2016-10-14T12:36:27-05:00 2015-12-31 Foundation Source One Hollow Ln Ste 212 Lake Success NY 11042 990PF 2015-01-01 866320000 The Surplus Line Association of Arizona Foundation % Foundation Source SURP 8008391754 Foundation Source 501 Silverside Rd Wilmington DE 198091377 TIMOTHY M DOWNEY President 8008391754 2016-09-29 true Jeffrey D Haskell P01345770 8008391754 2015 2017-02-10 21:41:12Z X 6523071 X 729500 15 15 39682 39682 -442 97253 0 240685 240685 1009440 280382 0 4956 29904 29904 34860 0 29904 531500 531500 566360 0 561404 443080 280382 44381 236302 236302 316817 316817 312721 737402 747876 744257 4743664 4984349 5229791 5842264 6285344 6523071 0 X 5842264 6285344 5842264 6285344 5842264 6285344 5842264 443080 6285344 6285344 Publicly-traded Securities 97253 97695 -442 -442 -442 false 507625 6189942 0.082008 508447 6095464 0.083414 454887 5993418 0.075898 326225 5858765 0.055682 103652 5294120 0.019579 0.316581 0.063316 6358013 402564 2804 405368 561404 X 2804 2804 2804 3000 3000 X 196 196 false false false false false false false true true AZ true false false false false true Foundation Source 8008391754 501 Silverside Road Suite 123 Wilmington DE 198091377 false false false false false false false false false false false false false false false false false false false false Marc Adler Foundation Source 501 Silverside Rd Wilmington DE 198091377 Dir 1.0 0 0 0 T Curtis Anderson Foundation Source 501 Silverside Rd Wilmington DE 198091377 VP 1.0 0 0 0 Larry Beach Foundation Source 501 Silverside Rd Wilmington DE 198091377 Sec / Treas 1.0 0 0 0 Karla Burt Foundation Source 501 Silverside Rd Wilmington DE 198091377 Dir 0 0 0 0 Timothy Downey Foundation Source 501 Silverside Rd Wilmington DE 198091377 Pres 1.0 0 0 0 Lanny Hair Foundation Source 501 Silverside Rd Wilmington DE 198091377 Dir 1.0 0 0 0 Erick L Johnson CPCU Foundation Source 501 Silverside Rd Wilmington DE 198091377 Dir 1.0 0 0 0 Konnie Keaschall-Kiser Foundation Source 501 Silverside Rd Wilmington DE 198091377 Dir 1.0 0 0 0 Gerald L Silver Foundation Source 501 Silverside Rd Wilmington DE 198091377 Dir 1.0 0 0 0 J SCOTT WEDE Foundation Source 501 Silverside Rd Wilmington DE 198091377 EXEC DIR 1.0 0 0 0 Ronda Lofton Foundation Source 501 Silverside Rd Wilmington DE 198091377 Dir 1.0 0 0 0 James Mann Foundation Source 501 Silverside Rd Wilmington DE 198091377 Dir 1.0 0 0 0 1055696 95908 5303232 6454836 0 6454836 96823 6358013 317901 317901 2804 2804 315097 315097 315097 561404 0 0 0 0 561404 2804 558600 315097 2013 2012 2011 193552 204024 397576 561404 315097 246307 643883 0 643883 193552 204024 246307 NONE X 100 CLUB OF ARIZONA 333 N 44TH ST STE 100 PHOENIX AZ 85008 N/A PC General & Unrestricted 15000 88-CRIME INC 32 N STONE AVE STE 1400 TUCSON AZ 85701 N/A PC General & Unrestricted 3000 AAMGA EDUCATION FOUNDATION 150 S WARNER RD STE 156 KING OF PRUSSIA PA 19406 N/A PC General & Unrestricted 100000 ABT PERFORMING ARTS ASSOCIATION INC 7701 W PARADISE LN PEORIA AZ 85382 N/A PC General & Unrestricted 5000 AMERICAN CANCER SOCIETY - GREAT WEST DIVISION 1636 N SWAN RD TUCSON AZ 85712 N/A PC General & Unrestricted 2500 AMYOTROPHIC LATERAL SCLEROSIS ASSOCIATION 4643 E THOMAS RD STE 1 PHOENIX AZ 85018 N/A PC General & Unrestricted 5000 ARIZONA COMMUNITY FOUNDATION 2201 E CAMELBACK RD STE 405B PHOENIX AZ 85016 N/A PC General & Unrestricted 2500 ARIZONA DIABETES FOUNDATION INC GREENWAY PROFESSIONAL BLDG PHOENIX AZ 85032 N/A PC General & Unrestricted 5000 ARTHRITIS FOUNDATION INC - PHOENIX CHAPTER 1221 E OSBORN RD STE 201 PHOENIX AZ 85014 N/A PC General & Unrestricted 5000 ASSISTANCE LEAGUE OF TUCSON INC 1307 N ALVERNON WAY TUCSON AZ 85712 N/A PC General & Unrestricted 5000 AUTISM SOCIETY OF GREATER PHOENIX PO BOX 10543 PHOENIX AZ 85064 N/A PC General & Unrestricted 10000 BANNER ALZHEIMERS FOUNDATION 2025 N 3RD ST STE 250 PHOENIX AZ 85004 N/A PC General & Unrestricted 10000 BOY SCOUTS OF AMERICA 2969 N GREENFIELD RD PHOENIX AZ 85016 N/A PC General & Unrestricted 5000 BOYS HOPE GIRLS HOPE 4225 MALSBARY RD STE 208 BLUE ASH OH 45242 N/A PC General & Unrestricted 3000 CAMELBACK KIWANIS SERVICE FUND 7220 N 16TH ST STE I PHOENIX AZ 85020 N/A PC General & Unrestricted 5000 COMMUNITY FOOD BANK INC 3003 S COUNTRY CLUB RD TUCSON AZ 85713 N/A PC General & Unrestricted 30000 DEREK HUGHES NAPSLO EDUCATIONAL FOUNDATION INC 4131 N MULBERRY DR STE 200 KANSAS CITY MO 64116 N/A PC General & Unrestricted 100000 DESERT SURVIVORS INC 1020 W STARR PASS BLVD TUCSON AZ 85713 N/A PC General & Unrestricted 5000 DODADS INC 12237 N MAKAYLA CANYON LN ORO VALLEY AZ 85755 N/A PC General & Unrestricted 5000 HACIENDA SNF INC 1402 E S MOUNTAIN AVE PHOENIX AZ 85042 N/A PC General & Unrestricted 15000 INSURANCE TRAINING AND EDUCATION CENTER INC 2828 N 36TH ST PHOENIX AZ 85008 N/A PC General & Unrestricted 50000 KITCHEN ON THE STREET INC 2650 E MOHAWK BLDG 3 STE 168 PHOENIX AZ 85050 N/A PC General & Unrestricted 15000 LEADERSHIP WORKSHOPS FOUNDATION FOR YOUTH AND FAMI 8711 E PINNACLE PEAK RD STE F101 SCOTTSDALE AZ 85255 N/A PC General & Unrestricted 5000 MAKE A WISH FOUNDATION OF ARIZONA INC 2901 N 78TH ST SCOTTSDALE AZ 85251 N/A PC General & Unrestricted 10000 ORAL EDUCATIONAL OPPORTUNITIES FOR THE HEARING IMP 3426 E SHEA BLVD PHOENIX AZ 85028 N/A PC General & Unrestricted 12500 PAZ DE CRISTO COMMUNITY CENTER 424 W BROADWAY RD MESA AZ 85210 N/A PC General & Unrestricted 12000 PLUS FOUNDATION 5353 WAYZATA BLVD STE 600 MINNEAPOLIS MN 55416 N/A SO I General & Unrestricted 15000 RYAN HOUSE 110 W MERRELL ST FL 1 PHOENIX AZ 85013 N/A PC General & Unrestricted 2500 SHRINERS HOSPITALS FOR CHILDREN - SALT LAKE CITY FAIRFAX RD AT VIRGINIA ST SALT LAKE CITY UT 84103 N/A PC General & Unrestricted 5000 SOJOURNER CENTER PO BOX 20156 PHOENIX AZ 85036 N/A PC General & Unrestricted 5000 SOUTHWEST DISTRICT KIWANIS FOUNDATION PO BOX 1603 MESA AZ 85211 N/A PC General & Unrestricted 15000 ST MARYS FOOD BANK ALLIANCE 2831 N 31ST AVE PHOENIX AZ 85009 N/A PC General & Unrestricted 15000 TUMBLEWEED CENTER FOR YOUTH DEVELOPMENT 3707 N 7TH ST STE 30 PHOENIX AZ 85014 N/A PC General & Unrestricted 6000 UNITED SERVICE ORGANIZATIONS INC PO BOX 96860 WASHINGTON DC 20077 N/A PC General & Unrestricted 2500 WASTE NOT INC 1700 N GRANITE REEF RD SCOTTSDALE AZ 85257 N/A PC General & Unrestricted 15000 YES SOLUTIONS INC 549 W 123RD ST NEW YORK NY 10027 N/A PC General & Unrestricted 10000 531500 14 15 14 39682 18 -442 ANNUITY INCOME 14 240685 279940 279940 false false false false false false false false false false X X 1 The Surplus Line Association of Ari KIERLAND BUS CTR 15849 N 71ST ST Scottsdale AZ 85254 729500 X Karla Burt *Removed from foundation in 2015. ANHEUSER-BUSCH INBEVFIN NT - 2 40047 38485 BANK AMER - 5.150% - 11/15/201 25673 26647 BANK OF AMERICA - 3.550% - 11/ 20000 20269 BURLINGTON NORTHERN SANTA FE - 54372 54073 CATERPILLAR FINANCIAL SE MTN - 27118 27301 CATERPILLAR FINL CORP PWRNTSBE 30000 30135 CITIGROUP INC - 5.500% - 09/13 28857 27275 CITIGROUP INC SUB NT - 3.500% 24065 24489 DEUTSCHE BANK - 3.250% - 01/11 51027 50027 GE - 5.000% - 03/15/2029 55230 54980 GE CAPITAL - 4.800% - 03/15/20 11967 12911 GE CAPITAL CORP - 4.500% - 11/ 27075 26920 GE CAPITAL INTERNOTES - 5.100% 26765 27075 GENERAL ELECTRIC CAPITAL CORP 25722 25989 GOLDMAN SACHS GP INC - 5.950% 32165 33371 GOLDMAN SACHS GROUP INC - 3.50 11770 11449 GOLDMAN SACHS GRP INC MTN BE - 25249 25244 HANCOCK JOHN LIFE INS CO - 5.0 17689 17443 JPMORGAN CHASE & CO - 4.125% - 25267 24967 MERRILL LYNCH MTN BE - 6.400% 27829 26839 SHELL INTERNATIONAL FIN - 4.30 53402 53289 STATOIL ASA - 3.125% - 08/17/2 25573 25611 STATOIL ASA NT - 3.700% - 03/0 26045 25316 WAL MART STORES INC NT - 5.800 28280 27356 ZIMMER HLDGS INC NOTE - 4.625% 26689 26796 27974 28592 288843 284129 JACKSON NATIONAL LIFE ANNUITY 581055 581055 COLUMBUS LIFE # CM5040241A 479084 502260 COLUMBUS LIFE - POLICY # CM504 286447 346296 COLUMBUS LIFE CM5037899A 276728 297228 COLUMBUS LIFE CM5037917A 278620 313671 COLUMBUS LIFE CM5037965A 282135 352295 COLUMBUS LIFE CM5064902A 146238 144701 JACKSON NATION LIFE ANNUITY # 273114 341608 JACKSON NATIONAL ANNUITY 10062 262579 271452 JACKSON NATIONAL LIFE #1003556 276650 282203 JACKSON NATIONAL LIFE 10047137 354657 354657 INTEGRITY LIFE INSURANCE ANNUI 950110 873388 NY LIFE INSURANCE ANNUITY #521 244921 244921 UNITED OF OMAHA LIFE INSURANCE 292011 324056 Administrative Fees 29904 29904 INCOME FROM ANNUITIES 240685 240685 990-PF Estimated Tax for 2015 3000 990-PF Excise Tax for 2014 8 990-PF Extension for 2014 1948