DAVID KOZICKI MEMORIAL FOUNDATION: Form 990PF, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
DAVID KOZICKI MEMORIAL FOUNDATION (EIN 11-3208317)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-15
IRS object ID
201803199349103045
Schema version
2017v2.3
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

FieldValueIRS element (for citing)
Return2018-11-15T13:36:45-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN113505128PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MARCEL GROSS CO INCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1691 DAHILL ROADAddressLine1Txt
CityBROOKLYNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11218ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN113208317EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE DAVID KOZICKI MEMORIAL FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlDAVIBusinessNameControlTxt
Phone7184355404PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O M GROSS 691 DAHILL RDAddressLine1Txt
CityBROOKLYNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11218ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTRUSTEEPersonNm
Person TitleDIRECTORPersonTitleTxt
Phone7184355404PhoneNum
Signature2018-11-15SignatureDt

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMARCEL GROSSPreparerPersonNm
PTINP01387210PTIN
Phone7184355404PhoneNum
Preparation2018-11-15PreparationDt
Self EmployedYes (X)SelfEmployedInd

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.87.74.254IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-11-15IPDt
IP Tm14:36:40IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdB9024D71FA5D47783EB614DFCD617837C14555E2AtSubmissionCreationDeviceId
At Submission Filing Device IdC28636B855306B7F16F6CDB4232AD1AADDEFDCB9AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$3,062,827FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$13,655ContriRcvdRevAndExpnssAmt
Interest On Sav Rev And Expnss$589InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$589InterestOnSavNetInvstIncmAmt
Dividends Rev And Expnss$25,738DividendsRevAndExpnssAmt
Dividends Net Invst Incm$25,738DividendsNetInvstIncmAmt
Gross Rents Rev And Expnss$16,614GrossRentsRevAndExpnssAmt
Gross Rents Net Invst Incm$13,306GrossRentsNetInvstIncmAmt
Net Rental Income Or Loss$2,083NetRentalIncomeOrLossAmt
Net Gain Sale Ast Rev And Expnss$356,450NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$458,430GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$356,450CapGainNetIncmNetInvstIncmAmt
Total Rev And Expnss$413,046TotalRevAndExpnssAmt
Total Net Invst Incm$396,083TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$0CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$0CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl$0CompOfcrDirTrstDsbrsChrtblAmt
Accounting Fees Rev And Expnss$3,000AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm$1,500AccountingFeesNetInvstIncmAmt
Accounting Fees Chrtbl Prps$1,500AccountingFeesChrtblPrpsAmt
Other Expenses Rev And Expnss$25,653OtherExpensesRevAndExpnssAmt
Other Expenses Net Invst Incm$25,097OtherExpensesNetInvstIncmAmt
Other Expenses Dsbrs Chrtbl$550OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$28,653TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$26,597TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$2,050TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$359,344ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$359,344ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$387,997TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$26,597TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$361,394TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses$25,049ExcessRevenueOverExpensesAmt
Net Investment Income$369,486NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Cash BOY$1,008,606CashBOYAmt
Cash EOY$1,003,046CashEOYAmt
Cash EOYFMV$1,003,046CashEOYFMVAmt
Invst Land Cost Or Other Basis$206,849InvstLandCostOrOtherBasisAmt
Land Bldg Investments BOY$206,849LandBldgInvestmentsBOYAmt
Land Bldg Investments EOY$206,849LandBldgInvestmentsEOYAmt
Land Bldg Investments EOYFMV$206,849LandBldgInvestmentsEOYFMVAmt
Other Investments BOY$467,678OtherInvestmentsBOYAmt
Other Investments EOY$764,836OtherInvestmentsEOYAmt
Other Investments EOYFMV$1,068,619OtherInvestmentsEOYFMVAmt
Other Assets BOY$1,087,757OtherAssetsBOYAmt
Other Assets EOY$821,208OtherAssetsEOYAmt
Other Assets EOYFMV$784,313OtherAssetsEOYFMVAmt
Total Assets BOY$2,770,890TotalAssetsBOYAmt
Total Assets EOY$2,795,939TotalAssetsEOYAmt
Total Assets EOYFMV$3,062,827TotalAssetsEOYFMVAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind
Capital Stock BOY$2,770,890CapitalStockBOYAmt
Capital Stock EOY$2,795,939CapitalStockEOYAmt
Additional Paid In Capital BOY$0AdditionalPaidInCapitalBOYAmt
Additional Paid In Capital EOY$0AdditionalPaidInCapitalEOYAmt
Retained Earning BOY$0RetainedEarningBOYAmt
Retained Earning EOY$0RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY$2,770,890TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$2,795,939TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$2,770,890TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$2,795,939TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$2,770,890TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses$25,049ExcessRevenueOverExpensesAmt
Other Increases$0OtherIncreasesAmt
Subtotal$2,795,939SubtotalAmt
Other Decreases$0OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY$2,795,939TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (5 entries)

PropertyPropertyDescHow AcquiredHowAcquiredCdAcquiredAcquiredDtSoldSoldDtGross Sales PriceGrossSalesPriceAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmtCost Or Other BasisCostOrOtherBasisAmt
WELLS FARGO CALL MAGELLAN MIDSTREAMP2017-04-212017-01-09$656$656$656
JOHNSON AND JOHNSONP1953-05-272017-04-21$120,643$18,663$18,663$101,980
SEC 1231 GAIN FROM R/E PARTNERSHIPP$15,084$15,084$15,084
L/T GAIN FROM R/E PARTNERSHIPP$315,361$315,361$315,361
CAPITAL GAINS DIVIDENDSP$6,686$6,686$6,686
FieldValueIRS element (for citing)
Capital Gain Net Income$356,450CapitalGainNetIncomeAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

FieldValueIRS element (for citing)
Liable Section4942 Tax0LiableSection4942TaxInd
Adjusted Qlfy Distri Yr1$512,518AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1$2,748,232NetVlNoncharitableAssetsYr1Amt
Distribution Yr10.186490DistributionYr1Rt
Adjusted Qlfy Distri Yr2$372,296AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2$2,725,807NetVlNoncharitableAssetsYr2Amt
Distribution Yr20.136582DistributionYr2Rt
Adjusted Qlfy Distri Yr3$505,842AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3$2,646,266NetVlNoncharitableAssetsYr3Amt
Distribution Yr30.191153DistributionYr3Rt
Adjusted Qlfy Distri Yr4$215,309AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4$2,777,228NetVlNoncharitableAssetsYr4Amt
Distribution Yr40.077527DistributionYr4Rt
Adjusted Qlfy Distri Yr5$185,735AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5$2,358,628NetVlNoncharitableAssetsYr5Amt
Distribution Yr50.078747DistributionYr5Rt
Total Distribution0.670499TotalDistributionRt
Average Distribution0.134100AverageDistributionRt
Net Vl Noncharitable Assets$2,936,815NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets$393,827AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct$3,695NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct$397,522AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions$361,394QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$7,390InvestmentIncomeExciseTaxAmt
Tax Under Section511$0TaxUnderSection511Amt
Subtotal$7,390SubtotalAmt
Subtitle A Tax$0SubtitleATaxAmt
Tax Based On Investment Income$7,390TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$3,881EstimatedPlusOvpmtIncmTxAmt
Extsn Request Income Tax Paid$0ExtsnRequestIncomeTaxPaidAmt
Backup Withholding Withheld$0BackupWithholdingWithheldAmt
Total Payments And Credits$3,881TotalPaymentsAndCreditsAmt
Es Penalty$0EsPenaltyAmt
Tax Due$3,509TaxDueAmt

Statements Regarding Acty StatementsRegardingActyGrp

FieldValueIRS element (for citing)
Legislative Political Acty0LegislativePoliticalActyInd
More Than100 Spent0MoreThan100SpentInd
Form1120 POL Filed0Form1120POLFiledInd
Section4955 Organization Tax$0Section4955OrganizationTaxAmt
Section4955 Managers Tax$0Section4955ManagersTaxAmt
Tax Reimbursed$0TaxReimbursedAmt
Activities Not Previously Rpt0ActivitiesNotPreviouslyRptInd
Changes To Articles Or Bylaws0ChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Organization Dissolved Etc0OrganizationDissolvedEtcInd
Section508e Rqr SatisfiedYes (1)Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (1)AtLeast5000InAssetsInd
Org Report Or Register StateNYOrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (1)Form990PFFiledWithAttyGenInd
Private Operating Foundation0PrivateOperatingFoundationInd
New Substantial ContributorsYes (1)NewSubstantialContributorsInd
Own Controlled Entity0OwnControlledEntityInd
Donor Advised Fund0DonorAdvisedFundInd
Comply With Public Insp RqrYes (1)ComplyWithPublicInspRqrInd
Website AddressN/AWebsiteAddressTxt
Individual With BooksMARCEL GROSSIndividualWithBooksNm
Phone7184355404PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line1691 DAHILL RDAddressLine1Txt
CityBROOKLYNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11204ZIPCd
FieldValueIRS element (for citing)
Foreign Accounts Question0ForeignAccountsQuestionInd

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

FieldValueIRS element (for citing)
Sale Or Exch Disqualified Prsn0SaleOrExchDisqualifiedPrsnInd
Brrw Or Lend Disqualified Prsn0BrrwOrLendDisqualifiedPrsnInd
Furn Goods Disqualified Prsn0FurnGoodsDisqualifiedPrsnInd
Pay Comp Disqualified Prsn0PayCompDisqualifiedPrsnInd
Transfer Ast Disqualified Prsn0TransferAstDisqualifiedPrsnInd
Payment To Government Official0PaymentToGovernmentOfficialInd
Uncorrected Prior Acts0UncorrectedPriorActsInd
Undistributed Income PY0UndistributedIncomePYInd
Business Holdings0BusinessHoldingsInd
Jeopardy Investments0JeopardyInvestmentsInd
Uncorrected PY Jeopardy Invst0UncorrectedPYJeopardyInvstInd
Influence Legislation0InfluenceLegislationInd
Influence Election0InfluenceElectionInd
Grants To Individuals0GrantsToIndividualsInd
Grants To Organizations0GrantsToOrganizationsInd
Noncharitable Purpose0NoncharitablePurposeInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
ZVI KOZICKI
210 MAPLE AVEMONSEYNY10952PRES20.00$0$0$0
JUDY KOZICKI
210 MAPLE AVEMONSEYNY10952DIRECTOR0.00$0$0$0
FieldValueIRS element (for citing)
Comp Of Hghst Pd Empl Or NONENONECompOfHghstPdEmplOrNONETxt
Other Employee Paid Over50k0OtherEmployeePaidOver50kCnt
Comp Of Hghst Pd Cntrct Or NONENONECompOfHghstPdCntrctOrNONETxt
Contractor Paid Over50k0ContractorPaidOver50kCnt

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$895,551AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$1,094,825AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$991,162FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$2,981,538TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$2,981,538AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$44,723CashDeemedCharitableAmt
Net Vl Noncharitable Assets$2,936,815NetVlNoncharitableAssetsAmt
Minimum Investment Return$146,841MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$146,841MinimumInvestmentReturnAmt
Tax Based On Investment Income$7,390TaxBasedOnInvestmentIncomeAmt
Total Tax$7,390TotalTaxAmt
Distributable Before Adj$139,451DistributableBeforeAdjAmt
Recoveries Qualfied Distri$0RecoveriesQualfiedDistriAmt
Distributable Before Ded$139,451DistributableBeforeDedAmt
Deduction From Distributable$0DeductionFromDistributableAmt
Distributable As Adjusted$139,451DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$361,394ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Qualifying Distributions$361,394QualifyingDistributionsAmt
Pct Sect4940e Org Net Invst Incm$0PctSect4940eOrgNetInvstIncmAmt
Adjusted Qualifying Distri$361,394AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$139,451DistributableAsAdjustedAmt
Undistributed Income PY$0UndistributedIncomePYAmt
Total For Prior Years$0TotalForPriorYearsAmt
Excess Distribution Cyov Yr5$71,127ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr4$85,146ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr3$382,003ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2$244,788ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1$380,566ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov$1,163,630TotalExcessDistributionCyovAmt
Qualifying Distributions$361,394QualifyingDistributionsAmt
Applied To Year1$0AppliedToYear1Amt
Applied To Prior Years$0AppliedToPriorYearsAmt
Treated As Distri From Corpus$0TreatedAsDistriFromCorpusAmt
Applied To Current Year$139,451AppliedToCurrentYearAmt
Remaining Distri From Corpus$221,943RemainingDistriFromCorpusAmt
Excess Distri Cyov App CY Corpus$0ExcessDistriCyovAppCYCorpusAmt
Excess Distribution Cyov App CY$0ExcessDistributionCyovAppCYAmt
Total Corpus$1,385,573TotalCorpusAmt
Prior Year Undistributed Incm$0PriorYearUndistributedIncmAmt
Prior Year Deficiency Or Tax$0PriorYearDeficiencyOrTaxAmt
Taxable1$0Taxable1Amt
Taxable2$0Taxable2Amt
Undistributed Income CY$0UndistributedIncomeCYAmt
Corpus Distri170b1 E Or4942g3$0CorpusDistri170b1EOr4942g3Amt
Excess Distri Cyov From Yr5$71,127ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$1,314,446ExcessDistriCyovToNextYrAmt
Excess From Year4$85,146ExcessFromYear4Amt
Excess From Year3$382,003ExcessFromYear3Amt
Excess From Year2$244,788ExcessFromYear2Amt
Excess From Year1$380,566ExcessFromYear1Amt
Excess From Current Year$221,943ExcessFromCurrentYearAmt

Supplementary Information SupplementaryInformationGrp

FieldValueIRS element (for citing)
Contributing ManagerZVI KOZICKIContributingManagerNm
Only Contri To PreselectedYes (X)OnlyContriToPreselectedInd

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (28 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
A TIME
1318 48TH STREETBROOKLYNNY11219NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$8,900
BAIS ROCHEL
145 SADDLE RIVER RDAIRMONTNY10952NONEPCTO CARRY OUT THEIE EXEMPT FUNCTION$3,310
BAIS YAKOV TEACHERS
4421 15TH AVEBROOKLYNNY11219NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$5,680
CONG KHAL TORAS CHAIM
5228 NEW UTRECT AVEBROOKLYNNY11219NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$45,728
CONG KOLLEL LOMDEI SHAS
445 S PASCACK RDSPRING VALLEYNY10977NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$4,370
CONG MACHNA SHALVA
5001 14TH AVEBROOKLYNNY11219NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$5,925
CONG TZEMACH TZADIK
1383 44TH STREETBROOKLYNNY11219NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$1,380
CONG YETEV LEV
1350 53RD STREETBROOKLYNNY11219NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$4,000
EIZER BACHURIM
74 W ECKERSON RDSPRING VALLEYNY10977NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$4,950
GAN EZRA
UNAMED ROADSPRING VALLEYNY10977NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$10,000
HATZOLAH
371 NY-306MONSEYNY10952NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$2,500
KOLLEL AHAVAS YERUSHALAYIM
269 BEACH 135TH STREETBELLE HARBORNY11694NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$8,095
KOLLEL EMES VEMUNAH
25 PHYLLIS TERRACEMONSEYNY10952NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$34,940
KOLLEL MISHNAS MENACHEM
1483 UNION STREETBROOKLYNNY11213NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$8,600
MIFAL V'CHESED
1933 50TH STBROOKLYNNY11204NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$8,050
MOSDOS VIZNITZ
25 PHYLLIS TERRACEMONSEYNY10952NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$33,545
RADOMSK LAKEWOOD
45 WHISPERING PINES LNLAKEWOODNJ08701NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$3,960
RCCS
762 BEDFORD AVEBROOKLYNNY11219NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$1,800
RIVKA LAUFER BIKUR CHOLIM
1406 57TH STREETBROOKLYNNY11219NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$1,000
SERET VIZHNITZ
4607 14TH AVEBROOKLYNNY11219NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$2,500
VARIOUS MISC COTRIBUTIONS
36 PHYLISS LNMONSEYNY10952NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$74,771
VIZNITZ MONSEY
52 ADAR CTMONSEYNY10952NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$7,200
YESHIVA AHAVAS YISROEL
2 LEE AVEBROOKLYNNY11211NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$9,725
YESHIVAS MEOR HATALMUD
1368 39TH STREETBROOKLYNNY11218NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$10,800
YESHIVAS BOBOV
1533 48TH STREETBROOKLYNNY11219NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$2,500
YESHIVAS IMREI CHAIM
1237 53RD STREETBROOKLYNNY11219NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$9,400
YESHIVAS MKOR CHAIM
160 LOCUST STREETLAKEWOODNJ08701NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$3,600
YESHIVAS VIZNITZ
15 ELYON RDMONSEYNY10952NONEPCTO CARRY OUT THEIR EXEMPT FUNCTION$42,115
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$359,344TotalGrantOrContriPdDurYrAmt
Total Grant Or Contri Apprv Fut$0TotalGrantOrContriApprvFutAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$589ExclusionAmt

Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$25,738ExclusionAmt

Net Rntl Incm Re Not Debt Fincd Prop NetRntlIncmReNotDebtFincdProp

FieldValueIRS element (for citing)
Exclusion16ExclusionCd
Exclusion$2,083ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion$356,450ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$0UnrelatedBusinessTaxblIncmAmt
Exclusion$384,860ExclusionAmt
Related Or Exempt Function Incm$0RelatedOrExemptFunctionIncmAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$384,860TotalIncomeProducingActyAmt

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

FieldValueIRS element (for citing)
Trnsfr Of Cash To Nonchrtbl EO0TrnsfrOfCashToNonchrtblEOInd
Trnsfr Other Asset Nonchrtbl EO0TrnsfrOtherAssetNonchrtblEOInd
Sales Or Exchanges Of Assets0SalesOrExchangesOfAssetsInd
Purchase Of Assets Nonchrtbl EO0PurchaseOfAssetsNonchrtblEOInd
Rental Of Facilities Oth Assets0RentalOfFacilitiesOthAssetsInd
Reimbursement Arrangements0ReimbursementArrangementsInd
Loans Or Loan Guarantees0LoansOrLoanGuaranteesInd
Performance Of Services Etc0PerformanceOfServicesEtcInd
Sharing Of Facilities Etc0SharingOfFacilitiesEtcInd
Relationships Nonchrtbl EO0RelationshipsNonchrtblEOInd

Schedule B IRS990ScheduleB

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
General RuleYes (X)GeneralRuleInd

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
Contributor1ContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1ZVI KOZICKIBusinessNameLine1Txt

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1210 MAPLE AVEAddressLine1Txt
CityMONSEYCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10952ZIPCd
FieldValueIRS element (for citing)
Total Contributions$13,655TotalContributionsAmt
Person ContributionYes (X)PersonContributionInd

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryACCOUNTINGCategoryTxt
Amt$3,000Amt
Net Investment Income$1,500NetInvestmentIncomeAmt
Disbursements Charitable Prps$1,500DisbursementsCharitablePrpsAmt

General Explanation Attachment GeneralExplanationAttachment

General Explanation GeneralExplanationGrp

FieldValueIRS element (for citing)
IdentifierGRANTS AND CONTRIBUTIONS PAIDIdentifierTxt
Form And Line ReferenceFORM 990PF PART XV LINE 3FormAndLineReferenceDesc
Medium ExplanationGRANTS AND CONTRIBUTIONS PAIDA TIME 27,830CHAIM V'CHESED 1,000CONG AHAVAS TZEDAKA V'CESED 150,000CONG ATERETH YEHOSHUA 20,000CONG ERETZ HACHAIM 5,000CONG BAIS HALEVI 2,750CONG CHESHEK SHLOMO 1,180CONG KHAL TORAS CHAIM 60,735CONG MIFAL CHAVRUSA 3,000CONG TZEMACH TZADIK 1,560CONG YESHUOS MOSHE 40,000EIZER L'BACHURIM 3,420ICHUD MOSDOS HACHINUCH 6,000KIPAS HACHZOKAS CHASANIM 5,000KOLEL EMES V'EMUNAH 21,980KOLLEL BOKER MISHNAS MENACHEM 2,810MERKAZ HAKOLILIM SQUARE 30,000MISGOV L'DOCH 1,380MOSDOS VIZNITZ 8,240TALMUD TORAH IMREI CHAIM 2,000TOMCHEI SHABBOS 10,000VARIOUS MISC CNTRIBUTIONS 74,518YESHIVA VIZNITZ 35,320 TOTAL 513,723MediumExplanationTxt

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOtherGrp

FieldValueIRS element (for citing)
Category Or ItemMUTUAL FUNDSCategoryOrItemTxt
Listed At Cost Or FMVAT COSTListedAtCostOrFMVCd
Book Value$764,836BookValueAmt
EOYFMV$1,068,619EOYFMVAmt

Other Assets Schedule OtherAssetsSchedule

Other Assets Schedule OtherAssetsScheduleGrp (2 entries)

DescDescBOY Book ValueBOYBookValueAmtEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
INVESTMENT IN PARTNERSHIPS$375,987$414,438$377,543
LOANS AND EXCHANGE$711,770$406,770$406,770

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (7 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
CONSULTANT$7,500$7,500$0
FOREIGN TAXES DIVIDENDS$564$564$0
NYS FILING FEES$550$0$550
MISCELLANEOUS$6$0$0
ORDINARY LOSS FROM MAGELLAN MIDSTREAM PARTNERS$2,502$2,502$0
MAINTENANCE$10,531$10,531$0
REAL ESTATE TAXES$4,000$4,000$0

Substantial Contributors Sch SubstantialContributorsSch

Substantial Contributor Detail SubstantialContributorDetail

FieldValueIRS element (for citing)
PersonZVI KOZICKIPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1210 MAPLE AVEAddressLine1Txt
CityMONSEYCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10952ZIPCd

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