2015-04-14T12:15:13-05:00 2014-05-31 721396621 CARR RIGGS & INGRAM LLC 1031 W MORSE BLVD SUITE 200 WINTER PARK FL 327893750 990PF 2013-06-01 593010451 HANS AND CAY JACOBSEN CHARITABLE FOUNDATION INC HANS 4078106672 PO BOX 2149 WINTER PARK FL 32790 TERESA BORCHECK PRESIDENT 4078106672 2015-03-13 1 MARLYN D FELSING CPA P00517771 4076447455 2013 2016-03-07 17:11:31Z X 6002748 X X 100575 100575 59674 1175869 59674 7250 0 167499 160249 32000 8000 24000 11415 9703 1712 38994 19497 19497 2164 2164 0 6784 6784 0 91357 46148 45209 319798 319798 411155 46148 365007 -243656 114101 15704 6251 6251 3011179 3215500 4812741 1618864 1180340 1183756 4645747 4402091 6002748 0 0 X 4645747 4402091 4645747 4402091 4645747 4402091 4645747 -243656 0 4402091 0 4402091 PUBLICLY TRADED SECURITIES 1144931 1116195 28736 28736 CAPITAL GAIN DIVIDENDS 30938 30938 30938 59674 0 281353 5310615 0.052979 221179 5121082 0.043190 226363 4972921 0.045519 283894 4719818 0.060149 68969 4536229 0.015204 0.217041 0.043408 5526055 239875 1141 241016 365007 X 1141 0 1141 0 1141 1076 400 1476 335 335 0 0 0 0 0 0 0 0 0 0 0 1 1 FL 1 0 0 0 0 1 WWW.HCJF.ORG CAPITAL CITY TRUST COMPANY 8668209671 PO BOX 1549 TALLAHASSEE FL 32302 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 TERESA W BORCHECK PO BOX 2149 WINTER PARK FL 32790 PRESIDENT 10.00 14000 0 0 W THOMAS BROOKS PO BOX 2149 WINTER PARK FL 32790 VICE PRESIDENT 2.00 6000 0 0 BRIAN BROOKS PO BOX 2149 WINTER PARK FL 32790 TREASURER 2.00 6000 0 0 SHANNON MCLIN CARLYLE PO BOX 2149 WINTER PARK FL 32790 SECRETARY 2.00 6000 0 0 NONE 0 NONE 0 0 5530908 79300 0 5610208 0 0 5610208 84153 5526055 276303 276303 1141 1141 275162 0 275162 0 275162 365007 0 365007 1141 363866 275162 12416 0 0 365007 12416 0 0 275162 77429 0 0 77429 0 0 0 0 0 0 0 77429 77429 TERESA BORCHECK PRESIDENT PO BOX 2149 WINTER PARK FL 32790 4078106672 INFO@HCFJ.ORG CONTACT THE FOUNDATION DIRECTLY OR VISIT THE FOUNDATION'S WEBSITE AT WWW.HCFJ.ORG FOR INFORMATION REGARDING FORM AND CONTENT OF APPLICATIONS REQUESTS ARE TO BE RECEIVED BY MAY 1 AND NOVEMBER 1 FOR CONSIDERATION AT THE SEMIANNUAL MEETINGS GRANTS ARE GENERALLY RESTRICTED TO PROGRAMS WHICH ASSIST CHILDREN AND YOUNG ADULTS, IN THE AREAS OF HEALTH, EDUCATION, CULTURE, RECREATION, AND ANY OTHER PROGRAM THAT WILL ADD TO THE BETTERMENT OF THEIR LIFE AND THEIR PARTICIPATION AS GOOD CITIZENS. GRANTS ARE EGENERALLY RESTRICTED TO PROGRAMS CONDUCTED IN LAKE AND SUMTER COUNTY FLORIDA. CHRISTIAN HOME AND BIBLE SCHOOL 301 WEST 13TH AVENUE MOUNT DORA FL 32757 EDUCATIONAL ORGANIZA FURNITURE AND FURNISHINGS FOR THE LUGAR COTTAGE, AND UPGRADED WI-FI IN THE CHILDREN'S HOMES 65949 SPECIAL OLYMPICS FLORIDA INC 1915 DON WICKHAM DRIVE CLERMONT FL 34711 CHARITABLE ORGANIZAT TO FUND PROJECT UNIFY FOR LAKE COUNTY 30000 HAVEN OF LAKE & SUMTER COUNTIES INC 2600 SOUTH STREET LEESBURG FL 34748 CHARITABLE ORGANIZAT THE CHILDREN'S DV/SA PROGRAM 25000 BOYS & GIRLS CLUB OF LAKE & SUMTER COUNTIES INC PO BOX 896179 LEESBURG FL 34789 EDUCATIONAL ORGANIZA PROJECT LEARN AND THE HOLIDAY BREAK, AND SUMMER BRAIN GAME 50000 UNIVERSITY OF CENTRAL FLORIDA FOUNDATION INC 12424 RESEARCH PARKWAY ORLANDO FL 32826 EDUCATIONAL ORGANIZA SCHOLARSHIPS 20000 QUEST INC PO BOX 531125 ORLANDO FL 32853 CHARITABLE ORGANIZAT CAMP THUNDERBIRD CAMPERSHIPS FOR LAKE AND SUMTER COUNTY CHILDREN 20000 LAKE SUMTER CHILDRENS ADVOCACY CENTER INC 300 SOUTH CANAL STREET LEESBURG FL 34748 CHARITABLE ORGANIZAT COUNSELING PROGRAM AND OPERATIONS 20000 EARLY LEARNING COALATION OF LAKE COUNTY 1300 CITIZENS BOULEVARD LEESBURG FL 34748 CHARITABLE ORGANIZAT CHILD CARE FOR CHILDREN 15000 SUMTER COUNTY YOUTH CENTER PO BOX 2092 BUSHNELL FL 33513 CHARITABLE ORGANIZAT BASKETBALL AND HOMEWORK/TUTORIAL PROGRAMS 14225 LAKE SUMTER STATE COLLEGE FOUNDATION 9501 US HWY 441 LEESBURG FL 34788 EDUCATIONAL ORGANIZA JOHNSON SCHOLARS STEM MATCH PROGRAM 10000 EDUCATIONAL FOUNDATION OF LAKE COUNTY 2045 PRUITT STREET LEESBURG FL 34748 EDUCATIONAL ORGANIZA BACK TO SCHOOL BACK PACK FAIR 10000 EASTER SEALS - CAMP CHALLENGE 31600 CAMP CHALLENGE RD SORRENTO FL 32776 CHARITABLE ORGANIZAT CAMPERSHIPS FOR LAKE AND SUMTER COUNTY RESIDENTS 10000 THE BOGGY CREEK GANG INC 30500 BRANTLEY BRANCH RD EUSTIS FL 32736 CHARITABLE ORGANIZAT REGISTRATION COSTS FOR LAKE AND SUMTER COUNTY ATTENDEES 10000 SOUTHERN SCHOLARSHIP FOUNDATION PO BOX 14406 GAINESVILLE FL 32604 EDUCATIONAL ORGANIZA COLLEGE HOUSING FOR LAKE AND SUMTER COUNTY STUDENTS 6000 TAKE STOCK IN CHILDREN LAKE AND SUMTER COUNTIES 910 E DIXIE AVE LEESBURG FL 34748 CHARITABLE ORGANIZAT COLLEGE CAMPUS TOUR AND CAREER DAY 5000 ASBURY UNITED METHODIST CHURCH 220 W HORATIO AVENUE MAITLAND FL 32751 RELIGOIUS ORGANIZATI MISSION TRIP 4624 BUFFALO SCHOLARSHIP FOUNDATION 251 BUFFALO TRAIL THE VILLAGES FL 32162 CHARITABLE ORGANIZAT FIRST IN FAMILY SCHOLARSHIP 4000 319798 0 14 100575 14 59674 INCOME TAX REFUND 01 7250 0 167499 0 167499 0 0 0 0 0 0 0 0 0 0 11415 9703 1712 ISHARES BARCLAYS AGG 0 0 ISHARES BARCLAYS 1-3 BOND ETF 500177 507552 PIMCO FDS PAC INVT MGMT SER LOW DURATION 308220 307307 PIMCO INV GRD CORP 201943 204081 VANGUARD INFLAT PROTECTED-IV 170000 164816 AT&T INC 30554 37953 ALLSTATE CORP 28780 66999 AMERICAN ELEC PWR INC 22013 30943 APPLE INC 75019 120270 ARTISAN INTERNATIONAL 50000 77716 BB&T CORP COM 39457 67308 CF INDUSTRIES HOLDINGS INC 31917 47445 CVS HEALTH CORP 45828 100250 COGNIZANT TECHNOLOGY SOL CL A 42868 63193 COLGATE PALMOLIVE CO COM 40633 61560 CONOCOPHILLIPS COM 47127 73545 DANAHER CORP DEL COM 53012 92155 DODGE & COX INT'L STOCK FUND 50000 76967 EBAY INC COM 43021 37033 EXXON MOBIL CORP 64565 87461 FEDERAL HOME LOAN BANKS DEB 1.250% 7/23/19 0 0 FEDERATED INVESTORS INCOME CLASS B 38889 60498 FISERV INC COM 42172 94974 FREEPORT-MCMORAN INC CL B 40595 36263 GENERAL DYNAMICS CORP COM 27820 54926 GENERAL ELECTIRC 1.50% 07/12/2016 151233 152352 INTERNATIONAL BUSINESS MACHSCOM 59003 62682 ISHARES CORE US AGGREGATE BOND 192341 191923 ISHARES RUSSELL 1000 INDEX 124620 215280 JOHNSON & JOHNSON 35841 56818 LABORATORY CORP AMER HLDGS 45149 55906 MFS RESEARCH INTERNATIONAL 173722 268109 MCDONALDS CORP 44519 50715 MCKESSON CORP 50724 124214 METLIFE INC 42437 70793 MICROSOFT CORP 39504 62024 NATIONAL OILWELL VARCO 62029 83098 NEXTERA ENERGY INC 22169 39431 NOW INC COM 0 0 OPPENHEIMER MAIN ST SML MD CP Y 140000 212250 ORACLE CORP COMMON 55763 78998 PROCTER & GAMBLE CO COM 43642 55745 PUBLIC SVC ENTERPRISE GROUP COM 22359 25714 QUALCOMM INC 50423 78037 ROPER INDUSTRIES INC 38143 72965 ROYCE FD PREMIER INSTL 214212 245444 SPDR S&P 500 UNIT SER 1 ETF 112070 192680 SCHLUMBERGER LTD 51546 58262 SCRIPPS NETWORKS INTERACTIVE 39435 73784 TARGET CORP 37948 41435 TEMPLETON INCOME TR GLB BD ADVSOR 151018 147985 THERMO FISHER SCIENTIFIC INCCOM 43890 100543 TRAVELERS COS INC 45640 84105 US BANCORP DEL COM NEW 44365 77630 UNION PAC CORP 52101 116573 UNITED TECHNOLOGIES CORP 39848 62759 VF CORPORATION 46406 92009 VANGUARD SMALL CAP INDEX 0 0 VERIZON COMMUNICATIONS 30526 41966 WAL MART STORES INC COM 42034 60648 ACTAVIS PLC 56570 172405 WEBSITE EXPENSE 3350 3350 0 INSURANCE 1275 1275 0 OTHER EXPENSES 2159 2159 0 INCOME TAX REFUND 7250 7250 38994 19497 19497