BETA

GOSTOMSKI FOUNDATION: Form 990PF, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
GOSTOMSKI FOUNDATION (EIN 46-6976292)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-11-15
IRS object ID
202103199349108965
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 ReturnHeader

FieldValueIRS element (for citing)
Return2021-11-15T16:42:16-06:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

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 Begin2020-01-01TaxPeriodBeginDt

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% ELLIOTT FRIEDMANInCareOfNm
Business Name ControlGOSTBusinessNameControlTxt
Phone7087996800PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O FH LLP 1313 WEST 175TH STREETAddressLine1Txt
CityHOMEWOODCityNm
State AbbreviationILStateAbbreviationCd
ZIP60430ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHAEL M GOSTOMSKIPersonNm
Person TitleTRUSTEEPersonTitleTxt
Phone7087996800PhoneNum
Signature2021-11-08SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMICHAEL MPersonFirstNm
Person LastGOSTOMSKIPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonELLIOTT FRIEDMANPreparerPersonNm
PTINP00082764PTIN
Phone7087996800PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$21,142,085FMVAssetsEOYAmt
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$97InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$97InterestOnSavNetInvstIncmAmt
Dividends Rev And Expnss$435,469DividendsRevAndExpnssAmt
Dividends Net Invst Incm$435,469DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss$2,293,419NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$3,201,655GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$2,293,419CapGainNetIncmNetInvstIncmAmt
Other Income Rev And Expnss$22,332OtherIncomeRevAndExpnssAmt
Other Income Net Invst Incm-$65,039OtherIncomeNetInvstIncmAmt
Total Rev And Expnss$2,751,317TotalRevAndExpnssAmt
Total Net Invst Incm$2,663,946TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$0CompOfcrDirTrstRevAndExpnssAmt
Legal Fees Rev And Expnss$3,581LegalFeesRevAndExpnssAmt
Legal Fees Net Invst Incm$1,791LegalFeesNetInvstIncmAmt
Legal Fees Adj Net Incm$0LegalFeesAdjNetIncmAmt
Legal Fees Dsbrs Chrtbl$1,790LegalFeesDsbrsChrtblAmt
Accounting Fees Rev And Expnss$5,250AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm$2,625AccountingFeesNetInvstIncmAmt
Accounting Fees Adj Net Incm$0AccountingFeesAdjNetIncmAmt
Accounting Fees Chrtbl Prps$2,625AccountingFeesChrtblPrpsAmt
Other Prof Fees Rev And Expnss$140,236OtherProfFeesRevAndExpnssAmt
Other Prof Fees Net Invst Incm$140,236OtherProfFeesNetInvstIncmAmt
Taxes Rev And Expnss$210,853TaxesRevAndExpnssAmt
Taxes Net Invst Incm$1,237TaxesNetInvstIncmAmt
Other Expenses Rev And Expnss$715,943OtherExpensesRevAndExpnssAmt
Other Expenses Net Invst Incm$708,937OtherExpensesNetInvstIncmAmt
Tot Opr Expenses Rev And Expnss$1,075,863TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$854,826TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Adj Net Incm$0TotOprExpensesAdjNetIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$4,415TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$959,649ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$959,649ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$2,035,512TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$854,826TotalExpensesNetInvstIncmAmt
Total Expenses Adj Net Incm$0TotalExpensesAdjNetIncmAmt
Total Expenses Dsbrs Chrtbl$964,064TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses$715,805ExcessRevenueOverExpensesAmt
Net Investment Income$1,809,120NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Cash BOY$125,441CashBOYAmt
Cash EOY$503,872CashEOYAmt
Cash EOYFMV$503,872CashEOYFMVAmt
Sav And Temp Cash Invst BOY$0SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$2,817,283SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$2,820,291SavAndTempCashInvstEOYFMVAmt
Corporate Stock BOY$11,605,997CorporateStockBOYAmt
Corporate Stock EOY$441,863CorporateStockEOYAmt
Corporate Stock EOYFMV$734,127CorporateStockEOYFMVAmt
Other Investments BOY$5,608,704OtherInvestmentsBOYAmt
Other Investments EOY$14,453,564OtherInvestmentsEOYAmt
Other Investments EOYFMV$17,083,255OtherInvestmentsEOYFMVAmt
Other Assets BOY$0OtherAssetsBOYAmt
Other Assets EOY$540OtherAssetsEOYAmt
Other Assets EOYFMV$540OtherAssetsEOYFMVAmt
Total Assets BOY$17,340,142TotalAssetsBOYAmt
Total Assets EOY$18,217,122TotalAssetsEOYAmt
Total Assets EOYFMV$21,142,085TotalAssetsEOYFMVAmt
Other Liabilities BOY$76,694OtherLiabilitiesBOYAmt
Other Liabilities EOY$199,031OtherLiabilitiesEOYAmt
Total Liabilities BOY$76,694TotalLiabilitiesBOYAmt
Total Liabilities EOY$199,031TotalLiabilitiesEOYAmt
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind
Retained Earning BOY$17,263,448RetainedEarningBOYAmt
Retained Earning EOY$18,018,091RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY$17,263,448TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$18,018,091TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$17,340,142TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$18,217,122TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$17,263,448TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses$715,805ExcessRevenueOverExpensesAmt
Other Increases$38,838OtherIncreasesAmt
Subtotal$18,018,091SubtotalAmt
Tot Net Ast Or Fund Balances EOY$18,018,091TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (6 entries)

PropertyPropertyDescHow AcquiredHowAcquiredCdGross Sales PriceGrossSalesPriceAmtCost Or Other BasisCostOrOtherBasisAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmt
PUBLICLY TRADED SECURITIESP$540,000$540,000
PUBLICLY TRADED SECURITIESP$205,889$225,888-$19,999-$19,999
PUBLICLY TRADED SECURITIESP$79,795$80,656-$861-$861
PUBLICLY TRADED SECURITIESP$32,776$37,495-$4,139-$4,719
PUBLICLY TRADED SECURITIESP$36,953$24,777$12,176$12,176
CHICAGO-POLAND INVST GROPUP - EXCESS DISTRIBUTIONP$195,181$195,181$195,181
FieldValueIRS element (for citing)
Capital Gain Net Income$2,293,419CapitalGainNetIncomeAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$25,147InvestmentIncomeExciseTaxAmt
Subtotal$25,147SubtotalAmt
Tax Based On Investment Income$25,147TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$5,000EstimatedPlusOvpmtIncmTxAmt
Exempt Frgn Org Tax Wthld At Srce$0ExemptFrgnOrgTaxWthldAtSrceAmt
Extsn Request Income Tax Paid$50,000ExtsnRequestIncomeTaxPaidAmt
Total Payments And Credits$55,000TotalPaymentsAndCreditsAmt
Form2220 AttachedYes (X)Form2220AttachedInd
Es Penalty$417EsPenaltyAmt
Overpayment$29,436OverpaymentAmt
Applied To ES Tax$29,436AppliedToESTaxAmt

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 Line1ELLIOTT FRIEDMANBusinessNameLine1Txt
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 PrsnfalsePayCompDisqualifiedPrsnInd
Transfer Ast Disqualified PrsnfalseTransferAstDisqualifiedPrsnInd
Payment To Government OfficialfalsePaymentToGovernmentOfficialInd
Uncorrected Prior ActsfalseUncorrectedPriorActsInd
Undistributed Income PYfalseUndistributedIncomePYInd
Business HoldingsfalseBusinessHoldingsInd
Jeopardy InvestmentsfalseJeopardyInvestmentsInd
Uncorrected PY Jeopardy InvstfalseUncorrectedPYJeopardyInvstInd
Influence LegislationfalseInfluenceLegislationInd
Influence ElectionfalseInfluenceElectionInd
Grants To IndividualsfalseGrantsToIndividualsInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Noncharitable PurposefalseNoncharitablePurposeInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonMICHAEL M GOSTOMSKIPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O FH ASSOC LLP 1313 W 175TH STAddressLine1Txt
CityHOMEWOODCityNm
State AbbreviationILStateAbbreviationCd
ZIP60430ZIPCd
FieldValueIRS element (for citing)
TitleTRUSTEETitleTxt
Average Hrs Per Wk Devoted To Pos0AverageHrsPerWkDevotedToPosRt
Compensation$0CompensationAmt
Employee Benefit Program$0EmployeeBenefitProgramAmt
Expense Account Other Allwnc$0ExpenseAccountOtherAllwncAmt
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$7,430,156AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$194,626AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$17,073,255FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$24,698,037TotalFMVOfUnusedAssetsAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$24,698,037AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$370,471CashDeemedCharitableAmt
Net Vl Noncharitable Assets$24,327,566NetVlNoncharitableAssetsAmt
Minimum Investment Return$1,216,378MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$1,216,378MinimumInvestmentReturnAmt
Tax Based On Investment Income$25,147TaxBasedOnInvestmentIncomeAmt
Total Tax$25,147TotalTaxAmt
Distributable Before Adj$1,191,231DistributableBeforeAdjAmt
Distributable Before Ded$1,191,231DistributableBeforeDedAmt
Distributable As Adjusted$1,191,231DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$964,064ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Charitable Assets Acquis Paid$0CharitableAssetsAcquisPaidAmt
Set Aside Suitability Test$0SetAsideSuitabilityTestAmt
Set Aside Cash Distri Test$0SetAsideCashDistriTestAmt
Qualifying Distributions$964,064QualifyingDistributionsAmt
Pct Sect4940e Org Net Invst Incm$0PctSect4940eOrgNetInvstIncmAmt
Adjusted Qualifying Distri$964,064AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$1,191,231DistributableAsAdjustedAmt
Undistributed Income PY$0UndistributedIncomePYAmt
Prior Year12018PriorYear1Yr
Prior Year22017PriorYear2Yr
Prior Year32016PriorYear3Yr
Excess Distribution Cyov Yr5$575,731ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr4$148,867ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr3$678,185ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr1$674,122ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov$2,076,905TotalExcessDistributionCyovAmt
Qualifying Distributions$964,064QualifyingDistributionsAmt
Applied To Year1$0AppliedToYear1Amt
Applied To Current Year$964,064AppliedToCurrentYearAmt
Remaining Distri From Corpus$0RemainingDistriFromCorpusAmt
Excess Distri Cyov App CY Corpus$227,167ExcessDistriCyovAppCYCorpusAmt
Excess Distribution Cyov App CY$227,167ExcessDistributionCyovAppCYAmt
Total Corpus$1,849,738TotalCorpusAmt
Taxable2$0Taxable2Amt
Undistributed Income CY$0UndistributedIncomeCYAmt
Excess Distri Cyov From Yr5$348,564ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$1,501,174ExcessDistriCyovToNextYrAmt
Excess From Year4$148,867ExcessFromYear4Amt
Excess From Year3$678,185ExcessFromYear3Amt
Excess From Year1$674,122ExcessFromYear1Amt
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 (14 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
ST MARY'S UNIVERSITY OF MINNESOTA
700 TERRACE HEIGHTSWINONAMN55987NONEPCGENERAL$310,000
COTTER SCHOOLS
1115 W BROADWAY STREETWINONAMN55987NONEPCGENERAL$345,100
FAMILY AND CHILDREN CENTER
1707 MAIN STREETLA CROSSEWI54601NONEPCGENERAL$15,000
FRANCISCAN FRIARS
1289 LAFOND AVENUEST PAULMN55104NONEPCGENERAL$35,000
VITERBO UNIVERSITY
900 VITERBO DRIVELA CROSSEWI54601NONEPCGENERAL$50,000
MINNESOTA MARINE ART MUSEUM
800 RIVERVIEW DRIVEWINONAMN55987NONEPCGENERAL$25,000
DE LASALLE HIGH SCHOOL
1 DE LASALLE DRIVEMINNEAPOLISMN55401NONEPCGENERAL$75,000
UNIVERSITY OF WISCONSIN - RIVER FALLS
410 S 3RD STREETRIVER FALLSWI54022NONEPCGENERAL$1,123
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
ST JOHN PAUL SCHOOL
580 E FRONT STREETWINONAMN55987NONEPCGENERAL$33,426
WINONA INTERNATIONAL FRIENDSHIP
PO BOX 378WINONAMN55987NONEPCGENERAL$20,000
WINONA VOLUNTEER SERVICE
402 E 2ND STWINONAMN55987NONEPCGENERAL$10,000
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$959,649TotalGrantOrContriPdDurYrAmt

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$97ExclusionAmt

Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$435,469ExclusionAmt
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 Incm Part VIIOtherInvestmentIncmPartVIIGrp

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion$2,293,419ExclusionAmt
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-$65,039
LESS AMOUNTS REPORTED ON 990T$87,371

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$87,371UnrelatedBusinessTaxblIncmAmt
Exclusion$2,663,946ExclusionAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$2,751,317TotalIncomeProducingActyAmt

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

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryTAX PREPARATIONCategoryTxt
Amt$5,250Amt
Net Investment Income$2,625NetInvestmentIncomeAmt
Disbursements Charitable Prps$2,625DisbursementsCharitablePrpsAmt

Depreciation Schedule DepreciationSchedule

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp (3 entries)

StockStockNmEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
UBS A/C 14615 - EQUITIES$0$0
UBS A/C 14618 - EQUITIES$261,254$419,550
UBS A/C 16116 - EQUITIES$180,609$314,577

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOtherGrp (28 entries)

Category Or ItemCategoryOrItemTxtListed At Cost Or FMVListedAtCostOrFMVCdBook ValueBookValueAmtEOYFMVEOYFMVAmt
UBS A/C 14615-KKK ENERGY INCAT COST$397,201$251,864
UBS A/C 14615-SPECL CR OPPORTAT COST$178,073$219,610
LOCUPLETO II - AI, LLCAT COST$0$250,000
BRIGHTWATER HOLDINGS SERIES DAT COST$49,546$420,000
CHG-IR LLCAT COST$188,082$467,324
CHG-MF LLCAT COST$436,020$1,431,000
CHG-COINVESTMENT LLCAT COST$755,094$930,788
CHG-BLACKBIRD LLCAT COST$542,721$650,589
CHG-GRANARY LLCAT COST$135,227$164,956
CHG-NEWBERRY LLCAT COST$72,122$100,000
CHICAGO-POLAND INVST GROUP LLCAT COST$0$0
HKI BRIGHTSOURCE LLCAT COST$183,626$140,000
GLOBAL PRIVATE INVESTORS I, LPAT COST$0$0
CHG - COINVESTMENT II LLCAT COST$1,424,378$1,985,700
CHG - OET LLCAT COST$1,469,903$1,482,071
CHG - SG LLCAT COST$1,143,067$1,100,000
CHG - SN LLCAT COST$2,071,394$1,931,880
CHG - CREDIT LLCAT COST$330,178$280,000
CHG - MF II LLCAT COST$107,673$110,000
CHG - CASTILIAN LLCAT COST$525,188$525,188
CHG - CM LLCAT COST$3,437,181$3,437,249
CHG - COINVESTMENT III LLCAT COST$400,762$400,000
CHG - GC LLCAT COST$52,768$60,000
CHG - LF I LLCAT COST$156,796$200,000
CHG - BLACKBIRD II LLCAT COST$274,487$310,000
CHG - PEARLMARK LLCAT COST$110,383$116,000
HKI HG CO-INVESTMENTAT COST$1,694$109,036
WINONA CO-OPAT COST$10,000$10,000

Legal Fees Schedule LegalFeesSchedule

Legal Fees LegalFeesGrp

FieldValueIRS element (for citing)
CategoryLEGAL FEESCategoryTxt
Legal Fees$3,581LegalFeesAmt
Net Investment Income$1,791NetInvestmentIncomeAmt
Disbursements Charitable Prps$1,790DisbursementsCharitablePrpsAmt

Other Assets Schedule OtherAssetsSchedule

Other Assets Schedule OtherAssetsScheduleGrp

FieldValueIRS element (for citing)
DescDIVIDEND RECEIVABLEDesc
BOY Book Value$0BOYBookValueAmt
EOY Book Value$540EOYBookValueAmt
EOYFMV$540EOYFMVAmt

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (2 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtNet Investment IncomeNetInvestmentIncomeAmt
OTHER PSHP INVSTMENT EXPENSES$708,937$708,937
NONDEDUCTIBLE EXPENSES$7,006

Other Income Schedule2 OtherIncomeSchedule2

Other Income Detail OtherIncomeDetail (3 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtNet Investment IncomeNetInvestmentIncomeAmt
UBS 14615 - OTHER INCOME$22,265$22,265
OTHER INCOME$67$67
LESS AMOUNT REPORTED ON 990-T-$87,371

Other Increases Schedule OtherIncreasesSchedule

Other Increases Detail OtherIncreasesDetail

FieldValueIRS element (for citing)
DescOTHER ADJUSTMENTDesc
Amt$38,838Amt

Other Liabilities Schedule OtherLiabilitiesSchedule

Other Liabilities Detail OtherLiabilitiesDetail (4 entries)

DescDescBOY Book ValueBOYBookValueAmtEOY Book ValueEOYBookValueAmt
LOCUPLETO II - AI, LLC$0$103,651
CAPITAL CONTRIBUTION PAYABLE - CHG-BLACKBIRD LLC$45,380$45,380
CAPITAL CONTRIBUTION PAYABLE - CHG-OET$31,314$0
OTHER PAYABLE$50,000

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees Detail OtherProfessionalFeesDetail

FieldValueIRS element (for citing)
CategoryINVESTMENT ADVISORY FEECategoryTxt
Amt$140,236Amt
Net Investment Income$140,236NetInvestmentIncomeAmt

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (3 entries)

CategoryCategoryTxtAmtAmtNet Investment IncomeNetInvestmentIncomeAmt
FOREIGN TAXES$188$188
FEDERAL TAXES$209,616
STATE TAXES$1,049$1,049

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