SHALLOW FORD FOUNDATION INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
SHALLOW FORD FOUNDATION INC (EIN 04-3795285)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-14
IRS object ID
201401349349306205
Schema version
2012v2.3
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)
Timestamp2014-05-14T14:35:13-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CANNON & COMPANY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12160 COUNTRY CLUB RDAddressLine1
CityWINSTONSALEMCity
StateNCState
ZIP Code271044208ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN043795285EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CLEMMONS COMMUNITY FOUNDATION INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCLEMNameControl

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 567AddressLine1
CityCLEMMONSCity
StateNCState
ZIP Code27012ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameFRANK H SAMUELSONName
TitlePRESIDENTTitle
Date Signed2014-05-06DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameGLEN E CANNONName
Phone3367250635Phone
Date Prepared2014-05-14DatePrepared
Self EmployedXSelfEmployed
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeXAddressChange
Name Of Principal Officer PersonFRANK H SAMUELSONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 567AddressLine1
CityCLEMMONSCity
StateNCState
ZIP Code27012ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1127786GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2004YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE CHARITABLE ASSISTANCE TO LOCAL, NATIONAL, AND INTERNATIONAL CHARITABLE SERVICE ACTIVITIES, INCLUDING MAKING OF DISTRIBUTIONS TO ORGANIZATIONS THAT QUALIFY AS EXEMPT UNDER SEC 501(C)(3) AND 170(C)(2)ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year4737ContributionsGrantsPriorYear
Contributions Grants Current Year974000ContributionsGrantsCurrentYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year380InvestmentIncomePriorYear
Investment Income Current Year-27392InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year5117TotalRevenuePriorYear
Total Revenue Current Year946608TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year18497GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY15000GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year30TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2531OtherExpensePriorYear
Other Expenses Current Year2774OtherExpensesCurrentYear
Total Expenses Prior Year21058TotalExpensesPriorYear
Total Expenses Current Year17774TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-15941RevenuesLessExpensesPriorYear
Revenues Less Expenses CY928834RevenuesLessExpensesCY
Total Assets BOY83399TotalAssetsBOY
Total Assets EOY1008005TotalAssetsEOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY83399NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1008005NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE CHARITABLE ASSISTANCE TO LOCAL, NATIONAL, AND INTERNATIONAL CHARITABLE SERVICE ACTIVITIES, INCLUDING MAKING OF DISTRIBUTIONS TO ORGANIZATIONS THAT QUALIFY AS EXEMPT UNDER SEC 501(C)(3) AND 170(C)(2)MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense17774Expense
Grants15000Grants
DescriptionTHE ORGANIZATION SUPPORTED LOCAL AND INTERNATIONAL NEEDS THROUGH GIFTS TO VARIOUS ORGANIZATIONS QUALIFIED THROUGH SEC 501(C)(3) AND 170(C)2Description
Total Program Service Expense17774TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingfalseComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OftrueForm8282PropertyDisposedOf
Number Of8282 Filed1NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicyfalseConflictOfInterestPolicy
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicyfalseDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonGLEN CANNONNamePerson
Telephone Number3367683438TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 567AddressLine1
CityCLEMMONSCity
StateNCState
ZIP Code27012ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
STEVE SESSIONS
DIRECTOR1.00X000
CHUCK ALEXANDER
DIRECTOR1.00X000
CHARLIE QUINN
DIRECTOR1.00X000
PAUL JOHNSON
DIRECTOR1.00X000
RON DAVIS
DIRECTOR1.00X000
GLEN CANNON
TREASURER1.00X000X
ANNE HENNIS
SECRETARY1.00X000X
THOMAS ORR
DIRECTOR1.00X000
FRANK SAMUELSON
PRESIDENT1.00X000X
JOHN STEWART
DIRECTOR1.00X000
JOANNA LYALL
DIRECTOR1.00X000
FieldValueIRS element (for citing)
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
All Other Contributions974000AllOtherContributions
Noncash Contributions153000NoncashContributions
Total Contributions974000TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column786TotalRevenueColumn
Exclusion$786ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other153000Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other181178Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-28178Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-28178TotalRevenueColumn
Exclusion-$28,178ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column946608TotalRevenueColumn
Exclusion-$27,392ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total15000Total
Program Services15000ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total526Total
Program Services526ProgramServices

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total142Total
Program Services142ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total70Total
Program Services70ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total177Total
Program Services177ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
MISCELLANEOUS10901090
MEMBERSHIP DUES570570
BANK CHARGES119119
EQUIPMENT RENTAL AND MAIN8080

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total17774Total
Program Services17774ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY77609BOY
EOY1758EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY5790BOY
EOY45011EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY961236EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY83399BOY
EOY1008005EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY48399BOY
EOY188004EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY35000BOY
EOY820001EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY83399BOY
EOY1008005EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY83399BOY
EOY1008005EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses928834ReconcilationRevenueExpenses
Reconcilation Other Changes-4228ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedfalseFSAudited

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years35400CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years51500CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years75308CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4737CurrentTaxYearMinus1Year
Current Tax Year21000CurrentTaxYear
Total187945Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years35400CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years51500CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years75308CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4737CurrentTaxYearMinus1Year
Current Tax Year21000CurrentTaxYear
Total187945Total
FieldValueIRS element (for citing)
Public Support Total170187945PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years527CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years440CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years284CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year380CurrentTaxYearMinus1Year
Current Tax Year786CurrentTaxYear
Total2417Total
FieldValueIRS element (for citing)
Total Support190362TotalSupport
Public Support Pertcentage1700.98730PublicSupportPertcentage170
Public Support Pertcent Prior Year0.92180PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedfalseRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1FORSYTH HUMANE SOCIETYBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 4140AddressLine1
Address Line2CLEMMONS RD NUMBER 185AddressLine2
CityCLEMMONSCity
StateNCState
ZIP Code27012ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient237055886EINOfRecipient
IRC Section501C3IRCSection
Amount Of Cash Grant7000AmountOfCashGrant

Schedule M IRS990ScheduleM

Real Estate Residential RealEstateResidential

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990153000NoncashContribsRptdF990
Method Of Determining RevenuesSALE PRICEMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGifts
Third Parties UsedtrueThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

FieldValueIRS element (for citing)
IdentifierTHIRD PARTY USED TO PROCESS NONCASH CONTRIBUTIONSIdentifier
Return ReferenceSCHEDULE M, PAGE 1, PART I, LINE 32BReturnReference
ExplanationUSED LICENSED REAL ESTATE AGENT TO SELL PROPERTYExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11B990 IS REVIEWED BY TREASURER PRIOR TO FILING
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19DOCUMENTS ARE MADE AVAILABLE UPON REQUEST

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