DAMICO FAMILY FOUNDATION: Form 990PF, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
DAMICO FAMILY FOUNDATION (EIN 01-0702653)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-11-07
IRS object ID
201633129349100503
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)
Return2016-11-07T08:38:57-06:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN271180831PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1HPM PARTNERS LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1600 SUPERIOR AVE SUITE 1000AddressLine1Txt
CityCLEVELANDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44114ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN010702653EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DAMICO FAMILY FOUNDATIONBusinessNameLine1Txt
Business Name Line2C/O HPM PARTNERS LLCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlDAMIBusinessNameControlTxt
Phone2167062461PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 SUPERIOR AVENUE NO 1000AddressLine1Txt
CityCLEVELANDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44114ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOSEPH F DAMICOPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone8477393200PhoneNum
Signature2016-11-04SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMATTHEW WOJTOWICZ CPAPreparerPersonNm
PTINP00969025PTIN
Phone2166870700PhoneNum
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$4,520,474FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$2,500ContriRcvdRevAndExpnssAmt
Schedule B Not RequiredYes (X)ScheduleBNotRequiredInd
Interest On Sav Rev And Expnss$9,868InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$9,868InterestOnSavNetInvstIncmAmt
Dividends Rev And Expnss$99,346DividendsRevAndExpnssAmt
Dividends Net Invst Incm$99,346DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss$130,078NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$960,502GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$130,078CapGainNetIncmNetInvstIncmAmt
Other Income Rev And Expnss$6,807OtherIncomeRevAndExpnssAmt
Other Income Net Invst Incm$0OtherIncomeNetInvstIncmAmt
Total Rev And Expnss$248,599TotalRevAndExpnssAmt
Total Net Invst Incm$239,292TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$0CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$0CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl$0CompOfcrDirTrstDsbrsChrtblAmt
Accounting Fees Rev And Expnss$2,500AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm$0AccountingFeesNetInvstIncmAmt
Accounting Fees Chrtbl Prps$0AccountingFeesChrtblPrpsAmt
Taxes Rev And Expnss$7,369TaxesRevAndExpnssAmt
Taxes Net Invst Incm$1,369TaxesNetInvstIncmAmt
Taxes Dsbrs Chrtbl$0TaxesDsbrsChrtblAmt
Other Expenses Rev And Expnss$452OtherExpensesRevAndExpnssAmt
Other Expenses Net Invst Incm$252OtherExpensesNetInvstIncmAmt
Other Expenses Dsbrs Chrtbl$0OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$10,321TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$1,621TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$0TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$470,181ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$470,181ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$480,502TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$1,621TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$470,181TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses-$231,903ExcessRevenueOverExpensesAmt
Net Investment Income$237,671NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Sav And Temp Cash Invst BOY$716,452SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$516,356SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$516,356SavAndTempCashInvstEOYFMVAmt
Other Investments BOY$3,596,909OtherInvestmentsBOYAmt
Other Investments EOY$3,819,352OtherInvestmentsEOYAmt
Other Investments EOYFMV$4,004,118OtherInvestmentsEOYFMVAmt
Total Assets BOY$4,313,361TotalAssetsBOYAmt
Total Assets EOY$4,335,708TotalAssetsEOYAmt
Total Assets EOYFMV$4,520,474TotalAssetsEOYFMVAmt
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$4,313,361RetainedEarningBOYAmt
Retained Earning EOY$4,335,708RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY$4,313,361TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$4,335,708TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$4,313,361TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$4,335,708TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$4,313,361TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses-$231,903ExcessRevenueOverExpensesAmt
Other Increases$254,250OtherIncreasesAmt
Subtotal$4,335,708SubtotalAmt
Other Decreases$0OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY$4,335,708TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (3 entries)

PropertyPropertyDescHow AcquiredHowAcquiredCdGross Sales PriceGrossSalesPriceAmtCost Or Other BasisCostOrOtherBasisAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmt
PUBLICLY TRADED SECURITIESP$35,539$33,475$2,064$2,064
PUBLICLY TRADED SECURITIESP$842,856$796,949$45,907$45,907
CAPITAL GAINS DIVIDENDSP$82,107$82,107$82,107
FieldValueIRS element (for citing)
Capital Gain Net Income$130,078CapitalGainNetIncomeAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

FieldValueIRS element (for citing)
Liable Section4942 Tax0LiableSection4942TaxInd
Adjusted Qlfy Distri Yr1$510,692AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1$4,479,376NetVlNoncharitableAssetsYr1Amt
Distribution Yr10.114010DistributionYr1Rt
Adjusted Qlfy Distri Yr2$227,100AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2$4,392,794NetVlNoncharitableAssetsYr2Amt
Distribution Yr20.051698DistributionYr2Rt
Adjusted Qlfy Distri Yr3$215,000AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3$4,099,839NetVlNoncharitableAssetsYr3Amt
Distribution Yr30.052441DistributionYr3Rt
Adjusted Qlfy Distri Yr4$194,500AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4$4,057,436NetVlNoncharitableAssetsYr4Amt
Distribution Yr40.047937DistributionYr4Rt
Adjusted Qlfy Distri Yr5$75,750AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5$1,334,735NetVlNoncharitableAssetsYr5Amt
Distribution Yr50.056753DistributionYr5Rt
Total Distribution0.322839TotalDistributionRt
Average Distribution0.064568AverageDistributionRt
Net Vl Noncharitable Assets$4,718,146NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets$304,641AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct$2,377NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct$307,018AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions$470,181QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Domestic Org Meeting Sect4940eYes (X)DomesticOrgMeetingSect4940eInd
Investment Income Excise Tax$2,377InvestmentIncomeExciseTaxAmt
Tax Under Section511$0TaxUnderSection511Amt
Subtotal$2,377SubtotalAmt
Subtitle A Tax$0SubtitleATaxAmt
Tax Based On Investment Income$2,377TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$6,704EstimatedPlusOvpmtIncmTxAmt
Total Payments And Credits$6,704TotalPaymentsAndCreditsAmt
Overpayment$4,327OverpaymentAmt
Applied To ES Tax$4,327AppliedToESTaxAmt
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 SatisfiedYes (1)Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (1)AtLeast5000InAssetsInd
Org Report Or Register StateOHOrgReportOrRegisterStateCd
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 BooksANTHONY DECELLOIndividualWithBooksNm
Phone2167062461PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line1600 SUPERIOR AVENUE 1000AddressLine1Txt
CityCLEVELANDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44114ZIPCd
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 (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
JOSEPH F DAMICO
1388 WEST LAKE STREETLIBERTYVILLEIL60048PRESIDENT0.00$0$0$0
PAMELA C DAMICO
1388 WEST LAKE STREETLIBERTYVILLEIL60048TREASURER0.00$0$0$0
ANTHONY D DECELLO
600 SUPERIOR AVENUE SUITE 1000CLEVELANDOH44114SECRETARY0.00$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

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$4,060,024AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$729,972AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$4,789,996TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$4,789,996AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$71,850CashDeemedCharitableAmt
Net Vl Noncharitable Assets$4,718,146NetVlNoncharitableAssetsAmt
Minimum Investment Return$235,907MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$235,907MinimumInvestmentReturnAmt
Tax Based On Investment Income$2,377TaxBasedOnInvestmentIncomeAmt
Total Tax$2,377TotalTaxAmt
Distributable Before Adj$233,530DistributableBeforeAdjAmt
Recoveries Qualfied Distri$0RecoveriesQualfiedDistriAmt
Distributable Before Ded$233,530DistributableBeforeDedAmt
Deduction From Distributable$0DeductionFromDistributableAmt
Distributable As Adjusted$233,530DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$470,181ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Qualifying Distributions$470,181QualifyingDistributionsAmt
Pct Sect4940e Org Net Invst Incm$2,377PctSect4940eOrgNetInvstIncmAmt
Adjusted Qualifying Distri$467,804AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$233,530DistributableAsAdjustedAmt
Undistributed Income PY$0UndistributedIncomePYAmt
Total For Prior Years$0TotalForPriorYearsAmt
Excess Distribution Cyov Yr5$33,310ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr3$13,716ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2$12,113ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1$293,315ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov$352,454TotalExcessDistributionCyovAmt
Qualifying Distributions$470,181QualifyingDistributionsAmt
Applied To Year1$0AppliedToYear1Amt
Applied To Prior Years$0AppliedToPriorYearsAmt
Treated As Distri From Corpus$0TreatedAsDistriFromCorpusAmt
Applied To Current Year$233,530AppliedToCurrentYearAmt
Remaining Distri From Corpus$236,651RemainingDistriFromCorpusAmt
Excess Distri Cyov App CY Corpus$0ExcessDistriCyovAppCYCorpusAmt
Excess Distribution Cyov App CY$0ExcessDistributionCyovAppCYAmt
Total Corpus$589,105TotalCorpusAmt
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$33,310ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$555,795ExcessDistriCyovToNextYrAmt
Excess From Year3$13,716ExcessFromYear3Amt
Excess From Year2$12,113ExcessFromYear2Amt
Excess From Year1$293,315ExcessFromYear1Amt
Excess From Current Year$236,651ExcessFromCurrentYearAmt

Supplementary Information SupplementaryInformationGrp

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

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (15 entries)

Address Line1RecipientUSAddress/AddressLine1TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
ACE UNIVERSITY OF NOTRE DAME
154 IEI BUILDINGNOTRE DAMEIN46556UNRELATEDPUBLIC CHARITYGENERAL SUPPORT$50,000
ALLENDALE ASSOCIATION
600 W GRAND AVELAKE VILLAIL60046UNRELATEDPUBLIC CHARITYGENERAL SUPPORT$10,000
AMERICAN HEART ASSOCIATION
208 S LASALLE ST 1500CHICAGOIL60604UNRELATEDPUBLIC CHARITYGENERAL SUPPORT$1,000
BEACON PLACE NFP
603 S MCALISTER AVEWAUKEGANIL60085UNRELATEDPUBLIC CHARITYGENERAL SUPPORT$10,000
BERNIE'S BOOK BANK
28101 BALLARD DRIVELAKE FORESTIL60045UNRELATEDPUBLIC CHARITYGENERAL SUPPORT$25,000
GOOD SPORTS
1515 HANCOCK STQUINCYMA02169UNRELATEDPUBLIC CHARITYGENERAL SUPPORT$10,000
GRIFFITH TUTORING GROUP
3346 N SOUTHPORT AVE 2SCHICAGOIN60657UNRELATEDPUBLIC CHARITYGENERAL SUPPORT$20,000
LAKE COUNTY HAVEN
PO BOX 127LIBERTYVILLEIL60048UNRELATEDPUBLIC CHARITYGENERAL SUPPORT$10,000
LES TURNER ALS FOUNDATION
5550 W TOUHY AVE 302SKOKIEMA60077UNRELATEDPUBLIC CHARITYGENERAL SUPPORT$2,000
LURIE CHILDREN'S HOSPITAL FOUNDATION
225 E CHICAGO AVECHICAGOIL60611UNRELATEDPUBLIC CHARITYGENERAL SUPPORT$25,000
NORTHERN ILLINOIS FOOD BANK
273 DEARBORN CTGENEVAIL60134UNRELATEDPUBLIC CHARITYGENERAL SUPPORT$25,000
PADS-LAKE COUNTY
1800 GRAND AVEWAUKEGANIL60085UNRELATEDPUBLIC CHARITYGENERAL SUPPORT$10,000
TUTORING CHICAGO
2145 N HALSTED STCHICAGOIL60614UNRELATEDPUBLIC CHARITYGENERAL SUPPORT$10,000
YOUTH & FAMILY COUNSELING
1585 N MILWAUKEE RD 14LIBERTYVILLEIL60048UNRELATEDPUBLIC CHARITYGENERAL SUPPORT$10,000
LAKE FOREST HOSPITAL
660 N WESTMORELAND RDLAKE FORESTIL60045UNRELATEDPUBLIC CHARITYGENERAL SUPPORT$252,181
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$470,181TotalGrantOrContriPdDurYrAmt
Total Grant Or Contri Apprv Fut$0TotalGrantOrContriApprvFutAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$9,868ExclusionAmt

Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$99,346ExclusionAmt

Other Investment Incm Part VII OtherInvestmentIncmPartVIIGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$6,807ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion$130,078ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$0UnrelatedBusinessTaxblIncmAmt
Exclusion$246,099ExclusionAmt
Related Or Exempt Function Incm$0RelatedOrExemptFunctionIncmAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$246,099TotalIncomeProducingActyAmt

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

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryHPM PARTNERS LLCCategoryTxt
Amt$2,500Amt
Net Investment Income$0NetInvestmentIncomeAmt
Disbursements Charitable Prps$0DisbursementsCharitablePrpsAmt

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOtherGrp (3 entries)

Category Or ItemCategoryOrItemTxtListed At Cost Or FMVListedAtCostOrFMVCdBook ValueBookValueAmtEOYFMVEOYFMVAmt
MISCELLANEOUS STOCKSAT COST$101,111$599,382
MISCELLANEOUS MUTUAL FUNDSAT COST$3,463,850$3,149,003
CARLYLE GMS FINANCE INVESTMENTAT COST$254,391$255,733

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (2 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
FILING FEES$200$0$0
BANK FEES$252$252$0

Other Income Schedule2 OtherIncomeSchedule2

Other Income Detail OtherIncomeDetail

FieldValueIRS element (for citing)
DescNATIONAL FINANCIAL SERVICES-NONDIVIDEND DISTRIBUTIONSDesc
Revenue And Expenses Per Books$6,807RevenueAndExpensesPerBooksAmt
Net Investment Income$0NetInvestmentIncomeAmt
Adjusted Net Income$6,807AdjustedNetIncomeAmt

Other Increases Schedule OtherIncreasesSchedule

Other Increases Detail OtherIncreasesDetail

FieldValueIRS element (for citing)
DescADJUSTMENT TO COST BASIS OF SECURITIES FOR GRANTDesc
Amt$254,250Amt

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (2 entries)

CategoryCategoryTxtAmtAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
FEDERAL EXCISE TAX$6,000$0$0
FOREIGN TAX PAID$1,369$1,369$0

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