CITY CLUB FOUNDATION: Form 990PF, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- CITY CLUB FOUNDATION (EIN 57-1190979)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-08-27
- IRS object ID
- 202012409349100321
- 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 Other Schedule2
- Other Decreases Schedule
- Other Expenses Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-08-27T16:33:37-05:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 420714325 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RSM US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 SOUTH PHILLIPS AVE STE 300 | AddressLine1Txt |
| City | SIOUX FALLS | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 571046721 | 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 | 571190979 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY CLUB FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CITY | BusinessNameControlTxt |
| Phone | 6128042923 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 671 BLACK BULL TRAIL | AddressLine1Txt |
| City | BOZEMAN | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59718 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SUSAN N INGEMAN | PersonNm |
| Person Title | TRUSTEE | PersonTitleTxt |
| Phone | 6128042923 | PhoneNum |
| Signature | 2020-08-18 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID HAAN | PreparerPersonNm |
| PTIN | P01623183 | PTIN |
| Phone | 6053369955 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 208.107.235.243 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-08-18 | IPDt |
| IP Tm | 09:01:02 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | FC3D497CFA5B94C1D9FEDF20DA6C30930BD0F692 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2020-11-19 02:30:22Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $1,269,652 | FMVAssetsEOYAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rcvd Rev And Expnss | $0 | ContriRcvdRevAndExpnssAmt |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Dividends Rev And Expnss | $38,512 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $38,512 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $14,449 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $93,969 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $14,449 | CapGainNetIncmNetInvstIncmAmt |
| Total Rev And Expnss | $52,961 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $52,961 | TotalNetInvstIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $0 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $0 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $0 | CompOfcrDirTrstDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $1,197 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $599 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Chrtbl Prps | $598 | AccountingFeesChrtblPrpsAmt |
| Other Expenses Rev And Expnss | $4,648 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $4,633 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Dsbrs Chrtbl | $15 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $5,845 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $5,232 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $613 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $66,000 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $66,000 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $71,845 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $5,232 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $66,613 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$18,884 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $47,729 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $94,717 | CashBOYAmt |
| Cash EOY | $47,090 | CashEOYAmt |
| Cash EOYFMV | $47,090 | CashEOYFMVAmt |
| Other Investments BOY | $990,449 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $1,018,017 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $1,222,562 | OtherInvestmentsEOYFMVAmt |
| Total Assets BOY | $1,085,166 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,065,107 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $1,269,652 | TotalAssetsEOYFMVAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
| No Donor Rstr Net Assests BOY | $1,085,166 | NoDonorRstrNetAssestsBOYAmt |
| No Donor Rstr Net Assests EOY | $1,065,107 | NoDonorRstrNetAssestsEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $1,085,166 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $1,065,107 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $1,085,166 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $1,065,107 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $1,085,166 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$18,884 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $1,066,282 | SubtotalAmt |
| Other Decreases | $1,175 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $1,065,107 | 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 |
|---|---|---|---|---|---|
| PUBLICLY TRADED SECURITIES | P | $93,448 | $79,520 | $13,928 | $13,928 |
| CAPITAL GAINS DIVIDENDS | P | $521 | $521 | $521 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $14,449 | CapitalGainNetIncomeAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | 0 | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $59,145 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $1,160,014 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.050986 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $68,653 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $1,194,284 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.057485 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $65,135 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $868,309 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 0.075014 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $61,340 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $1,057,995 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.057978 | DistributionYr4Rt |
| Adjusted Qlfy Distri Yr5 | $63,192 | AdjustedQlfyDistriYr5Amt |
| Net Vl Noncharitable Assets Yr5 | $1,065,077 | NetVlNoncharitableAssetsYr5Amt |
| Distribution Yr5 | 0.059331 | DistributionYr5Rt |
| Total Distribution | 0.300794 | TotalDistributionRt |
| Average Distribution | 0.060159 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $1,173,294 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $70,584 | AdjNetVlNoncharitableAssetsAmt |
| Net Investment Income Pct | $477 | NetInvestmentIncomePctAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $71,061 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $66,613 | QualifyingDistributionsAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $955 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $955 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $955 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $1,614 | EstimatedPlusOvpmtIncmTxAmt |
| Extsn Request Income Tax Paid | $0 | ExtsnRequestIncomeTaxPaidAmt |
| Backup Withholding Withheld | $0 | BackupWithholdingWithheldAmt |
| Total Payments And Credits | $1,614 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Overpayment | $659 | OverpaymentAmt |
| Applied To ES Tax | $659 | AppliedToESTaxAmt |
| Refund | $0 | RefundAmt |
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 | IL | 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 | N/A | WebsiteAddressTxt |
| Individual With Books | THOMAS W INGEMAN | IndividualWithBooksNm |
| Phone | 6128042923 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 671 BLACK BULL TRAIL | AddressLine1Txt |
| City | BOZEMAN | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59718 | 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 |
| 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 (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|---|---|---|---|
| SUSAN N INGEMAN | ||||||||
| 671 BLACK BULL TRAIL | BOZEMAN | MT | 59718 | TRUSTEE | 0.20 | $0 | $0 | $0 |
| MELISSA N BLANK | ||||||||
| 3577 DORSHIRE LANE | TIMNATH | CO | 80547 | TRUSTEE | 0.20 | $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 | $1,135,312 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $55,849 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $1,191,161 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $1,191,161 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $17,867 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $1,173,294 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $58,665 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $58,665 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $955 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $955 | TotalTaxAmt |
| Distributable Before Adj | $57,710 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $57,710 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $57,710 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $66,613 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $66,613 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $0 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $66,613 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $57,710 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $0 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr5 | $11,271 | ExcessDistributionCyovYr5Amt |
| Excess Distribution Cyov Yr4 | $8,911 | ExcessDistributionCyovYr4Amt |
| Excess Distribution Cyov Yr3 | $25,180 | ExcessDistributionCyovYr3Amt |
| Excess Distribution Cyov Yr2 | $22,033 | ExcessDistributionCyovYr2Amt |
| Excess Distribution Cyov Yr1 | $6,090 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $73,485 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $66,613 | QualifyingDistributionsAmt |
| Applied To Year1 | $0 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $57,710 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $8,903 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $0 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $0 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $82,388 | 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 | $11,271 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $71,117 | ExcessDistriCyovToNextYrAmt |
| Excess From Year4 | $8,911 | ExcessFromYear4Amt |
| Excess From Year3 | $25,180 | ExcessFromYear3Amt |
| Excess From Year2 | $22,033 | ExcessFromYear2Amt |
| Excess From Year1 | $6,090 | ExcessFromYear1Amt |
| Excess From Current Year | $8,903 | ExcessFromCurrentYearAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (17 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| ALPINE AUTISM | |||||||
| 2760 FIELDSTONE RD | COLORADO SPRINGS | CO | 80919 | NONE | 501(C)(3) | ALPINE AUTISM PROVIDES ACCESS TO EFFECTIVE TREATMENT FOR INDIVIDUALS AND FAMILIES AFFECTED BY AUTISM IN THE PIKES PEAK REGION, ENABLING THOSE AFFECTED BY AUTISM TO REACH THEIR FULL POTENTIAL. | $3,000 |
| COLORADO YOUTH OUTDOORS | |||||||
| 4927 E COUNTY RD 36 | FORT COLLINS | CO | 80528 | NONE | 501(C)(3) | DEDICATED TO BUILDING HEALTHY RELATIONSHIPS BETWEEN KIDS AND THEIR PARENTS THROUGH TRADITIONAL OUTDO | $1,000 |
| COMO PARK ZOO & CONSERVATORY | |||||||
| 1225 ESTABROOK DRIVE | ST PAUL | MN | 55103 | NONE | 501(C)(3) | SUPPORTS, PRESERVES, AND ENHANCES THE ZOO AND CONSERVATORY FOR RESIDENTS OF ST PAUL, MN AND SURROUNDING AREA. | $3,000 |
| EAGLE MOUNT BOZEMAN | |||||||
| 6901 GOLDENSTEIN LANE | BOZEMAN | MT | 59715 | NONE | 501(C)(3) | PROVIDES QUALITY THERAPEUTIC RECREATIONAL OPPORTUNITIES FOR PEOPLE WITH DISABILITIES AND YOUNG PEOPLE WITH CANCER WHILE ALSO PROVIDING SUPPORT FOR FAMILIES OF PARTICIPANTS. EAGLE MOUNT'S ACTIVITIES FOSTER FREEDOM, JOY, STRENGTH, FOCUS AND CONFIDENCE AND FOCUS ON PEOPLE'S ABILITIES WHILE GENTLY SUPPORTING THEIR DISABILITIES. | $4,000 |
| FOOD BANK FOR LARIMER COUNTY | |||||||
| 5706 WRIGHT DRIVE | LOVELAND | CO | 80538 | NONE | 501(C)(3) | FOOD BANK FOR LARIMER COUNTY IS COMMITTED TO PROVIDING THE DAY-TO-DAY NUTRITIONAL ASSISTANCE TO OUR NEIGHBORS IN NEED AND ALSO TO HELP STABILIZE THEIR LIVES BY PROVIDING HEALTH AND HOPE, AND PUTTING THEM ON A PATH TO SELF-SUFFICIENCY. | $2,000 |
| HAVEN | |||||||
| PO BOX 752 | BOZEMAN | MT | 59771 | NONE | 501(C)(3) | PROVIDES SAFE INTERVENTION FOR SURVIVORS OF DOMESTIC VIOLENCE, STALKING AND SEXUAL ASSAULT AND ALSO WORKS TO PREVENT FUTURE VIOLENCE FROM OCCURRING. HAVEN IS COMMITTED TO REDUCING THE INCIDENCE AND MINIMIZING THE IMPACT OF DOMESTIC ABUSE ON FAMILIES AND COMMUNITIES BY PROVIDING EMERGENCY SHELTER, CRISIS INTERVENTION, 24-HOUR SUPPORT LINE, LEGAL ADVOCACY, ON-GOING SUPPORT AND COUNSELING FOR ADULTS AND CHILDREN, REFERRALS AND EDUCATION. | $3,000 |
| HAZELDEN BETTY FORD FOUNDATION | |||||||
| PO BOX 11 | CENTER CITY | MN | 55012 | NONE | 501(C)(3) | THE HAZELDEN BETTY FORD FOUNDATION IS A FORCE OF HEALING AND HOPE FOR INDIVIDUALS, FAMILIES, AND COMMUNITIES AFFECTED BY ADDICTION TO ALCOHOL AND DRUGS. THE FOUNDATION IS A LEADING NONPROFIT PROVIDER OF COMPREHENSIVE INPATIENT AND OUTPATIENT TREATMENT FOR ADULTS AND YOUTH AT LOCATIONS NATIONWIDE. THE FOUNDATION ALSO ENCOMPASSES A GRADUATE SCHOOL OF ADDICTION STUDIES, AN ADDICTION RESEARCH CENTER, RECOVERY ADVOCACY, PROFESSIONAL AND MEDICAL PROGRAMS, SCHOOL-BASED PREVENTION RESOURCES AND A SPECIALIZED PROGRAM FOR CHILDREN WHO GROW UP IN FAMILIES WITH ADDICTION. | $5,000 |
| KITTSON COUNTY HOSPICE | |||||||
| BOX 581 | HALLOCK | MN | 56728 | NONE | 501(C)(3) | SPECIALIZED HOSPICE CARE OF INDIVIDUALS IN THE LATER STAGES OF LIFE. | $3,000 |
| MUSEUM OF THE ROCKIES | |||||||
| 600 WEST KAGY BLVD | BOZEMAN | MT | 59717 | NONE | 501(C)(3) | RECOGNIZED AS ONE OF THE WORLD'S FINEST RESEARCH AND HISTORY MUSEUMS AND IS RENOWNED FOR DISPLAYING AN EXTENSIVE COLLECTION OF DINOSAUR FOSSILS. THE MUSEUM HAS CHANGING EXHIBITS FROM AROUND THE WORLD, PERMANENT INDOOR AND OUTDOOR REGIONAL HISTORY EXHIBITS, PLANETARIUM SHOWS, EDUCATIONAL PROGRAMS, LECTURES, BENEFIT EVENTS AND A MUSEUM STORE. | $10,000 |
| PATHWAYS HOSPICE | |||||||
| 305 CARPENTER ROAD | FORT COLLINS | CO | 80525 | NONE | 501(C)(3) | PROVIDES HOSPICE CARE FOR DYING PERSONS AND THEIR FAMILIES THROUGHOUT THE LARIMER AND WELD COUNTY REGION AND MAKES GRIEF SUPPORT POSSIBLE TO FAMILY MEMBERS AND FRIENDS. | $1,000 |
| PROJECT SELF-SUFFICIENCY | |||||||
| 375 WEST 37TH STREET 200 | LOVELAND | CO | 80538 | NONE | 501(C)(3) | SINGLE PARENT CAREER COUNSELING, JOB SEARCH, EMERGENCY FUNDS, AND EDUCATIONAL SCHOLARSHIPS IN COLORADO. | $10,000 |
| REDEEMER LUTHERAN CHURCH | |||||||
| 7755 GREENSTONE TRAIL | FORT COLLINS | CO | 80525 | NONE | 501(C)(3) | PROVIDES FUNDS TO A YOUTH SCHOLARSHIP PROGRAM TO ASSIST YOUTH NEEDING FINANCIAL ASSISTANCE TO ATTEND CHURCH RETREATS, MISSION TRIPS, AND OTHER YOUTH MINISTRY ACTIVITIES. | $5,000 |
| ROUTT COUNTY UNITED WAY | |||||||
| 443 OAK STREET | STEAMBOAT SPRINGS | CO | 80477 | NONE | 501(C)(3) | ROUTT COUNTY UNITED WAY (COLORADO) INSPIRES, LEADS, AND UNITES PEOPLE, IDEAS, AND RESOURCES TO ADVANCE COMMUNITY IMPACT ON HEALTH, EDUCATION AND INCOME STABILITY. | $3,000 |
| THE NAPPIE PROJECT | |||||||
| PO BOX 1423 | LOVELAND | CO | 80539 | NONE | 501(C)(3) | THE NAPPIE PROJECT IS DEDICATED TO ENSURING THAT CHILDREN IN LOVELAND, FORT COLLINS AND SURROUNDING COMMUNITIES OF COLORADO HAVE AN ADEQUATE SUPPLY OF DIAPERS TO REMAIN CLEAN, DRY AND HEALTHY AND IS COMMITTED TO RAISING THE AWARENESS OF DIAPER NEED AND ITS IMPACT ON FAMILIES. | $2,000 |
| UNITED WAY OF LARIMER COUNTY | |||||||
| 525 WEST OAK STREET-SUITE 101 | FORT COLLINS | CO | 80521 | NONE | 501(C)(3) | UNITED WAY OF LARIMER COUNTY HELPS LOCAL CHILDREN AND FAMILIES SUCCEED IN SCHOOL, WORK AND LIFE BY TACKLING THE SOURCE OF COMMUNITY CHALLENGES AND DRIVING CHANGES TO LIVES AND COMMUNITY STRENGTHS IN THREE KEY WAYS: UNITING, HELPING AND EMPOWERING. | $3,000 |
| URBAN BOAT BUILDERS | |||||||
| 2288 UNIVERSITY AVENUE WEST | ST PAUL | MN | 55114 | NONE | 501(C)(3) | URBAN BOATBUILDERS PARTNERS WITH LOCAL MIDDLE SCHOOLS, HIGH SCHOOLS AND YOUTH-SERVING AGENCIES TO DELIVER ACADEMICALLY ENHANCED BOATBUILDING INSTRUCTION UTILIZING A STRATEGY FOR YOUTH TO LEARN, PRACTICE AND APPLY ACADEMIC CONCEPTS IN A CHALLENGING AND INNOVATIVE HANDS-ON ENVIRONMENT THAT COMPLEMENTS CLASSROOM LEARNING AND HELPS YOUTH DEVELOP SOCIAL AND LEADERSHIP SKILLS THAT LEAD TO A FINISHED PRODUCT. | $5,000 |
| VOICES CARRY - CHILD ADVOCACY CENTER | |||||||
| 5529 S TIMBERLINE ROAD | FORT COLLINS | CO | 80528 | NONE | 501(C)(3) | VOICES CARRY - CHILD ADVOCACY CENTER SEEKS TO REDUCE THE TRAUMA TO VICTIMS OF CHILD ABUSE AND THEIR FAMILIES THROUGH A COMPREHENSIVE RESPONSE TO CHILD ABUSE BY PROVIDING SUPPORT SERVICES IN A SAFE AND COMPASSIONATE ENVIRONMENT. | $3,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $66,000 | 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 | $38,512 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $14,449 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $52,961 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $52,961 | 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 | TAX ACCOUNTING FEES | CategoryTxt |
| Amt | $1,197 | Amt |
| Net Investment Income | $599 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $598 | DisbursementsCharitablePrpsAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (25 entries)
| Category Or ItemCategoryOrItemTxt | Listed At Cost Or FMVListedAtCostOrFMVCd | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| GENERAL ELECTRIC CO | AT COST | $65,664 | $24,106 |
| HONEYWELL INTERNATIONAL, INC. | AT COST | $7,367 | $44,250 |
| US BANCORP | AT COST | $43,791 | $77,077 |
| EMERSON ELECTRIC CO | AT COST | $30,325 | $42,706 |
| PROCTOR & GAMBLE CO | AT COST | $39,955 | $57,454 |
| CAPITAL ONE FINANCIAL CORP | AT COST | $29,483 | $45,280 |
| UNITED TECHNOLOGIES CORP | AT COST | $30,212 | $41,933 |
| GILEAD SCIENCES INC | AT COST | $39,353 | $32,490 |
| PFIZER, INC | AT COST | $32,102 | $39,180 |
| VERIZON COMMUNICATIONS | AT COST | $50,636 | $61,400 |
| LAMAR ADVERTISING | AT COST | $39,875 | $46,862 |
| NORTHWESTERN CORP | AT COST | $29,791 | $37,627 |
| MERCK & CO. | AT COST | $45,040 | $66,848 |
| WALMART STORES, INC. | AT COST | $21,058 | $35,652 |
| WALT DISNEY CO. | AT COST | $39,963 | $52,067 |
| COCO COLA CO | AT COST | $39,719 | $50,368 |
| JP MORGAN INC BUILDER SELECT | AT COST | $155,941 | $159,776 |
| ABBVIE INC. | AT COST | $24,825 | $33,645 |
| CVS/CAREMARK CORP. | AT COST | $55,031 | $56,089 |
| PUBLIC STORAGE 5.15% PREFERRED | AT COST | $12,500 | $13,010 |
| GUGGENHEIM TOTAL RET. BOND | AT COST | $20,000 | $20,081 |
| CARDINAL HEALTH INC. | AT COST | $55,064 | $44,763 |
| MICROSOFT CORP | AT COST | $35,616 | $63,080 |
| FIDELITY STRATEGIC INCOME FUND | AT COST | $50,000 | $50,774 |
| SPDR PORTFOLIO S&P 500 HIGH DIV | AT COST | $24,706 | $26,044 |
Other Decreases Schedule OtherDecreasesSchedule
Other Decreases Detail OtherDecreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BOOK/TAX DIFFERENCE IN BASIS OF CONTRIBUTED STOCK | Desc |
| Amt | $1,175 | Amt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (2 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| ILLINOIS FOUNDATION FILING FEES | $15 | $0 | $15 |
| BANK FEES | $4,633 | $4,633 | $0 |
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