CLARK FAMILY FOUNDATION INC: Form 990PF, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- CLARK FAMILY FOUNDATION INC (EIN 20-8087487)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-04-28
- IRS object ID
- 201541189349100309
- 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
- Expln Of Non Filing With AG Stmt
- Investments Corp Bonds Schedule
- Investments Corp Stock Schedule
- Investments Other Schedule2
- Other Assets Schedule
- Other Expenses Schedule
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-04-28T13:48:52-05:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 341897225 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HILL BARTH & KING LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3838 TAMIAMI TRAIL NORTH | AddressLine1Txt |
| City | NAPLES | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 34103 | 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 | 208087487 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARK FAMILY FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CLAR | BusinessNameControlTxt |
| Phone | 2395981700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 868 102ND AVENUE NORTH | AddressLine1Txt |
| City | NAPLES | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 34108 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES H KABCENELL | PersonNm |
| Person Title | DIRECTOR, VICE-PRESIDENT | PersonTitleTxt |
| Phone | 2395981700 | PhoneNum |
| Signature | 2015-04-27 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RONALD J WALTHER | PreparerPersonNm |
| PTIN | P00052535 | PTIN |
| Phone | 2392632111 | PhoneNum |
| Preparation | 2015-04-27 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-04-25 22:37:26Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $4,574,600 | FMVAssetsEOYAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Dividends Rev And Expnss | $118,568 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $118,048 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $160,771 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $134,542 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $160,771 | CapGainNetIncmNetInvstIncmAmt |
| Total Rev And Expnss | $279,339 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $278,819 | TotalNetInvstIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $0 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $0 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $0 | CompOfcrDirTrstDsbrsChrtblAmt |
| Other Prof Fees Rev And Expnss | $1,400 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $0 | OtherProfFeesNetInvstIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $1,400 | OtherProfFeesDsbrsChrtblAmt |
| Taxes Rev And Expnss | $2,972 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $1,194 | TaxesNetInvstIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $15,637 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $13,041 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Dsbrs Chrtbl | $2,596 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $20,009 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $14,235 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $3,996 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $255,000 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $255,000 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $275,009 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $14,235 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Dsbrs Chrtbl | $258,996 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $4,330 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $264,584 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $97,713 | CashBOYAmt |
| Cash EOY | $207,615 | CashEOYAmt |
| Cash EOYFMV | $207,615 | CashEOYFMVAmt |
| Sav And Temp Cash Invst BOY | $3 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $111 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $111 | SavAndTempCashInvstEOYFMVAmt |
| Corporate Stock BOY | $2,200,894 | CorporateStockBOYAmt |
| Corporate Stock EOY | $2,168,751 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $2,558,448 | CorporateStockEOYFMVAmt |
| Corporate Bonds BOY | $1,552,108 | CorporateBondsBOYAmt |
| Corporate Bonds EOY | $1,445,886 | CorporateBondsEOYAmt |
| Corporate Bonds EOYFMV | $1,480,216 | CorporateBondsEOYFMVAmt |
| Other Investments BOY | $339,659 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $374,314 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $325,455 | OtherInvestmentsEOYFMVAmt |
| Other Assets BOY | $4,725 | OtherAssetsBOYAmt |
| Other Assets EOY | $2,755 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $2,755 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $4,195,102 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,199,432 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $4,574,600 | TotalAssetsEOYFMVAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
| Capital Stock BOY | $0 | CapitalStockBOYAmt |
| Capital Stock EOY | $0 | CapitalStockEOYAmt |
| Additional Paid In Capital BOY | $0 | AdditionalPaidInCapitalBOYAmt |
| Additional Paid In Capital EOY | $0 | AdditionalPaidInCapitalEOYAmt |
| Retained Earning BOY | $4,195,102 | RetainedEarningBOYAmt |
| Retained Earning EOY | $4,199,432 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $4,195,102 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $4,199,432 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $4,195,102 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $4,199,432 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $4,195,102 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $4,330 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $4,199,432 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $4,199,432 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (3 entries)
| PropertyPropertyDesc | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt | How AcquiredHowAcquiredCd | Gross Sales PriceGrossSalesPriceAmt |
|---|---|---|---|---|
| SALE OF PUBLICLY TRADED SECURITIES | $28,163 | $28,163 | ||
| SALE OF PUBLICLY TRADED SECURITIES | -$1,934 | -$1,934 | ||
| CAPITAL GAINS DIVIDENDS | $134,542 | $134,542 | P | $134,542 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $160,771 | CapitalGainNetIncomeAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | 0 | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $204,273 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $4,389,347 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.046538 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $2,056 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $3,926,373 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.000524 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $69,727 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $3,883,009 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 0.017957 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $1,695 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $3,618,335 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.000468 | DistributionYr4Rt |
| Adjusted Qlfy Distri Yr5 | $1,695 | AdjustedQlfyDistriYr5Amt |
| Net Vl Noncharitable Assets Yr5 | $3,015,941 | NetVlNoncharitableAssetsYr5Amt |
| Distribution Yr5 | 0.000562 | DistributionYr5Rt |
| Total Distribution | 0.066049 | TotalDistributionRt |
| Average Distribution | 0.013210 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $4,554,856 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $60,170 | AdjNetVlNoncharitableAssetsAmt |
| Net Investment Income Pct | $2,646 | NetInvestmentIncomePctAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $62,816 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $258,996 | 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 | $2,646 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $2,646 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $2,646 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $2,000 | EstimatedPlusOvpmtIncmTxAmt |
| Total Payments And Credits | $2,000 | TotalPaymentsAndCreditsAmt |
| Tax Due | $646 | TaxDueAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | 0 | LegislativePoliticalActyInd |
| More Than100 Spent | 0 | MoreThan100SpentInd |
| Form1120 POL Filed | 0 | Form1120POLFiledInd |
| Section4955 Organization Tax | $0 | Section4955OrganizationTaxAmt |
| Section4955 Managers Tax | $0 | Section4955ManagersTaxAmt |
| Tax Reimbursed | $0 | TaxReimbursedAmt |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | 0 | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (1) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (1) | AtLeast5000InAssetsInd |
| Org Report Or Register State | FL | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | 0 | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | 0 | PrivateOperatingFoundationInd |
| New Substantial Contributors | 0 | NewSubstantialContributorsInd |
| Own Controlled Entity | 0 | OwnControlledEntityInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (1) | ComplyWithPublicInspRqrInd |
| Website Address | N/A | WebsiteAddressTxt |
| Individual With Books | DOLLIE COSTA SECRETARYTREASURER | IndividualWithBooksNm |
| Phone | 2395981700 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 868 102ND AVENUE NORTH | AddressLine1Txt |
| City | NAPLES | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 34108 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Accounts Question | 0 | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | 0 | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | 0 | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | 0 | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | 0 | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | 0 | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | 0 | PaymentToGovernmentOfficialInd |
| Uncorrected Prior Acts | 0 | UncorrectedPriorActsInd |
| Undistributed Income PY | 0 | UndistributedIncomePYInd |
| Business Holdings | 0 | BusinessHoldingsInd |
| Jeopardy Investments | 0 | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | 0 | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | 0 | InfluenceLegislationInd |
| Influence Election | 0 | InfluenceElectionInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Noncharitable Purpose | 0 | NoncharitablePurposeInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|---|---|---|---|
| DAVID M CLARK | ||||||||
| 868 102ND AVENUE NORTH | NAPLES | FL | 34108 | DIRECTOR, CHAIRMAN | 2.00 | $0 | $0 | $0 |
| LAURA L CLARK | ||||||||
| 868 102ND AVENUE NORTH | NAPLES | FL | 34108 | DIRECTOR, VICE PRESIDENT | 1.00 | $0 | $0 | $0 |
| ROBERT B CLARK | ||||||||
| 868 102ND AVENUE NORTH | NAPLES | FL | 34108 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| JAMES H KABCENELL | ||||||||
| 868 102ND AVENUE NORTH | NAPLES | FL | 34108 | DIRECTOR, VICE PRESIDENT | 2.00 | $0 | $0 | $0 |
| ELIZABETH L TAYLOR | ||||||||
| 868 102ND AVENUE NORTH | NAPLES | FL | 34108 | DIRECTOR, PRESIDENT | 3.00 | $0 | $0 | $0 |
| DOLLIE COSTA | ||||||||
| 868 102ND AVENUE NORTH | NAPLES | FL | 34108 | SECRETARY, TREASURER | 3.00 | $0 | $0 | $0 |
| LESLIE CLARK | ||||||||
| 868 102ND AVENUE NORTH | NAPLES | FL | 34108 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Hghst Pd Empl Or NONE | NONE | CompOfHghstPdEmplOrNONETxt |
| Other Employee Paid Over50k | 0 | OtherEmployeePaidOver50kCnt |
| Comp Of Hghst Pd Cntrct Or NONE | NONE | CompOfHghstPdCntrctOrNONETxt |
| Contractor Paid Over50k | 0 | ContractorPaidOver50kCnt |
Sum Of Program Related Invst SumOfProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $4,471,498 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $152,721 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $4,624,219 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $4,624,219 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $69,363 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $4,554,856 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $227,743 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $227,743 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $2,646 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $2,646 | TotalTaxAmt |
| Distributable Before Adj | $225,097 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $225,097 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $225,097 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $258,996 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $258,996 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $2,646 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $256,350 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $225,097 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $11,638 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Total Excess Distribution Cyov | $0 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $258,996 | QualifyingDistributionsAmt |
| Applied To Year1 | $11,638 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $225,097 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $22,261 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $0 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $0 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $22,261 | TotalCorpusAmt |
| Prior Year Undistributed Incm | $0 | PriorYearUndistributedIncmAmt |
| Prior Year Deficiency Or Tax | $0 | PriorYearDeficiencyOrTaxAmt |
| Taxable1 | $0 | Taxable1Amt |
| Taxable2 | $0 | Taxable2Amt |
| Undistributed Income CY | $0 | UndistributedIncomeCYAmt |
| Corpus Distri170b1 E Or4942g3 | $0 | CorpusDistri170b1EOr4942g3Amt |
| Excess Distri Cyov From Yr5 | $0 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $22,261 | ExcessDistriCyovToNextYrAmt |
| Excess From Current Year | $22,261 | ExcessFromCurrentYearAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributing Manager | DAVID M CLARK | ContributingManagerNm |
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (8 entries)
| Address Line1RecipientUSAddress/AddressLine1Txt | CityRecipientUSAddress/CityNm | State AbbreviationRecipientUSAddress/StateAbbreviationCd | ZIPRecipientUSAddress/ZIPCd | Recipient RelationshipRecipientRelationshipTxt | Recipient Foundation StatusRecipientFoundationStatusTxt | Grant Or Contribution PurposeGrantOrContributionPurposeTxt | AmtAmt |
|---|---|---|---|---|---|---|---|
| LACES OF LOVE CHARITABLE FOUNDATION INC | |||||||
| 2026 7TH STREET SOUTH | NAPLES | FL | 34102 | NONE | PUBLIC | CHARITABLE | $2,500 |
| RONALD MCDONALD HOUSE OF ARKANSAS | |||||||
| 1009 WOLFE STREET | LITTLE ROCK | AR | 72202 | NONE | PUBLIC | CHARITABLE | $100,000 |
| THE DARE TO CARE FOUNDATION INC | |||||||
| 9942 W DAFFODIL LANE | MIRAMAR | FL | 33025 | NONE | PUBLIC | CHARITABLE | $20,000 |
| FLORIDA BAPTIST CHILDREN'S HOMES INC | |||||||
| 1015 SIKES BLVD | LAKELAND | FL | 33802 | NONE | PUBLIC | CHARITABLE | $25,000 |
| THE SHELTER FOR ABUSED WOMEN & CHILDREN INC | |||||||
| 2635 WEEKS AVENUE | NAPLES | FL | 34112 | NONE | PUBLIC | CHARITABLE | $2,500 |
| PARTNERS FOR PROGRESS INC | |||||||
| 600 47TH STREET | SARASOTA | FL | 34234 | NONE | PUBLIC | CHARITABLE | $5,000 |
| RONALD MCDONALD HOUSE OF TAMPA BAY | |||||||
| 28 COLUMBIA DR | TAMPA | FL | 33606 | NONE | PUBLIC | CHARITABLE | $50,000 |
| RONALD MCDONALD HOUSE OF KENTUCKIANA | |||||||
| 550 S FIRST ST | LOUISVILLE | KY | 40202 | NONE | PUBLIC | CHARITABLE | $50,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $255,000 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $118,568 | ExclusionAmt |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $160,771 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $279,339 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $279,339 | TotalIncomeProducingActyAmt |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | 0 | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | 0 | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | 0 | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | 0 | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | 0 | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | 0 | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | 0 | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | 0 | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | 0 | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | 0 | RelationshipsNonchrtblEOInd |
Expln Of Non Filing With AG Stmt ExplnOfNonFilingWithAGStmt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | NOT REQUIRED. | ExplanationTxt |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corporate Bonds InvestmentsCorporateBondsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond | FIXED INCOME | BondNm |
| EOY Book Value | $1,445,886 | EOYBookValueAmt |
| EOYFMV | $1,480,216 | EOYFMVAmt |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Stock | EQUITIES AND MUTUAL FUNDS | StockNm |
| EOY Book Value | $2,168,751 | EOYBookValueAmt |
| EOYFMV | $2,558,448 | EOYFMVAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category Or Item | REAL ASSET FUNDS | CategoryOrItemTxt |
| Listed At Cost Or FMV | AT COST | ListedAtCostOrFMVCd |
| Book Value | $374,314 | BookValueAmt |
| EOYFMV | $325,455 | EOYFMVAmt |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DIVIDEND RECEIVABLE | Desc |
| BOY Book Value | $4,725 | BOYBookValueAmt |
| EOY Book Value | $2,755 | EOYBookValueAmt |
| EOYFMV | $2,755 | EOYFMVAmt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (7 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| INVESTMENT FEES | $13,041 | $13,041 | $0 |
| FILING FEES | $62 | $0 | $62 |
| INSURANCE | $1,423 | $0 | $1,423 |
| DUES | $725 | $0 | $725 |
| SUPPLIES | $85 | $0 | $85 |
| PUBLICATIONS | $213 | $0 | $213 |
| POSTAGE | $88 | $0 | $88 |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | PROFESSIONAL FEES | CategoryTxt |
| Amt | $1,400 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $1,400 | DisbursementsCharitablePrpsAmt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| EXCISE TAXES | $1,778 | $0 | $0 |
| FOREIGN TAXES | $1,194 | $1,194 | $0 |
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