MARY LINCOLN JOHNSON CHARITABLE FOUNDATION: Form 990PF, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
MARY LINCOLN JOHNSON CHARITABLE FOUNDATION (EIN 13-4281942)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-07-12
IRS object ID
201741939349100759
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)
Return2017-07-12T13:45:17-05:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN042620388PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1COLES & BODOIN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line175 SECOND AVENUEAddressLine1Txt
CityNEEDHAMCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02494ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN134281942EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE MARY LINCOLN JOHNSON CHARITABLEBusinessNameLine1Txt
Business Name Line2FOUNDATION C/O KING & NAVINS PCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlMARYBusinessNameControlTxt
Phone7812370150PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line120 WALNUT STREET NO 101AddressLine1Txt
CityWELLESLEY HILLSCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02481ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRICHARD NAVINSPersonNm
Person TitleTRUSTEEPersonTitleTxt
Phone7812370150PhoneNum
Signature2017-07-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonALAN W LAPIERRE CPAPreparerPersonNm
PTINP00113727PTIN
Phone7814551400PhoneNum
Preparation2017-07-12PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address71.174.83.35IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-07-12IPDt
IP Tm11:17:48IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdA5DC386298BBBBFE5CE1B6658339D9271F16D3CFAtSubmissionCreationDeviceId
At Submission Filing Device IdEBD73596909982A41C943B19138EFDC12C7ACCD8AtSubmissionFilingDeviceId
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$2,091,966FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$50,544ContriRcvdRevAndExpnssAmt
Dividends Rev And Expnss$58,384DividendsRevAndExpnssAmt
Dividends Net Invst Incm$52,650DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss$2,087NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$172,437GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$2,087CapGainNetIncmNetInvstIncmAmt
Total Rev And Expnss$111,015TotalRevAndExpnssAmt
Total Net Invst Incm$54,737TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$0CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$0CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl$0CompOfcrDirTrstDsbrsChrtblAmt
Legal Fees Rev And Expnss$5,000LegalFeesRevAndExpnssAmt
Legal Fees Net Invst Incm$0LegalFeesNetInvstIncmAmt
Legal Fees Dsbrs Chrtbl$5,000LegalFeesDsbrsChrtblAmt
Accounting Fees Rev And Expnss$2,275AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm$0AccountingFeesNetInvstIncmAmt
Accounting Fees Chrtbl Prps$2,275AccountingFeesChrtblPrpsAmt
Other Prof Fees Rev And Expnss$17,733OtherProfFeesRevAndExpnssAmt
Other Prof Fees Net Invst Incm$17,733OtherProfFeesNetInvstIncmAmt
Other Prof Fees Dsbrs Chrtbl$0OtherProfFeesDsbrsChrtblAmt
Taxes Rev And Expnss$610TaxesRevAndExpnssAmt
Taxes Net Invst Incm$610TaxesNetInvstIncmAmt
Taxes Dsbrs Chrtbl$0TaxesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$25,618TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$18,343TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$7,275TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$80,000ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$80,000ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$105,618TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$18,343TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$87,275TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses$5,397ExcessRevenueOverExpensesAmt
Net Investment Income$36,394NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Sav And Temp Cash Invst BOY$105,240SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$70,063SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$70,063SavAndTempCashInvstEOYFMVAmt
US Government Obligations BOY$106,669USGovernmentObligationsBOYAmt
US Government Obligations EOY$124,197USGovernmentObligationsEOYAmt
US Govt Obligations EOYFMV$126,447USGovtObligationsEOYFMVAmt
Corporate Stock BOY$920,810CorporateStockBOYAmt
Corporate Stock EOY$872,700CorporateStockEOYAmt
Corporate Stock EOYFMV$1,637,816CorporateStockEOYFMVAmt
Corporate Bonds BOY$235,536CorporateBondsBOYAmt
Corporate Bonds EOY$256,452CorporateBondsEOYAmt
Corporate Bonds EOYFMV$257,640CorporateBondsEOYFMVAmt
Total Assets BOY$1,368,255TotalAssetsBOYAmt
Total Assets EOY$1,323,412TotalAssetsEOYAmt
Total Assets EOYFMV$2,091,966TotalAssetsEOYFMVAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind
Capital Stock BOY$1,368,255CapitalStockBOYAmt
Capital Stock EOY$1,323,412CapitalStockEOYAmt
Additional Paid In Capital BOY$0AdditionalPaidInCapitalBOYAmt
Additional Paid In Capital EOY$0AdditionalPaidInCapitalEOYAmt
Retained Earning BOY$0RetainedEarningBOYAmt
Retained Earning EOY$0RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY$1,368,255TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$1,323,412TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$1,368,255TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$1,323,412TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$1,368,255TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses$5,397ExcessRevenueOverExpensesAmt
Other Increases$0OtherIncreasesAmt
Subtotal$1,373,652SubtotalAmt
Other Decreases$50,240OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY$1,323,412TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (9 entries)

PropertyPropertyDescAcquiredAcquiredDtSoldSoldDtGross Sales PriceGrossSalesPriceAmtCost Or Other BasisCostOrOtherBasisAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmt
5000 SHS BANCO SANTANDER2014-02-112016-12-27$25,254$45,185-$19,931-$19,931
106.383 SHS BANCO SANTANDER2014-05-142016-12-27$537$1,029-$492-$492
104.212 SHS BANCO SANTANDER2014-08-312016-12-27$526$1,040-$514-$514
113.331 SHS BANCO SANTANDER2014-11-182016-12-27$572$984-$412-$412
ANADARKO PETROLEUM 5.95%2009-05-202016-05-02$30,592$28,740$1,852$1,852
200 SHS VERSUM MATERIALS2006-06-202016-12-01$4,880$2,173$2,707$2,707
2000 SHS NAVIENT CORP2009-07-162016-09-29$28,246$12,818$15,428$15,428
1000 SHS CSRA INC2005-01-152016-09-29$26,604$30,865-$4,261-$4,261
1000 SHS BK NOVA SCOTIA2009-11-292016-12-01$55,226$47,516$7,710$7,710
FieldValueIRS element (for citing)
Capital Gain Net Income$2,087CapitalGainNetIncomeAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

FieldValueIRS element (for citing)
Liable Section4942 Tax0LiableSection4942TaxInd
Adjusted Qlfy Distri Yr1$111,702AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1$2,013,329NetVlNoncharitableAssetsYr1Amt
Distribution Yr10.055481DistributionYr1Rt
Adjusted Qlfy Distri Yr2$118,838AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2$2,163,293NetVlNoncharitableAssetsYr2Amt
Distribution Yr20.054934DistributionYr2Rt
Adjusted Qlfy Distri Yr3$111,000AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3$1,992,784NetVlNoncharitableAssetsYr3Amt
Distribution Yr30.055701DistributionYr3Rt
Adjusted Qlfy Distri Yr4$101,000AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4$1,821,504NetVlNoncharitableAssetsYr4Amt
Distribution Yr40.055449DistributionYr4Rt
Adjusted Qlfy Distri Yr5$86,036AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5$1,766,734NetVlNoncharitableAssetsYr5Amt
Distribution Yr50.048698DistributionYr5Rt
Total Distribution0.270263TotalDistributionRt
Average Distribution0.054053AverageDistributionRt
Net Vl Noncharitable Assets$2,012,951NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets$108,806AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct$364NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct$109,170AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions$87,275QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$728InvestmentIncomeExciseTaxAmt
Tax Under Section511$0TaxUnderSection511Amt
Subtotal$728SubtotalAmt
Subtitle A Tax$0SubtitleATaxAmt
Tax Based On Investment Income$728TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$1,125EstimatedPlusOvpmtIncmTxAmt
Total Payments And Credits$1,125TotalPaymentsAndCreditsAmt
Overpayment$397OverpaymentAmt
Applied To ES Tax$397AppliedToESTaxAmt
Refund$0RefundAmt

Statements Regarding Acty StatementsRegardingActyGrp

FieldValueIRS element (for citing)
Legislative Political Acty0LegislativePoliticalActyInd
More Than100 Spent0MoreThan100SpentInd
Form1120 POL Filed0Form1120POLFiledInd
Section4955 Organization Tax$0Section4955OrganizationTaxAmt
Section4955 Managers Tax$0Section4955ManagersTaxAmt
Tax Reimbursed$0TaxReimbursedAmt
Activities Not Previously Rpt0ActivitiesNotPreviouslyRptInd
Changes To Articles Or Bylaws0ChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Organization Dissolved Etc0OrganizationDissolvedEtcInd
Section508e Rqr Satisfied0Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (1)AtLeast5000InAssetsInd
Org Report Or Register StateMAOrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (1)Form990PFFiledWithAttyGenInd
Private Operating Foundation0PrivateOperatingFoundationInd
New Substantial Contributors0NewSubstantialContributorsInd
Own Controlled Entity0OwnControlledEntityInd
Donor Advised Fund0DonorAdvisedFundInd
Comply With Public Insp RqrYes (1)ComplyWithPublicInspRqrInd
Website AddressN/AWebsiteAddressTxt
Individual With BooksRICHARD R NAVINS TRUSTEEIndividualWithBooksNm
Phone7812370150PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line120 WALNUT STREET 101AddressLine1Txt
CityWELLESLEY HILLSCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02481ZIPCd
FieldValueIRS element (for citing)
Foreign Accounts Question0ForeignAccountsQuestionInd

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

FieldValueIRS element (for citing)
Sale Or Exch Disqualified Prsn0SaleOrExchDisqualifiedPrsnInd
Brrw Or Lend Disqualified Prsn0BrrwOrLendDisqualifiedPrsnInd
Furn Goods Disqualified Prsn0FurnGoodsDisqualifiedPrsnInd
Pay Comp Disqualified Prsn0PayCompDisqualifiedPrsnInd
Transfer Ast Disqualified Prsn0TransferAstDisqualifiedPrsnInd
Payment To Government Official0PaymentToGovernmentOfficialInd
Uncorrected Prior Acts0UncorrectedPriorActsInd
Undistributed Income PY0UndistributedIncomePYInd
Business Holdings0BusinessHoldingsInd
Jeopardy Investments0JeopardyInvestmentsInd
Uncorrected PY Jeopardy Invst0UncorrectedPYJeopardyInvstInd
Influence Legislation0InfluenceLegislationInd
Influence Election0InfluenceElectionInd
Grants To Individuals0GrantsToIndividualsInd
Grants To Organizations0GrantsToOrganizationsInd
Noncharitable Purpose0NoncharitablePurposeInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
ROBERT S JOHNSON
56 BARIBEAU DRIVE 211BRUNSWICKME04011TRUSTEE0.10$0$0$0
PETER G JOHNSON
5 TIFFANY TRAILHOPKINTONMA01748TURSTEE0.10$0$0$0
DAVID B JOHNSON
24 BEECH DRIVEBRUNSWICKME04001TRUSTEE0.10$0$0$0
ANNE S EVANS
157 WATERMAN ST UNIT 2PROVIDENCERI02906TRUSTEE0.10$0$0$0
THOMAS R JOHNSON
38 MORSE STREETWESTBOROUGHMA01581TRUSTEE0.10$0$0$0
JOHN H JOHNSON
912 JAYSMITH STREETGREAT FALLSVA22066TRUSTEE0.10$0$0$0
BENJAMIN B JOHNSON
CHURCH ROADBRUNSWICKME04011TRUSTEE0.10$0$0$0
JACK W SWENSON
30 COLPITTS ROAD PO BOX 348WESTONMA02493TRUSTEE0.70$0$0$0
RICHARD R NAVINS
20 WALNUT STREET 101WELLESLEY HILLSMA02481TRUSTEE0.50$0$0$0
FieldValueIRS element (for citing)
Comp Of Hghst Pd Empl Or NONENONECompOfHghstPdEmplOrNONETxt
Other Employee Paid Over50k0OtherEmployeePaidOver50kCnt
Comp Of Hghst Pd Cntrct Or NONENONECompOfHghstPdCntrctOrNONETxt
Contractor Paid Over50k0ContractorPaidOver50kCnt

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$1,965,738AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$77,867AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$2,043,605TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$2,043,605AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$30,654CashDeemedCharitableAmt
Net Vl Noncharitable Assets$2,012,951NetVlNoncharitableAssetsAmt
Minimum Investment Return$100,648MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$100,648MinimumInvestmentReturnAmt
Tax Based On Investment Income$728TaxBasedOnInvestmentIncomeAmt
Total Tax$728TotalTaxAmt
Distributable Before Adj$99,920DistributableBeforeAdjAmt
Recoveries Qualfied Distri$0RecoveriesQualfiedDistriAmt
Distributable Before Ded$99,920DistributableBeforeDedAmt
Deduction From Distributable$0DeductionFromDistributableAmt
Distributable As Adjusted$99,920DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$87,275ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Qualifying Distributions$87,275QualifyingDistributionsAmt
Pct Sect4940e Org Net Invst Incm$0PctSect4940eOrgNetInvstIncmAmt
Adjusted Qualifying Distri$87,275AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$99,920DistributableAsAdjustedAmt
Undistributed Income PY$0UndistributedIncomePYAmt
Total For Prior Years$0TotalForPriorYearsAmt
Excess Distribution Cyov Yr4$10,855ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr3$13,705ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2$11,637ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1$12,000ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov$48,197TotalExcessDistributionCyovAmt
Qualifying Distributions$87,275QualifyingDistributionsAmt
Applied To Year1$0AppliedToYear1Amt
Applied To Prior Years$0AppliedToPriorYearsAmt
Treated As Distri From Corpus$0TreatedAsDistriFromCorpusAmt
Applied To Current Year$87,275AppliedToCurrentYearAmt
Remaining Distri From Corpus$0RemainingDistriFromCorpusAmt
Excess Distri Cyov App CY Corpus$12,645ExcessDistriCyovAppCYCorpusAmt
Excess Distribution Cyov App CY$12,645ExcessDistributionCyovAppCYAmt
Total Corpus$35,552TotalCorpusAmt
Prior Year Undistributed Incm$0PriorYearUndistributedIncmAmt
Prior Year Deficiency Or Tax$0PriorYearDeficiencyOrTaxAmt
Taxable1$0Taxable1Amt
Taxable2$0Taxable2Amt
Undistributed Income CY$0UndistributedIncomeCYAmt
Corpus Distri170b1 E Or4942g3$0CorpusDistri170b1EOr4942g3Amt
Excess Distri Cyov From Yr5$0ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$35,552ExcessDistriCyovToNextYrAmt
Excess From Year3$11,915ExcessFromYear3Amt
Excess From Year2$11,637ExcessFromYear2Amt
Excess From Year1$12,000ExcessFromYear1Amt

Supplementary Information SupplementaryInformationGrp

FieldValueIRS element (for citing)
Contributing ManagerROBERT S JOHNSONContributingManagerNm
Only Contri To PreselectedYes (X)OnlyContriToPreselectedInd

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (7 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
MID COAST HOSPITAL
11 MEDICAL CENTER DRIVEBRUNSWICKME04011NONEHEALTH CAREHEALTH CARE$25,000
NEWTON-WELLESLEY HOSPITAL
2014 WASHINGTON STREETNEWTONMA02462NONEHEALTH CAREHEALTH CARE$5,000
PARMENTER VNA AND COMMUNITY CARE INC
266 COCHITUATE ROADWAYLANDMA01778NONECOMMUNITY HEALTH CARHEALTH CARE$25,000
PROJECT JUST BECAUSE
86 SOUTH STREETHOPKINTONMA01748NONEHEALTH CAREHEALTH CARE$5,000
WELLS FOR RELIEF INT'L
17-B MOUNT PLEASANT DRIVEASTONPA19014NONEHEALTH CAREHEALTH CARE$5,000
UMASS MEDICAL SCHOOL
333 SOUTH STREETSHREWSBURYMA01545NONEHEALTH CAREHEALTH CARE$10,000
PANDAS NETWORK
655 OAK GROVE AVENUE 1373MENLO PARKCA94026NONEHEALTH CAREHEALTH CARE$5,000
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$80,000TotalGrantOrContriPdDurYrAmt
Total Grant Or Contri Apprv Fut$0TotalGrantOrContriApprvFutAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$58,384ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion$2,087ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$0UnrelatedBusinessTaxblIncmAmt
Exclusion$60,471ExclusionAmt
Related Or Exempt Function Incm$0RelatedOrExemptFunctionIncmAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$60,471TotalIncomeProducingActyAmt

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

FieldValueIRS element (for citing)
Trnsfr Of Cash To Nonchrtbl EO0TrnsfrOfCashToNonchrtblEOInd
Trnsfr Other Asset Nonchrtbl EO0TrnsfrOtherAssetNonchrtblEOInd
Sales Or Exchanges Of Assets0SalesOrExchangesOfAssetsInd
Purchase Of Assets Nonchrtbl EO0PurchaseOfAssetsNonchrtblEOInd
Rental Of Facilities Oth Assets0RentalOfFacilitiesOthAssetsInd
Reimbursement Arrangements0ReimbursementArrangementsInd
Loans Or Loan Guarantees0LoansOrLoanGuaranteesInd
Performance Of Services Etc0PerformanceOfServicesEtcInd
Sharing Of Facilities Etc0SharingOfFacilitiesEtcInd
Relationships Nonchrtbl EO0RelationshipsNonchrtblEOInd

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 Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1HELEN B JOHNSONBusinessNameLine1Txt

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line167 MCKEEN STREETAddressLine1Txt
CityBRUNSWICKCityNm
State AbbreviationMEStateAbbreviationCd
ZIP040112920ZIPCd
FieldValueIRS element (for citing)
Total Contributions$50,544TotalContributionsAmt
Person ContributionYes (X)PersonContributionInd

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryACCOUNTING FEESCategoryTxt
Amt$2,275Amt
Net Investment Income$0NetInvestmentIncomeAmt
Disbursements Charitable Prps$2,275DisbursementsCharitablePrpsAmt

Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule

Investments Corporate Bonds InvestmentsCorporateBondsGrp

FieldValueIRS element (for citing)
BondCORPORATE BONDSBondNm
EOY Book Value$256,452EOYBookValueAmt
EOYFMV$257,640EOYFMVAmt

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp (2 entries)

StockStockNmEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
STOCK & EQUITY INVESTMENTS$833,410$1,614,641
PREFERRED STOCK$39,290$23,175

Investments Govt Obligations Sch InvestmentsGovtObligationsSch

FieldValueIRS element (for citing)
US Govt Obligations Book Vl EOY$124,197USGovtObligationsBookVlEOYAmt
US Govt Obligations EOYFMV$126,447USGovtObligationsEOYFMVAmt
State Local Sec Book Vl EOY$0StateLocalSecBookVlEOYAmt
State Local Sec EOYFMV$0StateLocalSecEOYFMVAmt

Legal Fees Schedule LegalFeesSchedule

Legal Fees LegalFeesGrp

FieldValueIRS element (for citing)
CategoryLEGAL FEESCategoryTxt
Legal Fees$5,000LegalFeesAmt
Net Investment Income$0NetInvestmentIncomeAmt
Disbursements Charitable Prps$5,000DisbursementsCharitablePrpsAmt

Other Decreases Schedule OtherDecreasesSchedule

Other Decreases Detail OtherDecreasesDetail

FieldValueIRS element (for citing)
DescCOST ADJUSTMENTDesc
Amt$50,240Amt

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees Detail OtherProfessionalFeesDetail

FieldValueIRS element (for citing)
CategoryINVESTMENT MANAGEMENT FEESCategoryTxt
Amt$17,733Amt
Net Investment Income$17,733NetInvestmentIncomeAmt
Disbursements Charitable Prps$0DisbursementsCharitablePrpsAmt

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (2 entries)

CategoryCategoryTxtAmtAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
FOREIGN TAXES$575$575$0
STATE FILING FEE$35$35$0

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