KOSCIUSKO 21ST CENTURY FOUNDATION INC: Form 990PF, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- KOSCIUSKO 21ST CENTURY FOUNDATION INC (EIN 35-1187105)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-04-27
- IRS object ID
- 201731179349100708
- 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
- Schedule B
- Accounting Fees Schedule
- General Explanation Attachment
- Investments Corp Bonds Schedule
- Investments Corp Stock Schedule
- Investments Govt Obligations Sch
- Investments Land Schedule2
- Investments Other Schedule2
- Land Etc Schedule2
- Other Assets Schedule
- Other Decreases Schedule
- Other Expenses Schedule
- Other Income Schedule2
- Other Increases Schedule
- Other Liabilities Schedule
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-04-27T14:11:10-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351178661 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Blue & Co LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 N Meridian St Suite 200 | AddressLine1Txt |
| City | Indianapolis | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | 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 | 351187105 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kosciusko 21st Century Foundation Inc | BusinessNameLine1Txt |
| Business Name Line2 | aka K21 Health Foundation | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | KOSC | BusinessNameControlTxt |
| Phone | 5742695188 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2170 N Pointe Drive | AddressLine1Txt |
| City | Warsaw | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46582 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RICH HADDAD | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 5742695188 | PhoneNum |
| Signature | 2017-04-27 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Amber Kocher CPA | PreparerPersonNm |
| PTIN | P00418596 | PTIN |
| Phone | 3176334705 | PhoneNum |
| Preparation | 2017-04-27 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 38.86.68.133 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-04-27 | IPDt |
| IP Tm | 14:11:08 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | CB73872C89F6C9C373A48B74A8C019EAB5F72C00 | 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 | $70,319,088 | 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 | $521,390 | ContriRcvdRevAndExpnssAmt |
| Interest On Sav Rev And Expnss | $632,437 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $632,437 | InterestOnSavNetInvstIncmAmt |
| Dividends Rev And Expnss | $846,745 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $846,745 | DividendsNetInvstIncmAmt |
| Gross Rents Rev And Expnss | $148,458 | GrossRentsRevAndExpnssAmt |
| Gross Rents Net Invst Incm | $148,458 | GrossRentsNetInvstIncmAmt |
| Net Rental Income Or Loss | $25,712 | NetRentalIncomeOrLossAmt |
| Net Gain Sale Ast Rev And Expnss | $2,198,994 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $48,621,497 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $2,198,994 | CapGainNetIncmNetInvstIncmAmt |
| Other Income Rev And Expnss | $2,959 | OtherIncomeRevAndExpnssAmt |
| Other Income Net Invst Incm | $2,959 | OtherIncomeNetInvstIncmAmt |
| Other Income Adj Net Incm | $0 | OtherIncomeAdjNetIncmAmt |
| Total Rev And Expnss | $4,350,983 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $3,829,593 | TotalNetInvstIncmAmt |
| Total Adj Net Incm | $0 | TotalAdjNetIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $180,972 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $0 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Adj Net Incm | $0 | CompOfcrDirTrstAdjNetIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $180,972 | CompOfcrDirTrstDsbrsChrtblAmt |
| Oth Empl Slrs Wgs Rev And Expnss | $74,620 | OthEmplSlrsWgsRevAndExpnssAmt |
| Oth Empl Slrs Wgs Net Invst Incm | $0 | OthEmplSlrsWgsNetInvstIncmAmt |
| Oth Empl Slrs Wgs Adj Net Incm | $0 | OthEmplSlrsWgsAdjNetIncmAmt |
| Oth Empl Slrs Wgs Dsbrs Chrtbl | $77,423 | OthEmplSlrsWgsDsbrsChrtblAmt |
| Pension Empl Bnft Rev And Expnss | $25,092 | PensionEmplBnftRevAndExpnssAmt |
| Pension Empl Bnft Net Invst Incm | $0 | PensionEmplBnftNetInvstIncmAmt |
| Pension Empl Bnft Adj Net Incm | $0 | PensionEmplBnftAdjNetIncmAmt |
| Pension Empl Bnft Dsbrs Chrtbl | $25,092 | PensionEmplBnftDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $17,000 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $0 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $0 | AccountingFeesAdjNetIncmAmt |
| Accounting Fees Chrtbl Prps | $17,000 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Rev And Expnss | $220,951 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $220,951 | OtherProfFeesNetInvstIncmAmt |
| Other Prof Fees Adj Net Incm | $0 | OtherProfFeesAdjNetIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $0 | OtherProfFeesDsbrsChrtblAmt |
| Taxes Rev And Expnss | $43,666 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $0 | TaxesNetInvstIncmAmt |
| Taxes Adj Net Incm | $0 | TaxesAdjNetIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Deprec And Dpltn Rev And Expnss | $111,403 | DeprecAndDpltnRevAndExpnssAmt |
| Deprec And Dpltn Net Invst Incm | $109,022 | DeprecAndDpltnNetInvstIncmAmt |
| Deprec And Dpltn Adj Net Incm | $0 | DeprecAndDpltnAdjNetIncmAmt |
| Occupancy Rev And Expnss | $43,654 | OccupancyRevAndExpnssAmt |
| Occupancy Net Invst Incm | $0 | OccupancyNetInvstIncmAmt |
| Occupancy Adj Net Incm | $0 | OccupancyAdjNetIncmAmt |
| Occupancy Dsbrs Chrtbl | $43,654 | OccupancyDsbrsChrtblAmt |
| Trav Conf Meeting Rev And Expnss | $20,017 | TravConfMeetingRevAndExpnssAmt |
| Trav Conf Meeting Net Invst Incm | $0 | TravConfMeetingNetInvstIncmAmt |
| Trav Conf Meeting Adj Net Incm | $0 | TravConfMeetingAdjNetIncmAmt |
| Trav Conf Meeting Dsbrs Chrtbl | $20,017 | TravConfMeetingDsbrsChrtblAmt |
| Printing And Pub Rev And Expnss | $3,801 | PrintingAndPubRevAndExpnssAmt |
| Printing And Pub Net Invst Incm | $0 | PrintingAndPubNetInvstIncmAmt |
| Printing And Pub Adj Net Incm | $0 | PrintingAndPubAdjNetIncmAmt |
| Printing And Pub Dsbrs Chrtbl | $3,801 | PrintingAndPubDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $1,056,533 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $13,724 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Adj Net Incm | $0 | OtherExpensesAdjNetIncmAmt |
| Other Expenses Dsbrs Chrtbl | $115,379 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $1,797,709 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $343,697 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $0 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $483,338 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $2,040,169 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $2,331,359 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $3,837,878 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $343,697 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $0 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $2,814,697 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $513,105 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $3,485,896 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sav And Temp Cash Invst BOY | $865,613 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $989,203 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $989,203 | SavAndTempCashInvstEOYFMVAmt |
| Prepaid Expenses BOY | $8,473 | PrepaidExpensesBOYAmt |
| Prepaid Expenses EOY | $8,668 | PrepaidExpensesEOYAmt |
| Prepaid Expenses EOYFMV | $8,668 | PrepaidExpensesEOYFMVAmt |
| US Government Obligations BOY | $5,922,534 | USGovernmentObligationsBOYAmt |
| US Government Obligations EOY | $5,871,192 | USGovernmentObligationsEOYAmt |
| US Govt Obligations EOYFMV | $5,772,281 | USGovtObligationsEOYFMVAmt |
| Corporate Stock BOY | $33,820,865 | CorporateStockBOYAmt |
| Corporate Stock EOY | $31,647,424 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $39,968,754 | CorporateStockEOYFMVAmt |
| Corporate Bonds BOY | $9,401,571 | CorporateBondsBOYAmt |
| Corporate Bonds EOY | $9,453,825 | CorporateBondsEOYAmt |
| Corporate Bonds EOYFMV | $9,241,735 | CorporateBondsEOYFMVAmt |
| Invst Land Cost Or Other Basis | $1,893,615 | InvstLandCostOrOtherBasisAmt |
| Invst Land Accum Depreciation | $347,668 | InvstLandAccumDepreciationAmt |
| Land Bldg Investments BOY | $1,654,969 | LandBldgInvestmentsBOYAmt |
| Land Bldg Investments EOY | $1,545,947 | LandBldgInvestmentsEOYAmt |
| Land Bldg Investments EOYFMV | $1,545,947 | LandBldgInvestmentsEOYFMVAmt |
| Other Investments BOY | $5,383,543 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $8,657,118 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $9,658,390 | OtherInvestmentsEOYFMVAmt |
| Land Bldg Equip Cost Or Other Bss | $361,446 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $62,717 | LandBldgEquipAccumDeprecAmt |
| Land BOY | $4,391 | LandBOYAmt |
| Land EOY | $298,729 | LandEOYAmt |
| Land EOYFMV | $298,729 | LandEOYFMVAmt |
| Other Assets BOY | $4,015,321 | OtherAssetsBOYAmt |
| Other Assets EOY | $2,835,381 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $2,835,381 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $61,077,280 | TotalAssetsBOYAmt |
| Total Assets EOY | $61,307,487 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $70,319,088 | TotalAssetsEOYFMVAmt |
| Accounts Payable BOY | $13,762 | AccountsPayableBOYAmt |
| Grants Payable BOY | $577,036 | GrantsPayableBOYAmt |
| Grants Payable EOY | $298,983 | GrantsPayableEOYAmt |
| Other Liabilities BOY | $81,198 | OtherLiabilitiesBOYAmt |
| Other Liabilities EOY | $90,116 | OtherLiabilitiesEOYAmt |
| Total Liabilities BOY | $671,996 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $389,099 | TotalLiabilitiesEOYAmt |
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
| Unrestricted BOY | $59,954,698 | UnrestrictedBOYAmt |
| Unrestricted EOY | $60,369,514 | UnrestrictedEOYAmt |
| Temporarily Restricted BOY | $450,586 | TemporarilyRestrictedBOYAmt |
| Temporarily Restricted EOY | $548,874 | TemporarilyRestrictedEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $60,405,284 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $60,918,388 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $61,077,280 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $61,307,487 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $60,405,284 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $513,105 | ExcessRevenueOverExpensesAmt |
| Other Increases | $891,810 | OtherIncreasesAmt |
| Subtotal | $61,810,199 | SubtotalAmt |
| Other Decreases | $891,811 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $60,918,388 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Property | Sale of Securities | PropertyDesc |
| How Acquired | P | HowAcquiredCd |
| Gross Sales Price | $48,621,497 | GrossSalesPriceAmt |
| Cost Or Other Basis | $46,422,503 | CostOrOtherBasisAmt |
| Gain Or Loss | $2,198,994 | GainOrLossAmt |
| Gains Minus Excess Or Losses | $2,198,994 | GainsMinusExcessOrLossesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $2,198,994 | CapitalGainNetIncomeAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | 0 | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $4,209,526 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $66,164,115 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.063622 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $3,838,345 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $67,153,038 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.057158 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $3,352,218 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $62,610,514 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 0.053541 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $3,002,834 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $57,062,361 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.052624 | DistributionYr4Rt |
| Adjusted Qlfy Distri Yr5 | $3,182,910 | AdjustedQlfyDistriYr5Amt |
| Net Vl Noncharitable Assets Yr5 | $57,452,206 | NetVlNoncharitableAssetsYr5Amt |
| Distribution Yr5 | 0.055401 | DistributionYr5Rt |
| Total Distribution | 0.282346 | TotalDistributionRt |
| Average Distribution | 0.056469 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $64,963,804 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $3,668,441 | AdjNetVlNoncharitableAssetsAmt |
| Net Investment Income Pct | $34,859 | NetInvestmentIncomePctAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $3,703,300 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $3,729,186 | 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 | $34,859 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $34,859 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $34,859 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $40,800 | EstimatedPlusOvpmtIncmTxAmt |
| Total Payments And Credits | $40,800 | TotalPaymentsAndCreditsAmt |
| Form2220 Attached | Yes (X) | Form2220AttachedInd |
| Overpayment | $5,941 | OverpaymentAmt |
| Applied To ES Tax | $5,941 | AppliedToESTaxAmt |
| Refund | $0 | RefundAmt |
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 |
| 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 | www.k21foundation.org | WebsiteAddressTxt |
| Individual With Books | RICH HADDAD | IndividualWithBooksNm |
| Phone | 5742695188 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2170 N Pointe Drive | AddressLine1Txt |
| City | WARSAW | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46582 | 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 (18 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 |
|---|---|---|---|---|---|---|---|---|
| RICHARD HADDAD | ||||||||
| 2170 North Pointe Drive | Warsaw | IN | 46582 | PRESIDENT | 40.00 | $180,972 | $5,279 | $0 |
| James TINKEY | ||||||||
| 2170 North Pointe Drive | Warsaw | IN | 46582 | Chairman | 1.00 | $0 | $0 | $0 |
| Scott Tucker | ||||||||
| 2170 North Pointe Drive | warsaw | IN | 46582 | Vice Chairman | 1.00 | $0 | $0 | $0 |
| Dana Krull | ||||||||
| 2170 North Pointe Drive | warsaw | IN | 46582 | Treasurer | 1.00 | $0 | $0 | $0 |
| Shari Boyle | ||||||||
| 2170 North Pointe Drive | warsaw | IN | 46582 | Secretary | 1.00 | $0 | $0 | $0 |
| Becky Alles | ||||||||
| 2170 North Pointe Drive | warsaw | IN | 46582 | diRECTOR | 1.00 | $0 | $0 | $0 |
| Karen Boling | ||||||||
| 2170 North Pointe Drive | warsaw | IN | 46582 | DiRECTOR | 1.00 | $0 | $0 | $0 |
| Dr David Dick | ||||||||
| 2170 North Pointe Drive | warsaw | IN | 46582 | diRECTOR | 1.00 | $0 | $0 | $0 |
| Rick Kerlin | ||||||||
| 2170 North Pointe Drive | warsaw | IN | 46582 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| Steve Grill | ||||||||
| 2170 North Pointe Drive | Warsaw | IN | 46582 | DiRECTOR | 1.00 | $0 | $0 | $0 |
| Andrew Grossnickle | ||||||||
| 2170 North Pointe Drive | warsaw | IN | 46582 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| Dr David Haines | ||||||||
| 2170 North Pointe Drive | warsaw | IN | 46582 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| Joe Hawn | ||||||||
| 2170 North Pointe Drive | warsaw | IN | 46582 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| Rosy Jansma | ||||||||
| 2170 North Pointe Drive | warsaw | IN | 46582 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| Jennifer Lucht | ||||||||
| 2170 North Pointe Drive | Warsaw | IN | 46582 | DiRECTOR | 1.00 | $0 | $0 | $0 |
| Max Mock | ||||||||
| 2170 North Pointe Drive | Warsaw | IN | 46582 | DiRECTOR | 1.00 | $0 | $0 | $0 |
| Kevin Roberts | ||||||||
| 2170 North Pointe Drive | warsaw | IN | 46582 | DiRECTOR | 1.00 | $0 | $0 | $0 |
| Steve Ross | ||||||||
| 2170 North Pointe Drive | warsaw | IN | 46582 | DiRECTOR | 1.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Hghst Pd Empl Or NONE | NONE | CompOfHghstPdEmplOrNONETxt |
| Other Employee Paid Over50k | 0 | OtherEmployeePaidOver50kCnt |
Compensation Of Hghst Pd Cntrct CompensationOfHghstPdCntrctGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Service TypeServiceTypeTxt | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WJ Carey Construction | |||||
| PO Box 534 | South Whitley | IN | 46787 | General Contractor | $263,385 |
| Marquette Associates | |||||
| 180 N LaSalle Suite 3500 | Chicago | IL | 60601 | Investment Consulting | $68,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contractor Paid Over50k | 0 | ContractorPaidOver50kCnt |
Sum Of Program Related Invst SumOfProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | Forgiveness of current Loan mortgage interest due from Kosciusko Health Services Pavilion, Inc., a section 501(c(3) Organization. | Description1Txt |
| Expenses1 | $905,900 | Expenses1Amt |
| Description2 | Forgiveness of current Loan due from Harvest with a Heart, Inc. a section 501(c)(3) Organization. | Description2Txt |
| Expenses2 | $8,589 | Expenses2Amt |
| Total | $914,489 | TotalAmt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $65,531,560 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $421,541 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $65,953,101 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $65,953,101 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $989,297 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $64,963,804 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $3,248,190 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $3,248,190 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $34,859 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $34,859 | TotalTaxAmt |
| Distributable Before Adj | $3,213,331 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $3,213,331 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $3,213,331 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $2,814,697 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $914,489 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $3,729,186 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $34,859 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $3,694,327 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $3,213,331 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $0 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr2 | $87,852 | ExcessDistributionCyovYr2Amt |
| Excess Distribution Cyov Yr1 | $982,854 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $1,070,706 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $3,729,186 | QualifyingDistributionsAmt |
| Applied To Year1 | $0 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $3,213,331 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $515,855 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $0 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $0 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $1,586,561 | 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 | $1,586,561 | ExcessDistriCyovToNextYrAmt |
| Excess From Year2 | $87,852 | ExcessFromYear2Amt |
| Excess From Year1 | $982,854 | ExcessFromYear1Amt |
| Excess From Current Year | $515,855 | ExcessFromCurrentYearAmt |
Supplementary Information SupplementaryInformationGrp
Application Submission Info ApplicationSubmissionInfoGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Person | KOSCIUSKO 21ST CENTURY FOUNDATION I | RecipientPersonNm |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2170 North Pointe Drive | AddressLine1Txt |
| City | Warsaw | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46582 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Phone | 5742695188 | RecipientPhoneNum |
| Form And Info And Materials | SEE STATEMENTS 20 AND 21. | FormAndInfoAndMaterialsTxt |
| Submission Deadlines | SEE STATEMENTS 20 AND 21. | SubmissionDeadlinesTxt |
| Restrictions On Awards | SEE STATEMENTS 20 AND 21. | RestrictionsOnAwardsTxt |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (100 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| DIRECT GRANT American Diabetes Association | |||||||
| 6415 Castleway West Dr Ste 114 | Indianapolis | IN | 46250 | NONE | PC | K21 Board of Directors Directed Donation | $1,000 |
| DIRECT GRANT Cardinal Services | |||||||
| 504 North Bay Dr | Warsaw | IN | 46580 | NONE | PC | K21 Board of Directors Directed Donation | $1,000 |
| DIRECT GRANT Chain 'O Lakes Chorus | |||||||
| PO Box 303 | Winona Lake | IN | 46590 | NONE | PC | K21 Board of Directors Directed Donation | $1,000 |
| DIRECT GRANT Fellowship Missions | |||||||
| PO Box 382 | Winona Lake | IN | 46590 | NONE | PC | K21 Board of Directors Directed Donation | $1,000 |
| DIRECT GRANT Grace College & Seminary | |||||||
| 200 Seminary Drive | Winona Lake | IN | 46590 | NONE | PC | K21 Board of Directors Directed Donation | $2,000 |
| DIRECT GRANT Gradway | |||||||
| PO Box 174 | Warsaw | IN | 46580 | NONE | PC | K21 Board of Directors Directed Donation | $1,000 |
| DIRECT GRANT Kosciusko County Shelter for Abuse | |||||||
| Po Box 12 | Warsaw | IN | 46581 | NONE | PC | K21 Board of Directors Directed Donation | $1,000 |
| DIRECT GRANT North Webster Day Care | |||||||
| PO Box 316 | North Webster | IN | 46555 | NONE | PC | K21 Board of Directors Directed Donation | $1,000 |
| DIRECT GRANT Riley Children's Foundation | |||||||
| 30 South Meridian St | Indianapolis | IN | 46204 | NONE | PC | K21 Board of Directors Directed Donation | $1,000 |
| DIRECT GRANT Tippecanoe Valley Community Schools | |||||||
| 8343 South State Road 19 | Akron | IN | 16910 | NONE | PC | K21 Board of Directors Directed Donation | $1,000 |
| DIRECT GRANT Wagon Wheel Theater | |||||||
| PO Box 804 | Warsaw | IN | 46581 | NONE | PC | K21 Board of Directors Directed Donation | $1,000 |
| DIRECT GRANT Northstar Medical | |||||||
| 6308 E Fulton St | Ada | MI | 49301 | NONE | PC | AED Equipment | $12,211 |
| DIRECT GRANT The Lutheran Foundation | |||||||
| 3024 Fairfield Ave | Fort Wayne | IN | 46807 | NONE | PC | Addiction Program and Project Funding | $50,000 |
| DIRECT GRANT Town of Winona Lake | |||||||
| 1310 Park Ave | Winona Lake | IN | 46590 | NONE | PC | Tennis Courts at Park - Grill Memorial | $89,339 |
| DIRECT GRANTS Other grants under 1000 | |||||||
| PO box 1810 | Warsaw | IN | 465811810 | NONE | PC | K21 Board of Directors Directed Donation | $5,500 |
| Cancer Care Grant Amanda Sudlow | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $1,104 |
| Cancer Care Grant Amos England | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $1,416 |
| Cancer Care Grant Angela Ward | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $4,924 |
| Cancer Care Grant Anthony Gee | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $6,298 |
| Cancer Care Grant Bernadene Boggs | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $4,228 |
| Cancer Care Grant Dallas Baugher | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $1,600 |
| Cancer Care Grant Donald Caverley | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $3,192 |
| Cancer Care Grant Dorothy Hash | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $1,180 |
| Cancer Care Grant Fred Hewitt | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $1,055 |
| Cancer Care Grant Garin Voorheis | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $4,000 |
| Cancer Care Grant Isaac Crow | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $6,000 |
| Cancer Care Grant Jason Bodley | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $2,274 |
| Cancer Care Grant Jesse Hurley | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $3,308 |
| Cancer Care Grant Jett Roe | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $4,200 |
| Cancer Care Grant Judy Roberts | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $2,500 |
| Cancer Care Grant Karen Stephenson | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $2,145 |
| Cancer Care Grant Larry Parker | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $1,284 |
| Cancer Care Grant Leslie Carnes | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $2,785 |
| Cancer Care Grant Lisa Seitz | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $2,500 |
| Cancer Care Grant Marcelle Heady | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $3,500 |
| Cancer Care Grant Maria Marquez | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $2,450 |
| Cancer Care Grant Mary Potts | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $1,500 |
| Cancer Care Grant Michael Dennin | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $1,000 |
| Cancer Care Grant Mitchell Dulworth | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $2,667 |
| Cancer Care Grant Naoma Foreman | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $3,200 |
| Cancer Care Grant Patricia Keim | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $4,500 |
| Cancer Care Grant Paul Tinkel | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $1,745 |
| Cancer Care Grant Randall Graber | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $1,584 |
| Cancer Care Grant Rhonda Allen | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $5,587 |
| Cancer Care Grant Rhonda Phillips | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $2,158 |
| Cancer Care Grant Richard Kelly | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $1,900 |
| Cancer Care Grant Rosa Ramos | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $1,402 |
| Cancer Care Grant Sabrina Sherow | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $1,989 |
| Cancer Care Grant Samantha Shepherd | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $2,000 |
| Cancer Care Grant Shirley Owens | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $1,433 |
| Cancer Care Grant Sondrea Hamilton | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $1,500 |
| Cancer Care Grant Stephen Jones | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $2,500 |
| Cancer Care Grant Tamara Drake | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $6,000 |
| Cancer Care Grant Teo Xique | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $1,103 |
| Cancer Care Grant Vicki Randall | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $4,727 |
| Cancer Care Grant Willie Fields | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $2,706 |
| Cancer Care Grant Wilma Justice | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $2,352 |
| Cancer Care Grant Other Grants less | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | I | PROVIDE FINANCIAL ASSISTANCE DUE TO CANCER DIAGNOSIS | $19,227 |
| CONDITIONAL GRANT All Things New | |||||||
| PO Box 367 | Winona Lake | IN | 46590 | NONE | PC | Facility Improvements | $14,189 |
| CONDITIONAL GRANT American Diabetes Association | |||||||
| 6415 Castleway West Dr Ste 114 | Indianapolis | IN | 46250 | NONE | PC | Scholarships for children attending diabetes camp | $7,050 |
| CONDITIONAL GRANT Atwood Community Building | |||||||
| PO Box 51 | Atwood | IN | 46502 | NONE | PC | AED | $1,674 |
| CONDITIONAL GRANT Crosswinds | |||||||
| 4150 Illinois Rd | Fort Wayne | IN | 46804 | NONE | PC | In-home Counseling services | $35,013 |
| CONDITIONAL GRANT Fellowship Missions | |||||||
| PO Box 382 | Winona Lake | IN | 46590 | NONE | PC | Facility Renovations | $37,000 |
| CONDITIONAL GRANT Grace College & Seminary | |||||||
| 200 Seminary Drive | Winona Lake | IN | 46590 | NONE | PC | Funds for Kosciusko Lakes & Streams research study | $92,652 |
| CONDITIONAL GRANT Heartline Pregnancy Center | |||||||
| 1515 Provident Dr Ste 180 | Warsaw | IN | 46580 | NONE | PC | B.A.B.E. Boutique, Clinical Supplies, Car Seats, STI Testing | $37,987 |
| CONDITIONAL GRANT Kosciusko County YMCA | |||||||
| 1305 Mariners Dr | Warsaw | IN | 46582 | NONE | PC | New Facility Development; LiveStrong Program | $435,000 |
| CONDITIONAL GRANT Kosciusko County Council on Aging | |||||||
| 800 Park Ave | Warsaw | IN | 46580 | NONE | PC | Transportation Van | $26,837 |
| CONDITIONAL GRANT Kosciusko County Shelter for Abuse | |||||||
| PO Box 12 | Warsaw | IN | 46581 | NONE | PC | New Facility Development | $52,056 |
| CONDITIONAL GRANT Kosciusko Health Services Pavilion | |||||||
| 1515 Provident Dr | Warsaw | IN | 46580 | NONE | PC | Phone System | $11,496 |
| CONDITIONAL GRANT Kosciusko Home Care & Hospice | |||||||
| 1515 Provident Drive Ste 250 | Warsaw | IN | 46580 | NONE | PC | Children's Oral Health, Medication and Dental, Medical Supplies | $133,449 |
| CONDITIONAL GRANT Lake City BMX Club | |||||||
| 5105 N Dovewood Trail | Warsaw | IN | 46582 | NONE | PC | Track Renovations | $5,100 |
| CONDITIONAL GRANT Lakeland Christian Academy | |||||||
| 1095 S 250 E | Winona Lake | IN | 46590 | NONE | PC | Tower Garden Systems | $3,512 |
| CONDITIONAL GRANT Lifeline Youth and Family Services | |||||||
| PO Box 80487 | Fort Wayne | IN | 49898 | NONE | PC | AED | $1,339 |
| CONDITIONAL GRANT Little Lambs Ministry | |||||||
| PO Box 176 | Syracuse | IN | 46567 | NONE | PC | Playground Renovation | $10,000 |
| CONDITIONAL GRANT Northern Indiana Hispanic Health Coalition | |||||||
| 323 Stocker Court | Elkhart | IN | 46516 | NONE | PC | Operational funding for bilingual advocate/health fairs | $48,750 |
| CONDITIONAL GRANT Positive Resource Connection | |||||||
| 525 Oxford Street | Fort Wayne | IN | 46806 | NONE | PC | Health Testing Supplies | $1,898 |
| CONDITIONAL GRANT Questa Foundation | |||||||
| 6502 Constitution Dr | Fort Wayne | IN | 46804 | NONE | PC | Health Scholars Program | $70,000 |
| CONDITIONAL GRANT REAL Services | |||||||
| 720 E Winona Ave | Warsaw | IN | 46580 | NONE | PC | Elderly programs | $30,000 |
| CONDITIONAL GRANT Syracuse Wawasee Park Foundation | |||||||
| 1013 North Long Dr | Syracuse | IN | 46567 | NONE | PC | Trails, Ice Rink, and equipment | $44,129 |
| CONDITIONAL GRANT Town of Milford | |||||||
| 121 S Main St | Milford | IN | 46542 | NONE | PC | Playground Renovation | $40,000 |
| CONDITIONAL GRANT Town of Pierceton | |||||||
| PO Box 496 | Pierceton | IN | 46562 | NONE | PC | Pathway Development | $9,363 |
| CONDITIONAL GRANT Town of Winona Lake | |||||||
| 1310 Park Ave | Winona Lake | IN | 46590 | NONE | PC | Pathway Development | $113,350 |
| CONDITIONAL GRANT Warsaw Community Schools | |||||||
| 1 Administration Dr | Warsaw | IN | 46580 | NONE | PC | Tower Garden Systems | $18,573 |
| CONDITIONAL GRANT Young Tiger Football | |||||||
| 1429 Durham Court | Winona Lake | IN | 46590 | NONE | PC | Equipment | $7,000 |
| CONDITIONAL GRANT Other grants less than 1000 | |||||||
| PO Box 1810 | Warsaw | IN | 465811810 | NONE | PC | To support stated purpose of grant | $1,126 |
| UNCONDITIONAL GRANT Baker Youth Club | |||||||
| 1401 E Smith St | Warsaw | IN | 46580 | NONE | PC | Summer Fitness Program | $20,000 |
| UNCONDITIONAL GRANT Big Brothers Big Sisters | |||||||
| 2349 Fairfield Avenue | Fort Wayne | IN | 46807 | NONE | PC | Stop Sexual Abuse Training | $5,000 |
| UNCONDITIONAL GRANT Brightpoint | |||||||
| 227 E Washington Blvd | Fort Wayne | IN | 46804 | NONE | PC | Operational Assistance | $17,500 |
| UNCONDITIONAL GRANT Cancer Services of Northeast Indiana | |||||||
| 6316 Mutual Drive | Fort Wayne | IN | 46825 | NONE | PC | Direct Assistance / Client Advocacy | $15,000 |
| UNCONDITIONAL GRANT City of Warsaw | |||||||
| 102 S Buffalo St | Warsaw | IN | 46580 | NONE | PC | DARE program | $4,000 |
| UNCONDITIONAL GRANT Erin's House for Grieving Children | |||||||
| 5670 YMCA Park Drvie West | Fort Wayne | IN | 46835 | NONE | PC | Operational Assistance | $7,500 |
| UNCONDITIONAL GRANT Fellowship Missions | |||||||
| PO Box 382 | Winona Lake | IN | 46590 | NONE | PC | Facility Repair | $25,000 |
| UNCONDITIONAL GRANT Grace College | |||||||
| 200 Seminary Drive | Winona Lake | IN | 46590 | NONE | PC | CLAS Operating Assistance; tobacco cessation program | $49,425 |
| UNCONDITIONAL GRANT Heartline Pregnancy Center | |||||||
| 1515 Provident Drive | Warsaw | IN | 46580 | NONE | PC | Mobile Unit Operations | $46,000 |
| UNCONDITIONAL GRANT Joe's Kids | |||||||
| 3540 Commerci Dr | Warsaw | IN | 46580 | NONE | PC | Operational Assistance | $12,500 |
| UNCONDITIONAL GRANT Kosciusko County Community Foundation | |||||||
| 102 East Market Street | Warsaw | IN | 46580 | NONE | PC | Good Samaritan Fund | $156,250 |
| UNCONDITIONAL GRANT Kosciusko County Shelter for Abuse | |||||||
| PO Box 12 | Warsaw | IN | 46581 | NONE | PC | Operating Transition Assistance | $30,000 |
| UNCONDITIONAL GRANT Kosciusko Home Care & Hospice | |||||||
| 1515 Provident Drive Ste 250 | Warsaw | IN | 46580 | NONE | PC | Operational Assistance | $329,868 |
| UNCONDITIONAL GRANT Mad Anthony's Children's Hope House | |||||||
| 7922 West Jefferson Blvd | Fort Wayne | IN | 46804 | NONE | PC | Operational Assistance | $15,000 |
| UNCONDITIONAL GRANT Ryan's Place | |||||||
| PO Box 73 | Goshen | IN | 46527 | NONE | PC | Operational Assistance | $6,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $2,331,359 | 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 | $632,437 | ExclusionAmt |
Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $846,745 | ExclusionAmt |
Net Rntl Incm Re Not Debt Fincd Prop NetRntlIncmReNotDebtFincdProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 16 | ExclusionCd |
| Exclusion | $25,712 | ExclusionAmt |
Other Investment Incm Part VII OtherInvestmentIncmPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $2,959 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $2,198,994 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $3,706,847 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $3,706,847 | TotalIncomeProducingActyAmt |
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 | 0 | RelationshipsNonchrtblEOInd |
Schedule B IRS990ScheduleB
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| General Rule | Yes (X) | GeneralRuleInd |
Contributor Information ContributorInformationGrp (8 entries)
| ContributorContributorNum | Address Line1ContributorUSAddress/AddressLine1Txt | CityContributorUSAddress/CityNm | State AbbreviationContributorUSAddress/StateAbbreviationCd | ZIPContributorUSAddress/ZIPCd | Total ContributionsTotalContributionsAmt | Person ContributionPersonContributionInd |
|---|---|---|---|---|---|---|
| Multi-Township EMS Corporation | ||||||
| 1 | 34 E Armstrong Rd | leesburg | IN | 46538 | $250,000 | Yes (X) |
| Donette Smock | ||||||
| 2 | 5867 E Island Ave | Syracuse | IN | 46567 | $35,300 | Yes (X) |
| Douglas Schrock | ||||||
| 3 | 631 E Northshore Dr | Syracuse | IN | 46567 | $10,575 | Yes (X) |
| Brian Hull | ||||||
| 4 | 7796 E Vawter Park Rd | Syracuse | IN | 46567 | $10,570 | Yes (X) |
| Zimmer Biomet | ||||||
| 5 | 345 E Main St | warsaw | IN | 46580 | $10,000 | Yes (X) |
| Bertsch Family Charitable Foundation | ||||||
| 6 | PO Box 1494 | warsaw | IN | 46581 | $6,000 | Yes (X) |
| Kosciusko Community Hospital | ||||||
| 7 | 2101 E Dubois Drive | Warsaw | IN | 46580 | $5,500 | Yes (X) |
| Donald Gunden | ||||||
| 8 | 64874 Orchard Drive | Goshen | IN | 46526 | $5,000 | Yes (X) |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | ACCOUNTING FEES | CategoryTxt |
| Amt | $17,000 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $17,000 | DisbursementsCharitablePrpsAmt |
General Explanation Attachment GeneralExplanationAttachment
General Explanation GeneralExplanationGrp (2 entries)
| IdentifierIdentifierTxt | Form And Line ReferenceFormAndLineReferenceDesc | Medium ExplanationMediumExplanationTxt |
|---|---|---|
| SUPPLEMENTARY INFORMATION | Form 990-PF, Part XV, Line 2A through 2d | LINE 2, NAME OF THE GRANT PROGRAM: K21 HEALTH AND WELLNESS COMMUNITY GRANTSLINE 2A AND 2B, FORM AND CONTENT OF APPLICATION:K21 HEALTH FOUNDATION EXISTS FOR THE BENEFIT OF KOSCIUSKO COUNTY CITIZENS TO ENSURE HEALTH CARE SERVICES ARE PROVIDED, AND TO ADVANCE PREVENTION AND HEALTHY LIFESTYLES. THIS WILL BE ACCOMPLISHED BY IDENTIFYING HEALTH NEEDS IN OUR COMMUNITY AND MAINTAINING AN ENDOWMENT SO FUNDING IS AVAILABLE, THROUGH INVESTMENTS AND GRANTS, FOR THOSE NEEDS. GRANT APPLICATIONS CAN BE ACCESSED THROUGH AN ONLINE PROCESS AT WWW.K21FOUNDATION.ORG UNDER "APPLY FOR GRANTS". GRANT APPLICATIONS ARE ACCEPTED FOUR TIMES EACH YEAR. APPLICATIONS RECEIVED AFTER THESE DEADLINES WILL BE HELD UNTIL THE NEXT CYCLE. FOR ASSISTANCE COMPLETING THE APPLICATION CONTACT: GRANT COORDINATOR, HOLLY SWOVERLAND, AT (574) 269-5188 OR HSWOVERLAND@K21FOUNDATION.ORG.LINE 2C, ANY SUBMISSION DEADLINES: SUBMISSION DEADLINES ARE FEB 1ST, MAY 1ST, AUG 1ST, AND NOV 1ST.LINE 2D, RESTRICTIONS AND LIMITATIONS ON AWARDS: GRANTEES MUST MEET THE FOLLOWING REQUIREMENTS:A)NON-PROFIT AGENCY WITH VERIFIED IRS TAX-EXEMPT STATUS, OR A GOVERNMENT AGENCY. B)BE IN GOOD STANDING WITH THE INDIANA SECRETARY OF STATE AS INDICATED IN A BUSINESS ENTITY REPORT. C)BYLAWS MUST REQUIRE TERM LIMITS FOR DIRECTORS AND A ROTATING BOARD IS STRONGLY ENCOURAGED.GRANT REQUESTS MUST MEET THE FOLLOWING REQUIREMENTS:A)PROJECT, PROGRAM, OR SERVICES MUST BENEFIT RESIDENTS OF KOSCIUSKO COUNTY. B)K21 GRANT PRIORITIES ARE FOR HEALTH NEEDS OR HEALTH IMPROVEMENT. ALTHOUGH THE FOUNDATION CONSIDERS ANY GRANT OPPORTUNITIES THAT CLEARLY ADDRESSES HEALTH AND WELLNESS ISSUES FOR OUR COMMUNITY, OUR PRIRORITES FOR FUNDING CONSIDERATION FOCUS ON THE FOLLOWING:1)NON-PROFIT ORGANIZATIONS PROVIDING DIRECT HEALTH SERVICES TO PEOPLE IN NEED. 2)FUNDING ORGANIZATIONS THAT ARE MAKING ADVANCES OR PROVIDING SERVICES IN PREVENTION IMPROVEMENTS TO MINIMIZE THE NEED FOR HEALTH SERVICES. 3)SUPPORTING THOSE WHO ARE DEVELOPING AND IMPLEMENTING SOLUTIONS TOWARD PROVIDING OPPORTUNITIES TO PURSUE HEALTHY LIFESTYLES AND DECISIONS. 4)A COMMITMENT TO REGULAR, CONSISTENT ASSESSMENT AND PARTICIPATION IN THE DISCOVERY OF EXISTING HEALTH NEEDS OF OUR COMMUNITY. |
| SUPPLEMENTARY INFORMATION | Form 990-PF, Part XV, Line 2A through 2d | LINE 2, NAME OF THE GRANT PROGRAM: CANCER CARE FUNDLINE 2A AND 2B, FORM AND CONTENT OF APPLICATION:THE KOSCIUSKO COUNTY CANCER CARE FUND, ADMINISTERED BY K21 HEALTH FOUNDATION, WAS ESTABLISHED FOR THE PURPOSE OF PROVIDING FINANCIAL ASSISTANCE TO FINANCIALLY-ELIGIBLE RESIDENTS OF KOSCIUSKO COUNTY WHO ARE SUFFERING FROM CANCER. THE PURPOSE OF THE FUND IS TO RELIEVE SOME OF THE FINANCIAL STRAIN THAT OFTEN ACCOMPANIES THAT DREADED DIAGNOSIS. THE ASSISTANCE PROVIDED INCLUDES BUT IS NOT LIMITED TO ITEMS SUCH AS RENT OR MORTGAGE PAYMENTS, UTILITIES, INSURANCE, FOOD, CAR PAYMENTS, AND PRESCRIPTION MEDICATIONS.IN NEARLY ALL SITUATIONS, FINANCIAL ASSISTANCE IS PAID DIRECTLY TO A VENDOR ON BEHALF OF THE CLIENTS. IN 2016 THE CANCER CARE FUND PROVIDED FINANCIAL ASSISTANCE TO APPROXIMATELY 100 KOSCIUSKO COUNTY CANCER PATIENTS AND THEIR FAMILIES. THE FUND DISBURSED OVER $100,000 FOR ITEMS SUCH AS RENT OR MORTGAGE PAYMENTS, UTILITIES, INSURANCE, FOOD, AND PRESCRIPTION MEDICATIONS, JUST TO NAME A FEW. THE FUNDS ARE PRIMARILY RAISED BY A GROUP OF DEDICATED INDIVIDUALS IN KOSCIUSKO COUNTY WHO VOLUNTEER HUNDREDS OF HOURS EACH YEAR TO PLAN A NUMBER OF FUNDRAISING EVENTS, SUCH AS THE GOLF OUTING, GALA AND AUCTION.THE CANCER FUND SOCIAL WORKER REVIEWS ALL CASES AND COLLABORATES WITH ONE OR MORE MEMBERS OF THE NINE-PERSON CANCER CARE COMMITTEE TO AUTHORIZE PAYMENTS FROM THE FUND. FOR APPLICATION ASSISTANCE, PLEASE CONTACT LAURA COOPER AT (574) 372-3500 OR LAURA@THEBEAMANHOME.ORGLINE 2C, ANY SUBMISSION DEADLINES: NONELINE 2D, RESTRICTIONS AND LIMITATIONS ON AWARDS: TO QUALIFY FOR ASSISTANCE, A RECIPIENT MUST PROVIDE:1. DOCUMENTED RESIDENT OF KOSCIUSKO COUNTY.2. VERIFIED CANCER DIAGNOSIS WITHIN THE LAST THREE MONTHS. 3. DEMONSTRATE A FINANCIAL NEED.4. COMPLETE REQUIRED APPLICATION. |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corporate Bonds InvestmentsCorporateBondsGrp (2 entries)
| BondBondNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| CORPORATE BONDS | $8,944,452 | $8,748,184 |
| Foreign Bonds | $509,373 | $493,551 |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Stock | EQUITY SECURITIES | StockNm |
| EOY Book Value | $31,647,424 | EOYBookValueAmt |
| EOYFMV | $39,968,754 | EOYFMVAmt |
Investments Govt Obligations Sch InvestmentsGovtObligationsSch
| Field | Value | IRS element (for citing) |
|---|---|---|
| US Govt Obligations Book Vl EOY | $5,871,192 | USGovtObligationsBookVlEOYAmt |
| US Govt Obligations EOYFMV | $5,772,281 | USGovtObligationsEOYFMVAmt |
| State Local Sec Book Vl EOY | $0 | StateLocalSecBookVlEOYAmt |
| State Local Sec EOYFMV | $0 | StateLocalSecEOYFMVAmt |
Investments Land Schedule2 InvestmentsLandSchedule2
Investment Land InvestmentLandGrp (4 entries)
| Category Or ItemCategoryOrItemTxt | Cost Or Other BasisCostOrOtherBasisAmt | Accumulated DepreciationAccumulatedDepreciationAmt | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|---|
| LAND | $23,895 | $0 | $23,895 | $23,895 |
| Land Improvements | $291,412 | $4,857 | $286,555 | $286,555 |
| Leasehold Improvements | $554,764 | $10,542 | $544,222 | $544,222 |
| Building | $1,023,544 | $332,269 | $691,275 | $691,275 |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (3 entries)
| Category Or ItemCategoryOrItemTxt | Listed At Cost Or FMVListedAtCostOrFMVCd | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| REAL ESTATE INVESTMENT FUND | FMV | $2,164,563 | $2,898,826 |
| Hedge FUND | FMV | $3,391,693 | $3,284,184 |
| Global Managed Volatility | FMV | $3,100,862 | $3,475,380 |
Land Etc Schedule2 LandEtcSchedule2
Land Etc LandEtcGrp (2 entries)
| Category Or ItemCategoryOrItemTxt | Cost Or Other BasisCostOrOtherBasisAmt | Accumulated DepreciationAccumulatedDepreciationAmt | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|---|
| OFFICE & COMPUTER EQUIPMENT | $68,643 | $62,717 | $5,926 | $5,926 |
| Construction in Progress | $292,803 | $0 | $292,803 | $292,803 |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp (3 entries)
| DescDesc | BOY Book ValueBOYBookValueAmt | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| Notes Receivable Held for grant making | $4,007,053 | $2,829,100 | $2,829,100 |
| RECEIVABLE - OTHER | $8,268 | $340 | $340 |
| Excise Tax Asset - Overpayment | $0 | $5,941 | $5,941 |
Other Decreases Schedule OtherDecreasesSchedule
Other Decreases Detail OtherDecreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | 2016 Book Value and Market Value Change between years | Desc |
| Amt | $891,811 | Amt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (7 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|---|
| KHSP Mortgage Interest Forgiveness | $905,900 | $0 | $0 | $0 |
| Harvest Loan Forgiveness | $8,589 | $0 | $0 | $0 |
| Fundraising Expenses | $38,379 | $0 | $0 | $38,379 |
| INSURANCE | $7,003 | $0 | $0 | $7,148 |
| MARKETING | $37,520 | $0 | $0 | $37,520 |
| MISCELLANEOUS EXPENSE | $46,006 | $13,724 | $0 | $32,332 |
| Expired Grants | $13,136 | $0 | $0 | $0 |
Other Income Schedule2 OtherIncomeSchedule2
Other Income Detail OtherIncomeDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Other Income | Desc |
| Revenue And Expenses Per Books | $2,959 | RevenueAndExpensesPerBooksAmt |
| Net Investment Income | $2,959 | NetInvestmentIncomeAmt |
Other Increases Schedule OtherIncreasesSchedule
Other Increases Detail OtherIncreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Unrealized Gain on Investments | Desc |
| Amt | $891,810 | Amt |
Other Liabilities Schedule OtherLiabilitiesSchedule
Other Liabilities Detail OtherLiabilitiesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Deferred Tax Liability | Desc |
| BOY Book Value | $81,198 | BOYBookValueAmt |
| EOY Book Value | $90,116 | EOYBookValueAmt |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | INVESTMENT MGT FEES | CategoryTxt |
| Amt | $220,951 | Amt |
| Net Investment Income | $220,951 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | EXCISE TAXES | CategoryTxt |
| Amt | $43,666 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
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