FIRST BANCSHARES INC: Form 990PF, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- FIRST BANCSHARES INC (EIN 37-1339718)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-05-13
- IRS object ID
- 201931339349100848
- Schema version
- 2018v3.1
- 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 Assets Schedule
- Other Expenses Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-13T09:26:22-05:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 370980065 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEST & COMPANY LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 613 BROADWAY AVE | AddressLine1Txt |
| City | MATTOON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61938 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 371339718 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FIRST MID-ILLINOIS BANCSHARES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FIRS | BusinessNameControlTxt |
| Phone | 2172347454 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 529 | AddressLine1Txt |
| City | MATTOON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61938 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LAURA REICHART | PersonNm |
| Person Title | ASSISTANT VP & TRUST OFFICER | PersonTitleTxt |
| Phone | 2172354747 | PhoneNum |
| Signature | 2019-05-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ALEX HAGEN | PreparerPersonNm |
| PTIN | P01275388 | PTIN |
| Phone | 2172354747 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 66.116.56.51 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-13 | IPDt |
| IP Tm | 09:24:57 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 8A1724882E8C3824CF2732C3003568C2B11A3915 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | E46E8CBB91B249769F382203A2C2CCCDDDA1D233 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $538,758 | 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 | $134 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $134 | InterestOnSavNetInvstIncmAmt |
| Interest On Savings Adj Net Incm | $134 | InterestOnSavingsAdjNetIncmAmt |
| Dividends Rev And Expnss | $17,354 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $17,354 | DividendsNetInvstIncmAmt |
| Dividends Adj Net Incm | $17,354 | DividendsAdjNetIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $6,003 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $117,528 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $6,003 | CapGainNetIncmNetInvstIncmAmt |
| Total Rev And Expnss | $23,491 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $23,491 | TotalNetInvstIncmAmt |
| Total Adj Net Incm | $17,488 | TotalAdjNetIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $7,767 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $5,178 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Adj Net Incm | $5,178 | CompOfcrDirTrstAdjNetIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $2,589 | CompOfcrDirTrstDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $1,500 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $1,000 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $1,000 | AccountingFeesAdjNetIncmAmt |
| Accounting Fees Chrtbl Prps | $500 | AccountingFeesChrtblPrpsAmt |
| Taxes Rev And Expnss | $590 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $246 | TaxesNetInvstIncmAmt |
| Taxes Adj Net Incm | $246 | TaxesAdjNetIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $15 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $0 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Adj Net Incm | $0 | OtherExpensesAdjNetIncmAmt |
| Other Expenses Dsbrs Chrtbl | $15 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $9,872 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $6,424 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $6,424 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $3,104 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $20,000 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $20,000 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $29,872 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $6,424 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $6,424 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $23,104 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$6,381 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $17,067 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $11,064 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sav And Temp Cash Invst BOY | $7,290 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $14,321 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $14,321 | SavAndTempCashInvstEOYFMVAmt |
| US Government Obligations BOY | $114,658 | USGovernmentObligationsBOYAmt |
| US Government Obligations EOY | $92,640 | USGovernmentObligationsEOYAmt |
| US Govt Obligations EOYFMV | $89,156 | USGovtObligationsEOYFMVAmt |
| Corporate Stock BOY | $135,294 | CorporateStockBOYAmt |
| Corporate Stock EOY | $144,506 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $133,886 | CorporateStockEOYFMVAmt |
| Corporate Bonds BOY | $310,431 | CorporateBondsBOYAmt |
| Corporate Bonds EOY | $310,912 | CorporateBondsEOYAmt |
| Corporate Bonds EOYFMV | $297,430 | CorporateBondsEOYFMVAmt |
| Other Investments BOY | $3,971 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $3,734 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $3,584 | OtherInvestmentsEOYFMVAmt |
| Other Assets BOY | $1,231 | OtherAssetsBOYAmt |
| Other Assets EOY | $381 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $381 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $572,875 | TotalAssetsBOYAmt |
| Total Assets EOY | $566,494 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $538,758 | TotalAssetsEOYFMVAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
| Capital Stock BOY | $1,369,571 | CapitalStockBOYAmt |
| Capital Stock EOY | $1,375,574 | CapitalStockEOYAmt |
| Additional Paid In Capital BOY | $0 | AdditionalPaidInCapitalBOYAmt |
| Additional Paid In Capital EOY | $0 | AdditionalPaidInCapitalEOYAmt |
| Retained Earning BOY | -$796,696 | RetainedEarningBOYAmt |
| Retained Earning EOY | -$809,080 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $572,875 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $566,494 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $572,875 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $566,494 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $572,875 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$6,381 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $566,494 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $566,494 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (9 entries)
| PropertyPropertyDesc | AcquiredAcquiredDt | SoldSoldDt | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt |
|---|---|---|---|---|---|---|
| LONG TERM COVERED SECURITIES | 2017-03-06 | 2018-09-11 | $103,862 | $103,331 | $531 | $531 |
| SHORT TERM COVERED SECURITIES | 2017-03-06 | 2018-01-29 | $6,486 | $5,916 | $570 | $570 |
| BRANDES INTL SMALL CAP | 2017-03-06 | 2018-12-11 | $163 | $163 | $0 | $0 |
| CAUSEWAY EMERGING | 2017-03-06 | 2018-12-11 | $273 | $273 | $0 | $0 |
| MAINGATE MLP FUND | 2015-12-28 | 2018-12-11 | $76 | $76 | $76 | |
| ROYCE SPECIAL EQUITY | 2016-12-05 | 2018-01-29 | $851 | $851 | $0 | $0 |
| ROYCE SPECIAL EQUITY | 2016-12-05 | 2018-12-11 | $264 | $264 | $0 | $0 |
| OPPENHEIMER SR FLOATING | 2018-05-07 | 2018-12-11 | $727 | $727 | $0 | $0 |
| CAPITAL GAIN DIVIDENDS | 2000-01-01 | 2018-12-31 | $4,826 | $4,826 | $4,826 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $6,003 | CapitalGainNetIncomeAmt |
| Net Short Term Capital Gain Loss | $570 | NetShortTermCapitalGainLossAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | 0 | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $23,552 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $524,943 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.044866 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $39,113 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $461,514 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.084749 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $52,981 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $443,931 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 0.119345 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $52,827 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $437,806 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.120663 | DistributionYr4Rt |
| Adjusted Qlfy Distri Yr5 | $159,154 | AdjustedQlfyDistriYr5Amt |
| Net Vl Noncharitable Assets Yr5 | $422,753 | NetVlNoncharitableAssetsYr5Amt |
| Distribution Yr5 | 0.376470 | DistributionYr5Rt |
| Total Distribution | 0.746093 | TotalDistributionRt |
| Average Distribution | 0.149219 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $562,369 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $83,916 | AdjNetVlNoncharitableAssetsAmt |
| Net Investment Income Pct | $171 | NetInvestmentIncomePctAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $84,087 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $23,104 | QualifyingDistributionsAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $341 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $341 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $341 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $360 | EstimatedPlusOvpmtIncmTxAmt |
| Extsn Request Income Tax Paid | $0 | ExtsnRequestIncomeTaxPaidAmt |
| Backup Withholding Withheld | $0 | BackupWithholdingWithheldAmt |
| Total Payments And Credits | $360 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Overpayment | $19 | OverpaymentAmt |
| Applied To ES Tax | $19 | 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 |
Persons With Books Name PersonsWithBooksName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAURA REICHART FIRST MID WEALTH MGMT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2172347454 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1515 CHARLESTON AVE | AddressLine1Txt |
| City | MATTOON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61938 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | FIRST MID WEALTH MANAGEMENT COMPANY | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1515 CHARLESTON AVE | AddressLine1Txt |
| City | MATTOON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61938 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Title | TRUSTEE | TitleTxt |
| Average Hrs Per Wk Devoted To Pos | 1.00 | AverageHrsPerWkDevotedToPosRt |
| Compensation | $7,767 | CompensationAmt |
| Employee Benefit Program | $0 | EmployeeBenefitProgramAmt |
| Expense Account Other Allwnc | $0 | ExpenseAccountOtherAllwncAmt |
| 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 | $562,973 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $7,960 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $570,933 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $570,933 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $8,564 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $562,369 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $28,118 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $28,118 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $341 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $341 | TotalTaxAmt |
| Distributable Before Adj | $27,777 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $27,777 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $27,777 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $23,104 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $23,104 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $0 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $23,104 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $27,777 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $0 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr5 | $138,436 | ExcessDistributionCyovYr5Amt |
| Excess Distribution Cyov Yr4 | $31,365 | ExcessDistributionCyovYr4Amt |
| Excess Distribution Cyov Yr3 | $31,033 | ExcessDistributionCyovYr3Amt |
| Excess Distribution Cyov Yr2 | $16,226 | ExcessDistributionCyovYr2Amt |
| Total Excess Distribution Cyov | $217,060 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $23,104 | QualifyingDistributionsAmt |
| Applied To Year1 | $0 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $23,104 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $0 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $4,673 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $4,673 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $212,387 | 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 | $133,763 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $78,624 | ExcessDistriCyovToNextYrAmt |
| Excess From Year4 | $31,365 | ExcessFromYear4Amt |
| Excess From Year3 | $31,033 | ExcessFromYear3Amt |
| Excess From Year2 | $16,226 | ExcessFromYear2Amt |
Supplementary Information SupplementaryInformationGrp
Application Submission Info ApplicationSubmissionInfoGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Person | JOSEPH R DIVELY | RecipientPersonNm |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 499 | AddressLine1Txt |
| City | MATTOON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61938 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Phone | 2172347454 | RecipientPhoneNum |
| Form And Info And Materials | LETTER OF APPLICATION DESCRIBING ORGANIZATION AND PURPOSE OF GRANT | FormAndInfoAndMaterialsTxt |
| Submission Deadlines | NONE | SubmissionDeadlinesTxt |
| Restrictions On Awards | AWARDS INCLUDE ONLY RELIGIOUS, CHARITABLE, SCIENTIFIC, LITERARY OR EDUCATIONAL PURPOSES WITHIN THE MEANING OF 501(C)(3) WITHIN THE UNITED STATES | RestrictionsOnAwardsTxt |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (2 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| SARAH BUSH LINCOLN HEALTH FOUNDATION | |||||||
| 1000 HEALTH CENTER DRIVE | MATTOON | IL | 61938 | NONE | PUBLIC | UNRESTRICTED GIFT | $10,000 |
| SOUTHEASTERN IL COMMUNITY FOUNDATION | |||||||
| 300 E WASHINGTON | EFFINGHAM | IL | 62401 | NONE | PUBLIC | UNRESTRICTED GIFT | $10,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $20,000 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $134 | ExclusionAmt |
Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $17,354 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $6,003 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $23,491 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $23,491 | 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 | $1,500 | Amt |
| Net Investment Income | $1,000 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $1,000 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $500 | DisbursementsCharitablePrpsAmt |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corporate Bonds InvestmentsCorporateBondsGrp (5 entries)
| BondBondNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| PRINCIPAL HIGH YIELD INST #4585 | $41,626 | $37,788 |
| DODGE & COX INCOME FUND #147 | $95,466 | $92,754 |
| METROPOLITAN WEST TOTAL RETURN BOND I | $92,158 | $89,385 |
| TEMPLETON GLOBAL BOND FUND | $41,300 | $39,308 |
| OPPENHEIMER SR FLOATING RATE FUND | $40,362 | $38,195 |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp (12 entries)
| StockStockNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| AMERICAN FUNDS EUROPACIFIC GROWTH F-2 #616 | $8,893 | $8,300 |
| T ROWE PRICE BLUE CHIP GROWTH FUND | $4,682 | $5,509 |
| NEUBERGER BERMAN GENESIS | $16,932 | $15,114 |
| GOTHAM INDEX PLUS INST | $5,950 | $6,381 |
| MAINGATE MLP FUND I | $4,465 | $3,455 |
| OPPENHEIMER DEV MKT Y | $6,875 | $7,671 |
| ROYCE SPECIAL EQYITY INST ROYCE | $17,247 | $13,718 |
| VANGUARD 500 INDEX FUND | $23,615 | $25,272 |
| BOSTON PARTNERS ALL CAP VALUE INSTL | $17,658 | $15,806 |
| BRANDES INT'L SMALL CAP EQUITY | $11,497 | $8,973 |
| CAUSEWAY EMERGING MKTS INSTL CL | $16,872 | $14,690 |
| CAUSEWAY INT'L VALUE FUND INSTL | $9,820 | $8,997 |
Investments Govt Obligations Sch InvestmentsGovtObligationsSch
| Field | Value | IRS element (for citing) |
|---|---|---|
| US Govt Obligations Book Vl EOY | $92,640 | USGovtObligationsBookVlEOYAmt |
| US Govt Obligations EOYFMV | $89,156 | USGovtObligationsEOYFMVAmt |
| State Local Sec Book Vl EOY | $0 | StateLocalSecBookVlEOYAmt |
| State Local Sec EOYFMV | $0 | StateLocalSecEOYFMVAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category Or Item | PRINCIPAL REAL ESTATE FUND INST #4934 | CategoryOrItemTxt |
| Listed At Cost Or FMV | AT COST | ListedAtCostOrFMVCd |
| Book Value | $3,734 | BookValueAmt |
| EOYFMV | $3,584 | EOYFMVAmt |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp (2 entries)
| DescDesc | BOY Book ValueBOYBookValueAmt | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| PREPAID EXCISE TAX | $200 | $360 | $360 |
| DIVIDENDS RECEIVABLE | $1,031 | $21 | $21 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | STATE FILING FEE | Desc |
| Revenue And Expenses Per Books | $15 | RevenueAndExpensesPerBooksAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $15 | DisbursementsCharitablePrpsAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|---|
| EXCISE TAX | $344 | $0 | $0 | $0 |
| FOREIGN TAX WITHHELD | $246 | $246 | $246 | $0 |
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