RICE MEMORIAL HOSPITAL AND WELFARE FUND: Form 990PF, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- RICE MEMORIAL HOSPITAL AND WELFARE FUND (EIN 35-6015582)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-05-09
- IRS object ID
- 201941299349100444
- Schema version
- 2018v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-09T11:01:39-05:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010604131 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRUST PROCESSING SOLUTIONS | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O BOX 894 | AddressLine1Txt |
| City | MILFORD | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 451500894 | 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 | 356015582 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RICE MEMORIAL HOSPITAL AND WELFARE 310006010 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | RICE | BusinessNameControlTxt |
| Phone | 8124641584 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O BOX 207 | AddressLine1Txt |
| City | EVANSVILLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 477020207 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | OLD NATIONAL WEALTH MANAGEMENT | PersonNm |
| Person Title | TRUSTEE | PersonTitleTxt |
| Phone | 8124641584 | PhoneNum |
| Signature | 2019-05-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DOUG HART | PreparerPersonNm |
| PTIN | P00241831 | PTIN |
| Phone | 5137748805 | PhoneNum |
| Preparation | 2019-05-09 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 216.68.127.170 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | A416636C39C5A383BF8D904AE6A1B5AFADE125C5 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | A416636C39C5A383BF8D904AE6A1B5AFADE125C5 | 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 | $944,941 | FMVAssetsEOYAmt |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Dividends Rev And Expnss | $19,444 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $19,426 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $58,392 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $230,242 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $58,392 | CapGainNetIncmNetInvstIncmAmt |
| Net ST Capital Gain Adj Net Incm | $0 | NetSTCapitalGainAdjNetIncmAmt |
| Total Rev And Expnss | $77,836 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $77,818 | TotalNetInvstIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $12,035 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $2,252 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $9,784 | CompOfcrDirTrstDsbrsChrtblAmt |
| Oth Empl Slrs Wgs Net Invst Incm | $0 | OthEmplSlrsWgsNetInvstIncmAmt |
| Oth Empl Slrs Wgs Adj Net Incm | $0 | OthEmplSlrsWgsAdjNetIncmAmt |
| Oth Empl Slrs Wgs Dsbrs Chrtbl | $0 | OthEmplSlrsWgsDsbrsChrtblAmt |
| Pension Empl Bnft Net Invst Incm | $0 | PensionEmplBnftNetInvstIncmAmt |
| Pension Empl Bnft Adj Net Incm | $0 | PensionEmplBnftAdjNetIncmAmt |
| Legal Fees Dsbrs Chrtbl | $0 | LegalFeesDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $1,010 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $0 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $0 | AccountingFeesAdjNetIncmAmt |
| Accounting Fees Chrtbl Prps | $1,010 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Dsbrs Chrtbl | $0 | OtherProfFeesDsbrsChrtblAmt |
| Interest Dsbrs Chrtbl | $0 | InterestDsbrsChrtblAmt |
| Taxes Rev And Expnss | $3,726 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $225 | TaxesNetInvstIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Deprec And Dpltn Rev And Expnss | $0 | DeprecAndDpltnRevAndExpnssAmt |
| Deprec And Dpltn Net Invst Incm | $0 | DeprecAndDpltnNetInvstIncmAmt |
| Trav Conf Meeting Net Invst Incm | $0 | TravConfMeetingNetInvstIncmAmt |
| Trav Conf Meeting Adj Net Incm | $0 | TravConfMeetingAdjNetIncmAmt |
| Printing And Pub Net Invst Incm | $0 | PrintingAndPubNetInvstIncmAmt |
| Printing And Pub Adj Net Incm | $0 | PrintingAndPubAdjNetIncmAmt |
| Tot Opr Expenses Rev And Expnss | $16,771 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $2,477 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $0 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $10,794 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $46,875 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $46,875 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $63,646 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $2,477 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $0 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $57,669 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $14,190 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $75,341 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Acct Rcvbl EOY | $0 | AcctRcvblEOYAmt |
| Acct Rcvbl EOYFMV | $0 | AcctRcvblEOYFMVAmt |
| Other Rcvbl Allwnc Dbtfl Acct | $0 | OtherRcvblAllwncDbtflAcctAmt |
| Other Investments BOY | $896,046 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $907,095 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $944,941 | OtherInvestmentsEOYFMVAmt |
| Total Assets BOY | $896,046 | TotalAssetsBOYAmt |
| Total Assets EOY | $907,095 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $944,941 | TotalAssetsEOYFMVAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
| Capital Stock BOY | $896,046 | CapitalStockBOYAmt |
| Capital Stock EOY | $907,095 | CapitalStockEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $896,046 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $907,095 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $896,046 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $907,095 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $896,046 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $14,190 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $910,236 | SubtotalAmt |
| Other Decreases | $3,141 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $907,095 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (110 entries)
| PropertyPropertyDesc | AcquiredAcquiredDt | SoldSoldDt | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt | How AcquiredHowAcquiredCd |
|---|---|---|---|---|---|---|---|
| 5. BANK OF AMERICA CORP | 2017-01-19 | 2018-02-02 | $160 | $113 | $47 | $47 | |
| 14.193 CARILLON EAGLE SMALL CAP GROWTH CL I FD #3933 | 2016-08-16 | 2018-02-02 | $910 | $781 | $129 | $129 | |
| 32.037 FEDERATED CLOVER SMALL VALUE CL IS FD #659 | 2016-08-16 | 2018-02-02 | $826 | $787 | $39 | $39 | |
| 12.583 JANUS HENDERSON ENTERPRISE CL I FD #102 | 2016-04-21 | 2018-02-02 | $1,566 | $1,130 | $436 | $436 | |
| 54.283 JPMORGAN US SMALL COMPANY CL L FD #1384 | 2017-01-31 | 2018-02-02 | $1,026 | $988 | $38 | $38 | |
| 55.559 BOSTON PARTNERS ALL-CAP VALUE INSTL FD #7007 | 2014-02-11 | 2018-02-02 | $1,530 | $1,144 | $386 | $386 | |
| 15. SELECT SECTOR SPDR MATERIALS ETF | 2017-03-21 | 2018-02-02 | $909 | $778 | $131 | $131 | |
| 52. SELECT SECTOR SPDR HLTH CARE ETF | 2017-03-21 | 2018-02-02 | $4,524 | $3,871 | $653 | $653 | |
| 50. SELECT SECTOR SPDR CONSUMER STAPLES | 2016-01-28 | 2018-02-02 | $2,825 | $1,817 | $1,008 | $1,008 | |
| 41. SELECT SECTOR SPDR CONSUMER DISCRETIONARY | 2016-01-28 | 2018-02-02 | $4,341 | $3,031 | $1,310 | $1,310 | |
| 27. SELECT SECTOR SPDR ENERGY | 2017-03-21 | 2018-02-02 | $1,948 | $1,874 | $74 | $74 | |
| 165. SELECT SECTOR SPDR FINL | 2017-03-21 | 2018-02-02 | $4,844 | $3,896 | $948 | $948 | |
| 43. SELECT SECTOR SPDR INDUSTRIAL ETF | 2017-03-21 | 2018-02-02 | $3,359 | $2,775 | $584 | $584 | |
| 126. AMEX TECHNOLOGY SELECT SPDR | 2017-03-21 | 2018-02-02 | $8,391 | $6,649 | $1,742 | $1,742 | |
| 25. REAL ESTATE SELECT SECTOR SPDR FD ETF | 2017-03-21 | 2018-02-02 | $780 | $780 | |||
| 1405.745 STATE STREET HEDGED INTL DEV EQUITY INDEX CL K FD #5904 | 2017-01-31 | 2018-02-02 | $14,606 | $12,933 | $1,673 | $1,673 | |
| 31. VANGUARD S&P 500 ETF | 2017-01-31 | 2018-02-02 | $7,862 | $6,474 | $1,388 | $1,388 | |
| 51.037 VICTORY SYCAMORE ESTABLISHED VALUE CL I FD #203 | 2016-04-21 | 2018-02-02 | $2,107 | $1,636 | $471 | $471 | |
| 850.547 VOYA GNMA INCOME CL I FD #2159 | 2014-10-10 | 2018-02-23 | $7,000 | $7,365 | -$365 | -$365 | |
| 15. APERGY CORP | 2017-12-27 | 2018-05-21 | $660 | $626 | $34 | $34 | |
| 1. AIR PRODS & CHEMS INC | 2017-12-27 | 2018-06-05 | $165 | $164 | $1 | $1 | |
| 1. ALPHABET INC CL A | 2015-02-20 | 2018-06-05 | $1,151 | $541 | $610 | $610 | |
| 1. ANALOG DEVICES INC | 2017-10-20 | 2018-06-05 | $100 | $89 | $11 | $11 | |
| 5. BANK OF AMERICA CORP | 2017-01-19 | 2018-06-05 | $145 | $113 | $32 | $32 | |
| 1. BERKSHIRE HATHAWAY INC CL B | 2015-02-20 | 2018-06-05 | $190 | $148 | $42 | $42 | |
| 1. BLACKROCK INC | 2015-09-14 | 2018-06-05 | $534 | $301 | $233 | $233 | |
| 2. CELGENE CORP | 2017-05-11 | 2018-06-05 | $156 | $239 | -$83 | -$83 | |
| 2. CHEVRONTEXACO CORP | 2012-06-25 | 2018-06-05 | $246 | $197 | $49 | $49 | |
| 30. CHURCH & DWIGHT INC | 2003-05-20 | 2018-06-05 | $1,402 | $159 | $1,243 | $1,243 | |
| 14. CONSTELLATION BRANDS INC | 2017-05-11 | 2018-06-05 | $3,153 | $2,494 | $659 | $659 | |
| 7. COSTCO WHSL CORP NEW | 2011-11-01 | 2018-06-05 | $1,384 | $584 | $800 | $800 | |
| 33. CROWN CASTLE INTL CORP | 2016-01-28 | 2018-06-05 | $3,404 | $2,811 | $593 | $593 | |
| 2. CUMMINS INC | 2017-06-13 | 2018-06-05 | $283 | $320 | -$37 | -$37 | |
| 2. DANAHER CORP | 2015-10-21 | 2018-06-05 | $204 | $135 | $69 | $69 | |
| 3. DOVER CORPORATION | 2017-12-27 | 2018-06-05 | $235 | $241 | -$6 | -$6 | |
| 3. EOG RESOURCES INC | 2016-04-25 | 2018-06-05 | $350 | $239 | $111 | $111 | |
| 2. EDWARDS LIFESCIENCES CORP | 2016-01-28 | 2018-06-05 | $284 | $152 | $132 | $132 | |
| 2. EQUIFAX INC | 2016-02-17 | 2018-06-05 | $235 | $204 | $31 | $31 | |
| 6. EXXON MOBIL CORP | 2016-04-25 | 2018-06-05 | $484 | $523 | -$39 | -$39 | |
| 3. FACEBOOK INC CL A | 2016-04-25 | 2018-06-05 | $579 | $330 | $249 | $249 | |
| 2. FEDEX CORP | 2016-09-19 | 2018-06-05 | $504 | $323 | $181 | $181 | |
| 6. FORTIVE CORP | 2016-11-23 | 2018-06-05 | $446 | $335 | $111 | $111 | |
| 2. GLOBAL PAYMENTS INC | 2017-12-27 | 2018-06-05 | $230 | $201 | $29 | $29 | |
| 3. HOME DEPOT | 2016-08-15 | 2018-06-05 | $576 | $412 | $164 | $164 | |
| 25. JP MORGAN CHASE & CO | 2016-10-20 | 2018-06-05 | $2,693 | $1,710 | $983 | $983 | |
| 5. KROGER CO | 2016-04-25 | 2018-06-05 | $124 | $183 | -$59 | -$59 | |
| 1. LENNOX INTL INC | 2016-05-13 | 2018-06-05 | $207 | $138 | $69 | $69 | |
| 2. LILLY ELI & CO | 2016-01-28 | 2018-06-05 | $169 | $154 | $15 | $15 | |
| 5. MICROSOFT CORP | 2017-06-13 | 2018-06-05 | $511 | $354 | $157 | $157 | |
| 2. NORTHROP GRUMMAN CORP | 2016-01-11 | 2018-06-05 | $659 | $377 | $282 | $282 | |
| 75. ORACLE CORPORATION | 2012-06-25 | 2018-06-05 | $3,534 | $2,060 | $1,474 | $1,474 | |
| 51. PAYPAL HLDGS INC | 2013-05-24 | 2018-06-05 | $4,337 | $1,655 | $2,682 | $2,682 | |
| 1. PIONEER NAT RES CO | 2016-05-04 | 2018-06-05 | $191 | $158 | $33 | $33 | |
| 4. PROGRESSIVE CORP OHIO COM | 2017-12-27 | 2018-06-05 | $251 | $226 | $25 | $25 | |
| 2. SELECT SECTOR SPDR MATERIALS ETF | 2017-03-21 | 2018-06-05 | $120 | $104 | $16 | $16 | |
| 9. SELECT SECTOR SPDR HLTH CARE ETF | 2017-03-21 | 2018-06-05 | $751 | $670 | $81 | $81 | |
| 80. SELECT SECTOR SPDR CONSUMER STAPLES | 2017-03-21 | 2018-06-05 | $3,984 | $4,410 | -$426 | -$426 | |
| 13. SELECT SECTOR SPDR CONSUMER DISCRETIONARY | 2017-03-21 | 2018-06-05 | $1,408 | $1,122 | $286 | $286 | |
| 12. SELECT SECTOR SPDR ENERGY | 2017-03-21 | 2018-06-05 | $906 | $833 | $73 | $73 | |
| 31. SELECT SECTOR SPDR FINL | 2017-03-21 | 2018-06-05 | $848 | $732 | $116 | $116 | |
| 10. SELECT SECTOR SPDR INDUSTRIAL ETF | 2017-03-21 | 2018-06-05 | $752 | $645 | $107 | $107 | |
| 32. AMEX TECHNOLOGY SELECT SPDR | 2017-03-21 | 2018-06-05 | $2,300 | $1,689 | $611 | $611 | |
| 11. REAL ESTATE SELECT SECTOR SPDR FD ETF | 2017-03-21 | 2018-06-05 | $349 | $343 | $6 | $6 | |
| 32. SELECT SECTOR SPDR TR UTILS | 2017-03-21 | 2018-06-05 | $1,584 | $1,656 | -$72 | -$72 | |
| 6. STARBUCKS CORP | 2016-08-15 | 2018-06-05 | $333 | $332 | $1 | $1 | |
| 2. STRYKER CORP | 2015-10-21 | 2018-06-05 | $354 | $200 | $154 | $154 | |
| 7. SUNTRUST BKS INC COM | 2016-10-20 | 2018-06-05 | $484 | $326 | $158 | $158 | |
| 5. TJX CO INC | 2012-02-07 | 2018-06-05 | $470 | $168 | $302 | $302 | |
| 2. THERMO FISHER SCIENTIFIC INC | 2009-02-06 | 2018-06-05 | $429 | $80 | $349 | $349 | |
| 16. VANGUARD VALUE ETF | 2016-01-28 | 2018-06-05 | $1,686 | $1,150 | $536 | $536 | |
| 4. VISA INC CL A | 2009-05-27 | 2018-06-05 | $534 | $67 | $467 | $467 | |
| 2. AON PLC CL A | 2016-08-15 | 2018-06-05 | $281 | $219 | $62 | $62 | |
| 4. MEDTRONIC PLC | 2016-01-28 | 2018-06-05 | $346 | $296 | $50 | $50 | |
| 12.473 CARILLON EAGLE SMALL CAP GROWTH CL I FD #3933 | 2016-08-16 | 2018-06-06 | $856 | $687 | $169 | $169 | |
| 28.118 DRIEHAUS EMERGING MKTS GROWTH INSTL FD #23 | 2011-11-01 | 2018-06-06 | $1,108 | $800 | $308 | $308 | |
| 32.475 FEDERATED CLOVER SMALL VALUE CL IS FD #659 | 2016-08-16 | 2018-06-06 | $863 | $798 | $65 | $65 | |
| 68.172 OAKMARK INTL INSTL FD #2886 | 2017-05-25 | 2018-06-06 | $1,892 | $1,815 | $77 | $77 | |
| 13.611 JANUS HENDERSON ENTERPRISE CL I FD #102 | 2016-04-21 | 2018-06-06 | $1,788 | $1,222 | $566 | $566 | |
| 64.367 JPMORGAN US SMALL COMPANY CL L FD #1384 | 2017-01-31 | 2018-06-06 | $1,303 | $1,171 | $132 | $132 | |
| 47.713 OPPENHEIMER INTL GROWTH CL I FD #1961 | 2017-05-25 | 2018-06-06 | $2,140 | $1,936 | $204 | $204 | |
| 68.982 BOSTON PARTNERS ALL-CAP VALUE INSTL FD #7007 | 2014-02-11 | 2018-06-06 | $1,878 | $1,420 | $458 | $458 | |
| 57.043 VICTORY SYCAMORE ESTABLISHED VALUE CL I FD #203 | 2016-04-21 | 2018-06-06 | $2,351 | $1,829 | $522 | $522 | |
| 8.094 CARILLON EAGLE SMALL CAP GROWTH CL I FD #3933 | 2016-08-16 | 2018-09-04 | $590 | $446 | $144 | $144 | |
| 22.23 DRIEHAUS EMERGING MKTS GROWTH INSTL FD #23 | 2011-11-01 | 2018-09-04 | $800 | $632 | $168 | $168 | |
| 23. EOG RESOURCES INC | 2016-04-25 | 2018-09-04 | $2,698 | $1,833 | $865 | $865 | |
| 12.619 FEDERATED CLOVER SMALL VALUE CL IS FD #659 | 2016-08-16 | 2018-09-04 | $343 | $310 | $33 | $33 | |
| 52.669 OAKMARK INTL INSTL FD #2886 | 2017-05-25 | 2018-09-04 | $1,347 | $1,403 | -$56 | -$56 | |
| 8.236 JANUS HENDERSON ENTERPRISE CL I FD #102 | 2016-04-21 | 2018-09-04 | $1,123 | $739 | $384 | $384 | |
| 31.034 JPMORGAN US SMALL COMPANY CL L FD #1384 | 2017-01-31 | 2018-09-04 | $645 | $565 | $80 | $80 | |
| 52. KROGER CO | 2016-04-25 | 2018-09-04 | $1,649 | $1,905 | -$256 | -$256 | |
| 24.368 OPPENHEIMER INTL GROWTH CL I FD #1961 | 2017-05-25 | 2018-09-04 | $1,020 | $989 | $31 | $31 | |
| 31.244 BOSTON PARTNERS ALL-CAP VALUE INSTL FD #7007 | 2014-02-11 | 2018-09-04 | $869 | $643 | $226 | $226 | |
| 9. SELECT SECTOR SPDR HLTH CARE ETF | 2017-03-21 | 2018-09-04 | $827 | $670 | $157 | $157 | |
| 8. SELECT SECTOR SPDR CONSUMER STAPLES | 2017-03-21 | 2018-09-04 | $428 | $441 | -$13 | -$13 | |
| 11. SELECT SECTOR SPDR CONSUMER DISCRETIONARY | 2017-03-21 | 2018-09-04 | $1,288 | $949 | $339 | $339 | |
| 23. SELECT SECTOR SPDR FINL | 2017-03-21 | 2018-09-04 | $653 | $543 | $110 | $110 | |
| 8. SELECT SECTOR SPDR INDUSTRIAL ETF | 2017-03-21 | 2018-09-04 | $615 | $516 | $99 | $99 | |
| 27. AMEX TECHNOLOGY SELECT SPDR | 2017-03-21 | 2018-09-04 | $2,031 | $1,425 | $606 | $606 | |
| 5. SELECT SECTOR SPDR TR UTILS | 2017-03-21 | 2018-09-04 | $268 | $259 | $9 | $9 | |
| 7. SHERWIN WILLIAMS CO | 2016-05-13 | 2018-09-04 | $3,218 | $2,056 | $1,162 | $1,162 | |
| 6. STRYKER CORP | 2015-10-21 | 2018-09-04 | $1,011 | $599 | $412 | $412 | |
| 8. VANGUARD VALUE ETF | 2013-09-10 | 2018-09-04 | $883 | $564 | $319 | $319 | |
| 30.816 VICTORY SYCAMORE ESTABLISHED VALUE CL I FD #203 | 2016-04-21 | 2018-09-04 | $1,326 | $988 | $338 | $338 | |
| 45. MEDTRONIC PLC | 2016-01-28 | 2018-09-04 | $4,295 | $3,328 | $967 | $967 | |
| 52. FORTIVE CORP | 2017-06-13 | 2018-09-25 | $4,462 | $2,585 | $1,877 | $1,877 | |
| 10. LENNOX INTL INC | 2016-05-13 | 2018-10-03 | $2,185 | $1,376 | $809 | $809 | |
| 59. SELECT SECTOR SPDR CONSUMER DISCRETIONARY | 2017-03-21 | 2018-10-03 | $6,786 | $5,091 | $1,695 | $1,695 | |
| 219. AMEX TECHNOLOGY SELECT SPDR | 2017-03-21 | 2018-10-03 | $16,613 | $11,557 | $5,056 | $5,056 | |
| 25000. FED HOME LN BK 1.75% 12/14/2018 | 2013-12-13 | 2018-12-14 | $25,000 | $25,000 | |||
| CAPITAL GAIN DIVIDENDS | $15,881 | P |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $58,392 | CapitalGainNetIncomeAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | false | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $55,287 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $994,719 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.055581 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $57,496 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $940,553 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.06113 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $48,033 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $1,000,210 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 0.048023 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $57,923 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $1,014,428 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.057099 | DistributionYr4Rt |
| Adjusted Qlfy Distri Yr5 | $61,209 | AdjustedQlfyDistriYr5Amt |
| Net Vl Noncharitable Assets Yr5 | $1,048,220 | NetVlNoncharitableAssetsYr5Amt |
| Distribution Yr5 | 0.058393 | DistributionYr5Rt |
| Total Distribution | 0.280226 | TotalDistributionRt |
| Average Distribution | 0.056045 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $1,019,377 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $57,131 | AdjNetVlNoncharitableAssetsAmt |
| Net Investment Income Pct | $753 | NetInvestmentIncomePctAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $57,884 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $57,669 | QualifyingDistributionsAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $1,507 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $1,507 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $1,507 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $1,976 | EstimatedPlusOvpmtIncmTxAmt |
| Extsn Request Income Tax Paid | $0 | ExtsnRequestIncomeTaxPaidAmt |
| Total Payments And Credits | $1,976 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Overpayment | $469 | OverpaymentAmt |
| Applied To ES Tax | $469 | AppliedToESTaxAmt |
| Refund | $0 | RefundAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | false | LegislativePoliticalActyInd |
| More Than100 Spent | false | MoreThan100SpentInd |
| Form1120 POL Filed | false | Form1120POLFiledInd |
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | false | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (true) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (true) | AtLeast5000InAssetsInd |
| Org Report Or Register State | IN | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (true) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | false | PrivateOperatingFoundationInd |
| New Substantial Contributors | false | NewSubstantialContributorsInd |
| Own Controlled Entity | false | OwnControlledEntityInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (true) | ComplyWithPublicInspRqrInd |
Persons With Books Name PersonsWithBooksName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OLD NATIONAL WEALTH MANAGEMENT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8124641584 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 207 | AddressLine1Txt |
| City | EVANSVILLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47702 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Accounts Question | false | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | false | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | false | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | false | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | false | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | false | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | false | PaymentToGovernmentOfficialInd |
| Uncorrected Prior Acts | false | UncorrectedPriorActsInd |
| Undistributed Income PY | false | UndistributedIncomePYInd |
| Business Holdings | false | BusinessHoldingsInd |
| Jeopardy Investments | false | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | false | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | false | InfluenceLegislationInd |
| Influence Election | false | InfluenceElectionInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Noncharitable Purpose | false | NoncharitablePurposeInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | OLD NATIONAL WEALTH MANAGEMENT | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 207 | AddressLine1Txt |
| City | EVANSVILLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47702 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Title | TRUSTEE | TitleTxt |
| Average Hrs Per Wk Devoted To Pos | 1 | AverageHrsPerWkDevotedToPosRt |
| Compensation | $12,035 | CompensationAmt |
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Summary Of Direct Chrtbl Acty | SummaryOfDirectChrtblActyGrp | |
| Sum Of Program Related Invst | SumOfProgramRelatedInvstGrp |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $1,034,901 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $0 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $1,034,901 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $1,034,901 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $15,524 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $1,019,377 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $50,969 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $50,969 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $1,507 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $1,507 | TotalTaxAmt |
| Distributable Before Adj | $49,462 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $49,462 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $49,462 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $57,669 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Charitable Assets Acquis Paid | $0 | CharitableAssetsAcquisPaidAmt |
| Set Aside Suitability Test | $0 | SetAsideSuitabilityTestAmt |
| Set Aside Cash Distri Test | $0 | SetAsideCashDistriTestAmt |
| Qualifying Distributions | $57,669 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $0 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $57,669 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $49,462 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $0 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr5 | $1,648 | ExcessDistributionCyovYr5Amt |
| Excess Distribution Cyov Yr4 | $2,536 | ExcessDistributionCyovYr4Amt |
| Excess Distribution Cyov Yr3 | $0 | ExcessDistributionCyovYr3Amt |
| Excess Distribution Cyov Yr2 | $11,358 | ExcessDistributionCyovYr2Amt |
| Excess Distribution Cyov Yr1 | $7,524 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $23,066 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $57,669 | QualifyingDistributionsAmt |
| Applied To Year1 | $0 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $49,462 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $8,207 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $0 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $0 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $31,273 | 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 | $1,648 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $29,625 | ExcessDistriCyovToNextYrAmt |
| Excess From Year4 | $2,536 | ExcessFromYear4Amt |
| Excess From Year3 | $0 | ExcessFromYear3Amt |
| Excess From Year2 | $11,358 | ExcessFromYear2Amt |
| Excess From Year1 | $7,524 | ExcessFromYear1Amt |
| Excess From Current Year | $8,207 | ExcessFromCurrentYearAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (3 entries)
| Business Name Line2RecipientBusinessName/BusinessNameLine2Txt | Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|---|
| INDIANA UNIVERSITY | ||||||||
| BURSAR OFFICE-FRANKLIN HALL 011 | 601 E KIRKWOOD AVE | BLOOMINGTON | IN | 474051233 | NONE | PC | SCHOLARSHIPS | $28,125 |
| PURDUE UNIVERSITY | ||||||||
| BURSAR OFFICE-OUTSIDE AWARDS | 1060 HOVDE HALL OF ADMIN | W LAFAYETTE | IN | 479071060 | NONE | PC | SCHOLARSHIPS | $15,625 |
| IUPUI | ||||||||
| OFFICE OF THE BURSAR | PO BOX 66144 | INDIANAPOLIS | IN | 462666144 | NONE | PC | SCHOLARSHIPS | $3,125 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $46,875 | TotalGrantOrContriPdDurYrAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fees Contracts From Govt Ag | FeesContractsFromGovtAgGrp | |
| Membership Dues And Assmnt | MembershipDuesAndAssmntGrp | |
| Int On Sav And Temp Cash Invst | IntOnSavAndTempCashInvstGrp |
Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $19,444 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Rntl Incm Re Debt Fincd Prop | NetRntlIncmReDebtFincdPropGrp | |
| Net Rntl Incm Re Not Debt Fincd Prop | NetRntlIncmReNotDebtFincdProp | |
| Net Rental Income Personal Prop | NetRentalIncomePersonalPropGrp | |
| Other Investment Incm Part VII | OtherInvestmentIncmPartVIIGrp |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $58,392 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Income Loss From Special Evt | NetIncomeLossFromSpecialEvtGrp | |
| Gross Profit Loss Sls Of Invntry | GrossProfitLossSlsOfInvntryGrp |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | $77,836 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $77,836 | TotalIncomeProducingActyAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Rln Of Acty To Accom Of Exmpt Prps | RlnOfActyToAccomOfExmptPrpsGrp |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | false | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | false | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | false | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | false | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | false | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | false | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | false | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | false | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | false | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | false | RelationshipsNonchrtblEOInd |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | TAX PREPARATION FEE (NON-ALLOC | CategoryTxt |
| Amt | $1,010 | Amt |
| Disbursements Charitable Prps | $1,010 | DisbursementsCharitablePrpsAmt |
Other Decreases Schedule OtherDecreasesSchedule
Other Decreases Detail OtherDecreasesDetail (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ROUNDING | $2 |
| ROC ADJUSTMENT | $14 |
| 2019 REVERSAL | $3,125 |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (3 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| FEDERAL TAX PAYMENT - PRIOR YE | $1,525 | $0 | $0 |
| FEDERAL ESTIMATES - PRINCIPAL | $1,976 | $0 | $0 |
| FOREIGN TAXES ON QUALIFIED FOR | $225 | $225 | $0 |
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