CHARLES FORD MEMORIAL HOME INC: Form 990PF, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- CHARLES FORD MEMORIAL HOME INC (EIN 45-5388556)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-10
- IRS object ID
- 202123149349101647
- Schema version
- 2020v4.0
- 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
- Accounting Fees Schedule
- Depreciation Schedule
- Gain Loss Sale Other Assets Sch
- Investments Corp Bonds Schedule
- Investments Corp Stock Schedule
- Investments Govt Obligations Sch
- Investments Other Schedule2
- Land Etc Schedule2
- Legal Fees Schedule
- Other Assets Schedule
- Other Expenses Schedule
- Other Income Schedule2
- Other Liabilities Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-10T14:09:15-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351490754 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLEM DASSEL & CO | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 459 | AddressLine1Txt |
| City | POSEYVILLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47633 | 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 | 455388556 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARLES FORD MEMORIAL HOME INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHAR | BusinessNameControlTxt |
| Phone | 8126824675 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 920 S MAIN STREET | AddressLine1Txt |
| City | NEW HARMONY | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47631 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VICKI CAMPBELL | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 8126824675 | PhoneNum |
| Signature | 2021-10-31 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | VICKI | PersonFirstNm |
| Person Last | CAMPBELL | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RICHARD MAIER CPA | PreparerPersonNm |
| PTIN | P00101632 | PTIN |
| Phone | 8128743627 | PhoneNum |
| Preparation | 2021-10-31 | PreparationDt |
| 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 | $10,561,834 | 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 | $16,405 | ContriRcvdRevAndExpnssAmt |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Dividends Rev And Expnss | $165,095 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $165,095 | DividendsNetInvstIncmAmt |
| Dividends Adj Net Incm | $165,095 | DividendsAdjNetIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $511,047 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $1,693,385 | GrossSalesPriceAmt |
| Other Income Rev And Expnss | $1,238,008 | OtherIncomeRevAndExpnssAmt |
| Other Income Net Invst Incm | $209,965 | OtherIncomeNetInvstIncmAmt |
| Other Income Adj Net Incm | $1,238,008 | OtherIncomeAdjNetIncmAmt |
| Total Rev And Expnss | $1,930,555 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $375,060 | TotalNetInvstIncmAmt |
| Total Adj Net Incm | $1,403,103 | TotalAdjNetIncmAmt |
| Oth Empl Slrs Wgs Rev And Expnss | $968,745 | OthEmplSlrsWgsRevAndExpnssAmt |
| Oth Empl Slrs Wgs Dsbrs Chrtbl | $968,745 | OthEmplSlrsWgsDsbrsChrtblAmt |
| Legal Fees Rev And Expnss | $520 | LegalFeesRevAndExpnssAmt |
| Legal Fees Net Invst Incm | $260 | LegalFeesNetInvstIncmAmt |
| Legal Fees Adj Net Incm | $260 | LegalFeesAdjNetIncmAmt |
| Accounting Fees Rev And Expnss | $15,030 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $7,515 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $7,515 | AccountingFeesAdjNetIncmAmt |
| Interest Rev And Expnss | $534 | InterestRevAndExpnssAmt |
| Interest Dsbrs Chrtbl | $534 | InterestDsbrsChrtblAmt |
| Taxes Rev And Expnss | $80,285 | TaxesRevAndExpnssAmt |
| Taxes Adj Net Incm | $3,436 | TaxesAdjNetIncmAmt |
| Taxes Dsbrs Chrtbl | $76,849 | TaxesDsbrsChrtblAmt |
| Deprec And Dpltn Rev And Expnss | $79,658 | DeprecAndDpltnRevAndExpnssAmt |
| Occupancy Rev And Expnss | $79,226 | OccupancyRevAndExpnssAmt |
| Occupancy Dsbrs Chrtbl | $79,226 | OccupancyDsbrsChrtblAmt |
| Trav Conf Meeting Rev And Expnss | $836 | TravConfMeetingRevAndExpnssAmt |
| Trav Conf Meeting Dsbrs Chrtbl | $836 | TravConfMeetingDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $599,971 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $23,668 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Dsbrs Chrtbl | $576,303 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $1,824,805 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $31,443 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $11,211 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $1,702,493 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $0 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $0 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $1,824,805 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $31,443 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $11,211 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $1,702,493 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $105,750 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $343,617 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $1,391,892 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $54,908 | CashBOYAmt |
| Cash EOY | $47,945 | CashEOYAmt |
| Cash EOYFMV | $47,945 | CashEOYFMVAmt |
| Acct Rcvbl | $38,896 | AcctRcvblAmt |
| Acct Rcvbl BOY | $45,405 | AcctRcvblBOYAmt |
| Acct Rcvbl EOY | $38,896 | AcctRcvblEOYAmt |
| Acct Rcvbl EOYFMV | $38,896 | AcctRcvblEOYFMVAmt |
| Prepaid Expenses BOY | $9,938 | PrepaidExpensesBOYAmt |
| Prepaid Expenses EOY | $4,296 | PrepaidExpensesEOYAmt |
| Prepaid Expenses EOYFMV | $4,296 | PrepaidExpensesEOYFMVAmt |
| US Government Obligations BOY | $200,000 | USGovernmentObligationsBOYAmt |
| US Government Obligations EOY | $100,000 | USGovernmentObligationsEOYAmt |
| US Govt Obligations EOYFMV | $103,230 | USGovtObligationsEOYFMVAmt |
| Corporate Stock BOY | $2,193,242 | CorporateStockBOYAmt |
| Corporate Stock EOY | $2,047,918 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $3,857,263 | CorporateStockEOYFMVAmt |
| Corporate Bonds BOY | $101,062 | CorporateBondsBOYAmt |
| Corporate Bonds EOY | $106,660 | CorporateBondsEOYAmt |
| Corporate Bonds EOYFMV | $102,093 | CorporateBondsEOYFMVAmt |
| Other Investments BOY | $2,434,420 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $2,733,536 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $5,021,579 | OtherInvestmentsEOYFMVAmt |
| Land Bldg Equip Cost Or Other Bss | $2,716,421 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,329,889 | LandBldgEquipAccumDeprecAmt |
| Land BOY | $1,363,009 | LandBOYAmt |
| Land EOY | $1,386,532 | LandEOYAmt |
| Land EOYFMV | $1,386,532 | LandEOYFMVAmt |
| Other Assets BOY | $5,936 | OtherAssetsBOYAmt |
| Other Assets EOY | $6,488 | OtherAssetsEOYAmt |
| Total Assets BOY | $6,407,920 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,472,271 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $10,561,834 | TotalAssetsEOYFMVAmt |
| Accounts Payable BOY | $34,940 | AccountsPayableBOYAmt |
| Accounts Payable EOY | $22,241 | AccountsPayableEOYAmt |
| Deferred Revenue BOY | $404 | DeferredRevenueBOYAmt |
| Deferred Revenue EOY | $273 | DeferredRevenueEOYAmt |
| Other Liabilities BOY | $458,681 | OtherLiabilitiesBOYAmt |
| Other Liabilities EOY | $430,112 | OtherLiabilitiesEOYAmt |
| Total Liabilities BOY | $494,025 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $452,626 | TotalLiabilitiesEOYAmt |
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
| No Donor Rstr Net Assests BOY | $5,913,895 | NoDonorRstrNetAssestsBOYAmt |
| No Donor Rstr Net Assests EOY | $6,019,645 | NoDonorRstrNetAssestsEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $5,913,895 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $6,019,645 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $6,407,920 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $6,472,271 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $5,913,895 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $105,750 | ExcessRevenueOverExpensesAmt |
| Subtotal | $6,019,645 | SubtotalAmt |
| Tot Net Ast Or Fund Balances EOY | $6,019,645 | TotNetAstOrFundBalancesEOYAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $4,776 | InvestmentIncomeExciseTaxAmt |
| Subtotal | $4,776 | SubtotalAmt |
| Tax Based On Investment Income | $4,776 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $5,920 | EstimatedPlusOvpmtIncmTxAmt |
| Total Payments And Credits | $5,920 | TotalPaymentsAndCreditsAmt |
| Overpayment | $1,144 | OverpaymentAmt |
| Applied To ES Tax | $1,144 | AppliedToESTaxAmt |
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 | IN | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (true) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | Yes (true) | PrivateOperatingFoundationInd |
| New Substantial Contributors | false | NewSubstantialContributorsInd |
| Own Controlled Entity | false | OwnControlledEntityInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (true) | ComplyWithPublicInspRqrInd |
| Website Address | N/A | WebsiteAddressTxt |
| Individual With Books | AMY KOCH | IndividualWithBooksNm |
| Phone | 8126824675 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 920 S MAIN ST | AddressLine1Txt |
| City | NEW HARMONY | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47631 | 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 | false | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | false | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | false | PaymentToGovernmentOfficialInd |
| 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 (9 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 |
|---|---|---|---|---|---|---|---|---|
| VICKI CAMPBELL | ||||||||
| 920 S MAIN ST | NEW HARMONY | IN | 47631 | PRESIDENT | 000.00 | $0 | $0 | $0 |
| DR RICHARD DIEMER | ||||||||
| 920 S MAIN ST | NEW HARMONY | IN | 47631 | VICE PRESIDE | 000.00 | $0 | $0 | $0 |
| PAUL ALLISON | ||||||||
| 920 S MAIN ST | NEW HARMONY | IN | 47631 | SECRETARY/TR | 000.00 | $0 | $0 | $0 |
| DR MARIE OPATRNY PEASE | ||||||||
| 920 S MAIN ST | NEW HARMONY | IN | 47631 | DIRECTOR | 000.00 | $0 | $0 | $0 |
| KAREN WALKER | ||||||||
| 920 S MAIN ST | NEW HARMONY | IN | 47631 | DIRECTOR | 000.00 | $0 | $0 | $0 |
| TRENT VAN HAAFTEN | ||||||||
| 920 S MAIN ST | NEW HARMONY | IN | 47631 | DIRECTOR | 000.00 | $0 | $0 | $0 |
| JOHN NORDGAUER | ||||||||
| 920 S MAIN ST | NEW HARMONY | IN | 47631 | DIRECTOR | 000.00 | $0 | $0 | $0 |
| SHAWN WORMAN | ||||||||
| 920 S MAIN ST | NEW HARMONY | IN | 47631 | DIRECTOR | 000.00 | $0 | $0 | $0 |
| ROSS VAUGHN | ||||||||
| 920 S MAIN ST | NEW HARMONY | IN | 47631 | DIRECTOR | 000.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Hghst Pd Empl Or NONE | NONE | CompOfHghstPdEmplOrNONETxt |
| Comp Of Hghst Pd Cntrct Or NONE | NONE | CompOfHghstPdCntrctOrNONETxt |
Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | THE CORPORATION OPERATES AN ASSISTED LIVING FACILITY. | Description1Txt |
| Expenses1 | $1,824,805 | Expenses1Amt |
Sum Of Program Related Invst SumOfProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | N/A | Description1Txt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $8,907,831 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $51,426 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $8,959,257 | TotalFMVOfUnusedAssetsAmt |
| Adjusted Total FMV Of Unused Ast | $8,959,257 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $134,389 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $8,824,868 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $441,243 | 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 | $1,702,493 | ExpensesAndContributionsAmt |
| Charitable Assets Acquis Paid | $103,174 | CharitableAssetsAcquisPaidAmt |
| Qualifying Distributions | $1,805,667 | QualifyingDistributionsAmt |
| Adjusted Qualifying Distri | $1,805,667 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Qualifying Distributions | $1,805,667 | QualifyingDistributionsAmt |
| Remaining Distri From Corpus | $1,805,667 | RemainingDistriFromCorpusAmt |
| Total Corpus | $1,805,667 | TotalCorpusAmt |
Private Operating Foundations PrivateOperatingFoundationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Private Operating Fndtn Ruling | 2012-10-01 | PrivateOperatingFndtnRulingDt |
| Section4942j3 | Yes (X) | Section4942j3Ind |
Lessor Adj Net Incm Min Invst Ret LessorAdjNetIncmMinInvstRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $441,243 | CurrentYearAmt |
| Year1 | $409,560 | Year1Amt |
| Year2 | $398,768 | Year2Amt |
| Year3 | $403,431 | Year3Amt |
| Total | $1,653,002 | TotalAmt |
Pct85 Lessor Adj Incm Or Min Ret Pct85LessorAdjIncmOrMinRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $375,057 | CurrentYearAmt |
| Year1 | $348,126 | Year1Amt |
| Year2 | $338,953 | Year2Amt |
| Year3 | $342,916 | Year3Amt |
| Total | $1,405,052 | TotalAmt |
Qualifying Distributions QualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $1,805,667 | CurrentYearAmt |
| Year1 | $1,772,751 | Year1Amt |
| Year2 | $1,521,437 | Year2Amt |
| Year3 | $1,252,137 | Year3Amt |
| Total | $6,351,992 | TotalAmt |
Qualifying Distri Made Drt QualifyingDistriMadeDrtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $1,805,667 | CurrentYearAmt |
| Year1 | $1,772,751 | Year1Amt |
| Year2 | $1,521,437 | Year2Amt |
| Year3 | $1,252,137 | Year3Amt |
| Total | $6,351,992 | TotalAmt |
Two Thirds Minimum Invst Ret TwoThirdsMinimumInvstRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $294,162 | CurrentYearAmt |
| Year1 | $273,040 | Year1Amt |
| Year2 | $265,845 | Year2Amt |
| Year3 | $268,954 | Year3Amt |
| Total | $1,102,001 | TotalAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Program Service Rev Part VII ProgramServiceRevPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BREWERY STREET RENT | Desc |
| Exclusion | 16 | ExclusionCd |
| Exclusion | $16,094 | ExclusionAmt |
Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $165,095 | ExclusionAmt |
Other Investment Incm Part VII OtherInvestmentIncmPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 15 | ExclusionCd |
| Exclusion | $209,965 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Related Or Exempt Function Incm | $511,047 | RelatedOrExemptFunctionIncmAmt |
Other Revenue Described OtherRevenueDescribedGrp (7 entries)
| DescDesc | Related Or Exempt Function IncmRelatedOrExemptFunctionIncmAmt |
|---|---|
| AMORTIZATION OF DEFERRED RE | $131 |
| MISCELLANEOUS | $191,318 |
| CHANGE IN FUTURE SERVICE OB | $52,339 |
| INCOME FROM GUESTS | $8,602 |
| INCOME - NEW RESIDENTS | $654,155 |
| LAUNDRY INCOME | $8,666 |
| SERVICE LEVEL INCOME | $96,738 |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | $391,154 | ExclusionAmt |
| Related Or Exempt Function Incm | $1,522,996 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $1,914,150 | TotalIncomeProducingActyAmt |
Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp
Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Line Number | 11B | LineNumberTxt |
| Relationship Statement | AMOUNTS CONTRIBUTED BY THE RESIDENTS TO THE HOME TO MAINTAIN THE HOME AND PROVIDE FOOD AND SHELTER FOR THE RESIDENTS. AMORTIZATION OF THE ASSETS GIVEN TO THE HOME BY THE RESIDENTS UPON ENTRANCE TO THE HOME. IT IS AMORTIZED OVER THE LIFE EXPECTANCY OF EACH OF THE RESIDENTS. THIS INCOME IS USED TO PROVIDE FOOD AND SHELTER TO THE RESIDENTS. CHANGE IN THE LIABILITY TO PROVIDE FOOD, SHELTER AND MEDICAL CARE FOR THE REMAINING LIFETIME CARE RESIDENTS. | RelationshipStatementTxt |
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 |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | ACCOUNTING | CategoryTxt |
| Amt | $15,030 | Amt |
| Net Investment Income | $7,515 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $7,515 | AdjustedNetIncomeAmt |
Depreciation Schedule DepreciationSchedule
Depreciation Property DepreciationPropertyGrp (286 entries)
| PropertyPropertyDesc | AcquiredAcquiredDt | Cost Or Other BasisCostOrOtherBasisAmt | Prior Year DepreciationPriorYearDepreciationAmt | Computation MethodComputationMethodTxt | LifeLifeRt | Current Year ExpenseCurrentYearExpenseAmt |
|---|---|---|---|---|---|---|
| ORIGINAL | 1954-10-01 | $8,000 | $8,000 | S/L | 50.0000 | |
| ADDITIONS | 1955-01-01 | $68,217 | $68,217 | S/L | 50.0000 | |
| ADDITIONS | 1956-01-01 | $31,285 | $31,285 | S/L | 50.0000 | |
| ADDITIONS | 1957-01-01 | $4,678 | $4,678 | S/L | 50.0000 | |
| ADDITIONS | 1959-01-01 | $105 | $105 | S/L | 50.0000 | |
| ADDITIONS | 1962-01-01 | $1,459 | $1,459 | S/L | 20.0000 | |
| ADDITIONS | 1962-01-01 | $95 | $95 | S/L | 20.0000 | |
| ADDITIONS | 1964-01-01 | $279 | $279 | S/L | 20.0000 | |
| DRIVEWAY | 1969-01-01 | $703 | $703 | S/L | 20.0000 | |
| DRIVEWAY | 1970-01-01 | $550 | $550 | S/L | 20.0000 | |
| ADDITION TO HOME | 1972-01-01 | $251,742 | $251,742 | S/L | 40.0000 | |
| DRIVE | 1972-01-01 | $9,500 | $9,500 | S/L | 10.0000 | |
| PAVING | 1973-01-01 | $3,042 | $3,042 | S/L | 10.0000 | |
| AIR COMPRESSOR | 1973-01-01 | $871 | $871 | S/L | 10.0000 | |
| COMPLETION OF ADDITION | 1973-01-01 | $16,391 | $16,391 | S/L | 40.0000 | |
| HEATING AND AIR CONDITIONING | 1974-07-01 | $1,018 | $1,018 | S/L | 20.0000 | |
| POSEYVILLE NURSERY-TREES | 1974-01-01 | $208 | $208 | S/L | 20.0000 | |
| CLOSET | 1976-05-01 | $717 | $717 | S/L | 20.0000 | |
| DOORS | 1977-04-01 | $7,417 | $7,417 | S/L | 20.0000 | |
| HANDRAILS | 1978-06-01 | $1,459 | $1,459 | S/L | 20.0000 | |
| NEW WING | 1979-12-01 | $78,842 | $78,842 | S/L | 20.0000 | |
| NEW WING-1980 | 1980-12-01 | $154,178 | $154,178 | S/L | 20.0000 | |
| NEW WING | 1980-12-01 | $30,957 | ||||
| LANDSCAPING | 1985-06-01 | $1,641 | $1,641 | S/L | 20.0000 | |
| STAINED GLASS WINDOWS-SUNROOM | 1985-06-01 | $2,682 | $2,682 | S/L | 20.0000 | |
| ELECTRICAL WORK | 1985-06-01 | $1,936 | $1,936 | S/L | 20.0000 | |
| LANDSCPAING | 1988-05-01 | $1,724 | $1,724 | S/L | 20.0000 | |
| ELECTRICAL WORK | 1989-03-01 | $5,503 | $5,503 | S/L | 20.0000 | |
| ASPHALT DRIVEWAY | 1997-07-31 | $4,271 | $4,271 | S/L | 20.0000 | |
| CHANDELIERS - PARLORS | 1985-06-01 | $8,250 | $8,250 | S/L | 10.0000 | |
| CANDLE SCONCES | 1985-06-01 | $454 | $454 | S/L | 10.0000 | |
| LIGHT FIXTURES | 1986-01-01 | $298 | $298 | S/L | 10.0000 | |
| MATTRESS | 1987-09-01 | $300 | $300 | S/L | 10.0000 | |
| FURNISHINGS & F. RES ROOM | 1988-05-01 | $1,966 | $1,966 | S/L | 10.0000 | |
| MATTRESS & SPRINGS | 1989-07-01 | $395 | $395 | S/L | 10.0000 | |
| CEILING FAN | 1989-06-01 | $371 | $371 | S/L | 10.0000 | |
| NIGHT STAND & TABLE | 1989-06-01 | $526 | $526 | S/L | 10.0000 | |
| BEDROOM SUIT | 1989-09-01 | $1,503 | $1,503 | S/L | 10.0000 | |
| BEDROOM SUIT | 1989-09-01 | $1,731 | $1,731 | S/L | 10.0000 | |
| MATTRESSES | 1990-11-01 | $560 | $560 | S/L | 10.0000 | |
| NIGHT STAND | 1992-03-06 | $208 | $208 | S/L | 10.0000 | |
| CHEST | 1992-03-06 | $258 | $258 | S/L | 10.0000 | |
| MATTRESS | 1992-09-01 | $257 | $257 | S/L | 10.0000 | |
| CEILING FANS-LIGHT | 1985-06-01 | $1,280 | $1,280 | S/L | 10.0000 | |
| WINDOW A/C FOR NANCY'S OFFICE | 1999-06-01 | $243 | $243 | S/L | 10.0000 | |
| BEDROOM FURNITURE | 1974-11-01 | $939 | $939 | S/L | 10.0000 | |
| BEDROOM FURNITURE | 1975-01-01 | $1,003 | $1,003 | S/L | 10.0000 | |
| BEDROOM FURNITURE | 1975-09-01 | $1,100 | $1,100 | S/L | 10.0000 | |
| BEDROOM FURNITURE | 1975-12-01 | $779 | $779 | S/L | 10.0000 | |
| BEDROOM FURNITURE | 1976-12-01 | $1,392 | $1,392 | S/L | 10.0000 | |
| BEDROOM FURNITURE - ANNA LEWIS | 1979-07-01 | $877 | $877 | S/L | 10.0000 | |
| SHOWER | 1983-03-01 | $1,108 | $1,108 | S/L | 10.0000 | |
| BUFFETT & HUTCH | 1985-05-01 | $4,730 | $4,730 | S/L | 10.0000 | |
| 4 PC BEDROOM SUITE | 1985-06-01 | $1,195 | $1,195 | S/L | 10.0000 | |
| BEDS | 1985-06-01 | $220 | $220 | S/L | 10.0000 | |
| SETS MATTRESS & BOX SPRINGS | 1985-06-01 | $1,200 | $1,200 | S/L | 10.0000 | |
| SETS MATTRESS & BOX SPRINGS | 1985-06-01 | $1,200 | $1,200 | S/L | 10.0000 | |
| BROYHILL DRESSER & CHEST | 1985-08-01 | $711 | $711 | S/L | 10.0000 | |
| 1999-12-31 | ||||||
| ADDITIONS | 1971-01-01 | $1,152 | $1,152 | S/L | 5.0000 | |
| ADDITIONS | 1972-01-01 | $7,757 | $7,757 | S/L | 5.0000 | |
| ADDITIONS | 1973-01-01 | $3,351 | $3,351 | S/L | 5.0000 | |
| CEILING DIFFUSERS | 1976-01-01 | $943 | $943 | S/L | 5.0000 | |
| DUMP CART | 1978-11-01 | $157 | $157 | S/L | 5.0000 | |
| GENERATOR | 1979-03-01 | $23,222 | $23,222 | S/L | 20.0000 | |
| DISHWASHER RACKS | 1980-02-01 | $168 | $168 | S/L | 3.0000 | |
| STEEL WORK TABLE | 1986-11-01 | $1,257 | $1,257 | S/L | 10.0000 | |
| SUMP PUMP | 1988-07-01 | $357 | $357 | S/L | 10.0000 | |
| CIRC PUMP | 1990-03-01 | $610 | $610 | S/L | 10.0000 | |
| BENTON-CIRCULATE PUMP & MOTOR | 1991-01-01 | $1,285 | $1,285 | S/L | 10.0000 | |
| TILLER | 1993-06-02 | $369 | $369 | S/L | 10.0000 | |
| ROOM AIR CONDITIONER UNIT | 1997-03-31 | $1,826 | $1,826 | S/L | 10.0000 | |
| 4 TON CARRIER AIR CONDITIONER | 1997-05-05 | $1,870 | $1,870 | S/L | 10.0000 | |
| 2 COOLING CHASIS | 1998-01-27 | $3,400 | $3,400 | S/L | 10.0000 | |
| LIGHT FOR PARKING LOT | 1999-12-15 | $373 | $373 | S/L | 10.0000 | |
| FIRE FILE & 2 CHAIRS | 1972-01-01 | $570 | $570 | S/L | 10.0000 | |
| FILE CABINETS | 1979-11-01 | $1,299 | $1,299 | S/L | 15.0000 | |
| FILE CABINET | 1991-05-01 | $132 | $132 | S/L | 10.0000 | |
| FILE CABINET | 1992-01-12 | $93 | $93 | S/L | 10.0000 | |
| 3 END TABLES & 3 LAMPS | 2000-12-05 | $670 | $670 | S/L | 10.0000 | |
| SCAFFOLDING | 2000-03-21 | $350 | $350 | S/L | 10.0000 | |
| HEATING UNIT | 2000-04-01 | $1,186 | $1,186 | S/L | 10.0000 | |
| 3 HOT WATER HEATERS | 2000-06-26 | $8,596 | $8,596 | S/L | 10.0000 | |
| CARRIER PKG TERMINAL A/C | 2000-06-27 | $1,186 | $1,186 | S/L | 10.0000 | |
| CARRIER UNIT | 2000-08-14 | $1,186 | $1,186 | S/L | 10.0000 | |
| INSTALLATION OF BATHROOM HEATER | 2000-12-26 | $986 | $986 | S/L | 10.0000 | |
| 3 FRONT GABLES COVERED W/ ALUMINUM FASCIA | 2001-10-18 | $2,549 | $2,549 | S/L | 10.0000 | |
| GLIDER ROCKER | 2001-12-31 | $240 | $240 | S/L | 10.0000 | |
| CROWN MOLDING FOR DINING ROOM | 2002-12-12 | $101 | $101 | S/L | 10.0000 | |
| CULVERT FOR BACK ENTRANCE | 2002-12-18 | $1,714 | $1,714 | S/L | 10.0000 | |
| ALARM SYSTEM | 2002-06-21 | $2,562 | $2,562 | S/L | 10.0000 | |
| HEATING & COOLING UNITS FOR EAST CORRIDOR | 2002-08-15 | $5,587 | $5,587 | S/L | 10.0000 | |
| SEWING MACHINE | 2002-08-29 | $115 | $115 | S/L | 10.0000 | |
| LAUNDRY CART & COVER | 2002-08-29 | $292 | $292 | S/L | 10.0000 | |
| HVAC SYSTEM FOR DINING ROOM | 2002-12-20 | $3,660 | $3,660 | S/L | 10.0000 | |
| CABINETS FOR NURSES' STATION | 2002-10-28 | $575 | $575 | S/L | 10.0000 | |
| CARPETING FOR WILMA JOYCE'S ROOM | 2002-09-30 | $1,198 | $1,198 | S/L | 10.0000 | |
| CHAIR FOR WILMA JOYCE BAILEY | 2002-10-01 | $564 | $564 | S/L | 10.0000 | |
| LIVING ROOM SUITE SHOW ROOM | 2002-12-09 | $1,000 | $1,000 | S/L | 10.0000 | |
| BEDROOM SUITE, CHAIRS, LAMPS & TABLES | 2002-12-09 | $3,255 | $3,255 | S/L | 10.0000 | |
| CABINETS IN PANTRY AND NURSES' STATION | 2002-12-26 | $298 | $298 | S/L | 10.0000 | |
| OUTSIDE BENCH | 2002-12-31 | $166 | $166 | S/L | 10.0000 | |
| KITCHEN LIGHTING | 2002-12-31 | $1,109 | $1,109 | S/L | 10.0000 | |
| HEAT & A/C - SOUTH | 2003-04-21 | $6,223 | $6,223 | S/L | 10.0000 | |
| HEAT & A/C - EAST/WEST | 2003-04-21 | $8,358 | $8,358 | S/L | 10.0000 | |
| HEAT & A/C - NORTH | 2003-04-21 | $6,193 | $6,193 | S/L | 10.0000 | |
| ELECTRICAL WORK FOR WALK IN FREEZER | 2003-05-01 | $775 | $775 | S/L | 10.0000 | |
| BUILDING IMP FOR WALK-IN | 2003-05-07 | $4,884 | $4,070 | S/L | 20.0000 | $244 |
| BUILDING IMPROVEMENTS | 2003-05-13 | $1,057 | $881 | S/L | 20.0000 | $53 |
| HANDICAP RAMP | 2003-07-19 | $2,237 | $1,836 | S/L | 20.0000 | $112 |
| CULVERT AT BACK ENTRANCE | 2003-09-10 | $16,994 | $13,878 | S/L | 20.0000 | $850 |
| OFFICE CABINETS | 2003-06-18 | $488 | $488 | S/L | 10.0000 | |
| WALK-IN FREEZER, SHELVING & WIRING | 2003-05-01 | $13,631 | $13,631 | S/L | 10.0000 | |
| TRACER EX2 WHEELCHAIR | 2003-01-02 | $422 | $422 | S/L | 10.0000 | |
| WATERPROOF BATH CHAIR | 2003-03-26 | $265 | $265 | S/L | 10.0000 | |
| CABINETS FOR NURSE'S STATION | 2003-05-01 | $913 | $913 | S/L | 10.0000 | |
| END TABLES | 2003-06-02 | $298 | $298 | S/L | 10.0000 | |
| ECHO-IS2400 | 2003-02-24 | $240 | $240 | S/L | 10.0000 | |
| LANDSCAPING FRONT GARDEN | 2003-10-01 | $3,131 | $3,131 | S/L | 10.0000 | |
| MIXER | 2003-02-05 | $104 | $104 | S/L | 10.0000 | |
| BEAUTY SHOP EQUIPMENT | 2003-02-05 | $1,007 | $1,007 | S/L | 10.0000 | |
| SHOWER CHAIRS | 2003-06-30 | $250 | $250 | S/L | 10.0000 | |
| MATTRESS | 2004-02-02 | $400 | $400 | S/L | 10.0000 | |
| LOCKED WALL MOUNTED BOX FOR RENT PMTS | 2004-02-26 | $114 | $114 | S/L | 10.0000 | |
| STORAGE CABINET | 2004-02-19 | $153 | $153 | S/L | 10.0000 | |
| SHOWER | 2004-02-09 | $2,834 | $2,255 | S/L | 20.0000 | $142 |
| SCREENS | 2004-06-09 | $140 | $140 | S/L | 10.0000 | |
| GUTTERING & FASCIA | 2004-07-29 | $1,500 | $1,156 | S/L | 20.0000 | $75 |
| ELECTRICAL WORK - ADDITIONAL CIRCUITS | 2004-07-11 | $1,097 | $850 | S/L | 20.0000 | $55 |
| STORAGE BUILDING | 2004-12-31 | $32,501 | $9,750 | S/L | 50.0000 | $650 |
| HVAC FOR STORAGE BUILDING | 2004-12-01 | $1,115 | $1,115 | S/L | 10.0000 | |
| INSTRUMENT TABLE FOR NURSING USE | 2004-12-10 | $142 | $142 | S/L | 10.0000 | |
| CUSHIONS FOR OUTSIDE CHAIRS & GLIDDER | 2004-07-09 | $442 | $442 | S/L | 10.0000 | |
| PORCH FURNITURE | 2004-08-18 | $989 | $989 | S/L | 10.0000 | |
| PORCH FURNITURE | 2004-08-02 | $738 | $738 | S/L | 10.0000 | |
| PORCH FURNITURE | 2004-09-11 | $1,245 | $1,245 | S/L | 10.0000 | |
| PORCH FURNITURE | 2004-10-12 | $425 | $425 | S/L | 10.0000 | |
| ADD'L COST IN STORAGE BUILDING | 2005-02-21 | $306 | $91 | S/L | 50.0000 | $6 |
| CARRIER HEATING & COOLING UNIT | 2005-05-05 | $1,038 | $1,038 | S/L | 10.0000 | |
| TOILET SEAT FRAME & SAFETY SPACER | 2005-11-17 | $356 | $356 | S/L | 10.0000 | |
| PORCH FURNITURE | 2005-04-14 | $3,714 | $3,714 | S/L | 10.0000 | |
| OAK BENCH | 2005-05-26 | $330 | $330 | S/L | 10.0000 | |
| 4I ROUND LIFT SPACER W/DURAGUARD WHITE | 2005-10-12 | $350 | $350 | S/L | 10.0000 | |
| HOLD UP BUTTON IN WALK-IN FREEZER | 2005-05-16 | $384 | $384 | S/L | 10.0000 | |
| SECURITY CALL SYSTEM | 2006-04-28 | $4,849 | $4,849 | S/L | 10.0000 | |
| FRONT ENTRY DOOR | 2006-11-01 | $5,147 | $1,694 | S/L | 40.0000 | $129 |
| PHONE SYSTEM | 2006-09-15 | $3,278 | $3,278 | S/L | 10.0000 | |
| 3 FILE CABINETS | 2006-09-15 | $510 | $510 | S/L | 10.0000 | |
| FURNITURE FOR SUN PORCH | 2006-09-18 | $4,026 | $4,026 | S/L | 10.0000 | |
| STAINLESS STEEL COUNTERS | 2008-03-17 | $5,440 | $5,440 | S/L | 10.0000 | |
| CUB CADET MOWER | 2008-04-17 | $2,700 | $2,700 | S/L | 7.0000 | |
| AUTOMATIC DOOR | 2009-06-17 | $2,613 | $1,851 | S/L | 15.0000 | $174 |
| HEATER & AC UNIT | 2009-11-16 | $633 | $633 | S/L | 7.0000 | |
| VACCUM | 2009-12-10 | $800 | $800 | S/L | 7.0000 | |
| ROOF | 2009-10-07 | $104,651 | $52,980 | S/L | 20.0000 | $5,232 |
| REFRIGERATOR | 2010-02-16 | $2,750 | $2,704 | S/L | 10.0000 | $46 |
| REFRIGERATOR FOR KITCHEN | 2010-06-07 | $2,750 | $2,635 | S/L | 10.0000 | $115 |
| 16 SMOKE ALARMS | 2010-07-28 | $1,072 | $1,072 | S/L | 5.0000 | |
| STOVE | 2010-08-24 | $3,606 | $3,366 | S/L | 10.0000 | $240 |
| FLAT SCREEN TV & DVD | 2010-10-18 | $1,048 | $1,048 | S/L | 5.0000 | |
| FIREPLACE ENTERTAINMENT CENTER | 2010-12-31 | $598 | $538 | S/L | 10.0000 | $60 |
| GABEL REPAIRS & SCREENED PORCHES | 2010-06-25 | $10,285 | $2,505 | S/L | 39.0000 | $264 |
| CARPET IN ENTRANCE | 2010-12-14 | $1,904 | $1,153 | S/L | 15.0000 | $127 |
| ? | 2011-09-12 | $952 | $793 | S/L | 10.0000 | $96 |
| CARPET, ROOM 111 | 2011-09-12 | $520 | $433 | S/L | 10.0000 | $52 |
| CARPET, ROOM 101 | 2011-09-29 | $934 | $771 | S/L | 10.0000 | $93 |
| CARPET ROOM 122 | 2012-02-07 | $525 | $401 | S/L | 10.0000 | $52 |
| CARPET ROOM 128 | 2012-02-27 | $788 | $601 | S/L | 10.0000 | $79 |
| CARPET-HALLWAY | 2012-10-16 | $1,421 | $1,030 | S/L | 10.0000 | $142 |
| CARPET - ROOM 119 | 2013-01-21 | $534 | $347 | S/L | 10.0000 | $54 |
| WALLS IN KITCHEN | 2013-02-18 | $2,445 | $420 | S/L | 39.0000 | $61 |
| CARPET - ROOM 114 | 2013-04-15 | $659 | $428 | S/L | 10.0000 | $66 |
| COMPUTER | 2013-11-26 | $749 | $749 | S/L | 5.0000 | |
| PLUMBING FOR HOT WATER SYSTEM | 2013-05-06 | $5,898 | $977 | S/L | 39.0000 | $147 |
| HOT WATER HEATER | 2013-07-08 | $1,354 | $880 | S/L | 10.0000 | $136 |
| REFRIGERATOR | 2013-07-29 | $3,184 | $2,070 | S/L | 10.0000 | $318 |
| MIXING LEVEL (HOT & COLD WATER) | 2013-12-23 | $2,609 | $1,696 | S/L | 10.0000 | $261 |
| GOLF CART | 2013-09-23 | $4,795 | $3,117 | S/L | 10.0000 | $479 |
| SPRINKLER SYSTEM | 2014-12-08 | $57,510 | $49,808 | S/L | 7.0000 | $4,108 |
| 2014 BUILDING REMODEL | 2014-12-01 | $139,479 | $17,580 | S/L | 39.0000 | $3,487 |
| 5 REFRIGERATORS | 2014-10-23 | $827 | $827 | S/L | 5.0000 | |
| 2 MEDICINE CABINETS, 3 TVS & 2 REFRIGERATORS | 2014-12-29 | $1,267 | $1,267 | S/L | 5.0000 | |
| TV | 2014-09-18 | $201 | $201 | S/L | 5.0000 | |
| MICROWAVE, REFRIGERATOR & BLINDS | 2014-10-23 | $1,004 | $1,004 | S/L | 5.0000 | |
| BLINDS & MICROWAVE | 2014-11-17 | $1,531 | $1,531 | S/L | 5.0000 | |
| WIRELESS CALL SYSTEM | 2014-09-02 | $70,385 | $62,215 | S/L | 7.0000 | $5,028 |
| STAINLESS STEEL SILVERWARE | 2014-09-30 | $602 | $602 | S/L | 5.0000 | |
| CARPET | 2014-12-22 | $2,681 | $2,681 | S/L | 5.0000 | |
| CHINA WARE | 2014-10-13 | $1,889 | $1,889 | S/L | 5.0000 | |
| CURTAINS | 2014-07-28 | $1,367 | $1,367 | S/L | 5.0000 | |
| CELL PHONE FOR NURSE CALL | 2014-07-28 | $725 | $725 | S/L | 5.0000 | |
| 3 MEDICINE CABINETS | 2014-10-23 | $517 | $517 | S/L | 5.0000 | |
| SHOWER CURTAIN PACKAGES | 2014-12-22 | $786 | $786 | S/L | 5.0000 | |
| ICE MACHINE | 2014-04-14 | $2,095 | $1,889 | S/L | 7.0000 | $150 |
| SPEED QUEEN COMMERCIAL DRYER | 2014-02-24 | $566 | $566 | S/L | 5.0000 | |
| SPEED QUEEN COMMERCIAL DRYER | 2014-03-10 | $742 | $742 | S/L | 5.0000 | |
| PTAC 7000 BTU | 2014-11-17 | $781 | $781 | S/L | 5.0000 | |
| SPEED QUEEN COMMERCIAL DRYER | 2014-11-25 | $551 | $551 | S/L | 5.0000 | |
| MATTRESS | 2014-04-07 | $429 | $429 | S/L | 5.0000 | |
| 5 TVS | 2014-10-23 | $1,009 | $1,009 | S/L | 5.0000 | |
| DESK & FILE CABINETS | 2015-10-22 | $4,374 | $3,645 | S/L | 5.0000 | $729 |
| CHAIRS | 2015-11-06 | $961 | $801 | S/L | 5.0000 | $160 |
| PTC073E35AXXX | 2015-01-05 | $738 | $738 | S/L | 5.0000 | |
| PTAC UNIT 7000 BTU | 2015-02-09 | $718 | $706 | S/L | 5.0000 | $12 |
| DISHES | 2015-02-16 | $1,889 | $1,826 | S/L | 5.0000 | $63 |
| WHIRLPOOL ELECTRIC DRYER | 2015-03-02 | $638 | $617 | S/L | 5.0000 | $21 |
| 2 LOUNGE CHAIRS | 2015-07-13 | $1,893 | $1,704 | S/L | 5.0000 | $189 |
| AMANA PTAC | 2015-10-05 | $759 | $645 | S/L | 5.0000 | $114 |
| AMANA PTAC | 2015-12-07 | $784 | $640 | S/L | 5.0000 | $144 |
| SPRINKLER SYSTEM | 2015-04-13 | $32,965 | $22,369 | S/L | 7.0000 | $4,709 |
| WINDOW BLINDS | 2015-03-16 | $1,918 | $1,822 | S/L | 5.0000 | $96 |
| MEDICINE CABINETS & FRIDGES | 2015-03-23 | $1,510 | $1,434 | S/L | 5.0000 | $76 |
| SHELVING & TOILETS | 2015-04-20 | $1,508 | $1,407 | S/L | 5.0000 | $101 |
| MICROWAVES | 2015-05-18 | $608 | $557 | S/L | 5.0000 | $51 |
| MEDICINE CABINETS & FRIDGES | 2015-06-01 | $1,197 | $1,097 | S/L | 5.0000 | $100 |
| MICROWAVE & BLINDS | 2015-07-13 | $814 | $733 | S/L | 5.0000 | $81 |
| REFRIGERATOR | 2015-07-20 | $225 | $199 | S/L | 5.0000 | $26 |
| BUILDING IMPROVEMENTS | 2015-12-15 | $139,019 | $14,555 | S/L | 39.0000 | $3,565 |
| 2 AIR CONDITIONERS | 2015-12-15 | $9,671 | $1,013 | S/L | 39.0000 | $248 |
| TV, MED CABINET, REFRIGERATORS | 2016-06-30 | $708 | $495 | S/L | 5.0000 | $142 |
| MAIN HALL A/C | 2016-11-01 | $2,977 | $242 | S/L | 39.0000 | $76 |
| WATER HEATER | 2016-08-15 | $4,223 | $1,443 | S/L | 10.0000 | $422 |
| LIFT RECLINER | 2016-04-19 | $770 | $565 | S/L | 5.0000 | $154 |
| OFFICE FURNITURE | 2016-05-09 | $8,776 | $6,436 | S/L | 5.0000 | $1,755 |
| FOLDING TABLES & CHAIRS | 2016-07-18 | $586 | $401 | S/L | 5.0000 | $117 |
| TV STAND/FIREPLACE | 2016-08-29 | $520 | $347 | S/L | 5.0000 | $103 |
| CARPET | 2016-11-07 | $10,440 | $6,612 | S/L | 5.0000 | $2,088 |
| BUILDING IMPROVEMENTS | 2016-12-15 | $80,876 | $6,394 | S/L | 39.0000 | $2,074 |
| WIRELESS KEYBOARD & STICK | 2016-05-23 | $212 | $152 | S/L | 5.0000 | $43 |
| COMPUTER FOR LIFE ENRICHMENT | 2016-08-29 | $1,064 | $709 | S/L | 5.0000 | $213 |
| WIRELESS NETWORK | 2016-11-07 | $3,230 | $2,046 | S/L | 5.0000 | $646 |
| 5 AMANA PTAC'S | 2016-11-07 | $3,550 | $2,248 | S/L | 5.0000 | $710 |
| CHAIRS | 2017-02-27 | $390 | $221 | S/L | 5.0000 | $78 |
| RADIO/PHONE INTERFACE UNIT | 2017-05-16 | $2,753 | $1,422 | S/L | 5.0000 | $551 |
| SARA LIFT | 2017-10-09 | $4,656 | $2,095 | S/L | 5.0000 | $931 |
| CARPET | 2017-10-09 | $11,472 | $5,162 | S/L | 5.0000 | $2,295 |
| BUILDING IMPROVEMENTS | 2017-11-20 | $86,536 | $4,623 | S/L | 39.0000 | $2,218 |
| TV, CABINET, REFRIGERATOR | 2017-03-28 | $571 | $314 | S/L | 5.0000 | $115 |
| 3 PTAC UNITS | 2017-09-11 | $1,830 | $854 | S/L | 5.0000 | $366 |
| DINING ROOM FURNISHINGS | 2017-07-25 | $13,701 | $6,622 | S/L | 5.0000 | $2,740 |
| CHAIRS & TV | 2017-12-26 | $624 | $250 | S/L | 5.0000 | $124 |
| FIRE ALARM PANEL | 2017-12-15 | $4,812 | $2,005 | S/L | 5.0000 | $963 |
| LIFT | 2017-07-05 | $4,000 | $2,000 | S/L | 5.0000 | $800 |
| WATER HEATER | 2017-12-15 | $2,868 | $597 | S/L | 10.0000 | $287 |
| TVS, REFRIGERATORS, MEDICINE CABINETS | 2018-07-17 | $2,520 | $714 | S/L | 5.0000 | $504 |
| NURSE COMPUTER, LE COMPUTER | 2018-03-01 | $3,023 | $1,108 | S/L | 5.0000 | $605 |
| ADMISSIONS LAPTOP | 2018-08-16 | $1,506 | $402 | S/L | 5.0000 | $301 |
| PAPER SHREDDER | 2018-10-22 | $621 | $145 | S/L | 5.0000 | $124 |
| PTAC | 2018-02-27 | $630 | $231 | S/L | 5.0000 | $126 |
| DRYER | 2018-03-19 | $582 | $204 | S/L | 5.0000 | $116 |
| BEAUTY SHOP CHAIR | 2018-04-23 | $1,069 | $356 | S/L | 5.0000 | $214 |
| WI-FI & EXTENDERS | 2018-09-18 | $1,290 | $322 | S/L | 5.0000 | $258 |
| PTAC | 2018-10-30 | $710 | $166 | S/L | 5.0000 | $142 |
| PTAC | 2018-11-15 | $881 | $206 | S/L | 5.0000 | $176 |
| CARDIAC MONITOR STAND | 2018-11-19 | $2,045 | $443 | S/L | 5.0000 | $409 |
| CARPET | 2018-07-15 | $8,718 | $2,615 | S/L | 5.0000 | $1,744 |
| TV, DVD, SHELF, CABLES | 2018-10-22 | $535 | $125 | S/L | 5.0000 | $107 |
| IMPROVEMENTS | 2018-12-31 | $86,991 | $2,231 | S/L | 39.0000 | $2,230 |
| TIME CLOCK | 2018-12-31 | $510 | $102 | S/L | 5.0000 | $102 |
| KORESEN FIRE & SECURITY | 2019-12-31 | $1,532 | S/L | 39.0000 | $39 | |
| MASH WORKS | 2019-12-31 | $2,414 | S/L | 39.0000 | $62 | |
| IMPROVEMENTS - SEE CARRYFORWARD | 2019-12-31 | $196,021 | S/L | 39.0000 | $5,026 | |
| HOME IMPROV - SEE CARRYFORWARD | 2019-12-31 | $60,075 | S/L | 39.0000 | $1,540 | |
| HOME FURNISHINGS (DETAIL CARRYFORWARD) | 2019-12-26 | $62,777 | S/L | 10.0000 | $6,278 | |
| MEDLINE | 2019-12-31 | $6,717 | S/L | 10.0000 | $672 | |
| COMPUTERS - SEE CARRYFORWARD | 2019-08-27 | $5,713 | $381 | S/L | 5.0000 | $1,143 |
| 2 PTAC UNITS | 2019-07-22 | $3,075 | $128 | S/L | 10.0000 | $308 |
| RESIDENTS REFRIGERATORS | 2019-07-22 | $1,025 | $43 | S/L | 10.0000 | $102 |
| PTAC UNIT | 2019-08-22 | $1,467 | $49 | S/L | 10.0000 | $147 |
| TOUCHSCREEN LAPTOP | 2020-04-14 | $1,192 | S/L | 5.0000 | $179 | |
| SURFACE BOOKS, OFFICE PRO | 2020-05-12 | $4,235 | S/L | 5.0000 | $565 | |
| IPADS | 2020-04-06 | $7,520 | S/L | 5.0000 | $1,128 | |
| CUB CADET ZERO TURN 2020ZT 1 42 MOWER | 2020-06-01 | $2,199 | S/L | 5.0000 | $257 | |
| CAMERA | 2020-09-08 | $3,910 | S/L | 5.0000 | $261 | |
| PATIO HEATERS | 2020-10-19 | $1,437 | S/L | 5.0000 | $48 | |
| SUNROOM KEYPAD | 2020-07-21 | $3,181 | S/L | 10.0000 | $133 | |
| IMPROVEMENTS | 2020-12-31 | $61,783 | S/L | 39.0000 | ||
| ARTWORK | 2020-08-25 | $8,726 | S/L | 10.0000 | $291 | |
| PTAC UNIT | 2020-04-06 | $768 | S/L | 10.0000 | $58 | |
| ELECTRONIC SCALE | 2020-08-25 | $691 | S/L | 10.0000 | $23 | |
| PTAC & THERMOSTAT | 2020-09-28 | $1,039 | S/L | 10.0000 | $26 | |
| WASHING MACHINE | 2020-10-01 | $981 | S/L | 10.0000 | $25 | |
| PTAC | 2020-12-14 | $694 | S/L | 10.0000 | $6 | |
| ROCKER RECLINER | 2020-05-05 | $659 | S/L | 10.0000 | $44 | |
| ART & BLINDS | 2020-11-19 | $1,160 | S/L | 10.0000 | $10 | |
| DECORATIONS | 2020-03-09 | $3,000 | S/L | 10.0000 | $250 |
Gain Loss Sale Other Assets Sch GainLossSaleOtherAssetsSch
Gain Loss Sale Other Asset GainLossSaleOtherAssetGrp (2 entries)
| AssetAssetDesc | How AcquiredHowAcquiredTxt | Gross Sales PriceGrossSalesPriceAmt | BasisBasisAmt | Total NetTotalNetAmt |
|---|---|---|---|---|
| MORGAN STANLEY | PURCHASE | $1,693,385 | $1,171,153 | $522,232 |
| MORGAN STANLEY | PURCHASE | $11,185 | -$11,185 |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corporate Bonds InvestmentsCorporateBondsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond | BONDS | BondNm |
| EOY Book Value | $106,660 | EOYBookValueAmt |
| EOYFMV | $102,093 | EOYFMVAmt |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp (2 entries)
| StockStockNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| MUTUAL FUNDS | $1,154,061 | $1,154,061 |
| STOCK | $893,857 | $2,703,202 |
Investments Govt Obligations Sch InvestmentsGovtObligationsSch
| Field | Value | IRS element (for citing) |
|---|---|---|
| State Local Sec Book Vl EOY | $100,000 | StateLocalSecBookVlEOYAmt |
| State Local Sec EOYFMV | $103,230 | StateLocalSecEOYFMVAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (3 entries)
| Category Or ItemCategoryOrItemTxt | Listed At Cost Or FMVListedAtCostOrFMVCd | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| CASH EQUIVALENTS | AT COST | $463,392 | $463,392 |
| EXCHANGED TRADED FUNDS | AT COST | $2,166,659 | $4,454,702 |
| OTHER | AT COST | $103,485 | $103,485 |
Land Etc Schedule2 LandEtcSchedule2
Land Etc LandEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Or Other Basis | $2,716,421 | CostOrOtherBasisAmt |
| Accumulated Depreciation | $1,329,889 | AccumulatedDepreciationAmt |
| Book Value | $1,386,532 | BookValueAmt |
| EOYFMV | $1,386,532 | EOYFMVAmt |
Legal Fees Schedule LegalFeesSchedule
Legal Fees LegalFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | LEGAL | CategoryTxt |
| Legal Fees | $520 | LegalFeesAmt |
| Net Investment Income | $260 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $260 | AdjustedNetIncomeAmt |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp (4 entries)
| DescDesc | BOY Book ValueBOYBookValueAmt | EOY Book ValueEOYBookValueAmt |
|---|---|---|
| POSEY COUNTY F.B. STOCK | $91 | $91 |
| RENT RECEIVABLE | $1,203 | $1,336 |
| INTEREST RECEIVABLE | $4,592 | $2,577 |
| ACCRUED EXISE TAXES | $50 | $2,484 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (59 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt | Net Investment IncomeNetInvestmentIncomeAmt |
|---|---|---|---|
| EXPENSES | |||
| FOOD | $92,494 | $92,494 | |
| PAPER SUPPLIES - HOUSEKEEPING | $4,551 | $4,551 | |
| PAPER SUPPLIES-DIETARY | $6,884 | $6,884 | |
| SUNDRY SUPPLIES | $2,066 | $2,066 | |
| LINENS - HOUSEKEEPING | $1,113 | $1,113 | |
| MISCELLANEOUS HOME SUPPLIES | $9,770 | $9,770 | |
| LAUNDRY | $1,922 | $1,922 | |
| INSURANCE - HOME | $36,771 | $36,771 | |
| INSURANCE - RESIDENTS | $843 | $843 | |
| INSURANCE - EMPLOYEE | $68,271 | $68,271 | |
| WATER SOFTNERS | $3,540 | $3,540 | |
| REPAIRS & MAINTENANCE | $184 | $184 | |
| CASUAL LABOR | $35,559 | $35,559 | |
| FIRE/SAFETY CONTRACTORS | $5,310 | $5,310 | |
| OUTSIDE EQUIPMENT MAINTENANCE | $1,027 | $1,027 | |
| INSIDE EQUIPMENT MAINTENANCE | $2,334 | $2,334 | |
| MAINTENANCE - SUPPLIES | $15,758 | $15,758 | |
| CONSULTATIONS - HOME | $15,623 | $15,623 | |
| DIETARY CONSULTANT | $2,011 | $2,011 | |
| MEDICAL SUPPLIES | $60,661 | $60,661 | |
| EMPLOYEE EXPENSE | $5,486 | $5,486 | |
| DOCTORS & HOSPITALS | $843 | $843 | |
| OFFICE SUPPLIES | $5,365 | $5,365 | |
| POSTAGE | $798 | $798 | |
| ALLOWANCE TO GUESTS | $5,149 | $5,149 | |
| INTEREST PAID TO GUESTS | $1,056 | $1,056 | |
| VEHICLE REPAIR AND MAINTENANC | $1,116 | $1,116 | |
| MISCELLANEOUS EXPENSE | $5,662 | $5,662 | |
| MAGAZINES & SUBSCRIPTIONS | $1,680 | $1,680 | |
| BANK FEES - GENERAL FUND | $23,668 | $23,668 | |
| BANK FEES - CHECKING ACCT | $151 | $151 | |
| EQUIPMENT RENTAL | $1,360 | $1,360 | |
| DISHWASHER RENTAL | $975 | $975 | |
| COPIER EXPENSE | $8,118 | $8,118 | |
| HOUSEKEEPING | $6,001 | $6,001 | |
| KITCHEN CLEANING SUPPLIES | $6,430 | $6,430 | |
| LIFE ENRICHMENT DIRECTOR EXPE | $8,326 | $8,326 | |
| MARKETING | $83,684 | $83,684 | |
| SPECIAL EVENTS | $8,383 | $8,383 | |
| ADVERTISING | $5,429 | $5,429 | |
| PENALTIES | $665 | $665 | |
| PAPER SUPPLIES-NURSING | $3,924 | $3,924 | |
| EDUCATION | $2,479 | $2,479 | |
| SMALL KITCHEN EQUIPMENT | $1,160 | $1,160 | |
| PROFESSIONAL DUES | $2,104 | $2,104 | |
| GENERATOR | $685 | $685 | |
| CLEANING SUPPLIES | $10,100 | $10,100 | |
| IT CONSULTANT | $2,020 | $2,020 | |
| IT SUPPLIES | $2,874 | $2,874 | |
| GASOLINE - VANS | $1,295 | $1,295 | |
| VAN LEASE | $12,922 | $12,922 | |
| YARD MAINTENANCE | $3,910 | $3,910 | |
| GARDEN | $1,378 | $1,378 | |
| PUBLIC RELATIONS | $3,576 | $3,576 | |
| MEDICAL EDUCATION & SEMINARS | $543 | $543 | |
| PAPER SUPPLIES-OTHER | $242 | $242 | |
| BEAUTICIAN PAYMENTS | $31 | $31 | |
| HELP WANTED | $3,691 | $3,691 |
Other Income Schedule2 OtherIncomeSchedule2
Other Income Detail OtherIncomeDetail (9 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt |
|---|---|---|---|
| ROYALTY INCOME | $209,965 | $209,965 | $209,965 |
| BREWERY STREET RENT | $16,094 | $16,094 | |
| AMORTIZATION OF DEFERRED REV. | $131 | $131 | |
| MISCELLANEOUS | $191,318 | $191,318 | |
| CHANGE IN FUTURE SERVICE OBLG | $52,339 | $52,339 | |
| INCOME FROM GUESTS | $8,602 | $8,602 | |
| INCOME - NEW RESIDENTS | $654,155 | $654,155 | |
| LAUNDRY INCOME | $8,666 | $8,666 | |
| SERVICE LEVEL INCOME | $96,738 | $96,738 |
Other Liabilities Schedule OtherLiabilitiesSchedule
Other Liabilities Detail OtherLiabilitiesDetail (7 entries)
| DescDesc | BOY Book ValueBOYBookValueAmt | EOY Book ValueEOYBookValueAmt |
|---|---|---|
| SECURITY DEPOSITS | $56,857 | $71,877 |
| OBLIGATION FOR FUTURE SERVICE | $373,248 | $320,909 |
| ACCRUED PAYROLL | $22,742 | $30,648 |
| STATE/COUNTY WITHHOLDINGS | $3,358 | $3,521 |
| UNEMPLOYMENT TAXES | $52 | $260 |
| OTHER WITHHOLDINGS | $684 | $552 |
| ACCRUED PAYROLL TAXES | $1,740 | $2,345 |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (3 entries)
| CategoryCategoryTxt | AmtAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt | Adjusted Net IncomeAdjustedNetIncomeAmt |
|---|---|---|---|
| FICA/MEDICARE EXPENSE | $75,271 | $75,271 | |
| UNEMPLOYMENT TAXES | $1,578 | $1,578 | |
| EXCISE TAXES | $3,436 | $3,436 |
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