FURP.ORG / PUBLIC DATA EXPLORER

H & H VAN KLAVEREN FAMILY FOUNDATION: Form 990PF, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
H & H VAN KLAVEREN FAMILY FOUNDATION (EIN 56-2296408)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-09-05
IRS object ID
201712499349100001
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 ReturnHeader

FieldValueIRS element (for citing)
Return2017-09-05T12:14:39-07:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN770000018PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1GRIMBLEBY COLEMAN CPAS INCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1200 W ROSEBURG AVEAddressLine1Txt
CityMODESTOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP953505255ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN562296408EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1H & H VAN KLAVEREN FAMILY FOUNDATIOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlH&HVBusinessNameControlTxt
Phone2095954606PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16012 WOODLAND AVEAddressLine1Txt
CityMODESTOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95358ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDAVID VAN KLAVERENPersonNm
Person TitleSECRETARYPersonTitleTxt
Phone2095954606PhoneNum
Signature2017-07-18SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCLIVE T GRIMBLEBYPreparerPersonNm
PTINP00209714PTIN
Phone2095274220PhoneNum
Preparation2017-07-18PreparationDt

Filing Security Information FilingSecurityInformation

FieldValueIRS element (for citing)
At Submission Creation Device IdA64F3D79A551834D7DDD0AD2D989808E418AAAFCAtSubmissionCreationDeviceId
At Submission Filing Device IdFCCEC9897D1D6E7010096191F7A74C91451C5FBAAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$1,854,877FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$1,691,186ContriRcvdRevAndExpnssAmt
Dividends Rev And Expnss$4,663DividendsRevAndExpnssAmt
Dividends Net Invst Incm$4,663DividendsNetInvstIncmAmt
Total Rev And Expnss$1,695,849TotalRevAndExpnssAmt
Total Net Invst Incm$4,663TotalNetInvstIncmAmt
Legal Fees Rev And Expnss$559LegalFeesRevAndExpnssAmt
Accounting Fees Rev And Expnss$1,700AccountingFeesRevAndExpnssAmt
Taxes Rev And Expnss$105TaxesRevAndExpnssAmt
Trav Conf Meeting Rev And Expnss$2,625TravConfMeetingRevAndExpnssAmt
Other Expenses Rev And Expnss$200OtherExpensesRevAndExpnssAmt
Tot Opr Expenses Rev And Expnss$5,189TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$0TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$0TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$125,000ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$125,000ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$130,189TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$0TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$125,000TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses$1,565,660ExcessRevenueOverExpensesAmt
Net Investment Income$4,663NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Sav And Temp Cash Invst BOY$176,319SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$52,130SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$52,130SavAndTempCashInvstEOYFMVAmt
Other Investments BOY$250,261OtherInvestmentsBOYAmt
Other Investments EOY$1,940,110OtherInvestmentsEOYAmt
Other Investments EOYFMV$1,802,747OtherInvestmentsEOYFMVAmt
Total Assets BOY$426,580TotalAssetsBOYAmt
Total Assets EOY$1,992,240TotalAssetsEOYAmt
Total Assets EOYFMV$1,854,877TotalAssetsEOYFMVAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind
Retained Earning BOY$426,580RetainedEarningBOYAmt
Retained Earning EOY$1,992,240RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY$426,580TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$1,992,240TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$426,580TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$1,992,240TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$426,580TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses$1,565,660ExcessRevenueOverExpensesAmt
Subtotal$1,992,240SubtotalAmt
Tot Net Ast Or Fund Balances EOY$1,992,240TotNetAstOrFundBalancesEOYAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

FieldValueIRS element (for citing)
Liable Section4942 TaxfalseLiableSection4942TaxInd
Net Vl Noncharitable Assets Yr1$180,938NetVlNoncharitableAssetsYr1Amt
Adjusted Qlfy Distri Yr2$139,928AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2$180,558NetVlNoncharitableAssetsYr2Amt
Distribution Yr20.774975DistributionYr2Rt
Adjusted Qlfy Distri Yr3$50,000AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3$307,657NetVlNoncharitableAssetsYr3Amt
Distribution Yr30.162519DistributionYr3Rt
Net Vl Noncharitable Assets Yr4$240,199NetVlNoncharitableAssetsYr4Amt
Adjusted Qlfy Distri Yr5$324,995AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5$208,037NetVlNoncharitableAssetsYr5Amt
Distribution Yr51.562198DistributionYr5Rt
Total Distribution2.499692TotalDistributionRt
Average Distribution0.833231AverageDistributionRt
Net Vl Noncharitable Assets$364,513NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets$303,724AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct$47NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct$303,771AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions$125,000QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$93InvestmentIncomeExciseTaxAmt
Subtotal$93SubtotalAmt
Tax Based On Investment Income$93TaxBasedOnInvestmentIncomeAmt
Tax Due$93TaxDueAmt

Statements Regarding Acty StatementsRegardingActyGrp

FieldValueIRS element (for citing)
Legislative Political ActyfalseLegislativePoliticalActyInd
More Than100 SpentfalseMoreThan100SpentInd
Form1120 POL FiledfalseForm1120POLFiledInd
Activities Not Previously RptfalseActivitiesNotPreviouslyRptInd
Changes To Articles Or BylawsfalseChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Organization Dissolved EtcfalseOrganizationDissolvedEtcInd
Section508e Rqr SatisfiedYes (true)Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (true)AtLeast5000InAssetsInd
Form990 PF Filed With Atty GenYes (true)Form990PFFiledWithAttyGenInd
Private Operating FoundationfalsePrivateOperatingFoundationInd
New Substantial ContributorsfalseNewSubstantialContributorsInd
Own Controlled EntityfalseOwnControlledEntityInd
Donor Advised FundfalseDonorAdvisedFundInd
Comply With Public Insp RqrYes (true)ComplyWithPublicInspRqrInd
Website AddressN/AWebsiteAddressTxt
Individual With BooksDAVID VAN KLAVERENIndividualWithBooksNm
Phone2095954606PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 4040AddressLine1Txt
CityMODESTOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95352ZIPCd
FieldValueIRS element (for citing)
Foreign Accounts QuestionfalseForeignAccountsQuestionInd

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

FieldValueIRS element (for citing)
Sale Or Exch Disqualified PrsnfalseSaleOrExchDisqualifiedPrsnInd
Brrw Or Lend Disqualified PrsnfalseBrrwOrLendDisqualifiedPrsnInd
Furn Goods Disqualified PrsnfalseFurnGoodsDisqualifiedPrsnInd
Pay Comp Disqualified PrsnfalsePayCompDisqualifiedPrsnInd
Transfer Ast Disqualified PrsnfalseTransferAstDisqualifiedPrsnInd
Payment To Government OfficialfalsePaymentToGovernmentOfficialInd
Undistributed Income PYfalseUndistributedIncomePYInd
Business HoldingsfalseBusinessHoldingsInd
Jeopardy InvestmentsfalseJeopardyInvestmentsInd
Uncorrected PY Jeopardy InvstfalseUncorrectedPYJeopardyInvstInd
Influence LegislationfalseInfluenceLegislationInd
Influence ElectionfalseInfluenceElectionInd
Grants To IndividualsfalseGrantsToIndividualsInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Noncharitable PurposefalseNoncharitablePurposeInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
BERNICE H VAN KLAVEREN
PO BOX 4040MODESTOCA95352PRESIDENT/DI000.00$0$0$0
DAVID VAN KLAVEREN
PO BOX 4040MODESTOCA95352SECRETARY000.00$0$0$0
C MARK VAN KLAVEREN
PO BOX 4040MODESTOCA95352TREASURER/DI000.00$0$0$0
BRUCE VAN KLAVEREN
PO BOX 4040MODESTOCA95352DIRECTOR000.00$0$0$0
HENRY VAN KLAVEREN JR
PO BOX 4040MODESTOCA95352DIRECTOR000.00$0$0$0
FieldValueIRS element (for citing)
Comp Of Hghst Pd Empl Or NONENONECompOfHghstPdEmplOrNONETxt
Comp Of Hghst Pd Cntrct Or NONENONECompOfHghstPdCntrctOrNONETxt

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

FieldValueIRS element (for citing)
Description1N/ADescription1Txt

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$252,036AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$118,028AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$370,064TotalFMVOfUnusedAssetsAmt
Adjusted Total FMV Of Unused Ast$370,064AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$5,551CashDeemedCharitableAmt
Net Vl Noncharitable Assets$364,513NetVlNoncharitableAssetsAmt
Minimum Investment Return$18,226MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$18,226MinimumInvestmentReturnAmt
Tax Based On Investment Income$93TaxBasedOnInvestmentIncomeAmt
Total Tax$93TotalTaxAmt
Distributable Before Adj$18,133DistributableBeforeAdjAmt
Distributable Before Ded$18,133DistributableBeforeDedAmt
Distributable As Adjusted$18,133DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$125,000ExpensesAndContributionsAmt
Qualifying Distributions$125,000QualifyingDistributionsAmt
Adjusted Qualifying Distri$125,000AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$18,133DistributableAsAdjustedAmt
Excess Distribution Cyov Yr5$314,603ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr3$34,874ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2$131,044ExcessDistributionCyovYr2Amt
Total Excess Distribution Cyov$480,521TotalExcessDistributionCyovAmt
Qualifying Distributions$125,000QualifyingDistributionsAmt
Applied To Current Year$18,133AppliedToCurrentYearAmt
Remaining Distri From Corpus$106,867RemainingDistriFromCorpusAmt
Total Corpus$587,388TotalCorpusAmt
Undistributed Income CY$0UndistributedIncomeCYAmt
Excess Distri Cyov From Yr5$314,603ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$272,785ExcessDistriCyovToNextYrAmt
Excess From Year3$34,874ExcessFromYear3Amt
Excess From Year2$131,044ExcessFromYear2Amt
Excess From Current Year$106,867ExcessFromCurrentYearAmt

Supplementary Information SupplementaryInformationGrp

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

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (6 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
DORDT COLLEGE
498 4TH AVE NESIOIX CENTERIA51250EDUCATIONALTO FURTHUR ACTIVITY OF ORGANIZATION$75,000
CORNERSTONE COMMUNITY
2200 SUNRISE AVEMODESTOCA95350RELIGOUSTO FURTHUR ACTIVITY OF ORGANIZATION$2,500
BETHANY CHRISTIAN SERVICES
3048 HAHN DRMODESTOCA95350RELIGIOUSTO FURTHER PURPOSE OF ORGANIZATION$40,000
COMMUNITY HOSPICE
4368 SPYRES WAYMODESTOCA95356TO FURTHUR PURPOSE OF ORGANIZATION$3,500
LIVING WATER INTL
4001 GREENBRIAR DRSTAFFORDTX77477TO FURTHER PURPOSE OF ORGANIZATION$2,500
PLANT THE SEED MINISTRIES
2870 PEACHTREE RD NWATLANTAGA30305RELIGIOUSTO FURTHER PURPOSE OF MINISTRIES$1,500
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$125,000TotalGrantOrContriPdDurYrAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$4,663ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Exclusion$4,663ExclusionAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$4,663TotalIncomeProducingActyAmt

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

FieldValueIRS element (for citing)
Trnsfr Of Cash To Nonchrtbl EOfalseTrnsfrOfCashToNonchrtblEOInd
Trnsfr Other Asset Nonchrtbl EOfalseTrnsfrOtherAssetNonchrtblEOInd
Sales Or Exchanges Of AssetsfalseSalesOrExchangesOfAssetsInd
Purchase Of Assets Nonchrtbl EOfalsePurchaseOfAssetsNonchrtblEOInd
Rental Of Facilities Oth AssetsfalseRentalOfFacilitiesOthAssetsInd
Reimbursement ArrangementsfalseReimbursementArrangementsInd
Loans Or Loan GuaranteesfalseLoansOrLoanGuaranteesInd
Performance Of Services EtcfalsePerformanceOfServicesEtcInd
Sharing Of Facilities EtcfalseSharingOfFacilitiesEtcInd
Relationships Nonchrtbl EOfalseRelationshipsNonchrtblEOInd

Schedule B IRS990ScheduleB

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

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
Contributor1ContributorNum
Contributor PersonESTATE OF HENRY VAN KLAVERENContributorPersonNm

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 4040AddressLine1Txt
CityMODESTOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95352ZIPCd
FieldValueIRS element (for citing)
Total Contributions$1,689,848TotalContributionsAmt
Noncash ContributionYes (X)NoncashContributionInd

Non Cash Property Contribution NonCashPropertyContributionGrp

FieldValueIRS element (for citing)
Contributor1ContributorNum
Noncash PropertySECURITIESNoncashPropertyDesc
Fair Market Value$1,689,848FairMarketValueAmt
Received2016-12-29ReceivedDt

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryACCOUNTINGCategoryTxt
Amt$1,700Amt

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOtherGrp (20 entries)

Category Or ItemCategoryOrItemTxtListed At Cost Or FMVListedAtCostOrFMVCdBook ValueBookValueAmtEOYFMVEOYFMVAmt
BLACKROCK CA MUN INC.AT COST$642$609
BLACKROCK MUNIYLD CA QLTAT COST$619$566
THORNBURG INCOME BUILDERAT COST$194,000$113,572
THORNBURG INCOME BUILDERAT COST$55,000$5
PRUDENTIAL SHORT TERMAT COST$490,681$491,125
LORD ABBETT SHORTAT COST$395,071$395,071
ABBOTT LABSAT COST$38,655$38,755
ALTRIA GROUPAT COST$112,631$112,249
ASTRAZENECA PLCAT COST$16,060$16,037
ABBVIE INCAT COST$91,335$91,176
AT & TAT COST$62,156$61,966
AMN ELEC POWERAT COST$13,921$13,851
AMGEN INCAT COST$26,895$26,611
AUTOMATIC DATAAT COST$28,242$28,059
BB&T CORPORATIONAT COST$73,864$74,338
BCE INCAT COST$49,669$49,726
DUKE ENERGY CORP NEWAT COST$38,386$38,189
JOHNSON AND JOHNSONAT COST$74,838$74,657
MICROSOFT CORPAT COST$83,972$82,958
PHILIP MORRIS INTLAT COST$93,473$93,227

Legal Fees Schedule LegalFeesSchedule

Legal Fees LegalFeesGrp

FieldValueIRS element (for citing)
CategoryGIANELLI & ASSOCIATESCategoryTxt
Legal Fees$559LegalFeesAmt

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (3 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt
EXPENSES
INVESTMENT ACCOUNT FEES$150
DEPARTMENT OF CHARITABLE REG$50

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (2 entries)

CategoryCategoryTxtAmtAmt
FRANCHISE TAX BOARD$10
US TREASURY$95