HANS & CAY JACOBSEN CHARITABLE FOUN DATION INC: Form 990PF, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- HANS & CAY JACOBSEN CHARITABLE FOUN DATION INC (EIN 59-3010451)
- Tax period
- 2012-06-01 to 2013-05-31
- Filed
- 2013-09-05
- IRS object ID
- 201322489349100207
- 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
- Legal Fees Schedule
- Other Expenses Schedule
- Other Income Schedule2
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-09-05T14:14:15-05:00 | Timestamp |
| Tax Period End Date | 2013-05-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 204193611 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Batts Morrison Wales & Lee PA | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 North Orange Avenue Suite 800 | AddressLine1 |
| City | Orlando | City |
| State | FL | State |
| ZIP Code | 32801 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnType |
| Tax Period Begin Date | 2012-06-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 593010451 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Hans and Cay Jacobsen Charitable Foundation Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HANS | NameControl |
| Phone | 4078106672 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2149 | AddressLine1 |
| City | Winter Park | City |
| State | FL | State |
| ZIP Code | 32790 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Teresa W Borcheck | Name |
| Title | President | Title |
| Phone | 4078106672 | Phone |
| Date Signed | 2013-08-26 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Michele M Wales | Name |
| PTIN | P00428093 | PTIN |
| Phone | 4077706000 | Phone |
| Date Prepared | 2013-08-26 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exempt PF | X | ExemptPF |
| FMV Assets EOY | 5558900 | 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 |
| Dividends Rev And Expnss | 122904 | DividendsRevAndExpnss |
| Dividends Net Invst Incm | 122904 | DividendsNetInvstIncm |
| Net Gain Sale Assets Rev And Expnss | 32889 | NetGainSaleAssetsRevAndExpnss |
| Gross Sales Price | 865428 | GrossSalesPrice |
| Capital Gain Net Incm Net Invst Incm | 32889 | CapitalGainNetIncmNetInvstIncm |
| Other Income Rev And Expnss | 11559 | OtherIncomeRevAndExpnss |
| Other Income Net Invst Incm | 1559 | OtherIncomeNetInvstIncm |
| Total Revenue And Expenses | 167352 | TotalRevenueAndExpenses |
| Total Net Investment Income | 157352 | TotalNetInvestmentIncome |
| Comp Ofcr Dir Trst Rev And Expnss | 32000 | CompOfcrDirTrstRevAndExpnss |
| Comp Ofcr Dir Trst Net Invst Incm | 8000 | CompOfcrDirTrstNetInvstIncm |
| Comp Ofcr Dir Trst Dsbrs Chrtbl Prps | 24000 | CompOfcrDirTrstDsbrsChrtblPrps |
| Legal Fees Rev And Expnss | 2500 | LegalFeesRevAndExpnss |
| Legal Fees Net Invst Incm | 2500 | LegalFeesNetInvstIncm |
| Legal Fees Dsbrs Chrtbl Prps | 0 | LegalFeesDsbrsChrtblPrps |
| Accounting Fees Rev And Expnss | 12415 | AccountingFeesRevAndExpnss |
| Accounting Fees Net Invst Incm | 12415 | AccountingFeesNetInvstIncm |
| Accounting Fees Dsbrs Chrtbl Prps | 0 | AccountingFeesDsbrsChrtblPrps |
| Other Prof Fees Rev And Expnss | 36854 | OtherProfFeesRevAndExpnss |
| Other Prof Fees Net Invst Incm | 18427 | OtherProfFeesNetInvstIncm |
| Other Prof Fees Dsbrs Chrtbl Prps | 18427 | OtherProfFeesDsbrsChrtblPrps |
| Taxes Rev And Expnss | 11315 | TaxesRevAndExpnss |
| Taxes Net Invst Incm | 0 | TaxesNetInvstIncm |
| Taxes Dsbrs Chrtbl Prps | 0 | TaxesDsbrsChrtblPrps |
| Trav Conf Meeting Rev And Expnss | 3388 | TravConfMeetingRevAndExpnss |
| Trav Conf Meeting Net Invst Incm | 3388 | TravConfMeetingNetInvstIncm |
| Trav Conf Meeting Dsbrs Chrtbl Prps | 0 | TravConfMeetingDsbrsChrtblPrps |
| Other Expenses Rev And Expnss | 5211 | OtherExpensesRevAndExpnss |
| Other Expenses Net Invst Incm | 5211 | OtherExpensesNetInvstIncm |
| Other Expenses Dsbrs Chrtbl Prps | 0 | OtherExpensesDsbrsChrtblPrps |
| Tot Opr Expenses Rev And Expnss | 103683 | TotOprExpensesRevAndExpnss |
| Tot Opr Expenses Net Invst Incm | 49941 | TotOprExpensesNetInvstIncm |
| Tot Opr Expenses Dsbrs Chrtbl Prps | 42427 | TotOprExpensesDsbrsChrtblPrps |
| Contri Gifts Paid Rev And Expnss | 240000 | ContriGiftsPaidRevAndExpnss |
| Contri Gifts Paid Dsbrs Chrtbl Prps | 240000 | ContriGiftsPaidDsbrsChrtblPrps |
| Total Expenses Rev And Expnss | 343683 | TotalExpensesRevAndExpnss |
| Total Expenses Net Invst Incm | 49941 | TotalExpensesNetInvstIncm |
| Total Expenses Dsbrs Chrtbl Prps | 282427 | TotalExpensesDsbrsChrtblPrps |
| Excess Of Revenue Over Expenses | -176331 | ExcessOfRevenueOverExpenses |
| Net Investment Income | 107411 | NetInvestmentIncome |
Balance Sheets BalanceSheets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | 5905 | CashBOY |
| Cash EOY | 15704 | CashEOY |
| Cash EOYFMV | 15704 | CashEOYFMV |
| Investments Corp Stock BOY | 3414063 | InvestmentsCorpStockBOY |
| Investments Corp Stock EOY | 3011179 | InvestmentsCorpStockEOY |
| Investments Corp Stock EOYFMV | 3909759 | InvestmentsCorpStockEOYFMV |
| Investments Corp Bonds BOY | 1402110 | InvestmentsCorpBondsBOY |
| Investments Corp Bonds EOY | 1618864 | InvestmentsCorpBondsEOY |
| Investments Corp Bonds EOYFMV | 1633437 | InvestmentsCorpBondsEOYFMV |
| Total Assets BOY | 4822078 | TotalAssetsBOY |
| Total Assets EOY | 4645747 | TotalAssetsEOY |
| Total Assets EOYFMV | 5558900 | TotalAssetsEOYFMV |
| Total Liabilities BOY | 0 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Org That Follow SFAS117 | X | OrgThatFollowSFAS117 |
| Unrestricted BOY | 4822078 | UnrestrictedBOY |
| Unrestricted EOY | 4645747 | UnrestrictedEOY |
| Total Net Assets BOY | 4822078 | TotalNetAssetsBOY |
| Total Net Assets EOY | 4645747 | TotalNetAssetsEOY |
| Total Liabilities Net Assets BOY | 4822078 | TotalLiabilitiesNetAssetsBOY |
| Total Liabilities Net Assets EOY | 4645747 | TotalLiabilitiesNetAssetsEOY |
Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Net Assets Fund Balances BOY | 4822078 | TotalNetAssetsFundBalancesBOY |
| Excess Of Revenue Over Expenses | -176331 | ExcessOfRevenueOverExpenses |
| Other Increases | 0 | OtherIncreases |
| Subtotal | 4645747 | Subtotal |
| Other Decreases | 0 | OtherDecreases |
| Total Net Assets Fund Balances EOY | 4645747 | TotalNetAssetsFundBalancesEOY |
Capital Gains And Losses CapitalGainsAndLosses
Capital Gains And Losses Info CapitalGainsAndLossesInfo (2 entries)
| Description Of AssetDescriptionOfAsset | How AcquiredHowAcquired | Gross Sales PriceGrossSalesPrice | Cost Or Other BasisCostOrOtherBasis | Gain Or LossGainOrLoss | Gains Minus Excess Or LossesGainsMinusExcessOrLosses |
|---|---|---|---|---|---|
| Publicly traded securities | P | 831655 | 832539 | -884 | -884 |
| Capital Gains Dividends | P | 33773 | 33773 | 33773 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | 32889 | CapitalGainNetIncome |
Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable For4942 Tax | 0 | LiableFor4942Tax |
| Qualifying Distributions Year1 | 221179 | QualifyingDistributionsYear1 |
| Noncharitable Assets Year1 | 5121082 | NoncharitableAssetsYear1 |
| Distribution Ratio Year1 | 0.043190 | DistributionRatioYear1 |
| Qualifying Distributions Year2 | 226363 | QualifyingDistributionsYear2 |
| Noncharitable Assets Year2 | 4972921 | NoncharitableAssetsYear2 |
| Distribution Ratio Year2 | 0.045519 | DistributionRatioYear2 |
| Qualifying Distributions Year3 | 283894 | QualifyingDistributionsYear3 |
| Noncharitable Assets Year3 | 4719818 | NoncharitableAssetsYear3 |
| Distribution Ratio Year3 | 0.060149 | DistributionRatioYear3 |
| Qualifying Distributions Year4 | 68969 | QualifyingDistributionsYear4 |
| Noncharitable Assets Year4 | 4536229 | NoncharitableAssetsYear4 |
| Distribution Ratio Year4 | 0.015204 | DistributionRatioYear4 |
| Qualifying Distributions Year5 | 433742 | QualifyingDistributionsYear5 |
| Noncharitable Assets Year5 | 5901418 | NoncharitableAssetsYear5 |
| Distribution Ratio Year5 | 0.073498 | DistributionRatioYear5 |
| Total Distribution Ratio | 0.237560 | TotalDistributionRatio |
| Average Distribution Ratio | 0.047512 | AverageDistributionRatio |
| Net Noncharitable Assets | 5310615 | NetNoncharitableAssets |
| Adjusted Noncharitable Assets | 252318 | AdjustedNoncharitableAssets |
| One Percent Net Investment Income | 1074 | OnePercentNetInvestmentIncome |
| Adj Nonchrtbl Assets And One | 253392 | AdjNonchrtblAssetsAndOnePct |
| Qualifying Distributions | 282427 | QualifyingDistributions |
Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm
| Field | Value | IRS element (for citing) |
|---|---|---|
| Domestic Org Meeting Sect4940e | X | DomesticOrgMeetingSect4940e |
| Investment Income Excise Tax | 1074 | InvestmentIncomeExciseTax |
| Tax Under Section511 | 0 | TaxUnderSection511 |
| Subtotal | 1074 | Subtotal |
| Subtitle A Tax | 0 | SubtitleATax |
| Tax Based On Investment Income | 1074 | TaxBasedOnInvestmentIncome |
| Est Tax Payments And Overpayment | 11750 | EstTaxPaymentsAndOverpayment |
| Total Credits And Payments | 11750 | TotalCreditsAndPayments |
| Overpayment | 10676 | Overpayment |
| Amount Credited To Next Year | 1076 | AmountCreditedToNextYear |
| Amount To Be Refunded | 9600 | 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 | FL | 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 | www.hansandcayjacobsenfoundation.org | WebsiteAddress |
| Books In Care Of Person Name | Capital City Trust Company | BooksInCareOfPersonName |
| Books In Care Of Phone Number | 8668209671 | BooksInCareOfPhoneNumber |
Books In Care Of US Address BooksInCareOfUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1549 | AddressLine1 |
| City | Tallahassee | City |
| State | FL | State |
| ZIP Code | 323021549 | 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 | 1 | PayCompensationToDsqflyPerson |
| Transfer Assets To Dsqfly Person | 0 | TransferAssetsToDsqflyPerson |
| Payment To Government Offical | 0 | PaymentToGovernmentOffical |
| Acts Fail To Qualify As Exceptions | 0 | ActsFailToQualifyAsExceptions |
| 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 (4 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 |
|---|---|---|---|---|---|---|---|---|
| Teresa W Borcheck | ||||||||
| PO Box 2149 | Winter Park | FL | 32790 | President | 10.00 | 14000 | 0 | 0 |
| W Thomas Brooks | ||||||||
| PO Box 2149 | Winter Park | FL | 32790 | Vice President | 2.00 | 6000 | 0 | 0 |
| Brian Brooks | ||||||||
| PO Box 2149 | Winter Park | FL | 32790 | Treasurer | 2.00 | 6000 | 0 | 0 |
| Shannon Mclin Carlyle | ||||||||
| PO Box 2149 | Winter Park | FL | 32790 | Secretary | 2.00 | 6000 | 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 | 5338942 | AvgMonthlyFMVOfSecurities |
| Avg Monthly Cash Balances | 52545 | AvgMonthlyCashBalances |
| FMV All Other Noncharitable Assets | 0 | FMVAllOtherNoncharitableAssets |
| Total FMV Of Unused Assets | 5391487 | TotalFMVOfUnusedAssets |
| Reduction Claimed | 0 | ReductionClaimed |
| Acquisition Indebtedness | 0 | AcquisitionIndebtedness |
| Adj Total FMV Of Unused Assets | 5391487 | AdjTotalFMVOfUnusedAssets |
| Cash Deemed Charitable | 80872 | CashDeemedCharitable |
| Net Noncharitable Assets | 5310615 | NetNoncharitableAssets |
| Minimum Investment Return | 265531 | MinimumInvestmentReturn |
Distributable DistributableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | 265531 | MinimumInvestmentReturn |
| Tax Based On Investment Income | 1074 | TaxBasedOnInvestmentIncome |
| Total Tax | 1074 | TotalTax |
| Distributable Amount Before Adj | 264457 | DistributableAmountBeforeAdj |
| Recoveries Qlfy Distributions | 10000 | RecoveriesQlfyDistributions |
| Distributable Amount Before Ded | 274457 | DistributableAmountBeforeDed |
| Deduction Fr Distributable | $0 | DeductionFrDistributableAmount |
| Distributable Amount As Adjusted | 274457 | DistributableAmountAsAdjusted |
Qualifying Distributions QualifyingDistributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | 282427 | ExpensesAndContributions |
| Program Related Investments Total | 0 | ProgramRelatedInvestmentsTotal |
| Qualifying Distributions | 282427 | QualifyingDistributions |
| One Pct Sect4940e Org Net Invst Incm | 1074 | OnePctSect4940eOrgNetInvstIncm |
| Adj Qualifying Distributions | 281353 | AdjQualifyingDistributions |
Undistributed Income UndistributedIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable Amount As Adjusted | 274457 | DistributableAmountAsAdjusted |
| Undistributed Income Prior Year | 20386 | UndistributedIncomePriorYear |
| Total For Prior Years | 0 | TotalForPriorYears |
| Total Excess Distri Carryover | 0 | TotalExcessDistriCarryover |
| Qualifying Distributions | 282427 | QualifyingDistributions |
| Applied To Year1 | 20386 | AppliedToYear1 |
| Applied To Prior Years | 0 | AppliedToPriorYears |
| Treated As Distri From Corpus | 0 | TreatedAsDistriFromCorpus |
| Applied To Current Year | 262041 | AppliedToCurrentYear |
| Remaining Distri From Corpus | 0 | RemainingDistriFromCorpus |
| Excess Distri Cyov App CY Corpus | 0 | ExcessDistriCyovAppCYCorpus |
| Excess Distri Cyov Applied CY | 0 | ExcessDistriCyovAppliedCY |
| Total Corpus | 0 | 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 | 12416 | UndistributedIncomeCY |
| Distri From Corpus170b1 E Or4942g3 | 0 | DistriFromCorpus170b1EOr4942g3 |
| Excess Distri Cyov From Year5 | 0 | ExcessDistriCyovFromYear5 |
| Excess Distri Cyov To Next Year | 0 | ExcessDistriCyovToNextYear |
Supplementary Information SupplementaryInformation
Appication Submission Info AppicationSubmissionInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Name | Teresa Borcheck President | RecipientName |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2149 | AddressLine1 |
| City | Winter Park | City |
| State | FL | State |
| ZIP Code | 32790 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Phone Number | 4078106672 | RecipientPhoneNumber |
| Recipient Email Address | info@hansandcayjacobsenfoundation.org | RecipientEmailAddress |
| Form And Info And Materials | Contact the Foundation directly or visit the Foundation's website at www.hansandcayjacobsenfoundation.org for information regarding form and content of applications. | FormAndInfoAndMaterials |
| Submission Deadlines | Requests are to be received by May 1 and November 1 for consideration at the semiannual meetings. | SubmissionDeadlines |
| Restrictions On Awards | Grants are generally restricted to programs which assist children and young adults, in the areas of health, education, culture, recreation, and any other programs that will add to the betterment of their life and their participation as good citizens. Grants are generally restricted to programs conducted in Lake and Sumter County, Florida. | RestrictionsOnAwards |
Grant Or Contri Paid During Year GrantOrContriPaidDuringYear (15 entries)
| Address Line1RecipientUSAddress/AddressLine1 | CityRecipientUSAddress/City | StateRecipientUSAddress/State | ZIP CodeRecipientUSAddress/ZIPCode | Recipient RelationshipRecipientRelationship | Recipient Foundation StatusRecipientFoundationStatus | Purpose Of Grant Or ContributionPurposeOfGrantOrContribution | AmountAmount |
|---|---|---|---|---|---|---|---|
| Association Of Small Foundations | |||||||
| 1720 North Street NW | Washington | DC | 200362907 | None | Educational Organiza | For programs and operations. | $1,000 |
| Beacon College Inc | |||||||
| 105 East Main Street | Leesburg | FL | 347485224 | None | Educational Organiza | For programs and operations. | $10,000 |
| Boys & Girls Club of Lake & Sumter Counties Inc | |||||||
| PO Box 896179 | Leesburg | FL | 347896179 | None | Educational Organiza | To fund Holiday Break 2012 and Overall Project Learn 2013. | $45,000 |
| Christian Home & Bible School | |||||||
| 301 West 13th Avenue | Mount Dora | FL | 327574271 | None | Educational Organiza | For programs and operations. | $20,000 |
| Church at South Lake | |||||||
| PO Box 121023 | Clermont | FL | 347121023 | None | Religious Organizati | For Buses N' Backpacks Program. | $5,000 |
| Early Learning Coalition of Lake County | |||||||
| 1300 Citizens Boulevard | Leesburg | FL | 347483965 | None | Charitable Organizat | For programs and operations. | $10,000 |
| Easter Seals Florida Inc | |||||||
| 2010 Mizell Avenue | Winter Park | FL | 327924119 | None | Charitable Organizat | Camp scholarships for Lake County children. | $10,000 |
| Haven of Lake & Sumter Counties Inc | |||||||
| 2600 South Street | Leesburg | FL | 347488740 | None | Charitable Organizat | To support Project Save Kids | $25,000 |
| Lake Sumter Childrens Advocacy Center Inc | |||||||
| 300 South Canal Street | Leesburg | FL | 347485904 | None | Charitable Organizat | For the expansion of the counseling program. | $20,000 |
| New Vision for Independence Inc | |||||||
| 9501 US Highway 441 | Leesburg | FL | 347883950 | None | Charitable Organizat | To fund the Blind Babies Program. | $10,000 |
| Southern Scholarship Foundation Inc | |||||||
| 322 Stadium Drive | Tallahassee | FL | 323043450 | None | Charitable Organizat | For programs and operations. | $6,000 |
| Special Olympics Florida Inc | |||||||
| 1915 Don Wickham Drive | Clermont | FL | 347111915 | None | Charitable Organizat | To fund a person as a young athelete trainer for Lake County. | $30,000 |
| Sumter County Youth Center | |||||||
| PO Box 2092 | Bushnell | FL | 335130109 | None | Charitable Organizat | For programs and operations. | $8,000 |
| The Boggy Creek Gang Inc | |||||||
| 30500 Brantley Branch Road | Eustis | FL | 327369596 | None | Charitable Organizat | For programs and operations. | $10,000 |
| University of Central Florida Foundation Inc | |||||||
| 12424 Research Parkway | Orlando | FL | 328263249 | None | Educational Organiza | For programs and operations and to fund nursing program. | $30,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Grant Or Contri Paid During Year | 240000 | TotGrantOrContriPaidDuringYear |
| Tot Grant Or Contri Approved Future | 0 | TotGrantOrContriApprovedFuture |
Analysis Income Producing Acty AnalysisIncomeProducingActy
Dividends And Int From Sec Part VII DividendsAndIntFromSecPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion Code | 14 | ExclusionCode |
| Exclusion | $122,904 | ExclusionAmount |
Other Investment Income Part VII OtherInvestmentIncomePartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion Code | 14 | ExclusionCode |
| Exclusion | $1,559 | ExclusionAmount |
Gain Sales Assets Oth Than Invntry GainSalesAssetsOthThanInvntry
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion Code | 14 | ExclusionCode |
| Exclusion | $32,889 | ExclusionAmount |
Other Revenue Described OtherRevenueDescribed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Recovery of prior year grants paid | Description |
| Exclusion Code | 01 | ExclusionCode |
| Exclusion | $10,000 | ExclusionAmount |
Subtotals Part XVIA SubtotalsPartXVIA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Income | $0 | UnrelatedBusinessIncomeAmount |
| Exclusion | $167,352 | ExclusionAmount |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Part XVIA | 167352 | 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 and tax advisory fees | Category |
| Amount | $12,415 | Amount |
| Net Investment Income | 12415 | NetInvestmentIncome |
| Disbursements Charitable Prps | 0 | DisbursementsCharitablePrps |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corp Bonds InvestmentsCorpBonds (5 entries)
| Name Of BondNameOfBond | EOY Book ValueEOYBookValue | EOYFMVEOYFMV |
|---|---|---|
| iShares Barclays (AGG) | 302359 | 300052 |
| iShares Barclays 1-3 Bond (CSJ) | 500177 | 506352 |
| PIMCO FDS PAC (PTLDX) | 338273 | 337747 |
| Vanguard INFLAT PRO IV (VIPSX) | 170000 | 167830 |
| PIMCO INV GRD (PIGIX) | 308055 | 321456 |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corp Stock InvestmentsCorpStock (51 entries)
| Name Of StockNameOfStock | EOY Book ValueEOYBookValue | EOYFMVEOYFMV |
|---|---|---|
| MFS Research International (MRSIX) | 233141 | 325412 |
| Templeton Income (TGBAX) | 230129 | 225810 |
| Actavis Inc (ACT) | 56570 | 100481 |
| Allstate Corp (ALL) | 28780 | 55476 |
| American Elec Pwr (AEP) | 22013 | 26576 |
| Apache Corp (APA) | 58831 | 52974 |
| Apple Inc (AAPL) | 75019 | 85450 |
| Artisan International (ARTIX) | 50000 | 67509 |
| AT&T (T) | 30554 | 37439 |
| BB&T Corp (BBT) | 39457 | 58433 |
| CF Industries Holdings (CF) | 31917 | 37237 |
| Cognizant Tech Sol CL A (CTSH) | 42869 | 42022 |
| Colgate Palmolive Co (CL) | 40633 | 52056 |
| ConocoPhillips (COP) | 47127 | 56433 |
| CVS/Caremark Corp (CVS) | 45828 | 73702 |
| Danaher Corp (DHR) | 53012 | 72638 |
| Dodge & Cox Int'l Stock Fund (DODFX) | 50000 | 63174 |
| Exxon Mobil Corp (XOM) | 64565 | 78709 |
| Federated Investors Income (FII) | 38889 | 59214 |
| Fiserv Inc (FISV) | 42172 | 68856 |
| Freeport-McMoran (FCX) | 40595 | 33068 |
| General Dynamics Corp (GD) | 27820 | 35852 |
| International Business Machs (IBM) | 59003 | 70727 |
| iShares Russell 1000 Index (IWB) | 124620 | 180840 |
| Johnson & Johnson (JNJ) | 35841 | 47141 |
| Kohls Corp (KSS) | 36458 | 39586 |
| Laboratory Corp Amer Hldgs (LH) | 45149 | 54222 |
| McDonald's (MCD) | 44519 | 48285 |
| McKesson Corp (MCK) | 50724 | 74578 |
| Metlife Inc (MET) | 42437 | 61452 |
| Microsoft Corp (MSFT) | 39504 | 52874 |
| National Oilwell Varco (NOV) | 62029 | 71355 |
| Nextera Energy (NEE) | 22169 | 30626 |
| Oppenheimer Main STR Small Cap (OPMYX) | 140000 | 174620 |
| Oracle Corp Common (ORCL) | 55763 | 63506 |
| Procter & Gamble Co (PG) | 43642 | 52964 |
| Publis Svc Enterprise Group (PEG) | 22359 | 21806 |
| Qualcom Inc (QCOM) | 50423 | 61576 |
| Roper Industries Inc (ROP) | 38143 | 63973 |
| Royce FD Premier Instl (RPFIX) | 214212 | 227474 |
| Scripps Networks Interactive (SNI) | 39435 | 65002 |
| SPDR S&P 500 Unit Ser 1 ETF (SPY) | 112070 | 163445 |
| Target Corp (TGT) | 37948 | 50735 |
| Thermo Fisher Scientific Inc (TMO) | 43890 | 75938 |
| Travelers Cos Inc (TRV) | 45640 | 75348 |
| Union Pac Corp (UNP) | 52101 | 90453 |
| United Technology Corp (UTX) | 39848 | 51246 |
| US Bancorp Del Com New (USB) | 44365 | 64510 |
| Verizon Communications (VZ) | 30526 | 40723 |
| VF Corporation (VFC) | 46406 | 67109 |
| Walmart Stores Inc (WMT) | 42034 | 59124 |
Legal Fees Schedule LegalFeesSchedule
Legal Fees LegalFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | Legal fees | Category |
| Amount | $2,500 | Amount |
| Net Investment Income | 2500 | NetInvestmentIncome |
| Disbursements Charitable Prps | 0 | DisbursementsCharitablePrps |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | Revenue And Expenses Per BooksRevenueAndExpensesPerBooks | Net Investment IncomeNetInvestmentIncome | Disbursements Charitable PrpsDisbursementsCharitablePrps |
|---|---|---|---|
| Insurance | 1266 | 1266 | 0 |
| Membership dues | 695 | 695 | 0 |
| Miscellaneous | 3250 | 3250 | 0 |
Other Income Schedule2 OtherIncomeSchedule2
Other Income OtherIncome (2 entries)
| DescriptionDescription | Revenue And Expenses Per BooksRevenueAndExpensesPerBooks | Net Investment IncomeNetInvestmentIncome | Adjusted Net IncomeAdjustedNetIncome |
|---|---|---|---|
| Miscellaneous | 1559 | 1559 | 1559 |
| Recovery of prior year grants paid | 10000 | 10000 |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees OtherProfessionalFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | Investment advisory & administrative fees | Category |
| Amount | $36,854 | Amount |
| Net Investment Income | 18427 | NetInvestmentIncome |
| Disbursements Charitable Prps | 18427 | DisbursementsCharitablePrps |
Taxes Schedule TaxesSchedule
Taxes Taxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | Federal excise tax | Category |
| Amount | $11,315 | Amount |
| Net Investment Income | 0 | NetInvestmentIncome |
| Disbursements Charitable Prps | 0 | DisbursementsCharitablePrps |
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