HEALTH FORWARD FOUNDATION INC: Form 990PF, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- HEALTH FORWARD FOUNDATION INC (EIN 15-6018016)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-05-04
- IRS object ID
- 202021259349101472
- Schema version
- 2019v5.1
- 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
- Accounting Fees Schedule
- Investments Govt Obligations Sch
- Investments Other Schedule2
- Other Expenses Schedule
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-05-04T13:40:32-05:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 161163912 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FITZGERALD DEPIETRO & WOJNAS CPAS PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 291 GENESEE STREET | AddressLine1Txt |
| City | UTICA | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13501 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 156018016 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SLOCUM-DICKSON FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SLOC | BusinessNameControlTxt |
| Phone | 3157245147 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1729 BURRSTONE ROAD | AddressLine1Txt |
| City | NEW HARTFORD | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13413 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DOMINIC PASSALACQUA | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 3157245147 | PhoneNum |
| Signature | 2020-05-04 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LYNNE STEWART | PreparerPersonNm |
| PTIN | P02011641 | PTIN |
| Phone | 3157242145 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | 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 | $1,293,558 | 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 | $1,000 | ContriRcvdRevAndExpnssAmt |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Dividends Rev And Expnss | $26,713 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $26,713 | DividendsNetInvstIncmAmt |
| Dividends Adj Net Incm | $26,713 | DividendsAdjNetIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $95,382 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $234,718 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $95,382 | CapGainNetIncmNetInvstIncmAmt |
| Total Rev And Expnss | $123,095 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $122,095 | TotalNetInvstIncmAmt |
| Total Adj Net Incm | $26,713 | TotalAdjNetIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $0 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $0 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Adj Net Incm | $0 | CompOfcrDirTrstAdjNetIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $0 | CompOfcrDirTrstDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $3,085 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $3,085 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $3,085 | AccountingFeesAdjNetIncmAmt |
| Accounting Fees Chrtbl Prps | $0 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Rev And Expnss | $8,709 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $8,709 | OtherProfFeesNetInvstIncmAmt |
| Other Prof Fees Adj Net Incm | $8,709 | OtherProfFeesAdjNetIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $0 | OtherProfFeesDsbrsChrtblAmt |
| Taxes Rev And Expnss | $1,574 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $0 | TaxesNetInvstIncmAmt |
| Taxes Adj Net Incm | $0 | TaxesAdjNetIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $6,527 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $6,527 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Adj Net Incm | $6,527 | OtherExpensesAdjNetIncmAmt |
| Other Expenses Dsbrs Chrtbl | $0 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $19,895 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $18,321 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $18,321 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $0 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $61,451 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $61,451 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $81,346 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $18,321 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $18,321 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $61,451 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $41,749 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $103,774 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $8,392 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| US Government Obligations BOY | $79,296 | USGovernmentObligationsBOYAmt |
| US Government Obligations EOY | $77,158 | USGovernmentObligationsEOYAmt |
| US Govt Obligations EOYFMV | $91,151 | USGovtObligationsEOYFMVAmt |
| Other Investments BOY | $953,196 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $997,083 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $1,202,407 | OtherInvestmentsEOYFMVAmt |
| Total Assets BOY | $1,032,492 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,074,241 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $1,293,558 | TotalAssetsEOYFMVAmt |
| Accounts Payable BOY | $1,500 | AccountsPayableBOYAmt |
| Accounts Payable EOY | $1,500 | AccountsPayableEOYAmt |
| Total Liabilities BOY | $1,500 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,500 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
| Capital Stock BOY | $1,030,992 | CapitalStockBOYAmt |
| Capital Stock EOY | $1,072,741 | CapitalStockEOYAmt |
| Additional Paid In Capital BOY | $0 | AdditionalPaidInCapitalBOYAmt |
| Additional Paid In Capital EOY | $0 | AdditionalPaidInCapitalEOYAmt |
| Retained Earning BOY | $0 | RetainedEarningBOYAmt |
| Retained Earning EOY | $0 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $1,030,992 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $1,072,741 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $1,032,492 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $1,074,241 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $1,030,992 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $41,749 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $1,072,741 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $1,072,741 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (11 entries)
| PropertyPropertyDesc | AcquiredAcquiredDt | SoldSoldDt | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt | How AcquiredHowAcquiredCd |
|---|---|---|---|---|---|---|---|
| DODGE AND COX STOCK FUND | 2000-08-11 | 2019-11-12 | $19,935 | $12,386 | $7,549 | $7,549 | |
| EUROPACIFIC GROWTH F-2 | 2015-12-24 | 2019-11-12 | $77,397 | $48,905 | $28,492 | $28,492 | |
| HARBOR CAPITAL APPRE ND | 2011-11-07 | 2019-11-12 | $24,935 | $12,912 | $12,023 | $12,023 | |
| T ROWE PRICE SMALL C | 2013-10-24 | 2019-05-07 | $10,000 | $8,900 | $1,100 | $1,100 | |
| VANGUARD MID-CAP IND MIRAL | 2008-08-07 | 2019-05-07 | $9,931 | $3,561 | $6,370 | $6,370 | |
| VANGUARD 500 INDEX F | 2011-11-07 | 2019-11-12 | $29,935 | $12,656 | $17,279 | $17,279 | |
| PIMCO SHORT TERM | 2018-05-15 | 2019-11-06 | $9,968 | $10,133 | -$165 | -$165 | |
| EUROPACIFIC GROWTH F-2 | 2015-12-24 | 2019-11-12 | $12,603 | $12,709 | -$106 | -$106 | |
| PIMCO SHORT TERM | 2018-05-15 | 2019-04-23 | $4,964 | $5,051 | -$87 | -$87 | |
| PIMCO SHORT TERM | 2018-05-15 | 2019-05-07 | $11,968 | $12,123 | -$155 | -$155 | |
| CAPITAL GAINS DIVIDENDS | $23,082 | $23,082 | $23,082 | P |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $95,382 | CapitalGainNetIncomeAmt |
| Net Short Term Capital Gain Loss | -$242 | NetShortTermCapitalGainLossAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | 0 | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $49,600 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $1,230,242 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.040317 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $49,765 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $1,202,312 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.041391 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $58,934 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $1,136,658 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 0.051848 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $65,700 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $1,211,004 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.054253 | DistributionYr4Rt |
| Adjusted Qlfy Distri Yr5 | $74,145 | AdjustedQlfyDistriYr5Amt |
| Net Vl Noncharitable Assets Yr5 | $1,246,975 | NetVlNoncharitableAssetsYr5Amt |
| Distribution Yr5 | 0.059460 | DistributionYr5Rt |
| Total Distribution | 0.247269 | TotalDistributionRt |
| Average Distribution | 0.049454 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $1,201,310 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $59,410 | AdjNetVlNoncharitableAssetsAmt |
| Net Investment Income Pct | $1,038 | NetInvestmentIncomePctAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $60,448 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $61,451 | QualifyingDistributionsAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Domestic Org Meeting Sect4940e | Yes (X) | DomesticOrgMeetingSect4940eInd |
| Investment Income Excise Tax | $1,038 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $1,038 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $1,038 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $0 | EstimatedPlusOvpmtIncmTxAmt |
| Extsn Request Income Tax Paid | $0 | ExtsnRequestIncomeTaxPaidAmt |
| Backup Withholding Withheld | $0 | BackupWithholdingWithheldAmt |
| Total Payments And Credits | $0 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $38 | EsPenaltyAmt |
| Tax Due | $1,076 | TaxDueAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | 0 | LegislativePoliticalActyInd |
| More Than100 Spent | 0 | MoreThan100SpentInd |
| Form1120 POL Filed | 0 | Form1120POLFiledInd |
| Section4955 Organization Tax | $0 | Section4955OrganizationTaxAmt |
| Section4955 Managers Tax | $0 | Section4955ManagersTaxAmt |
| Tax Reimbursed | $0 | TaxReimbursedAmt |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | 0 | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (1) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (1) | AtLeast5000InAssetsInd |
| Org Report Or Register State | NY | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (1) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | 0 | PrivateOperatingFoundationInd |
| New Substantial Contributors | 0 | NewSubstantialContributorsInd |
| Own Controlled Entity | 0 | OwnControlledEntityInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (1) | ComplyWithPublicInspRqrInd |
| Website Address | WWW.SLOCUMDICKSONFOUNDATION.COM | WebsiteAddressTxt |
| Individual With Books | FITZGERALD DEPIETRO WOJNAS | IndividualWithBooksNm |
| Phone | 3157242145 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 291 GENESEE ST | AddressLine1Txt |
| City | UTICA | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13501 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Accounts Question | 0 | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | 0 | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | 0 | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | 0 | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | 0 | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | 0 | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | 0 | PaymentToGovernmentOfficialInd |
| Uncorrected Prior Acts | 0 | UncorrectedPriorActsInd |
| Undistributed Income PY | 0 | UndistributedIncomePYInd |
| Business Holdings | 0 | BusinessHoldingsInd |
| Jeopardy Investments | 0 | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | 0 | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | 0 | InfluenceLegislationInd |
| Influence Election | 0 | InfluenceElectionInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Noncharitable Purpose | 0 | NoncharitablePurposeInd |
| Transactions Fail To Qlfy As Exc | 0 | TransactionsFailToQlfyAsExcInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (10 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 |
|---|---|---|---|---|---|---|---|---|
| TONY SPIRIDIGLOZZI | ||||||||
| 46 CLINTONVIEW BLVD | NEW HARTFORD | NY | 13413 | TREASURER | 1.00 | $0 | $0 | $0 |
| KELLY PARSONS | ||||||||
| 520 SENECA STREET | UTICA | NY | 13502 | DIRECTOR | 0.25 | $0 | $0 | $0 |
| PHYLLIS SPINNER | ||||||||
| 53 ELM STREET | DOLGEVILLE | NY | 13329 | DIRECTOR | 0.25 | $0 | $0 | $0 |
| SARAH PAPARELLA MPH LNHA | ||||||||
| 1070 LUTHER RD | EAST GREENBUSH | NY | 12061 | DIRECTOR | 0.25 | $0 | $0 | $0 |
| DOMINIC PASSALACQUA | ||||||||
| 2636 EDGEWOOD RD | UTICA | NY | 13501 | PRESIDENT | 1.00 | $0 | $0 | $0 |
| FRANCIS MUTOLO II | ||||||||
| 1107 ONTARIO ST | UTICA | NY | 13501 | DIRECTOR | 0.25 | $0 | $0 | $0 |
| JOYCE ASTAFAN | ||||||||
| 1435 HERKIMER RD | UTICA | NY | 13502 | ADMINISTRATOR | 1.00 | $0 | $0 | $0 |
| JAMES CESARE MD | ||||||||
| 32 MORGAN LANE | NEW HARTFORD | NY | 13413 | DIRECTOR | 0.25 | $0 | $0 | $0 |
| KENNETH S WILLIAMS | ||||||||
| 10 ABBEY RD | WHITESBORO | NY | 13492 | DIRECTOR | 0.25 | $0 | $0 | $0 |
| JOSEPH A DETRAGLIA ESQ | ||||||||
| 421 BROAD ST SUITE 10 | UTICA | NY | 13501 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Hghst Pd Empl Or NONE | NONE | CompOfHghstPdEmplOrNONETxt |
| Other Employee Paid Over50k | 0 | OtherEmployeePaidOver50kCnt |
| Comp Of Hghst Pd Cntrct Or NONE | NONE | CompOfHghstPdCntrctOrNONETxt |
| Contractor Paid Over50k | 0 | ContractorPaidOver50kCnt |
Sum Of Program Related Invst SumOfProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $1,219,604 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $0 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $1,219,604 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $1,219,604 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $18,294 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $1,201,310 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $60,066 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $60,066 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $1,038 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $1,038 | TotalTaxAmt |
| Distributable Before Adj | $59,028 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $59,028 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $59,028 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $61,451 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $61,451 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $1,038 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $60,413 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $59,028 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $0 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr5 | $2,676 | ExcessDistributionCyovYr5Amt |
| Excess Distribution Cyov Yr4 | $5,998 | ExcessDistributionCyovYr4Amt |
| Excess Distribution Cyov Yr3 | $2,815 | ExcessDistributionCyovYr3Amt |
| Total Excess Distribution Cyov | $11,489 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $61,451 | QualifyingDistributionsAmt |
| Applied To Year1 | $0 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $59,028 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $2,423 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $0 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $0 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $13,912 | TotalCorpusAmt |
| Prior Year Undistributed Incm | $0 | PriorYearUndistributedIncmAmt |
| Prior Year Deficiency Or Tax | $0 | PriorYearDeficiencyOrTaxAmt |
| Taxable1 | $0 | Taxable1Amt |
| Taxable2 | $0 | Taxable2Amt |
| Undistributed Income CY | $0 | UndistributedIncomeCYAmt |
| Corpus Distri170b1 E Or4942g3 | $0 | CorpusDistri170b1EOr4942g3Amt |
| Excess Distri Cyov From Yr5 | $2,676 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $11,236 | ExcessDistriCyovToNextYrAmt |
| Excess From Year4 | $5,998 | ExcessFromYear4Amt |
| Excess From Year3 | $2,815 | ExcessFromYear3Amt |
| Excess From Current Year | $2,423 | ExcessFromCurrentYearAmt |
Supplementary Information SupplementaryInformationGrp
Application Submission Info ApplicationSubmissionInfoGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Person | SLOCUM DICKSON FOUNDATION INC | RecipientPersonNm |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1729 BURRSTONE ROAD | AddressLine1Txt |
| City | NEW HARTFORD | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13413 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Phone | 3157245147 | RecipientPhoneNum |
| Form And Info And Materials | DETAILED LETTER REQUEST WITH SUPPORTING DOCUMENTS | FormAndInfoAndMaterialsTxt |
| Submission Deadlines | MARCH 1 AND SEPTEMBER 1 OF EACH YEAR | SubmissionDeadlinesTxt |
| Restrictions On Awards | CENTRAL NEW YORK, MEDICAL EDUCATION RELATED | RestrictionsOnAwardsTxt |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (13 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| CORNELL COOPERATIVE EXT HERK CTY | |||||||
| 5657 ST RT 5 | HERKIMER | NY | 13350 | NA | 501(C)(3) | GENERAL FUND | $4,500 |
| ELDER LIFE DBA PARKWAY CENTER | |||||||
| 222 MEMORIAL PARKWAY | UTICA | NY | 13501 | NA | 501(C)(3) | GENERAL FUND | $2,000 |
| HERKIMER COUNTY COMM COLL | |||||||
| 100 RESERVOIR ROAD | HERKIMER | NY | 13350 | NA | 501(C)(3) | GENERAL FUND | $2,000 |
| HOSPICE CARE & PALLIATIVE CARE | |||||||
| 4277 MIDDLESETTLEMENT RD | NEW HARTFORD | NY | 13413 | NA | 501(C)(3) | GENERAL FUND | $1,155 |
| MASONIC CARE COMMUNITY | |||||||
| 2150 BLEEKER STREET | UTICA | NY | 13501 | NA | 501(C)(3) | GENERAL FUND | $5,000 |
| MERCY FLIGHT CENTRAL | |||||||
| 2420 BRICKYARD ROAD | CANANDAIGUA | NY | 14424 | NA | 501(C)(3) | GENERAL FUND | $1,500 |
| MOHAWK VALLEY INSTITUTE FOR LEARNING IN | |||||||
| 100 SEYMOUR RD | UTICA | NY | 13502 | NA | 501(C)(3) | GENERAL FUND | $2,500 |
| SLOCUM DICKSON EDUCATIONAL INSTITUTE | |||||||
| 1729 BURRSTONE ROAD | NEW HARTFORD | NY | 13413 | NA | 501(C)(3) | GENERAL FUND | $20,000 |
| TR PROCTOR HIGH SCHOOL | |||||||
| 1203 HILTON AVE | UTICA | NY | 13501 | NA | 501(C)(3) | GENERAL FUND | $1,353 |
| UTICA COLLEGE | |||||||
| BURRSTONE ROAD | UTICA | NY | 13502 | NA | 501(C)(3) | GENERAL FUND | $15,065 |
| VALLEY HEALTH SERVICES INC | |||||||
| 690 W GERMAN STREET | HERKIMER | NY | 13350 | NA | 501(C)(3) | GENERAL FUND | $3,641 |
| LITTLE FALLS HOSPITAL | |||||||
| 140 BURWELL STREET | LITTLE FALLS | NY | 13365 | NA | 501(C)(3) | GENERAL FUND | $737 |
| ONEIDA HERKIMER MADISON BOCES | |||||||
| 4747 MIDDLESETTLEMENT ROAD | NEW HARTFORD | NY | 13413 | NA | 501(C)(3) | GENERAL FUND | $2,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $61,451 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $26,713 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $95,382 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $122,095 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $122,095 | TotalIncomeProducingActyAmt |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | 0 | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | 0 | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | 0 | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | 0 | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | 0 | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | 0 | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | 0 | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | 0 | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | 0 | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | 0 | RelationshipsNonchrtblEOInd |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | ACCOUNTING/LEGAL FEES | CategoryTxt |
| Amt | $3,085 | Amt |
| Net Investment Income | $3,085 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $3,085 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Investments Govt Obligations Sch InvestmentsGovtObligationsSch
| Field | Value | IRS element (for citing) |
|---|---|---|
| US Govt Obligations Book Vl EOY | $77,158 | USGovtObligationsBookVlEOYAmt |
| US Govt Obligations EOYFMV | $91,151 | USGovtObligationsEOYFMVAmt |
| State Local Sec Book Vl EOY | $0 | StateLocalSecBookVlEOYAmt |
| State Local Sec EOYFMV | $0 | StateLocalSecEOYFMVAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (13 entries)
| Category Or ItemCategoryOrItemTxt | Listed At Cost Or FMVListedAtCostOrFMVCd | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| EUROPACIFIC GROWTH FUND CLASS F-1 | AT COST | $104,893 | $106,053 |
| HARBOR CAPITAL APPRECIATION FUND | AT COST | $76,521 | $94,036 |
| METROPOLITAN WEST TOTAL RETURN BOND | AT COST | $143,249 | $144,486 |
| PIMCO TOTAL RETURN FUND INSTITUTIONAL | AT COST | $193,864 | $188,952 |
| T ROWE PRICE SMALL CAP STOCK | AT COST | $55,108 | $64,758 |
| TEMPLETON GLOBAL FUND CLASS A | AT COST | $59,355 | $54,058 |
| VANGUARD INTERMEDIATE TERM | AT COST | $41,897 | $41,371 |
| VANGUARD INFLATION PROTECTED | AT COST | $54,189 | $53,205 |
| VANGUARD 500 INDEX FUND INVESTOR SHARES | AT COST | $105,409 | $209,397 |
| VANGUARD MID-CAP STOCK INDEX FUND | AT COST | $50,646 | $132,504 |
| PIMCO SHORT TERM FUND INSTITUTIONAL | AT COST | $3,771 | $3,706 |
| MFS INTERNATIONAL DIVERSIFICATION FUND CLASS I | AT COST | $92,289 | $93,989 |
| SUNAMERICA MONEY MARKET | AT COST | $15,892 | $15,892 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (3 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|---|
| CONTRACT LABOR | $4,400 | $4,400 | $4,400 | $0 |
| INSURANCE | $1,866 | $1,866 | $1,866 | $0 |
| DOMAIN REGISTRATION | $261 | $261 | $261 | $0 |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | INVESTMENT FEES | CategoryTxt |
| Amt | $8,709 | Amt |
| Net Investment Income | $8,709 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $8,709 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | TAXES | CategoryTxt |
| Amt | $1,574 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
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