RENAISSANCE FAMILY FOUNDATION INC: Form 990PF, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- RENAISSANCE FAMILY FOUNDATION INC (EIN 46-1376165)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-13
- IRS object ID
- 201723179349100227
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990-PF
- Accounting Fees Schedule
- Investments Corp Stock Schedule
- Other Assets Schedule
- Other Expenses Schedule
- Other Increases Schedule
- Other Liabilities Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-13T08:55:55-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 Michigan Ave Ste 100 | AddressLine1Txt |
| City | East Lansing | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48823 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 461376165 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RENAISSANCE FAMILY FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | RENA | BusinessNameControlTxt |
| Phone | 5173496000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4100 OKEMOS ROAD | AddressLine1Txt |
| City | OKEMOS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48864 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Goran Jurkovic | PersonNm |
| Person Title | OFFICER | PersonTitleTxt |
| Phone | 5173496000 | PhoneNum |
| Signature | 2017-11-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID LOWENTHAL CPA | PreparerPersonNm |
| PTIN | P00378651 | PTIN |
| Phone | 5173326200 | PhoneNum |
| Preparation | 2017-11-07 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.59.56.33 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-08 | IPDt |
| IP Tm | 12:47:04 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | D3994C8C0EED3DC07268D0E06E8E0D044B4248A2 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $1,670,180 | 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 |
| Interest On Sav Rev And Expnss | $2,985 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $2,985 | InterestOnSavNetInvstIncmAmt |
| Dividends Rev And Expnss | $10,425 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $10,425 | DividendsNetInvstIncmAmt |
| Cap Gain Net Incm Net Invst Incm | $0 | CapGainNetIncmNetInvstIncmAmt |
| Total Rev And Expnss | $13,410 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $13,410 | TotalNetInvstIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $0 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $0 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $0 | CompOfcrDirTrstDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $3,000 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $0 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Chrtbl Prps | $0 | AccountingFeesChrtblPrpsAmt |
| Taxes Rev And Expnss | $116 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $0 | TaxesNetInvstIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $12,538 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $3,140 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Dsbrs Chrtbl | $0 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $15,654 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $3,140 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $0 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $127,500 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $127,500 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $143,154 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $3,140 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $127,500 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$129,744 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $10,270 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $284,491 | CashBOYAmt |
| Cash EOY | $145,330 | CashEOYAmt |
| Cash EOYFMV | $145,330 | CashEOYFMVAmt |
| Sav And Temp Cash Invst BOY | $1,018,515 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $1,029,272 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $1,029,272 | SavAndTempCashInvstEOYFMVAmt |
| Corporate Stock BOY | $480,295 | CorporateStockBOYAmt |
| Corporate Stock EOY | $493,805 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $493,805 | CorporateStockEOYFMVAmt |
| Other Assets BOY | $1,620 | OtherAssetsBOYAmt |
| Other Assets EOY | $1,773 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $1,773 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $1,784,921 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,670,180 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $1,670,180 | TotalAssetsEOYFMVAmt |
| Other Liabilities BOY | $7 | OtherLiabilitiesBOYAmt |
| Other Liabilities EOY | $1,500 | OtherLiabilitiesEOYAmt |
| Total Liabilities BOY | $7 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,500 | TotalLiabilitiesEOYAmt |
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
| Unrestricted BOY | $1,784,914 | UnrestrictedBOYAmt |
| Unrestricted EOY | $1,668,680 | UnrestrictedEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $1,784,914 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $1,668,680 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $1,784,921 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $1,670,180 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $1,784,914 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$129,744 | ExcessRevenueOverExpensesAmt |
| Other Increases | $13,510 | OtherIncreasesAmt |
| Subtotal | $1,668,680 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $1,668,680 | TotNetAstOrFundBalancesEOYAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | 0 | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $49,674 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $305,308 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.162701 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $92,318 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $701,583 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.131585 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $50,000 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $976,775 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 0.051189 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $0 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $123,125 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.000000 | DistributionYr4Rt |
| Total Distribution | 0.345475 | TotalDistributionRt |
| Average Distribution | 0.086369 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $196,773 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $16,995 | AdjNetVlNoncharitableAssetsAmt |
| Net Investment Income Pct | $103 | NetInvestmentIncomePctAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $17,098 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $127,500 | 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 | $103 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $103 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $103 | TaxBasedOnInvestmentIncomeAmt |
| Total Payments And Credits | $0 | TotalPaymentsAndCreditsAmt |
| Tax Due | $103 | TaxDueAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | 0 | LegislativePoliticalActyInd |
| More Than100 Spent | 0 | MoreThan100SpentInd |
| Form1120 POL Filed | 0 | Form1120POLFiledInd |
| Section4955 Organization Tax | $0 | Section4955OrganizationTaxAmt |
| Section4955 Managers Tax | $0 | Section4955ManagersTaxAmt |
| Tax Reimbursed | $0 | TaxReimbursedAmt |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | 0 | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (1) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (1) | AtLeast5000InAssetsInd |
| Org Report Or Register State | IN | OrgReportOrRegisterStateCd |
| Org Report Or Register State | MI | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (1) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | 0 | PrivateOperatingFoundationInd |
| New Substantial Contributors | 0 | NewSubstantialContributorsInd |
| Own Controlled Entity | 0 | OwnControlledEntityInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (1) | ComplyWithPublicInspRqrInd |
| Website Address | N/A | WebsiteAddressTxt |
| Individual With Books | Goran Jurkovic | IndividualWithBooksNm |
| Phone | 5173496000 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4100 OKEMOS ROAD | AddressLine1Txt |
| City | OKEMOS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48864 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Accounts Question | 0 | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | 0 | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | 0 | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | 0 | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | 0 | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | 0 | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | 0 | PaymentToGovernmentOfficialInd |
| Uncorrected Prior Acts | 0 | UncorrectedPriorActsInd |
| Undistributed Income PY | 0 | UndistributedIncomePYInd |
| Business Holdings | 0 | BusinessHoldingsInd |
| Jeopardy Investments | 0 | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | 0 | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | 0 | InfluenceLegislationInd |
| Influence Election | 0 | InfluenceElectionInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Noncharitable Purpose | 0 | NoncharitablePurposeInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (4 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 |
|---|---|---|---|---|---|---|---|---|
| Laura L Czelada CPA | ||||||||
| 4100 Okemos Road | OKEMOS | MI | 48864 | President/Director | 1.00 | $0 | $0 | $0 |
| Goran M Jurkovic | ||||||||
| 4100 Okemos Road | OKEMOS | MI | 48864 | Treasurer/Director | 1.00 | $0 | $0 | $0 |
| Robert P Mulligan | ||||||||
| 4100 Okemos Road | OKEMOS | MI | 48864 | Secretary/Director | 1.00 | $0 | $0 | $0 |
| Teri Battaglieri | ||||||||
| 4100 Okemos Road | OKEMOS | MI | 48864 | Executive Director/DirectoR | 2.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Hghst Pd Empl Or NONE | NONE | CompOfHghstPdEmplOrNONETxt |
| Other Employee Paid Over50k | 0 | OtherEmployeePaidOver50kCnt |
| Comp Of Hghst Pd Cntrct Or NONE | NONE | CompOfHghstPdCntrctOrNONETxt |
| Contractor Paid Over50k | 0 | ContractorPaidOver50kCnt |
Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | KANAWHA COUNTY DENTAL HEALTH COUNCIL INC - CONTRIBUTION FOR PURCHASE OF DENTAL EQUIPMENT | Description1Txt |
| Expenses1 | $12,500 | Expenses1Amt |
| Description2 | FLORIDA DEPARTMENT OF HEALTH - SEALANT PROGRAM FOR 2 FLORIDA COUNTIES | Description2Txt |
| Expenses2 | $70,000 | Expenses2Amt |
| Description3 | GEORGIA DEPARTMENT OF PUBLIC HEALTH - GRANT FOR ORAL HEALTH PROJECTS | Description3Txt |
| Expenses3 | $45,000 | Expenses3Amt |
Sum Of Program Related Invst SumOfProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $0 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $199,770 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $199,770 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $199,770 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $2,997 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $196,773 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $9,839 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $9,839 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $103 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $103 | TotalTaxAmt |
| Distributable Before Adj | $9,736 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $9,736 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $9,736 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $127,500 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $127,500 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $103 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $127,397 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $9,736 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $0 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr2 | $56,776 | ExcessDistributionCyovYr2Amt |
| Excess Distribution Cyov Yr1 | $34,641 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $91,417 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $127,500 | QualifyingDistributionsAmt |
| Applied To Year1 | $0 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $9,736 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $117,764 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $0 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $0 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $209,181 | TotalCorpusAmt |
| Prior Year Undistributed Incm | $0 | PriorYearUndistributedIncmAmt |
| Prior Year Deficiency Or Tax | $0 | PriorYearDeficiencyOrTaxAmt |
| Taxable1 | $0 | Taxable1Amt |
| Taxable2 | $0 | Taxable2Amt |
| Undistributed Income CY | $0 | UndistributedIncomeCYAmt |
| Corpus Distri170b1 E Or4942g3 | $0 | CorpusDistri170b1EOr4942g3Amt |
| Excess Distri Cyov From Yr5 | $0 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $209,181 | ExcessDistriCyovToNextYrAmt |
| Excess From Year2 | $56,776 | ExcessFromYear2Amt |
| Excess From Year1 | $34,641 | ExcessFromYear1Amt |
| Excess From Current Year | $117,764 | ExcessFromCurrentYearAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (3 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| KANAWHA COUNTY DENTAL HEALTH COUNCIL INC | |||||||
| 100 FLORIDA ST | CHARLESTON | WV | 25302 | NONE | PC | TO PURCHASE DENTAL EQUIPMENT | $12,500 |
| GEORGIA DEPARTMENT OF PUBLIC HEALTH | |||||||
| 2 PEACHTREE STREET | ATLANTA | GA | 30303 | NONE | GOV | GRANT FOR ORAL HEALTH PROJECTS | $45,000 |
| FLORIDA DEPARTMENT OF HEALTH | |||||||
| 400 W AIRPORT BLVD | SANFORD | FL | 32773 | NONE | GOV | SEALANT PROGRAM | $70,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $127,500 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $2,985 | ExclusionAmt |
Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $10,425 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $13,410 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $13,410 | TotalIncomeProducingActyAmt |
Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp
Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp (2 entries)
| Line NumberLineNumberTxt | Relationship StatementRelationshipStatementTxt |
|---|---|
| 3 | INTEREST ON SHORT TERM INVESTMENTS |
| 4 | DIVIDENDS ON SHORT TERM INVESTMENTS |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | 0 | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | 0 | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | 0 | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | 0 | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | 0 | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | 0 | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | 0 | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | 0 | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | 0 | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | Yes (1) | RelationshipsNonchrtblEOInd |
Relationship Schedule Detail RelationshipScheduleDetail (9 entries)
| Organization TypeOrganizationTypeDesc | Relationship DescriptionRelationshipDescriptionTxt |
|---|---|
| RENAISSANCE HEALTH SERVICE CORPORATION | |
| 501(C)(4) | INDIRECT CONTROLLING ENTITY |
| DELTA DENTAL PLAN OF MICHIGAN INC | |
| 501(C)(4) | COMMONLY CONTROLLED INDIRECTLY BY RENAISSANCE HEALTH SERVICE CORPORATION |
| DELTA DENTAL OF TENNESSEE INC | |
| 501(C)(4) | COMMONLY CONTROLLED INDIRECTLY BY RENAISSANCE HEALTH SERVICE CORPORATION |
| DELTA DENTAL PLAN OF NEW MEXICO INC | |
| 501(C)(4) | COMMONLY CONTROLLED INDIRECTLY BY RENAISSANCE HEALTH SERVICE CORPORATION |
| DELTA DENTAL OF NORTH CAROLINA | |
| 501(C)(4) | COMMONLY CONTROLLED INDIRECTLY BY RENAISSANCE HEALTH SERVICE CORPORATION |
| DELTA DENTAL PLAN OF OHIO inc | |
| 501(C)(4) | COMMONLY CONTROLLED INDIRECTLY BY RENAISSANCE HEALTH SERVICE CORPORATION |
| DELTA DENTAL PLAN OF INDIANA inc | |
| 501(C)(4) | COMMONLY CONTROLLED INDIRECTLY BY RENAISSANCE HEALTH SERVICE CORPORATION |
| DELTA DENTAL PLAN OF ARKANSAS | |
| 501(C)(4) | COMMONLY CONTROLLED INDIRECTLY BY RENAISSANCE HEALTH SERVICE CORPORATION |
| DELTA DENTAL OF KENTUCKY INC | |
| 501(C)(4) | COMMONLY CONTROLLED INDIRECTLY BY RENAISSANCE HEALTH SERVICE CORPORATION |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | AUDIT EXPENSE | CategoryTxt |
| Amt | $3,000 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Stock | MUTUAL FUNDS | StockNm |
| EOY Book Value | $493,805 | EOYBookValueAmt |
| EOYFMV | $493,805 | EOYFMVAmt |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INTEREST RECEIVABLE | Desc |
| BOY Book Value | $1,620 | BOYBookValueAmt |
| EOY Book Value | $1,773 | EOYBookValueAmt |
| EOYFMV | $1,773 | EOYFMVAmt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (6 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| REGULATORY AGENCY FEES | $79 | $0 | $0 |
| BANK CHARGES | $3,140 | $3,140 | $0 |
| contract labor | $111 | $0 | $0 |
| LIABILITY INSURANCE | $248 | $0 | $0 |
| DENTAL HEALTH EDUCATION | $6,606 | $0 | $0 |
| Promotional Expenses | $2,354 | $0 | $0 |
Other Increases Schedule OtherIncreasesSchedule
Other Increases Detail OtherIncreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET UNREALIZED GAIN | Desc |
| Amt | $13,510 | Amt |
Other Liabilities Schedule OtherLiabilitiesSchedule
Other Liabilities Detail OtherLiabilitiesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATES | Desc |
| BOY Book Value | $7 | BOYBookValueAmt |
| EOY Book Value | $1,500 | EOYBookValueAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | FEDERAL TAX EXPENSE | CategoryTxt |
| Amt | $116 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
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