KOSCIUSKO 21ST CENTURY FOUNDATION INC: Form 990PF, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
KOSCIUSKO 21ST CENTURY FOUNDATION INC (EIN 35-1187105)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-05-04
IRS object ID
201801249349100925
Schema version
2017v2.2
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)
Return2018-05-04T15:32:24-05:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN351178661PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BLUE & CO LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 N MERIDIAN ST SUITE 200AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN351187105EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KOSCIUSKO 21ST CENTURY FOUNDATION INCBusinessNameLine1Txt
Business Name Line2AKA K21 HEALTH FOUNDATIONBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlKOSCBusinessNameControlTxt
Phone5742695188PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12170 N POINTE DRIVEAddressLine1Txt
CityWARSAWCityNm
State AbbreviationINStateAbbreviationCd
ZIP46582ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRICH HADDADPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone5742695188PhoneNum
Signature2018-05-04SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAMBER KOCHER CPAPreparerPersonNm
PTINP00418596PTIN
Phone3176334705PhoneNum
Preparation2018-05-04PreparationDt
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$76,458,820FMVAssetsEOYAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$530,592ContriRcvdRevAndExpnssAmt
Interest On Sav Rev And Expnss$590,450InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$590,450InterestOnSavNetInvstIncmAmt
Dividends Rev And Expnss$1,036,491DividendsRevAndExpnssAmt
Dividends Net Invst Incm$1,036,491DividendsNetInvstIncmAmt
Gross Rents Rev And Expnss$230,898GrossRentsRevAndExpnssAmt
Gross Rents Net Invst Incm$230,898GrossRentsNetInvstIncmAmt
Net Rental Income Or Loss$78,036NetRentalIncomeOrLossAmt
Net Gain Sale Ast Rev And Expnss$1,226,892NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$46,660,314GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$1,226,892CapGainNetIncmNetInvstIncmAmt
Other Income Rev And Expnss$1,612OtherIncomeRevAndExpnssAmt
Other Income Net Invst Incm$1,612OtherIncomeNetInvstIncmAmt
Other Income Adj Net Incm$0OtherIncomeAdjNetIncmAmt
Total Rev And Expnss$3,616,935TotalRevAndExpnssAmt
Total Net Invst Incm$3,086,343TotalNetInvstIncmAmt
Total Adj Net Incm$0TotalAdjNetIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$185,622CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$0CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Adj Net Incm$0CompOfcrDirTrstAdjNetIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl$185,622CompOfcrDirTrstDsbrsChrtblAmt
Oth Empl Slrs Wgs Rev And Expnss$78,908OthEmplSlrsWgsRevAndExpnssAmt
Oth Empl Slrs Wgs Net Invst Incm$0OthEmplSlrsWgsNetInvstIncmAmt
Oth Empl Slrs Wgs Adj Net Incm$0OthEmplSlrsWgsAdjNetIncmAmt
Oth Empl Slrs Wgs Dsbrs Chrtbl$78,908OthEmplSlrsWgsDsbrsChrtblAmt
Pension Empl Bnft Rev And Expnss$26,064PensionEmplBnftRevAndExpnssAmt
Pension Empl Bnft Net Invst Incm$0PensionEmplBnftNetInvstIncmAmt
Pension Empl Bnft Adj Net Incm$0PensionEmplBnftAdjNetIncmAmt
Pension Empl Bnft Dsbrs Chrtbl$26,064PensionEmplBnftDsbrsChrtblAmt
Accounting Fees Rev And Expnss$17,515AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm$0AccountingFeesNetInvstIncmAmt
Accounting Fees Adj Net Incm$0AccountingFeesAdjNetIncmAmt
Accounting Fees Chrtbl Prps$17,515AccountingFeesChrtblPrpsAmt
Other Prof Fees Rev And Expnss$233,013OtherProfFeesRevAndExpnssAmt
Other Prof Fees Net Invst Incm$233,013OtherProfFeesNetInvstIncmAmt
Other Prof Fees Adj Net Incm$0OtherProfFeesAdjNetIncmAmt
Other Prof Fees Dsbrs Chrtbl$0OtherProfFeesDsbrsChrtblAmt
Taxes Rev And Expnss$96,618TaxesRevAndExpnssAmt
Taxes Net Invst Incm$0TaxesNetInvstIncmAmt
Taxes Adj Net Incm$0TaxesAdjNetIncmAmt
Taxes Dsbrs Chrtbl$0TaxesDsbrsChrtblAmt
Deprec And Dpltn Rev And Expnss$154,155DeprecAndDpltnRevAndExpnssAmt
Deprec And Dpltn Net Invst Incm$151,161DeprecAndDpltnNetInvstIncmAmt
Deprec And Dpltn Adj Net Incm$0DeprecAndDpltnAdjNetIncmAmt
Occupancy Rev And Expnss$40,982OccupancyRevAndExpnssAmt
Occupancy Net Invst Incm$0OccupancyNetInvstIncmAmt
Occupancy Adj Net Incm$0OccupancyAdjNetIncmAmt
Occupancy Dsbrs Chrtbl$40,982OccupancyDsbrsChrtblAmt
Trav Conf Meeting Rev And Expnss$7,644TravConfMeetingRevAndExpnssAmt
Trav Conf Meeting Net Invst Incm$0TravConfMeetingNetInvstIncmAmt
Trav Conf Meeting Adj Net Incm$0TravConfMeetingAdjNetIncmAmt
Trav Conf Meeting Dsbrs Chrtbl$7,644TravConfMeetingDsbrsChrtblAmt
Printing And Pub Rev And Expnss$2,645PrintingAndPubRevAndExpnssAmt
Printing And Pub Net Invst Incm$0PrintingAndPubNetInvstIncmAmt
Printing And Pub Adj Net Incm$0PrintingAndPubAdjNetIncmAmt
Printing And Pub Dsbrs Chrtbl$2,645PrintingAndPubDsbrsChrtblAmt
Other Expenses Rev And Expnss$928,298OtherExpensesRevAndExpnssAmt
Other Expenses Net Invst Incm$1,701OtherExpensesNetInvstIncmAmt
Other Expenses Adj Net Incm$0OtherExpensesAdjNetIncmAmt
Other Expenses Dsbrs Chrtbl$120,586OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$1,771,464TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$385,875TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Adj Net Incm$0TotOprExpensesAdjNetIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$479,966TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$2,731,240ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$2,732,649ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$4,502,704TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$385,875TotalExpensesNetInvstIncmAmt
Total Expenses Adj Net Incm$0TotalExpensesAdjNetIncmAmt
Total Expenses Dsbrs Chrtbl$3,212,615TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses-$885,769ExcessRevenueOverExpensesAmt
Net Investment Income$2,700,468NetInvestmentIncomeAmt
Adjusted Net Income$0AdjustedNetIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Sav And Temp Cash Invst BOY$989,203SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$1,142,163SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$1,142,163SavAndTempCashInvstEOYFMVAmt
Prepaid Expenses BOY$8,668PrepaidExpensesBOYAmt
Prepaid Expenses EOY$6,420PrepaidExpensesEOYAmt
Prepaid Expenses EOYFMV$6,420PrepaidExpensesEOYFMVAmt
US Government Obligations BOY$5,871,192USGovernmentObligationsBOYAmt
US Government Obligations EOY$4,442,800USGovernmentObligationsEOYAmt
US Govt Obligations EOYFMV$4,399,699USGovtObligationsEOYFMVAmt
Corporate Stock BOY$31,647,424CorporateStockBOYAmt
Corporate Stock EOY$30,811,741CorporateStockEOYAmt
Corporate Stock EOYFMV$44,960,813CorporateStockEOYFMVAmt
Corporate Bonds BOY$9,453,825CorporateBondsBOYAmt
Corporate Bonds EOY$7,579,592CorporateBondsEOYAmt
Corporate Bonds EOYFMV$7,488,611CorporateBondsEOYFMVAmt
Invst Land Cost Or Other Basis$2,321,930InvstLandCostOrOtherBasisAmt
Invst Land Accum Depreciation$498,829InvstLandAccumDepreciationAmt
Land Bldg Investments BOY$1,545,947LandBldgInvestmentsBOYAmt
Land Bldg Investments EOY$1,823,101LandBldgInvestmentsEOYAmt
Land Bldg Investments EOYFMV$1,823,101LandBldgInvestmentsEOYFMVAmt
Other Investments BOY$8,657,118OtherInvestmentsBOYAmt
Other Investments EOY$12,528,870OtherInvestmentsEOYAmt
Other Investments EOYFMV$14,486,810OtherInvestmentsEOYFMVAmt
Land Bldg Equip Cost Or Other Bss$69,098LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$65,710LandBldgEquipAccumDeprecAmt
Land BOY$298,729LandBOYAmt
Land EOY$3,388LandEOYAmt
Land EOYFMV$3,388LandEOYFMVAmt
Other Assets BOY$2,835,381OtherAssetsBOYAmt
Other Assets EOY$2,147,815OtherAssetsEOYAmt
Other Assets EOYFMV$2,147,815OtherAssetsEOYFMVAmt
Total Assets BOY$61,307,487TotalAssetsBOYAmt
Total Assets EOY$60,485,890TotalAssetsEOYAmt
Total Assets EOYFMV$76,458,820TotalAssetsEOYFMVAmt
Grants Payable BOY$298,983GrantsPayableBOYAmt
Grants Payable EOY$293,541GrantsPayableEOYAmt
Other Liabilities BOY$90,116OtherLiabilitiesBOYAmt
Other Liabilities EOY$159,729OtherLiabilitiesEOYAmt
Total Liabilities BOY$389,099TotalLiabilitiesBOYAmt
Total Liabilities EOY$453,270TotalLiabilitiesEOYAmt
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind
Unrestricted BOY$60,369,514UnrestrictedBOYAmt
Unrestricted EOY$59,288,022UnrestrictedEOYAmt
Temporarily Restricted BOY$548,874TemporarilyRestrictedBOYAmt
Temporarily Restricted EOY$744,598TemporarilyRestrictedEOYAmt
Tot Net Ast Or Fund Balances BOY$60,918,388TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$60,032,620TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$61,307,487TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$60,485,890TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$60,918,388TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses-$885,769ExcessRevenueOverExpensesAmt
Other Increases$6,961,330OtherIncreasesAmt
Subtotal$66,993,949SubtotalAmt
Other Decreases$6,961,329OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY$60,032,620TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp

FieldValueIRS element (for citing)
PropertySALE OF SECURITIESPropertyDesc
How AcquiredPHowAcquiredCd
Gross Sales Price$46,660,314GrossSalesPriceAmt
Cost Or Other Basis$45,433,422CostOrOtherBasisAmt
Gain Or Loss$1,226,892GainOrLossAmt
Gains Minus Excess Or Losses$1,226,892GainsMinusExcessOrLossesAmt
FieldValueIRS element (for citing)
Capital Gain Net Income$1,226,892CapitalGainNetIncomeAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

FieldValueIRS element (for citing)
Liable Section4942 Tax0LiableSection4942TaxInd
Adjusted Qlfy Distri Yr1$3,694,327AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1$64,963,804NetVlNoncharitableAssetsYr1Amt
Distribution Yr10.056867DistributionYr1Rt
Adjusted Qlfy Distri Yr2$4,209,526AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2$66,164,115NetVlNoncharitableAssetsYr2Amt
Distribution Yr20.063622DistributionYr2Rt
Adjusted Qlfy Distri Yr3$3,838,345AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3$67,153,038NetVlNoncharitableAssetsYr3Amt
Distribution Yr30.057158DistributionYr3Rt
Adjusted Qlfy Distri Yr4$3,352,218AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4$62,610,514NetVlNoncharitableAssetsYr4Amt
Distribution Yr40.053541DistributionYr4Rt
Adjusted Qlfy Distri Yr5$3,002,834AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5$57,062,361NetVlNoncharitableAssetsYr5Amt
Distribution Yr50.052624DistributionYr5Rt
Total Distribution0.283812TotalDistributionRt
Average Distribution0.056762AverageDistributionRt
Net Vl Noncharitable Assets$70,162,009NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets$3,982,536AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct$27,005NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct$4,009,541AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions$4,020,411QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Domestic Org Meeting Sect4940eYes (X)DomesticOrgMeetingSect4940eInd
Investment Income Excise Tax$27,005InvestmentIncomeExciseTaxAmt
Tax Under Section511$0TaxUnderSection511Amt
Subtotal$27,005SubtotalAmt
Subtitle A Tax$0SubtitleATaxAmt
Tax Based On Investment Income$27,005TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$34,859EstimatedPlusOvpmtIncmTxAmt
Extsn Request Income Tax Paid$0ExtsnRequestIncomeTaxPaidAmt
Backup Withholding Withheld$0BackupWithholdingWithheldAmt
Total Payments And Credits$34,859TotalPaymentsAndCreditsAmt
Form2220 AttachedYes (X)Form2220AttachedInd
Es Penalty$0EsPenaltyAmt
Overpayment$7,854OverpaymentAmt
Applied To ES Tax$7,854AppliedToESTaxAmt
Refund$0RefundAmt

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 StateINOrgReportOrRegisterStateCd
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 AddressWWW.K21FOUNDATION.ORGWebsiteAddressTxt
Individual With BooksRICH HADDADIndividualWithBooksNm
Phone5742695188PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line12170 N POINTE DRIVEAddressLine1Txt
CityWARSAWCityNm
State AbbreviationINStateAbbreviationCd
ZIP46582ZIPCd
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 (18 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
RICHARD HADDAD
2170 NORTH POINTE DRIVEWARSAWIN46582PRESIDENT40.00$185,622$5,464$0
SCOTT TUCKER
2170 NORTH POINTE DRIVEWARSAWIN46582CHAIRMAN1.00$0$0$0
ANDREW GROSSNICKLE
2170 NORTH POINTE DRIVEWARSAWIN46582VICE CHAIRMAN1.00$0$0$0
DANA KRULL
2170 NORTH POINTE DRIVEWARSAWIN46582TREASURER1.00$0$0$0
SHARI BOYLE
2170 NORTH POINTE DRIVEWARSAWIN46582SECRETARY1.00$0$0$0
BECKY ALLES
2170 NORTH POINTE DRIVEWARSAWIN46582DIRECTOR1.00$0$0$0
DR DAVID DICK
2170 NORTH POINTE DRIVEWARSAWIN46582DIRECTOR1.00$0$0$0
STEVE GRILL
2170 NORTH POINTE DRIVEWARSAWIN46582DIRECTOR1.00$0$0$0
JOE HAWN
2170 NORTH POINTE DRIVEWARSAWIN46582DIRECTOR1.00$0$0$0
ROSY JANSMA
2170 NORTH POINTE DRIVEWARSAWIN46582DIRECTOR1.00$0$0$0
RICK KERLIN
2170 NORTH POINTE DRIVEWARSAWIN46582DIRECTOR1.00$0$0$0
ANITA KISHAN
2170 NORTH POINTE DRIVEWARSAWIN46582DIRECTOR1.00$0$0$0
JENNIFER LUCHT
2170 NORTH POINTE DRIVEWARSAWIN46582DIRECTOR1.00$0$0$0
MAX MOCK
2170 NORTH POINTE DRIVEWARSAWIN46582DIRECTOR1.00$0$0$0
LISA O'NEILL
2170 NORTH POINTE DRIVEWARSAWIN46582DIRECTOR1.00$0$0$0
KEVIN ROBERTS
2170 NORTH POINTE DRIVEWARSAWIN46582DIRECTOR1.00$0$0$0
STEVE ROSS
2170 NORTH POINTE DRIVEWARSAWIN46582DIRECTOR1.00$0$0$0
BILL SMITH
2170 NORTH POINTE DRIVEWARSAWIN46582DIRECTOR1.00$0$0$0
FieldValueIRS element (for citing)
Comp Of Hghst Pd Empl Or NONENONECompOfHghstPdEmplOrNONETxt
Other Employee Paid Over50k0OtherEmployeePaidOver50kCnt

Compensation Of Hghst Pd Cntrct CompensationOfHghstPdCntrctGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdService TypeServiceTypeTxtCompensationCompensationAmt
WJ CAREY CONSTRUCTION
PO BOX 534SOUTH WHITLEYIN46787GENERAL CONTRACTOR$120,396
MARQUETTE ASSOCIATES
180 N LASALLE SUITE 3500CHICAGOIL60601INVESTMENT CONSULTING$68,000
FieldValueIRS element (for citing)
Contractor Paid Over50k0ContractorPaidOver50kCnt

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

FieldValueIRS element (for citing)
Description1FORGIVENESS OF CURRENT LOAN MORTGAGE PRINCIPAL AND INTEREST DUE FROM KOSCIUSKO HEALTH SERVICES PAVILION, INC., A SECTION 501(C(3) ORGANIZATION.Description1Txt
Expenses1$799,208Expenses1Amt
Description2FORGIVENESS OF CURRENT LOAN PRINCIPAL AND INTEREST DUE FROM HARVEST WITH A HEART, INC. A SECTION 501(C)(3) ORGANIZATION.Description2Txt
Expenses2$8,588Expenses2Amt
Total$807,796TotalAmt

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$70,812,625AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$417,841AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$71,230,466TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$71,230,466AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$1,068,457CashDeemedCharitableAmt
Net Vl Noncharitable Assets$70,162,009NetVlNoncharitableAssetsAmt
Minimum Investment Return$3,508,100MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$3,508,100MinimumInvestmentReturnAmt
Tax Based On Investment Income$27,005TaxBasedOnInvestmentIncomeAmt
Total Tax$27,005TotalTaxAmt
Distributable Before Adj$3,481,095DistributableBeforeAdjAmt
Recoveries Qualfied Distri$0RecoveriesQualfiedDistriAmt
Distributable Before Ded$3,481,095DistributableBeforeDedAmt
Deduction From Distributable$0DeductionFromDistributableAmt
Distributable As Adjusted$3,481,095DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$3,212,615ExpensesAndContributionsAmt
Program Related Invst Total$807,796ProgramRelatedInvstTotalAmt
Qualifying Distributions$4,020,411QualifyingDistributionsAmt
Pct Sect4940e Org Net Invst Incm$27,005PctSect4940eOrgNetInvstIncmAmt
Adjusted Qualifying Distri$3,993,406AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$3,481,095DistributableAsAdjustedAmt
Undistributed Income PY$0UndistributedIncomePYAmt
Total For Prior Years$0TotalForPriorYearsAmt
Excess Distribution Cyov Yr3$87,852ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2$982,854ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1$515,855ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov$1,586,561TotalExcessDistributionCyovAmt
Qualifying Distributions$4,020,411QualifyingDistributionsAmt
Applied To Year1$0AppliedToYear1Amt
Applied To Prior Years$0AppliedToPriorYearsAmt
Treated As Distri From Corpus$0TreatedAsDistriFromCorpusAmt
Applied To Current Year$3,481,095AppliedToCurrentYearAmt
Remaining Distri From Corpus$539,316RemainingDistriFromCorpusAmt
Excess Distri Cyov App CY Corpus$0ExcessDistriCyovAppCYCorpusAmt
Excess Distribution Cyov App CY$0ExcessDistributionCyovAppCYAmt
Total Corpus$2,125,877TotalCorpusAmt
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$0ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$2,125,877ExcessDistriCyovToNextYrAmt
Excess From Year3$87,852ExcessFromYear3Amt
Excess From Year2$982,854ExcessFromYear2Amt
Excess From Year1$515,855ExcessFromYear1Amt
Excess From Current Year$539,316ExcessFromCurrentYearAmt

Supplementary Information SupplementaryInformationGrp

Application Submission Info ApplicationSubmissionInfoGrp

FieldValueIRS element (for citing)
Recipient PersonKOSCIUSKO 21ST CENTURY FOUNDATION IRecipientPersonNm

Recipient US Address RecipientUSAddress

FieldValueIRS element (for citing)
Address Line12170 NORTH POINTE DRIVEAddressLine1Txt
CityWARSAWCityNm
State AbbreviationINStateAbbreviationCd
ZIP46582ZIPCd
FieldValueIRS element (for citing)
Recipient Phone5742695188RecipientPhoneNum
Form And Info And MaterialsSEE STATEMENTS 20 AND 21.FormAndInfoAndMaterialsTxt
Submission DeadlinesSEE STATEMENTS 20 AND 21.SubmissionDeadlinesTxt
Restrictions On AwardsSEE STATEMENTS 20 AND 21.RestrictionsOnAwardsTxt

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (133 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
CANCER CARE GRANT AMOS ENGLAND
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$2,069
CANCER CARE GRANT AMY VOTH-REED
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$2,050
CANCER CARE GRANT ANITA SORIANO
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$4,851
CANCER CARE GRANT ANTHONY GEE
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$4,700
CANCER CARE GRANT CARLOTTA TACKETT
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,420
CANCER CARE GRANT CATHRYN TAYLOR
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,000
CANCER CARE GRANT CAYLE WOODWARD
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$2,000
CANCER CARE GRANT CHARLES SWIHART
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$2,417
CANCER CARE GRANT CLINT CARDEN
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$2,900
CANCER CARE GRANT DANIEL FATTORUSSO
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$4,918
CANCER CARE GRANT DAVID COLLINS
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,920
CANCER CARE GRANT DAVID MCDONALD
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$3,575
CANCER CARE GRANT DELIA NAVARRO
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$2,900
CANCER CARE GRANT DIANA SALDIVAR
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$2,288
CANCER CARE GRANT DONALD CAVERLEY
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$2,324
CANCER CARE GRANT ERICA WEISSER
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$3,000
CANCER CARE GRANT ERIN ALLISON
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,500
CANCER CARE GRANT EVERETT GILLMAN
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,100
CANCER CARE GRANT GARIN VOORHEIS
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$2,500
CANCER CARE GRANT HEIDI PAUL
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$2,860
CANCER CARE GRANT ISAAC CROW
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,000
CANCER CARE GRANT JAMES SHELDON
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$5,168
CANCER CARE GRANT JAY RICE
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,630
CANCER CARE GRANT JEFFREY DENNIS
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,019
CANCER CARE GRANT JETT ROE
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,450
CANCER CARE GRANT JOE DEWITT
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$2,167
CANCER CARE GRANT JON NYCE
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$4,000
CANCER CARE GRANT JUAN GALLEGOS
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,648
CANCER CARE GRANT KENNETH NINE
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,214
CANCER CARE GRANT LISA SEITZ
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$3,000
CANCER CARE GRANT LORENE MARVEL
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$5,923
CANCER CARE GRANT LYNDA SNYDER
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,906
CANCER CARE GRANT MARCELLE HEADY
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$5,498
CANCER CARE GRANT MARSHA MCGLENNEN
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$2,887
CANCER CARE GRANT NICOLE KRILL
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,484
CANCER CARE GRANT NIKOLAI MARTINEZ
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$4,671
CANCER CARE GRANT PARKVIEW WARSAW Y
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$19,000
CANCER CARE GRANT PATRICIA BOWSER
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$2,000
CANCER CARE GRANT PHILLIP SURFACE
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$2,380
CANCER CARE GRANT RANDALL PIPER
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$2,063
CANCER CARE GRANT RHONDA ALLEN
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$6,761
CANCER CARE GRANT RICHARD SILVEUS
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,345
CANCER CARE GRANT RON HELMAN
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,500
CANCER CARE GRANT RON OLIVER
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$2,000
CANCER CARE GRANT ROSA RAMOS
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$3,659
CANCER CARE GRANT ROSARIO NUNEZ
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,000
CANCER CARE GRANT SABRINA SHEROW
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$2,825
CANCER CARE GRANT SONIA HUNZIKER
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$3,500
CANCER CARE GRANT STACEY YOTTER
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,500
CANCER CARE GRANT STEVE CONAWAY
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,055
CANCER CARE GRANT TAMARA DRAKE
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$2,500
CANCER CARE GRANT TERESA MOSS
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$2,000
CANCER CARE GRANT TONYA OUIMET
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,000
CANCER CARE GRANT VICKI RANDALL
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,492
CANCER CARE GRANT VONDARENE PERKINS
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$3,216
CANCER CARE GRANT WES KORN
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$1,552
CANCER CARE GRANT WILLIE FIELDS
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$3,213
CANCER CARE GRANT OTHER GRANTS LESS
PO BOX 1810WARSAWIN465811810NONEIPROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS$23,082
CONDITIONAL GRANT A BRIDGE TO HOPE
499 E 450 SOUTHWARSAWIN46580NONEPCOPERATIONAL ASSISTANCE$18,000
CONDITIONAL GRANT AGAITAS
1945 PHEASANT RIDGE DRWARSAWIN46580NONEPCEQUIPMENT$5,867
CONDITIONAL GRANT AMERICAN DIABETES ASSOCIATION
6415 CASTLEWAY WEST DR STE 114INDIANAPOLISIN46250NONEPCSCHOLARSHIPS FOR CHILDREN ATTENDING DIABETES CAMP$5,375
CONDITIONAL GRANT BOWEN CENTER
2621 E JEFFERSON STWARSAWIN46580NONEPCASSESSMENT, EQUIPMENT, OPERATIONAL$46,395
CONDITIONAL GRANT CARDINAL SERVICES
504 N BAY DRWARSAWIN46580NONEPCEQUIPMENT$22,360
CONDITIONAL GRANT CITY COUNTY ATHLETIC COMPLEX
3215 W OLD RD 30WARSAWIN46580NONEPCLAND PURCHASE$175,000
CONDITIONAL GRANT CITY OF WARSAW
102 S BUFFALO STWARSAWIN46580NONEPCEQUIPMENT$68,237
CONDITIONAL GRANT CROSSWINDS
4150 ILLINOIS RDFORT WAYNEIN46804NONEPCIN-HOME COUNSELING SERVICES$20,310
CONDITIONAL GRANT GRACE COLLEGE & SEMINARY
200 SEMINARY DRIVEWINONA LAKEIN46590NONEPCRESEARCH AND FACILITY EXPANSION$579,522
CONDITIONAL GRANT HEARTLINE PREGNANCY CENTER
1515 PROVIDENT DR STE 180WARSAWIN46580NONEPCB.A.B.E. BOUTIQUE, CLINICAL SUPPLIES, CAR SEATS, STI TESTING$52,950
CONDITIONAL GRANT HOUSING OPPORTUNITIES OF WARSAW
109 W CATHERINE STMILFORDIN46542NONEPCHOME REPAIRS$26,676
CONDITIONAL GRANT KOSCIUSKO COUNTY YMCA
1305 MARINERS DRWARSAWIN46582NONEPCLIVESTRONG PROGRAM$23,100
CONDITIONAL GRANT KOSCIUSKO COUNTY COUNCIL ON AGING
800 PARK AVEWARSAWIN46580NONEPCTRANSPORTATION VAN$14,761
CONDITIONAL GRANT KOSCIUSKO HOME CARE & HOSPICE
1515 PROVIDENT DRIVE STE 250WARSAWIN46580NONEPCCHILDREN'S ORAL HEALTH, MEDICATION AND DENTAL, MEDICAL SUPPLIES$318,188
CONDITIONAL GRANT LAKE CITY BMX CLUB
5105 N DOVEWOOD TRAILWARSAWIN46582NONEPCTRACK RENOVATIONS$35,919
CONDITIONAL GRANT LAKELAND CHRISTIAN ACADEMY
1095 S 250 EWINONA LAKEIN46590NONEPCNURSE FACILITY AND EQUIPMENT$8,000
CONDITIONAL GRANT MAGICAL MEADOWS
3386 E 525 NORTHWARSAWIN46582NONEPCLAND PURCHASE$80,000
CONDITIONAL GRANT NORTHERN INDIANA HISPANIC HEALTH COALITION
323 STOCKER COURTELKHARTIN46516NONEPCOPERATIONAL FUNDING FOR BILINGUAL ADVOCATE/HEALTH FAIRS$76,250
CONDITIONAL GRANT P4C PADDLE CLUB
PO BOX 634WARSAWIN46581NONEPCEQUIPMENT$4,990
CONDITIONAL GRANT POSITIVE RESOURCE CONNECTION
525 OXFORD STREETFORT WAYNEIN46806NONEPCHEALTH TESTING SUPPLIES$3,791
CONDITIONAL GRANT QUESTA FOUNDATION
6502 CONSTITUTION DRFORT WAYNEIN46804NONEPCHEALTH SCHOLARS PROGRAM$100,000
CONDITIONAL GRANT SYRACUSE WAWASEE PARK FOUNDATION
1013 NORTH LONG DRSYRACUSEIN46567NONEPCTRAILS, ICE RINK, AND EQUIPMENT$39,870
CONDITIONAL GRANT THE ROSE HOME
PO BOX 571SYRACUSEIN46567NONEPCHOME REPAIRS AND OPERATIONAL ASSISTANCE$21,336
CONDITIONAL GRANT THE WATERSHED FOUNDATION
PO BOX 55NORTH WEBSTERIN46555NONEPCCOMMUNITY OUTREACH AND EDUCATION$17,636
CONDITIONAL GRANT TIPPECANOE VALLEY SCHOOL CORP
8643 S STATE ROAD 19AKRONIN46910NONEPCEQUIPMENT$6,413
CONDITIONAL GRANT TOWN OF WINONA LAKE
1310 PARK AVEWINONA LAKEIN46590NONEPCPATHWAY DEVELOPMENT$51,875
CONDITIONAL GRANT WARSAW COMMUNITY SCHOOLS
1 ADMINISTRATION DRWARSAWIN46580NONEPCEQUIPMENT$22,800
CONDITIONAL GRANT WAWASEE COMMUNITY SCHOOLS
502 W BROOKLYN STSYRACUSEIN46567NONEPCEQUIPMENT$5,828
CONDITIONAL GRANT OTHER GRANTS LESS THAN 1000
502 W BROOKLYN STSYRACUSEIN46567NONEPCEQUIPMENT$17,437
DIRECT GRANT 2ND MILE MISSIONS
PO BOX 733WINONA LAKEIN46590NONEPCK21 BOARD OF DIRECTORS DIRECTED DONATION$1,000
DIRECT GRANT 212 MEDIA STUDIOS
929 E CENTER STWARSAWIN46580NONEPCCOMMUNICATIONS WORKSHOP FOR NONPROFITS$2,500
DIRECT GRANT AGAITAS
1945 PHEASANT RIDGE DRWARSAWIN46580NONEPCK21 BOARD OF DIRECTORS DIRECTED DONATION$2,000
DIRECT GRANT AMERICAN DIABETES ASSOCIATION
6415 CASTLEWAY WEST DR STE 114INDIANAPOLISIN46250NONEPCK21 BOARD OF DIRECTORS DIRECTED DONATION$1,000
DIRECT GRANT BPO ELKS LODGE
310 E CENTER STWARSAWIN46580NONEPCHOLIDAY ASSISTANCE FOR POOR$1,100
DIRECT GRANT BAKER YOUTH CLUB
1401 E SMITH STWARSAWIN46580NONEPCK21 BOARD OF DIRECTORS DIRECTED DONATION$2,000
DIRECT GRANT CITY OF WARSAW
102 S BUFFALO STWARSAWIN46580NONEPCALLEY DEVELOPMENT$2,200
DIRECT GRANT GRACE COLLEGE & SEMINARY
200 SEMINARY DRIVEWINONA LAKEIN46590NONEPCK21 BOARD OF DIRECTORS DIRECTED DONATION$2,000
DIRECT GRANT HEARTLINE PREGANCY CENTER
1515 PROVIDENT DR SUITE 180WARSAWMI46580NONEPCK21 BOARD OF DIRECTORS DIRECTED DONATION$1,000
DIRECT GRANT HOUSING OPPORTUNITIES OF WARSAW
1090W CATHERINE STMILFORDIN46542NONEPCHEALTHY HOMES TRAINING$1,000
DIRECT GRANT JOE'S KIDS
902 PROVIDENT DR SUITE CWARSAWIN46580NONEPCK21 BOARD OF DIRECTORS DIRECTED DONATION$1,000
DIRECT GRANT KOSCIUSKO COUNTY COMMUNITY FOUNDATION
102 E MARKET STWARSAWIN46580NONEPCK21 BOARD OF DIRECTORS DIRECTED DONATION$1,000
DIRECT GRANT MILESTONES EARLY EDUCATION CENTER
PO BOX 316NORTH WEBSTERIN46555NONEPCK21 BOARD OF DIRECTORS DIRECTED DONATION$1,000
DIRECT GRANT NORTHSTAR MEDICAL
6540 FULTON E SUITE AADAIN49301NONEPCAED PURCHASES$4,180
DIRECT GRANT RILEY CHILDREN'S FOUNDATION
30 SOUTH MERIDIAN STINDIANAPOLISIN46204NONEPCK21 BOARD OF DIRECTORS DIRECTED DONATION$1,000
DIRECT GRANT TIPPECANOE VALLEY COMMUNITY SCHOOLS
8343 SOUTH STATE ROAD 19AKRONIN16910NONEPCK21 BOARD OF DIRECTORS DIRECTED DONATION$1,000
DIRECT GRANT WARSAW COMMUNITY SCHOOLS
1 ADMINISTRATION DRWARSAWIN46580NONEPCMENTAL HEALTH CONVOCATIONS$4,500
DIRECT GRANTS OTHER GRANTS UNDER 1000
PO BOX 1810WARSAWIN465811810NONEPCK21 BOARD OF DIRECTORS DIRECTED DONATION$7,748
UNCONDITIONAL GRANT A BRIDGE TO HOPE
499 E 450 SOUTHWARSAWIN46580NONEPCOPERATIONAL ASSISTANCE$11,580
UNCONDITIONAL GRANT AGAITAS
1945 PHEASANT RIDGE DRWARSAWIN46580NONEPCOPERATIONAL ASSISTANCE$9,500
UNCONDITIONAL GRANT ALL THINGS NEW
PO BOX 367WINONA LAKEIN46590NONEPCOPERATIONAL ASSISTANCE$6,600
UNCONDITIONAL GRANT BAKER YOUTH CLUB
1401 E SMITH STWARSAWIN46580NONEPCSUMMER FITNESS PROGRAM$26,700
UNCONDITIONAL GRANT BIG BROTHERS BIG SISTERS
499 E 450 SOUTHWARSAWIN46580NONEPCOPERATIONAL ASSISTANCE$15,000
UNCONDITIONAL GRANT BRIGHTPOINT
227 E WASHINGTON BLVDFORT WAYNEIN46804NONEPCOPERATIONAL ASSISTANCE$17,500
UNCONDITIONAL GRANT CANCER SERVICES OF NORTHEAST INDIANA
6316 MUTUAL DRIVEFORT WAYNEIN46825NONEPCDIRECT ASSISTANCE / CLIENT ADVOCACY$15,000
UNCONDITIONAL GRANT CENTER FOR LAKES AND STREAMS
200 SEMINARY DRIVEWINONA LAKEIN46590NONEPCOPERATIONAL ASSISTANCE$40,000
UNCONDITIONAL GRANT CITY-COUNTY ATHLETIC COMPLEX
3215 W OLD RD 30WARSAWIN46580NONEPCOPERATIONAL ASSISTANCE$4,800
UNCONDITIONAL GRANT COMBINED COMMUNITY SERVICES
1195 MARINERS DRWARSAWIN46582NONEPCOPERATIONAL ASSISTANCE$17,000
UNCONDITIONAL GRANT ERIN'S HOUSE FOR GRIEVING CHILDREN
5670 YMCA PARK DRVIE WESTFORT WAYNEIN46835NONEPCOPERATIONAL ASSISTANCE$6,000
UNCONDITIONAL GRANT FELLOWSHIP MISSIONS
PO BOX 382WINONA LAKEIN46590NONEPCFACILITY REPAIR$15,000
UNCONDITIONAL GRANT GRACE COLLEGE
200 SEMINARY DRIVEWINONA LAKEIN46590NONEPCCLAS OPERATING ASSISTANCE; TOBACCO CESSATION PROGRAM$52,950
UNCONDITIONAL GRANT HARVEST WITH A HEART
201 S HIGBEE STMILFORDIN36542NONEPCOPERATIONAL ASSISTANCE$6,735
UNCONDITIONAL GRANT HEARTLINE PREGNANCY CENTER
1515 PROVIDENT DRIVEWARSAWIN46580NONEPCMOBILE UNIT OPERATIONS$44,300
UNCONDITIONAL GRANT HOUSING OPPORTUNITIES OF WARSAW
109 W CATHERINE STMILFORDIN46542NONEPCOPERATIONAL ASSISTANCE$15,670
UNCONDITIONAL GRANT JOE'S KIDS
902 PROVIDENT DR SUITE CWARSAWIN46580NONEPCOPERATIONAL ASSISTANCE$8,100
UNCONDITIONAL GRANT KCV CYCLING CLUB
PO BOX 325WINONA LAKEIN46590NONEPCOPERATIONAL ASSISTANCE$9,000
UNCONDITIONAL GRANT KOSCIUSKO COMMUNITY YMCA
1305 MARINERS DRWARSAWIN46582NONEPCOPERATIONAL ASSISTANCE$8,000
UNCONDITIONAL GRANT KOSCIUSKO COUNTY COMMUNITY FOUNDATION
102 EAST MARKET STREETWARSAWIN46580NONEPCGOOD SAMARITAN FUND$62,500
UNCONDITIONAL GRANT KOSCIUSKO COUNTY SHELTER FOR ABUSE
PO BOX 12WARSAWIN46581NONEPCOPERATING TRANSITION ASSISTANCE$15,000
UNCONDITIONAL GRANT KOSCIUSKO HOME CARE & HOSPICE
1515 PROVIDENT DRIVE STE 250WARSAWIN46580NONEPCOPERATIONAL ASSISTANCE$182,200
UNCONDITIONAL GRANT LAKE CITY BMX INC
5105 N DOVEWOOD TRAILWARSAWIN46582NONEPCOPERATIONAL ASSISTANCE$10,800
UNCONDITIONAL GRANT LAKELAND YOUTH CENTER
101 W CHICAGO STSYRACUSEIN46567NONEPCOPERATIONAL ASSISTANCE$9,600
UNCONDITIONAL GRANT MAD ANTHONY'S CHILDREN'S HOPE HOUSE
7922 WEST JEFFERSON BLVDFORT WAYNEIN46804NONEPCOPERATIONAL ASSISTANCE$10,000
UNCONDITIONAL GRANT POSITIVE RESOURCE CONNECTION
7922 WEST JEFFERSON BLVDFORT WAYNEIN46804NONEPCOPERATIONAL ASSISTANCE$12,000
UNCONDITIONAL GRANT RYAN'S PLACE
PO BOX 73GOSHENIN46527NONEPCOPERATIONAL ASSISTANCE$6,000
UNCONDITIONAL GRANT THE WATERSHED FOUNDATION
PO BOX 73GOSHENIN46527NONEPCOPERATIONAL ASSISTANCE$3,400
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$2,732,649TotalGrantOrContriPdDurYrAmt
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$590,450ExclusionAmt

Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$1,036,491ExclusionAmt

Net Rntl Incm Re Not Debt Fincd Prop NetRntlIncmReNotDebtFincdProp

FieldValueIRS element (for citing)
Exclusion16ExclusionCd
Exclusion$78,036ExclusionAmt

Other Investment Incm Part VII OtherInvestmentIncmPartVIIGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$1,612ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion$1,226,892ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$0UnrelatedBusinessTaxblIncmAmt
Exclusion$2,933,481ExclusionAmt
Related Or Exempt Function Incm$0RelatedOrExemptFunctionIncmAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$2,933,481TotalIncomeProducingActyAmt

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 (8 entries)

ContributorContributorNumAddress Line1ContributorUSAddress/AddressLine1TxtCityContributorUSAddress/CityNmState AbbreviationContributorUSAddress/StateAbbreviationCdZIPContributorUSAddress/ZIPCdTotal ContributionsTotalContributionsAmtNoncash ContributionNoncashContributionIndPerson ContributionPersonContributionInd
DR AND MRS RICK SASSO
110674 WINTERWOODCARMELIN46032$201,271Yes (X)
LUTHERAN HEALTH FOUNDATION
23024 FAIRFIELD AVEFORT WAYNEIN46807$100,000Yes (X)
JOHN THOMAS HALL TRUST
35867 E ISLAND AVESYRACUSEIN46567$10,000Yes (X)
DOUGLAS SCHROCK
4631 E NORTHSHORE DRSYRACUSEIN46567$10,000Yes (X)
DONETTE SMOCK
55867 E ISLAND AVESYRACUSEIN46567$8,000Yes (X)
KCV CYCLING CLUB
6PO BOX 325WINONA LAKEIN46590$5,000Yes (X)
DONALD GUNDEN
764874 ORCHARD DRIVEGOSHENIN46526$5,000Yes (X)
BERTSCH FAMILY CHARITABLE FOUNDATION
8PO BOX 1494WARSAWIN46581$5,000Yes (X)

Non Cash Property Contribution NonCashPropertyContributionGrp

FieldValueIRS element (for citing)
Contributor1ContributorNum
Noncash PropertyMARKETABLE SECURITIESNoncashPropertyDesc
Fair Market Value$201,271FairMarketValueAmt
Received2017-12-31ReceivedDt

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryACCOUNTING FEESCategoryTxt
Amt$17,515Amt
Net Investment Income$0NetInvestmentIncomeAmt
Adjusted Net Income$0AdjustedNetIncomeAmt
Disbursements Charitable Prps$17,515DisbursementsCharitablePrpsAmt

General Explanation Attachment GeneralExplanationAttachment

General Explanation GeneralExplanationGrp (2 entries)

IdentifierIdentifierTxtForm And Line ReferenceFormAndLineReferenceDescMedium ExplanationMediumExplanationTxt
SUPPLEMENTARY INFORMATIONFORM 990-PF, PART XV, LINE 2A THROUGH 2DLINE 2, NAME OF THE GRANT PROGRAM: K21 HEALTH AND WELLNESS COMMUNITY GRANTSLINE 2A AND 2B, FORM AND CONTENT OF APPLICATION:K21 HEALTH FOUNDATION EXISTS FOR THE BENEFIT OF KOSCIUSKO COUNTY CITIZENS TO ENSURE HEALTH CARE SERVICES ARE PROVIDED, AND TO ADVANCE PREVENTION AND HEALTHY LIVING. THIS WILL BE ACCOMPLISHED BY IDENTIFYING HEALTH NEEDS IN OUR COMMUNITY AND MAINTAINING AN ENDOWMENT SO FUNDING IS AVAILABLE, THROUGH INVESTMENTS AND GRANTS, FOR THOSE NEEDS. GRANT APPLICATIONS CAN BE ACCESSED THROUGH AN ONLINE PROCESS AT WWW.K21FOUNDATION.ORG UNDER "APPLY FOR GRANTS". GRANT APPLICATIONS ARE ACCEPTED FOUR TIMES EACH YEAR. APPLICATIONS RECEIVED AFTER THESE DEADLINES WILL BE HELD UNTIL THE NEXT CYCLE. FOR ASSISTANCE COMPLETING THE APPLICATION CONTACT: GRANT COORDINATOR, HOLLY SWOVERLAND, AT (574) 269-5188 OR HSWOVERLAND@K21FOUNDATION.ORG.LINE 2C, ANY SUBMISSION DEADLINES: SUBMISSION DEADLINES ARE FEB 1ST, MAY 1ST, AUG 1ST, AND NOV 1ST.LINE 2D, RESTRICTIONS AND LIMITATIONS ON AWARDS: GRANTEES MUST MEET THE FOLLOWING REQUIREMENTS:A)NON-PROFIT AGENCY WITH VERIFIED IRS TAX-EXEMPT STATUS, OR A GOVERNMENT AGENCY. B)BE IN GOOD STANDING WITH THE INDIANA SECRETARY OF STATE AS INDICATED IN A BUSINESS ENTITY REPORT. C)BYLAWS MUST REQUIRE TERM LIMITS FOR DIRECTORS AND A ROTATING BOARD IS STRONGLY ENCOURAGED.GRANT REQUESTS MUST MEET THE FOLLOWING REQUIREMENTS:A) PROJECT, PROGRAM, OR SERVICES MUST BENEFIT RESIDENTS OF KOSCIUSKO COUNTY.B) K21 GRANT PRIORITIES ARE FOR HEALTH NEEDS OR HEALTH IMPROVEMENT. ALTHOUGH THE FOUNDATION CONSIDERS ANY GRANT OPPORTUNITIES THAT CLEARLY ADDRESSES HEALTH AND WELLNESS ISSUES FOR OUR COMMUNITY, OUR PRIORITIES FOR FUNDING CONSIDERATION FOCUS ON THE FOLLOWING:1) NON-PROFIT ORGANIZATIONS PROVIDING DIRECT HEALTH SERVICES TO PEOPLE IN NEED.2) FUNDING ORGANIZATIONS THAT ARE MAKING ADVANCES OR PROVIDING SERVICES IN PREVENTION IMPROVEMENTS TO MINIMIZE THE NEED FOR HEALTH SERVICES.3) SUPPORTING THOSE WHO ARE DEVELOPING AND IMPLEMENTING SOLUTIONS TOWARD PROVIDING OPPORTUNITIES TO PURSUE HEALTHY LIFESTYLES AND DECISIONS. 4)A COMMITMENT TO REGULAR, CONSISTENT ASSESSMENT AND PARTICIPATION IN THE DISCOVERY OF EXISTING HEALTH NEEDS OF OUR COMMUNITY.
SUPPLEMENTARY INFORMATIONFORM 990-PF, PART XV, LINE 2A THROUGH 2DLINE 2, NAME OF THE GRANT PROGRAM: CANCER CARE FUNDLINE 2A AND 2B, FORM AND CONTENT OF APPLICATION:THE KOSCIUSKO COUNTY CANCER CARE FUND, ADMINISTERED BY K21 HEALTH FOUNDATION, WAS ESTABLISHED FOR THE PURPOSE OF PROVIDING FINANCIAL ASSISTANCE TO FINANCIALLY-ELIGIBLE RESIDENTS OF KOSCIUSKO COUNTY WHO ARE SUFFERING FROM CANCER. THE PURPOSE OF THE FUND IS TO RELIEVE SOME OF THE FINANCIAL STRAIN THAT OFTEN ACCOMPANIES THAT DREADED DIAGNOSIS. THE ASSISTANCE PROVIDED INCLUDES BUT IS NOT LIMITED TO ITEMS SUCH AS RENT OR MORTGAGE PAYMENTS, UTILITIES, INSURANCE, FOOD, CAR PAYMENTS, AND PRESCRIPTION MEDICATIONS. IN ALL SITUATIONS, FINANCIAL ASSISTANCE IS PAID DIRECTLY TO A VENDOR ON BEHALF OF THE CLIENTS. IN 2017 THE CANCER CARE FUND PROVIDED FINANCIAL ASSISTANCE TO OVER 100 KOSCIUSKO COUNTY CANCER PATIENTS AND THEIR FAMILIES. THE FUND DISBURSED APPROXIMATELY $185,000 FOR ITEMS SUCH AS RENT OR MORTGAGE PAYMENTS, UTILITIES, INSURANCE, FOOD, AND PRESCRIPTION MEDICATIONS, JUST TO NAME A FEW. THE FUNDS ARE PRIMARILY RAISED BY A GROUP OF DEDICATED INDIVIDUALS IN KOSCIUSKO COUNTY WHO VOLUNTEER HUNDREDS OF HOURS EACH YEAR TO PLAN A NUMBER OF FUNDRAISING EVENTS, SUCH AS THE GOLF OUTING, GALA AND AUCTION.THE CANCER FUND SOCIAL WORKER REVIEWS ALL CASES AND COLLABORATES WITH ONE OR MORE MEMBERS OF THE NINE-PERSON CANCER CARE COMMITTEE TO AUTHORIZE PAYMENTS FROM THE FUND. FOR APPLICATION ASSISTANCE, PLEASE CONTACT LAURA DEAL-DECKER AT (574) 372-3500 OR LAURA@KOSHELPCENTER.ORGLINE 2C, ANY SUBMISSION DEADLINES: NONELINE 2D, RESTRICTIONS AND LIMITATIONS ON AWARDS: TO QUALIFY FOR ASSISTANCE, A RECIPIENT MUST PROVIDE:1. DOCUMENTED RESIDENT OF KOSCIUSKO COUNTY.2. VERIFIED CANCER DIAGNOSIS WITHIN THE LAST THREE MONTHS. 3. DEMONSTRATE A FINANCIAL NEED.4. COMPLETE REQUIRED APPLICATION.

Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule

Investments Corporate Bonds InvestmentsCorporateBondsGrp (2 entries)

BondBondNmEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
CORPORATE BONDS$7,096,039$7,005,483
FOREIGN BONDS$483,553$483,128

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp

FieldValueIRS element (for citing)
StockEQUITY SECURITIESStockNm
EOY Book Value$30,811,741EOYBookValueAmt
EOYFMV$44,960,813EOYFMVAmt

Investments Govt Obligations Sch InvestmentsGovtObligationsSch

FieldValueIRS element (for citing)
US Govt Obligations Book Vl EOY$4,442,800USGovtObligationsBookVlEOYAmt
US Govt Obligations EOYFMV$4,399,699USGovtObligationsEOYFMVAmt
State Local Sec Book Vl EOY$0StateLocalSecBookVlEOYAmt
State Local Sec EOYFMV$0StateLocalSecEOYFMVAmt

Investments Land Schedule2 InvestmentsLandSchedule2

Investment Land InvestmentLandGrp (4 entries)

Category Or ItemCategoryOrItemTxtCost Or Other BasisCostOrOtherBasisAmtAccumulated DepreciationAccumulatedDepreciationAmtBook ValueBookValueAmtEOYFMVEOYFMVAmt
LAND$23,895$0$23,895$23,895
LAND IMPROVEMENTS$305,265$83,260$222,005$222,005
LEASEHOLD IMPROVEMENTS$969,226$270,567$698,659$698,659
BUILDING$1,023,544$145,002$878,542$878,542

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOtherGrp (4 entries)

Category Or ItemCategoryOrItemTxtListed At Cost Or FMVListedAtCostOrFMVCdBook ValueBookValueAmtEOYFMVEOYFMVAmt
REAL ESTATE INVESTMENT FUNDFMV$2,251,048$3,003,571
HEDGE FUNDFMV$3,562,012$3,702,866
GLOBAL MANAGED VOLATILITYFMV$3,081,921$4,173,669
US EQUITY INDEX PUTWRITE FUND LLCFMV$3,633,889$3,606,704

Land Etc Schedule2 LandEtcSchedule2

Land Etc LandEtcGrp

FieldValueIRS element (for citing)
Category Or ItemOFFICE & COMPUTER EQUIPMENTCategoryOrItemTxt
Cost Or Other Basis$69,098CostOrOtherBasisAmt
Accumulated Depreciation$65,710AccumulatedDepreciationAmt
Book Value$3,388BookValueAmt
EOYFMV$3,388EOYFMVAmt

Other Assets Schedule OtherAssetsSchedule

Other Assets Schedule OtherAssetsScheduleGrp (3 entries)

DescDescBOY Book ValueBOYBookValueAmtEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
NOTES RECEIVABLE HELD FOR GRANT MAKING$2,829,100$2,139,032$2,139,032
RECEIVABLE - OTHER$340$929$929
EXCISE TAX ASSET - OVERPAYMENT$5,941$7,854$7,854

Other Decreases Schedule OtherDecreasesSchedule

Other Decreases Detail OtherDecreasesDetail

FieldValueIRS element (for citing)
Desc2017 BOOK VALUE AND MARKET VALUE CHANGE BETWEEN YEARSDesc
Amt$6,961,329Amt

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (7 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtNet Investment IncomeNetInvestmentIncomeAmtAdjusted Net IncomeAdjustedNetIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
KHSP MORTGAGE INTEREST FORGIVENESS$799,208$0$0$0
HARVEST LOAN FORGIVENESS$8,588$0$0$0
FUNDRAISING EXPENSES$49,268$0$0$49,268
INSURANCE$7,186$0$0$7,113
MARKETING$34,149$0$0$34,149
MISCELLANEOUS EXPENSE$33,932$1,701$0$30,056
EXPIRED GRANTS-$4,033$0$0$0

Other Income Schedule2 OtherIncomeSchedule2

Other Income Detail OtherIncomeDetail

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Revenue And Expenses Per Books$1,612RevenueAndExpensesPerBooksAmt
Net Investment Income$1,612NetInvestmentIncomeAmt

Other Increases Schedule OtherIncreasesSchedule

Other Increases Detail OtherIncreasesDetail

FieldValueIRS element (for citing)
DescUNREALIZED GAIN ON INVESTMENTSDesc
Amt$6,961,330Amt

Other Liabilities Schedule OtherLiabilitiesSchedule

Other Liabilities Detail OtherLiabilitiesDetail

FieldValueIRS element (for citing)
DescDEFERRED TAX LIABILITYDesc
BOY Book Value$90,116BOYBookValueAmt
EOY Book Value$159,729EOYBookValueAmt

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees Detail OtherProfessionalFeesDetail

FieldValueIRS element (for citing)
CategoryINVESTMENT MGT FEESCategoryTxt
Amt$233,013Amt
Net Investment Income$233,013NetInvestmentIncomeAmt
Adjusted Net Income$0AdjustedNetIncomeAmt
Disbursements Charitable Prps$0DisbursementsCharitablePrpsAmt

Substantial Contributors Sch SubstantialContributorsSch

Substantial Contributor Detail SubstantialContributorDetail (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCd
DR AND MRS RICK SASSO
10674 WINTERWOODCARMELIN46032
LUTHERAN HEALTH FOUNDATION
3024 FAIRFIELD AVENUEFORT WAYNEIN46807

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail

FieldValueIRS element (for citing)
CategoryEXCISE TAXESCategoryTxt
Amt$96,618Amt
Net Investment Income$0NetInvestmentIncomeAmt
Adjusted Net Income$0AdjustedNetIncomeAmt
Disbursements Charitable Prps$0DisbursementsCharitablePrpsAmt

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.