SEMLER FAMILY FOUNDATION INC: Form 990PF, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- SEMLER FAMILY FOUNDATION INC (EIN 20-3523866)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-06-17
- IRS object ID
- 201301689349100305
- Schema version
- 2012v2.1
- 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
- Form 990-PF
- Accounting Fees Schedule
- Investments Corp Bonds Schedule
- Investments Corp Stock Schedule
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-06-17T09:23:01-05:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201717681 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOMERSET CPAS PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3925 RIVER CROSSING PKWY STE 300 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46240 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 203523866 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE SEMLER FAMILY FOUNDATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SEML | NameControl |
| Phone | 3172851615 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8015 HEYWARD DRIVE | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 462502263 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JERRY SEMLER | Name |
| Title | OFFICER | Title |
| Phone | 3172851615 | Phone |
| Date Signed | 2013-06-03 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SUSIE M KEATON CPA | Name |
| PTIN | P00765420 | PTIN |
| Phone | 3174722200 | Phone |
| Date Prepared | 2013-06-03 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exempt PF | X | ExemptPF |
| FMV Assets EOY | 1727588 | FMVAssetsEOY |
| Method Of Accounting Cash | X | MethodOfAccountingCash |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Not Required To Attach Schedule B | X | NotRequiredToAttachScheduleB |
| Interest On Savings Rev And Expnss | 2293 | InterestOnSavingsRevAndExpnss |
| Interest On Savings Net Invst Incm | 2293 | InterestOnSavingsNetInvstIncm |
| Dividends Rev And Expnss | 66144 | DividendsRevAndExpnss |
| Dividends Net Invst Incm | 66144 | DividendsNetInvstIncm |
| Net Gain Sale Assets Rev And Expnss | 237250 | NetGainSaleAssetsRevAndExpnss |
| Gross Sales Price | 5325449 | GrossSalesPrice |
| Capital Gain Net Incm Net Invst Incm | 237250 | CapitalGainNetIncmNetInvstIncm |
| Total Revenue And Expenses | 305687 | TotalRevenueAndExpenses |
| Total Net Investment Income | 305687 | TotalNetInvestmentIncome |
| Comp Ofcr Dir Trst Rev And Expnss | 0 | CompOfcrDirTrstRevAndExpnss |
| Comp Ofcr Dir Trst Net Invst Incm | 0 | CompOfcrDirTrstNetInvstIncm |
| Comp Ofcr Dir Trst Dsbrs Chrtbl Prps | 0 | CompOfcrDirTrstDsbrsChrtblPrps |
| Accounting Fees Rev And Expnss | 825 | AccountingFeesRevAndExpnss |
| Accounting Fees Net Invst Incm | 825 | AccountingFeesNetInvstIncm |
| Accounting Fees Dsbrs Chrtbl Prps | 0 | AccountingFeesDsbrsChrtblPrps |
| Other Prof Fees Rev And Expnss | 14853 | OtherProfFeesRevAndExpnss |
| Other Prof Fees Net Invst Incm | 14853 | OtherProfFeesNetInvstIncm |
| Other Prof Fees Dsbrs Chrtbl Prps | 0 | OtherProfFeesDsbrsChrtblPrps |
| Interest Rev And Expnss | 1853 | InterestRevAndExpnss |
| Interest Net Invst Incm | 1853 | InterestNetInvstIncm |
| Interest Dsbrs Chrtbl Prps | 0 | InterestDsbrsChrtblPrps |
| Taxes Rev And Expnss | 2666 | TaxesRevAndExpnss |
| Taxes Net Invst Incm | 0 | TaxesNetInvstIncm |
| Taxes Dsbrs Chrtbl Prps | 0 | TaxesDsbrsChrtblPrps |
| Tot Opr Expenses Rev And Expnss | 20197 | TotOprExpensesRevAndExpnss |
| Tot Opr Expenses Net Invst Incm | 17531 | TotOprExpensesNetInvstIncm |
| Tot Opr Expenses Dsbrs Chrtbl Prps | 0 | TotOprExpensesDsbrsChrtblPrps |
| Contri Gifts Paid Rev And Expnss | 74150 | ContriGiftsPaidRevAndExpnss |
| Contri Gifts Paid Dsbrs Chrtbl Prps | 74150 | ContriGiftsPaidDsbrsChrtblPrps |
| Total Expenses Rev And Expnss | 94347 | TotalExpensesRevAndExpnss |
| Total Expenses Net Invst Incm | 17531 | TotalExpensesNetInvstIncm |
| Total Expenses Dsbrs Chrtbl Prps | 74150 | TotalExpensesDsbrsChrtblPrps |
| Excess Of Revenue Over Expenses | 211340 | ExcessOfRevenueOverExpenses |
| Net Investment Income | 288156 | NetInvestmentIncome |
Balance Sheets BalanceSheets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | 4235 | CashBOY |
| Cash EOY | 100838 | CashEOY |
| Cash EOYFMV | 100838 | CashEOYFMV |
| Savings And Temp Cash Invst BOY | 108410 | SavingsAndTempCashInvstBOY |
| Savings And Temp Cash Invst EOY | 91668 | SavingsAndTempCashInvstEOY |
| Savings And Temp Cash Invst EOYFMV | 91668 | SavingsAndTempCashInvstEOYFMV |
| Investments Corp Stock BOY | 1093454 | InvestmentsCorpStockBOY |
| Investments Corp Stock EOY | 1389703 | InvestmentsCorpStockEOY |
| Investments Corp Stock EOYFMV | 1321116 | InvestmentsCorpStockEOYFMV |
| Investments Corp Bonds BOY | 365219 | InvestmentsCorpBondsBOY |
| Investments Corp Bonds EOY | 200449 | InvestmentsCorpBondsEOY |
| Investments Corp Bonds EOYFMV | 213966 | InvestmentsCorpBondsEOYFMV |
| Total Assets BOY | 1571318 | TotalAssetsBOY |
| Total Assets EOY | 1782658 | TotalAssetsEOY |
| Total Assets EOYFMV | 1727588 | TotalAssetsEOYFMV |
| Total Liabilities BOY | 0 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Org That Do Not Follow SFAS117 | X | OrgThatDoNotFollowSFAS117 |
| Capital Stock BOY | 1571318 | CapitalStockBOY |
| Capital Stock EOY | 1571318 | CapitalStockEOY |
| Paid In Or Capital Surplus BOY | 0 | PaidInOrCapitalSurplusBOY |
| Paid In Or Capital Surplus EOY | 0 | PaidInOrCapitalSurplusEOY |
| Retained Earnings BOY | 0 | RetainedEarningsBOY |
| Retained Earnings EOY | 211340 | RetainedEarningsEOY |
| Total Net Assets BOY | 1571318 | TotalNetAssetsBOY |
| Total Net Assets EOY | 1782658 | TotalNetAssetsEOY |
| Total Liabilities Net Assets BOY | 1571318 | TotalLiabilitiesNetAssetsBOY |
| Total Liabilities Net Assets EOY | 1782658 | TotalLiabilitiesNetAssetsEOY |
Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Net Assets Fund Balances BOY | 1571318 | TotalNetAssetsFundBalancesBOY |
| Excess Of Revenue Over Expenses | 211340 | ExcessOfRevenueOverExpenses |
| Other Increases | 0 | OtherIncreases |
| Subtotal | 1782658 | Subtotal |
| Other Decreases | 0 | OtherDecreases |
| Total Net Assets Fund Balances EOY | 1782658 | TotalNetAssetsFundBalancesEOY |
Capital Gains And Losses CapitalGainsAndLosses
Capital Gains And Losses Info CapitalGainsAndLossesInfo (5 entries)
| Description Of AssetDescriptionOfAsset | How AcquiredHowAcquired | Date AcquiredDateAcquired | Date SoldDateSold | Gross Sales PriceGrossSalesPrice | Cost Or Other BasisCostOrOtherBasis | Gain Or LossGainOrLoss | Gains Minus Excess Or LossesGainsMinusExcessOrLosses |
|---|---|---|---|---|---|---|---|
| JP MORGAN CHASE PUBLICLY TRADED SECURITIES | P | 2012-02-02 | 2012-12-31 | 655402 | 655876 | -474 | -474 |
| JP MORGAN CHASE PUBLICLY TRADED SECURITIES | P | 2011-01-01 | 2012-12-31 | 1256800 | 1161428 | 95372 | 95372 |
| TRIAD SECURITIES PUBLICLY TRADED SECURITIES | P | 2012-07-01 | 2012-12-31 | 3409691 | 3270895 | 138796 | 138796 |
| TRIAD SECURITIES PUBLICLY TRADED SECURITIES | P | 2012-07-01 | 2012-12-31 | 3408 | 3408 | 3408 | |
| CAPITAL GAINS DIVIDENDS | P | 148 | 148 | 148 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | 237250 | CapitalGainNetIncome |
Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable For4942 Tax | 0 | LiableFor4942Tax |
| Qualifying Distributions Year1 | 86330 | QualifyingDistributionsYear1 |
| Noncharitable Assets Year1 | 1689515 | NoncharitableAssetsYear1 |
| Distribution Ratio Year1 | 0.051098 | DistributionRatioYear1 |
| Qualifying Distributions Year2 | 89098 | QualifyingDistributionsYear2 |
| Noncharitable Assets Year2 | 1654130 | NoncharitableAssetsYear2 |
| Distribution Ratio Year2 | 0.053864 | DistributionRatioYear2 |
| Qualifying Distributions Year3 | 83220 | QualifyingDistributionsYear3 |
| Noncharitable Assets Year3 | 1519112 | NoncharitableAssetsYear3 |
| Distribution Ratio Year3 | 0.054782 | DistributionRatioYear3 |
| Qualifying Distributions Year4 | 102519 | QualifyingDistributionsYear4 |
| Noncharitable Assets Year4 | 1786164 | NoncharitableAssetsYear4 |
| Distribution Ratio Year4 | 0.057396 | DistributionRatioYear4 |
| Qualifying Distributions Year5 | 103106 | QualifyingDistributionsYear5 |
| Noncharitable Assets Year5 | 2125981 | NoncharitableAssetsYear5 |
| Distribution Ratio Year5 | 0.048498 | DistributionRatioYear5 |
| Total Distribution Ratio | 0.265638 | TotalDistributionRatio |
| Average Distribution Ratio | 0.053128 | AverageDistributionRatio |
| Net Noncharitable Assets | 1604117 | NetNoncharitableAssets |
| Adjusted Noncharitable Assets | 85224 | AdjustedNoncharitableAssets |
| One Percent Net Investment Income | 2882 | OnePercentNetInvestmentIncome |
| Adj Nonchrtbl Assets And One | 88106 | AdjNonchrtblAssetsAndOnePct |
| Qualifying Distributions | 74150 | QualifyingDistributions |
Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | 5763 | InvestmentIncomeExciseTax |
| Tax Under Section511 | 0 | TaxUnderSection511 |
| Subtotal | 5763 | Subtotal |
| Subtitle A Tax | 0 | SubtitleATax |
| Tax Based On Investment Income | 5763 | TaxBasedOnInvestmentIncome |
| Est Tax Payments And Overpayment | 1320 | EstTaxPaymentsAndOverpayment |
| Tax Paid With Extension | 6000 | TaxPaidWithExtension |
| Total Credits And Payments | 7320 | TotalCreditsAndPayments |
| Penalty For Underpayment | 1 | PenaltyForUnderpayment |
| Overpayment | 1556 | Overpayment |
| Amount Credited To Next Year | 1556 | AmountCreditedToNextYear |
| Amount To Be Refunded | 0 | AmountToBeRefunded |
Statements Regarding Activities StatementsRegardingActivities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Activities | 0 | LegislativePoliticalActivities |
| More Than100 Spent | 0 | MoreThan100Spent |
| Form1120 POL Filed | 0 | Form1120POLFiled |
| Sect4955 Tax On Organization | 0 | Sect4955TaxOnOrganization |
| Sect4955 Tax On Managers | 0 | Sect4955TaxOnManagers |
| Reimbursement Of Tax | 0 | ReimbursementOfTax |
| Activities Not Prev Reported | 0 | ActivitiesNotPrevReported |
| Changes To Articles Or Bylaws | 0 | ChangesToArticlesOrBylaws |
| Unrelated Bus Income Over1000 | 0 | UnrelatedBusIncomeOver1000 |
| Termination Etc | 0 | TerminationEtc |
| Requirements Of Sect508e | 1 | RequirementsOfSect508e |
| At Least5000 In Assets | 1 | AtLeast5000InAssets |
| States Filed With | IN | StatesFiledWith |
| Form990 PF Filed With AG | 1 | Form990PFFiledWithAG |
| Private Operating Foundation | 0 | PrivateOperatingFoundation |
| New Substantial Contributors | 0 | NewSubstantialContributors |
| Interest In Controlled Entity | 0 | InterestInControlledEntity |
| Applicable Insurance Contract | 0 | ApplicableInsuranceContract |
| Comply With Public Inspection Rqr | 1 | ComplyWithPublicInspectionRqr |
| Website Address | N/A | WebsiteAddress |
| Books In Care Of Person Name | JP MORGAN CHASE BANK NA | BooksInCareOfPersonName |
| Books In Care Of Phone Number | 3176843167 | BooksInCareOfPhoneNumber |
Books In Care Of US Address BooksInCareOfUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 EAST OHIO STREET | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46204 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Bank | 0 | ForeignBank |
Statements Regarding Acty4720 StatementsRegardingActy4720
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exchange With Dsqfly Person | 0 | SaleOrExchangeWithDsqflyPerson |
| Borrow Or Lend With Dsqfly Person | 0 | BorrowOrLendWithDsqflyPerson |
| Furnished Goods With Dsqfly Person | 0 | FurnishedGoodsWithDsqflyPerson |
| Pay Compensation To Dsqfly Person | 0 | PayCompensationToDsqflyPerson |
| Transfer Assets To Dsqfly Person | 0 | TransferAssetsToDsqflyPerson |
| Payment To Government Offical | 0 | PaymentToGovernmentOffical |
| Uncorrected Prior Acts | 0 | UncorrectedPriorActs |
| Undistributed Income Prior Years | 0 | UndistributedIncomePriorYears |
| Business Holdings | 0 | BusinessHoldings |
| Jeopardy Investments | 0 | JeopardyInvestments |
| Uncorrected Jeopardy Investments | 0 | UncorrectedJeopardyInvestments |
| Influence Legislation | 0 | InfluenceLegislation |
| Influence Election | 0 | InfluenceElection |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Noncharitable Purpose | 0 | NoncharitablePurpose |
| Rcv Funds To Pay Prsnl Bnft Contract | 0 | RcvFundsToPayPrsnlBnftContract |
| Pay Premiums Prsnl Bnft Contract | 0 | PayPremiumsPrsnlBnftContract |
| Prohibited Tax Shelter Transactn | 0 | ProhibitedTaxShelterTransactn |
Ofcr Dir Trustees Key Employee Info OfcrDirTrusteesKeyEmployeeInfo
Ofcr Dir Trustees Or Key Employee OfcrDirTrusteesOrKeyEmployee (9 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | TitleTitle | Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition | CompensationCompensation | Contri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtc | Expense Account Other AllowancesExpenseAccountOtherAllowances |
|---|---|---|---|---|---|---|---|---|
| JERRY D SEMLER | ||||||||
| 8015 HEYWARD DRIVE | INDIANAPOLIS | IN | 46250 | PRESIDENT | 1.00 | 0 | 0 | 0 |
| ROSEMARY R SEMLER | ||||||||
| 8015 HEYWARD DRIVE | INDIANAPOLIS | IN | 46250 | VICE-PRESIDENT | 1.00 | 0 | 0 | 0 |
| MICHAEL R SEMLER | ||||||||
| 8015 HEYWARD DRIVE | INDIANAPOLIS | IN | 46250 | TREASURER | 1.00 | 0 | 0 | 0 |
| KIMBERLY D HAMILTON | ||||||||
| 8015 HEYWARD DRIVE | INDIANAPOLIS | IN | 46250 | SECRETARY | 1.00 | 0 | 0 | 0 |
| MARY D DODSON | ||||||||
| 8015 HEYWARD DRIVE | INDIANAPOLIS | IN | 46250 | DIRECTOR | 1.00 | 0 | 0 | 0 |
| JOHN R SEMLER | ||||||||
| 8015 HEYWARD DRIVE | INDIANAPOLIS | IN | 46250 | DIRECTOR | 1.00 | 0 | 0 | 0 |
| KRISTIN D TERRELL | ||||||||
| 8015 HEYWARD DRIVE | INDIANAPOLIS | IN | 46250 | DIRECTOR | 1.00 | 0 | 0 | 0 |
| JEFFREY R SEMLER | ||||||||
| 8015 HEYWARD DRIVE | INDIANAPOLIS | IN | 46250 | DIRECTOR | 1.00 | 0 | 0 | 0 |
| SALLY D BUTLER | ||||||||
| 8015 HEYWARD DRIVE | INDIANAPOLIS | IN | 46250 | DIRECTOR | 1.00 | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Highest Paid Empl NONE | NONE | CompOfHighestPaidEmplNONE |
| Tot Number Of Oth Empl Paid Over50k | 0 | TotNumberOfOthEmplPaidOver50k |
| Comp Of Hghst Paid Cntrct NONE | NONE | CompOfHghstPaidCntrctNONE |
| Tot Number Of Cntrct Paid Over50k | 0 | TotNumberOfCntrctPaidOver50k |
Sum Of Program Related Investments SumOfProgramRelatedInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Minimum Investment Return MinimumInvestmentReturn
| Field | Value | IRS element (for citing) |
|---|---|---|
| Avg Monthly FMV Of Securities | 852300 | AvgMonthlyFMVOfSecurities |
| Avg Monthly Cash Balances | 489494 | AvgMonthlyCashBalances |
| FMV All Other Noncharitable Assets | 286751 | FMVAllOtherNoncharitableAssets |
| Total FMV Of Unused Assets | 1628545 | TotalFMVOfUnusedAssets |
| Reduction Claimed | 0 | ReductionClaimed |
| Acquisition Indebtedness | 0 | AcquisitionIndebtedness |
| Adj Total FMV Of Unused Assets | 1628545 | AdjTotalFMVOfUnusedAssets |
| Cash Deemed Charitable | 24428 | CashDeemedCharitable |
| Net Noncharitable Assets | 1604117 | NetNoncharitableAssets |
| Minimum Investment Return | 80206 | MinimumInvestmentReturn |
Distributable DistributableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | 80206 | MinimumInvestmentReturn |
| Tax Based On Investment Income | 5763 | TaxBasedOnInvestmentIncome |
| Total Tax | 5763 | TotalTax |
| Distributable Amount Before Adj | 74443 | DistributableAmountBeforeAdj |
| Recoveries Qlfy Distributions | 0 | RecoveriesQlfyDistributions |
| Distributable Amount Before Ded | 74443 | DistributableAmountBeforeDed |
| Deduction Fr Distributable | $0 | DeductionFrDistributableAmount |
| Distributable Amount As Adjusted | 74443 | DistributableAmountAsAdjusted |
Qualifying Distributions QualifyingDistributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | 74150 | ExpensesAndContributions |
| Program Related Investments Total | 0 | ProgramRelatedInvestmentsTotal |
| Qualifying Distributions | 74150 | QualifyingDistributions |
| One Pct Sect4940e Org Net Invst Incm | 0 | OnePctSect4940eOrgNetInvstIncm |
| Adj Qualifying Distributions | 74150 | AdjQualifyingDistributions |
Undistributed Income UndistributedIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable Amount As Adjusted | 74443 | DistributableAmountAsAdjusted |
| Undistributed Income Prior Year | 0 | UndistributedIncomePriorYear |
| Total For Prior Years | 0 | TotalForPriorYears |
| Excess Distri Carryover Year4 | 14001 | ExcessDistriCarryoverYear4 |
| Excess Distri Carryover Year3 | 7824 | ExcessDistriCarryoverYear3 |
| Excess Distri Carryover Year2 | 9357 | ExcessDistriCarryoverYear2 |
| Excess Distri Carryover Year1 | 3167 | ExcessDistriCarryoverYear1 |
| Total Excess Distri Carryover | 34349 | TotalExcessDistriCarryover |
| Qualifying Distributions | 74150 | QualifyingDistributions |
| Applied To Year1 | 0 | AppliedToYear1 |
| Applied To Prior Years | 0 | AppliedToPriorYears |
| Treated As Distri From Corpus | 0 | TreatedAsDistriFromCorpus |
| Applied To Current Year | 74150 | AppliedToCurrentYear |
| Remaining Distri From Corpus | 0 | RemainingDistriFromCorpus |
| Excess Distri Cyov App CY Corpus | 293 | ExcessDistriCyovAppCYCorpus |
| Excess Distri Cyov Applied CY | 293 | ExcessDistriCyovAppliedCY |
| Total Corpus | 34056 | TotalCorpus |
| Prior Year Undistributed Income | 0 | PriorYearUndistributedIncome |
| Prior Year Deficiency Or Tax | 0 | PriorYearDeficiencyOrTax |
| Taxable Amount1 | 0 | TaxableAmount1 |
| Taxable Amount2 | 0 | TaxableAmount2 |
| Undistributed Income CY | 0 | UndistributedIncomeCY |
| Distri From Corpus170b1 E Or4942g3 | 0 | DistriFromCorpus170b1EOr4942g3 |
| Excess Distri Cyov From Year5 | 0 | ExcessDistriCyovFromYear5 |
| Excess Distri Cyov To Next Year | 34056 | ExcessDistriCyovToNextYear |
| Excess From Year4 | 13708 | ExcessFromYear4 |
| Excess From Year3 | 7824 | ExcessFromYear3 |
| Excess From Year2 | 9357 | ExcessFromYear2 |
| Excess From Year1 | 3167 | ExcessFromYear1 |
Supplementary Information SupplementaryInformation
Appication Submission Info AppicationSubmissionInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Name | JERRY D SEMLER | RecipientName |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8015 HEYWARD DRIVE | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46250 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Phone Number | 3172851615 | RecipientPhoneNumber |
| Form And Info And Materials | SUBMIT LETTER DESCRIBING NEED FOR AND PURPOSE OF REQUESTED CONTRIBUTION. | FormAndInfoAndMaterials |
| Submission Deadlines | N/A | SubmissionDeadlines |
| Restrictions On Awards | N/A | RestrictionsOnAwards |
Grant Or Contri Paid During Year GrantOrContriPaidDuringYear (36 entries)
| Address Line1RecipientUSAddress/AddressLine1 | CityRecipientUSAddress/City | StateRecipientUSAddress/State | ZIP CodeRecipientUSAddress/ZIPCode | Recipient Foundation StatusRecipientFoundationStatus | Purpose Of Grant Or ContributionPurposeOfGrantOrContribution | AmountAmount |
|---|---|---|---|---|---|---|
| INDIANA UNIVERSITY FOUNDATION | ||||||
| 340 W MICHIGAN STREET | INDIANAPOLIS | IN | 46202 | PUBLIC CHARITY | PROGRAM SUPPORT | $11,000 |
| AMERICAN HEART ASSOCIATION | ||||||
| 6100 WEST 96TH STREET STE 200 | INDIANAPOLIS | IN | 46278 | PUBLIC CHARITY | PROGRAM SUPPORT | $100 |
| ARCHDIOCESE OF INDIANAPOLIS | ||||||
| PO BOX 1410 | INDIANAPOLIS | IN | 46206 | PUBLIC CHARITY | PROGRAM SUPPORT | $1,500 |
| BALL STATE UNIVERSITY - OTIS BOWEN CENTER | ||||||
| 2800 W BETHEL AVENUE | MUNCIE | IN | 47304 | PUBLIC CHARITY | PROGRAM SUPPORT | $1,000 |
| BEST BUDDIES INDIANA | ||||||
| 8604 ALLISONVILLE ROAD 165 | INDIANAPOLIS | IN | 46250 | PUBLIC CHARITY | PROGRAM SUPPORT | $100 |
| BISHOP CHATARD HIGH SCHOOL | ||||||
| 5885 N CRITTENDEN AVENUE | INDIANAPOLIS | IN | 46220 | PUBLIC CHARITY | PROGRAM SUPPORT | $5,000 |
| BOYSCOUTS OF AMERICA | ||||||
| 7125 FALL CREEK ROAD | INDIANAPOLIS | IN | 46256 | PUBLIC CHARITY | PROGRAM SUPPORT | $7,500 |
| CENTER FOR LEADERSHIP DEVELOPMENT | ||||||
| 2425 DR MARTIN LUTHER KING JR ST | INDIANAPOLIS | IN | 46208 | PUBLIC CHARITY | PROGRAM SUPPORT | $2,000 |
| CHILDREN'S MUSUEM OF INDIANAPOLIS | ||||||
| 3000 N MERIDIAN STREET | INDIANAPOLIS | IN | 46208 | PUBLIC CHARITY | PROGRAM SUPPORT | $5,000 |
| CHRISTEL HOUSE FOUNDATION | ||||||
| 10 W MARKET STREET SUITE 1990 | INDIANAPOLIS | IN | 46204 | PUBLIC CHARITY | PROGRAM SUPPORT | $1,000 |
| CONNER PRAIRIE | ||||||
| 13400 ALLISONVILLE ROAD | FISHERS | IN | 46038 | PUBLIC CHARITY | PROGRAM SUPPORT | $5,000 |
| CORNEA RESEARCH FOUNDATION OF AMERICA | ||||||
| 9002 N MERIDIAN ST STE 212 | INDIANAPOLIS | IN | 46260 | PUBLIC CHARITY | PROGRAM SUPPORT | $1,000 |
| FRIENDS OF HONDURAN CHILDREN INC | ||||||
| 1910 N ARLINGTON AVENUE | INDIANAPOLIS | IN | 46218 | PUBLIC CHARITY | PROGRAM SUPPORT | $100 |
| HOOSIER VETERANS ASSISTANCE FOUNDATION | ||||||
| 964 N PENNSYLVANIA STREET | INDIANAPOLIS | IN | 46204 | PUBLIC CHARITY | PROGRAM SUPPORT | $350 |
| HUMANE SOCIETY OF HAMILTON COUNTY | ||||||
| 1721 PLEASANT STREET SUITE B | NOBLESVILLE | IN | 46060 | PUBLIC CHARITY | PROGRAM SUPPORT | $100 |
| HUMANE SOCIETY OF INDIANAPOLIS | ||||||
| 7929 MICHIGAN ROAD | INDIANAPOLIS | IN | 46268 | PUBLIC CHARITY | PROGRAM SUPPORT | $100 |
| INDIANA HISTORICAL SOCIETY | ||||||
| 450 W OHIO STREET | INDIANAPOLIS | IN | 46202 | PUBLIC CHARITY | PROGRAM SUPPORT | $5,000 |
| INDIANA REPERTORY TREATRE | ||||||
| 140 W WASHINGTON STREET | INDIANAPOLIS | IN | 46204 | PUBLIC CHARITY | PROGRAM SUPPORT | $2,500 |
| INDIANAPOLIS ZOOLOGICAL SOCIETY | ||||||
| 1200 W WASHINGTON STREET | INDIANAPOLIS | IN | 46222 | PUBLIC CHARITY | PROGRAM SUPPORT | $5,000 |
| JUVENILE DIABETES FOUNDATION #201 | ||||||
| 10401 N MERIDIAN STREET STE 150 | INDIANAPOLIS | IN | 46290 | PUBLIC CHARITY | PROGRAM SUPPORT | $400 |
| KATE'S KART | ||||||
| 429 E DUPONT ROAD 119 | FORT WAYNE | IN | 46825 | PUBLIC CHARITY | PROGRAM SUPPORT | $100 |
| KIDNEY CANCER ASSOCIATION | ||||||
| PO BOX 803338 38269 | CHICAGO | IL | 60680 | PUBLIC CHARITY | PROGRAM SUPPORT | $300 |
| LITTLE SISTERS OF THE POOR | ||||||
| 2345 WEST 86TH STREET | INDIANAPOLIS | IN | 46260 | PUBLIC CHARITY | PROGRAM SUPPORT | $1,000 |
| MARIAN UNIVERSITY | ||||||
| 3200 COLD SPRING ROAD | INDIANAPOLIS | IN | 46222 | PUBLIC CHARITY | PROGRAM SUPPORT | $8,000 |
| MARINE TOYS FOR TOTS FOUNDATION | ||||||
| 18251 QUANTICO GATEWAY DRIVE | TRIANGLE | VA | 22172 | PUBLIC CHARITY | PROGRAM SUPPORT | $200 |
| MATTHEW 25 | ||||||
| 1045 W 146TH STREET SUITE A | CARMEL | IN | 46032 | PUBLIC CHARITY | PROGRAM SUPPORT | $200 |
| MERCIFUL HELP CENTER | ||||||
| 1045 W 146TH STREET SUITE A | CARMEL | IN | 46032 | PUBLIC CHARITY | PROGRAM SUPPORT | $100 |
| OUR LADY MOUNT CARMEL - THE GABRIEL PROJECT | ||||||
| 1045 W 146TH STREET SUITE A | CARMEL | IN | 46032 | PUBLIC CHARITY | PROGRAM SUPPORT | $100 |
| PEYTON MANNING CHILDREN'S HOSPITAL | ||||||
| 8402 HARCOURT ROAD SUITE 210 | INDIANAPOLIS | IN | 46260 | PUBLIC CHARITY | PROGRAM SUPPORT | $200 |
| PURDUE UNIVERSITY FOUNDATION | ||||||
| 403 W WOOD STREET | WEST LAFAYETTE | IN | 47907 | PUBLIC CHARITY | PROGRAM SUPPORT | $6,100 |
| RILEY CHILDREN'S FOUNDATION | ||||||
| 30 S MERIDIAN STREET STE 200 | INDIANAPOLIS | IN | 46204 | PUBLIC CHARITY | PROGRAM SUPPORT | $200 |
| SAGAMORE INSTITUTE FOR POLICY RESEARCH | ||||||
| 1630 N MERIDIAN STREET STE 450 | INDIANAPOLIS | IN | 46202 | PUBLIC CHARITY | PROGRAM SUPPORT | $2,500 |
| SEEDS OF HOPE INC | ||||||
| 1425 S MICKLEY AVENUE | INDIANAPOLIS | IN | 46241 | PUBLIC CHARITY | PROGRAM SUPPORT | $200 |
| STUDENTS AGAINST DESTRUCTIVE DECISIONS | ||||||
| 2840 N 300 E | WINCHESTER | IN | 47394 | PUBLIC CHARITY | PROGRAM SUPPORT | $100 |
| SUSAN G KOMEN FOUNDATION | ||||||
| 3500 DEPAUW BLVD STE 2070 | INDIANAPOLIS | IN | 46268 | PUBLIC CHARITY | PROGRAM SUPPORT | $100 |
| SYCAMORE FOUNDATION | ||||||
| 201 N ILLINOIS STREET STE 1701 | INDIANAPOLIS | IN | 46204 | PUBLIC CHARITY | PROGRAM SUPPORT | $1,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Grant Or Contri Paid During Year | 74150 | TotGrantOrContriPaidDuringYear |
| Tot Grant Or Contri Approved Future | 0 | TotGrantOrContriApprovedFuture |
Analysis Income Producing Acty AnalysisIncomeProducingActy
Int On Savings And Temp Cash Invst IntOnSavingsAndTempCashInvst
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion Code | 14 | ExclusionCode |
| Exclusion | $2,293 | ExclusionAmount |
Dividends And Int From Sec Part VII DividendsAndIntFromSecPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion Code | 14 | ExclusionCode |
| Exclusion | $66,144 | ExclusionAmount |
Gain Sales Assets Oth Than Invntry GainSalesAssetsOthThanInvntry
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion Code | 18 | ExclusionCode |
| Exclusion | $237,250 | ExclusionAmount |
Subtotals Part XVIA SubtotalsPartXVIA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Income | $0 | UnrelatedBusinessIncomeAmount |
| Exclusion | $305,687 | ExclusionAmount |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Part XVIA | 305687 | TotalPartXVIA |
Trnsfr Tr Rln With Noncharitable EO TrnsfrTrRlnWithNoncharitableEO
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Noncharitable EO | 0 | TrnsfrOfCashToNoncharitableEO |
| Trnsfr Oth Assets Noncharitable EO | 0 | TrnsfrOthAssetsNoncharitableEO |
| Sales Or Exchanges Of Assets | 0 | SalesOrExchangesOfAssets |
| Purchase Assets Noncharitable EO | 0 | PurchaseAssetsNoncharitableEO |
| Rental Of Facilities Etc | 0 | RentalOfFacilitiesEtc |
| Reimbursement Arrangements | 0 | ReimbursementArrangements |
| Loans Or Loan Guarantees | 0 | LoansOrLoanGuarantees |
| Performance Of Services Etc | 0 | PerformanceOfServicesEtc |
| Sharing Of Facilities Etc | 0 | SharingOfFacilitiesEtc |
| Relationships Noncharitable E Os | 0 | RelationshipsNoncharitableEOs |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees AccountingFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | ACCOUNTING FEES | Category |
| Amount | $825 | Amount |
| Net Investment Income | 825 | NetInvestmentIncome |
| Disbursements Charitable Prps | 0 | DisbursementsCharitablePrps |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corp Bonds InvestmentsCorpBonds (11 entries)
| Name Of BondNameOfBond | EOY Book ValueEOYBookValue | EOYFMVEOYFMV |
|---|---|---|
| VANGUARD FI SECS | 0 | 0 |
| EATON VANCE MUT FDS TR FLT RT | 0 | 0 |
| JPM HIGH YIELD FD | 0 | 0 |
| JPM SHORT DURATION BOND FD | 0 | 0 |
| DREYFUS /LAUREL FDS TR PRM | 0 | 0 |
| JPM INTL CURRENCY INCOME | 0 | 0 |
| DB BREN EM ASIA | 0 | 0 |
| SGD VS USD | 0 | 0 |
| JP MORGAN TR I FLOAT | 0 | 0 |
| BARC 95% PPN | 0 | 0 |
| TRIAD SECURITIES SEE STATEMENT | 200449 | 213966 |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corp Stock InvestmentsCorpStock (34 entries)
| Name Of StockNameOfStock | EOY Book ValueEOYBookValue | EOYFMVEOYFMV |
|---|---|---|
| SPDR S&P 500 EFT TRUST - 576 SHS | 0 | 0 |
| ISHARES S&P MIDCAP 400 INDEX FUND | 0 | 0 |
| DODGE & COX INTERNATIONAL STOCK | 0 | 0 |
| ARTISAN INTL VALUE FUND | 0 | 0 |
| ARBITRAGE FUNDS | 0 | 0 |
| ASTON OPTIMUM MID CAP FUND | 0 | 0 |
| JPM LARGE CAP GROWTH | 0 | 0 |
| JPM US REAL ESTATE FD | 0 | 0 |
| JPM MARKET EXPANSION INDEX | 0 | 0 |
| JPM ASIA 3 FD | 0 | 0 |
| JPM US LARGE CAP CORE PLUS | 0 | 0 |
| EDGEWOOD GROWTH FUND | 0 | 0 |
| POWERSHARES DB COMMODITY | 0 | 0 |
| MANNING & NAPIER FUND INC WORLD OPPORTUNITIES | 0 | 0 |
| MANNING & NAPIER FUND INC 3 SERIES | 0 | 0 |
| EATON VANCE MUT FDS TR GLOBAL MACRO | 0 | 0 |
| VICTORY PORTFOLIOS DIVRS STK | 0 | 0 |
| GATEWAY FUND | 0 | 0 |
| SPDR GOLD TRUST | 0 | 0 |
| HIGH BRIDGE DYNAMIC COMM | 0 | 0 |
| HSBC CONT BUFF EQ SPX | 0 | 0 |
| DB BREN EAFE | 0 | 0 |
| DB BREN ASIA BASKET | 0 | 0 |
| SG CONT BUFF EQ | 0 | 0 |
| SQ CONT BUFF EQ SPX | 0 | 0 |
| JOHN HANCOCK II | 0 | 0 |
| BNP CONT BUFF EQ | 0 | 0 |
| GS BREN EAFE | 0 | 0 |
| HSBC CONT BUFF EQ SPX | 0 | 0 |
| DB BREN BRENT CRUDE | 0 | 0 |
| JPM BREN EAFE | 0 | 0 |
| GS BREN EAFE | 0 | 0 |
| GS BREN EAFE | 0 | 0 |
| TRIAD SECURITIES SEE STATEMENT | 1389703 | 1321116 |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees OtherProfessionalFees (2 entries)
| CategoryCategory | AmountAmount | Net Investment IncomeNetInvestmentIncome | Disbursements Charitable PrpsDisbursementsCharitablePrps |
|---|---|---|---|
| INVESTMENT MANAGEMENT FEES | $5,808 | 5808 | 0 |
| TRIAD FEES | $9,045 | 9045 | 0 |
Taxes Schedule TaxesSchedule
Taxes Taxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | EXCISE TAX | Category |
| Amount | $2,666 | Amount |
| Net Investment Income | 0 | NetInvestmentIncome |
| Disbursements Charitable Prps | 0 | DisbursementsCharitablePrps |