LUTSEY FAMILY FOUNDATION INC: Form 990PF, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- LUTSEY FAMILY FOUNDATION INC (EIN 39-1657029)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-13
- IRS object ID
- 202043189349103699
- 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 Corp Bonds Schedule
- Investments Corp Stock Schedule
- Investments Govt Obligations Sch
- Investments Other Schedule2
- Other Expenses Schedule
- Other Professional Fees Schedule
- Substantial Contributors Sch
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-11-13T16:38:13-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 23819 | AddressLine1Txt |
| City | GREEN BAY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54305 | 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 | 391657029 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LUTSEY FAMILY FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LUTS | BusinessNameControlTxt |
| Phone | 9203399823 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 22074 | AddressLine1Txt |
| City | GREEN BAY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54305 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | THOMAS LUTSEY | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 9203399823 | PhoneNum |
| Signature | 2020-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHELLE MULLOY | PreparerPersonNm |
| PTIN | P01241748 | PTIN |
| Phone | 9204367800 | PhoneNum |
| Preparation | 2020-11-11 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-11-11 | IPDt |
| IP Tm | 12:10:54 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 7ACAF8CAEC680ED7509A9050F8CA0914B2800DE7 | 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 | $5,996,142 | 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 | $160,540 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $160,540 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $222,122 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $2,524,063 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $222,122 | CapGainNetIncmNetInvstIncmAmt |
| Total Rev And Expnss | $382,662 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $382,662 | 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 | $3,346 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $1,673 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Chrtbl Prps | $1,673 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Rev And Expnss | $600 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $300 | OtherProfFeesNetInvstIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $300 | OtherProfFeesDsbrsChrtblAmt |
| Taxes Rev And Expnss | $15,706 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $5,145 | TaxesNetInvstIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $73,941 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $39,468 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Dsbrs Chrtbl | $11,780 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $93,593 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $46,586 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $13,753 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $250,004 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $250,004 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $343,597 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $46,586 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $263,757 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $39,065 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $336,076 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $1 | CashBOYAmt |
| Sav And Temp Cash Invst BOY | $392,583 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $183,506 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $183,506 | SavAndTempCashInvstEOYFMVAmt |
| US Government Obligations BOY | $75,472 | USGovernmentObligationsBOYAmt |
| US Government Obligations EOY | $72,988 | USGovernmentObligationsEOYAmt |
| US Govt Obligations EOYFMV | $76,350 | USGovtObligationsEOYFMVAmt |
| Corporate Stock BOY | $4,599,972 | CorporateStockBOYAmt |
| Corporate Stock EOY | $4,941,400 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $5,314,897 | CorporateStockEOYFMVAmt |
| Corporate Bonds BOY | $39,562 | CorporateBondsBOYAmt |
| Corporate Bonds EOY | $39,402 | CorporateBondsEOYAmt |
| Corporate Bonds EOYFMV | $42,054 | CorporateBondsEOYFMVAmt |
| Other Investments BOY | $325,645 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $235,004 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $379,335 | OtherInvestmentsEOYFMVAmt |
| Total Assets BOY | $5,433,235 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,472,300 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $5,996,142 | TotalAssetsEOYFMVAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
| No Donor Rstr Net Assests BOY | $5,433,235 | NoDonorRstrNetAssestsBOYAmt |
| No Donor Rstr Net Assests EOY | $5,472,300 | NoDonorRstrNetAssestsEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $5,433,235 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $5,472,300 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $5,433,235 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $5,472,300 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $5,433,235 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $39,065 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $5,472,300 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $5,472,300 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (4 entries)
| PropertyPropertyDesc | How AcquiredHowAcquiredCd | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt |
|---|---|---|---|---|---|
| PUBLICLY TRADED SECURITIES | P | $2,508,700 | $2,301,941 | $206,759 | $206,759 |
| INVESTMENT K1S | P | $12,242 | $12,242 | $12,242 | |
| PTP'S K1S | P | $358 | $358 | $358 | |
| CAPITAL GAINS DIVIDENDS | P | $2,763 | $2,763 | $2,763 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $222,122 | CapitalGainNetIncomeAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | 0 | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $218,790 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $5,396,859 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.040540 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $234,984 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $4,960,013 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.047376 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $246,531 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $4,620,015 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 0.053362 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $253,937 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $5,005,859 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.050728 | DistributionYr4Rt |
| Adjusted Qlfy Distri Yr5 | $250,097 | AdjustedQlfyDistriYr5Amt |
| Net Vl Noncharitable Assets Yr5 | $5,204,170 | NetVlNoncharitableAssetsYr5Amt |
| Distribution Yr5 | 0.048057 | DistributionYr5Rt |
| Total Distribution | 0.240063 | TotalDistributionRt |
| Average Distribution | 0.048013 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $5,647,412 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $271,149 | AdjNetVlNoncharitableAssetsAmt |
| Net Investment Income Pct | $3,361 | NetInvestmentIncomePctAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $274,510 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $263,757 | QualifyingDistributionsAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $6,722 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $6,722 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $6,722 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $7,480 | EstimatedPlusOvpmtIncmTxAmt |
| Extsn Request Income Tax Paid | $8,200 | ExtsnRequestIncomeTaxPaidAmt |
| Backup Withholding Withheld | $0 | BackupWithholdingWithheldAmt |
| Total Payments And Credits | $15,680 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $25 | EsPenaltyAmt |
| Overpayment | $8,933 | OverpaymentAmt |
| Applied To ES Tax | $8,933 | 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 | WI | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (1) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | 0 | PrivateOperatingFoundationInd |
| New Substantial Contributors | Yes (1) | 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 LUTSEY | IndividualWithBooksNm |
| Phone | 9203399823 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 22074 | AddressLine1Txt |
| City | GREEN BAY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 543052074 | 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 | Yes (1) | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | 0 | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | 0 | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | 0 | PaymentToGovernmentOfficialInd |
| Acts Fail To Qlfy As Exceptions | 0 | ActsFailToQlfyAsExceptionsInd |
| 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 (6 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 |
|---|---|---|---|---|---|---|---|---|
| THOMAS J LUTSEY | ||||||||
| PO BOX 22074 | GREEN BAY | WI | 54305 | PRESIDENT | 1.00 | $0 | $0 | $0 |
| SHARON L LUTSEY | ||||||||
| PO BOX 22074 | GREEN BAY | WI | 54305 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| MATTHEW T LUTSEY | ||||||||
| PO BOX 22074 | GREEN BAY | WI | 54305 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| JEFFREY K LUTSEY | ||||||||
| PO BOX 22074 | GREEN BAY | WI | 54305 | DIRECTOR | 0.00 | $0 | $0 | $0 |
| NICHOLAS P LUTSEY | ||||||||
| PO BOX 22074 | GREEN BAY | WI | 54305 | DIRECTOR | 0.00 | $0 | $0 | $0 |
| ANDREW J LUTSEY | ||||||||
| PO BOX 22074 | GREEN BAY | WI | 54305 | DIRECTOR | 0.00 | $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 | $5,253,306 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $480,107 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $5,733,413 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $5,733,413 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $86,001 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $5,647,412 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $282,371 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $282,371 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $6,722 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $6,722 | TotalTaxAmt |
| Distributable Before Adj | $275,649 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $275,649 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $275,649 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $263,757 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $263,757 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $0 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $263,757 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $275,649 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $245,025 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Total Excess Distribution Cyov | $0 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $263,757 | QualifyingDistributionsAmt |
| Applied To Year1 | $245,025 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $18,732 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $0 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $0 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $0 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $0 | TotalCorpusAmt |
| Prior Year Undistributed Incm | $0 | PriorYearUndistributedIncmAmt |
| Prior Year Deficiency Or Tax | $0 | PriorYearDeficiencyOrTaxAmt |
| Taxable1 | $0 | Taxable1Amt |
| Taxable2 | $0 | Taxable2Amt |
| Undistributed Income CY | $256,917 | UndistributedIncomeCYAmt |
| Corpus Distri170b1 E Or4942g3 | $0 | CorpusDistri170b1EOr4942g3Amt |
| Excess Distri Cyov From Yr5 | $0 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $0 | ExcessDistriCyovToNextYrAmt |
Supplementary Information SupplementaryInformationGrp
Application Submission Info ApplicationSubmissionInfoGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Person | LUTSEY ENTERPRISES LLP ATTN MATT LU | RecipientPersonNm |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 22074 | AddressLine1Txt |
| City | GREEN BAY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54305 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Phone | 9203399823 | RecipientPhoneNum |
| Form And Info And Materials | NO STANDARD FORM OR APPLICATION PROCESS IS REQUIRED BY THE FOUNDATION. | FormAndInfoAndMaterialsTxt |
| Submission Deadlines | NONE | SubmissionDeadlinesTxt |
| Restrictions On Awards | NONE | RestrictionsOnAwardsTxt |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (36 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| BAILEYS HARBOR COMMUNITY ASSOCIATION | |||||||
| PO BOX 31 | BAILEYS HARBOR | WI | 54202 | NONE | PUBLIC CHARITY | 4TH OF JULY CELEBRATION | $50 |
| BOYS AND GIRLS CLUB OF DOOR COUNTY | |||||||
| 55 S 3RD AVE | STURGEON BAY | WI | 54235 | NONE | PUBLIC CHARITY | 2019 CELEBRITY GOLF OUTING | $5,000 |
| BOYS AND GIRLS CLUB OF DOOR COUNTY | |||||||
| 55 S 3RD AVE | STURGEON BAY | WI | 54235 | NONE | PUBLIC CHARITY | GENERAL OPERATIONS | $766 |
| BOYS AND GIRLS CLUB OF DOOR COUNTY | |||||||
| 55 S 3RD AVE | STURGEON BAY | WI | 54235 | NONE | PUBLIC CHARITY | GENERAL SUPPORT FOR ANNUAL OPERATIONS | $2,000 |
| BOYS AND GIRLS CLUB OF GREEN BAY | |||||||
| 311 S ONEIDA | GREEN BAY | WI | 54301 | NONE | PUBLIC CHARITY | GENERAL OPERATIONS | $3,400 |
| CASA OF BROWN COUNTY | |||||||
| 414 E WALNUT STREET SUITE 170 | GREEN BAY | WI | 54301 | NONE | PUBLIC CHARITY | CHAMPIONS FOR CHILDREN | $5,230 |
| DOOR CANCER | |||||||
| PO BOX 423 | STURGEON BAY | WI | 54235 | NONE | PUBLIC CHARITY | PROVIDE FINANCIAL ASSISTANCE TO PEOPLE LIVING WITH CANCER. | $647 |
| DOOR COUNTY FFA | |||||||
| 7842 WI 42 | EGG HARBOR | WI | 54209 | NONE | PUBLIC CHARITY | SPONSOR AGRICULTURAL EDUCATION | $2,385 |
| EMERALD CITY THEATRE | |||||||
| 2936 N SOUTHPORT AVE | CHICAGO | IL | 60657 | NONE | PUBLIC CHARITY | GENERAL SPONSORSHIP FOR THE EMERALD FUND | $50 |
| FAMILY FARMED | |||||||
| 7115 W NORTH AVE 504 | OAK PARK | IL | 60302 | NONE | PUBLIC CHARITY | GENERAL SUPPORT FOR ANNUAL OPERATIONS | $10,200 |
| FRIENDS OF AUDUBON | |||||||
| 3500 N HOYNE | CHICAGO | IL | 60618 | NONE | PUBLIC CHARITY | FUNDING FOR EDUCATIONAL NEEDS | $650 |
| GOLDEN HOUSE | |||||||
| PO BOX 727 | GREEN BAY | WI | 54305 | NONE | PUBLIC CHARITY | GOLD RIBBON BBQ | $1,000 |
| GREATER GREEN BAY COMMUNITY FOUNDATION | |||||||
| 320 N BROADWAY STREET SUITE 260 | GREEN BAY | WI | 54303 | NONE | PUBLIC CHARITY | SCHOLARSHIPS | $66,550 |
| HEART OF GOLD CHARITY | |||||||
| PO BOX 116 | TWIN LAKES | WI | 53181 | NONE | PUBLIC CHARITY | PROVIDE AID TO FAMILIES DEALING WITH A HEART DEFECT SITUATION AT CHILDREN'S HOSPITAL OF WISCONSIN. | $5,000 |
| HOUSE OF HOPE GREEN BAY | |||||||
| 1660 CHRISTIANA ST | GREEN BAY | WI | 54303 | NONE | PUBLIC CHARITY | KEY TO HOPE PLEDGE | $80,000 |
| JACKIE NITSCHKE CENTER INC | |||||||
| 630 CHERRY STREET | GREEN BAY | WI | 54301 | NONE | PUBLIC CHARITY | H.A.L.O. CAMPAIGN | $10,000 |
| JACKSONPORT ADVANCEMENT CORP | |||||||
| 6832 COUNTY T | EGG HARBOR | WI | 54209 | NONE | PUBLIC CHARITY | GENERAL CHARITABLE CAUSE TO ENRICH JACKSONPORT, WI | $500 |
| MAKE A WISH FOUNDATION | |||||||
| 200 N DURKEE STREET SUITE 60 | APPLETON | WI | 54911 | NONE | PUBLIC CHARITY | GENERAL OPERATIONS | $500 |
| NEW COMMUNITY SHELTER | |||||||
| 301 MATHER ST | GREEN BAY | WI | 54303 | NONE | PUBLIC CHARITY | SPONSORSHIP - GOLF EVENT | $5,000 |
| NEW COMMUNITY SHELTER | |||||||
| 301 MATHER ST | GREEN BAY | WI | 54303 | NONE | PUBLIC CHARITY | WINTER COAT CAMPAIGN AND GENERAL OPERATIONS | $5,500 |
| NOTRE DAME ACADEMY | |||||||
| 610 MARYHILL DRIVE | GREEN BAY | WI | 54303 | NONE | PUBLIC CHARITY | STUDENT SUPPORT FOR EDUCATION | $1,920 |
| NU FOUNDATION | |||||||
| 2285 S 67TH ST 200 | OMAHA | NE | 68106 | NONE | PUBLIC CHARITY | LYMPHOMA CLASSIFICATION STUDY | $25,000 |
| RIDGES SANCTUARY | |||||||
| 8270 WISCONSIN 57 | BAILEYS HARBOR | WI | 54202 | NONE | PUBLIC CHARITY | FESTIVAL OF NATURE SPONSORSHIP | $2,500 |
| ST PAUL'S UNITED METHODIST | |||||||
| 341 WILSON AVE | GREEN BAY | WI | 54303 | NONE | PUBLIC CHARITY | PASTY OPERATION | $500 |
| THE WOMEN'S FUND - DOOR COUNTY | |||||||
| PO BOX 802 | STURGEON BAY | WI | 54235 | NONE | PUBLIC CHARITY | ANNUAL LUNCHEON PARTNERSHIP | $1,000 |
| UNIVERSITY OF WISCONSIN FOUNDATION | |||||||
| 1848 UNIVERSITY AVE | MADISON | WI | 53726 | NONE | PUBLIC CHARITY | SUPPORT FOR THE CENTER FOR INTEGRATED AGRICULTURAL SYSTEMS | $10,000 |
| WRITE ON DOOR COUNTY | |||||||
| PO BOX 457 | FISH CREEK | WI | 54212 | NONE | PUBLIC CHARITY | DOOR COUNTY TREASURE HUNT | $944 |
| OPEN DOOR BIRD SANCTUARY | |||||||
| 4114 COUNTY ROAD I | JACKSONPORT | WI | 54235 | NONE | PUBLIC CHARITY | SUPPORT OPERATIONS THAT PROVIDE WILDLIFE AND ENVIRONMENTAL EDUCATION | $450 |
| SHIELDED HEARTS - NORTHEAST WI | |||||||
| 1228 BONNIE VIEW DRIVE | STURGEON BAY | WI | 54235 | NONE | PUBLIC CHARITY | PROVIDE FUNDS FOR PROMOTION OF PEER SUPPORT FOR MEMBERS | $741 |
| DAVID PHINNEY FOUNDATION | |||||||
| 357 S MCCASLIN BLVD STE 105 | LOUISVILLE | CO | 80027 | NONE | PUBLIC CHARITY | PROVIDE FUNDS TO SUPPORT PEOPLE LIVING WITH PARKINSON'S DISEASE | $500 |
| KIWANIS CLUB OF INVERNESS FLORIDA | |||||||
| PO BOX 2103 | INVERNESS | FL | 34451 | NONE | PUBLIC CHARITY | IN MEMORY OF PETER D'ELIA | $200 |
| NORTHERN DOOR CHILDREN'S THEATRE | |||||||
| 10520 JUDITH BLAZER DRIVE | SISTER BAY | WI | 54234 | NONE | PUBLIC CHARITY | EARLY CHILDHOOD EDUCATION | $729 |
| FAMILY SERVICES | |||||||
| 300 CROOKS STREET | GREEN BAY | WI | 54301 | NONE | PUBLIC CHARITY | SUPPORT THE CRISIS CENTER | $300 |
| CUP O JOY | |||||||
| 232 S BROADWAY | GREEN BAY | WI | 54303 | NONE | PUBLIC CHARITY | PROVIDE MUSICAL EDUCATIONAL OPPORTUNITIES - DONATION MADE IN MEMORY OF DANIEL OLSON | $200 |
| SEYMOUR COMMUNITY SCHOOL DISTRICT | |||||||
| 10 CIRCLE DRIVE | SEYMOUR | WI | 54165 | NONE | PUBLIC CHARITY | PARENT-TEACHER CONNECTION | $100 |
| DOOR COUNTY MASTER GARDENERS | |||||||
| 421 NEBRASKA ST | STURGEON BAY | WI | 54235 | NONE | PUBLIC CHARITY | PROVIDE FUNDS FOR MAKING A POSITIVE IMPACT ON HORTICULTURE THROUGH EDUCATION | $492 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $250,004 | 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 | $160,540 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $222,122 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $382,662 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $382,662 | 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 PREPARATION FEE | CategoryTxt |
| Amt | $3,346 | Amt |
| Net Investment Income | $1,673 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $1,673 | DisbursementsCharitablePrpsAmt |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corporate Bonds InvestmentsCorporateBondsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond | ML #2183 CORPORATE BONDS | BondNm |
| EOY Book Value | $39,402 | EOYBookValueAmt |
| EOYFMV | $42,054 | EOYFMVAmt |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp (33 entries)
| StockStockNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| ML #2176 EQUITIES | $1,854,846 | $2,203,160 |
| ML #2183 MUTUAL FDS/CLOSED END FDS | $118,805 | $118,541 |
| ML #2017 | $1,723,920 | $1,886,716 |
| BLACKSTONE ALTERNATIVES SOLUTION 2014 TRUST | $167,556 | $171,743 |
| BREP EUROPE IV REAL ESTATE FUND | $231,250 | $99,696 |
| CRESCENT VI MEZZANINE | $279,750 | $108,849 |
| CME GROUP | $9,245 | $26,495 |
| CORESITE REALTY CORP | $15,820 | $15,585 |
| CROWN CASTLE REIT | $12,971 | $19,475 |
| CISCO SYSTEMS | $7,753 | $13,429 |
| DOMINION ENERGY | $14,917 | $16,812 |
| DIGITAL RLTY TR | $6,917 | $16,045 |
| EPR PPTYS | $3,006 | $15,894 |
| EATON CORP | $21,057 | $23,396 |
| KINDER MORGAN INC | $16,085 | $20,514 |
| LOCKHHEED MARTIN CORP | $4,934 | $23,363 |
| MICROSOFT CORP | $8,043 | $23,970 |
| NEW RESIDENTIAL INVT CORP | $16,347 | $15,127 |
| PFIZER INC | $12,978 | $20,099 |
| QUALCOMM INC | $13,330 | $22,146 |
| STARWOOD PPTY TR INC | $14,546 | $19,813 |
| TARGET CORP | $14,369 | $32,309 |
| BLACKSTONE ALTERNATIVES SOLUTION IV FUND | $166,250 | $173,544 |
| BLACKSTONE ALTERNATIVES SOLUTION V FUND | $70,500 | $64,728 |
| AMGEN INC | $16,721 | $21,696 |
| AUTOMATIC DATA PROC | $13,918 | $16,368 |
| BROADCOM LTD | $21,109 | $23,702 |
| CATERPILLAR INC | $10,110 | $12,257 |
| ENBRIDGE INC | $15,432 | $17,340 |
| JPMORGAN CHASE & CO | $14,246 | $19,098 |
| NEXTERA ENERGY INC | $16,554 | $19,131 |
| STARBUCKS CORP | $13,884 | $16,793 |
| TEXAS INSTRUMENTS | $14,231 | $17,063 |
Investments Govt Obligations Sch InvestmentsGovtObligationsSch
| Field | Value | IRS element (for citing) |
|---|---|---|
| US Govt Obligations Book Vl EOY | $72,988 | USGovtObligationsBookVlEOYAmt |
| US Govt Obligations EOYFMV | $76,350 | USGovtObligationsEOYFMVAmt |
| State Local Sec Book Vl EOY | $0 | StateLocalSecBookVlEOYAmt |
| State Local Sec EOYFMV | $0 | StateLocalSecEOYFMVAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (10 entries)
| Category Or ItemCategoryOrItemTxt | Listed At Cost Or FMVListedAtCostOrFMVCd | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| GREEN BAY PACKERS SUPER BOWL RING | AT COST | $20,000 | $20,000 |
| ACP POWER AND ENERGY REAL ASSETFUND | AT COST | $19,435 | $120,178 |
| LS REAL ESTATE RECOVERTY IV TRUST | AT COST | $106,054 | $103,185 |
| APOLLO GLOBAL MGMT LLC | AT COST | $10,802 | $23,044 |
| BROOKFIELD INFRASTUCR | AT COST | $15,137 | $24,495 |
| CARLYLE GROUP LP | AT COST | $14,858 | $23,643 |
| BLACKSTONE GROUP LP | AT COST | $12,779 | $22,488 |
| MAGELLAN MIDSTREAM PARTNERS LP | AT COST | $11,574 | $14,774 |
| ENERGY TRANSFER LP | AT COST | $10,926 | $13,356 |
| CHENIERE ENERGY PARTNERS | AT COST | $13,439 | $14,172 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (9 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| WIRE FEE | $180 | $90 | $90 |
| MERRILL LYNCH BROKERAGE FEES | $27,266 | $27,266 | $0 |
| ADMINISTRATIVE - OTHER | $10 | $10 | $0 |
| LUTSEY ENTERPRISES MANAGEMENT FEE | $20,000 | $10,000 | $10,000 |
| POSTAGE & PRINTING | $559 | $280 | $279 |
| OUTSIDE SERVICES | $2,821 | $1,411 | $1,411 |
| BANK SERVICE CHARGES | $411 | $411 | $0 |
| MISC | $700 | $0 | $0 |
| OTHER INVESTMENT EXPENSES PARTNERSHIPS | $21,994 | $0 | $0 |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | E&S ENTREPRENEUR ADVISORS | CategoryTxt |
| Amt | $600 | Amt |
| Net Investment Income | $300 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $300 | DisbursementsCharitablePrpsAmt |
Substantial Contributors Sch SubstantialContributorsSch
Substantial Contributor Detail SubstantialContributorDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEFFREY G JACOBSON | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 127 CHEVY CHASE DRIVE | AddressLine1Txt |
| City | WAYZATA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55391 | ZIPCd |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| MERRILL LYNCH FOREIGN TAXES | $5,145 | $5,145 | $0 |
| EXCISE TAX | $10,561 | $0 | $0 |
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