DR DONALD N & JANE L BERNING: Form 990PF, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- DR DONALD N & JANE L BERNING (EIN 45-2457323)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-15
- IRS object ID
- 202103199349110400
- 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
- Depreciation Schedule
- Investments Corp Stock Schedule
- Investments Land Schedule2
- Investments Other Schedule2
- Other Expenses Schedule
- Other Income Schedule2
- Other Liabilities Schedule
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-15T20:11:23-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FOUNDATION SOURCE | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE HOLLOW LN STE 212 | AddressLine1Txt |
| City | LAKE SUCCESS | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11042 | 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 | 452457323 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dr Donald N & Jane L Berning Private | BusinessNameLine1Txt |
| Business Name Line2 | foundation | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % Foundation Source | InCareOfNm |
| Business Name Control | DRDO | BusinessNameControlTxt |
| Phone | 8008391754 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | Foundation Source 501 Silverside Rd | AddressLine1Txt |
| City | Wilmington | CityNm |
| State Abbreviation | DE | StateAbbreviationCd |
| ZIP | 198091377 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jack Benson | PersonNm |
| Person Title | President | PersonTitleTxt |
| Phone | 8008391754 | PhoneNum |
| Signature | 2021-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Jack | PersonFirstNm |
| Person Last | Benson | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Jeffrey D Haskell | PreparerPersonNm |
| PTIN | P01345770 | PTIN |
| Phone | 8008391754 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | TrustedCustomerGrp |
| 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 | $8,712,281 | FMVAssetsEOYAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rcvd Rev And Expnss | $0 | ContriRcvdRevAndExpnssAmt |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Interest On Sav Rev And Expnss | $4,924 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $4,924 | InterestOnSavNetInvstIncmAmt |
| Dividends Rev And Expnss | $3,060 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $3,060 | DividendsNetInvstIncmAmt |
| Gross Rents Rev And Expnss | $13,200 | GrossRentsRevAndExpnssAmt |
| Gross Rents Net Invst Incm | $13,200 | GrossRentsNetInvstIncmAmt |
| Net Rental Income Or Loss | -$9,587 | NetRentalIncomeOrLossAmt |
| Net Gain Sale Ast Rev And Expnss | $81 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $81 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $81 | CapGainNetIncmNetInvstIncmAmt |
| Other Income Rev And Expnss | $251,257 | OtherIncomeRevAndExpnssAmt |
| Other Income Net Invst Incm | $241,153 | OtherIncomeNetInvstIncmAmt |
| Total Rev And Expnss | $272,522 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $262,418 | TotalNetInvstIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $108,500 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $108,500 | CompOfcrDirTrstDsbrsChrtblAmt |
| Pension Empl Bnft Rev And Expnss | $9,121 | PensionEmplBnftRevAndExpnssAmt |
| Pension Empl Bnft Dsbrs Chrtbl | $9,121 | PensionEmplBnftDsbrsChrtblAmt |
| Other Prof Fees Rev And Expnss | $3,531 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $3,531 | OtherProfFeesNetInvstIncmAmt |
| Taxes Rev And Expnss | $9,141 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $4,648 | TaxesNetInvstIncmAmt |
| Deprec And Dpltn Rev And Expnss | $6,909 | DeprecAndDpltnRevAndExpnssAmt |
| Deprec And Dpltn Net Invst Incm | $6,909 | DeprecAndDpltnNetInvstIncmAmt |
| Deprec And Dpltn Adj Net Incm | $0 | DeprecAndDpltnAdjNetIncmAmt |
| Other Expenses Rev And Expnss | $51,704 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $11,508 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Dsbrs Chrtbl | $40,196 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $188,906 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $26,596 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $0 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $157,817 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $242,000 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $242,000 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $430,906 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $26,596 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $0 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $399,817 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$158,384 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $235,822 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sav And Temp Cash Invst BOY | $667,275 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $218,870 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $218,870 | SavAndTempCashInvstEOYFMVAmt |
| Corporate Stock BOY | $133,888 | CorporateStockBOYAmt |
| Corporate Stock EOY | $331,132 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $325,235 | CorporateStockEOYFMVAmt |
| Invst Land Cost Or Other Basis | $225,000 | InvstLandCostOrOtherBasisAmt |
| Invst Land Accum Depreciation | $55,272 | InvstLandAccumDepreciationAmt |
| Land Bldg Investments BOY | $176,637 | LandBldgInvestmentsBOYAmt |
| Land Bldg Investments EOY | $169,728 | LandBldgInvestmentsEOYAmt |
| Land Bldg Investments EOYFMV | $247,500 | LandBldgInvestmentsEOYFMVAmt |
| Other Investments BOY | $8,574,080 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $8,673,805 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $7,920,676 | OtherInvestmentsEOYFMVAmt |
| Total Assets BOY | $9,551,880 | TotalAssetsBOYAmt |
| Total Assets EOY | $9,393,535 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $8,712,281 | TotalAssetsEOYFMVAmt |
| Other Liabilities BOY | $4,173 | OtherLiabilitiesBOYAmt |
| Other Liabilities EOY | $4,212 | OtherLiabilitiesEOYAmt |
| Total Liabilities BOY | $4,173 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,212 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
| Retained Earning BOY | $9,547,707 | RetainedEarningBOYAmt |
| Retained Earning EOY | $9,389,323 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $9,547,707 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $9,389,323 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $9,551,880 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $9,393,535 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $9,547,707 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$158,384 | ExcessRevenueOverExpensesAmt |
| Subtotal | $9,389,323 | SubtotalAmt |
| Tot Net Ast Or Fund Balances EOY | $9,389,323 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Property | PUBLICLY-TRADED SECURITIES | PropertyDesc |
| Gross Sales Price | $81 | GrossSalesPriceAmt |
| Gain Or Loss | $81 | GainOrLossAmt |
| Gains Minus Excess Or Losses | $81 | GainsMinusExcessOrLossesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $81 | CapitalGainNetIncomeAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $3,278 | InvestmentIncomeExciseTaxAmt |
| Subtotal | $3,278 | SubtotalAmt |
| Tax Based On Investment Income | $3,278 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $1,200 | EstimatedPlusOvpmtIncmTxAmt |
| Exempt Frgn Org Tax Wthld At Srce | $0 | ExemptFrgnOrgTaxWthldAtSrceAmt |
| Total Payments And Credits | $1,200 | TotalPaymentsAndCreditsAmt |
| Form2220 Attached | Yes (X) | Form2220AttachedInd |
| Tax Due | $2,078 | TaxDueAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | false | LegislativePoliticalActyInd |
| More Than100 Spent | false | MoreThan100SpentInd |
| Form1120 POL Filed | false | Form1120POLFiledInd |
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | false | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (true) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (true) | AtLeast5000InAssetsInd |
| Org Report Or Register State | DE | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (true) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | false | PrivateOperatingFoundationInd |
| New Substantial Contributors | false | NewSubstantialContributorsInd |
| Own Controlled Entity | false | OwnControlledEntityInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (true) | ComplyWithPublicInspRqrInd |
Persons With Books Name PersonsWithBooksName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Foundation Source | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8008391754 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 501 Silverside Road Suite 123 | AddressLine1Txt |
| City | Wilmington | CityNm |
| State Abbreviation | DE | StateAbbreviationCd |
| ZIP | 198091377 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Accounts Question | false | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | false | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | false | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | false | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | Yes (true) | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | false | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | false | PaymentToGovernmentOfficialInd |
| Acts Fail To Qlfy As Exceptions | false | ActsFailToQlfyAsExceptionsInd |
| Uncorrected Prior Acts | false | UncorrectedPriorActsInd |
| Undistributed Income PY | false | UndistributedIncomePYInd |
| Business Holdings | false | BusinessHoldingsInd |
| Jeopardy Investments | false | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | false | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | false | InfluenceLegislationInd |
| Influence Election | false | InfluenceElectionInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Noncharitable Purpose | false | NoncharitablePurposeInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (2 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 |
|---|---|---|---|---|---|---|---|---|
| Faith Benson | ||||||||
| Foundation Source 501 Silverside Rd | Wilmington | DE | 198091377 | Sec | 1.0 | $0 | $0 | $0 |
| Jack Benson | ||||||||
| Foundation Source 501 Silverside Rd | Wilmington | DE | 198091377 | Dir, Pres | 40.0 | $108,500 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Summary Of Direct Chrtbl Acty | SummaryOfDirectChrtblActyGrp | |
| Sum Of Program Related Invst | SumOfProgramRelatedInvstGrp |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $132,955 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $623,476 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $7,791,491 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $8,547,922 | TotalFMVOfUnusedAssetsAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $8,547,922 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $128,219 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $8,419,703 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $420,985 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $420,985 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $3,278 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $3,278 | TotalTaxAmt |
| Distributable Before Adj | $417,707 | DistributableBeforeAdjAmt |
| Distributable Before Ded | $417,707 | DistributableBeforeDedAmt |
| Distributable As Adjusted | $417,707 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $399,817 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Charitable Assets Acquis Paid | $0 | CharitableAssetsAcquisPaidAmt |
| Set Aside Suitability Test | $0 | SetAsideSuitabilityTestAmt |
| Set Aside Cash Distri Test | $0 | SetAsideCashDistriTestAmt |
| Qualifying Distributions | $399,817 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $0 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $399,817 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $417,707 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $276,290 | UndistributedIncomePYAmt |
| Prior Year1 | 2018 | PriorYear1Yr |
| Prior Year2 | 2017 | PriorYear2Yr |
| Prior Year3 | 2016 | PriorYear3Yr |
| Qualifying Distributions | $399,817 | QualifyingDistributionsAmt |
| Applied To Year1 | $276,290 | AppliedToYear1Amt |
| Applied To Current Year | $123,527 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $0 | RemainingDistriFromCorpusAmt |
| Total Corpus | $0 | TotalCorpusAmt |
| Undistributed Income CY | $294,180 | UndistributedIncomeCYAmt |
| Excess Distri Cyov To Next Yr | $0 | ExcessDistriCyovToNextYrAmt |
| Excess From Current Year | $0 | ExcessFromCurrentYearAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Private Operating Foundations | PrivateOperatingFoundationsGrp |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributing Manager | NONE | ContributingManagerNm |
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (6 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| BETHESDA FOUNDATION INC | |||||||
| 625 EDEN PARK DRIVE 7TH FL | CINCINNATI | OH | 45202 | N/A | PC | Community Paramedicine program | $75,000 |
| COALITION OF CARE GREATER CINCINNATI | |||||||
| PO BOX 42693 | CINCINNATI | OH | 45242 | N/A | PC | General & Unrestricted | $7,000 |
| FRIENDS OF THE ROSE GARDEN MISSION INC | |||||||
| PO BOX 122089 | COVINGTON | KY | 41012 | N/A | PC | General & Unrestricted | $25,000 |
| GO PANTRY CORPORATION | |||||||
| 7960 KENTUCKY DR | FLORENCE | KY | 41042 | N/A | PC | General & Unrestricted | $10,000 |
| NORTHERN KENTUCKY AREA DEVELOPMENT DISTRICT | |||||||
| 22 SPIRAL DR | FLORENCE | KY | 41042 | N/A | PC | Meals on Wheels program | $100,000 |
| SUNRISE CHILDRENS SERVICES | |||||||
| PO BOX 1429 | MT WASHINGTON | KY | 40047 | N/A | PC | General & Unrestricted | $25,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $242,000 | TotalGrantOrContriPdDurYrAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fees Contracts From Govt Ag | FeesContractsFromGovtAgGrp | |
| Membership Dues And Assmnt | MembershipDuesAndAssmntGrp |
Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $4,924 | ExclusionAmt |
Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $3,060 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Rntl Incm Re Debt Fincd Prop | NetRntlIncmReDebtFincdPropGrp |
Net Rntl Incm Re Not Debt Fincd Prop NetRntlIncmReNotDebtFincdProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 16 | ExclusionCd |
| Exclusion | -$9,587 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Rental Income Personal Prop | NetRentalIncomePersonalPropGrp | |
| Other Investment Incm Part VII | OtherInvestmentIncmPartVIIGrp |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $81 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Income Loss From Special Evt | NetIncomeLossFromSpecialEvtGrp | |
| Gross Profit Loss Sls Of Invntry | GrossProfitLossSlsOfInvntryGrp |
Other Revenue Described OtherRevenueDescribedGrp (2 entries)
| DescDesc | ExclusionExclusionCd | ExclusionExclusionAmt |
|---|---|---|
| NET INCOME FROM ANNUITIES | 14 | $241,153 |
| INCOME FROM LIFE INSURANCE POLICIES | 14 | $10,104 |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | $249,735 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $249,735 | TotalIncomeProducingActyAmt |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | false | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | false | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | false | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | false | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | false | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | false | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | false | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | false | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | false | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | false | RelationshipsNonchrtblEOInd |
Depreciation Schedule DepreciationSchedule
Depreciation Property DepreciationPropertyGrp (2 entries)
| PropertyPropertyDesc | AcquiredAcquiredDt | Cost Or Other BasisCostOrOtherBasisAmt | Prior Year DepreciationPriorYearDepreciationAmt | Computation MethodComputationMethodTxt | LifeLifeRt | Current Year ExpenseCurrentYearExpenseAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt |
|---|---|---|---|---|---|---|---|---|
| BLDG-1 SUNNYMEDE | 2010-12-31 | $190,000 | $48,363 | SL | 27 | $6,909 | $0 | $0 |
| LAND-1 SUNNYMEDE | 2012-12-31 | $35,000 | L |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp (26 entries)
| StockStockNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| AMAZON COM | $22,845 | $39,083 |
| BORG WARNER INC | $18,719 | $11,592 |
| CLEAN ENERGY FUELS CORP | $17,609 | $15,720 |
| GENERAL MOTORS NOTE 7.25% 2/15 | ||
| GILEAD SCIENCES INC | $12,280 | $5,826 |
| GLOBAL X FDS GLOBAL X MLP ETF | $1,995 | $2,276 |
| INVESCO PREFERRED ETF | $11,265 | $11,491 |
| INVESCO SENIOR LOAN ETF | $10,840 | $11,029 |
| ISHARES BROAD USD HIGH YIELD C | $8,569 | $8,830 |
| ISHARES CORE US REIT ETF | $4,983 | $5,180 |
| ISHARES JP MORGAN USD EM MKTS | $11,202 | $11,475 |
| KINDER MORGAN INC | $21,458 | $6,835 |
| MOTORS LIQ CO GUC TR UBI | $306 | $44 |
| POLARIS INDUSTRIES | $15,236 | $9,528 |
| SCHWAB STRATEGIC TRINTL SMALL | $1,996 | $2,221 |
| SCHWAB U.S. SMALL-CA | $6,003 | $7,209 |
| SCHWAB US MID CAP | $6,010 | $6,886 |
| SCHWAB US TIPS | $4,530 | $4,594 |
| SPDR PORTFOLIO AGGREGATE BOND | $17,021 | $17,088 |
| SPDR PORTFOLIO DEVELOPED WORLD | $30,946 | $33,615 |
| SPDR PORTFOLIO EMERGING MARKET | $19,838 | $21,417 |
| SPDR S&P 500 GROWTH | $29,378 | $31,128 |
| SPDR S&P 500 VALUE | $22,625 | $24,107 |
| SPDR SER TR BARCLAYS CAP CONV | $7,058 | $8,031 |
| TWITTER INC | $25,434 | $27,075 |
| WORLD GOLD TRUST SPDR GOLD MIN | $2,986 | $2,955 |
Investments Land Schedule2 InvestmentsLandSchedule2
Investment Land InvestmentLandGrp (2 entries)
| Category Or ItemCategoryOrItemTxt | Cost Or Other BasisCostOrOtherBasisAmt | Accumulated DepreciationAccumulatedDepreciationAmt | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|---|
| BLDG-1 SUNNYMEDE | $190,000 | $55,272 | $134,728 | $247,500 |
| LAND-1 SUNNYMEDE | $35,000 | $35,000 |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (17 entries)
| Category Or ItemCategoryOrItemTxt | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| AMERICAN NATIONAL DEFERRED ANN | $700,000 | $675,482 |
| AMERICO FINANCIAL ANNUITY R575 | $355,818 | $327,353 |
| AMERICO FINANCIAL ANNUITY R592 | $628,355 | $571,803 |
| AMERICO FINANCIAL ANNUITY R609 | $611,269 | $556,255 |
| ASSURITY LIFE INSURANCE CO - P | $301,000 | $271,223 |
| ATHENE LIFE INS - ANNUITY 1384 | $581,642 | $551,513 |
| ATHENE LIFE INS - ANNUITY 1486 | $688,687 | $650,754 |
| EQUITABLE LIFE & CAUSALITY INS | $550,347 | $439,065 |
| EQUITRUST LIFE INS CO -ANNUITY | $589,109 | $510,561 |
| EQUITRUST LIFE INS -WHOLE LIFE | $349,438 | $345,944 |
| FIDELITY &GUARANTY -ANNUITY L4 | $417,800 | $396,672 |
| FIDELITY &GUARANTY -ANNUITY L9 | $529,736 | $508,546 |
| FIDELITY &GUARANTY -ANNUITY R0 | $785,557 | $714,858 |
| NAT WESTERN LIFE -ANNUITY 591 | $497,143 | $463,383 |
| NAT WESTERN LIFE -ANNUITY 169 | $692,728 | $588,001 |
| NAT WESTERN LIFE -ANNUITY 588 | $195,176 | $163,862 |
| NATIONWIDE - ANNUITY POLICY # | $200,000 | $185,401 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (7 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt | Net Investment IncomeNetInvestmentIncomeAmt |
|---|---|---|---|
| Administrative Fees | $39,494 | $39,494 | |
| Bank Charges | $170 | $170 | |
| POSTAGE/DELIVERY FEES | $108 | $108 | |
| Payroll Processing Fees | $677 | $677 | |
| Property insurance | $4,874 | $4,874 | |
| Property Maintenance | $6,356 | $6,356 | |
| State or Local Filing Fees | $25 | $25 |
Other Income Schedule2 OtherIncomeSchedule2
Other Income Detail OtherIncomeDetail (2 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt |
|---|---|---|
| net income from annuities | $241,153 | $241,153 |
| income from life insurance policies | $10,104 |
Other Liabilities Schedule OtherLiabilitiesSchedule
Other Liabilities Detail OtherLiabilitiesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PAYROLL TAX WITHHOLDINGS | Desc |
| BOY Book Value | $4,173 | BOYBookValueAmt |
| EOY Book Value | $4,212 | EOYBookValueAmt |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | Investment Management Services | CategoryTxt |
| Amt | $3,531 | Amt |
| Net Investment Income | $3,531 | NetInvestmentIncomeAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt |
|---|---|---|
| 990-PF Excise Tax for 2018 | $4,493 | |
| Property Taxes | $4,648 | $4,648 |
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