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THE MELLEN FOUNDATION INC: Form 990PF, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
THE MELLEN FOUNDATION INC (EIN 22-2778847)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-08-26
IRS object ID
202122389349100502
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)
Return2021-08-26T07:48:18-05:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN061533315PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CIRONEFRIEDBERG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line16 RESEARCH DRIVE 450AddressLine1Txt
CitySHELTONCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06484ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN222778847EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE MELLEN FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMELLBusinessNameControlTxt
Phone2033665876PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1460 COE AVENUEAddressLine1Txt
CityEAST HAVENCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06512ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonNEIL MELLENPersonNm
Person TitleSECRETARY/TREASURERPersonTitleTxt
Phone2033665876PhoneNum
Signature2021-08-18SignatureDt

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstNEILPersonFirstNm
Person LastMELLENPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonROBERT SCHLESSPreparerPersonNm
PTINP01236203PTIN
Phone2033665876PhoneNum
Preparation2021-08-18PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
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$2,792,646FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$100,000ContriRcvdRevAndExpnssAmt
Dividends Rev And Expnss$50,494DividendsRevAndExpnssAmt
Dividends Net Invst Incm$50,494DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss$5,203NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$562,324GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$5,203CapGainNetIncmNetInvstIncmAmt
Total Rev And Expnss$155,697TotalRevAndExpnssAmt
Total Net Invst Incm$55,697TotalNetInvstIncmAmt
Total Adj Net Incm$0TotalAdjNetIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$0CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$0CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Adj Net Incm$0CompOfcrDirTrstAdjNetIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl$0CompOfcrDirTrstDsbrsChrtblAmt
Other Prof Fees Rev And Expnss$747OtherProfFeesRevAndExpnssAmt
Other Prof Fees Net Invst Incm$0OtherProfFeesNetInvstIncmAmt
Other Prof Fees Adj Net Incm$0OtherProfFeesAdjNetIncmAmt
Other Prof Fees Dsbrs Chrtbl$747OtherProfFeesDsbrsChrtblAmt
Taxes Rev And Expnss$1,010TaxesRevAndExpnssAmt
Taxes Net Invst Incm$0TaxesNetInvstIncmAmt
Taxes Adj Net Incm$0TaxesAdjNetIncmAmt
Taxes Dsbrs Chrtbl$0TaxesDsbrsChrtblAmt
Other Expenses Rev And Expnss$11,644OtherExpensesRevAndExpnssAmt
Other Expenses Net Invst Incm$11,594OtherExpensesNetInvstIncmAmt
Other Expenses Adj Net Incm$0OtherExpensesAdjNetIncmAmt
Other Expenses Dsbrs Chrtbl$0OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$13,401TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$11,594TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Adj Net Incm$0TotOprExpensesAdjNetIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$747TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$84,000ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$84,000ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$97,401TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$11,594TotalExpensesNetInvstIncmAmt
Total Expenses Adj Net Incm$0TotalExpensesAdjNetIncmAmt
Total Expenses Dsbrs Chrtbl$84,747TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses$58,296ExcessRevenueOverExpensesAmt
Net Investment Income$44,103NetInvestmentIncomeAmt
Adjusted Net Income$0AdjustedNetIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Sav And Temp Cash Invst BOY$131,831SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$117,165SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$117,165SavAndTempCashInvstEOYFMVAmt
US Government Obligations BOY$229,037USGovernmentObligationsBOYAmt
US Government Obligations EOY$80,638USGovernmentObligationsEOYAmt
US Govt Obligations EOYFMV$82,592USGovtObligationsEOYFMVAmt
Corporate Stock BOY$676,197CorporateStockBOYAmt
Corporate Stock EOY$617,704CorporateStockEOYAmt
Corporate Stock EOYFMV$1,635,318CorporateStockEOYFMVAmt
Corporate Bonds BOY$670,753CorporateBondsBOYAmt
Corporate Bonds EOY$883,981CorporateBondsEOYAmt
Corporate Bonds EOYFMV$876,459CorporateBondsEOYFMVAmt
Other Investments BOY$15,784OtherInvestmentsBOYAmt
Other Investments EOY$82,112OtherInvestmentsEOYAmt
Other Investments EOYFMV$81,112OtherInvestmentsEOYFMVAmt
Other Assets BOY$81OtherAssetsBOYAmt
Other Assets EOY$0OtherAssetsEOYAmt
Other Assets EOYFMV$0OtherAssetsEOYFMVAmt
Total Assets BOY$1,723,683TotalAssetsBOYAmt
Total Assets EOY$1,781,600TotalAssetsEOYAmt
Total Assets EOYFMV$2,792,646TotalAssetsEOYFMVAmt
Other Liabilities BOY$379OtherLiabilitiesBOYAmt
Other Liabilities EOY$0OtherLiabilitiesEOYAmt
Total Liabilities BOY$379TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind
Capital Stock BOY$0CapitalStockBOYAmt
Capital Stock EOY$0CapitalStockEOYAmt
Additional Paid In Capital BOY$0AdditionalPaidInCapitalBOYAmt
Additional Paid In Capital EOY$0AdditionalPaidInCapitalEOYAmt
Retained Earning BOY$1,723,304RetainedEarningBOYAmt
Retained Earning EOY$1,781,600RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY$1,723,304TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$1,781,600TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$1,723,683TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$1,781,600TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$1,723,304TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses$58,296ExcessRevenueOverExpensesAmt
Other Increases$0OtherIncreasesAmt
Subtotal$1,781,600SubtotalAmt
Other Decreases$0OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY$1,781,600TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (4 entries)

PropertyPropertyDescHow AcquiredHowAcquiredCdGross Sales PriceGrossSalesPriceAmtCost Or Other BasisCostOrOtherBasisAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmt
CHARLES SCHWABP$73,987$74,226-$239-$239
CHARLES SCHWABP$467,720$464,192$3,528$3,528
MERRILL LYNCHP$20,000$18,703$1,297$1,297
CAPITAL GAINS DIVIDENDSP$617$617$617
FieldValueIRS element (for citing)
Capital Gain Net Income$5,203CapitalGainNetIncomeAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$613InvestmentIncomeExciseTaxAmt
Tax Under Section511$0TaxUnderSection511Amt
Subtotal$613SubtotalAmt
Subtitle A Tax$0SubtitleATaxAmt
Tax Based On Investment Income$613TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$2,630EstimatedPlusOvpmtIncmTxAmt
Exempt Frgn Org Tax Wthld At Srce$0ExemptFrgnOrgTaxWthldAtSrceAmt
Extsn Request Income Tax Paid$0ExtsnRequestIncomeTaxPaidAmt
Backup Withholding Withheld$0BackupWithholdingWithheldAmt
Total Payments And Credits$2,630TotalPaymentsAndCreditsAmt
Es Penalty$0EsPenaltyAmt
Overpayment$2,017OverpaymentAmt
Applied To ES Tax$2,017AppliedToESTaxAmt
Refund$0RefundAmt

Statements Regarding Acty StatementsRegardingActyGrp

FieldValueIRS element (for citing)
Legislative Political Acty0LegislativePoliticalActyInd
More Than100 Spent0MoreThan100SpentInd
Form1120 POL Filed0Form1120POLFiledInd
Section4955 Organization Tax$0Section4955OrganizationTaxAmt
Section4955 Managers Tax$0Section4955ManagersTaxAmt
Tax Reimbursed$0TaxReimbursedAmt
Activities Not Previously Rpt0ActivitiesNotPreviouslyRptInd
Changes To Articles Or Bylaws0ChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Organization Dissolved Etc0OrganizationDissolvedEtcInd
Section508e Rqr SatisfiedYes (1)Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (1)AtLeast5000InAssetsInd
Org Report Or Register StateCTOrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (1)Form990PFFiledWithAttyGenInd
Private Operating Foundation0PrivateOperatingFoundationInd
New Substantial ContributorsYes (1)NewSubstantialContributorsInd
Own Controlled Entity0OwnControlledEntityInd
Donor Advised Fund0DonorAdvisedFundInd
Comply With Public Insp RqrYes (1)ComplyWithPublicInspRqrInd
Website AddressN/AWebsiteAddressTxt

Persons With Books Name PersonsWithBooksName

FieldValueIRS element (for citing)
Business Name Line1NEIL MELLENBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2033665876PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line1460 COE AVENUEAddressLine1Txt
CityEAST HAVENCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06512ZIPCd
FieldValueIRS element (for citing)
Foreign Accounts Question0ForeignAccountsQuestionInd

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

FieldValueIRS element (for citing)
Sale Or Exch Disqualified Prsn0SaleOrExchDisqualifiedPrsnInd
Brrw Or Lend Disqualified Prsn0BrrwOrLendDisqualifiedPrsnInd
Furn Goods Disqualified Prsn0FurnGoodsDisqualifiedPrsnInd
Pay Comp Disqualified Prsn0PayCompDisqualifiedPrsnInd
Transfer Ast Disqualified Prsn0TransferAstDisqualifiedPrsnInd
Payment To Government Official0PaymentToGovernmentOfficialInd
Uncorrected Prior Acts0UncorrectedPriorActsInd
Undistributed Income PY0UndistributedIncomePYInd
Business Holdings0BusinessHoldingsInd
Jeopardy Investments0JeopardyInvestmentsInd
Uncorrected PY Jeopardy Invst0UncorrectedPYJeopardyInvstInd
Influence Legislation0InfluenceLegislationInd
Influence Election0InfluenceElectionInd
Grants To Individuals0GrantsToIndividualsInd
Grants To Organizations0GrantsToOrganizationsInd
Noncharitable Purpose0NoncharitablePurposeInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
DIANE MELLEN
30 SHADY LANEMONROECT06468PRESIDENT8.00$0$0$0
NEIL MELLEN
30 SHADY LANEMONROECT06468SECRETARY/TREASURER4.00$0$0$0
DAVID ZIEFF
6 RESEARCH DRIVESHELTONCT06484DIRECTOR1.00$0$0$0
FieldValueIRS element (for citing)
Comp Of Hghst Pd Empl Or NONENONECompOfHghstPdEmplOrNONETxt
Other Employee Paid Over50k0OtherEmployeePaidOver50kCnt
Comp Of Hghst Pd Cntrct Or NONENONECompOfHghstPdCntrctOrNONETxt
Contractor Paid Over50k0ContractorPaidOver50kCnt

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$2,461,859AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$124,498AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$2,586,357TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$2,586,357AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$38,795CashDeemedCharitableAmt
Net Vl Noncharitable Assets$2,547,562NetVlNoncharitableAssetsAmt
Minimum Investment Return$127,378MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$127,378MinimumInvestmentReturnAmt
Tax Based On Investment Income$613TaxBasedOnInvestmentIncomeAmt
Total Tax$613TotalTaxAmt
Distributable Before Adj$126,765DistributableBeforeAdjAmt
Recoveries Qualfied Distri$0RecoveriesQualfiedDistriAmt
Distributable Before Ded$126,765DistributableBeforeDedAmt
Deduction From Distributable$0DeductionFromDistributableAmt
Distributable As Adjusted$126,765DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$84,747ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Qualifying Distributions$84,747QualifyingDistributionsAmt
Pct Sect4940e Org Net Invst Incm$0PctSect4940eOrgNetInvstIncmAmt
Adjusted Qualifying Distri$84,747AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$126,765DistributableAsAdjustedAmt
Undistributed Income PY$0UndistributedIncomePYAmt
Total For Prior Years$0TotalForPriorYearsAmt
Excess Distribution Cyov Yr5$85,154ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr4$112,454ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr3$85,415ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2$119,291ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1$53,811ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov$456,125TotalExcessDistributionCyovAmt
Qualifying Distributions$84,747QualifyingDistributionsAmt
Applied To Year1$0AppliedToYear1Amt
Applied To Prior Years$0AppliedToPriorYearsAmt
Treated As Distri From Corpus$0TreatedAsDistriFromCorpusAmt
Applied To Current Year$84,747AppliedToCurrentYearAmt
Remaining Distri From Corpus$0RemainingDistriFromCorpusAmt
Excess Distri Cyov App CY Corpus$42,018ExcessDistriCyovAppCYCorpusAmt
Excess Distribution Cyov App CY$42,018ExcessDistributionCyovAppCYAmt
Total Corpus$414,107TotalCorpusAmt
Prior Year Undistributed Incm$0PriorYearUndistributedIncmAmt
Prior Year Deficiency Or Tax$0PriorYearDeficiencyOrTaxAmt
Taxable1$0Taxable1Amt
Taxable2$0Taxable2Amt
Undistributed Income CY$0UndistributedIncomeCYAmt
Corpus Distri170b1 E Or4942g3$0CorpusDistri170b1EOr4942g3Amt
Excess Distri Cyov From Yr5$43,136ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$370,971ExcessDistriCyovToNextYrAmt
Excess From Year4$112,454ExcessFromYear4Amt
Excess From Year3$85,415ExcessFromYear3Amt
Excess From Year2$119,291ExcessFromYear2Amt
Excess From Year1$53,811ExcessFromYear1Amt

Supplementary Information SupplementaryInformationGrp

FieldValueIRS element (for citing)
Contributing ManagerNEIL MELLENContributingManagerNm
Only Contri To PreselectedYes (X)OnlyContriToPreselectedInd

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (30 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
4 PAWS FOR ABILITY
253 DAYTON AVENUEXENIAOH45385501(C)(3)UNRESTRICTED$1,000
ADOPT-A-NATIVE ELDER PROGRAM
PO BOX 3401PARK CITYUT84060501(C)(3)UNRESTRICTED$1,000
AFTER THE FINISH LINE
10153 RIVERSIDE DRIVETOLUCA LAKECA91602501(C)(3)UNRESTRICTED$1,000
AMERICAN CIVIL LIBERTIES UNION
355 N 300 WSALT LAKE CITYUT84103501(C)(3)UNRESTRICTED$4,000
AZ GOLDEN RESCUE
5350 W DEL LAGOGLENDALEAZ85308501(C)(3)UNRESTRICTED$2,000
BEST FRIENDS ANIMAL SOCIETY
5001 ANGEL CANYON ROADKANABUT84741501(C)(3)UNRESTRICTED$500
BRIDGEPORT RESCUE MISSION
PO BOX 9057BRIDGEPORTCT06605501(C)(3)UNRESTRICTED$1,500
CLOTHING CHILDREN IN NEED
30 SHADY LANEMONROECT06468501(C)(3)UNRESTRICTED$4,000
DELANCY STREET FOUNDATION
600 EMBARCADEROSAN FRANCISCOCA94107501(C)(3)UNRESTRICTED$2,500
HOME FOR THE BRAVE
655 PARK AVENUEBRIDGEPORTCT06604501(C)(3)UNRESTRICTED$2,000
HOUSATONIC COMMUNITY COLLEGE
900 LAFAYETTE BLVDBRIDGEPORTCT06604501(C)(3)UNRESTRICTED$3,000
INNOCENCE PROJECT
40 WORTH STREETNEW YORKNY10013501(C)(3)UNRESTRICTED$25,000
INTERNATIONAL HEARING DOG INC
5901 EAST 89TH STREETHENDERSONCO80640501(C)(3)UNRESTRICTED$1,500
MONROE FIRE DEPARTMENT
18 SHELTON ROADMONROECT06468501(C)(3)UNRESTRICTED$1,000
MONROE FOOD PANTRY
980 MONROE TURNPIKEMONROECT06468501(C)(3)UNRESTRICTED$1,250
OPEN DOOR SHELTER INC
4 MERRITT STREETSO NORWALKCT06856501(C)(3)UNRESTRICTED$1,000
PEOPLE'S HEALTH CLINIC
PO BOX 681558PARK CITYUT84068501(C)(3)UNRESTRICTED$1,500
PLANNED PARENTHOOD OF UTAH
654 SOUTH 900 EASTSALT LAKE CITYUT84102501(C)(3)UNRESTRICTED$3,500
RIETS
515 WEST 185TH STREETNEW YORKNY10033501(C)(3)UNRESTRICTED$500
SALVATION ARMY
1313 CONNECTICUT AVENUEBRIDGEPORTCT06607501(C)(3)UNRESTRICTED$500
SAVE THE SOUND
900 CHAPEL STREET STE 2202NEW HAVENCT06510501(C)(3)UNRESTRICTED$500
SUMMITT LAND CONSERVANCY
PO BOX 1775PARK CITYUT84060501(C)(3)UNRESTRICTED$3,500
WILFIRE WARRIORS
PO BOX 11347EUGENEOR97440501(C)(3)UNRESTRICTED$500
VA SALT LAKE CITY HEALTH CARE SYSTEM GEORGE E WEHLEN VA MEDICAL CENTER
500 FOOTHILL DRIVESALT LAKE CITYUT84148501(C)(3)UNRESTRICTED$750
WARRIOR STORY FIELD
8228 OURAY DRIVELONGMONTCO80503501(C)(3)UNRESTRICTED$2,500
WEBER STATE UNIVERSITY
4018 UNIVERSITY CIRCLEOGDENUT84408501(C)(3)UNRESTRICTED$3,000
COVENANT HOUSE CA
1325 N WESTERN AVELOS ANGELESCA90027501(C)(3)UNRESTRICTED$2,000
INTERMOUNTAIN HEALTHCARE FUND
36 S STATE ST SUITE 2200SALT LAKE CITYUT84111501(C)(3)UNRESTRICTED$10,000
MONROE EMS
7 FAN HILL ROADMONROECT06468501(C)(3)UNRESTRICTED$1,500
LA FOOD BANK
1734 E 41ST STLOS ANGELESCA90058501(C)(3)UNRESTRICTED$1,500
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$84,000TotalGrantOrContriPdDurYrAmt
Total Grant Or Contri Apprv Fut$0TotalGrantOrContriApprvFutAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$50,494ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion$5,203ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$0UnrelatedBusinessTaxblIncmAmt
Exclusion$55,697ExclusionAmt
Related Or Exempt Function Incm$0RelatedOrExemptFunctionIncmAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$55,697TotalIncomeProducingActyAmt

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

FieldValueIRS element (for citing)
Trnsfr Of Cash To Nonchrtbl EO0TrnsfrOfCashToNonchrtblEOInd
Trnsfr Other Asset Nonchrtbl EO0TrnsfrOtherAssetNonchrtblEOInd
Sales Or Exchanges Of Assets0SalesOrExchangesOfAssetsInd
Purchase Of Assets Nonchrtbl EO0PurchaseOfAssetsNonchrtblEOInd
Rental Of Facilities Oth Assets0RentalOfFacilitiesOthAssetsInd
Reimbursement Arrangements0ReimbursementArrangementsInd
Loans Or Loan Guarantees0LoansOrLoanGuaranteesInd
Performance Of Services Etc0PerformanceOfServicesEtcInd
Sharing Of Facilities Etc0SharingOfFacilitiesEtcInd
Relationships Nonchrtbl EO0RelationshipsNonchrtblEOInd

Schedule B IRS990ScheduleB

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
General RuleYes (X)GeneralRuleInd

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
Contributor1ContributorNum
Contributor PersonNEIL MELLENContributorPersonNm

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line130 SHADY LANEAddressLine1Txt
CityMONROECityNm
State AbbreviationCTStateAbbreviationCd
ZIP06468ZIPCd
FieldValueIRS element (for citing)
Total Contributions$100,000TotalContributionsAmt
Person ContributionYes (X)PersonContributionInd

Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule

Investments Corporate Bonds InvestmentsCorporateBondsGrp

FieldValueIRS element (for citing)
BondBONDS - CHARLES SCHWABBondNm
EOY Book Value$883,981EOYBookValueAmt
EOYFMV$876,459EOYFMVAmt

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp

FieldValueIRS element (for citing)
StockEQUITIES - CHARLES SCHWABStockNm
EOY Book Value$617,704EOYBookValueAmt
EOYFMV$1,635,318EOYFMVAmt

Investments Govt Obligations Sch InvestmentsGovtObligationsSch

FieldValueIRS element (for citing)
US Govt Obligations Book Vl EOY$0USGovtObligationsBookVlEOYAmt
US Govt Obligations EOYFMV$0USGovtObligationsEOYFMVAmt
State Local Sec Book Vl EOY$80,638StateLocalSecBookVlEOYAmt
State Local Sec EOYFMV$82,592StateLocalSecEOYFMVAmt

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOtherGrp

FieldValueIRS element (for citing)
Category Or ItemMONEY MARKET - CHARLES SCHWABCategoryOrItemTxt
Listed At Cost Or FMVFMVListedAtCostOrFMVCd
Book Value$82,112BookValueAmt
EOYFMV$81,112EOYFMVAmt

Other Assets Schedule OtherAssetsSchedule

Other Assets Schedule OtherAssetsScheduleGrp

FieldValueIRS element (for citing)
DescACCRUED INTEREST PAIDDesc
BOY Book Value$81BOYBookValueAmt
EOY Book Value$0EOYBookValueAmt
EOYFMV$0EOYFMVAmt

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (2 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtNet Investment IncomeNetInvestmentIncomeAmtAdjusted Net IncomeAdjustedNetIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
INVESTMENT MGMT. FEES$11,594$11,594$0$0
CT FILING FEE$50$0$0$0

Other Liabilities Schedule OtherLiabilitiesSchedule

Other Liabilities Detail OtherLiabilitiesDetail

FieldValueIRS element (for citing)
DescDUE TO BROKERDesc
BOY Book Value$379BOYBookValueAmt
EOY Book Value$0EOYBookValueAmt

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees Detail OtherProfessionalFeesDetail

FieldValueIRS element (for citing)
CategorySECRETARIAL SERVICESCategoryTxt
Amt$747Amt
Net Investment Income$0NetInvestmentIncomeAmt
Adjusted Net Income$0AdjustedNetIncomeAmt
Disbursements Charitable Prps$747DisbursementsCharitablePrpsAmt

Substantial Contributors Sch SubstantialContributorsSch

Substantial Contributor Detail SubstantialContributorDetail

FieldValueIRS element (for citing)
PersonNEIL MELLENPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line130 SHADY LANEAddressLine1Txt
CityMONROECityNm
State AbbreviationCTStateAbbreviationCd
ZIP06848ZIPCd

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail

FieldValueIRS element (for citing)
CategoryFEDERAL EXCISE TAXESCategoryTxt
Amt$1,010Amt
Net Investment Income$0NetInvestmentIncomeAmt
Adjusted Net Income$0AdjustedNetIncomeAmt
Disbursements Charitable Prps$0DisbursementsCharitablePrpsAmt

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