COMMUNITY HEALTH FOUNDATION OF WARREN AND HENDERSON COUNTIES: Form 990PF, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTH FOUNDATION OF WARREN AND HENDERSON COUNTIES (EIN 20-8070870)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-05-29
- IRS object ID
- 202001509349100915
- Schema version
- 2019v5.0
- 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
- Other Assets Schedule
- Other Decreases Schedule
- Other Expenses Schedule
- Other Professional Fees Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-05-29T15:38:51-05:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 300031703 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAVANAUGH DAVIES BLACKMAN & CRAMBLET | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1021 N MAIN ST PO BOX 318 | AddressLine1Txt |
| City | MONMOUTH | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 614620318 | 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 | 208070870 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH FOUNDATION OF | BusinessNameLine1Txt |
| Business Name Line2 | WARREN & HENDERSON COUNTIES | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 3097349333 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 EAST BROADWAY | AddressLine1Txt |
| City | MONMOUTH | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61462 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GREG MCCLINTOCK | PersonNm |
| Person Title | DIRECTOR | PersonTitleTxt |
| Phone | 3097345214 | PhoneNum |
| Signature | 2020-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | L COLLEEN CRAMBLET | PreparerPersonNm |
| PTIN | P00057392 | PTIN |
| Phone | 3097342330 | PhoneNum |
| Preparation | 2020-05-29 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 173.233.174.190 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-05-29 | IPDt |
| IP Tm | 15:38:51 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 63A3843AB889A5C01C09698A2ACEFA994B3A9F56 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 61021ABCCC7BB003BC8BE50A590F6ABB704F0EA2 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-04-22 16:20:28Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $15,843,239 | FMVAssetsEOYAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Interest On Sav Rev And Expnss | $1,108 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $1,108 | InterestOnSavNetInvstIncmAmt |
| Dividends Rev And Expnss | $332,449 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $332,449 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $814,912 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $4,811,638 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $814,912 | CapGainNetIncmNetInvstIncmAmt |
| Total Rev And Expnss | $1,148,469 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $1,148,469 | TotalNetInvstIncmAmt |
| Accounting Fees Rev And Expnss | $2,050 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $2,050 | AccountingFeesNetInvstIncmAmt |
| Other Prof Fees Rev And Expnss | $50,000 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $50,000 | OtherProfFeesNetInvstIncmAmt |
| Other Expenses Rev And Expnss | $1,146 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $1,146 | OtherExpensesNetInvstIncmAmt |
| Tot Opr Expenses Rev And Expnss | $53,196 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $53,196 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $0 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $915,128 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $915,128 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $968,324 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $53,196 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $915,128 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $180,145 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $1,095,273 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sav And Temp Cash Invst BOY | $948,526 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $457,627 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $457,627 | SavAndTempCashInvstEOYFMVAmt |
| Other Assets BOY | $13,264,715 | OtherAssetsBOYAmt |
| Other Assets EOY | $13,908,635 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $15,385,612 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $14,213,241 | TotalAssetsBOYAmt |
| Total Assets EOY | $14,366,262 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $15,843,239 | TotalAssetsEOYFMVAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
| No Donor Rstr Net Assests BOY | $14,213,241 | NoDonorRstrNetAssestsBOYAmt |
| No Donor Rstr Net Assests EOY | $14,366,262 | NoDonorRstrNetAssestsEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $14,213,241 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $14,366,262 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $14,213,241 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $14,366,262 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $14,213,241 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $180,145 | ExcessRevenueOverExpensesAmt |
| Subtotal | $14,393,386 | SubtotalAmt |
| Other Decreases | $27,124 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $14,366,262 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (2 entries)
| PropertyPropertyDesc | How AcquiredHowAcquiredCd | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt |
|---|---|---|---|---|---|
| SALE OF INVESTMENTS-ST | P | $2,481,033 | $2,152,148 | $328,885 | $328,885 |
| SALE OF INVESTMENTS-LT | P | $2,179,800 | $1,844,578 | $335,222 | $335,222 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $814,912 | CapitalGainNetIncomeAmt |
| Net Short Term Capital Gain Loss | $328,885 | NetShortTermCapitalGainLossAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | false | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $383,370 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $14,963,177 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.025621 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $869,500 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $15,456,345 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.056255 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $898,899 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $13,884,788 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 0.064740 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $858,630 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $14,996,361 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.057256 | DistributionYr4Rt |
| Adjusted Qlfy Distri Yr5 | $812,892 | AdjustedQlfyDistriYr5Amt |
| Net Vl Noncharitable Assets Yr5 | $15,836,069 | NetVlNoncharitableAssetsYr5Amt |
| Distribution Yr5 | 0.051332 | DistributionYr5Rt |
| Total Distribution | 0.255204 | TotalDistributionRt |
| Average Distribution | 0.051041 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $15,258,692 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $778,819 | AdjNetVlNoncharitableAssetsAmt |
| Net Investment Income Pct | $10,953 | NetInvestmentIncomePctAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $789,772 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $915,128 | 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 | $10,953 | InvestmentIncomeExciseTaxAmt |
| Subtotal | $10,953 | SubtotalAmt |
| Tax Based On Investment Income | $10,953 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $16,000 | EstimatedPlusOvpmtIncmTxAmt |
| Total Payments And Credits | $16,000 | TotalPaymentsAndCreditsAmt |
| Overpayment | $5,047 | OverpaymentAmt |
| Applied To ES Tax | $5,047 | 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 | IL | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (true) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | false | PrivateOperatingFoundationInd |
| New Substantial Contributors | false | NewSubstantialContributorsInd |
| Own Controlled Entity | false | OwnControlledEntityInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (true) | ComplyWithPublicInspRqrInd |
| Website Address | N/A | WebsiteAddressTxt |
Persons With Books Name PersonsWithBooksName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAVANAUGH DAVIES BLACKMAN & CRAMBLE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3097342330 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1021 NORTH MAIN STREET | AddressLine1Txt |
| City | MONMOUTH | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61462 | 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 (11 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 |
|---|---|---|---|---|---|---|---|---|
| GREG MCCLINTOCK | ||||||||
| 707 NORTH 11TH ST | MONMOUTH | IL | 61462 | DIRECTOR | 000.00 | $0 | $0 | $0 |
| GARY HEATON | ||||||||
| 715 NORTH 9TH ST | MONMOUTH | IL | 61462 | SECRETARY | 000.00 | $0 | $0 | $0 |
| DOROTHY RICKETTS | ||||||||
| 202 NORTH G | MONMOUTH | IL | 61462 | CHAIRPERSON | 000.00 | $0 | $0 | $0 |
| DR JAMES BATTENBURG | ||||||||
| 2028 62ND ST | MONMOUTH | IL | 61462 | DIRECTOR | 000.00 | $0 | $0 | $0 |
| DON GLADFELTER | ||||||||
| 861 210TH AVE | MONMOUTH | IL | 61462 | DIRECTOR | 000.00 | $0 | $0 | $0 |
| MIKE CONNELL | ||||||||
| 1150 WARREN SCHOOL RD | MONMOUTH | IL | 61462 | VICE CHAIRPE | 000.00 | $0 | $0 | $0 |
| SPUD RILEY | ||||||||
| 1361 EAST BROADWAY | MONMOUTH | IL | 61462 | DIRECTOR | 000.00 | $0 | $0 | $0 |
| CAROL SHAW | ||||||||
| 1008 HWY 116 | ROSEVILLE | IL | 61473 | DIRECTOR | 000.00 | $0 | $0 | $0 |
| JON FERGUSON | ||||||||
| 17 FAIRWAY DRIVE | MONMOUTH | IL | 61462 | DIRECTOR | 000.00 | $0 | $0 | $0 |
| JACKIE KERNAN | ||||||||
| OSF HOLY FAMILY MD CTR 1000 W HARLE | MONMOUTH | IL | 61462 | EX-OFFICIO | 000.00 | $0 | $0 | $0 |
| LYNNE HAASE | ||||||||
| RR 1 BOX 112 | BIGGSVILLE | IL | 61418 | 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 |
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 | $15,133,825 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $357,233 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $15,491,058 | TotalFMVOfUnusedAssetsAmt |
| Adjusted Total FMV Of Unused Ast | $15,491,058 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $232,366 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $15,258,692 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $762,935 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $762,935 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $10,953 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $10,953 | TotalTaxAmt |
| Distributable Before Adj | $751,982 | DistributableBeforeAdjAmt |
| Distributable Before Ded | $751,982 | DistributableBeforeDedAmt |
| Distributable As Adjusted | $751,982 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $915,128 | ExpensesAndContributionsAmt |
| Qualifying Distributions | $915,128 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $10,953 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $904,175 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $751,982 | DistributableAsAdjustedAmt |
| Excess Distribution Cyov Yr3 | $22,593 | ExcessDistributionCyovYr3Amt |
| Excess Distribution Cyov Yr2 | $151,197 | ExcessDistributionCyovYr2Amt |
| Total Excess Distribution Cyov | $173,790 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $915,128 | QualifyingDistributionsAmt |
| Applied To Current Year | $751,982 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $163,146 | RemainingDistriFromCorpusAmt |
| Total Corpus | $336,936 | TotalCorpusAmt |
| Undistributed Income CY | $0 | UndistributedIncomeCYAmt |
| Excess Distri Cyov To Next Yr | $336,936 | ExcessDistriCyovToNextYrAmt |
| Excess From Year3 | $22,593 | ExcessFromYear3Amt |
| Excess From Year2 | $151,197 | ExcessFromYear2Amt |
| Excess From Current Year | $163,146 | ExcessFromCurrentYearAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Application Submission Info ApplicationSubmissionInfoGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Person | DOROTHY RICKETTS | RecipientPersonNm |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 EAST BROADWAY | AddressLine1Txt |
| City | MONMOUTH | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61462 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Phone | 3097349333 | RecipientPhoneNum |
| Recipient Email Address | NONE | RecipientEmailAddressTxt |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (6 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| OSF HEALTHCARE SYSTEMS FD | |||||||
| 1000 WEST HARLEM AVENUE | MONMOUTH | IL | 61462 | NONE | NOT FOR PROF | GRANT FOR EXPANSION | $600,000 |
| WARREN COUNTY HEALTH DEPT | |||||||
| SOUTH MAIN STREET | MONMOUTH | IL | 61462 | NONE | NOT FOR PROF | EQUIPMENT AND OPERATIONS | $15,000 |
| WARREN COUNTY YMCA | |||||||
| WEST BROADWAY | MONMOUTH | IL | 61462 | NONE | NOT FOR PROF | IMPROVEMENTS/ EQUIPMENT | $50,000 |
| HENDERSON CO RETIREMNT (OAKWOOD) | |||||||
| 604 OAKWOOD DRIVE | STRONGHURST | IL | 61480 | NONE | NOT FOR PROF | IMPROVEMENTS/EQUIPMENT | $200,000 |
| EAGLEVIEW HEALTH SYSTEMS | |||||||
| 1204 HIGHWAY 164 EAST | OQUAWKA | IL | 61469 | NONE | NOT FOR PROF | OPERATIONS | $35,000 |
| OAK LAWN NURSING & REHAB | |||||||
| 604 OAKWOOD DR PO BOX 30 | STRONGHURST | IL | 61480 | NONE | NOT FOR PROF | OPERATIONS | $15,128 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $915,128 | TotalGrantOrContriPdDurYrAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $1,108 | ExclusionAmt |
Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $332,449 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $814,912 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | $1,148,469 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $1,148,469 | TotalIncomeProducingActyAmt |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | false | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | false | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | false | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | false | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | false | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | false | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | false | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | false | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | false | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | false | RelationshipsNonchrtblEOInd |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | PREPARATION OF 990'S | CategoryTxt |
| Amt | $2,050 | Amt |
| Net Investment Income | $2,050 | NetInvestmentIncomeAmt |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp (21 entries)
| DescDesc | BOY Book ValueBOYBookValueAmt | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| LONGLEAF PARTNERS SMALL CAP FD | $492,024 | $581,904 | $518,350 |
| BLACKSTONE ALT MULTI STRAT | $311,358 | $322,471 | $314,381 |
| BOSTON PARTNERS GLOBAL | $381,506 | ||
| BAIRD INTERMEDIATE BONDS | $1,235,168 | $1,814,459 | $1,850,474 |
| DODGE & COX GLOBAL STK FD | $1,052,769 | $1,141,469 | $1,286,269 |
| PRINCIPAL DIVERSIFIED RE FD | $389,422 | $399,328 | $428,902 |
| SANDS CAPITAL GLOBAL STK FD | $953,578 | ||
| VANGUARD 500 INDEX FD | $2,828,778 | $2,590,013 | $3,723,692 |
| VANGUARD DEVELOPED MKTS FD | $1,475,222 | $524,457 | $616,015 |
| VANGUARD INTERMEDIATE GOVT BD FD | $1,285,421 | $1,446,514 | $1,457,826 |
| VANGUARD EMERGING MARKETS | $306,653 | $315,591 | $285,889 |
| WASATCH INTERNATIONAL GROWTH FD | $407,915 | ||
| WILLIAM BLAIR SML MED | $405,646 | $517,533 | $554,605 |
| TEMPLETON GLOBAL BOND FD | $482,595 | $510,965 | $458,104 |
| HARBOR EMERG MKTS | $371,983 | $377,562 | $418,333 |
| PARAMETRIC VOLATILITY | $401,926 | $333,078 | $349,717 |
| VIRTUS SEIX FLOAT RATE | $482,751 | ||
| GQG PARTNERS GLOBAL | $1,273,966 | $1,314,705 | |
| GRANDUER PEAK INTL OPPTY | $395,901 | $437,254 | |
| VNGUARD GLOBAL MINIMUM | $1,009,795 | $1,014,997 | |
| 361 GLBL LONG SHORT | $353,629 | $356,099 |
Other Decreases Schedule OtherDecreasesSchedule
Other Decreases Detail OtherDecreasesDetail (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED TAX PAYMENTS | $16,000 |
| 2018 INCOME TAX PAID | $8,841 |
| ACCRUED INTEREST/MKT ADJUSTMENT | $2,283 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (6 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt |
|---|---|---|
| EXPENSES | ||
| INSURANCE | $1,052 | $1,052 |
| FEES AND BANK CHARGES | $2 | $2 |
| ILLINOIS SEC OF STATE FILING | $10 | $10 |
| MISC SUPPLIES | $67 | $67 |
| IL ATTORNEY GENERAL FEE | $15 | $15 |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | INVESTMENT ADVISORY AND FILING | CategoryTxt |
| Amt | $50,000 | Amt |
| Net Investment Income | $50,000 | NetInvestmentIncomeAmt |
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