RIVERSIDE HEALTH FOUNDATION: Form 990PF, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- RIVERSIDE HEALTH FOUNDATION (EIN 48-1142989)
- Tax period
- 2016-10-01 to 2017-09-30
- Filed
- 2018-03-12
- IRS object ID
- 201840719349100704
- Schema version
- 2016v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990-PF
- Accounting Fees Schedule
- All Oth Prog Rltd Investments Sch
- Depreciation Schedule
- Investments Corp Bonds Schedule
- Investments Corp Stock Schedule
- Investments Govt Obligations Sch
- Other Expenses Schedule
- Other Income Schedule2
- Other Increases Schedule
- Other Professional Fees Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-03-12T09:36:36-05:00 | ReturnTs |
| Tax Period End | 2017-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1551 N WATERFRONT PKWY STE 300 | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 672066601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2016-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481142989 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIVERSIDE HEALTH FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % RON STEPHEN | InCareOfNm |
| Business Name Control | RIVE | BusinessNameControlTxt |
| Phone | 3167297363 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 9527 | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 672770527 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RON STEPHEN | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 3167297363 | PhoneNum |
| Signature | 2018-02-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SHAWNELL LINOT | PreparerPersonNm |
| PTIN | P01663908 | PTIN |
| Phone | 3162652811 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 167.68.126.162 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 48010220180715000002 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2018-03-12 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 317467770C39898C40CA0978F91E18CC850C4BAF | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 000AA6C7DCE44354A7A033CB729008034F4EBC2F | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $17,524,357 | FMVAssetsEOYAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rcvd Rev And Expnss | $0 | ContriRcvdRevAndExpnssAmt |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Dividends Rev And Expnss | $384,574 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $384,574 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $996,414 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $20,530,512 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $996,414 | CapGainNetIncmNetInvstIncmAmt |
| Other Income Rev And Expnss | $882 | OtherIncomeRevAndExpnssAmt |
| Total Rev And Expnss | $1,381,870 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $1,380,988 | TotalNetInvstIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $0 | CompOfcrDirTrstRevAndExpnssAmt |
| Accounting Fees Rev And Expnss | $13,390 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $1,339 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $0 | AccountingFeesAdjNetIncmAmt |
| Accounting Fees Chrtbl Prps | $12,051 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Rev And Expnss | $80,725 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $80,725 | OtherProfFeesNetInvstIncmAmt |
| Occupancy Rev And Expnss | $166 | OccupancyRevAndExpnssAmt |
| Trav Conf Meeting Rev And Expnss | $3,634 | TravConfMeetingRevAndExpnssAmt |
| Trav Conf Meeting Dsbrs Chrtbl | $3,634 | TravConfMeetingDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $170,579 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $590 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Dsbrs Chrtbl | $167,550 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $268,494 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $82,654 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $0 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $183,235 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $842,600 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $838,600 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $1,111,094 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $82,654 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $0 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $1,021,835 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $270,776 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $1,298,334 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sav And Temp Cash Invst BOY | $155,711 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $124,782 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $124,782 | SavAndTempCashInvstEOYFMVAmt |
| Prepaid Expenses BOY | $0 | PrepaidExpensesBOYAmt |
| Prepaid Expenses EOY | $3,254 | PrepaidExpensesEOYAmt |
| Prepaid Expenses EOYFMV | $3,254 | PrepaidExpensesEOYFMVAmt |
| US Government Obligations BOY | $1,100,257 | USGovernmentObligationsBOYAmt |
| US Government Obligations EOY | $802,511 | USGovernmentObligationsEOYAmt |
| US Govt Obligations EOYFMV | $802,511 | USGovtObligationsEOYFMVAmt |
| Corporate Stock BOY | $10,800,291 | CorporateStockBOYAmt |
| Corporate Stock EOY | $11,236,658 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $11,236,658 | CorporateStockEOYFMVAmt |
| Corporate Bonds BOY | $5,001,648 | CorporateBondsBOYAmt |
| Corporate Bonds EOY | $5,357,152 | CorporateBondsEOYAmt |
| Corporate Bonds EOYFMV | $5,357,152 | CorporateBondsEOYFMVAmt |
| Total Assets BOY | $17,057,907 | TotalAssetsBOYAmt |
| Total Assets EOY | $17,524,357 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $17,524,357 | TotalAssetsEOYFMVAmt |
| Accounts Payable BOY | $1,651 | AccountsPayableBOYAmt |
| Accounts Payable EOY | $2,058 | AccountsPayableEOYAmt |
| Total Liabilities BOY | $1,651 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,058 | TotalLiabilitiesEOYAmt |
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
| Unrestricted BOY | $17,056,256 | UnrestrictedBOYAmt |
| Unrestricted EOY | $17,522,299 | UnrestrictedEOYAmt |
| Temporarily Restricted BOY | $0 | TemporarilyRestrictedBOYAmt |
| Temporarily Restricted EOY | $0 | TemporarilyRestrictedEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $17,056,256 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $17,522,299 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $17,057,907 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $17,524,357 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $17,056,256 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $270,776 | ExcessRevenueOverExpensesAmt |
| Other Increases | $195,267 | OtherIncreasesAmt |
| Subtotal | $17,522,299 | SubtotalAmt |
| Tot Net Ast Or Fund Balances EOY | $17,522,299 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (7 entries)
| PropertyPropertyDesc | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt |
|---|---|---|---|---|
| US BANK 0630 | $4,067,219 | $3,477,945 | $589,274 | $589,274 |
| COMMERCE 69-4 | $2,837,897 | $2,822,999 | $14,898 | $14,898 |
| COMMERCE 69-2 | $2,051,245 | $1,987,630 | $63,615 | $63,615 |
| US BANK 1800 | $1,435,200 | $1,445,787 | -$10,587 | -$10,587 |
| COMMERCE 69-3 | $8,328,837 | $8,239,717 | $89,120 | $89,120 |
| COMMERCE 69-1 | $1,607,089 | $1,357,780 | $249,309 | $249,309 |
| COMMERCE 69-8 | $203,025 | $202,240 | $785 | $785 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $996,414 | CapitalGainNetIncomeAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | false | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $857,822 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $16,949,599 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.05061 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $895,334 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $18,165,228 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.049288 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $867,966 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $18,285,591 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 0.047467 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $841,399 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $17,306,860 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.048617 | DistributionYr4Rt |
| Adjusted Qlfy Distri Yr5 | $769,091 | AdjustedQlfyDistriYr5Amt |
| Net Vl Noncharitable Assets Yr5 | $17,025,676 | NetVlNoncharitableAssetsYr5Amt |
| Distribution Yr5 | 0.045172 | DistributionYr5Rt |
| Total Distribution | 0.241154 | TotalDistributionRt |
| Average Distribution | 0.048231 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $17,284,619 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $833,654 | AdjNetVlNoncharitableAssetsAmt |
| Net Investment Income Pct | $12,983 | NetInvestmentIncomePctAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $846,637 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $1,021,835 | QualifyingDistributionsAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Domestic Org Meeting Sect4940e | Yes (X) | DomesticOrgMeetingSect4940eInd |
| Investment Income Excise Tax | $12,983 | InvestmentIncomeExciseTaxAmt |
| Subtotal | $12,983 | SubtotalAmt |
| Tax Based On Investment Income | $12,983 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $16,237 | EstimatedPlusOvpmtIncmTxAmt |
| Total Payments And Credits | $16,237 | TotalPaymentsAndCreditsAmt |
| Overpayment | $3,254 | OverpaymentAmt |
| Applied To ES Tax | $3,254 | AppliedToESTaxAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | false | LegislativePoliticalActyInd |
| More Than100 Spent | false | MoreThan100SpentInd |
| Form1120 POL Filed | false | Form1120POLFiledInd |
| Section4955 Organization Tax | $0 | Section4955OrganizationTaxAmt |
| Section4955 Managers Tax | $0 | Section4955ManagersTaxAmt |
| Tax Reimbursed | $0 | TaxReimbursedAmt |
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | false | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (true) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (true) | AtLeast5000InAssetsInd |
| Org Report Or Register State | KS | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (true) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | false | PrivateOperatingFoundationInd |
| New Substantial Contributors | false | NewSubstantialContributorsInd |
| Own Controlled Entity | false | OwnControlledEntityInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (true) | ComplyWithPublicInspRqrInd |
| Website Address | N/A | WebsiteAddressTxt |
Persons With Books Name PersonsWithBooksName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RON STEPHEN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3167297363 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 9527 | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 672770527 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Accounts Question | false | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | false | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | false | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | false | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | false | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | false | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | false | PaymentToGovernmentOfficialInd |
| Uncorrected Prior Acts | false | UncorrectedPriorActsInd |
| Undistributed Income PY | false | UndistributedIncomePYInd |
| Undistr Incm Sect4942a2 Not App | false | UndistrIncmSect4942a2NotAppInd |
| Business Holdings | false | BusinessHoldingsInd |
| Jeopardy Investments | false | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | false | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | false | InfluenceLegislationInd |
| Influence Election | false | InfluenceElectionInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Noncharitable Purpose | false | NoncharitablePurposeInd |
| Transactions Fail To Qlfy As Exc | Yes (true) | TransactionsFailToQlfyAsExcInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|---|---|---|---|
| RANDY COONROD | ||||||||
| PO BOX 9527 | WICHITA | KS | 672770527 | CHAIRMAN/DIRECTOR | 1.0 | $0 | $0 | $0 |
| DR JERRY GASTON | ||||||||
| PO BOX 9527 | WICHITA | KS | 672770527 | VICE CHAIRMAN/DIRECTOR | 0.5 | $0 | $0 | $0 |
| RON STEPHEN | ||||||||
| PO BOX 9527 | WICHITA | KS | 672770527 | SECRETARY/TREASURER/DIRECTOR | 1.0 | $0 | $0 | $0 |
| TERRY FRY | ||||||||
| PO BOX 9527 | WICHITA | KS | 672770527 | DIRECTOR | 0.5 | $0 | $0 | $0 |
| RONNIE TROY | ||||||||
| PO BOX 9527 | WICHITA | KS | 672770527 | DIRECTOR | 0.5 | $0 | $0 | $0 |
| DR CAROLINE SORIA | ||||||||
| PO BOX 9527 | WICHITA | KS | 672770527 | DIRECTOR | 0.5 | $0 | $0 | $0 |
| SENATOR LES DONOVAN | ||||||||
| PO BOX 9527 | WICHITA | KS | 672770527 | DIRECTOR | 0.5 | $0 | $0 | $0 |
| DR DAN MCCARTY | ||||||||
| PO BOX 9527 | WICHITA | KS | 672770527 | DIRECTOR | 0.5 | $0 | $0 | $0 |
| DR JON KIRKPATRICK | ||||||||
| PO BOX 9527 | WICHITA | KS | 672770527 | DIRECTOR | 0.5 | $0 | $0 | $0 |
Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | N/A | Description1Txt |
Sum Of Program Related Invst SumOfProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | NONE | Description1Txt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $17,452,178 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $95,659 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $17,547,837 | TotalFMVOfUnusedAssetsAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $17,547,837 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $263,218 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $17,284,619 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $864,231 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $864,231 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $12,983 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $12,983 | TotalTaxAmt |
| Distributable Before Adj | $851,248 | DistributableBeforeAdjAmt |
| Distributable Before Ded | $851,248 | DistributableBeforeDedAmt |
| Distributable As Adjusted | $851,248 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $1,021,835 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Charitable Assets Acquis Paid | $0 | CharitableAssetsAcquisPaidAmt |
| Set Aside Suitability Test | $0 | SetAsideSuitabilityTestAmt |
| Set Aside Cash Distri Test | $0 | SetAsideCashDistriTestAmt |
| Qualifying Distributions | $1,021,835 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $12,983 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $1,008,852 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $851,248 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $539,235 | UndistributedIncomePYAmt |
| Prior Year1 | 2014 | PriorYear1Yr |
| Prior Year2 | 2013 | PriorYear2Yr |
| Prior Year3 | 2012 | PriorYear3Yr |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr1 | $0 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $0 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $1,021,835 | QualifyingDistributionsAmt |
| Applied To Year1 | $539,235 | AppliedToYear1Amt |
| Applied To Current Year | $482,600 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $0 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $0 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $0 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $0 | TotalCorpusAmt |
| Prior Year Undistributed Incm | $0 | PriorYearUndistributedIncmAmt |
| Taxable1 | $0 | Taxable1Amt |
| Undistributed Income CY | $368,648 | UndistributedIncomeCYAmt |
| Excess Distri Cyov To Next Yr | $0 | ExcessDistriCyovToNextYrAmt |
| Excess From Current Year | $0 | ExcessFromCurrentYearAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Private Operating Foundations | PrivateOperatingFoundationsGrp |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (11 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| VIA CHRISTI HEALTH | |||||||
| 707 N EMPORIA | WICHITA | KS | 67214 | NONE | SO III FI | OSTEOPATHIC MEDICAL EDUCATION | $350,000 |
| MENTAL HEALTH ASSOCIATION OF SOUTH CENTRAL KANSAS | |||||||
| 555 N WOODLAWN SUITE 3105 | WICHITA | KS | 67208 | NONE | PC | SERVICES FOR SENIORS | $110,000 |
| GUADALUPE CLINIC INC | |||||||
| 940 S FRANCIS | WICHITA | KS | 67211 | NONE | SO I | GENERAL HEALTH AND WELFARE | $50,000 |
| HOLY SAVIOR CATHOLIC CHURCH | |||||||
| 1425 N CHAUTAUQUA ST | WICHITA | KS | 67214 | NONE | PC | GENERAL HEALTH AND WELFARE | $10,000 |
| GRACEMED HEALTH CLINIC | |||||||
| 1122 N TOPEKA | WICHITA | KS | 67214 | NONE | PC | GENERAL HEALTH AND WELFARE | $25,000 |
| GREATER WICHITA YMCA | |||||||
| 402 N MARKET | WICHITA | KS | 67212 | NONE | PC | GENERAL HEALTH AND WELFARE | $15,000 |
| MEDICAL SERVICE BUREAU | |||||||
| 1530 S OLIVER STE 130 | WICHITA | KS | 67218 | NONE | PC | GENERAL HEALTH AND WELFARE | $6,100 |
| KANSAS CITY UNIVERSITY | |||||||
| 1750 INDEPENDENCE WAY | KANSAS CITY | MO | 64106 | NONE | PC | OSTEOPATHIC MEDICAL EDUCATION | $250,000 |
| CENTRAL PLAINS HEALTH CARE PARTNERSHIP | |||||||
| 1102 S HILLSIDE ST | WICHITA | KS | 67211 | NONE | PC | GENERAL HEALTH AND WELFARE | $5,000 |
| MEDICAL MINISTRY INTERNATIONAL CO SULEMAN SADIQ | |||||||
| 1337 N SHEFFORD ST | WICHITA | KS | 67212 | NONE | PC | GENERAL HEALTH AND WELFARE | $15,000 |
| WSU FOUNDATION | |||||||
| 4205 EAST 21ST ST N | WICHITA | KS | 67260 | NONE | PC | GENERAL HEALTH AND WELFARE | $2,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $838,600 | TotalGrantOrContriPdDurYrAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fees Contracts From Govt Ag | FeesContractsFromGovtAgGrp | |
| Membership Dues And Assmnt | MembershipDuesAndAssmntGrp | |
| Int On Sav And Temp Cash Invst | IntOnSavAndTempCashInvstGrp |
Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $384,574 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Rntl Incm Re Debt Fincd Prop | NetRntlIncmReDebtFincdPropGrp | |
| Net Rntl Incm Re Not Debt Fincd Prop | NetRntlIncmReNotDebtFincdProp | |
| Net Rental Income Personal Prop | NetRentalIncomePersonalPropGrp | |
| Other Investment Incm Part VII | OtherInvestmentIncmPartVIIGrp |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $996,414 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Income Loss From Special Evt | NetIncomeLossFromSpecialEvtGrp | |
| Gross Profit Loss Sls Of Invntry | GrossProfitLossSlsOfInvntryGrp |
Other Revenue Described OtherRevenueDescribedGrp (2 entries)
| DescDesc | ExclusionExclusionCd | ExclusionExclusionAmt |
|---|---|---|
| MISCELLANEOUS INCOME | 01 | $128 |
| EXCISE TAX OVERPAYMENT | 01 | $754 |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | $1,381,870 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $1,381,870 | TotalIncomeProducingActyAmt |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | false | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | false | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | false | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | false | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | false | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | false | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | false | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | false | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | false | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | false | RelationshipsNonchrtblEOInd |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | ACCOUNTING/TAX PREP FEES | CategoryTxt |
| Amt | $13,390 | Amt |
| Net Investment Income | $1,339 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $12,051 | DisbursementsCharitablePrpsAmt |
All Oth Prog Rltd Investments Sch AllOthProgRltdInvestmentsSch
All Other Program Related Invst AllOtherProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NONE | Desc |
Depreciation Schedule DepreciationSchedule
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corporate Bonds InvestmentsCorporateBondsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond | COMMERCE 69-4 - SEE STMT 1 | BondNm |
| EOY Book Value | $5,357,152 | EOYBookValueAmt |
| EOYFMV | $5,357,152 | EOYFMVAmt |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp (6 entries)
| StockStockNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| US BANK 0630 | $0 | $0 |
| US BANK 1800 | $0 | $0 |
| COMMERCE 69-2 - SEE STMT 2 | $2,820,392 | $2,820,392 |
| COMMERCE 69-3 - SEE STMT 3 | $6,682,701 | $6,682,701 |
| COMMERCE 69-4S | $0 | $0 |
| COMMERCE 69-8 - SEE STMT 4 | $1,733,565 | $1,733,565 |
Investments Govt Obligations Sch InvestmentsGovtObligationsSch
| Field | Value | IRS element (for citing) |
|---|---|---|
| US Govt Obligations Book Vl EOY | $802,511 | USGovtObligationsBookVlEOYAmt |
| US Govt Obligations EOYFMV | $802,511 | USGovtObligationsEOYFMVAmt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (7 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt | Net Investment IncomeNetInvestmentIncomeAmt |
|---|---|---|---|
| PHYSICIAN AWARENESS | $16,716 | $16,716 | |
| BANK SERVICE CHARGES | $590 | $590 | |
| INSURANCE | $2,297 | ||
| FEASIBILITY STUDY | $149,415 | $149,415 | |
| RESIDENTS HOUSING | $1,419 | $1,419 | |
| LICENSES & PERMITS | $40 | ||
| POSTAGE | $102 |
Other Income Schedule2 OtherIncomeSchedule2
Other Income Detail OtherIncomeDetail (2 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt |
|---|---|
| EXCISE TAX OVERPAYMENT | $754 |
| MISCELLANEOUS INCOME | $128 |
Other Increases Schedule OtherIncreasesSchedule
Other Increases Detail OtherIncreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | UNREALIZED GAINS | Desc |
| Amt | $195,267 | Amt |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | INVESTMENT EXPENSE | CategoryTxt |
| Amt | $80,725 | Amt |
| Net Investment Income | $80,725 | NetInvestmentIncomeAmt |
Comments