JOHN R AND ZELDA Z GRUBB CHARITABLE FOUNDATION: Form 990PF, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- JOHN R AND ZELDA Z GRUBB CHARITABLE FOUNDATION (EIN 42-6521745)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-15
- IRS object ID
- 202103199349108570
- Schema version
- 2020v4.1
- 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 Corp Bonds Schedule
- Investments Corp Stock Schedule
- Investments Govt Obligations Sch
- Investments Other Schedule2
- Legal Fees Schedule
- Other Assets Schedule
- Other Decreases Schedule
- Other Expenses Schedule
- Other Income Schedule2
- Other Increases Schedule
- Other Liabilities Schedule
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-15T16:43:16-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 666 WALNUT ST STE 1900 | AddressLine1Txt |
| City | DES MOINES | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 503093912 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 426521745 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE JOHN R AND ZELDA Z GRUBB | BusinessNameLine1Txt |
| Business Name Line2 | CHARITABLE FOUNDATION | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | JOHN | BusinessNameControlTxt |
| Phone | 5152599293 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4454 128TH ST | AddressLine1Txt |
| City | URBANDALE | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 503231728 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN W GRUBB | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 5152599293 | PhoneNum |
| Signature | 2021-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JOHN | PersonFirstNm |
| Person Last | GRUBB | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ALEXANDER RADIG CPA | PreparerPersonNm |
| PTIN | P01937466 | PTIN |
| Phone | 5152440266 | PhoneNum |
| Preparation | 2021-11-15 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | 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 | $14,037,263 | 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 | $640,606 | ContriRcvdRevAndExpnssAmt |
| Interest On Sav Rev And Expnss | $19,650 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $19,650 | InterestOnSavNetInvstIncmAmt |
| Interest On Savings Adj Net Incm | $19,650 | InterestOnSavingsAdjNetIncmAmt |
| Dividends Rev And Expnss | $192,937 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $192,937 | DividendsNetInvstIncmAmt |
| Dividends Adj Net Incm | $192,937 | DividendsAdjNetIncmAmt |
| Net Gain Sale Ast Rev And Expnss | -$243,704 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $2,803,517 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $0 | CapGainNetIncmNetInvstIncmAmt |
| Net ST Capital Gain Adj Net Incm | $0 | NetSTCapitalGainAdjNetIncmAmt |
| Other Income Rev And Expnss | $5,676,734 | OtherIncomeRevAndExpnssAmt |
| Other Income Net Invst Incm | $10,909 | OtherIncomeNetInvstIncmAmt |
| Other Income Adj Net Incm | $5,676,734 | OtherIncomeAdjNetIncmAmt |
| Total Rev And Expnss | $6,286,223 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $223,496 | TotalNetInvstIncmAmt |
| Total Adj Net Incm | $5,889,321 | TotalAdjNetIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $0 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $0 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Adj Net Incm | $0 | CompOfcrDirTrstAdjNetIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $0 | CompOfcrDirTrstDsbrsChrtblAmt |
| Oth Empl Slrs Wgs Rev And Expnss | $2,773,114 | OthEmplSlrsWgsRevAndExpnssAmt |
| Oth Empl Slrs Wgs Net Invst Incm | $0 | OthEmplSlrsWgsNetInvstIncmAmt |
| Oth Empl Slrs Wgs Adj Net Incm | $2,773,114 | OthEmplSlrsWgsAdjNetIncmAmt |
| Oth Empl Slrs Wgs Dsbrs Chrtbl | $0 | OthEmplSlrsWgsDsbrsChrtblAmt |
| Pension Empl Bnft Rev And Expnss | $196,018 | PensionEmplBnftRevAndExpnssAmt |
| Pension Empl Bnft Net Invst Incm | $0 | PensionEmplBnftNetInvstIncmAmt |
| Pension Empl Bnft Adj Net Incm | $196,018 | PensionEmplBnftAdjNetIncmAmt |
| Pension Empl Bnft Dsbrs Chrtbl | $0 | PensionEmplBnftDsbrsChrtblAmt |
| Legal Fees Rev And Expnss | $1,563 | LegalFeesRevAndExpnssAmt |
| Legal Fees Net Invst Incm | $0 | LegalFeesNetInvstIncmAmt |
| Legal Fees Adj Net Incm | $1,563 | LegalFeesAdjNetIncmAmt |
| Legal Fees Dsbrs Chrtbl | $0 | LegalFeesDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $107,001 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $0 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $100,676 | AccountingFeesAdjNetIncmAmt |
| Accounting Fees Chrtbl Prps | $6,325 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Rev And Expnss | $339,193 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $0 | OtherProfFeesNetInvstIncmAmt |
| Other Prof Fees Adj Net Incm | $339,193 | OtherProfFeesAdjNetIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $0 | OtherProfFeesDsbrsChrtblAmt |
| Taxes Rev And Expnss | $279,626 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $0 | TaxesNetInvstIncmAmt |
| Taxes Adj Net Incm | $279,626 | TaxesAdjNetIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Deprec And Dpltn Rev And Expnss | $181,706 | DeprecAndDpltnRevAndExpnssAmt |
| Deprec And Dpltn Net Invst Incm | $0 | DeprecAndDpltnNetInvstIncmAmt |
| Deprec And Dpltn Adj Net Incm | $181,706 | DeprecAndDpltnAdjNetIncmAmt |
| Other Expenses Rev And Expnss | $1,491,350 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $22,262 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Adj Net Incm | $1,469,088 | OtherExpensesAdjNetIncmAmt |
| Other Expenses Dsbrs Chrtbl | $0 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $5,369,571 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $22,262 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $5,340,984 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $6,325 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $385,019 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $385,019 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $5,754,590 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $22,262 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $5,340,984 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $391,344 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $531,633 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $201,234 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $548,337 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $610,487 | CashBOYAmt |
| Cash EOY | $920,492 | CashEOYAmt |
| Cash EOYFMV | $920,492 | CashEOYFMVAmt |
| Sav And Temp Cash Invst BOY | $599,263 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $1,751,893 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $1,751,893 | SavAndTempCashInvstEOYFMVAmt |
| Acct Rcvbl | $445,073 | AcctRcvblAmt |
| Acct Rcvbl BOY | $465,036 | AcctRcvblBOYAmt |
| Acct Rcvbl EOY | $445,073 | AcctRcvblEOYAmt |
| Acct Rcvbl EOYFMV | $445,073 | AcctRcvblEOYFMVAmt |
| Prepaid Expenses BOY | $9,805 | PrepaidExpensesBOYAmt |
| Prepaid Expenses EOY | $16,540 | PrepaidExpensesEOYAmt |
| Prepaid Expenses EOYFMV | $16,540 | PrepaidExpensesEOYFMVAmt |
| US Government Obligations BOY | $0 | USGovernmentObligationsBOYAmt |
| US Government Obligations EOY | $329,327 | USGovernmentObligationsEOYAmt |
| US Govt Obligations EOYFMV | $328,244 | USGovtObligationsEOYFMVAmt |
| Corporate Stock BOY | $0 | CorporateStockBOYAmt |
| Corporate Stock EOY | $136,200 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $166,320 | CorporateStockEOYFMVAmt |
| Corporate Bonds BOY | $0 | CorporateBondsBOYAmt |
| Corporate Bonds EOY | $246,019 | CorporateBondsEOYAmt |
| Corporate Bonds EOYFMV | $252,148 | CorporateBondsEOYFMVAmt |
| Other Investments BOY | $8,652,713 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $7,545,529 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $7,463,412 | OtherInvestmentsEOYFMVAmt |
| Land Bldg Equip Cost Or Other Bss | $6,658,670 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,012,409 | LandBldgEquipAccumDeprecAmt |
| Land BOY | $2,800,311 | LandBOYAmt |
| Land EOY | $2,646,261 | LandEOYAmt |
| Land EOYFMV | $2,646,261 | LandEOYFMVAmt |
| Other Assets BOY | $32,041 | OtherAssetsBOYAmt |
| Other Assets EOY | $46,880 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $46,880 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $13,169,656 | TotalAssetsBOYAmt |
| Total Assets EOY | $14,084,214 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $14,037,263 | TotalAssetsEOYFMVAmt |
| Accounts Payable BOY | $410,119 | AccountsPayableBOYAmt |
| Accounts Payable EOY | $393,675 | AccountsPayableEOYAmt |
| Other Liabilities BOY | $65,332 | OtherLiabilitiesBOYAmt |
| Other Liabilities EOY | $546,001 | OtherLiabilitiesEOYAmt |
| Total Liabilities BOY | $475,451 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $939,676 | TotalLiabilitiesEOYAmt |
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
| No Donor Rstr Net Assests BOY | $12,694,205 | NoDonorRstrNetAssestsBOYAmt |
| No Donor Rstr Net Assests EOY | $13,144,538 | NoDonorRstrNetAssestsEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $12,694,205 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $13,144,538 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $13,169,656 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $14,084,214 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $12,694,205 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $531,633 | ExcessRevenueOverExpensesAmt |
| Other Increases | $111,930 | OtherIncreasesAmt |
| Subtotal | $13,337,768 | SubtotalAmt |
| Other Decreases | $193,230 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $13,144,538 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (3 entries)
| PropertyPropertyDesc | AcquiredAcquiredDt | SoldSoldDt | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt |
|---|---|---|---|---|---|---|
| PUBLICLY TRADED SECURITIES | 2020-01-01 | 2020-12-31 | $1,066,464 | $1,096,268 | -$29,804 | -$29,804 |
| PUBLICLY TRADED SECURITIES | 2019-12-31 | 2020-12-31 | $1,737,051 | $1,950,953 | -$213,902 | -$213,902 |
| PUBLICLY TRADED SECURITIES | 2019-12-31 | 2020-12-31 | $2 | $2 | $2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | -$243,704 | CapitalGainNetIncomeAmt |
| Net Short Term Capital Gain Loss | -$29,804 | NetShortTermCapitalGainLossAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $2,797 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $2,797 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $2,797 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $4,000 | EstimatedPlusOvpmtIncmTxAmt |
| Exempt Frgn Org Tax Wthld At Srce | $0 | ExemptFrgnOrgTaxWthldAtSrceAmt |
| Extsn Request Income Tax Paid | $2,000 | ExtsnRequestIncomeTaxPaidAmt |
| Backup Withholding Withheld | $0 | BackupWithholdingWithheldAmt |
| Total Payments And Credits | $6,000 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $23 | EsPenaltyAmt |
| Overpayment | $3,180 | OverpaymentAmt |
| Applied To ES Tax | $3,180 | 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 | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (1) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (1) | AtLeast5000InAssetsInd |
| Org Report Or Register State | IA | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (1) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | Yes (1) | 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 | JOHN W GRUBB | IndividualWithBooksNm |
| Phone | 5152599293 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4454 128TH ST | AddressLine1Txt |
| City | URBANDALE | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 503231728 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN W GRUBB | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4454 128TH ST | AddressLine1Txt |
| City | URBANDALE | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 503231728 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Title | PRESIDENT, SECRETARY | TitleTxt |
| Average Hrs Per Wk Devoted To Pos | 1.00 | AverageHrsPerWkDevotedToPosRt |
| Compensation | $0 | CompensationAmt |
| Employee Benefit Program | $0 | EmployeeBenefitProgramAmt |
| Expense Account Other Allwnc | $0 | ExpenseAccountOtherAllwncAmt |
Compensation Highest Paid Empl CompensationHighestPaidEmplGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee BenefitsEmployeeBenefitsAmt | Expense AccountExpenseAccountAmt |
|---|---|---|---|---|---|---|---|---|
| GAYLE MOORE | ||||||||
| 116 REIMER ST | ELKADER | IA | 52043 | RN | 40.00 | $84,188 | $2,526 | $0 |
| KATLYN POOTS | ||||||||
| 1400 W MAIN ST | MCGREGOR | IA | 52157 | RN | 40.00 | $78,972 | $2,369 | $0 |
| KARA WINKOWITSCH | ||||||||
| 116 REIMER ST | ELKADER | IA | 52043 | RN | 40.00 | $76,344 | $0 | $0 |
| ALANNA MCSHANE | ||||||||
| 1400 W MAIN ST | MCGREGOR | IA | 52157 | RN | 40.00 | $69,678 | $2,090 | $0 |
| LISA BOLSINGER | ||||||||
| 116 REIMER ST | ELKADER | IA | 52043 | RN | 40.00 | $62,684 | $1,881 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Employee Paid Over50k | 9 | OtherEmployeePaidOver50kCnt |
Compensation Of Hghst Pd Cntrct CompensationOfHghstPdCntrctGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Service TypeServiceTypeTxt | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HEALTHCARE OF IOWA | |||||
| 5925 DRY CREEK LN NE | CEDAR RAPIDS | IA | 52402 | ACCOUNTING FEES/CONSULTING FEES | $414,391 |
| MARTIN BROS | |||||
| PO BOX 69 | CEDAR FALLS | IA | 50613 | FOOD | $243,876 |
| MILLENNIUM REHAB & CONSULTING | |||||
| 4725 MERLE HAY RD | DES MOINES | IA | 50322 | SKILLED THERAPIES | $238,091 |
| DIVERSACARE | |||||
| 5925 DRY CREEK LN NE | CEDAR RAPIDS | IA | 52402 | CONSULTING | $160,165 |
| WELLMARK | |||||
| PO BOX 14456 | DES MOINES | IA | 50306 | INSURANCE PREMIUMS | $136,309 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contractor Paid Over50k | 9 | ContractorPaidOver50kCnt |
Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | OPERATES TWO NURSING HOMES FOR THE ELDERLY WITH APPROXIMATELY 124 BEDS | Description1Txt |
| Expenses1 | $5,342,632 | 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 | $7,633,408 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $0 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $7,633,408 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $7,633,408 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $114,501 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $7,518,907 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $375,945 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sect4942j3j5 Fndtn And Frgn Org | Yes (X) | Sect4942j3j5FndtnAndFrgnOrgInd |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $391,344 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $391,344 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $0 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $391,344 | AdjustedQualifyingDistriAmt |
Private Operating Foundations PrivateOperatingFoundationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Private Operating Fndtn Ruling | 1997-01-29 | PrivateOperatingFndtnRulingDt |
| Section4942j3 | Yes (X) | Section4942j3Ind |
Lessor Adj Net Incm Min Invst Ret LessorAdjNetIncmMinInvstRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $375,945 | CurrentYearAmt |
| Year1 | $395,408 | Year1Amt |
| Year2 | $393,317 | Year2Amt |
| Year3 | $288,074 | Year3Amt |
| Total | $1,452,744 | TotalAmt |
Pct85 Lessor Adj Incm Or Min Ret Pct85LessorAdjIncmOrMinRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $319,553 | CurrentYearAmt |
| Year1 | $336,097 | Year1Amt |
| Year2 | $334,319 | Year2Amt |
| Year3 | $244,863 | Year3Amt |
| Total | $1,234,832 | TotalAmt |
Qualifying Distributions QualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $391,344 | CurrentYearAmt |
| Year1 | $422,620 | Year1Amt |
| Year2 | $409,941 | Year2Amt |
| Year3 | $415,569 | Year3Amt |
| Total | $1,639,474 | TotalAmt |
Qualifying Distri Not Used Drt QualifyingDistriNotUsedDrtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $0 | CurrentYearAmt |
| Year1 | $0 | Year1Amt |
| Year2 | $0 | Year2Amt |
| Year3 | $0 | Year3Amt |
| Total | $0 | TotalAmt |
Qualifying Distri Made Drt QualifyingDistriMadeDrtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $391,344 | CurrentYearAmt |
| Year1 | $422,620 | Year1Amt |
| Year2 | $409,941 | Year2Amt |
| Year3 | $415,569 | Year3Amt |
| Total | $1,639,474 | TotalAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Assets Sect4942j3 Bi TotalAssetsSect4942j3BiGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Two Thirds Minimum Invst Ret TwoThirdsMinimumInvstRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Support TotalSupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $5,812,629 | CurrentYearAmt |
| Year1 | $5,244,297 | Year1Amt |
| Year2 | $4,515,334 | Year2Amt |
| Year3 | $5,136,922 | Year3Amt |
| Total | $20,709,182 | TotalAmt |
Public Support Type PublicSupportType
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $5,812,629 | CurrentYearAmt |
| Year1 | $5,244,297 | Year1Amt |
| Year2 | $4,515,334 | Year2Amt |
| Year3 | $5,135,530 | Year3Amt |
| Total | $20,707,790 | TotalAmt |
Largest Support From EO LargestSupportFromEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Gross Investment Income GrossInvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $14,260 | CurrentYearAmt |
| Year1 | $174,446 | Year1Amt |
| Year2 | $360,618 | Year2Amt |
| Year3 | $352,624 | Year3Amt |
| Total | $901,948 | TotalAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|
| AHIENZ 57 PET RESCUE & TRANSPORT | ||||||
| PO BOX 188 | DE SOTO | IA | 500690188 | PC | ANIMAL PROTECTION AND WELFARE - PREVENTION OF CRUELTY TO ANIMALS | $2,500 |
| AMERICAN HEART ASSOCIATION | ||||||
| 5000 WESTOWN PKWY STE 340 | WEST DES MOINES | IA | 50266 | PC | DONATION OF FUNDS FOR GENERAL OPERATING OF HEART AND CIRCULATORY SYSTEM DISEASES, DISORDERS | $1,500 |
| ANIMAL RESCUE LEAGUE OF CENTRAL IOWA | ||||||
| 5452 NE 22ND STREET | DES MOINES | IA | 50313 | PC | ANIMAL PROTECTION AND WELFARE - PREVENTION OF CRUELTY TO ANIMALS | $2,500 |
| ASU FOUNDATION | ||||||
| 1201 SOUTH FOREST AVENUE | TEMPE | AZ | 85282 | PC | ASU - CHARTER FUND THAT SUPPORTS STUDENT INITIATIVES | $3,000 |
| BLANK CHILDREN'S HOSPITAL | ||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | PC | FUNDING FOR BLANK CHILDREN'S HOSPITAL PROGRAMS INCLUDING - CHILD LIFE AND THE CENTER FOR ADVOCACY & OUTREACH. | $2,449 |
| CONGREGATION OF BETH TEFILLAH | ||||||
| 6529 E SHEA BLVD | SCOTTSDALE | AZ | 85254 | PC | DONATION TO GENERAL FUND | $5,400 |
| ELKADER AREA CHAMBER OF COMMERCE | ||||||
| 207 N MAIN ST | ELKADOR | IA | 52043 | GOV | DONATION TO GENERAL FUND | $100 |
| FIRST UNITED METHODIST CHURCH | ||||||
| 428 WASHINGTON | AUDUBON | IA | 50025 | PC | DONATION TO GENERAL FUND TO PROVIDE BASIC HUMAN SERVICES TO THOSE IN NEED | $35,000 |
| FOOD BANK OF IOWA | ||||||
| 2221 E 17TH STREET | DES MOINES | IA | 503162115 | PC | FOOD BANKS/PANTRIES - SUPPLY GOODS, FOOD, AND OTHER SERVICES TO POOR | $10,000 |
| FRIENDS OF IOWA PBS | ||||||
| PO BOX 6400 | JOHNSTON | IA | 501316400 | PC | DONATION TO GENERAL FUND FOR EDUCATIONAL PURPOSE AND RELATED ACTIVITIES | $120 |
| HOPE MINISTRIES | ||||||
| PO BOX 862 | DES MOINES | IA | 503040862 | PC | DONATION TO GENERAL FUND TO PROVIDE BASIC HUMAN SERVICES TO THOSE IN NEED | $5,000 |
| HOYT SHERMAN PLACE | ||||||
| 1501 WOODLAND AVE | DES MOINES | IA | 50309 | PC | RAISE FUNDS FOR HISTORICAL HOYT SHERMAN PLACE, GENERAL FUNDING FOR UPKEEP AND MODIFICATIONS | $10,000 |
| IOWA DONOR NETWORK | ||||||
| 320 ADVENTURELAND DR NW | ALTOONA | IA | 50009 | PC | DONATION TO GENERAL FUND TO PROVIDE BASIC HUMAN SERVICES TO THOSE IN NEED | $1,000 |
| IOWA HEALTH CARE ASSOCIATION FOUNDATION | ||||||
| 1776 - 90TH STREET | WEST DES MOINES | IA | 502661564 | PC | DONATION TO GENERAL FUND FOR HEALTH CARE SCHOLARSHIPS | $130,000 |
| JUDICIAL WATCH | ||||||
| PO BOX 96235 | WASHINGTON | DC | 200906235 | PC | SUPPORTS THE CHECKS AND BALANCES WITHIN A JUDICIAL SYSTEM | $700 |
| LEADERSHIP INSTITUTE | ||||||
| STEVEN PJ WOOD BUILDING | ARLINGTON | VA | 22201 | PC | DONATION TO GENERAL FUND - PROVIDES GENERAL HEALTH AND REHABILITATIVE SERVICES | $500 |
| MAYO CLINIC | ||||||
| MAYO CLINIC | ROCHESTER | MN | 559029813 | PC | DONATION TO GENERAL FUND TO PROVIDE BASIC HUMAN SERVICES TO THOSE IN NEED | $2,500 |
| STRANDS OF STRENGTH | ||||||
| 1311 TULIP TREE LANE | WEST DES MOINES | IA | 50267 | PC | RAISE YOUR PURSE EVENT - RAISES FUNDS FOR DISEASES, DISORDERS, MEDICAL DISCIPLINES | $20,000 |
| VARIETY CLUB | ||||||
| 506 - 5TH AVENUE SUITE 310 | DES MOINES | IA | 503092323 | PC | DONATION TO GENERAL FUND TO PROVIDE AID/SERVICES TO THE HANDICAP | $102,750 |
| WEST DES MOINES CHRISTIAN CHURCH | ||||||
| 4501 MILLS CIVIC PKWY | WEST DES MOINES | IA | 50265 | PC | DONATION TO GENERAL FUND - PROVIDES GENERAL HEALTH AND REHABILITATIVE SERVICES | $50,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $385,019 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Program Service Rev Part VII ProgramServiceRevPartVIIGrp (2 entries)
| DescDesc | Related Or Exempt Function IncmRelatedOrExemptFunctionIncmAmt |
|---|---|
| NURSING HOMES | $4,996,257 |
| ASSISTED LIVING | $663,435 |
Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $19,650 | ExclusionAmt |
Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $192,937 | ExclusionAmt |
Other Investment Incm Part VII OtherInvestmentIncmPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $16,857 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | -$243,704 | ExclusionAmt |
Other Revenue Described OtherRevenueDescribedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER | Desc |
| Related Or Exempt Function Incm | $185 | RelatedOrExemptFunctionIncmAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | -$14,260 | ExclusionAmt |
| Related Or Exempt Function Incm | $5,659,877 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $5,645,617 | TotalIncomeProducingActyAmt |
Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp
Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp (4 entries)
| Line NumberLineNumberTxt | Relationship StatementRelationshipStatementTxt |
|---|---|
| 1A | THE FOUNDATION OPERATES TWO NURSING HOMES FOR THE ELDERLY WITH |
| 1A | APPROXIMATELY 124 BEDS. |
| 1B | THE FOUNDATION OPERATES AN ASSISTED LIVING FACILITY FOR THE ELDERLY. |
| 11A | OTHER MISCELLANEOUS INCOME |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | 1 | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DEPARTMENT OF HEALTH AND HUMAN SERVICES | BusinessNameLine1Txt |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 INDEPENDENCE AVE SW | AddressLine1Txt |
| City | WASHINGTON | CityNm |
| State Abbreviation | DC | StateAbbreviationCd |
| ZIP | 20201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | $640,606 | TotalContributionsAmt |
| Person Contribution | Yes (X) | PersonContributionInd |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|---|
| ACCOUNTING FEES | $100,676 | $0 | $100,676 | $0 |
| TAX PREPARATION | $6,325 | $0 | $0 | $6,325 |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corporate Bonds InvestmentsCorporateBondsGrp (3 entries)
| BondBondNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| BANK OF AMER COP B/E | $73,969 | $78,188 |
| MORGAN STANLEY B/E | $74,250 | $74,460 |
| CITIGROUP INC B/E | $97,800 | $99,500 |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Stock | PERSHING SQUARE TONTINE CL A | StockNm |
| EOY Book Value | $136,200 | EOYBookValueAmt |
| EOYFMV | $166,320 | EOYFMVAmt |
Investments Govt Obligations Sch InvestmentsGovtObligationsSch
| Field | Value | IRS element (for citing) |
|---|---|---|
| US Govt Obligations Book Vl EOY | $329,327 | USGovtObligationsBookVlEOYAmt |
| US Govt Obligations EOYFMV | $328,244 | USGovtObligationsEOYFMVAmt |
| State Local Sec Book Vl EOY | $0 | StateLocalSecBookVlEOYAmt |
| State Local Sec EOYFMV | $0 | StateLocalSecEOYFMVAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (23 entries)
| Category Or ItemCategoryOrItemTxt | Listed At Cost Or FMVListedAtCostOrFMVCd | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| AVISTA ONSHORE FEEDER FUND, LP | AT COST | $154,509 | $154,509 |
| PIMCO BRAVO FUND II OFFSHORE FEEDER AIV I, LP | AT COST | $168,571 | $168,571 |
| PIMCO BRAVO FUND II SPECIAL ONSHORE FEEDER (TE), LP | AT COST | $165,013 | $165,013 |
| PE PREMIER BLACKSTONE ENERGY PARTNERS II OFFSHORE | AT COST | $438,167 | $438,167 |
| PIMCO ENERGY & TACTICAL CREDIT OPPORTUNITIES FUND | AT COST | $417,082 | $161,600 |
| FEDERATED HERMES KAUFMAN SMALL CAP FUND IS | AT COST | $200,000 | $207,315 |
| JOHN HANCOCK INTL GROWTH FUND CL I | AT COST | $258,542 | $333,824 |
| MATTHEW ASIA DIVIDEND | AT COST | $418,180 | $472,223 |
| PRINCIPAL MIDCAP FUND CLASS I | AT COST | $202,198 | $205,123 |
| T. ROWE PRICE GLOBAL STK FD | AT COST | $211,042 | $206,021 |
| VICTORY SOPHUS EMERGING MARKETS FUND CLASS Y | AT COST | $211,223 | $225,132 |
| BLACKROCK MULTI SECTOR INCOME TR | AT COST | $233,996 | $245,560 |
| COLUMBIA STRATEGIC INCOME FUND CLASS INSTITUTIONAL | AT COST | $718,172 | $742,760 |
| DOUBLELINE LOW DURATION BOND FUND I | AT COST | $819,354 | $812,884 |
| FPA NEW INCOME INC | AT COST | $273,306 | $274,240 |
| PIMCO INCOME FUND CLASS 12 | AT COST | $1,245,657 | $1,246,129 |
| PIMCO MORTGAGE OPPORTUNITIES AND BOND FUND 1-2 | AT COST | $598,501 | $595,830 |
| T. ROWE PRICE GLOBAL MUTI-SECTOR BOND FUND CLASS NL | AT COST | $500,000 | $500,000 |
| BANK OF AMERICA CORPORATIONS 6.200% PREFERRED CLBL | AT COST | $50,720 | $49,980 |
| BERKLEY (WR) CORP | AT COST | $36,548 | $38,295 |
| CITIGROUP INC (C) 6.300% PREFERRED CLBL | AT COST | $103,852 | $102,240 |
| US CELLULAR CORP | AT COST | $53,500 | $50,600 |
| MORGAN STANLEY MONEY MARKET MUTUAL FUNDS | AT COST | $67,396 | $67,396 |
Legal Fees Schedule LegalFeesSchedule
Legal Fees LegalFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | LEGAL FEES | CategoryTxt |
| Legal Fees | $1,563 | LegalFeesAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $1,563 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CSV LIFE INSURANCE | Desc |
| BOY Book Value | $32,041 | BOYBookValueAmt |
| EOY Book Value | $46,880 | EOYBookValueAmt |
| EOYFMV | $46,880 | EOYFMVAmt |
Other Decreases Schedule OtherDecreasesSchedule
Other Decreases Detail OtherDecreasesDetail (6 entries)
| DescDesc | AmtAmt |
|---|---|
| ADDITIONAL BOOK DEPRECIATION IN EXCESS OF TAX DEPRECIATION | $21,485 |
| BOOK TAX DIFFERENCE PIMCO BRAVO FUND II OFFSHORE FEEDER AIV I, LP K-1 | $7,066 |
| NON-DEDUCTIBLE DONATIONS | $50 |
| NON-DEDUCTIBLE DUES | $1,583 |
| BOOK TAX DIFFERENCE PE PREMIER BLACKSTONE ENERGY PARTNERS II OFFSHORE K-1 | $16,183 |
| BOOK TAX DIFFERENCE UBS FINANCIAL SERVICES INC. 1099 | $146,863 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (22 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|---|
| ADVERTISING | $18,789 | $0 | $18,789 | $0 |
| BUSINESS EXPENSE | $1,817 | $0 | $1,817 | $0 |
| BUSINESS TRAVEL | $9,332 | $0 | $9,332 | $0 |
| DIETARY | $227,201 | $0 | $227,201 | $0 |
| DUES & LICENSES | $20,021 | $0 | $20,021 | $0 |
| EMPLOYEE RECRUITMENT | $12,842 | $0 | $12,842 | $0 |
| INCONTINENT CARE | $743 | $0 | $743 | $0 |
| INSURANCE | $50,764 | $0 | $50,764 | $0 |
| INVESTMENT FEES | $15,395 | $15,395 | $0 | $0 |
| LINEN AND BEDDING | $1,466 | $0 | $1,466 | $0 |
| LIFE INSURANCE | $42,155 | $0 | $42,155 | $0 |
| MANAGEMENT FEE | $13,733 | $6,867 | $6,866 | $0 |
| MISCELLANEOUS | $58,810 | $0 | $58,810 | $0 |
| OFFICE EXPENSE | $73,492 | $0 | $73,492 | $0 |
| PURCHASED SERVICES | $54,096 | $0 | $54,096 | $0 |
| REPAIRS & MAINTENANCE | $91,238 | $0 | $91,238 | $0 |
| SNF SUPPLIES & THERAPIES | $270,185 | $0 | $270,185 | $0 |
| STAFF EDUCATION | $22,816 | $0 | $22,816 | $0 |
| SUPPLIES | $246,034 | $0 | $246,034 | $0 |
| TELEPHONE | $15,178 | $0 | $15,178 | $0 |
| UTILITIES | $195,333 | $0 | $195,333 | $0 |
| WORKMENS COMPENSATION | $49,910 | $0 | $49,910 | $0 |
Other Income Schedule2 OtherIncomeSchedule2
Other Income Detail OtherIncomeDetail (5 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt |
|---|---|---|---|
| NET INVESTMENT INCOME FROM K-1 ACTIVITIES | $8,962 | $3,014 | $8,962 |
| UBS FINANCIAL SERVICES, INC. - CAPITAL GAIN DIVIDENDS | $7,895 | $7,895 | $7,895 |
| NURSING HOMES | $4,996,257 | $4,996,257 | |
| ASSISTED LIVING | $663,435 | $663,435 | |
| OTHER | $185 | $185 |
Other Increases Schedule OtherIncreasesSchedule
Other Increases Detail OtherIncreasesDetail (3 entries)
| DescDesc | AmtAmt |
|---|---|
| BOOK TAX DIFFERENCE AVISTA ONSHORE FEEDER FUND, LP K-1 | $163 |
| BOOK TAX DIFFERENCE PIMCO BRAVO FUND II SPECIAL ONSHORE FEEDER (TE), LP K-1 | $25,025 |
| ACCRUED VACATION | $86,742 |
Other Liabilities Schedule OtherLiabilitiesSchedule
Other Liabilities Detail OtherLiabilitiesDetail (3 entries)
| DescDesc | BOY Book ValueBOYBookValueAmt | EOY Book ValueEOYBookValueAmt |
|---|---|---|
| DEPOSITS | $63,720 | $52,940 |
| INCOME TAX PAYABLE | $1,612 | $2,761 |
| PPP LOAN | $0 | $490,300 |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | NURSING HOME MANAGEMENT & OTHER | CategoryTxt |
| Amt | $339,193 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $339,193 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (3 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|---|
| EXCISE TAX ON INVESTMENT | $2,797 | $0 | $2,797 | $0 |
| PAYROLL | $189,507 | $0 | $189,507 | $0 |
| PROPERTY | $87,322 | $0 | $87,322 | $0 |
Comments