SURPLUS LINE ASSOCIATION OF ARIZONA FOUNDATION TR: Form 990PF, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- SURPLUS LINE ASSOCIATION OF ARIZONA FOUNDATION TR (EIN 86-6320000)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-10-01
- IRS object ID
- 201522749349100502
- Schema version
- 2014v5.0
- 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
- Form 990-PF
- Schedule B
- Depreciation Schedule
- Investments Corp Bonds Schedule
- Investments Govt Obligations Sch
- Investments Other Schedule2
- Other Expenses Schedule
- Other Income Schedule2
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-10-01T09:39:40-05:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Foundation Source | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | One Hollow Ln Ste 212 | AddressLine1Txt |
| City | Lake Success | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11042 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 866320000 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The Surplus Line Association of Arizona | BusinessNameLine1Txt |
| Business Name Line2 | Foundation | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % Foundation Source | InCareOfNm |
| Business Name Control | SURP | BusinessNameControlTxt |
| Phone | 8008391754 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | Foundation Source 501 Silverside Rd | AddressLine1Txt |
| City | Wilmington | CityNm |
| State Abbreviation | DE | StateAbbreviationCd |
| ZIP | 198091377 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | timothy m downey | PersonNm |
| Person Title | president | PersonTitleTxt |
| Phone | 8008391754 | PhoneNum |
| Signature | 2015-09-22 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Jeffrey D Haskell | PreparerPersonNm |
| PTIN | P01345770 | PTIN |
| Phone | 8008391754 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $6,261,552 | FMVAssetsEOYAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rcvd Rev And Expnss | $499,000 | ContriRcvdRevAndExpnssAmt |
| Interest On Sav Rev And Expnss | $16 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $16 | InterestOnSavNetInvstIncmAmt |
| Dividends Rev And Expnss | $41,448 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $41,448 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $119,037 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $657,358 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $119,037 | CapGainNetIncmNetInvstIncmAmt |
| Other Income Rev And Expnss | $134,311 | OtherIncomeRevAndExpnssAmt |
| Other Income Net Invst Incm | $134,311 | OtherIncomeNetInvstIncmAmt |
| Total Rev And Expnss | $793,812 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $294,812 | TotalNetInvstIncmAmt |
| Taxes Rev And Expnss | $2,882 | TaxesRevAndExpnssAmt |
| Other Expenses Rev And Expnss | $29,573 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Dsbrs Chrtbl | $29,573 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $32,455 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $0 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $29,573 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $481,000 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $481,000 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $513,455 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $0 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $510,573 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $280,357 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $294,812 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sav And Temp Cash Invst BOY | $114,999 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $44,381 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $44,381 | SavAndTempCashInvstEOYFMVAmt |
| US Government Obligations BOY | $316,270 | USGovernmentObligationsBOYAmt |
| US Government Obligations EOY | $316,817 | USGovernmentObligationsEOYAmt |
| US Govt Obligations EOYFMV | $315,071 | USGovtObligationsEOYFMVAmt |
| Corporate Bonds BOY | $642,640 | CorporateBondsBOYAmt |
| Corporate Bonds EOY | $737,402 | CorporateBondsEOYAmt |
| Corporate Bonds EOYFMV | $747,529 | CorporateBondsEOYFMVAmt |
| Other Investments BOY | $4,487,998 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $4,743,664 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $5,154,571 | OtherInvestmentsEOYFMVAmt |
| Total Assets BOY | $5,561,907 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,842,264 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $6,261,552 | TotalAssetsEOYFMVAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
| Retained Earning BOY | $5,561,907 | RetainedEarningBOYAmt |
| Retained Earning EOY | $5,842,264 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $5,561,907 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $5,842,264 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $5,561,907 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $5,842,264 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $5,561,907 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $280,357 | ExcessRevenueOverExpensesAmt |
| Subtotal | $5,842,264 | SubtotalAmt |
| Tot Net Ast Or Fund Balances EOY | $5,842,264 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (2 entries)
| PropertyPropertyDesc | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt | How AcquiredHowAcquiredCd | AcquiredAcquiredDt | SoldSoldDt |
|---|---|---|---|---|---|---|---|
| Publicly-traded Securities | $62,284 | $64,602 | -$2,318 | -$2,318 | |||
| LINCOLN BENEFIT LIFE NON QUAL#LBF1224569 | $595,074 | $473,719 | $121,355 | $121,355 | P | 2004-12-31 | 2014-08-06 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $119,037 | CapitalGainNetIncomeAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | false | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $508,447 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $6,095,464 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.083414 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $454,887 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $5,993,418 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.075898 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $326,225 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $5,858,765 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 0.055682 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $103,652 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $5,294,120 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.019579 | DistributionYr4Rt |
| Adjusted Qlfy Distri Yr5 | $253,711 | AdjustedQlfyDistriYr5Amt |
| Net Vl Noncharitable Assets Yr5 | $4,613,779 | NetVlNoncharitableAssetsYr5Amt |
| Distribution Yr5 | 0.05499 | DistributionYr5Rt |
| Total Distribution | 0.289563 | TotalDistributionRt |
| Average Distribution | 0.057913 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $6,189,942 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $358,478 | AdjNetVlNoncharitableAssetsAmt |
| Net Investment Income Pct | $2,948 | NetInvestmentIncomePctAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $361,426 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $510,573 | QualifyingDistributionsAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Domestic Org Meeting Sect4940e | Yes (X) | DomesticOrgMeetingSect4940eInd |
| Investment Income Excise Tax | $2,948 | InvestmentIncomeExciseTaxAmt |
| Subtotal | $2,948 | SubtotalAmt |
| Tax Based On Investment Income | $2,948 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $1,000 | EstimatedPlusOvpmtIncmTxAmt |
| Applied To Es Tax | $1,948 | AppliedToEsTaxAmt |
| Total Payments And Credits | $2,948 | TotalPaymentsAndCreditsAmt |
| Form2220 Attached | Yes (X) | Form2220AttachedInd |
| Es Penalty | $8 | EsPenaltyAmt |
| Tax Due | $8 | TaxDueAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | false | LegislativePoliticalActyInd |
| More Than100 Spent | false | MoreThan100SpentInd |
| Form1120 POL Filed | false | Form1120POLFiledInd |
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | false | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (true) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (true) | AtLeast5000InAssetsInd |
| Org Report Or Register State | AZ | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (true) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | false | PrivateOperatingFoundationInd |
| New Substantial Contributors | false | NewSubstantialContributorsInd |
| Own Controlled Entity | false | OwnControlledEntityInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (true) | ComplyWithPublicInspRqrInd |
Persons With Books Name PersonsWithBooksName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Foundation Source | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8008391754 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 501 Silverside Road Suite 123 | AddressLine1Txt |
| City | Wilmington | CityNm |
| State Abbreviation | DE | StateAbbreviationCd |
| ZIP | 198091377 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Accounts Question | false | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | false | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | false | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | false | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | false | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | false | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | false | PaymentToGovernmentOfficialInd |
| Uncorrected Prior Acts | false | UncorrectedPriorActsInd |
| Undistributed Income PY | false | UndistributedIncomePYInd |
| Business Holdings | false | BusinessHoldingsInd |
| Jeopardy Investments | false | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | false | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | false | InfluenceLegislationInd |
| Influence Election | false | InfluenceElectionInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Noncharitable Purpose | false | NoncharitablePurposeInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt |
|---|---|---|---|---|---|---|
| Marc Adler | ||||||
| Foundation Source 501 Silverside Rd | Wilmington | DE | 198091377 | Dir | 1.0 | $0 |
| T Curtis Anderson | ||||||
| Foundation Source 501 Silverside Rd | Wilmington | DE | 198091377 | VP | 1.0 | $0 |
| Larry Beach | ||||||
| Foundation Source 501 Silverside Rd | Wilmington | DE | 198091377 | Sec / Treas | 1.0 | $0 |
| Karla Burt | ||||||
| Foundation Source 501 Silverside Rd | Wilmington | DE | 198091377 | Dir | 1.0 | $0 |
| Timothy Downey | ||||||
| Foundation Source 501 Silverside Rd | Wilmington | DE | 198091377 | Pres | 1.0 | $0 |
| Lanny Hair | ||||||
| Foundation Source 501 Silverside Rd | Wilmington | DE | 198091377 | Dir | 1.0 | $0 |
| Konnie Keaschall-Kiser | ||||||
| Foundation Source 501 Silverside Rd | Wilmington | DE | 198091377 | Dir | 1.0 | $0 |
| Gerald L Silver | ||||||
| Foundation Source 501 Silverside Rd | Wilmington | DE | 198091377 | Dir | 1.0 | $0 |
| J Scott Wede | ||||||
| Foundation Source 501 Silverside Rd | Wilmington | DE | 198091377 | Exec Dir | 1.0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Summary Of Direct Chrtbl Acty | SummaryOfDirectChrtblActyGrp | |
| Sum Of Program Related Invst | SumOfProgramRelatedInvstGrp |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $1,037,886 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $80,710 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $5,165,609 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $6,284,205 | TotalFMVOfUnusedAssetsAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $6,284,205 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $94,263 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $6,189,942 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $309,497 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $309,497 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $2,948 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $2,948 | TotalTaxAmt |
| Distributable Before Adj | $306,549 | DistributableBeforeAdjAmt |
| Distributable Before Ded | $306,549 | DistributableBeforeDedAmt |
| Distributable As Adjusted | $306,549 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $510,573 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Charitable Assets Acquis Paid | $0 | CharitableAssetsAcquisPaidAmt |
| Set Aside Suitability Test | $0 | SetAsideSuitabilityTestAmt |
| Set Aside Cash Distri Test | $0 | SetAsideCashDistriTestAmt |
| Qualifying Distributions | $510,573 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $2,948 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $507,625 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $306,549 | DistributableAsAdjustedAmt |
| Prior Year1 | 2012 | PriorYear1Yr |
| Prior Year2 | 2011 | PriorYear2Yr |
| Prior Year3 | 2010 | PriorYear3Yr |
| Excess Distribution Cyov Yr1 | $193,552 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $193,552 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $510,573 | QualifyingDistributionsAmt |
| Applied To Current Year | $306,549 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $204,024 | RemainingDistriFromCorpusAmt |
| Total Corpus | $397,576 | TotalCorpusAmt |
| Undistributed Income CY | $0 | UndistributedIncomeCYAmt |
| Excess Distri Cyov To Next Yr | $397,576 | ExcessDistriCyovToNextYrAmt |
| Excess From Year1 | $193,552 | ExcessFromYear1Amt |
| Excess From Current Year | $204,024 | ExcessFromCurrentYearAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Private Operating Foundations | PrivateOperatingFoundationsGrp |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributing Manager | NONE | ContributingManagerNm |
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (36 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| 100 CLUB OF ARIZONA | |||||||
| 5033 N 19TH AVE STE 123 | TEMPE | AZ | 85015 | N/A | PC | General & Unrestricted | $15,000 |
| 88-CRIME INC | |||||||
| 32 N STONE AVE STE 1400 | TUCSON | AZ | 85701 | N/A | PC | General & Unrestricted | $3,000 |
| AAMGA EDUCATION FOUNDATION | |||||||
| 150 S WARNER RD STE 156 | KING OF PRUSSIA | PA | 19406 | N/A | PC | General & Unrestricted | $80,000 |
| ABT PERFORMING ARTS ASSOCIATION INC | |||||||
| 7701 W PARADISE LN | PEORIA | AZ | 85382 | N/A | PC | General & Unrestricted | $5,000 |
| AMYOTROPHIC LATERAL SCLEROSIS ASSOCIATION | |||||||
| 4643 E THOMAS RD STE 1 | PHOENIX | AZ | 85018 | N/A | PC | General & Unrestricted | $2,500 |
| ARIZONA BRIDGE TO INDEPENDENT LIVING | |||||||
| 5025 E WASHINGTON ST STE 200 | PHOENIX | AZ | 85034 | N/A | PC | General & Unrestricted | $5,000 |
| ARIZONA COMMUNITY FOUNDATION | |||||||
| 2201 E CAMELBACK RD STE 405B | PHOENIX | AZ | 85016 | N/A | PC | General & Unrestricted | $2,500 |
| ARIZONA DIABETES FOUNDATION INC | |||||||
| GREENWAY PROFESSIONAL BLDG | PHOENIX | AZ | 85032 | N/A | PC | General & Unrestricted | $5,000 |
| ARTHRITIS FOUNDATION INC - PHOENIX CHAPTER | |||||||
| 1221 E OSBORN RD STE 201 | PHOENIX | AZ | 85014 | N/A | PC | General & Unrestricted | $5,000 |
| ASSISTANCE LEAGUE OF TUCSON INC | |||||||
| 1307 N ALVERNON WAY | TUCSON | AZ | 85712 | N/A | PC | General & Unrestricted | $5,000 |
| AUTISM SOCIETY OF GREATER PHOENIX | |||||||
| GREATER PHOENIX | PHOENIX | AZ | 85064 | N/A | PC | General & Unrestricted | $10,000 |
| BANNER ALZHEIMERS INSTITUTE | |||||||
| 1441 N 12TH ST | PHOENIX | AZ | 85006 | N/A | PC | General & Unrestricted | $3,000 |
| BOY SCOUTS OF AMERICA | |||||||
| 2969 N GREENFIELD RD | PHOENIX | AZ | 85016 | N/A | PC | General & Unrestricted | $5,000 |
| BOYS HOPE GIRLS HOPE | |||||||
| 1725 RIVERSIDE DR | CINCINNATI | OH | 45202 | N/A | PC | General & Unrestricted | $3,000 |
| CAMELBACK KIWANIS SERVICE FUND | |||||||
| 1426 W LUKE AVE | PHOENIX | AZ | 85013 | N/A | PC | General & Unrestricted | $5,000 |
| COMMUNITY FOOD BANK INC | |||||||
| 3003 S COUNTRY CLUB RD | TUCSON | AZ | 85713 | N/A | PC | General & Unrestricted | $27,000 |
| DEREK HUGHES NAPSLO EDUCATIONAL FOUNDATION INC | |||||||
| 4131 N MULBERRY DR STE 200 | KANSAS CITY | MO | 64116 | N/A | PC | General & Unrestricted | $50,000 |
| DESERT SURVIVORS INC | |||||||
| 1020 W STARR PASS BLVD | TUCSON | AZ | 85713 | N/A | PC | General & Unrestricted | $5,000 |
| HACIENDA SNF INC | |||||||
| 1402 E S MOUNTAIN AVE | PHOENIX | AZ | 85042 | N/A | PC | General & Unrestricted | $15,000 |
| INSURANCE TRAINING AND EDUCATION CENTER INC | |||||||
| 2828 N 36TH ST | PHOENIX | AZ | 85008 | N/A | PC | General & Unrestricted | $50,000 |
| KITCHEN ON THE STREET INC | |||||||
| 2650 E MOHAWK | PHOENIX | AZ | 85050 | N/A | PC | General & Unrestricted | $10,000 |
| LEADERSHIP WORKSHOPS FOUNDATION FOR YOUTH & FAMILY | |||||||
| 8711 E PINNACLE PEAK RD STE F 101 | SCOTTSDALE | AZ | 85255 | N/A | PC | General & Unrestricted | $5,000 |
| MAKE A WISH FOUNDATION OF ARIZONA INC | |||||||
| 711 E NORTHERN AVE | PHOENIX | AZ | 85020 | N/A | PC | General & Unrestricted | $10,000 |
| MARICOPA COUNTY COMMUNITY COLLEGE DISTRICT FDN | |||||||
| 2419 W 14TH ST | TEMPE | AZ | 85281 | N/A | PC | RSC Insurance Studies Program | $35,000 |
| ORAL ED OPPORTUNITIES FOR THE HEARING IMPAIRED | |||||||
| 3426 E SHEA BLVD | PHOENIX | AZ | 85028 | N/A | PC | General & Unrestricted | $12,500 |
| OUR FAMILY SERVICES INC | |||||||
| 2590 N ALVERNON WAY | TUCSON | AZ | 85712 | N/A | PC | New Beginnings for Women & Children | $5,000 |
| PAZ DE CRISTO COMMUNITY CENTER | |||||||
| 424 W BROADWAY RD | MESA | AZ | 85210 | N/A | PC | General & Unrestricted | $10,000 |
| PLUS FOUNDATION | |||||||
| 5353 WAYZATA BLVD STE 600 | MINNEAPOLIS | MN | 55416 | N/A | SO I | General & Unrestricted | $15,000 |
| RESURRECTION LUTHERAN CHURCH | |||||||
| 4930 E GREENWAY RD | SCOTTSDALE | AZ | 85254 | N/A | PC | General & Unrestricted | $12,500 |
| SHRINERS HOSPITALS FOR CHILDREN - SALT LAKE CITY | |||||||
| FAIRFAX RD AT VIRGINIA ST | SALT LAKE CITY | UT | 84103 | N/A | PC | General & Unrestricted | $5,000 |
| SOJOURNER CENTER | |||||||
| PO BOX 20156 | PHOENIX | AZ | 85036 | N/A | PC | General & Unrestricted | $5,000 |
| SOUTHWEST DISTRICT KIWANIS FOUNDATION | |||||||
| PO BOX 1603 | MESA | AZ | 85211 | N/A | PC | General & Unrestricted | $12,000 |
| ST MARYS FOOD BANK ALLIANCE | |||||||
| 2831 N 31ST AVE | PHOENIX | AZ | 85009 | N/A | PC | General & Unrestricted | $15,000 |
| TUMBLEWEED CENTER FOR YOUTH DEVELOPMENT | |||||||
| 3707 N 7TH ST STE 305 | PHOENIX | AZ | 85014 | N/A | PC | General & Unrestricted | $6,000 |
| WASTE NOT INC | |||||||
| 1700 N GRANITE REEF RD | SCOTTSDALE | AZ | 85257 | N/A | PC | General & Unrestricted | $10,000 |
| YES SOLUTIONS INC | |||||||
| 549 W 123RD ST APT MF | NEW YORK | NY | 10027 | N/A | PC | General & Unrestricted | $12,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $481,000 | TotalGrantOrContriPdDurYrAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fees Contracts From Govt Ag | FeesContractsFromGovtAgGrp | |
| Membership Dues And Assmnt | MembershipDuesAndAssmntGrp |
Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $16 | ExclusionAmt |
Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $41,448 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Rntl Incm Re Debt Fincd Prop | NetRntlIncmReDebtFincdPropGrp | |
| Net Rntl Incm Re Not Debt Fincd Prop | NetRntlIncmReNotDebtFincdProp | |
| Net Rental Income Personal Prop | NetRentalIncomePersonalPropGrp | |
| Other Investment Incm Part VII | OtherInvestmentIncmPartVIIGrp |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $119,037 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Income Loss From Special Evt | NetIncomeLossFromSpecialEvtGrp | |
| Gross Profit Loss Sls Of Invntry | GrossProfitLossSlsOfInvntryGrp |
Other Revenue Described OtherRevenueDescribedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INCOME FROM ANNUITIES | Desc |
| Exclusion | 14 | ExclusionCd |
| Exclusion | $134,311 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | $294,812 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $294,812 | TotalIncomeProducingActyAmt |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | false | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | false | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | false | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | false | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | false | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | false | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | false | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | false | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | false | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | false | RelationshipsNonchrtblEOInd |
Schedule B IRS990ScheduleB
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| General Rule | Yes (X) | GeneralRuleInd |
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | 1 | ContributorNum |
| Contributor Person | The Surplus Line Association of Ari | ContributorPersonNm |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | Kierland Bus Ctr N 15849 71st st | AddressLine1Txt |
| City | Scottsdale | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85254 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | $499,000 | TotalContributionsAmt |
| Person Contribution | Yes (X) | PersonContributionInd |
Depreciation Schedule DepreciationSchedule
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corporate Bonds InvestmentsCorporateBondsGrp (24 entries)
| BondBondNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| ANHEUSER-BUSCH INBEVFIN NT - 2 | $40,047 | $38,934 |
| BANK AMER - 5.150% - 11/15/201 | $25,673 | $27,403 |
| BANK OF AMERICA - 3.55% - 11/1 | $20,000 | $20,661 |
| BURLINGTON NORTHERN SANTA FE - | $54,372 | $55,271 |
| CATERPILLAR FINANCIAL SE MTN - | $27,118 | $28,865 |
| CATERPILLAR FINL CORP PWRNTSBE | $30,000 | $30,552 |
| CITIGROUP INC SUB NT - 3.500% | $24,065 | $24,378 |
| COCA COLA CO - 5.350% - 11/15/ | $22,695 | $22,178 |
| DEUTSCHE BANK-3.250%-01/11/201 | $51,027 | $51,114 |
| GE - 5.00% - 03/15/2029 | $55,230 | $55,953 |
| GE CAP CORP - 3.50% - 06/29/20 | $26,176 | $25,365 |
| GE CAPITAL - 4.80% - 03/15/201 | $11,967 | $13,171 |
| GE CAPITAL CORP - 4.500% - 11/ | $27,075 | $27,174 |
| GE CAPITAL INTERNOTES-5.10%-02 | $26,765 | $27,687 |
| GENERAL ELECTRIC CAPITAL CORP | $25,722 | $25,727 |
| GOLDMAN SACHS GP INC - 5.950% | $32,165 | $34,324 |
| GOLDMAN SACHS GRP - 3.700% - 0 | $25,639 | $25,426 |
| GOLDMAN SACHS GRP INC MTN BE - | $25,249 | $25,638 |
| JPMORGAN CHASE - 3.70% - 01/20 | $26,428 | $25,042 |
| SHELL INTERNATIONAL FIN - 4.30 | $53,402 | $54,872 |
| STATOIL ASA - 3.125% - 08/17/2 | $25,573 | $26,119 |
| STATOIL ASA NT - 3.700% - 03/0 | $26,045 | $26,026 |
| WAL MART STORES INC NT - 5.800 | $28,280 | $28,327 |
| ZIMMER HLDGS INC NOTE-04.6250% | $26,689 | $27,322 |
Investments Govt Obligations Sch InvestmentsGovtObligationsSch
| Field | Value | IRS element (for citing) |
|---|---|---|
| US Govt Obligations Book Vl EOY | $27,974 | USGovtObligationsBookVlEOYAmt |
| US Govt Obligations EOYFMV | $28,869 | USGovtObligationsEOYFMVAmt |
| State Local Sec Book Vl EOY | $288,843 | StateLocalSecBookVlEOYAmt |
| State Local Sec EOYFMV | $286,202 | StateLocalSecEOYFMVAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (16 entries)
| Category Or ItemCategoryOrItemTxt | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| COLUMBUS LIFE # CM5040241A | $463,460 | $486,637 |
| COLUMBUS LIFE - POLICY # CM504 | $273,032 | $332,880 |
| COLUMBUS LIFE CM5037899A | $268,204 | $288,705 |
| COLUMBUS LIFE CM5037917A | $269,625 | $304,676 |
| COLUMBUS LIFE CM5037965A | $272,033 | $342,192 |
| COLUMBUS LIFE CM5064902A | $146,238 | $144,701 |
| JACKSON NATION LIFE ANNUITY # | $260,162 | $328,657 |
| JACKSON NATIONAL ANNUITY 10062 | $255,751 | $264,625 |
| JACKSON NATIONAL LIFE #1003556 | $268,431 | $273,983 |
| JACKSON NATIONAL LIFE 10047137 | $340,884 | $340,884 |
| JACKSON NATIONAL LIFE ANNUITY | $563,666 | $563,665 |
| NEW YORK LIFE -QUAL ANNUITY #5 | $293,601 | $364,123 |
| NY LIFE INSURANCE ANNUITY # 52 | $286,934 | $280,641 |
| NY LIFE INSURANCE ANNUITY #521 | $237,795 | $237,795 |
| NY LIFE INSURANCE ANNUITY #521 | $258,737 | $283,251 |
| UNITED OF OMAHA LIFE INSURANCE | $285,111 | $317,156 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Administrative Fees | Desc |
| Revenue And Expenses Per Books | $29,573 | RevenueAndExpensesPerBooksAmt |
| Disbursements Charitable Prps | $29,573 | DisbursementsCharitablePrpsAmt |
Other Income Schedule2 OtherIncomeSchedule2
Other Income Detail OtherIncomeDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | income from annuities | Desc |
| Revenue And Expenses Per Books | $134,311 | RevenueAndExpensesPerBooksAmt |
| Net Investment Income | $134,311 | NetInvestmentIncomeAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (3 entries)
| CategoryCategoryTxt | AmtAmt |
|---|---|
| 990-PF Estimated Tax for 2014 | $1,000 |
| 990-PF Excise Tax for 2013 | $125 |
| 990-PF Extension for 2013 | $1,757 |
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