNonchrtblEOInd |
Relationship Schedule Detail RelationshipScheduleDetail (9 entries)
| Organization TypeOrganizationTypeDesc | Relationship DescriptionRelationshipDescriptionTxt |
|---|---|
| RENAISSANCE HEALTH SERVICE CORPORATION | |
| 501(C)(4) | INDIRECT CONTROLLING ENTITY |
| DELTA DENTAL PLAN OF MICHIGAN INC | |
| 501(C)(4) | COMMONLY CONTROLLED INDIRECTLY BY RENAISSANCE HEALTH SERVICE CORPORATION |
| DELTA DENTAL OF TENNESSEE INC | |
| 501(C)(4) | COMMONLY CONTROLLED INDIRECTLY BY RENAISSANCE HEALTH SERVICE CORPORATION |
| DELTA DENTAL PLAN OF NEW MEXICO INC | |
| 501(C)(4) | COMMONLY CONTROLLED INDIRECTLY BY RENAISSANCE HEALTH SERVICE CORPORATION |
| DELTA DENTAL OF NORTH CAROLINA | |
| 501(C)(4) | COMMONLY CONTROLLED INDIRECTLY BY RENAISSANCE HEALTH SERVICE CORPORATION |
| DELTA DENTAL PLAN OF OHIO INC | |
| 501(C)(4) | COMMONLY CONTROLLED INDIRECTLY BY RENAISSANCE HEALTH SERVICE CORPORATION |
| DELTA DENTAL PLAN OF INDIANA INC | |
| 501(C)(4) | COMMONLY CONTROLLED INDIRECTLY BY RENAISSANCE HEALTH SERVICE CORPORATION |
| DELTA DENTAL PLAN OF ARKANSAS | |
| 501(C)(4) | COMMONLY CONTROLLED INDIRECTLY BY RENAISSANCE HEALTH SERVICE CORPORATION |
| DELTA DENTAL OF KENTUCKY INC | |
| 501(C)(4) | COMMONLY CONTROLLED INDIRECTLY BY RENAISSANCE HEALTH SERVICE CORPORATION |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Stock | MUTUAL FUNDS | StockNm |
| EOY Book Value | $2,107,017 | EOYBookValueAmt |
| EOYFMV | $2,107,017 | EOYFMVAmt |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INTEREST RECEIVABLE | Desc |
| BOY Book Value | $22 | BOYBookValueAmt |
| EOY Book Value | $17 | EOYBookValueAmt |
| EOYFMV | $17 | EOYFMVAmt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (6 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| BANK CHARGES | $1,299 | $1,299 | $0 |
| LIABILITY INSURANCE | $786 | $0 | $786 |
| INVESTMENT MANAGER FEES | $4,828 | $4,828 | $0 |
| AFFILIATE CONTRACT LABOR | $7,207 | $0 | $7,207 |
| COMPUTER SERVICES | $624 | $0 | $624 |
| FEDERAL TAX EXPENSE | $3,510 | $3,510 | $0 |
Other Increases Schedule OtherIncreasesSchedule
Other Increases Detail OtherIncreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET UNREALIZED GAIN | Desc |
| Amt | $237,627 | Amt |
Other Liabilities Schedule OtherLiabilitiesSchedule
Other Liabilities Detail OtherLiabilitiesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATES | Desc |
| BOY Book Value | $1,973 | BOYBookValueAmt |
| EOY Book Value | $3,251 | EOYBookValueAmt |
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