JOHNSON FAMILY FOUNDATION: Form 990PF, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
JOHNSON FAMILY FOUNDATION (EIN 14-2009730)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-05-10
IRS object ID
201311309349101551
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-10T14:23:57-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN420714325EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MCGLADREY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11252 BELL VALLEY ROAD SUITE 300AddressLine1
CityROCKFORDCity
StateILState
ZIP Code61108ZIPCode
FieldValueIRS element (for citing)
Return Type990PFReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN142009730EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1JOHNSON FAMILY FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlJOHNNameControl

US Address USAddress

FieldValueIRS element (for citing)
Address Line13134 TALBOT TRAILAddressLine1
CityROCKFORDCity
StateILState
ZIP Code61114ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDENNIS JOHNSONName
TitleOFFICERTitle
Date Signed2013-05-09DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMICHAEL J SPODENName
PTINP00007977PTIN
Phone8152317300Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Exempt PFXExemptPF
FMV Assets EOY247700FMVAssetsEOY
Method Of Accounting CashXMethodOfAccountingCash

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Received Rev And Expnss16829ContriReceivedRevAndExpnss
Dividends Rev And Expnss7658DividendsRevAndExpnss
Dividends Net Invst Incm7658DividendsNetInvstIncm
Net Gain Sale Assets Rev And Expnss3356NetGainSaleAssetsRevAndExpnss
Gross Sales Price112892GrossSalesPrice
Capital Gain Net Incm Net Invst Incm3356CapitalGainNetIncmNetInvstIncm
Other Income Rev And Expnss826OtherIncomeRevAndExpnss
Other Income Net Invst Incm826OtherIncomeNetInvstIncm
Total Revenue And Expenses28669TotalRevenueAndExpenses
Total Net Investment Income11840TotalNetInvestmentIncome
Comp Ofcr Dir Trst Rev And Expnss0CompOfcrDirTrstRevAndExpnss
Comp Ofcr Dir Trst Net Invst Incm0CompOfcrDirTrstNetInvstIncm
Comp Ofcr Dir Trst Dsbrs Chrtbl Prps0CompOfcrDirTrstDsbrsChrtblPrps
Taxes Rev And Expnss389TaxesRevAndExpnss
Taxes Net Invst Incm39TaxesNetInvstIncm
Taxes Dsbrs Chrtbl Prps0TaxesDsbrsChrtblPrps
Other Expenses Rev And Expnss4718OtherExpensesRevAndExpnss
Other Expenses Net Invst Incm2000OtherExpensesNetInvstIncm
Other Expenses Dsbrs Chrtbl Prps0OtherExpensesDsbrsChrtblPrps
Tot Opr Expenses Rev And Expnss5107TotOprExpensesRevAndExpnss
Tot Opr Expenses Net Invst Incm2039TotOprExpensesNetInvstIncm
Tot Opr Expenses Dsbrs Chrtbl Prps0TotOprExpensesDsbrsChrtblPrps
Contri Gifts Paid Rev And Expnss75634ContriGiftsPaidRevAndExpnss
Contri Gifts Paid Dsbrs Chrtbl Prps75634ContriGiftsPaidDsbrsChrtblPrps
Total Expenses Rev And Expnss80741TotalExpensesRevAndExpnss
Total Expenses Net Invst Incm2039TotalExpensesNetInvstIncm
Total Expenses Dsbrs Chrtbl Prps75634TotalExpensesDsbrsChrtblPrps
Excess Of Revenue Over Expenses-52072ExcessOfRevenueOverExpenses
Net Investment Income9801NetInvestmentIncome

Balance Sheets BalanceSheets

FieldValueIRS element (for citing)
Cash BOY21901CashBOY
Cash EOY1699CashEOY
Cash EOYFMV1699CashEOYFMV
Accounts Receivable13000AccountsReceivable
Accounts Receivable BOY13000AccountsReceivableBOY
Accounts Receivable EOY13000AccountsReceivableEOY
Accounts Receivable EOYFMV13000AccountsReceivableEOYFMV
Investments Corp Stock BOY91764InvestmentsCorpStockBOY
Investments Corp Stock EOY66754InvestmentsCorpStockEOY
Investments Corp Stock EOYFMV79881InvestmentsCorpStockEOYFMV
Investments Corp Bonds BOY156970InvestmentsCorpBondsBOY
Investments Corp Bonds EOY150110InvestmentsCorpBondsEOY
Investments Corp Bonds EOYFMV153120InvestmentsCorpBondsEOYFMV
Total Assets BOY283635TotalAssetsBOY
Total Assets EOY231563TotalAssetsEOY
Total Assets EOYFMV247700TotalAssetsEOYFMV
Total Liabilities BOY0TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Org That Do Not Follow SFAS117XOrgThatDoNotFollowSFAS117
Capital Stock BOY0CapitalStockBOY
Capital Stock EOY0CapitalStockEOY
Paid In Or Capital Surplus BOY0PaidInOrCapitalSurplusBOY
Paid In Or Capital Surplus EOY0PaidInOrCapitalSurplusEOY
Retained Earnings BOY283635RetainedEarningsBOY
Retained Earnings EOY231563RetainedEarningsEOY
Total Net Assets BOY283635TotalNetAssetsBOY
Total Net Assets EOY231563TotalNetAssetsEOY
Total Liabilities Net Assets BOY283635TotalLiabilitiesNetAssetsBOY
Total Liabilities Net Assets EOY231563TotalLiabilitiesNetAssetsEOY

Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances

FieldValueIRS element (for citing)
Total Net Assets Fund Balances BOY283635TotalNetAssetsFundBalancesBOY
Excess Of Revenue Over Expenses-52072ExcessOfRevenueOverExpenses
Other Increases0OtherIncreases
Subtotal231563Subtotal
Other Decreases0OtherDecreases
Total Net Assets Fund Balances EOY231563TotalNetAssetsFundBalancesEOY

Capital Gains And Losses CapitalGainsAndLosses

Capital Gains And Losses Info CapitalGainsAndLossesInfo (3 entries)

Description Of AssetDescriptionOfAssetHow AcquiredHowAcquiredDate AcquiredDateAcquiredDate SoldDateSoldGross Sales PriceGrossSalesPriceCost Or Other BasisCostOrOtherBasisGain Or LossGainOrLossGains Minus Excess Or LossesGainsMinusExcessOrLosses
PUBLIC SECURITIESP2012-02-152012-10-195212451808316316
PUBLIC SECURITIESP2010-06-302012-10-09597635772820352035
CAPITAL GAINS DIVIDENDSP100510051005
FieldValueIRS element (for citing)
Capital Gain Net Income3356CapitalGainNetIncome

Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax

FieldValueIRS element (for citing)
Liable For4942 Tax0LiableFor4942Tax
Qualifying Distributions Year152027QualifyingDistributionsYear1
Noncharitable Assets Year1297243NoncharitableAssetsYear1
Distribution Ratio Year10.175032DistributionRatioYear1
Qualifying Distributions Year256930QualifyingDistributionsYear2
Noncharitable Assets Year2327493NoncharitableAssetsYear2
Distribution Ratio Year20.173836DistributionRatioYear2
Qualifying Distributions Year388757QualifyingDistributionsYear3
Noncharitable Assets Year3345432NoncharitableAssetsYear3
Distribution Ratio Year30.256945DistributionRatioYear3
Qualifying Distributions Year460813QualifyingDistributionsYear4
Noncharitable Assets Year4437053NoncharitableAssetsYear4
Distribution Ratio Year40.139143DistributionRatioYear4
Qualifying Distributions Year515427QualifyingDistributionsYear5
Noncharitable Assets Year5492985NoncharitableAssetsYear5
Distribution Ratio Year50.031293DistributionRatioYear5
Total Distribution Ratio0.776249TotalDistributionRatio
Average Distribution Ratio0.155250AverageDistributionRatio
Net Noncharitable Assets264979NetNoncharitableAssets
Adjusted Noncharitable Assets41138AdjustedNoncharitableAssets
One Percent Net Investment Income98OnePercentNetInvestmentIncome
Adj Nonchrtbl Assets And One41236AdjNonchrtblAssetsAndOnePct
Qualifying Distributions75634QualifyingDistributions

Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm

FieldValueIRS element (for citing)
Domestic Org Meeting Sect4940eXDomesticOrgMeetingSect4940e
Investment Income Excise Tax98InvestmentIncomeExciseTax
Tax Under Section5110TaxUnderSection511
Subtotal98Subtotal
Subtitle A Tax0SubtitleATax
Tax Based On Investment Income98TaxBasedOnInvestmentIncome
Est Tax Payments And Overpayment362EstTaxPaymentsAndOverpayment
Total Credits And Payments362TotalCreditsAndPayments
Overpayment264Overpayment
Amount Credited To Next Year264AmountCreditedToNextYear
Amount To Be Refunded0AmountToBeRefunded

Statements Regarding Activities StatementsRegardingActivities

FieldValueIRS element (for citing)
Legislative Political Activities0LegislativePoliticalActivities
More Than100 Spent0MoreThan100Spent
Form1120 POL Filed0Form1120POLFiled
Sect4955 Tax On Organization0Sect4955TaxOnOrganization
Sect4955 Tax On Managers0Sect4955TaxOnManagers
Reimbursement Of Tax0ReimbursementOfTax
Activities Not Prev Reported0ActivitiesNotPrevReported
Changes To Articles Or Bylaws0ChangesToArticlesOrBylaws
Unrelated Bus Income Over10000UnrelatedBusIncomeOver1000
Termination Etc0TerminationEtc
Requirements Of Sect508e0RequirementsOfSect508e
At Least5000 In Assets1AtLeast5000InAssets
States Filed WithILStatesFiledWith
Form990 PF Filed With AG1Form990PFFiledWithAG
Private Operating Foundation0PrivateOperatingFoundation
New Substantial Contributors0NewSubstantialContributors
Interest In Controlled Entity0InterestInControlledEntity
Applicable Insurance Contract0ApplicableInsuranceContract
Comply With Public Inspection Rqr1ComplyWithPublicInspectionRqr
Website AddressN/AWebsiteAddress
Books In Care Of Person NameDENNIS JOHNSONBooksInCareOfPersonName
Books In Care Of Phone Number9999999999BooksInCareOfPhoneNumber

Books In Care Of US Address BooksInCareOfUSAddress

FieldValueIRS element (for citing)
Address Line13134 TALBOT TRAILAddressLine1
CityROCKFORDCity
StateILState
ZIP Code61114ZIPCode
FieldValueIRS element (for citing)
Foreign Bank0ForeignBank

Statements Regarding Acty4720 StatementsRegardingActy4720

FieldValueIRS element (for citing)
Sale Or Exchange With Dsqfly Person0SaleOrExchangeWithDsqflyPerson
Borrow Or Lend With Dsqfly Person0BorrowOrLendWithDsqflyPerson
Furnished Goods With Dsqfly Person0FurnishedGoodsWithDsqflyPerson
Pay Compensation To Dsqfly Person0PayCompensationToDsqflyPerson
Transfer Assets To Dsqfly Person0TransferAssetsToDsqflyPerson
Payment To Government Offical0PaymentToGovernmentOffical
Uncorrected Prior Acts0UncorrectedPriorActs
Undistributed Income Prior Years0UndistributedIncomePriorYears
Business Holdings0BusinessHoldings
Jeopardy Investments0JeopardyInvestments
Uncorrected Jeopardy Investments0UncorrectedJeopardyInvestments
Influence Legislation0InfluenceLegislation
Influence Election0InfluenceElection
Grants To Individuals0GrantsToIndividuals
Grants To Organizations0GrantsToOrganizations
Noncharitable Purpose0NoncharitablePurpose
Rcv Funds To Pay Prsnl Bnft Contract0RcvFundsToPayPrsnlBnftContract
Pay Premiums Prsnl Bnft Contract0PayPremiumsPrsnlBnftContract
Prohibited Tax Shelter Transactn0ProhibitedTaxShelterTransactn

Ofcr Dir Trustees Key Employee Info OfcrDirTrusteesKeyEmployeeInfo

Ofcr Dir Trustees Or Key Employee OfcrDirTrusteesOrKeyEmployee (5 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeTitleTitleAvg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPositionCompensationCompensationContri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtcExpense Account Other AllowancesExpenseAccountOtherAllowances
DENNIS W JOHNSON
3134 TALBOT TRAILROCKFORDIL61114PRESIDENT0.00000
EVELYN J JOHNSON
3134 TALBOT TRAILROCKFORDIL61114SECRETARY0.00000
TONYA MEISTER
5335 PEPPER DRIVEROCKFORDIL61114DIRECTOR0.00000
CARY JOHNSON
8075 SLATER DRIVEROCKFORDIL61108DIRECTOR0.00000
RYNN JOHNSON
5271 DEERE POINTEROCKFORDIL61114DIRECTOR0.00000
FieldValueIRS element (for citing)
Comp Of Highest Paid Empl NONENONECompOfHighestPaidEmplNONE
Tot Number Of Oth Empl Paid Over50k0TotNumberOfOthEmplPaidOver50k
Comp Of Hghst Paid Cntrct NONENONECompOfHghstPaidCntrctNONE
Tot Number Of Cntrct Paid Over50k0TotNumberOfCntrctPaidOver50k

Sum Of Program Related Investments SumOfProgramRelatedInvestments

FieldValueIRS element (for citing)
Total0Total

Minimum Investment Return MinimumInvestmentReturn

FieldValueIRS element (for citing)
Avg Monthly FMV Of Securities249932AvgMonthlyFMVOfSecurities
Avg Monthly Cash Balances19082AvgMonthlyCashBalances
FMV All Other Noncharitable Assets0FMVAllOtherNoncharitableAssets
Total FMV Of Unused Assets269014TotalFMVOfUnusedAssets
Reduction Claimed0ReductionClaimed
Acquisition Indebtedness0AcquisitionIndebtedness
Adj Total FMV Of Unused Assets269014AdjTotalFMVOfUnusedAssets
Cash Deemed Charitable4035CashDeemedCharitable
Net Noncharitable Assets264979NetNoncharitableAssets
Minimum Investment Return13249MinimumInvestmentReturn

Distributable DistributableAmount

FieldValueIRS element (for citing)
Minimum Investment Return13249MinimumInvestmentReturn
Tax Based On Investment Income98TaxBasedOnInvestmentIncome
Total Tax98TotalTax
Distributable Amount Before Adj13151DistributableAmountBeforeAdj
Recoveries Qlfy Distributions0RecoveriesQlfyDistributions
Distributable Amount Before Ded13151DistributableAmountBeforeDed
Deduction Fr Distributable$0DeductionFrDistributableAmount
Distributable Amount As Adjusted13151DistributableAmountAsAdjusted

Qualifying Distributions QualifyingDistributions

FieldValueIRS element (for citing)
Expenses And Contributions75634ExpensesAndContributions
Program Related Investments Total0ProgramRelatedInvestmentsTotal
Qualifying Distributions75634QualifyingDistributions
One Pct Sect4940e Org Net Invst Incm98OnePctSect4940eOrgNetInvstIncm
Adj Qualifying Distributions75536AdjQualifyingDistributions

Undistributed Income UndistributedIncome

FieldValueIRS element (for citing)
Distributable Amount As Adjusted13151DistributableAmountAsAdjusted
Undistributed Income Prior Year0UndistributedIncomePriorYear
Total For Prior Years0TotalForPriorYears
Excess Distri Carryover Year58269ExcessDistriCarryoverYear5
Excess Distri Carryover Year439146ExcessDistriCarryoverYear4
Excess Distri Carryover Year371485ExcessDistriCarryoverYear3
Excess Distri Carryover Year241177ExcessDistriCarryoverYear2
Excess Distri Carryover Year137419ExcessDistriCarryoverYear1
Total Excess Distri Carryover197496TotalExcessDistriCarryover
Qualifying Distributions75634QualifyingDistributions
Applied To Year10AppliedToYear1
Applied To Prior Years0AppliedToPriorYears
Treated As Distri From Corpus0TreatedAsDistriFromCorpus
Applied To Current Year13151AppliedToCurrentYear
Remaining Distri From Corpus62483RemainingDistriFromCorpus
Excess Distri Cyov App CY Corpus0ExcessDistriCyovAppCYCorpus
Excess Distri Cyov Applied CY0ExcessDistriCyovAppliedCY
Total Corpus259979TotalCorpus
Prior Year Undistributed Income0PriorYearUndistributedIncome
Prior Year Deficiency Or Tax0PriorYearDeficiencyOrTax
Taxable Amount10TaxableAmount1
Taxable Amount20TaxableAmount2
Undistributed Income CY0UndistributedIncomeCY
Distri From Corpus170b1 E Or4942g30DistriFromCorpus170b1EOr4942g3
Excess Distri Cyov From Year58269ExcessDistriCyovFromYear5
Excess Distri Cyov To Next Year251710ExcessDistriCyovToNextYear
Excess From Year439146ExcessFromYear4
Excess From Year371485ExcessFromYear3
Excess From Year241177ExcessFromYear2
Excess From Year137419ExcessFromYear1
Excess From Current Year62483ExcessFromCurrentYear

Supplementary Information SupplementaryInformation

FieldValueIRS element (for citing)
Contributing ManagerDENNIS W JOHNSONContributingManager

Appication Submission Info AppicationSubmissionInfo

FieldValueIRS element (for citing)
Recipient NameDENNIS W JOHNSONRecipientName

Recipient US Address RecipientUSAddress

FieldValueIRS element (for citing)
Address Line13134 TALBOT TRAILAddressLine1
CityROCKFORDCity
StateILState
ZIP Code61114ZIPCode
FieldValueIRS element (for citing)
Recipient Phone Number9999999999RecipientPhoneNumber
Form And Info And MaterialsINITIAL INQUIRY SHOULD BE BRIEF, INDICATING THE NATURE OF THE PROJECT FOR WHICH SUPPORT IS SOUGHT.FormAndInfoAndMaterials
Submission DeadlinesNONESubmissionDeadlines
Restrictions On AwardsNONERestrictionsOnAwards

Grant Or Contri Paid During Year GrantOrContriPaidDuringYear (11 entries)

Address Line1RecipientUSAddress/AddressLine1CityRecipientUSAddress/CityStateRecipientUSAddress/StateZIP CodeRecipientUSAddress/ZIPCodeRecipient RelationshipRecipientRelationshipRecipient Foundation StatusRecipientFoundationStatusPurpose Of Grant Or ContributionPurposeOfGrantOrContributionAmountAmount
BURPEE MUSEUM
737 NORTH MAIN STREETROCKFORDIL61103NONEPUBLICEDUCATIONAL$250
DAVID C COOK
PO BOX 36720COLORADO SPRINGSCO80936NONEN/ARELIGIOUS$16,082
FIRST FREE CHURCH
2223 N MULFORD RDROCKFORDIL61107NONEPUBLICRELIGIOUS$10,250
KIDS AROUND THE WORLD
PO BOX 5225ROCKFORDIL61108NONEPUBLICGENERAL$40,273
ROCKFORD CHRISTIAN SCHOOLS
1401 N BELL SCHOOL ROADROCKFORDIL61107NONEPUBLICEDUCATIONAL$660
ROCKFORD COLLEGE
5050 EAST STATE STREETROCKFORDIL61108NONEPUBLICEDUCATIONAL$2,000
ROCKFORD RENEWAL MINISTRIES
611 NORTH COURT STREETROCKFORDIL61103NONEPUBLICGENERAL$150
WESTMINSTER CHURCH
2821 NORTH BELL SCHOOLROCKFORDIL61107NONEPUBLICRELIGIOUS$219
WINNEBAGO COUNTY CASA
403 ELM STREETROCKFORDIL61101NONEPUBLICGENERAL$250
FJC FOUNDATION
520 EIGHTH AVENUE 20TH FLOORNEW YORKNY10018NONEPUBLICGENERAL$500
SWEDISH AMERICAN HOSPITAL FOUNDATION
1401 EAST STATE STREETROCKFORDIL61104NONEPUBLICGENERAL$5,000
FieldValueIRS element (for citing)
Tot Grant Or Contri Paid During Year75634TotGrantOrContriPaidDuringYear
Tot Grant Or Contri Approved Future0TotGrantOrContriApprovedFuture

Analysis Income Producing Acty AnalysisIncomeProducingActy

Dividends And Int From Sec Part VII DividendsAndIntFromSecPartVII

FieldValueIRS element (for citing)
Exclusion Code14ExclusionCode
Exclusion$7,658ExclusionAmount

Other Investment Income Part VII OtherInvestmentIncomePartVII

FieldValueIRS element (for citing)
Exclusion Code14ExclusionCode
Exclusion$826ExclusionAmount

Gain Sales Assets Oth Than Invntry GainSalesAssetsOthThanInvntry

FieldValueIRS element (for citing)
Exclusion Code18ExclusionCode
Exclusion$3,356ExclusionAmount

Subtotals Part XVIA SubtotalsPartXVIA

FieldValueIRS element (for citing)
Unrelated Business Income$0UnrelatedBusinessIncomeAmount
Exclusion$11,840ExclusionAmount
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Part XVIA11840TotalPartXVIA

Rln Of Acty To Accom Of Exempt Prps RlnOfActyToAccomOfExemptPrps

Rln Of Acty To Accom Of Exempt Prps RlnOfActyToAccomOfExemptPrps

FieldValueIRS element (for citing)
Line Number1LineNumber
Relationship StatementNONERelationshipStatement

Trnsfr Tr Rln With Noncharitable EO TrnsfrTrRlnWithNoncharitableEO

FieldValueIRS element (for citing)
Trnsfr Of Cash To Noncharitable EO0TrnsfrOfCashToNoncharitableEO
Trnsfr Oth Assets Noncharitable EO0TrnsfrOthAssetsNoncharitableEO
Sales Or Exchanges Of Assets0SalesOrExchangesOfAssets
Purchase Assets Noncharitable EO0PurchaseAssetsNoncharitableEO
Rental Of Facilities Etc0RentalOfFacilitiesEtc
Reimbursement Arrangements0ReimbursementArrangements
Loans Or Loan Guarantees0LoansOrLoanGuarantees
Performance Of Services Etc0PerformanceOfServicesEtc
Sharing Of Facilities Etc0SharingOfFacilitiesEtc
Relationships Noncharitable E Os0RelationshipsNoncharitableEOs

Schedule B IRS990ScheduleB

FieldValueIRS element (for citing)
Organization501c3 Exempt PFXOrganization501c3ExemptPF
General RuleXGeneralRule

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor Number1ContributorNumber
Contributor Name IndividualDENNIS W JOHNSONContributorNameIndividual

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line13134 TALBOT TRAILAddressLine1
CityROCKFORDCity
StateILState
ZIP Code61114ZIPCode
FieldValueIRS element (for citing)
Aggregate Contributions16829AggregateContributions
Person Contribution TypeXPersonContributionType
Noncash Contribution TypeXNoncashContributionType

Noncash Property NoncashProperty

FieldValueIRS element (for citing)
Contributor Number From Part I1ContributorNumberFromPartI
Noncash Property DescriptionISHARES RUSSELL INDEX FDMIDCAP INDEX FUND SHARES: IWRNoncashPropertyDescription
Fair Market Value16829FairMarketValue
Date Received2012-12-26DateReceived

Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule

Investments Corp Bonds InvestmentsCorpBonds

FieldValueIRS element (for citing)
Name Of BondBONDSNameOfBond
EOY Book Value150110EOYBookValue
EOYFMV153120EOYFMV

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corp Stock InvestmentsCorpStock

FieldValueIRS element (for citing)
Name Of StockSTOCKNameOfStock
EOY Book Value66754EOYBookValue
EOYFMV79881EOYFMV

Other Expenses Schedule OtherExpensesSchedule

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionRevenue And Expenses Per BooksRevenueAndExpensesPerBooksNet Investment IncomeNetInvestmentIncomeDisbursements Charitable PrpsDisbursementsCharitablePrps
ADVISOR FEES200020000
IL FILING FEE2500
MISCELLANEOUS EXPENSE269300

Other Income Schedule2 OtherIncomeSchedule2

Other Income OtherIncome

FieldValueIRS element (for citing)
DescriptionSECURITIES SETTLEMENTDescription
Revenue And Expenses Per Books826RevenueAndExpensesPerBooks
Net Investment Income826NetInvestmentIncome
Adjusted Net Income826AdjustedNetIncome

Taxes Schedule TaxesSchedule

Taxes Taxes (2 entries)

CategoryCategoryAmountAmountNet Investment IncomeNetInvestmentIncomeDisbursements Charitable PrpsDisbursementsCharitablePrps
FOREIGN TAXES$39390
EXCISE TAX$35000

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