BETA

BERTOLON FAMILY FOUNDATION TR: Form 990PF, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
BERTOLON FAMILY FOUNDATION TR (EIN 04-6917944)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-10-25
IRS object ID
201602999349100105
Schema version
2015v2.1
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)
Return2016-10-25T10:50:05-05:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN420714325PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1RSM US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line180 CITY SQUAREAddressLine1Txt
CityBOSTONCityNm
State AbbreviationMAStateAbbreviationCd
ZIP021293742ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN046917944EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BERTOLON FAMILY FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBERTBusinessNameControlTxt
Phone6179129000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line180 CITY SQUAREAddressLine1Txt
CityBOSTONCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02129ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonHENRY BERTOLON JRPersonNm
Person TitleTRUSTEEPersonTitleTxt
Phone6179129000PhoneNum
Signature2016-10-25SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJAMES J FLEURIEL JRPreparerPersonNm
PTINP01061273PTIN
Phone6179129000PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$6,743FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$94,375ContriRcvdRevAndExpnssAmt
Dividends Rev And Expnss$2DividendsRevAndExpnssAmt
Dividends Net Invst Incm$2DividendsNetInvstIncmAmt
Cap Gain Net Incm Net Invst Incm$0CapGainNetIncmNetInvstIncmAmt
Total Rev And Expnss$94,377TotalRevAndExpnssAmt
Total Net Invst Incm$2TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$0CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$0CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl$0CompOfcrDirTrstDsbrsChrtblAmt
Other Expenses Rev And Expnss$220OtherExpensesRevAndExpnssAmt
Other Expenses Net Invst Incm$0OtherExpensesNetInvstIncmAmt
Other Expenses Dsbrs Chrtbl$0OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$220TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$0TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$0TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$90,660ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$90,660ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$90,880TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$0TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$90,660TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses$3,497ExcessRevenueOverExpensesAmt
Net Investment Income$2NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Sav And Temp Cash Invst BOY$3,246SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$6,743SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$6,743SavAndTempCashInvstEOYFMVAmt
Total Assets BOY$3,246TotalAssetsBOYAmt
Total Assets EOY$6,743TotalAssetsEOYAmt
Total Assets EOYFMV$6,743TotalAssetsEOYFMVAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind
Capital Stock BOY$0CapitalStockBOYAmt
Capital Stock EOY$0CapitalStockEOYAmt
Additional Paid In Capital BOY$0AdditionalPaidInCapitalBOYAmt
Additional Paid In Capital EOY$0AdditionalPaidInCapitalEOYAmt
Retained Earning BOY$3,246RetainedEarningBOYAmt
Retained Earning EOY$6,743RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY$3,246TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$6,743TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$3,246TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$6,743TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$3,246TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses$3,497ExcessRevenueOverExpensesAmt
Other Increases$0OtherIncreasesAmt
Subtotal$6,743SubtotalAmt
Other Decreases$0OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY$6,743TotNetAstOrFundBalancesEOYAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

FieldValueIRS element (for citing)
Liable Section4942 Tax0LiableSection4942TaxInd
Adjusted Qlfy Distri Yr1$66,685AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1$21,942NetVlNoncharitableAssetsYr1Amt
Distribution Yr13.039149DistributionYr1Rt
Adjusted Qlfy Distri Yr2$380,215AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2$27,153NetVlNoncharitableAssetsYr2Amt
Distribution Yr214.002688DistributionYr2Rt
Adjusted Qlfy Distri Yr3$87,318AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3$20,812NetVlNoncharitableAssetsYr3Amt
Distribution Yr34.195560DistributionYr3Rt
Adjusted Qlfy Distri Yr4$153,363AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4$48,361NetVlNoncharitableAssetsYr4Amt
Distribution Yr43.171212DistributionYr4Rt
Adjusted Qlfy Distri Yr5$164,740AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5$17,988NetVlNoncharitableAssetsYr5Amt
Distribution Yr59.158328DistributionYr5Rt
Total Distribution33.566937TotalDistributionRt
Average Distribution6.713387AverageDistributionRt
Net Vl Noncharitable Assets$13,217NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets$88,731AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct$0NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct$88,731AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions$90,660QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Domestic Org Meeting Sect4940eYes (X)DomesticOrgMeetingSect4940eInd
Investment Income Excise Tax$0InvestmentIncomeExciseTaxAmt
Tax Under Section511$0TaxUnderSection511Amt
Subtotal$0SubtotalAmt
Subtitle A Tax$0SubtitleATaxAmt
Tax Based On Investment Income$0TaxBasedOnInvestmentIncomeAmt
Total Payments And Credits$0TotalPaymentsAndCreditsAmt
Tax Due$0TaxDueAmt

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 SatisfiedYes (1)Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (1)AtLeast5000InAssetsInd
Org Report Or Register StateMAOrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (1)Form990PFFiledWithAttyGenInd
Private Operating Foundation0PrivateOperatingFoundationInd
New Substantial ContributorsYes (1)NewSubstantialContributorsInd
Own Controlled Entity0OwnControlledEntityInd
Donor Advised Fund0DonorAdvisedFundInd
Comply With Public Insp RqrYes (1)ComplyWithPublicInspRqrInd
Website AddressN/AWebsiteAddressTxt
Individual With BooksLES VITALEIndividualWithBooksNm
Phone6179129000PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line180 CITY SQUAREAddressLine1Txt
CityBOSTONCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02129ZIPCd
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 (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
HENRY J BERTOLON JR
245 DODGE STREETBEVERLYMA01915TRUSTEE1.00$0$0$0
DONNA BERTOLON
245 DODGE STREETBEVERLYMA01915TRUSTEE1.00$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

Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp

FieldValueIRS element (for citing)
Description1NONEDescription1Txt
Expenses1$0Expenses1Amt

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

FieldValueIRS element (for citing)
Description1NONEDescription1Txt
Expenses1$0Expenses1Amt
Total$0TotalAmt

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$0AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$13,418AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$13,418TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$13,418AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$201CashDeemedCharitableAmt
Net Vl Noncharitable Assets$13,217NetVlNoncharitableAssetsAmt
Minimum Investment Return$661MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$661MinimumInvestmentReturnAmt
Total Tax$0TotalTaxAmt
Distributable Before Adj$661DistributableBeforeAdjAmt
Recoveries Qualfied Distri$0RecoveriesQualfiedDistriAmt
Distributable Before Ded$661DistributableBeforeDedAmt
Deduction From Distributable$0DeductionFromDistributableAmt
Distributable As Adjusted$661DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$90,660ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Qualifying Distributions$90,660QualifyingDistributionsAmt
Pct Sect4940e Org Net Invst Incm$0PctSect4940eOrgNetInvstIncmAmt
Adjusted Qualifying Distri$90,660AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$661DistributableAsAdjustedAmt
Undistributed Income PY$0UndistributedIncomePYAmt
Total For Prior Years$0TotalForPriorYearsAmt
Excess Distribution Cyov Yr5$163,841ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr4$150,945ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr3$86,277ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2$378,857ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1$65,588ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov$845,508TotalExcessDistributionCyovAmt
Qualifying Distributions$90,660QualifyingDistributionsAmt
Applied To Year1$0AppliedToYear1Amt
Applied To Prior Years$0AppliedToPriorYearsAmt
Treated As Distri From Corpus$0TreatedAsDistriFromCorpusAmt
Applied To Current Year$661AppliedToCurrentYearAmt
Remaining Distri From Corpus$89,999RemainingDistriFromCorpusAmt
Excess Distri Cyov App CY Corpus$0ExcessDistriCyovAppCYCorpusAmt
Excess Distribution Cyov App CY$0ExcessDistributionCyovAppCYAmt
Total Corpus$935,507TotalCorpusAmt
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$163,841ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$771,666ExcessDistriCyovToNextYrAmt
Excess From Year4$150,945ExcessFromYear4Amt
Excess From Year3$86,277ExcessFromYear3Amt
Excess From Year2$378,857ExcessFromYear2Amt
Excess From Year1$65,588ExcessFromYear1Amt
Excess From Current Year$89,999ExcessFromCurrentYearAmt

Supplementary Information SupplementaryInformationGrp

FieldValueIRS element (for citing)
Contributing ManagerHENRY J BERTOLON JRContributingManagerNm
Contributing ManagerDONNA BERTOLONContributingManagerNm

Application Submission Info ApplicationSubmissionInfoGrp

FieldValueIRS element (for citing)
Recipient PersonHENRY J BERTOLON JR CO LES VITALERecipientPersonNm

Recipient US Address RecipientUSAddress

FieldValueIRS element (for citing)
Address Line180 CITY SQUAREAddressLine1Txt
CityBOSTONCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02129ZIPCd
FieldValueIRS element (for citing)
Recipient Phone6179129000RecipientPhoneNum
Form And Info And MaterialsTO BE DETERMINEDFormAndInfoAndMaterialsTxt
Submission DeadlinesNONESubmissionDeadlinesTxt
Restrictions On AwardsNONERestrictionsOnAwardsTxt

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (26 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
BEVERLY BOOTSTRAPS COMMUNITY SERVICES
371 CABOT STREETBEVERLYMA01915NONEPUBLIC CHARITYFOOD PANTRY; CAPITAL CAMPAIGN$25,000
BEVERLY HOSPITAL
85 HERRICK STREETBEVERLYMA01915NONEHOSPITALIMPROVE HEALTH & WELL BEING OF COMMUNITY$5,000
CAPE ABILITIES
895 MARY DUNN ROADHYANNISMA02601NONEPUBLIC CHARITYDAY-HABILITATION PROGRAM$2,000
CAPE COD HEALTHCARE FOUNDATION
PO BOX 370HYANNISMA02601NONEPUBLIC CHARITYPRESERVE HIGH STANDARDS OF HEALTHCARE EXCELLENCE ON CAPE COD$5,000
CAPE PLAYHOUSE
PO BOX 2001DENNISMA02638NONEPUBLIC CHARITYTO SUPPORT PROFESSIONAL THEATER ON CAPE COD$1,000
CARE DIMENSIONS
75 SYLVAN STREET SUITE B-102DANVERSMA01923NONEPUBLIC CHARITYGRIEF SUPPORT SERVICES$5,000
DENNIS MEMORIAL LIBRARY
1020 OLD BASS RIVER ROADDENNISMA02638NONEPUBLIC CHARITYSUPPORT OF LIBRARY FOR THE VILLAGE OF DENNIS$100
ESSEX COUNTY COMMUNITY FOUNDATION
175 ANDOVER STREET SUITE 101DANVERSMA01923NONEPUBLIC CHARITYSUPPORT LOCAL PHILANTHROPY TO STRENGTHEN NONPROFIT ORGANIZATIONS IN ESSEX COUNTY$1,000
H A W C
27 CONGRESS STREETSALEMMA01970NONEPUBLIC CHARITYHELP ABUSED WOMEN AND THEIR CHILDREN$1,000
JACOBS SEARS MEMORIAL LIBRARY
23 CENTER STREET PO BOX 782EAST DENNISMA02641NONEPUBLIC CHARITYINCREASE COLLECTION OF BOOKS AND MEDIA; SUPPORT OPERATING COSTS$500
MCLEAN HOSPITAL
115 MILL STREET MAIL STOP 126BELMONTMA024781064NONEPUBLIC CHARITYTO SUPPORT WOMEN WITH MENTAL HEALTH ISSUES$7,500
MOTHERS AGAINST DRUNK DRIVING
PO BOX 152274IRVINGTX750152274NONEPUBLIC CHARITYHELP ELIMINATE DRUNK DRIVING$200
NORTHEASTERN UNIVERSITY
360 HUNTINGTON AVENUEBOSTONMA02115NONESCHOOLSUPPORT SCHOLARSHIP FUND$1,000
OFFICER HAROLD L VITALE MEMORIAL FUND INC
20 BRISTOL ROADPEABODYMA019603474NONEPUBLIC CHARITYSUPPORT FOR LAW ENFORCEMENT ORGANIZATIONS, MAINTAIN MEMORIAL PARK, SCHOLARSHIPS$2,000
PINGREE SCHOOL
537 HIGHLAND STREETSOUTH HAMILTONMA01982NONESCHOOLENABLE STUDENTS TO PARTICIPATE IN SUMMER PROGRAMS$2,500
RIVER HOUSE
56 RIVER STREET PO BOX 3226BEVERLYMA01915NONEPUBLIC CHARITYSHELTER FOR HOMELESS MEN$500
SALVATION ARMY
50 ELLIOTT STREETBEVERLYMA01915NONEPUBLIC CHARITYTO SUPPORT THOSE IN NEED DURING THE HOLIDAYS$1,000
SECOND CONGREGATIONAL CHURCH
35 CONANT STREETBEVERLYMA01915NONECHURCHSUPPORT CHURCH AND ITS MISSIONS$13,200
THE HOLE IN THE WALL GANG CAMP
555 LONG WHARF DRIVENEW HAVENCT06511NONEPUBLIC CHARITYIN SUPPORT OF A CAMP FOR SERIOUS ILL CHILDREN AND THEIR FAMILIES$100
THE NSCC FOUNDATION INC
1 FERNCROFT ROADDANVERSMA01923NONESCHOOLENHANCE AND EXPAND EDUCATIONAL OPPORTUNITY$5,000
THE OTIS
PO BOX 877EAST DENNISMA02641NONEPUBLIC CHARITYIN SUPPORT OF VARIOUS CHARITABLE CAUSES$300
THE SIOUX CAMPBELL MEMORIAL EDUCATION
CAPE COD FIVE CENTS SAVINGS BANKORLEANSMA02653NONEN/AEDUCATIONAL FUND FOR CAMPBELL CHILDREN$10,000
THE TRUSTEES OF RESERVATIONS
572 ESSEX STREETBEVERLYMA01915NONEPUBLIC CHARITYPRESERVE THE MASSACHUSETTS LANDSCAPE$90
WELLSPRING HOUSE INC
302 ESSEX AVENUEGLOUCESTERMA01930NONEPUBLIC CHARITYHELP EMPOWER THOSE IN THE COMMUNITY WHO ARE IN NEED OF HELP AND GUIDANCE$500
WGBH
ONE GUEST STREETBOSTONMA02135NONEPUBLIC CHARITYSUPPORT EDUCATIONAL TELEVISION PROGRAMMING$170
WOMEN'S FUND OF ESSEX COUNTY
175 ANDOVER STREET STE 101DANVERSMA01923NONEPUBLIC CHARITYSUPPORT OF WOMEN & GIRLS IN NEED$1,000
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$90,660TotalGrantOrContriPdDurYrAmt
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$2ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$0UnrelatedBusinessTaxblIncmAmt
Exclusion$2ExclusionAmt
Related Or Exempt Function Incm$0RelatedOrExemptFunctionIncmAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$2TotalIncomeProducingActyAmt

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 PersonHENRY DONNA BERTOLONContributorPersonNm

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1245 DODGE STREETAddressLine1Txt
CityBEVERLYCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01915ZIPCd
FieldValueIRS element (for citing)
Total Contributions$94,375TotalContributionsAmt
Person ContributionYes (X)PersonContributionInd

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (2 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
MA FORM PC$160$0$0
BANK FEES$60$0$0

Substantial Contributors Sch SubstantialContributorsSch

Substantial Contributor Detail SubstantialContributorDetail (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCd
HENRY J BERTOLON JR
245 DODGE STREETBEVERLYMA01915
DONNA BERTOLON
245 DODGE STREETBEVERLYMA01915

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