LUTSEY FAMILY FOUNDATION INC: Form 990PF, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
LUTSEY FAMILY FOUNDATION INC (EIN 39-1657029)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-13
IRS object ID
201803179349101020
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)
Return2018-11-13T11:14:50-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN391173131PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SCHENCK SCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 23819AddressLine1Txt
CityGREEN BAYCityNm
State AbbreviationWIStateAbbreviationCd
ZIP543053819ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391657029EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LUTSEY FAMILY FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlLUTSBusinessNameControlTxt
Phone9203399823PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 22074AddressLine1Txt
CityGREEN BAYCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54305ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTHOMAS LUTSEYPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone9203399823PhoneNum
Signature2018-10-29SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMICHELLE R MULLOYPreparerPersonNm
PTINP01241748PTIN
Phone9204367800PhoneNum
Preparation2018-10-29PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address74.142.163.66IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-10-29IPDt
IP Tm13:31:37IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdEC3B3E6693BBF39118E1AB12E86B94CF4085E7F0AtSubmissionCreationDeviceId
At Submission Filing Device Id201AC506A6DA8D9D4516FED2DD8E9342B88F33A9AtSubmissionFilingDeviceId
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$5,199,596FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Schedule B Not RequiredYes (X)ScheduleBNotRequiredInd
Dividends Rev And Expnss$260,329DividendsRevAndExpnssAmt
Dividends Net Invst Incm$260,329DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss$329,201NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$2,922,250GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$329,201CapGainNetIncmNetInvstIncmAmt
Total Rev And Expnss$589,530TotalRevAndExpnssAmt
Total Net Invst Incm$589,530TotalNetInvstIncmAmt
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$4,758AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm$2,379AccountingFeesNetInvstIncmAmt
Accounting Fees Chrtbl Prps$2,379AccountingFeesChrtblPrpsAmt
Other Prof Fees Rev And Expnss$432OtherProfFeesRevAndExpnssAmt
Other Prof Fees Net Invst Incm$216OtherProfFeesNetInvstIncmAmt
Other Prof Fees Dsbrs Chrtbl$216OtherProfFeesDsbrsChrtblAmt
Taxes Rev And Expnss$2,597TaxesRevAndExpnssAmt
Taxes Net Invst Incm$2,597TaxesNetInvstIncmAmt
Taxes Dsbrs Chrtbl$0TaxesDsbrsChrtblAmt
Other Expenses Rev And Expnss$73,670OtherExpensesRevAndExpnssAmt
Other Expenses Net Invst Incm$54,198OtherExpensesNetInvstIncmAmt
Other Expenses Dsbrs Chrtbl$16,378OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$81,457TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$59,390TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$18,973TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$216,011ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$216,011ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$297,468TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$59,390TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$234,984TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses$292,062ExcessRevenueOverExpensesAmt
Net Investment Income$530,140NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Cash BOY$1CashBOYAmt
Cash EOY$1CashEOYAmt
Cash EOYFMV$1CashEOYFMVAmt
Sav And Temp Cash Invst BOY$167,946SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$619,927SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$619,927SavAndTempCashInvstEOYFMVAmt
US Government Obligations BOY$70,273USGovernmentObligationsBOYAmt
US Government Obligations EOY$69,600USGovernmentObligationsEOYAmt
US Govt Obligations EOYFMV$69,684USGovtObligationsEOYFMVAmt
Corporate Stock BOY$3,483,994CorporateStockBOYAmt
Corporate Stock EOY$3,404,662CorporateStockEOYAmt
Corporate Stock EOYFMV$3,570,601CorporateStockEOYFMVAmt
Corporate Bonds BOY$42,309CorporateBondsBOYAmt
Corporate Bonds EOY$36,027CorporateBondsEOYAmt
Corporate Bonds EOYFMV$36,686CorporateBondsEOYFMVAmt
Other Investments BOY$719,542OtherInvestmentsBOYAmt
Other Investments EOY$645,910OtherInvestmentsEOYAmt
Other Investments EOYFMV$902,697OtherInvestmentsEOYFMVAmt
Total Assets BOY$4,484,065TotalAssetsBOYAmt
Total Assets EOY$4,776,127TotalAssetsEOYAmt
Total Assets EOYFMV$5,199,596TotalAssetsEOYFMVAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind
Unrestricted BOY$4,484,065UnrestrictedBOYAmt
Unrestricted EOY$4,776,127UnrestrictedEOYAmt
Tot Net Ast Or Fund Balances BOY$4,484,065TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$4,776,127TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$4,484,065TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$4,776,127TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$4,484,065TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses$292,062ExcessRevenueOverExpensesAmt
Other Increases$0OtherIncreasesAmt
Subtotal$4,776,127SubtotalAmt
Other Decreases$0OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY$4,776,127TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp

FieldValueIRS element (for citing)
PropertyPUBLICLY TRADED SECURITIESPropertyDesc
Gross Sales Price$2,922,250GrossSalesPriceAmt
Cost Or Other Basis$2,593,049CostOrOtherBasisAmt
Gain Or Loss$329,201GainOrLossAmt
Gains Minus Excess Or Losses$329,201GainsMinusExcessOrLossesAmt
FieldValueIRS element (for citing)
Capital Gain Net Income$329,201CapitalGainNetIncomeAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

FieldValueIRS element (for citing)
Liable Section4942 Tax0LiableSection4942TaxInd
Adjusted Qlfy Distri Yr1$246,531AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1$4,620,015NetVlNoncharitableAssetsYr1Amt
Distribution Yr10.053362DistributionYr1Rt
Adjusted Qlfy Distri Yr2$253,937AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2$5,005,859NetVlNoncharitableAssetsYr2Amt
Distribution Yr20.050728DistributionYr2Rt
Adjusted Qlfy Distri Yr3$250,097AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3$5,204,170NetVlNoncharitableAssetsYr3Amt
Distribution Yr30.048057DistributionYr3Rt
Adjusted Qlfy Distri Yr4$223,271AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4$4,998,219NetVlNoncharitableAssetsYr4Amt
Distribution Yr40.044670DistributionYr4Rt
Adjusted Qlfy Distri Yr5$229,042AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5$4,635,627NetVlNoncharitableAssetsYr5Amt
Distribution Yr50.049409DistributionYr5Rt
Total Distribution0.246226TotalDistributionRt
Average Distribution0.049245AverageDistributionRt
Net Vl Noncharitable Assets$4,960,013NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets$244,256AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct$5,301NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct$249,557AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions$234,984QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$10,603InvestmentIncomeExciseTaxAmt
Tax Under Section511$0TaxUnderSection511Amt
Subtotal$10,603SubtotalAmt
Subtitle A Tax$0SubtitleATaxAmt
Tax Based On Investment Income$10,603TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$9,504EstimatedPlusOvpmtIncmTxAmt
Extsn Request Income Tax Paid$0ExtsnRequestIncomeTaxPaidAmt
Backup Withholding Withheld$0BackupWithholdingWithheldAmt
Total Payments And Credits$9,504TotalPaymentsAndCreditsAmt
Es Penalty$0EsPenaltyAmt
Tax Due$1,099TaxDueAmt

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 StateWIOrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (1)Form990PFFiledWithAttyGenInd
Private Operating Foundation0PrivateOperatingFoundationInd
New Substantial Contributors0NewSubstantialContributorsInd
Own Controlled Entity0OwnControlledEntityInd
Donor Advised Fund0DonorAdvisedFundInd
Comply With Public Insp RqrYes (1)ComplyWithPublicInspRqrInd
Website AddressN/AWebsiteAddressTxt
Individual With BooksTHOMAS LUTSEYIndividualWithBooksNm
Phone9203399823PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 22074AddressLine1Txt
CityGREEN BAYCityNm
State AbbreviationWIStateAbbreviationCd
ZIP543052074ZIPCd
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 (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
THOMAS J LUTSEY
PO BOX 22074GREEN BAYWI54305PRESIDENT1.00$0$0$0
SHARON L LUTSEY
PO BOX 22074GREEN BAYWI54305DIRECTOR1.00$0$0$0
MATTHEW T LUTSEY
PO BOX 22074GREEN BAYWI54305DIRECTOR0.00$0$0$0
JEFFREY K LUTSEY
PO BOX 22074GREEN BAYWI54305DIRECTOR0.00$0$0$0
NICHOLAS P LUTSEY
PO BOX 22074GREEN BAYWI54305DIRECTOR0.00$0$0$0
ANDREW J LUTSEY
PO BOX 22074GREEN BAYWI54305DIRECTOR0.00$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$4,665,131AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$370,415AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$5,035,546TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$5,035,546AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$75,533CashDeemedCharitableAmt
Net Vl Noncharitable Assets$4,960,013NetVlNoncharitableAssetsAmt
Minimum Investment Return$248,001MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$248,001MinimumInvestmentReturnAmt
Tax Based On Investment Income$10,603TaxBasedOnInvestmentIncomeAmt
Total Tax$10,603TotalTaxAmt
Distributable Before Adj$237,398DistributableBeforeAdjAmt
Recoveries Qualfied Distri$0RecoveriesQualfiedDistriAmt
Distributable Before Ded$237,398DistributableBeforeDedAmt
Deduction From Distributable$0DeductionFromDistributableAmt
Distributable As Adjusted$237,398DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$234,984ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Qualifying Distributions$234,984QualifyingDistributionsAmt
Pct Sect4940e Org Net Invst Incm$0PctSect4940eOrgNetInvstIncmAmt
Adjusted Qualifying Distri$234,984AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$237,398DistributableAsAdjustedAmt
Undistributed Income PY$202,038UndistributedIncomePYAmt
Total For Prior Years$0TotalForPriorYearsAmt
Total Excess Distribution Cyov$0TotalExcessDistributionCyovAmt
Qualifying Distributions$234,984QualifyingDistributionsAmt
Applied To Year1$202,038AppliedToYear1Amt
Applied To Prior Years$0AppliedToPriorYearsAmt
Treated As Distri From Corpus$0TreatedAsDistriFromCorpusAmt
Applied To Current Year$32,946AppliedToCurrentYearAmt
Remaining Distri From Corpus$0RemainingDistriFromCorpusAmt
Excess Distri Cyov App CY Corpus$0ExcessDistriCyovAppCYCorpusAmt
Excess Distribution Cyov App CY$0ExcessDistributionCyovAppCYAmt
Total Corpus$0TotalCorpusAmt
Prior Year Undistributed Incm$0PriorYearUndistributedIncmAmt
Prior Year Deficiency Or Tax$0PriorYearDeficiencyOrTaxAmt
Taxable1$0Taxable1Amt
Taxable2$0Taxable2Amt
Undistributed Income CY$204,452UndistributedIncomeCYAmt
Corpus Distri170b1 E Or4942g3$0CorpusDistri170b1EOr4942g3Amt
Excess Distri Cyov From Yr5$0ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$0ExcessDistriCyovToNextYrAmt

Supplementary Information SupplementaryInformationGrp

Application Submission Info ApplicationSubmissionInfoGrp

FieldValueIRS element (for citing)
Recipient PersonLUTSEY ENTERPRISES LLP ATTN MATT LURecipientPersonNm

Recipient US Address RecipientUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 22074AddressLine1Txt
CityGREEN BAYCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54305ZIPCd
FieldValueIRS element (for citing)
Recipient Phone9203399823RecipientPhoneNum
Form And Info And MaterialsNO STANDARD FORM OR APPLICATION PROCESS IS REQUIRED BY THE FOUNDATION.FormAndInfoAndMaterialsTxt
Submission DeadlinesNONESubmissionDeadlinesTxt
Restrictions On AwardsNONERestrictionsOnAwardsTxt

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (41 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
ALTRUSA CLUB OF GREEN BAY
PO BOX 5521DE PEREWI54115NONEPUBLIC CHARITYCHARITABLE$965
AMERICAN HEART ASSOCIATION
PO BOX 50035PRESCOTTAZ863045035NONEPUBLIC CHARITYGENERAL CHARITABLE$500
BIG BROTHERS BIG SISTERS GREEN BAY
1345 W MASON ST 210GREEN BAYWI54303NONEPUBLIC CHARITYGENERAL CHARITABLE$3,036
BOYS AND GIRLS CLUB OF DOOR COUNTY
55 S 3RD AVESTURGEON BAYWI54235NONEPUBLIC CHARITYGENERAL CHARITABLE$31,375
BOYS AND GIRLS CLUB OF GREEN BAY
311 S ONEIDAGREEN BAYWI54301NONEPUBLIC CHARITYGENERAL CHARITY$10,300
CATS ANONYMOUS INC
2701 LARSON ROAD STE BA 115GREEN BAYWI54303NONEPUBLIC CHARITYGENERAL OPERATIONS$1,000
DANIEL MURPHY SCHOLARSHIP FOUNDATION
228 S WABASH SUITE 600CHICAGOIL60604NONEPUBLIC CHARITYGENERAL OPERATIONS$2,700
DEPERE CHRISTIAN OUTREACH
506 BUTLER STREETDE PEREWI54115NONEPUBLIC CHARITYGENERAL CHARITABLE$5,384
DOOR COUNTY COMMUNITY FOUNDATION
342 LOUISIANA STREETSTURGEON BAYWI54235NONEPUBLIC CHARITYGENERAL CHARITABLE$40,000
DOOR COUNTY ECONOMIC DEVELOPMENT
222 N 3RD AVESTURGEON BAYWI54235NONEPUBLIC CHARITYGENERAL CHARITABLE$200
DOOR COUNTY HABITAT FOR HUMANITY
410 N 14TH AVESTURGEON BAYWI54235NONEPUBLIC CHARITYGENERAL CHARITABLE$1,126
FAMILY FARMED
7115 W NORTH AVE 504OAK PARKIL60302NONEPUBLIC CHARITYJANDRINK - 01/25/18 02:50PM WORKSHEET PRIVATE FOUNDATION$7,765
FRESH TASTE
5555 N SHERIDAN ROAD STE 18CHICAGOIL60640NONEPUBLIC CHARITYGENERAL CHARITABLE$12,000
GREATER GREEN BAY COMMUNITY FOUNDATION
310 W WALNUT ST SUITE 350GREEN BAYWI54303NONEPUBLIC CHARITYGENERAL CHARITABLE$5,000
HOUSE OF HOPE GREEN BAY
1660 CHRISTIANA STGREEN BAYWI54303NONEPUBLIC CHARITYGENERAL CHARITABLE$42,500
JACKSONPORT ADVANCEMENT CORP
6832 COUNTY TEGG HARBORWI54209NONEPUBLIC CHARITYGENERAL CHARITABLE$500
LOAVES & FISHES OF DOOR COUNTY INC
PO BOX 802STURGEON BAYWI54235NONEPUBLIC CHARITYGENERAL CHARITABLE$6,500
NEW COMMUNITY SHELTER
301 MATHER STGREEN BAYWI54303NONEPUBLIC CHARITYGENERAL OPERATIONS$18,542
NOTRE DAME ACADEMY
610 MARYHILL DRIVEGREEN BAYWI54303NONEPUBLIC CHARITYGENERAL CHARITABLE$1,100
REHABILITATION INSTITUTE OF CHICAGO
345 E SUPERIOR STREETCHICAGOIL60611NONEPUBLIC CHARITYGENERAL CHARITABLE$100
RIDGES SANCTUARY
8270 WISCONSIN 57BAILEYS HARBORWI54202NONEPUBLIC CHARITYGENERAL CHARITABLE$1,500
ST NORBERTS
100 GRANT STREETDE PEREWI54115NONEPUBLIC CHARITYGENERAL CHARITABLE$3,000
THE KITCHEN COMMUNITY INC
1980 8TH STBOULDERCO80302NONEPUBLIC CHARITYGENERAL CHARITABLE$5,000
THE WOMEN'S FUND - DOOR COUNTY
PO BOX 802STURGEON BAYWI54235NONEPUBLIC CHARITYGENERAL OPERATIONS$350
UNITED WAY OF DOOR COUNTY
57 N 3RD AVESTURGEON BAYWI54235NONEPUBLIC CHARITYGENERAL CHARITABLE$350
WILLOW TREE CORNERSTONE CHILD ADVOCACY CENTER
PO BOX 22308GREEN BAYWI54305NONEPUBLIC CHARITYGENERAL CHARITABLE$2,750
WRITE ON DOOR COUNTY
PO BOX 457FISH CREEKWI54212NONEPUBLIC CHARITYGENERAL CHARITABLE$500
4TH HOOAH WI
PO BOX 12361GREEN BAYWI54307NONEPUBLIC CHARITYGENERAL CHARITABLE$988
CASA OF BROWN COUNTY
414 E WALNUT STREET SUITE 170GREEN BAYWI54301NONEPUBLIC CHARITYGENERAL CHARITABLE$5,325
COMMUNITY BENEFIT TREE
2204 CROOKS AVENUE SUITE CKAUKAUNAWI54130NONEPUBLIC CHARITYGENERAL CHARITABLE$623
FRIENDS OF AUDUBON
3500 N HOYNECHICAGOIL60618NONEPUBLIC CHARITYGENERAL CHARITABLE$1,100
FRIENDS OF PENINSULA STATE PARK
11533 GILLMORE LNELLISON BAYWI54210NONEPUBLIC CHARITYGENERAL CHARITABLE$1,092
DEPERE VOYAGEUR BOOSTER CLUB
PO BOX 145DEPEREWI54115NONEPUBLIC CHARITYGENERAL CHARITABLE$250
SUSTAIN DOOR
308 S 12TH AVESTURGEON BAYWI54235NONEPUBLIC CHARITYGENERAL CHARITABLE$250
ST MARK'S LUTHERAN CHURCH
1167 KENWOOD DRIVEGREEN BAYWI54304NONEPUBLIC CHARITYGENERAL CHARITABLE$200
JAMES ZILLES CANCER BENEFIT
1671 HOFFMAN ROAD STE 10GREEN BAYWI54311NONEPUBLIC CHARITYGENERAL CHARITABLE$250
SHAWN OBERLEITNER BENEFIT
W9577 COUNTY ROAD WCRIVITZWI54114NONEPUBLIC CHARITYGENERAL CHARITABLE$100
DOOR COUNTY FIRE BENEFIT
519 LANSING AVESTURGEON BAYWI54235NONEPUBLIC CHARITYGENERAL CHARITABLE$250
NETWORK FOR GOOD
1140 CONNECTICUT AVE NW 700WASHINGTONDC20036NONEPUBLIC CHARITYGENERAL CHARITABLE$618
SAFE HAVEN PET SANCTUARY
302 MAIN AVEDEPEREWI54115NONEPUBLIC CHARITYGENERAL CHARITABLE$892
COMMUNITY FIRST FOUNDATION
5855 WADSWORTH BYPS UNIT AARVADACO80003NONEPUBLIC CHARITYGENERAL CHARITABLE$30
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$216,011TotalGrantOrContriPdDurYrAmt
Total Grant Or Contri Apprv Fut$0TotalGrantOrContriApprvFutAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$260,329ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion20ExclusionCd
Exclusion$329,201ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$0UnrelatedBusinessTaxblIncmAmt
Exclusion$589,530ExclusionAmt
Related Or Exempt Function Incm$0RelatedOrExemptFunctionIncmAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$589,530TotalIncomeProducingActyAmt

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

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryTAX PREPARATION FEECategoryTxt
Amt$4,758Amt
Net Investment Income$2,379NetInvestmentIncomeAmt
Disbursements Charitable Prps$2,379DisbursementsCharitablePrpsAmt

Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule

Investments Corporate Bonds InvestmentsCorporateBondsGrp

FieldValueIRS element (for citing)
BondML #6AF-02183 CORPORATE BONDSBondNm
EOY Book Value$36,027EOYBookValueAmt
EOYFMV$36,686EOYFMVAmt

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp (14 entries)

StockStockNmEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
ML #6AF-02178 EQUITIES$140,556$198,503
ML #6AF-02180 EQUITIES$133,470$149,065
ML #6AF-02181 EQUITIES$133,790$146,350
ML #6AF-02179 EQUITIES$132,971$143,767
ML #6AF-02175 EQUITIES$128,724$163,301
ML #6AF-02176 EQUITIES$167,969$200,317
ML #6AF-02183 MUTUAL FDS/CLOSED END FDS$109,323$108,544
ML #6AF-02017$1,012,010$1,018,586
ML #6AF-02174 EQUITIES$131,172$149,876
ML #6AF-02182 EQUITIES$117,290$151,292
ML #6AF-02219 EQUITIES$455,176$566,575
BLACKSTONE ALTERNATIVES$246,211$256,081
BREP EUROPE IV REAL ESTATE FUND$227,500$157,531
CRESCENT VI MEZZANINE$268,500$160,813

Investments Govt Obligations Sch InvestmentsGovtObligationsSch

FieldValueIRS element (for citing)
US Govt Obligations Book Vl EOY$69,600USGovtObligationsBookVlEOYAmt
US Govt Obligations EOYFMV$69,684USGovtObligationsEOYFMVAmt
State Local Sec Book Vl EOY$0StateLocalSecBookVlEOYAmt
State Local Sec EOYFMV$0StateLocalSecEOYFMVAmt

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOtherGrp (4 entries)

Category Or ItemCategoryOrItemTxtListed At Cost Or FMVListedAtCostOrFMVCdBook ValueBookValueAmtEOYFMVEOYFMVAmt
GREEN BAY PACKERS SUPER BOWL RINGAT COST$20,000$20,000
PUBLICLY TRADED PARTNERSHIPSAT COST$393,495$534,006
ACP POWER AND ENERGYAT COST$70,286$200,290
LS REAL ESTATE RECOVERTY IV TRUSTAT COST$162,129$148,401

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (8 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
WIRE FEE$150$150$0
MERRILL LYNCH BROKERAGE FEES$25,003$25,003$0
ADMINISTRATIVE - OTHER$2,117$0$0
LUTSEY ENTERPRISES MANAGEMENT FEE$20,000$10,000$10,000
POSTAGE & PRINTING$595$297$297
OUTSIDE SERVICES$12,161$6,080$6,081
INVESTMENT LOSSES$13,173$12,197$0
BANK SERVICE CHARGES$471$471$0

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees Detail OtherProfessionalFeesDetail

FieldValueIRS element (for citing)
CategoryE&S ENTREPRENEUR ADVISORSCategoryTxt
Amt$432Amt
Net Investment Income$216NetInvestmentIncomeAmt
Disbursements Charitable Prps$216DisbursementsCharitablePrpsAmt

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail

FieldValueIRS element (for citing)
CategoryMERRILL LYNCH FOREIGN TAXESCategoryTxt
Amt$2,597Amt
Net Investment Income$2,597NetInvestmentIncomeAmt
Disbursements Charitable Prps$0DisbursementsCharitablePrpsAmt

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